American Journal of Clinical Oncology-Cancer Clinical Trials最新文献

{"title":"Sex Differences in Postoperative Outcomes for Men and Women With Colon Cancer in the US Military Health System.","authors":"Yvonne L Eaglehouse, Michele M Gage, Sarah Darmon, Robert W Krell, Diego A Vicente, Craig D Shriver, Kangmin Zhu","doi":"10.1097/COC.0000000000001390","DOIUrl":"https://doi.org/10.1097/COC.0000000000001390","url":null,"abstract":"<p><strong>Objectives: </strong>Biological, behavioral, and health care access differences between men and women may contribute to differences in colon cancer diagnosis and treatment. We compared postoperative outcomes between men and women with colon cancer in the universal access Military Health System (MHS) to better understand sex-based differences in surgery.</p><p><strong>Methods: </strong>We identified patients with stage I to III colon adenocarcinoma receiving surgery in the Military Cancer Epidemiology (MilCanEpi) database between 2001 and 2014. Thirty-day postoperative outcomes included general cardiovascular and respiratory complications; infections (surgical site [SSI], urinary tract [UTI], and systemic); gastrointestinal (GI) complications (hemorrhage, bowel obstruction, ileus, intra-abdominal abscess, and anastomotic leakage); and hospital readmissions. Modified Poisson regression estimated adjusted rate ratios (ARRs) and 95% CIs in association with biological sex for the outcomes.</p><p><strong>Results: </strong>The study included 1073 male (mean age=59.5±13.5 y) and 794 female (mean age=59.6±13.5 y) patients. In the 30-day postoperative period, general complication rates were not different by sex (ARR=1.03, 95% CI: 0.76-1.40 for women vs. men). Female sex was associated with higher rates of UTI (ARR=2.44, 95% CI: 1.63-3.65) and lower rates of GI complications (ARR=0.79, 95% CI: 0.69-0.90) relative to men. There were no sex differences in 30-day hospital readmissions (ARR=0.90, 95% CI: 0.76-1.08 for women vs. men).</p><p><strong>Conclusions: </strong>In the MHS, female sex was associated with higher rates of UTI and lower rates of GI complications relative to men undergoing colon cancer surgery. Factors other than health care access, such as biological differences in pelvic anatomy, physiology, or immune responses, may contribute to observed differences.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern Radiotherapy for Axial Giant Cell Tumor of Bone: Impact of Gross Disease at Treatment Initiation.","authors":"Jong Yun Baek, Do Hoon Lim, Se-Jun Park, Jin-Sung Park","doi":"10.1097/COC.0000000000001380","DOIUrl":"https://doi.org/10.1097/COC.0000000000001380","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate outcomes of modern radiotherapy (RT) for giant cell tumor of bone (GCTB) in anatomically constrained axial sites and to assess the prognostic impact of disease burden at RT initiation.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients with pathologically confirmed GCTB of the spine, sacrum, or skull treated with RT between 2006 and 2024 at a single institution. Patients treated with palliative intent and 1 patient lost to follow-up immediately after RT were excluded. Local recurrence-free survival (LRFS) and progression-free survival (PFS) were calculated from RT initiation. Gross disease at RT was defined as a radiographically visible lesion on CT and/or MRI at RT initiation. Survival was estimated using the Kaplan-Meier method and compared by the log-rank test; prognostic factors were explored using univariate analyses.</p><p><strong>Results: </strong>Seventeen patients were included (postoperative RT, n=13; salvage RT, n=3; definitive RT, n=1) and treated with 3D-conformal RT (n=9), IMRT (n=3), or proton therapy (n=5). Median follow-up was 79.8 months. The 5-year LRFS and PFS rates were 75.1% and 68.3%, respectively. Four patients experienced local recurrence and 1 developed lung metastasis. Gross disease at RT initiation (n=8) was significantly associated with inferior LRFS (5 y LRFS: 46.9% vs. 100.0% without gross disease; P=0.018).</p><p><strong>Conclusions: </strong>In this cohort of axial GCTB treated with modern RT, gross disease at RT initiation was associated with inferior local control. Outcomes appeared more favorable when RT was delivered in the absence of gross disease, suggesting that maximal safe debulking before RT may be relevant in selected anatomically constrained cases.