Japanese journal of clinical oncology最新文献

{"title":"Triplet therapy with darolutamide and docetaxel for metastatic castration-sensitive prostate cancer: a multicenter real-world study.","authors":"Ibuki Tsuru, Satoru Taguchi, Ryo Tanaka, Taketo Kawai, Tomoyuki Kaneko, Yu Nakamura, Yoshifumi Miyauchi, Hayato Hoshina, Daisuke Obinata, Masashi Koshiba, Masashi Shiozaki, Jun Takahashi, Masato Kano, Akihiro Naito, Shohei Suda, Michio Noda, Nozomi Sugiyama, Takehiro Tanaka, Yukari Uemura, Jimpei Miyakawa, Jun Kamei, Shigenori Kakutani, Aya Niimi, Yuta Yamada, Yusuke Sato, Yukio Yamada, Hiroaki Nishimatsu, Takashi Murata, Sayuri Takahashi, Tappei Takada, Yoshiyuki Akiyama, Satoru Takahashi, Tetsuya Fujimura, Hiroshi Fukuhara, Tohru Nakagawa, Haruki Kume","doi":"10.1093/jjco/hyag110","DOIUrl":"10.1093/jjco/hyag110","url":null,"abstract":"<p><strong>Background: </strong>Triplet therapy with darolutamide and docetaxel has reshaped the treatment landscape of metastatic castration-sensitive prostate cancer (mCSPC). However, real-world evidence regarding its oncological outcomes and toxicity remains limited.</p><p><strong>Methods: </strong>We retrospectively reviewed 112 consecutive patients with mCSPC who were treated with triplet therapy. A deep prostate-specific antigen (PSA) response was defined as a PSA level < 0.2 ng/ml or a ≥ 90% decline from baseline. Castration-resistant prostate cancer (CRPC)-free survival was used as the survival endpoint. Clinicopathological factors associated with CRPC-free survival were analysed using a Cox proportional hazards model. Treatment-related adverse events (AEs) were comprehensively documented by type and grade.</p><p><strong>Results: </strong>During a median follow-up of 17.1 months, 15 patients developed CRPC and four died of prostate cancer; 1-year CRPC-free survival and overall survival rates were 89.8% (95% confidence interval, 83.9%-96.0%) and 98.8% (96.5%-100%), respectively. A deep PSA response was achieved in 73.2% of patients (PSA nadir <0.2 ng/ml) and in 96.4% (PSA ≥ 90% decline). In both the univariable and multivariable analyses, no baseline factor was significantly associated with CRPC-free survival. Grade ≥ 3 hematologic AEs occurred in 75.0% of patients. Among the 31 patients who discontinued docetaxel, 26 discontinued due to non-hematologic AEs.</p><p><strong>Conclusions: </strong>Triplet therapy demonstrated substantial clinical activity in real-world patients with mCSPC, with high rates of deep PSA response despite frequent AEs. These findings support the feasibility of triplet therapy in routine practice. Given the substantial toxicity burden, careful patient selection and proactive AE management remain important.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1255-1263"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421285","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":"Immune effector cell-associated hematotoxicity following CAR-T cell therapies: insights from a large national database.","authors":"Connor Frey","doi":"10.1093/jjco/hyag103","DOIUrl":"10.1093/jjco/hyag103","url":null,"abstract":"<p><p>Immune effector cell-associated hematotoxicity is a recognized but incompletely characterized complication of chimeric antigen receptor T-cell (CAR-T) therapy, defined by prolonged, severe, or recurrent cytopenias following CAR-T infusion, not explained by conditioning chemotherapy or disease progression alone. Despite formal consensus grading criteria from the European Hematology Association and European Bone Marrow Transplantation group, the post-marketing pharmacovigilance profile of ICAHT across all approved CAR-T agents has not been systematically described. The FDA Adverse Event Reporting System (FAERS) was queried through March 2026 using OpenVigil 2.1 for all seven currently FDA-approved CAR-T products. Disproportionality was assessed using the Reporting Odds Ratio (ROR) with 95% confidence intervals, Proportional Reporting Ratio with chi-squared statistic, and Bayesian Reporting Rate Ratio. An adverse drug reaction classification was applied when all three signal detection thresholds were simultaneously met. ICAHT cases were identified in five of seven agents. Axicabtagene ciloleucel had the highest case count (n = 18) and most precisely estimated ROR (1365.54; 95% CI: 778.83-2394.24). All five agents with ICAHT reports met pre-specified signal detection criteria across all three analytical methods, with lower ROR confidence bounds substantially exceeding 1.00 in every case. No ICAHT reports were identified for obecabtagene autoleucel or tisagenlecleucel, with the former having minimal post-marketing data and the latter potentially reflecting genuine mechanistic differences related to its 4-1BB co-stimulatory domain. These findings demonstrate that ICAHT generates exceptionally strong and concordant pharmacovigilance signals across multiple CAR-T products, supporting heightened post-infusion hematologic monitoring with a low threshold for investigating unexplained cytopenias.