Cancer Medicine最新文献

{"title":"Association Between Immune-Related Adverse Events and Treatment Outcomes in Advanced Gastric Cancer Patients Receiving Nivolumab Plus Chemotherapy: A Retrospective Study","authors":"Kazumasa Yamamoto,&nbsp;Hidekazu Hirano,&nbsp;Toshiharu Hirose,&nbsp;Hirokazu Shoji,&nbsp;Natsuko Okita,&nbsp;Atsuo Takashima,&nbsp;Ken Kato","doi":"10.1002/cam4.71252","DOIUrl":"10.1002/cam4.71252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immune-related adverse events (irAEs) have been linked to improved outcomes in patients undergoing treatment with immune checkpoint inhibitors (ICIs) for various cancers. However, the relationship between irAEs and overall survival (OS) in patients with advanced gastric cancer (AGC) receiving chemoimmunotherapy remains unclear. This study aimed to explore the association between irAEs and treatment outcomes in patients with AGC receiving chemotherapy plus nivolumab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed clinical data from patients with HER2-negative AGC who received first-line chemotherapy (SOX, CapeOX, or FOLFOX) plus nivolumab at the National Cancer Center Hospital between November 2021 and February 2023. Patients were stratified into two groups based on the occurrence of irAEs. Outcomes, including OS and progression-free survival (PFS), were compared using Kaplan–Meier analysis, landmark analysis, and Cox proportional hazards regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 60 patients analyzed, 15 (25%) developed irAEs of any grade, with 3 patients (5%) experiencing grade ≥ 3 irAEs. Patients with irAEs had significantly longer OS and PFS in comparison to those without irAEs (median OS: not reached vs. 17.1 months, <i>p</i> &lt; 0.01; median PFS: not reached vs. 6.8 months, <i>p</i> &lt; 0.01). Multivariate analysis identified the occurrence of irAEs as a favorable prognostic factor for OS (hazard ratio: 0.13; 95% CI: 0.03–0.59; <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that the occurrence of irAEs is associated with improved survival outcomes in patients with AGC receiving chemotherapy plus nivolumab. IrAEs may serve as a predictive marker for treatment response in this setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074099","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":"Early Tumor Shrinkage and Depth of Response as Predictive Markers of Treatment Response and Prognosis in Solid Tumors","authors":"Peng Cao,&nbsp;Xiaojuan Yang","doi":"10.1002/cam4.71251","DOIUrl":"10.1002/cam4.71251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evaluation of tumor efficacy is central to cancer care. Progression-free survival (PFS) is widely used as an early surrogate for treatment effectiveness, but more timely and reliable biomarkers are needed. Early tumor shrinkage (ETS) and depth of response (DpR) have emerged as promising predictors: ETS reflects early treatment sensitivity at first radiologic assessment, whereas DpR quantifies the maximum tumor reduction and may capture the durability of benefit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a narrative synthesis of clinical studies assessing ETS and/or DpR across solid tumors, focusing on their definitions, measurement under RECIST, and associations with PFS and overall suvival (OS). We also summarized advances in imaging and multidimensional assessment framworks that could improve the accuracy and clinical utility of these indicators, and highlighted sources of heterogeneity and current gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across multiple retrospective and post-hoc analyses, ETS provides an early signal that identifies patients more likely to benefit from therapy and can inform treatment adaptation. DpR shows consisten correlations with long-term outcomes and complements PFS by reflecting the magnitude of tumor control. Both ETS and DpR demonstrate predictive value for PFS and OS; however, variability in cut-offs (e.g., ETS 20%–30%), timing of assessments, tumor types, and treatment modalities limits comparability. Emerging imaging technologies and composite response frameworks offer opportunities to enhance measurement precision and reproducibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ETS and DpR are promising, clinically interpretable markers for monitoring treatment effcacy and prognosis. Standardized definitons, prospective validation, and integration with molecular and imaging biomarkers (e.g., ctDNA, radiomics, and machine—learning—enhanced imaging) are needed to refine their application and solidify their role in routine cancer therapy monitoring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074207","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":"Prevalence and Determinants of Impaired Bone Mineral Density and Fractures in the First National Dutch Wilms Tumor Survivor Cohort, a National DCCSS-LATER Study","authors":"Francis S. P. L. Wens,&nbsp;Demi T. C. de Winter,&nbsp;Geert O. Janssens,&nbsp;Rens Litjens,&nbsp;Jenneke E. van Atteveld,&nbsp;Rutger A. J. Nievelstein,&nbsp;Monique G. G. Hobbelink,&nbsp;Andrica C. H. de Vries,&nbsp;Jacqueline J. Loonen,&nbsp;Eline van Dulmen-den Broeder,&nbsp;Helena J. H. van der Pal,&nbsp;Saskia M. F. Pluijm,&nbsp;Leontien C. M. Kremer,&nbsp;Margriet van der Heiden-van der Loo,&nbsp;Marloes Louwerens,&nbsp;Hanneke M. van Santen,&nbsp;Daniel S. Olsson,&nbsp;Imo Hoefer,&nbsp;Sjoerd A. A. van den Berg,&nbsp;Harm van Tinteren,&nbsp;Sebastian J. C. M. M. Neggers,&nbsp;Marry M. van den