Seminars in oncology最新文献

{"title":"Prevalence, mutational spectrum and clinical implications of clonal hematopoiesis of indeterminate potential in plasma cell dyscrasias","authors":"Stefano Testa ,&nbsp;Jyoti Kumar ,&nbsp;Alex J. Goodell ,&nbsp;James L. Zehnder ,&nbsp;Kevin M. Alexander ,&nbsp;Surbhi Sidana ,&nbsp;Sally Arai ,&nbsp;Ronald M. Witteles ,&nbsp;Michaela Liedtke","doi":"10.1053/j.seminoncol.2022.11.001","DOIUrl":"10.1053/j.seminoncol.2022.11.001","url":null,"abstract":"<div><p>Clonal hematopoiesis of indeterminate potential (CHIP) is common both in healthy individuals and patients with hematological cancers. Recent studies have showed worse prognosis for patients with multiple myeloma (MM) and non-Hodgkin lymphoma undergoing stem cell transplant, that have concomitant presence of CHIP. Data regarding the clinical and biological role of CHIP in plasma cell dyscrasias (PCDs) is rapidly increasing. However, the prevalence and prognostic implication of CHIP in patients with MM outside of the transplant setting, and in those with other more indolent PCDs remains elusive. Here we explored the prevalence and clinical implications of CHIP detected through next-generation sequencing in 209 patients with PCDs including MM, light chain (AL) amyloidosis (ALA), monoclonal gammopathy of undetermined significance (MGUS), and smoldering multiple myeloma (SMM). To avoid attributing the mutations to the plasma cell clone, CHIP was defined as the presence of <em>DNMT3A, TET2,</em> or <em>ASXL1</em> mutations in the peripheral blood or bone marrow (DTA-CH). The prevalence of DTA-CH was 19% in patients with PCDs, with no difference between each PCD. <em>TET2</em> (23%) and <em>DNMT3A</em> (22%), were the most frequently mutated genes. DTA-CH correlated with older age in MM (<em>P</em> = .001) and MGUS/SMM (<em>P</em> = 0.0007), as well as with coronary artery disease or congestive heart failure in MM (<em>P</em> = .03). DTA-CH did not predict worse OS or PFS in either MM or ALA, nor it predict higher risk of progression to MM in patients with MGUS/SMM. Our results overall further elucidate the prevalence and mutational spectrum of CHIP in PCDs, providing more information regarding the clinical relevance of CHIP in this patient population.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 465-475"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9531576","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 narrative review of the principal glucocorticoids employed in cancer","authors":"Nerina Denaro ,&nbsp;Ornella Garrone ,&nbsp;Annamaria Morelli ,&nbsp;Benedetta Pellegrino ,&nbsp;Marco Carlo Merlano ,&nbsp;Denise Vacca ,&nbsp;Josie Pearce ,&nbsp;Daniele Farci ,&nbsp;Antonino Musolino ,&nbsp;Mario Scartozzi ,&nbsp;Chiara Tommasi ,&nbsp;Cinzia Solinas","doi":"10.1053/j.seminoncol.2023.01.004","DOIUrl":"10.1053/j.seminoncol.2023.01.004","url":null,"abstract":"<div><p>Glucocorticoids<span> (GCs) are a pharmacological class of drugs<span> widely used in oncology<span> in both supportive and palliative settings. GCs differentially impact organs with immediate and long-term effects; with suppressive effect on the immune system anchoring their use to manage the toxicities of immune checkpoint inhibitors (ICIs).</span></span></span></p><p>In addition, GCs are often used in the management of symptoms related to cancer or chemotherapy and as adjuvants in the treatment of pain in the management of other. In the palliative setting, GCs, especially administered subcutaneously can be to assist in the control of nausea, dyspnea, asthenia, and anorexia-cachexia syndrome.</p><p>In this narrative review, we aim to summarize the role of GCs in the different settings (curative, supportive, and palliative) to help clinicians use these important drugs in their daily clinical practice with cancer patients.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 429-438"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164038","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":"From doctors to ancillary staff: Regional and metropolitan cancer workforce perceptions and distress resulting from COVID-19 pandemic adaptations","authors":"Natasha A. Roberts ,&nbsp;Elizabeth Ahern ,&nbsp;Anita Pelecanos ,&nbsp;Harry Gasper ,&nbsp;Bryan Chan ,&nbsp;Zarnie Lwin","doi":"10.1053/j.seminoncol.2023.01.008","DOIUrl":"10.1053/j.seminoncol.2023.01.008","url":null,"abstract":"<div><h3>Introduction</h3><p>The declaration of the COVID-19 pandemic has resulted in necessary and rapid changes to health service delivery. In the Australian context, it has been broadly identified that these impacts have been felt by health care workers (HCW) providing care. We aimed to capture oncology HCW perceptions of support, stress, personal ability to meet needs and institutional preparedness across longitudinal periods of COVID-19 response in the early stages of the pandemic.