Cancer Medicine最新文献

{"title":"Serum Lipid Biomarkers and the Risk of Gastrointestinal Cancers in a Chinese Population: The Kailuan Prospective Study","authors":"Ying Xiao,&nbsp;Xin Du,&nbsp;Tianjie Wang,&nbsp;Dong Liu,&nbsp;Hongzhao You,&nbsp;Hao Wang,&nbsp;Hanyang Liang,&nbsp;Zhengqing Ba,&nbsp;Yilu Liu,&nbsp;Yu Ren,&nbsp;Jinghan Zeng,&nbsp;Weixian Yang,&nbsp;Shouling Wu,&nbsp;Jiansong Yuan","doi":"10.1002/cam4.70654","DOIUrl":"https://doi.org/10.1002/cam4.70654","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Current evidence on relationships between serum lipid biomarkers and the risk of gastrointestinal cancers remains controversial, with no consensus reached.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective cohort study within the Kailuan Cohort wherein 88,225 individuals with baseline information on triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was followed from 2006 to 2021 for the incidence of esophageal cancer (EC), gastric cancer (GC), and colorectal cancer (CRC). Cox proportional hazards models and restricted cubic spline (RCS) analysis were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Increased EC risk was associated with high HDL-C levels (HR_Q4vs.Q1 = 2.50, 95% CI: 1.57–3.98), while a U-shaped relationship between HDL-C and EC risk was revealed in the RCS analysis (<i>p</i>_overall ≤ 0.0001, <i>p</i>_nonlinear = 0.02). No robust association was identified between lipid biomarkers and GC risk. In multivariable analysis, increased CRC risk was positively associated with high TC levels (HR_Q4vs.Q1 = 1.42, 95% CI: 1.11–1.83, <i>p</i>_trend = 0.03), dose–responsely negatively associated with LDL-C levels over quartiles (HR_Q2vs.Q1 = 0.83, 95% CI: 0.66–1.02; HR_Q3vs.Q1 = 0.86, 95% CI: 0.69–1.07; HR_Q4vs.Q1 = 0.68, 95% CI: 0.53–0.86, <i>p</i>_trend = 0.02), and showed a diminished negative association with HDL-C levels over quartiles (HR_Q2vs.Q1 = 0.75, 95% CI: 0.60–0.94; HR_Q3vs.Q1 = 0.76, 95% CI: 0.61–0.95; HR_Q4vs.Q1 = 0.91, 95% CI 0.74–1.13, <i>p</i>_trend = 0.02). The subsequent RCS analysis revealed a linear negative relationship of LDL-C (<i>p</i>_overall = 0.004, <i>p</i>_nonlinear = 0.67) and a U-shaped relationship of HDL-C (<i>p</i>_overall = 0.05, <i>p</i>_nonlinear = 0.02) with CRC risk. Competitive risk analysis and sensitivity analysis confirmed the stability of our results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We observed a U-shaped relationship regarding HDL-C levels with EC and CRC risk, and a linear inverse relationship between LDL-C levels and CRC risk. Relevant serum lipid levels should be properly managed in high-risk individuals of certain gastrointestinal cancers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248761","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":"Merging of the Fukushima Health Management Survey With the National and Local Cancer Registry to Refine the Detection of Thyroid Cancer Cases After the 2011 Fukushima Daiichi Nuclear Power Plant Accident","authors":"Reiko Kimura-Tsuchiya,&nbsp;Masanori Nagao,&nbsp;Shigehira Saji,&nbsp;Fumikazu Hayashi,&nbsp;Tetsuya Ohira,&nbsp;Hiroki Shimura,&nbsp;Fumihiko Furuya,&nbsp;Satoru Suzuki,&nbsp;Satoshi Suzuki,&nbsp;Tetsuo Ishikawa,&nbsp;Susumu Yokoya,&nbsp;Hitoshi Ohto,&nbsp;Seiji Yasumura","doi":"10.1002/cam4.70610","DOIUrl":"https://doi.org/10.1002/cam4.70610","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>After the Fukushima Daiichi Nuclear Power Plant accident in 2011, the Fukushima Health Management Survey (FHMS) was implemented in Fukushima Prefecture to promote long-term health care. The FHMS included thyroid ultrasound examination (TUE) for individuals aged ≤ 18 years, including fetuses at the time of the accident. However, the FHMS may not have captured all cases of thyroid cancer because it only followed up with examinees. To address this gap, we aimed to merge individual-level information from the FHMS with national and local cancer registries (CRs) to determine the limitations of the FHMS and CRs in capturing thyroid cancer cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The FHMS-eligible residents' information was supplemented by merging and cross-validating the FHMS and CR data using the Fukushima Prefectural Cancer Registry (FPCR), 2008–2015, and the National Cancer Registry (NCR), 2016–2018. For analysis, registered cases were classified into three groups: registered in both the CR and FHMS, or only in the CRs, or only in the FHMS. The characteristics of each case were evaluated in each database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the FHMS, 212 thyroid cancer cases were identified through 2018, with another 42 cases identified in the CRs. Of the 176 thyroid cancer cases registered until 2015, 28 (15.9%) were identified in the FHMS only and 13 (7.4%) in the FPCR only. Of the 78 additional cases identified since 2016, 29 (37.2%) were identified in the NCR only and 6 (7.7%) in the FHMS only. This indicates that the NCR captured the cases more efficiently than the FPCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Merging data from the FHMS and CRs at the individual level is necessary to capture thyroid cancer cases more accurately after the 2011 nuclear accident.