Journal of the National Comprehensive Cancer Network最新文献

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Current and Emerging Biomarkers: Impact on Risk Stratification for Neuroblastoma. 当前和新兴的生物标记物:对神经母细胞瘤风险分层的影响。
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-08-01 DOI: 10.6004/jnccn.2024.7051
Meredith S Irwin, Kelly C Goldsmith
{"title":"Current and Emerging Biomarkers: Impact on Risk Stratification for Neuroblastoma.","authors":"Meredith S Irwin, Kelly C Goldsmith","doi":"10.6004/jnccn.2024.7051","DOIUrl":"10.6004/jnccn.2024.7051","url":null,"abstract":"<p><p>Neuroblastoma has heterogenous clinical presentations that are reflected by several well-defined clinical factors and biomarkers. Combinations of these clinical and biologic prognostic factors have been used for decades to generate classifiers to stratify patients into risk groups (low, intermediate, and high), which in turn are used to inform and tailor treatment as reported in the new NCCN Clinical Practice Guidelines in Oncology for Neuroblastoma. Risk classification uses clinical features, such as age and tumor stage, along with the most significant prognostic tumor biomarkers, including histologic features (differentiation and mitosis-karyorrhexis index), MYCN amplification status, chromosomal copy number alterations (segmental or numerical), and ploidy (DNA content). Recent next-generation sequencing approaches have identified additional tumor-specific genetic factors that have potential roles as prognostic and predictive biomarkers. These emerging biomarkers include telomerase maintenance mechanisms, such as telomerase reverse transcription (TERT) expression and alternative lengthening of telomeres (ALT) status. Somatic alterations of genes, including mutations in the anaplastic lymphoma kinase gene ALK, detected in >10% of patients with newly diagnosed disease, have both prognostic and predictive roles in determining eligibility for targeted therapies (eg, ALK tyrosine kinase inhibitors). In addition to diagnostic tumor-derived biomarkers, significant effort is being directed toward identification of markers to predict response to chemotherapy and immunotherapies. With the increasing use of GD2-containing immunotherapy regimens, efforts are aimed at identifying host or tumor microenvironment immune correlatives that can serve as predictive biomarkers. Understanding the potential role of liquid biopsies as biomarkers during and following treatment, including sequential circulating tumor DNA or tumor-specific mRNA transcripts, is expected to enhance the ability to predict recurrences and also inform understanding of tumor evolution and therapy resistance. These and other emerging biomarkers will lead to refinement and optimization of future neuroblastoma risk classification systems.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":"22 6","pages":""},"PeriodicalIF":14.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Care Patterns and Barriers to Outpatient Care for Adults With AML Following Intensive Chemotherapy at NCCN Member Institutions. NCCN 成员机构为接受强化化疗的急性髓细胞性白血病成人患者提供的护理模式和门诊护理障碍。
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-30 DOI: 10.6004/jnccn.2024.7026
Anna B Halpern, Jessica M Sugalski, Lindsey Bandini, Megan Othus, F Marc Stewart, Roland B Walter
{"title":"Care Patterns and Barriers to Outpatient Care for Adults With AML Following Intensive Chemotherapy at NCCN Member Institutions.","authors":"Anna B Halpern, Jessica M Sugalski, Lindsey Bandini, Megan Othus, F Marc Stewart, Roland B Walter","doi":"10.6004/jnccn.2024.7026","DOIUrl":"10.6004/jnccn.2024.7026","url":null,"abstract":"<p><strong>Background: </strong>Prolonged hospitalization following intensive (re)induction chemotherapy for acute myeloid leukemia (AML), while standard, is costly and resource intense, limits inpatient bed capacity, and negatively impacts quality of life. Early hospital discharge (EHD) following completion of chemotherapy has proven safe as an alternative at select institutions, but is not widely implemented.