Japanese journal of clinical oncology最新文献

{"title":"Correction to: Characterization of distant metastases in salivary gland cancer patients undergoing upfront surgery followed by postoperative radiation therapy: a multicenter analysis.","authors":"","doi":"10.1093/jjco/hyag136","DOIUrl":"10.1093/jjco/hyag136","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1290"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status and future perspectives of treatment de-escalation in localized head and neck cancer.","authors":"Shinya Hiraoka, Takeshi Kodaira, Nobuhiro Hanai, Naomi Kiyota","doi":"10.1093/jjco/hyag096","DOIUrl":"10.1093/jjco/hyag096","url":null,"abstract":"<p><p>Head and neck squamous cell carcinoma (HNSCC) often requires invasive multimodal therapy, including surgery, radiotherapy, and chemotherapy. Although these interventions have improved treatment outcomes, patients frequently experience long-term functional impairment and treatment-related morbidity. Consequently, clinical research has shifted toward treatment de-escalation, a paradigm aimed at preserving quality of life while maintaining oncologic control. This review summarizes the current evidence from prospective clinical trials on de-escalation strategies for HNSCC of the oropharynx, hypopharynx, larynx, and oral cavity, with a focus on radiotherapy-based approaches. Investigators have evaluated several de-escalation strategies, including total radiation dose reduction in definitive chemoradiotherapy, modification or omission of concurrent systemic therapy, de-intensification of prophylactic nodal irradiation, response-adapted treatment de-intensification, and minimally invasive approaches such as transoral surgery with risk-adapted postoperative therapy. These strategies target favorable-risk populations, particularly patients with human papillomavirus-associated oropharyngeal cancer. Although numerous phase II studies have reported encouraging clinical outcomes and acceptable toxicity profiles, definitive evidence supporting the safety and efficacy of de-escalation strategies remains unestablished in large-scale phase III trials. Unwarranted de-escalation for HNSCC should be avoided, particularly for medically fit patients, and promising strategies require validation in phase III trials before routine clinical adoption. Future challenges include prospective validation through clinical trials and the integration of predictive biomarkers to balance the delicate trade-off between toxicity reduction and oncologic safety.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1167-1181"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a prognostic signature based on expression of post-translational modification-related genes in acute myeloid leukemia.","authors":"Donghui Gan, Jinfang Zeng, Jun Lin, Xiaojun Chen, Mengting Huang, Dan Weng, Jun Yan","doi":"10.1093/jjco/hyag111","DOIUrl":"10.1093/jjco/hyag111","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) features high biological heterogeneity and unfavorable prognoses, demanding reliable prognostic biomarkers. Dysregulated post-translational modifications (PTMs) drive AML progression by disrupting protein function and cellular signaling. This work constructed a PTM-based risk signature to predict AML survival and dissect the tumor immune microenvironment.</p><p><strong>Methods: </strong>RNA-seq and clinical data of TCGA-Acute Myeloid Leukemia (LAML) AML patients and normal genotype-tissue expression samples were analyzed. Limma identified differentially expressed genes (DEGs), and overlapping PTM-related DEGs were screened. Unsupervised consensus clustering stratified patients into molecular subgroups, whose overall survival (OS) was compared via Kaplan-Meier curves. A prognostic score model was built through univariate Cox screening, least absolute shrinkage and selection operator dimension reduction and multivariate Cox regression, validated by time-dependent receiver operating characteristic curves. Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) and single-sample gene set enrichment analysis quantified immune infiltration, while tumor mutation burden (TMB) was calculated to characterize genomic features. The GSE71014 cohort served as external validation.</p><p><strong>Results: </strong>A four-gene signature (ITGAX, DOCK1, CPNE8, and GABRE) was established and validated. High-risk patients had markedly shorter OS, with 1-, 3-, and 5-year AUC values of 0.79, 0.79, and 0.90, consistent with external cohort results. The two risk groups displayed divergent immune landscapes; high-risk patients overexpressed multiple immune checkpoints. Though TMB was similar across groups, high-risk patients with low TMB had the worst survival. Low-risk patients showed greater cytarabine susceptibility, confirming the model's clinical value.