CA: A Cancer Journal for Clinicians最新文献

{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148064646","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":"Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline","authors":"Rebecca B. Perkins MD, MSc,&nbsp;Andrew M. D. Wolf MD,&nbsp;Timothy R. Church PhD,&nbsp;Elena B. Elkin PhD, MPA,&nbsp;Steven J. Skates PhD,&nbsp;Ruth D. Etzioni PhD,&nbsp;Carmen E. Guerra MD, MSCE,&nbsp;Abbe Herzig PhD,&nbsp;Richard M. Hoffman MD, MPH,&nbsp;Kevin C. Oeffinger MD,&nbsp;Sana Raoof MD, PhD,&nbsp;Ya-Chen Tina Shih PhD,&nbsp;Louise C. Walter MD,&nbsp;Charnita Zeigler-Johnson PhD,&nbsp;Deana Manassaram-Baptiste PhD, MPH,&nbsp;Robert A. Smith PhD","doi":"10.3322/caac.70041","DOIUrl":"10.3322/caac.70041","url":null,"abstract":"<p>This update expands the 2020 American Cancer Society (ACS) cervical cancer screening guideline for average-risk women and individuals with a cervix who are at average risk, to include self-collection for human papillomavirus (HPV) testing and revised guidance for exiting cervical cancer screening. Self-collected vaginal specimens, a method of primary HPV testing, align with the ACS cervical cancer screening guideline. When clinician-collected cervical specimens are used for HPV testing, repeat screening is recommended every 5 years for those with a negative test. For self-collected vaginal specimens, the ACS endorses the following recommendations of the Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee (of which it is a member): (1) primary HPV screening using clinician-collected cervical specimens is preferred, and self-collected vaginal specimens are acceptable for average-risk individuals aged 25–65 years; and (2) repeat testing in 3 years is recommended after a negative result on a self-collected HPV screening test. These recommendations apply only to combinations of collection devices and HPV assays approved by the US Food and Drug Administration for HPV testing in a clinical setting or at home. The rationale notes that the use of self-collected vaginal specimens can overcome barriers to screening for many patients, but most patients who test HPV-positive will require extra follow-up steps, and data on long-term, real-world effectiveness are limited. For certain high-risk individuals, clinician-collected samples are still recommended. Furthermore, in response to high rates of cervical cancer among individuals older than 65 years and with poor implementation of current exiting screening criteria, ACS has amended the 2020 guideline to recommend HPV testing at ages 60 and 65 years, with the last HPV test at an age no younger than 65 years as a requisite to exiting screening. The revised recommendation states: <i>To qualify for discontinuation of screening, the ACS recommends an average-risk woman or an individual with a cervix at average risk have negative primary HPV tests (preferred) or negative co-testing using HPV tests and cytology (acceptable) at ages 60 and 65 years.</i> If primary HPV tests or co-testing are not available, three consecutive negative cytology (Papanicolaou) tests at the recommended screening interval with the last test at age 65 years are acceptable. If self-collected vaginal specimens are used for HPV testing, the 3-year testing interval should be followed. Additional screening exit stipulations relate to women at higher risk because of prior abnormal test results or current immune suppression.