Asian Pacific Journal Of Cancer Prevention[JOURNAL]
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200 papers
Pathways to Care, Out- of- Pocket Expenditure, and Associated Factors Among Breast Cancer Patients in Kerala, India: A Hospital-Based Cross- Sectional Study.
Kumar MS, Mini M, Olickal JJ … +3 more , Muttath G, Pavithran K, Thankappan KR
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945961 · Publisher ↗
BACKGROUND: Breast cancer, the most common cancer among women in India, poses a significant public health challenge. However, data on pathways to care and out-of-pocket expenditure (OOPE) among breast cancer patients are...
BACKGROUND: Breast cancer, the most common cancer among women in India, poses a significant public health challenge. However, data on pathways to care and out-of-pocket expenditure (OOPE) among breast cancer patients are limited in India. Kerala, despite its high literacy rates and excellent healthcare access, continues to experience significant delays in cancer care, making it an important setting for this study. Therefore, we aimed to study the pathways to care, estimate OOPE, and identify factors associated with OOPE among breast cancer patients in the Indian state of Kerala. METHODS: We conducted a hospital-based cross-sectional study among 216 breast cancer patients (mean age: 57 years) from one private and one public tertiary cancer care centre (TCCC) in Kerala. A structured interview schedule was used to collect socio-demographic, clinical, and expenditure-related data. Descriptive statistics, Mann-Whitney U tests, and median regression analysis were performed. The duration of the study was from October 2024 to May 2025. RESULTS: Most participants were diagnosed at early stages (n=152, 70.4%), and 42.5% (n=92) had health insurance coverage. In the study, 168 (77.8%: 95% CI: 71.6-83.1%) participants followed indirect pathways, initially consulting traditional healers (25, 11.57%) or other healthcare providers (143, 66.20%) before reaching TCCCs. OOPE was significantly higher among patients treated in private TCCCs compared to those in public TCCCs (median INR 2,26,395 vs 1,93,290; p = 0.015). Residence ≥82 km from the centre (coefficient:28470; p=0.044), treatment at private TCCC (coefficient:50010; p=0.001) and indirect pathway to TCCC (coefficient:46180; p=0.015) were significantly associated with higher OOPE. CONCLUSION: The majority of breast cancer patients in Kerala accessed tertiary care through indirect pathways, with substantially higher out-of-pocket expenditure (OOPE) among those treated in private centres. Targeted policy interventions, such as strengthening primary care linkages and improving referral coordination, are essential to reduce delays in care pathways and alleviate the financial burden on breast cancer patients.
The Non-Coding Code: Silent Regulators of MEG3 and Let-7i-3p/5p in the Progression of Acute Lymphoblastic Leukemia.
Shanyoor GJ, Kadhim AA, Al-Khafaji HMAH … +2 more , Al-Saedi MKA, Mohammed MQ
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945960 · Publisher ↗
OBJECTIVE: Acute lymphoblastic leukemia (ALL) is one of the most common malignancies worldwide. The long non-coding RNA MEG3 functions as a tumor suppressor in several cancers, potentially influencing gene expression thr...
OBJECTIVE: Acute lymphoblastic leukemia (ALL) is one of the most common malignancies worldwide. The long non-coding RNA MEG3 functions as a tumor suppressor in several cancers, potentially influencing gene expression through transcriptional, translational, and epigenetic mechanisms. let-7i plays a role in leukemia progression. This study aimed to evaluate MEG3 gene expression in adult ALL patients and investigate its possible regulatory interaction with let-7i-3p and let-7i-5p. METHODS: A total of 83 blood samples, classified in a case-control study design, were collected from newly diagnosed ALL patients (n=53) and healthy controls (n=30). Hematological parameters were estimated using a CBC analyzer. RNA was extracted and reverse-transcribed into cDNA. Quantitative real-time PCR with gene-specific primers was employed to assess MEG3 and let-7i-3p/5p expression levels. RESULTS: ALL patients and healthy controls were matched for age (29.0±9.9 vs. 28.6±7.7 years, p=0.862) and sex (p=0.299). Hematological analysis revealed significant cytopenias in patients, including reduced Hemoglobin (Hb) (8.60±1.75 vs. 14.72±2.51 g/dL; p<0.001), white blood cells (WBCs) (4.91±2.84 vs. 7.96±1.57×109/L; p<0.001), and platelets (PLT) (156.96 ± 35.64 vs. 269.93±55.35×109/L; p<0.001). Gene expression analysis revealed that MEG3 was significantly downregulated in ALL patients (fold change 0.535±0.273; p=0.001), whereas Let-7i-3p/5p were upregulated (fold changes 1.875 ± 0.732 and 1.857 ± 0.891: p=0.003 and 0.004, respectively), indicating a different dysregulation pattern associated with adult ALL. CONCLUSION: This study demonstrates that adult ALL patients exhibit hematological abnormalities including anemia, leukopenia, and thrombocytopenia. Molecular analysis revealed a significant downregulation of lncRNA MEG3, alongside upregulation of let-7i-3p/5p, suggesting their potential involvement in leukemogenesis. These findings highlight the diagnostic and possibly prognostic relevance of MEG3 and let-7i in adult ALL and provide a basis for further investigation into their mechanistic roles and therapeutic targeting.
An Integrative Approach to Lung Cancer Therapy: Linking the TGF-β (+869 C/T) Polymorphism to a Structurally Validated Natural Inhibitor.
