Cancer最新文献

{"title":"Treatment of tenosynovial giant tumors with colony-stimulating factor 1 receptor kinase inhibitors: When to start? When to stop? When to restart?","authors":"Jean-Yves Blay, Armelle Dufresne, François Gouin, Gualter Vaz, Mehdi Brahmi","doi":"10.1002/cncr.35635","DOIUrl":"https://doi.org/10.1002/cncr.35635","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612339","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":"Changing treatment patterns for hepatocellular carcinoma: A Surveillance, Epidemiology, and End Results-Medicare study.","authors":"Franklin Iheanacho, Angela C Tramontano, Thomas Adam Abrams, Christopher R Manz","doi":"10.1002/cncr.35649","DOIUrl":"https://doi.org/10.1002/cncr.35649","url":null,"abstract":"<p><strong>Background: </strong>From 2007 to 2017, sorafenib was the sole systemic therapy for hepatocellular carcinoma (HCC), but nine new therapies were approved from 2017 to 2022. No studies have yet examined population-level treatment patterns for HCC since these approvals.</p><p><strong>Methods: </strong>For this retrospective cohort, Surveillance, Epidemiology, and End Results (SEER)-Medicare data were used to identify patients who had HCC diagnosed between 2014 and 2019 with claims through 2020. The authors examined patient characteristics, comorbidities, and receipt of local (e.g., transplantation, resection, embolization) and systemic (e.g., sorafenib, lenvatinib, atezolizumab plus bevacizumab) therapies. Cohort characteristics, treatment patterns, and overall survival (OS) were analyzed, and χ² tests and t-tests were used to compare treatments between the 2014-2017 and 2018-209 cohorts. Adjusted Cox models were used to compare median OS between treatment groups.</p><p><strong>Results: </strong>Among 11,766 patients (men, 69.2%; White, 76.9%; median age, 71 years), 60.5% received treatment within 1 year, which remained stable over time (2014-2017, 60.4%; 2018-2019, 61.0%; p = .84). The use of local therapy also remained stable (2014-2017, 52.1%; 2018-2019, 52.8%; p = .43), whereas the use of systemic therapy slightly decreased (2014-2017, 17.0%; 2018-2019, 15.2%; p = .01). First-line systemic treatments shifted significantly, with sorafenib use dropping from 84.5% (2014-2017) to 41.3% (2018-2019). The median OS among patients who received no treatment, systemic therapies first, or local therapies first was 2.2, 12.0, and 23.6 months, respectively. Patients who were diagnosed in 2019 had better OS (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.74-0.86) as did those who received systemic therapy first (HR, 0.33; 95% CI, 0.18-0.61), but survival was worse for those who received local therapy first (HR, 1.41; 95% CI, 1.08-1.84) compared with those who were diagnosed in 2014.</p><p><strong>Conclusions: </strong>Local therapy patterns remained stable, but novel therapies replaced sorafenib as the preferred first-line treatment, improving survival.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611425","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":"A phase 4, multicenter, global clinical study to evaluate discontinuation and rechallenge of pexidartinib in patients with tenosynovial giant cell tumor previously treated with pexidartinib.","authors":"Jayesh Desai, Andrew J Wagner, Irene Carrasco Garcia, Marilena Cesari, Michael Gordon, Chia-Chi Lin, Zsuzsanna Papai, Christopher W Ryan, William D Tap, Jonathan C Trent, Hans Gelderblom, Peter Grimison, Antonio López Pousa, Brian A Van Tine, Maria Rubinacci, Dong Dai, Abdul Waheed Rajper, Kristen Tecson, Margaret Wooddell, Silvia Stacchiotti","doi":"10.1002/cncr.35634","DOIUrl":"https://doi.org/10.1002/cncr.35634","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pexidartinib is effective in patients with tenosynovial giant cell tumor (TGCT) for whom surgery is not feasible. Durability of response after discontinuation of pexidartinib and the safety and efficacy of restarting pexidartinib have not been previously recorded. This phase 4 study was designed to mimic the real-world experience with pexidartinib to evaluate the effects of discontinuation of and retreatment with pexidartinib in patients with TGCT who previously benefited from the drug.