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

{"title":"Single-Cell Transcriptomic Analysis Reveals γδ T-Cell Infiltration and Presence of Immune Regulatory Molecules in Biliary Tract Cancer Microenvironment.","authors":"Saikat Mandal, Stuart Astbury, Jane I Grove, Judith M Ramage, Andrew M Jackson, Guruprasad P Aithal","doi":"10.1097/COC.0000000000001340","DOIUrl":"https://doi.org/10.1097/COC.0000000000001340","url":null,"abstract":"<p><strong>Objectives: </strong>Biliary tract cancer (BTC) remains therapeutically challenging with poor survival outcomes; systemic therapies achieving complete responses in only 2% to 5% of patients. γδ T-cell-based adoptive cell therapy represents a promising strategy due to MHC-independent activation. γδ T cells are activated through direct engagement of butyrophilin (BTN) family molecules; conversely, nonclassical HLA class-I molecules, particularly HLA-E, function as inhibitory ligands for NKG2A expressed on γδ T cells, suppressing anti-tumor immunity. Characteristics of tumor-infiltrating γδ T cells, their activity, and inhibitory interactions in BTC remain unexplored.</p><p><strong>Methods: </strong>Single-cell RNA-sequencing data from 19 BTC tumor samples in the Gene Expression Omnibus (GEO) were analyzed to characterize γδ T-cell infiltration and the expression of regulatory molecules. MHC-I molecules, butyrophilin (BTN) molecules, intercellular adhesion molecules (ICAM), and NKG2A checkpoint receptors were quantified.</p><p><strong>Results: </strong>γδ T cells comprised 0% to 4.9% of all cells present in the BTC tumor samples. Expression of BTN2A1, BTN2A2, BTN3A1, BTN3A2, and ICAM1 was noted in all the tissue samples, supporting Vγ9Vδ2 T-cell activation potential. Classic HLA class-I expression was preserved (70% to 90% of cells). HLA-E was overexpressed (60% to 95.7% of cells expressing HLA-E). Around 30% of NK cells and γδ T cells exhibited NKG2A positivity (log2 expression >2).</p><p><strong>Conclusions: </strong>Given the presence of regulatory molecules such as BTN and ICAM, Vγ9Vδ2 T-cell-based adoptive cell therapy appears promising. A combination of elevated HLA-E expression with high γδ T-cell NKG2A positivity establishes a potent inhibitory checkpoint axis in BTC. These findings support the rationale of investigating anti-NKG2A blockade combined with γδ T-cell-based adoptive therapy as a novel therapeutic strategy.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413498","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":"Small Bowel Cancer-Related Mortality in the United States, 1999 to 2024: A CDC WONDER Trend and Forecasting Analysis.","authors":"Arkadeep Dhali, Jyotirmoy Biswas, Ali Shan Hafeez","doi":"10.1097/COC.0000000000001337","DOIUrl":"10.1097/COC.0000000000001337","url":null,"abstract":"<p><strong>Objectives: </strong>Small bowel malignancies are rare, but mortality trends remain incompletely characterized. We assessed national small bowel cancer-related mortality trends in the United States.</p><p><strong>Methods: </strong>This retrospective population-based study used the CDC WONDER database. Deaths with small bowel malignancy listed as an underlying or contributing causewere queried. Analyses covered 1999 to 2024, except urbanization through 2020. Age-adjusted mortality rate (AAMR) per 100,000 were examined overall and by sex, age, census region, state, urbanization, and place of death. Joinpoint regression estimated annual percent change (APC)/average annual percent change (AAPC); autoregressive integrated moving average (ARIMA) models forecasted AAMRs.</p><p><strong>Results: </strong>AAMRs were stable from 1999 to 2012 (APC: -0.30), then increased significantly from 2012 to 2024 (APC: 2.47; 95% CI: 1.91-3.39), with a significant overall increase (AAPC: 1.02; 95% CI: 0.80-1.26). Males had higher mortality than females, with significant overall increases in both sexes. Older adults drove the age-related burden, rising significantly from 2012 to 2024 (APC: 2.91; 95% CI: 2.34-3.86; AAPC: 1.32; 95% CI: 1.09-1.60). Mortality increased significantly in the Midwest, South, and West, while the Northeast overall trend was not significant. Metropolitan AAMRs increased significantly through 2020. Most deaths occurred at home (18,212; 44.49%). Forecasts suggested overall AAMRs would remain near 0.82 per 100,000 in 2034, with widening prediction intervals.</p><p><strong>Conclusions: </strong>U.S. small bowel cancer-related mortality increased significantly, particularly after 2012, with variation by sex, age, geography, and urbanization.