Abdulsahib NB, Hameed MA, Yousif RH … +1 more , Jabir MS
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945959 · Publisher ↗
OBJECTIVE: This study aimed to create a genetic and clinical roadmap for the TGF-β pathway in an Iraqi population, focusing on the TGF-β1 (+869 C/T) polymorphism. METHODS: A structure-guided approach was used to identify...
OBJECTIVE: This study aimed to create a genetic and clinical roadmap for the TGF-β pathway in an Iraqi population, focusing on the TGF-β1 (+869 C/T) polymorphism. METHODS: A structure-guided approach was used to identify a natural compound, quercetin, as a potential inhibitor of its primary receptor, ALK5. The clinical aspect evaluated the biochemical profile of each patient by measuring serum levels of TGF-β and IL-17, while assessing the genetic predisposition of each individual using ARMS-PCR to genotype the TGF-β1 (+869C/T) polymorphism. Following the evaluation of clinical findings, a molecular docking study was conducted to investigate how quercetin interacts with the ALK5 kinase domain (PDB: 1VJY). RESULT: The study demonstrated a two-fold signature of risk among the patients. First, the levels of serum TGF-β and IL-17 were significantly elevated (P < 0.05) in lung cancer patients compared to healthy individuals. Second, patients exhibited a genetic predisposition to lung cancer-specifically, those with the "TT" genotype had a higher risk of developing the disease than individuals with the protective "CC" genotype. Furthermore, the model illustrated that quercetin forms key hydrogen bonds with the ALK5 kinase hinge residues Glu245 and Lys232, which are essential for inhibitory binding. CONCLUSION: This study established a strong connection between the activity of the TGF-β pathway, the +869C/T polymorphism, and lung cancer susceptibility in the Iraqi population. Additionally, it provided conclusive structural evidence supporting quercetin as a highly promising natural inhibitor of ALK5.
Labor Costs in Floriculture: The Link Between Pesticide Use and Occupational Cancer Risk.
Gomez-Ramirez N, Lis-Gutierrez JP
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945958 · Publisher ↗
OBJECTIVE: This article examines the financial impact of occupational cancer resulting from pesticide exposure and other carcinogenic agents in the floriculture sector of Cundinamarca, Colombia. It begins with a literatu...
OBJECTIVE: This article examines the financial impact of occupational cancer resulting from pesticide exposure and other carcinogenic agents in the floriculture sector of Cundinamarca, Colombia. It begins with a literature review covering (the) industry context, key occupational health factors, labor costs, and human capital. Based on this review, the study identifies gaps in the economic analysis of work-related illnesses such as cancer, particularly regarding hidden costs. Method: Using a quantitative explanatory approach, the research applies a multiple linear regression model to a dataset of 7,300 observations, analyzing absenteeism, labor costs, and worked days in relation to productivity. RESULTS: The findings show a (59%) drop in productivity per diagnosed worker, leading to increased costs. The model yields an R² of (0.876), statistically supporting the hypothesis. CONCLUSION: The study confirms the existence of hidden costs such as absenteeism, employee replacement, and medical expenses that are not reflected in financial statements.
Key Determinants Shaping Cancer Prevention Policy Governance in Iran.
Ghareh Beygi M, Isanedjad SM
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945957 · Publisher ↗
OBJECTIVE: Cancer prevention policy (CPP) plays a vital role in reducing the cancer burden, but it poses considerable challenges in health systems with limited resources and disparities in service access. Understanding t...
OBJECTIVE: Cancer prevention policy (CPP) plays a vital role in reducing the cancer burden, but it poses considerable challenges in health systems with limited resources and disparities in service access. Understanding the drivers, processes, and barriers influencing CPP governance is critical to designing equitable and effective interventions, particularly in low- and middle-income countries, such as Iran. METHODS: This qualitative study employed a case study approach to investigate the complex social and systemic factors shaping cancer prevention policy (CPP) governance in Iran. Data were collected through 25 semi-structured interviews with key stakeholders and an extensive review of 47 relevant documents. Participants were purposively selected from government agencies, academic institutions, NGOs, and cancer specialty centers. Data analysis combined deductive and inductive content analysis, facilitated by ATLAS.ti, to identify themes related to actors, processes, and contextual influences. RESULTS: Findings revealed that CPP governance is influenced by a network of domestically and internationally trained specialists, institutional leadership from the Ministry of Health, academic bodies, and civil society. Political, economic, and socio-cultural contexts significantly affected policy priorities and resource allocation. Challenges included insufficient needs assessments, fragmented stakeholder collaboration, and tensions between the growth of specialization and equitable access. Public demand for cancer prevention services remained low due to limited awareness and accessibility. Workforce shortages and cost constraints further complicated program implementation. CONCLUSION: Successful CPP governance requires inclusive participation, evidence-informed decision-making, and the adaptive integration of international expertise with local realities.
DNA Alterations in the Upstream Region of Exon 1 of OSBPL10 in Northern Thai Patients with Diffuse Large B-Cell Lymphoma.
Yimpak P, Tantiworawit A, Rattanathammethee T … +3 more , Daroontum T, Aungsuchawan S, Bumroongkit K
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945956 · Publisher ↗
BACKGROUND: Lymphoma is the most common hematologic malignancy in Thailand, with diffuse large B-cell lymphoma (DLBCL) being the predominant subtype. Early prognostic indicators are essential for guiding clinical decisio...
