Oncology最新文献

{"title":"Treatment Outcomes in Frail Patients with Advanced Pancreatic Ductal Adenocarcinoma: A Real-World Comparison of Gemcitabine, S-1, and Stereotactic Ablative Radiotherapy.","authors":"Chang Hyun Kim, Eun Jeong Kim, Tae Seung Lee, Jin Ho Choi, In Rae Cho, Sang Hyub Lee, Ji Kon Ryu, Hyun Cheol Kang, Eui Kyu Chie, Woo Hyun Paik","doi":"10.1159/000552276","DOIUrl":"https://doi.org/10.1159/000552276","url":null,"abstract":"<p><p>Background Elderly patients or those with poor performance status are underrepresented in clinical trials of pancreatic ductal adenocarcinoma (PDAC), and optimal treatment strategies for this frail population remain unclear. In real-world practice, gemcitabine, S-1, and stereotactic ablative radiotherapy (SABR) are used as first-line options in patients unfit for intensive combination chemotherapy. We compared these strategies in frail patients with advanced PDAC. Methods This single-center retrospective cohort study included frail patients with histologically confirmed PDAC diagnosed between February 2014 and February 2024. Frailty was defined as age ≥80 years or an Eastern Cooperative Oncology Group performance status ≥2. Patients with resectable disease were excluded. Eligible patients received first-line gemcitabine, S-1, or SABR. Overall survival (OS) was the primary endpoint. Propensity score-based overlap weighting was applied, and survival was analyzed using Kaplan-Meier methods and Cox regression. Results Among 63 patients, including 36 with metastatic disease and 27 with borderline resectable or locally advanced PDAC, median OS in metastatic PDAC was 7.70 months with gemcitabine and 4.33 months with S-1, with no significant difference after overlap weighting (HR, 1.31). In borderline resectable or locally advanced PDAC, SABR was not associated with inferior OS compared with systemic chemotherapy (HR, 1.78). Gemcitabine was associated with improved survival compared with S-1 in patients with tumor size ≥4 cm or peritoneal metastasis. Hematologic adverse events were more frequent with chemotherapy, whereas non-hematologic events were more common with SABR. Conclusions In frail patients with PDAC, gemcitabine and S-1 showed comparable survival in metastatic disease, and SABR showed no statistically significant difference in overall survival compared with systemic chemotherapy in borderline resectable or locally advanced disease, supporting individualized treatment.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840711","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":"Early Metastasis in Soft Tissue Sarcoma: Clinicopathologic Predictors and the Limits of Current Risk Stratification.","authors":"Dorian Yarih Garcia-Ortega, Miguel Angel Clara Altamirano, Ana Paulina Melendez-Fernandez, Maria Isabel Hernandez-Salcedo, Itzel Elizabeth Vidal-Sanchez, Claudia Haydee Sarai Caro-Sanchez, Sylvia Veronica Villavicencio-Valencia, Gabriela Concepcion Alamilla García, Kuauhyama Luna-Ortiz","doi":"10.1159/000551957","DOIUrl":"https://doi.org/10.1159/000551957","url":null,"abstract":"<p><p>Soft tissue sarcomas (STS) of the extremities and trunk are biologically heterogeneous, and distant metastasis remains the leading cause of disease-related mortality. A subset of patients develops metastases very early (≤12 months after diagnosis), suggesting a distinct aggressive phenotype that is poorly characterized. We aimed to identify clinicopathologic determinants of early distant metastasis (DM ≤12) and to assess the performance of an OS-based nomogram in this high-risk window.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 344 adult patients with extremity and trunk STS treated at a high-volume sarcoma center between 2010 and 2020. Early metastasis was defined as distant recurrence within 12 months of diagnosis. Survival was estimated using the Kaplan-Meier method. Cox proportional hazards models identified independent predictors of DM ≤12. The ability of Sarculator-predicted 5-year overall survival to discriminate early metastatic risk was evaluated and compared with clinicopathologic variables.</p><p><strong>Results: </strong>The median age was 47 years, and 50.6% were men. Tumors were predominantly deep (72.2%), large (median 11.3 cm), and high grade (G3, 62.3%), with liposarcoma (36.8%), synovial sarcoma (18%), and undifferentiated pleomorphic sarcoma (12.3%) as the most frequent histologies. Early distant metastasis occurred in 26% of patients and was associated with markedly inferior survival (median OS 21.5 vs. 89.1 months, p<0.001). On multivariable analysis, age <50 years, tumor size ≥10 cm, high grade, aggressive histologies (synovial sarcoma and undifferentiated pleomorphic sarcoma), deep location, and incomplete resection (R1/R2) independently predicted DM ≤12. The OS-based nomogram showed moderate discrimination for early metastasis (AUC 0.82, 95% CI 0.76-0.88) but did not outperform key clinicopathologic factors.