Background: High expression levels of cluster of differentiation 47 (CD47) have been recognized as poor survival in several different cancers. Nevertheless, the significance of CD47 in patients with solid tumors remains controversial. Methods: This meta‑analysis was based on a search of PubMed, Embase and Web of Science databases to obtain 22 eligible published studies (totaling 4,204 patients) between January 2018 and January 2024. The combined hazard ratios (HRs) for overall survival (OS) were evaluated, and the HRs for relapse‑free survival (RFS), progression‑free survival (PFS), and disease‑free survival (DFS), as well as odds ratios for clinicopathological data, were also respectively combined. Results: The data obtained from these studies were extracted from these published studies and analyzed. This study suggested that CD47 overexpression was related to shorter OS times in human solid tumors, with a combined HR for OS (according to the univariate analysis) of HR=1.60 [95% confidence intervals (95% CI): 1.43‑1.79; P<0.00001], and a pooled HR for OS (according to the multivariate analysis) of HR=2.02 (95% CI: 1.43‑2.84; P<0.0001). The subgroup analysis revealed that CD47 overexpression was related with inferior OS rates according to country, cancer type, sample size, analysis type and the method via which the HR value was obtained (i.e., reported or extracted; P<0.05); in addition, a high expression level of CD47 was also a predictor of poor DFS, PFS and RFS rates (P<0.00001). Certain factors, such as lymph node metastasis, TNM staging, differentiation type, tumor recurrence and tobacco exposure, resulted in an upregulation of CD47 (P<0.05). Conclusion: CD47 overexpression was found to be significantly related with an advanced clinical stage, poor differentiation types and tobacco exposure, and may serve as a valuable biomarker for predicting worse prognosis in human solid tumors.

The incidence of melanoma among young adults has risen, yet mortality has declined annually since the introduction of immune checkpoint inhibitors (ICI). The utilization of peri-operative ICI has significantly altered the treatment landscape in melanoma, with PD-1 inhibitors showing promising efficacy in improving relapse-free survival rates in high-risk stage II-III disease. With the increasing use of ICI, secondary concerns have emerged regarding the impact of cancer drugs on fertility and reproductive health among child-bearing women, especially in early-stage cancer settings. The exclusion of pregnant women from trials contributes to limited human data and clinical uncertainties, such as maternal and fetal toxicities related to ICI exposure during pregnancy, as well as the value of fertility preservation prior to ICI therapy. Additionally, uncertainty persists regarding pregnancy planning after immunotherapy in an adjuvant setting, given the potential detrimental effects of hormonal and immunological changes during pregnancy on melanoma relapse. These considerations raise questions about whether pregnancy-associated melanoma (PAM) represents a distinct disease entity that warrants tailored management compared to non-pregnant cases.

Purpose: Although the presence of Kirsten rat sarcoma virus (KRAS) mutations predicts of a lack of benefit from epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) therapy for none small cell cancer (NSCLC), it may be more sensitive to programmed combination therapy with cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors + anti-angiogenesis. Recent treatment guidelines and clinical studies related to adenocarcinoma in NSCLC have indicated that in patients with inoperable stage IV lung adenocarcinoma, immune checkpoint inhibitors in combination with anti-angiogenic drugs may exert a synergistic effect and significantly improve the efficacy of near-term treatment, but quantification and long-term follow-up of specific clinical indicators are still lacking. No previous cases of long-term good results with camrelizumab combined with anti-angiogenic agents for KRAS-mutated NSCLC have been described. Methods: This manuscript reports a case where patients with advanced NSCLC with pleural effusion and KRAS mutations treated poorly with conventional chemotherapy had long-term (more than 18 months) benefit with immunotherapy combined with an anti-angiogenic inhibitor. In this case, pharmaceutical care of the patient was carried out through therapeutic drug adjustment, compliance, efficacy assessment, and safety evaluation to provide a reference for improving the efficacy and safety of drug therapy in clinical practice. Results: As of the last follow-up date (December 2023), overall survival was 27 months and the patient is currently in good general condition with no significant complaints of discomfort. Conclusion: ICLs in combination with antiangiogenic therapy may be a therapeutic option for patients with KRAS mutations in advanced non-small cell lung cancer with good persistence.

