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

{"title":"Radiotherapy for the Treatment of Peyronie Disease (Induratio Penis Plastica): An American Radium Society (ARS) Appropriate Use Criteria (AUC).","authors":"Diane C Ling, Sevann Helo, Suzanne Russo, Leo Doumanian, Andrea M Harrow, Samuel Jean-Baptiste, Austin N Kirschner, Bobby Koneru, Christien Kluwe, Neil Newman, Kevin Pearlstein, Yasamin Sharifzadeh, Rahul Tendulkar, Austin Dove","doi":"10.1097/COC.0000000000001378","DOIUrl":"https://doi.org/10.1097/COC.0000000000001378","url":null,"abstract":"<p><strong>Objectives: </strong>To critically analyze the current evidence for the use of radiotherapy in the treatment of Peyronie Disease (PD).</p><p><strong>Methods: </strong>A systematic review of the literature was designed using the Population, Intervention, Comparator, Outcome, Timing and Study Design (PICOTS) framework and was assessed using Cochrane and PRISMA methodology. Eligible studies included prospective and retrospective studies published between January 1, 1970 and June 24, 2026. Clinical variant cases were developed as examples to illustrate practical applications of consensus recommendations. RAND-UCLA consensus methodology (modified Delphi) was used to rate the appropriateness of the treatment options.</p><p><strong>Results: </strong>Evidence to support the use of radiotherapy treatment of PD is limited by poor quality evidence, which is based on older studies, heterogenous patient cohorts, inconsistent radiation dose fractionation schedules, and lack of objective measurable outcomes and long-term follow-up. Data suggests that radiotherapy may result in faster resolution of pain for patients with acute-phase PD; however, this observation does not take into account the possibility that any improvement may be due to the natural disease course as some patients experience spontaneous symptom resolution. Radiotherapy is not useful in the treatment of erectile dysfunction or penile deformity or in chronic-phase PD.</p><p><strong>Conclusions: </strong>Current literature contains insufficient evidence to recommend the routine use of RT for the treatment of PD. RT for treatment of PD should not be considered outside of a clinical trial.</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":"148972025","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":"EGFR Mutation Subtype and Risk of Brain Metastases From Non-Small Cell Lung Cancer in the Osimertinib Era: EGFR Subtype and Brain Metastases in NSCLC.","authors":"Ameya Patel, Victor Lee, Amin H Nassar, So Yeon Kim, Henry S Park","doi":"10.1097/COC.0000000000001376","DOIUrl":"https://doi.org/10.1097/COC.0000000000001376","url":null,"abstract":"<p><strong>Objectives: </strong>In lung adenocarcinoma, EGFR gene mutations are common and targetable by tyrosine kinase inhibitors (TKIs). Many patients develop brain metastases that are challenging to treat with TKIs because of the blood-brain barrier. The EGFR L858R mutation is believed to carry a higher brain metastasis risk than the Exon 19 deletion (Ex19Del). We tested whether this remains true with more modern treatment with osimertinib, a newer brain-penetrant TKI.</p><p><strong>Methods: </strong>We used MSK-CHORD, a clinicogenomic database that applies natural language processing (NLP) to extract treatment and metastasis data from electronic health records. Among 7809 NSCLC cases, we studied 647 patients with EGFR mutations without brain metastasis at diagnosis, treated with either early-generation TKIs or osimertinib. Kaplan-Meier analysis and Cox proportional hazards models were used to evaluate brain-metastasis-free survival (BMFS) with hazard ratios (HR) and 95% CIs.</p><p><strong>Results: </strong>Overall, BMFS was shorter for patients with L858R versus Ex19Del mutations (51.4% vs. 59.7% at 5 y, HR: 1.38 [1.02-1.88], P=0.036). For patients receiving early-generation TKIs (n=249, 38.5%), BMFS was shorter for those with L858R versus Ex19Del mutations (46.2% vs. 64.5% at 5 y, HR: 1.91 [1.20-3.06], P=0.007). For patients on osimertinib (n=398, 61.5%), no significant association was observed between mutation subtype and BMFS (53.4% vs. 53.1%, HR: 1.13 [0.76-1.68], P=0.561).</p><p><strong>Conclusions: </strong>Differences in brain metastasis development between EGFR L858R and Ex19Del mutations appeared to be mitigated among patients undergoing osimertinib compared with early-generation TKIs. NLP models can transform complex medical records into data for studying disease dynamics, representing an important systems bioengineering approach.