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Yan F, Yu L, Liu Z, Qi J, Wang L, Zhou M, Yin P. Subnational trend and driving factors for pancreatic cancer burden in China, 1990-2021: an analysis based on the Global Burden of Disease Study 2021. Ann Med 2025; 57:2484465. [PMID: 40172666 PMCID: PMC11966975 DOI: 10.1080/07853890.2025.2484465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 03/04/2025] [Accepted: 03/16/2025] [Indexed: 04/04/2025] Open
Abstract
BACKGROUND The mortality of pancreatic cancer in China showed an increasing trend between 2005 and 2020, with significant discrepancies in the burden of pancreatic cancer in provinces. METHODS We analyzed numbers of death, incidence, disability-adjusted life years (DALY) and corresponding age-standardized rates for pancreatic cancer in China using data from the Global Burden of Disease Study 2021. We conducted trend analysis in pancreatic cancer burden over time by age group and gender. Decomposition analysis was used to assess the drivers of change in cancer-related deaths in China due to three explanatory factors: population growth, population ageing and age-specific mortality. RESULTS In 2021, the ASMR of pancreatic cancer in China was 5.72/100,000(95%UI: 4.59, 6.91), the age-standardized incidence (ASIR) rate was 5.64/100,000(95%UI: 4.52, 6.84) and the age-standardized DALY rate was 137.23/100,000 (95%UI:108.15, 166.74). From 1990 to 2021, the ASMR of pancreatic cancer in China generally showed an increasing trend (AAPC: 0.56, 95%UI: 0.52, 0.59). The burden of pancreatic cancer was consistently higher in Chinese men compared to women during the study period.Compared with 1990, the number of deaths from pancreatic cancer has increased in all provinces of China in 2021, with the overall number of deaths increasing by 67.49%. Population ageing was the major cause of the increase in deaths from pancreatic cancer in China, accounting for 45.89%. CONCLUSIONS The burden of pancreatic cancer in China is still at a high level and population ageing is the main reason for the increase in pancreatic cancer deaths.
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Affiliation(s)
- Fanshu Yan
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lingling Yu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhe Liu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinlei Qi
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lijun Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Yin
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Darbà J, Ascanio M. Hepatocellular carcinoma: what are the differential costs compared to the general population? J Med Econ 2025; 28:471-478. [PMID: 40126406 DOI: 10.1080/13696998.2025.2484073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 03/20/2025] [Accepted: 03/21/2025] [Indexed: 03/25/2025]
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC), which accounts for about 90% of all primary liver cancer cases, is the fifth most common malignancy and the second leading cause of cancer-related mortality worldwide. This study aims to analyse the differential costs of HCC-related hospital admissions compared to the general population in Spain. METHODS A retrospective multicenter study analyzed inpatient admissions from a Spanish national discharge database, covering 90% of hospitals between 2010 and 2022. HCC-related admissions were identified using ICD-9 and ICD-10 codes, while control admissions were selected from the general population in the same database without an HCC diagnosis. The direct hospitalization cost was included, covering medical examinations, procedures, medications, surgeries, personnel and equipment. Statistical methods, including nearest-neighbor matching, propensity score matching, and a generalized linear model, were used to estimate differential costs and to ensure comparability based on age, gender, and Charlson Comorbidity Index (CCI). RESULTS A total of 199,670 HCC-related hospital admissions and 200,000 control admissions were analyzed. Most HCC-related admissions involved male patients (78%) aged 66-85 years, with an average CCI of 5.18. HCC-related admissions incurred significantly higher costs, with an estimated differential cost of €1,303.68 using GLM, €1,804.25 via propensity score matching, and €1,767.77 using nearest-neighbor matching. Total costs per HCC admission ranged between €1,000 and €31,000. CONCLUSIONS HCC-related hospital admissions impose a significantly higher economic burden due to the complexity of care. Given the high mortality and resource utilization, advancements in early detection, treatment, and cost-effective interventions are needed to improve patient outcomes and reduce healthcare costs.
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Affiliation(s)
- Josep Darbà
- Department of Economics, Universitat de Barcelona, Barcelona, Spain
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Li R, Zhou X, Wang X, Cheng P, Xu J, Cao J, Gao Q, Zhu H. Global burden of depression and anxiety disorders in older adults, 1990-2019: An analysis of age-period-cohort and temporal-spatial patterns. J Affect Disord 2025; 383:90-100. [PMID: 40280434 DOI: 10.1016/j.jad.2025.04.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 04/07/2025] [Accepted: 04/19/2025] [Indexed: 04/29/2025]
Abstract
BACKGROUND Mental disorders are the leading causes of the global health-related burden and account for 10.6% of total disability (in disability adjusted life years, DALYs) among older adults, with depression and anxiety disorders being the most common contributors to this burden. This study provided a comprehensive epidemiological update on their global burden in older populations, analyzing evolving temporal trends, spatial distribution shifts, and identifying high-risk subgroups and geographic regions. METHOD Prevalence rates and disability-adjusted life years (DALYs) for depression and anxiety disorders in older adults from 1990 to 2019 were estimated using the GBD 2019. The Age-period-cohort (APC) modeling was applied to investigate the reasons behind these trends. In addition, we assessed the spatial patterns in different regions using the global and local Moran Index. RESULTS In 2019, 57.78 million (95 % UI 50.04, 66.30) older adults experienced depression and 46.26 million (95 % UI 59.93, 36.57) suffered from anxiety disorders globally. Depression accounted for 9.21 million DALYs (rate: 908.94, 95 % UI 625.45, 1234.56), while anxiety disorders contributed to 4.08 million DALYs (rate: 402.95, 95 % UI 264.96, 581.75). From 1990 to 2019, the depression prevalence increased (EAPC = 0.0424, 95 % CI 0.0261, 0.0587), and DALYs rates rose slightly (EAPC = 0.0142, 95 % CI -0.0071, 0.035). In contrast, the anxiety disorders prevalence and DALYs rate declined over the same period [EAPC = -0.1476 (95 % CI -0.1924,-0.1027) and -0.1476 (95 % CI -0.1917,-0.1035)]. Age-specific trends revealed inverted U-shaped depression trajectories, peaking among individuals aged 70-74 years, whereas anxiety disorders exhibited a U-shaped decline with the steepest reductions occurring at the extremes and slower declines in middle age groups. Males exhibited faster-growing depression burdens and rising late-life rates of anxiety disorders, contrasting with the declining trend observed in females. Socio-demographic disparities highlighted low-SDI regions with the highest depression burden (e.g., sub-Saharan Africa) versus high-SDI clusters for anxiety disorders (e.g., Western Europe). Spatial analyses identified depression hotspots in sub-Saharan Africa and anxiety clusters in Latin America and Western Europe, emphasizing divergent geographic patterns. CONCLUSION Combining temporal and spatial patterns, we explored temporal trends and five spatial patterns in global depression and anxiety disorders. The prevalence of depression and anxiety disorders was significantly elevated in regions exhibiting both fluctuating and stable high-aggregation patterns, particularly in Eastern/Western sub-Saharan Africa and Southern Latin America. National governments prioritize implementing targeted interventions to alleviate these burdens, while future studies should validate findings through comprehensive datasets and individual-level data to refine prevention strategies for high-risk populations and regions.
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Affiliation(s)
- Ruyu Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Environment and Aging, Capital Medical University, Beijing, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, Beijing, PR China
| | - Xiaoding Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Environment and Aging, Capital Medical University, Beijing, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, Beijing, PR China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Environment and Aging, Capital Medical University, Beijing, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, Beijing, PR China
| | - Peixia Cheng
- Beijing Key Laboratory of Environment and Aging, Capital Medical University, Beijing, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, Beijing, PR China; Department of Maternal and Child Health, School of Public Health, Capital Medical University, Beijing, PR China
| | - Jiaying Xu
- Psychiatry Class, School of Basic Medical Sciences, Capital Medical University, Beijing, PR China
| | - Jinhong Cao
- Medical Affairs Department, Hubei Maternal and Child Health Hospital, Wuhan, PR China.
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Key Laboratory of Environment and Aging, Capital Medical University, Beijing, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, Beijing, PR China.
| | - Huiping Zhu
- Beijing Key Laboratory of Environment and Aging, Capital Medical University, Beijing, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, Beijing, PR China; Department of Maternal and Child Health, School of Public Health, Capital Medical University, Beijing, PR China.
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Jiang S, Guo F, Li L. Biological mechanisms and immunotherapy of brain metastases in non-small cell lung cancer. Biochim Biophys Acta Rev Cancer 2025; 1880:189320. [PMID: 40220878 DOI: 10.1016/j.bbcan.2025.189320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2025] [Revised: 04/07/2025] [Accepted: 04/07/2025] [Indexed: 04/14/2025]
Abstract
Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality worldwide, with Brain Metastases serving as a significant adverse prognostic factor. The blood-brain barrier poses a substantial challenge in the treatment of brain metastases, as it restricts the penetration of many anticancer agents. Novel immunotherapy, such as immune checkpoint inhibitors (ICIs) have emerged as promising treatment for NSCLC and its associated brain metastases. This review summarizes the biological mechanism underlying NSCLC brain metastases and provides an overview of the current landscape of immunotherapy, exploring the mechanism of action and clinical applications of these advanced treatments.
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Affiliation(s)
- Sitong Jiang
- Department of Medical Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Fengzhu Guo
- Department of Medical Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Lin Li
- Department of Medical Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China.
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Wang Q, Sun L, Zhang G, Chen Z, Li G, Jin R. A novel nomogram based on machine learning predicting overall survival for hepatocellular carcinoma patients with dynamic α‑fetoprotein level changes after local resection. Oncol Lett 2025; 29:310. [PMID: 40342725 PMCID: PMC12059617 DOI: 10.3892/ol.2025.15056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 03/20/2025] [Indexed: 05/11/2025] Open
Abstract
The principal aim of the present study was to develop and validate a nomogram predicting overall survival (OS) in patients with α-fetoprotein (AFP)-negative hepatocellular carcinoma (AFP-NHCC) who experience dynamic changes in AFP level after hepatectomy. A cohort of 870 patients were enrolled and randomly assigned into a training cohort (n=600) and a validation cohort (n=270) at a 7:3 ratio. The key variables contributing to the nomogram were determined through random survival forest analysis and multivariate Cox regression. The discriminative ability of the nomogram was evaluated using time-dependent receiver operating characteristic curves and the area under the curves. Furthermore, the nomogram was comprehensively assessed using the concordance index (C-index), calibration curves and clinical decision curve analysis (DCA). Kaplan-Meier (KM) curves analysis was employed to discern survival rates across diverse risk strata of patients. Ultimately, the nomogram incorporated critical factors including sex, tumor size, globulin levels, gamma-glutamyl transferase and fibrinogen levels. In the training and validation cohorts, the C-indexes were 0.72 [95% confidence interval (CI): 0.685-0.755) and 0.664 (95% CI: 0.611-0.717], respectively, attesting to its predictive validity. The nomogram demonstrated excellent calibration and DCA further confirmed its clinical usefulness. Additionally, KM curve analysis unveiled statistically significant differences in OS among three distinct risk groups. In conclusion, the present study successfully formulated a nomogram predicting 3-, 5- and 8-year OS in patients with AFP-NHCC with dynamic changes in AFP level post-local resection. This model serves as a valuable tool for clinicians to promptly identify high-risk patients, thereby facilitating timely interventions and potentially enhancing patient survival outcomes.
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Affiliation(s)
- Qi Wang
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, P.R. China
- Beijing Institute of Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, P.R. China
| | - Lina Sun
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, P.R. China
- Beijing Institute of Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, P.R. China
| | - Gongming Zhang
- Department of General Surgery, Beijing You'an Hospital, Capital Medical University, Beijing 100069, P.R. China
| | - Zhuangzhuang Chen
- Department of General Surgery, Beijing You'an Hospital, Capital Medical University, Beijing 100069, P.R. China
| | - Guangming Li
- Department of General Surgery, Beijing You'an Hospital, Capital Medical University, Beijing 100069, P.R. China
| | - Ronghua Jin
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, P.R. China
- Beijing Institute of Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, P.R. China
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Yakupu A, Wang H, Huang L, Zhou J, Wu F, Lu Y, Lu S. Global, Regional, and National Levels and Trends in the Burden of Pressure Ulcer from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease 2019. INT J LOW EXTR WOUND 2025; 24:355-366. [PMID: 35379022 DOI: 10.1177/15347346221092265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pressure ulcer (PU) is a type of chronic ulcer, placing a high burden not only on patients' families but also on national healthcare systems globally. To determine the level, trends, and burden of PU worldwide and to provide an essential foundation for building targeted public policies on PUs at the national, regional, and global levels, data on PU were obtained from the Global Burden of Disease (GBD) 2019 Study. The incidence, disability-adjusted life years (DALYs), and deaths of PUs in 204 countries and regions from 1990 to 2019 were calculated and stratified by sex, age, geographical location, and sociodemographic index (SDI). The estimated annual percentage change (EAPC) of incidence, DALYs, and deaths was calculated to evaluate the temporal trends. A total of 3,170,796 new cases (95% uncertainty interval (UI), 3,499,729-2,875,433 cases) of PU were identified globally in 2019, more than 55% of which were among male individuals, and most of the new cases were concentrated in those 75-90 years of age. The burden of PU measured in DALYs was 481 423 (95% UI, 583 429-374 334) in 2019, 73% and 27% of which could be attributed to years of life lost (YLLs) and years lived with disability (YLDs), respectively. The burden increased gradually from 1990 to 2019 (from 267 846 [360 562-211 024] to 481 423 [95% UI, 583 429-374 334]). A total of 24 389 deaths were attributed to PU (95% UI, 31 260.82-17 299). The EAPC of incidence, DALYs, and deaths were negative in most regions, the age-standardized rate (ASR) of incidence, DALYs, and deaths were considered to be decreasing in most of the regions, and the EAPCs were negatively correlated with the SDI levels, universal health coverage (UHC), and gross domestic product (GDP), which shows that the ASRs of PU decreased as the economy developed and countries' healthcare system performances improved.
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Affiliation(s)
- Aobuliaximu Yakupu
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Hanqi Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Lifang Huang
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Jingqi Zhou
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Fangyi Wu
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Yong Lu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Shuliang Lu
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
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Meng X, Sun Q, Liu Z, Cao S, Xu C, Di L, Wu Y, Zhang W. TIMELESS as a prognostic biomarker and therapeutic target in gastric cancer. J Genet Eng Biotechnol 2025; 23:100504. [PMID: 40390494 DOI: 10.1016/j.jgeb.2025.100504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Revised: 04/14/2025] [Accepted: 04/28/2025] [Indexed: 05/21/2025]
Abstract
BACKGROUND Gastric cancer (GC), one of the most prevalent malignancies worldwide, is characterized by complex etiological and pathological mechanisms. Emerging evidence on the dysregulation of circadian clock genes has revealed promising opportunities for improving the diagnosis, treatment, and prognosis of patients with GC. METHODS This study utilized a multifaceted approach combining machine learning algorithms, gene set enrichment analysis, immune infiltration profiling, survival prognosis analysis, drug sensitivity testing, and in vitro experiments to investigate the functional roles of core clock genes in GC. RESULTS By integrating data from The Cancer Genome Atlas, Gene Expression Omnibus datasets, and the National Center for Biotechnology Information database, we identified 29 differentially expressed clock genes in GC. Among these, the application of four distinct machine learning algorithms highlighted TIMELESS (TIM) and BHLHE41 as pivotal genes, with TIM demonstrating notable diagnostic performance (area under the receiver operating characteristic curve = 0.802). Elevated TIM expression was strongly associated with poor clinical prognosis and increased infiltration of immune cells in tumor tissues. Notably, a specific interaction was identified between TIM and the pyroptosis-associated molecule CASP8, indicating a potential synergistic role in GC pathogenesis. Additionally, bortezomib emerged as a potential targeted therapeutic agent capable of modulating TIM activity in GC. CONCLUSION TIM is identified as a promising diagnostic biomarker and therapeutic target in GC, offering valuable implications for improving patient prognosis and guiding personalized treatment strategies.
