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

{"title":"Efficacy and Safety of Camrelizumab Combination Therapy in Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis.","authors":"Umar Akram, Zain A Nadeem, Obaid Ur Rehman, Muhammad A Raza, Aimen Nadeem, Khawaja Abdul Rehman, Rutaab Kareem, Maheen Zahid, Eeshal Fatima, Hamza Ashraf, Haider Ashfaq, Muhammad K Amin, Moazzam Shahzad","doi":"10.1097/COC.0000000000001299","DOIUrl":"10.1097/COC.0000000000001299","url":null,"abstract":"<p><strong>Objectives: </strong>The role of camrelizumab in combination therapy for triple-negative breast cancer (TNBC) is unclear. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of camrelizumab combination therapy in women with TNBC.</p><p><strong>Methods: </strong>We electronically searched MEDLINE, Embase, Scopus, Cochrane CENTRAL, and Clinicaltrials.gov from inception till March 2024. We performed a meta-analysis on the R version 4.3.3 using the \"meta\" and \"metasens\" packages through RStudio. Proportions were pooled using a random effects model. The between-study heterogeneity was assessed by Higgins I ² statistics.</p><p><strong>Results: </strong>A total of 9 studies comprising 357 patients were pooled. We observed an overall low risk of bias in the included studies. The results revealed an overall response rate of 58% (95% CI: 30%-84%, I2 =94%), a 1-year survival rate of 71% (95% CI: 54%-85%, I2 =49%), a 1-year progression free survival rate of 22% (95% CI: 0%-25%; I2 =93%), stable disease in 25% (95% CI: 10%-44%, I2 =85%) of participants at last follow-up and progressive disease in 11% (95% CI: 2%-25%, I2 =79%) with camrelizumab combination therapy. Several treatment-related adverse events were reported in the included studies. Neutropenia was most common in 66% patients, followed by leukopenia in 59% patients. Among general AEs, asthenia was reported by 32% and fatigue was reported by 51% of the patients.</p><p><strong>Conclusions: </strong>Camrelizumab combination therapy showed promising results in TNBC treatment, with good survival outcomes. Depending upon the outcomes of future phase III trials, factors influencing the efficacy of camrelizumab might be explored.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"499-509"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054783","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":"Effects of a Family-centered Early Palliative Care Intervention on the Mental Health and Quality of Life in Patients With Advanced Cancer and Their Caregivers.","authors":"Congming Bu, Jing Wang, Feng Gu, Jing Peng, Dianjiao Hu, Xian Zhang","doi":"10.1097/COC.0000000000001301","DOIUrl":"10.1097/COC.0000000000001301","url":null,"abstract":"<p><strong>Objectives: </strong>This study explored the effectiveness of family-centered early palliative care on emotional well-being and quality of life for Chinese advanced cancer (AC) and their caregivers (CGs).</p><p><strong>Methods: </strong>Involving 104 AC (including lung, breast, and colon) and CGs, a remote randomized controlled trial was undertaken. Patients and CGs randomly assigned in pairs to either an intervention group (IG) (n=52) or a control group (n=52). While both groups underwent 4 weeks of health education, the IG also received 4 weeks of early palliative care. Various scales, including the Hospital Anxiety and Depression Scale, Connor Davidson Resilience Scale, Benefit Discovery Rating Scale, Caregiver Positive Feelings Scale, Functional Evaluation of Cancer Therapy Scale, and Caregiver Quality of Life (QoL) Scale, were applied to assess anxiety, depression, resilience, benefit discovery, and QoL at baseline (T1), immediately after the intervention (T2), and one month following the intervention (T3) for patients and CGs, respectively.</p><p><strong>Results: </strong>At T2 and T3, the patients in the IG exhibited significantly higher resilience, benefit discovery, QoL, and lower anxiety and depression compared to the control group ( P <0.01). Analysis using a linear mixed model revealed a substantial interaction among group, time, and role regarding anxiety, depression, and resilience ( P <0.01), highlighting distinct differences in resilience and improvements in anxiety and depression between patients and CGs ( P <0.01).</p><p><strong>Conclusions: </strong>The study demonstrated that family-centered early palliative care interventions effectively enhanced the mental well-being and QoL for AC and CGs.