The Lancet Oncology最新文献

{"title":"Influence of stage at cancer diagnosis on NHS hospital care costs in England: a national, retrospective, population-based cohort study using individual patient-level data","authors":"Clare Pearson, David A Jones, Gavin Baily, Roger Cherry, Ewan Gray, Sara Hiom, Brian Rous, Katie Spencer, Sophie Jose","doi":"10.1016/s1470-2045(25)00678-3","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00678-3","url":null,"abstract":"<h3>Background</h3>Estimates of the cost of cancer care are crucial for the economic evaluation of screening interventions and other early cancer diagnosis initiatives. However, data on the cost of cancer is scarce. This study estimated National Health Service (NHS) hospital care costs for eight cancer types by stage at diagnosis in England.<h3>Methods</h3>This national, retrospective, population-based cohort study used individual patient-level data collated by the National Disease Registration Service, NHS England. We included patients aged 50–79 years who were diagnosed with a colorectal, head and neck, liver and bile duct, lung, lymphoma, oesophageal, ovarian, or pancreatic cancer in England between Jan 1, 2014, and Dec 31, 2017. For each patient, we obtained linked national health-care records, incorporating all inpatient hospital care, outpatient activity, and accident and emergency department attendances, and costed these using a payer perspective. Patients were excluded if registration was death certificate only, records related only to a secondary metastatic site, sex and cancer type were incompatible, death status or date were uncertain, or there were zero health-care costs from 6 months before diagnosis to end of follow-up. Net, cancer-related, regression-adjusted hospital care costs were reported for each cancer type and stage overall, annually, and by phase of care. Within each annual period and phase, mean monthly costs were also estimated.<h3>Findings</h3>Of 359 106 cancer records registered, 345 629 cancers were available for analysis, and 333 657 cancers were included in the analysis (147 334 [44·2%] occurred in female patients and 186 323 [55·8%] in male patients; 303 227 [90·9%] among participants of White ethnicity, 4452 [1·3%] among participants of mixed or other ethnicity, 7870 [2·3%] among participants of Asian ethnicity, 4179 [1·3%] among participants of Black ethnicity, and 13 929 [4·2%] among participants of unknown ethnicity). Overall costs were higher at later stages for colorectal, head and neck, lymphoma, and ovarian cancers with mean stage IV costs of £37 838, £36 657, £42 667, and £45 871, respectively. Costs for liver and bile duct, lung, oesophageal, and pancreatic cancers were highest for those diagnosed at stage II (£28 356, £29 553, £33 640, and £39 351, respectively), and slightly lower at stages I, III, and IV. Health-care costs were highest in the initial treatment and the end-of-life phases of care. Within each phase, mean cost per month increased with stage for most cancer types studied, though fewer months of follow-up were observed in each phase for liver and bile duct, lung, oesophageal, and pancreatic cancers.<h3>Interpretation</h3>Cancer-related NHS hospital care costs by stage at diagnosis differed between cancer types; this heterogeneous pattern could inform detailed and nuanced economic evaluations of early detection initiatives.<h3>Funding</h3>GRAIL Bio UK.","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146223043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-based personalisation of neoadjuvant chemotherapy duration in HER2-positive early breast cancer (TRAIN-3): primary results from a multicentre, single-arm, phase 2 study","authors":"Fleur M Louis, Anna van der Voort, Mette S van Ramshorst, Antonios Daletzakis, Ingrid A Mandjes, Inge Kemper, Mariette J Agterof, Wim A van der Steeg, Joan B Heijns, Marlies L van Bekkum, Ester J M Siemerink, Philomeen M Kuijer, Astrid Scholten, Jelle Wesseling, Marie-Jeanne T F D Vrancken Peeters, Mees D Egeler, Lonneke V van de Poll-Franse, Ritse M Mann, Gabe S Sonke, Elise van Leeuwen-Stok","doi":"10.1016/s1470-2045(25)00707-7","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00707-7","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Neoadjuvant treatment comprising six to nine cycles of anti-HER2 based chemotherapy yields high pathological complete response rates and excellent survival outcomes in patients with stage II–III HER2-positive breast cancer but comes with noteworthy side-effects. The TRAIN-3 study investigated if patients treated with this regimen who have a rapid complete radiological response on MRI are candidates for early surgery. The study showed that one-third of patients with hormone receptor-negative tumours and one-sixth of patients with hormone receptor-positive tumours had a pathological complete response after only three cycles of chemotherapy. Here, we report the results of the primary endpoint, 3-year event-free survival.