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

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Cardiovascular Risk Profile of Nivolumab Anti-cancer Therapy: A Review of Current Literature. 纳武单抗抗癌治疗的心血管风险概况:当前文献综述
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-05-01 Epub Date: 2025-02-26 DOI: 10.1097/COC.0000000000001166
Zaheer Qureshi, Zaofashan Zaheer, Zoha Asghar, Muhammad Bakhtiar, Eeshal Fatima, Faryal Altaf
{"title":"Cardiovascular Risk Profile of Nivolumab Anti-cancer Therapy: A Review of Current Literature.","authors":"Zaheer Qureshi, Zaofashan Zaheer, Zoha Asghar, Muhammad Bakhtiar, Eeshal Fatima, Faryal Altaf","doi":"10.1097/COC.0000000000001166","DOIUrl":"10.1097/COC.0000000000001166","url":null,"abstract":"<p><strong>Objectives: </strong>Immune checkpoint inhibitors (ICI) upregulate host antitumor immunity, proving efficacy across diverse tumor types. Currently approved ICI treatment primarily targets the programmed cell death receptor 1 (PD-1) and its ligand PD-L1, and cytotoxic T lymphocyte-antigen 4 (CTLA-4). Nivolumab is a monoclonal antibody that targets the human PD-1 receptor and is an entirely human immunoglobulin G4 (IgG4), approved by the FDA for various cancers like advanced melanoma, metastatic renal cell carcinoma, Hodgkin lymphoma, and advanced lung carcinoma. This review will summarise and discuss the recent literature on cardiotoxicity associated with nivolumab therapy.</p><p><strong>Methods: </strong>We searched online databases like PubMed, Scopus, Google Scholar, and Embase for articles related to Nivolumab.</p><p><strong>Results: </strong>Cardiotoxicity with ICI use is most commonly represented as myocarditis. Patients present with complaints of shortness of breath, palpitations, edema, and fatigue. Takotsubo cardiomyopathy, or broken heart syndrome, is characterized by systolic dysfunction of the left ventricle, mimicking a myocardial infarction but without associated coronary ischemia and with minimal elevation of cardiac enzymes. In the CHECKMATE-037 trial, ventricular arrhythmias occurred in <10% of those who received nivolumab. In a retrospective analysis of patients treated with ICI (predominantly nivolumab monotherapy) for lung cancer, 11% of the patients developed major adverse cardiac events, including myocarditis, non-ST-segment elevated myocardial infarction, supraventricular tachycardia, and pericardial disorders.</p><p><strong>Conclusion: </strong>Close collaboration between cardiology and oncology specialists is crucial for early detection and effective management of cardiac complications, enhancing the safety of nivolumab anticancer therapy.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"235-241"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505843","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
Meta-analysis of Therapeutic Approaches in Acute Myeloid Leukemia: Unveiling Trends and Predictors of Treatment Response. 急性髓系白血病治疗方法的荟萃分析:揭示治疗反应的趋势和预测因素。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-05-01 Epub Date: 2025-03-31 DOI: 10.1097/COC.0000000000001169
Zaheer Qureshi, Abdur Jamil, Faryal Altaf, Rimsha Siddique
{"title":"Meta-analysis of Therapeutic Approaches in Acute Myeloid Leukemia: Unveiling Trends and Predictors of Treatment Response.","authors":"Zaheer Qureshi, Abdur Jamil, Faryal Altaf, Rimsha Siddique","doi":"10.1097/COC.0000000000001169","DOIUrl":"10.1097/COC.0000000000001169","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate emerging trends and predictors for optimizing treatment strategies for acute myeloid leukemia (AML).</p><p><strong>Method: </strong>A literature search was conducted on PubMed, Embase, Web of Science, and Google Scholar databases. Bias assessment was conducted using Cochrane's risk of bias tool, while statistical analyses were performed using Review Manager and Comprehensive Meta-Analysis software.