Cancer最新文献

{"title":"Health literacy and all-cause mortality among cancer patients","authors":"Bashir Al Hussein Al Awamlh MD,&nbsp;Kelvin A. Moses MD, PhD,&nbsp;Julia Whitman MS,&nbsp;Thomas Stewart PhD,&nbsp;Sunil Kripalani MD, MSc,&nbsp;Kamran Idrees MD, MSCI","doi":"10.1002/cncr.35794","DOIUrl":"https://doi.org/10.1002/cncr.35794","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between health literacy and all-cause mortality among cancer patients remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective cohort study of 9603 patients diagnosed with prostate, lung, breast, renal, colorectal, brain, head and neck, bladder, pancreatic, liver, sarcoma, and gastric cancers who were screened for health literacy between 2008 and 2018, using the Brief Health Literacy Screen (BHLS). Higher scores (range, 3–15) indicate higher health literacy. The association between all-cause mortality and health literacy was estimated using multivariable Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8608 (89%) patients were non-Hispanic White. The median follow-up was 3.1 years. Patients with a BHLS score of 15 had a median survival improvement of 9.4 months (95% confidence interval [CI], 6.0–13.2 months) compared to those with a score of 9. Lower BHLS scores (9 vs. 15) were associated with higher mortality in stages II (adjusted hazard ratio [aHR], 2.6 [95% CI, 1.5–5.1]) and III (aHR 2.9 [95% CI, 1.4-6.0]) prostate cancer; stages I (aHR 1.7 [95% CI, 1.1–2.5]) and IV (aHR, 1.6 [95% CI, 1.2–2.1]) lung cancer; stage I colorectal cancer (aHR, 2.2 [95% CI, 1.3–4.7]); stage I renal cancer (aHR, 1.8 [95% CI, 1.1–3.4]); stages I (aHR, 2.6 [95% CI, 1.3–7.1]) and IV (aHR, 1.7 [95% CI, 1.2–2.7]) head and neck cancer; stage II bladder cancer (aHR, 1.6 [95% CI, 1.0–2.8]); stage I liver cancer (aHR, 4.1 [95% CI, 1.9–9.3]); and all stages of breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lower health literacy was associated with higher all-cause mortality among patients with 12 different types of cancer, varying by cancer type and stage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35794","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554709","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 effect of online cognitive behavioral therapy for insomnia in adolescents and young adults after childhood cancer: Results from a randomized controlled trial","authors":"Hinke van der Hoek MSc,&nbsp;Shosha H. M. Peersmann MSc,&nbsp;Heleen Maurice-Stam PhD,&nbsp;Gertjan J. L. Kaspers MD, PhD,&nbsp;Esther M. M. van den Bergh MSc,&nbsp;Wim J. E. Tissing MD, PhD,&nbsp;Leontien C. M. Kremer MD, PhD,&nbsp;Floor Abbink MD, MSc,&nbsp;Andrica C. H. de Vries MD, PhD,&nbsp;Jacqueline Loonen MD, PhD,&nbsp;Annemieke van Straten PhD,&nbsp;Martha A. Grootenhuis PhD,&nbsp;Raphaële R. L. van Litsenburg MD, PhD","doi":"10.1002/cncr.35796","DOIUrl":"https://doi.org/10.1002/cncr.35796","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Insomnia is common during and after childhood cancer and associated with negative health outcomes and impaired quality of life. Many adolescents and young adults do not receive treatment. Internet-delivered cognitive behavioral therapy for insomnia (iCBT-i) can fill this gap. This study assesses the effectiveness of the iCBT-i intervention “iSleep youth”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients (12–30 years old) with an Insomnia Severity Index ≥8, ≥6 months after treatment, and &lt;10 years after diagnosis were 1:1 randomized to iSleep youth or the wait list-control group. iSleep youth consists of five online sessions with a coach. Outcomes were sleep efficiency (actigraph-based), insomnia, fatigue, and health-related quality of life (HRQOL). Differences over time between iSleep youth and controls, 3 months (T3) and 6 months (T6) from baseline, were assessed with linear mixed models, controlling for age, sex, and time since end of treatment. iSleep youth also had a follow-up measurement after 12 months (T12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-four (response rate, 49%) patients participated: 68.9% females, mean age, 18.5 years (SD = 3.5), and mean time since end of treatment 3.8 years (SD = 2.3). No significant effects between the two groups were found for sleep efficiency. However, iSleep youth had a beneficial effect on insomnia severity at T3 (β = –0.79) and T6 (β = –0.55), on fatigue at T3 (β = –1.08) and T6 (β = –0.52) and on HRQOL at T3 (β = 0.46) and T6 (β = 0.62). The scores did not change from T6 to T12 in iSleep youth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>iSleep youth is effective in treating insomnia and concurrent fatigue in adolescents and young adults after childhood cancer and should be implemented.