Cancer statistics, 2018

Impact of the COVID-19 pandemic on adherence to diagnostic colonoscopy after a positive non-invasive screening test for colorectal cancer in two Indiana healthcare systems

Objective

To describe trends in the use of non-invasive tests (NIST) and the interval between a positive NIST and diagnostic colonoscopy.

Methods

Using a retrospective time-trend design, we examined medical records of patients within two large Indiana integrated healthcare systems who had a positive NIST between January 2019 and June 2021 and quantified the proportion of patients who had not completed colonoscopy within 60, 90, and 180 days to determine the interval between NIST result and diagnostic colonoscopy in days.

Results

Of 1379 patients with positive NISTs, 930 (68 %) underwent diagnostic colonoscopy during the 30-month study timeframe. Median time to colonoscopy completion was significantly longer in 2020 compared to 2019 (50 vs. 37 days, p < 0.01) and 2021 (46 days, p = 0.06). The proportion of patients completing colonoscopy within 90 days of a positive FIT in 2019, 2020, and 2021 were 79 %, 83 %, and 72 %, respectively (p = 0.63), and were 86 %, 78 %, and 84 %, respectively, after positive FIT/DNA (p = 0.07). Median time to diagnostic colonoscopy completion was significantly longer in 2020, likely due to the COVID-19 pandemic.

Conclusions

Studies of outcomes in those who declined or delayed colonoscopy in 2020 are needed to estimate the potential subsequent colorectal cancer disease burden.

Postoperative Surgical Site and Secondary Infections in Colorectal Cancer Patients With a History of SARS-CoV-2: A Retrospective Cohort Study

BACKGROUND

The outbreak of the COVID-19 pandemic brought unique challenges to the field of healthcare, particularly to the surgical field. This retrospective cohort study aims to compare the risk of surgical site infection (SSI) and secondary infection between colorectal cancer (CRC) patients with a history of COVID-19 infection and those without.

METHOD

A cohort of 200 CRC patients, comprising 100 with a documented history of COVID-19 infection and 100 without, were retrospectively analyzed. Independent sample t-tests for continuous variables, Chi-square tests for categorical variables, and additionally univariate and multivariate binary logistic regression analysis were performed using IBM SPSS Statistics for Windows, Version 29.0.2 (Released 2023; IBM Corp., Armonk, New York, United States). The data were collected from the medical records of patients treated at the Hernia and Colorectal Surgery department of the Second Affiliated Hospital of Dalian Medical University, Dalian, China. Key clinical variables examined included the incidence of SSIs, occurrence of secondary infections, presence of comorbidities such as diabetes and hypertension, and duration of hospitalization.

RESULTS

The comparative analysis yielded compelling differences between CRC patients with a history of COVID-19 infection and those without. The study revealed a significantly higher incidence of SSI (68.8% vs. 31.3%, p=0.003) and secondary infection (70.1% vs. 29.9%, p<0.001) among patients with a history of COVID-19. In the multivariate analysis for SSIs, hypertension (OR = 2.78, 95%CI: 1.03-7.54, p=0.044) and surgical procedure type (open vs. laparoscopic) (OR = 6.04, 95%CI: 1.88-19.43, p=0.003) were found to be significant independent predictors. Patients with a history of COVID-19 had a significantly higher incidence of secondary infections (70.1% vs. 29.9%, p<0.001), with multivariate analysis showing COVID-19 status (OR: 3.053, 95%CI: 1.515-6.154, p=0.002), hypertension (OR: 2.632, 95% CI: 1.154-6.006, p=0.021), and diabetes mellitus (OR: 4.326, 95%CI: 2.029-9.226, p<0.001) as independent risk factors.

CONCLUSION

This study highlights significant insight into SSI rates, secondary infection rates, and clinical characteristics between CRC patients with and without a history of COVID-19 infection. The findings underscore that CRC patients with hypertension who underwent open surgery procedures exhibited a higher susceptibility to SSI. Following CRC patients in combination with comorbidities such as hypertension, diabetes, and a history of COVID-19 infection exhibited higher susceptibility to secondary infections. This study contributes to the evolving understanding of the impact of COVID-19 history on surgical outcomes, providing valuable insight to healthcare providers in optimizing care for CRC patients in the context of this ongoing health crisis.

Toxicity Profile and Efficacy of Docetaxel Following Paclitaxel- or Pemetrexed-Platinum Chemotherapy Alone or in Combination With Immune Checkpoint Inhibitors in NSCLC Patients: A Single Institution Retrospective Analysis

BackgroundDocetaxel alone or in combination with ramucirumab or nintedanib is recommended as second-line treatment in metastatic non-small cell lung cancer (NSCLC) patients after progression on first-line platinum-base chemotherapy in combination with immune-checkpoint inhibitors (ICI). The purpose of our study was to compare the toxicity profile and efficacy of docetaxel after paclitaxel- or pemetrexed-platinum chemotherapy alone or in combination with ICI.Patients und MethodsMetastatic NSCLC patients treated with docetaxel after pemetrexed or paclitaxel-platinum with chemotherapy with or without ICI were included in our retrospective analysis.ResultsWe included in our analyses a total of 53 patients (median age 60.3 years (SD 9.35) in the paclitaxel-group, and 62 years (SD 12) in the pemetrexed-group) treated at our Institution with docetaxel following either paclitaxel or pemetrexed chemotherapy. No treatment-related deaths and no new safety signals were observed.ConclusionDocetaxel alone or in combination with ramucirumab or nintedanib demonstrated encouraging antitumor activity with a manageable safety profile in patients who have progressed on previous paclitaxel-or pemetrexed platinum-based chemotherapy. The results of this analysis can be a helpful reference in conducting further trials of new second-line treatment options.

Low Expression of Mitochondrial Ribosomal Protein S5 is Associated With Poor Prognosis in Patients With Clear Cell Renal Cell Carcinoma

Mitochondrial ribosomal protein S5 (MRPS5) is abnormally expressed in various tumor tissues and may be a key molecule for the regulation of tumors. Our aim is to investigate the relationship between the expression of MRPS5 in clear cell renal cell carcinoma (ccRCC) and the prognosis of patients. MRPS5 expression in fresh tumoral tissues and peritumoral tissues of patients with ccRCC was examined by quantitative reverse transcription polymerase chain reaction, western blotting, and immunohistochemical staining, respectively. MRPS5 expression level in paraffin-embedded tumoral tissue samples with ccRCC was evaluated by immunohistochemical scoring criteria. The relationship between the expression of MRPS5 and the clinicopathological parameters and prognosis of patients with ccRCC was analyzed statistically. The expression of MRPS5 mRNA and protein in fresh tumoral tissues was lower than that in peritumoral tissues. Among 160 paraffin-embedded tumoral tissue samples, 99 cases (61.9%) showed high expression and 61 cases (38.1%) showed low expression of MRPS5. The expression level of MRPS5 was significantly correlated with T classification, TNM stage, and Fuhrman grade. Kaplan-Meier method and log-rank test indicated that patients with low MRPS5 expression had significantly poorer overall survival and recurrence-free survival than high MRPS5 expression. Multivariate analysis revealed that MRPS5 expression was an independent predictor of overall survival and recurrence-free survival, respectively. MRPS5 low expression was a risk factor for the prognosis of patients. The expression level of MRPS5 is significantly correlated with the postoperative survival status, which has the potential to be used as a novel prognostic biomarker for patients with ccRCC.

Diagnostic and prognostic potential of FBXO8 expression in kidney renal clear cell carcinoma and its regulation of renal adenocarcinoma cells

BACKGROUND

The F-box protein 8 Gene (FBXO8) has been shown to suppress invasion and metastasis in various cancer types. Recurrence and drug resistance pose significant challenges in renal cell carcinoma (RCC). Identifying novel biomarkers is crucial for addressing these issues.

METHODS

Data on RNA sequencing and patient survival for KIRC was obtained from The Cancer Genome Atlas (TCGA), UALCAN, and Gene Expression Omnibus (GEO) databases. We confirmed FBXO8 gene expression and its impact on survival. Clinical characteristics were classified, and FBXO8 expression differences among various categories were observed. We conducted biofunctional predictions and analyzed the tumor microenvironment (TME), immune cell infiltration, and immune checkpoints in relation to FBXO8 expression. FBXO8 was overexpressed using a plasmid, and we assessed Kidney renal clear cell carcinoma (KIRC) cell proliferation, migration, and apoptosis through CCK8, wound healing tests, and western blot analysis.

RESULTS

Our findings revealed decreased FBXO8 expression in KIRC, with patients exhibiting low FBXO8 expression experiencing shorter survival times. The low expression group showed elevated TME immune and estimate scores. Biofunctional analyses indicated that FBXO8 expression was notably linked to drug metabolism cytochrome P450, nutrition disease, receptor-ligand activity, and neuroactive ligand-receptor interaction. Furthermore, we discovered significant correlations between FBXO8 expression and immune cell infiltration, as well as checkpoints such as CD274. Overexpression (OE) of FBXO8 led to a marked reduction in cell proliferation and migration, along with increased apoptosis, as evidenced by apoptosis-related protein expression.

CONCLUSION

This study demonstrates that FBXO8 serves as a biomarker for KIRC and plays a role in regulating cell proliferation, migration, and apoptosis.

Forecasting Asparaginase Need and Cost for Childhood Cancer Using ACCESS FORxECAST

PURPOSE

Asparaginase (ASN) is a critical component of pediatric ALL protocols. Until recently, ASN was available in three formulations: native Escherichia coli, PEGylated E. coli (PEG), and Erwinase, with native E. coli typically more accessible in low- and middle-income countries (LMICs). Short shelf lives, intermittent availability, and concern for substandard formulations in LMICs have created a need for proactive ASN demand estimates.

