International Journal of Clinical Oncology最新文献

{"title":"Anti-HER2 plus endocrine therapy versus anti-HER2 plus chemotherapy in hormone receptor-positive and HER2-positive metastatic breast cancer: a retrospective study.","authors":"Zhenhua Fan, Yang Yuan, Xiaoyan Chen, Tao Wang, Shaohua Zhang, Li Bian, Xueli Mo","doi":"10.1007/s10147-025-02887-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02887-y","url":null,"abstract":"<p><strong>Background: </strong>No clinical trials demonstrated anti-HER2 plus chemotherapy (anti-HER2 + ChT) was superior to anti-HER2 plus endocrine therapy (anti-HER2 + ET) in HR + /HER2 + MBC. This study aims to compare efficacy of anti-HER2 + ET with anti-HER2 + ChT in real-world clinical practice, and analyze clinical outcome of anti-HER2 + ET as maintenance therapy after benefiting from anti-HER2 + ChT.</p><p><strong>Methods: </strong>This study retrospectively compared two regimens: anti-HER2 + ChT vs anti-HER2 + ET, utilizing chi-square tests for response rate comparisons and Kaplan-Meier approach for survival analysis.</p><p><strong>Results: </strong>Totally, 241 eligible patients were included in this study. In first-line setting, 197 patients (81.7%) received anti-HER2 + ChT and 44 (18.3%) received anti-HER2 + ET. Objective response rate (54.3% vs 11.4%, P < 0.001) and clinical benefit rate (82.7% vs 68.2%, P = 0.029) of anti-HER2 + ChT group were higher than those of anti-HER2 + ET. PFS analysis showed there was no significant difference between anti-HER2 + ChT and anti-HER2 + ET in first-line (mPFS, 15.0 m [95%CI 12.1-17.9] vs 9.0 m [95%CI 0.5-17.5]; HR 1.32 [0.88-1.98]; P = 0.162) and the front two lines of treatment (PFS-2, 26.0 m [95%CI 23.0-29.0] vs 24.0 m [95%CI 15.9-32.1]; HR 1.03 [0.64-1.64]; P = 0.919). Notably, PFS of patients with anti-HER2 + ChT maintained by anti-HER2 + ET was superior to anti-HER2 + ET (24.0 m [95%CI 18.0-30.0] vs 17.0 m [95%CI 9.5-24.5]; HR 0.53 [0.32-0.89]; P = 0.005) and other anti-HER2 + ChT group (24.0 m vs 12.0 m [95%CI 9.1-15.0]; HR 0.52 [0.36-0.76]; P < 0.001).</p><p><strong>Conclusion: </strong>While anti-HER2 + ChT showed superior disease control over anti-HER2 + ET, it didn't confer a survival advantage, possibly due to small sample size or retrospective design constraints. For patients deriving benefit from anti-HER2 + ChT, transitioning to maintenance therapy with anti-HER2 + ET may represent an optional strategy.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FLOT vs DOS neoadjuvant chemotherapy in locally advanced gastric cancer: propensity score analysis.","authors":"Lu-Yang Zhang, Sen Zhang, Xuan Zhao, Hao Li, Lu Zang, Jun-Jun Ma, Min-Hua Zheng, Abe Fingerhut","doi":"10.1007/s10147-025-02888-x","DOIUrl":"https://doi.org/10.1007/s10147-025-02888-x","url":null,"abstract":"<p><strong>Background: </strong>The safety and efficacy of neoadjuvant FLOT (Fluorouracil, Leucovorin, Oxaliplatin, Docetaxel) and DOS (Docetaxel, Oxaliplatin, S-1) regimens for locally advanced gastric cancer (LAGC) have not been compared.</p><p><strong>Methods: </strong>Patients with histologically confirmed LAGC (stage ≥ cT3 or cN + , no metastasis) treated between 2017-2021 were retrospectively included and propensity-matched into FLOT (4 cycles, n = 72) and DOS (3 cycles, n = 72) groups. Outcomes included RECIST response, grade 3/4 adverse events, surgical/pathological results, and R0 resection rates, and long-term survival (overall survival [OS] and progression-free survival [PFS]).</p><p><strong>Results: </strong>RECIST response rates were 41.7% (FLOT) vs. 47.2% (DOS); R0 resection rates were 63.9% vs. 72.2%. No significant differences were observed in operative time, blood loss, hospital stay, histopathological regression (TRG1a: 2.8% vs. 8.3%; TRG1b: 13.9% vs. 16.7%), postoperative morbidity (29.8% vs. 24.5%), or grade 3/4 toxicity (20.8% vs. 13.9%). The 5-year OS rates were 42.7% and 50.4% (p = 0.652), and the PFS rates were 33.7% and 41.4% (p = 0.548) for the FLOT and DOS groups, respectively.</p><p><strong>Conclusion: </strong>DOS demonstrated no significant but favorable feasibility, safety, and efficacy compared to FLOT in LAGC. Shorter hospital stay with DOS may enhance patient comfort and reduce healthcare burden.