Cancer Medicine最新文献

{"title":"Lifestyle Behaviors and Physical Health in Canadian Childhood, Adolescent, and Young Adult Cancer Survivors.","authors":"Selina R van den Oever, Ismay A E de Beijer, Oluwaseyi A Lawal, Heide T Adham, Tamilore Ashofor, Amanda Button, Jenny Duong, Jennifer Giles, Leontien C M Kremer, Helena van der Pal, Kathleen Reynolds, Rachel M Taylor, Saskia M F Pluijm, Fiona M Schulte","doi":"10.1002/cam4.72324","DOIUrl":"10.1002/cam4.72324","url":null,"abstract":"<p><strong>Background: </strong>With this study, we aimed to investigate the longitudinal relationships between lifestyle behaviors and physical health in childhood, adolescent, or young adult (CAYA) cancer survivors attending the Long-Term Survivor's Clinic (LTSC) in Calgary, Canada.</p><p><strong>Methods: </strong>Survivors attended the LTSC once or twice a year and completed a questionnaire at each visit. Among survivors of any cancer diagnosis who were aged ≥ 11 years at the time of assessment, physical health was captured using two outcomes: the number of self-reported physical health problems and the number of physical health-related medications used. Self-reported lifestyle behaviors, including physical activity, alcohol, tobacco, and cannabis use, and sleep quality were scored as healthy (1) or unhealthy (0), and combined into a sum score ranging from 0 to 5. Multivariable, generalized linear mixed models (GLMM) were estimated to assess the association between lifestyle behaviors (sum score and individual behaviors) and physical health outcomes, irrespective of time. To address our second research question, cross-lagged GLMMs, incorporating a time component, were estimated to assess directionality between lifestyle sum score and the number of physical health problems.</p><p><strong>Results: </strong>In total, 766 responses from 312 CAYA cancer survivors (median age at follow-up 23.8 years; 49% male; 37% diagnosed with leukemia) were included. A healthier lifestyle sum score and sufficient physical activity were associated with fewer physical health problems (estimate -0.15, SE 0.06, p-value 0.02 and estimate -0.23, SE 0.11, p-value 0.04, respectively). No significant associations were found between lifestyle and the number of medications used. Lifestyle behaviors at an earlier time did not predict better physical health at a later time and vice versa.</p><p><strong>Conclusions: </strong>Findings confirm an association between a healthy lifestyle and fewer physical health problems. Additional studies are warranted to further elucidate directional pathways between a survivor's lifestyle and physical health.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72324"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101696","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":"Prognostic Value of Perioperative Inflammatory-Immune-Nutritional Indicators in Advanced Gallbladder Cancer.","authors":"Rongxuan Li, Bingchen Wang, Xiao Chen, Dayong Cao, Jianguo Zhou","doi":"10.1002/cam4.72351","DOIUrl":"10.1002/cam4.72351","url":null,"abstract":"<p><strong>Objective: </strong>To explore the perioperative changes in inflammatory-immune-nutritional indicators in patients with advanced gallbladder cancer (GBC), defined as American Joint Committee on Cancer (AJCC) Stage III-IV, and to assess whether individual indicators provide incremental prognostic information beyond conventional clinicopathological factors.</p><p><strong>Methods: </strong>Patients with pathologically confirmed advanced GBC who underwent surgery at the Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, between 2010 and 2022 were retrospectively enrolled. Preoperative and postoperative Day 7 values of the albumin-to-alkaline phosphatase ratio (AAPR), albumin-to-globulin ratio (AGR), albumin-bilirubin score (ALBI), advanced lung cancer inflammation index (ALI), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and systemic inflammation response index (SIRI) were calculated. Perioperative dynamic changes were compared, and Cox proportional hazards models were constructed to evaluate the incremental prognostic value of these indicators.</p><p><strong>Results: </strong>Among 103 patients with advanced GBC, all eight inflammatory-immune-nutritional indicators showed significant changes between the preoperative period and postoperative Day 7. Several preoperative and postoperative indicators were associated with cancer-specific survival (CSS) in cutoff-based exploratory analyses. After the incorporation of these indicators into clinicopathological models, most extended models showed varying degrees of improvement in discrimination and goodness of fit.