BACKGROUND: Lymphoma is the most common hematologic malignancy in Thailand, with diffuse large B-cell lymphoma (DLBCL) being the predominant subtype. Early prognostic indicators are essential for guiding clinical decisions. Genetic alterations, particularly in regulatory regions, may serve as potential biomarkers. This study investigated sequence alterations upstream of exon 1 of the OSBPL10 gene and their clinical relevance in a Northern Thai DLBCL population. METHODS: Eighty-five DLBCL patients residing in Northern Thailand were genotyped to assess sequence alterations in the upstream regulatory region of OSBPL10. RESULTS: Two previously reported single nucleotide polymorphisms (SNPs)-rs76150980 (G>C) and rs62244394 (C>G) and two additional alterations not listed in public SNP databases were identified. The heterozygous GC genotype of rs76150980 and the CG genotype of rs62244394 were significantly associated with a reduced risk of extranodal involvement (OR = 0.229 and 0.196, respectively). While no significant difference in overall survival (OS) was observed, individuals carrying the CG/GG genotypes of rs62244394 had significantly longer progression-free survival (PFS) compared to homozygous CC individuals (median PFS: 39.7 months, 95% CI: 30.4-49.0 vs. 17.3 months, 95% CI: 12.4-22.2; p = 0.031). Additionally, two upstream substitutions-C>T at chr3:31,981,252 and G>T at chr3:31,981,259-showed genotype frequencies of CC (87.1%), CT (3.5%), TT (9.4%) and GG (89.4%), GT (2.4%), TT (8.2%), respectively. At the allele level, the T allele at both positions was associated with increased International Prognostic Index risk (OR = 3.615 and 4.717), while the T allele at position 31,981,259 was associated with lower odds of the aggressive non-GCB subtype (OR = 0.324). No significant OS or PFS differences were observed for these variants. CONCLUSION: Variations upstream of OSBPL10 were associated with extranodal involvement and selected clinical parameters in DLBCL, highlighting the prognostic potential of regulatory-region SNPs and the importance of population-specific genetic diversity in lymphoma research.
A Network Meta-Analysis Comparing the Efficacy of Lenvatinib, Atezolizumab plus Bevacizumab, and Sorafenib in the Treatment of Unresectable Hepatocellular Carcinoma.
Remitha NPSI, Sasmana IGAP, Kusuma IKWA … +4 more , Mamangdean CT, Supadmanaba IGP, Sindhughosa DA, Mariadi IK
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945955 · Publisher ↗
INTRODUCTION: Globally, hepatocellular carcinoma (HCC) ranks as the third most common cause of cancer-related death. The five-year overall survival (OS) rate for patients with unresectable HCC is only 12%. Currently, sys...
INTRODUCTION: Globally, hepatocellular carcinoma (HCC) ranks as the third most common cause of cancer-related death. The five-year overall survival (OS) rate for patients with unresectable HCC is only 12%. Currently, systemic therapies have become the primary treatment options for unresectable hepatocellular carcinoma. Studies comparing the efficacy of first-line treatments including lenvatinib, atezolizumab plus bevacizumab, and sorafenib have shown inconsistent results. There remains a need for updated comparative evidence on cross-mechanism therapy regimens for unresectable disease, as existing findings are still not completely clear. This network meta-analysis aims to provide clearer insights into which treatment offers greater efficacy for patients with unresectable HCC. METHODS: This study was conducted following the 2022 PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Literature searches were performed using PubMed, ScienceDirect, Google Scholar, the Cochrane Library, SpringerLink, and EBSCO to gather studies comparing lenvatinib, atezolizumab plus bevacizumab, and sorafenib for the management of unresectable HCC. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Overall survival (OS) was analyzed using R statistical software (version 4.4.0). RESULTS: Eleven studies reporting overall survival (OS) were included in the OS analysis comparing lenvatinib, atezolizumab plus bevacizumab, and sorafenib in the treatment of unresectable HCC. The network meta-analysis showed no significant OS differences between atezolizumab plus bevacizumab and lenvatinib (HR: 0.98; 95% CI: 0.24-4.10) or sorafenib (HR: 1.4; 95% CI: 0.21-9.87). Furthermore, there was no significant difference in OS between lenvatinib and sorafenib (HR: 1.41; 95% CI: 0.38-5.14). Based on the SUCRA plot in this meta-analysis, atezolizumab plus bevacizumab showed the highest probability of being ranked first among the three therapies. Lenvatinib had the highest probability of being ranked second, while sorafenib was more likely to be ranked third. CONCLUSION: Atezolizumab plus bevacizumab, lenvatinib, and sorafenib demonstrated similar therapeutic efficacy based on overall survival. Although the hazard ratios (HRs) were not statistically significant, the SUCRA ranking suggested a clinical trend favoring atezolizumab plus bevacizumab.
Pesticide Exposure and the Risk of Ovarian Cancer among Postmenopausal Women in Rural Punjab, India.
Samtani R, Sharma N, M S … +1 more , Deb R
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945954 · Publisher ↗
OBJECTIVE: Punjab, a state in Northern India, has reported an alarming rise in cancer cases, which has been linked to the extensive use of pesticides in agriculture. Ovarian cancer, often diagnosed at late stages, lacks...
