Therapeutic Advances in Medical Oncology最新文献

{"title":"Changes in female cancer diagnostic billing rates over the COVID-19 period in the Ontario Health Insurance Plan.","authors":"Deanna McLeod, Ilidio Martins, Anna V Tinker, Amanda Selk, Christine Brezden-Masley, Nathalie LeVasseur, Alon D Altman","doi":"10.1177/17588359251339919","DOIUrl":"https://doi.org/10.1177/17588359251339919","url":null,"abstract":"<p><strong>Background: </strong>The initial response to coronavirus disease 2019 (COVID-19) in Ontario included suspension of cancer screening programs and deferral of diagnostic procedures and many treatments. Although the short-term impact of these measures on female cancers is well documented, few studies have assessed the mid- to long-term impacts.</p><p><strong>Objectives: </strong>To compare annual billing prevalence and incidence rates of female cancers during the COVID-19 period (2020-2022) to pre-COVID-19 levels (2015-2019).</p><p><strong>Design: </strong>Retrospective analysis of aggregated claims data for female cancer diagnostic codes from the Ontario Health Insurance Plan (OHIP).</p><p><strong>Methods: </strong>Linear regression analysis was used to fit pre-COVID-19 (2015-2019) data for each OHIP billing code and extrapolate counterfactual values for the years of 2020-2022. Excess billing rates were calculated as the difference between projected and actual rates for each year.</p><p><strong>Results: </strong>In 2020, OHIP billing prevalence rates for cervical, breast, uterine, and ovarian cancers decreased relative to projected values for that year by -50.7/100k, -13.9/100k, -3.5/100k, and -3.8/100k, respectively. The reverse was observed in 2021 with rate increases of 47.8/100k, 59.1/100k, 2.5/100k, and 3.7/100k, respectively. In 2022, the excesses were further amplified, especially for cervical and breast cancers (111.2/100k and 78.67/100k, respectively). The net excess patient billing rate for 2020-2022 was largely positive for all female cancer types (108.3/100k, 123.7/100k, 5.2/100k, and 1.8/100k, respectively). Analysis of billing incidence rates showed similar trends.</p><p><strong>Conclusion: </strong>The expected female cancer billing rate decreases in 2020 were followed by large increases in 2021 and 2022, resulting in a cumulative excess during the COVID-19 period. Further research is required to assess the nature of these changes.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251339919"},"PeriodicalIF":4.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161110","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 and safety of rituximab biosimilar (DRL_RI) versus MabThera^® in low-tumor-burden follicular lymphoma: the FLINTER study.","authors":"Narendra Maharaj, Dharma Rao Uppada, Anand Eswaraiah, Ranjith Kakkattu, Pramod Reddy, Volha A Kalenik, David Belada, Ana Oliveira Ramos, Jin Seok Kim, Yauheni V Baranau","doi":"10.1177/17588359251339925","DOIUrl":"https://doi.org/10.1177/17588359251339925","url":null,"abstract":"<p><strong>Background and objectives: </strong>This phase III study (RI-01-006; FLINTER) was conducted to demonstrate equivalent efficacy of DRL_RI to EU-approved rituximab (MabThera^®) in patients with previously untreated Stage II-IV, CD20-positive, low-tumor-burden follicular lymphoma (LTB-FL). This study also evaluated safety, immunogenicity, rituximab concentrations, and pharmacodynamics (PD) of DRL_RI compared with MabThera.</p><p><strong>Design and methods: </strong>Previously untreated, stage II-IV, CD20-positive LTB-FL patients (<i>N</i> = 317) were randomized (1:1) to receive DRL_RI (<i>n</i> = 162) or MabThera (<i>n</i> = 155) as intravenous infusions of 375 mg/m² weekly for 4 weeks (induction period), and thereafter every 8 weeks from Week 12 to Week 36 (maintenance treatment), and followed up till Week 52. The primary end point was best overall response rate (BORR) up to Week 28 based on blinded independent central review. Efficacy equivalence was demonstrated if the two-sided 90% confidence interval (CI) for BORR difference was within the prespecified equivalence margin (±17%). Secondary end points included objective and complete responses, duration of response, progression-free survival, overall survival, safety, immunogenicity, mean serum concentrations, and PD.