</p><p><strong>Conclusions: </strong>This PTM-associated signature accurately stratifies AML patients and reveals immune microenvironment disparities. It enables precise personalized prognosis and identifies PTM-related genes as promising therapeutic targets for AML immunotherapy.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1215-1233"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter randomized phase III trial of weekly cisplatin chemoradiotherapy versus radiotherapy in elderly patients with head and neck squamous cell carcinoma unfit for high-dose cisplatin: JCOG2405 (ELDER-WEEKLY).","authors":"Kota Kawabata, Koichi Yasuda, Satoaki Nakamura, Yoshitaka Honma, Ryusuke Suzuki, Yuri Ueda, Satoshi Saito, Kazuto Matsuura, Nobuhiro Hanai, Naoki Nakamura, Junki Mizusawa, Keita Sasaki, Haruhiko Fukuda, Takashi Mizowaki, Naomi Kiyota","doi":"10.1093/jjco/hyag097","DOIUrl":"10.1093/jjco/hyag097","url":null,"abstract":"<p><p>Chemoradiotherapy (CRT) with high-dose cisplatin (100 mg/m2) is the standard treatment for locally advanced squamous cell carcinoma of the head and neck (SCCHN). However, this regimen is often intolerable in elderly patients because of its toxicity, and the optimal treatment for those unfit for high-dose cisplatin remains unclear. CRT with weekly cisplatin (40 mg/m2) has been developed as a more tolerable alternative and has demonstrated comparable efficacy with reduced toxicity in several trials involving nonelderly patients. We therefore designed a multicenter, randomized phase III trial (JCOG2405) to confirm the superiority of CRT with weekly cisplatin over radiotherapy alone in patients aged ≥70 years with locally advanced SCCHN who are unfit for high-dose cisplatin. The primary endpoint is overall survival. A total of 250 patients from 59 institutions will be enrolled over 5 years. The trial has been registered in the Japan Registry of Clinical Trials (study number: jRCTs031250688).</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1272-1279"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Suicide risk among individuals diagnosed with cancer during versus before the COVID-19 pandemic: a nationwide population-based study.","authors":"","doi":"10.1093/jjco/hyag148","DOIUrl":"10.1093/jjco/hyag148","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1291-1292"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 pre-existing schizophrenia spectrum disorder on the receipt of invasive and systemic therapy for gastric cancer: a multicenter nationwide cohort study in Japan.","authors":"Myo Min Khant, Masaki Fujiwara, Yuto Yamada, Taisuke Ishii, Tomone Watanabe, Takashi Fukao, Maiko Fujimori, Naoki Nakaya, Toshihiko Kawamura, Koji Otsuki, Yoshihiko Kakiuchi, Taichi Shimazu, Shiro Hinotsu, Yosuke Uchitomi, Masatoshi Inagaki","doi":"10.1093/jjco/hyag102","DOIUrl":"10.1093/jjco/hyag102","url":null,"abstract":"<p><strong>Background: </strong>Patients with schizophrenia spectrum disorders (SSD) experience higher cancer mortality, partly because of later-stage diagnosis and lower rates of recommended treatments. While treatment disparities have been reported across several cancer types, no study has specifically examined stage-appropriate treatment for gastric cancer among patients with SSD.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using a nationwide Hospital-Based Cancer Registry linked to administrative data in Japan. Patients who received initial treatment for gastric cancer between 2018 and 2021 were included. Multivariable logistic regression models examined the association between SSD and the receipt of stage-appropriate cancer treatments, adjusting for age, sex, clinical stage, Charlson Comorbidity Index, and Barthel Index.</p><p><strong>Results: </strong>Among 189 447 patients from 709 hospitals, 1312 had SSD. Patients with SSD were more likely to be diagnosed at advanced stages. In crude analysis, SSD was associated with lower rates of surgical or endoscopic treatment; however, this association was not statistically significant after adjustment (adjusted odds ratio [aOR], 0.90; 95% confidence interval [CI], 0.75-1.08). In contrast, SSD was independently associated with lower rates of postoperative adjuvant chemotherapy for pathological stage II/III disease (aOR, 0.64; 95% CI, 0.45-0.91) and systemic therapy for stage IV disease (aOR, 0.36; 95% CI, 0.28-0.47).</p><p><strong>Conclusions: </strong>Among patients with gastric cancer, SSD was associated with reduced receipt of systemic therapy but not surgical or endoscopic treatment. Efforts to improve early detection among patients with SSD may be important for reducing treatment disparities, alongside strengthened support for systemic therapy to ensure equitable access to guideline-recommended gastric cancer care.