OBJECTIVE: Punjab, a state in Northern India, has reported an alarming rise in cancer cases, which has been linked to the extensive use of pesticides in agriculture. Ovarian cancer, often diagnosed at late stages, lacks systematic screening within the population under the national program. The present study aimed to screen postmenopausal women for ovarian cancer and to evaluate pesticide exposure as a potential risk factor. METHODS: A total of 1,327 postmenopausal women, residing in 48 villages for at least ten years, were screened annually for CA-125 levels. Women with CA-125 levels >35 U/mL were referred for transvaginal ultrasound. Demographic data were collected through a semi-structured questionnaire. For pesticide profiling, a case-control design was adopted. Blood samples were collected and analyzed for organochlorine and organophosphate residues using gas chromatography. RESULTS: Among 1,327 postmenopausal women screened, 30 (2.3%) had elevated CA-125 levels (>35 U/ml); no ovarian cancers were detected during follow-up imaging and specialist evaluation. In the case-control analysis (24 cases; 42 controls), detectable pesticide residues were associated with a crude 6.7-fold increased odds of ovarian cancer (95% CI: 1.4-32.7). After multivariable adjustment for parity and education, Ethion (aOR = 6.29, 95% CI: 1.37-28.8) and DDE (aOR = 6.39, 95% CI: 1.35-30.3) remained associated, though confidence intervals were wide, reflecting small sample size. In agricultural participants, chlorpyrifos detections were more frequent among controls (OR = 0.12, p = 0.008). CONCLUSION: Although no ovarian cancer cases were detected during screening, the study highlights the prevalence of pesticide exposure among women in Punjab's Malwa region and its possible association with ovarian cancer risk. Routine population screening using CA-125 is not supported in light of current evidence and guidelines. Instead, strengthening diagnostic and registry systems in rural areas, reducing harmful exposures through safer agricultural practices, and conducting well-powered prospective studies with repeated exposure assessments are essential to clarify risks and inform targeted strategies in high-exposure settings.
Protein Expression of MAGEB2 in Normal Oral Mucosa, Oral Epithelial Dysplasia, and Oral Squamous Cell Carcinoma and Its Association with Clinicopathological Parameters.
Hasyim NA, Manzoor S, Wong GR … +3 more , Zaini ZM, Zain RB, Ramanathan A
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945953 · Publisher ↗
OBJECTIVE: To compare the expression of the MAGEB2 antibody in normal oral mucosa (NOM), oral epithelial dysplasia (OED), and oral squamous cell carcinoma (OSCC) patients, and to evaluate the association of MAGEB2 expres...
OBJECTIVE: To compare the expression of the MAGEB2 antibody in normal oral mucosa (NOM), oral epithelial dysplasia (OED), and oral squamous cell carcinoma (OSCC) patients, and to evaluate the association of MAGEB2 expression with clinicopathological characteristics and overall survival in OSCC patients. METHODS: Immunohistochemical staining with the MAGEB2 antibody was performed on 20 NOM, 40 OED, and 60 OSCC samples. The Kruskal-Wallis test was used to compare MAGEB2 expression between NOM, OED, and OSCC tissues. The diagnostic accuracy of MAGEB2 in distinguishing NOM, OED, and OSCC tissues, and the prognostic accuracy of MAGEB2 in relation to socio-demographic and clinicopathological characteristics, were determined using receiver operating characteristic (ROC) curve analysis. Kaplan-Meier survival analysis was used to determine the association between MAGEB2 expression and overall survival (OS) in OSCC patients. RESULT: MAGEB2 expression was observed in 61.7% of OSCC, 27.5% of OED, and 20.0% of NOM tissues. MAGEB2 expression was significantly higher in OSCC compared to OED and NOM tissues (p < 0.05). However, no significant difference was found between MAGEB2 expression in NOM and OED. MAGEB2 was able to distinguish OSCC from OED tissue with 63.3% sensitivity and 72.5% specificity. A significant association between MAGEB2 expression and age was observed, whereas no associations were found with other socio-demographic or clinicopathological characteristics, or with overall survival (OS) in OSCC patients. However, a trend toward better OS was noted in OSCC patients with high MAGEB2 expression. CONCLUSION: MAGEB2 is a potential biomarker in cancer whereby its protein expression is seen highest in oral cancer.
Therapeutic Targeting of S100A2 Enhances Chemotherapy Efficacy in vitro in Oral Cancer.
Kumar M, Prasad CP, Chopra C … +2 more , Thapa S, Chauhan SS
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945952 · Publisher ↗
OBJECTIVE: Despite advancements in multimodal therapies, oral squamous cell carcinoma (OSCC) continues to exhibit poor clinical outcomes, particularly in advanced and recurrent cases. Recent studies have identified the c...
OBJECTIVE: Despite advancements in multimodal therapies, oral squamous cell carcinoma (OSCC) continues to exhibit poor clinical outcomes, particularly in advanced and recurrent cases. Recent studies have identified the calcium-binding protein S100A2 as a critical mediator of OSCC progression and resistance to therapy. Our prior work demonstrated that cytoplasmic overexpression of S100A2 in oral cancer patients is associated with tumor recurrence and reduced survival. Given its reported role in promoting epithelial-to-mesenchymal transition (EMT), cellular proliferation, and invasiveness, we investigated the in vitro functional impact of S100A2 inhibition in OSCC. METHODS: Silencing S100A2 significantly impaired tumor cell proliferation and enhanced apoptotic cell death, as evidenced by Annexin V and caspase-3 activation. RESULTS: Notably, S100A2-deficient OSCC cells exhibited increased sensitivity to chemotherapeutic agents, including carboplatin, 5-fluorouracil, paclitaxel, and doxorubicin, through mitochondrial apoptotic pathways. CONCLUSION: These findings position S100A2 as a potential therapeutic target for overcoming drug resistance and improving treatment efficacy in OSCC. Further mechanistic studies and in vivo validation are warranted to explore its translational relevance in clinical oncology.
Molecular Insights into Identification of Natural AKT1/mTOR Signaling Inhibitors from Veratrum Viride-Derived Alkaloids for Breast Cancer Treatment: A Comprehensive Analysis Using Network Pharmacology, Molecular Docking, and Molecular Dynamics.