</p><p><strong>Results: </strong>The BORR up to Week 28 was 80.2% versus 79.4% for DRL_RI versus MabThera group; with a difference of 0.89% (90% CI: -6.67 to 8.48; 95% CI: -8.05 to 9.93 within the prespecified margin). Both treatment groups were comparable for all secondary efficacy end points. Treatment-emergent adverse events were reported in 68.6% of patients; safety, immunogenicity, and mean serum concentrations were similar between groups. Peripheral B-cell counts declined below quantifiable limits in most patients, with a median time to B-cell depletion of 6.9 versus 7.0 days for DRL_RI versus MabThera.</p><p><strong>Conclusion: </strong>The study demonstrated efficacy equivalence of DRL_RI to MabThera; with comparable safety, immunogenicity, serum concentrations, and PD between groups.</p><p><strong>Trial registration: </strong>This trial was registered at ClinicalTrials.gov identifier: NCT03976102 and EudraCT (2018-004223-36).</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251339925"},"PeriodicalIF":4.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151841","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":"CanAssist Breast-based prognostication in low-intermediate estrogen receptor positive (ER^1%-20%) early-stage breast cancer patients helps guide treatment decisions.","authors":"Susmita Ghosh, Tejal Deepak Durgekar, Manvi Sunder, Badada Ananthamurthy Savitha, Payal Shrivastava, Naveen Krishnamoorthy, Deepti K Shivashimpi, Manjiri M Bakre","doi":"10.1177/17588359251342218","DOIUrl":"https://doi.org/10.1177/17588359251342218","url":null,"abstract":"<p><strong>Background: </strong>The estrogen receptor (ER) is one of the key biomarkers in breast cancer (BC), and therapy decisions are based on ER expression levels. However, the benefit of endocrine therapy in patients with ER expression (ER^1%-20%) is debatable. Owing to aggressive tumor biology, like triple-negative BC patients, many ER^1%-20% patients are considered to have worse outcomes and may benefit from additional drugs. This treatment dilemma in ER^1%-20% patients can be addressed by prognostication for risk of recurrence, which remains underexplored.</p><p><strong>Objective: </strong>The study aims to assess whether CanAssist Breast (CAB), an immunohistochemistry-based prognostic test validated globally in ER+/PR+/HER2- early-stage breast cancer (EBC) patients, would help prognosticate ER^1%-20% patients and thereby aid in treatment planning.</p><p><strong>Design: </strong>We conducted secondary data analyses of previously published retrospective studies to evaluate CAB prognostication in ER^1%-20% and ER^>20% subgroups across different clinical parameters.</p><p><strong>Methods: </strong>Analysis of CAB-based risk stratification was conducted on 2896 ER+/PR+/HER2- EBC patients with a known percentage of ER staining in both ER^1%-20% and ER^>20% subgroups. Kaplan-Meier survival curves were used to evaluate distant recurrence-free interval (DRFI).</p><p><strong>Results: </strong>ER^1%-20% patients constituted 6% of the total cohort. Overall, CAB significantly identified 65% of ER^1%-20% patients as low risk (LR) with acceptable DRFI of 91% and 35% as high risk (HR) with worse DRFI of 61% (<i>p</i> < 0.0001; hazard ratio (HR/LR), 5.175). ER^1%-20% patients are mostly younger, with T2, grade 3, lymph node positive tumors, and have a twofold higher incidence of distant recurrence than ER^>20% patients. CAB-based prognostication was significant in these subgroups analyzed with acceptable DRFI in LR patients of ~90% and a drop in DRFI in HR patients to ⩽66% (<i>p</i> = 0.01 to <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>CAB-based risk stratification of ER^1%-20% patients is significant and would add value in treatment decisions for additional targeted treatments to HR patients.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251342218"},"PeriodicalIF":4.