Oncology最新文献

{"title":"Application of a general LLM-based classification system to retrieve information about oncological trials.","authors":"Fabio Dennstädt, Paul Windisch, Irina Filchenko, Johannes Zink, Paul Martin Putora, Ahmed Shaheen, Roberto Gaio, Nikola Cihoric, Marie Wosny, Stefanie Aeppli, Max Schmerder, Mohamed Shelan, Janna Hastings","doi":"10.1159/000546946","DOIUrl":"https://doi.org/10.1159/000546946","url":null,"abstract":"<p><strong>Purpose: </strong>The automated classification of clinical trials and key categories within the medical literature is increasingly relevant, particularly in oncology, as the volume of publications and trial reports continues to expand. Large Language Models (LLMs) may provide new opportunities for automating diverse classification tasks. They could be used for general-purpose text classification retrieving information about oncological trials.</p><p><strong>Methods and materials: </strong>A general text classification framework with adaptable prompt, model and categories for the classification was developed. The framework was tested with four datasets comprising nine binary classification questions related to oncological trials. Evaluation was conducted using a locally hosted Mixtral-8x7B-Instruct v0.1-GPTQ model and three cloud-based LLMs: Mixtral-8x7B-Instruct v0.1, Llama3.1-70B-Instruct, and Qwen-2.5-72B.</p><p><strong>Results: </strong>The system consistently produced valid responses with the local Mixtral-8x7B-Instruct model and the Llama3.1-70B-Instruct model. It achieved a response validity rate of 99.70% and 99.88% for the cloud-based Mixtral and Qwen models, respectively. Across all models, the framework achieved an overall accuracy of >94%, precision of >92%, recall of >90%, and an F1-score of >92%. Question-specific accuracy ranged from 86.33% to 99.83% for the local Mixtral model, 85.49% to 99.83% for the cloud-based Mixtral model, 90.50% to 99.83% for the Llama3.1 model, and 77.13% to 99.83% for the Qwen model.</p><p><strong>Conclusions: </strong>The LLM-based classification framework exhibits robust accuracy and adaptability across various oncological trial classification tasks. While there remain some challenges such as strong prompt dependence and high computational and hardware demands, LLMs will play a crucial role for automating the classification of oncological trials and literature as the technology continues to advance.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-18"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FDG-PET/CT and CT compared for evaluation of tumor response to first-line immunotherapy and prediction of prognosis in non-small-cell lung cancer patients.","authors":"Kazuhiro Kitajima, Kosuke Matsuda, Toshiyuki Minami, Akifumi Nakamura, Kozo Kuribayashi, Soichiro Funaki, Takashi Kijima, Koichiro Yamakado","doi":"10.1159/000546339","DOIUrl":"https://doi.org/10.1159/000546339","url":null,"abstract":"<p><strong>Introduction: </strong>Immunotherapy-modified positron emission tomography response criteria in solid tumors (imPERCIST) using FDG-PET/CT and immune-related response evaluation criteria in solid tumors (irRECIST) using CT were compared for evaluation of response prognosis prediction, and effect on patient management in non-small-cell lung cancer (NSCLC) patients treated with first-line immunotherapy, or immunotherapy and chemotherapy combined.</p><p><strong>Methods: </strong>Thirty-three patients (26 males, median 68.0 years old) with histologically NSCLC without EGFR/ALK/KRAS alterations underwent pembrolizumab treatment only or immunotherapy combined with chemotherapy. FDG-PET/CT and diagnostic CT scanning was performed at the baseline and after two to four cycles (2 in 8, 3 in 12, 4 in 13 patients). Findings for therapeutic response obtained with imPERCIST and irRECIST were compared. Progression-free survival (PFS) and overall survival (OS) were examined using log-rank and Cox methods.