BMC Cancer最新文献

{"title":"Comparing the performance of DeoxyriboNucleic Acid methylation analysis and cytology for detecting cervical (pre)cancer in women with high-risk human papillomavirus-positive status in a gynecologic outpatient population.","authors":"Hong Tao, Fang Yu, Li Yang, Xiaozhu Pei, Saiping Mao, Xing Fan","doi":"10.1186/s12885-024-13126-4","DOIUrl":"10.1186/s12885-024-13126-4","url":null,"abstract":"<p><strong>Background: </strong>Primary screening for high-risk human papillomavirus (hrHPV) with cytological triage for women with non-16/18 hrHPV-positive status has become popular in China. However, cytology relies on the subjective judgment of pathologists, leading to inconsistent clinical performance.</p><p><strong>Methods: </strong>A total of 657 hrHPV-positive women aged 25-64 years were enrolled in this cross-sectional study. All participants underwent colposcopic biopsy after cytology triage, with cytology residual specimens undergoing DNA methylation testing. CIN2+ and CIN3+ sensitivity and specificity were compared between the different triage strategies (n=487): PAX1 methylation (PAX1^m) , Glycophorin C methylation (GYPC^m), cytology, and combinations between them or with HPV16/18.</p><p><strong>Results: </strong>The area under the receiver operating characteristic curves (AUCs) for PAX1^m and GYPC^m in detecting CIN2 or worse (CIN2+) were 0.867 (95% confidence interval [CI]: 0.796-0.937) and 0.873 (95% CI: 0.808-0.938), respectively. The sensitivities of PAX1^m and GYPC^m were consistent with those of cytology for both CIN2+ and CIN3+ detection. The relative specificities of PAX1^m and GYPC^m for CIN2+ detection compared to cytology were 2.83 (95% CI: 2.33-2.45) and 3.09 (95% CI: 2.40-3.98), respectively. The relative specificities of combining HPV 16/18 with PAX1^m and GYPC^m for CIN2+ detection compared to cytology were 3.38 (95% CI: 2.96-3.86) and 3.67 (95% CI: 3.15-4.27), respectively. Compared to low levels of DNA methylation, high levels of PAX1^m and GYPC^m resulted in odd ratios (ORs) of 57.66 (95% CI: 13.57-409.12, p < 0.001) and 23.87 (95% CI: 6.49-115.42, p < 0.001) for CIN3+, adjusted for HPV 16/18 and cytology results.</p><p><strong>Conclusions: </strong>PAX1^m and GYPC^m demonstrated superior ability to identify cervical precancerous lesions and cervical cancer, with AUC values exceeding 0.85. For detecting CIN2+/CIN3+ in women with hrHPV-positive status, DNA methylation (combined with HPV 16/18) showed higher specificity than cytology (combined with HPV 16/18) and is a potential molecular biomarker for detecting cervical (pre)cancer.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The optimal timing of breast cancer surgery after COVID-19 infection: an observational study.","authors":"Zhao Bi, Wei-Hao Cheng, Wen-Hao Zheng, Tong-Yue Ren, Peng Chen, Yan-Bing Liu, Peng-Fei Qiu, Wei-Li Wang, Yong-Sheng Wang","doi":"10.1186/s12885-024-13080-1","DOIUrl":"10.1186/s12885-024-13080-1","url":null,"abstract":"<p><strong>Purpose: </strong>It is controversial for the optimal time of breast cancer surgery after COVID-19 infection. Purpose was to assess the risk of postoperative complication in breast cancer patients with COVID-19 infection, in order to select optimal surgery timing after COVID-19 infection.</p><p><strong>Methods: </strong>Breast cancer patients infected with COVID-19 and performed surgery between December 20th, 2022 to March 20th, 2023 were included in this prospective study (n = 577). Patients performed surgery between May 1, 2019 to October 1, 2019 were listed as control group (n = 329). They had not been infected with COVID-19 before surgery. Patients were grouped by time of surgery relative to COVID-19 infection. Database was evaluated using logistic regression.</p><p><strong>Results: </strong>Patients infected with COVID-19 had a higher incidence of complications after surgery compared to that not-COVID-19 infection (6.59% vs. 3.04%). Multivariable logistic analysis demonstrated that timing of surgery was associated with complications (OR = 4.253; 95% CI: 0.855-21.153, P = 0.044). Patients performed surgery within 2 weeks after COVID-19 infection had the highest rates of complication (17.65%) when compared with other groups, while the incidence was decreased into 5.51% when surgery 2 weeks or more after COVID-19 infection. With a median follow-up was 10 months, all patients with complications were recovered without serious complications or death, which had no adverse effect on subsequent anti-tumor therapy.