</p><p><strong>Conclusion: </strong>Early distant metastasis defines a distinct ultra-high-risk phenotype in extremity and trunk STS, driven predominantly by tumor biology and surgical factors. Although Sarculator remains useful for global risk stratification, it does not fully capture patients destined for very early relapse.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-16"},"PeriodicalIF":1.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777462","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":"Intratumoral Heamorrhage Induced by Atezolizumab plus Bevacizumab Combination Therapy in Patients with Hepatocellular Carcinoma.","authors":"Takashi Takeuchi, Hajime Yokota, Jun Koizumi, Akiyo Takada, Maaya Miyakoshi, Sadahisa Ogasawara, Naoya Kanogawa, Masanori Inoue, Keisuke Koroki, Sae Yumita, Takuro Horikoshi, Katsuhiro Nasu, Takashi Uno","doi":"10.1159/000551878","DOIUrl":"https://doi.org/10.1159/000551878","url":null,"abstract":"<p><p>Introduction The purpose of this study was to investigate the incidence, risk factors, and prognostic significance of intratumoral hemorrhage (ITH) in patients with hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab (A+B) therapy. Methods In this single‑center retrospective cohort, 107 consecutive patients with HCC received A+B between October 2020 and March 2022 and underwent contrast‑enhanced CT before and after therapy initiation. ITH was defined on the arterial phase of the first follow‑up CT as intratumoral contrast pooling with a surrounding low‑attenuation rim absent on non‑contrast images. When present, foci were counted and graded (1-4); maximum tumor diameter was measured on portal‑venous phase images. Progression‑free survival (PFS) from treatment start to progression or death was analyzed per RECIST 1.1 and modified RECIST (mRECIST). Results On the first follow up CT, ITH was observed in 12 of 107 patients (11.2%). Patients with ITH had larger tumors than those without (p=0.002). ITH was confined to the tumor; no intraperitoneal hemorrhage occurred. Among nine patients with serial CTs, ITH grade decreased during follow up in seven (77.8%). Thereafter, A+B was discontinued for progressive disease (PD) in five of these cases. PFS did not differ between patients with and without ITH by RECIST 1.1 or mRECIST (p=0.74 and 0.98, respectively). Conclusion ITH was an early, on‑treatment radiologic finding during A+B therapy for HCC and was more frequent in larger tumors. In this cohort, ITH was not associated with a statistically significant difference in PFS. Among patients with serial CT examinations, ITH grade decreased during follow-up in most evaluable cases; however, the clinical significance of this temporal change remains to be determined. No hemoperitoneum was observed, supporting careful observation in the absence of overt hemorrhage.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777596","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 of hypoglycemic agents with the risk of platinum-based chemotherapy-induced peripheral neuropathy in patients with type 2 diabetes mellitus.","authors":"Takeshi Horii, Kenji Onda, Airi Yutasaka, Masaya Hasumi, Saori Yoda, Kenichi Suzuki, Kiyoshi Mihara","doi":"10.1159/000549964","DOIUrl":"https://doi.org/10.1159/000549964","url":null,"abstract":"<p><p>Introduction In patients with cancer who also have type 2 diabetes (T2D), platinum-based chemotherapy can worsen the neuropathy owing to its neurotoxicity. Glucose-lowering agents may mitigate chemotherapy-induced peripheral neuropathy by improving glycemic control and reducing metabolic stress. However, their clinical utility in reducing the risk of chemotherapy-induced peripheral neuropathy-potentially (CIPN-P) has not been fully validated, and which drugs are associated with a decreased incidence of neuropathy in this context remains unclear. Methods We conducted a retrospective cohort study by using the nationwide Medical Data Vision claims database in Japan, which includes patients treated at acute-care hospitals. From April 2008 to December 2022, 119,061 patients with T2D were prescribed hypoglycemic agents and received platinum-based chemotherapy. Patients with type 1 diabetes, other diabetes types, or pre-existing neuropathy were excluded. The outcome, CIPN-P, was defined as a new prescription of gabapentin, duloxetine, mirogabalin, or cyanocobalamin following an International