</p></div><div><h3>Methods and materials</h3><p>An electronic survey was developed to measure the weekly impacts and distress experienced by HCW during the early phases of the pandemic. Hospital email communications relating to pandemic directives were noted. HCW included nursing, medical, ancillary staff and allied health team members at 2 study sites, 1 metropolitan and 1 regional center in Queensland, Australia. Descriptive statistics were applied to quantitative data, and a framework analysis for qualitative data. Key themes were synthesized using mixed methods approaches.</p></div><div><h3>Results</h3><p>A total of 176 HCW consented to participate. Four key themes were identified. Key theme 1 was <em>strategies for protection</em>, and included the subthemes of <em>self-isolation, using personal protective equipment (PPE), protecting patients</em> and <em>families and each other</em>. Key theme 2 was <em>navigating rules and keeping up</em>, and included the subthemes of <em>compliance, exceptions, conflict</em> and <em>complex decision fatigue</em>. Key theme 3 was <em>tempered optimism</em>, with subthemes including <em>this is grief, pride in one's place</em> and <em>strategies for coping</em>. Key theme 4 was <em>framing the new normal</em>, with subthemes including <em>using technology, second wave</em> and <em>uncertainty.</em></p></div><div><h3>Conclusion</h3><p>Staff groups reported the emotional impacts of rapid change across clinical areas and centers. Distress corresponded to rapid change amid uncertainty, rather than reported infection rates. These findings give insight into the experiences of patient facing oncology HCW during periods of uncertainty, potentially informing policy in the future.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 490-496"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164695","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":"Is the neutrophil-to-lymphocyte ratio a prognostic factor in non-small cell lung cancer patients who receive adjuvant chemotherapy?","authors":"David Smith ,&nbsp;Micaela Raices ,&nbsp;Federico Cayol ,&nbsp;Franco Corvatta ,&nbsp;Lucas Caram ,&nbsp;Agustín Dietrich","doi":"10.1053/j.seminoncol.2023.01.006","DOIUrl":"10.1053/j.seminoncol.2023.01.006","url":null,"abstract":"<div><p>Inflammation plays a key role in malignant tumor progression. Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and, as such, high isolated pretreatment NLR has been shown in some studies to be associated with worse long-term outcomes. We summarize the data regarding the utility of NLR as a prognosis factor and present results of a single institution study assessing the usefulness of high preoperative NLR as a prognosis factor for patients with successfully resected NSCLC who receive adjuvant cisplatin-based chemotherapy. While largely supportive of the value of NLR as a prognostic factor, the literature is not consistent and suggest a more nuanced association. Our single institution study adds to the exiting literature. We conclude preoperative NLR can be used as a reliable, cost-effective biomarker to estimate prognosis in NSCLC patients who have undergone lung lobectomy with curative intent followed by cisplatin-based adjuvant chemotherapy.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 482-489"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775423000076/pdfft?md5=1609e339834c18ae2c822c868135553f&pid=1-s2.0-S0093775423000076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9516537","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":"The challenges of selecting cancer medicines for the WHO Essential Medicines List with the elephant in the room: A path forward","authors":"Tito Fojo","doi":"10.1053/j.seminoncol.2023.01.005","DOIUrl":"10.1053/j.seminoncol.2023.01.005","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 427-428"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775423000052/pdfft?md5=abe936cb5be7937f43ddbb2b72a529b3&pid=1-s2.0-S0093775423000052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9162369","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":"Predictors of treatment refusal in patients with colorectal cancer: A systematic review","authors":"Yoshan Moodley ,&nbsp;Kumeren Govender ,&nbsp;Jacqueline van Wyk ,&nbsp;Seren Reddy ,&nbsp;Yuming Ning ,&nbsp;Steven Wexner ,&nbsp;Laura Stopforth ,&nbsp;Shona Bhadree ,&nbsp;Vasudevan Naidoo ,&nbsp;Shakeel Kader ,&nbsp;Shalen Cheddie ,&nbsp;Alfred I. Neugut ,&nbsp;Ravi P. Kiran","doi":"10.1053/j.seminoncol.2023.01.002","DOIUrl":"10.1053/j.seminoncol.2023.01.002","url":null,"abstract":"<div><p>This systematic review was conducted to investigate predictors of treatment refusal in colorectal cancer (CRC) patients. An understanding of these predictors would inform statistical models for the identification of high-risk patients who might benefit from interventions that seek to improve treatment compliance. We performed a search of PubMed and Scopus to identify potentially relevant studies on predictors of treatment refusal in CRC patients that were published between January 1, 2000 and December 31, 2021. We screened manuscripts using predefined eligibility criteria. Information on study design, study location, patient characteristics, treatments, rates and predictors of treatment refusal, and the impact of treatment refusal on mortality or survival were collected from eligible studies. Study quality was assessed using the Newcastle-Ottawa score. The overall findings of the review process were summarized using descriptive statistics and a narrative synthesis. A total of 13 studies were included in this review. Ten studies reported on refusal of CRC surgery, refusal rate: 0.25%–3.26%; three studies reported on chemotherapy refusal (one of which reported on both surgery and chemotherapy refusal), refusal rate: 7.8%–41.5%; and one study reported on refusal of any cancer treatment, refusal rate: 8.7%. The bulk of the published literature confirmed the harmful association between treatment refusal and poor survival outcomes in CRC patients. Frequently cited predictors of treatment refusal included patient demographic characteristics (age, race, gender), clinical characteristics (disease stage, comorbidity), and factors that impact access to cancer care services (healthcare insurance, facility level). Potentially high rates of treatment refusal pose a challenge to CRC control. This review has identified several factors which must be considered when attempting to reduce treatment refusal in CRC patients. Furthermore, these factors should be tested as components of predictive risk models for this important outcome.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 456-464"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9162370","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":"Airway disorders associated with immune checkpoint inhibitor therapy: Two case reports and a systematic review","authors":"Naoki Kawakami ,&nbsp;Hiroaki Saito ,&nbsp;Susumu Takahashi ,&nbsp;Shinpei Kajie ,&nbsp;Rina Kato ,&nbsp;Kazuhiro Shimaya ,&nbsp;Yoko Wakai ,&nbsp;Kazuhito Saito ,&nbsp;Mai Sakashita","doi":"10.1053/j.seminoncol.2023.01.003","DOIUrl":"10.1053/j.seminoncol.2023.01.003","url":null,"abstract":"<div><p><span><span><span><span>Immune checkpoint inhibitors (ICI) are widely used for the </span>treatment of various malignant neoplasms. </span>Interstitial lung disease is a well-known immune-related adverse event, however, ICI-induced airway disease remains under-recognized. Herein, we report two similar cases of pembrolizumab-induced </span>tracheobronchitis<span><span><span> presenting as persistent chronic cough and dyspnea. Blood tests revealed elevated C-reactive protein levels without </span>eosinophilia<span>. Spirometry demonstrated mild airflow obstruction. </span></span>Computed tomography<span><span> revealed diffuse thickening of the tracheobronchial walls and bronchiectasis predominantly in the lower lobes. </span>Bronchoscopy<span> revealed edematous and erythematous tracheobronchial mucosa<span>, and bronchial biopsy tissue exhibited marked inflammation with predominant infiltration of CD8+ lymphocytes. Subsequently, pembrolizumab-induced tracheobronchitis was diagnosed in both cases. Cessation of </span></span></span></span></span>pembrolizumab<span><span> and initiation of erythromycin<span>, inhaled corticosteroids, and long-acting beta-agonists gradually improved the symptoms, airflow obstruction, and radiographic findings. These were completely resolved in one case. The other case initially showed a poor response to systemic corticosteroids combined with the aforementioned </span></span>drugs<span>, but improved gradually and almost completely. These cases exemplify ICI-induced airway disease that is, an under-recognized manifestation of immune-related adverse events. In addition, we have systematically searched the PubMed database for articles on ICI-induced airway disease, categorized the retrieved articles as eosinophilic and non-eosinophilic airway diseases, and reviewed the differences in treatment and prognoses between these two categories.