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Facility Distance and Adjuvant Radiotherapy for WHO Grade 2-3 Meningioma.","authors":"Nipun Gorantla, Connor J Kinslow, Dylan K Kim, George Ashji, Sruthi Ranganathan, Joshua A Budhu, Divya Yerramilli, James Janopaul-Naylor, Andrew R Barsky, Gustav Cederquist, Brandon S Imber, Melissa R Zinovoy, Luke R G Pike, Edward Christopher Dee","doi":"10.1097/COC.0000000000001388","DOIUrl":"https://doi.org/10.1097/COC.0000000000001388","url":null,"abstract":"<p><strong>Objectives: </strong>Adjuvant radiotherapy (RT) is commonly used after surgery for WHO grade 2 and 3 meningioma, but the role of patient-facility distance in RT receipt and dose/fractionation choice is not well defined. We examined whether travel distance was associated with receipt and type of adjuvant RT.</p><p><strong>Methods: </strong>We used the National Cancer Database to identify adults diagnosed between 2010 and 2020 with surgically treated WHO grade 2 or 3 meningioma and a CROWFLY distance ≤250 miles. Patients were categorized into 3 groups according to WHO grade and extent of resection: grade 2 with gross total resection, grade 2 with subtotal resection/biopsy, and grade 3 with any resection. Outcomes were receipt of adjuvant RT, SRS/HF-SRS versus fractionated EBRT among classifiable RT recipients, and overall survival.</p><p><strong>Results: </strong>Among 14,218 patients, 4063 (28.6%) received adjuvant RT. In multivariate models, the odds of RT receipt decreased with increasing distance, becoming statistically significant at 25 to <50 miles and remaining lower in more distant bins. Among 2767 classifiable RT recipients, greater distance was associated with higher odds of SRS/HF-SRS rather than fractionated EBRT. Distance was not associated with overall survival. Selected fine-bin estimates included OR=1.47 at 25 to <50 miles, OR=2.40 at 75 to <100 miles, and OR=3.08 at 150 to 250 miles.</p><p><strong>Conclusions: </strong>Greater patient-facility distance was associated with lower receipt of adjuvant RT and greater use of shorter stereotactic regimens among treated patients. These findings support geography as a predictor of both whether and how patients with higher-grade meningioma receive postoperative radiotherapy.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Existing Anxiety and Depression as a Risk Factor for Increased Postoperative Healthcare Utilization in Spine Tumor Patients.","authors":"Joshua Woo, Nicole Rivera, Adedotun Bello, Ezinne Oguguo, Brandon Lee, Tobechukwu Ndika, Nina Min, Emmy Duerr, Ramzy Ahmed, Seeley Yoo, Dana Rowe, Ellen O'Callaghan, Tara Dalton, Pakawat Chongsathidkiet, Samantha E Spellicy, Eli Johnson, Andrea N Goodwin, Kerri-Anne Crowell, Trupti Trivedi, Maria E Garcia, Melissa Erickson, C Rory Goodwin","doi":"10.1097/COC.0000000000001385","DOIUrl":"https://doi.org/10.1097/COC.0000000000001385","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to elucidate the association between pre-existing anxiety and depression and postoperative outcomes in spine tumor patients.</p><p><strong>Methods: </strong>A retrospective study was performed using the national PearlDiver Mariner database for adults with an oncologic indication who underwent spine surgery between 2011 and 2023. Patients with pre-existing anxiety or depression diagnoses were propensity score-matched by age, sex, comorbidities, and geography 1:1 to controls without psychiatric diagnoses.</p><p><strong>Results: </strong>Seven thousand ten total spine tumor patients with pre-existing anxiety or depression diagnoses were identified and matched to controls. Among metastatic spine disease (MSD) patients, at 30 days postoperative, pre-existing anxiety was associated with more emergency (OR=1.3, 95% CI: 1.1-1.6) and outpatient (OR=1.2, 95% CI: 1.1-1.4) visits, more palliative care (OR=1.3, 95% CI: 1.1-1.5) and cognitive behavioral therapy (CBT) (OR=1.5, 95% CI: 1.1-2.2), and more opioid (OR=1.3, 95% CI: 1.1-1.5) and SSRI (OR=2.8, 95% CI: 2.1-3.7) utilization relative to nonanxiety controls. These increased odds were consistent across time points in the MSD group. Among patients with depression, similar trends were observed at all time points as with anxiety.</p><p><strong>Conclusions: </strong>Pre-existing anxiety and/or depression in spine tumor patients are associated with greater postoperative outpatient health care utilization, particularly in MSD patients.