Cancers最新文献

{"title":"The Usefulness of Indocyanine Green in Modern Gynecological Oncology-Analysis, Literature Review, and Future Perspectives.","authors":"Michał Kostrzanowski, Grzegorz Ziółkowski, Agata Mandes, Grzegorz Panek, Michał Ciebiera, Filip Dąbrowski","doi":"10.3390/cancers17183081","DOIUrl":"10.3390/cancers17183081","url":null,"abstract":"<p><p>Indocyanine green (ICG) is a fluorescent agent which is characterized by a wide range of applications in the proper visualization of the operating field, differentiation of vital structures, and localization of lesions to be excised. An investigation and overview of novel approaches of indocyanine green in modern gynecological oncology was conducted, including ovarian cancer surgery with its compartmental approach and compartmental surgery in endometrial cancer. Ureteral visualization and perfusion, lymphography, lymph node transfers, or the localization of anastomotic leakage in bowel surgery are examples of applications aimed at reducing the risk of surgical complications and improving the patients' quality of life. The general use of indocyanine green in lymph node detection, subcategorized and analyzed, is constantly improved and reviewed. A therapeutic approach with macromolecules is being tested in preclinical models. Early results could suggest the future application of indocyanine green not only in broad-sense imaging but also as a cytotoxic agent conjugated with macromolecules. Further studies on the application of indocyanine green in laparoscopy, open surgery, and finally as a curative cytotoxic agent are needed.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrepancies Between the Tennessee Nomogram and Oncotype DX: Implications for the Korean Breast Cancer Population-The BRAIN Study.","authors":"Suk Jun Lee, Joo Heung Kim, Jee Hyun Ahn, So Hyeon Gwon, Ilkyun Lee, Seho Park, Nak-Hoon Son","doi":"10.3390/cancers17183083","DOIUrl":"10.3390/cancers17183083","url":null,"abstract":"<p><strong>Background: </strong>Oncotype DX (ODX) is widely used to estimate recurrence risk and guide adjuvant therapy in hormone receptor-positive (HR+), HER2-negative early-stage breast cancer. However, limited accessibility and high costs have prompted the use of alternative clinical models, such as the Tennessee nomogram. This study aimed to validate the predictive performance of the Tennessee nomogram in a Korean breast cancer cohort and identify factors contributing to discrepancies between nomogram predictions and ODX results.</p><p><strong>Methods: </strong>We retrospectively analyzed data on1298 patients with HR+/HER2-, node-negative invasive breast cancer who underwent ODX testing between May 2013 and August 2023. Predictive probabilities were calculated using the Tennessee nomogram and compared with actual ODX recurrence scores. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were determined. Discordant cases were examined for clinicopathologic characteristics contributing to prediction errors.</p><p><strong>Results: </strong>The nomogram demonstrated an overall accuracy of 86.1% (sensitivity 0.130, specificity 0.989, AUC 0.776). Discordant results were observed in 13.9% of cases, primarily in patients with a high histologic grade, PR negativity, and elevated Ki-67 index. Most false negatives clustered within the ODX score range of 25-30, suggesting underestimation of risk in borderline-high cases.</p><p><strong>Conclusions: </strong>The Tennessee nomogram may be a useful surrogate when ODX testing is unavailable, but caution is warranted in patients with aggressive tumor biology. In such cases, ODX testing should be prioritized to guide adjuvant therapy decisions.