JNCI Cancer Spectrum最新文献

{"title":"Utility of metastasis-directed radiotherapy with and without hormonal therapy in management of oligometastatic prostate cancer.","authors":"William S Chen, Abuzar Moradi Tuchayi, Ali Sabbagh, Inkyu Kim, Evan Porter, Amir Ashraf-Ganjouei, Yun Rose Li, Alon Witztum, Abhejit Rajagopal, Steven N Seyedin, Roxanna Juarez, Peter R Carroll, Felix Y Feng, Eric J Small, Thomas A Hope, Julian C Hong","doi":"10.1093/jncics/pkaf096","DOIUrl":"https://doi.org/10.1093/jncics/pkaf096","url":null,"abstract":"<p><strong>Background: </strong>Metastasis-directed radiotherapy (MDT) is mainstay in management of oligometastatic prostate cancer (PCa), and PSMA-PET is currently the most sensitive imaging modality for localizing PCa metastases. The efficacy of MDT guided by PSMA-PET imaging with and without androgen deprivation therapy (ADT) +/- androgen-receptor pathway inhibitor (ARPI) has not yet been well characterized. We sought to evaluate the efficacy of PSMA PET-guided MDT.</p><p><strong>Methods: </strong>This is a single-institutional retrospective study of patients diagnosed with metastatic PCa by PSMA-PET imaging who were treated with MDT. Survival analyses were performed using the Kaplan-Meier method with Cox proportional hazards testing for significance. Cumulative incidence analyses were performed with Gray's testing for significance.</p><p><strong>Results: </strong>194 metastatic lesions from 101 patients identified by PSMA PET were irradiated with MDT. 47 of the 79 (59%) patients with hormone-sensitive PCa (HSPC) received ADT +/- ARPI along with MDT. 4 of 194 lesions (2.1%) demonstrated radiographic progression after MDT, with a median follow-up of 22.4 months. 2-year cumulative incidence of progression from HSPC to CRPC was 11% in patients who received ADT +/- ARPI and 35% in those who did not (P = .027). Median biochemical progression free survival of patients with CRPC, HSPC treated without ADT or ARPI, and HSPC treated with ADT +/- ARPI was 5.4, 7.6, and 43.9 months respectively (P < .0001). No Grade 3-5 adverse effects were observed.</p><p><strong>Conclusions: </strong>MDT guided by PSMA-PET imaging is well-tolerated and delays biochemical progression in patients with CRPC and HSPC, with a greater effect observed in patients also receiving ADT +/- ARPI.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251020","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":"Comorbidity prevalence and incidence in cancer survivors: a longitudinal All of Us study.","authors":"Jung Ae Lee, Ratna Pakpahan, Daniel J Amante, Ben S Gerber, Lin Yang","doi":"10.1093/jncics/pkaf093","DOIUrl":"https://doi.org/10.1093/jncics/pkaf093","url":null,"abstract":"<p><p>Comorbidities worsen cancer survival but patterns of pre-existing and new onset comorbidities among cancer survivors are unknown. We investigated self-reported and clinically diagnosed comorbidity among cancer survivors in the All-of-Us program's national database. Eight highly prevalent comorbidities were identified using self-reported data from the personal health history (PHH) survey among cancer survivors (n = 20,534) and non-cancer adults (n = 113,628), and validated among cancer survivors (n = 26,978) using data from electronic health records (EHRs). Among 5-year survivors (n = 9,174) documented in EHR, we further estimated the incidence of new-onset comorbidities. The most prevalent comorbidities identified in PHH data were hypertension (40.5%), osteoarthritis (28.4%), depression (28.0%), and obesity (23.2%). EHR data identified pre-existing comorbidities: hypertension (43.3%), osteoarthritis (29.4%), depression (19.4%), and obesity (19.1%). During five-year survival, over 50% cancer survivors developed at least one new comorbidity, and over 25% developed two or more. The onset of new comorbidities showed a sharp increase in the first-year post-diagnosis. Incidence rates varied by age, race and ethnicity. Future research is needed to develop effective strategies to prevent newly onset comorbidities during and after cancer treatment.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251042","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":"Identifying clustering in patterns of late effects among survivors of adolescent and young adult hodgkin lymphoma.","authors":"Kellee Parker, Mallorie Heneghan, Qian W Li, Ann Brunson, Judy Ou, Heydon K Kaddas, Renata Abrahão, Jessica Chubak, Karen J Wernli, Brad Zebrack, Erin E Hahn, Lawrence H Kushi, Hazel B Nichols, Theresa Keegan, Anne C Kirchhoff","doi":"10.1093/jncics/pkaf094","DOIUrl":"https://doi.org/10.1093/jncics/pkaf094","url":null,"abstract":"<p><strong>Background: </strong>We examined late effects clustering among adolescent and young adult (AYA; age 15-39 years at diagnosis) Hodgkin Lymphoma (HL) survivors and identified characteristics associated with each cluster.