</p><p><strong>Results: </strong>imPERCIST indicated that 10 patients had complete metabolic response (CMR), eight partial metabolic response (PMR), three stable metabolic disease (SMD), and 12 progressive metabolic disease (PMD), while irRECIST showed that two had complete response (CR), 14 PR, nine SD, and eight PD, indicating substantial concordance (κ=0.615). Twenty-eight patients showed progression and 18 died from NSCLC after a median 16.2 months. Patients showing response based on imPERCIST and irRECIST (CMR/PMR, CR/PR, respectively) showed significantly longer PFS and OS than non-responders (SMD/PMD, SD/PD, respectively) (imPERCIST p<0.0001 and p=0.0001, respectively; irRECIST p=0.0018 and p=0.011, respectively). imPERCIST resulted in a change of management in 12 of the 33 patients (36.3%) with an additional effect on patient management in 4 patients (12.1%) evaluated by irRECIST.</p><p><strong>Conclusion: </strong>For evaluation of NSCLC patients for tumor response and patient management following first-line immunotherapy or that combined with chemotherapy, and predicting prognosis, both FDG-PET/CT and CT findings are accurate, with FDG-PET/CT superior.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-22"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Obesity on Patients with Diffuse Large B-Cell Lymphoma Receiving CAR T-Cell Therapy.","authors":"Jia Yi Tan, Yong Hao Yeo, Hermon Kha Kin Wong, Shatha Elemian, Marwa Mir, Qi Xuan Ang, Arya Mariam Roy, Daniel Ezekwudo, Hamid S Shaaban","doi":"10.1159/000545933","DOIUrl":"https://doi.org/10.1159/000545933","url":null,"abstract":"<p><p>Obesity has been associated with poorer outcomes in conventional cancer therapies. However, its impact on Chimeric Antigen Receptor (CAR) T-cell therapy for patients with diffuse large B-cell lymphoma (DLBCL) remains unclear. This study aims to evaluate how obesity affects in-hospital outcomes and adverse effects in patients with DLBCL receiving CAR-T therapy. Using the National Readmission Database (NRD), we included adults aged ≥18 with DLBCL who received CAR-T therapy between 2018 and 2020. We compared in-hospital outcomes and adverse effects between patients with and without obesity. Propensity score matching (caliper of 0.2, 1:1 ratio) was performed to ensure similar baseline characteristics between the groups. We adjusted the following confounding variables: age, comorbidities such as cardiovascular diseases including hypertension, coronary artery disease, congestive heart disease, and valvular heart disease, diabetes mellitus, hyperlipidemia, cerebrovascular accident, obstructive sleep apnea, liver disease, pulmonary disease, chronic kidney disease, obesity, anemia, and social factors including smoking, alcohol use, and illicit drug use. Data analysis was conducted using R studio software. A total of 1,874 patients with DLBCL who received CAR-T therapy were included in the study. Of these, 171 had obesity (9.1%, 59.5 ± 12.1 years of age, 41.5% female) and 1,703 did not (90.9%, 61.9 ±12.4 years of age, 35.9% female). After propensity score matching, there were 160 patients with obesity (50.0%, 59.7 ± 12.2 years of age, 41.9% female) and 160 patients without obesity (50.0%, 58.6 ± 13.0 years of age, 41.3% female). Patients with obesity had significantly higher rates of early mortality (10.6% vs. 4.4%, p = 0.03) and non-home discharge (18.8% vs. 8.1%, p = 0.01) compared to those without obesity. There were no significant differences in 30-day readmission (18.1% vs. 21.3%, p = 0.48). In terms of in-hospital complications, the rates of acute kidney injury (20.0% vs. 23.1%, p = 0.50), cardiac complications (4.4% vs. 3.8%, p = 0.78), leukopenia (41.3% vs. 44.4%, p = 0.57), neurotoxicity (10.6% vs. 8.1%, p = 0.44), pulmonary embolism (1.3% vs. 0.0%, p = 0.16), and infection (44.4% vs. 43.8%, p = 0.91) were comparable between the two groups. Patients with DLBCL and concomitant obesity receiving CAR-T therapy experienced higher rates of early mortality and non-home discharge compared to non-obese patients. These findings underscore the need for tailored management strategies to improve outcomes for this patient population.