Prostate Cancer (PCa) remains a leading malignancy in males, with significant morbidity and mortality. Despite advancements in treatment, challenges like resistance, recurrence, and metastasis persist. Traditional Chinese Medicine (TCM) offers a promising adjunctive approach, enhancing treatment efficacy, reducing toxicity, delaying progression, and improving quality of life.

Cancer therapies such as chemotherapy enhance the survival rates but come with side effects such as ocular toxicity which reduces the QoL.

IntroductionImmunotherapy approaches have improved by Immune check point inhibitors such as PD-1, CTLA-4, and PD-L1 inhibitors. However, the response to immunotherapy varies widely among patients due to various factors. Co-administration of probiotics with ICIs has become a promising strategy to improve therapeutic outcomes. This review evaluates the impact of environmental factors and life style on cancer pathophysiology, outcome of disease, and response to the treatment. It evaluates the role of probiotics in modulating immune responses and the synergistic interaction of probiotics with immunotherapy.MethodsWe conducted a comprehensive systematic review of clinical and preclinical studies to assess the effects of probiotics on immunotherapy outcomes. Studies were selected based on their focus on probiotics' role in immune response modulation and interaction with ICIs. Data from trials involving patients with varying responses to immunotherapy, including those with prior resistance, were analyzed to explore the probiotic-enhanced immunotherapy.ResultsGut microbiome has wide effects on immune responses through different pathways like production of short chain fatty acids (SCFAs), polysaccharide A, and indole-3-carbaldehyde. Also, probiotics found to enhance Anit-inflammatory responses and increase CD8+ T-cell activity, suggesting a synergistic effect with ICIs. Gut microbiota composition plays a key role in determining the effectiveness of immunotherapy, especially in treatment-resistant patients. For optimized treatment outcomes, personalized probiotics tailored to individual's microbiota showed potential. Important challenges are treatment resistance and compromised mucosal integrity because of microbiome alterations. Effective drug delivery also remains as important barriers to common adoption.ConclusionFor immunotherapy outcomes improvement, immune responses modulation and gut microbiome diversity enhancement show probiotics important promise. Despite their potential, limitations must be addressed including treatment resistance and also delivery challenges. In order to maximize therapeutic benefits, personalized probiotic strategies have to be developed, and also the mechanisms by which probiotics improve ICI efficacy require elucidation through further research.

Novel hormonal agents (NHAs), including enzalutamide, abiraterone acetate, apalutamide, and darolutamide, have improved survival in advanced prostate cancer (PCa). However, their potential neurological adverse effects (AEs)-notably cognitive impairment, seizures, and falls-raise safety concerns, particularly in older adults. This study aimed to compare the neurological safety profiles of NHAs in men with advanced PCa using a Bayesian network meta-analysis (NMA).

This study aimed to investigate the efficacy of olanzapine, an antiemetic agent used to prevent chemotherapy-induced nausea and vomiting (CINV), at 5 and 10 mg/day, by chemotherapy emetogenic risk, and to evaluate the efficacy of low dose olanzapine at 2.5 mg/day.

Selective outcome-reporting bias refers to the selective reporting of a subset of study findings. This methodological limitation may occur in cancer-related acupuncture studies, where valid empirical studies on psychometric performance are still lacking. We assessed the risk of selective outcome reporting bias in studies published in English that were included in a systematic review on acupuncture for preventing cancer chemotherapy-induced nausea and vomiting. For each study, we searched for registry availability and, if present, assessed its validity. We described each study outcome (nausea, vomiting, or both) according to the following seven items: type of outcome, domain, specific measurement, specific metric, type of data, methods of aggregation, and timepoint unit and time. Eleven studies published between 1987 and 2019 in English were evaluated. Only four (36%) had a registry, of which only two were prospective and therefore considered valid. Discrepancies were found in the specific measurement of the outcome in two studies and in the specific metric. In many other cases, discrepancies were not evaluable due to missing information. No study reported complete outcomes as planned in the published protocol. Communication about the importance of prospective trial registration, including outcome details, should be enforced to reduce the risk of selective outcome reporting bias in oncology acupuncture studies.