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Affiliation(s)
- Xiangrong Meng
- Department of Laboratory Diagnosis, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qi Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Heilong Jiang University of Chinese Medicine, Harbin, China
| | - Zhongshuang Liu
- Department of Stomatology, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Shenqi Cao
- Anesthesiology, Harbin Medical University, Harbin, China
| | - Chunyang Xu
- Department of Laboratory Diagnosis, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Longjiang Di
- School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan Wu
- Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenjing Zhang
- Department of Laboratory Diagnosis, the Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Li Q, Zhang H, Yun-Liu H, Zheng P, Xu X. C1qtnf6 Expression as a Prognostic Biomarker and Therapeutic Target in Lung Adenocarcinoma: Implications for Immune Infiltration and Tumor Progression. Cancer Rep (Hoboken) 2025; 8:e70205. [PMID: 40490027 DOI: 10.1002/cnr2.70205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 02/04/2025] [Accepted: 04/09/2025] [Indexed: 06/11/2025] Open
Abstract
BACKGROUND The incidence and mortality of lung cancer are increasing every year, making it the primary cause of cancer-related fatalities globally. Upregulation of C1qtnf6 expression is observed in various human cancers. This study aimed to explore the function of C1qtnf6 in lung adenocarcinoma (LUAD) progression. METHODS We used The Cancer Genome Atlas (TCGA) dataset to analyze data on lung cancer. The relationship between C1qtnf6 expression and treatment outcomes in patients with LUAD was evaluated using a Kaplan-Meier survival analysis. The receiver operating characteristic (ROC) curve was analyzed to ascertain the diagnostic value of C1qtnf6 in LUAD. Additionally, we performed a correlation analysis to investigate the association between the transcription of C1qtnf6 and inflammation in LUAD. To create LUAD cell lines with reduced C1qtnf6 expression, C1qtnf6 was knocked down, and several in vitro analyses were conducted to determine how C1qtnf6 knockdown affected the proliferation and apoptosis of LUAD cells. Furthermore, the relationship between C1qtnf6 and Interleukin-10 (IL-10) was verified. Using the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and Gene Ontology (GO) studies, we further examined the impact of C1qtnf6 knockdown on the biological behavior of LUAD cells. RESULTS TCGA dataset analysis revealed that C1qtnf6 expression was much higher in LUAD tissues than in the adjoining normal tissues. Correlation analysis revealed a relationship between C1qtnf6 expression and immune cell infiltration in LUAD. It has been demonstrated that C1qtnf6 expression is closely associated with the tumor immunological milieu, immune checkpoint blockade (ICB), and response to cisplatin treatment. In vitro tests revealed that C1qtnf6 knockdown reduced IL-10 levels, accelerated apoptosis, and hindered the growth of LUAD cells, thus indicating a possible link between C1qtnf6 and inflammation. CONCLUSION Our results show that C1qtnf6 may be useful as a prognostic indicator for LUAD.
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Affiliation(s)
- Qincai Li
- Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
- College of Chinese Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Hua Zhang
- The Second Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Hai Yun-Liu
- College of Chinese Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Peifeng Zheng
- Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Xiaogang Xu
- College of Chinese Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
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Tao Y, Cheng W, Zhen H, Shen J, Guan H, Liu Z. Global time-trend analysis and projections of disease burden for neuroblastic tumors: a worldwide study from 1990 to 2021. Ital J Pediatr 2025; 51:164. [PMID: 40437514 PMCID: PMC12121101 DOI: 10.1186/s13052-025-01983-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Accepted: 05/07/2025] [Indexed: 06/01/2025] Open
Abstract
BACKGROUND Neuroblastoma and other peripheral nerve cell tumors (NB-PNT) are the most common extracranial solid tumors in children. This study aimed to describe the global burden of NB-PNT across different age groups and genders, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) in various countries and regions. Additionally, we analyzed changes in the disease burden over the past three decades and predicted future trends up to 2036. METHODS Using open data from the Global Burden of Disease (GBD) database (1990-2021), we provided a dynamic description of the disease burden of NB-PNT patients across different age and gender groups on a global scale. Joinpoint analysis was used to calculate the average annual percentage change (AAPC) to quantify trends in the burden of NB-PNT. Meanwhile, the Bayesian Age-Period-Cohort (BAPC) model was applied to predict the changes in disease burden up to 2036. RESULTS From 1990 to 2021, the global burden of NB-PNT increased significantly, with global prevalence rising from 41,456 to 56,326 cases. Gender and age disparities were evident, with male patients and patients aged 6-11 months exhibiting higher disease burden. Regional variations were observed, with higher disease burdens in regions with a higher sociodemographic index (SDI), although low-SDI regions showed a consistent upward trend. Overall, the prevalence of NB-PNT increased year by year (overall AAPC = 0.64% [0.56 - 0.72%]), with a slight decline in age-standardized mortality rates observed in 2019 (APC2019 - 2021 = -2.02%). Projections indicate a slight decline in both incidence and mortality rates by 2036, with a more pronounced reduction in females. CONCLUSIONS A higher burden of NB-PNT was evident among male patients and infants. The disease burden in low-SDI regions has increased in recent years, while a decline was observed in high-SDI regions. Over the past 30 years, the burden rose overall, although a decline in incidence was observed in 2019. Projections indicate a slight decrease in global incidence and mortality rates through 2036.
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Affiliation(s)
- Yinjie Tao
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Weishi Cheng
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Hongnan Zhen
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jing Shen
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Hui Guan
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Zhikai Liu
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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Yin Y, Zhang X. Analysis of trends in the burden of colorectal cancer in China and globally from 1990 to 2021 with projections for the next 15 years: a cross-sectional study based on the GBD database. Front Public Health 2025; 13:1518536. [PMID: 40492005 PMCID: PMC12146330 DOI: 10.3389/fpubh.2025.1518536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 03/04/2025] [Indexed: 06/11/2025] Open
Abstract
Objective To analyze the changes in the burden of colorectal cancer in China and globally from 1990 to 2021, and to explore the disease burden across different age groups and sexes by integrating projected data from 2022 to 2036. This study aims to provide a scientific foundation for formulating targeted prevention and control strategies. Materials and methods This study utilized colorectal cancer data from the Global Burden of Disease (GBD) database for the period 1990-2021. Trend analysis was conducted using Joinpoint regression, and future burden projections from 2022 to 2036 were made with an Auto-Regressive Integrated Moving Average (ARIMA) model. Key indicators analyzed included the Age-Standardized Incidence Rate (ASIR), Age-Standardized Prevalence Rate (ASPR), Age-Standardized Mortality Rate (ASMR), and Disability-Adjusted Life Years (DALYs). Results Between 1990 and 2021, the burden of colorectal cancer increased both in China and globally, although notable differences were observed across gender and regions. In Chinese men, the ASIR and ASMR have shown a continuous rise, reaching approximately 50 and 300 per 100,000, respectively, by 2021. Projections indicate that these rates will continue to increase through at least 2036. The ASIR in Chinese women also exhibits an upward trend, whereas the global ASIR for women has declined. From 1990 to 2021, both China and the world experienced a steady rise in ASPR, with minimal fluctuations. In contrast, while the ASDR has decreased in both China and globally, the volatility in China's ASDR is notably more pronounced than that observed worldwide. Conclusion The burden of colorectal cancer in China is projected to increase significantly in the coming years, particularly among males and the older adult population. This study provides critical scientific insights for the development of targeted prevention strategies and resource allocation, underscoring the urgent need to enhance early screening initiatives and health education efforts in China.
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Affiliation(s)
- Yulai Yin
- Nankai University School of Medicine, Nankai University, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
- Department of Colorectal Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
| | - Xiaoyu Zhang
- Department of Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou, China
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11
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Deng Y, Zhang X, Hu F, Lan X. Quantitative 18F-FDG PET/CT Model for predicting pathological complete response to neoadjuvant immunochemotherapy in NSCLC: comparison with RECIST 1.1 and PERCIST. Eur J Nucl Med Mol Imaging 2025:10.1007/s00259-025-07342-8. [PMID: 40418330 DOI: 10.1007/s00259-025-07342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2025] [Accepted: 05/08/2025] [Indexed: 05/27/2025]
Abstract
PURPOSE This study aimed to evaluate the predictive value of 18F-FDG PET/CT for pathological complete response (pCR) after neoadjuvant immunochemotherapy in resectable non-small cell lung cancer (NSCLC) and develop a quantitative pCR prediction model. We compared the model's performance with RECIST 1.1 and PERCIST. METHOD A retrospective review was conducted on patients with resectable NSCLC who received neoadjuvant immunochemotherapy from January 2020 to December 2023. Patients with both pre-treatment (18F-FDG PET/CT scan-1) and preoperative scans (18F-FDG PET/CT scan-2) were included. 18F-FDG PET/CT parameters, clinical characteristics, and follow-up data were collected. Logistic regression was used to identify independent predictors and construct the prediction model. The model's predictive performance was compared with RECIST 1.1 and PERCIST criteria. The model was validated with an external cohort from January to September 2024. Postoperative pathological results serve as the gold standard for pCR. RESULTS 36 patients were included for model development, with 19 (52.8%) achieving pCR. ΔTLR% (percentage change between two scans in tumor-to-liver ratio) and SULpeak from scan-2 were significant predictors. The developed prediction model demonstrated outstanding performance with an area under the curve (AUC) of 0.975, 100% sensitivity, and 94.1% specificity. In comparison, RECIST 1.1 showed poor sensitivity (10.5%) but high specificity (100%), while PERCIST had moderate sensitivity (73.7%) and specificity (94.1%). Validation with 8 patients confirmed the model's accuracy. CONCLUSIONS This study suggests that 18F-FDG PET/CT, specifically the ΔTLR% and SULpeak from scan-2, is a reliable predictor of pCR in resectable NSCLC undergoing neoadjuvant immunochemotherapy. The quantitative prediction model outperforms both RECIST 1.1 and PERCIST. These findings highlight the potential clinical utility of this model, although further validation with larger cohorts is required to confirm its robustness and generalizability.
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Affiliation(s)
- Yueling Deng
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China
| | - Xiao Zhang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China
| | - Fan Hu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China.
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12
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Wang R, Chen Y, Shao X, Chen T, Zhong J, Ou Y, Chen J. Burden of Skin Cancer in Older Adults From 1990 to 2021 and Modelled Projection to 2050. JAMA Dermatol 2025:2834545. [PMID: 40397469 PMCID: PMC12096324 DOI: 10.1001/jamadermatol.2025.1276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Accepted: 03/27/2025] [Indexed: 05/22/2025]
Abstract
Importance Skin cancer is a significant public health threat in the aging population, yet data on its burden and trends are limited. Objective To evaluate the global burden of skin cancer among adults 65 years or older from 1990 to 2021, and to project its change to 2050. Design, Setting, and Participants In this observational study, population-based registry data were extracted from the Global Burden of Diseases (GBD) Study 2021. The database covers 204 countries and territories, ensuring global applicability of the results. Data analysis was conducted from June 9, 2024, to February 18, 2025. Main Outcomes and Measures Age-standardized rates of prevalence, incidence, deaths, and disability-adjusted life-years (DALYs) were calculated per 100 000 population. Estimated rates of disease burden were calculated for 2050. Results A worldwide total of 153 993 melanoma, 1 463 424 squamous cell carcinoma (SCC), and 2 802 354 basal cell carcinoma (BCC) instances were estimated for 2021. SCC exhibited the highest age-standardized rate of prevalence (236.91 per 100 000 population; 95% uncertainty interval [UI], 188.23-303.82), deaths (6.16 per 100 000 population; 95% UI, 5.13-6.87), and DALYs (95.50 per 100 000 population; 95% UI, 81.65-106.39), whereas BCC displayed the highest incidence rate (371.97 per 100 000 population; 95% UI, 310.75-439.58). The disease burden was notably greater in male individuals than in female individuals. During the observation period, the global burden of skin cancer among older people demonstrated a general upward trend. Decomposition analysis indicated that population growth was the primary contributor to this increase. Health-inequality analysis revealed a disproportionately higher burden shouldered by countries with higher sociodemographic index (SDI) levels. Frontier analysis identified the countries with considerable potential to mitigate skin cancer. It was anticipated that only incidence and prevalence rates attributable to keratinocyte cancer (KC), along with DALYs rate related to BCC, would increase by 2050. Conclusions and Relevance The older population (particularly male individuals and those living in high-SDI countries) is facing a substantial growing burden of skin cancer. Despite the relative incompleteness of KC data and lack of race and ethnicity data, these results highlight the urgency for more effective prevention and management strategies targeting high-risk groups.
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Affiliation(s)
- Ruiyao Wang
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yangmei Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyi Shao
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tingqiao Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Judan Zhong
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Ou
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin Chen
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Khan M, Papier K, Pirie KL, Key TJ, Atkins J, Travis RC. Sex differences in cancer incidence: prospective analyses in the UK Biobank. Br J Cancer 2025:10.1038/s41416-025-03028-y. [PMID: 40341249 DOI: 10.1038/s41416-025-03028-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 03/12/2025] [Accepted: 04/10/2025] [Indexed: 05/10/2025] Open
Abstract
BACKGROUND We examined differences in cancer incidence between women and men and the extent to which these persisted after accounting for established risk factors. METHODS Prospective analyses in the UK Biobank to examine associations between sex and risk of 15 cancers (and 13 subtypes) using minimal and multivariable-adjusted Cox proportional hazards regression models. Multivariable models were stratified for age, deprivation index, and region, and adjusted for ethnicity, qualifications, height, BMI, smoking status, alcohol, and site-specific risk factors. RESULTS During 10.5 (SD 2.2) years of follow-up, 32,315 incident cancers across 15 anatomical sites (58.1% in women) were identified in 470,771 individuals (53.8% women). Some differences in cancer risk between the sexes attenuated to the null in the multivariable-adjusted models, but men remained at greater risk than women for cancers at eight sites: oesophageal adenocarcinoma (hazard ratio 5.45; 95% confidence interval, 4.18-7.12), gastric cardia (3.65; 2.48-5.38), bladder (3.47; 2.85-4.24), oral cavity (2.06; 1.69-2.51), liver (1.91; 1.48-2.47), kidney (1.77; 1.51-2.09), rectum (1.70; 1.47-1.96), and leukaemia (1.43; 1.21-1.69). Men had lower risks for cancers of the breast, thyroid (0.36; 0.26-0.49), anus (0.41; 0.26-0.64), and lung adenocarcinoma (0.72; 0.62-0.84). CONCLUSION Further research on these sex differences in risk may provide insights into cancer aetiology.
