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

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Concurrent Use of Trastuzumab Deruxtecan and Radiation Therapy in HER2-positive and HER2-low Metastatic Breast Cancer: A Single-center Experience and Review of the Literature. 在 HER2 阳性和 HER2 低的转移性乳腺癌中同时使用曲妥珠单抗德鲁司坦和放疗:单中心经验与文献综述》。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-12-01 Epub Date: 2024-07-16 DOI: 10.1097/COC.0000000000001135
Jihane Bouziane, Pierre Loap, Kim Cao, Sofiane Allali, Yacine Gounane, Gokoulakrichenane Loganadane, Laurence Escalup, Jean-Yves Pierga, Youlia Kirova
{"title":"Concurrent Use of Trastuzumab Deruxtecan and Radiation Therapy in HER2-positive and HER2-low Metastatic Breast Cancer: A Single-center Experience and Review of the Literature.","authors":"Jihane Bouziane, Pierre Loap, Kim Cao, Sofiane Allali, Yacine Gounane, Gokoulakrichenane Loganadane, Laurence Escalup, Jean-Yves Pierga, Youlia Kirova","doi":"10.1097/COC.0000000000001135","DOIUrl":"10.1097/COC.0000000000001135","url":null,"abstract":"<p><strong>Objectives: </strong>Recent DESTINY-Breast trials have demonstrated trastuzumab deruxtecan's effectiveness in HER2-positive and HER2-low metastatic breast cancer. However, safety concerns remain regarding its combination with radiation therapy (RT). The purpose of this work is to assess the toxicity profile of combining trastuzumab deruxtecan and RT in patients with HER2-positive and HER2-low metastatic breast cancer to address these concerns.</p><p><strong>Methods: </strong>We conducted a retrospective study which included patients treated at Institut Curie Paris between November 2020 and January 2024. Patients with HER2-positive and HER2-low metastatic breast cancer who received concurrent trastuzumab deruxtecan and RT were identified. Data on patient demographics, treatment regimens, radiation doses, toxicity profiles, and treatment discontinuations were collected. Follow-up was conducted from the last day of radiotherapy until death or the last examination and toxicities were graded using the CTCAE V5.0.</p><p><strong>Results: </strong>The studied population includes all 33 patients with HER2-positive and HER2-low metastatic breast cancer who underwent concurrent treatment with trastuzumab deruxtecan and radiotherapy. The median follow-up was 11 months. The most common acute grade 1 toxicity was nausea. Grade 2 toxicities affected 21.2% of patients, including asthenia, mucositis, cardiac decompensation, and diarrhea. Trastuzumab deruxtecan discontinuation occurred in 5 patients due to systemic treatment-related toxicities, including nausea, thrombocytopenia, neutropenia, and cardiac decompensation. There were 21.2% reported with late toxicities, with nausea being the most prevalent.</p><p><strong>Conclusions: </strong>Our series of patients who received concurrent treatment of radiotherapy and trastuzumab deruxtecan are showing acceptable toxicity. Larger prospective studies are needed to evaluate the toxicity and efficacy of this combination.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"580-584"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621724","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}
引用次数: 0
Institution-level Patterns of Care for Early-stage Oropharynx Cancers in the United States. 美国机构层面的早期口咽癌治疗模式。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-11-01 Epub Date: 2024-06-20 DOI: 10.1097/COC.0000000000001125
James R Janopaul-Naylor, Yuan Liu, Yichun Cao, Ashley J Schlafstein, Conor Steuer, Mihir R Patel, James E Bates, Mark W McDonald, William A Stokes
