Review of intelligent diagnosis methods for imaging gland cancer based on machine learning

Gland cancer is a high-incidence disease that endangers human health,and its early detection and treatment require efficient,accurate,and objective intelligent diagnosis methods.In recent years,the advent of machine learning techniques has yielded satisfactory results in intelligent gland cancer diagnosis based on clinical images,significantly improving the accuracy and efficiency of medical image interpretation while reducing the workload of doctors.The focus of this study is to review,classify,and analyze intelligent diagnosis methods for imaging gland cancer based on machine learning and deep learning.This paper briefly introduces some basic imaging principles of multimodal medical images,such as the commonly used computed tomography(CT),magnetic resonance imaging(MRI),ultrasound(US),positron emission tomography(PET),and pathology.In addition,the intelligent diagnosis methods for imaging gland cancer were further classified into supervised learning and weakly supervised learning.Supervised learning consists of traditional machine learning methods,such as K-nearest neighbor algorithm(KNN),support vector machine(SVM),and multilayer perceptron,and deep learning methods evolving from convolutional neural network(CNN).By contrast,weakly supervised learning can be further categorized into active learning,semisupervised learning,and transfer learning.State-of-the-art methods are illustrated with implementation details,including image segmentation,feature extraction,and optimization of classifiers.Their performances are evaluated through indicators,such as accuracy,precision,and sensitivity.In conclusion,the challenges and development trends of intelligent diagnosis methods for imaging gland cancer were addressed and discussed.

MRD-directed and risk-adapted individualized stratified treatment of AML

Measurable residual disease(MRD)has been widely recognized as a biomarker for deeply evaluating complete remission(CR),predicting relapse,guiding pre-emptive interventions,and serving as an endpoint surrogate for drug testing.However,despite the emergence of new technologies,there remains a lack of comprehensive understanding regarding the proper techniques,sample materials,and optimal time points for MRD assessment.In this review,we summarized the MRD methods,sample sources,and evaluation frequency according to the risk category of the European Leukemia Net(ELN)2022.Additionally,we emphasize the importance of properly utilizing and combining these technologies.We have also refined the flowchart outlining each time point for preemptive interventions and intervention paths.The evaluation of MRD in acute myeloid leukemia(AML)is sophisticated,clinically applicable,and technology-dependent,and necessitates standardized approaches and further research.

肺癌免疫检查点抑制剂的联合治疗研究进展

检查点抑制剂(immune checkpoint inhibitors, ICIs)治疗是目前最常用的免疫治疗方案,已被批准用于黑色素瘤、肾癌、头颈癌、膀胱癌等多种肿瘤的临床治疗,在肺癌治疗中更是取得突破性进展,成为肺癌综合治疗的新支柱。但由于肿瘤的异质性及肿瘤微环境的复杂性,ICIs单药在非选择患者中有效率偏低。手术、化疗、放疗、靶向治疗等治疗手段可与免疫治疗产生协同作用,联合疗法成为目前探索的热点。本文着重于免疫检查点抑制剂联合治疗策略的研究进展,并描述了免疫疗法如何被用于早期癌症的治疗。

Advances and challenges in immunotherapy of small cell lung cancer

Small cell lung cancer(SCLC) is a highly lethal disease, characterized by early metastasis and rapid growth, and no effective treatment after relapse. Etoposide-platinum(EP) combination has been the backbone therapy of SCLC over the past 30 years. It is extremely urgent and important to seek new therapies for SCLC. In the past 5 years,immunotherapy, such as immune checkpoint inhibitors programmed cell death protein-1(PD-1), cytotoxic T lymphocyte associatedprotein-4(CTLA-4), has made remarkable achievements in the treatment of patients with SCLC, and it has become the first-line option for the treatment of some patients. Some traditional chemotherapeutic drugs or targeted drugs, such as alkylating agent temozolomide and transcription inhibitor lurbinectedin, have been found to have immunomodulatory effects and are expected to become new immunotherapeutic agents. In this study, we aimed to review the efficacy of new treatments for SCLC and discuss the current challenges and application prospect in the treatment of SCLC patients.

Focused evaluation of the roles of macrophages in chimeric antigen receptor (CAR) T cell therapy associated cytokine release syndrome

Cytokine release syndrome(CRS)is a major obstacle to the widespread clinical application of chimeric antigen receptor(CAR)T cell therapies.CRS can also be induced by infections(such as SARS-CoV-2),drugs(such as therapeutic antibodies),and some autoimmune diseases.Myeloid-derived macrophages play key roles in the pathogenesis of CRS,and participate in the production and release of the core CRS cytokines,including interleukin(IL)-1,IL-6,and interferon-γ.In this review,we summarize the roles of macrophages in CRS and discuss new developments in macrophage activation and the related mechanisms of cytokine regulation in CRS.