Doxorubicin is an antitumor antibiotic. It is often used in veterinary medicine to treat and extend the lives of dogs with cancer. A cardiotoxic side effect can lead to heart failure and treatment discontinuation. This systematic review and meta-analysis aimed to evaluate the drug's cardiotoxic effects on the ejection fraction (EF) of dogs in doxorubicin protocols. The search was done in eight databases, with a total of 3587 articles screened, resulting in fifteen eligible articles included. A report on the included studies' methods and results was done. It also assessed the risk of bias. Thirteen articles demonstrated cardiac changes in echocardiography with different routes of administration (intravenous and intracoronary). The intracoronary route was more toxic, and in all six studies performed, there was heart failure. The intravenous route caused heart failure in six of the nine studies. A meta-analysis showed this drug worsened heart disease. It included four studies where it significantly lowered the EF. Overall, the intervention produced a mean reduction of 21.24% in EF. This review shows doxorubicin's impact on cardiac function. It reveals the need for careful monitoring of each patient.

Patients with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) are treated with curative intent. Treatment guidelines recommend tumor resection, followed by adjuvant radiotherapy or chemoradiotherapy in patients with high risk of disease recurrence, or definitive chemoradiotherapy in patients who do not undergo surgery. When indicated, concurrent cisplatin provides benefit over radiotherapy alone but is highly toxic. In this systematic literature review, we review adverse event (AE) profiles of cisplatin-based chemoradiotherapy in patients with LA SCCHN and synthesize AE management strategies based on expert clinical opinion.

To assess the long-term impact of chemotherapy exposure on pregnancy outcomes in women treated during childhood, adolescence, or young adulthood (CAYA).

Tislelizumab, a PD-1-targeting monoclonal antibody, can potentially treat advanced esophageal squamous cell carcinoma (ESCC). Using pooled clinical data, this study evaluates Tislelizumab's efficacy and safety in advanced ESCC.

Huachansu capsule (HCSC) is a traditional Chinese patent medicine derived from toad venom (Bufo bufo gargarizans Cantor). In China, HCSC has been widely used as a therapeutic agent for breast cancer (BC). It exerts antitumor effects by inducing apoptosis of BC cells, disrupting the tumor cell cycle, and regulating the immune system. Preliminary clinical studies have confirmed its antitumor efficacy in BC patients.

Background: Chemotherapy-induced thrombocytopenia (CIT) impacts a significant number of patients undergoing oncological treatment. Aim: This study explored the usefulness of Carica papaya leaf extract (CPLE) in the context of CIT, including side effect and optimal treatment dosage and duration. Methods: Systematic literature reviews were conducted on (a) studies of patients with solid tumors and CIT who received CPLE, and (b) animal studies focused on CPLE for CIT. Risk of bias was assessed and meta-analyses were conducted. Results: In the meta-analysis of studies on oncological patients with CIT (total N = 410, intervention N = 205), the overall effect size for CPLE administration was 2.20, 95% confidence interval (CI): 0.96-3.44, P < 0.001. In the meta-analysis on animal models (total N = 84, intervention N = 42), two effect sizes were computed for two platelet measurements at different time intervals: 5.74, 95% CI: 0.32 = 11.16, P < 0.001 and 7.13, 95% CI: 4.23-10.02, P < 0.001, respectively. CPLE dosage varied between 580 and 3300 mg, with a mean of 1500 mg per day. No studies reported major side effects of CPLE administration. Conclusion: Despite heterogeneity and risk of bias concerns, the research literature available so far of both animal models and human participants suggests that CPLE might be an effective strategy for dealing with CIT. However, more rigorous research is still needed.

This meta-analysis aimed to evaluate the effectiveness and reliability of probiotic interventions in managing chemotherapy-induced complications among patients with leukemia, providing evidence-based insights for clinical decision-making. Studies in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data were comprehensively searched up to March 5, 2024. Randomized controlled trials (RCTs) comparing probiotic use with conventional care in leukemia patients undergoing chemotherapy were included. The included studies examined all possible chemotherapy-related adverse effects without selective outcome reporting. Data synthesis was conducted using RevMan 5.4 and STATA 15.0. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to evaluate the quality of evidence for each outcome. Eight RCTs encompassing 753 participants were analyzed. Compared with conventional care, probiotics significantly reduced constipation (odds ratio [OR] = 0.61, 95% CI = 0.30-1.24, P < 0.05), nausea (OR = 0.51, 95% CI = 0.41-0.63], P < 0.00001), chemotherapy-induced diarrhea (OR = 0.39, 95% CI = 0.26-0.57], P < 0.00001), bloating (OR = 0.38, 95% CI = 0.20-0.76, P = 0.006), vomiting (OR = 0.62, 95% CI = 0.39-0.98, P = 0.04), and indigestion (OR = 0.55, 95% CI = 0.31-0.95, P = 0.03). Notable improvements were observed in procalcitonin and tumor necrosis factor-alpha levels. Evidence quality was high for most outcomes, with moderate ratings for dyspepsia, constipation, and vomiting. In conclusion, probiotic supplementation appears to moderately alleviate chemotherapy-induced complications in patients with leukemia. Nevertheless, because of limitations such as small sample sizes and potential data variability, further validation through large-scale RCTs is necessary.

