Cancer Medicine最新文献

{"title":"Implementing a Genetic Counselor-Led Model for Hereditary Myeloid Malignancies: A Real-World Study","authors":"Madeline VanDerGraaf,&nbsp;Georgianne Younger,&nbsp;Kyle Dillahunt,&nbsp;Jennifer Smith,&nbsp;Athena Puski,&nbsp;Nicole Blum,&nbsp;Hailey Manwiller,&nbsp;Jaime Nagy,&nbsp;Grerk Sutamtewagul,&nbsp;Kittika Poonsombudlert,&nbsp;Moon Ley Tung","doi":"10.1002/cam4.71240","DOIUrl":"https://doi.org/10.1002/cam4.71240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hereditary hematological malignancy syndromes (HHMS) are more common than previously thought, and identification of an HHMS syndrome can inform the choice of treatments, transplant, and testing of other family members. Genetic testing guidelines for hematological malignancy have broadened; however, there remain a multitude of barriers and complexities with germline genetic testing for these patients. Here, we describe a process for the evaluation and testing of patients for HHMS as well as our respective findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult patients with a new diagnosis or history of myeloid malignancy and referred for genetic counseling from 2020 to 2023 within a single institution were reviewed. Descriptive statistics were performed, and frequency data was gathered for relevant patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of forty-nine patients were evaluated by a genetic counselor based on their myeloid malignancy; forty-three patients underwent genetic testing. Genetic testing revealed an HHMS for six patients, with two additional patients found to have abnormalities on ancillary testing that could not be genetically characterized. Thirty-five patients met NCCN age-based criteria for genetic testing; however, this was not mutually exclusive with those diagnosed with HHMS. Inpatient genetic counseling had a median timeline of 53 days from referral to result (range: 32–56.75 days). Outpatient genetic counseling had a median timeline of 96 days from referral to result (range: 64–144 days).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our proposed process demonstrates an efficient structure for patients with hematological malignancy while supporting the importance of the genetic counselor within the malignant hematology and stem cell transplant teams.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145037958","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":"Quality of Life in Adult Individuals Living With or at Risk of a Hereditary Cancer Predisposition Syndrome: A Scoping Review of the Qualitative Literature","authors":"M. Sztankay,&nbsp;S. Wheelwright,&nbsp;V. Vassiliou,&nbsp;E. M. A. Bleiker,&nbsp;B. Rahman,&nbsp;B. Holzner,&nbsp;A. Yener,&nbsp;V. Engele,&nbsp;A. S. Oberguggenberger,&nbsp;EORTC Quality of Life Group","doi":"10.1002/cam4.71069","DOIUrl":"https://doi.org/10.1002/cam4.71069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The in-depth understanding of the impact of a hereditary cancer predisposition syndrome (HCPS) on the health-related quality of life (HRQOL) of individuals with a hereditary cancer burden contributes to the improvement of counselling strategies as well as care planning and informs the development of patient-reported outcome measures (PROMs) for standardised HRQOL assessment. This is the first review to systematically identify and synthesise the evidence from qualitative literature on HRQOL issues relevant for adult individuals living with (the risk of) HCPS between 1991 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligible studies were qualitative studies of adult individuals' experiences, including direct quotes and studies on the development or validation of health outcome measures. The literature was searched from 1991 to 2024 using the databases PubMed, CINAHL, Embase, and PsycINFO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We screened 13,410 references for study inclusion by title and abstract, resulting in the retrieval of 606 full papers. More than 6800 qualitative patient quotes were extracted and coded by four raters. Reviewed literature provided a comprehensive picture of the experience of individuals living with (the risk of) HCPS in nine identified HRQOL domains (decision-making, impact on family and social relationships, emotional response to test result, living with HCPS, perspective on life and self, HCPS-related symptoms, taking measures to prevent the development or progression of cancer, issues related to the health care system, practical issues of life).