CA: A Cancer Journal for Clinicians最新文献

{"title":"Cancer statistics for Hispanic/Latino people, 2026","authors":"Anatu H. Saka MPH,&nbsp;Tyler B. Kratzer MPH,&nbsp;Angela N. Giaquinto MSPH,&nbsp;Natalia Mazzitelli MPH,&nbsp;Paulo S. Pinheiro PhD,&nbsp;Ana P. Ortiz PhD, MPH,&nbsp;Dinorah Martinez Tyson PhD, MPH, MA,&nbsp;Ahmedin Jemal DVM, PhD,&nbsp;Rebecca L. Siegel MPH","doi":"10.3322/caac.70107","DOIUrl":"10.3322/caac.70107","url":null,"abstract":"<p>The Hispanic/Latino population is the second largest racial and ethnic group in the United States, accounting for 20% of the total population (68 million), plus approximately 3 million Hispanic Americans residing in Puerto Rico. Herein, the American Cancer Society reports cancer occurrence, risk factors, and screening for US Hispanic people using federally funded, high-quality, population-based cancer registry data and national vital statistics and survey data. In 2026, an estimated 229,900 Hispanic people will be diagnosed with cancer, and 54,200 will die from the disease in the continental United States and Hawaii. Cancer incidence during 1998–2022 rose in Hispanic women (from 345 to 385 per 100,000) and fell in Hispanic men (from 471 to 389 per 100,000), narrowing the male-to-female incidence rate ratio from a peak of 1.40 (95% CI, 1.38–1.42) in 2002 to 1.01 (95% CI, 1.00–1.02; <i>p</i> = .02) in 2022. This pattern is partly driven by declining incidence of lung and prostate cancers among men and increasing incidence of breast and uterine corpus cancers among women. Although temporal trends mirror the general population, the Hispanic cancer distribution is distinct, consistent with relatively lower prevalence of smoking, alcohol drinking, and screening and higher prevalence of obesity and cancer-causing infections. Compared with White people, Hispanic people have one half the incidence of lung and urinary bladder cancers and 24% lower breast cancer but double the rate of liver, stomach, and gallbladder cancers, 61%–65% higher acute lymphocytic leukemia, and 36% higher cervical cancer. The cancer burden in Puerto Rico is distinct, with lower rates of lung cancer but higher rates of cervical, prostate, and colorectal cancers compared with other US Hispanic populations. Residents in Puerto Rico also experience lasting health care system challenges from extreme weather events. Thus, prevention efforts should target the unique cancer profile of the Hispanic population, including infection prevention and control, healthy eating, physical activity, and routine screening, especially for cervical and colorectal cancer that are 11 percentage points lower than White people.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101524","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":"A changing landscape in gastric cancer","authors":"Lindsay M. Hannan MD, MSPH,&nbsp;Vaia Florou MD, MS","doi":"10.3322/caac.70113","DOIUrl":"10.3322/caac.70113","url":null,"abstract":"&lt;p&gt;Gastric cancer (GC) remains one of the most lethal cancers globally. In this issue of &lt;i&gt;CA: A Cancer Journal for Clinicians&lt;/i&gt;, Wang et al. provide a comprehensive review of recent advances across the spectrum of GC.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The rapidly evolving treatment paradigm of metastatic disease is particularly striking and is the focus of this editorial. Clinicians now face questions that were uncommon a decade ago: Which treatment should take priority when several biomarkers are actionable, and how should that choice influence subsequent therapy? The emergence of claudin 18.2 (CLDN18.2)-directed antibodies, antibody–drug conjugates, and cellular therapy makes these questions increasingly relevant.