Cancer Management and Research最新文献

{"title":"Clinical Characteristics and Long-Term Follow-Up of Leukoencephalopathy in Pediatric Acute Lymphoblastic Leukemia After Chemotherapy.","authors":"Jun Feng, Xiao Xiao, Jihong Tang, Bingbing Zhang","doi":"10.2147/CMAR.S631566","DOIUrl":"10.2147/CMAR.S631566","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the clinical characteristics and long-term outcomes of leukoencephalopathy (LE) in pediatric patients with acute lymphoblastic leukemia (ALL) after chemotherapy, with the goal of evaluating diagnosis, treatment, and prognosis.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 48 pediatric ALL patients diagnosed with LE after chemotherapy at the Children's Hospital of Soochow University (February 2010-December 2024). Data included general information, Clinical manifestations and diagnostic imaging results. Compared with a control group of 27 healthy children, the patients' cognitive function was assessed by using the Behavioural Rating Inventory of Executive Function-2 (BRIEF-2) and the Wechsler Intelligence Scale for Children (WISC).</p><p><strong>Results: </strong>Neurological symptoms were observed in 47.92% (23/48) of LE patients, including seizures (27.08%), paralysis (12.50%), limb numbness (10.42%), and speech impairment (10.42%). Brain MRI revealed white matter abnormalities, predominantly in the periventricular regions (47.92%), parietal lobes (37.50%), and frontal lobes (22.92%). Long-term follow-up demonstrated that 73.91% of symptomatic patients experienced rapid neurological improvement, and 83.33% of cases showed a significant reduction in MRI lesions within 12 months. Compared to controls, patients with LE exhibited higher BRIEF-2 scores (indicating executive dysfunction) for self-monitoring, emotional control, working memory, and planning/organization (all P < 0.05). The WISC scores were significantly lower for the total IQ, perceptual reasoning, working memory, and processing speed (P < 0.05).</p><p><strong>Conclusion: </strong>Post-chemotherapy LE in pediatric ALL presents with diverse neurological symptoms and neuroimaging abnormalities accompanied by mild-to-moderate cognitive deficits. However, the prognosis appears favorable, with most patients showing symptom resolution and improved imaging findings.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"631566"},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011952","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":"Breaking the Feedback Loop: A Model of Vicious Cycle for CIPN and Acupuncture-Medication Combination.","authors":"Jiajing Wang, Yifei Guo, Jiao Gou, Xuan Liu, Xiaorui Wang, Chenguang Yang","doi":"10.2147/CMAR.S635480","DOIUrl":"10.2147/CMAR.S635480","url":null,"abstract":"<p><p>Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and often debilitating complication of cancer therapy, whose chronicity and refractoriness cannot be adequately explained by traditional linear etiological models. This review proposes and organizes a \"vicious cycle\" model as a hypothesis: initial neuronal injury caused by chemotherapeutic agents initiates a self-sustaining positive feedback loop in which mitochondrial dysfunction and oxidative stress reciprocally amplify each other, thereby activating neuroinflammation and ion channel remodeling. These processes collectively drive neuronal hyperexcitability, which further exacerbates mitochondrial damage and inflammatory responses, ultimately establishing a pathological circuit composed of multiple interconnected nodes. Building on this hypothesized framework, the article systematically evaluates current therapeutic strategies. Many conventional pharmacological interventions predominantly focus on specific targets. While some exhibit pleiotropic effects, the difficulty in disrupting the integrated dynamics of the entire cycle may partially explain their limited disease-modifying capabilities. In contrast, traditional Chinese medicine (TCM)-through the synergistic multi-target effects of acupuncture, bioactive herbal constituents, and compound formulations-shows potential to concurrently modulate several critical nodes within the cycle, suggesting promising advantages in holistic regulation, despite the preliminary and heterogeneous nature of current supporting evidence. On this basis, we propose an integrative \"acupuncture combined with herbal medicine\" strategy: acupuncture may enable rapid modulation of the neuro-immune network, whereas herbal medicine may support sustained repair of molecular pathways, together potentially contributing to disruption of the pathological cycle from microscopic mechanisms to macroscopic phenotypes. This approach advocates a paradigm shift in CIPN management-from symptom control toward breaking the pathological cycle-and offers a novel theoretical framework and integrated therapeutic pathway for further investigation of this persistent clinical challenge.