Abstract Background: Ovarian cancer (OC) still has the highest mortality rate of all gynecological malignancies, diagnosed mostly at advanced stages, resulting in a generally poor outcome. Radical tumor debulking, followed by platinum-based chemotherapy with/without bevacizumab and with/without PARP inhibitors is the standard of care in advanced OC. However, the majority of patients will ultimately relapse due to the development of platinum resistance. Efforts to apply immunotherapy has been less successful, however, immunologic processes play an important role in tumorigenesis and therapy response. Little is known about immune-marker, cytokine and chemokine expression in OC. In view of biomarker research to identify patients at high risk for relapse, we here determined cytokine/chemokine/immune-related marker levels in blood samples of primary, non-metastatic, high grade serous (HGS) OC patients before and after therapy to estimate their value with regard to progression-free survival (PFS), overall survival (OS) and platinum resistance. Patients and Methods: Plasma samples of 53 HGSOC patients were collected prior (n=53) and following platinum-based chemotherapy (n=27) with/without bevacizumab. Cytokine/chemokine/immune-related marker levels were quantified using the Olink Target 48 Cytokine panel and Immune Surveillance Panel (LuminoDx, San Diego, USA), which includes total 89 immune-related proteins and requires only one μL of sample. Results were correlated between cytokine/chemokine/immune related marker levels and PFS and OS using the Cox proportional hazards model and Log-rank test as well as platinum resistance applying the student`s t-test. Results: Associations between cytokine/chemokine/immune-related marker levels and patient outcomes were evaluated using Cox proportional hazards models. At baseline, lower IL19 levels and higher FASLG and CEACAM5 levels were significantly associated with an improved PFS (p<0.01). Lower IL17A, IL19, VEGFA, IL27 and higher FASLG levels were significantly associated with a longer OS (p<0.01). Decreases in FASLG and CEACAM5 levels over the course of treatment correlated with a longer PFS while increasing VEGFA levels were significantly associated with a longer OS. Additionally, high baseline IL19 and IL6 levels and low CXCL12 and IL18 levels were significantly associated with the development of platinum resistance (p<0.05). IL19 was the only marker demonstrating statistical significance (p<0.05) for both, PFS and platinum resistance. Conclusion: Here we demonstrate the potential value of cytokine, chemokine and immune-related marker plasma levels to better estimate PFS, OS as well as platinum resistance in HGSOC. These prognostic and predictive markers may be further developed into clinical assays to support patient management. Citation Format: Sabine Kasimir-Bauer, Buesra Eser, Yipeng Wang, Gordon Vansant, Stefanos I. Moukas, Rainer Kimmig, Fabinshy Thangarajah. Comprehensive cytokine, chemokine and immune marker evaluation in plasma samples of primary, non-metastatic high grade serous ovarian cancer patients to estimate outcome and platinum resistance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 6461.

The progression from ductal carcinoma in situ (DCIS) to invasive breast carcinoma (IBC) critically determines patient outcomes, yet its mechanisms remain incompletely understood. Integrating single-cell RNA sequencing, spatial transcriptomics, and genomics across 28 patients with synchronous DCIS and IBC, we delineate the spatial-molecular hierarchy of this transition. Invasion is primarily driven by clonal expansion of pre-existing DCIS subclones, emphasizing transcriptional reprogramming and tumor microenvironment (TME) remodeling over acquisition of additional driver alterations. IBC cells exhibit pronounced epithelial-mesenchymal transition and metabolic reprogramming. We uncover dynamic TME remodeling at the invasive front, identifying key ligand-receptor interactions (e.g., PPIA-BSG, MDK-LRP1, CXCL12-CXCR4) facilitating basement membrane disruption, angiogenesis and immunosuppression. Deconvolution of basement membrane breach reveals four molecularly defined stages (NMFT1-NMFT4) with progressively worsening patient survival. This study establishes a unified spatial-molecular atlas of DCIS-IBC progression, highlighting clonal expansion, transcriptional plasticity and TME remodeling as key drivers of invasion.

