JNCI Journal of the National Cancer Institute最新文献

{"title":"A new microsimulation model of HPV natural history for comparison of novel cervical screening strategies.","authors":"Nicole G Campos, Li C Cheung, Fangya Mao, Brian Befano, Didem Egemen, Stephen Sy, Jane J Kim, Nicolas Wentzensen, Kanan Desai, Silvia de Sanjosé, Mark Schiffman","doi":"10.1093/jnci/djag376","DOIUrl":"https://doi.org/10.1093/jnci/djag376","url":null,"abstract":"<p><strong>Background: </strong>The cost-effectiveness of cervical cancer screening strategies is estimated by health decision models. Fidelity to HPV natural history and multi-state carcinogenesis is critical to improve evaluations of new screening tests.</p><p><strong>Methods: </strong>We developed a new health decision model of the HPV genotype-specific causal pathway to cervical cancer based on cohort, trial, and cross-sectional data. The novel model presents several new approaches in representing early HPV natural history: 1) transitions between health states are estimated by new statistical approaches adapted to handle intermittently-observed data; 2) transitions are directly estimated from observational data (i.e., statistically identifiable) rather than calibrated to fit; and 3) precancer is rigorously defined using histopathology and HPV genotyping as a surrogate for cancer risk.</p><p><strong>Results: </strong>We present a model for pending policy decisions in Brazil. Model outputs closely match age-specific prevalence data from São Paulo for thirteen carcinogenic HPV types 16/18/31/33/35/45/52/58 (modeled individually) and 39/51/56/59/68 (grouped). The model-projected median age of precancer is 30.0 years (95% CI: 27.9-32.3 years).</p><p><strong>Conclusions: </strong>By restricting model health states and transitions to the essential, directly observable causal pathway, our approach can generate metrics with measurable standard errors for cost-effectiveness analyses. Comparative modeling analyses are underway to assess differences in results relative to existing state-of-the-art models. Our approach can be generalized to evaluate the cost-effectiveness of an HPV-based screen-triage-treat approach with extended genotyping that has been demonstrated efficacious in nine PAVE Consortium countries.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147782","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":"Response to Liu and Zhao.","authors":"Hong Truong, Maria I Carlo","doi":"10.1093/jnci/djag369","DOIUrl":"https://doi.org/10.1093/jnci/djag369","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136716","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 validated clinical calculator of a brain metastasis risk (BrMR) prediction model in stage I-III breast cancer patients.","authors":"Akshara S Raghavendra, Nuria Kotecki, Kristofer Jennings, Ottavia Amato, Ahmad Awada, Nuhad K Ibrahim","doi":"10.1093/jnci/djag377","DOIUrl":"https://doi.org/10.1093/jnci/djag377","url":null,"abstract":"<p><strong>Background: </strong>Brain metastasis (BM) significantly affects survival and quality of life in patients with breast cancer. A validated tool to predict BM risk at diagnosis of early breast cancer (eBC) could enable targeted surveillance and improve patient selection for clinical trials.</p><p><strong>Methods: </strong>Patients with stage I-III eBC diagnosed from January 1, 1997, to May 6, 2020, at The University of Texas MD Anderson Cancer Center were reviewed as a training cohort. After data curation and multiple imputation of missing values, a linear predictive model (Brain Metastasis Risk [BrMR]) was developed and implemented as an online calculator. The model was applied to an independent validation cohort of stage I-III patients referred to Institut Jules Bordet, Belgium, from 2001 to 2021.</p><p><strong>Results: </strong>BM occurred in 2408 of 40 282 training-cohort patients and 35 of 1644 validation-cohort patients. BrMR showed strong discrimination (C-index = 0.79, training; 0.76, validation), with areas under the receiver operating characteristic curve of 0.81, 0.79, 0.76, and 0.75 at 4, 6, 8, and 10 years, respectively. Inflammatory breast cancer, HER2 positivity, higher Ki-67, lymphovascular invasion, adjuvant chemotherapy, grade III, and higher T/N-status were associated with increased BM risk; ER/PR positivity, older age, endocrine therapy, lobular histology, grade II, and lower T-status were associated with decreased risk.</p><p><strong>Conclusions: </strong>BrMR accurately predicts BM risk in eBC and may support risk stratification and trial enrichment. Prospective validation is needed before clinical use as a surveillance tool.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136686","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: Comprehensive clinical and genomic analysis of early onset cancer of the bladder and upper urinary tract.","authors":"Yang Liu, Dan Zhao","doi":"10.1093/jnci/djag368","DOIUrl":"https://doi.org/10.1093/jnci/djag368","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136694","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":"Stat Bite: Breast cancer subtype incidence rates in women under 50 from 2019 to 2023.","authors":"Patricia K Murphy, Mark E Sellers, Kathleen A Cronin","doi":"10.1093/jnci/djag262","DOIUrl":"https://doi.org/10.1093/jnci/djag262","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":"118 10","pages":"1987"},"PeriodicalIF":7.