Eswaran AP, Jayaraman S, Natarajan SR … +1 more , Veeraraghavan VP
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945951 · Publisher ↗
OBJECTIVE: Breast cancer (BC) is a complex illness that affects millions of women globally. As its incidence rises, new treatment strategies are needed. Veratrum viride, a traditional medicinal herb, is known for its the...
OBJECTIVE: Breast cancer (BC) is a complex illness that affects millions of women globally. As its incidence rises, new treatment strategies are needed. Veratrum viride, a traditional medicinal herb, is known for its therapeutic potential, yet its molecular mechanism of action against BC remains unclear. The purpose of this preliminary investigation is to assess V. viride's anti-breast cancer potential by identifying its active compounds and using bioinformatics techniques to clarify their multi-target mechanisms. MATERIALS & METHODS: Initially, eleven compounds from V. viride were examined for pharmacokinetic and toxicity characteristics. Network pharmacology was used to predict and integrate compound-target interactions with genes linked to BC. Topological and drug-protein interaction (DPI) analyses were employed to identify important hub genes. KEGG pathway enrichment and Gene Ontology (GO) analyses were conducted to validate functional relevance. Target-compound interactions were verified through molecular docking and molecular dynamics simulation analysis. RESULTS: Using ADMET profiling analysis and drug-likeness properties, three alkaloids namely jervine, veratramine, and rubijervine were identified as promising drug candidates. We identified six important hub genes: MTOR, INSR, FOXO1, FOXO3, RPS6KB1, and AKT1. According to GO and KEGG analyses, the compounds targeted pathways important in the regulation of BC, including AMPK, HIF-1, FOXO, and PI3K/AKT/mTOR. Moreover, jervine demonstrated robust binding stability and affinity with core targets in molecular docking and dynamics simulations. CONCLUSION: This work provides the first evidence that alkaloids derived from V. viride, especially jervine, may act as multi-target inhibitors against BC. However, further experimental validation is required to confirm their therapeutic efficacy.
Tumor Budding Significance as a Biomarker for Clinicopathology and Prognostic Evaluation in Gynecological Malignancy: A Bayesian Meta-Analysis.
Wiguna IGWW, Armerinayanti NW, Mamangdean CT … +7 more , Mahayana NPK, Putri PMWS, Tungga KMK, Simanjuntak AMT, Wijayanto FPS, Khanaruksombat S, Winata IGS
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945950 · Publisher ↗
OBJECTIVE: Tumor budding (TB) has been recommended as a marker for prognosis and therapeutic decision-making in various types of cancer, yet it has not been comprehensively studied in gynecological malignancies. This stu...
OBJECTIVE: Tumor budding (TB) has been recommended as a marker for prognosis and therapeutic decision-making in various types of cancer, yet it has not been comprehensively studied in gynecological malignancies. This study aimed to evaluate the relationship between TB and clinicopathological features, as well as prognosis, in patients with gynecological malignancies, using a Bayesian meta-analysis design. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 protocol was followed. A systematic literature search was conducted using PubMed, ScienceDirect, and Cochrane databases. A meta-analysis was performed to assess the relationship between TB and clinicopathological parameters using odds ratios (ORs). Prognostic outcomes were analyzed using hazard ratios (HRs). Specific Bayesian priors were applied to each variable. Data analysis was conducted using R (version 4.4.0). RESULTS: Eighteen cohort studies (n = 3,320) involving patients with cervical and endometrial cancer were included. Bayesian meta-analysis showed that TB was significantly associated with clinicopathological parameters, specifically cancer stage (OR=2.91; 95%CrI: 1.86-4.41; prediction interval (PI) OR=2.92; 95%CrI: 0.82-9.92; τ2=0.53), grading (OR=5.00; 95%CrI: 2.83-8.76; PI OR=5.00; 95% CrI: 0.89-27.87; τ2=0.77), nodal involvement (OR=3.63; 95%CrI: 2.41-5.47; PI OR=3.63; 95%CrI: 0.85-15.52; τ2=0.66), and lymphovascular invasion (LVI) (OR=4.22; 95%CrI: 2.52-6.92; PI OR=4.22; 95%CrI: 0.63-27.80; τ2=0.89). Overall survival (OS) showed an HR of 2.14 (95%CrI: 1.27-3.63; PI HR=2.14; 95%CrI: 0.83-5.58; τ2=0.25) and DFS showed an HR of 1.20 (95%CrI: 0.77-1.59; PI HR=1.21; 95%CrI: 0.14-2.20; τ2=0.42). CONCLUSION: Tumor budding is significantly associated with clinicopathological features and prognosis in patients with gynecological malignancies.
Association of Green Tea Consumption and the Risk of Liver Cancer Incidence among Japanese Adults.
Funabashi O, Sakaniwa R, Kawasaki R … +2 more , Tamakoshi A, Iso H
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945949 · Publisher ↗
BACKGROUND: The association between green tea consumption and the risk of liver cancer has been reported inconsistently. This study aimed to investigate this association in a large, prospective cohort study of Japanese a...
