Cancer Investigation最新文献

{"title":"Cancer-Associated Fibroblast Exosomes in Breast Cancer: Mechanisms of Tumor-Stroma Crosstalk and Clinical Implications.","authors":"Arezoo Ghareh-Hasanlou, Negar Yavari Tehrani-Fard, Parastoo Akbarabadi, Maryam Etesami, Sara Zareian, Roudabeh Behzadi-Andouhjerdi, Zeinab Piravar, Sadegh Babashah","doi":"10.1080/07357907.2026.2746413","DOIUrl":"https://doi.org/10.1080/07357907.2026.2746413","url":null,"abstract":"<p><p>Breast cancer progression is shaped by a continuous exchange of signals between tumor cells and the surrounding stroma, in which cancer-associated fibroblasts (CAFs) are among the most influential partners. This review concentrates on CAF-derived exosomes as the principal vehicles of that exchange, and on how their cargo and mode of delivery differ across functionally distinct CAF subtypes. Exosomes are nanoscale vesicles that carry microRNAs (miRNAs), long noncoding RNAs, proteins, and metabolites between cells, and CAF-derived vesicles have been linked to epithelial-mesenchymal transition (EMT), angiogenesis, metabolic rewiring, and resistance to chemotherapy, radiotherapy, and endocrine therapy. In estrogen receptor-positive disease, exosomal miR-22 delivered by CD63⁺ CAFs silences ESR1 and PTEN and blunts the response to tamoxifen, while proteins such as ADAM10 and the long noncoding RNA SNHG3 have been tied to motility and glycolytic reprogramming. The immune consequences are equally important, although the evidence here is thinner than is often implied: vesicular PD-L1 suppresses T cell priming, and spatially resolved studies now place distinct FAP⁺ CAF states next to specific macrophage and regulatory lymphocyte populations. Not all CAFs behave this way. Meflin⁺ and CD146⁺ subsets restrain tumor growth, which is why indiscriminate stromal depletion has repeatedly failed and why subtype-selective approaches are needed. We also consider the practical obstacles that still limit translation, including vesicle heterogeneity, the difficulty of separating exosomes from other small extracellular vesicles, and the absence of validated biomarkers.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Adverse Drug Reaction, Medication Adherence and Quality of Life in Breast Cancer Patients: A Prospective Observational Study.","authors":"Mohamed Akram Ali S, Hariharan B, Sathishkumar K, Somasundram C, Tharun B, Vijayasakthi M","doi":"10.1080/07357907.2026.2745102","DOIUrl":"https://doi.org/10.1080/07357907.2026.2745102","url":null,"abstract":"<p><p>Breast cancer is one of the most common cancer-causing diseases among women worldwide and the treatment of it is often linked with negative drug reactions (ADRs), decreased adherence to medications, and decreased quality of life (QoL). While these clinical results have been studied separately, there is still a lack of clinical trials that combine the assessment of treatment safety, adherence, and patient quality of life. Thus, the present prospective observational study was carried out to thoroughly assess the ADRs, medication adherence and QoL of breast cancer patients undergoing systemic therapy treatment in a tertiary care hospital. One hundred breast cancer patients were recruited and demographic and clinical data were gathered by patient interviews and medical records. The National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) was used to assess ADRs, 8-item Morisky Medication Adherence Scale (MMAS-8) to assess medication adherence. Further, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) is used to assess QoL. The relationships between the study variables were assessed using descriptive statistics, Chi-square test, Mann-Whitney U test, Kruskal-Wallis test, Spearman's rank correlation and logistic regression analysis. The results showed a strong positive correlation between adherence and QoL (Spearman's <math><mrow><mi>ρ</mi></mrow></math> = 0.61, <math><mrow><mi>p</mi></mrow></math> < 0.001). The clinical assessment framework integrated here offers a practical solution to determine the safety of treatment and adherence to medications. Hence, patient outcome enhances clinical decision making and helps to manage breast cancer in the long term.