European Journal of Cancer最新文献

{"title":"Response to letter entitled: Re: Higher relative survival in breast cancer patients treated in certified and high-volume breast cancer centres - A population-based study in Belgium.","authors":"Roos Leroy, Jolyce Bourgeois, Jean-Luc Canon, Birgit Carly, Evandro de Azambuja, Peter van Dam, Liv Veldeman","doi":"10.1016/j.ejca.2024.115167","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115167","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":" ","pages":"115167"},"PeriodicalIF":7.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822012","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":"Outcomes following long-term disease control with immune checkpoint inhibitors in patients with advanced melanoma.","authors":"Eleanor E Handel, Janet McKeown, Joe Wei, Roma A Kankaria, Hannah Burnette, Douglas B Johnson, Aleigha Lawless, Juliane Czapla, Ryan J Sullivan, Lea Jessica Albrecht, Lisa Zimmer, Joanna Mangana, Reinhard Dummer, Jolien I Kessels, Bart Neyns, Clara Allayous, Celeste Lebbe, Christina Boatwright, Janice M Mehnert, Margaret Ottaviano, Paolo A Ascierto, Anna M Czarnecka, Piotr Rutkowski, Serigne N Lo, Georgina V Long, Alexander M Menzies, Matteo S Carlino","doi":"10.1016/j.ejca.2024.115171","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115171","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICI) can achieve durable responses in patients with advanced melanoma, and results from clinical trials suggest cure may be possible for a subset of patients. Despite clinical trial data, little is known about the risk, character, and clinical outcome of late recurrences after ICI. This study aimed to explore the disease outcomes and survival in a cohort of patients with long-term responses to ICI. We retrospectively identified patients treated with ICI for advanced melanoma with long-term disease control, defined as not requiring a subsequent line of systemic therapy within 3 years of ICI commencement. We analysed disease characteristics, treatment, toxicity, recurrence patterns, management, and outcomes. A total of 567 patients were identified with a median follow-up of 7.1 years: 504 (89 %) without disease progression within 3 years (cohort 1) and 63 (11.1 %) with disease progression within 3 years managed without a change in systemic therapy (cohort 2). Subsequent progression after 3 years occurred for 39 (7.7 %) patients in cohort 1, compared to 14 (22 %) in cohort 2. Predictors for late progression after 3 years were a non-complete radiological response (CR) best response and prior progression within 3 years. Thirty-two patients (5.6 %) died during follow-up, 8 (1.4 %) from melanoma, 6 (1.2 %) from cohort 1 and 2 (3.2 %) from cohort 2. In this population of patients with advanced melanoma with long-term disease control from ICI, the risk of subsequent disease progression and death was low. This suggests that a significant proportion of long-term ICI responders are likely cured and may inform the frequency and duration of follow-up.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115171"},"PeriodicalIF":7.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817463","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":"Prognosis of early-onset versus late-onset sporadic colorectal cancer: Systematic review and meta-analysis.","authors":"Fabio Carbone, Antonino Spinelli, Davide Ciardiello, Marco Realis Luc, Stefano de Pascale, Emilio Bertani, Nicola Fazio, Uberto Fumagalli Romario","doi":"10.1016/j.ejca.2024.115172","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115172","url":null,"abstract":"<p><strong>Background: </strong>In the last years, a dramatic increase in colorectal cancer (CRC) diagnoses in early-onset (EO) patients has been observed. The prognosis of EO-CRC compared to late-onset (LO) patients is still unclear. This meta-analysis aims to clarify whether there is any difference in the prognosis between the two groups.