Objective: Recently, the therapeutic effects of the combination of radiotherapy (RT) and immune checkpoint inhibitors (ICIs) on lung cancer (LC) have piqued the interest of the scientific community. Clinical trials have confirmed that RT and ICI therapy exert synergistic therapeutic effects. However, treatment with the RT-ICI combination can lead to the occurrence of pneumonitis, limiting the implementation of the treatment plan, decreasing the tumor control rate, and inducing immunosuppressive pneumonitis and radiation pneumonitis. Therefore, this study performed a systematic review and meta-analysis of pneumonitis prevalence among patients with LC who were treated with a combination of ICIs and chemoradiotherapy (CRT).Methods: Literature published between January 1, 2010, and October 15, 2023, were searched in the PubMed, Cochrane Library, Embase, and Web of Science databases by two authors. The primary outcomes analyzed in this study were the incidence rates of all-grade pneumonitis and ≥ grade 3 pneumonitis.Results: This study analyzed 53 studies involving 4226 patients. The pooled incidence rates of all-grade and ≥ grade 3 pneumonitis were 36.0% (95% confidence interval (CI): 30.0–41.0) and 3.0% (95% CI: 2.0–4.0), respectively. The all-grade pneumonitis incidence rates in Asian patients (51%; 95% CI: 38%–63%) were higher than those in non-Asian patients (26%; 95% CI: 22%–31%). Conventional RT was associated with higher rates of all-grade pneumonitis than stereotactic body radiation therapy (SBRT) (37%; 95% CI: 31%–42% vs. 26.0%; 95% CI: 20%–33%). Additionally, sequential immunotherapy was associated with higher rates of all-grade pneumonitis than concurrent immunotherapy ((38%; 95% CI: 31%–45% vs. 25.0%; 95% CI: 20%–30%)). Furthermore, anti-PD1 therapy was associated with higher rates of all-grade pneumonitis than PD-L1 therapy (40%; 95% CI: 32%–47% vs. 20.0%; 95% CI: 16%–24%). Similar incidence rates of ≥ grade 3 pneumonitis were reported in all included studies.Conclusion: This study suggests that the combination of ICIs and RT/CRT is a safe and feasible therapeutic regimen for patients with LC. However, these findings are based on observational studies and are associated with significant heterogeneity. Hence, large prospective studies are needed to validate the findings of this meta-analysis.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD42023485613.

The first palladium-catalyzed direct ring-opening of mono-substituted phenyl and heteroaryl cyclopropyl ketones to obtain α,β-unsaturated ketones is described. The reaction features high stereoselectivity to obtain (E)-1-phenylbut-2-en-1-one derivatives.

Chemotherapy is one of the main treatments for breast cancer patients. However, chemotherapy-related nausea and vomiting can significantly reduce patients’ quality of life and lead to electrolyte disturbance and metabolic imbalance in severe cases. Therefore, to identify the risk factors for nausea and vomiting during chemotherapy in these patients is very important. This retrospective study included 113 patients with breast cancer undergoing chemotherapy and used antiemetic drugs hospitalized in First Affiliated Hospital of Chengdu Medical College between January 1, 2021, and January 1, 2023. Of these, 26 (23.01%) patients developed nausea and vomiting. The univariate and multivariate logistics regression analyses showed that patients combined with diabetes, hypertension, chronic hepatitis B, >65 years of age, >8 cycles of chemotherapy, and had a history of nausea and vomiting are the risk factors for nausea and vomiting. However, due to the limited sample size and some risk factor data missing from this study, further prospective studies are needed to improve and verify.

Rationale: Patients with bone metastasis-associated cancer pain often experience a complex mix of pain types. Consequently, the use of multimodal combination therapy is essential. While monitoring for common adverse reactions in pain treatment, it is also crucial to be vigilant for the rare but serious serotonin syndrome. Patient concerns: A 53-year-old female with metastatic gastric cancer was hospitalized due to severe, uncontrolled thoracic and cervical pain. During the titration of her cancer pain medication, she developed serotonin syndrome. Diagnoses: He was diagnosed with refractory cancer pain and serotonin syndrome. Interventions: The complete process of cancer pain medication in a patient with gastric cancer and bone metastasis was analyzed, with a primary focus on the selection of analgesic medications, adjustment of opioid dosages, and prevention and treatment of medication-associated adverse reactions. Outcomes: The patient’s cancer pain was well controlled, with the prompt management of adverse reactions. Furthermore, by adjusting the medication regimen, intolerable adverse reactions were prevented. Lessons: In clinical settings, personalized analgesic regimens must be developed for patients with cancer pain to enhance patient compliance with medication, prevent the occurrence of severe adverse reactions, and improve the overall quality of life of patients with cancer. Healthcare professionals should pay increased attention to ADRs associated with opioid medications, whereas pharmacists should assist them in promptly identifying ADRs.

Background: Leptomeningeal metastasis (LM) is a severe complication of advanced non-small-cell lung cancer (NSCLC) that is increasingly detected due to improved diagnostics. Intrathecal therapy, which involves delivering drugs directly into the subarachnoid space, has become a key treatment approach. A variety of cytotoxic drugs, targeted therapies, immune-checkpoint inhibitors, and combination treatments are now available through different intrathecal protocols, offering new hope to patients. Methods: Extensive searches were conducted in PubMed, Embase, the Cochrane Library, Web of Science, Wanfang Data, CNKI, and VIP. Data collected included histological subtype, intrathecal delivery method, treatment regimen, median progression-free survival (mPFS), median overall survival (mOS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) in ≥10% of patients. Results: Twelve clinical studies with 544 patients (average age 53.27 years) met the criteria. Drug delivery was via lumbar puncture or Ommaya reservoir. Objective response rates were 34.5%–86.4%, and disease control rates were 62.5%–94.9%. Three trials reported progression-free survival of 3.5, 6.3, and 9.6 months, with overall survival from 3.66 to 17 months. AEs in over 10% of patients included myelosuppression, gastrointestinal issues, and neurological symptoms. Conclusion: Intrathecal therapy offers significant clinical benefits, especially when combined with other treatments, with a manageable toxicity profile.