Oncology最新文献

{"title":"Prognostic impact of NLR, PLR, MLR, and SII in gastric cancer patients treated with immune checkpoint inhibitors: A Systematic Review and meta-analysis.","authors":"Cheng-Hsi Yeh, Shih-Ho Wang","doi":"10.1159/000551598","DOIUrl":"https://doi.org/10.1159/000551598","url":null,"abstract":"<p><p>Gastric cancer remains a significant global health burden, with immune checkpoint inhibitors showing variable effectiveness in treatment outcomes. This systematic review and meta-analysis examined the prognostic significance of hematologic inflammatory indices in advanced gastric cancer patients receiving immune checkpoint inhibitor. We conducted a comprehensive search of PubMed, EMBASE, and Cochrane CENTRAL databases through August 2023, focusing on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). Our analysis included eighteen studies encompassing 2,061 patients with advanced gastric cancer undergoing immune checkpoint inhibitor treatment. The meta-analysis demonstrated that elevated pretreatment inflammatory indices were consistently associated with worse clinical outcomes. High NLR showed significant associations with poor overall survival (adjusted HR: 1.73, 95% CI: 1.38-2.17) and progression-free survival (adjusted HR: 2.16, 95% CI: 1.30-3.58). Similarly, elevated PLR correlated with worse overall survival (adjusted HR: 1.77, 95% CI: 1.38-2.25) and progression-free survival (adjusted HR: 1.56, 95% CI: 1.22-1.99). High MLR and SII also demonstrated significant associations with poorer overall survival outcomes. Higher pretreatment NLR, PLR, MLR, and SII were associated with poorer survival in advanced gastric cancer patients receiving immune checkpoint inhibitors, suggesting a potential role for these simple blood-based indices in risk stratification that warrants confirmation in prospective studies.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-31"},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016338","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":"Biomarker-Oriented Contextual Analysis of First-Line Zolbetuximab and Immunotherapy-Based Strategies in HER2-Negative Metastatic Gastric Cancer.","authors":"Arianna Sabatini, Elisabetta Bengala, Vincenzo Picone","doi":"10.1159/ocl/aebag012","DOIUrl":"https://doi.org/10.1159/ocl/aebag012","url":null,"abstract":"<p><p>Purpose In HER2-negative metastatic gastric cancer, immune checkpoint inhibitors (ICIs) and CLDN18.2-targeted antibody zolbetuximab, combined with chemotherapy (CT), have emerged as first line options. Treatment selection is relatively straightforward in microsatellite instability-high (MSI-H), PD-L1 combined positive score (CPS)-high/negative disease, but uncertainty persists in overlapping biomarkers-particularly CLDN18.2-positive tumors with low-to-intermediate PD-L1 CPS-where direct comparative evidence is lacking. Methods Individual patient data were reconstructed from published Kaplan-Meier curves of pivotal phase III trials (SPOTLIGHT/GLOW, CheckMate-649, KEYNOTE-859). Descriptive, unadjusted indirect comparisons of progression-free survival (PFS) and overall survival (OS) were performed using pooled CT as common reference. Findings were interpreted within a biomarker-oriented framework incorporating PD-L1 CPS, CLDN18.2 expression, MSI status and treatment mechanisms. Results PFS benefit versus pooled CT was marked with zolbetuximab plus CT (hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.53-0.68), but more modest with pooled ICI-based regimens (HR 0.81, 95% CI 0.75-0.88). Both strategies improved OS. CLDN18.2-positive tumors are predominantly PD-L1 CPS-low, a biological context where ICI benefit may be heterogeneous. Conversely, zolbetuximab demonstrated consistent efficacy in this selected population; leveraging its established mechanism of direct CLDN18.2-targeting and innate immune activation, it provides a biomarker-directed therapeutic option that addresses the clinical gap in PD-L1 CPS-low disease. Conclusions Population-level efficacy estimates should not be interpreted as therapeutic interchangeability between ICIs and CLDN18.2-targeted therapy. Without direct comparative data, treatment selection in CLDN18.2-positive, PD-L1 CPS-low disease requires integration of biomarker biology and clinical context. This biomarker-informed framework supports clinical decision-making under uncertainty.