Chinese clinical oncology最新文献

{"title":"Adjuvant CDK4/6 inhibitors and novel therapies in early breast cancer: lessons from monarchE overall survival data.","authors":"Tatsunori Shimoi","doi":"10.21037/cco-2026-1-0004","DOIUrl":"https://doi.org/10.21037/cco-2026-1-0004","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980570","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":"Efficacy and safety of TAS-102 followed by regorafenib or reverse sequence in later-line treatment of metastatic colorectal cancer: a systematic review and meta-analysis.","authors":"Bannawich Sapapsap, Sirapratch Champarhorm, Anchana Pongpun, Nattapong Kanchana, Jittipon Tantivit, Nattawut Leelakanok","doi":"10.21037/cco-2026-1-0018","DOIUrl":"https://doi.org/10.21037/cco-2026-1-0018","url":null,"abstract":"<p><strong>Background: </strong>Trifluridine/tipiracil (TAS-102) and regorafenib are approved and widely utilized as later-line treatment options for patients with metastatic colorectal cancer (mCRC). However, the optimal sequence between these agents remains unclear. We conducted a systematic review and meta-analysis to compare the efficacy and safety of two treatment sequences: TAS-102 followed by regorafenib (TR) versus regorafenib followed by TAS-102 (RT) in patients with mCRC who had previously failed chemotherapy.</p><p><strong>Methods: </strong>This study was registered with PROSPERO (CRD42024622437). We systematically searched six databases (PubMed, Scopus, CINAHL, ScienceDirect, medRXiv, and OpenGrey) up to June 1, 2025. Risk of bias was assessed using the ROBINS-I tool. Pooled estimates with 95% confidence intervals (CIs) were calculated using a random-effects model. For studies lacking hazard ratios (HRs), we estimated the HRs using the ratio of median survival times. Publication bias was evaluated with a funnel plot.</p><p><strong>Results: </strong>Thirteen observational studies with moderate to critical risk of bias were included. No significant difference was found in overall survival (OS) (HR =1.04, 95% CI: 0.86-1.25, I2=72%) or progression-free survival (PFS) (HR =1.34, 95% CI: 0.77-2.34, I2=92%) between the TR and RT groups. The RT group had a higher disease control rate (DCR) (33.1% vs. 28.0%) and tended to have more adverse events (AEs).</p><p><strong>Conclusions: </strong>OS and PFS outcomes were comparable between patients treated with TAS-102 followed by regorafenib and those receiving the reverse sequence. Although the RT group was associated with a slightly higher DCR, this was accompanied by a trend toward increased AEs.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980619","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":"Role of androgen receptor signaling in chemoresistance in urothelial cancer: a narrative review.","authors":"Taro Akai, Gaku Yamamichi, Hiroshi Miyamoto","doi":"10.21037/cco-2025-1-165","DOIUrl":"10.21037/cco-2025-1-165","url":null,"abstract":"<p><strong>Background and objective: </strong>Intravesical instillation of chemotherapeutic drugs remains a cornerstone in the management of non-muscle-invasive bladder tumor following transurethral surgery, where they are routinely employed to prevent disease recurrence and progression. In patients with locally advanced or metastatic urothelial carcinoma, cisplatin-based combination chemotherapy continues to represent the standard systemic treatment and has also been used in the neoadjuvant setting prior to radical cystectomy. Despite these established strategies, a substantial proportion of these patients exhibit intrinsic or acquired resistance to chemotherapeutic regimens, ultimately leading to poor oncologic outcomes, although the molecular mechanisms underlying chemoresistance remain only partially understood. Meanwhile, accumulating evidence has increasingly suggested a critical role of androgen receptor (AR) signaling in promoting not only the development and progression of urothelial cancer but also resistance to conventional non-surgical therapy for bladder cancer. In this review article, we aim to summarize available data suggesting that AR is involved in chemosensitivity in urothelial cancer.</p><p><strong>Methods: </strong>We searched five scholarly databases [PubMed, Embase, Scopus, Google Scholar, and World Health Organization (WHO) Global Index Medicus], using the relevant keywords variably combined. Studies published in English from January 1950 to January 2026 were considered.