Cancer Medicine最新文献

{"title":"Contemporary Characteristics and Outcomes of Pediatric Oncology Patients Participating in Early Phase Clinical Trials","authors":"Avina Rami,&nbsp;Kira Bona,&nbsp;Suzanne Shusterman,&nbsp;Karen Wright,&nbsp;Andrew E. Place,&nbsp;Puja J. Umaretiya,&nbsp;Ketki Bhushan,&nbsp;Steven G. DuBois,&nbsp;Kevin Campbell","doi":"10.1002/cam4.71222","DOIUrl":"https://doi.org/10.1002/cam4.71222","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Phase 1 or phase 1/2 trials are a first step in pediatric cancer drug development. Currently, there is a paucity of information regarding contemporary outcomes for pediatric patients enrolled in these trials. We describe characteristics and outcomes of patients enrolled in pediatric phase 1 clinical trials over a 9-year period at a single institution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We queried our clinical trials management system to generate a list of patients enrolled and treated on pediatric phase 1 or phase 1/2 trials from 2011 to 2019. We collected baseline demographics, clinical data, efficacy, and safety endpoints post-enrollment including: time to death, objective response to therapy, duration on therapy, need for dose modification, and occurrence of dose-limiting toxicity. Overall survival was calculated using Kaplan–Meier methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 224 unique patients accounted for 259 enrollments and 242 treatment episodes. The median age at enrollment was 11 years (range 0–27 years) and 56.2% were male. The majority were White (85.7%) and Non-Hispanic (88.2%). English was the primary language for 86.3% of patients, and 54.9% had private insurance. Solid tumors were the most common malignancy (41.0%), followed by brain tumors (34.1%), and hematologic malignancies (24.9%). Among treatment episodes, 49.3% received targeted monotherapy. After first enrollment, 27.6% of patients had an objective response to therapy (52.9% for hematologic malignancies, 20.5% for brain tumors, and 15.8% for solid tumors). The median duration of therapy was 1.5 months. Median overall survival from first enrollment for 218 patients treated with available vital status was 13.1 months. Toxicity outcomes included 27 patients (11.2%) requiring dose modification and 22 patients (9.0%) having a DLT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall survival is poor for patients in pediatric oncology early phase trials, despite approximately a quarter having an initial response. These data are informative for discussions between providers and families regarding outcomes after phase 1 trial participation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012473","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":"Comparative Effectiveness of Opioids and Opioid Substitutes on Pain and Health Related Quality of Life Among Cancer Survivors","authors":"Shirley K. Chan Sanchez,&nbsp;Samuel V. David,&nbsp;Efstathia Polychronopoulou,&nbsp;Mukaila Raji,&nbsp;Yong-Fang Kuo","doi":"10.1002/cam4.71189","DOIUrl":"https://doi.org/10.1002/cam4.71189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Chronic pain is a major but modifiable contributor to poor quality of life among long-term cancer survivors. With growing concern over opioid-related risks, gabapentinoids have emerged as a safer alternative, though evidence comparing their effectiveness remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using SEER-MHOS linked data (1998–2021) to examine pain interference and health-related quality of life (HRQoL) among 24,651 cancer survivors. Participants were categorized as opioid-only (OPIOID-only), gabapentinoid-only (GABA-only), both (BOTH), or no medication (NONE). Changes in pain interference and Physical and Mental Component Summary scores (PCS, MCS) were analyzed using paired t-tests and multivariate regression, adjusting for demographic and clinical covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a 1 to 3 year follow-up, all groups showed increased pain interference and declines in PCS and MCS scores. PCS declined by −1.01 in the OPIOID-only group and −1.06 in the GABA-only group. The BOTH group had stable PCS (+0.06) and a modest improvement in pain interference (−0.07). Multivariate models showed no significant difference between OPIOID-only and GABA-only for pain interference or PCS, but the BOTH group had significantly less pain worsening (<i>p</i> = 0.0001) and PCS decline (<i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gabapentinoids demonstrate comparable effectiveness as opioids for pain and HRQoL in cancer survivors, supporting their use as a safer alternative. Combination therapy showed better physical function and pain control, but findings may reflect higher baseline comorbidity and limited decline capacity rather than true superiority. These results underscored the need for personalized, multimodal pain management and further research on the long-term safety of combination therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012320","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 Population Pharmacogenomics on Cisplatin-Induced Neurotoxicities in Testicular Cancer Survivors","authors":"Swetha Nakshatri,&nbsp;Paul C. Dinh Jr,&nbsp;Lawrence H. Einhorn,&nbsp;Darren R. Feldman,&nbsp;Robert J. Hamilton,&nbsp;David J. Vaughn,&nbsp;Chunkit Fung,&nbsp;Christian Kollmannsberger,&nbsp;Robert A. Huddart,&nbsp;Lois B. Travis,&nbsp;Nancy J. Cox,&nbsp;M. Eileen Dolan","doi":"10.1002/cam4.71218","DOIUrl":"https://doi.org/10.1002/cam4.71218","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cisplatin is a commonly used chemotherapeutic across numerous cancer types that can cause neurotoxicities in patients, including peripheral sensory neuropathy, tinnitus, hearing loss, and vertigo.