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pipeline for the Automatic Identification of Randomized Controlled Oncology Trials and Assignment of Tumor Entities Using Natural Language Processing.","authors":"Paul Windisch, Fabio Dennstädt, Carole Koechli, Robert Förster, Christina Schröder, Daniel M Aebersold, Daniel R Zwahlen","doi":"10.1159/000546970","DOIUrl":"https://doi.org/10.1159/000546970","url":null,"abstract":"<p><strong>Background: </strong>Most tools trying to automatically extract information from medical publications are domain agnostic and process publications from any field. However, only retrieving trials from dedicated fields could have advantages for further processing of the data.</p><p><strong>Methods: </strong>We trained a small transformer model to classify trials into randomized controlled trials (RCTs) vs. non-RCTs and oncology publications vs. non-oncology publications. In addition, we used two large language models (GPT-4o and GPT-4o mini) for the same task. We assessed the performance of the three models and then developed a simple set of rules to extract the tumor entity from the retrieved oncology RCTs.</p><p><strong>Results: </strong>On the unseen test set consisting of 100 publications, the small transformer achieved an F1-score of 0.96 (95% CI: 0.92 - 1.00) with a precision of 1.00 and a recall of 0.92 for predicting whether a publication was an RCT. For predicting whether a publication covered an oncology topic, the F1-score was 0.84 (0.77 - 0.91) with a precision of 0.75 and a recall of 0.95. GPT-4o achieved an F1-score of 0.94 (95% CI: 0.90 - 0.99) with a precision of 0.89 and a recall of 1.00 for predicting whether a publication was an RCT. For predicting whether a publication covered an oncology topic the F1-score was 0.91 (0.85 - 0.97) with a precision of 0.91 and a recall of 0.91. The rule-based system was able to correctly assign every oncology RCT in the test set to a tumor entity.</p><p><strong>Conclusion: </strong>In conclusion, classifying publications depending on whether they were randomized controlled oncology trials or not was feasible and enabled further processing using more specialized tools such as rule-based systems and potentially dedicated machine learning models.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-16"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Factors Influencing Early Detection Practices of Oral Carcinomas by Dentists: A Cross-Sectional Study.","authors":"Zoofa Talha, Ishtiaq Ahmad, Aida Uzakova, Mariyam Sarfraz","doi":"10.1159/000546971","DOIUrl":"https://doi.org/10.1159/000546971","url":null,"abstract":"<p><p>Introduction Oral cancer (OC) is the second most common type of cancer in Pakistan, and early diagnosis can improve survival rates. However, 75% of these cases are diagnosed at an advanced stage. To reduce the incidence and mortality associated with OC, emphasis should be placed on the detailed screening of the oral cavity by dentists. Prevention and early detection practices are important because they increase five-year survival and reduce recurrence. This study aimed to assess the early detection practices of OC by dentists and determine the factors influencing their screening practices. Methods This cross-sectional study was conducted from June 1, 2022, to October 31, 2022, among 235 dentists from the public and private sectors of Islamabad, Pakistan. A validated survey questionnaire with 62 closed-ended items was used. The outcome variable \"early detection practices of oral carcinomas\" was measured on a scale of 0-8 based on the steps involved in the screening practices. Knowledge scores related to clinical presentation (0-14) and risk factors (0-16) of OC were generated by assigning one point to each correct response. Multivariate linear regression analysis was used to evaluate factors influencing early detection practice scores. Results 81.7% of participants had low knowledge related to clinical presentation (mean score=7.5, SD=2.2), and 55.3% had high knowledge (mean score=10.4, SD=2.06) related to the risk factors of oral cancers. The mean score for practices related to the early detection of oral carcinomas was 5.4 (SD=2.04). The duration since attending professional development courses significantly predicted early detection practice scores (P<0.001). With increasing duration, the early detection practice scores decreased. Moreover, \"guidelines about OC examinations\" significantly predicted practice scores (higher scores where written guidelines were present) (P<0.001). Conclusion This study highlights that the early detection of OC improves prognosis, reduces mortality, and minimizes treatment costs. These results emphasize regular professional development courses for the early detection of OC among dentists. This indicates that early detection practices are better in facilities with written guidelines, further emphasizing the need for comprehensive educational materials and training of dentists to improve screening practices. Healthcare authorities should put efforts into implementing a continuous dental education system tailored to the needs of dentists in Pakistan.