</p><p><strong>Patients and methods: </strong>From February 2023 through May 2023, the NCCN Best Practices Committee conducted a survey evaluating AML hospitalization patterns, care models, and barriers to EHD at its 33 member institutions.</p><p><strong>Results: </strong>A total of 30 (91%) institutions completed the survey; two-thirds treat >100 patients with AML annually and 45% treat more than half of these with intensive chemotherapy. In the (re)induction setting, 80% of institutions keep patients hospitalized until blood count recovery, whereas 20% aim to discharge patients after completion of chemotherapy if medically stable and logistically feasible. The predominant reasons for the perceived need for ongoing hospitalization were high risk of infection, treatment toxicities, and lack of nearby/accessible housing. There was no significant association between ability to practice EHD and annual AML volume or treatment intensity patterns (P=.60 and P=.11, respectively). In contrast, in the postremission setting, 87% of centers support patients following chemotherapy in the outpatient setting unless toxicities arise requiring readmission. Survey responses showed that 80% of centers were interested in exploring EHD after (re)induction but noted significant barriers, including accessible housing (71%), transportation (50%), high toxicity/infection rate (50%), high transfusion burden (50%), and limited bed availability for rehospitalization (50%).</p><p><strong>Conclusions: </strong>Hospitalization and care patterns following intensive AML therapy vary widely across major US cancer institutions. Although only 20% of surveyed centers practice EHD following intensive (re)induction chemotherapy, 87% do so following postremission therapy. Given the interest in exploring the EHD approach given potential advantages of EHD for both patients and health care systems, strategies to address identified medical and logistical barriers should be explored.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"469-474"},"PeriodicalIF":14.8,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Establishing Consensus for Mohs Micrographic Surgical Techniques in the Treatment of Melanoma in Situ for Future Clinical Trials: A Modified Delphi Study. 建立莫氏显微外科技术治疗原位黑色素瘤的共识,以利于未来的临床试验:改良德尔菲研究。
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-30 DOI: 10.6004/jnccn.2024.7036
Kristen K Curtis, Nathan J Fakult, Jennifer L Strunck, Sumaira Z Aasi, Christine S Ahn, Murad Alam, Anna A Bar, Ramona Behshad, Christopher K Bichakjian, Diana Bolotin, Susan L Boone, Jeremy S Bordeaux, Jerry D Brewer, David R Carr, John A Carucci, Jason R Castillo, Sean R Christensen, Melanie A Clark, Lindsey K Collins, Addison M Demer, Daniel B Eisen, Hao Feng, Bahar F Firoz, Roy C Grekin, Jason M Hirshburg, Todd E Holmes, Conway C Huang, Thomas A Jennings, Shang I Brian Jiang, Sailesh Konda, Justin J Leitenberger, Jesse M Lewin, Ian A Maher, Elise Ng, Ida F Orengo, Faramarz H Samie, Drew K Saylor, Victoria Rose Sharon, Teo Soleymani, Susan M Swetter, Jesalyn A Tate, Marta J Van Beek, Nahid Y Vidal, Alok Vij, Ashley Wysong, Yaohui Gloria Xu, Bryan T Carroll, Wesley Y Yu
{"title":"Establishing Consensus for Mohs Micrographic Surgical Techniques in the Treatment of Melanoma in Situ for Future Clinical Trials: A Modified Delphi Study.","authors":"Kristen K Curtis, Nathan J Fakult, Jennifer L Strunck, Sumaira Z Aasi, Christine S Ahn, Murad Alam, Anna A Bar, Ramona Behshad, Christopher K Bichakjian, Diana Bolotin, Susan L Boone, Jeremy S Bordeaux, Jerry D Brewer, David R Carr, John A Carucci, Jason R Castillo, Sean R Christensen, Melanie A Clark, Lindsey K Collins, Addison M Demer, Daniel B Eisen, Hao Feng, Bahar F Firoz, Roy C Grekin, Jason M Hirshburg, Todd E Holmes, Conway C Huang, Thomas A Jennings, Shang I Brian Jiang, Sailesh Konda, Justin J Leitenberger, Jesse M Lewin, Ian A Maher, Elise Ng, Ida F Orengo, Faramarz H Samie, Drew K Saylor, Victoria Rose Sharon, Teo Soleymani, Susan M Swetter, Jesalyn A Tate, Marta J Van Beek, Nahid Y Vidal, Alok Vij, Ashley Wysong, Yaohui Gloria Xu, Bryan T Carroll, Wesley Y Yu","doi":"10.6004/jnccn.2024.7036","DOIUrl":"10.6004/jnccn.2024.7036","url":null,"abstract":"<p><strong>Background: </strong>Mohs micrographic surgery (MMS) is a promising treatment modality for melanoma in situ (MIS). However, variations in surgical technique limit the generalizability of existing data and may impede future study of MMS in clinical trials.