Cancer最新文献

{"title":"Opioid prescribing trends and pain scores among adult patients with cancer in a large health system","authors":"Laura Van Metre Baum MD, MPH,&nbsp;Pamela R. Soulos MPH,&nbsp;Madhav KC PhD, MPH,&nbsp;Molly M. Jeffery PhD,&nbsp;Kathryn J. Ruddy MD, MPH,&nbsp;Catherine C. Lerro PhD, MPH,&nbsp;Hana Lee PhD,&nbsp;David J. Graham MD, MPH,&nbsp;Donna R. Rivera PharmD, MSc,&nbsp;Mark Liberatore PharmD, RAC,&nbsp;Michael S. Leapman MD, MHS,&nbsp;Vikram Jairam MD,&nbsp;Michaela A. Dinan PhD,&nbsp;Cary P. Gross MD,&nbsp;Henry S. Park MD, MPH","doi":"10.1002/cncr.70027","DOIUrl":"10.1002/cncr.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Opioid stewardship policies could adversely affect pain management for patients with cancer. Yet patients with cancer are also at risk for opioid-related harms. This study sought to determine trends in opioid prescribing by clinical stratum and pain for patients with cancer from 2016 to 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted of opioid-naive adults with newly diagnosed cancer from 2016 to 2020 (<i>N</i> = 10,232) in a large Connecticut health system. Logistic regression was used to calculate changes in the predicted probability of opioid prescribing from 2016 to 2020. Two subpopulations were examined: patients treated surgically (<i>n</i> = 4405) and patients with metastatic cancer (<i>n</i> = 2158). Flowsheet pain scores for patients with metastatic cancer were used to stratify by no pain (all scores, 0) versus any pain. The main outcomes were new (≥1 prescription in the 0–6 months after diagnosis) and additional (0–6 and 7–9 months) opioid prescriptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A decline was observed in the predicted probability of new (71.1% to 64.6%; <i>p</i> &lt; .001) and additional prescribing (27.2% to 24.2%; <i>p</i> = .07 [not significant]) declined. Among surgical patients, the predicted probability of new opioid prescribing fell (96.0% to 88.6%; <i>p</i> &lt; .001), whereas additional prescribing was stable (13%). For patients with metastatic cancer with pain, new opioid prescribing was stable (56%). For those reporting no pain, the predicted probability of new opioid prescribing declined from 61.6% to 36.1% (<i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the context of widespread policy changes, this study showed a modest decline in new and additional opioid prescribing for patients with cancer. In metastatic cancer, prescribing remained stable for patients reporting pain and declined steeply for those reporting no pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 19","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110977","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":"Unveiling the impact of chemotherapy in patients with breast cancer: A longitudinal study on peripheral inflammation, multimodal magnetic resonance imaging, and cognition","authors":"Rob Colaes MSc,&nbsp;Gwen Schroyen PhD,&nbsp;Ahmed Radwan MD, PhD,&nbsp;Rebeca Alejandra Gavrila Laic PhD,&nbsp;Shannon Helsper PhD,&nbsp;Uwe Himmelreich PhD,&nbsp;Sigrid Hatse PhD,&nbsp;Ann Smeets MD, PhD,&nbsp;Karen Caeyenberghs PhD,&nbsp;Stefan Sunaert MD, PhD,&nbsp;Sabine Deprez PhD","doi":"10.1002/cncr.70095","DOIUrl":"10.1002/cncr.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The pathophysiology of chemotherapy-induced cognitive impairment (CICI) remains unclear. Besides direct neurotoxicity, chemotherapy may trigger peripheral proinflammatory responses leading to neuroinflammation and neuronal injury. This longitudinal study investigated changes in peripheral inflammatory and neuronal markers, and multimodal magnetic resonance imaging measures from pre-to post-chemotherapy, and their potential role in CICI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 32 women receiving chemotherapy for early breast cancer (C+), 35 patients not exposed to chemotherapy (C–), and 46 healthy women (HC) age- and education-matched. Participants were assessed at diagnosis (T0), 3 months post-chemotherapy (T1), and 1 year post-chemotherapy (T2), or at matched intervals. Differences over time were assessed in cognitive outcomes, peripheral inflammatory and neuronal markers, and multimodal magnetic resonance imaging measures, reflecting white matter (WM) lesions, magnetic resonance spectroscopy metabolites, WM microstructure, and the diffusion tensor imaging along the perivascular space (DTI-ALPS) index. To investigate changes in WM structure, the authors performed a longitudinal fixel-based analysis on multi-shell diffusion-weighted images. Associations between peripheral inflammation and WM microstructure were explored, as well as their relationship to both subjective and objective cognitive outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study observed alterations after chemotherapy in subjective and objective cognition, inflammatory