Cancer最新文献

{"title":"Association between visceral adiposity index and cancer risk in the UK Biobank cohort.","authors":"Solange Parra-Soto, Jirapitcha Boonpor, Nathan Lynskey, Carolina Araya, Frederick Ho, Jill P Pell, Carlos Celis-Morales","doi":"10.1002/cncr.35576","DOIUrl":"10.1002/cncr.35576","url":null,"abstract":"<p><strong>Background: </strong>The visceral adiposity index (VAI) is a marker of visceral fat accumulation and metabolic dysfunction, but there is limited evidence of its association with cancer. The objective of this study was to investigate associations between the VAI and both incident cancer at 23 sites and all-cause cancer.</p><p><strong>Methods: </strong>In total, 385,477 participants (53.3% women; mean age, 56.3 years) from the UK Biobank prospective cohort were included in this study. The median follow-up was 8.2 years (interquartile range, 7.3-8.9 years). The VAI was calculated using formula the published by Amato et al. and was categorized into sex-specific tertiles. Twenty-four incident cancers were the outcomes. Cox proportional hazard models were adjusted for sociodemographics, lifestyle factors, and multimorbidity counts.</p><p><strong>Results: </strong>Over the follow-up period, 47,882 individuals developed cancer. In the fully adjusted models, the VAI was associated with a higher risk of six cancer sites. Individuals in the highest tertile, compared with those in the lowest tertile, had higher risks of uterine (hazard ratio [HR], 2.09; 95% confidence interval [CI], 1.76-2.49), gallbladder (HR, 1.83; 95% CI, 1.26-2.66), kidney (HR, 1.39; 95% CI, 1.18-1.64), liver (HR, 1.25; 95% CI, 1.00-1.56), colorectal (HR, 1.14; 95% CI, 1.05-1.24), and breast (HR, 1.11; 95% CI, 1.03-1.19) cancers and of all-cause cancer (HR, 1.05). There was no evidence of a nonlinear association between the VAI and cancer risk.</p><p><strong>Conclusions: </strong>The VAI was associated with six cancer sites and with all-cause cancer. The prognostic and etiologic roles of visceral fat accumulation and dysfunction in cancer warrant further research.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35576"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370363","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":"Self-rated health is an independent predictor of subsequent late mortality after blood or marrow transplantation: A Blood or Marrow Transplant Survivor Study report.","authors":"Nora Balas, Joshua Richman, Wendy Landier, Sadeep Shrestha, Katia J Bruxvoort, Lindsey Hageman, Qingrui Meng, Elizabeth Ross, Alysia Bosworth, Hok Sreng Te, F Lennie Wong, Ravi Bhatia, Stephen J Forman, Saro H Armenian, Daniel J Weisdorf, Smita Bhatia","doi":"10.1002/cncr.35598","DOIUrl":"10.1002/cncr.35598","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of suboptimal self-rated health (SRH) and its association with subsequent all-cause and cause-specific mortality after blood or marrow transplantation (BMT) were examined.</p><p><strong>Methods: </strong>Study participants were drawn from the multicenter Blood or Marrow Transplant Survivor Study, and included patients who were transplanted between 1974 and 2014 and had survived ≥2 years after BMT. Participants (aged ≥18 years) completed a survey at a median of 9 years from BMT, and were followed for a median of 5.6 years after survey completion. Survivors provided information on sociodemographic factors, chronic health conditions, health behaviors, and SRH (a single-item measure rated as excellent, very good, good, fair, or poor; excellent, very good, and good SRH were classified as good SRH, and fair and poor were classified as suboptimal SRH). The National Death Index Plus and Accurint databases and medical records provided vital status through December 2021.</p><p><strong>Results: </strong>Of 3739 participants, 784 died after survey completion (21%). Overall, 879 BMT survivors (23.5%) reported suboptimal SRH. Pain, low socioeconomic status, psychological distress, lack of exercise, severe/life-threatening chronic health conditions, post-BMT relapse, obesity, smoking, and male sex were associated with suboptimal SRH. BMT survivors who reported suboptimal SRH had a 1.9-fold increased risk of all-cause mortality (95% confidence interval [CI], 1.6-2.3), 1.8-fold increased risk of recurrence-related mortality (95% CI, 1.4-2.5), and 1.9-fold increased risk of non-recurrence-related mortality (95% CI, 1.4-2.4) compared to those who reported good SRH.