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results contribute to insight on how individuals at risk cope with genetic testing and will inform the development of a PROM on their HRQOL that will be applicable for individualised patient management and service evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145037957","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":"Individualized Prognostic Insights: CONUT-GBRS for Survival Prediction in Gallbladder Cancer","authors":"Si-qi Yang,&nbsp;Rui-qi Zou,&nbsp;Yu-shi Dai,&nbsp;Jun-ke Wang,&nbsp;Wen-jie Ma,&nbsp;Hai-jie Hu,&nbsp;Fu-yu Li","doi":"10.1002/cam4.71203","DOIUrl":"https://doi.org/10.1002/cam4.71203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The most suitable prognostic prediction system for gallbladder cancer (GBC) is yet to be determined. This study aims to establish a combined score integrating preoperative patients' nutritional and immune status and pathological parameters to forecast the survival outcomes following curative-intent surgery of GBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included patients diagnosed with GBC based on postoperative pathological examinations. The patients underwent curative surgery at West China Hospital of Sichuan University (China) between January 2014 and December 2022. Using the controlling nutritional status (CONUT) score and gallbladder cancer predictive risk score (GBRS), we generated the CONUT-GBRS for every patient, and the patients were divided into two groups based on the optimal cutoff value. Comparisons were made between the two groups regarding clinicopathologic features and survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The optimal cutoff value for the CONUT-GBRS was 1.39. There were 99 and 201 individuals in the high and low CONUT-GBRS groups, respectively. Patients with high CONUT-GBRS experienced poorer overall survival and disease-free survival compared with those with low CONUT-GBRS, even after propensity score matching analysis. Both univariate and multivariate Cox analyses established that CONUT-GBRS stood as an independent prognostic factor for GBC patients. Subgroup analysis indicated that CONUT-GBRS was also an effective predictor of prognosis in patients with incidental GBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CONUT-GBRS serves as an advantageous, straightforward, and cost-effective prognostic tool for GBC, offering valuable prognostic insights and guiding the tailoring of individualized treatment strategies to improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 18","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038121","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":"Because Doing “It” Matters to Patients: Development and Evaluation of a What Matters to Me Tool That Elicits Patients' Priorities to Support Cancer Treatment Shared Decision-Making","authors":"Bruce D. Rapkin,&nbsp;Ariana E. Tao,&nbsp;Brieyona C. Reaves,&nbsp;Krystal A. Rivera,&nbsp;Lauren K. Jones,&nbsp;Rita R. Ravichandar,&nbsp;Dennis Yi-Shin Kuo,&nbsp;Rafi Kabarriti,&nbsp;Alexander I. Sankin,&nbsp;Ahmed A. Aboumohamed,&nbsp;Kara L. Watts,&nbsp;Damara N. Gutnick,&nbsp;Ellen Miller-Sonet","doi":"10.1002/cam4.71169","DOIUrl":"10.1002/cam4.71169","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cancer impinges on nearly every aspect of the lives of patients, survivors, and loved ones. This study presents progress in developing the “What Matters to Me” Worksheet (WMTM-Worksheet), designed to elicit personal priorities across multiple life domains. WMTM-Worksheet items were finalized based on clinician recommendations and patient feedback. Individuals at any point in cancer treatment were interviewed post-appointment about using the WMTM-Worksheet prior to their appointment.&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;To finalize the WMTM Worksheet, initial samples of clinicians and patients were interviewed on its content and usability. Oncology clinicians were recruited by email; 25 accepted and were surveyed about current practices of incorporating patient priorities and preferences into treatment planning, and the usability, practicality, and feasibility of the 17-item WMTM Worksheet. Patients were English- or Spanish-speaking adults diagnosed with gynecological, head and neck, or urological cancers. Patients at any point in active treatment or follow-up were eligible. An initial sample of 15 patients was administered a cognitive interview about the WMTM Worksheet by telephone to assess its clarity, relevance, and feasibility. Next, 61 patients taking part in the user experience portion of this study were identified through the electronic medical record (EMR), contacted by telephone, and offered participation in a onetime interview regarding the WMTM Worksheet. They received the WMTM Worksheet prior to a clinic appointment. Questions regarding user experience were administered by telephone 1–3 days later.