Antiangiogenic combination therapy-antiangiogenic agents combined with immune checkpoint inhibitors and/or chemotherapy-has become an important treatment strategy for advanced driver-negative non-small cell lung cancer (NSCLC). We conducted a network meta-analysis to compare efficacy and safety and identify optimal antiangiogenic combinations.

This network meta-analysis evaluated the efficacy of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists, with or without Dexamethasone (D), for preventing chemotherapy-induced nausea and vomiting (CINV) in patients undergoing highly emetogenic chemotherapy (HEC) who were limited to these regimens.

Immune checkpoint inhibitors (ICPis) are associated with islet function impairment (IFI), manifesting as hyperglycemia, diabetes mellitus (DM), or diabetic ketoacidosis (DKA). Delayed detection and management may lead to irreversible β-cell damage and life-threatening complications. We conducted a systematic review and meta-analysis to assess the risk of IFI associated with ICPis.

Chemotherapy-related cardiac dysfunction (CTRCD) is a major limitation of cardiotoxic cancer therapies. Although global longitudinal strain (GLS) allows early detection of myocardial injury, preventive strategies remain scarce. Angiotensin receptor-neprilysin inhibitors (ARNIs) may offer cardioprotection, but current evidence is limited. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating Sacubitril/Valsartan versus control in patients undergoing chemotherapy. PubMed, Embase, and Cochrane databases were searched. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were computed for binary and continuous outcomes. Four randomized controlled trials comprising 412 participants were included; 42.7% received ARNI therapy, with follow-up ranging from 6 to 18 months. Compared with control, ARNI significantly preserved left ventricular systolic function (MD 1.47%, 95% CI 0.59-2.34) and attenuated GLS deterioration (MD -0.93%, 95% CI -1.49 to -0.38). However, ARNI did not significantly reduce the incidence of CTRCD (RR 0.40, 95% CI 0.08-1.97) or all-cause mortality (RR 0.63, 95% CI 0.08-5.01). ARNI increased the risk of hypotension but had no significant effects on NT-proBNP or dyspnea. In conclusion, ARNI therapy improves GLS and left ventricular ejection fraction during chemotherapy but has not yet demonstrated reductions in CTRCD or mortality. Hypotension remains a key safety consideration.

Chemotherapy-induced nausea and vomiting (CINV) is a common and severe adverse effect of breast cancer (BC) treatment that compromises treatment adherence and quality of life. This meta-analysis aims to assess the prevalence and risk factors of CINV in BC patients, thereby providing clinical insights for its prevention and improvement. Patient/material and methods: Relevant literature was identified through an extensive search of electronic databases from their inception up to July 10, 2025: PubMed, Web of Science, Embase, Cochrane, CNKI, Wanfang, and VIP databases on prevalence rates, odds ratios (OR), and corresponding 95% confidence intervals (CI) were extracted for analysis.

PURPOSE: Osimertinib displays substantial inter-individual variability in both pharmacokinetics and pharmacodynamics. This study aimed to explore the exposure-response relationship of osimertinib, thereby to provide a basis for personalized therapeutic strategies. METHODS: We systematically searched PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine Literature Database separately through October 2024, with no study type restrictions. The Newcastle-Ottawa Scale was used for quality assessment, and data were extracted and recorded using Excel software. The meta-analysis was conducted using Stata software. RESULTS: A total of nine observational studies were included. Among them, five studies identified a correlation between steady-state trough concentration and progression-free survival, with three specifically demonstrating that the low steady-state trough concentration group had longer progression-free survival. One study observed a negative correlation between clearance and overall survival via Cox proportional hazards regression. Additionally, several studies reported correlations between exposure and adverse events, though conclusions varied substantially across studies. CONCLUSION: Multiple studies demonstrated that lower osimertinib steady-state trough concentration correlated with longer progression-free survival in Non-Small-Cell Lung Cancer, challenging the conventional assumption that higher drug exposure directly translates to superior efficacy. No consistent overall survival association exists. The relationships of adverse events remain unclear due to inconsistent study outcomes. These findings highlight the need for personalized dosing strategies through further research.

The aim of the present study was to investigate the prevalence of oral manifestations among patients undergoing chemotherapy.