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Affiliation(s)
- Maira Khan
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kirstin L Pirie
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tim J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Joshua Atkins
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Ungvari Z, Fekete M, Buda A, Lehoczki A, Fekete JT, Varga P, Ungvari A, Győrffy B. Depression increases cancer mortality by 23-83%: a meta-analysis of 65 studies across five major cancer types. GeroScience 2025:10.1007/s11357-025-01676-9. [PMID: 40314846 DOI: 10.1007/s11357-025-01676-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Accepted: 04/23/2025] [Indexed: 05/03/2025] Open
Abstract
Depression is a prevalent but often underrecognized comorbidity among cancer patients. Emerging evidence suggests that psychological distress may adversely impact cancer outcomes, but the magnitude of its effect on survival remains unclear. This meta-analysis evaluates the association between depression diagnosed after cancer diagnosis and cancer-specific and all-cause mortality across major cancer types. A systematic search of PubMed, Web of Science, Google Scholar, and the Cochrane Library was conducted to identify cohort studies examining the impact of depression on cancer mortality. Studies were included if they assessed clinically diagnosed depression or depressive symptoms using validated scales and reported hazard ratios (HRs) for mortality outcomes. A random-effects meta-analysis was performed to pool HR estimates, with heterogeneity assessed via Cochran's Q and I2 statistics. Funnel plots and Egger's test were used to evaluate publication bias. A total of 65 cohort studies were included. Depression was associated with significantly increased cancer-specific mortality in colorectal cancer (HR 1.83, 95% CI 1.47-2.28), breast cancer (HR 1.23, 95% CI 1.13-1.34), lung cancer (HR 1.59, 95% CI 1.36-1.86), and prostate cancer (HR 1.74, 95% CI 1.36-2.23). When considering mixed cancer types, depression was linked to a 38% increased risk of cancer mortality (HR 1.38, 95% CI 1.20-1.60). Significant heterogeneity was observed across studies (I2 range 56-98%), suggesting variations in study populations and methodologies. Sensitivity analyses confirmed the robustness of the findings, and trial sequential analysis indicated sufficient evidence for a conclusive association. Depression after cancer diagnosis is associated with a significantly increased risk of cancer-specific mortality across multiple cancer types. These findings highlight the urgent need for integrating routine mental health screening and interventions into oncology care. Future research should focus on mechanistic pathways and targeted interventions to mitigate the negative impact of depression on cancer survival.
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Affiliation(s)
- Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- IDoctoral College/Institute of Preventive Medicine and Public Health, International Training Program in Geroscience Semmelweis University, Budapest, Hungary
| | - Mónika Fekete
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
| | - Annamaria Buda
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
- Health Sciences Division, Doctoral College, Semmelweis University, Budapest, Hungary
| | - Andrea Lehoczki
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
- Health Sciences Division, Doctoral College, Semmelweis University, Budapest, Hungary
| | - János Tibor Fekete
- Dept. of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, 1117, Budapest, Hungary
| | - Péter Varga
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
- Health Sciences Division, Doctoral College, Semmelweis University, Budapest, Hungary
| | - Anna Ungvari
- Institute of Preventive Medicine and Public Health, Semmelweis University, Semmelweis University, Budapest, Hungary.
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary.
| | - Balázs Győrffy
- Dept. of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, 1117, Budapest, Hungary
- Dept. of Biophysics, Medical School, University of Pecs, 7624, Pecs, Hungary
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15
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Reichardt LM, Hindelang B, Süberkrüb L, Hamberger KL, Graw JA, Schuetze K, Zechendorf E, Mannes M, Halbgebauer R, Wohlgemuth L, Gebhard F, Huber-Lang M, Relja B, Bergmann CB. Absolute lymphocyte count trajectory predicts clinical outcome in severely injured patients. Eur J Trauma Emerg Surg 2025; 51:190. [PMID: 40314767 PMCID: PMC12048453 DOI: 10.1007/s00068-025-02864-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Accepted: 04/12/2025] [Indexed: 05/03/2025]
Abstract
PURPOSE Lymphopenia is associated with adverse clinical outcome in trauma, but no immunomonitoring method is established to identify patients at risk. Absolute lymphocyte count (ALC) represents a promising biomarker and may support clinical decision-making in the intensive care unit (ICU). This study examined the temporal patterns of ALC in severely injured patients and their correlation with clinical outcomes. METHODS 38 severely injured patients with an Injury Severity Score (ISS) of 18 and greater were enrolled. Blood samples were collected on admission and after 8, 24 and 48 h and 5 and 10 days. 38 healthy volunteers served as controls. Patients were classified into four groups after 48 h based on their dynamic ALC: persistent lymphopenia (PL), rapidly decreasing (RD), slowly rising (SR) and normal fluctuation (NF). The groups were compared regarding physical performative outcome - defined as unfavorable when patients died or new functional disability necessitated long term care, in-hospital mortality, ICU length of stay (LOS), and incidence of multi-organ dysfunction syndrome (MODS). RESULTS A significant reduction in ALC was observed in all patients over 10 days when compared to healthy volunteers, with all patients trending towards a recovery of their ALC after 10 days. PL and RD were associated with an unfavorable physical performative outcome, increased in-hospital mortality, ICU LOS and incidence of MODS. CONCLUSION The dynamic course of ALC represents a cheap and clinically implementable approach for immunomonitoring within 48 h in severely injured patients. The ALC dynamic may early identify severely injured patients at risk, thus facilitating more informed clinical decision-making.
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Affiliation(s)
- Lena-Marie Reichardt
- Translational and Experimental Trauma Research, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Bianca Hindelang
- Translational and Experimental Trauma Research, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Lönna Süberkrüb
- Translational and Experimental Trauma Research, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Kim Lena Hamberger
- Translational and Experimental Trauma Research, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Jan A Graw
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Ulm, Ulm, Germany
| | - Konrad Schuetze
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Elisabeth Zechendorf
- Department of Intensive Care and Intermediate Care, University Hospital of the Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Marco Mannes
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Rebecca Halbgebauer
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Lisa Wohlgemuth
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Florian Gebhard
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany
| | - Borna Relja
- Translational and Experimental Trauma Research, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Christian B Bergmann
- Translational and Experimental Trauma Research, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany.
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany.
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16
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Zhang B, Tang M, Li X. A narrative review of sleep and breast cancer: from epidemiology to mechanisms. Cancer Causes Control 2025; 36:457-472. [PMID: 39731679 DOI: 10.1007/s10552-024-01951-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 12/17/2024] [Indexed: 12/30/2024]
Abstract
Breast cancer is the leading cause of cancer-related death and the most common cancer among women worldwide. It is crucial to identify potentially modifiable risk factors to intervene and prevent breast cancer effectively. Sleep factors have emerged as a potentially novel risk factor for female breast cancer. Current epidemiologic studies suggest a significant impact of sleep factors on breast cancer. Exposure to abnormal sleep duration, poor sleep quality, sleep disorders, sleep medication use, or night shift work can increase the risk of breast cancer by decreasing melatonin secretion, disrupting circadian rhythm, compromising immune function, or altering hormone levels. However, there are still controversies regarding the epidemiologic association, and the underlying mechanisms have yet to be fully elucidated. This paper summarizes the epidemiologic evidence on the associations between sleep factors, including sleep duration, sleep quality, sleep disorders, sleep medication use, sleep habits, and night shift work, and the development of breast cancer. The potential mechanisms underlying these associations were also reviewed.
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Affiliation(s)
- Bao Zhang
- Department of Clinical Nutrition, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Mengsha Tang
- School of Humanity and Management, Wannan Medical College, Wuhu, 241002, Anhui, China
| | - Xiude Li
- Department of Clinical Nutrition, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China.
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Thereaux J, Badic B, Fuchs B, Leven C, Caillard A, Lacut K, Metges JP, Couturaud F. Comprehensive assessment of 1-year postoperative venous thromboembolism and associated mortality risks in hepatopancreatobiliary cancer surgeries: A national survey. Surgery 2025; 181:109171. [PMID: 39952022 DOI: 10.1016/j.surg.2025.109171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 12/13/2024] [Accepted: 01/08/2025] [Indexed: 02/17/2025]
Abstract
BACKGROUND Venous thromboembolism is a well-recognized complication after hepatopancreatobiliary surgery. However, there is a paucity of nationwide data on risk factors and incidence within 1 year of surgery in patients undergoing hepatopancreatobiliary surgery. METHODS This nationwide observational population-based cohort study used data extracted from all patients undergoing surgery for cancer surgery of the liver and the pancreas in France between 1 January 2015 and 31 December 2017. Estimation of 1 postoperative year cumulative incidence of venous thromboembolism and Cox proportional hazards model on 1-year global mortality were performed. RESULTS During the study period, 16,960 patients underwent cancer surgery of the liver (n = 9,381) or pancreas (n = 7,579). The 90-day postoperative rate of venous thromboembolism was 6.1% (cancer surgery of the liver) and 6.7% (cancer surgery of the pancreas). Main risk factors of 90-day postoperative rate of venous thromboembolism were major hepatectomy (1.85; 1.55-2.21), left pancreatectomy (1.45; 1.18-1.79), presence of obesity (1.41; 1.16-1.71), history of venous thromboembolism (4.58; 3.41-6.14), open approach (1.31; 1.06-1.62), and the occurrence of serious surgical complication (1.55; 1.35-1.79). At 1 year, patients undergoing cancer surgery of the liver were at a lower risk of cumulative incidence (%) of venous thromboembolism compared with the cancer surgery of the pancreas group (P < .001) (7.0; 6.5-7.6 vs 9.8; 9.1-10.4). Patients with venous thromboembolism within 1 year had greater risks of 1-year global mortality for each hepatopancreatobiliary surgery group: 3.58 (95% confidence interval, 3.02-4.23) and 3.97 (95% confidence interval, 3.40-4.63), respectively. CONCLUSION Postoperative venous thromboembolism is a significant issue after hepatopancreatobiliary surgery, within 90 days postoperatively and up to 1 year, with the cancer surgery of the pancreas group being particularly at risk. A greater risk of global mortality within 1 year for patients experiencing early or late venous thromboembolism was found.
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Affiliation(s)
- Jérémie Thereaux
- University Brest, CHU Brest, Brest, France; Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France.
| | - Bogdan Badic
- Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France; Univ Brest, CHU Brest, UMR 1304, Western Brittany Thrombosis Group, Brest, France
| | - Basil Fuchs
- Department of Medical Information, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France
| | - Cyril Leven
- University Brest, CHU Brest, Brest, France; Department of Biochemistry and Pharmaco-Toxicology, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France
| | - Anais Caillard
- Department of Anesthesia and Intensive Care, La Cavale Blanche and Morvan University Hospitals, Boulevard Tanguy Prigent, Brest, France
| | - Karin Lacut
- University Brest, CHU Brest, Brest, France; Department of Internal Medicine, Vascular Medicine and Pneumology, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France
| | | | - Francis Couturaud
- University Brest, CHU Brest, Brest, France; Department of Internal Medicine, Vascular Medicine and Pneumology, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France
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Hou X, Wei Z, Qi X, Liu D, Sun Y, Jiang Y, Liu C, Zhou W, Yang L, Liu K. Biomimetic modification of macrophage membrane-coated prussian blue nanoparticles loaded with SN-38 to treat colorectal cancer by photothermal-chemotherapy. Drug Deliv Transl Res 2025; 15:1525-1539. [PMID: 39251553 DOI: 10.1007/s13346-024-01689-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2024] [Indexed: 09/11/2024]
Abstract
SN-38 is the active metabolite of irinotecan and acts as an effective topoisomerase I inhibitor with therapeutic effects on many malignant tumors, including some drug-resistant cancers. However, the poor solubility, low bioavailability, and severe dose-dependent toxicity limits the clinical application of SN-38. Currently, emerging macrophage membrane-coated nanoparticles provide an efficient biomimetic approach to develop novel SN-38 formulations for the reduction of its side effects. Photothermal therapy (PTT) is a promising methods in tumor treatment to thermally ablate tumors using various materials such Prussian blue nanoparticles (NPs) and can combined with chemotherapy to synergistically work. There is no report that combined SN38 and photothermal therapy for the treatment of colorectal cancer (CRC). SN38-PB@CM NPs were constructed by loading SN-38 into macrophage cell membrane-coated hollow mesoporous Prussian blue (PB) NPs. The morphology, size and zeta potential were evaluated by transmission microscopy and dynamic light scatter (DLS). Coomassie bright blue staining was performed to assess total protein profile. The photothermal properties of it were also investigated via near-infrared imaging. CCK8 and calcein-AM/PI staining were used to evaluate cell viability. Flow cytometry was performed to assess cell apoptosis. The fluorescent microscopy was used to observe cellular uptake of SN38-PB@CM NPs to assess its internalization in vitro. The biodistribution, tumor-targeting efficacy, antitumor efficacy and safety of SN38-PB@CM NPs in vivo were assessed in CT26 tumor-bearing mice via In Vivo Imaging System. SN38-PB@CM NPs were successfully constructed and exhibited a uniform size distribution (140.5 ± 4.3 nm) and an excellent drug-loading capacity (5.61 ± 0.64%). SN38-PB@CM NPs showed stable release properties within 72 h. It can also enhance the selective intracellular delivery of SN38 in vitro and showed good near-infrared (NIR) photothermal properties. And the NPs showed excellent tumor targeting, effective photothermal therapy, improved biosafety and antitumor efficacy on CT26-bearing mice. Multifunctional SN38-PB@CM NPs could achieve improved biosafety, great tumor-targeting, high-efficiency PTT and excellent antitumor efficacy, which provided a promising and attractive combination therapy for the treatment of CRC.
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Affiliation(s)
- Xuyang Hou
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Zuxing Wei
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xiaoyan Qi
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Dekun Liu
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yin Sun
- Department of of Pharmaceutical Pharmacology, University of South China, Hengyang, Hunan, China
| | - Yuhong Jiang
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Chao Liu
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Weihan Zhou
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Leping Yang
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Kuijie Liu
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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19
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Rafati I, Destrempes F, Yazdani L, Barat M, Karam E, Fohlen A, Nguyen BN, Castel H, Tang A, Cloutier G. Enhancing Liver Nodule Visibility and Diagnostic Classification Using Ultrasound Local Attenuation Coefficient Slope Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2025; 51:807-814. [PMID: 39890529 DOI: 10.1016/j.ultrasmedbio.2025.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 01/03/2025] [Accepted: 01/12/2025] [Indexed: 02/03/2025]
Abstract
OBJECTIVE B-mode ultrasound (US) presents challenges in accurately detecting and distinguishing between benign and malignant liver nodules. This study utilized quantitative US local attenuation coefficient slope (LACS) imaging to address these limitations. MATERIALS AND METHODS This is a prospective, cross-sectional study in adult patients with definable solid liver nodules at US conducted from March 2021 to December 2023. The composite reference standard included histopathology when available or magnetic resonance imaging. LACS images were obtained using a phantom-free method. Nodule visibility was assessed by computing the contrast-to-noise ratio (CNR). Classification accuracy for differentiating benign and malignant lesions was assessed with the area under the receiver operating characteristic curve (AUC), along with sensitivity and specificity. RESULTS The study enrolled 97 patients (age: 62 y ± 13 [standard deviation]), with 57.0% malignant and 43.0% benign observations (size: 26.3 ± 18.9 mm). LACS images demonstrated higher CNR (12.3 dB) compared to B-mode (p < 0.0001). The AUC for differentiating nodules and liver parenchyma was 0.85 (95% confidence interval [CI]: 0.79-0.90), with higher values for malignant (0.93, CI: 0.88-0.97) than benign nodules (0.76, CI: 0.66-0.87). A LACS threshold of 0.94 dB/cm/MHz provided a sensitivity of 0.83 (CI: 0.74-0.89) and a specificity of 0.82 (CI: 0.73-0.88). LACS mean values were higher (p < 0.0001) in malignant (1.28 ± 0.27 dB/cm/MHz) than benign nodules (0.98 ± 0.19 dB/cm/MHz). CONCLUSION LACS imaging improves nodule visibility and provides better differentiation between benign and malignant liver nodules, showing promise as a diagnostic tool.
