JNCI Cancer Spectrum最新文献

{"title":"Evaluating patient diversity in EP-CTs in Australia through a prospective multi-Centre non-randomised cohort study.","authors":"Udit Nindra, Joanne Tang, Jun Hee Hong, Martin Hong, Christina Teng, Joe Wei, Andrew Killen, Adam Cooper, Kate Wilkinson, Weng Ng, Charlotte Lemech, Wei Chua, Abhijit Pal","doi":"10.1093/jncics/pkaf035","DOIUrl":"https://doi.org/10.1093/jncics/pkaf035","url":null,"abstract":"<p><strong>Background: </strong>Early Phase Clinical Trials (EP-CTs) continue to have significant difficulty with enrolling real-world populations with many minorities being underrepresented. Reasons for this include patient or clinician perception as well as cultural, linguistic or social barriers. In Australia, there is currently no prospective data in the EP-CT space regarding recruitment of priority populations.</p><p><strong>Methods: </strong>PEARLER (Patient divErsity in eARLy phasE clinical tRials) was a multi-centre, prospective, cohort study involving two major EP-CT centres in Sydney, Australia. All participants who were consented to an EP-CT between August 2023 and August 2024 were enrolled. Participants completed a baseline demographic survey which included cultural and linguistic status, sexual orientation, socioeconomic status and regional diversity.</p><p><strong>Results: </strong>One-hundred and fourteen participants were recruited. Median age was 63 years (25-83 years) with predominance for female participants (52%). No participant reported a non-binary gender. All participants reported their sexuality as heterosexual with no LGBTQIA+ participants recruited. 34 participants (30%) were identified as culturally diverse whilst 28 (25%) were linguistically diverse. One patient identified as indigenous Australian. 26% of participants were born overseas with 44% having at least one parent born overseas. The majority were living in households with family members with 8% of participants living alone.</p><p><strong>Conclusion: </strong>PEARLER is the first prospective study that provides granular description of social, cultural, linguistic, economic and sexual diversity amongst EP-CT participants. Certain subgroups are under-represented including those with sexual diversity, gender diversity and indigenous backgrounds. Ongoing efforts to monitor and promote inclusion of diverse populations in clinical trials are vital.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of symptomatic toxicities for novel therapies in adult oncology trials: A scoping review.","authors":"Amanda L King, Tamara Vasilj, Diane Cooper, Elizabeth Vera, Sefanit Berhanu, Morgan Johnson, Ciara Locke, Bennett McIver, Ethan Basch, Joseph Cappeleri, Amylou Dueck, Mark R Gilbert, Lee Jones, Yuelin Li, Lori M Minasian, Bryce B Reeve, Terri S Armstrong, Tito Mendoza","doi":"10.1093/jncics/pkaf036","DOIUrl":"https://doi.org/10.1093/jncics/pkaf036","url":null,"abstract":"<p><strong>Background: </strong>Patients' self-report of their symptoms can provide important data for the evaluation of treatment benefit and tolerability of oncology drugs. Contemporary treatment approaches, including immunotherapy and molecular targeted therapies, have unique toxicities based on their novel mechanisms of action. This scoping review aimed to summarize evidence from existing reviews and clinical practice guidelines to examine the type and prevalence of toxicities including symptomatic adverse events (sympAEs) for adult cancer patients to inform clinical care and therapeutic trials.</p><p><strong>Methods: </strong>A systematic search of PubMed, Web of Science, and Embase was performed using predefined eligibility criteria. Thirty-one literature reviews and 3 clinical practice guidelines met inclusion criteria and were selected for review and data abstraction.</p><p><strong>Results: </strong>Findings from this scoping review demonstrated several leading sympAEs that were reported across immunotherapy and targeted therapy drugs, including fatigue, diarrhea and rash. In addition to these more prevalent sympAEs, there were some less frequently reported class-specific sympAEs, which had potential for significant harm or disability to the patient if not properly identified and treated. Many studies reported toxicities as AEs or syndromes solely using data reported by clinicians without additional self-report from patients.</p><p><strong>Conclusion: </strong>We identified several core sympAEs experienced by patients participating in oncology trials using immunotherapy and targeted therapy agents, which has implications for future trial design and drug labeling. Future cancer trials should assess patient-reported sympAEs based on identified drug mechanism to inform the tolerability of these newer agents and enhance patient safety during trial participation and clinical care.