{"title":"Institution-level Patterns of Care for Early-stage Oropharynx Cancers in the United States.","authors":"James R Janopaul-Naylor, Yuan Liu, Yichun Cao, Ashley J Schlafstein, Conor Steuer, Mihir R Patel, James E Bates, Mark W McDonald, William A Stokes","doi":"10.1097/COC.0000000000001125","DOIUrl":"10.1097/COC.0000000000001125","url":null,"abstract":"<p><strong>Objectives: </strong>The adoption of transoral robotic surgery and shifting epidemiology in oropharyngeal squamous cell cancer have stimulated debate over upfront and adjuvant treatment. Institutional variation in practice patterns can be obscured in patient-level analyses. We aimed to characterize institutional patterns of care as well as identify potential associations between patterns of care and survival.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients identified from 2004-2015 in the National Cancer Database. We analyzed 42,803 cases of oropharyngeal squamous cell cancer Stage cT1-2N0-2bM0 (AJCC 7th edition) treated with curative intent surgery and/or radiotherapy. We defined facility-4-year periods to account for changing institutional practice patterns. The 42,803 patients were treated within 2578 facility-4-year periods. We assessed institutional practice patterns, including the ratio of upfront surgery to definitive radiotherapy, case volumes, use of adjuvant therapies (radiotherapy or chemoradiotherapy), and margin positivity rates. Survival associations with institutional practice patterns were estimated with Cox regression.</p><p><strong>Results: </strong>The ratio of upfront surgery to definitive radiotherapy ranged from 80-to-1 to 1-to-23. The institution-level median rate of adjuvant radiotherapy was 69% (IQR 50%-100%), adjuvant chemoradiotherapy was 44% (IQR 0%-67%), and margin-positive resection was 33% (IQR 0%-50%). On patient-level MVA, worse overall survival was not significantly associated with institutional case volume, adjuvant radiotherapy, or adjuvant chemoradiotherapy utilization.</p><p><strong>Conclusions: </strong>High rates of multimodal therapy and positive margins underscore the importance of multidisciplinary care and highlight variable patterns of care across institutions. Further work is warranted to explore indicators of high-quality care and to optimize adjuvant therapy in the HPV era.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"542-548"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical Margins After Neoadjuvant Radiation for Locally Advanced Vulvar Carcinoma: What is an Adequate Margin? 局部晚期外阴癌新辅助放疗后的手术边缘:什么是足够的边缘?
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-11-01 Epub Date: 2024-07-08 DOI: 10.1097/COC.0000000000001127
Michelle Ertel, John A Vargo, Anna Weimer, Adam Richman, Sushil Beriwal, Mohammed Mohammed, Jaime Lesnock
{"title":"Surgical Margins After Neoadjuvant Radiation for Locally Advanced Vulvar Carcinoma: What is an Adequate Margin?","authors":"Michelle Ertel, John A Vargo, Anna Weimer, Adam Richman, Sushil Beriwal, Mohammed Mohammed, Jaime Lesnock","doi":"10.1097/COC.0000000000001127","DOIUrl":"10.1097/COC.0000000000001127","url":null,"abstract":"<p><strong>Objective: </strong>We aim to explore whether the surgical tumor free margin is important for overall survival (OS) and local control in patients who undergo neoadjuvant radiation (RT) for vulvar cancer.</p><p><strong>Methods: </strong>A retrospective review from 2004 to 2021 of patients who underwent RT followed by surgical resection was performed. Patients were categorized into groups based on margin status (no residual disease, >8 mm, close margins defined as 1 to 7 mm, or positive). Local control and OS were analyzed using the Kaplan-Meier with log rank test. Multivariate analysis was performed with cox hazards model.</p><p><strong>Results: </strong>Eighty-three patients were included. A complete pathologic response (pCR) was found in 56% (n=46) of patients. The median follow-up time was 35 months (range: 4 to 216). The median OS for the entire cohort was 46 months (95% CI: 32.3-59.7). Having a pCR improved both OS and disease-free survival (DFS) compared with residual disease by 81 and 91 months, respectively ( P <0.001). In the 2 patients with a margin >8 mm, there was no statistical difference in survival between those with close margins (46 vs. 25 mo, P =0.485). Factors that significantly impacted both OS and DFS were depth of invasion (DOI) and LVSI. On multivariate analysis of those with residual disease, there was no difference in OS or DFS by margin status but having a DOI >9 mm showed decreased OS (HR: 3.654; 95% CI: 1.317-10.135).