Classification of Diseases, 10th Revision code for peripheral neuropathy. Patients were followed for three years after chemotherapy. Baseline covariates included age, sex, body mass index, hemoglobin A1c, and estimated glomerular filtration rate. Multivariable Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We examined their diagnoses, treatments, and procedures, categorizing them into patients with CIPN-P (n=22,559) and those without (n=96,502). Results The incidence of CIPN-P was 18.9%. The concomitant use of sodium-glucose cotransporter 2 inhibitors was associated with a lower risk of CIPN-P, with an overall hazard ratio HR of 0.89 (95% CI: 0.82-0.96, p=0.01). Empagliflozin (HR hazard ratio: 0.85) and dapagliflozin (HR: 0.85) were each associated with a significantly lower risk. Conclusion These results suggest that sodium-glucose cotransporter 2 inhibitors may be associated with CIPN-P in patients undergoing platinum-based chemotherapy. These associations may support more individualized antidiabetic treatment strategies in patients receiving platinum-based chemotherapy.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691275","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":"Serum microRNA-122 predicts early progressive disease in unresectable hepatocellular carcinoma with atezolizumab plus bevacizumab therapy.","authors":"Shigeki Yamamoto, Norio Akuta, Tetsuya Hosaka, Yasuka Eriksson, Shunya Goto, Yasue Takeuchi, Hitomi Sezaki, Satoshi Saitoh, Mariko Kobayashi, Hiromitsu Kumada, Fumitaka Suzuki","doi":"10.1159/000551990","DOIUrl":"https://doi.org/10.1159/000551990","url":null,"abstract":"<p><p>Introduction Atezolizumab plus bevacizumab is a standard first-line therapy for unresectable HCC; however, a proportion of patients develop early progressive disease (PD). Reliable pretreatment predictive biomarkers remain an unmet need. This study investigated the association between baseline serum microRNA-122 (miR-122) levels and early PD. Methods We retrospectively analyzed 64 consecutive patients with unresectable HCC and Child-Pugh class A treated with atezolizumab plus bevacizumab between October 2020 and January 2026 with available baseline serum samples. Early PD was defined as radiological progression within 6 weeks according to modified RECIST. Clinical, laboratory, and tumor characteristics were compared between patients with and without early PD. ROC analysis determined optimal cutoff values, and logistic regression identified factors associated with early PD. Results Early PD at the radiological assessment within 6 weeks of treatment initiation was observed in 16 patients (25.0%). Baseline serum AST, AFP, protein induced by vitamin K absence or antagonist II (PIVKA-II), miR-122 levels and the presence of macrovascular invasion were significantly different between early PD and non-early PD. Multivariate logistic regression analysis identified higher levels of miR-122 levels (≥0.101 fold changes) and AFP (≥332.35 μg/L) as independent predictors of early PD. Even when limited to cases without prior treatment with molecularly targeted therapy, the same results were obtained. Conclusion Baseline serum miR-122 levels were independently associated with early PD in patients with unresectable HCC treated with atezolizumab plus bevacizumab. Serum miR-122 may serve as a predictive biomarker to identify patients at high risk of early treatment failure.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691326","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":"Hypoxia-Induced microRNAs confer survival advantage in bladder cancer by fine-tuning oncogenic Pathways.","authors":"Takaya Ohno, Yuki Nakajima, Yuki Yoshikawa, Takuya Tsujino, Ryoichi Maenosono, Ko Nakamura, Tomoaki Takai, Taizo Uchimoto, Tatsuo Fukushima, Kazuki Nishimura, Yusuke Yano, Takuya Higashio, Tomohisa Matsunaga, Keita Nakamori, Haruhito Azuma, Teruo Inamoto","doi":"10.1159/000551754","DOIUrl":"https://doi.org/10.1159/000551754","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder cancer (BC) is influenced by hypoxic conditions, which promote tumor progression and resistance to therapy. MicroRNAs (miRNAs) play key roles in regulating gene expression under hypoxia.</p><p><strong>Methods: </strong>This study utilized a miRNA array to compare expression profiles under normoxic and hypoxic conditions. We analyzed 1024 genes, focusing on differentially expressed miRNAs. Survival analysis was performed using a cohort of 408 BC patients from TCGA (The Cancer Genome Atlas). Target prediction for hypoxia-inducible factors (HIFs) and cancer-related genes was performed.