Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk fac...Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus infections.Unfortunately,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited success.For advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted therapy.Emerging immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific immunomodulators.In this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.展开更多
Hepatocellular carcinoma(HCC)is a lethalmalignancy.Formany years,chemotherapeutic regimens have served as the foundation of sys-temic therapies for advanced HCCdespite their limited efficacy and significant adverse ef...Hepatocellular carcinoma(HCC)is a lethalmalignancy.Formany years,chemotherapeutic regimens have served as the foundation of sys-temic therapies for advanced HCCdespite their limited efficacy and significant adverse effects.In recent decades,novel systemic therapies such as immunotherapy and targeted therapy have profoundly transformed HCC management.Although some patients with advanced HCC exhibit dramatically improved outcomes,the efficacy of immunotherapy and targeted therapy,either asmonotherapy or in combina-tion,remains limited.Numerous trials have indicated that locoregional therapies,including transarterial chemoembolization(TACE),hepatic arterial infusion chemotherapy(HAIC),and transarterial radioembolization(TARE),may synergize with systemic therapies to enhance ad-vanced HCC treatment.However,further studies are required to optimize these combination regimens.In contrast,curative treatments,such as surgical resection,liver transplantation,or local ablation,are typically recommended for patients with early-stage HCC.Although these treatments have achieved an impressivemedian overall survival(OS)exceeding 60months,more than half of the patients experience recurrence within 5 years.Consequently,the development of effective perioperative neoadjuvant or adjuvant therapies is urgently needed to reduce the incidence of recurrence and metastasis.It provides a comprehensive overview of recent advances in systemic therapies for advanced HCC,as well as adjuvant or neoadjuvant immunotherapies for early HCC.Additionally,emerging clinical trials and trial designs for future investigations into systemic therapies for HCC management are critically analyzed.展开更多
Adventitious agents,comprising unintentionally introduced microorganisms in the production of biological products,pose a significant challenge in ensuring the safety of gene therapy products.The revised International ...Adventitious agents,comprising unintentionally introduced microorganisms in the production of biological products,pose a significant challenge in ensuring the safety of gene therapy products.The revised International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use(ICH)guildline Q5A(R2)from September 2022 highlights the inclusion of viral vector-based gene therapy products in safety discussions,emphasizing controls in material sourcing,testing,and viral clearance[1].Detecting adventitious virus contamination is complex due to the unique characteristics of gene therapy products and the limitations of routine testing methods.The US Food and Drug Administration(FDA)recommends incorporating routine and specific virus detection methods,including those outlined in various pharmacopeias.Existing control methods have limitations,prompting the need for highly sensitive and broad-spectrum detection approaches.Unlike traditional biological products,gene therapy products primarily consist of live viruses,necessitating methods that distinguish between the main virus and adventitious viruses.Current virus detection techniques,such as polymerase chain reaction(PCR),sequencing,mass spectrometry,and DNA microarrays[2e4],have their drawbacks.展开更多
Esophageal cancer is one of the most difficult cancers to treat since it is often at an advanced stage at the time of symptom presentation.For locally advanced esophageal cancer,treatment options include multidiscipli...Esophageal cancer is one of the most difficult cancers to treat since it is often at an advanced stage at the time of symptom presentation.For locally advanced esophageal cancer,treatment options include multidisciplinary treatment such as surgery or definitive chemoradiotherapy.Surgery has a high local control rate because it involves excision of the cancer along with the surrounding organs;however,it is still highly invasive,although advances in surgery have reduced the burden on patients.On the other hand,chemoradiotherapy may also be applicable in cases in which surgery is inoperable owing to complications or distant lymph node metastasis.However,chemoradiotherapy using X-ray irradiation can cause late toxicities,including those to the heart.Proton beam therapy is widely used to treat esophageal cancer because of its characteristics,and some comparisons between proton beam therapy and X-ray therapy or surgery have recently been reported.This review discusses the role of proton beam therapy in esophageal cancer in comparison to X-ray therapy and surgery.展开更多