</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":"148972100","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":"Impact of COVID on National Practice Patterns of Adjuvant Radiation Therapy Completion in Treatment of Glioblastoma.","authors":"Dupre Orr, Evan Becker, Kai Ding, Shearwood McClelland","doi":"10.1097/COC.0000000000001359","DOIUrl":"https://doi.org/10.1097/COC.0000000000001359","url":null,"abstract":"<p><strong>Objective: </strong>External beam radiation therapy (EBRT) remains the standard adjuvant treatment following maximally safe resection of glioblastoma multiforme (GBM). Hypofractionated radiotherapy (HFRT) offers comparable oncologic outcomes to standard fractionated radiotherapy (SFRT) while reducing overall treatment duration. The COVID-19 pandemic accelerated adoption of shorter regimens, yet its impact on national practice patterns and treatment completion has not been fully characterized.</p><p><strong>Methods: </strong>Using the National Cancer Database, GBM patients receiving adjuvant radiotherapy from 2018 to 2022 were identified. SFRT was defined as 1.8 to 2.0 Gy per fraction to 60 to 66 Gy, and HFRT as 2.66 to 2.70 Gy per fraction to 40.05 to 40.5 Gy. Patients were grouped into pre-COVID (2018 to 2019), COVID (2020), and post-COVID (2021 to 2022) cohorts. Rates of HFRT utilization and radiotherapy completion were compared using a χ2 test.</p><p><strong>Results: </strong>Among 43,696 patients, HFRT use increased from 10.1% pre-COVID to 11.9% post-COVID. HFRT demonstrated significantly higher treatment completion rates across all periods (79.3% to 82%) compared with SFRT (33.7% to 37.6%). Overall radiotherapy completion increased from 38.9% to 43.6% across the study period (P<0.0001). Most patients who completed radiotherapy also received chemotherapy (86.5%), were treated at academic centers (52.7%), and had a Charlson/Deyo comorbidity score of 0 (73.8%).</p><p><strong>Conclusion: </strong>Increased HFRT adoption during and after the pandemic was associated with improved treatment adherence, likely reflecting reduced logistical burden and shorter treatment duration. These findings support HFRT as an efficient, patient-centered radiotherapy approach for GBM, particularly in settings where minimizing treatment interruptions is critical. Further research is needed to evaluate long-term outcomes and potential impacts on treatment disparities.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984009","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 Sacituzumab Govitecan for Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCTs).","authors":"Lance G Tolentino, Marharyta Khaustova, Reham Z Alrwaitey, Asiya S Chintala, Debasrita Baidya, Vutukuri Y Kumar, Dalal Abdelrahim, Nnenna S S Ejiogu, Vanshika Bhardwaj, Breman A Peethambar, Muhammad Ayyan","doi":"10.1097/COC.0000000000001365","DOIUrl":"https://doi.org/10.1097/COC.0000000000001365","url":null,"abstract":"<p><strong>Objectives: </strong>Sacituzumab govitecan (SG), a Trop-2-directed antibody-drug conjugate, has demonstrated clinical activity in HER2-negative breast cancer. Our meta-analysis aimed to evaluate the efficacy and safety of SG compared with standard chemotherapy in patients with breast cancer.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search across multiple databases for RCTs comparing SG with standard treatment in patients with breast cancer. The primary outcomes were progression-free survival (PFS) and overall survival (OS). Secondary outcomes included objective response rate (ORR), clinical benefit rate (CBR), disease control measures, and treatment-related adverse events. Hazard ratios (HRs), mean differences (MDs), and risk ratios (RRs) with 95% CIs were pooled using a random-effects model.</p><p><strong>Results: </strong>Six RCTs encompassing 2481 patients were included. SG significantly improved PFS (HR=0.59), OS (HR=0.63), and ORR (RR=1.64) compared with chemotherapy. CBR was also significantly higher with SG (RR=1.89), and the rate of progressive disease was significantly lower (RR=0.62). Overall treatment-related adverse events were similar in both groups (RR=1.05). Neutropenia and diarrhea were significantly more frequent in the SG group.</p><p><strong>Conclusions: </strong>Our meta-analysis shows that sacituzumab govitecan significantly improves PFS, OS, and ORR compared with standard chemotherapy in patients with HER2-negative breast cancer. Although associated with higher rates of neutropenia and diarrhea, its overall safety profile remains manageable. These results reinforce the role of SG as an effective treatment option for both metastatic TNBC and HR+/HER2- breast cancer and support its continued evaluation in earlier treatment settings and combination strategies, including immunotherapy.