Journal of Clinical Oncology最新文献

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Risks of Organ Preservation in Rectal Cancer: Beyond Distant Metastases, Ultimate Local Failure Can Also Be a Problem. 直肠癌器官保存的风险:除了远处转移,最终的局部衰竭也可能是一个问题。
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-10 Epub Date: 2025-03-13 DOI: 10.1200/JCO-24-02518
Joanna Socha, Krzysztof Bujko
{"title":"Risks of Organ Preservation in Rectal Cancer: Beyond Distant Metastases, Ultimate Local Failure Can Also Be a Problem.","authors":"Joanna Socha, Krzysztof Bujko","doi":"10.1200/JCO-24-02518","DOIUrl":"10.1200/JCO-24-02518","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1742-1743"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624858","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}
引用次数: 0
Frequency and Clinical Significance of Clonal and Subclonal Driver Mutations in High-Risk Neuroblastoma at Diagnosis: A Children's Oncology Group Study. 高危神经母细胞瘤诊断中克隆和亚克隆驱动突变的频率和临床意义:一项儿童肿瘤组研究
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-10 Epub Date: 2025-03-04 DOI: 10.1200/JCO-24-02407
Esther R Berko, Arlene Naranjo, Alexander A Daniels, Samantha N McNulty, Kateryna Krytska, Todd Druley, Kirstin Zelley, Balakrishna Koneru, Lulu Chen, Grace Polkosnik, Meredith S Irwin, Rochelle Bagatell, John M Maris, C Patrick Reynolds, Steven G DuBois, Julie R Park, Yael P Mossé
{"title":"Frequency and Clinical Significance of Clonal and Subclonal Driver Mutations in High-Risk Neuroblastoma at Diagnosis: A Children's Oncology Group Study.","authors":"Esther R Berko, Arlene Naranjo, Alexander A Daniels, Samantha N McNulty, Kateryna Krytska, Todd Druley, Kirstin Zelley, Balakrishna Koneru, Lulu Chen, Grace Polkosnik, Meredith S Irwin, Rochelle Bagatell, John M Maris, C Patrick Reynolds, Steven G DuBois, Julie R Park, Yael P Mossé","doi":"10.1200/JCO-24-02407","DOIUrl":"10.1200/JCO-24-02407","url":null,"abstract":"<p><strong>Purpose: </strong>Relapsed high-risk neuroblastomas (NBLs) are enriched for targetable mutations in <i>ALK</i> and RAS-MAPK pathways, yet the prognostic effect of these aberrations and relevance of subclonal mutations at diagnosis remain undefined. We describe the spectrum and clinical significance of clonal and subclonal pathogenic alterations in high-risk NBL.</p><p><strong>Methods: </strong>We developed a focused high-risk NBL sequencing panel including <i>ALK</i>, <i>NRAS</i>, <i>KRAS</i>, <i>HRAS</i>, <i>BRAF</i>, <i>PTPN11</i>, <i>TP53</i>, and <i>ATRX</i> genes for ultra-deep sequencing and applied this assay to 242 pretherapy tumors from patients enrolled on the phase III trial Children's Oncology Group ANBL0532. We assessed the effect of clonal and subclonal mutations on event-free survival (EFS) and overall survival (OS).</p><p><strong>Results: </strong><i>ALK</i>-activating mutations occurred in 21.5% of tumors (n = 52, 30 clonal, 22 subclonal), and 3.3% (n = 8) showed <i>ALK</i> amplification. EFS and OS for patients with any <i>ALK</i>-aberrant tumor were inferior to patients with wild-type (WT) <i>ALK</i> tumors (5-year OS 37.7% <i>v</i> 66.3%; hazard ratio [HR], 1.992; <i>P</i> = .0007). EFS and OS for patients with tumors harboring activating <i>ALK</i> mutations ≥5% variant allele frequency (VAF) were inferior to <i>ALK</i> WT (5-year OS 37.7% <i>v</i> 66.3%; HR, 1.966; <i>P</i> = .0041). The 5-year EFS and OS for patients with <i>ALK</i>-amplified tumors were 25.0%. RAS pathway mutations occurred in 7.9% of tumors (n = 19; four clonal, 15 subclonal), with EFS and OS for those with VAF ≥5% inferior to RAS-WT patients (5-year OS 19.1% <i>v</i> 60.0%; HR, 3.021; <i>P</i> = .0168).</p><p><strong>Conclusion: </strong>Ultra-deep sequencing of high-risk NBLs demonstrates that oncogenic aberrations are more prevalent at diagnosis than previously recognized. <i>ALK</i> and RAS pathway aberrations confer inferior outcomes in patients treated with contemporary therapy, emphasizing the need for novel therapeutic approaches.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1673-1684"},"PeriodicalIF":42.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556788","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}