profiles, neurofilament light chain, the DTI-ALPS index, and WM microstructure within the left inferior longitudinal fasciculus and in the genu of the prefrontal corpus callosum. Alterations in peripheral inflammatory profiles were associated with worse performance in objective cognition, but not with changes in WM microstructure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Peripheral inflammatory responses and alterations in WM microstructure are potential key mechanisms underlying CICI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 19","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090763","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":"Prospective associations between sleep quality and sexual satisfaction in distressed breast cancer survivors: Secondary analysis from the Apps Reaching Cancer Survivors randomized trial","authors":"Kelly M. Shaffer PhD,&nbsp;Katharine E. Daniel PhD,&nbsp;Kara P. Wiseman PhD,&nbsp;Lee M. Ritterband PhD,&nbsp;David C. Mohr PhD,&nbsp;Wendy Cohn PhD,&nbsp;Shayna L. Showalter MD,&nbsp;Philip I. Chow PhD","doi":"10.1002/cncr.70093","DOIUrl":"10.1002/cncr.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>One in 20 women globally will be diagnosed with breast cancer in her lifetime and face increased risk for poor sleep quality and sexual functioning after treatment. Limited evidence exists on how these prevalent survivorship concerns influence each other over time. This secondary analysis examined the prospective association between breast cancer survivors' sleep quality and sexual satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Distressed breast cancer survivors (<i>N</i> = 313; mean age, 52 years [range: 27–77 years]; 84% non-Hispanic White) reported sleep quality (Pittsburgh Sleep Quality Index) and sexual satisfaction (Patient Reported Outcomes Measurement Information System Satisfaction With Sex Life Scale) at baseline, 8 weeks, 6 months, and 12 months in a randomized clinical trial of an application-based distress intervention. Parallel-process latent growth modeling was used to test associations between trajectories of these domains, adjusting for age and partner status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most survivors (77%) reported clinically significant impairments in both sleep quality and sexual satisfaction at one or more timepoints. Model fit was strong (χ²[29] = 24.47; <i>p</i> = .71; comparative fit index = 1.00; standardized root mean square residual = .025), with no moderation by intervention condition. Both sleep quality (<i>p</i> &lt; .001) and sexual satisfaction (<i>p</i> = .004) improved over time, with greater improvements observed among participants with worse initial scores (<i>p</i> = .01 for both associations). Sleep quality and sexual satisfaction were positively associated at baseline (<i>p</i> &lt; .001), but initial levels in one domain did not predict changes in the other, and their trajectories were not significantly related.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Poor sleep and low sexual satisfaction commonly co-occur among distressed breast cancer survivors and are cross-sectionally related. However, changes in these domains occurred independently over time, highlighting the importance of evaluating both concerns and providing domain-specific survivorship care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 19","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084832","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":"Remnant cholesterol and systemic inflammation as synergistic predictors of cancer risk: A 16-year prospective cohort study","authors":"Hongxue Xu MD,&nbsp;Peipei Liu MD,&nbsp;Shuohua Chen PhD,&nbsp;Guodong Wang MM,&nbsp;Shouling Wu MD,&nbsp;Xuemei Zhang PhD","doi":"10.1002/cncr.70096","DOIUrl":"10.1002/cncr.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Remnant cholesterol (RC), a marker of triglyceride-rich lipoproteins, has been implicated in cardiovascular disease via inflammatory pathways, but its role in cancer development remains unclear. This study investigated the independent and joint effects of RC and systemic inflammation on long-term cancer risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors analyzed data from 136,158 participants in the Kailuan cohort who were free from cancer and cardiovascular disease at baseline. RC was calculated as total cholesterol minus high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. High-sensitivity C-reactive protein (hs-CRP) was used to assess systemic inflammation. Incident cancer cases were identified during a median follow-up of 16.18 years. Cox proportional hazards models, interaction analyses, mediation analysis, and cross-lagged panel models were used to assess the relationships between RC, hs-CRP, and cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 7080 incident cancers were recorded. Compared