Oncology and Therapy最新文献

{"title":"A US Survey Across Seven Early-Stage Cancers Assessing the Humanistic Burden of Recurrence on Patients and Caregivers.","authors":"Raquel Aguiar-Ibáñez, Kelly McQuarrie, Ana Martinez, Hannah Penton, Laura DiGiovanni, Rutika Raina, Marieke Heisen, Sayeli Jayade","doi":"10.1007/s40487-025-00328-4","DOIUrl":"10.1007/s40487-025-00328-4","url":null,"abstract":"<p><strong>Introduction: </strong>Patients diagnosed with an early-stage cancer are at risk of recurrence. Although the economic burden of a cancer recurrence is described in the literature, little is known about the humanistic burden of an early-stage cancer recurrence. Therefore, we surveyed patients and caregivers to understand the impact of a first cancer recurrence on patient and caregiver quality of life (QoL).</p><p><strong>Methods: </strong>Patients with early-stage bladder, gastric, head and neck (HN), melanoma, non-small cell lung, renal cell, and triple-negative breast cancers (TNBC) that recurred and caregivers of such patients completed a self-administered, online survey exploring QoL impacts. QoL was evaluated using de novo questions and the following instruments: EQ-5D-5L (patients and caregivers), European Organisation for Research and Treatment of Cancer Core Quality of Life questionnaire (patients only), and CareGiver Oncology Quality of Life questionnaire (caregivers only). Patient and caregiver responses and scores were stratified by type of cancer and type of recurrence (locoregional or distant/metastatic).</p><p><strong>Results: </strong>Among patients (N = 202), QoL was found to differ significantly across tumor types at time of survey, with lower scores seen in patients with renal cell carcinoma, gastric cancer, and HN cancer and higher scores seen in patients with melanoma and TNBC. Among caregivers (N = 100), QoL did not differ across tumor types. In both patients and caregivers, decreases in QoL were observed from pre-recurrence to post-recurrence, with greater worsening in QoL seen with distant/metastatic versus locoregional recurrences. Most patients reported worrying and feeling anxious and stressed about their condition. Most caregivers reported worrying about the cared-for person's cancer getting worse or coming back and that caring for the person was challenging post-recurrence.</p><p><strong>Conclusion: </strong>Our findings demonstrate the importance of preventing recurrences and their negative impact on patients' and caregivers' QoL. Early-stage cancer treatments that prevent recurrences can provide better QoL.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"339-361"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncotype DX Recurrence Score and Germline BRCA Variants in Patients with HR-Positive/HER2-Negative Early Breast Cancer: A Retrospective Observational Study.","authors":"Stefania Morganti, Rabia A Khan, Luis C Berrocal-Almanza, Miguel Miranda, Linlin Luo, Xiaoqing Xu, Ann H Partridge, Filipa Lynce","doi":"10.1007/s40487-025-00332-8","DOIUrl":"10.1007/s40487-025-00332-8","url":null,"abstract":"<p><strong>Introduction: </strong>The Oncotype DX (ODX) recurrence score (RS) is prognostic and predictive of chemotherapy benefit in patients with hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative early breast cancer. Data on the distribution of germline BRCA1 and/or BRCA2 pathogenic variants (gBRCA PV) by RS are limited. This retrospective, real-world study explored demographics, clinical characteristics, gBRCA testing rates, and gBRCA PV prevalence in HR-positive/HER2-negative stage I-III breast cancer, stratified by RS.</p><p><strong>Methods: </strong>Deidentified patient data (from 1 January 2011 to 30 September 2022) from US electronic health records in a nationwide database were used. Patients aged ≥ 18 years with HR-positive/HER2-negative breast cancer and a known ODX RS were included. Demographics, clinical characteristics, and genetic testing rates were compared in patients with low, intermediate, and high tumor RS. gBRCA PV prevalence was compared across categories in patients who underwent genetic testing.