&lt;/p&gt;&lt;p&gt;For many years, palliative systemic treatment relied almost entirely on cytotoxic chemotherapy along with trastuzumab as an option for human epidermal growth factor receptor 2 (HER2)-positive disease&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and the vascular endothelial growth factor 2 (VEGFR2) antagonist ramucirumab as an option after first-line therapy.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Only experimental options were available once these therapies became ineffective or intolerable. This landscape has changed considerably over the past 5 years; Biomarker-driven treatment is now part of routine clinical practice, and actionable targets continue to evolve. The addition of immune checkpoint inhibitors to chemotherapy was one of the recent significant advancements.&lt;span&gt;&lt;sup&gt;4-6&lt;/sup&gt;&lt;/span&gt; Programmed death ligand-1 (PD-L1) expression, quantified using the combined positive score (CPS), is used to identify patients most likely to benefit from immunotherapy, with the magnitude of benefit generally increasing with higher CPS. Treatment decisions remain difficult for tumors with low PD-L1 expression, in which the incremental benefit is less clear. Microsatellite instability-high status and, in selected settings, high tumor mutational burden provide additional information regarding the suitability of treatment with immune checkpoint inhibitors, but this pertains to only a relatively small proportion of patients.&lt;/p&gt;&lt;p&gt;HER2-directed therapy has also expanded. HER2 is overexpressed in a subset of GCs&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; and has been successfully targeted with trastuzumab, the antibody–drug conjugate fam-trastuzumab deruxtecan-nxki, and the dual HER2-targeted, bispecific antibody zanidatamab. The eligibility criteria for first-line combinations differ. Pembrolizumab with trastuzumab and fluoropyrimidine-containing and platinum-containing chemotherapy is approved by the US Food and Drug Administration (FDA) for first-line treatment of HER2-positive advanced gastric or gastroesophageal junction adenocarcinoma with a PD-L1 CPS ≥1.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; However, the combination of zanidatamab, tislelizumab, and chemotherapy, which was approved by the FDA on August 25, 2026, does not require PD-L1 positivity.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; These distinctions matter when ","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101591","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":"Recurrent prostate adenocarcinoma after radical prostatectomy: Principles of multidisciplinary management across a spectrum of disease","authors":"Amar U. Kishan MD,&nbsp;Yulia Zekster MD,&nbsp;Adam E. Singer MD, PhD,&nbsp;Kekoa Taparra MD, PhD, MPH,&nbsp;Luca F. Valle MD,&nbsp;Michael L. Steinberg MD,&nbsp;Nicholas G. Nickols MD, PhD,&nbsp;Robert E. Reiter MD, MBA,&nbsp;Johannes Czernin MD,&nbsp;Jeremie Calais MD, PhD,&nbsp;John K. Lee MD, PhD,&nbsp;Lawrence R. Hardesty BS,&nbsp;Matthew B. Rettig MD","doi":"10.3322/caac.70111","DOIUrl":"10.3322/caac.70111","url":null,"abstract":"&lt;p&gt;A man aged 76 years in good health presented for evaluation of a rising prostate-specific antigen (PSA) level after prior radical prostatectomy (Figure 1). Briefly, his prostate cancer had been diagnosed 5 years prior in the setting of a rising PSA. A standard biopsy had revealed International Society of Urological Pathology (ISUP) grade group 3 disease, and he underwent radical prostatectomy without pelvic nodal sampling. Pathologic examination demonstrated extracapsular extension and the presence of intraductal carcinoma; otherwise, at final pathology, the tumor was ISUP grade group 3, with negative surgical margins but evidence of perineural invasion. Postoperative PSA was undetectable for 3 years and then began to slowly rise, reaching 0.06 ng/dL 42 months after surgery. PSA then began to rise more rapidly, reaching 0.37 ng/dL 51 months after