</p><p><strong>Methods: </strong>A modified Delphi method was selected to establish consensus on optimal MMS techniques for treating MIS in future clinical trials. The Delphi method was selected due to the limited current data, the wide range of techniques used in the field, and the intention to establish a standardized technique for future clinical trials. A literature review and interviews with experienced MMS surgeons were performed to identify dimensions of the MMS technique for MIS that (1) likely impacted costs or outcomes of the procedure, and (2) showed significant variability between surgeons. A total of 8 dimensions of technical variation were selected. The Delphi process consisted of 2 rounds of voting and commentary, during which 44 expert Mohs surgeons across the United States rated their agreement with specific recommendations using a Likert scale.</p><p><strong>Results: </strong>Five of eight recommendations achieved consensus in Round 1. All 3 of the remaining recommendations achieved consensus in Round 2. Techniques achieving consensus in Round 1 included the use of a starting peripheral margin of ≤5 mm, application of immunohistochemistry, frozen tissue processing, and resecting to the depth of subcutaneous fat. Consensus on the use of Wood's lamp, dermatoscope, and negative tissue controls was established in Round 2.</p><p><strong>Conclusions: </strong>This study generated 8 consensus recommendations intended to offer guidance for Mohs surgeons treating MIS. The adoption of these recommendations will promote standardization to facilitate comparisons of aggregate data in multicenter clinical trials.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Increasing Colorectal Screening Uptake in Spouses of Patients With Colorectal Cancer Using a Randomized Behavioral Trial. 通过随机行为试验提高结直肠癌患者配偶的结直肠癌筛查率
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-29 DOI: 10.6004/jnccn.2024.7018
Jerrald Lau, Lina Choe, Daphne Hui Juan Lee, Athena Ming-Gui Khoo, Wei-Ling Koh, Cherie Peh, Alyssa Ng, Tian-Zhi Lim, Bettina Lieske, Kuok-Chung Lee, Choon-Seng Chong, Choon-Sheong Seow, Christopher H L Keh, Jing-Yu Ng, Ker-Kan Tan
{"title":"Increasing Colorectal Screening Uptake in Spouses of Patients With Colorectal Cancer Using a Randomized Behavioral Trial.","authors":"Jerrald Lau, Lina Choe, Daphne Hui Juan Lee, Athena Ming-Gui Khoo, Wei-Ling Koh, Cherie Peh, Alyssa Ng, Tian-Zhi Lim, Bettina Lieske, Kuok-Chung Lee, Choon-Seng Chong, Choon-Sheong Seow, Christopher H L Keh, Jing-Yu Ng, Ker-Kan Tan","doi":"10.6004/jnccn.2024.7018","DOIUrl":"10.6004/jnccn.2024.7018","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is one of the few cancers for which screening has been associated with better survival and morbidity, but screening uptake has been underexplored in spouses of existing patients with CRC. The objective of this study was to evaluate whether a brief, structured behavioral intervention delivered to spouses of patients with CRC in a colorectal clinical setting could increase fecal immunochemical test (FIT) uptake within 3 months of the study period.</p><p><strong>Methods: </strong>This study was designed as a block randomized, unblinded, parallel trial conducted in the colorectal outpatient clinics of 2 public tertiary hospitals in Singapore from December 2017 to February 2023. The intervention group received a structured informational pamphlet on CRC screening by the Singapore Ministry of Health and a printed guide with instructions on how to properly use a FIT kit.</p><p><strong>Results: </strong>No significant differences in baseline characteristics were observed between the 2 groups. There was a statistically significant difference (P<.001) in FIT screening uptake between spouses in each group, with 86.2% (n=25) in the intervention group and 38.7% (n=12) in the control group.