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152066","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":"Comorbidity and Risk of Complications and Readmissions Following Surgery for Patients With Renal Cell Carcinoma in the Military Health System.","authors":"Yvonne L Eaglehouse, Sarah Darmon, Jie Lin, Sean Q Kern, Craig D Shriver, Kangmin Zhu","doi":"10.1097/COC.0000000000001277","DOIUrl":"10.1097/COC.0000000000001277","url":null,"abstract":"<p><strong>Objectives: </strong>The effect of comorbidity on kidney and urinary complications after surgery for renal cell carcinoma (RCC) is unclear. We aimed to assess the effect of comorbidity on postoperative complications and readmissions among patients with RCC in the Military Health System, which provides universal access to care to eligible beneficiaries.</p><p><strong>Methods: </strong>We identified a cohort of patients aged 18 and older diagnosed with stage I to III RCC between 2001 and 2014 who received nephrectomy in the MilCanEpi database. Outcomes included 90-day general and kidney and urinary complications and hospital readmissions. The adjusted rate ratios (ARRs) with 95% CIs for Elixhauser comorbidity (0, 1 to 2, 3 to 4, ≥5) and outcomes were estimated using multivariable Poisson regression.</p><p><strong>Results: </strong>The study included 1470 patients with a median (IQR) comorbidity count of 2 (0 to 3). Overall, patients with ≥5 comorbidities had elevated rates of general complications (ARR=1.47, 95% CI=0.96, 2.23) relative to patients with no comorbidity. For kidney and urinary complications, patients with 1 to 2 (ARR=1.65, 95% CI=1.07, 2.54), 3 to 4 (ARR=2.29, 95% CI=1.45, 3.62), and ≥5 comorbidities (ARR=2.64, 95% CI=1.60, 4.34) had statistically significant higher risks relative to patients with no comorbidity. Patients with ≥5 comorbidities had higher risk of readmission (ARR=1.65, 95% CI=1.08, 2.54 vs. no comorbidity), while the risks were not statistically different for patients with lower comorbidity.</p><p><strong>Conclusions: </strong>The results demonstrate the increased risk for postoperative kidney and urinary complications and readmissions for patients with RCC and comorbidity and highlights the importance of comorbidity management in surgical care among patients with RCC.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"333-341"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806371","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 Camrelizumab Plus Apatinib for Esophageal Squamous Cell Carcinoma: A Systematic Review and Meta-analysis.","authors":"Ahmed Raza, Fnu Kalpina, Mudasar Nisar, Muhammad Saffi Ullah, Faiza Fatima, Zain Sadiq, Mahnoor Fatima, Zaheer Qureshi","doi":"10.1097/COC.0000000000001247","DOIUrl":"10.1097/COC.0000000000001247","url":null,"abstract":"<p><p>Esophageal squamous cell carcinoma (ESCC) is a major global health burden with limited treatment options. Combining immunotherapy with antiangiogenic agents has shown promise. Camrelizumab, a PD-1 inhibitor, and apatinib, a VEGFR-2 inhibitor, offer synergistic effects, improving outcomes in patients with advanced or metastatic ESCC. A literature search was conducted across PubMed, Cochrane, Embase, Scopus, and clinicaltrials.gov from inception till May 2025. Nine studies evaluating the safety and efficacy of camrelizumab plus apatinib were included. Analysis was conducted on R Studio v4.5.0. Pooled estimates were reported as proportions and 95% CI using a random effect model. Statistical heterogeneity was assessed using I ². Subgroup analysis was based on treatment exposure. The pooled 1-year overall survival (OS) rate was 71%, with treatment-naive patients exhibiting a statistically higher 1-year OS of 95% compared with 55% in pretreated patients. One-year progression-free survival was 25%. The overall response rate was significantly higher in the treatment-naive group than in the previously treated group (87% vs. 28%). Previously treated patients showed a modest complete response rate (CRR) of 1%, while treatment-naive patients showed a significantly higher CRR of 22%. Partial response rate was significantly higher in the treatment-naive subgroup (64% vs. 26%). Hemangioma was the significant adverse event in the treatment-naive subgroup (47% vs. 12%). Rates of leukopenia, neutropenia, anemia, and thrombocytopenia were comparable between the 2 subgroups. Camrelizumab plus apatinib has shown promising efficacy with improved OS, PFS, and response rates. Large-scale trials are warranted to validate these findings and optimize treatment strategies.