1.Progress in cancer therapy-related oral mucositis pathogenesis,diagnosis,and treatment
Chinese Journal of Clinical Oncology 2025;52(5):248-252
Oral mucositis(OM)is a prevalent and debilitating cancer therapy-related side effect that significantly impairs the quality of life of patients with cancer.In this article,we review anticancer treatment-induced OM,elucidate the underlying pathophysiological mechanisms,and discuss various preventive and therapeutic strategies,including basic oral care,nutritional supplements,cryotherapy,photobiomodula-tion therapy,and pharmacological interventions.While single modality treatments might yield certain clinical benefits,an integrated ap-proach,combining prophylactic measures with multimodal therapies,could more effectively reduce OM incidence and severity,promote mucosal healing,minimize the risk of serious complications,and enhance patient outcomes.
2.Research progress in maintenance therapy for unresectable locally advanced esopha-geal squamous cell carcinoma
Chinese Journal of Clinical Oncology 2025;52(5):253-258
Esophageal cancer is one of the leading causes of cancer-related mortality in China,and esophageal squamous cell carcinoma(ES-CC)is the predominant histological subtype.Most people are diagnosed with ESCC at an advanced stage and are thus ineligible for surgical resection.The current therapeutic options for unresectable locally advanced ESCC are limited.The risks of recurrence and metastasis are high after first-line treatment,such as with definitive concurrent chemoradiotherapy(dCCRT).Recent advances in targeted therapies and im-mune checkpoint inhibitors(ICIs)have expanded the clinical treatment options for ESCC.However,no consensus has been reached on whether maintenance therapy provides survival benefits or which maintenance strategies should be prioritized.We provide a systematic re-view of the progress of research on postprimary maintenance therapy for patients with unresectable locally advanced ESCC,with the goal of optimizing comprehensive treatment strategies and providing information for personalized therapeutic decision making.
3.Multidisciplinary expert consensus on the management of diarrhea associated with tyr-osine kinase inhibitor therapy in HER2-positive breast cancer
Chinese Journal of Clinical Oncology 2025;52(5):217-233
Human epidermal growth factor receptor 2(HER2)tyrosine kinase inhibitors(TKIs),including lapatinib,pyrotinib,neratinib,and tucatinib,have become major therapeutic options for HER2-positive breast cancer.However,the use of these agents are often associated with adverse events,of which diarrhea is one of the most common and clinically significant.Diarrhea not only negatively affects the physical health of patients but also significantly impairs their quality of life,potentially leading to treatment delays or discontinuations.Therefore,the effective management of diarrhea is crucial to ensure patient adherence to HER2-TKI therapy and improve the patients'quality of life.Cur-rently,no multidisciplinary expert consensus in China exists regarding the management of anti-HER2-TKI-related diarrhea in breast cancer.Spearheaded by the Breast Cancer Integrative Rehabilitation Professional Committee of China Anti-Cancer Association,domestic experts from multiple disciplines,including breast oncology,pharmacy,gastroenterology,nutrition,and traditional Chinese medicine,jointly de-veloped a multidisciplinary expert consensus on the management of TKI-associated diarrhea in HER2-positive breast cancer.This consensus was formulated through a comprehensive review of domestic and international guidelines,relevant literature,and evidence-based medical research while considering the clinical practice in China.This consensus aims to provide clinicians with a set of multidisciplinary,compre-hensive guidelines for managing diarrhea associated with anti-HER2-TKIs to enhance the overall treatment outcomes and quality of life of patients with HER2-positive breast cancer.
4.Research advances in the application of one-step nucleic acid amplification technology in sentinel lymph node biopsy for breast cancer
Yang XIN ; Sun XIAO ; Wang YONGSHENG
Chinese Journal of Clinical Oncology 2025;52(5):259-263
One-step nucleic acid amplification(OSNA)technology is a molecular diagnostic technology that assesses the metastatic status of lymph nodes by detecting the expression level of cytokeratin 19 mRNA in sentinel lymph nodes(SLNs).It is characterized by its rapidity,ac-curacy,semi-quantitative nature,and high reproducibility,thereby providing comprehensive lymph node diagnostic information for clinical physicians.It is of great significance regarding avoiding secondary axillary lymph node dissection(ALND)or excessive ALND.The de-escala-tion treatment pattern for breast cancer is the current therapeutic strategy pursued by surgeons.SLN biopsy(SLNB)can help patients re-ceive more precise and personalized treatment,thereby reducing unnecessary treatment intensity and side effects while ensuring thera-peutic efficacy.This article reviews the application of OSNA detection in SLNB.
