Therapeutic Advances in Medical Oncology最新文献

{"title":"Combination of immunotherapy-based systemic therapy and radiotherapy achieves durable response and favorable survival in recurrent head and neck cancer.","authors":"Jingbo Wang, Gulidanna Shayan, Xin Guo, Xiaodong Huang, Ye Zhang, Runye Wu, Lin Gui, Sheng Yang, Xuesong Chen, Yuan Qu, Kai Wang, Jianghu Zhang, Yuchao Ma, Jingwei Luo, Shengyu Zhou, Xiaohui He, Junlin Yi","doi":"10.1177/17588359251367358","DOIUrl":"10.1177/17588359251367358","url":null,"abstract":"<p><strong>Background: </strong>There is an unmet clinical need for the locoregional recurrent head and neck squamous cell carcinoma (HNSCC). Moreover, little data regarding the therapeutic survival outcomes are available for the unresectable recurrent setting that did not receive radiotherapy during the initial course of treatment.</p><p><strong>Objectives: </strong>To investigate the survival outcomes of radiation-naïve recurrent HNSCC who were treated with first-line immunotherapy-based systemic therapy in combination with radical locoregional radiotherapy.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Methods: </strong>From January 2019 to December 2023, locoregional recurrent HNSCC patients receiving immune checkpoint inhibitor (ICI)-based systemic therapy plus locoregional radiotherapy as first-line treatment in our institution were selected. Median follow-up was 16.4 months.</p><p><strong>Results: </strong>A total of 23 patients with recurrent HNSCC met the inclusion criteria and were finally analyzed. The median time to progression from the beginning of initial course of treatment was 9.3 months. Nineteen patients (82.6%) harbored recurrent stage IV (rIV) disease according to AJCC eighth edition, and 17 (73.9%) patients were assessed unresectable. For overall cohort, the median progression-free survival (PFS) and locoregional progression-free survival (LRPFS) were 17.0 months and 27.2 months, while the median overall survival (OS) and distant metastasis-free survival (DMFS) were not reached. The 1-year OS, PFS, LRPFS, and DMFS were 100%, 79.5%, 79.5%, and 100%, respectively. Twenty patients obtained objective response during the treatment course, achieving the 1-year duration of response (DOR) of 75.3%, and the median of 16.7 months. Combined positive score (CPS) ⩾ 20 was unveiled to be correlated with significantly favorable PFS compared with CPS < 20 or unknown (1-year PFS: 100% vs 50.0%, <i>p</i> = 0.035).</p><p><strong>Conclusion: </strong>This study presented promising survival and tumor control with durable response in recurrent HNSCC, supporting the use of radical RT as the first-line treatment in addition to ICI-based systemic therapy, in particular for patients with CPS ⩾ 20.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251367358"},"PeriodicalIF":4.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065479","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":"A protocol paper on the implementation of health care model to improve the survival of breast cancer patients in India.","authors":"Biswajit Dubashi, Nisha K Jose, Supriya Mallick, Budhi Singh, Ruchi Tripathi, Nandini Devi, Surendran Veeraiah","doi":"10.1177/17588359251372832","DOIUrl":"10.1177/17588359251372832","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the leading cause of cancer-related morbidity and mortality among Indian females, accounting for 13.5% of new cancer cases and 10.6% of all cancer deaths. The median 5-year survival rate was 73.8%, ranging from 93.3% for patients with stage I to only 24.5% for those with stage IV disease. A comprehensive package of effective interventions implemented with quality is expected to improve survival.</p><p><strong>Objectives: </strong>To develop and implement a package of interventions so that at least 80% of patients with breast cancer are provided with evidence-based quality care.</p><p><strong>Design: </strong>The proposed implementation research will follow a mixed-method approach executed at 13 sites in India.</p><p><strong>Methods: </strong>The study will be conducted in three phases. During the formative phase, facilitators and barriers in diagnostic evaluation and treatment delivery in patients with non-metastatic breast cancer will be identified using a mixed-method approach. Simultaneously, prospective baseline data collection with emphasis on selected key performance indicators (KPIs) will be done for 6 months. Results from the formative phase will be used to develop a healthcare model that will ensure evidence-based quality care for at least 80% of stage II breast cancer patients. In the implementation phase, a trial run of this health care package will be conducted, and periodic assessment of its smooth running will be ensured. Depending on the requirements of each site, two to three iterations will be done, and a final healthcare package will be fixed. This finalized model will be executed for 1 year. At the end of 1 year, selected KPIs will be reassessed. At the evaluation phase, the outcome of the model will be assessed by comparing KPIs. Even after completing this project, patients will be followed up regularly for tracking long-term outcomes.