International Journal of Clinical Oncology最新文献

{"title":"Risk stratification for recurrence after nephrectomy in high-risk renal cell carcinoma patients.","authors":"Taisuke Tobe, Jun Teishima, Hideto Ueki, Yusuke Shiraishi, Naoto Wakita, Yasuyoshi Okamura, Kotaro Suzuki, Yukari Bando, Takuto Hara, Tomoaki Terakawa, Koji Chiba, Akihisa Yao, Hideaki Miyake","doi":"10.1007/s10147-025-02825-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02825-y","url":null,"abstract":"<p><strong>Background: </strong>To identify prognostic factors that guide adjuvant therapy decisions, we investigated factors predicting recurrence in patients with high-risk clear cell renal cell carcinoma (RCC) after nephrectomy.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with non-metastatic, high-risk clear cell RCC who underwent radical or partial nephrectomy at our institution and affiliated centers between January 2016 and March 2024. Multivariate analysis using the Cox proportional hazards model was performed to identify clinicopathological factors associated with recurrence. On the basis of these factors, we developed a risk stratification model.</p><p><strong>Results: </strong>A total of 338 patients were included. The 5-year recurrence-free survival (RFS) rate was 54.3%. Multivariate analysis identified a body mass index of ≤ 22 kg/m² (Hazard Ratio [HR]: 2.61), rhabdoid differentiation (HR: 5.14), anemia (HR: 1.97), hypercalcemia (HR: 2.67), and C-reactive protein ≥ 0.5 mg/dL (HR: 1.72) as independent predictors of recurrence. RFS was significantly different between patients with varying numbers of risk factors: 3-year RFS rates were 22.6% for those with 3-4 factors, 47.9% for those with two, 75.5% for those with one, and 83.6% for those with none.</p><p><strong>Conclusion: </strong>We identified independent predictors of recurrence in patients with nephrectomy-treated clear cell RCC. Patients stratified according to a risk score based on these factors had different recurrence rates, suggesting that this score could assist in guiding adjuvant therapy decisions.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626250","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":"Trends in real-world outcomes of patients with metastatic renal cell cancer in the recent treatment era: a single-institution analysis.","authors":"Yasutomo Nakai, Shunki Nakagawa, Yutaka Kurahashi, Shu Okamoto, Yuichiro Nakamura, Yujiro Hayashi, Norihiko Kawamura, Akira Nagahara, Kazuo Nishimura, Masashi Nakayama","doi":"10.1007/s10147-025-02829-8","DOIUrl":"https://doi.org/10.1007/s10147-025-02829-8","url":null,"abstract":"<p><strong>Background: </strong>Systemic therapy for metastatic renal cell cancer (mRCC) has changed significantly due to randomized controlled trial results. We investigated whether these changes affect real-world outcomes and clarified factors associated with treatment outcomes in patients from a single institution outside of clinical trials.</p><p><strong>Methods: </strong>We retrospectively reviewed records of mRCC patients treated at Osaka International Cancer Institute between January 2005 and May 2024. Between-group analysis of progression-free survival (PFS) and overall survival (OS) by Kaplan-Meier comparison and identification of survival-associated factors by univariate and multivariate analyses were performed. Patients assumed ineligible for clinical trials were analyzed in subgroups according to any of Eastern Cooperative Oncology Group performance status > 1, hemoglobin level < 9.0 g/dL, estimated glomerular filtration rate < 40 mL/min/1.73 m², platelet count < 100,000/μL, neutrophil count < 1500/μL, non-clear cell histology, or brain metastasis.</p><p><strong>Results: </strong>In total, 320 patients were evaluated: 2005-2009, n = 58; 2010-2014, n = 77; 2015‒2019, n = 86; and 2020‒2024, n = 99. Significant between-group differences were observed for median PFS (7 vs. 8 vs. 12 vs. 20 months; p = 0.0048) and (35 vs. 38 vs. 67 vs. 52 months; p = 0.0206). Multivariate analysis revealed that first-line or subsequent-line immune checkpoint inhibitor (ICI) use was an independent factor for OS (HR: 0.28, p < 0.0001). Even among 112 (35%) trial-ineligible patients, multivariate analysis demonstrated that the use of first-line or subsequent-line ICI was an independent factor for OS (HR: 0.26, p < 0.0001).