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921593","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":"Ultra-Hypofractionated Radiotherapy in Breast Cancer Before and After COVID-19.","authors":"Andre A Konski, YoonKyung Chung, Chi-Mei Liu, Elizabeth Y Rula, Gary M Freedman","doi":"10.1097/COC.0000000000001373","DOIUrl":"https://doi.org/10.1097/COC.0000000000001373","url":null,"abstract":"<p><strong>Objectives: </strong>We assess whether the COVID-19 pandemic was associated with increased adoption of ultra-hypofractionated (UH) radiotherapy (RT) in the United States.</p><p><strong>Methods: </strong>A retrospective cohort study of women with early-stage breast cancer across the United States using medical claims of a 5% sample of Fee-for-Service Medicare beneficiaries with newly diagnosed breast cancer treated with lumpectomy and post-surgery radiotherapy between 2018 and 2021. The primary endpoint was the beneficiary's fractionation schedule for the first course of radiotherapy treatment. The schedule was classified as: UH (≤5 fractions), hypofractionated (6 to 10 fractions), moderate (11 to 21 fractions), and conventional (22+ fractions).</p><p><strong>Results: </strong>Among 4086 patients, 2504 (61%) were in the pre-COVID group, and 1582 (39%) were in the post-COVID group. Both groups were similar in age, health status, and geographical location. The UH rate increased 5-fold from 1.7% in the pre-COVID group to 8.4% in the post-COVID group (adj diff=6.8 pp, P<0.0001). Conversely, the conventional RT rate dropped from 23.2% of the pre-COVID to 16.4% of the post-COVID group (adj diff=6.8 pp, P<0.0001).</p><p><strong>Conclusions: </strong>A significant increase in 5-fraction UH and a decrease in conventional RT treatment were observed among Medicare breast cancer patients in the 18 months following the COVID-19 pandemic.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921731","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":"Neoadjuvant Adaptive Pazopanib With Concurrent Fixed-Dose Radiation in Localized Soft-Tissue Sarcoma.","authors":"Rohit Rao, Felicia Tejawinata, Malena Johnson, Pingfu Fu, Ankit Mangla","doi":"10.1097/COC.0000000000001368","DOIUrl":"https://doi.org/10.1097/COC.0000000000001368","url":null,"abstract":"<p><strong>Objectives: </strong>There is a critical need to improve the pathologic outcomes for patients with localized resectable soft-tissue sarcoma (LR-STS) receiving preoperative radiation therapy (RT) and surgery. We sought to determine the pathologic outcomes of patients receiving toxicity-adjusted pazopanib concurrently with fixed-dose RT.</p><p><strong>Methods: </strong>We performed a retrospective single-institution study of patients with LR-STS receiving preoperative RT and pazopanib. Patients received pazopanib, adjusted between daily dosing of 200 and 800 mg depending on tolerance, along with a fixed dose of preoperative RT (50 Gy in 25 fractions). Outcomes included pnCR (≤5% viable tumor [VT] following resection), mPR (≤10% VT), pPR (10% to 50% VT), radiologic response, adverse events, and distant metastasis-free survival (DMFS).</p><p><strong>Results: </strong>Fourteen patients with LR-STS were included. Five patients (35.7%) had pnCR, 3 patients (21.4%) had mPR, and 6 patients had pPR. The median DMFS was 6 months (IQR: 19). Nine patients completed the full course of pazopanib at 800 mg with preoperative RT and recorded a pnCR rate of 44.5% (n=4) and mPR rate of 22.3% (n=2). Three patients (33.4%) recorded a pPR. Five patients received pazopanib between 200 and 600 mg with preoperative RT and had a pnCR of 20% and mPR of 20%. Median DMFS was 14 months (IQR: 24). Grade 3 treatment-related hypertension was noted in 3 patients, and 1 patient had wound dehiscence.</p><p><strong>Conclusions: </strong>Concurrent administration of pazopanib with fixed-dose RT increases the likelihood of pnCR and mPR compared with historical controls. Dose adjustment of pazopanib to prevent toxicity does not affect outcomes.