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881. Impact of Anti-EGFR Therapies on HER2-Positive Metastatic Colorectal Cancer: A Systematic Literature Review and Meta-Analysis of Clinical Outcomes.

作者: Tanios S Bekaii-Saab.;Krzysztof Lach.;Ling-I Hsu.;Muriel Siadak.;Mike Stecher.;James Ward.;Rachel Beckerman.;John H Strickler.
来源: Oncologist. 2023年28卷10期885-893页
HER2 overexpression/amplification in patients with RAS wild-type (WT) metastatic colorectal cancer (mCRC) may be associated with resistance to standard-of-care anti-EGFR therapies. Given the lack of comprehensive investigations into this association, we assessed the prognostic or predictive effect of HER2 amplification/overexpression on anti-EGFR treatment outcomes.

882. Genetic variants of antioxidant and xenobiotic metabolizing enzymes and their association with prostate cancer: A meta-analysis and functional in silico analysis.

作者: Beatriz Álvarez-González.;Patricia Porras-Quesada.;Verónica Arenas-Rodríguez.;Alba Tamayo-Gómez.;Fernando Vázquez-Alonso.;Luis Javier Martínez-González.;Antonio F Hernández.;María Jesús Álvarez-Cubero.
来源: Sci Total Environ. 2023年898卷165530页
The development and progression of prostate cancer (PCa) depends on complex interactions between genetic, environmental and dietary factors that modulate the carcinogenesis process. Interactions between chemical exposures and genetic polymorphisms in genes encoding xenobiotic metabolizing enzymes (XME), antioxidant enzymes and DNA repair enzymes have been reported as the main drivers of cancer. Thus, a better understanding of the causal risk factors for PCa will provide avenues to identify men at increased risk and will contribute to develop effective detection and prevention methods. We performed a meta-analysis on 17,518 cases and 42,507 controls obtained from 42 studies to determine whether seven SNPs and one CNV pertaining to oxidative stress, xenobiotic detoxification and DNA repair enzymes are associated with the risk of PCa (GPX1 (rs1050450), XRCC1 (rs25487), PON1 (rs662), SOD2 (rs4880), CAT (rs1001179), GSTP1 (rs1695) and CNV GSTM1). A significant increased risk of PCa was found for SOD2 (rs4880) ORGG+GA vs. AA 1.08; 95%CI 1.01-1.15, CAT (rs1001179) ORTT vs. TC+CC 1.39; 95%CI 1.17-1.66, PON1 (rs662) ORCT vs. CC+TT 1.17; 95%CI 1.01-1.35, GSTP1 (rs1695) ORGG vs. GA+AA 1.20; 95%CI 1.05-1.38 and GSTM1 (dual null vs. functional genotype) ORN vs. NN1+NN2 1.34; 95%CI 1.10-1.64. The meta-analysis showed that the CNV GSTM1, and the SNPs GSTP1 (rs1695) and CAT (rs1001179) are strongly associated with a greater risk of PCa and, to a lesser extent, the genetic variants SOD2 (rs4880) and PON1 (rs662). Although several antioxidant enzymes and XME play an important role in the PCa development, other risk factors such as chemical exposures should also be considered to gain insight on PCa risk. The functional in silico analysis showed that the genetic variants studied had no clinical implication regarding malignancy, except for GPX1 (rs1050450) SNP.

883. ENIGMA CHEK2gether Project: A Comprehensive Study Identifies Functionally Impaired CHEK2 Germline Missense Variants Associated with Increased Breast Cancer Risk.