surgery. He underwent a prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) scan at that time, which showed an enhancing nodular soft tissue along the right prostate bed (1.1 × 0.5 cm) with intense PSMA uptake, as well as uptake in a 3-mm right internal iliac node, a 3-mm right common iliac node, and a 3-mm aortocaval node (Figure 2). Focal uptake in a left presacral area was thought to represent a ganglion, whereas uptake in the T11 vertebral body was equivocal; follow-up magnetic resonance imaging (MRI) of the thoracic spine confirmed that the T11 lesion was a hemangioma. MRI of the prostate bed showed a small focus of T2-hypointense soft tissue in the right pelvis lateral to the prostatectomy bed measuring 15 × 5 mm.&lt;/p&gt;&lt;p&gt;The patient was evaluated by a radiation oncologist, urologist, and medical oncologist, and decided to pursue a clinical trial of stereotactic body radiotherapy (SBRT; ClinicalTrials.gov identifier NCT03541850).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; He received 40 grays (Gy) in five fractions to the prostate bed gross nodule and PSMA-positive nodes, 30 Gy in five fractions to the prostate bed, and 25 Gy in five fractions to the elective lymph node regions. In addition to SBRT, he started a planned short course of androgen-deprivation therapy (ADT; this was allowed on the protocol) but stopped after 1 month because of intolerance. PSA dropped to 0.18 ng/dL 6 months after SBRT, but then rose to 0.27 ng/dL 3months later and 0.99 ng/dL 6 months after that (now nearly 6 years after his prostatectomy). PSMA PET/CT imaging revealed a decrease in size and positivity of the right internal iliac node, with stable low uptake in the right CI node and prostate bed, and resolution of the aortocaval node. However, there was new uptake in two 4–6 mm left para-aortic nodes and a 5-mm node anterior to the aorta (Figure 3).&lt;/p&gt;&lt;p&gt;The patient enrolled on a trial of PSMA PET/CT–guided, metastasis-directed therapy (MDT) with 6 months of androgen-annihilation therapy (AAT; leuprolide, apalutamide, and abiraterone; ClinicalTrials.gov identifier NCT03902951).&lt;span&gt;&lt;sup&gt;","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072953","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":"Advances in therapeutic approaches to gastric cancer","authors":"Feng Wang MD, PhD,&nbsp;王峰,&nbsp;Zi-Xian Wang MD, PhD,&nbsp;王梓贤,&nbsp;Yu-Jing Zhang MD, PhD,&nbsp;张玉晶,&nbsp;Ye He MD, PhD,&nbsp;何叶,&nbsp;Jia-Fu Ji MD, PhD,&nbsp;季加孚,&nbsp;Yuan-Fang Li MD, PhD,&nbsp;李元方,&nbsp;Xiu-Juan Qu MD, PhD,&nbsp;曲秀娟,&nbsp;Yi Ba MD, PhD,&nbsp;巴一,&nbsp;Shu-Qiang Yuan MD, PhD,&nbsp;袁庶强,&nbsp;Rui-Hua Xu MD, PhD,&nbsp;徐瑞华","doi":"10.3322/caac.70103","DOIUrl":"10.3322/caac.70103","url":null,"abstract":"<p>Gastric cancer remains a leading cause of cancer-related mortality worldwide, with nearly 1 million new cases diagnosed annually. Despite innovations in diagnosis, most patients still present at advanced stages, contributing to a poor prognosis. For early gastric cancer, endoscopic resection or minimally invasive surgery has become standard, offering comparable oncologic outcomes with faster recovery compared with open surgery. In locally advanced disease, resection of the primary lesion and D2 lymphadenectomy, defined as dissection of lymph nodes along two levels of blood vessels supplying the stomach, remains the cornerstone of curative surgery, whereas perioperative chemotherapy, particularly oxaliplatin-based regimens, has demonstrated improved survival benefits compared with surgery alone. The integration of immunotherapy into perioperative therapy for locally advanced disease and first-line palliative therapy for metastatic disease represents a paradigm shift, with programmed death 1/programmed death-ligand 1 inhibitors combined with chemotherapy significantly improving pathologic complete response rates