Inflammatory bowel disease(IBD)represents a significant disease burden marked by chronic inflammation and complications that adversely affect patients’quality of life.Effective diagnostic strategies involve clinical ...Inflammatory bowel disease(IBD)represents a significant disease burden marked by chronic inflammation and complications that adversely affect patients’quality of life.Effective diagnostic strategies involve clinical assessments,endoscopic evaluations,imaging studies,and biomarker testing,where early diagnosis is essential for effective management and prevention of long-term complications,highlighting the need for continual advancements in diagnostic methods.The intricate interplay between genetic factors and the outcomes of biological therapy is of critical importance.Unraveling the genetic determinants that influence responses and failures to biological therapy holds significant promise for optimizing treatment strategies for patients with IBD on biologics.Through an indepth examination of current literature,this review article synthesizes critical genetic markers associated with therapeutic efficacy and resistance in IBD.Understanding these genetic actors paves the way for personalized approaches,informing clinicians on predicting,tailoring,and enhancing the effectiveness of biological therapies for improved outcomes in patients with IBD.展开更多
Prostate cancer is the most common non-cutaneous cancers occurring in American men,and whilemost men with early-stage prostate cancers are cured,up to a third might manifest with biochemical recurrence(BCR)of prostate...Prostate cancer is the most common non-cutaneous cancers occurring in American men,and whilemost men with early-stage prostate cancers are cured,up to a third might manifest with biochemical recurrence(BCR)of prostate cancer.BCR is a disease entitywhich is characterized by a rising prostate-specific antigen(PSA)in the setting of a previously treated localized prostate cancerwith either surgery or radiation therapywith curativeintent.展开更多
Designing and synthesizing nanomedicines with multi-modal tumor therapeutic capabilities is the key to cancer treatment.Herein,we prepared MICG nanoparticles(NPs)by assembling glucose oxidase(GOx)and indocyanine green...Designing and synthesizing nanomedicines with multi-modal tumor therapeutic capabilities is the key to cancer treatment.Herein,we prepared MICG nanoparticles(NPs)by assembling glucose oxidase(GOx)and indocyanine green(ICG)with manganese carbonate(MnCO_(3))NPs for starvation therapy cascaded chemodynamic therapy,enhanced phototherapy and immune activation.In MICG NPs,the GOx consumes intratumoral glucose resulting in starvation therapy,and simultaneously produces H_(2)O_(2)and decreases p H in tumor.The intensified acidic tumor environment promotes the decomposition of MnCO_(3)NPs to release Mn^(2+).The Mn^(2+)further catalyzes H_(2)O_(2)to generate hydroxyl radical for chemodynamic therapy.While ICG can generate singlet oxygen(^(1)O_(2))and heat to kill cancer cells through phototherapy mechanism.The hydroxyl radical and ^(1)O_(2) will further accelerate the oxidative stress,intensify immunogenic cell death,induce dendritic cell maturation,and thus activate systemic immunity.This work provides a new therapeutic platform for combining therapy of tumor.展开更多
Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer-related mortality.While early-stage CRC patients generally exhibit favorable overall survival(OS)rates,the prognos...Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer-related mortality.While early-stage CRC patients generally exhibit favorable overall survival(OS)rates,the prognosis for metastatic CRC(mCRC)remains poor,with a survival rate<15%.Targeted combination therapy remains the main treatment strategy for mCRC,with a median OS(mOS)of only 25-30 months.展开更多
BACKGROUND Radiation therapy is an important treatment for esophageal tumors.However,there is still controversy regarding the total dose and fraction dose.The optimal dose and fractionation schedule have not yet been ...BACKGROUND Radiation therapy is an important treatment for esophageal tumors.However,there is still controversy regarding the total dose and fraction dose.The optimal dose and fractionation schedule have not yet been clearly established.Hypofractionated radiotherapy is becoming more popular,but it is unknown whether this is the optimal choice for esophageal tumors.In addition,the appropriate dose per fraction is uncertain.We performed a retrospective study to address these issues.AIM To report the cumulative survival and toxicity associated with the delivered dose escalation and hypofractionation schedule of radiation therapy for esophageal squamous cell carcinoma.METHODS Forty-seven patients treated for inoperable locally advanced thoracic esophageal squamous cell carcinoma with helical tomotherapy using different total doses and doses per fraction were enrolled.Toxicity and adverse events were evaluated in all patients to determine the acute and long-term effects according to the Toxicity Criteria of The Radiation Therapy Oncology Group.Overall survival was calculated using the Kaplan-Meier method.Logistic analysis was used to identify the correlation between dose delivered to the primary tumor and the degree of toxicity.In multivariate analysis,all variables were entered in a single step using the method of backward stepwise regression.RESULTS Six patients died of bleeding related to aorto-esophageal fistulization.Four patients died of tracheo-esophageal fistulas,and 7 patients died of local recurrence.The remaining 20 patients died of metastases and multi-organ failure due to organ metastases.The dose of radiation and the dose level were positively correlated with esophageal toxicity,which was much greater with dose escalation and dose level per fraction increase.CONCLUSION Esophageal toxicity can be tolerated below a prescribed radiation dose of 60 Gy and less than 2.3 Gy per fraction.展开更多
BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidel...BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)has become a growing health concern globally.Microvascular invasion and high tumor burden are key factors limiting the curative effect of selective internal radiation therapy(SI...BACKGROUND Hepatocellular carcinoma(HCC)has become a growing health concern globally.Microvascular invasion and high tumor burden are key factors limiting the curative effect of selective internal radiation therapy(SIRT).CASE SUMMARY This case study reports a 49-year-old woman who was diagnosed with China Liver Cancer Staging(CNLC)IIIa HCC and>15 cm tumor diameter.Initially,due to insufficient future liver remnant and vascular invasion,the tumor was unresectable;however,radical hepatectomy was performed after successful conversion therapy with SIRT using yttrium-90(90Y)resin microspheres followed by hepatic arterial infusion chemotherapy(HAIC)with tyrosine kinase inhibitor(TKI)and anti-programmed death-1(PD-1)antibody.SIRT using 90Y resin microspheres was given by the right hepatic artery and chemoembolization was simultaneously performed in the tumor’s feeding vessels from the right diaphragmatic artery.HAIC was followed every three weeks with lenvatinib and tislelizumab.At 4 months post-SIRT,the tumor was downstaged to CNLC Ib and the patient successfully underwent hepatectomy.The histopathological examination of the resected specimen showed extensive necrosis.CONCLUSION This case study provides evidence for an integrated treatment strategy combining SIRT and HAIC with TKI and anti-PD-1 antibodies for patients with large HCC and microvascular invasion.Further confirmatory trials are required in the future.展开更多
Despite existing curative options like surgical removal,tissue destruction techniques,and liver transplantation for early-stage hepatocellular carcinoma(HCC),the rising incidence and mortality rates of this global hea...Despite existing curative options like surgical removal,tissue destruction techniques,and liver transplantation for early-stage hepatocellular carcinoma(HCC),the rising incidence and mortality rates of this global health burden necessitate continuous exploration of novel therapeutic strategies.This review critically assesses the dynamic treatment panorama for HCC,focusing specifically on the burgeoning role of immunotherapy in two key contexts:early-stage HCC and downstaging advanced HCC to facilitate liver transplant candidacy.It delves into the unique immunobiology of the liver and HCC,highlighting tumor-mediated immune evasion mechanisms.Analyzing the diverse immunothera-peutic approaches including checkpoint inhibitors,cytokine modulators,vaccines,oncolytic viruses,antigen-targeting antibodies,and adoptive cell therapy,this review acknowledges the limitations of current diagnostic markers alpha-fetoprotein and glypican-3 and emphasizes the need for novel biomarkers for patient selection and treatment monitoring.Exploring the rationale for neoadjuvant and adjuvant immunotherapy in early-stage HCC,current research is actively exploring the safety and effectiveness of diverse immunothera-peutic approaches through ongoing clinical trials.The review further explores the potential benefits and challenges of combining immunotherapy and liver transplant,highlighting the need for careful patient selection,meticulous monitoring,and novel strategies to mitigate post-transplant complications.Finally,this review delves into the latest findings from the clinical research landscape and future directions in HCC management,paving the way for optimizing treatment strategies and improving long-term survival rates for patients with this challenging malignancy.展开更多
Hepatocellular carcinoma(HCC)is one of the most common malignant tumors globally and is the most prevalent type of primary liver cancer,posing a heavy burden on global health.Surgical resection and liver transplantati...Hepatocellular carcinoma(HCC)is one of the most common malignant tumors globally and is the most prevalent type of primary liver cancer,posing a heavy burden on global health.Surgical resection and liver transplantation are the gold standard for the radical treatment of HCC.However,due to the heterogeneity and high invasiveness of HCC,the rates of local and distant recurrence are extremely high,with over 70%of patients experiencing recurrence within 5 years after treatment,significantly impacting the long-term quality of life.Therefore,researchers are exploring other treatment methods to reduce tumor recurrence and improve patient survival.To date,extensive research has concentrated on new alternative therapies,including radiotherapy(e.g.,selective internal radiotherapy),targeted drug therapy(e.g.,sorafenib and lenvatinib),and immunotherapy(e.g.,immune checkpoint inhibitors),which have played an integral role in the comprehensive treatment of HCC.This review mainly focuses on the cutting-edge advancements in these treatment methods for HCC and their potential role in reducing HCC recurrence.展开更多
