Use of MRI Radiomics Models in Evaluating the Low HER2 Expression in Breast Cancer.

OBJECTIVE: To investigate the magnetic resonance imaging (MRI) radiomics models in evaluating the human epidermal growth factor receptor 2(HER2) expression in breast cancer.

Materials and Methods: The MRI data of 161 patients with invasive ductal carcinoma (non-special type) of breast cancer were retrospectively collected, and the MRI radiomics models were established based on the MRI imaging features of the fat suppression T2 weighted image (T2WI) sequence, dynamic contrast-enhanced (DCE)-T1WIsequence and joint sequences. The T-test and the least absolute shrinkage and selection operator (LASSO) algorithm were used for feature dimensionality reduction and screening, respectively, and the random forest (RF) algorithm was used to construct the classification model.

Results: The model established by the LASSO-RF algorithm was used in the ROC curve analysis. In predicting the low expression state of HER2 in breast cancer, the radiomics models of the fat suppression T2WI sequence, DCE-T1WI sequence, and the combination of the two sequences showed better predictive efficiency. In the receiver operating characteristic (ROC) curve analysis for the verification set of low, negative, and positive HER2 expression, the area under the ROC curve (AUC) value was 0.81, 0.72, and 0.62 for the DCE-T1WI sequence model, 0.79, 0.65 and 0.77 for the T2WI sequence model, and 0.84, 0.73 and 0.66 for the joint sequence model, respectively. The joint sequence model had the highest AUC value.

Conclusions: The MRI radiomics models can be used to effectively predict the HER2 expression in breast cancer and provide a non-invasive and early assistant method for clinicians to formulate individualized and accurate treatment plans.

Transarterial Chemoembolization Combined with Tyrosine Kinase Inhibitors Plus Immune Checkpoint Inhibitors Versus Tyrosine Kinase Inhibitors Plus Immune Checkpoint Inhibitors in Unresectable Hepatocellular Carcinoma with First- or Lower-Order Portal Vein Tumor Thrombosis.

PURPOSE: To compare the efficacy of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) plus immune checkpoint inhibitors (ICIs) (TACE-TKI-ICI) versus TKIs plus ICIs (TKI-ICI) for unresectable hepatocellular carcinoma (HCC) with first- or lower-order portal vein tumor thrombosis (PVTT). MATERIALS AND METHODS: A retrospective study was performed in HCC patients with first- or lower-order PVTT receiving TKIs (Lenvatinib or sorafenib) plus ICIs (camrelizumab, sintilimab, or atezolizumab) with or without TACE from four institutions between January 2019 and January 2022. Propensity score-based method was performed to minimize bias by confounding factors. Tumor response, progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were evaluated and compared between the two groups. RESULTS: After inverse probability of treatment weighting, two balanced pseudopopulations were created: 106 patients in the TACE-TKI-ICI group and 109 patients in the TKI-ICI group. The objective response rate was higher in the TACE-TKI-ICI group (50.9% vs. 28.4%, P < 0.001). The median PFS and OS were significantly longer in the TACE-TKI-ICI group than in the TKI-ICI group (PFS: 9.1 vs. 5.0 months, P = 0.005; OS: 19.1 vs. 12.7 months, P = 0.002). In Cox regression, TACE-TKI-ICI treatment was an independent predictor of favorable OS. Treatment-related grade 3/4 AEs were comparable between the two groups (22.6% vs. 17.9%, P = 0.437). CONCLUSION: TACE-TKI-ICI therapy contributed to better tumor control, PFS and OS than TKI-ICI therapy in unresectable HCC patients with first- or lower-order PVTT.

Distal radial artery access is a safe and feasible technique in the anatomical snuffbox for visceral intervention.