</p><p><strong>Methods: </strong>We included AYAs with HL in 2006-2018 from the California and Utah Cancer Registries linked to statewide hospitalization, emergency department, and ambulatory surgery visit data. We identified severe late effects >2 years after cancer diagnosis in nine late effects categories. Latent class analysis (LCA) was used to identify late effects clusters. Multinomial logistic regression models estimated adjusted associations of demographic and treatment characteristics with LCA late effect group.</p><p><strong>Results: </strong>We identified 4,635 AYA HL survivors with median follow-up of 8.2 years and four late effects groups: 77.1% had a low probability of any late effect (Low Morbidity), 12.8% had high probability of Thyroid disorders, 8.0% had high probability of Cardiovascular Disease (CVD), and 2.1% had high probability of Multiple Conditions (CVD, diabetes/pancreatic, thyroid, and renal diseases). Publicly insured AYAs were more likely than those with private insurance to be in the CVD (OR = 1.53, 95%CI = 1.18-1.98) and Multiple Conditions (OR = 2.17, 95%CI = 1.29-3.66) than the Low Morbidity group. AYAs with radiation were more likely to be in the Multiple Conditions (OR = 2.31, 95%CI = 1.41-3.78) and Thyroid (OR = 2.81, 95%CI = 2.20-3.58) groups. Hematopoietic cell transplantation was associated with Multiple Conditions (OR = 9.50, 95%CI = 5.82-15.50), CVD (OR = 3.82, 95%CI = 2.96-4.93), and Thyroid (OR = 2.86, 95%CI = 2.12-3.85) groups.</p><p><strong>Conclusions: </strong>While most AYA HL survivors were in the Low Morbidity group, those with public insurance or intense treatment may be at higher risk for multiple conditions.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199385","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":"Physical activity and molecular subtypes of colorectal cancer: a pooled observational analysis and mendelian randomisation study.","authors":"Christos V Chalitsios, Georgios Markozannes, Elom K Aglago, Sonja I Berndt, Daniel D Buchanan, Peter T Campbell, Yin Cao, Andrew T Chan, Niki Dimou, David A Drew, Amy J French, Peter Georgeson, Marios Giannakis, Stephen B Gruber, Marc J Gunter, Tabitha A Harrison, Michael Hoffmeister, Li Hsu, Wen-Yi Huang, Meredith Aj Hullar, Jeroen R Huyghe, Brigid M Lynch, Victor Moreno, Neil Murphy, Christina C Newton, Jonathan A Nowak, Mireia Obón-Santacana, Shuji Ogino, Conghui Qu, Stephanie L Schmit, Robert S Steinfelder, Wei Sun, Claire E Thomas, Amanda E Toland, Quang M Trinh, Tomotaka Ugai, Caroline Y Um, Bethany Van Guelpen, Syed H Zaidi, Robert E Schoen, Michael O Woods, Hermann Brenner, Laura Andreson, Andrew J Pellatt, Ulrike Peters, Amanda I Phipps, Konstantinos K Tsilidis","doi":"10.1093/jncics/pkaf095","DOIUrl":"https://doi.org/10.1093/jncics/pkaf095","url":null,"abstract":"<p><strong>Background: </strong>Physical activity is associated with lower colorectal cancer (CRC) risk, but its association with molecular subtypes defined by genetic and epigenetic alterations of the disease is unclear. Such information may enhance the understanding of the mechanisms related to the benefits of physical activity.</p><p><strong>Methods: </strong>Pooled observational (ncases=5,386, ncontrols=6,798; nstudies=5) and genome-wide association data (ncases=8,178, ncontrols=10,472; nstudies=5) were utilised. We used multivariable logistic regression models and Mendelian randomisation (MR) to assess the association between physical activity and the risk of CRC subtypes defined by individual tumour markers (and marker combinations), namely microsatellite instability (MSI) status, CpG island methylator phenotype (CIMP) status, BRAF and KRAS mutations. We used case-only analysis to test for differences between molecular subtypes. We applied Bonferroni correction to account for multiple tests.</p><p><strong>Results: </strong>In the pooled observational analysis, higher levels of physical activity were associated with lower CRC risk (ORObs-per 1SD=0.94, 95%CI 0.90-0.97), with an association that was stronger in males (ORObs-per 1SD=0.91, 95%CI 0.87-0.96) than in females (ORObs-per 1SD=0.97, 95%CI 0.91-1.03) (Pinteraction=0.04). Higher physical activity was associated with a lower risk of CRC across all molecular subtypes, especially in males. There was no difference in the associations by subtypes by pooled observational or MR analyses. The findings did not differ by study design, anatomical site, and early or late age onset of CRC.