Lancet Oncology最新文献

{"title":"Exercise oncology: from trials and guidelines to routine clinical care.","authors":"Michelle B Nadler, Christopher M Booth","doi":"10.1016/S1470-2045(26)00386-4","DOIUrl":"10.1016/S1470-2045(26)00386-4","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1194-1195"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891884","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":"Counting who was not tested: artificial intelligence extraction of genomic and treatment data from hospital records.","authors":"Paramita Chatterjee, Matthew A Reyna, Ravi B Parikh","doi":"10.1016/S1470-2045(26)00449-3","DOIUrl":"10.1016/S1470-2045(26)00449-3","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1207-1209"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061471","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":"Patient-reported symptom monitoring in patients with lung cancer (SYMPRO-Lung trial): long-term, post-hoc survival results of a multicentre, stepped-wedged, cluster-randomised clinical trial.","authors":"Marloes J Hassing, Nicole E Billingy, Corina J G van den Hurk, Michel M van den Heuvel, Cornelia A Verberkt, Annemarie Becker-Commissaris, Iris Walraven","doi":"10.1016/S1470-2045(26)00305-0","DOIUrl":"10.1016/S1470-2045(26)00305-0","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome (PRO) symptom monitoring has been shown to improve overall survival. Yet, available evidence largely derives from resource-intensive studies limited to patients with advanced cancer. We aimed to assess the effect of PRO symptom monitoring on overall and progression-free survival in patients with stage I-IV lung cancer in a real-world clinical setting, with follow-up extending to 5 years.</p><p><strong>Methods: </strong>The SYMPRO-Lung trial was a multicentre, stepped-wedged, cluster-randomised clinical trial across 14 medical centres in the Netherlands. Patients were eligible for inclusion if they were aged 18 years or older with stage I-IV lung cancer (new-onset or recurrent; cytologically or histologically confirmed or radiological suspected) and were starting new treatment. All hospitals started with a control period (standard of care) and, according to randomisation by a computer-generated allocation sequence, crossed over at predefined timepoints to the intervention period (completing weekly online symptom assessments for 1 year). The primary outcome for SYMPRO-Lung trial was health-related quality of life, which has been previously reported. In this post-hoc analysis, we assessed long-term survival outcomes of overall survival and progression-free survival, with overall survival as the primary outcome. Survival analyses in the intention-to-treat population was performed using Cox mixed-effects modelling, adjusted for age, sex, stage, histology, Eastern Cooperative Oncology Group performance status, systemic treatment line, and a random effect for site clustering. The study is registered with Netherlands Trial Register, NL7897, and is complete.</p><p><strong>Findings: </strong>Of the 515 patients initially enrolled to the SYMPRO-Lung trial between Oct 24, 2019, and Sept 16, 2021, 446 (87%) patients were included in this post-hoc analysis (230 [52%] male; 216 [48%] female). 235 (53%) were assigned to the pooled intervention group and 211 (47%) patients to the control group. 69 (13%) of 515 patients were excluded due to the absence of informed consent for the use of their data in follow-up research or because linkage to the Netherlands Cancer Registry could not be established. At a median follow-up 50 months (IQR 46-55), median overall survival was 26 months in the intervention group (IQR 9-not reached, 95% CI 21-33) compared with 21 months (IQR 10-54, 95% CI 17-26) in the control group. Analyses adjusting for confounders showed that PRO symptom monitoring might be associated with improved overall survival (hazard ratio [HR] 0·80, 95% CI 0·63-1·00, p=0·049). Analyses adjusting for confounders showed that PRO symptom monitoring showed no significant difference in progression-free survival between groups (0·86, 0·70-1·07; p=0·18).