</p><p><strong>Methods: </strong>A systematic review was conducted on EMBASE-Medline, Pubmed and Cochrane Library in March 2024 to identify studies comparing overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), local recurrence (LR) and distant recurrence (DR) risk outcomes between EO-CRC (<50 years old) and LO-CRC (>50 years old) with at least 50 patients per group and one year of follow-up. The risk of bias was assessed with the ROBINS-E tool. Data from stage prevalence and survival were extracted and meta-analysed. Meta-regression was used to identify impacting effect modifiers. The PROSPERO registration number was CRD42024573264.</p><p><strong>Results: </strong>Twenty-six studies were identified; 1,062,037 patients (13.4% EO-CRC and 86.6% LO-CRC) were included in the stage prevalence and 567,689 in the prognostic meta-analysis. Overall, 60% of the EO-CRC and 49% of the LO-CRC were diagnosed with an advanced stage (III-IV) of disease (RR 1.26, 95%CI 1.19-1.35, I²=87%). EO-CRC had a better OS than LO-CRC (HR 0.89, 95%CI 0.81-0.99, I²=89%) but equal CSS (HR 0.94, 95%CI 0.83-1.06, I²=82%), DFS (HR 1.05 95%CI 0.94-1.16, I²=76%), LR (HR 1.41, 95%CI 0.62-3.18, I²=49%) and DR (HR 1.51, 95%CI 0.79-2.89) risk. Meta-regression analysis identified a worse DFS in the EO-CRC rectal cancer subgroup (HR 1.14, 95%CI 1.00-1.30, I²=0%).</p><p><strong>Conclusions: </strong>Despite the high heterogeneity of existing studies, EO-CRC patients are diagnosed with significantly more advanced stages than LO-CRC, although this is not reflected in any difference in cancer-related survival. There is an urgent need for increased vigilance in the early detection of CRC in young patients.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115172"},"PeriodicalIF":7.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834676","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":"Maternal use of hormonal contraception and risk of childhood leukemia: A Scandinavian population-based cohort study.","authors":"Caroline H Hemmingsen, Susanne K Kjaer, Sarah Hjorth, Ulrika Nörby, Anne Broe, Anton Pottegård, Justine Bénévent, Kjeld Schmiegelow, Charlotte Wessel Skovlund, Maarit K Leinonen, Hedvig Nordeng, Lina S Mørch, Marie Hargreave","doi":"10.1016/j.ejca.2024.115168","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115168","url":null,"abstract":"<p><strong>Background: </strong>Maternal hormonal contraception use has been associated with childhood leukemia risk. However, studies are few and often based on self-reported information.</p><p><strong>Methods: </strong>Using registry data from Denmark, Norway, and Sweden, we identified 3,183,316 children (born 1996-2018) and followed them from birth until leukemia diagnosis, censoring (death, emigration, other cancer, 20th birthday) or study closure (December 31st, 2017, 2018 or 2020). We estimated hazard ratios (HRs) and 95 % confidence intervals (CIs) for childhood leukemia (any, lymphoid and non-lymphoid) associated with maternal recent use (≤ 3 months before or during pregnancy) or previous use (before recent use) of hormonal contraception overall and by type, compared to no use.</p><p><strong>Results: </strong>During 29,455,528 person-years, 1701 children developed leukemia (no use: 518, previous use: 974, recent use: 209). Maternal recent use of hormonal contraception was associated with an increased leukemia risk in children (HR 1.22, 95 % CI 1.04-1.44; incidence rate per 1,000,000 person-years [IR] 65), compared to no use (IR 53). The association was strongest for non-lymphoid leukemia (HR 1.69, 95 % CI 1.20-2.37) and mainly driven by the oral combined products, both for any leukemia (HR 1.29, 95 % CI 1.05-1.59) and non-lymphoid leukemia (HR 1.75, 95 % CI 1.17-2.62). Additionally, non-lymphoid leukemia was associated with recent use of the non-oral progestin-only products (HR 2.10, 95 % CI 1.28-3.44).</p><p><strong>Conclusions: </strong>Although the absolute risk was low, maternal hormonal contraception use up to or during pregnancy was associated with an increased childhood leukemia risk, particularly non-lymphoid leukemia, and mainly driven by oral combined and non-oral progestin-only products.