European Journal of Cancer最新文献

{"title":"Overall survival of patients with de Novo HER2-positive metastatic breast cancer in the Netherlands from 2008 to 2017: A population-based cohort study of systemically treated patients","authors":"Nan Ding ,&nbsp;Karlijn E.P.E. Hermans ,&nbsp;Thiemo J.A. van Nijnatten ,&nbsp;Sanne M.E. Engelen ,&nbsp;Jolien Tol ,&nbsp;Loes Kooreman ,&nbsp;Marie-Jeanne T.F.D. Vrancken-Peeters ,&nbsp;Sabine Siesling ,&nbsp;Adri C. Voogd ,&nbsp;Vivianne C.G. Tjan-Heijnen ,&nbsp;Sandra M.E. Geurts","doi":"10.1016/j.ejca.2025.115475","DOIUrl":"10.1016/j.ejca.2025.115475","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to determine whether real-world overall survival (OS) of patients with <em>de Novo</em> HER2-positive (HER2 +) metastatic breast cancer (MBC) in the Netherlands improved over time.</div></div><div><h3>Methods</h3><div>Data of patients diagnosed with <em>de Novo</em> HER2 + MBC in 2008–2017 were retrieved from the Netherlands Cancer Registry. OS was estimated per two-year period using the Kaplan-Meier method and compared using the log-rank test for trend and the multivariable Cox proportional hazards analysis, adjusted for baseline characteristics and local therapy. First-given systemic and local therapy use was determined per two-year period.</div></div><div><h3>Results</h3><div>Among 1458 patients included, 99 % (1452/1458) were female and 53 % (775/1458) aged 50–74 years at diagnosis. Comparing patients diagnosed with <em>de Novo</em> HER2 + MBC in 2008–2009 versus 2016–2017, the median OS improved from 30·9 months (95 %CI:25·0–35·4) to 57·3 months (95 %CI:46·7–68·1) (p-value for trend&lt;0·001) (adjusted hazard rate ratio =0·49, 95 %CI:0·40–0·59). The use of any HER2-targeted therapy increased from 64 % (178/279) to 84 % (287/340), while the use of pertuzumab-based therapy increased from 0 % to 67 % (227/340) over the same period. The use of surgery remained stable over time, while radiotherapy use for both the primary tumour and metastases increased in recent years, from 16 % (44/279) and 15 % (42/279) in 2008–2009–22 % (76/340) and 26 % (88/340) in 2016–2017, respectively.</div></div><div><h3>Conclusion</h3><div>OS has doubled over ten years, for patients diagnosed with <em>de Novo</em> HER2 + MBC in the Netherlands between 2008 and 2017. No change in metastatic presentation was observed over time, suggesting the improved OS is most likely explained by treatment improvements.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115475"},"PeriodicalIF":7.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant treatment of gastrointestinal stromal tumor: State of the art in 2025","authors":"Nicolas Penel ,&nbsp;Axel Le Cesne ,&nbsp;Jean-Yves Blay","doi":"10.1016/j.ejca.2025.115473","DOIUrl":"10.1016/j.ejca.2025.115473","url":null,"abstract":"<div><div>The management of gastrointestinal stromal tumors (GISTs) has been revolutionized by the discovery of their sensitivity to imatinib. Most localized GISTs can be cured by surgery alone. The present overview aims to discuss the results of four recent randomized trials or updates assessing adjuvant imatinib. The duration of adjuvant treatments varied in these 4 trials (1 year <em>versus</em> zero, 2 years <em>versus</em> zero, 3 years <em>versus</em> 1 year and 6 years <em>versus</em> 3 years). All these trials showed that adjuvant imatinib improves disease/relapse-free survival in patients at high-risk of GIST relapse. Nevertheless, only one trial showed an overall survival improvement, in favor of 3-year treatment compared to 1-year treatment. But these randomized trials did not assess <em>KIT</em> or <em>PDGFRA</em> mutational status at study entry. Moreover, the definition of high-risk GIST differed across these trials. So, the patient subset that benefits the most from adjuvant imatinib therapy remains undetermined. The optimal duration of adjuvant imatinib therapy remain unclear.