Cancer Medicine最新文献

{"title":"The Associations Between the TyG Index and the Risk of Cancer—A Systematic Review and Meta-Analysis","authors":"Hongyu Li,&nbsp;Zijie Chen,&nbsp;Guoheng Jiang,&nbsp;Wenqian Yu,&nbsp;Jing Luo,&nbsp;Shiyi Li,&nbsp;Linjun Xie,&nbsp;Xuan Bai,&nbsp;Yiting Xu,&nbsp;Yi Jiang,&nbsp;Menglin He,&nbsp;Min Mao,&nbsp;Xin Wang","doi":"10.1002/cam4.71232","DOIUrl":"10.1002/cam4.71232","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The triglyceride glucose (TyG) index, a simple and reliable surrogate marker of insulin resistance (IR), has garnered increasing attention in metabolic research. Although IR is mechanistically linked to carcinogenesis through multiple pathways, including chronic inflammation, hyperinsulinemia-driven pro-mitogenic signaling, and altered adipokine secretion, the specific utility of the TyG index for cancer risk assessment remains unclear. This systematic review examines whether the TyG index shows consistent associations across cancer types and holds value as an independent risk predictor beyond established metabolic syndrome components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched PubMed, Embase, and Web of Science databases from 2008 (the year the TyG index was established as an IR marker) to December 31, 2024, for studies on the TyG index-cancer association. Cohort, cross-sectional, and case–control studies were included. Using meta-analysis, we pooled effect sizes and conducted subgroup analyses by gender, region, population source, and study design. Trial sequential analysis (TSA) evaluated evidence reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This meta-analysis incorporated a total of 20 eligible studies. Our findings demonstrated that elevated TyG index levels were significantly associated with increased risks of various malignancies, including digestive system cancers (OR: 1.22, 95% CI 1.13–1.31), urogenital system cancers (OR: 2.04, 95% CI 1.53–2.71), and breast cancer (OR: 1.64, 95% CI 1.49–1.80) when compared to lower TyG index levels. These associations remained consistent across all pre-specified subgroup analyses stratified by study characteristics. Furthermore, TSA confirmed sufficient statistical power for definitive conclusions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The consistent observed association between elevated TyG index and increased cancer risk highlights its potential as a candidate biomarker for further investigation. While these findings support the biological plausibility of insulin resistance in oncogenesis, current evidence—partially derived from observational studies—cannot establish causality or direct clinical utility. Future research should prioritize: (1) prospective validation of TyG index thresholds for cancer risk prediction, (2) mechanistic studies elucidating its role in tumor biology, and (3) assessment of its incremental value to existing risk stratification tools.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204933","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":"Characterization and Management of Cytokine Release Syndrome From the MonumenTAL-1 Study of Talquetamab in Patients With Relapsed/Refractory Multiple Myeloma","authors":"Niels W. C. J. van de Donk,&nbsp;Ajai Chari,&nbsp;Thomas Martin,&nbsp;Amrita Krishnan,&nbsp;Leo Rasche,&nbsp;Jing Christine Ye,&nbsp;Rakesh Popat,&nbsp;Brea Lipe,&nbsp;Cesar Rodriguez,&nbsp;Carolina Schinke,&nbsp;Sheri Skerget,&nbsp;Deeksha Vishwamitra,&nbsp;Raluca Verona,&nbsp;Jue Gong,&nbsp;Indrajeet Singh,&nbsp;Michela Campagna,&nbsp;Tara Masterson,&nbsp;Brandi Hilder,&nbsp;Jaszianne Tolbert,&nbsp;Thomas Renaud,&nbsp;M. Damiette Smit,&nbsp;Christoph Heuck,&nbsp;Maria-Victoria Mateos","doi":"10.1002/cam4.71276","DOIUrl":"10.1002/cam4.71276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cytokine release syndrome (CRS) is a common adverse event associated with T-cell redirection therapies (TCRT), including talquetamab, the first GPRC5D × CD3 bispecific antibody approved for relapsed/refractory multiple myeloma (RRMM). We describe CRS with talquetamab and implications for clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients without prior TCRT received talquetamab 0.4 mg/kg weekly (QW) and 0.8 mg/kg every other week (Q2W), with two or three step-up doses, respectively, plus pretreatment with a glucocorticoid, antihistamine, and antipyretic. A separate cohort of patients with prior TCRT received talquetamab at either the QW or Q2W schedule. CRS was graded per American Society for Transplantation and Cellular Therapy criteria and managed per study protocol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across talquetamab QW (<i>n</i> = 143), Q2W (<i>n</i> = 145), and prior TCRT (<i>n</i> = 51) cohorts, most CRS events occurred during step-up doses and were grade 1 or 2; grade 3 CRS events were rare. Approximately one-third of patients experienced more than one CRS event. Fewer patients experienced subsequent CRS events if tocilizumab was used versus not used to treat their first CRS event. Overall response rates with talquetamab were similar among patients with and without tocilizumab