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.

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

Background/Objectives: P-glycoprotein (P-gp, ABCB1/MDR1) is a key ATP-binding cassette transporter involved in multidrug resistance in cancer, limiting intracellular accumulation of various chemotherapeutic (CT) agents. Several antidepressants (ADs) have been shown to modulate P-gp function. This dual pharmacological profile raises the possibility of repurposing ADs as chemosensitizers to enhance anticancer drug efficacy. The objective of this review was to summarize the available evidence on the combined use of ADs and chemotherapeutics to overcome P-gp-mediated resistance. Methods: A systematic search was performed in PubMed, Scopus, and PsycInfo/PsycArticles databases using a comprehensive search string combining terms for P-gp, ADs, chemotherapy, and drug resistance. Inclusion criteria were preclinical or clinical studies investigating the effect of ADs in combination with chemotherapeutics on P-gp-mediated resistance in cancer models. Eleven relevant studies were identified and qualitatively analyzed. Results: Across diverse cancer models, including colon, breast, and multidrug-resistant cell lines, several ADs significantly enhanced the cytotoxicity of many chemotherapeutic agents. The proposed mechanisms involved downregulation of P-gp expression, inhibition of efflux activity, and increased intracellular drug accumulation. Conclusions: The combination of ADs with CT agents shows promising potential in overcoming P-gp-mediated multidrug resistance, enhancing antitumor efficacy in preclinical models. Further translational and clinical research is needed to validate these findings, optimize dosing strategies, and assess the risk-benefit profile in cancer patients, particularly those with comorbid depressive disorders.

The clinical application of doxorubicin (DOX) is severely restricted by its dose-dependent cardiotoxicity. This study aimed to investigate the protective mechanisms of traditional Chinese medicine-derived natural compounds (TCM-NCs) against DOX-induced cardiotoxicity. A systematic analysis was performed on 104 preclinical studies (encompassing in vivo and in vitro models) retrieved from PubMed, Web of Science and Embase, summarising the cardioprotective effects and mechanisms of 65 TCM-NCs. These compounds exert multitarget protective effects by modulating six core pathways: oxidative stress/ferroptosis, apoptosis, inflammation/pyroptosis, mitochondrial homeostasis, autophagy and endoplasmic reticulum stress. Target validation further identified Nrf2, Sirt1, mTOR and AMPK as potential central hub nodes underlying their protective actions. These findings offer a theoretical foundation and promising drug candidates for the prevention of chemotherapy-related cardiac injury, with future research directions focusing on clinical translation and druggability optimisation.

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.

Immune checkpoint inhibitor-induced bullous pemphigoid (ICI-BP) is a rare and complex cutaneous immune-related adverse event (cirAE) that often impacts the continuation of ICI therapy. Currently, there are no prospective clinical studies addressing the optimal management of BP alongside ICI continuation, with existing evidence largely derived from case reports or series. This study systematically analyzes published case reports and series to compile evidence regarding the management of ICI-BP and ICI rechallenge, aiming to inform clinical practice.

To identify the impact of CT-defined emphysema on efficacy and immune checkpoint inhibitor-related pneumonitis (ICIP) risk among non-small cell lung cancer (NSCLC) patients who receive ICIs.

In proficient mismatch repair (pMMR) non metastatic rectal cancer, standard neoadjuvant chemoradiotherapy (nCRT) yields low pathological and clinical complete response rates. Early randomized trials suggest adding PD 1 inhibitors may increase response but randomized evidence has not been synthesized.

