Cancer[JOURNAL]
Sun
200 papers
Reply to "Real-world safety, prognostic, and design considerations in ketogenic diet trials for pancreatic cancer".
Hanna DL, Roberts CGP, Jameson GS … +7 more , Roe DJ, Borazanci E, Zoller AR, Rabinowitz JD, Gately S, Von Hoff DD, Rasco DW
Cancer · 2026 Jul · PMID 42361077 · Publisher ↗
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Pediatric cancer survival in the United States from 2001 to 2021.
Stevenson JM, Lupo PJ, Miller TP … +5 more , Dai S, Henley SJ, Tai E, Boring MA, Siegel DA
Cancer · 2026 Jul · PMID 42360091 · Publisher ↗
BACKGROUND: Approximately 15,000 United States (US) children and adolescents, 0-14 and 15-19 years old, respectively, are diagnosed with cancer annually. Although overall survival now exceeds 80%, cancer remains the seco...
BACKGROUND: Approximately 15,000 United States (US) children and adolescents, 0-14 and 15-19 years old, respectively, are diagnosed with cancer annually. Although overall survival now exceeds 80%, cancer remains the second leading cause of death in this population, and improvements have not been uniform across subgroups. METHODS: Five- and 10-year relative survival (RS) for cancer cases diagnosed during 2001-2021 among individuals <20 years old at diagnosis were calculated using the National Program of Cancer Registries database, covering 87.4% of the US population. Results were stratified by age, sex, race and ethnicity, US Census region, economic status, cancer type, stage, and diagnosis year. All-cause survival was calculated using the Kaplan-Meier method with log-rank testing. RESULTS: Among 272,279 pediatric cancers diagnosed from 2001 to 2021, 5-year RS was 84.7%, and 10-year RS was 82.3%. Five-year RS increased from 83.0% in 2001-2011 to 86.8% in 2012-2021. Ten-year RS was higher for females than males. By age, adolescents 15-19 years old had the highest RS, whereas infants had the lowest. Non-Hispanic Black patients had the lowest 5- and 10-year RS (79.2% and 76.3%, respectively) compared with non-Hispanic White patients (86.3% and 84.0%). RS was highest for patients in the top 25% of counties by economic status and in the Northeastern US Census region. Overall, all-cause 10-year survival was 81.7% and differed by sex, age, race and ethnicity, stage, and cancer subtypes. CONCLUSIONS: Pediatric cancer survival has continued to improve. However, differences persist by age, sex, race and ethnicity, economic status, geography, and cancer type.
Distribution and rate of lymph node metastasis following neoadjuvant chemoimmunotherapy in non-small cell lung cancer.
Qiu J, Yue H, Wang S … +3 more , Li K, Peng A, Xu X
BMC Cancer · 2026 Jun · PMID 42351059 · Full text
BACKGROUND: Neoadjuvant chemoimmunotherapy (NCIT) has emerged as a standard care for resectable non-small cell lung cancer (NSCLC). However, the pattern of lymph node metastasis (LNM) following this treatment remains poo...
BACKGROUND: Neoadjuvant chemoimmunotherapy (NCIT) has emerged as a standard care for resectable non-small cell lung cancer (NSCLC). However, the pattern of lymph node metastasis (LNM) following this treatment remains poorly characterized. This study aimed to elucidate the distribution and rate of LNM after NCIT. METHODS: We retrospectively analyzed 394 NSCLC patients who received NCIT followed by R0 resection at Shanghai Pulmonary Hospital between 2019 and 2022. Pathological data were evaluated to determine LNM distribution and rate, with subgroup analyses performed based on tumor location and histology. Multivariable logistic regression identified independent predictors of nodal downstaging. Kaplan-Meier analyses evaluated survival outcomes based on the extent of lymphadenectomy. Multivariable Cox proportional hazards regression models were performed to identify independent prognostic factors associated with disease-free survival (DFS) and overall survival (OS). RESULTS: Among the 394 patients, predominant LNM stations were 13R (9.4%), 7 (9.4%), 13L (5.8%), 2R (5.6%), 4R (5.3%), and 10R (5.1%). N1 metastasis rates were generally higher across all lobes, especially at station 13. Notably, right lower lobe tumors exhibited high metastasis rates to the superior mediastinum. Survival analysis demonstrated a trend toward more favorable DFS among patients receiving systematic lymph node dissection (SLND) compared with those undergoing non-SLND (P = 0.182). Similarly, patients with ≥ 6 dissected lymph node stations showed a trend toward more favorable DFS compared with those with < 6 dissected lymph node stations (P = 0.100); however, neither association reached statistical significance. Furthermore, multivariable Cox regression identified non-adenocarcinoma histological types (squamous cell carcinoma: HR = 0.58, 95% CI: 0.37-0.92, P = 0.020; others: HR = 0.34, 95% CI: 0.17-0.70, P = 0.004) as independent predictors of improved DFS. For OS, advanced baseline clinical N stage (cN1 vs. cN0: HR = 8.48, 95% CI: 1.07-66.98, P = 0.043) was confirmed as an independent risk factor for worse survival, whereas non-adenocarcinoma/non-squamous histology (HR = 0.13, 95% CI: 0.02-0.95, P = 0.044) served as an independent protective factor. CONCLUSIONS: Post-NCIT lymph node involvement patterns in NSCLC patients varied according to primary tumor location. SLND and the retrieval of ≥ 6 dissected lymph node stations were associated with favorable DFS trends, although these findings were not statistically significant and require further validation.