METHODS

We adapted FORxECAST, a pediatric cancer drug forecasting model, to focus on ASN for pediatric ALL. The model is adaptable to user data and defaults to best available public data where local data are unavailable. We forecast ASN quantity and cost in three case study countries for four scenarios using two regimens-base regimen (BR) and intensified regimen (IR)-outlining how quantity and costs vary on the basis of ASN formulation, dose, and second-line availability.

RESULTS

Native E. coli is cheaper than PEG for first-line treatment across all scenarios. Regimen intensification from BR to IR requires a substantially higher cost when PEG is used relative to native E. coli. The cost of treating ASN hypersensitivity with Erwinase for BR in Burundi, Ghana, and Turkmenistan is $19,660 in US dollars (USD), $24,800 USD, and $15,246 USD, respectively.

CONCLUSION

Treatment intensification requires a cost increase that should be accessible for most LMICs, but PEG utilization is substantially more costly, suggesting that prioritizing investment in intensifying treatment using native E. coli is the least costly approach to maximize treatment availability. Cost savings associated with native E. coli utilization may liberate funds for Erwinase procurement for patients with ASN hypersensitivity. Future analyses needed include an evaluation of costs associated with preventing abandonment due to compliance complexity with native E. coli given increased administration frequency compared with PEG.

STAT3 mediates ECM stiffness-dependent progression in ovarian cancer

The treatment of ovarian cancer remains a medical challenge and its malignant progression is connected with obvious changes in both tissue and cell stiffness. However, the accurate mechanical-responsive molecules and mechanism remains unclear in ovarian cancer. Based on our previous results combined with the crucial regulatory role of STAT3 in the malignant progression of various cancer types, we want to investigate the relationship between STAT3 and matrix stiffness in ovarian cancer and further explore the potential mechanisms. Collagen-coated polyacrylamide gels (1, 6, and 60 kPa) were prepared to mimic soft or hard matrix stiffness. Western blotting, qRT-PCR, flow cytometry, IHC, EdU assays, and TEM were used to evaluate the effect of STAT3 in vitro under different matrix stiffnesses. Furthermore, a BALB/c nude mouse model was established to assess the relationship in vivo. Our results confirmed the differential expression of STAT3/p-STAT3 not only in normal and malignant ovarian tissues but also under different matrix stiffnesses. Furthermore, we verified that STAT3 was a mechanically responsive gene both in vitro and in vivo, and the mechanical response was carried out by altering the migration-related molecules (TNFAIP1) and adhesion-related molecules (LPXN, CNN3). The novel findings suggest that STAT3, a potential therapeutic target for clinical diagnosis and treatment, is a mechanically responsive gene that responds to matrix stiffness, particularly regulation in migration and adhesion in the progression of ovarian cancer.

Beyond the visible: preliminary evaluation of the first wearable augmented reality assistance system for pancreatic surgery

PURPOSE

The retroperitoneal nature of the pancreas, marked by minimal intraoperative organ shifts and deformations, makes augmented reality (AR)-based systems highly promising for pancreatic surgery. This study presents preliminary data from a prospective study aiming to develop the first wearable AR assistance system, ARAS, for pancreatic surgery and evaluating its usability, accuracy, and effectiveness in enhancing the perioperative outcomes of patients.

METHODS

We developed ARAS as a two-phase system for a wearable AR device to aid surgeons in planning and operation. This system was used to visualize and register patient-specific 3D anatomical models during the surgery. The location and precision of the registered 3D anatomy were evaluated by assessing the arterial pulse and employing Doppler and duplex ultrasonography. The usability, accuracy, and effectiveness of ARAS were assessed using a five-point Likert scale questionnaire.

RESULTS

Perioperative outcomes of five patients underwent various pancreatic resections with ARAS are presented. Surgeons rated ARAS as excellent for preoperative planning. All structures were accurately identified without any noteworthy errors. Only tumor identification decreased after the preparation phase, especially in patients who underwent pancreaticoduodenectomy because of the extensive mobilization of peripancreatic structures. No perioperative complications related to ARAS were observed.

CONCLUSIONS

ARAS shows promise in enhancing surgical precision during pancreatic procedures. Its efficacy in preoperative planning and intraoperative vascular identification positions it as a valuable tool for pancreatic surgery and a potential educational resource for future surgical residents.

Loss of Kmt2c or Kmt2d primes urothelium for tumorigenesis and redistributes KMT2A-menin to bivalent promoters

Members of the KMT2C/D-KDM6A complex are recurrently mutated in urothelial carcinoma and in histologically normal urothelium. Here, using genetically engineered mouse models, we demonstrate that Kmt2c/d knockout in the urothelium led to impaired differentiation, augmented responses to growth and inflammatory stimuli and sensitization to oncogenic transformation by carcinogen and oncogenes. Mechanistically, KMT2D localized to active enhancers and CpG-poor promoters that preferentially regulate the urothelial lineage program and Kmt2c/d knockout led to diminished H3K4me1, H3K27ac and nascent RNA transcription at these sites, which leads to impaired differentiation. Kmt2c/d knockout further led to KMT2A-menin redistribution from KMT2D localized enhancers to CpG-high and bivalent promoters, resulting in derepression of signal-induced immediate early genes. Therapeutically, Kmt2c/d knockout upregulated epidermal growth factor receptor signaling and conferred vulnerability to epidermal growth factor receptor inhibitors. Together, our data posit that functional loss of Kmt2c/d licenses a molecular 'field effect' priming histologically normal urothelium for oncogenic transformation and presents therapeutic vulnerabilities.

Androgen deprivation therapy use and the risk of heart failure in patients with prostate cancer: a systematic review and meta-analysis

BACKGROUND & AIM

We aimed in this study to investigate the relationship between Androgen Deprivation Therapy (ADT) use and the risk of heart failure in patients with prostate cancer. In this research, the negative or positive effects of ADT in the development of cardiovascular diseases or its exacerbation in people with prostate cancer have been investigated.

MATERIALS AND METHODS

For this research, we reviewed articles from PubMed, Scopus, and Google Scholar databases until February 2024. We extracted and screened titles, abstracts, and full texts of related articles. The quality of studies was assessed and extracted and analyzed data.

RESULT

A total of 9 studies comprising 189,045 patients were included in the meta-analysis, examining the association between androgen deprivation therapy (ADT) and heart failure. The overall pooled hazard ratio (HR) was 1.299 (95% CI: 1.003-1.595), indicating a significantly increased risk of heart failure with ADT. Subgroup analyses revealed that the risk was stronger in Asian populations (pooled HR = 1.545, 95% CI: 1.180-1.910) compared to North American populations (pooled HR = 0.779, 95% CI: 0.421-1.138).

CONCLUSIONS

ADT has a significant relationship with cardiovascular disease. According to the analysis, ADT has increased the risk of heart failure in people with prostate cancer by 30%.

CYFIP2: potential pancreatic cancer biomarker and immunotherapeutic target

OBJECTIVE

It has been shown that the CYFIP2 (Cytoplasmic FMR1-interacting protein 2) gene is apoptosis p53-dependent and is associated with poor prognosis in malignant tumors such as gastric cancer and other and cervical cancer. However, the prognostic potential of CYFIP2 in pancreatic cancer remains unclear. In this work, we first explain the great potential of CYFIP2 malignant progression from a broader perspective (pan-cancer) and confirm its oncogenic value in pancreatic cancer.

METHODS

The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx) database, CELL and GEO databases were utilized to explore the distribution of the CYFIP2 gene in human cancers. Data were analyzed using a variety of web-based platforms and software such as R (4.3.2), UCSC, MethSurv, Cytoscape (v3.10.2), UALAND, STRING, TISIDB, Harmonizome 3.0, TIMER 2.0, TCIA and TIDE. The R packages R packages ?limma? and ?ggplot2? were used to compare and visualize CYFIP2 mRNA expression. The R packages ?survminer? and ?survival? were used to statistically analyze the relationship between CYFIP2 expression and the survival and prognosis of tumor patients. the R package ?ss GSEA? was used to assess the correlation between CYFIP2 expression and immune infiltration. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Variation Analysis (GSVA) were used to explore the multiple biological functions and regulatory pathways in which CYFIP2 co-expressed genes co-engage in pancreatic cancer. The R package ?maftool? was used to explore somatic mutation information in pancreatic cancer, and the TIDE database and the R package ?oncoPredic? were used to explore immunotherapeutic responses and sensitive drugs. Pancreatic cancer cell lines were constructed with the specific expression of CYFIP2 mRNA, and their invasive and metastatic abilities were analysed using scratch and transwell assays.

RESULTS

Bioinformatics analysis and in vitro experiments confirmed that CYFIP2 was differentially expressed in a variety of tumors and correlated with clinical stage, and could be used as a potential marker for evaluating the prognosis and immunotherapy of a variety of tumors, including KIRC (Kidney renal clear cell carcinoma), PAAD (Pancreatic adenocarcinoma), PAAD (Pancreatic adenocarcinoma), SKCM (Skin Cutaneous Melanoma), and UCEC (Uterine Corpus Endometrial Carcinoma).Mutations in the CYFIP2 gene and methylation indices can affect the prognosis of tumor patients. In addition, we found that CYFIP2 expression values in pancreatic cancer were positively correlated with the expression of most immune cells, especially CD8?+?T Cells, and significantly negatively correlated with macrophages M0, and negatively correlated with the metastatic and invasive ability of pancreatic cancer cells, which may provide new strategies and ideas for pancreatic cancer immunotherapy.