Advances in treating multiple myeloma (MM) have improved survival, shifting the management focus toward quality of life. Peripheral neuropathy (PN) is a common treatment-related toxicity that significantly impairs quality of life. However, standardized assessment methods for PN in patients with MM are currently lacking. A comprehensive search of multiple databases (PubMed, Embase, Cochrane Library, and KoreaMed) was conducted to identify relevant records. Eligible studies were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty-two studies were included, and 17 PN assessment tools were identified. Nerve conduction studies and the National Cancer Institute Common Terminology Criteria for Adverse Events were the most commonly used clinician-based tools, whereas the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity was the most frequently used patient-reported outcome measure. The use of these tools varies depending on whether their purpose is diagnostic or evaluative. To the best of our knowledge, this is the first systematic review to evaluate PN assessment tools for patients with MM, revealing substantial heterogeneity across studies. By organizing these diverse approaches, our findings can guide researchers and clinicians toward a more consistent and standardized PN evaluation, ultimately improving the management of treatment-related neuropathy in MM.

Stachydrine, a principal bioactive alkaloid derived from Leonurus japonicus (motherwort), has attracted significant interest due to its diverse pharmacological activities and nutritional relevance. This systematic review synthesizes current evidence on its therapeutic potential across multiple organ systems. Stachydrine core pharmacological activities are: Cardiovascular protection: Stachydrine mitigates myocardial ischemia/reperfusion injury by scavenging free radicals, reducing myocardial biomarkers (CK, LDH, cTnT), and enhancing nitric oxide (NO) production. It attenuates pathological ventricular remodeling by suppressing ROS-mediated activation of NF-κB and improves cardiac calcium handling by protecting sarcoplasmic reticulum function. Antitumor effects: In cancers (e.g. hepatocellular carcinoma, breast cancer, colorectal cancer), stachydrine inhibits tumor proliferation, metastasis, and chemoresistance by targeting pathways such as TGF-β/Smad, PI3K/Akt/mTOR, and JAK2/STAT3. It also modulates the tumor microenvironment by reprogramming tumor-associated macrophages. Renoprotective actions: It ameliorates drug-induced renal fibrosis by suppressing tubular cell apoptosis via downregulation of caspase-9/caspase-12 and inhibiting inflammatory cytokine release.

Hyponatremia is the most prevalent electrolyte imbalance in cancer patients. Symptoms potentially signaling hyponatremia include altered mental status, neurological condition, headache, nausea, dizziness, and balance loss. Its management is particularly challenging as it must account for prognosis, treatment-related factors, and quality of life, especially in individuals treated with immune checkpoint inhibitors (ICIs). This systematic review and meta-analysis assessed the incidence of hyponatremia in patients receiving ICIs or immune-based combinations compared with placebo or other anticancer treatments. The review was registered in PROSPERO (CRD420251137412). Eligible studies included randomized clinical trials, quasi-experimental, and observational studies reporting hyponatremia frequency in patients treated with ICIs. Risk of bias was assessed using the ROB 2 tool for randomized studies and ROBINS-I for observational studies. A meta-analysis for proportions was performed using generalized linear mixed models. Proportion was measured for any grade of hyponatremia, grade 1-2, and grade ≥ 3; and three separate subgroup meta-analyses were performed: one for any grade, one for grade 1 or 2, and one for grade ≥ 3. Thirteen studies were included in the quantitative analyses. Any-grade hyponatremia was reported in 7 studies (934 patients, 49 events), with a pooled prevalence of 5.0% (95% CI = [2.3%; 11.9%]; I2 = 81.8%). Grade 1-2 hyponatremia was assessed in 7 studies (314 patients, 36 events) with a pooled prevalence of 1.2% (95% CI = [0.03%; 37.8%]; I2 = 88.2%). Grade ≥ 3 hyponatremia was evaluated in 14 studies (652 patients, 35 events), yielding a pooled prevalence of 5.5% (95% CI = [3.1%; 9.6%]; I2 = 44.8%). No significant small-study effects were detected for grade ≥ 3 events (Egger's test P = 0.313). These findings support routine electrolyte surveillance in patients treated with ICIs and highlight the need for further studies to clarify mechanisms and risk factors and define optimal monitoring strategies to improve both safety and outcomes.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and is the leading cause of cancer-related deaths worldwide. The majority of patients with HCC are diagnosed at an advanced stage, resulting in limited treatment options. In recent years, numerous clinical trials have confirmed that immunotherapy, particularly anti-programmed cell death 1 (anti-PD-1)/programmed cell death ligand 1 (PD-L1), has emerged as a promising treatment for advanced HCC. However, in real-world practice, the clinical efficacy of adding immunotherapy to locoregional therapies remains unknown, representing a knowledge gap.