to manage CRS. Baseline characteristics were not associated with CRS incidence, recurrence, duration, or severity, whereas immune biomarkers showed some trends in association with CRS parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CRS outcomes with talquetamab were consistent with those seen with other TCRT in RRMM, including teclistamab (BCMA×CD3 bispecific antibody), indicating a similar clinical approach, including early vigilance and prompt treatment of CRS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>NCT03399799/NCT04634552</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204946","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":"Extracellular Volume Fraction Combined With Pathological Features of α-SMA and FAP for Predicting the Prognosis of Patients With Pancreatic Ductal Adenocarcinoma After Surgery and Evaluating the Efficacy of Chemotherapy","authors":"Liqiang Liu,&nbsp;Sicheng Xu,&nbsp;Pengbiao Miao,&nbsp;Xing He,&nbsp;Yaorong Peng,&nbsp;Qixian Zhou,&nbsp;Junkai Ren,&nbsp;Zhenyu Zhou,&nbsp;Huilin Ye,&nbsp;Wenbin Li","doi":"10.1002/cam4.71281","DOIUrl":"10.1002/cam4.71281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the extracellular matrix of pancreatic ductal adenocarcinoma (PDAC) using the extracellular volume fraction (fECV) derived from enhanced CT images, integrating fECV with α-SMA-positive cancer-associated fibroblasts (CAFs) and FAP-positive CAFs to investigate their relationship with clinicopathological characteristics and prognosis of patients with PDAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of 124 patients who underwent surgical resection for PDAC was conducted. Immunohistochemistry was applied to determine the expression of α-SMA and FAP. fECV was calculated by attenuation values of PDAC and aorta. The Kaplan–Meier method was used to plot the postoperative overall survival (OS) and disease-free survival (DFS) curves. A Cox proportional hazards regression model was used to develop a predictive model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High α-SMA (OS: <i>p</i> &lt; 0.001; DFS: <i>p</i> = 0.065) and FAP (OS: <i>p</i> &lt; 0.001; DFS: <i>p</i> &lt; 0.001) expressions and low fECV (OS: <i>p</i> &lt; 0.001; DFS: <i>p</i> &lt; 0.001) predict poor prognosis. Patients with co-high expression of α-SMA and FAP had worse OS and DFS. Multivariable analysis identified α-SMA (OS: hazard ratio [HR], 2.34 [95% CI, 1.30–4.21], <i>p</i> = 0.005), FAP (OS: HR, 4.43 [95% CI, 2.72–7.19], <i>p</i> &lt; 0.001), and fECV (OS: HR, 0.58 [95% CI, 0.37–0.90], <i>p</i> = 0.015) as independent predictors of prognosis. The predictive model established by combining fECV with α-SMA and FAP in this study cohort demonstrated the best predictive value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The integration of fECV with α-SMA and FAP expressions offers a robust method for predicting clinical outcomes in PDAC patients, potentially guiding treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205002","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":"Implementation of the Hospitalist System and In-Hospital Mortality Among Patients With Cancer: Using the National Health Insurance Cohort Data","authors":"Yun Seo Jang,&nbsp;Il Yun,&nbsp;Yu Shin Park,&nbsp;Eun-Cheol Park,&nbsp;Jaeyong Shin","doi":"10.1002/cam4.71207","DOIUrl":"10.1002/cam4.71207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hospitalists are directly responsible for inpatients, from hospitalization to discharge. Recently, Korea has started reimbursing hospitalist inpatient services. However, evidence of hospitalists being associated with improved healthcare quality is lacking. We investigated the association between the hospitalist system and reduced in-hospital mortality among patients with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This national population-based retrospective cohort study included 398,732 patients with cancer from tertiary and general hospitals with hospitalists whose data were extracted from the Korean National Health Insurance Service Cohort Database in 2021. In-hospital mortality data was obtained, defined as the presence of a record of death between admission and discharge. To increase comparability, we performed a 1:3 propensity score matching based on sex, age, hospital type, hospital region, Charlson Comorbidity Index (CCI), and primary cancer type. We used generalized estimation equation models to estimate the adjusted odds ratios (OR) for in-hospital mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients under the hospitalist system had a lower risk of in-hospital mortality (OR: 0.91; 95% CI: 0.87–0.96). Specifically, patients in their 80s (OR = 0.31; 95% confidence interval [CI]: 0.19–0.52) and those with high CCI (OR = 0.93; 95% CI: 0.87–0.99) had a more significant association with lower in-hospital mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hospitalist services are associated with reduced in-hospital mortality rates in cancer patients, which may be influenced by continuous patient management and expertise. Our results highlight the need for dedicated personnel stationed in hospital wards for improved outcomes of patients with cancer. Our results may encourage the government to consider the expansion of the current policies for efficient allocation of healthcare resources among hospitals in Korea.