Oncology最新文献

{"title":"Evaluating the Automated Extraction of Radiation Oncology Trial Data at Scale from the ClinicalTrials.gov Database Using a Large Language Model.","authors":"Fabio Dennstaedt, Lena Kretzschmar, Nikola Cihoric, Philip Heesen, Maksym Fritsak, Siyer Roohani, Daniel M Aebersold, Matthias Guckenberger, Sebastian M Christ","doi":"10.1159/ocl/aebag024","DOIUrl":"https://doi.org/10.1159/ocl/aebag024","url":null,"abstract":"<p><p>Background The rapid growth of biomedical publishing in radiation oncology has created a need for automated methods to extract structured information from unstructured text. Large language models (LLMs) show promise in biomedical natural language processing, but their use for clinical trial data curation remains to be systematically evaluated. Methods We evaluated an LLM-based extraction system for radiation oncology trials on ClinicalTrials.gov. Forty-five classification questions spanning variables such as trial design, tumor type, stage, radiotherapy modality, systemic therapy, and outcomes were implemented using the data-element-extractor Python library with three open-source LLMs (GPT-OSS-20B, GPT-OSS-120B, and Qwen-3.6-27B). A manually curated ground-truth of 94 trials was used for performance evaluation based on accuracy, precision, recall, and F1-score. Results Qwen-3.6-27B achieved the highest overall accuracy of 92.0% across all questions. For the 39 Boolean questions, it demonstrated 93.0% accuracy, 81.6% precision, 83.7% recall, and an F1-score of 82.6%, with 23 Boolean questions achieving an F1-score ≥80.0%. Three numerical questions reached accuracy ≥80.0%. Applied to the full dataset, the system characterized the clinical landscape of radiotherapy trials, detailing the prevalence of advanced techniques (e.g., 13.7% SBRT) and the integration of systemic agents, including chemotherapy (57.3%) and immunotherapy (26.1%). Conclusion LLM-based extraction can enable accurate, scalable curation of radiotherapy trial data. While challenges remain with complex categorical or numerical variables, open-source LLMs can serve as effective components of transparent, auditable clinical research pipelines.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228234","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":"Hepatocellular carcinoma screening in a tertiary hospital. What are we missing?","authors":"Francisco Capinha, Inês Coelho Rodrigues, Miguel Moura, Sofia Carvalhana, Helena Cortez-Pinto","doi":"10.1159/ocl/aebag023","DOIUrl":"https://doi.org/10.1159/ocl/aebag023","url":null,"abstract":"<p><strong>Introduction: </strong>Screening for hepatocellular carcinoma (HCC) aims to detect early tumors, with a positive impact on survival. In clinical practice there are several challenges on the application of HCC screening: patients with unknown liver disease, poor patient adherence or problems in the health care system, leading to an underperformance. We aim to evaluate the performance of the HCC screening, the reasons of missed or delayed diagnosis, and prognostic implications in patients with HCC in a tertiary center.</p><p><strong>Methods: </strong>Retrospective study including patients with an HCC diagnosis, that have been discussed by a liver tumors board from 2020 to 2023 in a tertiary hospital. HCC screening was defined according to the EASL recommendations. Considering the target population for screening, subgroups were considered and compared: (a) diagnosed through screening; (b) missed screening due to suboptimal patient adherence and/or systemic healthcare inefficiencies; (c) undiagnosed advanced chronic liver disease (uACLD), that would have indication for surveillance if already diagnosed. For patients diagnosed through screening, we considered a margin of 2 months (8 months) as \"complete surveillance\" and between 8 to 12 months as \"incomplete surveillance\". To access the survival benefit, we compared the overall survival of the screened population and those do not diagnose through screening.</p><p><strong>Results: </strong>We included 174 patients, 136 had advanced chronic liver disease (ACLD): 70% Child-Pugh (CP) A; 20% CP B; 10% CP C. The most common etiologic factor was excessive alcohol consumption (37%). The proportion of patients diagnosed in screening was 26%. Regarding Barcelona Clinic Liver Cancer (BCLC) stage at diagnosis, 4% BCLC-0, 37% BCLC-A, 10% BCLC-B, 33% BCLC-C and 15% BCLC-D. Patients in subgroup (a) had HCC diagnosed at earlier stages (BCLC-0 and BCLC-A). The subgroup (c) had a higher proportion CP B and C (p = 0.008), vascular invasion (p = 0.01), extrahepatic involvement (p = 0.052) and hepatic dysfunction according to ALBI score (p < 0.001) at time of diagnosis. Overall survival was significantly higher for screened group.