and overall survival, especially in programmed death ligand 1–positive and microsatellite instability-high tumors. Targeted agents include claudin 18.2 antibody, with zolbetuximab establishing a new first-line standard for claudin 18.2–positive disease, and antibody–drug conjugates, such as trastuzumab deruxtecan for human epidermal growth factor receptor 2–positive disease, both of which have revolutionized treatment paradigms. Emerging strategies include dual immune checkpoint inhibition, bispecific antibodies, chimeric antigen receptor T-cell therapy, and fibroblast growth factor receptor 2b–targeting agents. Ultimately, the field is moving toward personalized, biomarker-driven approaches within multidisciplinary frameworks, although overcoming acquired resistance and addressing global disparities in therapeutic access remain important challenges.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987443","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":"Redefining early stage nonsmall cell lung cancer: The dawn of the risk-adaptive and biologically precise era","authors":"Clarissa Mathias MD, PhD,&nbsp;Fabio Ynoe Moraes MD, PhD, MBA","doi":"10.3322/caac.70102","DOIUrl":"10.3322/caac.70102","url":null,"abstract":"&lt;p&gt;For decades, the management of early stage nonsmall cell lung cancer (NSCLC) was guided primarily by anatomic staging and surgical resection. Although this approach has achieved favorable outcomes for many patients, it does not fully account for the biologic heterogeneity that influences recurrence risk and treatment response. Contemporary advances in lung cancer screening, surgical techniques, precision radiotherapy, molecular profiling, and perioperative systemic therapies have collectively transformed the therapeutic landscape, supporting a more risk-adaptive approach that integrates anatomic, biologic, and patient-specific factors into clinical decision-making.&lt;/p&gt;&lt;p&gt;In this context, the review by Zhang et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; provides a comprehensive overview of the advances that are reshaping the management of localized NSCLC. Progress in lung cancer screening, minimally invasive and parenchyma-sparing surgery, stereotactic ablative radiotherapy (SABR) and other highly conformal radiotherapy techniques, together with the integration of perioperative immunotherapy and molecularly targeted therapies, has broadened the therapeutic landscape and enabled increasingly individualized treatment approaches.&lt;/p&gt;&lt;p&gt;Importantly, the review highlights the evolving limitations of relying solely on the tumor-node-metastasis classification to guide treatment decisions. Although tumor-node-metastasis staging remains the cornerstone of prognostic assessment and therapeutic planning, it provides limited information regarding tumor biology, host immune interactions, or the likelihood of micrometastatic disease.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The increasing availability of molecular profiling, circulating tumor DNA analysis, and other emerging biomarkers offers opportunities to complement anatomic staging with biologic risk assessment, potentially enabling more individualized treatment strategies. Rather than replacing established staging systems, these advances support a more integrated framework in which anatomic extent of disease, molecular alterations, immune characteristics, and dynamic biomarkers collectively inform clinical decision-making. As the field continues to evolve, the central challenge will be determining how these emerging tools can be incorporated into evidence-based care while maintaining equitable access across diverse health care settings.