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Top 100 most cited articles on cyclin-dependent kinase 4/6 inhibitors — a bibliometric and altmetric analysis
No full textIntroduction. This study aims to evaluate both the scientific impact and the digital visibility of the top 100 most cited articles on cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, which have gained prominence in recent years in the treatment of cancer, through bibliometric and altmetric analysis.
Material and methods. In this study, original research articles and reviews published before 2025 were retrieved from the Web of Science (WoS) database. The selected articles were analyzed in terms of total citation counts, publication years, journal impact factors, authors, and affiliated institutions. Altmetric Attention Scores (AAS) were used to assess their visibility on social media and digital platforms. Additionally, author collaborations, citation networks, and keyword co-occurrence maps were generated using VOSviewer software.
Results. A total of 1,528 articles meeting the inclusion criteria and the top 100 most cited articles were analyzed. The most productive institution was identified as the Dana Farber Cancer Institute, while the United States was the most productive country, contributing to 84% of the publications. Most of the highly cited studies were published between 2016 and 2019. In the altmetric analysis, a significant positive correlation was found between the AAS and citation count, journal impact factor (JIF), and 5-year impact factor (5-year JIF). It was observed that articles published in recent years had lower digital visibility.
Conclusions. As the first study to analyze the most cited articles on CDK4/6 inhibitors, this analysis demonstrates that academic impact is significantly associated with visibility on digital platforms. The strong concordance between altmetric data and bibliometric indicators highlights the importance of these new metrics in evaluating scientific impact. By jointly assessing scientific output and digital engagement, this study provides a meaningful contribution to the literature
Heterogeneity in response to neoadjuvant therapy in HER2-positive breast cancer — impact of HER2 score, hormonal receptor status, and Ki-67 proliferation index
No full textIntroduction. Human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) is a biologically heterogeneous disease, exhibiting varying responses to neoadjuvant therapy. This study aimed to assess the predictive value of the HER2 immunohistochemical (IHC) score, hormone receptor (HR) status (including estrogen and progesterone receptors), and the Ki-67 proliferation index in determining pathological complete response (pCR) in patients with HER2-positive BC receiving neoadjuvant therapy (NAT).
Material and methods. This prospective study involved 174 female patients with HER2-positive BC who were scheduled to receive NAT. Pre-treatment biopsy specimens were analyzed using immunohistochemistry (IHC) to evaluate HER2, estrogen receptor (ER), progesterone receptor (PR), and Ki-67 index. For cases with a HER2 IHC score of 2+, HER2 amplification was verified through in situ hybridization (ISH). The pathological response was subsequently evaluated and correlated with these biomarkers.
Results. HER2 score of 3+, high Ki-67 ( > 38%), and PR-negativity were significantly linked to higher pCR rates (p < 0.05).
