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

{"title":"Recent Updates on Pediatric Oncological Emergencies and Their Management.","authors":"Sharan Shanubhogue, Shravani Reddy, Ruksana Sidhique P R, Jagdish P Meena, Aditya K Gupta, Rachna Seth","doi":"10.1097/COC.0000000000001330","DOIUrl":"https://doi.org/10.1097/COC.0000000000001330","url":null,"abstract":"<p><p>Pediatric oncological emergencies are acute, life-threatening complications arising from malignancies or their treatment. Prompt recognition and intervention are essential to prevent significant morbidity and mortality. Pediatric oncological emergencies are categorized as metabolic, structural, hematological, or treatment-related. Structural emergencies include superior mediastinal syndrome, spinal cord compression, and raised intracranial pressure. Metabolic complications such as tumor lysis syndrome (TLS) and hypercalcemia are frequent, with TLS most common in leukemias and high-grade lymphomas. Hematological crises, hyperleukocytosis with leukostasis, and severe cytopenias may result in bleeding or infections. Treatment-related complications like febrile neutropenia and neutropenic enterocolitis (NEC) add further challenges. Effective management requires a multidisciplinary approach that combines early diagnosis, vigilant monitoring, supportive measures, and disease-directed therapy. Recent progress in risk stratification, early warning systems, and intensive supportive care has improved the ability to anticipate and mitigate these crises. Novel diagnostic tools, including point-of-care ultrasonography (POCUS) and laboratory markers, allow for faster identification of high-risk patients, while updated management guidelines provide evidence-based strategies for intervention. This review highlights novel insights and recent updates in the recognition and management of pediatric oncological emergencies.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730622","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":"Racial Disparities in Pancreatic Cancer: A Comprehensive Population-Based Analysis of Survival, Surgical Access, and Prognostic Factors.","authors":"Arkadeep Dhali, Saikat Mandal, Muhammad Asad, Jyotirmoy Biswas, Manideepa Maji","doi":"10.1097/COC.0000000000001328","DOIUrl":"https://doi.org/10.1097/COC.0000000000001328","url":null,"abstract":"<p><strong>Objectives: </strong>Racial disparities in pancreatic cancer outcomes remain incompletely explained. Using a large population-based data set, we quantified racial differences in survival and evaluated mediators, including surgical access, treatment timeliness, and area-level socioeconomic status.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using SEER data. Adults with malignant pancreatic neoplasms were included; patients with unknown race or missing survival data were excluded. Race was classified as White, Black, or Other. Coprimary outcomes were overall survival (OS) and cancer-specific survival (CSS). Analyses included Kaplan-Meier survival analysis, multivariable Cox regression, and propensity-score matching.</p><p><strong>Results: </strong>The cohort comprised 162,783 patients: White 130,374 (80.1%), Black 18,858 (11.6%), and Other 13,551 (8.3%). Median OS was 6, 5, and 6 months; 5-year OS was 8.8%, 8.2%, and 10.7%, respectively (P<0.001). The Black race was associated with worse OS (HR 1.097; 95% CI: 1.079-1.115) and CSS (HR 1.064; 95% CI: 1.046-1.083) versus White. After matching (18,858 pairs), the Black race remained associated with worse OS (HR 1.158; 95% CI: 1.131-1.185) and CSS (HR 1.121; 95% CI: 1.094-1.148). Black patients had lower surgical receipt (13.9% vs. 16.6%), lower adjusted odds of surgery (OR 0.717; 95% CI: 0.684-0.752), and longer time-to treatment (37.0 vs. 33.2 d). Surgery explained 26.3% of the disparity, and income explained 14.2%; 56.1% remained unexplained.</p><p><strong>Conclusions: </strong>Black patients with pancreatic cancer had worse OS and CSS than White patients, only partly explained by lower surgical receipt and socioeconomic differences.