JNCI Cancer Spectrum最新文献

{"title":"Early onset blood cancer risks associated with living near Superfund sites.","authors":"Haokun Yuan, Mary Beth Terry, Wan Yang","doi":"10.1093/jncics/pkag099","DOIUrl":"10.1093/jncics/pkag099","url":null,"abstract":"<p><p>Residential environmental chemical exposures have been associated with elevated cancer risks. This study examined the risk associated with living near Superfund sites for leukemia and lymphoma-two \"indicator\" cancers with high sensitivity to environmental chemical exposures. Analyzing 127 locations with available data (55 New York City neighborhoods and 72 counties, totaling 39.25% of the US population; 23 with large Superfund sites), the study found modestly higher area-level incidence rates of leukemia and lymphoma in locations classified as affected by Superfund sites. For lymphoma, estimated incidence rate ratio was 1.07 (95% CI = 1.02 to 1.11) among individuals aged 20-49 years and 1.05 (95% CI = 1.02 to 1.09) among individuals aged 50-64 years, corresponding to a 1.19 and 1.14 area-level relative risk respectively for the two groups living within 2 km (New York City) or 5 km (elsewhere) of a Superfund site. As many Superfund sites are located around population centers, these findings highlight the need for mitigating such exposures and cancer risks.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13712186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069504","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":"Sociodemographic trends in prostate cancer: insights from the All of Us Research Program.","authors":"Dhruv G Pillai, Vivian A Guedes, Nicholas G Micheletti, Jessica D Kindrick, Benjamin C Brim, Hyoyoung Choo-Wosoba, Cindy H Chau, William D Figg","doi":"10.1093/jncics/pkag070","DOIUrl":"10.1093/jncics/pkag070","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer disproportionately affects vulnerable populations. The All of Us Research Program (AoURP) is a database that aims to encapsulate the diversity of the United States. To explore the utility of this dataset in assessing prostate cancer disparities, we investigated whether treatment usage, disease progression, and genomic research participation vary across sociodemographic factors among AoURP participants with prostate cancer.</p><p><strong>Methods: </strong>We identified AoURP participants with prostate cancer. Genomic research participation in AoURP, treatment usage, time-to-treatment, and time-to-metastasis were assessed by demographics and distance from a National Cancer Institute-designated comprehensive cancer center. Multivariable logistic regression and Cox proportional hazards regression were performed to evaluate treatment usage and time-to-treatment and time-to-metastasis, respectively.</p><p><strong>Results: </strong>We observed lower genomic data availability in Black vs White patients (P < .001). In multivariable analyses, patients residing more than 80 miles from an NCI-designated comprehensive cancer center were less likely to receive androgen receptor pathway inhibitors (odds ratio [OR] = 0.30, 95% CI = 0.14 to 0.66; P = .002) and bone targeting agents (OR = 0.46, 95% CI = 0.30 to 0.70; P < .001) but more likely to undergo prostatectomy (OR = 1.97, 95% CI = 1.43 to 2.71; P < .001) than those residing less than 40 miles away. These patients also initiated treatment faster (hazard ratio [HR] = 1.54, 95% CI = 1.27 to 1.87; P < .001) and developed metastasis slower (HR = 0.58, 95% CI = 0.40 to 0.86; P = .006). Black patients were less likely to receive radiation (OR = 0.45, 95% CI = 0.23 to 0.88; P = .020), prostatectomy (OR = 0.65, 95% CI = 0.44 to 0.96; P = .028), and bone targeting agents (OR = 0.65, 95% CI = 0.45 to 0.93; P = .018) than White patients.</p><p><strong>Conclusions: </strong>Prostate cancer treatment usage, disease progression, and genomic research participation varied between demographic populations. As AoURP matures, additional studies may leverage future data releases to confirm these findings.