JNCI Cancer Spectrum最新文献

{"title":"Sequential chemo-durvalumab, reduced dose RT, and consolidation durvalumab for unresectable stage III NSCLC unfit for PACIFIC regimen (DEDALUS trial).","authors":"Francesco Agustoni, Jessica Saddi, Diego Luigi Cortinovis, Stefano Arcangeli, Luca Sala, Catherine Klersy, Valeria Musella, Giulia Galli, Sabrina Borgetto, Giulia Maria Stella, Daniela Cicognini, Alessandra Ferrari, Paolo Pedrazzoli, Francesco Grossi, Andrea Riccardo Filippi","doi":"10.1093/jncics/pkag050","DOIUrl":"https://doi.org/10.1093/jncics/pkag050","url":null,"abstract":"<p><strong>Introduction: </strong>The PACIFIC study established the standard of care for unresectable, stage III non-small cell lung cancer. The DEDALUS trial is a Phase 2, open-label, multicenter study enrolling patients who are eligible for sequential CRT plus immunotherapy.</p><p><strong>Methods: </strong>Patients had unresectable stage IIIA-C NSCLC, regardless of PD-L1 status. After three cycles of chemo-durvalumab, responders received hypofractionated thoracic radiotherapy (45 Gy over three weeks) with durvalumab, then continued durvalumab for up to 12 months or until disease progression. Primary endpoint was safety, assessed by the incidence of Grade 3 and 4 possibly related adverse events (PRAEs) within six months. Secondary endpoints included PFS, OS and quality of life (NCT05128630).</p><p><strong>Results: </strong>Between February 2022 and August 2024, 28 patients were screened, and 25 enrolled across three Italian centers. Enrollment was halted early due to low recruitment. We recorded 9 Grade 3 to 4 PRAEs, which accounted for 6.4% of all AEs; 7 patients (28%) experienced at least one grade 3 to 4 PRAE. Only one was immune-related, while the remaining PRAEs were related to chemotherapy, none to RT.Median PFS was 13.2 months (95% CI: 4.9-18.6), median OS was 17.5 months (95% CI: 10.7-18.6). Among the 16 patients who started maintenance without progression median PFS was 18.6 months (95% CI: 12.8-not reached), median OS was not reached.</p><p><strong>Conclusions: </strong>The early closure of the study and the reduced sample size make it difficult to draw significant conclusions. However, feasibility and safety seem to be acceptable, early PFS and OS data are promising, especially for patients who completed the full treatment sequence.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837942","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":"Psychosocial factors and overall mortality after prostate cancer diagnosis among predominantly low-income Black and White adults.","authors":"Douglas Demoulin, Loren Lipworth, Melinda C Aldrich, Leo J Russo, Heather Munro, Francesca Kolitsopoulos, Ronald Fisa, Kabisa Mwala, Martha J Shrubsole, Wei Zheng, Xiao-Ou Shu","doi":"10.1093/jncics/pkag029","DOIUrl":"https://doi.org/10.1093/jncics/pkag029","url":null,"abstract":"<p><strong>Introduction: </strong>Psychosocial factors may influence PCa survival, but evidence is limited for low-income populations.</p><p><strong>Methods: </strong>This study utilized data from the Southern Community Cohort Study (SCCS), a prospective cohort of ∼85,000 individuals aged 40 to 79, from predominantly low-income backgrounds, enrolled between 2002 to 2009 across 12 southeastern states. A total of 1,367 men (1,058 Black and 309 White) found with PCa during the follow-up of 34,313 men were included. The Kaplan-Meier method was used to generate 5-year survival rates with log-rank tests for statistical significance. Multivariable Cox models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for psychosocial-mortality associations.</p><p><strong>Results: </strong>Over 18-years of follow-up, 291 Black (27.5%) and 59 White (19.1%) PCa patients died (P=0.03). White men self-reporting major depressive symptoms and their inability to control important things in life (ITC) had an 11% (Psurvival = 0.01) and 12% (Psurvival = 0.01) lower 5-year survival compared to those that didn't, with aHR of 2.56, (95% CI = 1.13-5.77) and 2.30 (95% CI = 1.07-4.95), respectively. Inverse associations were found for per SD increase in depression score (aHR = 0.84, 95%CI = 0.74-0.96.) among black patients. Testing for multiplicative interaction was significant for race-depression (Pinteraction = 0.02) and race-ITC (Pinteraction 0.04). The associations were mainly seen among PCa cases diagnosed within 5 years after baseline survey.</p><p><strong>Conclusion: </strong>Psychosocial-mortality associations among PCa patients are complex and may not affect individuals equally. Programs aiming to reduce mortality for individuals with PCa should consider their psychosocial needs and demographic background.