&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;Of the 61 patient respondents, 57% were over age 65, 59% female, 41% Hispanic, 45% Black; 49% had an annual income below $35,000. Patient responses yielded seven principal components, reflecting domains such as symptoms, family caregiving, work, and hobbies. Most patients (62%) said the WMTM-Worksheet helped them think about disease and treatment; 30% said it helped communication with clinicians. Eighty-five percent were glad to share their concerns, and only 10% found it difficult to complete.&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;The WMTM-Worksheet can bring patients' broader priorities into care planning. Patients may be better able to anticipate and avoid problems. Discussion of priorities validates patients' concerns and promotes trust. Implementation will require the clinical infrastructure to support shared decision-making and in","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032511","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":"Efficacy of Immune Checkpoint Inhibitors in Combination With Platinum-Based Doublet Chemotherapy for Extensive-Stage Small-Cell Lung Cancer Patients With Eastern Cooperative Oncology Group-Performance Status 2–3: A Single-Institution Retrospective Study","authors":"Kosuke Sakai,&nbsp;Shigeru Ishii,&nbsp;Shin Yokosuka,&nbsp;Tomoyuki Takahashi,&nbsp;Yuichiro Kawano,&nbsp;Hiroaki Nishimura,&nbsp;Yoshiki Kuwabara,&nbsp;Maiko Sasaki-Toda,&nbsp;Yumiko Ogawa-Kobayashi,&nbsp;Satoshi Kikuchi,&nbsp;Yusuke Hirata,&nbsp;Hiroyuki Kyoyama,&nbsp;Gaku Moriyama,&nbsp;Nobuyuki Koyama,&nbsp;Kazutsugu Uematsu","doi":"10.1002/cam4.71136","DOIUrl":"https://doi.org/10.1002/cam4.71136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prognosis of small-cell lung cancer (SCLC) remains poor, particularly in patients with extensive-stage SCLC. The IMpower133 and CASPIAN trials revealed the efficacy of immune checkpoint inhibitors (ICIs) in extensive-stage SCLC patients with good performance status (PS). The aim of this study was to investigate the efficacy of ICIs in patients with poor PS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Patients with extensive-stage SCLC who visited Saitama Medical Center, Saitama Medical University (Kawagoe, Japan) (September 2019–December 2022) were enrolled and followed up until February 2024. Objective response rate (ORR) and overall survival (OS) were compared between patients who received platinum-based doublet chemotherapy with an ICI (atezolizumab or durvalumab; ICI group) and those treated with platinum-based doublet chemotherapy alone (non-ICI group). Results were stratified by the Eastern Cooperative Oncology Group performance status (ECOG-PS) (i.e., 0–1 and 2–3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 74 patients were included in the study (median OS: 327 days). In patients with ECOG-PS 0–1, ORR was 76.5% and 56.5% in the ICI group (<i>n</i> = 17) and non-ICI group (<i>n</i> = 23), respectively; OS was 406 and 379 days, respectively. In patients with ECOG-PS 2–3, ORR was 93.3% and 56.3% in the ICI group (<i>n</i> = 15) and non-ICI group (<i>n</i> = 16), respectively; OS was 446 days and 169 days, respectively. This evidence indicates that the addition of an ICI significantly improved OS (<i>p</i> = 0.00661) and enhanced ORR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with extensive-stage SCLC and ECOG-PS 2–3, the addition of atezolizumab or durvalumab to platinum-doublet chemotherapies improved the ORR, resulting in a better prognosis. These findings suggest that chemoimmunotherapy may be a feasible treatment option beyond the ideal clinical trial populations, addressing an unmet clinical need.