Cancer最新文献

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

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

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

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

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

{"title":"First person profile: Jennifer S. Temel, MD","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35758","DOIUrl":"https://doi.org/10.1002/cncr.35758","url":null,"abstract":"&lt;p&gt;Pioneering work by Jennifer S. Temel, MD, has filled a large gap in cancer care. Although new treatments over the past decades have extended the lives of many patients with cancer and improved the quality of their lives, support for a myriad of physical and psychosocial needs accompanying a cancer diagnosis through treatment and end-of-life care for both patients and caregivers has lagged.&lt;/p&gt;&lt;p&gt;Dr Temel has changed that by developing a model that transformed palliative care from being an exclusive offering for very ill and hospitalized patients near death to an option for all patients with cancer at the time of diagnosis. Moving palliative care upstream in the outpatient setting and delivering it over the course of a patient’s illness have been demonstrated during more than 20 years of research to improve the patient experience as measured by patient-reported outcomes. It also improves a patient’s health care delivery, she says.&lt;/p&gt;&lt;p&gt;Findings from her research have been published in major medical journals. For example, a 2010 randomized study published in &lt;i&gt;The New England Journal of Medicine&lt;/i&gt; showed that early palliative care significantly improved the quality of life and mood of patients with metastatic non–small cell lung cancer.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Two recent randomized studies published in 2024 in &lt;i&gt;JAMA&lt;/i&gt; also demonstrated the efficacy and scalability of early palliative care. One showed the effectiveness and scalability of a stepped palliative care approach in which patients receive palliative care visits at key points in their cancer trajectories; when a decrement in quality of life is noted, more intensive palliative care is administered.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The other demonstrated the effectiveness and feasibility of delivering early palliative care via telehealth.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;“A big piece of palliative care, especially when provided early in the disease in an outpatient setting, is about things like coping, living life to the fullest with a serious illness, and also things like accepting and understanding what the illness and prognosis mean,” says Dr Temel.&lt;/p&gt;&lt;p&gt;Because of her work, early palliative care is now recommended as the standard of care for patients with serious cancers by all national organizations, such as the American Society of Clinical Oncology and the National Comprehensive Cancer Network.&lt;/p&gt;&lt;p&gt;Dr Temel is a professor of medicine at the Harvard Medical School, a thoracic oncologist at the Massachusetts General Hospital (MGH) Cancer Center, and the Barbara McCue Endowed Chair in Oncology and Cancer Outcomes Research at MGH.&lt;/p&gt;&lt;p&gt;Although she wanted to be a physician from a young age, becoming an oncologist was not preordained. A thorny problem presented itself that made her think twice—a huge fear of blood. In college, she chose to work in a laboratory to see if laboratory science might be a better fit than being a physician. As chance would have it, her laboratory was in ","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638805","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":"Higher rates of long-term complications after prostate cancer treatment","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35761","DOIUrl":"https://doi.org/10.1002/cncr.35761","url":null,"abstract":"&lt;p&gt;Men with prostate cancer treated with prostatectomy and radiotherapy have significantly higher rates of long-term complications after accounting for age-related symptoms and disease, according to a cohort study published in &lt;i&gt;JAMA Oncology&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Compared to people who did not undergo prostate cancer treatment, patients who underwent prostatectomy and those who underwent radiotherapy had 7.23- and 2.76-times greater risks, respectively, of developing urinary or sexual complications at 12 years.&lt;/p&gt;&lt;p&gt;Radiotherapy also was linked to a 3-fold increased risk of bladder cancer and a 100-fold increased risk of radiation cystitis and radiation proctitis.&lt;/p&gt;&lt;p&gt;The results are based on a novel approach to assessing the long-term risk of complications following prostate cancer treatment by comparing the risk in patients with prostate cancer who underwent treatment to the risk in a control population (untreated group) that included people without prostate cancer or with untreated prostate cancer. Data for all participants were obtained from two large prostate cancer prevention trials that allowed for a comparison of rates of age-dependent functional changes that increase with age (e.g., erectile dysfunction).&lt;/p&gt;&lt;p&gt;Among the 29,196 participants in the two trials, 3946 had prostate cancer: 655 underwent prostatectomy, and 1056 underwent radiotherapy.&lt;/p&gt;&lt;p&gt;Other findings included a higher rate of artificial urinary sphincter placement 12 years after prostatectomy (4.76 cases per 1000 years of follow-up) in comparison with untreated patients (who underwent no sphincter operations) and an increased rate of penile prosthesis implantation in participants who underwent prostatectomy or radiotherapy (4.40 and 1.50 times for each 1000 years of follow-up, respectively) in comparison with untreated participants (0.43 times for each 1000 years of follow-up).&lt;/p&gt;&lt;p&gt;According to the study authors led by Joseph M. Unger, PhD, a biostatistician at the SWOG Statistics and Data Management Center of the Fred Hutchinson Cancer Center, the findings “should be explicitly reflected in national cancer screening and treatment guidelines and be integral to shared decision-making with patients before initiation of prostate-specific antigen screening, biopsy, or prostate cancer treatment.” They note that quantitative information such as these findings on treatment-related risks of prostate cancer are not currently included in the guidelines of any national organization, and they recommend their inclusion to help to foster informed decision-making.