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248598","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":"Prediction Model for Brain Metastasis in Patients With Metastatic Germ-Cell Tumors","authors":"Tareq Salous,&nbsp;Ryan Ashkar,&nbsp;Sandra K. Althouse,&nbsp;Clint Cary,&nbsp;Timothy Masterson,&nbsp;Nasser H. Hanna,&nbsp;Jennifer King,&nbsp;Lawrence H. Einhorn,&nbsp;Nabil Adra","doi":"10.1002/cam4.70649","DOIUrl":"https://doi.org/10.1002/cam4.70649","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Brain metastasis (BM) is an independent adverse prognostic factor in metastatic germ cell tumors (mGCT). We aimed to establish an effective and practical BM prediction model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Between January 1990 and September 2017, 2291 patients with mGCT who were treated at Indiana University were identified. Patients were divided into two categories: BM present (<i>N</i> = 154) and BM absent (<i>N</i> = 2137). Kaplan–Meier methods were used to analyze progression free survival (PFS) and overall survival (OS). Logistic regression was used to determine a predictive model for whether BM was present. The data was separated into training and validation datasets with equal numbers of events in each.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 2-year PFS and OS for patients with versus without BM: 17% versus 65% (<i>p</i> &lt; 0.001) and 62% versus 91% (<i>p</i> &lt; 0.001) respectively. Among the 154 patients with BM, 64 (42%) had radiation only (whole-brain radiotherapy or gamma knife), 22 (14%) had BM-surgery only, 14 (9%) had both radiation and BM-surgery. 54 patients (35%) did not receive local therapy for BM. Stepwise selection was used to determine the best model with <i>p</i> &lt; 0.15 as the entry and staying criteria. The model with the largest ROC AUC was used moving forward. The model was tested in the validation dataset. A model was generated including age at diagnosis ≥ 40, choriocarcinoma predominant histology, pre-chemotherapy hCG≥ 5000, presence of pulmonary metastases size &lt; 3, or ≥ 3 cm, and presence of bone metastasis. Patients with score of 0, 1, 2, 3, 4, 5, 6, 7, 8 points had a 0.6%, 1.4%, 3.5%, 8.2%, 18.3%, 36%, 58%, 78%, 90% probability of having BM, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prediction model developed in this study demonstrated discrimination capability of predicting BM occurrence in mGCT and can be used to identify high-risk patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70649","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248891","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 Combined Prognostic Value of 18F-FDG PET/CT Metabolic Parameters of Immune Organs and Hematological Immune-Related Markers in Patients With Locally Advanced Cervical Cancer","authors":"Yi Li,&nbsp;Xin Wang,&nbsp;Yuanlin Li,&nbsp;Wanhu Li,&nbsp;Defeng Liu,&nbsp;Longxiang Guo,&nbsp;Xiuli Liu,&nbsp;Zhichao Li,&nbsp;Ao Liu,&nbsp;Minghuan Li","doi":"10.1002/cam4.70650","DOIUrl":"https://doi.org/10.1002/cam4.70650","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to explore the prognostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) metabolic parameters of immune organs and hematological immune-related markers for patients with locally advanced cervical cancer (LACC) undergoing concurrent chemoradiotherapy (CCRT), and to establish prognostic nomograms based on these potential biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 180 patients with LACC undergoing CCRT were retrospectively reviewed and randomly divided into training and validation groups at a 7:3 ratio. Cox regression analysis was performed to identify independent prognostic factors for progression-free survival (PFS) and overall survival (OS) from hematological immune-related markers and ¹⁸F-FDG PET/CT metabolic parameters of the primary tumor, spleen, and bone marrow (BM). Nomograms were developed and evaluated using receiver operating characteristic curves, concordance index (C-index), calibration curves, and decision curve analysis (DCA). Spearman correlation analysis was used to assess the relationships among metabolic parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariable analysis identified International Federation of Gynecology and Obstetrics (FIGO) stage, neutrophil-to-lymphocyte ratio (NLR), and spleen maximum standardized uptake value (SUV_spleen) as independent prognostic factors for PFS. For OS, the independent prognostic factors were FIGO stage, NLR, metabolic tumor volume, and SUV_spleen. The nomograms demonstrated better prognostic performance for PFS (area under curve [AUC]: 0.875 and 0.862; C-index: 0.809 and 0.775) and OS (AUC: 0.858 and 0.814; C-index: 0.828 and 0.792) in the training and validation groups. Calibration curves and DCA indicated that the nomograms have good