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115168"},"PeriodicalIF":7.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817461","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":"Hydroxychloroquine in combination with platinum doublet chemotherapy as first-line treatment for extensive-stage small cell lung cancer (Study 15): A randomised phase II multicentre trial.","authors":"Siow Ming Lee, Madeleine Hewish, Samreen Ahmed, Dionysis Papadatos-Pastos, Eleni Karapanagiotou, Fiona Blackhall, Amy Ford, Robin Young, Angel Garcia, Arvind Arora, Abigail Hollingdale, Tanya Ahmad, Martin Forster, Alastair Greystoke, Fion Bremner, Robin Rudd, Laura Farrelly, Simran Vaja, Allan Hackshaw","doi":"10.1016/j.ejca.2024.115162","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115162","url":null,"abstract":"<p><strong>Background: </strong>Most patients with small-cell lung cancer (SCLC) present with extensive-stage (ES) disease and have a poor prognosis despite achieving high initial response rates to platinum-based doublet chemotherapy. This study evaluated whether adding hydroxychloroquine (HCQ) to chemotherapy could improve outcomes.</p><p><strong>Methods: </strong>This was a randomised multicentre phase II trial. Eligible patients had untreated ES-SCLC, a performance status 0-2 and measurable disease. Patients were randomly assigned (1:1 ratio) to HCQ (400 mg orally twice daily) plus carboplatin-gemcitabine or carboplatin-etoposide alone. Chemotherapy was administered for up to six cycles, with HCQ given concurrently and then as single agent for up to 30 months. Primary endpoint was PFS, aiming for a hazard ratio (HR) of 0.70.</p><p><strong>Results: </strong>72 patients were randomised (36 HCQ+chemotherapy and 36 chemotherapy alone). Median HCQ treatment duration was 4.4 months. HCQ did not improve PFS (HR 1·12 95 %CI 0·69-1.84; p = 0·64), with a median of 5.7 months (HCQ+chemotherapy) versus 6.2 months (chemotherapy). The corresponding median OS were 8.9 and 10.2 months (HR 0.83, 95 %CI 0.48-1.45, p = 0.52). Fewer patients in the HCQ arm completed four cycles of chemotherapy due to adverse events (64 % vs. 81 %). Grade ≥ 3 adverse events were higher in the HCQ+chemotherapy arm (83.3 % vs. 27.8 %), primarily anaemia, neutropenia, and thrombocytopenia, partly due to the initially higher gemcitabine dose used CONCLUSIONS: Combining HCQ with platinum doublet chemotherapy did not improve PFS or OS outcomes for ES-SCLC, resulting in more patients stopping chemotherapy due to increased adverse events. When considered alongside other randomised studies of HCQ in cancer, the evidence collectively indicates a limited role for HCQ as a therapeutic option.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115162"},"PeriodicalIF":7.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853172","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 modified Glasgow Prognostic Score (mGPS) can guide decisions for immunotherapy treatment beyond progression.","authors":"Jonas Saal, Markus Eckstein, Manuel Ritter, Peter Brossart, Michael Hölzel, Viktor Grünwald, Niklas Klümper","doi":"10.1016/j.ejca.2024.115163","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115163","url":null,"abstract":"<p><strong>Background: </strong>Treatment beyond progression (TBP) is common in patients treated with immune-checkpoint inhibitors (ICI), however, there is no biomarker to select patients that are more likely to derive benefit from TBP. Here, we investigated the potential of the modified Glasgow Prognostic Score (mGPS) as a predictive biomarker to select patients for TBP.</p><p><strong>Methods: </strong>We performed a post-hoc analysis of the immunotherapy arms in the randomized phase 3 trials IMmotion151 (renal cell carcinoma), OAK (non-small cell lung cancer) and IMvigor211 (urothelial cancer). The main outcome was post-progression overall survival (PPOS) after the first investigator-assessed disease progression (PD), in mGPS risk groups. The mGPS classifies patients into three risk groups based on C-reactive protein (CRP) and albumin.