</p><p><strong>Conclusions: </strong>Our study demonstrated that a brief, structured behavioral intervention offered to spouses accompanying patients with CRC while they wait for the clinic appointment is useful in increasing FIT screening uptake rates. Colorectal clinics can consider setting aside 10 to 15 minutes to educate accompanying spouses in the future as a complementary avenue to holistically promote CRC prevention, subjected to the resources available in each clinic.</p><p><strong>Clinicaltrials: </strong>gov identifier: NCT04544852.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Systemic Treatment Strategies and Outcomes of Patients With Synchronous Peritoneal Metastases of Gastric Origin: A Nationwide Population-Based Study. 胃源性腹膜同步转移患者的系统治疗策略和疗效:一项基于全国人口的研究。
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-29 DOI: 10.6004/jnccn.2024.7013
Niels A D Guchelaar, Bo J Noordman, Marion W Welten, Myron T van Santen, Micha J de Neijs, Stijn L W Koolen, Rob H A Verhoeven, Esther Oomen-de Hoop, Pieter C van der Sluis, Sjoerd M Lagarde, Hanneke W M van Laarhoven, Ignace H J T de Hingh, Geert-Jan Creemers, Bianca Mostert, Bas P L Wijnhoven, Ron H J Mathijssen
{"title":"Systemic Treatment Strategies and Outcomes of Patients With Synchronous Peritoneal Metastases of Gastric Origin: A Nationwide Population-Based Study.","authors":"Niels A D Guchelaar, Bo J Noordman, Marion W Welten, Myron T van Santen, Micha J de Neijs, Stijn L W Koolen, Rob H A Verhoeven, Esther Oomen-de Hoop, Pieter C van der Sluis, Sjoerd M Lagarde, Hanneke W M van Laarhoven, Ignace H J T de Hingh, Geert-Jan Creemers, Bianca Mostert, Bas P L Wijnhoven, Ron H J Mathijssen","doi":"10.6004/jnccn.2024.7013","DOIUrl":"10.6004/jnccn.2024.7013","url":null,"abstract":"<p><strong>Background: </strong>Palliative systemic treatment is currently standard of care for metastatic gastric cancer. However, patients with peritoneal metastases of gastric origin are often underrepresented in clinical studies due to unmeasurable radiologic disease. This study describes the systemic treatment strategies and outcomes in patients with peritoneal metastases in a nationwide real-world setting.</p><p><strong>Methods: </strong>Patients with gastric adenocarcinoma and synchronous peritoneal metastases (with or without other metastases) diagnosed in the Netherlands between 2015 and 2020 were identified from the nationwide Netherlands Cancer Registry. Median overall survival (OS) and time-to-treatment failure were determined and multivariable Cox regression analyses were used to compare treatment groups, corrected for relevant tumor and patient characteristics.</p><p><strong>Results: </strong>In total, 1,972 patients were included, of whom 842 (43%) were treated with palliative systemic therapy. The majority received capecitabine + oxaliplatin (CAPOX; 44%), followed by fluorouracil/leucovorin/oxaliplatin (FOLFOX; 19%), and epirubicin + capecitabine + oxaliplatin (EOX; 8%). Of the 99 (45%) patients who received second-line systemic treatment, ramucirumab + paclitaxel were administered most frequently (63%). After adjustment for sex, age, comorbidities, performance status, tumor location, Lauren classification, and the presence of metastases outside of the peritoneum, patients treated with a triplet containing docetaxel and those treated with a regimen containing trastuzumab had a significantly longer OS compared with patients treated with a doublet containing a fluoropyrimidine derivate + oxaliplatin (hazard ratio [HR], 0.69; 95% CI, 0.52-0.91, and HR, 0.68; 95% CI, 0.51-0.91, respectively). Monotherapy was associated with a shorter OS (HR, 2.08, 95% CI, 1.53-2.83).</p><p><strong>Conclusions: </strong>There is substantial heterogeneity in systemic treatment choices in patients with gastric cancer and peritoneal metastases in the Netherlands. In this study, patients treated with triplets containing docetaxel and with trastuzumab-containing regimens survived longer than patients who received doublet therapy. Despite this, median OS for all treatment groups remained below one year.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"405-412"},"PeriodicalIF":14.8,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
