Publications
2026
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Real-world implementation and cost impact analysis of Oncotype DX testing in early-stage breast cancer
CONCLUSION: This study highlights the importance of streamlined testing processes and the need for clinician training in interpreting test results in a real-world setting. In addition, the findings underscore the role of ODX in enhancing personalized treatment in HR + , HER2- eBC while reducing overtreatment. The cost analysis indicates substantial cost savings with ODX testing. -
Statin Use and Survival in Early Breast Cancer According to Different Intrinsic Subtypes
CONCLUSIONS AND RELEVANCE: In this cohort study of patients with early breast cancer, prediagnostic statin use was not associated with higher survival; however, postdiagnostic statin use was associated with lower all-cause and breast cancer-specific mortality among patients with hormone receptor-positive intrinsic subtypes. These findings suggest that statin therapy may improve survival of patients with early hormone receptor-positive subtypes. -
Distinct roles of WHO Score, CCI, and CFS in prognosis and treatment decisions for non-small cell lung cancer: A retrospective real-world study
CONCLUSIONS: WHO Score remains a robust prognostic indicator for survival in NSCLC. CFS shows significant potential in reflecting treatment decisions related to frailty, capturing risks not fully addressed by WHO Score. CCI offered minimal additive prognostic information. While WHO Score is fundamental, incorporating CFS enhances frail patient assessment, though its independent survival prediction value warrants further study. -
Menopausal hot flashes, night sweats, and insomnia disappeared with lamotrigine: a case report
CONCLUSIONS: Menopausal vasomotor symptoms disappeared with lamotrigine and returned after stopping the medicine in this case. The precise action mechanism(s) of lamotrigine is unknown. Lamotrigine has interactions with estrogen and progesterone medicines. So, this effect we describe might not have been just a coincidence. Lamotrigine could be worth further research in regards to menopausal symptoms.
2025
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Impact of the COVID-19 pandemic on the quality of life of early breast cancer patients undergoing adjuvant chemotherapy - an observational, multicenter study
BACKGROUND AND PURPOSE: We evaluated the impact of the coronavirus disease 2019 (COVID-19) pandemic on health-related quality of life (HRQoL) in early-stage breast cancer patients receiving adjuvant chemotherapy. -
Comprehensive Genomic Profiling in Advanced Non-Small Cell Lung Cancer: A Real-World Cohort Study in Finland
CONCLUSIONS: CGP affects the treatment strategies for NSCLC. Nearly half of our entire cohort had a genetic alteration eligible for approved targeted therapies. Besides these findings, CGP provides additional data to assess treatment decisions and outcomes, including co-occurring genetic alterations and TMB. In real-world clinical practice, the practical application of this information can be restricted by the varying unavailability of optimal treatments. -
A systematic approach to study the effects of acquisition parameters and biological factors on computerized mammography analysis using ex vivo human tissue: A protocol description
BACKGROUND: Mammography is the most common imaging modality for the detection of breast cancer. Artificial intelligence algorithms for mammography analysis have shown promising performance for breast cancer risk assessment and lesion detection and classification; however, these models often fail the test of external validation. The evidence points to variations in image acquisition-known as the batch effect-as a main contributing factor to the lack of the models generalization and robustness.... -
The metabolome of fecal extracellular vesicles in patients with malignant solid tumors
Dysregulated metabolism, a hallmark of cancer, creates unique metabolic features that can be employed to elucidate cancer prognosis, personalized treatment, and therapeutic response. Metabolomics has emerged as a powerful tool for profiling biomarkers in cancer studies. Most cancer metabolomic research on extracellular vesicles (EVs) has focused on human biofluids as samples. The metabolome of fecal EVs, a connecting link for host-microbiome interactions in cancer, has not been extensively... -
Outcome of lung cancer surgery and proportion of lung cancer patients eligible for surgery in five Finnish hospitals in 2018, real world study
BACKGROUND AND PURPOSE: Lung cancer is one of the most common malignancies worldwide and is associated with high mortality. In Finland, overall lung cancer survival is lower than in other Nordic countries. A recent Finnish Cancer Registry publication reported that only 11.8% of patients underwent surgery. We aimed to assess whether operability and surgical outcomes contribute to Finland's inferior lung cancer survival rates. -
The association between intrinsic breast cancer subtypes, mammography screening and prognosis: a large population-based real world cohort study
CONCLUSION: In this real-world dataset, triple-negative tumors had the highest risk of death and majority of these tumors were found after the screening age. In screening-aged females, patients with screen-detected tumors had the best survival, while patients with interval tumors and patients not attending screening had the worst prognosis. -
Gut microbiota-derived extracellular vesicles form a distinct entity from gut microbiota
Extracellular vesicles (EVs), nanoparticles secreted by both gram-negative and gram-positive bacteria, carry various biomolecules and cross biological barriers. Gut microbiota-derived EVs are currently being investigated as a communication mechanism between the microbiota and the host. Few clinical studies, however, have investigated gut microbiota-derived EVs. Here, we show that machine learning models were able to accurately distinguish gut microbiota and respective microbiota-derived EV... -
