Clinical Medicine Insights-Oncology

High Expression of ZNF208 Predicts Better Prognosis and Suppresses the Tumorigenesis of Breast Cancer
Wei J, Jiao F, Wang X, Qiao Y, Yuan Z, Liu F, Fang Y and Pan Y
Breast cancer (BRCA), the hormone related malignant tumor, is well-known for poor prognosis. ZNF208 mainly acts as a transcription factor in various tumors, and the single nucleotide polymorphisms (SNPs) of ZNF208 are related to telomere length. Nevertheless, its role in breast tumorigenesis is largely unknown.
Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia
Shahbar A, Alhifany AA, Alatawi YM, Alnuhait M, Alshammari A, Alshamrani M, Kinsara A, AlQubbany A, Alharbi M, Alnatsheh A and Alfoheidi M
HER2-targeting therapies may increase the risk of decreased left ventricular ejection fraction (LVEF), potentially leading to heart failure. The growing number of breast cancer survivors due to HER2-targeted treatments necessitates long-term cardiotoxicity management.
Th9 and Th17 Cells in Human Ulcerative Colitis-Associated Dysplastic Lesions
Cui G, Yuan A, Sørbye SW and Florholmen J
Inflammation is the most important deriving force for the development of colitis-associated colorectal cancer (CAC) through the Inflammation-Pretumor dysplasia-CAC sequence. T helper (Th) subsets Th9 and Th17 cells can potentially stimulate inflammation in the ulcerative colitis (UC). Therefore, Th9 and Th17 cells may play a promoting role in the colitis-associated dysplasia (CAD).
Role of Bispecific Antibodies in Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NENs): Review of Literature
Mohamed A, Elhawi M, Trybula M, Elshawy M, Chakrabarti S, Selfridge E and Asa SL
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a heterogeneous group of neoplasms with an increasing incidence in the last few decades. Despite therapeutic advances in the management of GEP-NENs, resistance to many of these treatments has made their management a great challenge. One of the most recent advances in oncologic therapy is targeting multiple receptors simultaneously and engaging immune cells in the tumor microenvironment through bispecific antibodies (BsAbs). Since the FDA approval of the anti-CD3 × anti CD19 BsAb blinatumomab, for management of B-cell acute lymphoblastic leukemia, around a hundred different BsAbs have been developed and tested in various clinical trials. In this article, we review the current development of BsAbs developed or being currently tested for the management of GEP-NENs, their mechanism of action, current results from ongoing trials, toxicities, and upcoming trials.
High Systemic Immune-Inflammation Index Values Before Treatment Predict Poor Pancreatic Cancer Outcomes After Definitive Chemoradiotherapy
Topkan E, Kucuk A, Ozturk D, Ozkan EE, Kılıç Durankuş N, Şenyürek Ş, Selek U and Pehlivan B
The systemic immune-inflammation index (SII) is an effective tool for predicting the prognosis of patients with cancer. However, its value in patients with locally advanced pancreatic ductal adenocarcinoma (LA-PDAC) undergoing definitive chemoradiotherapy has yet to be addressed. Therefore, we aimed to retrospectively investigate the prognostic significance of the pretreatment SII on the survival outcomes of patients with unresectable LA-PDAC treated with concurrent chemoradiotherapy (C-CRT).
Adaptive Treatment of Metastatic Prostate Cancer Using Generative Artificial Intelligence
Derbal Y
Despite the expanding therapeutic options available to cancer patients, therapeutic resistance, disease recurrence, and metastasis persist as hallmark challenges in the treatment of cancer. The rise to prominence of generative artificial intelligence (GenAI) in many realms of human activities is compelling the consideration of its capabilities as a potential lever to advance the development of effective cancer treatments. This article presents a hypothetical case study on the application of generative pre-trained transformers (GPTs) to the treatment of metastatic prostate cancer (mPC). The case explores the design of GPT-supported adaptive intermittent therapy for mPC. Testosterone and prostate-specific antigen (PSA) are assumed to be repeatedly monitored while treatment may involve a combination of androgen deprivation therapy (ADT), androgen receptor-signalling inhibitors (ARSI), chemotherapy, and radiotherapy. The analysis covers various questions relevant to the configuration, training, and inferencing of GPTs for the case of mPC treatment with a particular attention to risk mitigation regarding the hallucination problem and its implications to clinical integration of GenAI technologies. The case study provides elements of an actionable pathway to the realization of GenAI-assisted adaptive treatment of metastatic prostate cancer. As such, the study is expected to help facilitate the design of clinical trials of GenAI-supported cancer treatments.