</p><p><strong>Results: </strong>Of 3637 patients (median age: 62 years), 950 (26.1%) had low, 2155 (59.3%) had intermediate, and 532 (14.6%) had high tumor RS. Despite increases in genetic testing over time, gBRCA status was determined in only 31.5% (n = 1147/3637) of patients. Among tested patients, 37/1147 (3.2%) had gBRCA PV; median age was lower in gBRCA PV carriers than in noncarriers (52 versus 56 years; p = 0.034); tumors from gBRCA PV carriers had significantly higher grade (p = 0.002) and median RS (p = 0.001) than tumors from noncarriers; prevalence of gBRCA PV was highest among tested patients with high tumor RS (n = 14/185; 7.6%), but gBRCA PVs were identified among patients with intermediate (n = 19/674; 2.8%) and low (n = 4/288; 1.4%) tumor RS.</p><p><strong>Conclusions: </strong>Prevalence of gBRCA PV was highest among patients with high tumor RS, but not negligible in patients with intermediate and low tumor RS. Wider implementation of genetic testing, irrespective of ODX RS, could help optimize the management of patients with HR-positive/HER2-negative early breast cancer.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"363-379"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Dosimetric Predictors of Early Onset Postradiation Hypothyroidism in Patients with Head and Neck Malignancies: A Logistic Regression Analysis.","authors":"Ahmad Ameri, Zohreh Azma, Khashayar Fattah, Fereshteh Talebi, Pooya Ameri, Nazanin Rahnama, Mansour Lesan, Sanaz Poshtmahi, Farahnaz Rahimi, Marjan Mirsalehi, Farzad Taghizadeh-Hesary","doi":"10.1007/s40487-025-00338-2","DOIUrl":"10.1007/s40487-025-00338-2","url":null,"abstract":"<p><strong>Introduction: </strong>Hypothyroidism commonly occurs as a side effect following radiotherapy for head and neck malignancies, yet limited information exists to predict the risk of postradiation hypothyroidism. This study aims to investigate the clinical and dosimetric factors that may predict early onset postradiation hypothyroidism (EO-PRH).</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with head and neck cancer treated between 2018 and 2021, with a minimum follow-up duration of 12 months. The thyroid gland was contoured on computed tomography (CT) scans, and dose-volume histograms were analyzed, incorporating thyroid volume and V_5-60 into the analysis. Logistic regression and receiver operating characteristic (ROC) analysis were performed to identify predictors and assess the model's predictive value.</p><p><strong>Results: </strong>Among the 84 eligible patients, 17 (20.2%) developed hypothyroidism within 1 year. The percentage of thyroid volume receiving 30 Gy (V₃₀) emerged as the sole significant dosimetric predictor of EO-PRH (odds ratio [OR] 1.02, 95% confidence interval [95% CI] 1.005-1.05, p = 0.03). Univariable analysis revealed significant differences in cancer histopathology, primary tumor site, V_15,30, and VS_15,30 (the volume of the thyroid spared from radiation doses 15 Gy and 30 Gy) between the hypothyroid and euthyroid groups (p < 0.10). Multivariable analysis identified the primary cancer site (OR 9.09, 95% CI 1.59-100) and V₃₀ (OR 1.26, 95% CI 1.007-1.76) as independent significant variables predicting EO-PRH. The predictive model incorporating cancer histopathology, primary tumor site, V_15,30, and VS_15,30 effectively predicted postradiation thyroid dysfunction (area under the receiver operating characteristic curve [AUC-ROC] 0.84, 95% CI 0.73-0.95, p < 0.001).</p><p><strong>Conclusions: </strong>V₃₀ could serve as a dosimetric predictor of hypothyroidism following neck radiotherapy. This study underscores that a predictive model encompassing cancer type and site, along with V_15,30 and VS_15,30, can effectively predict EO-PRH.