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35796","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554711","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":"Top advances of the year: Small cell lung cancer","authors":"Misty D. Shields MD, PhD,&nbsp;Anne C. Chiang MD, PhD,&nbsp;Lauren A. Byers MD","doi":"10.1002/cncr.35770","DOIUrl":"https://doi.org/10.1002/cncr.35770","url":null,"abstract":"<p>Lung cancer remains the leading cause of cancer-related mortality in both men and women. Small cell lung cancer (SCLC) is notorious for its early metastatic spread, aggressive biology, and high frequency of disease relapse, resulting in inferior outcomes. In the last few years, immunotherapy for extensive-stage SCLC has offered a glimmer of hope by improving survival by approximately 2 months. In 2024, therapeutic breakthroughs for SCLC led to a meaningful impact for patients, offering potential for long-term survival. Here, the authors report the top advances from 2024, including the practice-changing implementation of consolidative durvalumab immunotherapy for limited-stage SCLC, lessons learned from the timing of immunotherapy with radiation using LU-005, how the delta-like ligand 3 bispecific T-cell engager tarlatamab affects the relapsed landscape, the addition of lurbinectedin to atezolizumab immunotherapy for extensive-stage SCLC, and the promising role of antibody–drug conjugates. In a forward-thinking approach, the authors discuss the feasibility of biomarker selection with the Southwest Oncology Group SWOG S1929 study and how precision medicine may inform consolidative treatments for extensive-stage SCLC through neuroendocrine subtyping with the Southwest Oncology Group SWOG S2409 (PRISM) trial. Finally, they conclude with the exciting role of advocacy with the newly formed advocacy group <i>Small Cell SMASHERS</i>, amplifying support for SCLC. In 2024, the <i>scientific revolution</i> for SCLC has arrived, spearheading a new <i>era of change</i> for this disease.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554216","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":"Colonoscopy and stool tests more effective and cost-effective than novel blood-based screening tests","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35752","DOIUrl":"https://doi.org/10.1002/cncr.35752","url":null,"abstract":"&lt;p&gt;Novel first-generation blood-based tests for colorectal cancer screening may decrease the incidence and mortality of colorectal cancer in comparison with no screening but are far less effective and cost-effective than colonoscopy and the currently available stool tests, according to a cost-effectiveness analysis comparing colorectal screening options that has been published in the &lt;i&gt;Annals of Internal Medicine&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The study was conducted to estimate the clinical and economic impacts of cutting-edge colorectal screening tests, or first-generation cell-free DNA blood tests, in comparison with colonoscopy and stool tests such as fecal immunochemical testing (FIT) and multitarget stool DNA testing (MT-sDNA or Cologuard). The novel tests that were assessed included those recently approved by the US Food and Drug Administration as well as a blood test that detects circulating DNA that may arise from cancers (Guardant Shield), a novel FIT-RNA test (Geneoscopy ColoSense), and a next-generation FIT-DNA blood test.&lt;/p&gt;&lt;p&gt;“Even though it is a scientific breakthrough to be able to detect signals in the blood from colorectal cancer, the detection rate for early-stage cancers and for precancerous polyps is not high with the first generation of blood tests,” says the lead author of the study, Uri Ladabaum, MD, professor of medicine and director of the Gastrointestinal Cancer Prevention Program at Stanford University School of Medicine. “That is what makes their expected benefit lower than with stool tests or colonoscopy, which lead to more prevention via removal of precancerous polyps and early detection of cancer.”&lt;/p&gt;&lt;p&gt;For example, the study found that colonoscopy and FIT yielded more than a 70% reduction in the number of colorectal cancers and more than a 75% reduction in colorectal cancer deaths in comparison with no screening (assuming a 100% participation in screening), whereas the reductions in the number of colorectal cancers and deaths with the novel blood-based test Guardant Shield were 42% and 56%, respectively.&lt;/p&gt;&lt;p&gt;Colonoscopy and stool tests also were less costly. For example, the MT-sDNA stool test (Cologuard) cost $6300 per quality-adjusted life-year (QALY) gained versus no screening compared to $89,600 per QALY gained with the Guardant Shield versus no screening.