Conclusions. These findings support the integration of HER2 score, HR status, and Ki-67 index into the prediction of pCR after NAT in HER2-positive BC
Hybrid electrotherapy approach with successful combination of leadless atrial pacemaker and subcutaneous cardioverter-defibrillator for secondary prevention of sudden cardiac death in a patient with long QT syndrome
No full textCorrelation between plasma Afamin and gestational diabetes mellitus during pregnancy
No full textObjectives: We investigated the correlation of plasma Afamin levels with gestational diabetes mellitus (GDM) during pregnancy and assessed its predictive value for the risk and prognosis of GDM. Material and methods: A total of 993 pregnant women were included in this nested case-control study. The fasting blood samples in their first trimester were collected. Ninety-one women were diagnosed with GDM, and they were subdivided into insulin treatment group (Group A1, 30 cases) and non-insulin treatment group (Group A2, 61 cases) according to whether they needed to treat with insulin. Another 91 pregnant women with normal glucose tolerance were as the control group (NC group). The plasma and umbilical cord blood levels of Afamin were measured in the first and second trimesters using enzyme-linked immunosorbent assay (ELISA). The correlation of Afamin levels with GDM during pregnancy and its predictive value were assessed. Results: Plasma Afamin levels in both GDM groups (A1 and A2) were significantly higher than in the control group at all pregnancy stages (p < 0.01). Afamin levels in the second trimester were significantly higher in Group A1 than those in Group A2 (p < 0.05). Multivariate logistic regression identified that plasma Afamin levels in the first trimester (OR = 1.126, 95% CI: 1.032-1.228, p = 0.008) and in the second trimester (OR = 1.173, 95% CI: 1.092-1.259, P = 0.000) were the independent risk factors for GDM, along with insulin resistance index (OR = 1.62, 95% CI: 1.036-2.534, p = 0.034). ROC analysis showed optimal cut-off value of plasma Afamin was 65.90 mg/L in the first trimester (AUC = 0.858, sensitivity = 75.8%, specificity = 85.7%) and 85.09 mg/L in the second trimester (AUC = 0.874, sensitivity = 92.3%, specificity = 76.9%). Conclusions: Elevated plasma Afamin levels during the first and second trimesters are associated with GDM, supporting Afamin level as a potential biomarker for early GDM risk prediction
Identification of completed coronary stent healing by optical coherence tomography — validation study with histopathology in porcine model of coronary restenosis
No full textBackground: The potential of optical coherence tomography (OCT) is limited by incomplete validation with histopathology. The study aimed to assess whether OCT can identify a completely healed coronary stent.
Material and methods: The study included 40 swine and total of 106 stents (82 DES, 24 BMS). Follow-up OCT and histopathology examination was done after 28 days (n = 53) and 90-days (n = 53). 273 frames were matched between histopathology and OCT. Histopathologic criteria for completed healing: high endothelialization score (2–3), low inflammation score (0–1), low fibrin score (0–1), high neointimal smooth muscle score (2–3) and lack of binary restenosis.
Results: Predictors of a well healed stent were presence of homogenous neointima (OR: 2.53) and the total number of struts per section (OR: 1.11). The presence of microvessels (OR: 0.28) and increasing neointimal area (OR: 0.65) predicted incomplete healing. Cutoff values were identified: inflammation score was the highest in segments with neointima thickness over 0.35 mm. Persistent fibrin deposits were found at 28-day follow-up in DES with less than 13 embedded struts per section and neointima area less than 2.234 mm2. The number of embedded struts per section showed a positive correlation with the healing score, while both protruding covered and protruding uncovered struts showed a negative correlation.
Conclusions: OCT demonstrated moderate ability to predict completed stent healing
Pretreatment cancer-related cognitive impairment in older patients
No full textIntroduction. Cognitive impairment is common in older adults and may be worsened by cancer and its treatment. While cancer-related cognitive impairment (CRCI) during and after therapy is well documented, less is known about cognitive deficits present before treatment begins. The objective herein, was to identify factors independently associated with pretreatment CRCI in older adults with cancer, using data from a geriatric oncology service in a tertiary hospital in Lima, Peru.
Material and methods. This observational case-control study analyzed data from Comprehensive Geriatric Assessments (CGA) conducted in patients aged ≥ 60 years prior to initiating chemotherapy or surgery. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with CRCI defined as an MMSE score < 24. Multivariate logistic regression was used to identify independent predictors of CRCI.
Results. A total of 189 patients were included (58 with CRCI, 131 without), with a mean age of 75.1 years; 45% were women. The overall prevalence of CRCI was 30.7%. In univariate analysis, CRCI was associated with older age, fewer years of education, malnutrition, depression, higher comorbidity burden, functional dependence, lower handgrip strength, and sarcopenia in women (all p < 0.05). In multivariate analysis, three variables remained significantly associated with CRCI years in education (adjusted OR = 0.75; 95% CI 0.67–0.84; p < 0.001), handgrip strength (adjusted OR = 0.90; 95% CI 0.83–0.98; p = 0.015), and presence of depression (adjusted OR = 3.32; 95% CI 1.20–9.17; p = 0.020).
