Cancer is thought to be the second most prevalent and leading cause of mortality worldwide, affecting both men and women among other chronic diseases. While there are several treatment options available, significant strains, side effects, and resistance have led researchers to focus on finding novel alternative medications for cancer treatment. Antioxidants and the immunomodulatory activities of medicinal plants are studied and considered to have anti-cancer effects. Medicinal plants contain diverse phytoconstituents as natural drugs, which possess numerous medicinal properties used for treating and preventing various illnesses. These phytoconstituents work through several mechanisms to target and kill cancer cells. Anticancer mechanisms include suppression and arrest of the G0/G1 phase, acting as anti-mitotic and anti-microtubule agents, enhancing the activity of macrophages, inhibiting cancer cells through various signaling cascades, anti-angiogenesis, and cytotoxicity. Investigating botanical sources and their metabolites can uncover new chemical entities for cancer treatment at the molecular target level and provide future interventions in cancer therapy. This article summarizes a few medicinal plants and their mechanisms of action for their anticancer potential. Furthermore, we discuss the future prospects and limitations of using medicinal plants in cancer treatment.

A growing body of literature has demonstrated improved quality of life in cancer patients who utilize web-based patient portals; however, no studies have investigated their impact on objective clinical measures. The study aimed to evaluate the impact of patient portal utilization on clinical outcomes in cancer care. Patient portal platforms provide patients with direct access to their providers through messaging, medication requests, and other tools. There is a knowledge gap in the literature regarding whether electronic patient portals enhance outcomes in cancer care.

This study is a retrospective analysis of 791 patients with multiple myeloma within the Scripps Health system. The effect of MyScripps electronic patient portal use on unplanned hospital visits and mortality was assessed. Outcomes were also evaluated in relation to the age-adjusted Charlson comorbidity index and chemotherapy use.

Results showed that older, male, Hispanic, and Spanish-speaking patients had lower portal utilization. Those with inactive portal status had higher rates of unplanned hospital visits and mortality. Inactive portal status was an independent predictor of unplanned hospital visits in two multivariable logistic regression analyses. A logistic regression model investigating the interaction between patient portal use and age-adjusted Charlson comorbidity index revealed that active portal status remained a predictor of unplanned hospital visits.

This study highlights the potential to improve clinical outcomes among patients with multiple myeloma, particularly in vulnerable communities, by increasing access to electronic patient portals.

Information on the survival of urothelial cancer (UCa) patients with brain metastases (BM) is largely unreliable due to the rarity of such cases. Previous studies that have attempted to capture the prevalence and survival of these patients are limited to case series and retrospective studies with small cohort sizes. This study aimed to explore patient characteristics and treatment outcomes based on treatment modalities from a large sample of patients with UCa and BM.

In this retrospective study, we utilized the TriNetX Research Network, a real-world and in-house database with longitudinal electronic medical records from 92 institutions. The database was queried for patients with UCa who also had BM. Kaplan–Meier plots were used to assess overall survival (OS). Log-rank tests were applied for stratified outcomes. The Cox proportional hazards model was used for continuous data.

We identified 357 patients with UCa and BM, representing 4.7% of the 7,521 patients diagnosed with primary UCa. The mean age at diagnosis was 65.6 years, with a predominance of male patients (67%). The median OS from BM diagnosis was 18.6 months. For patients treated solely with stereotactic radiosurgery (SRS), the median OS was 20.8 months. For those treated with both SRS and surgical resection, the median OS was 18.6 months. There was no significant difference in survival between patients treated with SRS alone and those treated with both SRS and surgical resection (p = 0.875). For patients treated only with gemcitabine chemotherapy, the median OS was 15.4 months.

This study represents the largest known retrospective analysis of UCa patients with BM. Survival trends for patients treated with surgical resection, SRS, and systemic therapies are described in detail.

Information on the survival of urothelial cancer (UCa) patients with brain metastases (BM) is largely unreliable due to the rarity of such cases. Previous studies that have attempted to capture the prevalence and survival of these patients are limited to case series and retrospective studies with small cohort sizes. This study aimed to explore patient characteristics and treatment outcomes based on treatment modalities from a large sample of patients with UCa and BM.

In this retrospective study, we utilized the TriNetX Research Network, a real-world and in-house database with longitudinal electronic medical records from 92 institutions. The database was queried for patients with UCa who also had BM. Kaplan–Meier plots were used to assess overall survival (OS). Log-rank tests were applied for stratified outcomes. The Cox proportional hazards model was used for continuous data.

