JNCI Journal of the National Cancer Institute最新文献

{"title":"Response to Yuan and Yu.","authors":"Ioannis Zerdes, Antonios Valachis","doi":"10.1093/jnci/djaf080","DOIUrl":"10.1093/jnci/djaf080","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1285-1286"},"PeriodicalIF":9.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730051","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":"End-of-life care quality for American Indians with cancer.","authors":"Marc A Emerson, Lisa P Spees, Bradford E Jackson, Soroush Fariman, Joel Begay, Hayley N Morris, Ana I Salas, Christopher D Baggett, Tomi Akinyemiju, Ronny A Bell, Stephanie B Wheeler","doi":"10.1093/jnci/djaf007","DOIUrl":"10.1093/jnci/djaf007","url":null,"abstract":"<p><strong>Background: </strong>American Indians experience disparities in cancer outcomes. Little is known about the quality of end-of-life care in American Indian patients with cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed end-of-life care for North Carolina patients who died (decedents) diagnosed with any cancer between 2003 and 2018 using the Cancer Information & Population Health Resource. Measures of end-of-life care quality were informed by existing literature and included in-hospital death, hospice use, and other health-care utilization within the last 30 days of life. Associations between race and ethnicity and end-of-life outcomes were evaluated to estimate adjusted risk ratios (RRs). Because within-group heterogeneity can influence health outcomes and intervention effectiveness, we also evaluated associations among American Indian individuals only.</p><p><strong>Results: </strong>We identified 163 285 (1769 American Indian and 161 516 White) decedents. The majority (60%) of American Indian individuals lived in a geographic area characterized by non-federally recognized tribes. American Indian decedents had greater proportions of rural residence than White decedents (54.5% American Indian vs 30.4% White) and dual-Medicaid/Medicare enrollment (37.4% American Indian vs 17.7% White). Compared with White decedents, American Indian decedents had increased hospital admission (adjusted RR = 1.10, 95% confidence interval [CI] = 1.06 to 1.15), intensive care unit admission (adjusted RR = 1.21, 95% CI = 1.11 to 1.32), and more than 1 emergency department visit (adjusted RR = 1.31, 95% CI = 1.20 to 1.44) in the last 30 days of life. We observed statistically significant within-group variation in end-of-life care quality among American Indian patients.</p><p><strong>Conclusions: </strong>Structural barriers to care and rurality may contribute to lower-quality end-of-life care among American Indian decedents compared with White patients. High-quality, culturally appropriate end-of-life care will require a better understanding of care decision-making and access.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1188-1197"},"PeriodicalIF":9.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079032","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":"Real-world impact of the platinum chemotherapy shortage on US patients with advanced cancer.","authors":"Jacob B Reibel, Lova L Sun, Ravi B Parikh, Nadim Mahmud, Lainie P Martin, Rebecca A Hubbard, Ronac Mamtani","doi":"10.1093/jnci/djae307","DOIUrl":"10.1093/jnci/djae307","url":null,"abstract":"<p><p>The recent cisplatin and carboplatin (\"platinum\") chemotherapy shortage, first announced on February 10, 2023, has impacted cancer patients nationwide. Here, we quantify the extent to which the shortage affected platinum chemotherapy prescribing and short-term mortality. This cohort study included 11 797 adults with advanced solid cancers who initiated first-line therapy during the 1-year period before (February 1, 2022-February 9, 2023) or during (February 10, 2023-January 31, 2024) the platinum shortage. During the shortage, there was a 2.7% absolute reduction in platinum use (95% CI = -4.4% to -0.9%) compared to the previous year. At the peak of the shortage, there was a 15.1% absolute reduction in platinum prescribing (June 2023: 57.8% [95% CI = 53.6% to 62.0%]) compared to 1 year prior (June 2022: 72.9% [95% CI = 70.7% to 75.2%]). There was no difference in mortality before vs during the shortage (adjusted hazard ratio 1.00; 95% CI = 0.94 to 1.07) with median follow-up time of 7.6 months. Further research is required to study shortage impacts on long-term mortality.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1276-1278"},"PeriodicalIF":9.