CA: A Cancer Journal for Clinicians最新文献

{"title":"Cancer treatment and survivorship statistics, 2025","authors":"Nikita Sandeep Wagle PhD, MBBS, MHA,&nbsp;Leticia Nogueira PhD, MPH,&nbsp;Theresa P. Devasia PhD,&nbsp;Angela B. Mariotto PhD,&nbsp;K. Robin Yabroff PhD,&nbsp;Farhad Islami MD, PhD,&nbsp;Ahmedin Jemal DVM, PhD,&nbsp;Rick Alteri MD,&nbsp;Patricia A. Ganz MD,&nbsp;Rebecca L. Siegel MPH","doi":"10.3322/caac.70011","DOIUrl":"10.3322/caac.70011","url":null,"abstract":"<p>The number of people living with a history of cancer in the United States continues to rise because of the growth and aging of the population as well as improved survival through advances in early detection and treatment. To assist the public health community serve the needs of these survivors, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using data from the Surveillance, Epidemiology, and End Results cancer registries, the Centers for Disease Control and Prevention's National Center for Health Statistics, and the United States Census Bureau. In addition, cancer treatment patterns are presented from the National Cancer Database along with a brief overview of treatment-related side effects. As of January 1, 2025, about 18.6 million people were living in the United States with a history of cancer, and this number is projected to exceed 22 million by 2035. The three most prevalent cancers are prostate (3,552,460), melanoma of the skin (816,580), and colorectum (729,550) among males and breast (4,305,570), uterine corpus (945,540), and thyroid (859,890) among females. About one half (51%) of survivors were diagnosed within the past 10 years, and nearly four fifths (79%) were aged 60 years and older. Racial differences in treatment in 2021 were common across disease stage; for example, Black people with stage I-II lung cancer were less likely to undergo surgery than their White counterparts (47% vs. 52%). Larger disparities exist for rectal cancer, for which 39% of Black people with stage I disease undergo proctectomy or proctocolectomy compared to 64% of their White counterparts. Targeted, multi-level efforts to expand access to high-quality care and survivorship resources are vital to reducing disparities and advancing support for all survivors of cancer.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 4","pages":"308-340"},"PeriodicalIF":232.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176850","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":"Cancer treatment and survivorship statistics, 2025: An urgent call to optimize health after cancer","authors":"Lidia Schapira MD,&nbsp;Christine M. Duffy MD","doi":"10.3322/caac.70017","DOIUrl":"10.3322/caac.70017","url":null,"abstract":"&lt;p&gt;The publication of the American Cancer Society’s “Cancer Treatment and Survivorship Statistics, 2025” report affirms that the number of people living in the United States with a history of cancer is rising because of advances in detection and treatment that have improved survival.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; In our opinion, it also presents a new opportunity to engage all stakeholders in the discourse on cancer survivorship. More cancers have become treatable and controllable, and the sheer number of survivors demands a concerted approach involving a trained health care workforce, accessible referral pathways, and adequate reimbursement for services rendered.&lt;/p&gt;&lt;p&gt;There are reasons to celebrate the findings as we learn that general cancer mortality continues to fall, with an overall incidence decline in men. Yet these improvements are not distributed equally among subpopulations because cancer mortality continues to rise in women, and we are presented with evidence of the persistence of disparities in access to life-saving cancer treatment and receipt of guideline-concordant care. For instance, there is evidence that patients with private insurance are twice as likely to receive recommended treatment for stage II–III colon cancer compared with patients who are uninsured, and Black patients are less likely than White patients to receive surgery for early stage colon and rectal cancers.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; Disparities in receipt of guideline-concordant care have been reported for patients with many solid tumors,&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; and this inevitably leads to worse outcomes.&lt;/p&gt;&lt;p&gt;The global disruption caused by the coronavirus disease 2019 pandemic will continue to be studied for years, but some of its consequential effects are beginning to surface. Among them are delays in screening and disruptions in care pathways that contribute to stage migration.