Heuvel-Eibrink","doi":"10.1002/cam4.71229","DOIUrl":"10.1002/cam4.71229","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Wilms tumors (WT) are the most common kidney tumors in children, with excellent survival rates (90%). However, late adverse effects warrant attention. Limited data exist on musculoskeletal sequelae in WT survivors. We aimed to assess the prevalence and determinants of impaired bone mineral density (BMD) and fractures in a national cohort of Dutch WT survivors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This cross-sectional study includes WT survivors treated between 1963 and 2002, recruited as part of the DCCSS-LATER cohort between 2016 and 2020. Dual-energy X-ray absorptiometry (DXA) scans were used to assess BMD. Low BMD was defined as a <i>Z</i>-score ≤ 1. From 5 years after diagnosis, fracture prevalence was assessed by questionnaires. Univariable logistic regression was used to analyze associations between impaired BMD as well as fractures with independent variables like patient characteristics, treatments, comorbidities, and lifestyle-related factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 437 invited kidney tumor survivors, 233 WT survivors participated (median age 32.1 years, median follow-up 27.8 years). DXA scans and fracture data were available for 173 and 221 WT survivors, respectively. Low BMD at any site was observed in 26% (<i>n</i> = 46/173) of survivors and was significantly associated with treatment including ≥ 4 drugs (OR 2.76; 95% CI = 1.13–6.70). Abdominal radiotherapy doses &gt; 30 Gy (OR 4.84; 95% CI = 1.06–22.2) were significantly associated with low lumbar spine BMD. The prevalence of fragility fractures was 16.3% (<i>n</i> = 36/221). The standardized incidence ratio (SIR) of any first fracture was 2.34 for males and 5.38 for females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Wilms tumor survivors treated with ≥ 4 drugs or abdominal radiotherapy (&gt; 30 Gy) seem to be at increased risk of impaired BMD; this could indicate the need for surveillance for this subset of Wilms tumor survivors exposed to these treatment regimens in the past.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12438959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068692","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":"Real-World Treatment Patterns and Survival Outcomes in Metastatic Triple Negative Breast Cancer: Immunotherapy- Versus Anti-Angiogenic Therapy-Combined-With-Chemotherapy","authors":"Yingzhe Wang,&nbsp;Song Wu,&nbsp;Jianbin Li,&nbsp;Yang Yuan,&nbsp;Li Bian,&nbsp;Shaohua Zhang,&nbsp;Tao Wang,&nbsp;Zefei Jiang","doi":"10.1002/cam4.71164","DOIUrl":"10.1002/cam4.71164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There is limited clinical evidence comparing different chemotherapy-based combination therapies. This study aimed to evaluate and compare the efficacy and safety of chemotherapy combined with immunotherapy versus chemotherapy combined with anti-angiogenic therapy in the treatment of metastatic triple-negative breast cancer (TNBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included patients with metastatic TNBC who received either anti-PD-1 monoclonal antibody or bevacizumab in combination with chemotherapy. The primary endpoint was progression-free survival (PFS); the secondary endpoints included overall response rate (ORR), clinical benefit rate (CBR), and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between October 2018 and June 2024, 130 eligible patients were enrolled. Of these, 60 patients received chemotherapy combined with anti-PD-1 monoclonal antibody, and 70 patients received chemotherapy combined with bevacizumab. The median PFS was 5.9 months (95% CI: 4.3–8.7) in the immunotherapy group, compared to 3.0 months (95% CI: 2.2–4.7) in the bevacizumab group (hazard ratio [HR] = 0.42, 95% confidence interval [CI] 0.28–0.62, <i>p</i> &lt; 0.0001). The ORR rates were 55% in the immunotherapy group and 27.1% in the bevacizumab group (<i>p</i> = 0.001). The CBR rates were 43.3% and 22.9%, respectively (<i>p</i> = 0.013). The overall incidence of adverse events was comparable between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the treatment of metastatic TNBC, chemotherapy combined with immunotherapy offers significant survival advantages over chemotherapy combined with bevacizumab.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068742","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":"“Quite Devastating, Traumatic, and Lonely”: Understanding the Mental Health Experiences of Hispanic/Latino Rectal Cancer Patients and Their Caregivers","authors":"Zaria N. Cosby,&nbsp;Julian P. Howland,&nbsp;Eleanor Brown,&nbsp;Lucas K. Carpenter,&nbsp;Kristen M. Davis-Lopez,&nbsp;Min Young Kim,&nbsp;Patricia Castañeda,&nbsp;Maria Gonzalez,&nbsp;Miriam T. Hernandez,&nbsp;Ysabel Duron,&nbsp;Gladys M. Rodriguez,&nbsp;Sandra S. Zaky,&nbsp;Arden M. Morris,&nbsp;Aaron J. Dawes","doi":"10.1002/cam4.71253","DOIUrl":"10.1002/cam4.71253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Psychological distress increases after a cancer diagnosis. However, patients who identify as Hispanic/Latino are less likely than their White counterparts to receive mental health care after being diagnosed, placing them at risk of poor psychological adjustment. The parent research objective aimed to characterize the treatment experiences of rectal cancer patients who identify as Hispanic/Latino. This qualitative secondary analysis specifically explored patients' emotional and psychological experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We partnered with local community health workers to recruit rectal cancer patients who identified as Hispanic/Latino and their caregivers from California's Bay Area and Central Valley. Semi-structured interviews (<i>n</i> = 21) were conducted in either Spanish or English based on patient preference. Initial themes were identified using reflexive analysis. Experiences of distress were found in nearly all interviews, motivating this qualitative secondary analysis using directed content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified three main themes: (1) emotional reactions to the initial diagnosis, (2) perspectives and emotions experienced throughout treatment, and (3) coping strategies and advice for others. Participants reported shock and incongruence with their diagnosis. The treatment journey caused feelings of embarrassment and frustration from difficulties such as racial profiling and insurance. Patients coped through faith and support from trusted individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Rectal cancer patients who identify as Hispanic/Latino endure emotional distress at multiple stages of their cancer journey, including from sources that are unique to this population. Culturally and linguistically tailored interventions are needed to help mitigate this psychological burden and to provide active, coordinated support throughout the treatment phase in order to better prepare patients for survivorship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068725","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":"Metabolic Reprogramming of Cancer Cells and Therapeutics Targeting Cancer Metabolism","authors":"Jilsy M. J. Punnasseril,&nbsp;Abdul Auwal,&nbsp;Vinod Gopalan,&nbsp;Alfred King-Yin Lam,&nbsp;Farhadul Islam","doi":"10.1002/cam4.71244","DOIUrl":"10.1002/cam4.71244","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cancer metabolism is a field focused on the unique alterations in metabolic pathways that occur in cancer cells, distinguishing them from the metabolic processes in normal cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An extensive review of the current literature on the metabolic adaptation of cancer cells was carried out in the current study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rapidly proliferating cells require high levels of molecules, such as glucose, amino acids, lipids, and nucleotides, along with increased energy demand (ATP). These requirements are met through alterations in the processes involving glucose, amino acid, lipid, and nucleotide metabolism. Modifications in glucose metabolism in cancer cells involve changes in glucose uptake, glycolysis, the pentose phosphate pathway, and the tricarboxylic acid cycle. Similarly, alterations in amino acid metabolism in cancer cells relate to upregulated amino acid transport and glutaminolysis. Cancer cells also have increased lipid intake from the extracellular microenvironment, upregulated lipogenesis, and enhanced lipid storage and mobilization from intracellular lipid droplets. These rapidly proliferating cells also achieve their increased demand for nucleotides by changing the expression of enzymes in the salvage and de novo nucleotide pathways. Consequently, these metabolic processes are targets for developing cancer therapeutics. However, it is important to note that the metabolic changes in cancer cells can also contribute to resistance against various cancer therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review will explore the various ways in which cancer cells reprogram metabolic processes to sustain rapid proliferation and survival. The information presented in this report could help in the therapeutics designed to target them, and the challenges of cancer drug resistance arising from these metabolic adaptations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068787","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":"Promising Cancer Vaccine for Glioblastoma Therapy: A Focus on mRNA Vaccine","authors":"Sama Barati,&nbsp;Sahar Ghoflchi,&nbsp;Pejman Hosseinzadeh,&nbsp;Sobhan Pouramini,&nbsp;Hossein Hosseini,&nbsp;Mohammad Jalili-Nik","doi":"10.1002/cam4.71187","DOIUrl":"https://doi.org/10.1002/cam4.71187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glioblastoma (GBM) is an aggressive primary brain tumor with poor prognosis and low survival rates. Standard treatments, such as surgery and radiotherapy, are limited by tumor infiltration and resistance. To review current vaccine strategies for GBM, including peptide, virotherapy, cell-based, and genetic vaccines, with a focus on mRNA vaccines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Relevant literature on GBM vaccines and immunotherapy was reviewed to summarize design, mechanisms, and potential clinical applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cancer vaccines aim to activate the immune system to target tumor cells. mRNA vaccines are promising due to their flexibility, rapid production, and strong immune activation, though clinical investigation is ongoing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vaccine-based therapies, particularly mRNA vaccines, hold potential for personalized GBM treatment, but further studies are needed to confirm efficacy and optimize use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062542","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":"Tackling Health Inequalities in Cancer Screening: Experiences