Bidirectional relationship between the systemic immune-inflammation index and post-autologous stem cell transplantation anemia in multiple myeloma: a retrospective cohort study.
Liu L, Ruan M, Wang M … +4 more , Pu L, Ling Z, Bo J, Zhu K
BMC Cancer · 2026 Jun · PMID 42351050 · Full text
BACKGROUND: Autologous stem cell transplantation (ASCT) is a core consolidation therapy for multiple myeloma (MM). However, post-transplant anemia is a common complication that impairs recovery and prognosis. The systemi...
BACKGROUND: Autologous stem cell transplantation (ASCT) is a core consolidation therapy for multiple myeloma (MM). However, post-transplant anemia is a common complication that impairs recovery and prognosis. The systemic immune-inflammation index (SII), a convenient indicator of systemic inflammatory burden, is associated with prognosis in various cancers. This study aimed to investigate the bidirectional relationship between pre-ASCT SII and post-ASCT anemia in patients with MM, determine the predictive value of SII for anemia, and explore the effect of baseline anemia on inflammatory levels. METHODS: This single-center retrospective cohort study recruited 200 patients with MM who underwent their first ASCT between January 2020 and December 2025. Patients were divided into high-SII and low-SII groups (n = 100 each) based on the optimal cutoff value, which was determined using receiver operating characteristic curve analysis. The primary outcome was the incidence of anemia within 30 days of ASCT. Multivariate logistic regression and Cox proportional hazards models were used to analyze the independent predictive value of SII for anemia occurrence and recovery time. The relationship between baseline anemia status and SII levels was also analyzed using multivariate linear regression. RESULTS: Baseline characteristics showed that the high SII group had a significantly higher prevalence of baseline anemia (57.0% vs. 42.0%, P = 0.034). Within 30 days post-transplant, the high SII group had a significantly higher incidence of anemia (64.0% vs. 36.0%, P < 0.001), more severe anemia (moderate-to-severe anemia: 39.0% vs. 18.0%, P = 0.019), and a longer recovery time (median duration: 34.0 days vs. 16.4 days, P < 0.001). Multivariable analysis showed that high SII was an independent risk factor for post-transplant anemia (adjusted odds ratio [aOR] = 2.86, 95% CI: 1.52-5.38, P = 0.001) and was independently associated with delayed anemia recovery (adjusted hazard ratio [aHR] = 0.65, 95% CI: 0.50-0.85, P = 0.002). Reverse association analysis showed that after adjusting for relevant confounding factors, baseline anemia exhibited a trend toward association with increased log₁₀SII (β = 0.16, P = 0.085), and baseline hemoglobin level was negatively correlated with log₁₀SII (r=-0.22, P = 0.008). Subgroup analysis suggested that the predictive effect of SII on anemia was stronger in patients with ISS stage III and those who developed post-transplant infection (P for interaction < 0.05 for both). CONCLUSION: In patients with MM undergoing ASCT, a high pre-transplant SII is an independent predictor for the occurrence, severity, and delayed recovery of post-ASCT anemia. Baseline anemia status was associated with increased inflammatory burden. This suggests a potential bidirectional association between inflammation and anemia. SII is an easily accessible indicator that can be used to identify high-risk patients for anemia, providing new insights for optimizing peri-transplant management. CLINICAL TRAIL NUMBER: not applicable.
Efficacy and tolerability of CDK 4/6 inhibitors in HR-positive HER2-negative de novo metastatic breast cancer patients aged ≥ 70 years.
Atci MM, Erciyestepe M, Erturk K
BMC Cancer · 2026 Jun · PMID 42351034 · Full text
BACKGROUND: Current guidelines recommend endocrine therapy with CDK 4/6 inhibitors as the first and most strongly evidenced treatment for patients with hormone receptor-positive, HER2-negative metastatic breast cancer, u...
BACKGROUND: Current guidelines recommend endocrine therapy with CDK 4/6 inhibitors as the first and most strongly evidenced treatment for patients with hormone receptor-positive, HER2-negative metastatic breast cancer, unless they are experiencing visceral crisis or resistance to endocrine therapy. CDK 4/6 inhibitors can cause hematological and gastrointestinal toxicity. In case of toxicity, drug doses need to be reduced. Sometimes, depending on the degree of toxicity, taking a break or even stopping treatment may be considered. METHODS: All patients included in our study were 70 years of age or older, had de novo metastatic disease, were hormone receptor-positive and HER2-negative, and were receiving CDK 4/6 inhibitors as part of their metastatic first-line treatment. Recorded common side effects of CDK 4/6 inhibitors. Survival analyses were conducted on patients who had dose reductions due to these side effects. Additionally, OS and PFS were compared according to the type of CDK 4/6 inhibitor the patients received and the Charlson comorbidity index. Our study was conducted retrospectively and as a single-center study. RESULTS: Median OS was 33.0 months (27.0-38.9). Median OS was statistically significantly better in patients with a Charlson comorbidity index < 10 (patients aged 70-79 years with no comorbidities other than metastatic breast cancer) compared to those with a Charlson comorbidity index ≥ 10 (patients aged 80 and over or with comorbidities other than metastatic breast cancer) (41.5 vs. 15.0 months, p < 0.001). CDK 4/6 inhibitor selection and dose reduction did not significantly affect median OS. Median PFS was 27.0 months (22.5-31.4). Similar to variables affecting OS, PFS was significantly worse in patients with a Charlson comorbidity index ≥ 10 and in patients with more than 3 bone metastases. CONCLUSIONS: A review of the literature reveals that studies on the efficacy and tolerability of CDK 4/6 inhibitors have primarily focused on a limited number of patients aged 70 years or older. The results of these studies, similar to our study, generally indicate that efficacy and survival are similar to those in younger patients, and that dose reductions do not significantly impact survival. Furthermore, there are no studies in the literature yet that examine the relationship between the Charlson comorbidity index and survival in elderly patients with multiple comorbidities who are receiving CDK 4/6 inhibitors.