</p><p><strong>Conclusions: </strong>In this cohort, response to RT, not margin status drives survival and recurrence. Given residual disease, the optimal margin is not clear, as there were only 2 patients with >8 mm margins. A close or positive margin had no impact on OS or local recurrence. A DOI >9 mm significantly impacts both OS and local recurrence even when accounting for other factors.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"549-554"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555853","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}
引用次数: 0
Efficacy of Sacituzumab Govitecan in Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: A Comprehensive Systematic Review and Meta-analysis. 萨妥珠单抗戈维替康对激素受体阳性/人类表皮生长因子受体 2 阴性晚期乳腺癌的疗效:全面系统综述与 Meta 分析》。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-11-01 Epub Date: 2024-06-21 DOI: 10.1097/COC.0000000000001121
Zaheer Qureshi, Abdur Jamil, Eeshal Fatima, Faryal Altaf, Rimsha Siddique
{"title":"Efficacy of Sacituzumab Govitecan in Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: A Comprehensive Systematic Review and Meta-analysis.","authors":"Zaheer Qureshi, Abdur Jamil, Eeshal Fatima, Faryal Altaf, Rimsha Siddique","doi":"10.1097/COC.0000000000001121","DOIUrl":"10.1097/COC.0000000000001121","url":null,"abstract":"<p><strong>Objectives: </strong>Breast cancer is the most diagnosed cancer in women, with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) being the predominant subtype. Sacituzumab govitecan (SG), a novel antibody-drug conjugate, has emerged as a promising treatment for metastatic HR+/HER2- breast cancer. This systematic review and meta-analysis aimed to evaluate its efficacy and safety.</p><p><strong>Methods: </strong>Adhering to \"Preferred Reporting Items for Systematic Reviews and Meta-Analyses\" guidelines, a comprehensive search was conducted in PubMed, Scopus, and Cochrane databases up to December 2023. We included clinical trials and observational studies evaluating SG in patients with HR+/HER2- advanced breast cancer. The primary outcome was progression-free survival (PFS). In contrast, the secondary outcomes included overall survival, objective response rate, clinical benefit rate, duration of response (DOR), and adverse event profiles. Review Manager (Version 5.4) was used for the statistical analysis.</p><p><strong>Results: </strong>Nine studies met the inclusion criteria for systematic review; 2 were suitable for meta-analysis. The pooled analysis showed a hazard ratio of 0.53 (95% CI: 0.34-0.83; P = 0.005; I2 = 86%) for PFSl and a hazard ratio of 0.63 (95% CI: 0.36-1.11; P = 0.11; I2 = 92%) for overall survival. The pooled analysis of the duration of response showed significant results with a standard mean difference = 0.22 (95% CI: 0.03-0.42; P = 0.02; I2 = 61%).</p><p><strong>Conclusion: </strong>SG demonstrates significant benefit in PFS and duration of response in patients of HR+/HER2- advanced breast cancer.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"526-534"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441071","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}
引用次数: 0
Disparities in Survival Outcomes Among Patients With Metastatic Melanoma in Texas: Implications for Policy and Interventions in the Era of Immune Checkpoint Inhibitors. 德克萨斯州转移性黑色素瘤患者生存结果的差异:免疫检查点抑制剂时代的政策和干预措施的意义》(Implications for Policy and Interventions in the Era of Immune Checkpoint Inhibitors)。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-11-01 Epub Date: 2024-06-28 DOI: 10.1097/COC.0000000000001128
Olajumoke A Olateju, Osaro Mgbere, J Douglas Thornton, Zhen Zeng, Ekere J Essien