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1284-1287"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360746","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":"De-escalation of breast surgery for early stage breast cancer.","authors":"Takeshi Murata, Tomomi Fujisawa, Fumikata Hara, Toshiyuki Ishiba, Yukinori Ozaki, Takehiko Sakai, Yasuaki Sagara, Hideo Shigematsu, Akihiko Shimomura, Kazuki Sudo, Kaori Terata, Yoichi Naito, Kazuki Nozawa, Tadahiko Shien","doi":"10.1093/jjco/hyag098","DOIUrl":"10.1093/jjco/hyag098","url":null,"abstract":"<p><p>Breast cancer treatment is rapidly evolving toward precision-based de-escalation strategies for oncological safety and minimizing treatment-related morbidity. In early stage disease, minimally invasive approaches, such as non-surgical ablation techniques, including cryoablation and radiofrequency ablation, potentially constitute alternatives to conventional surgery for carefully selected low-risk tumors. Active surveillance trials challenge the necessity of immediate surgery for low-risk ductal carcinoma in situ, reflecting a paradigm shift toward risk-adapted management. In the neoadjuvant setting, achieving radiologic and pathologic complete responses, particularly in HER2-positive and triple-negative subtypes, is being investigated to determine the feasibility of omitting breast surgery under strict imaging and biopsy-guided protocols. Circulating tumor DNA-based minimal residual disease assays offer a promising tool for refining risk stratification and potentially guiding the extent of surgery and adjuvant therapy. These strategies represent a transformative movement toward biologically tailored, response-adapted, less invasive treatments for early breast cancer to optimize quality of life without compromising long-term outcomes.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"1182-1188"},"PeriodicalIF":2.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360797","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":"External validation of a three-variable Ewing sarcoma prognostic score and incremental value of the Glasgow prognostic score in adults: a multicenter cohort study.","authors":"Burak Paçacı, Gül Akın, Adem Deligönül, Seda Jeral, Özkan Alan, Yunus Avcı, Emre Yılmaz, İlhan Hacıbekiroğlu, Mert Özdemir, Hatice Odabaş, Selma Akdoğan, Mehmet Beşiroğlu, Mesut Özgün Özdal, Melike Özçelik, Mustafa Altay Tekeş, Osman Sütcüoğlu, Elif Büşra Ayvacı, Mesut Yılmaz, Nazım Can Demircan, Murat Sarı","doi":"10.1093/jjco/hyag170","DOIUrl":"https://doi.org/10.1093/jjco/hyag170","url":null,"abstract":"<p><strong>Objective: </strong>To externally validate a three-variable Ewing sarcoma score and assess the incremental prognostic value of the Glasgow prognostic score (GPS) in adults.</p><p><strong>Methods: </strong>This retrospective cohort included 133 adults treated at 10 Turkish centers (2010-2026). The Ewing score used metastases, tumor diameter >5 cm, and leukocytes >11 000/mm3; GPS used C-reactive protein >10 mg/L and albumin <3.5 g/dl. Outcomes were overall (OS) and event-free survival (EFS). Discrimination was assessed using the concordance index and time-dependent area under the curve. Center-clustered Cox models included the Ewing score and ordinal GPS. Bootstrap uncertainty was estimated within centers.</p><p><strong>Results: </strong>During a median 81.1-month follow-up, 67 deaths and 82 EFS events occurred. Ewing score concordance indices were 0.668 (95% bootstrap confidence interval [CI]: 0.613-0.721) for OS and 0.688 (95% CI: 0.641-0.734) for EFS. High-risk patients had inferior outcomes, but low- and intermediate-risk groups were not separated. Each one-level increase in GPS was associated with shorter OS (hazard ratio [HR]: 2.67, 95% CI: 1.95-3.65) and EFS (HR: 2.31, 95% CI: 1.44-3.69). GPS increased the concordance index by 0.091 (95% bootstrap CI: 0.041-0.143) for OS and 0.070 (95% bootstrap CI: 0.027-0.115) for EFS. Its OS association was strongest within 24 months and attenuated thereafter.</p><p><strong>Conclusions: </strong>The Ewing score identified a high-risk population but incompletely separated lower-risk patients. GPS added independent prognostic information, but the extension requires external validation before clinical use.