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a global, multicenter, phase 4 study that enrolled patients with TGCT who were experiencing clinical benefit from pexidartinib in one of four prior phase 1 or phase 3 studies investigating pexidartinib in the disease. Patients could choose to continue pexidartinib at the same dose (the treatment-continuation cohort) or discontinue treatment with the option to restart pexidartinib (the treatment-free/retreatment cohort). Tumor progression determined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, patient-reported outcomes (the Patient-Reported Outcomes Measurement Information System-Physical Function [PROMIS-PF] questionnaire and the EuroQol 5-dimension, 5-level [EQ-5D-5L] visual analog scale), and safety were assessed every 3 months. The primary end point was the proportion of patients in the treatment-free/retreatment cohort who remained treatment-free at month 12 and 24; this did not depend on disease progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-two patients were enrolled: 21 chose to enter the treatment-continuation cohort, and 11 entered the treatment-free/retreatment cohort. During the treatment-free period, six of 11 (54.5%) patients in the treatment-free/retreatment cohort had progressive disease (PD) according to RECIST, version 1.1, whereas no patient in the treatment-continuation cohort had disease progression. Over the 24-month study, three of 11 (27.3%) patients in the treatment-free/retreatment cohort restarted treatment because of RECIST version 1.1 PD, symptomatic progression, or both (n = 1 each). The probability of remaining treatment-free in the treatment-free/retreatment cohort was 73% (95% confidence interval, 37%-90%). In the treatment-free/retreatment cohort, the median progression-free survival of the treatment-free period was 22.8 months (95% confidence interval, 1.6 months to not estimable). By 6 months of retreatment, all retreated patients achieved new disease stabilization with no new safety concerns; two patients had clinically significant improvements in PROMIS-PF and EQ-5D-5L visual analog scale scores. The mean PROMIS-PF and EQ-5D-5L scores remained stable throughout the study. There was no hepatotoxicity and no new safety signal in either cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this small phase 4 study designed to evaluate outcomes in patients who stopped and restarted pexidartinib, 54.5% of patients who discontinued pexidar","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613351","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":"Neutrophil-to-lymphocyte ratio (NLR) at diagnosis in essential thrombocythemia: A new promising predictor of thrombotic events.","authors":"Alessia Ripamonti, Fabrizio Cavalca, Laura Montelisciani, Laura Antolini, Carlo Gambacorti-Passerini, Elena Maria Elli","doi":"10.1002/cncr.35638","DOIUrl":"https://doi.org/10.1002/cncr.35638","url":null,"abstract":"<p><strong>Background: </strong>Myeloproliferative neoplasms represent a heterogeneous group of acquired hematopoietic stem cell diseases in which chronic inflammation is essential for both clonal evolution and thrombotic complications. The neutrophil-to-lymphocyte ratio (NLR), reflecting the imbalance between systemic inflammation and immunity, is emerging as a prognostic biomarker in several diseases, including hematological ones.</p><p><strong>Methods: </strong>A total of 473 patients with essential thrombocythemia (ET), the relationship between NLR value at diagnosis and the risk of thrombotic events in the follow-up, in addition to conventional clinical and biological variables, were retrospectively analyzed.</p><p><strong>Results: </strong>A total of 78 thrombotic events were reported for an incidence rate of 1.8 × 100 patients/year. In multivariate analysis, NLR value ≥4 at diagnosis was associated with higher cumulative thrombotic risk (hazard ratio [HR], 2.05; 95% CI, 1.29-2.28; p = .0001) as well International Prognostic Score for Thrombosis in Essential Thrombosis score intermediate-high (HR, 2.69; 95% CI, 1.27-5.72; p = .01) and diabetes (HR, 2.49; 95% CI, 1.23-3.05; p = .010). Concerning arterial thrombotic events, in multivariate analysis, NLR value at diagnosis ≥4 was predictive for thrombosis (HR, 2.13; 95% CI, 1.31-4.04; p = .001 as well diabetes (HR, 2.44; 95% CI, 1.05-5.68; p = .04) and hypertension (HR, 2.46; 95% CI, 1.05-5.68; p = .01). About venous thrombotic events, NLR value ≥5 was a marker predictive for venous thrombosis (HR, 2.99; 95% CI, 2.45-6.48; p = .01) as well age >60 years old (HR, 2.26; 95% CI, 1.0-5.10; p = .05).</p><p><strong>Conclusion: </strong>NLR value is a simple, cost-effective, and easy-to-obtain inflammatory marker that can predict a diagnosis the risk of thrombosis in ET. Our results suggest that NLR value could be integrated into conventional cardiovascular risk scores, to better classify high-risk patients who are candidates for cytoreductive therapy. Further larger and prospective studies are warranted.