{"title":"Disparities in Survival Outcomes Among Patients With Metastatic Melanoma in Texas: Implications for Policy and Interventions in the Era of Immune Checkpoint Inhibitors.","authors":"Olajumoke A Olateju, Osaro Mgbere, J Douglas Thornton, Zhen Zeng, Ekere J Essien","doi":"10.1097/COC.0000000000001128","DOIUrl":"10.1097/COC.0000000000001128","url":null,"abstract":"<p><strong>Objectives: </strong>Disparities exist in the length and quality of survival from melanoma. This study evaluated, in a Texas cohort, patient factors associated with melanoma survival and examined if newer immune-oncologic agents extend survival compared with conventional therapies.</p><p><strong>Methods: </strong>A retrospective analysis of patients diagnosed with metastatic melanoma from 2011 to 2018 in the Texas Cancer Registry database. Multivariable Cox proportional hazard regression was used to evaluate patient characteristics associated with cancer-specific survival (CSS) and overall survival (OS). The patient cohort was then grouped based on receipt of first-line immunotherapy or other therapies. The association between receipt of immunotherapy and survival was assessed with Kaplan-Meier analysis and inverse probability treatment weighted Cox regression.</p><p><strong>Results: </strong>There were 1372 patients with metastatic melanoma. Factors associated with increased melanoma mortality risk (CSS) included being male (HR: 1.13, 95% CI: 1.02-1.26), non-Hispanic black (HR: 1.28, 95% CI: 1.13-1.45), living in poorer counties (HR: 1.40, 95%CI: 1.20-1.64), and having multimorbidity (HR: 1.35, 95% CI: 1.05-1.74). All minority races and Hispanics had poorer OS compared with non-Hispanic Whites. Patients who received first-line immunotherapy had significantly longer median (interquartile range) survival (CSS: 27.00 [21.00 to 42.00] mo vs. 16.00 [14.00 to 19.00] mo; OS: 22.00 [17.00 to 27.00] mo vs. 12.00 [11.00 to 14.00] mo). They also had reduced mortality risk (HR for CSS: 0.80; 95% CI: 0.73-0.88; P <0.0001; HR for OS: 0.76; 95% CI: 0.69-0.83; P <0.0001) compared with the nonimmunotherapy cohort.</p><p><strong>Conclusions: </strong>This study showed differences in risks from melanoma survival based on patient demographic and clinical characteristics. Low socioeconomic status increased mortality risk, and first-line immunotherapy use favored survival. Health policies and tailored interventions that will promote equity in patient survival and survivorship are essential for managing metastatic melanoma.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"517-525"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472228","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}
引用次数: 0
Efficacy and Safety of BRCA-targeted Therapy (Polyadenosine Diphosphate-ribose Polymerase Inhibitors) in Treatment of BRCA-mutated Breast Cancer: A Systematic Review and Meta-analysis. 治疗 BRCA 基因突变乳腺癌的 BRCA 靶向疗法(多腺苷二磷酸核糖聚合酶抑制剂)的有效性和安全性:系统回顾与元分析》。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-11-01 Epub Date: 2024-06-20 DOI: 10.1097/COC.0000000000001120
Zaheer Qureshi, Abdur Jamil, Faryal Altaf, Rimsha Siddique, Adnan Safi
{"title":"Efficacy and Safety of BRCA-targeted Therapy (Polyadenosine Diphosphate-ribose Polymerase Inhibitors) in Treatment of BRCA-mutated Breast Cancer: A Systematic Review and Meta-analysis.","authors":"Zaheer Qureshi, Abdur Jamil, Faryal Altaf, Rimsha Siddique, Adnan Safi","doi":"10.1097/COC.0000000000001120","DOIUrl":"10.1097/COC.0000000000001120","url":null,"abstract":"<p><p>Breast cancer is the second leading cause of women's cancer deaths after lung cancer. Risk factors such as environment, lifestyle, and genetics contribute to its development, including mutation in the breast cancer (BRCA) gene. Polyadenosine diphosphate-ribose polymerase inhibitors (PARPi) target these mutations, benefiting patients with advanced cancers. This review summarizes PARPi' safety and efficacy in the treatment of BRCA-mutated breast cancer. PubMed, The Cochrane Library for Clinical Trials, and Science Direct, were searched for articles from inception to April 2024. Eligible