International Journal of Clinical Oncology最新文献

{"title":"Prior response to anti-VEGF agents predicts the efficacy of trifluridine/tipiracil plus bevacizumab in patients with metastatic colorectal cancer.","authors":"Masahiro Hirakawa, Tamotsu Sagawa, Yutaka Okagawa, Norito Suzuki, Koshi Fujikawa, Kohichi Takada","doi":"10.1007/s10147-026-03035-w","DOIUrl":"https://doi.org/10.1007/s10147-026-03035-w","url":null,"abstract":"<p><strong>Background: </strong>Trifluridine/Tipiracil (FTD/TPI) combined with bevacizumab (Bev) is a standard treatment for patients with unresectable metastatic colorectal cancer (mCRC) in later-line therapy. Despite the availability of other drugs like regorafenib and fruquintinib, there is no consensus on the optimal treatment choice or sequence for later-line therapies due to a lack of clearly defined prognostic indicators. This multicenter real-world analysis aimed to identify predictive factors related to the effectiveness of FTD/TPI + Bev.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed the medical records from our institution and collaborating centers of 71 mCRC patients given FTD/TPI + Bev as third-line or later treatment. Survival data were calculated using the Kaplan-Meier method, and group comparisons were made using the log-rank test. Multivariate analyses of progression-free survival (PFS) and overall survival (OS) were performed using a Cox proportional-hazards model.</p><p><strong>Results: </strong>A performance status (PS) of 0-1, absence of liver metastases, and fewer metastatic sites were significantly associated with improved PFS. For OS, significant differences were observed according to PS, presence of liver metastases, number of metastatic sites, and RAS/BRAF mutational status. Among patients who received anti-VEGF agents in second-line therapy, those with a second-line PFS of more than 9 months had significantly better median PFS and OS with FTD/TPI + Bev compared to those with a median PFS of 9 months or less. In multivariate analysis, PS and duration of second-line PFS were the only significant predictors of PFS and OS.</p><p><strong>Conclusion: </strong>The response to anti-VEGF agents in second-line therapy may predict the efficacy of FTD/TPI + Bev in subsequent treatments.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814614","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":"Bridging the distance in precision oncology: a nationwide survey on institutional perspectives toward telemedicine and decentralized trials in Japan.","authors":"Hiroya Taniguchi, Takeshi Kawakami, Hironaga Satake, Yuko Tamura, Takuma Matsunaga, Yu Sunakawa","doi":"10.1007/s10147-026-03034-x","DOIUrl":"https://doi.org/10.1007/s10147-026-03034-x","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive genomic profiling (CGP) has been reimbursed under Japan's universal health coverage since 2019, yet access remains uneven because designated institutions are concentrated in urban areas. Although CGP can identify actionable alterations, fewer than 10% of patients receive matched therapies, often due to geographic barriers to clinical trial enrollment. This nationwide survey evaluated institutional challenges in CGP implementation and explored the perceived role of telemedicine and decentralized clinical trials (DCTs) in improving equitable access.</p><p><strong>Methods: </strong>A web-based questionnaire was distributed to professionals involved in CGP across government-designated hospitals for cancer genomic medicine between December 2024 and February 2025. Respondents provided institutional data and perceptions regarding CGP access, telemedicine use, and barriers to trial participation.</p><p><strong>Results: </strong>A total of 194 professionals from 140 hospitals responded. On average, 23.5% of CGP-tested patients were referred from non-designated hospitals, often requiring multiple in-person visits. Fifty-eight percent of respondents supported telemedicine for both informed consent and result disclosure, citing reduced travel burden, while concerns included digital literacy and institutional workload. Sixty-one percent reported that over half of eligible patients declined genotype-matched trials due to travel distance. Institutions facing higher dropout rates expressed greater support for DCTs (67% \"strongly needed\").</p><p><strong>Conclusion: </strong>This nationwide study identified major geographic and logistical barriers to equitable precision oncology in Japan. Most institutions view telemedicine and DCTs as essential to expanding access to genomic testing and clinical trials. Japan's experience may offer insights for other healthcare systems considering integration of telemedicine into national precision oncology frameworks under universal health coverage.