Cancer Management and Research最新文献

{"title":"VEGF-Leptin Crosstalk in Breast and Ovarian Cancer: Drivers of Angiogenesis and Progression.","authors":"Ahood A Al-Eidan","doi":"10.2147/CMAR.S635303","DOIUrl":"https://doi.org/10.2147/CMAR.S635303","url":null,"abstract":"<p><p>Breast and ovarian cancers (BC and OC) remain among the leading causes of cancer-related deaths among women worldwide. Their progression is critically dependent on tumor angiogenesis and a permissive metabolic microenvironment. Vascular endothelial growth factor (VEGF) is a key factor in tumor angiogenesis and neovascularization. Leptin, conversely, a hormone that is produced by adipocytes, serves as an important mediator of tumor proliferation, inflammation, and metastasis. Increasing evidence suggests that VEGF and leptin act via multiple overlapping oncogenic pathways. They collectively promote tumor growth, survival, and angiogenesis. Obesity, hypoxia, and interactions between adipose tissue and the stroma further enhance this oncogenic axis by increasing the expression of VEGF and leptin and supporting metabolic reprogramming of the tumor. In BC and OC, persistent activation of the VEGF-leptin network contributes to aggressive disease progression, treatment resistance, and unfavorable clinical outcomes. Studies have indicated cytokine release, hypoxia and necrosis induction, angiogenesis, and tumor metastasis by interconnected immune pathways mediated by leptin and VEGF. Important roles of different receptors have also been uncovered in several in-vitro and in-vivo experiments. The findings have opened avenues for developing targeted monotherapies and combination therapeutic strategies to control tumor progression by inhibiting diverse signaling pathways. This review highlights the reciprocal VEGF-leptin feedback interaction in obesity-associated BC and OC, integrating evidence form biomarker studies and therapeutic perspectives. It also examines the influence of obesity and hypoxia on tumor progression and discusses current therapeutic strategies targeting this interconnected angiogenic-metabolic interaction.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"635303"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HER2-Targeted Antibody-Drug Conjugates in Advanced HER2-Low Breast Cancer: Mechanisms, Clinical Efficacy, and Resistance Strategies.","authors":"Mengsha Yang, Xiaokun Ding, Peng Ye, Xiaohong Xu","doi":"10.2147/CMAR.S633762","DOIUrl":"https://doi.org/10.2147/CMAR.S633762","url":null,"abstract":"<p><p>Globally, breast cancer is the most frequently diagnosed malignancy in women, with the HER2-low subtype (IHC 1+ or IHC 2+/ISH-) accounting for approximately 45%-55% of all invasive breast cancer cases. Conventional HER2-targeted therapies are ineffective for this subtype, and treatment has long relied on endocrine therapy or chemotherapy, with a median overall survival of less than 18 months after resistance development. This narrative review synthesizes evidence from clinical trials identified through systematic searches of the PubMed, ASCO, and ESMO databases until December 2025. Antibody-drug conjugates (ADCs) combine targeted delivery with potent cytotoxicity. The next-generation ADC trastuzumab deruxtecan (T-DXd) has achieved a breakthrough in the treatment of HER2-low breast cancer, attributed to its high drug-to-antibody ratio (DAR = 8), robust bystander effect, and non-classical killing mechanisms mediated by the tumor microenvironment. The landmark DESTINY-Breast04 trial provided the first definitive evidence that T-DXd significantly prolongs progression-free survival (PFS) and overall survival (OS). The DESTINY-Breast06 study further expanded the population that may benefit to include patients with HER2-ultralow expression and moved treatment to an earlier line, after endocrine therapy failure and before chemotherapy initiation. Chinese ADCs, such as disitamab vedotin (objective response rate [ORR], 33.3%), SHR-A1811, and MRG002, have also shown promising efficacy. However, resistance mechanisms, including target loss, impaired endocytosis, payload efflux, abnormalities in DNA repair, and suppression of the immune microenvironment, are emerging. Combination strategies involving endocrine therapy, immune checkpoint inhibitors, and HER2 tyrosine kinase inhibitors are expected to overcome resistance and enhance the efficacy of treatment. This review provides a comprehensive overview of ADC development in advanced HER2-low breast cancer, summarizes key clinical data, resistance mechanisms, and combination strategies, and discusses future directions, including biomarker development and optimal treatment sequencing, to guide clinical practice and future research in this area.