with the lowest quartile of RC (Q1), participants in the highest quartile (Q4) had a significantly increased risk of overall cancer (hazard ratio [HR], 1.188; 95% confidence interval [CI], 1.108–1.273), lung cancer (HR, 1.349; 95% CI, 1.179–1.543), and colorectal cancer (HR, 1.775; 95% CI, 1.443–2.184). Participants with both high RC and high hs-CRP had the highest risk (HR, 1.332; 95% CI, 1.268–1.400). Mediation analysis revealed that RC mediated 8.31% of the hs-CRP–cancer relationship, and vice versa. Cross-lagged models confirmed a bidirectional temporal association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RC and systemic inflammation act synergistically and bidirectionally to increase cancer risk, supporting a metabolic–inflammatory axis in carcinogenesis. These findings identify novel, potentially modifiable targets for early cancer risk stratification and prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 19","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079096","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":"Safety and promising efficacy with enhanced CAR T-cell therapy for lymphoma","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.70035","DOIUrl":"10.1002/cncr.70035","url":null,"abstract":"&lt;p&gt;Results of the first-in-human trial using enhanced chimeric antigen receptor (CAR) T-cell therapy, armed with proinflammatory cytokines (interleukin 18 [IL-18]) to target malignant lymphocytes in patients with refractory or relapsed lymphoma, show that the enhanced CAR T-cell therapy carries a safety profile similar to that of other CAR T-cell therapies and demonstrates promising efficacy.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Of the 21 patients in the trial, 81% achieved a complete or partial response after 3 months of the armored CAR T-cell therapy, with 52% achieving a complete response. In the same group of participants, 62% had cytokine release syndrome (47% of these cases were grade 1 or 2), and 14% had grade 1 or 2 immune effector cell-associated neurotoxicity syndrome. The median duration of response was 9.6 months at a median follow-up of 17.5 months.&lt;/p&gt;&lt;p&gt;Toxicity was similar to that of other CAR T-cell therapies and consisted mainly of grade 1 or 2 adverse events, none of which were unexpected or delayed.&lt;/p&gt;&lt;p&gt;The lead author of the study, Jakub Svoboda, MD, an associate professor of medicine at the Hospital of the University of Pennsylvania in Philadelphia, Pennsylvania, says that he and his colleagues are encouraged by the favorable toxicity profile of the armored CAR T-cell therapy and “surprised by the efficacy in this setting with over 50% of patients achieving complete response.”&lt;/p&gt;&lt;p&gt;Preclinical studies conducted by the researchers demonstrated that IL-18–armored CAR T cells have superior antitumor efficacy and result in prolonged survival in mouse models. Dr Svoboda and his colleagues decided to test their armored CAR T-cell therapy on patients with lymphoma who had relapsed after therapy or did not respond to standard anti-CD19 CAR T-cell therapy.&lt;/p&gt;&lt;p&gt;Dr Svoboda says that the trial demonstrated that it is possible to retarget the same surface antigen (CD19) with armored CAR T cells and achieve durable responses. He underscores that approximately one third of the patients had no response to prior standard anti-CD19 CAR T-cell therapy. Some of these refractory patients achieved long-term responses when they were treated with the armored anti-CD19 CAR T-cell therapy.&lt;/p&gt;&lt;p&gt;However, he cautions that the results of the trial come from a small sample. He and his colleagues are currently conducting a larger trial using IL-18–armored anti-CD19 CAR T-cell therapy to confirm the efficacy results. He says that the concept of administering CAR T-cell therapy after the failure of prior CAR T-cell therapy is a reasonable strategy with the right product.&lt;/p&gt;&lt;p&gt;“We are hoping that the concept of armoring CARs with proinflammatory cytokines may have implications in settings where cellular therapies face challenges,” he says, adding that secreting cytokines at the tumor site may allow for the recruitment of important components of the immune system and enhance the CARs themselves.&lt;/p&gt;&lt;p&gt;“This modification may ultimately overcome some of the im","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074094","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":"Report provides review of major modifiable cancer risk factors, HPV vaccination, and cancer screenings","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.70034","DOIUrl":"10.1002/cncr.70034","url":null,"abstract":"&lt;p&gt;A recent report presents current data on major modifiable cancer risk factors, human papillomavirus (HPV) vaccination rates, and cancer screenings in the United States among adults during and after the COVID-19 pandemic versus the years before the pandemic.