</p><p><strong>Results: </strong>We included 44 studies and the pooled results showed that high-dose cytarabine (HDAC) in induction therapy significantly improved the complete remission (CR) rate than standard-dose cytarabine (SDAC) in younger adults but not older adults (OR: 1.29, 95% CI: 1.12-1.49, P =0.0004 and OR: 1.02, 95% CI: 0.80-1.29, P =0.87, respectively). In consolidation therapy, HDAC showed a significant benefit in event-free survival (EFS) over SDAC (RR: 1.30, 95% CI: 1.04-1.62, P =0.02). The pooled analysis also revealed that idarubicin (IDR) was associated with improved CR rates than daunorubicin (DNR) (OR: 1.34, 95% CI: 1.02-1.76, P =0.04). However, the results do not substantiate the claim that IDR is better than mitoxantrone (MTZ) or that DNR is superior to MTZ in inducing CR (OR: 0.88, 95% CI: 0.72-1.08, P =0.22 and OR: 0.85, 95% CI: 0.72-1.01, P =0.06, respectively). The evidence has also shown that the pooled composite complete response (CRc) rates for FLT3 inhibitors such as sorafenib, gilteritinib, and quizartinib were 56%, 31%, and 36%, respectively. The pooled results further showed that the overall CRc for patients receiving IDH inhibitors and immune checkpoint inhibitors were 49.6% (95% CI: 37-63) and 26% (95% CI: 18.7-35), respectively.</p><p><strong>Conclusion: </strong>Chemotherapy, targeted therapy, and immunotherapy are valuable treatment options for AML patients. However, the efficacy of these AML treatments may vary depending on AML status and patient characteristics such as age and cytogenetic risk.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"242-256"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755684","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
Impact of Consensus Guidelines, Clinical Trials, and COVID-19 on Fractionation Practices for Node-negative Intact Breast Cancer. 共识指南、临床试验和COVID-19对淋巴结阴性完整乳腺癌分离实践的影响
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-05-01 Epub Date: 2025-02-04 DOI: 10.1097/COC.0000000000001167
Jessica Cruttenden, Jonathan Grant, Jaden Evans, George Cannon, David K Gaffney, Matthew Poppe, Lindsay M Burt, Vilija Avizonis, Dustin Boothe
{"title":"Impact of Consensus Guidelines, Clinical Trials, and COVID-19 on Fractionation Practices for Node-negative Intact Breast Cancer.","authors":"Jessica Cruttenden, Jonathan Grant, Jaden Evans, George Cannon, David K Gaffney, Matthew Poppe, Lindsay M Burt, Vilija Avizonis, Dustin Boothe","doi":"10.1097/COC.0000000000001167","DOIUrl":"10.1097/COC.0000000000001167","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether hypofractionated radiotherapy (HF-RT) in node-negative intact breast cancer significantly increased after guideline updates, trial publications, and COVID-19.</p><p><strong>Methods: </strong>Patients with node-negative breast cancer undergoing lumpectomy and adjuvant RT were identified in the National Cancer Database. Receiving ≥25 and <50 Gy in 5-20 fractions defined HF-RT. Receiving 50 to 66 Gy in >20 fractions defined conventional RT (CF-RT). Patient characteristics were compared with X 2 testing. Joinpoint analysis identified when fractionation significantly changed. Variables associated with HF-RT were identified by univariate and multivariate (MVA) logistic regression. Two-sided P -value <0.05 was significant.</p><p><strong>Results: </strong>Patients meeting criteria totaled 236,336; 54.8% received CF-RT and 45.2% HF-RT. HF-RT and 5-fraction RT significantly increased after 2015 and 2019, respectively ( P <0.05). On MVA, HF-RT was positively associated with: age older than or equal to 65 years (OR 2.14, P <0.001); private insurance (OR 1.27, P =0.03); treatment in Midwest (OR 1.66, P <0.001) or Western United States (US) (OR 3.77, P <0.001); distance ≥50 miles (OR 1.16, P =0.001); later year of diagnosis (OR 1.44, P <0.001); and partial breast irradiation (OR 2.08, P <0.001). HF-RT was negatively associated with: community (OR 0.49, P <0.001) or integrated network (0.55, P <0.001) centers; grade 2 (OR 0.83, P <0.001) or 3 (OR 0.49, P <0.001), hormone receptor negative (OR 0.66, P <0.001), and HER2+ (OR 0.74, P <0.001) disease; positive surgical margins (OR 0.61, P <0.001); and presence of lympho-vascular invasion (OR 0.86, P <0.001).</p><p><strong>Conclusions: </strong>HF-RT in node-negative intact breast cancer increased after 2015, coinciding with US and European guideline updates. Five-fraction RT increased after 2019, coinciding with COVID-19 and FAST-Forward trial results.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"222-229"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124051","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