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611801","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":"Risk stratification in the clinical application of minimal residual disease assessment in acute myeloid leukemia.","authors":"Congxiao Zhang, Runxia Gu, Huijun Wang, Chunlin Zhou, Yan Li, Yuntao Liu, Shuning Wei, Dong Lin, Kaiqi Liu, Qiuyun Fang, Xiaoyuan Gong, Benfa Gong, Shaowei Qiu, Guangji Zhang, Bingcheng Liu, Ying Wang, Yingchang Mi, Hui Wei, Jianxiang Wang","doi":"10.1002/cncr.35641","DOIUrl":"https://doi.org/10.1002/cncr.35641","url":null,"abstract":"<p><strong>Background: </strong>In acute myeloid leukemia (AML), further investigation is warranted to integrate measurable residual disease (MRD) with genetic characteristics for formulating a dynamic prognostic system for predicting response and selecting appropriate postremission therapeutic strategies.</p><p><strong>Methods: </strong>The authors incorporated MRD with genetic risk classification and assessed its impact on transplantation decision making within different risk cohorts, comprising 769 patients with newly diagnosed AML across three clinical trials. Only patients who achieved complete remission (CR) within two courses of chemotherapy were selected.</p><p><strong>Results: </strong>In the favorable-risk and intermediate-risk groups, patients who underwent transplantation according to the protocol experienced significant 3-year overall survival (OS) benefits compared with those who did not (favorable-risk group: hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20-0.73l p = .004; intermediate-risk group: HR, 0.53; 95% CI, 0.33-0.85; p = .008). In the intermediate-risk group, early detection of MRD positivity, even after the initial course of chemotherapy, was associated with a significantly elevated cumulative incidence of relapse (47.2% vs. 36.0%; p = .009) and a notable extension of OS with allogeneic hematopoietic stem cell transplantation (HR, 0.47; 95% CI, 0.28-0.79; p = .004). Conversely, patients who achieved MRD negativity at either of the two time points had comparable OS in the favorable-risk and intermediate-risk groups, regardless of whether they underwent transplant or not. In the adverse-risk group, allogeneic hematopoietic stem cell transplantation led to improvements in OS irrespective of MRD status (HR, 0.51; 95% CI, 0.38-0.69; p < .001).</p><p><strong>Conclusions: </strong>Early clearance of MRD demonstrated significant prognostic value, particularly for patients in the favorable-risk and intermediate-risk groups. Positive MRD status after two courses of intensive chemotherapy were associated with a higher relapse rate and inferior OS, necessitating allogeneic hematopoietic stem cell transplantation.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612323","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":"A comparison of isolated limb infusion/perfusion, immune checkpoint inhibitors, and intralesional therapy as first-line treatment for patients with melanoma in-transit metastases.","authors":"Danielle K DePalo, Michelle M Dugan, Syeda Mahrukh Hussnain Naqvi, David W Ollila, Tina J Hieken, Matthew S Block, Winan J van Houdt, Michel W J M Wouters, Sophie J M Reijers, Nethanel Asher, Kristy K Broman, Zoey Duncan, Matilda Anderson, David E Gyorki, Hayden Snow, Jenny Held, Jeffrey M Farma, John T Vetto, Jane Y C Hui, Madison Kolbow, Robyn P M Saw, Serigne N Lo, Georgina V Long, John F Thompson, Youngchul Kim, Lilit Karapetyan, Lars Ny, Alexander C J van Akkooi, Roger Olofsson Bagge, Jonathan S Zager","doi":"10.1002/cncr.35636","DOIUrl":"https://doi.org/10.1002/cncr.35636","url":null,"abstract":"<p><strong>Background: </strong>Isolated limb infusion and perfusion (ILI/ILP) has been a mainstay treatment for unresectable melanoma in-transit metastases (ITM), but increased use of immune checkpoint inhibitors (ICI) and intralesional therapy (talimogene laherparepvec [TVEC]) introduced several different management options. This study compares first-line ILI/ILP, ICI, and TVEC.</p><p><strong>Methods: </strong>Retrospective review from 12 international institutions included patients treated from 1990 to 2022 with first-line ILI/ILP, ICI, or TVEC for unresectable melanoma ITM.</p><p><strong>Results: </strong>A total of 551 patients were treated, with ILI/ILP (n = 356), ICI (n = 125), and TVEC (n = 70) with median follow-up of 5.5 years. Tumor burden was highest with ILI/ILP and lowest with TVEC (p = .002). Breslow thickness was lowest with TVEC (p = .007). TVEC was mostly used in stage IIIB disease versus IIIC for ILI/ILP and ICI (p = .01). Using ICI as the reference category, TVEC had the highest odds of a complete response (CR) (odds ratio, 1.96; p = .029) and a longer local progression-free survival (PFS) (hazard ratio [HR], 0.40; p = .003). ILI/ILP had shorter local PFS (HR, 1.72; p = .012), PFS (HR, 1.79; p < .001), distant metastasis-free survival (DMFS) (HR, 1.75; p = .014), overall survival (HR, 1.82; p = .009), and melanoma-specific survival (HR, 2.29; p = .004). Stage IIIB disease had longer DMFS (HR, 0.24; p < .001) compared to IIIC/D.