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Affiliation(s)
- Iman Rafati
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada; Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada
| | - Ladan Yazdani
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada; Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada
| | - Maxime Barat
- Department of Radiology, University of Montreal Hospital, Montréal, Québec, Canada
| | - Elige Karam
- Department of Radiology, University of Montreal Hospital, Montréal, Québec, Canada
| | - Audrey Fohlen
- Department of Radiology, University of Montreal Hospital, Montréal, Québec, Canada
| | - Bich N Nguyen
- Department of Pathology, University of Montreal Hospital, Montréal, Québec, Canada
| | - Hélène Castel
- Departments of Hepatology and Liver Transplantation, University of Montreal Hospital, Montréal, Québec, Canada
| | - An Tang
- Department of Radiology, University of Montreal Hospital, Montréal, Québec, Canada; Department of Radiology, Radiation Oncology and Nuclear Medicine, University of Montreal, Montréal, Québec, Canada; Laboratory of Clinical Image Processing, University of Montreal Hospital Research Center, Montréal, Québec, Canada.
| | - Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montréal, Québec, Canada; Institute of Biomedical Engineering, University of Montreal, Montréal, Québec, Canada; Department of Radiology, Radiation Oncology and Nuclear Medicine, University of Montreal, Montréal, Québec, Canada.
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20
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Cork MJ, Deleuran M, Geng B, Silverberg JI, Simpson EL, Stein Gold LF, Irvine AD, Romero W, Valdez H, Fan H, Alderfer J. Long-Term Safety of Abrocitinib in Moderate-to-Severe Atopic Dermatitis: Integrated Analysis by Age. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2025; 13:1164-1175.e2. [PMID: 40081761 DOI: 10.1016/j.jaip.2025.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 02/20/2025] [Accepted: 02/28/2025] [Indexed: 03/16/2025]
Abstract
BACKGROUND Abrocitinib has a manageable long-term safety profile for patients with moderate-to-severe atopic dermatitis. Identifying populations at higher risk of adverse events will help optimize dose selection. OBJECTIVE To evaluate abrocitinib long-term safety by age. METHODS Data (cutoff: September 25, 2021) from JADE clinical trials were pooled in a consistent-dose cohort (patients who received the same abrocitinib dose throughout exposure) or a variable-dose cohort (patients who received abrocitinib 200 mg [12 wk], were randomly assigned later to receive abrocitinib 200 mg, 100 mg, or placebo [up to 40 wk], and assigned to receive abrocitinib 200 mg or 100 mg in the long-term study). Data were stratified post hoc by age at baseline (12 to < 18 y; 18 to < 40 y, 40 to < 65 y, and ≥65 y). Incidence rates of treatment-emergent adverse events (TEAEs) of special interest were assessed. RESULTS Analysis included 3,802 patients (exposure: 5,214 patient-years). The incidence rates for serious adverse events, TEAEs leading to study discontinuation, serious infections, herpes zoster, thrombocytopenia, lymphopenia, nonmelanoma skin cancer, malignancies (excluding nonmelanoma skin cancer), major cardiovascular events, and venous thromboembolism were numerically higher in patients aged 65 years or older than in younger patients. Overall, adolescents had the lowest rates for TEAEs of special interest. CONCLUSIONS Abrocitinib has a manageable long-term safety profile. TEAEs of special interest were lower in adolescents and higher in the 65-years-old or older age group. Risk of specific TEAEs was numerically higher in patients aged 65 years or older treated with abrocitinib 200 mg and underscores the importance of dose selection in older patients.
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Affiliation(s)
- Michael J Cork
- Sheffield Dermatology Research, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield and Sheffield Children's Hospital, Sheffield, UK
| | - Mette Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Bob Geng
- Department of Allergy and Immunology, UC San Diego School of Medicine, San Diego, calif
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Eric L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, ore
| | | | - Alan D Irvine
- Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
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21
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Bussu F, Daloiso A, Pagliuca G, Settimi S, Scanu A, Margani V, Mele DA, Di Stefano V, Bonomo M, Cazzador D, Parrilla C, Rizzo D, Zanoletti E, Nicolai P, Gallo A, Galli J. Margins in head and neck non-melanoma skin cancer surgery: clinical/pathological criteria and their impact on oncological outcomes and therapeutic choices. A systematic review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2025; 45:S121-S136. [PMID: 40400382 DOI: 10.14639/0392-100x-suppl.1-45-2025-n1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2025] [Accepted: 03/18/2025] [Indexed: 05/23/2025]
Abstract
Introduction Non-melanoma skin cancers (NMSCs), including basal (BCC) and squamous cell carcinoma (SCC), are the most prevalent malignancies affecting the skin, with the head and neck region being the most common site of involvement. Surgical excision remains the primary treatment modality. The role of surgical margins in the treatment of skin SCC and BCC of the head and neck remains a subject of ongoing debate. Clear definitions and guidelines regarding adequate surgical margins, as well as their impact on recurrence rates and overall outcomes, are critical for improving clinical management. This systematic review aims to evaluate the current literature on the definitions of surgical margins for SCC and BCC of the head and neck, as well as their impact on local recurrence, disease free survival, and other patient-centred outcomes. Materials and methods We conducted a systematic review following the PRISMA guidelines. A comprehensive search was performed across multiple databases, including PubMed and Scopus, for studies published up to December 2024. Eligible studies included those that reported on surgical margin definitions, surgical outcomes, and recurrence rates for SCC and BCC of the skin in the head and neck region. Data were extracted and analysed for margin size and oncological outcomes. Results Following the application of inclusion and exclusion criteria, 30 studies have been retrieved for qualitative synthesis. Of these, 12 studies focused on SCC only, 14 on BCC only, and 4 on mixed histologies. Margin involvement rates ranged widely across the studies included (5-56%) as did thelocal recurrence rate (0-20%). This is associated with a variability of the surgical margin both for SCC and BCC, and of the definition of margin as close/negative at final pathology. Most studies do not define a threshold for close vs. negative margins at final pathology. All studies but one reported a significant correlation between positive margins and oncological outcomes, with particular regards to local recurrence. Conclusions The findings highlight a lack of consensus on the optimal surgical margins for SCC and BCC of the head and neck, suggesting that margins may need to be individualised based on tumour characteristics, location, and patient factors. In particular, the anatomical complexity of the head and neck region suggests to separately address different high-risk areas as nose/midface, periauricular, and periocular with specific recommendations also concerning clinical margins.
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Affiliation(s)
- Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliera Universitaria di Sassari; Department of Medicine Surgery and Pharmacy, Sassari University, Sassari, Italy
| | - Antonio Daloiso
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua; Padua, Italy
| | - Giulio Pagliuca
- Otolaryngology University Unit, "S.M. Goretti", Latina, Italy
| | - Stefano Settimi
- Unit of Otorhinolaryngology, "A. Gemelli" University Hospital Foundation IRCCS; Head, Neck and Sensory Organs Department, Catholic University of Sacred Heart, Rome, Italy
| | - Alessandro Scanu
- Otolaryngology Division, Azienda Ospedaliera Universitaria di Sassari; Department of Medicine Surgery and Pharmacy, Sassari University, Sassari, Italy
| | - Valerio Margani
- Otolaryngology University Unit, "S.M. Goretti", Latina, Italy
| | - Dario Antonio Mele
- Unit of Otorhinolaryngology, "A. Gemelli" University Hospital Foundation IRCCS; Head, Neck and Sensory Organs Department, Catholic University of Sacred Heart, Rome, Italy
| | | | - Marta Bonomo
- Otolaryngology Division, Azienda Ospedaliera Universitaria di Sassari; Department of Medicine Surgery and Pharmacy, Sassari University, Sassari, Italy
| | - Diego Cazzador
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua; Padua, Italy
| | - Claudio Parrilla
- Unit of Otorhinolaryngology, "A. Gemelli" University Hospital Foundation IRCCS; Head, Neck and Sensory Organs Department, Catholic University of Sacred Heart, Rome, Italy
| | - Davide Rizzo
- Otolaryngology Division, Azienda Ospedaliera Universitaria di Sassari; Department of Medicine Surgery and Pharmacy, Sassari University, Sassari, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua; Padua, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua; Padua, Italy
| | - Andrea Gallo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Jacopo Galli
- Unit of Otorhinolaryngology, "A. Gemelli" University Hospital Foundation IRCCS; Head, Neck and Sensory Organs Department, Catholic University of Sacred Heart, Rome, Italy
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22
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Gibbs WN. The Spinal Bone Marrow in Health and Disease. Magn Reson Imaging Clin N Am 2025; 33:351-369. [PMID: 40287251 DOI: 10.1016/j.mric.2025.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2025]
Abstract
Radiologists play a key role in identifying, characterizing, sampling, and, in some cases, treating abnormalities of the spinal bone marrow. This article discusses the composition and dynamic nature of the bone marrow, and how these changes directly correlate with the imaging appearance. Examples of entities that are diffuse, infiltrative, solitary, and multifocal are shown and diagnostic dilemmas and mimics are described The radiologist must be aware of the expected appearance and variability of the bone marrow in order to provide timely, accurate diagnoses.
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Affiliation(s)
- Wende N Gibbs
- Department of Neuroradiology, Barrow Neurological Institute, Phoenix, AZ, USA.
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23
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Wan X, Wang D. Curcumin: Epigenetic Modulation and Tumor Immunity in Antitumor Therapy. PLANTA MEDICA 2025; 91:320-337. [PMID: 39689889 DOI: 10.1055/a-2499-1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2024]
Abstract
Curcumin (turmeric) is the main ingredient of the Chinese herbal turmeric rhizome, used to treat tumors, diabetes, inflammation, neurodegenerative diseases, cardiovascular diseases, metabolic syndrome, and liver diseases. The antitumor effects of curcumin have received even more attention. One of the main mechanisms of the antitumor effects includes inhibition of tumor invasion and migration, induction of tumor cell apoptosis, and inhibition of various cell signaling pathways. It has been found that the antitumor biological activity of curcumin in the body is associated with epigenetic mechanisms. That also implies that curcumin may act as a potential epigenetic modulator to influence the development of tumor diseases. The immune system plays an essential role in the development of tumorigenesis. Tumor immunotherapy is currently one of the most promising research directions in the field of tumor therapy. Curcumin has been found to have significant regulatory effects on tumor immunity and is expected to be a novel adjuvant for tumor immunity. This paper summarizes the antitumor effects of curcumin from four aspects: molecular and epigenetic mechanisms of curcumin against a tumor, mechanisms of curcumin modulation of tumor immunotherapy, reversal of chemotherapy resistance, and a novel drug delivery system of curcumin, which provide new directions for the development of new antitumor drugs.
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Affiliation(s)
- Xin Wan
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Dong Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
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24
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Turongkaravee S, Nathisuwan S, Baisamut T, Meanwatthana J. Cost-Utility Analysis of Genomic Profiling in Directing Targeted Therapy in Advanced NSCLC in Thailand. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2025; 23:479-491. [PMID: 39918787 PMCID: PMC12052874 DOI: 10.1007/s40258-025-00950-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2025] [Indexed: 05/06/2025]
Abstract
BACKGROUND Sequential next-generation sequencing (NGS) testing has demonstrated cost-effectiveness in guiding targeted therapy with tyrosine kinase inhibitors (TKIs) for advanced non-small cell lung cancer (aNSCLC) in developed countries. However, its cost-effectiveness in developing countries remains uncertain. OBJECTIVE The aim was to conduct a cost-utility analysis comparing sequential NGS testing with the current approach of single epidermal growth factor receptor (EGFR) testing combined with first-line targeted therapy, as implemented under Thailand's Universal Health Coverage scheme for aNSCLC. METHOD Hybrid decision tree and Markov models were developed to estimate the lifetime costs and quality-adjusted life years (QALYs) associated with each strategy. The models simulate cohorts of aNSCLC patients who receive platinum-based chemotherapy or TKIs based on identified gene alterations. Patients enter the model at 60 years of age. The incremental cost-effectiveness ratio (ICER) was computed from a societal perspective. The analysis employed a lifetime horizon and discounted costs and outcomes at a rate of 3%. Furthermore, uncertainty and scenario analyses were conducted. FINDINGS A sequential NGS testing strategy could identify an additional 19% of patients with biomarker-positive findings who subsequently received biomarker-driven targeted therapy compared to a single EGFR testing strategy. The number needed to screen to identify a single gene mutation and administer first-line TKI was six for the sequential NGS testing strategy. Compared to the single EGFR testing, the ICER of the sequential NGS testing strategy was 1,851,150 THB/QALY (US$51,335). At a willingness-to-pay threshold of 160,000 THB/QALY (US$4437), the single EGFR testing strategy demonstrated 100% cost-effectiveness. In contrast, the sequential NGS testing was not deemed cost-effective. The sensitivity of the ICER was influenced by the overall survival rates associated with anaplastic lymphoma kinase (ALK) inhibitors and platinum-based chemotherapy. INTERPRETATION Sequential NGS testing identified a greater number of patients with aNSCLC eligible for targeted therapies, resulting in improved survival rates and enhanced QALYs compared to single EGFR testing. However, in the context of Thailand, sequential NGS testing was not cost-effective. The single EGFR testing strategy emerged as the most cost-effective option for guiding first-line targeted therapy.
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Affiliation(s)
- Saowalak Turongkaravee
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Surakit Nathisuwan
- Division of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayuthaya Rd, Phayathai, Ratchathewi, Bangkok, 10400, Thailand
| | - Thanyanan Baisamut
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jennis Meanwatthana
- Division of Clinical Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayuthaya Rd, Phayathai, Ratchathewi, Bangkok, 10400, Thailand.
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25
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Karir A, Shah PL, Orton CM. An insight into interventional bronchoscopy. Clin Med (Lond) 2025; 25:100321. [PMID: 40334941 DOI: 10.1016/j.clinme.2025.100321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Revised: 04/16/2025] [Accepted: 04/26/2025] [Indexed: 05/09/2025]
Abstract
The emergent field of interventional bronchoscopy provides an alternative approach for the diagnosis and management of a range of respiratory conditions. Within malignant disease, robotic navigational bronchoscopy provides a stable platform to sample small and difficult to reach pulmonary nodules, while malignant central airway obstruction can be managed through transcopic stent insertion. A range of therapeutic modalities have been developed for benign disease, which provide alternatives to standard therapy, particularly in the context of endobronchial valves for chronic obstructive pulmonary disease, and bronchial thermoplasty for asthma, while transbronchial cryoexcision lung biopsy offers a non-surgical option for undiagnosed interstitial lung disease. With a rich pipeline of technology being developed through robust clinical trial processes, the field of interventional bronchoscopy will continue to grow to become an invaluable asset, not only to the field of respiratory medicine, but to the general physician.
