Shengmian Li

This guideline aims to provide evidence-based recommendations for the prevention, screening, assessment, diagnosis, treatment decision, and survivorship care of older adults with cancer. The CACA Geriatric Oncology Society convened expert panels to plan, write, and revise the manuscript. These experts engaged in in-depth discussions to propose clinical practice recommendations for geriatric oncology. The guideline highlights the increasing prevalence and mortality of cancer among the older adults in China, driven by an aging population. It emphasizes that a comprehensive geriatric assessment is critical for optimal treatment decision-making. Additionally, the use of traditional Chinese Medicine is suggested to minimize toxicity, alleviate symptoms, and enhance immune function. In conclusion, integrative and multidisciplinary approaches are essential to achieving both increased longevity and improved quality of life for older patients with cancer.

Background: Reactive cutaneous capillary endothelial proliferation (RCCEP) is a common immune-related adverse event (irAE) related to camrelizumab. This study sought to investigate the relationship between RCCEP and the treatment efficacy of camrelizumab in esophageal cancer (EC), and to explore the risk factors for RCCEP. Methods: This retrospective study collected the data of patients with EC who were treated with camrelizumab between November 2019 and November 2023. The patients were divided into RCCEP-negative groups and RCCEP-positive groups based on the occurrence of RCCEP. Subsequently, the Chi-squared test was applied to analyze the differences in objective response rate (ORR) and disease control rate (DCR) between the two groups. The association between progression-free survival (PFS) or overall survival (OS), and RCCEP was analyzed by the log-rank test. The factors associated with RCCEP were analyzed using univariable and multivariable Logistic regression analyses. Data cutoff was on February 2, 2024. Results: In total, 397 patients were included in this study, of whom 128 (32.24%) suffered from RCCEP. There were no significant differences in the baseline characteristics of the patients in the RCCEP-negative and RCCEP-positive groups. Among the patients with RCCEP, seven had grade 3 RCCEP, and none had grade 4 or 5 RCCEP. Compared with the patients without RCCEP, those with RCCEP had a significantly higher ORR (71.09% vs. 43.87%, Pvs. 72.49%, PConclusions: In the EC patients treated with camrelizumab, those with RCCEP had significantly better outcomes in terms of the ORR, DCR, PFS, and OS than those without RCCEP. The emergence of RCCEP may serve as a potential predictor for the therapeutic efficacy of camrelizumab in the treatment of EC. More camrelizumab treatment cycles and not receiving combined anti-angiogenic therapy were independent risk factors for RCCEP.

Rationale: This study used proteomics‐based data‐independent acquisition (DIA) technology with the aim of screening for differential expression proteins in type I gastric neuroendocrine neoplasm (g‐NEN). Methods: Differential expression proteins in type I g‐NEN and peritumoral tissues were screened using DIA with liquid chromatography/tandem mass spectrometry (DIA‐LC/MS/MS). The identified proteins were then functionally analysed using bioinformatics methods. We selected the three most highly expressed proteins, combined with patients' clinical data, for prognostic analysis. Results: Compared with peritumoral tissues, 224 proteins were up‐regulated, and 70 were down‐regulated. The most significantly enriched biological processes and pathways were vacuolar proton‐transporting V‐type ATPase complex assembly and metabolism‐related pathways. PCSK1, FBXO2, ACSL1, IRS2, and PTPRZ1 expression was markedly up‐regulated in type I g‐NENs. High IRS2 expression significantly correlated with a shorter time to recurrence. Conclusions: Our study provides a comprehensive proteomic signature based on DIA‐LC/MS/MS and highlights high IRS2 expression as a potential prognostic marker for type I gNENs.

Emerging evidence has revealed the significant roles of nicotinamide n-methyltransferase (NNMT) in cancer initiation, development, and progression; however, a pan-cancer analysis of NNMT has not been conducted. In this study, we first thoroughly investigated the expression and prognostic significance of NNMT and the relationship between NNMT and the tumor microenvironment using bioinformatic analysis. NNMT was significantly increased and associated with poor prognosis in many common cancers. NNMT expression correlated with the infiltration levels of cancer-associated fibroblasts and macrophages in pan-cancer. Function enrichment analysis discovered that NNMT related to cancer-promoting and immune pathways in various common cancers, such as colon adenocarcinoma, head and neck squamous cell carcinoma, ovarian serous cystadenocarcinoma, and stomach adenocarcinoma. NNMT expression was positively correlated with tumor-associated macrophages (TAMs), especially M2-like TAMs. The results suggest that NNMT might be a new biomarker for immune infiltration and poor prognosis in cancers, providing new direction on therapeutics of cancers.

