Metastases

Antiplatelet Therapy Mitigates Brain Metastasis Risk in Non‑Small Cell Lung Cancer: Insights from a Comprehensive Retrospective Study

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In a retrospective observational cohort Martín‑Abreu et al. from the Hospital Universitario de Canarias published in the journal Cancers (Basel) to evaluate whether exposure to antiplatelet therapy reduces the incidence and delays the onset of brain metastases in patients with non‑small cell lung cancer (NSCLC). Use of antiplatelet agents—mainly aspirin—was associated with a significantly reduced incidence of brain metastases (6.9% vs. 20.0%), longer metastasis‑free interval (77.5 vs. 62.6 months), improved Progression-Free Survival, and no cases of brain metastasis among those initiating therapy post‑diagnosis 1).

Critical Review

* Strengths:

  • Large sample size (n=650) over 4 years—impressive real‑world data.
  • Statistically significant findings with p<0.001 for key outcomes.
  • Stage‑stratified analysis adds biological plausibility.

* Weaknesses/Limitations:

  • Retrospective design limits causal inference—confounding by indication is possible; patients on antiplatelet therapy were older with more comorbidities, thus inherently different.

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Comparison of survival benefit and safety profile between lenvatinib and donafenib as conversion therapy in patients with hepatocellular carcinoma 

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In a retrospective comparative cohort study, Hou et al. 1) published in the American Journal of Translational Research, the authors—affiliated with the Department of Oncology, Department of Gynaecology and Obstetrics, and Department of Neurosurgery at Shijiazhuang People’s Hospital (Hebei, China), as well as Beijing Water Conservancy Hospital—compared the survival benefit and safety profile of lenvatinib versus donafenib as conversion therapy in patients with hepatocellular carcinoma (HCC) at China National Liver Cancer (CNLC) stages I–III.

Lenvatinib demonstrated significantly superior survival outcomes—both in overall survival and progression-free survival—compared to donafenib. It also showed better tolerability, with fewer grade ≥3 adverse events.

❌ 1. Study Design: Retrospective = Weak Evidence

This is yet another retrospective single-center analysis, plagued by inherent biases—selection, reporting, and confounding—that no amount of statistical massaging can resolve. No randomization, no blinding, and no control for treatment timing or physician discretion. In oncology, where treatment nuances matter, such designs should be considered hypothesis-generating at best, not guidance for clinical practice.

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