Clinical oncology最新文献

{"title":"Clinicopathological features and outcomes of patients with adenoid cystic carcinoma of the breast in a large cancer institution: Retrospective analysis of 20 years of real-world experience","authors":"Susanna Slater , Myrto Kastrisiou , Mae Alghawas , Edward Phillips , Stephen Johnston , Zoe Kemp , Emma Kipps , Marina Parton , Nicholas Turner , Alicia Okines","doi":"10.1016/j.clon.2025.104024","DOIUrl":"10.1016/j.clon.2025.104024","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104024"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448680","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":"What happened to patients eligible for POSNOC who did not enter the trial?","authors":"Georgina Hanbury , Jasmine Timbres , Elinor Sawyer , Daniel Smith","doi":"10.1016/j.clon.2025.104016","DOIUrl":"10.1016/j.clon.2025.104016","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104016"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448865","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":"Breast Cancer Adjuvant Radiotherapy Without Tattoos: Comparison Between Surface Imaging and Four-point Localisation","authors":"C. Lenci,&nbsp;F. De Felice,&nbsp;M. Tomaciello,&nbsp;R. Caiazzo,&nbsp;S. Arcieri,&nbsp;M. Fantoni,&nbsp;G. Montalto,&nbsp;A.L. Magnante,&nbsp;G. Minniti","doi":"10.1016/j.clon.2026.104052","DOIUrl":"10.1016/j.clon.2026.104052","url":null,"abstract":"<div><h3>Aims</h3><div>Precise patient positioning is critical for successful radiotherapy (RT) in right-sided breast cancer, ensuring adequate tumour coverage while sparing organs at risk (OARs). Conventional tattoo-based setups can cause patient distress. Surface-guided radiotherapy (SGRT) using systems like AlignRT offers a promising, noninvasive alternative. This prospective single-centre study compared the accuracy and reproducibility of SGRT versus conventional tattoo-based positioning for right-sided breast cancer RT.</div></div><div><h3>Materials and Methods</h3><div>Eligible patients underwent a crossover study design, receiving both positioning methods at different points in their treatment. Setup errors were quantified from pretreatment cone-beam computed tomography (CT) registrations. Observations were analysed for each group. Data were analysed using the Shapiro-Wilk test for normality and independent two-sample t-tests to compare positioning errors.</div></div><div><h3>Results</h3><div>A total of 52 patients were enrolled, and a total of 136 observations were analysed for each group. SGRT positioning resulted in significantly lower mean errors compared to the tattoo-based method across all three directions: longitudinal (<em>P</em> &lt; 0.001), vertical (<em>P</em> &lt; 0.001) and lateral (<em>P</em> = 0.044). Box plot analysis confirmed SGRT had less inter-fraction variability and fewer clinically significant outliers (errors &gt;1 cm), demonstrating superior setup stability.</div></div><div><h3>Conclusions</h3><div>SGRT with AlignRT provides superior accuracy and reproducibility for patient positioning in right-sided breast cancer RT. This approach enhances treatment precision, reduces setup variability, and improves patient experience by eliminating the need for permanent tattoos. Future studies are warranted to confirm these findings and assess long-term clinical outcomes.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104052"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137174","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":"Two Versus Five-Fraction Magnetic Resonance-Guided Adaptive Radiotherapy with DOminant-TArgeted Boost in Localized Prostate Cancer (DOTA-2): Interim Acute Toxicity Analysis of the Phase II Randomised Trial","authors":"R. Romrattaphan,&nbsp;P. Dankulchai,&nbsp;T. Prasartseree,&nbsp;W. Sittiwong,&nbsp;W. Thaweerat,&nbsp;S. Junlabut,&nbsp;S. Nitipitch","doi":"10.1016/j.clon.2025.104029","DOIUrl":"10.1016/j.clon.2025.104029","url":null,"abstract":"<div><h3>Aims</h3><div><strong>DOminant-TArgeted Boost in Localized Prostate Cancer (</strong><strong>DOTA-2</strong><strong>)</strong> is a phase II randomised controlled trial comparing two ultra-hypofractionated radiotherapy with dominant intraprostatic lesion (DIL) boost: 26 Gy/2F, 32 Gy to DIL vs 36.25 Gy/5F, 40 Gy to DIL, without androgen deprivation therapy (ADT), for prostate cancer.</div></div><div><h3>Materials and methods</h3><div>Patients with low- to favourable-intermediate-risk prostate cancer were randomly assigned to receive either 2 fractions or 5 fractions. Magnetic resonance-guided adaptive radiotherapy (MRgART) was delivered using the Unity® MR-Linac with the adapt-to-shape workflow for every fraction. The primary endpoint was cumulative grade ≥2 acute genitourinary (GU) and gastrointestinal (GI) toxicity. Secondary endpoints included quality of life in the urinary and sexual domains. An interim analysis of acute GU and GI toxicities was conducted on the first 22 patients from the total planned cohort of 44.