The Chinese Society of Clinical Oncology Breast Cancer(CSCO BC)guidelines have been widely implemented in China since the first release in 2017.The Guideline Working Committee has also published multiple versions in E...The Chinese Society of Clinical Oncology Breast Cancer(CSCO BC)guidelines have been widely implemented in China since the first release in 2017.The Guideline Working Committee has also published multiple versions in English,Arabic,and other languages to facilitate communications with international experts.展开更多
Introduction: In December 2019, COVID 19 spread worldwide, but did not officially start in MOROCCO until March 02, 2020. Since then, this pandemic has significantly impacted the health status of patients in general an...Introduction: In December 2019, COVID 19 spread worldwide, but did not officially start in MOROCCO until March 02, 2020. Since then, this pandemic has significantly impacted the health status of patients in general and cancer patients in particular. The main objective of our study is to evaluate the prognosis of patients treated for cancer and infected with COVID-19. Material and method: A descriptive study with prospective collection was carried out at the medical oncology department of CHU Hassan II in FEZ over a period of two years, from March 2020 to March 2022. Data was carried out on the software SPSS. Results: One hundred cancer patients tested positive for COVID-19 infection and were collected within our department. The average age was 56 years [22-91]. The sex ratio was 1.2. Patients with breast cancer were the most affected by this infection (34%). The clinical symptomatology was dominated by the respiratory syndrome (45%).The diagnosis was made through thoracic CT scan in 62% of cases. 76% of patients were in a metastatic stage. 96% of patients were undergoing oncological treatment. For symptomatique patients, the standard treatment approach involved using antibiotics in 76% of cases. Evolution was marked by recovery in 79% of patients, with a death rate of 12% in this cancer patient population. Conclusion: COVID-19 infection is particularly severe in cancer patients. Mortality among these patients remains high and is associated with overall patient characteristics. However, anticancer treatments have not shown deleterious effects on the course of COVID-19.展开更多
Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO...Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.展开更多
Pleural mesothelioma is a very aggressive malignancy that arises from the pleural mesothelial cell lining and is linked strongly to prior asbestos exposure.The ban on asbestos has helped to lower the incidence,but in ...Pleural mesothelioma is a very aggressive malignancy that arises from the pleural mesothelial cell lining and is linked strongly to prior asbestos exposure.The ban on asbestos has helped to lower the incidence,but in developing countries like India,it is expected to rise.It has an extended latency period usually progressing over decades and presents with nonspecific symptoms.It has a median survival ranging between 10-22 months.The diagnosis of malignant pleural mesothelioma is challenging and is done using computed tomography(CT),magnetic resonance imaging,or positron emission tomography-CT,with the last two predicting the resectability of the tumor better than CT alone.A pleural biopsy along with an array of immunohistochemical markers,such as p16,BRCA1 associated protein 1,and claudin-4,are required for a definitive diagnosis.Several genetic alterations have prognostic significance as well.The current histological subtype identification is indispensable for decision making because of the new therapeutic avenues being explored.The combination of nivolumab and ipilimumab-based immunotherapy outperformed platinum and pemetrexed-based chemotherapy in terms of survival benefit and improved quality of life especially for non-epithelioid subtypes.However,the latter continues to be a robust treatment option for patients with the epithelioid subtype.Surgery is recommended for resectable cases with radiotherapy being indicated in neoadjuvant,adjuvant,and palliative settings along with systemic treatment.This review article provides an overview of epidemiology,etiology,clinical manifestations,diagnostic approaches(including immunohistochemical and genetic markers),staging,and multidisciplinary approaches to current treatment for malignant pleural mesothelioma using surgery,chemotherapy,immunotherapy,and radiotherapy.It also sheds light on some recent studies(EMPHACIS,CALGB30901,Checkmate-743,etc.)that have led to significant developments in recent years with clinically meaningful results.展开更多
Background: Cancer patients suffer physical, psychological, spiritual, and social pains, especially in the advanced stage. Nurses spend more time with patients than any other healthcare team member. This study aimed t...Background: Cancer patients suffer physical, psychological, spiritual, and social pains, especially in the advanced stage. Nurses spend more time with patients than any other healthcare team member. This study aimed to assess nurses’ behavior and care experiences in patients with advanced cancer and explore patients’ perceptions of nursing care. Methods: A cross-sectional study was conducted with eight nurses and thirty patients with advanced cancer hospitalized in the oncology unit at Sylvanus Olympio Teaching Hospital of Lomé from July to August 2020. Results: The mean age of nurses was 34.3 years ranging from 23 to 48 years. There were five men (62.5%) and three women (37.5%). The mean duration of working in oncology nursing of all was less than two years. Only one nurse has training in palliative care. Stress (100%), sadness (100%), and fear (50%) were the most frequently expressed feeling of nurses. The frequently expressed difficulties were the lack of training in palliative care (87.5%), insufficiency of nursing staff (75%), and helplessness in front of the patient’s distress (75%). Among the thirty patients, were 22 women (72.7%) and 8 men (27.3%). The needs expressed by the patients were psychological support (n = 11;36.7%), pain relief (n = 10;33.3%), and moral support (n = 9;30%). Most of the patients (73.3%) affirmed that nurses did not inform them well about their disease. Three (10%) were very satisfied with the care provided, 23 patients (76.7%) were satisfied and 4 (13.3%) were unsatisfied. Conclusion: This study revealed that nursing care in Togolese patients with cancer faces many difficulties and there is a need for providing specialized oncology nursing.展开更多
Right-sided colon cancers (RCC) and left-sided colon cancers (LCC) have different epidemiological, physiological, pathological, genetic, and clinical characteristics, which result in differences in the course, prognos...Right-sided colon cancers (RCC) and left-sided colon cancers (LCC) have different epidemiological, physiological, pathological, genetic, and clinical characteristics, which result in differences in the course, prognosis, and outcome of disease. The objective of our study is to compare right-sided colon cancers and left-sided colon cancers regarding clinicopathological and survival characteristics. This is a retrospective study of 664 patients with colon cancer treated at the medical oncology department of Fez over a period from December 2009 to September 2020. Rectosigmoid, descending colon, and splenic flexure tumors were considered left-sided colon cancers, whereas ascending colon tumors were considered right-sided colon cancers. The Kaplan Meier method was used to estimate median survival. The study included 664 patients (female, 47%) having colon cancer with a median age of 60 years (23 - 83). Of the patients, 78.5% (n = 519) had LCC and 19.36 % (n = 128) had RCC. The rate of patients aged ≥ 65 years and the rate of patients with a family history of colon cancer was higher in the LCC patients. The proportion of poorly differentiated adenocarcinomas represented 3%, of which 63% had cancer of the right colon. There was a significantly higher proportion of higher T stage (T3-4: 62% vs 38%) in right sided tumors as compared to left sided tumors. The rate of metastatic patients was 64.1% in the RCC group and 43% in the LCC group. The median follow-up period was 14 months in the RCC group and 19 months in the LCC group with higher median overall survival in the LCC group (32 vs 21 months). We found histopathological differences between right and left sided colon cancer. Tumors on the right colon were found to be more aggressive, as expressed by poorer differentiation, higher T stage associated with a median overall survival better in left colon cancer.展开更多