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"490-498"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183260","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":"Outcomes of Patients With Esophageal and Gastric Carcinoma at a Safety-net Health Care System: A Juncture to Explore Disparities in Diverse Socioeconomic Cohorts and Ethnicities.","authors":"Kalyani Narra, Sachita Guthula, Kari J Teigen, Susmita Potti, Jolonda C Bullock, Timothy J Brown","doi":"10.1097/COC.0000000000001287","DOIUrl":"10.1097/COC.0000000000001287","url":null,"abstract":"<p><strong>Objectives: </strong>Outcomes for upper gastrointestinal (UGI) cancers are poor except for those patients whose cancers are diagnosed at a very early stage. Unique socioeconomic factors may result in worse outcomes in the safety-net setting given that these patients often seek care later in the disease course. This study aims to understand the survival outcomes of patients with UGI cancers in a safety-net health care (SNH) setting.</p><p><strong>Methods: </strong>Patients diagnosed with esophageal squamous (ES), esophageal adenocarcinoma (EA), and gastric carcinomas (G) at JPS Health Network in Fort Worth, Texas from January 1, 2018, to December 31, 2022, were identified in the tumor registry database. The electronic health record was queried for clinical characteristics, pathology variables, and management outcomes. Kaplan-Meier curve was used to illustrate the difference in survival time across cancer stages from an index date of diagnosis with censoring at date of last contact.</p><p><strong>Results: </strong>A total of 171 patients were included: the median age was 57 years, but 15 patients were under 40 years. By ethnicity, 40% were Hispanic. The majority were male (71%) and uninsured (65%). G was the most common primary site (n = 92, 54%), followed by EA (n = 58, 34%) and ES (n = 21, 12%). Of the 125 stage 4B patients, 69 (55%) did not receive any treatment, 6 received only palliative radiation, and the remainder received systemic therapy. In patients with stage 4B, the median overall survival for patients with systemic treatment was 7.9 months (95% CI: 6.7-11), compared with 2.1 months (95% CI: 1.5-3.0) without treatment.</p><p><strong>Conclusions: </strong>In an urban safety-net population with a high percentage of Hispanic population, most patients with advanced UGI cancers did not receive systemic therapy. Interventions to improve outcomes must consider the unique socioeconomic needs of this vulnerable population to translate clinical trial results into improved outcomes.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"472-477"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812199","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":"Efficacy of Veliparib Plus Temozolomide Combination Therapy in Cancer: A GRADE-Assessed Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Parsa Sepehri, Fateme Hejazi, Milad Ghanikolahloo, Alireza Milajerdi","doi":"10.1097/COC.0000000000001382","DOIUrl":"10.1097/COC.0000000000001382","url":null,"abstract":"<p><p>Temozolomide (TMZ) is widely used in aggressive cancers, but its efficacy may be limited by tumor DNA repair mechanisms. Inhibition of PARP with veliparib (ABT-888) has been proposed to enhance TMZ-induced cytotoxicity. We conducted this systematic review and meta-analysis to evaluate the efficacy of this combination on overall survival (OS) and progression-free survival (PFS) in patients with cancer. PubMed, Scopus, CENTRAL, and ClinicalTrials.gov were systematically searched up to August 2026, using predefined terms. Eligible studies were phase II and III randomized controlled trials (RCTs) evaluating PFS and OS of veliparib combined with temozolomide versus control therapy. Random-effects models with restricted maximum-likelihood (REML) estimation with Hartung-Knapp (HK) adjustment were applied. Statistical analyses were performed with R with significance set at P <0.05. Certainty of evidence was assessed using the GRADE framework. From 729 records screened, 4 RCTs enrolling 1022 patients were included. No statistically significant improvement was shown in OS (HR=0.94, 95% CI: 0.78-1.13, I2 =0.0) or PFS (HR=0.88, 95% CI: 0.71-1.08, I2 =25.5). Subgroup analyses for OS similarly showed no statistically significant benefit. This meta-analysis did not demonstrate a statistically significant OS and PFS benefit from veliparib plus temozolomide compared with control therapy. This finding should be interpreted cautiously. The certainty of evidence was rated as moderate for both OS and PFS according to GRADE. Future studies should focus on biomarker-driven approaches and optimized dosing strategies to better define the clinical utility of this regimen.