American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting最新文献

{"title":"Beyond Checkpoint Inhibition: Keeping Therapeutic Options Open.","authors":"Urvashi Mitbander Joshi, Jasmin Hundal, Jonaphine R Mata, Megan D Schollenberger, Govind Warrier, Jason J Luke, Evan J Lipson, Pauline Funchain","doi":"10.1200/EDBK-25-473856","DOIUrl":"https://doi.org/10.1200/EDBK-25-473856","url":null,"abstract":"<p><p>Combination immune checkpoint inhibitor therapy (ICI) with ipilimumab (anti-cytotoxic T-lymphocyte-associated protein 4) + nivolumab (anti-PD-1) in untreated, metastatic melanoma has achieved a ten-year melanoma-specific survival of 52%. However, approximately 40%-55% of patients with metastatic melanoma have primary resistance and do not initially respond to anti-PD-1, and an additional 25% of patients develop secondary resistance, exhibiting an initial response followed by disease progression. In PD-1-refractory melanoma, treatment options are limited. Addition of ipilimumab, relatlimab (anti-LAG3), or lenvatinib (VEGFR TKI) has minimal to modest efficacy. Switching to targeted BRAF/MEK inhibition improves survival for BRAF-mutant disease. MEK and KIT inhibitors have limited activity in NRAS- and KIT-mutant metastatic melanoma, respectively. Recently, personalized, autologous tumor-infiltrating lymphocyte therapy has become a US Food and Drug Administration-approved second-line option; lifileucel demonstrates durable response (approximately 30%) in heavily pretreated, metastatic melanoma. Emerging therapeutics that show promising clinical benefit in ongoing clinical trials include novel engineered oncolytic viral and human leukocyte antigen (HLA)-restricted immune-mediated T-cell therapies. As a therapy which is limited to patients who are HLA-A*02:01, T-cell receptor (TCR) engineered T cells (TCR-T) iterates on personalized adoptive cell transfer, and immune mobilizing monoclonal TCRs against cancer are CD3 bispecifics that bind glycoprotein 100 (tebentafusp, approved for metastatic uveal melanoma) or PRAME to activate T cells. Finally, in patients at high risk for immune-related adverse events (irAEs), ICI should still be considered. ICI may be given with modified immunosuppression in patients with autoimmune disease or previous organ transplantation. Cumulative data support safe administration in older patients and in ICI rechallenge for patients with previous irAE.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e473856"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering the Next Generation of Cancer Research Advocates: Community Engagement Across the Research Continuum.","authors":"Melissa Mazor, Sarah Miller, Sarah Mollman, Layla Fattah, Heather Brandt, Victoria Foster, Shena Gazaway, Jamila Sly, Rushil V Patel, Jean Claude Noel, Dolores Moorehead, J Nicholas Odom","doi":"10.1200/EDBK-25-100050","DOIUrl":"https://doi.org/10.1200/EDBK-25-100050","url":null,"abstract":"<p><p>Community engagement represents a foundational strategy for advancing cancer research and improving health outcomes. This study examines advocacy as a form of community engagement across the cancer research continuum, aligning with ASCO's 2024-2025 presidential theme of \"Driving Knowledge to Action: Building a Better Future.\" We present a comprehensive framework that promotes bidirectional learning, trust, and transparency at all stages of research, from conception to dissemination. The spectrum of engagement approaches is described, ranging from consultative models to fully collaborative partnerships, highlighting how each creates critical touchpoints throughout the research process. We identify significant challenges to meaningful community engagement-including institutional barriers, historical mistrust, and sustainability concerns-while offering practical solutions drawn from successful examples across diverse cancer research settings. This study concludes with actionable recommendations for advancing robust community engagement through diverse representation, mentorship programs, institutional support mechanisms, and dedicated funding channels. By integrating advocacy throughout the research continuum, we create pathways for patients, caregivers, community representatives, and emerging professionals to shape research agendas, inform study designs, and participate in translating findings into policy and practice, ultimately ensuring cancer research is inclusive, relevant, and accessible to all communities.