This meta-analysis assessed the latest clinical efficacy and safety of adjuvant chemotherapy (ACT) after concurrent chemoradiotherapy (CCRT) compared to CCRT alone for locally advanced cervical cancer. Studies were pooled via random effects model. Overall survival (OS; risk of death from any cause) and progression-free survival (PFS; risk of disease progression) were primary endpoints. Secondary outcomes included disease-free survival (DFS; absence of recurrence), local failure rate, distant metastasis rate (DMR), and toxicities. A total of 22 studies (n = 7466) were included. CCRT + ACT was associated with significant improvement in OS, PFS, and DMR compared to CCRT alone. Subgroup analyses of RCTs, studies with >3 ACT cycles, and with a follow-up of 5 years indicated no statistical difference in OS and PFS between two groups, suggesting that the clinical advantage of ACT may be limited, particularly given emerging immunotherapies. Moreover, ACT was associated with a higher rate of hematologic and gastrointestinal toxicities.

Lung transplantation is a well-established treatment for end-stage lung disease. Viral infections represent major infective complications after lung transplantation. Respiratory viruses can increase immune responses and the development of acute rejection. We describe the case of a 60-year-old man, who underwent bilateral lung transplantation in July 2023. He was admitted to our Unit in December 2024 for worsening shortness of breath associated to dry cough. Arterial blood gas analysis on room air showed respiratory failure. RT-PCR panel for respiratory viruses on a specimen obtained from bronchoalveolar lavage fluid came out positive for Coronavirus OC43, while chest CT-scan showed bilateral patchy infiltrates. Based on in vitro activity data, authorized off-label therapy with remdesivir was administered for 5 days Clinical conditions, together with laboratory data and arterial blood gas analysis, improved quickly. In conclusion, viral infections are a major clinical issue after lung transplant, however targeted therapy is not always possible. New treatment options are needed even to prevent complications, such as acute rejection. This clinical case suggests remdesivir could have a role in non-SARS-CoV-2 coronavirus infections.

Background: Erdheim-Chester Disease (ECD) is a rare, multisystemic histiocytosis with complex diagnosis and management. Case Presentation: We report a case of a 44-year-old male with ECD,confirmed by lung biopsy, presenting with persistent fatigue, intermittent low-grade fever, and bilateral interstitial lung disease. The patient initially received vincristine and prednisone, followed by maintenance therapy with 6-mercaptopurine, which resulted in both symptomatic and radiographic improvement. However, disease progression was noted after six months. Second-line therapy using a cytarabine-based regimen adapted from the Japan LCH Study Group-02 protocol achieved sustained remission for over two years. Conclusion: This case highlights the diagnostic complexity and therapeutic challenges of pulmonary-predominant ECD. It further underscores the potential utility of sequential cytotoxic chemotherapy as an alternative strategy in settings where targeted therapies, such as BRAF inhibitors, are not accessible. Future studies are needed to validate the role of such regimens in broader ECD populations.

Paclitaxel is the primary chemotherapy agents for many high-incidence cancers, and they also pose a significant risk for peripheral neuropathy. This study investigated the factors influencing paclitaxel-induced peripheral neuropathy (PIPN). We utilized PRO-CTCAE to assess the incidence of PIPN in patients receiving a tri-weekly regimen of single-agent albumin-bound paclitaxel through an online platform within one week after chemotherapy. Multivariable logistic regression was employed to analyze the impact of personal characteristics, clinical data and chemotherapy dose. All the statistical analyses were conducted in R studio. The incidence of acute severe to very severe PIPN was 36.7%, and the risk factors included per 200 mg increment in cumulative dose (OR 1.13, 95% 1.03 ∼ 1.24), estimated glomerular filtration rate < 90 ml/min/1.73m2 (OR 1.72, 95%CI 1.11 ∼ 2.66), anemia (OR 2.60, 95%CI 1.63 ∼ 4.15), albumin ≥ 40g/L (OR 1.74, 95%CI 1.04 ∼ 2.90), female (OR 1.98, 95%CI 1.19 ∼ 3.29), and overweight (OR 1.74, 95%CI 1.04 ∼ 2.91). The incidence of acute severe to very severe peripheral neuropathy caused by albumin-bound paclitaxel is relatively high. Nutritional status, gender, renal function and cumulative dose were all closely related to this incidence rate. Therefore, in the future, it is of great importance that a comprehensive and systematic assessment regarding the individual risks for patients be carried out in a meticulous manner. Relevant research should be conducted into the mechanisms underlying peripheral neuropathy, with particular attention to the role of individual factors.