</p><p><strong>Conclusions: </strong>This single-item measure could help identify vulnerable subpopulations who could benefit from interventions to mitigate the risk for subsequent mortality.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35598"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142386615","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":"Phase 2 trial of avelumab in combination with gemcitabine in advanced leiomyosarcoma as a second-line treatment (EAGLES, Korean Cancer Study Group UN18-09).","authors":"Miso Kim, Yu Jung Kim, Koung Jin Suh, Se Hyun Kim, Jeong Eun Kim, Juhyeon Jeong, Jung Yong Hong, Jeeyun Lee, Su Jin Lee, Sung Yong Oh, Jung Hoon Kim, Gyeong-Won Lee, Mi Sun Ahn, Wonyoung Choi, Yoon Ji Choi, Taebum Lee, Chiyoon Oum, Jeongkyu Kim, Young Saing Kim, Jin-Hee Ahn","doi":"10.1002/cncr.35609","DOIUrl":"10.1002/cncr.35609","url":null,"abstract":"<p><strong>Background: </strong>In this single-arm, multicenter, phase 2 trial, the authors evaluated the efficacy and safety of avelumab plus gemcitabine in patients with leiomyosarcoma (LMS) who failed on first-line chemotherapy.</p><p><strong>Methods: </strong>Patients with advanced LMS received avelumab 10 mg/kg on days 1 and 15 (for up to 24 months) plus gemcitabine 1000 mg/m² on days 1, 8, and 15 of a 28-day cycle until they developed disease progression or intolerable toxicity. The primary end point was the objective response rate (ORR).</p><p><strong>Results: </strong>In total, 38 patients were enrolled. Of these, 35 patients were evaluable, and the ORR was 20% (95% confidence interval; [CI], 8%-37%). The disease control rate was 71%, and the median duration of response was 21.8 months (range, 7.6 to ≥43.3 months). The median progression free-survival was 5.6 months (95% CI, 4.5-6.8 months), and the median overall survival was 27.5 months (95% CI, 20.4-34.6 months). Grade 3-4 adverse events occurred in 70% of patients, of which neutropenia was the most common (54%). Immune-mediated adverse events occurred in five patients (14%; hypothyroidism, n = 3; hepatitis, n = 2). Patients who had a higher density of tumor-infiltrating lymphocytes (greater than the median) exhibited better ORR (35% vs. 8%; p = .104), progression-free survival (median, 7.3 vs. 3.3 months; p = .024), and overall survival (median, not reached vs. 21.5 months; p = .027).</p><p><strong>Conclusions: </strong>The combination of avelumab and gemcitabine demonstrated promising efficacy and manageable safety in patients with advanced LMS who progressed on first-line therapy. Tumor-infiltrating lymphocyte density may be an important factor in predicting the response to combining immunotherapy with chemotherapy.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35609"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142454011","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":"Frequency and clinical associations of common mental disorders in adults with high-grade glioma-A multicenter study.","authors":"Susanne Singer, Melanie Schranz, Melina Hippler, Robert Kuchen, Carolin Weiß Lucas, Jürgen Meixensberger, Michael Karl Fehrenbach, Naureen Keric, Meike Mitsdoerffer, Jens Gempt, Jan Coburger, Almuth Friederike Kessler, Jens Wehinger, Martin Misch, Julia Onken, Marion Rapp, Martin Voß, Minou Nadji-Ohl, Marcus Mehlitz, Marcos Tatagiba, Ghazaleh Tabatabai, Mirjam Renovanz","doi":"10.1002/cncr.35653","DOIUrl":"10.1002/cncr.35653","url":null,"abstract":"<p><strong>Background: </strong>One third of adults with cancer suffer from common mental disorders in addition to their malignant disease. However, it is unknown whether this proportion is the same in patients who have brain tumors and which factors modulate the risk for psychiatric comorbidity.</p><p><strong>Methods: </strong>In a multicenter study, patients with high-grade glioma at 13 neurooncology clinics were enrolled consecutively and interviewed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID) to diagnose common mental disorders. Predictors of psychiatric comorbidity were investigated using binary logistic regression.</p><p><strong>Results: </strong>Six hundred ninety-one patients were interviewed. The proportion of patients who had mental disorders was 31% (95% confidence interval [CI], 28%-35%). There was evidence for an association of psychiatric comorbidity with the following factors: younger age (odds ratio [OR], 1.9; 95% CI, 1.1-3.4; p = .04), stable disease versus complete remission (OR, 1.7; 95% CI, 1.1-2.8; p = .04), lower income (OR, 1.7; 95% CI, 1.0-2.8; p = .04), living alone (OR, 1.6; 95% CI, 1.0-2.6; p = .05), fatigue (OR, 1.6; 95% CI, 1.1-2.4; p = .03), and impaired cognitive functioning (OR, 2.3; 95% CI, 1.5-3.6; p < .01). There was no evidence for independent effects of gender, histology, affected lobe, time since diagnosis, or employment status.