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Affiliation(s)
- Ashish Karir
- National Heart and Lung Institute, Dovehouse Street, Imperial College London, London SW3 6LY, UK; Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
| | - Pallav L Shah
- National Heart and Lung Institute, Dovehouse Street, Imperial College London, London SW3 6LY, UK; Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
| | - Christopher M Orton
- National Heart and Lung Institute, Dovehouse Street, Imperial College London, London SW3 6LY, UK; Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
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26
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Abdollahimajd F, Abbasi F, Motamedi A, Koohi N, Robati RM, Gorji M. Using the power of artificial intelligence to improve the diagnosis and management of nonmelanoma skin cancer. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2025; 30:25. [PMID: 40391342 PMCID: PMC12087911 DOI: 10.4103/jrms.jrms_607_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 01/04/2025] [Accepted: 02/19/2025] [Indexed: 05/21/2025]
Abstract
Nonmelanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma, is the most prevalent type of skin cancer. While generally less aggressive than melanoma, early detection and treatment are crucial to prevent the complications. Artificial intelligence (AI) systems show promise in enhancing the accuracy, efficiency, and accessibility of NMSC diagnosis and management. These systems can facilitate early interventions, reduce unnecessary procedures, and promote collaboration among healthcare providers. Despite AI algorithms demonstrating moderate-to-high performance in diagnosing NMSC, several challenges remain. Ensuring the robustness, explainability, and generalizability of these models is vital. Collaborative efforts focusing on data diversity, image quality standards, and ethical considerations are necessary to address these issues. Building patient trust is also essential for the successful implementation of AI in the clinical settings. AI algorithms may outperform experts in controlled environments but can fall short in the real-world clinical applications, indicating a need for more prospective studies to evaluate their effectiveness in the practical scenarios. Continued research and development are essential to fully realize AI's potential in improving NMSC diagnosis and management by overcoming the existing challenges and conducting comprehensive studies.
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Affiliation(s)
| | - Fatemeh Abbasi
- Department of Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Alireza Motamedi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Narges Koohi
- Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Mohamoud Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mona Gorji
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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27
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Yu W, Long L, Hou Q, Yi B. Development of a nomogram for overall survival prediction in primary upper lobe lung cancer patients: A SEER population-based analysis. PLoS One 2025; 20:e0321955. [PMID: 40299864 PMCID: PMC12040116 DOI: 10.1371/journal.pone.0321955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Accepted: 03/12/2025] [Indexed: 05/01/2025] Open
Abstract
BACKGROUND The upper lobe is the most common site of primary lung cancer, however, very few reports focus on its prognosis. This study aims to identify prognostic factors of lung cancer in the upper lobe, as well as to establish an effective nomogram for individualized overall survival (OS) prediction. METHODS Patients diagnosed with lung cancer were collected from the Surveillance, Epidemiology, and End Results Program (SEER) database for the period of 2010-2017,as recorder in the 2021 SEER database release. The demographic characteristics and OS differed in the primary sites of the upper, middle and lower lobes were drawn. The primary upper lobe lung cancer patients were further stratified by the risk indicators including Mets at DX-bone, stage, histology, grade and sex; and their OS differences in stratification were compared by the Kaplan-Meier method and the Log-Rank test. The univariate and the multivariate Cox regression were employed to determine the independent prognostic factors for the primary upper lobe lung cancer and to build a nomogram model for its OS prediction. RESULTS Depending on the different primary sites of lung cancer occurrence, all the collected patients were divided into three groups of the upper lobe (30295 individuals), the middle lobe (2801 individuals) and the lower lobe (16757 individuals), where the upper lobe group gained our attention with the largest population and an overwhelmingly low OS compared to the middle lobe group (P <0.0001). With the results of the univariate and multivariate Cox regression model analyses, age, sex, grade, histology type, stage, regional lymph nodes removed, bone metastasis and liver metastasis were selected as the prognostic factors and a prediction nomogram model was built. The calibration curves showed no significant bias from the reference line and the concordance index between the survival nomogram prediction and the actual outcome for 2-year and 3-year OS was 0.761 (95% CI, 0.757-0.765). The time-dependent receiver operating characteristic curves showed that the areas under curve for 2-year and 3-year OS were 0.840 and 0.836, respectively. CONCLUSION A novel nomogram was established which achieved good performance in predicting the probability of OS in the primary upper lobe lung cancer, indicating its potential value in individualized prediction of the clinical outcome in these patients.
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Affiliation(s)
- Wenze Yu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lu Long
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qizhuo Hou
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bin Yi
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Antonen EM, Nadler MB, Langelier DM, Campbell KL, Flamer D, Cho JH, Capozza S, Avery L, Bland KA, Leatherdale S, Manthorne J, Jones JM. A remotely delivered exercise-based rehabilitation program for patients with persistent chemotherapy-induced peripheral neuropathy (EX-CIPN): Protocol for a phase I feasibility trial. PLoS One 2025; 20:e0322371. [PMID: 40299845 PMCID: PMC12040081 DOI: 10.1371/journal.pone.0322371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Accepted: 03/18/2025] [Indexed: 05/01/2025] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neurotoxicity (CIPN) is a prevalent adverse effect of chemotherapy agents that is estimated to be present in 2/3 of patients who receive neurotoxic chemotherapy. In 30-40% of these patients, CIPN signs and symptoms can persist for months or years post-treatment. Recent studies have supported exercise as a feasible and possibly effective intervention for CIPN; however, more rigorous studies are needed to confirm feasibility, estimate efficacy, and clarify risk. In response, we developed an innovative virtual exercise-based rehabilitation program (EX-CIPN) for cancer survivors with persistent CIPN. METHODS This study is a phase I study conducted at the Princess Margaret Cancer Centre in cancer survivors with persistent CIPN, with a focus on feasibility, acceptability, and safety. A total of 40 patients aged 18 or older, with persistent CIPN at least 6 months after chemotherapy completion will be recruited and receive the EX-CIPN program. The EX-CIPN program is a 10-week virtual home-based intervention that includes an individualized exercise program supported with a mobile application (Physitrack), wearable technology (FitBit), and weekly virtual check-ins with an oncology exercise specialist. The primary outcome of feasibility will be assessed by examining accrual, retention, and adherence rates. Acceptability will be assessed through qualitative interviews. Safety events will be monitored and reported based on CTCAE v5. Secondary outcomes will be collected using questionnaires and physiological assessments at baseline (T1), after the intervention (T2), and 3-months after intervention (T3). CONCLUSION This phase I study will determine intervention feasibility, acceptability, and safety and will inform the planning for a future Phase II RCT with the EX-CIPN intervention.
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Affiliation(s)
- Eric M. Antonen
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Michelle B. Nadler
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - David M. Langelier
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kristin L. Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Flamer
- Anesthesiology & Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jang Hyuk Cho
- Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Dongsan, Republic of Korea
| | - Scott Capozza
- Rehabilitation Department, Yale New Haven Hospital, New Haven, Connecticut, United States of America
| | - Lisa Avery
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Kelcey A. Bland
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Jennifer M. Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
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Hincapié-Carvajal JA, Cedeño-Camaño Z, Igualá-González N, Martínez-Salazar AL, Martínez-Sandoya A, Arias-Murcia SE. The cultural competence of health professionals in the care of cancer patients: a scoping review. Rev Gaucha Enferm 2025; 46:e20240253. [PMID: 40298767 DOI: 10.1590/1983-1447.2025.20240253.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 11/22/2024] [Indexed: 04/30/2025] Open
Abstract
OBJECTIVE To explore the available evidence on the cultural competence of health professionals in the care of cancer patients. METHODS Scoping review carried out between April and May 2024. The databases Scopus, Medline (via Pubmed) and BVS (Lilacs) were used as sources. The sample included articles from the last ten years, resulting from primary research, literature reviews and systematic reviews in English, Portuguese and Spanish. Data were manually extracted and analyzed using an inductive thematic construction process. RESULTS 31 studies were included, mostly quantitative research produced in North America. Four themes emerged from the synthesis: 1) Barriers to culturally competent care in oncology settings; 2) Strategies for implementing cultural practices; 3) Intervention measures to improve the cultural competence of oncology care providers; and 4) Outcomes of cultural competence on patient satisfaction and professional development. CONCLUSION Evidence reveals that cultural barriers limit effective cancer care. However, strategies and interventions to improve cultural competence increase patient satisfaction and benefit providers' professional development in oncology care.
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Affiliation(s)
| | - Zelibeth Cedeño-Camaño
- Universidad Especializada de las Américas (UDELAS). Facultad de Ciencias Médicas y Clínicas. Ciudad de Panamá, Panamá
| | - Nataly Igualá-González
- Universidad Especializada de las Américas (UDELAS). Facultad de Ciencias Médicas y Clínicas. Ciudad de Panamá, Panamá
| | | | - Arian Martínez-Sandoya
- Universidad Especializada de las Américas (UDELAS). Facultad de Ciencias Médicas y Clínicas. Ciudad de Panamá, Panamá
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Andersson E, Axelsson U, Rönnow CF, Thorlacius H, Persson L, Fridhammar A. The Potential Health Economic Value of Adding Magnetomotive Ultrasound to Current Diagnostic Methods for Detecting Lymph Node Metastases in Rectal Cancer. PHARMACOECONOMICS 2025:10.1007/s40273-025-01490-3. [PMID: 40257727 DOI: 10.1007/s40273-025-01490-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2025] [Indexed: 04/22/2025]
Abstract
BACKGROUND Local resection of early rectal cancer (RC) is a desirable treatment option compared with surgery, offering reduced morbidity, mortality, health care costs and avoidance of stoma. However, local resection is restricted to cases without suspicion of lymph node metastases (LNM). Current methods to diagnose LNM and risk estimations based on histopathology cannot reliably identify patients eligible for local resection. The NanoEcho diagnostic system is based on a novel method for lymph node staging in RC. The aim of this study was to perform a health economic analysis at an early stage of clinical development to estimate the potential value of adding NanoEcho diagnostics to current diagnostic methods in RC. METHODS A Markov model for RC diagnosis was developed where the costs and health outcomes, including quality-adjusted life years (QALYs), for adding the NanoEcho diagnostics to current diagnostic methods were compared with current diagnostic methods alone. The diagnostic performance of the NanoEcho diagnostic system is still unknown and the base-case analysis was performed at an assumed 85% sensitivity and 85% specificity. Two testing strategies corresponding to two alternative ways of implementing the diagnostic test in clinic were evaluated: (1) examine all patients diagnosed with RC and (2) examine only patients diagnosed with clinical stages T1 and T2. RESULTS Adding the NanoEcho diagnostic system resulted in a gain of 0.032 life years and 0.124 QALYs per patient in the target population compared with current diagnostic methods alone. At a cost-neutral level, the estimated justifiable price of NanoEcho diagnostics was SEK 6995 in the first testing strategy and SEK 50,658 in the second testing strategy. The justifiable price of the NanoEcho diagnostics at a willingness to pay of 500,000 SEK/QALY was SEK 10,654 in the first testing strategy and SEK 65,132 in the second testing strategy. CONCLUSION The results indicate that adding NanoEcho diagnostics to standard of care can potentially reduce healthcare costs and increase quality of life in RC patients, assuming a sensitivity and specificity of 85%.
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Affiliation(s)
| | | | - Carl-Fredrik Rönnow
- Department of Clinical Sciences, Malmö, Section of Surgery, Lund University, Lund, Sweden
| | - Henrik Thorlacius
- Department of Clinical Sciences, Malmö, Section of Surgery, Lund University, Lund, Sweden
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Yi H, Cai M, Wei X, Cao Y, Kuai L, Xu D, Qiu Y, Han S. Evaluation of changes in price, volume and expenditure of PD-1 drugs following the government reimbursement negotiation in China: a multiple-treatment period interrupted time series analysis. J Glob Health 2025; 15:04069. [PMID: 40247711 PMCID: PMC12006830 DOI: 10.7189/jogh.15.04069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2025] Open
Abstract
Background Government reimbursement negotiation (GRN) is an important policy tool to increase the accessibility of drugs. In China, the impact of GRN implementation on programmed death-1 (PD-1) drugs price, procurement volume, and expenditure is unknown. Methods This study used a multiple-treatment period interrupted time series design covering the period from the first-time recorded in Chinese Medical Economic Information database to 2022 to examine changes in hospital procurement price, volume and expenditure of PD-1 drugs after the implementation of GRN in China. Data were obtained from 698 public hospitals of 30 provinces in China. Results A total of four PD-1 drugs have been selected in the National Reimbursement Drug List via GRN between March 2019 and 2022. After the implementation of the first-time GRN, the prices of all PD-1 drugs decreased significantly, with Camrelizumab experiencing the largest reduction in price and the largest increase in volume and expenditure. The Camrelizumab's price decreased by 1151.75 Chinese Yuan (CNY) (β2 = -1151.75; 95% confidence interval (CI) = -1254.534, 1048.96), volume increased by 159.549 thousand defined daily doses (β2 = 159.549; 95% CI = 119.12, 199.979) and expenditure increased by 11.172 million CNY (β2 = 11.172; 95% CI = 1.653, 20.692). Following the implementation of the second-time of GRN, Sintilimab showed the largest decrease in price, with price decreased by 164.099 CNY (β4 = -164.099; 95% CI = -171.867, 156.331), Tislelizumab had the largest increase in volume and expenditure, with the volume increased by 102.185 thousand defined daily doses (β4 = 102.185; 95% CI = 47.862, 156.509) and expenditure increased by 4.119 million CNY (β4 = 4.119; 95% CI = -3.808, 12.047). Conclusions The GRN policy improved the accessibility and affordability of PD-1 drugs. Health insurance policy-makers need to consider the legitimate interests of PD-1 drug manufacturers while ensuring the sustainability of the basic health insurance fund.
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Affiliation(s)
- Hongbin Yi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
- International Research Centre for Medicinal Administration, Peking University, Beijing, China
| | - Mengtian Cai
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
- International Research Centre for Medicinal Administration, Peking University, Beijing, China
| | - Xiaoxia Wei
- Department of Pharmacy, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Yingdan Cao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
- International Research Centre for Medicinal Administration, Peking University, Beijing, China
| | - Liping Kuai
- Science and Technology Development Centre, Chinese Pharmaceutical Association, Beijing, China
| | - Dongyan Xu
- Science and Technology Development Centre, Chinese Pharmaceutical Association, Beijing, China
| | - Yue Qiu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Sheng Han
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
- International Research Centre for Medicinal Administration, Peking University, Beijing, China
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Li X, Xu Y, Ou Y, Li H, Xu W. Optimizing Treatment Selection for Early Hepatocellular Carcinoma Based on Tumor Biology, Liver Function, and Patient Status. J Hepatocell Carcinoma 2025; 12:777-790. [PMID: 40255902 PMCID: PMC12009567 DOI: 10.2147/jhc.s514248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Accepted: 04/08/2025] [Indexed: 04/22/2025] Open
Abstract
Early-stage hepatocellular carcinoma (HCC) represents a critical window for curative treatment. However, treatment selection is complicated by significant heterogeneity in tumor biology, liver function, and patient performance status. This review provides a comprehensive overview of current curative-intent strategies for early-stage HCC, including liver transplantation, surgical resection, and local ablative therapies. We emphasize the importance of integrating tumor-specific characteristics-such as microvascular invasion, size, and anatomical location-with liver reserve metrics, including portal hypertension, Child-Pugh classification, and novel indices like albumin-bilirubin and albumin-indocyanine green evaluation grades. Furthermore, we discuss recent advances in non-thermal ablation techniques (eg, high-intensity focused ultrasound and irreversible electroporation), and technical innovations in radiofrequency ablation and cryoablation that are expanding the therapeutic landscape. By combining macro-level functional assessments with micro-level biological indicators, this review advocates for a personalized, evidence-based framework to optimize long-term outcomes in early HCC. The future of HCC management lies in standardizing individualized therapy.