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"350-360"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976610","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":"Prognostic Value of Multiparameter Biomarkers in Pleural Effusion of Patients With Non-small Cell Lung Cancer for Predicting Survival Outcomes: A Prospective Cohort Study.","authors":"Dan Yang, Bao-Hong Cui, Hui-Yan Wang, Zhi-Ran Zhang, Ming-Yan Zhang","doi":"10.1097/COC.0000000000001269","DOIUrl":"10.1097/COC.0000000000001269","url":null,"abstract":"<p><strong>Objective: </strong>Pleural effusion is a frequent and clinically significant complication in patients with non-small cell lung cancer (NSCLC), frequently causing debilitating respiratory symptoms, most notably dyspnea. The development of MPE is strongly correlated with unfavorable prognosis in NSCLC patients. This study aims to evaluate the prognostic value of multiparameter biomarkers (including CA125, CEA, CYFRA21-1, NSE, and LDH) in patients with NSCLC complicated by pleural effusion.</p><p><strong>Methods: </strong>In this prospective cohort study, we included 119 patients diagnosed with NSCLC and pleural effusion. We systematically assessed the levels of these biomarkers in pleural effusion and their relationship with overall survival. Univariate and multivariate Cox regression analyses were used to explore the association between these biomarkers and patient prognosis.</p><p><strong>Results: </strong>The study found that levels of CA125, CYFRA21-1, and LDH in pleural effusion were significantly correlated with overall survival, with higher levels associated with shorter survival times. In addition, as the volume of pleural effusion increased, the levels of these biomarkers also significantly rose. Multivariate Cox regression analysis indicated that age, larger pleural effusion volume, and elevated levels of CA125, CYFRA21-1, and LDH were independent risk factors for overall survival.</p><p><strong>Conclusion: </strong>The findings of this study suggest that CA125, CYFRA21-1, and LDH in pleural effusion may be potential biomarkers for assessing prognosis in patients with NSCLC and pleural effusion. While these results offer valuable insights into their potential role in clinical practice, further validation through larger, multicenter studies is needed to confirm their prognostic significance.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"326-332"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543797","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":"Adjuvant Chemotherapy After Curative Intent Resection of Ampullary Cancer (ADAPTA): Study Protocol for a Pan-European Prospective Multicenter Double Single Arm Trial.","authors":"Bas A Uijterwijk, Daniel H L Lemmers, Dorine S Klei, Hanneke Wilmink, Michele Ghidini, Alberto Zaniboni, Michele Millella, Aldo Scarpa, Claudio Luchini, Patrick Maisonneuve, Marc G Besselink, Mohammed Abu Hilal","doi":"10.1097/COC.0000000000001271","DOIUrl":"10.1097/COC.0000000000001271","url":null,"abstract":"<p><strong>Objectives: </strong>Ampullary adenocarcinoma (AAC) is rare. Five-year survival rates of 30% to 70% are seen after resection. This broad range of survival could be explained by the morphologic heterogeneity in the 3 subtypes of AAC (pancreatobiliary, intestinal, and mixed subtype), which complicates the prediction of individual prognosis and clinical decision making with regard to adjuvant therapy. To date, there are no prospective studies to elucidate whether adjuvant chemotherapy improves survival in these patients.</p><p><strong>Methods: </strong>The ADAPTA study is a phase II prospective single-arm multicenter cohort study including 200 patients with resected AAC (100 patients with intestinal subtype, and 100 with pancreatobiliary- and mixed subtype). All patients will be treated with CAPOX/ FOLFIRINOX, respectively. Outcomes will be compared after propensity score matching to the data of all patients in consecutive participating centers not treated according to the proposed regime.</p><p><strong>Conclusions: </strong>This pioneering prospective study aims to generate evidence on the impact of adjuvant chemotherapy tailored to the histopathologic subtypes of AAC. The outcomes of this trial could lead to changes in clinical guidelines or pave the way for future randomized controlled trials.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06068023.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"342-349"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437323","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 Abdomen and Pelvis.","authors":"Riddhi R Patel, Jonathan Feit, Grace Werling, Nora M White, 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, Neeta Somaiah, Dejka M Araujo","doi":"10.1097/COC.0000000000001267","DOIUrl":"10.1097/COC.0000000000001267","url":null,"abstract":"<p><strong>Objectives: </strong>Synovial sarcoma (SS) of the abdomen and pelvis is a rare and understudied condition. This study aimed to evaluate survival outcomes, assess calculated versus observed outcomes, and describe radiographic features among patients with localized abdominal/pelvic SS.