Cancer Medicine最新文献

{"title":"Distinct Clinicopathological Features of HER2-Negative, HER2-Low, and HER2-Overexpressing Urothelial Carcinoma in a Large Chinese Cohort","authors":"Shanshan Wang,&nbsp;Dingwei Ye,&nbsp;Li Yang,&nbsp;Fan Cheng,&nbsp;Tiejun Yang,&nbsp;Xiaoping Zhang,&nbsp;Zhixian Yu,&nbsp;Qingyun Zhang,&nbsp;Yong Yang","doi":"10.1002/cam4.71289","DOIUrl":"https://doi.org/10.1002/cam4.71289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the expression patterns of Human Epidermal Growth Factor Receptor 2 (HER2) and their clinicopathological associations across the full spectrum (negative, low, and overexpression) in a large cohort of Chinese urothelial carcinoma (UC) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A multicenter registry study (April 2023–March 2024) across eight Chinese tertiary hospitals included 1054 UC patients. Demographic, clinical, and pathological data were analyzed to identify factors associated with different HER2 expression levels (IHC 0 vs. 1+ vs. 2+/3+). A subset of patients was evaluated for additional IHC markers (e.g., CK20, GATA3, P16, Uroplakin3, Ki-67).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1054 patients, 18.6% were HER2-negative (IHC 0), 23.0% were HER2-low (IHC 1+), and 58.4% exhibited HER2 overexpression (IHC 2+/3+). Increasing HER2 expression was significantly associated with bladder tumor location (63.1% in IHC 2+/3+, <i>p</i> &lt; 0.001), infiltrative tumors (61.1% in IHC 2+/3+, <i>p</i> &lt; 0.001), and high-grade tumors (62.5% in IHC 2+/3+, <i>p</i> &lt; 0.001). In a sub-analysis comparing HER2-low (1+) and HER2-overexpressing (2+/3+) groups, multivariable logistic regression confirmed bladder primary site (OR = 1.783, <i>p</i> = 0.001), infiltrative status (OR = 1.492, <i>p</i> = 0.027), and high-grade differentiation (OR = 1.918, <i>p</i> = 0.001) as independent predictors of HER2 overexpression, though the model's predictive ability was modest (AUC = 0.64). Expression of CK20, GATA3, P16, and Uroplakin3 also differed significantly between HER2-negative and HER2-positive groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study delineates distinct clinicopathological profiles for HER2-negative, HER2-low, and HER2-overexpressing UC in Chinese patients. These findings provide a crucial evidence base for refining personalized treatment strategies, particularly for HER2-targeted therapies like antibody-drug conjugates (ADCs), across the entire spectrum of HER2 expression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272221","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 Pilot Study: Adaptation Phase of the PROMIS Women Education Program—Promoting Cervical Cancer Prevention Methods Among Muslim Women in Virginia","authors":"Asmaa Namoos,&nbsp;NourEldin Abosamak,&nbsp;Vanessa Sheppard","doi":"10.1002/cam4.71296","DOIUrl":"https://doi.org/10.1002/cam4.71296","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this comprehensive research project is to address the notable disparities in cervical cancer prevention experienced by Muslim women in Virginia, compared with non-Muslim women. Low participation in prevention and control activities, such as cervical cancer screening and HPV vaccination, often leads to their diagnosis with late-stage cervical cancer. The long-term research goal is to develop a culturally appropriate and religiously adapted intervention program to promote cervical cancer screening and prevention among Muslim women. Driven by an integrative conceptual model, the primary aim is to adapt existing evidence-based educational materials to create a religiously adapted and culturally appropriate intervention program to improve cancer screening rates among Muslim women in the U.S.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study adapted existing evidence-based educational materials to fit religious and cultural contexts, facilitated through focus group sessions with 10 Muslim women aged 18 and older. Additionally, interviews with five Muslim religious leaders provided feedback on the materials. The PEN-3 model was employed to categorize and analyze cultural factors influencing health behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preliminary findings from the thematic analysis, structured around the three domains of cultural identity, relationships, and expectations, and cultural empowerment, indicated a strong positive reception and increased awareness among participants. Key themes identified include the importance of culturally sensitive health messages, the influential role of community leaders, and the need for educational materials that consider cultural and gender dynamics. Data saturation was reached after the second focus group session, as no new themes emerged in participating discussions. Additionally, the Community Advisory Board (CAB) actively participated in the refinement process by reviewing the educational materials alongside the research team, ensuring that the content was culturally appropriate and aligned with community needs. Participants