Cancer最新文献

{"title":"Use and expenditure of mental health service and psychotropic medication by race and ethnicity among cancer survivors with serious psychological distress","authors":"Hyunjung Lee PhD,&nbsp;So-Yeon Kang PhD, MBA,&nbsp;Alexandre Chan PharmD, PhD, MPH,&nbsp;Zhiyuan Zheng PhD,&nbsp;Ahmedin Jemal DVM, PhD,&nbsp;Farhad Islami MD, PhD","doi":"10.1002/cncr.70328","DOIUrl":"10.1002/cncr.70328","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Access to mental health care is critical to improving cancer survivors’ quality of life; however, evidence on mental health care use among cancer survivors is limited, particularly by race and ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>By using 2012–2021 Medical Expenditure Panel Survey data, this study examined racial and ethnic disparities in mental health care visits, expenditures, prescription pattern, and medication use, adjusted for multiple individual socioeconomic factors and health status among cancer survivors with serious psychological distress (SPD; Kessler Psychological Distress Scale score, ≥13).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of cancer survivors with SPD (<i>N</i> = 1132), only 28% had mental health care visits. The number of counseling visits in non-Hispanic Black (NHB) survivors (−1.74 visits; 95% CI, −2.70 to −0.79 visits) and psychiatrist visits in non-Hispanic other (NHO) survivors (−1.21 visits; 95% CI, −1.91 to −0.52 visits) was lower compared with non-Hispanic White (NHW) survivors. NHB survivors spent less on mental health visits than NHW survivors (total annual expenditure: −$226; 95% CI, −$384 to −$68; out-of-pocket expenditure: −$75; 95% CI, −$110 to −$40). Although psychotropic medications were more likely to be prescribed to NHB than NHW survivors by 22.2 percentage points (95% CI, 9.2 to 35.2 percentage points), NHB survivors were less likely to use antidepressants (−15.1 percentage points; 95% CI, −24.9 to −5.4 percentage points) and anxiolytics (−12.7 percentage points; 95% CI, −20.0 to −5.4 percentage points). Psychotropic medication prescription was similar between NHW and other racial and ethnic groups but Hispanic survivors were less likely to use antidepressants (−9.6 percentage points; 95% CI, −18.7 to −0.5 percentage points) and NHO survivors were less likely to use anxiolytics (−15.0 percentage points; 95% CI, −24.8 to −5.3 percentage points).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Racial and ethnic differences were found in office-based mental health care professional visits, related expenditures, and prescription medication use among cancer survivors with SPD, which calls for equitable interventions in mental health care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 6","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429789","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":"Risks of thrombosis and hemorrhage in concurrent use of anticoagulants and potential interacting prostate cancer agents","authors":"Tzu-Fei Wang MD,&nbsp;Anna Clarke MSc,&nbsp;Mitchell Rath MSc,&nbsp;Samantha Yoo PhD,&nbsp;Deena Fremont MSc,&nbsp;Cynthia Wu MD,&nbsp;Pietro Ravani MD, PhD,&nbsp;Dominick Bossé MD,&nbsp;Robert Talarico MSc,&nbsp;Marc Carrier MD,&nbsp;Manish M. Sood MD","doi":"10.1002/cncr.70266","DOIUrl":"10.1002/cncr.70266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pharmacokinetic studies suggest that specific prostate cancer therapies may alter the metabolism of direct oral anticoagulants (DOACs), leading to elevated risks of thrombosis or bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To assess the risk of thrombosis or bleeding, population-based, retrospective, parallel analyses were conducted in Ontario and Alberta, Canada, among adults patients with prostate cancer who were prescribed a DOAC and a potentially interacting androgen receptor pathway inhibitor (including enzalutamide, apalutamide, or abiraterone) compared with non-DOACs between 2012 and 2023. Analyses were stratified based on a DOAC-inducer cohort (enzalutamide or apalutamide, which might increase the risk of thrombosis) and a DOAC-inhibitor cohort (abiraterone, which might