&lt;/p&gt;&lt;p&gt;Investigators used computerized modeling based on all available information on current and novel blood-based screening tests to make projections about the number of colorectal cancer cases and deaths that could be expected with various screening strategies over time.&lt;/p&gt;&lt;p&gt;Dr Ladabaum says that a key motivation for conducting the analysis was to assess what might happen if blood-based tests increase screening and if they are used instead of colonoscopy or stool-based tests.&lt;/p&gt;&lt;p&gt;To address these questions, he and his colleagues played out several plausible scenarios to provide long-term outcome estimates of colorectal cancer incidence and de","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533515","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":"Utilization, health care expenditures, and patient costs of definitive treatment modalities for localized prostate cancer in the United States","authors":"Nikhil T. Sebastian MD,&nbsp;Dattatraya Patil MBBS, MPH,&nbsp;Pretesh R. Patel MD,&nbsp;Ashesh B. Jani MD,&nbsp;Bruce W. Hershatter MD,&nbsp;Vishal R. Dhere MD,&nbsp;Karen D. Godette MD,&nbsp;C. Adam Lorentz MD,&nbsp;Aaron D. Weiss MD,&nbsp;Shreyas S. Joshi MD,&nbsp;Martin G. Sanda MD,&nbsp;Sagar A. Patel MD","doi":"10.1002/cncr.35795","DOIUrl":"https://doi.org/10.1002/cncr.35795","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radical prostatectomy (RP) and radiotherapy (RT) are standard-of-care treatments for localized prostate cancer. The authors studied the utilization and total health care and patient-incurred costs of RP and RT in the United States using the Merative MarketScan Medicare (Medicare Supplemental and Coordination of Benefits [MDCR]) and Commercial (Commercial Claims and Encounters [CCAE]) databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Men were identified who had nonmetastatic prostate cancer treated with RP, external-beam RT (EBRT), brachytherapy (BT), EBRT combined with BT (EBRT + BT), stereotactic body RT (SBRT), or proton-beam therapy (PBT) between 2009 and 2022. Year-to-year treatment utilization was compared using the Kendall Tau-b test. Mean total health care and patient out-of-pocket costs within 12 months of treatment were compared using the Kruskal–Wallis test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the MDCR database, 44,937 patients were identified who received treatment with RP (<i>n</i> = 12,879), EBRT (<i>n</i> = 26,193), BT (<i>n</i> = 926), EBRT + BT (<i>n</i> = 4706), PBT (<i>n</i> = 57), or SBRT (<i>n</i> = 176). Between 2009 and 2021, EBRT use increased from 52.5% to 62.2% (<i>p</i> for trend &lt; .001), SBRT increased from 0.4% to 0.5% (<i>p</i> &lt; .001), BT decreased from 3.1% to 1.0% (<i>p</i> &lt; .001), and EBRT + BT decreased from 14.8% to 6.8% (<i>p</i> &lt; 0.001); whereas use remained similar for RP (from 29.1% to 29.4%; <i>p</i> = .82) and PBT (from 0.1% to 0.1%; <i>p</i> = .93). In the CCAE database, 75,626 patients were identified who received treatment with RP (<i>n</i> = 50,278), EBRT (<i>n</i> = 16,985), BT (<i>n</i> = 1243), EBRT + BT (<i>n</i> = 6811), PBT (<i>n</i> = 92), or SBRT (<i>n</i> = 217). EBRT use increased from 20.0% to 24.9% (<i>p</i> &lt; .001), SBRT increased from 0.1% to 0.8% (<i>p</i> &lt; .001), BT decreased from 2.5% to 0.7% (<i>p</i> &lt; .001), and EBRT + BT decreased from 10.6% to 7.4% (<i>p</i> &lt; .001); whereas use remained similar for RP (from 66.8% to 66.1%; <i>p</i> for trend = .82), and PBT (from 0.1% to 0.1%; <i>p</i> for trend = .76). In the MDCR and CCAE databases, PBT had the highest total cost, whereas BT had the lowest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Between 2009 and 2021, there was increasing use of EBRT and SBRT, whereas use of RP remained stable. Although BT was the least costly, its utilization as monotherapy and combined with EBRT declined.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554428","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":"Immune checkpoint inhibitors increase the risk of psoriasis","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35753","DOIUrl":"https://doi.org/10.1002/cncr.35753","url":null,"abstract":"&lt;p&gt;Patients with cancer treated with immune checkpoint inhibitors (ICIs) had a 2-fold increased risk of developing psoriasis, according to an observational, national cohort study conducted in Taiwan.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The results are based on a cohort of 135,230 Taiwanese patients with stage III/IV cancer who received neoplastic medications for cancer between January 2019 and June 2021; 3188 were eligible to receive ICIs, including programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-LI) inhibitors (ICI users), and 132,042 were eligible for non-ICIs (controls).