</p><p><strong>Conclusions: </strong>It needs to be cautious when breast cancer surgery was performed within 2 weeks after COVID-19 infection. Although the incidence of complications in patients undergoing surgery 2 weeks after COVID-19 infection is still slightly high, surgery might be recommended considering urgency of treatment, good prognosis of complications and the lack of influence on subsequent adjuvant therapy.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer care treatment attrition in adults: Measurement approaches and inequities in patient dropout rates - a rapid review.","authors":"Jenny Shand, Elizabeth Stovold, Lucy Goulding, Kate Cheema","doi":"10.1186/s12885-024-13096-7","DOIUrl":"10.1186/s12885-024-13096-7","url":null,"abstract":"<p><strong>Background: </strong>Cancer treatment attrition refers to the discontinuation of prescribed cancer therapies before completion. It can significantly impact patient outcomes and cancer survival rates making it a critical concern. There is growing evidence on inequalities in cancer care, the avoidable systematic differences in the health of different groups of people. Understanding the extent of treatment attrition, why it happens, for whom, and associated inequalities may improve cancer care delivery and patient outcomes.</p><p><strong>Methods: </strong>A rapid review was conducted to identify existing evidence on measures of cancer treatment attrition, definitions, reasons for attrition and potential inequalities. The review followed a systematic approach but with abbreviated processes to facilitate quicker evidence synthesis. Searches were restricted to MEDLINE and Embase databases from their inception dates to May 7, 2024. Additional searches were performed in PubMed, Google Scholar, and key grey literature from relevant organizations. Inclusion criteria were adults with any type of cancer undergoing treatment, with studies reporting quantitative or qualitative data on treatment attrition conducted outside of clinical trials. Exclusion criteria included studies on children or adolescents, clinical trials, non-English publications, and various non-research article types. Data extraction and quality assessment were performed using standardized tools, and studies were synthesized narratively.</p><p><strong>Results: </strong>The search retrieved 1,353 references, with 40 studies meeting inclusion criteria. Most studies were retrospective. Studies covered various cancer types and treatments, reporting measures of attrition and reasons for treatment drop-out. Factors influencing attrition included disease progression, death, clinical deterioration, treatment toxicity, and socioeconomic factors such as lower income or socioeconomic disadvantage.</p><p><strong>Conclusions: </strong>This review highlights significant variability in how treatment attrition is measured and defined, and suggests potential inequalities in who discontinues treatment. Standardized measures of attrition and data collection on reasons for discontinuation are essential to improve cancer care outcomes and equity. Future research should focus on developing these standardized metrics and exploring interventions targeting identified disparities to support cancer patients to complete treatment and improve outcomes.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and validation of a population pharmacokinetic model for apatinib in patients with tumors.","authors":"Li'an Zuo, Jing Ling, Nan Hu, Rong Chen","doi":"10.1186/s12885-024-13118-4","DOIUrl":"10.1186/s12885-024-13118-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a population pharmacokinetic (PPK) model for oral apatinib in Chinese oncology patients and investigate the factors influencing the pharmacokinetics of apatinib.