BACKGROUND: The association between green tea consumption and the risk of liver cancer has been reported inconsistently. This study aimed to investigate this association in a large, prospective cohort study of Japanese adults. Methods: The Japan Collaborative Cohort (JACC) Study included 41,999 participants (18,205 men and 23794 women) aged 40-79 years, free from liver cancer at baseline between 1988 and 1990. Validated self-administered questionnaires were used to assess individual socio-demographics, medical history, and lifestyles. Participants were then followed for liver cancer incidence until the end of 2009. Cox proportional hazard models were utilized to calculate hazard ratios (HRs) with 95% confidence intervals (95% CIs) of liver cancer based on the frequency of green tea consumption of <1 cup (reference), 2-4, 5-6, and ≥7 cups/day, after adjusting for potential confounding factors, including age, sex, study area, education, histories of diabetes, liver diseases, and gallbladder disease, body mass index, drinking status, smoking status, coffee consumption, sports participation, and walking. Major confounders, including coffee consumption, drinking status, and a history of liver disease, were further stratified in the analysis. Population-attributable fractions (PAFs) of liver cancer was also calculated based on green tea consumption. RESULTS: Green tea consumption was associated with a trend of lower risk of liver cancer with the multivariable HR (95% CI) of 0.87 (0.61-1.23) for 2-4 cups/day, 0.87 (0.61-1.25) for 5-6 cups/day, and 0.61 (0.40-0.95) for ≥7 cups/day, compared to <1 cup/day (p for trend= 0.029). The inverse association was statistically significant for men, people without a history of liver diseases other than cancer, and current drinkers. The multivariable PAF (95%CI) for ≥7 cups/day was 7.1% (0.9-11.4). CONCLUSION: Green tea consumption was associated with a lower risk of liver cancer in Japanese adults in a dose-response manner, ranging from <1 cup/day to ≥7 cups/day.
Prediction of Outcomes of Brain Irradiation in Correlation with Molecular Subtypes in Patients with Metastatic Breast Cancer.
Sohaib A, Alhefny M, Amin MT … +1 more , Mekhail Y
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945948 · Publisher ↗
BACKGROUND: Brain metastases (BM) are a major complication in metastatic breast cancer, especially in HER2-positive and triple-negative subtypes. Despite advances in systemic therapy, BM remains associated with a poor pr...
BACKGROUND: Brain metastases (BM) are a major complication in metastatic breast cancer, especially in HER2-positive and triple-negative subtypes. Despite advances in systemic therapy, BM remains associated with a poor prognosis and often requires radiotherapy. This study evaluates the outcomes of brain irradiation across subtypes and proposes a prognostic scoring system to guide treatment. METHODS: This retrospective study analyzed data from 348 breast cancer patients with BM to develop a prognostic scoring system for radiotherapy decisions. The data included molecular subtypes, number of brain lesions, and survival outcomes. Kaplan-Meier and Cox proportional hazards models were used to identify prognostic factors. The scoring system, based on the significance of predictors, was compared with physician-selected radiotherapy techniques to assess its potential for optimizing care. RESULTS: Luminal breast cancer was most prevalent (42.6%), followed by HER2-positive and triple-negative (19% each). Median BM onset was 23 months; headache was the most common symptom (48%). HER2-positive and triple-negative patients developed metastases earlier than luminal and triple-positive (P=0.001). Survival was better for luminal and triple-positive, poorer for HER2-positive and triple-negative. Patients with fewer than five brain lesions had higher survival rates (P=0.001). The scoring system incorporated molecular subtype, lesion burden, and patient characteristics. Scores above 3.5 predicted worse survival, with higher scores strongly linked to poorer outcomes (P=0.001). CONCLUSION: This study identifies key prognostic factors influencing survival in breast cancer patients with BM and proposes a scoring system to guide radiotherapy decisions. Molecular subtypes, metastatic burden, and clinical characteristics significantly affect outcomes, with HER2-positive and triple-negative subtypes showing the poorest survival. The system provides a structured approach for treatment selection, though further validation is needed to ensure its accuracy and clinical utility in personalized radiotherapy planning.
The Prognostic Impact of Supraclavicular Lymph Node Metastases in Lung Cancer: Do We Need a Modification of the Current Staging System?
Sohaib A, Sedeek HF, El Madawie M … +3 more , Elabd NS, Abouelhassan U, Alhefny M
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945947 · Publisher ↗
BACKGROUND: The management of Stage IIIB non-small-cell lung cancer (NSCLC) is complex. The current staging system does not distinguish between ipsilateral and contralateral supraclavicular lymph node involvement, althou...
BACKGROUND: The management of Stage IIIB non-small-cell lung cancer (NSCLC) is complex. The current staging system does not distinguish between ipsilateral and contralateral supraclavicular lymph node involvement, although this distinction may impact prognosis. This study investigates the differences in prognosis between these two presentations of N3 disease. METHODS: This study presents a retrospective analysis of 113 patients diagnosed with Stage IIIB NSCLC who had supraclavicular lymph node metastases and underwent chemoradiation therapy. Patients were categorized based on whether their supraclavicular involvement was ipsilateral or contralateral to the primary lung tumor. Survival outcomes were calculated and correlated with various factors. RESULTS: Patients with ipsilateral supraclavicular metastases had a median progression-free survival of 12 months, compared to 9 months for those with contralateral involvement. The median overall survival for the two groups was 17 months and 14 months, respectively. Poorer survival outcomes were associated with contralateral nodal involvement, older age, poor performance status, and exclusive radiotherapy treatment. CONCLUSION: Contralateral supraclavicular metastases are associated with a worse prognosis compared to ipsilateral involvement in Stage IIIB NSCLC. These findings suggest a need to reevaluate their classification within current staging systems and to consider systemic treatment for these high-risk patients. Phase III randomized controlled trials are needed to validate this observation.
Knowledge, Attitudes and Practices among Cancer Patients and Their Caregivers: Insights from a Cross-Sectional Study.