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837909","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":"Personalized risk prediction of financial toxicity in patients with cancer: an interpretable machine learning study.","authors":"Haluk Damgacioglu, Kalyani Sonawane, Gerard A Silvestri, Katherine R Sterba, Elizabeth G Hill, Scott B Cantor, Evan M Graboyes, Ashish A Deshmukh","doi":"10.1093/jncics/pkag049","DOIUrl":"https://doi.org/10.1093/jncics/pkag049","url":null,"abstract":"<p><strong>Background: </strong>Financial toxicity (FT), the economic stress from medical care, is common among people with cancer and is associated with worse health outcomes. While risk factors for FT are known, personalized FT risk prediction tools to help mitigate FT are lacking.</p><p><strong>Methods: </strong>This study developed and evaluated machine learning models to predict FT risk using data from the Medical Expenditures Panel Survey-Experiences with Cancer Survivorship Supplement for patients undergoing or within one year of cancer treatment. FT was defined as the presence of > 1 of the following: bankruptcy, unpaid medical bills, payment concerns, or debt. Several models were trained using demographic, clinical, economic, and social variables. Fine-tuning was performed to enhance sensitivity in predicting FT. The Shapley additive explanations (SHAP) were used for interpretability of the model.</p><p><strong>Results: </strong>Among 793 people with cancer, 283 (36%) experienced FT. A fine-tuned random forest algorithm achieved an AUROC of 0.84 (95% CI = 0.78 to 0.91) and an accuracy of 0.78 (95% CI = 0.71 to 0.85), with a sensitivity of 0.84 (95% CI = 0.72 to 0.92) and specificity of 0.75 (95% CI = 0.66 to 0.83), demonstrating balanced classification performance. SHAP values identified key predictors of FT risk, including younger age, lower income, higher medical expenditures, and poorer health status. To support clinical implementation, we developed a web-based FT risk calculator (https://hd-research.shinyapps.io/ftriskcalc/).</p><p><strong>Conclusion: </strong>The fine-tuned random forest algorithm resulted in promising results for predicting personalized FT risk. Integrated into a web-based calculator, the model has strong potential to help mitigate FT by identifying high-risk patients early in the cancer care continuum.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837887","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":"Cancer risk associated with abatacept among older individuals with rheumatoid arthritis in the United States.","authors":"Shyfuddin Ahmed, Xavier Mariette, Raphaele Seror, Eric A Engels","doi":"10.1093/jncics/pkag051","DOIUrl":"https://doi.org/10.1093/jncics/pkag051","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between abatacept therapy and cancer risk among individuals with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>We conducted a case-control study of individuals with RA in the United States aged 65 to 99 years (17,665 cancer cases and 53,652 controls during 2008 to 2019) using the SEER-Medicare database. For assessing risk of nonmelanoma skin cancer (NMSC), individuals of White race with RA and NMSC and corresponding controls were selected from Medicare beneficiaries residing in SEER areas. Exposure to abatacept, tumor necrosis factor inhibitors (TNFis), and conventional disease-modifying antirheumatic drugs (cDMARDs) was ascertained using prescription claims. Individuals exposed to both abatacept and TNFi were excluded. We calculated adjusted odds ratios (ORs) to measure associations between abatacept (±cDMARD) and risk for cancer overall, 17 specific cancer sites, and NMSC.</p><p><strong>Results: </strong>2.5% of SEER cancer cases and 2.6% of controls were treated with abatacept (±cDMARD). Overall cancer risk was not associated with exposure to abatacept compared with TNFi (±cDMARD) (adjusted OR 1.03, 95% confidence interval [95%CI] 0.88-1.21) or with cDMARDs only (1.02, 0.87-1.19). Abatacept was associated with increased NMSC risk compared to both TNFi (±cDMARD) (adjusted OR 1.31, 95%CI 1.01-1.70) and cDMARDs only (1.31, 1.01-1.71). Abatacept was also associated with increased lung cancer risk among individuals with recent-onset RA (adjusted OR 1.53, 95%CI 1.01 to 2.32, compared with TNFi). These associations were not significant after correction for multiple comparisons.