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-27"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between HER-2 and lymph node metastasis in gastric cancer: a meta-analysis.","authors":"Yu-Ting Wang, Tao Guo, Ya Hui, Zhu Na, Guang-Rong Dai","doi":"10.1159/000546630","DOIUrl":"https://doi.org/10.1159/000546630","url":null,"abstract":"<p><strong>Background and aim: </strong>Human epidermal growth factor receptor 2 (HER-2) on the development of gastric cancer have been widely discussed in the literature. This meta-analysis aimed to assess the relationship between HER-2 and lymph node metastasis in gastric cancer using systematic evaluation and Meta-analysis, which can be of some clinical value for treatment and prognosis. METHODS Relevant databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. PubMed, Embase, Cochrane Library, and Web of Science databases were used to systematically search the literature published up to May 1, 2024. Twenty-one papers were screened and included for quantitative analysis, a data collection form was created, and the quality of the literature was evaluated using the Newcastle-Ottawa Scale (NOS). The results were represented by a Forest plot. I2 was used to assess heterogeneity, Begg's funnel plot was used to test for possible publication bias, and the source of heterogeneity was clarified by the Galbraith plot. Subgroup analyses were performed according to country and test method after excluding studies with significant heterogeneity. All statistical analyses were calculated using stata17.0. RESULTS A total of 624 papers were retrieved, and 21 were selected and included. Meta-analysis showed that there was heterogeneity between HER-2 positive and HER-2 negative mediators in the study (I2=68.0%, P<0.000). Therefore, the 95% CI (3.12, 95% CI: 2.10, 4.65) of the combined OR calculated by the random effects model was statistically significant. By comparing the incidence of lymph node metastasis between the HER-2 positive group and the HER-2 negative group, it was found that the incidence of lymph node metastasis between the two groups was significantly different. It is suggested that patients with HER-2 overexpression in cancer tissues may be more prone to lymph node metastasis. CONCLUSION This meta-analysis showed an association between HER-2 and positive lymph node status in gastric cancer patients. This could be valuable for selecting treatment options for gastric cancer patients.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-19"},"PeriodicalIF":2.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of AI-Based Chatbots in Liver Cancer Information Dissemination: A Comparative Analysis of GPT, DeepSeek, Copilot, and Gemini.","authors":"Mustafa Karaagac, Sedat Carkit","doi":"10.1159/000546726","DOIUrl":"https://doi.org/10.1159/000546726","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aimed to evaluate AI-based chatbots (GPT, DeepSeek, Copilot, Gemini) in disseminating information on liver cancer, emphasizing content quality, adherence to established guidelines, and ease of comprehension.</p><p><strong>Methods: </strong>Between January and February 2025, four chatbots were examined us-ing publicly accessible free versions lacking independent reasoning capabilities. Three frequently searched Google Trends questions (\"What is liver cancer awareness?\", \"What are the symptoms of liver cancer?\", and \"Is liver cancer treatable?\") were posed. Their responses were assessed via the DISCERN instrument, Cole-man-Liau Index, Patient Education Materials Assessment Tool for Print, and alignment with American Asso-ciation for the Study of Liver Diseases, National Comprehensive Cancer Network, and European Society for Medical Oncology recommendations. Statistical analysis was performed using SPSS 22.