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Getting more people to stop smoking and improving cervical cancer prevention, including screening and HPV vaccination, are two key takeaways from the American Cancer Society (ACS) report on cancer prevention and early detection.&lt;/p&gt;&lt;p&gt;Key findings of the report suggest that improving cancer prevention is critical to lowering the burden of cancer on individuals and society. An estimated 40% of cancers in the United States are attributed to modifiable life factors, among which tobacco use remains the leading cause of preventable death. Despite a drop in smoking prevalence to 11% in 2023, 27 million adults still smoke, with a high prevalence in specific populations: American Indians, Alaska Natives, Black males, people with a lower level of education, and bisexual females.&lt;/p&gt;&lt;p&gt;Of all adults who smoke, 36% reported using menthol-flavored cigarettes; this level doubles or increases even more in Black people (76%) and bisexual people (63%). The lead author of the study, Priti Bandi, PhD, scientific director of the risk factors and screening research team in the ACS Surveillance &amp; Health Equity Science Department, underscores that menthol-flavored cigarettes can increase smoking in youth and reduce cessation success. The high level of menthol-flavored cigarette smoking in Black and bisexual people is due to the targeted marketing of these products to these communities by the tobacco industry, she says.&lt;/p&gt;&lt;p&gt;Flavored tobacco products are particularly attractive to and used by young people. The report also found that nearly 9 in 10 teenagers who used tobacco products preferred menthol cigarettes (42%), cigars (71%), and flavored e-cigarettes and nicotine pouches (90%). The use of e-cigarettes among young adults has grown from 9% in 2019 to 13% in 2023.&lt;/p&gt;&lt;p&gt;“Tobacco remains the leading cause of preventable cancer death,” Dr Bandi says. “Therefore, tobacco prevention in young people and smoking cessation, via delivery of evidence-based smoking cessation services, is key to reducing cancer risk and burden.”&lt;/p&gt;&lt;p&gt;Another modifiable risk factor that could prevent more disease and deaths is cancer screening. In particular, the report found that current cervical cancer screening levels remain lower than pre-pandemic levels. Dr Bandi calls this a “continuing disappointing pattern of declines in up-to-date screening in the past two decades.” She notes that the up-to-date cervical cancer screening rate in 2021 was 73%, which was below pre-pandemic levels.&lt;/p&gt;&lt;p&gt;The report also showed that the uptake of the HPV vaccine was flat from 2021 to 2023, with 61% of adolescents aged 13–17 years receiving the vaccine. Dr Bandi calls this an unexpected finding considering the pre","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074140","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":"Avelumab combined with axitinib for patients with advanced thymoma B3 and thymic carcinoma","authors":"Fabio Conforti MD,&nbsp;Laura Pala MD,&nbsp;Chiara Catania MD,&nbsp;Paolo Andrea Zucali PhD,&nbsp;Isabella Sala MSc,&nbsp;Matteo Perrino MD,&nbsp;Fabio De Vincenzo MD,&nbsp;Nadia Cordua MD,&nbsp;Jacopo Canzian MD,&nbsp;Benedetta Tinterri MD,&nbsp;Emily Governini MD,&nbsp;Marzia Bendoni MD,&nbsp;Armando Santoro MD,&nbsp;Giuseppe Giaccone PhD,&nbsp;Tommaso Martino De Pas MD","doi":"10.1002/cncr.70092","DOIUrl":"10.1002/cncr.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patients with advanced thymoma B3 (TB3) and thymic carcinoma (TC) resistant to chemotherapy have limited treatment options. The final overall survival (OS) results of the CAVEATT trial are presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The CAVEATT was a single-arm, multicentric, phase II trial testing the combination of avelumab (anti–PD-L1) and axitinib (antiangiogenesis) in patients with advanced TB3 or TC, who had progressed after at least one line of platinum-based chemotherapy. Patients could have received prior antiangiogenesis drugs but not immune checkpoint inhibitors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two patients were enrolled: 27 had TC, 3 TB3, and 2 a mixed TB3/TC. Most (91%, 29/32) had Stage IVB disease, and 41% (13/32) had prior antiangiogenesis treatment. After a median follow-up for overall survival (OS) of 48.9 months (range, 2.5–61.1), 23 deaths occurred. Median OS was 23.4 months (95% CI, 16.5–31.1), with 12- and 24-month OS rates of 77.7% (95% CI, 58.8–88.7) and 48.5% (95% CI, 30.3–64.6), respectively. No significant OS differences emerged across most subgroups, except for patients without liver metastases (OS hazard ratio [OS-HR], 0.39; 95% CI, 0.17–0.89) and lower lactate dehydrogenase levels (OS-HR, 0.25; 95% CI, 0.10–0.65), who had significantly