JCO Global Oncology最新文献

{"title":"Critical Review: Efficacy and Safety of Biosimilar Cetuximab Versus Innovator Cetuximab in Indian Patients With Head and Neck Cancer.","authors":"Anita Ramesh","doi":"10.1200/GO-25-00115","DOIUrl":"https://doi.org/10.1200/GO-25-00115","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500115"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698552","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":"Comprehensive Genomic Profiling of Anaplastic Thyroid Cancer Identifies Alterations in <i>THRA</i>, a Potential Modifier of Cellular Plasticity.","authors":"Vaishakhi Trivedi, Vanita Noronha, Munita Bal, Pratik Chandrani, Disha Poojary, Elveera Saldanha, Anuradha Choughule, Priyanka Pange, Vinod Gupta, Nandini Menon, Vijay Patil, Minit Shah, Pankaj Chaturvedi, Kumar Prabhash, Amit Dutt","doi":"10.1200/GO-24-00610","DOIUrl":"https://doi.org/10.1200/GO-24-00610","url":null,"abstract":"<p><strong>Purpose: </strong>Lineage-specific cellular plasticity is one of the emerging hallmarks of cancer. The undifferentiated state of anaplastic thyroid cancer (ATC) represents an instance of cellular plasticity where lineage-specific molecular markers are underacknowledged. In this study, we identified recurrent mutations in the thyroid hormone receptor α (<i>THRA</i>) gene, which may play a role in lineage-specific cellular plasticity in ATC.</p><p><strong>Materials and methods: </strong>We performed whole-exome sequencing and targeted sequencing of 68 formalin-fixed paraffin-embedded orphan tumors of ATC from Indian patients.</p><p><strong>Results: </strong>Our analysis reveals the hallmark mutations in <i>TP53</i> (approximately 42%), <i>BRAF</i> (approximately 10.3%), <i>KRAS</i> (approximately 2.9%), <i>NRAS</i> (29.4%), <i>HRAS</i> (23.5%), <i>NF1</i> (1.5%), <i>AKT1</i> (approximately 2.9%), and <i>PIK3CA</i> (approximately 1.5%) genes. Interestingly, we found significant mutations in <i>THRA</i> (approximately 11%) in our cohort, unlike the White population, which is a substantial gene in the thyroid cell's differentiation process. <i>THRA</i> mutations co-occur with TP53 and other hallmark genes, which suggests a synergetic molecular mechanism in phenotypic change in ATC.</p><p><strong>Conclusion: </strong>Our data reveal the significant association of <i>THRA</i> mutations potentially influencing cellular plasticity in a subset of patients with ATC.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400610"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659283","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":"Association of Decayed, Missing, Filled Teeth Score With the Risk for Buccal Mucosa Cancer, Stratified on Tobacco and Alcohol Use: A Multicenter Case-Control Study From India.","authors":"Grace Sarah George, Arjun Singh, Romi Moirangthem, Aniket Patil, Gayathri B Pullat, Sakshi Sagare, Manigreeva Krishnatreya, Aseem Mishra, Rahul Sonwane, Bayan Hosseini, Anil Chaturvedi, Pankaj Chaturvedi, Rajesh Dikshit, Sharayu Mhatre","doi":"10.1200/GO-25-00119","DOIUrl":"10.1200/GO-25-00119","url":null,"abstract":"<p><strong>Purpose: </strong>Buccal mucosa cancer (BMC), the most prevalent oral cancer (OC) site, is a multifactorial disease. With relatively high prevalence of periodontal diseases because of poor oral hygiene practices, oral health indicators remain an area of exploration in the Indian context for its association with BMC.</p><p><strong>Methods: </strong>A total of 1,673 histologically confirmed cases and 1,601 frequency-matched controls from a hospital-based, multicenter case-control study was analyzed for the risk of BMC because of the oral hygiene indicators-denture use, number of decayed, missing, and filled teeth, and the Decayed, Missing, Filled Teeth (DMFT) score. Logistic regression models, adjusted for potential confounders like age, sex, rural-urban status, education, and tobacco and alcohol use (duration and frequency), were used to estimate odds ratios (ORs) and 95% CI. Analysis was further stratified on tobacco chewing and smoking.</p><p><strong>Results: </strong>We obtained an increased risk of decayed (OR_{>2 decayed teeth}, 1.53; 95% CI, 1.09 to 2.16), missing teeth (OR_{>2 missing teeth}, 2.59; 95% CI, 1.99 to 3.37), and high DMFT scores (OR_{>3 DMFT score}, 2.07; 95% CI, 1.62 to 2.66). Similar results were observed on the stratified analysis. Protective effect was observed for teeth filling (OR_{>2 teeth-fillings}, 0.59; 95% CI, 0.34 to 1.03) and denture use (OR_{ever versus never used dentures}, 0.63; 95% CI, 0.47 to 0.85).