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115473"},"PeriodicalIF":7.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relative dose intensity of first-line FOLFOXIRI and FOLFOX/FOLFIRI both in combination with bevacizumab affects prognosis of metastatic colorectal cancer patients: A pooled analysis of TRIBE and TRIBE2 studies","authors":"R. Moretto ,&nbsp;D. Rossini ,&nbsp;Mariam Grazia Polito ,&nbsp;Carlotta Antoniotti ,&nbsp;Rossana Intini ,&nbsp;Veronica Conca ,&nbsp;Paola Andena ,&nbsp;Martina Carullo ,&nbsp;Lisa Salvatore ,&nbsp;Marco Maria Germani ,&nbsp;Francesca Bergamo ,&nbsp;Alessandro Passardi ,&nbsp;Paolo Ciracì ,&nbsp;Emiliano Tamburini ,&nbsp;Chiara Boccaccio ,&nbsp;Alberto Zaniboni ,&nbsp;Gianluca Masi ,&nbsp;Filippo Pietrantonio ,&nbsp;Sara Lonardi ,&nbsp;C. Cremolini","doi":"10.1016/j.ejca.2025.115470","DOIUrl":"10.1016/j.ejca.2025.115470","url":null,"abstract":"<div><h3>Background</h3><div>The relative dose intensity (RDI) of cytotoxic agents affects cancer patients’ clinical outcome, especially in the curative setting. Poor data are available in metastatic colorectal cancer (mCRC) and with specific regard to the use of the triplet FOLFOXIRI.</div></div><div><h3>Methods</h3><div>We performed a pooled analysis of the phase III TRIBE and TRIBE2 studies comparing FOLFOXIRI/bev to doublets (FOLFOX or FOLFIRI)/bev in order to assess the prognostic impact of the RDI (&lt;80 % <em>versus</em> ≥80 %) during the first 8 cycles of induction treatment of both the triplet and the doublet regimens.</div></div><div><h3>Results</h3><div>Overall, 282/581 (49 %) and 404/580 (70 %) of patients treated with FOLFOXIRI/bev and doublets/bev, respectively, received RDI≥ 80 %. Patients receiving RDI≥ 80 % had more favorable clinical condition and tumor-related prognostic features. RDI≥ 80 % was associated with higher ORR (62 % vs 53 %, OR: 1.44, 95 %CI:1.13 – 1.82; p = 0.0026), and longer PFS (11.5 versus 10.0 months; HR: 0.80, 95 %CI: 0.71 – 0.91; p &lt; 0.001) and OS (27.9 versus 22.2 months; HR: 0.75, 95 %CI: 0.65 – 0.85; p &lt; 0.001). These results were confirmed in multivariable models (p &lt; 0.001). Similar ORR (58 % vs 56 %, OR: 1.09, 95 %CI: 0.81–1.48; p = 0.57), PFS (10.8 versus 10.0 months; HR:0.96, 95 %CI: 0.83–1.12; p = 0.63) and OS (22.9 versus 24.9 months; HR:1.07, 95 %CI: 0.90–1.26; p = 0.46) were observed between patients treated with FOLFOXIRI/bev receiving RDI&lt; 80 % and those treated with doublets/bev receiving RDI≥ 80 %. These results were confirmed after stratification for unbalanced baseline characteristics between these subgroups (stratified p_ORR=0.55; p_PFS=0.70; stratified p_OS=0.33). As expected, patients in the RDI&lt; 80 % group experienced a higher incidence of severe chemo-related adverse events (72 % vs 34 %, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Maintaining an adequate RDI in the first-line therapy of mCRC improves patients’ clinical outcomes. Since there is no benefit from chemotherapy intensification in the case of low RDI, the secondary prophylaxis of chemotherapy-related severe adverse events might be preferrable rather than individual agents’ dose reductions.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115470"},"PeriodicalIF":7.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Tissue-agnostic target profiles and treatment efficacy in cancer patients: Insights from the C-CAT clinicogenomic repository” [Eur J Cancer 220 (2025) 115380]","authors":"Rui Kitadai ,&nbsp;Yusuke Okuma ,&nbsp;Taro Shibata ,&nbsp;Takashi Kohno ,&nbsp;Takafumi Koyama","doi":"10.1016/j.ejca.2025.115439","DOIUrl":"10.1016/j.ejca.2025.115439","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115439"},"PeriodicalIF":7.