Cancer最新文献

{"title":"The impact of opioid use associated with curative-intent cancer surgery on safe opioid prescribing practice among veterans: An observational study","authors":"Marilyn M. Schapira MD, MPH,&nbsp;Sumedha Chhatre PhD,&nbsp;Patience M. Dow PhD,&nbsp;Charles E. Leonard PharmD, MSCE,&nbsp;Peter Groeneveld MD,&nbsp;Jason M. Prigge BS,&nbsp;Christopher Roberts MA,&nbsp;Zachary F. Meisel MD,&nbsp;Ravi B. Parikh MD,&nbsp;Ravishankar Jayadevappa PhD,&nbsp;Emily C. Paulson MD,&nbsp;Robert S. Krouse MD,&nbsp;Katie J. Suda PharmD, MS, FCCP,&nbsp;Pallavi Kumar MD, MPH,&nbsp;Visala Muluk MD,&nbsp;Rebecca A. Hubbard PhD","doi":"10.1002/cncr.70009","DOIUrl":"10.1002/cncr.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Opioid exposure during cancer therapy may increase long-term unsafe opioid prescribing. This study sought to determine the rates of coprescription of benzodiazepine and opioid medications and new persistent opioid use after surgical treatment of early-stage cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted among a US veteran population via the Veterans Affairs Corporate Data Warehouse database. Participants were opioid-naive persons aged ≥21 years with a new diagnosis of stage 0–III cancer between January 1, 2015, and December 31, 2016. Outcomes were days of coprescription of benzodiazepines and opioids in the 13 months posttreatment and new persistent opioid use. The exposure was total morphine milligram equivalents (MMEs) attributed to treatment and prescribed from 30 days before through 14 days after the index surgical procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 9213 veterans, coprescription of benzodiazepines and opioids occurred in 366 patients (4.0%) and new persistent opioid use in 981 patients (10.6%). In a linear model adjusting for patient, clinical, and geographic factors, persons in the highest quartile compared to no opioid exposure had increased days with coprescription of benzodiazepines and opioids (mean difference, 1.0; 95% CI, 0.3–1.7). In a discrete time survival analysis, persons in the highest quartile of MME exposure compared to none had a greater risk of new persistent opioid use (hazard ratio, 1.6; 95% CI, 1.3–1.9).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>More than one of 10 opioid-naive veterans undergoing curative-intent surgical treatment for cancer developed new persistent opioid use. Optimizing cancer treatment pain management strategies to mitigate long-term opioid-related health risks is crucial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008003","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 utility of artificial intelligence in gastrointestinal oncology: A systematic review of randomized controlled trials","authors":"Luke E. Sorensen MD,&nbsp;Vanessa A. Moore BS,&nbsp;Jared L. Gregston BS,&nbsp;Joseph D. Spear BS, MBA,&nbsp;C. Asa Candler BS,&nbsp;Bibi Maryam MD,&nbsp;Shari Clifton MLIS, AHIP,&nbsp;Katie Keyser BS,&nbsp;Anh B. Lam DO, MBA,&nbsp;Ryan D. Nipp MD, MPH","doi":"10.1002/cncr.70043","DOIUrl":"10.1002/cncr.70043","url":null,"abstract":"<p>In the field of gastrointestinal oncology, the development of novel artificial intelligence (AI) processes may help with multiple aspects of cancer care delivery. However, a comprehensive understanding of the current utility of AI in gastrointestinal oncology is lacking. The authors conducted searches in the following databases: MEDLINE (Ovid), Embase (Ovid), and CINAHL (Cumulative Index of Nursing and Allied Health) Ultimate (EBSCO). The analysis focused on publication trends and outcomes of randomized controlled trials (RCTs) that used AI to manage gastrointestinal malignancies. From our initial search retrieval of 3730 studies, 27 RCTs (with a total of 29,895 patients) were identified that met inclusion criteria. The first RCT was published in 2019, followed by five in 2020, four in 2021, six in 2022, and 11 in 2023. Colorectal malignancies comprised the majority of the literature (23 of 27 studies; 85%), with other studies focused on gastric cancer (three of 27 studies; 11%) and hepatocellular carcinoma (one of 27 studies; 4%). Of the included RCTs, 25 (93%) had a primary outcome focused on lesion/cancer detection throughout the gastrointestinal tract using endoscopy or ultrasound, with others focused on algorithmic-based AI assistance with postoperative pain management or histologic diagnosis. Overall, 22 of 27 studies (81%) met their primary end point with a statistically significant result. In this systematic review, the authors observed a recent increase in the number of RCTs focused on AI within the field of gastrointestinal oncology and identified specific areas in which AI is being used. Findings from this work should help to inform further investigations to develop and test innovative AI uses, enhance care delivery, and improve patient outcomes.