Cancer最新文献

{"title":"A phase 2 study of adjuvant chemotherapy with 5-fluorouracil/leucovorin and oxaliplatin after lung metastasectomy for colorectal cancer (WJOG5810G)","authors":"Nozomu Machida MD, PhD,&nbsp;Takehiro Okumura MD,&nbsp;Narikazu Boku MD, PhD,&nbsp;Junji Kishimoto MA,&nbsp;Tomohiro Nishina MD, PhD,&nbsp;Koichi Suyama MD, PhD,&nbsp;Yasuhisa Ohde MD, PhD,&nbsp;Katsunori Shinozaki MD, PhD,&nbsp;Hideo Baba MD, PhD,&nbsp;Shinya Tokunaga MD,&nbsp;Hisato Kawakami MD, PhD,&nbsp;Takashi Tsuda MD, PhD,&nbsp;Masahito Kotaka MD, PhD,&nbsp;Hiroyuki Okuda MD, PhD,&nbsp;Hisateru Yasui MD,&nbsp;Kentaro Yamazaki MD, PhD,&nbsp;Shuichi Hironaka MD, PhD,&nbsp;Kei Muro MD, PhD,&nbsp;Ichinosuke Hyodo MD, PhD","doi":"10.1002/cncr.35807","DOIUrl":"https://doi.org/10.1002/cncr.35807","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The clinical significance of adjuvant chemotherapy after lung metastasectomy for colorectal cancer remains unknown. This phase 2 study evaluated adjuvant chemotherapy with modified 5-fluorouracil/leucovorin and oxaliplatin (mFOLFOX6) after lung metastasectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligibility criteria included colorectal adenocarcinoma, first curative resection of ≤4 lung metastases, and no prior chemotherapy. Treatment consisted of 12 cycles of mFOLFOX6. The primary endpoint was the 5-year overall survival (OS) rate, with the expectation of 50% (threshold, 35%) and a planned sample size of 100 (90% power; alpha error, 5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-two patients were enrolled between July 2011 and July 2014; patient enrollment was closed prematurely because of slow accrual. Excluding four ineligible patients, the characteristics of the 48 patients in the efficacy analysis set were a median age of 62 years (range, 43–75 years), Eastern Cooperative Oncology Group performance status of 0 in 45 patients, prior resection of extrathoracic metastasis in four patients, and postoperative carcinoembryonic antigen within normal range in 43 patients; the status of lung metastasis was single in 34 patients, unilateral in 40 patients, and metachronous in 41 patients; and a disease-free interval between primary tumor resection and diagnosis of lung metastasis of &lt;2 years in 33 patients. The 5-year OS rate was 85.2% (95% confidence interval [CI], 71.4%–92.6%), and the 5-year disease-free survival rate was 60.2% (95% CI, 44.9%–72.4%). Forty-one of the 52 patients (78.8%) in the safety analysis set completed 12 cycles of mFOLFOX6. Grade ≥3 adverse events were neutropenia (50.0%), fatigue (7.7%), peripheral sensory neuropathy (7.7%), and other (&lt;5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adjuvant chemotherapy with mFOLFOX6 is feasible, and may be effective after lung metastasectomy for colorectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human papillomavirus-related cancers and human papillomavirus vaccination among Arab Americans: A call to unveil disparities and bridge the research gaps","authors":"Nada Al-Antary MD,&nbsp;Nemer Assi BS,&nbsp;Mrudula Nair BDS, MPH,&nbsp;Milkie Vu PhD, MA,&nbsp;Reem F. Siddiqui BSci,&nbsp;Farzan Siddiqui MD, PhD,&nbsp;Eric Adjei Boakye PhD","doi":"10.1002/cncr.35830","DOIUrl":"https://doi.org/10.1002/cncr.35830","url":null,"abstract":"&lt;p&gt;Human papillomavirus (HPV) infection involves multiple carcinogenic genotypes that play a fundamental role in the pathogenesis of cervical, head and neck, and anal cancers among others. Extensive evidence indicates that cervical cancer is almost entirely attributable to HPV,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; making it a significant public health concern due to its high prevalence and mortality rates among women globally. HPV is also associated with approximately 90% of the increasing cases of anal cancer, approximately 70% of the increasing cases of oropharyngeal cancers, and a smaller percentage of other genital cancers, such as penile, vulvar, and vaginal cancers.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; HPV infection was associated with approximately 37,800 cancer cases diagnosed in the United States per year during 2017 to 2021.