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109810","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":"Age- and sex-specific prevalence of deficient mismatch repair protein expression in gastric, colorectal, and endometrial cancers: a center-based study of older Japanese patients.","authors":"Tomio Arai, Akiko Komatsu, Takuya Nagasaka, Seiya Kamino, Hirofumi Rokutan, Keisuke Nonaka, Nobuo Kanazawa, Tetsuya Nakazato, Toshiyuki Ishiwata","doi":"10.1093/jjco/hyag172","DOIUrl":"https://doi.org/10.1093/jjco/hyag172","url":null,"abstract":"<p><strong>Background: </strong>Recent advancements in immunotherapy have revolutionized microsatellite instability-high (MSI-H) tumor management. Given the higher prevalence of MSI-H/deficient mismatch repair (dMMR) in older and female patients, characterizing these specific populations is clinically essential. We aimed to elucidate MSI-H/dMMR prevalence and predictive factors in older patients with gastric, colorectal, and endometrial cancers.</p><p><strong>Methods: </strong>Using molecular and immunohistochemical analysis, we evaluated MSI status and MMR protein expression in 429, 647, and 54 patients with gastric, colorectal, and endometrial cancers, respectively (median age: 78 years for each group). Multivariable logistic regression analysis was performed to identify independent factors associated with dMMR status.</p><p><strong>Results: </strong>MSI-H was identified in 17.0% and 9.8% of gastric and colorectal cancer cases, respectively, and dMMR was identified in 17.0%, 9.1%, and 18.5% of gastric, colorectal, and endometrial cancer cases, respectively. dMMR prevalence was significantly higher in patients aged ≥80 years than in those <80 years for gastric (28.5% vs. 8.1%) and colorectal (13.5% vs. 5.9%) cancers, while endometrial cancers showed a non-significant increase with age (24.0% vs. 13.8%). Multivariable analysis identified primary site (adjusted odds ratio [aOR] = 4.20), age (aOR = 3.89), and female sex (aOR = 2.73) as independent predictors of dMMR in gastric cancer. For colorectal cancer, primary site (aOR = 16.88) and age (aOR = 1.91) were independently associated with dMMR.</p><p><strong>Conclusions: </strong>Advanced age, sex, and primary tumor site are strong independent predictors of dMMR status. These findings underscore the value of routine MSI/MMR testing, particularly in older individuals, to optimize immunotherapy candidate selection.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109748","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":"HALP is a novel marker for predicting overall survival in patients with malignant soft tissue sarcoma: a retrospective study.","authors":"Seiji Shimomura, Ryu Terauchi, Toshiharu Shirai, Naoki Mizoshiri, Yuki Mori, Yusei Katsuyama, Daichi Hayashi, Ryosuke Nishi, Kenji Takahashi","doi":"10.1093/jjco/hyag171","DOIUrl":"https://doi.org/10.1093/jjco/hyag171","url":null,"abstract":"<p><strong>Background: </strong>Malignant soft tissue sarcomas (STSs) are rare, aggressive tumors with diverse subtypes and variable prognoses. Current prognostic markers, such as tumor size and grade, do not sufficiently predict postoperative outcomes. Therefore, this study aimed to assess the prognostic significance of the hemoglobin, albumin, lymphocyte, platelet (HALP) score, an integrated immunonutritional marker, for predicting overall survival (OS) in patients with extremity and trunk STSs.</p><p><strong>Methods: </strong>We analysed 99 patients with primary STS who underwent wide excision. The primary endpoint was OS. Systemic inflammatory and nutritional indices, including HALP, were evaluated using pre-treatment blood samples. OS was analysed using Kaplan-Meier curves and Cox proportional hazards models. Receiver operating characteristic curve analysis was used to determine the prognostic value of the HALP score.</p><p><strong>Results: </strong>Twenty-nine deaths occurred during a median follow-up of 83.6 months. Three- and five-year OS were 82.1% and 74.2%, respectively. Lower HALP was associated with worse OS (hazard ratio 3.89, 95% confidence interval 1.66-9.13; P = 0.002). In multivariable analysis, a low HALP score (≤39.4) remained independently associated with worse OS (hazard ratio 3.17, 95% confidence interval 1.33-7.54; P = 0.011). The 5-year time-dependent AUC for HALP was 0.763, which was numerically higher than those of the other inflammatory and nutritional indices; however, the differences were not statistically significant.</p><p><strong>Conclusions: </strong>The HALP score stratified patients with STS by risk of adverse postoperative outcomes and may serve as a practical and accessible exploratory prognostic marker. Prospective validation is required before HALP can be incorporated into prognostic models or used to guide treatment decisions.