Collecting duct carcinoma (CDC), or Bellini duct carcinoma, is a rare and aggressive subtype of renal cell carcinoma, accounting for 0.2% - 1% of cases. It often presents at an advanced stage with nonspecific symptoms...Collecting duct carcinoma (CDC), or Bellini duct carcinoma, is a rare and aggressive subtype of renal cell carcinoma, accounting for 0.2% - 1% of cases. It often presents at an advanced stage with nonspecific symptoms, requiring histopathology for diagnosis. Surgery remains the standard of care for localized disease, serving both diagnostic and therapeutic purposes, though adjuvant chemotherapy has shown limited efficacy. In metastatic CDC, the gemcitabine-cisplatin regimen is commonly used due to its resemblance to urothelial cancer and supportive data from prospective studies. Newer therapies offer promise in advanced cases. Immune checkpoint inhibitors, such as nivolumab alone or with ipilimumab, have shown benefits in patients with high PD-L1 expression. Targeted therapies like cabozantinib demonstrated efficacy and safety as first-line treatments in phase II trials, while sunitinib and sorafenib have shown responses in various case reports and cohorts. However, combining chemotherapy with bevacizumab did not improve outcomes in phase II trials. Despite therapeutic advances in urothelial cancers and clear cell renal tumors, the CDC entity remains a challenging malignancy, emphasizing the need for continued research to understand the true efficacy of treatment and to prolong survival in advanced disease.展开更多
BACKGROUND Total neoadjuvant therapy(TNT)has been proposed as an advancement over standard long-course chemoradiotherapy(LCCRT)for the treatment of locally advanced rectal cancer(LARC).It has been suggested that TNT e...BACKGROUND Total neoadjuvant therapy(TNT)has been proposed as an advancement over standard long-course chemoradiotherapy(LCCRT)for the treatment of locally advanced rectal cancer(LARC).It has been suggested that TNT enhances resect-ability,improves treatment compliance,increases the rate of pathological comp-lete response,and reduces the risk of systemic recurrence.However,concerns have been raised that the prolonged interval to surgery associated with TNT,particularly in regimens such as the Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation(RAPIDO)protocol,may exacerbate fibrosis,leading to more technically challenging resections and poorer surgical outcomes.RAPIDO vs LCCRT.METHODS A single-center,retrospective cohort study was conducted of patients with LARC treated with TNT-RAPIDO or standard LCCRT followed by surgical resection between 2014 and 2024.A total of 99 patients with LARC were analyzed,inclu-ding 29 treated with TNT-RAPIDO and 70 treated with standard LCCRT.Demo-graphics,clinicopathological characteristics and early post-operative outcomes were compared between both groups.RESULTS Both groups were comparable in terms of demographics and clinicopathological characteristics.The median interval from initiation of neoadjuvant therapy to Core Tip:Rectal cancer and preoperative induction therapy followed by dedicated operation has emerged as a total neoadjuvant therapy strategy with improved oncological and functional outcomes.The impact of total neoadjuvant therapy on operative difficulty and short-term surgical outcomes,compared with long-course chemoradiotherapy,remains an area of ongoing debate.This cohort study of 99 patients demonstrated that the Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation(RAPIDO)protocol does not increase surgical difficulty or compromise early surgical outcomes compared with long-course chemoradiotherapy.It may also confer a shorter total stoma duration and a lower permanent stoma rate.randomized controlled trials in the future are warranted to more accurately assess the differences between TNT-RAPIDO and LCCRT in relation to oncological outcomes.展开更多
In this manuscript,we comment on the article by Zhou et al,who assessed the efficacy of hepatic arterial infusion chemotherapy(HAIC)and its combination strategies for advanced hepatocellular carcinoma(HCC)using networ...In this manuscript,we comment on the article by Zhou et al,who assessed the efficacy of hepatic arterial infusion chemotherapy(HAIC)and its combination strategies for advanced hepatocellular carcinoma(HCC)using network metaanalysis methodology.We focus specifically on the potential advantages and role of HAIC in the treatment algorithm for advanced HCC.However,there remains numerous knowledge gaps before the role of HAIC can be established.There is significant heterogeneity of HAIC regimes with difficult interpretation of the clinical outcomes.Additionally,there is a lack of direct comparative data between HAIC,systemic chemotherapy,novel immunotherapies and targeted therapies.The underlying biochemical mechanisms that might explain the efficacy of HAIC and its effect on the HCC microenvironment requires further research.In the developing era of nanotechnology and targeted drug delivery systems,there is potential for integration of HAIC with novel technologies to effectively treat advanced HCC whilst minimising systemic complications.展开更多
BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive di...BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.展开更多
Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied fo...Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.展开更多
This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinom...This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.展开更多
Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evalua...Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.展开更多
文摘Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus infections.Unfortunately,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited success.For advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted therapy.Emerging immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific immunomodulators.In this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.