Attitudes and dilemmas facing fertility preservation decision-making by oncology patients from the perspective of healthcare professionals: a qualitative study.
Deng Q, Lazhen W, Qian S … +5 more , Zhou Y, Li Y, Chen J, Ren Q, Tan H
BMC Cancer · 2026 Jun · PMID 42351016 · Full text
BACKGROUND: Fertility protection aims to prevent irreversible damage to fertility. The current study explored attitudes and dilemmas facing healthcare professionals treating oncology patients with the aim of producing em...
BACKGROUND: Fertility protection aims to prevent irreversible damage to fertility. The current study explored attitudes and dilemmas facing healthcare professionals treating oncology patients with the aim of producing empirical evidence to aid decision-making on fertility preservation. METHODS: Fifteen healthcare workers in oncology-related departments of three tertiary general hospitals in Hunan Province were enrolled by purposive sampling and semi-structured interviews conducted. Themes were extracted, analyzed and summarized using NVivo 12.0 software. RESULTS: Three themes were identified: (1) decision-making perceptions and attitudes of healthcare professionals; (2) decision-making dilemmas of patients due to psychosocial pressure, information transmission barriers, time pressures and economic burden; (3) dilemmas affecting the implementation of decisions due to the necessity to balance oncology treatment and fertility preservation and lack of decision-support resources. Seven sub-themes were also identified. CONCLUSIONS: The current study found a need among healthcare professional participants to improve their understanding of fertility preservation, indicating significant gaps in their knowledge base. Oncology patients suffer many pressures and difficult choices which the healthcare system fails to support and a supply-side imbalance exists. The quality of fertility care in oncology requires improvement by better informing healthcare professionals, creating decision-making aids and constructing a localized decision support system. CLINICAL REGISTRATION NUMBER: Not applicable.
Habitat model based on CEUS for noninvasive prediction of EGFR mutation status in peripheral NSCLC.
Zeng J, Wei L, Chen H … +5 more , Liang Y, Huang F, Qin T, Gao Y, Liao X
BMC Cancer · 2026 Jun · PMID 42351011 · Full text
BACKGROUND: To develop and validate a contrast-enhanced ultrasound (CEUS)-based habitat model for noninvasive prediction of epidermal growth factor receptor (EGFR) mutation status in patients with peripheral non-small ce...
BACKGROUND: To develop and validate a contrast-enhanced ultrasound (CEUS)-based habitat model for noninvasive prediction of epidermal growth factor receptor (EGFR) mutation status in patients with peripheral non-small cell lung cancer (NSCLC). METHODS: This retrospective study included 187 patients with NSCLC confirmed by histopathology from April 2021 to February 2025. All patients underwent CEUS of the lung before biopsy. Patients for whom complete EGFR gene testing results were available were randomly divided into a training set and a test set at a ratio of 8:2. Habitat imaging was used to differentiate the tumor into distinct regions, and then an unsupervised clustering method was used to extract and analyze habitat features to establish Habitat_Model. The Shapley additive explanations (SHAP) method was used to improve the interpretability of the model. In addition, Rad_Model based on radiomics features of tumors was constructed. Finally, a combined model was established by combining the habitat features and clinical-radiological indicators with logistic regression analysis. The predictive performance was evaluated using receiver operating characteristic curve (ROC), calibration, and decision curve analysis (DCA). RESULTS: The areas under the curve (AUCs) of Habitat_Model and Rad_Model were 0.898 and 0.857 in the training set, and 0.784 and 0.649 in the testing set, respectively. Habitat_Model showed excellent performance. Incorporating clinical-radiological indicators via the combined model slightly improved its performance, resulting in AUC values of 0.904 and 0.812 for the training and testing sets, respectively. The calibration curves and DCA exhibited excellent fit for the combined model, while providing great clinical net benefit. CONCLUSIONS: Our habitat model demonstrates a good capacity for predicting EGFR mutation status in peripheral NSCLC, providing valuable noninvasive reference for clinical pathways on targeted therapy.
Pharmacokinetics, safety, and efficacy of fuzuloparib in combination with abiraterone acetate and prednisone in patients with metastatic castration-resistant prostate cancer: a phase 1 dose escalation and expansion study.
Dai T, Xu Z, Wang H … +9 more , Han W, Zhang D, Tang K, Wang X, Huang J, He C, Zhou X, Zhang D, Yang C
BMC Cancer · 2026 Jun · PMID 42351007 · Full text
BACKGROUND: Studies have shown that poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors can potentiate the antitumor effect of abiraterone acetate plus prednisone (AA-P) in metastatic castration-resistant pr...