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign and Malignant Tumors of the Hand: Patterns, Pathology, and Surgical Outcomes in a Large Retrospective Cohort.","authors":"Fabiana Battaglia, Roberta Giuffrida, Marco Pagano, Luigi Troisi, Gabriele Delia","doi":"10.3390/cancers17183079","DOIUrl":"10.3390/cancers17183079","url":null,"abstract":"<p><p><i>Background:</i> Hand tumors encompass a heterogeneous spectrum of benign, malignant, and tumor-like lesions with diverse clinical behavior. While international studies have reported epidemiological and clinicopathological features, large-scale data in Italian populations are scarce. This retrospective analysis represents one of the largest Italian surgical series of histologically confirmed hand tumors. The objective was to evaluate clinicopathological characteristics, anatomical distribution, and surgical outcomes of these lesions over a 5-year period. <i>Methods:</i> A total of 250 patients who underwent surgery for hand tumors at the Department of Plastic and Reconstructive Surgery, University Hospital \"G. Martino,\" Messina, Italy, from January 2020 to December 2024, were retrospectively reviewed. Data from clinical records, imaging, and histopathology were categorized as tumor-like lesions, benign neoplasms, or malignant tumors. Demographic and clinical variables were compared across diagnostic groups. <i>Results:</i> The cohort included 127 males and 123 females (mean age 49.3 ± 18.6 years). Lesions were most frequently located in the digits (62%), followed by palm (21%), dorsum (11%), and wrist (6%). Tumor-like lesions represented 37.6% of cases, predominantly mucous cysts and foreign body granulomas. Benign tumors accounted for 49.2%, with giant cell tumors of the tendon sheath as the most common (31.7%). Malignant tumors were rare (10.4%), mainly squamous cell carcinoma, basal cell carcinoma, and melanoma. Patients with malignant lesions were significantly older (67.4 years) compared with those with benign or tumor-like lesions (<i>p</i> < 0.01). <i>Conclusions:</i> Benign and tumor-like lesions predominate among hand tumors, whereas malignancies are infrequent but clinically important. Surgical excision remains the treatment of choice, guided by preoperative imaging and confirmed histopathologically. Expanding this cohort and integrating molecular diagnostics with patient-reported outcomes may enhance future management strategies.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Nomograms to Predict the Probability of Recurrence at Specific Sites in Patients with Cutaneous Melanoma.","authors":"Eszter Anna Janka, Imre Lőrinc Szabó, Tünde Toka-Farkas, Lilla Soltész, Zita Szentkereszty-Kovács, Beatrix Ványai, Tünde Várvölgyi, Anikó Kapitány, Andrea Szegedi, Gabriella Emri","doi":"10.3390/cancers17183080","DOIUrl":"10.3390/cancers17183080","url":null,"abstract":"<p><strong>Background: </strong>Risk assessment models are increasingly being used in oncology to improve therapeutic and follow-up decisions for individual patients.</p><p><strong>Methods: </strong>In our study, we used a university hospital registry database containing data on patients diagnosed with invasive cutaneous melanoma between 2000 and 2019 (training cohort: N = 1402; validation cohort: N = 601). Using multivariate Cox regression models, we identified clinicopathological variables that are independent risk factors for melanoma recurrence at specific sites. We then constructed nomograms to predict the probability of recurrence at 3, 5, and 10 years.</p><p><strong>Results: </strong>Age, sex, primary tumor location, histological subtype, Clark invasion level and AJCC pT category were independent prognostic factors for melanoma recurrence in regional lymph nodes. Age, sex, primary tumor location, Clark level of invasion, AJCC pT stage and regional lymph node metastasis were risk factors for skin/soft tissue (including muscle)/non-regional lymph node metastases. We found that AJCC pT category and sex were also independent prognostic factors for melanoma recurrence in the lung, visceral sites, and brain. Furthermore, the nomogram predicting recurrence in the lung and visceral sites incorporated the presence of regional lymph node and skin/soft tissue/non-regional lymph node metastases. ROC curves showed good performance of the nomograms in both the training and validation cohorts. The calibration curve showed a good fit.</p><p><strong>Conclusion: </strong>Our results support the high prognostic value of AJCC pT stage and patient sex, which remained consistent across all melanoma stages, and demonstrate the feasibility of creating nomogram models to predict recurrence risk in melanoma patients.