Lancet Oncology最新文献

{"title":"Russia slashes federal cancer funding to spend on defence.","authors":"Sharmila Devi","doi":"10.1016/S1470-2045(26)00556-5","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00556-5","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194924","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":"Europe has fallen behind in number of oncology trials.","authors":"Elizabeth Gourd","doi":"10.1016/S1470-2045(26)00555-3","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00555-3","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194982","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":"Time to say goodbye to full-field digital mammography in population-based screening?","authors":"Lidewij M F H Neeter","doi":"10.1016/S1470-2045(26)00524-3","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00524-3","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148328","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":"Invasive interval breast cancer rates after digital breast tomosynthesis plus synthesised mammography versus digital mammography screening (TOSYMA): 24-month follow-up of the multicentre, open-label, randomised, controlled, superiority trial.","authors":"Stefanie Weigel, Hans-Werner Hense, Veronika Weyer-Elberich, Jörg Czwoydzinski, Thomas Decker, Hiltraud Kajüter, Florian Oesterling, Jasper Heilmann, Andreas Stang, Joachim Kieschke, Susanne Wienbeck, Oliver Stephan, Sonja Baier, Miriam Krischke, Alexander Sommer, Joachim Gerß, Walter Heindel","doi":"10.1016/S1470-2045(26)00341-4","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00341-4","url":null,"abstract":"<p><strong>Background: </strong>Despite high invasive breast cancer detection rates, the effectiveness of digital breast tomosynthesis screening is still uncertain. We aimed to compare the invasive interval cancer rates in women screened with digital breast tomosynthesis plus synthesised two-dimensional (s2D) mammography with those screened with digital mammography.</p><p><strong>Methods: </strong>TOSYMA is a multicentre, open-label, parallel-group, randomised, controlled, superiority trial done at 17 screening sites across two federal states in Germany. Women aged 50-70 years were randomly allocated (1:1) to digital breast tomosynthesis plus s2D mammography or digital mammography. The first primary endpoint of TOSYMA (TOSYMA-1) was the detection rate of invasive breast cancer and has been previously reported. The second primary endpoint (TOSYMA-2) was the invasive interval cancer rate, defined as the proportion of women who developed an invasive breast cancer in the 24-month interval after being negative at screening (ie, no ductal carcinoma in situ or invasive breast cancer detection) in TOSYMA-1. The primary endpoint was analysed in all participants with a negative screening result in TOSYMA-1. The cumulative incidence of invasive interval cancers at 12 months in screen-negative women was the prespecified secondary outcome. Suspected interval cancers were identified by data linkage to cancer registries. The study is registered on ClinicalTrials.gov (NCT03377036) and is closed to accrual but follow-up is ongoing.</p><p><strong>Findings: </strong>Between July 5, 2018, and Dec 30, 2020, 99 689 women were enrolled in TOSYMA-1 and 99 558 participants included in the modified full analysis set of TOSYMA-1. The median age was 57 years (IQR 53-62) in the TOSYMA-2 modified full analysis set and all participants were female. 49 299 (99·1%) of 49 762 women assigned digital breast tomosynthesis plus s2D mammography screened negative in TOSYMA-1, as were 49 456 (99·3%) of 49 796 women assigned digital mammography who had evaluable data and were included in the TOSYMA-2 modified full analysis set. Invasive interval cancers were detected in 70 of 49 299 women in the digital breast tomosynthesis plus s2D mammography group (invasive interval rate 14·2 cases per 10 000 women screened with a negative result) and in 92 of 49 456 women in the digital mammography group (18·6 cases per 10 000 women screened with a negative result; adjusted odds ratio [OR] 0·76 [95% CI 0·55-1·06]; p=0·11). Invasive interval cancers were detected within 12 months in 22 women in the digital breast tomosynthesis plus s2D mammography group (4·5 cases per 10 000 women screened with a negative result) and in 31 women in the digital mammography group (6·3 cases per 10 000 women screened with a negative result; OR 0·71 [95% CI 0·52-0·97]).