Double-tract reconstruction is superior to esophagogastrostomy in controlling reflux esophagitis and enhancing quality of life after proximal gastrectomy: Results from a prospective randomized controlled clinical trial in China

Objective

The aim of this study was to prospectively compare double-tract reconstruction (DTR) and esophagogastrostomy (EG) after proximal gastrectomy (PG) regarding the incidence of reflux esophagitis, quality of life (QOL), nutritional status and surgical safety.

Methods

This study was a randomized controlled trial. Patients eligible for PG were enrolled and randomly assigned to the EG group and DTR group. The characteristics of patients, parameters for surgical safety, incidence of reflux esophagitis, nutrition status and QOL were collected and compared between the two groups. Univariate analysis and multivariate analysis were performed to determine the significant factors affecting the incidence of reflux esophagitis after PG.

Results

Thirty-seven patients of the EG group and 36 patients of the DTR group were enrolled. The incidence of reflux esophagitis was significantly lower in the DTR group than in the EG group (8.3% vs. 32.4%, P=0.019). The DTR group demonstrated a more favorable QOL than the EG group after PG. The nutritional status was balanced within the EG group and the DTR group. The operation time was longer in the DTR group than in the EG group (191 min vs. 221 min, P=0.001), while surgical safety was similar in the two groups.

Conclusions

Our research demonstrated that DTR is superior to EG after PG in terms of the incidence of reflux esophagitis and provides a more satisfactory QOL without increasing surgical complications or sacrificing nutritional status.

Hormone analysis and candidate genes identification associated with seed size in Camellia oleifera

Camellia oleifera is an important woody oil species in China. Its seed oil has been widely used as a cooking oil. Seed size is a crucial factor influencing the yield of seed oil. In this study, the horizontal diameter, vertical diameter and volume of C. oleifera seeds showed a rapid growth tendency from 235 days after pollination (DAP) to 258 DAP but had a slight increase at seed maturity. During seed development, the expression of genes related to cell proliferation and expansion differ greatly. Auxin plays an important role in C. oleifera seeds; YUC4 and IAA17 were significantly downregulated. Weighted gene co-expression network analysis screened 21 hub transcription factors for C. oleifera seed horizontal diameter, vertical diameter and volume. Among them, SPL4 was significantly decreased and associated with all these three traits, while ABI4 and YAB1 were significantly increased and associated with horizontal diameter of C. oleifera seeds. Additionally, KLU significantly decreased (2040-fold). Collectively, our data advances the knowledge of factors related to seed size and provides a theoretical basis for improving the yield of C. oleifera seeds.

Transcriptome and Anatomical Comparisons Reveal the Effects of Methyl Jasmonate on the Seed Development of Camellia oleifera

Seed is a major storage organ that determines the yield and quality of Camellia oleifera (C. oleifera). Methyl jasmonate (MeJA) is a signaling molecule involved in plant growth and development. However, the role of MeJA in the development of C. oleifera seeds remains a mystery. This study demonstrated that the larger seeds induced by MeJA resulted from more cell numbers and a larger cell area in the outer seed coat and embryo at the cellular level. At the molecular level, MeJA could regulate the expression of factors in the known signaling pathways of seed size control as well as cell proliferation and expansion, resulting in larger seeds. Furthermore, the accumulation of oil and unsaturated fatty acids due to MeJA-inducement was attributed to the increased expression of fatty acid biosynthesis-related genes but reduced expression of fatty acid degradation-related genes. CoMYC2, a key regulator in jasmonate signaling, was considered a potential hub regulator which directly interacted with three hub genes (CoCDKB2-3, CoCYCB2-3, and CoXTH9) related to the seed size and two hub genes (CoACC1 and CoFAD2-3) related to oil accumulation and fatty acid biosynthesis by binding to their promoters. These findings provide an excellent target for the improvement of the yield and quality in C. oleifera.