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109771","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":"Molecular targeted therapies for pediatric low-grade gliomas: current perspectives and future directions.","authors":"Shigeru Yamaguchi, Yukitomo Ishi, Miki Fujimura","doi":"10.1093/jjco/hyag169","DOIUrl":"https://doi.org/10.1093/jjco/hyag169","url":null,"abstract":"<p><p>Pediatric low-grade gliomas (pLGGs) are a heterogeneous group of tumors characterized by frequent activation of the mitogen-activated protein kinase (MAPK) signaling pathway, often driven by a single oncogenic alteration. Recent advances in molecular profiling have identified actionable alterations involving BRAF, FGFR, NF1, and receptor tyrosine kinases, leading to the development of genotype-directed molecular targeted therapies. Clinical trials of BRAF, MEK, and RAF inhibitors have demonstrated substantial antitumor activity, and targeted therapy is increasingly being incorporated into the treatment of pLGGs. However, because patients with pLGGs generally have favorable long-term survival and may exhibit prolonged periods of tumor stability as part of their natural history, several challenges remain regarding the optimal use of these agents. These include patient selection, timing of treatment initiation, treatment duration, long-term toxicities, and tumor regrowth after treatment discontinuation. In particular, rapid tumor regrowth, referred to as rebound, may occur after discontinuation of MAPK pathway inhibitors, although its risk factors and optimal preventive strategies remain unclear. Furthermore, the effects of prolonged pathway inhibition on the natural history and oncogene-induced senescence of pLGGs are unknown. This review summarizes the molecular landscape and current evidence for genotype-directed therapies in pLGGs and discusses the clinical challenges associated with their long-term implementation. Future treatment strategies should therefore focus on optimizing the timing and duration of targeted therapy while considering long-term toxicities, patient growth and development, and the natural history of pLGGs.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109602","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":"Interpreting TP53 pathogenic variants in germline testing and cancer genomics: pathogenicity, origin, and clinical actionability.","authors":"Issei Imoto, Nobue Takaiso, Akiyo Yoshimura","doi":"10.1093/jjco/hyag158","DOIUrl":"https://doi.org/10.1093/jjco/hyag158","url":null,"abstract":"<p><p>Next-generation sequencing has increased the sensitivity of pathogenic variant (PV) detection and enabled the quantitative assessment of variant allele fractions (VAFs) in clinical cancer genetics. However, these advances have exposed the limitations of equating molecular detection with a definitive germline diagnosis. The most clinically consequential example is TP53: in leukocyte-derived DNA, a detected TP53 PV may represent constitutional germline heterozygosity, postzygotic constitutional mosaicism, or blood-limited clonal hematopoiesis, including acquired clonal expansion to high VAF. Rarely, a detected signal may reflect circulating tumor cell-related tumor-in-normal contamination. Separately, an apparent variant signal may reflect a technical artifact rather than a true biological finding. Accurate origin attribution is essential because Li-Fraumeni syndrome (LFS) confers a high lifetime risk of multiple cancers, and confirmed constitutional TP53 PVs have major implications for lifelong surveillance, cancer treatment, reproductive counseling, and cascade testing. Misattribution may lead to either overdiagnosis with unnecessary interventions or under-recognition of clinically significant constitutional mosaicism. This interpretive challenge now extends beyond hereditary cancer clinics. In tumor-only cancer genomic profiling (CGP) or liquid biopsy, a TP53 PV does not by itself establish germline origin but may prompt germline follow-up when allele fraction, tumor context, and clinical features are compatible. This issue is particularly relevant in Japan, where germline TP53 testing for suspected LFS has not been routinely available under the national health insurance system and where CGP has become an important entry point to presumed germline or uncertain-origin findings. This review proposes an origin-aware, three-layer framework comprising variant pathogenicity assessment, origin attribution, and clinical actionability. The goal is structured management of uncertainty to support proportionate surveillance, cascade testing, and shared decision-making.