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; In addition, the pandemic exposed fault lines across health care systems and exacerbations in disparities in cancer care. Other global events, including wars and famine that lead to massive migration, will undoubtedly have an impact on global cancer statistics in years to come.&lt;/p&gt;&lt;p&gt;Robust data banks are essential to advancing our understanding of long-term outcomes in cancer survivors. Studies like the St Jude Lifetime Cohort and the Childhood Cancer Survivor Study have generated invaluable insights into survivorship in pediatric populations. The National Cancer Institute-funded cancer epidemiology survivor cohorts, which were established to follow survivors over time to capture data on treatment exposures, long-term health outcomes, and social determinants of health, are an important step that will inform future interventions and guidelines for care, but comprehensive population-based surveillance of survivorship outcomes remains limited.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Growing recognition of the toxicities and long-term burdens associated with cancer t","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 4","pages":"277-279"},"PeriodicalIF":232.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176851","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":"Reirradiation: Standards, challenges, and patient-focused strategies across tumor types","authors":"Arnaud Beddok, Jonas Willmann, Anna Embring, Ane L. Appelt, Panagiotis Balermpas, Kevin Chua, J. Isabelle Choi, Bernice Simone Elger, Dorota Gabrys, Peter Hoskin, Maximilian Niyazi, David Pasquier, Kelly Paradis, Orit Kaidar-Person, Corien Plaisier, Nicole C. Schmitt, Conor E. Steuer, Juliette Thariat, Sue S. Yom, Philip Poortmans, Eliana Vasquez Osorio, Nicolaus Andratschke","doi":"10.3322/caac.70016","DOIUrl":"https://doi.org/10.3322/caac.70016","url":null,"abstract":"Reirradiation (reRT), defined as administering a course of radiation therapy to a specific area previously irradiated, is an evolving treatment strategy for locoregionally recurrent cancer that offers significant potential and poses inherent challenges. Advances in such techniques as intensity-modulated and stereotactic body radiation therapy have improved precision, making reRT a viable option for complex scenarios previously deemed high-risk. Nevertheless, reRT remains associated with substantial risks—including life-threatening side effects, functional impairments, and psychosocial effects—which must be carefully balanced against the patient's overall health and the likelihood of achieving cancer control or palliation. Patient selection is essential to optimize outcomes while mitigating risks. Decisions should account for tumor characteristics at the time of primary diagnosis and recurrence, elapsed time since prior treatment, the possibility of delivering meaningful doses to the tumor, and the cumulative irradiation tolerance of normal tissues. Advanced imaging modalities, such as functional magnetic resonance imaging and fluorine-18–labeled fluorodeoxyglucose–positron emission tomography, are important for distinguishing recurrences from treatment-induced changes, refining treatment targets, and minimizing exposure to healthy tissue. Combined treatment with systemic regimens—targeted therapies and immunotherapy in particular—offers promising opportunities but requires coordination to manage side effects. Standardized guidelines, such as those from the European Society of Therapeutic Radiology and Oncology-European Society for Research and Treatment of Cancer, are essential for improving the consistency of reporting, guiding clinical decision making, and fostering patient-centered care. Multidisciplinary collaboration and ongoing research, particularly through clinical trials, are central to fully exploiting reRT strategies. In addition, the development of innovative techniques, such as proton therapy, would likely enable safer treatments. These efforts aim to improve the therapeutic balance of reRT, enhancing outcomes and quality of life.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"87 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165671","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":"Germ cell and other tumors in individuals with differences in sex development.","authors":"Selma Feldman Witchel,Miguel Reyes-Múgica","doi":"10.3322/caac.70015","DOIUrl":"https://doi.org/10.3322/caac.70015","url":null,"abstract":"Approximately one in 3500 to one in 5100 live-born infants have atypical external genital development, known as differences in sex development (DSD). In 2005, an expert consensus conference thoroughly reviewed aspects of health care for individuals with DSD. The conference proposed a classification system to help provide individualized evaluations and management. Some types of DSD are associated with germ cell tumors, which comprise a heterogeneous group of neoplasms derived from germline cells. These neoplasms commonly occur in infants, children, adolescents, and young adults. Herein, an overview of DSDs and risks for germ cell tumors is provided.