Abstract 89: Reduced kinase D-interacting substrate of 220kDa (Kidins220) in pancreatic cancer promotes EGFR/ERK signaling and disease progression

Kidins220 (Kinase D-Interacting Substrate, 220kDa), also known as ARMS (ankyrin repeat-rich membrane spanning) is a transmembrane scaffolding protein. Kidins220 acts as a platform for protein-protein interactions to coordinate cell plasticity, migration and neural growth receptor signalling. Present study aims to investigate the involvement of Kidins220 in the disease progression of pancreatic cancer. Pancreatic tumors (n=149) together with paired adjacent background tissues were collected at Peking University Cancer Hospital with written consent from the patients and also an ethical approval from the Peking University Cancer Hospital Research Ethics Committee. Kidins220 transcript levels were determined using real-time PCR. Relevance of Kidins220 transcript levels and pathologic/clinical features was analyzed. Knockdown of Kidins220 was carried out with a lentiviral Kidins220 shRNA. Immunohistochemical (IHC) staining of Kidins220 was performed on a pancreatic tissue microarray (TMA) (PA2081a, US Biomax, Inc., Rockville, MD, USA). A decreased expression of Kidins220 transcripts was observed in pancreatic cancer tissues in comparison with the paired background control (P=0.029). According to the TNM staging, early stage tumors (TNM 1&2) expressed higher levels of Kidins220 transcripts compared with its expression in more advanced tumors (TNM 3&4 stage, p=0.0034). In line with the finding from the Beijing pancreatic cancer cohort, a reduced expression of Kidins220 protein was seen in the pancreatic carcinomas of the TMA using IHC, p<0.001 compared with normal control. Moreover, based on the IHC results, primary tumors with distance metastases exhibited a decreased level of Kidins220 expression compared to those without metastasis. Knockdown of Kidins220 in pancreatic cancer cell lines PANC1 and MIA-PaCa-2 promoted migration and invasion of both cell lines. A protein array analysis (KinexTM) revealed an increased EGFR phosphorylation in the Kidins220 knockdown pancreatic cancer cell lines which was confirmed with Western blot. The Kidins220 knockdown-resulted increased invasion was eliminated by targeting EGFR using both gefitinib or with the irreversible pan-HER tyrosine kinase inhibitor, neratinib. Proliferation assays showed that neratinib was more effective to inhibit proliferation of PANC-1 and Mia-PaCa-2 cells at a range of concentration from 20nM to 2μM. In conclusion, the expression of Kidins220 was reduced in pancreatic cancer and the reduced expression in primary tumors was associated with distant metastases. Reduced Kidins220 expression promoted migration and invasion of pancreatic cancer cells through an upregulation of EGFR. The therapeutic potential of neratinib or gefitinib for reduced kidins220 relevant disease progression and metastasis in pancreatic cancers is yet to fully investigated.

Citation Format: Shuo Cai, Ping-Hui Sun, Xiangyu Gao, Ke Ji, Xiuyun Tian, Chunyi Hao, Bilal Al-Sarireh, Paul Griffiths, Steven Hiscox, Jared Tonkington, Jun Cai, Wen G. Jiang, Lin Ye. Reduced kinase D-interacting substrate of 220kDa (Kidins220) in pancreatic cancer promotes EGFR/ERK signaling and disease progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 89.

[Corrigendum] Inhibition of sphingosine-1-phosphate phosphatase 1 promotes cancer cells migration in gastric cancer: Clinical implications

We have recently noticed an accidental error in part of a figure which appeared in the above‑mentioned article. In Fig. 3A, the image for the HGC27‑pEF, 15 h panel was mistakenly replicated as the HGC27‑KD, 0 h panel in the same figure, and the AGS‑pEF, 15 h and AGS KD, 0 h panels were mistakenly switched with each other. We have reviewed the original files and the individual figures for the submitted composite figure, and realized that the error occurred when we produced the composite figure by marrying the individual images to the final figure. The same image was accidentally pasted twice without us being fully aware of the error. We have identified all the original images, and the corrected version of Fig. 3 is shown below. We regret that this error occurred, and thank the Editor for affording us the opportunity to publish this Corrigendum. [the original article was published in the Oncology Reports 34: 1977-1987, 2015; DOI: 10.3892/or.2015.4162].