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005583","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":"Preoperative intensity-modulated radiation therapy in lower extremity soft tissue sarcomas with and without dose avoidance of uninvolved skin/subcutaneous tissue","authors":"Siyer Roohani MD,&nbsp;Anthony M. Griffin MSc,&nbsp;Zhihui Amy Liu PhD,&nbsp;Charles N. Catton MD,&nbsp;Colleen I. Dickie MSc,&nbsp;Peter C. Ferguson MD,&nbsp;David G. Kirsch MD, PhD,&nbsp;Brian O’Sullivan MD,&nbsp;David B. Shultz MD, PhD,&nbsp;Kim M. Tsoi MD, PhD,&nbsp;Philip Wong MD, MSc,&nbsp;Jay S. Wunder MD,&nbsp;Peter W. M. Chung MD","doi":"10.1002/cncr.70049","DOIUrl":"10.1002/cncr.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study was to evaluate whether dosimetric sparing of uninvolved normal tissues, including skin/subcutaneous <i>flaps</i>, affects acute and late toxicities in preoperative image-guided intensity-modulated radiation therapy (IG-IMRT) for lower extremity soft tissue sarcomas (LE-STS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with LE-STS from a phase 2 preoperative IG-IMRT trial (flap-sparing-IMRT, 2005–2009) and a prospectively maintained institutional database (standard-IMRT, 2005–2020) were propensity matched by age, sex, tumor size, grade, location, wound closure, and interval from IG-IMRT to surgery; all received 50 Gy in 25 fractions preoperatively. The primary outcome was major wound complication (MWC). Secondary outcomes were late Radiation Therapy Oncology Group toxicities, functional scores (Toronto Extremity Salvage Score [TESS]; Musculoskeletal Tumor Society scales [MSTS-87 or MSTS-93]), and oncologic outcomes. Kaplan–Meier estimates, cumulative incidence functions, and linear, logistic, and Cox regression were used, as appropriate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-five patients who received flap-sparing-IMRT were 1:5 matched to 275 patients who received standard-IMRT (median follow-up, 104 vs. 56 months, respectively). Regression analyses identified no significant association between treatment technique and MWCs (29% vs. 27%; odds ratio, 0.92; <i>p</i> = .77), late grade 2 or greater toxicities: subcutaneous fibrosis (15% vs. 8%), joint stiffness (5% vs. 2%), edema (11% vs. 10%), fracture (2% vs. 4%), or functional outcomes (TESS, 87 vs. 89; MSTS-87, 33 vs. 33; and MSTS-93, 93 vs. 97; all <i>p</i> &gt; .1). Five-year overall survival (83.6% vs. 75.2%), disease-free survival (65.5% vs. 64.1%), local recurrence (5.2% vs. 7.3%), distant metastasis (29.1% vs. 30.1%) were also comparable (<i>p</i> &gt; .1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Flap-sparing-IMRT with specific avoidance of uninvolved skin/subcutaneous tissues demonstrated minimal differences in MWCs, late toxicity, and functional and oncologic outcomes compared with standard-IMRT in patients with LE-STS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998745","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":"Clinical and biological factors associated with response to immune checkpoint inhibitors in advanced sarcomas: IMPRESARC, a French retrospective multicenter cohort study","authors":"Mina Fazel MD,&nbsp;Romain Varnier MD,&nbsp;Hélène Vanacker MD, PhD,&nbsp;Nicolas Penel MD, PhD,&nbsp;Sarah Watson MD, PhD,&nbsp;Benjamin Verret MD,&nbsp;Thibaud Valentin MD,&nbsp;Emmanuelle Bompas MD,&nbsp;Waisse Waissi MD, PhD,&nbsp;Alexandra Meurgey MD,&nbsp;Françoise Ducimetière PhD,&nbsp;Jean-Yves Blay MD, PhD,&nbsp;Armelle Dufresne MD, PhD,&nbsp;Mehdi Brahmi MD, PhD","doi":"10.1002/cncr.70052","DOIUrl":"10.1002/cncr.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immune checkpoint inhibitors (ICIs) in unselected sarcomas yield limited response rates and tumor control. Long-term responders have however been reported, suggesting a critical challenge in refining patient selection, by identifying reliable predictive factors for response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors conducted a multicenter, retrospective study of patients with advanced sarcomas treated with ICIs in six French reference sarcoma centers. The study assessed efficacy and safety, as well as clinical and biological variables associated with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 272 patients were included in the analysis. The ORR was 17%, with 16% partial responses and 1% complete responses. Stable disease (SD) occurred in 33% of patients, resulting in a disease control rate