demonstrated a heightened readiness to engage in preventive behaviors, highlighting the effectiveness of a culturally tailored educational approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272449","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":"End-Of-Life Outcomes and Healthcare Utilization for Patients With Hepatocellular Carcinoma Who Received Immune Checkpoint Inhibition","authors":"Margaret C. Wheless,&nbsp;Anna-Carson R. Uhelski,&nbsp;Sarah K. Cimino,&nbsp;Henry J. Domenico,&nbsp;Sara F. Martin,&nbsp;Mohana B. Karlekar,&nbsp;Thatcher R. Heumann,&nbsp;Kristen K. Ciombor,&nbsp;Laura W. Goff,&nbsp;Rajiv Agarwal","doi":"10.1002/cam4.71293","DOIUrl":"https://doi.org/10.1002/cam4.71293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Immune checkpoint inhibitors (ICI) have revolutionized treatment for advanced hepatocellular carcinoma (HCC). However, end-of-life (EOL) outcomes and healthcare utilization patterns prior to death for patients who receive ICI compared to non-ICI as their last therapy are unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with advanced HCC evaluated from January 1, 2020, and who died by March 29, 2024, were included for analysis. Primary EOL outcomes include: advance directives, goals of care conversations, location of death, palliative care referral, hospice referral, and hospice duration. Secondary healthcare utilization outcomes include systemic therapy receipt, emergency department visits, hospitalizations, and intensive care unit admissions within 14, 30, and 90 days of death. Outcomes were stratified by ICI or non-ICI as the last therapy received, and <i>p</i> values were derived using Pearson's chi-square test for equality of proportions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 71 patients for our retrospective cohort: mean age 64.1 years; 70.8% male; Child Pugh (CP) status at last treatment: 51.1% CPA, 40.0% CPB, 8.9% CPC. No differences in EOL outcomes were detected between groups; median days enrolled in hospice did not differ (24.5 days [non-ICI] vs. 10 days [ICI]; <i>p</i> = 0.39). Yet, a higher proportion of patients who received ICI as the last therapy had increased healthcare utilization across secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with advanced HCC receiving ICI as their last treatment before death, compared to those receiving non-ICI, had similar EOL outcomes but higher healthcare utilization. Further investigation into risk stratification to predict high healthcare utilizers could guide decision-making around the ongoing use of ICI near the EOL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272448","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":"Differential Expression of One-Carbon Pathway Enzyme ALDH1L1 Is Linked to Tumorigenicity of Low-Grade Bladder Cancer Cells Through Metabolic Reprogramming","authors":"Halle M. Meyers,&nbsp;Jaspreet Sharma,&nbsp;Amira A. Abdellatef,&nbsp;Mikyoung You,&nbsp;David Raines,&nbsp;Kyle C. Strickland,&nbsp;Susan Sumner,&nbsp;Blake R. Rushing,&nbsp;Natalia I. Krupenko,&nbsp;Sergey A. Krupenko","doi":"10.1002/cam4.71291","DOIUrl":"https://doi.org/10.1002/cam4.71291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>RT4 bladder cancer cell line, derived from a nonmuscle-invasive low-grade subtype, is one of the few neoplastic cell lineages that maintain high expression of the candidate tumor suppressor ALDH1L1. Here, we investigated how differential ALDH1L1 expression affects cellular characteristics and tumorigenicity of RT4 cells as well as tumor metabotypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We characterized RT4 cells and two shRNA clones (sh506/low ALDH1L1 expression; sh572/ALDH1L1 is lost) for proliferation, migration, clonogenic capacity, and mitochondrial respiration. We have further evaluated the tumorigenic potential of RT4 cells and the two clones in nude mice and compared metabotypes of derived tumors using untargeted metabolomics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both clones with diminished ALDH1L1 expression exhibited increased proliferation rates with doubling times of 19.4 h (sh506) and 23.2 h (sh572) versus 36.3 h for RT4 cells. Downregulation of ALDH1L1 expression also enhanced motility and clonogenic capacity. Proliferation and clonogenic capacity were highest for the sh506 clone (low ALDH1L1 expression), while motility was strongest for the sh572 clone (complete ALDH1L1 loss). Both clones showed altered energy metabolism, as indicated by a reduced basal oxygen consumption rate and enhanced maximal respiration rate following oligomycin treatment. Mouse xenograft tumors derived from ALDH1L1-deficient RT4 clones were significantly larger than RT4 cell-derived tumors. Of note, complete ALDH1L1 loss (sh572 clone) was less advantageous for tumor growth than the partial loss of the protein (sh506 clone). Untargeted metabolomics has shown that tumors with downregulated ALDH1L1 have altered the metabolism of fatty acids, amino acids, CoA, and acylcarnitines. Alterations in several key pathways, including