Zhimin Zeng

While first‐line immune checkpoint inhibitors (ICIs) combined with chemoradiotherapy (CRT) represent a crucial advancement for unresectable locally advanced esophageal squamous cell carcinoma (ESCC), the optimal sequencing of these modalities remains unresolved. To evaluate the efficacy and safety of induction, concurrent, and consolidation ICI strategies, this multicenter real‐world cohort study enrolled 662 patients with Stage II–IVA unresectable ESCC across 12 cancer centers. Patients were categorized into induction (IC‐CRT), concurrent (ICRT), and consolidation (CRT‐IC) groups, with inverse probability of treatment weighting (IPTW) applied to balance baseline characteristics. Following IPTW adjustment, the median overall survival (OS) in the IC‐CRT, ICRT, and CRT‐IC groups was 34.7 months, not reached, and 23.1 months, respectively ( p = 0.016), while the corresponding median progression‐free survival (PFS) times were 20.1, 25.3, and 12.9 months, respectively ( p = 0.014). Among the three sequencing strategies, ICRT achieved the most favorable survival outcomes, followed by IC‐CRT and CRT‐IC. Multivariable Cox regression confirmed that ICRT was associated with a significantly reduced risk of mortality compared with IC‐CRT (HR = 0.71, p = 0.046) and CRT‐IC (HR = 0.53, adjusted p < 0.001). Safety profiles indicated that ICRT carried the highest burden of Grade 3–4 treatment‐related pneumonitis (7.7%). In conclusion, ICRT as a first‐line treatment for locally advanced ESCC showed the most favorable survival profile compared with induction or consolidation sequencing, although its higher toxicity profile necessitates careful patient selection and proactive clinical management. In contrast, the CRT‐IC strategy exhibited the best tolerability but the least favorable survival outcome.

Purpose:Pulmonary sarcomatoid carcinoma (PSC) is a highly aggressive and poorly differentiated subtype of non–small cell lung cancer (NSCLC) associated with a poor prognosis. We conducted a prospective, single-arm, phase II trial to evaluate the efficacy and safety of tislelizumab in combination with anlotinib as first-line therapy in patients with advanced PSC.Patients and Methods:Eligible patients with advanced PSC without EGFR or ALK mutations received tislelizumab plus anlotinib as first-line treatment until disease progression or unacceptable toxicities. The primary endpoint was the objective response rate (ORR) assessed per RECIST version 1.1. Secondary endpoints included the disease control rate (DCR), duration of response, progression-free survival (PFS), overall survival (OS), and safety.Results:Between August 2021 and June 2025, a total of 29 patients were enrolled, with a median age of 71 years (range: 39–79). Two patients (6.90%) achieved a complete response, and 14 (48.28%) achieved a partial response, yielding an ORR of 55.17% [95% confidence interval (CI), 35.69%–73.55%]. The DCR was 96.55% (95% CI, 82.24%–99.91%). After a median follow-up duration of 16.73 months, the median PFS was 9.40 months (95% CI, 3.67–13.30 months), and the median OS was 14.37 months (95% CI, 9.03–17.50 months). The most common treatment-related adverse events (TRAE) were hyperuricemia and maculopapular rash. Grade 3 to 4 TRAEs occurred in eight patients (27.59%), with no treatment-related deaths reported.Conclusions:The combination of tislelizumab and anlotinib demonstrated promising antitumor activity with a manageable safety profile as first-line therapy in patients with advanced PSC.

Data from the efficacy and safety of tislelizumab plus anlotinib as first-line treatment in advanced pulmonary sarcomatoid carcinoma: a single-arm phase II trial.

Neoadjuvant chemoimmunotherapy followed by surgery markedly improves outcomes in patients with stage III unresectable non-small cell lung cancer (NSCLC). However, the efficacy and safety of continuing concurrent chemoradiotherapy (cCRT) followed by immunotherapy consolidation in patients who experience failure of neoadjuvant treatment remain unclear. The present real-world study included patients who received cCRT and consolidation immunotherapy after failure of neoadjuvant chemoimmunotherapy at The Second Affiliated Hospital of Nanchang University, Nanchang, China, between May 2018 and August 2024. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were treatment-related adverse events and overall survival (OS). PFS time among patients who experienced neoadjuvant treatment failure was compared with that of patients with unresectable stage III NSCLC treated with the PACIFIC regimen at the same center. A total of 67 patients were included. The median PFS time was 26.0 months (95% CI, 17.8-39.0), with 1-, 2- and 3-year OS rates of 92.5, 79.1 and 77.6%, respectively. The incidence of immune-related adverse events was 34.33% and radiation-related adverse events occurred in 63.2% of patients. Grade ≥3 immunotherapy-related pneumonitis occurred in 5.97% of cases and radiation-related pneumonitis occurred in 4.48%. Comparison with 30 patients previously treated with the PACIFIC regimen showed no significant difference in PFS (HR, 1.155; 95% CI, 0.657-2.032; P=0.615). Notably, treatment-related adverse events were frequent, with bone marrow suppression observed in 86.57% of cases. In conclusion, induction immunotherapy combined with chemotherapy followed by cCRT and immunotherapy consolidation appears effective and safe for patients with stage III NSCLC who have failed neoadjuvant chemoimmunotherapy.