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e100050"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Updates in Testicular Cancer: Optimizing Survivorship and Survival.","authors":"Aditya Bagrodia, Hege Sagstuen Haugnes, Ragnhild Hellesnes, Mai Dabbas, Fred Millard, Lucia Nappi, Siamak Daneshmand, Christian Kollmannsberger, Lawrence H Einhorn","doi":"10.1200/EDBK-25-472654","DOIUrl":"https://doi.org/10.1200/EDBK-25-472654","url":null,"abstract":"<p><p>Testicular cancer is a rare but highly curable malignancy, predominantly affecting young men. Advances in multimodal therapy, including cisplatin-based chemotherapy, radiotherapy, and surgical interventions, have resulted in excellent cancer-specific survival. However, with improved survival rates, long-term health consequences and survivorship issues have emerged as critical concerns. Testicular cancer survivors (TCSs) are at risk of adverse health outcomes, including endocrine dysfunction, cardiovascular disease, secondary malignancies, chemotherapy-induced neuropathy, and psychosocial challenges. Endocrine disturbances such as hypogonadism and infertility require careful monitoring, while cardiovascular risks necessitate long-term preventive strategies. Survivors also face an elevated risk of secondary malignancies, necessitating tailored follow-up. Recent advances in the de-escalation of therapy, particularly for stage II seminoma and metastatic germ cell tumors, aim to balance oncologic efficacy with minimizing toxicity. This review discusses the evolving landscape of testicular cancer survivorship, the impact of treatment-related complications, and contemporary management strategies, emphasizing a multidisciplinary approach to optimize long-term outcomes and quality of life.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e472654"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicancer Early Detection Tests at a Crossroads: Commercial Availability Ahead of Definitive Evidence.","authors":"Carmen E Guerra, Jennifer Keating Litton, Carolina E Viswanath, A Mark Fendrick","doi":"10.1200/EDBK-25-473834","DOIUrl":"https://doi.org/10.1200/EDBK-25-473834","url":null,"abstract":"<p><p>Multicancer early detection tests (MCEDs), sometimes referred to as liquid biopsies, are tests that can screen for multiple cancers by analyzing blood, urine, and other bodily fluids for biomarkers released by cancer cells. These tests have the potential to change the cancer screening paradigm if they are shown to reduce cancer mortality. However, it is not yet known whether MCEDs reduce mortality. Randomized controlled trials, the gold standard for evaluating cancer screening programs, are currently evaluating the effectiveness of MCEDs. However, because cancer-specific and all-cause mortality are end points that can take years to reach, trials are being designed with surrogate end points such as stage of disease at detection. However, the correlation between cancer stage and survival appears to vary by cancer type, and many have argued that trials must also continue to follow for the gold standard of mortality end points until these surrogate end points are appropriately validated. The widespread use of MCEDs before conclusive evidence supporting their use has the potential to cause harm to patients, could widen health inequities, and further drive health care costs. Consequently, providers should engage in shared decision making regarding MCED tests with patients who inquire about MCEDs emphasizing that MCEDs should be additive to, not replacements for, the currently recommended cancer screening tests.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e473834"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Follow-Up Care After Treatment for Primary Breast Cancer: Strategies and Considerations.","authors":"Maria Alice Franzoi, Wolfgang Janni, Jessica Erdmann-Sager, Cristina Kline-Quiroz, Henning Schäffler, Kerstin Pfister, Amanda Fazzalari, Ines Vaz Luis","doi":"10.1200/EDBK-25-473472","DOIUrl":"https://doi.org/10.1200/EDBK-25-473472","url":null,"abstract":"<p><p>Advancements in early detection and multimodal treatment strategies have significantly improved survival rates for early-stage breast cancer, now exceeding 80% at 10 years. However, breast cancer survivors (BCS) often experience persistent physical, psychological, and social challenges as direct consequences of cancer and its treatment. Effective survivorship care requires a proactive, multidisciplinary, and team-based approach to address these burdens comprehensively. Despite growing recognition of the complex needs of BCS, a persistent gap remains between symptom burden, supportive care needs, and actual care delivery. This disparity underscores the urgent need to innovate and optimize survivorship care models. This article explores the most prevalent symptoms and concerns experienced by BCS, particularly those arising from systemic and local therapies during post-treatment follow-up phase, and outlines evidence-based strategies for their management. Additionally, it examines the role of technology as a promising enabler in enhancing the quality, efficiency, accessibility, and patient-centeredness of survivorship care. By integrating multidisciplinary, proactive symptom management with digital health tools and innovative care approaches, health care systems can be equipped to better support BCS, ultimately improving their long-term health outcomes and quality of life.