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We aimed to evaluate, for the first time, how genetic ancestry impacts cisplatin-induced neurotoxicities and if disparities are related to population differences in allele frequency.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In a cohort of cisplatin-treated testicular cancer survivors, relationships between genetic ancestry and neurotoxicities, medications, and lifestyle factors were assessed using logistic regression and Kruskal–Wallis tests and multiple pairwise comparisons using the Wilcoxon rank-sum test (Benjamini–Hochberg adjustment). Associations between single nucleotide polymorphism (SNP) genotypes and neurotoxicities with significant inter-population disparities were calculated to identify independent, functional variants with population allele frequency differentiation associated with toxicities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Following four cycles of cisplatin-based chemotherapy, African ancestry survivors were significantly more likely to have neuropathy and vertigo versus European and Asian-axis ancestry survivors, although Asian axis survivors were significantly younger at evaluation than other ancestries. Following filtering for population allele frequency differentiation, functional relevance, and independence, 19,992 SNPs were tested for association with toxicities. Although none passed the Bonferroni threshold, two and four SNPs were associated with neuropathy and vertigo, respectively, at suggestively significant &lt;i&gt;p&lt;/i&gt; &lt; 1.0 × 10&lt;sup&gt;−4&lt;/sup&gt;. For neuropathy, rs34904346 (&lt;i&gt;p&lt;/i&gt; = 2.0 × 10&lt;sup&gt;−5&lt;/sup&gt;) was an expression quantitative trait locus (eQTL) for RNF24 in nerve tissue, with three other RNF24 eQTLs associated with neuropathy (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). For vertigo, rs3777909 (&lt;i&gt;p&lt;/i&gt; = 3.1 × 10&lt;sup&gt;−5&lt;/sup&gt;) was an eQTL for MFSD4B in nerve and REV3L in brain tissue, along with three other eQTLs for MFSD4B and four for REV3L associated with vertigo (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In silico, higher MFSD4B and REV3L expression in cancer cell lines were associated with significantly greater cisplatin sensitivity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;African ancestry was associated with increased cisplatin-induced peripher","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998625","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 Open-Label, Single-Arm, Phase II Trial of Sintilimab Plus Anlotinib for Metastatic Non-Small Cell Lung Cancer After First-Line PD-(L)1 Inhibitor","authors":"Xun Shi,&nbsp;Chen Lin,&nbsp;Lishu Lou,&nbsp;Qiong He,&nbsp;Guangyuan Lou,&nbsp;Wei Hong,&nbsp;Lan Shao,&nbsp;Jun Zhao,&nbsp;Cuiping Gu,&nbsp;Xinmin Yu,&nbsp;Ying Jin","doi":"10.1002/cam4.71191","DOIUrl":"https://doi.org/10.1002/cam4.71191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although immune checkpoint inhibitors (ICIs) have markedly improved first-line management of non-small cell lung cancer (NSCLC), many tumors eventually escape control after anti-PD-(L)1 therapy, leaving a clear therapeutic gap. Preclinical studies and preliminary clinical data suggest that coupling ICIs with anti-angiogenesis therapy can yield complementary antitumor effects. Consequently, we launched this investigation to evaluate the therapeutic benefit and tolerability of sintilimab, a PD-(L)1–blocking monoclonal antibody, together with the oral multi-target anti-angiogenesis agent anlotinib in metastatic NSCLC individuals experiencing progression after first-line PD-(L)1 inhibition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>At Zhejiang Cancer Hospital, we conducted a phase II trial, single-arm, open-label investigation (registration No. NCT04691388). Patients were adults diagnosed with metastatic NSCLC whose disease had advanced after PD-(L)1 blockade; they received sintilimab plus anlotinib on a 21-day cycle. Investigator-assessed objective response rate (ORR) served as the principal efficacy endpoint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between March 2021 and January 2024, twenty-nine individuals were recruited (median age 63, range 45–74, 96.6% male). Tumor assessment identified five partial responses (PR) (17.2%), nineteen cases of stable disease (SD) (65.5%) and three progressions (10.3%), yielding an ORR of 17.2% and a disease-control rate (DCR) of 82.8%. The cohort's median progression-free survival (PFS) measured 5.0 months (90% CI, 4.2–7.3), and 