European Journal of Cancer最新文献

{"title":"European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics - Update 2024.","authors":"Claus Garbe, Teresa Amaral, Ketty Peris, Axel Hauschild, Petr Arenberger, Nicole Basset-Seguin, Lars Bastholt, Veronique Bataille, Lieve Brochez, Veronique Del Marmol, Brigitte Dréno, Alexander M M Eggermont, Maria Concetta Fargnoli, Ana-Maria Forsea, Christoph Höller, Roland Kaufmann, Nicole Kelleners-Smeets, Aimilios Lallas, Celeste Lebbé, Ulrike Leiter, Caterina Longo, Josep Malvehy, David Moreno-Ramirez, Paul Nathan, Giovanni Pellacani, Philippe Saiag, Eggert Stockfleth, Alexander J Stratigos, Alexander C J Van Akkooi, Ricardo Vieira, Iris Zalaudek, Paul Lorigan, Mario Mandala","doi":"10.1016/j.ejca.2024.115152","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115152","url":null,"abstract":"<p><p>This guideline was developed in close collaboration with multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF) and the European Organization for Research and Treatment of Cancer (EORTC). Recommendations for the diagnosis and treatment of melanoma were developed on the basis of systematic literature research and consensus conferences. Cutaneous melanoma (CM) is the most dangerous form of skin tumor and accounts for 90 % of skin cancer mortality. The diagnosis of melanoma can be made clinically and must always be confirmed by dermoscopy. If melanoma is suspected, a histopathological examination is always required. Sequential digital dermoscopy and whole-body photography can be used in high-risk patients to improve the detection of early-stage melanoma. If available, confocal reflectance microscopy can also improve the clinical diagnosis in special cases. Melanoma is classified according to the 8th version of the American Joint Committee on Cancer classification. For thin melanomas up to a tumor thickness of 0.8 mm, no further diagnostic imaging is required. From stage IB, lymph node sonography is recommended, but no further imaging examinations. From stage IIB/C, whole-body examinations with computed tomography or positron emission tomography CT in combination with magnetic resonance imaging of the brain are recommended. From stage IIB/C and higher, a mutation test is recommended, especially for the BRAF V600 mutation. It is important to perform a structured follow-up to detect relapses and secondary primary melanomas as early as possible. A stage-based follow-up regimen is proposed, which in the experience of the guideline group covers the optimal requirements, although further studies may be considered. This guideline is valid until the end of 2026.</p>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"215 ","pages":"115152"},"PeriodicalIF":7.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863726","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":"Cancer immunotherapy in elderly patients: The concept of immune senescence challenged by clinical experience","authors":"Mathilde Guégan ,&nbsp;Malvina Bichon ,&nbsp;Nathalie Chaput ,&nbsp;Roch Houot ,&nbsp;Jean Lemoine","doi":"10.1016/j.ejca.2024.115145","DOIUrl":"10.1016/j.ejca.2024.115145","url":null,"abstract":"<div><div>Cancer immunotherapy, including immune checkpoint inhibitors, chimeric antigen receptor T-cell therapy and bispecific antibodies, has led to major improvements in the treatment of a wide range of hematologic malignancies and solid tumors. However, age-mediated immune system modifications, known as immunosenescence, may preclude its efficacy in elderly patients. In this review, we assessed the efficacy of these different cancer immunotherapies in elderly patients compared to young patients to revisit the concept of immunosenescence from a therapeutic perspective.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115145"},"PeriodicalIF":7.