Evaluation of Control Arm Quality in Recent Radiation Oncology Randomized Clinical Trials. 近期放射肿瘤学随机临床试验对照组质量评价。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-05-01 Epub Date: 2025-02-10 DOI: 10.1097/COC.0000000000001168
Ifeanyi O Ekpunobi, Laura E Flores, Reshma Jagsi, Shearwood McClelland
{"title":"Evaluation of Control Arm Quality in Recent Radiation Oncology Randomized Clinical Trials.","authors":"Ifeanyi O Ekpunobi, Laura E Flores, Reshma Jagsi, Shearwood McClelland","doi":"10.1097/COC.0000000000001168","DOIUrl":"10.1097/COC.0000000000001168","url":null,"abstract":"<p><strong>Background: </strong>For randomized controlled trials (RCTs) to provide the highest levels of evidence for clinical practice, it is ethically imperative for patients assigned to the control arm to receive standard-of-care treatment. Oncologic medical trials investigating new systemic agents have demonstrated a high proportion of RCTs with inadequate control arms. It is unknown whether this finding is prevalent in oncologic trials investigating radiation therapy (RT) for cancer.</p><p><strong>Methods: </strong>ClinicalTrials.gov was queried for registered clinical trials investigating RT in patients with cancer from 2013 to 2023. Each control arm was analyzed, with the standard of care determined by National Comprehensive Cancer Center Network (NCCN) guidelines at the time of initial trial posting.</p><p><strong>Results: </strong>Five hundred eight interventional studies with results registered were included, of which 12 met inclusion criteria for final analysis. Two trials each investigated RT usage in central nervous system, prostate, head and neck, and breast disease sites, and 1 each for lung, hepatobiliary, rectal, and bone disease sites. Most trials were industry-funded (83%); 75% of studies took place in the United States. Hundred percent of trials had an adequate control arm per the corresponding NCCN guidelines.</p><p><strong>Conclusion: </strong>All recently completed oncologic RCTs investigating RT for cancer involved an adequate control arm. This finding contrasts with the high proportion of inadequate control arms in medical oncology trials. These findings suggest that adequate control arm treatments are feasible to achieve in trial design, emphasizing both the need for continued focus on improving the quality of ethical oncologic research trials and a possible subspecialty that may serve as an exemplar.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"230-234"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383984","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
Evaluating the Safety and Efficacy of Adding Liver-Directed Radiation Therapy to Atezolizumab and Bevacizumab in Advanced Hepatocellular Carcinoma: A Single-Center Retrospective Cohort Analysis. 评估Atezolizumab和Bevacizumab加肝定向放疗治疗晚期肝细胞癌的安全性和有效性:单中心回顾性队列分析
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-04-30 DOI: 10.1097/COC.0000000000001214
Timothy J Brown, Uri Amit, Rohi Gheewala, Edgar Ben-Josef, Thomas B Karasic
