JNCI Journal of the National Cancer Institute最新文献

{"title":"Determinants of late metastases in renal cell carcinoma.","authors":"Payal Kapur, Hua Zhong, Alana Christie, Haitao Xu, Qi Cai, Ellen Araj, David Kim, Jeffrey Miyata, Vanina T Tcheuyap, Colleen T Ball, David D Thiel, Alexander Parker, Samuel O Antwi, Brad C Leibovich, Zora Modrusan, John C Cheville, James Brugarolas","doi":"10.1093/jnci/djaf060","DOIUrl":"10.1093/jnci/djaf060","url":null,"abstract":"<p><strong>Background: </strong>The mechanisms underlying metastatic latency in renal cell carcinoma (RCC) remain poorly understood.</p><p><strong>Methods: </strong>This study evaluated 2 large independent cohorts for differences in tumor biology between patients who developed metastases early (≤1 year after nephrectomy) and those with late onset (>3 years).</p><p><strong>Results: </strong>In the discovery cohort (n = 161), late metastatic RCC was associated with clear cell histology (88.9% vs 78.7%), lower pathological stage (pT1-2; 40.3% vs 18.0%), and favorable histopathological features including low grade (40.0% vs 2.3%), less sarcomatoid (5.6% vs 21.8%), and reduced necrosis (37.7% vs 78.3%; all P < .02). Late metastatic RCC tumors exhibited increased angiogenesis (63.5% vs 19.4%) and reduced inflammation (78.8% vs 50.0%; all P < .02) profiles. Genomic driver analyses revealed comparable rates of PBRM1 and SETD2 loss in late and early metastatic RCC, while BAP1 loss was significantly less common in late metastatic RCC (7.5% vs 27.1%; P < .02). In multivariable models, BAP1/PBRM1/SETD2 status and tumor necrosis emerged as key discriminators of late metastatic RCCs. These findings were confirmed in the second cohort (n = 307). Late metastatic RCC was enriched for fatty acid oxidation and angiogenesis pathways, supporting a less aggressive phenotype. This was further evidenced by a lower engraftment rate in murine models (0% vs 36.5%; P < .001) and significantly longer overall survival from the time of metastasis (median survival doubled, P < .001). Interestingly, late metastatic RCC shared genomic and phenotypic features with RCC that metastasizes to the pancreas, suggesting a common underlying biology influencing both metastatic latency and pancreatic tropism.</p><p><strong>Conclusions: </strong>Overall, these findings advocate for recognition of late metastatic RCC because of its distinct biology and improved prognosis.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1387-1400"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596991","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":"Response to Zhou, Cui, Sun et al.","authors":"Stephanie Tuminello, Wiley M Turner, Emanuela Taioli","doi":"10.1093/jnci/djaf082","DOIUrl":"10.1093/jnci/djaf082","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1524"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730070","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":"Frailty and outcomes in adults undergoing systemic anticancer treatment: a systematic review and meta-analysis.","authors":"Jessica Pearce, Sally Martin, Sophie Heritage, Emma G Khoury, Joanna Kucharczak, Thitikorn Nuamek, David A Cairns, Galina Velikova, Suzanne H Richards, Andrew Clegg, Alexandra Gilbert","doi":"10.1093/jnci/djaf017","DOIUrl":"10.1093/jnci/djaf017","url":null,"abstract":"<p><strong>Background: </strong>It is increasingly recognized that frailty should be assessed and considered in treatment decision making in patients with cancer. This review and meta-analysis synthesizes existing evidence evaluating the association between baseline frailty and systemic anticancer treatment outcomes in adults with cancer.</p><p><strong>Methods: </strong>Five databases were systematically searched from database inception to January 2023 to identify prognostic factor studies (cohort or case-control design) reporting the associations between validated frailty assessments (pretreatment) and follow-up outcomes in adults with solid-organ malignancy undergoing systemic anticancer treatment. Risk of bias was assessed via Quality of Prognosis Studies in Systematic Reviews tool. Where appropriate, associations between frailty and outcomes (survival, toxicity, treatment tolerance, functional decline/quality of life, and hospitalization) were synthesized in meta-analysis and presented as forest plots.</p><p><strong>Results: </strong>A total of 58 studies met inclusion criteria. They were undertaken in a range of tumor sites and mainly in older patients and advanced and/or palliative disease settings. Most had low or moderate risk of bias. Nine frailty assessment tools were evaluated. Four outcomes were synthesized in meta-analysis, which demonstrated the prognostic value of 2 tools: Geriatric-8 (survival, treatment tolerance, hospitalization) and Vulnerable Elders Survey-13 (survival, toxicity, treatment tolerance). Overall pooled estimates indicate that frailty conveys an increased risk of mortality (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.41 to 2.00), toxicity (odds ratio [OR] 1.83, 95% CI = 1.24 to 2.68), treatment intolerance (OR = 1.68, 95% CI = 1.32 to 2.12), and hospitalization (OR = 1.94, 95% CI = 1.32 to 2.83).