引用次数: 0
Erratum: Every Patient Is Unique and Deserves the Best: The Present and Future Treatment Landscape of Uncommon Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancer. 勘误:每个病人都是独特的,值得最好的:非小细胞肺癌中罕见表皮生长因子受体突变的现在和未来治疗前景。
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-08 DOI: 10.1200/JCO-25-00997
Derek De-Rui Huang, James Chih-Hsin Yang
{"title":"Erratum: Every Patient Is Unique and Deserves the Best: The Present and Future Treatment Landscape of Uncommon Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancer.","authors":"Derek De-Rui Huang, James Chih-Hsin Yang","doi":"10.1200/JCO-25-00997","DOIUrl":"https://doi.org/10.1200/JCO-25-00997","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2500997"},"PeriodicalIF":42.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007369","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}
引用次数: 0
Dose-Escalated Stereotactic Versus Conventional Radiotherapy for Painful Bone Metastases (ROBOMET): A Multicenter, Patient-Blinded Randomized Clinical Trial. 剂量递增的立体定向放疗与常规放疗治疗疼痛性骨转移(ROBOMET):一项多中心、患者盲法随机临床试验。
IF 45.3 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-08 DOI: 10.1200/jco-24-01447
Carole Mercier,Charlotte Billiet,Piet Ost,Katrien Vandecasteele,Geert De Kerf,Michaël Claessens,Steven Van Laere,Peter Vermeulen,Luc Dirix,Yolande Lievens,Dirk Verellen,Piet Dirix
{"title":"Dose-Escalated Stereotactic Versus Conventional Radiotherapy for Painful Bone Metastases (ROBOMET): A Multicenter, Patient-Blinded Randomized Clinical Trial.","authors":"Carole Mercier,Charlotte Billiet,Piet Ost,Katrien Vandecasteele,Geert De Kerf,Michaël Claessens,Steven Van Laere,Peter Vermeulen,Luc Dirix,Yolande Lievens,Dirk Verellen,Piet Dirix","doi":"10.1200/jco-24-01447","DOIUrl":"https://doi.org/10.1200/jco-24-01447","url":null,"abstract":"PURPOSETo test whether dose-escalated single fraction (SF) stereotactic body radiotherapy (SBRT) of 20 Gy to painful bone metastases is superior to conventional SF three-dimensional (3D) conformal radiotherapy (RT) to a standard dose of 8 Gy in achieving complete pain response (CR).METHODSA single-blind, randomized, controlled, phase III trial (ROBOMET) included 126 patients with up to three painful bone metastases, randomly assigned between April 2019 and October 2022 at multiple centers in Belgium. Inclusion criteria were uncomplicated painful bone metastases (worst pain score ≥2 on a 0-10 pain scale) arising from a solid tumor. Treatment consisted of either a single SBRT fraction of 20 Gy or a single conventional RT fraction of 8 Gy. The primary end point was the proportion of patients with a CR 1 month after RT scored according to the International Consensus on Palliative Radiotherapy Endpoints analyzed as per an intention-to-treat principle.RESULTSAfter 1 month, 16 of 63 (25% [95% CI, 15 to 38]) patients treated with conventional RT achieved CR versus 23 of 63 (37% [95% CI, 25 to 50]) treated with SBRT (P = .25). After 3 months, 15 of 63 (24% [95% CI, 14 to 36]) patients achieved CR after conventional RT versus 21 of 63 (33% [95% CI, 22 to 46]) after SBRT (P = .32). Among patients evaluable after 3 months and treated per protocol, the SBRT group had more complete responders (21/39, 54% [95% CI, 37 to 70]) than the conventional RT group (15/48, 31% [95% CI, 19 to 46]; P = .048).CONCLUSIONSBRT failed to demonstrate improved CR rates after 1 month.","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":"1 1","pages":"JCO2401447"},"PeriodicalIF":45.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926401","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}
引用次数: 0
Sharper Focus, Greater Comfort? Lessons From the ROBOMET Trial. 更专注,更舒适?ROBOMET试验的经验教训。
IF 45.3 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-08 DOI: 10.1200/jco-25-00659
Edward Chmiel,Matthias Guckenberger,Erin F Gillespie,Shankar Siva
