Introduction: An increasing number of studies have demonstrated the pivotal role of microbiota changes in the onset, progression, diagnosis, treatment, and prognosis of lung adenocarcinoma (LUAD). However, a comprehensive analysis of intratumoral microbiome variation across distinct LUAD stages has not been performed. The aim of this study was to identify the microbial markers that significantly vary during tumor stage of LUAD.Methods: Here, we used the cancer genome atlas (TCGA) database to comprehensively compare and analyze the differences in microbial composition between 267 patients with early and 224 patients with advanced LUAD. In order to determine the best biomarkers, we used the random forest (RF) model and found that the microbial markers have a certain ability in predicting the stage of LUAD.Results: We found that there were certain differences in the microbiome of patients with LUAD at different stages, especially in the tumor tissues of patients with advanced LUAD, whose co-abundance network was significantly more complex. We also found that five bacterial biomarkers (Pseudoalteromonas, Luteibacter, Caldicellulosiruptor, Loktanella, and Serratia) were correlated with LUAD stage, among which Pseudoalteromonas, Luteibacter, Caldicellulosiruptor, and Serratia were significantly overexpressed in patients with advanced LUAD. In particular, after integrating the biomarkers of mRNA, we achieved an area under the curve (AUC) of 0.70.Discussion: Our study revealed the microbial profile of patients with LUAD and the intrinsic pathogenic mechanism between the microbiome and the disease, and established a multi-omics model to determine LUAD tumor stage.

Background: In recent years, the combination of CDK4/6 inhibitors (CDK4/6i) and endocrine therapy (ET) has emerged as the standard first-line treatment for hormone receptor positive (HR+) and human epidermal growth factor receptor 2 negative (HER2−) metastatic breast cancer (MBC) patients. However, the comparison between the efficacy of CDK4/6i has been poorly explored before. Moreover, it remains unclear about the optimal choice of CDK4/6i in the first-line treatment for HR+/HER2− MBC patients in Asian, especially Chinese populations. Objectives: Our study aims to compare the efficacy of three CDK4/6i widely used in the Chinese population (palbociclib, abemaciclib, and dalpiciclib) in the real world. Design: From 2020 to 2023, the medical records of patients diagnosed with HR+/HER2− MBC were retrospectively assessed in seven institutions in China. Patients who received first-line palbociclib, abemaciclib, or dalpiciclib plus ET were included. Methods: Demographic and clinical data were retrospectively collected and analyzed. Real-world progression-free survival (rwPFS), overall survival (OS), and objective response rate were used to analyze the clinical outcome. Results: In total, 209 HR+/HER2− MBC patients were eligible for this study. Eighty-eight (42.1%), 79 (37.8%), and 42 (20.1%) patients were administered first-line palbociclib, abemaciclib, or dalpiciclib plus ET. The overall median rwPFS was 19 months, with no significant difference between these three CDK4/6i ( p = 0.84). The results were similar even after propensity score matching. The median OS was not reached. Cox univariate and multivariate regression analysis identified that higher KI67 index, liver metastasis, and primary endocrine resistance were independent risk factors for rwPFS in patients with initial CDK4/6i plus ET. Conclusion: This study presents a comparison of the real-world efficacy between three CDK4/6i widely used in the Chinese population. Palbociclib, abemaciclib, and dalpiciclib demonstrated comparable efficacy in Chinese patients with advanced HR+/HER2− MBC. Trial registration: ClinicalTrials.gov identifier: NCT06344780.

Objective: Limited real-world efficacy and safety data exist regarding the use of trastuzumab deruxtecan (T-DXd) in the Chinese population with human epidermal growth factor receptor (HER2)-positive and HER2-low advanced breast cancer (BC). This multicenter, observational, real-world study aimed to evaluate the efficacy and safety of T-DXd for the treatment of Chinese patients with HER2-positive and HER2-low advanced BC. Methods: The medical records of 61 patients were collected from The Second Hospital of Dalian Medical University, Beijing Chaoyang District Sanhuan Cancer Hospital, Beijing Jingxin Hospital, and Cancer Hospital of the Chinese Academy of Medical Sciences. The primary endpoint of the study was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), time to response (TTR), and safety. PFS and OS were analyzed using the Kaplan–Meier method and log-rank test. Results: The primary endpoint, PFS was 10.51 months (95% confidence interval (CI), 3.02–NE) in the HER2-low group and 10.18 months (95% CI, 3.88–NE) in the HER2-positive group. Regarding the secondary endpoints in the HER2-low and HER2-positive groups, OS data were immature, ORR rates were 37.93% and 62.50%, DCR rates were 79.31% and 87.50%, and the median TTR rates were 1.28 and 1.31 months, respectively. In the subgroup analysis, front-line treatment with T-DXd was associated with increased beneficial effects. The primary adverse events (AEs) related to T-DXd treatment were gastrointestinal reactions and bone marrow suppression, which were predominantly grades 1–2, with no severe grade 4/5 AEs reported, only one patient developed infectious pneumonia. Conclusion: This study was the first multicenter, real-world study of T-DXd for advanced BC in China. The findings demonstrated that T-DXd may be an effective antitumor treatment with controllable adverse reactions in patients with advanced BC irrespective of HER2 expression levels.