predictive accuracy and clinical utility. Spearman correlation analysis revealed significant positive correlations among total lesion glycolysis, SUV_spleen, SUV_BM, and platelet-to-lymphocyte ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The nomograms based on metabolic parameters of immune organs and hematological immune-related markers demonstrated high predictive value for patients with LACC undergoing CCRT. The observed correlations between the metabolic parameters of the primary tumor and immune organs suggest a widespread disturbance of systemic immunity caused by the tumor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70650","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248760","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":"Multi-Institutional Phase II Study on the Efficacy and Safety of Dynamic Tumor-Tracking, Moderately Hypofractionated Intensity-Modulated Radiotherapy in Patients With Locally Advanced Pancreatic Cancer","authors":"Michio Yoshimura,&nbsp;Masahiro Hiraoka,&nbsp;Masaki Kokubo,&nbsp;Takashi Sakamoto,&nbsp;Katsuyuki Karasawa,&nbsp;Yukinori Matsuo,&nbsp;Mitsuhiro Nakamura,&nbsp;Nobutaka Mukumoto,&nbsp;Satoshi Morita,&nbsp;Takashi Mizowaki","doi":"10.1002/cam4.70648","DOIUrl":"10.1002/cam4.70648","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For delivering high radiation doses to pancreatic tumors, organ motion management is indispensable; however, studies on this are limited. We aimed to evaluate the efficacy and safety of dynamic tumor tracking (DTT) moderately hypofractionated intensity-modulated radiotherapy (IMRT) in patients with locally advanced pancreatic cancer (LAPC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with histological confirmation for LAPC were included. A linac system, which was mounted with a gimbal function, was used for DTT-IMRT. The prescribed dose was 48 Gy in 15 fractions. The primary endpoint was the 1-year rate of freedom from locoregional progression (FFLP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DTT-IMRT was successfully administered in 25 patients enrolled from four institutions. The median range of respiratory motion during DTT-IMRT was 9.8 mm (range: 3.5–27.3 mm), and the median tracking accuracy was 2.6 mm (range: 0.7–5.2 mm). With a median follow-up period of 13.9 months, the 1-year FFLP rate was 75.3% (lower limit of one-sided 80% confidence interval [CI]: 60.2%), which satisfied the predetermined primary endpoint. One-year locoregional progression-free survival, progression-free survival, and overall survival were 56.0% (95% CI: 34.8%–72.7%), 44.0% (95% CI: 24.5%–61.9%), and 60.0% (95% CI: 38.4%–76.1%), respectively. Regarding nonhematologic toxicities, grade 3 acute gastrointestinal (GI) toxicity was observed in two patients (8%), and two patients (8%) each experienced grade 3 late GI and non-GI toxicities. No grade 4 or 5 nonhematologic toxicities were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DTT moderately hypofractionated IMRT shows preferable locoregional control without significant toxicity in patients with LAPC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>UMIN000017521</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187815","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 Effects of Silibinin Combined With EGFR-TKIs in the Treatment of NSCLC","authors":"Xiaocen Wang","doi":"10.1002/cam4.70643","DOIUrl":"10.1002/cam4.70643","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Currently, the most effective oral targeted therapies for NSCLC in clinical practice are EGFR-TKIs. However, acquired drug resistance often leads to tumor progression and recurrence. EGFR overexpression and activation of its downstream pathways are primary contributors to both mutations in tumor cells and their development of drug resistance. Silibinin has been identified as a promising agent that can suppress EGFR signaling through multiple mechanisms. However, its poor water solubility and difficulty penetrating cell membranes result in rapid metabolism in vivo, and significantly affect its concentration in the blood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive search of the English PubMed database using various combinations of keywords, including “silibinin,” “epidermal growth factor receptor,” “phosphorylation,” “chemotherapy,” “nano,” and “non-small cell lung cancer.” The results were then filtered for their relevance and impact on current treatment paradigms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This review presents a comprehensive exploration of the mechanisms underlying the EGFR autophosphorylation pathways that contribute to acquire drug resistance in. Additionally, this study delves into the potential of silibinin as a novel therapeutic agent for NSCLC, evaluating its advantages and limitations on the basis of existing research. The majority of the available data suggest that combining silibinin with first-generation TKIs would yield promising outcomes because of additive or synergistic effects, suggesting