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770845","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":"Association between antibiotic use, immune-related adverse events, and efficacy of immunotherapy in esophageal squamous cell carcinoma.","authors":"Tomoaki Shirakawa, Hiroo Imai, Ken Saijo, Ryo Saito, Shiori Ishikawa, Iori Takahashi, Keigo Komine, Kota Ouchi, Yuki Kasahara, Sakura Taniguchi, Yuya Yoshida, Ryunosuke Numakura, Shonosuke Wakayama, Hidekazu Shirota, Masanobu Takahashi, Hisato Kawakami","doi":"10.1007/s10147-026-03036-9","DOIUrl":"https://doi.org/10.1007/s10147-026-03036-9","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICIs) are essential for treating esophageal squamous cell carcinoma (ESCC). As antibiotics (Abx) may reduce ICI efficacy, and immune-related adverse events (irAEs) relate to better outcomes, we investigated their association.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 121 advanced or metastatic ESCC patients treated with ICIs, assessing outcomes based on Abx use and irAEs.</p><p><strong>Results: </strong>Forty-one patients (33.9%) were in the Abx (+) group, showing a significantly shorter median progression-free survival (PFS) (2.5 vs. 6.5 months; p = 0.029) and lower disease control rate (36.8% vs. 60.9%; p = 0.0145) than those in the Abx (-) group. irAEs were less frequent in the Abx (+) group (29.3% vs. 58.8%; p = 0.0037). The positive impact of irAEs on ICI efficacy was significant in overall population [irAE(-) vs. irAE(+): PFS, 4.4 months (95% CI 2.5-5.3) vs. 8.8 months (95% CI 5.9-13.7); log-rank p = 0.001; Hazard ratio (HR) 1.76, 95% CI 1.14-2.74; p = 0.011; overall survival (OS), 10.6 months (95% CI 7.0-13.1) vs. 18.1 months (95% CI 9.2-25.9); log-rank p = 0.043; HR 1.61, 95% CI 1.01-2.55; p = 0.046] but diminished if received Abx. Notably, the Abx (-)/irAE (+) group had the best outcomes, while the Abx (+)/irAE (-) group had the worst PFS (8.7 vs. 2.4 months; HR 2.07; p = 0.011) and OS (18.1 and 6.8 months; HR 1.89; p = 0.036).</p><p><strong>Conclusion: </strong>Antibiotic use was linked to reduced ICI efficacy and fewer irAEs, suggesting impaired immune activation in ESCC patients.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770805","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":"Introducing the J-CONNECT database: a real-world oncology resource for Japan.","authors":"Masafumi Okada, Shigemi Matsumoto, Yuriko Maehara, Tomoko Kanayama, Dimitra Lambrelli, Tadashi Koga, Manabu Muto","doi":"10.1007/s10147-026-03011-4","DOIUrl":"https://doi.org/10.1007/s10147-026-03011-4","url":null,"abstract":"<p><strong>Background: </strong>Real-world data (RWD) and real-world evidence (RWE) are increasingly important in oncology, where randomized controlled trials often exclude elderly patients, those with comorbidities, and rare cancer subtypes. To meet the need for high-quality oncology RWD in Japan, the J-CONNECT Consortium was launched to build a multiinstitutional database of chemotherapy-treated solid cancer patients using electronic medical records (EMRs).</p><p><strong>Methods: </strong>Data were collected from 12 Ministry of Health, Labour and Welfare-designated cancer care hospitals, with expansion to 15 institutions planned by 2026. J-CONNECT links hospital cancer registry information with EMRs, capturing demographics, staging, treatments, laboratory results, and biomarkers. Coverage and distributional characteristics were evaluated by comparing distributions with the National Hospital-based Cancer Registry by cancer site, age, and sex.</p><p><strong>Results: </strong>The database included 51,497 patients diagnosed after 2018. Major cancer groups were breast (12,363), lung (6743), prostate (5235), colorectal (4012), pancreas (3720), stomach (2383), esophagus (1960), and liver (1731). Sex distributions were consistent with national data, while some variability was observed by age.</p><p><strong>Conclusion: </strong>J-CONNECT is a robust oncology database in which clinical and biomarker variables are available, although completeness may vary; fitness-for-purpose should be assessed on a study-by-study basis. Coverage and distributional characteristics and also regulatory acceptance highlight its value for research, PMS, and policy. Future directions include expansion to 25 hospitals, integration of outcome and resource-use data, and adoption of common data models for broader collaboration. We believe J-CONNECT provides valuable oncology data supporting research, post-marketing surveillance, and public health policy in Japan.