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e473472"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Oncology: Tackling Disparities and Promoting Innovations in Low- and Middle-Income Countries.","authors":"Regina Barragan-Carillo, Fredrick Chite Asirwa, Rodrigo Dienstmann, Dinesh Pendhakar, Erika Ruiz-Garcia","doi":"10.1200/EDBK-25-473930","DOIUrl":"https://doi.org/10.1200/EDBK-25-473930","url":null,"abstract":"<p><p>Global cancer incidence is projected to rise dramatically, with over 35 million new cases anticipated by 2050, disproportionately affecting low- and middle-income countries (LMICs) where up to 70% of cancer deaths are expected to occur. This manuscript provides an in-depth assessment of the structural, economic, and sociocultural barriers that drive cancer care disparities in LMICs, including limited access to prevention, diagnosis, treatment, and palliative care services. Key challenges include shortages in oncology workforce, diagnostic infrastructure, radiotherapy access, and participation in clinical trials. Socioeconomic inequities, stigma, and high out-of-pocket costs further exacerbate delayed care and poor outcomes. Some innovative interventions have improved access and quality of cancer care in resource constrained settings. These include task-shifting models, digital health tools, community-based awareness and screening programs, and South-South collaborations that foster local drug innovation and manufacturing. It also explores emerging strategies in precision medicine, AI-assisted decision making, and tele-oncology tailored to LMICs. The role of public-private partnerships, sustainable financing, and international collaborations in advancing cancer control is critically examined. The future of global oncology hinges on a shift from fragmented, reactive responses to coordinated, data-driven, and sustainable strategies. By strengthening health systems and embracing context-sensitive innovation, the global community can address the widening cancer care gap and improve outcomes for vulnerable populations worldwide.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e473930"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Opportunities for Global Cervical Cancer Elimination: How Can We Build a Model for Other Cancers?","authors":"Clement Adebamowo, Paolo Giorgi Rossi, Philip E Castle","doi":"10.1200/EDBK-25-473702","DOIUrl":"https://doi.org/10.1200/EDBK-25-473702","url":null,"abstract":"<p><p>Cervical cancer remains a leading cause of cancer-related death among women globally, despite the availability of effective prevention through human papillomavirus (HPV) vaccination and HPV-based screening. This review explores the state-of-the-art technologies for cervical cancer prevention, examining their efficacy, implementation challenges, and global disparities in access. Prophylactic HPV vaccination and HPV DNA testing have demonstrated high efficacy in reducing cervical cancer incidence, yet their uptake remains uneven-especially in low- and middle-income countries (LMICs), where the disease burden is greatest. Barriers include infrastructure limitations, workforce shortages, sociocultural obstacles, and competing health priorities. Strategies such as single-dose vaccination, early childhood immunization, self-sampling, and screen-and-treat approaches offer promising pathways to expand access. In high-income countries (HICs), where HPV vaccine uptake is higher and screening systems are more established, the reduced risk of infection and high negative predictive value of HPV testing support a shift toward screening deintensification. Precision prevention frameworks-leveraging biomarkers, genotyping, and artificial intelligence-offer further opportunities to enhance accuracy and efficiency. The review also underscores the importance of health system strengthening, international collaboration, and policy support to achieve the WHO's 90-70-90 targets for cervical cancer elimination. Moreover, innovations developed for cervical cancer prevention-such as decentralized screening, mobile health platforms, and task-shifting-offer a valuable model for improving strategies for primary and secondary prevention of other cancers.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e473702"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal De-Escalation Strategies in Early Breast Cancer.","authors":"Icro Meattini, Ana Tecic Vuger, Carlotta Becherini, Eliza J Epstein, John P Garcia, Elizabeth R Berger, Nadia Harbeck","doi":"10.1200/EDBK-25-473462","DOIUrl":"https://doi.org/10.1200/EDBK-25-473462","url":null,"abstract":"<p><p>The excellent cure rates documented in clinical trials today constitute a very high bar for attempts to de-escalate therapy for early-stage breast cancer (EBC). Moreover, any therapy de-escalation must be made in the context of an optimal multimodal treatment concept as de-escalation of one modality should not be met by escalation of another. In surgery, omission of sentinel lymph node biopsy can now be safely offered for patients with low-risk hormone receptor-positive/human epidermal growth factor receptor 2-negative (HER2-) disease. After neoadjuvant therapy, adapting surgical and/or radiation therapy (RT) treatment