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Cancer: Uncovering the Predictive Role of NOTCH as an Emerging Candidate Biomarker for Therapeutic Strategies.","authors":"Chiara Cusumano, Federica Squillante, Marco Roma, Roberto Miano, Maria Pia Felli","doi":"10.3390/cancers17183078","DOIUrl":"10.3390/cancers17183078","url":null,"abstract":"<p><p>Bladder cancer (BCa) is one of the most diagnosed cancers worldwide. It is classified as non-muscle-invasive (NMIB), confined to the mucosa, and muscle-invasive (MIB), extended to deeper layers or formed metastases. The poor outcomes associated with MIBC indicate the urgent need for candidate biomarkers to improve treatment strategies. Molecular characterisation of both NMIBC and MIBC, and especially the classification of tumours into molecular subtypes, could provide the development of novel therapeutics in high-risk muscle-invasive bladder cancer. A few studies have focused on pathways implicated in MIBC, including growth factors, DNA-RNA modifying enzymes and the differential roles played by the NOTCH receptors. NOTCH1 has been revealed as a tumour suppressor; in contrast, NOTCH2 and NOTCH3 have demonstrated an oncogenic role in BCa. Recent reports have found that NOTCH2 and NOTCH3 are associated with poor prognosis. Moreover, inhibiting these NOTCH receptors effectively restrained BCa growth and metastasis, suggesting the potential value of targeting NOTCH as a promising therapeutic strategy for bladder cancer. Given the crucial role of the NOTCH pathway, we will discuss the different predictive value of the four NOTCH receptors and the potential of NOTCH-combined therapy in BCa.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>PARP3</i> Promotes AML Progression via Activation of PI3K/AKT/mTOR Signaling.","authors":"Tingyong Cao, Yurong Zhang, Huan Liu, Hongbin Zhang, Liangliang Li, Xiaoli Li, Li Zhao","doi":"10.3390/cancers17183076","DOIUrl":"10.3390/cancers17183076","url":null,"abstract":"<p><p><b>Background</b>: Acute myeloid leukemia (AML) remains a hematopoietic clonal malignancy that is characterized by a poor prognosis, largely attributable to chemotherapy resistance and a high incidence of post-chemotherapy relapse. Therefore, the identification of novel molecular markers is crucial for optimizing treatment regimens and improving outcomes for this disease. <b>Methods</b>: We first investigated the expression levels of poly(ADP-ribose)polymerase 3(<i>PARP3</i>) mRNA in data from our center and the Gene Expression Omnibus (GEO), then explored the role of <i>PARP3</i> in AML through cell experiments. <b>Results</b>: Our results demonstrated that the expression levels of <i>PARP3</i> were significantly elevated in AML samples compared to controls (<i>p</i> < 0.05). Based on the median expression of <i>PARP3</i>, 151 cases of AML from TCGA data were divided into two groups. The results showed that <i>PARP3</i>-high group had markedly shorter overall survival (OS) than the <i>PARP3</i>-low group (OS: median: 1.18 vs. 3.88 years; <i>p</i> < 0.001). The overexpression of <i>PARP3</i> was correlated with older age and high-risk stratification in the AML from TCGA data (<i>p</i> < 0.05). Finally, we confirmed that specifically down-regulating <i>PARP3</i> expression impaired AML cell proliferation, disrupted cell cycle process, inhibited migration, accelerated apoptosis, and impaired the PI3K/AKT/mTOR signaling pathway in vitro. <b>Conclusions</b>: <i>PARP3</i>-mediated activation of the PI3K/AKT/mTOR signaling pathway enhances AML cell proliferation and migration, identifying it as a potential therapeutic target for poor-prognosis AML.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Molecular Characteristics of 100 Atypical Teratoid Rhabdoid Tumor Patients from Low- and Middle-Income Countries.","authors":"Noha A Ismail, Shaimaa Aboubakr, Amal Mosaab, Eslam Maher, Hanafy Hafez, Hala Taha, Dina Yassin, Amal Refaat, Mohamed S Zaghloul, Mohamed El-Beltagy, Abdelrahman Enayat, Volker Hovestadt, Olfat Ahmed, Mark W Kieran, Ahmed El-Hemaly, Shahenda Ei-Naggar, Alaa El-Haddad","doi":"10.3390/cancers17183077","DOIUrl":"10.3390/cancers17183077","url":null,"abstract":"<p><strong>Background: </strong>Atypical teratoid rhabdoid tumor (ATRT) is a highly aggressive, rare pediatric central nervous system malignancy. Prognostic factors for optimizing risk stratification and management in a large uniformly treated cohort are lacking.