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770829","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 and safety of second-line fluorouracil, leucovorin, and irinotecan plus ramucirumab according to prior first-line regimens in metastatic colorectal cancer: a multicenter retrospective study.","authors":"Toshinori Yanagawa, Kozo Kataoka, Hiroki Osumi, Mitsuhiro Furuta, Zhenxin Rao, Ayako Imada, Yuko Fukumoto, Jihyung Song, Kazuma Ito, Kei Kimura, Manabu Shiozawa, Masataka Ikeda","doi":"10.1007/s10147-026-03010-5","DOIUrl":"https://doi.org/10.1007/s10147-026-03010-5","url":null,"abstract":"<p><strong>Background: </strong>Fluorouracil, leucovorin, and irinotecan (FOLFIRI) plus ramucirumab is a well-established second-line treatment for metastatic colorectal cancer (mCRC) following bevacizumab-based chemotherapy. However, its efficacy after other first-line regimens, including anti-EGFR antibody-based and triplet chemotherapy, remains insufficiently characterized. The aim of this study was to compare the efficacy and safety of FOLFIRI plus ramucirumab between patients treated with different first-line treatment regimens.</p><p><strong>Methods: </strong>This retrospective multicenter study included 186 mCRC patients who received second-line FOLFIRI plus ramucirumab between 2016-2025. Patients were classified into three groups based on their first-line regimens: Bmab (bevacizumab-based), EGFR (anti-EGFR antibody-based), and Triplet (triplet chemotherapy). The primary endpoint was progression-free survival (PFS). Survival outcomes were evaluated using the Kaplan-Meier method and a propensity score-stratified Cox proportional hazards model.</p><p><strong>Results: </strong>The incidence of grade ≥ 3 adverse events, the median PFS and overall survival (OS) in the Bmab, EGFR, and Triplet groups were comparable (adverse events; 33.8%, 33.3%, 37.3%; PFS: 8.2, 8.6, and 8.7 months; and OS: 18.9, 23.0, and 17.8 months, respectively). In the propensity score-adjusted model using the Bmab group as the reference, no evidence of a difference was detected in PFS (adjusted hazard ratio [95% CI]: 1.84 [0.88-3.83] and 0.97 [0.66-1.45] in the EGFR and Triplet groups, respectively) or OS (1.26 [0.64-2.47] and 0.84 [0.55-1.29] in the EGFR and Triplet groups, respectively).</p><p><strong>Conclusions: </strong>In this retrospective real-world cohort, FOLFIRI plus ramucirumab appeared feasible after anti-EGFR antibody-based or triplet chemotherapy, with no clear signal of markedly different outcomes across prior first-line regimens.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770784","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":"Optimal adjuvant strategy in intermediate-risk cervical cancer: a systematic review and meta-analysis.","authors":"Akira Yokoi, Hiroko Machida, Mika Okazawa-Sakai, Koji Nishino, Hanae Nishino, Mizue Itoi, Takumi Mitamura, Fumiaki Isohashi, Keisuke Tsuchida, Haruya Saji, Satoe Fujiwara, Noriko Ii, Miho Watanabe, Tadaaki Nishikawa, Satoshi Nakagawa, Michiko Kodama, Shinya Sato, Kazuhiro Takehara, Tohru Morisada, Shin-Ei Noda, Munetaka Takekuma, Hiroaki Kajiyama, Hideki Tokunaga, Tsukasa Baba, Yoichi Kobayashi, Aikou Okamoto","doi":"10.1007/s10147-026-03028-9","DOIUrl":"https://doi.org/10.1007/s10147-026-03028-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of adjuvant treatment strategies following radical hysterectomy for intermediate-risk, early-stage cervical cancer using a reconstructed HR Hazard ratio (HR) meta-analysis.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted by the Japan Society of Gynecologic Oncology Cervical Cancer Committee. PubMed/MEDLINE, Cochrane, and Ichushi were searched on July 29, 2025, using \"cervical cancer,\" \"intermediate-risk,\" and \"adjuvant therapy.\" Studies comparing adjuvant radiotherapy alone (RT) with no further treatment (NFT), concurrent chemoradiotherapy (CCRT), or systemic chemotherapy (CT) after conventional radical hysterectomy were independently reviewed by two reviewers. Primary outcomes were survival and grade ≥ 3 treatment-related toxicities.</p><p><strong>Results: </strong>Of 402 screened articles, 24 studies comprising 9278 patients were included: RT (n = 4167), NFT (n = 2057), CCRT (n = 2118), and CT (n = 936). The majority of studies enrolled patients with ≥ 2 Sedlis risk factors (median 84.2%, interquartile range 44.7-100%). Compared with NFT, RT significantly improved recurrence-free survival (HR 0.61, P < 0.01) but did not confer a significant overall survival benefit (HR 0.77, P = 0.09). RT also reduced recurrence in patients with a single risk factor (HR 0.55, P < 0.01). RT showed no survival disadvantage compared with CCRT (recurrence-free survival: HR 1.26; overall survival: HR 1.07), and survival outcomes were comparable between RT and CT (recurrence-free survival: HR 0.86; overall survival: HR 1.16) (all P > 0.05). Grade ≥ 3 toxicities were significantly lower with RT than with CCRT (odds ratio 0.25; P < 0.001).