</p><p><strong>Conclusion: </strong>In our cohort, only about a quarter of HCC cases were diagnosed through screening, with impact on survival. Among patients with indication for screening, only one third achieved diagnostic yield. Our findings emphasize the need to improve HCC screening strategies and the pivotal role of primary care in the early diagnosis of underlying liver disease.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224648","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":"Fusobacterium nucleatum mediated crosstalk drives cisplatin resistance in head and neck cancer.","authors":"Muhammad Daood Khan, Malik Arslan Ali, Ahmed Shabbir Chaudhry, Ali Ahsan, Ishtiaq Ahmad","doi":"10.1159/ocl/aebag021","DOIUrl":"https://doi.org/10.1159/ocl/aebag021","url":null,"abstract":"<p><p>Cisplatin remains a cornerstone of head and neck cancer (HNC) treatment, yet resistance frequently undermines therapeutic efficacy. Emerging evidence implicates Fusobacterium nucleatum, enriched in the tumour microbiome, in promoting chemoresistance via molecular and microenvironmental mechanisms. This review synthesises evidence from PubMed, Scopus, and Web of Science (January 2015-September 2025) examining F. nucleatum's contribution to cisplatin resistance in HNC. Cisplatin resistance involves tumour-intrinsic pathways, such as nucleotide excision repair, homologous recombination, and ATP7B-mediated drug efflux. F. nucleatum indirectly enhances resistance via Wnt5a/Ca²⁺-NFATc3 signalling, downregulation of p53 and E-cadherin, and activation of the NLRP3 inflammasome, which recruits myeloid-derived suppressor cells. It also amplifies inflammation and chemoresistance by escalating the senescence-associated secretory phenotype, promoting a tumour-supportive microenvironment. These findings highlight microbiome host crosstalk as a therapeutic target, suggesting that microbiota-directed strategies alongside cisplatin may improve outcomes in resistant HNC.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147935","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":"Cancer-type-specific gaps between treatment recommendation and implementation following comprehensive genomic profiling: a nationwide real-world study.","authors":"Yosuke Nakano, Ataru Igarashi, Minoru Esaki","doi":"10.1159/ocl/aebag018","DOIUrl":"https://doi.org/10.1159/ocl/aebag018","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive genomic profiling (CGP) has been reimbursed in Japan since 2019; however, the extent to which treatments recommended by expert panels are subsequently implemented and how this varies across cancer types remain unclear.</p><p><strong>Methods: </strong>Among 50,974 patients with solid tumors registered in the C-CAT database between June 2019 and April 2023, 44,669 adult patients met the eligibility criteria and were included in the analysis. Patients were grouped into three cohorts: non-small cell lung cancer (NSCLC), colorectal cancer (CRC), and other solid tumors. We evaluated the proportion of patients with at least one drug-based treatment recommended by an expert panel (PoTR) and the proportion who subsequently received an expert-panel-recommended treatment (PoTI). We also conducted exploratory multivariable analyses of factors associated with PoTR and, among patients who received a treatment recommendation, PoTI.</p><p><strong>Results: </strong>The PoTR was 54.57% for NSCLC, 53.80% for CRC, and 39.92% for other solid tumors. The PoTI was 16.74%, 7.96%, and 7.74%, respectively. A substantial gap between treatment recommendation and implementation was observed across cancer types. Among the Cohort C organ groups, PoTI was higher in the prostate and breast groups and lower in the pancreatic and soft-tissue groups. Exploratory adjusted analyses showed that the associations of age, ECOG performance status, CGP panel, and cohort differed between the PoTR and conditional PoTI models.</p><p><strong>Conclusion: </strong>This nationwide analysis found substantial variation in treatment recommendation, recorded implementation, and the gap between them across the prespecified cancer cohorts. These descriptive findings may help frame patient counseling and expectations regarding treatment recommendation and subsequent implementation after CGP.