Clinical challenges in neoadjuvant immunotherapy for non-small cell lung cancer

Immune checkpoint inhibitors(ICIs),a type of immunotherapy,have become one of the most important therapeutic options for first-and second-line treatment of advanced non-small cell lung cancer(NSCLC).Recent clinical studies have shown that immunotherapy can offer substantial survival benefits to patients with early-stage or resectable advanced NSCLC.However,considering the importance of timing when using ICIs and their associated adverse events(AEs),the advantages and disadvantages of using these agents need to be weighed carefully when deciding the use of a combined treatment.In addition,the inconsistency between imaging assessment and pathological results poses further challenges to the evaluation of efficacy of neoadjuvant immunotherapy.It is also important to develop new methodologies and discover suitable biomarkers that can be used to evaluate survival outcomes of immunotherapy and identify patients who would benefit the most from this treatment.In this review,we aimed to summarize previous results of ongoing clinical trials on neoadjuvant immunotherapy for lung cancer and discuss the challenges and future perspectives of this therapeutic approach in the treatment of resectable NSCLC.

Coexisting opportunities and challenges:In which scenarios can minimal/measurable residual disease play a role in advanced non-small cell lung cancer?

Curative therapy was not previously available for patients with advanced non-small cell lung cancer(NSCLC);thus,the concept of minimal/measurable(or molecular)residual disease(MRD)was not applicable to these patients.However,advances in targeted and immunotherapy have revolutionized the treatment landscape for patients with advanced NSCLC,with emerging evidence of long-term survival and even the hope of complete remission(CR)by imaging examination.The latest research shows that patients with oligometastatic lung cancer can benefit from local treatment.After removing the lesions,the choice of follow-up therapy and monitoring of the lesions could remain uncertain.MRD plays a role in identifying early-stage NSCLC patients with high risks of recurrence and determining adjuvant therapy after radical treatment.In recent years,evidence has been accumulating regarding the use of circulating cell-free tumor DNA(ctDNA)to assess MRD in solid tumors.This study discussed the possible applications of ctDNA-based MRD monitoring in advanced NSCLC and described the current challenges and unresolved problems in the application of MRD in advanced NSCLC.

Molecular classification of small cell lung cancer subtypes:Characteristics,prognostic factors,and clinical translation

Small cell lung cancer(SCLC)is a highly malignant tumor with a very poor prognosis;therefore,more effective treatments are urgently needed for patients afflicted with the disease.In recent years,emerging molecular classifications based on key transcription factors of SCLC have provided more information on the tumor pathophysiology,metastasis,immune microenvironment,and acquired therapeutic resistance and reflected the intertumoral heterogeneity of the various SCLC phenotypes.Additionally,advances in genomics and single-cell sequencing analysis have further revealed the high intratumoral heterogeneity and plasticity of the disease.Herein,we review and summarize these recent lines of evidence and discuss the possible pathogenesis of SCLC.

Epidermal growth factor receptor compound and concomitant mutations:advances in precision treatment strategies

Epidermal growth factor receptor(EGFR)mutations are common oncogenic driver mutations in patients with non-small cell lung cancer(NSCLC).The application of EGFR-tyrosine kinase inhibitors(TKIs)is beneficial for patients with advanced and early-stage NSCLC.With the development of next-generation sequencing technology,numerous patients have been found to have more than one genetic mutation in addition to a single EGFR mutation;however,the efficacy of conventional EGFR-TKIs and the optimal treatments for such patients remain largely unknown.Thus,we review the incidence,prognosis,and current treatment regimens of EGFR compound mutations and EGFR concomitant mutations to provide treatment recommendations and guidance for patients with these mutations.

Current landscape and challenges ahead of immuno-molecular mechanism and immunotherapy strategy of brain metastases

Brain metastases are the most common central nervous system malignancies in adults.The popular view is that due to the existence of the blood–brain barrier,whether there are immune cells in the central nervous system has always been controversial.Current research shows that immune cells do exist in the central nervous system and play a vital role in the occurrence and development of brain metastasis.The central nervous system has a unique immune microenvironment,and the study of its mechanism is of great significance for the prediction and treatment of brain metastases.This article aims to discuss the components of the brain tumor microenvironment(TME)and immune mechanism of tumor brain metastasis,in the hopes of making better treatment through combination therapy.