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Pembrolizumab-induced Guillain-Barrésyndrome in triple-negative breast cancer:A case report

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World Journal of Clinical oncology 2025年第2期16卷 144-151页

作者： Phani Bhavana Cherukuri Muhammad Tayyeb Sai Rakshith Gaddameedi Doantrang Du Trishala Meghal Department of Internal Medicine Monmouth Medical CenterLong BranchNJ 07740United States Department of hematology oncology Monmouth Medical CenterLong BranchNJ 07740United States

BACKGROUND The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers,including triple-negative breast ***,it is associated with immune-related adverse events,including rare but serious neurological complications such as Guillain-Barrésyndrome(GBS).GBS is a potentially life-threatening autoimmune disorder characterized by muscle weakness and *** present a unique case of pembrolizumab-induced GBS to highlight the importance of recognizing this complication and managing it promptly in patients receiving immune checkpoint *** SUMMARY A 69-year-old woman with a medical history of hypertension,anxiety,depression,and stage IIIB triple-negative breast cancer treated with pembrolizumab,carboplatin,and paclitaxel,presented to the emergency department with a 1-month history of tingling,lower extremity weakness,and shooting *** progressed to global weakness,ascending paralysis,and double *** examination revealed significant lower extremity weakness and sensory *** resonance imaging of the lumbar spine and cerebrospinal fluid analysis confirmed *** treatment with intravenous immunoglobulin led to relapse,requiring additional intravenous immunoglobulin and high-dose *** patient’s condition improved,pembrolizumab therapy was permanently discontinued,and she was discharged to a rehabilitation *** Pembrolizumab can induce GBS,necessitating early recognition,prompt diagnosis,and multidisciplinary management to prevent serious complications.

关键词： Pembrolizumab Guillain-Barrésyndrome Triple-negative breast cancer Immune-related adverse events Intravenous immunoglobulin therapy High-dose steroids Case report

Fever and Infection Prevalence in hematology-oncology Hospitalized Patients: A Single-center Retrospective Study

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Journal of Cancer Therapy 2018年第3期9卷 231-241页

作者： Inês Almeida Costa Sérgio Chacim José Mariz Internal Medicine Department Centro Hospitalar de Sao Joao Porto Portugal Departmentof hematology-oncology Clinic Instituto Português de Oncologia (IPO) Porto Portugal

Fever is prevalent in hospitalized patients. In hematology-oncology patients, it is related with infection, a disease manifestation or a consequence of immunological dysfunction. This single-center retrospective study aims to determine fever prevalence, describe its causes and evaluate the impact of infection on mortality. We reviewed clinical records of 222 patients admitted to the hospital in three random months of 2015. Around 35% of all hospitalizations were complicated by fever, 42.5% of unknown origin. 90.4% were under treatment. Around 81% did antibiotics, most commonly piperacillin/tazobactam, for around 11 days. 41% changed antibiotics due to fever persistence or microbiological results. The diagnostic yield of microbiological tests was 25%;in 66.7%, a Gram-negative microorganism was isolated. We didn’t find an association between infection and mortality. We conclude that fever is common in our hematology-oncology clinic and that the team is trained to assume infection;empirical treatment is in accordance with international recommendations.

关键词： Fever Infection hematology-oncology Onco-hematology Neutropenia

Late effects of the treatment of childhood cancer

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World Journal of Clinical Cases 2025年第7期13卷 6-12页

作者： Jelena Roganovic Department of Pediatric oncology and hematology Children's Hospital ZagrebZagreb 10000Croatia Faculty of Biotechnology and Drug Development University of RijekaRijeka 51000Croatia

Excellent progress has been made in the last few decades in the cure rates of pediatric malignancies,with more than 80%of children with cancer who have access to contemporary treatment being ***,the therapies responsible for this survival can also produce adverse physical and psychological long-term outcomes,referred to as late effects,which appear months to years after the completion of cancer *** has shown that 60%to 90%of childhood cancer survivors(CCSs)develop one or more chronic health conditions,and 20%to 80%of survivors experience severe or life-threatening complications during ***,understanding the late side effects of such treatments is important to improve the health and quality of life of the growing population of CCSs.