Background: Preoperative biopsy techniques, including fine needle aspiration (FNA), core needle biopsy (CNB), and surgical excision, are commonly employed in early-stage breast cancer. Our study aimed to assess the impact of these three biopsy techniques on prognosis and, importantly, for the first time, to explore the effect of surgical waiting time following biopsy on survival outcomes. Methods: In this study (ChiCTR2300075857), we retrospectively analyzed medical records from breast cancer patients who underwent FNA, CNB, or excision from 2009 to 2017 and were subsequently treated with standard surgical procedures. Overall survival (OS) and disease-free survival (DFS) were examined using Kaplan‒Meier analysis and Cox proportional hazards models. Findings: The study cohort consisted of 4465, 1305, and 950 patients who underwent FNA, CNB, and excision biopsies, respectively. The median waiting period between biopsy and surgery was 5 days (IQR 3-8) in the FNA group and 8 days (IQR 4-15) in the CNB group. The majority of excision biopsies took place on the same day as the standard surgical procedure. Univariate analysis showed that the excision group had better OS (HR=0.57, p<0.01) and DFS (HR=0.69, p<0.01) compared to the FNA and CNB groups. However, after adjustment using multivariate and propensity-score matching analyses, no significant differences in OS (p=0.16) or DFS (p=0.44) were observed between the groups. Furthermore, patients with a waiting period for surgery exceeding 14 days demonstrated worse DFS both in the FNA group (p=0.022) and the excision group (p=0.047). In the CNB group, a surgical waiting time exceeding 30 days led to worse DFS (p=0.015) and OS (p=0.034). Interpretation: Despite the different biopsy techniques, the prognoses of patients were similar. Notably, this is the first study to explore the impact of surgical waiting time, and our findings suggest that reducing the interval across all groups may improve survival outcomes. However, due to the retrospective design, there is an inevitable risk of information bias, which limits the robustness of the results to some extent. Thereby, well-designed prospective studies and randomized trials are required in the future to validate the conclusion. Fundings: This research was funded by the CAMS Innovation Fund for Medical Sciences (2021-I2M-1-014) and the Beijing Hope Run Special Fund of Cancer Foundation of China (LC2022A02).

Abstract Background: Inetetamab is a neotype HER2-targeted monoclonal antibody with amino acids modified Fc segment which optimizes the antibody-dependent cellular cytotoxicity effect. However, robust evidence evaluating the combination of inetetamab combined with pertuzumab, paclitaxel and carboplatin (TCbIP) for neoadjuvant therapy is still lacking. This study aimed to evaluate the efficacy and safety of TCbIP as a neoadjuvant therapy for patients with locally advanced HER2-positive breast cancer. We now present the updated results of this trial. Methods: This phase II trial included female patients with histologically confirmed stage IIA to IIIC HER2-positive primary invasive breast cancer. Eligible patients received TCbIP treatment every three weeks for a maximum of six cycles followed by surgery. The primary endpoint was pathologic complete response (pCR, ypT0/is ypN0) rate. Key secondary endpoints included near pCR (npCR, residual breast disease < 1cm) rate, objective response rate (ORR) and safety. Results: From November 2021 to July 2023, 40 patients were enrolled in the trial. One patient received one cycle of the study treatment but was lost to follow-up without surgery, and five patients received one cycle of the study treatment and were still undergoing treatment, leaving 34 patients in the intention-to-treat (ITT) population. Among these 34 patients (82.4% in stage III), 22 patients completed the study treatment and surgery (per-protocol [PP] population) and 12 patients were still undergoing neoadjuvant treatment. The ORR was 91.2% (31/34) in the ITT population and 86.4% (19/22) in the PP population. Among the 22 patients in the PP population, 12 patients (54.5%) achieved pCR, and18 patients (81.8%) achieved npCR. The pCR rates for patients with hormone receptor (HR) negative and positive tumors were 80.0% (8/10) and 33.3% (4/12), respectively. The most common grade 3 adverse event was neutropenia (17.6%). No significant reduction in the left ventricular ejection fraction was observed in any patient. Conclusions: Neoadjuvant therapy with TCbIP demonstrated promising efficacy and manageable toxicity in patients with HER2-positive locally advanced breast cancer. Registration number: NCT05749016 (www.clinicaltrials.gov). Citation Format: Yue Chai, Jiaxuan Liu, Mingxia Jiang, Maiyue He, Xin Wang, Yipeng Wang, Xue Yang, Jing Wang, Binghe Xu, Qiao Li. Updated Results of a Phase II Study: Neoadjuvant Inetetamab Combined with Pertuzumab, Paclitaxel and Carboplatin for Locally Advanced HER2-Positive Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-18-12.