Effect of vitamin E δ-tocotrienol and aspirin on Wnt signaling in human colon cancer stem cells and in adenoma development in APCmin/+ mice

In this study, we evaluated the effects of vitamin E δ-tocotrienol (DT3) and aspirin on Wnt signaling in human colon cancer stem cells (CCSCs) and in the prevention of adenoma formation in APCmin/+ mice. We found that knockdown of the adenomatous polyposis coli (APC) gene led to subsequent activation of Wnt signaling in colon epithelial cells (NCM460-APCsiRNA) and induction of β-catenin and its downstream target proteins c-MYC, cyclin D1, and survivin. When aspirin and DT3 were combined, cell growth and survival were inhibited and apoptosis was induced in colon epithelial cells and CCSCs. However, DT3 and/or aspirin had little or no effect on the control of normal colon epithelial cells (NCM460-NCsiRNA). The induction of apoptosis was directly related to the activation of caspase 8 and cleavage of BH3-interacting-domain (BID) to truncated BID. In addition, DT3- and/or aspirin-induced apoptosis was associated with cleaved Poly (ADP-ribose) polymerase (PARP), elevated levels of cytosolic cytochrome c and BAX, and depletion of antiapoptotic protein BCl-2 in CCSCs. The combination of aspirin and DT3 inhibited the self-renewal capacity, Wnt/β-catenin receptor activity, and expression of β-catenin and its downstream targets c-MYC, cyclin D1, and survivin in CCSCs. We also found that treatment with DT3 alone or combined with aspirin significantly inhibited intestinal adenoma formation and Wnt/β-catenin signaling and induced apoptosis, compared with vehicle, in APCmin/+ mice. Our study demonstrated a rationale for further investigation of the combination of DT3 and aspirin for colorectal cancer prevention and therapy.

Deep learning radiomics on grayscale ultrasound images assists in diagnosing benign and malignant of BI-RADS 4 lesions

This study aimed to explore a deep learning radiomics (DLR) model based on grayscale ultrasound images to assist radiologists in distinguishing between benign breast lesions (BBL) and malignant breast lesions (MBL). A total of 382 patients with breast lesions were included, comprising 183 benign lesions and 199 malignant lesions that were collected and confirmed through clinical pathology or biopsy. The enrolled patients were randomly allocated into two groups: a training cohort and an independent test cohort, maintaining a ratio of 7:3.We created a model called CLDLR that utilizes clinical parameters and DLR to diagnose both BBL and MBL through grayscale ultrasound images. In order to assess the practicality of the CLDLR model, two rounds of evaluations were conducted by radiologists. The CLDLR model demonstrates the highest diagnostic performance in predicting benign and malignant BI-RADS 4 lesions, with areas under the receiver operating characteristic curve (AUC) of 0.988 (95% confidence interval : 0.949, 0.985) in the training cohort and 0.888 (95% confidence interval : 0.829, 0.947) in the testing cohort.The CLDLR model outperformed the diagnoses made by the three radiologists in the initial assessment of the testing cohorts. By utilizing AI scores from the CLDLR model and heatmaps from the DLR model, the diagnostic performance of all radiologists was further enhanced in the testing cohorts. Our study presents a noninvasive imaging biomarker for the prediction of benign and malignant BI-RADS 4 lesions. By comparing the results from two rounds of assessment, our AI-assisted diagnostic tool demonstrates practical value for radiologists with varying levels of experience.

Prognostic value of coronary artery calcium scoring in patients with non-small cell lung cancer using initial staging computed tomography

BACKGROUND

Lung cancer is a leading cause of cancer-related mortality worldwide, with non-small cell lung cancer (NSCLC) comprising 85% of cases. Due to the lack of early clinical signs, metastasis often occurs before diagnosis, impacting treatment and prognosis. Cardiovascular disease (CVD) is a common comorbidity in lung cancer patients, with shared risk factors exacerbating outcomes.

METHODS

This study investigates the association between coronary artery calcium (CAC) scores, major adverse cardiovascular events (MACE), and survival outcomes in NSCLC patients, utilizing positron emission tomography-computed tomography (PET-CT) for CAC scoring. A retrospective cohort study of 154 NSCLC patients (mean age 66.3 years, 52% women) at the University of Utah (2005-2022) was conducted. Baseline PET-CT or CT imaging was used to quantify CAC scores, categorized into five risk levels. Cox proportional hazards and logistic regression analyses assessed the impact of CAC scores on survival and cardiovascular events, adjusting for confounders such as age, gender, and smoking status.

RESULTS

Higher CAC scores were significantly associated with increased MACE, acute myocardial infarction (MI), and poorer overall survival. The severe risk CAC score group had significantly lower survival (p = 0.022). Logistic regression revealed a strong association between higher CAC scores and MI incidence (moderate: OR = 13.8, severe: OR = 21.2) and MACE (severe: OR = 10.2). Smoking history was a significant predictor of overall survival (p = 0.006).

CONCLUSION

CAC scoring via PET-CT provides valuable prognostic insights in NSCLC patients, highlighting the need for integrated cardiovascular risk management in this population. Further research and advanced technologies like machine learning could enhance CAC scoring application in clinical practice.

TRIAL REGISTRATION

Retrospectively registered.

The Activation of the CCND1 Promoter by AP-1 and SOX Transcription Factors in PC3 Prostate Cancer Cells Can Be Prevented by Anacardic Acid Analogs

Targeting more than one in nine men before age 70, prostate cancer is the most common type of cancer in men. The increased levels of cyclins, leading to activation of cyclin-dependent kinases (CDKs), play a critical role in the increased proliferation of prostate cancer cells. In this study, the regulation of the cyclin D1 (CCND1) promoter activity by activator protein-1 (AP-1) and SRY-related HMG-box (SOX) transcription factors has been characterized in PC3 prostate cancer cells. The SOX and AP-1 transcription factors can cooperate to activate the CCND1 promoter in PC3 prostate cancer cells and such cooperation can be enhanced by protein kinase A (PKA) and/or mitogen-activated protein kinase kinase 1 (ERK kinase 1, MAP2K1) signaling pathways. Moreover, anacardic acid analogs have been assessed for their potential in reducing cell viability and CCND1 promoter activity. The anacardic acid analog 8b, obtained from γ-resorcylic acid, reduces the viability and proliferation of PC3 cells by decreasing CCND1 promoter activity. The effect of analog 8b, which perfectly mimics the structure of anacardic acid, can be attributed to the inhibition of the activities of the transcription factors SOX and AP-1, which are important regulators of CCND1 promoter activity in prostate cancer cells.

RBM19 promotes the progression of prostate cancer under docetaxel treatment via SNHG21/PIM1 axis

RBM family proteins plays the critical role in the progression of numerous tumors. However, whether RBM family proteins involved in prostate cancer (PCa) progression is remain elucidated. In our study, an RNAi screen containing shRNA library targeting 54 members of the RBM family was applied to identify the critical RBM proteins involved in prostate cancer progression under docetaxel treatment, and RBM19 was selected. RBM19 was up-regulated in PCa specimens and correlated with the prognosis and Gleason score of PCa patients. Functionally assays revealed that RBM19 promoted PCa progression under docetaxel treatment both in vivo and in vitro. Mechanistically, RBM19 could bind to LncRNA SNHG21, thereby increased SNHG21 expression through enhancing its stability. Furthermore, SNHG21 bind to PIM1 proteins and prevented it from ubiquitin-protease dependent degradation and ultimately enhancing mitochondrial homeostasis. Overall, our study indicates the RBM19/SNHG21/PIM1 axis may be the encouraging target for docetaxel-tolerance PCa treatment.

Metabolic Complete Response of Metastatic Oncogene-Negative, PDL1-Negative Non-Small Cell Lung Cancer After Chemo-Immunotherapy and Radiotherapy: A Case Report

A 71-year-old male ex-smoker presented in October 2021 to our department with a brain and bone metastatic adenocarcinoma NSCLC. PDL1, ROS, EGFR, and ALK were negative. He underwent stereotactic radiotherapy for brain metastases. In November 2021, he started a chemotherapy (CHT) regimen with cisplatin (75 mg/m2 every 21 days) and pemetrexed (500 mg/m2 every 21 days), and ICI with Atezolizumab (1200 mg every 21 days). In July 2022, RT to the lung tumor and mediastinal nodal was performed with a total dose of 45 Gy in 15 fractions. He continued with immunotherapy until December 2022, when a grade 3-4 toxicity from immunotherapy was observed (hypothyroidism, psoriasis, and cystitis). He achieved a complete clinical response to the therapy. To date, the patient is alive, with a complete metabolic response, without treatment at 37 months from diagnosis.

Non-invasive early-stage cancer detection: current methods and future perspectives

This review paper explores the realm of non-invasive methods for early cancer detection. Early identification is crucial for effective therapeutic intervention, and non-invasive techniques have emerged as promising tools to enhance diagnostic accuracy and improve patient outcomes. The paper thoroughly examines the advantages, limitations, and prospects of various non-invasive approaches, including blood tests, non-blood-based tests, and diverse imaging modalities. It discusses the biomarkers found in blood for early-stage cancer detection, specifying the types of cancer associated with each biomarker. The non-blood-based tests focus on components in saliva, urine, and breath for cancer detection, alongside current studies and future perspectives on various cancers. Optical imaging methods covered in this review include fluorescence imaging in the near-infrared (NIR) region, bioluminescence imaging, and Raman spectroscopy for early-stage cancer detection. The review also highlights the pros and cons of ultrasound imaging in early-stage cancer detection. Additionally, the clinical implications of using AI for cancer detection, both present and future, are explored. This paper provides valuable insights for researchers and clinicians working in the field of non-invasive early-stage cancer detection.