Conclusions. Nearly one in three older adults with cancer presented with cognitive impairment before treatment. Higher educational attainment and greater handgrip strength were associated with lower odds of CRCI, while depression significantly increased the risk. These findings highlight the need for early cognitive screening and comprehensive interventions targeting modifiable factors in geriatric oncology care
Combination therapies with olaparib — new treatment options
No full textIntroduction. Olaparib, the first approved poly(ADP)-ribose polymerase (PARP) inhibitor (PARPi), is a cornerstone of targeted therapy in patients with homologous recombination deficiency (HRD), in particular with pathogenic (P) or likely pathogenic (LP) variants in the BRCA1/2 genes. Growing evidence also indicates its efficacy in combination therapies, regardless of the presence of classical HRD markers.
Material and methods. A narrative literature review was conducted, including the results of clinical trials with olaparib in monotherapy and combination therapies, preclinical data, current guidelines of scientific societies (ESMO, NCCN, PTOK, PTGO) and the role of molecular diagnostics, including the presence of P/LP variants, both germline and somatic, in the qualification for therapy in ovarian, endometrial and prostate cancer.
Results. Combination therapy with olaparib and bevacizumab shows high efficacy in patients with ovarian cancer and HRD. The DUO-E study confirmed the clinical benefit of olaparib in combination with durvalumab in patients with endometrial cancer and proficient mismatch repair (pMMR), usually poorly responding to immunotherapy. Olaparib also shows efficacy in patients with prostate cancer and P/LP variants in BRCA1/2 genes, both as monotherapy and in combination with new hormonal agents, regardless of HRD status.
Conclusions. Olaparib in monotherapy is effective in patients with P/LP variants in the BRCA1/2 genes, while its use in combination therapies allows for the extension of indications for targeted treatment. Comprehensive molecular diagnostics and further research on the mechanisms of resistance and new strategies for personalizing oncological treatment are of key importance
Neutrophil-to-high-density lipoprotein cholesterol ratio is related to in-stent neoatherosclerosis and plaque vulnerability: An optical coherence tomography study
No full textBackground: In-stent neoatherosclerosis (ISNA) is the primary cause of in-stent restenosis (ISR). The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) has been independently associated with atherosclerosis and coronary artery stenosis. Aims: To assess whether NHR predicts ISNA and vulnerable plaques in ISR patients using optical coherence tomography (OCT). Methods: This cross-sectional study enrolled 216 individuals with 220 ISR lesions who percutaneous coronary intervention guided by OCT between July 2018 and November 2022. Participants were stratified into tertiles based on NHR: tertile 1 (NHR <3.464; n = 72), tertile 2 (3.464 ≤NHR ≤5.131; n = 72), and tertile 3 (NHR >5.131; n = 72). The clinical baseline, angiographic, and OCT characteristics were recorded and analyzed. Associations between NHR, ISNA, and thin fibrous caps (TCFA) were analyzed using both univariable and multivariable logistic regression analyses. Receiver operating characteristic curve analysis was conducted to assess the diagnostic capability of NHR for identifying ISNA and TCFA. Results: The highest NHR tertile had higher incidences of ISNA and TCFA than the lowest tertile. NHR positively correlated with ISNA and plaque vulnerability. NHR was independently associated with ISNA and TCFA in multivariable models (ISNA: OR, 1.318; 95% CI, 1.145– 1.516; TCFA: OR, 1.369; 95% CI, 1.183–1.584). The areas under the curve were 0.656 for ISNA and 0.717 for TCFA. Receiver operating characteristic-derived cut-offs were NHR 4.058 for ISNA (sensitivity 69.72%; specificity 59.81%) and 4.109 for TCFA (sensitivity 83.93%; specificity 56.88%). Conclusions: In patients with DES-ISR, NHR was independently associated with OCT-defined ISNA and TCFA, with modest discrimination; moreover, larger prospective studies are needed to validate these finding