articles were analyzed, and data were extracted for meta-analysis using RevMan 5.4 software with a random-effect model. Out of 430 articles identified from online databases, only 6 randomized control trials including 3610 patients were included in the analysis. PARPi therapy improved progression-free survival (hazard ratio: 0.64; 95% CI: 0.56, 0.73; P < 0.00001) and overall survival (hazard ratio: 0.84; 95% CI: 0.73, 0.98 P = 0.02), according to the analysis. In our safety analysis, the risk of adverse events was not statistically different between PARPi versus chemotherapy (relative risk [RR]: 1.08; 95% CI: 0.44, 2.68; P = 0.86), and combined PARPi and standard chemotherapy (RR: 1.00; 95% CI: 0.93, 1.07; P = 0.80). The only statistically significant difference was observed in anemia, where PARPi increased the risk of developing anemia compared with standard chemotherapy (RR: 6.17; 95% CI: 2.44, 15.58; P = 0.0001). In BRCA-mutated breast cancer, PARPi treatment shows better overall survival and progression-free survival compared with standard chemotherapy or placebo. Furthermore, PARPi, either alone or in combination therapy, does not increase the risk of adverse events in these patients, as per the meta-analysis.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"555-562"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428179","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}
引用次数: 0
Disparities in Receipt of Adjuvant Immunotherapy among Stage III Melanoma Patients. III 期黑色素瘤患者接受辅助免疫疗法的差异。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-11-01 Epub Date: 2024-06-28 DOI: 10.1097/COC.0000000000001117
Kathleen M Mulligan, Hanna Kakish, Omkar Pawar, Fasih Ali Ahmed, Mohamedraed Elshami, Luke D Rothermel, Jeremy S Bordeaux, Iris Y Sheng, Ankit Mangla, Richard S Hoehn
{"title":"Disparities in Receipt of Adjuvant Immunotherapy among Stage III Melanoma Patients.","authors":"Kathleen M Mulligan, Hanna Kakish, Omkar Pawar, Fasih Ali Ahmed, Mohamedraed Elshami, Luke D Rothermel, Jeremy S Bordeaux, Iris Y Sheng, Ankit Mangla, Richard S Hoehn","doi":"10.1097/COC.0000000000001117","DOIUrl":"10.1097/COC.0000000000001117","url":null,"abstract":"<p><strong>Objective: </strong>Melanoma survival has greatly improved with the advent of immunotherapy, but unequal access to these medications may exist due to nonmedical patient factors such as insurance status, educational background, and geographic proximity to treatment.</p><p><strong>Methods: </strong>We used the National Cancer Database to assess patients with nonmetastatic cutaneous melanoma who underwent surgical resection and sentinel lymph node biopsy (SLNB) with tumor involvement from 2015 to 2020. We evaluated rates of adjuvant immunotherapy among this patient population based on patient, tumor, and facility variables, including insurance status, socioeconomic status, pathologic stage (IIIA-IIID), and treatment facility type and volume.</p><p><strong>Results: </strong>Adjuvant immunotherapy was associated with improved survival for stage III melanoma, with a slight increase in 5-year OS for stage IIIA (87.9% vs. 85.9%, P=0.044) and a higher increase in stages IIIB-D disease (70.3% vs. 59.6%, P<0.001). Receipt of adjuvant immunotherapy was less likely for patients who were older, low socioeconomic status, or uninsured. Low-volume and community cancer centers had higher rates of adjuvant immunotherapy overall for all stage III patients, whereas high-volume and academic centers used adjuvant immunotherapy much less often for stage IIIA patients compared with those in stages IIIB-D.</p><p><strong>Conclusions: </strong>Our results demonstrate inconsistent use of adjuvant immunotherapy among patients with stage III melanoma despite a significant association with improved survival. Notably, there was a lower use of adjuvant immunotherapy in patients of lower SES and those treated at high-volume centers. Equity in access to novel standards of care represents an opportunity to improve outcomes for patients with melanoma.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"509-516"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472227","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}