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Outcomes in the Evolving Second-Line Systemic Therapy Landscape in Hepatocellular Carcinoma: A Single-Institution Experience.","authors":"Mark F deBettencourt, Kayeromi Gomez, Nina Undevia Yedavalli","doi":"10.1097/COC.0000000000001389","DOIUrl":"https://doi.org/10.1097/COC.0000000000001389","url":null,"abstract":"<p><strong>Objectives: </strong>Historically, few treatments existed for hepatocellular carcinoma (HCC) until sorafenib's approval in 2007. Meaningful treatment advances included approval of atezolizumab plus bevacizumab in 2020 and tremelimumab plus durvalumab in 2022. However, optimal second-line systemic therapy and outcomes after current first-line therapies are unclear.</p><p><strong>Methods: </strong>Patients treated with systemic therapy for HCC between 2018 and 2025 were retrospectively reviewed. Demographics, clinical characteristics, treatment history, and survival outcomes were collected. Survival was analyzed using Kaplan-Meier methods. Univariable and multivariable analyses were conducted.</p><p><strong>Results: </strong>In total, 143 patients were reviewed (median age 67.4; 72.0% male). First-line systemic therapy included sorafenib (28.0%), nivolumab (21.0%), lenvatinib (18.9%), atezolizumab/bevacizumab (16.1%), and tremelimumab/durvalumab (8.4%). Fifty-two patients (36.4%) received second-line therapy: immunotherapy (48.1%), TKI (40.4%), and ramucirumab (11.5%). AFP ≥400 was present in 48.1% of second-line patients. Leading barriers to second-line treatment were patient choice (40.7%) and poor performance status (38.5%). Median overall survival after second-line therapy was 8.5, 9.1, and 9.3 months for TKI, immunotherapy, and ramucirumab, respectively (P=0.903). Median progression-free survival was 3.1, 3.9, and 3.7 months (P=0.598).</p><p><strong>Conclusions: </strong>One third of patients received second-line therapy, with patient choice and declining performance status as leading barriers. Ramucirumab's underutilization, comparable efficacy, and favorable toxicity profile make it worthy of increased consideration for second-line systemic therapy. Prospective studies are needed to elucidate factors influencing optimal second-line therapy in HCC.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Contributing to Non-Initiation of Planned Systemic Therapy Among Inpatients Evaluated for a Phase II Randomized Controlled Oncology Trial.","authors":"Kolton Kardokus, Cameron Anzel, Momina Anwar, Lisa Perry, Shearwood McClelland","doi":"10.1097/COC.0000000000001383","DOIUrl":"https://doi.org/10.1097/COC.0000000000001383","url":null,"abstract":"<p><strong>Objectives: </strong>The Spine Patient Optimal Radiosurgery Treatment for Symptomatic MEtastatic Neoplasms (SPORTSMEN) multicenter phase II randomized controlled trial evaluates radiation therapy (RT) for symptomatic spinal metastases, with 3-month pain-relief as the primary endpoint. The Inpatient Metastatic Spine Score (IMSS) identifies inpatients with anticipated survival to meet this endpoint. Because systemic therapy eligibility is an IMSS component and contributes to survival, understanding the reversal of intended systemic treatment may refine RT patient selection.</p><p><strong>Methods: </strong>Inpatients at an NCI-designated cancer center evaluated for SPORTSMEN with planned but uninitiated systemic therapy were retrospectively evaluated. Clinical characteristics, trial status, RT, functional status, hospitalization events, IMSS, and treatment decisions were abstracted from the EMR. Oncology documentation and goals-of-care discussions identified treatment plan changes.</p><p><strong>Results: </strong>Three patients were identified. All met the SPORTSMEN eligibility criteria and had medical oncology plans for systemic therapy. Baseline ECOG ranged from 1 to 3. Performance status decline following evaluation (median of 5 d) and goals-of-care changes drove treatment noninitiation. Median time from systemic therapy support to noninitiation was 6 days, and median time from trial evaluation to transition in care goals was 10 days; 2 patients transitioned to hospice and 1 to palliative-intent care. Two patients would not have qualified for enrollment by IMSS if the initial treatment plan withheld systemic therapy.</p><p><strong>Conclusions: </strong>Among inpatients evaluated for SPORTSMEN, reversal of planned systemic therapy occurred over 6 days. This timeframe should inform evaluation for trial enrollment with regard to overall prognosis. Longitudinal functional assessment and early goals-of-care discussions with validated prognostic tools may improve identification of patients likely to benefit from RT.