</p><p><strong>Conclusions: </strong>Among older adults with RA, abatacept exposure was not associated with cancer risk overall, but there was some evidence for increased risks of NMSC and lung cancer.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814742","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":"Financial reimbursement for clinical trial participation costs: a pilot feasibility study.","authors":"Courtney P Williams, Nicole L Henderson, Nusrat Jahan, Erica Stringer-Reasor, Andres Azuero, Maria Pisu, Rebecca C Arend, Gabrielle B Rocque","doi":"10.1093/jncics/pkag048","DOIUrl":"https://doi.org/10.1093/jncics/pkag048","url":null,"abstract":"<p><strong>Background: </strong>Clinical trial participants rarely represent the real-world treatment population, potentially due to costs associated with participation. Monetary reimbursement for trial-related costs could address financial barriers to trial recruitment and retention.</p><p><strong>Methods: </strong>This mixed methods, pilot, feasibility study provided financial reimbursement to women with breast cancer participating in a clinical trial. Patients were reimbursed $1,000/month during their first four months of trial participation, surveyed biweekly to assess changes in financial toxicity, then interviewed to explore the effects of receiving reimbursement on trial-related costs and recruitment and retention. Mixed-effect modeling and thematic analysis were completed. Feasibility was defined as 80% retention of patients on the reimbursement study, with those retained completing 75% of surveys.</p><p><strong>Results: </strong>Of 39 consented patients, 33 patients completed the pilot study (85% retention, 100% survey completion). Patients were a median 52 years old (IQR 44 to 59), 48% Black, 67% privately insured, and 42% found it difficult to live on their current income. Patient financial toxicity modestly decreased. Patients (n = 32) reported using the reimbursement to pay for trial visit-related food, transportation, caregiver expenses, and out-of-pocket medical costs. Patients felt receiving reimbursement affected trial retention more so than recruitment, stating \"I would have enrolled regardless…[but knowing] it wasn't going to place a financial strain on us because of these reimbursements…It made it easier for me to feel good about continuing.\"</p><p><strong>Conclusion: </strong>Reimbursement for clinical trial-related costs is feasible, suggests decreases in financial toxicity, and is a promising approach to improve trial retention outcomes in women with breast cancer.</p><p><strong>Clinicaltrials.gov id: </strong>NCT05871125.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814943","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":"Exploration of BMI and circulating metabolic factors as predictors of metformin benefit in CCTG MA.32.","authors":"Pamela J Goodwin, Marguerite Ennis, Bingshu E Chen, Karen A Gelmon, Timothy J Whelan, Jennifer A Ligibel, Alastair M Thompson, Lois E Shepherd, Wendy R Parulekar, Ryan Dowling, Vuk Stambolic","doi":"10.1093/jncics/pkag045","DOIUrl":"https://doi.org/10.1093/jncics/pkag045","url":null,"abstract":"<p><strong>Background: </strong>In the MA.32 randomized adjuvant breast cancer (bc) trial, metformin (vs placebo) did not impact invasive disease free (IDFS) or overall survival (OS) in estrogen/progesterone receptor (ER/PgR) positive or negative bc; exploratory analyses suggested a benefit in HER2 positive bc. We investigated whether body mass index (BMI) and obesity-associated blood variables predicted metformin benefit in immunohistochemically defined bc subtypes [luminal (ER/PgR positive, HER2 negative), triple negative (TNBC; ER, PgR, HER2 negative), HER2 positive].</p><p><strong>Methods: </strong>3649 non-diabetic patients with high risk T1-3, N0-3 M0 bc were randomized. Baseline fasting plasma was assayed for insulin, glucose, leptin, hsCRP; Homeostasis Model Assessment (HOMA) was calculated. For each bc subtype and each outcome [distant recurrence free survival (DRFS), OS, IDFS], Cox models examined interactions of Body Mass Index (BMI) and blood variables with metformin vs placebo outcomes.</p><p><strong>Results: </strong>Mean age was 51.1 to 53.0 years; mean BMI 27.3 to 27.5 kg/m. 2 Most cancers were T2, N0 or N1 and grade 2 to 3; 2104 (57.7%) were luminal, 925 (25.3%) TN and 620 (17.0%) HER2 positive. Median follow-up 95.9 months. In luminal bc, significant interactions were identified for leptin, insulin and HOMA on DRFS and in TNBC a significant interaction was identified for glucose on DRFS, with potential adverse effects of metformin at lower levels of each variable. In those with HER2 positive bc, no variable predicted metformin benefit.