ESMO OpenPub Date : 2025-05-01DOI: 10.1016/j.esmoop.2025.104632
E. Tzoras , D. Salgkamis , N. Tsiknakis , H. Johansson , W. Sun , M. Hellström , A. Andersson , S. Loibl , M. Untch , C. Denkert , P. Jank , M. Rantalainen , J. Hartman , I. Zerdes , A. Matikas , J. Bergh , T. Foukakis
{"title":"78P Validation of an AI-based solution for breast cancer risk stratification using digital H&E images: Subgroup analysis within PANTHER clinical trial","authors":"E. Tzoras , D. Salgkamis , N. Tsiknakis , H. Johansson , W. Sun , M. Hellström , A. Andersson , S. Loibl , M. Untch , C. Denkert , P. Jank , M. Rantalainen , J. Hartman , I. Zerdes , A. Matikas , J. Bergh , T. Foukakis","doi":"10.1016/j.esmoop.2025.104632","DOIUrl":"10.1016/j.esmoop.2025.104632","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 ","pages":"Article 104632"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ESMO OpenPub Date : 2025-05-01DOI: 10.1016/j.esmoop.2025.104627
M.A. Toli , X. Liu , L. Eriksson Bergman , S. Lando , D. Massa , C.E. Boman , C. Tranchell , G. Fotia , C. Vernieri , V. Guarneri , J. Bergh , M.V. Dieci , A. Matikas , T. Foukakis
{"title":"73P Prognostic value of the relative change of Ki-67 during neoadjuvant chemotherapy for triple-negative breast cancer: A population-based study","authors":"M.A. Toli , X. Liu , L. Eriksson Bergman , S. Lando , D. Massa , C.E. Boman , C. Tranchell , G. Fotia , C. Vernieri , V. Guarneri , J. Bergh , M.V. Dieci , A. Matikas , T. Foukakis","doi":"10.1016/j.esmoop.2025.104627","DOIUrl":"10.1016/j.esmoop.2025.104627","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 ","pages":"Article 104627"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ESMO OpenPub Date : 2025-05-01DOI: 10.1016/j.esmoop.2025.105109
S.T.C. Shepherd , C. Kelly-Morland , S. Drage , A.F. Brady , R. Macwana , L. Pickering , J. Larkin , P. Hill , S. Turajlic
{"title":"Fatal intracranial haemorrhage shortly after belzutifan initiation in von Hippel–Lindau (VHL) disease-associated haemangioblastoma","authors":"S.T.C. Shepherd , C. Kelly-Morland , S. Drage , A.F. Brady , R. Macwana , L. Pickering , J. Larkin , P. Hill , S. Turajlic","doi":"10.1016/j.esmoop.2025.105109","DOIUrl":"10.1016/j.esmoop.2025.105109","url":null,"abstract":"<div><h3>Background</h3><div>Belzutifan, a selective hypoxia-inducible factor-2α inhibitor, is approved for von Hippel–Lindau (VHL) disease-associated tumours and is Food and Drug Administration-approved for the management of advanced sporadic clear-cell renal-cell carcinoma. While belzutifan has demonstrated efficacy across VHL-related lesions, real-world safety data remain limited.</div></div><div><h3>Patients and methods</h3><div>We report a fatal intracranial haemorrhage occurring within 72 h of belzutifan initiation in a patient with VHL-associated central nervous system haemangioblastomas (CNS-HBs).</div></div><div><h3>Results</h3><div>This represents the third post-marketing case of early haemorrhage involving CNS or spinal haemangioblastomas, following previously reported spinal and cerebellar bleeds. Although CNS-HBs are highly vascular, spontaneous haemorrhage is exceedingly rare. The clustering of haemorrhagic events in these cases, within days of treatment initiation, suggests a rare but potentially serious adverse event not currently listed on regulatory labels.</div></div><div><h3>Conclusions</h3><div>This case highlights the importance of pharmacovigilance as belzutifan use expands into broader real-world populations, particularly in rare disease settings where trial cohorts are small and long-term safety data are limited.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105109"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ESMO OpenPub Date : 2025-05-01DOI: 10.1016/j.esmoop.2025.105079
M. de Scordilli , M. Bortolot , S. Torresan , C. Noto , S. Rota , P. Di Nardo , A. Fumagalli , M. Guardascione , E. Ongaro , L. Foltran , F. Puglisi
{"title":"Precision oncology in biliary tract cancer: the emerging role of liquid biopsy","authors":"M. de Scordilli , M. Bortolot , S. Torresan , C. Noto , S. Rota , P. Di Nardo , A. Fumagalli , M. Guardascione , E. Ongaro , L. Foltran , F. Puglisi","doi":"10.1016/j.esmoop.2025.105079","DOIUrl":"10.1016/j.esmoop.2025.105079","url":null,"abstract":"<div><div>Liquid biopsy has already proven effective in aiding diagnosis, risk stratification and treatment personalization in several malignancies, and it could represent a practice-changing tool also in biliary tract cancer, even though clinical applications are currently still limited. It is promising for early diagnosis, especially in high-risk populations, and several studies on circulating free DNA (cfDNA), circulating tumour cells and differential microRNA (miRNA) profiles in this setting are ongoing. Circulating tumour DNA (ctDNA) also appears as a feasible noninvasive biomarker in the curative setting, in detecting minimal residual disease after resection and in monitoring disease recurrence. As of today, it can be particularly valuable in biliary tract cancer for genomic profiling, with a good concordance with tissue samples for most molecular alterations. CtDNA analysis may especially be considered in clinical practice when the tumour tissue is not sufficient for next-generation sequencing, or when urgent therapeutic decisions are needed. Moreover, it offers the possibility of providing a real-time picture to monitor treatment response and dynamically identify resistance mutations, potentially representing a way to optimize treatment strategies.