Timothée Vigié, Alexandre Perrier, Brice Chanez, Julien De Martino, Loëtitia Favre, Florence Coulet, Jean-Baptiste Bachet, Erell Guillerm, Léo Mas
{"title":"Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with <i>EGFR</i> exon 19 deletion: a case report and literature review.","authors":"Timothée Vigié, Alexandre Perrier, Brice Chanez, Julien De Martino, Loëtitia Favre, Florence Coulet, Jean-Baptiste Bachet, Erell Guillerm, Léo Mas","doi":"10.1177/17588359241312078","DOIUrl":"10.1177/17588359241312078","url":null,"abstract":"<p><p>Pancreatic cancer is a rising cause of cancer death. Therapeutic options are scarce and of limited efficacy. Up to 26% of patients with metastatic pancreatic cancer could benefit from targeted therapies. We report here for the first time the case of three patients with metastatic pancreatic ductal adenocarcinoma (PDAC) without <i>KRAS</i> alteration for whom an activating mutation in exon 19 of the epidermal growth factor receptor (<i>EGFR</i>) gene was found through mainstreaming NGS. The <i>EGFR</i> variant was confirmed on multiple tumor samples and by circulating tumor DNA (ctDNA) analysis in two patients. The three patients were treated with osimertinib with early molecular, biologic, and morpho-metabolic responses. At the last follow-up, one patient had an ongoing response after 17 months, and disease control had been maintained for 8 and 6 months in the other two. Known resistance mechanisms were observed on ctDNA analysis at progression. These observations demonstrate the benefit of osimertinib for treating <i>EGFR</i>-mutated PDAC and highlight the interest in investigating rare molecular alterations, especially in patients without <i>KRAS</i> alterations.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359241312078"},"PeriodicalIF":4.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754442","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}
Yizhen Chen, Yuanyuan Zheng, Jia Wu, Rong Ye, Hangdong Jia, Zhenyuan Zhou, Weijie Chen, Linwei Xu, Yuhua Zhang, Ming Zheng
{"title":"Neoadjuvant chemotherapy combined with bevacizumab for resectable colorectal liver metastasis with risk factors for recurrence: a multicenter real-world study.","authors":"Yizhen Chen, Yuanyuan Zheng, Jia Wu, Rong Ye, Hangdong Jia, Zhenyuan Zhou, Weijie Chen, Linwei Xu, Yuhua Zhang, Ming Zheng","doi":"10.1177/17588359251328457","DOIUrl":"10.1177/17588359251328457","url":null,"abstract":"<p><strong>Background: </strong>Currently, guidelines prohibit the addition of targeted drugs in neoadjuvant chemotherapy (NAC) for initially resectable colorectal liver metastasis (CRLM).</p><p><strong>Objective: </strong>Nevertheless, efficacy data of NAC combined with bevacizumab (Bev) for initially resectable CRLM with risk factors for recurrence (RFR) are lacking.</p><p><strong>Designs: </strong>We conducted a multicenter real-world cohort study to retrospectively analyze the efficacy and feasibility of NAC combined with Bev for CRLM with RFR.</p><p><strong>Methods: </strong>The patients were divided into the NAC alone group and NAC combined with the Bev group. We designated progression-free survival (PFS), objective response rate (ORR), and overall survival (OS) as the outcomes. Kaplan-Meier, Cox proportional hazards regression models, and subgroup analysis were utilized. RFR was a clinical risk score of 3-5. Subgroup analysis was applied to explore which subgroup was more suitable for NAC combined with Bev.</p><p><strong>Results: </strong>Between 2015 and 2020, this multicenter real-world study encompassed 335 CRLM patients from six medical centers who underwent curative hepatectomy following NAC. Two hundred seventeen patients were in the NAC alone group, and 118 received NAC combined with Bev. The NAC alone group exhibited an ORR of 51.15%, compared to 66.95% in the NAC combined with Bev (<i>p</i> = 0.005). The R0 resection rates achieved 91.71% for the NAC alone group and 94.92% for the NAC combined with Bev (<i>p</i> = 0.276). Three-year PFS rate was 27.6% for NAC alone and 41.5% for the NAC combined with the Bev group (<i>p</i> = 0.006). Furthermore, the 3-year OS was calculated to be 57.0% for the NAC alone and 66.7% for the NAC combined with Bev patients (<i>p</i> = 0.079).</p><p><strong>Conclusion: </strong>For initially resectable CRLM patients with RFR, NAC combined with Bev exhibited a higher ORR and longer PFS.</p><p><strong>Chinese clinical trial registry: </strong>ChiCTR2400082966.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251328457"},"PeriodicalIF":4.