Cancer Management and Research最新文献

{"title":"Application of Liquid Biopsy Technology in Lung Cancer: A Bibliometric Study and Visualization Analysis.","authors":"Yueqi Xu, Biao Huang, Guoshuang Zhu, Nidan Chen, Yao Gao, Zenan Wu, Lisha Mo, Liangji Liu","doi":"10.2147/CMAR.S550357","DOIUrl":"10.2147/CMAR.S550357","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is a major global health threat, and traditional treatments are hindered by tumor heterogeneity and drug resistance. Liquid biopsy technology offers new opportunities for precise diagnosis and treatment of lung cancer; however, its clinical application still presents challenges. Therefore, we aimed to elucidate the research progress and future trends of liquid biopsy technology through a bibliometric analysis.</p><p><strong>Methods: </strong>Literature on liquid biopsy technology in lung cancer research spanning from 1990 to 2024 was retrieved from the Web of Science Core Collection. Various bibliometric tools were employed, including VOSviewer (1.6.20), Cite Space (6.2.R3), RStudio (utilizing the R package bibliometrix), and Scimago Graphica, to explore the current situation and research hotspots in this area. The research covered multiple aspects, including publication counts, contributions from different countries and institutions, journals involved, authorship, co-references, and keywords. By generating corresponding visualization maps, an attempt was made to forecast future development trends within this research field.</p><p><strong>Results: </strong>We identified 363 articles published in 198 journals, authored by 2518 authors from 266 institutions across 54 countries/regions. The journal, country, institution, and author with the highest number of publications were Cancer, China, Harvard University, and ROLFO C. Over the past 34 years, research on the application of liquid biopsy technology in lung cancer have primarily focused on cancer diagnosis, biomarkers, and treatment monitoring.</p><p><strong>Conclusion: </strong>Liquid biopsy technology is rapidly evolving in the field of lung cancer. Detecting biomarkers such as circulating tumor DNA, circulating tumor cells, and extracellular vesicles, facilitates early detection and monitoring of treatment response, reveals drug resistance mechanisms, and promotes personalized treatment. With the advancement of technology and international cooperation, liquid biopsy is expected to provide more accurate diagnosis and treatment for patients with lung cancer in the future.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2153-2168"},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184705","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":"Postoperative Anxiety in Childbearing-Age Women with PTMC: Comparison Between Traditional Surgery and Thermal Ablation.","authors":"Bo Yu, Yukun Luo, Shi Tan, Ligang Cui, Xiaoxiao Liu, Qidi Zhou","doi":"10.2147/CMAR.S538777","DOIUrl":"10.2147/CMAR.S538777","url":null,"abstract":"<p><strong>Objective: </strong>To compare postoperative anxiety in childbearing-age women with PTMC undergoing traditional surgery and thermal ablation, and identify influencing factors.</p><p><strong>Methods: </strong>This retrospective cohort study included 118 women of childbearing age who underwent surgery for papillary thyroid microcarcinoma (PTMC) between January and December 2023. Postoperative anxiety symptoms and their influencing factors were prospectively assessed during follow-up visits using standardized questionnaires: the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Self-Rating Anxiety Scale (SAS), the Thyroid Cancer-Specific Health-Related Quality of Life Questionnaire (THYCA-QoL), and the Reproductive Health Literacy Scale. Demographic characteristics and clinical data were analyzed using univariate analysis and multiple linear regression models to identify risk factors.</p><p><strong>Results: </strong>Postoperative anxiety was significantly associated with long-term levothyroxine use (β=0.405, p=0.011) and surgical approach. Traditional surgery patients demonstrate higher physical health (2.50 vs 1.50, p<0.001) and social/family scores (2.17 vs 1.50, p<0.001) than the ablation group parallels greater levothyroxine dependency (89.4% vs 15.2%, p<0.001). Symptom-anxiety correlations differed between groups: traditional surgery was associated with multidimensional drivers (voice changes r=0.572, weight gain r=0.488), whereas thermal ablation primarily correlated with transient voice changes (r=0.507).