BACKGROUND: Studies have shown that poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors can potentiate the antitumor effect of abiraterone acetate plus prednisone (AA-P) in metastatic castration-resistant prostate cancer (mCRPC). This study evaluated the pharmacokinetics, safety, and efficacy of fuzuloparib, a PARP inhibitor, in combination with AA-P in mCRPC patients who had not received prior novel hormonal agents. METHODS: This was a dose escalation and expansion study. In dose escalation, eligible patients received fuzuloparib at 100 or 150 mg BID for 5 days, followed by fuzuloparib plus AA-P (abiraterone acetate 1000 mg QD, prednisone 5 mg BID) in 28-day treatment cycles. The higher tolerated dose of fuzuloparib was selected for dose expansion. In dose expansion, two treatment groups were planned. The fuzuloparib group received fuzuloparib for 5 days, and the abiraterone group received AA-P for 5 days. Both groups were then treated with the combination therapy. RESULTS: A total of 39 patients were enrolled and treated. As of July 12, 2023, the median follow-up time was 23.2 months (range, 3.9-44.3). No obvious drug-drug interaction was observed between 150 mg fuzuloparib and AA-P, and no dose-limiting toxicities were identified. Treatment-related adverse events (TRAEs) occurred in 36 (92.3%) patients, of which 20 (51.3%) reported grade ≥ 3 TRAEs. At the end of Week 12, prostate-specific antigen (PSA) response rate was 71.8% (95% CI, 55.1-85.0). The median time to PSA progression was 19.4 months (95% CI, 11.3-27.8). Objective response rate was 60% and disease control rate was 90% among patients with evaluable target lesions. The median duration of response was 8.1 months (95% CI, 4.6-31.5), and the median time to radiographic progression was 27.9 months (95% CI, 14.0-not reached). Time to disease progression was generally longer in patients with homologous recombination repair gene mutations, including those with BRCA mutations. CONCLUSIONS: Fuzuloparib plus AA-P had an acceptable safety profile and showed promising efficacy among mCRPC patients. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04108247 (Registered on September 26, 2019).
Metformin inhibits small intestinal neuroendocrine tumor growth in vivo.
Axling F, Backman S, Hellman P … +3 more , Norlén O, Barazeghi E, Stålberg P
BMC Cancer · 2026 Jun · PMID 42350991 · Full text
BACKGROUND: Small intestinal neuroendocrine tumors (SI-NETs) are slow-growing but highly metastatic, with most patients presenting metastases at diagnosis. Radical surgery remains the only potential curative option when...
BACKGROUND: Small intestinal neuroendocrine tumors (SI-NETs) are slow-growing but highly metastatic, with most patients presenting metastases at diagnosis. Radical surgery remains the only potential curative option when feasible. Consequently, there is a critical need for novel therapeutic strategies that can limit tumor progression and enable more personalized treatment approaches in combination with current clinical practices. In this study, we evaluated the impact of metformin on SI-NET cell growth in vivo, characterized the associated microRNA expression profile, and identified potential driver genes modulated by metformin treatment. METHODS: A total of 22 SI-NET xenograft mouse models were established using CNDT2.5 and GOT1 cells. Mice were treated with metformin (2.56 mg/mL in drinking water) or water as control for 4 weeks. To explore the molecular impact of metformin, both small-RNA and total-RNA sequencing were performed on the dissected xenograft tumors. Proliferation and apoptosis were further evaluated by immunohistochemistry. RESULTS: In vivo treatment of SI-NET cells with metformin led to a reduction in tumor size in both CNDT2.5 and GOT1 xenograft models. Our sequencing analyses identified seven altered microRNAs and 1,776 differentially expressed genes in metformin-treated tumors compared to controls. To uncover potential driver genes in SI-NETs affected by metformin, we compared the differentially expressed genes from GOT1 xenograft model with those identified by comparing single-cell RNA profile of enterochromaffin cells to SI-NETs. This novel approach revealed a set of significantly regulated genes, including those involved in tumor proliferation, apoptosis, and metastasis, as well as genes related to voltage-gated calcium channels and signal transduction. CONCLUSIONS: Our novel findings support further investigation of metformin as a potential therapeutic agent in clinical trials for SI-NET patients, and suggest that identified miRNAs should be assessed as potential predictive biomarkers for metformin treatment. This study highlights novel candidate driver genes affected by metformin, which are associated with key cellular processes and enterochromaffin cell's function, offering insights into the underlying mechanisms in SI-NETs.
Serving sulfur to boost anti-tumour immunity.
Brewer G
Nat Rev Cancer · 2026 Jun · PMID 42350819 · Publisher ↗
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Updates on intratumoral therapies in melanoma.
Ma VT, Steimle AK, Patel JD … +10 more , Burkey C, Moser JC, Javed A, Tul Rehman H, Seker ME, Birbrair A, Ozkan OS, Albertini MR, Najjar YG, Kulkarni RP
Cancer · 2026 Jul · PMID 42349466 · Full text
Intratumoral therapies provide an opportunity for novel strategies in the management of advanced melanoma. These approaches deliver concentrated doses of therapeutic immune agents directly into individual tumor(s), achie...
Intratumoral therapies provide an opportunity for novel strategies in the management of advanced melanoma. These approaches deliver concentrated doses of therapeutic immune agents directly into individual tumor(s), achieving local tumor control and induction of systemic antitumor immune responses while minimizing the risk of immune-related adverse events. Talimogene laherparepvec, a genetically modified herpes simplex virus type 1-encoding granulocyte-macrophage colony-stimulating factor, was the first oncolytic viral therapy approved in a solid tumor indication. In pivotal trials of patients with melanoma, talimogene laherparepvec demonstrated durable responses. Building on this paradigm, next-generation oncolytic agents incorporate additional genetic modifications, such as fusogenic proteins and immunostimulatory transgenes, to enhance local cytotoxicity and systemic immune priming. Clinical studies of intratumoral, injectable agents since 2010 have evaluated monotherapy as well as combination strategies with immune checkpoint inhibitors, revealing improved response rates and durable remissions, including in patients with immune checkpoint inhibitor-resistant disease. This review summarizes the mechanistic rationale, preclinical evidence, and clinical development of intratumoral therapies in melanoma. Key trial outcomes, safety profiles, and practical considerations for administration are discussed. Emerging trends include image-guided visceral injection, combinatorial regimens, and the integration of intratumoral therapy in the neoadjuvant setting. As these therapies evolve, intratumoral approaches may expand their role in melanoma management, bridging locoregional tumor control with systemic immune activation and complementing existing systemic treatments.