&lt;/p&gt;&lt;p&gt;The widespread implementation of low-dose computed tomography screening has fundamentally altered the presentation of NSCLC. Landmark trials, specifically the National Lung Screening Trial&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; and the NELSON trial,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; have demonstrated significant mortality reductions, cementing low-dose computed tomography as the gold standard for high-risk populations. However, this screening success has precipitated a &lt;i&gt;stage migration&lt;/i&gt;, characterized by a dramatic increase in the detection of early stage lesions, particularly ground-glass opacities.&lt;/p&gt;&lt;p&gt;Simu","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910286","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":"Early stage nonsmall cell lung cancer: Toward a risk-adaptive paradigm in the era of biologic precision","authors":"Chaoqi Zhang MD, PhD,&nbsp;张超奇,&nbsp;Xuanyu Gu MD,&nbsp;谷炫谕,&nbsp;Pan Wang MD,&nbsp;王攀,&nbsp;Dongyu Li MD,&nbsp;李东宇,&nbsp;Guochao Zhang MD,&nbsp;张国超,&nbsp;Ting Wang MD, PhD,&nbsp;王婷,&nbsp;Peng Wu PhD,&nbsp;吴芃,&nbsp;Wei Rao MD,&nbsp;饶薇,&nbsp;Shan Muhammad PhD,&nbsp;Binghua Tan MD,&nbsp;谭炳华,&nbsp;Yun Che MD, PhD,&nbsp;车云,&nbsp;Mobai Zhu MD,&nbsp;朱墨白,&nbsp;Qilin Qiao MD,&nbsp;乔奇临,&nbsp;Fanbo Lai MD,&nbsp;来凡博,&nbsp;Bohui Zhao MD,&nbsp;赵博慧,&nbsp;Kailun Fei MD,&nbsp;费凯伦,&nbsp;Yue Wu PhD,&nbsp;吴玥,&nbsp;Zhihui Zhang PhD,&nbsp;张志慧,&nbsp;Min Dai PhD,&nbsp;代敏,&nbsp;Wanqing Chen MD, PhD,&nbsp;陈万青,&nbsp;Yawei Zhang PhD,&nbsp;张亚玮,&nbsp;Nan Bi MD,&nbsp;毕楠,&nbsp;Jie Wang MD,&nbsp;王洁,&nbsp;Jie He MD, PhD,&nbsp;赫捷","doi":"10.3322/caac.70100","DOIUrl":"10.3322/caac.70100","url":null,"abstract":"<p>The clinical landscape of early stage nonsmall cell lung cancer is at transformative crossroads. Driven by the widespread adoption of low-dose computed tomography screening, the frequent detection of ground-glass opacities, and a rising incidence among never-smokers, the diagnostic center of gravity has shifted toward earlier, potentially curable disease. This shift has been accompanied by equally important therapeutic advances, including parenchyma-sparing surgical techniques, minimally invasive platforms enhanced by digital navigation, and the transformative integration of perioperative immunotherapy and targeted agents. Concurrently, noninvasive monitoring approaches, such as liquid biopsy, have emerged as powerful tools to guide precision management. Despite this progress, substantial barriers to achieving a universal cure persist. Clinicians continue to face uncertainty in the management of ground-glass opacities, the anatomy-based TNM staging system fails to capture the biologic heterogeneity of early tumors, and global disparities in access to innovation remain unresolved. To address these challenges, the authors propose a shift toward a risk-adaptive management paradigm that harnesses artificial intelligence–driven analytics and multi-omics profiling to tailor treatment intensity according to each patient's biologic risk. Such an approach would enable appropriate escalation for high-risk individuals while permitting safe de-escalation for those at low risk. This holistic, lifespan-oriented strategy must be embraced to deliver equitable and durable cures for patients with early stage nonsmall cell lung cancer.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910240","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":"The new (version 9) American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging protocol for carcinoma of the vulva","authors":"Alexander B. Olawaiye MD,&nbsp;Elliot A. Asare MD, MS,&nbsp;Ian S. Hagemann MD, PhD,&nbsp;Priya R. Bhosale MD, MBA,&nbsp;Stephanie Gaillard MD, PhD,&nbsp;Brian Rous MBBChir, PhD,&nbsp;Bunja Rungruang MD,&nbsp;Shitanshu Uppal MD, MBA,&nbsp;Gulisa Turashvili MD, PhD,&nbsp;Kaled M. Alektiar MD,&nbsp;Jonathan A. Cosin MD,&nbsp;Uma Krishnamurti MD, PhD,&nbsp;Lee-may Chen MD,&nbsp;Keiichi Fujiwara MD, PhD,&nbsp;Matthew A. Powell