</p><p><strong>Conclusion: </strong>The multidimensional anxiety after traditional surgery originates from thyroid dysfunction and complications, whereas thermal ablation is associated with a lower psychological burden with manageable short-term symptoms. Treatment selection should be individualized prioritizing reproductive timelines and individualized risk-benefit profiles.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2143-2152"},"PeriodicalIF":2.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147774","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":"Deep Learning for Cancer Detection Based on Genomic and Imaging Data: A Comprehensive Review.","authors":"Xinyu Wang, Can Su","doi":"10.2147/CMAR.S533522","DOIUrl":"10.2147/CMAR.S533522","url":null,"abstract":"<p><p>Cancer is a major global health challenge, and early detection is critical to improving survival rates. Advances in genomics and imaging technologies have made the integration of genomic and imaging data a common practice in cancer detection. Deep learning, especially Convolutional Neural Networks (CNNs), demonstrates substantial potential for early cancer diagnosis by autonomously extracting valuable features from large-scale datasets, thus enhancing early detection accuracy. This review summarizes the progress in deep learning applications for cancer detection using genomic and imaging data. It examines current models, their applications, challenges, and future research directions. Deep learning introduces innovative approaches for precision diagnosis and personalized treatment, facilitating advancements in early cancer screening technologies.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2089-2125"},"PeriodicalIF":2.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147751","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":"Peritoneal Metastasis in Non-Small Cell Lung Cancer: A Systematic Review of Clinical Features, Molecular Profiles, Diagnostic Approaches, and Outcomes.","authors":"Ryuichi Ohta, Yoshinori Ryu, Kaoru Tanaka, Chiaki Sano, Hidetoshi Hayashi","doi":"10.2147/CMAR.S542123","DOIUrl":"10.2147/CMAR.S542123","url":null,"abstract":"<p><strong>Introduction: </strong>Peritoneal metastasis is an uncommon but clinically significant manifestation of non-small cell lung cancer (NSCLC). While traditionally associated with gastrointestinal or ovarian malignancies, emerging reports suggest that NSCLC, particularly adenocarcinoma with driver mutations, can also exhibit peritoneal dissemination. This systematic review aims to synthesize current evidence on the clinical characteristics, diagnostic modalities, molecular profiles, treatment strategies, and outcomes of NSCLC patients with peritoneal metastasis.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, and Web of Science from inception through April 2025. Studies were eligible if they reported peritoneal metastasis in histologically confirmed NSCLC patients. Data on histopathology, molecular alterations, diagnosis, treatment, and survival were extracted. The review was conducted in accordance with PRISMA 2020 guidelines.</p><p><strong>Results: </strong>Twenty-seven studies met inclusion criteria, comprising 19 case-based reports and seven retrospective cohort studies. Adenocarcinoma was the predominant histologic type (93%), and EGFR mutations were the most frequently reported molecular alteration. Diagnosis was primarily established via ascitic cytology, imaging, or intraoperative findings. Targeted therapy (eg, EGFR- or BRAF-directed TKIs) yielded temporary disease control in selected cases. However, median overall survival after peritoneal metastasis ranged from 2.0 to 5.2 months. Prognostic factors included poor performance status, absence of actionable mutations, and concurrent pleural metastasis.</p><p><strong>Conclusion: </strong>Peritoneal metastasis in NSCLC is rare but associated with poor prognosis. Molecular-guided therapies offer transient benefit, underscoring the need for early recognition and individualized treatment approaches. Prospective studies are warranted to better define predictors and optimal management strategies for this atypical metastatic pattern.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2127-2141"},"PeriodicalIF":2.