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"447-463"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase I Study of Sorafenib Combined with Gemcitabine and Carboplatin in Patients with Advanced Solid Tumors.","authors":"Daphne W M Voogd, Merel J J Lucassen, Ruud van der Noll, Sybrand W J Zielhuis, David Boss, Jos H Beijnen, Hilde Rosing, Matthijs Tibben, Alwin D R Huitema, Jan H M Schellens, Neeltje Steeghs","doi":"10.1007/s40487-025-00340-8","DOIUrl":"10.1007/s40487-025-00340-8","url":null,"abstract":"<p><strong>Introduction: </strong>A combination of targeted anticancer drugs with cytotoxic therapy can potentially overcome multidrug resistance. The multi-target kinase inhibitor sorafenib demonstrates synergistic activity when combined with chemotherapeutics in preclinical models. This phase I trial aimed to assess safety, tolerability, efficacy, and pharmacokinetics of sorafenib with gemcitabine and carboplatin.</p><p><strong>Methods: </strong>This single-center, open-label, dose-escalation and dose-expansion study included patients with advanced solid tumors considered for palliative treatment with gemcitabine and carboplatin. The maximum tolerated dose (MTD) was determined using a classic 3 + 3 dose-escalation design. Antitumor activity was evaluated every two treatment cycles.</p><p><strong>Results: </strong>In total, 45 patients received treatment. Of the patients, 49% (n = 22) were male, and median age was 58 years [range: 27-72 years]. After dose-escalation, sorafenib 400 mg once daily (q.d.) on days 1-21, gemcitabine 500 mg/m² on day 1 and day 8 (D1D8), and carboplatin AUC3 on day 1 (D1) every 3 weeks (Q3W) were established as the MTD. Grade 4 treatment-related toxicities, all hematological, were seen in 22% of the patients. Frequently observed grade 3 adverse events were neutropenia (33%), thrombocytopenia (31%), leukopenia (16%), and fatigue (13%). Dose reductions were required in 33% of the patients across all dose levels. Disease control rate after 18 weeks was 50%. Median progression-free survival and overall survival were 5.4 months and 10.1 months, respectively.</p><p><strong>Conclusions: </strong>A recommended phase 2 regimen of sorafenib 400 mg q.d. combined with gemcitabine 500 mg/m² D1D8 and carboplatin AUC3 D1, Q3W showed a manageable toxicity profile. This combination could provide an effective treatment option for patients in whom other therapies have failed since antitumor activity was seen across heavily pretreated tumor types. Alternative dosing regimens should be studied to optimize the dosing schedule.</p><p><strong>Trial registration: </strong>EudraCT: 2007-004129-75.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"465-483"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Elranatamab Versus Current Therapies for the Management of Patients with Triple-Class Exposed, Relapsed and Refractory Multiple Myeloma, Including Other Bispecific and Physician's Choice of Treatment in Spain.","authors":"Cristina Encinas, Virginia Lozano, Patrick Hlavacek, Julia Llinares, Sofía Toribio-Castelló, David Carcedo, Jordi Asís-Montalt, Joaquín Martínez-López","doi":"10.1007/s40487-025-00333-7","DOIUrl":"10.1007/s40487-025-00333-7","url":null,"abstract":"<p><strong>Introduction: </strong>Elranatamab is a bispecific anti-B-cell maturation antigen (BCMA) and -CD3 antibody recently approved in Spain for the treatment of adult patients with triple-class exposed relapsed and refractory multiple myeloma (TCE-RRMM). The objective of this analysis was to assess its cost-effectiveness versus teclistamab, another recently approved bispecific antibody, and a treatment basket representing current physician's choice of treatment (PCT).</p><p><strong>Methods: </strong>A partitioned survival model with three health states was adapted to the Spanish setting. Efficacy data were obtained from the MagnetisMM-3 clinical trial for elranatamab, and from a matching adjusted indirect comparison (MAIC) of elranatamab versus teclistamab and PCT. Utility values were gathered from the MagnetisMM-3 trial for each health state. Only direct costs (2024 €) were considered. Deterministic and probabilistic sensitivity analyses were conducted to assess the uncertainty of the variables and determine the robustness of the results.