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"7 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122303","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 in the treatment of hepatocellular carcinoma: An overview of the current and evolving therapeutic landscape for clinicians","authors":"Dimitrios Moris, Alessandro Martinino, Sarah Schiltz, Peter J. Allen, Andrew Barbas, Debra Sudan, Lindsay King, Carl Berg, Charles Kim, Mustafa Bashir, Manisha Palta, Michael A. Morse, Michael E. Lidsky","doi":"10.3322/caac.70018","DOIUrl":"https://doi.org/10.3322/caac.70018","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the sixth most common malignancy and the third leading cause of cancer-related death worldwide. Contemporary advances in systemic and locoregional therapies have led to changes in peer-reviewed guidelines regarding systemic therapy as well as the possibility of downstaging disease that may enable some patients with advanced disease to ultimately undergo partial hepatectomy or transplantation with curative intent. This review focuses on all modalities of therapy for HCC, guided by modern-day practice-changing randomized data where available. The surgical management of HCC, including resection and transplantation, both of which have evolving criteria for what is considered biologically resectable and transplantable, as well as locoregional therapy (i.e., therapeutic embolization, ablation, radiation, and hepatic arterial infusion), are discussed. Historical and modern-day practice-changing trials evaluating immunotherapy with targeted therapies for advanced disease, as well as adjuvant systemic therapy, are also summarized. In addition, this article examines the critical dimension of toxicities and patient-oriented considerations to ensure a comprehensive and balanced discourse on treatment implications.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"55 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097591","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":"Comprehensive management of vulvovaginal cancers","authors":"Angélica Nogueira-Rodrigues MD, PhD,&nbsp;Maaike H. M. Oonk MD, PhD,&nbsp;Domenica Lorusso MD, PhD,&nbsp;Brian Slomovitz MD,&nbsp;Mario M. Leitão Jr MD,&nbsp;Glauco Baiocchi MD, PhD","doi":"10.3322/caac.70014","DOIUrl":"10.3322/caac.70014","url":null,"abstract":"<p>Vulvar and vaginal cancers represent rare malignancies, with an incidence of 2.7 per 100,000 women for vulvar cancer, predominantly affecting women older than 60 years, although rising rates are observed in younger demographics. Approximately 90% of vulvar cancers are squamous cell carcinoma and frequently are associated with human papillomavirus (HPV) infection. Vaginal cancer, constituting less than 1% of all female cancers, similarly exhibit HPV-related trends. This review delineates the etiology, histopathology, and treatment strategies for carcinomas and vulvovaginal melanomas and sarcomas. Surgical intervention remains the primary treatment modality for vulvar cancer, involving tumor resection and inguinofemoral lymph node staging. For locally advanced vulvar carcinoma, chemoradiation is advised when exenterative surgery would be indicated. Recurrence rates within 2 years after diagnosis range from 12% to 37%. Unfortunately, systemic treatments for recurrent or metastatic disease are limited, with 5-year survival rates at approximately 20%. Current evidence primarily derives from retrospective studies or small phase 2 trials or otherwise is extrapolated from the treatment of cervical cancer. Enrollment in clinical trials is strongly advocated, along with prompt access to best supportive care to mitigate the effect of locoregional progression on quality of life. Moreover, the psychosocial implications of treatment on body image and sexuality necessitate careful consideration. Future HPV vaccination initiatives may reduce cancer incidence, although significant effects of such vaccination will manifest over decades, underscoring the urgent need to enhance treatment efficacy and minimize morbidity in vulvar and vaginal cancers.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 5","pages":"410-435"},"PeriodicalIF":232.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066589","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 5","pages":"410-435"},"PeriodicalIF":232.