Nature Reviews Clinical Oncology最新文献_第3页

Rechallenge with immune-checkpoint inhibitors in patients with advanced-stage lung cancer 免疫检查点抑制剂在晚期肺癌患者中的再挑战

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-06-09 DOI: 10.1038/s41571-025-01029-7

Li-Bo Tang, Ying-Long Peng, Ji Chen, Jia-Ting Li, Mei-Mei Zheng, Lv Wu, Chang Lu, Xue-Wu Wei, Dong-Xuan Cai, Zhi Guo, Zi-Rui Ren, Si-Di Lv, Yu Deng, Zhi-Hong Chen, Chong-Rui Xu, Qing Zhou

{"title":"Rechallenge with immune-checkpoint inhibitors in patients with advanced-stage lung cancer","authors":"Li-Bo Tang, Ying-Long Peng, Ji Chen, Jia-Ting Li, Mei-Mei Zheng, Lv Wu, Chang Lu, Xue-Wu Wei, Dong-Xuan Cai, Zhi Guo, Zi-Rui Ren, Si-Di Lv, Yu Deng, Zhi-Hong Chen, Chong-Rui Xu, Qing Zhou","doi":"10.1038/s41571-025-01029-7","DOIUrl":"https://doi.org/10.1038/s41571-025-01029-7","url":null,"abstract":"Lung cancer remains the leading cause of cancer-related mortality globally, with many patients diagnosed with advanced-stage disease. Treatment in this setting relies on systemic therapies, including chemotherapy, targeted therapy and immunotherapy. Immune-checkpoint inhibitors (ICIs), which promote or restore antitumour immunity by inhibiting immunosuppressive signalling pathways, are currently the most widely used immunotherapies in these patients. However, immune-related adverse events (irAEs) or disease progression often necessitate discontinuation of these agents, leaving many patients with limited subsequent treatment options. In this scenario, ICI rechallenge has emerged as a potential strategy. Despite this potential, evidence for ICI rechallenge after either disease progression or irAEs in patients with non-small-cell lung cancer is limited and evidence for those with small cell lung cancer seems to be non-existent. In this Review, we provide a comprehensive overview of the available data on ICI rechallenge in the context of both disease progression and irAEs, including a summary of current guidance on clinical management and detailed discussions of safety and efficacy. We also highlight important unanswered questions in an attempt to guide future research in this area.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"40 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237819","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

Surrogate end points in oncology: aligning drug development incentives and patient needs 肿瘤替代终点：调整药物开发激励和患者需求

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-06-06 DOI: 10.1038/s41571-025-01031-z

Matthew Vogel, Rona Yaeger, David J. Stewart, Vivek Subbiah, Frank S. David

{"title":"Surrogate end points in oncology: aligning drug development incentives and patient needs","authors":"Matthew Vogel, Rona Yaeger, David J. Stewart, Vivek Subbiah, Frank S. David","doi":"10.1038/s41571-025-01031-z","DOIUrl":"https://doi.org/10.1038/s41571-025-01031-z","url":null,"abstract":"In a provocative News & Views article (Prasad, V. Surrogate end points in oncology: the speed–uncertainty trade-off from the patients’ perspective. Nat. Rev. Clin. Oncol. 22, 313–314 (2025))1, Vinay Prasad reviews patient survey data indicating a willingness to wait 16 months to obtain moderate certainty of a drug’s efficacy and 22 months for high certainty. On the basis of these results, he advocates for moving away from surrogate end points, such as progression-free survival (PFS), to place greater emphasis on late-line treatments and incentivize the development of fewer anticancer drugs, in the hope that “truly transformative drugs” would still be developed and only “the most marginal drugs” would be abandoned1. Although we share the goal of maximizing the development of transformative medicines, the approach Prasad proposes might do more harm than good.First, point estimates from discrete choice surveys do not fully capture the limited options and highly heterogeneous preferences of real-world patients. Prasad critiques the design of the PERSEUS trial for enrolling all patients with newly diagnosed multiple myeloma instead of only the highest risk subgroup, but the thousands of patients who could benefit from the broader inclusion criteria might disagree — and that is the point. Patients deserve the freedom to choose from a set of treatment options that has not been artificially reduced as a policy preference rather than on the basis of evidence. For some patients, waiting an additional 11–22 months for a new drug to be approved would mean never accessing that treatment within their remaining lifetime.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"10 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228750","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