of 49%. Median PFS was 2.7 months (95% confidence interval [CI], 2.5–3.4), with 28% of patients showing PFS &gt;6 months and 13% with PFS &gt;12 months. Median OS was 13.5 months (95% CI, 11.0–17.3). The safety profile was consistent with that of clinical trials, with 5% of patients experiencing grade ≥3 adverse events and 10% discontinuing treatment due to toxicity. Poorer outcomes were associated with high Eastern Cooperative Oncology Group performance status (≥1), cyclophosphamide coadministration, and high derived neutrophil-to-lymphocyte ratio. Anti-programmed death-ligand 1 (PD-L1) therapies were associated with shorter OS compared to anti–PD-1. Histotypes such as alveolar soft part sarcoma (ASPS) had better survival, whereas dedifferentiated liposarcoma had poorer outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite a short median PFS, certain histological subtypes, including ASPS, chordomas, SMARCA4-deficient tumors, gastro-intestinal stromal tumor, and <i>NF1</i> mutations, showed strong activity signals, indicating long-term responses in some patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998744","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":"Association of patient and physician characteristics with androgen-deprivation-therapy intensification in patients with de novo hormone-sensitive metastatic prostate cancer: A population-based study","authors":"David-Dan Nguyen MDCM MPH,&nbsp;Raj Satkunasivam MD MS,&nbsp;Khatereh Aminoltejari MD MSc,&nbsp;Amanda Hird MD MSc,&nbsp;Soumyajit Roy MD,&nbsp;Scott C. Morgan MD MSc,&nbsp;Shawn Malone MD,&nbsp;Michael Ong MD,&nbsp;Di Maria Jiang MD,&nbsp;Geoffrey T. Gotto MD MPH,&nbsp;Bobby Shayegan MD,&nbsp;Girish S. Kulkarni MD PhD,&nbsp;Rodney H. Breau MD MSc,&nbsp;Aly-Khan A. Lalani MD,&nbsp;Christopher J. D. Wallis MD PhD","doi":"10.1002/cncr.70070","DOIUrl":"10.1002/cncr.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Treatment intensification with androgen receptor signaling inhibitors and/or chemotherapy is guideline recommended for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC). However, most patients only receive androgen deprivation therapy monotherapy. The aim was to identify physician-, patient-, and tumor-related factors associated with the receipt of treatment intensification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A population-based cohort study was conducted in Ontario, Canada, which included men ≥66 years newly diagnosed with de novo mHSPC between January 2014 and December 2022. Hierarchical regression modeling was used to examine the association of physician, patient, and tumor characteristics with the receipt of treatment intensification, defined as the initiation of an androgen receptor signaling inhibitor, docetaxel, or both within six months of diagnosis. Darlington’s method was used to assess predictor importance via standardized regression coefficients (SRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 6099 eligible older men newly diagnosed with de novo mHSPC, 1475 (24.2%) received treatment intensification. In multivariable modeling, patients initiated on androgen deprivation therapy by radiation oncologists were less likely to receive treatment intensification (odds ratio [OR]. 0.48; 95% CI, 0.37–0.61; <i>p</i> &lt; .01; SRC: 19.46; <i>p</i> &lt; .01) whereas those by medical oncologists were more likely to receive treatment intensification (OR, 1.64; 95% CI, 1.21–2.22; <i>p</i> &lt; .01; SRC: 9.56; <i>p</i> &lt; .01), each compared to urologists. Older patients were significantly less likely to receive treatment intensification (OR 0.94 per year over age 66; 95% CI, 0.93–0.95; <i>p</i> &lt; .01; SRC: –36.21; <i>p</i> &lt; .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patient and physician characteristics significantly influence variation in the use of treatment intensification for de novo mHSPC. These findings inform targeted interventions and policies to enhance the delivery of life-prolonging mHSPC care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 18","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990787","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 quality of patient decision aids for lung cancer screening: Results from an environmental scan","authors":"Robert J. Volk PhD,&nbsp;Jessica S. Lettieri MPH,&nbsp;Viola B. Leal MPH,&nbsp;Gabrielle F. Duhon MPH, CHES,&nbsp;Kristin G. Maki PhD,&nbsp;M. Priscila Bernal Brietzke PhD,&nbsp;Naomi Q. P. Tan PhD,&nbsp;Elisa E. Douglas PhD, MSPH,&nbsp;Sarah Coles MD,&nbsp;Mark H. Ebell MD, MS,&nbsp;Maria C. Mejia MD, MPH,&nbsp;Ella A. Kazerooni MD, MS,&nbsp;Lauren Rosenthal MPH,&nbsp;Robert A. Smith