Obesity is recognized as the second highest risk factor for cancer. The pathogenic mechanisms underlying tobaccorelated cancers are well characterized and efective programs have led to a decline in smoking and related...Obesity is recognized as the second highest risk factor for cancer. The pathogenic mechanisms underlying tobaccorelated cancers are well characterized and efective programs have led to a decline in smoking and related cancers, but there is a global epidemic of obesity without a clear understanding of how obesity causes cancer. Obesity is heterogeneous, and approximately 25% of obese individuals remain healthy(metabolically healthy obese, MHO), so which fat deposition(subcutaneous versus visceral, adipose versus ectopic) is "malignant"? What is the mechanism of carcinogenesis? Is it by metabolic dysregulation or chronic inflammation? Through which chemokines/genes/signaling pathways does adipose tissue influence carcinogenesis? Can selective inhibition of these pathways uncouple obesity from cancers? Do all obesity related cancers(ORCs) share a molecular signature? Are there common(overlapping) genetic loci that make individuals susceptible to obesity, metabolic syndrome, and cancers? Can we identify precursor lesions of ORCs and will early intervention of high risk individuals alter the natural history? It appears unlikely that the obesity epidemic will be controlled anytime soon; answers to these questions will help to reduce the adverse efect of obesity on human condition.展开更多
Objective:In China over the past decade,psychosocial oncology has emerged as a new program. Development of this program requires attention to current opportunities,obstacles and cultural concerns. Methods: A selected ...Objective:In China over the past decade,psychosocial oncology has emerged as a new program. Development of this program requires attention to current opportunities,obstacles and cultural concerns. Methods: A selected literature review of academic papers in Chinese and English language journals and web sites was analyzed for themes regarding the current status,challenges,and opportunities for psychosocial oncology in China. Results: China’s national cancer strategy (2004-2010),based on WHO guidelines,is focused on cancer prevention and treatment,as well as quality of life among cancer patients and their families. The Chinese Anti-Cancer Association is now funding research,training and international collaboration in psychosocial oncology. The newly organized Chinese Psychosocial Oncology Society,founded in 2006,aims to provide a national forum for psychosocial oncology research. Cultural and systemic challenges to establishing psychosocial oncology as a core discipline in China include: (1) the family’s desire to ‘protect’ cancer patients by with-holding cancer-related information; (2) stigma and privacy regarding mental health issues; (3) biomedical practitioners’ claims that psychosocial on-cology is not sufficiently evidence-based; and (4) limited funding for psychosocial oncology care and research. Conclusion: The International Psycho-Oncology Society (IPOS) is considered a valuable resource towards China’s interest in partnering with the international psychosocial oncology community to enhance the discipline globally.展开更多
Cancer poses a major health problem worldwide.There is a trend of increasing incidence and mortality of several types of cancer in China.Although major breakthroughs have been made in cancer treatment,including advanc...Cancer poses a major health problem worldwide.There is a trend of increasing incidence and mortality of several types of cancer in China.Although major breakthroughs have been made in cancer treatment,including advances in surgical procedures,radiotherapy,chemotherapy,targeted therapy,and immunotherapy,the prognosis of cancer patients is still not optimal.It is widely accepted that malnutrition is commonly seen in cancer patients and that nutritional intervention can improve such patients’overall survival status by supplementing deficient nutrients,regulating abnormal metabolism,improving immune function,and modulating tumor growth.Thus,fighting malnutrition can improve patients’quality of life and survival.This review article provides a summary of development of nutritional oncology as an independent clinical discipline,recent advances,and problems and challenges faced by health care professionals in managing malnutrition among cancer patients.We propose several strategies and approaches to establish nutritional intervention programs in hospitals,including education,clinical nutritional diagnosis and treatment,which may meet the nutrition and treatment goals for patients with cancer in China.We hope that with national-wide development and implementation of nutritional intervention programs,more cancer patient in China will benefit from such endeavors,making nutritional oncology the frontier of cancer treatment not only in China,but also in whole world.展开更多
BACKGROUND Patient satisfaction and reported outcomes are becoming increasingly important in determining the efficacy of clinical care.To date no study has evaluated the patient experience in the orthopedic oncology o...BACKGROUND Patient satisfaction and reported outcomes are becoming increasingly important in determining the efficacy of clinical care.To date no study has evaluated the patient experience in the orthopedic oncology outpatient setting to determine which factors of the encounter are priorities to the patient.AIM To evaluate what factors impact patient experience and report satisfaction in an outpatient orthopedic oncology clinic.METHODS Press Ganey®patient surveys from a single outpatient orthopedic oncology clinic at a tertiary care setting were prospectively collected per routine medical care.All orthopedic oncology patients who were seen in clinic and received electronic survey were included.All survey responses were submitted within one month of clinic appointment.IRB approval was obtained to retrospectively collect survey responses from 2015 to 2016.Basic demographic data along with survey category responses were collected and statistically analyzed.RESULTS One hundred sixty-two patient surveys were collected.Average patient age was 54.4 years(SD=16.2 years)and were comprised of 51.2% female and 48.4%male.64.2%of patients were from in-state.Out of state residents were more likely to recommend both the practice and attending physician.The likelihood to recommend attending physician was positively associated with MD friendliness/courtesy(OR=14.4,95%CI:2.5-84.3),MD confidence(OR=48.2,95%CI:6.2-376.5),MD instructions follow-up care(OR=2.5,95%CI:0.4-17.4),and sensitivity to needs(OR=16.1,95%CI:1-262.5).Clinic operations performed well in the categories of courtesy of staff(76%)and cleanliness(75%)and less well in ease of getting on the phone(49%),information about delays(36%),and wait time(37%).CONCLUSION Orthopedic specialties can utilize information from this study to improve care from the patient perspective.Future studies may be directed at how to improve these areas of care which are most valued by the patient.展开更多