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744513","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":"Rituximab maintenance for patients with diffuse large B-cell lymphoma in first complete remission: Long-term results of the HOVON-84 randomized phase III study by the HOVON and the Nordic Lymphoma Group (clinical trial number: NTR1014)","authors":"Pieternella Johanna Lugtenburg,&nbsp;Peter de Nully Brown,&nbsp;Bronno van der Holt,&nbsp;Eva de Jongh,&nbsp;Josée M. Zijlstra","doi":"10.1016/j.ejca.2024.115144","DOIUrl":"10.1016/j.ejca.2024.115144","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115144"},"PeriodicalIF":7.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744514","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":"Cutaneous relapses location in diffuse large B-cell lymphoma leg type after first line immunochemotherapy","authors":"A. Benarfa,&nbsp;S. Ingen-Housz-Oro,&nbsp;E. Durot,&nbsp;M. Beylot-Barry,&nbsp;A. Pham-Ledard","doi":"10.1016/j.ejca.2024.115143","DOIUrl":"10.1016/j.ejca.2024.115143","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115143"},"PeriodicalIF":7.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759064","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":"Patient access to perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin and docetaxel in patients with resectable gastric cancer in the Netherlands","authors":"Julie F.M. Geerts ,&nbsp;Marieke Pape ,&nbsp;Pauline A.J. Vissers ,&nbsp;Rob H.A. Verhoeven ,&nbsp;Bianca Mostert ,&nbsp;Bas P.L. Wijnhoven ,&nbsp;Camiel Rosman ,&nbsp;Irene E.G. van Hellemond ,&nbsp;Grard A.P. Nieuwenhuijzen ,&nbsp;Hanneke W.M. van Laarhoven","doi":"10.1016/j.ejca.2024.115137","DOIUrl":"10.1016/j.ejca.2024.115137","url":null,"abstract":"<div><h3>Background</h3><div>The FLOT4 trial demonstrated superior survival of perioperative chemotherapy with 5-fluorouracil, oxaliplatin, and docetaxel (FLOT) compared to anthracycline triplets for resectable gastric cancer. These results were presented at the American Society of Clinical Oncology (ASCO) congress in June 2017 and published in April 2019. However, adoption of novel treatments in clinical practice often encounters delays. This study assesses the patterns of perioperative chemotherapy utilization and FLOT uptake in clinical practice within the Netherlands.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted with resectable gastric cancer patients (cT_1–4a,XcN_allcM₀) between 2015–2020 from the Netherlands Cancer Registry. Descriptive statistics, Cochran-Armitage tests, Fisher's exact or unpaired T-tests, and Jonckheere-Terpstra tests were used to analyze chemotherapy trends and FLOT uptake across hospitals.</div></div><div><h3>Results</h3><div>Among 3290 included patients, 42.9 % received neoadjuvant treatment. In 2015, 43.6 % of patients received perioperative chemotherapy versus 43.5 % in 2020 (p = 0.63). 40 out of 62 hospitals (64.5 %) adopted FLOT between the ASCO presentation and the full publication. FLOT increased from 42.9 % before publication to 86.8 % after publication (p &lt; 0.0001), while anthracycline triplet use decreased to 0.9 % (p &lt; 0.0001). Higher hospital volume was associated with fewer days to adoption (p = 0.04) but not with adoption of FLOT before publication (p = 0.14).</div></div><div><h3>Conclusion</h3><div>Timing of FLOT adoption varied among Dutch hospitals, leading to unequal patient access to effective treatments. Establishing (inter)national guidelines on provisional treatment adjustment pending publication is crucial to reduce variation in access. Moreover, rapid publication of final trial results is imperative to reduce variation in practice and ensure fair patient treatment.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115137"},"PeriodicalIF":7.