基金work was supported by grants from the National Natural Science Foundation of China(No.82073346)Doctoral Through Train Scien-tific Research Project of Chongqing(No.CSTB2022BSXM-JCX0004)+1 种基金Famous Teachers section of the Chongqing Talents Program(No.4246ZP112)Special Projects of Army Medical University for Improving Scientific and Technological Innovation Capabilities(No.2019XLC1009).
文摘Hepatocellular carcinoma(HCC)is a lethalmalignancy.Formany years,chemotherapeutic regimens have served as the foundation of sys-temic therapies for advanced HCCdespite their limited efficacy and significant adverse effects.In recent decades,novel systemic therapies such as immunotherapy and targeted therapy have profoundly transformed HCC management.Although some patients with advanced HCC exhibit dramatically improved outcomes,the efficacy of immunotherapy and targeted therapy,either asmonotherapy or in combina-tion,remains limited.Numerous trials have indicated that locoregional therapies,including transarterial chemoembolization(TACE),hepatic arterial infusion chemotherapy(HAIC),and transarterial radioembolization(TARE),may synergize with systemic therapies to enhance ad-vanced HCC treatment.However,further studies are required to optimize these combination regimens.In contrast,curative treatments,such as surgical resection,liver transplantation,or local ablation,are typically recommended for patients with early-stage HCC.Although these treatments have achieved an impressivemedian overall survival(OS)exceeding 60months,more than half of the patients experience recurrence within 5 years.Consequently,the development of effective perioperative neoadjuvant or adjuvant therapies is urgently needed to reduce the incidence of recurrence and metastasis.It provides a comprehensive overview of recent advances in systemic therapies for advanced HCC,as well as adjuvant or neoadjuvant immunotherapies for early HCC.Additionally,emerging clinical trials and trial designs for future investigations into systemic therapies for HCC management are critically analyzed.
基金financially supported by Beijing Municipal Science&Technology Commission,China(Grant No.:Z221100007922015)Youth Development Research Foundation of National Institutes for Food and Drug Control,China(Grant No.:2020B1).
文摘Adventitious agents,comprising unintentionally introduced microorganisms in the production of biological products,pose a significant challenge in ensuring the safety of gene therapy products.The revised International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use(ICH)guildline Q5A(R2)from September 2022 highlights the inclusion of viral vector-based gene therapy products in safety discussions,emphasizing controls in material sourcing,testing,and viral clearance[1].Detecting adventitious virus contamination is complex due to the unique characteristics of gene therapy products and the limitations of routine testing methods.The US Food and Drug Administration(FDA)recommends incorporating routine and specific virus detection methods,including those outlined in various pharmacopeias.Existing control methods have limitations,prompting the need for highly sensitive and broad-spectrum detection approaches.Unlike traditional biological products,gene therapy products primarily consist of live viruses,necessitating methods that distinguish between the main virus and adventitious viruses.Current virus detection techniques,such as polymerase chain reaction(PCR),sequencing,mass spectrometry,and DNA microarrays[2e4],have their drawbacks.
文摘Esophageal cancer is one of the most difficult cancers to treat since it is often at an advanced stage at the time of symptom presentation.For locally advanced esophageal cancer,treatment options include multidisciplinary treatment such as surgery or definitive chemoradiotherapy.Surgery has a high local control rate because it involves excision of the cancer along with the surrounding organs;however,it is still highly invasive,although advances in surgery have reduced the burden on patients.On the other hand,chemoradiotherapy may also be applicable in cases in which surgery is inoperable owing to complications or distant lymph node metastasis.However,chemoradiotherapy using X-ray irradiation can cause late toxicities,including those to the heart.Proton beam therapy is widely used to treat esophageal cancer because of its characteristics,and some comparisons between proton beam therapy and X-ray therapy or surgery have recently been reported.This review discusses the role of proton beam therapy in esophageal cancer in comparison to X-ray therapy and surgery.
