Chinese clinical oncology最新文献

{"title":"Postoperative concurrent chemoradiotherapy plus apatinib for patients with high-grade glioma: a retrospective cohort study.","authors":"Lvjuan Cai, Jing Feng, Xiaoyan Li, Wenmin Ying, Guo Li, Huachun Luo, Xinpeng Wang, Mengjing Wu, Zhichao Fu","doi":"10.21037/cco-24-51","DOIUrl":"https://doi.org/10.21037/cco-24-51","url":null,"abstract":"<p><strong>Background: </strong>Radiotherapy plus temozolomide followed by adjuvant temozolomide was the standard treatment for high-grade gliomas. This study aimed to explore the effectiveness and safety of the addition of apatinib in patients with high-grade gliomas after surgery.</p><p><strong>Methods: </strong>In this retrospective cohort study, patients with high-grade glioma [World Health Organization (WHO) grade III or IV] treated with apatinib and concurrent chemoradiotherapy (cCRT) after surgery from October 2017 to February 2021 were reviewed. High-grade glioma patients used cCRT alone in the same period were reviewed as the control group. Progression-free survival (PFS), overall survival (OS), the grade of peritumoral brain edema (PTBE) and safety profiles were recorded. Cox regression analyses were used to determine the associated factors of PFS and OS.</p><p><strong>Results: </strong>A total of 60 patients with high-grade glioma were reviewed, with 30 patients in the apatinib plus cCRT group and 30 patients in the cCRT group. The median PFS of the apatinib plus cCRT group compared with the cCRT group was 8.53 vs. 7.33 months (P=0.62), and the median OS was 13.70 vs. 14.30 months (P=0.93). Multivariate analysis revealed that only pathological grade was independently associated with PFS [hazard ratio (HR) =4.445, 95% confidence interval (CI): 1.857 to 10.641, P<0.001] and OS (HR =3.737, 95% CI: 1.530 to 9.123, P=0.004). The apatinib plus cCRT also improved PTBE (P=0.001), and decrease the corticosteroids use than cCRT alone (P=0.002). No grade 3 or higher adverse event was observed in both groups.</p><p><strong>Conclusions: </strong>Post-operative cCRT plus apatinib was feasible for patients with high-grade glioma, with manageable toxicities.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 6","pages":"82"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Befotertinib in first-line treatment for Chinese non-small cell lung cancer patients harboring common EGFR-mutations reveals similar efficacy to other third-generation EGFR-TKIs but somewhat different safety profile.","authors":"Jens Benn Sørensen, Eric Santoni-Rugiu, Edyta Maria Urbanska","doi":"10.21037/cco-24-19","DOIUrl":"10.21037/cco-24-19","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"88"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence assistance during upper endoscopy: a game changer in detection of esophageal squamous cell carcinoma?","authors":"Annemijn D I Maan, Arjun D Koch","doi":"10.21037/cco-24-46","DOIUrl":"10.21037/cco-24-46","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"89"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The differences in the distribution characteristics and prognostic value of tumor-infiltrating T lymphocyte subsets between lung adenocarcinoma and lung squamous cell carcinoma.","authors":"Zhen Zhang, Shaoyan Zhang, Yalai Xu, Xiaoning Liu, Wenjie Dong","doi":"10.21037/cco-24-62","DOIUrl":"https://doi.org/10.21037/cco-24-62","url":null,"abstract":"<p><strong>Background: </strong>The characteristics of tumor immune microenvironment are important factors affecting the efficacy of immunotherapy, and there are differences in the distribution of tumor-infiltrating lymphocyte (TIL) subsets in different types of tumors. This study aims to compare the distributions of cluster of differentiation (CD) 4+ and CD4+ T cell subsets of TILs and their clinical significance between lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC).</p><p><strong>Methods: </strong>The tumor tissues of 78 LUAD and 56 LUSC patients who underwent surgery at The Second Affiliated Hospital of Zhengzhou University between October 2020 and October 2022 were collected, TIL level were detected by pathological observation, and the proportions of CD4+, CD4+ T cell subsets and CD4+/CD4+ ratio in TILs were detected by flow cytometry. These indicators were compared between LUAD and LUSC, and their correlations with clinicopathological characteristics and patient survival were analyzed.