{"title":"Evaluating the Safety and Efficacy of Adding Liver-Directed Radiation Therapy to Atezolizumab and Bevacizumab in Advanced Hepatocellular Carcinoma: A Single-Center Retrospective Cohort Analysis.","authors":"Timothy J Brown, Uri Amit, Rohi Gheewala, Edgar Ben-Josef, Thomas B Karasic","doi":"10.1097/COC.0000000000001214","DOIUrl":"https://doi.org/10.1097/COC.0000000000001214","url":null,"abstract":"<p><strong>Objectives: </strong>Radiation therapy (RT) may potentiate an antitumor immune response when combined with immunotherapy in advanced hepatocellular carcinoma (HCC) but carries the potential risk of bowel toxicity and impaired liver function. We describe our single-center experience of adding liver-directed RT to atezolizumab and bevacizumab (A/B) in patients with advanced HCC.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study of patients with HCC naive to systemic therapy who received A/B with or without liver-directed RT from January 1, 2020 until May 1, 2023. We assessed safety outcomes, the real-world response rate (rwRR), overall survival (OS), and time-to-progression (TTP) from initiation of A/B. Time-to-event outcomes were analyzed by Kaplan-Meier methodology. Given anticipated baseline imbalances between cohorts, no formal comparisons were performed.</p><p><strong>Results: </strong>We identified 49 patients (n=34 control, n=15 RT) who met the inclusion criteria. The cohorts differed in the presence of ascites, baseline liver dysfunction, infection with hepatitis B, and alcoholic liver disease. Two patients in the control group (5.8%) and 1 patient in the RT group (6.7%) experienced clinically significant bleeding. One patient (6.7%) developed possible RT-induced liver disease. The rwRR in the RT group was 73.3% (11/15) compared with 17.6% (6/34) in the control group. The median OS in the RT group was 14.4 months, and 10.8 months in the control group. Median TTP was 6.4 months with RT compared with 5.8 months in the control group.</p><p><strong>Conclusions: </strong>The addition of liver RT to A/B resulted in limited additional toxicity with increased response rates, although significant differences in baseline characteristics limit a full interpretation of this data. Ongoing trials and trials under development will provide informative data regarding the addition of RT to A/B, particularly to assess the impact on OS and TTP.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057524","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
The Role of Adjuvant Chemotherapy in Endometrial Cancer Following Preoperative Neoadjuvant Chemoradiation Therapy. 子宫内膜癌术前新辅助放化疗后辅助化疗的作用。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-04-23 DOI: 10.1097/COC.0000000000001205
Margaret R Flanigan, Michelle Ertel, John A Vargo, Li Wang, Michelle M Boisen, Sarah Taylor, Shannon K Rush, Paniti Sukumvanich, Jamie L Lesnock
{"title":"The Role of Adjuvant Chemotherapy in Endometrial Cancer Following Preoperative Neoadjuvant Chemoradiation Therapy.","authors":"Margaret R Flanigan, Michelle Ertel, John A Vargo, Li Wang, Michelle M Boisen, Sarah Taylor, Shannon K Rush, Paniti Sukumvanich, Jamie L Lesnock","doi":"10.1097/COC.0000000000001205","DOIUrl":"https://doi.org/10.1097/COC.0000000000001205","url":null,"abstract":"<p><strong>Objectives: </strong>In patients with surgically unresectable disease who undergo neoadjuvant chemoradiation (CRT) or neoadjuvant radiation therapy (RT) before surgical staging, little is known about whether adjuvant chemotherapy confers a survival benefit. We aim to explore the survival impact of adjuvant chemotherapy in patients with locally advanced endometrial cancer who undergo neoadjuvant CRT or RT.</p><p><strong>Methods: </strong>A retrospective, single-institution review of all patients from April 2008 to October 2021 who underwent neoadjuvant RT or CRT before surgical resection of endometrial cancer was performed. Kaplan-Meier method with log-rank test was used to determine differences in overall survival (OS) and disease-free survival (DFS) between the group that received adjuvant chemotherapy and the group that did not. Subgroup analysis was performed to assess whether specific subgroups benefited from adjuvant chemotherapy.