</p><p><strong>Conclusions: </strong>BMI and blood variables did not identify subgroups with luminal or triple negative bc who benefitted from metformin nor those with HER2 positive bc who did not benefit.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814861","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":"Hearing/vestibular problems, racial differences, and associations with physical function impairment among breast cancer survivors.","authors":"Jincong Q Freeman, Fangyuan Zhao, Wenji Guo, Megan J Huisingh-Scheetz, Jayant M Pinto, Olufunmilayo I Olopade, Dezheng Huo","doi":"10.1093/jncics/pkag047","DOIUrl":"10.1093/jncics/pkag047","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors face many health challenges, including tinnitus, hearing loss, and vertigo which will grow with an aging population and improved treatment outcomes. However, the prevalence of hearing/vestibular problems, racial differences, and relationships to physical function are poorly characterized in breast cancer survivors.</p><p><strong>Methods: </strong>Between July and September 2023, we surveyed the Chicago Multiethnic Epidemiologic Breast Cancer Cohort. Tinnitus, hearing loss, and vertigo were self-reported and verified through electronic health records. Physical function impairment was measured using the SF-36 10-item instrument. We fit logistic regression models for hearing/vestibular problems and linear regression models for physical function score, controlling for sociodemographic and clinical factors.</p><p><strong>Results: </strong>Of 1,466 breast cancer survivors (mean [SD] age, 63.5 [11.8] years), 16.6%, 17.3%, and 8.6% reported experiencing tinnitus, hearing loss, and vertigo, respectively. Black survivors had lower odds of hearing loss (adjusted odds ratio [AOR], 0.51; 95% CI, 0.31-0.86) but greater odds of vertigo (AOR, 2.29; 95% CI, 1.34-3.89) than White survivors. Survivors with hearing/vestibular problems had higher average impairment scores (worse physical function) than those without. In the adjusted regression models, survivors who reported experiencing tinnitus (β, 0.76; 95% CI, 0.10-1.43), hearing loss (β, 0.73; 95% CI, 0.06-1.40), or vertigo (β, 1.70; 95% CI, 0.81-2.58) had a higher level of physical function impairment.</p><p><strong>Conclusions: </strong>This study demonstrates racial differences in hearing/vestibular problems and associations between these problems and physical function impairment. Survivorship programs should consider routine screening and interventions to improve hearing health and physical function among breast cancer survivors.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771505","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":"Racial disparities and utilization trends of first-line targeted therapies for metastatic breast cancer.","authors":"Yehoda M Martei, Kan Chen, Modesty Obasohan, Ronac Mamtani, Erin Aakhus, Lawrence N Shulman, Rebecca A Hubbard, Amy Clark","doi":"10.1093/jncics/pkag043","DOIUrl":"https://doi.org/10.1093/jncics/pkag043","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to determine temporal trends and racial disparities in utilization and time to treatment initiation (TTI) of CDK4/6 inhibitors (CDK4/6i) and pertuzumab for first-line metastatic breast cancer (MBC).</p><p><strong>Design: </strong>We extracted data from a nationwide electronic health record-derived deidentified database. Female patients ≥18 years old with ER+/HER2- or HER2+ MBC eligible for CDK4/6i(3/2015-10/2021) or pertuzumab(07/2012-09/2021) were included. Our outcomes were adjusted temporal trends in the proportion of patients receiving respective therapies using logistic regression with natural cubic splines for time trends and tested for changes in utilization over time within and between racial groups (non-Hispanic White (NHW) or non-Hispanic Black (NHB). Similar models using linear regression estimated mean TTI.</p><p><strong>Results: </strong>5173(NHW = 4478; NHB = 695) ER+/HER2- and 2321(NHW = 1915; NHB = 406) HER2+ MBC patients were included. There were significant differences in the proportion initiating CDK4/6i over time within racial groups (NHW, 23.5%(95%CI: 20.1%-27.3%) in 2015 to 53.8%(95%CI: 48.6%-59.0%) in 2021; NHB, 20.6%(95%CI: 11.9%-33.0%) in 2015 to 73.6%(95%CI: 61.7%-83.0%) in 2021) and between groups(p = 0.009). There was a significant increase in utilization of pertuzumab within both racial groups over time(p < 0.001), but no significant difference between groups(p = 0.45). TTI decreased over time with no significant differences in TTI trends between the two groups.