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy-related hand-foot syndrome and hand-foot skin reaction: a review of management and possible approaches for Asian patients by the Japanese pharmacist-led oncodermatology study team.","authors":"Yohei Iimura, Hirotoshi Iihara, Yoshitaka Saito, Hisanaga Nomura, Takuya Iwamoto, Mayumi Kotera, Yusuke Tsuchiya, Tatsuya Sumiya, Mariko Kono, Daisuke Hirate, Tomohiro Kurokawa, Toshinobu Hayashi, Hironobu Hashimoto, Junichi Higuchi, Ryuta Urakawa, Hiroyuki Saotome, Seiichiro Kuroda","doi":"10.1007/s10147-025-02895-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02895-y","url":null,"abstract":"<p><strong>Background: </strong>Hand-foot syndrome (HFS) and hand-foot skin reaction (HFSR) are adverse effects induced by cytotoxic chemotherapeutic agents, such as capecitabine, pegylated liposomal doxorubicin, and multi-kinase inhibitors. HFS/HFSR can significantly reduce patients' quality of life and impact cancer treatment intensity due to severe pain in the hands and feet. Although several recommendations and guidelines have been published, most focus on European and American populations, with no management guidelines specifically addressing Asian patients. Given that Asian skin types differ from those of Europeans and Americans, treatment recommendations tailored to Asian populations are needed.</p><p><strong>Methods: </strong>A narrative review of published articles retrieved following a systematic search of PubMed, the Cochrane Library, Medical Online, and Ichushi-Web between January 2000 and March 2025 was conducted. The search strategy targeted clinical trials using keywords related to HFS, palmar-plantar erythrodysesthesia, HFSR, prevention, therapy, and relevant anticancer agents. The review adhered to the PRISMA 2020 guidelines; However, formal quality assessment tools such as GRADE or the Cochrane risk-of-bias tool were not applied.</p><p><strong>Results: </strong>In total, 53 articles were included in this review, which found different recommendations from European countries due to the differences in skin type. Among the recommended treatments was topical diclofenac, suggested as a potential and novel prevention strategy for capecitabine-induced HFS. However, high potent topical steroids, such as lidocaine patches, or antiseptic solutions, were not recommended.</p><p><strong>Conclusions: </strong>This review provides evidence-based recommendations for the prevention and treatment of HFS/HFSR in Asian patients, taking into account their unique skin characteristics.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of cisplatin-based neoadjuvant chemotherapy and risk factors for residual extravesical disease in muscle-invasive bladder cancer: insights from a nationwide cohort.","authors":"Ryoichi Saito, Rikiya Taoka, Jun Miki, Wataru Fukuokaya, Yoshiyuki Matsui, Shingo Hatakeyama, Takashi Kawahara, Ayumu Matsuda, Taketo Kawai, Tomokazu Sazuka, Minoru Kato, Takeshi Sano, Fumihiko Urabe, Soki Kashima, Hirohito Naito, Yoji Murakami, Makito Miyake, Kei Daizumoto, Yuto Matsushita, Takuji Hayashi, Junichi Inokuchi, Yusuke Sugino, Kenichiro Shiga, Noriya Yamaguchi, Shingo Yamamoto, Keiji Yasue, Takashige Abe, Shotaro Nakanishi, Katsuyoshi Hashine, Masato Fujii, Kiyoaki Nishihara, Hiroaki Matsumoto, Shuichi Tatarano, Koichiro Wada, Sho Sekito, Ryo Maruyama, Naotaka Nishiyama, Hiroyuki Nishiyama, Hiroshi Kitamura, Hidefumi Kinoshita","doi":"10.1007/s10147-025-02833-y","DOIUrl":"10.1007/s10147-025-02833-y","url":null,"abstract":"<p><strong>Background: </strong>Cisplatin-based neoadjuvant chemotherapy (NAC) improves survival in muscle-invasive bladder cancer (MIBC) as long as disease progression does not occur during treatment. However, predictors of NAC sensitivity remain elusive in clinical practice. This study evaluated the efficacy of NAC followed by radical cystectomy (NAC-RC) in cStage II-IIIA MIBC and identified the risk factors associated with residual extravesical disease.</p><p><strong>Methods: </strong>Clinical data from 1474 patients who underwent radical cystectomy for cStage II-IIIA urothelial carcinoma were collected from 36 institutions of the Japanese Urological Oncology Group. Overall survival (OS) and non-urinary tract recurrence-free survival (NUT-RFS) were compared between the NAC-RC and upfront RC groups using the Kaplan-Meier method adjusted by inverse probability of treatment weighting. Logistic regression was used to identify independent risk factors for RED.</p><p><strong>Results: </strong>Pathological complete response (pT0N0) was achieved in 33.1 and 20.2% of cStage II and IIIA patients in the NAC-RC group, respectively, compared with 16.3 and 4.5% in the RC group. NAC significantly improved the OS and NUT-RFS in the IPTW-adjusted cohort. BCG-unresponsiveness, low serum albumin levels, and a high neutrophil-to-lymphocyte ratio were independent predictors of RED in the NAC-RC cohort. Squamous differentiation was associated with worse prognosis but a favorable response to NAC in some tumors.