that optimizing the time and dosage of each of these treatments is crucial for achieving the best results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The existing evidence is inadequate to endorse the clinical application of nano silibinin for NSCLC treatment. Developing multifunctional nanomedicines that incorporate silibinin, EGFR-TKIs, and other bioactive compounds is a recommended future strategy for NSCLC treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Multimorbidity on Symptom Burden and Symptom Clusters in Patients Receiving Chemotherapy","authors":"Carolyn Harris,&nbsp;Marilyn J. Hammer,&nbsp;Yvette P. Conley,&nbsp;Steven M. Paul,&nbsp;Bruce A. Cooper,&nbsp;Joosun Shin,&nbsp;Kate Oppegaard,&nbsp;Lisa Morse,&nbsp;Jon D. Levine,&nbsp;Christine Miaskowski","doi":"10.1002/cam4.70418","DOIUrl":"https://doi.org/10.1002/cam4.70418","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Detailed information on patient characteristics and symptom burden associated with multimorbidity in oncology patients is extremely limited. Purposes were to determine the prevalence of low (≤ 2) and high (≥ 3) multimorbidity in a sample of oncology outpatients (<i>n</i> = 1343) undergoing chemotherapy and evaluate for differences between the two multimorbidity groups in demographic and clinical characteristics; the occurrence, severity, and distress of 38 symptoms; and the stability and consistency of symptom clusters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Self-Administered Comorbidity Questionnaire, patients were classified into low and high multimorbidity groups. Memorial Symptom Assessment Scale was used to assess the occurrence, severity, and distress of 38 symptoms prior to the patients' second or third cycle of chemotherapy. For each multimorbidity group, symptom clusters based on occurrence rates were identified using exploratory factor analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the low group (61.4%), patients in the high group (38.6%) were older, had fewer years of education, were less likely to be married or partnered, less likely to be employed, and had a lower annual income. In addition, they had a higher body mass index, poorer functional status, were a longer time since their cancer diagnosis, and were more likely to have received previous cancer treatments and have metastatic disease. Patients in the low and high groups reported 12.7 (±6.7) and 15.9 (±7.5) concurrent symptoms, respectively. Eight and seven symptom clusters were identified for the low and high groups, respectively. Psychological, gastrointestinal, weight gain, hormonal, and respiratory clusters were stable across multimorbidity groups. Weight gain and respiratory clusters were consistent. Three unstable clusters were identified in the low group and two in the high group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings suggest that higher multimorbidity is associated with various social determinants of health and a higher symptom burden. Differences between multimorbidity groups may be related to aging, treatments, and/or comorbid conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248430","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":"Retrospective Study of Genetic Testing Results Reveals Pathogenic Variants Beyond BRCA1/2 in Hereditary Breast and Ovarian Cancer Cases in New Brunswick: Implications for Future Care","authors":"Kelly Gauvin,&nbsp;Véronique Allain,&nbsp;Nadia Bouhamdani,&nbsp;Chloe Williams,&nbsp;Yanis Saheb,&nbsp;Catherine Savoie,&nbsp;Lynn Macrae,&nbsp;Katherine Hodson,&nbsp;Yun Amber Zhu,&nbsp;Eric Allain,&nbsp;Mouna Ben Amor","doi":"10.1002/cam4.70640","DOIUrl":"10.1002/cam4.70640","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In Canada, founder variants in breast cancer susceptibility genes have been identified in populations residing in Québec and Newfoundland, thus demonstrating the value in characterizing the genetic profile of local populations for better clinical management. New Brunswick has a diverse, yet genetically unexplored population that includes founder Irish and Acadian ancestry, among others, and we hypothesized that this population could demonstrate potential enrichments for variants in breast cancer genes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Health records were retrospectively analyzed for 445 cases referred to the genetics clinic in Moncton, New Brunswick, their molecular results were summarized and compared to allele frequencies from similar studies in Canada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No ethnic or age-related correlation for specific variants could be identified. However, <i>BRCA</i>1/2 variant frequency was lower than expected in the study group and variants in other susceptibility genes such as ATM and CHEK2 were higher when compared to similar studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Perspectives</h3>\u0000 \u0000 <p>This study demonstrates a distinct profile in hereditary breast cancer genetics in a previously uncharacterized population, thus adding to existing knowledge of population genetics in Atlantic Canada.