</p><p><strong>Conclusions: </strong>Utilization of targeted therapies increased over time, however NHB patients were less likely to receive CDK4/6i compared to NHW. Approximately half of eligible patients did not receive pertuzumab. Further research is needed to understand mediators and design interventions to address underutilization of these therapies and those contributing to racial disparities in CDK4/6i utilization.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771474","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":"Understanding randomized controlled trial generalizability through an embedded molecular diagnostics trial.","authors":"Patrick Lewicki, Arnav Srivastava, Ralph Jiang, Anna Johnson, Khurshid Ghani, Kevin Ginsburg, Tudor Borza, Kristian Stensland, Simpa S Salami, Elai Davicioni, Rodney L Dunn, Stephanie Daignault-Newton, Ganesh S Palapattu, Daniel E Spratt, Michael Cher, Matthew Schipper, Robert T Dess, Todd M Morgan, Udit Singhal","doi":"10.1093/jncics/pkag040","DOIUrl":"https://doi.org/10.1093/jncics/pkag040","url":null,"abstract":"<p><strong>Purpose: </strong>Issues with randomized controlled trial (RCT) generalizability are well described, but whether these result from differences in patient management across contexts remains unknown. We studied management of patients with high-risk prostate cancer after radical prostatectomy (RP) inside and outside of an RCT evaluating the impact of a genomic classifier (GC) on post-RP treatment decision-making (Genomics in Michigan Impacting Observation of Radiation [G-MINOR]; NCT02783950).</p><p><strong>Materials and methods: </strong>338 patients enrolled in G-MINOR, and propensity score matched eligible but non-enrolled patient cohorts (pre-trial and trial contemporary) from the Michigan Urological Surgery Improvement Collaborative (MUSIC), in which the trial was embedded, were compared for rates and time to secondary treatment (adjuvant or salvage therapy) after prostatectomy.</p><p><strong>Results: </strong>Among 338 patients in the G-MINOR cohort, 69 (31 adjuvant, 38 salvage) received secondary treatment, compared with 266 (183 adjuvant, 83 salvage) and 104 (60 adjuvant, 44 salvage) in the 1,014 contemporary and 338 pre-trial matched MUSIC cohorts. Time to secondary treatment was significantly shorter in the MUSIC cohort across all comparisons. For example, matching G-MINOR to synchronous MUSIC patients demonstrated 84% vs 74% estimated 2-year treatment-free survival for trial and \"real world\" patients, respectively (p < 0.001).</p><p><strong>Conclusions and relevance: </strong>Controlling for key clinicopathologic factors, patients in the G-MINOR RCT and MUSIC cohorts were managed differently, even after stratifying by genomic risk. These findings suggest challenges in RCT generalizability extend beyond the representativeness of trial participants. Differences in management may also explain why divergent patient outcomes are observed in RCTs vs real-world settings.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771533","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":"Y-box Binding Protein-1 at the Crossroads of DNA Damage Response and Tumor Immune Evasion.","authors":"Mahmoud Toulany, Quaovi H Sodji","doi":"10.1093/jncics/pkag044","DOIUrl":"https://doi.org/10.1093/jncics/pkag044","url":null,"abstract":"<p><p>Tumor response to radiotherapy is shaped by multiple factors including immune modulation, tumor microenvironment and genetic factors. Among these, the Y-box binding protein-1 (YB-1) is a multifunctional DNA/RNA-binding protein frequently overexpressed in tumors. YB-1 controls the activation of DNA damage response (DDR) signaling following radiotherapy. Emerging evidence suggests that the role of YB-1 extends beyond DDR regulation to shaping tumor-immune interactions by regulating cytokine production, promoting immune evasion, and altering immune checkpoint expression. Elucidating these immune-related functions of YB-1 may uncover novel mechanisms of tumor immune evasion and identify novel therapeutic targets to enhance cancer immunotherapy. This mini-review summarizes current insights into the role of YB-1 in immune regulation, highlighting its impact on tumor immunity and potential clinical applications.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771551","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}