of Eastern European and African Communities in Northeast Scotland","authors":"Sarah R. Prowse,&nbsp;Shaun Treweek,&nbsp;María José Pavez Larrea,&nbsp;Miriam Brazzelli,&nbsp;Adriana Uribe","doi":"10.1002/cam4.71236","DOIUrl":"https://doi.org/10.1002/cam4.71236","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This report provides insights from ethnic minority community members who may be under-served by the healthcare system in Northeast Scotland, focusing on how to improve the delivery of cancer screening programmes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A partnership approach was used to engage the public with particular emphasis on reaching Polish/Eastern European and African communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Key areas for improvement identified through discussion groups include communication, cultural competence, access to screening services, and knowledge-raising initiatives to help individuals navigate the UK healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings offer recommendations as to how healthcare systems can engage with diverse communities for meaningful reform within cancer screening programmes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062790","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":"Mechanisms, Clinical Trials, and New Treatments for BCG-Unresponsive in Nonmuscle Invasive Bladder Cancer","authors":"Xiaotong Huang,&nbsp;Xuan Wang,&nbsp;Zihe He,&nbsp;Yishu Huang,&nbsp;Bing Hu,&nbsp;Weiying Chen,&nbsp;Haifang Du","doi":"10.1002/cam4.71243","DOIUrl":"https://doi.org/10.1002/cam4.71243","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bacillus Calmette–Guérin (BCG) is the standard adjuvant therapy for high-risk non-muscle invasive bladder cancer (NMIBC), yet treatment failure occurs in 30% to 40% of patients. Those with BCG-unresponsive disease face a high risk of progression and represent a critical unmet need in urologic oncology. This review summarizes the mechanisms of BCG failure and evaluates emerging therapies for BCG-unresponsive NMIBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive literature review of clinical trials and preclinical studies through August 2025, focusing on therapeutic strategies for BCG-unresponsive NMIBC. Mechanisms of BCG resistance, regulatory definitions, and results from recent Phase II/III trials were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multiple novel therapies have demonstrated efficacy in BCG-unresponsive patients. Immune checkpoint inhibitors (e.g., pembrolizumab) achieved complete response (CR) rates of 41% in carcinoma in situ (CIS) patients. Gene therapies such as nadofaragene firadenovec and CG0070 induced CR rates of 51% and 75%, respectively. Device-assisted therapies including hyperthermic intravesical chemotherapy (HIVEC) showed 24-month recurrence-free survival of 57.4%. The IL-15 superagonist Anktiva (nogapendekin alfa inbakicept), recently FDA-approved, achieved a 71% CR rate with a median duration of 26.6 months when combined with BCG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The treatment landscape for BCG-unresponsive NMIBC is rapidly evolving, with immune checkpoint inhibitors, gene therapies, targeted agents, and advanced drug delivery systems showing promising efficacy. These innovations provide bladder-preserving options for patients ineligible for radical cystectomy. Future directions include biomarker-driven therapy selection, combination regimens, and optimized intravesical delivery platforms to improve long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062793","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":"Cost-Effectiveness Analysis of First-Line Chemotherapy for Metastatic Pancreatic Cancer in Japan","authors":"Yuriko Sasahara,&nbsp;Yuki Takumoto,&nbsp;Tatsunori Murata,&nbsp;Manabu Akazawa,&nbsp;Hiroto Narimatsu","doi":"10.1002/cam4.71233","DOIUrl":"https://doi.org/10.1002/cam4.71233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>Pancreatic cancer is a highly aggressive disease with limited treatment options. The combination of tegafur, gimeracil, and oteracil (S-1) has emerged as a promising treatment approach in Japan. However, the economic implications of S-1 compared to other chemotherapy regimens have not been fully explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cost-effectiveness analysis study evaluated the economic position of S-1 relative to fluorouracil+leucovorin+irinotecan+oxaliplatin (FFX), gemcitabine+Nab-paclitaxel (GnP), and gemcitabine (GEM) for the treatment of distant metastatic pancreatic cancer in Japan. Incremental cost-effectiveness ratios were calculated using quality-adjusted life years (QALYs) as the measure of effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>S-1 demonstrated the lowest incremental cost-effectiveness ratio compared to FFX, GnP, and GEM, indicating that it offers the most value for the cost. The total cost per QALY for S-1 was significantly lower than the other regimens. Additionally, S-1 was associated with favourable safety and convenience profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study suggest that S-1 is a cost-effective and promising treatment option for distant metastatic pancreatic cancer in Japan. Its favourable economic profile, combined with its safety and convenience advantages, makes it a viable choice for patients and healthcare providers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062541","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}