</p><p><strong>Conclusion: </strong>Our findings suggest that DMFT score is associated with the risk of BMC and should be included in national oral health programs for prevention of OCs, along with other indicators of oral hygiene.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500119"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698549","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":"Impact of Ethnicity on Breast Cancer Outcome: A Systematic Review and Meta-Analysis of Randomized Phase III Trials of the Last Decade.","authors":"Emma Zattarin, Luca Moscetti, Elisa D'Agostino, Alberto Bertolotti, Isabella Sperduti, Chiara Chiavelli, Fabio Canino, Federico Piacentini, Laura Cortesi, Massimo Dominici, Angela Toss","doi":"10.1200/GO-25-00139","DOIUrl":"https://doi.org/10.1200/GO-25-00139","url":null,"abstract":"<p><strong>Purpose: </strong>It remains uncertain whether ethnicity affects the benefit derived from novel breast cancer (BC) treatments. Thus, we conducted a systematic review and meta-analysis to evaluate the heterogeneity of treatment efficacy across different ethnic groups, in both the advanced BC (aBC) setting and the early BC (eBC) setting.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Scopus for phase III randomized controlled trials (RCTs) leading to BC drug approval between 2013 and 2023 that had available hazard ratios (HRs) for outcome according to ethnicity. We excluded nonrandomized studies. We compared the three most represented ethnic groups, Whites, Asians, and Blacks, among themselves and with other underrepresented groups (UGs). The pooled HRs and 95% CI in ethnic subgroups were calculated using a random-effects model, and the heterogeneity between the estimates was assessed with an interaction test.</p><p><strong>Results: </strong>Among 23 selected RCTs (14,000 patients) in the aBC setting, 20 provided HRs (95% CI) for progression-free survival (PFS) in the subgroup of Whites, 17 for Asians, four for Blacks, and 23 for non-Asians (Whites + all non-Asian UG) or non-Whites (Asians + all non-Asian UG). Risk of bias was low for all the included RCTs. The HRs for PFS with experimental versus control drugs were 0.62 (95% CI, 0.57 to 0.68) for Whites, 0.54 (95% CI, 0.44 to 0.66) for Asians, and 0.54 (95% CI, 0.34 to 0.85) for Blacks with no significant interethnic difference (<i>P</i> = .233 for Whites <i>v</i> Asians, <i>P</i> = .564 for Whites <i>v</i> Blacks, <i>P</i> = .992 for Asians <i>v</i> Blacks). Similarly, Whites versus non-Whites and Asians versus non-Asians showed no significantly different magnitude of benefit (<i>P</i> = .406 and <i>P</i> = .226, respectively). No differences were observed in eBC trials either.</p><p><strong>Conclusion: </strong>These results offer reassurance for the broader applicability of clinical trial results despite ethnic imbalance.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500139"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540262","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":"Clinical Characteristics and Treatment Outcomes of Colorectal Cancer in Jordan, a Resource-Restricted Country.","authors":"Hikmat Abdel-Razeq, Maha Barbar, Sarah Abdel-Razeq, Fawzi Abuhijla, Issa Mohamad, Kamal Al-Rabi, Akram Al-Ibraheem, Hazem Hammad, Asem Mansour","doi":"10.1200/GO-25-00079","DOIUrl":"https://doi.org/10.1200/GO-25-00079","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal cancer is the second most prevalent cancer in Jordan and remains the second leading cause of cancer-related deaths in both men and women. This manuscript aims to explore the situation of colorectal cancer in Jordan, a resource-restricted country, and provide insights into clinical presentation and treatment outcomes.</p><p><strong>Materials and methods: </strong>We reviewed all reports from the Jordan Cancer Registry over the past 20 years. Treatment outcome data were obtained from the King Hussein Cancer Center (KHCC) registry since its inception in 2006 until August 2022. Overall survival (OS) was reported for the whole group and stratified by disease stage. Age-standardized incidence rates (ASIR) and mortality estimates were obtained from the latest GLOBOCAN reports.</p><p><strong>Results: </strong>During the study period, a total of 3,424 patients from the KHCC cancer registry were included in this analysis. Only a minority of the patients were diagnosed with early-stage disease, with 132 (3.9%) patients at stage I and 589 (17.2%) at stage II, whereas the majority presented with stage III (n = 1,383, 40.4%) and stage IV (1,131, 33.0%) disease. After a median follow-up of 49 months, the 5-year OS for the whole group was 53.9% (95% CI, 52.0% to 55.8%) and varied by disease stage; 87.7% (95% CI, 80.3% to 93.5%) for stage I, 84.7% (95% CI, 81.3% to 87.9%) for stage II, 69.9% (95% CI, 67.0% to 72.8%) for stage 3, and only 14.5% (95% CI, 12.2% to 16.9%) for patients with stage IV disease, <i>P</i> < .0001.