Background Prompt treatment for breast cancer is a critical factor in healthcare provision. Preoperative biopsy techniques, namely, fine needle aspiration (FNA), core needle biopsy (CNB), and surgical excision, are usually employed. Our study aimed to assess the impacts of these three biopsies and, importantly, for the first time, to explore the effects of surgical wait time on early-stage breast cancer prognosis.Methods We retrospectively analyzed patients with unilateral early invasive ductal carcinoma who underwent FNA, CNB, or excision biopsies from 2009 to 2017 and were subsequently treated with standard surgical procedures. We recorded various clinical characteristics, histopathological features, and waiting time for surgery. Survival outcomes were examined using Kaplan‒Meier analysis and the Cox proportional hazards model.Findings Our cohort comprised 4465, 1305, and 950 patients who underwent FNA, CNB, and excision biopsies, respectively. The median waiting period between biopsy and surgery was 5 days for the FNA group and 8 days for the CNB group. The majority of excision biopsies took place on the same day as the standard surgical procedure. Univariate analysis showed that the excision group had better overall survival (OS) (HR=0.57, p<0.01) and disease-free survival (DFS) (HR=0.69, p<0.01) than the FNA and CNB groups. However, multivariate and propensity-score matching analyses revealed no significant differences in prognosis between the groups. Furthermore, in the FNA and excision groups, patients with a waiting period for surgery exceeding 14 days demonstrated a worse DFS. In the CNB group, a surgical waiting time beyond 30 days led to worse DFS and OS.Interpretation Despite the differences in biopsy methods, patients exhibited similar prognoses. However, the surgical waiting time was shorter in the FNA group than in the CNB group. Notably, a reduction in the waiting period for surgery across all groups potentially improved patient survival.Funding This research was funded in part by the CAMS Innovation Fund for Medical Sciences (2021-I2M-1-014 to Y.W.) and the Beijing Hope Run Special Fund of Cancer Foundation of China (LC2020B15 to G.L. and LC2022A02 to Y.W.).Conflict of Interest: The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.Ethical Approval: The Ethical Committee granted approval for this study. The work has been reported in line with the STROCSS criteria.

e12602 Background: Triple negative breast cancer (TNBC) has the traits of early onset, high malignancy and no effective molecular targets to act on, neoadjuvant chemotherapy is recommended as the preferred treatment for locally advanced TNBC with highly recurrence risk. The addition of platinum-based agents to conventional taxanes regimens in locally advanced TNBC can significantly improve pathological complete response (pCR) rate. Anti-angiogenic drugs are currently one of the few targeted therapies that have achieved efficacy in TNBC. Apatinib, an inhibitor of VEGFR2, shows significant antitumor activity in the patients with breast cancer. Methods: Pathologically confirmed TNBC patients with clinical stage I-IIIC (per AJCC 8th ed) with no previous surgery or radio-chemotherapy treatment were enrolled in our center from September 2018 to June 2020. Enrolled patients received 4-8 neoadjuvant treatment cycles of apatinib 250mg per day + paclitaxel 175mg/m2 d1 + carboplatin AUC = 4 d2 q14d (Apa+TC), followed by sequential surgery. Enrolled patients who underwent surgery were matched with TNBC patients received paclitaxel and carboplatin intense regimen (TC) contemporarily in our center by propensity score matching (PSM). pCR in breast and axilla (ie. ypT0/Tis ypN0) was the primary endpoint. Objective response rate (ORR), disease control rate (DCR), event-free survival (EFS), overall survival (OS) and adverse events (AEs) are secondary endpoints. Results: 25 locally advanced TNBC patients were enrolled for neoadjuvant therapy of Apa+TC. In radiological evaluation, 2 patients achieved CR, 20 patients achieved PR, 3 patients achieved SD, which indicated an ORR of 88% and a DCR of 100%. 23 of 25 enrolled patients underwent surgery, with a pCR rate of 60.87% (95%CI: 38.54%-80.29%). 69 patients who were treated by TC before surgery were matched by PSM based on baseline stage T and stage N features. A significant higher pCR rate was achieved in Apa+TC arm compared with TC alone (60.87% vs. 30.43%, respectively, P = 0.009). Similar incidence of AEs was observed between two arms. The main AEs were hematologic toxicities fatigue, digestive canal symptoms, transaminase elevation and peripheral neurotoxicity in Apa+TC arm. Grade III-IV AEs included granulocytopia (14/25), thrombocytopenia (4/25), anaemia (3/25), fatigue (1/25), hypertension (1/25) and arrhythmia (1/25). Meanwhile, apatinib-related AEs, including hypertension, proteinuria, and hand-and-foot syndrome, were mild. Due to the limited time, the survival follow-up is still in progress. Conclusions: Apatinib combined with paclitaxel and carboplatin intensive regimen achieved a better efficacy and manageable adverse events in neoadjuvant chemotherapy for locally advanced TNBC, which might be a promising strategy in the treatment of locally advanced TNBC. Clinical trial information: NCT03735082.