Programmed death-ligand 1 (PD-L1) is an immune checkpoint molecule that enables tumor cells to escape immune surveillance, and its blockade by immune checkpoint inhibitors has become an effective therapeutic strategy in various cancers. Previous studies have primarily focused on genomic and transcriptomic features within specific cancer types, while proteomic analyses remain relatively limited. Here, we conducted a comprehensive pan-cancer meta-analysis encompassing 12 human cancer types to systematically characterize PD-1/PD-L1 signaling pathways at both the proteomic and transcriptomic levels. We observed clear cancer-type-specific patterns of PD-1/PD-L1 expression. Pathway-crosstalk analyses further revealed multiple pathways and phosphorylation events influencing PD-1/PD-L1 activity. Immune-infiltration profiling identified MMP9+ neutrophils as key immune subsets associated with PD-1/PD-L1 pathway activity. Using proteomic data, we constructed a PD-L1-centered protein-protein interaction network and identified TAP proteins as potential predictive biomarkers in small-cell lung cancer. We also established a biomarker signature capable of predicting clinical response to anti-PD-1 therapy in non-small-cell lung cancer and validated this gene set in two independent previously published cohorts. Finally, we developed an interactive web application (https://yuyingsuo-simm.shinyapps.io/PD-L1_Profiling/) to facilitate visualization of PD-L1 features and exploration of its associations with genes and pathways of interest.

Diagnosis of immune checkpoint inhibitor-related myocarditis (ICI-M) represents a substantial challenge in clinical practice. A range of imaging and laboratory parameters are frequently utilized for diagnosis, but the reliability of these modalities remains controversial. The present meta-analysis evaluates diagnostic and prognostic parameters in ICI-M.

Background: First-line chemoimmunotherapy (I + C) is the standard of care for advanced non-squamous non-small cell lung cancer (NSCLC) without oncogenic mutation. Bevacizumab has been shown to enhance the efficacy of chemotherapy in non-squamous NSCLC, yet its added value when combined with I + C (I + C + B) remains unclear. To address this gap, we conducted a real-world comparative study and a network meta-analysis to evaluate I + C + B versus I + C in this setting. Methods: This retrospective study included patients with advanced EGFR/ALK-negative non-squamous NSCLC treated with first-line I + C + B or I + C. Propensity score matching (PSM) was employed to balance baseline characteristics between groups. Efficacy endpoints were progression-free survival (PFS) and overall survival (OS). Subgroup analyses examined outcomes by PD-L1 expression, age, metastases, and chemotherapy, among other factors. In parallel, a network meta-analysis of four randomized trials (n = 2026) indirectly compared I + C + B against I + C for PFS, OS, and safety outcomes. Results: A total of 277 patients were included, with 167 (60.3%) receiving I + C + B and 110 (39.7%) receiving I + C. Before PSM, the I + C + B regimen significantly prolonged PFS versus I + C (hazard ratio [HR] = 0.69, 95% CI 0.52-0.92, p = 0.010), with this benefit maintaining post-matching (HR = 0.70, 95% CI 0.49-0.99, p = 0.045). However, OS did not differ significantly between groups in either the pre-PSM (HR = 0.93, 95% CI: 0.67-1.30; p = 0.665) or matched analyses (HR = 0.84, 95% CI: 0.54-1.29; p = 0.421). Subgroup analyses suggested greater PFS benefit from I + C + B among PD-L1-negative, older patients, those with brain metastases or multiple metastatic sites, and in patients receiving specific chemotherapy doublets. The network meta-analysis confirmed a PFS advantage for I + C + B over I + C (HR = 0.84, 95% CI: 0.71-0.98) without an OS benefit (HR = 0.95, 95% CI: 0.79-1.14). Toxicity was higher with I + C + B; rates of grade 3-5 adverse events, serious adverse events, and treatment discontinuation were all significantly increased compared to I + C. Conclusions: In the first-line treatment of advanced EGFR/ALK-negative non-squamous NSCLC, adding bevacizumab to I + C improved PFS but did not translate into an OS gain. Although PFS benefits were observed in certain subgroups, these were accompanied by significantly increased treatment-related toxicities. Our findings suggest that no clear subgroup has been identified where the benefit outweighs the risks, necessitating extreme clinical caution.

