Cancer Management and Research最新文献

{"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}

{"title":"Severe Immune-Related Adverse Events Associated with Durable Antitumor Responses Following Immune Checkpoint Inhibitor Therapy: Two Case Reports.","authors":"Qunxiang Chen, Xianglan Lin, Lingdan Chen, Juan Yao, Yun Yan, Xiaoyu Zhang, Dunya Yang, Xiangwu Lin, Shuyi Chen, Xi Chen, Naying Yu","doi":"10.2147/CMAR.S621884","DOIUrl":"10.2147/CMAR.S621884","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have achieved remarkable success in treating advanced cancers, yet the accompanying immune-related adverse events (irAEs) pose a major challenge to their clinical application. Growing evidence suggests an association between irAEs and improved clinical outcomes; however, the heterogeneity in this relationship warrants further exploration.</p><p><strong>Case presentation: </strong>This article reports two cases of patients with advanced cancer who achieved long-term disease control after experiencing severe irAEs. Case one involved a patient with heavily pretreated Luminal B1 advanced breast cancer who developed Grade 3 immune-related arrhythmia and heart failure following treatment with Toripalimab combined with chemotherapy. Case two involved a patient with ROS1-fusion advanced lung adenocarcinoma who, after developing resistance to Crizotinib, received chemotherapy and Tislelizumab, leading to Grade 3 immune-related hypopituitarism, adrenal insufficiency, and cutaneous toxicity. Both patients were managed with corticosteroids with or without immunosuppressants and discontinued all antitumor therapies. Despite this, they have achieved a partial response (PR) with a duration of response (DoR) of 22 and 37 months, respectively, and both responses are ongoing at the time of this report.</p><p><strong>Conclusion: </strong>In this series, two patients with advanced solid tumors achieved durable tumor responses after developing severe irAEs and discontinuing treatment, suggesting that severe irAEs may herald the establishment of long-term immune memory. However, the association between irAEs and efficacy is not straightforward, as the type and severity of irAEs and the use of immunosuppressive intervention all influence the ultimate clinical benefit. In the absence of reliable predictive biomarkers, clinical decisions should not equate irAEs directly with efficacy markers; rather, the benefits and risks of immune activation should be carefully weighed.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"621884"},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954979","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":"Thyroid Cancer in the Modern Era: From Molecular Landscape and Multimodal Diagnostics to Integrative Traditional Chinese Medicine-A Comprehensive Review.","authors":"Yingqi Xiong, Yaxin Hu, Manya Wang, Xin Xiong, Haishen Zhao","doi":"10.2147/CMAR.S635801","DOIUrl":"10.2147/CMAR.S635801","url":null,"abstract":"<p><p>In recent decades, the global incidence of thyroid cancer has risen sharply mainly due to the high detection rate of papillary thyroid microcarcinoma and overdiagnosis, with its overall mortality staying steady. Classic pathogenic drivers encompass childhood radiation exposure, iodine disorder, and hallmark gene alterations including BRAF V600E, RET/PTC, RAS and PAX8/PPARγ. Modern multimodal diagnostic systems integrating artificial intelligence-assisted high-resolution ultrasound, Thyroseq-V2, Afirma, circulating tumor DNA detection and refined pathological examination achieve precise preoperative stratification. Aberrant activation of MAPK/ERK, PI3K/AKT and Wnt/β-catenin cascades, coupled with an immune-suppressive tumor microenvironment dominated by M2-type tumor-associated macrophages, regulatory T cells and PD-L1 overexpression, drives thyroid cancer progression and dedifferentiation. Current comprehensive integrated therapeutic strategies cover robotic surgery, radioactive iodine ablation, external radiotherapy, molecular targeted drugs (sorafenib, lenvatinib, vemurafenib combined with trametinib) and novel immunotherapy. Traditional Chinese Medicine (TCM), based on the TCM pathogenesis of liver qi stagnation, phlegm-blood stasis and qi-blood deficiency for goiter, serves as an adjuvant therapy for thyroid cancer. Active ingredients such as honokiol, artesunate, ginsenoside Rg3, astragalus polysaccharide and curcumin can suppress tumor proliferation, reshape anti-tumor immunity and inhibit metastasis via regulating reactive oxygen species, PI3K/AKT pathway, epithelial-mesenchymal transition and matrix metalloproteinases. Existing clinical observations confirm that TCM can relieve clinical discomfort, improve life quality and lower recurrence risk when combined with conventional radioiodine or anti-tumor treatment. However, the clinical application of TCM for thyroid cancer is greatly restricted by insufficient syndrome differentiation standardization, low-quality clinical evidence and unclear herbal safety risks. Most available studies are small-sample retrospective analyses lacking large-scale, multicenter randomized controlled trials to verify efficacy and safety. Future research should focus on standardized clinical trial design, in-depth pharmacological mechanism exploration, and construction of standardized thyroid cancer integrative diagnosis and treatment regimens combining Western precision therapy and TCM adjuvant intervention, to clarify the definite positioning of TCM in whole-course thyroid cancer management.