Therapeutic Advances in Medical Oncology最新文献

{"title":"Management of biliary tract cancers in elderly patients: a French multicenter retrospective study (PRONOBIL-ACABi).","authors":"Marine Valery, Julien Edeline, Julie Henriques, Leony Antoun, Heloise Bourien, Antoine Lebeaud, Nadim Fares, Christophe Tournigand, Thierry Lecomte, David Tougeron, Vincent Hautefeuille, Angelique Vienot, Nicolas Williet, Jean-Baptiste Bachet, David Malka, Cristina Smolenschi, Antoine Hollebecque, Jane-Rose Paccard, Maxime Frélaut, Pascal Hammel, Anthony Turpin, Alice Boileve","doi":"10.1177/17588359251344013","DOIUrl":"10.1177/17588359251344013","url":null,"abstract":"<p><strong>Background: </strong>Biliary tract cancers (BTC) are often diagnosed after the age of 70, when comorbidities and compromised performance status (PS) are more prevalent.</p><p><strong>Objectives: </strong>This study compared clinical and disease characteristics and outcomes in BTC patients aged ⩽70 and >70 years.</p><p><strong>Design and methods: </strong>PRONOBIL-ACABI is a cohort study including 1256 BTC patients treated across 16 French centers from January 2003 to June 2021. We analyzed demographics, clinical characteristics, treatment modalities, molecular profiles, overall survival (OS) as the primary endpoint, and progression-free survival (PFS).</p><p><strong>Results: </strong>Among the 1256 BTC patients (53% male; median age: 64.5), 31% were aged >70. Patients >70 exhibited poorer PS (PS ⩾2, 17% vs 8%; <i>p</i> < 0.0001), a higher rate of comorbidities (⩾1, 89% vs 78%; <i>p</i> < 0.0001), and were less often proposed a molecular profile (43% vs 65%; <i>p</i> < 0.0001) than those ⩽70. Patients with unresectable BTC aged >70 had significantly shorter OS compared to younger patients (median OS: 14.6 vs 17.4 months, <i>p</i> < 0.0001), despite similar PFS (median PFS: 6.6 vs 5.8 months, <i>p</i> = 0.61). They were also less likely to receive first-line chemotherapy (87% vs 97%, <i>p</i> < 0.0001). In resected BTC, survival outcomes were comparable across age groups, with a median OS of 47.0 months in patients >70 vs 48.8 months in those ⩽70.</p><p><strong>Conclusion: </strong>Patients aged >70 years with unresectable BTC had a significantly shorter OS compared to those aged ⩽70, despite similar first-line PFS. In resected BTC, elderly patients achieved OS and PFS outcomes comparable to those aged ⩽70.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251344013"},"PeriodicalIF":4.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Endostar plus concurrent chemoradiotherapy in locally advanced cervical cancer: a multicenter, phase II randomized trial.","authors":"Fang Wu, Xiaobi Tang, Wenqi Liu, Zhanxiong Luo, Haixing Huang, Meilian Liu, Hongqian Wang, Sihui Liao, Shanshan Ma, Li Jiang, Yong Zhang","doi":"10.1177/17588359251379397","DOIUrl":"10.1177/17588359251379397","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cervical cancer remains the fourth most common malignant cancer in females and the fourth most common cause of mortality in women worldwide. Approximately 70% of new cases are diagnosed as locoregionally advanced cervical cancer (LACC), posing a significant threat to women's health. Concurrent chemoradiotherapy (CCRT) is the established standard treatment for LACC. However, more than 30% of patients still experience local recurrence and distant metastasis. Improving treatment outcomes for LACC is a critical global objective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the safety and efficacy of adding Endostar to CCRT in patients with LACC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a multicenter, open-label, randomized, controlled, phase II trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 120 patients were randomly allocated (1:1) to receive either CCRT alone (definitive radiotherapy plus cisplatin 40 mg/m&lt;sup&gt;2&lt;/sup&gt; every week for 4-5 cycles) or CCRT plus Endostar, Endostar at a dose of 7.5 mg/m&lt;sup&gt;2&lt;/sup&gt;/day, from 5 days before CCRT for 10 consecutive days every 15 days for four cycles).