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022291","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":"A Review on Biomarker-Enhanced Machine Learning for Early Diagnosis and Outcome Prediction in Ovarian Cancer Management","authors":"Somayyeh Hormaty,&nbsp;Anwar Nather Seiwan,&nbsp;Bushra H. Rasheed,&nbsp;Hanieh Parvaz,&nbsp;Ali Gharahzadeh,&nbsp;Hamid Ghaznavi","doi":"10.1002/cam4.71224","DOIUrl":"https://doi.org/10.1002/cam4.71224","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ovarian cancer (OC) remains the most lethal gynecological malignancy, largely due to its late-stage diagnosis and nonspecific early symptoms. Advances in biomarker identification and machine learning offer promising avenues for improving early detection and prognosis. This review evaluates the role of biomarker-driven ML models in enhancing the early detection, risk stratification, and treatment planning of OC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed literature spanning clinical, biomarker, and ML studies, emphasizing key diagnostic and prognostic biomarkers (e.g., CA-125, HE4) and ML techniques (e.g., Random Forest, XGBoost, Neural Networks). The review synthesizes findings from 17 investigations that integrate multi-modal data, including tumor markers, inflammatory, metabolic, and hematologic parameters, to assess ML model performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Biomarker-driven ML models significantly outperform traditional statistical methods, achieving AUC values exceeding 0.90 in diagnosing OC and distinguishing malignant from benign tumors. Ensemble methods (e.g., Random Forest, XGBoost) and deep learning approaches (e.g., RNNs) excel in classification accuracy (up to 99.82%), survival prediction (AUC up to 0.866), and treatment response forecasting. Combining CA-125 and HE4 with additional markers like CRP and NLR enhances specificity and sensitivity. However, limitations such as small sample sizes, lack of external validation, and exclusion of imaging/genomic data hinder clinical adoption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Biomarker-driven ML represents a transformative approach for OC management, improving diagnostic precision and personalized care. Future research should prioritize multi-center validation, multi-omics integration, and explainable AI to overcome current challenges and enable real-world implementation, potentially reducing OC mortality through earlier detection and optimized treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022290","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 Evidence of Active Surveillance for Prostate Cancer in Spain; Midterm Results","authors":"J. Rubio-Briones,&nbsp;A. Borque-Fernando,&nbsp;L. M. Esteban Escaño,&nbsp;A. Wong,&nbsp;A. Guijarro Cascales,&nbsp;E. Gómez Gómez,&nbsp;J. M. Gil Fabra,&nbsp;F. Sanguedolce,&nbsp;F. Gomez-Veiga,&nbsp;P. A. López González,&nbsp;A. Plata Bello,&nbsp;N. Rodríguez García,&nbsp;M. Montesino Semper,&nbsp;J. F. Suárez Novo,&nbsp;R. Hajianfar,&nbsp;L. l. Fumadó Ciutat,&nbsp;A. González Alfaro,&nbsp;J. M. Duarte Ojeda,&nbsp;A. Bono Ariño,&nbsp;C. Quicios Dorado,&nbsp;A. Loizaga Iriarte,&nbsp;G. García Fadrique,&nbsp;J. M. Giménez Bachs,&nbsp;S. García Barreras,&nbsp;Y. Pallas Costa,&nbsp;A. Vilaseca Cabo,&nbsp;M. Rodrigo Aliaga,&nbsp;F. Campanario Pérez,&nbsp;P. Servián,&nbsp;J. M. Campá Bortoló,&nbsp;M. Soto Delgado,&nbsp;J. M. Rodríguez de Ledesma,&nbsp;C. Sánchez Rodríguez,&nbsp;V. Chantada Abal,&nbsp;Y. E. Hernández Martínez,&nbsp;B. Herrera Imbroda,&nbsp;P. Dolezal,&nbsp;J. Gual Frau,&nbsp;P. Medrano Llorente,&nbsp;J. Moreno Jiménez,&nbsp;J. S. Serrano Uribe,&nbsp;C. B. Congregado Ruiz,&nbsp;A. Reyes,&nbsp;T. Fernández Aparicio,&nbsp;J. García Rodríguez,&nbsp;M. Cuadras Solé,&nbsp;A. García Seguí,&nbsp;J. J. Pacheco Bru,&nbsp;J. Mayor de Castro,&nbsp;A. Mira Moreno,&nbsp;J. L. Molina Suárez","doi":"10.1002/cam4.71173","DOIUrl":"https://doi.org/10.1002/cam4.71173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In this multicenter longitudinal study, data from the Spanish Register in AS (AEU-PIEM/2014/0001) were reviewed. The study focused on a cohort of AS patients registered between 2014 and 2019, featuring open inclusion criteria and diverse follow-up strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3315 AS patients were recruited, with 2881 and 434 categorized into the low and intermediate risk groups based on NCCN grouping at inclusion. The median age was 67 years, and only 11% underwent diagnostic biopsy guided by MRI. The median time between follow-up visits was 6.03 months. Over a median follow-up of 62 months (Q1–3: 43.78–85.58), 37% remained in AS, while 8% transitioned to watchful waiting due to aging or intercurrent disease. Death