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"635801"},"PeriodicalIF":2.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918574","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":"Multidisciplinary Team Nursing Care During Peri-Transplantation for ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report.","authors":"Xiaoying Hong, Genqun Wang, Li Cai, Yuanjiao Lin, Yi Zhao","doi":"10.2147/CMAR.S620125","DOIUrl":"10.2147/CMAR.S620125","url":null,"abstract":"<p><p>This case report describes the nursing experience of a patient with ALK‑negative anaplastic large cell lymphoma undergoing autologous hematopoietic stem cell transplantation. A multidisciplinary team model was established, integrating professionals from haematology, rehabilitation, nutrition, psychology to deliver comprehensive peri‑transplant care. An individualized treatment and nursing plan was developed for the peri-transplant period. This plan included pre-transplant physical and psychological preparation, environmental readiness, and management of complications during transplantation, such as infection, bleeding, gastrointestinal symptoms, malnutrition, and depressive mood. Over a 26-day period, successful hematopoietic reconstitution was achieved, and the patient was discharged smoothly from the isolation unit. Post-transplantation, continuous nursing support was provided in infection control, diet, and exercise, along with regular follow-up for two months. The patient's laboratory parameters returned to normal, and both physical and psychological conditions recovered well.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"620125"},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918622","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 <i>KEAP1</i>-<i>NFE2L2</i>/NRF2 Axis in Non-Small Cell Lung Cancer Radioresistance: Redox Homeostasis and Emerging DNA Damage Response Mechanisms.","authors":"Xinyu Jia, Eerdemutu, Yuan Ren, Shiduo Yang, Chang Yang, Qiaochu Ding, Yu Lin","doi":"10.2147/CMAR.S633472","DOIUrl":"10.2147/CMAR.S633472","url":null,"abstract":"<p><p>Radioresistance and local recurrence remain major barriers to effective radiotherapy in non-small cell lung cancer (NSCLC). Loss-of-function <i>KEAP1</i> alterations or activating <i>NFE2L2</i> alterations can stabilize NRF2, but do not alone establish sustained transcriptional activity or functional dependency. This focused narrative review evaluates clinical radiotherapy studies and mechanistically informative preclinical studies linking the <i>KEAP1</i>-<i>NFE2L2</i>/NRF2 axis to NSCLC radioresistance. We prioritized clinical studies reporting radiotherapy-specific outcomes and preclinical studies coupling NRF2-related molecular status or perturbation with radiation-response endpoints; contextual studies informed metabolic, DNA damage response (DDR), immune and normal-lung effects. Evidence most consistently supports NRF2-mediated redox protection through glutathione-dependent defense, cellular reducing capacity and antioxidant enzymes, limiting radiation-induced reactive oxygen species (ROS) accumulation and oxidative injury. Limited studies further suggest that NRF2 may affect DNA-damage signaling, checkpoint control and repair. The detailed RPA32-TOPBP1-ATR-CHK1 model is therefore considered proposed rather than established in NRF2-active NSCLC. Retrospective clinical studies associate pathogenic <i>KEAP1</i>/<i>NFE2L2</i> alterations with impaired local control in some radiotherapy-treated cohorts, but do not justify treating genomic status, protein abundance, transcriptional activity and functional dependency as equivalent measures or demonstrate treatment-predictive value. NRF2-mediated normal-lung protection also constrains systemic inhibition. Prospective studies integrating molecular classification, radiation-response endpoints, local control and normal-tissue toxicity are required before biomarker-guided radiosensitization can be considered.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"633472"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904586","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":"Clinicopathological Significance of Ultrasound Risk Features and the Taller-Than-Wide Sign for Tumor Advancement in Differentiated Thyroid Cancer: A Single-Center Analysis.","authors":"Michał Miciak, Krzysztof Jurkiewicz, Natalia Kalka, Maja Reiner, Maksymilian Cyprian Szymański, Szymon Biernat, Dorota Diakowska, Krzysztof Kaliszewski","doi":"10.2147/CMAR.S615445","DOIUrl":"10.2147/CMAR.S615445","url":null,"abstract":"<p><strong>Purpose: </strong>Ultrasound (US) imaging plays a pivotal role in the preoperative assessment of thyroid cancer (TC). Suspicious US features, including hypoechogenicity, microcalcifications, high vascularity, irregular shape, irregular margins, and the taller-than-wide (TTW) sign, are widely used for preoperative risk stratification of thyroid nodules. This study aimed to investigate the associations between preoperative US features and histopathological indicators of tumor advancement in differentiated thyroid cancer (DTC).