Due to coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2,there has been a major reallocation of resources that has impacted the treatment of many diseases,including cancer.The...Due to coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2,there has been a major reallocation of resources that has impacted the treatment of many diseases,including cancer.The growing use of information and communication technologies(ICT),together with a new approach to work aimed at ensuring the safety of health care professionals and patients alike,has allowed us to maintain the quality of care while ensuring biosecurity.The application of ICT to health care(eHealth)aims to significantly improve the quality,access to,and effectiveness of medical care.In fact,the expanded use of ICT has been recognized as a key,cost-effective priority for health care by the World Health Organisation.The medical speciality of radiation oncology is closely linked to technology and as a consequence of coronavirus disease 2019,ICT has been widely employed by radiation oncologists worldwide,providing new opportunities for interaction among professionals,including telemedicine and e-learning,while also minimizing treatment interruptions.Future research should concentrate on this emerging paradigm,which offers new opportunities,including faster and more diverse exchange of scientific knowledge,organizational improvements,and more efficient workflows.Moreover,these efficiencies will allow professionals to dedicate more time to patient care,with a better work-life balance.In the present editorial,we discuss the opportunities provided by these digital tools,as well as barriers to theirimplementation,and a vision of the future.展开更多
In the majority of phase Ⅲ clinical trials, patients are generally excluded on the basis of specific comorbidities, performance status Eastern Cooperative Oncology Group ≥ 2, age ≥ 65 years, previous malignancies, ...In the majority of phase Ⅲ clinical trials, patients are generally excluded on the basis of specific comorbidities, performance status Eastern Cooperative Oncology Group ≥ 2, age ≥ 65 years, previous malignancies, brain metastases, active infections, psychiatric disorders, non-measurable disease, number and type of previous lines of chemotherapies or biologic therapies. A question is raised: Can results of phase Ⅲstudies be extended to the general population? There is increasing attention to and a resurgence of some terms as "real world" or "real practice" which are wrongly viewed as contrary to clinical trial protocols. In fact, the general perception is that a contraposition exists between "wrong"(retrospective and biased) and "right"(prospective, randomized, well statistically designed) clinical research. We have to change this perspective. Real practice studies, generally retrospective in their nature, deserve to be reevaluated; biases are physiologically present but their punctual and rigorous description and analysis can help the interpretation of and in some cases reinforce results and their hypothesis-generating power. The correct and balanced interaction between clinical trials and real practice reports can help the scientific community to improve the knowledge on anti-cancer drug efficacy.展开更多
Specific research foci:(1) Mouse models of gamma-herpes virus-68(γHV-68) and polyomavirus(Py V) infections during neonatal versus adult life.(2) For human papilloma virus(HPV)-positive oropharyngeal carcinoma(OPC)—(...Specific research foci:(1) Mouse models of gamma-herpes virus-68(γHV-68) and polyomavirus(Py V) infections during neonatal versus adult life.(2) For human papilloma virus(HPV)-positive oropharyngeal carcinoma(OPC)—(a) Asking the question: Is oral sex a powerful carcinogen?(b) Examining the evidence for the vertical transmission of HPV infection.(c) Examining the relationship between HPV and Epstein–Barr virus(EBV) infections and nasopharyngeal cancer(NPC) in West European, East European, and East Asian countries.(d) Examining the association between HPVpositive OPC and human leukocyte antigen(HLA).(3) For non-smoking East Asian female lung adenocarcinoma—(a) Examining the incidence trends of HPV-positive OPC and female lung adenocarcinoma according to birth cohorts.(b) Examining the association between female lung adenocarcinoma and HPV.(c) Examining the associations of lung adenocarcinoma with immune modulating factors.(4) For triple-negative breast carcinoma(TNBC) in East Asians—(a) Examining the association between TNBC and HPV.(b) Examining the unique epidemiological characteristics of patients with TNBC. A summary "epidemiological" model tying some of these findings together.展开更多
Aims： To investigate the research status of radiation oncology in China through survey of literature in international radiation oncology journals and retrospectively compare the outputs of radiation oncology articles...Aims： To investigate the research status of radiation oncology in China through survey of literature in international radiation oncology journals and retrospectively compare the outputs of radiation oncology articles of the three major regions of China--Mainland （ML）, Taiwan （TW） and Hong Kong （HK）. Methods： Radiation oncology journals were selected from ＂oncology＂ and ＂radiology, nuclear ＆ medical image＂ category from Science Citation Index Expand （SCIE）. Articles from the ML, TW and HK were retrieved from MEDLINE. The number of total articles, clinical trials, case reports, impact factors （IF）, institutions and articles published in each journals were conducted for quantity and quality comparisons. Results： A total 818 articles from 13 radiation oncology journals were searched, of which 427 are from ML, 259 from TW, and 132 from HK. Ninety-seven clinical trials and 5 case reports are reported in China. Accumulated IF of articles from ML （1,417.11） was much higher than that of TW （1,003.093） and HK （544.711）, while the average IF of articles from ML is the lowest. Conclusions： The total number of articles from China especially ML increased significantly in the last decade. The number of articles published from the ML has exceeded those from TW and HK. However, the quality of articles from TW and HK is better than that from ML.展开更多
Radiation oncology is one of the three major treatment modalities to manage cancer patient cares,and is a discipline mainly driven by technology and medical devices.Modern radiation treatments have become fairly compl...Radiation oncology is one of the three major treatment modalities to manage cancer patient cares,and is a discipline mainly driven by technology and medical devices.Modern radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s)while maximizing the sparing of normal organ structures.Recently,different forms of linear accelerators/radioactive source based machines have been invented and developed with the aim of providing improved treatments and more treatment options.Besides linear accelerators(Linac)that have been undergoing constant improvement and advancement and can deliver fairly complicated dose distribution patterns,imaging systems,computer information and calculation systems have been more and more integrated into radiotherapy processes.To bring radiotherapy to a potentially higher level,many institutions have either acquired or started to consider particle therapy,especially proton therapy.The complexity of modern radiotherapy demands in-depth understanding of radiation physics and machine engineering as well as computer information systems.This paper is intended to provide an introductory description of radiation oncology and related procedures,and to provide an overview of the current status of medical devices in radiotherapy in the United States of America.This paper covers the radiation delivery systems,imaging systems,treatment planning systems,record and verify systems,and QA systems.展开更多