</p><p><strong>Conclusion: </strong>Simple, brief frailty assessments including Geriatric-8 and Vulnerable Elders Survey-13 are prognostic for a range of important outcomes in patients undergoing systemic anticancer treatment. Risk estimates should be used to support shared decision making.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1316-1339"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064601","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":"Facility exposure to wildfire disasters and hospital length of stay following lung cancer surgery.","authors":"Leticia M Nogueira, K Robin Yabroff, Elizabeth Yates, James M Shultz, R Burciaga Valdez, Amruta Nori-Sarma","doi":"10.1093/jnci/djaf040","DOIUrl":"10.1093/jnci/djaf040","url":null,"abstract":"<p><strong>Background: </strong>Wildfires pose substantial health and safety threats to patients recovering from lung cancer surgery. Without specific disaster preparedness guidelines, surgical oncologists might resort to improvisational strategies, such as extending post-operative length of stay (LOS) to support surgical recovery and better protect the health and safety of patients.</p><p><strong>Methods: </strong>Individuals aged ≥18 years who received curative-intent lobectomy or pneumonectomy for stage I-III non-small-cell lung cancer between 2004 and 2021 were selected from the National Cancer Database. Exposure was defined as a Federal Emergency Management Agency wildfire Presidential Disaster Declaration in the county of the treating facility between the date of surgery and the date of discharge from the hospital. Differences in the cumulative distribution function of LOS were evaluated between exposed and propensity score-matched unexposed patients treated at the same facility.</p><p><strong>Results: </strong>Patients exposed to a wildfire disaster declaration in the county of the treating facility had longer LOS than unexposed patients (9.4 days compared to 7.5 days, respectively; P < .001) overall and for each stage (I-III) for which surgery is the recommended treatment modality.</p><p><strong>Conclusions: </strong>Patients whose facility was impacted by a wildfire disaster during recovery from lung cancer surgery had longer LOS than similar patients treated at the same facility but at times when no disaster occurred. Such findings complicate the use of LOS as a post-operative quality metric. Future studies should evaluate whether extended hospital stay improves surgical care outcomes during disasters. Moreover, these findings should be considered for disaster preparedness guidelines tailored to vulnerable patient populations.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1360-1365"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596993","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 Siegel, Kratzer, Smith et al.","authors":"Archie Bleyer, Lynn A G Ries, Danielle B Cameron, Sara A Mansfield, Stuart E Siegel, Ronald D Barr","doi":"10.1093/jnci/djaf096","DOIUrl":"10.1093/jnci/djaf096","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1518-1519"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173614","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":"Correction to: Survival in Young-Onset Metastatic Colorectal Cancer: Findings From Cancer and Leukemia Group B (Alliance)/SWOG 80405.","authors":"","doi":"10.1093/jnci/djaf124","DOIUrl":"10.1093/jnci/djaf124","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1525"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187043","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":"Changes in time-to-treatment initiation for breast, non-small cell lung, colon, or rectal cancers throughout the COVID-19 pandemic in the United States.","authors":"Qinjin Fan, Weichuan Dong, Elizabeth J Schafer, Nikita Sandeep Wagle, Jingxuan Zhao, Kewei Sylvia Shi, Xuesong Han, K Robin Yabroff, Leticia M Nogueira","doi":"10.1093/jnci/djaf011","DOIUrl":"10.1093/jnci/djaf011","url":null,"abstract":"<p><p>The COVID-19 pandemic disrupted health care and reduced cancer diagnoses in the United States, raising concerns about its impact on time-to-treatment initiation (TTI), a critical factor for survival. This study examined the changes in TTI for 1 213 481 individuals newly diagnosed with female breast, nonsmall cell lung, colon, or rectal cancer between 2019 and 2022, using the National Cancer Database. We compared TTI in 2020-2022 with 2019 by cancer site, diagnosis time of year, stage, and treatment modality. In 2020, TTI statistically significantly decreased for all cancers compared to 2019, especially in the second quarter (2.97-4.29 days). However, TTI increased across sites in 2021 (0.31-2.15 days) and in 2022 (1.43-5.07 days). Reduced diagnoses and efforts to prioritize cancer care during the pandemic may partly explain observed TTI decreases, whereas workforce constraints likely contributed to the later increases. Ongoing evaluation of TTI and associations with patient outcomes is warranted.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1506-1511"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080199","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":"Association of opioid and benzodiazepine coprescribing with adverse events among older adults with cancer.","authors":"Devon K Check, Samir Soneji, Harvey Jay Cohen, Andrea Des Marais, Katie F Jones, Charles E Gaber, Jessica S Merlin, Amy O'Regan, Nicole Fergestrom, Lauren E Wilson, Aaron N Winn","doi":"10.1093/jnci/djaf072","DOIUrl":"10.1093/jnci/djaf072","url":null,"abstract":"<p><strong>Background: </strong>Many older adults with cancer are coprescribed opioids/benzodiazepines; evidence on harms is lacking.