</div></div><div><h3>Results</h3><div>Patients were randomly assigned to either the 2-fraction (N = 10) or 5-fraction stereotactic body radiotherapy (SBRT) (N = 12), stratified by risk group, prostate volume, and DIL location. The median follow-up time was 16 weeks. The cumulative worst acute grade ≥2 GU toxicity was reported in 2/10 (20%) patients in the 2-fraction group vs 4/12 (33.3%) in the 5-fraction group (<em>P</em> = 0.48), with no cases of grade ≥3 acute GU toxicity. No grade ≥2 acute GI toxicity was observed in either arm. The two groups had no significant difference in International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) scores.</div></div><div><h3>Conclusion</h3><div>Two-fraction SBRT with a DIL boost, delivered using MRgART without ADT, demonstrated acceptable acute GU and GI toxicity in this interim analysis, suggesting the feasibility of continuing the investigation.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104029"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997616","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":"Safety and Efficacy of Nivolumab Plus Ipilimumab in Microsatellite Instability-High/Mismatch Repair-Deficient Colorectal Cancer: A Systematic Review","authors":"E. Kokori ,&nbsp;I.C. Abraham ,&nbsp;G. Olatunji ,&nbsp;J.E. Aboje ,&nbsp;O.A. Akinruli ,&nbsp;S.A. Joseph ,&nbsp;E.A. Agyemang ,&nbsp;C. Ezeano ,&nbsp;S.O. Bukky ,&nbsp;N. Aderinto ,&nbsp;C.E. Agbo","doi":"10.1016/j.clon.2025.104028","DOIUrl":"10.1016/j.clon.2025.104028","url":null,"abstract":"<div><h3>Aims</h3><div>Colorectal cancer (CRC) remains a significant global health burden, with rising incidence and mortality despite advances in screening and treatment. Microsatellite instability-high (MSI-H) and mismatch repair–deficient (dMMR) CRCs comprise a distinct molecular subtype characterised by a high mutational burden and immunogenicity, rendering them responsive to immune checkpoint inhibitors. The combination of nivolumab (anti–programmed cell death protein 1 [PD-1]) and ipilimumab (anti-CTLA-4) has emerged as a promising therapeutic strategy. This systematic review aims to evaluate the safety and efficacy of nivolumab plus ipilimumab combination therapy in patients with MSI-H/dMMR CRC.</div></div><div><h3>Materials and methods</h3><div>A literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and Scopus up to March 2025. Eligible studies included clinical trials or observational studies that reported efficacy (objective response rate [ORR], progression-free survival [PFS], and overall survival [OS]) and safety outcomes (treatment-related adverse events [TRAEs]) of nivolumab plus ipilimumab combination therapy in MSI-H/dMMR CRC. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool and the Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>Six studies (N = 758) were included: four phase II trials, one phase III randomised trial, and one phase II neoadjuvant trial. Participants were predominantly White, with a median age of 56.5–66 years, and most had right-sided tumours. Across studies, nivolumab plus ipilimumab combination therapy demonstrated favourable ORRs (31–69%), durable PFS, and OS benefits, particularly in metastatic settings. Neoadjuvant use also showed a promising pathologic response. TRAEs were generally manageable; grade 3–4 events occurred in 14–35% of patients, commonly diarrhoea, fatigue, and endocrinopathies.</div></div><div><h3>Conclusion</h3><div>Nivolumab plus ipilimumab is an effective and relatively well-tolerated option for MSI-H/dMMR CRC, offering significant clinical benefit across disease stages. Ongoing trials and longer follow-up are warranted to optimise dosing, identify predictive biomarkers, and refine patient selection.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104028"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997610","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":"Immune Checkpoint Inhibitor Therapy for Advanced, Unresectable Esophageal Squamous Cell Carcinoma: A Series of Patient-level Meta-analyses From Phase III Trials","authors":"M.S. Beshr ,&nbsp;R.H. Shembesh ,&nbsp;M.V. Nounou ,&nbsp;M.E. Ali ,&nbsp;E.C. Smyth ,&nbsp;M. Abdelrahim ,&nbsp;F. Pietrantonio ,&nbsp;M. Elhadi ,&nbsp;M. Moehler","doi":"10.1016/j.clon.2026.104032","DOIUrl":"10.1016/j.clon.2026.104032","url":null,"abstract":"<div><h3>Aim</h3><div>This study reconstructed patient-level data to provide updated evidence on survival outcomes across PD-L1 expression subgroups.</div></div><div><h3>Materials and Methods</h3><div>A systematic search was conducted on March 2, 2025, using PubMed, Embase, Web of Science, Cochrane, and Scopus for RCTs comparing ICIs to chemotherapy in advanced ESCC. Kaplan-Meier curves were reconstructed using a time-to-event algorithm for all patients and for PD-L1 subgroups. KMSubtraction was used to retrieve unpublished survival data. A patient-level meta-analysis was performed using a stratified Cox model.</div></div><div><h3>Results</h3><div>Thirteen phase III trials (6,672 patients) were included. In the first-line setting, patients with TPS &lt;1% (from CheckMate-648 and ESCORT-1st) showed no overall survival (OS) benefit (HR: 0.88, p = 0.187), whereas those with TPS ≥1% from the same trials showed a significant benefit (HR: 0.61, p &lt; 0.001).