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038317","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":"Livebirth rates significantly lower among women diagnosed with cancer","authors":"Carrie Printz","doi":"10.3322/caac.70012","DOIUrl":"10.3322/caac.70012","url":null,"abstract":"&lt;p&gt;Women who are diagnosed with cancer during their reproductive years have significantly fewer livebirths than those without cancer, according to a Danish registry-based cohort study.&lt;/p&gt;&lt;p&gt;Researchers found that livebirth rates after a cancer diagnosis increasingly declined with age and varied with specific cancers. The rates of a first livebirth after cancer were lowest among women with leukemia, breast cancer, and cancers of the gynecological tract or central nervous system.&lt;/p&gt;&lt;p&gt;“The data affirms that most young people with cancer should be referred for fertility preservation counseling as soon as possible, even if they’re ambivalent about having children,” says Kutluk Oktay, MD, PhD, director of the Laboratory of Molecular Reproduction and Fertility Preservation at the Yale School of Medicine in New Haven, Connecticut. “I think we’ve made big progress in this area in the U.S., but around the world, and even here, there’s some heterogeneity.”&lt;/p&gt;&lt;p&gt;The study appears in the Journal of &lt;i&gt;Cancer Survivorship&lt;/i&gt; (doi:10.1007/s11764-024-01720-1).&lt;/p&gt;&lt;p&gt;The study population came from the DANAC II cohort, which included women aged 18–39 years who were diagnosed with cancer between 1978 and 2016 and matched them with 60 women without a cancer diagnosis. Each woman came from a general population that included 21,596 women with cancer and 1,295,760 women without cancer.&lt;/p&gt;&lt;p&gt;The primary outcome was a livebirth after cancer with follow-up until death, emigration, or end of follow-up.&lt;/p&gt;&lt;p&gt;Findings showed that the 20-year cumulative incidence of livebirth after cancer was lower among women with cancer (0.22) than those without cancer (0.34).&lt;/p&gt;&lt;p&gt;The hazard ratio (HR) of a livebirth for all women diagnosed with cancer was 0.61 (95% CI, 0.59–0.63). Researchers excluded women with a livebirth within the 259 days after their cancer diagnosis and found that the HR of livebirth after cancer remained unchanged. It was highest among women aged 18–25 years (0.72) and lowest among women aged 33–39 years (0.50). The HR was lowest for women with breast, gynecological, and central nervous system cancers along with leukemia. In contrast, women with malignant melanoma had HRs of a first livebirth comparable to those of women who had not been diagnosed with cancer.&lt;/p&gt;&lt;p&gt;Women with and without cancer were comparable in terms of the initiation of assisted reproductive technology after their cancer diagnosis or study entry: 79% of the total population of women who initiated assisted reproductive technology after cancer had not had children, whereas 76% of the women not diagnosed with cancer had not had children. Only 21% of the women with a child or children before their cancer treatment initiated assistive reproductive technology after their diagnosis.&lt;/p&gt;&lt;p&gt;The results were similar to findings from a 2011 Norwegian study of women with and without cancer who were 16–45 years old between 1967 and 2004 according to Dr Oktay. That study was published in the &lt;i&gt;Inter","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 3","pages":"171-173"},"PeriodicalIF":232.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925737","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":"Active monitoring of DCIS shows promise in short-term study","authors":"Carrie Printz","doi":"10.3322/caac.70013","DOIUrl":"10.3322/caac.70013","url":null,"abstract":"&lt;p&gt;Early results from the first study comparing active monitoring to surgery for patients with low-risk ductal carcinoma in situ (DCIS) support the short-term safety of active monitoring.&lt;/p&gt;&lt;p&gt;Researchers released the 2-year findings from a prospective, randomized clinical trial known as the Comparing an Operation to Monitoring With or Without Endocrine Therapy (COMET) study. Results showed that the rate of invasive cancer in both groups was low, but patients who had surgery (or guideline-concordant care) for DCIS had a slightly higher rate of invasive cancer than the group that underwent active monitoring. Although the study is a preliminary analysis, investigators are encouraged by the findings.