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375821","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":"Association of English language proficiency and breast cancer oncologic outcomes.","authors":"Revathi Ravella, Lillian A Boe, Anushri Mahabir, Boris A Mueller, Emma N Hahesy, Jeehee Isabelle Choi, Anyi Li, Simon N Powell, Atif J Khan, Lior Z Braunstein","doi":"10.1093/jncics/pkag079","DOIUrl":"10.1093/jncics/pkag079","url":null,"abstract":"<p><p>Few studies have compared oncologic outcomes directly between English-speaking (ES) and non-English-speaking (NES) patients. We performed a matched cohort study of stage I-III breast cancer patients with ES patients propensity matched 3:1 to NES patients based on age, tumor stage, nodal involvement, and receipt of adjuvant therapy. Patients were categorized as ES or NES according to preferred language documented in the electronic medical record. Primary outcomes were locoregional recurrence (LRR), disease-free survival (DFS), and overall survival (OS). Among 2768 patients (2076 ES; 692 NES), median age at diagnosis was 62 years (range = 25-94). Ten-year LRR was 9.5% vs 13% (P = .032), 10-year DFS was 71% vs 63% (P = .008), and 10-year OS was 79% vs 74% (P = .12) for ES and NES patients, respectively. These findings suggest that NES patients may have inferior breast cancer outcomes, even in highly resourced academic environments. These findings highlight the need for targeted interventions beyond language assistance.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793315","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":"Treatment patterns and outcomes in advanced clear cell sarcoma and gastrointestinal neuroectodermal tumors.","authors":"Adel Shahnam, Daniel Reinhorn, Mrinal M Gounder, Rhoena Desir-Camille, Olayode Babatunde, Ciara M Kelly, Lauren B Banks, Viswatej Avutu, Ping Chi, Sujana Movva, Mark A Dickson, Damon R Reed, Mary L Keohan, Cristina R Antonescu, Meera Hameed, Konstantinos Linos, Narasimhan Agaram, Robert G Maki, Sandra P D'Angelo, William D Tap","doi":"10.1093/jncics/pkag096","DOIUrl":"10.1093/jncics/pkag096","url":null,"abstract":"<p><strong>Background: </strong>Clear cell sarcoma and gastrointestinal neuroectodermal tumor are ultra-rare soft tissue sarcomas with no established standard of care for advanced disease. Data evaluating outcomes of systemic therapy remain limited. We aimed to evaluate systemic therapy in patients with metastatic clear cell sarcoma and gastrointestinal neuroectodermal tumor treated at a tertiary referral institution.</p><p><strong>Methods: </strong>This is a retrospective, single-institution study of patients with metastatic clear cell sarcoma and gastrointestinal neuroectodermal tumor diagnosed between January 2000 and May 2025. The primary objective was to describe patterns of systemic therapy use, and secondary endpoints included overall survival (OS) and real-world progression-free survival (PFS). Survival outcomes were estimated using the Kaplan-Meier method. Hazard ratios were estimated using Cox proportional hazards models. Exploratory analyses evaluated outcomes by treatment class.</p><p><strong>Results: </strong>A total of 66 patients were included; 55 received systemic therapy. Median follow-up was 192 months, and patients received a median of 2 treatment lines with heterogeneous sequencing. Median OS was 18 months (95% CI = 13.6 to 28.0). In first-line analyses, tyrosine kinase inhibitor-based therapy and immune checkpoint inhibitors were associated with improved OS compared with doxorubicin-based chemotherapy (tyrosine kinase inhibitor: hazard ratio [HR] = 0.33, 95% CI = 0.14 to 0.79; P = .01; immune checkpoint inhibitor: HR = 0.39, 95% CI = 0.10 to 0.94; P = .04). Median first-line real-world PFS was 3.8 months (95% CI = 2.9 to 6.3), with no statistically significant differences between treatment classes. Nondoxorubicin-based chemotherapy was associated with shorter real-world PFS compared with doxorubicin regimens (HR = 4.1, 95% CI = 1.71 to 9.83; P < .001).</p><p><strong>Conclusions: </strong>Metastatic clear cell sarcoma and gastrointestinal neuroectodermal tumor is highly aggressive with limited effective systemic options. Outcomes remain poor, highlighting the need for novel therapies and collaborative studies.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030615","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":"Evaluating a shared decision engagement system in the National Cancer Institute Community Oncology Research Program: a multi-level randomized controlled trial.","authors":"Sarah T Hawley, Kelley M Kidwell, Reshma Jagsi, Anne K Barber, Rachel Wills, Selina L Chow, Oudom Kour, Diana Segovia, Paul Abrahamse, Ken Resnicow, Brian J Zikmund-Fisher, Timothy P Hofer, Heather B Neuman","doi":"10.1093/jncics/pkag100","DOIUrl":"10.1093/jncics/pkag100","url":null,"abstract":"<p><strong>Background: </strong>Improving patient-centered care and communication in breast cancer remains challenging in the complex and evolving landscape of breast cancer care delivery.