Saini SK, Srivastava S, Sarvaiya J … +1 more , Sharma M
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945946 · Publisher ↗
OBJECTIVE: To evaluate the levels of knowledge, attitudes, and practices (KAP) regarding cancer among patients and their caregivers, and to determine how these factors influence health-seeking behavior and early detectio...
OBJECTIVE: To evaluate the levels of knowledge, attitudes, and practices (KAP) regarding cancer among patients and their caregivers, and to determine how these factors influence health-seeking behavior and early detection practices. Additionally, the study aimed to identify key gaps and barriers that may hinder effective cancer prevention and timely treatment. METHODS: A cross-sectional study was conducted with 140 participants, using a structured, pretested questionnaire. KAP scores were analyzed using descriptive statistics, t-tests, and regression analysis to determine the predictors of health behaviors. Correlation analysis was used to assess the interrelationships among KAP components. RESULT: Moderate levels of knowledge (mean score: 62.2 ± 9.7) and attitudes (71.1 ± 8.0) were observed, with notable gaps in awareness of risk factors and early detection methods. Practice scores (82.6 ± 9.5) were influenced by both attitude and knowledge levels, with knowledge showing the strongest correlation with practice (r = 0.51, p < 0.001). Regression analysis identified education level (β = 0.33, p < 0.001) and economic status (β = 0.23, p = 0.03) as significant predictors of KAP scores. CONCLUSION: Knowledge and attitudes are key determinants of cancer-related health behaviors. Enhancing awareness and fostering positive attitudes through targeted educational interventions can improve early detection, treatment adherence, and preventive practices. Strengthening public health initiatives, addressing stigma, and improving access to healthcare are critical for optimizing cancer outcomes and promoting sustainable behavioral change.
The Combined Effects of Eleutherine bulbosa Ethanol Extract and Tamoxifen On Cox-2 Levels in a BaLB/c Mouse Breast Cancer Model.
Andriani D, Usman AN, Yulianty R … +2 more , Stang S, Aryandy A
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945945 · Publisher ↗
OBJECTIVE: Chronic inflammation and oxidative stress play important roles in breast cancer progression. Cyclooxygenase-2 (COX-2) is a major proinflammatory enzyme that is often overexpressed in tumor cells. Eleutherine b...
OBJECTIVE: Chronic inflammation and oxidative stress play important roles in breast cancer progression. Cyclooxygenase-2 (COX-2) is a major proinflammatory enzyme that is often overexpressed in tumor cells. Eleutherine bulbosa (Dayak onion) is a traditional Indonesian medicinal plant with antioxidant and anti-inflammatory properties. This study aimed to evaluate the effect of a combination of ethanol extract of E. bulbosa and tamoxifen on COX-2 levels in a 7,12-dimethylbenz[a]anthracene (DMBA)-induced BALB/c mouse model. METHODS: A total of thirty-six 8-10-week-old female BALB/c mice were randomly divided into six groups: a negative control, a positive control (DMBA alone), and four treatment groups that received E. bulbosa extract (180 mg/kg BW), tamoxifen (10 mg/kg BW), or their combination for 14 days. COX-2 levels were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analysis included the Shapiro-Wilk test (normality), Levene's test (homogeneity), Brown-Forsythe test, and Games-Howell post hoc test. RESULT: All treatment groups showed a decrease in COX-2 levels compared to the positive control. The combination group (tamoxifen + E. bulbosa) exhibited the lowest COX-2 levels (3.86 ng/mL), close to the value observed in the negative control group (3.07 ng/mL), indicating a synergistic effect between the two agents. CONCLUSION: The combination of tamoxifen and E. bulbosa ethanol extract significantly reduced COX-2 levels in DMBA-induced breast cancer models. These results suggest the potential of this combination as an effective adjuvant therapy. Further studies are needed to confirm the underlying molecular mechanisms and to evaluate its toxicity profile.
In Silico Identification of Hydroxyxanthone Derivatives as CDK2/EGFR Dual Inhibitor for Colorectal Cancer Treatment.
Hermawan F, Puspitasari AD, Marlina LA … +4 more , Yudha E, Fatmasari N, Hastuti LP, Vifta RL
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945944 · Publisher ↗
OBJECTIVE: Both CDK2 (cyclin-dependent kinase 2) and EGFR (epidermal growth factor receptor) play significant roles in the development and progression of colorectal cancer. In vitro studies of several hydroxyxanthone der...
OBJECTIVE: Both CDK2 (cyclin-dependent kinase 2) and EGFR (epidermal growth factor receptor) play significant roles in the development and progression of colorectal cancer. In vitro studies of several hydroxyxanthone derivatives for the treatment of WiDr cancer cell lines have revealed potential anticancer activity against colorectal cancer. The present study aims to identify hydroxyxanthone derivatives as potential drug candidates for colorectal cancer treatment through an in silico approach. METHODS: Interactions between seven hydroxyxanthone (X1-X7) derivatives and CDK2 and EGFR were analyzed using molecular docking, molecular dynamics simulations, and binding energy calculations based on the MM-PBSA method. We also evaluated the physicochemical properties and ADMET profiles using the pkCSM server. RESULT: Docking studies demonstrated that all hydroxyxanthone derivatives exhibited favorable binding affinities, ranging from -7.25 to -8.57 kcal/mol against CDK2 and -6.79 to -8.31 kcal/mol against EGFR. Following 200 ns molecular dynamics simulations, compounds X4, X5, and X7 showed higher structural stability than doxorubicin and comparable stability to the native ligands C62 and erlotinib. Consistently, MM/PBSA analysis revealed that X4 (-20.27 kcal/mol) and X7 (-25.29 kcal/mol) achieved the most favorable binding free energies for CDK2 and EGFR, respectively. Moreover, these compounds satisfied Lipinski's criteria and met the minimum requirements for ADMET drug-likeness parameters. CONCLUSION: Hydroxyxanthone derivatives X4, X5, and X7 exhibit the strongest potential as dual CDK2/EGFR inhibitors and may, therefore, serve as promising candidates for colorectal cancer therapy. Nevertheless, further in vitro and in vivo investigations are required to experimentally validate their therapeutic potential.