</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of 665 patients with DTC who were treated between 2008 and 2024. Preoperative US features, including hypoechogenicity, microcalcifications, high vascularity, irregular shape, irregular margins, and the TTW sign, were correlated with extrathyroidal extension (ETE) and lymph node metastases (LNM). Associations were evaluated using Pearson's χ² test, Fisher's exact test where appropriate, odds ratios (ORs), and Cramér's V. Statistical significance was defined as p < 0.05.</p><p><strong>Results: </strong>All analyzed US features were significantly associated with histopathological indicators of tumor advancement (p < 0.05). Of all evaluated conventional US features, the strongest associations were observed between microcalcifications and ETE, and between high vascularity and LNM (Cramér's V = 0.32 and 0.38, respectively). The TTW sign was significantly associated with ETE (OR = 2.96, 95% CI: 1.73-5.07) and LNM (OR = 9.07, 95% CI: 5.07-16.24).</p><p><strong>Conclusion: </strong>Among US features, the TTW sign demonstrated particularly strong associations with histopathological indicators of tumor advancement, especially LNM. These findings support the potential value of comprehensive preoperative assessment of US features and warrant further prospective studies with multivariable modelling to better define the role of the TTW sign in preoperative risk stratification of DTC.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"615445"},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905054","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":"Research Progress on the Relationship Between Radiation Enteritis and Gut Microbiota Dysbiosis.","authors":"Jingru Xu, Yulin Liu, Yilin Xiao, Yuxing Chen, Enqing Meng, Min Jin, Mengjiao Wu, Yan Zong, Hongli Liu","doi":"10.2147/CMAR.S640003","DOIUrl":"10.2147/CMAR.S640003","url":null,"abstract":"<p><p>Radiation enteritis (RE) is the most common complication of pelvic radiotherapy, often manifesting as diarrhea, hematochezia, and tenesmus. In some cases, it progresses to chronic radiation enteritis, leading to intestinal fibrosis and fistula formation, which severely impacts patients'quality of life and prognosis. Current therapeutic strategies for RE include radioprotective agents, surgery, nutritional support, and symptomatic management. However, their efficacy remains limited. The gut microbiota, a complex microbial community residing in the human digestive tract, is closely linked to human health. Numerous studies have identified gut microbiota dysbiosis in the context of RE. This review illustrates the intricate relationship between RE and the gut microbiota, focusing on the underlying mechanisms of their interaction. It also introduces emerging therapeutic strategies targeting the gut microbiota for RE, including engineered probiotics, washed microbiota transplantation (WMT), and ROS-scavenging nanomaterials, offering novel insights for its diagnosis and treatment.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"640003"},"PeriodicalIF":2.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900112","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":"Multidisciplinary Management of Severe Taxane-Induced Nail Toxicity in a Breast Cancer Patient.","authors":"Natalia Sauer, Marta Kowalczuk, Adrian Arkada, Jacek Calik","doi":"10.2147/CMAR.S606559","DOIUrl":"10.2147/CMAR.S606559","url":null,"abstract":"<p><strong>Introduction: </strong>Taxane-induced nail toxicity (TINT) is a relatively common but often underreported adverse effect of docetaxel-based chemotherapy that may significantly impair quality of life and functional status. Severe cases can require structured supportive care involving multiple clinical disciplines. We present a case of high-grade TINT in a patient with breast cancer successfully managed with a multidisciplinary supportive approach.</p><p><strong>Case presentation: </strong>A 70-year-old woman with HER2-positive breast cancer received neoadjuvant TCH chemotherapy (docetaxel, cyclophosphamide, trastuzumab), followed by surgery and adjuvant trastuzumab emtansine. Nail toxicity developed after the second cycle of docetaxel and progressed to subungual hemorrhages, onycholysis, and marked onychodystrophy associated with pain and functional limitation. The patient underwent podiatric treatment including mechanical nail debridement and topical collagen-based serum therapy. Supportive pharmacologic management, including selective COX-2 inhibitors, was also introduced.</p><p><strong>Results: </strong>Gradual epithelial healing and nail regrowth were observed over a six-month follow-up period. Pain and functional impairment improved, and systemic oncologic therapy was continued without interruption. No recurrence of severe nail complications was noted during subsequent treatment.