Synergistic anticancer efficacy of polydatin and sorafenib against the MCF-7 breast cancer cell line via inhibiting of PI3K/AKT/mTOR pathway and reducing resistance to treatment

Polydatin (PD), a glucoside derivative of resveratrol, has been investigated for its potential to mitigate sorafenib (SOF) side effects and combat multidrug resistance in cancer treatment. The study evaluated its mechanism of action for inhibiting the protein kinase B/mTOR pathway in promoting breast cancer proliferation. The combined PD and SOF have synergistic effects with a combination index (CI) < 1 in the liver (HepG2) and breast (MCF-7) cancer cell lines. Molecular docking studies were conducted to analyze interactions of PD& SOF with protein kinases as well as apoptotic and multidrug resistance proteins, including AKT1, PI3K, mTOR, Apaf-1, and ABCB1 in MCF-7 cells. Experimental validation through real-time PCR confirmed. PD has a strong binding affinity, particularly with AKT1 (-56 kcal/mol) and ABCB1 (-27.16 kcal/mol), a gene associated with multidrug resistance. These interactions were linked to anti-proliferative anti-angiogenic effects and reduced resistance to treatment, demonstrating PD has potential therapeutic benefits. Furthermore, PD combined with SOF induced apoptosis, inhibited cell growth, and arrested MCF-7 cells in the sub-G1 phase with increased intracellular ROS. This was accompanied by reduced expression of AKT1 and ABCB1 genes, reinforcing the anticancer efficacy of PD/SOF combination therapy. In conclusion, the findings suggest that PD/SOF could serve as a promising anticancer treatment strategy, warranting further investigation for potential clinical applications and mechanistic studies in vivo.

Assessment of detraining through a six-minute walk test in patients with heart disease

BACKGROUND

Detraining can partially or completely reduce training-induced metabolic adaptations. However, the duration for which the rehabilitation effects persist after detraining, especially in patients with heart disease, remains unclear.

OBJECTIVES

To evaluate the principle of reversibility/detraining in patients with heart disease via the 6-minute walk test (6MWT) after a period of rest.

DESIGN AND SETTING

A retrospective cohort study developed at the Rehabilitation Center of the Universidade Federal do Triângulo Mineiro in Uberaba/MG, Brazil.

METHODS

This clinical, retrospective longitudinal study involved 20 patients with heart disease who underwent 5 months of supervised cardiac rehabilitation (CR). The mean age of participants was 64.05 ± 9.25 years. The initial rehabilitation was followed by an interruption period and rehabilitation for another 5 months. Functional capacity was assessed using the 6MWT.

RESULTS

In the specific analysis of the distance covered, values of P = 0.03 and P = 0.01 were obtained on comparing post-training (669.64 ± 58.80 meters) with post-detraining (640.82 ± 101.23 meters) and post-detraining with post-retraining (650.82 ± 96.28 meters), respectively. No significant difference was observed for the comparison between training and retraining (P = 0.83).

CONCLUSION

Cardiovascular rehabilitation positively stimulates functional capacity, whereas detraining significantly reduces it. The 6MWT is effective in measuring changes in physical capacity.

Thermoresponsive gel embedding extracellular vesicles from adipose stromal cells improves the healing of colonic anastomoses following irradiation in rats

Anastomotic leak occurrence is a severe complication after colorectal surgery. Considering the difficulty of treating these leaks and their impact on patient care, there is a strong need for an efficient prevention strategy. We evaluated a combination of extracellular vesicles (EVs) from rat adipose-derived stromal cells with a thermoresponsive gel, Pluronic® F127 (PF-127) to prevent anastomotic leaks. The pro-regenerative and immunomodulatory potencies of EVs are assessed in vitro. In vivo efficacy are assessed in rat with a colonic anastomosis model after irradiation. Endoscopic, anatomical and histological data show a consistent effect of EVs + gel on the healing of colonic anastomosis. These results are illustrated by a smaller anastomotic ulcer size, less fibrosis and less inflammatory infiltrations in the EVs + gel group. This multi-modal investigation is the first to point-out the translational potential of EVs combined with PF-127 for the healing of high-risk colorectal anastomosis.

Decoding skin cancer classification: perspectives, insights, and advances through researchers' lens

Skin cancer is a significant global health concern, with timely and accurate diagnosis playing a critical role in improving patient outcomes. In recent years, computer-aided diagnosis systems have emerged as powerful tools for automated skin cancer classification, revolutionizing the field of dermatology. This survey analyzes 107 research papers published over the last 18 years, providing a thorough evaluation of advancements in classification techniques, with a focus on the growing integration of computer vision and artificial intelligence (AI) in enhancing diagnostic accuracy and reliability. The paper begins by presenting an overview of the fundamental concepts of skin cancer, addressing underlying challenges in accurate classification, and highlighting the limitations of traditional diagnostic methods. Extensive examination is devoted to a range of datasets, including the HAM10000 and the ISIC archive, among others, commonly employed by researchers. The exploration then delves into machine learning techniques coupled with handcrafted features, emphasizing their inherent limitations. Subsequent sections provide a comprehensive investigation into deep learning-based approaches, encompassing convolutional neural networks, transfer learning, attention mechanisms, ensemble techniques, generative adversarial networks, vision transformers, and segmentation-guided classification strategies, detailing various architectures, tailored for skin lesion analysis. The survey also sheds light on the various hybrid and multimodal techniques employed for classification. By critically analyzing each approach and highlighting its limitations, this survey provides researchers with valuable insights into the latest advancements, trends, and gaps in skin cancer classification. Moreover, it offers clinicians practical knowledge on the integration of AI tools to enhance diagnostic decision-making processes. This comprehensive analysis aims to bridge the gap between research and clinical practice, serving as a guide for the AI community to further advance the state-of-the-art in skin cancer classification systems.

Targeting mitochondria and programmed cell death as potential interventions for metastatic castration-resistant prostate cancer

Prostate cancer is one of the major causes of morbidity and mortality in men worldwide. Most patients with prostate cancer will turn into end-of-life stage when those tumor cells become metastatic castration-resistant prostate cancer (mCRPC). The mCRPC subsequently developed a resistance to androgen signaling. The current regimens for mCRPC therapy are still ineffective. Much evidence from in vitro and in vivo studies explored the roles of therapeutic interventions targeted at the mitochondria and programmed cell death for prostate cancer therapy. The present review will focus on the recent medications which targeted at mitochondria and programmed cell death in mCRPC and the significant findings from each study will be summarized and discussed. Development of therapeutic interventions, particularly at mitochondrial and cytotoxic targets for treatment of mCRPC without inducing cellular toxicity of normal tissues will be considered as the novel therapeutic strategy for mCRPC.

Causal associations of tea consumption on risk of pancreatic adenocarcinoma and the mediating role of vascular endothelial growth factor D levels

Tea is one of the most widely consumed beverages in the world. However, the association between tea and risk of pancreatic adenocarcinoma remains controversial. This study aimed to investigate the causal relationship between tea consumption and risk of pancreatic adenocarcinoma and to explore their mediating effects. The two-sample Mendelian randomisation (MR) analysis showed an inverse causal relationship between tea intake and pancreatic adenocarcinoma (OR: 0·111 (0·02, 0·85), P < 0·04). To examine the mediating effects, we explored the potential mechanisms by which tea intake reduces the risk of pancreatic adenocarcinoma. Based on the oral bioavailability and drug-like properties in Traditional Chinese Medicine Systems Pharmacology database, we selected the main active ingredients of tea. We screened out the fifteen representative targeted genes by Pharmmapper database, and the gene ontology enrichment analysis showed that these targeted genes were related to vascular endothelial growth factor (VEGF) pathway. The two-step MR analysis of results showed that only VEGF-D played a mediating role, with a mediation ratio of 0·230 (0·066, 0·394). In conclusion, the findings suggest that VEGF-D mediates the effect of tea intake on the risk of pancreatic adenocarcinoma.

Developing a novel dosiomics model to predict treatment failures following lung stereotactic body radiation therapy

Purpose

The purpose of this study was to investigate the dosiomics features of the interplay between CT density and dose distribution in lung SBRT plans, and to develop a model to predict treatment failure following lung SBRT treatment.

Methods

A retrospective study was conducted involving 179 lung cancer patients treated with SBRT at the University of Nebraska Medical Center (UNMC) between October 2007 and June 2022. Features from the CT image, Biological Effective Dose (BED) and five interaction matrices between CT and BED were extracted using radiomics mathematics. Our in-house feature selection pipeline was utilized to evaluate and rank features based on their importance and redundancy, with only the selected non-redundant features being used for predictive modeling. We randomly selected 151 cases and 28 cases as training and test datasets. Four different models were trained utilizing the Balanced Random Forest framework on the same training dataset to differentiate between failure and non-failure cases. These four models utilized the same number of selected features extracted from CT-only, BED-only, a combination of CT and BED, and a composite of CT and BED including their interaction matrices, respectively.

Results

The cohort included 125 non-failure cases and 54 failure cases, with a median follow-up time of 34.4 months. We selected the top 17 important and non-redundant features (with the Pearsons's coefficient < 0.5) in each model. When evaluated on the same independent test set, the four models-CT features-only, BED features-only, a combination of CT and BED features, and a composite model including features from CT and BED that includes their interaction matrices-achieved AUC values of 0.56, 0.75, 0.73, and 0.82, respectively, with corresponding accuracies of 0.61, 0.79, 0.71, and 0.79. The composite model demonstrated the highest AUC and accuracy, indicating that incorporating interactions between CT and BED reveals more predictive capabilities in distinguishing between failure and non-failure cases.

Conclusion

The dosiomics model integrating the interaction between CT and Dose can effectively predict treatment failure following lung SBRT treatment and may serve as a useful tool to proactively evaluate and select lung SBRT treatment plans to reduce treatment failure in the future.

Nanoformulations in the treatment of lung cancer: current status and clinical potential

OBJECTIVE

Recent developments in nanotechnology have regained hope in enabling the eradication of lung cancer, while overcoming the drawbacks of the classic therapeutics. Nevertheless, there are still formidable obstacles that hinder the translation of such platforms from the bench into the clinic. Herein, we shed light on the clinical potential of these formulations and discuss their future directions.