The advent of immune checkpoint inhibitors has introduced innovative therapeutic paradigms for the management of human epidermal growth factor receptor 2 (HER2)-negative advanced gastric or gastroesophageal junction cancer (GC/GEJC). However, the efficacy and safety of programmed cell death protein 1 (PD-1) inhibitors combined with chemotherapy versus chemotherapy alone in patients with HER2-negative advanced GC/GEJC remain contentious. The comparability among different subgroups is not fully understood, necessitating the identification of optimal patient demographics and the exploration of potential biomarkers.

This study aimed to systematically evaluate the efficacy and safety of combination therapies with immune checkpoint inhibitors (ICIs) in patients with driver gene-negative non-small cell lung cancer (NSCLC) and liver metastases. These patients typically have poor prognosis and limited responses to immunotherapy. This study synthesized existing literature by conducting a network meta-analysis to determine the most effective first-line ICI combination regimen to guide clinical treatment decisions.

Breast cancer is the most common cancer and the main cause of death because of malignant tumors in women, worldwide. The impact of Crocus sativus on several cancers has been discussed. Recent studies provide evidence regarding the anticancer properties of C. sativus and its bioactive constituents against breast cancer. This study aims to systematically review the efficacy of this botanical drug and its constituents on breast cancer, and their mechanism of action for the first time. Due to the lack of human studies in this field, the present research focused on preclinical studies.

Therapeutic resistance continues to pose one of major problem in effectively managing prostate cancer (PCa) is the advancement of therapeutic resistance. A key mechanism underlying this resistance is the suppression of apoptosis, often triggered by increased expression of anti-apoptotic Bcl-2 family proteins.

Poly (ADP-ribose) polymerase inhibitors (PARPi) have become a key treatment for ovarian cancer, particularly in patients with BRCA mutations or homologous recombination deficiency (HRD).

Poly (ADP-ribose) polymerase (PARP) inhibitors (PARPis) are effective agents in different tumor types. A typical class of adverse events (AEs) associated with these agents, often leading to treatment modifications and discontinuations of treatment, is hematological toxicity. In our systematic review and safety meta-analysis, we investigated the incidence and risk of all grades and ≥ grade (G) 3 hematological AEs, including anemia, neutropenia, thrombocytopenia, and acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) due to PARPis, used alone or in combination, in patients diagnosed with solid tumors. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We systematically searched the PubMed, EMBASE, and Cochrane databases, the American Society of Clinical Oncology, and the European Society of Medical Oncology meeting abstracts for randomized clinical trials (RCTs) concerning the use of PARPis in patients with solid tumors. The search deadline was April 30, 2024. We calculated risk ratios (RRs) for all-grade and ≥ G3 AEs of PARPis versus non-PARPis. 31 phase II/III RCTs were included. Anemia was the most common all-grade (49.2%) and ≥ G3 AE (25.0%). The administration of PARPis significantly increased the risk of developing all grades of anemia (RR = 2.15, p < 0.00001), neutropenia (RR = 1.50, p = 0.0002), and thrombocytopenia (RR = 2.59, p < 0.00001) compared to non-PARPis. Similarly, a significant increase in the risk of ≥ G3 anemia (RR = 5.43, p < 0.00001), neutropenia (RR = 1.70, p = 0.002), and thrombocytopenia (RR = 5.42, p < 0.00001) was detected. PARPis did not increase the risk of AML/MDS (p = 0.86). PARPis increase the risk of hematologic toxicity compared to other treatments in solid tumors. Clinicians should be aware of this risk, especially given the expected increase in PARPis use in the next year in different tumor types.

Immune checkpoint inhibitors (ICIs) have improved outcomes for various malignancies. However, serious immune-related adverse events (irAEs), including neurologic complications (NAEs), may occur. The aim of this study was to examine the incidence and spectrum of NAEs and evaluate management strategies for reducing their impact.