Modern radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s)while maximizing th...Modern radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s)while maximizing the sparing of normal organ structures.Recently,different forms of linear accelerators/radioactive source based machines have been invented and developed with the aim of providing improved treatments and more treatment options.Besides linear accelerators(Linac)that have been undergoing constant improvement and advancement and can deliver fairly complicated dose distribution patterns,imaging systems,computer information and calculation systems have been more and more integrated into radiotherapy processes.To bring radiotherapy to a potentially higher level,many institutions have either acquired or started to consider particle therapy,especially proton therapy.The complexity of modern radiotherapy demands in-depth understanding of radiation physics and machine engineering as well as computer information systems.This paper is intended to provide an introductory description of radiation oncology and related procedures,and to provide an overview of the current status of medical devices in radiotherapy in the United States of America.This paper covers the radiation delivery systems,imaging systems,treatment planning systems,record and verify systems,and QA systems.展开更多
<strong>Introduction: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">Morbidity and Mortality (M&M) rounds can ident...<strong>Introduction: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">Morbidity and Mortality (M&M) rounds can identify adverse events and improve patient safety however adoption in cancer centers is not routine. Herein we report the results of a chemotherapy-specific gynecologic oncology M&M rounds and identify reasons for hospital admission < 30 days after chemotherapy treatment. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Between July 2014 and April 2016, all admissions < 30 days from chemotherapy administration were prospectively collected along with clinical data. Admissions were described and classified as planned or unplanned and as associated with chemotherapy or with underlying disease. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">585 patients were admitted, 78% of whom had ovarian cancer and 43% of whom had recurrent disease. Overall, 47% of admissions were unplanned and these were significantly longer than planned admissions (5.6 vs. 2.4 days, p = 0.0003). Of unplanned admissions, 43% were due to chemotherapy, and 57% were due to disease burden. 74% of patients had received >1 prior line of chemotherapy, and 22% were on clinical trial. The most common causes of unplanned admission were nausea, vomiting or failure to thrive (28.9%), fever (17.9%) and small bowel obstruction (19.9%). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There is a high rate of unplanned admission < 30 days after chemotherapy and patients with ovarian cancer and recurrent disease are at the highest risk. This information can be used to counsel patients about complications of chemotherapy and to improve supportive management. M&M conferences surrounding unplanned admissions after chemotherapy may help guide therapy, encourage best supportive care, and prompt re-evaluation of treatment goals in heavily pretreated patients with recurrent.</span></span></span></span>展开更多
Artificial intelligence(AI)is a computer science that tries to mimic human-like intelligence in machines that use computer software and algorithms to perform specific tasks without direct human input.Machine learning(...Artificial intelligence(AI)is a computer science that tries to mimic human-like intelligence in machines that use computer software and algorithms to perform specific tasks without direct human input.Machine learning(ML)is a subunit of AI that uses data-driven algorithms that learn to imitate human behavior based on a previous example or experience.Deep learning is an ML technique that uses deep neural networks to create a model.The growth and sharing of data,increasing computing power,and developments in AI have initiated a transformation in healthcare.Advances in radiation oncology have produced a significant amount of data that must be integrated with computed tomography imaging,dosimetry,and imaging performed before each fraction.Of the many algorithms used in radiation oncology,has advantages and limitations with different computational power requirements.The aim of this review is to summarize the radiotherapy(RT)process in workflow order by identifying specific areas in which quality and efficiency can be improved by ML.The RT stage is divided into seven stages:patient evaluation,simulation,contouring,planning,quality control,treatment application,and patient follow-up.A systematic evaluation of the applicability,limitations,and advantages of AI algorithms has been done for each stage.展开更多
After that the era of chemotherapy in the treatment of solid tumors have been overcome by the "translational era", with the innovation introduced by targeted therapies, medical oncology is currently looking ...After that the era of chemotherapy in the treatment of solid tumors have been overcome by the "translational era", with the innovation introduced by targeted therapies, medical oncology is currently looking at the dawn of a new "immunotherapy era" with the advent of immune checkpoint inhibitors(CKI) antibodies.The onset of PD-1/PD-L1 targeted therapy has demonstrated the importance of this axis in the immune escape across almost all human cancers.The new CKI allowed to significantly prolong survival and to generate durable response, demonstrating remarkable efficacy in a wide range of cancer types.The aim of this article is to review the most up to date literature about the clinical effectiveness of CKI antibodies targeting PD-1/PD-L1 axis for the treatment of advanced solid tumors and to explore transversal challenges in the immune checkpoint blockade.展开更多
In April 2017,the first edition Chinese Society of Clinical Oncology Breast Cancer(CSCO BC)guidelines were released.These guidelines were based on medical evidence,as well as the accessibility and cost effectiveness o...In April 2017,the first edition Chinese Society of Clinical Oncology Breast Cancer(CSCO BC)guidelines were released.These guidelines were based on medical evidence,as well as the accessibility and cost effectiveness of various anticancer drugs in China.The CSCO BC guidelines include regimens with a high level of evidence,good product accessibility and high consistent consensus among Chinese experts as level I recommendations.Regimens with a high level of evidence but poor product accessibility or expert consensus are included as level II recommendations.展开更多
基金supported by the China Postdoctoral Science Foundation(Grant No.2023T160788)the Beijing Science and Technology Plan(Grant No.Z181100001718215).