Dysregulation of phosphoenolpyruvate carboxykinase in cancers: A comprehensive analysis

BACKGROUND

Phosphoenolpyruvate carboxykinase (PEPCK) plays a crucial role in gluconeogenesis, glycolysis, and the tricarboxylic acid cycle by converting oxaloacetate into phosphoenolpyruvate. Two distinct isoforms of PEPCK, specifically cytosolic PCK1 and mitochondrial PCK2, have been identified. Nevertheless, the comprehensive understanding of their dysregulation in pan-cancer and their potential mechanism contributing to signaling transduction pathways remains elusive.

METHODS

We conducted comprehensive analyses of PEPCK gene expression across 33 diverse cancer types using data from The Cancer Genome Atlas (TCGA). Multiple public databases such as HPA, TIMER 2.0, GEPIA2, cBioPortal, UALCAN, CancerSEA, and String were used to investigate protein levels, prognostic significance, clinical associations, genetic mutations, immune cell infiltration, single-cell sequencing, and functional enrichment analysis in patients with pan-cancer. PEPCK expression was analyzed about different clinical and genetic factors of patients using data from TCGA, GEO, and CGGA databases. Furthermore, the role of PCK2 in Glioma was examined using both in vitro and in vivo experiments.

RESULTS

The analysis we conducted revealed that the expression of PEPCK is involved in both clinical outcomes and immune cell infiltration. Initially, we verified the high expression of PCK2 in GBM cells and its role in metabolic reprogramming and proliferation in GBM.

CONCLUSION

Our study showed a correlation between PEPCK (PCK1 and PCK2) expression with clinical prognosis, gene mutation, and immune infiltrates. These findings identified two possible predictive biomarkers across different cancer types, as well as a comprehensive analysis of PCK2 expression in various tumors, with a focus on GBM.

A potential decision-making algorithm based on endoscopic ultrasound for staging early gastric cancer: a retrospective study

BACKGROUND

Clinical staging of gastric cancer (GC) before treatment is essential. Endoscopic ultrasound (EUS) is a recommended staging tool, but its efficacy remains controversial. Our previous prospective study evaluated the potential value of EUS for T staging and presented discrepancies. In this study, we aimed to evaluate the efficacy of EUS in T staging by comparing it with pathological staging. We analyze the factors that can potentially affect accuracy to identify suitable subgroups for EUS staging.

METHODS

Data from a total of 1763 consecutive patients with GC from January 2015 to December 2017 were analyzed. Results from EUS and pathological T staging were compared. The factors that might affect EUS's accuracy were analyzed.

RESULTS

The sensitivity, specificity, positive predictive value, and negative predictive value of EUS in patients with early GC were 62.08%, 96.13%, 90.94%, and 80.21%, respectively. The accuracy rates of uT1, uT2-uT4, and uT3-uT4 were 90.94%, 79.02%, and 78.39%, respectively. In multivariate analysis, underestimation was more likely to be observed in patients with tumors located in the middle or upper third of the stomach. Overestimation was more likely to be observed in patients with tumors located in the lower third or those without ulcer. Other factors affecting accuracy included ulcer, differentiation, larger size and undergoing surgery.

CONCLUSION

Our findings highlight the role of EUS in determining the T staging of GC. Overestimation and underestimation in T-staging were significantly associated with the tumor location in early GC, and a decision-making algorithm was proposed for clinical practice in early cancers based on these findings.

Impact of Yangzheng Xiaoji on the adhesion and migration of human cancer cells: the role of the AKT signalling pathway

BACKGROUND

Yangzheng Xiaoji is a traditional Chinese medical formulation that has been shown to have anticancer actions in patients with various solid tumours. The mechanisms of the potential anticancer action of Yangzheng Xiaoji are unknown. In the present study, we investigated the direct effects of Yangzheng Xiaoji on a range of human cancer cell lines and investigated the possible mechanism(s) of its action.