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147753","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":"Symptom Burden and Quality of Life in Multiple Myeloma: A Multicenter Study.","authors":"Jebrin Alkrinawi, Nizar Abu Hamdeh, Mohammad Alnees, Ibraheem AbuAlrub, Abdalaziz Darwish, Duha Najajra, Osama Ewidat, Yahya Z Fraitekh, Mohammad Masu Apos D, Omar Hammam Salloum, Reem J Saad, Nasim Abukaresh, Mustafa A Shahrori, Mahdi Awwad, Basem Bali, Nora I Baraghithi, Ahmad Alhashlamon, Yasmin Ahmad Rjoub, Mohammad Maswadeh, Zeina Sinnokrot, Firas Besharieh, Majde Abu Khaled, Rashed Saed, Rafufan Alsaied, Waed Awad, Nuha Riyad, Sarah Awad, Bashar Dawood, Yousef Abdelhay Yousef Abu Rayyan, Loay Shaheen, Majdi Khaled Zaid, Mohammed Manassra, Khairi Alzirei, Ali Abdullah, Haitham Abu Khadija","doi":"10.1159/ocl/aebag019","DOIUrl":"https://doi.org/10.1159/ocl/aebag019","url":null,"abstract":"<p><p>Introduction Symptom burden is a critical determinant of treatment tolerance and survivorship in multiple myeloma (MM). We investigated how symptom severity and interference relate to patient-reported quality of life (QoL) across multiple domains in a multicenter real-world MM cohort. Methods This multicenter study included 250 previously treated patients with multiple myeloma recruited from six hospitals in the West Bank, Palestine.Symptom severity and interference were assessed at baseline using the MDASI-MM, and QoL was evaluated one month later with the FACT-MM. Multivariable linear regression adjusted for demographic and clinical covariates was applied. Results are reported as adjusted β coefficients with 95% confidence intervals, and a two-sided P<0.05 was considered statistically significant. Results Greater symptom burden was consistently associated with poorer quality of life. General, specific, and overall symptom severity showed the strongest associations with lower physical well-being, disease-specific concerns, pain-related quality of life, Trial Outcome Index, and FACT-MM total score. Specific symptoms were also associated with lower social well-being. Symptom interference domains showed similar but smaller associations, particularly with physical well-being, functional well-being, pain, and composite quality-of-life scores. Conclusion In this multicenter cohort of patients with multiple myeloma, higher symptom burden was consistently associated with poorer quality of life, especially in physical functioning, pain, and disease-specific concerns. Routine symptom monitoring may help identify patients who need early supportive care interventions.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128211","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":"Stage-specific quality of life and tolerability of CDK4/6 inhibitors in HR-positive/HER2-negative breast cancer: a narrative review.","authors":"Luca Scafuri, Carlo Buonerba, Vincenzo Marotta, Anna Rita Amato, Germano Guerra, Giuseppe Di Lorenzo","doi":"10.1159/ocl/aebag020","DOIUrl":"https://doi.org/10.1159/ocl/aebag020","url":null,"abstract":"<p><strong>Background: </strong>Cyclin-dependent kinase 4/6 (CDK4/6) inhibitor tolerability should be interpreted alongside treatment benefit, patient-reported outcomes (PROs), and treatment continuation. This narrative review examines these outcomes in hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic and early breast cancer.</p><p><strong>Summary: </strong>In MONALEESA-2, median overall survival (OS) was 63.9 versus 51.4 months with ribociclib plus letrozole versus letrozole alone (hazard ratio [HR] 0.76), while global health-related quality of life (HRQoL) was maintained. PALOMA-2 and MONARCH 3 improved progression-free survival (HRs 0.58 and 0.540) without demonstrated OS improvement. Earlier CDK4/6 inhibitor use in SONIA increased exposure and toxicity without demonstrating improved OS or global HRQoL. In monarchE, with abemaciclib plus endocrine therapy versus endocrine therapy alone, seven-year invasive disease-free survival (iDFS) was 77.4% versus 70.9% (HR 0.734), and OS was 86.8% versus 85.0% (HR 0.842). NATALEE showed a 4.5-percentage-point five-year iDFS difference; its OS estimate remained uncertain. Three-year mean global-health-status changes in NATALEE were -3.10 versus -1.96 points with ribociclib plus a nonsteroidal aromatase inhibitor versus the aromatase inhibitor alone. Grade ≥3 diarrhea occurred in 7.8% of abemaciclib-treated monarchE patients. PALLAS and PENELOPE-B did not demonstrate improved iDFS; 42.2% of PALLAS palbociclib initiators discontinued early, including 27.2% because of adverse events.</p><p><strong>Key messages: </strong>Global HRQoL, individual symptoms, and continuation answer different questions. Discussions about metastatic treatment should integrate disease control and sequencing; discussions about adjuvant treatment should address absolute recurrence reduction and planned duration. Both require consideration of baseline symptoms, uncertainty, and individual priorities.