JNCI Cancer Spectrum最新文献

{"title":"Treatment Strategies for Triple-Negative Primary Breast Cancer in Older Women: A Systematic Review.","authors":"Buraq Ahmed, Qutaiba Al-Khames Aga, Kwok-Leung Cheung, Jana de Boniface, Michael Gnant, Maria-Joao Cardoso, Emad Rakha, Thiraviyam Elumalai, Nadia Harbeck, Orit Kaidar-Person, Agrawal Amit","doi":"10.1093/jncics/pkaf049","DOIUrl":"https://doi.org/10.1093/jncics/pkaf049","url":null,"abstract":"<p><strong>Purpose: </strong>Although the relative proportion of triple-negative breast cancer (TNBC) decreases with age, its prevalence is rising with an ageing population. This study examines real-world treatment practices, whether age in older women with TNBC (owTNBC) affects therapy and outcomes, focusing on the potentially curable nature of early-stage TNBC.</p><p><strong>Methods: </strong>A PRISMA-compliant search using PICO criteria identified literature from 2014 to 2023 across five databases (MEDLINE, Embase, PubMed, Web of Science, and Scopus), focusing on women aged 65 and older with early-stage TNBC.</p><p><strong>Results: </strong>From 7,171 records, 37 studies were included. owTNBC exhibited less aggressive features, including lower Ki67, higher androgen receptor and higher Bcl2 expressions. Breast-conserving surgery with radiation therapy (RT) was associated with improved overall survival and breast cancer-specific survival (BCSS) with fewer recurrences compared with mastectomy+/-RT. Patients with owTNBC were more likely to receive RT than systemic therapy, and the lack of RT correlated with worse outcomes. Multivariate analyses showed that systemic treatment improved 5-year overall survival and BCSS. Overall outcomes did not show significant differences between women aged ≥70 and <70 at a median follow-up of 46 months.</p><p><strong>Conclusions: </strong>The lack of overall outcome improvements following owTNBC treatments may not solely be due to absent targetable receptors, as the intrinsic biology in older patients may be relatively favourable. Instead, treatment selection biases against active treatment due to age-related factors may contribute significantly. Treatment decisions should be biology-based and guided by a multidisciplinary, holistic and patient-centred approach that carefully considers comorbidities, functional status, social support and patient preferences.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078182","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":"Trends in Medicare payments within the first year of cervical cancer diagnosis, 2010-2019.","authors":"Mohammad A Karim, Ning Zhang, Hui Zhao, Ya-Chen Tina Shih, Lakshmi S M Kodali, Sharon H Giordano, Sanjay Shete","doi":"10.1093/jncics/pkaf043","DOIUrl":"10.1093/jncics/pkaf043","url":null,"abstract":"<p><p>Assessing Medicare payment trends for cervical cancer care is important to mitigate the financial impact on Medicare. This multiyear cross-sectional study included 65 years and older cervical cancer patients in SEER registries diagnosed between 2010 and 2019 who had continuous Part A and B Medicare coverage at least 6 months before diagnosis and at least within the first year of diagnosis and were not enrolled in any Health Maintenance Organization (HMO) in this duration. The main outcomes were trends in total and service-specific mean monthly Medicare payments within the first year of a cervical cancer diagnosis. This study included 2147 cervical cancer patients. The mean Medicare payments increased from $8300 in 2010 to $8520 in 2019, largely driven by a statistically significant increase in outpatient services costs, from $1361 to $2056 (AAPC = 5.45, 95% CI = 1.38 to 9.67, P = .008). These findings highlight the need for policy actions to mitigate cervical-cancer-related financial impact on Medicare.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996634","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":"Thriving after cancer: a special collection on the benefits of exercise and nutrition in cancer survivorship.","authors":"Leila Tchelebi, Justin Brown","doi":"10.1093/jncics/pkaf048","DOIUrl":"10.1093/jncics/pkaf048","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":"9 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274853","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":"Curative or non-curative: immunotherapy for advanced melanoma.","authors":"Richard Kelly, Abigail Miller, Rachel Roberts-Thomson, Andrew Haydon","doi":"10.1093/jncics/pkaf041","DOIUrl":"10.1093/jncics/pkaf041","url":null,"abstract":"<p><p>Advanced melanoma was historically considered incurable; however, a 52% 10-year melanoma-specific survival rate from seminal immunotherapy trials challenges that conclusion.1 There is no literature exploring clinicians' discussion of treatment intent with patients, or whether this represents cure. We performed a multicenter retrospective cohort analysis to examine treatment intent, using electronic medical records to identify 278 patients with unresectable or stage IV melanoma consented for immunotherapy from 2019 to 2023. Thirty-two (12%) were consented for curative-intent treatment (CIT). CIT frequency was not significantly influenced by patient or disease characteristics. Patients consented for CIT received significantly higher rates of combination immunotherapy than patients consented for non-curative-intent treatment (NCIT), 76% (16/21) vs 47% (116/246), P = .022. Among 267 unresectable patients, CIT rates differed significantly between Victoria and South Australia, 14% (20/142) vs 0.8% (1/125), P < .001. Our data confirms variability of documented treatment-intent in advanced melanoma. Further research is needed to understand how this affects patients.