</p><p><strong>Conclusion: </strong>This case illustrates that severe taxane-induced nail toxicity may be effectively controlled with coordinated multidisciplinary supportive care. Early podiatric intervention combined with pharmacologic symptom management may help maintain treatment continuity and improve patient comfort during taxane-based chemotherapy.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"606559"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896665","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":"Baseline Gustave Roussy Immune Score and Survival in Extensive-Stage Small-Cell Lung Cancer Treated with First-Line Chemoimmunotherapy.","authors":"David Sánchez-García, Miguel Borregón-Rivilla, Alejandro Moya-Martínez, María Valero Revert, Beatriz Grau-Mirete, Mariano Martínez-Marín, Elena Navarro-Vicente, Cristina Bernabé Martínez, María Orengo-López, Marta Hernández Sáez, Álvaro Muñoz Abad, Paula Rodríguez-Payá, María Pamies-Ramón, María Guirado-Risueño, Javier-David Benitez-Fuentes, Asia Ferrández-Arias","doi":"10.2147/CMAR.S627848","DOIUrl":"10.2147/CMAR.S627848","url":null,"abstract":"<p><strong>Background: </strong>First-line chemoimmunotherapy has improved outcomes in extensive-stage small-cell lung cancer (ES-SCLC), but survival remains heterogeneous and routine-care prognostic tools are limited.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed consecutive adults with stage IV ES-SCLC treated with platinum-etoposide plus a programmed death-ligand 1 inhibitor at three Spanish hospitals from August 2021 to December 2024. Outcomes included overall survival (OS), progression-free survival (PFS), objective response, and immune-related toxicity. Baseline Gustave Roussy Immune Score (GRIm) was defined as high-risk when at least two of albumin <35 g/L, lactate dehydrogenase above the upper limit of normal, and neutrophil-to-lymphocyte ratio >6 were present. Baseline Cox models included high-risk GRIm, platelet-to-lymphocyte ratio >180, and Eastern Cooperative Oncology Group performance status ≥2; maintenance exposure was assessed in a 3-month OS landmark analysis. Analyses were exploratory.</p><p><strong>Results: </strong>Among 51 patients, mean age was 64.2 years, 72.5% were men, and 82.3% had ECOG performance status 0-1. During follow-up, 43 deaths and 50 PFS events occurred. Objective response rate was 70.6%, median OS was 11.9 months, and median PFS was 5.7 months. Median OS was 14.2 months with low-risk GRIm and 5.4 months with high-risk GRIm. High-risk GRIm was independently associated with worse OS (hazard ratio [HR] 5.59) and PFS (HR 3.50), while PLR >180 was associated with worse OS (HR 2.37). In the 3-month landmark cohort (n=47), maintenance exposure remained associated with longer OS (HR 0.21), although this analysis remained vulnerable to residual selection bias.</p><p><strong>Conclusion: </strong>Baseline GRIm was the most consistent candidate prognostic marker in this real-world ES-SCLC cohort. The study did not assess prediction of immunotherapy benefit, and prospective validation is warranted before treatment decisions are guided by GRIm.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"627848"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896683","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":"Remodeling the Tumor Microenvironment: Mechanistic Insights and Translational Frontiers of TCM-Derived Bioactive Monomers.","authors":"Yunxuan Fei, Jiahui Lu, Zhexian Yu, Chenfei Xu, Meilin Tian, Qianqian Li, Huimin Ye, Ying Lu, Wenli Shen, Qiaohui He, Anjing Wang, Zhezhong Zhang, Haixin Qin, Yaping Yu","doi":"10.2147/CMAR.S613568","DOIUrl":"10.2147/CMAR.S613568","url":null,"abstract":"<p><p>Recent studies have shown that tumor development and therapeutic resistance are closely linked to the tumor microenvironment (TME), a dynamic ecosystem composed of vascular networks, immune and stromal cells, extracellular matrix components, cytokines, and extracellular vesicles. This review summarizes current mechanistic evidence on how bioactive monomers and purified active fractions derived from traditional Chinese medicine (TCM), including polysaccharides, saponins, alkaloids, terpenoids, flavonoids, and polyphenols, regulate TME-associated processes. These compounds have been reported to modulate macrophage polarization, T-cell and natural killer (NK)-cell surveillance, dendritic-cell maturation, myeloid-derived suppressor cell (MDSC) and neutrophil activities, cancer-associated fibroblast (CAF) activation, angiogenic signaling, cytokine networks, exosome-mediated communication, and extracellular matrix remodeling. However, most available evidence remains derived from cell models and animal experiments, and clinical validation is limited. Therefore, TCM-derived bioactive monomers should currently be interpreted as mechanistic probes, lead structures, or candidate adjunctive agents rather than established TME-directed therapies. Future research should prioritize compound standardization, dose-response relationships, pharmacokinetic and toxicological characterization, reproducible model systems, validated TME biomarkers, and controlled clinical trials.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"18 ","pages":"613568"},"PeriodicalIF":2.6,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879110","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}