</p><p><strong>Conclusions: </strong>Cisplatin-based NAC improves outcomes in patients with cStage II-IIIA MIBC, including some tumors with squamous differentiation; however, its benefits may be limited in BCG-unresponsive cases. Given the biological heterogeneity of urothelial cancer, individualized treatment planning that integrates biological features and treatment history is needed for patients with MIBC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2106-2117"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid switching to improve delirium symptoms in patients with cancer: a systematic review.","authors":"Kousuke Yamanaka, Takaaki Hasegawa, Yoshinobu Matsuda, Shinichiro Inoue, Hitoshi Tanimukai, Saho Wada, Jun Kako","doi":"10.1007/s10147-025-02850-x","DOIUrl":"10.1007/s10147-025-02850-x","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common and distressing symptom in patients with cancer, while opioids-which are essential in managing cancer pain-can cause delirium. Opioid switching is a widely used strategy for the management of opioid-induced delirium; however, its efficacy is yet to be verified. This systematic review aimed to determine opioid switching's efficacy and safety for managing opioid-induced delirium in patients with cancer.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the PRISMA guidelines. We searched four databases (PubMed, Cochrane Controlled Register of Trials, Cochrane Library, and Ichishi-Web) on September 6, 2023, with an updated PubMed search on October 20, 2024. Our review included studies on opioid switching for managing delirium in patients with cancer. If there were less than two randomized controlled trials (RCTs), we included observational studies. Data extraction and evaluation were independently conducted by two reviewers using the GRADE evaluation. The study protocol was registered (UMIN000051787).</p><p><strong>Results: </strong>The literature search identified seven observational studies without a control group; however, no RCTs were found. Four observational studies reported improvements in the severity of delirium symptoms. No study reported worsening pain or dyspnea after opioid switching. According to the GRADE framework, all outcomes were graded very low on certainty.</p><p><strong>Conclusions: </strong>Although observational studies imply opioid switching's effectiveness for managing opioid-induced delirium in patients with cancer, there is a lack of RCTs and the level of evidence is very low. Thus, RCTs are warranted to confirm opioid switching's efficacy.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1896-1905"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-marketing surveillance of radium-223 chloride in Japanese patients with castration-resistant prostate cancer with bone metastasis-final analysis of 3-year extended follow-up focusing on bone fractures.","authors":"Naoya Masumori, Makoto Hosono, Shunji Takahashi, Yoshiyuki Kakehi, Hirotsugu Uemura, Toshiyuki Sunaya, Kako Shimotsumagari, Yasuhiro Matsuba, Masatoshi Adachi, Haruka Kakiuchi, Seigo Kinuya","doi":"10.1007/s10147-025-02846-7","DOIUrl":"10.1007/s10147-025-02846-7","url":null,"abstract":"<p><strong>Background: </strong>A post-marketing surveillance (PMS) study was conducted in Japan to assess real-world outcomes with radium-223 treatment in men with metastatic castration-resistant prostate cancer (mCRPC). Results from the treatment period showed that radium-223 was generally well tolerated. Follow-up was subsequently extended to 3 years to collect data on fracture events. Results of the extended follow-up are now reported.</p><p><strong>Methods: </strong>This prospective, non-interventional, multicenter, single-cohort PMS study enrolled men with CRPC and bone metastases treated with radium-223 under clinical practice. Extended follow-up lasted until 3 years after the first administration of radium-223. Data on clinical fractures and survival were collected.</p><p><strong>Results: </strong>A total of 334 patients were enrolled, with a median follow-up of 15.3 months (range 1-50). The overall incidence proportion of fractures reported as adverse events was 7.76% (95% confidence interval [CI] 5.09-11.25%), with a fracture incidence rate of 5.22 patients [with fracture]/100 person-years (PY). Patients who received bone-modifying agents (BMAs) had a numerically lower incidence of fractures (5.85%; 3.46/100PY vs 9.93%; 7.92/100PY). Median overall survival was 26.32 months (95% CI 21.65-not reached).</p><p><strong>Conclusion: </strong>Compared with existing reference data, there was no obvious increase in the incidence of clinical fractures in Japanese patients with mCRPC who were treated with radium-223 under clinical practice. As is already well known for androgen deprivation, BMAs may also be useful in reducing bone fracture after radium-223.