Increased primary breast tumor expression of CD73 is associated with development of bone metastases and is a potential biomarker for adjuvant bisphosphonate use
CONCLUSIONS: High CD73 expression is associated with development of bone metastases. Zoledronate counteracts this effect. These results suggest that CD73 expression might serve as a biomarker for adjuvant zoledronic acid use. -
Increased PD-1 expression in livers associated with PD-1-antibody-induced hepatotoxicity
Vanishing bile duct syndrome (VBDS) is a serious drug induced liver injury characterized by chronic cholestasis and loss of intrahepatic bile ducts. VBDS has been reported also following checkpoint inhibitor treatment. We compared CD3 + , CD4 + , CD8 + , CD20 + , CD57 + , PD-1 + and PD-L1 + lymphocyte infiltrates in liver biopsies of patients that encountered VBDS (n = 2) or hepatotoxicity (n = 3) after pembrolizumab (n = 4) or nivolumab (n = 1) treatment with samples from normal liver (n = 10),... -
Lifetime Treatment Trajectories of Mantle Cell Lymphoma: Simulation Based Analysis of 20 Years of Real-World Data
Mantle cell lymphoma is a rare type of B-cell lymphoma, which is considered incurable yet treatable. In recent years, the treatment options of mantle cell lymphoma have multiplied, and the focus of treatment is expected to shift from traditional chemoimmunotherapy toward precision medicine. However, this development is hindered by the high costs of targeted therapies. To provide a baseline for future assessment of costs and benefits of new and emerging MCL treatments, we established a predictive... -
Gut microbiome-derived bacterial extracellular vesicles in patients with solid tumours
CONCLUSION: Our findings suggest that bEVs are unique functional entities. There is a need to explore bEVs together with conventional gut microbiome analysis in functional cancer research to decipher the potential of bEVs as cancer diagnostic or therapeutic biomarkers.
2024
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Human papillomavirus E6 alters Toll-like receptor 9 transcripts and chemotherapy responses in breast cancer cells in vitro
CONCLUSION: HPV16 may influence breast cancer cell TLR9 transcription and chemotherapy responses and could thereby affect breast cancer prognosis. These results suggest that HPV may have a previously unrecognized role in breast cancer pathophysiology and warrant further studies on the topic. -
Depression and Anxiety Symptoms Before and After Breast-Cancer Diagnosis Among Young Women in the Northern Finland Birth Cohort 1966
CONCLUSION: Depressive and somatic symptoms increased significantly among young females at 3-8 years after breast-cancer diagnosis compared with the time before the cancer diagnosis. Psychosocial measures of support for breast-cancer survivors should be provided over the long-term. -
The Association of Metformin, Other Antidiabetic Medications, and Statins with the Prognosis of Hepatocellular Carcinoma in Patients with Type 2 Diabetes: A Retrospective Cohort Study
This study aimed to explore whether the prediagnostic use of metformin and statins is associated with the prognosis of patients with hepatocellular carcinoma (HCC) and type 2 diabetes. We identified 1383 eligible individuals who had both type 2 diabetes and HCC diagnosed between 1998 and 2017 from several Finnish registers. Cox models were fitted for cause-specific and all-cause mortality in relation to the use of antidiabetic medications and statins prior to the HCC diagnosis. Prediagnostic... -
The association of breast cancer patients survival and prior menopausal hormone therapy in women with type 2 diabetes
We investigated the association of prediagnostic use of menopausal hormone therapy (MHT) with breast cancer survival among women with type 2 diabetes (T2D). The study cohort was identified from a Finnish nationwide diabetes database, and consisted of women with T2D, who were diagnosed with breast cancer between 2000 and 2011 (n = 3189). The patients were classified according to their previous MHT use: systemic MHT, local MHT, and no history of any MHT. The cumulative mortality from breast... -
Front-line and second-line treatment for mantle cell lymphoma in clinical practice: A multicenter retrospective analysis
CONCLUSION: Front-line treatment in this cohort of MCL was as expected and with a median PFS of over 3.5 years. Second-line treatment strategies were heterogeneous and the median second-line PFS was little over 1 year. -
Serum protein profiling reveals an inflammation signature as a predictor of early breast cancer survival
CONCLUSIONS: Inflammation and immunity-related serum proteins have the potential to rise above the classical prognostic factors of early-stage breast cancer. They may also help to distinguish benign from malignant breast lesions. -
Neuropilin-1 and placental growth factor as prognostic factors in metastatic breast cancer
CONCLUSION: Especially NRP-1 and PlGF have prognostic potential in metastatic breast cancer patients treated with a bevacizumab-taxane combination. Patients with low plasma levels of NRP-1 or PlGF have longer OS than patients with high levels. Patients with both low NRP-1 and PlGF levels appear to have excellent long-term survival. -
Gut microbiome-derived bacterial extracellular vesicles in patients with solid tumours
CONCLUSION: Our findings suggest that bEVs are unique functional entities. There is a need to explore bEVs together with conventional gut microbiome analysis in functional cancer research to decipher the potential of bEVs as cancer diagnostic or therapeutic biomarkers.