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of comorbid schizophrenia with cancer stage at admission, treatments, length of stay, and 30-day in-hospital mortality in patients with pancreatic cancer: A retrospective matched-pair cohort study in Japan","authors":"Jiashiang Lin ,&nbsp;So Sato ,&nbsp;Shotaro Aso ,&nbsp;Kiyohide Fushimi ,&nbsp;Hiroki Matsui ,&nbsp;Hideo Yasunaga","doi":"10.1016/j.ejca.2025.115468","DOIUrl":"10.1016/j.ejca.2025.115468","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have suggested an association between comorbid schizophrenia and various outcomes in patients with cancer, including cancer stage at admission, treatment, and in-hospital mortality. However, studies focusing specifically on patients with pancreatic cancer are limited.</div></div><div><h3>Aims</h3><div>This study aimed to elucidate the association between comorbid schizophrenia and cancer stage at admission, treatment, length of stay, and 30-day in-hospital mortality in patients with pancreatic cancer, while considering patient background factors, medical facilities, and year of treatment.</div></div><div><h3>Method</h3><div>We conducted a retrospective matched-pair cohort study using data from the Japanese Diagnosis Procedure Combination database. Patients with pancreatic cancer and comorbid schizophrenia were matched to those without psychiatric disorders at a maximum ratio of 1:4 according to sex, age group, year of admission, and admission facility. Each matched pair was treated as a cluster, and multivariable regression analyses using generalised estimating equations were performed to evaluate the association between psychiatric comorbidities and cancer-related outcomes.</div></div><div><h3>Results</h3><div>After adjusting for patient background factors, medical facilities, and the year of treatment, patients with comorbid schizophrenia were significantly more likely to be admitted with stage IV cancer, less likely to undergo chemotherapy, and more likely to have longer hospital stays and higher 30-day in-hospital mortality than those without psychiatric disorders. Although not statistically significant, patients with schizophrenia were less likely to undergo cancer-directed surgery.</div></div><div><h3>Conclusions</h3><div>Patients with pancreatic cancer and comorbid schizophrenia were significantly more likely to present with advanced cancer at admission, were less likely to receive chemotherapy, had longer hospital stays, and experienced higher 30-day in-hospital mortality than those without psychiatric disorders. Although not statistically significant, patients with schizophrenia were less likely to undergo cancer-directed surgery.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115468"},"PeriodicalIF":7.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in resection rates and postoperative mortality for gastrointestinal cancers between 2005 and 2020 in the Netherlands","authors":"Quince M.M.A. Timmermans ,&nbsp;Ignace H.J.T. de Hingh ,&nbsp;Marloes A.G. Elferink ,&nbsp;Bas P.L. Wijnhoven ,&nbsp;Erik J. Schoon ,&nbsp;Johannes H.W. de Wilt ,&nbsp;Lydia G.M. van der Geest ,&nbsp;Pauline A.J. Vissers","doi":"10.1016/j.ejca.2025.115469","DOIUrl":"10.1016/j.ejca.2025.115469","url":null,"abstract":"<div><h3>Aim</h3><div>This study assesses trends in resection rates and postoperative mortality for oesophageal, gastric, colon, rectal, periampullary and pancreatic cancer in the Netherlands.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included all patients with gastrointestinal cancer diagnosed in the period 2005–2020 as registered in the Netherlands Cancer Registry. Cochran-Armitage trend tests were used to assess trends in resection rates. Multivariable logistic regression analyses were used to assess the association between time period and resection rates and postoperative mortality and were stratified for nonmetastatic versus metastatic disease at initial diagnosis.