基金Supported by The European Union-Next Generation EU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008。
文摘Inflammatory bowel disease(IBD)represents a significant disease burden marked by chronic inflammation and complications that adversely affect patients’quality of life.Effective diagnostic strategies involve clinical assessments,endoscopic evaluations,imaging studies,and biomarker testing,where early diagnosis is essential for effective management and prevention of long-term complications,highlighting the need for continual advancements in diagnostic methods.The intricate interplay between genetic factors and the outcomes of biological therapy is of critical importance.Unraveling the genetic determinants that influence responses and failures to biological therapy holds significant promise for optimizing treatment strategies for patients with IBD on biologics.Through an indepth examination of current literature,this review article synthesizes critical genetic markers associated with therapeutic efficacy and resistance in IBD.Understanding these genetic actors paves the way for personalized approaches,informing clinicians on predicting,tailoring,and enhancing the effectiveness of biological therapies for improved outcomes in patients with IBD.
文摘Prostate cancer is the most common non-cutaneous cancers occurring in American men,and whilemost men with early-stage prostate cancers are cured,up to a third might manifest with biochemical recurrence(BCR)of prostate cancer.BCR is a disease entitywhich is characterized by a rising prostate-specific antigen(PSA)in the setting of a previously treated localized prostate cancerwith either surgery or radiation therapywith curativeintent.
基金supported by the National Key Research and Development Program of China(No.2022YFA1207600)the National Natural Science Foundation of China(Nos.62375289,62175262)+2 种基金the Science and Technology Innovation Program of Hunan Province(No.2022RC1201)the Scientific Research Fund of Hunan Provincial Education Department(No.22B0081)Postdoctoral Funding Project of Jiangsu Province(No.2019Z156)。
文摘Designing and synthesizing nanomedicines with multi-modal tumor therapeutic capabilities is the key to cancer treatment.Herein,we prepared MICG nanoparticles(NPs)by assembling glucose oxidase(GOx)and indocyanine green(ICG)with manganese carbonate(MnCO_(3))NPs for starvation therapy cascaded chemodynamic therapy,enhanced phototherapy and immune activation.In MICG NPs,the GOx consumes intratumoral glucose resulting in starvation therapy,and simultaneously produces H_(2)O_(2)and decreases p H in tumor.The intensified acidic tumor environment promotes the decomposition of MnCO_(3)NPs to release Mn^(2+).The Mn^(2+)further catalyzes H_(2)O_(2)to generate hydroxyl radical for chemodynamic therapy.While ICG can generate singlet oxygen(^(1)O_(2))and heat to kill cancer cells through phototherapy mechanism.The hydroxyl radical and ^(1)O_(2) will further accelerate the oxidative stress,intensify immunogenic cell death,induce dendritic cell maturation,and thus activate systemic immunity.This work provides a new therapeutic platform for combining therapy of tumor.
基金supported by grants from the National Natural Science Foundation of China(Nos.U22A20330 and 82373372)the Key Project of Research and Development Plan in Heilongjiang Province(Nos.2022ZX06C01 and JD2023SJ40)+1 种基金the Natural Science Funding of Heilongjiang(No.YQ2022H017)the Haiyan Foundation of Harbin Medical University Cancer Hospital(No.JJJQ 2024-02).
文摘Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer-related mortality.While early-stage CRC patients generally exhibit favorable overall survival(OS)rates,the prognosis for metastatic CRC(mCRC)remains poor,with a survival rate<15%.Targeted combination therapy remains the main treatment strategy for mCRC,with a median OS(mOS)of only 25-30 months.
文摘BACKGROUND Radiation therapy is an important treatment for esophageal tumors.However,there is still controversy regarding the total dose and fraction dose.The optimal dose and fractionation schedule have not yet been clearly established.Hypofractionated radiotherapy is becoming more popular,but it is unknown whether this is the optimal choice for esophageal tumors.In addition,the appropriate dose per fraction is uncertain.We performed a retrospective study to address these issues.AIM To report the cumulative survival and toxicity associated with the delivered dose escalation and hypofractionation schedule of radiation therapy for esophageal squamous cell carcinoma.METHODS Forty-seven patients treated for inoperable locally advanced thoracic esophageal squamous cell carcinoma with helical tomotherapy using different total doses and doses per fraction were enrolled.Toxicity and adverse events were evaluated in all patients to determine the acute and long-term effects according to the Toxicity Criteria of The Radiation Therapy Oncology Group.Overall survival was calculated using the Kaplan-Meier method.Logistic analysis was used to identify the correlation between dose delivered to the primary tumor and the degree of toxicity.In multivariate analysis,all variables were entered in a single step using the method of backward stepwise regression.RESULTS Six patients died of bleeding related to aorto-esophageal fistulization.Four patients died of tracheo-esophageal fistulas,and 7 patients died of local recurrence.The remaining 20 patients died of metastases and multi-organ failure due to organ metastases.The dose of radiation and the dose level were positively correlated with esophageal toxicity,which was much greater with dose escalation and dose level per fraction increase.CONCLUSION Esophageal toxicity can be tolerated below a prescribed radiation dose of 60 Gy and less than 2.3 Gy per fraction.