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699980","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":"Small-RNA sequencing reveals potential serum biomarkers for gallbladder cancer: Results from a three-stage collaborative study of large European prospective cohorts","authors":"Alice Blandino ,&nbsp;Dominique Scherer ,&nbsp;Felix Boekstegers ,&nbsp;Trine B. Rounge ,&nbsp;Hilde Langseth ,&nbsp;Stephanie Roessler ,&nbsp;Kristian Hveem ,&nbsp;Hermann Brenner ,&nbsp;Sonali Pechlivanis ,&nbsp;Melanie Waldenberger ,&nbsp;Justo Lorenzo Bermejo","doi":"10.1016/j.ejca.2024.115138","DOIUrl":"10.1016/j.ejca.2024.115138","url":null,"abstract":"<div><div>Gallbladder cancer (GBC) is an aggressive disease with limited treatment options but high prevention potential. GBC tumours take 10–20 years to develop, a timeframe that holds potential for early detection. MicroRNAs (miRNAs) play a central role in abnormal cell processes, and circulating miRNAs may constitute valuable biomarkers of early disease. We used microarray data to pre-select differentially expressed miRNAs in formalin-fixed paraffin-embedded (FFPE) gallbladder tissue samples (GBC n = 40, normal n = 8). We then applied small-RNA sequencing to screen for miRNA expression differences in serum samples from three European prospective cohorts (n = 37 GBC case-control pairs), and validated the most promising candidates in three independent cohorts (n = 36 GBC case- control pairs). Statistical analyses included robust linear regression, pathway and meta-analysis, and examination of expression correlation between miRNAs and target genes. MiR-4533 and miR-671–5p were overexpressed in GBC tissue and serum samples, and meta-analysis confirmed the overexpression of miR-4533 in GBC serum samples from the prospective cohorts (p-value = 4.1×10^-4), especially in individuals of female sex, under 63.5 years, or with a BMI below 26.2 kg/m². Pathway and correlation analyses revealed that miR-4533 targets <em>SIPA1L2</em> in the Rap1 signalling pathway, and <em>SIPA1L2</em> was downregulated in GBC serum samples. Our study highlights the advantage of integrating small-RNA sequencing results from different types of samples and independent datasets, and the need for international research collaborations to identify and validate biomarkers for secondary prevention of rare tumours such as GBC. The function of miR-4533 and its interaction with <em>SIPA1L2</em> in GBC development need to be further investigated.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115138"},"PeriodicalIF":7.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Panacreatic cancer risk after benign gallbladder disease: A Swedish population-based cohort study","authors":"Cecilia Radkiewicz ,&nbsp;Jonas F. Ludvigsson ,&nbsp;Ernesto Sparrelid ,&nbsp;Louise Emilsson","doi":"10.1016/j.ejca.2024.115140","DOIUrl":"10.1016/j.ejca.2024.115140","url":null,"abstract":"<div><h3>Aim</h3><div>The purpose of this nationwide registry-based cohort study was to outline pancreatic cancer risk after benign gallbladder disease (GBD). Anatomically adjacent cancers were investigated to address incidental findings.</div></div><div><h3>Methods</h3><div>We included all Swedes aged 20–79 years with histologically confirmed GBD (cholecystitis and/or cholecystectomy) in 1992–2016 and five matched non-exposed population comparators. Follow-up started one month after GBD and incidence rates (IR) and hazard ratios (HR) with 95 % confidence intervals (CI) up to 15 years after GBD were estimated using Poisson and Cox regression, respectively. Fully adjusted models included sex, age, year, education, type 2 diabetes, obesity, smoking-, and alcohol-related disorders. Analyses were stratified by follow-up and flexible parametric models applied to assess time-varying effects. Interaction models were used to identify patient groups at risk.</div></div><div><h3>Results</h3><div>680 and 1890 incident pancreatic cancers were detected over 15 years in 130907 GBD exposed and 571618 non-exposed, respectively. An excess pancreatic cancer risk was mainly seen within the first 2 years; IR: 84 [95 % CI 73,95] versus 31 [95 % CI 27,34] per 100000 person-years corresponding to an HR of 2.74 [95 % CI 2.31,3.25]. The same pattern was noted for duodenal cancer while primary liver cancer risk was elevated across follow-up. An initial extrahepatic biliary cancer risk elevation shifted to a reduction over time. The 2-year pancreatic cancer risk was augmented in younger (age 20–49) individuals, HR 7.64 [95 % CI 3.73,15.65].</div></div><div><h3>Conclusion</h3><div>Our findings urge more studies on the clinical follow-up the first years after cholecystitis to detect early pancreatic cancer.