</div></div><div><h3>Results</h3><div>A total of 226 925 patients with nonmetastatic and 92 343 with metastatic disease were included. A lower likelihood of undergoing resection was observed for patients diagnosed between 2017 and 2020 as compared to 2005–2008 for nonmetastatic colon (OR=0.73; 95 %CI:0.68–0.79) and rectal cancer (OR=0.44; 95 %CI:0.40–0.48). In contrast, higher resection rates were observed for nonmetastatic gastric (OR=1.17; 95 %CI:1.03–1.32), periampullary (OR=2.44;95 %CI:2.09–2.84) and pancreatic cancer (OR=2.81; 95 %CI:2.51–3.15 comparing the same time periods). Patients with nonmetastatic disease diagnosed in 2017–2020 had a lower likelihood of 90-day postoperative mortality compared to 2005–2008 for all cancer types with ORs ranging between 0.27 (95 %CI:0.22–0.33, rectal cancer) and 0.60 (95 %CI:0.43–0.84, periampullary cancer). In colon and rectal cancer patients presenting with metastatic disease, resection rates and postoperative mortality significantly decreased over time.</div></div><div><h3>Conclusion</h3><div>Resection rates decreased for some gastrointestinal cancer types possibly due to the introduction of treatment strategies without resection (e.g. watchful waiting). Postoperative mortality decreased for all patients, possibly as a result of increased quality of care, and improved patient selection.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115469"},"PeriodicalIF":7.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olanzapine combined with standard antiemetics for the prevention of nausea and vomiting in patients with germ cell tumor undergoing a 5-day cisplatin-based chemotherapy (NAVIGATE study)： A phase III crossover trial","authors":"Lulu Zhang ,&nbsp;Meiting Chen ,&nbsp;Qingru Zhou ,&nbsp;Cong Xue ,&nbsp;Riqing Huang ,&nbsp;Xiaoju Diao ,&nbsp;Jibin Li ,&nbsp;Jing Peng ,&nbsp;Qiufang Zheng ,&nbsp;Mengqian Ni ,&nbsp;Lijia Zhou ,&nbsp;Daining Wang ,&nbsp;Haifeng Li ,&nbsp;Wei Yang ,&nbsp;Shu Dun ,&nbsp;Zhuowei Liu ,&nbsp;Yalan Wang ,&nbsp;Yanxia Shi ,&nbsp;Xin An","doi":"10.1016/j.ejca.2025.115437","DOIUrl":"10.1016/j.ejca.2025.115437","url":null,"abstract":"<div><div>Purpose Prophylactic use of olanzapine significantly improves chemotherapy-induced nausea and vomiting (CINV) in patients receiving single-day highly emetogenic chemotherapy and 3-day cisplatin-based chemotherapy. This phase III, double-blind, placebo-controlled crossover trial aimed to evaluate the efficacy and safety of olanzapine combined with triple antiemetic therapy for CINV in germ cell tumor (GCT) patients receiving 5-day cisplatin-based chemotherapy.Methods Eligible patients receiving at least two consecutive identical courses of 5-day cisplatin-based chemotherapy were randomly assigned to either olanzapine (5 mg) or its matching placebo during days 1–7 of the first chemotherapy cycle, then crossed over to the alternate group during the second cycle. The primary endpoint was complete response (CR) rate. Main secondary endpoints included CR rates in acute and delayed phases, no nausea rates, and toxicities. Results Between January 2022 and February 2024, 77 patients were enrolled, 40 were randomized to the olanzapine group, and 37 to the placebo group during the first course. The overall CR rate was 55.8 % (43/77) in the olanzapine group, compared with 36.3 % (28/77) in the placebo group (<em>P</em> = 0.03). The CR rates in the acute and delayed phases were 62.3 % (48/77) vs. 40.3 % (31/77), <em>P</em> = 0.01, and 79.2 % (61/77) vs. 53.2 % (41/77), <em>P</em> = 0.04, respectively. No nausea rates were also significantly higher in the olanzapine group than those in the placebo group: 36.4 % vs. 15.6 % in overall phase (<em>P</em> = 0.005), 39.0 % vs.16.9 % in acute phase (<em>P</em> = 0.004) and 72.7 % vs. 49.4 % in delayed phase (<em>P</em> = 0.005). Addition of olanzapine did not increase toxicities. Conclusion This trial provides the first high-level evidence supporting the olanzapine-based four-drug combination to prevent CINV in GCT patients undergoing 5-day cisplatin-based chemotherapy. Clinical Trial Registration: <em>ClinicalTrials.gov</em>, number NCT05198796.