文摘The Chinese Society of Clinical Oncology Breast Cancer(CSCO BC)guidelines have been widely implemented in China since the first release in 2017.The Guideline Working Committee has also published multiple versions in English,Arabic,and other languages to facilitate communications with international experts.
文摘Introduction: In December 2019, COVID 19 spread worldwide, but did not officially start in MOROCCO until March 02, 2020. Since then, this pandemic has significantly impacted the health status of patients in general and cancer patients in particular. The main objective of our study is to evaluate the prognosis of patients treated for cancer and infected with COVID-19. Material and method: A descriptive study with prospective collection was carried out at the medical oncology department of CHU Hassan II in FEZ over a period of two years, from March 2020 to March 2022. Data was carried out on the software SPSS. Results: One hundred cancer patients tested positive for COVID-19 infection and were collected within our department. The average age was 56 years [22-91]. The sex ratio was 1.2. Patients with breast cancer were the most affected by this infection (34%). The clinical symptomatology was dominated by the respiratory syndrome (45%).The diagnosis was made through thoracic CT scan in 62% of cases. 76% of patients were in a metastatic stage. 96% of patients were undergoing oncological treatment. For symptomatique patients, the standard treatment approach involved using antibiotics in 76% of cases. Evolution was marked by recovery in 79% of patients, with a death rate of 12% in this cancer patient population. Conclusion: COVID-19 infection is particularly severe in cancer patients. Mortality among these patients remains high and is associated with overall patient characteristics. However, anticancer treatments have not shown deleterious effects on the course of COVID-19.
文摘Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.
文摘Pleural mesothelioma is a very aggressive malignancy that arises from the pleural mesothelial cell lining and is linked strongly to prior asbestos exposure.The ban on asbestos has helped to lower the incidence,but in developing countries like India,it is expected to rise.It has an extended latency period usually progressing over decades and presents with nonspecific symptoms.It has a median survival ranging between 10-22 months.The diagnosis of malignant pleural mesothelioma is challenging and is done using computed tomography(CT),magnetic resonance imaging,or positron emission tomography-CT,with the last two predicting the resectability of the tumor better than CT alone.A pleural biopsy along with an array of immunohistochemical markers,such as p16,BRCA1 associated protein 1,and claudin-4,are required for a definitive diagnosis.Several genetic alterations have prognostic significance as well.The current histological subtype identification is indispensable for decision making because of the new therapeutic avenues being explored.The combination of nivolumab and ipilimumab-based immunotherapy outperformed platinum and pemetrexed-based chemotherapy in terms of survival benefit and improved quality of life especially for non-epithelioid subtypes.However,the latter continues to be a robust treatment option for patients with the epithelioid subtype.Surgery is recommended for resectable cases with radiotherapy being indicated in neoadjuvant,adjuvant,and palliative settings along with systemic treatment.This review article provides an overview of epidemiology,etiology,clinical manifestations,diagnostic approaches(including immunohistochemical and genetic markers),staging,and multidisciplinary approaches to current treatment for malignant pleural mesothelioma using surgery,chemotherapy,immunotherapy,and radiotherapy.It also sheds light on some recent studies(EMPHACIS,CALGB30901,Checkmate-743,etc.)that have led to significant developments in recent years with clinically meaningful results.
文摘Background: Cancer patients suffer physical, psychological, spiritual, and social pains, especially in the advanced stage. Nurses spend more time with patients than any other healthcare team member. This study aimed to assess nurses’ behavior and care experiences in patients with advanced cancer and explore patients’ perceptions of nursing care. Methods: A cross-sectional study was conducted with eight nurses and thirty patients with advanced cancer hospitalized in the oncology unit at Sylvanus Olympio Teaching Hospital of Lomé from July to August 2020. Results: The mean age of nurses was 34.3 years ranging from 23 to 48 years. There were five men (62.5%) and three women (37.5%). The mean duration of working in oncology nursing of all was less than two years. Only one nurse has training in palliative care. Stress (100%), sadness (100%), and fear (50%) were the most frequently expressed feeling of nurses. The frequently expressed difficulties were the lack of training in palliative care (87.5%), insufficiency of nursing staff (75%), and helplessness in front of the patient’s distress (75%). Among the thirty patients, were 22 women (72.7%) and 8 men (27.3%). The needs expressed by the patients were psychological support (n = 11;36.7%), pain relief (n = 10;33.3%), and moral support (n = 9;30%). Most of the patients (73.3%) affirmed that nurses did not inform them well about their disease. Three (10%) were very satisfied with the care provided, 23 patients (76.7%) were satisfied and 4 (13.3%) were unsatisfied. Conclusion: This study revealed that nursing care in Togolese patients with cancer faces many difficulties and there is a need for providing specialized oncology nursing.