BackgroundThe utilization of neoadjuvant chemotherapy (NAC) originated in the treatment of locally advanced breast cancer (BC). Our study is designed to elucidate the effects of NAC on patients with T1N0M0 triple-negative and HER-2 positive BC.MethodsThis study involved the selection of 10,614 patients diagnosed with T1N0M0 triple-negative and HER-2 positive Breast Cancer (BC) from the Surveillance, Epidemiology, and End Results (SEER) database. To ascertain the impact of Neoadjuvant Chemotherapy (NAC) on T1a, T1b, and T1c N0M0 BC, we conducted multivariate Cox regression analyses. Similarly, we performed multivariate Cox regression analyses to compare the effects of neoadjuvant chemotherapy against adjuvant chemotherapy on T1N0M0 BC. The Kaplan-Meier method was employed to delineate survival curves for different molecular subtypes and clinical stages.ResultsThe data results from the SEER database reveal a significant enhancement of overall survival (OS) in T1c BC patients as a result of NAC. For T1b BC patients, NAC does not present any significant effect. Contrarily, NAC seems to adversely impact the OS of T1a triple-negative BC patients. However, the prognosis comparison between neoadjuvant and adjuvant chemotherapy for T1N0M0 breast cancer did not show any significant difference, with the exception of T1a triple-negative BC.ConclusionsPatients with T1cN0M0 triple-negative and HER-2 positive BC may derive OS benefits from NAC. Additionally, NAC could be detrimental to T1a triple-negative BC.

Background The prognostic impact of HER2-low on overall survival (OS) and disease-free survival (DFS) in patients with resectable breast cancer (BC) remains controversial, partly resulting from the hormone receptor (HR) status. Objective To investigate the prognostic impact of HER2-low in different HR subgroups. Patients and Methods We retrospectively retrieved medical records of treatment-naive primary HER2-low and HER2-zero BC patients who were diagnosed with invasive ductal carcinoma and underwent surgery in the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2009 to September 2017 ( n = 7371). We compared the clinicopathologic features and performed Cox regression and landmark survival analyses to explore the prognostic impact of HER2-low on survival outcomes during distinct post-surgery intervals—36 months, 60 months, and 120 months. Results HER2-low BC, compared to HER2-zero BC, exhibited less aggressive clinicopathologic features, such as smaller invasion size, lower grade, increased nerve invasion, higher HR positivity, and a higher proportion of low-Ki67 cases. In the HR-positive subgroup, HER2-low demonstrated improved OS ( p = 0.046) and DFS ( p = 0.026) within 60 months. Conversely, HER2-low displayed worse DFS ( p = 0.046) in the HR-negative subgroup after 36 months from surgery. The findings remained robust in uni- and multi-variable Cox models. Conclusions HER2-low BCs manifested less aggressive clinicopathologic features than the HER2-zero cases. The prognostic impact of HER2-low in resectable BCs exhibits variability contingent upon the patients’ HR status.