</p><p><strong>Interpretation: </strong>Weekly PRO symptom monitoring was associated with meaningful improvement in long-term overall survival among patients with","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1260-1270"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944943","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":"Burden of cancer in Africa, 1990-2023: a systematic analysis from the Global Burden of Disease Study 2023.","authors":"","doi":"10.1016/S1470-2045(26)00291-3","DOIUrl":"10.1016/S1470-2045(26)00291-3","url":null,"abstract":"<p><strong>Background: </strong>Cancer remains a leading cause of death and disability worldwide, with a disproportionately rising burden across Africa. Effective policy responses have been consistently hampered by fragmented and incomplete cancer surveillance data. Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, we estimated the burden of 48 cancer types across all 54 African countries over the period 1990 to 2023. These age-disaggregated and sex-disaggregated findings provide a crucial empirical foundation to inform regional control strategies and monitor progress towards global health targets.</p><p><strong>Methods: </strong>We applied GBD 2023 methodology to estimate fatal and non-fatal outcomes of cancer alongside risk-attributable burden from 88 modifiable risk factors, across all 54 African countries. The estimation of cancer burden attributable to risk factors followed the comparative risk assessment framework. Estimates of incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) were stratified by age, sex, location, and year (1990-2023) and reported as counts and age-standardised rates per 100 000 population. Mean estimates represent the mean across 250 draws, with 95% uncertainty intervals calculated from the 2·5th and 97·5th percentiles.</p><p><strong>Findings: </strong>In 2023, cancer, including non-melanoma skin cancer, accounted for an estimated 1·54 million (95% uncertainty interval 1·37-1·75) incident cases, 923 000 (824 000-1 020 000) deaths, and 33·9 million (30·6-37·1) DALYs across all ages and both sexes in Africa, of which 98·2% (97·9-98·3) were attributable to YLLs. In Africa, 10·7 million (8·9-12·9) DALYs and 306 000 (254 000-363 000) cancer deaths in 2023 were attributable to the 88 risk factors assessed in GBD 2023, equivalent to 31·6% (26·8-35·9) of total DALYs and 33·1% (28·7-37·2) of total cancer deaths across all ages and both sexes. Between 1990 and 2023, deaths attributable to risk factors increased by 216·0% (159·3-284·5) for both sexes combined. In 2023, incident cancer cases in females numbered 960 000 (821 000-1 130 000), with breast and cervical cancers together accounting for 53·5% (44·7-62·2) of all female incident cases. In males, prostate, liver, tracheal, bronchus and lung, and colorectal cancers were the leading types, together accounting for 44·8% (36·2-54·3) of all male cancers in Africa in 2023. Childhood cancer (ages 0-19 years) in Africa accounted for 104 000 (84 600-130 000) incident cases and 54 700 (47 500-64 500) deaths, representing 27·7% (26·6-29·4) of global incidence and 38·0% (36·3-40·0) of global deaths in 2023. Cancers in adolescents and young adults (ages 15-39 years) contributed 26·6% (26·4-27·5) of total cancer DALYs in Africa, those in older adults aged 40-64 years contributed 44·8% (43·8-45·6), and those in adults aged 65 years and older contributed 18·3% (17·4-19·1).</p><p><stron","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1314-1340"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of cancer attributable to infections in 2024: a worldwide incidence analysis.","authors":"Harriet Rumgay, Damien Georges, Yue Huang, Mayo Hirabayashi, Richa Shah, Catherine de Martel, Jin Young Park, Isabelle Soerjomataram, Gary M Clifford","doi":"10.1016/S1470-2045(26)00307-4","DOIUrl":"10.1016/S1470-2045(26)00307-4","url":null,"abstract":"<p><strong>Background: </strong>Infectious agents are an important preventable cause of cancer globally. To inform prevention efforts, we provide a comprehensive picture of cancer burden attributable to infections, including newly established, carcinogenic infectious agents and latest global cancer incidence estimates.