</p><p><strong>Conclusion: </strong>Adjuvant RT represents an effective and well-tolerated postoperative strategy for intermediate-risk, early-stage cervical cancer. Adjuvant CT may represent a potential alternative option.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770774","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":"Association between preoperative diaphragmatic dome height for overall survival in patients with lung cancer and obstructive ventilatory disorder.","authors":"Masaya Noguchi, Yuji Higashimoto, Toshiki Takemoto, Masashi Shiraishi, Hiroki Mizusawa, Kengo Kanki, Ryota Matsuzawa, Akira Tamaki, Yasuhiro Tsutani","doi":"10.1007/s10147-026-03022-1","DOIUrl":"https://doi.org/10.1007/s10147-026-03022-1","url":null,"abstract":"<p><strong>Background: </strong>To investigate the relationship between preoperative diaphragmatic dome height (DDH), measured on chest radiographs, and postoperative overall survival (OS) and disease-specific survival (DSS) due to respiratory-related deaths in patients with lung cancer and obstructive ventilatory disorder (OVD).</p><p><strong>Methods: </strong>This single-center retrospective study included 302 patients with lung cancer and OVD who underwent lobectomy between 2017 and 2024. DDH was measured on chest radiographs 1 month preoperatively, and the patients were divided into the low DDH (lower than the first quartile, 18.8 mm) and high DDH (≥ 18.8 mm) groups. The associations of DDH with OS and DSS were evaluated using Cox proportional hazards models and Fine-Gray competing risk analysis, respectively. Kaplan-Meier curves and log-rank tests were used for survival comparisons.</p><p><strong>Results: </strong>Overall, 65 patients (21%) died postoperatively. Cox proportional hazards and Fine-Gray analyses indicated that DDH (hazard ratio: 2.10, 95% confidence interval [CI]: 1.22-3.61, p < 0.01; subdistribution hazard ratio: 2.50, 95% CI: 1.14-5.45, p < 0.05) was an independent prognostic factor for 3-year OS and DSS. Furthermore, survival curve analysis demonstrated that the low DDH group had significantly lower 3-year OS (70% vs 85%, p < 0.01) and 3-year DSS (80% vs 92%, p < 0.01) compared with the high DDH group.</p><p><strong>Conclusions: </strong>DDH is an independent prognostic factor for OS and DSS in patients with lung cancer and OVD, suggesting that it can serve as a novel physiological marker for long-term prognosis.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728992","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":"Barriers and facilitators for online genetic care for hereditary cancer in Japan: findings from surveys of both clients and medical professionals.","authors":"Sayaka Ueno, Yusaku Urakawa, Fumino Kato, Arisa Ueki, Keika Kaneko, Koji Matsumoto, Hiromi Sugawara, Sayoko Takeuchi, Reiko Yoshida, Miho Kakuta, Kiwamu Akagi, Kazuo Tamura, Akira Hirasawa","doi":"10.1007/s10147-026-03026-x","DOIUrl":"https://doi.org/10.1007/s10147-026-03026-x","url":null,"abstract":"<p><strong>Background: </strong>Online genetic care can offer a promising solution to the shortage of qualified medical professionals in genetic medicine, which leads to regional disparities in access. However, despite global adoption, its use in Japan remains limited.</p><p><strong>Methods: </strong>Two questionnaire surveys were conducted to investigate potential needs and barriers regarding online genetic care: one involving 858 medical professionals (738 physicians and 120 genetic counselors or nurses), and the other involving 443 clients who received in-person genetic counseling.</p><p><strong>Results: </strong>Only 14.0% of the medical professionals had experience with online genetic care, although 85.9% of the professionals engaged in cancer genetics were willing to consider providing it in the future. Notably, a discrepancy was found regarding hospital selection: clients prioritized access to specialized medical care, whereas professionals assumed clients valued accessibility for family members. Professionals expressed greater concerns about adequacy of online communication, client environments and internet security. Among clients, 89.1% estimated they would sufficiently understand and accept total content of counseling session if were conducted online. Older age and infrequent internet use were associated with lower acceptance and higher anxiety regarding online methods. Concerns about ability to use the necessary technology affected clients' willingness to encourage online care for their relatives.