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151838","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":"Impact of prophylactic cranial irradiation on survival in extensive-stage small cell lung cancer receiving first-line chemoimmunotherapy: a propensity score-matched study.","authors":"Shichao Zhou, Wanchen Zhai, Qian Zhang, Hui Li, Yun Fan","doi":"10.1177/17588359251341158","DOIUrl":"10.1177/17588359251341158","url":null,"abstract":"<p><strong>Background: </strong>Chemoimmunotherapy has emerged as the standard first-line treatment for extensive-stage small cell lung cancer (ES-SCLC), improving survival outcomes. However, the role of prophylactic cranial irradiation (PCI) in the context of chemoimmunotherapy remains undefined.</p><p><strong>Objectives: </strong>This study aimed to evaluate the impact of PCI on overall survival (OS) in patients with ES-SCLC after chemoimmunotherapy administration.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>This retrospective analysis included 261 patients with ES-SCLC treated with first-line chemoimmunotherapy between January 2019 and December 2023. All patients underwent MRI scans to confirm the absence of brain metastases. After 1:2 propensity score matching (PSM), 46 and 81 patients were assigned to the PCI and observation groups, respectively. The primary endpoint was OS, with additional exploration of progression-free survival (PFS), the cumulative incidence of intracranial metastases, and intracranial progression-free survival (iPFS).</p><p><strong>Results: </strong>After PSM, the two groups were well-balanced in baseline characteristics. Survival analysis showed a median OS of 19.9 months (95% confidence interval (CI): 11.8-28.0) in the PCI group and 15.6 months (12.3-18.9) in the observation group, without a significant difference (hazard ratio (HR) = 0.763 (95% CI: 0.484-1.206), log-rank <i>p</i> = 0.265). PCI significantly reduced the risk of brain metastasis (Fine-Gray <i>p</i> = 0.002), with 1-year cumulative incidence rates of 13.8% (3.4%-24.2%) in the PCI group and 53.4% (41.3%-65.6%) in the observation group. Subgroup analysis showed that for ES-SCLC patients achieving a partial response to initial chemoimmunotherapy, the PCI group had longer median OS (25.7 months (95% CI: 15.4-36.1) vs 19.4 months (15.4-23.4); HR = 0.502 (0.284-0.886); log-rank <i>p</i> = 0.021).</p><p><strong>Conclusion: </strong>PCI did not improve OS in ES-SCLC patients receiving first-line chemoimmunotherapy, while it may confer a survival benefit for patients who achieve remission following chemoimmunotherapy. In addition, PCI significantly reduced the incidence of brain metastases. These findings warrant further randomized studies for verification.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251341158"},"PeriodicalIF":4.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143710","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 and safety of distinct regimens for individuals with advanced EGFR-mutated non-small-cell lung cancer who progressed on EGFR tyrosine-kinase inhibitors: a systematic review and network meta-analysis.","authors":"Wengang Zhang, Jian Xiong, Yujie Li, Jing Nie, Wencheng Zhao, Zhiyi Guo, Xinyue Liu, Qianqian Zhang, Xuyang Chen, Li Ye, Zhimin Chen, Hao Wang, Kandi Xu, Lishu Zhao, Yujin Liu, Lihua Huang, Yuhang Li, Yayi He","doi":"10.1177/17588359251338046","DOIUrl":"10.1177/17588359251338046","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Targeted therapy with EGFR tyrosine-kinase inhibitors (TKIs) is the preferred first-line treatment for EGFR-mutated advanced non-small-cell lung cancer (NSCLC), but acquired resistance inevitably occurs in almost all responding individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We aimed to comprehensively review the literature to investigate the efficacy and safety of distinct regimens in the subsequent-line setting, thereby identifying the optimal regimen for these TKI-resistant NSCLC patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A systematic review and network meta-analysis (NMA) using a Bayesian framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources and methods: &lt;/strong&gt;The PubMed, Embase, Cochrane Library databases, and abstracts of ASCO, ESMO, and WCLC were searched from database inception to November 3, 2024, to identify eligible randomized controlled trials (RCTs) that assessed distinct regimens for individuals with advanced EGFR-mutated NSCLC who progressed on TKIs. The outcomes of progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and grade 3 or higher adverse events (⩾3AEs) were compared and ranked in overall patients and various subgroups among eight regimens by NMA and the surface under the cumulative ranking curve, respectively. The protocol is registered with PROSPERO, CRD42024601619.