</p><p><strong>Conclusions: </strong>TVEC as first-line therapy for unresectable melanoma ITM was associated with superior CR rates and local PFS. Notably, TVEC was used in patients with a lower Breslow thickness, disease stage, and tumor burden. Therefore, when compared to ILI/ILP and ICI, TVEC should be considered as first-line therapy for unresectable stage IIIB melanoma ITM with minimal tumor burden and lower Breslow thickness.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613350","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":"Colorectal cancer screening and prevention","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35613","DOIUrl":"10.1002/cncr.35613","url":null,"abstract":"&lt;p&gt;In August 2024, the American Society for Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG) published an update on quality indicators for colonoscopy to ensure that the highest standards are met for performing colonoscopy.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; That same month, the American Cancer Society (ACS) and Color Health launched a new pilot program that provides free at-home colorectal cancer screening kits to people in underserved and rural areas.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Both ventures attempt to address ongoing gaps in colorectal cancer screening: one by continuing to focus on the optimal performance of colonoscopy to ensure its preventive potential and the other by broadening accessibility to screening in communities where access remains a barrier.&lt;/p&gt;&lt;p&gt;First issued in 2006 and again in 2015, the ACG/ASGE guidelines on quality indicators for colonoscopy provide a framework for quality improvement efforts that endoscopists or endoscopy units can use to improve their technical performance of a colonoscopy. The guidelines offer comprehensive or general colonoscopy indicators broken down into three periods (pre-, intra-, and postprocedural indicators), with each quality indicator classified as an outcome or process measure based on current evidence.&lt;/p&gt;&lt;p&gt;Emphasized in the updated guidelines, as in the 2015 guidelines, are what the authors call “priority indicators”—those indicators seen as the most clinically relevant and related to key colonoscopy outcomes. It is recommended that all endoscopists and endoscopy units measure these indicators, according to the lead author of the guidelines, Douglas K. Rex, MD, director of endoscopy at Indiana University Hospital in Indianapolis.&lt;/p&gt;&lt;p&gt;The identified priority quality indicators include the (1) adenoma detection rate, (2) sessile serrated lesion detection rate (a new priority indicator), (3) rate of using recommended screening and surveillance intervals, (4) bowel preparation adequacy rate (a new priority indicator), and (5) cecal intubation rate (which can be measured intermittently or not at all after consistent high-level performance has been demonstrated).&lt;/p&gt;&lt;p&gt;Dr Rex says that the inclusion of the sessile serrated lesion detection rate as a priority indicator may be new to some oncologists, but it reflects new evidence showing that although an important subset of colonoscopists adequately detect conventional adenomas, their detection of sessile serrated lesions is suboptimal. Detection of both types of lesions is critical to screening because colorectal cancer develops through both of these two pathways: the adenoma–carcinoma sequence and the serrated polyp–carcinoma sequence. “Cancers arising through these two pathways can typically be distinguished by their molecular features,” he says.&lt;/p&gt;&lt;p&gt;“It is now recommended that all colonoscopists measure their detection of both types of precancerous lesions,” he says.&lt;/p&gt;&lt;p&gt;Underlying the emphasis on priority in","PeriodicalId":138,"journal":{"name":"Cancer","volume":"130 23","pages":"3945"},"PeriodicalIF":6.