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105079"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Real-world comparison of pembrolizumab alone and combined with chemotherapy in metastatic lung adenocarcinoma patients with PD-L1 expression ≥50%","authors":"H.H. Hektoen , K.M. Tsuruda , O.T. Brustugun , K. Neumann , B.K. Andreassen","doi":"10.1016/j.esmoop.2025.105073","DOIUrl":"10.1016/j.esmoop.2025.105073","url":null,"abstract":"<div><h3>Objectives</h3><div>The frontline treatment of metastatic lung adenocarcinoma with high Programmed death-ligand 1 (PD-L1) expression (≥50%) includes immune checkpoint inhibitors (ICIs) either as monotherapy or combined with chemotherapy. The added benefit of chemotherapy in this context lacks direct comparison in head-to-head trials. We aimed to compare these two ICI treatment modalities both overall and within relevant patient subgroups in a real-world setting.</div></div><div><h3>Materials and methods</h3><div>This retrospective, nationwide study included 410 individuals diagnosed in Norway during 2017 to 2021 with stage IV non-small-cell lung adenocarcinoma, PD-L1 expression ≥50%, and treated first line with the ICI pembrolizumab, either as monotherapy (<em>n</em> = 317) or in combination with platinum-based chemotherapy (<em>n</em> = 93). We analyzed early (6-month) and overall (3-year) risk of death after treatment initiation using Cox regression, adjusted for and stratified by sex, age, stage, PD-L1 expression, performance status, and education.</div></div><div><h3>Results</h3><div>Patients treated with combination therapy had a higher median overall survival compared with monotherapy (22.6 months versus 14.2 months), and reduced risk of overall death, although not statistically significant after adjustment [hazard ratio (HR) 0.74, 95% confidence interval (CI) 0.54-1.00]. However, the risk of early death was significantly lower in patients receiving combination therapy, even after adjustment (HR 0.41, 95% CI 0.23-0.76). Across most subgroups, patients receiving combination therapy had comparable or superior survival outcomes relative to those receiving monotherapy. Particularly noteworthy were the observed benefits from combination therapy over monotherapy among females, individuals with stage IVB disease, and those with PD-L1 expression exceeding 75%.</div></div><div><h3>Conclusion</h3><div>Our real-world study demonstrates that combination therapy with ICI and chemotherapy provides superior early survival benefits over monotherapy in PD-L1-high patients. Additionally, certain subgroups showed enhanced overall survival. These findings challenge current treatment practices and underscore the need for further validation to optimize patient selection for monotherapy versus combination therapy, in particular to reassess the role of PD-L1 in treatment decisions.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105073"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ESMO OpenPub Date : 2025-05-01DOI: 10.1016/j.esmoop.2025.105097
E. Shimada , M. Nakagawa , M. Endo , N. Yokoyama , A. Nabeshima , T. Fujiwara , A. Kawai , Y. Nakashima
{"title":"Landscape of ultra-rare sarcomas: a nationwide study for epidemiology and prognosis","authors":"E. Shimada , M. Nakagawa , M. Endo , N. Yokoyama , A. Nabeshima , T. Fujiwara , A. Kawai , Y. Nakashima","doi":"10.1016/j.esmoop.2025.105097","DOIUrl":"10.1016/j.esmoop.2025.105097","url":null,"abstract":"<div><h3>Background</h3><div>The concept of ‘ultra-rare sarcoma’ was established to raise awareness of the clinical challenges resulting from its rarity. Given the novelty of this classification and the consequent paucity of data, this study aimed to investigate the epidemiology and prognosis of ultra-rare sarcomas.</div></div><div><h3>Design</h3><div>We analyzed data from the Bone and Soft Tissue Tumor Registry in Japan from 2001 to 2019, comparing ultra-rare and non-ultra-rare sarcomas. To assess the prognostic impact of ultra-rare sarcomas, we used Kaplan–Meier survival analysis with propensity score matching, multivariate analysis, and a machine learning technique known as random survival forest.