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 14 RCTs, involving 3177 participants and 8 treatment regimens (chemotherapy plus ivonescimab (programmed cell death protein 1/vascular endothelial growth factor inhibitor; chemotherapy + ivonescimab (CT + IVO)); CT + amivantamab + lazertinib (CT + AMI + LAZ), CT + immunotherapy + bevacizumab (CT + IO + BEV), CT + AMI, CT + BEV, CT + IO, CT, and IO), were included. Overall, in patients, the most pronounced PFS benefit was observed with the \"CT + IVO,\" followed by \"CT + AMI + LAZ,\" \"CT + IO + BEV,\" and \"CT + AMI,\" ranked second, third, and fourth, respectively. In terms of OS, the regimen of \"CT + AMI\" ranked the best, followed by \"CT + IVO.\" However, the comparisons of OS among different regimens did not reach statistical significance, possibly due to immature data. The results for ORR and DCR were similar to those for OS, with \"CT + AMI\" topping the rankings, followed by \"CT + AMI + LAZ.\" In terms of safety, the incidence of ⩾3AEs was highest in \"CT + AMI + LAZ,\" followed by \"CT + AMI.\" In subgroup analysis, \"CT + IVO\" demonstrates stable PFS benefits across clinicopathological characteristics, ranking first in most subgroups. Due to the unavailability of OS subgroup data in most RCTs, many regimens were missing in the OS subgroup analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Integrating the results of different clinical outcomes and subgroup analyses, we conclude that \"CT + IVO\" is the optimal treatment option with an acceptable safety profile for patients with advanced EGFR-mutated NSCLC who have progressed on TKIs. \"CT + AMI + LAZ\" and \"C","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251338046"},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111980","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":"Patterns of SARS-CoV-2-specific humoral and cellular immune response in actively treated patients with solid cancer following prime BNT162b2 COVID-19 vaccination: results from phase IV CoVigi trial.","authors":"Radka Lordick Obermannova, Iveta Selingerova, Regina Demlova, Dominika Okruhlicova, Jiri Nevrlka, Katerina Cerna-Pilatova, Kristina Greplova, Zdenka Cermakova, Dalibor Valik, Igor Kiss, Marketa Palacova, Alexandr Poprach, Hana Lejdarova, Sarka Selvekerova, Martina Vaneckova, Lenka Zdrazilova-Dubska","doi":"10.1177/17588359251316224","DOIUrl":"10.1177/17588359251316224","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients are particularly vulnerable during the COVID-19 pandemic. Vaccinations are essential in controlling the pandemic. However, due to their exclusion from clinical trials for COVID-19 vaccines, there is limited data on the vaccines' effectiveness and safety for this group.</p><p><strong>Objectives: </strong>We evaluated humoral (anti-S antibody) and cellular (T-cell) immune response in patients with solid cancer on systemic anticancer treatment versus healthy controls prime-vaccinated by the BNT162b2 COVID-19 mRNA vaccine.</p><p><strong>Methods: </strong>CoVigi was the phase IV prospective open-label non-randomized multicentric clinical trial evaluating anti-S and anti-N SARS-CoV-2 antibodies and SARS-CoV-2-specific T-cell response by IFN-γ-release assay in several time points during the prime COVID-19 mRNA vaccination (prior to the first vaccine dose, prior to the second dose, at 4-8 weeks, at 3 months, and 6 months after vaccination). Immune response was analyzed in the context of previous SARS-CoV-2 infection and anticancer therapy (chemotherapy (CT) + monoclonal antibodies (mAb), mAb, immune checkpoint inhibitors, tyrosine kinase inhibitors, and curative radiotherapy).