</p><p><strong>Conclusions: </strong>Our findings suggest that physical activity is not differentially associated with the four major molecular subtypes involved in colorectal carcinogenesis, indicating that its benefits extend broadly across colorectal cancer pathogenesis.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199390","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":"Magnitude of persistent poverty and cervical cancer incidence, stage at diagnosis, and mortality.","authors":"Poria Dorali, Haluk Damgacioglu, Trisha L Amboree, Ana Patricia Ortiz, Brian C Orr, Kalyani Sonawane, Ashish A Deshmukh","doi":"10.1093/jncics/pkaf091","DOIUrl":"10.1093/jncics/pkaf091","url":null,"abstract":"<p><p>Socioeconomically disadvantaged counties exhibit higher cervical cancer incidence and poorer survival. However, the specific impact of the magnitude of persistent poverty on these outcomes remains largely unexamined. Using national cancer registry data, we observed that women living in persistent poverty counties (PPCs) that have experienced extreme poverty (≥40% poverty) has more than 1.5 times higher cervical cancer incidence and twice the mortality rate vs women who lived in non-PPCs. Furthermore, stage-specific incidence was consistently higher in PPCs across localized, regional, and distant diagnoses. Five-year mortality for localized cervical cancer diagnoses was nearly twice as high in extreme poverty counties (11% vs 6%, two-sided p-value = 0.03). These findings highlight significant disparities in cervical cancer outcomes associated with increasing magnitude of persistent poverty and underscore the need for targeted interventions in economically vulnerable communities to reduce disparities and achieve cervical cancer elimination goals.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091785","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":"Geospatial disparities, health system factors, and breast cancer care quality.","authors":"Michael J Hassett, Angela C Tramontano, Hajime Uno, Debra P Ritzwoller, Rinaa S Punglia","doi":"10.1093/jncics/pkaf089","DOIUrl":"https://doi.org/10.1093/jncics/pkaf089","url":null,"abstract":"<p><strong>Background: </strong>Despite longstanding efforts to improve breast cancer care quality, wide performance gaps persist. We sought to identify regions demonstrating meaningfully low performance and characterize health-system and health-profession factors associated with geospatial disparities.</p><p><strong>Methods: </strong>We used the Surveillance, Epidemiology, and End Results-Medicare linked database and the Health Resources and Services Administration area health resource file to characterize performance across healthcare service areas using four metrics: diagnosis stage, chemotherapy, radiation, and endocrine therapy. We used principal component analysis to identify healthcare facility and provider characteristics associated with performance; and hierarchical multivariable modeling to attribute total variance proportionally to five domains: patient characteristics, health service area region, healthcare facility and provider characteristics, randomness, and unexplained.</p><p><strong>Results: </strong>Among 31,571 women aged 66-79 diagnosed 2007-2013 with stage I-III breast cancer and treated with surgery, 61% had stage 1 disease, 23% received chemotherapy, 54% received radiation therapy, and 42% received endocrine therapy. Health system factors explained more variance for endocrine therapy (21%), chemotherapy (12%), and radiation therapy (12%), compared to geospatial region or patient characteristics. Health profession-factors were associated with quality for stage, radiation therapy and chemotherapy; healthcare facility-factors were associated with quality for stage, endocrine therapy, and chemotherapy. Patient characteristics explained <5% of observed variance.</p><p><strong>Conclusions: </strong>Reassuringly, only a small number of regions demonstrated suboptimal breast cancer care. Optimal performance was associated with multidisciplinary teams and facilities with robust resources and higher volumes. Incorporating geospatial and health system factors into quality measurement efforts could foster the design of impactful quality improvement programs.