Tag: pubmed

Oncologist. 2025 Jun 24:oyaf193. doi: 10.1093/oncolo/oyaf193. Online ahead of print.

ABSTRACT

PURPOSE: Synovial sarcoma (SS) is aggressive with poor outcomes. Cellular therapies are now FDA approved for advanced disease, but are restricted to certain HLA-A*02 alleles. We estimate eligibility to cellular therapies by race and ethnicity.

MATERIALS AND METHODS: Demographic and clinical features of SS cases from 2001 to 2020 were obtained from the United States Cancer Statistics (USCS; NPCR-SEER). Survival analyses were performed overall and by races/ethnicity. The proportion eligible for cellular therapy was estimated by races/ethnicity using previously published data on HLA-A*02 status and MAGE-A4 positivity.

RESULTS: From 2001 to 2020, 10,605 patients (48% female, 64% Non-Hispanic White, 17% Hispanic) with SS were identified. The incidence rate was 1.5-1.8/million/person-years and was stable over time, corresponding to an average 530 new cases annually. The most common primary site was the extremity (n = 5,877; 58%), and most patients presented with localized disease (n = 5,753; 54%). The 5-year cause-specific survival was 60% across all races/ethnicities and 79% for localized, 57% for regional, 12% for distant disease. Differences by race and ethnicity were found in the proportions of patients expected to be eligible for HLA-restricted cellular therapies targeting MAGE-A4. People of European/European descent had the highest estimated proportion (25-39%), and people of Asian/Pacific Islander descent had the lowest (11-17%).

CONCLUSION: Engineered T-cells targeting MAGE-A4 have shown encouraging safety and efficacy in advanced SS; however, eligibility restrictions will lead to racial and ethnic disparities. HLA-independent solutions must be developed to counter disparities and ensure all patients have access.

PMID:40554677 | DOI:10.1093/oncolo/oyaf193

Oncologist. 2025 Jun 24:oyaf191. doi: 10.1093/oncolo/oyaf191. Online ahead of print.

ABSTRACT

BACKGROUND: Lung adenocarcinoma (LUAD) is a major cause of cancer death. Traditional histopathological classification overlooks molecular heterogeneity, limiting personalized treatment. This study used multiomic data to define LUAD subtypes, assess prognostic significance, and analyze immune features, aiming to improve targeted therapy and clinical outcomes.

METHODS: This study used Consensus Clustering and Gap Statistics to analyze LUAD multiomic data, including mRNA, lncRNA, miRNA, DNA methylation, and mutations. Clustering was validated by silhouette plots and heatmaps. Molecular characterization involved regulon activity, immune and metabolic profiling. Functional assays (qPCR, WB, CCK-8, flow cytometry) assessed NDNF’s role in LUAD.

RESULTS: Two molecular LUAD subtypes showed distinct clustering and survival outcomes. One subtype had worse prognosis and unique immune features, including checkpoint expression and microenvironment differences. Gene signatures and metabolism varied by subtype. NDNF was downregulated in tumors; its overexpression suppressed LUAD cell viability and promoted apoptosis, suggesting tumor-suppressive function.

CONCLUSION: This study identifies two LUAD subtypes with distinct molecular and immune features linked to prognosis and therapy response. NDNF downregulation and its tumor-suppressive effects highlight its therapeutic potential. These findings support improved LUAD stratification and personalized treatment strategies.

IMPLICATIONS FOR PRACTICE: This study reveals two LUAD molecular subtypes with distinct prognoses and immune features, offering a basis for more precise treatment strategies. The identification of NDNF as a potential tumor suppressor suggests its value as both a biomarker and therapeutic target. These findings support improved LUAD stratification and personalized therapy.

PMID:40554675 | DOI:10.1093/oncolo/oyaf191

Oncologist. 2025 Jun 24:oyaf189. doi: 10.1093/oncolo/oyaf189. Online ahead of print.

ABSTRACT

BACKGROUND: Nab-paclitaxel is a standard second-line treatment for advanced gastric cancer, but the role of PD-1 inhibitors remains uncertain. This multicenter, randomized phase II trial evaluated the efficacy of nab-paclitaxel plus camrelizumab (Cam-NP) versus nab-paclitaxel alone (NP) in patients with advanced gastric adenocarcinoma resistant to prior treatment.