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; This widespread impact of HPV underscores the critical need for effective primary and secondary prevention strategies.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Fortunately, an effective intervention exists: the HPV vaccine. Routine HPV immunization has resulted in a substantial decrease in HPV prevalence with a potential in reduction of over 90% of HPV-associated cancers.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; It is estimated that 35,000 of the 37,800 HPV-associated cancers could be prevented by the 9-valent HPV vaccine.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The Advisory Committee on Immunization Practices recommends routine HPV vaccination for adolescents 11–12 years old.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Catch-up vaccination is also recommended for both males and females 13–26 years old and shared clinical decision-making about the vaccination through age 45 years.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Nationally, HPV vaccination rates among adolescents 13–17 years old are 76.8% for at least one dose and 61.4% for completing the vaccination series as of 2023.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Moreover, it was previously reported that ethnic minorities including African American and Latino have lower HPV completion rate compared to White individuals.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; However, there is a concerning lack of data on HPV vaccination rates among marginalized groups, specifically Arab American adolescents and young adults. This makes it challenging to assess the vaccination coverage and identify gaps that need to be addressed. Given the growing Arab American population in the United States, there is an urgent need for more research to understand and address the disparities in HPV, HPV vaccination, and the associated cancer burden in this community.&lt;/p&gt;&lt;p&gt;Arab Americans make up various ethnicities of immigrants from the Arabic-speaking countries of the Middle East, North Africa, and Sub-Saharan Africa. Since the 1880s, they have been settling in sizable numbers in the United States.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; It is estimate that there are 3.7 million Arab Americans in the United States as of 2022.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; Their Arab heritage reflects a culture that is thousands of ","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35830","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime body weight patterns, weight loss, and renal cell carcinoma subtypes","authors":"Zhengyi Deng PhD, MBBS,&nbsp;Chiyuan Amy Zhang MPH,&nbsp;Justin X. Moore PhD, MPH,&nbsp;Saira Khan PhD, MPH,&nbsp;Rebecca E. Graff ScD,&nbsp;Ken Batai PhD,&nbsp;Melissa L. Bondy PhD,&nbsp;Benjamin I. Chung MD,&nbsp;Marvin E. Langston PhD, MPH","doi":"10.1002/cncr.35763","DOIUrl":"https://doi.org/10.1002/cncr.35763","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increased body mass index (BMI) in midlife is a recognized risk factor for renal cell carcinoma (RCC), but data on lifetime BMI patterns and their associations with RCC and subtypes remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the National Institutes of Health–American Association of Retired Persons Diet and Health Study (<i>n</i> = 204,364), the authors evaluated lifetime body weight patterns using: 1) BMI at ages 18, 35, 50, and baseline (mean [SD]: 61.6 [5.3] years); 2) BMI trajectory across adulthood; 3) cumulative exposure to excess weight, measured as weighted years overweight/obese (WYO); and 4) BMI change between specific ages. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for overall RCC (<i>n</i> = 1425), aggressive RCC (<i>n</i> = 583), fatal RCC (<i>n</i> = 339), and histologic subtypes, including clear cell RCC (ccRCC, <i>n</i> = 541), papillary RCC (pRCC, <i>n</i> = 146), and chromophobe RCC (chRCC, <i>n</i> = 64).