Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor therapy.This study aimed to evaluate the efficacy and...Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor therapy.This study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor treatment.Methods:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were enrolled.Participants were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after enrollment.Adverse events(AEs)and toxicities were assessed.Results:A total of 409 participants were enrolled,with 206 assigned to the RSGB group.At week 4,there was a trend towards improvement,but the differences were not statistically significant.At week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue levels.Additionally,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar results.Multivariate linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week 8.No serious drug-related AEs or toxicities were observed.Conclusions:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible toxicities.These findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.展开更多
Pancreatic ductal adenocarcinoma(PDAC)is a common cause of cancer-related death,and most patients are with advanced disease when diagnosed.At present,despite a variety of treatments have been devel-oped for PDAC,few e...Pancreatic ductal adenocarcinoma(PDAC)is a common cause of cancer-related death,and most patients are with advanced disease when diagnosed.At present,despite a variety of treatments have been devel-oped for PDAC,few effective treatment options are available;on the other hand,PDAC shows significant resistance to chemoradiotherapy,targeted therapy,and immunotherapy due to its heterogeneous genetic profile,molecular signaling pathways,and complex tumor immune microenvironment.Nevertheless,over the past decades,there have been many new advances in the key theory and understanding of the in-trinsic mechanisms and complexity of molecular biology and molecular immunology in pancreatic can-cer,based on which more and more diverse new means and reasonable combination strategies for PDAC treatment have been developed and preliminary breakthroughs have been made.With the continuous ex-ploration,from surgical local treatment to comprehensive medical management,the research-diagnosis-management system of pancreatic cancer is improving.This review focused on the variety of treatments for advanced PDAC,including traditional chemotherapy,targeted therapy,immunotherapy,microenviron-ment matrix regulation as well as the treatment targeting epigenetics,metabolism and cancer stem cells.We pointed out the current research bottlenecks and future exploration directions.展开更多
Background and aims:The ASAP and GALAD scores are widely used diagnostic models for detecting hepatocellular carcinoma(HCC),incorporating factors such as sex,age,alpha-fetoprotein(AFP),protein induced by vitamin K abs...Background and aims:The ASAP and GALAD scores are widely used diagnostic models for detecting hepatocellular carcinoma(HCC),incorporating factors such as sex,age,alpha-fetoprotein(AFP),protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ),and lens culinaris agglutinin-reactive fraction of AFP(AFP-L3%).This study compares the diagnostic efficacy of the ASAP and GALAD scores in the early detection of HCC in patients with non-alcoholic fatty liver disease(NAFLD).Methods:NAFLD patients with and without HCC were recruited from 12 Chinese tertiary hospitals.Serum levels of AFP,PIVKA-II,and AFP-L3%were measured.The diagnostic accuracy of individual biomarkers,the ASAP score,and the GALAD score in detecting NAFLD-HCC at various stages was evaluated using receiver operating characteristic(ROC)curves and area under the curve(AUC)values.Results:In a cohort of 147 NAFLD-HCC cases and 460 NAFLD controls,both the ASAP and GALAD scores outperformed individual biomarkers in detecting NAFLD-HCC.The ASAP score demonstrated a high AUC of 0.910(sensitivity:80.3%,specificity:92.8%)for identifying NAFLD-HCC at all stages,surpassing AFP(AUC:0.716,P<0.001),PIVKA-II(AUC:0.849,P<0.001),AFP-L3%(AUC:0.663,P<0.001),and the GALAD score(AUC:0.882,P?0.014).Comparable results were observed for early-stage NAFLD-HCC and for detecting HCC in NAFLD patients with or without cirrhosis.Conclusion:The ASAP score,which excludes the AFP-L3%indicator,demonstrated superior performance in differentiating NAFLD-HCC compared to the GALAD score,suggesting its potential for early screening of HCC in NAFLD patients.展开更多
基金This study was supported by grants from the National Natural Science Foundation of China(81972726,82273074 and 82372813)Dawn Project Foundation of Shanghai(21SG36)+2 种基金Shanghai Health Academic Leader Program(2022XD001)the Natural Science Foundation of Shanghai(22ZR1477900)Adjunct Talent Fund of Zhejiang Provincial People’s Hospital(2021-YT).