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The CCRT + E arm demonstrated a significantly higher complete response rate (CRR) compared to the CCRT arm (68.3% vs 35.0%, &lt;i&gt;p&lt;/i&gt; = 0.001), while the overall response rate (ORR) was similarly in both arms (98.3% vs 100%, &lt;i&gt;p&lt;/i&gt; = 1.000). The CCRT + E arm showed significantly improved distant metastasis-free survival (DMFS) (1-year: 91.6% vs 94.8%, 2-year: 82.3% vs 91.6%, 5-year: 67.0% vs 88.0% &lt;i&gt;p&lt;/i&gt; = 0.029). No significant differences were found in overall survival (OS), progression-free survival (PFS), or locoregional recurrence-free survival (LRFS) (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Multivariable analysis identified maximum tumor diameter &gt;4 cm and failure to achieve CR as predictive factors of poor PFS, and maximum tumor diameter &gt;4 cm and stage IIIA-IVA disease as poor prognostic factors for OS. According to the subgroup analysis, Endostar significantly improved the DMFS in cohorts of patients with squamous cell carcinoma (&lt;i&gt;p&lt;/i&gt; = 0.005), a maximum tumor diameter &gt; 4 cm (&lt;i&gt;p&lt;/i&gt; = 0.011), and stage IB2 or IIA2-IIB disease (&lt;i&gt;p&lt;/i&gt; = 0.005). The rates of acute and late adverse reactions were similar in both arms (&lt;i&gt;p&lt;/i&gt; &gt; 0.05), with no cardiac toxicity, hypertension, or grade 5 toxicity reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The addition of Endostar to CCRT significantly enhanced tumor response (CRR) and reduced distant metastasis (DMFS) in LACC patients without increasing treatment toxicity, offering a promising therapeutic enhancement. Clinically, patients with squamous cell carcinoma, maximum tumor diameter &gt; 4 cm, and International Federation of Gynecology and Obstetrics stage IB2 or IIA2-IIB disease derived particularly robust DMFS benefits from the combination regimen, suggesting they should be prioritized for this approach. Although the 5-year DMFS results are encouraging, va","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251379397"},"PeriodicalIF":4.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of radionuclide therapies in metastatic castration-resistant prostate cancer.","authors":"Xin Fei, Rui-Da Huang, Xuan Zhou, Shi-Jie Ye, Nan Nan, Ke-Jie Wang, Qi Ma","doi":"10.1177/17588359251379739","DOIUrl":"10.1177/17588359251379739","url":null,"abstract":"<p><p>The treatment of metastatic castration-resistant prostate cancer (mCRPC) remains a huge challenge. Newer radionuclides, such as ²²³Ra, ¹⁷⁷Lu, ²²⁵Ac, etc., have shown efficacy in alleviating cancer-related pain and also in enhancing the prognosis of mCRPC patients. These novel radionuclides have emerged as important weapons in the treatment of mCRPC. This article reviews recent advances and key clinical trials in various radionuclides and their combinations in the application for treating mCRPC. Further directions of this new treatment strategy are also discussed in this review.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251379739"},"PeriodicalIF":4.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of belzutifan versus everolimus for previously treated advanced clear cell renal cell carcinoma in the United States and China.","authors":"Baolong Ding, Hongting Yao, Tiantian Tao, Yuyang Sun, Yulu Zhu, Haomin Zhu, Jia Wang, Zhuying Jing, Lihong Gao, Yingtao Lin, Xin Li","doi":"10.1177/17588359251379708","DOIUrl":"10.1177/17588359251379708","url":null,"abstract":"<p><strong>Background: </strong>The LITESPARK-005 trial demonstrated the efficacy and safety of belzutifan in patients with previously treated clear cell renal cell carcinoma (ccRCC). This study aims to evaluate the cost-effectiveness of belzutifan compared to everolimus in treating patients with advanced ccRCC who have received at least one systemic therapy from the perspective of the Chinese healthcare system and the US payers.</p><p><strong>Objectives: </strong>To provide previously treated ccRCC patients with the option of belzutifan and to offer recommendations regarding in China.</p><p><strong>Design: </strong>The cost-effectiveness analysis.</p><p><strong>Methods: </strong>A partitioned survival model was constructed based on data from the LITESPARK-005 trial. Patients transitioned through three mutually exclusive health states: progression-free survival (PFS), progressive disease, and death. The model cycle length was set at 28 days, with a lifetime horizon. Direct medical costs and utility values were obtained from published literature and real-world healthcare data. The model estimated total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). Price simulations, sensitivity analyses, and scenario analyses were conducted to assess model robustness.