Correction to "Scientific highlights and perspectives from the International Inflammatory Breast Cancer Symposium 2025".
Cancer · 2026 Jul · PMID 42349433 · Publisher ↗
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Podocalyxin may be down-regulated by progesterone in high grade serous ovarian cancer spheroids to increase responsiveness to carboplatin and NK cells.
Le Tran N, Wang Y, Quinn KM … +3 more , Bilandzic M, Stephens A, Nie G
BMC Cancer · 2026 Jun · PMID 42343334 · Full text
BACKGROUND: Ovarian cancer is the most lethal gynaecological malignancy with limited therapeutic options. We have previously reported that the transmembrane protein podocalyxin (PODXL) promotes survival of high grade ser...
BACKGROUND: Ovarian cancer is the most lethal gynaecological malignancy with limited therapeutic options. We have previously reported that the transmembrane protein podocalyxin (PODXL) promotes survival of high grade serous carcinoma (HGSC) spheroids against chemotherapy agent carboplatin and NK cell cytotoxicity, and that silencing PODXL by gene editing significantly sensitizes HGSC cells to these treatments. Progesterone, a widely used hormone, has been reported to down-regulate PODXL in endometrial epithelial cells. METHODS: In this current study, we investigated whether progesterone could also lower PODXL in HGSC spheroids to sensitize them to carboplatin and NK cells. Kuramochi cells, a high PODXL expressing HGSC model, was first used to examine the effect of progesterone on PODXL expression. Cells were treated with progesterone or a vehicle control and PODXL levels were assessed. Kuramochi spheroids were then generated from pre-treated cells and exposed to carboplatin to evaluate changes in chemotherapy sensitivity. To assess immune susceptibility, spheroids were co-cultured with primary human NK cells isolated from peripheral blood mononuclear cells, and the effects were examined following 24, 48, and 72 h of co-culture. Additionally, primary HGSC cells were treated with progesterone to assess its ability to modulate PODXL expression in patient-derived samples. RESULTS: Progesterone pre-treatment significantly reduced PODXL expression in Kuramochi spheroids resulting in increased sensitivity to carboplatin and increased NK cell infiltration and cytotoxicity. Furthermore, progesterone showed potential to reduce PODXL expression in ascites-derived primary HGSC cells. CONCLUSIONS: These findings suggest that further studies should explore the utility of progesterone-mediated down-regulation of PODXL in HGSC cancer to increase responsiveness to chemotherapy and NK cells.
Reduction of cancer cell quantity and viability in autologous blood salvaged from patients with liver cancer: efficacy of intraoperative cell salvage coupled with leukocyte depletion filtration.
Wang J, Li Z, Cheng Y … +6 more , You L, Cheng Z, Wu M, Sun Y, Chen L, Guo J
BMC Cancer · 2026 Jun · PMID 42343303 · Full text
OBJECTIVE: This in vitro study aims to evaluate the effects of intraoperative cell salvage (ICS) combined with leukocyte depletion filtration (LDF) on hepatocellular carcinoma (HCC) cell number and viability in salvaged...
OBJECTIVE: This in vitro study aims to evaluate the effects of intraoperative cell salvage (ICS) combined with leukocyte depletion filtration (LDF) on hepatocellular carcinoma (HCC) cell number and viability in salvaged autologous blood from patients undergoing liver cancer surgery. METHODS: Twenty patients undergoing open radical resection for primary liver cancer with ICS were enrolled in the study.Blood samples of 20 ml each were procured at three distinct stages: from the surgical field(S1),post ICS treatment(S2),and post ICS treatment combined with leukocyte depletion filter(LDF) filtration(S3).Within these 20-ml blood samples,10 ml underwent cancer cell enrichment procedures, followed by identification and enumeration of cancer cells using immunofluorescence staining.The remaining 10 ml of blood samples were cultured for a duration of three weeks, with subsequent assessment of cell viability using immunofluorescence techniques subsequent to enrichment procedures. RESULTS: HCC cells were identified in samples obtained from S1(19/20),S2(18/20),and S3 (16/20) without a significant difference in the detection rate(P > 0.05).However, a significant reduction in HCC cells count was observed in samples from S2 and S3 when compared to S1(P < 0.05). Notably, no statistically significant differences were noted between HCC cells counts in samples from S2 and S3(P > 0.05). Following three weeks of culture, optical microscopy revealed the presence of liver cancer cell clusters exclusively in S1 samples, while such clusters were absent in samples from S2 and S3. Further examination under fluorescence microscopy indicated the presence of epithelial-mesenchymal hybrid-type HCC cells(S1: 400, S2: 14) and mesenchymal-type HCC cells(S1: 100, S2: 21) in both S1 and S2 samples, whereas no HCC cells were detected in S3 samples.Specifically, HCC cells in S1 samples manifested as liver cancer cell clusters, whereas such clusters were notably absent in samples from S2 and S3. CONCLUSION: Following treatment with ICS alone or in combination with LDF (ICS-LDF), both the number and viability of hepatocellular carcinoma (HCC) cells in salvaged autologous blood were markedly decreased, with no cell cluster formation, which lowered the risk of salvaging cancer cells to some extent. Nevertheless, LDF failed to completely remove HCC cells from all samples, and its filtration efficiency may be compromised when the HCC cell number exceeds a certain threshold.