PhD","doi":"10.1002/cncr.70008","DOIUrl":"10.1002/cncr.70008","url":null,"abstract":"<p>Shared decision making is recommended for lung cancer screening (LCS) by professional organizations and payers. Patient decision aids can be used to support shared decision making, but they need to meet quality standards to minimize the potential for biased and poorly informed patient decisions. After the updated LCS recommendation from the US Preventive Services Task Force in 2021, the authors conducted an environmental scan of public-facing patient educational materials and evaluated them against criteria from the International Patient Decision Aid Standards for high-quality patient decision aids. The Google site search function was used to search websites from National Cancer Institute-funded cancer centers, professional societies, patient advocacy groups, cancer coalitions, and private organizations for educational materials on LCS. A general web search using Google, Google Scholar, and select databases was also conducted. Considerations unique to the LCS context (e.g., the importance of annual screening and smoking cessation) were documented. The search identified 96 educational materials that included information about both benefits and harms of LCS. Of these, 39 did not meet qualifying criteria for decision aids, with failure to explicitly identify LCS as a decision being the primary reason for exclusion. Only 10 of the remaining decision aids met quality criteria from the International Patient Decision Aid Standards. These aids emphasized that LCS should be performed annually, most avoided stigmatizing language, and several included personalization features using prediction models. Clinicians and patients can be confident in using these high-quality aids to complement the process of shared decision making for LCS. Validated aids in languages other than English and Spanish are needed.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 17","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927375","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":"Outcomes show a reduction in treatment failure associated with dose-escalated, hypofractionated radiation therapy for localized prostate cancer","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.70013","DOIUrl":"10.1002/cncr.70013","url":null,"abstract":"<p>Long-term results of a phase 3 randomized trial comparing conventionally fractionated intensity-modulated radiation therapy (CIMRT) with dose-escalated, hypofractionated intensity-modulated radiation therapy (HIMRT) in patients with localized prostate cancer found considerable improvement in treatment failure rates among patients treated with HIMRT versus CIMRT according to a study published in the <i>Journal of Clinical Oncology</i>.<span>¹</span></p><p>The findings add to the growing body of evidence supporting the use of hypofractionated IMRT and making it the current standard of care. Data from the current study show that at a median follow-up of 13.2 years, men undergoing HIMRT had less frequent treatment failure than those undergoing CIMRT (11% vs. 21%). The result shows improvement but was not statistically significant. When the analysis was limited to patients who did not receive androgen deprivation therapy (ADT), patients treated with HIMRT showed a significant improvement in treatment failure in comparison with patients treated with CIMRT (13% vs. 26%; <i>p</i> = .039).</p><p>The study also found that long-term distant metastases were rare and occurred primarily in the intermediate-risk cohort treated with CIMRT or HIMRT (8% vs. 4%).</p><p>A total of 222 patients with localized prostate cancer were included in the trial; 206 of the patients were evaluable. Most patients had intermediate-risk disease (71%), 90% had a PSA level ≤10 ng/mL, 48% had Gleason grade 2 disease, and 24% received ADT. Patients were randomized to CIMRT (<i>n</i> = 102) or HIMRT (<i>n</i> = 104). Patients treated with CIMRT received 75.6 Gy in 42 fractions (1.8 Cy per fraction) over 8.4 weeks. Patients treated with HIMRT received 72 Gy in 30 fractions (2.4 Gy per fraction) over 6 weeks.</p><p>The results build on an initial assessment of the trial at a median follow-up of 9.5 months that showed 8-year failure rates of 10.7% with HIMRT and 15.4% with CIMRT.<span>²</span> Similar to the initial results, the long-term results showed no statistically significant difference between HIMRT and CIMRT in grade 2 or higher late gastrointestinal adverse effects (10% vs. 4% at 10 years, <i>p</i> = .09) or grade 2 or higher genitourinary adverse effects (26% vs. 23% at 10 years, <i>p</i> = .5).