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1199-1206"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bayesian re-analysis of ERA223 and PEACE-3 temporal dynamics and bone protection in radium-223-treated metastatic castration-resistant prostate cancer.","authors":"Wei Chen, Soichiro Yoshida, Shugo Yajima, Motohiro Fujiwara, Hiroyuki Sato, Akihiro Hirakawa, Hiroshi Fukushima, Yosuke Yasuda, Hajime Tanaka, Yasuhisa Fujii","doi":"10.1093/jjco/hyag093","DOIUrl":"10.1093/jjco/hyag093","url":null,"abstract":"<p><strong>Objective: </strong>To define the time course of fracture risk with radium-223 in combination with androgen receptor pathway inhibitor (ARPi) therapy and assess the clinical impact of concomitant bone-protective agent (BPA) use on mitigating this risk.</p><p><strong>Methods: </strong>An exploratory person-time approximation approach was used to perform a Bayesian re-analysis of the landmark ERA223 and PEACE-3 clinical trials. In ERA223, we estimated interval-specific fracture incidence rate ratios (IRRs) during follow-up to characterize temporal trajectories. Interval-specific analyses were based on an exploratory person-time approximation approach. In PEACE-3, we used published hazard ratios to re-derive posterior distributions of risk ratios, risk differences, and posterior distributions comparing pre- vs post-mandatory BPA fracture incidences. Posterior distributions were modeled with beta-binomial and gamma-Poisson conjugate priors.</p><p><strong>Results: </strong>In the ERA223 population, the fracture excess risk peaked during the first year of treatment, with elevated interval-specific IRRs in the 0-6 month and 6-12 month intervals. In PEACE-3, the treatment-induced fracture burden for the radium-223 combination treatments was lower following requirement of BPA, with the risk ratio (RR) falling from 2.54 (95% credible interval [CrI] = 1.53-4.60) prior to the mandate to 1.46 (95% CrI 0.88-2.49) post-implementation. The addition of BPA prophylaxis demonstrated a synergistic protective effect, yielding a more pronounced reduction in fracture risk within the radium-223 combination arm relative to the ARPi-monotherapy group.</p><p><strong>Conclusions: </strong>Fracture risk was confined to early periods of ERA223 treatment and diminished after the compulsory addition of BPAs in PEACE-3. Due to the limitations of using estimated person-time data and observational comparisons, the findings are best interpreted as descriptive and hypothesis-generating.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1234-1239"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply to \"Is female breast cancer mortality in Japan declining or still increasing? A request for clarification\".","authors":"Kota Katanoda, Hirokazu Tanaka, Yuri Ito","doi":"10.1093/jjco/hyag109","DOIUrl":"10.1093/jjco/hyag109","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1282-1283"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is female breast cancer mortality in Japan declining or still increasing? A request for clarification.","authors":"Takayoshi Uematsu","doi":"10.1093/jjco/hyag108","DOIUrl":"10.1093/jjco/hyag108","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1280-1281"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary cancer multigene panel testing in the United States and Europe: real-world constraints and implications for responsible integration in Japan.","authors":"Issei Imoto, Nobue Takaiso, Akiyo Yoshimura, Yoshio Makita","doi":"10.1093/jjco/hyag095","DOIUrl":"10.1093/jjco/hyag095","url":null,"abstract":"<p><p>Multigene panel testing has become an important component of hereditary cancer evaluation in Western practice. This shift has been driven by advances in next-generation sequencing, declining costs, and the increasing relevance of germline findings to treatment, surveillance, prevention, and cascade testing. In Japan, publication of The Japanese Society for Hereditary Tumors Guidance: Hereditary Cancer Syndromes with Multigene Panel Testing, 2025 Edition provided a timely framework for reconsidering how Western experience should inform domestic implementation. Evidence from the United States and Europe has fostered the view that multigene panel testing has replaced sequential single-gene testing as a first-line approach because of its broader diagnostic yield and growing use in routine care. However, broader detection does not automatically translate into broader clinical benefit. Multigene panel testing is most valuable when the pathogenic variants detected are sufficiently prevalent, highly penetrant, and linked to established surveillance, risk-reducing surgery, targeted therapy, or cascade testing. Broader panels may also increase variants of uncertain significance, psychological burden, and unnecessary management. This review examines why multigene panel testing came to be seen as a first-line approach, distinguishes diagnostic yield from meaningful clinical utility, and considers why Western adoption should inform Japanese practice not as a mandate for indiscriminate expansion, but as support for phased, quality-assured, utility-oriented integration.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1159-1166"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}