</p><p><strong>Methods: </strong>We gathered 199 blood concentration monitoring data points from 91 inpatient oncology participants receiving oral apatinib at the Third Affiliated Hospital of Soochow University. Covariates, such as age, gender, body weight, and indices of liver and renal function, were examined to assess their influence on the pharmacokinetic parameters of apatinib. The PPK model was developed using the nonlinear mixed-effects modeling procedure (NONMEM), and model validation was conducted using the bootstrap method and normalized prediction distribution error (NPDE) method.</p><p><strong>Results: </strong>The structural model adopted a one-compartment structure with first-order elimination. Notably, aspartate aminotransferase (AST) and the co-administered drug type emerged as primary covariates affecting apatinib clearance (CL/F). The finalized model was expressed as CL/F (L/h) = 56.7 × (AST/26.6)^-0.298 × θ, when apatinib was combined with monoclonal antibodies, θ was 1; when combined with paclitaxel, θ was 0.58; when combined with other drugs (e.g., platinum, capecitabine, or the combination of tegafur, gimeracil, and oteracil potassium), θ was 1.60; When used as monotherapy, θ was 1.38. V/F = 674 L, and the absorption rate constant (Ka) was fixed at 0.08 h^-1. Bootstrap results affirmed the model's reliability and stability, while NPDE outcomes attested to the model's fit.</p><p><strong>Conclusion: </strong>Our study successfully established a PPK model for apatinib in oncology patients, revealing that liver function status and co-administered drug types significantly impacted apatinib CL/F. This finding underscored the potential necessity for dose adjustments to optimize efficacy, particularly in patients undergoing different chemotherapy regimens involving apatinib.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated bulk and single-cell profiling characterize sphingolipid metabolism in pancreatic cancer.","authors":"Biao Zhang, Bolin Zhang, Tingxin Wang, Bingqian Huang, Lijun Cen, Zhizhou Wang","doi":"10.1186/s12885-024-13114-8","DOIUrl":"10.1186/s12885-024-13114-8","url":null,"abstract":"<p><strong>Background: </strong>Abnormal sphingolipid metabolism (SM) is closely linked to the incidence of cancers. However, the role of SM in pancreatic cancer (PC) remains unclear. This study aims to explore the significance of SM in the prognosis, immune microenvironment, and treatment of PC.</p><p><strong>Methods: </strong>Single-cell and bulk transcriptome data of PC were acquired via TCGA and GEO databases. SM-related genes (SMRGs) were obtained via MSigDB database. Consensus clustering was utilized to construct SM-related molecular subtypes. LASSO and Cox regression were utilized to build SM-related prognostic signature. ESTIMATE and CIBERSORT algorithms were employed to assess the tumour immune microenvironment. OncoPredict package was used to predict drug sensitivity. CCK-8, scratch, and transwell experiments were performed to analyze the function of ANKRD22 in PC cell line PANC-1 and BxPC-3.</p><p><strong>Results: </strong>A total of 153 SMRGs were acquired, of which 48 were linked to PC patients' prognosis. Two SM-related subtypes (SMRGcluster A and B) were identified in PC. SMRGcluster A had a poorer outcome and more active SM process compared to SMRGcluster B. Immune analysis revealed that SMRGcluster B had higher immune and stromal scores and CD8 + T cell abundance, while SMRGcluster A had a higher tumour purity score and M0 macrophages and activated dendritic cell abundance. PC with SMRGcluster B was more susceptible to gemcitabine, paclitaxel, and oxaliplatin. Then SM-related prognostic model (including ANLN, ANKRD22, and DKK1) was built, which had a very good predictive performance. Single-cell analysis revealed that in PC microenvironment, macrophages, epithelial cells, and endothelial cells had relatively higher SM activity. ANKRD22, DKK1, and ANLN have relatively higher expression levels in epithelial cells. Cell subpopulations with high expression of ANKRD22, DKK1, and ANLN had more active SM activity. In vitro experiments showed that ANKRD22 knockdown can inhibit the proliferation, migration, and invasion of PC cells.</p><p><strong>Conclusion: </strong>This study revealed the important significance of SM in PC and identified SM-associated molecular subtypes and prognostic model, which provided novel perspectives on the stratification, prognostic prediction, and precision treatment of PC patients.