increase the risk of bleeding). Overlap weighted Cox proportional hazard models accounting for 37 covariates were performed independently in each jurisdiction and were pooled using random-effects meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 2997 individuals were included (2107 from Ontario and 890 from Alberta). In patients who received enzalutamide or apalutamide, there was no increased risk of all thrombosis in the DOAC groups compared with the non-DOAC groups (pooled hazard ratio, 0.83; 95% confidence interval, 0.36–1.93). In patients who received abiraterone, no significant differences were observed in any bleeding events comparing the DOAC and non-DOAC groups (pooled hazard ratio, 1.16; 95% confidence interval, 0.10–13.99). The results were consistent in multiple sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The concurrent use of enzalutamide, apalutamide, or abiraterone with DOACs did not contribute to clinically meaningful changes in the risk of thrombosis or bleeding in individuals with prostate cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 6","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375478","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 impact of the patient macroenvironment on molecular subgroups in endometrial cancer","authors":"Henrica M. J. Werner MD, PhD,&nbsp;Frederiek A. H. van Dijk BSc,&nbsp;Stephanie W. Vrede MD, PhD,&nbsp;Anouk A. S. van den Bosch MD,&nbsp;Marike S. Lombaers MD,&nbsp;Jasmin Asberger MD, PhD,&nbsp;Jutta Huvila MD, PhD,&nbsp;Marc Snijders MD, PhD,&nbsp;Valeria Tubita MD, PhD,&nbsp;Gemma Mancebo Moreno MD,&nbsp;Xavier Matias-Guiu MD,&nbsp;Petra Bretová MD, PhD,&nbsp;ENITEC Consortium,&nbsp;Vit Weinberger MD,&nbsp;Johanna M. A. Pijnenborg MD","doi":"10.1002/cncr.70333","DOIUrl":"10.1002/cncr.70333","url":null,"abstract":"<p>More than half of endometrial cancer diagnoses can be attributed to obesity. A purely molecular classification in endometrial cancer hampers further understanding of the impact of patient macroenvironment as a major risk factor. The relationship between patient factors, such as age, body mass index (BMI), comorbidity, and ethnicity, and molecular subgroups was studied in a publicly available data set (<i>N</i> = 225) and two multicenter European cohorts (<i>N</i> = 223; <i>N</i> = 946). Age at diagnosis was highest in the <i>TP53</i>-mutated subgroup, and differed significantly between molecular subgroups. Patients with obesity were younger at diagnosis compared to their lean counterparts across all molecular subgroups (61.9 vs. 66.2 years; <i>p</i> &lt; .01). Survival was worst in the <i>TP53</i>-mutated subgroup but improved with increasing BMI, which resulted in nonsignificant differences from other subgroups when BMI was &gt;35. These data underscore that patient factors remain important, and their integration with molecular factors needs to be better understood to ultimately improve treatment and prevention strategies in endometrial cancer.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 6","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363542","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":"Oral TKI sevabertinib approved for advanced HER2-mutant NSCLC","authors":"Leah Lawrence","doi":"10.1002/cncr.70277","DOIUrl":"10.1002/cncr.70277","url":null,"abstract":"&lt;p&gt;The US Food and Drug Administration (FDA) granted accelerated approval of the oral tyrosine kinase inhibitor (TKI) sevabertinib (Hyrnuo) for adults with locally advanced or metastatic, nonsquamous non–small cell lung cancer whose tumors have &lt;i&gt;HER2&lt;/i&gt; (&lt;i&gt;ERBB2&lt;/i&gt;) tyrosine kinase domain (TKD) activating mutations and who have received prior systemic therapy.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;“This is an important approval,” says Daniel Morgensztern, MD, a professor of medicine at Washington University School of Medicine in St. Louis, Missouri. “Sevabertinib now joins zongertinib, another TKI, and trastuzumab deruxtecan, an antibody–drug conjugate, as the third targeted therapy for &lt;i&gt;HER2&lt;/i&gt; mutations.”