Background：Clinical laboratory data, indicative of tumor cell growth and metabolic activity, warrants investigation for its potential in predicting lung cancer metastasis. Aims: The purpose is to develop a predictive model for regional lymph node involvement and skip metastasis in lung cancer using machine learning methods and integrating clinical laboratory information and patient characteristics. Methods: Data from lung cancer patients at Chongqing University Fuling Hospital between January 2020 and December 2022 were analyzed retrospectively. Patients were divided into N (regional lymph node involvement prediction) and M (skip metastasis prediction) groups based on TNM staging criteria. Prognostic factors were determined through univariate analysis and LASSO regression, and machine learning algorithms were used to develop predictive models. Results: Out of a total of 1629 cases analyzed, 861 were in the N group and 519 were in the M group. Univariate analysis revealed 40 parameters that were significantly different between the two groups (p < 0.05) and 27 parameters, respectively. LASSO regression identified 13 characteristic factors for the N group and 12 for the M group. In the N group, these factors included tumor size, prothrombin time (PT), mean platelet volume, fibrinogen, platelet count, procalcitonin, carbohydrate antigen 15-3 (CA 15-3), carcinoembryonic antigen (CEA), adenosine deaminase, red blood cell distribution width, thrombin time, smoking and drinking history. In the M group, the factors were cytokeratin 19 fragment, tumor size, CEA, CA 15-3, squamous cell carcinoma-related antigen, alkaline phosphatase, fibrinogen, hemoglobin, calcium, albumin, PT, and absolute monocyte value. The test set results indicated that the Logistic regression model was optimal for both groups, achieving AUCs of 0.888 and 0.875, respectively. Conclusion: This study demonstrates the potential of using machine learning algorithms alongside clinical characteristics and laboratory data to predict regional lymph node involvement and skip metastasis in lung cancer.

Background Cancer-associated depression is a multifaceted condition that arises from the interplay of biological, psychological, and social factors in individuals diagnosed with cancer. Understanding the background of this condition involves exploring how cancer and its treatments can precipitate depressive symptoms and the mechanisms behind this association. Objective To describe and synthesize information on the complicated interactions between chronic stress, inflammation, immunological responses, and cancer development. To review the existing evidence regarding mechanisms that may include neurotransmitter imbalances, structural brain changes, and genetic predispositions as key contributors to depression in cancer. Methods Literature searches on Cancer-associated Depression were conducted in electronic databases like APA PsycINFO, Medline, Google Scholar, Embase, PubMed, Scopus, and Web of Science to understand the potential relationship between stress-induced depression and cancer. Research on the neurochemical, anatomical, immunological, genetic, and psychological changes that support cancer-related depression was collected, together with study features and findings, and the impact of depression on cancer was extracted. Results The literature search revealed a compilation of quantitative and qualitative studies about depression in cancer patients. Findings suggested the possibility of a link between cancer-induced stress and depression. Increased levels of proinflammatory cytokines (like IL-6) and dysregulation of the neurotransmitters including serotonin had shown links to the onset of depression in cancer patients. Lastly, antidepressants along with psychological interventions were found to be effective in treating depression in cancer patients. Conclusions This Narrative review contributes insights into the need for integrating oncology and mental health services to address the psychosocial needs of cancer patients. Future research should focus on the bidirectional interactions between stress and cancer, aiming to improve cancer care by incorporating mental health support, ultimately enhancing patient outcomes and quality of life.