关键词： Survivorship Cancer Children Treatment Late effects

Proton pump inhibitors and all-cause mortality risk among cancer patients

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World Journal of Clinical oncology 2025年第1期16卷 34-42页

作者： Arunkumar Krishnan Carolin Victoria Schneider Declan Walsh Department of Supportive oncology Atrium Health Levine CancerCharlotteNC 28204United States Department of Medicine Section of Hematology and OncologyWake Forest University School of MedicineWinston-SalemNC 27101United States Department of Medicine Ⅲ GastroenterologyMetabolic Diseasesand Intensive CareUniversity Hospital RWTH AachenAachen 52074Germany

BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related *** evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater *** To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize *** This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare *** study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer *** prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)*** primary outcome was all-cause *** patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding *** Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these *** a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individual

关键词： All-cause mortality Cancer Histamine-2 receptor antagonists Mortality Malignancy Proton pump inhibitors Carcinoma Outcome

Hypoxia inducible factor in hepatocellular carcinoma:A therapeutic target

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World Journal of Gastroenterology 2015年第42期21卷 12171-12178页

作者： Daniel Lin Jennifer Wu Fellow hematology and Medical oncology Program NYU School of Medicine Perlmutter Cancer Center NYU Langone Medical Center Division of Hematology and Oncology NYU School of Medicine Subdivision of GI Oncology Perlmutter Cancer Center NYU Langone Medical Center Division of Hematology and Oncology

Hepatocellular carcinoma(HCC) is one of the most commonly diagnosed and deadly cancers worldwide; its incidence has been rising in the United States due to the increase in hepatitis C associated cirrhosis and the growing epidemic of obesity. There have been no effective therapeutic options in the advanced disease setting beyond sorafenib, a multi-targeted tyrosine kinase inhibitor that showed significant survival benefit. Because of this, there is an urgent need to search for novel pathways in sorafenib experienced patients. This review will focus on the role of hypoxia and hypoxiainducible factor alpha(HIF-1α) in cancer development, specifically in HCC. We will discuss the biology of HIF-1α, the pathways with which it interacts, and the function of HIF-1α in HCC. Furthermore, we will review studies highlighting the relevance of HIF-1α in the clinical setting, as well as the pre-clinical data supporting its further investigation. Finally, we will conclude with a discussion of the potential role of a HIF-1α m RNA antagonist for the treatment of HCC, and hypothesize the ways in which such an inhibitor may be best utilized in the management of advanced HCC. Hypoxia plays a significant role in the development of HCC. HIF-1α is a key transcription factor involved in the hypoxic response of cancer cells. It activates transcription of genes responsible for angiogenesis, glucose metabolism, proliferation, invasion and metastasis in HCC. Its involvement in multiple, essential tumor pathways makes it an attractive potential therapeutic target in HCC.

关键词： Hypoxia Hypoxia-inducible factor alpha Hepatocellu

Management of gastrointestinal bleed in the intensive care setting,an updated literature review

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World Journal of Critical Care Medicine 2025年第1期14卷 20-41页

作者： Vignesh K Nagesh Sai Priyanka Pulipaka Ruchi Bhuju Emelyn Martinez Shruthi Badam Gomathy Aarthy Nageswaran Hadrian Hoang-Vu Tran Daniel Elias Charlene Mansour Jaber Musalli Sanket Bhattarai Lokeash Subramani Shobana Tannishtha Sethi Ritvik Sethi Namrata Nikum Chinmay Trivedi Amer Jarri Colin Westman Nazir Ahmed Shawn Philip Simcha Weissman Jonathan Weinberger Ayrton I Bangolo Department of Internal Medicine Palisades Medical CenterNorth BergenNJ 07047United States Department of Internal Medicine University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Hackensack Palisades Medical CenterNorth BergenNJ 07047United States Department of Gastroenterology Hackensack University Medical CenterHackensackNJ 07061United States Department of Pulmonology and Critical Care HCA Florida Bayonet Point HospitalHudsonFL 34667United States Department of hematology&oncology John Theurer Cancer Center at Hackensack University Medical CenterHackensackNJ 07601United States

Gastrointestinal(GI)bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit(ICU).This literature review consolidates current insights on the epidemiology,etiology,management,and outcomes of GI bleeding in critically ill *** bleeding remains a significant concern,especially among patients with underlying risk factors such as coagulopathy,mechanical ventilation,and renal *** GI bleeding in the ICU requires a multidisciplinary approach,including resuscitation,endoscopic intervention,pharmacologic therapy,and sometimes surgical *** with enhanced management strategies,GI bleeding in the ICU is associated with considerable morbidity and mortality,particularly when complicated by multi-organ *** review reiterates the need for adequate resuscitation and interventions in managing GI bleeding in critically ill patients,aiming to enhance survival rates and improve the quality of care within the ICU setting.