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664286","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":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148064647","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148064648","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148063324","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":"Global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2022","authors":"Harriet Rumgay PhD,&nbsp;Murielle Colombet MSc,&nbsp;Amanda Ramos da Cunha DDS, MSc, PhD,&nbsp;Adalberto M. Filho PhD,&nbsp;Saman Warnakulasuriya DSc,&nbsp;David I. Conway BDS, MPH, PhD,&nbsp;Anil Chaturvedi PhD,&nbsp;Shama Virani PhD,&nbsp;Beatrice Lauby-Secretan PhD,&nbsp;Andre L. Carvalho MD, PhD, MPH,&nbsp;Suzanne T. Nethan MDS, MPH,&nbsp;Ahmedin Jemal DVM, PhD,&nbsp;Freddie Bray BSc, MSc, PhD","doi":"10.3322/caac.70048","DOIUrl":"10.3322/caac.70048","url":null,"abstract":"<p>Cancers of the lip, oral cavity, and pharynx (LOCP) represent a substantial public health challenge worldwide. Using GLOBOCAN national estimates of incidence, detailed cancer registry data from <i>Cancer Incidence in Five Continents</i>, and population statistics from the United Nations, the authors report the distribution of new cases of LOCP cancers in 185 countries by sex in 2022. Age-standardized incidence rates were calculated. For countries lacking registry data, regional averages from high-quality registries were used to impute subsite-specific estimates. Worldwide, 758,000 people were diagnosed with LOCP cancers in 2022, with oral cavity cancer accounting for approximately 42% of cases, followed by oropharynx (19.3%), nasopharynx (15.9%), hypopharynx (11.4%), salivary gland (7.3%), and lip (4.2%) cancers. Oral cavity cancer was the most frequent LOCP subsite among women in 141 countries and among men in 93 countries, and incidence rates were highest in countries in South-Central Asia. Oropharyngeal cancer was the most frequent LOCP subsite among men in 44 countries and among women in five countries across Europe, Northern America, South America, Australia, and New Zealand. Nasopharyngeal cancer was the most common subsite among men in 39 countries and women in 23 countries, mainly in Northern Africa, Middle Africa, and Eastern and South-Eastern Asia. Rates of hypopharyngeal and salivary gland cancers were low globally, although the incidence burden was greater than that of lip cancer. The authors discuss incidence patterns in relation to disease etiology and the prospects of delivering effective cancer control measures, spanning primary prevention, early detection, cancer treatment, and survivorship.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658082","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":"Fuzuloparib with or without apatinib as maintenance therapy in newly diagnosed, advanced ovarian cancer (FZOCUS-1): A multicenter, randomized, double-blind, placebo-controlled phase 3 trial","authors":"Lingying Wu MD,&nbsp;Jing Wang MD,&nbsp;Qingshui Li BS,&nbsp;Danbo Wang PhD,&nbsp;Cuiying Zhang MM,&nbsp;Junying Tang MD,&nbsp;Guonan Zhang BS,&nbsp;Min Hao PhD,&nbsp;Desheng Yao MD, PhD,&nbsp;Qinglei Gao MD,&nbsp;Youzhong Zhang PhD,&nbsp;Ruifang An MD,&nbsp;Rutie Yin MD,&nbsp;Li Wang BS,&nbsp;Bairong Xia MD,&nbsp;Qi Zhou MS,&nbsp;Hongying Yang MM,&nbsp;Jianqing Zhu MD,&nbsp;Kui Jiang MM,&nbsp;Zhengzheng Chen MM,&nbsp;Qiang Wu MD,&nbsp;Wei Duan MM,&nbsp;Yi Huang MM,&nbsp;Hui Zhang PhD,&nbsp;Shuqing Wei MM,&nbsp;Guiling Li MD,&nbsp;Yuanguang Meng MD,&nbsp;Ke Wang MM,&nbsp;Xinfeng Yang BS,&nbsp;Xianghua Huang PhD,&nbsp;Lingya Pan MD,&nbsp;Jinjin Yu BS,&nbsp;Ge Lou PhD,&nbsp;Yu Zhang PhD,&nbsp;Huaijun Zhou MD,&nbsp;Xiaoqing Guo MD, PhD,&nbsp;Hong Yang PhD,&nbsp;Xiaodong Cheng MD,&nbsp;Xiumin Li MM,&nbsp;Wuliang Wang MD,&nbsp;Hongqin Zhao BS,&nbsp;Yunxia Li BS,&nbsp;Yingjie Yang PhD,&nbsp;An Lin BS,&nbsp;Wenjun Cheng MD,&nbsp;Lihong Chen MD,&nbsp;Xiaoying Xie BS,&nbsp;Wen Di MD, PhD,&nbsp;Yuanjing Hu MD,&nbsp;Mo Chen MD,&nbsp;Hongwu Wen MD,&nbsp;Liping Cai MM,&nbsp;Xiaohua Wu MD, PhD,&nbsp;Zhongqiu Lin MD, PhD,&nbsp;Quanren Wang PhD,&nbsp;Xinfeng Yang PhD,&nbsp;Ning Li