</p><p><strong>Conclusion: </strong>Online genetic care shows high potential for client acceptance and can effectively address regional disparities in Japan. To bridge the gap between client needs and professional perceptions and to overcome the digital divide, it is necessary to develop secure, accessible systems and provide education for both patients and healthcare providers.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770839","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":"Prevalence and prognostic impact of cancer cachexia in patients with bladder cancer: a multicenter retrospective study.","authors":"Osamu Mito, Satoru Muto, Kosuke Kitamura, Naoya Nagaya, Yuki Nagashima, Junki Morino, Kazuhiko Fujita, Shigeo Horie","doi":"10.1007/s10147-026-03043-w","DOIUrl":"https://doi.org/10.1007/s10147-026-03043-w","url":null,"abstract":"<p><strong>Background: </strong>Cancer cachexia is characterized by progressive skeletal muscle loss and systemic inflammation. Although sarcopenia is a known prognostic factor in bladder cancer, the prevalence and prognostic significance of cancer cachexia defined by standardized criteria remain unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed patients receiving first-line systemic chemotherapy for urothelial carcinoma at three institutions. Cancer cachexia was defined using the 2011 European Palliative Care Research Collaborative (EPCRC) criteria based on weight loss, body mass index, and CT-derived L3 skeletal muscle index. Patients were categorized by onset timing: no cachexia, baseline cachexia (pre-treatment), and acquired cachexia (developed during treatment). Survival outcomes and prognostic factors were analyzed using Kaplan-Meier methods, logistic regression, and Cox proportional hazards models.</p><p><strong>Results: </strong>Among 150 eligible patients, 45 (30.0%) had baseline cachexia, and 67 (44.7%) developed acquired cachexia during the observation period, resulting in a cumulative prevalence of 74.7%. Cachexia was significantly associated with advanced disease stage and sarcopenia. Overall survival (OS) significantly differed among the three groups (log-rank test, P = 0.005). The median OS was not reached in the no cachexia group, 836 days in the acquired cachexia group, and 742 days in the baseline cachexia group. Multivariable Cox analysis identified acquired cachexia, baseline cachexia and elevated C-reactive protein (CRP) (≥ 0.4 mg/dL) as independent predictors of poor OS.</p><p><strong>Conclusion: </strong>Cancer cachexia is highly prevalent in patients with bladder cancer receiving first-line chemotherapy and is independently associated with reduced survival, regardless of onset timing. Early identification may improve risk stratification and guide supportive interventions.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716568","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 new era of AML therapy: current standards and emerging targets.","authors":"Naoko Hosono","doi":"10.1007/s10147-026-03038-7","DOIUrl":"https://doi.org/10.1007/s10147-026-03038-7","url":null,"abstract":"<p><p>Over the past decade, AML therapy has evolved from the uniform \"7 + 3\" regimen toward a personalized approach. This transition integrates molecular genetic profiles with clinical fitness, driven by the genomic elucidation of AML and the development of selective targeted agents. Key advancements include the integration of FLT3 inhibitors into intensive chemotherapy and the emergence of venetoclax. When combined with hypomethylating agents, venetoclax has redefined the standard of care for older or unfit patients. Furthermore, IDH1/2 inhibitors and menin inhibitors have provided potent options for molecular subsets defined by IDH1/2 mutations and KMT2A rearrangements or NPM1 mutations, respectively. Innovations such as the liposomal formulation CPX-351 and oral formulations of CC-486 and oral decitabine/cedazuridine have further optimized treatment delivery and improved patient quality of life. Despite these breakthroughs, intrinsic clonal heterogeneity and drug-resistant mutations, particularly TP53 mutation, remain significant challenges. Current research is actively exploring next-generation inhibitors, antibody-drug conjugates, and cellular immunotherapies such as BiTEs and CAR-T cells. This review summarizes the recent pharmacological evolution in AML and discusses how these emerging therapies bring us closer to the ultimate goal of achieving a definitive cure.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716566","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}