</p><p><strong>Methods: </strong>A retrospective chart review of 58 patients diagnosed with localized abdominal/pelvic SS between 1992 and 2022 was performed. Overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) were assessed. Sarculator-predicted 5-year OS and disease-free survival (DFS) were compared with observed outcomes.</p><p><strong>Results: </strong>Twenty-four (41%) patients had tumors located in the extra-abdominal/pelvic region, and 34 (59%) had tumors located in the intra-abdominal/pelvic region. Most of the patients were female (62%). Survival outcomes revealed a median OS: 5.5 years, 5-year OS: 53%, median MFS: 1.5 years, and 5-year MFS: 32%. Patients with intra-abdominal/pelvic tumors had significantly worse MFS than those with extra-abdominal/pelvic tumors (median 1.3 vs. 2.7 y; P =0.023). Larger tumor size (≥5 cm MFS HR: 4.20, 95% CI: 1.48-11.95), poorly differentiated histology (MFS HR: 2.92, 95% CI: 1.13-7.53), and positive/unknown margins (OS HR: 2.96, 95% CI: 1.29-6.78; LRFS HR: 6.61, 95% CI: 1.65-26.50; MFS HR: 2.45, 95% CI: 1.23-4.89) were associated with worse outcomes. Sarculator-predicted and observed 5-year OS (49% vs. 52%) and DFS (30% vs. 26%) were consistent. Imaging features such as cystic changes and calcification were more frequent in larger and monophasic tumors.</p><p><strong>Conclusions: </strong>In localized abdomen/pelvic SS patients, tumor size, location, and surgical margins are critical prognostic factors. Sarculator may aid in risk stratification.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"309-316"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670727","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":"Contributing Factors to Delay of Adjuvant Postsurgical Radiation for Malignant Brain Tumors: A Single Institution Experience in a Rural State.","authors":"Grace Guzman, Ghassan Makhoul, Sahana Bettadapura, William J Shelton, Sean G Young, Pearman D Parker, Sanjay Maraboyina, Jing Jin, Ruofei Du, Analiz Rodriguez","doi":"10.1097/COC.0000000000001266","DOIUrl":"10.1097/COC.0000000000001266","url":null,"abstract":"<p><strong>Objectives: </strong>Malignant tumors of the central nervous system (CNS) are associated with high morbidity and mortality, requiring prompt and coordinated multidisciplinary care. Although adjuvant radiotherapy (RT) is a standard component of treatment that improves survival, delays in initiating RT remain common and may negatively impact patient outcomes. This study investigates patient-related factors contributing to delayed adjuvant RT in individuals with high-grade gliomas (HGGs) and brain metastases (BMs) treated at a tertiary care center in Arkansas.</p><p><strong>Methods: </strong>Electronic medical records (EMR) were retrospectively reviewed for patients diagnosed with HGGs and BMs who sought medical treatment at the University of Arkansas for Medical Sciences (UAMS) from 2019 to 2022. Statistical analysis included evaluation of the association of sociodemographic and clinical variables with radiotherapy status, using multivariable logistic regression and survival analysis.</p><p><strong>Results: </strong>Our sample included 219 patients diagnosed with HGGs or BMs who were treated at UAMS. Out of the 219 patients, 72.1% (n=158) patients received adjuvant RT treatment. In this group, 102 patients underwent timely RT treatment while 53 received delayed treatment. The timing of radiation was not available for 3 patients. Our analysis revealed an association between the Charlson Comorbidities Index (CCI) and RT timing status, suggesting a higher probability of receiving late RT with a higher CCI score ( P =0.048). In addition, patients who received delayed RT also had a significantly longer interval between surgery and RT treatment compared with patients with timed adjuvant RT ( P <0.0001 for both).</p><p><strong>Conclusions: </strong>We found that patients with a higher CCI score suggested an increased probability of experiencing delayed RT.