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Tumor Histologic Regression and Immunotherapy Outcomes in Recurrent or Metastatic Melanoma.","authors":"Aslı Geçgel, Zeynep Sıla Gökdere, Talha Özüdoğru, Meltem Akıncı, Nilay Duman, Banu Yaman, Erdem Göker, Burçak Karaca","doi":"10.1080/07357907.2026.2739846","DOIUrl":"https://doi.org/10.1080/07357907.2026.2739846","url":null,"abstract":"<p><strong>Background: </strong>Histologic regression in primary cutaneous melanoma has shown inconsistent prognostic associations, and its relevance to immune checkpoint inhibitor (ICI) outcomes in patients who later develop recurrent or metastatic disease remains unclear. This study aimed to evaluate the association between primary tumor histologic regression and treatment response and survival outcomes in patients with recurrent or metastatic melanoma treated with ICIs.</p><p><strong>Methods: </strong>This retrospective single-center cohort included 81 patients with resected stage I-III cutaneous melanoma who later developed recurrent or metastatic disease and received ICIs. Histologic regression was classified as present or absent based on primary pathology reports. Objective response rate (ORR) and disease control rate (DCR) were assessed according to RECIST v1.1. Progression-free survival (PFS) and overall survival (OS) from ICI initiation were estimated using Kaplan-Meier analysis and evaluated with prespecified multivariable Cox models.</p><p><strong>Results: </strong>Histologic regression was identified in 24 patients (29.6%). Baseline characteristics were largely comparable between groups, although regression was more frequent in male patients (83.3% vs 59.6%; p = 0.039). ORR was numerically higher in the regression-present group (58.3% vs 43.9%; p = 0.330), and DCR was also higher (87.5% vs 66.7%; p = 0.061). Median PFS was significantly longer in patients with regression (39.3 vs 17.8 months; log-rank p = 0.044). In multivariable analysis, regression remained independently associated with longer PFS (adjusted HR, 0.43; 95% CI, 0.19-0.94; p = 0.035), whereas no independent association with OS was observed (adjusted HR, 0.54; 95% CI, 0.28-1.06; p = 0.071).</p><p><strong>Conclusions: </strong>In patients with recurrent or metastatic melanoma treated with ICIs, primary tumor histologic regression was independently associated with prolonged PFS but not OS. These findings suggest a potential link between regression and early immune-mediated disease control, while its impact on long-term survival remains uncertain.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Dental Care Access, Oral Cancer Counseling, and Oral Cancer Examination Among U.S. Adults with a History of Cancer: Results from NHANES, 2015-2018.","authors":"Rahaf H Bin Hamdan, Alex Júnio Silva Cruz, Abdullah M AlDosari, Muath A Aldosari, Mauro Henrique Nogueira Guimarães de Abreu","doi":"10.1080/07357907.2026.2739841","DOIUrl":"https://doi.org/10.1080/07357907.2026.2739841","url":null,"abstract":"<p><p>This study examined disparities in access to dental care among U.S. adults with a history of cancer and identified factors associated with receiving oral cancer examination and counseling. Data were drawn from the 2015-2018 National Health and Nutrition Examination Survey (NHANES), including 11,281 adults aged 20 years and older, representing a weighted U.S. population of approximately 236.5 million. Weighted logistic regression models were used to assess associations between cancer history and unmet dental needs, oral cancer counseling, and oral cancer examination, adjusting for demographic and behavioral factors. Overall, 11.1% of participants reported a history of cancer, with higher prevalence observed among older adults, non-Hispanic Whites, and former smokers. Individuals with a cancer history reported lower levels of unmet dental needs compared to those without cancer (11.6% vs. 19.5%). However, they were more likely to receive oral cancer counseling (36.4% vs. 26.2%) and oral cancer examinations (41.7% vs. 26.4%). Adjusted analyses showed that cancer history was associated with reduced odds of unmet dental needs (OR = 0.76, 95% CI: 0.58-1.00) and increased odds of receiving oral cancer counseling (OR = 1.37, 95% CI: 1.01-1.86) and examination (OR = 1.38, 95% CI: 1.07-1.78). Despite these findings, disparities persist in access to preventive oral health services.