5.Progress in the clinical application of tumor RNA vaccines
Huang YUHAN ; Huang SHENGLIN ; Fang ZHUTING
Chinese Journal of Clinical Oncology 2025;52(8):413-419
Tumor ribonucleic acid(RNA)vaccines,which are emerging as promising cancer immunotherapies,have achieved significant technological breakthroughs during the COVID-19 pandemic.These vaccines activate immune responses through precise antigen expression.However,they face challenges such as suboptimal delivery efficiency and insufficient immunogenicity.Current studies focus on three design strategies:conventional messengerribonucleic acid(mRNA),self-amplifying mRNA,and circular RNA(circRNA)vaccines coupled with lipid nanoparticles(LNP)and polyethylene glycol(PEG)optimization for enhanced delivery.Clinical trials have demonstrated the synergistic effic-acy of RNA vaccines in combination with immune checkpoint inhibitors,chemotherapy,or oncolytic viruses.However,clinical translation is hindered by the complexity of antigen selection and storage stability limitations.In this review,we systematically summarize the recent clin-ical advancements in tumor RNA vaccines,analyze their technical challenges,and propose innovative strategies to address the current thera-peutic bottlenecks to guide future research and clinical applications.
6.Prediction of spread through air spaces in lung adenocarcinoma based on CT radiomics and comparison of different peritumoral expansion regions
Ma ZHENGXIAO ; Zhuo YUE ; Huang CHAO ; Shi LEI ; Bao ZHEN ; Su DAN
Chinese Journal of Clinical Oncology 2025;52(8):392-400
Objective:This study aimed to evaluate the value of CT-based radiomics machine learning models in predicting spread through air spaces(STAS)in lung adenocarcinoma(LUAD)and to determine the optimal peritumoral analysis region.Methods:Data from 378 pa-tients who underwent non-small cell lung cancer surgery at Zhejiang Cancer Hospital between January 2013 to January 2017 were retro-spectively analyzed.Logistic regression,random forest,and XGBoost models were constructed using regions extending 0,3,6,9,and 12 mm outward from the tumor margin.Results:The XGBoost model using the 6 mm peritumoral region performed best on the test set,with an AUC-ROC of 0.855(95%CI:0.756-0.950),followed by the XGBoost model using the 9 mm region.Decision curve analysis(DCA)indicated that the XGBoost models for the 6 mm and 9 mm regions had higher net clinical benefits.Feature analysis revealed that some wavelet trans-form features significantly contributed to STAS prediction.Conclusions:This preliminary study suggests that CT-based radiomics machine learning models have predictive value for STAS.The XGBoost model based on the 6 mm peritumoral region demonstrated the best perform-ance,and holds promise in assisting preoperative assessment.
7.Research progress of S100A16 in tumor development,progression,and drug resistance
Jin SHUO ; Cheng YIHAN ; Ai LIPING ; Zheng YI ; Zhang HONGMEI
Chinese Journal of Clinical Oncology 2025;52(8):401-406
The S100 calcium-binding protein family member A16(S100A16)exhibits differential expression in various malignant tumors and plays a critical role in tumor progression,including effects on tumor cell proliferation,apoptosis,adhesion,epithelial-mesenchymal transition,migration,and invasion.Its aberrant expression is associated with adverse clinical outcomes,making it a potential prognostic biomarker.Fur-thermore,S100A16 is closely linked to the infiltration of immune cells within the tumor microenvironment,contributing to the establish-ment of an immunosuppressive state.The expression level of S100A16 in tumor-associated endothelial cells may also correlate with the formation of an inhibitory immune microenvironment.Additionally,S100A16 has been implicated in tumor chemotherapy resistance.This review summarizes recent advances in our understanding of the mechanisms by which S100A16 contributes to different types of tumors,its regulatory effects on the tumor immune microenvironment,and its role in drug treatment resistance.The aim of this review is to elucidate the underlying mechanisms of tumor prevention and treatment and provide a theoretical foundation for overcoming drug resistance in can-cer therapy.