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612423","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":"Increased head and neck cancer linked to cannabis use","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35614","DOIUrl":"10.1002/cncr.35614","url":null,"abstract":"&lt;p&gt;People who use cannabis, particularly those with a cannabis use disorder, are significantly more likely to develop head and neck cancers than nonusers, according to a recent study published in &lt;i&gt;JAMA Otolaryngology–Head and Neck Surgery&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Adults with a cannabis use disorder, which was defined as excessive use of cannabis with associated psychosocial symptoms and impairment in functioning, were found to be 3.5–5 times more likely to develop head and neck cancer than nonusers of cannabis. The increased risk was seen for all site-specific head and neck cancers, including oral, oropharyngeal, and laryngeal cancers, and was consistent after stratification for older and younger age.&lt;/p&gt;&lt;p&gt;The finding adds to the list of modifiable risk factors associated with head and neck cancers, which include tobacco use, excessive alcohol consumption, and human papillomavirus exposure.&lt;/p&gt;&lt;p&gt;Niels C. Kokot, MD, a head and neck surgeon at the University of Southern California Keck Medicine and senior author of the study, says that the finding highlights cannabis use as a significant risk factor for head and neck cancer that warrants further investigation into causation.&lt;/p&gt;&lt;p&gt;“The next steps involve designing studies to determine the amount and type of cannabis use and how these factors impact the risk of head and neck cancer,” he says. “This will help us better understand the specifics of this association.”&lt;/p&gt;&lt;p&gt;In the study, Dr Kokot and his colleagues retrospectively reviewed 20 years of data from 64 health care organizations for US adults with (more than 116,000) or without (nearly 4 million) a cannabis use disorder recorded at an outpatient hospital clinic (patients with no prior history of head and neck cancer were chosen so that the relative risk of developing a new head and neck cancer could be compared between the two groups). The two groups were matched by demographic characteristics, alcohol-related disorders, and tobacco use, creating two cohorts of 115,865 each. In the cannabis use disorder group, cancer cases were tracked after 1 year of cannabis use for up to 5 years.&lt;/p&gt;&lt;p&gt;The relative risk of developing a new head and neck cancer was 3.49 for adults with a cannabis-related disorder compared to nonusers. A higher risk of developing a head and neck cancer in those with a cannabis-related disorder was seen across the different types of head and neck cancer, with a relative risk of 2.51 for oral cancer, 4.90 for oropharyngeal cancer, and 8.39 for laryngeal cancer (vs. nonusers).&lt;/p&gt;&lt;p&gt;Wojciech (Wojtek) Mydlarz, MD, director of Johns Hopkins Head and Neck Surgery for the National Capitol Region, says that the study is likely the “first large study to look at these numbers of patients and look at associations across a large population. Most providers do feel there is a real risk to develop head and neck cancer with most inhaled substances and exposures, whether they are tobacco or cannabis and others,” he says.&lt;/p&gt;&lt;p","PeriodicalId":138,"journal":{"name":"Cancer","volume":"130 23","pages":"3946"},"PeriodicalIF":6.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612509","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":"Promising long-term disease control and survival with pembrolizumab and cabozantinib for head and neck cancer","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35615","DOIUrl":"10.1002/cncr.35615","url":null,"abstract":"&lt;p&gt;Long-term follow-up of a phase 2, single-arm study of the combination of pembrolizumab and cabozantinib for patients with recurrent or metastatic head and neck cancer showed encouraging tolerability of the regimen as well as disease control and overall survival (OS) at 2 years, according to a study published in &lt;i&gt;Clinical Cancer Research&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;At 22.4 months’ follow-up, the median progression-free survival (PFS) and OS were 12.8 and 27.7 months, respectively, with 2-year PFS and OS rates of 32.6% and 54.7%, respectively.&lt;/p&gt;&lt;p&gt;Previously reported findings of the study showed a median PFS of 14.6 months with a 1-year PFS rate of 54% and a median OS of 22.3 months with a 1-year OS rate of 68.4% at a median follow-up of 10.6 months.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The multicenter, open-label study included 36 patients with inoperable, recurrent, and/or metastatic head and neck cancer treated with the combination therapy, of which 33 were evaluable.&lt;/p&gt;&lt;p&gt;The long-term adverse events included hypothyroidism (5.5%) and grade 1 aspartate aminotransferase and alanine aminotransferase elevation (2.8%).