&lt;/p&gt;&lt;p&gt;“I don’t think we have enough long-term data yet to offer active monitoring to DCIS patients, because two years is pretty short, but if these results are supported and durable at five years, we may be able to start offering it as a possible option,” says coprincipal investigator Shelley Hwang, MD, MPH, who is the vice-chair of research in the Department of Surgery at the Duke Cancer Institute in Durham, North Carolina. “The results are very provocative in terms of turning the assumption that we’ve always had on its head, and that’s why it’s such an important study—because it challenges dogma.”&lt;/p&gt;&lt;p&gt;Dr Hwang and her colleagues presented the COMET study results in December 2024 at the San Antonio Breast Cancer Symposium. Findings were concurrently published in the &lt;i&gt;Journal of the American Medical Association&lt;/i&gt; (doi:10.1001/jama.2024.26698).&lt;/p&gt;&lt;p&gt;The trial enrolled 995 women aged 40 years or older with a new diagnosis of hormone receptor–positive grade 1 or 2 DCIS without invasive cancer. Participants were enrolled at 100 US Alliance Cooperative Group clinical trial sites from 2017 to 2023. They were randomized, with 484 participants assigned to active monitoring and 473 assigned to receive surgery. Participants will be followed for 10 years.&lt;/p&gt;&lt;p&gt;The main purpose is to determine if DCIS, which is also called stage 0 breast cancer, needs to be treated with surgery in every patient.&lt;/p&gt;&lt;p&gt;“We’ve never really put our treatments to that sort of test because everyone has been really fearful of doing anything less,” Dr Hwang says.&lt;/p&gt;&lt;p&gt;The study excluded patients who were hormone receptor–negative as well as those who had a physical finding such as a lump, bloody discharge, or changes in the skin. Patients were allowed to enter the study regardless of the size of their DCIS.&lt;/p&gt;&lt;p&gt;Active monitoring, with or without endocrine therapy, included follow-up breast imaging along with a physical examination every 6 months. Although endocrine therapy was not mandatory, more than 70% chose to receive it. Guidance-concordant care was surgery with or without radiation therapy and with or without endocrine therapy. This group also had 6-month follow-ups.&lt;/p&gt;&lt;p&gt;The primary outcome of the preliminary analysis was the 2-year cumulative risk of an invasive breas","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 3","pages":"174-176"},"PeriodicalIF":232.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925738","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":"Transforming treatment paradigms: Focus on personalized medicine for high-grade serous ovarian cancer","authors":"Pawel Kordowitzki DVM, PhD,&nbsp;Britta Lange PhD,&nbsp;Kevin M. Elias MD, PhD,&nbsp;Marcia C. Haigis PhD,&nbsp;Sylvia Mechsner MD, PhD,&nbsp;Ioana Elena Braicu MD, PhD,&nbsp;Jalid Sehouli MD, PhD","doi":"10.3322/caac.70008","DOIUrl":"10.3322/caac.70008","url":null,"abstract":"<p>High-grade serous ovarian cancer (HGSOC) is the most common and aggressive subtype of ovarian cancer, accounting for approximately 70% of all ovarian cancer cases and contributing significantly to the high mortality rates associated with this disease. Because of the asymptomatic nature of early stage disease, most patients are diagnosed at advanced stages when the cancer has already spread into the abdominal cavity, requiring complex and intensive surgical and chemotherapeutic interventions followed by maintenance therapies. Although a minority of cases are associated with well defined genetic syndromes, specific risk factors and a clear etiology in many cases remain elusive. HGSOC tumors are characterized by a high frequency of somatic gene copy number alterations, often associated with defects in homologous recombination repair of DNA. All attempts to introduce an effective screening for HGSOC to date have been unsuccessful. This review elucidates the complexities surrounding HGSOC and encompasses its etiology, epidemiology, classification, pathogenesis, and the current array of treatment strategies. Understanding molecular underpinnings is crucial for the development of targeted therapies and personalized multimodal treatment approaches in centralized therapeutic structures. This review also examines the importance of the tumor microenvironment. In addition, the authors' objective is to underscore the critical importance of placing the patient's perspective and diversity at the forefront of therapeutic strategies, thereby fostering a genuinely participatory decision-making process and ultimately improving patient quality of life.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 5","pages":"436-460"},"PeriodicalIF":232.4,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849449","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}