Background: The aim of this study is to evaluate and compare the safety and efficacy of endoscopic mucosal resection with a cap (EMR-c) with those of endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors (R-NETs) ≤ 15 mm in diameter, and to analyze the risk factors of incomplete resection. Methods: A total of 122 patients who underwent EMR-c or ESD for R-NETs at the Fourth Hospital of Hebei Medical University between February 2007 and December 2020 were invovled in this study. The clinical outcomes of two groups were compared and evaluated. Results: A total of 122 patients with 128 R-NETs underwent endoscopic resection (EMR-c, 80; ESD, 48). In terms of duration of operation, EMR-c was significantly shorter than ESD (p < 0.001). Univariate analysis and multivariate analysis suggested that tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection in patients with R-NETs in this study. Conclusions: Both EMR-c and ESD were safe and effective treatments for R-NETs ≤ 15 mm in diameter. In addition, tumor diameter ≥ 8 mm was an independent risk factor for incomplete resection.

Background: Emerging evidence revealed the significant roles of Nicotinamide n-methyltransferase (NNMT) in cancer initiation, development, and progression, but there is no pan-cancer analysis of NNMT. Here, we aimed to analyze the expression and prognostic value of NNMT in pan-cancer and to gain insights into the association between NNMT and immune infiltration.Methods: We analyzed NNMT expression patterns and the association between NNMT expression levels and prognosis in pan-cancer via the Oncomine, Tumor Immune Estimation Resource (TIMER), Gene Expression Profiling Interactive Analysis (GEPIA), and Kaplan–Meier Plotter databases. After that, TIMER2 and Immune Cell Abundance Identifier (ImmuCellAI) databases were applied to investigate the relation between NNMT expression and immune infiltration across different cancer types. Signaling pathways related to NNMT expression were identified by gene set enrichment analysis (GSEA).Results: NNMT was significantly upregulated in various common cancers, and it was associated with prognosis. High expression of NNMT was associated with poor overall survival (OS) and relapse-free survival (RFS) in various common cancers, such as Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC), head and neck squamous cell carcinoma (HNSC), Ovarian serous cystadenocarcinoma (OV) and stomach adenocarcinoma (STAD). NNMT remarkably correlated with the levels of cancer associated fibroblasts (CAFs) and Macrophage cells infiltration. Conclusion: NNMT may serve as a promising prognostic biomarker in pan-cancer andhas positive association with immune infiltrates.

Purpose: The detection rate of colorectal neuroendocrine tumours (CR-NETs) is increasing, but their treatment is still controversial. Lymph node metastasis is an important reference index for the selection of treatment. The aim of our study was to investigate the factors associated with lymph node metastasis and prognosis of CR-NETs. Methods: The case characteristics of patients with colorectal neuroendocrine tumours from January 2011 to December 2020 were retrospectively analysed, including age, gender, tumour size, tumour location, lymph node metastasis, pathological grade and follow-up. Results: A total of 195 cases of CR-NETs were included in this study. When 15 mm was used as the cut-off value, the sensitivity, specificity and area under the curve (AUC) of lymph node metastases were 95.9%, 95.2% and 0.986, respectively. Multivariate analysis suggested that tumour size ≥ 15 mm (OR: 30.517, 95% CI: 1.250 ~ 744.996, p = 0.036) and lymphovascular invasion (OR: 42.796, 95% CI: 2.882 ~ 635.571, p = 0.006) were independent risk factors for lymph node metastasis. Age ≥ 56 (HR: 7.434, 95% CI: 1.334 ~ 41.443, p = 0.022) and distant metastasis (HR: 24.487, 95% CI: 5.357 ~ 111.940, p < 0.001) were independent prognostic factors in multivariable analyses. Conclusions: When the size of a CR-NET is ≥ 15 mm, the risk of lymph node metastasis is higher, and it is recommended to choose the surgical method carefully. Tumour size and lymphovascular invasion were independent risk factors for lymph node metastasis. Age ≥ 56 and distant metastasis were independent prognostic factors.

Copy number alterations are crucial for gastric cancer (GC) development. In this study, Tocopherol alpha transfer protein-like (TTPAL) was identified to be highly amplified in our primary GC cohort (30/86). Multivariate analysis showed that high TTPAL expression was correlated with the poor prognosis of GC patients. Ectopic expression of TTPAL promoted GC cell proliferation, migration, and invasion in vitro and promoted murine xenograft tumor growth and lung metastasis in vivo. Conversely, silencing of TTPAL exerted significantly opposite effects in vitro. Moreover, RNA-sequencing and co-immunoprecipitation (Co-IP) followed by liquid chromatograph-mass spectrometry (LC-MS) identified that TTPAL exerted oncogenic functions via the interaction of Nicotinamide-N-methyl transferase (NNMT) and activated PI3K/AKT signaling pathway. Collectively, TTPAL plays a pivotal oncogenic role in gastric carcinogenesis through promoting PI3K/AKT pathway via cooperating with NNMT. TTPAL may serve as a prognostic biomarker of patients with GC.