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731128","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":"Future perspectives on immunotherapy for hepatocellular carcinoma.","authors":"Landon L Chan, Stephen L Chan","doi":"10.1177/17588359251323199","DOIUrl":"10.1177/17588359251323199","url":null,"abstract":"<p><p>In recent years, several global phase III trials have shown that combinations of immune checkpoint inhibitors (ICIs) offer superior efficacy and survival compared to multi-kinase inhibitors, establishing them as the gold standard for treating patients with advanced hepatocellular carcinoma (HCC). This success has led to investigations into expanding the use of immunotherapy into various other settings and populations, including neoadjuvant and adjuvant therapies, patients with decompensated liver function and those awaiting liver transplantation. Despite its proven efficacy, a significant number of patients still develop resistance to immunotherapy, highlighting the need for innovative strategies to address this challenge. Approaches aimed at enhancing tumour immunogenicity, such as combining immunotherapy with transarterial chemoembolization or radiation therapies, show significant promise. Additionally, novel immunotherapeutics - such as triplet therapy, bispecific antibodies, adoptive T-cell therapy and cancer vaccines - are in early development for HCC. These agents have demonstrated potential for synergistic effects with existing ICIs, with initial studies yielding positive outcomes. In this review, we offer our future perspective on immunotherapy, emphasizing emerging indications, novel combination strategies and the development of new immunotherapeutic agents. Overall, the future of immunotherapy in HCC is brimming with extraordinary potential, set to transform the treatment landscape and redefine the possibilities for managing this challenging disease.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251323199"},"PeriodicalIF":4.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721479","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":"Toxicities and management strategies of emerging antibody-drug conjugates in breast cancer.","authors":"Sora Kang, Sung-Bae Kim","doi":"10.1177/17588359251324889","DOIUrl":"10.1177/17588359251324889","url":null,"abstract":"<p><p>Antibody-drug conjugates (ADCs) offer a promising therapeutic approach for various cancers, enhancing the therapeutic window while mitigating systemic adverse effects on healthy tissues. ADCs have achieved remarkable clinical success, particularly in treating breast cancer, becoming a standard therapy across all subtypes, including hormone receptor-positive, human epidermal growth factor receptor 2-positive, and triple-negative breast cancer. Although designed to selectively target antigens via monoclonal antibodies, ADCs can exhibit toxicity in normal tissues, often due to off-target effects of their cytotoxic payloads. Understanding and managing these toxicities according to established guidelines are crucial for enhancing ADC clinical efficacy, minimizing adverse events, and ultimately improving patient outcomes. This review comprehensively examines the toxicities of ADCs employed in breast cancer treatment and explores their management strategies. Furthermore, we investigate novel ADCs beyond trastuzumab deruxtecan and sacituzumab govitecan, evaluating their potential efficacy and corresponding safety profiles.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251324889"},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731183","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":"Breast imaging characteristics in Thai transgender women: mammography and ultrasound outcomes in a pilot study.","authors":"Poonpissamai Suwajo, Pavinee Annoppornchai, Jenjeera Prueksadee, Patcharin Krongtham, Sopark Manasnayakorn","doi":"10.1177/17588359251327984","DOIUrl":"10.1177/17588359251327984","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer screening in transgender women, particularly those undergoing hormone therapy, remains understudied. Limited screening guidelines exist for transgender individuals, creating a need for tailored recommendations. This study addresses breast cancer screening outcomes in Thai transgender women using mammography and ultrasound.</p><p><strong>Objectives: </strong>To assess breast imaging characteristics and screening outcomes in transgender women in Thailand and identify factors associated with breast density.</p><p><strong>Design: </strong>A descriptive correlation study with a cross-sectional design.</p><p><strong>Methods: </strong>Sixty-six transgender women over 40 years of age, who had been on hormone replacement therapy for at least 5 years, were recruited from three clinics. Participants underwent mammography and breast ultrasound, with imaging analyzed using the Breast Imaging-Reporting and Data System (BI-RADS) system. Data were analyzed with descriptive statistics and Spearman's correlation.</p><p><strong>Results: </strong>The average age of participants was 49.2 years, with an average of 16.3 years of hormone use. Of the participants, 80.3% had undergone breast augmentation. Most participants (86.4%) were classified as BI-RADS 2 and dense breast tissue. Screening findings were mostly negative or benign (94%), with the remaining 6% demonstrating probably benign findings. No signs of malignancy were detected. There was no significant correlation between age, BMI, hormone use duration, BI-RADS, and breast density.</p><p><strong>Conclusion: </strong>Breast cancer screening among transgender women in Thailand showed high rates of dense breast tissue and low abnormality detection. Moreover, most of them have previously undergone breast augmentation. Therefore, screening guidelines should use both mammography and ultrasound for early detection.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251327984"},"PeriodicalIF":4.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721466","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}