Purpose: Pulmonary sarcomatoid carcinoma (PSC) is a highly aggressive and poorly differentiated subtype of non–small cell lung cancer (NSCLC) associated with a poor prognosis. We conducted a prospective, single-arm, phase II trial to evaluate the efficacy and safety of tislelizumab in combination with anlotinib as first-line therapy in patients with advanced PSC. Patients and Methods: Eligible patients with advanced PSC without EGFR or ALK mutations received tislelizumab plus anlotinib as first-line treatment until disease progression or unacceptable toxicities. The primary endpoint was the objective response rate (ORR) assessed per RECIST version 1.1. Secondary endpoints included the disease control rate (DCR), duration of response, progression-free survival (PFS), overall survival (OS), and safety. Results: Between August 2021 and June 2025, a total of 29 patients were enrolled, with a median age of 71 years (range: 39–79). Two patients (6.90%) achieved a complete response, and 14 (48.28%) achieved a partial response, yielding an ORR of 55.17% [95% confidence interval (CI), 35.69%–73.55%]. The DCR was 96.55% (95% CI, 82.24%–99.91%). After a median follow-up duration of 16.73 months, the median PFS was 9.40 months (95% CI, 3.67–13.30 months), and the median OS was 14.37 months (95% CI, 9.03–17.50 months). The most common treatment-related adverse events (TRAE) were hyperuricemia and maculopapular rash. Grade 3 to 4 TRAEs occurred in eight patients (27.59%), with no treatment-related deaths reported. Conclusions: The combination of tislelizumab and anlotinib demonstrated promising antitumor activity with a manageable safety profile as first-line therapy in patients with advanced PSC.

Immune checkpoint inhibitors (ICIs)-related myocarditis, a severe complication characterized by elevated cardiac troponin I, poses significant clinical challenges in distinguishing it from acute myocardial infarction (AMI). Our study aimed to identify plasma protein biomarkers that differentiate ICIs-myocarditis from AMI. Plasma samples from 5 ICIs-myocarditis patients (with paired baseline and diagnosis samples) and 5 angiography-confirmed AMI patients, matched for age, gender, smoking history, and pre-existing heart disease, were analyzed using label-free liquid chromatography-mass spectrometry (LC-MS) proteomics. A total of 1,521 plasma proteins were identified, with 1,325 quantifiable. Proteomic profiling revealed differentially expressed proteins (DEPs) in ICIs-myocarditis associated with myocardial contraction, proteasome activity, NF-κB signaling, immunoregulation, and amino acid metabolism. Through validation in animal models of ICIs-myocarditis and AMI, two plasma proteins—MYOM3 (myomesin 3) and Galectin-1 (LGALS1)—were identified as potential biomarkers linked to the onset of ICIs-related myocarditis. Further validation using expanded clinical cohorts confirmed their differential expression. These findings highlight MYOM3 and Galectin-1 as promising biomarkers for distinguishing ICIs-related myocarditis from AMI, providing insights for clinical diagnosis and mechanistic research into immune-related cardiotoxicity.

Background: Non-small cell lung cancer (NSCLC) patients with leptomeningeal metastasis (LM) have a very poor prognosis. Intrathecal pemetrexed (IP) has shown moderate efficacy in treating patients with NSCLC-LM. Myelosuppres... | Find, read and cite all the research you need on Tech Science Press

Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare lung cancer characterized by early metastasis and invasion. It is predominantly diagnosed at a locally advanced or metastatic stage, hindering the possibility of surgical intervention. However, a standard treatment for advanced PSC remains unestablished. This study evaluated the effects of chemotherapy and immunotherapy-based strategies in patients with advanced PSC. Methods: The Surveillance, Epidemiology, and End Results (SEER) database and data from three cancer centers were used in this retrospective study. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Univariate and multivariate analyses were conducted to identify the prognostic factors. Results: In total, 202 patients with stage IV PSC were identified from the SEER database (median OS, 5 months). The median follow-up time of patients from the three centers was 18.8 months. First-line treatment with immunotherapy-based regimens and chemotherapy was administered to 12 and 27 patients, respectively. The median PFS was 2.1 and 7.3 months [hazard ratio (HR), 0.16; 95% confidence interval (CI), 0.06–0.40; P < 0.001], while the median OS was 3.6 and 21.4 months (HR, 0.21; 95% CI, 0.09–0.50; P < 0.001) in the chemotherapy and immune-based groups, respectively. The immunotherapy-based regimen was an independent prognostic factor for PFS (HR, 0.21; 95% CI, 0.08–0.55; P = 0.001) and OS (HR, 0.20; 95% CI, 0.08–0.49; P < 0.001). Conclusions: Conventional chemotherapy offered limited benefits in patients with advanced PSC; however, those who received first-line immunotherapy-based regimens exhibited significantly improved responses.

Cancer patients with COVID-19 have a higher infection rate and mortality rate than non-cancer patients. However, there are few studies on the correlation between the serum C-reactive protein (CRP) and cancer patients with COVID-19. This study aims to investigate the association between serum CRP and the incidence of COVID-19 pneumonia in cancer patients at the end of 2022 in China. This cross-sectional study with a retrospective cohort between December 2022 and February 2023 assessed cancer patients complicated with COVID-19 infection in 2 Chinese institutions. Logistic regression analyses were used to compute Odds ratio (OR) and 95%CIs for the association between serum CRP and the incidence of COVID-19 pneumonia in cancer patients. A total of 213 cancer patients with COVID-19 were enrolled. Eighty-six patients (40.4%) developed COVID-19 pneumonia, among which 23 patients (10.8%) progressed to severe cases. Univariate Logistic regression showed that high CRP levels were found to be an unfavorable predictor of COVID-19 outcomes (OR = 17.9, 95%CI: 7.3, 43.6; P < .001). In the multivariate analysis, high CRP levels were associated with a higher incidence rate of COVID-19 pneumonia (OR = 9.8, 95%CI: 2.2, 43.8; P = .003). In the multivariate logistic regression model and smooth curve fitting, we found a correlation between CRP and COVID-19 pneumonia. The serum CRP was associated with the incidence of Omicron variant COVID- 19 pneumonia in cancer patients. Hence, cancer patients with high CRP level maybe need for timely computer tomography examination and more aggressive treatment.