glutathione metabolism (sh506), and TCA cycle (sh572), depend on the extent of ALDH1L1 downregulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study underscores ALDH1L1 as a key metabolic regulator of proliferation, migration, and tumorigenicity in RT4 bladder cancer cells, suggesting that retaining low ALDH1L1 expression can provide a metabolic advantage for growth of aggressive tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272447","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":"Patient and Clinician Perspectives on the Communication of Genomic Results in Cancer Care","authors":"Eleanor Johnston,&nbsp;Zoulikha Zair,&nbsp;Leanna Goodwin,&nbsp;Louise Carter,&nbsp;Fiona Thistlethwaite,&nbsp;Matthew G. Krebs,&nbsp;Donna M. Graham,&nbsp;Kate Duffus,&nbsp;Emma Darlington,&nbsp;Natalie Cook","doi":"10.1002/cam4.71287","DOIUrl":"10.1002/cam4.71287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patients diagnosed with advanced cancer are increasingly being offered comprehensive genomic profiling (CGP) to determine whether they are eligible for biomarker-informed treatment. The communication of CGP results to patients can be suboptimal and associated with patient anxiety. This study explores patient, clinician and public experiences of CGP and preferred methods of communicating results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Focus groups were held with patients and carers, with the resulting data evaluated by thematic analysis. Concurrently, a questionnaire was designed and distributed to 60 clinicians involved in CGP studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four patients with a current/previous cancer diagnosis and 10 carers attended the focus groups. Experience with CGP was minimal and often limited to what participants had read on the internet. Patients/carers felt the delivery of results was very complicated and emphasised emotional facets to communicating CGP results and the wish for delivery to be tailored to them. Questionnaire responses were received from 10 UK sites. 92% of clinicians ensured patients received their CGP results, with the majority (57%) returning all CGP results, but 30% would only report on actionable mutations. Results were delivered face to face by 38% of clinicians, while other methods included letters, phone calls, or a combination of approaches. Many clinicians expressed an interest in receiving training on how to feedback CGP results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a need to develop and implement a standardised approach to returning CGP results, as well as increasing healthcare professional education and confidence with interpreting CGP. Due to the increasing access to CGP as part of routine healthcare, it is essential clinicians feel confident to interpret this information and that patients have results returned to them in an understandable format.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249035","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":"Efficacy and Safety of EGF/EGFR Vaccines in EGFR-Driven Solid Tumors: A Systematic Review and Meta-Analysis of Controlled and Single-Arm Studies","authors":"Fei Chen,&nbsp;Ling Bai,&nbsp;Jiuwei Cui","doi":"10.1002/cam4.71295","DOIUrl":"10.1002/cam4.71295","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite multiple clinical trials, the benefits and safety of epidermal growth factor (EGF)/EGF receptor (EGFR) vaccines in EGFR-driven solid tumors remain unclear due to small sample sizes and heterogeneous study designs. This systematic review and meta-analysis aimed to evaluate their efficacy and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted pairwise and single-arm meta-analyses following PRISMA guidelines (PROSPERO: CRD420251026774). Searches in PubMed, Embase, and Cochrane Library identified 26 trials (2701 participants). The primary endpoint was overall survival (OS), with secondary analyses of progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (TRAEs). Statistical analyses were performed using R software, with fixed or random-effects models per heterogeneity (<i>I</i>²).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with best supportive care, vaccine monotherapy significantly improved long-term OS in NSCLC and GBM (3-year OR = 2.16, 5-year OR = 3.20) and prolonged median OS in NSCLC (HR = 0.76). In single-arm studies, NSCLC patients receiving vaccine monotherapy had a 1-year OS of 64% (75% in first-line maintenance), with an ORR of 2% and DCR of 31%. For GBM, vaccine combination therapy improved 3-year OS (OR = 2.42) and 2-year PFS (OR = 1.63) versus standard therapy. Single-arm combination analyses showed an overall 1-year OS of 84%, ORR of 42%, and DCR of 87%, while NSCLC first-line combination achieved a 1-year OS of 85% and DCR of 89%. Notably, EGFR-mutant NSCLC patients had a pooled ORR of 65% and DCR of 98%. Common TRAEs were grade 1–2 (injection site reactions, fever, headache, and vomiting), and combination therapy had no new or severe toxicities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EGF/EGFR