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"635480"},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011964","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":"LRRC32 Mediates Resistance to Everolimus in Hormone Receptor-Positive, HER2-Negative Breast Cancer.","authors":"Liguang Wang, Xue Chen, Xiaojiao Li, Yu Wang, Rong Shen","doi":"10.2147/CMAR.S619010","DOIUrl":"10.2147/CMAR.S619010","url":null,"abstract":"<p><strong>Aim: </strong>Everolimus is approved for hormone receptor-positive, HER2-negative breast cancer, but resistance mechanisms remain incompletely understood. This study aimed to investigate the functional role of LRRC32 in mediating Everolimus resistance using patient-derived organoid (PDO) models of this breast cancer subtype.</p><p><strong>Materials and methods: </strong>Everolimus-resistant and sensitive breast cancer organoids were established from patient-derived tumor tissues. RNA sequencing was performed to compare expression profiles. In vitro functional assays were conducted, including LRRC32 overexpression and shRNA-mediated knockdown, MTT cell viability assay, flow cytometric apoptosis detection, and flow cytometric cell cycle analysis.</p><p><strong>Results: </strong>RNA sequencing identified significant LRRC32 upregulation in resistant cells with a fold change of 180.46 (p < 0.001). LRRC32 overexpression reduced apoptosis and enhanced cell survival, whereas knockdown increased apoptosis. Cell cycle analysis showed that LRRC32 knockdown in resistant cells significantly increased the G1-phase fraction, hindering G0/G1-to-S transition.</p><p><strong>Conclusion: </strong>Our findings suggest that LRRC32 plays a pivotal role in modulating the sensitivity of breast cancer cells to Everolimus.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"619010"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007780","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":"LONP2 Enhances Cervical Cancer Growth and Metastatic Potential by Upregulating PLS3 and Activating PI3K/AKT Signaling.","authors":"Ying Yang, Jing Sun, Liu Tian, Jing Liao","doi":"10.2147/CMAR.S631538","DOIUrl":"10.2147/CMAR.S631538","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the role of LONP2 in cervical cancer progression and elucidate the underlying signaling mechanisms.</p><p><strong>Methods: </strong>HeLa cervical cancer cells were transduced with lentiviral vectors to overexpress LONP2 or simultaneously overexpress LONP2 and knock down plastin 3 (PLS3). Protein expression was assessed by Western blotting. Cell viability, apoptosis, migration, and invasion were evaluated using CCK-8 assays, flow cytometry, and Transwell assays, respectively. The involvement of the PI3K/AKT signaling pathway was examined by detecting the phosphorylation levels of PI3K and AKT. A nude mouse xenograft model was established to validate the in vitro findings.</p><p><strong>Results: </strong>LONP2 overexpression significantly increased PLS3 protein expression in cervical cancer cells. Functionally, LONP2 promoted cell proliferation, migration, invasion, and tumor growth while suppressing apoptosis. Knockdown of PLS3 markedly attenuated these tumor-promoting effects both in vitro and in vivo. Mechanistically, LONP2 overexpression enhanced the phosphorylation of PI3K and AKT without significantly affecting total PI3K or AKT expression, indicating activation of the PI3K/AKT signaling pathway. Importantly, silencing PLS3 effectively reversed LONP2-induced PI3K/AKT pathway activation. Consistent findings were observed in xenograft tumors, where PLS3 knockdown suppressed tumor growth and reduced p-PI3K and p-AKT expression.