</p><p><strong>Results: </strong>The base-case analysis showed that belzutifan in China generated 2.038 QALYs at a total cost of $102,561.26 and an ICER of $54,430.16/QALY, which exceeded the willingness to pay (WTP) threshold ($39,076.44/QALY). Belzutifan in the United States generated 2.280 QALYs at a total cost of $796,227.28 with an ICER of $270,864.46/QALY, which significantly exceeded the WTP threshold ($150,000/QALY). The PFS utility value and the drug cost of belzutifan were the main factors affecting the change in ICER, whether in China or the United States. At current pricing, belzutifan was unlikely to be cost-effective. Price simulations indicated the belzutifan would be cost-effective when the price of belzutifan remained below $5.524/mg in the United States and $0.779/mg in China.</p><p><strong>Conclusion: </strong>Compared to everolimus, belzutifan is not cost-effective at its current price for treating previously treated RCC in the United States. In China, the belzutifan group was cost-effective when the price of belzutifan was less than $0.779/mg. This study suggests that reducing the price could substantially improve the economic viability of belzutifan.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251379708"},"PeriodicalIF":4.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with accepting chemotherapy despite the risk of fertility loss in Latin American breast cancer patients-LACOG 0414 study.","authors":"Gustavo Werutsky, Cynthia Villarreal-Garza, Henry L Gomez, Saúl Campos-Gómez, Rosa Ortiz Reyes, Pedro E R Liedke, Tomás Reinert, Vanessa Dybal, Jeovany Martinez-Mesa, Paulo Ricardo Nunes Filho, Rafaela Gomes de Jesus, Facundo Zaffaroni, Vitória Silva Garcia, Mariana Fauth Seibel, Pablo Barrios, Matheus Soares Rocha, Carlos H Barrios","doi":"10.1177/17588359251378946","DOIUrl":"10.1177/17588359251378946","url":null,"abstract":"<p><strong>Background: </strong>Fertility loss due to chemotherapy is a major concern for young patients with breast cancer (BC), influencing treatment decisions and quality of life. Despite established guidelines recommending fertility counseling, access to fertility preservation remains limited in Latin America.</p><p><strong>Objectives: </strong>This study evaluated attitudes and preferences regarding fertility-related concerns and chemotherapy decision-making among young Latin American women with early-stage BC.</p><p><strong>Design: </strong>A prospective cohort study was conducted at seven institutions in Brazil, Mexico, and Peru.</p><p><strong>Methods: </strong>Premenopausal women aged 18-40 years with stage I-III BC requiring (neo)adjuvant chemotherapy completed a fertility questionnaire before treatment, along with validated quality-of-life assessments (EORTC QLQ-C30 and EORTC QLQ-BR23). One year after chemotherapy initiation, the patients were reassessed for ovarian function status and quality of life. Factors associated with chemotherapy acceptance despite potential infertility risks were analyzed using univariate and multivariate Poisson regression models.</p><p><strong>Results: </strong>A total of 270 patients were included (mean age, 33.9 years). Prior to diagnosis, 41.5% of the women had children, and 31.1% expressed a desire for future childbearing. Among the participants, 8.5% were unaware of chemotherapy-induced infertility risks, 21.5% would decline chemotherapy if the infertility risk exceeded 25%, and 20.0% would accept treatment despite a 76%-100% infertility risk. In addition, 44.1% of patients required at least a 20% increase in survival probability to accept chemotherapy. In the multivariate analysis, married patients were significantly less likely to refuse chemotherapy (risk ratio: 0.88, 95% confidence interval: 0.82-0.94; <i>p</i> < 0.01). One year post-treatment, 73.1% of the patients experienced chemotherapy-induced amenorrhea.</p><p><strong>Conclusion: </strong>Fertility concerns significantly impact chemotherapy decision-making in young Latin American patients with BC. Limited fertility awareness, socioeconomic disparities, and restricted access to fertility preservation contribute to these challenges. Strengthening fertility counseling and improving access to preservation options are essential for supporting informed treatment decisions in this population.</p><p><strong>Trial registration: </strong>(ClinicalTrials.gov): NCT02862990.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251378946"},"PeriodicalIF":4.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting response and survival to first-line treatment with baseline [¹⁸F]FDG-PET-CT in patients with small-cell lung cancer: an integrated diagnostic approach.","authors":"David Ventura, Philipp Schindler, Peter Kies, Annalen Bleckmann, Michael Mohr, Georg Lenz, Michael Schäfers, Wolfgang Roll, Georg Evers","doi":"10.1177/17588359251379665","DOIUrl":"10.1177/17588359251379665","url":null,"abstract":"<p><strong>Background: </strong>Small-cell lung cancer (SCLC) is a highly malignant disease with a propensity for early progression and high mortality. The prognostic value of treatment response and survival has been verified for solely established imaging, clinical, and biochemical markers. There is a lack of evidence for the combination of those parameters with machine learning and integrated models, particularly in the context of molecular imaging.