The Impact of Adjuvant Chemotherapy on the Long-Term Prognosis of Breast Malignant Phyllodes Tumors: A Propensity Score-Matched Study. 辅助化疗对乳腺恶性植物瘤长期预后的影响:倾向评分匹配研究
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-29 DOI: 10.6004/jnccn.2024.7023
Zilin Zhuang, Ailifeire Yilihamu, Zhihua Li, Rong Lei, Xun Li, Mengjia Han, Wei Wei, Guangxin Li, Zhen Ma, Yulu Zhang, Hui Hu, Xiaoyun Xiao, Yan Nie
{"title":"The Impact of Adjuvant Chemotherapy on the Long-Term Prognosis of Breast Malignant Phyllodes Tumors: A Propensity Score-Matched Study.","authors":"Zilin Zhuang, Ailifeire Yilihamu, Zhihua Li, Rong Lei, Xun Li, Mengjia Han, Wei Wei, Guangxin Li, Zhen Ma, Yulu Zhang, Hui Hu, Xiaoyun Xiao, Yan Nie","doi":"10.6004/jnccn.2024.7023","DOIUrl":"10.6004/jnccn.2024.7023","url":null,"abstract":"<p><strong>Background: </strong>Malignant phyllodes tumors (MPTs) are rare breast tumors with high risks of local recurrence and distant metastasis. Surgical intervention is the primary treatment, but the effectiveness of adjuvant therapies is uncertain. This study was designed to analyze the prognostic risk factors associated with MPTs and evaluate the efficacy of postoperative adjuvant chemotherapy.</p><p><strong>Patients and methods: </strong>Patients who were first diagnosed with MPT without distant metastasis and received R0 resection surgery between 1999 and 2023 were included in the present study and stratified into 2 groups: chemotherapy and nonchemotherapy groups. Propensity score matching (PSM) was used to balance baseline characteristics between groups. Kaplan-Meier curves were used to estimate local recurrence-free survival (LRFS) and overall survival (OS). Cox proportional hazards analyses (univariate and multivariate) were conducted to identify prognostic risk factors.</p><p><strong>Results: </strong>We conducted a study involving 145 patients, 31 of whom underwent a total of 12 different chemotherapy regimens following initial surgical resection. Most patients received chemotherapy regimens primarily consisting of anthracyclines, including anthracycline + ifosfamide (AI) or anthracycline + cyclophosphamide/docetaxel (AC-T) regimens. After a median follow-up of 54.5 months, 37 (25.5%) patients experienced local recurrence and 24 (16.6%) experienced distant metastasis. No significant difference was detected in the rates of local recurrence or distant metastasis between the 2 groups. Axillary lymph node positivity was the only risk factor for LRFS, whereas older age, larger tumors, axillary lymph node positivity, local recurrence, and distant metastasis were significantly associated with worse OS. Chemotherapy did not emerge as a protective factor for LRFS (P=.501) or OS (P=.854). After PSM, patients in the chemotherapy group did not exhibit better 5-year LRFS (P=.934) or 5-year OS (P=.328).</p><p><strong>Conclusions: </strong>According to our retrospective evaluation, postoperative adjuvant chemotherapy was not associated with improved survival in patients with MPTs without distant metastasis.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
21-Gene Recurrence Score and Survival Outcomes in the Phase III Multicenter TAILORx Clinical Trial. 21 基因复发评分与 TAILORx III 期多中心临床试验的生存结果。
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-17 DOI: 10.6004/jnccn.2024.7008
Sherry X Yang, John Yu, Molin Wang
