Clinical oncology最新文献

{"title":"Oncoflash","authors":"F. Holt , R. Simoes","doi":"10.1016/j.clon.2025.103946","DOIUrl":"10.1016/j.clon.2025.103946","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103946"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The BRAFV600E Mutation Enhances Age-Based Prognostic Stratification in Radioiodine-Treated Papillary Thyroid Cancer: A Retrospective Cohort Study","authors":"J. Cao ,&nbsp;H. Liang ,&nbsp;X. Li ,&nbsp;X. Guan ,&nbsp;Y.Z. Ma ,&nbsp;J. Li","doi":"10.1016/j.clon.2025.103945","DOIUrl":"10.1016/j.clon.2025.103945","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate whether BRAF^V600E mutation status enhances the value of age in predicting clinical outcomes for papillary thyroid carcinoma (PTC) patients receiving radioactive iodide (RAI) therapy.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective analysis of 1160 PTC patients treated with RAI therapy. Patients were stratified by age (≤18, 18-55, and ≥55 years) and BRAF^V600E status. Clinicopathological characteristics, treatment responses, and risk factors for poor outcomes (biochemical/structural incomplete response biochemical incomplete response/structural incomplete response [BIR/SIR]) were analysed using logistic regression.</div></div><div><h3>Results</h3><div>BRAF^V600E-positive patients aged ≤18 years showed aggressive features, including larger tumour size, higher lymph node metastasis rates, elevated thyroglobulin levels (TgAb-negative), and worse 6-month/3-year outcomes (all <em>P</em> &lt; .05). Multivariate analysis confirmed high-risk subtypes, distant metastasis, and elevated Tg levels as independent BIR/SIR predictors. BRAF^V600E-negative patients showed no significant age-related clinical characteristics and outcomes (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>BRAF^V600E mutation status significantly modifies the impact of age in PTC patients with RAI therapy. Patients aged ≤18 years with BRAF^V600E-positive exhibit distinct aggressive behaviours and poorer RAI therapy responses. These findings support integrating BRAF^V600E testing with age stratification to refine risk assessment and therapeutic strategies.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103945"},"PeriodicalIF":3.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Next-Generation Sequencing-Guided Targeted Therapies in Advanced Cancer: A Systematic Review and Meta-Analysis.","authors":"F Kazmi, R Katyal, T F D Liu, P Gkogkou, S P Blagden, S Lord, D Dodwell, N Shrestha","doi":"10.1016/j.clon.2025.103943","DOIUrl":"https://doi.org/10.1016/j.clon.2025.103943","url":null,"abstract":"<p><strong>Aims: </strong>Precision oncology, driven by next-generation sequencing (NGS), enables the use of matched targeted therapies (MTTs) tailored to tumour-specific genomic alterations. While benefits in early-stage cancer are well-established, the impact of MTTs in relapsed or metastatic settings remains unclear. This systematic review and meta-analysis (PROSPERO ID: CRD42023471466) evaluates the efficacy and safety of NGS-guided MTTs in patients with advanced solid and haematological tumours.</p><p><strong>Materials and methods: </strong>Searches of CENTRAL, MEDLINE, EMBASE (to 30 October 2024), reference lists, and conference proceedings identified randomized controlled trials (RCTs) comparing NGS-guided MTTs (alone or combined with standard of care systemic treatment [SOC]) versus SOC alone in patients with advanced cancers that had progressed after at least one prior systemic therapy. Primary outcomes were progression-free survival (PFS), overall survival (OS), and grade ≥3 adverse events. Data extraction and bias assessment were conducted independently by two reviewers. Random-effects meta-analysis was performed using the DerSimonian-Laird method.</p><p><strong>Results: </strong>Thirty RCTs (7393 patients) were included that collectively enrolled patients with eight different cancer types. With a median follow-up ranging from 12 months to 62.3 months, MTTs were associated with a 30-40% reduction in the risk of disease progression. No consistent OS benefit was observed with MTT monotherapy. However, combining MTTs with SOC resulted in improved OS, particularly in patients with prostate and urothelial cancer, but conferred PFS gain without OS improvement in those with breast and ovarian cancer. In terms of adverse events, we observed MTTs increased toxicity risk compared to SOC, specifically, in combination regimens. Most studies were at high risk of bias, with performance and detection bias being common limitations.