41.1% of participants remained progression-free at six months. Overall survival reached a median of 15.1 months (90% CI, 8.6–not yet reached), with an 18-month survival proportion of 44.8%. Grade ≥ 3 treatment-related toxicity was dominated by hypertension, occurring in 10.3% of participants; no patient discontinued therapy or died because of drug-related events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sintilimab combined with anlotinib exhibited favorable antitumor activity and tolerable toxicity in post-anti-PD-(L)1 therapy of metastatic NSCLC patients, supporting further randomized controlled trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov: NCT04691388. Registered December 31, 2020</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998733","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":"Gender Medicine in Computed Tomography Radiomics Analysis to Predict Disease Progression in Liver Respectable Colorectal Cancer Patients","authors":"Annarita Fanizzi,&nbsp;Arianna Campione,&nbsp;Samantha Bove,&nbsp;Oronzo Brunetti,&nbsp;Deniz Can Guven,&nbsp;Angelo Cirillo,&nbsp;Andrea Lupo,&nbsp;Chiara Macrì,&nbsp;Leonardo Ricchitelli,&nbsp;Alessandro Rizzo,&nbsp;Elsa Vitale,&nbsp;Maria Colomba Comes,&nbsp;Raffaella Massafra","doi":"10.1002/cam4.70991","DOIUrl":"https://doi.org/10.1002/cam4.70991","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gender medicine is an evolving discipline that examines how diseases manifest and progress differently in men and women. Tailoring medical therapies and diagnostic approaches can enhance patient outcomes. While radiomics is emerging as a promising tool in personalized medicine, few studies evaluate its role in gender medicine within radiology. In this context, our preliminary objective was to determine whether radiomic features could predict disease-free survival within 3 years after the last follow-up in patients with colorectal liver metastases, with an emphasis on gender differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study analyzed preoperative CT scans of 196 patients from The Cancer Imaging Archive who underwent resection of colorectal cancer liver metastasis. Using the Pyradiomics library, we extracted 1316 features for each patient. We developed an analysis framework applied initially to the entire patient sample, then separately to male and female subsamples. This framework included: Volume of Interest (VOI) segmentation, handcrafted feature extraction and selection, detection of confounding patients, and training of ensemble classification models comprising five classifiers. Performance was assessed through 100 rounds of 10-fold cross-validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The selected feature subsets for male and female subsamples showed no overlap. The ensemble model demonstrated a notable improvement in performance when trained on the female subsample (mean AUC of 80.5%) compared to the model trained on the entire dataset (mean AUC of 64.8%), while performance for the male subsample remained nearly unchanged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although further validation with a larger dataset and external confirmation is needed, these preliminary results suggest a meaningful impact of gender medicine in radiology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934876","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":"Casemanagers Positioned as Key Advance Care Planning Conversationalists in Oncology Care: A Qualitative Interview Study on the Perspectives of Healthcare Professionals and Patients","authors":"Anouk Putker,&nbsp;Marieke Perry,&nbsp;Jelmer Chalkiopoulos,&nbsp;Annika Piek,&nbsp;Yvonne Engels,&nbsp;Evelien Kuip","doi":"10.1002/cam4.71195","DOIUrl":"https://doi.org/10.1002/cam4.71195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The increasing global cancer burden and advances in treatments have extended patients' life expectancy, leading to greater prognostic uncertainty and a higher demand for palliative care. Advance care planning (ACP) is essential in this context, ensuring that patients' future care aligns with their values and preferences. Oncology case managers, being nurses with specialized training, have emerged as key ACP conversationalists. This study explores the perspectives of healthcare professionals and patients on case managers as ACP conversationalists for advanced cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative interview study was conducted with 12 patients who recently had an ACP conversation with their case managers and 12 healthcare professionals, including medical oncologists and case managers, at a university medical center in the Netherlands. Transcripts of semi-structured interviews were analyzed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three main themes emerged: (1) Trust as the foundation for effective ACP, where patients valued the casemanagers' familiarity and accessibility; (2) ACP aligns with the competencies and tasks of the casemanager, as their communication skills and disease knowledge were seen as strengths; (3) Challenges related to responsibility around treatment decisions and the reluctance of