steps to systemic treatment response has already become a reality, yet technical quality assurance is mandatory. Increased use of novel targeted agents in eBC requires adaptation of RT timing that has been addressed by current consensus recommendations. Last but not least, omission of chemotherapy (CTx) is a key question for patients and their physicians in hormone receptor-positive/HER2- EBC. In patients with zero to three involved lymph nodes, gene expression assays safely allow CTx omission. Endocrine response assessment, that is, Ki67 determination, after a short 4-week endocrine therapy before surgery adds important information, particularly for premenopausal patients. The overall goal of therapy de-escalation is to reduce treatment burden without compromising patient outcomes. Thus, de-escalation concepts overall, as well as biomarkers used for therapy de-escalation, need to be evidence-based and validated by prospective clinical trials.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e473462"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Sexual Health for Cancer Survivors.","authors":"Laila S Agrawal, Liz O'Riordan, Caleb Natale, Lawrence C Jenkins","doi":"10.1200/EDBK-25-472856","DOIUrl":"10.1200/EDBK-25-472856","url":null,"abstract":"<p><p>Changes to sexual function after cancer treatment are extremely prevalent, affecting up to 90% of female patients with cancer and 40%-85% of male patients with cancer. Sexual health concerns include low libido, genitourinary syndrome of menopause, dyspareunia, erectile dysfunction (ED), hypogonadism, body image concerns, and impacts on intimate relationships. Given the significant impact of sexual dysfunction on quality of life, oncology professionals should integrate sexual health discussions into routine patient care, regardless of the patient's age, sex, or cancer type. Sexuality is best understood in a biopsychosocial framework and cancer treatments including chemotherapy, surgery, radiation, and endocrine therapy can affect all of these domains. Management of genitourinary syndrome of menopause includes nonhormonal and low-dose local hormonal options. Pelvic floor dysfunction and vaginal stenosis can be treated with pelvic floor physical therapy and use of vaginal dilator therapy. ED can be treated with phosphodiesterase type 5 inhibitors and if needed, interventions such as intracavernosal injection of vasoactive agents, urethral suppositories, vacuum erection devices, and surgical implants are available. Cancer treatments such as chemotherapy, radiation, and androgen-deprivation therapy can lead to hypogonadism in men, which can be treated with testosterone therapy, unless contraindicated. Psychosocial counseling, sex therapy, and couples counseling are options for impact to sexual response, body image, and relationship concerns. A comprehensive, patient-centered approach to sexual health can help improve outcomes and overall well-being for cancer survivors.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e472856"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveling Up: Harnessing Cutting-Edge Technology to Enhance Oncology Education and Learning.","authors":"Eleonora Teplinsky, Tae Hoon Kim, Stephanie Haddad, Jasmin Hundal, Traci Wolbrink, Caroline Chung","doi":"10.1200/EDBK-25-472884","DOIUrl":"10.1200/EDBK-25-472884","url":null,"abstract":"<p><p>The integration and utilization of digital media, gamified learning strategies, and artificial intelligence (AI) are fundamentally transforming the landscape of oncology education and learning. These technologies collectively enhance knowledge dissemination, facilitate professional networking and mentoring, and enrich the overall educational experience for the learner. Digital formats, including social media, offer flexible and asynchronous learning modalities that provide access to the latest studies and research, expert commentary, and opportunities for professional development and collaboration. Gamification, through the application of game-based elements within educational frameworks, promotes critical thinking, supports the acquisition and reinforcement of key concepts, and fosters engagement. AI, increasingly recognized for its disruptive potential, introduces a new dimension of information exchange and novel methodologies for learner assessment and customization of educational pathways. These tools also can present potential challenges, such as the proliferation of misinformation, heightened academic and professional competition, and the imperative to critically appraise AI-generated outputs. This article examines the transformative role of these emerging technologies in oncology education, while also addressing the associated risks and underscoring the need for learners to cultivate evaluative and critical thinking skills to navigate these tools responsibly.</p>","PeriodicalId":37969,"journal":{"name":"American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting","volume":"45 3","pages":"e472884"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}