Journal of Clinical Oncology最新文献

{"title":"They Not Like Us: Evaluating the Diverse Strategies in Locally Advanced Rectal Cancer Treatment.","authors":"Pratik Shah, Tony Philip","doi":"10.1200/JCO-24-02178","DOIUrl":"10.1200/JCO-24-02178","url":null,"abstract":"<p><p><i>The Oncology Grand Rounds series is designed to place original reports published in the</i> Journal <i>into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in</i> Journal of Clinical Oncology<i>, to patients seen in their own clinical practice</i>.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1620-1624"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811586","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":"Immune Checkpoint Combos in Metastatic Castration-Resistant Prostate Cancer: Where Are We Going, What Are We Doing, and Why?","authors":"Susan F Slovin","doi":"10.1200/JCO-24-02402","DOIUrl":"10.1200/JCO-24-02402","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1617-1619"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624849","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":"Clinical Behavior of Breast Cancer in Young <i>BRCA</i> Carriers and Prediagnostic Awareness of Germline <i>BRCA</i> Status.","authors":"Matteo Lambertini, Eva Blondeaux, Loredana M Tomasello, Elisa Agostinetto, Anne-Sophie Hamy, Hee Jeong Kim, Maria Alice Franzoi, Rinat Bernstein-Molho, Florentine Hilbers, Katarzyna Pogoda, Hans Wildiers, Jyoti Bajpai, Michail Ignatiadis, Halle C F Moore, Ann H Partridge, Kelly-Anne Phillips, Angela Toss, Christine Rousset-Jablonski, Carmen Criscitiello, Tiphaine Renaud, Alberta Ferrari, Shani Paluch-Shimon, Robert Fruscio, Wanda Cui, Stephanie M Wong, Claudio Vernieri, Kathryn J Ruddy, Maria Vittoria Dieci, Alexios Matikas, Mariya Rozenblit, Cynthia Villarreal-Garza, Laura De Marchis, Fabio Puglisi, Kenny A Rodriguez-Wallberg, Francois P Duhoux, Luca Livraghi, Marco Bruzzone, Luca Boni, Judith Balmaña","doi":"10.1200/JCO-24-01334","DOIUrl":"10.1200/JCO-24-01334","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical behavior of breast cancer in young <i>BRCA</i> carriers according to the specific <i>BRCA</i> gene (<i>BRCA1 v BRCA2</i>) and the association of the timing of genetic testing (before <i>v</i> at diagnosis) with prognosis.</p><p><strong>Methods: </strong>This was an international, multicenter, hospital-based, retrospective cohort study that included 4,752 patients harboring germline pathogenic/likely pathogenic variants (PVs) in <i>BRCA1</i> or <i>BRCA2</i>, who were diagnosed with stage I-III invasive breast cancer at 40 years or younger between January 2000 and December 2020 in 78 centers worldwide (ClinicalTrials.gov identifier: NCT03673306).</p><p><strong>Results: </strong>Compared with <i>BRCA2</i> carriers (n = 1,683), <i>BRCA1</i> carriers (n = 3,069) had more frequently hormone receptor-negative (74.4% <i>v</i> 15.5%) and high-grade (77.5% <i>v</i> 49.1%) tumors. Similar outcomes were observed in <i>BRCA1</i> and <i>BRCA2</i> carriers but with a different pattern and risk of disease-free survival events over time. Compared with patients tested for <i>BRCA</i> at diagnosis (ie, between 2 months before and up to 6 months after diagnosis; n = 1,671), those tested before diagnosis (ie, any time up to 2 months before diagnosis; n = 411) had smaller tumors (T1: 61.3% <i>v</i> 32.4%), less nodal involvement (N0: 65.9% <i>v</i> 50.8%), less frequently received chemotherapy (84.4% <i>v</i> 92.9%), and axillary dissection (37.5% <i>v</i> 47.4%). Patients tested before diagnosis had better overall survival (OS; unadjusted hazard ratio [HR], 0.61 [95% CI, 0.40 to 0.92]); however, this result lost statistical significance after adjustment for potential confounders including tumor stage (adjusted HR, 0.74 [95% CI, 0.47 to 1.15]).</p><p><strong>Conclusion: </strong>This global study provides evidence on the different clinical behavior of breast cancer in young <i>BRCA1</i> and <i>BRCA2</i> carriers. Identifying a <i>BRCA</i> PV in healthy individuals was associated with earlier-stage breast cancer diagnosis and lower treatment burden, as well as better unadjusted OS.