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921577","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 Savolitinib Plus Osimertinib in EGFR-Mutant, MET-Aberrant Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.","authors":"Eshal Amir, Muhammad W Khan, Muhammad S Mannan, Syed M Rayyan, Muhammad A H Khan, Hammad Saif, Hunain Shahbaz, Syed M Hussain, Hamayel Khan, Muhammad Shahzaib, Mueed Iqbal, Ahmed Javed","doi":"10.1097/COC.0000000000001367","DOIUrl":"https://doi.org/10.1097/COC.0000000000001367","url":null,"abstract":"<p><strong>Objectives: </strong>NSCLC is the leading cause of cancer-related mortality. While combined therapy including savolitinib and osimertinib appears promising, there exists a lack of comprehensive pooled evidence regarding its anti-oncological activity.</p><p><p>The objective of this study is to evaluate the efficacy and safety of combined therapy in patients with NSCLC.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in MEDLINE, the Cochrane Central Register of controlled trials, and ClinicalTrials.gov. Randomized controlled trials and prospective single-arm studies evaluating savolitinib combined with osimertinib were included. A random-effects single-arm meta-analysis of proportions was performed using logit transformation and inverse variance weighting, with restricted maximum likelihood (REML) estimation and Knapp-Hartung adjustment. Results were reported with a 95% CI, and heterogeneity was assessed using the I2 statistic. Sensitivity analysis was conducted using the Freeman-Tukey transformation.</p><p><strong>Results: </strong>The primary analysis included 4 post-TKI, MET-selected combination cohorts (SACHI, SAVANNAH, and TATTON Part B; n=338) from 7 reports of 5 trials after de-duplication of overlapping data sets. First-line (FLOWERS) and MET-unselected (Yoh) cohorts were analyzed separately. The pooled objective response rate (ORR) was 53.9% (95% CI: 45.1-62.4), disease control rate (DCR) was 85.2% (79.2-89.8), 6-month progression-free survival (PFS) rate was 59.8%, and grade ≥3 adverse events occurred in 48.8% of patients. ORR estimates were consistent across studies and remained robust across sensitivity and subgroup analyses.</p><p><strong>Conclusions: </strong>Combined therapy shows encouraging results in selected MET, post-TKI NSCLC. However, reliance on single-arm data warrants further randomized controlled trials.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908060","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":"From Correlation to Clinical Translation: The Biological-Grounding×Translational-Readiness Framework for Artificial Intelligence in Non-Small-Cell Lung Cancer.","authors":"Hadeel A Albalawi","doi":"10.1097/COC.0000000000001370","DOIUrl":"https://doi.org/10.1097/COC.0000000000001370","url":null,"abstract":"<p><p>Non-small-cell lung cancer (NSCLC) remains the leading cause of cancer death worldwide, and clinicians now face a rapidly expanding array of artificial intelligence (AI) tools promising earlier detection, better treatment selection, and more precise radiotherapy, yet few have altered what happens at the bedside. The problem is not poor benchmark performance; it is that strong benchmark performance has repeatedly failed to translate into demonstrable patient benefit, because most published NSCLC models are retrospective, single-center, and validated only against metrics that do not track survival, toxicity, or procedural burden. This review argues that 2 orthogonal deficits explain that gap: an absence of biological grounding and an absence of lifecycle validation and introduces the biological-grounding×translational-readiness (BG×TR) matrix, an NSCLC-specific framework that locates any AI model along these 2 axes and identifies the single next study required to advance it toward clinical use. Applying this framework across the NSCLC care continuum, nodule detection, histopathologic and molecular inference, prognostic stratification, radiotherapy planning, immunotherapy response prediction, and disease surveillance, shows that the field's most biologically grounded models are rarely its most clinically validated, and vice versa. Spatial transcriptomics is proposed as a mechanistic ground-truth platform to close this gap. The review closes with a practical, clinician-facing agenda, biologically informed models, federated multi-institutional validation, and prospective adaptive trials, whose success should be measured not by AUROC but by longer, less toxic survival for patients with NSCLC.