文摘Right-sided colon cancers (RCC) and left-sided colon cancers (LCC) have different epidemiological, physiological, pathological, genetic, and clinical characteristics, which result in differences in the course, prognosis, and outcome of disease. The objective of our study is to compare right-sided colon cancers and left-sided colon cancers regarding clinicopathological and survival characteristics. This is a retrospective study of 664 patients with colon cancer treated at the medical oncology department of Fez over a period from December 2009 to September 2020. Rectosigmoid, descending colon, and splenic flexure tumors were considered left-sided colon cancers, whereas ascending colon tumors were considered right-sided colon cancers. The Kaplan Meier method was used to estimate median survival. The study included 664 patients (female, 47%) having colon cancer with a median age of 60 years (23 - 83). Of the patients, 78.5% (n = 519) had LCC and 19.36 % (n = 128) had RCC. The rate of patients aged ≥ 65 years and the rate of patients with a family history of colon cancer was higher in the LCC patients. The proportion of poorly differentiated adenocarcinomas represented 3%, of which 63% had cancer of the right colon. There was a significantly higher proportion of higher T stage (T3-4: 62% vs 38%) in right sided tumors as compared to left sided tumors. The rate of metastatic patients was 64.1% in the RCC group and 43% in the LCC group. The median follow-up period was 14 months in the RCC group and 19 months in the LCC group with higher median overall survival in the LCC group (32 vs 21 months). We found histopathological differences between right and left sided colon cancer. Tumors on the right colon were found to be more aggressive, as expressed by poorer differentiation, higher T stage associated with a median overall survival better in left colon cancer.
文摘Obesity is recognized as the second highest risk factor for cancer. The pathogenic mechanisms underlying tobaccorelated cancers are well characterized and efective programs have led to a decline in smoking and related cancers, but there is a global epidemic of obesity without a clear understanding of how obesity causes cancer. Obesity is heterogeneous, and approximately 25% of obese individuals remain healthy(metabolically healthy obese, MHO), so which fat deposition(subcutaneous versus visceral, adipose versus ectopic) is "malignant"? What is the mechanism of carcinogenesis? Is it by metabolic dysregulation or chronic inflammation? Through which chemokines/genes/signaling pathways does adipose tissue influence carcinogenesis? Can selective inhibition of these pathways uncouple obesity from cancers? Do all obesity related cancers(ORCs) share a molecular signature? Are there common(overlapping) genetic loci that make individuals susceptible to obesity, metabolic syndrome, and cancers? Can we identify precursor lesions of ORCs and will early intervention of high risk individuals alter the natural history? It appears unlikely that the obesity epidemic will be controlled anytime soon; answers to these questions will help to reduce the adverse efect of obesity on human condition.
文摘Objective:In China over the past decade,psychosocial oncology has emerged as a new program. Development of this program requires attention to current opportunities,obstacles and cultural concerns. Methods: A selected literature review of academic papers in Chinese and English language journals and web sites was analyzed for themes regarding the current status,challenges,and opportunities for psychosocial oncology in China. Results: China’s national cancer strategy (2004-2010),based on WHO guidelines,is focused on cancer prevention and treatment,as well as quality of life among cancer patients and their families. The Chinese Anti-Cancer Association is now funding research,training and international collaboration in psychosocial oncology. The newly organized Chinese Psychosocial Oncology Society,founded in 2006,aims to provide a national forum for psychosocial oncology research. Cultural and systemic challenges to establishing psychosocial oncology as a core discipline in China include: (1) the family’s desire to ‘protect’ cancer patients by with-holding cancer-related information; (2) stigma and privacy regarding mental health issues; (3) biomedical practitioners’ claims that psychosocial on-cology is not sufficiently evidence-based; and (4) limited funding for psychosocial oncology care and research. Conclusion: The International Psycho-Oncology Society (IPOS) is considered a valuable resource towards China’s interest in partnering with the international psychosocial oncology community to enhance the discipline globally.
文摘Cancer poses a major health problem worldwide.There is a trend of increasing incidence and mortality of several types of cancer in China.Although major breakthroughs have been made in cancer treatment,including advances in surgical procedures,radiotherapy,chemotherapy,targeted therapy,and immunotherapy,the prognosis of cancer patients is still not optimal.It is widely accepted that malnutrition is commonly seen in cancer patients and that nutritional intervention can improve such patients’overall survival status by supplementing deficient nutrients,regulating abnormal metabolism,improving immune function,and modulating tumor growth.Thus,fighting malnutrition can improve patients’quality of life and survival.This review article provides a summary of development of nutritional oncology as an independent clinical discipline,recent advances,and problems and challenges faced by health care professionals in managing malnutrition among cancer patients.We propose several strategies and approaches to establish nutritional intervention programs in hospitals,including education,clinical nutritional diagnosis and treatment,which may meet the nutrition and treatment goals for patients with cancer in China.We hope that with national-wide development and implementation of nutritional intervention programs,more cancer patient in China will benefit from such endeavors,making nutritional oncology the frontier of cancer treatment not only in China,but also in whole world.
