Cancer Medicine最新文献

{"title":"Treatment Patterns and Clinical Outcomes Among Chinese Patients With Newly Diagnosed Multiple Myeloma: A Multicenter Retrospective Study (CHAMP-MM).","authors":"Jian Cui, Xiaoyan Qu, Chunrui Li, Fei Li, Liye Zhong, Xiaohong Fu, Gang Liu, Lugui Qiu, Gang An","doi":"10.1002/cam4.72332","DOIUrl":"10.1002/cam4.72332","url":null,"abstract":"<p><p>The therapeutic landscape for newly diagnosed multiple myeloma (NDMM) in China has evolved significantly with wider access to novel agents, including proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and CD38 monoclonal antibodies. However, real-world data on treatment patterns and outcomes, particularly among high-risk subgroups, remain limited. The CHAMP-MM study aimed to evaluate real-world frontline and post-initial relapse treatment patterns and outcomes in NDMM patients, including high-risk subgroups, defined as those age ≥ 65 (elderly), with renal impairment (RI), and with 1q cytogenetic abnormalities. The study utilized electronic medical record data from five tertiary hematologic centers in China. Adult patients diagnosed with active MM between 2018 and 2022 were included and followed until last visit or end of study (December 31, 2023). A total of 1139 patients were analyzed, including 364 elderly, 148 with RI, and 334 with 1q abnormalities. PI+IMiD-based regimens were the most common frontline therapy (50.0%) overall, as well as in elderly patients and 1q subgroups, whereas PI-based regimens were more frequently used in RI patients. Only 25.1% of NDMM patients received autologous stem cell transplant after induction. Following initial relapse, PI+IMiD-based (32.6%) and CD38-based (30.9%) regimens predominated. Frontline overall response rates were approximately 80% across all groups, whereas the proportion of patients achieving very good partial response (PR) or better ranged from 60.9% to 75.1% across subgroups. While overall 12- and 24-month progression-free survival (PFS) rates remained high, outcomes were poorer in high-risk subgroups. This study reflects real-world treatment trends in China over 5 years and emphasizes the continued need for tailored treatment approaches in high-risk populations.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72332"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079420","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":"Evaluating a Polygenic Risk Score for Hepatocellular Carcinoma in Multiethnic Cirrhosis Patients in Texas.","authors":"Priya B Shetty, Nia Choi, Hao T Duong, Fasiha Kanwal, Saira Khaderi, Amit G Singal, Sumeet K Asrani, Michelle Luster, Abeer Al-Sarraj, Ashwin Rao, Jinyoung Byun, Christopher I Amos, Hashem B El-Serag, Aaron P Thrift","doi":"10.1002/cam4.72375","DOIUrl":"10.1002/cam4.72375","url":null,"abstract":"<p><strong>Background and aims: </strong>Genome-wide association studies (GWAS) that were previously conducted in European and Asian cohorts have identified numerous genetic risk factors for hepatocellular carcinoma (HCC) and its precursors and risk factors. A polygenic risk score (PRS) composed of these key SNPs for HCC may be useful for risk stratification in clinical settings for U.S. patients with cirrhosis.</p><p><strong>Methods: </strong>Using genetic and clinical data from the Texas HCC Consortium cohort, we evaluated a weighted PRS constructed from 11 independent SNPs previously shown to be associated with advanced liver disease (PNPLA3-TM6SF2-GCKR-HSD17B13-GATAD2A-TRIB2-PPP1R3B-CPN1-ERLIN1-APOE-MBOAT7). We used Fine-Gray competing risk models to estimate hazard ratios (HR) and 95% confidence intervals (CI) to test the association between the PRS and HCC.</p><p><strong>Results: </strong>The 1888 patient cohort included non-Hispanic White (NHW; 50.4%), non-Hispanic Black (NHB; 18.5%), and Hispanic (28.6%) patients, and 116 developed incident HCC. Each unit increase in the PRS was associated with increasing risk of HCC (HR = 2.20; 95% CI (1.53, 3.18)). The 11-SNP PRS was strongly associated with risk of HCC in NHW patients (HR = 2.53, 95% CI (1.65, 3.89)) but not among NHB and Hispanic patients. Similarly, the magnitude of the PRS effect on HCC risk differed by cirrhosis etiology with the strongest association for cirrhosis due to Hepatitis C (HR = 3.81, 95% CI (1.64, 8.82)).</p><p><strong>Conclusions: </strong>Our study shows that PRS is generally promising for HCC risk prediction; however, the current PRS that was derived from previous GWAS of primarily NHW and Asian patients is not robust over different groups, limiting their use for risk stratification in diverse populations with different etiologies.