</p><p><strong>Conclusion: </strong>In this single-center cohort, perioperative inflammatory-immune-nutritional indicators exhibit significant dynamic changes in advanced GBC and can improve, to a certain extent, the prognostic performance of models based on conventional clinicopathological characteristics. These indicators may serve as useful supplementary tools for risk stratification and individualized prognostic assessment in patients with advanced GBC.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72351"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101617","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 Travel Time With Definitive Prostate Cancer Treatment: A United States Registry Cohort Study.","authors":"Filippo Dagnino, Stephan Korn, Danesha Daniels, Zhiyu Qian, Daniel Stelzl, Hanna Zurl, Klara Pohl, Mei-Chin Hsieh, Brenda Y Hernandez, Andrea Piccolini, Giovanni Lughezzani, Nicolò M Buffi, Stuart R Lipsitz, Amanda Reich, Joel S Weissman, Alexander P Cole, Quoc-Dien Trinh, Hari S Iyer","doi":"10.1002/cam4.72376","DOIUrl":"10.1002/cam4.72376","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate cancer (PCa) mortality disparities are partly driven by unequal access to care. Transportation barriers may limit access to definitive treatment. We studied how driving travel time affects receipt of definitive PCa treatment.</p><p><strong>Materials and methods: </strong>We conducted a cohort study of men with non-metastatic PCa (2000-2015; follow-up through 2018) across the metropolitan area cancer registries of seven US states. Travel time was estimated using Google Maps isochrones representing driving time thresholds to reach the hospital appended to geomasked residential addresses. Outcomes were \"no treatment,\" \"radical surgery,\" or \"radiotherapy\". Covariate-adjusted multinomial logistic regression with interaction terms assessed modification by sociodemographic factors.</p><p><strong>Results: </strong>The study included 132,939 men, of whom 37.0% received no treatment, 41.0% underwent surgery, and 22.0% received radiotherapy. Longer driving time (≥ 90 min vs. < 30 min) was associated with higher radical prostatectomy (aOR: 1.08, 95% CI: 1.03, 1.12), but lower radiotherapy (0.72, 95% CI: 0.69-0.76). Subgroup analyses revealed higher surgery associated with longer driving times among those in nSES Q1 (aOR: 1.33, 95% CI: 1.21-1.45) vs. Q5 (aOR: 0.94, 95% CI: 0.86-1.04), those in low (aOR: 1.16, 95% CI: 1.09-1.24) vs. high (aOR: 1.03, 95% CI: 0.98-1.09) population density areas, and those with regional (aOR: 1.30, 95% CI: 1.14-1.48) vs. localized (aOR: 1.05, 95% CI: 1.00-1.09) disease. Longer driving time was mostly associated with lower odds of radiotherapy across sociodemographic subgroups.</p><p><strong>Conclusions: </strong>Higher travel time was associated with lower radiotherapy receipt, but higher surgery use in deprived and rural patients, warranting further investigation.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72376"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163776","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 Association Between CD40 rs1883832 Polymorphism and Cancer Susceptibility: A Systematic Review and Meta-Analysis.","authors":"Bingxiang Wang, Min Gao, Shuhao Fan, Huaiju Ge, Chao Li, Cheng Li","doi":"10.1002/cam4.72243","DOIUrl":"10.1002/cam4.72243","url":null,"abstract":"<p><p>The CD40 gene, a key immune regulatory molecule, has been implicated in tumorigenesis, and its functional polymorphism rs1883832 located in the Kozak sequence, may modulate cancer susceptibility by influencing CD40 expression. To clarify inconsistent epidemiological findings, a comprehensive meta-analysis was conducted to evaluate the association between the CD40 rs1883832 polymorphism and overall cancer risk. Eligible case-control studies were systematically identified from PubMed, Web of Science and Cochrane Library up to August 15, 2025, and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated under five genetic models. Eight studies encompassing 3858 cancer cases and 4699 controls met the inclusion criteria. The results revealed a significant association between the rs1883832 T allele and elevated cancer risk in 4 multiple models, including the allele (T vs. C: OR = 1.26, 95% CI: 1.09-1.47, p < 0.01), homozygous (TT vs. CC: OR = 1.58, 95% CI: 1.16-2.16, p < 0.01), recessive (TT vs. TC + CC: OR = 1.43, 95% CI: 1.18-1.82, p < 0.01), and dominant (TT + TC vs. CC: OR = 1.29, 95% CI: 1.03-1.62, p = 0.03) models. Subgroup analyses revealed suggestive patterns of associations in lung cancer and Asian populations. Sensitivity analyses confirmed the robustness of these findings, and no substantial publication bias was detected. In conclusion, this meta-analysis provides compelling evidence that the CD40 rs1883832 T allele may confer increased susceptibility to cancer, thereby underscoring the potential influence of immune gene polymorphisms in carcinogenesis and their relevance for genetic risk assessment in oncology. Trial Registration: PROSPERO number: CRD420251130223.