</p><p><strong>Objectives: </strong>The aim of this study was to predict early disease progression and survival using CT-based radiomic features (RF), integrating [¹⁸F]FDG-PET-CT and clinical parameters.</p><p><strong>Design: </strong>This retrospective pilot study included 62 patients with non-metastatic and metastatic SCLC who underwent stage-based primary treatment following baseline [¹⁸F]FDG-PET-CT. The development of a machine learning approach, incorporating clinical and molecular imaging parameters, enables the creation of a model capable of predicting treatment response and survival.</p><p><strong>Methods: </strong>A radiomics signature was generated based on the first-line treatment response by RECIST 1.1 criteria. The RF was integrated using binary logistic regression analysis with the PET parameter metabolic tumor volume (MTV) of the primary tumor and initial disease stage. The integrated model with the highest AUC for predicting early disease progression was evaluated for predicting progression-free survival (PFS) and overall survival (OS) in both non-metastatic and metastatic patients.</p><p><strong>Results: </strong>A single CT-based RF demonstrated predictive capacity (AUC = 0.81). Integration of the MTV and disease stage enhanced the predictive capacity (AUC = 0.9). A Youden index-based threshold of <0.62 was identified as a significant predictor of prolonged PFS: non-metastatic disease with a median PFS of 25 versus 4 months (HR = 0.072; <i>p</i> = 0.002); metastatic disease with a median PFS of 9 versus 5 months (HR 0.219; <i>p</i> = 0.004). The integrated model also predicted OS in metastatic disease with a median OS of 15 versus 8 months (HR 0.381; <i>p</i> = 0.013).</p><p><strong>Conclusion: </strong>A multiparametric approach based on a Radiomics model may potentially be capable of identifying patients at risk for early disease progression, PFS, and OS in non-metastatic and metastatic SCLC.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251379665"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-specific characteristics and outcomes in esophageal neuroendocrine carcinoma: a Chinese-Western comparison with prognostic nomogram.","authors":"Ai-Qing Li, Shu-Hui Wang, Jun Li, Hong-Tan Chen, Zhen Liu","doi":"10.1177/17588359251375454","DOIUrl":"10.1177/17588359251375454","url":null,"abstract":"<p><strong>Background: </strong>Esophageal neuroendocrine carcinoma (ENEC) is a rare, aggressive malignancy with limited comparative data between Eastern and Western populations. Optimal management strategies remain unclear, and prognostic tools for risk stratification are lacking.</p><p><strong>Objectives: </strong>To analyze differences in clinicopathological features, treatment patterns, and survival outcomes between Chinese and American ENEC patients, and to develop a prognostic nomogram for unresectable disease.</p><p><strong>Design: </strong>A retrospective comparative cohort study.</p><p><strong>Methods: </strong>We analyzed 88 ENEC patients from a Chinese institution and 545 from the Surveillance, Epidemiology, and End Results (SEER) database. Demographic, tumor, treatment, and survival data were compared using Chi-square tests and Kaplan-Meier analysis. Cox regression identified prognostic factors for cancer-specific survival. A nomogram for unresectable ENEC was developed using SEER data and evaluated using C-index, calibration curves, and receiver operating characteristic analysis.</p><p><strong>Results: </strong>Significant population differences included age distribution (46-65 years: 51.1% Chinese vs 35.4% SEER, <i>p</i> < 0.001), tumor location (lower esophagus: 22.7% vs 62.2%), histology (small cell: 38.6% vs 76.9%), and metastatic presentation (M1: 28.4% vs 54.1%, all <i>p</i> < 0.01). Among non-metastatic patients, 77.8% Chinese underwent surgery versus 19.2% SEER (<i>p</i> < 0.001). Despite this treatment disparity, median survival was similar for surgical patients (48 vs 32 months, <i>p</i> = 0.93). Metastatic disease and age >65 were independent adverse prognostic factors in both cohorts. The Chinese cohort showed additional prognostic factors including tumor location and histology. The nomogram incorporating age, tumor location, N stage, M stage, and chemotherapy achieved a C-index of 0.725 with excellent calibration at 12 and 24 months.