</p><p><strong>Results: </strong>We found a strong prognostic value for the mGPS when assessed at the time of PD (PD-mGPS) in all three trials. High-risk PD-mGPS was associated with significantly shorter PPOS compared to low-risk PD-mGPS (HR for death 18.3 (95 % CI 6.71-50.0, p < 0.001)) for RCC, UC: HR 4.16 (95 % CI 2.58-6.69, p < 0.001) and NSCLC HR 2.53 (95 % CI 1.70-3.77, p < 0.001). Importantly, patients within all three trials only derived benefit from ICI-TBP compared to switch to further-line treatment in the PD-mGPS low-risk group (RCC: HR 0.18 (95 % CI 0.06-0.55, p = 0.002); UC: HR 0.59 (95 % CI 0.34-1.00, p = 0.052); NSCLC: 0.62 (0.41-0.92, p = 0.018) compared to PD-mGPS intermediate/ high risk).</p><p><strong>Conclusions: </strong>These findings suggest that the mGPS measured at the time of radiologic PD can identify patients with a better prognosis who may benefit from continued atezolizumab therapy, aiding in the selection for TBP in clinical practice.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115163"},"PeriodicalIF":7.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812406","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":"Metastasis-directed stereotactic radiotherapy and systemic treatment continuation for patients with oligoprogressive metastatic breast cancer.","authors":"Monica Milano, Carmine Valenza, Annamaria Ferrari, Sara Gandini, Dario Trapani, Celeste Santoro, Elena Battaiotto, Ambra Carnevale Schianca, Elisa Giordano, Jalissa Katrini, Grazia Castellano, Beatrice Taurelli Salimbeni, Maria Cristina Leonardi, Samantha Dicuonzo, Carmen Criscitiello, Nadia Bianco, Silvia Dellapasqua, Elisabetta Munzone, Giuseppe Curigliano, Marco Colleoni, Barbara Alicja Jereczek-Fossa","doi":"10.1016/j.ejca.2024.115164","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115164","url":null,"abstract":"<p><strong>Background: </strong>About 15-20 % of patients with metastatic breast cancer (mBC) can experience oligoprogressive disease (OPD) in ≤ 5 sites of disease. Patients with OPD may benefit from metastasis-directed stereotactic radiotherapy (SBRT) to all sites of cancer progression while maintaining the same systemic treatment, aiming to prolong the time to next systemic treatment (NEST). This study aims to assess the outcomes provided by this multimodal strategy.</p><p><strong>Methods: </strong>Prospective-retrospective, single-center, cohort study including consecutive patients who received SBRT to all extracranial OPD sites (≤ 5), from January 2011 to June 2023, without changing systemic therapy, according to the multidisciplinary tumor board's indication. The primary endpoint was post-radiotherapy progression-free survival (pRT-PFS). A sample size of 130 patients was needed to estimate a median pRT-PFS of 8 months with a 95 % confidence interval (95 %CI) ranging from 5.4 (considered clinically significant) to 10.6 months.</p><p><strong>Results: </strong>129 patients were included: 99 (77 %) had hormone receptor-positive/HER2-negative (HR+/HER2-) disease, 116 (90 %) had ≤ 2 oligoprogressive lesions, 118 (91 %) presented with non-visceral OPD involving bones or lymph nodes. Patients experienced OPD after a median PFS on systemic therapy (pre-OPD PFS) of 11.3 months (95 % CI, 8.7-13.0). Median pRT-PFS was 11.3 months (95 % CI, 9.1-13.5) and median NEST was 13.6 months (95 % CI, 11.5-15.2). Only 19 (15 %) patients experienced a subsequent PD in the OPD sites treated with SBRT.</p><p><strong>Conclusion: </strong>Patients with oligoprogressive mBC, especially with HR+/HER2- disease and non-visceral OPD after a durable pre-OPD PFS, benefit from OPD-directed SBRT while maintaining the same systemic treatment, suggesting its broader implementation in clinical practice.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115164"},"PeriodicalIF":7.