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72243"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164142","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":"Next-Generation Sequencing-Based Molecular Profiling and Management of Advanced Solid Tumors: A Real-World Experience in a Community-Based Academic Cancer Center.","authors":"Gayathri Moorthy, Annette Sereika, Karen Kaul, Megan Parilla, Mir B Alikhan, Michael Bouma, Dyson Wake, Peter J Hulick, Henry M Dunnenberger, Linda M Sabatini, Mathew Yang, Kathy A Mangold, Erin Proctor, Nicholas Evans, Nicholas Miller, Donald L Helseth, Darryck Maurer, Justin Brueck, Janardan Khandekar, Bruce Brockstein","doi":"10.1002/cam4.72355","DOIUrl":"10.1002/cam4.72355","url":null,"abstract":"<p><strong>Background: </strong>Advances in molecular and cell biology have led to a paradigm shift in cancer management. We implemented next-generation sequencing (NGS) at our community-based academic cancer center over a decade ago. We sought to optimize the use of genomics and understand its impact in identifying actionable genomic alterations to determine therapy options in patients with advanced solid tumors for whom standard therapies had been exhausted.</p><p><strong>Methods: </strong>Through a prospective non-randomized trial, patients with advanced solid tumors who had exhausted standard therapies and who did not qualify for routine guideline-concordant NGS at the time of the study (the study excluded at least Stage 1B lung and Stage IV colorectal cancers) underwent in-house NGS on tumor specimens to identify actionable alterations, and pharmacogenomic testing. Our in-house-developed/integrated bioinformatics pipeline (Flype) was used for structured reporting and served as a molecular knowledgebase. Patients were presented at a multidisciplinary molecular tumor board.</p><p><strong>Results: </strong>251 patients underwent somatic tissue NGS. 173 patients (68.9%) had alterations targetable with FDA-approved or currently investigational drugs. 75 patients (29.9%) had alteration(s) qualifying them for FDA-approved drug(s) for their tumor type. An additional 61 patients (24.3%) had alterations qualifying them for \"off-label\" use of FDA-approved drugs. 40 patients (15.9%) qualified for tumor-agnostic therapies. Of the 224 patients (89.2%) who had RNA analysis, eight (3.6%) had targetable fusions. Of the 33 patients (19.1%) who received NGS-guided targeted therapies, 19 (57.6%) were on treatment for longer than three months. 255 patients underwent pharmacogenomics testing, with over 40% having an alteration in typical response to opioids or antidepressants.</p><p><strong>Conclusions: </strong>In this real-world study, 54.2% of patients with advanced solid tumors were identified as candidates for FDA-approved therapies (on- or off-label), supporting the utility of in-house NGS in providing genomics-guided care for patients.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72355"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101708","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":"Combined Active Bone Marrow-Sparing Radiotherapy and Prophylactic PEG-rhG-CSF to Reduce Severe Neutropenia During Platinum-Doublet Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer: A Phase II Trial.","authors":"ShanBing Wang, Jiapei Liu, Hui Zhong, Kaijian Lei, Chunxiu Wang, Xia Zhang, Ting Li, Yuming Jia","doi":"10.1002/cam4.72366","DOIUrl":"10.1002/cam4.72366","url":null,"abstract":"<p><strong>Background: </strong>Platinum-doublet concurrent chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC) is frequently complicated by severe neutropenia. This Phase II trial investigated whether combining active bone marrow-sparing (ABMS) radiotherapy with prophylactic pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) could reduce the incidence of grade ≥ 3 neutropenia below a prespecified historical benchmark of 30%.</p><p><strong>Methods: </strong>Patients with FIGO 2018 stage IIA2-IVA LACC received SPECT-guided ABMS radiotherapy (45 Gy external beam plus 30 Gy brachytherapy) concurrent with paclitaxel/carboplatin every 21 days for 4 cycles followed by prophylactic PEG-rhG-CSF. Using Simon's two-stage design (α = 0.05, β = 0.20), we tested whether grade ≥ 3 neutropenia could be reduced from a historical benchmark of 30% to ≤ 15%. The primary endpoint was grade ≥ 3 neutropenia incidence; secondary endpoints included other cytopenias, treatment completion, and survival outcomes.