occurred in 199 (6%) of patients, with 3 due to prostate cancer progression and 196 attributed to other causes. At 2 and 5 years, pathological progression-free survival, metastasis-free survival, and active treatment-free survival were 68% and 51%, 99% and 99%, and 70% and 50%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Midterm oncological outcomes of AS in Spain align with major international series. We denote underuse of guideline recommendations such as use of MRI or TP Bx for initial PCa characterization. Collaborative efforts are crucial in the search for algorithms, new imaging, or biomarkers to refine indications and transition to active treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT02865330</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021849","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":"A Novel Approach for Cisplatin-Resistant Esophageal Squamous Cell Carcinoma via Amino Acid Transporter LAT1 Inhibition","authors":"Takeru Mozumi,&nbsp;Narumi Harada-Shoji,&nbsp;Yohei Ozawa,&nbsp;Yuto Yamazaki,&nbsp;Ryoyu Niikuni,&nbsp;Kentaro Imai,&nbsp;Yusuke Taniyama,&nbsp;Chiaki Sato,&nbsp;Hiroshi Okamoto,&nbsp;Hirotaka Ishida,&nbsp;Atsushi Kunimitsu,&nbsp;Iku Sasaki-Higashimoto,&nbsp;Chisa Kobayashi,&nbsp;Shozo Furumoto,&nbsp;Takaaki Abe,&nbsp;Takashi Suzuki,&nbsp;Takashi Kamei","doi":"10.1002/cam4.71234","DOIUrl":"https://doi.org/10.1002/cam4.71234","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Esophageal squamous cell carcinoma (ESCC) represents an aggressive cancer type associated with poor prognosis, often treated with neoadjuvant chemotherapy (NAC) using cisplatin-based regimens. However, cisplatin resistance limits therapeutic efficacy, necessitating a deeper understanding of resistance mechanisms. L-type amino acid transporter 1 (LAT1) plays a crucial role in amino acid uptake and is linked to cancer cell survival through activation of the mammalian target of rapamycin (mTOR) pathway. The involvement of LAT1 in cisplatin resistance in ESCC remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>LAT1 expression in ESCC patient samples post-NAC was evaluated by immunohistochemistry, and its association with clinicopathological factors and survival outcomes was analyzed. ESCC cell lines with varying cisplatin sensitivities were assessed for LAT1 expression using western blotting. Amino acid metabolism was examined via radiotracer uptake of ¹⁸F-FET and ¹⁸F-FDG. RNA sequencing was conducted to identify differentially expressed genes associated with mTOR signaling and autophagy. Finally, the effect of the LAT1 inhibitor JPH203 on cell proliferation was tested.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High LAT1 expression was significantly associated with larger tumor size, lymph node metastasis, advanced pathological stage, and poor NAC response. Patients with high LAT1 expression exhibited shorter disease-free survival and overall survival. Cisplatin-resistant ESCC cells (KYSE520) showed elevated LAT1 expression, which further increased following cisplatin treatment. Radiotracer assays revealed that ¹⁸F-FET uptake was significantly higher in KYSE520 after cisplatin treatment compared to the sensitive cell line TE5. RNA sequencing identified regulation of mTOR pathway components and autophagy-related genes in cisplatin-resistant cells. Treatment with JPH203 significantly suppressed cell proliferation, particularly in KYSE520 cells, indicating LAT1's role in sustaining tumor cell survival under chemotherapy stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LAT1 contributes to cisplatin resistance in ESCC by sustaining amino acid metabolism and promoting mTOR-dependent autophagy. Targeting LAT1 with JPH203 enhances cisplatin sensitivity, suggesting that LAT1 inhibition could be a promising therapeutic strategy for overcoming chemoresistance in ESCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71234","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012985","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":"Actionable Genes and Carcinogenic Pathways for Gastric Cancer in Latinos","authors":"Ingrid M. Montes-Rodríguez,&nbsp;Hilmaris Centeno-Girona,&nbsp;Sol V. Pérez-Mártir,&nbsp;Noridza Rivera,&nbsp;Marcia Cruz-Correa","doi":"10.1002/cam4.71216","DOIUrl":"https://doi.org/10.1002/cam4.71216","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric cancer (GC) is the fourth leading cause of cancer-related death globally. Tumor profiling has revealed