</p><p><strong>Methods: </strong>The SharES (Alliance A231901CD) trial (ClinicalTrials.gov NCT04549571) was carried out in collaboration with the Alliance National Cancer Institute Community Oncology Research Program Research Base to evaluate a multilevel intervention in a crossed design: (1) a patient-level randomized intervention of the evidence-based iCanDecide online tool with added emotional support enhancements, intended to promote better information uptake by supporting management of distress associated with a new diagnosis vs the standard version, and (2) a clinic-level stepped-wedge randomized clinician dashboard intervention. Patient-reported outcomes assessed 5 weeks after registration were knowledge about breast cancer locoregional treatment (primary outcome), with cancer worry and breast cancer self-efficacy as key secondary outcomes. We evaluated outcomes using linear mixed models, considering the nesting of individuals within the clinic across time periods.</p><p><strong>Results: </strong>We enrolled 542 (403 evaluable) patients and 54 clinicians across 25 surgical clinics. The CIs for all outcomes included zero but excluded prespecified clinically important differences in the knowledge score. We found good fidelity to the intervention components and considerable variation in the primary outcome across sites.</p><p><strong>Conclusions: </strong>The addition of emotional support components to a patient support tool previously found effective is unlikely to result in clinically important improvements in knowledge, cancer worry, or breast cancer self-efficacy. The strong engagement of National Cancer Institute Community Oncology Research Program sites, clinicians, and patients with the study and intervention components suggests future cancer care delivery studies could use implementation strategies to promote multilevel patient-centered communication interventions.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04549571.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074623","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":"Alcohol intake and risk of stomach cancer: a pooled analysis of 20 cohorts.","authors":"Harindra Jayasekara, Molin Wang, Yang Peng, Sarah K Abe, Christian C Abnet, Hui Cai, Andrew T Chan, Mridul Datta, A Heather Eliassen, Yu-Tang Gao, Edward L Giovannucci, Mayo Hirabayashi, Tao Hou, Wen-Yi Huang, Ugonna Ihenacho, Manami Inoue, Woon-Puay Koh, Susanna C Larsson, Linda M Liao, Erikka Loftfield, Marjorie L McCullough, Anthony B Miller, Lorelei A Mucci, Gwen A Murphy, Jin Young Park, Song-Yi Park, Anna Prizment, Kim Robien, Thomas E Rohan, Norie Sawada, Marissa M Shams-White, Xiao-Ou Shu, Rashmi Sinha, Mingyang Song, Meir J Stampfer, Yangbo Sun, Anne Tjønneland, Caroline Y Um, Piet A van den Brandt, Renwei Wang, Jean Wactawski-Wende, Emily White, Lynne Wilkens, Alicja Wolk, Jian-Min Yuan, Robin Room, Andrew Haydon, Robert J MacInnis, M Constanza Camargo, Graham G Giles, Roger L Milne, Pietro Ferrari, Stephanie A Smith-Warner","doi":"10.1093/jncics/pkag073","DOIUrl":"10.1093/jncics/pkag073","url":null,"abstract":"<p><strong>Background: </strong>Stomach cancer presents complex etiological heterogeneity. Ethanol in alcoholic beverages and its metabolite acetaldehyde are carcinogens causally linked to several cancers, but their role in gastric carcinogenesis has not been established. We analyzed harmonized, individual-level prospective data to examine associations between alcohol intake and risk of stomach cancer and its subtypes.</p><p><strong>Methods: </strong>In total, 2 009 951 participants in 20 cohorts (mean follow-up = 9 to 29 years) within the Pooling Project of Prospective Studies of Diet and Cancer (n = 8357 incident invasive gastric adenocarcinomas) were included. We used Cox regression to assess associations between alcohol intake and risk of stomach cancer overall and by anatomical and histological subtype and population subgroup, adjusting for confounders.