</p><p><strong>Discussion: </strong>Achieved targeted interventions will help to set up a clinical care pathway with early diagnosis, timeliness of providing treatment, reduced default and abandonment, and improved survival among breast cancer patients in India.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251372832"},"PeriodicalIF":4.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065410","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":"Pregnancy and breast cancer in young women: current updates and future directions.","authors":"Shiliang Zhang, Sena B Guclu, Marla Lipsyc-Sharf, Nimmi S Kapoor","doi":"10.1177/17588359251369973","DOIUrl":"10.1177/17588359251369973","url":null,"abstract":"<p><p>The relationship between pregnancy and breast cancer is complicated. On one hand, pregnancy can influence breast cancer risk and tumor biology, and on the other, a breast cancer diagnosis and its subsequent management can significantly affect fertility, family planning, and future pregnancies. This interaction presents challenges unique to young women with breast cancer (YWBC). This review provides an updated overview of YWBC and pregnancy-associated breast cancer (PABC), including the rising prevalence of YWBC, current understanding of the biology of PABC and its subtypes, and the management of PABC. We address the critical issue of how breast cancer treatment impacts family planning and future pregnancies, including current data on interrupting endocrine treatment for pregnancy. Additionally, we examine recent advancements in early-stage breast cancer as well as gaps in knowledge regarding how targeted treatments affect ovarian reserve. Finally, we highlight key areas of future research that could improve the prevention, management, and understanding of cancer treatment's impact on fertility in YWBC.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251369973"},"PeriodicalIF":4.2,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024241","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":"Comment on \"Adjuvant treatment after neoadjuvant chemoradiotherapy and surgery in patients with esophageal squamous cell carcinoma: a real-world study\".","authors":"Yizhou Huang, Maohui Chen, Chun Chen, Bin Zheng","doi":"10.1177/17588359251372694","DOIUrl":"10.1177/17588359251372694","url":null,"abstract":"","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251372694"},"PeriodicalIF":4.2,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024217","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":"Safety of fruquintinib in Chinese patients with colorectal cancer: an age subgroup analysis from a phase IV real-world clinical practice study.","authors":"Yi Wang, Yifu He, Zhiqiang Wang, Haijun Zhong, Zuoxing Niu, Shujun Yang, Tao Zhang, Liangjun Zhu, Yongqian Shu, Jianjun Peng, Yan Song, Jian Li, Ying Yuan, Haibo Zhang, Gengsheng Yu, Yunqi Hua, Jianjun Xiao, Jianfei Fu, Yulong Zheng, Jingyu Zhu, Hua Xue, Xian Luo, Michael Shi, Weiguo Su, Jin Li, Shukui Qin","doi":"10.1177/17588359251363537","DOIUrl":"10.1177/17588359251363537","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is increasingly prevalent among young adults (<50 years) in China, a demographic that has been historically underrepresented in clinical studies. While most patients with CRC are aged ⩾65 years, this age group is also underrepresented in trials, highlighting the need for a better understanding of treatment outcomes in both younger and older populations. A recent phase IV trial evaluating the safety of fruquintinib in Chinese patients with metastatic CRC (mCRC) showed a manageable profile.</p><p><strong>Objectives: </strong>This subgroup analysis of the phase IV study primarily aims to evaluate the safety of fruquintinib in different age groups.</p><p><strong>Design: </strong>Prospective real-world study.</p><p><strong>Methods: </strong>The data of patients with CRC from the phase IV fruquintinib trial (NCT04005066) were collected for the young (<50 years) and the late elderly (⩾75 years) patients with CRC who were enrolled between April 24, 2019, and September 27, 2022. The safety outcomes, including treatment-emergent adverse events (TEAEs) and treatment-related adverse events (TRAEs), were recorded.