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013118","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":"Synergies, partnership outcomes, and lessons learned: a qualitative evaluation of cancer center-coalition engagement.","authors":"Aubrey Villalobos, Paula Darby Lipman, Jennifer Beebe-Dimmer, Evelinn A Borrayo, Katherine J Briant, Amanda Bruegl, Craig Dee, Sarah Chavez, Bettina Drake, Selisha Snowy Johnson, Kara Kikuchi, Jennifer Leeman, Jan Lowery, Jason A Mendoza, Myra Parker, Lisa Purvis, Kelly Wells Sittig, Hayley S Thompson, Mary Wangen, Stephanie B Wheeler","doi":"10.1093/jncics/pkaf038","DOIUrl":"10.1093/jncics/pkaf038","url":null,"abstract":"<p><strong>Background: </strong>Nine National Cancer Institute-Designated Cancer Centers received supplemental funding to expand community outreach and engagement activities through a partnership with Centers for Disease Control and Prevention-funded comprehensive cancer control coalitions. This article reports on an evaluation of these awards focused on organizational relationships and partnership outcomes.</p><p><strong>Methods: </strong>The National Cancer Institute, community outreach and engagement, and coalition representatives co-designed the evaluation, which involved document review and 18 semistructured interviews with 16 community outreach and engagement and 19 coalition representatives. Artificial intelligence-generated interview transcripts were dual-coded in NVivo, version 20/R1, software.</p><p><strong>Results: </strong>The funding generated a diverse collection of projects and partnerships. Community outreach and engagement-coalition synergies and lessons learned were evident in the following domains: infrastructure; community and partner engagement; data monitoring; and intervention implementation, evaluation, and dissemination. Outcomes of this funding initiative were evident in the following domains: strengthened partnerships, expanded knowledge, improved health or health-care programs and policies, and thriving communities.</p><p><strong>Conclusions: </strong>Fostering community outreach and engagement-coalition partnerships created opportunities to use synergies and build capacity for engagement across multiple domains, contributing to enhanced trust and implementation of interventions across the cancer continuum. The findings provide examples and lessons on which cancer centers and coalitions can capitalize. Successful collaborative relationships were based on identifying shared goals and complementary expertise and roles, sharing financial and other resources, and a commitment to authentic and open dialogue. Although modest and short term, supplemental funding can strengthen organizational relationships and promote effective collaboration on community-facing activities; it can also lead to improved research engagement and translation of evidence to practice.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035745","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":"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 C Cappelleri, 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":"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 the 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":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730149","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":"Ending nuclear weapons, before they end us†.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Marion Birch, Inga Blum, Peter Doherty, Andy Haines, Ira Helfand, Richard Horton, Kati Juva, Jose F Lapena, Robert Mash, Olga Mironova, Arun Mitra, Carlos Monteiro, Elena N Naumova, David Onazi, Tilman Ruff, Peush Sahni, James Tumwine, Carlos Umaña, Paul Yonga, Chris Zielinski","doi":"10.1093/jncics/pkaf044","DOIUrl":"10.1093/jncics/pkaf044","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":"9 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093861","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":"Accuracy of self-reported exam indications for breast cancer screening.","authors":"Erin J Aiello Bowles, Hongyuan Gao, Lynn E Fleckenstein, Perla Bravo, Michael G Nash, Bryan Comstock, Chris Neslund-Dudas, Jin Mou, Larry G Kessler","doi":"10.1093/jncics/pkaf046","DOIUrl":"10.1093/jncics/pkaf046","url":null,"abstract":"<p><p>We validated updated National Health Interview Survey questions on mammography indications compared with electronic health records (EHRs). We asked 244 Kaiser Permanente Washington members ages 40-74 years and eligible for breast cancer screening to self-report their most recent mammogram reason by using a series of new hierarchical yes/no questions. We first asked if they had the mammogram because of a health problem, then as a follow-up test, and last for screening. We compared self-reported reasons with 2 EHR datasets: procedure/diagnostic codes and radiologist-defined indications. Self-reported exams for a health problem had 89.2% agreement with codes and 92.2% agreement with radiologist-defined indications. Self-reported exams for follow-up had 87.5% agreement with codes and 89.3% agreement with radiologist-defined indications. Self-reported exams for screening had 91.4% agreement with codes and 95.7% agreement with radiologist-defined indications. Self-reported mammogram indications have good agreement with procedure/diagnostic codes and radiologist-reported indications, when asked using this novel hierarchical approach.