Comparison of survival outcomes between clinical trial participants and non-participants of patients with advanced non-small cell lung cancer: A retrospective cohort study

Background: Clinical trials for advanced non-small cell lung cancer (NSCLC) have been conducted extensively. However, the effect of participation in clinical trials on survival outcomes remains unclear. This study aimed to assess whether participation in clinical trials was an independent prognostic factor for survival in patients with advanced NSCLC. Methods: We analyzed the medical records of patients aged ≥18 years who were newly diagnosed with stage IIIB or IV NSCLC and received chemotherapy or immunotherapy from September 2016 to June 2020 in this retrospective cohort study. To reduce the impact of confounding factors, propensity score matching (PSM) was performed. The Kaplan-Meier method and log-rank test were used to calculate and compare the overall survival (OS) and progression-free survival (PFS) of the patients. Finally, Cox proportional hazards regression was employed to examine the correlation between clinical trial participation and survival outcomes. Results: The study enrolled 155 patients in total, of which 62 (40.0 %) patients participated in NSCLC clinical trials. PSM identified 50 pairs of patients in total. The median PFS and OS of clinical trial participants and non-participants were 17.2 vs. 13.9 months (p = 0.554) and 32.4 vs. 36.5 months (p = 0.968), respectively. According to the results of multivariate Cox proportional hazards regression analysis, clinical trial participation was not an independent prognostic factor for advanced NSCLC patients (HR: 0.89, 95 % CI: 0.50–1.61; p = 0.701). Conclusions: The clinical trial participants with advanced NSCLC displayed similar survival outcomes compared with the non-participating patients in this cohort

Machine learning predicts cancer-associated venous thromboembolism using clinically available variables in gastric cancer patients

Stomach cancer (GC) has one of the highest rates of thrombosis among cancers and can lead to considerable morbidity, mortality, and additional costs. However, to date, there is no suitable venous thromboembolism (VTE) prediction model for gastric cancer patients to predict risk. Therefore, there is an urgent need to establish a clinical prediction model for VTE in gastric cancer patients. We collected data on 3092 patients between January 1, 2018 and December 31, 2021. And after feature selection, 11 variables are reserved as predictors to build the model. Five machine learning (ML) algorithms are used to build different VTE predictive models. The accuracy, sensitivity, specificity, and AUC of these five models were compared with traditional logistic regression (LR) to recommend the best VTE prediction model. RF and XGB models have selected the essential characters in the model: Clinical stage, Blood Transfusion History, D-Dimer, AGE, and FDP. The model has an AUC of 0.825, an accuracy of 0.799, a sensitivity of 0.710, and a specificity of 0.802 in the validation set. The model has good performance and high application value in clinical practice, and can identify high-risk groups of gastric cancer patients and prevent venous thromboembolism

Dilational Properties of Novel Amphiphilic Dendrimers at Water–Air and Water–Heptane Interfaces

In this work, a series of novel amphiphilic dendrimers taking polyamidoamine dendrimer as the core with different hydrophobic tails QPAMC_m were synthesized and the dilational properties were studied as monolayers by dilational rheological measurements at the water–air and water–<i>n</i>-heptane interfaces to explore the nature of adsorption behaviors. The results showed that the maximum values of the dilational modulus seemed to have no obvious variation in a wide change of hydrophobic chain length at the surface. However, there was considerable variability in the tendency of the influence of bulk concentration on the dilational modulus at the two different interfaces. It was interestingly found that the diffusion-exchange process slowed down with the increase of alkyl chain length leading to more elastic nature of adsorption film, which was contrary to the tendencies of conventional single chain and gemini surfactants. It is reasonable to consider that, in the case of the molecule having short chain length such as QPAMC₈, the alkyl chains are too short to overlap across the headgroup, enable the intermolecular hydrophobic interaction to be predominant with increasing of surface concentration, which enhances the elasticity and shows the slowest diffusion-exchange process. Whereas, when the chain length increases to 12 or 16, the alkyl chains are long enough to act intramolecularly to form intracohesion conformation, which results in enhancing the diffusion-exchange process. In conclusion, the interfacial behaviors are dictated by the size ratio between the tail and headgroup. A reasonable model with respect to the molecular interaction was proposed on the basis of experimental data. The results of interfacial tension relaxation and dynamic light scattering (DLS) experiments, in accord with the proposed mechanism, also present the unusual tendency comparing to the traditional single or gemini surfactants

Association of immune checkpoint inhibitors therapy with arterial thromboembolic events in cancer patients: A retrospective cohort study

Abstract Background Immune checkpoint inhibitors (ICIs) have emerged as a standard treatment for various malignancies. However, research indicates blocking the immune checkpoint pathway may exacerbate atherosclerotic lesions. Objectives We aimed to investigate whether ICI therapy increases the risk of arterial thromboembolic events (ATEs). Methods A retrospective cohort study was conducted on patients with histologically confirmed cancer at our institution between 2018 and 2021, using the propensity score matching method. The primary endpoint was ATEs occurrence, comprising acute coronary syndrome, stroke/transient ischemic attack, and peripheral arterial thromboembolism. Subgroup analyses assessed whether the ICI treatment effect on ATEs varied over time by limiting the maximum follow‐up duration. Logistic regression analysis identified ATE risk factors in ICI‐treated patients. Results Overall, the ICI group (n = 2877) demonstrated an ATEs risk 2.01 times higher than the non‐ICI group (RR, 2.01 [95% CI (1.61–2.51)]; p < 0.001). Subgroup analysis revealed no significant increase in ATEs risk for ICI‐treated patients within 1 year (Limited to a max 9‐month follow‐up, p = 0.075). However, ATEs risk in the ICI group rose by 41% at 1 year (p = 0.010) and 97% at 4 years (p ≤ 0.001). Age, diabetes, hypertension, peripheral atherosclerosis, atrial fibrillation, chronic ischemic heart disease, distant cancer metastasis, and ICI treatment cycles contributed to ATEs risk elevation in ICI‐treated patients. Conclusion ICI‐treated patients may exhibit a higher risk of ATEs, especially after 1 year of treatment