Cancer Innovation

This systematic review is carried out using the preferred reporting items on systematic reviews and meta-analysis (PRISMA) guideline in three steps as follows:

• Step 1:

  Identifying studies (total of 193 studies were initially included).

• Step 2:

  Selecting the studies (total of 30 articles met the inclusion criteria for our comprehensive review).

• Step 3:

  Data extraction and summarization (A data extraction form was developed in Google Sheets, consisting of eight variables, including Authors, Year, the aim of the study (Objective), Data set(s), Data type, Important features, type of artificial intelligence (machine learning or deep learning), and the Explained model. Two reviewers (Amirehsan Ghasemi and Soheil Hashtarkhani) extracted data from all included articles, and any disagreement was resolved by consensus.

This study focuses on developing and validating prognostic nomograms for young breast cancer patients, integrating multiple clinical factors such as TNM stage, HER2 status, and pathological differentiation to predict overall survival and breast cancer-specific survival. Using data from the SEER and METABRIC databases, the nomograms provide accurate 3-, 5-, and 10-year survival estimates. Dynamic versions of these nomograms offer personalized, user-friendly tools to guide clinical decision-making, with the goal of improving prognosis and treatment outcomes for breast cancer with young patients.

The graphical abstract summarizes a study evaluating CDK4/6 inhibitors (CDK4/6i) combined with endocrine therapy in hormone receptorr-positive (HR+/human epidermal growth factor receptor 2 metastatic breast cancer patients. It highlights a median progression-free survival (PFS) of 12.8 months, with significant factors reducing PFS including visceral metastasis, Eastern Cooperative Oncology Group Performance Status ≥ 1, low estrogen receptor/progesterone receptor levels, high Ki-67, and later-stage treatment. Adverse reactions such as neutropenia (29.1%), leukopenia (13.7%), and anemia (4.1%) were manageable. A prognostic nomogram showed good predictive performance (C-index 0.714), and a rechallenge of CDK4/6i demonstrated median PFS of 7.7 months, extending to 11.4 months for nonprogression discontinuation.

This prospective multicenter clinical study revealed that for metastatic Human epidermal factor receptor 2 (HER2)-positive breast cancer patients with abnormal activation of the PI3K/Akt/mTOR (PAM) pathway and previous trastuzumab treatment, the combination of inetetamab with sirolimus and chemotherapy is equivalent to the combination of pyrotinib and chemotherapy, and this regimen could be one of the treatment options for PAM pathway activated metastatic HER2-positive breast cancer patients.

Ibrutinib, a Bruton's tyrosine kinase inhibitor, has been associated with a significant increase in the risk of ventricular arrhythmias. In our present study, we aimed to investigate the cardiotoxicity of ibrutinib and explore the potential protective effects of metformin in ibrutinib-treated mice. Our findings revealed that long-term exposure to ibrutinib triggered ventricular myocardial apoptosis and fibrosis, leading to alterations in cardiac electrophysiological properties and an increased potential for ventricular arrhythmia. In this ibrutinib-induced model of cardiac toxicity, metformin demonstrated the ability to upregulate the AMPK and PI3K/AKT signaling pathway, thereby mitigating the ibrutinib-induced cardiotoxicity. As a result, we have demonstrated the protective effects of metformin in counteracting ibrutinib-induced cardiotoxicity and propose it as a potential pharmaceutical therapeutic strategy for related diseases.