</p><p><strong>Results: </strong>A total of 2798 patients with CRC enrolled in the phase IV study were categorized into two subgroups: 512 were young (age <50), and 239 were late elderly (age ⩾75). The young CRC subgroup received more intense treatment with a median treatment duration of 2.75 months, and the late elderly received a median treatment duration of 2.40 months. Combination therapy duration was longer than that of monotherapy in young (4.10 vs 2.40 months) and late elderly patients (3.90 vs 2.10 months). The incidence of TEAE was comparable across the young (78.71%) and the late elderly groups (77.41%). In the young CRC subgroup, the most common TRAEs were palmar-plantar erythrodysesthesia ((PPES) 20.31%) and hypertension (14.06%), whereas in the late elderly, they were hypertension (20.50%) and PPES (14.23%).</p><p><strong>Conclusion: </strong>The safety profile of fruquintinib was comparable across age subgroups. Young CRC patients tend to receive more intensive fruquintinib treatment. For the late elderly, who are more susceptible to TRAEs due to underlying health conditions, fruquintinib also offers a safe treatment option. Combination therapy duration was longer than monotherapy in both subgroups, suggesting its promising approach for optimizing treatment outcomes in both age subgroups.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251363537"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993228","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":"A nomogram for predicting the risk of chemoradiotherapy-associated thrombocytopenia in patients with esophageal cancer: a real-world cohort study.","authors":"Jia-Xuan Yang, Si-Yu Zuo, Jie Yang, Lin-Rui Gao, Zong-Mei Zhou, Nan Bi, Qin-Fu Feng, Ji-Ma Lv, Lin Sun, Wen-Qing Wang, Lei Deng, Xin Wang, Tao Zhang, Jian-Yang Wang, Ze-Fen Xiao, Wen-Cheng Zhang, Wen-Yang Liu","doi":"10.1177/17588359251363894","DOIUrl":"10.1177/17588359251363894","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia is a common hematological toxicity in esophageal cancer (EC) patients receiving radiation therapy.</p><p><strong>Objectives: </strong>The purpose of this study was to construct and validate a nomogram for predicting the incidence of thrombocytopenia in EC patients receiving radiotherapy.</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Methods: </strong>All data were collected from 435 EC patients who received radiation therapy from a real-world cohort study from 2016 to 2021. Thrombocytopenia was assessed according to the toxicity criteria of the Radiation Therapy Oncology Group (RTOG). Univariate and multivariate logistic regression analyses were used to identify significant risk factors for thrombocytopenia. The result was presented in the form of a nomogram. The performance of the model was evaluated by the receiver operating characteristic (ROC) curves and calibration curves. External validation was conducted using an independent cohort of 149 EC patients from another cancer center. Propensity score matching was utilized to balance the covariates between the 1:1 matched two groups. Survival analysis was conducted using the Kaplan-Meier method and compared with the log-rank test.</p><p><strong>Results: </strong>A total of 104(23.91%) patients developed thrombocytopenia. Univariate and multivariate logistic regression analysis showed that age, body mass index, planning target volume, tumor location, tumor-node-metastasis stage, platelet count before radiotherapy, history of liver cirrhosis, cycles of induction chemotherapy, and concurrent chemotherapy regimen were the independent predictors of chemoradiotherapy-associated thrombocytopenia and were finally incorporated into our nomogram. The results of the ROC curve showed that the nomogram had high prediction accuracy. The sensitivity of the external validation set was 0.852 (95% CI: 0.663-0.958), and the specificity was 0.820 (95% CI: 0.740-0.883). The calibration curve presented good concordance (Hosmer-Lemeshow test, <i>p</i> = 0.825). An online nomogram-based prediction tool was developed to facilitate clinical implementation. No significant difference was observed in overall survival between patients who experienced severe thrombocytopenia and not (log-rank test, <i>p</i> = 0.390).</p><p><strong>Conclusion: </strong>This nomogram provides a prediction tool of chemoradiotherapy-associated thrombocytopenia in EC patients receiving radiotherapy, which may facilitate the potential candidate's selection of high-risk EC patients for thrombocytopenia.