</p><p><strong>Conclusion: </strong>NGS-guided MTTs significantly enhance PFS, especially when combined with SOC, with OS benefits being more tumour-specific. Increased toxicity rates with MTTs underscore the need for careful in patient selection. Furthermore, genomic profiling should be routinely integrated into the management of patients with advanced or recurrent cancers.</p>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"103943"},"PeriodicalIF":3.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Molecular Tools for Identifying and Guiding Treatment of Cancers of Unknown Primary: A Systematic Review","authors":"S. Saibil ,&nbsp;X. Yao ,&nbsp;D. Sivajohanathan ,&nbsp;M.D. Deodat ,&nbsp;M. Vickers ,&nbsp;P. Wheatley-Price ,&nbsp;J.-Y. Yoon ,&nbsp;H. Feilotter","doi":"10.1016/j.clon.2025.103944","DOIUrl":"10.1016/j.clon.2025.103944","url":null,"abstract":"<div><h3>Background</h3><div>Cancer of unknown primary (CUP) represents a significant clinical challenge due to its heterogeneity and the poor prognosis often associated with the disease. Molecular profiling has emerged as a promising approach to address the challenges associated with CUP. This systematic review evaluates the existing evidence on the value of different types of molecular tools for CUP diagnosis and treatment.</div></div><div><h3>Methods</h3><div>MEDLINE, EMBASE and Cochrane Database of Systematic Reviews published between 2013 and 2024 were searched for shortlisting eligible studies, relating to the use of molecular profiling tests in clinical management of CUP patients. Eight studies are included in this review.</div></div><div><h3>Results</h3><div>Among 1556 publications from the literature search, four randomized controlled trials (RCTs), one comparative study, two single-arm studies reporting comparative data, and one diagnostic study were included.</div><div>The certainty of the aggregate evidence ranged from low to very low for the studies, as assessed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Studies using contemporary methods to determine tumour of origin or tumour agnostic actionable mutations demonstrated the positive impact on survival of CUP patients with access to targeted therapy and immunotherapy.</div></div><div><h3>Conclusions</h3><div>This systematic review highlights the complexities of the existing literature in patients with CUP. The published impact of molecular profiling tools on survival outcomes by guiding treatment has been limited due to study design; however, improved survival has been shown in patients who have received immunotherapy or targeted therapy. The results from future RCTs or high-quality comparative studies will clarify the role of molecular profiling tools in patients with CUP.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103944"},"PeriodicalIF":3.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Decision-making at Oncology Multidisciplinary Team Meetings: A Structured Observational Study","authors":"Y. Koo ,&nbsp;J. Shafiq ,&nbsp;J. Yanga ,&nbsp;S. Avery ,&nbsp;S.K. Vinod","doi":"10.1016/j.clon.2025.103942","DOIUrl":"10.1016/j.clon.2025.103942","url":null,"abstract":"<div><h3>Aims</h3><div>Multidisciplinary meetings (MDMs) are crucial in cancer care, with increasing attention on improving the quality of decision-making. Validated tools have been utilised to assess MDM performance internationally. However, no studies have been performed within the Australian context. This study evaluates the quality of decision-making at oncology MDMs across three affiliated academic institutions in Australia.</div></div><div><h3>Materials and methods</h3><div>This prospective observational study encompassed 14 different MDMs across three cancer centres in South Western Sydney Local Health District, NSW, Australia. Two trained observers observed four randomly chosen MDMs per tumour site, assessing the information quality and the team contributions, using the validated Metric for the Observation of Decision-Making (MDT-MODe) tool. Behaviours were scored on a Likert scale from 1 (behaviour contrary to the defined optimum) to 5 (evidence-based optimal behaviour).</div></div><div><h3>Results</h3><div>A total of 64 MDMs (N = 498 patients) were observed, with an average of seven cases per meeting (range: 2-15). Management decisions were made in 99% of the cases. Psychosocial factors (Mean (M) = 1.27, standard deviation [SD] = 0.70), comorbidities (M = 1.69, SD = 1.13) and patient's views (M = 1.12, SD = 0.51) were less comprehensively addressed compared to radiology (M = 4.10, SD = 1.52), pathology (M = 3.73, SD = 1.54) and patient history (M = 4.60, SD = 0.73) (<em>P</em> &lt;  0.05). Regarding disciplinary contributions, cancer specialist nurses scored considerably lower (M = 1.04, SD = 0.38) compared to other team members (<em>P</em> &lt;  0.05). The quality of information was consistent across MDMs, with mean scores of 2.5 to 2.99, however quality of team contributions varied more significantly.