8.Research progress on the effects of lactic acid on tumor immune microenvironment and immunotherapy
Chen YAN ; Hu ZENAN ; Jiang LEI
Chinese Journal of Clinical Oncology 2025;52(8):407-412
An increasing number of studies have demonstrated that lactic acid,a key signaling molecule,plays a critical role in tumorigenes-is,immunotherapy response,and cellular metabolism regulation.Immunotherapy has become a mainstay of cancer treatment;however,most patients fail to respond,which may stem from the tumor immune microenvironment(TIME).Lactic acid,a central metabolic modulat-or of the tumor immune response,accumulates in the TIME and suppresses immune cell activity,thereby promoting tumor growth and im-mune escape.Targeting lactate metabolism and its associated pathways presents a novel strategy to overcome immunotherapy resistance.This article reviews current research on the regulatory mechanism of lactic acid in the TIME and immunotherapy,providing new ideas for combating tumor immunotherapy resistance.
9.Research progress in targeted therapy and immunotherapy of metastatic colorectal cancer
Wei CAIJIE ; Tu WENYING ; Li YUNXIA ; Jian SHENGQIANG ; Li WEN ; Li HAILONG ; Ren SHIPU
Chinese Journal of Clinical Oncology 2025;52(8):420-426
Colorectal cancer(CRC)is a common malignancy of the digestive system,with increasing morbidity and mortality worldwide.The standard treatment for CRC has,in the past,been surgery,chemotherapy,and radiotherapy.However,these treatments have significant side effects and are particularly challenging for patients with advanced metastatic CRC(mCRC).Therefore,it is crucial to explore alternative and more effective treatments.In recent years,with the development of molecular technology,numerous biomarkers have been identified,and targeted therapy and immunotherapy have achieved surprisingly positive results in the treatment of mCRC.Patients receiving targeted ther-apy and immunotherapy have an improved prognosis and quality of life.On this basis,this article reviews the latest research progress in tar-geted therapy and immunotherapy for mCRC,providing a reference for precision treatment of mCRC.
10.FGFR1 reduces the sensitivity of colorectal cancer cells to oxaliplatin by inhibiting the activity of PI3K/AKT signaling pathway
Cao LUYANG ; Zuo HAOJIAN ; Chen HAN ; Peng XIAOMEI ; Shi XINPENG ; Luo XIAOYONG
Chinese Journal of Clinical Oncology 2025;52(8):379-385
Objective:To investigate the effects of fibroblast growth factor receptor 1(FGFR1)on the resistance of colorectal cancer(CRC)cells to oxaliplatin(OXA).Methods:An OXA-resistant cell line(HCT8/OXA)was established by treating HCT8 CRC cells with low-dose OXA for a long period in vitro.The CCK-8 assay was used to compare the viability of the HCT8 and HCT8/OXA cells after OXA treatment and to exam-ine their resistance to the anticancer drug.Second-generation high-throughput sequencing technology was used to identify differentially ex-pressed genes between the parental and drug-resistant cells.The expression of FGFR1 in the HCT8 and HCT8/OXA cells was detected by Western blot assay.Colony formation and flow cytometric assays were used to determine cell proliferation and apoptosis,respectively.The expression of PI3K/AKT signaling pathway-related proteins was detected using Western blot assay.Results:Compared with the levels in the HCT8 cells,the FGFR1 levels were significantly increased in the HCT8/OXA cells(P<0.01).FGFR1 overexpression in the HCT8 cells increased their drug resistance(P<0.01)and proliferation(NC+OXA:236.67±6.24;FGFR1+OXA:568.33±6.24)and decreased their apoptotic rate after OXA treatment(NC+OXA:27.83±0.85;FGFR1+OXA:17.47±1.25).FGFR1 knockdown in the HCT8/OXA cells reduced their drug resistance(P<0.01)and proliferative ability(Si-NC+OXA:411±8.29;Si-FGFR1+OXA:233.33±20.55)and increased their apoptotic rate(Si-NC+OXA:2.85±0.17;Si-FGFR1+OXA:14.42±0.77).FGFR1 inhibited the activity of the PI3K/AKT signaling pathway and cell apoptosis and improved the proliferation and drug resistance of the CRC cells.By contrast,an activator of the PI3K/AKT pathway blocked the effects of FGFR1 on this sig-naling pathway and drug resistance in the CRC cells.Conclusions:FGFR1 can inhibit the PI3K/AKT signaling pathway and thereby reduce the sensitivity of CRC cells to OXA.

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