Qiliang Zhai

Article: Comparative efficacy and safety of intelligent pressure-controlled versus flexible vacuum-assisted ureteral access sheath for 2-4 cm renal calculi - Minerva Urology and Nephrology 2024 Aug 02 - Minerva Medica - Journals

Background: Clear cell renal cell carcinoma (ccRCC) most commonly metastasizes to the lungs, lymph nodes, bones, and liver. Metastasis to the breast is exceptionally rare, representing less than 0.5% of cases. Herein, we report an unprecedented case of triple metastasis with the longest recorded latency period. Case presentation: An 86-year-old female presented with a painless left breast mass 25 years after undergoing radical nephrectomy for ccRCC. Multi-modality imaging (mammography, ultrasound, MRI) revealed a suspicious breast lesion. Subsequent chest CT and PET-CT identified synchronous metastatic nodules in the lungs and brain. Histopathological examination of the resected breast mass confirmed metastatic carcinoma. The diagnosis of ccRCC metastasis was substantiated by an immunohistochemical profile positive for PAX8, CAIX, and CD10, while negative for estrogen receptor, progesterone receptor, and HER2. Conclusion: This case highlights breast metastasis as a rare but critical differential diagnosis in patients with a history of ccRCC, even decades after initial treatment. It underscores the necessity of lifelong follow-up for ccRCC survivors and demonstrates the integral role of imaging and pathological confirmation in guiding clinical diagnosis. Furthermore, the remarkable 25-year latency period challenges existing surveillance paradigms and provides a compelling rationale for the use of combined immunotherapy and targeted agents in managing ultra-late, multi-metastatic recurrences.

Castration-resistant prostate cancer (CRPC) presents significant therapeutic challenges due to its aggressive nature and poor prognosis. Targeting Aurora-A kinase (AURKA) has shown promise in cancer treatment. This study investigates the efficacy of ART-T cell membrane-encapsulated AMS@AD (CM-AMS@AD) nanoparticles (NPs) in a photothermal–chemotherapy–immunotherapy combination for CRPC. Bioinformatics analysis of the Cancer Genome Atlas-prostate adenocarcinoma (TCGA-PRAD) dataset revealed overexpression of AURKA in PCa, correlating with poor clinical outcomes. Single-cell RNA sequencing data from the GEO database showed a significant reduction in immune cells in CRPC. Experimentally, T cell membrane-biomimetic NPs loaded with the AURKA inhibitor Alisertib and chemotherapy drug DTX were synthesized and characterized by dynamic light scattering and transmission electron microscopy, showing good stability and uniformity (average diameter: 158 nm). In vitro studies demonstrated that these NPs inhibited CRPC cell proliferation, increased the G2/M cell population, and elevated apoptosis, confirmed by γH2AX expression. In vivo, CM-AMS@AD NPs accumulated in tumor tissues, significantly slowed tumor growth, decreased proliferation, increased apoptosis, and improved the immune environment, enhancing dendritic cell (DC) maturation and increasing CD8 + /CD4 + ratios. These findings suggest that CM-AMS@AD NPs offer a promising triple-combination therapy for CRPC, integrating photothermal, chemotherapy, and immunotherapy, with significant potential for future clinical applications.