MD,&nbsp;Mauricio A. Cuello MD, PhD,&nbsp;David G. Mutch MD","doi":"10.3322/caac.70104","DOIUrl":"https://doi.org/10.3322/caac.70104","url":null,"abstract":"<p>The American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging for all cancer sites has been updated periodically as a published manual for many years. The last update of the manual version, the eighth edition <i>AJCC Cancer Staging Manual</i>, went into use on January 1, 2018. The AJCC has since restructured and updated its processes for curating, analyzing, and publishing updates to the TNM staging system. All AJCC staging-related data are now housed on its new application programming interface. Consequently, the subsequent AJCC TNM staging updates are now published electronically as protocols and are released by disease sites. The protocol for carcinoma of the vulva, AJCC version 9, is now published. The new TNM vulvar cancer staging was validated using the American College of Surgeons’ National Cancer Data Base. This article highlights the changes to the new AJCC TNM staging protocol for carcinoma of the vulva; these changes align with the 2021 International Federation for Gynecology and Obstetrics staging. The most important of the changes are: (1) a new method for depth of invasion measurement, (2) the addition of a new T subcategory—T4, (3) redefined N subcategories, and (4) an increased number of M subcategories with the addition of <i>clinical</i> to all M subcategories.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849263","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":"Thank You to Reviewers 2026","authors":"","doi":"10.3322/caac.70108","DOIUrl":"https://doi.org/10.3322/caac.70108","url":null,"abstract":"<p>In order to maintain the high standards of <i>CA</i>’s content, the Editors of <i>CA</i> rely on the knowledge and dedication of many experts in deciding which topics to pursue, which manuscripts to publish, and what modifications to make to ensure medical and scientific accuracy and suitability for our readers. We thank our Associate Editors and our Editorial Advisory Board, who continue to provide these services for us time and time again.</p><p>We are also greatly indebted to the effort and expertise of the following individuals for reviewing manuscripts for the journal from July 1, 2025, to June 30, 2026. These individuals go beyond expectations by consistently and expeditiously delivering comprehensive, discerning reviews.</p><p>Nadeem R. Abu-Rustum</p><p>Pedro Barata</p><p>Surinder Batra</p><p>Beth Beadle</p><p>Daniel Benedetti</p><p>Sushil Beriwal</p><p>Stephanie Blank</p><p>Susana Campos</p><p>Fumiko Chino</p><p>Clay Cockerell</p><p>Adil Daud</p><p>Michael Davies</p><p>Ajay Dhakal</p><p>Jessica DiSilvestro</p><p>Milana Dolezal</p><p>Julien Edeline</p><p>Bita Esmaeli</p><p>Douglas Evans</p><p>Vaia Florou</p><p>Zhi Ven Fong</p><p>Anand Ganesan</p><p>Ben George</p><p>Amandeep Godara</p><p>Krishna Gunturu</p><p>Lindsay Hannan</p><p>Jeremy Harris</p><p>Kate Hetherington</p><p>Kathleen Horst</p><p>Fernando Hugo</p><p>Ahmedin Jemal</p><p>Rachel Jimenez</p><p>Corinne Joshu</p><p>Hina Khan</p><p>Albert E. Kim</p><p>Kevin B. Kim</p><p>Matthew Kudek</p><p>Matteo Lambertini</p><p>Phebe Lemert</p><p>Gilberto Lopes de Lima Lopes Junior</p><p>Stefano Luminari</p><p>Martin Ma</p><p>Kim Margolin</p><p>Carol Marquez</p><p>Jonathan Marron</p><p>Claudia Massarotti</p><p>Paul Mathew</p><p>Clarissa Mathias</p><p>Sandy Mazzoni</p><p>Krishnan Patel</p><p>Mack Roach</p><p>Ilana Schlam</p><p>Vivek Subbiah</p><p>Molly Taylor</p><p>Derek Tsang</p><p>Angela E. Usher</p><p>Hao Wang</p><p>Lori Wirth</p><p>Fabio Ynoe de Moraes</p><p>Youssef Zeidan</p><p>Mu-Sheng Zeng</p><p>Janie Zhang</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 5","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849199","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":"Discordant