MATERIALS AND METHODS

Extract of Yangzheng Xiaoji (DME25) was prepared using dimethyl sulfoxide. The influence of DME25 on in vitro growth, adhesion and migration was examined using in vitro function assays. The effects on signalling protein kinases were assessed using western blotting.

RESULTS

DME25 suppressed adhesion and migration of various cancer cell, including those of breast, prostate, lung, osteosarcoma and colorectal cancer. Further investigation showed an involvement of the phosphatidylinositol 3-kinases/protein kinase B (PI3K/AKT) pathway in the inhibitory effect on the adhesion of cancer cells by DME25.

CONCLUSION

Yangzheng Xiaoji exerts its anticancer effects not only via synergistically working together with chemotherapy, but also by directly inhibiting adhesion and migration of cancer cells. The PI3K/AKT pathway is a potential signalling pathway targeted by Yangzheng Xiaoji.

Expression of breast cancer metastasis suppressor-1, BRMS-1, in human breast cancer and the biological impact of BRMS-1 on the migration of breast cancer cells

Breast cancer metastasis suppressor-1 (BRMS1) is a candidate metastasis-suppressing gene and has been shown to potentially inhibit tumor progression without blocking the growth of orthotopic tumors, in different tumor types including non-small cell lung cancer, ovarian, melanoma and breast cancers.

MATERIALS AND METHODS

BRMS-1 gene transcript was quantified in breast cancer sample tissues and analyzed against histological and clinical patient outcome. Human breast cancer cell lines, MDA MB-231 and MCF-7 were used to genetically-modify the expression of BRMS-1 and test for biological responses following BRMS-1 modifications. Key candidate signal pathways, influenced by BRMS-1 were also explored.

RESULTS

BRMS1 was present in MDA MB-231 and MCF-7 cell lines. Using anti-BRMS1 transgenes, we knocked-down the transcripts of BRMS1 in both cells at the mRNA and protein levels. Knockdown of BRMS1 gave both cells a faster cell growth rate, rapid pace of cellular migration and invasion, compared to respective wild-type and control cells (p<0.05). Blocking phospholipase-Cγ (PLCγ) had a significant influence on the BRMS-1-induced cell migration. Finally, significantly low levels of BRMS1 were observed in patients with high-grade tumors (p=0.12), in patients with distant metastasis (p=0.05) and those who died of breast cancer (p=0.0037). In addition, patients with low levels of BRMS1 had a significantly shorter overall survival (p=0.035).

CONCLUSION

BRMS-1 is aberrantly expressed in human breast cancer and is inversely-correlated with disease progression and patient survival. This is likely to be occurring via its influence on invasion and migration of breast cancer cells.

The Value of Perioperative Chemotherapy for Patients With Hepatoid Adenocarcinoma of the Stomach Undergoing Radical Gastrectomy

BACKGROUND

Hepatoid adenocarcinoma of the stomach (HAS) is a rare type of gastric cancer, but the role of perioperative chemotherapy is still poorly understood. The aim of this retrospective study was to investigate the associations between perioperative chemotherapy and prognosis of HAS.

METHOD

We retrospectively analyzed patients with locally advanced HAS who received radical surgery in Peking University Cancer Hospital between November 2009 and October 2020. Patients were divided into neoadjuvant chemotherapy-first (NAC-first) group and surgery-first group. The relationships between perioperative chemotherapy and prognosis of HAS were analyzed using univariate, multivariate survival analyses and propensity score matching analysis (PSM).

RESULTS

A total of 100 patients were included for analysis, including 29 in the NAC-first group and 71 in the surgery-first group. The Her-2 amplification in HAS patients was 22.89% (19/83). For NAC-first group, 4 patients were diagnosed as tumor recession grade 1 (TRG1), 4 patients as TRG 2, and 19 patients as TRG 3. No significant difference in prognosis between the surgery-first group and the NAC-first group (P=0.108) was found using PSM analysis. In the surgery-first group, we found that the survival rate was better in group of ≥6 cycles of adjuvant chemotherapy than that of <6 cycles (P=0.013).