作者: Lenka Stolarova.;Petra Kleiblova.;Petra Zemankova.;Barbora Stastna.;Marketa Janatova.;Jana Soukupova.;Maria Isabel Achatz.;Christine Ambrosone.;Paraskevi Apostolou.;Banu K Arun.;Paul Auer.;Mollie Barnard.;Birgitte Bertelsen.; .;Marinus J Blok.;Nicholas Boddicker.;Joan Brunet.;Elizabeth S Burnside.;Mariarosaria Calvello.;Ian Campbell.;Sock Hoai Chan.;Fei Chen.;Jian Bang Chiang.;Anna Coppa.;Laura Cortesi.;Ana Crujeiras-González.; .;Kim De Leeneer.;Robin De Putter.;Allison DePersia.;Lisa Devereux.;Susan Domchek.;Anna Efremidis.;Christoph Engel.;Corinna Ernst.;D Gareth R Evans.;Lidia Feliubadaló.;Florentia Fostira.;Olivia Fuentes-Ríos.;Encarna B Gómez-García.;Sara González.;Christopher Haiman.;Thomas van Overeem Hansen.;Jan Hauke.;James Hodge.;Chunling Hu.;Hongyan Huang.;Nur Diana Binte Ishak.;Yusuke Iwasaki.;Irene Konstantopoulou.;Peter Kraft.;James Lacey.;Conxi Lázaro.;Na Li.;Weng Khong Lim.;Sara Lindstrom.;Adriana Lori.;Elana Martinez.;Alexandra Martins.;Koichi Matsuda.;Giuseppe Matullo.;Simone McInerny.;Kyriaki Michailidou.;Marco Montagna.;Alvaro N A Monteiro.;Luigi Mori.;Katherine Nathanson.;Susan L Neuhausen.;Heli Nevanlinna.;Janet E Olson.;Julie Palmer.;Barbara Pasini.;Alpa Patel.;Maria Piane.;Bruce Poppe.;Paolo Radice.;Alessandra Renieri.;Nicoletta Resta.;Marcy E Richardson.;Toon Rosseel.;Kathryn J Ruddy.;Marta Santamariña.;Elizabeth Santana Dos Santos.;Lauren Teras.;Amanda E Toland.;Amy Trentham-Dietz.;Celine M Vachon.;Alexander E Volk.;Nana Weber-Lassalle.;Jeffrey N Weitzel.;Lisa Wiesmuller.;Stacey Winham.;Siddhartha Yadav.;Drakoulis Yannoukakos.;Song Yao.;Valentina Zampiga.;Magnus Zethoven.;Ze Wen Zhang.;Tomas Zima.;Amanda B Spurdle.;Ana Vega.;Maria Rossing.;Jesús Del Valle.;Arcangela De Nicolo.;Eric Hahnen.;Kathleen B M Claes.;Joanne Ngeow.;Yukihide Momozawa.;Paul A James.;Fergus J Couch.;Libor Macurek.;Zdenek Kleibl.
来源: Clin Cancer Res. 2023年29卷16期3037-3050页
Germline pathogenic variants in CHEK2 confer moderately elevated breast cancer risk (odds ratio, OR ∼ 2.5), qualifying carriers for enhanced breast cancer screening. Besides pathogenic variants, dozens of missense CHEK2 variants of uncertain significance (VUS) have been identified, hampering the clinical utility of germline genetic testing (GGT).

884. Identification of lncRNAs Deregulated in Epithelial Ovarian Cancer Based on a Gene Expression Profiling Meta-Analysis.

作者: Martín Salamini-Montemurri.;Mónica Lamas-Maceiras.;Lidia Lorenzo-Catoira.;Ángel Vizoso-Vázquez.;Aida Barreiro-Alonso.;Esther Rodríguez-Belmonte.;María Quindós-Varela.;M Esperanza Cerdán.
来源: Int J Mol Sci. 2023年24卷13期
Epithelial ovarian cancer (EOC) is one of the deadliest gynecological cancers worldwide, mainly because of its initially asymptomatic nature and consequently late diagnosis. Long non-coding RNAs (lncRNA) are non-coding transcripts of more than 200 nucleotides, whose deregulation is involved in pathologies such as EOC, and are therefore envisaged as future biomarkers. We present a meta-analysis of available gene expression profiling (microarray and RNA sequencing) studies from EOC patients to identify lncRNA genes with diagnostic and prognostic value. In this meta-analysis, we include 46 independent cohorts, along with available expression profiling data from EOC cell lines. Differential expression analyses were conducted to identify those lncRNAs that are deregulated in (i) EOC versus healthy ovary tissue, (ii) unfavorable versus more favorable prognosis, (iii) metastatic versus primary tumors, (iv) chemoresistant versus chemosensitive EOC, and (v) correlation to specific histological subtypes of EOC. From the results of this meta-analysis, we established a panel of lncRNAs that are highly correlated with EOC. The panel includes several lncRNAs that are already known and even functionally characterized in EOC, but also lncRNAs that have not been previously correlated with this cancer, and which are discussed in relation to their putative role in EOC and their potential use as clinically relevant tools.