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"633762"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Immune-Inflammation Index is Associated with Pressure Injury in Hospitalized Patients with Non-Small Cell Lung Cancer: A Retrospective Cohort Study.","authors":"Jianyun Liu, Jinxiao Wang","doi":"10.2147/CMAR.S626001","DOIUrl":"https://doi.org/10.2147/CMAR.S626001","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between admission systemic immune-inflammation index (SII) and incident pressure injury (PI) in hospitalized patients with non-small cell lung cancer (NSCLC) and assess its discriminative performance.</p><p><strong>Materials and methods: </strong>This single-center retrospective cohort included 428 hospitalized patients with NSCLC (119 with PI and 309 without PI). Admission SII was calculated from platelet, neutrophil, and lymphocyte counts. Logistic regression and ROC analyses were performed, with DeLong comparisons, bootstrap internal validation, calibration, and decision-curve analysis.</p><p><strong>Results: </strong>Patients with PI had higher SII than those without PI (median 1223.49 [IQR 963.35-1519.65] vs 868.37 [694.89-1089.19], P < 0.001). In multivariable analysis, SII (OR per 100 units = 1.339, 95% CI: 1.223-1.466), BMI (OR = 0.549, 95% CI: 0.467-0.645), and CRP (OR = 1.254, 95% CI: 1.173-1.341) were independently associated with PI. The AUC was 0.763 for SII and 0.908 for the combined SII-BMI-CRP model; bootstrap optimism-corrected AUC was 0.904 (95% CI: 0.878-0.934).</p><p><strong>Conclusion: </strong>Higher admission SII was independently associated with incident PI and showed discrimination comparable to BMI, CRP, and NLR. The combined SII-BMI-CRP model showed greater discrimination with stable bootstrap internal validation. These findings support further evaluation of SII as an adjunct to clinical risk assessment, with external validation and baseline Braden Scale comparison warranted before routine use.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"626001"},"PeriodicalIF":2.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Multiplex PCR to Detect the <i>BCR-ABL1</i> Transcripts in Chronic Myeloid Leukaemia Patients in Indonesia.","authors":"Delita Prihatni, Nur Izzatun Nafsi, Ernawati Ernawati, Nina Susana Dewi, Almira Zada, Yunia Sribudiani","doi":"10.2147/CMAR.S607952","DOIUrl":"https://doi.org/10.2147/CMAR.S607952","url":null,"abstract":"<p><strong>Background: </strong>There are limited commercial kits available for the identification of <i>BCR-ABL1</i> gene fusion transcripts in chronic myeloid leukaemia (CML) patients. Most kits are based on RT-PCR to detect <i>e14a2</i> and <i>e13a2</i> transcripts as major breakpoint segments, but do not detect minor transcripts. Therefore, this study aimed to develop a multiplex PCR approach for <i>BCR-ABL</i> gene transcripts.</p><p><strong>Methods: </strong>Primers were designed to amplify four <i>BCR-ABL1</i> transcripts from the cDNA reverse transcribed from 52 archived mRNAs from CML patients. The <i>BCR-ABL1</i> transcripts were identified by multiplex PCR, and the assay performance was compared to Xpert^® BCR-ABL Ultra (GeneXpert).</p><p><strong>Results: </strong>The multiplex TD-PCR successfully amplified four <i>BCR-ABL1</i> transcripts, with detection limits of 10 fg/µL for e13a2 and e14a2 and 100 fg/µL for e1a2 and e19a2. Out of 52 archived RNA samples, 40 were confirmed positive. The most common transcript was e14a2, which was identified in 72.5% of the confirmed positive samples, followed by e13a2, identified in 25% of the positive samples. The e19a2 transcript was identified in 2.5% of the positive samples. No patients expressed the e1a2 transcript type or co-expressed both e14a2 and e13a2. The overall sensitivity and specificity of the multiplex PCR when compared to GeneXpert results were 97.56% (95% CI: 87.14-99.94%) and 100% (95% CI: 71.51-100%), respectively.</p><p><strong>Conclusion: </strong>The multiplex PCR assay developed to identify the four <i>BCR-ABL1</i> transcripts can be implemented in CML diagnostic settings.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"607952"},"PeriodicalIF":2.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and External Validation of a Preoperative Nomogram for Predicting Axillary Lymph Node Metastasis in Breast Cancer Using Routine Ultrasound and Core Needle Biopsy Variables.","authors":"Nijiati Taxifulati, Gulisumuhan Abulaiti, Yuan Zhang, Chenming Guo, Xin Yang","doi":"10.2147/CMAR.S627718","DOIUrl":"https://doi.org/10.2147/CMAR.S627718","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative assessment of axillary lymph node metastasis (ALNM) is essential for individualized axillary management in breast cancer, yet imaging-based evaluation alone remains imperfect. We aimed to develop and externally validate a practical nomogram based on routinely available preoperative ultrasound and core needle biopsy (CNB) variables.