BACKGROUND: Immune checkpoint inhibitors (ICIs) combined with other agents have emerged as the standard first-line treatment for metastatic hepatocellular carcinoma (HCC), replacing tyrosine kinase inhibitors (TKIs). However, the comparative efficacy and safety of different ICI-based combinations remains unclear. OBJECTIVE: To evaluate the efficacy and safety of ICI-based combinations versus TKIs across different regimens through a systematic review and network meta-analysis (NMA) of phase III randomized controlled trials (RCTs). METHODS: A comprehensive literature search was conducted across major databases and conference proceedings between 2019 and 2024. Eligible studies included phase III RCTs that evaluated ICI combinations in the first-line setting for metastatic HCC. Pairwise meta-analysis and Bayesian NMA were performed to assess overall survival (OS), progression-free survival (PFS), overall response rate (ORR), treatment-related adverse events (TRAEs), grade 3–4 TRAEs, and therapy discontinuation owing to toxicity. RESULTS: Six RCTs comprising 3937 patients were included in the study. Compared with TKIs, ICI-based combinations improved OS (OR, 0.72; 95% CI: 0.58–0.91) and ORR (OR: 3.13; 95% CI: 2.07–4.47), without significantly increasing TRAEs. No significant benefit was observed in PFS (OR, 0.81; 95% CI: 0.56–1.19). The NMA rankings suggested camrelizumab plus rivaroceranib (CAM+ RIVO), nivolumab plus ipilimumab (NIVO + IPI), and durvalumab plus remelimumab (DURVA + TREME) as the most effective regimens for OS, PFS, and ORR, respectively. DURVA + TREME appeared to have the best safety profile, and CAM + RIVO was associated with higher rates of treatment discontinuation due to toxicity. CONCLUSION: ICI-based combinations are more effective than TKIs in improving the OS and ORR in patients with metastatic HCC, with an acceptable safety profile. CAM + RIVO, NIVO + IPI, and DURVA + TREME have emerged as promising first-line options, although direct comparisons in future trials are warranted to confirm these findings.

Antineoplastic agents are toxic compounds, generally used in the treatment of cancers, which are recognized as carrying a cancer development risk. In this systematic review and meta-analysis of human biomonitoring studies, we have assessed the effects of exposure to antineoplastic drugs on levels of DNA strand breaks in leukocytes, measured by the comet assay. Focusing on the application of the comet assay in human biomonitoring of occupational exposure to antineoplastic agents, we have analyzed 458 original research studies which used this assay, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-ScR). The systematic review led to 23 studies, of which 20 studies met the criteria for inclusion in the meta-analysis. Using standardized mean difference and 95% confidence interval (CI), the meta-analyses show increased levels of DNA strand breaks in subjects exposed to antineoplastic drugs (1.26, 95% CI: 0.78, 1.73). Results originate mainly from studies on healthcare workers, with only one study in an industrial setting. Subgroup analysis indicates that all studies combined from middle-income countries have a higher effect size (1.77, 95% CI: 1.00, 2.55) than studies from high-income countries (0.49, 95% CI: 0.09, 0.90). This difference between middle- and high-income countries may be attributable in part to differences in exposure levels or exposure assessment. Additionally, sensitivity analysis indicates that studies with moderate/high risk of comet assay measurement bias have higher effect size (2.07, 95% CI: 0.82, 3.31) than studies with low risk of bias (0.73, 95% CI: 0.34, 1.13); and that studies with high risk of exposure misclassification have higher effect size (1.47, 95% CI: 0.89, 2.06) than studies with low/moderate risk (0.13, 955 CI: -0.08, 0.33). Most studies have low/moderate risk of bias related to the comet assay procedure (15 out of 20 studies), absence of reporting the use of assay controls (1 out of 20 studies), blinded analysis of samples (7 out 20 studies); exposure assessment (16 out of 20 studies). In conclusion, this systematic review and meta-analysis shows that exposure to antineoplastic drugs is associated with increased levels of DNA strand breaks in human leukocytes.