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher BMI at all ages was associated with greater hazard of overall RCC and all subtypes (HR, 1.10–1.40 per 5-unit increase), except chRCC (HR, 0.80–0.98). Similar patterns were observed for BMI trajectories indicating weight gain during adulthood to overweight/obesity, compared to maintaining normal BMI. Higher WYO (per SD increase) was associated with an elevated hazard of overall RCC (HR, 1.17; 95% CI, 1.12–2.22), aggressive RCC (HR, 1.21; 95% CI, 1.13–1.29), fatal RCC (HR, 1.16; 95% CI, 1.06–1.27), and ccRCC (HR, 1.20; 95% CI, 1.13–1.30), but not pRCC (HR, 1.13; 95% CI, 0.97–1.32) and chRCC (HR, 0.92; 95% CI, 0.68–1.25). BMI reduction of ≥10%, particularly after age 50 (HR, 0.72; 95% CI, 0.52–0.99), was associated with lower RCC hazard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lifetime excess weight and adult weight gain were associated with increased risk of RCC, particularly ccRCC, whereas weight loss was associated with reduced risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INO-CD22: A multicenter, real-world study of inotuzumab ozogamicin safety and effectiveness in adult patients with relapsed/refractory acute lymphoblastic leukemia","authors":"Cristina Papayannidis MD, PhD,&nbsp;Elisabetta Petracci PhD,&nbsp;Patrizia Zappasodi MD,&nbsp;Nicola Fracchiolla MD,&nbsp;Fabio Ciceri MD,&nbsp;Chiara Sartor MD, PhD,&nbsp;Elisa Roncoroni MD,&nbsp;Francesco Di Raimondo MD,&nbsp;Daniele Mattei MD,&nbsp;Maria Benedetta Giannini MD,&nbsp;Francesco Lanza MD,&nbsp;Michele Gottardi MD, PhD,&nbsp;Maria Ilaria Del Principe MD,&nbsp;Erika Borlenghi MD,&nbsp;Monica Fumagalli MD,&nbsp;Daniele Vallisa MD,&nbsp;Simona Sica MD,&nbsp;Nicola Di Renzo MD,&nbsp;Francesco Fabbiano MD,&nbsp;Elisabetta Todisco MD, PhD,&nbsp;Paolo de Fabritiis MD,&nbsp;Mario Luppi MD,&nbsp;Francesco Passamonti MD,&nbsp;Paolo Corradini MD,&nbsp;Fara Petruzziello MD,&nbsp;Fabrizio Pane MD,&nbsp;Felicetto Ferrara MD,&nbsp;Greta Mambelli BSc,&nbsp;Roberta Volpi BSc,&nbsp;Federica Frabetti BSc,&nbsp;Chiara Zingaretti PhD,&nbsp;Giovanni Marconi MD,&nbsp;Giovanni Martinelli MD","doi":"10.1002/cncr.35820","DOIUrl":"https://doi.org/10.1002/cncr.35820","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inotuzumab ozogamicin (IO) has helped to change the treatment paradigm in B-cell acute lymphoblastic leukemia (B-ALL) but real-world data are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The INO-CD22 study is a multicenter retrospective cohort study of adult patients with relapsed/refractory B-ALL treated with IO in 24 Italian centers from 2014 to 2019, with the aim of assessing the response, survival, and toxicity of IO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data for 73 eligible patients were obtained: the median age at the start of IO treatment was 52.7 years (I–III quartiles, 51.9–53.5 years), the median number of previous lines was three (I–III quartiles, two to four), and prior exposure to induction standard chemotherapy and blinatumomab occurred in 85% and 57.5% of cases, respectively. IO was administered following the label schedule. A 74.0% overall response rate was achieved, with a 69.8% complete remission rate and a 4.1% complete remission with incomplete hematologic reconstitution rate. The median duration of response was 4.4 months (I–III quartiles, 2.3–11.2 months). With a median follow-up of 37.2 months, the median overall survival (OS) was 7.9 months (95% CI, 6.08–12.42 months) with a 3- and 5-year OS of 21.2% (95% CI, 11.9%–32.3%) and 5.3% (95% CI, 9.6%–29.8%), respectively. Overall, 37% of patients were able to proceed to allogeneic hematopoietic stem cell transplantation. Eight patients (11.0%) experienced veno-occlusive disease/sinusoidal obstruction syndrome; the most frequent grade ≥3 nonhematologic adverse events were liver toxicities and pneumonia (two grade 4 and one grade 5, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the limitations of retrospective studies, the INO-CD22 study highlights the favorable safety profile and clinical activity of IO within a real-world context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35820","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization and perceptions of chaplaincy among hospitalized adults of Dharmic religions with cancer","authors":"Rushil V. Patel MD,&nbsp;Jill M. Bowden MDiv, BCC,&nbsp;Danielle Boselli MS,&nbsp;Ashley E. Strahley MPH,&nbsp;Sydney-Evelyn L. Gibbs Msgh,&nbsp;Komal P. Murali PhD, RN, ACNP-BC,&nbsp;Viraj R. Patel MPH,&nbsp;Ritesh R. Kotecha MD,&nbsp;Judith