</p><p><strong>Methods: </strong>This retrospective, two-center cohort study included 295 women with pathologically confirmed primary breast cancer who underwent breast surgery with axillary nodal staging between January 2021 and January 2025. The training cohort included 182 patients from the Changji Branch, and the external validation cohort included 113 patients from the First Affiliated Hospital of Xinjiang Medical University. Candidate predictors were evaluated using univariable analysis, LASSO regression, and multivariable logistic regression. Model discrimination, calibration, and clinical utility were assessed using receiver operating characteristic analysis, calibration analysis, and decision curve analysis.</p><p><strong>Results: </strong> ALNM was confirmed in 88 of 182 patients (48.4%) in the training cohort and 50 of 113 patients (44.2%) in the external validation cohort. The final nomogram included ultrasound-reported calcifications, tumor size, histological grade, CNB-derived lymphovascular invasion, and HER2 status. The model showed good discrimination, with an AUC of 0.858 (95% CI 0.805-0.911) in the training cohort and 0.854 (95% CI 0.779-0.929) in the external validation cohort. Calibration and decision curve analyses supported acceptable model performance and potential clinical utility in both cohorts.</p><p><strong>Conclusion: </strong>We developed and externally validated an interpretable preoperative nomogram using routinely obtainable ultrasound and CNB variables for individualized estimation of ALNM risk in breast cancer. The model may support preoperative risk stratification and axillary management planning, although prospective multicenter validation is warranted.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"627718"},"PeriodicalIF":2.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Prediction of Prolonged Length of Stay in Older Patients with Lung Cancer: A Multicenter Study Using XGBoost with SHAP Interpretation.","authors":"Xiao Li, Shuying Liu, Yating Gao, Dongfeng Zhang, Xiao Zhang, Kaining Zhang, Xia Wang, Huijuan Zhang, Xiaofei Li, Jierong Yin","doi":"10.2147/CMAR.S643647","DOIUrl":"10.2147/CMAR.S643647","url":null,"abstract":"<p><strong>Background: </strong>Prolonged length of stay (PLOS) is common among older patients with lung cancer and is associated with increased risks of adverse outcomes, greater healthcare resource utilization, and reduced treatment efficiency. However, reliable risk stratification tools specifically designed for this population, particularly in the Chinese healthcare context, remain lacking.</p><p><strong>Methods: </strong>This multicenter retrospective study included patients aged 65 years or older with primary lung cancer from two Chinese hospitals. PLOS was defined as a length of stay exceeding the 75th percentile of the overall cohort. After least absolute shrinkage and selection operator‑based feature selection from 34 candidate variables, six machine learning models were developed in the training set and validated using both internal and external validation sets. Model performance was assessed using discrimination, calibration, and clinical utility metrics. The optimal model was interpreted using SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>A total of 5,836 patients were included. Among the six models, XGBoost achieved the highest discriminative performance, with area under the receiver operating characteristic curve values of 0.821 (95% CI: 0.806-0.837) in the training set, 0.773 in internal validation, and 0.727 in external validation. Calibration curves and decision curve analysis demonstrated satisfactory agreement and net clinical benefit. SHAP analysis identified pneumonia, hypoproteinemia, C‑reactive protein (CRP), uric acid (UA), and admission pathway as the top five predictors. Pneumonia, hypoproteinemia, CRP, admission pathway, and systolic blood pressure were positively associated with PLOS, whereas UA and total protein showed negative associations.</p><p><strong>Conclusion: </strong>The XGBoost model provided robust and generalizable predictions of PLOS in older Chinese patients with lung cancer. Its interpretability may facilitate early identification of high‑risk individuals and support targeted perioperative interventions in geriatric oncology care.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"643647"},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Toxicity Profiles and Associated Factors in Patients with Advanced Cancer Receiving Daytime Chemotherapy: A Latent Profile Analysis.","authors":"Ying Zheng, Xiaoli Huang, Tao Xu, Jianqiong Feng, Qiu Wan, Xia Gan, Min Du","doi":"10.2147/CMAR.S634242","DOIUrl":"10.2147/CMAR.S634242","url":null,"abstract":"<p><strong>Background: </strong>Financial toxicity (FT) may persist among patients with advanced cancer receiving daytime chemotherapy because of prolonged treatment, frequent hospital visits, and nonmedical expenses. However, heterogeneity in this outpatient setting remains insufficiently understood.