longer survival compared to patients with liver metastases and with higher lactate dehydrogenase levels, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of avelumab and axitinib demonstrated long-term efficacy in heavily pretreated patients with TC and TB3. This finding underscores the meaningful impact of immune checkpoint inhibitors and antiangiogenesis drugs on the prognosis of this patient population</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074162","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":"Sexual health among Danish cancer survivors and individuals with no history of cancer: Baseline findings from the nationwide Project SEXUS cohort study","authors":"Cecilie H. Madsen MD,&nbsp;Christian Graugaard MD, PhD,&nbsp;Susanne O. Dalton MD, PhD,&nbsp;Mikael Andersson MSc,&nbsp;Pernille E. Bidstrup MSc, PhD,&nbsp;Morten Frisch MD, PhD, DScMed","doi":"10.1002/cncr.70074","DOIUrl":"10.1002/cncr.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Being diagnosed with and treated for cancer often results in physical symptoms and psychosocial distress that may affect sexual health. This population-based study in Denmark aimed to compare the sexual health of cancer survivors across multiple cancer sites with that of individuals with no history of cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were used from 4085 cancer survivors and 58,590 individuals without cancer aged 15 to 89 years, who participated in the nationally representative <i>Project SEXUS</i> cohort study. Prevalence estimates for sexual outcomes were calculated, and logistic regression analyses yielded confounder-adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for associations of cancer survivorship with sexual outcomes, both overall and across cancer sites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cancer survivors experienced significantly more sexual challenges than individuals without cancer, both overall and in the first 5 years after their most recent cancer diagnosis. This difference was seen across multiple cancer sites and regardless of age at diagnosis (&lt;60 vs. ≥60 years). Among several statistically significant findings, particularly high aORs were noted for dissatisfaction with breast appearance (aOR: 1.89; CI, 1.49–2.41) and genital pain dysfunction (aOR: 1.74; CI, 1.32–2.28) among women and lack of sexual needs (aOR: 1.93; CI, 1.61–2.30) and erectile dysfunction (aOR: 2.79; CI, 2.30–3.38) among men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to individuals with no history of cancer, sexual health was significantly affected among cancer survivors of both sexes and across cancer sites, time since diagnosis, and age at diagnosis. Health care professionals should recognize and routinely address the sexual challenges experienced by cancer survivors to enhance their biopsychosocial recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074084","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":"Neoadjuvant immunochemotherapy for nonsurgical HPV-negative head and neck cancer","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.70036","DOIUrl":"10.1002/cncr.70036","url":null,"abstract":"&lt;p&gt;Giving immunotherapy with chemotherapy before radiation to nonsurgical patients with locoregionally advanced human papillomavirus (HPV)–negative head and neck cancer may improve treatment efficacy according to the phase 2, nonrandomized De-Escalation Therapy for Human Papillomavirus Negative Disease trial 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;In this trial of 36 nonsurgical patients with stage IVa/b HPV-negative head and neck squamous cell carcinoma, 53% of the patients had a deep response (i.e., &gt;50% tumor shrinkage per the Response Evaluation Criteria in Solid Tumors) after receiving neoadjuvant nivolumab plus chemotherapy (carboplatin and paclitaxel) before radiation. The deep response rate after neoadjuvant nivolumab plus chemotherapy met the primary endpoint of an improvement over the historical control of induction chemotherapy alone. Of the full cohort, 86% achieved an objective response (≥30% tumor shrinkage).&lt;/p&gt;&lt;p&gt;Investigators also tested the ability to de-escalate the radiation dose and volume among the deep responders after neoadjuvant immunochemotherapy. Compared to the 16 patients who were assigned to standard chemoradiation, the 19 patients who received de-escalated chemoradiation had fewer acute toxic effects during treatment and fewer distant metastases.&lt;/p&gt;&lt;p&gt;“Taken together, this suggests that neoadjuvant immunochemotherapy may improve outcomes in locoregionally advanced HPV-negative head and neck cancer, while also selecting patients who can do well with lower doses and volumes of radiation, which can lead to fewer side effects,” says the lead author of the study, Ari Rosenberg, MD, an oncologist and assistant professor of medicine at the University of Chicago Medicine who specializes in immunotherapy and other treatments for head and neck and thyroid cancers.