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1706-1719"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491972","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":"Reply to: \"Risks of Organ Preservation in Rectal Cancer: Beyond Distant Metastases, Ultimate Local Failure Can Also Be a Problem,\" \"Organ Preservation in Rectal Cancer: Fear of Risks Versus the Risks of Fear,\" and \"Distant Metastases With Nonoperative Management in Rectal Cancer: Challenges in Defining Risk\".","authors":"Laura M Fernandez, Guilherme P São Julião, Carlos Cerdan-Santacruz, Andrew G Renehan, Geerard L Beets, Amjad Parvaiz, Jose Azevedo, Bruna B Vailati, Rodrigo O Perez","doi":"10.1200/JCO-25-00132","DOIUrl":"10.1200/JCO-25-00132","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1746-1748"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624854","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":"Risks of Organ Preservation in Rectal Cancer: Data From Two International Registries on Rectal Cancer.","authors":"Laura M Fernandez, Guilherme P São Julião, Carlos Cerdan Santacruz, Andrew G Renehan, Oscar Cano-Valderrama, Geerard L Beets, Jose Azevedo, Blas F Lorente, Rocío S Rancaño, Sebastiano Biondo, Eloy Espin-Basany, Bruna B Vailati, Per J Nilsson, Anna Martling, Cornelis J H Van De Velde, Amjad Parvaiz, Angelita Habr-Gama, Rodrigo O Perez","doi":"10.1200/JCO.24.00405","DOIUrl":"10.1200/JCO.24.00405","url":null,"abstract":"<p><strong>Purpose: </strong>Organ preservation has become an attractive alternative to surgery (total mesorectal excision [TME]) among patients with rectal cancer after neoadjuvant therapy who achieve a clinical complete response (cCR). Nearly 30% of these patients will develop local regrowth (LR). Although salvage resection is frequently feasible, there may be an increased risk for development of subsequent distant metastases (DM). The aim of this study is to compare the risk of DM between patients with LR after Watch and Wait (WW) and patients with near-complete pathologic response (nPCR) managed by TME at the time of reassessment of response.</p><p><strong>Methods: </strong>Data from patients enrolled in the International Watch & Wait Database (IWWD) with cCR managed by WW and subsequent LR were compared with patients managed by TME (with ≤10% cancer cells-nPCR) from the Spanish Rectal Cancer Project (VIKINGO project). The primary end point was DM-free survival at 3 years from decision to WW or TME. The secondary end point was possible risk factors associated with DM.</p><p><strong>Results: </strong>Five hundred and eight patients with LR were compared with 893 patients with near-complete response after TME. Overall, DM rate was significantly higher among LRs (22.8% <i>v</i> 10.2%; <i>P</i> ≤ .001). Independent risk factors for DM included LR (<i>v</i> TME at reassessment; <i>P</i> = .001), ypT3-4 status (<i>P</i> = .016), and ypN+ status (<i>P</i> = .001) at the time of surgery. 3-year DM-free survival was significantly worse for patients with LR (75% <i>v</i> 87%; <i>P</i> = .001). When stratified for pathologic stage, patients with LR did significantly worse through all stages (<i>P</i> ≤ .009).</p><p><strong>Conclusion: </strong>Patients with LR appear to have a higher risk for subsequent DM development than patients with nPCR managed by TME at restaging irrespective of final pathology. Leaving the primary undetectable tumor in situ until development of LR may result in worse oncologic outcomes.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1663-1672"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522041","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":"Erratum: Pertuzumab Retreatment for Human Epidermal Growth Factor Receptor 2-Positive Locally Advanced/Metastatic Breast Cancer (PRECIOUS Study): Final Overall Survival Analysis.","authors":"Yutaka Yamamoto, Hiroji Iwata, Shigehira Saji, Masato Takahashi, Tetsuhiro Yoshinami, Takayuki Ueno, Tatsuya Toyama, Takashi Yamanaka, Toshimi Takano, Masahiro Kashiwaba, Koichiro Tsugawa, Yoshie Hasegawa, Kenji Tamura, Hiroshi Tada, Fumikata Hara, Tomomi Fujisawa, Naoki Niikura, Naruto Taira, Satoshi Morita, Masakazu Toi, Shinji Ohno, Norikazu