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091761","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":"Anthropometric measures and incidence of obesity-related cancers in the HCHS/SOL Onco-SOL ancillary study.","authors":"Pragnya Wanjerkhede, Gregory Talavera, Linda C Gallo, Noe C Crespo, Ilir Agalliu, Andrew F Olshan, Kelly R Evenson, Thomas E Rohan, Martha L Daviglus, Amber Pirzada, Humberto Parada","doi":"10.1093/jncics/pkaf088","DOIUrl":"https://doi.org/10.1093/jncics/pkaf088","url":null,"abstract":"<p><strong>Background: </strong>Obesity is highly prevalent among Hispanic/Latino adults and is an established risk factor for 13 cancers; however, studies focused on Hispanic/Latino adults are limited. We examined six anthropometric measures in association with incidence of obesity-related cancers (ORCs) among Hispanic/Latino adults, overall and by sex, age, and heritage.</p><p><strong>Methods: </strong>We included 16,415 Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos. Baseline (2008-2011) anthropometric measures included body mass index (BMI), waist circumference, waist-to-height ratio, waist-to-hip ratio (WHp), fat mass index, and percent body fat. The incidence of 13 ORCs was ascertained through linkages with four state cancer registries (n = 330 incident ORC diagnosed over a mean follow-up of 10.7 years). Survey-weighted Cox models estimated covariate-adjusted hazard ratios (aHRs) and 95% confidence intervals (95%CIs) for the associations between each anthropometric measure and latent class analysis-derived groups and ORC risk.</p><p><strong>Results: </strong>HRs were elevated among adults with the highest levels of anthropometric measures, and more so among women than among men. For example, a BMI ≥30 (vs < 25) kg/m2 was associated with aHR of 1.42 (95%CI = 0.88-2.30) overall, and aHRs of 2.22 (95%CI = 1.18-4.16) in women and 0.46 (95%CI = 0.20-1.02) in men. aHRs also varied by Hispanic/Latino heritage. For example, a one-standard deviation increase in BMI was associated with a 63% (HR = 1.63; 95%CI = 1.10-2.41) increase in ORC risk among South American adults, but not among Central American adults (HR = 1.03; 95%CI = 0.53-2.00).</p><p><strong>Conclusions: </strong>Multiple anthropometric measures were positively associated with ORC risk, particularly among women. Efforts to reduce obesity may be important for cancer prevention in Hispanic/Latino adults.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091714","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":"Therapy-Related-Myeloid-Neoplasm-Risk score (TMNRS): a convenient score for tMN risk assessment in adult cancer patients.","authors":"Abhay Singh, Megan M Herr, Rahul Mishra, Rusina Karia, Theresa Hahn, Swapna Thota","doi":"10.1093/jncics/pkaf087","DOIUrl":"https://doi.org/10.1093/jncics/pkaf087","url":null,"abstract":"<p><strong>Background: </strong>A prediction model for estimating risk of therapy-related myeloid neoplasms (tMN), a late effect with a high mortality after chemotherapy and/or radiation, is currently unavailable. Ability to predict risk at initial cancer presentation can be key for early detection and risk mitigation.</p><p><strong>Methods: </strong>Using SEER-Medicare linked database, 970,390 adults diagnosed with first primary cancer from 2000-2011 (with follow-up through 2015) were selected. The sample was divided into training (n = 582,234) and validation cohorts (n = 388,156). Various tMN risk factors were utilized for the development of tMN prediction model: The Therapy-Related Myeloid Neoplasm Risk Score (TMNRS). TMNRS was created as a simple arithmetic sum of independent predictors of tMN weighted according to the adjusted hazard ratio from the Cox proportional hazards analysis.</p><p><strong>Results: </strong>In addition to the known risk factors of chemotherapy and radiation exposure, history of autoimmune disease and G-CSF exposure emerged as consistent predictors of tMN after each of the five cancers in the study. Cancer survivors were categorized into distinct risk groups with variable risk of tMN.</p><p><strong>Conclusion: </strong>TMNRS provides a simple and convenient office-based mechanism to identify solid cancer patients at variable risks of tMN development. This risk assessment tool provides preliminary insights that may contribute to future research on the management of patients, particularly those receiving adjuvant therapies. Further investigation is required to fully evaluate its clinical utility and potential effects on patient care.