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718486","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":"Divergent Biliary Tract Cancer Trajectories: ARIMA Forecasting Reveals Alarming 2030 Projections With Distinct Gender-Stratified Epidemiology in Asian Countries.","authors":"Saikat Mandal, Manideepa Maji, Arkadeep Dhali","doi":"10.1097/COC.0000000000001322","DOIUrl":"https://doi.org/10.1097/COC.0000000000001322","url":null,"abstract":"<p><p>Cholangiocarcinoma (CCA) and gallbladder cancer demonstrate profoundly divergent epidemiological trajectories across 2 decades (2003 to 2017), demanding urgent investigation. Population-based registry data from the cancer incidence in 5 continents project, spanning 3 periods (2003 to 2007, 2008 to 2012, and 2013 to 2017) across 12 Asian countries, reveal an exponential acceleration in CCA, with striking gender-specific patterns indicating distinct aetiological mechanisms. Between 2003 and 2017, CCA incidence increased 136.3% while gallbladder cancer rose only 7.7%, which is a 128.6 percentage-point differential. Geographic variation was extreme: Iran and Kuwait demonstrated significant CCA escalation; Israel showed a 234.7% CCA increase, whereas gallbladder cancer declined by 35.6%. In contrast, Japan, Korea, and China exhibited substantial CCA growth (126.8% to 144.0%), whereas gallbladder cancer remained stable. Endemic liver-fluke regions showed attenuated divergence (Thailand: 60.1% CCA vs. 26.6% gallbladder, 33.5 percentage-point gap). ARIMA modelling reveals alarming 2030 projections: Republic of Korea, 3.38 per 100,000 (95% CI: 0.39-6.36; 193% increase); Japan, 2.19; China, 1.09; Thailand, 2.02. Gallbladder cancer projects relative stability. Gender-stratified analysis reveals striking divergence: CCA demonstrates pronounced male predominance in nonendemic regions (Japan: 1.62; Korea: 1.68; China: 1.43 male-to-female ratios), suggesting male-predominant behavioural and metabolic risk factors, including smoking, alcohol consumption, and metabolic dysfunction-associated fatty liver disease (MAFLD). Conversely, gallbladder cancer demonstrates universal female predominance (0.38 to 0.75 ratios) reflecting cholelithiasis epidemiology. This profound gender divergence provides compelling evidence for independent aetiological mechanisms. These findings mandate urgent investigation of emerging nonparasitic CCA risk factors in developed Asian economies, prospective studies examining smoking, alcohol, MAFLD, and metabolic syndrome, and enhanced surveillance infrastructure.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724357","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":"A Pilot Feasibility and Acceptability Study of a Structured Nurse-Led Family Caregiver Program Among Caregivers of Hospitalized Cancer Patients.","authors":"James Raj K, Preeti R Bhupali","doi":"10.1097/COC.0000000000001326","DOIUrl":"https://doi.org/10.1097/COC.0000000000001326","url":null,"abstract":"<p><strong>Introduction: </strong>Family caregivers of hospitalized cancer patients play a vital role in supporting patient care, but often experience considerable burden, stress, and reduced quality of life due to limited preparation and a lack of structured professional support.</p><p><strong>Objectives: </strong>To assess the feasibility and acceptability of a structured nurse-led family caregiver program and to explore preliminary trends in caregiver burden, stress, and quality of life.</p><p><strong>Methods: </strong>A pre-experimental 1-group pretest-posttest design was used. Fifteen family caregivers of hospitalized cancer patients were recruited from a tertiary care hospital in Bangalore using purposive sampling. Standardized tools, including the Zarit Burden Interview, DASS-21 stress subscale and WHOQOL-BREF were administered before and after the intervention. The nurse-led caregiver program was delivered through face-to-face sessions during hospitalization. Descriptive statistics were used for data analysis.</p><p><strong>Results: </strong>The intervention was feasible to deliver within routine hospital schedules, and all participants completed the study. Posttest scores showed a reduction in caregiver burden and stress levels, along with an improvement in quality-of-life scores.</p><p><strong>Conclusions: </strong>The structured nurse-led family caregiver program was feasible and acceptable in the hospital setting. The findings support conducting a larger study to evaluate the effectiveness of the intervention.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717445","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":"National Trends and Disparities in Mortality From Early-Onset Pancreatic Cancer in the United States, 1999 to 2020.","authors":"Albert E Orhin, Natalie A Y Akoto, Boniface Mensah, Aymen Naeem, Kwasi A Ofori, Oscar Burke, Ekua Yeboah","doi":"10.1097/COC.0000000000001329","DOIUrl":"https://doi.org/10.1097/COC.0000000000001329","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of early-onset pancreatic cancer (EOPC) is rising among younger adults in the United States, yet it remains unclear whether this trend has affected population-level mortality. We evaluated national trends in EOPC-related mortality and examined disparities by sex, race, ethnicity, and urban-rural residence.