</p><p><strong>Methods: </strong>In this worldwide incidence analysis, we used data from the Global Cancer Observatory's Cancer Today (GLOBOCAN) database of cancer incidence in 2024 to estimate population-attributable fractions (PAFs), absolute numbers, and age-standardised incidence rates (ASIRs) of new cancer cases attributable to 12 infectious agents classified as Group 1 carcinogens by the IARC Monographs Programme: Helicobacter pylori, human papillomavirus (HPV), hepatitis B (HBV) and hepatitis C viruses (HCV), Epstein-Barr virus (EBV), Kaposi's sarcoma-associated herpesvirus, Schistosoma haematobium, human T-cell lymphotropic virus, Opisthorchis viverrini, Clonorchis sinensis, Merkel cell polyomavirus, and HIV. Estimates stratified by sex, country, and age group were aggregated by UN geographical subregion and World Bank income group.</p><p><strong>Findings: </strong>An estimated 2·3 million new cancer cases were attributable to infections globally in 2024, which is equivalent to 12% of all cancer cases. The largest number of cases was attributable to H pylori (n=760 000, PAF 4%), followed by HPV (n=750 000, 4%), HBV (n=360 000, 2%), EBV (n=260 000, 1%), and HCV (n=160 000, <1%). The largest burden of infection-attributable cancer was in eastern Asia, with 990 000 cases (42% of the global total, ASIR 31·9 per 100 000 cases). ASIRs were also higher than the global average (22·7) in sub-Saharan Africa (28·5), central and eastern Europe (24·3), and southeastern Asia (23·1). Focused analysis of EBV-attributable cancers revealed regional variation in the distribution of cancer types.</p><p><strong>Interpretation: </strong>Our findings highlight the importance of infection control to achieve cancer prevention. Scientifically proven, but often underused, approaches include HPV and HBV vaccination; testing and treatment of HIV, H pylori, HBV, and HCV; safe injection practices; access to condoms and pre-exposure prophylaxis to prevent HIV transmission; and screening of precancerous lesions for HPV-driven cervical and anal cancer. Our findings also inform the investment cases for research and development for new prevention tools, most notably for EBV.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"1237-1248"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term exposure to wildfire-related PM_2·5 and overall survival of older patients with lung cancer: a retrospective, registry-based cohort study.","authors":"Min Zhang, Juan P Wisnivesky, Minghao Qiu, Mahdieh Danesh Yazdi, Kanhua Yin, Rosalind J Wright, Joel D Schwartz, Christine C Ekenga, Robert O Wright, Yaguang Wei","doi":"10.1016/S1470-2045(26)00295-0","DOIUrl":"10.1016/S1470-2045(26)00295-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fine particulate matter (PM&lt;sub&gt;2·5&lt;/sub&gt;) has been identified as a key risk factor for lung cancer incidence and survival. PM&lt;sub&gt;2·5&lt;/sub&gt; from wildfire smoke is an increasingly important contributor to total PM&lt;sub&gt;2·5&lt;/sub&gt; in the USA, driven by climate change, and potentially more toxic than non-wildfire PM&lt;sub&gt;2·5&lt;/sub&gt; due to its smaller particle size and higher toxic contents. However, the effects of wildfire-related PM&lt;sub&gt;2·5&lt;/sub&gt; on the overall survival of patients with lung cancer remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study included patients aged 65 years or older with histologically confirmed primary small-cell lung cancer or non-small-cell lung cancer (as defined by the International Classification of Diseases for Oncology, Third Edition) from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database between Jan 1, 2006, and Dec 31, 2019, for whom residential zip code-based estimates of wildfire-related PM&lt;sub&gt;2·5&lt;/sub&gt; and non-wildfire PM&lt;sub&gt;2·5&lt;/sub&gt; were available. Individuals diagnosed at the in situ stage, without continuous enrolment in Medicare Parts A and B, or with missing exposure or covariate data were excluded. Participants were followed up annually from diagnosis until death, loss to follow-up, or the end of the study in 2019, whichever came first. Daily estimates of ambient wildfire-related PM&lt;sub&gt;2·5&lt;/sub&gt; and total PM&lt;sub&gt;2·5&lt;/sub&gt; across the contiguous USA (from 2006 to 2019) were obtained from previously developed and validated models and spatially aggregated to zip code level. Non-wildfire PM&lt;sub&gt;2·5&lt;/sub&gt; was calculated as the difference between total PM&lt;sub&gt;2·5&lt;/sub&gt; and wildfire-related PM&lt;sub&gt;2·5&lt;/sub&gt;, and negative values were excluded. The main outcome was all-cause