{"title":"Sharper Focus, Greater Comfort? Lessons From the ROBOMET Trial.","authors":"Edward Chmiel,Matthias Guckenberger,Erin F Gillespie,Shankar Siva","doi":"10.1200/jco-25-00659","DOIUrl":"https://doi.org/10.1200/jco-25-00659","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":"110 1","pages":"JCO2500659"},"PeriodicalIF":45.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926402","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}
引用次数: 0
Outcomes of Radium-223 and Stereotactic Ablative Radiotherapy Versus Stereotactic Ablative Radiotherapy for Oligometastatic Prostate Cancers: The RAVENS Phase II Randomized Trial. 镭-223联合立体定向消融放疗与立体定向消融放疗治疗少转移性前列腺癌的疗效:RAVENS II期随机试验
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-07 DOI: 10.1200/JCO-25-00131
Jarey H Wang, Alexander D Sherry, Soha Bazyar, Philip Sutera, Noura Radwan, Ryan M Phillips, Matthew P Deek, Jiayun Lu, Shirl Dipasquale, Curtiland Deville, Theodore L DeWeese, Daniel Y Song, Hao Wang, Robert F Hobbs, Reem Malek, Sara A Dudley, Stephen C Greco, Emmanuel S Antonarakis, Catherine H Marshall, Samuel Denmeade, Channing J Paller, Michael A Carducci, Kenneth J Pienta, Orhan K Oz, Matthew Ramotar, James L Leenstra, Sean S Park, Matthew C Abramowitz, Neil Desai, Alejandro Berlin, Bradley J Stish, Chad Tang, Phuoc T Tran, Ana P Kiess
{"title":"Outcomes of Radium-223 and Stereotactic Ablative Radiotherapy Versus Stereotactic Ablative Radiotherapy for Oligometastatic Prostate Cancers: The RAVENS Phase II Randomized Trial.","authors":"Jarey H Wang, Alexander D Sherry, Soha Bazyar, Philip Sutera, Noura Radwan, Ryan M Phillips, Matthew P Deek, Jiayun Lu, Shirl Dipasquale, Curtiland Deville, Theodore L DeWeese, Daniel Y Song, Hao Wang, Robert F Hobbs, Reem Malek, Sara A Dudley, Stephen C Greco, Emmanuel S Antonarakis, Catherine H Marshall, Samuel Denmeade, Channing J Paller, Michael A Carducci, Kenneth J Pienta, Orhan K Oz, Matthew Ramotar, James L Leenstra, Sean S Park, Matthew C Abramowitz, Neil Desai, Alejandro Berlin, Bradley J Stish, Chad Tang, Phuoc T Tran, Ana P Kiess","doi":"10.1200/JCO-25-00131","DOIUrl":"https://doi.org/10.1200/JCO-25-00131","url":null,"abstract":"<p><strong>Purpose: </strong>Randomized clinical trials (RCTs) have shown progression-free survival (PFS) benefits of metastasis-directed therapy (MDT) without androgen deprivation therapy for oligometastatic castration-sensitive prostate cancer (omCSPC). Most patients with bone metastatic (BM) omCSPC recur with additional bone disease after MDT. We hypothesized the BM-targeting alpha-emitter radium-223 dichloride (Ra223) could target subclinical bone disease and delay progression.</p><p><strong>Methods: </strong>This is an investigator-initiated, multicenter, open-label phase II RCT. Eligible men with recurrent omCSPC with ≥one bone metastasis (≤three on conventional imaging and/or ≤five on molecular imaging) were randomly assigned (1:1) to stereotactic ablative radiation (SABR) MDT alone or SABR MDT with Ra223 (six cycles). Primary end point was composite PFS.</p><p><strong>Results: </strong>From August 9, 2019, to March 2, 2023, 64 patients were randomly assigned, 33 to SABR MDT and 31 to SABR MDT/Ra223 balancing for key covariates. Most SABR MDT/Ra223 patients (87%) received six cycles of Ra223. The median PFS was 11.8 months with SABR MDT and 10.5 months with SABR MDT/Ra223 (adjusted hazard ratio [aHR], 1.42 [95% CI, 0.79 to 2.56]; <i>P</i> = .24). Seven patients (11%) experienced grade 3 treatment-related adverse events (no grade 4 or 5), 2 of 33 (6%) with SABR and 5 of 30 (17%) with SABR MDT/Ra223. Patients with high-risk (HiRi) pathogenic mutations in <i>ATM</i>, <i>BRCA1/2</i>, <i>RB1</i>, or <i>TP53</i> had worse PFS (HR, 5.95 [95% CI, 1.83 to 19.3]; <i>P</i> = .003). Greater T-cell receptor (TCR) unique productive rearrangements were prognostic for improved PFS independent of the treatment arm (aHR, 0.45 [95% CI, 0.21 to 0.96]; <i>P</i> = .04).</p><p><strong>Conclusion: </strong>Adding Ra223 to SABR MDT in BM omCSPC does not delay progression of disease. We provide evidence for an HiRi mutational signature and TCR repertoire as prognostic biomarkers in omCSPC treated with SABR MDT, highlighting the importance of collecting biological correlates in RCTs for omCSPC.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2500131"},"PeriodicalIF":42.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016688","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}