</p><p><strong>Methods: </strong>Using SEER-Medicare (2012-2019), we identified patients with breast, colorectal, or lung cancer. Cox proportional hazards models estimated the adjusted hazard ratios (HRs) of coprescribing (measured from claims, at the day level) with the immediate risk of overdose, fall/fracture, and all-cause hospitalization. In a secondary analysis, models were stratified by ≥90 days of continuous medication supply.</p><p><strong>Results: </strong>In our cohort of 107 288 patients, compared with those prescribed neither medication, those prescribed benzodiazepines had an increase in the immediate risk of falls/fractures (HR = 1.17, 95% CI = 1.02 to 1.34) and all-cause hospitalizations (HR = 1.08, 95% CI = 1.04 to 1.12). Patients prescribed opioids had an increase in the immediate risk of overdose (HR = 5.62, 95% CI = 4.86 to 5.62), falls/fractures (HR = 1.56, 95% CI = 1.41 to 1.73), and all-cause hospitalizations (HR = 1.26, 95% CI = 1.23 to 1.30). HRs were similar for patients coprescribed opioids/benzodiazepines. For patients without continuous exposure to 1 or both medications, effects were larger for coprescribed opioids/benzodiazepines vs opioids for overdose (HR = 15.22, 95% CI = 8.79 to 26.35 vs HR = 6.85, 95% CI = 6.85 to 26.35) and all-cause hospitalization (HR = 3.21, 95% CI = 2.60 to 3.96 vs HR = 1.98, 95% CI = 1.87 to 2.10).</p><p><strong>Conclusions: </strong>Overall, compared with no prescribing, benzodiazepine prescribing and opioid prescribing were each associated with an increase in the immediate risk of adverse events. Effects were similar for those prescribed opioids and those coprescribed opioids/benzodiazepines. For patients with intermittent vs long-term medication exposure, coprescribing additionally increased the risk of overdose and all-cause hospitalization.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1465-1473"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669906","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":"Sex-specific radiation-associated lung cancer mortality risks as impacted by smoking among US radiological technologists.","authors":"Cato M Milder, Elizabeth K Cahoon, Sara J Schonfeld, Dale L Preston, Bruce H Alexander, Martha S Linet, Cari M Kitahara","doi":"10.1093/jnci/djaf064","DOIUrl":"10.1093/jnci/djaf064","url":null,"abstract":"<p><strong>Background: </strong>The Life Span Study of Japanese atomic bomb survivors estimated greater risks of radiation-associated lung cancer among females than males, with direct implications for occupational radiation safety policy. To evaluate replicability of these findings in radiation workers, we assessed sex-specific radiation-associated risks of lung cancer mortality in a large cohort of US radiological technologists.</p><p><strong>Methods: </strong>Using data from 4 questionnaires (1983-2013), we reconstructed lifetime smoking history for 83 715 female and 26 650 male technologists. We estimated individual lung occupational radiation doses using badge dose and questionnaire data. We used Poisson regression to investigate joint radiation-smoking effects on sex-averaged and sex-specific lung cancer mortality risk.</p><p><strong>Results: </strong>For 1243 female and 607 male technologists who died from lung cancer, median cumulative lung dose was 16.2 mGy (non-cases: 7.7 mGy) and 24.5 mGy (non-cases: 10.1 mGy), respectively. Excess risk of lung cancer increased with increasing radiation dose. However, smoking modified this effect: the radiation effect at 100 mGy increased until 16 cigarettes/day, after which it declined. Excess relative risk (ERR) per 100 mGy was greater among males (never smoking additive ERR = 1.98; 95% CI = 0.34 to 6.25) than females (never smoking additive ERR = 0.40; 95% CI = -0.02 to 1.21); sex differences persisted up to ∼40 cigarettes/day.</p><p><strong>Conclusions: </strong>Our results indicated radiation-associated risks of lung cancer mortality were stronger in males than females, in contrast to the Life Span Study. However, both studies found radiation-associated risks were highest in workers with light-to-moderate smoking intensity. Altogether, these findings reinforce the importance of rigorous radiation protection measures for all radiation workers, regardless of sex, alongside interventions to support smoking cessation.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1429-1437"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669909","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: Racial and socioeconomic disparities in non-small cell lung cancer molecular diagnostics uptake.","authors":"Pengxiang Zhou, Jiaojiao Cui, Rujing Sun, Xiao Liu, Guangping Li","doi":"10.1093/jnci/djaf081","DOIUrl":"10.1093/jnci/djaf081","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1522-1523"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730049","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}