文摘BACKGROUND Patient satisfaction and reported outcomes are becoming increasingly important in determining the efficacy of clinical care.To date no study has evaluated the patient experience in the orthopedic oncology outpatient setting to determine which factors of the encounter are priorities to the patient.AIM To evaluate what factors impact patient experience and report satisfaction in an outpatient orthopedic oncology clinic.METHODS Press Ganey®patient surveys from a single outpatient orthopedic oncology clinic at a tertiary care setting were prospectively collected per routine medical care.All orthopedic oncology patients who were seen in clinic and received electronic survey were included.All survey responses were submitted within one month of clinic appointment.IRB approval was obtained to retrospectively collect survey responses from 2015 to 2016.Basic demographic data along with survey category responses were collected and statistically analyzed.RESULTS One hundred sixty-two patient surveys were collected.Average patient age was 54.4 years(SD=16.2 years)and were comprised of 51.2% female and 48.4%male.64.2%of patients were from in-state.Out of state residents were more likely to recommend both the practice and attending physician.The likelihood to recommend attending physician was positively associated with MD friendliness/courtesy(OR=14.4,95%CI:2.5-84.3),MD confidence(OR=48.2,95%CI:6.2-376.5),MD instructions follow-up care(OR=2.5,95%CI:0.4-17.4),and sensitivity to needs(OR=16.1,95%CI:1-262.5).Clinic operations performed well in the categories of courtesy of staff(76%)and cleanliness(75%)and less well in ease of getting on the phone(49%),information about delays(36%),and wait time(37%).CONCLUSION Orthopedic specialties can utilize information from this study to improve care from the patient perspective.Future studies may be directed at how to improve these areas of care which are most valued by the patient.
文摘Due to coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2,there has been a major reallocation of resources that has impacted the treatment of many diseases,including cancer.The growing use of information and communication technologies(ICT),together with a new approach to work aimed at ensuring the safety of health care professionals and patients alike,has allowed us to maintain the quality of care while ensuring biosecurity.The application of ICT to health care(eHealth)aims to significantly improve the quality,access to,and effectiveness of medical care.In fact,the expanded use of ICT has been recognized as a key,cost-effective priority for health care by the World Health Organisation.The medical speciality of radiation oncology is closely linked to technology and as a consequence of coronavirus disease 2019,ICT has been widely employed by radiation oncologists worldwide,providing new opportunities for interaction among professionals,including telemedicine and e-learning,while also minimizing treatment interruptions.Future research should concentrate on this emerging paradigm,which offers new opportunities,including faster and more diverse exchange of scientific knowledge,organizational improvements,and more efficient workflows.Moreover,these efficiencies will allow professionals to dedicate more time to patient care,with a better work-life balance.In the present editorial,we discuss the opportunities provided by these digital tools,as well as barriers to theirimplementation,and a vision of the future.
文摘In the majority of phase Ⅲ clinical trials, patients are generally excluded on the basis of specific comorbidities, performance status Eastern Cooperative Oncology Group ≥ 2, age ≥ 65 years, previous malignancies, brain metastases, active infections, psychiatric disorders, non-measurable disease, number and type of previous lines of chemotherapies or biologic therapies. A question is raised: Can results of phase Ⅲstudies be extended to the general population? There is increasing attention to and a resurgence of some terms as "real world" or "real practice" which are wrongly viewed as contrary to clinical trial protocols. In fact, the general perception is that a contraposition exists between "wrong"(retrospective and biased) and "right"(prospective, randomized, well statistically designed) clinical research. We have to change this perspective. Real practice studies, generally retrospective in their nature, deserve to be reevaluated; biases are physiologically present but their punctual and rigorous description and analysis can help the interpretation of and in some cases reinforce results and their hypothesis-generating power. The correct and balanced interaction between clinical trials and real practice reports can help the scientific community to improve the knowledge on anti-cancer drug efficacy.
文摘Specific research foci:(1) Mouse models of gamma-herpes virus-68(γHV-68) and polyomavirus(Py V) infections during neonatal versus adult life.(2) For human papilloma virus(HPV)-positive oropharyngeal carcinoma(OPC)—(a) Asking the question: Is oral sex a powerful carcinogen?(b) Examining the evidence for the vertical transmission of HPV infection.(c) Examining the relationship between HPV and Epstein–Barr virus(EBV) infections and nasopharyngeal cancer(NPC) in West European, East European, and East Asian countries.(d) Examining the association between HPVpositive OPC and human leukocyte antigen(HLA).(3) For non-smoking East Asian female lung adenocarcinoma—(a) Examining the incidence trends of HPV-positive OPC and female lung adenocarcinoma according to birth cohorts.(b) Examining the association between female lung adenocarcinoma and HPV.(c) Examining the associations of lung adenocarcinoma with immune modulating factors.(4) For triple-negative breast carcinoma(TNBC) in East Asians—(a) Examining the association between TNBC and HPV.(b) Examining the unique epidemiological characteristics of patients with TNBC. A summary "epidemiological" model tying some of these findings together.
基金supported by the Research and Innovation Project for College Graduates of Jiangsu Province (No. CXZZ12_0588)Natural Science Foundation of China (No. 81272504)+4 种基金Innovation Team [No. LJ201123 (EH11)]Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD) (JX10231801)Key Academic Discipline of Jiangsu Province "Medical Aspects of Specific Environments", Six Major Talent Peak Project of Jiangsu Province (2013-WSN-040)Jiangsu Provincial Science and Technology Projects [BK2011854 (DA11)]"333" Project of Jiangsu Province [BRA2012210 (RS12)]
文摘Aims： To investigate the research status of radiation oncology in China through survey of literature in international radiation oncology journals and retrospectively compare the outputs of radiation oncology articles of the three major regions of China--Mainland （ML）, Taiwan （TW） and Hong Kong （HK）. Methods： Radiation oncology journals were selected from ＂oncology＂ and ＂radiology, nuclear ＆ medical image＂ category from Science Citation Index Expand （SCIE）. Articles from the ML, TW and HK were retrieved from MEDLINE. The number of total articles, clinical trials, case reports, impact factors （IF）, institutions and articles published in each journals were conducted for quantity and quality comparisons. Results： A total 818 articles from 13 radiation oncology journals were searched, of which 427 are from ML, 259 from TW, and 132 from HK. Ninety-seven clinical trials and 5 case reports are reported in China. Accumulated IF of articles from ML （1,417.11） was much higher than that of TW （1,003.093） and HK （544.711）, while the average IF of articles from ML is the lowest. Conclusions： The total number of articles from China especially ML increased significantly in the last decade. The number of articles published from the ML has exceeded those from TW and HK. However, the quality of articles from TW and HK is better than that from ML.