</p><p><strong>Key content and findings: </strong>This article focuses on synthesizing current knowledge regarding the involvement of AR in modulating the efficacy of chemotherapeutic agents used for bladder cancer and discusses their potential of overcoming chemoresistance. Several potential downstream effectors of AR signaling, which increase or decrease chemosensitivity, have also been identified.</p><p><strong>Conclusions: </strong>Available data may indicate that therapeutic strategies incorporating anti-AR therapy, apart from its direct anti-tumor activity, may hold considerable promise as a sensitizer of chemotherapy in patients with urothelial cancer.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"39"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962403","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":"Genome-wide 5-hydroxymethylcytosine in circulating cell-free DNA reflects DNA methylation dynamics for non-invasive detection of early hepatocellular carcinoma.","authors":"Junya Peng, Xu Pan","doi":"10.21037/cco-2026-1-0022","DOIUrl":"10.21037/cco-2026-1-0022","url":null,"abstract":"<p><strong>Background: </strong>Early hepatocellular carcinoma (HCC) remains difficult to diagnose because of its insidious and asymptomatic onset. Liquid biopsy provides a promising non-invasive approach for early tumor detection. 5-Hydroxymethylcytosine (5-hmC), the oxidation product of 5-methylcytosine (5-mC), has emerged as an informative epigenetic mark reflecting tumor-associated alterations during hepatocarcinogenesis. This study aimed to identify and validate a circulating cell-free DNA (cfDNA) 5-hmC-based signature for the early detection of HCC and to evaluate its diagnostic and prognostic potential.</p><p><strong>Methods: </strong>Using an XGBoost-based ensemble learning framework, we identified cfDNA 5-hmC markers that defined an early HCC 5-hmC signature. The signature was assessed in training and validation cohorts using receiver operating characteristic (ROC) analysis, with the area under the curve (AUC) as the primary performance metric.</p><p><strong>Results: </strong>We defined a 19-gene cfDNA 5-hmC signature (eHMS), which showed high diagnostic accuracy for early HCC across multiple precancerous states, with AUCs of 92.3% (healthy controls vs. early HCC), 82.5% [benign liver lesions (BLL) vs. early HCC], 78.8% [chronic hepatitis B (CHB) vs. early HCC], 81.3% (liver cirrhosis vs. early HCC), and 89.4% when pooling all non-HCC, further validated in an external cfDNA cohort (AUC =93.5%). When traced to tissue 5-mC, the 5-mC-related eHMS (MeHMS) score distinguished tumors from adjacent tissues with an AUC of 99.9% and showed improved discriminatory performance compared with alpha-fetoprotein (AFP, AUC =71.5%). Moreover, the signature may reflect early metabolic reprogramming and provide prognostic value by stratifying patients for survival and disease progression.</p><p><strong>Conclusions: </strong>Our findings indicate that the eHMS represents a promising biomarker for liquid biopsy in early HCC surveillance.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"32"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962209","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":"Hormone therapy in younger women: reassessing risk narratives in the era of precision menopausal care.","authors":"Auro Del Giglio","doi":"10.21037/cco-2025-1-166","DOIUrl":"https://doi.org/10.21037/cco-2025-1-166","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"25"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962186","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":"First-line programmed death-1 blockade plus chemotherapy in low programmed cell death ligand 1 esophageal squamous cell carcinoma: beyond a single biomarker.","authors":"Shigenori Kadowaki","doi":"10.21037/cco-2025-1-168","DOIUrl":"https://doi.org/10.21037/cco-2025-1-168","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"23"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962192","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":"Small cell lung cancer: a therapeutic update in the era of immunotherapy and beyond-a narrative review.","authors":"Andrés Barba, Sergio Martínez-Recio, Mikel Portu, Ana Maria Soto-Cambres, Juan Carlos Trujillo, Nuria Farré, Margarita Majem","doi":"10.21037/cco-25-104","DOIUrl":"10.21037/cco-25-104","url":null,"abstract":"<p><strong>Background and objective: </strong>Small cell lung cancer (SCLC) is an aggressive neuroendocrine malignancy with frequent relapse and poor long-term survival. We review current and emerging therapeutic strategies across disease stages, emphasizing multimodal treatment and novel systemic agents.