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136692","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":"Combined Detection of Tumor Stem Cell Markers CD133 and OCT4 in Early Non-Small Cell Lung Cancer Screening and Prognostic Evaluation.","authors":"Shuhong Guan, Junkang Huangfu, Xiaoqin Zhu, Yunqi Ge, Ying Ding, Tianyu Chen, Yilei Zhang, Tingting Yang, Huimin Liu, Long Zhang, Xiyao Chen, Jun Zhou","doi":"10.2147/CMAR.S551828","DOIUrl":"10.2147/CMAR.S551828","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the expression of cancer stem cell (CSC) markers CD133 and OCT4 in early-stage non-small cell lung cancer (NSCLC), evaluate their diagnostic value in early screening, and analyze their prognostic significance.</p><p><strong>Methods: </strong>A retrospective study was conducted on 80 patients with early-stage NSCLC (stages I-IIA) and 40 healthy controls from January 2021 to December 2023. Expression levels of CD133 and OCT4 were assessed by immunohistochemistry (IHC) and quantitative real-time PCR (qRT-PCR). Clinicopathological data were analyzed, and all patients were followed for 24 months to assess overall survival (OS). Diagnostic efficacy was evaluated by ROC analysis, and prognostic factors were identified by Cox regression.</p><p><strong>Results: </strong>CD133 and OCT4 were significantly upregulated in NSCLC tissues compared with adjacent normal tissues and healthy controls (P<0.001). High expression correlated with poor differentiation, larger tumor size (≥3 cm), lymph node metastasis, and stage IB-IIA (P<0.05). ROC analysis showed AUCs of 0.809 for CD133, 0.796 for OCT4, and 0.893 for their combination, with combined sensitivity of 88.7% and specificity of 82.5%. Patients with high expression of both markers had markedly reduced 2-year OS compared with low-expression cases (P<0.01). Multivariate Cox regression identified high CD133 expression (HR=2.45, 95% CI: 1.38-4.36, P=0.003), high OCT4 expression (HR=2.17, 95% CI: 1.22-3.86, P=0.007), poor differentiation (HR=1.91, P=0.021), tumor size ≥3 cm (HR=1.84, P=0.039), lymph node metastasis (HR=2.08, P=0.020), and stage IB-IIA (HR=2.22, P=0.016) as independent prognostic risk factors.</p><p><strong>Conclusion: </strong>CD133 and OCT4 are overexpressed in early-stage NSCLC and are associated with aggressive disease and poor prognosis. Combined detection provides superior diagnostic accuracy (AUC=0.893) compared to single markers and may serve as a valuable biomarker panel for early screening and risk stratification. These markers also have potential utility in guiding individualized treatment strategies.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2077-2087"},"PeriodicalIF":2.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136657","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":"Sunvozertinib Monotherapy in Advanced Lung Adenocarcinoma with <i>EGFR</i> Exon 20 Insertion and High PD-L1 Expression: A Case Report.","authors":"Juan Zhou, Hui Han","doi":"10.2147/CMAR.S524920","DOIUrl":"10.2147/CMAR.S524920","url":null,"abstract":"<p><p>As a key oncogenic driver in non-small-cell lung cancer (NSCLC), <i>epidermal growth factor receptor</i> (<i>EGFR</i>) exon 20 insertion mutations account for 2-5% of <i>EGFR</i>-mutated NSCLC cases and display marked heterogeneity. Conventional <i>EGFR</i> tyrosine kinase inhibitors (TKIs) are ineffective against these mutations. Sunvozertinib, an orally administered, potent, and highly selective <i>EGFR</i>-TKI, has been approved in China for second-line treatment of NSCLC harboring <i>EGFR</i> exon 20 insertion mutations. Historically, patients with <i>EGFR</i> exon 20 insertion and high programmed death-ligand 1 (PD-L1) expression often received combined immunotherapy and chemotherapy. In the present case report, we describe a patient who exhibited intolerance to first-line immunochemotherapy and was subsequently switched to sunvozertinib for maintenance therapy. This regimen yielded a prolonged progression-free survival, with manageable safety and tolerability profiles. These findings demonstrated that sunvozertinib could be a promising first-line treatment option for NSCLC patients with <i>EGFR</i> exon 20 insertion.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2069-2076"},"PeriodicalIF":2.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130055","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":"Determinants and Consequences of Parental Uncertainty in Childhood Cancer: A Systematic Review.","authors":"Cucu Taqyah, Fitri Ariyanti Abidin, Aulia Iskandarsyah","doi":"10.2147/CMAR.S538600","DOIUrl":"10.2147/CMAR.S538600","url":null,"abstract":"<p><strong>Purpose: </strong>Although illness uncertainty has been widely studied in adults, little is known about this issue in childhood cancer, particularly from parents' perspectives. Unaddressed parental perception of illness uncertainty (parental uncertainty) may undermine both parental well-being and children's treatment outcomes. This systematic review aims to synthesize existing evidence on the determinants and consequences of parental uncertainty in childhood cancer.