</p><p><strong>Conclusion: </strong>ENEC demonstrates distinct population-specific characteristics between Chinese and Western patients, with fundamental differences in treatment approaches but comparable surgical outcomes. The validated nomogram provides superior risk stratification for unresectable disease compared to traditional staging. These findings support population-tailored management strategies rather than universal treatment paradigms for ENEC.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251375454"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in treatment-related cardiopulmonary disease-specific mortality in NSCLC based on pathological subtypes: a retrospective population-based cohort study.","authors":"You Mo, Xinyi Liang, Duncan Wei, Dawei Chen, Jinming Yu","doi":"10.1177/17588359251379962","DOIUrl":"10.1177/17588359251379962","url":null,"abstract":"<p><strong>Background: </strong>While cancer-specific mortality has decreased with therapeutic advances, a growing proportion of survivors are at risk of treatment-related adverse effects (AEs).</p><p><strong>Objectives: </strong>To assess cardiopulmonary disease-specific mortality risks in patients with non-small-cell lung cancer (NSCLC) based on pathological subtypes.</p><p><strong>Design: </strong>This was a retrospective cohort study. Mortality data from the Surveillance, Epidemiology, and End Results Program database and AE data from the FDA Adverse Event Reporting System were analyzed in NSCLC patients. In addition, an independent validation cohort comprising 161 NSCLC patients was enrolled.</p><p><strong>Methods: </strong>The piecewise regression was established using the Joinpoint software to characterize temporal trends. Univariate and multivariate analyses for specific mortality were performed using the Cox risk regression model.</p><p><strong>Results: </strong>From 2012 to 2016, patients with lung adenocarcinoma (LADC) showed a 2.06% annual reduction in mortality. Conversely, this population exhibited a 3.82% yearly increase in cardiovascular disease (CVD)-specific mortality and a 6.54% rise in pulmonary disease-specific mortality during the same period. Patients with lung squamous cell carcinoma (LSCC) may have benefited more from the initiation of immunotherapy, with a gradual decrease in incidence (2016-2019, -5.19%). The incidence of large-cell lung cancer (LCLC) declined significantly (2008-2012, -14.52%; 2012-2016, -7.93%; 2016-2019, -6.42%), with decrease in overall mortality (2008-2012, -10.63%; 2012-2016, -8.76%; 2016-2019, -10.27%) and cancer-specific mortality (2008-2012, -12.17%; 2012-2016, -10.35%; 2016-2019, -10.78%). LCLC showed no significant rise in CVD-specific mortality (2012-2016: CVD-specific mortality, -4.83%; pulmonary disease-specific mortality, -0.82%. 2016-2019: CVD-specific mortality, -21.82%; pulmonary disease-specific mortality, -12.78%) compared to LSCC and LADC. The reporting odds ratio (ROR = 47.80, 95% CI, 24.44-93.50) of endocarditis of LADC was the top-reported AE. Multivariate analysis showed that immune checkpoint blockade was associated with increased CVD death (HR = 4.602, 95% CI, 1.154-18.359, <i>p</i> = 0.031).</p><p><strong>Conclusion: </strong>Our analyses revealed a temporal increase in cardiopulmonary disease-specific mortality among NSCLC patients during the study period. This trend coincided with the introduction of targeted therapies and immunotherapies, particularly in LADC patients. CVD-specific mortality risk requires extensive attention during anticancer therapy, regardless of the geographical population.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251379962"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of androgen receptor targeting in prostate cancer: third-generation inhibitors and beyond.","authors":"Alice Bernard-Tessier, Natacha Naoun, Solenn Barraud, Ronan Flippot, Cedric Pobel, Macarena Rey, Capucine Baldini, Christophe Massard, Anna Patrikidou, Alina Fuerea, Mario Di Palma, Laurence Albigès, Yohann Loriot, Karim Fizazi","doi":"10.1177/17588359251379416","DOIUrl":"10.1177/17588359251379416","url":null,"abstract":"<p><p>The androgen receptor (AR) pathway plays a fundamental role in the treatment of prostate cancer, from the localized stage to metastatic disease, even in castration-resistant prostate cancer (CRPC). Despite the significant benefit for the earlier use of second-generation AR pathway inhibitors (ARPI), treatment