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72375"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134493","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":"Correction to \"Immune-Related Adverse Events and Therapeutic Outcomes After Stopping Immune Checkpoint Inhibitors due to Toxicity Among Patients With Metastatic Melanoma (University Hospitals Sussex)\".","authors":"","doi":"10.1002/cam4.72412","DOIUrl":"10.1002/cam4.72412","url":null,"abstract":"","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72412"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206374","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":"Diabetes Among Finnish Pancreatic Cancer Patients: Prevalence, Time Interval Between Diabetes and Cancer Diagnosis, and Overall Survival.","authors":"Suitiala Roosa, Aaltonen Panu, Mustonen Harri, Sund Malin, Seppänen Hanna","doi":"10.1002/cam4.72380","DOIUrl":"https://doi.org/10.1002/cam4.72380","url":null,"abstract":"<p><strong>Introduction: </strong>New-onset diabetes (NOD) potentially associated with pancreatic cancer (PC) requires further investigation to assess its potential as a tool for PC screening.</p><p><strong>Material and methods: </strong>In this longitudinal nationwide register study, which includes 14,712 PC patients and 18 years of follow-up time (2000-2018), we aimed to assess the prevalence of diabetes by using a large national registry. Survival was analyzed according to diabetes status and duration (long-term diabetes, i.e., DM diagnosed > 3 years prior to PC, NOD, i.e., DM diagnosed 0-3 years prior to PC, or DM diagnosed after PC diagnosis) and treatment status (curative intent vs. palliative) using multivariable Cox regression analysis.</p><p><strong>Results: </strong>Overall, 18% of PC patients had diabetes. The median time interval between DM and PC diagnoses was 4.8 months. In the multivariable Cox regression analysis, only DM diagnosed after PC was associated with worse survival, both in the palliative intent treatment group (HR 1.12, 95% CI 1.03-1.23, p = 0.011) and in the curative intent treatment group (HR 1.44, 95% CI 1.14-1.81, p = 0.002). Among patients diagnosed with diabetes prior to PC, neither long-term nor NOD significantly affected survival.</p><p><strong>Conclusions: </strong>Most of the diabetic PC-patients have been diagnosed with DM within a close proximity of cancer diagnosis. The progression from diabetes to clinically detectable cancer seems to be rapid-less than 6 months. Given the aggressive nature of PC and the fact that NOD can be an early sign, screening may need to begin at the time of diabetes diagnosis. The fact that a DM diagnosis made after a PC diagnosis is associated with worse survival may suggest that pancreatic tumors that cause hyperglycemia are particularly aggressive.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72380"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222892","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":"Clinicopathological Features and Exploratory Outcome Associations of Bone Marrow Fibrosis in Newly Diagnosed Acute Lymphoblastic Leukemia: A Single-Center Retrospective Cohort Study.","authors":"Ying Chen, Si-Heng Liu, Cen-Xia Ran, Wu-Chen Yang, Jia Li, Xian-Gui Peng, Lei Gao, Li Gao, Yi-Mei Feng, Qin Wen, Jun Rao, Pei-Yan Kong, Xi Zhang, Cheng Zhang","doi":"10.1002/cam4.72339","DOIUrl":"10.1002/cam4.72339","url":null,"abstract":"<p><p>Bone marrow fibrosis (MF) reflects stromal remodeling and has been associated with treatment resistance and adverse outcomes in hematologic malignancies; however, its clinical significance in acute lymphoblastic leukemia (ALL) remains uncertain. We retrospectively analyzed 103 patients with newly diagnosed ALL and documented MF grades between 2018 and 2023, comparing patients with MF grades 0-1 and those with MF grades 2-3. Higher-grade MF was present in 50 patients (48.5%). B-ALL accounted for a greater proportion of cases in the MF 2-3 group than in the MF 0-1 group (94.0% vs. 69.8%; nominal p = 0.002), and this difference remained statistically significant after false discovery rate correction. No mutation-level difference between the MF groups remained significant after correction for multiple comparisons. In Cox regression, MF 2-3 was associated with a lower observed hazard of death compared with MF 0-1 (adjusted HR, 0.26; 95% CI, 0.12-0.55; p < 0.001). A similar association was observed in a sensitivity analysis restricted to patients with B-ALL (adjusted HR, 0.30; 95% CI, 0.13-0.70; p = 0.005). Given the retrospective design, limited number of deaths, and potential residual confounding, this unexpected inverse association should be considered exploratory and should not be interpreted as evidence of a biologically protective effect of MF. In conclusion, higher-grade MF was common in newly diagnosed ALL and was associated with B-lineage disease. An unexpected inverse association between MF grade and observed mortality was identified in this cohort and persisted in the B-ALL-restricted sensitivity analysis. External validation is required before MF can be considered for prognostic stratification or treatment decision-making.