</p><p>“These data represent one of the largest follow-ups published so far for hypofractionated regimens and provide the most robust long-term data on the safety and tolerability of hypofractionated regimens in prostate cancer, while potentially indicating that dose-escalated, shorter courses of radiation for prostate cancer may provide higher efficacy than traditional, conventionally fractionated radiation,” says the lead author of the study, Comron Hassanzadeh, MD, MPH, an assistant professor of genitourinary radiation oncology at The University of Texas MD Anderson Cancer Center.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 17","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923731","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":"Optimizing treatment for platinum-resistant ovarian clear cell carcinoma: Efficacy of gemcitabine and combination therapy with bevacizumab","authors":"Yasunori Yoshino MD,&nbsp;Akiko Furusawa MD, PhD,&nbsp;Katsuhiko Nara PharmD,&nbsp;Ayumi Taguchi MD, PhD,&nbsp;Masako Ikemura MD, PhD,&nbsp;Hideo Arai MD, PhD,&nbsp;Tsubasa Hiraki MD, PhD,&nbsp;Aya Ishizaka MD,&nbsp;Saki Tsuchimochi MD, PhD,&nbsp;Harunori Honjoh MD, PhD,&nbsp;Naoyuki Miyasaka MD, PhD,&nbsp;Yasuyuki Hirashima MD, PhD,&nbsp;Kenbun Sone MD, PhD,&nbsp;Nao Kino MD, PhD","doi":"10.1002/cncr.70071","DOIUrl":"10.1002/cncr.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Platinum-resistant (PR) ovarian clear cell carcinoma (OCCC) is highly resistant to chemotherapy and has a poor prognosis. Both in-vitro and clinical studies have suggested that gemcitabine (GEM) is particularly effective against OCCC. Moreover, a combination with bevacizumab (Bev) is expected to enhance the efficacy of chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To clarify these effects, the authors conducted a multicenter, retrospective cohort study of 130 patients who received treatment single-agent chemotherapy, with or without Bev, for PR-OCCC. The effects of loss of AT-rich interaction domain 1A (ARID1A) protein expression also were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients who received GEM as their first regimen achieved better overall survival (OS) than those who received other agents (median OS, 15.2 vs. 11.0 months; hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.41–0.96; <i>p</i> = .032). Bev combination therapies demonstrated a significantly improved time to treatment failure compared with chemotherapy alone (6.6 vs. 2.7 months; HR, 0.61; 95% CI, 0.41–0.87; <i>p</i> = .009) and showed a trend toward longer OS (23.3 vs. 9.8 months; HR, 0.62; 95% CI, 0.34–1.05; <i>p</i> = .085). ARID1A status did not affect OS in the overall group or in the group that received GEM as the first-line regimen (<i>p</i> = .41 and <i>p</i> = .31, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Collectively, the current findings suggest that GEM, particularly as a first-line treatment, may improve the prognosis of patients with PR-OCCC. Moreover, Bev combination therapy is a promising option for treating PR-OCCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 17","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920564","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":"NCCN guidelines focus on treatment options for patients with multiple myeloma","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.70014","DOIUrl":"10.1002/cncr.70014","url":null,"abstract":"&lt;p&gt;The National Comprehensive Cancer Network (NCCN) recently published significant updates specific to treatment options for patients with newly diagnosed multiple myeloma (MM) who are eligible or ineligible for hematopoietic cell transplantation (HCT), recommendations for maintenance therapy, and treatment options for previously treated MM.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Based on the most recent clinical evidence, the recommendations are meant to serve as guidelines, and clinicians are encouraged to use their best judgment when applying the recommendations in the context of individual clinical circumstances.&lt;/p&gt;&lt;p&gt;Ajay K. Nooka, MD, MPH, associate director of clinical research at the Winship Cancer Institute at Emory University in Atlanta, Georgia, points to several new updates for oncologists.&lt;/p&gt;&lt;p&gt;Patients who do not meet the criteria for high risk are considered to be at standard risk.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;New updates for the diagnostic workup of MM include renal biopsy for albuminuria or abnormal renal function and the addition of next-generation sequencing for &lt;i&gt;TP53&lt;/i&gt; mutation assessment. The updates also include a revised recommendation for baseline clonotype identification at diagnosis and for the storage of an aspirate sample for future clonotype identification to enable minimal residual disease testing through next-generation sequencing.