Background: Beta-blockers are frequently used anti-hypertensive agents. It has been proposed that beta-blocker usage can potentially impact outcomes among cancer patients. While there is existing literature on the matter, studies have yielded conflicting results. The aim of this systemic review and meta-analysis is to further investigate the effect of beta-blockers on survival and recurrence among those diagnosed with cancer. Methods: We systematically searched PubMed, Web of Science, Embase, and Cochrane Library for relevant studies published until October 16 th, 2023. Hazard ratios (HR) and their corresponding 95% confidence intervals were extracted from the studies. Subgroup analysis and sensitivity analysis were performed to investigate heterogeneity and make results more reliable. Results: Data from fifty-four studies was included in this meta-analysis. A subgroup analysis was conducted based on the type of beta blockers and the type of cancer to assess the overall survival (OS) outcome. It was found that beta-blockers had no significant impact on overall survival, based on the type of cancer (HR=0.99; 95% CI: 0.94-1.04; P=0.70), and the type of beta-blockers (HR=0.99; 95% CI: 0.91-1.04; P=0.23). However, statistically significant results were observed for the outcome of cancer recurrence, favoring the beta-blocker group over the control group. A sensitivity analysis was conducted on both the outcomes to assess the heterogeneity in the results, reducing it considerably. Conclusion: According to our results, it can be concluded that the usage of beta-blockers generally has no significant impact on survival outcomes, however, a positive impact on recurrence was observed. There was a downward, yet non-significant, trend in pancreatic and ovarian cancer, indicating that further studies should investigate this.

Background: Pancreatic cancer is the fourth leading cause of cancer deaths worldwide, a particularly lethal cancer, with the majority of cases dead inside the first year. Mortality statistics have barely changed in over fifty years. Case history: This case history recounts the atypical presentation of a rare pancreatic adenocarcinoma as an aggressive pancreatic pseudocyst, that required multiple drainage/ablative surgeries, mostly in a short time span of 3 months, and recurring. Biopsy revealed its true nature as a rare mucinous adenocarcinoma, by then stage 4 with peritoneal metastases, therefore deemed inoperable, the worst prognosis. Palliative FOLFOX chemotherapy followed by SABR radiotherapy were proposed, with the PARP inhibitor, Olaparib planned as maintenance treatment. These therapies were not expected to radically change the prognostic outlook. However, on compassionate grounds, some experimental therapies, were combined, intended to synergise with the palliative protocols. These therapies included daily high dose methylcobalamin injections, twice weekly, intravenous high dose, vitamin C, liposomal alpha lipoic acid, a ketogenic diet, anti-cachectic medium chain triglyceride oil, high dose vitamin D and a functional food containing colostrum, naturally high in the activated vitamin D binding protein, as well as in lactoferrin, haptocorrin and other immune modulating components. In addition, a quartet of off label drugs, which early research shows have some anti-cancer actions, were prescribed: doxycycline, metformin, atorvastatin and the antiprotozoan drug, mebendazole. Outcome: The patient responded well to these protocols, and was on the road to recovery within 6 months, and in complete remission for almost two years now. The rationale for such therapies is reviewed and analysed, and weighting is assessed for the individual therapies. We propose that such an integrative combination of standard/non standard, research based therapies may provide a blueprint for survival in pancreatic cancer that deserves formal clinical trials. &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

Colorectal cancer (CRC) remains a significant health concern in the world. The existing standard of care guidelines for CRC surveillance falls short of effectively and timely detecting recurrence or metastasis. In recent years, circulating tumor DNA (ctDNA) has emerged as a promising material for minimal residual disease (MRD) detection. In this paper, we provide an exhaustive review of the methods utilized for MRD detection via ctDNA, present evidence supporting the potential of ctDNA MRD as a valuable biomarker in clinical applications, and engage in a discussion regarding ongoing ctDNA MRD based clinical trials in CRC. Lastly, we offer insights into future prospects of ctDNA-based MRD methodological advancements and clinical research. It’s foreseeable that more sensitive, flexible, and economic MRD detection methods will emerge with the deeper research on cfDNA genomics, fragmentomics, methylomes, and nucleosome imprinting. At the same time, MRD-guided intervention study will evolve for revolutionizing the treatment paradigm of CRC.

