Clinical oncology最新文献

{"title":"Developing a Paired Whole Genome Sequencing Service for Children With Cancer","authors":"L. Sarkies ,&nbsp;P. Thomas ,&nbsp;E.A. Edeko ,&nbsp;S. Leiter ,&nbsp;J. Trotman ,&nbsp;R. Armstrong ,&nbsp;A. Vedi","doi":"10.1016/j.clon.2024.07.009","DOIUrl":"10.1016/j.clon.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>The uniqueness of paired (tumor and germline) whole genome sequencing (PWGS) in cancer diagnosis and management lies in not just its ability to uncover oncogenic drivers and potential treatment targets but also on the identification of underlying cancer predisposition syndromes, which has significant implications for the patient and their family.</div></div><div><h3>Aims</h3><div>This is a descriptive article highlighting the processes taken by our team to incorporate PWGS into routine National Health Service (NHS) clinical care for children with cancer. The main aim of this article is to share our experience with other centers that may wish to set up similar services and set the stage for future quantitative/qualitative research.</div></div><div><h3>Methods</h3><div>This article is further supported by an audit focusing on children in whom an underlying cancer predisposition was confirmed.</div></div><div><h3>Results</h3><div>The audit highlights the success of the program to date, with 100% of families identified as being at risk of a cancer predisposition syndrome being offered referral to clinical genetics and 100% of at-risk first-degree relatives being offered predictive counseling and testing. Areas requiring improvement included discussion of reproductive options as only six out of nine families (67%) had a documented discussion.</div></div><div><h3>Conclusions</h3><div>Incorporation of the audit recommendations will improve our service, and sharing of our experience will hopefully encourage more pediatric oncology services to introduce PWGS into routine clinical care and reduce inequity of access. Further work is required to assess the long-term cancer risk reduction and establish the psychosocial impact of PWGS for the child and family.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103623"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104947","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 Constitutional Genomic Testing on Current Breast Cancer Care","authors":"W. Cheah,&nbsp;R.I. Cutress,&nbsp;D. Eccles,&nbsp;E. Copson","doi":"10.1016/j.clon.2024.08.006","DOIUrl":"10.1016/j.clon.2024.08.006","url":null,"abstract":"<div><div>The most commonly diagnosed cancer in women worldwide is cancer of the breast. Up to 20% of familial cases are attributable to pathogenic mutations in high-penetrance (BReast CAncer gene 1 [BRCA1], BRCA2, tumor protein p53 [TP53], partner and localizer of breast cancer 2 [PALB2]) or moderate-penetrance (checkpoint kinase 2 [CHEK2], Ataxia-telangiectasia mutated [ATM], RAD51C, RAD51D) breast-cancer-predisposing genes. Most of the breast-cancer-predisposing genes are involved in DNA damage repair via homologous recombination pathways. Understanding these pathways can facilitate the development of risk-reducing and therapeutic strategies. The number of breast cancer patients undergoing testing for pathogenic mutations in these genes is rapidly increasing due to various factors. Advances in multigene panel testing have led to increased detection of pathogenic mutation carriers at high risk for developing breast cancer and contralateral breast cancer. However, the lack of long-term clinical outcome data and incomplete understanding of variants, particularly for moderate-risk genes limits clinical application. In this review, we have summarized the key functions, risks, and prognosis of breast-cancer-predisposing genes listed in the National Health Service (NHS) England National Genomic Test Directory for inherited breast cancer and provide an update on current management implications including surgery, radiotherapy, systemic treatments, and post-treatment surveillance.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103631"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OncoFlash—Research Updates in a Flash!","authors":"S. Parikh ,&nbsp;K.T. Jayaprakash","doi":"10.1016/j.clon.2024.10.031","DOIUrl":"10.1016/j.clon.2024.10.031","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103659"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615207","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":"Sequencing Targeted Therapy in Era of Precision Medicine for Thyroid Cancers","authors":"I.S. Boon","doi":"10.1016/j.clon.2024.103704","DOIUrl":"10.1016/j.clon.2024.103704","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103704"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964051","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":"Exploring gene expression in localised prostate cancer: Insights from a randomised control trial with a focus on hypoxia and angiogenic genomic biomarkers post-EBRT and HDR-BTb","authors":"T. Lodhi ,&nbsp;M. Reardon ,&nbsp;A.M. Rojas ,&nbsp;A. Choudhury ,&nbsp;P. Hoskin","doi":"10.1016/j.clon.2024.10.020","DOIUrl":"10.1016/j.clon.2024.10.020","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Pages 6-7"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428757","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":"Response