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"317-325"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566275","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":"Care Patterns and Gastric Cancer-Related Outcomes in Patients With Pathogenic/Likely Pathogenic Germline CDH1 Variants: A 14-Year Single-Center Analysis.","authors":"Robert Schoeneich, Rishi R Patel, Bohae R Lee, Paolo Disano, Matthew T Gao, Madeline VanDerGraaf, Matthew Gosse, Rami El Abiad, Avraham Levin, Chandrikha Chandrasekharan, Hisakazu Hoshi, Andrew M Bellizzi, Naomi H Fei, Udhayvir S Grewal","doi":"10.1097/COC.0000000000001350","DOIUrl":"https://doi.org/10.1097/COC.0000000000001350","url":null,"abstract":"<p><strong>Objectives: </strong>Hereditary diffuse gastric cancer (HDGC) due to germline CDH1 pathogenic or likely pathogenic (P/LP) variants has traditionally been managed with prophylactic total gastrectomy (PTG), although contemporary data suggest a lower and more heterogeneous cancer risk. Real-world management patterns remain incompletely defined.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center cohort study of adult patients with germline CDH1 P/LP variants managed between 2011 and 2024. Patients were categorized as undergoing PTG within 1 year of diagnosis or deferring surgery with endoscopic surveillance (ES). Primary outcomes included the detection of signet ring cell carcinoma (SRCC) and invasive gastric cancer.</p><p><strong>Results: </strong>A total of 27 patients were identified (median age: 48 y; 81.5% female). Eight (29.6%) underwent early PTG, while 18 (66.7%) initially deferred surgery; 1 presented with de novo metastatic gastric cancer. Among PTG patients, 7 of 8 (87.5%) had Tis/T1a SRCC, and none had nodal involvement. Among those deferring PTG, surveillance was heterogeneous: 8 (44.4%) underwent structured ES, 6 (33.3%) had a single endoscopy, and 4 (22.2%) had no surveillance. Within structured ES, 1 patient (12.5%) developed invasive T2 disease, while the others had Tis/T1a SRCC or normal histology. Delayed gastrectomy (27.8%) revealed predominantly T1a SRCC without nodal involvement.</p><p><strong>Conclusions: </strong>Most detected lesions were early-stage and node-negative, and delayed gastrectomy did not appear to compromise pathologic outcomes in selected patients. However, invasive progression during surveillance underscores that ES is not without risk. These findings support a risk-adapted, patient-centered approach to CDH1 management with emphasis on structured surveillance and shared decision-making.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382464","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":"Executive Summary of the American Radium Society (ARS) Appropriate Use Criteria (AUC) for the Use of Radiation in the Prevention and Treatment of Heterotopic Ossification (HO).","authors":"Austin Dove, Phillip Bennion, Sam Jean-Baptiste, Austin N Kirschner, Bobby Koneru, Christien Kluwe, Neil Newman, Tracy M Paul, Kevin Pearlstein, Yasamin H Sharifzade-Moghaddam, Nick Scarcella, Stephen M Schaaf, Rahul Tendulkar, Suzanne Russo","doi":"10.1097/COC.0000000000001345","DOIUrl":"https://doi.org/10.1097/COC.0000000000001345","url":null,"abstract":"<p><strong>Objectives: </strong>To summarize the current evidence for radiation therapy (RT) in the prevention and treatment of heterotopic ossification (HO), including patient selection, optimal RT technique, and associated risks.</p><p><strong>Methods: </strong>This multispecialty-led committee includes radiation oncologists, rheumatologists, orthopedic surgeons, and physical medicine/rehabilitation physicians. Using the population, intervention, comparator, outcome, timing and study design (PICOTS) framework, evidence regarding treatment outcomes was assessed using Cochrane and PRISMA methodology. Eligible studies included prospective and retrospective studies published between January 1, 1980, and November 1, 2025, from Embase, Medline, and PubMed databases. Of the 197 articles identified using the search strategy, 83 were selected for inclusion as evidence, including 27 well-designed studies (phase II randomized and phase III), 16 moderately well-designed studies that account for most common biases (matched cohort and phase II studies), 31 studies with design limitations (retrospective reviews), 2 supplemental studies (not useful as primary evidence), and 7 meta-analyses. Additional studies were included to provide context and were not used to guide recommendations. Well-established RAND-UCLA consensus methodology (modified Delphi) was used to rate the appropriateness of the treatment options.</p><p><strong>Results: </strong>The results of this analysis demonstrate that in appropriately selected patients, RT is an effective and safe therapy for prophylaxis of HO formation.</p><p><strong>Conclusions: </strong>This systematic review provides consensus guidelines for the use of RT as prophylaxis of HO based on current peer-reviewed evidence in the literature.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334059","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}