This research aimed to assess the effectiveness of daratumumab in the treatment of relapsed and refractory multiple myeloma (RRMM) within a real - world setting. We conducted a retrospective analysis of the clinical features and treatment outcomes of patients diagnosed with RRMM at the Union Hospital of Fujian Medical University from 2018 to 2024. The study cohort consisted of 62 patients, with a median age of 62 years. 80.6% of patients received one line therapy before administration of daratumumab. The median follow - up duration was 16.1 (1.9 - 69.6) months, and the median number of daratumumab treatment cycles was 7.5 (1 - 72) courses. Among the 56 evaluable cases, the overall response rate (ORR) was 89.3%, which included 11 cases (19.6%) attaining a stringent complete response (sCR) and 13 cases (23.2%) achieving a complete response (CR). The median progression free survival (PFS) of the entire cohort was 25.2 months. The 1 - year and 3 - year PFS rates were 75.2% and 25.4% respectively. The median overall survival (OS) was 42.7 months. The 1 - year and 3 - year OS rates were 84.2% and 62.8% respectively. Multivariate analysis indicated that poor performance status was independent unfavorable prognostic factors for PFS and OS. In conclusions, an early daratumumab - based treatment regimen has demonstrated promising therapeutic potential for treating RRMM and warrants further validation and exploration in future clinical practice.

Acute myeloid leukemia (AML) is a heterogeneous malignancy specified by clonal proliferation of hematopoietic stem cells. This study identifies novel therapeutics for AML by integrating differential gene expression (DEG) and survival analyses. Publicly available GEO microarray datasets were analyzed, including data from 615 AML patients and 22 healthy controls. Multivariate Cox regression identified hazardous genes impacting survival. Protein-protein interaction networks using CytoScape revealed hub genes such as CCT5, ZBTB16, APP, and PTPN6. Functional enrichment revealed key AML-related pathways, such as PI3K/Akt and NF-kappaB signaling. Drug repurposing using the LINCS L1000CDS2 database highlighted potential therapeutics, including 16-Hydroxytriptolide and Tryptosthin AG-1478, with roles in reversing hazardous gene expression patterns. Additional candidates such as Vemurafenib, Parthenolide and Wortmannin, demonstrated promise as targeted agents. These findings underscore the potential of integrating bioinformatics and drug discovery toidentify precision medicine in AML. Further studies are warranted to validate these targets and explore their clinical utility.

Gastric adenocarcinoma is one of the most common cancers in the world. The purpose of this study was to investigate the role of non-smooth muscle cell aggregation protein II complex G2 subunit (NCAPG2) in gastric cancer cells. Cell growth, proliferation, migration, invasion and albumin-bound paclitaxel resistance were detected by cell counting kit-8, flow cytometry, Transwell chamber and nude mouse xenograft model. Western blot was used to detect the expression of NCAPG2, STAT3 and NF-κB signaling pathways. The expression of NCAPG2 was significantly up-regulated in gastric adenocarcinoma cells. Knockdown of NCAPG2 inhibited cell proliferation, migration and invasion, and inhibited tumor growth. In addition, knockdown of NCAPG2 reduced the resistance of gastric adenocarcinoma cells to albumin-bound paclitaxel and down-regulated STAT3 and NF-κB signaling pathways. In summary, NCAPG2 plays an important role in the malignant progression of gastric adenocarcinoma and is involved in the resistance to albumin-bound paclitaxel.