MD","doi":"10.3322/caac.70042","DOIUrl":"10.3322/caac.70042","url":null,"abstract":"<p>Although poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPis) and bevacizumab were approved as first-line maintenance for advanced ovarian cancer (OC), evidence comparing this combination with PARPi monotherapy, especially in <i>BRCA</i>-mutated/homologous recombination-deficient (HRD) patients, is lacking. This study compared combined fuzuloparib (a PARPi) plus apatinib (a vascular endothelial growth factor receptor-2 inhibitor) with either fuzuloparib or placebo as first-line maintenance in patients with advanced OC. Patients who had newly diagnosed, advanced OC and responded to first-line, platinum-based chemotherapy were randomized 2:2:1 to receive combined fuzuloparib (100 mg twice daily) plus apatinib (375 mg daily), fuzuloparib (150 mg twice daily) plus placebo, or double-placebo treatment. The primary end point was blinded independent review committee (BIRC)-assessed progression-free survival (PFS). Six hundred seventy-four patients were randomized to receive fuzuloparib plus apatinib (<i>n</i> = 269), fuzuloparib (<i>n</i> = 269), or placebo (<i>n</i> = 136). At the final analysis (November 1, 2024; 385 BIRC-assessed PFS events; median follow-up, 40 months), the median BIRC-assessed PFS was 26.9 months with the combination versus placebo (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.44–0.75; one-sided <i>p</i> &lt; .0001) and 29.9 months with fuzuloparib monotherapy versus placebo (HR, 0.58; 95% CI, 0.44–0.75; one-sided <i>p</i> &lt; .0001) compared with 11.1 months with placebo. A PFS benefit was observed regardless of germline <i>BRCA1/2</i> mutation status. In homologous recombination-deficient patients (including those with <i>BRCA1/2</i> mutations), combined fuzuloparib and apatinib produced a PFS similar to that of fuzuloparib (34.1 vs. 35.8 months, respectively); in homologous recombination-proficient patients, PFS had a trend favoring the combination (16.6 vs. 11.0 months; HR, 0.73; 95% CI, 0.45–1.19). Both treatments were well tolerated. Overall survival was immature. Both fuzuloparib and combination therapy improved PFS compared with placebo as maintenance therapy for patients who had newly diagnosed, advanced OC. Adding apatinib to fuzuloparib did not prolong PFS among homologous recombination-deficient patients. There was a PFS benefit trend among homologous recombination-proficient patients who received combination therapy compared with those who received monotherapy.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585160","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":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148094951","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148094952","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":"Reirradiation: Standards, challenges, and patient-focused strategies across tumor types","authors":"Arnaud Beddok MD, PhD,&nbsp;Jonas Willmann MD,&nbsp;Anna Embring MD, PhD,&nbsp;Ane L. Appelt PhD,&nbsp;Panagiotis Balermpas MD,&nbsp;Kevin Chua MD,&nbsp;J. Isabelle Choi MD,&nbsp;Bernice Simone Elger MD, PhD,&nbsp;Dorota Gabrys MD, PhD,&nbsp;Peter Hoskin MD,&nbsp;Maximilian Niyazi MD, PhD,&nbsp;David Pasquier MD, PhD,&nbsp;Kelly Paradis PhD,&nbsp;Orit Kaidar-Person MD, PhD,&nbsp;Corien Plaisier BSc,&nbsp;Nicole C. Schmitt MD,&nbsp;Conor E. Steuer MD,&nbsp;Juliette Thariat MD, PhD,&nbsp;Sue S. Yom MD, PhD,&nbsp;Philip Poortmans MD, PhD,&nbsp;Eliana Vasquez Osorio PhD,&nbsp;Nicolaus Andratschke MD","doi":"10.3322/caac.70016","DOIUrl":"10.3322/caac.70016","url":null,"abstract":"<p>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.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"630-666"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70016","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}