JNCI Journal of the National Cancer Institute最新文献

{"title":"Response to Lei.","authors":"Changchuan Jiang","doi":"10.1093/jnci/djag043","DOIUrl":"10.1093/jnci/djag043","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"948"},"PeriodicalIF":7.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing high-quality cancer survivorship care in primary care: future directions for policy and research.","authors":"Julien A M Vos, Nicole L Stout, Larissa Nekhlyudov","doi":"10.1093/jnci/djaf259","DOIUrl":"10.1093/jnci/djaf259","url":null,"abstract":"<p><p>Nearly 20 million people in the United States are living with and beyond a cancer diagnosis, many of whom survive for decades after treatment. As this population continues to grow and age, primary care plays an increasingly important role in managing long-term and late effects of treatment. However, efforts to improve survivorship care delivery in primary care have only recently gained attention. With more survivors relying on their primary care clinicians, there is a clear need to strengthen the implementation of high-quality survivorship care in primary care settings. In this commentary, we explore how high-quality survivorship care can be implemented in primary care, using the implementation plan outlined in the National Academies of Sciences, Engineering, and Medicine report Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. We describe the evidence on primary care clinicians' roles across the cancer care continuum and map the evidence to the National Academies of Sciences, Engineering, and Medicine report's 5 implementation objectives: payment, access, workforce, digital health, and accountability. Through this work, we identify future directions for policy and research to ensure that primary care can serve as a \"common good\" for all cancer survivors.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"783-788"},"PeriodicalIF":7.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: Prostate cancer clinicopathological presentation in Southeast Africa during the 2010 decade.","authors":"Maarten C Bosland","doi":"10.1093/jnci/djag059","DOIUrl":"10.1093/jnci/djag059","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"949-950"},"PeriodicalIF":7.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A smoking-related plasma protein score and smoking-related cancer risk and mortality in the Atherosclerosis Risk in Communities study.","authors":"Meng Ru, Christopher Douville, Aghiles Guenoun, Hana Zahed, Christie M Ballantyne, Kenneth R Butler, Josef Coresh, David J Couper, Panagis Galiatsatos, Marc J Gunter, Ron C Hoogeveen, Mattias Johansson, Corinne E Joshu, P Martijn Kolijn, Christina M Lill, Jiayun Lu, Michael T Marrone, Giovanna Masala, David C Muller, Anna E Prizment, Raul Zamora-Ros, Nilanjan Chatterjee, Adrienne Tin, Elizabeth A Platz","doi":"10.1093/jnci/djag004","DOIUrl":"10.1093/jnci/djag004","url":null,"abstract":"<p><strong>Background: </strong>Self-reported smoking may not fully capture individualized risk of smoking-related cancer, but circulating proteins may reflect biological consequences of smoking. Thus, we developed a score based on smoking-related proteins and evaluated its association with smoking-related cancer.</p><p><strong>Methods: </strong>This prospective cohort study included 10 563 participants aged 47-70 years in the Atherosclerosis Risk in Communities study. Plasma proteins were measured using the SomaScan Platform (SomaLogic Operating Co, Inc). The score was constructed from proteins associated with current smoking, pack-years, or recent quitting identified by linear regression and elastic net regression. Cox regression was used to estimate adjusted hazard ratios and 95% confidence intervals (CIs). We confirmed the association in a case-cohort study in the European Prospective Investigation into Cancer and Nutrition.</p><p><strong>Results: </strong>Adjusted hazard ratios comparing score quartiles 4 to 1 for total incidence and mortality of 13 smoking-related cancers were 3.89 (95% CI = 3.06 to 4.96) and 5.73 (95% CI = 4.08 to 8.06) before and 2.28 (95% CI = 1.65 to 3.15) and 2.07 (95% CI = 1.74 to 4.10) after adjusting for self-reported smoking. Adjusted hazard ratios for lung cancer were 12.1 (95% CI = 7.11 to 20.6) and 14.2 (95% CI = 7.58 to 26.8) before and 3.04 (95% CI = 1.59 to 5.81) and 4.12 (95% CI = 1.99 to 8.53) after adjusting. In European Prospective Investigation into Cancer and Nutrition, adjusted hazard ratios for lung cancer were 9.47 (95% CI = 6.82 to 13.15) before and 2.23 (95% CI = 1.48 to 3.35) after adjusting.</p><p><strong>Conclusion: </strong>The smoking-related protein score provided relative risk information for smoking-associated cancers beyond self-reported smoking, which was confirmed in an independent cohort. Such a score may be considered for use in risk stratification for prevention and cancer screening in settings in which detailed smoking history cannot be obtained.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"917-925"},"PeriodicalIF":7.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: Growth of zero-premium Medicare Advantage plans in counties with high cancer mortality.","authors":"Zhihao Lei","doi":"10.1093/jnci/djag042","DOIUrl":"10.1093/jnci/djag042","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"946-947"},"PeriodicalIF":7.