E. Nelson MD, JD","doi":"10.1002/cncr.35797","DOIUrl":"10.1002/cncr.35797","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Spiritual care provided by chaplains plays a key role in cancer care in the United States, yet little is known about chaplaincy utilization among people of Dharmic religions (Hinduism, Buddhism, Sikhism, Jainism) with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multi-methods study reviewed the records of patients (aged 18 years and older) who were hospitalized at a dedicated cancer hospital (2015–2019) and conducted interviews with chaplains and adults of Dharmic religions (2020). Primary outcomes included measuring chaplaincy utilization (at least one chaplain visit) across different religions and identifying perceptions of chaplaincy. Secondary outcomes involved measuring unmet spiritual needs on admission, types of spiritual care needs, and variables associated with chaplaincy utilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 54,828 patients, 2% were of Dharmic religions (<i>n</i> = 1163; 58.4% Hindu, 33.2% Buddhist, 4.8% Sikh, 3.4% multiple, &lt;1% Jain). Compared with others, those of Dharmic religions were younger (median age, 59 vs. 63 years; <i>p</i> &lt; .001), predominantly East or South Asian (78.7% vs. 5.6%; <i>p</i> &lt; .001), and had higher rates of advanced illness (22.6% vs. 15.2%; <i>p</i> &lt; .001) but lower chaplaincy utilization (31.6% vs. 36.7%; <i>p</i> &lt; .001). There were no significant differences in unmet spiritual needs on admission (Dharmic religions vs. others, 8.7% vs. 9.4%; <i>p</i> = .41). Ritual care was the most frequently documented spiritual care need (72%). Multivariable analysis indicated that longer length of stay, non-Dharmic religion, and advanced illness were associated with higher chaplaincy utilization. Themes identified from the interviews included unfamiliarity with chaplaincy, concerns about faith-discordant care, addressing spiritual care needs independently, and solutions for concordant care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>People of Dharmic religions with cancer were less likely to use chaplaincy services. Barriers included unfamiliarity and faith discordance. Spiritual care incorporating faith-specific resources is urgently needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosing and clinical outcomes of ruxolitinib in patients with myelofibrosis in a real-world setting: Interim results of the Italian observational study (ROMEI)","authors":"Massimo Breccia MD,&nbsp;Francesca Palandri MD, PhD,&nbsp;Maurizio Martelli MD,&nbsp;Francesco Mendicino MD,&nbsp;Alessandra Malato MD, PhD,&nbsp;Giuseppe A. Palumbo MD, PhD,&nbsp;Silvia Sibilla MD,&nbsp;Nicola Di Renzo MD,&nbsp;Elisabetta Abruzzese MD, PhD,&nbsp;Sergio Siragusa MD,&nbsp;Monica Crugnola MD,&nbsp;Carmine Selleri MD,&nbsp;Fabrizio Pane MD,&nbsp;Paolo Sportoletti MD,&nbsp;Bruno Martino MD,&nbsp;Stefana Impera MD,&nbsp;Alessandra Ricco MD,&nbsp;Maria Langella MD,&nbsp;Paolo Ditonno MD,&nbsp;Giuseppe Carli MD,&nbsp;Federico Itri MD,&nbsp;Anna Marina Liberati MD,&nbsp;Tiziana Urbano MD,&nbsp;Agostino Tafuri MD,&nbsp;Vita Polizzi MD,&nbsp;Domenico Pastore MD,&nbsp;Erika Morsia MD,&nbsp;Giulia Benevolo MD,&nbsp;Giorgia Micucci MD,&nbsp;Gabriella Farina MD,&nbsp;Massimiliano Bonifacio MD,&nbsp;Elena Maria Elli MD,&nbsp;Angelo Gardellini MD,&nbsp;Valerio De Stefano MD,&nbsp;Giovanni Caocci MD,&nbsp;Antonietta Pia Falcone MD,&nbsp;Daniele Vallisa MD,&nbsp;Marco Brociner MD,&nbsp;Mario Tiribelli MD,&nbsp;Gianni Binotto MD,&nbsp;Barbara Pocali MD,&nbsp;Francesco Cavazzini MD,&nbsp;Simona Tomassetti MD,&nbsp;Francesca Lunghi MD,&nbsp;Mauro Di Ianni MD,&nbsp;Alessandro Allegra MD,&nbsp;Barbara Anaclerio MD,&nbsp;Serena Mazzotta MD,&nbsp;Nicola Orofino MD,&nbsp;Filippo Gherlinzoni MD,&nbsp;Chiara Castiglioni PharmD,&nbsp;Marina Landoni PharmD,&nbsp;Diletta Valsecchi PharmD,&nbsp;Michela Magnoli MSc,&nbsp;Paola Guglielmelli MD, PhD,&nbsp;Francesco Passamonti MD","doi":"10.1002/cncr.35801","DOIUrl":"10.1002/cncr.35801","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Myelofibrosis (MF) significantly impacts patients’ overall survival (OS) and quality of life (QOL). This prospective study analyzed ruxolitinib dosing patterns