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920378","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":"Glucose metabolism assessed by fluorodeoxyglucose positron emission tomography and response to chemoimmunotherapy in esophageal squamous cell carcinoma: An exploratory analysis.","authors":"Nobufumi Sekino, Takeshi Toyozumi, Masaya Uesato, Akira Nakano, Tadashi Shiraishi, Koichi Hayano, Yasunori Matsumoto, Yoshihiro Kurata, Hisahiro Matsubara, Michihiro Maruyama","doi":"10.1159/ocl/aebag010","DOIUrl":"https://doi.org/10.1159/ocl/aebag010","url":null,"abstract":"<p><strong>Introduction: </strong>Tumor glucose metabolism, as assessed by fluorodeoxyglucose positron emission tomography (FDG-PET), can reflect both intrinsic tumor biology and the host systemic condition. Increased FDG uptake has been linked to aggressive tumor behavior, altered metabolic activity, and a distinct tumor microenvironment. However, its clinical relevance remains unclear in patients with unresectable or recurrent esophageal squamous cell carcinoma (ESCC) treated with chemoimmunotherapy.</p><p><strong>Methods: </strong>We retrospectively analyzed 47 patients treated with fluorouracil plus cisplatin-based chemoimmunotherapy. FDG-PET was performed before treatment initiation, and maximum standardized uptake value (SUVmax) was used to assess tumor glucose metabolism. Treatment response was evaluated according to the Response Evaluation Criteria in Solid Tumors, and overall survival (OS) was calculated from the start of treatment. Patients were classified using an exploratory data-derived SUVmax cutoff value of 17.55, and treatment response, survival, and baseline characteristics were compared between groups. Continuous SUVmax was also analyzed using Cox models.</p><p><strong>Results: </strong>Patients with high SUVmax showed a significantly higher response rate than those with low SUVmax (83.3% vs. 52.6%, p = 0.0462). Higher SUVmax was independently associated with shorter OS (adjusted HR per unit, 1.105; 95% CI, 1.008-1.213; p = 0.0320).</p><p><strong>Conclusion: </strong>Higher pretreatment SUVmax was associated with a higher response rate but poorer OSin patients with unresectable or recurrent ESCC receiving chemoimmunotherapy. SUVmax may reflect both treatment sensitivity and aggressive tumor biology and may provide clinically relevant information on treatment response and prognosis, although the cutoff-based findings require external validation.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920528","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":"Effects of amputation versus limb salvage surgery on the prognosis of primary extremity chondrosarcoma: Evidence from the Surveillance, Epidemiology, and End Results database.","authors":"Hsin-Chang Chen, Yu-Cheng Lo, Ya-Ling Lee, Yi-An Li","doi":"10.1159/ocl/aebag011","DOIUrl":"https://doi.org/10.1159/ocl/aebag011","url":null,"abstract":"<p><strong>Aim: </strong>The demographic and clinical factors influencing the decision between amputation and limb salvage surgery (LSS) in chondrosarcoma patients are compared.</p><p><strong>Methods: </strong>Data from the Surveillance, Epidemiology, and End Results program were utilized. Individuals ≥ 18-year-old with primary chondrosarcoma located in the limbs and underwent cancer-directed surgery were included. Patients were divided into groups based on receiving LSS or amputation. Factors associated with amputation were determined by logistic regression. Overall survival (OS) and cancer-specific survival (CSS) were assessed by Cox proportional hazard regression analysis.</p><p><strong>Results: </strong>The study included 746 patients (LSS:617; amputation: 129). Compared with patients who underwent LSS, those who underwent amputation had poorer OS (adjusted hazard ratio [aHR]: 1.44, 95% confidence intervals [CI]: 1.08-1.93) and CSS (aHR: 1.60, 95% CI: 1.15-2.21). Lower limb as the primary site (adjusted odds ratio[aOR]: 1.87; 95% CI: 1.21-2.89; p=0.005), and M1 stage (aOR: 2.29; 95% CI:1.31-4.01) were significantly associated with a higher likelihood of undergoing amputation.