Background The recommended transfusion threshold for surgical oncology patients remains unclear owing to insufficient evidence from randomized controlled trials. Evidence from observational studies has been questioned because of huge patient heterogeneity. We aimed to assess the safety of restrictive transfusion at a minimum tolerable haemoglobin threshold for surgical oncology patients with observational data using a tailored design and analysis. Methods Data were collected from four representative regional hospitals in China during 2015 − 2016. Surgical inpatients with seven types of cancer (total cancers) comprised 6055 participants as the base population. In our design, we (1) derived a primary analytic sample by the interested zone of transfusion decision: 6–10 g/dL; (2) selected the control group according to trigger haemoglobin threshold; (3) evaluated the patient heterogeneity between the transfused and non-transfused groups with key covariates according to standardized mean difference (SMD) values. Analysis is mainly based on two datasets: The base population to obtain a natural pattern of transfusion practice; and the primary analytic sample to evaluate the safety of a restrictive transfusion strategy. Results In the base population, 836 (13.81%) were transfused and showed high heterogeneity compared with non-transfused patients (SMD: 7.1–71.31%); there was a significant positive association between transfusion and the composite outcome (in-hospital complications and death) (P < 0.05). In the primary analytic sample, patient heterogeneity was greatly reduced (all SMD ≤ 10%). Compared with non-transfusion, transfusion no longer increased the risk of the composite outcome for total cancers at haemoglobin 6–10 g/dL (odds ratio [OR]: 1.18, 95% confidence interval [CI]: 0.71–1.98), especially for colorectal cancer at 6 − 8 g/dL (OR: 0.54, 95% CI: 0.17–1.68). Compared with those transfused at haemoglobin 8–10 g/dL, patients transfused at 6–8 g/dL did not increase the risk of the composite outcome for total cancers (OR: 1.08, 95% CI: 0.44–2.65), especially for colorectal cancer (OR: 0.46, 95% CI: 0.12–1.82). Conclusions A restrictive transfusion threshold of 8 g/dL may be feasible for total cancers, with a threshold as low as 6 g/dL for colorectal cancer. Restrictive transfusion evidence can be complemented with observational data using a tailored design and analysis.

Purpose Overexpression of polycomb repressive complex 2 (PRC2) is commonly expressed in various malignancies, often correlating with unfavorable prognoses and indicating its potential as a therapeutic target.This study aimed to elucidate the comprehensive role of PRC2, especially in the context of breast cancer (BRCA), examining its association with the cell cycle and its implications within the tumor immune microenvironment. Methods Utilizing a comprehensive approach, we evaluated the levels of the primary components of PRC2, composed of EZH2, SUZ12, and EED. By employing Gene Set Enrichment Analysis (GSEA), we integrated these expression profiles. We introduced a cumulative representation known as the PRC2 complex score to assess the collective impact of these proteins in BRCA. Results Analysis revealed a pronounced increase in PRC2 expression in BRCA tissues compared to their normal counterparts. Intriguingly, this heightened expression was not uniform across all BRCA subtypes, hinting at subtype-specific or regulatory patterns for PRC2. Additionally, a pivotal role for the PRC2 complex in cell cycle advancement was observed, suggesting its involvement in promoting cell proliferation. A noteworthy association was also discerned between the PRC2 complex and immune cell dynamics, highlighting its potential in shaping the immunological landscape within BRCA. Conclusion Our findings underscore the potential of the PRC2 complex as a pivotal biomarker in the progression of BRCA. The intricate role it plays in the tumor immune microenvironment, particularly its influence on Th2 cell regulation, opens new avenues for targeted therapeutic strategies.

Breast cancer (BC) constitutes one of the most pervasive malignancies affecting the female population. Despite progressive improvements in diagnostic and therapeutic technologies, leading to an increased detection of early stage BCs, locally advanced breast cancer (LABC) persists as a significant clinical challenge. Owing to its poor overall survival (OS) rate, elevated recurrence rate, and high potential for distant metastasis, LABC prominently impacts the comprehensive efficacy of BC treatments. Radiotherapy, encompassing preoperative, intraoperative, and postoperative modalities, is acknowledged as an effective strategy for mitigating BC metastasis and enhancing survival rates among patients. Nevertheless, the domain of preoperative neoadjuvant radiotherapy (NART) remains conspicuously underexplored in clinical studies. Available research suggests that NART can induce tumor volume reduction, provoke fibrotic changes in tumor and adjacent normal tissues, thereby mitigating intraoperative cancer propagation and enhancing the quality of life for LABC patients. This manuscript seeks to provide a review of contemporary research pertaining to LABC and its preoperative radiotherapy.