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967156","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":"Associations between early tumor shrinkage/depth of response and survival from the ARCAD database.","authors":"Hideaki Bando, Yuriko Takeda, Toshihiro Misumi, Tomomi Nishikawa, Masashi Wakabayashi, Kentaro Yamazaki, Eiji Oki, Jean-Yves Douillard, Cornelis J A Punt, Miriam Koopman, Eric Van Cutsem, Carsten Bokemeyer, Alan P Venook, Heinz-Josef Lenz, Yoshihiko Maehara, Thierry Andre, Qian Shi, Aimery de Gramont, Takayuki Yoshino","doi":"10.1093/jncics/pkaf042","DOIUrl":"10.1093/jncics/pkaf042","url":null,"abstract":"<p><strong>Background: </strong>Early tumor shrinkage and depth of response have emerged as potential prognostic indicators in metastatic colorectal cancer (CRC). However, their associations with overall survival, progression-free survival (PFS), and postprogression survival in patients receiving anti-epidermal growth factor receptor (EGFR) antibodies or bevacizumab remain unclear.</p><p><strong>Methods: </strong>We analyzed 3219 treatment-naive patients with RAS wild-type metastatic CRC from 8 randomized studies (CRYSTAL, OPUS, PRIME, CAIRO2, CALGB80405, WJOG4407G, ATOM, PARADIGM) in the Aid and Research in Digestive Cancerology database. Early tumor shrinkage was defined as a 20% or more reduction in tumor size at 8 ± 2 weeks, whereas depth of response was assessed by maximum tumor shrinkage at nadir. Cox regression models evaluated the associations of early tumor shrinkage and depth of response with overall survival, PFS, and postprogression survival, adjusting for confounders. A 2-sided test was conducted with a significance level of .05.</p><p><strong>Results: </strong>Early tumor shrinkage and depth of response substantially stratified overall survival, PFS, and postprogression survival outcomes across all treatment groups. Early tumor shrinkage positivity was associated with improved overall survival, PFS, and postprogression survival in anti-EGFR and bevacizumab-based therapies, with a trend toward better outcomes in the anti-EGFR group. The depth of response analysis revealed optimal cutoff values of 0.55 for anti-EGFR-based therapy and 0.47 for bevacizumab-based therapy to achieve a median overall survival of approximately 32 months.</p><p><strong>Conclusions: </strong>Early tumor shrinkage and depth of response serve as valuable prognostic markers in RAS wild-type metastatic CRC, particularly for patients treated with anti-EGFR antibodies. These findings highlight the potential role of early tumor shrinkage and depth of response in guiding treatment strategies and improving outcomes for patients with CRC.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024309","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":"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":"10.1093/jncics/pkaf034","url":null,"abstract":"<p><strong>Background: </strong>Data on prospective associations of accelerometer-measured physical activity, sedentary behavior, and mortality among cancer survivors are lacking. Our study examined accelerometer-measured daily physical activity (including light, moderate to vigorous, total, and steps), sedentary behavior (sitting time and mean bout duration), and mortality among cancer survivors in the Women's Health Accelerometry Collaboration.</p><p><strong>Methods: </strong>Postmenopausal women in the Collaboration who reported a cancer diagnosis at least 1 year prior to wearing an ActiGraph GT3X+ device on the hip for at least 4 of 7 days from 2011 to 2015 were included. Outcomes included all-cause, cancer-related, and cardiovascular disease (CVD)-related mortality. Covariate-adjusted Cox regression estimated hazard ratios (HRs) and 95% CIs for each physical activity and sedentary behavior measure in association with mortality.</p><p><strong>Results: </strong>Overall, 2479 cancer survivors (mean [SD] age, 74.2 [6.7] years) were followed up for 8.3 years. For all-cause mortality (n = 594 cases), every 78.1 minutes per day in light physical activity, 96.5 minutes per day in total physical activity, 102.2 minutes per day in sitting time, and 4.8 minutes in a sitting bout duration had hazard ratios of 0.92 (95% CI = 0.84 to 1.01), 0.89 (95% CI = 0.80 to 0.98), 1.12 (95% CI = 1.02 to 1.24), and 1.04 (95% CI = 0.96 to 1.12), respectively. Linear associations for cancer mortality (n = 168) and CVD mortality (n = 109) were not statistically significant, except for steps (hazard ratio per 2469 steps/d = 0.66, 95% CI = 0.45 to 0.96) and sitting time (hazard ratio = 1.30, 95% CI = 1.02 to 1.67) for CVD mortality. Nonlinear associations showed benefits of moderate to vigorous physical activity (for all-cause and CVD mortality) and steps (all-cause mortality only) maximized at approximately 60 minutes per day and 5000-6000 steps per day, respectively.</p><p><strong>Conclusions: </strong>Among postmenopausal cancer survivors, higher physical activity and lower sedentary behavior 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":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730145","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}