</p><p><strong>Conclusion: </strong>In this population-based real-world study, amputation was associated with poorer OS and CSS among adults with primary extremity chondrosarcoma. This association likely reflects the advanced or surgically complex disease characteristics of patients requiring amputation rather than a direct adverse effect of amputation itself. These findings provide epidemiologic evidence to characterize this high-risk subgroup and inform future risk-stratified studies.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920487","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":"CCL5, CLEC11A, IL-7, IL-8, and IL-13: Diagnostic Serum Biomarkers of Gastric Cancer Identified in a 48-Multiplex Panel.","authors":"Jefim Brodkin, Tuomas Kaprio, Harri Mustonen, Alli Leppä, Arto Kokkola, Marko Salmi, Sirpa Jalkanen, Caj Haglund, Camilla Böckelman","doi":"10.1159/ocl/aebag009","DOIUrl":"10.1159/ocl/aebag009","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric cancer is the fifth most common cancer worldwide and the fifth leading cause of cancer-related death. Its poor prognosis is primarily due to a late diagnosis and a lack of effective treatments for advanced disease.</p><p><strong>Methods: </strong>We examined a patient cohort comprising 239 individuals who underwent surgery for histologically verified gastric adenocarcinoma in the Department of Surgery at Helsinki University Hospital between 2000 and 2009, comparing them to 48 healthy controls. We measured the serum protein concentrations for 48 different cytokines and growth factors using Bio-Rad's premixed Bio-Plex Pro Human Cytokine 27-plex and 21-plex assay kits.</p><p><strong>Results: </strong>Five serum biomarkers were identified as indicative of gastric cancer. Cancer patients had higher serum levels of CLEC11A [odds ratio (OR) 1.16, 95% confidence interval (CI) 1.08-1.26, p = 0.004], IL-7 (OR 2.73, 95% CI: 1.48-5.04, p = 0.014), IL-8 (OR 6.30, 95% CI: 2.23-20.0, p = 0.017), and IL-13 (OR 2.67, 95% CI: 1.33-5.37, p = 0.041). The CCL5 levels were lower in cancer patients compared with controls (OR 0.30, 95% CI: 0.14-0.60, p = 0.014).</p><p><strong>Conclusion: </strong>In a large cohort of 239 patients, we identified five biomarkers for which serum levels associated with gastric cancer: CCL5, CLEC11A, IL-7, IL-8, and IL-13. High serum levels of CLEC11A have not previously been associated with gastric cancer. Our results provide new support to further explore the effect of these inflammatory molecules and the role they play in gastric cancer. This may help identify novel noninvasive diagnostic methods as well as potential new druggable targets.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920510","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/aebag004","DOIUrl":"10.1159/ocl/aebag004","url":null,"abstract":"","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Neoadjuvant Docetaxel, Cisplatin, and 5-Fluorouracil-Induced Neutropenia on Histological Tumor Response in Esophageal Squamous Cell Carcinoma: A Retrospective Study.","authors":"Takahito Inagaki, Miki Sato, Masaoki Kin, Koji Otsuka, Masahiko Murakami, Mari Kogo","doi":"10.1159/ocl/aebag003","DOIUrl":"https://doi.org/10.1159/ocl/aebag003","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the relationship between neoadjuvant docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy-induced neutropenia and histological tumor response or prognosis to support appropriate postoperative treatment selection in patients with esophageal cancer receiving neoadjuvant DCF.</p><p><strong>Methods: </strong>Patients with esophageal cancer who underwent neoadjuvant DCF followed by surgery at Showa Medical University Hospital, Japan were retrospectively analyzed. A Cox proportional hazards regression analysis including prognostic factors (chemotherapy-induced neutropenia) was performed to determine progression-free survival (PFS). Survival curves for the histological tumor response grades 0-1b and 2-3, stratified by neutropenia severity, were estimated by Kaplan-Meier analysis, and compared using the log-rank test.