The Role of Antibody-Drug Conjugates in Urothelial Cancer: A Review of Recent Advances in the Treatment of Locally Advanced and Metastatic Urothelial Cancer
Vlachou E, Johnson BA and Hoffman-Censits J
Locally advanced and metastatic urothelial cancer (la/mUC) is an aggressive disease with poor prognosis. Platinum-based chemotherapy has remained the first-line treatment for decades and until recently no other treatment options existed. Today, novel agents called antibody drug conjugates (ADCs), including enfortumab vedotin (EV) and sacituzumab govitecan (SG), have been approved for la/mUC offering patients treatment options following or instead of traditional chemotherapy. The EV consists of the chemotherapy monomethyl auristatin E linked to anti-nectin-4 antibody. Single-agent response rates for EV are 40% to 52% including activity in patients with liver metastases, a phenotype associated with worse outcomes. In 2023, EV in combination with pembrolizumab almost doubled progression-free and overall survival versus platinum-based chemotherapy, which led to accelerated FDA approval as first-line treatment for all patients with la/mUC. Safety profile of EV monotherapy and combination with pembrolizumab is generally manageable with peripheral neuropathy and cutaneous toxicity among the most common treatment-related adverse events (TRAEs). The SG is another ADC targeting TROP-2 with SN-38 as payload. It is approved as late-line treatment for la/mUC with ORR 27% and most common TRAEs include gastrointestinal symptoms and neutropenia. Finally, a recent cancer agnostic accelerated approval for trastuzumab deruxtecan (T-DXd) in HER2-positive (IHC3+) solid tumors provides another active ADC option for biomarker-selected patients with treatment refractory la/mUC. Several new ADCs are being investigated in urothelial cancer (UC) clinical trials. This review summarizes the clinical studies and real-world data regarding the use of ADCs in UC.
Cancer Biomarkers and Precision Oncology: A Review of Recent Trends and Innovations
AlDoughaim M, AlSuhebany N, AlZahrani M, AlQahtani T, AlGhamdi S, Badreldin H and Al Alshaykh H
The discovery of cancer-specific biomarkers has resulted in major advancements in the field of cancer diagnostics and therapeutics, therefore significantly lowering cancer-related morbidity and mortality. Cancer biomarkers can be generally classified as prognostic biomarkers that predict specific disease outcomes and predictive biomarkers that predict disease response to targeted therapeutic interventions. As research in the area of predictive biomarkers continues to grow, precision medicine becomes far more integrated in cancer treatment. This article presents a general overview on the most recent advancements in the area of cancer biomarkers, immunotherapy, artificial intelligence, and pharmacogenomics of the Middle East.
Efficacy and Safety of Paclitaxel-Based PD-1/PD-L1 Immunotherapies for Triple-Negative Breast Cancer: A Systematic Review and Network Meta-Analysis
Dai Y, Ruan T, Yang W, Liu S, Chen J, Fang Y and Li Q
Triple negative breast cancer (TNBC) is a deadly subtype of breast cancer with limited treatment options. Currently, programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors have become the first choice for breast cancer immunotherapies. Despite paclitaxel being considered a cornerstone drug in breast cancer treatment, the effectiveness, safety, and optimal drug selection for its combination with PD-1/PD-L1 inhibitors remain uncertain.