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211247","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":"Peptide Modulation Overrides Glycan Synergy in Gold Nanoparticle-Based Vaccines for Cancer Immunotherapy","authors":"Narumi Harada,&nbsp;Mayumi Niimura,&nbsp;Yasuhisa Sakamoto,&nbsp;Akihiro Nita,&nbsp;Mayuko Shimoda,&nbsp;Shiho Wada,&nbsp;Koki Murata,&nbsp;Masahiro Wakao,&nbsp;Tomomi Kamba,&nbsp;Hiroyuki Shinchi,&nbsp;Toshiro Moroishi","doi":"10.1002/cam4.71286","DOIUrl":"10.1002/cam4.71286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We have previously developed a gold nanoparticle (GNP)-based anti-cancer immunotherapy, termed integrated glyco-nanovaccine (iGN). The iGN is composed of GNPs conjugated to a synthetic toll-like receptor (TLR) 7 ligand, an antigen peptide, and a mannose sugar chain. However, the effect of the combination of different sugar chains and antigen peptides on iGN-mediated anticancer immunotherapy remains to be elucidated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We compared the anti-tumor effects of two different sugar chains: α-mannose and sialic acid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We showed that not only the sugar chain but also the antigen peptide plays a pivotal role in iGN uptake by immune cells. In contrast to α-mannose, which promoted GNP internalization by bone marrow-derived dendritic cells (BMDC), sialic acid modification resulted in limited cellular uptake. The integration of major histocompatibility complex class I-restricted ovalbumin peptides drastically changed this cellular recognition pattern, particularly for sialic acid-modified iGN. The peptide largely improved the uptake of nanoparticles, delivery of the TLR 7 ligand, and subsequent activation of the type I interferon pathway in BMDC. Sialic acid-modified iGN demonstrated comparable induction of CD8⁺ T cell and efficacy of anti-cancer therapy to α-mannose-modified iGN in an EG7 syngeneic mouse tumor model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results indicate that antigens, and not only the sugar chain, critically determine both the cellular internalization and immunotherapeutic efficacy of iGNs. This study presents a new design principle for glyco-nanovaccines, where peptides override glycan synergy and determine therapeutic efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197594","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, Xingliang Tan, Zhiming Wu, Yi Tang, Qianghua Zhou, Wensu Wei, Cong Yang, Long Huang, Yanjun Wang, Kai Yao","doi":"10.1002/cam4.71274","DOIUrl":"https://doi.org/10.1002/cam4.71274","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>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% (n = 11) (Kappa 0.11, 95% CI -0.26 to 0.47; p = 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><p><strong>Conclusion: </strong>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>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":"e71274"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-Related Adverse Events and Associated Outcomes in Patients With Advanced Urothelial Carcinoma Treated With Enfortumab Vedotin: Analysis of the UNITE Study","authors":"Amanda Nizam,&nbsp;Charles B. Nguyen,&nbsp;Jinju Li,&nbsp;Emily C. Zabor,&nbsp;Pavlos Msaouel,&nbsp;Cindy Y. Jiang,&nbsp;Omar Alhalabi,&nbsp;Eugene Oh,&nbsp;Matthew P. Davidsohn,&nbsp;Ilana B. Epstein,&nbsp;Dimitra Rafailia Bakaloudi,&nbsp;Rafee Talukder,&nbsp;Tanya Jindal,&nbsp;Amy K. Taylor,&nbsp;Michael J. Glover,&nbsp;Ali Raza Khaki,&nbsp;Emily Lemke,&nbsp;Hannah Mabey,&nbsp;Bashar Abuqayas,&nbsp;Albert Jang,&nbsp;Jason R. Brown,&nbsp;Sean T. Evans,&nbsp;Cameron Pywell,&nbsp;Arnab Basu,&nbsp;Mehmet A. Bilen,&nbsp;Pedro C. Barata,&nbsp;Yousef Zakharia,&nbsp;Matthew I. Milowsky,&nbsp;Deepak Kilari,&nbsp;Christopher J. Hoimes,&nbsp;Sumit A. Shah,&nbsp;Hamid Emamekhoo,&nbsp;Nancy B. Davis,&nbsp;Shilpa Gupta,&nbsp;Petros Grivas,&nbsp;Joaquim Bellmunt,&nbsp;Matthew T. Campbell,&nbsp;Ajjai S. Alva,&nbsp;Vadim S. Koshkin","doi":"10.1002/cam4.71284","DOIUrl":"10.1002/cam4.71284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Enfortumab vedotin-ejfv (EV), an antibody–drug conjugate approved for advanced urothelial carcinoma (aUC), has limited real-world safety data and no validated predictive biomarkers. Retrospective studies suggest higher objective response rates (ORR) among patients developing EV-related dermatologic toxicities, but survival implications remain unclear. This analysis assessed the safety of EV monotherapy and the impact of dermatologic and neurologic toxicities on efficacy outcomes in a multi-institutional cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>UNITE is a multicenter, retrospective study across 16 US sites of patients with aUC treated with targeted agents, including EV. Primary endpoints were the incidence of EV treatment-related adverse events (TRAEs, any