&lt;/p&gt;&lt;p&gt;Programmed death ligand 1 (PD-L1) was a predictive biomarker for a response to chemoimmunotherapy and survival. Progression-free survival at 24 months was 88% for patients with PD-L1 expression with a combined positive score (CPS) of 20 or more but 59% for patients with PD-L1 expression with a CPS of less than 20 (&lt;i&gt;p&lt;/i&gt; = .16). The overall survival rates were 88% and 69%, respectively.&lt;/p&gt;&lt;p&gt;He says that the study builds on data from the KEYNOTE-689 study, which showed improved event-free survival with neoadjuvant immunotherapy for patients with surgically treated head and neck cancer. The phase 3 study found that the addition of neoadjuvant pembrolizumab to the standard of care (surgery and adjuvant radiotherapy with or without concomitant cisplatin) resulted in improved event-free survival at 36 months in comparison with the standard of care alone (57.6% vs. 46.4%; &lt;i&gt;p&lt;/i&gt; = .008). The study also found a significant improvement in event-free survival for patients whose tumors expressed PD-L1 with a CPS of 10 versus those treated with the standard of care alone (59.8% vs. 45.9%; &lt;i&gt;p&lt;/i&gt; = .004).&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074179","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":"Rethinking prestige and dependency in global oncology","authors":"Saroj Niraula MBBS, MD, MSc, FRCPC","doi":"10.1002/cncr.70087","DOIUrl":"10.1002/cncr.70087","url":null,"abstract":"&lt;p&gt;Global oncology has made substantial progress over the past two decades. Childhood cancer survival has improved in many low- and middle-income countries (LMICs), diagnostic and treatment infrastructure has expanded, and cancer has become a global health priority alongside infectious diseases.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; These gains reflect the efforts of LMIC health systems, often supported by international partnerships.&lt;/p&gt;&lt;p&gt;Despite these improvements, a gap persists between global oncology’s potential and its reality, which are maintained by persistent structural and cultural patterns. Global health still operates in a hierarchical manner where institutions in high-income countries (HICs) retain control over funding, recognition, and agenda setting, whereas LMIC actors remain constrained by externally imposed standards and power dynamics.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Although this structure may sometimes have led to improvements in measured outcomes, it also sustains dependency across research, training, and health financing. In countries like Uganda, disruptions in foreign aid have jeopardized access to essential treatments, revealing the fragility of donor-reliant systems.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Recent US funding cuts to the Global Alliance for Vaccine and Immunization and to the World Health Organization further illustrate how political shifts in donor countries can destabilize LMIC programs.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; Addressing these legacies requires not only resources and technology but fidelity to patients and systems: a foundation that endures beyond shifting agendas and political turns. When survival depends on visibility rather than durability, institutions adapt in ways that subvert priorities. These imbalances foster a form of structural corruption, propelled by the universal impulse to seek prestige and influence.&lt;/p&gt;&lt;p&gt;Ambition and prestige can be productive, and desirable, when aligned with equal opportunities for patients. In global health, these opportunities become problematic when they dictate priorities according to misaligned, external definitions of success. International partnerships offer resources and visibility, and at their best, can build capacity that endures beyond the partnership itself. However, when partnerships are designed to impress external audiences, they risk privileging symbolic achievement over local relevance. They impose foreign agendas, encourage unhealthy competition within LMICs for resources and recognition, and rely on unprepared HIC visiting delegations at the expense of long-term needs.&lt;span&gt;&lt;sup&gt;6, 7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Several years ago during my first job at Bhaktapur Cancer Hospital in Nepal, a donor from New Zealand gifted a radiotherapy machine to replace a 50-year-old cobalt unit. A large celebration followed. The donor was revered, the hospital leadership celebrated for securing a legacy, and a costly bunker was built at local expense. The machine itself never operated, presumably alread","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068758","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}