2023
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Statin Use, Cholesterol Level, and Mortality Among Females With Breast Cancer
CONCLUSIONS AND RELEVANCE: Results of this cohort study showed that postdiagnostic use of statins was associated with reduced BC mortality compared with nonuse, and the risk was associated with subsequent change in serum cholesterol level. This finding suggests that cholesterol-lowering interventions with statins may be beneficial for patients with BC. -
Genomic characterization of IDH-mutant astrocytoma progression to grade 4 in the treatment setting
As the progression of low-grade diffuse astrocytomas into grade 4 tumors significantly impacts patient prognosis, a better understanding of this process is of paramount importance for improved patient care. In this project, we analyzed matched IDH-mutant astrocytomas before and after progression to grade 4 from six patients (discovery cohort) with genome-wide sequencing, 21 additional patients with targeted sequencing, and 33 patients from Glioma Longitudinal AnalySiS cohort for validation. The... -
Real-world Data: MCL2 Protocol Demonstrates Excellent Treatment Results Among Patients With Mantle Cell Lymphoma Not Fulfilling the Original Trial Inclusion Criteria
No abstract -
Breast density and the likelihood of malignant MRI-detected lesions in women diagnosed with breast cancer
CONCLUSION: Women diagnosed with breast cancer who have dense breasts have more incidental MRI-detected lesions, but higher breast density does not translate to increased likelihood of malignant incidental lesions. -
CD73 regulates zoledronate-induced lymphocyte infiltration in triple-negative breast cancer tumors and lung metastases
INTRODUCTION: Bisphosphonates (BPs) are bone-protecting osteoclast inhibitors, typically used in the treatment of osteoporosis and skeletal complications of malignancies. When given in the adjuvant setting, these drugs may also prevent relapses and prolong overall survival in early breast cancer (EBC), specifically among postmenopausal patients. Because of these findings, adjuvant nitrogen-containing BPs (N-BPs), such as zoledronate (ZOL), are now the standard of care for high-risk EBC patients,... -
Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events
CONCLUSIONS: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers. -
Impact of Timing of Surgery and Adjuvant Treatment on Survival of Adult IDH-wild-type Glioblastoma: A Single-center Study of 392 Patients
CONCLUSIONS: Interval from referral to surgery in the range of 4-10 weeks was not associated with decreased survivals in IDH-wt glioblastomas. In contrast, delay exceeding 30 days from surgery to adjuvant treatment may decrease long-term survival. -
Survival with lung cancer in Finland has not improved during 2007-2019-a single center retrospective population-based real-world study
CONCLUSION: Echoing the results of CONCORD-3, this study confirmed that the real-world survival of unselected lung cancer populations in Finland has not improved over the last 15 years, mainly because of the unchanged proportions of patients with late-stage lung cancer. This calls for earlier recognition of lung cancer, achieved by screening and increasing awareness of the disease. -
Survival of patients with mantle cell lymphoma in the rituximab era: Retrospective binational analysis between 2000 and 2020
Mantle cell lymphoma (MCL) is a rare peripheral B-cell lymphoma characterised by eventual relapse and progression towards a more aggressive disease biology. With the introduction of rituximab- and cytarabine-based immunochemotherapy regimens, the prognosis of the disease has changed dramatically over the last two decades. To assess the real-world survival of patients with MCL, we used a population-based cohort of 564 patients with MCL who were diagnosed and treated between 2000 and 2020. Patient...