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerometer-measured physical activity, sedentary behavior, and mortality among cancer survivors: the Women's Health Accelerometry Collaboration.","authors":"Eric T Hyde, Kelly R Evenson, Gretchen E Bandoli, Jingjing Zou, Noe C Crespo, Humberto Parada, Michael J LaMonte, Annie Green Howard, Steve Nguyen, Meghan B Skiba, Tracy E Crane, Marcia L Stefanick, I-Min Lee, Andrea Z LaCroix","doi":"10.1093/jncics/pkaf034","DOIUrl":"https://doi.org/10.1093/jncics/pkaf034","url":null,"abstract":"<p><strong>Background: </strong>Data on prospective associations of accelerometer-measured physical activity (PA), sedentary behavior (SB), and mortality among cancer survivors are lacking. Our study examined accelerometer-measured daily PA (including light, moderate-to-vigorous PA [MVPA], total PA, and steps), SB (sitting time and mean bout duration), and mortality among cancer survivors in the Women's Health Accelerometry Collaboration (WHAC).</p><p><strong>Methods: </strong>Postmenopausal women in WHAC who reported a cancer diagnosis ≥1 year prior to wearing an ActiGraph GT3X+ on the hip for ≥4 of 7 days from 2011-2015 were included. Outcomes included all-cause, cancer, and cardiovascular disease (CVD) mortality. Covariate-adjusted Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for each PA and SB measure in association with mortality.</p><p><strong>Results: </strong>Overall, 2,479 cancer survivors (mean [SD] age, 74.2 [6.7] years) were followed for 8.3 years. For all-cause mortality (n = 594 cases), every 78.1 min/day in light PA, 96.5 min/day in total PA, 102.2 min/day in sitting time, and 4.8 min in sitting bout duration had HRs (95%CIs) of 0.92 (0.84-1.01), 0.89 (0.80-0.98), 1.12 (1.02-1.24) and 1.04 (0.96-1.12), respectively. Linear associations for cancer mortality (n = 168) and CVD mortality (n = 109) were not statistically significant except for steps (HR per 2,469 steps/day=0.66, 95%CI: 0.45-0.96) and sitting time (HR = 1.30, 95%CI: 1.02-1.67) for CVD mortality. Nonlinear associations showed benefits of MVPA (for all-cause and CVD mortality) and steps (all-cause mortality only) maximized around 60 min/day and 5,000 steps/day, respectively.</p><p><strong>Conclusions: </strong>Among postmenopausal cancer survivors, higher PA and lower SB was associated with reduced hazards of all-cause and CVD mortality.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEC-GIFT: a fairness-aware machine learning framework for lung cancer screening eligibility using real-world data.","authors":"Piyawan Conahan, Lary A Robinson, Trung Le, Gilmer Valdes, Matthew B Schabath, Margaret M Byrne, Lee Green, Issam El Naqa, Yi Luo","doi":"10.1093/jncics/pkaf030","DOIUrl":"10.1093/jncics/pkaf030","url":null,"abstract":"<p><strong>Objective: </strong>We use real-world data to develop a lung cancer screening (LCS) eligibility mechanism that is both accurate and free from racial bias.</p><p><strong>Methods: </strong>Our data came from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. We built a systematic fairness-aware machine learning framework by integrating a Group and Intersectional Fairness and Threshold (GIFT) strategy with an easy ensemble classifier- (EEC-) or logistic regression- (LR-) based model. The best LCS eligibility mechanism EEC-GIFT* and LR-GIFT* were applied to the testing dataset and their performances were compared to the 2021 US Preventive Services Task Force (USPSTF) criteria and PLCOM2012 model. The equal opportunity difference (EOD) of developing lung cancer between Black and White smokers was used to evaluate mechanism fairness.</p><p><strong>Results: </strong>The fairness of LR-GIFT* or EEC-GIFT* during training was notably greater than that of the LR or EEC models without greatly reducing their accuracy. During testing, the EEC-GIFT* (85.16% vs 78.08%, P < .001) and LR-GIFT* (85.98% vs 78.08%, P < .001) models significantly improved sensitivity without sacrificing specificity compared to the 2021 USPSTF criteria. The EEC-GIFT* (0.785 vs 0.788, P = .28) and LR-GIFT* (0.785 vs 0.788, P = .30) showed similar area under receiver operating characteristic curve (AUC) values compared to the PLCOM2012 model. While the average EODs between Blacks and Whites were significant for the 2021 USPSTF criteria (0.0673, P < .001), PLCOM2012 (0.0566, P < .001), and LR-GIFT* (0.0081, P < .001), the EEC-GIFT* model was unbiased (0.0034, P = .07).