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 439-455"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9217742","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":"TOC","authors":"","doi":"10.1053/S0093-7754(23)00020-9","DOIUrl":"https://doi.org/10.1053/S0093-7754(23)00020-9","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Page A3"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775423000209/pdfft?md5=8d8fb2492e80010f43e5fef7388f6f63&pid=1-s2.0-S0093775423000209-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136916360","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":"Torticollis as a presenting symptom of pediatric CNS tumors: A systematic review","authors":"Nadejda Baklizi,&nbsp;Musthafa Raswoli,&nbsp;Michala Burges,&nbsp;Daniel C. Moreira,&nbsp;Ibrahim Qaddoumi","doi":"10.1053/j.seminoncol.2022.09.003","DOIUrl":"10.1053/j.seminoncol.2022.09.003","url":null,"abstract":"<div><p><span>To assess the frequency of torticollis<span><span> as a presenting symptom of pediatric </span>CNS tumors and its impact on pre-diagnostic symptom intervals (PSIs) and patient outcomes. We performed a </span></span>systematic review<span> of studies reporting torticollis in children with various CNS tumors. We searched PubMed for studies published from January 1972 to March 2021 in English. Case reports were included in the analysis if the following criteria were met (1) torticollis was the presenting symptom secondary to a CNS tumor (2) children &lt;18 years of age, (3) underwent imaging intervention and (4) outcome data provided. Of 1,365 relevant articles, 45 were eligible for analysis according to our inclusion criteria representing 95 patients. Two independent investigators extracted the data, and a third investigator arbitrated discrepancies. We found that 38.9% of CNS tumors exhibited torticollis as the only presenting symptom. PSI lengths ranged from 0 to 4 years (median, 5 months) for low-grade tumors, and patient age and PSI length were inversely associated. Of patients with low-grade tumors, 23.8% received physiotherapy, in contrast with 0% of patients with high-grade tumors. PSI length also increased for patients who received rehabilitation, and 39.3% and 7.1% of patients with high-grade and low-grade tumors, respectively, died of their disease. Patients with low-grade tumors and torticollis as a primary presenting symptom were more likely to have a prolonged PSI. Therefore, CNS tumors should be considered in the differential diagnosis of acquired torticollis in children.</span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 419-425"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40386849","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":"Maintenance or consolidation therapy in small-cell lung cancer: an updated systematic review and meta-analysis.","authors":"Lorenzo Belluomini ,&nbsp;Sara Pilotto ,&nbsp;Alice Avancini ,&nbsp;Jessica Insolda ,&nbsp;Marco Sposito ,&nbsp;Jessica Menis ,&nbsp;Chiara Ciccarese ,&nbsp;Roberto Iacovelli ,&nbsp;Miriam Grazia Ferrara ,&nbsp;Michele Milella ,&nbsp;Emilio Bria ,&nbsp;Antonio Rossi","doi":"10.1053/j.seminoncol.2022.09.001","DOIUrl":"10.1053/j.seminoncol.2022.09.001","url":null,"abstract":"<div><p><span><span>We performed an updated meta-analysis to explore the role of maintenance therapy in SCLC. </span>Clinical trials with randomization to maintenance/consolidation (</span><em>V)</em> placebo or observation or best supportive care in SCLC, both extended and limited disease were searched from January 2009 to March 2022. The hazard ratios (HR) for progression-free survival (PFS) and overall survival (OS) with the relative 95% confidence interval (CI) were extracted from each study. Summary HR was calculated using random- or fixed-effects models, depending on the heterogeneity of the included studies. A total of 9 studies were identified. Neither PFS nor OS were improved with maintenance/consolidation (PFS: random-effect; HR 0.93; 95% CI 0.71–1.21; <em>P</em>=0.10; OS: fixed-effect; HR 0.98; 95% CI 0.89–1.08; <em>P</em><span>=0.14). Among the different strategies, immunotherapy maintenance showed a significantly decreased risk of progression (</span><em>V)</em>standard of care (random-effect; HR 0.80; 95% CI 0.66–0.97; <em>P</em>=0.03). The current updated meta-analysis did not demonstrate a benefit of maintenance/consolidation therapy in SCLC, with only a PFS benefit for immunotherapy approach.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 389-393"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40388766","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}