</p><p><strong>Results: </strong>Of 1024 miRNAs, 508 were downregulated and 516 upregulated in hypoxia. Four miRNAs (hsa-miR-210, hsa-miR-4435, hsa-miR-6875, hsa-miR-193b) were upregulated >50-fold, and four (hsa-miR-1250, hsa-miR-1288, hsa-miR-362, hsa-miR-6828) were downregulated. Upregulated miRNAs were associated with a trend toward improved overall survival in 408 BC patients (Log-rank p = 0.049). Three downregulated miRNAs targeted HIF-1α, while three upregulated miRNAs targeted HIF-3α. Hsa-miR-210 targeted AGO2 and USP10, with hsa-miR-4435 also targeting AGO2.</p><p><strong>Conclusion: </strong>BC under hypoxia exhibits a specific miRNA profile targeting HIFs and cancer-related genes including AGO2 and USP10, potentially influencing treatment success and survival.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633907","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 Tyrosine Kinase Inhibitors on Estimated Glomerular Filtration Rate in Chronic Myeloid Leukemia Patients.","authors":"Awni Alshurafa, Maria Benkhadra, Nabeel Mohammad Qasem, Anas M Babiker, Yousef Al-Asa'd, Mahmoud Y Haik, Mohamed A Yassin","doi":"10.1159/000551753","DOIUrl":"https://doi.org/10.1159/000551753","url":null,"abstract":"<p><strong>Introduction: </strong>Tyrosine kinase inhibitors (TKIs) are the cornerstone of therapy for chronic myeloid leukemia (CML). Although nephrotoxicity has been reported, existing evidence remains inconsistent, with limited data from the Gulf region. This study aimed to evaluate the impact of TKIs on renal function among patients with CML treated at Hamad Medical Corporation (HMC), Qatar.</p><p><strong>Methods: </strong>This retrospective, single-center study included adults with CML who received a TKI between 2016 and 2023. The primary outcome was the change in estimated glomerular filtration rate (eGFR) over time. Secondary outcomes included acute kidney injury (AKI), chronic kidney disease (CKD), and the need for dialysis. Repeated-measures analysis of variance (RM-ANOVA) was used to assess eGFR trends.</p><p><strong>Results: </strong>A total of 209 patients were followed for a median of 69.3 months (IQR, 39.4-117.8). Imatinib was the most frequently prescribed TKI (n=136, 65.1%), followed by dasatinib (n=39, 18.7%) and nilotinib (n=34, 16.3%). The mean baseline eGFR was 93.8 mL/min/1.73 m² (SD 26.3) and showed no significant decline at 3 months (p=0.498), 3 years (p=0.112), or 8 years (p=0.297). However, among dasatinib-treated patients, eGFR significantly decreased from 87.5 (SD 16.7) to 76.8 (SD 11.4) over three years (p=0.042). AKI occurred in 17 (8.1%) patients, CKD in 4 (1.9%), and none required dialysis. No significant differences were observed across TKI types.</p><p><strong>Conclusion: </strong>Renal function remained largely stable during long-term TKI therapy. Dasatinib was associated with a significant decline in eGFR, whereas imatinib and nilotinib demonstrated no such effect.  .</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581764","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":"Transforming Acute Myeloid Leukemia Care Through Precision Medicine: Integrating Genomic Profiling, Measurable Residual Disease, and Targeted Therapies.","authors":"Rafal Al-Shibly, Maria Benkhadra, Mohamed A Yassin","doi":"10.1159/000551702","DOIUrl":"https://doi.org/10.1159/000551702","url":null,"abstract":"<p><p>Acute myeloid leukemia (AML) is a biologically heterogeneous and clinically aggressive hematologic malignancy, with outcomes that remain poor for many older adults and patients with adverse-risk disease. Advances in cytogenetics and next-generation sequencing have uncovered actionable lesions (e.g., FLT3, IDH1/2, NPM1) and enabled biomarker-driven risk stratification and therapy selection. Since 2017, multiple targeted and antibody-drug conjugate approaches-often combined with intensive chemotherapy or hypomethylating agents-have improved remission rates in molecularly defined subsets. Measurable residual disease (MRD) assessment using multiparameter flow cytometry and molecular assays is increasingly used to refine post-remission decisions, including transplantation and maintenance strategies, but is constrained by assay variability, clonal hematopoiesis, and limited evidence for MRD-directed interventions. This narrative review synthesizes the evolving genomic landscape, guideline-endorsed targeted therapies, and investigational strategies in AML, and provides a practical framework that integrates genomic profiling, MRD-informed decision-making, and algorithmic treatment pathways while highlighting real-world barriers to implementation and equity.