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812401","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":"An international survey on the knowledge, attitudes and clinical patterns of use of medical cannabis for cancer care: The TASMAN study.","authors":"Dario Trapani, Sara J Nidhamalddin, Sara Gandini, Marco Filetti, Sara C Altuna, Ambra Carnevale Schianca, Angelica Petrillo, Shilpa M Murthy, Fabio Girardi, Jacques B Bezuidenhout, Khalid El Bairi, Pasquale Lombardi, Shah Z Khan, Csongor G Lengyel, Andreas Seeber, Sadaqat Hussain, Fahmi U Seid, Essam Elfaham, Andrew O Odhiambo, Yakup Coskun, Habeeb S Baker, Arman R Chowdhury, Armando Genazzani, Gennaro Daniele, Giampiero Porzio, Giuseppe Curigliano, Raffaele Giusti","doi":"10.1016/j.ejca.2024.115158","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115158","url":null,"abstract":"<p><strong>Background: </strong>Medical cannabis (MC) has gained traction in oncology for managing cancer-related symptoms, but its integration faces challenges due to limited evidence, inconsistent guidelines, and varied legal frameworks.</p><p><strong>Methods: </strong>The TASMAN study aimed to assess the knowledge, attitudes, and practices of oncologists and palliative care providers globally regarding MC use in cancer care. A survey of healthcare providers from diverse regions and income levels was conducted.</p><p><strong>Results: </strong>we study included 179 participants (response rate: 51.1 %), with an equal gender distribution (49.4 % female) and a median age of 37 years. Participants were primarily oncologists (71.5 %), practicing in university hospitals (40.2 %) or cancer centres (32.4 %), with over half from low- and middle-income countries. Most respondents (92.7 %) were unaware of clinical guidelines for MC. A proportion of 44.1 % were familiar with MC use, 78.8 % recognized its role in cancer pain, and 34 % identified its role in managing cachexia. Awareness of specific products was low, with only 10 % familiar with specific cannabis products. Three-quarters of respondents (84.4 %) did not prescribe MC routinely. Legal status and regulations were unclear for most participants; 40 % noted cannabis as illegal. MC use and patient requests were more common in high-income countries and the EURO region, with palliative care providers demonstrating the highest awareness and prescription rates.</p><p><strong>Conclusion: </strong>Clearer regulations, standardized guidelines, and targeted education are essential to support the safe integration of MC into oncology and palliative care, ultimately improving the quality of life for cancer patients.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115158"},"PeriodicalIF":7.6,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794199","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":"Characteristics and outcomes in patients with lenalidomide-refractory multiple myeloma treated with 1-3 prior lines of therapy: Analysis of individual patient-level data from daratumumab clinical trials.","authors":"Kwee Yong, Hermann Einsele, Jordan M Schecter, Tito Roccia, William Deraedt, Nikoletta Lendvai, Ana Slaughter, Carolina Lonardi, Kaitlyn Connors, Keqin Qi, Anil Londhe, Robin Carson, Akshay Kharat, Patricia Cost, Satish Valluri, João Mendes, Lida Pacaud, Nitin Patel, Erika Florendo, Binod Dhakal","doi":"10.1016/j.ejca.2024.115157","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115157","url":null,"abstract":"<p><strong>Background: </strong>The introduction of proteasome inhibitors (PIs) and lenalidomide as treatment for newly diagnosed multiple myeloma (MM) has led to an increased population of lenalidomide-refractory patients. Limited data are available characterizing current treatments and outcomes in this difficult-to-treat population.</p><p><strong>Methods: </strong>Individual patient-level data were analyzed from the treatment arms of multiple daratumumab studies, including APOLLO, CASTOR, CANDOR, EQUULEUS, ALCYONE, MAIA, GRIFFIN, POLLUX, and CASSIOPEIA. Included patients were PI exposed and lenalidomide refractory, received 1-3 prior lines of therapy (LOT), and had an Eastern Cooperative Oncology Group performance status < 2. Treatments and outcomes were analyzed by number of prior LOT in the lenalidomide-refractory population. Time to next treatment (TTNT), progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan-Meier method.