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076639","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":"Dose to the Fetus in Pregnant Women Undergoing Stereotactic Radiosurgery for Brain Tumors.","authors":"Ruth S Aytehgeza, Shearwood McClelland","doi":"10.1097/COC.0000000000001379","DOIUrl":"https://doi.org/10.1097/COC.0000000000001379","url":null,"abstract":"<p><strong>Objectives: </strong>Stereotactic radiosurgery (SRS) treats intracranial tumors during pregnancy when intervention cannot be delayed until delivery. However, fetal radiation exposure raises toxicity and carcinogenic concerns, especially above 50 mGy. This review evaluates published evidence on fetal exposure during SRS to assess the safety of Gamma Knife radiosurgery (GKRS) compared with other platforms. Although pregnancy is a relative contraindication to radiation therapy, urgent intracranial tumor treatment may be necessary, making knowledge of fetal exposure and safety critical.</p><p><strong>Methods: </strong>A comprehensive literature search (PubMed, MEDLINE, Embase, Google Scholar) identified studies published through May 2026 evaluating fetal radiation doses, exposure determinants, dosimetric methodologies, and maternal-fetal outcomes during cranial SRS.</p><p><strong>Results: </strong>Five key studies were identified, including clinical case reports, dosimetric analyses, and phantom models. Gamma Knife demonstrated the lowest exposure, ranging from 1.5 to 3.1 mGy in legacy systems down to 0.49 to 1.28 mGy with modern equipment. CyberKnife reported fetal doses of ~42 mGy. For additional linear accelerator (LINAC) systems, modeling data suggested exposure in the low tens of milligrays due to increased scatter and leakage radiation. Across platforms, fetal dose correlated directly with target distance, treatment duration, internal scatter, machine leakage, and delivery system design. No adverse maternal or fetal outcomes were reported, and all recorded doses remained well below deterministic injury thresholds.</p><p><strong>Conclusions: </strong>Although the ideal fetal radiation dose is zero, available evidence indicates that fetal exposure during SRS remains below accepted thresholds for deterministic effects regardless of SRS treatment modality. Gamma Knife demonstrates the most favorable dosimetric profile due to reduced leakage and dedicated intracranial design. When treatment cannot be delayed, SRS may be considered in selected pregnant patients with individualized planning and multidisciplinary input. Further standardized studies are needed to refine comparative safety across platforms.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076566","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":"Primary Synovial Sarcoma of the Extremities Benefits From Perioperative Radiation and Chemotherapy.","authors":"Riddhi R Patel, Jonathan Feit, Grace Werling, Nora M White, Natalie Perez, Andrew J Bishop, Patrick P Lin, Raul F Valenzuela Perez, Alexander J Lazar, Robert S Benjamin, Shreyaskumar R Patel, Joseph Ludwig, Vinod Ravi, John A Livingston, Maria A Zarzour, Anthony Conley, Robert Hromas, Neeta Somaiah, Dejka M Araujo","doi":"10.1097/COC.0000000000001374","DOIUrl":"https://doi.org/10.1097/COC.0000000000001374","url":null,"abstract":"<p><strong>Objectives: </strong>Synovial sarcoma (SS) mostly arises in the extremities, yet data focused exclusively on primary extremity tumors remain limited. Therefore, we evaluated survival outcomes in patients with localized extremity SS treated at a large sarcoma referral center.</p><p><strong>Methods: </strong>A retrospective chart review of patients diagnosed with primary extremity SS between 2000 and 2020 with localized disease was conducted. Overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) were evaluated.</p><p><strong>Results: </strong>The study included 287 patients (median age: 35 y; follow-up: 5.3 y). Most tumors arose in the lower extremity (75%), and the median tumor size was 6 cm (range: 0.4 to 24). The median OS was 14 years, with a 10-year OS of 57%. Ten-year LRFS was 76%, and 10-year MFS was 51%. Tumors ≥5 cm (aHR: 2.06, 95% CI: 1.12-3.79), and the poorly differentiated subtype (aHR: 1.93, 95% CI: 1.01-3.69) were associated with inferior OS. For LRFS, positive/unknown margins were strongly associated with elevated local-recurrence risk (aHR: 4.09, 95% CI: 2.30-7.28), whereas perioperative radiation therapy significantly improved LRFS (aHR: 0.38, 95% CI: 0.22-0.68). For MFS, in a subgroup of patients with tumors ≥4 cm, perioperative chemotherapy was independently associated with improved MFS (aHR: 0.54, 95% CI: 0.34-0.86).