</p><p><strong>Results: </strong>Eighty-nine patients, 48 (54%) of whom received adjuvant chemotherapy, were identified. There was no statistically significant difference in OS (P=0.062) between those who received adjuvant chemotherapy and those who did not. Adjuvant chemotherapy had a significant association with worse DFS (P=0.037). On subgroup analysis, there were no statistically significant differences in OS or DFS in any subgroups when examining the impact of adjuvant chemotherapy.</p><p><strong>Conclusions: </strong>After receiving neoadjuvant CRT or RT for advanced and high-grade endometrial cancers, adjuvant chemotherapy was not predictive of improved OS, but was predictive of worse DFS. A larger cohort and longer follow-up are needed to ascertain whether certain high-risk subgroups of patients benefit from adjuvant chemotherapy.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994632","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
Long-Lasting Cigarette Smoking Alterations in Immune Function Occur in Cannabis Smokers, Possibly Rendering Them Vulnerable to Smoking-Related Tumors in Later Life. 长期吸烟会改变吸食大麻的人的免疫功能,这可能使他们在以后的生活中容易患与吸烟有关的肿瘤。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-04-23 DOI: 10.1097/COC.0000000000001203
Steven Lehrer, Peter Rheinstein
{"title":"Long-Lasting Cigarette Smoking Alterations in Immune Function Occur in Cannabis Smokers, Possibly Rendering Them Vulnerable to Smoking-Related Tumors in Later Life.","authors":"Steven Lehrer, Peter Rheinstein","doi":"10.1097/COC.0000000000001203","DOIUrl":"https://doi.org/10.1097/COC.0000000000001203","url":null,"abstract":"<p><strong>Objectives: </strong>Active cigarette smoking leads to increased CXCL5 production. CXCL5 mediates the immune response by attracting immune cells to areas of inflammation. Elevated CXCL5 levels are associated with various inflammatory diseases and tumorigenesis. In addition, smoking is linked to an increase in the level of the cytokine CEACAM6 in the bloodstream of smokers. CEACAM6 is increased in pancreatic adenocarcinoma, breast cancer, non-small-cell lung cancer, gastric cancer, colon cancer, and other cancers and promotes tumor progression, invasion, and metastasis. Although cytokine secretion in the innate immune response returns to nonsmoker levels after quitting smoking, the effects on the adaptive response appear to persist for years or decades due to epigenetic memory. As a result, epigenetic changes induced by smoking may contribute to long-lasting alterations in immune function, including elevated CXCL5 and CEACAM6. The effects of cannabis smoking might be similar.</p><p><strong>Methods: </strong>In the current study we used UK Biobank (UKB) data to assess the relationship of CXCL5, CEACAM6, and pulmonary function to cigarette and cannabis smoking. Our UK Biobank application was approved as UKB project 57245 (S.L. and P.H.R.). Our analysis included all subjects with smoking and/or marijuana use data in the UK Biobank database. Circulating levels of CXCL5 and CEACAM6 were from UKB Olink data. Individual CXCL5 and CEACAM6 levels are NPX, Normalized Protein expression, Olink arbitrary unit in Log2 scale (Olink Proteomics AB, Uppsala, Sweden; http://www.olink.com).</p><p><strong>Results: </strong>Current smokers and past smokers had elevated circulating levels of CXCL5 and CECAM6. In multivariate analysis, current, past, or no smoking history was significantly related to CXCL5 level and CECAM6 levels, independent of the effects of age, sex. Frequency of cannabis use had a similar effect. In multivariate analysis, frequency of cannabis use was significantly related to CXCL5 level and CECAM6 levels, independent of the effects of age, sex, and years between last cannabis use and enrollment in study.</p><p><strong>Conclusions: </strong>We can confirm a previous report of epigenetic changes induced by cigarette smoking that may contribute to long-lasting alterations in immune function related to CXCL5 and CEACAM6. In addition, we have found that these same long-lasting smoking alterations in immune function related to CXCL5 and CEACAM6 occur in cannabis smokers, possibly rendering them vulnerable to smoking-related tumors in later life.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048203","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