The Influence of Cancer Type on Stroke Incidence: A Retrospective Study
Acır İ, Erdoğan HA, Toka E and Yayla V
The aim of this study is to examine the hematological and biochemical variables in patients diagnosed with cancer-related stroke who have different types of cancer and to evaluate the effects of these variables.
Changes in Intestinal Microbiota and Their Relationship With Patient Characteristics in Colorectal Cancer
Zhao L, Fang Y, Zhang J, Wei C, Ji H, Zhao J, Wang D and Tang D
Gut microbiota are associated with the pathological features and development of colorectal cancer (CRC); however, how gut microbiota changes in patients with CRC is unknown. This study investigated the role of gut microbiota in the development and progression of CRC by retrospectively comparing the structural differences between the gut microbiota of patients with CRC and healthy individuals.
Serum Cystatin S (CST4): A Novel Prognostic Marker for Gastric Cancer
Gu C, Chen S, Huang L, Cao C, Yuan R, Kou Z, Chen W, Shi H and Gu X
Serum Cystatin S (CST4), a secretory protein that inhibits cellular matrix degradation, significantly influences the tumor microenvironment and tumor progression. However, the prognostic value of serum CST4 in gastric cancer (GC) remains unclear. This study aims to explore serum CST4's utility in GC prognostic assessment.
Diagnostic and Predictive Recurrence Value of Plasma Fibrinogen in Patients With Adrenocortical Carcinoma
Ma C, Yang B and Mao Q
The correlation between fibrinogen levels and adrenocortical carcinoma (ACC) remains unclear. This study aimed to explore the value of preoperative plasma fibrinogen as a biomarker for ACC.
First-Line Camrelizumab Plus Rivoceranib in Advanced Hepatocellular Carcinoma: A China-Based Cost-Effectiveness Analysis
Xiang G, Huang Y, Zhang N, Du X, Wu Y, Gan L, Li Y, Jiang T and Liu Y
Hepatocellular carcinoma poses a significant public health burden in China, necessitating the economic evaluation of new therapeutic strategies for policy-makers and clinicians. The international, randomized phase 3 trial CARES-310 revealed that camrelizumab plus rivoceranib provided a substantial clinical benefit in patients with advanced hepatocellular carcinoma, but the economic outcome remains unclear. This study aimed to evaluate the cost-effectiveness of camrelizumab plus rivoceranib versus sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CARES-310) from the perspective of the Chinese health care system.
Synthesizing Efficiency Tools in Radiotherapy to Increase Patient Flow: A Comprehensive Literature Review
Ramiah D and Mmereki D
The promise of novel technologies to increase access to radiotherapy in low- and middle-income countries (LMICs) is crucial, given that the cost of equipping new radiotherapy centres or upgrading existing machinery remains a major obstacle to expanding access to cancer treatment. The study aims to provide a thorough analysis overview of how technological advancement may revolutionize radiotherapy (RT) to improve level of care provided to cancer patients. A comprehensive literature review following some steps of systematic review (SLR) was performed using the Web of Science (WoS), PubMed, and Scopus databases. The study findings are classified into different technologies. Artificial intelligence (AI), knowledge-based planning, remote planning, radiotherapy, and scripting are all ways to increase patient flow across radiation oncology, including initial consultation, treatment planning, delivery, verification, and patient follow-up. This review found that these technologies improve delineation of organ at risks (OARs) and considerably reduce waiting times when compared with conventional treatment planning in RT. In this review, AI, knowledge-based planning, remote radiotherapy treatment planning, and scripting reduced waiting times and improved organ at-risk delineation compared with conventional RT treatment planning. A combination of these technologies may lower cancer patients' risk of disease progression due to reduced workload, quality of therapy, and individualized treatment. Efficiency tools, such as the application of AI, knowledge-based planning, remote radiotherapy planning, and scripting, are urgently needed to reduce waiting times and improve OAR delineation accuracy in cancer treatment compared with traditional treatment planning methods. The study's contribution is to present the potential of technological advancement to optimize RT planning process, thereby improving patient care and resource utilization. The study may be extended in the future to include digital integration and technology's impact on patient safety, outcomes, and risk. Therefore, in radiotherapy, research on more efficient tools pioneers the development and implementation of high-precision radiotherapy for cancer patients.