&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The approval was based on the results of the phase 1/2 SOHO-01 trial published in &lt;i&gt;The New England Journal of Medicine&lt;/i&gt; by Xiuning Le, MD, PhD, an associate professor at The University of Texas MD Anderson Cancer Center in Houston, Texas, and her colleagues.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The trial tested 20 mg of sevabertinib twice daily in patients with locally advanced or metastatic disease. The included patients were defined by their prior therapy: Cohort D (&lt;i&gt;n&lt;/i&gt; = 81) comprised previously treated patients with no prior HER2-targeted therapy, Cohort E (&lt;i&gt;n&lt;/i&gt; = 55) comprised patients who previously received HER2-directed antibody–drug conjugates, and Cohort F (&lt;i&gt;n&lt;/i&gt; = 73) comprised patients who had received no prior treatment.&lt;/p&gt;&lt;p&gt;Sevabertinib appeared to have activity in patients with and without prior treatment, including HER2-directed therapy. However, the FDA approval was only for patients who had received prior therapy.&lt;/p&gt;&lt;p&gt;The primary endpoint of objective response, as assessed by independent central review, occurred in 64% of the patients in Cohort D, in 38% of the patients in Cohort E, and in 71% of the patients in Cohort F. The median durations of response were similar across the cohorts at 9.2, 8.5, and 11.0 months, respectively.&lt;/p&gt;&lt;p&gt;Progression-free survival (PFS) was a secondary endpoint. Patients with no prior HER2-directed therapy (Cohort D) had a median PFS of 8.3 months. Patients with prior HER2-directed treatment had a median PFS of 5.5 months. Median PFS was not reached in the group of patients with no prior treatment.&lt;/p&gt;&lt;p&gt;Dr Le and her colleagues conducted an exploratory biomarker analysis of patients in Cohort D. Sevabertinib appeared to have limited activity in patients with non-TKD alterations, with only one of seven patients responding to treatment. They also found that circulating tumor DNA (ctDNA) subgroups were associated with “distinct outcomes.” Specifically, patients with no ctDNA detected and those with ctDNA clearance had prolonged PFS in comparison with patients with persistent ctDNA.&lt;/p&gt;&lt;p&gt;Approximately one third (31%) of the patients experienced grade 3 or higher drug-related adverse events. The most common adverse event was diarrhea, which occurred in the","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 5","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147352934","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":"FDA approves first treatment for smoldering multiple myeloma","authors":"Leah Lawrence","doi":"10.1002/cncr.70276","DOIUrl":"10.1002/cncr.70276","url":null,"abstract":"&lt;p&gt;The FDA has approved the subcutaneous injection of anti-CD38 monoclonal antibody daratumumab and hyaluronidase-fihj for patients with high-risk smoldering multiple myeloma (SMM), a precursor to multiple myeloma.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This is the first FDA-approved drug for adults with high-risk SMM.&lt;/p&gt;&lt;p&gt;The antibody gained approval based on results of the phase 3 AQUILA trial, which were published in &lt;i&gt;The New England Journal of Medicine&lt;/i&gt; by Meletios A. Dimopoulos, MD, a professor and chairman of clinical therapeutics at the School of Medicine of the National and Kapodistrian University of Athens, and his colleagues.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;AQUILA randomly assigned 390 patients with high-risk SMM to either subcutaneous daratumumab monotherapy or active monitoring. Patients assigned to daratumumab had a 51% reduction in the risk for progression or death in comparison with patients assigned to active monitoring (hazard ratio, 0.49; 95% CI, 0.36–0.67; &lt;i&gt;p&lt;/i&gt; &lt; .001). The 5-year progression-free survival rate was 63.1% with daratumumab and 40.8% with active monitoring. The overall survival rates at 5 years were 93.0% with daratumumab and 86.9% with active monitoring; although the results were numerically better with daratumumab, the difference was not statistically significant.