</p><p><strong>Aim: </strong>To identify latent FT profiles among patients with advanced cancer receiving daytime chemotherapy and examine factors associated with profile membership.</p><p><strong>Methods: </strong>This cross-sectional study recruited 335 patients with advanced cancer receiving daytime chemotherapy in Southwest China from November 2025 to January 2026. Participants completed the COST-PROM scale, Hospital Anxiety and Depression Scale, and Family APGAR Index. Latent profile analysis identified FT profiles, and forced-entry multinomial logistic regression examined adjusted associations.</p><p><strong>Results: </strong>Three profiles were identified: High FT (32.5%, n=109), Moderate FT (31.7%, n=106), and Low FT (35.8%, n=120). Univariate comparisons showed significant differences across demographic, socioeconomic, clinical, and psychosocial characteristics. With High FT as the reference, a higher total HADS score, representing overall psychological distress, was associated with higher odds of Moderate FT membership (adjusted odds ratio (aOR) = 1.081, 95% CI: 1.042-1.121), whereas disease duration < 6 months versus > 1 year was associated with lower odds (aOR = 0.437, 95% CI: 0.203-0.937). For Low versus High FT membership, disease duration <6 months versus >1 year (aOR = 4.394, 95% CI: 1.749-11.041) and each one-point increase in Family APGAR score (aOR = 1.536, 95% CI: 1.235-1.910) were associated with higher adjusted odds.</p><p><strong>Conclusion: </strong>FT showed cross-sectional heterogeneity in this population. The observed associations may inform context-specific assessment and supportive-care planning, but profile selection and several regression estimates remain uncertain. External and longitudinal validation is required.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"634242"},"PeriodicalIF":2.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cabozantinib After Immunotherapy in Advanced Renal Cell Carcinoma. The CARE Study by the Hellenic Gu Cancer Group.","authors":"Aristotelis Bamias, Michael Liontos, Ioannis Binas, Dimitra Stefanou, Kimon Tzannis, Roubini Zakopoulou, Nikolaos Dedes, Dimitrios Deligiannis, Ioanna Katsiana, Areti Mamali, Meropi Galari, Konstantina Kakogianni, Vasiliki Nikolaidou, Dimitrios C Ziogas, Napoleon Moulavasilis, Vasiliki Magoula, Efstathia Giannopoulou, Christos Christodoulou, Meletios Athanasios Dimopoulos, Michael Chrisofos","doi":"10.2147/CMAR.S597256","DOIUrl":"10.2147/CMAR.S597256","url":null,"abstract":"<p><strong>Background: </strong>The widespread use of immune checkpoint inhibitor (ICI)-based combinations as first-line therapy for metastatic renal cell carcinoma (mRCC) has created an unmet need for effective treatment options at disease progression. Cabozantinib is recommended after ICI failure; however, real-world evidence regarding its efficacy and safety in this setting remains limited, particularly following contemporary ICI-containing regimens.</p><p><strong>Methods: </strong>CARE was a retrospective, multicenter, non-interventional study conducted in Greece. Patients with locally advanced or metastatic RCC who received cabozantinib monotherapy after progression on at least one prior ICI-containing regimen were included. The primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. Exploratory analyses evaluated outcomes according to prior therapies and timing of cabozantinib administration.</p><p><strong>Results: </strong>Thirty patients were included. Prior immunotherapy consisted mainly of nivolumab monotherapy or nivolumab plus ipilimumab, while cabozantinib was administered predominantly as second-line treatment. No complete responses were observed; twelve patients achieved partial response, resulting in an ORR of 40% (95% CI: 22.7-59.4). Stable disease was observed in 56.7% of patients. Median follow-up was 20 months (95% CI 15.2-24.6). Median PFS was 21 months (95% CI: 12.5-NR), and median OS was 29.7 months (95% CI: 25.5-NR). Prior exposure to tyrosine kinase inhibitors was associated with shorter PFS, while ORR and OS were not significantly affected. Cabozantinib demonstrated a manageable safety profile, with fatigue and diarrhea being the most common adverse events. Grade III-IV toxicities occurred in 26.7% of patients.</p><p><strong>Conclusion: </strong>In this real-world Greek cohort, cabozantinib demonstrated meaningful clinical activity and an acceptable safety profile in mRCC patients progressing after ICI-based therapy. These findings support cabozantinib as an effective treatment option in the post-immunotherapy setting and contribute valuable real-world evidence to inform therapeutic sequencing in mRCC.