</p><p><strong>Conclusions: </strong>Approximately one third of adult patients with high-grade glioma may suffer from a clinically relevant common mental disorder, without notable disparity between the genders. In particular, clinicians should pay attention to possible comorbidities for cases in which patients exhibit compromised subjective cognitive function, are younger than 50 years, maintain a state of stable disease, or live alone.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35653"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643523","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":"Potential new treatment for cancer-related cachexia: Patients with cancer-related cachexia who were treated with ponsegromab had a significant increase in weight gain from the baseline in comparison with patients treated with a placebo.","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35657","DOIUrl":"https://doi.org/10.1002/cncr.35657","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":"e35657"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142925915","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":"A prospective study on diagnostic accuracy of technology-enabled early detection of oral cancer and epidemiology of tobacco and other substances use in rural India.","authors":"Divya Khanna, Aseem Mishra, Praveen Birur, Tulika Shruti, Keerthi Gurushanth, Nirza Mukhia, Ruchi Pathak, Arjun Gurmeet Singh, Anupama Shetty, Satyajit Pradhan, Pankaj Chaturvedi","doi":"10.1002/cncr.35702","DOIUrl":"10.1002/cncr.35702","url":null,"abstract":"<p><strong>Background: </strong>Lip and oral cavity cancer is leading cause of cancer mortality among Indian men. This study evaluated diagnostic accuracy of mobile health (mHealth) enabled screening for early detection of oral premalignant lesions or oral cancer (OPML/OC). It also described epidemiology of tobacco and other substance use and associated oral lesions in rural northern India.</p><p><strong>Methods: </strong>A prospective study enrolled 10,101 high-risk individuals from rural settings of Varanasi district, India, between February 2021 and June 2023. Trained field workers captured habits information and oral cavity images and provided screening as suspicious or nonsuspicious on mHealth. Onsite experts and remote specialists provided clinical diagnoses. Diagnostic accuracy of mHealth-enabled screening was evaluated. A subset of 252 participants was followed to assess changes in oral lesions.</p><p><strong>Results: </strong>Prevalence of substance use was 55.7%, with 21.4% having OPML/OC. Sensitivity of field workers and remote diagnosis for detecting OPML/OC was moderate when compared with onsite expert. Overall, interobserver agreement was substantial. During follow-up, the remote specialists identified 30 new and 13 progressive lesions with a significant decline in the red mean parameter of red, green, and blue colour ratios.</p><p><strong>Conclusion: </strong>Although mHealth-enabled screening demonstrated lower sensitivity in detecting OPML/OC, their high specificity and expanded access to screening positions mHealth as a valuable tool for improving oral cancer screening coverage in Varanasi. This is particularly crucial given the high burden of oral cancer driven by prevalent smokeless tobacco and areca nut use and the current lack of effective population-based screening programs in this region.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":"e35702"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918729","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":"Comorbid conditions and survival among Black women with ovarian cancer.","authors":"Alicia R Richards, Courtney E Johnson, Nachalie Ramos Montalvo, Anthony J Alberg, Elisa V Bandera, Melissa Bondy, Lindsay J Collin, Michele L Cote, Theresa A Hastert, Kristin Haller, Namita Khanna, Jeffrey R Marks, Edward S Peters, Bo Qin, Jeanine Staples, Paul D Terry, Andrew Lawson, Joellen M Schildkraut, Lauren C Peres","doi":"10.1002/cncr.35694","DOIUrl":"10.1002/cncr.35694","url":null,"abstract":"<p><strong>Background: </strong>Black women with epithelial ovarian cancer (EOC) have worse survival and a higher burden of comorbid conditions compared with other racial groups. This study examines the association of comorbid conditions and medication use for these conditions with survival among Black women with EOC.