vaccines may improve survival in EGFR-driven solid tumors, particularly NSCLC and GBM. Monotherapy enables long-term disease control, and combination therapy enhances efficacy without added toxicity, supporting further clinical validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO CRD420251026774</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145256919","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":"Preliminary Study on Phonation Reconstruction Using Free Anterolateral Thigh and Sternohyoid Myocutaneous Flaps After Total Laryngectomy","authors":"Hongming Wei,&nbsp;Jian Li,&nbsp;Huilei Dong,&nbsp;Yang Xu,&nbsp;Xin Li,&nbsp;Zhu Liu,&nbsp;Tie Lu,&nbsp;Bin Li,&nbsp;Zhendong Li,&nbsp;Hongwei Liu","doi":"10.1002/cam4.71294","DOIUrl":"10.1002/cam4.71294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In this study, we evaluated and compared the outcomes of phonation reconstruction using free anterolateral thigh (ALT) and sternohyoid myocutaneous flaps in patients undergoing total laryngectomy for locally advanced laryngeal and hypopharyngeal cancers, providing insights into optimal reconstructive approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 10 patients with locally advanced laryngeal or hypopharyngeal at Liaoning Cancer Hospital &amp; Institute were enrolled. All patients underwent total laryngectomy with simultaneous voice reconstruction. The reconstruction method was selected based on the extent of the hypopharyngeal defect. For patients without mucosal defects in the hypopharynx (<i>n</i> = 7), a sternohyoid myocutaneous flap was used. For those with large mucosal defects (<i>n</i> = 3), a free ALT flap was applied for voice reconstruction. Quality of life (QoL) was assessed preoperatively and postoperatively using a modified Chinese version of the University of Washington Quality of Life (UW-QOL) questionnaire. Postoperative complications were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both ALT and sternohyoid myocutaneous flaps demonstrated good feasibility and safety in phonation reconstruction following total laryngectomy. Phonation was achieved intraoperatively without the need for additional voice prosthetic devices. No statistically significant differences were observed between the groups regarding QoL or postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preliminary findings suggest that both ALT and sternohyoid myocutaneous flaps are viable options for phonation reconstruction following total laryngectomy. Phonation reconstruction contributed to a moderate improvement in patients' quality of life post-laryngectomy. Strengthening perioperative management is essential for optimizing surgical outcomes. Further studies with larger sample sizes and controlled designs are warranted to validate these findings and provide more robust evidence to guide the selection of surgical techniques in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249004","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":"An Evaluation of HER2 Expression Heterogeneity in Primary Tumors and Metastatic Lymph Nodes of Patients With Advanced Extramammary Paget's Disease: Prognostic and Therapeutic Implications","authors":"Zhicheng Liu,&nbsp;Xingliang Tan,&nbsp;Zhiming Wu,&nbsp;Yi Tang,&nbsp;Qianghua Zhou,&nbsp;Wensu Wei,&nbsp;Cong Yang,&nbsp;Long Huang,&nbsp;Yanjun Wang,&nbsp;Kai Yao","doi":"10.1002/cam4.71274","DOIUrl":"10.1002/cam4.71274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>HER2 expression in primary versus metastatic tumors in advanced Extramammary Paget's Disease (EMPD) remains inadequately characterized. This investigation aimed to assess HER2 expression heterogeneity between primary tumors and metastatic lymph nodes (LNs) in patients with advanced EMPD and to assess the prognostic value of HER2 expression and other pathological factors in determining the therapeutic value of HER2 targeting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 170 patients diagnosed with primary EMPD. Survival outcomes were analyzed using multivariate Cox regression and log-rank analysis, while inconsistencies in HER2 expression between primary and metastatic LNs were assessed using the kappa coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HER2 high-expression was observed in 71.6% of primary tumors and 68.8% of metastatic LNs, with high HER2 expression correlating with poorer overall survival. Multivariate Cox analysis identified advanced N stage and HER2 high-expression in primary tumors as independent poor prognostic factors. In 31 paired samples, the discordance rate of HER2 status between primary tumors and corresponding LNs was 35.48% (<i>n</i> = 11) (Kappa 0.11, 95% CI −0.26 to 0.47; <i>p</i> = 0.540), with 19.4% of cases showing a shift from high HER2 expression in primary tumors to low expression in metastatic LNs. Patients treated with disitamab vedotin had an 80% objective response rate (ORR) and a 100% disease control rate (DCR), with no adverse events above grade 3–4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HER2 