Chemotherapy-induced peripheral neuropathy remains a major complication in pediatric cancer, with disrupted somatosensory and nociceptive processing being a key aspect. This review synthesizes empirical studies on alterations in somatosensory and nociceptive processing in children and adolescents with cancer. We conducted this review in accordance with PRISMA 2020 guidelines and preregistered it in PROSPERO. A systematic search was performed in MEDLINE, CINAHL, and Web of Science in April 2025. Eligible studies were screened by two independent reviewers and synthesized narratively. Risk of bias was assessed using the Newcastle Ottawa Quality Assessment Scale for Case-Control Studies. Nine studies met the inclusion criteria, all using cross-sectional designs and quantitative sensory testing (QST) or other pain protocols. Overall, findings suggest altered somatosensory processing in this population, with higher mechanical and thermal detection thresholds in patients compared to controls. Findings on nociceptive processing were more heterogeneous, with most studies suggesting unaltered pain sensitivity in the lower pain range and increased sensitivity in the higher pain range, highlighting increased pain vulnerability to more intense pain stimuli following cancer and its treatment. This review reveals a pattern of decreased somatosensory processing and increased nociceptive processing in pediatric patients/survivors with cancer, likely attributable to damage of peripheral nervous tissues as well as central sensitization.

Background. NOTCH receptors play a pivotal role in carcinogenesis. Upon ligand binding, a cascade of proteolytic cleavages mediated by ADAM proteases and the γ-secretase complex activates the receptor, ultimately releasing the NOTCH intracellular domain (NICD). NICD translocates to the nucleus, where it regulates gene expression. This review mainly aims to evaluate γ-secretase inhibitors (GSIs) as anticancer agents in preclinical and clinical settings, with a focus on their ability to block tumor progression, target cancer stem cells, and overcome resistance to standard therapies. Methods. A systematic search was conducted in the ISI Web of Science, PubMed, and Scopus databases, following PRISMA guidelines. The review included preclinical in vitro and in vivo studies, as well as clinical trials, investigating GSIs, either as monotherapy or in combination with other treatments, in TNBC, metastatic melanoma, PDAC, gastric cancer, and NSCLC. Exclusion criteria included duplicates, non-English articles, studies published before 2010, studies on non-cancer conditions, research unrelated to NOTCH signaling, and studies outside the selected cancer types. Overall, 69 articles were included and categorized into the five types of cancer analyzed (20 on NSCLC, 22 on TNBC, 11 on metastatic melanoma, 7 on GC, and 9 on PDAC). Of these, 60 studies corresponded to preclinical research in the types of cancer, and 9 studies corresponded to clinical trials in the types of cancer except for GC. Two independent authors screened and extracted relevant data, with disagreements resolved by the corresponding author. Findings were synthesized qualitatively across cancer types under study. Results. This review summarizes therapeutic advances involving GSIs in cancers driven by oncogenic NOTCH signaling, based on the 69 articles included. Preclinical studies show that GSIs synergize with chemotherapy and radiotherapy, particularly in NSCLC, melanoma, and TNBC, and block EMT, overcome therapeutic resistance, and improve prognosis. Commonly used GSIs include DAPT and RO4929097, which enhance the efficacy of agents, such as gemcitabine (PDAC), paclitaxel, osimertinib, erlotinib, and crizotinib (NSCLC), and 5-FU (gastric cancer, TNBC). Promising strategies include combining GSIs with SAHA, ATRA, CB-103, and other NOTCH signaling targeting molecules, either alone or with chemo- and radiotherapy. Clinical trials with GSIs, however, remain limited. RO4929097 is the most extensively tested GSI in clinical settings. PDAC trials combining GSIs with gemcitabine showed no benefit; melanoma trials yielded modest outcomes; and TNBC trials demonstrated partial responses to GSIs but overall low efficacy and significant adverse events. Discussion and Conclusions. Despite encouraging preclinical evidence, clinical trials with GSIs have underperformed, largely due to tumor heterogeneity, dosing limitations, and the non-selective nature of γ-secretase inhibition. Other NOTCH inhibitors, such as DLL4 antibodies, also resulted in partial responses and secondary effects. Future strategies should prioritize receptor-specific NOTCH inhibitors, patient stratification based on NOTCH pathway activation, and optimized combination regimens. Emerging approaches include integrating immunotherapy with advanced technologies such as CRISPR, CAR-T cells, and bispecific antibodies, as well as targeted delivery systems to enhance efficacy and reduce toxicity. Additional research directions include addressing the tumor microenvironment and EMT-driven resistance, elucidating the mechanisms of immune evasion, and inhibiting tumor angiogenesis. Finally, leveraging artificial intelligence and big-data-driven personalized medicine, including sex-specific considerations, will be essential for improving patient outcomes.