</p><p><strong>Results: </strong>There was no significant difference in the TILs level between LUAD and LUSC (P>0.05). The CD4+/CD4+ ratio in LUSC was lower, and proportion of CD4+ T cells was higher than those in LUAD (all P<0.05). In LUAD, the proportions of CD4+, CD4+ T cells and CD4+/CD4+ were correlated with tumor size or tumor-node-metastasis (TNM) stage, while in LUSC, only the proportions of CD4+ and CD4+ T cells were correlated with tumor size, degree of differentiation or TNM stage. In LUAD patients, higher proportions of CD4+, CD4+ T cells and lower CD4+/CD4+ predicted longer survival, and high CD4+/CD4+ (>1.04) was an independent risk factor for PFS and OS (P<0.05); In LUSC patients, there was no correlation between the proportions of CD4+ T cells, CD4+ T cells and CD4+/CD4+ ratio, and patient prognosis (P>0.05).</p><p><strong>Conclusions: </strong>There were differences in the distribution and balance of CD4+ and CD4+ TIL subsets between LUAD and LUSC, among which CD4/CD4+ ratio closely affected the prognosis of LUAD patients but had relatively weak prognostic value in LUSC patients due to the restriction of CD4+ T cells.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 6","pages":"83"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dural metastases in breast cancer: progression pattern, treatment and prognosis-a single center experience.","authors":"Yujie Wang, Yimin Han, Yanzhao Yang, Cheng Xu","doi":"10.21037/cco-24-30","DOIUrl":"10.21037/cco-24-30","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Dural metastasis (DM) remains one of the most challenging clinical scenarios in breast cancer treatment. To date, no clear standard care of dural metastases has been established. We sought to identify the progression pattern or treatment strategies that could possibly improve prognosis of breast cancer patients with DM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with breast cancer diagnosed with radiological confirmed dural metastases excluding leptomeningeal invasion alone or meningeal invasion subsequent to brain parenchyma metastases between 2014 and 2021 in single center were reviewed. All patients underwent head-enhanced magnetic resonance imaging (MRI). Imaging information, treatment and prognostic data were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 66 breast cancer patients were analyzed in this study, with 50 survival status including 43 deaths. Hormone receptors positive [estrogen receptor (ER)/progesterone receptor (PR)] accounted for 43.9% of the study cohorts followed by triple-negative breast cancer (TNBC) and HER2+ subtypes successively. Most cases (34, 51.5%) were diagnosed without parenchymal brain metastases prior to or at time of DM diagnosis. Three morphological patterns were determined by MRI including nodular, thickened with nodules, and diffuse thickened types. The frontoparietal dura was the most frequently involved site, accounting for 43.9% (29/66) of the patients, followed by temporal dura and parietal dura, ranking second and third (21/66 and 15/66, respectively). Fifty-four patients had extensive bone metastasis before the diagnosis of DM, within them, the median duration from bone metastasis to the diagnosis of DM was 419 days. Forty-two patients received radiotherapy for DM, including 25 with whole brain radiotherapy (WBRT), 4 with craniospinal axis irradiation (CSI), and 13 with DM and/or brain parenchyma lesions. Multivariate analysis indicates that initial diagnosis age, brain metastasis status, neurological symptoms and systemic treatment status and are significant prognostic factors (P=0.002, 0.03, 0.02, 0.001 and 0.02, respectively). The median survival time from the diagnosis of DM was 458 days in patients who received radiotherapy compared with 225 days in patients who did not receive radiotherapy, with a hazard ratio (HR) 0.65 [95% confidence interval (CI): 0.302-1.305] and P value of 0.06. Leptomeningeal invasion, parenchymal brain metastases and number of DM-involved sites were associated with the medical decision of WBRT. There were more leptomeningeal invasion cases distributed to WBRT group (17/29 vs. 7/37, P=0.001), and a higher likelihood of concurrent parenchymal brain lesions (19/27 vs. 13/37, P=0.