</p><p><strong>Methods: </strong>Following PRISMA guidelines, six databases (Scopus, SAGE, Taylor & Francis, MEDLINE Ultimate, PubMed, and ScienceDirect) were systematically searched. Eligible studies were appraised using the Mixed-Methods Appraisal Tool (MMAT), and data were narratively synthesized.</p><p><strong>Results: </strong>From 979 initially identified records, 14 studies met the inclusion criteria. Parental uncertainty was found to be influenced by both risk and protective factors. Risk factors include older parental age, lower educational attainment, lower income, maternal unemployment, barriers to healthcare access, shorter time since diagnosis, and higher treatment intensity. Protective factors include active coping skills, parental education support, communication support from healthcare providers, and positive parent-child communication. Parental uncertainty was consistently associated with adverse psychological outcomes, such as anxiety, depression, rumination, post-traumatic stress symptoms (PTSS), parenting stress, and dysfunctional problem-solving, while reducing positive outcomes such as resilience, mastery, constructive coping, and health-related quality of life (HRQoL).</p><p><strong>Conclusion: </strong>Parental uncertainty in childhood cancer is driven by multiple factors and linked to significant psychological burdens, with PTSS as the most prominent consequence. Early interventions targeting parental mental health soon after diagnosis are essential to reduce long-term risks, including PTSD.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2049-2068"},"PeriodicalIF":2.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129973","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":"Dermatotoxicity of Immune Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer: Current Advances in Mechanistic Insights and Predictive Biomarker Identification.","authors":"Shiliang Shao, Wenjuan Zheng, Xuyang Li, Ao Qi, Yifeng Gu, Yabin Gong, Qin Wang, Lijing Jiao, Ling Xu","doi":"10.2147/CMAR.S528555","DOIUrl":"10.2147/CMAR.S528555","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have substantially improved clinical outcomes in patients with advanced non-small cell lung cancer (NSCLC). However, the cutaneous immune-related adverse events (cirAEs) they elicit-being the most frequent and earliest-emerging toxicities-not only compromise treatment adherence but also exhibit a distinct positive association with systemic immune activation and antitumor efficacy. Given these characteristics, elucidating the pathogenic mechanisms of cirAEs and identifying predictive biomarkers are critical for the early detection and intervention of cirAEs, as well as for forecasting the onset of other immune-related adverse events (irAEs) and assessing ICI therapeutic prognosis. This review systematically summarizes recent advances in the pathological mechanisms of cirAEs and predictive biomarkers. Mechanistically, cirAEs result from multifactorial interplay, including genetic predisposition, shared antigen-driven cross-reactivity, and breakdown of cutaneous immune tolerance. For predictive biomarkers, strategies span traditional predictors (eg, demographic and immunological features) and their clinical translation challenges to emerging methods leveraging multi-omics integration and radiomics. Finally, this review addresses future challenges and directions in cirAEs research: Specifically, the positive association between cirAEs and efficacy demands accurate differentiation of \"manageable toxicities\" from \"high-risk toxicities\"; furthermore, future studies must validate causal biomarkers via prospective multi-omics cohorts and develop AI-driven dynamic prediction models to enable toxicity-stratified management and optimization of personalized immunotherapy.