&lt;/p&gt;&lt;p&gt;The update added daratumumab as a high-risk treatment option based on evidence from the phase 3 AQUILA trial showing that patients treated with subcutaneous daratumumab had a significantly lower risk of progression to active MM.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The updated recommendations call for the addition of central nervous system disease management, including multimodality therapy, radiation, intrathecal chemotherapy, and systemic chemotherapy, and novel agents such as chimeric antigen receptor (CAR) T-cell therapy.&lt;/p&gt;&lt;p&gt;For primary therapy in patients who are candidates for HCT, the update recommends the quadruple regimen of isatuximab-irfc, bortezomib, lenalidomide, and dexamethasone (Isa-VRd).&lt;/p&gt;&lt;p&gt;For primary therapy in patients for whom HCT is deferred or who are not candidates for HCT, the update recommends either daratumumab, bortezomib, lenalidomide, and dexamethasone or Isa-VRd for patients who are &lt;80 years old and are not frail. Dr Nooka emphasizes that all the treatment recommendations are based on the strongest (category 1) evidence.&lt;/p&gt;&lt;p&gt;The recommendations provide guidance on the treatment of patients in certain circumstances. Patients can receive more than one B-cell maturation antigen (BCMA)–targeted therapy, although the optimal sequencing of sequential BCMA-targeted therapies is not known. Dr Nooka emphasizes, however, that accumulated data suggest that immediately following with the second BCMA-directed therapy after relapse may be associated with lower response rates.&lt;/p&gt;&lt;p&gt;Other circumstances include the use of belantamab mafodotin-blmf (as available ","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 17","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923732","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":"Mutational landscape and tyrosine kinase inhibitor sensitivity in EGFR L833 and H835 mutated non–small cell lung cancer","authors":"Long Huang MD,&nbsp;Fanxu Zeng MD,&nbsp;Peng Huang MD,&nbsp;Dou Ren MD,&nbsp;Zhiqi Liu MD,&nbsp;Hanlin Chen MSc,&nbsp;Xiaoying Wu MSc,&nbsp;Jiaohui Pang MSc,&nbsp;Qiuxiang Ou PhD,&nbsp;Xiaotian Zhao MSc,&nbsp;Hua Bao PhD,&nbsp;Chengchuan Jiang MD,&nbsp;Nong Yang PhD","doi":"10.1002/cncr.70063","DOIUrl":"10.1002/cncr.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Non–small cell lung cancer (NSCLC) patients with <i>EGFR</i> L833 and H835 mutations show potentially satisfying responses to EGFR tyrosine kinase inhibitors (TKI); however, investigations on their molecular and clinical characteristics are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>DNA sequencing data from 240 NSCLC patients with <i>EGFR</i> L833 and H835 mutations were analyzed, including 57 with EGFR-TKI treatment records. An external cohort of 346 <i>EGFR</i> L858R-mutated NSCLC patients was also evaluated for comparative molecular landscape analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the study cohort, 98.3% of patients with <i>EGFR</i> L833 mutations and 100% with <i>EGFR</i> H835 mutations had concurrent <i>EGFR</i> mutations. A total of 97.5% of patients (78 of 80) with <i>EGFR</i> H835L mutations had concurrent L833V mutations, whereas the most frequent comutations of <i>EGFR</i> L833V were L858R (44.1%) and H835L (37.0%). Compared to <i>EGFR</i> L858R patients in the external cohort, those with <i>EGFR</i> L833V+H835L and L833V+L858R mutations had less frequent <i>LRP1B</i>, <i>RB1</i>, <i>TP53</i> mutations, <i>CD4K</i> amplifications, and mutations in the RTK-RAS and cell-cycle signaling pathways. Tumor mutational burden, chromosomal instability, and whole-genome duplication rates were lower in these patients compared to those with classical <i>EGFR</i> L858R. Notably, patients with <i>EGFR</i> L833 and H835 mutations achieved a median progression-free survival (PFS) of 16.4 months, similar to patients with classical <i>EGFR</i> mutations. PFS was comparable across mutation subtypes and different generations of EGFR-TKIs received.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the unique molecular characteristics of NSCLC patients with <i>EGFR</i> L833 and H835 mutations and confirms their sensitivity to all generations of EGFR-TKIs, with PFS comparable to L858R, providing real-world evidence for clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 17","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920565","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}