基金was given by a 2017 Research Grant of the Italian Society of Interventional Cardiology (SICI-GISE)
文摘BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.
基金The Fujian Key Laboratory of Translational Cancer Medicine and The Yttrium Little Red Flower Health Fund Project of Henan Sunshine Medical and Health Development Foundation,No.HKP2024001.
文摘BACKGROUND Hepatocellular carcinoma(HCC)has become a growing health concern globally.Microvascular invasion and high tumor burden are key factors limiting the curative effect of selective internal radiation therapy(SIRT).CASE SUMMARY This case study reports a 49-year-old woman who was diagnosed with China Liver Cancer Staging(CNLC)IIIa HCC and>15 cm tumor diameter.Initially,due to insufficient future liver remnant and vascular invasion,the tumor was unresectable;however,radical hepatectomy was performed after successful conversion therapy with SIRT using yttrium-90(90Y)resin microspheres followed by hepatic arterial infusion chemotherapy(HAIC)with tyrosine kinase inhibitor(TKI)and anti-programmed death-1(PD-1)antibody.SIRT using 90Y resin microspheres was given by the right hepatic artery and chemoembolization was simultaneously performed in the tumor’s feeding vessels from the right diaphragmatic artery.HAIC was followed every three weeks with lenvatinib and tislelizumab.At 4 months post-SIRT,the tumor was downstaged to CNLC Ib and the patient successfully underwent hepatectomy.The histopathological examination of the resected specimen showed extensive necrosis.CONCLUSION This case study provides evidence for an integrated treatment strategy combining SIRT and HAIC with TKI and anti-PD-1 antibodies for patients with large HCC and microvascular invasion.Further confirmatory trials are required in the future.
文摘Despite existing curative options like surgical removal,tissue destruction techniques,and liver transplantation for early-stage hepatocellular carcinoma(HCC),the rising incidence and mortality rates of this global health burden necessitate continuous exploration of novel therapeutic strategies.This review critically assesses the dynamic treatment panorama for HCC,focusing specifically on the burgeoning role of immunotherapy in two key contexts:early-stage HCC and downstaging advanced HCC to facilitate liver transplant candidacy.It delves into the unique immunobiology of the liver and HCC,highlighting tumor-mediated immune evasion mechanisms.Analyzing the diverse immunothera-peutic approaches including checkpoint inhibitors,cytokine modulators,vaccines,oncolytic viruses,antigen-targeting antibodies,and adoptive cell therapy,this review acknowledges the limitations of current diagnostic markers alpha-fetoprotein and glypican-3 and emphasizes the need for novel biomarkers for patient selection and treatment monitoring.Exploring the rationale for neoadjuvant and adjuvant immunotherapy in early-stage HCC,current research is actively exploring the safety and effectiveness of diverse immunothera-peutic approaches through ongoing clinical trials.The review further explores the potential benefits and challenges of combining immunotherapy and liver transplant,highlighting the need for careful patient selection,meticulous monitoring,and novel strategies to mitigate post-transplant complications.Finally,this review delves into the latest findings from the clinical research landscape and future directions in HCC management,paving the way for optimizing treatment strategies and improving long-term survival rates for patients with this challenging malignancy.
基金Supported by the National Natural Science Foundation of China,No.82270634Third Affiliated Hospital of Naval Medical University,No.tf2024yzyy01.
文摘Hepatocellular carcinoma(HCC)is one of the most common malignant tumors globally and is the most prevalent type of primary liver cancer,posing a heavy burden on global health.Surgical resection and liver transplantation are the gold standard for the radical treatment of HCC.However,due to the heterogeneity and high invasiveness of HCC,the rates of local and distant recurrence are extremely high,with over 70%of patients experiencing recurrence within 5 years after treatment,significantly impacting the long-term quality of life.Therefore,researchers are exploring other treatment methods to reduce tumor recurrence and improve patient survival.To date,extensive research has concentrated on new alternative therapies,including radiotherapy(e.g.,selective internal radiotherapy),targeted drug therapy(e.g.,sorafenib and lenvatinib),and immunotherapy(e.g.,immune checkpoint inhibitors),which have played an integral role in the comprehensive treatment of HCC.This review mainly focuses on the cutting-edge advancements in these treatment methods for HCC and their potential role in reducing HCC recurrence.