关键词： Gastrointestinal bleed Varices Variceal bleeding Diverticular bleed Angiodysplasia Ulcer Hemorrhoids Endoscopy Enteroscopy Embolization

The therapeutic implications of immunosuppressive tumor aerobic glycolysis

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Cellular & Molecular Immunology 2022年第1期19卷 46-58页

作者： Bradley I.Reinfeld WKimryn Rathmell Tae Kon Kim Jeffrey C.Rathmell Department of Medicine Division of Hematology and OncologyVanderbilt University Medical CenterNashvilleTNUSA

In 2011,Hanahan and Weinberg added“Deregulating Cellular Energetics”and“Avoiding Immune Destruction”to the six previous hallmarks of *** this seminal paper,there has been a growing consensus that these new hallmarks are not mutually exclusive but rather *** following review summarizes how founding genetic events for tumorigenesis ultimately increase tumor cell glycolysis,which not only supports the metabolic demands of malignancy but also provides an immunoprotective niche,promoting malignant cell proliferation,maintenance and *** mechanisms by which altered metabolism contributes to immune impairment are multifactorial:(1)the metabolic demands of proliferating tumor cells and activated immune cells are similar,thus creating a situation where immune cells may be in competition for key nutrients;(2)the metabolic byproducts of aerobic glycolysis directly inhibit antitumor immunity while promoting a regulatory immune phenotype;and(3)the gene programs associated with the upregulation of glycolysis also result in the generation of immunosuppressive cytokines and *** this perspective,we shed light on important considerations for the development of new classes of agents targeting cancer *** types of therapies can impair tumor growth but also pose a significant risk of stifling antitumor immunity.

关键词： cancer metabolism immuno logy glycolysis

Bone targeted therapies for the prevention of skeletal morbidity in men with prostate cancer

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Asian Journal of Andrology 2014年第3期16卷 341-347页

作者： Philip J Saylor Division of hematology-oncology Massachusetts General Hospital Cancer Center Boston Massachusetts USA.

Men with prostate cancer suffer substantially from bone-related complications. Androgen deprivation therapy itself is a cause of loss of bone mineral density and is associated with an increased incidence of osteoporotic fractures. In advanced disease, bone is by far the most common site of metastasis. Complications of bone metastases prominently include pain and the potential for skeletal events such as spinal cord compression and pathologic fractures. Elevated osteoclast activity is an important aspect of the pathophysiology of both treatment-related osteoporosis and skeletal complications due to metastases. The osteoclast is therefore a therapeutic target. Denosumab is a fully human monoclonal antibody to receptor activator of nuclear factor-K-B ligand that was designed to potently inhibit osteoclast activity and is the central focus of this review. Bisphosphonates, radiopharmaceuticals and systemically-active hormonal agents such as abiraterone acetate and enzalutamide have each been shown to improve skeletal morbidity in specific clinical situations. Denosumab is the only agent that has been shown to prevent osteoporotic fractures in men receiving androgen deprivation therapy and at elevated risk for fracture. It has also demonstrated superiority to the potent bisphosphonate zoledronic acid for the prevention of skeletal-related events in men with castration-resistant prostate cancer metastatic to bone. Efficacy and toxicity data will be discussed.

关键词： denosumab osteoporosis osteopenia osteoclast RANK (receptor activator of nuclear factor-kappa B) skeletal-relatedevents

Association of image-defined risk factors,tumor resectability,and prognosis in children with localized neuroblastoma

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World Journal of Pediatrics 2019年第6期15卷 572-579页

作者： An-An Zhang Ci Pan Min Xu Xiao-Xia Wang Qi-Dong Ye Yi-Jin Gao Jing-Yan Tang Key Laboratory of Pediatric hematology and oncology Ministry of HealthDepartment of Pediatric Hematology and OncologyShanghai Children's Medical CenterShanghai Jiaotong University School of Medicine(SJTU-SM)ShanghaiChina

Background Although localized neuroblastoma has a good prognosis,some cases have undergone treatment failure or *** from biologic features such as MYCN status,we wondered whether some characteristics of growing tumors are prognostic,such as a well-encapsulated mass without infiltration of vital *** analyzed the diagnostic utility of image-defined risk factors(IDRFs)to predict successful treatment and *** overall goal was to achieve maximum cure rates for patients with localized neuroblastoma through a better understanding of clinical *** We retrospectively reviewed the images of patients with localized neuroblastoma who were enrolled between June 1998 and December 2012 at a single institution in Shanghai,*** categorization regarding IDRFs was available in 67 *** was assessed at diagnosis and after four cycles of neoadjuvant chemotherapy,on *** median follow-up period was 84 months(range: 48-132 months)after *** MRI and CT indicated a total of 177 IDRFs in these 67 *** regression analysis revealed a highly significant negative correlation between the numbers of IDRFs and the possibility of complete removal of *** extension of the tumor,compression of the trachea,and encasement of the main artery in localized neuroblastoma were predictors for incomplete tumor *** to univariate analysis,≥4 IDRFs and intraspinal extension of the tumor were significant indicators of poor *** The number of IDRFs was useful in predicting surgical outcome and event-free *** number of IDRFs should be considered in protocol planning,instead of IDRF presence or absence.

关键词： Image-defined risk factors Localized neuroblastoma Prognosis Surgery