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant peripheral nerve sheath tumors: a report from Children's Oncology Group study ARST0332.","authors":"Jacquelyn N Crane, Wei Xue, Amira Qumseya, Donald A Barkauskas, Khang Chau, Serena Y Tan, Susan Hiniker, Roshni Dasgupta, Rajkumar Venkatramani, Sheri L Spunt, Aaron R Weiss, Theodore W Laetsch","doi":"10.1093/jnci/djaf359","DOIUrl":"10.1093/jnci/djaf359","url":null,"abstract":"<p><strong>Background: </strong>The cornerstone of the treatment of malignant peripheral nerve sheath tumors is surgical resection. Radiation and chemotherapy are variably employed. The optimal treatment remains uncertain, particularly for unresectable or metastatic disease and patients with neurofibromatosis type 1 (NF-1).</p><p><strong>Methods: </strong>We present data for 58 patients with newly diagnosed malignant peripheral nerve sheath tumors enrolled on the Children's Oncology Group study ARST0332. Patients were treated with risk-adapted therapy including surgery with or without radiotherapy and ifosfamide and doxorubicin chemotherapy.</p><p><strong>Results: </strong>Most patients had primary tumors that were greater than 5 cm (86%), deep (95%), and invasive (74%), and 10% had distant metastases. Of the patients, 32 (55%) had germline NF-1, and 26 (45%) did not. Among patients, 31 received neoadjuvant therapy, and 22 were evaluable for response with 5 (23%) attaining an objective response, 10 (45%) stable disease, and 7 (32%) progressive disease. Estimated 5-year event-free survival was 87%, 52%, and 0% for the low- (n = 8), intermediate-, (n = 44), and high-risk (n = 6) patients, respectively. In univariate analysis, event-free survival and overall survival differed by sex, presence or absence of metastatic disease, risk group, and achievement of upfront or delayed R0 and/or R1. There was no difference in event-free survival or overall survival based on germline NF-1 status.</p><p><strong>Conclusion: </strong>The treatment strategy in ARST0332 achieved excellent outcomes for low-risk malignant peripheral nerve sheath tumors. Patients with high-risk (metastatic) malignant peripheral nerve sheath tumors have poor outcomes, and novel treatments are needed (NCT00346164).</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"829-838"},"PeriodicalIF":7.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptive design increased success but does not significantly accelerate confirmatory oncology trials.","authors":"Sujata Purja, Eunyoung Kim","doi":"10.1093/jnci/djag129","DOIUrl":"https://doi.org/10.1093/jnci/djag129","url":null,"abstract":"<p><strong>Background: </strong>Adaptive designs (ADs) are increasingly employed to improve trial efficiency; however, their benefits over fixed designs in late-phase oncology trials remain underexplored. We aimed to determine whether ADs in phase III cancer trials are associated with primary completion time and primary endpoint success compared with fixed designs.</p><p><strong>Methods: </strong>This cross-sectional study analyzed phase III randomized lung and breast cancer trials initiated between 2000 and 2020 using Aggregate Analysis of ClinicalTrials.gov database (static version downloaded April 15, 2025). Eligible trials had time-to-event primary endpoints and were completed or terminated. Trials were classified as adaptive or non-adaptive based on pre-planned design modifications. Associations between trial design and primary completion time were examined using Kaplan-Meier curves and multivariable cause-specific Cox regression, while primary endpoint success via multivariable logistic regression.</p><p><strong>Results: </strong>Of 421 eligible trials, 210 employed ADs. Adoption of ADs increased over time, with group-sequential designs being most common adaptive approach. ADs showed earlier primary completion, but no significant association was observed after multivariable adjustment. Adaptive trials had higher hazards of early stopping for efficacy or futility and lower hazards of administrative termination. Among 396 trials with available results, 163 achieved primary endpoint success. Adaptive trials had higher odds of success than non-adaptive trials (66.26% vs 33.74%; odds ratio: 2.363, 95% confidence interval: 1.491 to 3.778; P<.001).</p><p><strong>Conclusion: </strong>ADs were associated with higher primary endpoint success but not shorter primary completion time. Given high failure rates in late-phase oncology, ADs may improve efficiency primarily by facilitating data-driven decisions rather than accelerating trial timelines.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoxifen for mammographic density reduction-results from the KARISMA endoxifen trial.","authors":"Per Hall, Mattias Hammarström, Jenny Bergqvist, Kamila Czene, Mikael Eriksson, Marike Gabrielson, José Tapia, Steven Quay, Stephen Nash, Magnus Bäcklund","doi":"10.1093/jnci/djag087","DOIUrl":"https://doi.org/10.1093/jnci/djag087","url":null,"abstract":"<p><strong>Background: </strong>(Z)-endoxifen is the tamoxifen metabolite that possesses the highest affinity to the estrogen receptor and is evolving as an alternative to tamoxifen. Mammographic breast density (MBD) change has been shown to be a proxy for tamoxifen therapy response. The objective was to measure the effect of 2 different doses of (Z)-endoxifen on MBD, safety, and side effects in healthy women.