引用次数: 0
Safety and Efficacy of Trastuzumab Deruxtecan for Metastatic HER2+ and HER2-low Breast Cancer: An Updated Systematic Review and Meta-Analysis of Clinical Trials. 曲妥珠单抗德鲁司坦治疗转移性HER2+和HER2-low乳腺癌的安全性和有效性:临床试验的最新系统回顾和元分析》。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-11-01 Epub Date: 2024-07-02 DOI: 10.1097/COC.0000000000001126
Zaheer Qureshi, Faryal Altaf, Abdur Jamil, Rimsha Siddique, Eeshal Fatima
{"title":"Safety and Efficacy of Trastuzumab Deruxtecan for Metastatic HER2+ and HER2-low Breast Cancer: An Updated Systematic Review and Meta-Analysis of Clinical Trials.","authors":"Zaheer Qureshi, Faryal Altaf, Abdur Jamil, Rimsha Siddique, Eeshal Fatima","doi":"10.1097/COC.0000000000001126","DOIUrl":"10.1097/COC.0000000000001126","url":null,"abstract":"<p><strong>Objectives: </strong>Trastuzumab deruxtecan (T-DXd) is a novel antibody-drug conjugate (ADC) promising in treating metastatic HER2+ and HER2-low breast cancer. This updated systematic review and meta-analysis, integrating data from the latest clinical trials, aimed to evaluate the safety and efficacy of T-DXd in this patient population.</p><p><strong>Methods: </strong>We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, Scopus, and Web of Science up to January 2024, focusing on clinical trials that assessed T-DXd's efficacy and safety. Eligibility criteria were based on the PICOS framework, and selected studies underwent rigorous quality assessment and data extraction. The primary outcomes were progression-free survival (PFS), overall survival (OS), and the incidence of adverse events. A random-effects meta-analysis was performed to synthesize the data.</p><p><strong>Results: </strong>Seven studies involving 2,201 patients met the inclusion criteria. The pooled analysis revealed that T-DXd significantly improved PFS (OR=0.37, 95% CI: 0.27-0.52), indicating a robust efficacy in slowing disease progression. However, treatment was associated with an increased risk of anemia (OR=2.10, 95% CI: 1.36-3.25), fatigue (OR=1.56, 95% CI: 1.21-2.02), nausea (OR=6.42, 95% CI: 4.37-9.42), vomiting (OR=6.21, 95% CI: 3.14-12.25), constipation (OR=2.26, 95% CI: 1.53-3.34), and notably, drug-related interstitial lung disease (OR=10.89, 95% CI: 3.81-31.12). The efficacy outcomes demonstrated significant heterogeneity, which was addressed through sensitivity analysis.</p><p><strong>Conclusions: </strong>T-DXd shows significant efficacy in treating metastatic HER2+ and HER2-low breast cancer, offering a valuable therapeutic option for patients with advanced disease. However, the treatment is associated with notable adverse events, including a heightened risk of ILD. These findings underscore the need for careful patient selection, monitoring, and management strategies to mitigate risks. Future research should focus on optimizing treatment protocols and exploring methods to enhance safety profiles.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"535-541"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477926","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}
引用次数: 0
Case Study on Analysing the Early Disease Detection of Pancreatic Ductal Adenocarcinoma in Korean Association for Clinical Oncology. 韩国临床肿瘤学协会胰腺导管腺癌早期疾病检测分析案例研究。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-10-01 Epub Date: 2024-07-04 DOI: 10.1097/COC.0000000000001118
Sijithra Ponnarassery Chandran, N Santhi
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引用次数: 0
Proceedings of the American Radium Society ® 106th Annual Meeting. 美国镭学会第 106 届年会论文集。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2024-10-01 Epub Date: 2024-08-21 DOI: 10.1097/COC.0000000000001139
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引用次数: 0
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