Therapeutic outcomes of PD-1 blockade-related regimens versus docetaxel in previously immunotherapy-treated advanced non-small cell lung cancer: a retrospective, exploratory study.
Huang TT, Wang XY, Li Q … +1 more , Song PF
BMC Cancer · 2026 Jun · PMID 42343297 · Full text
BACKGROUND: The optimal treatment strategy for patients with advanced non-small cell lung cancer (NSCLC) following progression on initial immune checkpoint inhibitors (ICIs) therapy remained poorly defined. The present s...
BACKGROUND: The optimal treatment strategy for patients with advanced non-small cell lung cancer (NSCLC) following progression on initial immune checkpoint inhibitors (ICIs) therapy remained poorly defined. The present study aimed to identify the therapeutic outcomes of PD-1 blockade-based regimens versus docetaxel in previously immunotherapy-treated advanced NSCLC retrospectively. METHODS: Patients with advanced NSCLC who failed prior PD-1/PD-L1 blockades therapy between January 2019 and December 2025 were screened retrospectively. A total of 64 patients who received PD-1 blockade-related regimens (PD-1 blockades plus chemotherapy or PD-1 blockades plus anlotinib) were treated as observation group (OG), while 63 patients who received docetaxel single-agent were deemed as control group (CG). Therapeutic outcomes including objective response rate (ORR), disease control rate (DCR), duration of response (DoR), progression-free survival (PFS), overall survival (OS) and treatment related adverse events (TRAEs) were compared between the two groups. RESULTS: ORR of the 64 patients who received PD-1 blockade-based regimens in OG was 26.6% compared with 15.9% of the 63 patients who received docetaxel monotherapy in CG (P = 0.141). DCR was significantly higher in OG at 82.8% compared with 54.0% in CG (P < 0.001). The median DoR of responders in the OG and CG was 7.1 months (95%CI: 2.5-11.7) and 3.1 months (95%CI: 1.9-4.3), respectively (P = 0.056). The median PFS of 64 patients in OG and 63 patients in CG was 6.5 months and 3.3 months, respectively (P = 0.008). Similarly, the median OS was dramatically longer with PD-1 blockade-related regimens versus docetaxel group (median OS: 16.8 vs. 9.5 months, P = 0.013). After adjustment for available prognostic factors including best response to prior ICIs therapy, the treatment effect remained directionally consistent for DCR, PFS and OS, whereas ORR remained statistically non-significant. The adjusted estimates were as follows: ORR, adjusted OR = 1.85, 95%CI: 0.72-4.81, P = 0.209; DCR, adjusted OR = 4.01, 95%CI: 1.56-10.42, P = 0.004; PFS, adjusted HR = 0.59, 95%CI: 0.38-0.89, P = 0.011; and OS, adjusted HR = 0.62, 95%CI: 0.39-0.93, P = 0.020. TRAEs of any grade occurred in 82.8% of patients receiving PD-1 blockade-related regimens vs. 81.0% of patients receiving docetaxel monotherapy, and grade ≥ 3 TRAEs in OG and CG was 42.2% and 34.9%, respectively. Common TRAEs in both groups included fatigue, nausea/vomiting and hematologic toxicity. CONCLUSION: PD-1 blockade-based regimens were associated with promising disease-control and survival outcomes compared with docetaxel monotherapy with an acceptable safety profile among patients with previously ICIs-treated advanced NSCLC in clinical practice. Given the retrospective, non-randomized and exploratory design, prospective clinical trials are warranted to confirm these findings subsequently.
Integrated analysis of IGHV rearrangements and cytogenetic abnormalities in a large chronic lymphocytic leukemia cohort (CLL-POL1).
Własiuk P, Szelest M, Paziewska M … +27 more , Karczmarczyk A, Czekalska S, Zawada M, Hut M, Przybyszewski O, Soin M, Wojtaszewska M, Pępek M, Kwak A, Pokrywka M, Wójcik P, Leszczyńska A, Bukowicz J, Szyca W, Nowak-Ozimek E, Kowalik A, Borg K, Makuch-Łasica H, Wojtas M, Solarska I, Jaskuła E, Sobczyńska-Konefał A, Paruzel K, Chudy A, Wawrzyniak E, Stokłosa T, Giannopoulos K
BMC Cancer · 2026 Jun · PMID 42343292 · Full text
The somatic hypermutation (SHM) status of immunoglobulin heavy-chain variable region gene (IGHV) is a well-established prognostic factor in chronic lymphocytic leukemia (CLL). We analyzed clonotypic IGHV-IGHD-IGHJ rearra...