885. Efficacy and safety of FDA-approved IDH inhibitors in the treatment of IDH mutated acute myeloid leukemia: a systematic review and meta-analysis.

作者: Xiu Chen.;Hongyun Xing.;Xiaolu Xie.;Liqiu Kou.;Jun Li.;Yaling Li.
来源: Clin Epigenetics. 2023年15卷1期113页
To systematically evaluate the efficacy and safety of FDA-approved isocitrate dehydrogenase (IDH) inhibitors in the treatment of IDH-mutated acute myeloid leukemia (AML).

886. A multi-platform normalization method for meta-analysis of gene expression data.

作者: Rachisan Djiake Tihagam.;Sanchita Bhatnagar.
来源: Methods. 2023年217卷43-48页
Transcriptomic profiling is a mainstay of translational cancer research and is often used to identify cancer subtypes, stratify responders vs. non-responders patients, predict survival, and identify potential targets for therapeutic intervention. Analysis of gene expression data gathered by RNA sequencing (RNA-seq) and microarray is generally the first step in identifying and characterizing cancer-associated molecular determinants. The methodological advancements and reduced costs associated with transcriptomic profiling have increased the number of publicly available gene expression profiles for cancer subtypes. Data integration from multiple datasets is routinely done to increase the number of samples, improve statistical power, and provide better insight into the heterogeneity of the biological determinant. However, utilizing raw data from multiple platforms, species, and sources introduces systematic variations due to noise, batch effects, and biases. As such, the integrated data is mathematically adjusted through normalization, which allows direct comparison of expression measures among studies while minimizing technical and systemic variations. This study applied meta-analysis to multiple independent Affymetrix microarray and Illumina RNA-seq datasets available through the Gene Expression Omnibus (GEO) and The Cancer Gene Atlas (TCGA). We have previously identified a tripartite motif containing 37 (TRIM37), a breast cancer oncogene, that drives tumorigenesis and metastasis in triple-negative breast cancer. In this article, we adapted and assessed the validity of Stouffer's z-score normalization method to interrogate TRIM37 expression across different cancer types using multiple large-scale datasets.

887. Best first-line therapy for people with advanced non-small cell lung cancer, performance status 2 without a targetable mutation or with an unknown mutation status.

作者: Rolof Gp Gijtenbeek.;Kim de Jong.;Ben Jw Venmans.;Femke Hm van Vollenhoven.;Anneke Ten Brinke.;Anthonie J Van der Wekken.;Wouter H van Geffen.
来源: Cochrane Database Syst Rev. 2023年7卷7期CD013382页
Most people who are newly diagnosed with non-small cell lung cancer (NSCLC) have advanced disease. For these people, survival is determined by various patient- and tumor-related factors, of which the performance status (PS) is the most important prognostic factor. People with PS 0 or 1 are usually treated with systemic therapies, whereas people with PS 3 or 4 most often receive supportive care. However, treatment for people with PS 2 without a targetable mutation remains unclear. Historically, people with a PS 2 cancer are frequently excluded from (important) clinical trials because of poorer outcomes and increased toxicity. We aim to address this knowledge gap, as this group of people represents a significant proportion (20% to 30%) of the total population with newly diagnosed lung cancer.