</div></div><div><h3>Conclusion</h3><div>Evaluating MDMs using a validated tool provides valuable insights into decision-making quality across MDMs. There was a consistent high standard of comprehensive medical information presented, but team contributions varied and psychosocial issues, comorbidities and patient preferences were less well considered. These findings provide an opportunity for offering feedback to MDMs, facilitating the identification of potential interventions to improve the quality of decision-making.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103942"},"PeriodicalIF":3.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paid MBP advert CO_Journals_AI_Conference_280x210_180925_SEB_01","authors":"","doi":"10.1016/S0936-6555(25)00195-5","DOIUrl":"10.1016/S0936-6555(25)00195-5","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103940"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RCR Meetings","authors":"","doi":"10.1016/S0936-6555(25)00194-3","DOIUrl":"10.1016/S0936-6555(25)00194-3","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103939"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncoflash—Research Updates in a Flash!","authors":"D. Shor ,&nbsp;K. Thippu Jayaprakash","doi":"10.1016/j.clon.2025.103932","DOIUrl":"10.1016/j.clon.2025.103932","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103932"},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Radiotherapy Plan Robustness: A Systematic Literature Review.","authors":"S Kim, D Bernstein, A Taylor","doi":"10.1016/j.clon.2025.103938","DOIUrl":"https://doi.org/10.1016/j.clon.2025.103938","url":null,"abstract":"<p><strong>Aims: </strong>Advances in radiotherapy have led to increasingly conformal and complex treatment plans. The progressive reduction in safety margins around the target volume and the increased use of hypofractionated radiotherapy further heighten their vulnerability to systematic geometric uncertainties, which may compromise target volume coverage and increase doses to normal tissues. Evaluating treatment plan robustness, therefore, is crucial to ensuring the safe and effective delivery of radiotherapy. This systematic literature review provides a comprehensive overview of current practices for assessing treatment plan robustness across radiotherapy modalities.</p><p><strong>Materials and methods: </strong>A Pubmed search was conducted for studies published up to July 2025 that evaluated plan robustness.</p><p><strong>Results: </strong>Of 287 publications, 225 met the inclusion criteria. Most studies (173 of 225) focused on proton therapy, with setup (198 studies) and range (184 studies) being the most commonly considered uncertainties. Robustness evaluation methods varied widely and were categorised as dose-volume histogram (DVH)-based, voxel-based and radiobiological metrics. The most commonly used method for evaluating plan robustness involved visualising DVHs by overlapping those from multiple uncertainty scenarios to represent all possible variations. Frequently used dosimetric parameters for clinical target volume (CTV) coverage included variations of CTV D95%, D98% and V95% and the proportion of scenarios in which CTV D98%>95%. Voxel-based metrics, such as Max-Min dose distributions and voxel-wise dose reconstructions, provided spatial information on areas susceptible to uncertainties. Radiobiological metrics assessed robustness through changes in tumour control and normal tissue complication probabilities, highlighting the clinical impact of dose variations arising from uncertainty scenarios.</p><p><strong>Conclusion: </strong>Currently, there is no international consensus on evaluating plan robustness. We recommend combining DVH-based metrics with spatially informative voxel-based approaches. Establishing a standardised framework for robustness evaluation, along with integrating commercial robust evaluation software tools that enable the generation of these metrics, will be essential for its adoption in clinical practice.</p>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"103938"},"PeriodicalIF":3.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging Based Delineation in Head and Neck Cancers: Balancing Coverage and Toxicity","authors":"S. Haider","doi":"10.1016/j.clon.2025.103941","DOIUrl":"10.1016/j.clon.2025.103941","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103941"},"PeriodicalIF":3.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}