</p><p><strong>Conclusion: </strong>LONP2 promotes cervical cancer progression by upregulating PLS3 expression and activating the PI3K/AKT signaling pathway. The LONP2/PLS3/PI3K-AKT signaling axis represents a novel mechanism driving cervical cancer progression and may serve as a potential therapeutic target for cervical cancer treatment.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"631538"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007825","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":"Impact of Oncology Patients' Knowledge and Awareness on Emergency Visits and Hospital Admissions: A Cross-Sectional Study.","authors":"Nada Alsuhebany, Shuroug A Alowais, Waad Saleh Alanazi, Taif Z Alanazi, Sarah Ibrahim Aldaghreer, Bashayer Alshehri, Nadin Almosnid, Salwa Y Hafez, Lama Alfehaid, Mashael Almuqrin, Khalid Al Sulaiman, Khalid A Alamer, Ibrahim M Asiri","doi":"10.2147/CMAR.S616119","DOIUrl":"10.2147/CMAR.S616119","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy remains a cornerstone of cancer treatment, but is frequently accompanied by adverse effects that can affects patients' quality of life. In Saudi Arabia, patients' understanding of chemotherapy regimens and related toxicities is not well characterized. This study aimed to evaluate chemotherapy awareness among cancer patients and examine its association with hospital admissions and emergency department (ED) visits.</p><p><strong>Methods: </strong>This cross-sectional descriptive study was conducted at a tertiary hospital in Saudi Arabia, between year of 2022 to 2023. Adult cancer patients receiving at least one chemotherapy cycle were interviewed using a validated, investigator-developed questionnaire assessing beliefs and knowledge about cancer diagnosis, treatment regimens, and side effects. Awareness levels were classified as highly aware or not/low aware based on self-reports verified against electronic medical records (EMR). Descriptive statistics summarized demographic characteristics, while independent <i>t</i>-tests compared mean awareness scores between groups. Negative binomial regression examined associations between awareness levels, hospital admissions, and ED visits, adjusting for demographic covariates, with a sensitivity analysis additionally adjusting for advanced (stage IV) disease.</p><p><strong>Results: </strong>A total of 270 participants were enrolled (mean age 52 years; 61.1% female). Breast (33.7%) was the most common diagnosis, with 48.1% at stage IV disease. Overall, 69.3% of patients were classified as highly aware. Highly aware patients demonstrated significantly greater knowledge of treatment goals, chemotherapy regimens, and side effects. Greater awareness was associated with higher rates of ED visits and hospital admissions in adjusted analyses. Female gender and limited English fluency were also significant predictors of higher hospital admissions.</p><p><strong>Conclusion: </strong>Most oncology patients demonstrated high awareness of their chemotherapy. Awareness was not independently associated with emergency visits or hospital admissions; instead, female gender and limited English proficiency were the principal correlates of higher utilization. Structured patient education is needed to translate awareness into effective self-management and reduce healthcare utilization.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"616119"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007703","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-Based Model to Predict Survival in Resectable Intrahepatic Cholangiocarcinoma.","authors":"Guoteng Qiu, Shizheng Mi, Jiali Chen, Haichuan Wang, Le Luo","doi":"10.2147/CMAR.S630710","DOIUrl":"10.2147/CMAR.S630710","url":null,"abstract":"<p><strong>Purpose: </strong>Many studies attempted to precisely predict survival or recurrence of patients with resectable intrahepatic cholangiocarcinoma using perioperative indicators. However, machine learning has been infrequently applied to predict postoperative survival in patients with intrahepatic cholangiocarcinoma (ICC). We therefore compared the performance of three prognostic models: the Cox proportional hazards model, random survival forest, and DeepSurv.