and associated clinical outcomes in patients with MF over 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ROMEI, a multicenter, observational, ongoing study, enrolled 508 adult patients with MF treated with ruxolitinib. For the current interim analysis, eligible patients with baseline platelet values were categorized into two groups based on ruxolitinib starting dosage: as expected (AsEx, <i>n</i> = 174) and lower than expected (LtEx, <i>n</i> = 132); ruxolitinib dose changes, interruptions and time to permanent discontinuation were analyzed, along with symptoms response, health-related QOL scores, spleen response, OS, and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-three percent of patients started at a lower-than-expected dose. Both groups showed reduction in average daily ruxolitinib doses over 12 months. Symptoms response rate was similar in both groups at week 48 (40.8% AsEx vs 40.9% LtEx). The AsEx group demonstrated higher spleen response rates at both 24 weeks (50.0% vs 30.2%) and 48 weeks (57.7% vs 45.8%) with a shorter median time to first response (3.3 vs 11.1 months, <i>p</i> = .019) when compared to the LtEx group. Both groups showed upward trends in health-related QOL values. Estimated median OS was not reached for the AsEx group versus 4.7 years in the LtEx group (<i>p</i> = .014). Adverse events were reported in 87.4% and 84.9% of patients in the AsEx and LtEx groups, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The ROMEI study demonstrated the importance of optimal ruxolitinib dosage in patients with MF for maximum effectiveness and improved OS, with manageable safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic horizon of acute myeloid leukemia: Success, optimism, and challenges","authors":"Jayastu Senapati MD, DM,&nbsp;Tapan M. Kadia MD,&nbsp;Naval G. Daver MD,&nbsp;Courtney D. DiNardo MD,&nbsp;Gautam Borthakur MD,&nbsp;Farhad Ravandi MD,&nbsp;Hagop M. Kantarjian MD","doi":"10.1002/cncr.35806","DOIUrl":"10.1002/cncr.35806","url":null,"abstract":"<p>Focused research in acute myeloid leukemia (AML) biology and treatment has led to the identification of new therapeutic targets and several new drug approvals over the last decade. Progressive improvements in response and survival have mirrored these improvements in treatment options. Traditionally adverse subtypes such as <i>FLT3</i>–internal tandem duplication–positive AML now have better outcomes with potent FLT3 inhibitors, and menin inhibitors in <i>KMT2A</i>-rearranged and other MEIS/HOX–dependent leukemias hold promise toward improving outcomes. More patients with AML are now able to undergo a consolidative allogeneic hematopoietic stem cell transplantation (HSCT), and the rates of nonrelapse mortality with or without HSCT have also decreased. Comprehensive genomic interrogation of AML has elucidated mechanisms of response and resistance to treatments, which has enabled more precise decision algorithms and better prognostication. Deep levels of measurable residual disease assessment in some AML subsets hold the potential to dynamically modify treatment on the basis of these responses. Improving frontline intensive and low-intensity therapies, by incorporating venetoclax and other targeted agents, is the most important intervention to improve AML outcomes. Despite these developments, a sizeable percentage of AML, such as AML with <i>TP53</i> or <i>MECOM</i> aberrations, postmyeloproliferative neoplasm AML, and so forth, remains as subsets without significant improvement in outcomes and no targeted options. Evolving strategies with natural killer cell–based approaches, novel antibody–drug conjugates, bispecific T-cell engagers, and engineered chimeric antigen receptor T-cell therapies are being evaluated, and may fill the therapeutic vacuum for some of the high-risk AML subtypes.