</p><p><strong>Results: </strong>Among 204 patients with solid cancer and 73 healthy controls, 65% of SARS-CoV-2-naïve patients with cancer developed anti-S antibodies after the first vaccine dose, rising to 92% after the second dose. By 6 months, all BNT162b2-vaccinated patients with solid cancer developed antibody response. Patients treated with CT showed impaired both humoral and cellular immune response to BNT162b2 vaccination. Antibody levels in SARS-CoV-2-recovered patients were comparable to healthy controls. T-cell response peaked after the second dose of BNT162b2 and was not significantly impaired in solid cancer patients except those treated with CT.</p><p><strong>Conclusion: </strong>Immune response to BNT162b2 COVID-19 mRNA vaccine is substantially shaped by pre-vaccination COVID-19 infection. All patients with solid cancer on active anticancer therapy exhibited seroconversion after COVID-19 vaccination, although the extent of both humoral and cell immune response was substantially hampered in those treated by CT.</p><p><strong>Trial registration: </strong>EudraCT No. 2021-000566-14 (registration date February 17, 2021).</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251316224"},"PeriodicalIF":4.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094931","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":"Evaluating changes in the breast cancer-related quality of life of young women with breast cancer: long-term results from a multicenter prospective cohort.","authors":"Bryan F Vaca-Cartagena, Fernanda Mesa-Chavez, Ana S Ferrigno Guajardo, Hatem A Azim, Federico Rotolo, Alejandra Platas, Alan Fonseca, Marlid Cruz-Ramos, Ana Rodriguez, Alejandro Mohar, Cynthia Villarreal-Garza","doi":"10.1177/17588359251337493","DOIUrl":"10.1177/17588359251337493","url":null,"abstract":"<p><strong>Background: </strong>Young women with breast cancer (YWBC) typically undergo intensive treatment that negatively impacts their quality of life (QoL). However, limited information is available on how their QoL changes, as most research has focused on older patients.</p><p><strong>Objectives: </strong>To assess changes in QoL among YWBC, identify the most affected QoL domains, and identify the factors associated with these changes.</p><p><strong>Design: </strong>Joven & Fuerte is a multicenter cohort of women aged ⩽40 in Mexico with newly diagnosed BC from 2014 to 2020.</p><p><strong>Methods: </strong>Participants completed the European Organization for Research and Treatment of Cancer Breast Cancer module QLQ-BR23 questionnaire at five different time points from enrollment until year 5 postdiagnosis. Clinical and treatment data were also collected. Group-based multivariate trajectory modeling was used to analyze longitudinal changes across QoL domains and classify patients into appropriate groups. Logistic models were then employed to identify associations between variables and group classification.</p><p><strong>Results: </strong>A total of 477 women (median age: 36 years; interquartile range 32-38) were included. Most had public health insurance (87%) and were diagnosed with stage II (49%) or III (39%) BC. Two trajectory groups, namely, \"good\" and \"poor,\" were identified based on QLQ-BR23 scores. Most patients (<i>n</i> = 294, 62%) were in the poor group. In the good group, sexual enjoyment scores remained stable from baseline to year 5 (51.4), whereas those in the poor group decreased (51.0-37.3). Distress related to hair loss over time declined, with scores decreasing from 36.3 to 27.0 in the good trajectory group and from 43.4 to 31.2 in the poor trajectory group. For future perspective, the good group improved from 56.4 to 79.0, while the poor group increased from 39.3 to 57.2. Patients with human epidermal growth factor receptor 2-positive BC (adjusted odds ratio (aOR) = 0.57, 95% confidence interval (CI) 0.35-0.94, <i>p</i> = 0.028) and those with public health insurance (aOR = 0.41, 95% CI 0.16-0.90, <i>p</i> = 0.035) were less likely to belong to the poor trajectory group.