adapted de-escalation of neo-adjuvant therapy for intermediate risk HER2-positive early breast cancer: an institutional experience","authors":"T. Talbot,&nbsp;F. Rehman,&nbsp;L. Kenny,&nbsp;V. Harding,&nbsp;O. Hatcher,&nbsp;S. Cleator","doi":"10.1016/j.clon.2024.103727","DOIUrl":"10.1016/j.clon.2024.103727","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103727"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429121","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":"A comprehensive overview of a single-institutional (University College London Hospital) experience with CDK4/6 inhibitors in ER+/HER2- metastatic breast cancer","authors":"T.J. Walsh,&nbsp;L.M. Vallodolid,&nbsp;K. Gayford,&nbsp;R. Nayar,&nbsp;K. DeSouza,&nbsp;R. Roylance","doi":"10.1016/j.clon.2024.103728","DOIUrl":"10.1016/j.clon.2024.103728","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103728"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429122","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 in Radiation Oncology","authors":"S.K. Vinod ,&nbsp;R. Merie ,&nbsp;S. Harden","doi":"10.1016/j.clon.2024.02.001","DOIUrl":"10.1016/j.clon.2024.02.001","url":null,"abstract":"<div><div>High-quality decision making in radiation oncology requires the careful consideration of multiple factors. In addition to the evidence-based indications for curative or palliative radiotherapy, this article explores how, in routine clinical practice, we also need to account for many other factors when making high-quality decisions. Foremost are patient-related factors, including preference, and the complex interplay between age, frailty and comorbidities, especially with an ageing cancer population. Whilst clinical practice guidelines inform our decisions, we need to account for their applicability in different patient groups and different resource settings. With particular reference to curative-intent radiotherapy, we explore decisions regarding dose fractionation schedules, use of newer radiotherapy technologies and multimodality treatment considerations that contribute to personalised patient-centred care.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103523"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Chemoradiotherapy versus Radiotherapy Alone in the Treatment of Stage II and T3N0M0 Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis","authors":"H. Zeng,&nbsp;H. Wang,&nbsp;S. Liu,&nbsp;X. Xu","doi":"10.1016/j.clon.2024.10.004","DOIUrl":"10.1016/j.clon.2024.10.004","url":null,"abstract":"<div><h3>Aims</h3><div>The efficacy of concurrent chemoradiotherapy (CCRT) for Stage II and T3N0 nasopharyngeal carcinoma (NPC), particularly during the shift from two-dimensional conventional radiotherapy (2DCRT) to intensity-modulated radiotherapy (IMRT) is debated.Therefore this study aims to systematically evaluate and meta-analyze survival benefits of CCRT versus radiotherapy alone for Stage II and T3N0 NPC, stratified by radiotherapy techniques.</div></div><div><h3>Materials and methods</h3><div>As of April 1, 2024, we conducted an exhaustive literature search across databases such as PubMed, Embase, Cochrane Library, and Web of Science, with the aim of identifying and screening studies that compare the efficacy of CCRT versus radiotherapy alone in the treatment of Stage II and T3N0 NPC.</div></div><div><h3>Results</h3><div>A total of 10 studies encompassing 5015 patients were included in this comprehensive analysis. The findings indicate that, apart from progression-free survival (PFS), CCRT did not improve survival outcomes, including overall survival (OS), distant metastasis-free survival (DMFS), local recurrence-free survival (LRRFS), and failure-free survival (FFS), with all <em>P</em> values exceeding 0.05. Concurrently, the incidence of grade ≥3 adverse events associated with CCRT was significantly elevated (odds ratio [OR] = 3.77, 95% confidence interval [CI] = 2.75–5.15, <em>P</em> &lt; 0.0001). Subgroup analysis revealed that, compared with RT, the combination of 2DCRT with concurrent chemotherapy significantly improved OS (hazard ratio [HR] = 0.57, 95% CI = 0.46–0.71, <em>P</em> &lt; 0.00001), PFS (HR = 0.65, 95% CI=0.53–0.78, <em>P</em> &lt; 0.00001), DMFS (HR = 0.54, 95% CI = 0.37–0.79, <em>P</em> = 0.002), and LRRFS (HR = 0.63, 95% CI = 0.49–0.82, <em>P</em> = 0.0005). In contrast, the combination of IMRT with concurrent chemotherapy failed to demonstrate improvements in OS, PFS, DMFS, or LRRFS, with all <em>P</em> values exceeding 0.05.</div></div><div><h3>Conclusion</h3><div>In contrast with RT, CCRT did not enhance survival in stage II and T3N0 NPC patients, yet caused more adverse reactions. 2DCRT combined with concurrent chemotherapy significantly improved OS, PFS, DMFS, and LRRFS, while IMRT with concurrent chemotherapy showed no clinical benefits.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103652"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evidence for Low-level Laser Therapy for Oral Mucositis in Head and Neck Cancer Radiotherapy","authors":"J. O'Hara ,&nbsp;M.S. Iqbal","doi":"10.1016/j.clon.2024.103731","DOIUrl":"10.1016/j.clon.2024.103731","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103731"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964053","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}