METHODS: Patients were randomized to receive either Cam-NP or NP until disease progression, intolerable toxicity, or consent withdrawal. The primary endpoint was the overall response rate (ORR), with secondary endpoints including progression-free survival (PFS), overall survival (OS), and safety.

RESULTS: 61 patients were randomized, with 58 receiving treatments. At a median follow-up of 34.5 months, the Cam-NP group achieved a significantly higher ORR (33.3% vs. 10.7%; p = 0.039) and longer median PFS (5.62 vs. 4.21 months; p = 0.006). Median response duration also favored Cam-NP (4.64 vs. 2.96 months; p = 0.058). While the Cam-NP group showed a longer OS (9.8 vs. 7.2 months; p = 0.087), this was not statistically significant. The most common grade 3-4 adverse event was hematological toxicity.

CONCLUSIONS: Cam-NP significantly improved ORR and PFS compared to NP as a second-line treatment for advanced gastric adenocarcinoma. Larger studies and biomarker exploration are needed to validate these findings.

PMID:40554667 | DOI:10.1093/oncolo/oyaf189

Dtsch Arztebl Int. 2025 Sep 5;(Forthcoming):arztebl.m2025.0089. doi: 10.3238/arztebl.m2025.0089. Online ahead of print.

ABSTRACT

BACKGROUND: Both radical prostatectomy (RP) and radiotherapy (RT) are recommended as standard treatments for prostate cancer. The prospective comparisons available to date provide only limited information.

METHODS: We used data from the database of our university cancer center to compare the metastasis-free (MFS), cancer-specific (CSS) and overall survival (OS) of all patients with prostate cancer who underwent either RP or RT in the period 2014-2024. Stage-, age-, and frailty-specific sensitivity analyses were carried out.

RESULTS: Of 2685 patients with prostate cancer, 1999 (74%) underwent RP and 686 (26%) underwent RT. The RP patients were younger (66 vs. 74 years); a higher percentage of the RP patients than of the RT patients had high-risk prostate cancer (60% vs. 43%), stage cT3 (47% vs. 9.6%), and stage cN1 (11 vs. 5.2%), while the RT patients more commonly had ECOG status 1-2 (16% vs. 6.7%; p<0.001 for all comparisons). Univariate analyses of MFS mostly favored RT, while univariate analyses of OS mostly favored RP. These differences, however, were no longer seen after adjustment for patient and tumor characteristics in multivariable Cox regression models, nor were they seen in sensitivity analyses of D’Amico risk groups, age categories, or ECOG status. Lastly, in 2:1 propensity-score-matched analyses, no differences between RP and RT were found in any of the oncological outcome measures (p≥0.15 for MFS, CSS, and OS).

CONCLUSION: The findings of this real-world study of prostate cancer patients who underwent either RP or RT suggest equally effective cancer control by the two methods when the statistical analysis is adjusted for patient and tumor characteristics. At present, patients with high-risk prostate cancer und unfavorable disease stages more commonly undergo RP.

PMID:40554664 | DOI:10.3238/arztebl.m2025.0089

Chaos. 2025 Jun 1;35(6):063137. doi: 10.1063/5.0230984.

ABSTRACT

We argue that a physics experiment with systems involving drifting parameters requires a paradigm shift: the measured signal, a curve, should be compared with a band resulting from simulations. Based on earlier theoretical results, an accurate description of drifting dissipative chaotic systems can only be given by following an ensemble of trajectories. After convergence to a time-dependent attractor (to the so-called snapshot attractor), the ensemble faithfully represents the dynamics. We point out that an experimentally measured signal should wander within the spread of the converged numerical ensemble, i.e., to behave as any of the ensemble members on the snapshot attractor. If that is the case, the model (a set of ordinary differential equations) used for the simulation can be considered credible. The transient period preceding the arrival to the attractor can be divided into two phases when using two initially localized ensembles. In the first one, a quick spread of the ensembles takes place, and a plume diagram evolves. The next, intermediate phase corresponds to a convergence of the no longer localized ensembles to the same unique time-dependent attractor and lasts approximately as long as the averages and other statistical moments of the two ensembles remain distinct.

PMID:40554584 | DOI:10.1063/5.0230984

J Assoc Physicians India. 2025 May;73(5):e6-e10. doi: 10.59556/japi.73.0955.