</p><p><strong>Results: </strong>Treatment with elranatamab is cost-effective compared to PCT, generating 0.92 additional quality-adjusted life years (QALYs) and an additional €17,860 over a lifetime horizon, yielding an incremental cost-effectiveness ratio (ICER) of €24,754/QALY. Elranatamab is dominant (less costly, more effective) versus teclistamab, providing 0.60 additional QALYs and generating cost savings (- €101,026). Sensitivity analyses confirmed the direction of the base case results.</p><p><strong>Conclusion: </strong>Elranatamab is a cost-effective treatment versus PCT and dominant over teclistamab for the treatment of adult patients with TCE-RRMM in the Spanish setting.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"381-395"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience and Care Pathway of Patients with Lung Cancer: An Online International Survey.","authors":"Pauline Frank, Julie Laurent, Lorraine Dallas, Pasquale Varriale, Andrew Ciupek","doi":"10.1007/s40487-024-00314-2","DOIUrl":"10.1007/s40487-024-00314-2","url":null,"abstract":"<p><strong>Introduction: </strong>This research sought to identify trends in the patient with lung cancer (LC) care pathway, experiences, and needs, across geographies and healthcare settings.</p><p><strong>Methods: </strong>Patients living with LC for more than 18 years in nine countries completed an online survey covering these domains-demographic, disease, treatment, and patient preferences for information and support services. Recruitment was primarily from patient with LC communities on online platforms.</p><p><strong>Results: </strong>A total of 1000 patients with LC completed the survey across Europe (49%), North America (29%), and Asia (22%). Demographics of participants were different to what has been reported in literature-there were a lower proportion of type non-small cell lung cancer (NSCLC), a higher proportion of type small cell lung cancer (SCLC), a higher rate of early-stage diagnosis, and a younger population. There were 56% male participants. Although physicians were the main stakeholders influencing treatment choice and quality of life (QoL) discussions, the patient's family/relatives ranked highly as important stakeholders. The top reasons patients reported choosing a treatment were related to efficacy, and hesitation to start a treatment was related to concerns about side effects. QoL was an important factor in both cases. Patients are impacted physically, socially, and mentally-50% report an impact on employment status, 48% report daily difficulties in mental well-being, and 64% have received psychological support or would like to. Disparities were observed across countries in genetic/biomarker testing completed or planned (30-88%) and being asked to participate in clinical trials (15-49%), which reflects the status of how different patient with LC care pathways have adopted innovation in LC care.</p><p><strong>Conclusion: </strong>Both medical and external factors impact experiences and outcomes of patients living with LC, including the role of family in treatment and QoL discussions. There are intercountry differences in knowledge and disease management.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"145-164"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggressive Subtypes of Laryngeal Chondrosarcoma and their Clinical Behavior: A Systematic Review.","authors":"Cesare Piazza, Claudia Montenegro, Michele Tomasoni, Ilmo Leivo, Göran Stenman, Abbas Agaimy, Roderick H W Simpson, Nina Zidar, Alfio Ferlito","doi":"10.1007/s40487-024-00323-1","DOIUrl":"10.1007/s40487-024-00323-1","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngeal chondrosarcoma (CS) is a rare indolent malignant tumor. High-grade (G3), dedifferentiated (DD), and myxoid (MY) CSs are considered more aggressive subtypes due to their metastatic potential and relatively poor outcomes. The aim of this systematic review is to evaluate treatment modalities and survival outcomes in patients affected by these rarer CS subtypes.</p><p><strong>Methods: </strong>Papers published from January 1, 2000, to August 25, 2024, describing cases of laryngeal G3, DD, and MY CS were included.