</p><p><strong>Methods: </strong>Least absolute shrinkage and selection operator (LASSO) regression was used for variable selection, and 13 variables were finally selected for model training. Model discrimination was evaluated using the concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (time-dependent AUC). Model calibration was assessed using calibration curves and the integrated Brier score (IBS).</p><p><strong>Results: </strong>A total of 394 consecutive patients with intrahepatic cholangiocarcinoma who underwent curative resection between January 2010 and December 2016 were retrospectively enrolled. In the validation set, the Harrell's C-index was 0.680 for CoxPH, 0.700 for random survival forest, and 0.680 for DeepSurv. The random survival forest achieved the highest mean time-dependent AUC (0.738) and the lowest IBS (0.147), followed by DeepSurv (AUC: 0.723; IBS: 0.235) and CoxPH (AUC: 0.713; IBS: 0.148). The final model was visualized on a web-based platform (https://shizhengmi.shinyapps.io/exam/).</p><p><strong>Conclusion: </strong>The random survival forest demonstrated favorable discrimination and calibration, highlighting the potential value of ensemble learning in intrahepatic cholangiocarcinoma. The top five predictors in the final model were CA19-9, albumin, tumor differentiation, CEA, and tumor number.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"630710"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007864","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":"Herbal Medicine and the Gastrointestinal Microbiota in Gastric Precancerous Lesions and Gastric Cancer: Mechanistic Evidence and Translational Challenges.","authors":"Jing Zhang, Yang Yao","doi":"10.2147/CMAR.S626166","DOIUrl":"https://doi.org/10.2147/CMAR.S626166","url":null,"abstract":"<p><p>Gastric cancer (GC) remains one of the leading causes of cancer-related morbidity and mortality worldwide. Increasing evidence indicates that microbial alterations associated with GC extend beyond <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and involve coordinated ecological changes across the oral cavity, gastric mucosa, gastric fluid, and intestine. These compartment-specific microbial communities exhibit distinct compositional and functional characteristics throughout the progression from chronic gastritis and precancerous lesions of gastric cancer (PLGC) to established GC, suggesting that gastrointestinal microbial dysbiosis contributes to disease development through interactions involving mucosal barrier function, inflammation, immune regulation, and microbial metabolism. Traditional Chinese medicine (TCM) has been widely used in the prevention and treatment of GC and PLGC. Recent experimental and clinical studies suggest that certain herbal formulas and natural compounds may influence gastrointestinal microbial composition, microbial metabolites, host immune responses, and epithelial barrier function while also exhibiting anti- <i>H. pylori</i>, anti-inflammatory, and anti-tumor activities. This review summarizes current evidence regarding compartment-specific alterations of the oral, gastric mucosal, gastric fluid, and intestinal microbiota during gastric carcinogenesis, emphasizing the ecological heterogeneity of these microbial niches and the methodological considerations required for their interpretation. We further summarize experimental evidence demonstrating that TCM formulas and bioactive constituents regulate gastrointestinal microbiota, microbial metabolism, programmed cell death, and inflammatory signaling in models of <i>H. pylori</i> infection, PLGC, and GC. In addition, available randomized clinical studies investigating microbiota-related effects of TCM formulas in patients with PLGC or GC are critically reviewed.