</p><p><strong>Conclusion: </strong>A high proportion of YWBC experience a poor QoL trajectory over time, particularly in areas related to sexual health, future perspective, and hair loss.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251337493"},"PeriodicalIF":4.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094926","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":"Total neoadjuvant therapy in high-risk rectal cancer: organ preservation and survival outcomes in a single-center retrospective cohort.","authors":"Zhiyuan Zhang, Ruiyan Wu, Zhenyu Ke, Fan Xia, Guichao Li, Juefeng Wan, Hui Zhang, Yujia Deng, Zhen Zhang, Yan Wang, Lijun Shen","doi":"10.1177/17588359251332466","DOIUrl":"https://doi.org/10.1177/17588359251332466","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer poses a significant global health burden. Conventional neoadjuvant chemoradiotherapy (nCRT) demonstrates limited efficacy in achieving disease-free survival (DFS) and organ preservation. Total neoadjuvant therapy (TNT), an emerging paradigm integrating systemic chemotherapy with radiotherapy, aims to address these limitations.</p><p><strong>Objectives: </strong>To evaluate the short- and long-term oncological outcomes and organ preservation feasibility of TNT in high-risk locally advanced rectal cancer (LARC) patients.</p><p><strong>Designs: </strong>A retrospective study was conducted to analyze the short-term and long-term results after total nCRT.</p><p><strong>Methods: </strong>This retrospective study involved 110 rectal cancer patients with high-risk features treated at the Fudan University Shanghai Cancer Center from 2008 to 2022. Patients underwent comprehensive staging and received nCRT followed by either total mesorectal excision (TME) or a watch and wait (W&W) strategy. The regimen included concurrent chemoradiotherapy with 50 Gy/25 fractions and at least six cycles of induction or consolidation chemotherapy. Both short-term and long-term outcomes were collected and analyzed.</p><p><strong>Results: </strong>Among the LARC patients, 73.6% were stage III, and 47.3% opted for the W&W strategy. The combined rate of clinical complete response or confirmed pathological complete response (pCR) reached 49.1%. During follow-up, 10% of patients experienced local regrowth. The 3-year DFS and overall survival (OS) rates were 75.7% and 92.4%, respectively. The W&W strategy could achieve superior outcomes than patients without pCR in DFS (<i>p</i> = 0.021) and OS (<i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>TNT demonstrates durable survival outcomes and facilitates organ preservation in over 50% of high-risk LARC patients. Intensive surveillance is critical for the early detection of local regrowth.</p><p><strong>Trial registration: </strong>Our study is retrospective in nature, rather than a prospective clinical trial. Therefore, registration was not conducted, and the Clinical Trial Number is not applicable.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251332466"},"PeriodicalIF":4.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064736","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":"Impact of CD44/326 peritoneal cells as response indicators in advanced gastric cancer patients receiving repeated intraperitoneal perfusion normothermic chemotherapy.","authors":"Odilon de Souza Filho, Reinaldo Rondinelli, Antônio Carlos Acetta, Sérgio Bertolace, Alexandre Palladino, Cristiano Duque Guedes, Claudia Cristine Rocha Vieira, Luis Claudio Santos Thuler, Claudia Diniz, Everton Cruz Dos Santos, Eliana Abdelhay","doi":"10.1177/17588359251337480","DOIUrl":"https://doi.org/10.1177/17588359251337480","url":null,"abstract":"<p><strong>Background: </strong>In gastric cancer (GC), the dissemination of neoplastic cells (NCs) in the peritoneal cavity is related to disease progression and poor prognosis. Elimination of NC through chemotherapy is needed to achieve better outcomes before conversion surgery.</p><p><strong>Objectives: </strong>The objective of this study was to evaluate the impact of NC CD44+/CD326+ levels through flow cytometry (FC) on peritoneal lavage (PL) fluid as a response indicator for conversion surgery.