actionable gene alterations that guide treatment strategies and enhance survival. Among Hispanics living in Puerto Rico (PRH), GC ranks among the top 10 causes of cancer-related death. However, the genetic mutational landscape of GC tumors from PRH remains unexplored. This study aimed to identify the most prevalent genetic alterations in GC tumors among PRH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined tumor mutational profiles of GC from 106 PRH between 2015 and 2022 (provided by CARIS Life Sciences and the Precision Oncology Alliance). Next-generation sequencing data were available for 85 cases, which were categorized as hypermutated (≥ 10 mutations/megabase) or non-hypermutated (&lt; 10 mutations/megabase).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the non-hypermutated cases, the most frequently mutated genes were <i>TP53</i> (56.9%), <i>CDH1</i> (29.2%), <i>ARID1A</i> (27.4%), and <i>KMT2D</i> (25.7%). Compared to TCGA, a majority non-Hispanic cohort, PRH had significantly higher mutational frequencies in driver genes in both intestinal type (<i>TP53</i>, <i>CBLB</i>, and <i>MYH11</i>) and diffuse type (<i>CDH1</i>, <i>ARID1A</i>, and <i>KMT2D</i>) GC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Intestinal-type GC in PR aligns with the chromosomal instability (CIN) molecular classification, showing a higher frequency of <i>TP53</i> mutations than TCGA, potentially indicating more aggressive tumor biology and poorer prognosis. Diffuse-type GC showed higher <i>CDH1</i> mutations, correlating with the genomically stable (GS) classification, characterized by fewer chromosomal changes but significant genetic alterations, including those in <i>ARID1A</i> and <i>KMT2D</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows that the unique genetic landscape of GC tumors in this group may lead to more aggressive cases and affect treatment responses, contributing to higher mortality rates. The higher mutation rates in biomarkers related to prognosis and therapy suggest that further research might uncover additional susceptibility variants. This underscores the importance of including Hispanics in genomic studies to better understand the genetic pathways associated with the risk and progression of GC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022244","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":"Emerging Radiopharmaceuticals Beyond FDG for Ovarian Cancer: A Review of Advances in Nuclear Medicine","authors":"Mara M. K. Veenstra,&nbsp;Sophie Veldhuijzen van Zanten,&nbsp;Erik Vegt,&nbsp;Ingrid A. Boere,&nbsp;Heleen J. van Beekhuizen,&nbsp;Julie Nonnekens,&nbsp;Frederik A. Verburg,&nbsp;Maarten G. J. Thomeer","doi":"10.1002/cam4.71167","DOIUrl":"https://doi.org/10.1002/cam4.71167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This review summarizes the role and future prospects of nuclear medicine in ovarian cancer, focusing on novel radiopharmaceuticals beyond FDG for diagnostic, predictive, and therapeutic applications within a theranostic framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A narrative literature review was conducted using major databases. Peer-reviewed articles addressing non-FDG radiopharmaceuticals in ovarian cancer were identified and assessed; FDG-based studies were excluded due to the availability of prior comprehensive reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Novel radiopharmaceuticals show potential to enhance diagnostic accuracy, allow early evaluation of treatment response, predict chemotherapy resistance, and support stratification for targeted therapies. Several tracers are under investigation for theranostic use, offering combined diagnostic and therapeutic benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Incorporating novel radiopharmaceuticals into ovarian cancer management may help overcome limitations of conventional imaging and systemic therapy. Theranostic strategies, uniting molecular imaging with radionuclide therapy, represent a promising step toward personalized medicine and could significantly influence clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nuclear medicine, through innovative radiopharmaceuticals and theranostic approaches beyond FDG, is expected to expand its role in ovarian cancer care. Further research is needed to validate these applications and facilitate their integration into clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012685","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}