Mesothelioma has a poor prognosis, with a 5-year overall survival (OS) rate less than 5%. Immunotherapy has been proven as a promising alternative to platinum-based therapies in first-line treatment. Our systematic literature search included 7 randomized clinical trials involving 2,549 patients to evaluate the impact of immunotherapy on OS across different lines of therapy, histologic subtypes, and ECOG performance status, and to assess the correlation between OS, progression-free survival (PFS), and objective response rate (ORR). Immunotherapy significantly improved OS (HR 0.78, P = 0.0005) with a similar benefit observed in first-line and second/later-line treatment (P = 0.25) as well as in all ECOG statuses (P = 0.32). A significantly greater benefit was observed in non-epithelioid compared to epithelioid mesothelioma (P = 0.002). Additionally, a strong correlation was shown only between OS and PFS (r = 0.86, P = 0.01). Our results emphasize the importance of immunotherapy in mesothelioma and further support PFS as a surrogate endpoint.

Fluoropyrimidines (FPs) are antineoplastic agents used for the treatment of various solid tumors, especially gastrointestinal cancers. Patients with variations in dihydropyrimidine dehydrogenase gene (DPYD), which can determine the partial or complete deficiency of the dihydropyrimidine dehydrogenase enzyme (DPD), are at an increased risk of developing severe and potentially life-threatening toxicity. Worldwide the introduction of pharmacogenetic testing into clinical practice has been a slow process and in our center the analysis of the DPYD gene has been adopted since April 2020. We evaluated the clinical application of routine DPYD screening and its ability to prevent early-onset of fluoropyrimidine-related toxicity in patients treated at the Oncology Reference Center of Basilicata (IRCCS-CROB), a recognized cancer centre in Southern Italy. From April 2020 to November 2022, 300 patients (male 137; female 163) diagnosed with various types of cancer were subjected to DPYD genotyping, before starting treatment with FPs. In accordance with the current European Medicines Agency (EMA) and the Italian Association of Medical Oncology (AIOM) guidelines patients were tested for four DPYD variants that are associated with reduced DPD activity. FPs dose adjustments in DPYD variant carriers were made following the previously mentioned guidelines. Three hundred patients underwent DPYD testing and thirteen (4.3%) patients were found to be heterozygous variant carriers; ten out of thirteen patients received FP dose reduction as indicated by the guidelines, one out of thirteen patients received alternative treatment, two of the thirteen patients received no treatment at all. The main toxicities observed in patients who received a DPYD genotype-based dose reduction were anemia, neutropenia, nausea and mucositis but events were primarily grade 1 or 2. Our experience confirms the technical feasibility and the usefulness of DPYD genotyping to reduce the risk of severe FPs toxicities.

The benefit of programmed cell death protein-1 (PD-1)/programmed cell death protein ligand-1 (PD-L1) inhibitors remains unclear in non-small cell lung cancer (NSCLC) patients with poor performance status (PS). In the current multi-centre retrospective cohort study, advanced or recurrent NSCLC patients treated with PD-1/PD-L1 inhibitors were enrolled. Of the 219 patients enrolled, 44 had PS 2–4. The objective response rate (ORR) of patients with PS 2–4 in 1st line was 33%. Among 1st line group, median progression-free survival (PFS) in patients with PS 2 was significantly longer compared to that in patients with PS 3–4 (15.3 months vs. 0.9 months, P = 0.039, Log-rank test). Among previously treated patients, the ORR of patients with PS 2–4 was only 4%, and PFS and overall survival was poor even in patients with PS 2. PD-1/PD-L1 inhibitors can be an option for PS 2 NSCLC patients in 1st line setting.