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Background: In the era of immunotherapy, neoadjuvant immunochemotherapy (NAIC) for the treatment of locally advanced esophageal squamous cell carcinoma (ESCC) is used clinically but lacks of high-level clinical evidence. This study aimed to compare the safety and long-term efficacy of NAIC followed by minimally invasive esophagectomy (MIE) with those of neoadjuvant chemotherapy (NAC) followed by MIE., Methods: A prospective, single-center, open-label, randomized phase III clinical trial was conducted at Henan Cancer Hospital, Zhengzhou, China. Patients were randomly assigned to receive either neoadjuvant toripalimab (240 mg) plus paclitaxel (175 mg/m 2 ) + cisplatin (75 mg/m 2 ) (toripalimab group) or paclitaxel + cisplatin alone (chemotherapy group) every 3 weeks for 2 cycles. After surgery, the toripalimab group received toripalimab (240 mg every 3 weeks for up to 6 months). The primary endpoint was event-free survival (EFS). The pathological complete response (pCR) and overall survival (OS) were key secondary endpoints. Adverse events (AEs) and quality of life were also assessed., Results: Between May 15, 2020 and August 13, 2021, 252 ESCC patients ranging from T1N1-3M0 to T2-3N0-3M0 were enrolled for interim analysis, with 127 in the toripalimab group and 125 in the chemotherapy group. The 1-year EFS rate was 77.9% in the toripalimab group compared to 64.3% in the chemotherapy group (hazard ratio [HR] = 0.62; 95% confidence interval [CI] = 0.39 to 1.00; P = 0.05). The 1-year OS rates were 94.1% and 83.0% in the toripalimab and chemotherapy groups, respectively (HR = 0.48; 95% CI = 0.24 to 0.97; P = 0.037). The patients in the toripalimab group had a higher pCR rate (18.6% vs. 4.6%; P = 0.001). The rates of postoperative Clavien-Dindo grade IIIb or higher morbidity were 9.8% in the toripalimab group and 6.8% in the chemotherapy group, with no significant difference observed (P = 0.460). The rates of grade 3 or 4 treatment-related AEs did not differ between the two groups (12.5% versus 12.4%)., Conclusions: The interim results of this ongoing trial showed that in resectable ESCC, the addition of perioperative toripalimab to NAC is safe, may improve OS and might change the standard treatment in the future., (© 2024 The Author(s). Cancer Communications published by John Wiley & Sons Australia, Ltd on behalf of SUN YAT‐SEN UNIVERSITY CANCER CENTER.)

Background: Lung cancer is the leading cause of cancer-related mortality in the world. Circulating single-molecule amplification and resequencing technology (cSMART) can successfully detect epidermal growth factor receptor (EGFR) mutation in non-small cell lung cancer (NSCLC). However, few studies have investigated the association between clinical characteristics and the diagnostic accuracy of cSMART technique in lung adenocarcinoma., Methods: We enrolled 95 patients, which included paraffin embedded tumor tissues and matched plasma samples. Retrospectively analyzed the correlation between clinical characteristics and sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of cSMART., Results: Of the 95 lung adenocarcinoma cancer patients, 49 (51.5%) and 40 (42.1%) harbored EGFR mutations respectively in tissue and plasma. In younger than 60 years group, sensitivity, specificity and consistency for cSMART were 81.0%, 100%, and 90.9% (P<.001). In metastasis group, sensitivity, specificity, and consistency for cSMART were 92.9%, 77.8%, and 87.0% (P=.001). By univariate analysis, younger than 60 years (OR=5.938; 95% confidence interval: 1.835-19.210; P=.001); metastasis group (OR=4.482; 95% confidence interval: 1.432-14.024; P=.007) were significantly correlated with a higher accuracy. By multivariate analysis, younger than 60 years (P=.003) and metastasis (P=.004) were confirmed as independent factors for diagnostic accuracy of EGFR mutation in plasma through cSMART., Conclusion: cSMART is feasible for detection EGFR mutation in plasma when tissue is unavailable. Age and metastasis might be considered as independent factors in diagnostic accuracy of cSMART in lung adenocarcinoma., (© 2017 Wiley Periodicals, Inc.)

Breast cancer occurs earlier in Chinese women than in Caucasian women. We have compared the clinicopathologic characteristics and prognosis in very young and older premenopausal women with breast cancer in south China. We separated 905 consecutive premenopausal patients with first diagnosis of breast cancer, surgically treated at the Sun Yat-sen University Cancer Center from October 2003 to December 2006, into a very young group (189 [13.7%]; <35 years old) and an older group (716 [52.0%]; 35-57 years old). Approximately, 90% of patients received adjuvant chemotherapy and hormonal therapy with tamoxifen for hormone-receptor (HR)-positive breast cancer. We retrospectively compared the clinicopathologic factors and survival rates of these two groups. The 3-year disease-free survival rate (78.0% versus 89.1%, p < 0.001) was poorer in the very young group, and 3-year overall survival rate (94.3% versus. 96.8%, p = 0.10) was similar. Moreover, the 3-year overall survival rate (p = 0.020) and disease-free survival rate (p < 0.001) were significantly poorer in HR-positive patients in the very young group whereas there was no significant difference in outcomes between the HR-negative groups. In China, age younger than 35 years is an independent predictor of breast cancer recurrence. In very young women with HR-positive breast cancer, chemotherapy plus tamoxifen alone may not be adequate standard treatment., (© 2011 Wiley Periodicals, Inc.)