</p><p><strong>Interpretation: </strong>TOSYMA-2 indicates that about a quarter of invasive interval cancers occurring with digital mammography over 2 year","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148347","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":"Impact of the Trump Administration on the Affordable Care Act.","authors":"Bryant Furlow","doi":"10.1016/S1470-2045(26)00540-1","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00540-1","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137213","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":"Neoadjuvant niraparib monotherapy for unresectable, homologous recombination deficiency-positive, high-grade serous ovarian cancer (NANT): a multicentre, single-arm, phase 2 trial.","authors":"Dan Liu, Zikun Peng, Wei Zhang, Cui Feng, Ping Wang, Jundong Li, Yuanjia Wen, Wanying Shan, Yu Xia, Huayi Li, Bingquan Li, Ronghua Liu, Mingfu Wu, Zhen Li, Rong Liu, Gang Chen, Ya Wang, Xiaofei Jiao, Xiao Li, Cheng Liu, Rutie Yin, Shengtao Zhou, Maomao Li, Zhifeng Xia, Yu Dong, Shanyang He, Yi Huang, Kun Song, Li Hong, Ding Ma, Yong Fang, Qinglei Gao","doi":"10.1016/S1470-2045(26)00387-6","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00387-6","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy followed by interval debulking surgery is standard treatment for advanced ovarian cancer that is unlikely to achieve optimal cytoreduction. We aimed to evaluate a chemotherapy-free regimen of neoadjuvant niraparib monotherapy in homologous recombination deficiency (HRD)-positive disease initially unsuitable for primary debulking surgery.</p><p><strong>Methods: </strong>This single-arm, phase 2 trial was conducted at six tertiary hospitals in China. Eligible patients were aged 18-75 years, had treatment-naïve, FIGO stage III-IV HRD-positive high-grade serous or endometrioid ovarian cancer, an ECOG performance status of 0-2, with a low likelihood of complete primary debulking surgery based on prespecified criteria. Patients received oral niraparib monotherapy for two 28-day cycles with an individualised starting dose of 200 mg or 300 mg. Protocol-permitted supportive care was provided as clinically indicated. Co-primary endpoints were investigator-assessed objective response rate in the response-evaluable population and R0 resection rate after interval debulking surgery in the operated population. Safety was assessed in all patients who received at least one dose of niraparib. The trial was registered with ClinicalTrials.gov (NCT04507841), is closed to enrolment, and this report presents the primary analysis.</p><p><strong>Findings: </strong>Between Jan 8, 2021, and Jul 18, 2023, 127 patients were screened, and 67 were enrolled into the study. All enrolled patients were female and self-identified as Han Chinese (median age 55 years [IQR 50-62]). At the data cutoff (Dec 29, 2025), median follow-up was 37·7 months (IQR 31·8-48·5). Among 48 response-evaluable patients, 30 achieved an objective response, with an objective response rate of 63% (95% CI 47-76). Among 40 operated patients, 32 achieved R0 resection, with an R0 resection rate of 80% (95% CI 64-91). The most common grade 3-4 treatment-related adverse events were thrombocytopenia in 32 (48%) of 67 patients, leukopenia in 13 (19%) patients, anaemia in 12 (18%) patients, and neutropenia in nine (13%) patients. Serious adverse events occurred in 19 (28%) patients. No treatment-related deaths occurred.</p><p><strong>Interpretation: </strong>Neoadjuvant niraparib showed anti-tumour activity and enabled R0 resection in selected patients with HRD-positive advanced ovarian cancer who were initially unsuitable for primary debulking surgery. This strategy remains investigational and requires randomised validation against standard platinum-taxane neoadjuvant chemotherapy.</p><p><strong>Funding: </strong>National Key Technology Research and Development Program of China, National Natural Science Foundation of China, Natural Science Foundation of Hubei Province, Innovative Drug Research and Development National Science and Technology Major Project, and Zai Lab (Shanghai).