Predictors and Patterns of Recurrence in Vulvar Cancer. 外阴癌复发的预测因素和模式。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-04-21 DOI: 10.1097/COC.0000000000001200
Francesca De Maria, Francesco Raspagliesi, Vito Chiantera, Umberto Leone Roberti Maggiore, Simone Bruni, Camilla Valsecchi, Ilaria Cuccu, Valentina Chiappa, Fabio Ghezzi, Giovanni Scambia, Jvan Casarin, Giorgio Bogani
{"title":"Predictors and Patterns of Recurrence in Vulvar Cancer.","authors":"Francesca De Maria, Francesco Raspagliesi, Vito Chiantera, Umberto Leone Roberti Maggiore, Simone Bruni, Camilla Valsecchi, Ilaria Cuccu, Valentina Chiappa, Fabio Ghezzi, Giovanni Scambia, Jvan Casarin, Giorgio Bogani","doi":"10.1097/COC.0000000000001200","DOIUrl":"https://doi.org/10.1097/COC.0000000000001200","url":null,"abstract":"<p><strong>Objective: </strong>To identify prognostic factors predicting recurrence in vulvar cancer patients undergoing surgery.</p><p><strong>Methods: </strong>We retrospectively evaluated data from consecutive patients with vulvar cancer treated between 2002 and 2024 in 2 Italian centers. Basic descriptive statistics and multivariable analysis were used to create predictive models for patient outcomes. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using a Cox proportional hazards model.</p><p><strong>Results: </strong>The study included 283 patients diagnosed with vulvar cancer (239 with squamous cell carcinoma). The most frequent stages were stage I (50.9%) and stage III (30.4%). After a median follow-up of 27 months, 91 (32.2%) recurrences were observed, of which 20% were local, 6% were regional, and 6% were distant. The five-year DFS and OS were 46% and 60%, respectively. Multivariate analysis identified the presence of positive lymph nodes (hazard ratio [HR]: 3.54, 95% confidence interval [CI]: 1.04-12.08), age (HR: 1.02, 95% CI: 1-1.04), FIGO stage II (HR: 3.12, 95% CI: 1.24-7.87), and FIGO stage IV (HR: 3.85, 95% CI: 1.19-12.43) as factors associated with worse DFS. Positive nodes (HR: 2.64, 95% CI: 1.2-5.8) and tumor diameter >4 cm (HR: 1.89, 95% CI: 1.05-3.42) were associated with OS. FIGO stage >I was predictive of regional and distant recurrences, but no factor was found to correlate with local recurrence.</p><p><strong>Conclusions: </strong>FIGO stage >I was predictive of regional and distant recurrences, while no factors influencing local recurrence were identified. Positive nodes, age, and FIGO stage >I correlated with DFS, whereas tumor diameter >4 cm and positive nodes influenced OS.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038129","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
Standard Versus Extended Pelvic Lymphadenectomy in Patients With Bladder Cancer: A Systematic Review and Meta-analysis. 标准与扩展盆腔淋巴结切除术在膀胱癌患者中的应用:一项系统回顾和荟萃分析。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-04-21 DOI: 10.1097/COC.0000000000001206
Hunaina Aman, Muhammad Hamza, Asad Ramzan, Mariam Saqib, Zain Ul Abideen, Abdul Haseeb, Hira Habib, Aiza Bint-E-Shafqat, Abdul Azeez Umar Azad, Hira Waris, Mushood Ahmed, Muhammad Ayyan, Nouman Aziz
{"title":"Standard Versus Extended Pelvic Lymphadenectomy in Patients With Bladder Cancer: A Systematic Review and Meta-analysis.","authors":"Hunaina Aman, Muhammad Hamza, Asad Ramzan, Mariam Saqib, Zain Ul Abideen, Abdul Haseeb, Hira Habib, Aiza Bint-E-Shafqat, Abdul Azeez Umar Azad, Hira Waris, Mushood Ahmed, Muhammad Ayyan, Nouman Aziz","doi":"10.1097/COC.0000000000001206","DOIUrl":"https://doi.org/10.1097/COC.0000000000001206","url":null,"abstract":"<p><strong>Objectives: </strong>For decades, pelvic lymph node dissection (PLND) has been a critical component of radical cystectomy in patients with bladder cancer. Although its role in curative surgery for high-risk non-muscle-invasive and muscle-invasive cases is well-established, the therapeutic advantages of extended PLND remain a topic of ongoing debate.