SIGNIFICANCE OF REVIEW

The current article sheds light on the recent advancements in the recruitment of nanoformulations against lung cancer, focusing on their unique features, merits, and demerits. Moreover, inorganic nanoparticles, including gold, silver, magnetic, and carbon nanotubes are highlighted as emerging drug delivery technologies. Furthermore, the clinical status of these formulations is discussed, with particular attention on the challenges that they encounter in their clinical translation. Lastly, the future perspectives in this promising area are inspired.

KEY FINDINGS

Nanoformulations have a promising potential in improving the physico-chemical properties, pharmacokinetics, delivery efficiency, and selectivity of lung cancer therapeutics. The key challenges that encounter their clinical translation include their structural intricacy, high production cost, scale-up issues, and unclear toxicity profiles. The application of biodegradable platforms improves the biosafety of lung cancer-targeted nanomedicine. Moreover, the design of novel targeting strategies that apply a lower number of components can promote their industrial scalability and deliver them to the market at affordable prices.

CONCLUSIONS

Nanomedicines have opened up new possibilities for treating lung cancer. Focusing on tackling the challenges that hinder their clinical translation will promote the future of this area of endeavor.

Chemical perturbations impacting histone acetylation govern colorectal cancer differentiation

Dysregulated epigenetic programs that restrict differentiation, reactivate fetal genes, and confer phenotypic plasticity are critical to colorectal cancer (CRC) development. By screening a small molecule library targeting epigenetic regulators using our dual reporter system, we found that inhibiting histone deacetylase (HDAC) 1/2 promotes CRC differentiation and anti-tumor activity. Comprehensive biochemical, chemical, and genetic experiments revealed that on-target blockade of the HDAC1/2 catalytic domain mediated the differentiated phenotype. Unbiased profiling of histone posttranslational modifications induced by HDAC1/2 inhibition nominated acetylation of specific histone lysine residues as potential regulators of differentiation. Genome-wide assessment of implicated marks indicated that H3K27ac gains at HDAC1/2-bound regions associated with open chromatin and upregulation of differentiation genes upon HDAC1/2 inhibition. Disrupting H3K27ac by degrading acetyltransferase EP300 rescued HDAC1/2 inhibitor-mediated differentiation of a patient-derived CRC model using single cell RNA-sequencing. Genetic screens revealed that DAPK3 contributes to CRC differentiation induced by HDAC1/2 inhibition. These results highlight the importance of specific chemically targetable histone modifications in governing cancer cell states and epigenetic reprogramming as a therapeutic strategy in CRC.

Pulmonary metastases from pancreatic cancer have different clinico-radiological features compared with those from colorectal cancer

BACKGROUND

Although pulmonary metastasectomy is a commonly-performed procedure, data are lacking on the feasibility and oncological efficacy of removal of pulmonary metastases from pancreatic cancer. In this study, we retrospectively compared features of pulmonary metastases from pancreatic cancer versus colorectal cancer (CRC, patients with CRC being common candidates for pulmonary metastasectomy) and outcomes of removing such metastases, with our aim being to identify specific features of the former.

METHODS

Data on removal of 182 pulmonary metastases (29 from pancreatic and 153 from CRC) performed from January 2013 to April 2024 were included in this analysis. Radio-pathological findings were compared between these groups. The study cohort comprised 139 pulmonary metastasectomies in 119 patients (24 with pancreatic cancer and 95 with CRC) in whom R0 resection was achieved and follow-up data were available.

RESULTS

Atypical radiological findings of pulmonary metastases, including polygonal-shape (P < 0.001), spiculae (P < 0.001), air bronchogram (P = 0.012), peripheral ground-glass opacities (P < 0.001), and pleural tags (P < 0.001) were present more frequently in metastases from pancreatic cancer than from CRC. Furthermore, pleural lavage cytology was more frequently positive in pulmonary metastases from pancreatic cancer than in those from CRC (P < 0.001). Disease-free survival was significantly shorter after the removal of metastases from pancreatic than from CRC (P < 0.001).

CONCLUSIONS

Some pulmonary metastases from pancreatic cancer have atypical radiological features. Surgical interventions for these may enable diagnosis. The prognosis is significantly poorer after removing metastases from pancreatic cancer than from CRC. The therapeutic significance of our findings requires further investigation.

Unlocking the future of colorectal cancer detection: Advances in screening glycosylation-based biomarkers on biological mass spectrometry technology

The incidence of colorectal cancer (CRC) is increasingly affecting younger populations, with its mortality rate rising annually. However, current clinical diagnostic techniques, such as colonoscopy and CEA antigen testing, remain invasive and prone to false-positive results, complicating early diagnosis and intervention. Glycosylation, a key post-translational modification, plays an essential role in cellular function, physiological regulation, and disease processes. In recent years, mass spectrometry technology has emerged as a powerful tool for screening glycan biomarkers, owing to its exceptional separation capabilities and sensitivity. This review encompasses the advancements in CRC glycan biomarkers from 2016 to 2024, with particular emphasis placed on N/O-glycan biomarkers identified through mass spectrometry. Nonetheless, the intrinsic low abundance and polyhydroxy nature of glycans hinder the specificity and sensitivity of current glycan biomarkers. To overcome these limitations, this article outlines pretreatment strategies for N/O-glycans, including glycan release, enrichment, purification, and derivatization, in conjunction with relative quantification techniques and high-throughput bioinformatics tools for biomarker screening. These strategies are anticipated to enhance the efficiency and precision of glycan biomarker identification through mass spectrometry. These advancements hold significant promise for enhancing CRC prevention, diagnosis, and treatment, thereby potentially improving patient outcomes and quality of life.

Association between sidedness and survival among chemotherapy refractory metastatic colorectal cancer patients treated with trifluridine/tipiracil or regorafenib

BACKGROUND

The impact of sidedness on survival of later-line treatment in patients with metastatic colorectal cancer (mCRC) is undetermined. This study aimed to investigate the association between sidedness and survival among chemotherapy refractory patients with mCRC treated with trifluridine/tipiracil (TAS-102) or regorafenib or both.

PATIENTS AND METHODS

Patients with mCRC treated with TAS-102 or regorafenib between 2015 and 2020 was retrospectively collected. Patients were stratified into TAS-102 first and regorafenib first, then subdivided into TAS-102 followed by regorafenib (T-R) and regorafenib followed by TAS-102 (R-T) groups. The oncologic outcomes were presented with time-to-treatment failure (TTF) and overall survival (OS).

RESULTS

After matching, 376 TAS-102 patients and 376 regorafenib patients were included for outcomes comparison. TTF had insignificant differences while OS was significantly different between TAS-102 and regorafenib groups. Median TTF and OS were 1.9 months versus 2.0 months (P = .701) and 9.1 months versus 7.0 months (P = .008) in TAS-102 and regorafenib, respectively. The OS benefits were consistent regardless primary tumor location. Subgroup analysis with 174 T-R patients and 174 R-T patients was investigated for treatment sequences. TTF and OS had significant differences in both groups. Median TTF and OS were 8.5 months versus 6.3 months (P = .001) and 14.4 months versus 12.6 months (P = .035) in T-R and R-T groups, respectively. The TTF and OS benefits were persisted regardless primary tumor location.

CONCLUSION

TAS-102 first provided a better survival benefit in chemotherapy refractory patients with mCRC across all sidedness. Further prospective studies are warranted to validate our conclusions.

LIMD1-AS1 promotes the progression of prostate cancer and affects the function of prostate cancer cells by down-regulating miR-29c-3p

PURPOSE

Prostate cancer (PCa) is a prevalent and lethal malignancy affecting males, with a considerable proportion of patients experiencing poor survival outcomes. The regulatory role of LIMD1-AS1 in the initiation and progression of PCa is emerging as a significant factor, however, the precise mechanisms governing its influence are yet to be fully elucidated.

METHODS

qRT-PCR was employed to assess the expression of LIMD1-AS1 and miR-29c-3p. The Cell Counting Kit-8 (CCK-8) was used to assess cell proliferation in PCa cells. Apoptosis rates were determined using flow cytometry. Cell migration and invasion were evaluated using the transwell assay. The targeted relationship of LIMD1-AS1 and miR-29c-3p was confirmed through dual-luciferase reporter gene analysis.

RESULTS

Increased expression of LIMD1-AS1 and decreased expression of miR-29c-3p were observed in both tumor tissues and serum from PCa patients. LIMD1-AS1 exhibited diagnostic and prognostic significance in PCa patients. Functionally, LIMD1-AS1 modulated the expression of miR-29c-3p to potentiate the proliferative, migratory, and invasive capabilities of PCa cells while concurrently inhibiting apoptosis.

CONCLUSION

LncRNA LIMD1-AS1 promotes the advancement of PCa by regulating miR-29c-3p, indicating that LIMD1-AS1/miR-29c-3p axis could serve as potential therapeutic targets for the therapeutic intervention of PCa.

Clinical perspectives on the value of testing for STK11 and KEAP1 mutations in advanced NSCLC

Standard first-line therapy for patients with metastatic non-small cell lung cancer (mNSCLC) without identified actionable mutations consists of regimens comprising immune checkpoint inhibitors (ICIs), alone or in combination with platinum-based chemotherapy (CTx). However, approximately 20-30% of patients with mNSCLC (including some patients with high tumor programmed cell death ligand-1 expression) display primary resistance to ICIs, either alone or in combination with CTx. Mutations in tumor suppressor genes serine/threonine kinase 11 (STK11), and Kelch-like ECH-associated protein 1 (KEAP1) often detected in patients with Kirsten rat sarcoma virus mutations, are associated with an aggressive disease phenotype and resistance to standard ICI regimens. Consequently, there is an important need for effective treatments for patients with NSCLC with STK11 or KEAP1 mutations. In this article, we describe new data on the prevalence of STK11 and KEAP1 mutations in a large clinical population, consider practicalities around the detection of these mutations using available biomarker testing methodologies, and describe experiences of managing some of these difficult-to-treat patients in our clinical practice.