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Dural metastases can occur as a subsequent event in patients with poorly controlled extensive bone metastases, with the frontoparietal area being the most commonly involved site. Radiotherapeutic strategy is highly influenced","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"81"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefit from addition of local therapy in oligometastatic oesophageal squamous cell carcinoma.","authors":"Yuvnik Trada, Fiona Day, Jarad Martin","doi":"10.21037/cco-24-41","DOIUrl":"10.21037/cco-24-41","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"90"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility of the deep hypothermal cryotherapy plus immune checkpoint inhibitor for treatment of severe malignant central airway obstruction.","authors":"Zhibing Luo, Changwen Deng, Shaoyong Gao, Xiaodong Wu, Xia Fang, Xiaoping Zhu, Qiang Li, Wujian Xu","doi":"10.21037/cco-24-74","DOIUrl":"https://doi.org/10.21037/cco-24-74","url":null,"abstract":"<p><strong>Background: </strong>The recurrence shortly after interventional therapy poses a great challenge in managing malignant central airway obstruction (MCAO). While cryotherapy has shown potential benefits when combined with immunotherapy in lung cancer, its effectiveness for improving local control of malignant central airway tumors is not well understood. This study aims to evaluate the clinical efficacy and safety of combining these strategies.</p><p><strong>Methods: </strong>A total of 12 patients with MCAO who had been treated with a combination of cryotherapy and immune checkpoint inhibitors (ICIs) were compiled for analysis in a tertiary hospital in Shanghai East Hospital, China. The primary endpoint is the duration of efficacy (DoE) for MACO after the combined therapy, which was defined as the time interval of the airway stayed patency without additional repeated interventional treatment. Secondary endpoints encompassed an assessment of objective response rate, overall survival and the adverse events.</p><p><strong>Results: </strong>Twelve patients received a combination therapy between January 2021 and December 2023. Median age was 66 years, 91.7% male. Fifty percent were squamous carcinoma. 50.0% had medium to low programmed cell death-ligand 1 (PD-L1) levels. 41.7% patients' performance status scored higher than 2. 91.7% (11/12) of the patients objectively respond to the combined therapy, with a median DoE of 10.0 (95% confidence interval: 3.7-21.7) months. The 6-, 12- and 18-month survival rate was 75.0%, 50.0% and 41.8%, respectively. The most common adverse event was granulation. Other events included mild rash, pneumonitis, and hypothyroidism. No severe procedure-related adverse events occurred.</p><p><strong>Conclusions: </strong>In patients with endoluminal or mixed MCAO, our findings suggest that combining endobronchial cryotherapy with ICIs may help maintain airway patency, offering a promising preliminary signal for this therapeutic approach.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 6","pages":"84"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E203K mutation in MAP2K1 (MEK1) causes acquired resistance to PD-1 blockade but responds to trametinib: a case report.","authors":"Weibing Leng, Guixia Wei, Leiming Sheng, Dan Jiang, Meng Qiu","doi":"10.21037/cco-24-61","DOIUrl":"https://doi.org/10.21037/cco-24-61","url":null,"abstract":"<p><strong>Background: </strong>Epstein-Barr virus-associated gastric cancer (EBVaGC) is characterized by higher lymphocytic infiltration, which predicts sensitivity to immunotherapy. However, there are few studies investigating the mechanisms of acquired resistance to programmed cell death protein 1 (PD-1) blockade and its subsequent treatment strategies for EBVaGC.</p><p><strong>Case description: </strong>We describe the case of a patient with EBVaGC who was initially treated with first-line chemotherapy plus Sintilimab, a fully humanized anti-PD-1 monoclonal antibody, resulting in a near-complete response. However, the acquired resistance to the immunotherapy treatment emerged shortly after consolidating radiotherapy, and subsequent second-line chemotherapy plus Sintilimab proved ineffective, confirming the true acquired resistance to PD-1 blockade. Re-biopsy of the treatment-resistant tumors revealed that a secondary gain-of-function mutation in mitogen-activated protein kinase kinase 1 (MAP2K1/MEK1) E203K had been acquired. Subsequently, the patient received an off-label MEK inhibitor trametinib and achieved a rapid and durable response.