&lt;/p&gt;&lt;p&gt;“These are very impressive results,” says Ajay K. Nooka, MD, MPH, a professor at Emory University School of Medicine in Atlanta, Georgia. “Although the survival difference was not statistically significant, it serves as an indicator of the natural history of the disease, where an intervention may yield improved outcomes as we continue to follow patients over a longer period of time.” Dr Nooka adds that despite this being the first treatment approved by the FDA for SMM, it is still unclear exactly which patients would benefit.&lt;/p&gt;&lt;p&gt;In the AQUILA trial, high risk was defined as a clonal bone marrow plasma cell (BMPC) level ≥10% and one or more of the following risk factors: a serum M protein level ≥30 g/L, immunoglobulin A SMM, immunoparesis with a reduction of two uninvolved immunoglobulin isotypes, a serum involved/uninvolved free light chain ratio ≥8 but &lt;100, and a clonal BMPC level of &gt;50% to &lt;60%.&lt;/p&gt;&lt;p&gt;Since the trial was designed, the definition of high-risk SMM has evolved. A current agreement defines it with the 20/2/20 model, Dr Nooka says. Patients with high-risk disease have two or more of the following: a BMPC level &gt;20%, an M protein level &gt;2 g/dL, an involved/uninvolved free light chain ratio &gt;20, and a fluorescence in situ hybridization abnormality.&lt;/p&gt;&lt;p&gt;“The FDA states that the drug was approved for high-risk SMM but did not specify what high-risk SMM is,” says Dr Nooka. “That leaves the burden on societies like the International Myeloma Society to figure it out.”&lt;/p&gt;&lt;p&gt;So far, he says, there seems to be a general agreement to use the 20/2/20 criteria to define these patients, but even these criteria need more r","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 5","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147352983","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":"Two new options for NPM1-mutated relapsed, refractory acute myeloid leukemia","authors":"Leah Lawrence","doi":"10.1002/cncr.70275","DOIUrl":"10.1002/cncr.70275","url":null,"abstract":"&lt;p&gt;The US Food and Drug Administration (FDA) recently approved two menin inhibitors for the treatment of relapsed or refractory acute myeloid leukemia (AML) with &lt;i&gt;NPM1&lt;/i&gt; mutations: revumenib and ziftomenib.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;“&lt;i&gt;NPM1&lt;/i&gt; mutations are present in about one-third of adult patients diagnosed with AML,” says Srinivas K. Tantravahi, MBBS, an associate professor in the Division of Hematology at the Huntsman Cancer Institute at the University of Utah in Salt Lake City. “In &lt;i&gt;NPM1&lt;/i&gt;-mutated AML, the KMT2A-menin interaction drives aberrant oncogenic gene expression that leads to leukemia. Menin inhibitors block the KMT2A-menin interaction and reverse this process, resulting in differentiation of leukemia stem cells.”&lt;/p&gt;&lt;p&gt;In October 2025, revumenib, a first-in-class, potent, highly selective oral menin inhibitor, was approved for adult and pediatric patients (1 year old or older) with &lt;i&gt;NPM1&lt;/i&gt;-mutated AML with no satisfactory alternative treatment options; it was previously approved for relapsed or refractory AML with KMT2A translocation.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The new approval was based on the results of the phase 1/2 AUGMENT-101 trial, which treated 94 patients who had either &lt;i&gt;KMT2Ar&lt;/i&gt; acute leukemia or &lt;i&gt;NPM1&lt;/i&gt;-mutated AML with oral revumenib once every 12 h.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Patients had a median of two prior lines of therapy, with half of the patients having previously undergone allogeneic hematopoietic stem cell transplantation.&lt;/p&gt;&lt;p&gt;The rate of complete remission (CR) plus complete remission with partial hematological recovery (CRh) was 22.8% with a median duration of response of 6.4 months.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Among patients who responded, 38.9% were able to receive an allogeneic transplant.&lt;/p&gt;&lt;p&gt;In November 2025, the FDA approved ziftomenib for adults with &lt;i&gt;NPM1&lt;/i&gt;-mutated AML and no alternative treatments based on the results of the phase 1/2 KOMET-001 trial, in which patients received 600 mg of ziftomenib once daily.