Artificial Intelligence can Facilitate Application of Risk Stratification Algorithms to Bladder Cancer Patient Case Scenarios
Yudovich MS, Alzubaidi AN and Raman JD
Chat Generative Pre-Trained Transformer (ChatGPT) has previously been shown to accurately predict colon cancer screening intervals when provided with clinical data and context in the form of guidelines. The National Comprehensive Cancer Network (NCCN) guideline on non-muscle invasive bladder cancer (NMIBC) includes criteria for risk stratification into low-, intermediate-, and high-risk groups based on patient and disease characteristics. The aim of this study is to evaluate the ability of ChatGPT to apply the NCCN Guidelines to risk stratify theoretical patient scenarios related to NMIBC.
Efficacy and Safety of Bevacizumab Biosimilar (Encoda) Compared With Reference Bevacizumab (Avastin) in Patients With Metastatic Colorectal Cancer: A Multicenter, Real-World Study
Shan H, Wang M, Huang S, Liu H, Liu J and Du Q
The bevacizumab biosimilar (Encoda), which was approved by the National Medical Products Administration (NMPA) in China in 2019, is a biosimilar of bevacizumab. Approval of bevacizumab biosimilar (Encoda) for metastatic colorectal cancer (mCRC) was based on the extrapolation principle of biosimilar. However, there is currently no available data regarding the efficacy and safety of both bevacizumab biosimilar (Encoda) and bevacizumab in patients with mCRC.
Platelet-Rich Plasma Inhibits Breast Cancer Proliferation
Han C, Chen C, Lu N, Xue L, Xing D, Wu W, Li W and Lu X
Platelet-rich plasma (PRP) helps promote wound healing, but it is unclear whether it stimulates breast cancer cell proliferation, which restricts its application in breast cancer patients. This article explored the effect of PRP on breast cancer cell proliferation through preclinical experiments.
Prognostic Factors in Postoperative Brain Metastases Derive From Non-small Cell Lung Cancer: A Retrospective Analysis
Chen H, Sun L, Yang Z, Qu Y, Tong N, Sun C and Xia L
Brain metastases are crucial in cancer progression, requiring focused efforts on the screening, early detection, and treatment. However, accurate forecasting the postoperative prognosis of patients with non-small cell lung cancer brain metastasis remains a challenge. This retrospective study aims to discern the factors that influence the prognosis of such patients.
Adhesion Reduction Agent Guardix-SG Versus MegaShield for Postoperative Swallowing Function Analysis in Thyroidectomy Patients
Lee HK, Hwang J, Jo S, Kim JK, Lee CR, Kang SW, Nam KH and Cho SR
Antiadhesion products are essential for postoperative care in patients after thyroidectomy by providing a physical barrier to cover the exposed tissue and thus preventing abnormal adhesion of adjacent tissues. Since thyroidectomy may result in swallowing difficulties arising from damage or inflammation of the surrounding tissues, the use of antiadhesion agents such as MegaShield or Guardix-SG will help reduce scar formation. This may thus improve postoperative swallowing function in patients.
Modifiable Risk Factors Including Self-Perceived Stress for Breast Cancer in Hong Kong: A Case-Control Study of 10 757 Subject
Yeo W, Yuen LW, Tsoi KK, Chan EY, Kwok CC, Soong I, Ng TY, Chiu J, Chan M, Chan SW, Wong TT, Chan YH, Li LP, Yau CC, Hung WK and Cheung PS
In Hong Kong, breast cancer is the commonest female cancer. In addition to intrinsic risk factors that cannot be modified, other factors may be potentially modifiable. The objective of this report was to determine modifiable risk factors in association with breast cancer among Chinese women in our locality.