</p><p><strong>Conclusion: </strong>Over time, treatment outcomes appeared to have improved with real-world treatment for mRCC, with use of ICIs being related to improvements in treatment outcomes.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626252","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":"Survival impact and recurrence prediction using oncologic resectability classification in hepatocellular carcinoma following hepatic resection: a Japanese multi-center study.","authors":"Norifumi Iseda, Shinji Itoh, Mizuki Ninomiya, Hiroto Kayashima, Takashi Motomura, Takuma Izumi, Takeo Toshima, Shohei Yoshiya, Yo-Ichi Yamashita, Kengo Fukuzawa, Toru Utsunomiya, Shoichi Inokuchi, Takashi Maeda, Eiji Tsujita, Kazutoyo Morita, Hidefumi Higashi, Keishi Sugimachi, Takahiro Tomino, Ryosuke Minagawa, Koichi Kimura, Hideaki Uchiyama, Noboru Harada, Tomoharu Yoshizumi","doi":"10.1007/s10147-025-02840-z","DOIUrl":"https://doi.org/10.1007/s10147-025-02840-z","url":null,"abstract":"<p><strong>Background: </strong>The oncological criteria of resectability for HCC were reported by the Japanese Expert Consensus 2023. The relationship between classification at recurrence and prognosis is unclear in cases with surgical resection in the initial treatment. Factors that predict recurrence patterns are also unknown.</p><p><strong>Methods: </strong>Data were analyzed retrospectively from 937 patients who underwent hepatic resection for primary HCC at 10 facilities. Kaplan-Meier analyses of overall survival (OS) and recurrence-free survival (RFS) after hepatic resection defined according to resectability classification, resectable (R), borderline resectable (BR) 1, and BR2, were performed. In patients who underwent curative resection for R-HCC, we examined the classification and prognosis at the time of recurrence, as well as the factors associated with BR1 or BR2 recurrence.</p><p><strong>Results: </strong>RFS and OS rates were significantly better in the R group than in the BR1 and BR2 groups (P < 0.01). Prognosis was worse in patients whose initial HCC was resected with R and whose recurrence was BR1 or BR2 (P < 0.01). Male sex, α-fetoprotein > 12 ng/dL, Des-γ-carboxy prothrombin > 150 mAU/mL, tumor size > 5 cm, poor differentiation, and microscopic vascular invasion were predictors of BR1 or BR2 recurrence within 2 years after curative resection for R-HCC. We developed a scoring system based on these six factors, which stratified not only prognosis but also recurrence pattern.</p><p><strong>Conclusions: </strong>Our results extend this framework by demonstrating the prognostic significance at the time of recurrence and provide factors to predict high-risk recurrence.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626251","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":"PMDA regulatory update on approval and revision of the precautions for use of anticancer drugs in Japan; nivolumab plus ipilimumab for hepatocellular carcinoma, fedratinib for myelofibrosis, talquetamab for multiple myeloma, and belzutifan for tumors associated with von Hippel-Lindau disease and renal cell carcinoma.","authors":"Noriomi Matsumura, Masaki Mandai","doi":"10.1007/s10147-025-02830-1","DOIUrl":"https://doi.org/10.1007/s10147-025-02830-1","url":null,"abstract":"","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617373","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":"Pterygomandibular raphe invasion as a novel grading and prognostic factor for squamous cell carcinoma of buccal mucosa: a retrospective study with propensity score matching.","authors":"Ryoji Yoshida, Riu Lin, Keisuke Yamana, Takeshi Obayashi, Hisashi Takeshita, Kosuke Shinohara, Kenta Kawahara, Masatoshi Hirayama, Nozomu Takahashi, Akiyuki Hirosue, Masanori Shinohara, Hideki Nakayama","doi":"10.1007/s10147-025-02821-2","DOIUrl":"https://doi.org/10.1007/s10147-025-02821-2","url":null,"abstract":"<p><strong>Background: </strong>Squamous cell carcinoma of the buccal mucosa (SCCBM) is a prevalent malignancy of the oral cavity with high morbidity and mortality rates. The pterygomandibular raphe (PMR) connects the oral cavity, pharynx, and masticator space, serving as a key anatomical landmark during surgical resection. However, PMR invasion into SCCBM remains poorly understood. This study assessed the prognostic significance of PMR invasion in patients with resectable SCCBM.