&lt;h3&gt;Methods&lt;/h3&gt;TRAIN-3 is a multicentre, single-arm, phase 2 study conducted across 43 hospitals in the Netherlands. Patients with stage II–III HER2-positive breast cancer aged 18 years or older and with a WHO performance status of 0 or 1 were eligible for inclusion. Patients received neoadjuvant chemotherapy consisting of paclitaxel (80 mg/m&lt;sup&gt;2&lt;/sup&gt;, day 1 and 8 of each 21-day cycle, intravenous), trastuzumab (6 mg/kg on day 1 of each cycle [loading dose 8 mg/kg on day 1 of cycle 1], intravenous), carboplatin (area under the curve 6 mg/mL per min on day 1 of each cycle, intravenous) and pertuzumab (420 mg on day 1 of each cycle [loading dose 840 mg on day 1 of cycle 1], intravenous) for up to nine cycles, and were referred for surgery once a complete radiological response was observed on MRI. Patients who had a pathological complete response post-surgery completed 1 year of adjuvant trastuzumab and pertuzumab. Patients with residual invasive disease in the resection specimen continued chemotherapy for a total of nine cycles, followed by 14 cycles of trastuzumab emtansine (3·6 kg/mg, day 1 of each 21-day cycle, intravenous). Adverse events of grade 3 or worse and grade 2 or worse left ventricular ejection fraction and neuropathy were registered until 30 days after the last adjuvant treatment cycle. The primary endpoint was 3-year event-free survival; analyses were done in hormone receptor-negative and hormone receptor-positive patients separately on an intention-to-treat basis. This trial is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; (&lt;span&gt;&lt;span&gt;NCT03820063&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;); recruitment is closed, and follow-up for secondary endpoints is ongoing.&lt;h3&gt;Findings&lt;/h3&gt;Between April 1, 2019, and May 12, 2021, 235 patients with hormone receptor-negative tumours and 232 with hormone receptor-positive tumours were ","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146223410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards response-adapted neoadjuvant breast cancer treatment","authors":"Guilherme Nader-Marta, Erica L Mayer","doi":"10.1016/s1470-2045(25)00767-3","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00767-3","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146205161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram-based risk classification for predicting response to metastasis-directed stereotactic body radiotherapy in PSMA PET-staged oligorecurrent prostate cancer (PORTAL): an international, retrospective cohort study","authors":"Timo F W Soeterik, Marcin Miszczyk, Max Peters, Mateusz Bilski, Giulio Francolini, Pietro Garlatti, Luca Nicosia, Filippo Alongi, Maris Mezeckis, Justyna Kociolek, Carlo Greco, Tomasz Techmański, Eline H Huele, Frederik R Teunissen, Paulien G Westhoff, Wessel Vis, Marie A D Haverkort, Jochem R N van der Voort van Zyp, Martijn P W Intven, Joanne M van der Velden, Wietse S C Eppinga","doi":"10.1016/s1470-2045(25)00717-x","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00717-x","url":null,"abstract":"<h3>Background</h3>Metastasis-directed therapy (MDT) can defer androgen deprivation therapy (ADT) in oligorecurrent prostate cancer, but outcomes vary and there is a paucity of risk stratification tools. We aimed to develop and validate a nomogram to predict ADT-free survival.<h3>Methods</h3>In this international, retrospective cohort study across ten hospitals and academic institutions in Europe (Austria, Italy, Latvia, the Netherlands, Poland, and Portugal), we included men aged 18 years and older with histologically confirmed prostate cancer (all subtypes) previously treated with curative-intent local therapy, who developed metachronous oligorecurrent, hormone-sensitive disease (≤5 prostate-specific membrane antigen [PSMA] PET-detected pelvic nodal or distant metastases or both) and received stereotactic body radiotherapy to all lesions without adjuvant systemic therapy. The primary endpoint was the proportion of patients remaining ADT-free at 1 year of follow-up. Ten clinical predictors were evaluated in a multivariable Cox model with backward elimination. Internal validation with bootstrapping assessed model performance (C-index and calibration), followed by external validation.<h3>Findings</h3>A total of 1461 men treated between July 1, 2014, and Dec 31, 2023, were screened, of whom 586 were included in the development cohort (307 [52%] pelvic nodal and 279 [48%] distant metastases); median follow-up was 37 months (IQR 24–58). The external validation cohort (henceforth validation cohort) comprised 131 patients (57 [44%] pelvic nodal, 74 [56%] distant), with a median follow-up 43 months (24–57). ADT-free survival at 1 year was 84·3% (95% CI 81·4–87·3) in the development cohort and 92·8% (88·4–97·4) in the validation cohort. Independent predictors of earlier ADT initiation were higher pre-MDT PSA (hazard ratio 1·05 [95% CI 1·03–1·08]), shorter PSA doubling time (0·97 [0·95–0·98]), three to five lesions (HR 1·74 [1·33–2·28]), and distant metastases (HR 1·45 [1·18–1·78]). Model discrimination was 0·66 (95% CI 0·65–0·68) in the development cohort and 0·65 (95% CI 0·55–0·75) in the external validation cohort. Risk stratification separated patients into three prognostic groups—low risk, intermediate risk, and high risk (p&lt;0·0001).<h3>Interpretation</h3>This nomogram predicts ADT-free survival after MDT in oligorecurrent prostate cancer. While individual-level discrimination was modest, risk-group stratification showed meaningful separation, supporting its potential use in treatment selection.