</p><p><strong>Methods: </strong>In a prospective study of 592 Black women with EOC, the Charlson comorbidity index (CCI) based on self-reported data, three cardiometabolic comorbidities (type 2 diabetes, hypertension, and hyperlipidemia), and medication use for each cardiometabolic comorbidity were evaluated. Cox proportional hazards regression models were used to examine the association of comorbid conditions and related medication use with all-cause mortality while adjusting for relevant covariates overall and by histotype (high-grade serous [HGS]/carcinosarcoma vs. non-HGS/carcinosarcoma) and stage (I/II vs. III/IV).</p><p><strong>Results: </strong>A CCI of ≥2 was observed in 42% of the cohort, and 21%, 67%, and 34% of women had a history of type 2 diabetes, hypertension, and hyperlipidemia, respectively. After adjusting for prognostic factors, a CCI ≥2 (vs. 0; hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.04-1.71) and type 2 diabetes (HR, 1.42; 95% CI, 1.10-1.84) were associated with an increased risk of mortality. The increased risk of mortality for type 2 diabetes was present specifically among women with HGS/carcinosarcoma (HR, 1.47; 95% CI, 1.10-1.97) and among women with stage III/IV disease (HR, 1.47; 95% CI, 1.10-1.98). The authors did not find evidence that hypertension, hyperlipidemia, or medication use for the cardiometabolic comorbidities meaningfully impacted survival.</p><p><strong>Conclusion: </strong>Comorbid conditions, especially type 2 diabetes, had a significant adverse impact on survival among Black women with EOC.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":"e35694"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918691","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":"Incidence rates of soft tissue sarcoma among U.S. military servicemen: Comparison with the rates in the general U.S. population.","authors":"Julie A Bytnar, Ashley B Anderson, Benjamin K Potter, Craig D Shriver, Kangmin Zhu","doi":"10.1002/cncr.35607","DOIUrl":"10.1002/cncr.35607","url":null,"abstract":"<p><strong>Background: </strong>Soft tissue sarcoma (STS) is one of the most frequently diagnosed cancers among men younger than age 30 years and a leading cause of cancer death in men younger than age 40 years. The military may be more exposed to STS risk factors and have generally better health and health care access than the general population, which may relate to lower cancer risk and/or early detection. This study compared STS incidence between servicemen and men in the general U.S.</p><p><strong>Population: </strong></p><p><strong>Methods: </strong>Data were from the Department of Defense's Automated Central Tumor Registry (ACTUR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. Subjects were active-duty servicemen in ACTUR and men in SEER aged 18-59 years diagnosed with STS from 1990 to 2013. Age-adjusted rates, incidence rate ratios (IRR), and 95% CIs were calculated.</p><p><strong>Results: </strong>STS incidence rates were lower in ACTUR than SEER overall (IRR = 0.86 [0.78-0.93]), for 18- to 39-year-old men (IRR = 0.78 [0.70-0.86]), by race (White: IRR = 0.85 [0.77-0.95]; Black: IRR = 0.77 [0.63-0.94]), for sites other than skin/connective/soft tissue (IRR = 0.49 [0.37-0.63]), other specified histologies (IRR = 0.84 [0.71-0.98]), and unspecified histology (IRR = 0.57 [0.38-0.82]). Rates were lower in ACTUR for regional (IRR = 0.37 [0.28-0.47]) and distant metastases (IRR = 0.58 [0.43-0.76]), even when race and age stratified. However, rates were higher in ACTUR for 40- to 59-year-old men (IRR = 1.25 [1.04-1.48]) and localized tumors (IRR = 1.16 [1.04-1.29]).</p><p><strong>Conclusion: </strong>Lower STS rates among servicemen may relate to better health and early detection and treatment of STS-associated conditions within the military health system, which provides universal care. Higher rates among 40- to 59-year-old servicemen may result from greater cumulative military-related exposures.