</p><p><strong>Findings: </strong>Out of 4764 patients, 915 patients (prior LOT, one [n = 114]; two [n = 462]; three [n = 339]) met inclusion criteria. Median follow-up was 29·7 months (range 28·0-31·7). The overall response rate was 55·4 %. Estimated median TTNT was 9·7 months, median PFS was 10·0 months, and median OS was 27·5 months. Response rates and PFS decreased as number of prior LOT increased. Prognostic factors for response, TTNT, PFS, and OS included International Staging System stage, baseline plasmacytoma status, baseline hemoglobin, anti-CD38-refractory status, and cytogenetic risk status.</p><p><strong>Interpretation: </strong>Lenalidomide-refractory patients treated with 1-3 prior LOT have poor PFS and OS, which generally worsen with each additional LOT, highlighting the need for new and effective treatments for this population.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115157"},"PeriodicalIF":7.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823600","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":"A new treatment strategy for mid-low rectal cancer patients exhibiting a clinical complete or near-complete response to neoadjuvant chemoradiotherapy: Transanal endoscopic microsurgery --A multicenter prospective case-control clinical trial by MONT-R.","authors":"Xiaoyuan Qiu, Jiaolin Zhou, Huizhong Qiu, Zhanlong Shen, Bin Wu, Wenzhuo Jia, Beizhan Niu, Fei Li, Hongwei Yao, Aiwen Wu, Ke Hu, Huadan Xue, Guangxi Zhong, Weixun Zhou, Weijie Chen, Ganbin Li, Guole Lin","doi":"10.1016/j.ejca.2024.115156","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115156","url":null,"abstract":"<p><strong>Background: </strong>Total mesorectal excision is the standard surgery for locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT), but it may lead to high complication rates and poor quality of life. This study evaluates whether transanal endoscopic microsurgery (TEM), as a partial resection procedure, can enhance quality of life for clinical complete response (cCR) or near-cCR patients without compromising survival.</p><p><strong>Methods: </strong>Between May 2017 to September 2021, 80 patients with T3-4N0M0 or TanyN+M0 mid-low rectal cancer achieving cCR or near-cCR post-nCRT were prospectively included at 6 Chinese centers. Patients underwent either TEM (Group A, n = 38) or radical surgery (Group B, n = 41). Clinicopathological, oncological, and functional outcomes were analyzed.</p><p><strong>Results: </strong>Postoperative histology revealed 22 ypT0 (57.9 %), 5 ypT1 (13.2 %), 10 ypT2 (26.3 %), and 1 ypT3 (2.6 %) cases in group A and 20 pCR (48.8 %), 1 T0N1 (2.4 %), 5 T1N0 (12.2 %), 12 T2-3N0 (29.3 %), 3 T2-3N1 (7.3 %) cases in group B. After a 60-month median follow-up, local recurrence occurred in 2 patients (5.26 %) in Group A and none in Group B. Distant metastases occurred in 8 patients (21.05 %) in group A and 7 (17.07 %) in group B. There was no significant difference between the two groups in 5-year disease-free survival (P = 0.658) or 5-year overall survival (P = 0.465). Group A showed significantly faster recovery (P < 0.001) and better sphincter function per Wexner (1 vs. 4, P = 0.001) and LARS (0 vs. 17, P < 0.001) scores than Group B.</p><p><strong>Conclusion: </strong>TEM may be an effective approach for assessing residual tumors in LARC patients with cCR or near-cCR. This approach offers an option for those requiring sphincter preservation, with no significant compromise in long-term oncological outcomes observed in our study.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"216 ","pages":"115156"},"PeriodicalIF":7.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853178","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}