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109424","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":"Association of radiotherapy with survival across metastatic patterns in metastatic small cell lung cancer in the immunotherapy era: a SEER analysis.","authors":"Shulin Zhao, Zhixiang Bo, Ping Chen, Chu Gao, Jin Huang, Cheng Shen","doi":"10.1093/jjco/hyag168","DOIUrl":"https://doi.org/10.1093/jjco/hyag168","url":null,"abstract":"<p><strong>Background: </strong>Radiotherapy (RT) combined with chemoimmunotherapy may have synergistic effects and improve treatment efficacy and survival in extensive-stage small cell lung cancer (ES-SCLC). However, its association with survival appears to be inconsistent across different metastatic patterns.</p><p><strong>Methods: </strong>Patients with metastatic SCLC diagnosed between 2020 and 2023 were identified from the Surveillance, Epidemiology, and End Results database. Propensity score matching (PSM), Kaplan-Meier analysis, and Cox regression were used to evaluate the association between RT and cancer-specific survival (CSS). Inverse probability of treatment weighting (IPTW) and overlap weighting were performed as sensitivity analyses.</p><p><strong>Results: </strong>A total of 4707 patients were included. Liver metastasis was the most common site-specific metastasis (44.1%), followed by bone (42.1%), brain (30.1%), and lung metastasis (16.1%). Multi-organ metastases without brain involvement were the most common metastatic pattern (21.2%), followed by other/unspecified (16.0%) and multi-organ metastases with brain involvement (15.5%). After 1:1 PSM, additional RT was associated with higher CSS in the liver only (HR, 0.68; 95% CI, 0.51-0.91; P = .009), lung only (HR, 0.55; 95% CI, 0.38-0.80; P = .002), multi-organ without brain (HR, 0.77; 95% CI, 0.64-0.92; P = .005), and other/unspecified cohorts (HR, 0.67; 95% CI, 0.54-0.82; P < .001). No significant association was observed in the bone only, brain only, or multi-organ with brain cohorts. IPTW and overlap weighting analyses yielded consistent results.</p><p><strong>Conclusions: </strong>In the immunotherapy era, among patients with metastatic SCLC receiving first-line chemoimmunotherapy, the association between additional RT and CSS may vary across metastatic patterns.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080839","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":"Early progression after immune checkpoint inhibitor therapy in recurrent or metastatic head and neck squamous cell carcinoma: association with disease distribution in a single-center retrospective study.","authors":"Hiroki Noda, Takuma Makino, Yuto Naoi, Shohei Fujimoto, Mizuo Ando","doi":"10.1093/jjco/hyag167","DOIUrl":"https://doi.org/10.1093/jjco/hyag167","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) are an important treatment option for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, some patients experience rapid disease progression shortly after ICI initiation, potentially resulting in deterioration of general condition and limited opportunities for subsequent treatment. This study investigated clinicopathological factors associated with early progression after ICI initiation in patients with R/M HNSCC.</p><p><strong>Methods: </strong>We retrospectively analyzed 207 patients with R/M HNSCC treated with nivolumab or pembrolizumab at a single institution. Early progression was defined as disease progression within 90 days after ICI initiation. Associations between clinicopathological factors and early progression were evaluated using logistic regression analyses.</p><p><strong>Results: </strong>Early progression was observed in 80 patients (38.6%). In an exploratory survival comparison, patients with early progression had significantly shorter overall survival than those without early progression. Early progression rates increased from distant-only disease to locoregional-only disease and combined locoregional and distant disease. In multivariable analysis, combined locoregional, and distant disease showed the strongest independent association with early progression. Elevated neutrophil-to-lymphocyte ratio and hypoalbuminemia were also independently associated with early progression. In contrast, treatment regimen, treatment line, number of lesions, and bulky disease were not significantly associated with early progression.</p><p><strong>Conclusion: </strong>Disease distribution was associated with early progression after ICI initiation in patients with R/M HNSCC, with combined locoregional and distant disease showing the strongest independent association. These findings suggest that both disease status and host condition may influence failure to achieve adequate disease control shortly after ICI initiation.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038714","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}