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"597256"},"PeriodicalIF":2.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramedullary Ependymoma of the Cervicomedullary Junction: Gross Total Resection and Surgical Nuances in an Anatomically Rare Location.","authors":"Seyed Reza Mousavi, Kamran Hosseini, Hossein Ramezani Abadeh, Mohammadhadi Amir Shahpari Motlagh, Masoud Delavari, Niloofar Borzou, Majid Reza Farrokhi","doi":"10.2147/CMAR.S633170","DOIUrl":"10.2147/CMAR.S633170","url":null,"abstract":"<p><strong>Background: </strong>Intramedullary ependymomas are rare, slow-growing tumors (WHO grade II in most cases) arising from the ependymal cells of the spinal cord's central canal. In this case, histopathological examination confirmed a tanycytic ependymoma (WHO grade II). Although they have low potential for infiltration and seeding, and complete surgical excision is generally curative, the complex anatomy of the cervicomedullary region makes total resection particularly challenging.</p><p><strong>Case presentation: </strong>We present the case of a 34-year-old woman who presented with subacute quadriparesis (McCormick grade III, MRC 3-4/5), diminished gag reflex, hyperreflexia, and spastic gait. Magnetic resonance imaging (MRI) suggested the diagnosis of a cervicomedullary junction (CMJ) ependymoma and definitive diagnosis was established histopathologically. The patient underwent successful microscopic total resection via a posterior midline approach, including suboccipital craniectomy, C1 and C2 laminectomy, and midline myelotomy, all performed under intraoperative neuromonitoring. At one-year follow-up, the patient demonstrated improvement to McCormick grade I with MRC grade 5/5 in all limbs. Postoperative MRI confirmed complete resection without evidence of local recurrence.</p><p><strong>Conclusion: </strong>Neurological recovery was assessed using the McCormick Scale and Medical Research Council (MRC) muscle strength grading. The patient improved from a preoperative McCormick grade III (significant motor weakness requiring assistance for ambulation) to grade I (normal neurological function) at one-year follow-up. MRC muscle strength improved from 3-4/5 in all limbs preoperatively to 5/5 in all limbs postoperatively. Postoperative MRI at one-year follow-up confirmed complete resection without evidence of local recurrence. This case suggests that gross total resection of cervicomedullary ependymomas under intraoperative neuromonitoring is achievable and can result in excellent neurological outcomes, highlighting the importance of precise microsurgical techniques and intraoperative monitoring in managing these challenging tumors.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"633170"},"PeriodicalIF":2.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upregulated lncRNA AK058003 in Tumor-Educated Platelets and Plasma as Liquid Biopsy Biomarkers for Esophageal Cancer.","authors":"Xiuqi Wei, Honghua Yan, Yi Zeng, Kaidong Zhu, Teng Li, Junli Fan, Hui Wang","doi":"10.2147/CMAR.S643641","DOIUrl":"10.2147/CMAR.S643641","url":null,"abstract":"<p><strong>Purpose: </strong>Esophageal cancer (EC) ranks thirteenth in incidence and seventh in cancer-related mortality worldwide in 2024, with an estimated 494,000 new cases and 442,000 deaths, and esophageal squamous cell carcinoma (ESCC) remains the predominant histological subtype in China. Endoscopic biopsy and serum markers (SCCA, CA 19-9, CEA) have limited sensitivity or are invasive. This study evaluated the diagnostic potential of platelet and plasma lncRNA AK058003 in EC.</p><p><strong>Patients and methods: </strong>Platelet and plasma lncRNA AK058003 expression was quantified by quantitative real-time PCR in 64 EC patients and 64 healthy controls. Diagnostic performance was assessed by ROC curve analysis. Correlations with clinicopathological parameters were analyzed.</p><p><strong>Results: </strong>Tumor-educated platelet (TEP) and plasma lncRNA AK058003 were significantly upregulated in EC patients (P = 0.0042 and P < 0.0001, respectively). Plasma lncRNA AK058003 showed an AUC of 0.83 (sensitivity 82.8%, specificity 76.6%), whereas TEP lncRNA AK058003 yielded an AUC of 0.65 (sensitivity 64.1%, specificity 60.9%). TEP lncRNA AK058003 expression was significantly higher in T3-T4 than T1-T2 stages (P = 0.0025) and correlated with tumor size (P = 0.0017).</p><p><strong>Conclusion: </strong>Both TEP and plasma lncRNA AK058003 were significantly upregulated in EC. Plasma lncRNA AK058003 demonstrated promising diagnostic performance (AUC 0.83, sensitivity 82.8%, specificity 76.6%), while TEP lncRNA AK058003 overexpression correlated with tumor size, supporting their potential as non-invasive liquid-biopsy biomarkers for EC diagnosis.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"643641"},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}