Marya Hussain, Christine Brezden-Masley, Stephen Chia, Giuseppe Curigliano, Marc Webster, Jan-Willem Henning
{"title":"Clinician's guide: expert insights on the use of CDK4/6 inhibitors in patients with early breast cancer.","authors":"Marya Hussain, Christine Brezden-Masley, Stephen Chia, Giuseppe Curigliano, Marc Webster, Jan-Willem Henning","doi":"10.1177/17588359251326710","DOIUrl":"10.1177/17588359251326710","url":null,"abstract":"<p><p>The introduction of the cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors abemaciclib and ribociclib to the adjuvant setting marks a significant advancement in the treatment of hormone-receptor-positive, human epidermal growth factor receptor 2-negative early breast cancer (HR+, HER2- EBC). Despite significant strides in early detection and treatment, many patients continue to face the risk of disease recurrence, highlighting the need for more effective adjuvant therapies. These CDK4/6 inhibitors, combined with adjuvant endocrine therapy, have shown promising efficacy in reducing recurrence rates while maintaining a manageable safety profile, as evidenced by the monarchE and NATALEE trials. This paper explores the integration of adjuvant CDK4/6 inhibitors into clinical practice, focusing on disease-free survival and safety outcomes. Key considerations in selecting between abemaciclib and ribociclib are discussed, including patient risk profiles, efficacy and safety profiles, treatment duration, and individual patient preferences. In addition, we discuss managing adverse events to prevent premature discontinuation, with strategies that include dose holds, dose reductions, proactive symptom management, and patient education. The paper also highlights strategies to enhance patient medication adherence and the involvement of multidisciplinary care teams to support treatment delivery. As research continues to evolve, additional follow-ups of the monarchE and NATALEE trials and future trials will further refine patient selection and treatment sequencing, ultimately improving outcomes and enhancing the quality of life for patients with HR+, HER2- EBC.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251326710"},"PeriodicalIF":4.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693359","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}
Jiahui Hu, Shu Zhao, Mengxuan Zuo, Chun Hui Li, Wang Yao, Xinyu Yang, WeiWei Xing, Peng Song
{"title":"Local-region treatment comparison following conversion therapy of hepatocellular carcinoma: a period and age-dependent analysis.","authors":"Jiahui Hu, Shu Zhao, Mengxuan Zuo, Chun Hui Li, Wang Yao, Xinyu Yang, WeiWei Xing, Peng Song","doi":"10.1177/17588359251316665","DOIUrl":"10.1177/17588359251316665","url":null,"abstract":"<p><strong>Background: </strong>Transarterial chemoembolization (TACE) is a potential conversion therapeutic strategy for unresectable hepatocellular carcinoma (uHCC). However, therapeutic options following conversion therapy are still controversial.</p><p><strong>Objectives: </strong>This study aimed to compare the efficacy and safety of surgical resection (SR) and microwave ablation (MWA) after TACE conversion therapy for uHCC.</p><p><strong>Design: </strong>A retrospective, multi-institutional study.</p><p><strong>Methods: </strong>From June 2008 to October 2022, 8842 consecutive uHCC patients underwent initial TACE at 15 hospitals were identified. Among them, 1348 eligible patients who received TACE conversion therapy were included. The propensity score matching (PSM) was applied to reduce selection bias. To explore the effect of age on conversion therapy, a therapeutic factor analysis with age change was performed. The overall survival (OS) and disease-free survival (DFS) were compared using the Kaplan-Meier method with the log-rank test.</p><p><strong>Results: </strong>After PSM 1:1, 542 patients in the MWA group were matched with those in the SR group. SR demonstrated better long-term survival outcomes (median OS, 10.6 vs 5.8 years, HR:1.83, 95% CI: 1.48-2.25, <i>p</i> < 0.001 and median DFS, 3.2 vs 2.5 years, HR: 1.27, 95% CI:1.09-1.49, <i>p</i> = 0.003) than MWA. There was an improvement in the 5-year DFS rate for MWA from 17.1% during 2009-2016 to 37.3% during 2017-2022, becoming comparable to the 40.8% of SR (<i>p</i> = 0.129). When the uHCC patients downstage met Milan criteria, the long-term OS and DFS were comparable between two groups (both, <i>p</i> > 0.05). SR presents an OS advantage over MWA at the age (years) of 45-54 (<i>p</i> <i>=</i> 0.036), 55-65 (<i>p</i> = 0.001), and >65 (<i>p</i> < 0.001), except <45(<i>p</i> = 0.140).</p><p><strong>Conclusion: </strong>MWA might be acceptable as an alternative to SR in first-line therapeutic scheme after TACE conversion therapy for uHCC, especially, for the aged <45 years cohorts.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251316665"},"PeriodicalIF":4.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664364","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":"Corrigendum to \"Selpercatinib in Chinese patients with <i>RET</i>-fusion-positive non-small-cell lung cancer: updated efficacy and safety analysis from the LIBRETTO-321 phase II trial\".","authors":"","doi":"10.1177/17588359251327771","DOIUrl":"https://doi.org/10.1177/17588359251327771","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/17588359241307199.].</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251327771"},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658705","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}