CONCLUSION

NAC based on platinum and fluorouracil may not improve the Overall survival (OS) and Disease-free survival time (DFS) of patients with locally advanced HAS. Patients who received ≥6 cycles of adjuvant chemotherapy had better survival. Therefore, the combination treatment of radical gastrectomy and sufficient adjuvant chemotherapy is recommended for patients with locally advanced HAS.

Reduced kinase D‑interacting substrate of 220 kDa (Kidins220) in pancreatic cancer promotes EGFR/ERK signalling and disease progression

Kidins220 is a transmembrane scaffold protein involved in several types of cancer. The aim of the present study was to examine the role of Kidins220 in tumorigenesis and disease progression of pancreatic cancer. The relevant signalling pathways including EGFR, EMT, and MMP were also investigated. The expression of Kidins220 was examined at the transcript and protein level. The Kidins220 knockdown cell model was established and its influence on cellular functions was determined. Involvement of Kidins220 in tumorigenesis and metastasis was examined in CD1 mice, respectively. The results showed that, reduced Kidin220 expression was associated with tumorigenesis, metastasis, and overall survival of pancreatic cancer. Knockdown of Kidins220 promoted proliferation, colony formation and tumorigenic capacity of pancreatic cancer cells in vitro and in vivo, respectively. Kidins220 regulated pancreatic cancer cell migration through the EGFR/AKT/ERK signalling pathway. Furthermore, enhanced EMT was observed in the pancreatic cancer cell lines with the knockdown of Kidins220, underlying EGFR regulation. Kidins220 also affected cell invasion via MMP1. A reduced expression of Kidins220 was observed in pancreatic cancer, which is associated with disease progression, distant metastasis and poor prognosis. The loss of Kidins220 in pancreatic cancer may contribute to disease progression through the upregulation of EGFR and downstream signalling.

Clinical use of internal distraction osteogenesis in the rehabilitation of gunshot injuries of the mandible

Rehabilitation of gunshot injuries that require combined reconstruction of bone and soft tissue poses a considerable challenge. We describe three cases of rehabilitation for mandibular defects and deformities caused by gunshot injuries. After debridement, three kinds of internal distractors were used. The bony transport discs were distracted about 10-22mm, and the new bone formed well in the distracted gaps. There was no evidence of infection during the consolidation period or follow up. Aesthetic appearance was also pleasing after treatment. Internal distraction osteogenesis after debridement might be a practical way of synchronously reconstructing bony and soft tissue after mandibular gunshot injuries.

Lymph node metastatic patterns of gastric carcinoma with a combination of adenocarcinoma and neuroendocrine carcinoma components

BACKGROUND

Gastric mixed-adenoneuroendocrine carcinoma (G-MANEC) is a subtype of gastric cancer. Building upon prior research findings, we propose that tumours containing both neuroendocrine carcinoma (NEC) and adenocarcinoma (AC) components, with each component ranging from 1% to 99% of the tumour, be classified as a distinct entity. We hereby term this adenoneuroendocrine mixed gastric cancer (G-ANEC). Research on lymph node (LN) involvement in G-MANEC has focused mainly on metastasis status, with limited studies on metastatic composition.

AIM

To investigate the LN metastasis patterns of G-ANEC, the clinicopathological features associated with these metastasis patterns, and to explore adjuvant chemotherapy regimens for G-ANEC.

METHODS

We analyzed 68 G-ANEC cases treated with radical surgery and confirmed LN metastasis at Peking University Cancer Hospital between August 2012 and June 2022. Utilizing χ² tests in IBM statistical product and service solutions statistics and R software.

RESULTS

We identified three distinct LN metastasis patterns in G-ANEC that were significantly associated with the NEC proportion, tumour invasion depth, Lauren classification, and tumour location (P values: 0.008, 0.015, 0.01, and 0.004, respectively). When the SOX/XELOX regimen was applied for adjuvant chemotherapy, patients with LN metastasis comprising only AC exhibited better overall survival (OS) (94.25 ± 11.07 months vs 54.36 ± 11.36 months) than did those with NEC. When LN metastasis components contained NEC, there was a trend towards improved OS (64 ± 10.77 months vs 54.35 ± 11.36 months) and disease-free survival (71.28 ± 9.92 months vs 66.28 ± 11.93 months) in patients treated with the etoposide and cisplatin compared to those receiving the SOX/XELOX regimen.