</p><p><strong>Conclusion: </strong>Our EEC-GIFT* LCS eligibility mechanism can significantly mitigate racial biases in eligibility determination without compromising its predictive performance.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building research infrastructure to advance precision medicine in colorectal cancer.","authors":"Stephanie L Schmit, Nicole C Loroña, Daniel Sobieski, Marco Matejcic, Nathalie T Nguyen, Hannah J Hoehn, Diana B Diaz, Kritika Shankar, Eric M Cockman, Esther Jean-Baptiste, Ya-Yu Tsai, R Blake Buchalter, Karina Brito, Rusche Wilson, Domenico Coppola, Clifton Fulmer, Ozlen Saglam, Alexandra F Tassielli, Francisca Beato, Ruifan Dai, Jennifer A Freedman, Kristen Purrington, Bo Hu, Daniel Mcgrail, Heather Gibson, Kun Jiang, Teresita Muñoz-Antonia, Idhaliz Flores, Edna Gordian, José A Oliveras Torres, Iona Cheng, Erin L Van Blarigan, Seth I Felder, Julian A Sanchez, Jason B Fleming, Erin M Siegel, Douglas Cress, Patricia Thompson, Mariana C Stern, Jamie K Teer, Jane C Figueiredo","doi":"10.1093/jncics/pkaf027","DOIUrl":"https://doi.org/10.1093/jncics/pkaf027","url":null,"abstract":"<p><strong>Background: </strong>Addressing critical gaps in precision medicine initiatives in colorectal cancer (CRC) requires building larger collaborative studies.</p><p><strong>Methods: </strong>The Latino Colorectal Cancer Consortium (LC3) is a resource that harmonizes data collected in observational studies with data from individuals who identify as Hispanic/Latino with a diagnosis of primary colorectal adenocarcinoma. Data collected includes demographics, medical history, family history, and lifestyle risk factors from patient-completed surveys. Vital status, cause of death, treatment, and clinicopathological characteristics were obtained through medical chart abstraction, pathology reports and/or linkage to state cancer registries. Blood, saliva, or normal colonic tissues were used to extract and genotype germline DNA. Tumor tissue (snap frozen or formalin-fixed paraffin-embedded) were evaluated by pathologists for diagnosis, tissue content, tumor cellularity, necrosis, immune infiltration, and additional histopathologic characteristics. A centralized database with a virtual tumor repository was created to facilitate collaborative research.</p><p><strong>Results: </strong>As of April 2024, LC3 assembled data from 2,210 patients (diagnosed 1994 to 2023). The mean age at diagnosis was 57 (range: 19-93) years; 54.3% of participants were male, and 62.0% had been diagnosed with colon cancer. Surveys were completed by 1,722 (77.8%) participants. Ongoing multi-omics profiling on up to 600 patients include: genome-wide germline genotyping, paired tumor/normal whole exome sequencing, bulk RNA-seq, T cell receptor immunosequencing, and multiplex immunofluorescence.</p><p><strong>Conclusions: </strong>This consortium fills an important gap in research infrastructure in CRC as well as improving precision medicine initiatives for all individuals.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks of colorectal and extracolonic cancers following colorectal cancer: a systematic review and Meta-Analysis.","authors":"Ye Kyaw Aung, Ye Zhang, Mark A Jenkins, Aung Ko Win","doi":"10.1093/jncics/pkaf031","DOIUrl":"https://doi.org/10.1093/jncics/pkaf031","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer survivors face increased risks of developing new primary cancers in colorectum and other anatomical sites. This systematic review aimed to estimate primary colorectal and extracolonic cancers risks following colorectal cancer.</p><p><strong>Methods: </strong>Peer-reviewed articles published before January 2025 were screened across four databases to identify studies using population cancer registry reporting standardized incidence ratios (SIRs) of primary cancers following colorectal cancer, compared with the general population. A meta-analysis was conducted to summarize the SIRs, and age-specific cumulative risks of primary cancers following colorectal cancer were estimated using the summarized SIRs and age-, sex-, calendar-, region- and cancer-specific incidence data.</p><p><strong>Results: </strong>Of 8254 articles identified, 57 were included in meta-analysis. The pooled SIRs (95% confidence interval) for any primary cancer, extracolonic cancer and colorectal cancer were 1.13 (1.06-1.20), 1.10 (1.03-1.17), and 1.55 (1.33-1.77), respectively. Increased risks were also observed for primary cancers of small intestine, ovary, uterus, testes, kidney, female breast, thyroid, and prostate overall, as well as for lung and urinary bladder cancer in recent studies. The cumulative risks of any primary cancer, extracolonic cancer, and colorectal cancer to age 75 years were: 38.5%, 31.6%, and 8.24% in Australasia; 33.8%, 30.9%, and 4.77% in North America; 27.4%, 25.6%, and 8.01% in East Asia; and 33.4%, 28.8%, and 4.68% in Europe.