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study analyzing clinical and outcome data for 100 newly diagnosed ATRT patients aged <18 years treated at the Children's Cancer Hospital, Egypt, from 2008 to 2022. They were treated uniformly as per the Dana-Farber Cancer Institute modified IRS-III protocol. Molecular subgroups (MYC, SHH, and TYR) were determined via a DNA methylation array for patients who had sufficient DNA material available for the methylation analysis. Treatment toxicities were graded per the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.</p><p><strong>Results: </strong>The median age at diagnosis was 1.88 years (IQR 0.99, 3.01); 28% were under 1 year of age, 45% were between 1 and 3 years old, and 26% were above 3 years of age. At diagnosis, 39% of patients had metastatic disease. A total of 60% of patients had gross residual disease following surgical excision. In multivariable analysis, age < 1 year and metastatic disease had a significant impact on event-free survival (EFS) (<i>p</i> = 0.047 and <i>p</i> = 0.002, respectively); however, only metastatic disease had a significantly negative effect on overall survival (OS) and cumulative incidence of relapse (CIR) (<i>p</i> = 0.002 for OS and <i>p</i> < 0.001 for CIR). DNA methylation was performed for 69 patients who were classified as having a TYR (n = 13), SHH (n = 34), MYC (n = 17), or non-ATRT diagnosis (n = 5). In the cohort of the 64 patients with ATRT defined by methylation, no significant survival differences were observed. Treatment-related deaths were reported in 28% of our studied group. Gram-negative septicemia was the most common cause of toxic death. The 5-year EFS and OS of the whole cohort were 12% and 13%, respectively.</p><p><strong>Conclusions: </strong>In this cohort, no significant survival differences were observed among the methylation subgroups. The higher treatment-related mortality in our cohort compared to the original protocol's toxic-related deaths suggested that intensive and lengthy chemotherapy regimens may need modification for our population. The need for a short intensified approach, including a limited induction cycle followed by an intensified high-dose consolidation therapy, may be more appropriate for our patients with low socioeconomic status to avoid a repeated and prolonged course of protracted neutropenia.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cure of Recurrent Ovarian Cancer: A Multicenter Retrospective Study.","authors":"Masahiro Sumitomo, Yasushi Kotani, Kosuke Murakami, Kaoru Abiko, Kazuko Sakai, Tomoyuki Otani, Akihiko Ueda, Masayo Ukita, Atsuko Taga, Ikuko Emoto, Kentaro Sekiyama, Minami Okudate, Motonori Matsubara, Yukio Yamanishi, Kazuto Nishio, Masaki Mandai, Noriomi Matsumura","doi":"10.3390/cancers17183069","DOIUrl":"10.3390/cancers17183069","url":null,"abstract":"<p><strong>Background: </strong>The prognosis for recurrent ovarian cancer is poor, but a small percentage of patients can be cured. The aim of this study was to clarify the criteria for being cured and the characteristics of cured cases.</p><p><strong>Methods: </strong>Ovarian cancer cases at 2 university hospitals and 8 community hospitals were analyzed to identify patients who were considered cured after complete remission (CR) following recurrence. Analyses of the tumors were performed and included <i>BRCA1/2</i> mutation analysis.</p><p><strong>Results: </strong>Of the 157 cases of recurrence, 21 (13%) showed no evidence of disease (NED). NED cases had a lower rate of ascites at the initial diagnosis, longer disease-free survival, a higher rate of solitary lesions, and a higher rate of secondary debulking surgery. All CR cases except for one showed no further recurrence when DFS reached 4 years, which was considered a criterion for being cured. The case of relapse occurred after long-term treatment with bevacizumab. Furthermore, 19.4% of the CR cases achieved 4-year DFS, which represents 9.3% of the cases of recurrent ovarian cancer and 2.3% of all cases of ovarian cancer. <i>BRCA</i> mutation analysis of the tumor was possible in 17 of the 30 cases of recurrent ovarian cancer that achieved a 4-year DFS. Pathogenic variants of <i>BRCA</i> were found in 5 of the 11 cases of high-grade serous carcinoma.