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907990","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":"Low Dose Radiotherapy for the Treatment of Inflammatory Periarticular Disorders: An American Radium Society (ARS) Appropriate Use Criteria (AUC).","authors":"Austin N Kirschner, Bobby Koneru, Suzanne Russo, Tracy M Paul, Phillip Bennion, Samuel Jean-Baptiste, Christien Kluwe, Diane C Ling, Neil Newman, Kevin Pearlstein, Nick Scarcella, Stephen Schaff, Rebecca Senehi, Yasamin Sharifzadeh, Rahul Tendulkar, Austin Dove","doi":"10.1097/COC.0000000000001371","DOIUrl":"https://doi.org/10.1097/COC.0000000000001371","url":null,"abstract":"<p><strong>Objectives: </strong>To summarize the current evidence for low-dose radiation therapy (LDRT) in the treatment of inflammatory periarticular disorders (PAD) (tendinitis, enthesitis, fasciitides, and bursitis), including patient selection, optimal RT technique, and associated risks.</p><p><strong>Methods: </strong>A systematic literature review was designed using the Population, Intervention, Comparator, Outcome, Timing, and Study Design (PICOTS) framework and was assessed using the Cochrane and PRISMA methodologies. Eligible studies included prospective and retrospective studies published between January 1, 1996, and January 1, 2026. Clinical variant cases were developed as examples to illustrate practical applications of consensus recommendations. RAND-UCLA consensus methodology (modified Delphi) was used to rate the appropriateness of the treatment options.</p><p><strong>Results: </strong>LDRT is considered an appropriate treatment as a second-line treatment of chronic plantar fasciitis refractory to other therapies. LDRT may be an appropriate second-line treatment for other types of chronic, refractory PAD not associated with tendon full-thickness tears. LDRT is not usually appropriate as first-line treatment for early-stage PAD or in cases with complete tendon tears.</p><p><strong>Conclusions: </strong>The level of evidence to support the use of LDRT for the treatment of inflammatory PAD is limited. Based on the available evidence, LDRT may be considered for second-line treatment in appropriately selected patients.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908024","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":"Comparative Analysis of Characteristics and Outcomes of Patients with Early-Onset Versus Average-Onset Small Bowel Neuroendocrine Tumors.","authors":"Matthew T Gao, Rishi R Patel, Jason Semprini, Charles W Shi, Manas Pustake, Tao Xu, Seth J Concors, Michael O'Rorke, Joseph S Dillon, Chandrikha Chandrasekharan, Udhayvir S Grewal","doi":"10.1097/COC.0000000000001372","DOIUrl":"https://doi.org/10.1097/COC.0000000000001372","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of early-onset gastrointestinal malignancies is increasing globally; however, early-onset small bowel neuroendocrine tumors (EO-SBNETs) remain poorly characterized. We evaluated clinical characteristics, treatment patterns, incidence trends, and survival outcomes of EO-SBNETs compared with average-onset SBNETs (AO-SBNETs).</p><p><strong>Methods: </strong>We conducted a retrospective population-based cohort study using the Surveillance, Epidemiology, and End Results (SEER) database (2004 to 2021). Patients with SBNETs were identified using ICD-O-3 histology codes and categorized as early-onset (30 to 49 y) or average-onset (≥50 y). Baseline characteristics were compared using χ2 tests. Overall survival (OS) was estimated using the Kaplan-Meier method and evaluated with multivariable Cox regression models that adjusted for demographic, socioeconomic, clinical, and treatment-related factors. Temporal incidence trends were assessed using linear regression.</p><p><strong>Results: </strong>Among 3713 patients with SBNETs, 925 (25.0%) had EO-SBNETs. EO-SBNETs were more frequently observed in females and racial and ethnic minority populations, including non-Hispanic Black and Hispanic patients (all P<0.05). Stage at diagnosis and treatment patterns, including rates of surgery, lymphadenectomy, chemotherapy, and radiation therapy, were comparable between the groups. Incidence increased significantly over time in both EO-SBNETs and AO-SBNETs (annual increase 14.9% vs. 14.8%, P<0.001), without differences in temporal trends. The median OS was not reached for AO-SBNETs and was 188 months for EO-SBNETs. On multivariable analysis, early-onset disease was independently associated with improved survival (HR=0.50, 95% CI: 0.41-0.60, P<0.001).</p><p><strong>Conclusions: </strong>EO-SBNETs represent a rising and clinically distinct subgroup characterized by similar presentation and treatment but relatively favorable long-term outcomes compared with AO-SBNETs, suggesting potential biological differences warranting further investigation.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908038","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}