Abstract Background Inetetamab is the first domestically developed innovative anti-HER2 monoclonal antibody in China, proven effective and safe in HER2-positive advanced breast cancer. However, its efficacy and safety in neoadjuvant treatment of HER2-positive locally advanced breast cancer (LABC) remain to be validated. Methods This prospective cohort study aimed to evaluate the efficacy and safety of inetetamab combined with pertuzumab, taxanes, and carboplatin (TCbIP) in neoadjuvant therapy for HER2-positive LABC, comparing it to data from patients treated with the TCbHP regimen (trastuzumab combined with pertuzumab, taxanes, and carboplatin) using propensity score matching (PSM). The primary endpoint was total pathological complete response (tpCR). Adverse events (AEs), objective response rate (ORR), and near-pCR were key secondary endpoints. Results Forty-four patients with clinical stage IIA-IIIC HER2-positive LABC were prospectively enrolled and treated with the TCbIP regimen. The tpCR rate among 28 patients who completed surgery was 60.7%, comparable to and slightly higher than the TCbHP group in PSM (60.7% vs. 53.6%, P = 0.510). The ORR was 96.4%, and the DCR reached 100.0%. The most common ≥ grade 3 AE was neutropenia (21.4% vs. 11.9%, P = 0.350). No significant reduction in left ventricular ejection fraction was observed, and no patient withdrew from treatment due to AEs. Conclusion Neoadjuvant therapy with TCbIP showed good efficacy and safety in patients with HER2-positive LABC and might be another promising option for neoadjuvant treatment. Trial registration NCT05749016 (registration date: Nov 01, 2021).

e12609 Background: Inetetamab is an Fc segment-modified innovative anti-HER2 monoclonal antibody. It has been proven to be effective and safe in HER2-positive advanced breast cancer. However, its efficacy and safety in the neoadjuvant treatment of HER2-positive locally advanced breast cancer (LABC) remains to be validated. This study aimed to evaluate the efficacy and safety of Inetetamab-based neoadjuvant therapy (TCbIP). Methods: In this prospective cohort study, we investigated the efficacy and safety of TCbIP in neoadjuvant therapy for HER2-positive LABC, and compared with TCbHP regimen (trastuzumab combined with pertuzumab, paclitaxel, and carboplatin) with propensity score matching (PSM). Thirty-four patients (clinical stage IIA-IIIC, HER2-positive LABC) were prospectively enrolled in this study and treated with the TCbIP regimen. The primary endpoint was total pathological complete response (tpCR). Adverse events (AEs), objective response rate (ORR), and near-pCR were key secondary endpoints. Results: The pCR rate of 28 patients who finished surgery was 60.7%, and was comparable and slightly higher (60.7% vs. 53.6%, P = 0.510) than the TCbHP group in PSM. The ORR was 96.4% and DCR reached 100.0%. The most common ≥grade 3 AE was neutropenia (21.4% vs. 11.9%, P = 0.350). No significant reduction in left ventricular ejection fraction was observed, and no patient withdrew from treatment due to AEs. Conclusions: Neoadjuvant therapy with TCbIP resulted in good efficacy and safety in patients with HER2-positive LABC, and might be another promising option for neoadjuvant treatment. Clinical trial information: NCT05749016 .

Objective The aim of this study was to disseminate insights from a nationwide pilot of the International Classification of Diseases-11th revision (ICD-11).Materials and methods The strategies and methodologies employed to implement the ICD-11 morbidity coding in 59 hospitals in China are described. The key considerations for the ICD-11 implementation were summarized based on feedback obtained from the pilot hospitals. Coding accuracy and Krippendorff's alpha reliability were computed based on the coding results in the ICD-11 exam.Results Among the 59 pilot hospitals, 58 integrated ICD-11 Coding Software into their health information management systems and 56 implemented the ICD-11 in morbidity coding, resulting in 3 723 959 diagnoses for 873 425 patients being coded over a 2-month pilot coding phase. The key considerations in the transition to the ICD-11 in morbidity coding encompassed the enrichment of ICD-11 content, refinement of tools, provision of systematic and tailored training, improvement of clinical documentation, promotion of downstream data utilization, and the establishment of a national process and mechanism for implementation. The overall coding accuracy was 82.9% when considering the entire coding field (including postcoordination) and 92.2% when only one stem code was considered. Krippendorff's alpha was 0.792 (95% CI, 0.788-0.796) and 0.799 (95% CI, 0.795-0.803) with and without consideration of the code sequence, respectively.Conclusion This nationwide pilot study has enhanced national technical readiness for the ICD-11 implementation in morbidity, elucidating key factors warranting careful consideration in future endeavors. The good accuracy and intercoder reliability of the ICD-11 coding achieved following a brief training program underscore the potential for the ICD-11 to reduce training costs and provide high-quality health data. Experiences and lessons learned from this study have contributed to WHO's work on the ICD-11 and can inform other countries when formulating their transition plan.