</p><p><strong>Methods: </strong>The study included 82 patients with SCCBM, excluding those with T4b, who underwent radical resection at Kumamoto University Hospital between 2000 and 2017. Patients were categorized into three groups based on PMR invasion patterns: non-contact, contact, and invasion. The relationship between PMR invasion and clinicopathological characteristics was analyzed using the Fisher's exact test. The Kaplan-Meier method, log-rank test, and propensity score-matched analyses were used for survival analysis.</p><p><strong>Results: </strong>Contact or invasion into the PMR was significantly associated with advanced clinical T and N stages, clinical stage, endophytic growth pattern, high-grade invasion pattern, and poor tumor differentiation. Patients with PMR invasion had a higher proportion of recurrences in the buccal subcutaneous, mandibular, and masticator spaces. Univariate analysis indicated that contact- or invasion-type PMR invasion predicted worse overall survival (OS). The impact of PMR invasion on OS was confirmed using a propensity score-matched analysis.</p><p><strong>Conclusion: </strong>This study revealed that PMR invasion is a potential novel grading and prognostic factor for resectable SCCBM, with significance in planning the extent of SCCBM resection.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608290","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":"Role of cystatin C-based sarcopenia index in predicting postoperative infectious complications after major urologic cancer surgery.","authors":"Ryo Andy Ogasawara, Shugo Yajima, Naoki Imasato, Tomonori Kanagawa, Minoru Inoue, Kohei Hirose, Ken Sekiya, Madoka Kataoka, Yasukazu Nakanishi, Hitoshi Masuda","doi":"10.1007/s10147-025-02828-9","DOIUrl":"https://doi.org/10.1007/s10147-025-02828-9","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia has been linked to an increased risk of postoperative complications and poor prognosis in patients undergoing major surgery for urological cancer. The sarcopenia index has emerged as a potential marker of muscle mass. This study investigated the relationship between the sarcopenia index and the occurrence of postoperative infections in patients undergoing major urological surgery.</p><p><strong>Methods: </strong>A total of 416 patients who underwent radical cystectomy, prostatectomy, nephrectomy, partial nephrectomy, or nephroureterectomy between April 2023 and May 2024 were retrospectively analyzed. The sarcopenia index was determined using the following formula: [(serum creatinine/serum cystatin C) × 100]. An optimal threshold for the sarcopenia index was established by using receiver operating characteristic curve analysis. The primary endpoint was the incidence of postoperative infectious complications, including pneumonia, urinary tract infections, and surgical site infections. We also examined the incidence of urinary tract infection and total postoperative complications in the sub-analyses.</p><p><strong>Results: </strong>Of the 416 included patients, 172 (41%) had a sarcopenia index below the determined threshold. Postoperative infectious complications were more in patients with lower sarcopenia index values than in those with higher values (11 vs. 3%, P = 0.0014). However, no significant association was found in the sub-analyses. Multivariate analysis identified a reduced sarcopenia index and contaminated surgical wounds (primarily from radical cystectomy) as independent predictors of postoperative infections.</p><p><strong>Conclusion: </strong>Patients undergoing major urological cancer surgery with a lower sarcopenia index are at an elevated risk of developing postoperative infectious complications. The sarcopenia index may help clinicians predict postoperative infections and improve perioperative management.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608291","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":"Clinical utility of a novel perioperative quality assessment metric, trifecta, for radical cystectomy.","authors":"Mahito Atsuta, Fumihiko Urabe, Kosuke Iwatani, Masataka Kubo, Naoki Uchida, Hirokazu Kagawa, Naoya Tomomasa, Shun Saito, Takayuki Sano, Wataru Fukuokaya, Kazuhiro Takahashi, Takafumi Yanagisawa, Shunsuke Tsuzuki, Takahiro Kimura, Jun Miki","doi":"10.1007/s10147-025-02791-5","DOIUrl":"https://doi.org/10.1007/s10147-025-02791-5","url":null,"abstract":"<p><strong>Background: </strong>Assessing the quality of surgical procedures is crucial for improving outcomes in radical cystectomy (RC). While the Pentafecta metric has been used, its reliance on the absence of local recurrence within 1 year delays postoperative assessment. For timely clinical decision-making, a new metric that facilitates earlier evaluation is needed. We propose such a metric, named \"Trifecta\". We evaluated its impact on prognosis and identified predictors for achieving it.