2022
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Survival of patients with mantle cell lymphoma in the rituximab era: Retrospective binational analysis between 2000 and 2020
Mantle cell lymphoma (MCL) is a rare peripheral B-cell lymphoma characterised by eventual relapse and progression towards a more aggressive disease biology. With the introduction of rituximab- and cytarabine-based immunochemotherapy regimens, the prognosis of the disease has changed dramatically over the last two decades. To assess the real-world survival of patients with MCL, we used a population-based cohort of 564 patients with MCL who were diagnosed and treated between 2000 and 2020. Patient... -
The Association of Metformin, Other Antidiabetic Medications, and Statins With the Prognosis of Colon Cancer in Patients With Type 2 Diabetes: A Retrospective Cohort Study
CONCLUSION: Additional evidence was found for use of statins being associated with an improved survival from CC in patients with pre-existing T2D, but for metformin use the evidence was weaker. -
The Association of Metformin, Other Antidiabetic Medications and Statins on the Prognosis of Rectal Cancer in Patients with Type 2 Diabetes: A Retrospective Cohort Study
Metformin and statin use have been associated with an improved prognosis for colorectal cancer in persons with type 2 diabetes (T2D). Data regarding rectal cancer (RC) have been inconclusive; therefore, we investigated the issue with high-quality data and a robust study design. We identified 1271 eligible patients with T2D and incident RC between 1998 and 2011 from the Diabetes in Finland (FinDM) database. Cox models were fitted for cause-specific mortality rates to obtain adjusted estimates of... -
Adjuvant Capecitabine for Early Breast Cancer: 15-Year Overall Survival Results From a Randomized Trial
CONCLUSION: Addition of capecitabine to a chemotherapy regimen that contained docetaxel, epirubicin, and cyclophosphamide prolonged the survival of patients with early breast cancer. -
How breast cancer recurrences are found - a real-world, prospective cohort study
BACKGROUND: There is very limited data available on how most breast cancer recurrences, either distant metastases or locoregional recurrences (LRR), are actually discovered in routine clinical practice. -
Incidence and outcomes of cancer in 16- to 17-year-old adolescents
No abstract
2021
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Incidence and outcomes of cancer in 16- to 17-year-old adolescents
No abstract -
Radiological and pathological assessment of response to neoadjuvant CDK4/6 inhibitor and endocrine treatments in a real-life setting-initial results
CONCLUSION: Although none of the patients achieved a pathologically complete response, neoadjuvant CDK4/6I + E treatment rendered all tumors operable. MRI appears to be reliable in the assessment of the neoadjuvant CDK4/6I + E treatment response in a real-life setting. Larger studies are warranted to confirm these results. -
Association of antidiabetic medication and statins with survival from ductal and lobular breast carcinoma in women with type 2 diabetes
We investigated the survival of female patients with pre-existing type 2 diabetes (T2D) diagnosed with invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) of breast, in relation to the use of metformin, other antidiabetic medication (ADM) and statins. The study cohort consisted of 3,165 women (2,604 with IDC and 561 with ILC). The cumulative mortality from breast cancer (BC) and from other causes was calculated using the Aalen-Johansen estimator. The cause-specific mortality... -
CD73 facilitates EMT progression and promotes lung metastases in triple-negative breast cancer
CD73 is a cell surface ecto-5'-nucleotidase, which converts extracellular adenosine monophosphate to adenosine. High tumor CD73 expression is associated with poor outcome among triple-negative breast cancer (TNBC) patients. Here we investigated the mechanisms by which CD73 might contribute to TNBC progression. This was done by inhibiting CD73 with adenosine 5'-(α, β-methylene) diphosphate (APCP) in MDA-MB-231 or 4T1 TNBC cells or through shRNA-silencing (sh-CD73). Effects of such inhibition on... -
Early-Life Risk Factors for Breast Cancer - Prospective Follow-up in the Northern Finland Birth Cohort 1966
CONCLUSIONS: Early-life residence and socioeconomic conditions may have an impact on developing breast cancer in women in adult life. All breast cancer cases of this study were relatively young, and most of them are assumed to be premenopausal. -
Real-world, single-centre prospective data of age at breast cancer onset: focus on survival and reproductive history
CONCLUSIONS: Despite the suggested undertreatment of older patients, we report excellent long-term outcomes in all age groups in this prospective cohort. Later endogenous endocrine exposure may cause delay in breast cancer onset, but the exact biology behind this phenomenon is so far unclear. -
Association of Metformin, Other Antidiabetic Medications, and Statins With Incidence of Colon Cancer in Patients With Type 2 Diabetes
CONCLUSION: This study found insufficient evidence for an association between metformin, insulin, other oral type 2 diabetes medications, or statins and the incidence of CC.