888. Role of miR-21 in the diagnosis of colorectal cancer: Meta-analysis and bioinformatics.

作者: Jiaxin Li.;Huili Chen.;Guiying Sun.;Xiaoyue Zhang.;Hua Ye.;Peng Wang.
来源: Pathol Res Pract. 2023年248卷154670页
Advanced colorectal cancer (CRC) has a bad prognosis and is challenging to cure. Therefore, there is an urgent need for an effective early diagnosis marker. MicroRNA-21 (miR-21) regulates the expression of multiple cancer target genes. The objective of this study was to assess the diagnostic role of miR-21 in CRC.A meta-analysis of PubMed, Cochrane Library, EMBASE, and Web of Science databases was performed with a carefully designed search strategy to identify records related to the diagnostic role of miR-21 in CRC. TCGA data was used to search for different microRNAs in colorectal cancer samples and surrounding tissues. In addition, potential target genes for miR-21 were predicted and evaluated by functional analysis. We conducted a meta-analysis for 10 studies, including 728 blood samples of patients with CRC and 472 healthy controls. The combined sensitivity and specificity of miR-21 to diagnose colorectal cancer were 0.79 (95% CI: 0.67-0.87) and 0.92 (95% CI: 0.85-0.96), respectively. The combined positive likelihood ratio (PLR) was 10.20 (95% CI: 4.8-21.5), the combined negative likelihood ratio (NLR) was 0.23 (95% CI: 0.14-0.37), the diagnostic odds ratio (DOR) was 45.00 (95% CI:15-132), the area under the summary receiver operating characteristic curve (SROC) for the included studies was 0.93(95%CI: 0.91-0.95). Simultaneously, TCGA data showed that miR-21 was a differential microRNA in colorectal cancer tissues and adjacent tissues, and it was an up-regulated gene. After verification by three databases, 48 target genes of miR-21 were obtained. Through GO enrichment analysis, it was found that the target genes were mainly distributed in the fiber center, the molecular function was mainly focused on cytokine receptor binding, and the biological process was mainly focused on ubiquitin-dependent protein catabolism mediated by the proteasome. KEGG pathway analysis showed that the target genes were mainly distributed in tumor pathways.

889. Predicted Proteome Association Studies of Breast, Prostate, Ovarian, and Endometrial Cancers Implicate Plasma Protein Regulation in Cancer Susceptibility.

作者: Isabelle Gregga.;Paul D P Pharoah.;Simon A Gayther.;Ani Manichaikul.;Hae Kyung Im.;Siddhartha P Kar.;Joellen M Schildkraut.;Heather E Wheeler.
来源: Cancer Epidemiol Biomarkers Prev. 2023年32卷9期1198-1207页
Predicting protein levels from genotypes for proteome-wide association studies (PWAS) may provide insight into the mechanisms underlying cancer susceptibility.

890. Causal impacts of educational attainment on chronic liver diseases and the mediating pathways: Mendelian randomization study.

作者: Yiying Wang.;Lijie Kong.;Chaojie Ye.;Chun Dou.;Jie Zheng.;Min Xu.;Yu Xu.;Mian Li.;Zhiyun Zhao.;Jieli Lu.;Yuhong Chen.;Weiqing Wang.;Guang Ning.;Yufang Bi.;Tiange Wang.
来源: Liver Int. 2023年43卷11期2379-2392页
Educational attainment is an essential socio-economic indicator with broad implications for lifestyle behaviour and metabolic health. We aimed to investigate the causal effect of education on chronic liver diseases and the potential mediating pathways.

891. TMEM200A is a potential prognostic biomarker and correlated with immune infiltrates in gastric cancer.

作者: Fujin Fang.;Tiantian Zhang.;Huan Lei.;Xiaobing Shen.
来源: PeerJ. 2023年11卷e15613页
Gastric cancer (GC) is one of the most common malignant tumors in the digestive system. Several transmembrane (TMEM) proteins are defined as tumor suppressors or oncogenes. However, the role and underlying mechanism of TMEM200A in GC remain unclear.

892. Myasthenia Gravis and Ischemic Stroke: A Bidirectional Mendelian Randomization Study.

作者: Chen Liu.;Chengyuan Mao.;Shen Li.;Yun Su.;Hongbing Liu.;Xin Wang.;Weishi Liu.;Jiawei Zhao.;Xuyang Liu.;Yuming Xu.
来源: Curr Neurovasc Res. 2023年20卷2期270-279页
Autoimmune diseases are associated with cardiovascular and cerebrovascular diseases. However, whether myasthenia gravis (MG) and ischemic stroke (IS) are causally related remains unclear.