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating clinical and image-based parameters for prediction of early post-prostatectomy incontinence recovery: simplified nomogram approach.","authors":"I-Hung Shao, Sy-Yuan Chen, Hung-Yi Chen, Ting-Wen Sheng, Ying-Hsu Chang, Chung-Yi Liu, Liang-Kang Huang, Hung-Chen Kan, Po-Hung Lin, Kai-Jie Yu, Cheng-Keng Chuang, See-Tong Pang, Chun-Te Wu","doi":"10.1186/s12885-024-13072-1","DOIUrl":"10.1186/s12885-024-13072-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop a novel model that combines both clinical and image-based parameters to predict early recovery of urinary incontinence after robotic-assisted radical prostatectomy (RARP) more easily and precisely.</p><p><strong>Materials and methods: </strong>We retrospectively enrolled data from patients who underwent RARP performed by a single surgeon. Clinical parameters were collected through medical chart review. All patients received cystography one week after RARP to evaluate the anastomosis healing condition. All cystography images were analyzed by a single radiologist who was blinded to the clinical status of the patients. Multivariate analysis was performed to select significant predictors for early post-prostatectomy incontinence (PPI) recovery, defined as being pad-free within four weeks after surgery.</p><p><strong>Results: </strong>A total of 293 patients were enrolled in this study. Among them, 26.7% experienced immediate dryness after surgery, while 47.6% achieved being pad-free within one month. The overall continence rate was over 90% six months after surgery. In univariate analysis, factors associated with early PPI recovery were BMI, T stage, NVB preservation, surgical margin status, downward bladder neck, and bladder neck angle on cystography. BMI, NVB preservation, and downward bladder neck remained significant in multivariate analysis (p-values = 0.041, 0.027, and 0.023, respectively). A nomogram model was established based on these three predictors.</p><p><strong>Conclusion: </strong>This is the first model to combine preoperative clinical factors, peri-surgical factors, and postoperative image-based factors to predict PPI recovery after RARP. This model can assist clinicians in taking optimal actions for PPI and also reduce patient anxiety.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated expression levels of the protein kinase DYRK1B induce mesenchymal features in A549 lung cancer cells.","authors":"Soraya Sester, Gerrit Wilms, Joana Ahlburg, Aaron Babendreyer, Walter Becker","doi":"10.1186/s12885-024-13057-0","DOIUrl":"10.1186/s12885-024-13057-0","url":null,"abstract":"<p><strong>Background: </strong>The protein kinase DYRK1B is a negative regulator of cell proliferation but has been found to be overexpressed in diverse human solid cancers. While DYRK1B is recognized to promote cell survival and adaption to stressful conditions, the consequences of elevated DYRK1B levels in cancer cells are largely uncharted.</p><p><strong>Methods: </strong>To elucidate the role of DYRK1B in cancer cells, we established a A549 lung adenocarcinoma cell model featuring conditional overexpression of DYRK1B. This system was used to characterize the impact of heightened DYRK1B levels on gene expression and to monitor phenotypic and functional changes.</p><p><strong>Results: </strong>A549 cells with induced overexpression of wild type DYRK1B acquired a mesenchymal cell morphology with diminished cell-cell contacts and a reorganization of the pericellular actin cytoskeleton into stress fibers. This transition was not observed in cells overexpressing a catalytically impaired DYRK1B variant. The phenotypic changes were associated with increased expression of the transcription factors SNAIL and SLUG, which are core regulators of epithelial mesenchymal transition (EMT). Further profiling of DYRK1B-overexpressing cells revealed transcriptional changes that are characteristic for the mesenchymal conversion of epithelial cells, including the upregulation of genes that are related to cancer cell invasion and metastasis. Functionally, DYRK1B overexpression enhanced the migratory capacity of A549 cells in a wound healing assay.