molecular biomarkers in unfavorable intermediate-risk localized prostate cancer","authors":"Michael Rooney MD, MS,&nbsp;Krishnan R. Patel MD, MHS,&nbsp;Shalin Shah MD,&nbsp;Justin R. Gregg MD,&nbsp;Steven Jay Frank MD,&nbsp;Karen Hoffman MD, MHSc, MPH,&nbsp;Ryan Park MD,&nbsp;Comron J. Hassanzadeh MD, MPH,&nbsp;Seungtaek Choi MD,&nbsp;Sean McGuire MD, PhD,&nbsp;Quynh-Nhu Nguyen MD,&nbsp;Daniel N. Costa MD,&nbsp;Patricia Troncoso MD,&nbsp;Sumit K. Subudhi MD,&nbsp;Shuang George Zhao MD, PhD,&nbsp;Curtis A. Pettaway MD,&nbsp;Paul Corn MD, PhD,&nbsp;Chad Tang MD,&nbsp;Phuoc T. Tran MD, PhD","doi":"10.3322/caac.70105","DOIUrl":"10.3322/caac.70105","url":null,"abstract":"&lt;p&gt;A Black gentleman aged 67 years was referred for evaluation of an elevated prostate-specific antigen (PSA) level of 4.9 ng/mL detected during routine screening, representing an increase from a prior value of 3.6 ng/mL 1 year earlier and a gradual rise from values in the low 2 ng/mL range beginning in his mid-50s. He reported no lower urinary tract symptoms and had an Eastern Cooperative Oncology Group performance status of 0. His past medical history was notable only for well controlled hypertension and hyperlipidemia. He had no family history of prostate cancer. He remained physically active and had an estimated life expectancy exceeding 10 years based on actuarial life tables,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; with both parents having lived into their late 80s. His American Urological Association International Prostate Symptom Score was 6, and his score on the Sexual Health Inventory for Men was 19. Digital rectal examination revealed subtle induration involving the right peripheral zone of the prostate without fixation.&lt;/p&gt;&lt;p&gt;Multiparametric magnetic resonance imaging (MRI) of the prostate demonstrated a 1.9-cm lesion characterized as a Prostate Imaging-Reporting and Data System score of 5 (&lt;i&gt;very high&lt;/i&gt; likelihood of significant cancer). It was located within the right posterior peripheral zone at the mid-gland, without radiographic evidence of extracapsular extension or seminal vesicle invasion. No suspicious pelvic lymph nodes were identified.&lt;/p&gt;&lt;p&gt;Transrectal ultrasound–guided, systematic and MRI-targeted biopsies were subsequently performed. Pathologic sampling included a systematic 12-core biopsy sampling of the entire prostate, from which seven of 12 cores were positive. The biopsy was enhanced by MRI-informed targeting of the aforementioned lesion with a Prostate Imaging-Reporting and Data System score of 5 and yielded two of three positive cores. Of all biopsies, the highest Gleason score was 4 + 3 = 7, representing an intermediate grade and correlating to International Society of Urological Pathology (ISUP) grade group 3,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; with pattern 4 in approximately 60% and no cribriform features. Perineural invasion was present, and overall tumor involvement ranged from 20% to 70% within positive cores. Based on these findings, the patient was staged with clinical T2b, N0, M0 (cT2bN0M0) disease.&lt;/p&gt;&lt;p&gt;According to National Comprehensive Cancer Network (NCCN) criteria, the patient was classified as having unfavorable intermediate-risk (UIR) prostate cancer based on the presence of ISUP grade group 3&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; adenocarcinoma and ≥50% of cores that were positive for cancer. Staging with prostate-specific membrane antigen–positron emission tomography demonstrated no evidence of nodal or distant metastatic disease.