&lt;/p&gt;&lt;p&gt;Walter M. Stadler, MD, Chief Clinical Officer for City of Hope, Chicago, says that the study re-emphasizes the need to discuss long-term urinary, sexual, and bowel toxicities with patients with prostate cancer before embarking on definitive local therapy.&lt;/p&gt;&lt;p&gt;“More importantly, these toxicities need to be balanced with known benefits of definitive local therapy, especially in patients for whom the ","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638761","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":"The relationship between cardiometabolic abnormalities and mortality in the Women’s Health Initiative: A comparison of associations among women with cancer to women without cancer","authors":"Sreejata Raychaudhuri MD,&nbsp;Eric McLaughlin MS,&nbsp;Michael L. Pennell PhD,&nbsp;Marcia Stefanick PhD,&nbsp;Kerryn Reding PhD,&nbsp;Alexi Vasbinder PhD,&nbsp;Richard K. Cheng MD,&nbsp;Ana Barac MD,&nbsp;Michael S. Simon MD, MPH","doi":"10.1002/cncr.35804","DOIUrl":"https://doi.org/10.1002/cncr.35804","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prior studies of participants with breast and other obesity-associated cancers in the Women’s Health Initiative (WHI) showed worse mortality and cardiovascular disease (CVD) outcomes for individuals with a higher number of cardiometabolic risk factors at study entry. The purpose of this analysis is to compare the relationship between cardiometabolic abnormalities and mortality among women with and without cancer in the WHI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women with one of five early-stage obesity-associated cancers (breast, colorectal, endometrial, ovarian, and non-Hodgkin lymphoma) and controls without any new or prior history of cancer were selected from the WHI-Life and Longevity after Cancer ancillary study. Cardiometabolic abnormalities included high waist circumference (≥88 cm), hypertension (&gt;130/85 mm Hg), and self-reported history of diabetes and/or elevated cholesterol. Multivariable Cox proportional hazards models (all-cause mortality) and Fine-Gray models (CVD and non-CVD mortality) were used to evaluate the association between cardiometabolic risk factors and survival outcomes for the cancer and noncancer cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 7491 and 35,508 women were studied in the cancer and noncancer cohorts, respectively. Adjusted analyses showed that increased number of cardiometabolic abnormalities was associated with increased short-term risk of all-cause mortality, with the association being stronger among the noncancer “controls” compared to the cancer cohort (interaction <i>p</i> value = .02). Associations were similar between cancer cases and controls in competing risk models for CVD and non-CVD mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preexisting cardiovascular abnormalities are an important predictor of adverse health outcomes among women with and without cancer in the WHI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602635","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":"Caring for caregivers in early-phase clinical oncology trials","authors":"Leah L. Thompson MD,&nbsp;Caterina S. Florissi BA,&nbsp;Debra Lundquist PhD, RN,&nbsp;Rachel B. Jimenez MD","doi":"10.1002/cncr.35805","DOIUrl":"https://doi.org/10.1002/cncr.35805","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602636","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":"The human oral microbiome and risk of colorectal cancer within three prospective cohort studies in the United States","authors":"Emily Vogtmann PhD, MPH,&nbsp;Yukiko Yano PhD, MPH,&nbsp;Semi Zouiouich PhD,&nbsp;Xing Hua PhD,&nbsp;Yunhu Wan PhD,&nbsp;Vaishnavi Purandare MS,&nbsp;Shilan Li PhD,&nbsp;Casey L. Dagnall BS,&nbsp;Kristine Jones BS,&nbsp;Belynda D. Hicks MS,&nbsp;Amy Hutchinson MS,&nbsp;J. Gregory Caporaso PhD,&nbsp;William Wheeler PhD,&nbsp;Wen-Yi Huang PhD,&nbsp;Neal D. Freedman PhD, MPH,&nbsp;Dale P. Sandler PhD, MPH,&nbsp;Laura E. Beane Freeman PhD,&nbsp;Linda M. Liao PhD,&nbsp;Mitchell H. Gail MD, PhD,&nbsp;Jianxin Shi PhD,&nbsp;Christian C. Abnet PhD, MPH,&nbsp;Rashmi Sinha PhD","doi":"10.1002/cncr.35802","DOIUrl":"https://doi.org/10.1002/cncr.35802","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Oral microbes detected in feces have been associated with colorectal cancer (CRC) in cross-sectional studies. This study investigated the prospective associations between the oral microbiome and incident CRC in the Agricultural Health Study (AHS), National Institutes of Health–AARP (NIH-AARP) Diet and Health Study, and Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals with oral samples collected before incident CRC diagnoses were identified in the AHS (<i>N</i> = 331), NIH-AARP (<i>N</i> = 249), and PLCO (<i>N</i> = 446) and compared with referent subcohorts (<i>N</i> = 3431). The V4 region of the 16S ribosomal RNA gene was sequenced from oral wash DNA, and the data were processed with QIIME2. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall CRC and by anatomic subsite (i.e., proximal colon, distal colon, and rectum) were estimated with Cox proportional hazards models with adjustment for potential confounders by cohort and then meta-analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, no associations were found between microbial characteristics and CRC risk. However, associations were observed with alpha and beta diversity indices and individual genera in analyses stratified by anatomic subsite. For instance, the presence of <i>Olsenella</i> was strongly positively associated with distal colon cancer risk (HR, 2.16; 95% CI, 1.59–2.95), whereas the presence of <i>Prevotella 2</i> was positively associated with rectal cancer risk (HR, 1.68; 95% CI, 1.14–2.46).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large study of the prospective association between the oral microbiome and CRC risk showed numerous site-specific associations, including multiple associations with distal colon and rectal cancer risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35802","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595310","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}