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispecific Antibodies in Multiple Myeloma: A Concise Review of Current Treatments.","authors":"Amir M Ansari, Sogol Attaripour, Sahil Garg, Imad A Tabbara","doi":"10.1080/07357907.2026.2675661","DOIUrl":"10.1080/07357907.2026.2675661","url":null,"abstract":"<p><p>The treatment landscape for multiple myeloma (MM) has evolved significantly over the years; however, the disease remains incurable. Heavily pretreated patients with refractory disease to anti-CD38 therapies, proteasome inhibitors (PIs), and immunomodulatory drugs (IMiDs) face a very poor prognosis. Bispecific antibodies (BsAbs) are the newest, and most promising available therapy for heavily pretreated patients with relapsed refractory multiple myeloma (RRMM). BsAbs primarily rely on T cell activation to target cancer cells by binding malignant plasma cells to cytotoxic T cells via surface antigens. BsAbs consist of two binding sites: one that targets a specific antigen on the surface of MM cells, such as B-cell maturation antigen (BCMA), G-protein-coupled receptor class C group 5 member D (GPRC5D), or fragment crystallizable receptor-like 5 (FcRH5), and another that binds to CD3, a T-cell receptor. Ongoing research aimed at optimizing sequencing strategies, mitigating toxicity, and evaluating combination approaches will be critical to maximizing the durability of response and improving long-term outcomes in this high-risk population.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"933-944"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Second Primary Tumours in Cutaneous Lymphoma Populations.","authors":"Shuaijun Zou, Ruiqian Yao, Xiaoyan Yang, Erwen Kou, Sijia Huang, Hao Zhu, Liangzhe Wang, Julin Gu, Yuanjie Zhu","doi":"10.1080/07357907.2026.2675664","DOIUrl":"10.1080/07357907.2026.2675664","url":null,"abstract":"<p><p>The elevated incidence of second primary tumors (SPTs) has been reported in certain subtypes of cutaneous T-cell lymphomas (CTCLs) and cutaneous B-cell lymphomas (CBCLs), but remains unclear for overall primary cutaneous lymphomas (PCLs). Using Surveillance, Epidemiology and End Results (SEER) data, we analyzed 20,970 patients with PCLs and evaluated standardized incidence ratios (SIRs) and survival outcomes of SPTs stratified by lymphoma subtype (indolent vs. aggressive). A total of 2,589 SPTs were identified (SIR = 1.40, 95% CI 1.35-1.45), with significantly elevated risks across sex, ethnicity, stage, latency, year of diagnosis, and treatment. Both indolent and aggressive CTCLs were associated with increased SPT risk, with SIRs of 1.27 (1.16-1.39) and 1.38 (1.11-1.69), respectively. Lymphatic and hematopoietic malignancies predominated in indolent CTCLs, along with thyroid cancer, whereas aggressive CTCLs were mainly associated with extranodal non-Hodgkin lymphoma and myeloma. Increased SPT incidence was also observed in indolent and aggressive CBCLs (SIR = 1.49 and 1.38), with indolent CBCLs showing a broad SPT spectrum including lung cancer and cutaneous melanoma. Patients younger than 30 years, with stage I disease or aggressive PCLs, had decreased age-adjusted overall and disease-specific survival, indicating a need for more intensive surveillance.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"984-993"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Risk of Hyperglycemia with PI3K Inhibitors in Cancer Patients-A Meta-Analysis.","authors":"Zhan Rong, Shenhong Wu","doi":"10.1080/07357907.2026.2721528","DOIUrl":"https://doi.org/10.1080/07357907.2026.2721528","url":null,"abstract":"<p><p>Phosphatidylinositol 3-kinase (PI3K) inhibitors are a promising class of targeted oncologic therapies but metabolic toxicities, particularly hyperglycemia, limit their use. We conducted a meta-analysis of phase II/III randomized controlled trials to quantify the incidence and relative risk (RR) of hyperglycemia associated with PI3K inhibition in cancer patients. A systematic search of PubMed through August 2025 identified 16 eligible trials, comprising approximately 5,000 patients. Among patients treated with PI3K inhibitors, the summary incidence of all-grade hyperglycemia was 44.4% (95% CI: 33.3-55.5%), while high-grade hyperglycemia occurred in 18.6% (95% CI: 9.7-27.6%). PI3K inhibitor was associated with an increased risk of hyperglycemia with an RR of 3.43 (95% CI: 2.42-4.87, <i>p</i> < 0.001) for all-grade events and 9.79 (95% CI: 5.77-16.62, <i>p</i> < 0.001) for high-grade events. Subgroup analysis showed that cancer type significantly moderated the incidence of high-grade hyperglycemia (p = 0.01). Subgroup analyses also showed significant variation among PI3K inhibitor subtypes (p < 0.01), with PI3Kα-selective inhibitors conferring the greatest relative risk, particularly for severe hyperglycemia, whereas dual PI3K/mTOR inhibitors showed comparatively lower risk. These findings have demonstrated that PI3K inhibitors are associated with a significantly increased risk of hyperglycemia. Proactive monitoring and early intervention are essential to mitigate adverse outcomes and optimize therapeutic benefit.