mortality. A time-varying Cox proportional hazards model was applied to estimate the primary exposure of interest of the long-term effects of 3-year moving averages of wildfire-related PM&lt;sub&gt;2·5&lt;/sub&gt; and non-wildfire PM&lt;sub&gt;2·5&lt;/sub&gt; concentrations on overall survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between Jan 1, 2008, and Dec 31, 2019 (the analysis period), 414 016 patients with lung cancer contributed 1 211 490 person-years of follow-up, with a median follow-up of 2 years (IQR 1-4). Of these, 208 468 (50·4%) patients were female, 205 548 (49·6%) were male, 356 356 (86·1%) were White, 36 914 (8·9%) were Black, 18 982 (4·6%) were Asian or Pacific Islander, and 1269 (0·3%) were American Indian or Alaska Native; race or ethnicity was unknown for 495 patients (0·1%). The median concentrations of PM&lt;sub&gt;2·5&lt;/sub&gt; were 0·28 μg/m&lt;sup&gt;3&lt;/sup&gt; (IQR 0·21-0·39) for wildfire-related PM&lt;sub&gt;2·5&lt;/sub&gt; and 8·11 μg/m&lt;sup&gt;3&lt;/sup&gt; (6·84-9·47) for non-wildfire PM&lt;sub&gt;2·5&lt;/sub&gt;. Each 1-SD increase in wildfire-related PM&lt;sub&gt;2·5&lt;/sub&gt; or non-wildfire PM&lt;sub&gt;2·5&lt;/sub&gt; was associated with an increased risk of death for patients with lung cancer (HR 1·0229, 95% CI 1·0189-1·0270; p","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1304-1313"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluating aglatimagene in localised prostate cancer.","authors":"Thomas Büttner, Davide Scafa, Julian P Layer, Manuel Ritter, Glen Kristiansen, Markus Eckstein, Niklas Klümper","doi":"10.1016/S1470-2045(26)00356-6","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00356-6","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"e440-e441"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075203","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":"Cancer and the microbiome: from association to intervention.","authors":"Ali Moradi, Rahul Winayak, Sumanta Kumar Pal","doi":"10.1016/S1470-2045(26)00326-8","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00326-8","url":null,"abstract":"<p><p>The gut microbiome is increasingly recognised as a clinically modifiable determinant of efficacy and toxicity across systemic cancer therapies, with the most mature evidence in patients receiving immune checkpoint inhibitors (ICIs). The composition and function of intestinal microbes can influence treatment outcomes by affecting immune priming, antigen presentation, host-microbial co-metabolism, drug biotransformation, and epithelial barrier integrity. In melanoma, non-small-cell lung cancer, and renal cell carcinoma, higher microbial diversity, ecological stability, and enrichment of immunostimulatory pathways have been associated with improved ICI response and survival. By contrast, antibiotics and proton pump inhibitors are linked to inferior outcomes because they disrupt the microbiome. Microbiome-directed interventions, including faecal microbiota transplantation, dietary modifications, prebiotics, probiotics, and live biotherapeutic products, are undergoing clinical testing but remain at the investigational stage. This Review synthesises current evidence linking the intestinal microbiome to anticancer therapy outcomes, evaluates strategies and challenges for therapeutic modulation of the microbiome, and introduces emerging insights into the mycobiome.</p>","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"e519-e531"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075232","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":"Personalised medicine in oncology: inequality aversion in a fast-moving field.","authors":"Wim van Harten","doi":"10.1016/S1470-2045(26)00435-3","DOIUrl":"10.1016/S1470-2045(26)00435-3","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1197-1199"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061981","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":"Microplastics and cancer: a looming threat?","authors":"The Lancet Oncology","doi":"10.1016/S1470-2045(26)00483-3","DOIUrl":"https://doi.org/10.1016/S1470-2045(26)00483-3","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"27 10","pages":"1193"},"PeriodicalIF":33.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075185","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}