</div><div>For a combined positive score (CPS) ≥10, pooled data from ASTRUM-007, KEYNOTE-590, ORIENT-15, and GEMSTONE-304 showed significant OS benefit (HR: 0.60, p &lt; 0.001). CPS &lt;10 (KEYNOTE-590, ORIENT-15, and GEMSTONE-304) also showed benefit (HR: 0.81, p = 0.02), but no survival benefit was seen in CPS 1–9 (ASTRUM-007 and GEMSTONE-304) (HR: 0.82, p = 0.117).</div></div><div><h3>Conclusion</h3><div>PD-L1 appears to be a useful biomarker in advanced ESCC. Patients with PD-L1 levels of 10 or higher consistently showed survival benefits. For PD-L1 &lt;10, treatment decisions may be less clear; further research on combining PD-L1 with other biomarkers is needed. Patients with PD-L1 &lt;1 showed minimal benefit and should be informed about the limited efficacy of ICIs.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104032"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036286","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":"Risk of Symptomatic Skeletal Events After Discontinuation of Long-term Denosumab in Patients With Bone Metastases: A Retrospective Cohort Study","authors":"H. Hara ,&nbsp;N. Fukase ,&nbsp;R. Sawada ,&nbsp;T. Takemori ,&nbsp;Y. Nakamatsu ,&nbsp;R. Kuroda ,&nbsp;T. Akisue","doi":"10.1016/j.clon.2026.104058","DOIUrl":"10.1016/j.clon.2026.104058","url":null,"abstract":"<div><h3>Aims</h3><div>The optimal duration of denosumab (Dmab) therapy for patients with bone metastases remains uncertain, particularly regarding the balance between preventing skeletal-related events and the risk of medication-related osteonecrosis of the jaw (MRONJ) after treatment discontinuation. This study evaluated the incidence and risk factors of symptomatic skeletal events (SSEs) following Dmab discontinuation.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analysed 178 patients with bone metastases who discontinued Dmab after ≥6 doses and had ≥3 months of follow-up. Incidence, timing, and risk factors of SSEs were assessed using Cox regression. A landmark analysis was performed in patients treated for ≥2 years (n = 152), with SSE-free survival compared between discontinuation and continuation groups, with and without propensity score matching (PSM). Incidence rates of SSEs and MRONJ were compared between patients treated for &lt;2 and ≥2 years.</div></div><div><h3>Results</h3><div>SSEs occurred in 16.9% of patients, with 77% developing within one year after discontinuation, particularly within six months. Longer Dmab treatment duration was associated with reduced SSE risk (HR, 0.96; 95% CI, 0.93–0.99). The incidence of SSEs was lower in the ≥2-year group compared with the &lt;2-year group (0.044 vs. 0.201 per person-year), whereas MRONJ incidence was higher (0.091 vs. 0.055 per person-year, P &lt; 0.001). In the ≥2-year landmark cohort, the number of prior SSEs was the only independent predictor of subsequent SSEs. After ≥2 years, SSE-free survival was not significantly different between discontinuation and continuation groups after PSM (P = 0.074). Median overall survival from Dmab initiation was 41 months, with 1- and 2-year survival rates of 96% and 72%, respectively.</div></div><div><h3>Conclusion</h3><div>Discontinuation of Dmab after ≥2 years may be a reasonable option for selected patients with stable disease. However, decisions must balance the benefit of reduced SSE risk with the increased likelihood of MRONJ. Patients with a history or greater burden of SSEs remain at increased risk and require close monitoring.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104058"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164370","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":"Carbon impact of patient travel for breast radiotherapy: A comparison of two UK centres","authors":"Emily Scott ,&nbsp;Amani Chowdhury ,&nbsp;Elizabeth Halliday ,&nbsp;Daniel Megias ,&nbsp;Clare Kane ,&nbsp;Sarah Needleman ,&nbsp;Andreas Makris","doi":"10.1016/j.clon.2025.104022","DOIUrl":"10.1016/j.clon.2025.104022","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104022"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448681","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":"Reviewer Thank You 2025","authors":"","doi":"10.1016/S0936-6555(26)00061-0","DOIUrl":"10.1016/S0936-6555(26)00061-0","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104090"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448733","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":"Sacituzumab Govitecan in Advanced Triple negative breast cancer: Real world experience in a tertiary care centre","authors":"Sharon Costa,&nbsp;Maira Iqbal,&nbsp;Katy Herring,&nbsp;Mariam Jafri,&nbsp;Rahul Chowdhary","doi":"10.1016/j.clon.2025.104013","DOIUrl":"10.1016/j.clon.2025.104013","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104013"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448864","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}