Radiomics as a tool for prognostic prediction in transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis.

INTRODUCTION: Transarterial chemoembolization (TACE) is one of the predominant locoregional therapeutic modalities for addressing hepatocellular carcinoma (HCC). However, achieving precise prognostic predictions and effective patient selection remains a challenging pursuit. The primary objective of this systematic review and meta-analysis is to evaluate the efficacy of radiomics in forecasting the prognosis associated with TACE treatment. METHODS: A comprehensive exploration of pertinent original studies was undertaken, encompassing databases of PubMed, Web of Science and Embase. The studies' quality was meticulously evaluated employing the quality assessment of diagnostic accuracy studies 2 (QUADAS-2), the radiomics quality score (RQS) and the METhodological RadiomICs Score (METRICS). Pooled statistics, along with 95% confidence intervals (95% CI), were computed for sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Additionally, a summary receiver operating characteristic curve (sROC) was generated. To discern potential sources of heterogeneity, meta-regression and subgroup analyses were performed. RESULTS: The systematic review incorporated 29 studies, comprising a total of 5483 patients, with 14 studies involving 2691 patients qualifying for inclusion in the meta-analysis. The assessed studies exhibited commendable quality with regard to bias risk, with mean RQS of 12.90 ± 5.13 (35.82% ± 14.25%) and mean METRICS of 62.98% ± 14.58%. The pooled sensitivity was 0.83 (95% CI: 0.78-0.87), specificity was 0.86 (95% CI: 0.79-0.92), PLR was 6.13 (95% CI: 3.79-9.90), and NLR was 0.20 (95% CI: 0.15-0.27). The area under the sROC was 0.90 (95% CI: 0.87-0.93). Significant heterogeneity within all the included studies was observed, while meta-regression and subgroup analyses revealed homogeneous and promising findings in subgroups where principal methodological variables such as modeling algorithms, imaging modalities, and imaging phases were specified. CONCLUSION: Radiomics models have exhibited robust predictive capabilities concerning prognosis subsequent to TACE, thereby presenting promising prospects for clinical translation.

Progress in immunotherapy for neuroendocrine neoplasm of the digestive system.

Neuroendocrine neoplasms (NENs) are rare heterogeneous tumors that can develop in almost any organ, with the digestive organs, including the gastrointestinal tract and pancreas being the most commonly affected sites. Despite the fact that advances in initial therapies have progressed, there is presently no recognized effective treatment for advanced NEN. Immune checkpoint inhibitors (ICIs) have shown superior efficacy in treating several types of solid tumors. Despite their successful role in the treatment of partial NENs, such as small cell lung cancer, and Merkel cell carcinoma, the role of ICIs in most of the NENs remains limited. Nevertheless, due to their specific anti-tumor mechanisms and acceptable safety profile, ICIs are a promising avenue for further study in NENs therapy. Recent clinical trials have illustrated that combination therapy with ICI is more efficient than monotherapy, and multiple clinical trials are constantly ongoing to evaluate the efficacy and safety of these combination therapies. Therefore, the purpose of this review is to provide a comprehensive summary of the clinical progress of immunotherapy in NENs affecting the digestive system, with a specific emphasis on the application of programmed cell death protein 1/programmed death receptor ligand 1 inhibitor. Furthermore, this review has an exploration of the potential beneficiary population and the inherent value of utilizing immunotherapy in the management of NENs.