ABSTRACT

BACKGROUND: With major attention paid to the most evidently manifested illness like a seizure, few of the silent and deep-boring illnesses like dental issues are often neglected. This study has aimed to analyze the dental illness in people living with epilepsy (PWE).

METHODS: This was a prospective, single-center, case-control study conducted among PWE and their family members from March to May 2022. A survey on demographic parameters, dental hygiene practices, and symptoms of dental illness was taken, followed by a detailed dental examination of the study participants. Independent t -test was used to compare dental illness among PWE and controls.

RESULTS: A total of 69 patients were included, with a mean age of 32.5 ± 2.4 years, and 45 (63%) patients were symptomatic with dental issues. Patients from higher socioeconomic status were found to have better dental hygiene practices but also had a higher prevalence of wasting disease of teeth. About 67 of 69 PWE and 19 of 33 controls were found to have dental illness. PWE had a higher degree of asymptomatic soft tissue abnormalities (24 vs 0%, p < 0.0001) and periodontal disease (13 vs 7.4%, p < 0.0001) as compared to controls. Symptomatic PWE, in comparison to controls, had statistically significant hard tissue abnormalities (66 vs 33%, p = 0.0001), periodontal disease (48 vs 0%, p < 0.0001), and poor dental hygiene status (83 vs 33%, p < 0.0001). Duration and type of epilepsy had no impact on being symptomatic or asymptomatic with dental issues.

CONCLUSION: The hidden yet significant burden of dental illness must be addressed in PWE to improve the quality of life.

PMID:40553526 | DOI:10.59556/japi.73.0955

J Assoc Physicians India. 2025 May;73(5):44-48. doi: 10.59556/japi.73.0969.

ABSTRACT

INTRODUCTION: To study outcomes of the triple-drug therapy in newly diagnosed type 2 diabetes mellitus (T2DM) [glycated hemoglobin (HbA1c) ≥9%] with respect to change in HbA1c, low-density lipoprotein (LDL) levels, weight, waist circumference, variation in drug dosages, hypoglycemic events, patient response of well-being, and corresponding result satisfaction.

MATERIALS AND METHODS: It was a prospective, observational study conducted from 1st June 2018 to 31st May 2019 at Indira Gandhi Medical College and Hospital, Shimla, a tertiary care hospital in Himachal Pradesh. During the initial 3 months, patients were treated with triple-drug [oral hypoglycemic agents (OHAs)] therapy and then switched over to dual or single therapy (OHAs) depending on the HbA1c levels and were followed up for 1 year.

OBSERVATIONS: A total of 137 participants completed the study period. At baseline, the mean values of fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), HbA1c, and LDL were 218.4 ± 36 mg/dL, 343.94 ± 60 mg/dL, 10.5 ± 1.42%, and 120.34 ± 30.99 mg/dL, respectively. At the end of 12 weeks, the mean values of FPG, PPPG, HbA1c, and LDL were reduced to 123 ± 16 mg/dL, 164 ± 30 mg/dL, 8.14 ± 0.97%, and 109.04 ± 28.28 mg/dL, respectively. The differences were highly significant statistically when compared with the baseline observations. At the end of the study (52 weeks), the mean values of FPG, PPPG, HbA1c, and LDL were 96 ± 10 mg/dL, 146 ± 16 mg/dL, 6.14 ± 0.43%, and 90.55 ± 28.14 mg/dL. Reductions in values were statistically significant when compared with both the baseline and 12-week values.

CONCLUSION: Early induction of combination therapy with glimepiride, metformin, and pioglitazone results in more desirable outcomes in terms of greater reduction in HbA1c level and lower incidence of hypoglycemia as compared to the conventional add-on therapy.

PMID:40553523 | DOI:10.59556/japi.73.0969

J Assoc Physicians India. 2025 May;73(5):37-42. doi: 10.59556/japi.73.0946.

ABSTRACT

INTRODUCTION: Human immunodeficiency virus (HIV)-associated neurocognitive deficits (HAND) distress a substantial proportion of people living with HIV (PLHIV). The present research intends to examine the neurocognitive functions in PLHIV, compared to healthy volunteers.

MATERIALS AND METHODS: About 48 HIV patients were recruited from one tertiary health care center, while 24 matched healthy volunteers were enrolled as controls from the community. Neurocognitive functions were assessed using the Hindi Mental Status Examination (HMSE), Addenbrooke’s Cognitive Examination (ACE)-III, and International HIV Dementia Scale (IHDS) questionnaires, along with the computer-based color-word Stroop cognitive task.