</p><p><strong>Results: </strong>A total of 38 patients (15 G3, 13 DD, and 10 MY) were selected. Cricoid cartilage was the most common site of origin. Total laryngectomy (TL) was often performed. Primary conservative approaches in 42.8% of patients were followed by loco-regional recurrence.</p><p><strong>Conclusions: </strong>Aggressive subtypes of CS require a radical approach because of the higher rate of loco-regional and distant recurrences compared to low-grade CS. TL with radical intent is the most common treatment, and adjuvant therapy should be considered after careful multidisciplinary discussion.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"49-67"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Study of Lanreotide Autogel in Routine Practice in Patients with Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) in Hong Kong and Taiwan.","authors":"Jen-Shi Chen, Li-Yuan Bai, Hsiao-Hsiang Cheng, Stephen Lam Chan, Ji-Yan Zou, Xiaofeng Shi, Aude Houchard, Xuan-Mai Truong-Thanh, Ming-Huang Chen","doi":"10.1007/s40487-024-00302-6","DOIUrl":"10.1007/s40487-024-00302-6","url":null,"abstract":"<p><strong>Introduction: </strong>There is a lack of data on the efficacy, effectiveness, and safety of lanreotide autogel in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) of Chinese ethnicity. This noninterventional, retrospective study evaluated the effectiveness and safety of lanreotide autogel in patients of Chinese ethnicity with GEP-NETs in clinical practice.</p><p><strong>Methods: </strong>Patients' charts were abstracted from five hospitals in Hong Kong and Taiwan (July-September 2021), where lanreotide autogel is approved for treating GEP-NETs. Included patients were adults with unresectable, metastatic, or locally advanced GEP-NETs who received a first injection (index) of lanreotide autogel 120 mg between 01 January 2017 and 30 June 2020 (planned sample size: N = 30). Follow-up ran from index to a maximum of 48 (± 4) weeks or until disease progression, start of new antitumor treatment, or death. The primary endpoint was progression-free survival (PFS) rate at week 48 (±4), and secondary endpoints included PFS rate at week 24 (±4), estimated using Kaplan-Meier analyses. All analyses were descriptive.</p><p><strong>Results: </strong>Of 27 patients enrolled, 22 (81.5%) had 48 weeks of follow-up. Tumors of pancreatic origin were the most common (73.9%). PFS rate was 0.96 (95% confidence interval: 0.72 - 0.99) at 24 weeks and 0.82 (0.53-0.94) at 48 weeks. Overall, 74.1% patients experienced ≥ 1 treatment-emergent adverse event; none were serious. No deaths were reported.</p><p><strong>Conclusions: </strong>Lanreotide autogel was well tolerated and showed good tumor control rate in a real-world setting. These findings align with results from previous studies in Caucasian, Japanese, and Korean patients, thus supporting lanreotide autogel for treating patients with GEP-NETs of Chinese ethnicity.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"69-83"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Systemic Therapy in Chondrosarcoma: New Horizons.","authors":"Ka Hou C Li, Ashish Gulia, Florence Duffaud, Robin L Jones","doi":"10.1007/s40487-024-00317-z","DOIUrl":"10.1007/s40487-024-00317-z","url":null,"abstract":"<p><p>The systemic treatment landscape for advanced and metastatic chondrosarcoma, a malignancy with limited responsiveness to conventional therapies, has always been notoriously challenging. While standard chemotherapy offers minimal benefits, certain subtypes, such as mesenchymal and dedifferentiated chondrosarcomas, have shown some response to systemic therapies initially developed for other sarcomas. Investigational strategies are focusing on molecular targets, including mutations in the isocitrate dehydrogenase gene (IDH), signaling pathways, such as hedgehog and death receptor 5 (DR5) and immune modulation. IDH mutations, notably found in conventional and dedifferentiated chondrosarcomas, have prompted the evaluation of IDH inhibitors, which have demonstrated promising efficacy in preclinical and early clinical trials, despite limited data in