</p><p><strong>Conclusions: </strong>The present data identify DYRK1B as a regulator of phenotypic plasticity in A549 cells. Increased expression of DYRK1B induces mesenchymal traits in A549 lung adenocarcinoma cells.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of immune checkpoint inhibitors vs. chemotherapy combined with brain radiotherapy in non-small cell lung cancer patients with brain metastases.","authors":"Tengfei Wang, Rumeng Li, Shuyan Liu, Qiuji Wu, Wen Ouyang, Conghua Xie","doi":"10.1186/s12885-024-13110-y","DOIUrl":"10.1186/s12885-024-13110-y","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is a prevalent form of cancer, often leading to brain metastases (BM) and a significant decline in patient prognosis. Whether immune checkpoint inhibitors (ICIs) combined with brain radiotherapy is superior to conventional chemotherapy combined with brain radiotherapy in those patients remains to be explored.</p><p><strong>Materials and methods: </strong>Our study enrolled 161 NSCLC patients with BM who underwent either ICIs combined with brain radiotherapy or chemotherapy combined with brain radiotherapy. End points included overall survival (OS), progression-free survival (PFS), intracranial PFS (IPFS), and extracranial PFS (EPFS). Univariate and multivariate Cox regressions were employed to identify prognostic risk variables.</p><p><strong>Results: </strong>Patients receiving ICIs combined with brain radiotherapy exhibited significantly longer OS compared to those receiving chemotherapy combined with brain radiotherapy (34.80 months vs. 17.17 months, P = 0.005). In the Cox regression analysis, chemotherapy combined with brain radiotherapy (HR, 1.82; 95% CI, 1.09-3.05; P = 0.023), smoking (HR, 1.75; 95% CI, 1.02-2.99; P = 0.043) and squamous cell carcinoma (HR, 2.59; 95% CI, 1.31-5.13; P = 0.006) were associated with a worse prognosis. After propensity score matching (PSM), this finding remained consistent with before PSM (43.73 months vs. 17.17 months, P = 0.018). Squamous cell carcinoma (HR, 2.46; 95% CI, 1.15-5.26; P = 0.021) and CT + RT (HR, 2.11; 95% CI, 1.15-3.88; P = 0.016) were associated with a less favorable prognosis.</p><p><strong>Conclusion: </strong>The study suggests that the combination of ICIs and brain radiotherapy provides superior OS for NSCLC patients with BM, compared to the chemotherapy combined with brain radiotherapy.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-depth analysis and trends of cancer mortality in Kazakhstan: a joinpoint analysis of nationwide healthcare data 2014-2022.","authors":"Ruslan Akhmedullin, Temirgali Aimyshev, Gulnur Zhakhina, Sauran Yerdessov, Altynay Beyembetova, Ayana Ablayeva, Aigerim Biniyazova, Temirlan Seyil, Diyora Abdukhakimova, Aidana Segizbayeva, Yuliya Semenova, Abduzhappar Gaipov","doi":"10.1186/s12885-024-13128-2","DOIUrl":"10.1186/s12885-024-13128-2","url":null,"abstract":"<p><strong>Background: </strong>Cancer remains a leading cause of death both globally and in Kazakhstan, making it crucial to track its mortality trends. This study aimed to investigate cancer mortality trends from 2014 to 2022 in Kazakhstan.</p><p><strong>Methods: </strong>This study utilized data from Kazakhstan's Unified National Electronic Health System to perform descriptive data analysis and employed Joinpoint regression models to analyze average annual percent change (AAPC) in cancer-related mortality estimates. The authors also examined the mortality-to-incidence ratio (MIR) and proportionate mortality (PM).</p><p><strong>Results: </strong>The study analyzed 123,622 cancer-related death reports from 2014 to 2022. Major causes included trachea, bronchus, and lung cancer (16.01%), stomach cancer (11.43%), and colon and rectum cancer (10.05%), accounting for 37.48% of all cancer-related deaths. AAPCs showed a significant increase in mortality for individuals aged 18-44 (1.36%; 95% CI: 0.05%; 2.71%), while those aged 45-59 and 60-74 experienced decreases of -2.02% (95% CI: -3.05%; -0.96%) and - 2.10% (95% CI:-3.22%; -0.96%), respectively. PM was stable until 2019 but decreased from 2020 to 2021, while MIR increased during the same period. A significant decrease in oesophageal cancer mortality was observed in both females (-4.03%; 95% CI: -6.11%; -1.83%) and males (-2.44%; 95% CI: -4.89%; -0.02%), whereas ovarian cancer mortality increased by 0.95% (95% CI: 0.03%; 1.91%). In males, mortality from trachea, bronchus, and lung cancers decreased by -2.14% (95% CI: -3.00%; -1.25%), while \"other neoplasms\" rose by 6.21% (95% CI: 1.40%; 11.27%). Regional analysis highlighted variability, with the Kyzylorda region showing a pronounced increase in mortality (27.18%; 95% CI: 14.11%; 42.35%).