was frequently expressed in both primary tumors and metastatic LNs in EMPD patients, though heterogeneity was observed. HER2 status should be assessed in both primary and metastatic sites. Disitamab vedotin shows promise for treating HER2-positive advanced EMPD, warranting further study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237462","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 COVID-19 on Time to Treat Breast Cancer and Racial Disparities Among Women in the Military Health System From FY2018-2022","authors":"Melody F. Mullin,&nbsp;Amanda Banaag,&nbsp;Christian Coles,&nbsp;Yvonee Eaglehouse,&nbsp;Kangmin Zhu,&nbsp;Tracey P. Koehlmoos","doi":"10.1002/cam4.71292","DOIUrl":"10.1002/cam4.71292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast cancer is the most diagnosed cancer among women in the United States, and early identification and initiation of treatment are critical to improving outcomes. This study aims to investigate the breast cancer time to treat trends among women in the Military Health System before and during the COVID-19 pandemic and if racial or socioeconomic disparities existed in timely treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of all female MHS beneficiaries ages 18–63 years during fiscal years 2018–2022. Incident breast cancer was defined as one inpatient or three outpatient diagnoses of breast cancer within a 90-day period and no previous breast cancer diagnosis in the 3 years prior. Time to treatment was calculated in days and timely treatment was identified if received within 90 days (surgical intervention) or 120 days (chemotherapy and radiation) after initial diagnosis. Study analyses included a <i>t</i>-test and Kaplan–Meier curve for time to treatment and an adjusted modified Poisson regression for the relative risk of timely treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A cohort of 14,286 women with incident breast cancer was identified; 94% received timely treatment. The average time to treatment was greater during the pandemic period (47.7 days, 95% CI = 46.6–48.7) compared to the pre-pandemic period (44.8 days, 95% CI = 43.7–45.9). Regression results indicated no difference in the likelihood of timely treatment in the pandemic period (0.99 aRR, 0.98–1.01 95% CI), no racial or socioeconomic disparities, and timely treatment was more likely to be received in the direct care setting (aRR = 1.04, 95% CI = 1.01–1.07).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite facing access to care challenges compounded by the COVID-19 pandemic, the MHS was able to provide timely treatment to women for incident breast cancer. In addition, this study observed no racial or socioeconomic disparities in the timely treatment of breast cancer in a population with equal access to care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231158","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":"Research Advances of Extrachromosomal Circular DNA in Breast Cancer","authors":"Xiaodan Zhu,&nbsp;Yiyang Qian,&nbsp;Quan Tang,&nbsp;Jiahui Li,&nbsp;Yuqing Geng,&nbsp;Shixia Gong,&nbsp;Chunhui Jin","doi":"10.1002/cam4.71285","DOIUrl":"10.1002/cam4.71285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This article presents an extensive review of the advancements in research concerning extrachromosomal circular DNA (ecDNA) within the context of breast cancer. As a distinct form of DNA, ecDNA is critically involved in the initiation, progression, diagnosis, and treatment of breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The article provides a comprehensive analysis of the mechanisms underlying the formation of ecDNA, highlighting factors such as aberrant DNA damage repair and chromosomal rearrangements. It further examines the biological roles of ecDNA in augmenting oncogene expression, fostering tumor heterogeneity, and facilitating immune evasion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Epidemiological studies indicate significant variability in the distribution of ecDNA across different breast cancer subtypes, with a notable association with invasive subtypes, such as triple-negative breast cancer. The presence of ecDNA is linked to poor prognosis and treatment resistance in patients. Current detection technologies for ecDNA include molecular biology and imaging techniques, and its detectability in plasma underscores its potential as a biomarker for liquid biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The development of ecDNA-targeted therapies and their integration with immunotherapy strategies offers promising new avenues for breast cancer treatment. Despite challenges such as incomplete elucidation of mechanisms, standardization of detection methods, and ethical considerations, ecDNA remains a valuable biomarker and therapeutic target in breast cancer. Future research is anticipated to advance its clinical transformation and application in individualized treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145230969","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}