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251363894"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993197","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":"Histologic transformation after targeted therapy resistance in driver gene-positive NSCLC: mechanisms and therapeutic challenges.","authors":"Xinyue Li, Kaibo Ding, Dujiang Liu, Yuxia Wang, Yanjun Xu","doi":"10.1177/17588359251369038","DOIUrl":"10.1177/17588359251369038","url":null,"abstract":"<p><p>Targeted therapies have significantly improved the prognosis and productivity of non-small-cell lung cancer (NSCLC) patients carrying driver mutations, but drug resistance is inevitable. Histological transformation, an important resistance mechanism, is often manifested as transformation into small-cell lung cancer, large-cell neuroendocrine carcinoma, squamous cell carcinoma, and sarcomatoid carcinoma. The mechanisms involved are complex, including RB1/TP53 inactivation, epithelial-mesenchymal transition, and microenvironmental changes. Post-transformation tumors are often more aggressive and drug-resistant, with limited therapeutic options and poorer prognosis. In this paper, we systematically review the histological transformation types, molecular mechanisms, and therapeutic strategies of NSCLC after resistance to targeted therapy, with the aim of providing a reference for clinical decision-making and promoting the development of individualized therapy.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251369038"},"PeriodicalIF":4.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993200","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 utidelone in pretreated patients with metastatic breast cancer in China: a multicenter, real-world study.","authors":"Shihui Hu, Tengfei Chao, Ning Xie, Quchang Ouyang, Fei Xu, Hong Wang, Yannan Zhao, Chengcheng Gong, Biyun Wang","doi":"10.1177/17588359251368684","DOIUrl":"10.1177/17588359251368684","url":null,"abstract":"<p><strong>Background: </strong>Utidelone (UTD1), a genetically engineered epothilone derivative, has been approved in China for use in combination with capecitabine in treating metastatic breast cancer (MBC) patients previously treated with anthracyclines or taxanes.</p><p><strong>Objectives: </strong>To evaluate the real-world efficacy and safety of UTD1 in Chinese patients with MBC and to explore potential predictors of therapeutic effectiveness.</p><p><strong>Design: </strong>A multicenter, retrospective, real-world study.</p><p><strong>Methods: </strong>MBC patients who received UTD1 between March 2021 and August 2023 were identified using an electronic database. Outcome variables included progression-free survival (PFS), overall survival (OS), time to treatment failure (TTF), objective response rate (ORR), clinical benefit rate (CBR), and adverse events (AEs).</p><p><strong>Results: </strong>A total of 270 MBC patients were included, with 81.1% presenting with visceral metastasis and 23.7% with brain metastasis. The median number of treatment lines for UTD1 was 3. UTD1 showed a median PFS of 3.97 months (95% confidence interval (CI) 3.33-4.61) and a median OS of 20.63 months (95% CI 16.72-24.54). Among the patients, 17.4% received UTD1 monotherapy, and 82.6% received UTD1-based combination therapy. The median TTF was 2.80 months (95% CI 2.31-3.29). The ORR was 8.4%, and the CBR was 33.5%. The most common AE was peripheral neuropathy (PN, 55.2%). Patients with unresolved PN from previous therapy or receiving UTD1 through intravenous infusion on days 1-5 were more likely to develop ⩾grade 3 PN.</p><p><strong>Conclusion: </strong>UTD1 is a new option for patients who have previously received taxanes and anthracyclines, with its clinical toxicity controllable.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251368684"},"PeriodicalIF":4.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970295","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":"Comparison of the efficacy of mFOLFOX-6 and mDCF regimens in the treatment of metastatic gastric cancer: a multicenter retrospective study.","authors":"Ogur Karhan, Serdar İleri, Zuhat Urakçı, Yasin Sezgin, Ümit Yıldırım, Beyza Ünlü, Hacer Demir, Hasibe Bilge Gür, Ayşe Demirci, Melih Şimşek, Hüseyin Salih Semiz, Savaş Gökçek, Nilgün Yıldırım, Tuğçe Kübra Güneş, Abdilkerim Oyman, Tolga Doğan, Gamze Gököz Doğu, Yusuf İlhan, Özgür Tanrıverdi, Ali İnal, Nadiye Sever, Ezgi Türkoğlu, Tugay Avcı, Sadi Kerem Okutur, Pınar Peker, Doğan Bayram, Onur Yazdan Balçık, Pervin Can Şancı, Seray Saray, Pınar Çoban Eşdur, İsmail Beypınar, Sezai Tunç","doi":"10.1177/17588359251368069","DOIUrl":"10.1177/17588359251368069","url":null,"abstract":"<p><strong>Background: </strong>Metastatic gastric cancer (GC) and gastroesophageal junction (GEJ) cancer are associated with a poor prognosis. Recent advancements in treatment have incorporated trastuzumab, anti-PD-1 agents, and anti-claudin therapies alongside chemotherapy (ChT), significantly improving outcomes. Contemporary studies predominantly employ doublet ChT as the backbone for these regimens, although historically triplet ChT regimens have been favored, particularly in younger patients requiring rapid tumor shrinkage.