</p><p><strong>Conclusions: </strong>Outcomes in extremity SS are driven by tumor size, subtype, and margin status. Perioperative radiation is recommended as it is associated with superior local control, and perioperative chemotherapy is highly recommended, particularly in patients with a tumor size of ≥4 cm, as it is associated with improved MFS.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041646","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":"Radiation-Induced Proctitis and Hemorrhagic Cystitis: A Review of Management With Comparative Perspectives on Radiation Enteritis and Pneumonitis.","authors":"Veronia Fahmy, Gretchen Hermann, Alec M Block, James S Welsh","doi":"10.1097/COC.0000000000001384","DOIUrl":"https://doi.org/10.1097/COC.0000000000001384","url":null,"abstract":"<p><p>Radiation therapy is a cornerstone in the management of pelvic and thoracic malignancies, but injury to surrounding normal tissue remains a clinically significant source of late morbidity despite advances in treatment delivery. Radiation-induced proctitis and hemorrhagic cystitis are consequential pelvic toxicities, typically presenting months to years after treatment with rectal bleeding, diarrhea, urgency, tenesmus, hematuria, and irritative lower urinary tract symptoms. Beyond the pelvis, radiation enteritis and pneumonitis represent important gastrointestinal and pulmonary complications that may similarly impair quality of life. Although severe toxicity has become less common with contemporary treatment planning, management remains challenging because of the chronic, multifactorial nature of radiation injury and limited high-quality randomized evidence. Treatment is generally individualized according to symptom severity, affected organ, and chronicity. Medical therapies include anti-inflammatory agents, antioxidants, and topical or intravesical treatments aimed at reducing inflammation and promoting mucosal healing. For chronic hemorrhagic disease, endoscopic interventions such as argon plasma coagulation, radiofrequency ablation, laser therapy, and cryotherapy target friable or telangiectatic lesions. In refractory cases, hyperbaric oxygen therapy (HBOT) has emerged as an important salvage modality by promoting angiogenesis, neovascularization, and tissue repair in irradiated tissue. Surgery is reserved for severe, refractory disease or complications, including fistula, obstruction, or life-threatening hemorrhage. This review examines contemporary management of radiation-induced proctitis and hemorrhagic cystitis, with comparative discussion of radiation enteritis and pneumonitis. We highlight organ-specific differences in pathophysiology, presentation, medical and endoscopic therapies, HBOT, and surgical intervention, emphasizing a stepwise approach to management.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018534","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":"Clinical Outcomes of Sacituzumab Govitecan in Breast Cancer: A Systematic Review, Meta-Analysis, and GRADE Assessment of Randomized Evidence.","authors":"Muhammad M Amjad, Maryam Rafique, Syeda F Hussain, Mehroz Mustafa, Tayyaba I Qazi, Saaim Sikandar, Amir H Khan, Hassam S Khan, Qalb E Zainab, Ayesha Zaheer, Hamza Ali, Muhammad A Yousfani, Preety Kumari, Marhaba Noor, Affan M Mian, Alishba Amjad, Muhammad Farhan, Aleena A Malik, Muhammad H Khattak, Bilal W Khan","doi":"10.1097/COC.0000000000001369","DOIUrl":"https://doi.org/10.1097/COC.0000000000001369","url":null,"abstract":"<p><strong>Objectives: </strong>Sacituzumab govitecan (SG), a Trop-2-directed antibody-drug conjugate delivering SN-38, has shown promising activity in advanced breast cancer. However, variability across trials and inclusion of nonrandomized data in prior meta-analyses limit the certainty of its efficacy and safety. This study aimed to evaluate the effectiveness and safety of SG using only randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed/MEDLINE, Embase, Scopus, and Cochrane Library were searched from June 2025 to April 2026. RCTs comparing SG with standard therapies in breast cancer patients were included. Outcomes included objective response rate (ORR), overall survival (OS), progression-free survival (PFS), and grade ≥3 adverse events. Random-effects models were used to calculate pooled risk ratios (RR) and hazard ratios (HR) with 95% CIs. Risk of bias (RoB 2) and GRADE approaches were applied.</p><p><strong>Results: </strong>Six RCTs (n=2508) were included. SG significantly improved ORR (RR=1.62; 95% CI: 1.11-2.37), OS (HR=0.68; 95% CI: 0.54-0.86), and PFS (HR=0.60; 95% CI: 0.51-0.72), although heterogeneity was moderate to high in some analyses. SG was associated with a higher risk of grade ≥3 adverse events (RR=1.12; 95% CI: 1.05-1.20), particularly diarrhea and neutropenia. Subgroup and sensitivity analyses confirmed the robustness of efficacy outcomes.