</div></div><div><h3>Results</h3><div>Among the 22 821 patients analyzed, ultra-rare sarcomas accounted for 18.9% of the cases. Ultra-rare bone sarcomas were older than non-ultra-rare bone sarcomas (mean age: 57.6 versus 39.2 years, <em>P</em> < 0.001), while ultra-rare soft tissue sarcomas appeared in younger patients (mean age: 49.4 versus 62.2 years, <em>P</em> < 0.001). For patients >80 years old with bone sarcomas and those <20 years old with soft tissue sarcomas, ultra-rare sarcomas constituted approximately half of the cases. Survival analysis indicated that ultra-rare bone sarcomas were associated with longer survival (<em>P</em> = 0.022), whereas ultra-rare soft tissue sarcomas showed no significant difference in overall survival (<em>P</em> = 0.052). When stratified by age, however, patients <40 years old with ultra-rare soft tissue sarcomas had shorter survival (<em>P</em> < 0.001). Multivariate analysis indicated hazard ratios of 0.73 for ultra-rare bone and 1.25 for ultra-rare soft tissue sarcomas. Random survival forest showed that the importance of ultra-rare sarcomas was relatively low compared with other parameters.</div></div><div><h3>Conclusion</h3><div>Ultra-rare sarcomas are more common among older bone sarcoma patients and younger soft tissue sarcoma patients. Young patients with ultra-rare soft tissue sarcomas have a significantly worse prognosis. Overall, while ultra-rare sarcomas have a generally minor impact on prognosis, their effects are more pronounced in specific age groups.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105097"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ESMO OpenPub Date : 2025-05-01DOI: 10.1016/j.esmoop.2025.105059
J. Wang , Y. Zhang , R. Bai , Y. Wu , Z. Tong , A. Liu , Y. Zhang , H. Wang , X. Wu , Y. Cheng , H. Yang , Q. Zhou , X. Xing , X. Chen , F. Qiu , F. Ma
{"title":"Novel TROP2 antibody–drug conjugates for treatment of HER2-negative metastatic breast cancer patients with brain metastases: a promising option☆","authors":"J. Wang , Y. Zhang , R. Bai , Y. Wu , Z. Tong , A. Liu , Y. Zhang , H. Wang , X. Wu , Y. Cheng , H. Yang , Q. Zhou , X. Xing , X. Chen , F. Qiu , F. Ma","doi":"10.1016/j.esmoop.2025.105059","DOIUrl":"10.1016/j.esmoop.2025.105059","url":null,"abstract":"<div><h3>Background</h3><div>ESG401 is a further optimized antibody–drug conjugate comprising a humanized anti-trophoblast cell-surface antigen 2 immunoglobulin G1 monoclonal antibody conjugated to SN-38, a topoisomerase I inhibitor, via a proprietary novel stable linker. The analysis aimed to explore the efficacy of ESG401 in human epidermal growth factor receptor 2 (HER2)-negative breast cancer (BC) patients with brain metastases (BMs), a population urging significant clinical need with limited systematic treatment options.</div></div><div><h3>Patients and methods</h3><div>This subgroup analysis was conducted as part of an open-label, multi-dose, dose-escalation, and cohort-expansion multicenter phase I trial. Eligible participants were aged 18-75 years and had locally advanced or metastatic solid tumors. For this subgroup analysis, patients with histologically confirmed HER2-negative BC and BMs were enrolled. Efficacy endpoints included overall objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). Intracranial-specific endpoints included intracranial ORR (iORR), intracranial DCR (iDCR), and intracranial PFS. This trial is registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, NCT04892342.</div></div><div><h3>Results</h3><div>Among 17 patients with efficacy-evaluable BMs, the iORR was 41% (7/17) [95% confidence interval (CI) 18.4% to 67.1%] including 3 patients achieving an intracranial complete response. The iDCR was 76% (13/17) (95% CI 50.1% to 93.2%). The overall ORR was 53% (9/17) (95% CI 27.8% to 77.0%), the overall DCR was 71% (12/17) (95% CI 44.0% to 89.7%), and the medium PFS was 5.7 months. The safety profile was consistent with previous reports.</div></div><div><h3>Conclusions</h3><div>These findings suggest that ESG401 is a promising and well-tolerated treatment option for BMs.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 5","pages":"Article 105059"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ESMO OpenPub Date : 2025-05-01DOI: 10.1016/j.esmoop.2025.104613
Y. Lin , Y. Yu , Q. Wang , K. Huang , S. Guo , J. Zhang , Y. He , F. Meng , J. Yuan , C. Song
{"title":"59P A novel non-invasive machine learning model for predicting tertiary lymphoid structures and treatment response to neoadjuvant therapy in triple-negative breast cancer: A multicenter retrospective study","authors":"Y. Lin , Y. Yu , Q. Wang , K. Huang , S. Guo , J. Zhang , Y. He , F. Meng , J. Yuan , C. Song","doi":"10.1016/j.esmoop.2025.104613","DOIUrl":"10.1016/j.esmoop.2025.104613","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 ","pages":"Article 104613"},"PeriodicalIF":7.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}