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35607"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794009","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":"Contemporary trends in utilization of metastasectomy in the era of targeted and immunotherapies.","authors":"Jesse E Passman, Michael J Kallan, Jeffrey L Roberson, Sara P Ginzberg, Wajid Amjad, Jacqueline M Soegaard Ballester, Gabriella Tortorello, Douglas Fraker, Giorgos C Karakousis, Edmund K Bartlett, Heather Wachtel","doi":"10.1002/cncr.35664","DOIUrl":"10.1002/cncr.35664","url":null,"abstract":"<p><strong>Background: </strong>Metastasectomy is a useful adjunct in the management of metastatic cancer. Widespread adoption of novel targeted and immunotherapies has improved the survival profiles of multiple malignancies, which has potentially altered the role of metastasectomy. This study aimed to characterize trends in metastasectomy across five primary cancers eligible for these therapies.</p><p><strong>Methods: </strong>The National Inpatient Sample was used to identify patients who underwent metastasectomy in the United States (2016-2021). Patients with procedure codes for resection of the lung, liver, adrenal gland, brain, or small bowel and concurrent diagnosis codes for secondary malignant neoplasm of that site were included. Subjects were subcategorized by primary malignancy: colorectal cancer, lung cancer, breast cancer, melanoma, or renal cancer. Sample weights were used to produce national estimates, which were incidence adjusted by primary malignancy. Trends in utilization were calculated with average annual percent change (AAPC) and linear regression coefficients.</p><p><strong>Results: </strong>Colorectal cancer was the most frequent indication for metastasectomy (n = 57,644 cases), followed by lung cancer (n = 55,090 cases), breast cancer (n = 12,616 cases), renal cancer (n = 8427 cases), and melanoma (n = 5658 cases). Utilization of metastasectomy increased over the study period for breast cancer (AAPC, +10.6%; p = .013) and melanoma (AAPC, +8.3%; p = .040) but did not change for lung cancer (AAPC, -1.6%; p = .26), colorectal cancer (AAPC, +0.3%; p = .83), or renal cancer (AAPC, +2.3%; p = .36).</p><p><strong>Conclusions: </strong>Between 2016 and 2021, utilization of metastasectomy increased significantly for melanoma and breast cancer. The role of metastasectomy will likely continue to develop as new treatment protocols improve survival profiles for patients with metastatic disease.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35664"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805636","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":"Imatinib dose reduction after major molecular response in chronic-phase chronic myeloid leukemia.","authors":"Zongru Li, Xiaoshuai Zhang, Yijing Zhao, Linping Lu, Yong Guo, Robert Peter Gale, Yazhen Qin, Qian Jiang","doi":"10.1002/cncr.35565","DOIUrl":"10.1002/cncr.35565","url":null,"abstract":"<p><strong>Background: </strong>In people with chronic-phase chronic myeloid leukemia (CML) receiving imatinib and achieving major molecular response (MMR), dose reduction may decrease adverse events but may be associated with a loss of molecular response. Whether digital droplet polymerase chain reaction (ddPCR) can identify persons in whom dose reduction might be unsuccessful is unknown.</p><p><strong>Methods: </strong>Data from 716 consecutive subjects who achieved MMR after initial imatinib therapy (400 mg/day) were obtained. A total of 486 subjects remained on full-dose imatinib, whereas 230 subjects had their dose reduced to 300 or 200 mg/day. The outcomes of these cohorts were compared via landmark and propensity score matching analyses.</p><p><strong>Results: </strong>Imatinib dose reduction showed no significant effect on the subsequent achievement of deeper molecular responses (4- and 4.5-log reductions in BCR::ABL1 transcripts; MR⁴ and MR^4.5), maintenance of MMR, or attainment of therapy-free remission when compared with subjects without dose reduction. In subjects achieving MR⁴, however, the probability of maintaining MR⁴ (p = .002) was lower in the reduced-dose group. In multivariable analyses, failure to achieve MR^4.5 as determined by ddPCR at the time of dose reduction was significantly associated with briefer MMR failure-free survival (FFS; hazard ratio [HR], 10.3; 95% confidence interval [CI], 1.3-82.9; p = .03) and MR⁴ FFS (HR, 6.8; 95% CI, 2.6-18.0; p < .001).</p><p><strong>Conclusions: </strong>Imatinib dose reduction after achieving MMR does not adversely affect response deepening or MMR maintenance in chronic-phase CML but compromises MR⁴ maintenance. The results of ddPCR may identify people who benefit from imatinib dose reduction.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35565"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277520","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}