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2118-2127"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world treatment patterns and clinical outcomes with tucatinib-based therapy in patients with HER2-positive metastatic breast cancer: analyses of two nationwide administrative health claims databases.","authors":"Carey Anders, Edward Neuberger, Naomi R M Schwartz, Karen Bartley, Shu Wang, Yutong Liu, Brian T Pittner, Peter A Kaufman, Jane Meisel","doi":"10.1007/s10147-025-02800-7","DOIUrl":"10.1007/s10147-025-02800-7","url":null,"abstract":"<p><strong>Purpose: </strong>To describe real-world characteristics and clinical outcomes among patients with HER2+ MBC receiving tucatinib-based treatments.</p><p><strong>Methods: </strong>This retrospective study included patients diagnosed with HER2+ MBC between January 2017 and December 2022 from two administrative health claims databases, Merative^TMMarketScan^® and the Komodo Healthcare Map^™. Patient characteristics were captured at baseline (≤ 6 months prior to tucatinib initiation). Outcomes were assessed starting from tucatinib-based treatment initiation and included real-world time to discontinuation (rwTTD) and treatment persistence.</p><p><strong>Results: </strong>There were 150 patients in MarketScan^® who received tucatinib-based therapy: median (IQR) prior lines of therapy (LOT) was 2 (2-4) and 110 patients (73.3%) had brain metastases. 436 patients in Komodo^™ received tucatinib-based therapy: median (IQR) prior LOTs were 2 (1-3), and 307 (70.4%) had brain metastases. Median (95% CI) rwTTD was 7.4 (5.0-13.1) months in MarketScan^® (median follow-up 9.7 months) and 9.0 (7.4-9.8) months in Komodo^™ (median follow-up 10.3 months). In patients who received tucatinib in combination with trastuzumab and capecitabine immediately following trastuzumab deruxtecan (T-DXd) and after ≥ 2 prior HER2-directed therapies (MarketScan^®: n = 26, median prior LOT 4; Komodo: n = 34, median prior LOT 3), median (95% CI) rwTTD was 5.5 (3.4-not reached [NR]) months in MarketScan^® and 4.8 (3.2-NR) months in Komodo.</p><p><strong>Conclusion: </strong>These results reinforce the real-world effectiveness of tucatinib in patients with HER2+ MBC, including patients with prior T-DXd treatment. Further research is needed to determine the optimal treatment sequencing for patients with HER2+ MBC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1982-1991"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of vaginal cytology for postoperative surveillance of endometrial cancer.","authors":"Yuko Watanabe, Eiji Kobayashi, Tatsuo Masuda, Mamoru Kakuda, Satoshi Nakagawa, Kosuke Hiramatsu, Tadashi Iwamiya, Shinya Matsuzaki, Eiji Nakatani, Yutaka Ueda","doi":"10.1007/s10147-025-02843-w","DOIUrl":"10.1007/s10147-025-02843-w","url":null,"abstract":"<p><strong>Background: </strong>The value of conducting vaginal cytology surveillance after endometrial cancer (EC) surgery has not been fully established, yet in Japan it is still performed routinely in many institutions. We have retrospectively examined its diagnostic and prognostic values.</p><p><strong>Methods: </strong>We studied 759 EC cases that underwent hysterectomy at our hospital in Osaka, Japan from January 2010 to December 2019. Information on the clinicopathological factors at the time of initial and postoperative treatments, and the sites and diagnostic timing of recurrences were extracted from medical records and analyzed.</p><p><strong>Results: </strong>Recurrences from primary EC were observed in 11.2% of the patients (85/759). In 23.5% of the cases (20/85), the recurrence included a vaginal component. The two most common single-sites of recurrence were vagina (14.1%, 12/85) and lung (12.9%, 11/85). The diagnosis of vaginal recurrence was made from symptoms and gynecological examination in 14 of the 20 cases. Only one was diagnosed solely by vaginal cytology; in that case, macroscopic lesions appeared two months after obtaining the abnormal cytology.</p><p><strong>Conclusions: </strong>We found that, in postoperative follow-up surveillance for EC, most cases of vaginal recurrence were first diagnosed by a careful pelvic examination. For current routine postoperative practice, monitoring critical symptoms and conducting careful gynecological examinations has been shown to be more important than cytological examinations.