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Patients, including the 23% with a prior transplant, had a median of two prior lines of therapy.&lt;/p&gt;&lt;p&gt;Among patients in the phase 1b and phase 2 portion of the trial, the CR plus CRh rate was 25% with a median duration of response of 3.7 months. The rates of CR plus CRh were similar for patients with prior exposure to venetoclax and for patients without prior exposure.&lt;/p&gt;&lt;p&gt;“Both drugs can be effective, but unfortunately, most patients will relapse even after achieving MRD [minimal residual disease] negative response,” says Dr Tantravahi. “However, median overall survival in patients who had a CR and CRh was 23.3 months in revumenib and 18.4 months in ziftomenib treated patients, which is a major improvement in relapsed/refractory &lt;i&gt;NPM1&lt;/i&gt;-mutated AML.”&lt;/p&gt;&lt;p&gt;Wei Ying Jen, BM BCh, an assistant professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center in Houston, Texas, agrees and notes that these d","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 5","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147352977","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":"Secondary primary malignancies in indolent non-Hodgkin lymphoma patients receiving frontline bendamustine-rituximab","authors":"Gwynivere A. Davies MD, MPH,&nbsp;Anca Prica MD,&nbsp;Zharmaine Ante PhD,&nbsp;Ning Liu PhD,&nbsp;Gregory R. Pond PhD,&nbsp;Amaris K. Balitsky MD, MSC,&nbsp;Adam Suleman MD,&nbsp;Lee Mozessohn MD, MPH","doi":"10.1002/cncr.70327","DOIUrl":"10.1002/cncr.70327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bendamustine-rituximab (BR) is common frontline therapy for indolent B-cell non-Hodgkin lymphomas (iBCL), but its association with secondary primary malignancies (SPM) is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors conducted a population-based study using linked Ontario health care databases. Patients ≥18 years old with untreated iBCL receiving BR (2013–2022) were compared to a historical cohort receiving cyclophosphamide-based regimens (rituximab, cyclophosphamide, vincristine, prednisone/rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone [R-CVP/CHOP], 2006–2012). Five-year SPM incidence was assessed using cumulative incidence function and competing risk models. Landmark analysis was conducted at 6 months after index date.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 6878 patients (BR, 4611; R-CVP/CHOP, 2267) were identified; BR recipients were older (65.6 vs. 62.8 years, <i>p</i> &lt; .001). The 5-year cumulative incidence of SPM was higher with BR versus R-CVP/CHOP (8.9% vs. 7.2%, <i>p</i> = .019) as was the SPM rate at 6.4 versus 4.9 per 100,000 person-days (<i>p</i> = .006), with higher rates of respiratory tract, male genitourinary, and skin cancers. Myelodysplastic syndrome/acute myeloid leukemia cases were similar accounting for group size (<i>n</i> = 23 vs. 11, <i>p</i> = .20). Multivariable analysis showed no significant difference in SPM risk (hazard ratio [HR], 1.13; 95% CI, 0.93–1.36, <i>p</i> = .22); full versus abbreviated BR was associated with borderline higher SPM risk (cumulative incidence function, 10.7% vs. 7.2%; HR, 1.51, <i>p</i> = .06). No difference was seen by cycles for R-CVP/CHOP. Development of SPM shortened survival (HR, 3.67; 95% CI, 3.15–4.29, <i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although BR patients demonstrated a higher SPM risk at 5 years in univariate models, this finding was not present on multivariable analysis. An increased number of BR cycles was associated with borderline increased SPM risk. These findings require prospective validation and studies examining risk-adapted abbreviation of chemotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 5","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343048","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 smoking on health-related quality-of-life outcomes in prostate cancer survivors","authors":"Benjamin Borgert MD,&nbsp;Hannah