</p><p><strong>Results: </strong>Among 53 patients (median age, 66 years [range: 48-78]; median PFS, 21 months), 33 (62.2 %) had clinical stage (cStage) IV disease, and 36 (67.9%) had grade 3/4 neutropenia. Multivariate analysis showed that cStage IVb (hazard ratio [HR]: 3.46, P = 0.004) and histological tumor response grade 0-1b (HR: 6.09, P < 0.001) were independent poor prognostic factors for PFS. In the grade 3/4 neutropenia group, a lower histological tumor response was associated with shorter PFS (median PFS: grade 0-1b, 10.1 months vs. grade 2-3, not reached, P < 0.001).</p><p><strong>Conclusions: </strong>In this study, cStage IVb and histological tumor response grade 0-1b were poor prognostic factors for PFS in patients with esophageal cancer who received neoadjuvant DCF followed by surgery. The histological tumor response was associated with PFS in patients with grade 3/4 neutropenia.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866196","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":"Low Stromal CD11c Expression Indicates a Poor Prognosis in Rectal Cancer Patients.","authors":"Rosa-Maria Penttinen, Tuomas Kaprio, Jaana Hagström, Jussi Kasurinen, Ines Beilmann-Lehtonen, Caj Haglund, Camilla Böckelman","doi":"10.1159/ocl/aebag005","DOIUrl":"https://doi.org/10.1159/ocl/aebag005","url":null,"abstract":"<p><strong>Introduction: </strong>The immune landscape of the tumor microenvironment significantly influences the development and prognosis of colorectal cancer (CRC). High intratumoral and stromal expressions of CD3+ and CD8+ T-lymphocytes have been associated with a better prognosis in CRC patients. However, the prognostic role of antigen-presenting cells, such as dendritic cells and macrophages, has less attention.</p><p><strong>Methods: </strong>In this study, we assessed the impact of CD11c expression and the disease-specific survival (DSS) in CRC patients. Thus, we evaluated the CD11c expression on tissue microarray samples via immunohistochemistry from 516 patients who underwent surgery at Helsinki University Hospital between 2000 and 2005. Samples were categorized as low expression (<5% positive stromal area) and high expression (≥5% positive). Colon and rectal cancer patients were analyzed separately using Cox regression for survival analysis.</p><p><strong>Results: </strong>A lower CD11c expression associated with a worse DSS among rectal cancer patients (p < 0.001) and right-sided colon cancer patients (p = 0.03), but not among left-sided colon cancer patients (p = 0.41). Among rectal cancer patients, results remained consistent regardless of whether the patient received preoperative radiation (p < 0.003 and p = 0.03, respectively). In the multivariable analysis after adjusting for age, sex, stage, grade, and a mismatch repair status, a lower CD11c expression remained an independent prognostic factor among rectal cancer patients (p = 0.009), but not among colon cancer patients (p = 0.15). These results suggest that stromal CD11c expression captures the distinct immunological characteristics of rectal cancer compared to colon cancer.</p><p><strong>Conclusions: </strong>We conclude that CD11c could serve as a prognostic marker for rectal cancer patients. However, the immunological mechanisms differentiating colon and rectal cancers warrant further research.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866225","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":"Albumin-Bilirubin Grade, Tumor Characteristics, and Survival of Patients with Hepatocellular Carcinoma.","authors":"Rossella Donghia R, Brian I Carr","doi":"10.1159/ocl/aebag006","DOIUrl":"10.1159/ocl/aebag006","url":null,"abstract":"<p><strong>Introduction: </strong>Albumin-bilirubin (ALBI) grade has recently been introduced as an objective measure of liver function and has been shown to be useful in prognostication for patients with hepatocellular carcinoma (HCC). The reasons for this usefulness in HCC prognostication are not clear.