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581720","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":"Can splenic characteristics predict rectal cancer chemotherapy toxicity and treatment outcomes in rectal cancer patients?","authors":"Lara Wirth, Alex Besson, Paige Hudson, Josephine Yeung, Justin M Yeung","doi":"10.1159/000551703","DOIUrl":"https://doi.org/10.1159/000551703","url":null,"abstract":"<p><strong>Introduction: </strong>Rectal cancer requires multidisciplinary management, including chemotherapy treatment, for successful clinical outcomes. Splenic characteristics on CT imaging has been proposed to reflect immune function. This study explores whether splenic size and splenic density on pre-treatment computer tomography (CT) scans predicts chemotherapy dose limiting toxicities (DLT) and cancer outcomes in rectal cancer patients.</p><p><strong>Methods: </strong>A retrospective study of rectal cancer patients who received chemotherapy treatment with curative intent from February 2013 to March 2023 was conducted. Pre-treatment CT scans were collected for measurement of splenic volume and density. Receiver operating characteristics (ROC) analyses of splenic density and volume was performed to calculate the area under the curve (AUC). The AUC was used to determine association with overall survival (OS), disease free survival (DFS) and DLT.</p><p><strong>Results: </strong>234 patients were included, 98 (41.8%) patients were classified as having diffuse reduction of spleen density (DROSD). The DROSD group experienced significantly reduced dose limiting toxicities (13.3% vs 24.3%, p = 0.045). There was no significant association between OS or DFS with splenic volume or density.</p><p><strong>Conclusion: </strong>This study has shown that DROSD is an independent predictive factor for reduced DLT in rectal cancer patients undergoing chemotherapy treatment. Further research is needed to validate findings and elucidate underlying mechanisms.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513848","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":"Nivolumab versus Best Supportive Care after failure of Chemotherapy in Non-Small Cell Lung Cancer Patients with ECOG 3 or 4: A Propensity Matched Analysis.","authors":"Pawan Kumar Singh, Geetika Arya, Vineela Surapaneni, Aman Ahuja, Jahanvi Grover, Yogita Kumar, Dhruva Chaudhry","doi":"10.1159/000551462","DOIUrl":"10.1159/000551462","url":null,"abstract":"<p><strong>Introduction: </strong>Non small cell lung cancer (NSCLC) patients with poor Eastern Cooperative Oncology Group Performance Status (ECOG PS >2) represent a challenging subset of patients. Best supportive care (BSC) has been the standard of care as per NCCN guidelines in this cohort; however immune checkpoint inhibitors have a potential of offering better tolerance and survival benefits. This study aimed to compare outcomes of immunotherapy versus BSC in NSCLC patients with PS>2.</p><p><strong>Methods: </strong>This is a retrospective analysis of NSCLC patients who have progressed on initial lines of therapy and had ECOG PS 3 or 4. A propensity score matching was conducted between the two groups- those who received immune checkpoint inhibitors (nivolumab group) and those who were managed with BSC (BSC group) using the variables of age, sex, smoking status, stage and tumor type. The final study cohort included 39 patients in nivolumab arm and 21 in BSC arm. Baseline demographics, treatment responses, overall survival (OS), and adverse events were compared.</p><p><strong>Results: </strong>Most patients were males (81.7%), smokers (85%), and had stage IV disease (75%), and squamous histology (70%). PDL1 status was unknown in 53.3%. All patients had initially received platinum-based-doublet chemotherapy. Compared to the nivolumab group, the BSC group had a higher proportion of ECOG 4 patients (80.9% vs 35.9%, p<0.001), while more nivolumab patients had PDL1 levels of 1-49% (30.8% vs 14.3%, p=0.003). Median progression-free survival in the nivolumab group was 18-weeks, with 25.6% remaining progression-free at data cutoff. Median OS was significantly longer with nivolumab: 29-weeks (95% CI: 11.3-46.7) versus 8-weeks (95% CI: 3.5-12.5; p<0.001) with adjusted-hazard-ratio of 0.243 (95% CI: 0.106-0.56; p<0.001). In the nivolumab group, 23.1% had partial-responses, and 41% showed at least one-point improvement in PS (4.8% in the BSC group).</p><p><strong>Conclusion: </strong>Immunotherapy demonstrated superior survival outcomes and acceptable tolerability profile than BSC in NSCLC patients with PS >2.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-15"},"PeriodicalIF":1.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504627","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}