{"title":"21-Gene Recurrence Score and Survival Outcomes in the Phase III Multicenter TAILORx Clinical Trial.","authors":"Sherry X Yang, John Yu, Molin Wang","doi":"10.6004/jnccn.2024.7008","DOIUrl":"10.6004/jnccn.2024.7008","url":null,"abstract":"<p><strong>Background: </strong>Recurrence score (RS) based on a 21-gene genomic assay is frequently used to estimate risk of distant recurrence for choice of adjuvant chemotherapy in breast cancer. It remains unclear whether RS is an independent prognostic factor for breast cancer-specific survival (BCSS) and overall survival (OS) in the TAILORx trial population.</p><p><strong>Methods: </strong>We evaluated the association of RS with BCSS and OS plus recurrence-free interval (RFI) and invasive disease-free survival (DFS) using multivariable Cox proportional hazards regression analysis, adjusting for clinicopathologic measures, in 8,916 patients with hormone receptor-positive, HER2-negative, node-negative breast cancer. Likelihood ratio (LR) test was used to assess the relative amount of prognostic information provided by RS to BCSS, OS, RFI, and DFS, comparatively.</p><p><strong>Results: </strong>Event rates for BCSS, OS, RFI, and DFS were 1.7%, 5.2%, 5.6%, and 12.6%, respectively, by up to 11.6 years of follow-up. Compared with low-range RS (0-10), patients with midrange (11-25) and high-range (26-100) RS had inferior BCSS (adjusted hazard ratio [aHR], 5.12 [95% CI, 2.09-16.92] and 8.03 [95% CI, 2.91-28.47], respectively) and RFI (aHR, 1.68 [95% CI, 1.23-2.36] and 3.05 [95% CI, 2.02-4.67], respectively), independent of clinicopathologic factors. High-range score was associated with an increased risk of DFS (aHR, 1.56 [95% CI, 1.20-2.04]) but not significantly associated with OS (aHR, 1.44 [95% CI, 0.95-2.18]). Midrange score was associated with neither DFS (aHR, 1.15 [95% CI, 0.96-1.38]) nor OS (HR 1.14 [95% CI, 0.87-1.52]). LR-χ2 values were 83.0 and 65.1 for RFI and BCSS, respectively, and 17.5 and 33.6 for OS and DFS, respectively (P<.0001).</p><p><strong>Conclusions: </strong>RS is an independent measure for BCSS and recurrence prognoses relative to OS in early-stage breast cancer. It carries more prognostic information for breast cancer-specific outcomes.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"376-381"},"PeriodicalIF":14.8,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Patient-Reported Quality of Life at Diagnosis in Adolescent and Young Adults With Cancer. 青少年癌症患者在确诊时的生活质量报告。
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-12 DOI: 10.6004/jnccn.2024.7012
Goldy C George, Clark Andersen, Xiaohui Tang, Elizabeth Rodriguez, Midhat Jafry, Maria C Swartz, Sairah Ahmed, Carlos H Barcenas, J Andrew Livingston, Michael E Roth, Michelle A T Hildebrandt
{"title":"Patient-Reported Quality of Life at Diagnosis in Adolescent and Young Adults With Cancer.","authors":"Goldy C George, Clark Andersen, Xiaohui Tang, Elizabeth Rodriguez, Midhat Jafry, Maria C Swartz, Sairah Ahmed, Carlos H Barcenas, J Andrew Livingston, Michael E Roth, Michelle A T Hildebrandt","doi":"10.6004/jnccn.2024.7012","DOIUrl":"10.6004/jnccn.2024.7012","url":null,"abstract":"<p><strong>Background: </strong>The overall landscape of health-related quality of life (HRQoL) has not been thoroughly investigated in adolescents and young adults (AYAs) with cancer. Data are also lacking on how well HRQoL at the time of cancer diagnosis can prognosticate long-term survival in AYA survivors.</p><p><strong>Patients and methods: </strong>We included 3,497 survivors of AYA cancer (age 15-39 years at diagnosis) who completed the Short-Form 12 Health Survey (SF-12) HRQoL questionnaire at diagnosis. Physical component summary (PCS) and mental component summary (MCS) scores were generated, with scores <50 representing poor HRQoL. Differences in HRQoL by patient characteristics and tumor type were investigated using violin plots and t tests/analysis of variance. The effect of HRQoL on overall survival was assessed using Kaplan-Meier plots and Cox proportional hazards models.</p><p><strong>Results: </strong>Overall mean PCS and MCS scores in this racially/ethnically diverse cohort (64% White, 19% Hispanic, 10% Black, and 7% other race/ethnicity) were 43.6 and 46.7, respectively. Women with breast cancer reported the most favorable PCS (50.8), and those with cervical cancer reported the lowest MCS (42.8). Age at diagnosis was associated positively with PCS (P<.001) and inversely with MCS (P<.001). Females had higher PCS yet lower MCS than males (both P<.001). Marginalized racial and ethnic populations reported lower PCS than White patients (P<.001). Physical and mental HRQoL were prognostic and associated with increased risk of poor survival (hazard ratio, 1.95; 95% CI, 1.72-2.21 for physical HRQoL, and 1.26; 95% CI, 1.13-1.40 for mental HRQoL).