&lt;/p&gt;&lt;p&gt;The patient was evaluated in a multidisciplinary clinic and expressed interest in definitive radiation therapy (RT) over surgery. Given his UIR disease, standard management options included RT al","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 4","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811662","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":"Daraxonrasib significantly improves overall and progression-free survival in patients with previously treated metastatic pancreatic cancer","authors":"Carrie Printz","doi":"10.3322/caac.70097","DOIUrl":"https://doi.org/10.3322/caac.70097","url":null,"abstract":"&lt;p&gt;Few therapies are available for patients with previously treated metastatic pancreatic ductal adenocarcinomas (mPDACs), and those that exist offer limited benefit while causing toxic side effects. The median overall survival (OS) for patients with the disease is less than 1 year.&lt;/p&gt;&lt;p&gt;More than 90% of PDAC cases, including mPDAC, have mutations in the &lt;i&gt;KRAS&lt;/i&gt; gene, and researchers have long sought a way to effectively target them. Although some targeted therapies for the mutation exist, they are limited to rare molecular subgroups.&lt;/p&gt;&lt;p&gt;Scientists have developed new types of &lt;i&gt;RAS&lt;/i&gt;(ON) multiselective inhibitors to target a broader range of variants and to improve outcomes for patients with hard-to-treat cancers. In the phase 3 RASolute 302 trial, the &lt;i&gt;RAS&lt;/i&gt;(ON) inhibitor daraxonrasib demonstrated significant, unprecedented improvements in both OS and progression-free survival (PFS) for patients with mPDAC.&lt;/p&gt;&lt;p&gt;The international phase 3 trial compared daraxonrasib to chemotherapy in 500 patients with mPDAC. Results showed nearly a doubling of survival with fewer side effects in patients treated with daraxonrasib versus chemotherapy.&lt;/p&gt;&lt;p&gt;“We have never seen survival like this before in patients with advanced pancreas cancer who have progressed on one line of chemotherapy, so it will absolutely be landscape-changing for therapeutic options,” says Rachna Shroff, MD, chief of the Division of Hematology/Oncology at the University of Arizona Cancer Center in Tucson. “This is a game changer for pancreas cancer.”&lt;/p&gt;&lt;p&gt;The research was presented at the 2026 American Society of Clinical Oncology Annual Meeting and was published simultaneously in &lt;i&gt;The New England Journal of Medicine&lt;/i&gt; (doi:10.1056/NEJMoa2605555).&lt;/p&gt;&lt;p&gt;Daraxonrasib is an oral &lt;i&gt;RAS&lt;/i&gt;(ON) multiselective, tricomplex inhibitor of the active guanosine triphosphate–bound state of mutant and wild-type &lt;i&gt;RAS&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;The open-label, randomized trial assigned patients previously treated for mPDAC to receive either once daily oral daraxonrasib or chemotherapy of the investigator’s choice. The dual primary endpoints were OS and PFS in the subpopulation of patients with &lt;i&gt;RAS&lt;/i&gt; G12 mutations (91.8% of patients).&lt;/p&gt;&lt;p&gt;The overall study population included patients with &lt;i&gt;RAS&lt;/i&gt; G12, G13, or Q61 mutations as well as those with no identified &lt;i&gt;RAS&lt;/i&gt; mutation. Key secondary endpoints included OS and PFS in the overall population along with objective responses and patient-reported quality of life in the &lt;i&gt;RAS&lt;/i&gt; G12 and overall populations. Investigators also assessed safety.&lt;/p&gt;&lt;p&gt;In the study population, 248 patients received daraxonrasib, and 252 patients received chemotherapy. For patients in the &lt;i&gt;RAS&lt;/i&gt; G12 group, the median OS was 13.2 months with daraxonrasib and 6.6 months with chemotherapy. In the overall population, the median OS was 13.2 and 6.7 months, respectively. In both groups, the hazard ratio was 0.40 (&lt;i&gt;p&lt;/i&gt; &lt; .001).&lt;/p&gt;&lt;p&gt;For patients wi","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 4","pages":""},"PeriodicalIF":685.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784613","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}