<h3>Funding</h3>None.","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146205162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"US EPA turning a blind eye to formaldehyde's cancer risks, critics contend","authors":"Bryant Furlow","doi":"10.1016/s1470-2045(26)00069-0","DOIUrl":"https://doi.org/10.1016/s1470-2045(26)00069-0","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"334 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"France plans national targeted lung cancer screening","authors":"Barbara Casassus","doi":"10.1016/s1470-2045(26)00070-7","DOIUrl":"https://doi.org/10.1016/s1470-2045(26)00070-7","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicians warn plan to hit NHS cancer targets within 3 years needs more detail","authors":"Emma Wilkinson","doi":"10.1016/s1470-2045(26)00058-6","DOIUrl":"https://doi.org/10.1016/s1470-2045(26)00058-6","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-hypofractionated versus conventionally fractionated radiotherapy for localised prostate cancer (HYPO-RT-PC): 10-year outcomes of an open-label, randomised, phase 3, non-inferiority trial","authors":"Per Nilsson, Adalsteinn Gunnlaugsson, Lars Beckman, Anders Widmark, Per Fransson, Morten Hoyer, Magnus Lagerlund, Jon Kindblom, Bengt Johansson, Kirsten Björnlinger, Claes Ginman, Martha Olsson, Måns Agrup, Elisabeth Kjellén, Björn Zackrisson, Björn Tavelin, Lars Franzén, Harald Anderson, Camilla Thellenberg Karlsson","doi":"10.1016/s1470-2045(25)00656-4","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00656-4","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;HYPO-RT-PC is a phase 3 trial comparing ultra-hypofractionated and conventionally fractionated radiotherapy in intermediate-to-high-risk localised prostate cancer. This 10-year update reports long-term efficacy and toxicity outcomes.&lt;h3&gt;Methods&lt;/h3&gt;In this open-label, randomised, phase 3, non-inferiority trial done in ten centres in Sweden and two in Denmark, we recruited men aged 75 years or younger with intermediate-risk or high-risk prostate cancer and a WHO performance status between 0 and 2. Previous or current androgen deprivation therapy was not permitted. Patients were randomly assigned (1:1) to ultra-hypofractionated radiotherapy (42·7 Gy in seven fractions, 3 days per week for 2·5 weeks) or conventionally fractionated radiotherapy (78·0 Gy in 39 fractions, 5 days per week for 8 weeks). Randomisation was performed with a minimisation algorithm balancing T stage, Gleason score, prostate-specific antigen, and trial centre. The primary endpoint was failure-free survival, defined as time from randomisation to the first occurrence of biochemical failure, evidence of clinical progression, initiation of androgen deprivation therapy, or death from prostate cancer, analysed in the per-protocol population. The non-inferiority margin was 4% at 5 years and had previously been met, corresponding to a critical hazard ratio (HR) limit of 1·338. Toxicity was assessed using the Radiation Therapy Oncology Group morbidity scale. Here, we report long-term efficacy and safety results at 10 years. The trial is registered with the ISRCTN registry, ISRCTN45905321, and is closed.&lt;h3&gt;Findings&lt;/h3&gt;Between July 1, 2005, and Nov 4, 2015, 1200 patients were randomly assigned to conventional fractionated radiotherapy (n=602) or ultra-hypofractionated radiotherapy (n=598). Ten patients withdrew consent, eight were found to be ineligible, and two died of reasons unrelated to prostate cancer. 1180 patients constituted the per-protocol population (591 in the conventional fractionation group and 589 in the ultra-hypofractionation group). After a median follow-up of 10·6 years (IQR 9·0–13·0) in the conventional fractionation group and 10·7 years (9·1–12·7) in the ultra-hypofractionation group, 205 and 178 primary events were observed, respectively. 10-year failure-free survival was 65% (95% CI 61–69) in the conventionally fractionated group and 72% (68–76) in the ultra-hypofractionated group. The adjusted HR for the primary endpoint was 0·84 (95% CI 0·69–1·03; Cox regression analysis), confirming non-inferiority. The 10-year cumulative incidence of late grade 2 or worse genitourinary toxic effects was 30% (95% CI 26–34) in the conventional fractionation group and 28% (24–32) in the ultra-hypofractionated group (HR 1·01, 95% CI 0·81–1·25; p=0·95). For late grade 2 or worse gastrointestinal toxic effects, the corresponding figures were 14% (95% CI 11–18) and 14% (11–17; HR 0·94, 95% CI 0·70–1·28; p=0·72).&lt;h3&gt;Interpretation&lt;/h3&gt;This 10-year follow-up confirm","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unauthorised cancer drug in Zimbabwe raises patient safety concerns","authors":"Paul Adepoju","doi":"10.1016/s1470-2045(26)00057-4","DOIUrl":"https://doi.org/10.1016/s1470-2045(26)00057-4","url":null,"abstract":"","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New free trade agreement might bring cheaper cancer drugs to India","authors":"Karl Gruber","doi":"10.1016/s1470-2045(26)00056-2","DOIUrl":"https://doi.org/10.1016/s1470-2045(26)00056-2","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}