引用次数: 0
Development and Validation of a Novel Prediction Model for Hearing Loss From Cisplatin Chemotherapy. 顺铂化疗导致听力损失的新预测模型的建立和验证。
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-05 DOI: 10.1200/JCO-24-01861
Joshua Millstein, Shahrad R Rassekh, Austin L Brown, Qi Nie, Adam J Esbenshade, Kristin R Knight, Michael E Scheurer, Lillian Sung, Beth Brooks, Diana J Moke, Colin J D Ross, Michael Wright, Victoria Mena, Teresa Rushing, Bruce C Carleton, Etan Orgel
{"title":"Development and Validation of a Novel Prediction Model for Hearing Loss From Cisplatin Chemotherapy.","authors":"Joshua Millstein, Shahrad R Rassekh, Austin L Brown, Qi Nie, Adam J Esbenshade, Kristin R Knight, Michael E Scheurer, Lillian Sung, Beth Brooks, Diana J Moke, Colin J D Ross, Michael Wright, Victoria Mena, Teresa Rushing, Bruce C Carleton, Etan Orgel","doi":"10.1200/JCO-24-01861","DOIUrl":"https://doi.org/10.1200/JCO-24-01861","url":null,"abstract":"<p><strong>Purpose: </strong>Cisplatin treats many common tumors but causes permanent and debilitating hearing loss (HL). The objective of this study was to develop and externally validate a predictive model of HL in cisplatin-treated children and adolescent cancer survivors.</p><p><strong>Methods: </strong>The Pediatric Holistic Evaluation of Auditory Risk (PedsHEAR) model architecture used several machine learning approaches followed by an ensemble predictor. The primary end point was post-treatment communication-affecting HL (International Society of Pediatric Oncology Ototoxicity Scale [SIOP] Grade ≥2). PedsHEAR was developed from a multicenter data set of cisplatin-exposed patients up to 21 years old (1984-2017) and externally validated using data from the Children's Oncology Group ACCL05C1 study (2007-2012) and two combined institutional cohorts (1988-2022). The model predicts post-treatment HL in each patient (probability [%], 95% CI) and classifies patients as low, intermediate, or high risk for HL (probability HL <0.33, 0.33-0.60, >0.60, respectively).</p><p><strong>Results: </strong>In the training data set (n = 1,115, median age 6.3 years, SIOP Grade ≥2 HL 44%), PedsHEAR demonstrated excellent discrimination (AUC, 0.93 [95% CI, 0.92 to 0.95]) and then successfully validated within the internal (testing; AUC, 0.79 [95% CI, 0.74 to 0.85]) and two external validation cohorts (AUC, 0.74 and AUC, 0.67). In an aggregate validation cohort (n = 631), the model predicted the probability of HL (AUC, 0.76 [95% CI, 0.72 to 0.79]) and classified 22% (141/631), 71% (447/631), and 7% (43/631) of patients as low, intermediate, or high risk for HL.</p><p><strong>Conclusion: </strong>PedsHEAR predicted SIOP Grade ≥2 HL in pediatric cisplatin-treated patients. This is the first validated model to successfully predict cisplatin-induced HL in a broadly representative population treated with diverse regimens across a range of treatment settings.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2401861"},"PeriodicalIF":42.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994523","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}
引用次数: 0
Characteristics of Patients and Prognostic Factors Across Treatment Lines in Metastatic Colorectal Cancer: An Analysis From the Aide et Recherche en Cancérologie Digestive Database. 转移性结直肠癌患者的特点和预后因素:来自Aide et Recherche en canc<s:1> rologie消化数据库的分析。
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-05 DOI: 10.1200/JCO-24-01968
