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Recombinant human granulocyte colony‐stimulating factor (G‐CSF) administration in patients with cancer and coronavirus disease (COVID‐19) remains controversial. Concerns exist that it may worsen COVID‐19 outcomes by triggering an inflammatory cytokine storm, despite its common use for managing chemotherapy‐induced neutropenia (CIN) or febrile neutropenia post‐chemotherapy. Here, we determined whether prophylactic or therapeutic G‐CSF administration following chemotherapy exacerbates COVID‐19 progression to severe/critical conditions in breast cancer patients with COVID‐19. Between December 2022 and February 2023, all 503 enrolled breast cancer patients had concurrent COVID‐19 and received G‐CSF post‐chemotherapy, with most being vaccinated pre‐chemotherapy. We prospectively observed COVID‐19‐related adverse outcomes, conducted association analyses, and subsequently performed Mendelian randomization (MR) analyses to validate the causal effect of genetically predicted G‐CSF or its associated granulocyte traits on COVID‐19 adverse outcomes. Only 0.99% (5/503) of breast cancer patients experienced COVID‐19‐related hospitalization following prophylactic or therapeutic G‐CSF administration after chemotherapy. No mortality or progression to severe/critical COVID‐19 occurred after G‐CSF administration. Notably, no significant associations were observed between the application, dosage, or response to G‐CSF and COVID‐19‐related hospitalization (all p >.05). Similarly, the MR analyses showed no evidence of causality of genetically predicted G‐CSF or related granulocyte traits on COVID‐19‐related hospitalization or COVID‐19 severity (all p >.05). There is insufficient evidence to substantiate the notion that the prophylactic or therapeutic administration of G‐CSF after chemotherapy for managing CIN in patients with breast cancer and COVID‐19 would worsen COVID‐19 outcomes, leading to severe or critical conditions, or even death, especially considering the context of COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

Background: Immunochemotherapy has become the first‐line treatment for initial diagnosed metastatic nasopharyngeal carcinoma (mNPC). Loco‐regional radiotherapy combined with systemic chemotherapy significantly improves the survival. However, the safety and efficacy of loco‐regional radiotherapy combined with immunochemotherapy remained unknown. Methods: Patients with de novo mNPC who received immunochemotherapy followed by loco‐regional radiotherapy were included from two cancer centers. Toxicity and treatment response were assessed using CTCAE 5.0 and RECIST 1.1, respectively. Overall survival (OS) and progression‐free survival (PFS) were analyzed using the Kaplan–Meier method. Results: From 2019 to 2021, a total of 16 patients were retrospectively analyzed. The median follow‐up was 28 months (range 14–47 months). No one died. One‐year, 2‐year, and 3‐year PFS rate was 93.8%, 58.4% and 50.1%, respectively. Radiotherapy‐related acute severe (grade 3 or higher) toxicity was dermatitis (1/16, 6.3%) and mucositis (2/16, 12.5%). Conclusions: Loco‐regional radiotherapy provided a promising efficacy with modest toxicity for patients with mNPC who received immunochemotherapy. [ABSTRACT FROM AUTHOR]

Background: Despite the rising incidence and mortality of breast cancer among women in China, there are currently few predictive models for breast cancer in the Chinese population and with low accuracy. This study aimed to identify major genetic and life‐style risk factors in a Chinese population for potential application in risk assessment models. Methods: A case–control study in southeast China was conducted including 1321 breast cancer patients and 2045 controls during 2013–2016, in which the data were randomly divided into a training set and a test set on a 7:3 scale. The association between genetic and life‐style factors and breast cancer was examined using logistic regression models. Using AUC curves, we also compared the performance of the logistic model to machine learning models, namely LASSO regression model and support vector machine (SVM), and the scores calculated from CKB, Gail and Tyrer–Cuzick models in the test set. Results: Among all factors considered, the best model was achieved when polygenetic risk score, lifestyle, and reproductive factors were considered jointly in the logistic regression model (AUC = 0.73; 95% CI: 0.70–0.77). The models created in this study performed better than those using scores calculated from the CKB, Gail, and Tyrer–Cuzick models. However, the logistic model and machine learning models did not significantly differ from one another. Conclusion: In summary, we have found genetic and lifestyle risk predictors for breast cancer with moderate discrimination, which might provide reference for breast cancer screening in southeast China. Further population‐based studies are needed to validate the model for future applications in personalized breast cancer screening programs. [ABSTRACT FROM AUTHOR]