</p><p><strong>Methods: </strong>Healthy premenopausal women included in the national Swedish screening program in Stockholm were invited to KARISMA Endoxifen, a proof of principle, dose determining, double-blinded, randomized, placebo-controlled trial. Women were randomly assigned to placebo or 1 or 2 mg of (Z)-endoxifen daily for 6 months.</p><p><strong>Results: </strong>In all, 240 women were randomly assigned. There was a significant relative change in MBD in both (Z)-endoxifen arms compared to placebo: -19.3% (95% confidence interval [CI] = -6.15% to -32.4%) in the 1 mg arm and -26.5% (95% CI = -14.1% to -38.9%) in the 2 mg arm. The number of participants discontinuing because of adverse events related to the investigational medicinal product was 4 (placebo), 5 (1 mg), and 11 (2 mg), respectively. Participants on 2 mg of (Z)-endoxifen reported significantly higher scores of vasomotor symptoms, compared with placebo. No clinically significant changes in hematological safety tests or vital signs were noted.</p><p><strong>Conclusion: </strong>Both 1 and 2 mg of (Z)-endoxifen significantly reduced MBD to a degree comparable to the established 20 mg dose of tamoxifen. The 1 mg dosage of (Z)-endoxifen indicated superior tolerability. Future studies are necessary to confirm impact on breast cancer incidence.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT05068388.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Title: Ultra-processed food intake and postmenopausal breast cancer risk in the NIH-AARP diet and health study.","authors":"Caitlin P O'Connell, Kaelyn F Burns, Hyokyoung G Hong, Lisa Kahle, Linda M Liao, Jessica M Madrigal, Camella J Rising, Rashmi Sinha, Neha Khandpur, Eurídice Martínez Steele, Gretchen Gierach, Erikka Loftfield","doi":"10.1093/jnci/djag124","DOIUrl":"https://doi.org/10.1093/jnci/djag124","url":null,"abstract":"<p><strong>Background: </strong>UPF intake is associated with obesity. Despite obesity being a risk factor for postmenopausal breast cancer, evidence for an association between UPF and breast cancer is limited. Our objective was to assess the association between UPF intake and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.</p><p><strong>Methods: </strong>Participants reported dietary intake via a food frequency questionnaire at baseline in 1995 to 1996 and were followed through 2018. Food items were disaggregated into food codes and assigned Nova classification via database linkage. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for quintiles of UPF (g/1000 kcal/day) and postmenopausal breast cancer risk overall, by estrogen receptor (ER) status, and type (invasive or ductal carcinoma in situ (DCIS)), with and without adjustment for body mass index (BMI).</p><p><strong>Results: </strong>Among 181,460 postmenopausal women, 14,484 were diagnosed with breast cancer over a median 21 years of follow-up. Median (IQR) UPF intake was 284.6 (191.1 to 466.6) g/1000 kcal/day. No associations between UPF intake and postmenopausal breast cancer risk overall (HRQ5vs.Q1=0.98, 95% CI = 0.93-1.03; Ptrend=0.32), by ER status (ER+ HRQ5vs.Q1=1.01, 95% CI = 0.94-1.09; P  trend=0.95; ER-: HRQ5 vs Q1=1.02, 95% CI = 0.87-1.20; P  trend=0.58), or by type (invasive: HRQ5vs.Q1=0.98, 95% CI = 0.92-1.04; P  trend=0.14; DCIS HRQ5vs.Q1=1.00, 95% CI = 0.87-1.13; P  trend=0.26) were observed. Following BMI adjustment, inverse trends for overall (P  trend=0.03) and invasive (P  trend=0.01) breast cancer were observed.</p><p><strong>Conclusion: </strong>UPF intake was not associated with postmenopausal breast cancer in the NIH-AARP cohort. Inverse trends observed after adjusting for BMI are likely spurious, owing to over-adjustment.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing models of survivorship care research: an overview and recommendations for future studies.","authors":"Julien A M Vos, Daan Brandenbarg, Raymond J Chan, Jon Emery, Karolina Lisy, Larissa Nekhlyudov, Michael Jefford","doi":"10.1093/jnci/djag123","DOIUrl":"https://doi.org/10.1093/jnci/djag123","url":null,"abstract":"<p><p>The growing population of cancer survivors underscores the need for models of care that effectively address their long-term needs. Over recent decades, various models have been proposed, but guidance regarding their development, testing, implementation, and evaluation remains limited. To address this gap, we conducted an overview of randomized controlled trials (RCTs) that assessed survivorship care models (1) to identify common features and methodological gaps; and (2) to assess how these models contribute to improving survivorship care by mapping their pre-defined endpoints to the quality domains of the Quality of Cancer Survivorship Care Framework and the goals of the Quintuple Aim. Lastly, we provide recommendations for future studies, specifically focusing on clarifying terminology, adopting trial methods that move beyond standard comparative designs, expanding research to more diverse populations and settings, and incorporating endpoints that capture both high-quality care and broader health system performance.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}