</p><p><strong>Methods: </strong>We performed a narrative review based on a comprehensive literature search in PubMed, Embase and the Cochrane Library for studies published up to 1 April 2025, with late-breaking abstracts considered through July 2025. Medical Subject Headings (MeSH) and free-text terms related to small cell lung cancer, chemotherapy, immunotherapy, radiotherapy, surgery and emerging agents were combined with Boolean operators. No language restrictions were applied.</p><p><strong>Key content and findings: </strong>For limited-stage disease, concurrent platinum-etoposide chemoradiotherapy remains the backbone, and durvalumab consolidation after definitive chemoradiotherapy has become a new standard based on the ADRIATIC trial. For extensive-stage disease, first-line chemoimmunotherapy with atezolizumab or durvalumab combined with platinum-etoposide is the current standard of care, and emerging data support selected maintenance strategies. In relapsed disease, outcomes remain poor, but lurbinectedin, DLL3-directed bispecific T-cell engagers such as tarlatamab, and antibody-drug conjugates targeting B7-H3 or TROP-2 show early activity. Transcriptional plasticity and intratumor heterogeneity are increasingly recognized as key drivers of treatment resistance.</p><p><strong>Conclusions: </strong>While immunotherapy has improved outcomes, most patients ultimately relapse. Integrating molecular subtyping, optimizing multimodality care, and accelerating clinical trial enrollment are key to further progress in SCLC.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"34"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962353","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":"Claudin 18.2 testing in gastroesophageal and pancreatobiliary cancers: current status, clinical implications and challenges.","authors":"Sun Mi Lee, Huamin Wang","doi":"10.21037/cco-2025-1-170","DOIUrl":"10.21037/cco-2025-1-170","url":null,"abstract":"<p><p>Claudin (CLDN) 18.2 is a tight-junction protein predominantly expressed in normal gastric epithelium. Malignant transformation can disrupt epithelial cell polarity, resulting in the exposure and overexpression of CLDN18.2 on tumor cell surfaces. This characteristic makes CLDN18.2 a promising therapeutic target in subsets of patients with gastric and gastroesophageal junction (G/GEJ), and pancreatobiliary cancers. The recent approval by the US Food and Drug Administration (FDA) of the anti-CLDN18.2 monoclonal antibody zolbetuximab marks a significant advancement in the management of locally advanced, unresectable, or metastatic HER2-negative, CLDN18.2-positive G/GEJ adenocarcinoma. The increasing adoption and ongoing clinical trials of CLDN18.2-targeted therapies in G/GEJ and pancreatobiliary cancers have intensified the demand for reliable diagnostic testing. These developments underscore the need for accurate, standardized assessment of CLDN18.2 expression to inform patient selection and treatment planning. This review examines the current status, clinical implications, and challenges of CLDN18.2 testing in G/GEJ, as well as its expanding application in pancreatobiliary cancers. Multiple CLDN18.2 antibody clones and immunohistochemical staining platforms are currently utilized across clinical laboratories, each demonstrating variable accuracy, sensitivity, and specificity in detecting CLDN18.2 expression. Furthermore, CLDN18.2 expression is frequently heterogeneous within these cancers. Optimizing the clinical utility of CLDN18.2 testing requires rigorous attention to pre-analytic factors, such as tissue handling, fixation, and selection of representative tumor samples; analytic factors, including assay validation, antibody selection, and consistency in staining procedures; and post-analytic factors, such as scoring methods and clear cutoff criteria for interpretation. Each of these elements critically influences assay performance and reliability. Careful selection and evaluation of tumor samples, particularly in small biopsies or cytology specimens, are essential to ensure accurate assessment. Standardization of all aspects of CLDN18.2 immunohistochemistry, from specimen preparation to interpretation, is necessary to achieve accurate, reproducible, and clinically meaningful results that guide therapeutic decisions for patients with G/GEJ and pancreatobiliary cancers.