2020
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Association of Metformin, Other Antidiabetic Medications, and Statins With Incidence of Colon Cancer in Patients With Type 2 Diabetes
CONCLUSION: This study found insufficient evidence for an association between metformin, insulin, other oral type 2 diabetes medications, or statins and the incidence of CC. -
Prognostic factors in metastatic breast cancer: a prospective single-centre cohort study in a Finnish University Hospital
CONCLUSIONS: These results confirm ER status as a primary prognostic factor in metastatic breast cancer. Furthermore, it also suggests that the presence of initial lymph node metastases could serve as a prognostic factor in recurrent breast cancer. -
High Parity Predicts Poor Outcomes in Patients With Luminal B-Like (HER2 Negative) Early Breast Cancer: A Prospective Finnish Single-Center Study
While breast cancer prognoses are generally good, different molecular subtypes are known to have varying outcomes. Previous studies using breast cancer registries have suggested that high parity may be an adverse prognostic factor in luminal breast cancer, but breast cancer subtype definitions have varied and there have been few prospective studies. We therefore collected prospective data from patients diagnosed with early breast cancer at a single institution and followed them for a median of... -
Survival after breast cancer in women with type 2 diabetes using antidiabetic medication and statins: a retrospective cohort study
Background: We assessed survival of breast cancer in women with type 2 diabetes (T2D) treated with metformin, other types of antidiabetic medication (ADM) and statins.Materials and Methods: The study cohort consisted of women with T2D and diagnosed with breast cancer in Finland in 1998─2011. Mortality rates from breast cancer and other causes were analysed by Cox models, and adjusted hazard ratios (HRs) with 95% confidence intervals (Cls) were estimated in relation to the use of different types... -
Early progression of breast cancer during neoadjuvant chemotherapy may predict poorer prognoses
Background: In Finland, breast cancers treated with neoadjuvant chemotherapy (NACT) are usually locally advanced and/or have an inflammatory phenotype. We evaluated early NACT responses in breast tumours and lymph nodes and their correlation with survival.Material and methods: We collected a retrospective dataset of 145 patients with very high-risk but non-metastasised breast cancers that were treated with NACT in a Finnish University Hospital between September 2013 and January 2019. The...
2019
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Cytoplasmic Mineralocorticoid Receptor Expression Predicts Dismal Local Relapse-free Survival in Non-triple-negative Breast Cancer
CONCLUSION: Cytoplasmic MR expression is a strong predictor of local recurrence in non-metastatic breast cancer patients with non-TNBC tumour phenotype. -
High baseline Tie1 level predicts poor survival in metastatic breast cancer
CONCLUSIONS: This is the first study to demonstrate the prognostic value of baseline Tie1 plasma concentration in patients with metastatic breast cancer. Combined with the results of the Ang2 analyses, the patients with both high Tie1 and Ang2 levels before treatment had the poorest survival. -
Elevated preoperative serum levels of collagen I carboxyterminal telopeptide predict better outcome in early-stage luminal-B-like (HER2-negative) and triple-negative subtypes of breast cancer
Type 1 collagen is an important part of the extracellular matrix and changes in its metabolism and distribution are essential in breast cancer induction and progression. Serum concentrations of type 1 collagen synthesis (aminoterminal propeptide (PINP)) and degradation markers (carboxyterminal telopeptide (ICTP)) have previously been studied in early and metastatic breast cancer, but no data are available on specific breast cancer subtypes. We assayed 662 preoperative serum samples for PINP and... -
Low Plasma IL-8 Levels During Chemotherapy Are Predictive of Excellent Long-Term Survival in Metastatic Breast Cancer
CONCLUSION: Low IL-8 levels during chemotherapy treatment might help identify patients with prolonged survival. -
Association of antidiabetic medication and statins with breast cancer incidence in women with type 2 diabetes
CONCLUSIONS: No evidence of an association between the use of metformin or statins and the incidence of breast cancer in women with T2D was found. Among insulin users, a slightly higher incidence of breast cancer was observed.