medical oncologists to relinquish control of the conversation. Both patients and professionals recognized the importance of casemanagers having ACP conversations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Casemanagers are well-positioned to lead ACP conversations in oncology care, offering trust, continuity, and expertise. Despite some concerns regarding responsibility and medical decision-making, their role can improve the quality of ACP, supporting more personalized and timely palliative care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934905","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":"Exploring the Costs of Hospital and Emergency Department Utilisation in the First Three Years After Diagnosis for Adults Diagnosed With Pancreatic Cancer in Queensland, Australia","authors":"Shafkat Jahan,&nbsp;Daniel Lindsay,&nbsp;Abbey Diaz,&nbsp;Ming Li,&nbsp;Joan Cunningham,&nbsp;Gail Garvey","doi":"10.1002/cam4.71193","DOIUrl":"https://doi.org/10.1002/cam4.71193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To quantify costs incurred by the health system for hospital episodes and emergency department (ED) presentations for pancreatic cancer patients within the first three years after diagnosis in Queensland, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Settings and Design</h3>\u0000 \u0000 <p>Using a linked administrative dataset, CancerCostMod, which includes cancer diagnoses from the Queensland Cancer Registry (1st July 2011–30th June 2015) and linked Queensland Health Admitted Patient Data Collection and ED Information Systems records (1st July 2011–30th June 2018), we assessed costs for adults diagnosed with primary pancreatic cancer (International Classification of Diseases, 10th Revision: C25). Costs (in Australian dollars) were assigned using national public costs and private hospital charge datasets for the relevant year. Descriptive analyses were conducted to evaluate hospital and ED utilization and costs. Cost variations across sociodemographic and clinical characteristics were assessed using Kruskal–Wallis or Mann–Whitney <i>U</i> tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Principal Findings</h3>\u0000 \u0000 <p>Among 2082 individuals diagnosed with pancreatic cancer, hospital episodes (<i>n</i> = 26,405) in the first three years after diagnosis cost a total of $100.7 million; median cost per patient was $36,832. For ED presentations (<i>n</i> = 4228), corresponding figures were $3.6 million (total) and $963 (median per patient). Most of the total hospital (81%) and ED (79%) costs occurred in the first year after diagnosis. Patients who survived ≤ 6 months had the lowest median cost per patient but accounted for 38% of total hospital costs. Median cost per patient varied substantially by socio-demographic (i.e., Age groups, Indigenous status, socio-economic disadvantages) and clinical characteristics (i.e., comorbidity, cancer morphology, location of tumor, tumor resection, palliative care).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlight the significant economic burden of pancreatic cancer on the healthcare system, especially within the first year. Targeted strategies are essential to optimize healthcare delivery, ensure equitable access, and improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935290","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":"Towards Inclusive Colorectal Cancer Screening: Experiences and Needs of Adults With Intellectual Disabilities","authors":"Theresa Wagner,&nbsp;Alma R. Herscovici,&nbsp;Amelie Fuchs,&nbsp;Sebastian Kabas,&nbsp;Mara Hilbert,&nbsp;Laura M. König,&nbsp;Matthias Unseld,&nbsp;Elisabeth L. Zeilinger","doi":"10.1002/cam4.71212","DOIUrl":"https://doi.org/10.1002/cam4.71212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>People with intellectual disabilities (ID) face significant barriers to healthcare and preventive cancer care, resulting in delayed cancer diagnosis and higher mortality rates. There is limited understanding of the factors that influence their participation in colorectal cancer (CRC) screening, particularly from their own perspectives. This study aimed to identify the barriers, facilitators, and needs of people with ID for an inclusive CRC screening programme from their own experiences and viewpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured qualitative interviews and focus groups (<i>N</i> = 31) were conducted with adults with ID in Austria. Interviews and group discussions were audio recorded and transcribed verbatim. Thematic analysis was used as a flexible method to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes were identified from the data with each consisting of two to four sub-themes: (1) independence within individually adjusted scopes of arrangement and decision-making, (2) ‘When it comes to health, I do it’, (3) enhancing wellbeing, (4) seeing the person first, then their ID, and (5) deficits in resources and the healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings reveal significant barriers to healthcare and preventive cancer care for people with ID. The following practical implications were derived: Eliminating discrimination, improving