Abstract Background: The incidence of small intestine neuroendocrine neoplasms (SI-NEN) has increased significantly, posing challenges in early diagnosis and effective management due to non-specific symptoms and complex tumor biology, especially in predicting distant metastasis (DM). Methods: This retrospective study analyzed 3,157 patients diagnosed with SI-NEN from 2005 to 2015 using the Surveillance, Epidemiology, and End Results (SEER) database. We employed multifactorial logistic regression to identify independent risk factors for DM and developed several machine learning models to predict its occurrence. These included a suite of nine key models: XGBoost, Logistic Regression, LightGBM, Random Forest, Complement Naive Bayes, Multi-Layer Perceptron Classifier, Decision Tree, Gradient Boosting Decision Tree, and Support Vector Machine, all validated through k-fold cross-validation and hyperparameter optimization. Furthermore, we extended our analysis to survival studies to identify prognostic factors that may significantly influence patient outcomes. Results: Logistic regression demonstrated the highest efficacy, achieving an AUC of 0.774 in the training set and 0.747 in the validation set, values which are considered high, indicating superior performance in detecting early DM. Additionally, a machine learning-enhanced clinical nomogram was constructed, incorporating individual patient characteristics for personalized treatment planning. Survival analysis identified key prognostic indicators, and the resulting prognostic nomogram displayed high predictive accuracy, validated through calibration curves and decision curve analysis. Conclusion: The study underscores the utility of advanced predictive models in enhancing the diagnostic and prognostic assessment of SI-NEN, suggesting a framework for future clinical application and continuous improvement of these models. The developed predictive and prognostic nomograms provide crucial tools for clinical decision-making, potentially improving overall survival and quality of life by facilitating personalized treatment strategies based on detailed risk profiles. Keywords: SI-NEN, distant metastasis, machine learning, logistic regression, prognostic nomogram, survival analysis, SEER database.

Introduction: Acute lymphoblastic leukemia (ALL) is the most common malignant neoplasm in children. Although the prognosis is good, complications caused by chemotherapy are still a large challenge for clinicians. Among them, pancreatitis is one of the most serious complications after the application of asparaginase, which is an important part of treatment. The occurrence of pancreatitis may affect chemotherapy tolerance and prognosis of ALL. We intend to establish a predictive model for the risk of pancreatitis in children with ALL during chemotherapy based on clinical data. Method: Collect clinical data of ALL patients under CCLG-ALL, screen variables that may be related to the occurrence of pancreatitis through lasso regression, divide the total patient into a training set and a validation set in a ratio of 8:2, build a prediction model in the training set, and evaluate prediction ability through area under the receiver operating characteristic curve (AUC) and calibration curve. External validation is done in the validation set. Results: A total of 321 patients with ALL were included in this study, including 58 patients with pancreatitis and 263 patients in the control group. Risk factors related to pancreatitis were elevated total bilirubin, direct bilirubin and induction chemotherapy. C statistic and AUC obtained in the training set of this model was 0.862 and 0.86, and the AUC of this model in the validation set was 0.95. Conclusion: This study constructs a risk prediction model for pancreatitis in children with acute lymphoblastic leukemia receiving chemotherapy, and the results suggest that the prediction ability is good. A nomogram based on this model was developed. Among the risk factors, increased total bilirubin and direct bilirubin may indicate that pancreatitis may be related to biliary obstruction, and induction chemotherapy may indicate that children may have predisposing factors for pancreatitis. Further research may be needed in these two aspects in the future.

