Francisco Cezar Aquino de Moraes

Breast cancer (BC) is the most common cancer among women worldwide, with more than 3 million new cases and 1 million deaths projected by 2040 [1,2]. In the United States, it is the most frequently ...

The protein Niemann-Pick type C intracellular cholesterol transporter 2 (NPC2) contains a lipid recognition domain and plays a vital role in intracellular cholesterol transport through the late end...

1. Gastric cancer (GC) is a malignant tumor of the digestive system that ranks fifth in terms of global cancer incidence and mortality [1,2]. Most GC cases are related to the histopathological prog...

Antiretroviral therapy has enabled people living with HIV (PLWH) to achieve near-normal life expectancy, but non-AIDS-defining cancers are increasingly frequent. Immune checkpoint inhibitors (ICIs) may be effective in this population, although evidence remains limited because PLWH have often been excluded from trials. This study assessed the efficacy and safety of ICIs in PLWH. We conducted a systematic review and meta-analysis using Medline, Scopus, Web of Science, and Cochrane Library. Studies reporting outcomes of PLWH with malignancies treated with ICIs were included. Analyses were performed in R version 4.4.2. Fourteen studies including 935 patients were analyzed. Compared with people living without HIV, PLWH showed no significant differences in overall survival (HR, 0.88; 95% CI, 0.71-1.08; p = 0.23), progression-free survival (HR, 1.13; 95% CI, 0.89-1.42; p = 0.38), any adverse events (OR, 0.90; 95% CI, 0.52-1.58; p = 0.71), or severe adverse events (OR, 1.04; 95% CI, 0.51-2.10; p = 0.91). In PLWH, the pooled objective response rate was 36%, and disease control rate was 64%. ICIs showed comparable efficacy and safety in PLWH and people living without HIV. www.crd.york.ac.uk/prospero identifier is CRD420251113906.

Breast cancer (BC) is the most common cancer among women worldwide, with over 2.3 million new cases annually. Recent studies suggest that Human Papillomavirus (HPV), a known oncogenic virus, may be involved in BC development. This study investigates HPV prevalence in BC samples and its potential role in tumorigenesis. Random-effects meta-analyses were conducted to estimate raw proportions and odds ratio (OR), with 95% confidence intervals (CIs). Heterogeneity was assessed using I². Statistical significance was set at p < 0.05. Analyses were performed in R 4.5.0 RESULTS: Our meta-analysis encompassed 82 studies and evaluated 7,683 breast cancer (BC) tissue samples to assess the presence of HPV. The overall prevalence of HPV in BC specimens was estimated at 23% (95%CI: 19%-28%). When stratified by continent, Oceania exhibited the highest regional prevalence at 38%. Comparative analysis between BC tissues and healthy controls revealed a significantly increased likelihood of HPV detection in the cancer group (OR 5.06; P < 0.001). This association remained statistically robust in both case-control (OR 6.34; P < 0.001) and cross-sectional designs (OR 2.83; P < 0.001). Among continents, South America demonstrated the most pronounced association (OR 11.66; P = 0.005). Subgroup analysis based on economic classification indicated that countries with low-income settings had the highest HPV prevalence (34%; 95%CI: 9%-73%). Evaluation by BC subtype revealed that luminal B had the highest HPV-positive rate (44%; 95%CI: 27%-61%). This meta-analysis reveals a global presence of HPV in BC and suggests a possible link. Further well-designed studies are needed to confirm its role in tumorigenesis.

Background: Malignant gastric outlet obstruction (MGOO) is a disabling complication of advanced gastrointestinal cancers, accounting for 50–80% of gastric outlet obstruction cases. As patients have unresectable disease, management is palliative and traditionally relies on surgical gastrojejunostomy (SGJ) or enteral stenting, both with limitations. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has recently emerged, but its role remains uncertain. We conducted a systematic review and meta-analysis comparing EUS-GE with SGJ and enteral stenting. Methods: Pubmed, Embase, Scopus, and Cochrane were searched for eligible studies. Mean differences (MDs) and risk ratio (RR) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was examined with I ² statistics and trial sequential analysis evaluated the cumulative evidence. Prespecified subgroup analyses were conducted for randomized controlled trials and propensity score-matched studies. Statistical analyses were performed using RStudio. Results: Twenty-two studies were included, comprising 22,211 and 1,479 patients in the EUS-GE vs SGJ and EUS-GE vs enteral stenting analysis, respectively. EUS-GE was associated with fewer infections (RR 0.46; p = 0.0137), overall postoperative complications (RR 0.38; p < 0.0001), including both major (RR 0.43; p = 0.0109) and minor complications (RR 0.35; p < 0.0001), and a reduced need for reintervention (RR 0.15; p < 0.0001) than SGJ, as well as higher clinical success (RR 1.11; p = 0.0003) compared with enteral stenting. SGJ showed higher technical success (RR 0.98; p = 0.0003). Conclusion: EUS-GE offers a safe and effective minimally invasive alternative for MGOO. Its growing evidence base supports its consideration as a preferred option in centers with appropriate expertise.