</p><p><strong>Methods: </strong>The study aimed to determine, in HCC patients, whether ALBI grade correlates with indices of HCC aggressiveness. A large cohort of nonsurgical HCC patients was examined for ALBI grade in relation to maximum tumor diameter (MTD), tumor focality, percentage of patients with portal vein thrombosis (PVT), serum alpha-fetoprotein (AFP) levels and survival.</p><p><strong>Results: </strong>ALBI grade was significantly associated with HCC aggressiveness parameters, particularly AFP, PVT, and tumor multifocality, but not with MTD. Similar associations were observed in the subset of patients with low AFP levels. ALBI grade showed a strong and graded relationship with survival, comparable to that observed for serum albumin alone. In Cox models stratified by ALBI categories, AFP, PVT, and tumor multifocality were independently associated with mortality.</p><p><strong>Conclusions: </strong>These findings suggest that ALBI reflects not only liver function, but also correlates with tumor aggressiveness features.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840811","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":"Redefining Fitness in Chronic Lymphocytic Leukaemia: A Treatment-Specific Framework for the Targeted Therapy Era.","authors":"Yousef Al-Asa'd, Salem H Alshemmari, Nabeel Mohammad Qasem, Afaf Al Battah, Mohamed A Yassin","doi":"10.1159/ocl/aebag001","DOIUrl":"10.1159/ocl/aebag001","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic advances in chronic lymphocytic leukaemia (CLL) have made treatment selection far more nuanced than in the chemoimmunotherapy era. Patients now have access to two principal therapeutic strategies: continuous therapy with Bruton's tyrosine kinase inhibitors (BTKis) or fixed-duration regimens combining venetoclax with CD20 monoclonal antibodies and/or BTKis. These strategies carry fundamentally different safety profiles, monitoring requirements, and logistical demands, necessitating a treatment-specific approach to fitness assessment.</p><p><strong>Summary: </strong>The objective of this article was to synthesise current evidence and propose a practical, treatment-specific fitness assessment framework for patients with CLL, enabling physicians to match patient characteristics to the most appropriate targeted therapy. This was a narrative review of the literature from PubMed, Scopus, and Embase. Landmark randomised controlled trials, contemporary expert opinion papers, and current guidelines from ESMO, ASCO, and ESC were reviewed. The two therapeutic paradigms impose distinct fitness demands. For continuous BTKi therapy, cardiovascular comorbidity is the dominant determinant, given the class-effect risk of atrial fibrillation and hypertension. For fixed-duration venetoclax-based regimens, the key determinants instead shift to renal function and tumour burden, which govern tumour lysis syndrome risk, and to the social support and hospital access required for intensive ramp-up monitoring. Building on this distinction, the landmark phase 3 CLL17 trial (N Engl J Med, 2026) demonstrated that fixed-duration venetoclax-obinutuzumab and venetoclax-ibrutinib are non-inferior to continuous ibrutinib, with superior rates of undetectable minimal residual disease and lower treatment discontinuation, particularly in older patients. Notably, frailty - better conceptualised as lower resilience - is dynamic rather than fixed and may improve during effective targeted therapy. Structured pre-treatment screening can be performed with validated instruments such as the G8, VES-13, GAH, and the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS); however, no single tool has yet been prospectively validated for outcome prediction specifically with BTKi or BCL-2 inhibitor therapy, and addressing this evidence gap is a priority for future research.</p><p><strong>Key messages: </strong>A treatment-specific, individualised fitness assessment - rather than an age-based or aggregate comorbidity score - is the appropriate framework for CLL in the targeted therapy era. Most patients, including those with lower resilience, are candidates for targeted therapy; the clinical imperative is to match each patient to the treatment best suited to their specific fitness profile.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840807","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}