The somatic hypermutation (SHM) status of immunoglobulin heavy-chain variable region gene (IGHV) is a well-established prognostic factor in chronic lymphocytic leukemia (CLL). We analyzed clonotypic IGHV-IGHD-IGHJ rearrangements in 4,251 newly diagnosed CLL patients in Poland (CLL-POL1), representing the largest national cohort to date. In total, 4,328 productive rearrangements were evaluated, of which 93% represented single clonal rearrangements. Additionally, double productive clonal rearrangements were identified in 76 cases (1.8%), of which 27 (35.5%) displayed discordant IGHV SHM status. Stereotyped B-cell receptor subsets were assigned to 10.6% of sequences, predominantly enriched in unmutated CLL (U-CLL) compared to mutated CLL (M-CLL) (72.8% vs. 22%; p < 0.001). High-risk subsets (#1, #2, #5, #6, #59, #99) accounted for over a half of all stereotyped cases and were enriched in patients with TP53 mutation. Most stereotyped subsets showed preferential or exclusive usage of specific IGHV genes. Integration of cytogenetic data revealed a strong enrichment of del(17p), del(11q), and trisomy 12 within U-CLL, whereas M-CLL was characterized by higher frequency of isolated del(13q). In summary, this study highlights distinct IGHV-IGHD-IGHJ pairing preferences and the heterogenous distribution of stereotyped subsets, revealing biologically meaningful associations with TP53 mutation and cytogenetic profiles.
Spiral volumetric modulated arc therapy enhances peak-to-valley dose contrast for 3D-GRID radiotherapy compared to VMAT and tomotherapy.
Weiwei W, Liu Z, Weizhi L … +3 more , Zhenghuan L, Zhitao D, Chuangao W
BMC Cancer · 2026 Jun · PMID 42343259 · Full text
PURPOSE: Three-dimensional GRID radiotherapy for bulky tumours requires high peak dose while effectively preserving a low-dose intratumoural valley, but this remains challenging with current linac-based techniques. Spira...
PURPOSE: Three-dimensional GRID radiotherapy for bulky tumours requires high peak dose while effectively preserving a low-dose intratumoural valley, but this remains challenging with current linac-based techniques. Spiral volumetric modulated arc therapy (sVMAT) is an integrated delivery technique with synchronized longitudinal couch motion and gantry rotation that generates a spiral/helical beam trajectory, combining key advantages of volumetric modulated arc therapy (VMAT) and helical tomotherapy (TOMO). This study evaluated the dosimetric feasibility of sVMAT for single-fraction 3D-GRID radiotherapy and compared it with conventional VMAT and TOMO. METHODS: Twenty patients with bulky tumours were retrospectively replanned. Cylindrical GRID peak structures with a diameter of 1.0 cm were generated within the GTV using a uniform 0.5-1.0 cm retraction from the GTV boundary and a 1.0 cm clearance from adjacent OARs; cylinders violating these spatial constraints were automatically truncated or excised. A single fraction of 18 Gy was prescribed to the virtual GRID peaks only, while dose to the intervening non-peak GTV valley was minimized as low as reasonably achievable rather than intentionally prescribed. For each patient, three plans were individually generated: VMAT, TOMO and sVMAT. sVMAT plans were created on the NeuRT Aurora platform using DeepPlan with synchronized gantry rotation and bidirectional couch translation. Dosimetric comparisons included gradient index (GI), peak-to-valley dose ratio using two definitions (PVDR=D/D and PVDR=D/D), and OAR sparing. Delivery efficiency was evaluated using monitor units (MU) and beam-on time. RESULTS: sVMAT showed the strongest overall dosimetric performance. sVMAT achieved the steepest dose gradient, with a lower GI than VMAT and TOMO (8.86 ± 2.00 vs. 14.93 ± 5.18 and 15.07 ± 5.97; both p < 0.001). PVDR1 was numerically highest with sVMAT (5.137 ± 2.325), compared with VMAT (4.692 ± 2.213) and TOMO (3.963 ± 2.288). PVDR2 was also highest with sVMAT (2.975 ± 0.470 vs. 2.604 ± 0.464 and 2.575 ± 0.567, respectively). All three techniques met single-fraction OAR constraints without clinically meaningful differences. Both MU and beam-on time for sVMAT were intermediate between VMAT and TOMO, with VMAT showing the lowest values and TOMO the highest; mean beam-on time was 1181 ± 512 s for sVMAT, versus 307 ± 30 s for VMAT and 1896 ± 1224 s for TOMO. CONCLUSION: For cylindrical 3D-GRID radiotherapy, sVMAT provided superior dose confinement and enhanced peak-to-valley dose contrast, while maintaining OAR sparing comparable to VMAT and TOMO. These findings support sVMAT as a promising platform for modern high-contrast 3D-GRID radiotherapy.
Impact of superior mesenteric artery (SMA) adherent tissue in the context of pancreatic head resections- an observational study.
Azizian A, Bernhardt M, Rühlmann F … +6 more , Schild-Suhren S, Crede M, Bösch F, Gärtner D, Ghadimi M, Gaedcke J
BMC Cancer · 2026 Jun · PMID 42343258 · Full text
BACKGROUND: Resection of the periadventitial neurolymphatic tissue around the superior mesenteric artery (SMA) is considered a crucial component of oncologically complete resection in pancreatic head and corpus carcinoma...