Purpose: Gastric cancer (GC) remains a major global health burden, with poor survival rates. HER2 is a key biomarker for targeted therapy, but discordance between primary tumors and metastases may impact treatment decisions. This meta-analysis evaluated the prevalence and clinical relevance of HER2 status differences between primary gastric cancers and metastatic lesions. Methods: A systematic search of PubMed, Embase, and Cochrane was conducted for studies assessing HER2 status in matched primary and metastatic gastric cancer samples. Pooled proportions and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses by metastatic site were performed. Statistical analyses were conducted using R software, version 4.2.3. Results: This meta-analysis included 3,515 patients across 20 studies. The pooled proportion of HER2-positive expression in primary gastric tumors was 13% (95% CI: 12–15%; I ² = 68.7%), while HER2-negative tumors accounted for 74% (95% CI: 72%-76%; I ² = 94.9%). In metastatic sites, the overall pooled proportion of HER2-positive lesions was 18% (95% CI: 16%-20%; I ² = 77.3%), with notable variation across anatomical locations: 38% in lung metastases, 31% in liver metastases, 19% in lymph nodes, and 7% in peritoneum. Conversely, HER2-negative metastases accounted for 82% overall (95% CI: 80%-84%; I ² = 78.2%), with proportions of 93% in peritoneum, 81% lymph nodes, 69% in liver metastases, and 62% in lung. Conclusions: Significant heterogeneity in HER2 expression between primary and metastatic gastric cancer underscores the need for reassessment of HER2 status in metastatic sites. Relying solely on primary tumor samples may lead to underestimation of HER2 positivity and suboptimal therapeutic decisions. Incorporating site-specific HER2 testing into clinical practice may enhance patient selection for HER2-targeted therapies and improve treatment outcomes. Graphic

Gastric cancer (GC) remains the fifth most common and lethal cancer worldwide, often diagnosed at advanced stages, with limited treatment options and poor survival. Beyond established risk factors, the ABO blood group system has been suggested as a potential prognostic factor, but evidence remains inconclusive. Medline, Scopus, and Web of Science were searched to 27 July 2025, for studies including GC patients with reported overall survival (OS) stratified by blood types O, A, B, and AB. Kaplan-Meier curves from eligible studies were digitized to reconstruct individual patient data, which were pooled to estimate median OS and hazard ratios (HR) using Cox regression. Seven studies comprising 8,726 GC patients were included (O: 3,693; A: 946; B: 605; AB: 315). Median OS was highest for type O (85.1 months, 95% CI 77.5-86.4) and AB (78.2 months, 95% CI 73.9-NA), and lowest for type A (20.0 months, 95% CI 17.9-21.9) and B (35.5 months, 95% CI 27.9-78.5). Compared with non-O, type O had a significantly better prognosis (HR 0.63; p < 0.0001). Type A (HR 1.85; p < 0.0001) and type B (HR 1.20; p = 0.0018) were associated with worse survival, while type AB showed a favorable prognosis compared to non-AB (HR 0.83; p = 0.039). ABO blood group is a significant prognostic factor in GC, with types A and B linked to poorer survival.

Triple-negative breast cancer (TNBC) lacks estrogen, progesterone, and HER2 receptors, limiting treatment options. Neoadjuvant anthracycline- and taxane-based chemotherapy remains standard, achieving pathological complete response (pCR) rates of 30%. We compared neoadjuvant treatments for early-stage TNBC using a systematic review and network meta-analysis (NMA). PubMed, EMBASE, and Cochrane were searched for randomized and observational studies of neoadjuvant treatment in TNBC. Odds ratios (OR) with 95% confidence intervals were pooled using a random-effects model. Certainty of evidence was assessed with GRADE. Statistical analyses were performed using RStudio. Thirty-seven studies with 7.683 patients were included. Twenty-five treatment nodes were formed, with paclitaxel (P) or docetaxel (D) + anthracycline - based (A) chemotherapy as the main comparator. Compared with PA-based + cyclophosphamide, higher pCR rates were observed with PA-based + carboplatin + pembrolizumab + cyclophosphamide (OR 3,04) and PA - based + carboplatin + veliparib + cyclophosphamide (OR 2,67). When DA-based + cyclophosphamide was the comparator, DA-based + cyclophosphamide + bevacizumab (OR 1,67) increased pCR. The SUCRA ranked PA-based + carboplatin + pembrolizumab, paclitaxel + carboplatin + atezolizumab, and DA-based + lobaplatin as most effective. Platinum agents, PARP inhibitors, and immune checkpoint inhibitors were associated with higher pCR rates in early-stage TNBC. CRD42025640277.