Background: This single-center retrospective study compared the efficacy of breast-conserving therapy along with axillary lymph node dissection (ALND) with mastectomy and ALND with regard to survival of Chinese patients with occult breast cancer. Materials & methods: Univariate Kaplan-Meier analysis and multivariate Cox proportional hazards model were used to compare treatments and prognosis. Results: A total of 111 patients with a median follow-up of 72.9 months were included. Thirty-nine patients with mastectomy + ALND had better disease-free survival than 72 patients with breast-conserving therapy + ALND (HR = 0.31; p = 0.012). Patients with radiotherapy demonstrated inferior survival for both overall survival (HR = 2.67; p = 0.071) and disease-free survival (HR = 5.35; p = 0.002). Surgical strategies and radiotherapy remained significantly predictive of better disease-free survival in multivariate analyses. Conclusion: Mastectomy and ALND demonstrate superior disease-free prognosis compared with breast-conserving therapy and ALND in occult breast cancer. Li et al. have conducted a single-center retrospective study in China, finding that mastectomy and axillary lymph node dissection offer superior disease-free prognosis compared with breast-conserving therapy and axillary lymph node dissection.

The risk of subsequent cerebrovascular disease among cancer patients of multiple cancers in the US is not well understood. A total of 3,843,261 cancer patients diagnosed from 1975 to 2018, were included from the surveillance, epidemiology, and end results (SEER) database. Standardized mortality ratios (SMRs) and absolute excess risks (AERs) were estimated. The overall cerebrovascular disease SMR was 1.04 (95% CI, 1.03-1.04), and the AER per 10,000 person-years at risk was 0.89. When compared with the US general population, greater cerebrovascular disease risk was correlated with certain cancer sites, American Indian/Alaska Native race, Asian or Pacific Islander race, unmarried marital status, distant metastasis, younger age, and an earlier time of cancer diagnosis. Clinically, more precision and proactive strategies for cerebrovascular disease prevention are required to subgroup of cancer patients with a greater risk of cerebrovascular disease, especially within the first two months.

ImportanceBreast cancer (BC) remains a pervasive malignant neoplasm worldwide, with increasing incidence. However, there are a scarcity of studies examining the clinical characteristics and prognosis of Chinese patients with BC who have undergone surgery.ObjectiveTo evaluate overall survival (OS) and disease-free survival (DFS) in patients with surgically treated BC in China, focusing on histopathology and surgical approach.Design, Setting, and ParticipantsThis cohort study included a retrospective review of the medical records of patients with unilateral BC who underwent surgery between January 2009 and September 2017, with a median follow-up time of 7.69 years. Clinical features were extracted from these records, and survival analysis was performed. Data analysis was conducted in March 2023.Main Outcomes and MeasuresPatients’ OS and DFS.ResultsThe study included 14 782 patients (14 724 [99.6%] female patients; mean [SD] age, 51.6 [10.9] years). Invasive ductal carcinoma (IDC) was the most prevalent type, observed in 12 671 patients (85.6%). Stages 0, I, II, III, and IV accounted for 6.4% (919 patients), 32.0% (4579 patients), 40.5% (5791 patients), 20.2% (2896 patients), and 0.9% (126 patients) of cases, respectively. Hormone receptor (HR) positivity was observed in 10 241 patients (75.1%), and 3665 (29.1%) tested positive for ERBB2 (formerly HER2/neu). The HR-negative–ERBB2-negative, HR-negative–ERBB2-positive, HR-positive–ERBB2-negative, and HR-positive–ERBB2-positive subtypes constituted 13.3% (1666 patients), 12.7% (1595 patients), 57.8% (7251 patients), and 16.2% (2034 patients) of cases, respectively. Breast-conserving surgery (BCS) was performed in 2884 patients (19.5%). The 5-year and 10-year OS rates were 92.9% (13 689 of 14 732) and 87.4% (3287 of 3760), while the 5-year and 10-year DFS rates were 89.0% (12 916 of 14 512) and 82.9% (3078 of 3713), respectively. Multivariate analysis found that for patients with IDC, age, BCS, invasive tumor size, tumor grade, lymphovascular invasion (LVI), the number of lymph node metastases (LNMs), distant metastasis, Ki67, and HR status were associated with OS, whereas invasive tumor size, tumor grade, LVI, the number of LNMs, HR status, and ERBB2 status were associated with DFS. After propensity score matching, BCS was equivalent to mastectomy with respect to survival in patients with IDC.Conclusions and RelevanceThis cohort study of patients with BC who underwent surgery in China provides valuable insights into the histopathological characteristics and survival outcomes of this population. The diverse histopathological features emphasize the necessity for customized treatment strategies. The relatively low BCS rate in the study population suggests the need for heightened awareness and adoption of this approach, considering its potential advantages for survival.