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but are complicated by immune-related adverse events, including acute kidney injury (AKI). As clinical experience matures and treatment durations lengthen, initial estimates of ICI-AKI incidence and the perceived risks of resuming therapy may become outdated.

To investigate the association between pretreatment controlling nutritional status (CONUT) score and clinical outcomes for cancer patients treated with immune checkpoint inhibitors (ICIs).

Osimertinib, a third-generation epidermal growth factor receptor (EGFR) inhibitor, was developed to overcome resistance from EGFR-mutant non-small-cell lung cancer (NSCLC). While it offers significant therapeutic benefits, reports have linked Osimertinib to cardiotoxic effects. This study aims to clarify the direct cardiotoxicity of Osimertinib by reviewing clinical trials and cohort studies involving Osimertinib monotherapy compared to other EGFR inhibitors. A search was conducted in online databases. Measured outcomes included risk of heart failure (HF), myocardial infarction (MI), decline in left ventricular ejection fraction (LVEF), arrhythmias, and pericardial effusion. These outcomes were reported as risk ratio (RR) with a random effects model using 95% confidence intervals (CI). Five studies with 19,008 patients (age 68 ± 13, 65% female) were selected. Osimertinib therapy was associated with an increased risk of HF (RR = 1.45, 95% CI 1.19-1.76, p = 0.0002), decline in LVEF (RR = 3.10, 95% CI 1.72-5.59, p = 0.0002) and MI (RR = 1.40, 95% CI 1.09-1.79, p = 0.0078) compared to other EGFR inhibitors. There was no difference in the risk of arrhythmias and pericardial effusion. Osimertinib therapy is associated with an increased risk of HF and a decline in LVEF compared to other EGFR inhibitors, while associations with MI and arrhythmias were less consistent. Although these events are infrequent, their potential severity warrants proactive cardiac monitoring for patients receiving Osimertinib, particularly in patients with pre-existing risk factors.

Despite the significant survival benefit offered by immune checkpoint inhibitors (ICIs) in patients with hepatocellular carcinoma (HCC), a subset of patients still develop drug resistance. Recent evidence suggests that proton pump inhibitors (PPIs) may influence the therapeutic efficacy of ICIs, but the clinical relevance of this interaction remains unclear. This meta-analysis aims to systematically evaluate the association between concomitant PPIs use and clinical outcomes in HCC patients receiving ICIs therapy.

Bone metastases are a frequent and clinically consequential complication of advanced non-small cell lung cancer (NSCLC), associated with substantial morbidity and poor survival. Whether adding radiotherapy (RT) to immune checkpoint inhibitors (ICIs) improves outcomes remains uncertain.

The systematic review and meta-analysis aim to thoroughly assess the efficacy of manual interventions like massage therapy, reflexology, and acupressure techniques in relation to overall symptoms, pain, and quality of life (QOL) in patients suffering from CIPN.