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128221","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":"Erratum.","authors":"","doi":"10.1159/ocl/aebag016","DOIUrl":"https://doi.org/10.1159/ocl/aebag016","url":null,"abstract":"<p><p>In the article by Cacho-Díaz et al. entitled \"Targeted Therapies and Utility of the Lung-molGPA in Non-Small-Cell Lung Cancer Patients with Brain Metastases\" [Oncology. 2022;100:542-554. https://doi.org/10.1159/000525082], author errors occurred in the reporting of the EGFR- and ALK-positive patient numbers in the Abstract and in the terminology used to describe the comparison group in the subgroup survival analysis, and the following is being corrected.In the Results section of the Abstract, the corrected sentence is as follows:\"650 had a positive tumor mutational/rearrangement status (546 had EGFR mutations, 107 had ALK rearrangements, and 3 had both EGFR and ALK alterations).\"In the analyses by tumor mutational status reported in the Abstract, the Results, Figure 1c, Figure 1 legend, and Tables 3, 4, and 5, the group of 743 patients described as having a \"negative tumor mutational status\" included both patients with negative EGFR/ALK test results and patients whose EGFR/ALK status was unknown. Therefore, references to \"negative tumor mutational status\" in relation to this group should read: \"non-positive tumor mutational status (negative or unknown).\"The authors state that this group comprised all patients without a documented positive EGFR or ALK result and was calculated as 1,393 patients in the total cohort minus 650 patients with a documented actionable alteration, giving 743 patients.The authors have confirmed that the analyses were performed using the final EGFR and ALK counts and that these corrections do not affect the reported hazard ratios or the conclusions of the article.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112893","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":"The prognostic impact of sarcopenia and hypoalbuminemia on overall survival in esophageal cancer: a retrospective single-center study.","authors":"Karolina Votavova, Radka Lohynska, Tereza Drbohlavova, Miloslav Pala, Marie Rybkova, Zdenka Pechacova","doi":"10.1159/ocl/aebag017","DOIUrl":"https://doi.org/10.1159/ocl/aebag017","url":null,"abstract":"<p><p>: Introduction: The aim of the study was to investigate the influence of sarcopenia and hypoalbuminemia on overall survival in patients with esophageal cancer.</p><p><strong>Methods: </strong>Data from 138 patients treated for esophageal cancer at the Institute of Radiation Oncology, Bulovka University Hospital, Prague, Czech Republic, between 2009 and 2018 were retrospectively analyzed. Sarcopenia was assessed using the skeletal muscle index (SMI) derived from staging CT scans at the level of the L3 vertebra.</p><p><strong>Results: </strong>SMI was assessed in 129 (93.5%) patients and baseline albumin levels were available in 114 (82.6%) patients. The median overall survival was 9 months (range 1-154 months). Sarcopenia was detected in 80 patients (58.0%) and hypoalbuminemia in 38 patients (27.5%). Notably, 68.8% of sarcopenic patients had a normal or higher BMI, highlighting the limited ability of BMI alone to identify nutritionally compromised patients. Both sarcopenia and hypoalbuminemia were significantly associated with worse overall survival on Kaplan-Meier analysis (sarcopenia: p = 0.049; hypoalbuminemia: p = 0.007). On univariate Cox regression, sarcopenia showed a non-significant trend (HR 1.393, 95% CI 0.967-2.006; p = 0.075), while hypoalbuminemia was significantly associated with overall survival (HR 0.574, 95% CI 0.384-0.859; p = 0.007); neither factor retained independent prognostic significance on multivariate analysis.</p><p><strong>Conclusion: </strong>Sarcopenia and hypoalbuminemia were associated with worse overall survival in our cohort of patients with esophageal cancer on univariate analysis. Given the study's limitations, these findings should be regarded as hypothesis-generating and warrant confirmation in larger, prospective cohorts.