Reshaping the Landscape of Locoregional Treatments for Breast Cancer Liver Metastases: A novel, intratumoral, p21-targeted percutaneous therapy increases survival in BALB/c mice inoculated with 4T1 triple negative breast cancer cells in the liver

Patients with disseminated metastatic disease from breast cancer are likely to have liver involvement in >50% of cases at some point during disease progression. These patients have a poor prognosis; and, when treated with the standard of care systemic therapy they have a median survival of <9-months. Increasing survival in breast cancer patients will likely require the administration of better therapies that are specifically targeted to treat distant metastases. One approach to increasing treatment efficacy for breast cancer liver metastases is through the application locoregional therapies. Locoregional therapies are an appealing interventional approach for breast cancer patients with liver metastases since these tumor lesions are accessible via minimally invasive procedures that can be administered using either ultrasound or CT imaging. Current locoregional therapies to treat breast cancer liver metastases are non-specific and have not produced significant increases in survival. The goal of this study was to design and test a targeted locoregional therapeutic intervention for breast cancer liver metastases. The lead candidate, a fixed-dose small-molecule drug called MBC-005, was tested in vitro and then the efficacy was evaluated in a BALB/c mouse liver metastases model. A novel formulation of N-allyl noroxymorphone hydrochloride incorporated into an alginate-based gel overcomes many of the limitations associated with the administration of small-molecule drugs, which include solubility, off-target toxicity, and enzymatic degradation. In vitro results demonstrated that MBC-005 mediated its anti-tumorigenic effect through a p21-dependent mechanism via a novel molecular pathway, in which N-allyl noroxymorphone component of MBC-005 stimulated the opioid growth factor receptor to increase p21 expression. Intratumoral administration of MBC-005 increased survival 3.9-fold in mice and significantly decreased tumor volume 4-fold. While many cytotoxic therapies increase p21 expression as a response to DNA damage, MBC-005 increased p21 expression independent cytotoxic DNA damage. MBC-005 did not induce off-target toxicity; and, as such, would be amenable to multiple rounds of administration. Nevertheless, it is notable that the positive effects of MBC-005 treatment on increasing survival and decreasing tumor volume in mice was achieved using a single dose.

Elevated Expression of Cell Adhesion, Metabolic, and Mucus Secretion Gene Clusters Associated with Tumorigenesis, Metastasis, and Poor Survival in Pancreatic Ductal Adenocarcinoma

OBJECTIVES

Technological advances in identifying gene expression profiles are being applied to study an array of cancers. The goal of this study was to identify differentially expressed genes in pancreatic ductal adenocarcinoma (PDAC) and examine their potential role in tumorigenesis and metastasis.

METHODS

The transcriptomic profiles of PDAC and non-tumorous tissue samples were derived from the gene expression omnibus (GEO), which is a public repository. The GEO2R tool was used to further derive differentially expressed genes from those profiles.

RESULTS

In this study, a total of 68 genes were derived from upregulated PDAC genes in three or more transcriptomic profiles and were considered PDAC gene sets. The identified PDAC gene sets were examined in the molecular signatures database (MSigDB) for ontological investigation, which revealed that these genes were involved in the extracellular matrix and associated with the cell adhesion process in PDAC tumorigenesis. The gene set enrichment analysis showed greater enrichment scores for the gene sets. Moreover, the identified gene sets were examined for protein-protein interaction using the STRING database. Based on functional k-means clustering, the following three functional cluster groups were identified in this study: extracellular matrix/cell adhesion, metabolic, and mucus secretion-related protein groups. The receiver operating characteristic (ROC) curve revealed greater specificity and sensitivity for these cluster genes in predicting PDAC tumorigenesis and metastases. In addition, the expression of the cluster genes affects the overall survival rate of PDAC patients. Using the cancer genome atlas (TCGA) database, the associations between expression levels and clinicopathological features were validated.

CONCLUSIONS

Overall, the genes identified in this study appear to be critical in PDAC development and can serve as potential diagnostic and prognostic targets for pancreatic cancer treatment.

Association of "a body shape index" with the risk of developing colorectal cancer in U.S. patients with metabolic syndrome: evidence from the NHANES 1999-2018

BACKGROUND

Colorectal cancer (CRC) is the third most common cancer worldwide and presents a significant challenge to public health. Metabolic syndrome (MetS) is a condition that is predominantly characterized by abdominal obesity and metabolic abnormalities such as hypertension, hyperglycemia, and hyperlipidemia, and it is one of the critical risk factors for CRC. Traditional anthropometric measures have limitations in accurately assessing the risk associated with abdominal obesity. This study aimed to investigate the association between "A Body Shape Index" (ABSI) and the risk of developing CRC among individuals with MetS utilizing data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

This cross-sectional study conducted a statistical analysis of all adult participants who met the diagnostic criteria for MetS in the NHANES data from 1999 to 2018. The ABSI was calculated to quantify abdominal obesity. ABSI is derived from a formula that incorporates waist circumference (WC), body mass index (BMI), and height, and is calculated as ABSI = WC / (BMI^(2/3) × Height^(1/2)). Multivariate logistic regression modeling was used to examine the independent association between ABSI and CRC incidence. Receiver Operating Characteristic (ROC) curves were employed to analyze the ability of ABSI compared to traditional metrics in identifying CRC risk.

RESULTS

This study involved 16,018 MetS patients with a mean age of 51.8 years, of whom 50.3% were male and 49.7% were female. Logistic regression adjusted for confounders revealed a significant association between an elevated ABSI and an increased risk of developing CRC (odds ratio (OR): 1.433, 95% confidence interval (CI): 1.116 to 1.841; P = 0.005). ROC analyses confirmed that the predictive accuracy of the ABSI for the risk of developing CRC area under the curve (AUC): (0.668, 95% CI: 0.624 to 0.713) surpassed that of traditional measurement methods.

CONCLUSION

Among individuals with MetS, the ABSI is linked to an elevated risk of developing CRC. Compared with traditional anthropometric indices, the ABSI is a superior predictive marker for the risk of developing CRC.

Ribosomal rodeo: wrangling translational machinery in gynecologic tumors

Gynecologic cancers are a significant cause of morbidity and mortality among women worldwide. Despite advancements in diagnosis and treatment, the molecular mechanisms underlying the development and progression of these cancers remain poorly understood. Recent studies have implicated translational machinery (ribosomal proteins (RPs) and translation factors (TFs)) as potential drivers of oncogenic processes in various cancer types, including gynecologic cancers. RPs are essential components of the ribosome, which is responsible for protein synthesis. In this review paper, we aim to explore the role of translational machinery in gynecologic cancers. Specifically, we will investigate the potential mechanisms by which these components contribute to the oncogenic processes in these cancers and evaluate the feasibility of targeting RPs as a potential therapeutic strategy. By doing so, we hope to provide a broader view of the molecular pathogenesis of gynecologic cancers and highlight their potential as novel therapeutic targets for the management of these challenging diseases.

Exploring the Prognostic Value of Tumour-Associated Genes in Clear Cell Renal Cell Carcinoma Through Single-Cell RNA Sequencing Insights

Clear cell renal cell carcinoma (ccRCC) characterised by its diversity and a tendency to defy standard therapeutic approaches. Amidst the advent of immunotherapy, it has become imperative to pinpoint prognostic indicators of the tumour microenvironment (TME) influence the efficacy of treatments. Employing single-cell RNA sequencing (scRNA-seq), this research delved into the diverse landscape of ccRCC, uncovering its complex underpinnings and pinpointing molecular avenues for therapeutic intervention. We constructed a prognostic model using 101 machine learning algorithms and integrated data from multiple cohorts, including TCGA, ICGC, and microarray datasets. The model's efficacy was assessed using the Concordance Index (C-index), and further analyses included pseudotime analysis of tumour cells, mutation analysis and correlation analysis between the prognostic model and tumour immunity. The prognostic model, combining Lasso regression and survival Support Vector Machine (SVM), demonstrated robust discrimination with a C-index of 0.650. Investigation into the TME uncovered pronounced associations between the presence of immune cell infiltrates and patient outcomes, with a notable emphasis on the impact of CCL2-expressing neoplastic cells. The GO Biological Processes (GOBP) encompass the regulation of endothelial cell maturation, the formation of endothelial layers, the enhancement of gene expression controlled by Notch receptors, and the development of endothelial barriers. The research effectively pinpointed critical prognostic markers and crafted a forecasting model that achieved a C-index of 0.650, highlighting the significant impact of immune cell infiltration, especially CCL2+ neoplastic cells, on ccRCC patient prognosis.

Patterns of care and outcomes for hepatocellular carcinoma and pancreatic cancer based on rurality of patient's residence in a rural midwestern state

BACKGROUND

Although advancements in surgical planning and multidisciplinary care have improved the survival of patients with hepatopancreatic cancers in recent years, the impact of the rurality of patient residence on care received and survival is not well known. We aimed to assess the association between the rurality of a patient's residence and cancer-specific survival outcomes among patients with hepatocellular carcinoma (HCC) and pancreatic cancer (PC) in Iowa, hypothesizing that patients in rural areas would experience lower survival.

METHODS

Adult patients diagnosed with HCC or PC between 2010 and 2020 were identified using the Iowa Cancer Registry. Chi-square tests were used to compare categorical variables by rural/urban status. Logistic regression was used to examine factors associated with receiving surgery. Multivariable-adjusted Cox proportional hazards regression was used to determine associations with cancer-specific mortality.