Options for later‑line therapy are limited for patients with human epidermal growth factor receptor 2 (HER2)‑positive breast cancer who have exhibited resistance to several systemic treatments. Antibody drug conjugates (ADCs) and immune checkpoint inhibitors are novel approaches for HER2‑positive breast cancer, but few reports have been published regarding the efficacy of their combinations, particularly in patients with prior ADC failure. The present report describes a case of recurrent metastatic HER2‑positive breast cancer, which responded poorly to several perioperative systemic therapies, including chemotherapies, HER2‑targeted antibodies, small molecule inhibitors and trastuzumab emtansine (an ADC), along with post‑surgical radiotherapy. Following failure of front‑line therapies for recurrent cancer located in the chest wall, combination treatment with another HER2‑targeted ADC, disitamab vedotin (120 mg), and zimberelimab (240 mg), a fully humanized anti‑programmed cell death protein‑1 (PD‑1) antibody, administered intravenously every 2 weeks, was initiated. The tumor lesions improved slightly after two cycles of treatment and shrunk markedly, and almost disappeared at the end of the sixth cycle of therapy. The patient is still in remission at present. The present findings suggest the potential efficacy of HER2‑targeted ADCs combined with PD‑1 inhibitors for patients with HER2‑positive breast cancer, including those resistant to prior HER2‑targeted ADCs.

Anaplastic thyroid carcinoma (ATC) is one rare type of thyroid carcinoma without standard systemic treatment for advanced disease. Recent evidence has demonstrated promising efficacy of immune checkpoint inhibitors, particularly those targeting programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1), in a variety of solid tumors. However, there have been no research of immune checkpoint inhibitors plus chemotherapy in ATC. Here, we present the case of a 37-year-old man with metastatic ATC with positive PD-L1 expression, who achieved long-term remission of 34 months after later-line treatment with zimberelimab (a PD-1 inhibitor) and nab-paclitaxel, followed by single-agent zimberelimab maintenance therapy. After three cycles of the combination treatment, the thyroid lesion and the liver metastases shrank dramatically, leading to the best overall response of partial remission. PD-L1 expression may serve as a potential biomarker for tumor response to immune checkpoint inhibitors in ATC. Our review highlights the need for further studies investigating the role of PD-L1 status as biomarker to predict the prognosis of immunotherapy in the treatment of ATC.

To evaluate the efficacy and safety of rivaroxaban in preventing catheter-related thrombosis (CRT) in breast cancer patients undergoing chemotherapy with peripherally inserted central catheters (PICC). A prospective cohort study enrolled breast cancer patients who underwent PICC placement for chemotherapy at the San Huan Cancer Hospital from November 2021 to August 2023. The treatment group received 10 mg of oral rivaroxaban daily for 2 months along with routine grip strength training, while the control group received grip strength training only. CRT occurrence was confirmed by vascular ultrasound, and group comparisons were made using the χ² test, with logistic regression analyzing CRT risk factors. Of 314 patients, 181 received treatment and 133 were in the control group. The treatment group had a significantly lower incidence of CRT (2.2 %, 4/181) compared to the control group (12.0 %, 16/133) (p < 0.001). Univariate analysis showed a higher risk of CRT in patients in the non-prophylaxis group (p = 0.002), patients aged ≥50 years (p = 0.014), and those with prior endocrine therapy (p = 0.030). Multivariate analysis identified rivaroxaban prophylaxis (p = 0.009) and age (p = 0.026) as independent risk factors for thrombosis. The use of rivaroxaban for prophylactic anticoagulation was safe. All CRT-diagnosed patients completed their antitumor therapy without new thrombosis or pulmonary embolism. Two months of rivaroxaban prophylaxis effectively and safely reduce CRT incidence in breast cancer patients with PICC.