</p><p><strong>Methods: </strong>Using the CDC WONDER database, we identified pancreatic cancer-related deaths among adults aged 25 to 44 years from 1999 to 2020. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 US standard population, and temporal trends were assessed using Joinpoint regression (AAPC and APC).</p><p><strong>Results: </strong>Among 12,166 EOPC-related deaths, overall mortality declined significantly (AAPC: -1.4%; 95% CI: -2.01 to -0.81). Men had higher mortality than women (AAMR 0.9 vs. 0.5 per 100,000), though women experienced a steeper decline. Non-Hispanic Black individuals carried the highest mortality burden (AAMR 1.0 per 100,000) and showed no significant improvement over the study period (AAPC: -0.66%; P=0.2), with a nonsignificant upward trend after 2013 (APC +1.94%) in contrast to significant declines among non-Hispanic White individuals. Urban populations showed significant mortality reductions, and rural trends remained stable.</p><p><strong>Conclusions: </strong>EOPC mortality declined significantly over 2 decades, likely reflecting broader uptake of multimodal therapy among younger patients, but improvements were not evenly distributed, with persistent disparities among non-Hispanic Black individuals, males, and rural populations. These findings highlight ongoing inequities in pancreatic cancer outcomes and the need for targeted public health and research efforts to address disparities in early-onset disease.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678276","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":"Trends in Pancreatic Neuroendocrine Tumor-Related Mortality in the United States, 1999-2023, With Forecasts to 2033.","authors":"Arkadeep Dhali, Rick Maity, Ali Shan Hafeez, Muhammad Usman, Harsh Purohit, Jyotirmoy Biswas, Asad Zaman, Abdul Rafae Faisal, Manideepa Maji, Saikat Mandal","doi":"10.1097/COC.0000000000001327","DOIUrl":"https://doi.org/10.1097/COC.0000000000001327","url":null,"abstract":"<p><strong>Objectives: </strong>Pancreatic neuroendocrine tumors (pNETs) are uncommon neoplasms, and contemporary US population-level mortality evaluations for malignant endocrine neoplasms of the pancreas are limited. This study assessed long-term mortality trends and forecast future trajectories for malignant neoplasms of the endocrine pancreas using US death-certificate data.</p><p><strong>Methods: </strong>In this study, CDC WONDER Multiple Cause of Death public-use death-certificate data from the USA were analyzed for 1999 to 2023. Deaths were identified using ICD-10 code C25.4 when listed anywhere on the death certificate. Age-adjusted mortality rates (AAMRs) per 1,000,000 population were standardized to the 2000 US standard population. Joinpoint Regression Program estimated annual percent change (APC) using Monte Carlo permutation testing (2-tailed, P<0.05). ARIMA models generated 10-year forecasts.</p><p><strong>Results: </strong>From 1999 to 2023, 1912 deaths were attributed to pNETs (894 women and 1018 men). Overall, AAMR declined significantly from 2004 to 2019 (APC -12.38; 95% CI: -25.46 to -11.25). Female AAMR decreased significantly from 1999 to 2019 (APC -11.08; 95% CI: -13.30 to -10.09). Male AAMR decreased significantly from 2004 to 2019 (APC -13.27; 95% CI: -19.54 to -11.85) and increased significantly in 2019 to 2023 (APC 18.94; 95% CI: 0.56 to 72.06). The highest deaths occurred in California (181) and Texas (118). Forecasted overall AAMR in 2033 was 0.12 per 1,000,000 (95% prediction interval -0.65 to 0.90; lower bounds truncated at 0).</p><p><strong>Conclusions: </strong>The United States pNET-related mortality declined significantly from 2004 to 2019, with an upturn after 2019 (significant in males). Forecasts suggest low mortality through 2033, but with substantial uncertainty and limitations in death-certificate coding.