Jean-Baptiste Bachet, Aimery de Gramont, Morteza Raeisi, Manel Rakez, Richard M Goldberg, Niall C Tebbutt, Eric Van Cutsem, Daniel G Haller, J Randolph Hecht, Robert J Mayer, Stuart M Lichtman, Al B Benson, Alberto F Sobrero, Josep Tabernero, Richard Adams, John R Zalcberg, Axel Grothey, Takayuki Yoshino, Thierry André, Qian Shi, Benoist Chibaudel
{"title":"Characteristics of Patients and Prognostic Factors Across Treatment Lines in Metastatic Colorectal Cancer: An Analysis From the Aide et Recherche en Cancérologie Digestive Database.","authors":"Jean-Baptiste Bachet, Aimery de Gramont, Morteza Raeisi, Manel Rakez, Richard M Goldberg, Niall C Tebbutt, Eric Van Cutsem, Daniel G Haller, J Randolph Hecht, Robert J Mayer, Stuart M Lichtman, Al B Benson, Alberto F Sobrero, Josep Tabernero, Richard Adams, John R Zalcberg, Axel Grothey, Takayuki Yoshino, Thierry André, Qian Shi, Benoist Chibaudel","doi":"10.1200/JCO-24-01968","DOIUrl":"https://doi.org/10.1200/JCO-24-01968","url":null,"abstract":"<p><strong>Purpose: </strong>Several lines of treatment can be used sequentially in patients with metastatic colorectal cancer. We investigated the evolution of patient/tumor characteristics and their prognostic impact across treatment lines to develop an overall prognostic score (OPS).</p><p><strong>Patients and methods: </strong>Individual patient data from 48 randomized trials were analyzed. The end point was overall survival (from random assignment to death). Missing data were imputed. The complete data set was then separated into construction (80%) and validation sets (20%). The Cox's model was used to define risk groups for survival using the OPS. The discrimination capability was assessed in each treatment-line via bootstrapping to obtain optimism-corrected calibration and discrimination C-indices. Internal validation was done in the validation set.</p><p><strong>Results: </strong>A total of 37,560 patients (26,974 in first-line [1L], 7,693 in second-line [2L], and 2,893 in third-line [3L]) were analyzed. Some clinical, biological, and molecular characteristics of patients/tumors included in therapeutic trials evolve over the lines. Seven independent prognostic variables were retained in the final multivariate model common to all lines: Eastern Cooperative Oncology Group performance status, hemoglobin, platelet count, WBC/absolute neutrophil count ratio, lactate dehydrogenase, alkaline phosphatase, and the number of metastatic sites. The OPS was used to define four patient subgroups with significantly different prognoses in 1L, 2L, and 3L, separately, with adequate C-indices: 0.65, 0.66, and 0.69 in the construction set and 0.65, 0.66, and 0.68 in the validation set, respectively. The OPS was not predictive, with 3L drugs (<i>v</i> placebo) or subsequent line (2L/1L or 3L/2L) extending survival in all prognostic groups.</p><p><strong>Conclusion: </strong>The same prognostic model using practical variables can be used before all treatment lines. The OPS could better stratify patients in future clinical trials and help to therapeutic decision in routine practice.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"JCO2401968"},"PeriodicalIF":42.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010153","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}
引用次数: 0
Breast, Colorectal, and Pancreatic Cancer Mortality With Pathogenic Variants in ATM, CHEK2, or PALB2. 与ATM、CHEK2或PALB2致病变异有关的乳腺癌、结直肠癌和胰腺癌死亡率。
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-01 Epub Date: 2025-02-28 DOI: 10.1200/JCO-24-02442
Christine M Veenstra, Paul Abrahamse, Ann S Hamilton, Kevin C Ward, Scarlett L Gomez, Lihua Liu, Steven J Katz, Timothy P Hofer, Allison W Kurian