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Reirradiation: A Multi-Institutional Retrospective Analysis of Feasibility, Tolerability, and Clinical Outcomes.","authors":"Helen X Hou, Hannah J Roberts, Priyadarshini S Pathak, Harvey J Mamon, Joseph D Mancias, Harshabad Singh, Motaz Qadan, Carlos Fernandez-Del Castillo, Julie L Koenig, Theodore S Hong, Celia R Blaszkowsky, Lawrence S Blaszkowsky, Aparna R Parikh, Jill N Allen, Jeffrey W Clark, Colin D Weekes, Ritchell van Dams, Jennifer Y Wo","doi":"10.1097/COC.0000000000001381","DOIUrl":"https://doi.org/10.1097/COC.0000000000001381","url":null,"abstract":"<p><strong>Objectives: </strong>With improvements in systemic therapy for pancreatic cancer (PC), the role of radiation therapy (RT) to optimize local control has increased. While the tolerability and outcomes for RT for PC are well described, limited data exist on the feasibility and clinical impact after pancreatic reirradiation (re-RT). This study retrospectively reviews a multi-institutional experience of pancreatic re-RT.</p><p><strong>Methods: </strong>A retrospective analysis of 44 patients treated with pancreatic reirradiation at 2 academic centers between 2012 and 2025 was conducted. The primary study endpoint was local control (LC) from the completion of re-RT. Secondary endpoints included progression-free survival (PFS), distant metastasis-free survival (DMFS), overall survival (OS), and chemotherapy-free (CT-free) interval. Median BED for pancreatic re-RT was 59.5 Gy (range: 8.5 to 97.9) delivered in a median of 20 fractions (range: 3 to 28), with 77.3% (n=34) receiving concurrent chemotherapy. Re-RT techniques included: 3D-CRT (n=5), IMRT/VMAT (n=27), SBRT (n=12), and proton RT (n=3).</p><p><strong>Results: </strong>Median follow-up after re-RT was 8.0 months (range: 1.0 to 81.1). Among patients alive, the median follow-up was 7.5 months (range: 3.6 to 32.8). 95.5% (42/44) completed re-RT. Following re-RT, 22 patients received further systemic therapy; the median CT-free interval was 5.4 months (range: 0.0 to 35.4). The 6- and 12-month LC from the time of re-RT were 69.6% and 58.5%. The 6-month PFS, DMFS, and OS were 47.7%, 61.0%, and 71.6%, respectively. Acute grade ≥3 toxicities occurred in 2 patients, including anorexia, dysphagia, and GI bleed.</p><p><strong>Conclusions: </strong>Pancreatic re-RT is feasible and may offer promising local control and time off chemotherapy for selected patients. Future studies should refine patient selection criteria for pancreatic re-RT, and improvements in RT delivery with online adaptive therapy may further minimize toxicity.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted Therapies in Non-Small Cell Lung Cancer: A Contemporary Review.","authors":"Ahmed Abdelmonem, Bidhan Bikram Shah, Mouza Al Shebli, Imad A Tabbara","doi":"10.1097/COC.0000000000001275","DOIUrl":"10.1097/COC.0000000000001275","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer-related mortality worldwide, with non-small cell lung carcinoma (NSCLC) comprising over 85% of cases. Advances in molecular diagnostics and precision oncology have shifted treatment toward mutation-driven strategies, resulting in significantly improved patient outcomes. This review synthesizes current evidence on the most clinically relevant genetic alterations in NSCLC and their corresponding targeted therapies, including epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) rearrangements, ROS1 fusions, BRAF V600E mutations, MET exon 14 skipping mutations, RET and NTRK fusions, HER2 alterations, and KRAS G12C mutations. We outline mechanisms of action, clinical efficacy, and limitations of FDA-approved tyrosine kinase inhibitors (TKIs) and emerging agents, with emphasis on resistance pathways, both on-target and bypass-mediated, observed during treatment with drugs such as osimertinib, crizotinib, sotorasib, and entrectinib. The role of next-generation sequencing (NGS), liquid biopsy, and comprehensive biomarker profiling in guiding personalized therapy selection is also discussed, along with strategies for sequential therapy and rational combination approaches.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"510-516"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Diagnostic Performance of Early Lung Cancer by Integrating Multiplex Nucleic Acid Aptamer Detection With Conventional Tumor Markers: A Prospective Observational Study.","authors":"Hongxia Yuan, Weijun Wang, Zhengli Wei, Lei Zhang, Dedai Lu, Yingjie Liu, Keji He, Tao Wang, Shiqi Liao","doi":"10.1097/COC.0000000000001316","DOIUrl":"10.1097/COC.0000000000001316","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the value of incorporating multiplex nucleic acid aptamer detection into conventional serum tumor marker testing for improving the early diagnosis of lung cancer.