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091745","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":"MammaPrint predicts chemotherapy benefit in HR+HER2- early breast cancer: FLEX Registry real-world data.","authors":"Adam M Brufsky, Kent F Hoskins, Henry J Conter, Pond Kelemen, Mehran Habibi, Laila Samian, Rakshanda L Rahman, Laura Lee, Eduardo C Dias, Regina Hampton, Beth A Sieling, Cynthia R Osborne, Eric Brown, Jailan A Elayoubi, Priyanka Sharma, Jayanthi Ramadurai, Laurie Matt-Amaral, Alfredo A Santillan, Sasha Davis, Philip Albaneze, Harshini Ramaswamy, Nicole Chmielewski-Stivers, Andrea Menicucci, William Audeh, Pat Whitworth, Nathalie Johnson, Joyce O'Shaughnessy","doi":"10.1093/jncics/pkaf079","DOIUrl":"10.1093/jncics/pkaf079","url":null,"abstract":"<p><strong>Background: </strong>Gene expression assays help personalize adjuvant chemotherapy decisions for hormone receptor-positive, HER2-negative (HR+HER2-) early breast cancer (EBC). The 70-gene risk of distant-recurrence signature, MammaPrint, demonstrated clinical utility in guiding chemotherapy de-escalation in genomically low risk patients in the MINDACT trial. This study evaluates MammaPrint as a continuous predictor of chemotherapy benefit in HR+HER2- EBC using real-world data (RWD) from the FLEX Registry.</p><p><strong>Methods: </strong>The study evaluated 1002 patients treated with endocrine therapy (ET) only or ET with chemotherapy (ET+CT) enrolled in FLEX (NCT03053193) with 5-year median follow-up. Propensity-score matching balanced treatment groups by menopausal status, T-stage, and nodal status. The primary endpoint was distant recurrence-free interval (DRFI). Regression and Cox proportional hazards models assessed chemotherapy benefit across MammaPrint Index (MPI) risk.</p><p><strong>Results: </strong>Most patients were postmenopausal (70.1%), node-negative (70.0%), and had grade 2 tumors (51.2%). The regression models showed that MPI strongly predicted 5-year DRFI in ET only (R2 = 0.99, P < .001) and ET + CT (R2 = 0.90, P < .001) groups, corresponding to an average absolute chemotherapy benefit of 5.6% in High 1 and 10.9% in High 2. Minimal improvement in DRFI with chemotherapy was observed for Low (1.7%) and UltraLow (<1.0%) risk groups. A multivariate Cox model with an MPI-by-treatment interaction term demonstrated that increasing MPI risk was associated with greater chemotherapy benefit on DRFI (HR = 0.15, P = .047). Chemotherapy benefit was significantly associated with premenopausal status, but not age, T-stage, nodal status, or grade.</p><p><strong>Conclusions: </strong>These RWD from the FLEX Registry demonstrate that MPI is predictive of both DRFI prognosis and chemotherapy benefit in HR+HER2- EBC. (NCT03053193).</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835044","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}

{"title":"Physical activity and mobility disability in older adult cancer survivors.","authors":"Justin C Brown, Shengping Yang","doi":"10.1093/jncics/pkaf084","DOIUrl":"10.1093/jncics/pkaf084","url":null,"abstract":"<p><strong>Background: </strong>Cancer survivors may be more likely to experience accelerated declines in physical function compared to cancer-free controls, but objective data and knowledge of preventive interventions are limited.</p><p><strong>Methods: </strong>The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, single-blinded, randomized trial conducted at 8 centers across the United States that enrolled 1635 sedentary adults aged 70-89 years and with physical limitations but who could walk 400 m at baseline, of which 371 (22.7%) reported a history of cancer. Participants were randomized in a 1:1 ratio to a health education or physical activity program. The primary endpoint was time to major mobility disability, defined objectively by the inability to walk 400 m in less than 15 minutes.</p><p><strong>Results: </strong>Cancer history modified the effect of randomized group on major mobility disability (P = .006). Among those randomized to the health education program, participants with a history of cancer were 53% more likely to develop major mobility disability compared with participants who did not have a history of cancer (Hazard Ratio (HR) = 1.53; 95% CI = 1.18 to 1.99; P = .001). Among participants with a history of cancer, those randomized to the physical activity program were 43% less likely to develop major mobility disability compared with the health education program (HR = 0.57; 95% CI = 0.40 to 0.82; P = .003).</p><p><strong>Conclusion: </strong>In this analysis of a randomized clinical trial, cancer survivors had an increased risk of mobility disability compared with non-cancer controls, and physical activity attenuated this risk.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":"9 5","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032994","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}