{"title":"Breast, Colorectal, and Pancreatic Cancer Mortality With Pathogenic Variants in <i>ATM</i>, <i>CHEK2</i>, or <i>PALB2</i>.","authors":"Christine M Veenstra, Paul Abrahamse, Ann S Hamilton, Kevin C Ward, Scarlett L Gomez, Lihua Liu, Steven J Katz, Timothy P Hofer, Allison W Kurian","doi":"10.1200/JCO-24-02442","DOIUrl":"10.1200/JCO-24-02442","url":null,"abstract":"<p><strong>Purpose: </strong>Oncologists encounter patients with pathogenic variants (PVs) in <i>ATM</i>, <i>CHEK2</i>, or <i>PALB2</i>, but little is known about their cancer mortality.</p><p><strong>Methods: </strong>Patients who were 20 years or older, diagnosed in 2013-2019 with breast, colorectal, or pancreatic cancer, and reported to SEER registries in California and Georgia were linked to germline genetic testing results from four clinical laboratories and followed through 2021. Multivariable models of cancer mortality were fit; for each cancer, the reference group was the average hazard across all genetically tested patients with that diagnosis. Each cancer was modeled separately, followed by a single model that interacted the cancer type with all covariates. In addition to fixed effects models, random effects models were used as a regularization approach to reduce overfitting.</p><p><strong>Results: </strong>A total of 70,272 tested patients with breast (48,473 estrogen receptor-/progesterone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative; 9,957 HER2-positive; 11,842 triple-negative) cancer, 5,822 with colorectal cancer, and 1,861 with pancreatic cancer were analyzed; the mean follow-up was 3.9 years. Patients with <i>ATM</i>, <i>CHEK2</i>, or <i>PALB2</i> PVs had no differences in breast, colorectal, or pancreatic cancer mortality. Patients with <i>ATM</i> PVs in triple-negative breast cancer appeared to have higher mortality in fixed effects models (hazard ratio [HR], 3.7 [95% CI, 1.8 to 7.8]), but not in random effects models (HR, 1.2 [95% CI, 0.8 to 1.6]) that reduce overfitting. Patients with <i>BRCA1</i>/<i>2</i> PVs had lower triple-negative breast cancer mortality in both models (fixed HR, 0.6 [95% CI, 0.5 to 0.9], random HR, 0.7 [95% CI, 0.6 to 0.8]). Patients with Lynch syndrome gene PVs had lower colorectal cancer mortality in both models (fixed HR, 0.5 [95% CI, 0.4 to 0.8], random HR, 0.7 [95% CI, 0.5 to 0.9]).</p><p><strong>Conclusion: </strong>Patients with <i>ATM</i>, <i>CHEK2</i>, or <i>PALB2</i> PVs had similar breast, colorectal, and pancreatic cancer mortality to the average genetically tested patient with their cancer type.</p>","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1587-1596"},"PeriodicalIF":42.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527809","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}
引用次数: 0
Erratum: Health-Related Quality of Life in Transplant-Ineligible Patients With Newly Diagnosed Multiple Myeloma: Findings From the Phase III MAIA Trial. 不适合移植的新诊断多发性骨髓瘤患者的健康相关生活质量:来自III期MAIA试验的发现。
IF 42.1 1区 医学
Journal of Clinical Oncology Pub Date : 2025-05-01 Epub Date: 2025-03-26 DOI: 10.1200/JCO-25-00558
Aurore Perrot, Thierry Facon, Torben Plesner, Saad Z Usmani, Shaji Kumar, Nizar J Bahlis, Cyrille Hulin, Robert Z Orlowski, Hareth Nahi, Peter Mollee, Karthik Ramasamy, Murielle Roussel, Arnaud Jaccard, Michel Delforge, Lionel Karlin, Bertrand Arnulf, Ajai Chari, Jianming He, Kai Fai Ho, Rian Van Rampelbergh, Clarissa M Uhlar, Jianping Wang, Rachel Kobos, Katharine S Gries, John Fastenau, Katja Weisel
{"title":"Erratum: Health-Related Quality of Life in Transplant-Ineligible Patients With Newly Diagnosed Multiple Myeloma: Findings From the Phase III MAIA Trial.","authors":"Aurore Perrot, Thierry Facon, Torben Plesner, Saad Z Usmani, Shaji Kumar, Nizar J Bahlis, Cyrille Hulin, Robert Z Orlowski, Hareth Nahi, Peter Mollee, Karthik Ramasamy, Murielle Roussel, Arnaud Jaccard, Michel Delforge, Lionel Karlin, Bertrand Arnulf, Ajai Chari, Jianming He, Kai Fai Ho, Rian Van Rampelbergh, Clarissa M Uhlar, Jianping Wang, Rachel Kobos, Katharine S Gries, John Fastenau, Katja Weisel","doi":"10.1200/JCO-25-00558","DOIUrl":"10.1200/JCO-25-00558","url":null,"abstract":"","PeriodicalId":15384,"journal":{"name":"Journal of Clinical Oncology","volume":" ","pages":"1615"},"PeriodicalIF":42.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730015","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}
引用次数: 0
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