</p><p><strong>Translation: </strong>For the Chinese translation of the abstract ","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127999","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":"Blank spaces on the map: genomics for global cancer research.","authors":"David J Adams, Sarah Moody, C Daniela Robles-Espinoza","doi":"10.1016/S1470-2045(26)00460-2","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00460-2","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"1209-1210"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075159","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":"Proton pump inhibitors and durvalumab in PACIFIC.","authors":"Marjolein Metselaar-Albers, Lourens Bloem, Dorieke van Balen, Karijn Suijkerbuijk, Arief Lalmohamed","doi":"10.1016/S1470-2045(26)00402-X","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00402-X","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"e446"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075220","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":"Not all thoracic micronodules are metastases.","authors":"Catherine A Murphy, Lee Fidler, Jason Robins, Isaac Yang, Katarzyna J Jerzak","doi":"10.1016/S1470-2045(26)00447-X","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00447-X","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"e532"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075225","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":"Development and external validation of a new prognostic model for metastatic clear cell renal cell carcinoma: a preregistered analysis using data from randomised clinical trials in the checkpoint inhibitor era.","authors":"Anke Richters, Marinde J G Bond, Hans M Westgeest, Berna C Özdemir, Johanna A A Damen, Katja K H Aben, Axel Bex","doi":"10.1016/S1470-2045(26)00338-4","DOIUrl":"10.1016/S1470-2045(26)00338-4","url":null,"abstract":"<p><strong>Background: </strong>Prognostic classification of patients with metastatic clear cell renal cell carcinoma (mccRCC) is instrumental for clinical trials and treatment decisions. Hence, optimal performance of prognostic models is crucial. This study aimed to develop and externally validate the new Clinical Prognostic Index in the Checkpoint Inhibitor era (CPI2) model using clinical trial data, and to externally validate the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model.</p><p><strong>Methods: </strong>Individual patient data from the clinical trials CheckMate-214 and CheckMate-9ER were used for development and external validation of the CPI2 model, respectively. Both trials included previously untreated mccRCC patients of all IMDC prognostic groups and Karnofsky performance status of at least 70%, and randomly allocated them to receive either sunitinib or nivolumab plus ipilimumab (CheckMate-214) or nivolumab plus cabozantinib (CheckMate-9ER). Using a Cox proportional hazards model, predictors were selected from a list of patient, disease, and laboratory parameters using Akaike information criterion-based backwards selection. Bootstrapping was used to estimate coefficients and a shrinkage factor to correct for optimism. Calibration plots and Uno's C-index for discriminative accuracy were calculated for the CPI2 model and IMDC model in both trial populations.</p><p><strong>Findings: </strong>Data from 1096 patients included in CheckMate-214 between October, 2014, and February, 2016, and 651 patients included in CheckMate-9ER between September, 2017, and May, 2019, were used. Median follow-up was 40 months (IQR 13-94) in CheckMate-214 data and 38 months (15-53) in CheckMate-9ER data. In total, 665 (38%) of 1747 patients were aged 65 years or older; 1289 (74%) were male, and 458 (26%) were female. A prognostic model based on age, Karnofsky performance status, previous nephrectomy, metastatic locations (liver, lung, bone, and lymph node), and seven laboratory parameters (calcium, alkaline phosphatase, albumin, lactate dehydrogenase, absolute neutrophil count, lymphocyte count, and white blood cell count) was developed based on CheckMate-214 data. Classification into three prognostic groups provided discriminative accuracy at 36 months of 0·72 (95% CI 0·69-0·75) in CheckMate-214 and 0·72 (0·68-0·76) in CheckMate-9ER, which was 0·65 (0·62-0·68) and 0·61 (0·57-0·65) for the IMDC classification, respectively. Calibration showed adequate agreement between predicted and observed mortality risks. PD-L1 expression did not improve prognostic accuracy. CPI2 favourable, intermediate, and poor risk groups included 472 (43%), 366 (33%), and 258 (24%) of 1096 CheckMate-214 patients and 257 (39%), 196 (30%), and 198 (30%) of 651 CheckMate-9ER patients, respectively.</p><p><strong>Interpretation: </strong>The CPI2 model, using 14 readily available clinical parameters, demonstrated improvement in discriminative accuracy compa","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1295-1303"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920223","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}