Masuda","doi":"10.1200/JCO-25-00722","DOIUrl":"https://doi.org/10.1200/JCO-25-00722","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":"43 14","pages":"1749"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994952","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":"Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update.","authors":"Ko Un Park, Mark R Somerfield, Nirupama Anne, Muriel Brackstone, Alison K Conlin, Henrique Lima Couto, Lynn T Dengel, Andrea Eisen, Brittany E Harvey, Jeffrey Hawley, Janice N Kim, Nwamaka Lasebikan, Elizabeth S McDonald, Deepti Pradhan, Samantha Shams, Raymond Mailhot Vega, Alastair M Thompson, Mylin A Torres","doi":"10.1200/JCO-25-00099","DOIUrl":"https://doi.org/10.1200/JCO-25-00099","url":null,"abstract":"<p><strong>Purpose: </strong>To update the ASCO evidence-based recommendations on the use of sentinel lymph node biopsy (SLNB) in patients with early-stage breast cancer treated with initial surgery.</p><p><strong>Methods: </strong>ASCO convened an Expert Panel to develop updated recommendations based on a systematic literature review (January 2016-May 2024).</p><p><strong>Results: </strong>Eleven randomized clinical trials (14 publications), eight meta-analyses and/or systematic reviews, and one prospective cohort study met the inclusion criteria for this systematic review. Expert Panel members used available evidence and informal consensus to develop practice recommendations.</p><p><strong>Recommendations: </strong>Clinicians should not recommend routine SLNB in select patients who are postmenopausal and ≥50 years of age and with negative findings on preoperative axillary ultrasound for grade 1-2, small (≤2 cm), hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer and who undergo breast-conserving therapy. Clinicians may offer postmastectomy radiation (RT) with regional nodal irradiation (RNI) and omit axillary lymph node dissection (ALND) in patients with clinically node-negative invasive breast cancer ≤5 cm who receive mastectomy and have one to two positive sentinel nodes. Clinicians may offer SLNB in patients who have cT3-T4c or multicentric tumors (clinically node-negative) or ductal carcinoma in situ treated with mastectomy, and in patients who are obese, male, or pregnant, or who have had prior breast or axillary surgery. Clinicians should not recommend ALND for patients with early-stage breast cancer who do not have nodal metastases, and clinicians should not recommend ALND for patients with early-stage breast cancer who have one or two sentinel lymph node metastases and will receive breast-conserving surgery and whole-breast RT with or without RNI.Additional information is available at www.asco.org/breast-cancer-guidelines.This guideline has been endorsed by the American Society for Radiation Oncology (ASTRO).</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":"43 14","pages":"1720-1741"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995145","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":"COSMIC-021 Phase Ib Study of Cabozantinib Plus Atezolizumab: Results from the Locally Advanced or Metastatic Urothelial Carcinoma Cohorts.","authors":"Sumanta K Pal, Yohann Loriot, Andrea Necchi, Parminder Singh, Daniel Castellano, Lance Pagliaro, Cristina Suarez, Bradley A McGregor, Ulka N Vaishampayan, Ralph J Hauke, Thomas Powles, Carla M L Van Herpen, Kevin D Courtney, Robert Dreicer, Ramu Sudhagoni, Martin Schwickart, Svetlana Andrianova, Neeraj Agarwal","doi":"10.1200/JCO-24-01675","DOIUrl":"10.1200/JCO-24-01675","url":null,"abstract":"<p><strong>Purpose: </strong>The COSMIC-021 study assessed the safety and efficacy of cabozantinib plus atezolizumab in advanced solid tumors. Presented here are results from the expansion cohorts with advanced urothelial carcinoma (UC).</p><p><strong>Methods: </strong>This phase Ib study (ClinicalTrials.gov identifier: NCT03170960) enrolled patients with inoperable locally advanced/metastatic UC into four tumor cohorts: first-line cisplatin-eligible (cis-eligible), first-line cisplatin-ineligible (cis-ineligible), previous platinum-containing chemotherapy (previous chemotherapy-treated), and previous immune checkpoint inhibitor (ICI)-treated. Patients received oral cabozantinib 40 mg once daily and intravenous atezolizumab 1,200 mg once every 3 weeks. The primary end point was objective response rate (ORR), as assessed by the investigator per RECIST v1.1 every 6 weeks for 12 months and every 12 weeks thereafter; the secondary end point was safety.