&lt;/p&gt;&lt;p&gt;With an average follow-up of 18 months (or 197,107 person-years), 295 patients (0.2%) were diagnosed with psoriasis.&lt;/p&gt;&lt;p&gt;The increased risk of psoriasis among the ICI users and those treated with chemotherapy or targeted agents (non-ICI users) was 5.76 and 1.44 cases per 1000 person-years, respectively, per the as-started analysis (i.e., intention-to-treat analysis), with a hazard ratio of 3.31 (95% CI, 1.93–5.68).&lt;/p&gt;&lt;p&gt;Consistent findings were found via an on-treatment analysis, which showed 16.13 and 2.35 cases per 1000 person-years for ICI users and non-ICI users, respectively.&lt;/p&gt;&lt;p&gt;The study was conducted to clarify the risk of psoriasis in patients with cancers treated with ICIs because of the growing use of ICIs to treat cancer and frequent immune-related adverse effects often reported with their usage. Given the nonrandomized design of the study, investigators used a statistical method called inverse probability of treatment weighting to adjust for confounding in observational trials.&lt;/p&gt;&lt;p&gt;Commenting on the study, Jason Luke, MD, an associate professor of medicine at the University of Pittsburgh and UPMC Hillman Cancer Center, calls the findings somewhat new but not especially surprising or novel considering the long-standing recognition of a link between anti–PD-1 agents and dermatologic issues, particularly in patients with melanoma.&lt;/p&gt;&lt;p&gt;He notes that people are increasingly recognizing the potential long-term toxicities associated with anti–PD-1 agents, such as chronic fatigue and now psoriasis. “Monitoring for these and early intervention are therefore important to maximize quality of life,” he says. “This being said, access to these medicines should not be limited for patients given they have the potential for long-term disease control of metastatic disease.”&lt;/p&gt;&lt;p&gt;Citing the well-established association between various human leukocyte antigen haplotypes and rheumatologic diseases, he notes that the study did not address the association between ethnicity (or germline genetics) and immunotherapy-related dermatologic toxicity. Dr Luke also notes that the generalizability of the results is not clear because of the different genetic background of people in Taiwan with respect to, for example, people in the United States or those with a predominantly Caucasian heritage. “The ability to apply these data directly in the USA may be unclear,” h","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533514","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":"More evidence on benefits of HIPEC for recurrent ovarian cancer","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35754","DOIUrl":"https://doi.org/10.1002/cncr.35754","url":null,"abstract":"<p>The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery significantly improved overall survival in comparison with cytoreductive surgery alone in platinum-sensitive patients with recurrent ovarian cancer, according to evidence from a randomized trial conducted by UNICANCER/CHIPOR investigators.<span>¹</span></p><p>This is the first prospective, randomized evidence showing an improved survival benefit with the addition of HIPEC in patients undergoing complete cytoreductive surgery for their first late-relapsing ovarian cancer, say the authors led by Jean-Marc Classe, MD, PhD, surgeon and professor of oncology at the Institut de Cancérologie de l’Ouest.</p><p>The study found a nearly 10-month improvement in overall survival with the addition of HIPEC (cisplatin [75 mg/m²] in serum [2 L/m²] at 41 ±1°C for 60 min) to complete cytoreductive surgery. At a median follow-up of 6.2 years, patients treated with HIPEC plus cytoreductive surgery had a median overall survival of 54.3 months versus 45.8 months for those treated with cytoreductive surgery alone.</p><p>The results are based on 415 patients randomized to cytoreductive surgery alone (<i>n</i> = 208) or with HIPEC (<i>n</i> = 207) for first relapse of epithelial ovarian cancer. All patients had completed at least 6 months of platinum-based chemotherapy. The authors note that the trial population was highly chemosensitive, with approximately one half having a platinum-free interval of more than 19 months, most (three quarters) having a high-grade serous histology, and one quarter having the BRCA mutation.</p><p>“When treating patients with late first relapse of serous or high-grade serous or high-grade endometrioid ovarian cancer amenable to complete cytoreductive surgery at specialist centers, platinum-based HIPEC should be considered to extend overall survival,” state the authors.</p><p>Elise Kohn, MD, head of Gynecologic Cancer Therapeutics in the Cancer Therapy Evaluation Program at the National Cancer Institute, says, “I am not convinced about HIPEC and do not support it because there are so many biases in the trials, and it is difficult to dissect them.”