</p><p><strong>Methods: </strong>The \"Trifecta\" metric was defined as meeting three criteria: adequate lymphadenectomy (≥ 10 nodes), negative surgical margins, and absence of Clavien-Dindo grade 3-5 complications within 30 days after surgery. This retrospective study analyzed data from patients who underwent RC and lymphadenectomy between April 2014 and June 2024. Kaplan-Meier analysis and Cox proportional hazards models were used to assess oncological outcomes, while logistic regression was used to identify predictors for failing to achieve \"Trifecta\" .</p><p><strong>Results: </strong>Of the 196 patients included, 121 (61.7%) achieved \"Trifecta\" and this was significantly associated with improved intrapelvic RFS (HR 0.42; P = 0.014), CSS (HR 0.56; P = 0.032), and OS (HR 0.57; P = 0.020) but not MFS (HR 0.85; P = 0.620). Low serum levels of albumin were significantly associated with \"Trifecta\" failure (OR 2.06; P = 0.021), but not with survival outcomes.</p><p><strong>Conclusion: </strong>Achieving \"Trifecta\" was associated with improved survival outcomes, and low serum levels of albumin predicted a higher likelihood of failure to achieve it. The \"Trifecta\" metric enables early and clinically relevant evaluation of surgical quality, offering a practical alternative to traditional metrics.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591113","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":"Real-world trends in the use and outcomes of novel androgen receptor signaling inhibitor therapy in patients with non-metastatic castration-resistant prostate cancer: a multicenter retrospective study.","authors":"Fumiya Yoneyama, Naoki Fujita, Yohei Kawashima, Masanao Shinohara, Ryuji Tabata, Ryuma Tanaka, Takuya Oishi, Hikari Miura, Kyo Togashi, Kazutaka Okita, Hirotaka Horiguchi, Toshikazu Tanaka, Daisuke Noro, Yuichiro Suzuki, Satoshi Sato, Chikara Ohyama, Shingo Hatakeyama","doi":"10.1007/s10147-025-02827-w","DOIUrl":"https://doi.org/10.1007/s10147-025-02827-w","url":null,"abstract":"<p><strong>Background: </strong>Although three phase III trials demonstrated significant oncological benefits of novel androgen receptor signaling inhibitors (ARSIs) in patients with non-metastatic castration-resistant prostate cancer (nmCRPC), trends in novel ARSI use have been sparsely documented. Moreover, the safety and oncological benefits of novel ARSIs in real-world nmCRPC settings remain unclear.</p><p><strong>Methods: </strong>This multicenter retrospective study evaluated 318 consecutive patients with nmCRPC treated between 2001 and 2024. Trends in the use of novel ARSIs were analyzed. Adverse events associated with novel ARSIs were assessed using the Common Terminology Criteria for Adverse Events version 5.0. Multivariable Cox proportional hazards regression analyses were conducted to evaluate the effects of novel ARSIs on metastasis-free survival (MFS) and overall survival (OS).</p><p><strong>Results: </strong>The median age and follow-up period after nmCRPC diagnosis were 77 years and 46 months, respectively. Of the 318 patients, 231 (73%) received novel ARSI treatment at some point during nmCRPC management. First-line use of novel ARSIs gradually increased following their initial approval for nmCRPC in 2014. The rate of first-line novel ARSI use was significantly higher in 2020-2024 than in 2014-2019 (68% vs. 33%, P < 0.001). The incidence rates of any-grade and grade ≥ 3 adverse events associated with novel ARSIs were 23% and 2.2%, respectively. After adjusting for confounding variables, novel ARSIs were independently and significantly associated with prolonged MFS and OS.</p><p><strong>Conclusions: </strong>Novel ARSIs have become a primary treatment strategy for nmCRPC in real-world settings, demonstrating both safety and significant oncological benefits.