Jeong Uk Lim, Woo Kyung Ryu, Nuri Park, Juwhan Choi, Eunyoung Lee, Sang-Yun Lee, Jun Hyeok Lim
{"title":"Current and future perspectives in extensive-stage small-cell lung cancer.","authors":"Jeong Uk Lim, Woo Kyung Ryu, Nuri Park, Juwhan Choi, Eunyoung Lee, Sang-Yun Lee, Jun Hyeok Lim","doi":"10.1177/17588359251326705","DOIUrl":"https://doi.org/10.1177/17588359251326705","url":null,"abstract":"<p><p>Small-cell lung cancer (SCLC) is a highly aggressive and rapidly proliferative malignancy that has historically had limited therapeutic advancements. Recent advancements in the understanding of SCLC have led to attempts at subtyping the disease based on transcription factor characteristics, offering new insights into its biology and potential therapeutic targets. In addition, significant progress has been made in developing treatment regimens, providing new hope for improved patient outcomes. The introduction of immune checkpoint inhibitors, such as atezolizumab and durvalumab, in combination with traditional chemotherapy, has marked a significant advancement, demonstrating improved overall survival and progression-free survival compared to chemotherapy alone. Despite these advancements, the prognosis for extensive-stage SCLC (ES-SCLC), the more advanced form of SCLC, remains poor, highlighting the critical need for ongoing research and the development of novel therapeutic strategies. New treatment modalities, such as lurbinectedin and anti-Delta-like Canonical Notch Ligand 3 antibodies, are now included in the treatment options for refractory SCLC, and many more treatment strategies involving combination therapies are being studied. Advances in molecular profiling and the identification of biomarkers are aiding in the development of personalized treatment approaches. This review focuses on these recent advancements and emerging strategies in the treatment of ES-SCLC.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251326705"},"PeriodicalIF":4.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650227","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}
Chao An, Lujun Shen, Qifeng Chen, Yiquan Jiang, Chen Li, He Ren, Peihong Wu, Xi Liu
{"title":"Identification of candidates with hepatocellular carcinoma to receive TACE combined with MWA by assessing tumor burden and radiologic features.","authors":"Chao An, Lujun Shen, Qifeng Chen, Yiquan Jiang, Chen Li, He Ren, Peihong Wu, Xi Liu","doi":"10.1177/17588359251324052","DOIUrl":"https://doi.org/10.1177/17588359251324052","url":null,"abstract":"<p><strong>Background: </strong>There is still no noninvasive, automated, and accurate model for guiding physicians in the decision-making of transarterial chemoembolization combined with microwave ablation (TACE-MWA) in intermediate-stage hepatocellular carcinoma (HCC).</p><p><strong>Objectives: </strong>To develop a prognostic score based on the tumor burden and radiomic features for the prediction of the long-term survival of patients with intermediate-stage HCC after TACE-MWA.</p><p><strong>Methods: </strong>From June 2008 to October 2022, a total of 2189 consecutive patients from seven tertiary-care hospitals with intermediate-stage HCC who received initial TACE combined with MWA were enrolled. Among them, 2189 were divided into training cohort (<i>N</i> = 1753), and internal test cohort (<i>N</i> = 436) in a single center, and 316 patients were assigned to external test cohort in another 6 centers. A prognostic scoring system was constructed using tumor burden and radiologic features (TBR) and compared with conventional predicting systems.</p><p><strong>Results: </strong>In training cohort, multivariate Cox regression analysis suggested that tumor burden (hazard ratio (HR), 0.693; 95% confidence interval (CI): 0.505, 0.814; 1 point per 1.0 increase, <i>p</i> = 0.024), radiologic features (HR, 0.349; 95% CI: 0.236, 0.517; <i>p</i> < 0.001), and alpha-fetoprotein (HR, 1.629; 95% CI: 1.280, 2.073; <i>p</i> < 0.001) were independent prognostic factors for OS. A prognostic model that comprises TBR was built, which showed significantly higher AUC values than other clinical stagings in all three cohorts. Moreover, the TBR score provided greater net benefit across the range of reasonable threshold probabilities than other models. Based on cutoff values of 32 and 74 centiles of the TBR score, the cohort was divided into low-, middle-, and high-risk strata, which provide consistent performance in survival discrimination across different patient subgroups.</p><p><strong>Conclusion: </strong>The TBR score serves as an efficient instrument for risk stratification, guiding the course of adjuvant targeted and immunotherapies for HCC patients undergoing TACE-MWA combined treatment.</p><p><strong>Design: </strong>A retrospective, multi-institutional study.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251324052"},"PeriodicalIF":4.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650603","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}