893. Family history and breast cancer risk for Asian women: a systematic review and meta-analysis.

作者: Heran Wang.;Robert J MacInnis.;Shuai Li.
来源: BMC Med. 2023年21卷1期239页
Studies of women of European ancestry have shown that the average familial relative risk for first-degree relatives of women with breast cancer is approximately twofold, but little is known for Asian women. We aimed to provide evidence for the association between family history and breast cancer risk for Asian women by systematically reviewing published literature.

894. Prognostic significance of N6-methyladenosine-modified related chemotransferase METTL3 in gastric carcinoma: Evidence from meta-analysis.

作者: Chenglou Zhu.;Qiong Wu.;Yan Xu.;Jichun Ma.;Yongli Hu.;Junhong Wang.;Zhenhua Gao.;Mingxu Da.
来源: Int J Biol Markers. 2023年38卷3-4期185-193页
N6-methyladenosine (m6A) methylation is known as the research hotspot for tumor epimodification, and its associated methyltransferase-like3 (METTL3) is significantly differentially expressed in gastric carcinoma, but its clinical value has not been summarized. This meta-analysis aimed to evaluate the prognostic significance of METTL3 in gastric carcinoma.

895. Genomic Alterations and the Incidence of Brain Metastases in Advanced and Metastatic NSCLC: A Systematic Review and Meta-Analysis.

作者: Conor S Gillespie.;Mohammad A Mustafa.;George E Richardson.;Ali M Alam.;Keng Siang Lee.;David M Hughes.;Carles Escriu.;Rasheed Zakaria.
来源: J Thorac Oncol. 2023年18卷12期1703-1713页
Brain metastases (BMs) in patients with advanced and metastatic NSCLC are linked to poor prognosis. Identifying genomic alterations associated with BM development could influence screening and determine targeted treatment. We aimed to establish prevalence and incidence in these groups, stratified by genomic alterations.

896. Discordance of PIK3CA mutational status between primary and metastatic breast cancer: a systematic review and meta-analysis.

作者: Justus Rosin.;Ella Svegrup.;Antonios Valachis.;Ioannis Zerdes.
来源: Breast Cancer Res Treat. 2023年201卷2期161-169页
In light of the clinically meaningful results of the PI3K inhibitors in PIK3CA-mutated metastatic breast cancer (BC) patients, the reliable identification of PIK3CA mutations is of outmost importance. However, lack of evidence on the optimal site and timing of assessment, presence of temporal heterogeneity and analytical factors pose several challenges in clinical routine. We aimed to study the discordance rates of PIK3CA mutational status between primary and matched metastatic tumors.

897. Prognostic Value of Neurotrophic Tyrosine Receptor Kinase Gene Fusions in Solid Tumors for Overall Survival: A Systematic Review and Meta-Analysis.

作者: Ulrik Lassen.;Carsten Bokemeyer.;Jesus Garcia-Foncillas.;Antoine Italiano.;Gilles Vassal.;Noman Paracha.;Marisca Marian.;Yuxian Chen.;Louise Linsell.;Keith Abrams.
来源: JCO Precis Oncol. 2023年7卷e2200651页
Evidence suggests that neurotrophic tyrosine receptor kinase (NTRK) gene fusions in solid tumors are predictive biomarkers for targeted inhibition across a number of adult and pediatric tumor types. However, despite robust clinical response to tyrosine receptor kinase (TRK) inhibitors, the natural history and prognostic implications of NTRK fusions in solid tumors are poorly understood. It is important to evaluate their prognostic significance on survival to provide some context to the clinical effectiveness observed in clinical trials of TRK-targeted therapies.

898. Circulating Tumor DNA as a Minimal Residual Disease Assessment and Recurrence Risk in Patients Undergoing Curative-Intent Resection with or without Adjuvant Chemotherapy in Colorectal Cancer: A Systematic Review and Meta-Analysis.