文摘Radiation oncology is one of the three major treatment modalities to manage cancer patient cares,and is a discipline mainly driven by technology and medical devices.Modern radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s)while maximizing the sparing of normal organ structures.Recently,different forms of linear accelerators/radioactive source based machines have been invented and developed with the aim of providing improved treatments and more treatment options.Besides linear accelerators(Linac)that have been undergoing constant improvement and advancement and can deliver fairly complicated dose distribution patterns,imaging systems,computer information and calculation systems have been more and more integrated into radiotherapy processes.To bring radiotherapy to a potentially higher level,many institutions have either acquired or started to consider particle therapy,especially proton therapy.The complexity of modern radiotherapy demands in-depth understanding of radiation physics and machine engineering as well as computer information systems.This paper is intended to provide an introductory description of radiation oncology and related procedures,and to provide an overview of the current status of medical devices in radiotherapy in the United States of America.This paper covers the radiation delivery systems,imaging systems,treatment planning systems,record and verify systems,and QA systems.
文摘Modern radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s)while maximizing the sparing of normal organ structures.Recently,different forms of linear accelerators/radioactive source based machines have been invented and developed with the aim of providing improved treatments and more treatment options.Besides linear accelerators(Linac)that have been undergoing constant improvement and advancement and can deliver fairly complicated dose distribution patterns,imaging systems,computer information and calculation systems have been more and more integrated into radiotherapy processes.To bring radiotherapy to a potentially higher level,many institutions have either acquired or started to consider particle therapy,especially proton therapy.The complexity of modern radiotherapy demands in-depth understanding of radiation physics and machine engineering as well as computer information systems.This paper is intended to provide an introductory description of radiation oncology and related procedures,and to provide an overview of the current status of medical devices in radiotherapy in the United States of America.This paper covers the radiation delivery systems,imaging systems,treatment planning systems,record and verify systems,and QA systems.
文摘<strong>Introduction: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">Morbidity and Mortality (M&M) rounds can identify adverse events and improve patient safety however adoption in cancer centers is not routine. Herein we report the results of a chemotherapy-specific gynecologic oncology M&M rounds and identify reasons for hospital admission < 30 days after chemotherapy treatment. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Between July 2014 and April 2016, all admissions < 30 days from chemotherapy administration were prospectively collected along with clinical data. Admissions were described and classified as planned or unplanned and as associated with chemotherapy or with underlying disease. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">585 patients were admitted, 78% of whom had ovarian cancer and 43% of whom had recurrent disease. Overall, 47% of admissions were unplanned and these were significantly longer than planned admissions (5.6 vs. 2.4 days, p = 0.0003). Of unplanned admissions, 43% were due to chemotherapy, and 57% were due to disease burden. 74% of patients had received >1 prior line of chemotherapy, and 22% were on clinical trial. The most common causes of unplanned admission were nausea, vomiting or failure to thrive (28.9%), fever (17.9%) and small bowel obstruction (19.9%). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There is a high rate of unplanned admission < 30 days after chemotherapy and patients with ovarian cancer and recurrent disease are at the highest risk. This information can be used to counsel patients about complications of chemotherapy and to improve supportive management. M&M conferences surrounding unplanned admissions after chemotherapy may help guide therapy, encourage best supportive care, and prompt re-evaluation of treatment goals in heavily pretreated patients with recurrent.</span></span></span></span>
文摘Artificial intelligence(AI)is a computer science that tries to mimic human-like intelligence in machines that use computer software and algorithms to perform specific tasks without direct human input.Machine learning(ML)is a subunit of AI that uses data-driven algorithms that learn to imitate human behavior based on a previous example or experience.Deep learning is an ML technique that uses deep neural networks to create a model.The growth and sharing of data,increasing computing power,and developments in AI have initiated a transformation in healthcare.Advances in radiation oncology have produced a significant amount of data that must be integrated with computed tomography imaging,dosimetry,and imaging performed before each fraction.Of the many algorithms used in radiation oncology,has advantages and limitations with different computational power requirements.The aim of this review is to summarize the radiotherapy(RT)process in workflow order by identifying specific areas in which quality and efficiency can be improved by ML.The RT stage is divided into seven stages:patient evaluation,simulation,contouring,planning,quality control,treatment application,and patient follow-up.A systematic evaluation of the applicability,limitations,and advantages of AI algorithms has been done for each stage.
文摘After that the era of chemotherapy in the treatment of solid tumors have been overcome by the "translational era", with the innovation introduced by targeted therapies, medical oncology is currently looking at the dawn of a new "immunotherapy era" with the advent of immune checkpoint inhibitors(CKI) antibodies.The onset of PD-1/PD-L1 targeted therapy has demonstrated the importance of this axis in the immune escape across almost all human cancers.The new CKI allowed to significantly prolong survival and to generate durable response, demonstrating remarkable efficacy in a wide range of cancer types.The aim of this article is to review the most up to date literature about the clinical effectiveness of CKI antibodies targeting PD-1/PD-L1 axis for the treatment of advanced solid tumors and to explore transversal challenges in the immune checkpoint blockade.
基金This work was supported by the Capital Clinical Characteristic Application Research(Grant No.Z181100001718215)the innovative projects of PLA General Hospital(Grant No.CX19011).
文摘In April 2017,the first edition Chinese Society of Clinical Oncology Breast Cancer(CSCO BC)guidelines were released.These guidelines were based on medical evidence,as well as the accessibility and cost effectiveness of various anticancer drugs in China.The CSCO BC guidelines include regimens with a high level of evidence,good product accessibility and high consistent consensus among Chinese experts as level I recommendations.Regimens with a high level of evidence but poor product accessibility or expert consensus are included as level II recommendations.