grade) and TRAE-related treatment modifications. Secondary endpoints included a comparison of ORR, progression-free survival (PFS), and overall survival (OS) between patients with and without dermatologic toxicities and neuropathy. To reduce immortal time bias, Cox regression models incorporated TRAEs as time-dependent covariates to adjust for EV treatment duration as well as Eastern Cooperative Oncology Group performance status (ECOG PS), hemoglobin, and liver metastases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2018 and 2023, 485 patients with aUC received &gt; 1 dose of EV monotherapy. Most (67%) received &gt; 2 prior therapy lines. Any grade TRAEs occurred in 77%, most frequently neuropathy (36%) and dermatologic toxicities (27%); 57% required treatment modification and 21% discontinued EV, primarily due to neuropathy (9%) and fatigue (3%). Patients with dermatologic toxicities and neuropathy had higher ORR (56% vs. 42%; <i>p</i> = 0.007 and 64% vs. 35%; <i>p</i> &lt; 0.0001, respectively). Neuropathy was independently associated with improved OS (HR 0.66; 95% CI 0.50–0.87; <i>p</i> = 0.002); dermatologic TRAEs were not associated with PFS or OS benefit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EV safety outside clinical trials was consistent with prior reports, with no new signals. Treatment modifications were most often due to neuropathy, dermatologic toxicities, and fatigue. Both dermatologic toxicities and neuropathy correlated with higher ORR, but only neuropathy was independently associated with improved OS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197650","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, Amanda Banaag, Christian Coles, Yvonee Eaglehouse, Kangmin Zhu, Tracey P Koehlmoos","doi":"10.1002/cam4.71292","DOIUrl":"https://doi.org/10.1002/cam4.71292","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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 t-test and Kaplan-Meier curve for time to treatment and an adjusted modified Poisson regression for the relative risk of timely treatment.</p><p><strong>Results: </strong>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><p><strong>Conclusion: </strong>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>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":"e71292"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kupffer Phase Radiomics Signature in Sonazoid Contrast-Enhanced Ultrasound Predicts Immunohistochemistry Marker Expression in Hepatocellular Carcinoma.","authors":"Chen Li, Yuan Liu, Mingxiao Wu, Weide Dai, Jinghai Song, Yong Wang","doi":"10.1002/cam4.71153","DOIUrl":"https://doi.org/10.1002/cam4.71153","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies have explored the value of radiomics signatures in predicting immunohistochemical (IHC) staining markers. This study aimed to investigate and validate radiomics models based on the Kupffer phase of Sonazoid contrast-enhanced intraoperative ultrasonography (S-CEUS) images for predicting IHC marker expression in hepatocellular carcinoma (HCC).</p><p><strong>Method: </strong>Overall, 113 consecutive patients diagnosed with HCC between November 2019 and May 2023 were retrospectively analyzed. Histopathological assessment included IHC staining for GS, CD10, GPC3, and HSP70. Radiomic features extracted from S-CEUS images were selected and analyzed. A Naïve Bayes classifier was employed to predict IHC marker expression in HCC, using selected clinical biomarkers and radiomic features.</p><p><strong>Results: </strong>For GPC3, the radiomics classifier achieved a macro-average area under the receiver operating characteristic curve (AUC) of 0.700, indicating strong performance. For GS, both radiomics and combined clinical-radiomics classifiers exhibited strong discrimination (AUCs: 0.870 and 0.882, respectively). The radiomics classifier outperformed clinical biomarkers (total and direct bilirubin) in predicting CD10, with a macro-average AUC of 0.834. However, its accuracy decreased for higher HSP70 marker expression levels (AUC: 0.694). These findings underscore the consistent effectiveness of radiomics across different IHC markers when compared to traditional clinical approaches.</p><p><strong>Conclusions: </strong>The Kupffer phase in the S-CEUS-based radiomics signature is an excellent biomarker for predicting IHC marker expression in patients with HCC.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":"e71153"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145230938","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":"Research Advances of Extrachromosomal Circular DNA in Breast Cancer.","authors":"Xiaodan Zhu, Yiyang Qian, Quan Tang, Jiahui Li, Yuqing Geng, Shixia Gong, Chunhui Jin","doi":"10.1002/cam4.71285","DOIUrl":"https://doi.org/10.1002/cam4.71285","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>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><p><strong>Conclusions: </strong>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>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 19","pages":"e71285"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}