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807373","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":"Following the American Cancer Society guideline for cancer survivors and obesity-related cancer survival.","authors":"Ying Wang, Christina C Newton, Marjorie L McCullough, Lauren R Teras, Clara Bodelon, Erika Rees-Punia, Caroline Y Um, Laura Makaroff, Alpa V Patel","doi":"10.1093/jnci/djaf051","DOIUrl":"10.1093/jnci/djaf051","url":null,"abstract":"<p><strong>Background: </strong>In 2022, the American Cancer Society updated its guideline for cancer survivors. However, the impact of post-diagnosis adherence on mortality risk for those with obesity-related cancers remains unclear.</p><p><strong>Methods: </strong>This study followed nonsmoking participants from the Cancer Prevention Study-II Nutrition Cohort diagnosed with obesity-related cancers between 1992 and 2002 through 2020. Post-diagnosis adherence to ACS guidelines-body mass index (BMI), physical activity, diet, and alcohol consumption-was scored on a scale from 0 to 8. Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 3742 cancer survivors (mean age 67.6 years) with a median follow-up of 15.6 years, 2430 deaths occurred. Survivors with a score of 6-8 had a 24% lower risk of all-cause mortality (HR = 0.76; 95% CI = 0.68 to 0.85), a 33% lower risk of cardiovascular disease mortality (HR = 0.67; 95% CI = 0.54 to 0.83), and a 21% lower risk of cancer-specific mortality (HR = 0.79; 95% CI = 0.64 to 0.97) compared to those with a score of 0-3. Higher BMI and physical activity scores were associated with lower all-cause mortality. Compared to survivors with a consistently low ACS guideline score (<5) both before and after diagnosis, those with a consistently high score (≥5) had lower all-cause and cardiovascular disease mortality. Additionally, survivors who improved their score from low to high had lower all-cause mortality.</p><p><strong>Conclusions: </strong>A lifestyle aligned with the ACS nutrition and physical activity guideline is associated with lower mortality risk among nonsmoking survivors of obesity-related cancers.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1260-1270"},"PeriodicalIF":9.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772657","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":"Body composition and checkpoint inhibitor treatment outcomes in advanced melanoma: a multicenter cohort study.","authors":"Mark Schuiveling, Laurens S Ter Maat, Isabella A J Van Duin, Rik J Verheijden, Max F Troenokarso, Pim Moeskops, Joost J C Verhoeff, Sjoerd G Elias, Wouter A C van Amsterdam, Femke Burgers, Franchette W P J Van den Berkmortel, Marye J Boers-Sonderen, Martijn F Boomsma, Jan Willem De Groot, John B A G Haanen, Geke A P Hospers, Djura Piersma, Gerard Vreugdenhil, Hans M Westgeest, Ellen Kapiteijn, Mariette Labots, Wouter B Veldhuis, Paul J Van Diest, Pim A De Jong, Josien P W Pluim, Tim Leiner, Mitko Veta, Karijn P M Suijkerbuijk","doi":"10.1093/jnci/djaf039","DOIUrl":"10.1093/jnci/djaf039","url":null,"abstract":"<p><strong>Background: </strong>The association of body composition with checkpoint inhibitor outcomes in melanoma is a matter of ongoing debate. In this study, we aim to investigate body mass index (BMI) alongside computed tomography (CT)-derived body composition metrics in the largest cohort to date.</p><p><strong>Methods: </strong>Patients treated with first-line anti-PD1 ± anti-CTLA4 for advanced melanoma were retrospectively identified from 11 melanoma centers in The Netherlands. From baseline CT scans, 5 body composition metrics were extracted: subcutaneous adipose tissue index, visceral adipose tissue index, skeletal muscle index, density, and gauge. These metrics were correlated in univariable and multivariable Cox proportional hazards analysis with progression-free survival, overall survival, and melanoma-specific survival (PFS, OS, and MSS).</p><p><strong>Results: </strong>A total of 1471 eligible patients were included. Median PFS and OS were 9.1 and 38.1 months, respectively. Worse PFS was observed in underweight patients (multivariable hazard ratio [HR] = 1.86, 95% CI = 1.14 to 3.06). Furthermore, prolonged OS was observed in patients with higher skeletal muscle density (multivariable HR = 0.88, 95% CI = 0.81 to 0.97) and gauge (multivariable HR = 0.61, 95% CI = 0.82 to 0.998), whereas higher visceral adipose tissue index was associated with worse OS (multivariable HR = 1.12, 95% CI = 1.04 to 1.22). No association with survival outcomes was found for overweight, obesity, or subcutaneous adipose tissue.</p><p><strong>Conclusion: </strong>Our findings suggest that underweight BMI is associated with worse PFS, whereas higher skeletal muscle density and lower visceral adipose tissue index were associated with improved OS. These associations were independent of known prognostic factors, including sex, age, performance status, and extent of disease. No significant association between higher BMI and survival outcomes was observed.