文摘Collecting duct carcinoma (CDC), or Bellini duct carcinoma, is a rare and aggressive subtype of renal cell carcinoma, accounting for 0.2% - 1% of cases. It often presents at an advanced stage with nonspecific symptoms, requiring histopathology for diagnosis. Surgery remains the standard of care for localized disease, serving both diagnostic and therapeutic purposes, though adjuvant chemotherapy has shown limited efficacy. In metastatic CDC, the gemcitabine-cisplatin regimen is commonly used due to its resemblance to urothelial cancer and supportive data from prospective studies. Newer therapies offer promise in advanced cases. Immune checkpoint inhibitors, such as nivolumab alone or with ipilimumab, have shown benefits in patients with high PD-L1 expression. Targeted therapies like cabozantinib demonstrated efficacy and safety as first-line treatments in phase II trials, while sunitinib and sorafenib have shown responses in various case reports and cohorts. However, combining chemotherapy with bevacizumab did not improve outcomes in phase II trials. Despite therapeutic advances in urothelial cancers and clear cell renal tumors, the CDC entity remains a challenging malignancy, emphasizing the need for continued research to understand the true efficacy of treatment and to prolong survival in advanced disease.
文摘BACKGROUND Total neoadjuvant therapy(TNT)has been proposed as an advancement over standard long-course chemoradiotherapy(LCCRT)for the treatment of locally advanced rectal cancer(LARC).It has been suggested that TNT enhances resect-ability,improves treatment compliance,increases the rate of pathological comp-lete response,and reduces the risk of systemic recurrence.However,concerns have been raised that the prolonged interval to surgery associated with TNT,particularly in regimens such as the Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation(RAPIDO)protocol,may exacerbate fibrosis,leading to more technically challenging resections and poorer surgical outcomes.RAPIDO vs LCCRT.METHODS A single-center,retrospective cohort study was conducted of patients with LARC treated with TNT-RAPIDO or standard LCCRT followed by surgical resection between 2014 and 2024.A total of 99 patients with LARC were analyzed,inclu-ding 29 treated with TNT-RAPIDO and 70 treated with standard LCCRT.Demo-graphics,clinicopathological characteristics and early post-operative outcomes were compared between both groups.RESULTS Both groups were comparable in terms of demographics and clinicopathological characteristics.The median interval from initiation of neoadjuvant therapy to Core Tip:Rectal cancer and preoperative induction therapy followed by dedicated operation has emerged as a total neoadjuvant therapy strategy with improved oncological and functional outcomes.The impact of total neoadjuvant therapy on operative difficulty and short-term surgical outcomes,compared with long-course chemoradiotherapy,remains an area of ongoing debate.This cohort study of 99 patients demonstrated that the Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation(RAPIDO)protocol does not increase surgical difficulty or compromise early surgical outcomes compared with long-course chemoradiotherapy.It may also confer a shorter total stoma duration and a lower permanent stoma rate.randomized controlled trials in the future are warranted to more accurately assess the differences between TNT-RAPIDO and LCCRT in relation to oncological outcomes.
文摘In this manuscript,we comment on the article by Zhou et al,who assessed the efficacy of hepatic arterial infusion chemotherapy(HAIC)and its combination strategies for advanced hepatocellular carcinoma(HCC)using network metaanalysis methodology.We focus specifically on the potential advantages and role of HAIC in the treatment algorithm for advanced HCC.However,there remains numerous knowledge gaps before the role of HAIC can be established.There is significant heterogeneity of HAIC regimes with difficult interpretation of the clinical outcomes.Additionally,there is a lack of direct comparative data between HAIC,systemic chemotherapy,novel immunotherapies and targeted therapies.The underlying biochemical mechanisms that might explain the efficacy of HAIC and its effect on the HCC microenvironment requires further research.In the developing era of nanotechnology and targeted drug delivery systems,there is potential for integration of HAIC with novel technologies to effectively treat advanced HCC whilst minimising systemic complications.
基金Supported by Qilu Health Outstanding Young Talent Cultivation Project,No.QDFY-3839。
文摘BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.
文摘Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.
文摘This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.
文摘Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.