RESULTS

Of 1877 patients with HCC, 58%, 27%, and 16% resided in metropolitan, micropolitan, and rural areas, respectively. Approximately 70% of patients in rural areas traveled ≥50 miles for definitive care. Additionally, those residing in rural areas had the highest proportion of patients receiving definitive care at non-Commission on Cancer (CoC) centers (12.6% metro vs 14% micro vs 22.2% rural, P < .001). In a multivariable-adjusted analysis of patients with stage I to III disease, definitive care at a non-CoC center was independently associated with lower odds of surgery (odds ratio [OR] = 0.23; 95% CI, 0.12-0.45; P < .0001) and higher mortality risk (OR = 1.39; 95% CI, 1.07-1.79; P = .01), though rural residence was not. For PC, 5465 patients were diagnosed, and 51%, 28%, and 20% resided in metropolitan, micropolitan, and rural areas, respectively. Similar to HCC, although rural residence was neither associated with odds of surgery nor with mortality risk, receiving definitive care at non-CoC accredited centers was associated with significantly lower odds of receiving surgery (OR = 0.17; 95% CI, 0.11-0.26; P < .0001) and higher mortality risk (OR = 1.48; 95% CI, 1.23-1.77; P < .0001).

CONCLUSION

Rural residents with hepatopancreatic cancer have the highest proportion of patients receiving definitive care at non-CoC centers, which is associated with lower odds of receiving surgery and higher odds of mortality. This highlights the importance of standardizing complex cancer care and the need to foster collaboration between specialized and non-specialized centers.

Exploring the dual role of endoplasmic reticulum stress in urological cancers: Implications for tumor progression and cell death interactions

The endoplasmic reticulum (ER) is crucial for maintaining calcium balance, lipid biosynthesis, and protein folding. Disruptions in ER homeostasis, often due to the accumulation of misfolded or unfolded proteins, lead to ER stress, which plays a significant role in various diseases, especially cancer. Urological cancers, which account for high male mortality worldwide, pose a persistent challenge due to their incurability and tendency to develop drug resistance. Among the numerous dysregulated biological mechanisms, ER stress is a key factor in the progression and treatment response of these cancers. This review highlights the dual role of aberrant ER stress activation in urologic cancers, affecting both tumor growth and therapeutic outcomes. While ER stress can support tumor growth through pro-survival autophagy, it primarily inhibits cancer progression via apoptosis and pro-death autophagy. Interestingly, ER stress can paradoxically aid cancer progression through mechanisms such as exosome-mediated immune evasion. Additionally, the review examines how pharmacological interventions, particularly with phytochemicals, can stimulate ER stress-mediated tumor suppression. Key regulators, including PERK, IRE1α, and ATF6, are discussed for their roles in upregulating CHOP levels and triggering apoptosis. In conclusion, a deeper understanding of ER stress in urological cancers not only clarifies the complex interactions between cellular stress and cancer progression but also provides new opportunities for innovative therapeutic strategies.

Temporal Trends in Racial and Gender Disparities of Early Onset Colorectal Cancer in the United States: An Analysis of the CDC WONDER Database

BACKGROUND

The mortality rates of early-onset colorectal cancer (EOCRC) have surged globally over the past two decades. While the underlying reasons remain largely unknown, understanding its epidemiology is crucial to address this escalating trend. This study aimed to identify disparities potentially influencing these rates, enhancing risk assessment tools, and highlighting areas necessitating further research.

METHODS

Using the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) database, this study assessed EOCRC mortality data from 2012 to 2020. Individuals under 50 years who succumbed to EOCRC were identified through the International Classification of Diseases, Tenth Revision (ICD-10) codes. Data interpretation and representation were performed using R 4.2.2 software.

RESULTS

Between 2012 and 2020, EOCRC mortality rates fluctuated marginally between 1.7 and 1.8 per 100,000. Male mortality rates increased from 1.9 to 2.0 per 100,000, while female rates varied between 1.5 and 1.6 per 100,000. Significant variations were observed across age groups, with the 40-49 years category experiencing an increase from 6.34 (2012) to 6.94 (2020) per 100,000. Racial category-based data revealed the highest mortality rates among African Americans. Geographically, Mississippi and Alabama exhibited elevated mortality rates. Age-adjusted mortality rate (AAMR) assessments indicated a marked decline for both genders from 2012 to 2020, with consistently higher rates for men.

CONCLUSION

The findings highlight the evolving landscape of EOCRC mortality, revealing significant gender, age, and racial disparities. These results underscore the urgent need for tailored health strategies and intensified research efforts targeting these disparities.

Plasma Ceramide C24:0/C16:0 Ratio is Associated with Improved Survival in Patients with Pancreatic Ductal Adenocarcinoma

BACKGROUND

Pancreatic ductal adenocarcinoma (PDAC) has a high fatality rate, with surgery as the only curative treatment. Identification of new biomarkers related to survival may help guide discovery of new pathophysiologic pathways and potential therapeutic targets. As long-chain ceramides have been linked to tumor proliferation, we sought to determine if ceramide levels were prognostic in PDAC.

METHODS

Patients from two phase I studies of PDAC were followed for all-cause mortality. Ceramide levels (C24:0, C22:0, and C16:0) were quantified before treatment and at study intervals. Multivariable Cox regression models assessed the association of ceramide levels and mortality after adjusting for other univariable predictors, including time-dependent tumor resection. The ability of repeated ceramide measures to discriminate patients at risk for mortality was also assessed using multivariable modeling and the c-statistic.

RESULTS

Higher plasma C16:0 concentration was associated with higher all-cause mortality in univariable and multivariable analysis (adjusted hazard ratio [aHR] 1.41, 95% confidence interval [CI] 1.09-1.82; p < 0.01). In contrast, a higher plasma C24:0/C16:0 ratio was associated with lower all-cause mortality in multivariable analysis (aHR 0.69, 95% CI 0.49-0.97; p = 0.032). Discrimination of mortality was significantly improved with the addition of either plasma C16:0 or C24:0/C16:0 levels, with optimal discrimination occurring using repeated measures of the C24:0/C16:0 ratio (c-statistic 0.73 vs. c-statistic 0.66; p < 0.001).

CONCLUSIONS

Higher plasma C16:0 and lower C24:0/C16:0 ratios are independently associated with mortality in PDAC and show an ability to improve discrimination of mortality in this deadly disease. Further studies are needed to confirm this association and evaluate this novel pathway for potential therapeutic targets.

mTOR inhibitors potentially preserve fertility in female patients with haematopoietic malignancies: a narrative review

Haematologic malignancies are considered among the more common adolescent and young adult (AYA) cancers. Many female AYA patients with haematopoietic malignancies face impaired fertility. Haematologic malignancies patients tend to be treated with more aggressive systemic chemotherapy than that of solid tumours. In adult women, treatment-related contraception causes age-related fertility loss. Graft-versus-host disease (GVHD) after allogeneic haematopoietic stem cell transplantation is associated with decreased fertility. Ovarian cryopreservation is often indicated for haematopoietic malignancies; however, follicle loss associated with ovarian cryopreservation and ovarian minimal residual disease, which result in the withdrawal of the transplantation, are important issues. These problems may not be fully addressed by conventional methods of fertility preservation, such as oocyte, embryo, and ovarian cryopreservation, leaving room for research into new treatment approaches, such as fertility preservation drugs. In recent years, preclinical studies have shown that mTOR inhibitors may preserve chemotherapy-induced follicular loss, may have follicle-preserving effects on follicle loss associated with cryopreservation and transplantation of ovarian tissue, may have fertility-preserving effects on aging-related infertility. Clinical studies have shown that mTOR inhibitors may have the potential for indirect fertility preservation by controlling GVHD, have a limited anti-tumor effect against haematopoietic malignancies. The purpose of this article is to outline the various issues faced by female survivors of haematopoietic malignancies and discuss the potential of mTOR inhibitors as a safe treatment option. Based on current research, mTOR inhibitors seem promising and innovative fertility preservation agents regarding preclinical conditions, and further study, including clinical trials, should be expected.

Exploring the association of ADAM17 expression with survival in patients with non-small cell lung cancer

The A disintegrin and metalloprotease (ADAM) family is involved in many vital cellular events, from proliferation to migration, and accumulated evidence suggests its increased expression in malignant tumors. In this study, we investigated ADAM17 expression in non-small cell lung cancer (NSCLC) and its relationship with clinicopathological factors and survival. Immunohistochemical staining of ADAM expression was performed in 108 patients with NSCLC and in 54 control cases with no known malignant diagnosis. Association between ADAM17 expression, clinicopathological factors, and survival were analyzed. The Kaplan-Meier method was used for survival analysis. ADAM17 was lowly expressed in 89 (82.4%) and highly expressed in 19 (17.6%) of the patients with NSCLC. In univariate analysis, high ADAM17 expression, lymphovascular invasion, stage, and treatment response significantly affected progression-free survival (PFS) and overall survival (OS) (p < 0.05). Multivariate analysis also showed that high ADAM17 expression, lymphovascular invasion, stage, and treatment response were important prognostic factors for PFS and OS (p < 0.05). Our study revealed that high ADAM17 expression significantly associated with OS and PFS in patients with NSCLC. ADAM17 may potentially be the area of a new targeted treatment strategy in NSCLC. Thus, routine evaluation of ADAM17 expression in patients with NSCLC may be a future consideration.

Automated quality control analysis for American College of Radiology (ACR) digital mammography (DM) phantom images

PURPOSE

To develop and validate an automated software analysis method for mammography image quality assessment of the American College of Radiology (ACR) digital mammography (DM) phantom images.