Objective: The aim of this study is to investigate the prognostic correlation between tumor budding and stage I-II cervical cancer, with the goal of providing guidance for postoperative diagnosis and treatment strategies for patients.Methods: A comprehensive search was conducted across 12 databases including Pubmed, Cochrane, Embase, Scopus, OVID, Web of Science, EBSCohost, CNKI, Wan-Fang, VIP, Dui-Xiu and CBM to identify relevant literature on the association between tumor budding and prognosis or clinicopathological features of cervical cancer.The quality of included studies was assessed using the Newcastle-Ottawa scale. Statistical analysis was performed using Review Manager.Results: Our findings demonstrate that high-grade tumor budding in stage I-II cervical cancer is associated with significantly poorer overall survival (P<0.0001) and disease-free survival (P<0.0001). Subgroup analyses revealed that irrespective of sample size and histological type, the overall survival in the high-grade tumor budding group is markedly lower than that in the low-grade tumor budding group; similarly regardless of stage inclusion criteria, budding type, field boundary value or sample size,the disease-free survival in the high-grade tumor budding group is significantly lower than that in the low-grade tumor budding group.Furthermore,high grade tumor budding is correlated with several adverse pathological features.Conclusion: In light of these results,it can be concluded that tumor budding serves as an unfavorable prognostic factor for stage I-II cervical cancer,and may inform I-II stage postoperative treatment planning for such patients.

Objective: The aim of this study is to comprehensively investigate the clinical manifestations, pathological diagnosis, differential diagnosis, and prognostic implications in patients with diffuse large B-cell lymphoma (DLBCL) manifesting as bone marrow invasion accompanied by peripheral blood counts. Method: A retrospective analysis was conducted on 16 patients diagnosed with DLBCL involving bone marrow and exhibiting peripheral blood abnormalities. Detailed clinical data, laboratory investigations, bone marrow biopsy hematoxylin and eosin (HE) sections, and immunohistochemical stains were compiled and analyzed. Results: Among the patients, B symptoms (11/16, 68.75%) and fatigue (9/16, 56.25%) were the most common symptoms. The diagnostic accuracy of bone marrow biopsy was 100%(16/16). The distribution pattern of abnormal cells in bone marrow biopsies was diffuse in 37.5%(6/16), interstitial in 31.25%(5/16), mixed in 18.75%(3/16), and nodular in 12.5%(2/16) of cases. The tumors originated from the germinal center in 12.5% (2/16) of cases and from non-germinal center sources in 87.5%(14/16). Fibrosis grades were distributed as follows: grade 0 in 1 case (1/16), grade 1 in 7 cases (7/16), and grade 2 in 8 cases (8/16).All 16 patients exhibited invasive disease progression, 3 fatalities ocuuring due to lack of treatment.1 patient unfortunately passed away six months after commencing R-CHOP and R-DHAP chemotherapy. Conclusion: This study offers a comprehensive insight into the clinical and pathological features of DLBCL infiltrating bone marrow with peripheral blood reduction, highlighting the importance of accurate diagnostic techniques and timely intervention in these patients.

Background Colorectal carcinoma with isolated metastasis to the scapula is a rare occurrence. The is a paucity of accounts detailing experience with this unique scenario. We present a case of oligometastatic colon adenocarcinoma to the scapula with subsequent scapulectomy, in which the patient had eventual visceral disease recurrence yet still gained a palliative benefit from the procedure. Methods We detail the account of a patient with metastatic colorectal carcinoma to the right scapula and subsequent treatment for the scapular metastasis. Results The patient underwent successful total scapulectomy for metastatic colon adenocarcinoma with negative margins achieved. He had an uneventful postoperative course and discharged home on day three. Upon follow up after total scapulectomy, the patient experienced significant symptom improvement and functional recovery. Conclusion We believe a significant benefit to the patient's overall quality of life was provided by undergoing this procedure. Therefore, this option should remain part of the oncologic surgeon's armamentarium to offer a palliative option to patients with the goal of controlling pain and retaining function.