</p><p><strong>Methods: </strong>Patients with GC and NCs in the peritoneal cavity with or without peritoneal carcinomatosis (PC) and ascites were evaluated via minimally invasive staging. The PLs of patients were analyzed by FC to quantify NCs. All patients were treated with repeated intraperitoneal perfusion normothermic chemotherapy (RIPPENC). Patients who had negative NCs or reduced NCs were referred for conversion surgery.</p><p><strong>Results: </strong>Thirty patients were enrolled in this study and divided into three groups. In the first group, 20 patients with positive cytology (C+) and/or PC with a PC index (PCI) ⩽6 were treated with RIPPENC. Otherwise, six patients with C+ and PC with a PCI >7 and four patients with C+, ascites, and a PCI ranging from 15 to 22 were treated with palliative RIPPENC. The percentage of CD44+/CD326+ cells was correlated with the number of RIPPENC cycles and resections. The median follow-up time was 14.8 months. The overall median survival since the first RIPPENC was 14.6 months among those who did not undergo resection and 22.6 months among those who underwent resection (<i>p</i> = 0.001). Moreover, we observed a correlation between the percentage of CD44+/CD326+ cells in the PL region and patient survival.</p><p><strong>Conclusion: </strong>The use of FC to identify PL CD44+/CD326+ cell levels may be an important innovative biomarker for determining the presence of NCs, directly affecting the success of RIPPENC for conversion surgery.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251337480"},"PeriodicalIF":4.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019121","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":"Characteristics, treatments, and outcomes of adolescents and adults with neuroblastoma: a retrospective study in China.","authors":"Weiji Xie, Yu Zhang, Jiaqian Xu, Feifei Sun, Jia Zhu, Yi Que, Junting Huang, Zijun Zhen, Suying Lu, Juan Wang, Yizhuo Zhang","doi":"10.1177/17588359251337494","DOIUrl":"https://doi.org/10.1177/17588359251337494","url":null,"abstract":"<p><strong>Background: </strong>Neuroblastoma (NB) is rare in adolescents and adults, resulting in limited availability of data.</p><p><strong>Objectives: </strong>We comprehensively investigated the characteristics, treatments, and outcomes of adolescent and adult patients with NB, aiming to provide a more in-depth insight into this disease.</p><p><strong>Design: </strong>A retrospective, single-center study.</p><p><strong>Methods: </strong>We retrieved and analyzed the medical data of patients with NB aged 10 years or older at diagnosis who were treated at Sun Yat-sen University Cancer Center between June 2005 and January 2024.</p><p><strong>Results: </strong>Sixty-five patients (30 males and 35 females) were enrolled, with a median age of 20 years (interquartile range, 14-26 years), including 27 patients aged 10-18 years and 38 patients aged >18 years. Most patients were classified as M-stage disease (<i>n</i> = 40, 61.5%), high-risk (<i>n</i> = 42, 64.6%), and poorly differentiated NB (<i>n</i> = 27, 41.5%). Additionally, 3 (6.7%) patients had <i>MYCN</i> amplification, and 5 (25%) had <i>ALK</i> mutations. The genomic landscape revealed that mutations in the cell cycle and DNA repair pathways are related to chemotherapy sensitivity. After induction therapy, 34 (52.3%) patients achieved complete response (CR). The 5-year progression-free survival (PFS) and overall survival (OS) rates were 33.1% ± 6.9% and 55.1% ± 7.6%, respectively. Patients who achieved CR after induction therapy had superior PFS (<i>p</i> = 0.009), with 5-year PFS rates of 44.0% ± 10.6% compared to 18.5% ± 8.5% in non-CR patients.</p><p><strong>Conclusion: </strong>Adolescent and adult patients with NB exhibit distinct characteristics, less chemotherapy sensitivity, and poorer outcomes compared to pediatric patients. Achieving CR after induction therapy is associated with better outcomes. Further investigation for new therapies is required.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251337494"},"PeriodicalIF":4.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061878","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}