</p><p><strong>Methods: </strong>This prospective observational study enrolled 158 participants, including patients with pathologically confirmed lung cancer (n=82), individuals with benign pulmonary lesions (n=26), and healthy controls (n=50). Serum levels of 5 conventional tumor markers, neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCAg), pro-gastrin-releasing peptide (ProGRP), and cytokeratin 19 fragment 21-1 (CYFRA21-1) were examined. Nucleic acid aptamer signals (ΔCt values and positivity rates) were measured in all participants. A conventional model, an aptamer-based model, and a combined model integrating both approaches were constructed. Diagnostic performance for early lung cancer was compared using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Serum levels of all 5 conventional tumor markers and nucleic acid aptamer signals differed significantly among the 3 groups. For lung cancer diagnosis, the combined model (conventional tumor markers plus nucleic acid aptamer detection) demonstrated higher area under the ROC curve (AUC), sensitivity, and specificity than the conventional model alone. In diagnosing early lung cancer, the combined model achieved the best discriminative performance. The combined model improved discrimination and reclassification for early lung cancer.</p><p><strong>Conclusions: </strong>Integrating nucleic acid aptamer detection with conventional tumor marker testing enhances the diagnostic accuracy and discriminative ability for early lung cancer. The incremental value of this combined approach suggests a potential optimized strategy for early lung cancer detection.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"465-471"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Decade Trends and Future Projections of Malignant Skin Melanoma Burden in the United States and Globally: A Pairwise Analysis From the Global Burden of Disease 2023.","authors":"Ibraheem Altamimi, Faisal A Al-Harbi, Abdelmalek Ammar AlHaj Abdelghani, Fahad S Almutairi, Jana Wadie Alahmadi, Renad Mashhour Alsaaedi, Kamel Majed Abdallah Enaim, Retaj Suliman Aldobiyan, Wareef Omran Albealdi, Faisal Ibrahim Alfadda, Alanoud Abdullah Al Daej, Hamza Ashraf, Haifa Alfalah","doi":"10.1097/COC.0000000000001292","DOIUrl":"10.1097/COC.0000000000001292","url":null,"abstract":"<p><strong>Objectives: </strong>Malignant melanoma, although less frequent than other skin cancers, accounts for most skin cancer deaths due to its aggressive and metastatic nature. Despite therapeutic progress, its global distribution remains uneven. Comparative analyses of United States and worldwide melanoma trends, particularly by sex, are limited.</p><p><strong>Methods: </strong>We analyzed melanoma incidence, prevalence, and mortality from 1990 to 2023 using Global Burden of Disease (GBD) 2023 data. Age-standardized rates per 100,000 population were obtained for the United States and globally. Temporal patterns were examined using joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% CIs. Pairwise tests compared US and global trajectories. Future mortality was projected through 2050 using autoregressive integrated moving average (ARIMA) modeling.</p><p><strong>Results: </strong>From 1990 to 2023, US age-standardized mortality declined by 28% (2.38 to 1.72 per 100,000; AAPC: -0.96*; 95% CI: -1.21 to -0.71), whereas global mortality decreased modestly (0.82 to 0.74; AAPC: -0.29*; 95% CI: -0.46 to -0.12). US incidence declined (AAPC: -0.41*; 95% CI: -0.65 to -0.16), contrasting with a global rise (AAPC: 0.54*; 95% CI: 0.38 to 0.70). Prevalence fell in the United States (AAPC: -0.39*; 95% CI: -0.62 to -0.16) but increased globally (AAPC: 0.80*; 95% CI: 0.55 to 1.04). Males consistently exhibited higher incidence and mortality than females. All pairwise comparisons between US and global trajectories were significant ( P <0.001*). ARIMA projections indicate a slight increase in US male mortality by 2050, whereas female and global rates are expected to continue declining.</p><p><strong>Conclusions: </strong>Between 1990 and 2023, melanoma incidence and mortality declined in the United States but rose or plateaued globally, with persistent male predominance. Sustaining global progress requires strengthened prevention, early detection, and equitable access to effective treatment.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"478-489"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}