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115140"},"PeriodicalIF":7.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in toxicities and survival outcomes among Japanese patients with Stage III colorectal cancer receiving adjuvant fluoropyrimidine monotherapy: A pooled analysis of 4 randomized controlled trials (JCOG2310A)","authors":"Hidekazu Hirano ,&nbsp;Kozo Kataoka ,&nbsp;Toshifumi Yamaguchi ,&nbsp;Anna Dorothea Wagner ,&nbsp;Yasuhiro Shimada ,&nbsp;Masafumi Inomata ,&nbsp;Tetsuya Hamaguchi ,&nbsp;Yasumasa Takii ,&nbsp;Junki Mizusawa ,&nbsp;Yusuke Sano ,&nbsp;Akio Shiomi ,&nbsp;Manabu Shiozawa ,&nbsp;Masayuki Ohue ,&nbsp;Tomohiro Adachi ,&nbsp;Hideki Ueno ,&nbsp;Satoshi Ikeda ,&nbsp;Koji Komori ,&nbsp;Shunsuke Tsukamoto ,&nbsp;Atsuo Takashima ,&nbsp;Yukihide Kanemitsu","doi":"10.1016/j.ejca.2024.115139","DOIUrl":"10.1016/j.ejca.2024.115139","url":null,"abstract":"<div><h3>Background</h3><div>Fluoropyrimidine remains the key agent of adjuvant chemotherapy for stage III colorectal cancer (CRC). Western studies have shown that female sex is a favorable prognostic factor after surgery, but it is also a risk factor for adverse events (AEs) during adjuvant chemotherapy with fluoropyrimidine. However, little is known about whether sex differences in treatment outcomes exist in this setting in the Asian population.</div></div><div><h3>Methods</h3><div>Patients with stage III CRC who received adjuvant fluoropyrimidine monotherapy in 4 randomized controlled trials were analyzed. Incidences of AEs and survival outcomes were compared between female and male patients.</div></div><div><h3>Results</h3><div>A total of 3170 patients (female, 1516; male, 1654) were included in this analysis. Compared with males, females were less likely to have a relative dose intensity (≥90 %: female 59.1 % vs. male 67.6 %), with a higher proportion of requiring dose reduction (28.8 % vs. 20.4 %) and a lower proportion of completing adjuvant chemotherapy (77.0 % vs. 81.7 %). Multivariable analyses demonstrated that female sex was associated with a higher incidence of grade 3–4 AEs (odds ratio 1.80 [95 % CI 1.51–2.14]). Female sex was identified as a favorable prognostic factor for overall survival (hazard ratio [HR]: 0.80 [0.65–0.97]) and relapse-free survival (HR: 0.73 [0.63–0.85]) in multivariable analyses. Female patients had fewer time-to recurrence (TTR) events than male patients (5-year TTR: 17.7 % vs. 22.3 %).</div></div><div><h3>Conclusion</h3><div>Sex had implications for the development of AEs and survival outcomes of Japanese patients with stage III CRC who received adjuvant fluoropyrimidine monotherapy.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115139"},"PeriodicalIF":7.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695091","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":"Measuring quality in the care of metastatic colorectal cancer utilising available registry data: A modified Delphi study","authors":"Catherine Dunn ,&nbsp;Jeremy Shapiro ,&nbsp;Margaret Lee ,&nbsp;Rachel Wong ,&nbsp;Belinda Lee ,&nbsp;Hui-Li Wong ,&nbsp;Matthew Loft ,&nbsp;Azim Jalali ,&nbsp;Peter Gibbs","doi":"10.1016/j.ejca.2024.115142","DOIUrl":"10.1016/j.ejca.2024.115142","url":null,"abstract":"<div><h3>Background and aims</h3><div>The current lack of quality indicators for patients with metastatic colorectal cancer compromises our ability to examine the quality of care delivered, and to ensure optimal patient outcomes. We sought to define a novel set of quality indicators that could be assessed using available data from a prospective comprehensive clinical colorectal cancer registry, ultimately enabling us to explore local practice and benchmark performance between institutions.</div></div><div><h3>Methods</h3><div>We performed a systematic review of the literature to review existing quality indicators for metastatic colorectal cancer. We engaged an expert panel of medical oncologists in a two-step modified Delphi analysis, using online questionnaires to rate and refine our initial list of candidate indicators, and to generate potential new ones.