BACKGROUND: Lung cancer remains the foremost cause of cancer-related mortality worldwide. With the expanding use of PD-1/PD-L1 inhibitors in its treatment, a comprehensive understanding of their safety profiles and economic implications is essential to guide clinical decision-making. OBJECTIVE: This study evaluates the safety and economics of PD-1/PD-L1 inhibitors in NSCLC. Our findings indicate that they are a cost-effective option with a favorable benefit-risk profile, offering practical guidance for immunotherapy decisions. METHODS: We have conducted a comprehensive literature search for randomized controlled trials (RCTs) evaluating PD-1/PD-L1 inhibitors in PubMed, Web of Science, and the Cochrane Library up to August 2025. Eligible studies were limited to English-language RCTs relevant to network meta-analysis (NMA). This systematic review and NMA was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extraction was carried out independently by two investigators. The data were then synthesized using a Bayesian random-effects model for NMA. The primary outcome was the incidence of immune-related adverse events, which was analyzed and compared across different PD-1/PD-L1 inhibitor regimens. RESULTS: A total of 60 eligible articles were involved, covering 13 treatments and 23,992participants. The safety evaluation revealed significant differences in toxicity profiles among PD-1/PD-L1 inhibitors, highlighting treatment-specific adverse effect patterns. Based on disability-adjusted life years (DALYs), the pharmacoeconomic analysis identified pembrolizumab as a dominant therapeutic strategy. CONCLUSIONS: Among the evaluated regimens, nivolumab plus ipilimumab was associated with the broadest toxicity spectrum. Sintilimab demonstrated a more favorable safety profile than other PD-1/PD-L1 inhibitors and ranked highest in the safety assessment.Our pharmacoeconomic analysis identified pembrolizumab as the most cost-effective option across treatment lines for NSCLC. The protocol was registered in advance in PROSPERO online platform as CRD42023442502.

To evaluate the effect of zinc supplements in preventing chemotherapy and radiotherapy-related oral mucositis (OM) in cancer patients.

Human epidermal growth factor receptor 2 (HER2) overexpression occurs in various subtypes of salivary gland cancers (SGC) and can be associated with treatment challenges and poor clinical outcomes. Zanidatamab is a dual HER2-targeted, bispecific antibody that has demonstrated antitumor activity across multiple HER2-positive tumor types. This combined analysis aimed to assess the efficacy and safety of zanidatamab in HER2-positive SGC.

Immune checkpoint inhibitors (ICIs) combined with standard chemotherapy (CT) or chemoradiotherapy (CRT) have shown promising results in recent randomized controlled trials (RCTs) for advanced or recurrent cervical cancer (CC). However, comprehensive evidence is needed to evaluate their efficacy and safety, particularly in the context of patient subgroups and immune response mechanisms. This meta-analysis aimed to synthesize data from RCTs and apply trial sequential analysis (TSA) to validate findings.

The use of immune checkpoint inhibitors (ICIs) in patients with pre-existing sarcoidosis raises concerns about disease reactivation. However, the incidence and clinical implications of sarcoidosis flare under ICI therapy remain poorly defined. Given the rarity of this scenario and limited reported events, this quantitative synthesis aimed to provide an exploratory summary of the available evidence and its uncertainty.

Nasopharyngeal carcinoma (NPC) has a poor prognosis, largely due to immune escape. The programmed cell death protein 1 (PD-1) receptor and its ligand, PD-L1, play critical roles in this immune evasion. Consequently, blocking the PD-1/PD-L1 pathway with immune checkpoint inhibitors has become an established therapeutic strategy.

Esophageal cancer exhibits peak incidence in Asia and Africa, representing the sixth most common malignancy and seventh leading cause of global cancer mortality. Esophageal squamous cell carcinoma (ESCC) constitutes 90% of esophageal cancer cases. The European Medicines Agency approved programmed death 1 (PD-1) inhibitors plus chemotherapy as a first-line treatment for high PD-1-expressing ESCC.

While some studies have investigated the effectiveness of exercise interventions during adjuvant chemotherapy in cancer patients, the findings are inconclusive. This systematic review and meta-analysis aimed to quantify the effectiveness of exercise interventions specifically in patients with colorectal cancer (CRC) during adjuvant chemotherapy.