Lancet Oncology最新文献

{"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}

{"title":"Affordability in the era of precision oncology.","authors":"Deirdre Weymann, Dean A Regier","doi":"10.1016/S1470-2045(26)00436-5","DOIUrl":"10.1016/S1470-2045(26)00436-5","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1206-1207"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060892","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":"Accelerating equitable cancer genomics and precision oncology in health care and research: a Lancet Oncology Commission.","authors":"Raffaella Casolino, Joaquin Mateo, Elisabeth G E de Vries, Amber Johns, Melanie Courtot, Rita T Lawlor, Sandra Perdomo, Stacy W Gray, Raquel Perez-Lopez, Clare Turnbull, David Torrents, Kerstin Noelle Vokinger, Dilara Akhoundova, Jean-Marc Bourque, Andrés F Cardona, Yoon Jung Chang, Debyani Chakravarty, Ievgeniia Chicherova, Karen Ann Cranston, Melissa Davis, Amanda Drury, Oskar Frisell, Raquel Manzano Garcia, Robert L Grossman, Yosr Hamdi, Simon Hediger, Thomas Hofmarcher, Oliver Hofmann, Jakob Nikolas Kather, Hannah Kim, Kazuto Kato, Bartha Maria Knoppers, Kjong-Van Lehmann, Dilani Lokuhetty, Patricia M LoRusso, Deborah Mascalzoni, Nicola Mulder, Travis Osterman, Folakemi Odedina, Aparna R Parikh, Solomon Rotimi, Brian Rous, Shawn Sweeney, Bhawna Sirohi, Zbyslaw Sondka, Ciara Staunton, Kjetil Taskén, Alex Wagner, C Benedikt Westphalen, Jianmin Wu, Joly Yann, Ma'n H Zawati, Andrew V Biankin, Takayuki Yoshino, Lincoln Stein, Mark Lawler","doi":"10.1016/S1470-2045(26)00302-5","DOIUrl":"10.1016/S1470-2045(26)00302-5","url":null,"abstract":"<p><p>Cancer genomics and precision oncology are increasingly central to cancer care, but many health systems struggle to implement them equitably, effectively, and sustainably. This Commission defines the current global precision oncology landscape and analyses the scientific, structural, and health-system challenges shaping its delivery and impact. Findings indicate that access to cancer genomics and precision oncology remains profoundly unequal across and within countries, leaving millions of patients without guideline-indicated interventions each year. These disparities extend to research, with genomic studies and clinical trials concentrated in high-income settings and among populations of predominantly European ancestry. At the same time, fragmented and poorly integrated data ecosystems restrict evidence generation, knowledge sharing, and clinical impact. Beyond questions of access and implementation, the clinical benefit of precision oncology is highly heterogeneous. The greatest and most consistent gains are confined to a few well validated biomarker-treatment pairings, typically supported by companion diagnostics; broader approaches such as comprehensive genomic profiling and tumour-agnostic strategies, might expand options for selected patients, but only a few patients receiving matched therapy derive meaningful benefit. The Commission also identifies a paradox of success: rapid expansion of precision oncology has increased cognitive, organisational, data, workforce, and financial burdens, while evidence of broad population-level benefit has lagged behind. In response, the Commission offers a comprehensive and context-responsive approach for integrating cancer genomics and precision oncology into health systems effectively, equitably, and sustainably. The Commission developed a value-based resource-stratified implementation framework, a system-readiness assessment tool, a precision oncology workforce competency-based framework, a precision oncology monitoring and evaluation framework, and principles for responsible data sharing and health-system learning. Cancer genomics and precision oncology can improve outcomes and strengthen health systems if scaled equitably, sustainably, and according to evidence, public value, national context, and patient needs. This Commission offers a basis for global consensus on a more equitable, evidence-informed, and sustainable path forward.</p>","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"e454-e507"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149062183","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":"Long Thanh Nguyen, Hannah Louise Bromley","doi":"10.1016/S1470-2045(26)00444-4","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00444-4","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"e447"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075180","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":"Balancing benefits, costs, and harms: policy implications of expanding cancer susceptibility testing from genetics clinics to the general population.","authors":"Clare Turnbull, Sandra Perdomo, Susan Domchek, William D Foulkes, Paul Pharoah, Patricia Ashton-Prolla, Bhawna Sirohi, Joaquin Mateo, Hilary A Robbins, Richard Sullivan, Mark Lawler, Raffaella Casolino","doi":"10.1016/S1470-2045(26)00390-6","DOIUrl":"10.1016/S1470-2045(26)00390-6","url":null,"abstract":"<p><p>Cancer susceptibility testing is rapidly advancing beyond specialist genetics clinics into routine oncology and population-level genomics initiatives. This expansion positions germline pathogenic variants in cancer susceptibility genes and polygenic risk scores as crucial tools for precision prevention, surveillance, and early detection. However, implementation has outpaced the evidence needed to justify testing at scale, particularly in well populations. For a small number of first-wave genes-including BRCA1, BRCA2, MLH1, and MSH2-cancer risks are well established and downstream medical interventions are supported by substantial observational evidence, albeit with an absence of randomised trials. Contrastingly, for many later discovered genes now included on multigene panels, penetrance estimates remain uncertain, variant-specific risks are poorly resolved, and evidence is scarce or absent regarding mortality reduction, quality of life benefit, or cost-effectiveness for the recommended downstream interventions. Polygenic risk scores offer promise for stratified prevention, but their discriminatory capacity is constrained, performance is ancestry dependent, and clinical utility remains uncertain in most settings. Building on the Lancet Oncology Commission on cancer genomics and precision oncology, this Policy Review examines the evidentiary, clinical, and health-system challenges associated with cancer susceptibility testing across clinical care and public health prevention. We argue that the value of such testing should be assessed in terms of its clinical value and public health utility, with careful attention to the context in which testing is offered. We propose a tiered, context-specific approach to implementation, aimed at distinguishing settings in which susceptibility testing could provide a net benefit from those scenarios in which its use should remain restricted, highly selective, or confined to research.</p>","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"e508-e518"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061274","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":"Inequities in access to precision oncology: shared challenges, unified blueprint.","authors":"C S Pramesh, Manju Sengar","doi":"10.1016/S1470-2045(26)00448-1","DOIUrl":"10.1016/S1470-2045(26)00448-1","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1200-1202"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149062001","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":"Correction to Lancet Oncol 2026; 27: 1077-93.","authors":"","doi":"10.1016/S1470-2045(26)00472-9","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00472-9","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"e450"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075250","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}