</p><p><strong>Conclusions: </strong>Physical and mental HRQoL at diagnosis vary across patient characteristics in AYA cancer survivors. Poor HRQoL at diagnosis may be a prognosticator of diminished overall survival among AYA cancer survivors.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Chemotherapy-Induced Peripheral Neuropathy in Patients With Gastroesophageal Cancer. 胃食管癌患者化疗引起的周围神经病变
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-08 DOI: 10.6004/jnccn.2024.7014
Merel J M van Velzen, Marieke Pape, Mirjam A G Sprangers, Jessy Joy van Kleef, Bianca Mostert, Laurens V Beerepoot, Marije Slingerland, Elske C Gootjes, Ronald Hoekstra, Lonneke V van de Poll-Franse, Nadia Haj Mohammad, Hanneke W M van Laarhoven
{"title":"Chemotherapy-Induced Peripheral Neuropathy in Patients With Gastroesophageal Cancer.","authors":"Merel J M van Velzen, Marieke Pape, Mirjam A G Sprangers, Jessy Joy van Kleef, Bianca Mostert, Laurens V Beerepoot, Marije Slingerland, Elske C Gootjes, Ronald Hoekstra, Lonneke V van de Poll-Franse, Nadia Haj Mohammad, Hanneke W M van Laarhoven","doi":"10.6004/jnccn.2024.7014","DOIUrl":"10.6004/jnccn.2024.7014","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy for various stages of gastroesophageal cancer (GEC) is often neurotoxic. Chemotherapy-induced peripheral neuropathy (CIPN) impairs health-related quality of life (HRQoL). This study investigates the incidence and severity of CIPN and its association with HRQoL in patients with GEC.</p><p><strong>Patients and methods: </strong>Patients who received chemoradiotherapy or chemotherapy for GEC were identified from the Netherlands Cancer Registry. Patient-reported data (measured using the EORTC QLQ-CIPN20 and EORTC QLQ-C30) were collected through the Prospective Observational Cohort Study of Esophageal-Gastric Cancer Patients (POCOP) at baseline and at 3, 6, 9, 12, 18, and 24 months after treatment initiation. Linear mixed effects models were constructed to assess CIPN and the correlation between CIPN and HRQoL was analyzed using Spearman's correlation.</p><p><strong>Results: </strong>A total of 2,135 patients were included (chemoradiotherapy: 1,593; chemotherapy with curative intent: 295; palliative chemotherapy: 247). In all 3 treatment groups, CIPN significantly increased during treatment (adjusted mean score of CIPN at 6 months: chemoradiotherapy, 8.3 [baseline: 5.5]; chemotherapy with curative intent, 16.0 [baseline: 5.6]; palliative therapy, 25.4 [baseline: 10.7]). For chemoradiotherapy, the adjusted mean score continued to increase after treatment (24 months: 11.2). For chemotherapy with curative intent and palliative therapy, the adjusted mean score of CIPN decreased after treatment but did not return to baseline values. CIPN was negatively correlated with HRQoL in all treatment groups, although significance and strength of the correlation differed over time.</p><p><strong>Conclusions: </strong>Because of the poor prognosis of GEC, it is essential to consider side effects of (neurotoxic) treatment. The high prevalence and association with HRQoL indicate the need for early recognition of CIPN.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"455-461"},"PeriodicalIF":14.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Artificial Intelligence and Oncology. 人工智能与肿瘤学。
IF 14.8 2区 医学
Journal of the National Comprehensive Cancer Network Pub Date : 2024-07-01 DOI: 10.6004/jnccn.2024.0037
Daniel M Geynisman
{"title":"Artificial Intelligence and Oncology.","authors":"Daniel M Geynisman","doi":"10.6004/jnccn.2024.0037","DOIUrl":"10.6004/jnccn.2024.0037","url":null,"abstract":"","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":"22 5","pages":"277"},"PeriodicalIF":14.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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