Reply to ‘Surrogate end points in oncology: aligning drug development incentives and patient needs’ 回复“肿瘤替代终点：调整药物开发激励和患者需求”

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-06-06 DOI: 10.1038/s41571-025-01032-y

Vinay Prasad

{"title":"Reply to ‘Surrogate end points in oncology: aligning drug development incentives and patient needs’","authors":"Vinay Prasad","doi":"10.1038/s41571-025-01032-y","DOIUrl":"https://doi.org/10.1038/s41571-025-01032-y","url":null,"abstract":"In a recent News & Views (Prasad, V. Surrogate end points in oncology: the speed–uncertainty trade-off from the patients’ perspective. Nat. Rev. Clin. Oncol. 22, 313–314 (2025))1, I discussed two studies that, using surveys, show that patients with cancer crave information about how long and how well they will live. That is, patients are willing to wait for overall survival (OS) results rather than accepting improvements in progression-free survival (PFS). In their Correspondence, Matthew Vogel and collaborators defend the widespread use of surrogate end points (Vogel, M. et al. Surrogate end points in oncology: aligning drug development incentives and patient needs. Nat. Rev. Clin. Oncol. https://doi.org/10.1038/s41571-025-01031-z (2025))2. I appreciate their interest in my article, although I find five problems with the points they raise.First, Vogel et al. argue that patients “deserve the freedom to choose” and should not have policymakers limit their options. This is not a logical argument for using PFS instead of OS, but an argument against trials altogether. Why then should policymakers limit choice to drugs with a demonstrated PFS benefit? Why not also permit those showing some improvements in objective response rate? Why can’t patients receive daratumumab plus bortezomib, lenalidomide and dexamethasone (the regimen tested in the PERSEUS trial) with added teclistamab or talquetamab if they want to? We know that these agents are active. The truth is that we perform clinical trials because we need to know which regimens improve clinical outcomes, and whether they are worth the cost and toxicities. Given that societies, through healthcare systems, often pay for these drugs, knowing that this money is well spent is imperative. Moreover, patients want to know whether they will be better off with these new regimens.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"10 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228752","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

Novel colorectal cancer screening methods — opportunities and challenges 新型结直肠癌筛查方法——机遇与挑战

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-06-06 DOI: 10.1038/s41571-025-01037-7

Melina A. McCabe, Anthony J. Mauro, Robert E. Schoen

{"title":"Novel colorectal cancer screening methods — opportunities and challenges","authors":"Melina A. McCabe, Anthony J. Mauro, Robert E. Schoen","doi":"10.1038/s41571-025-01037-7","DOIUrl":"https://doi.org/10.1038/s41571-025-01037-7","url":null,"abstract":"Globally, colorectal cancer (CRC) is the second leading cause of cancer death and the third most common incident cancer. CRC begins as adenomatous or serrated polyps, and in particular as advanced precursor lesions (APLs), which have the potential to progress into invasive cancers. Screening for CRC facilitates early detection and can identify cancers more amenable to cure, and can also detect and remove precursor lesions, thus also preventing CRC. Colonoscopy is the mainstay of screening in the USA and has the distinct advantage of enabling both detection and removal of precursors lesions. However, colonoscopy is burdensome, expensive and invasive, and often has negative findings. Non-invasive tests, such as testing stool samples for biomarkers of risk, have the potential to identify individuals who are more likely to benefit from colonoscopy. From a public health perspective, improving compliance with screening remains a priority. Technological innovations, including the emergence of new markers to improve stool testing and the development of blood tests that examine cell-free DNA have the potential to improve screening uptake and effectiveness. The trade-off between uptake of screening testing, detection of cancer and important precursor lesions such as APLs, and costs make for a complex calculus. In this Review, we describe the current state of CRC screening and evaluate the risks and benefits of new developments in screening.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"33 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228837","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

Empowering oncologists: a practical approach to overcoming barriers to clinical trial enrolment 授权肿瘤学家：克服临床试验登记障碍的实用方法

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-06-03 DOI: 10.1038/s41571-025-01038-6

Changchuan Jiang, Ryan D. Nipp, Tian Zhang

引用次数: 0

Daratumumab and missed sequencing opportunities in transplant-ineligible multiple myeloma: lessons for future trials 在不适合移植的多发性骨髓瘤中，Daratumumab和错失的测序机会：对未来试验的教训

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-05-29 DOI: 10.1038/s41571-025-01034-w

Ghulam Rehman Mohyuddin, Aaron M. Goodman

引用次数: 0

Prospective comparisons support the use of navigational bronchoscopy 前瞻性比较支持导航支气管镜检查的使用