chondrosarcoma. Additionally, the hedgehog pathway, implicated in chondrosarcoma progression, has been targeted with inhibitors, although clinical translation has shown mixed results. Immunotherapy, including programmed cell death 1 (PD-1) checkpoint inhibitors and chimeric antigen receptor-T (CAR-T) cells, is also being investigated but faces challenges due to the immunosuppressive tumour microenvironment. Among new approaches, DR5 agonists such as INBRX-109 have shown single-agent efficacy, with minimal toxicity, opening possibilities for use in combination therapies to improve outcomes. Given the heterogenous and treatment-resistant nature of chondrosarcoma, we highlight the need for multi-omics and genetic profiling to guide personalized, combination therapies that target multiple carcinogenic pathways. The integration of multi-targeted approaches could enhance efficacy, address tumour heterogeneity, and overcome resistance, presenting a hopeful direction for systemic therapy in this challenging cancer. The investigation of combination regimens with IDH inhibitors, immunotherapy and DR5 agonists hold promise for transforming the management of advanced chondrosarcoma.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician and Patient Preferences for the Treatment of Metastatic Castration-Sensitive and Castration-Resistant Prostate Cancer: A Best-Worst Scaling Study in Japan.","authors":"Takahiro Kimura, Noriko Takahashi, Keiko Asakawa, Atsushi Saito, Takeshi Mitomi, Takumi Lee, Mika Matsumura","doi":"10.1007/s40487-025-00326-6","DOIUrl":"10.1007/s40487-025-00326-6","url":null,"abstract":"<p><strong>Introduction: </strong>Despite many prostate cancer (PC) treatment options in Japan, physicians' and patients' preferences in metastatic castration-sensitive PC (mCSPC) and castration-resistant PC (CRPC) are unclear.</p><p><strong>Methods: </strong>For this cross-sectional study, an online questionnaire survey based on the best-worst scaling (profile case) approach was designed. Physicians' and patients' questionnaires, comprising six attributes (efficacy, safety, target patients, dosage, administration, and medical expenditures), had 24 and 26 items for mCSPC and CRPC surveys, respectively. Four items were presented during each session; respondents selected the \"most important\" and \"least important\" among these. The objective was to elicit attributes important for treatment and their relative importance levels among physicians and patients and to explore similarities and differences in choices. Multinomial logit and hierarchical Bayesian models were applied, and preferences were presented as relative importance and utility values.</p><p><strong>Results: </strong>Responses of 177 physicians (urologists: 173; oncologists: 4) and 292 patients (mCSPC: 94; CRPC: 198) were analyzed. Most patients with CRPC (63.1%) had no metastases. Efficacy was the most important attribute overall. Physicians considered patient survival the most important among efficacy items (11.1%), whereas patients with mCSPC prioritized prevention of metastases spread (9.7%) and prostate-specific antigen (PSA) elevation (9.3%). In CRPC, both physicians and patients prioritized prevention of metastasis development or its spread (physicians: 9.6%; patients: 8.3%) and PSA elevation (physicians: 9.3%; patients: 7.9%). After efficacy, physicians prioritized items related to target patients (cardiovascular disorders; mCSPC: 4.8%; CRPC: 3.4%), whereas patients prioritized safety (mCSPC: falls or fractures [5.6%]; CRPC: liver dysfunction [4.7%]). Patients with mCSPC were also concerned about rising medical expenditures (5.4%).</p><p><strong>Conclusion: </strong>Treatment efficacy was the most important attribute for both physicians and patients in Japan in mCSPC and CRPC settings, although their preferences differed in priority based on outcomes. These findings may be useful to improve shared decision-making for PC treatment in Japan.</p>","PeriodicalId":44205,"journal":{"name":"Oncology and Therapy","volume":" ","pages":"217-232"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}