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"626166"},"PeriodicalIF":2.6,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988138","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":"Serum NGAL and G-CSFR as Predictive and Prognostic Biomarkers for Trastuzumab-Based Therapy in HER2-Positive Gastric Cancer: A Retrospective Study.","authors":"Jingwen Ying, Zui Wang, Jing Wang, Minming Xia","doi":"10.2147/CMAR.S607440","DOIUrl":"https://doi.org/10.2147/CMAR.S607440","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate serum neutrophil gelatinase-associated lipocalin (NGAL) and granulocyte colony-stimulating factor receptor (G-CSFR) in predicting efficacy and prognosis of trastuzumab-based targeted therapy in HER2-positive gastric cancer patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study enrolled 150 patients with HER2-positive gastric cancer who were admitted to our hospital between January 2023 and January 2025. All patients received trastuzumab-based combination chemotherapy (XELOX or SOX regimen) and were categorized into responders and non-responders according to the RECIST 1.1 criteria. Baseline patient data and clinicopathological parameters related to gastric cancer were retrospectively collected. Serum levels of NGAL and G-CSFR were measured at three time points: before treatment (T0), after 2 cycles of therapy (T1), and after 4 cycles of therapy (T2). Differences in the dynamic changes of these biomarkers between groups were compared. Multivariate logistic regression analysis was performed to identify independent prognostic factors. ROC curves were constructed to evaluate the predictive performance of NGAL, G-CSFR, and their combined use for assessing the efficacy of trastuzumab-based targeted therapy in HER2-positive gastric cancer patients. Kaplan‑Meier analysis was used to assess the relationship between different NGAL and G‑CSFR levels and progression‑free survival (PFS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The proportions of TNM stage IV, HER2 FISH-positive status, and poorly differentiated pathological types were significantly higher in the non-responder group than in the responder group (P &lt; 0.05). At T0, T1, and T2, serum NGAL levels were significantly higher in the non-responder group than in the responder group, and G-CSFR levels were significantly lower (P &lt; 0.05). In both groups, NGAL levels progressively decreased over the treatment course, while G-CSFR levels progressively increased (P &lt; 0.05). Multivariate logistic regression analysis identified poor differentiation and higher T0 NGAL levels as independent risk factors for non-response to trastuzumab-based targeted therapy in HER2-positive gastric cancer patients, while higher T0 G-CSFR levels served as an independent protective factor (P &lt; 0.05). ROC curve analysis demonstrated that the combination of NGAL and G-CSFR at T0 yielded an AUC of 0.813 for predicting treatment response, which was significantly superior to that of either single marker (NGAL: 0.656; G-CSFR: 0.731). The combined assay achieved a sensitivity of 0.766 and a specificity of 0.751. Kaplan-Meier analysis showed that the high NGAL group had a median PFS of 6.0 (5.0, 9.0) months, significantly shorter than the low NGAL group with 7.0 (7.0, 11.0) months (Log-rank χ&lt;sup&gt;2&lt;/sup&gt; = 6.511, P = 0.011); the low G-CSFR group had a median PFS of 6.0 (5.0, 8.0) months, significantly shorter than the high G-CSFR group with 8.0 (8.0, 11.0) months (Log-rank χ&lt;sup&gt;2&lt;/sup&gt; = 15.9","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"607440"},"PeriodicalIF":2.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988161","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":"Dynamic Neutrophil-to-Lymphocyte Ratio Stratifies Survival and Immune-Related Adverse Events in Lung and Gastric Cancer Patients with Immunotherapy.","authors":"Chengcheng Qian, Mengting Wang, Chuyi Liu, Feng Liu, Wenying Zhang, Xiaohua Hu, Yanjie Zhang, Bin Jiang, Jiongyi Wang, Ming Xu, Haihua Yuan","doi":"10.2147/CMAR.S629956","DOIUrl":"10.2147/CMAR.S629956","url":null,"abstract":"<p><strong>Background: </strong>Dynamic neutrophil-to-lymphocyte ratio (NLR) has emerged as a prognostic marker in immunotherapy outcomes, yet phase-specific alterations in NLR after immunotherapy and their association with treatment efficacy remain underreported. This study aimed to clarify the prognostic utility of NLR dynamics in patients receiving immune checkpoint inhibitors (ICIs) therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed 101 cancer patients (including lung and gastric cancer) treated with ICIs. NLR was measured at three time points: baseline (prior to ICIs initiation), Cycle 1 (C1, 1 month post-treatment), and Cycle 3 (C3, 3 months post-treatment). Pearson's chi-square test and Kaplan-Meier survival analyses were used to assess associations between NLR dynamics and immune-related adverse events (irAEs), progression-free survival (PFS), and overall survival (OS).