IMPORTANCEAtopic dermatitis (AD) accounts for a large proportion of the burden of skin disease with a prevalence of around 10% among adults worldwide. In addition, systematic reviews and meta-analyses have found that AD is associated with cancer risk at several sites, if found to be causal this could highlight potential treatment targets to reduce cancer risk.OBJECTIVETo assess the potential causative link between AD and 14 site-specific cancers in a two-sample Mendelian randomization study.EXPOSUREAtopic dermatitisDESIGN, SETTING, AND PARTICIPANTSFrom the largest genome-wide association study (GWAS) of AD (10,788 cases and 30,047 non-cases), genetic variants highly associated (P < 5E-08) with AD in European population were selected as instrumental variables (IVs). Data from large cancer consortia, as well as the UK Biobank study(n=442,239) and the FinnGen study (n=218,792) were employed to assess genetic associations with 14 site-specific cancers and overall cancer. A set of complementary approaches and sensitivity analyses were carried out to examine the robustness of our results. In addition, associations for the same cancer site from different data sources were combined using meta-analyses.RESULTSWe discovered no strong causal evidence of AD on the risk of overall cancer, with effect estimates close to zero. After Benjamini–Hochberg correction, the inverse weighted method indicated no association of AD on overall cancer risk in both the UK biobank (OR, 1.00; 95%CI, 0.94-1.06; FDR, 0.98) and FinnGen studies (OR, 0.96; 95%CI, 0.92, 1.02; FDR, 0.68). No strong evidence of association was found between genetically predicted AD and the risk of any other site-specific cancers.CONCLUSIONS AND RELEVANCEOur MR investigation does not support a causal effect of AD on cancer risk. This finding has important implications for the prevention and management of both AD and cancer, as it reduces the concern of potential adverse effects of AD on cancer outcomes.

Abstract Introduction: Serving as the key intermediate in metabolic pathways, acyl-CoA is coordinated by various acyl-CoA binding domain containing proteins (ACBDs). ACBD6 is a crucial member of the ACBD family, and previous studies have indicated its potential in tumorigenesis and cancer progress. However, the clinical relevance of ACBD6 in breast cancer is still elusive. The objective of this study is to investigate the association between ACBD6 expression and other clinicopathological features of breast cancer, furtherly explore its specific role in metabolism and prognostic value. Methods: We retrospectively analyzed 90 patients and used immunohistochemical staining to determine their ACBD6 statuses. Web platforms are also used to analyze ACBD6. Results: Results showed that patients with high ACBD6 expression tend to be older, more likely to be progesterone receptor negative, and more often classified into triple-negative breast cancer. Web platforms such as LinkedOmics and BCIP uniformly confirm that ACBD6 level is elevated in breast cancerous tissues. Higher expression of ACBD6 is associated with more aggressive clinicopathological features, as well as worse prognosis. Conclusions: ACBD6 assists with N-myristoyltransferase enzymes to functionally support glycine myristoylation, and interacts with lysophospholipid-acyltransferase enzymes, protecting the integrity of membrane lipid bilayer from the destructive nature of acyl-CoA. Also, ACBD6 could influence hematopoiesis and vascular endothelium development. Despite precise cognition remains scarce, ACBD6 multi-functionally works in the occurrence and metabolic reprogramming of breast cancer. Further researches are deserved to elucidate the biological mechanisms, prognostic and therapeutic value of ACBD6.