Purpose：The primary objective of this study was to comprehensively evaluate and compare the therapeutic efficacy of trastuzumab in combination with capecitabine plus cisplatin versus capecitabine plus cisplatin in the management of patients diagnosed with advanced human epidermal growth factor receptor 2 (HER2)-positive gastric cancer. Aiming to facilitate clinical decision-making and ultimately improving treatment outcomes for this specific patient population. Methods：A comprehensive computerized search was conducted across multiple databases, including Cochrane Library, Web of Science, PubMed, Embase, CNKI, CBM, VIP, and Wanfang to identify domestic and foreign clinical randomized controlled trials (RCTs), investigating the efficacy of trastuzumab in combination with capecitabine plus cisplatin for the treatment of patients with advanced HER2-positive gastric cancer. The search encompassed articles published from the inception of the databases until July 1, 2022. Results：This meta-analysis comprised 12 studies involving a total of 1199 patients diagnosed with advanced HER2-positive gastric cancer. The results revealed that the experimental group exhibited significantly higher rates of total effectiveness and control compared to the control group. Moreover, the experimental group showed a significant increase in median survival time compared to the control group. Additionally, the experimental group exhibited a significantly higher quality of life score and demonstrated improved prognosis in terms of carbohydrate antigen 19-9 (CA19-9) levels, with a lower recurrence rate. The experimental group showed a decrease in the stage of gastric cancer based on carbohydrate antigen 72-4 (CA72-4) levels and (CEA) levels compared to the control group.. Furthermore, the experimental group exhibited a notable enhancement in the therapeutic efficacy of vascular endothelial growth factor (VEGF) and a superior prognosis compared to the control group. Conclusion：Trastuzumab in combination with capecitabine plus cisplatin can be a preferred first-line treatment option for advanced HER2-positive gastric cancer, accompanying by a promising therapeutic efficacy.

Introduction While there is a growing volume of evidence suggesting that relatively prevalent functional polymorphisms present within apoptosis-related genes may influence human prostate cancer (PCa) susceptibility, the clinical relevance of these findings remains inconclusive. This meta-analysis was thus developed with the goal of generating more precise estimates of the relationships between polymorphisms in four apoptosis-associated genes (NKX3‑1, Caspase-3, Caspase-9, and BCL‑2) and the risk of PCa. Material and methods The PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and SinoMed (CNKI and Wanfang) databases were searched for relevant studies published through December 20, 2023 using the following keywords: ‘polymorphism’ or ‘variant’ and ‘carcinoma’ or ‘cancer’ or ‘tumor’ and ‘NKX3-1’, ‘CASP3’ or ‘Caspase-3’, ‘CASP9’ or ‘Caspase-9’, ‘BCL-2’ or ‘B-cell lymphoma’ and ‘prostate cancer’ or ‘PCa’ or ‘prostate adenocarcinoma’. Results This approach led to the identification of 22 case-control studies related to the association between apoptosis-related gene polymorphisms and PCa susceptibility enrolling 9,706 cases and 12,567 controls. Subsequent analyses revealed that the NKX3-1 rs2228013, CASP9 rs1052571, and CASP9 rs4645982 polymorphisms were associated with greater PCa risk, whereas the CASP3 rs4647603 polymorphism was associated with a risk reduction. Conclusions These findings provide strong evidence for the potential contributions of polymorphisms in the apoptosis-related caspase-3, caspase-9, and NKX3-1 genes in the onset and progression of PCa.