Kay MD,&nbsp;Ram Sankar Basak PhD,&nbsp;Deborah Usinger BS,&nbsp;Richard S. Matulewicz MD, MSCI,&nbsp;Ethan M. Basch MD,&nbsp;Adam O. Goldstein MD, MPH,&nbsp;Ronald C. Chen MD, MPH,&nbsp;Marc A. Bjurlin DO, MSc","doi":"10.1002/cncr.70336","DOIUrl":"10.1002/cncr.70336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Smoking may negatively affect health-related quality of life (HRQOL) in prostate cancer survivors, even though it is not a smoking-related malignancy. The longitudinal association of smoking with HRQOL was evaluated by focusing on intensity and duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients from the population-based North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study, enrolled via the state cancer registry (2011–2013), were analyzed. HRQOL was measured with the Short Form 12 instrument at intervals of up to 5 years posttreatment. Smoking status was self-reported. Linear and mixed-effects models assessed associations with controlling for age, treatment, and time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 842 participants, 474 underwent prostatectomy, 258 had radiation therapy, and 110 had brachytherapy. Concurrent smoking was associated with worse general health, mental health, and physical functioning (all <i>p</i> &lt; .05). Graded analysis revealed a significant dose response, with smoking ≥1 pack/day linked to the greatest declines in general health (β = −3.25; <i>p</i> &lt; .001) and physical functioning (β = −2.35; <i>p</i> = .003) at 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Smoking demonstrates significant concurrent and longitudinal associations with poorer HRQOL in prostate cancer survivors, with a clear dose–response pattern. These results underscore the critical need to integrate structured smoking assessment and cessation support as a core component of comprehensive prostate cancer survivorship care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 5","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147342980","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":"Multiomic characterization of small cell lung cancer: Real-world insights into therapeutic opportunities","authors":"Sonam Puri MD,&nbsp;Andrew Elliott PhD,&nbsp;Abdul Rafeh Naqash MD,&nbsp;Hassan Abu Shukair MD,&nbsp;Kathleen C. Kerrigan DO,&nbsp;Shiven Patel MD,&nbsp;Andreas Seeber MD, PhD,&nbsp;Florian Kocher PhD,&nbsp;Dipesh Uprety MD,&nbsp;Hirva Mamdani MD,&nbsp;Amit A. Kulkarni MD,&nbsp;Gilberto Lopes MD,&nbsp;Balazs Halmos MD,&nbsp;Hossein Borghaei DO,&nbsp;Wallace Akerley MD,&nbsp;Gabriel L. Sica MD, PhD,&nbsp;Stephen V. Liu MD,&nbsp;Trudy G. Oliver PhD,&nbsp;Taofeek K. Owonikoko MD, PhD","doi":"10.1002/cncr.70284","DOIUrl":"10.1002/cncr.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The dominant expression of lineage-related transcription factors (TFs)—<i>ASCL1</i>, <i>NEUROD1</i>, <i>POU2F3</i>, and, controversially, <i>YAP1</i>—has enabled the classification of small cell lung cancer (SCLC) into distinct subtypes (SCLC-A/N/P/Y, respectively). Emerging evidence suggests that a T cell–inflamed phenotype characterizes an SCLC subset. A large-scale multiomic analysis of samples from real-world patients with SCLC was conducted to examine the expression of clinically relevant biomarkers across SCLC subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Comprehensive molecular profiling of patient samples (<i>N</i> = 944) was performed via next-generation DNA sequencing (592-gene panel or whole exome), RNA sequencing (whole transcriptome), and immunohistochemistry. Tumors were stratified on the basis of the dominant expression of an individual TF (SCLC-A/N/Y/P subtypes), coexpression of multiple TFs (mixed), or low expression of all four TFs (TF−) for characterization of immune-related gene signatures (T-cell inflamed, natural killer cell, and Stimulator of Interferon Genes pathway) and clinically relevant target genes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort was composed of 25.6% SCLC-A, 10.2% SCLC-N, 12.5% SCLC-Y, 4.3% SCLC-P, 19.5% SCLC TF−, and 27.9% mixed subtypes. The SCLC-Y subtype exhibited the highest expression of