&lt;/p&gt;&lt;p&gt;Lead author and principal investigator Nabil F. Saba, MD, professor and vice chair of the Department of Hematology and Medical Oncology and director of the Head and Neck Cancer Medical Oncology Program at the Winship Cancer Institute at Emory University, says that the results confirm the robust clinical activity of cabozantinib and pembrolizumab in head and neck squamous cell cancers. He notes the encouraging survival outcomes seen with longer follow-up, which indicated that the combination treatment is promising in this setting and merits further evaluation.&lt;/p&gt;&lt;p&gt;The updated results included an analysis of biomarkers that have implications for future patient selection for this combination or similar agents within these drug classifications (an anti–programmed cell death protein 1 inhibitor, such as pembrolizumab, with a vascular endothelial growth factor receptor tyrosine kinase inhibitor, such as cabozantinib). Based on baseline tissue samples obtained from patients’ tumors, a correlation between a higher density of CD8+, CD103+, and CSF-1R+ cells and improved OS was noted.&lt;/p&gt;&lt;p&gt;Dr Saba clarifies that these findings may suggest a possible innate immune mechanism of cabozantinib “given the function of CSF1-R in regulating tumor-associated macrophages, a known target of cabozantinib.”&lt;/p&gt;&lt;p&gt;Based on these results, a phase 2/3 trial (Stellar-305) comparing pembrolizumab and zanzalintinib with pembrolizumab and a placebo in the same patient population is underway and accruing patients in different countries. “Results from this trial are eagerly awaited, as it could potentially change the standard of care in this patient population,” says Dr Saba.&lt;/p&gt;&lt;p&gt;Commenting on the study, Aliyah Pabani, MD, MPH, an assistant professor of oncology at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, calls the results promi","PeriodicalId":138,"journal":{"name":"Cancer","volume":"130 23","pages":"3947"},"PeriodicalIF":6.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612640","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":"Cardiovascular disease and stroke following cancer and cancer treatment in older adults","authors":"Jaidyn Muhandiramge BMedSc(Hons), MD,&nbsp;John R. Zalcberg MBBS, PhD,&nbsp;Erica T. Warner ScD, MPH,&nbsp;Galina Polekhina PhD,&nbsp;Peter Gibbs MBBS, MD,&nbsp;G. J. van Londen MD, MS,&nbsp;Wendy B. Bernstein MD,&nbsp;Finlay Macrae MBBS, MD,&nbsp;Andrew Haydon MBBS, PhD,&nbsp;Jeanne Tie MBChB, MD,&nbsp;Jeremy L. Millar MBChB, BMedSc,&nbsp;Victoria J. Mar MBBS, PhD,&nbsp;Lucy Gately MBBS, PhD,&nbsp;Andrew Tonkin MBBS, MD,&nbsp;Leslie Ford MD,&nbsp;Asad Umar DVM, PhD,&nbsp;Andrew T. Chan MD, MPH,&nbsp;Robyn L. Woods BSc(Hons), PhD,&nbsp;Suzanne G. Orchard BSc(Hons), PhD","doi":"10.1002/cncr.35503","DOIUrl":"10.1002/cncr.35503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cancer survivors can be at risk of cardiovascular disease (CVD) because of either their malignancy or its treatment. Although studies linking cancer and CVD exist, few examine risk in older adults, the impact of cancer treatment, or the effect of aspirin on reducing risk in this cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors conducted a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial to investigate the impact of cancer and cancer treatment on a composite CVD end point comprising hospitalization for heart failure (HHF), myocardial infarction (MI), and stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 15,454 Australian and US ASPREE participants, 1392 had an incident cancer diagnosis. Rates of CVD were greater in the cancer risk-set compared to the cancer-free risk-set (20.8 vs. 10.3 events per 1000 person-years; incidence rate ratio, 2.03; 95% confidence interval, 1.51–2.66), with increased incidence seen across MI, HHF, overall stroke, and ischemic stroke. Increased incidence remained after adjustment for clinically significant risk factors for CVD. Incidence was greatest in metastatic, hematological, and lung cancer. Chemotherapy was associated with increased risk of CVD. Similar rates of CVD were seen across aspirin and placebo groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Incidence of CVD, including MI, HHF, and ischemic stroke, was increased in older adults with cancer. Aspirin did not impact CVD incidence. Risk may be higher in those with metastatic, hematological, and lung cancer, and following chemotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"130 23","pages":"4138-4148"},"PeriodicalIF":6.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277517","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}