作者: Anusha Chidharla.;Eliot Rapoport.;Kriti Agarwal.;Samragnyi Madala.;Brenda Linares.;Weijing Sun.;Sakti Chakrabarti.;Anup Kasi.
来源: Int J Mol Sci. 2023年24卷12期
Emerging data have suggested that circulating tumor DNA (ctDNA) can be a reliable biomarker for minimal residual disease (MRD) in CRC patients. Recent studies have shown that the ability to detect MRD using ctDNA assay after curative-intent surgery will change how to assess the recurrence risk and patient selection for adjuvant chemotherapy. We performed a meta-analysis of post-operative ctDNA in stage I-IV (oligometastatic) CRC patients after curative-intent resection. We included 23 studies representing 3568 patients with evaluable ctDNA in CRC patient post-curative-intent surgery. Data were extracted from each study to perform a meta-analysis using RevMan 5.4. software. Subsequent subgroup analysis was performed for stages I-III and oligometastatic stage IV CRC patients. Results showed that the pooled hazard ratio (HR) for recurrence-free survival (RFS) in post-surgical ctDNA-positive versus -negative patients in all stages was 7.27 (95% CI 5.49-9.62), p < 0.00001. Subgroup analysis revealed pooled HRs of 8.14 (95% CI 5.60-11.82) and 4.83 (95% CI 3.64-6.39) for stages I-III and IV CRC, respectively. The pooled HR for RFS in post-adjuvant chemotherapy ctDNA-positive versus -negative patients in all stages was 10.59 (95% CI 5.59-20.06), p < 0.00001. Circulating tumor DNA (ctDNA) analysis has revolutionized non-invasive cancer diagnostics and monitoring, with two primary forms of analysis emerging: tumor-informed techniques and tumor-agnostic or tumor-naive techniques. Tumor-informed methods involve the initial identification of somatic mutations in tumor tissue, followed by the targeted sequencing of plasma DNA using a personalized assay. In contrast, the tumor-agnostic approach performs ctDNA analysis without prior knowledge of the patient's tumor tissue molecular profile. This review highlights the distinctive features and implications of each approach. Tumor-informed techniques enable the precise monitoring of known tumor-specific mutations, leveraging the sensitivity and specificity of ctDNA detection. Conversely, the tumor-agnostic approach allows for a broader genetic and epigenetic analysis, potentially revealing novel alterations and enhancing our understanding of tumor heterogeneity. Both approaches have significant implications for personalized medicine and improved patient outcomes in the field of oncology. The subgroup analysis based on the ctDNA method showed pooled HRs of 8.66 (95% CI 6.38-11.75) and 3.76 (95% CI 2.58-5.48) for tumor-informed and tumor-agnostic, respectively. Our analysis emphasizes that post-operative ctDNA is a strong prognostic marker of RFS. Based on our results, ctDNA can be a significant and independent predictor of RFS. This real-time assessment of treatment benefits using ctDNA can be used as a surrogate endpoint for the development of novel drugs in the adjuvant setting.

899. Unveiling the Prognostic Significance of BCL6+/CD10+ Mantle Cell Lymphoma: Meta-Analysis of Individual Patients and Systematic Review.