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1245-1252"},"PeriodicalIF":9.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468191","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":"Human papillomavirus-related squamous cell carcinomas after blood or marrow transplantation-a Blood or Marrow Transplant Survivor Study report.","authors":"Anna Sällfors Holmqvist, Qingrui Meng, Wendy Landier, Lindsey Hageman, Liton F Francisco, Elizabeth Schlichting Ross, Nora Balas, Alysia Bosworth, Hok Sreng Te, Ravi Bhatia, F Lennie Wong, Daniel Weisdorf, Saro H Armenian, Smita Bhatia","doi":"10.1093/jnci/djaf021","DOIUrl":"10.1093/jnci/djaf021","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) is associated with an increased risk for a variety of squamous cell carcinomas in the general population. The risk for subsequent squamous cell carcinomas in blood or marrow transplantation survivors that are potentially related to HPV (cervical, oropharyngeal, vulvar, vaginal, anal, and penile cancer; HPV-related squamous cell carcinomas) remains unknown.</p><p><strong>Methods: </strong>We determined the risk of HPV-related squamous cell carcinomas in 7936 2-year survivors of autologous or allogeneic blood or marrow transplantation performed between 1974 and 2014 and identified the role of demographic and clinical factors associated with HPV-related squamous cell carcinomas using proportional subdistribution hazards model for competing risks. Standardized incidence ratio was used to compare the risk of HPV-related squamous cell carcinoma with age-, sex-, and calendar-specific incidence in the general population.</p><p><strong>Results: </strong>The median age at transplantation was 46 years (range = 0-78 years); 58.5% (n = 4642) were male, and 72.2% (n = 5727) were non-Hispanic White. Half (50.3%, n = 3991) of the patients had received an allogeneic blood or marrow transplantation. The standardized incidence ratio for oropharyngeal squamous cell carcinomas (n = 53) was 1.8 (95% confidence interval [CI] = 1.3 to 2.3) and for cervical squamous cell carcinoma among female blood or marrow transplantation recipients (n = 26) was 9.4 (95% CI = 6.3 to 13.6) compared with the general US population. The hazard of an HPV-related squamous cell carcinoma was higher among allogeneic blood or marrow transplantation recipients with chronic graft vs host disease (any HPV-related squamous cell carcinoma: HR = 6.24, 95% CI = 3.11 to 12.50; oropharyngeal: HR = 4.85, 95% CI = 2.11 to 11.15; cervical: HR = 4.98, 95% CI = 1.65 to 15.00; reference: autologous blood or marrow transplantation). Pre-blood or marrow transplantation radiation increased the risk of oropharyngeal squamous cell carcinoma (HR = 2.98, 95% CI = 1.57 to 5.65).</p><p><strong>Conclusion: </strong>These findings underscore the importance of risk-based HPV vaccination and surveillance after blood or marrow transplantation.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1166-1174"},"PeriodicalIF":9.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064602","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":"Development of a policy model for pediatric acute lymphoblastic leukemia to facilitate economic evaluation.","authors":"Petros Pechlivanoglou, Linda Luu, Qing Li, Juan David Rios, Alexandra Moskalewicz, Sumit Gupta","doi":"10.1093/jnci/djaf024","DOIUrl":"10.1093/jnci/djaf024","url":null,"abstract":"<p><strong>Background: </strong>New highly effective, but expensive, immunotherapies have revolutionized the treatment of relapsed pediatric acute lymphoblastic leukemia (ALL) but their long-term clinical and economic impact is unclear. We developed the ALL Policy microsimulation model to estimate long-term clinical and economic outcomes for patients with pediatric ALL aged 0-17 in Ontario, Canada. We also illustrate the model's clinical utility through a cost-effectiveness analysis of blinatumomab in relapsed B-cell ALL.</p><p><strong>Methods: </strong>The ALL Policy model is informed using health administrative data and chart abstracted data from Ontario, Canada, and published literature. The model estimates lifetime risk of relapse, bone marrow transplant (BMT), conditional life expectancy, quality-adjusted life years (QALYs), and total health-care costs for individuals with pediatric ALL and can be stratified by relevant clinical characteristics (eg, B-cell or T-cell lineage). Additionally, we subset the model to patients with relapsed B-cell ALL to illustrate use of the model in estimating the cost-effectiveness of blinatumomab vs standard chemotherapy.