</p><p><strong>Conclusion: </strong>One third of all patients with colorectal cancer are diagnosed with metastatic disease, which explains the lower survival rates observed compared with Western countries. Programs and initiatives focused on the prevention and early detection of colorectal cancer should be a national priority.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500079"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591295","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":"Comparison Between Acute Leukemia Screening Tube and Lineage-Specific Panels for the Diagnosis of Acute Leukemia in Kenya.","authors":"Douglas I Munga, Nancy A Okinda, Geoffrey A Omuse, Elizabeth M Kagotho","doi":"10.1200/GO-25-00069","DOIUrl":"https://doi.org/10.1200/GO-25-00069","url":null,"abstract":"<p><strong>Purpose: </strong>Acute leukemia is a group of hematologic malignancies categorized according to the immature cells that proliferate and replace the normal bone marrow. Flow cytometry has emerged as a cornerstone in the diagnosis of hematologic malignancies. Staged analysis with a screening tube containing specific lineage markers determines the need for subsequent testing if there is an abnormal population (blasts). The specific lineage panels to be analyzed are determined depending on the positive markers in the screening tube. This study aimed to determine the agreement of diagnosis using the acute leukemia screening tube (ALST) and the lineage-specific panel.</p><p><strong>Methods: </strong>This was an analytical cross-sectional study performed at the Aga Khan University Hospital, Nairobi. It included 256 cases diagnosed as acute leukemia. The diagnosis after the screening tube was compared with the final diagnosis from the lineage-specific panels, and Cohen's Kappa was used to determine the level of agreement.</p><p><strong>Results: </strong>Of the 256 cases, the overall agreement was 94%, with 14 cases being discordant. Myeloperoxidase interpretation in the screening tube accounted for 64% (9 of 14) of the discrepant results.</p><p><strong>Conclusion: </strong>The study demonstrated that the ALST is almost as good as lineage-specific panels in the diagnosis and classification of acute leukemias. The screening tube can be an added diagnostic tool to complement morphology in resource-limited centers with the capacity to interpret flow cytometry analysis.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500069"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Germline Variants in Advanced Renal Cell Carcinoma in North India.","authors":"Chitrakshi Nagpal, Mohit Kumar Divakar, Hemavathi Baskarane, Ghazal Tansir, Rishabh Jain, Aparna Sharma, Ranjit Kumar Sahoo, Sameer Bakhshi, Ishaan Gupta, Shilpi Minocha, Saran Kumar, Pranay Tanwar, Brusabhanu Nayak, Rishi Nayyar, Sridhar P, Seema Kaushal, Sanjay Ojha, Parnika Nangla, Kunhi Parambath Haresh, Amlesh Seth, Atul Batra","doi":"10.1200/GO-25-00137","DOIUrl":"https://doi.org/10.1200/GO-25-00137","url":null,"abstract":"<p><strong>Purpose: </strong>Genetic predisposition plays an important role in the pathogenesis of renal cell carcinoma. The prevalence of pathogenic/likely pathogenic (P/LP) in patients with renal cell cancer (RCC) is highly variable, and close to 40% of these can be missed with the current testing guidelines.</p><p><strong>Methods: </strong>This is a prospective study of all patients with metastatic RCC unselected for high-risk features, registered at our center between September 2023 and August 2024. Baseline clinicopathologic details were collected, and germline whole-exome sequencing was done on blood samples. Our aim was to determine the frequency of germline mutations in an unselected cohort of patients with metastatic RCC. Germline P/LP variants were visualized using cBioPortal, and chi-square and Mann-Whitney <i>U</i> tests were used to identify differences in patients with/without these variants.</p><p><strong>Results: </strong>Out of 140 participants, P/LP variants in cancer-predisposition genes were detected in 20%, and 4.2% were in RCC-associated genes. <i>Fumarate hydratase</i> was the most common RCC-associated variant (2.8%), while <i>WT1</i>, <i>BRCA1</i>, <i>BRIP1,</i> and <i>ATM</i> (1.4% each) were the commonest non-RCC-associated variants. RCC-associated genes were more frequent in non-clear cell histology (<i>P</i> = .02); there was no difference in cancer predisposition genes on the basis of age, histology, or sex.