文摘Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor therapy.This study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor treatment.Methods:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were enrolled.Participants were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after enrollment.Adverse events(AEs)and toxicities were assessed.Results:A total of 409 participants were enrolled,with 206 assigned to the RSGB group.At week 4,there was a trend towards improvement,but the differences were not statistically significant.At week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue levels.Additionally,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar results.Multivariate linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week 8.No serious drug-related AEs or toxicities were observed.Conclusions:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible toxicities.These findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.
基金supported by grants from the National Key R&D Program of China(2016YFC1303800)Jilin Provincial Key Labora-tory of Biological Therapy(20170622011JC)+1 种基金Jilin Provincial Science and Technology Department(20190303146SF)Jilin Province Finance Department(2018SCZWSZX-010).
文摘Pancreatic ductal adenocarcinoma(PDAC)is a common cause of cancer-related death,and most patients are with advanced disease when diagnosed.At present,despite a variety of treatments have been devel-oped for PDAC,few effective treatment options are available;on the other hand,PDAC shows significant resistance to chemoradiotherapy,targeted therapy,and immunotherapy due to its heterogeneous genetic profile,molecular signaling pathways,and complex tumor immune microenvironment.Nevertheless,over the past decades,there have been many new advances in the key theory and understanding of the in-trinsic mechanisms and complexity of molecular biology and molecular immunology in pancreatic can-cer,based on which more and more diverse new means and reasonable combination strategies for PDAC treatment have been developed and preliminary breakthroughs have been made.With the continuous ex-ploration,from surgical local treatment to comprehensive medical management,the research-diagnosis-management system of pancreatic cancer is improving.This review focused on the variety of treatments for advanced PDAC,including traditional chemotherapy,targeted therapy,immunotherapy,microenviron-ment matrix regulation as well as the treatment targeting epigenetics,metabolism and cancer stem cells.We pointed out the current research bottlenecks and future exploration directions.
基金supported by the National Natural Science Foundation of China(Nos 81871949 and 82171834 to H.Z.,No.82273074 to T.Y.)the Jiangsu Six Talent Peaks Project(No.WSN-102 to H.Z.)+1 种基金the Key Research and Development Program of Social Development of Jiangsu Province(No.BE2022725 to H.Z.)the Dawn Project Foundation of Shanghai(No.21SG36 to T.Y.).
文摘Background and aims:The ASAP and GALAD scores are widely used diagnostic models for detecting hepatocellular carcinoma(HCC),incorporating factors such as sex,age,alpha-fetoprotein(AFP),protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ),and lens culinaris agglutinin-reactive fraction of AFP(AFP-L3%).This study compares the diagnostic efficacy of the ASAP and GALAD scores in the early detection of HCC in patients with non-alcoholic fatty liver disease(NAFLD).Methods:NAFLD patients with and without HCC were recruited from 12 Chinese tertiary hospitals.Serum levels of AFP,PIVKA-II,and AFP-L3%were measured.The diagnostic accuracy of individual biomarkers,the ASAP score,and the GALAD score in detecting NAFLD-HCC at various stages was evaluated using receiver operating characteristic(ROC)curves and area under the curve(AUC)values.Results:In a cohort of 147 NAFLD-HCC cases and 460 NAFLD controls,both the ASAP and GALAD scores outperformed individual biomarkers in detecting NAFLD-HCC.The ASAP score demonstrated a high AUC of 0.910(sensitivity:80.3%,specificity:92.8%)for identifying NAFLD-HCC at all stages,surpassing AFP(AUC:0.716,P<0.001),PIVKA-II(AUC:0.849,P<0.001),AFP-L3%(AUC:0.663,P<0.001),and the GALAD score(AUC:0.882,P?0.014).Comparable results were observed for early-stage NAFLD-HCC and for detecting HCC in NAFLD patients with or without cirrhosis.Conclusion:The ASAP score,which excludes the AFP-L3%indicator,demonstrated superior performance in differentiating NAFLD-HCC compared to the GALAD score,suggesting its potential for early screening of HCC in NAFLD patients.