immune-related gene signatures, with comparable expression observed in mixed samples expressing <i>YAP1</i>. Additionally, expression of clinically relevant target genes found in SCLC-A (<i>DLL3</i>, <i>SEZ6</i>, and <i>BCL2</i>) and SCLC-N (<i>SSTR2</i>) was increased in mixed samples expressing <i>ASCL1</i> and <i>NEUROD1</i>. The TF− subtype was not associated with increased immune-related signatures or other target genes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large-scale multiomic analysis revealed significant associations between SCLC subtypes and specific immune signatures and comutations. These findings provide insights into the molecular heterogeneity of SCLC, and highlight potential biomarkers for targeted therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 5","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147315740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A trial of risk-adapted prostate cancer screening in a federally supported health center network serving a high-risk population","authors":"Peter H. Gann MD, ScD,&nbsp;Nathan Stackhouse MD, MPH,&nbsp;Nicole Gastala MD,&nbsp;Weiwei Ma PhD, MS,&nbsp;Margaret E. Wright PhD,&nbsp;Karriem Watson DHSc, MS, MPH, PhD,&nbsp;Christopher Stepping MEd,&nbsp;Patrice King-Lee MS,&nbsp;Ziqiao Xu MS,&nbsp;Tushar Patel MD,&nbsp;Michael R. Abern MD","doi":"10.1002/cncr.70340","DOIUrl":"10.1002/cncr.70340","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Although Black men experience earlier onset and higher mortality from prostate cancer (PCa), no studies to date have tested interventions that encourage adoption of risk-adapted prostate-specific antigen (PSA) screening. The authors conducted a 15-month trial in clinics serving Chicago communities with high PCa mortality and Black population density. Their objective was to determine the impact of “Smart PSA” guidelines on screening behavior and biopsy outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Through presentations, in-clinic reminders, and on-site visits, primary care providers (PCPs) were exposed to basic PSA guidelines recommending starting age, repeat test interval, and stopping age, based on race, family history, and baseline PSA. For the intervention period and a matched control period 3 years earlier, the authors extracted data from clinical databases on all visits by men age 35 and over, at six clinics. The primary end point was change in incidence of a screening PSA linked to a PCP encounter.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 4252 and 4022 patients, similar in age and race, had qualifying encounters during intervention and pre-intervention, respectively. PSA screening following encounters increased from 18.7 to 33.0 per 100 patients (Δ = 14.3; 95% CI, 12.4–16.1) with odds ratio = 2.43 (95% CI, 2.17–2.71), adjusted for pre-specified covariates. Guideline compliance was indicated by a larger increase in screening of younger Black patients, and earlier repeat testing after a borderline PSA. Increased screening of men 70 and older indicated potential noncompliance. Biopsy incidence increased from 0.57 to 0.92 per 100 (Δ = 0.35; 95% CI, –0.03 to 0.75), with PCa prevalence at biopsy increasing from 43% to 74%. Total PCa incidence rose 2.7-fold (0.25 to 0.68 per 100, &lt;i&gt;p&lt;/i&gt; = .007), with incidence of cancer beyond grade group 1 increasing 3-fold (&lt;i&gt;p&lt;/i&gt; = .008).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;These findings demonstrate that risk-adapted PSA guidelines can be adopted and sustained by PCPs in high-risk settings. Although PCa incidence increased substantially, the predominance of aggressive cancer was unchanged, consistent with the effect of intensified screening in a high-risk population with sparse prior screening for a cancer with long latency. Sustained intensification should eventually cause a new equilibrium, necessitating additional efforts to avoid overdiagnosis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 ","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 5","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147315748","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}