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678341","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":"Local Control Outcomes of Patients With Brain Metastases From Small Cell Lung Cancer Treated With Stereotactic Radiosurgery.","authors":"Anirudh Bommireddy, Lilyana Angelov, John H Suh, Erin S Murphy, Praveen Pendyala, Ehsan H Balagamwala, Timothy A Chan, Jennifer S Yu, Gene H Barnett, Alireza M Mohammadi, Glen H J Stevens, Matthew M Grabowski, Samuel T Chao","doi":"10.1097/COC.0000000000001325","DOIUrl":"https://doi.org/10.1097/COC.0000000000001325","url":null,"abstract":"<p><strong>Objectives: </strong>Stereotactic radiosurgery (SRS) is increasingly used for brain metastases (BM) from small cell lung cancer (SCLC), either after whole brain radiation therapy (WBRT) or upfront. We report institutional outcomes for patients with SCLC treated with SRS for BM.</p><p><strong>Methods: </strong>Patients who underwent single-fraction SRS for intact BM from 2002 to 2025 were identified from a single-institution. The primary endpoint was local control (LC); secondary endpoints were freedom from distant brain failure (FFDBF) and overall survival (OS).</p><p><strong>Results: </strong>The study included 135 patients with 429 BM. Median follow-up was 6 months. Median prescription dose was 22 Gy (IQR: 20 to 24 Gy). Eighty-five BM with median size 2.6 cm (IQR: 2.1 to 3.4 cm) received <20 Gy. Of these, 22 (26%) BM underwent staged SRS to 30 Gy. Twenty-six patients with 63 BM (15%) underwent upfront SRS, 43 patients with 105 BM (24%) had prior prophylactic cranial irradiation (PCI), 64 patients with 249 BM (58%) had prior WBRT, and 2 patients with 12 BM (3%) had both PCI and WBRT. Thirty-two patients with 112 BM (26%) received concurrent systemic therapy. One-year LC, FFDBF, and OS were 89%, 21%, and 26%, respectively. For BM receiving ≥20 Gy, 30 Gy (staged), and <20 Gy, 1-year LC was 92%, 87%, and 68%, respectively. Prescription dose ≥20 Gy or staged SRS (P=0.01) was associated with improved LC, while prior PCI/WBRT and concurrent systemic therapy were not.</p><p><strong>Conclusions: </strong>SRS provides high LC for SCLC BM, including post-PCI/WBRT recurrences. OS remains limited by systemic progression. Prescription dose ≥20 Gy or staged SRS should be considered when feasible.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678308","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":"Standard-of-Care Treatment of Glioblastoma: Out-of-Pocket Cost Modeling of Adjuvant Radiation Therapy Duration Across Current-Year Medicaid and Medicare Plans.","authors":"Ena C Oboh, Victoria S Wu, Martha Khlopin, Shearwood McClelland","doi":"10.1097/COC.0000000000001324","DOIUrl":"https://doi.org/10.1097/COC.0000000000001324","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal radiotherapy (RT) duration for older adults with glioblastoma (GBM)-6 weeks (60 Gy/30 fractions) versus 3 weeks (40 Gy/15 fractions)-remains debated. Level 1 evidence demonstrates no significant difference in survival between these regimens. Limited data exist on how insurance coverage influences patient out-of-pocket (OOP) costs across treatment lengths. This study quantifies OOP expenses by insurance plan to improve cost transparency and inform decision-making.</p><p><strong>Methods: </strong>Using NCCN guidelines, standard treatment protocols were defined, including surgical resection, adjuvant RT, and concurrent and adjuvant temozolomide for 12 cycles. A 2-year cost model was constructed for a Medicare- and/or Medicaid-eligible patient aged 65 years or older with GBM. Aggregate OOP costs were calculated by summing deductibles, copayments, and coinsurance under Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D.</p><p><strong>Results: </strong>Treatment charges included neurosurgery, neuro-oncology, and radiation oncology consultations; follow-up; diagnostic imaging; RT planning and delivery; systemic therapy; laboratory monitoring; and tumor-treating fields. Under Original Medicare, beneficiaries pay 20% of Medicare Part B charges after the deductible, with no annual OOP cap, and prescription drug costs under Part D. OOP costs were higher for 30-fraction RT compared with 15-fraction RT. Medigap Plan G beneficiaries incurred OOP costs of $2332.04 and $2319.42 for 30- and 15-fraction RT, respectively. Medicaid fully covered all approved services.</p><p><strong>Conclusions: </strong>Three-week RT for GBM reduces patient OOP costs by ∼5% compared with 6-week RT. Incorporating financial considerations into treatment discussions may help reduce the economic burden of GBM care and support shared decision-making.