</p><p><strong>Results: </strong>Baseline NLR showed no significance with irAEs. However, elevated C1 NLR was related with early irAEs in both lung and gastric cancers (OR = 2.883, p = 0.029). In lung cancer patients, a reduced C3 NLR was significantly associated with longer PFS (HR = 2.376, p = 0.006) and OS (HR = 3.315, p < 0.001), whereas the association was weaker in gastric cancer (PFS: HR = 1.758, p = 0.085; OS: HR = 2.284, p = 0.019). Multivariate analysis identified C3 NLR was associated independently with both PFS and OS in lung cancer patients. Furthermore, a ≥ 30% elevation in NLR stratified patients into distinct risk categories, with the potential clinical value influenced by tumor type.</p><p><strong>Conclusion: </strong>Phase-specific NLR dynamics were correlated with distinct immunotherapy outcomes. C1 NLR was associated with early toxicity in both lung and gastric cancers, whereas sustained NLR reduction at C3 was associated with more favorable survival outcomes in lung cancer. These findings suggest that longitudinal, phase-specific NLR assessment may provide complementary information for monitoring treatment-related outcomes and requires further prospective validation.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"629956"},"PeriodicalIF":2.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966567","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":"The Impact of Microsatellite Instability and CD8+ Tumor Infiltrating Lymphocytes on Neoadjuvant Chemotherapy Response in Colorectal Cancer: A Prospective Observational Study.","authors":"Prapanca Nugraha, Yunia Sribudiani, Reno Rudiman, Susanti Susanti, Hermin Aminah Usman, Afrida Helen, Etis Primastari, Bambang Am Am Setya Sulthana, Raden Yohana Azhar, Kiki Lukman","doi":"10.2147/CMAR.S629872","DOIUrl":"10.2147/CMAR.S629872","url":null,"abstract":"<p><strong>Background: </strong>Treatment of colorectal cancer includes surgery and chemotherapy, along with advances in personalised therapies, which focus on achieving safer and more effective outcomes. One of the processes underlying colorectal cancer is microsatellite instability (MSI), and CD8+ Tumor Infiltrating Lymphocytes (TILs) belong to the immune cell subset that shows high impact on cancerous cells. The purpose of this study is to determine whether MSI, CD8+ TILs expression, and chemotherapy response are related.</p><p><strong>Methods: </strong>This is a retrospective cohort study of colorectal cancer patients who received chemotherapy in the neoadjuvant setting, prior to tumor resection, at a tertiary general hospital in West Java, Indonesia. The MSI examination was carried out using qPCR-HRM (BioColoMelt-Dx), and the TILs CD8+ expression was carried out using immunohistochemistry. The chemotherapy response was evaluated using response evaluation criteria for solid tumors (RECIST).</p><p><strong>Results: </strong>Forty-one subjects were enrolled in this study. There were three subjects (7.3%) with microsatellite instability (1 MSI-L, 2 MSI-H) and 19 subjects (46.3%) with high CD8+ TILs expression. There were 28 (68.3%) subjects in stage III, followed by stage IV (22%) and stage II (9.8%). There were 10 subjects (24%) who showed progressive disease, and 16 subjects (39%) with high expression of CD8+ TILs showed partial chemotherapy response. MSI showed a significant association with age (P<0.05). The CD8+ TILs expression showed no significant association with sex, subtype, grade, or tumor location, but significantly associated with age, stage and chemotherapy response (P < 0.05). Subjects with MSI tend to have early onset disease. Colorectal cancer with high CD8+ TILs expression was less likely to have metastasis (stage IV) and had a better chemotherapy response when compared to those with low CD8+ TILs expression.</p><p><strong>Conclusion: </strong>The MSI status showed no significant relationship with CD8+ TILs. Patients with high CD8+ TILs showing a relationship with a better chemotherapy response and a better prognosis in colorectal cancer patients.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"629872"},"PeriodicalIF":2.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966577","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}