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112864","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":"C-reactive protein-to-albumin ratio predicts survival in hepatocellular carcinoma on atezolizumab plus bevacizumab.","authors":"Mayumi Ehara, Toshifumi Tada, Atsushi Morii, Kaho Aoe, Tatsuya Sakane, Naoki Shinmaru, Yuta Inoue, Jun Kitadai, Yuki Shiomi, Takanori Matsuura, Masaki Omori, Motochika Hamanaka, Shohei Komatsu, Takashi Nishimura, Yuzo Kodama","doi":"10.1159/ocl/aebag015","DOIUrl":"https://doi.org/10.1159/ocl/aebag015","url":null,"abstract":"<p><p>Background Systemic inflammation and nutritional status influence tumor progression and response to systemic therapy. The C-reactive protein-to-albumin ratio (CAR), a simple composite of these factors, has been associated with prognosis in hepatocellular carcinoma (HCC); however, its clinical significance in patients treated with atezolizumab plus bevacizumab (Atez/Bev) remains unclear. We aimed to evaluate the prognostic value of baseline CAR in patients with unresectable HCC receiving Atez/Bev. Methods We retrospectively analyzed 289 patients with unresectable HCC treated with Atez/Bev across three institutions. The optimal CAR cutoff was determined using time-dependent receiver operating characteristic analysis at the median overall survival (OS) time point. Survival outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards models. Results The median progression-free survival (PFS) and OS were 6.8 and 26.5 months, respectively. The optimal CAR cutoff was 0.056. Patients with high CAR showed significantly poorer radiological response, PFS, and OS than those with low CAR. In multivariate analysis, CAR ≥0.056 was independently associated with shorter PFS (HR, 1.752; 95% CI, 1.296-2.367; p < 0.001) and OS (HR, 2.175; 95% CI, 1.323-2.948; p < 0.001). Time-dependent ROC analysis showed that CAR and neutrophil-to-lymphocyte ratio had comparable prognostic performance up to 18 months, whereas CAR showed significantly higher AUROC values from 24 months onward. Conclusion Baseline CAR is an independent prognostic biomarker in patients with unresectable HCC treated with Atez/Bev and may be a useful biomarker for risk stratification and prediction of long-term outcomes.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030954","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 Clinicopathologic Factors on Breast Cancer Diagnosed in Pregnancy.","authors":"Malcolm Su, Diti Patel, Samira Syed, Glenda Delgado-Ramos, Heather McArthur, Ina Patel, Poorni Manohar, Shifa Kanjwal","doi":"10.1159/ocl/aebag014","DOIUrl":"https://doi.org/10.1159/ocl/aebag014","url":null,"abstract":"<p><strong>Introduction: </strong>Effective management of breast cancer diagnosed during pregnancy (PrBC) requires the coordination of multiple specialists, including maternal fetal medicine specialists (MFM) and medical oncologists, as patients often present at a younger age with more aggressive tumor biology. It is critical to evaluate how increased time from diagnosis to treatment initiation may impact development of pregnancy complications and maternal survival outcomes.</p><p><strong>Methods: </strong>A retrospective study was conducted to evaluate all female patients who were diagnosed with breast cancer during pregnancy across a safety-net hospital and private comprehensive cancer center from January 2015 and December 2024. Event-free survival (EFS) and overall survival (OS) were analyzed using Cox proportional hazards models adjusting for covariates including initiation of treatment during pregnancy.</p><p><strong>Results: </strong>Among 34 patients with PrBC, 20 (58.8%) patients received chemotherapy during pregnancy, and 19 (55.8%) patients experienced maternal or fetal complications during pregnancy. Four patients (1.8%) were diagnosed with Stage I breast cancer, 10 patients (29.4%) had Stage II disease, 12 patients (35.3%) were diagnosed with Stage III breast cancer, and 8 patients (23.5%) were diagnosed with Stage IV disease. Patients who experienced complications of pregnancy also had experienced increased time between initial biopsy to establishment with MFM compared to those without complications (p=0.03). There were no significant differences in EFS and OS among patients who did and did not initiate treatment during pregnancy nor was increased time from breast cancer diagnosis to systemic treatment initiation associated with worsened EFS or OS. Stage III and IV breast cancer diagnosis (HR 9.79; 95% CI, 1.30-76.9; p=0.03) were associated with worsened EFS; increased BMI at diagnosis was also associated with worsened OS (HR 1.30; 95% CI, 1.05-1.62; p=0.02).</p><p><strong>Conclusion: </strong>While initiation of antenatal chemotherapy was not associated with improved patient outcomes, clinicopathologic factors-including increased BMI-may impact survival in PrBC. Establishment of a dedicated interdisciplinary team may improve coordination of multidisciplinary care and optimize outcomes within PrBC care.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025659","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}