accessibility, designing appropriate information and educational materials, implementing mandatory ID-specific training for health professionals, considering the importance of emotions and implementing ID-appropriate health services. Considering these aspects when developing inclusive cancer screening programmes is of paramount importance to promote equitable health and cancer prevention, especially for marginalised and vulnerable groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934974","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":"Global Burden, Projection, and Inequalities Analysis of Cancer Attributable to Occupational Carcinogen Exposure in Individuals Aged Over 40 Years","authors":"Nanxi Hu,&nbsp;Hui Li,&nbsp;Kaili Yu,&nbsp;Yang Yu,&nbsp;Xiaohua Wu,&nbsp;Xinyi Huang,&nbsp;Hongtao Lin,&nbsp;Shuqing Zou,&nbsp;Jinluan Li","doi":"10.1002/cam4.71213","DOIUrl":"https://doi.org/10.1002/cam4.71213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In this study, we investigated the global burden, projection, and inequalities of cancer attributable to occupational carcinogen exposure in individuals aged over 40 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Global Burden of Disease 2021 dataset, we examined age-standardized disability-adjusted life years (ASR-DALYs) and deaths associated with cancer attributable to occupational carcinogen exposure. Statistical analyses included: the estimated Annual Percentage Change to assess trends (1990–2021); Bayesian age-period-cohort modeling for projections to 2030 and 2050; decomposition analysis to quantify contributions of aging, population growth, and epidemiological changes; and slope and concentration indices (SII, CI) to evaluate health inequalities by sociodemographic index (SDI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, the global ASR-DALYs attributable to occupational carcinogen exposure were 239.3 per 100,000 (95% uncertainty intervals [UI]: 180.76–300.91), with significant declines found since 1990. The ASR-deaths in the same year were 11.45 per 100,000 (95% UI: 8.57–14.29). By 2050, ASR-DALYs and ASR-deaths are projected to decline to 177.24 and 8.50 per 100,000, respectively. Men exhibited higher DALYs and mortality (3.92 million DALYs, 0.18 million deaths) compared with women. From 1990 to 2021, high SDI regions exhibited the most substantial decline, whereas low-middle SDI regions experienced the highest increase. The most prominent occupational carcinogens were asbestos (ASR-DALYs: 142.36 per 100,000), silica (50.36 per 100,000), and diesel engine exhaust (20.56 per 100,000). Among the seven types of occupational cancers observe, tracheal, bronchial, and lung cancers exhibited the highest ASR-DALY and ASR-deaths. Population growth is the primary contributor to both DALYs and deaths globally, followed by epidemiological changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the declining global burden of cancer due to occupational exposure to carcinogens; however, significant disparities persist. Addressing occupational cancer risk in low-SDI regions and under-researched populations is crucial for reducing this health burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Safety of Cadonilimab: A Systematic Review and Single-Arm Meta-Analysis","authors":"Zhuo Zhang,&nbsp;Jiao Yu,&nbsp;Zhiqi Zhang,&nbsp;Qianxin Liu,&nbsp;Xiaocong Pang,&nbsp;Ying Zhou","doi":"10.1002/cam4.71210","DOIUrl":"https://doi.org/10.1002/cam4.71210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cadonilimab (AK104) is a bispecific antibody that simultaneously targets programmed cell death-1 and cytotoxic T-lymphocyte antigen-4. It has received approval for the treatment of cervical cancer and gastric/gastroesophageal junction cancer. This meta-analysis aims to assess cadonilimab's safety profile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review of electronic databases was conducted to identify clinical trials that reported cadonilimab's safety data. Immune-related adverse events (irAEs) was the primary endpoint, and treatment-related adverse events (TRAEs) were the secondary endpoints. A single-group proportion meta-analysis was conducted by R software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1271 patients across more than five cancer types in 11 clinical trials were included in this study. The incidence of any grade irAEs, grade ≥ 3 irAEs, irAEs leading to treatment discontinuation, and irAEs associated with mortality was 43.3% [95% confidence interval (CI), 33.3%–53.4%], 11.3% (95% CI, 9.5%–13.3%), 3.7% (95% CI, 1.5%–6.5%), and 0% (95% CI, 0%–0.4%), respectively. Hypothyroidism was the most common all-grade irAEs (13.3%, 95% CI, 8.9%–18.5%). The incidence of TRAEs was higher in the combined therapy group compared to the cadonilimab monotherapy group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The irAEs associated with cadonilimab are generally manageable. When combining with other anticancer agents, physicians and pharmacists should be particularly aware of the potential increase in TRAEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144929511","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}