</p><p><strong>Results: </strong>Evidence for an association between alcohol intake and overall stomach cancer risk was weak (hazard ratio, HR, for ≥30 vs 0.1-<5 g/day: 1.06 [95% confidence interval, CI = 0.96 to 1.16], Pbetween-studies heterogeneity = .43). Positive associations with stomach cancer risk were observed in never smokers (HR, for ≥30 vs 0.1-<5 g/day: 1.20 [95% CI = 1.02 to 1.42]; Pinteraction = .02) and for Asian studies (HR, 1.21 [95% CI = 1.02 to 1.42]; Pinteraction = .01). Modest increased risks were observed for noncardia cancers such as those of the fundus, body, and greater curvature, but not distally located noncardia cancers. HRs did not differ materially between diffuse- and intestinal-type cancers (Pheterogeneity > .05).</p><p><strong>Conclusion: </strong>There was little evidence of an overall association between alcohol intake and stomach cancer risk, although modest positive associations were observed among never smokers and in Asian.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578331","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":"Evaluating the impact of virtual oncology financial and legal navigation on cancer-related financial toxicity.","authors":"Jean S Edward, Lynn J Andreae, Haafsah Fariduddin, Elizabeth Ruschman, Lori Eisele, Mackenzie Caldwell, Joanna Doran, Monica Bryant, Jordan Heflin, Brent Shelton, John D'Orazio, Kimberly D Northrip","doi":"10.1093/jncics/pkag085","DOIUrl":"10.1093/jncics/pkag085","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of a virtual oncology financial and legal navigation (OFLN) intervention on cancer-related financial toxicity (FT) and health-related quality of life (QOL) in pediatric and adolescent and young adult (PAYA) cancer patients and caregivers, as well as to assess the intervention's acceptability and feasibility.</p><p><strong>Methods: </strong>A single-arm trial was conducted in a PAYA oncology clinic between March 2024 and May 2025. Pre- and post-intervention surveys included the Comprehensive Score for Financial Toxicity (COST), Patient-Reported Outcomes Measurement Information System global health, anxiety and depression scales, National Comprehensive Cancer Network's Distress Thermometer, and intervention acceptability, appropriateness, and feasibility of measures.</p><p><strong>Results: </strong>The majority (36 patients and 88 caregivers) identified as female (73%), non-Hispanic White (85%), rural residents (61%), with incomes above the federal poverty level (71%). Participants reported moderate levels of FT at baseline with a mean COST of 20.9 (SD = 11.14) for patients and 19.3 (SD = 10.12) for caregivers and high levels of anxiety, depression, and distress. Among caregivers, there was a significant (P = .01) post-intervention increase in COST (indicating decreased FT). Almost all patients reported decreases in subjective stress and anxiety (94%) and feeling better prepared to navigate financial/legal issues. Participants rated the intervention highly across implementation outcomes of acceptability (76%), appropriateness (76%), and feasibility (75%), which was also supported by 89% enrollment and 95% retention rates.</p><p><strong>Conclusion: </strong>Findings demonstrate that virtual OFLN has the potential to increase access to supportive care services, especially in rural communities. Additional research supporting scalability and uptake for widespread implementation is needed. ClinicalTrials.gov ID: NCT07409662.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813053","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":"Response to Buffoni.","authors":"Jean S Edward","doi":"10.1093/jncics/pkag105","DOIUrl":"10.1093/jncics/pkag105","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127479","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":"Population-based registry analysis of cervical cancer trends in Tashkent, Uzbekistan 2014-2024.","authors":"Ulugbek Khudayberdievich Mirzaev, Jasur Ravshanovich Juraev, Iroda Pulatovna Sharipova, Sarvar Temurovich Islomov, Nodira Isroilovna Tursunova, Sitora Rakhmatova, Fatima Shokir Qizi Shodieva, Mirzarakhim Mirzakhakimovich Baynazarov, Khasanjon Kobiljon Ugli Odilov, Dilbar Yuldashevna Yuldasheva, Golib Abdulloyevich Khakimov","doi":"10.1093/jncics/pkag107","DOIUrl":"10.1093/jncics/pkag107","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a leading cause of morbidity and mortality among women in Uzbekistan, exceeding WHO elimination targets. Despite a school-based HPV vaccination program launched in 2019, screening coverage remains low, leading to delayed diagnoses; we examined cervical cancer trends in Tashkent (2014-2024) to evaluate the impact of the Korea Foundation for International Healthcare (KOFIH) screening project and UNFPA/UNDP HPV testing initiatives.