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Pembrolizumab in Advanced Gastric Cancer: A Systematic Review and Meta-Analysis.","authors":"Kunhong Tang, Wei Zheng Huang, Jiaqi Wei, Xiaorong Zhou, Tingting Li, Yaling Li, Jun Li","doi":"10.1080/07357907.2026.2680664","DOIUrl":"10.1080/07357907.2026.2680664","url":null,"abstract":"<p><p>This meta-analysis integrates data from 7 randomized controlled trials comprising 4,560 patients with advanced gastric cancer to evaluate the efficacy and safety of pembrolizumab as monotherapy or in combination with chemotherapy. Compared to control treatments, pembrolizumab significantly improved overall survival and objective response rate, though no significant difference was observed in progression-free survival. While the risk of immune-related adverse events and severe treatment-related adverse events increased with pembrolizumab, the incidence of all-grade adverse events was not significantly different. Importantly, pembrolizumab was not associated with an increased risk of treatment-related death (OR = 0.99, 95% CI 0.59-1.65), indicating that the risk of fatal adverse events is comparable to that of chemotherapy alone. This finding helps address a common clinical concern regarding the safety profile of immunotherapy. Subgroup analyses revealed that patients with PD-L1 combined positive score of 10 or higher derived the greatest benefit in objective response rate and progression-free survival. Combination therapy demonstrated superior efficacy over monotherapy across all survival outcomes but was associated with higher immune-related toxicity. Based on these findings, pembrolizumab in combination with chemotherapy is recommended as first-line treatment for patients with good performance status and PD-L1 combined positive score of 10 or higher. For elderly patients or those with reduced performance status, monotherapy may offer a favorable balance between efficacy and safety. Routine PD-L1 testing and proactive adverse event management are essential for optimizing treatment outcomes.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"945-965"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of miR-145 in HER2-Positive Locally Advanced or Metastatic Urothelial Carcinoma Treated with Disitamab Vedotin.","authors":"Binghai Li, Dan Li, Ningning Deng, Pei Liu","doi":"10.1080/07357907.2026.2677806","DOIUrl":"10.1080/07357907.2026.2677806","url":null,"abstract":"<p><p>Disitamab vedotin (RC48), a HER2-targeted antibody-drug conjugate, has shown promising activity in locally advanced or metastatic urothelial carcinoma (la/mUC), but clinically useful biomarkers remain lacking. In this retrospective single-center real-world study, we evaluated the efficacy of RC48 and the clinical relevance of tumor miR-145 expression in 136 patients with HER2-positive la/mUC treated between June 2022 and October 2024. Clinical outcomes included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). The ORR and DCR were 64.0% and 75.7%, respectively. Median OS was 15.5 months (95% CI: 12.6-28.5), and median PFS was 9.2 months (95% CI: 7.1-11.8). In univariate Cox analysis, miR-145 was the only variable significantly associated with OS (HR = 0.676, <i>p</i> = 0.002). High miR-145 expression was associated with improved OS and a higher complete response rate than low expression. Time-dependent ROC analysis showed an AUC of 76.3% at 2 years, and decision curve analysis suggested potential clinical utility. These findings indicate that miR-145 may serve as a candidate prognostic biomarker for risk stratification in RC48-treated la/mUC.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"1008-1016"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Transcriptomics Open a New Era of Pan-Cancer Analysis.","authors":"Yuqi Sheng, Yuwei Yang, Ruizhe Zhang, Moxin Li, Qinyu Ge","doi":"10.1080/07357907.2026.2681845","DOIUrl":"10.1080/07357907.2026.2681845","url":null,"abstract":"<p><p>Spatial transcriptomics (ST) is revolutionizing pan-cancer analysis by enabling the in situ integration of spatial architecture with molecular profiles. This review synthesizes key advances, including deciphering conserved and divergent spatial ecosystems across cancers, mapping the heterogeneity of driver genes, tracing metastatic evolution, and establishing novel spatial molecular classifications. It further discusses how these insights inform clinical translation for diagnosis and therapy stratification. While integration of multi-cancer datasets and translational efficiency remain challenges, ST is a pivotal bridge toward spatially informed, broad-spectrum oncological strategies.</p>","PeriodicalId":9463,"journal":{"name":"Cancer Investigation","volume":" ","pages":"966-983"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}