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136767","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":"Response to DeStefano.","authors":"Steven M Babin, Luke C Mullany","doi":"10.1093/jnci/djag203","DOIUrl":"10.1093/jnci/djag203","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1982"},"PeriodicalIF":7.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301662","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":"Editor's Note: Targeting Primitive Chronic Myeloid Leukemia Cells by Effective Inhibition of a New AHI-1-BCR-ABL-JAK2 Complex.","authors":"","doi":"10.1093/jnci/djag260","DOIUrl":"10.1093/jnci/djag260","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1991"},"PeriodicalIF":7.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840132","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":"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":"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":"1899-1906"},"PeriodicalIF":7.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650363/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outdoor air pollution and prostate cancer risk in the National Institutes of Health-AARP Diet and Health Study.","authors":"Lydia Marcus Post, Lauren Hurwitz, Jared A Fisher, Joel D Kaufman, Stella Koutros, Rena R Jones","doi":"10.1093/jnci/djag137","DOIUrl":"10.1093/jnci/djag137","url":null,"abstract":"<p><strong>Background: </strong>Outdoor air pollution, including fine particulate matter (PM2.5), is an established carcinogen, yet few studies evaluate its associations with prostate cancer risk, and findings are mixed.</p><p><strong>Methods: </strong>We used spatiotemporal prediction models to estimate annual average historical residential PM2.5 (1980-2017) and nitrogen dioxide (NO2) (1990-2017) concentrations for 289 299 men aged 50 years and older in the National Institutes of Health-AARP Diet and Health Study, enrolled from 6 states and 2 metro areas in 1995-1996, followed through 2018. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals of associations between 5-year average PM2.5 and NO2 and incident prostate cancer, overall and by tumor aggressiveness (ie, advanced [n = 5791], high-grade [ie, Gleason score ≥8, n = 5793], fatal [n = 3057]). We evaluated interactions with hypothesized effect modifiers.</p><p><strong>Results: </strong>Historical PM2.5 and NO2 concentrations were not associated with prostate cancer risk overall (10-year lagged PM2.5 HR per 5 µg/m3 = 1.00, 95% confidence interval [CI] = 0.98 to 1.02; 10-year lagged NO2 HR per 10 ppb = 1.00, 95% CI = 0.98 to 1.01). Some positive trends were observed for aggressive disease (eg, high-grade: 10-year lagged PM2.5 HR = 1.03, 95% CI = 0.99 to 1.09; advanced: 10-year lagged NO2 HR = 1.04, 95% CI = 0.99 to 1.08). Stratified analyses also showed stronger associations for aggressive disease among Hispanic men (eg, high-grade: NO2 HR = 1.25, 95% CI = 1.05 to 1.48; P = .01 for interaction). Heterogeneity was also evident by urbanicity (high-grade: P = .01 for interaction, PM2.5 and NO2) and state (advanced: P = .05 for interaction, NO2), potentially reflecting air pollution mixture heterogeneity.</p><p><strong>Conclusions: </strong>In this large US cohort, historical residential PM2.5 or NO2 concentrations were not associated with prostate cancer risk overall; however, risk was elevated in some subgroups and for aggressive outcomes. Future evaluation of air pollution mixture components may clarify observed subgroup differences.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1907-1918"},"PeriodicalIF":7.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838122","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":"Predicting median survival times from early data in immunotherapy trials using exponential-decay modeling.","authors":"Tarquin Opperman, Ram Patel, John Dean Chiong, David J Stewart, Abdullah Nasser","doi":"10.1093/jnci/djag146","DOIUrl":"10.1093/jnci/djag146","url":null,"abstract":"<p><p>In oncology trials, overall survival and progression-free survival (PFS) are typically summarized with Kaplan-Meier curves, but medians cannot be estimated when follow-up is early. We evaluated whether exponential-decay regression applied to the earliest quartile of Kaplan-Meier data could approximate mature medians. A total of 114 phase III immunotherapy trials encompassing 420 treatment arms were analyzed, yielding 618 evaluable survival curves across overall survival and PFS endpoints. For immunotherapy overall survival, predicted and reported medians showed no significant difference (P = .59; R2 = 0.76; concordance correlation coefficient = 0.87). For immunotherapy PFS, predictions modestly overestimated medians (P < .001; R2 = 0.50). Nonimmunotherapy arms demonstrated overestimation for both overall survival (R2 = 0.61) and PFS (R2 = 0.68). Pooled overall survival performance was good (R2 = 0.70). Early exponential modeling may offer a transparent tool for interim overall survival estimation in immunotherapy trials, warranting prospective validation.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1971-1974"},"PeriodicalIF":7.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868434","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}