Multiphoton microscopy (MPM) was introduced to label‐freely obtain tumor‐infiltrating lymphocytes (TILs) images from a total of 611 patients, and the prognostic value of TILs in breast cancer was assessed by the MPM method (TILs‐MPM) and guidelines method proposed by the International Immuno‐Oncology Biomarker Working Group (TILs‐WG), respectively. Moreover, the clinical (CLI) model, TILs‐WG + TILs‐MPM model, and full model (CLI + TILs‐WG + TILs‐MPM) were developed to investigate the prognostic value of TILs. The results show that TILs‐WG performs better in estrogen receptor (ER)‐negative subgroup, and TILs‐MPM is comparable with TILs‐WG in the ER‐negative subgroup, but has the best performance in the ER‐positive subgroup. Furthermore, the TILs‐WG + TILs‐MPM model can significantly improve the prognostic power compared with the TILs‐WG model, and the full model has excellent performance, with high area under the curve (AUC) and hazard ratio (HR) in both ER‐positive, ER‐negative subgroups, and the complete cohort. Our results suggest that the combination of TILs‐WG with TILs‐MPM model can greatly improve the prognostic value of TILs. [ABSTRACT FROM AUTHOR]

Neoadjuvant treatment is often considered in breast cancer patients with axillary lymph node involvement, but most of patients do not have a pathologic complete response to therapy. The detection of residual nodal disease has a significant impact on adjuvant therapy recommendations which may improve survival. Here, we investigate whether multiphoton microscopy (MPM) could identify the pathological changes of axillary lymphatic metastasis after neoadjuvant chemotherapy in breast cancer. And furthermore, we find that there are obvious differences in seven collagen morphological features between normal node and residual axillary disease by combining with a semi‐automatic image processing method, and also find that there are significant differences in four collagen features between the effective and no‐response treatment groups. These research results indicate that MPM may help estimate axillary treatment response in the neoadjuvant setting and thereby tailor more appropriate and personalized adjuvant treatments for breast cancer patients. [ABSTRACT FROM AUTHOR]

Background: Partner and localizer BRCA2 (PALB2) is a breast cancer predisposition gene, but the clinical relevance of PALB2 germline mutations in Chinese patients with breast cancer remains unknown. This study attempted to investigate the full prevalence and spectrum of PALB2 germline mutations in China and the associations between PALB2 germline mutations and breast cancer risk.Methods: A total of 21,216 unselected patients with breast cancer were enrolled from 10 provinces in China, and 5890 Chinese women without cancer were enrolled as healthy controls. PALB2 screening was based on next-generation sequencing.Results: A total of 16,501 BRCA1/2-negative patients with breast cancer were analyzed. Deleterious PALB2 mutation carriers accounted for 0.97% (n = 160) in the breast cancer cohort and for 0.19% (n = 11) in the healthy control cohort. Forty-one novel PALB2 germline mutations were identified. A high frequency of PALB2 c.751C>T was detected, and it accounted for 10.63% of the PALB2 germline mutations detected (17 of 160). PALB2 mutations were significantly associated with increased breast cancer risk (odds ratio [OR], 5.23; 95% confidence interval [CI], 2.84-9.65; P < .0001), especially among women 30 years old or younger (OR, 10.09; 95% CI, 3.95-25.79; P < .0001). Clinical characteristics, including a family history, bigger tumor size, triple-negative breast cancer, positive lymph nodes, and bilateral breast cancer, were closely related to PALB2 mutations.Conclusions: This study revealed a comprehensive spectrum of PALB2 germline mutations and characteristics of PALB2-related breast cancer in China. PALB2 germline mutations confer a moderately increased risk for breast cancer but profoundly increase breast cancer risk for those 30 years old or younger in the Chinese population. [ABSTRACT FROM AUTHOR]