He Li

Advances in the management of ovarian cancer liver metastasis

Abstract Liver metastasis represents a critical challenge in cancer progression, with particularly complex therapeutic implications. In ovarian cancer patients, ovarian cancer liver metastasis (OCLM) marks a distinct stage of disease progression that demands specialized diagnostic and therapeutic approaches. Despite its clinical significance, guidance for OCLM management remains notably absent in current clinical practice. This comprehensive review synthesizes recent advances in the management of OCLM, with special emphasis on a resectability‐based classification system.

Analysis of fertility-preserving treatment outcomes in patients with POLE-mutated endometrioid carcinoma

To explore the clinical outcomes of fertility-sparing treatment (FST) in patients with POLE-mutated endometrioid carcinoma (EEC). A total of 9 EEC patients who received FST and were classified to the POLE-mutated subtype in Peking University People's Hospital from April 2020 to October 2023, were retrospectively collected. Clinical and pathological data were analyzed to describe the outcomes of FST in patients with POLE-mutated EEC. A total of 9 patients with EEC including 6 cases with well-differentiated (G1) and 3 cases with moderately-differentiated (G2). The average age was 34.8±2.1 years. POLE mutation sites were P286R (5 cases), V411L (2 cases), L424I (1 cases), and S459F (1 cases), respectively. The median follow-up time was 16 months (9-41 months). The complete response (CR) rate was 88.9% (8/9), with a median time to CR of 5.5 months (3-18 months). The partial response (PR) rate was 11.1% (1/9). The relapse rate was 50.0% (4/8), with a median recurrence time of 9.5 months (5-25 months). Of these, 75% (3/4) underwent secondary FST, with all achieving CR again (3/3). Three of 5 who were out-of-indication patients achieved CR by individual therapy. FST in patients with POLE-mutated EEC achieve a CR rate of 88.9% in this study, the largest number of retrievable reports. In certain patients who are out-of-indication, individualized treatment may also result in remission. However, unlike surgical patients, some patients experience disease recurrence and whether POLE-mutated EEC is sensitive to conventional therapy in FST is controversial given its pathogenesis.

Predictive models for lymph node metastasis in endometrial cancer: A systematic review and bibliometric analysis

Background: Lymph node metastasis is associated with a poorer prognosis in endometrial cancer. Objective: The objective was to synthesize and critically appraise existing predictive models for lymph node metastasis risk stratification in endometrial cancer. Design: This study is a systematic review. Data Sources and Methods: We searched the Web of Science for articles reporting models predicting lymph node metastasis in endometrial cancer, with a systematic review and bibliometric analysis conducted based upon which. Risk of bias was assessed by the Prediction model Risk Of BiAS assessment Tool (PROBAST). Results: A total of 64 articles were included in the systematic review, published between 2010 and 2023. The most common articles were “development only.” Traditional clinicopathological parameters remained the mainstream in models, for example, serum tumor marker, myometrial invasion and tumor grade. Also, models based upon gene-signatures, radiomics and digital histopathological images exhibited an acceptable self-reported performance. The most frequently validated models were the Mayo criteria, which reached a negative predictive value of 97.1%–98.2%. Substantial variability and inconsistency were observed through PROBAST, indicating significant between-study heterogeneity. A further bibliometric analysis revealed a relatively weak link between authors and organizations on models predicting lymph node metastasis in endometrial cancer. Conclusion: A number of predictive models for lymph node metastasis in endometrial cancer have been developed. Although some exhibited promising performance as they demonstrated adequate to good discrimination, few models can currently be recommended for clinical practice due to lack of independent validation, high risk of bias and low consistency in measured predictors. Collaborations between authors, organizations and countries were weak. Model updating, external validation and collaborative research are urgently needed. Registration: None.

Adjuvant chemoradiotherapy versus chemotherapy alone in stage III endometrial cancer: A systematic review and meta‐analysis

AbstractObjectiveTo discuss the impact of chemoradiotherapy (CRT) on the survival of patients with stage III endometrial cancer (EC) compared with chemotherapy (CT) alone.MethodsArticles involving adjuvant CRT versus CT on survival in stage III EC were retrieved from PubMed and EMBASE. Hazard ratios (HRs) of overall survival (OS) and relapse‐free survival (RFS) were collected and pooled, and publication bias was measured by Begg's and Egger's test. Quality of researches was measured by the Newcastle–Ottawa scale and the modified Jadad scale.ResultsEleven were included in the statistical analysis. A significant advantage of CRT over CT on OS was shown (HR 0.59, 95% CI 0.49–0.70). Further subgroup analysis suggested the advantage was mostly associated with stage IIIC (HR 0.63, 95% CI 0.52, 0.76]). A similar result favoring CRT was also reached on RFS (HR 0.66, 95% CI 0.47–0.93). No significant publication bias was observed.ConclusionCRT was associated with a better OS and RFS than CT alone in stage III EC patients.

Chiral and Dual Drugs Combination Reduces Tumor-Associated Neutrophils-Induced T-Cell Immunoparalysis to Treat Epithelial Ovarian Cancer

In antitumor activities, baicalin and astragaloside IV inhibit tumor growth, induce cell death, and restrain metastasis in various cancers. Generally, a mixture of massive herbs like scutellaria or astragalus matches with other drugs to reach a curative effect in traditional Chinese prescription. Therefore, researchers aspire to an effective type of drug combination that shows promoted absorption and higher bioavailability in preclinical studies. Here, we report an optical method to detect chiral baicalin and astragaloside IV and also monitor the absorption of different chirals in ovarian cells. Eventually, R-Baicalin-Astragaloside IV dual drugs combination shows promoted absorption of each other compared with single chiral drugs or another. Based on the optical method results, we designed a series of in vitro and in vivo experiments to explain and analyze the mechanism of the curative effect. Therein, the result reveals that the tumor-associated neutrophils were reduced via the down-regulated TLR4/MYD88/NF-κB pathway to increased PD-1/PD-L1 immune response in epithelial ovarian cancer under the influence of R-Baicalin-Astragaloside IV. Thus, this work offers a comprehensive report on structure-activity relationships of chiral and dual drug strategies to improve its bioavailability in therapy of ovarian cancer.