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor burden and heterogenous treatment effect of apalutamide in metastatic castration-sensitive prostate cancer","authors":"Wataru Fukuokaya MD,&nbsp;Keiichiro Mori MD, PhD,&nbsp;Takafumi Yanagisawa MD, PhD,&nbsp;Fumihiko Urabe MD, PhD,&nbsp;Pawel Rajwa MD, PhD,&nbsp;Alberto Briganti MD, PhD,&nbsp;Shahrokh F. Shariat MD, PhD,&nbsp;Nobuaki Matsubara MD,&nbsp;Takahiro Kimura MD, PhD,&nbsp;Akihiro Hirakawa PhD","doi":"10.1002/cncr.35819","DOIUrl":"10.1002/cncr.35819","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Investigation remains incomplete regarding potential variations in the effect of androgen receptor pathway inhibitors, including apalutamide, based on baseline tumor burden in patients with metastatic castration-sensitive prostate cancer (mCSPC).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The authors analyzed individual participant-level data from 1052 patients with mCSPC who were randomized in the TITAN trial (apalutamide vs. placebo, both with androgen-deprivation therapy). Outcomes included radiographic progression-free survival (PFS), second PFS (PFS2), and overall survival (OS). Multivariable Cox proportional hazards regression models, with and without restricted cubic splines, were used to determine the association between apalutamide benefit and bone metastasis count or visceral metastasis. Subgroup treatment effects were quantified based on inverse probability of treatment weighting-adjusted hazard ratios (HRs).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Analysis using restricted cubic splines indicated that apalutamide provided less benefit for PFS2 and OS in patients with fewer bone metastases. The authors also found evidence of a heterogeneous effect of apalutamide on PFS2 and OS between patients with two or less bone metastases and those with three or more bone metastases. In patients who had two or less bone metastases, there was no evidence of a benefit from apalutamide for radiographic PFS (HR, 0.65; 95% confidence interval [CI], 0.35–1.22), PFS2 (HR, 1.18; 95% CI, 0.66–2.12), or OS (HR, 1.05; 95% CI, 0.60–1.83). No evidence of an association was noted between visceral metastasis and apalutamide benefit.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The addition of apalutamide to androgen-deprivation therapy may provide less benefit in patients with mCSPC who have fewer bone metastases. Counting baseline bone metastases may help identify optimal candidates for apalutamide treatment of mCSPC.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Clinical trials registration&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;NCT02489318&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Plain language summary&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;\u0000 \u0000 &lt;p&gt;In an analysis of individual participant data from a trial (the TITAN trial) in patients with metastatic (spreading","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 7","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced long-term side effects with MRI-guided radiotherapy in prostate cancer","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35762","DOIUrl":"https://doi.org/10.1002/cncr.35762","url":null,"abstract":"<p><b>M</b>agnetic resonance imaging (MRI)–guided stereotactic body radiotherapy (SBRT) for the treatment of prostate cancer reduces long-term gastrointestinal and genitourinary toxicity compared to computed tomography (CT)–guided SBRT after 2 years of treatment and is linked to less deterioration of bowel and sexual function according to a prespecified secondary analysis of the phase 3 MIRAGE trial published in <i>European Urology</i>.<span>¹</span></p><p>The results provide longer term data at 2 years after treatment on the incidence of physician-scored toxicity and patient-reported quality-of-life measures after MRI-guided radiotherapy versus CT-guided radiotherapy.</p><p>Previous results of the MIRAGE trial showed that MRI-guided radiotherapy, which included an aggressive reduction in the planning treatment margin from 4 mm (used with CT-guided radiotherapy) to 2 mm, significantly lowered rates of acute genitourinary and gastrointestinal toxicities scored by physicians as higher than grade 2 and lowered patient-reported deterioration of urinary and bowel quality of life in the first 3 months following treatment.<span>²</span></p><p>At 2 years, MRI-guided SBRT significantly reduced the incidence of late grade 2 or higher genitourinary toxicity (27% vs. 51%, <i>p</i> = .004) and gastrointestinal toxicity (1.4% vs. 9.5%, <i>p</i> = .02) versus CT-guided SBRT.