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72339"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079401","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":"Serum Bile Acid Metabolomics-Based Machine Learning Model for Non-Invasive Diagnosis of Gastric Cancer.","authors":"Nuo Yao, Xiaodong Qu, Ya Zheng, Songbo Li, Xidong Fang, Kexin Lin, Xingyu Zhao, Danyang Zhao, Yongning Zhou, Junye Liu, Yongquan Shi","doi":"10.1002/cam4.72346","DOIUrl":"10.1002/cam4.72346","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) has posed a severe threat to human health. Metabolomics analysis has been applied in the context of multiple diseases, offering new perspectives for the development of non-invasive detections.</p><p><strong>Objective: </strong>We aimed to develop a diagnostic model for GC based on a serum bile acid (BA) panel.</p><p><strong>Methods: </strong>A total of 632 participants were recruited for serum samples collection, and their clinical characteristics were recorded. Targeted BA profiling was conducted using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Participants from Xi'an were randomly allocated into a training cohort and an internal tuning cohort at a 7:3 ratio. The key BAs were identified through the two-step selection method, and nine machine learning (ML) models were constructed and optimized. The optimal model was further evaluated externally using an independent validation cohort from Lanzhou.</p><p><strong>Results: </strong>A panel of 10 serum BAs was confirmed for the construction of a diagnostic model. The XGBoost model exhibited the best performance on the tuning cohort, with an area under the receiver operating characteristic curve (AUROC) of 0.858. It also exhibited robust performance on the external validation cohort (AUROC = 0.816), significantly outperforming tumor markers (with the highest AUROC of CA72-4 = 0.68). The developed model also demonstrated satisfactory predictive performance for patients with resectable stage GC (Stage I-II) (average precision [AP] = 0.75).</p><p><strong>Conclusion: </strong>GC patients exhibit BA metabolic disorders. The XGBoost model based on a 10-BA panel exhibited superior efficacy in GC detection, indicating its promising potential for clinical application.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72346"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134541","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":"Serial ctDNA Analysis for Monitoring Molecular Response and Acquired Resistance in Metastatic NSCLC and HR+/HER2-Negative Breast Cancer: A Real-World Study","authors":"Franciele Hinterholz Knebel,&nbsp;Maurício Fernando Silva Almeida Ribeiro,&nbsp;Rudinei Diogo Marques Linck,&nbsp;Isabela Flauzino Ferreira,&nbsp;Cibele Masotti,&nbsp;Rodrigo Saddi,&nbsp;Karina Perez Sacardo,&nbsp;Felipe Sales Nogueira Amorim Canedo,&nbsp;Leandro Jonata Carvalho Oliveira,&nbsp;Daniele Coelho Duarte,&nbsp;Paula Fontes Asprino,&nbsp;Ernande Xavier dos Santos,&nbsp;Elisângela Monteiro Coser,&nbsp;Dimitrios Kleftogiannis,&nbsp;Louise J. Barber,&nbsp;Marco Gerlinger,&nbsp;João Victor Machado Alessi,&nbsp;Andrea Kazumi Shimada,&nbsp;Fernando Costa Santini,&nbsp;Ciro Eduardo de Souza,&nbsp;Olavo Feher,&nbsp;Gilberto de Castro Junior,&nbsp;Frederico Perego Costa,&nbsp;Max Senna Mano,&nbsp;Artur Katz,&nbsp;Anamaria Aranha Camargo,&nbsp;Fabiana Bettoni","doi":"10.1002/cam4.72208","DOIUrl":"10.1002/cam4.72208","url":null,"abstract":"<p>Circulating tumor DNA (ctDNA) is a promising biomarker for disease monitoring, yet evidence of its clinical utility in routine care remains limited. We evaluated the utility of serial ctDNA monitoring using digital PCR (ddPCR) for detecting acquired resistance (AR) and monitoring response in metastatic non-small cell lung cancer (NSCLC) and breast cancer (MBC). This real-world, longitudinal study included 48 metastatic patients (42 with <i>EGFR</i>-mutant NSCLC; 6 with HR+/HER2-negative MBC) treated