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Affiliation(s)
- Xing Li
- Department of Ultrasound Diagnosis and Treatment, Tianjin Cancer Hospital Airport Hospital, National Clinical Research Center for Cancer, Tianjin, People’s Republic of China
- Department of Ultrasound Diagnosis and Treatment, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People’s Republic of China
| | - Yong Xu
- Department of Ultrasound Diagnosis and Treatment, Tianjin Cancer Hospital Airport Hospital, National Clinical Research Center for Cancer, Tianjin, People’s Republic of China
- Department of Ultrasound Diagnosis and Treatment, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People’s Republic of China
| | - Yanmei Ou
- Department of Ultrasound Diagnosis and Treatment, Tianjin Cancer Hospital Airport Hospital, National Clinical Research Center for Cancer, Tianjin, People’s Republic of China
| | - Huikai Li
- Department of Hepatobiliary Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People’s Republic of China
| | - Wengui Xu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People’s Republic of China
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Xiao Q, Xu P, Xu W, Song Q, Mao Y. Identification of characteristic genes in cutaneous squamous cell carcinoma based on weighted gene co-expression network analysis. Front Genet 2025; 16:1470584. [PMID: 40296873 PMCID: PMC12034687 DOI: 10.3389/fgene.2025.1470584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 03/31/2025] [Indexed: 04/30/2025] Open
Abstract
Objective This study aims to identify characteristic genes associated with cutaneous squamous cell carcinoma (cSCC). Methods Differentially expressed genes (DEGs) and hub genes in key module were identified using the limma package and weighted gene co-expression network analysis (WGCNA) in R software, respectively. The intersection of these genes was then subjected to LASSO regression to pinpoint characteristic genes. The correlation between immune cell infiltration and these characteristic genes was further elucidated using single-sample Gene Set Enrichment Analysis and Spearman correlation analysis. Results A total of 113 DEGs were identified, along with their associated biological pathways. From this pool, five characteristic genes-ADH1B, CCL27, ID4, LRP4 and S100A9-were selected and validated. Immune infiltration analysis revealed significant correlations between these genes and various immune cell types, particularly with CCL27, ID4, LRP4 and S100A9. Conclusion The identification of characteristic genes for cSCC provides valuable insights into its molecular mechanisms. The correlations between these genes and immune cell infiltration suggests their potential roles in tumor immunity.
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Affiliation(s)
- Qipeng Xiao
- Department of Dermatology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China
| | - Pengfei Xu
- Department of Dermatology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China
| | - Wenjun Xu
- College of Nursing, Jiujiang Vocational University, Jiujiang, Jiangxi, China
| | - Qiuhe Song
- Department of Dermatology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China
| | - Yousheng Mao
- Department of Dermatology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China
- Jiujiang Clinical Precision Medicine Research Center, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China
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Liu L, Li D, Zhuo A, Lu J, Zou J, Huang G, Hu Z, Zhang Z, Deng Y, Yang L. A LncRNA panel within EpCAM-specific exosomes for noninvasive early diagnosing non-small cell lung cancer. Respir Res 2025; 26:144. [PMID: 40223051 PMCID: PMC11995661 DOI: 10.1186/s12931-025-03220-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Accepted: 04/04/2025] [Indexed: 04/15/2025] Open
Abstract
BACKGROUND Plasma tumor-associated exosomes represent a promising source for cancer biomarkers; however, the role of long non-coding RNAs (lncRNAs) within these exosomes is not well-defined in non-small cell lung cancer (NSCLC). METHODS We identified a panel of NSCLC-specific lncRNAs within plasma EpCAM-specific exosomes (Epexo) through a comparative analysis of lncRNA profiles between plasma Epexo and lung tissues. The panel's diagnostic value was firstly evaluated in a retrospective cohort of 210 NSCLC patients and 245 healthy controls, and validated in a prospective cohort of 192 patients with pulmonary nodules (nodule size < 3 cm in diameter). The evaluation utilized the area under the ROC curve (AUC) based on a random forest model. For precision, repeat testing was conducted with 31 randomly selected samples. Additionally, 39 paired tissue-plasma samples were employed to assess the concordance of lncRNA expression between tissue and plasma within the same individuals. RESULTS The panel, including linc01125, HNF1A-AS1, MIR100HG, linc01160, and ZNRF3-AS1, demonstrated superior capability in distinguishing early-stage NSCLC patients from controls, achieving AUC values of 0.805 and 0.856 in the discovery and validation set, respectively. The panel also showed potential for differentiating adenocarcinoma and squamous cell carcinoma. Repeat sample testing showed a consistency of 90.3% for this panel. The expression levels of MIR100HG and HNF1A-AS1 showed significant correlations between plasma Epexo and cancerous tissues. CONCLUSIONS The identified lncRNA panel, consisting of linc01125, HNF1A-AS1, MIR100HG, linc01160, and ZNRF3-AS1, presents a promising diagnostic tool for NSCLC. CLINICAL TRIAL NUMBER not applicable.
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Affiliation(s)
- Linyuan Liu
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Danlei Li
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Amei Zhuo
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Jiachun Lu
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
- Key Laboratory of Clinical Molecular Diagnosis and Research for High Incidence Diseases in Western Guangxi Universities, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, China
- School of Public health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jianjun Zou
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
- Department of Oncology, Guangzhou Chest Hospital, Guangzhou, 510095, China
| | - Guitian Huang
- Physical Examination Center, Affiliated First People's Hospital, Guangzhou Medical university, Guangzhou, 511468, China
| | - Zhaoting Hu
- Department of Health Management Center, The Third Affiliated Hospital, Southern Medical University, Guangzhou, 510630, China
| | - Zili Zhang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Yibin Deng
- Key Laboratory of Clinical Molecular Diagnosis and Research for High Incidence Diseases in Western Guangxi Universities, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, China.
| | - Lei Yang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China.
- Key Laboratory of Clinical Molecular Diagnosis and Research for High Incidence Diseases in Western Guangxi Universities, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, China.
- School of Public health, Guangzhou Medical University, Guangzhou, 511436, China.
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Ungvari Z, Fekete M, Varga P, Lehoczki A, Munkácsy G, Fekete JT, Bianchini G, Ocana A, Buda A, Ungvari A, Győrffy B. Association between red and processed meat consumption and colorectal cancer risk: a comprehensive meta-analysis of prospective studies. GeroScience 2025:10.1007/s11357-025-01646-1. [PMID: 40210826 DOI: 10.1007/s11357-025-01646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Accepted: 04/01/2025] [Indexed: 04/12/2025] Open
Abstract
Increasing evidence suggests that red and processed meat consumption may elevate the risk of colorectal cancer (CRC), yet the magnitude and consistency of this association remain debated. This meta-analysis aims to quantify the relationship between red and processed meat intake and the risk of CRC, colon cancer, and rectal cancer using the most comprehensive set of prospective studies to date. We conducted a comprehensive search in PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar databases from 1990 to November 2024, to identify relevant prospective studies examining red, processed, and total meat consumption in relation to colorectal, colon, and rectal cancer risk. Hazard ratios (HR) and 95% confidence intervals (CI) were extracted for each study and pooled using a random-effects model to account for variability among studies. Statistical evaluation was executed using the online platform MetaAnalysisOnline.com. A total of 60 prospective studies were included. Red meat consumption was associated with a significantly increased risk of colon cancer (HR = 1.22, 95% CI 1.15-1.30), colorectal cancer (HR = 1.15, 95% CI 1.10-1.21), and rectal cancer (HR = 1.22, 95% CI 1.07-1.39). Processed meat consumption showed similar associations with increased risk for colon cancer (HR = 1.13, 95% CI 1.07-1.20), colorectal cancer (HR = 1.21, 95% CI 1.14-1.28), and rectal cancer (HR = 1.17, 95% CI 1.05-1.30). Total meat consumption also correlated with an elevated risk of colon cancer (HR = 1.22, 95% CI 1.11-1.35), colorectal cancer (HR = 1.17, 95% CI 1.12-1.22), and rectal cancer (HR = 1.28, 95% CI 1.10-1.48). This meta-analysis provides robust evidence that high consumption of red and processed meats is significantly associated with an increased risk of colorectal, colon, and rectal cancers. These findings reinforce current dietary recommendations advocating for the limitation of red and processed meat intake as part of cancer prevention strategies.
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Affiliation(s)
- Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral College, Health Sciences Division/Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Mónika Fekete
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
| | - Péter Varga
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
- Doctoral College, Health Sciences Division, Budapest, Hungary
| | - Andrea Lehoczki
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
- Doctoral College, Health Sciences Division, Budapest, Hungary
| | - Gyöngyi Munkácsy
- Department of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, H- 1117, Budapest, Hungary
| | - János Tibor Fekete
- Department of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, H- 1117, Budapest, Hungary
| | - Giampaolo Bianchini
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Ocana
- Experimental Therapeutics in Cancer Unit, Instituto de Investigación Sanitaria San Carlos (IdISSC), and CIBERONC, Madrid, Spain
- INTHEOS-CEU-START Laboratory, Facultad de Medicina, Universidad CEU San Pablo, 28668 Boadilla del Monte, Madrid, Spain
| | - Annamaria Buda
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
- Doctoral College, Health Sciences Division, Budapest, Hungary
| | - Anna Ungvari
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary.
| | - Balázs Győrffy
- Jozsef Fodor Center for Prevention and Healthy Aging, Semmelweis University, Budapest, Hungary
- Department of Bioinformatics, Semmelweis University, 1094, Budapest, Hungary
- Cancer Biomarker Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, H- 1117, Budapest, Hungary
- Department of Biophysics, Medical School, University of Pecs, H- 7624, Pecs, Hungary
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Yang J, Liu HM, Qu X, Jiang F, Hao JW, Rong PR, Ning P, Zheng AJ. Developing a model for predicting suicide risk among prostate cancer survivors. Front Med (Lausanne) 2025; 12:1483266. [PMID: 40276742 PMCID: PMC12018404 DOI: 10.3389/fmed.2025.1483266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 03/20/2025] [Indexed: 04/26/2025] Open
Abstract
Objective Given the significantly higher suicide risk among cancer survivors compared to the general population, and considering that prostate cancer survivors make up the largest group of cancer survivors, it is imperative to develop a model for predicting suicide risk among prostate cancer survivors. Methods Clinical data of prostate cancer patients were extracted from the surveillance, epidemiology, and end results (SEER) database and randomly divided into a training cohort and a validation cohort in a 7:3 ratio. Initial variable selection was performed using univariate Cox regression, Best Subset Regression (BSR), and Least Absolute Shrinkage and Selection Operator (LASSO). Variables to be included in the final model were selected using backward stepwise Cox regression. Model performance was evaluated using the Concordance Index (C-index), Receiver Operating Characteristic (ROC) curves, and calibration curves. Results Data from 238,534 prostate cancer patients were obtained from the SEER database, of which 370 (0.16%) died by suicide. Seven variables including age, race, marital status, household income, PSA levels, M stage, and surgical status were included in the final model. The model demonstrated good discriminative ability in both the training and validation cohorts, with C-indices of 0.702 and 0.688, respectively. ROC values at 3, 5, and 10 years were 0.727/0.644, 0.700/0.698, and 0.735/0.708, respectively. Calibration curves indicated a high degree of consistency between model predictions and actual outcomes. High-risk prostate cancer survivors had a 3.5 times higher risk of suicide than the low-risk group (0.007 vs. 0.002, P < 0.001), a finding supported by data from the validation cohort and the entire cohort. Conclusion A reliable predictive model for suicide risk among prostate cancer survivors was successfully established based on seven readily obtainable clinical predictors. This model can effectively aid healthcare professionals in quickly identifying high-risk prostate cancer survivors and timely implementation of preventive interventions.
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Affiliation(s)
| | | | | | | | | | | | - Peng Ning
- Baoji High-Tech Hospital, Baoji, China
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Liu PC, Lin YS, Ou YC, Hsu CY, Tung MC, Chiu YM. Comprehensive analysis of prostate cancer life expectancy, loss of life expectancy, and healthcare expenditures: Taiwan national cohort study spanning 2008 to 2019. PLoS One 2025; 20:e0310613. [PMID: 40198602 PMCID: PMC11978119 DOI: 10.1371/journal.pone.0310613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 02/14/2025] [Indexed: 04/10/2025] Open
Abstract
Prostate cancer (PCa) is the second most commonly diagnosed cancer worldwide and the 5th leading cause of death from cancer for men in Taiwan. The incidence of synchronous metastatic PCa in Taiwan is higher than U.S. and Europe. We aim to present the latest life expectancy (LE), loss of LE, and lifetime cost associated with PCa in Taiwan. The PCa data are based on Taiwan Cancer Registry and National Health Insurance Database. Total 30,207 new cases of PCa were recorded during 2008-2019 nationwide. LE, estimated loss of LE and lifetime cost were stratified by age, cancer stage, Gleason score, grade group and serum PSA level at diagnosis. We compared LE and healthcare cost outcomes between synchronous metastatic PCa patients in 3 age groups. Among the 30,207 new cases, the low to intermediate risk groups, high-risk groups, and regional and metastatic PCa accounted for 54.1%, 13.2%, and 32.6% of cases, respectively. A considerable proportion of synchronous metastatic PCa was noted in Taiwan when compared with the U.S. For synchronous metastatic PCa, the highest LE is 9.22 years for ages 20-64 years, followed by ages 65-74 (8.29 years) and ages 75-89 years (4.58 years). The loss of LE in the three age groups is 13.63, 6.75, and 3.87 years, respectively. The healthcare cost of synchronous metastatic PCa in all age groups is higher than the average cost for PCa patients in Taiwan. This study provides real-world evidence to support health care policy-making and clinical decisions regarding PCa. Due to the high proportion of synchronous metastatic PCa in Taiwan, the findings of this analysis emphasize the importance of early detection of PCa, which can save LE and decrease the total cost burden on the healthcare system.