</p><p><strong>Results: </strong>A total of 121 patients (previous ICI-treated cohort, n = 31, and each of the other cohorts, n = 30) received study treatment from March 2018 to November 2021. The ORR (95% CI) was 30% (15 to 49) for cis-eligible, 20% (8 to 39) for cis-ineligible, 27% (12 to 46) for previous chemotherapy-treated, and 10% (2 to 26) for previous ICI-treated cohorts. The median progression-free survival (95% CI) was 5.5 (1.6 to 11.6), 5.6 (3.1 to 11.1), 5.4 (1.6 to 7.6), and 3.0 (1.8 to 5.5) months, respectively. Grade 3 or 4 treatment-related adverse events (TRAEs) were experienced by 43%, 67%, 57%, and 45% of patients, respectively. TRAEs led to discontinuation of all treatment components in 17%, 13%, 3%, and 19%, respectively. No grade 5 TRAEs were reported in any cohort.</p><p><strong>Conclusion: </strong>The novel combination of cabozantinib plus atezolizumab exhibited clinical activity in advanced UC that is cis-eligible, cis-ineligible, or previously treated with platinum-containing chemotherapy; clinical activity in previous ICI-treated UC was modest. The toxicity profile was consistent with that previously reported for the combination.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1650-1662"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449129","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":"Distant Metastases With Nonoperative Management in Rectal Cancer: Challenges in Defining Risk.","authors":"Krishan R Jethwa, Christopher L Hallemeier, Nina N Sanford","doi":"10.1200/JCO-24-02714","DOIUrl":"10.1200/JCO-24-02714","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1743-1745"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624843","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":"Pertuzumab Retreatment for Human Epidermal Growth Factor Receptor 2-Positive Locally Advanced/Metastatic Breast Cancer (PRECIOUS Study): Final Overall Survival Analysis.","authors":"Yutaka Yamamoto, Hiroji Iwata, Shigehira Saji, Masato Takahashi, Tetsuhiro Yoshinami, Takayuki Ueno, Tatsuya Toyama, Takashi Yamanaka, Toshimi Takano, Masahiro Kashiwaba, Koichiro Tsugawa, Yoshie Hasegawa, Kenji Tamura, Hiroshi Tada, Fumikata Hara, Tomomi Fujisawa, Naoki Niikura, Naruto Taira, Satoshi Morita, Masakazu Toi, Shinji Ohno, Norikazu Masuda","doi":"10.1200/JCO-24-01673","DOIUrl":"10.1200/JCO-24-01673","url":null,"abstract":"<p><p>In the primary analysis of the open-label phase III PRECIOUS study, pertuzumab retreatment combined with trastuzumab plus chemotherapy of physician's choice (PTC) significantly improved investigator-assessed progression-free survival (PFS) compared with trastuzumab plus physician's choice chemotherapy (TC) in patients with human epidermal growth factor receptor 2 (HER2)-positive locally advanced/metastatic breast cancer (LA/mBC). Here, we report final overall survival (OS) at the median follow-up of 25.8 months. Patients who have previously received pertuzumab-containing regimens as first-/second-line treatment for LA/mBC were randomly assigned 1:1 to two groups, PTC group (n = 110) and TC group (n = 109). Median OS was longer in the PTC group (median OS 36.2 <i>v</i> 26.5 months; hazard ratio [HR], 0.73 [one side 95% CI upper limit, 0.97]). Updated median investigator-assessed PFS (5.5 <i>v</i> 4.2 months; HR, 0.81 [one side 95% CI upper limit, 1.02]) were also better in the PTC group. Median PFS by independent review did not show the difference between the two groups (4.4 <i>v</i> 4.4 months; HR, 1.03 [one side 95% CI upper limit, 1.36]). These findings suggest that dual HER2 blockade with pertuzumab plus trastuzumab could contribute to improving OS in patients who have previously been treated with pertuzumab-containing regimens for HER2-positive LA/mBC.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1631-1637"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032370","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}