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187819","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":"Health Economic Evaluations of Circulating Tumor DNA Testing for Cancer Screening: Systematic Review","authors":"Mingjun Rui,&nbsp;Yingcheng Wang,&nbsp;Joyce H. S. You","doi":"10.1002/cam4.70641","DOIUrl":"10.1002/cam4.70641","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cancer detection remains a significant global healthcare challenge, and circulating tumor DNA (ctDNA) is a biomarker for noninvasive cancer screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review aimed to describe health economic evaluations of ctDNA for cancer screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was performed (following PRISMA guidelines) across MEDLINE, Embase, APA PsycINFO, Cochrane Library, Web of Science, and the Center for Review and Dissemination. The review included full-scale health economic analyses such as cost–effectiveness, cost–utility, cost–benefit, and cost–consequence analyses. The quality of the included reports was assessed using CHEERS 2022 standards, and each report was categorized as excellent, very good, good, or insufficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen studies were selected, including four ctDNA tests (EBV-DNA, cf-DNA, mSEPT9, and mt-sDNA) for three types of cancer screening: nasopharyngeal carcinoma (NPC) (2; 11.11%), breast cancer (BC) (1; 5.56%), and colorectal cancer (CRC) (15; 83.33%). Five studies (27.78%) found ctDNA cost-effective for CRC screening (mt-sDNA (with higher uptake than conventional tests) versus fecal immunochemical testing (FIT) or colonoscopy (<i>n</i> = 4); mSEPT9 versus computed tomography colonoscopy (CTC) (<i>n</i> = 1)). Thirteen studies (72.22%) found ctDNA not cost-effective for NPC (EBV-DNA versus no screening (<i>n</i> = 2)); BC (cf-DNA versus conventional testing (<i>n</i> = 1)); CRC (mSEPT9 versus FIT or colonoscopy (<i>n</i> = 2)); mt-sDNA versus FIT or colonoscopy (<i>n</i> = 5); mSEPT9 or mt-sDNA versus conventional tests (<i>n</i> = 3)). The CHEERS assessment found all reports in the “very good” category.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All ctDNA tests were generally not cost-effective comparing to conventional screening methods, except when the mt-sDNA uptake was higher than the comparators or when mSEPT9 was compared with CTC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>CRD42023477732</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187782","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":"Challenges and Clinical Relevance in Diagnosing Metastatic Cells From Non-Hematopoietic Malignancies in Bone Marrow Aspirates","authors":"Elise Kaspi,&nbsp;Charlotte Grosdidier,&nbsp;Yaël Berda-Haddad,&nbsp;Maud Arpin,&nbsp;Sylvie Cointe,&nbsp;Shirley Fritz,&nbsp;Amandine Bonifay,&nbsp;Marie Koubi,&nbsp;Carine Jiguet-Jiglaire,&nbsp;Patrice Roll,&nbsp;Diane Frankel","doi":"10.1002/cam4.70645","DOIUrl":"10.1002/cam4.70645","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The causes of cytopenias are numerous, and the bone marrow aspirate helps to identify them. In rare cases, these cytopenias are due to bone marrow metastases from solid cancers. The techniques used in hematology laboratories are limited in characterizing these cells. Interaction with the cytopathology laboratory becomes critical for characterizing tumor cells and completing a comprehensive diagnosis from the bone marrow aspirate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This article describes a series of 38 bone marrow aspirates from 36 patients with bicytopenias who underwent bone marrow aspiration and for whom the hematologists sent the sample to the cytopathology laboratory to complete the diagnosis by immunocytochemistry and FISH if necessary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of patients is 66 years, and the sex ratio is 2.8. Metastases were found in 11 cases of lung carcinoma, 4 cases of prostate carcinoma, 2 cases of breast carcinoma, 1 case of kidney carcinoma, 1 case of glioblastoma, 1 case of Ewing's sarcoma, and 1 case of melanoma. Among them, bone marrow aspiration was the only method to establish the initial diagnosis for seven patients. In six cases, immunocytochemistry confirmed the presence of carcinoma cells but could not identify their origin. In seven cases, tumor cells were insufficient to be characterized by immunocytochemistry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Collaboration between laboratories is essential for the management of bone marrow aspirates containing non-hematopoietic metastases. Bone marrow aspiration may be sufficient to diagnose solid tumors, enabling faster initiation of treatment for patients already at an advanced stage of their disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 3","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187779","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}