at a Brazilian oncology reference center. Serial plasma samples were analyzed by ddPCR for activating and resistance mutations at specific time points. In the NSCLC cohort, <i>EGFR</i> T790M was detected in 48.4% of patients who progressed on 1st/2nd-generation TKIs. For patients on 3rd-generation TKIs, <i>EGFR</i> C797S was the main AR mechanism (47%), followed by <i>PIK3CA</i>, <i>BRAF</i> mutations, and <i>ERBB2</i>/<i>EGFR</i> amplifications. Longitudinal analysis anticipated radiological progression by approximately 5 months. Early molecular response, characterized by mutation clearance, preceded radiological response. In the MBC cohort, hotspot <i>ESR1</i> mutations (D538G, L536R, Y537S) were identified in 50% of patients. Variations in ctDNA fractional abundance predicted disease progression up to 9 months before radiological confirmation. This study provides real-world evidence that ddPCR-based ctDNA monitoring enables early detection of resistance and predicts disease progression significantly earlier than standard imaging in both NSCLC and MBC. Despite the limited sample size, particularly in the MBC cohort, these real-world findings support liquid biopsy as a minimally invasive tool with the potential to guide therapeutic decisions and inform personalized management in precision oncology. Larger prospective studies are needed to confirm these observations.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101453","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":"Association of Primary Care Physician Density With Metastatic Cancer at Initial Diagnosis: A Population-Based Study of 7 Cancers.","authors":"Muhammad Sohaib Khan, Tammy Leonard, Bella Etingen, Saad Mallick, Natalie Williams, Herbert J Zeh, Patricio M Polanco","doi":"10.1002/cam4.72269","DOIUrl":"https://doi.org/10.1002/cam4.72269","url":null,"abstract":"<p><strong>Background: </strong>Patients with metastatic cancer at initial diagnosis have the worst prognosis. Despite their involvement in initial assessment, the relationship between Primary Care Physician availability and metastatic cancer at initial diagnosis remains unexplored. Our objective was to determine whether Primary Care Physician availability is associated with patients having metastatic cancer at initial diagnosis.</p><p><strong>Methodology: </strong>This was a cross-sectional study of patients aged ≥ 18 and diagnosed with breast, colorectal, liver, lung, ovarian, pancreatic, or prostate cancer from 2015 to 2019. Population-based Texas and California cancer registries were used for patient data. The main exposure was county-level Primary Care Physician density per 3500 individuals. Additional exposures included demographic factors, insurance, rural-urban continuum codes, county poverty rates, and US State at Diagnosis. The primary outcome was adjusted odds of metastatic cancer at initial diagnosis. Subgroup analyses based on insurance type, age group, and metropolitan residence were performed. Models were stratified by cancer type.</p><p><strong>Results: </strong>Overall, 708,451 patients were included. On combined multivariable analysis, with each additional Primary Care Physician per 3500 individuals, the odds for primary outcome decreased by 2% to 6%. In a stratified analysis using Primary Care Physician density per 3500 individuals as a categorical variable, compared with counties with < 1 Primary Care Physician, counties with 3 or more Primary Care Physicians had reduced odds of primary outcome for multiple cancer types with no statistically significant difference for counties with 1-1.9 Primary Care Physicians.</p><p><strong>Conclusion: </strong>Increased Primary Care Physician availability was associated with a nonlinear decrease in odds for metastatic cancer at diagnosis. Thus, increasing physician density can possibly lower the likelihood of metastatic cancer at initial diagnosis.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72269"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222876","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":"Implementation of Risk Prediction Models Using Electronic Health Data for Early Detection of Pancreatic Cancer: A Prospective Pilot Feasibility Study.","authors":"Bechien U Wu, Tiffany Q Luong, Eva Lustigova, Christie Jeon, Eric J Puttock, Rebecca H Moon, Mercedes A Munis, Wansu Chen","doi":"10.1002/cam4.72368","DOIUrl":"10.1002/cam4.72368","url":null,"abstract":"<p><strong>Background and aims: </strong>We previously developed multiple machine-learning and regression-based risk prediction models using retrospective electronic health records (EHR) to estimate near-term risk of pancreatic cancer (PC). This pilot study aimed to assess the feasibility of an early detection strategy combining initial EHR-based risk prediction with downstream imaging and blood-based testing.