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2035-2048"},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124347","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":"Association Between Human Papillomavirus and Thymic Cancer: A Population-Based Cohort Study.","authors":"Peng-Tzu Liu, Wan-Lun Hsu, Tzu-I Chen, Chung-Ju Chiang, Mei-Hung Pan, Hui-Ling Lee, Chia-Chuan Wang, Chien-Jen Chen, Vinchi Wang, Yong-Chen Chen","doi":"10.2147/CMAR.S537425","DOIUrl":"10.2147/CMAR.S537425","url":null,"abstract":"<p><strong>Background: </strong>Thymic carcinoma is an uncommon malignancy with unclear etiology. Although human papillomavirus (HPV) has been implicated in multiple cancers, its potential association with thymic cancer remains poorly studied in large population-based cohorts. This study aimed to investigate the role of HPV in developing thymic cancer and the risk of different HPV genotypes on thymic cancer.</p><p><strong>Methods: </strong>We examined the longitudinal relationship between HPV infection and thymic cancer in a cohort of 10,558 women aged 30 to 65 years who were enrolled in 1991 or 1992 in Taiwan. Cervical cells collected at the beginning of this study were tested for 39 types of HPV. The incidence of newly developed thymic cancer was determined through a computerized linkage with the National Cancer Registry by using the topography code 164 for thymic cancer in the International Classification of Diseases, Ninth Edition.</p><p><strong>Results: </strong>An increased risk of thymic cancer was associated with HPV infection, with an HR (95% CI) of 2.42 (0.62 to 9.38) after adjustment for age and body mass index. The level of risk was higher for infections with HPV types classified in the International Agency for Research on Cancer group 3, with an adjusted HR (95% CI) of 11.82 (2.51 to 55.70).</p><p><strong>Conclusion: </strong>This population-based cohort study provides longitudinal evidence that HPV infection may be associated with an increased risk of thymic cancer. While no significant overall association was observed, subgroup analysis revealed a notable association with HPV genotypes classified as IARC group 3. Additional studies are necessary to confirm the role of HPV in thymic carcinogenesis.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2023-2033"},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124300","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":"Modified Glasgow Prognostic Score Incorporating CRP/Albumin Ratio and LDH Levels as Prognostic Indicators in Patients with Multiple Myeloma: A Retrospective Study.","authors":"Mustafa Duran, Nermin Keni Begendi","doi":"10.2147/CMAR.S540819","DOIUrl":"10.2147/CMAR.S540819","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether integrating the CRP/Albumin Ratio (CAR) and Lactate Dehydrogenase (LDH) levels into the Modified Glasgow Prognostic Score (mGPS) enhances its prognostic accuracy in patients with multiple myeloma (MM).</p><p><strong>Patients and methods: </strong>A single-center retrospective study was conducted on patients diagnosed with multiple myeloma (MM) at Afyonkarahisar Health Sciences University between 2017 and 2023. Demographic, clinical, and laboratory data including mGPS, CAR, LDH, and ISS staging were collected. Survival outcomes were assessed using Kaplan-Meier curves, and Cox regression models were used to determine prognostic factors.</p><p><strong>Results: </strong>Among the 130 patients, the ISS score was the strongest predictor of mortality (HR = 1.63, 95% CI: 1.27-2.09, p = 0.0001). mGPS 2 combined with LDH > 250 IU (HR = 1.96, 95% CI: 1.32-2.92) and CAR > 0.51 (HR = 1.71, 95% CI: 1.16-2.53) were independent risk factors. mGPS alone remained a consistent prognostic marker (HR = 1.42, 95% CI: 1.14-1.77). One-year survival was 50.0% in the mGPS 2 group, dropping to 30.3% at two years. The mGPS 2 + LDH > 250 IU group had the poorest survival (39.5% to 23.3%), followed by the mGPS 2 + CAR > 0.51 group (44.9% to 28.6%). Median PFS was 28.0, 47.0, and 9.0 months in mGPS0, mGPS1, and mGPS2, respectively (p < 0.001), with mGPS2 showing significantly shorter PFS. mGPS2, CAR, LDH, and their combinations were independent predictors of progression. In mGPS2, OS and PFS declined steadily over 36 months, with the lowest long term PFS in the CAR elevated subgroup.</p><p><strong>Conclusion: </strong>Integrating CAR and LDH into the mGPS offers a cost-effective and accessible approach to improve risk stratification in patients with MM. This enhanced model provides a comprehensive assessment of systemic inflammation and tumour burden, supporting its potential use in clinical decision making.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2009-2021"},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112039","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}