</p><p><strong>Conclusion: </strong>Colorectal cancer survivors have an increased risk of subsequent primary cancers, both extracolonic and colorectal, when compared with the general population. These findings underscore the necessity for tailored surveillance and prevention strategies to effectively identify and manage subsequent primary cancers in this population.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI meets informed consent: a new era for clinical trial communication.","authors":"Michael Waters","doi":"10.1093/jncics/pkaf028","DOIUrl":"https://doi.org/10.1093/jncics/pkaf028","url":null,"abstract":"<p><p>Clinical trials are fundamental to evidence-based medicine, providing patients with access to novel therapeutics and advancing scientific knowledge. However, patient comprehension of trial information remains a critical challenge, as registries like ClinicalTrials.gov often present complex medical jargon that is difficult for the general public to understand. While initiatives such as plain-language summaries and multimedia interventions have attempted to improve accessibility, scalable and personalized solutions remain elusive. This study explores the potential of Large Language Models (LLMs), specifically GPT-4, to enhance patient education regarding cancer clinical trials. By leveraging informed consent forms (ICFs) from ClinicalTrials.gov, the researchers evaluated two AI-driven approaches-direct summarization and sequential summarization-to generate patient-friendly summaries. Additionally, the study assessed the capability of LLMs to create multiple-choice question-answer pairs (MCQAs) to gauge patient understanding. Findings demonstrate that AI-generated summaries significantly improved readability, with sequential summarization yielding higher accuracy and completeness. MCQAs showed high concordance with human-annotated responses, and over 80% of surveyed participants reported enhanced understanding of the authors in-house BROADBAND trial. While LLMs hold promise in transforming patient engagement through improved accessibility of clinical trial information, concerns regarding AI hallucinations, accuracy, and ethical considerations remain. Future research should focus on refining AI-driven workflows, integrating patient feedback, and ensuring regulatory oversight. Addressing these challenges could enable LLMs to play a pivotal role in bridging gaps in clinical trial communication, ultimately improving patient comprehension and participation.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forward momentum: Progressive change through diversity equity and inclusion initiatives (DEI) in academic healthcare.","authors":"Chaitanya Kalavagunta, Bansi Savla, Jessica White, Dominic Bulkley, Anna Dunlap, Renee Kwok, Kennecia Shaw, Michael MacFarlane, Sara Dudley, David Alicia, Kimberly Marter, Rivka Leichter, Cameron Chason, Søren M Bentzen, William Regine, Melissa Vyfhuis","doi":"10.1093/jncics/pkaf029","DOIUrl":"https://doi.org/10.1093/jncics/pkaf029","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the impact of a two-year Diversity, Equity, and Inclusion (DEI) intervention program within a radiation oncology department. We analyzed employee perceptions of inclusivity, bias, training, and career development, recognizing the challenges of assessing DEI initiatives in an evolving sociopolitical context.</p><p><strong>Methods: </strong>A voluntary survey was distributed in 2021 and 2023. The survey assessed four DEI domains: Inclusivity, Department Bias, Training/Education, and Career Development. Responses were analyzed using nonparametric tests. DEI initiatives included implicit bias training, allyship training, book clubs, anonymous feedback platforms, and a DEI website.</p><p><strong>Results: </strong>Survey completion rates were 40% (2021) and 50% (2023). Significant improvements were observed in Inclusivity (3.72 vs. 3.91, p = 0.042), Training/Education (3.57 vs. 4.14, p < 0.001), and Career Development (3.39 vs. 3.60, p = 0.019). Department Bias showed no significant change (p = 0.130). Anti-DEI sentiment increased in 2023, highlighting challenges in fostering inclusivity. Subgroup analyses revealed improvements for Black employees but persistent disparities for women.