</p><p><strong>Conclusions: </strong>Despite slight increases in MIR during the COVID-19 pandemic, overall cancer mortality trends remained stable. The findings highlight the need for targeted interventions, especially for individuals aged 18-44, ovarian cancer, and \"other neoplasms\". Further research is needed to explore regional mortality variations.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PD-1/PD-L1 immune checkpoint inhibitors in the treatment of unresectable locally advanced or metastatic triple negative breast cancer: a meta-analysis on their efficacy and safety.","authors":"Zuxiu Wang, Peimeng You, Zhanglei Yang, Hanxi Xiao, Xinrong Tang, Yongping Pan, Xuhuan Li, Feng Gao","doi":"10.1186/s12885-024-13105-9","DOIUrl":"10.1186/s12885-024-13105-9","url":null,"abstract":"<p><strong>Background: </strong>Triple negative breast cancer (TNBC) represents a particularly aggressive and clinically challenging subtype of breast cancer, characterized by its invasive nature and generally poor prognosis. Treatment options for unresectable TNBC are limited. In recent years, the advent of PD-1/PD-L1 immune checkpoint inhibitors has offered a promising new treatment option for unresectable TNBC. The role of PD-1/PD-L1 immune checkpoint inhibitors (ICIs) in unresectable TNBC management remains a subject of debate. This article aims to synthesize evidence from randomized controlled trials (RCTs) through a meta-analysis (MA) to provide a comprehensive evaluation of the efficacy and safety profile of ICIs in the treatment of unresectable TNBC.</p><p><strong>Method: </strong>We searched PubMed, Embase, Cochrane library, Web of Science, and ClinicalTrials.gov for the eligible RCTs which compared the efficacy and safety of PD-1/PD-L1 ICIs and chemotherapy alone. The outcomes analyzed included overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and treatment-related adverse effects (AEs).</p><p><strong>Results: </strong>This meta-analysis included 11 trials. Therapy with PD-L1 inhibitors was superior to chemotherapy in terms of OS in both the intention-to-treat (ITT) population and the PD-L1-positive population. (ITT: HR: = 0.90 [0.81, 0.99], P = 0.04, I² = 48%; PD-L1 + : HR = 0.82 [0.70, 0.95], P = 0.01, I² = 64%); In terms of PFS, treatment with PD-L1 inhibitors prolonged PFS in both the ITT and PD-L1-positive populations compared with chemotherapy (ITT: HR: = 0.85 [0.77, 0.93], P = 0.0006, I² = 46%; PD-L1 + : HR = 0.72 [0.62, 0.83], P < 0.00001, I² = 70%, Fig. 5); Compared with chemotherapy alone, treatment with PD-1 inhibitors prolonged OS in both the PD-L1-positive and ITT populations. (ITT: HR = 0.87 [0.78, 0.96], P = 0.007, I² = 71%; CPS ≥ 1: HR = 0.81 [0.71, 0.92], P = 0.001, I² = 39%); In terms of PFS, therapy with PD-1 inhibitors improved PFS in both the ITT population and the PD-L1-positive population compared with chemotherapy. (ITT: HR = 0.79 [0.70, 0.90], P = 0.0004, I² = 0%; CPS ≥ 1: HR = 0.71 [0.61, 0.83], P < 0.0001, I² = 0%; CPS ≥ 10: HR = 0.67 [0.53, 0.84], P = 0.0008, I² = 0%).</p><p><strong>Conclusion: </strong>Both PD-1 and PD-L1 inhibitors can offer survival benefits to TNBC patients, with the primary beneficiaries being those who are PD-L1-positive. However, immunotherapy can also lead to an increase in treatment-related adverse events. Therefore, it is essential to conduct a risk assessment for each patient before starting treatment to prevent the occurrence of serious adverse reactions.</p><p><strong>Trial registration: </strong>This systematic review study has been filed with PROSPERO (Registration number: CRD42024571775).</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}