CONCLUSION

We found a significant correlation between the NEC percentage, tumour invasion depth, Lauren classification, and tumour location and LN metastasis patterns in G-ANEC. For G-ANEC, a lower proportion of NEC or AC in the primary lesion does not preclude the possibility of these components metastasizing to the LNs. Different adjuvant chemotherapy regimens should be administered on the basis of the varying components of LN metastasis in patients with G-ANEC.

Cadonilimab with chemotherapy in HER2-negative gastric or gastroesophageal junction adenocarcinoma: the phase 1b/2 COMPASSION-04 trial

Treatment with anti-programmed cell death protein 1 (PD-1) therapy and chemotherapy prolongs the survival of patients with unresectable advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma. The benefit from anti-PD-1 therapy is enriched in patients with programmed cell death 1 ligand 1 (PD-L1) combined positive score (CPS)-positive or CPS-high tumors compared with patients with PD-L1 CPS-negative or CPS-low tumors. In this phase 1b/2 study, we evaluated the efficacy and safety of cadonilimab, a bispecific antibody targeting PD-1 and cytotoxic T-lymphocyte antigen-4, plus chemotherapy as first-line treatment in patients with human epidermal growth factor receptor 2-negative unresectable advanced or metastatic gastric or GEJ adenocarcinoma. The primary endpoint was the recommended phase 2 dose (RP2D) for phase 1b and the objective response rate for phase 2. Secondary endpoints included disease control rate, duration of response, time to response, progression-free survival, overall survival (OS) and safety. The primary endpoint was met. No dose-limiting toxicities were observed during dose escalation in phase 1b; the recommended phase 2 dose was determined as 6 mg kg-1 every 2 weeks. The objective response rate was 52.1% (95% confidence interval (CI) = 41.6-62.5), consisting of complete and partial responses in 4.3% and 47.9% of patients, respectively. The median duration of response, progression-free survival and OS were 13.73 months (95% CI = 7.79-19.12), 8.18 months (95% CI = 6.67-10.48) and 17.48 months (95% CI = 12.35-26.55), respectively. The median OS in patients with a PD-L1 CPS ≥ 5 was 20.32 months (95% CI = 4.67-not estimable); in patients with a PD-L1 CPS < 1, the median OS reached 17.64 months (95% CI = 11.63-31.70). The most common treatment-related grade 3 or higher adverse events were decreased neutrophil count (19.1%), decreased platelet count (16.0%), anemia (12.8%) and decreased leukocyte count (8.5%). No new safety signal was identified. The current regimen showed promising clinical activity and manageable safety in patients with gastric or GEJ adenocarcinoma regardless of PD-L1 expression. Chinadrugtrials.org.cn registration: CTR20182027.

[Neoadjuvant immunotherapy ushers in a new era of gastric cancer treatment]

Recent advances in tumor immunology have made immunotherapy a new direction for neoadjuvant treatment of gastric cancer. Multiple clinical trials have confirmed that combining immunotherapy with chemotherapy and targeted therapy in the neoadjuvant treatment of gastric cancer can effectively improve treatment response and prolong patient survival time. This article aims to comment on the application of immunotherapy in the neoadjuvant treatment of gastric cancer, exploring its mechanisms, integration strategies with traditional treatments, safety, and personalized precision therapy in the hope of providing new insights and directions for the field of gastric cancer treatment.