</p><p><strong>Methods: </strong>A comprehensive literature search of major bibliographic databases was performed from inception to November 2024. Studies comparing extended PLND (extended or super extended) with standard PLND were identified. Data for clinical outcomes was extracted and pooled estimates were calculated using a random effects model with RevMan 5.4.</p><p><strong>Results: </strong>A total of 11 studies (2 RCTs and 9 observational) were included reporting data for 4001 patients. The pooled analysis demonstrated that extended PLND was associated with significantly better recurrence-free survival (HR=0.67, 95% CI: 0.60-0.74). Standard PLND led to significantly higher 5-year recurrence rates (RR=1.44, 95% CI: 1.28-1.62) compared with the extended approach. The pooled estimates for disease-specific survival (HR=0.86, 95% CI: 0.62-1.19), overall survival (HR=0.99, 95% CI: 0.86-1.16), and complications remained comparable.</p><p><strong>Conclusions: </strong>Extended PLND can lead to favorable recurrence-free survival and 5-year recurrence rates. However, retrospective observational studies mainly drive the evidence, and additional RCTs are required to reach a definitive conclusion.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065245","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
The Impact of Race and Ethnicity on Location and Delivery of Palliative Radiotherapy. 种族和民族对姑息性放疗的位置和递送的影响。
IF 1.6 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-04-14 DOI: 10.1097/COC.0000000000001202
Anthony K Heng, Ted Gooley, Simon S Lo, Jonathan T Yang, Erin F Gillespie, Lia M Halasz, Yolanda D Tseng
{"title":"The Impact of Race and Ethnicity on Location and Delivery of Palliative Radiotherapy.","authors":"Anthony K Heng, Ted Gooley, Simon S Lo, Jonathan T Yang, Erin F Gillespie, Lia M Halasz, Yolanda D Tseng","doi":"10.1097/COC.0000000000001202","DOIUrl":"https://doi.org/10.1097/COC.0000000000001202","url":null,"abstract":"<p><strong>Objectives: </strong>Among patients that underwent palliative RT (pRT) at a single institution, we evaluated whether differences exist across race and ethnicity in location of pRT consultation and delivery of pRT.</p><p><strong>Methods: </strong>This retrospective study included cancer patients aged 18 years or older who received pRT between 10/2021 and 10/2022. Logistic regression models were used to examine univariable (UVA) and multivariable (MVA) associations between race and pRT consult in the inpatient (vs. outpatient) setting. A subset analysis of quality metrics for pRT delivery was limited to patients who had outpatient consults for pain.</p><p><strong>Results: </strong>Four hundred forty patients underwent 548 pRT consults (104 inpatient and 444 outpatient) followed by a course of pRT. Most patients were male (58.2%), White non-Hispanic (WNH) (72.6%), and English-speaking (92.9%). On MVA adjusting for histology, language, and insurance type, consults for Black/African American (BAA) patients had 2.92 higher odds of being performed in the inpatient setting compared with consults for WNH patients (95% CI: 1.28-6.70, P=0.011), although the global P-value was P=0.217. Among 290 outpatient consults for painful lesions, no differences in time to pRT start (global P=0.84), number of prescribed fractions of RT (global P=0.94), or new prescriptions for opioids (global P=0.69) were noted by race and ethnicity.</p><p><strong>Conclusions: </strong>In this study, BAA race was associated with the location of pRT consultation, but no discernible differences were noted regarding the outpatient delivery of pRT for pain. These findings support the importance of inpatient pRT programs to ensure equitable access. More research is needed to understand barriers to outpatient consult.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054912","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
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