RESULTS: The total HMSE scores (p = 0.0047), IHDS scores (p = 0.0002), and ACE-III scores (p < 0.0001) were statistically lower in PLHIV, compared to controls. The specific domain scores of ACE-III in PLHIV were also statistically lower compared to the control group, with greater differences seen in memory (p < 0.0001) and language (p = 0.0012) domains. Similarly, higher reaction time was seen in PLHIV in comparison with the control group (p < 0.0001) during Stroop cognitive task performance, while a statistically significant difference in accuracy was not observed among groups. Further, among PLHIV, reaction time had a significant positive correlation with years since diagnosis of HIV infection (p = 0.006, r = 0.39, Spearman correlation).

CONCLUSION: Observations demonstrate neurocognitive deficits in PLHIV across multiple domains. Our study, therefore, offers insights into the neurocognitive manifestations of HIV infection, which could facilitate tailored preventive and therapeutic interventions by healthcare providers to enhance the overall quality of life for PLHIV.

PMID:40553522 | DOI:10.59556/japi.73.0946

J Assoc Physicians India. 2025 May;73(5):34-36. doi: 10.59556/japi.73.0937.

ABSTRACT

BACKGROUND: The Family Adoption Program (FAP) is an integral part of medical education aimed at fostering empathy and practical skills among medical students by exposing them to rural healthcare settings. This study assesses the perceptions and experiences of Bachelor of Medicine and Bachelor of Surgery (MBBS) students regarding the FAP, with a focus on their professional development and challenges encountered during the program.

METHODS: A cross-sectional study was conducted using a predesigned and pretested questionnaire. The questionnaire link was distributed via WhatsApp to MBBS students from the 2021, 2022, and 2023 batches. The data collected included students’ prior exposure to rural settings, perceived professional growth, and challenges faced during the program. Descriptive statistics were used to analyze the data.

RESULTS: The study found that 63.8% of students had prior exposure to rural settings before joining MBBS, reflecting a diverse participant background. A majority (81.4%) believed that the FAP enhanced their ability to become empathetic and confident physicians. However, 44.9% of students reported communication barriers, and 35.8% faced difficulties in gaining trust and cooperation from family members, highlighting key challenges in the program.

CONCLUSION: The FAP is valued for its role in developing empathy and confidence among medical students, though communication and trust-building remain significant challenges. Addressing these issues could further enhance the program’s effectiveness.

PMID:40553521 | DOI:10.59556/japi.73.0937

J Assoc Physicians India. 2025 May;73(5):25-28. doi: 10.59556/japi.73.0930.

ABSTRACT

OBJECTIVES: Cardiovascular diseases (CVDs) have become a major cause of mortality in India and abroad. Various risk scores have been formulated to estimate CVD risk. The preferred biomarker for the detection of myocardial cell necrosis is cardiac troponin. Highly sensitive troponin assays are now available. Computed tomography coronary angiogram (CT-CAG) is the standard noninvasive modality to identify as well as exclude coronary artery disease (CAD). Our study aims to correlate high-sensitivity troponin I (hs-cTnI) and the QRESEARCH cardiovascular (CV) risk algorithm (QRISK3) score against CT-CAG and determine whether, by using these data, we can detect or rule out CAD accurately by noninvasive means alone.

MATERIALS AND METHODS: We evaluated 100 subjects who presented with chest pain (primary prevention population) to the cardiology outpatient department. A detailed history was obtained, and blood investigations, including hs-cTnI, were conducted. The QRISK3 score was calculated, and CT-CAG was performed for all. Hs-cTnI >6 was considered significant. Those who had >50% diameter stenotic lesion(s) were deemed to have significant CAD.

RESULTS: In our study with 100 subjects, 80 had hs-cTnI <6, and 20 subjects had hs-cTnI >6. The QRISK3 score did not show any statistical correlation with hs-cTnI. The hs-cTnI levels were compared with CT-CAG results and found that 80% of subjects with elevated hs-cTnI had CAD.

CONCLUSION: A strong correlation between elevated hs-cTnI levels and CAD by CT-CAG was established by our study. The early detection of CAD will prompt early management and delay further progression of the disease.

PMID:40553519 | DOI:10.59556/japi.73.0930