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2138-2147"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of BRCA1/2 genetic testing in perioperative breast cancer management: advancing shared decision-making and personalized care.","authors":"Sayaka Obayashi, Mayu Aoki, Keiko Tanabe, Yuko Nakazawa, Misato Ogino, Takaaki Fujii, Ken Shirabe","doi":"10.1007/s10147-025-02773-7","DOIUrl":"10.1007/s10147-025-02773-7","url":null,"abstract":"<p><strong>Background: </strong>BRCA1/2 genetic testing has become essential in breast cancer management, guiding surgical decisions, surveillance, and targeted therapies. While it has revolutionized personalized medicine, challenges remain in its implementation.</p><p><strong>Objective: </strong>This review summarizes the impacts of BRCA1/2 genetic testing on surgical choices and risk-reducing strategies, plus its role in the therapy of PARP inhibitors.</p><p><strong>Methods: </strong>We analyzed recent studies, clinical guidelines, and meta-analyses focusing on the clinical utility of BRCA1/2 genetic testing in breast cancer management.</p><p><strong>Results: </strong>Breast-conserving therapy (BCT) does not conclusively impact survival in BRCA1/2 mutation carriers, making it a viable option for those preferring breast conservation. The benefit of contralateral risk-reducing mastectomy remains uncertain, but it may be considered if the patient understands the risks and benefits. Risk-reducing salpingo-oophorectomy effectively prevents ovarian and fallopian tube cancers and improves survival. MRI is superior to mammography for early cancer detection in high-risk women and is beneficial for surveillance when contralateral mastectomy is not performed. BRCA1/2 testing is also essential for determining eligibility for PARP inhibitor therapy, particularly olaparib, which has shown efficacy in early breast cancer patients with BRCA1/2 mutations in the OlympiA trial.</p><p><strong>Conclusion: </strong>BRCA1/2 genetic testing enhances personalized breast cancer treatment but presents challenges in patient selection, decision-making, genetic counseling, and insurance coverage. A multidisciplinary approach is essential for shared decision-making and improved outcomes in BRCA1/2 mutation carriers.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1890-1895"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is daikenchuto effective for postoperative intestinal dysfunction after gastroenterological cancer surgery? An updated meta-analysis of randomized controlled trials.","authors":"Hideki Kogo, Akihisa Matsuda, Yasuyuki Negishi, Rimpei Morita, Hiroshi Yoshida","doi":"10.1007/s10147-025-02854-7","DOIUrl":"10.1007/s10147-025-02854-7","url":null,"abstract":"<p><strong>Backgrounds: </strong>Postoperative intestinal dysfunction is a major complication following abdominal surgery. Daikenchuto (DKT), Japanese herbal (Kampo) medicine, has been investigated the efficacy for postoperative intestinal dysfunction. However, the studies have conveyed inconclusive results and previous meta-analysis included not only true randomized controlled trials (RCTs), but low-quality RCTs.</p><p><strong>Methods: </strong>A comprehensive electronic literature search was conducted through April 2025 to identify true RCTs comparing patients between with or without perioperative DKT administration in gastroenterological cancer surgery. The primary outcome was the time to first postoperative flatus. A meta-analysis was performed using random-effects models to calculate mean difference (MD) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Eleven true RCTs involving 1413 patients (with DKT group, n = 716; Without DKT group, n = 697) were included. The meta-analysis demonstrated a significant improvement of the time to first postoperative flatus in the With DKT group than in the Without DKT group, with an MD of - 0.19 (95% CI - 0.34 to - 0.04, P = 0.01), and no significant between-study heterogeneity was observed (χ² = 8.12, I² = 26%, P = 0.23). Subgroup analysis demonstrated a significantly shorter time to first postoperative flatus in categories of surgery other than colorectal, studies of double-blinded, multi-institutional, 100 or more patients included.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that DKT can improve postoperative intestinal dysfunction (i.e., first postoperative flatus) after gastroenterological cancer surgery, but the efficacy was modest. Thus, the efficacy of DKT on improving postoperative intestinal dysfunction warrants further investigation in more high quality RCTs.</p><p><strong>Registry and registration number: </strong>This systematic review and meta-analysis was registered with UMIN-CTR (ID: UMIN000066046) ( https://www.umin.ac.jp/ctr/index-j.htm ).</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1916-1924"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}