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115437"},"PeriodicalIF":7.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of secondary myelodysplastic syndromes and acute myeloid leukaemia following poly(ADP-ribose) polymerase inhibitor treatment for advanced-stage recurrent ovarian cancer: A retrospective cohort study in England","authors":"Luke Steventon ,&nbsp;Shibani Nicum ,&nbsp;Pinkie Chambers ,&nbsp;Kenneth Man ,&nbsp;David Dodwell ,&nbsp;Zhe Wang ,&nbsp;Apini Patel ,&nbsp;Ben Pickwell-Smith ,&nbsp;Li Wei","doi":"10.1016/j.ejca.2025.115472","DOIUrl":"10.1016/j.ejca.2025.115472","url":null,"abstract":"<div><h3>Background</h3><div>Poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance therapies are used to treat advanced ovarian cancer in first line and recurrent settings. Because of concerns about associations between PARPi therapy and secondary cancers myelodysplastic syndrome (MDS) and acute myeloid leukaemia (AML), a meta-analysis of clinical trials was conducted, reporting MDS/AML incidence of 0.73 %; however, clinical trial populations are highly selective and may not reflect incidence in the wider population.</div></div><div><h3>Methods</h3><div>This retrospective cohort study calculated incidence of MDS/AML within five years of completing first-line chemotherapy + /- PARPi maintenance for recurrent, advanced-stage ovarian cancer. Absolute and relative risks were calculated and compared to meta-analysis.</div></div><div><h3>Results</h3><div>Of 11,531 included patients, 1529 received PARPi and 10,002 chemotherapy only. Absolute risk of MDS/AML was 0.3 % (n = 5/1529) for chemotherapy + PARPi maintenance therapy versus 0.1 % (n = 10/10,002) for chemotherapy alone. Relative risk was 2.97 (95 % CI 1.02, 8.68, p = 0.046) in patients receiving PARPi maintenance versus chemotherapy alone.</div></div><div><h3>Discussion</h3><div>Relative risk of MDS/AML was greater in patients treated with PARPi; however, absolute risk was low in both treatment groups and lower than in the meta-analysis of trials. This analysis suggests small increased relative risk of MDS/AML associated with PARPi maintenance versus chemotherapy only, but not increased absolute risk.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115472"},"PeriodicalIF":7.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant chemotherapy for colon cancer: A systematic review and meta-analysis of randomized controlled trials","authors":"Mariana Macambira Noronha ,&nbsp;Luiz F. Costa Almeida ,&nbsp;Anelise Poluboiarinov Cappellaro ,&nbsp;Luís Felipe Leite da Silva ,&nbsp;Lucas Diniz da Conceição ,&nbsp;Junior Samuel Alonso de Menezes ,&nbsp;Marcos Belotto ,&nbsp;Renata D.’Alpino Peixoto","doi":"10.1016/j.ejca.2025.115476","DOIUrl":"10.1016/j.ejca.2025.115476","url":null,"abstract":"<div><h3>Introduction</h3><div>Neoadjuvant chemotherapy (NAC) treatment has appeared as a promising alternative to upfront surgery to improve efficacy outcomes in non-metastatic colon cancer, but the findings are still controversial. Considering this ongoing debate, we conducted a systematic review and meta-analysis of randomized controlled trials to assess the benefit of NAC in high-risk stage II and stage III colon cancer.</div></div><div><h3>Materials and methods</h3><div>We searched PubMed, Embase, and Cochrane for clinical trials evaluating NAC in non-metastatic colon cancer. Random and fixed effects models were employed for statistical analyses in Review Manager software version 5.4. Moreover, to evaluate the heterogeneity, I² statistics were used.