</p><p><strong>Conclusion: </strong>Patients with advanced RCC have a high prevalence of germline variants in both RCC-associated and non-RCC cancer-specific genes irrespective of the high-risk genetic features, signifying the importance of a baseline genetic evaluation in all patients with advanced RCC as it has implications for family screening and, in future, selection of therapy.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500137"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612161","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":"Who Reconstitutes the Chemotherapy? The Educational and Practice Needs of Oncology Pharmacists in West Africa: A Call for Multidisciplinary Team Approach in Oncology Care.","authors":"Runcie C W Chidebe, Ramatu M Alabelewe, Krishna Prasad Sapkota, Darlingtina K Esiaka, Candidus C Nwakasi, Gloria C Okwu, Jacinta Emejulu, Adamu A Umar, Ndifreke Okwuegbunam, Funsho David, Toyosi Adepoju, Agha A Agha, Ejike S Ugwu, Simeon C Aruah, Richard Mshelia, Rob Duncombe, Noel N Wannang, Peace C Babalola, R Donald Harvey, Cindy O'Bryant, Folakemi T Odedina","doi":"10.1200/GO-25-00021","DOIUrl":"https://doi.org/10.1200/GO-25-00021","url":null,"abstract":"<p><strong>Purpose: </strong>Oncology pharmacists (OPs) play a crucial role in cancer care, treatment, survivorship, and multidisciplinary teams (MDTs). OPs have specialized training in designing, administering, monitoring, and modifying oncology chemotherapy; managing adverse events; and evaluating clinical trials and investigational drugs. Yet, the state of OP has remained largely unknown in the clinical oncology workforce of the West African region. Therefore, this study aimed to understand who reconstitutes chemotherapy and to explain the OP educational and practice needs, challenges, and solutions in Nigeria.</p><p><strong>Materials and methods: </strong>Using a concurrent embedded mixed method design, 35 OPs completed a questionnaire, and 12 others responded to a semistructured interview. The data were then subjected to inductive thematic and descriptive analyses.</p><p><strong>Results: </strong>The findings showed that 54% of the OPs were responsible for chemotherapy reconstitution, and only 60% of the oncology centers had a biosafety cabinet. 91% of OPs were practicing; however, only 54% were trained in OP, and none of the OPs were board-certified. Most of the OPs spent time weekly on reconstitution, administrative duties, teaching, and training; only 3% spent on oncology clinical trials and conferences and 8% on noninterventional research. We identified four themes: (1) Some OPs are not reconstituting chemotherapy: A Call for MDT, (2) For OP, No Training is Enough, (3) Board Certification will give OPs Recognition, and (4) Introduction of OP Course in Universities.</p><p><strong>Conclusion: </strong>To improve patient treatment outcomes, training on chemotherapy reconstitution should be prioritized, integration of OPs into MDTs, and the safe handling of chemotherapy in centers should be mandated in the region. The West African Postgraduate College of Pharmacists should be supported in expanding its curriculum and introducing OP fellowships.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500021"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540263","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":"Establishing Interventional Radiology in a Low-Resource Setting: Lessons From Obafemi Awolowo University Teaching Hospitals Complex, Nigeria.","authors":"Adeleye D Omisore, Akinola A Odedeyi, Olusola C Famurewa, Adeniyi S Aderibigbe, Roli Y Akinsulore, Folasade M Adeyemi, Adebayo F Adisa, Ernestina C Orji, Abidemi I Ayeni, Anuoluwapo G Towoju, Victoria L Mango, Yolanda Bryce, Oluwatosin Z Omoyiola, Marcia Edelweiss, Farouk Dako, Olusegun I Alatise, Peter T Kingham, Elizabeth J Sutton","doi":"10.1200/GO-24-00637","DOIUrl":"https://doi.org/10.1200/GO-24-00637","url":null,"abstract":"<p><strong>Purpose: </strong>The introduction of an interventional radiology (IR) unit at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in 2017 marked a significant advancement in health care delivery in a low-resource setting in Nigeria. This study documents the processes, milestones, services, challenges, innovations, and collaborations that have supported the establishment of an IR unit.</p><p><strong>Methods: </strong>We conducted an institutional review board-approved retrospective case study using archival data from the service records (2017-2024). To supplement our findings, we distributed a structured survey to 51 referring clinicians using Google Forms, with a 100% response rate. We analyzed the data descriptively using Microsoft Excel.