</div></div><div><h3>Results</h3><div>Thirty-five unique quality indicators for metastatic colorectal cancer were identified from the literature. Nine of these 35 were able to be captured in TRACC, and an additional 3 novel indicators, also captured in TRACC, were added to the list to reflect current practice. After 2 online surveys of eight medical oncologists, a final list of 14 quality indicators were recommended for inclusion.</div></div><div><h3>Conclusion</h3><div>A modified Delphi method was used to propose a set of 14 novel quality indicators to be extracted from an existing comprehensive metastatic colorectal cancer clinical registry. The quality indicators intentionally encompassed critical components of modern, multi-disciplinary care, spanning the treatment continuum across diagnosis to end of life. These will be used in work underway utilising TRACC data to identify potential gaps in care and avenues for quality improvement.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115142"},"PeriodicalIF":7.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744512","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":"Impact of personalized response-directed surgery and adjuvant therapy on survival after neoadjuvant immunotherapy in stage III melanoma: Comparison of 3-year data from PRADO and OpACIN-neo","authors":"Irene L.M. Reijers ,&nbsp;Alexander M. Menzies ,&nbsp;Marta Lopez-Yurda ,&nbsp;Judith M. Versluis ,&nbsp;Elisa A. Rozeman ,&nbsp;Robyn P.M. Saw ,&nbsp;Winan J. van Houdt ,&nbsp;Ellen Kapiteijn ,&nbsp;Astrid A.M. van der Veldt ,&nbsp;Karijn P.M. Suijkerbuijk ,&nbsp;Hanna Eriksson ,&nbsp;Geke A.P. Hospers ,&nbsp;Willem M.C. Klop ,&nbsp;Alejandro Torres Acosta ,&nbsp;Lindsay Grijpink-Ongering ,&nbsp;Maria Gonzalez ,&nbsp;Anja van der Wal ,&nbsp;Abrahim Al-Mamgani ,&nbsp;Andrew J. Spillane ,&nbsp;Richard A. Scolyer ,&nbsp;Christian U. Blank","doi":"10.1016/j.ejca.2024.115141","DOIUrl":"10.1016/j.ejca.2024.115141","url":null,"abstract":"<div><h3>Background</h3><div>Pathologic response following neoadjuvant immune checkpoint blockade (ICB) in stage III melanoma serves as a surrogate marker for long-term outcomes. This may support more personalized, response-directed treatment strategies.</div></div><div><h3>Methods</h3><div>The OpACIN-neo and PRADO trials were phase 2 studies evaluating neoadjuvant treatment with ipilimumab and nivolumab in stage III melanoma. In OpACIN-neo, all patients underwent therapeutic lymph node dissection (TLND) without subsequent adjuvant therapy. In contrast, PRADO explored a response- directed strategy, where patients achieving a major pathologic response (MPR) omitted TLND and adjuvant therapy, while those without a pathologic response (pNR) received TLND and adjuvant therapy. Here, we provide a descriptive post-hoc comparison of 3-year survival outcomes between the non-personalized approach in OpACIN-neo and the response-directed approach in PRADO.</div></div><div><h3>Results</h3><div>For patients who achieved an MPR, the 3-year recurrence-free survival (RFS) was 93 % for those without TLND versus 96 % for those with TLND (log-rank p = 0.47), and distant metastasis-free survival (DMFS) was 98 % compared to 96 % (log-rank p = 0.49), respectively. For patients with pNR, 3-year RFS rates were 64 % for those receiving adjuvant systemic therapy and 35 % for patients without (log-rank p = 0.10). DMFS rates were 70 % versus 52 % (log-rank p = 0.24), respectively.</div></div><div><h3>Conclusions</h3><div>These data suggest that TLND and adjuvant therapy may be safely omitted in most patients achieving an MPR, while adjuvant systemic therapy following TLND appears to improve RFS and DMFS in patients with pNR. Although these results are hypothesis-generating and require further validation, they offer a potential foundation for developing personalized neoadjuvant immunotherapy approaches.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"214 ","pages":"Article 115141"},"PeriodicalIF":7.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699979","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}