</p><p>Clinically relevant deterioration of urinary irritation with MRI-guided SBRT also was reported by patients (14 of 73 vs. 24 of 68, <i>p</i> = .03), as was deterioration of bowel function (19 of 72 vs. 30 of 71, <i>p</i> = .04).</p><p>“This work supports the use of MRI-guided stereotactic body radiation therapy with tight margins for men with clinically localized prostate cancer to reduce posttreatment adverse effects,” says Gianluca Giannarini, MD, associate editor of <i>European Urology</i>.</p><p>Commenting on the study, Walter M. Stadler, MD, Chief Clinical Officer for City of Hope, Chicago, says that although the results are promising, there are several issues that limit the applicability of MRI-guided SBRT. He says that SBRT versus current short-course radiotherapy for localized prostate cancer is not yet considered standard treatment for most patients with localized prostate cancer. Another issue is that the assessment of toxicity in the study was based on physician assessment—not patient derived—and this could be potentially biased.</p><p>“Finally, the increased cost and technology requirements for MRI-guidance means that the vast majority of centers do not have this capacity,” he says.</p><p>Given these issues, he thinks that “this is not yet appropriate for general practice.”</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study of outcomes across time and treatment regimens in newly diagnosed, FMS-like tyrosine kinase 3 (FLT3)-mutated acute myeloid leukemia","authors":"Alexandre Bazinet MD, MSc,&nbsp;Alex Bataller MD, PhD,&nbsp;Tapan Kadia MD,&nbsp;Naval Daver MD,&nbsp;Nicholas J. Short MD,&nbsp;Musa Yilmaz MD,&nbsp;Koji Sasaki MD, PhD,&nbsp;Courtney D. DiNardo MD, MSCE,&nbsp;Gautam M. Borthakur MD,&nbsp;Ghayas Issa MD,&nbsp;Ian Bouligny MD,&nbsp;Sherry Pierce RN,&nbsp;Guillermo Garcia-Manero MD,&nbsp;Farhad Ravandi MD,&nbsp;Hagop M. Kantarjian MD","doi":"10.1002/cncr.35813","DOIUrl":"https://doi.org/10.1002/cncr.35813","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>FMS-like tyrosine kinase 3 (<i>FLT3</i>) mutations, either internal tandem duplications (<i>FLT3</i>-ITD) or tyrosine kinase domain (<i>FLT3</i>-TKD), are common in acute myeloid leukemia (AML). <i>FLT3</i>-ITD confers an adverse prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors performed a retrospective study including 619 patients to evaluate outcomes in newly diagnosed <i>FLT3</i>-mutated AML across treatment regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In patients with <i>FLT3</i>-ITD–mutated AML who received intensive chemotherapy (IC), the addition of a FLT3 inhibitor (FLT3i) was associated with trends toward improved relapse-free survival (median 32.3 vs. 14.3 months with vs. without a FLT3i; <i>p</i> = .055) and overall survival (OS; 35.5 vs. 18.9 months with vs. without a FLT3i; <i>p</i> = .098). In patients with <i>FLT3</i>-ITD mutations who received low-intensity (LIT) regimens, triplets (LIT plus a FLT3i plus venetoclax) were associated with significantly longer OS (19.1 months) compared with those who received other treatment combinations (11.2 months with LIT alone, 9.2 months with LIT plus FLT3i, and 10.3 months with LIT plus venetoclax). Patients with <i>FLT3</i>-ITD plus <i>NPM1</i> co-mutations who received any therapy had a trend toward improved OS (2-year OS: 47% vs. 33%; <i>p</i> = .087). The <i>FLT3</i>-ITD allelic ratio; <i>IDH1</i>, <i>IDH2</i>, <i>WT1</i>, <i>RUNX1</i>, and myelodysplastic syndrome-related mutations; and adverse cytogenetics had no significant impact on OS. In landmark analyses, allogeneic stem cell transplantation was associated with a trend toward improved OS in patients with <i>FLT3</i>-ITD mutations who received IC (52.6 vs. 22.7 months with versus without allogeneic stem cell transplantation; <i>p</i> = .076) and a marked improvement in OS in those who received LIT (38.6 vs. 14.0 months with vs. without allogeneic stem cell transplantation; <i>p</i> &lt; .0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A FLT3i and allogeneic stem cell transplantation are key treatment modalities for patients who have <i>FLT3</i>-mutated AML. LIT-based triplets are promising in IC-ineligible patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}