</p><p><strong>Conclusions: </strong>SG provides significant improvements in survival and response outcomes in advanced breast cancer, with a manageable toxicity profile. These findings support its role as an effective treatment option, particularly in pretreated patients, while highlighting the need for further research to optimize its clinical use.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002939","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":"Combination of Immune Checkpoint Inhibitors With Vascular Endothelial Growth Factor-Targeted Agents in Advanced Gastric and Gastroesophageal Adenocarcinoma: A Systematic Review and Meta-analysis.","authors":"Umar Akram, Sameen Tahira, Muhammad Ansab, Muhammad Zubair, Mudasar Nisar, Junaid Huissain, Ahmad Basharat","doi":"10.1097/COC.0000000000001375","DOIUrl":"https://doi.org/10.1097/COC.0000000000001375","url":null,"abstract":"<p><p>Gastric and gastroesophageal junction (G/GEJ) adenocarcinomas remain a major global health burden. Combining antiangiogenic agents with immune checkpoint inhibitors (ICIs) may enhance antitumor activity and improve outcomes. This systematic review and meta-analysis evaluated the efficacy and safety of ICIs plus VEGF-targeted agents in advanced G/GEJ adenocarcinoma. A comprehensive search across multiple databases was conducted till March 2026. Original studies evaluating ICIs plus VEGF-targeted agents in adults with advanced, unresectable, or metastatic G/GEJ adenocarcinoma and reporting overall response rate (ORR) were included. Proportions with 95% CIs were pooled. Twenty-six studies involving 1354 patients were included. Camrelizumab, pembrolizumab, and nivolumab were the most commonly used ICIs, while apatinib was the most frequently used VEGF-targeted agent. The pooled ORR was 33% (95% CI, 24%-44%) and the disease control rate (DCR) was 79% (95% CI, 72%-85%). Stable disease and progressive disease rates were 42% (95% CI, 36%-47%) and 17% (95% CI, 12%-24%), respectively. Pooled progression-free survival rates were 39%, 17%, and 9% at 6, 12, and 18 months, respectively. Corresponding overall survival rates were 72%, 44%, and 24%. Subgroup analysis showed that adding chemotherapy to ICIs plus VEGF-targeted agents improved ORR (56%), DCR (90%), and survival outcomes. The most commonly reported adverse events were neutropenia (38%), and thrombocytopenia (33%). ICIs plus VEGF-targeted agents showed promising activity, particularly when combined with chemotherapy. However, substantial interstudy heterogeneity limits definitive conclusions, highlighting the need for larger, standardized trials to optimize treatment strategies and identify patients most likely to benefit.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002991","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":"The Evolution of Prostate Cancer Presentation in the United States.","authors":"James B Yu, Subharup Guha, Jilcha D Feyisa, Aparna Krishnan, Nirav S Kapadia","doi":"10.1097/COC.0000000000001377","DOIUrl":"https://doi.org/10.1097/COC.0000000000001377","url":null,"abstract":"<p><strong>Objectives: </strong>As for other cancers, there may have been changes to prostate cancer presentation in terms of aggressiveness and extent of disease.</p><p><strong>Methods: </strong>Patients with prostate adenocarcinoma from 2004 to 2022 in the National Cancer Database (NCDB) and 2013 to 2018 in the Surveillance, Epidemiology, and End Results (SEER)-Decipher linked database were evaluated. We estimated age-adjusted incidence of elevated PSA (>10), high-grade prostate cancer (Gleason score of 4+4 and higher), metastatic prostate cancer, and trend in recorded Decipher GC score.</p><p><strong>Results: </strong>The age adjusted proportion of patients who presented with a PSA >10 ng/dL declined from 2002 to 2009 and then rose. The proportion of patients who presented with high-grade cancer was stable from 2004 to 2008, increased from 2008 to 2015, and stabilized from 2015 to 2022. The proportion presenting with metastatic prostate cancer increased starting around 2007. GC score declined from 2010 to 2013, increased rapidly from 2013 to 2016, and then continued to rise at a slower pace from 2016 to 2018.</p><p><strong>Conclusions: </strong>There has been a nationwide increase in metastatic and aggressive prostate cancer.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972105","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}