</p><p><strong>Results: </strong>Fifty-four patients were enrolled. Grade ≥ 3 neutropenia occurred in 13.0% (7/54; 95% CI: 5.4%-24.9%), meeting the prespecified success criterion (one-sided exact binomial test, p = 0.003 versus the 30% benchmark). Other grade ≥ 3 toxicities included leukopenia (18.5%), anemia (3.7%), thrombocytopenia (5.6%), and febrile neutropenia (1.9%). Overall, 85.2% of patients completed all 4 planned chemotherapy cycles, and all completed radiotherapy within 8 weeks (median overall treatment time: 50 days). At a median follow-up of 40 months, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 88.8% and 88.9%, respectively (6 events each); the study was not powered for survival efficacy.</p><p><strong>Conclusions: </strong>The combination of ABMS radiotherapy and prophylactic PEG-rhG-CSF was associated with a grade ≥ 3 neutropenia rate of 13.0% and a chemotherapy completion rate of 85.2% during platinum-doublet CCRT for LACC. Because the single-arm design and reliance on historical controls preclude causal inference, these findings are hypothesis-generating and primarily establish the operational feasibility of this dual hematoprotection approach. Formal evaluation of safety and efficacy requires the ongoing randomized trial (ChiCTR2400087321).</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2100046911. Registered May 30, 2021.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72366"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167493","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":"Safety Profiles of Immune Checkpoint Inhibitor Strategies in Gastrointestinal Cancers and Their Association With Clinical Outcomes: A Systematic Review and Meta-Analysis.","authors":"Jing Lei, Yiyi Yu, Qing Liu, Ningping Zhang, Yi Wang, Yating Yang, Tianshu Liu, Minzhi Lv","doi":"10.1002/cam4.72357","DOIUrl":"10.1002/cam4.72357","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) are increasingly used in patients with gastrointestinal cancer (GIC). However, ICI-associated adverse event (AE) profiles in GIC remain poorly characterized, and whether AE incidence is associated with clinical outcomes is unclear.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) were identified through February 2025. Primary outcomes included treatment-related AEs (TRAEs) and immune-related AEs (irAEs) (any grade/Grade 3+). Single-arm random-effects meta-analysis pooled AE incidences; risk ratios (RRs) compared toxicity across ICI regimens. Digitized Kaplan-Meier curves reconstructed survival data for pooled analysis and Cox models. Weighted Spearman's tests assessed correlations between AE incidences and median overall survival (OS)/progression-free survival (PFS).</p><p><strong>Results: </strong>Forty RCTs enrolling 10,233 patients investigated ICI monotherapy, dual-ICI therapy, and ICI combination regimens. Pooled any-grade TRAE incidences were 68.0% (monotherapy, 95% CI: 60%-76%, I² = 97.4%, p < 0.001), 87.0% (dual therapy, 95% CI: 73%-100%, I² = 98.0%, p < 0.001), and 90.0% (combination therapy, 95% CI: 83%-96%, I² = 94.6%, p < 0.001). IrAE incidences reached 24.0% (monotherapy, 95% CI: 18%-29%, I² = 67.2%, p < 0.05) and 37.0% (combination therapy, 95% CI: 25%-49%, I² = 98.8%, p < 0.001). Relative to monotherapy, dual-ICI therapy elevated any-grade (RR = 1.28, 95% CI: 1.05-1.55) and grade ≥ 3 TRAEs (RR = 2.71, 95% CI: 1.84-3.99); ICI combination therapy increased any-grade (RR = 1.32, 95% CI: 1.15-1.51) and grade ≥ 3 TRAEs (RR = 2.98, 95% CI: 2.30-3.87). Any-grade TRAEs moderately correlated with median OS (R = 0.46, p < 0.001) and PFS (R = 0.50, p < 0.001). Any-grade irAEs strongly correlated with median OS (R = 0.90, p < 0.001) and moderately with PFS (R = 0.57, p < 0.001).</p><p><strong>Conclusion: </strong>While AE incidence is high among GIC patients receiving ICIs, most events are low-grade. Dual-ICI and ICI-based combination therapies carry higher TRAE and irAE risks than monotherapy. At the trial level, higher non-severe irAE incidence correlated with favorable survival outcomes; this exploratory ecological association does not apply to individual patients.</p><p><strong>Systematic review registration: </strong>This study was registered on International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY202230144).</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72357"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190313","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":"Response to Letter to the Editor Regarding \"Emotional Reactivity and Regulation Relate to Surgical Treatment Decision Making Among Newly Diagnosed Women With Breast Cancer\".","authors":"Catherine Benedict, Bita Nouriani, Eric Neri, Kate Miller, Allison W Kurian, James J Gross, David Spiegel","doi":"10.1002/cam4.72289","DOIUrl":"10.1002/cam4.72289","url":null,"abstract":"","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72289"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206334","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 Role of Dysphagia in Depression, Anxiety, and Symptom Clusters Among Nasopharyngeal Carcinoma Survivors After Intensity-Modulated Radiotherapy: A