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Affiliation(s)
- Pin-Chun Liu
- Division of Urology, Department of Surgery, Tungs’ Taichung Metroharbor Hospital, Taichung City, Taiwan
| | - Yi-Sheng Lin
- Division of Urology, Department of Surgery, Tungs’ Taichung Metroharbor Hospital, Taichung City, Taiwan
| | - Yen-Chuan Ou
- Division of Urology, Department of Surgery, Tungs’ Taichung Metroharbor Hospital, Taichung City, Taiwan
| | - Chao-Yu Hsu
- Division of Urology, Department of Surgery, Tungs’ Taichung Metroharbor Hospital, Taichung City, Taiwan
| | - Min-Che Tung
- Division of Urology, Department of Surgery, Tungs’ Taichung Metroharbor Hospital, Taichung City, Taiwan
| | - Ying-Ming Chiu
- Departments of Allergy, Immunology, and Rheumatology, Tungs’ Taichung MetroHarbor Hospital, Taichung City, Taiwan
- Departments of big data research center, Tungs’ Taichung MetroHarbor Hospital, Taichung City, Taiwan
- Departments of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City, Taiwan
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Xiang X, Li Y, Liang N, Wang B, Wang H. Assessing healthcare payment reforms' effects on economic inequities and catastrophic expenditures among cancer patients in ethnic minority regions of China. BMC Med 2025; 23:208. [PMID: 40189513 PMCID: PMC11974073 DOI: 10.1186/s12916-025-04040-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Accepted: 03/26/2025] [Indexed: 04/09/2025] Open
Abstract
BACKGROUND Ethnic minority groups are particularly vulnerable to healthcare inequities, with catastrophic medical expenditures often pushing them into poverty. However, empirical research on the impact of healthcare reforms on these populations remains limited. This study aims to address this gap by exploring the effects of healthcare payment reforms on healthcare outcomes and financial protection during serious illnesses among ethnic minority populations. METHODS A cross-sectional study was conducted using data from three major ethnic minority groups in China: the Zhuang, Hui, and Manchu. The analysis is based on hospitalization data from 59,622 ethnic minority cancer patients spanning from 2013 to 2024. Ordinary least squares (OLS) linear regression was employed to assess the effects of healthcare payment reforms on healthcare expenses and cost-sharing. RESULTS The findings indicate that, compared to traditional payment methods, the implementation of diagnosis-related group (DRG) payment reforms led to reductions in hospitalization, drug, and treatment expenses for ethnic minority patients. However, a closer examination of the cost structure reveals that while DRG payment systems have reduced expenditures for public health insurance fund, they have simultaneously increased out-of-pocket costs for minority patients. CONCLUSIONS Given that many ethnic minority patients belong to economically disadvantaged groups with limited financial resources, the rise in out-of-pocket costs exacerbates their economic burden, making them more vulnerable to catastrophic medical expenditures. This situation poses a severe challenge to minority patients already in precarious financial circumstances. This study offers insights and lessons from China that may guide governments worldwide in mitigating healthcare inequities faced by vulnerable populations.
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Affiliation(s)
- Xin Xiang
- Institute of Fiscal and Finance, Shandong Academy of Social Sciences, Jinan, China
| | - Yu Li
- Medical Insurance Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Ning Liang
- Medical Insurance Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Bangqin Wang
- Medical Insurance Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
| | - Hongzhi Wang
- Research Center of Hospital Management and Medical Prevention, Guangxi Academy of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, Guangxi, 530021, China.
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Pedreira NP, Costa ETT, Costa de Castro C, Rodrigues GAD, Pedreira NP, Ramos GMG, Gonçalves FE, Seabra IL, Dias de Sousa FDJ, Aben-Athar CYUP, Ramos AMPC. Satisfaction with nursing care among patients with cancer receiving palliative care in a hospital. Int J Palliat Nurs 2025; 31:195-204. [PMID: 40257762 DOI: 10.12968/ijpn.2024.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2025]
Abstract
BACKGROUND Few studies evaluate the satisfaction of patients with cancer receiving palliative care with the nursing care received. OBJECTIVE To evaluate satisfaction among patients with cancer in hospitalised palliative care with respect to the nursing care they received. METHOD This was a quantitative, descriptive-correlational and cross-sectional study that was reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. It was carried out in a university hospital in the city of Belém, Brazil. The participants were adults with cancer who were receiving palliative care and who had been hospitalised for more than 72 hours. Data collection took place between December 2022 and September 2023, and instruments were used for bedside interviews. RESULTS Patients receiving minimal care reported being satisfied with their nursing care in the technical-professional dimension (p=0.04). CONCLUSION The association between patient satisfaction and the degree of dependence is unprecedented in the scientific scenario and has the potential to motivate more in-depth studies in this area.
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Westman B, Bergenmar M, Sharp L, Bergkvist K. Exploring patients' opportunities for participation in meetings with a contact nurse, prior to cancer treatment - An interview study. Eur J Oncol Nurs 2025; 75:102826. [PMID: 39908879 DOI: 10.1016/j.ejon.2025.102826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 01/28/2025] [Accepted: 01/30/2025] [Indexed: 02/07/2025]
Abstract
PURPOSE In Swedish cancer care, Contact Nurses (CNs), have a role to enhance the patients' opportunities for participation through improved communication and information. The aim of this study was to explore how patients describe their opportunities for participation during the first encounter with the CN, prior to starting the cancer treatment. METHODS Semi-structured interviews with 14 patients with cancer, planned for curative treatment, were performed. Purposeful sampling, based on estimated high or low activation level measured with PAM-13®, as well as gender and age, were used. The interviews were analysed, using a qualitative inductive approach. RESULTS The overarching theme "Dealing with an entirely new life situation" encompass three categories; "Establish relationships", "Gaining understanding of the illness" and "Taking part in treatment planning". The relationships with the CNs as well as the understanding of what was being planned, was considered important. Having the opportunity to communicate essential matters and the adaption of the information, was also found to be of great importance. The perceived possibilities to participate in the planning of treatment and care varied, with some patients describing the plan to be predetermined, while others had a more accommodating experience. CONCLUSION The result highlights the importance for CNs of establishing relationships with their patients. It also points out the importance of the patients understanding of their situation. These insights emphasize the need for CNs to prioritize empathic communication, the need to adapt information to the patient's preunderstanding and to actively involve patients in their care planning, enhancing overall patient satisfaction and outcomes.
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Affiliation(s)
- Bodil Westman
- Department of Care Science, Sophiahemmet University, Stockholm, Sweden; Regional Cancer Centre Stockholm-Gotland, Region Stockholm, Stockholm, Sweden.
| | - Mia Bergenmar
- Department of Care Science, Sophiahemmet University, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Pelvic Cancer, Psychosocial Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Lena Sharp
- Regional Cancer Centre Stockholm-Gotland, Region Stockholm, Stockholm, Sweden; Umeå University, Department of Nursing, Umeå, Sweden
| | - Karin Bergkvist
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Lechien JR, Chiesa-Estomba CM, Hans S. Practical considerations for choosing transoral laser microsurgery versus transoral robotic surgery for supraglottic laryngeal cancers. Curr Opin Otolaryngol Head Neck Surg 2025; 33:92-101. [PMID: 39903652 DOI: 10.1097/moo.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2025]
Abstract
PURPOSE OF REVIEW To review the pros and cons of treating supraglottic laryngeal cancer with transoral laser microsurgery (TOLM) or transoral robotic surgery (TORS). RECENT FINDINGS The use of TORS is limited by the cost and the availability of the robots despite a faster learning curve than TOLM. The laryngeal exposure difficulty, the use of long instruments, and the restricted view of the surgical field consist of the primary limitations of TOLM, which are addressed in TORS technology through a 30° view of surgical fields, and the 180° amplitude of the instruments. The indications of TOLM and TORS are similar and include cT1-T2 and some selected cT3 with moderate invasion of the preepiglottic space. The rates of positive margins in TORS-SGL are lower than those of TOLM-supraglottic laryngectomy (SGL), while both approaches report similar duration of hospital stays. Patients treated with TORS report higher rates of percutaneous gastrostomy and temporary tracheotomy compared to TOLM. The feeding tube and oral diet re-start appear comparable between both groups. The overall survival, disease-free survival, local, regional, and relapse-free survival rates of TORS are reported to be higher than those found for TOLM SGL. SUMMARY TORS and TOLM SGL are well tolerated and effective approaches for cT1, cT2, and some selected cT3 LSCC. The functional and surgical outcomes appear comparable. TORS could have superior survival and loco-regional outcomes than TOLM, which could be attributed to the fastest TORS learning curve, and its superiority in terms of tumor/operating field visualization, and instrument movements.
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Affiliation(s)
- Jerome R Lechien
- Research and Robotic Study Groups of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Surgery, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons
- Division of Laryngology & Broncho-esophagology, Department of Otolaryngology-Head and Neck Surgery, EpiCURA Hospital, University of Mons, Baudour, Belgium
- Department of Otolaryngology-Head and Neck Surgery, Polyclinic de l'Atlantique, Poitiers
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
| | - Carlos M Chiesa-Estomba
- Research and Robotic Study Groups of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology-Head and Neck Surgery, Donostia University Hospital Donosti-San, Sebastián, Spain
| | - Stéphane Hans
- Research and Robotic Study Groups of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
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Liu S, Du B, Zhou S, Shao N, Zheng S, Kuang X, Zhang Y, Shi Y, Lin Y. Patterns of Recurrence and Survival Outcomes of HER2-Low Expression in Early-Stage Breast Cancer. Clin Breast Cancer 2025; 25:242-250.e6. [PMID: 39674766 DOI: 10.1016/j.clbc.2024.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 11/20/2024] [Accepted: 11/20/2024] [Indexed: 12/16/2024]
Abstract
PURPOSE To characterize site-specific recurrence patterns and survival outcomes of patients with human epidermal growth factor receptor 2 (HER2)-low breast cancer. METHODS This retrospective cohort study included patients diagnosed with early-stage breast cancer at a single institution in China from January 2010 to December 2020. Patterns of the first site of recurrence were compared between patients with HER2-low and HER2-0 tumors using competing risks regression analysis. Disease-free survival (DFS) and overall survival (OS) were evaluated using Kaplan-Meier method. RESULTS A total of 2055 patients were analyzed (median follow-up 52.3 months), comprising 1102 (53.6%) patients with HER2-low and 953 (46.4%) with HER2-0 tumors. Patients with HER2-0 tumors had a significantly higher 5-year cumulative incidence of visceral recurrence than those with HER2-low tumors (7.20% vs. 4.50%; P = .046), especially for the lung recurrence (4.16% vs. 2.81%; P = .044). In the hormone receptor (HoR)-positive subgroup, HER2-low patients had a significantly higher risk of local recurrence (10-year cumulative incidence rate, 7.58% vs. 2.61%; P = .013) but a relatively lower risk of contralateral breast cancer (10-year cumulative incidence rate, 0.90% vs. 4.53%; P = .044) compared with HER2-0 patients. Nevertheless, there were no significant differences between the HER2-0 and HER2-low patients regarding the time to all sites of recurrence after adjusting other potential risk factors (all P > .05), DFS (P = .763), and OS (P = .106). CONCLUSION Site-specific recurrence patterns differ between HER2-low and HER2-0 patients. However, it does not support that HER2-low breast cancer is a distinct prognostic subtype.
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Affiliation(s)
- Sihua Liu
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Beidi Du
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shuling Zhou
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Laboratory of Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Nan Shao
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shaoquan Zheng
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaying Kuang
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yunjian Zhang
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yawei Shi
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Ying Lin
- Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Brotherton JML, Vajdic CM, Nightingale C. The socioeconomic burden of cervical cancer and its implications for strategies required to achieve the WHO elimination targets. Expert Rev Pharmacoecon Outcomes Res 2025; 25:487-506. [PMID: 39783967 DOI: 10.1080/14737167.2025.2451732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Revised: 01/01/2025] [Accepted: 01/07/2025] [Indexed: 01/12/2025]
Abstract
INTRODUCTION Cervical cancer is almost entirely preventable by vaccination and screening. Population-based vaccination and screening programs are effective and cost effective, but millions of people do not have access to these programs, causing immense suffering. The WHO Global Strategy for the elimination of cervical cancer as a public health problem calls for countries to meet ambitious vaccination, screening, and treatment targets. AREAS COVERED Epidemiological evidence indicates marked socioeconomic gradients in the burden of cervical cancer and vaccination, screening, and treatment coverage. The unacceptable socioeconomic burden of cervical cancer is largely a function of inequitable access to these programs. We discuss these inequities, and highlight strategies enabled by new evidence and technology. Single dose HPV vaccination, HPV-based screening, and the rapidly moving technology landscape have enabled task-shifting, innovation in service delivery and the possibility of scale. Equitable access to optimal care for the treatment of invasive cancers remains a challenge. EXPERT OPINION Cervical cancer can be eliminated equitably. It will require global political will, sustained public and private investment, and community leadership to safely and sustainably embed proven tools, technology and infrastructure in local health and knowledge systems.
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Affiliation(s)
- Julia M L Brotherton
- Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, NSW, Australia
| | - Claire M Vajdic
- Surveillance and Evaluation Research Program, Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - Claire Nightingale
- Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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Naz I, Turgut B, Gunay Ucurum S, Komurcuoglu B, Ozer Kaya D. Investigation of factors associated with static and dynamic balance in early-stage lung cancer survivors. J Cancer Surviv 2025; 19:594-602. [PMID: 37964048 DOI: 10.1007/s11764-023-01492-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Balance impairment and falls are common among patients after cancer treatment. This study aimed to compare static and dynamic balance functions in lung cancer survivors (LCS) and healthy controls and to investigate the factors related to balance in LCS. METHODS Cross-sectional data were collected from lung cancer patients whose treatment had been completed within the previous 3 months (n = 60) and age and gender-matched healthy controls (n = 60). Clinical characteristics and history of falls were recorded. Pulmonary function tests and measurements of respiratory muscle strength were performed. Dynamic and static balance, fear of falling, knee-extension strength, physical activity level, dyspnea, comorbidity, and quality of life (QoL) were assessed using the Time Up and Go Test, Single Leg Standing Test, the Fall Efficacy Scale-International, hand-held dynamometer, the International Physical Activity Questionnaire, the Modified Medical Research Dyspnea Scale, the Charlson Comorbidity Index, and the European Organization for Research and Treatment of Cancer QoL Scale. RESULTS LCS reported a higher fall rate and exhibited lower dynamic balance compared to controls (p < 0.05). The number of chemotherapy cycles, number of falls in the past year, fear of falling, perceived dyspnea, forced expiratory volume in 1 s (%), maximal inspiratory pressure (%), knee-extension strength, physical activity score, and QoL score related to physical function were correlated with balance function in LCS (p < 0.05). CONCLUSION LCS had a higher risk of falls and lower dynamic balance function which might be related to various clinical and physical parameters. IMPLICATIONS FOR CANCER SURVIVORS Identifying factors related to balance should be considered within the scope of fall prevention approaches for these patients.