resistance is still emerging. A deeper understanding of the biology of ARPI resistance is crucial for developing new therapeutic targets. In this review, we will explore the biology of second-generation ARPI resistance and discuss the evolving landscape of third-generation ARPI and steroid hormone inhibitors, which are shaping the future of prostate cancer therapeutics. Targeting the biosynthesis of steroid precursors with CYP11A1 inhibition, inducing AR degradation with proteolysis-targeting chimera degraders or restoring ARPI sensitivity with EZH2 inhibitors are among the most advanced strategies in development. Alongside these new drugs, AR genomic alterations and particularly AR mutations emerge as a promising biomarker for patient selection. These innovative therapeutics help bring more personalized approaches to patients with prostate cancer, aiming to overcome resistance and improve patient outcomes.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251379416"},"PeriodicalIF":4.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and clinical characteristics of mesothelioma in the Chinese population: a multicenter study.","authors":"Shengjie Yang, Yue Hao, Ke Wang, Haipeng Xu, Long Huang, Ling Xu, Rui Meng, Bihui Li, Jianhui Huang, Youcai Zhu, Xuefei Shi, Dong Wang, Ziyan Yang, Zhenying Guo, Jingxun Wu, Wenfeng Li, Jianfei Fu, Yinghua Ji, Zongyang Yu, Miao Li, Huijing Feng, Lin Wang, Qing Ji, Wenjun Tang, Zhengbo Song, Chunwei Xu, Qian Wang","doi":"10.1177/17588359251378879","DOIUrl":"10.1177/17588359251378879","url":null,"abstract":"<p><strong>Background: </strong>Mesothelioma is a rare and highly aggressive tumor that causes severe damage. However, there is a lack of systematic reports on the incidence and clinical characteristics of mesothelioma in the Chinese population.</p><p><strong>Objectives: </strong>This study aims to characterize the epidemiological features of mesothelioma in the Chinese population and to evaluate the effectiveness of current treatment strategies, to inform clinical decision-making and improve patient care.</p><p><strong>Designs: </strong>The epidemiological characteristics of patients were collected by regional study centers according to the predefined inclusion and exclusion criteria. Asbestos exposure status was clearly identified for each patient, and treatment strategies were analyzed across mesothelioma cases with different primary tumor sites.</p><p><strong>Methods: </strong>Data on mesothelioma patients and their treatment information were collected from 11 hospitals across China between January 2006 and December 2024. Epidemiological data and baseline characteristics were summarized using descriptive methods. The Kaplan-Meier method was used to analyze progression-free survival (PFS) and overall survival (OS). Key response indicators included the objective response rate (ORR) and disease control rate (DCR).</p><p><strong>Results: </strong>A total of 927 patients from 11 provinces in China were included in the analysis. The major types of mesothelioma observed were pleural mesothelioma (<i>n</i> = 537), peritoneal mesothelioma (<i>n</i> = 240), pericardial mesothelioma (<i>n</i> = 5), and mesothelioma of the tunica vaginalis testis (<i>n</i> = 5). Among these patients, 163 had confirmed asbestos exposure. For pleural mesothelioma, 45.6% (<i>n</i> = 245) of patients were from Yunnan Province. For peritoneal mesothelioma, 62.5% (<i>n</i> = 150) of patients were from Zhejiang Province. The median PFS rates for pleural and peritoneal mesothelioma patients were 6.6 and 5.7 months, respectively. The median OS was 16.6 months for pleural mesothelioma and 12.1 months for peritoneal mesothelioma. The ORR for pleural mesothelioma was 15%, with a DCR of 85.9%, while the ORR for peritoneal mesothelioma was 14.4%, with a DCR of 84.7%.</p><p><strong>Conclusion: </strong>The incidence of mesothelioma in China exhibits distinct regional characteristics. Pleural mesothelioma is predominantly associated with crocidolite asbestos exposure in Yunnan Province, while peritoneal mesothelioma is linked to hand-spun chrysotile asbestos exposure in Zhejiang Province, with notable sex differences observed. No significant differences in treatment outcomes were identified between pleural and peritoneal mesothelioma patients undergoing first-line therapy. These findings highlight the importance of region-specific strategies for the diagnosis and treatment of mesothelioma in China.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251378879"},"PeriodicalIF":4.2,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}