Regarding the site of arterial access during the intervention, transracial intervention can reduce the risk of bleeding and vessel-related complications as well as improve patient comfort. Importantly, the distal radial artery (DRA) approach may reduce the incidence of radial artery occlusion and digital ischemia, but the feasibility and safety of DRA in performing subdiaphragmatic vascular interventions remain unclear. From January 2018 to December 2019, 106 patients were admitted to our department for visceral angiography and intervention by left distal radial artery accessing in an anatomical snuffbox. In total, 152 times of vascular interventions were performed during this period. Patients demographics, procedure details, technical success, and access site-related complications were recorded and evaluated. The mean age was 58.9 (range 22-86) years. Males accounted for 80.2%. Thirty-five patients (33%) had 2 or more procedures via the DRA approach. Technical success was achieved for 96.1% of procedures (146 cases) and 3.9% of cases failed to perform the intended procedure via the DRA approach (6 cases). The 4-Fr sheath was used in 86.8% of cases, and the 5 Fr sheath was used in the rest of the 13.2% of procedures. The rate of asymptomatic radial artery occlusion was 5.7% (6 of 106 patients). No patient suffered from distal limb ischemia after a long-time follow-up. Eight patients suffered postoperative local pain, transient numbness, or local bruised in the anatomical snuffbox without major complications. Patients with postoperative complications recovered quickly by using nonsteroidal anti-inflammatory drugs or without further treatment. Left distal radial artery access is safe and feasible as a new technique for visceral angiography and intervention.

Efficacy of docetaxel combined carboplatin for the treatment of patients with castration-resistant prostate cancer: A protocol of systematic review and meta-analysis.

BACKGROUND: A numerous published studies have reported that docetaxel combined carboplatin (DC) has been utilized for the treatment of patients with castration-resistant prostate cancer (CRPC). However, there are still contradictory results. Therefore, this systematic review and meta-analysis will explore the efficacy and safety of DC for the treatment of patients with CRPC. METHODS: We will systematically and comprehensively search MEDLINE, EMBASE, Cochrane Library, Web of Science, CINAHL, WANGFANG, CBM, and CNKI from the beginning up to the March 1, 2020, regardless language and publication time. We will consider randomized controlled trials that evaluated the efficacy and safety of DC for the treatment of patients with CRPC. The treatment effects of all dichotomous data will be estimated as risk ratio and 95% confidence intervals (CIs), and that of continuous outcomes will be calculated as standardized mean difference or mean difference and 95% CIs. Methodological quality will be appraised by Cochrane risk of bias tool, and quality of evidence will be identified by Grading of Recommendations Assessment Development and Evaluation. Statistical analysis will be undertaken by RevMan 5.3 software. RESULTS: This study will systematically explore the efficacy and safety of DC for the treatment of patients with CRPC. CONCLUSION: This study may provide helpful evidence to determine whether DC is an effective treatment for patients with CRPC or not. SYSTEMATIC REVIEW REGISTRATION: INPLASY202040076.

Transarterial Chemoembolization Monotherapy Versus Combined Transarterial Chemoembolization-Microwave Ablation Therapy for Hepatocellular Carcinoma Tumors ≤5 cm: A Propensity Analysis at a Single Center.

PURPOSE: To compare effectiveness of transarterial chemoembolization (TACE) combined with microwave ablation (MWA; TACE-MWA) with TACE alone for treating hepatocellular carcinoma (HCC) tumors ≤5 cm. MATERIALS AND METHODS: We reviewed data of 244 patients treated for HCC by TACE-MWA or TACE from June 2014 to December 2015. Median follow-up period was 505 days (TACE-MWA group: 485 days; TACE group: 542 days). Patients were propensity score matched (1:2 ratio); outcomes of TACE-MWA and TACE groups were compared. Primary endpoints were tumor responses, including tumor necrosis rates after initial treatment, tumor responses at 6 months [per modified Response Evaluation Criteria in Solid Tumors (mRECIST)], and time to tumor progression (TTP). Secondary endpoints were overall survival (OS) and re-intervention times. RESULTS: After initial treatments, tumor necrosis rates were higher in the TACE-MWA group (n = 48; 92.1% [58/63]) than the TACE group (n = 96; 46.3% [56/121]; P < 0.001). At 6 months' follow-up, the TACE-MWA group had better tumor responses (CR + PR + SD [per mRECIST]: TACE-MWA, 95.8%; TACE, 64.5%; P < 0.001). The TACE-MWA group had better TTP (P < 0.001), but did not significantly differ in OS (P = 0.317). TACE-MWA decreased re-TACE times from 1.90 to 0.52; and re-MWA times from 0.22 to 0.17. In subgroup analysis, TACE-MWA also showed better TTP in patients with tumors ≤3 cm (P < 0.001) and 3-5 cm (P = 0.004). CONCLUSIONS: Compared with TACE, TACE-MWA leads to better responses for HCC tumors ≤5 cm.