</p><p><strong>Methods: </strong>This prospective study included adults aged 50-84 years with an estimated ≥ 1% 18-month risk of PC, identified between January 2021 and March 2023 using four previously validated models. Patients with a history or active suspicion of PC were excluded. Participants completed cross-sectional imaging and CA19-9 Labs at baseline and again at 18 months. Outcomes included enrollment rates, test completion rate, and burden of incidental findings.</p><p><strong>Results: </strong>Of 1251 eligible patients, 102 (8.2%) enrolled (median age 69 years [IQR 62-75]; 58% women; 48% Hispanic, 34% White, 11% Black, and 7% Asian). At baseline, 89 (87%) completed imaging and 98 (96%) completed CA19-9. At 18 months, 79% completed both imaging and CA19-9. Ten (10%) participants underwent additional clinical evaluations triggered by imaging findings. Evaluations included an endoscopic ultrasound, renal imaging, and FibroScan. CA19-9 results were normal in most participants, though 18% had elevated levels at baseline.</p><p><strong>Conclusions: </strong>Real-time EHR-based ML algorithms can be combined with blood- and imaging-based surveillance for early detection of PC with acceptable burden of incidental findings. However, improved patient engagement is a key aspect that will need to be addressed in order to successfully scale an AI-guided strategy for early detection.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72368"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190286","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":"Age-Dependent Patterns of Cisplatin-Induced Ototoxicity in Head and Neck Cancer: A Longitudinal Audiologic Analysis.","authors":"C Suzuki, Y Kishimoto, M Yamamoto, N Yamamoto, M Kitamura, S Hiraoka, R Nakashima, S Morita, K Omori","doi":"10.1002/cam4.72323","DOIUrl":"10.1002/cam4.72323","url":null,"abstract":"<p><strong>Background: </strong>Cisplatin (CDDP) is a key chemotherapeutic agent used to treat head and neck cancer. Improved survival rates have increased concerns about CDDP-induced ototoxicity, as this toxicity significantly impacts survivors' quality of life. However, the dose-dependent and age-related patterns of CDDP-induced ototoxicity remain incompletely defined. Therefore, in this study, we aimed to characterize CDDP-induced ototoxicity by tracking longitudinal hearing data and evaluating the associated factors.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed a cohort of 316 patients with head and neck cancer who received CDDP-based chemotherapy at a tertiary cancer center between January 2009 and June 2023. Hearing function was longitudinally assessed using pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) across the cumulative CDDP dose. Multivariate logistic regression analyses were performed to identify the factors associated with ototoxicity, including the cumulative dose, age, radiotherapy, and the primary tumor site.</p><p><strong>Results: </strong>At baseline, older patients exhibited substantially impaired high-frequency hearing compared with younger patients. Across all age groups, hearing deteriorated in a dose-dependent manner following CDDP exposure. However, despite smaller apparent longitudinal threshold shifts, older patients developed clinically relevant PTA-defined ototoxicity at lower cumulative CDDP doses than younger patients, reflecting limited auditory reserve. Contrastingly, larger threshold shifts observed in younger patients reflected greater measurable dynamic range from preserved baseline hearing rather than an increased vulnerability. DPOAE changes were attenuated in older patients, suggesting that DPOAE had reduced sensitivity for detecting CDDP-induced ototoxicity in the presence of pre-existing cochlear damage.</p><p><strong>Conclusion: </strong>CDDP-induced ototoxicity shows distinct age-dependent patterns, with older patients experiencing clinically significant hearing impairment at lower cumulative doses despite smaller longitudinal changes. These findings highlight the need for age-adapted monitoring strategies and cumulative dose-conscious treatment planning to preserve auditory function in cancer survivors.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72323"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101552","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}