</p><p><strong>Objective: </strong>The aim of this study was to compare the efficacy of mFOLFOX-6 and mDCF regimens in the treatment of advanced GC and GEJ adenocarcinoma.</p><p><strong>Design: </strong>This was a retrospective multicenter study.</p><p><strong>Methods: </strong>Patient data were obtained from the databases of 25 hospitals across Turkey. Demographic and clinicopathological characteristics were documented. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, and group discrepancies were assessed with log-rank test.</p><p><strong>Results: </strong>A total of 493 patients were included in the analysis, with similar baseline characteristics between the two groups. The objective response rate was 36.3% in the mDCF group and 38% in the mFOLFOX-6 group (<i>p</i> = 0.7). The median PFS was 6 months for mDCF and 7 months for mFOLFOX-6 (<i>p</i> = 0.2), while the median OS was 12 months for mDCF and 11 months for mFOLFOX-6 (<i>p</i> = 0.4). Grade 3-4 neutropenia occurred in 27.6% of patients treated with mDCF versus 17.8% with mFOLFOX-6 (<i>p</i> = 0.01). Likewise, grade 3-4 anemia was more frequent in the mDCF group (9.5%) compared to the mFOLFOX-6 group (4.8%; <i>p</i> = 0.04).</p><p><strong>Conclusion: </strong>Modified FOLFOX-6 demonstrated comparable efficacy to mDCF in the treatment of advanced GC and GEJ adenocarcinoma. Moreover, mFOLFOX-6 was associated with a lower incidence of hematological adverse effects.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251368069"},"PeriodicalIF":4.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970300","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":"Treatment de-escalation for metastatic good-risk seminoma with carboplatin AUC10: predictive factors and patterns of relapse.","authors":"Nasreen Abdul Aziz, Didjier Danger Masangwi, Sushila Ganguli, Anand Sharma, Kenrick Ng, Prabhakar Rajan, Jonathan Shamash","doi":"10.1177/17588359251369040","DOIUrl":"10.1177/17588359251369040","url":null,"abstract":"<p><strong>Background: </strong>We have previously demonstrated that carboplatin AUC10 is a viable alternative to cisplatin-based combination chemotherapy for patients with metastatic good-risk seminoma. The International Germ Cell Cancer Collaborative Group (IGCCCG) update identified lactate dehydrogenase (LDH) as an adverse prognostic marker in those receiving cisplatin-based therapies but its relevance in patients treated with carboplatin AUC10 is unknown.</p><p><strong>Objectives: </strong>To update survival outcomes of patients treated with carboplatin AUC10, explore patterns of treatment relapse and determine the impact of clinical and biochemical factors on oncological outcomes.</p><p><strong>Design: </strong>Multi-centre retrospective cohort study of 236 patients treated with carboplatin AUC10 from January 2000 to December 2021.</p><p><strong>Methods: </strong>Clinical parameters including age, stage, number of cycles delivered, primary tumour location, LDH level, relapse date, post-relapse treatment and cause of death were extracted. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier method and event-time distributions were compared using the log-rank test. Variables predictive of PFS and OS were identified using Cox proportional hazards model.</p><p><strong>Results: </strong>The primary tumour site was testis in 95% (n = 225) of patients. Stage distribution was II (86%, n = 204) and III (14%, n = 32). Fourteen patients (6%) relapsed with 11 receiving salvage bleomycin, etoposide and cisplatin. Updated 5-year PFS and OS were 89% and 93%, respectively, over a median follow-up of 88 months. Twenty-three patients (10%) had LDH ⩾2.5 upper limit normal, with 5-year PFS and OS of 78% and 86%, respectively. Age was not associated with risk of relapse. The addition of a fourth cycle of carboplatin was not associated with better outcomes even after adjusting for other risk factors on multivariate analysis. Approximately 50% of relapsed patients were successfully salvaged.</p><p><strong>Conclusion: </strong>Carboplatin AUC10 remains an effective de-escalation regimen for metastatic seminoma, with robust survival rates at prolonged follow-up. Elevated LDH indicates poorer oncological outcomes with carboplatin AUC10, though survival remained comparable to cisplatin-based chemotherapy.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251369040"},"PeriodicalIF":4.2,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970427","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}