</p><p><strong>Results: </strong>All chatbots largely provided relevant and impartial information. GPT and DeepSeek scored lower on specifying infor-mation sources and update timelines, whereas Copilot omitted local therapies (e.g., Radiofrequency Ablation, Transarterial Chemoembolization, Transarterial Radioembolization), resulting in reduced scientific accuracy. Gemini and Copilot performed better in \"Understandability,\" while GPT and DeepSeek excelled in \"Actiona-bility.\" Although GPT demonstrated consistency across multiple treatment options, it did not explicitly refer-ence international guidelines. Study limitations included language constraints, variations in chatbot updates, and reliance on a single inquiry round.</p><p><strong>Conclusions: </strong>AI chatbots show potential as initial informational tools for liver cancer but cannot replace professional medical consultation. In complex diseases requiring multidis-ciplinary management, frequent guideline-based updates, expert validation, and diverse data sources are critical to enhancing clinical relevance and patient outcomes.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-15"},"PeriodicalIF":2.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Fusion Imaging and Cone-Beam Computed Tomography Guided Radiofrequency Ablation for Hepatocellular Carcinoma Poorly Visualized on Ultrasonography.","authors":"Keizo Kato, Hiroshi Abe, Makiko Ika, Yuhi Sakamoto, Mizuki Takeuchi, Shingo Komazaki, Shinichiro Takeda, Sadahiro Ito, Shohei Shimizu, Ryota Matsuo","doi":"10.1159/000546427","DOIUrl":"https://doi.org/10.1159/000546427","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency ablation (RFA) generally involves the insertion of a radiofrequency electrode into the hepatocellular carcinoma (HCC) nodule under ultrasonography (US) guidance. However, the procedure is often not feasible for patients whose HCC is undetectable on conventional US. Advances in imaging technology, such as fusion imaging (FI) and cone-beam computed tomography (CBCT), may enhance treatment precision and efficacy for these challenging cases. This study assessed the efficacy of RFA guided by FI and CBCT in managing HCC poorly visualized on ultrasonography US.</p><p><strong>Methods: </strong>HCC nodules were classified into GOOD (clearly delineated), POOR (poorly delineated), and NONE (undetectable) based on US visualization. All nodules underwent RFA guided by FI and CBCT either in combination with transcatheter arterial chemoembolization (TACE) or without TACE. The technical success rate and local tumor progression post-RFA were evaluated using dynamic contrast-enhanced imaging. Between-group differences were analyzed retrospectively.</p><p><strong>Results: </strong>A total of 420 patients with 595 HCC nodules were enrolled. Complete ablation rates were 91.4%, 94.9%, and 86.2% in the GOOD, POOR, and NONE groups, respectively. For nodules with over 50% lipiodol accumulation, the complete ablation rates were 91.5%, 96.5%, and 88.8%; for those with less than 50% lipiodol accumulation, they were 95.5%, 100%, and 62.5%; and for those without lipiodol accumulation, they were 89.5%, 77.8%, and 82.4% in the GOOD, POOR, and NONE groups, respectively. Significant factors associated with complete ablation included larger nodule size and lipiodol accumulation. Cumulative local tumor progression rates at 1 year were 4.5%, 0%, and 3.8%, with no significant differences among groups.</p><p><strong>Conclusion: </strong>FI and CBCT guidance effectively achieve local control for HCC, including nodules poorly visualized on US, with outcomes comparable to US-visible nodules, especially for those with lipiodol accumulation.