BACKGROUND: Resection of the periadventitial neurolymphatic tissue around the superior mesenteric artery (SMA) is considered a crucial component of oncologically complete resection in pancreatic head and corpus carcinomas. However, a substantial proportion of patients experience severe postoperative diarrhea due to resection of the splanchnic nerves within the SMA-adjacent tissue. The aim of the present study was to histopathologically analyze the semi-circumferential periadventitial neurolymphatic tissue surrounding the SMA in pancreatic cancer patients for the presence of malignant cells, in order to evaluate its oncological significance and to determine whether its resection may confer a long-term survival benefit. METHODS: A total of 66 patients with resectable malignant tumours of the pancreas treated at the University Medical Centre Göttingen were prospectively enrolled in this exploratory pilot study. The dissected semi-circumferential tissue around the SMA was processed by complete embedding and serial sectioning and analyzed for the presence of malignant cells. Survival analyses were performed using the Kaplan-Meier method with log-rank testing. RESULTS: In 7.6% of all cases (n = 5), malignant cells were found in the tissue adjacent to the SMA (SMA). In all SMA-patients, histopathological workup showed a pancreatic ductal adenocarcinoma (PDAC). In 80% of SMA-patients (n = 4), an R1 resection margin was confirmed. Patient outcomes (overall survival [OS] and cancer-specific survival [CSS]) were primarily determined by R-status. CONCLUSIONS: Malignant SMA-adjacent tissue involvement was identified in 7.6% of resectable pancreatic head tumours and was exclusive to PDAC. R-status appears to be the dominant determinant of survival. These findings should be considered hypothesis-generating and require validation in larger prospective cohorts.
Machine learning-powered audio-omics processing method as an auxiliary diagnostic approach for advanced nasopharyngeal carcinoma.
You T, Huan F, Luo Z … +5 more , Ma Y, Liu Z, Wu S, Zhang D, Gong L
BMC Cancer · 2026 Jun · PMID 42343241 · Full text
PURPOSE: Nasopharyngeal carcinoma (NPC) is located in the nasopharyngeal mucosa and is a malignant tumour of the head and neck, and approximately 70% of patients have intermediate to advanced disease at the time of initi...
PURPOSE: Nasopharyngeal carcinoma (NPC) is located in the nasopharyngeal mucosa and is a malignant tumour of the head and neck, and approximately 70% of patients have intermediate to advanced disease at the time of initial diagnosis. Epstein-Barr virus (EBV) is closely correlated with etiology and pathogenesis of NPC, serological detection of EBV antibodies is a common screening method for NPC. However, only approximately 60% of NPC cases are associated with EBV infection. Herein, this work aimed to develop and internally evaluate a machine learning-based acoustic signal processing model as a preliminary non-invasive auxiliary diagnostic approach for advanced NPC. MATERIALS AND METHODS: First, we collected the audio files from 359 advanced NPC patients and 304 healthy controls in our hospital from 2022 to 2025. The machine learning-powered Nasopharyngeal Carcinoma Screening (ML-NPCS) system for screening NPC. And the ML-NPCS system is composed of three steps: speech acquisition, acoustic features extraction, and classification decision-making. RESULTS: In the independent test set, ML-NPCS achieved an accuracy of 84.2% (95% CI, 77.1%-89.4%), a sensitivity of 88.9% (95% CI, 79.6%-94.3%), and a specificity of 78.7% (95% CI, 66.9%-87.1%); the independent test set comprised 133 participants (72 patients with advanced NPC and 61 healthy controls). CONCLUSION: The ML-NPCS model demonstrated preliminary potential for distinguishing advanced NPC patients from healthy controls using voice-derived acoustic features. Further prospective evaluation in early-stage disease, symptomatic controls, and external cohorts is required before population-level screening use can be considered.
Remotely delivered resistance training program in adult sarcoma survivors: a pilot study.
Davis LE, Austin SC, Hayden JB … +5 more , Doung YC, Gundle KR, Ryan CW, Stoyles SA, Winters-Stone KM
BMC Cancer · 2026 Jun · PMID 42343234 · Full text
BACKGROUND: Treatment of sarcoma often leads to serious long-term health consequences, including decreased physical functioning. Supervised progressive resistance training (PRT) has been shown to improve physical functio...
BACKGROUND: Treatment of sarcoma often leads to serious long-term health consequences, including decreased physical functioning. Supervised progressive resistance training (PRT) has been shown to improve physical functioning in survivors of carcinomas. We conducted a single-arm, pre-post study to assess the feasibility of remote delivery of a supervised, individualized resistance training program in sarcoma survivors. METHODS: Survivors of extremity sarcomas who were more than 2 years from final sarcoma treatment with no evidence of recurrent disease were eligible. Participants followed a PRT program of exercises that were tailored to each patient's exercise capacity. Each week for 12 weeks, participants engaged in one unsupervised session and one supervised session delivered remotely by videoconferencing. Feasibility was measured by retention rate, session completion rate, and safety. Changes in self-reported physical function, health-related quality of life, and fatigue were assessed with patient reported outcome measures, while objective physical function was assessed by the short physical performance battery (SPPB). The COVID pandemic emerged during the accrual period, requiring protocol modification to objective assessments. RESULTS: Ten participants aged 27-69 enrolled in the study; the majority had a lower extremity tumor (70%) and all participants had undergone surgery and chemotherapy for sarcoma. Nine participants completed end-of-intervention assessments (90% retention). Adherence to twice-weekly exercise sessions was 86%. Significant improvements in pre-post 36-Item Short Form Survey (SF-36) physical component summary score showed a moderate-to-large effect size (Cohen's d > 0.50). Self-reported fatigue also improved (FACIT-Fatigue 9 point improvement, d = 0.61, p = 0.06). SPPB data was incomplete due to COVID-related study disruption of in-person testing. CONCLUSION: Remote delivery of PRT was feasible and safe in sarcoma survivors and improved several domains of health-related quality of life. A larger, definitive exercise trial could inform specific exercise prescription(s) for sarcoma patients, who currently have little evidence-based exercise guidance. TRIAL REGISTRATION: Registered with ClinicalTrials.gov (NCT04247425) on 2020-01-24.
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