Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-associated death globally. Second-line therapies are crucial for improving survival and quality of life among individuals suffering from advanced HCC who have not responded to first-line therapies. This study sought to evaluate the safety and efficacy of different second-line therapies for advanced HCC by network meta-analysis. A network meta-analysis was carried out on 26 randomized controlled trials comprising 10 368 people suffering from advanced HCC. The treatments evaluated included cabozantinib, pembrolizumab, brivanib, apatinib, and other targeted therapies. The principal results assessed included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). The evaluation also encompassed adverse events (AEs) as well as those classified as grade 3-4 AEs. Cabozantinib 60 mg once daily (QD) demonstrated the most significant improvement in OS [mean difference (MD) = 3.36, 95% confidence interval (CI) = 2.01, 4.70] and PFS (MD = 3.26, 95% CI = 2.59, 3.94), ranking highest among the therapies evaluated. Brivanib 800 mg once daily (OD) was most effective in terms of ORR [odds ratio (OR) = 7.13, 95% CI = 1.42, 35.88], while apatinib 750 mg QD ranked highest for DCR (OR = 3.92, 95% CI = 1.76, 8.71). Codrituzumab 1600 mg administered every 2 weeks demonstrated the most advantageous health profile, markedly decreasing AEs and instances of grade 3-4 AEs. Pembrolizumab 200 mg administered every 3 weeks indicated good effectiveness. Alongside a tolerable safety profile, indicating its potential as a reasonable second-line treatment option. Cabozantinib 60 mg QD and pembrolizumab 200 mg Q3W arise as the most suitable second-line therapies alternatives for advanced HCC, offering substantial improvements in survival and disease control with manageable adverse effects. These findings support the integration of both targeted and immune therapies in handling of advanced HCC.

This study addresses the lack of a comprehensive meta-analysis comparing the efficacy and safety of first-line anti-blocking the programmed cell death 1 (PD-1) and anti-programmed death ligand 1 (PD-L1) therapies in patients with extensive-stage small-cell lung cancer, using reconstructed individual patient data.

In traditional Chinese medicine (TCM), Curcuma longa L. has been used since ancient times to treat chest and abdominal distending pain caused by cold coagulation, qi stagnation, and blood stasis, as well as cold-bi syndrome shoulder-arm pain. Colorectal cancer (CRC) falls under the categories of "Jiju" (Mass Accumulation) in TCM. The core pathogenesis involves spleen deficiency, dampness-toxin accumulation, and blood stasis, which are closely related to qi circulation stagnation, blood stasis, and phlegm coagulation. Curcuma longa L. is pungent and warm in nature, with the effects of "breaking blood to eliminate masses and promoting qi to resolve stagnation". Curcumin, a polyphenolic compound, is the main pharmacological component extracted from the rhizomes of Curcuma longa L. Modern pharmacological studies have found that curcumin exhibits multiple pharmacological activities, including anti-inflammatory, anti-tumor, anti-angiogenic, anti-metastatic, and anti-multidrug resistance effects.

Cadonilimab (AK104) is a bispecific antibody that simultaneously targets programmed cell death-1 and cytotoxic T-lymphocyte antigen-4. It has received approval for the treatment of cervical cancer and gastric/gastroesophageal junction cancer. This meta-analysis aims to assess cadonilimab's safety profile.

To evaluate the risk of cardiovascular adverse events associated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in patients with EGFR-mutated non-small cell lung cancer (NSCLC).

Oral mucositis (OM) is one of the most frequent and debilitating complications in children undergoing treatment for hematologic malignancies. Current management strategies focus on minimizing OM severity and alleviating symptoms. This systematic review aimed to evaluate the effectiveness of photobiomodulation (PBM) in preventing OM in pediatric patients with hematologic malignancies receiving chemotherapy.

Neoadjuvant immune checkpoint inhibitors have emerged as a potential treatment option for muscle-invasive bladder cancer (MIBC), but their comparative efficacy and safety remain unclear. This meta-analysis evaluated pathological outcomes and adverse events of neoadjuvant PD-(L)1 inhibitors across different therapeutic approaches. A systematic search was conducted across multiple databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases), from their inception to December 21, 2024, for studies investigating neoadjuvant PD-(L)1 inhibitors in patients with MIBC. Primary outcomes included pathological complete response (pCR), pathological partial response (pPR), downstaging (DS), and grade ≥3 immune-related adverse events (irAEs). Random-effects models were used to calculate pooled estimates, with subgroup analyses performed based on treatment strategy and inhibitor type. Twenty-nine studies were finally included, involving 33 treatment arms. The overall pooled pCR rate was 32.7% (95% confidence interval [CI]: 27.7%-37.7%), with PD-(L)1 inhibitors plus chemotherapy showing the highest rate (39.2%, 95% CI: 32.1%-46.3%), followed by dual checkpoint inhibition (27.6%, 95% CI: 15.5%-39.6%), and monotherapy (24.6%, 95% CI: 16.9%-32.3%). The overall pooled pPR was 45.3% (95% CI: 38.4%-52.2%), and DS rate was 62.9% (95% CI: 53.1%-72.8%). Grade ≥3 irAEs varied significantly by approach: 9.4% (95% CI: 6.0%-12.7%) for monotherapy, 24.9% (95% CI: 9.6%-40.2%) for dual checkpoint inhibition, and 14.2% (95% CI: 6.9%-21.5%) for combination with chemotherapy. Sensitivity analyses confirmed the robustness of these findings. Neoadjuvant PD-(L)1 inhibitors demonstrate promising efficacy in MIBC with acceptable toxicity profiles. Combination with chemotherapy provides the highest pathological response rates with moderate toxicity, while monotherapy offers a favorable safety profile that may benefit cisplatin-ineligible patients. These findings support the continued investigation of these approaches in ongoing Phase III trials.

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.

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.

Anticoagulants were suggested to influence cancer survival by possible immunomodulatory effect. However, it remained unclear if concomitant use of anticoagulants and various types of them could influence the efficacy of immune checkpoint inhibitors (ICIs) in cancer patients. Accordingly, the meta-analysis was performed to systematically evaluate the effect of concomitant anticoagulants in cancer patients receiving ICIs. Relevant studies were obtained by literature search in PubMed, Embase, and Web of Science databases. A conservative random-effect model was used to combine the results. A total of 2686 patients were enrolled, including all the patients analyzed for overall survival (OS) and 2457 patients for progression-free survival (PFS). The publication types of these 5 studies were retrospective studies. We found that concomitant use of anticoagulants significantly impaired the PFS (hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.10-1.51, p = 0.002) and OS (HR:1.26, 95% CI:1.07-1.47, p = 0.004) of cancer patients receiving ICIs. Subgroup analyses showed that there was worse OS in heparin product subgroup (HR, 2.90; 95%CI: 1.71-4.92, p < 0.001). Our findings suggested that concomitant use of anticoagulants seemed to significantly impair the survival of cancer patients treated with ICIs.

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.

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).