Comparative Performance Evaluation of GCN, GAT, and GraphSAGE Architectures for Drug-Gene Interaction Prediction in Ameloblastoma via MEK-Pathway Targeting.
Ubayathulla N, Muthusekar MR, Yadalam PK
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945943 · Publisher ↗
INTRODUCTION: A key element of computational drug discovery is the precise prediction of drug-gene interactions, particularly when working with intricate biological systems where relational dependencies are essential. Be...
INTRODUCTION: A key element of computational drug discovery is the precise prediction of drug-gene interactions, particularly when working with intricate biological systems where relational dependencies are essential. Because biological networks are graph-structured, traditional machine learning techniques frequently fall short. Graph Neural Networks (GNNs) have emerged as a viable approach for learning meaningful representations from this data type in response to this challenge. In this study, three state-of-the-art GNN architectures Graph Convolutional Networks (GCN), Graph Attention Networks (GAT), and GraphSAGE are comprehensively compared using a bipartite graph constructed from drug-target biochemical activity data. METHODS: Using the Probes and Drugs website, drugs associated with MEK signalling were downloaded. The data, with drugs and genes as nodes, targets as edges, and activity biochemical as edge weights, along with other node-level features, were preprocessed for further analysis. A bipartite graph comprising 321 nodes consisting of gene names and target types and 1,028 edges weighted by levels of biochemical activity was constructed. To differentiate genes from targets, node features were encoded using a two-dimensional one-hot vector. Each GNN model was trained using a standardized three-layer architecture for 100 epochs with identical hyperparameters: Mean Squared Error (MSE) as the loss function, a learning rate of 0.01, and a dropout rate of 0.2. To ensure a fair performance comparison across models, the training-validation split was maintained at 80/20. RESULTS: The GCN model exhibited steady convergence, with a train-to-validation loss ratio of 1.0433, a final validation loss of 0.9807, and a minimum validation loss of 0.8923. Although it showed slightly greater overfitting tendencies with a train-to-validation ratio of 1.0553, GAT outperformed the other models in terms of generalization, achieving the lowest final validation loss (0.9551) and the lowest minimum validation loss (0.8653). In contrast, GraphSAGE demonstrated the most balanced performance, with a train-to-validation loss ratio of 0.9949 and a final validation loss of 1.0052, indicating exceptional generalization and stability qualities that make it particularly suitable for inductive learning scenarios. CONCLUSION: The findings indicate that each architecture exhibits distinct advantages: GraphSAGE demonstrates superior generalization in dynamic graph environments; GAT enables more nuanced modeling through attention mechanisms; and GCN remains computationally stable and efficient. These results provide biomedical informatics researchers with valuable insights to guide the selection of GNN architectures for biological graph learning tasks. To enhance the translational potential of GNN-based drug discovery pipelines, future research should focus on integrating dynamic graph structures, richer node features, and supervised learning approaches aligned with empirical biological outcomes.
HPV Self-Sampling for Cervical Cancer Screening in Morocco: A Cross-Sectional Study.
Chellat FZ, Bahra N, Chami Khazraji Y … +8 more , Bekkali R, Bennani M, Gaizi Z, Tachfouti N, El Fakir S, Ben Abdallah A, El Mzibri M, Berraho M
Asian Pac J Cancer Prev · 2026 Apr · PMID 41945942 · Publisher ↗
OBJECTIVE: Morocco is currently planning to introduce HPV testing as the primary screening method in routine cervical cancer screening. Accordingly, HPV self-sampling offers a potential solution to increase participation...
OBJECTIVE: Morocco is currently planning to introduce HPV testing as the primary screening method in routine cervical cancer screening. Accordingly, HPV self-sampling offers a potential solution to increase participation rates, particularly in underserved regions. Therefore, this study was designed to assess the feasibility and acceptability of HPV self-sampling using the GeneXpert assay as an alternative to clinician-administered screenings in Morocco. METHODS: A cross-sectional study was conducted among 997 women aged 30 or 40 years from four Moroccan provinces. Participants were offered the choice of clinician-collected sampling, supervised self-sampling, or unsupervised self-sampling. Socioeconomic and clinical data were collected using structured questionnaires, and HPV detection and genotyping were performed using the GeneXpert HPV assay. RESULTS: Overall, 13% of participants opted for self-sampling, including 4.8% who chose unsupervised, and 8.2% supervised self-sampling. Women living in urban areas, younger participants (30 years old), and those with higher education and income levels were more likely to select self-sampling. Satisfaction was high: 92.2% found the procedure easy to perform, all participants reported comfort using the cytobrush, and all indicated willingness to recommend the test to relatives or friends. Additionally, the diagnostic performance of high-risk HPV (hrHPV) testing was comparable between self-collected and clinician-collected samples, demonstrating no effect of sampling method on HPV detection. CONCLUSION: HPV self-sampling is feasible and highly acceptable among Moroccan women. However, the low uptake, particularly in rural settings, highlights the need for targeted education and awareness efforts. Integrating self-sampling into national screening programs may improve participation and contribute to reducing cervical cancer incidence in Morocco.
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