</p><p><strong>Conclusions: </strong>This study highlights the aberrant activation of the mitogen-activated protein kinase (MAPK) pathway as another important mechanism of resistance to immunotherapy. This case provides direct clinical evidence that MEK1 E203K is involved in resistance to immune checkpoint inhibitors (ICIs). Furthermore, for the first time, the MEK inhibitor trametinib has shown promising results in treating tumors with this mutation.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 6","pages":"87"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing therapeutic frontiers in urothelial carcinoma: targeted strategies and clinical implications.","authors":"Marcela G B Guimarães, Thiago A Miranda, Fernanda N C Haum, Gabriel Clemente B Pereira, Daniel M Girardi","doi":"10.21037/cco-24-67","DOIUrl":"https://doi.org/10.21037/cco-24-67","url":null,"abstract":"<p><p>Urothelial carcinoma poses significant challenges in clinical management due to its aggressive nature and high prevalence. While most diagnoses involve localized disease, advanced urothelial carcinoma (aUC) often leads to short overall survival (OS). Historically, platinum-based chemotherapy has been the primary treatment for aUC, although its efficacy is limited. However, recent therapeutic advancements, such as immune checkpoint inhibitors (ICIs) and targeted therapy using antibody-drug conjugates (ADCs) and tyrosine kinase inhibitors (TKIs), have shown promise in clinical trials, initially among patients who have undergone platinum-based chemotherapy. Recently, phase III clinical trials have assessed the effectiveness of ICIs, ADCs, and TKIs either in combination or as monotherapy in the first line setting for patients with aUC. As a result of this expanding knowledge, the combination of enfortumab vedotin (EV) with pembrolizumab in the front-line scenario became the new standard of care for aUC, demonstrating significant enhancements in OS and progression-free survival compared to platinum-based chemotherapy. Additionally, other ADCs and targeted therapies have exhibited promising efficacy in clinical trials. This review summarizes recent advancements in the treatment landscape of aUC, focusing on the efficacy and safety profiles of ICIs, ADCs, and TKIs, highlighting the evolving standards and promising combination approaches in the management of this challenging malignancy.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 6","pages":"86"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumour plasticity and tumour microenvironment interactions as potential immunologic targets for pancreatic cancer treatment.","authors":"Xu Zhou, Christoph Springfeld, Susanne Roth, Teresa Peccerella, Peter Bailey, Markus W Büchler, John Neoptolemos","doi":"10.21037/cco-24-72","DOIUrl":"https://doi.org/10.21037/cco-24-72","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) is a malignant cancer with a high mortality and limited treatment options. Systemic chemotherapy remains the only approach for improving survival in patients with unresectable locally advanced and/or metastatic disease which comprises most patients. Targeted therapies have so far been disappointing with limited applicability and improvement in overall survival. Patients with resectable PDAC have improved survival with adjuvant chemotherapy, whereas neoadjuvant chemotherapy is the best option for borderline resectable PDAC. In patients with locally advanced unresectable PDAC, resection rates may be improved with induction chemotherapy and possibly radiotherapy. Immunotherapy has proved to be relatively effective in multiple solid cancer types, and yet has shown poor or no efficacy in PDAC treatment. With the development of tumour and tumour microenvironment (TME) stratification by transcriptomic and histological profiling, we are able to have a deeper understanding of the clinical implications of TME heterogeneity and tumour plasticity. PDAC and stromal cells within the TME including cancer associated fibroblasts can be reprogrammed under certain treatment conditions to switch, at least to some extent, the whole immune-cold complex towards a more immune-hot and chemo-sensitive state. This approach may provide us with a new perspective in the design of immunotherapy and chemotherapy combination regimens.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"13 6","pages":"85"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}