</p><p>For example, she questions why HIPEC is effective. Could it be the heat? The intraperitoneal (location of) chemotherapy? “These trials never control for all variables,” she says.</p><p>“I think that oncologists should remain skeptical and only use HIPEC in the setting of a trial or only when being very transparent with a patient about what the evidence shows, that the patients involved had a very good prognosis altogether, and other issues such as toxicity,” Dr Kohn says.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533513","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":"Adjuvant chemotherapy in localized, resectable extremity and truncal soft tissue sarcoma and survival outcomes – A systematic review and meta-analysis of randomized controlled trials","authors":"Megan H. Goh BS,&nbsp;Marcos R. Gonzalez MD,&nbsp;Hillary M. Heiling PhD,&nbsp;Emanuele Mazzola PhD,&nbsp;Joseph J. Connolly BS,&nbsp;Edwin Choy MD PhD,&nbsp;Gregory M. Cote MD PhD,&nbsp;Dimitrios Spentzos MD MMSc,&nbsp;Santiago A. Lozano-Calderon MD PhD","doi":"10.1002/cncr.35792","DOIUrl":"https://doi.org/10.1002/cncr.35792","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The role of adjuvant chemotherapy in localized, resectable soft tissue sarcomas (STSs) remains controversial. Despite positive findings reported in previous meta-analyses, the majority of randomized controlled trials (RCTs) fail to show a meaningful benefit. We conducted an updated meta-analysis to reassess the role of adjuvant chemotherapy in treating localized, resectable STSs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review was conducted to identify RCTs that compared local therapy (surgery with or without radiotherapy) to local therapy with adjuvant chemotherapy. Articles were independently reviewed, and risk of bias was assessed by two authors. The outcomes assessed were overall survival (OS) and disease-free survival (DFS). The meta-analysis was performed using a random effects model (to account for possible heterogeneity across studies) for survival endpoints with the inverse-variance method, in which each study is weighted with the inverse of the variance of its effect estimate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 19 RCTs comprising 2128 patients were included. Our study found that adjuvant chemotherapy improved OS (hazard ratio [HR], 0.80; <i>p</i> = .002) and DFS (HR, 0.78; <i>p</i> = .002). Doxorubicin-based monotherapy significantly improved OS (HR, 0.80; <i>p</i> = .01) and DFS (HR, 0.74; <i>p</i> = .0003), whereas doxorubicin-ifosfamide combined therapy did not significantly improve OS (HR, 0.78; <i>p</i> = .078) or DFS (HR, 0.94; <i>p</i> = .770). Doxorubicin-based ifosfamide combined therapy had moderate heterogeneity across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study partially supports the benefit of adjuvant chemotherapy in the treatment of localized, resectable STSs. Nevertheless, because of the heterogeneity of STSs, the benefit and the risks of treatment with adjuvant chemotherapy need to be evaluated on an individual benefit–risk basis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527711","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":"Cervical cancer stigma – A silent barrier to the elimination of cervical cancer","authors":"Hyo Sook Bae PhD, MD, MH,&nbsp;Sarah M. Temkin MD","doi":"10.1002/cncr.35776","DOIUrl":"https://doi.org/10.1002/cncr.35776","url":null,"abstract":"&lt;p&gt;Despite being a preventable disease, cervical cancer continues to be a leading cause of death among women globally. In 2022, there were an estimated 660,000 new cases and 350,000 deaths globally.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Women living with social inequities, particularly those residing in low- and middle-income countries, face the highest burdens of disease.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; In May 2018, the World Health Organization (WHO) Director General announced a global call for action to eliminate cervical cancer, urging nations to target and maintain an incidence rate below 4 per 100,000 women. To achieve this goal, strategic targets were established under the “90-70-90” framework: vaccination (90% of girls fully vaccinated with the human papillomavirus [HPV] vaccine by the age of 15 years), screening (70% of women screened using a high-performance test by the age of 35 years, and again by the age of 45 years), and treatment (90% of women with precancer treated and 90% of women with invasive cancer managed).&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; These objectives rest on the estimate that if each country met the 90-70-90 targets by 2030, cervical cancer could be eliminated within the next century.