</div></div><div><h3>Results</h3><div>A total of 1248 patients from 4 clinical trials were included. The NAC group demonstrated a 38 % reduction in the risk of death. (HR 0.62; 95 % CI 0.41–0.92; I² = 0 %), and a 21 % reduction in the risk of disease recurrence (HR 0.79; 95 % CI 0.65–0.96; I² = 0 %). Additionally, the NAC group had higher R0 resection, with an increase of 80 % in the odds compared to upfront surgery (OR 1.80; 95 % CI 1.24–2.61; I² = 0 %). Pathological complete response and major pathologic response (PCR) were achieved in 5.9.% % and 36.2 %, respectively. Patients with proficient mismatch repair achieved a higher PCR rate and a consistent reduction in the risk of recurrence compared to the overall population, with proportions of 6.3 % and 32 %, respectively. Also, there was no significant addition to the toxicity profile in the NAC arm.</div></div><div><h3>Conclusion</h3><div>Our systematic review and meta-analysis support the feasibility and survival benefits of neoadjuvant chemotherapy for high-risk stage II and III colon cancer.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115476"},"PeriodicalIF":7.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances and challenges in targeted therapies for HER2-amplified colorectal cancer","authors":"Margot Pizzamiglio,&nbsp;Audrey Soulabaille,&nbsp;Widad Lahlou,&nbsp;Lorenzo Pilla,&nbsp;Aziz Zaanan,&nbsp;Julien Taieb","doi":"10.1016/j.ejca.2025.115471","DOIUrl":"10.1016/j.ejca.2025.115471","url":null,"abstract":"<div><div>Colorectal cancer is the third most common cancer in terms of incidence rate in adults and the second most common cause of cancer-related death in Europe. Despite an increase in overall survival throughout the years, the prognosis of metastatic colorectal cancer remains poor. Until recently, its treatment was based on the use of standard chemotherapy combined with, anti-epidermal growth factor receptor (for <em>RAS</em> wild-type tumors) or anti-vascular endothelial growth factor, or immunotherapy for tumors with mismatch repair deficiency. Over the last years, precision medicine has become a challenge in oncology and there has been an increasing development of biomarker-driven therapies for metastatic colorectal cancer leading to better outcomes for specific molecular subgroups of patients. Human epidermal growth factor receptor 2 (<em>HER2</em>) amplification/overexpression has been identified in about 6 % of patients with <em>RAS</em> wild-type metastatic CRC and established as an important and drugable biomarker. Its prognostic and predictive implications are still debated but <em>HER2</em> becoming a therapeutic target with promising results of anti-<em>HER2</em> therapies for <em>HER2</em>-positive metastatic CRC. Multiple <em>HER2</em>-targeted regimens are now part of National Comprehensive Cancer Network and European Society for Medical Oncology guidelines with two recent Food and Drug Administration approvals for previously treated <em>HER2</em>-positive metastatic colorectal cancer for tucatinib (in combination with trastuzumab) and for trastuzumab-deruxtecan in patients with previously treated <em>HER2</em>-positive metastatic colorectal cancer. This review explores the prognostic and predictive value of <em>HER2</em> as a biomarker in CRC, describing its molecular structure, the clinical characteristics of patients with <em>HER2</em> alterations, diagnostic approaches and the most relevant clinical trials assessing its current and future role as a therapeutic target in metastatic colorectal cancer.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"222 ","pages":"Article 115471"},"PeriodicalIF":7.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}