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-05-29 DOI: 10.1038/s41571-025-01039-5

Peter Sidaway

引用次数: 0

Benefit from huCAR19-IL18 cells in patients with CD19+ lymphomas after CAR T cells CAR - T细胞治疗后CD19+淋巴瘤患者获益于huCAR19-IL18细胞

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-05-23 DOI: 10.1038/s41571-025-01036-8

Diana Romero

引用次数: 0

Tumour and microenvironment crosstalk in NSCLC progression and response to therapy 非小细胞肺癌进展和治疗反应中的肿瘤和微环境串扰

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-05-16 DOI: 10.1038/s41571-025-01021-1

Zahraa Rahal, Roy El Darzi, Seyed Javad Moghaddam, Tina Cascone, Humam Kadara

{"title":"Tumour and microenvironment crosstalk in NSCLC progression and response to therapy","authors":"Zahraa Rahal, Roy El Darzi, Seyed Javad Moghaddam, Tina Cascone, Humam Kadara","doi":"10.1038/s41571-025-01021-1","DOIUrl":"https://doi.org/10.1038/s41571-025-01021-1","url":null,"abstract":"The treatment landscape of non-small-cell lung cancer (NSCLC) is evolving rapidly, driven by advances in the development of targeted agents and immunotherapies. Despite this progress, some patients have suboptimal responses to treatment, highlighting the need for new therapeutic strategies. In the past decade, the important role of the tumour microenvironment (TME) in NSCLC progression, metastatic dissemination and response to treatment has become increasingly evident. Understanding the complexity of the TME and its interactions with NSCLC can propel efforts to improve current treatment modalities, overcome resistance and develop new treatments, which will ultimately improve the outcomes of patients. In this Review, we provide a comprehensive view of the NSCLC TME, examining its components and highlighting distinct archetypes characterized by spatial niches within and surrounding tumour nests, which form complex neighbourhoods. Next, we explore the interactions within these components, focusing on how inflammation and immunosuppression shape the dynamics of the NSCLC TME. We also address the emerging influences of patient-related factors, such as ageing, sex and health disparities, on the NSCLC–TME crosstalk. Finally, we discuss how various therapeutic strategies interact with and are influenced by the TME in NSCLC. Overall, we emphasize the interconnectedness of these elements and how they influence therapeutic outcomes and tumour progression.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"54 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066883","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

Roles of the gut microbiota in immune-related adverse events: mechanisms and therapeutic intervention 肠道微生物群在免疫相关不良事件中的作用：机制和治疗干预

IF 78.8 1区医学

Nature Reviews Clinical Oncology Pub Date : 2025-05-14 DOI: 10.1038/s41571-025-01026-w

Ya-Qi Gao, Yong-Jie Tan, Jing-Yuan Fang

{"title":"Roles of the gut microbiota in immune-related adverse events: mechanisms and therapeutic intervention","authors":"Ya-Qi Gao, Yong-Jie Tan, Jing-Yuan Fang","doi":"10.1038/s41571-025-01026-w","DOIUrl":"https://doi.org/10.1038/s41571-025-01026-w","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) constitute a major breakthrough in the field of cancer therapy; their use has resulted in improved outcomes across various tumour types. However, ICIs can cause a diverse range of immune-related adverse events (irAEs) that present a considerable challenge to the efficacy and safety of these treatments. The gut microbiota has been demonstrated to have a crucial role in modulating the tumour immune microenvironment and thus influences the effectiveness of ICIs. Accumulating evidence indicates that alterations in the composition and function of the gut microbiota are also associated with an increased risk of irAEs, particularly ICI-induced colitis. Indeed, these changes in the gut microbiota can contribute to the pathogenesis of irAEs. In this Review, we first summarize the current clinical challenges posed by irAEs. We then focus on reported correlations between alterations in the gut microbiota and irAEs, especially ICI-induced colitis, and postulate mechanisms by which these microbial changes influence the occurrence of irAEs. Finally, we highlight the potential value of gut microbial changes as biomarkers for predicting irAEs and discuss gut microbial interventions that might serve as new strategies for the management of irAEs, including faecal microbiota transplantation, probiotic, prebiotic and/or postbiotic supplements, and dietary modulations.","PeriodicalId":19079,"journal":{"name":"Nature Reviews Clinical Oncology","volume":"4 1","pages":""},"PeriodicalIF":78.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945670","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