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Stigma, a powerful social process involving negative labeling and stereotyping of certain human characteristics as socially undesirable, remains a significant but often overlooked barrier to cervical cancer prevention efforts.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Although the understanding that the HPV infection acquired through sexual contact was the cause of cervical cancer was a major scientific breakthrough, this discovery also linked stigma surrounding the female reproductive tract, sexual contact, and promiscuity to cancer prevention efforts.&lt;span&gt;&lt;sup&gt;7-10&lt;/sup&gt;&lt;/span&gt; Cancer stigma is being increasingly recognized as an issue to be addressed in global cancer control efforts.&lt;span&gt;&lt;sup&gt;10, 11&lt;/sup&gt;&lt;/span&gt; Addressing challenges specific to cervical cancer stigma can potentially provide an opportunity to enhance cancer control efforts.&lt;/p&gt;&lt;p&gt;The origins of the word stigma can be traced to the classical Greek, where the term was used to describe the branding of outcast groups as a permanent mark of their status. Stigma lowers an individual’s status in society by differentiating those who are viewed to be normal from those who are different. This process results in social inequality, marking the boundaries that define outsiders, and labeling “us” versus “them.”&lt;span&gt;&lt;sup&gt;6, 12-14&lt;/sup&gt;&lt;/span&gt; Cultural, social norms drive and facilitate the resultant power dynamics that include isolation, status loss, and discrimination.&lt;span&gt;&lt;sup&gt;6, 15, 16&lt;/sup&gt;&lt;/span&gt; As a harmful influence on behavior, stigma serves to reinforce inequities by impeding access to health care resources.&lt;span&gt;&lt;sup&gt;17&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Cancer stigma can be conceptualized using an eco-social multilevel framework, categorizing the manifestations on individual, interpersonal, comm","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35776","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513748","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":"Impact of race/ethnicity on MammaPrint genomic assay risk and prognosis in early breast cancer: A National Cancer Data Base analysis","authors":"Rima B. Patel MD,&nbsp;Tianxiang Sheng MSc,&nbsp;Marcio A. Diniz PhD,&nbsp;Joseph A. Sparano MD,&nbsp;Amy Tiersten MD","doi":"10.1002/cncr.35771","DOIUrl":"https://doi.org/10.1002/cncr.35771","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Black race is associated with poorer prognosis in hormone receptor (HR)–positive, HER2-negative early breast cancer (EBC). The impact of race/ethnicity on the risk distribution and prognostic information provided by the 70-gene MammaPrint assay was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women with HR-positive EBC with tumors up to 5 cm in size and zero to three involved lymph nodes, who were diagnosed between 2009 and 2018, and who had an available MammaPrint result were identified in the National Cancer Data Base (NCDB). <i>t</i>-tests and χ² tests were used to compare patient characteristics, whereas log-rank tests assessed differences in overall survival (OS) between racial/ethnic subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 6137 women included, 82.8% (<i>n</i> = 5084) were non-Hispanic White, 8.9% (<i>n</i> = 545) were non-Hispanic Black (NHB), 4.8% (<i>n</i> = 292) were Hispanic, and the remainder were other/unknown (<i>n</i> = 216). Of these women, 58.4% (<i>n</i> = 3587) were MammaPrint low risk and 41.6% (<i>n</i> = 2550) were MammaPrint high risk. NHB and Hispanic women were more likely to have a high-risk MammaPrint result (<i>p</i> &lt; .001) than other racial/ethnic subgroups. Five-year OS was worse for the MammaPrint high-risk versus low-risk group (92.6% vs. 96.6%; <i>p</i> &lt; .0001). There were no significant differences in OS on the basis of race/ethnicity in the MammaPrint low-risk (<i>p</i> = .34) or high-risk (<i>p</i> = .79) subgroups. However, Black race did not affect mortality in the overall population (hazard ratio, 1.15; 95% confidence interval, 0.84–1.58).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NHB and Hispanic women were more likely to have high-risk MammaPrint results in this NCDB cohort. Although there were no differences in survival by race/ethnicity in the MammaPrint low- and high-risk groups, these findings are limited by the lack of association between race/ethnicity and mortality in the overall population when adjusting for other clinicopathologic prognostic covariates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513486","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}