Background: Since the COVID-19 pandemic started in 2019, has resulted in various health conditions, including adverse effects on different systems. The female reproductive system (FRS) is known to be one of the organs affected by the virus or the vaccination due to its high expression of the ACE 2 receptor, which is one of the primary receptors of COVID-19 that facilitates its entry into the cells. This review assessed the impact of COVID-19 infection and vaccination on the female reproductive system and their relationship with endometrial, ovarian, cervical, and vulvar cancers. Recent findings: COVID-19 virus may elevate pro-inflammatory factors, such as TNF-α, IL-6, interleukin-1β (IL-1β), and interferon-gamma (IFN-γ), during both the acute and recovery phases of infection. COVID-19 infection can heighten the inflammatory response and cell susceptibility by downregulating the ACE-2 receptor. Additionally, COVID-19 influences the female reproductive system by altering the epithelial-mesenchymal tissue microenvironment and disrupting blood vessels and endothelial cells. However, studies fail to acknowledge the potential impact of vaccination on FRS. Conclusion: Given the pivotal roles of the TMPRSS2 enzyme and ACE2 receptor in the pathogenic mechanism of the coronavirus, it is suggested that cells expressing higher levels of these enzymes and receptors may be more prone to endometrial cancer development. Notably, the cytokine storm and ACE/ACE2 pathway imbalance increase the risk of ovarian cancer. Cervical cells have a low expression of the ACE2 receptor, reducing the likelihood of infection in intraepithelial cervical cells and cervical cancer. Although coronavirus infection and its immunization can lead to vulvar aphthous ulcers, limited research investigates the link between COVID-19 infection, immunization, and vulvar cancer.

Background: Multiple myeloma (MM) has different complications, including renal failure, anemia, infections, metabolic complications, and skeletal problems. Hypercalcemia is the most common metabolic complication, and the presence of hypercalcemia indicates worse outcomes. Aims: The study aims to examine outcomes such as hospitalization costs, length of stay, survival rates, and the incidence of complications of hypercalcemia in multiple myeloma patients admitted in the United States from 2017 to 2020. Methods: We performed a retrospective analysis using the National Inpatient Sample database to determine the incidence of hypercalcemia in patients admitted to United States hospitals from 2017 to 2020. Univariate and multivariate logistic regression were used to calculate the odds ratio. We used STATA software 17 to perform the analysis. Results: We found that the total number of patients with MM was 437799, out of which 8.6% had hypercalcemia. The mean age of the patients was 69 years, and hypercalcemia was found to be more common in males (55%) than females (45%). The presence of hypercalcemia was also associated with increased mortality (adjusted odds ratio 1.3, p-value 0.00). It was also seen that MM patients who had hypercalcemia had a higher risk of complications, including acute kidney injury (OR 3, p<0.05), hyperkalemia (OR 1.8, p-value <0.05), metabolic acidosis (1.4, p-value <0.05), spinal cord compression (OR 0.9, p-value >0.05), increased length of stay (OR 3, p-value <0.05), and higher cost of hospitalizations (p-value <0.05). Conclusion: The data is also limited to the demographic characteristics, impact, and outcomes of hypercalcemia on patients with MM. This study contributes valuable insights into the clinical implications of hypercalcemia in patients with multiple myeloma (MM). It fills existing gaps in the literature by utilizing a large population-based dataset.

Objective: Biliary Tract Cancer (BTC) is a significant health concern with limited resectable cases. This meta-analysis assessed the safety of triplet regimens for advanced BTC, specifically gemcitabine, cisplatin, nab-paclitaxel, and gemcitabine, oxaliplatin, erlotinib, along with their associated adverse events. Method: Following PRISMA guidelines, we systematically reviewed PubMed/Medline, Google Scholar, and the Cochrane Library from inception to November 2022. Results: Our analysis of 5 studies favored Gem+Cisplatin+nab-Paclitaxel over GEMOX-T in terms of safety and adverse events. Qualitative analysis of 7 studies (491 patients) showed that Gem+Cisplatin+nab-Paclitaxel also outperformed in median overall survival, progression-free survival, and response rates. Conclusion: This study suggests that Gem+Cisplatin+nab-Paclitaxel is a safer and more effective treatment than GEMOX-T for advanced BTC. It exhibits superior outcomes in terms of survival and response rates. Further research should focus on optimizing treatment regimens to reduce adverse effects in advanced BTC patients.