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"36"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962216","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":"Fos-related antigen 1 is required for Helicobacter pylori-induced inflammatory response in gastric epithelial cells through NF-κB pathway.","authors":"Yang Yang, Shihe Shao","doi":"10.21037/cco-2025-1-188","DOIUrl":"10.21037/cco-2025-1-188","url":null,"abstract":"<p><strong>Background: </strong>Chronic gastritis affects ~50% of the population, frequently linked to Helicobacter pylori (H. pylori). Fos-related antigen 1 (FRA-1) has been reported to be involved in stomach inflammation and malignancy. The study aimed to investigate the regulatory role of FRA-1 in H. pylori-induced inflammatory response of gastric epithelial cells, and to explore its mechanism and application prospect of FRA-1 in H. pylori infection treatment.</p><p><strong>Methods: </strong>GES-1 cells were selected to knock down the level of FRA-1 by specific small interfering RNA (siRNA) prior to H. pylori infection. The messenger RNA (mRNA) expression of FRA-1 and cytokines was quantified by real-time quantitative polymerase chain reaction (RT-qPCR), protein levels were analyzed by western blot, and cytokine secretion was measured by enzyme-linked immunosorbent assay (ELISA). Nuclear factor-κB (NF-κB) activity was then assessed by western blot and immunofluorescence.</p><p><strong>Results: </strong>It was showed that infection with H. pylori markedly increased FRA-1 expression levels. Knockdown analysis identified that FRA-1 was required for H. pylori-induced inflammatory cytokines expression in GES-1 cells. In addition, FRA-1 exerted proinflammatory response to H. pylori by augmenting NF-κB activation.</p><p><strong>Conclusions: </strong>This work suggests a key function for FRA-1 in underlying the inflammatory pathology of H. pylori-associated gastritis, and that it could serve as a useful detection indicator and therapeutic target.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"28"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962202","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":"Impact of neoadjuvant chemotherapy vs. upfront surgery on survival in early-onset colorectal cancer-a single centre experience.","authors":"Oluwabukunmi Modupe Salami, Hao Yi, Guangyi Liu, Yang Li","doi":"10.21037/cco-2026-1-0006","DOIUrl":"10.21037/cco-2026-1-0006","url":null,"abstract":"<p><strong>Background: </strong>Early-onset colorectal cancer (EO-CRC) has been gaining momentum in the oncologic community and has a reputation for being overtreated. Neoadjuvant therapy has been proven to be an effective treatment for rectal cancers; however, treatment outcomes in this group have yet to be studied. The purpose of this study was to compare overall survival (OS) between the upfront surgery (UFS) group and the neoadjuvant chemotherapy (NAC) group in EO-CRC.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 162 patients with stage III-IV locally advanced EO-CRC who underwent radical surgery at a single centre between January 2018 and December 2023. Baseline characteristics, treatment modalities, pathological findings, metastasis, recurrence and survival outcomes, disease-free survival (DFS) and OS, were compared. Survival was assessed using Kaplan-Meier analysis and Cox regression. Propensity score matching (PSM) was performed to adjust for baseline differences.</p><p><strong>Results: </strong>Baseline demographics were broadly similar except for higher abdominal pain frequency in UFS (42.1% vs. 17.2%, P=0.01). NAC was associated with greater rectal tumor proportion (75.9% vs. 43.6%, P=0.002) and higher pathological downstaging after matching (23/45 vs. 22/45, P=0.001). Survival analyses revealed improved DFS (P=0.005) and OS (P=0.001) with NAC, along with reduced recurrence (P=0.001). Multivariate analysis identified preoperative stage, nodal status, invasion, and metastases as key survival predictors; NAC was not an independent predictor.</p><p><strong>Conclusions: </strong>In EO-CRC, NAC achieves tumour downstaging and survival benefits compared to UFS. These findings support the integration of NAC into multimodal treatment strategies to improve oncologic outcomes in selected patients. Larger prospective studies are needed.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 2","pages":"31"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962442","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}