</p><p><strong>Results: </strong>Simulated pediatric ALL patients diagnosed from 2002 to 2012 had a projected conditional life expectancy of 64.90 years. The lifetime risk of BMT was estimated at 12.5%. Lifetime health-care costs were $244 433 Canadian Dollars (CAD) (95% confidence interval = $213 314 to $303 430). Treatment with blinatumomab compared to standard chemotherapy post-relapse was estimated to result in 1.08 additional QALYs and an additional cost of $59 410 CAD (incremental cost-effectiveness ratio of $54 885/QALY).</p><p><strong>Conclusion: </strong>The ALL policy model can serve as a modeling foundation for timely economic evaluation. Introduction of blinatumomab in relapsed B-cell ALL may be a cost-effective strategy.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1228-1236"},"PeriodicalIF":9.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414333","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: Associations of self-identified race and ethnicity and genetic ancestry with mortality among cancer survivors.","authors":"Hari S Iyer, Iona Cheng, Scarlett L Gomez, Timothy R Rebbeck","doi":"10.1093/jnci/djaf126","DOIUrl":"https://doi.org/10.1093/jnci/djaf126","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187044","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: Validation of a breast cancer assay for radiotherapy omission: an individual participant data meta-analysis.","authors":"Dan Li, Yun Liu, Qiongyu Duan, Xiaodong Chen","doi":"10.1093/jnci/djaf115","DOIUrl":"https://doi.org/10.1093/jnci/djaf115","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965502","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 radiation-induced normal tissue toxicity with a high genetic risk for rheumatoid arthritis.","authors":"Alan McWilliam, Deborah Marshall, Sarah L Kerns, Gillian C Barnett, Ana Vega, Thodori Kapouranis, Miguel E Aguado Barrera, Barbara Avuzzi, David Azria, Jenny Chang-Claude, Ananya Choudhury, Carla Coedo Costa, Alison Dunning, Marie-Pierre Farcy-Jacquet, Corinne Faivre-Finn, Sara Gutiérrez-Enríquez, Olivia Fuentes-Ríos, Antonio Gómez Caamaño, Maarten Lambrecht, Carlos López Pleguezuelos, Tiziana Rancati, Tim Rattay, Dirk de Ruysscher, Petra Seibold, Elena Sperk, Christopher Talbot, Adam Webb, Liv Veldeman, Barry S Rosenstein, Catharine M L West","doi":"10.1093/jnci/djae349","DOIUrl":"10.1093/jnci/djae349","url":null,"abstract":"<p><strong>Background: </strong>Overlapping genes are involved with rheumatoid arthritis (RA) and DNA repair pathways. Therefore, we hypothesized that patients with a high polygenic risk score for RA will have an increased risk of radiotherapy toxicity given the involvement of DNA repair.</p><p><strong>Methods: </strong>Primary analysis was performed on 1494 prostate cancer, 483 lung cancer, and 1820 breast cancer patients assessed for development of radiotherapy toxicity in the REQUITE (validating pREdictive models and biomarkers of radiotherapy toxicity to reduce side effects and improve QUalITy of lifE in cancer survivors) study. Validation cohorts were available from the Radiogenomics Consortium. All patients had undergone curative-intent radiotherapy and were assessed prospectively for toxicity. Germline genomic data was available for all patients, allowing a polygenic risk score to be calculated using 101 RA risk variants. Polygenic risk score was analyzed as a continuous variable and with a more than 90th percentile cutoff. Associations with acute and late standardized total average toxicity (STAT) scores and individual toxicity endpoints were analyzed in multivariable models with preselected adjustment variables.</p><p><strong>Results: </strong>Increasing polygenic risk score for RA did not increase the risk of STAT-acute or STAT-late in any cohort. There was an increased risk of late esophagitis in the lung cancer cohort (coefficient = 0.018, P = .01), however this was not validated (P = .79). No individual acute or late toxicity endpoints were statistically significantly associated with polygenic risk score for the prostate or breast cohorts. No statistically significant results were found in the validation cohorts in multivariable models.</p><p><strong>Conclusions: </strong>Patients with a high genetic risk for RA do not show increased levels of toxicity after radiotherapy suggesting treatment planning does not need to be modified for such patients.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1018-1026"},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931729","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}