</p><p><strong>Methods: </strong>We analyzed Tashkent City Oncoregister data for women diagnosed with invasive cervical cancer or carcinoma in situ (CIS) between 2014 and 2024 (n = 2140) after data cleaning. We calculated age-standardized incidence and mortality rates, assessed survival using Kaplan-Meier methods, and identified mortality predictors using Cox regression models.</p><p><strong>Results: </strong>The age-standardized incidence of invasive cervical cancer was 14.9 per 100 000. After KOFIH and UNFPA/UNDP implementation, CIS diagnoses increased 3.4-fold (0.2-4.7 per 100 000), while the proportion of advanced-stage (III-IV) disease declined by 43%. Five-year survival showed clear stage dependence, ranging from 91.5% for CIS to 27.8% for stage IV. Age and stage were independent predictors of mortality. Crude mortality declined from 10.2 to 1.1 per 100 000 from 2014 to 2024, and case fatality decreased from 48.6% (2014-2019) to 27.2% (2020-2024).</p><p><strong>Conclusion: </strong>Organized screening through KOFIH and UNFPA initiatives can improve early detection and reduce mortality. However, 76.6% of staged invasive cases remain advanced (II-IV), and more than 80% of women have never been screened, underscoring the need to expand screening, sustain HPV vaccination, and strengthen prevention programs in Central Asia.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13694106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136663","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":"Integrating efficacy and safety profile in advanced HCC: A network meta-analysis of first-line systemic therapies.","authors":"Wei Yu Chua, Joseph J Zhao, Choong-Kun Lee, Yung-Yeh Su, Suat Ying Lee, Joycelyn Jie Xin Lee, David Wai-Meng Tai, Sze Huey Tan, Raghav Sundar, Kennedy Yao Yi Ng","doi":"10.1093/jncics/pkag084","DOIUrl":"https://doi.org/10.1093/jncics/pkag084","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma(HCC) is the sixth most common cancer and the third leading cause of cancer-related death worldwide. Our updated network meta-analysis aims to compare and rank first-line treatment regimens for advanced HCC.</p><p><strong>Methods: </strong>We searched PubMed, EMBASE, Scopus, and Cochrane from inception to May 2025 for phase III RCTs investigating first-line systemic therapies for advanced HCC. Derived hazard ratios(HRs) for each study were pooled in a random-effects NMA. The primary outcome was overall survival(OS), progression-free survival(PFS), objective response rate(ORR), and ≥ Grade 3 treatment-related adverse events(TRAE) of the assessed treatment in comparison to Sorafenib and Lenvatinib. Subgroup analysis for OS and PFS was conducted using study-level HRs. P-scores were used to rank the treatment strategies numerically.</p><p><strong>Results: </strong>Seventeen studies involving 12,727 patients were included in the final analysis. Nivolumab-Ipilimumab(HR:0.61,95%CI:0.44-0.84), Atezolizumab-Bevacizumab(HR:0.66,95%CI:0.48-0.90), Durvalumab-Tremelimuma(HR:0.76,95%CI:0.59-0.97), Sintilimab-BevSim(HR:0.57,95%CI:0.41-0.80), and Camrelizumab-Rivoceranib(HR:0.62,95%CI:0.45-0.85) had superior OS compared to Sorafenib. Only Sintilimab-BevSim(HR:0.66,95%CI:0.44-0.99) and Nivolumab-Ipilimumab(HR:0.70,95%CI:0.54-0.92) had superior OS compared to Lenvatinib. Based on p-score rankings only, Nivolumab-Ipilimumab had the highest p-score for OS, PFS, and ORR among the three FDA and EMA approved combination regimens, with similar ≥ Grade 3 TRAE compared to Sorafenib. In the subgroup analysis, Atezolizumab-Cabozantinib has the highest p-score for HBV, Atezolizumab-Bevacizumab the highest for HCV, Durvalumab-Tremelimumab for non-viral aetiology, and Pembrolizumab-Lenvatinib for AFP≥400.</p><p><strong>Conclusion: </strong>Our NMA comprehensively compares therapeutic regimens across key clinical outcomes, including OS, PFS, ORR, and ≥ Grade 3 TRAE. The heterogeneity in treatment responses across patient subgroups underscores the importance of personalized approaches in managing HCC.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793286","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}