We identified 357 patients with UCa and BM, representing 4.7% of the 7,521 patients diagnosed with primary UCa. The mean age at diagnosis was 65.6 years, with a predominance of male patients (67%). The median OS from BM diagnosis was 18.6 months. For patients treated solely with stereotactic radiosurgery (SRS), the median OS was 20.8 months. For those treated with both SRS and surgical resection, the median OS was 18.6 months. There was no significant difference in survival between patients treated with SRS alone and those treated with both SRS and surgical resection (p = 0.875). For patients treated only with gemcitabine chemotherapy, the median OS was 15.4 months.

This study represents the largest known retrospective analysis of UCa patients with BM. Survival trends for patients treated with surgical resection, SRS, and systemic therapies are described in detail.

Olaparib is a selective poly (ADP-ribose) polymerase inhibitor. However, its clinical application is hindered by low solubility and undesired pharmacokinetic profiles (e.g., relatively short circulation). Therefore, the present study aims to exploit polymeric micelles as a safe solubilizer and nanocarrier of olaparib, in order to improve its solubility and pharmacokinetics.

Poly (ε-caprolactone)-co-poly (benzyl 5-methyl-2-oxo-1,3-dioxane-5-carboxylate), i.e., benzyl-functionalized trimethylene carbonate)-b-poly (ethylene glycol) (P(CL-co-TMC-Bz)-PEG), was synthesized by ring-opening polymerization, and used to prepare the π-π-stacked polymeric micelles for olaparib encapsulation. A series of olaparib-loaded micelles with different polymer concentrations and wt% loadings were prepared using different methods to investigate the effect of formulation variables on the size of polymeric micelles and drug loadings. In addition, the in vitro release of olaparib from the micelles, and the cytotoxicity of micellar olaparib formulations on the SKOV3 tumor cell line were evaluated by UV spectrophotometry and CCK-8 assay, respectively. Finally, the blood circulation kinetics and side effects of the incorporated olaparib in the micelles and free olaparib were investigated in SD rats using ultra-high performance liquid chromatography analysis and H&E staining, respectively.

It was found that P(CL11-co-TMC-Bz5)-PEG micelles served as a safe and excellent solubilizer for olaparib, and that the solubilization capacity was easily tailored by adjusting the polymer concentration. In addition, when loaded in micelles, olaparib exhibited a sustained release behavior in vitro, and obvious cytotoxicity on SKOV3 cells. The in vivo studies revealed that olaparib incorporated in P(CL11-co-TMC-Bz5)-PEG polymeric micelles exhibited prolonged circulation (t1/2 = 2.00 hours), when compared to free olaparib (t1/2 ≤ 0.25 hours), and excellent safety. However, in terms of taking advantage of the EPR effect of the micelle delivery system to achieve the targeted olaparib delivery, the circulation time of olaparib in the micelles remained rather short.

Improvements, such as chemical crosslinking and drug conjugation, are required to improve the retention of olaparib-loaded polymeric micelles in blood circulation, and benefit from the use of micelles as a targeted delivery system.

Three-dimensional power Doppler (3DPD) ultrasound has been used for assessing adnexal masses, and in this study, we aimed to perform a meta-analysis to evaluate its role in the differential diagnosis of adnexal masses.

A search for primary studies assessing the diagnostic performance of 3DPD in discriminating benign from malignant masses carried out between January 1990 and May 2023 was performed in Medline (PubMed), Scopus, and Web of Science databases with study quality evaluated using QUADAS-2.

We identified 404 citations. Ultimately, 18 studies comprising 2,975 women were included, and the mean prevalence of malignant lesions was 37%. In most cases, the quality of studies was moderate. Overall, pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 3DPD vascular tree assessment for studies including any type of mass were 77% (95% confidence interval [CI] = 52%–91%), 80% (95% CI = 37%–97%), 3.9 (95% CI = 0.7–20.9), and 0.29 (95% CI = 0.10–0.81), respectively. Heterogeneity was high for both sensitivity and specificity. Pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 3DPD vascular tree assessment for studies including only “complex” or “suspicious” adnexal masses were 90% (95% CI = 82%–94%), 88% (95% CI = 74%–95%), 7.3 (95% CI = 3.2–16.4), and 0.12 (95% CI = 0.06–0.22), respectively. Heterogeneity was moderate for both sensitivity and specificity. We could not perform quantitative synthesis for studies estimating 3D vascular indexes.

The diagnostic performance of 3DPD for discriminating benign from malignant adnexal masses is good, and there is great heterogeneity in diagnostic criteria when using this technique.