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Affiliation(s)
- Ilknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey.
| | - Büsra Turgut
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
| | - Sevtap Gunay Ucurum
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
| | - Berna Komurcuoglu
- Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, University of Health Sciences, Yenisehir Mah. Gaziler Cad. No:331 Konak, 35170, Izmir, Turkey
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
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Aftabi S, Barzegar Behrooz A, Cordani M, Rahiman N, Sadeghdoust M, Aligolighasemabadi F, Pistorius S, Alavizadeh SH, Taefehshokr N, Ghavami S. Therapeutic targeting of TGF-β in lung cancer. FEBS J 2025; 292:1520-1557. [PMID: 39083441 PMCID: PMC11970718 DOI: 10.1111/febs.17234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 05/22/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024]
Abstract
Transforming growth factor-β (TGF-β) plays a complex role in lung cancer pathophysiology, initially acting as a tumor suppressor by inhibiting early-stage tumor growth. However, its role evolves in the advanced stages of the disease, where it contributes to tumor progression not by directly promoting cell proliferation but by enhancing epithelial-mesenchymal transition (EMT) and creating a conducive tumor microenvironment. While EMT is typically associated with enhanced migratory and invasive capabilities rather than proliferation per se, TGF-β's influence on this process facilitates the complex dynamics of tumor metastasis. Additionally, TGF-β impacts the tumor microenvironment by interacting with immune cells, a process influenced by genetic and epigenetic changes within tumor cells. This interaction highlights its role in immune evasion and chemoresistance, further complicating lung cancer therapy. This review provides a critical overview of recent findings on TGF-β's involvement in lung cancer, its contribution to chemoresistance, and its modulation of the immune response. Despite the considerable challenges encountered in clinical trials and the development of new treatments targeting the TGF-β pathway, this review highlights the necessity for continued, in-depth investigation into the roles of TGF-β. A deeper comprehension of these roles may lead to novel, targeted therapies for lung cancer. Despite the intricate behavior of TGF-β signaling in tumors and previous challenges, further research could yield innovative treatment strategies.
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Affiliation(s)
- Sajjad Aftabi
- Department of Human Anatomy and Cell ScienceUniversity of Manitoba College of MedicineWinnipegCanada
- Paul Albrechtsen Research Institute, CancerCare ManitobaUniversity of ManitobaWinnipegCanada
- Department of Physics and AstronomyUniversity of ManitobaWinnipegCanada
| | - Amir Barzegar Behrooz
- Department of Human Anatomy and Cell ScienceUniversity of Manitoba College of MedicineWinnipegCanada
- Electrophysiology Research Center, Neuroscience InstituteTehran University of Medical SciencesIran
| | - Marco Cordani
- Department of Biochemistry and Molecular Biology, Faculty of BiologyComplutense UniversityMadridSpain
- Instituto de Investigaciones Sanitarias San Carlos (IdISSC)MadridSpain
| | - Niloufar Rahiman
- Nanotechnology Research Center, Pharmaceutical Technology InstituteMashhad University of Medical SciencesIran
- Department of Pharmaceutical Nanotechnology, School of PharmacyMashhad University of Medical SciencesIran
| | - Mohammadamin Sadeghdoust
- Division of BioMedical Sciences, Faculty of MedicineMemorial University of NewfoundlandSt. John'sCanada
| | - Farnaz Aligolighasemabadi
- Department of Human Anatomy and Cell ScienceUniversity of Manitoba College of MedicineWinnipegCanada
| | - Stephen Pistorius
- Department of Human Anatomy and Cell ScienceUniversity of Manitoba College of MedicineWinnipegCanada
- Paul Albrechtsen Research Institute, CancerCare ManitobaUniversity of ManitobaWinnipegCanada
- Department of Physics and AstronomyUniversity of ManitobaWinnipegCanada
| | - Seyedeh Hoda Alavizadeh
- Nanotechnology Research Center, Pharmaceutical Technology InstituteMashhad University of Medical SciencesIran
- Department of Pharmaceutical Nanotechnology, School of PharmacyMashhad University of Medical SciencesIran
| | - Nima Taefehshokr
- Apoptosis Research CentreChildren's Hospital of Eastern Ontario Research InstituteOttawaCanada
| | - Saeid Ghavami
- Department of Human Anatomy and Cell ScienceUniversity of Manitoba College of MedicineWinnipegCanada
- Paul Albrechtsen Research Institute, CancerCare ManitobaUniversity of ManitobaWinnipegCanada
- Faculty Academy of Silesia, Faculty of MedicineKatowicePoland
- Children Hospital Research Institute of ManitobaUniversity of ManitobaWinnipegCanada
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Wu Z, Chen Y, Ma Y, Xiao T, Xiao Y. Economic burden of infective endocarditis in Zhejiang region from 2007 to 2016. BMC Infect Dis 2025; 25:455. [PMID: 40169965 PMCID: PMC11963642 DOI: 10.1186/s12879-025-10846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 03/21/2025] [Indexed: 04/03/2025] Open
Abstract
BACKGROUND Infective endocarditis (IE) has attracted widespread public attention. However, studies on its economic burden remain scarce. METHODS This retrospective study aimed to collect data on the clinical characteristics of patients with IE from electronic medical records and estimate the economic burden with disability-adjusted life years (DALYs). Additionally, the changing trend of IE from 2007 to 2016 and differences between native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE) on economic burden were analyzed. RESULTS There were 407 patients with IE enrolled in this study. The total DALY loss was 1710.2. The average indirect economic burden ranged from $6253.27 to $14766.34 from 2007 to 2016 showing a stable trend, which was 1.67 to 2.46 times the annual per gross domestic product (GDP). Interestingly, the average indirect economic burden for females ranged from $5941.37 to $17261.07 with a significant upward trend during this period (P = 0.035).The average DALY loss and indirect economic burden were highest in patient aged ≤ 19 (4.82, $21486.12) and lowest in those aged 80-89(0.46, $342.87), decreasing significantly with age(both P<0.001). Finally, there were no significant differences in the average DALY loss and indirect economic burden between the PVE group and NVE group during this period (2.69 vs. 2.63, P = 0.740; $9224.0vs. $11789.4, P = 0.136). CONCLUSIONS The DALY loss and indirect economic burden associated with IE were notably high, particularly among younger patients and females. These findings highlight the need for targeted preventive care and early interventions, especially for youth and gender-specific strategies, to reduce disparities in IE burden.
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Affiliation(s)
- Zhenzhu Wu
- Department of Infectious Disease, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325025, China
| | - Yi Chen
- Department of Gastroenterology, Wenzhou People's Hospital, Wenzhou, 325000, China
| | - Yingying Ma
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000, China
| | - Tingting Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000, China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000, China.
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Yang Z, Luo Y, Lu R, Liu X, Liu H, Liu S, Huang C, Tian J, Zhang L. Incidence Rates of Cutaneous Immune-Related Adverse Events in Patients with Lung Cancer: A Systematic Review and Meta-Analysis. Curr Oncol 2025; 32:195. [PMID: 40277752 PMCID: PMC12025845 DOI: 10.3390/curroncol32040195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Revised: 03/17/2025] [Accepted: 03/18/2025] [Indexed: 04/26/2025] Open
Abstract
OBJECTIVE Cutaneous immune-related adverse events (cirAEs) represent a prevalent manifestation of adverse reactions linked to immune checkpoint inhibitors (ICIs) therapy, substantially affecting patients' quality of life. This systematic review and meta-analysis aimed to quantify the pooled incidence of cirAEs in this population and strengthen clinical awareness for early recognition and management. METHODS A comprehensive search of PubMed, Embase, CINAHL, Cochrane Library, CBM, CNKI, and Wanfang databases was conducted from inception to December 2022. Literature that reported the incidence of cirAEs in patients with lung cancer receiving ICIs therapy was included. A meta-analysis was conducted using R software, version 4.4.1 to estimate the pooled incidence of cirAEs, and a random-effects model was used for data synthesis. Begg's rank correlation and funnel plots were used to assess publication bias. RESULTS A total of 99 articles involving 23,814 patients with lung cancer receiving ICIs therapy were included, with publication dates ranging from 2012 to 2022. The meta-analysis results reveal that the incidence of cirAEs in patients with lung cancer was 20.26% (95% confidence interval [CI (17.12-23.81)]. Significant differences were observed between all subgroups, including continent, study type, combination therapy, dual ICIs therapy, and diagnostic criteria for cirAEs for Grade 1-2 and Grade 3-4 incidences. CONCLUSIONS The incidence of cirAEs in patients with lung cancer is relatively high, particularly undergoing combined or dual ICIs therapy. To comprehensively characterize cirAEs in patients with lung cancer, large-scale multicenter studies integrating real-world pharmacovigilance data are warranted to establish precise incidence estimates and identify clinically significant risk factors. IMPLICATIONS FOR CLINICAL PRACTICE This review's insights aroused clinical staff's attention and concern about cirAEs, potentially enhancing the quality of life of patients with cancer.
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Affiliation(s)
- Zhihui Yang
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
- Evidence Based Nursing and Midwifery Practice PR China: A JBI Centre of Excellence, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China
| | - Yuanyuan Luo
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
| | - Ruiqi Lu
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
| | - Xinqi Liu
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
| | - Hanyu Liu
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
| | - Suting Liu
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
| | - Chen Huang
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
| | - Jinhui Tian
- Evidence Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, No. 199, Donggang West Road, Lanzhou 730000, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China; (Z.Y.)
- Evidence Based Nursing and Midwifery Practice PR China: A JBI Centre of Excellence, No. 1023, South Shatai Road, Baiyun District, Guangzhou 510515, China
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Guo Z, Zhu Z, Lin X, Zhang KM, Wu Q, Wang S, Luo M, Lin X, Wang L, Zhou J. Conception and Concern: A Review of Breast Cancer Risk in Assisted Reproductive Technology. Int J Biol Sci 2025; 21:2647-2671. [PMID: 40303287 PMCID: PMC12035894 DOI: 10.7150/ijbs.105357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 02/25/2025] [Indexed: 05/02/2025] Open
Abstract
This review examines the complex relationship between assisted reproductive technology (ART) and the potential risk of breast cancer. Through a thorough analysis, we explore various aspects of this association, considering both the theoretical and mechanistic overlap between ART and breast cancer, as well as the growing body of empirical research aimed at elucidating this relationship. Theoretical analysis suggests that ART exposure inevitably increases levels of reproductive hormones over a relatively short period, potentially elevating susceptibility to breast cancer. However, current clinical evidence does not strongly support this hypothesis, and no direct correlation between ART and breast cancer development has been established. Our study lays the groundwork for informed discussion and offers recommendations for further research in this area of women's health, based on a comprehensive review of both theoretical and clinical research. The findings provide valuable information to guide both specialists and patients in decision-making regarding ART treatment. As we navigate the complexities surrounding conception, this manuscript serves as an essential resource for understanding and addressing the potential risks of breast cancer in the context of ART.
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Affiliation(s)
- Zijie Guo
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
| | - Ziyu Zhu
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
| | - Xixi Lin
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
| | | | - Qingliang Wu
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
- The Ninth People's Hospital of Hangzhou, Hangzhou, Zhejiang, 310014, China
| | - Shenkangle Wang
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
| | - Mingpeng Luo
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310014, China
| | - Xiaona Lin
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
| | - Linbo Wang
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
| | - Jichun Zhou
- Department of Surgical Oncology, Affiliated Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, 310016, China
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Wan G, Li S, Tang Q, Qiu H, Zhang Q, Yu L. An updated patent review of EZH2 inhibitors (2024-present). Expert Opin Ther Pat 2025:1-14. [PMID: 40116819 DOI: 10.1080/13543776.2025.2483399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Revised: 02/26/2025] [Accepted: 03/19/2025] [Indexed: 03/23/2025]
Abstract
INTRODUCTION EZH2 forms the PRC2 complex with SUZ12 and EED. As a crucial catalytic subunit of PRC2, EZH2 modifies histone H3K27 via its SET domain, resulting in chromatin condensation and suppressing the transcription of related target genes. EZH2 not only functions in PRC2-dependent transcriptional repression but can also activate gene expression in PRC2-independent circumstances or regulate the activity of downstream genes via its own activating mutations. On the basis of the critical role of EZH2 in cancer, the development of inhibitors targeting EZH2 provides a new strategy for cancer therapy. AREAS COVERED The purpose of this review is to summarize the molecular mechanisms of EZH2 inhibitors and emphasize the research progress on EZH2 inhibitors published in the patent literature in recent years. The literature and patent databases of PubMed, Web of Science, SCIFinder, WIPO, USPTO, EPO, and CNIPA were combined to search for more effective EZH2 inhibitors. EXPERT OPINION Recently, a wide range of structurally diverse EZH2 inhibitors, particularly EZH2 degraders, have been identified. These EZH2 modulators have demonstrated significant potential in treating various diseases, with cancer being a primary focus. The development of small molecules targeting EZH2 with distinct pharmacological effects is poised with numerous opportunities.
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Affiliation(s)
- Guoquan Wan
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, China
| | - Siyan Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, China
| | - Qifan Tang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, China
| | - Huapei Qiu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, China
| | - Qiangsheng Zhang
- School of Life Science and Engineering, Southwest Jiaotong University, Chengdu, China
| | - Luoting Yu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu, China
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Zhao Q, Zhang Y, Ji L, Pan Z. Network analysis of anxiety and depressive symptoms among patients with cardiovascular disease. BMC Public Health 2025; 25:1085. [PMID: 40119287 PMCID: PMC11927245 DOI: 10.1186/s12889-025-22269-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2025] [Accepted: 03/10/2025] [Indexed: 03/24/2025] Open
Abstract
BACKGROUND Patients with cardiovascular disease (CVD) often experience anxiety and depression. However, the central and bridge symptoms of anxiety and depression among patients with CVD remain unclear. Network analysis is a statistical method that can reveal and visualise complex relationships between multiple variables. This study aimed to identify the central and bridge symptoms in the anxiety-depression network, which may provide potential targets for preventing and intervening in anxiety and depression. METHODS A total of 1180 patients with CVD were selected from the Psychology and Behavior Investigation of Chinese Residents. The survey was conducted from July 10 to September 15, 2021. Face-to-face electronic questionnaires were distributed to respondents by the investigators. The Generalized Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depressive symptoms among patients with CVD. Network analysis was conducted using R4.02 to identify central and bridge symptoms in the anxiety-depression network. RESULTS Among the 1180 patients with CVD included in this study, 673 (57%) were male and 507 (43%) were female. More than half (53.5%) of patients were under 60 years old. The mean GAD-7 score was 4.66 ± 4.38, and 169 (14.3%) patients had anxiety symptoms. The mean PHQ-9 score was 6.29 ± 5.29, and 235 (19.9%) had depressive symptoms. Furthermore, 144 (12.2%) patients people had both anxiety and depressive symptoms. In the network of anxiety and depressive symptoms, "unable to sit still because of anxiety", "feeling afraid that something terrible is about to happen", and "feeling bad or like a failure, or disappointing oneself or family" were the most influential and central symptoms. We also found that "feeling afraid that something terrible is about to happen" and "thoughts of dying or hurting oneself in some way" were pivotal bridge symptoms between anxiety and depression. CONCLUSIONS This study provides new insights into the network structure of anxiety and depression in patients with CVD. These identified central and bridge symptoms may be potentially effective targets for preventing anxiety and depression in patients with CVD, and may provide treatment strategies for patients with anxiety and depression.
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Affiliation(s)
- Qiuge Zhao
- School of Nursing, Shandong Second Medical University, 7166# Baotong West Road, Weifang, Shandong, 261053, P. R. China
| | - Yuzhen Zhang
- Affiliated Hospital of Shandong Second Medical University, 2428# Yuhe Road, Kuiwen District, Weifang, Shandong, 271000, P. R. China
| | - Lili Ji
- School of Nursing, Shandong Second Medical University, 7166# Baotong West Road, Weifang, Shandong, 261053, P. R. China.
| | - Zhaoqian Pan
- The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, Shandong, 250031, P. R. China.
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