Latent Profile and Mediation Analysis Based on a Cross-Sectional Study.","authors":"Hui Zhao, Yongjiao Kang, Jiajie Xu, Yanling Wen, Wen Hu, Yuying Fan, Yan He","doi":"10.1002/cam4.72321","DOIUrl":"10.1002/cam4.72321","url":null,"abstract":"<p><strong>Objective: </strong>To identify distinct dysphagia profiles among nasopharyngeal carcinoma (NPC) survivors and to examine the mediating roles of depression and anxiety in the relationship between these profiles and broader symptom clusters. This study hypothesized that subgroup membership would have differential effects on symptom clusters through psychological mediating pathways. The study aimed to provide evidence for the development of precision symptom management interventions.</p><p><strong>Methods: </strong>In this cross-sectional study, 271 survivors recruited from a tertiary cancer hospital in Guangzhou (January 2023-December 2024) completed standardized assessments of dysphagia, psychological status, and symptoms. Latent profile analysis (LPA) identified subgroups of survivors with distinct dysphagia profiles; exploratory factor analysis extracted symptom clusters, multivariable linear regression examined associated factors, and parallel mediation analysis with bootstrap resampling tested the mediating effects.</p><p><strong>Results: </strong>Dysphagia prevalence among NPC survivors was 57.2%, with the highest prevalence (72.7%) observed among survivors within 6 months post-treatment. LPA identified two survivor subgroups with distinct dysphagia profiles: a high dysphagia burden subgroup (51.0%) and a low dysphagia burden subgroup (49.0%). Three symptom clusters were extracted: Systemic/Psychological, Oral/Swallowing, and Gastrointestinal/Neuropathic. Membership in the high dysphagia burden subgroup and anxiety significantly predicted all clusters (p < 0.05). Mediation analyses revealed that dysphagia subgroup membership had significant total effects on all clusters (p < 0.001). Depression showed statistical mediation for the Systemic/Psychological and Oral/Swallowing clusters, whereas anxiety showed statistical mediation for the Systemic/Psychological and Gastrointestinal/Neuropathic clusters.</p><p><strong>Conclusions: </strong>NPC survivors exhibit distinct dysphagia burden profiles, including high- and low-burden subgroups. A high dysphagia burden profile is directly associated with a greater overall symptom burden and indirectly contributes to more severe symptom clusters via depression and anxiety. These findings highlight the need for early identification of survivors within this high-risk subgroup, and the integration of swallowing rehabilitation with psychological interventions for comprehensive symptom management.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72321"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079388","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":"Unveiling the Prognostic Power of Circulating Tumor DNA in Multiple Myeloma: A Systematic Review and Updated Meta-Analysis.","authors":"Wanting Ying, Lei Fan, Ran Li, Xiaoyan Qu","doi":"10.1002/cam4.72244","DOIUrl":"10.1002/cam4.72244","url":null,"abstract":"<p><p>Circulating tumor DNA (ctDNA) serves as a non-invasive liquid biopsy technique, offering potential utility in the prognostic evaluation of multiple myeloma (MM). In this study, we performed a systematic review and updated meta-analysis to analyze the association between ctDNA and the prognosis of patients diagnosed with MM. A comprehensive literature search was performed across PubMed, Embase, Web of Science, and the Cochrane Library to retrieve relevant literature published up to May 29, 2025, assessing the impact of ctDNA on survival outcomes in patients with MM. The survival outcomes included overall survival (OS), progression-free survival (PFS), and time to progression (TTP). A total of 948 MM patients from 14 studies were included in the analysis. Patients with detectable ctDNA exhibited a significantly increased risk of aggressive disease progression (hazard ratio [HR], 3.21; 95% confidence interval [CI], 1.98-5.18) and reduced OS (HR, 3.97; 95% CI, 2.24-7.04). Subgroup analyses consistently indicated that ctDNA positivity was associated with accelerated disease progression, irrespective of race, disease status, treatment, or ctDNA detection method. In subgroups defined by relapsed or refractory MM (RRMM) and Oceanian or Caucasian race, ctDNA positivity was significantly correlated with poorer OS. However, the associations were not significant in newly diagnosed MM (NDMM) or among Asian patients. Therefore, we conclude that ctDNA is a potential predictor of inferior survival outcomes in MM patients.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72244"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068994","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}