作者: Dani Ran Castillo.;Daniel Park.;Won Jin Jeon.;Bowon Joung.;Jae Lee.;Chieh Yang.;Bryan Pham.;Christopher Hino.;Esther Chong.;Andrea Shields.;Anthony Nguyen.;Joel Brothers.;Yan Liu.;Ke K Zhang.;Huynh Cao.
来源: Int J Mol Sci. 2023年24卷12期
Mantle cell lymphoma (MCL) is a type of non-Hodgkin lymphoma (NHL) characterized by a hallmark translocation of t (11; 14). CD10 negativity has been used to differentiate MCL from other NHL types; however, recently, there has been an increase in the number of reported cases of CD10-positive MCL. This warrants further investigation into this rarer immunophenotype and its clinical significance. BCL6, which is a master transcription factor for the regulation of cell proliferation and key oncogene in B cell lymphomagenesis, has been reported to have co-expression with CD10 in MCL. The clinical significance of this aberrant antigen expression remains unknown. We conducted a systematic review by searching four databases and selected five retrospective analyses and five case series. Two survival analyses were conducted to determine if BCL6 positivity conferred a survival difference: 1. BCL6+ vs. BCL6- MCL. 2. BCL6+/CD10+ vs. BCL6-/CD10+ MCL. Correlation analysis was conducted to determine if BCL6 positivity correlated with the Ki67 proliferation index (PI). Overall survival (OS) rates were performed by the Kaplan-Meier method and log-rank test. Our analyses revealed that BCL6+ MCL had significantly shorter overall survival (median OS: 14 months vs. 43 months; p = 0.01), BCL6+/CD10+ MCL had an inferior outcome vs. BCL6+/CD10- MCL (median OS: 20 months vs. 55 months p = 0.1828), BCL6+ MCL had significantly higher percentages of Ki67% (Ki67% difference: 24.29; p = 0.0094), and BCL6 positivity had a positive correlation with CD10+ status with an odds ratio 5.11 (2.49, 10.46; p = 0.0000286). Our analysis showed that BCL6 expression is correlated with CD10 positivity in MCL, and BCL6 expression demonstrated an inferior overall survival. The higher Ki67 PI in BCL6+ MCL compared to BCL6- MCL further supports the idea that the BCL6+ immunophenotype may have prognostic value in MCL. MCL management should consider incorporating prognostic scoring systems adjusted for BCL6 expression. Targeted therapies against BCL6 may offer potential therapeutic options for managing MCL with aberrant immunophenotypes.

900. Molecular-Biology-Driven Frontline Treatment for Chronic Lymphocytic Leukemia: A Network Meta-Analysis of Randomized Clinical Trials.

作者: Andrea Rizzuto.;Angelo Pirrera.;Emilia Gigliotta.;Salvatrice Mancuso.;Candida Vullo.;Giulia Maria Camarda.;Cristina Rotolo.;Arianna Roppolo.;Corinne Spoto.;Massimo Gentile.;Cirino Botta.;Sergio Siragusa.
来源: Int J Mol Sci. 2023年24卷12期
The treatment of chronic lymphocytic leukemia (CLL) currently relies on the use of chemo-immunotherapy, Bruton's tyrosine kinase inhibitors, or BCL2 inhibitors alone or combined with an anti-CD20 monoclonal antibody. However, the availability of multiple choices for the first-line setting and a lack of direct head-to-head comparisons pose a challenge for treatment selection. To overcome these limitations, we performed a systematic review and a network meta-analysis on published randomized clinical trials performed in the first-line treatment setting of CLL. For each study, we retrieved data on progression-free survival (according to del17/P53 and IGHV status), overall response rate, complete response, and incidence of most frequent grade 3-4 adverse event. We identified nine clinical trials encompassing 11 different treatments, with a total of 5288 CLL patients evaluated. We systematically performed separated network meta-analyses (NMA) to evaluate the efficacy/safety of each regimen in the conditions previously described to obtain the surface under the cumulative ranking curve (SUCRA) score, which was subsequently used to build separated ranking charts. Interestingly, the combination of obinutuzumab with acalabrutinib reached the top of the chart in each sub-analysis performed, with the exception of the del17/P53mut setting, where it was almost on par with the aCD20 mAbs/ibrutinib combination (SUCRA aCD20-ibrutinib and O-acala: 93.5% and 91%, respectively) and of the safety evaluation, where monotherapies (acalabrutinib in particular) gave better results. Finally, considering that NMA and SUCRA work for single endpoints only, we performed a principal component analysis to recapitulate in a cartesian plane the SUCRA profiles of each schedule according to the results obtained in each sub-analysis, confirming again the superiority of aCD20/BTKi or BCL2i combinations in a first-line setting. Overall, here we demonstrated that: (1) a chemotherapy-free regimen, such as the combination of aCD20 with a BTKi or BCL2i, should be the preferred treatment choice despite biological/molecular characteristics (preferred regimen O-acala); (2) there is less and less room for chemotherapy in the first line treatment of CLL.
共有 8005 条符合本次的查询结果, 用时 2.646527 秒