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-21"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Human Epidermal Growth Factor Receptor-2 Therapies in Biliary Tract Cancers: A Meta-Analysis on Disease Location, Human Epidermal Growth Factor Receptor-2 Status, and Survival Outcomes.","authors":"Silvia Camera, Margherita Rimini, Silvia Foti, Federica Lo Prinzi, Francesco Vitiello, Elisabeth Amadeo, Mara Persano, Stefano Cascinu, Andrea Casadei-Gardini, Federico Rossari","doi":"10.1159/000545308","DOIUrl":"10.1159/000545308","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, the therapeutic scenario of metastatic biliary tract cancers (BTCs) beyond first-line has profoundly changed owing to target therapies. human epidermal growth factor receptor-2 (HER2) represents a promising molecular target that is frequently altered in BTC. The present meta-analyses aimed to describe the response rates and survival outcomes in patients with HER2-positive locally advanced/metastatic BTC treated with anti-HER2 therapies. Moreover, the study is intended to provide an update on the evolving therapeutic scenario of HER2-overexpressed BTC.</p><p><strong>Methods: </strong>We performed a systematic review of the literature to identify clinical trials investigating any regimen comprising a HER2-targeted therapy for metastatic BTC, and we conducted three subsequent meta-analyses on second-line phase II trials. The first one was performed to compare the group of HER2 3+ versus the group of HER2 2+ BTC patients for objective response rate (ORR). The second one compared patients according to the tumor location (gallbladder carcinoma [GBC] or extrahepatic cholangiocarcinoma [eCCA] versus intrahepatic cholangiocarcinoma [iCCA]) for ORR. The third one evaluated the overall outcomes in terms of overall survival (OS) and progression-free survival (PFS).</p><p><strong>Results: </strong>Patients with advanced BTC and HER2 3+ had better ORR compared to HER2 2+, with a 3.7-fold higher probability of experiencing objective responses (HR 3.70, 95% CI, 1.34-10.25, p = 0.0119). Likewise, patients with GBC or eCCA had a 2.74-fold higher probability of experiencing an objective response compared to patients with iCCA (HR 2.74, 95% CI, 1.12-6.73, p = 0.0275). The weighted pooled analysis of trials with anti-HER2 agents in second line or beyond revealed an mPFS of 4.9 months (95% CI, 4.2-5.6), while mOS was 10.8 months (95% CI, 9.0-12.8).</p><p><strong>Conclusions: </strong>Our meta-analyses have revealed improved efficacy in patients with HER2 3+ metastatic BTC and in patients with GBC or eCCA treated with anti-HER2 therapies, with a considerable mPFS and mOS in the overall population of the phase II trials analyzed. Further studies are paramount to confirm our preliminary results.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to Transarterial Chemoembolization and Transarterial Radioembolization with Respect to Region and Urbanity in the USA: A Large Retrospective Healthcare Claims Database Study.","authors":"Nathan Sim, John T Moon, Hanzhou Li, Nicholas Lima, Zachary Bercu, Janice Newsome","doi":"10.1159/000546514","DOIUrl":"10.1159/000546514","url":null,"abstract":"<p><strong>Introduction: </strong>Access to highly specialized interventional oncology procedures such as transarterial chemoembolization (TACE) and radioembolization (TARE) may be limited in nonmetropolitan areas of the USA. This study aimed to evaluate whether disparities in access to TACE and TARE exists in these regions.</p><p><strong>Methods: </strong>This study characterizes the distribution of these procedures across regions by metropolitan status through utilization of a large commercial healthcare claims database (Truven Merative Marketscan). Patients with a diagnosis of primary hepatocellular carcinoma (n = 41,280) were categorized into those who received TACE (n = 1,780) or TARE (n = 1,179). Chi-squared tests of association were utilized to analyze regional data.</p><p><strong>Results: </strong>Statistical analyses showed significant differences between most regional comparisons with most patients receiving these procedures originating from metropolitan areas overall.</p><p><strong>Conclusion: </strong>Though limited to TACE and TARE, this study reveals a disparate distribution of TACE and TARE utilization across regions with preference toward metropolitan over nonmetropolitan areas, which may represent a barrier for access to care for nonmetropolitan patients, though this remains to be studied.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-5"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}