</p><p><strong>Conclusions: </strong>Approximately 10% of patients with recurrent ovarian cancer achieved a 4-year DFS and were mostly cured. The curing of cases not involving high-grade serous carcinoma (HGSC) was unrelated to the presence of pathogenic <i>BRCA</i> variants.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the Mitochondria in High-Grade Gliomas.","authors":"Shaunak Sathe, Qi Li, Jinkyu Jung, Jing Wu","doi":"10.3390/cancers17183062","DOIUrl":"10.3390/cancers17183062","url":null,"abstract":"<p><p>High-grade gliomas are aggressive primary brain tumors and often fatal. They are characterized by rapid growth, treatment resistance, and significant heterogeneity both within and between tumors. A growing body of evidence highlights the mitochondria, dynamic organelles essential for energy production, apoptosis regulation, and metabolic rewiring, as a critical driver in glioma progression and treatment resistance. As a result, these insights have sparked growing interest in mitochondrial-directed therapies. This review highlights the distinct metabolic features and mitochondrial processes of glioma, outlining the rationale for targeting mitochondrial function. We discuss recent advances in mitochondrial-targeted therapies, with a focus on caseinolytic protease P (ClpP) agonism as a breakthrough in the treatment of diffuse midline glioma (DMG). Moreover, we discuss the pathogenic link between mitochondrial metabolism and epigenetic regulation, and the potential therapeutic benefit of disrupting this interaction.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alteration of Prognostic Factors for Patients with Brain Metastases from Lung Cancer Before and After the Introduction of Immune Checkpoint Inhibitors: A Retrospective Single-Institution Study.","authors":"Yohei Yamamoto, Tomona Maetani, Hiroki Narita, Yurika Terasawa, Naoki Kato, Yasuharu Akasaki, Yuichi Murayama, Toshihide Tanaka","doi":"10.3390/cancers17183067","DOIUrl":"10.3390/cancers17183067","url":null,"abstract":"<p><strong>Background/objectives: </strong>Immune checkpoint inhibitors (ICIs) have improved outcomes in advanced lung cancer, but their real-world impact on patients with brain metastases remains insufficiently characterized. This study aimed to compare treatment outcomes before and after the introduction of ICIs and to identify prognostic factors in patients with lung cancer brain metastases.</p><p><strong>Methods: </strong>We retrospectively analyzed 186 patients treated for brain metastases from lung cancer at our institution between 2014 and 2023. Patients were classified into a Pre-ICI group (N = 93, 2014-2018) and a Post-ICI group (N = 93, 2019-2023). Overall survival (OS) was analyzed by Kaplan-Meier method and Cox regression. Baseline factors included age, sex, histology, Charlson-Deyo score, extracranial metastases, radiotherapy, systemic therapy, and neutrophil-to-lymphocyte ratio (NLR, cutoff = 4).</p><p><strong>Results: </strong>Median OS improved significantly in the Post-ICI group compared with the Pre-ICI group (10.9 vs. 4.7 months, <i>p</i> < 0.01). When stratified by systemic therapy, median OS was 4.7 months with conventional chemotherapy, 14.7 months with molecular targeted therapy overall, further prolonged to 25.5 months in the Post-ICI era, and 23.4 months for all patients receiving ICIs. The most notable benefits were observed in patients with squamous cell carcinoma and small cell carcinoma. Patients with NLR ≥ 4 showed shorter OS, but NLR did not remain significant in multivariate analysis. In EGFR-mutant adenocarcinoma, the survival benefit from ICIs was limited.</p><p><strong>Conclusions: </strong>ICIs significantly improved survival in patients with lung cancer brain metastases, particularly those with squamous cell carcinoma or small cell carcinoma. NLR may provide supportive prognostic information, while molecular targeted therapy and ICIs represent major drivers of improved survival in this population.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 18","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}