</p><p><strong>Conclusions: </strong>This exploratory study suggests that targeted DEI initiatives can improve employee perceptions of workplace culture in academic healthcare settings. Notably, the program improved perceptions of inclusivity, training opportunities, and career development. However, persistent gender inequities in training and career development highlight the need for monitoring and focused efforts. These findings can inform future DEI strategies and underscore the importance of continued vigilance in promoting an inclusive work environment. Future research should explore the program's downstream effects on patient care, clinical trial enrollment, and residency enrollment.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiome in Colorectal Cancer: Metagenomics from Bench to Bedside.","authors":"Amir Torshizi Esfahani, Nikta Zafarjafarzadeh, Fatemeh Vakili, Anahita Bizhanpour, Amirhesam Mashaollahi, Bita Karimi Kordestani, Mahdieh Baratinamin, Somayeh Mohammadpour","doi":"10.1093/jncics/pkaf026","DOIUrl":"https://doi.org/10.1093/jncics/pkaf026","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is a major global health challenge. Emerging research highlights the pivotal role of the gut microbiota in influencing CRC risk, progression, and treatment response. Metagenomic approaches, especially high-throughput shotgun sequencing, have provided unprecedented insights into the intricate connections between the gut microbiome and CRC. By enabling comprehensive taxonomic and functional profiling, metagenomics has revealed microbial signatures, activities, and biomarkers associated with colorectal tumorigenesis. Furthermore, metagenomics has shown a potential to guide patient stratification, predict treatment outcomes, and inform microbiome-targeted interventions. Despite remaining challenges in multi-omics data integration, taxonomic gaps, and validation across diverse cohorts, metagenomics has propelled our comprehension of the intricate gut microbiome-CRC interplay. This review underscores the clinical relevance of microbial signatures as potential diagnostic and prognostic tools in CRC. Furthermore, it discusses personalized treatment strategies guided by this omics' approaches.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor localization strategies of multicancer early detection tests: a quantitative assessment.","authors":"Christopher Tyson, Kevin H Li, Xiting Cao, James M O'Brien, Elliot K Fishman, Elizabeth K O'Donnell, Carlos Duran, Vijay Parthasarathy, Seema P Rego, Omair A Choudhry, Tomasz M Beer","doi":"10.1093/jncics/pkaf011","DOIUrl":"10.1093/jncics/pkaf011","url":null,"abstract":"<p><strong>Background: </strong>Multicancer early detection tests may expand cancer screening. Characterizing diagnostic resolution approaches following positive multicancer early detection tests is critical. Two trials employed distinct resolution approaches: a molecular signal to predict tissue of origin and an imaging-based diagnostic strategy. This modeling study characterizes diagnostic journeys and impact in a hypothetical population of average-risk multicancer early detection-eligible patients.</p><p><strong>Methods: </strong>A mathematical expression for diagnostic burden was derived using positive predictive value (PPV), molecular tissue of origin localization accuracy, and numbers of procedures associated with each diagnostic outcome. Imaging-based and molecular tissue of origin-informed strategies were compared. Excess lifetime cancer risk due to futile radiation exposure was estimated using organ-specific diagnostic imaging radiation doses.</p><p><strong>Results: </strong>Across all PPVs and localization performances, a molecular tissue of origin strategy resulted in a higher diagnostic burden (mean = 3.6 [0.445] procedures vs mean = 2.6 [0.100] procedures) for the imaging strategy. Estimated diagnostic burden was higher for molecular tissue of origin in 95.5% of all PPV and tissue of origin accuracy combinations; at least 79% PPV and 90% accuracy would be required for a molecular tissue of origin-informed strategy to be less burdensome than imaging. The maximum rate of excess cancer incidence from radiation exposure for multicancer early detection false-positive results (individuals aged 50-84 years) was 64.6 of 100 000 (annual testing, 99% specificity), 48.5 of 100 000 (biennial testing, 98.5% specificity), and 64.6 of 100 000 (biennial testing, 98% specificity).</p><p><strong>Conclusions: </strong>An imaging-based diagnostic strategy is more efficient than a molecular tissue of origin-informed approach across almost all PPV and tissue of origin accuracy combinations. The use of an imaging-based approach for cancer localization can be efficient and low-risk compared with a molecular-informed approach.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}