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678297","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":"Comprehensive Analysis of Conditional Survival in Radiation-treated Patients With Gynecologic Malignancies Using the SEER Database.","authors":"Kuo Zhang, Jimmy S Patel, Ashley Schlafstein, Clifton Fuller, Jill Remick, Tony T Eng","doi":"10.1097/COC.0000000000001254","DOIUrl":"10.1097/COC.0000000000001254","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we report conditional survival rate for gynecologic malignancies using Surveillance, Epidemiology, and End Results (SEER) database for patients who have received treatment with radiation therapy.</p><p><strong>Methods: </strong>Utilizing the SEER 22 database and SEER*Stat 8.4.3, regional gynecologic malignancies (cervix uteri, corpus uteri, vagina, vulva) treated with external beam radiation therapy (EBRT), brachytherapy, or both, were identified between 2000 and 2020. 5-year CS was calculated annually for each type of cancer treated with different types of therapies up to 5 years post diagnosis. The timeframes for percentages of survived patients are 12 to 72, 24 to 84, 36 to 96, 48 to 108, and 60 to 120 months, which gives the percentage of patients surviving up to 5 years at 1 to 5 years from when patients received diagnosis.</p><p><strong>Results: </strong>There were 59,441 patients who received radiation in the initial cohort. This was further subdivided into 24,073 (40%) patients who received EBRT only, 18,528 (31%) who received brachytherapy only, and 16,840 (28%) who received combined EBRT and brachytherapy. 5-year CS was calculated each year after initial diagnosis up to 5 years after. For all types of cancers that were analyzed, the 5-year CS increased as the year after diagnosis increased.</p><p><strong>Conclusions: </strong>CS is an effective method to prognosticate patients over time. In our cohort of patients with gynecologic malignancies treated with radiation, the overall trends for 5-year CS were similar across any treatment modality. These findings may help elucidate statistics for survivorship care and may help develop evidence-based policies.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"171-175"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994164","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 and Safety of Antibody Drug Conjugates in Previously Treated Hormone Receptor Positive HER2 Negative (or Low) Metastatic Breast Cancer-A Systematic Review and Meta-Analysis.","authors":"Yijin Huang, Dingde Ye, Fazal Hassan, Mary J Hart, Qingxiang Xu","doi":"10.1097/COC.0000000000001259","DOIUrl":"10.1097/COC.0000000000001259","url":null,"abstract":"<p><strong>Objectives: </strong>Antibody-drug conjugates (ADCs) have improved outcomes for metastatic hormone receptor-positive (HR+) and human epidermal growth factor receptor 2 (HER2)-negative or low breast cancer; however, direct efficacy comparisons are limited. We compared trastuzumab deruxtecan (T-DXd), sacituzumab govitecan (SG), and datopotamab deruxtecan (Dato-DXd) in chemotherapy-pretreated HR+/HER2-negative or low metastatic breast cancers.</p><p><strong>Methods: </strong>This meta-analysis conducted a comprehensive search of the Embase and Ovid Medline databases up to July 2025. Efficacy endpoints were progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Hazard and odds ratios were calculated for the relevant outcomes. Safety was assessed using grade ≥3 treatment-related adverse events (TRAEs).</p><p><strong>Results: </strong>Four randomized controlled trials were included. All 3 ADCs significantly improved PFS ( P <0.00001) and ORR ( P =0.008) compared with chemotherapy. Both T-DXd and SG demonstrated significant OS benefits ( P =0.002), whereas Dato-DXd did not ( P =0.94). For SG, OS benefit was observed primarily in later (≥3) lines ( P =0.03). Among them, T-DXd demonstrated the most favorable outcomes across PFS, OS, and ORR, particularly in earlier lines. Grade ≥3 treatment-related adverse events (TRAEs) were most frequent with SG (60.2%), followed by T-DXd (52.6%) and Dato-DXd (20.8%). Neutropenia was the most common grade ≥3 TRAE with SG and T-DXd, while stomatitis was most common with Dato-DXd.</p><p><strong>Conclusions: </strong>T-DXd demonstrated better efficacy in pretreated HR+/HER2-low metastatic breast cancer (MBC), especially in earlier lines. SG showed significant OS benefit primarily in later lines. Dato-DXd showed no OS benefit but had the most favorable safety profile.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"188-195"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287689","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}