METHODS

Twenty-seven DICOM images were acquired using Fuji mammography systems. All images were evaluated by three expert medical physicists using the Royal Australian and New Zealand College of Radiologists (RANZCR) mammography quality control guideline. To enhance the robustness and sensitivity assessment of our algorithm, an additional set of 12 images from a Hologic mammography system was included to test various phantom positional adjustments. The software automatically chose multiple regions of interest (ROIs) for analysis. A template matching method was primarily used for image analysis, followed by an additional method that locates and scores each target object (speck groups, fibers, and masses).

RESULTS

The software performance shows a good to excellent agreement with the average scoring of observers (intraclass correlation coefficient [ICC] of 0.75, 0.79, 0.82 for speck groups, fibers, and masses, respectively). No significant differences were found in the scoring of target objects between human observers and the software. Both methods achieved scores meeting the pass criteria for speck groups and masses. Expert observers allocated lower scores to fiber objects, with diameters less than 0.61 mm, when compared to the software. The software was able to accurately score objects when the phantom position changed by up to 25 mm laterally, up to 5 degrees rotation, and overhanging the chest wall edge by up to 15 mm.

CONCLUSIONS

Automated software analysis is a feasible method that may help improve the consistency and reproducibility of mammography image quality assessment with reduced reliance on human interaction and processing time.

Early-stage diagnosis of ovarian cancer via digital immunoassay on a SlipChip

Ovarian cancer (OC) is one of the three major gynecologic malignancies and has the highest mortality rate because of the late diagnosis. Liquid biopsy based on serum protein biomarkers has demonstrated great potential for early diagnosis but remains limited by the analysis performance of conventional immunoassay technologies, such as chemiluminescence, and biomarkers, such as CA125. To address this challenge and achieve accurate early-stage diagnosis of OC, we developed a digital immunoassay on a SlipChip (DiSC) for quantitative analysis of a potential serum protein biomarker, Spondin-1 (SPON1). The DiSC system achieved a limit of detection (LoD) of 23 fg/μL for digital quantification of SPON1. The DiSC system was utilized to quantify the serum level of SPON1 in 357 clinical serum samples, including 63 from patients with benign ovarian tumors and 294 from patients with malignant ovarian cancer, ranging from stages I to IV. SPON1 concentrations were significantly different in samples from patients with malignant ovarian cancer. Notably, significantly different SPON1 levels were observed in early stages (I and II), in lymph node-negative cases (N0), and before metastasis (M0), suggesting that SPON1 could serve as a sensitive diagnostic biomarker for early-stage OC. The differential diagnostic model based on SPON1 levels quantified using DiSC demonstrated an area under the curve (AUC) of 0.8187 for early-stage OC, a significant improvement over CA-125 (AUC = 0.6967). For OC of all stages, the AUC was 0.8225, which could be further increased to 0.8750 when combined with CA-125. This showcases the potential of SPON1 as a novel biomarker for sensitive early-stage diagnosis of ovarian cancer and the capability of the DiSC system in discovering low-abundance biomarkers for disease diagnosis.

Prognostic significance of a 3-gene ferroptosis-related signature in lung cancer via LASSO analysis and cellular functions of UBE2Z

Ferroptosis is a newly identified form of non-apoptotic programmed cell death resulting from iron-dependent lipid peroxidation. It is controlled by integrated oxidation and antioxidant systems. Ferroptosis exerts a crucial effect on the carcinogenesis of several cancers, including pulmonary cancer. Herein, a ferroptosis-associated gene signature for lung cancer prognosis and diagnosis was identified using integrative bioinformatics analyses. From the FerrDB database, 256 ferroptotic regulators and markers were identified. Of these, 25 exhibited differential expression between lung cancer and non-cancerous samples, as evidenced by the GSE19804 and GSE7670 datasets from the GEO database. Utilizing LASSO Cox regression analysis on TCGA-LUAD data, a potent 3-gene risk signature comprising CAV1, RRM2, and EGFR was established. This signature adeptly differentiates various survival outcomes in lung cancer patients, including overall survival and disease-specific intervals. Based on the 3-gene risk signature, lung cancer patients were categorized into high-risk and low-risk groups. Comparative analysis revealed 69 differentially expressed genes between these groups, with UBE2Z significantly associated with overall survival in TCGA-LUAD. UBE2Z was found to be upregulated in LUAD tissues and cells compared to normal controls. Functionally, the knockdown of UBE2Z curtailed aggressive behaviors in LUAD cells, including viability, migration, and invasion. Moreover, this knockdown led to a decrease in the mesenchymal marker vimentin while elevating the epithelial marker E-cadherin within LUAD cell lines. In conclusion, the ferroptosis-associated 3-gene risk signature effectively differentiates prognosis and clinical features in patients with lung cancer. UBE2Z was identified through this model, and it is upregulated in LUAD samples. Its knockdown inhibits aggressive cellular behaviors, suggesting UBE2Z's potential as a therapeutic target for lung cancer treatment.

Pyrimidine-triazole-tethered tert-butyl-piperazine-carboxylate suppresses breast cancer by targeting estrogen receptor signaling and β-catenin activation

Several chemotherapeutics against breast cancer are constrained by their adverse effects and chemoresistance. The development of novel chemotherapeutics to target metastatic breast cancer can bring effective clinical outcomes. Many breast cancer patients present with tumors that are positive for estrogen receptors (ERs), highlighting the importance of targeting the ER pathway in this particular subtype. Although selective estrogen receptor modulators (SERMs) are commonly used, their side effects and resistance issues necessitate the development of new ER-targeting agents. In this study, we report that a newly synthesized compound, TTP-5, a hybrid of pyrimidine, triazole, and tert-butyl-piperazine-carboxylate, effectively binds to estrogen receptor alpha (ERα) and suppresses breast cancer cell growth. We assessed the impact of TTP-5 on cell proliferation using MTT and colony formation assays and evaluated its effect on cell motility through wound healing and invasion assays. We further explored the mechanism of action of this novel compound by detecting protein expression changes using Western blotting. Molecular docking was used to confirm the interaction of TTP-5 with ERα. The results indicated that TTP-5 significantly reduced the proliferation of MCF-7 cells by blocking the ERα signaling pathway. Conversely, although it did not influence the growth of MDA-MB-231 cells, TTP-5 hindered their motility by modulating the expression of proteins associated with epithelial-mesenchymal transition (EMT), possibly via the Wnt/β-catenin pathway.

Synthesis and in vitro exploration of the 8-carbo substituted 5-methoxyflavones as anti-breast and anti-lung cancer agents targeting protein kinases (VEGFR-2 & EGFR)

The 8-aryl-, 8-styryl- and 8-arylethynyl substituted 5-methoxyflavones were synthesized and characterized using a combination of spectroscopic techniques. Single crystal X-ray diffraction (XRD) study on a representative compound 3h shows an inverted dimer linked by fused ten and six-membered ring motifs involving intermolecular CO⋯HC and CH⋯OC hydrogen bonds. Compounds 3b, 3c, 3d, 4a and 4b exhibited strong activity against the human breast (MCF-7) cancer cell line (IC50 = 13.68 ± 0.72, 16.91 ± 0.40, 13.63 ± 0.36, 14.66 ± 0.47 and 12.26 ± 0.45 μM, respectively) and lung (A549) cancer cell line (IC50 = 15.38 ± 0.33, 10.00 ± 0.28, 12.38 ± 0.30, 12.84 ± 0.33 and 8.47 ± 0.30 μM, respectively) compared to quercetin (IC50 = 40.61 ± 1.07 and 58.17 ± 0.50 μM, respectively). Compounds 3b, 3c and 4b exhibited dual inhibitory effect against the vascular endothelial growth factor receptor-2 (VEGFR-2) and the epidermal growth factor receptor (EGFR) tyrosine kinase phosphorylation. Molecular docking revealed that strong alignment with the enzyme backbone is achieved mostly by hydrophobic (π-π, and π-H) contacts and by hydrogen bonding interaction with the residues in the active sites of VEGFR-2 and EGFR. The test compounds possess favorable drug-likeness properties, supporting their potential as promising therapeutic candidates.

BRAF V600E positive papillary thyroid carcinoma (TERT and TP53 mutation coexistence excluded): Correlation of clinicopathological features and the extent of surgical treatment and its complications

INTRODUCTION

Papillary thyroid carcinoma (PTC) frequently harbors the BRAF V600E mutation. Recent research suggests that aggressive behavior in BRAF V600E+ PTC may be due to an undetected mutation in the TERT gene. This study aims to observe the clinicopathological features of BRAF V600+ PTC and correlate them with surgical treatment complications.

METHODS

A retrospective analysis was conducted on the BRAF V600E+ PTC cohort from July 2019 to January 2023. The histopathological features and surgical treatment (total thyroidectomy - group A, total thyroidectomy + central block neck dissection - group B) complications were correlated. Patients with TERT and TP53 mutation were excluded. Next-generation sequencing and real-time PCR were used for genetic analysis.

RESULTS

Out of 121 PTCs, 65 cases showed BRAF V600E mutation with the following features: intracapsular spread (13.8%), extracapsular spread (27.7%), extrathyroidal spread (15.4%), multifocality (26.2%), angioinvasion (12.3%), and local metastasis (27.7%). The incidence of surgical complications in group A/B was: reversible recurrent laryngeal nerve (RLN) paresis 3.7/7.1%, RLN paresis permanent 0/2.4%, paresthesia 6.8/23.8%, hypocalcemia 36.4/61.9% on day 1 and 27.3/33.3% on day 3, and bleeding 2.3/9.5%. There was no significant difference in clinicopathological features between the BRAF V600E+ and BRAF V600E- PTC groups. Group B had a significantly higher incidence of hypoacalcaemia on postoperative day 1 (p = 0.047).

CONCLUSION

The BRAF V600E mutation will certainly remain important in the preoperative diagnosis of PTC. The more radical surgical procedures currently recommended may be abandoned in the future, particularly elective CLND, which has a higher risk of postoperative complications.