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583853","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":"Celecoxib has less aggravating effect on cisplatin-induced nephrotoxicity in comparison with non-selective cyclooxygenase inhibitors: a retrospective multi-institutional study.","authors":"Keisuke Okamoto, Yoshitaka Saito, Kenta Takahashi, Yoh Takekuma, Jun Sakakibara-Konishi, Katsuya Narumi, Mitsuru Sugawara, Masaki Kobayashi","doi":"10.1007/s10147-025-02810-5","DOIUrl":"https://doi.org/10.1007/s10147-025-02810-5","url":null,"abstract":"<p><strong>Background: </strong>Cisplatin (CDDP)-induced nephrotoxicity (CIN) is one of its most serious adverse effects. Although we previously demonstrated that celecoxib, a cyclooxygenase (COX)-2 selective inhibitor, attenuates CIN in a basic study, there are no reports that have evaluated its clinical impact on CIN. Therefore, we aimed to determine the effect of celecoxib on CIN compared with that of non-selective COX inhibitors.</p><p><strong>Methods: </strong>Patients with lung cancer receiving CDDP (≥ 60 mg/m²)-containing regimens with regular administration of loxoprofen or naproxen (COX-1 group), or celecoxib were evaluated in this retrospective, multi-institutional study. The primary endpoint was the evaluation of CIN incidence in all treatment cycles between the groups. In addition, the variance in creatinine clearance (CCr) and the incidence of gastrointestinal adverse effects were evaluated.</p><p><strong>Results: </strong>CIN occurred in 24.2% of patients in the COX-1 group (n = 33) and 0% of those in the celecoxib group (n = 15) in all cycles, showing a significant difference (P = 0.04). In addition, the variance in CCr was significantly smaller in the celecoxib group than in the COX-1 group in all cycles, as well as at the primary endpoint (P = 0.02). However, there was no difference in the incidence of CIN or variance in CCr in the first cycle between the two groups. The incidences of nausea, vomiting, and anorexia were similar between the groups, implying a similar amount of oral hydration.</p><p><strong>Conclusion: </strong>These findings suggest that celecoxib is less aggravating on CIN than non-selective COX inhibitors.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575390","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":"Factors associated with primary resistance to enfortumab vedotin in previously treated patients with metastatic urothelial carcinoma: a multicenter retrospective study.","authors":"Daiki Ikarashi, Nozomi Hayakawa, Go Kaneko, Yuma Sakura, Yuki Endo, Ryo Yamashita, Suguru Shirotake, Yukihiro Kondo, Eiji Kikuchi, Wataru Obara","doi":"10.1007/s10147-025-02822-1","DOIUrl":"https://doi.org/10.1007/s10147-025-02822-1","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the primary resistance factors to enfortumab vedotin (EV) monotherapy by comparing treatment outcomes between the early progressive disease (EPD) group and non-EPD group.</p><p><strong>Methods: </strong>We retrospectively analyzed 121 patients with advanced urothelial carcinoma who received EV monotherapy across five institutions between 2019 and 2024. The patients were categorized into the EPD group (n = 34), defined by radiologically confirmed progressive disease within 3 months of EV initiation, and the non-EPD group (n = 87). The clinical parameters and oncological outcomes were compared between groups. The emergence of new metastatic lesions was defined as the detection of metastases in organs not previously identified as metastatic sites at baseline, during prior chemotherapy or immune checkpoint inhibitors (ICIs) before the initiation of EV.</p><p><strong>Results: </strong>The median overall survival was significantly shorter in the EPD group than in the non-EPD group (6.5 vs. 19.9 months, p < 0.001). The EPD group had a significantly higher incidence of new metastatic lesions and a lower prevalence of normal Hb levels. Multivariate analysis identified low Hb and the presence of new metastatic lesions as independent predictors of EPD. Among patients with new metastases in the EPD group, an average of 74% of lesions emerged during ICI treatment and 75% involved multiple foci. Notably, more than 50% of these new lesions showed progression at the same sites following EV therapy.</p><p><strong>Conclusions: </strong>Patients with low hemoglobin levels and new metastatic lesions before EV treatment may be at increased risk for EPD. For these patients, alternative treatment strategies should be considered before initiating EV.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575413","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}