</p><p><strong>Results: </strong>The establishment of the IR unit in the OAUTHC was driven by structured training, international collaborations, and innovative solutions to overcome infrastructural limitations. The unit began with breast intervention services and was expanded to offer diverse ultrasound- and computed tomography-guided body intervention services. Breast biopsies (31.4%) and liver biopsies (23.5%) constituted the majority of IR referrals. Survey respondents (78.4%; 40 of 51) acknowledged the significant impact of IR services in reducing the need for invasive surgeries, with 84.3% (43 of 51) suggesting the need for increased procedure availability to address long waiting times. Despite challenges such as limited procedural options (56.9%) and long waiting times (41.2%), clinicians rated the IR unit's contributions to patient care as very important (41.2%) or moderately important (52.9%). Key lessons include the importance of structured training programs, leveraging international partnerships to overcome resource gaps, and implementing adaptive strategies to meet local needs.</p><p><strong>Conclusion: </strong>The IR unit transformed patient care at the OAUTHC. This is a replicable model for building sustainable IR programs in other Nigerian hospitals and low-resource settings.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400637"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540261","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":"Geographical Differences in the Management and Outcomes of Patients With Advanced Urothelial Carcinoma Treated With Pembrolizumab After Progression on Platinum-Based Chemotherapy: Results From ARON-2 Study.","authors":"Mimma Rizzo, Andrey Soares, Shilpa Gupta, Fabio Calabrò, Hideki Takeshita, Maria Teresa Bourlon, Se Hoon Park, Patrizia Giannatempo, Zin War Myint, Thomas Büttner, Enrique Grande, Ondrej Fiala, Daniele Santini, Aristotelis Bamias, Roubini Zakopoulou, Sebastiano Buti, Ravindran Kanesvaran, Pasquale Rescigno, Javier Molina-Cerrillo, Ilana Epstein, Fernando Sabino Marques Monteiro, Francesco Massari, Camillo Porta, Joaquin Bellmunt, Matteo Santoni","doi":"10.1200/GO-24-00564","DOIUrl":"10.1200/GO-24-00564","url":null,"abstract":"<p><strong>Purpose: </strong>Our investigation assessed the impact of geographical disparities in the treatment of patients with advanced urothelial cancer (aUC) included in the international, real-world ARON-2 trial.</p><p><strong>Patients and methods: </strong>The study population comprised 1,137 patients with aUC treated with pembrolizumab for relapsed or progressive disease after platinum-based chemotherapy (PBC) at 63 institutions in 19 countries. Patients were divided into three geographical areas: Europe (area 1: 791 patients), the United States (area 2: 156 patients), and Asia (area 3: 190 patients). Clinicopathologic and treatment data were extracted from medical records. The primary end points were to identify differences in patient and treatment characteristics and to assess overall survival (OS) and progression-free survival (PFS) between the three areas.</p><p><strong>Results: </strong>There were differences in patient characteristics: more patients age 70 years and older in area 1; more patients with BMI ≥25 kg/m², squamous histotype, and T1 neoplasia at diagnosis in area 2; and more pure urothelial carcinoma in area 3. There were differences in treatment characteristics: Bacillus Calmette-Guérin instillations and primary tumor surgery were more common in area 1; neoadjuvant and adjuvant PBC, third-line therapies, and specifically enfortumab vedotin (EV) were less common in area 1. Median OS (mOS) from pembrolizumab initiation was 13.0 months in area 1, 29.1 months in area 2 and 13.2 months in area 3 (<i>P</i> < .001), and median PFS was 4.8 months, 5.2 months, and 3.8 months, respectively (<i>P</i> = .002). In patients receiving EV after progression to PBC and pembrolizumab, mOS was 44.1 months in area 1, 31.7 months in area 2, and 23.8 months in area 3 (<i>P</i> = .267).</p><p><strong>Conclusion: </strong>Real-world data suggest that facilitating and extending access to targeted therapies for patients with aUC in different geographical areas worldwide may lead to a consistent and widespread survival increase.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400564"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591206","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}