Nab-paclitaxel combined with oxaliplatin and S-1 as conversion therapy for advanced gastric adenocarcinoma

343

Background: Conversion therapy can improve the survival of patients with locally advanced unresectable or potentially resectable metastatic gastric adenocarcinoma. This study was conducted to evaluate the efficacy and safety of nab-paclitaxel combined with oxaliplatin and S-1 as a conversion therapy in gastric cancer. Methods: This was a single-arm, multicenter, open-label trial of patients with locally advanced unresectable or potentially resectable metastatic gastric adenocarcinoma. Eligible patients were administered nab-paclitaxel (150 mg/m2, day 1), oxaliplatin (85 mg/m2, day 1), and S-1 (80–120 mg/day, days 1–14) every 21 days for two or four cycles. Radiographic assessments were performed after two cycles of treatment. Subsequent treatment or surgery was decided by the investigator according to assessment results and patient's condition. The primary endpoint was R0 resection rate. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. Results: From January 2020 to September 2022, 62 patients (49 males/13 females) with a median age of 58.9 years (range: 36–73) were enrolled in this study. Sixteen (25.8%) of the 62 patients had distant metastasis. The overall response rate and disease control rate of 54 patients who underwent at least one assessment were 61.1% (33/54, 95% CI: 46.9–74.1%) and 94.4% (51/54, 95% CI: 84.6–98.8%), respectively. Of the 39 patients who underwent surgery, 33 (84.6%, 95% CI: 69.5–94.1%) patients had an R0 resection, two had an R1 resection, and four had exploratory laparotomies. The pathological complete response rate was 15.4% (6/39, 95% CI: 6.4–31.2%). After a median follow-up time of 8.4 months, the 1-year PFS rate was 68.6% (95% CI: 53.4–83.8%), whereas the median PFS and OS were not reached. Seven patients died because of disease progression (5 patients who did not undergo surgery), myocardial infarction (1 patient), and electrolyte disturbance (1 patient). Treatment-related adverse events occurred in 82.3% (51/62) patients, although most events were grade 1–2. Common hematological toxicities were leukopenia (61.3%), neutropenia (54.8%), anemia (41.9%), and thrombocytopenia (30.6%). Common non-hematological treatment-related adverse events were nausea (53.2%), fatigue (43.5%), hepatic function abnormal (33.9%), neurotoxicity (29.0%), and diarrhea (24.2%). Conclusions: Nab-paclitaxel combined with oxaliplatin and S-1 showed promising efficacy and acceptable toxicity in patients with locally advanced unresectable or potentially resectable metastatic gastric cancer. Clinical trial information: NCT04047953 .

Identification and Validation of Molecular Features of the Anoikis Gene-Related Hub Genes in Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma (NPC) is a malignant tumor originating from nasopharyngeal mucosa. Anoikis, a form of programmed cell death induced by detachment from the extracellular matrix, normally prevents metastasis. Resistance to anoikis in cancer cells can enhance their metastatic potential. This study identifies anoikis-related genes (ARGs) associated with NPC to elucidate tumorigenesis mechanisms. Analysis of the GSE12452 dataset from GEO revealed 77 differentially expressed ARGs in NPC tissues. GO and KEGG analyses highlighted significant enrichment in apoptosis-related pathways. A PPI network identified MYC, FN1, BRCA1, and FGF2 as Hub genes. Correlation analysis showed MYC positively correlated with activated dendritic cells (p < 0.01) but negatively with naive CD4 T cells (p < 0.001). FN1 was positively correlated with activated dendritic cells (p < 0.01) and negatively with M1 macrophages (p < 0.05). FGF2 negatively correlated with naive CD4 T cells (p < 0.001), while BRCA1 was positively correlated with eosinophils (p < 0.01). GSVA and GSEA indicated that MYC, FN1, BRCA1, and FGF2 were significantly enriched in cell cycle and DNA replication pathways. Immunohistochemistry and qPCR of 50 NPC samples confirmed the overexpression of these genes. Knockdown of MYC, FN1, BRCA1, and FGF2 led to increased tumor cell malignancy, with statistical significance (p < 0.05). This study identifies MYC, FN1, BRCA1, and FGF2 as anoikis-related genes (ARGs) with significant regulatory roles in nasopharyngeal carcinoma (NPC). These ARGs are found to be involved in the development and progression of NPC, suggesting their potential as therapeutic targets for this cancer.