Oncologist最新文献

{"title":"Colorectal Cancer in Pregnancy: Case Discussions and Real-World Data as well as literature review on current knowledge.","authors":"Suzanne Poulgrain, Ted Gibbons, Cian O'Leary, Sophie Feng, Vikram Jain, Connor Gerard O'Leary","doi":"10.1093/oncolo/oyaf097","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf097","url":null,"abstract":"<p><p>Colorectal cancer during pregnancy is a rare event; but given the well-recognised increasing incidence of young onset colorectal cancer and delayed child-bearing seen in the western world, it is anticipated to sharply increase in the next two decades. In this paper the authors analyse three cases of colorectal cancer occurring in pregnancy, including the therapeutic approach and relevant outcomes. Two of the three cases received chemotherapy during pregnancy, all three children were born premature with one child having a significantly low birth weight. A review of our institutions referrals related to early onset colorectal cancer (EOCRC) revealed a 50% increased incidence in the last decade in line with worldwide trends of increase in this population. This paper also reviews the literature related to EOCRC in pregnancy and current diagnosis and management recommendations. Challenges with the therapeutic approach are experienced when symptoms are masked by the pregnancy, and when the diagnostic workup needs to weigh benefits to mother with harms to child. There is a clear and increasing need for consensus guidelines and further research into this field.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor in response to the article: \"Squamous cell carcinoma arising in chronically damaged skin (Marjolijn's Ulcer)\".","authors":"Zvi Ackerman","doi":"10.1093/oncolo/oyaf160","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf160","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between tumor growth rate and survival in patients with metastatic breast cancer treated with trastuzumab deruxtecan.","authors":"Philip He, Dhiraj Gambhire, Haiming Zhou, Xiaoyang Ma, Yoshihiro Emura, Abderrahmane Laadem, David Leung, Susan Bates, Antonio Tito Fojo, Olivier Rixe","doi":"10.1093/oncolo/oyaf057","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf057","url":null,"abstract":"<p><strong>Background: </strong>Previous studies in multiple metastatic tumors treated with diverse anticancer agents including immunotherapy, chemotherapy, mAb, and TKIs have suggested the rate of tumor growth (g-score) is inversely associated with survival.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients with metastatic breast cancer (mBC) treated with trastuzumab deruxtecan (T-DXd), ado-trastuzumab emtansine (T-DM1), or chemotherapy to investigate the impact of those therapies on g-score and explore the association of g-score with clinical outcomes. This is the first report assessing g-score in tumors treated with an ADC.</p><p><strong>Results: </strong>We investigated the association of g-score with progression-free (PFS) and overall survival (OS) in 2 phase 3 studies in patients with HER2 + mBC (DESTINY-Breast03 (DB-03)) and HER2-low mBC (DESTINY-Breast04 (DB-04)). After grouping patients according to quartiles of g-scores, we explored the association between g-score and PFS/OS using Kaplan-Meier plots and Cox regression models. The median g-score was higher for T-DM1, suggesting a faster growth rate at 0.0009/day vs that for T-DXd at 0.0002/day (P < .0001). Additionally, with data collection stopped at the time of database lock, 23% and 48% of tumors demonstrated only regression without growth in the T-DM1 and T-DXd arms, respectively. In DB-04, median g was 0.0018/day and 0.0006/day (P < .0001); with 17% and 32% of tumors demonstrating only regression with treatment of physician's choice (TPC) and T-DXd, respectively.</p><p><strong>Conclusions: </strong>Compared to T-DM1 and TPC therapies, T-DXd significantly reduced the rate of tumor growth in the overall population and across subgroups. In both studies, the tumor growth rate was inversely associated with PFS and OS. In addition, it showed improved concordance with survival compared to ORR. The use of tumor growth rate as an intermediate endpoint may potentially accelerate drug development and reduce a patient's exposure to agents with limited or no activity.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of 2 different fibroblast growth factor receptor-inhibitors in a patient with extrahepatic cholangiocarcinoma harboring an FGFR2 mutation: a case report.","authors":"Ilianna Galli-Vareia, Petr Szturz, Ioannis A Voutsadakis, Nicolas Villard, Georgia Tsoumakidou, Mapi Fleury, Gabriela Herrera, Francois Fasquelle, Sebastien Godat, Antonia Digklia","doi":"10.1093/oncolo/oyae294","DOIUrl":"10.1093/oncolo/oyae294","url":null,"abstract":"<p><p>Cholangiocarcinoma (CCA) is a type of cancer with few effective systemic therapies. Elucidation of the molecular landscape of the disease from genomic studies based on next-generation sequencing (NGS) has contributed to the introduction of new targeted therapies. One of these treatments consists of a class of small molecules that target members of the fibroblast growth factor receptors (FGFRs) family of receptor tyrosine kinases. We report here on a patient with a cholangiocarcinoma bearing an FGFR2 mutation. The patient was treated with 2 different FGFR inhibitors, as the first caused ocular toxicity. She obtained clinical benefits from both. This case illustrates the efficacy of FGFR inhibitors on cholangiocarcinoma with specific point mutations.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor prognosis of early-stage acral melanoma with a history of trauma: a multicenter analysis of 468 patients.","authors":"Yi Teng, Jin Wu, Xin Cai, Weizhen Zhang, Kui Jiang, Hongfeng Zhou, Zhen Guo, Jiwei Liu, Yan Wang, Fang Liu, Shijie Lan, Hongxue Meng, Xiang Ji, Mei Xiang, Yongqi Li, Di Wu","doi":"10.1093/oncolo/oyaf086","DOIUrl":"10.1093/oncolo/oyaf086","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested that trauma may be a risk factor for the development and prognosis of acral melanoma (AM).</p><p><strong>Methods: </strong>This population-based retrospective cohort study included patients with AM and a confirmed history of trauma who received treatment at 5 melanoma treatment centers in China. Factors associated with recurrence and survival were analyzed using univariate and multivariate Cox regression analyses.</p><p><strong>Results: </strong>Totally 468 AM cases were included in this study, with 101 patients in the trauma group and 367 in the non-trauma group. The trauma group had more patients with ulceration (P = .027), mitotic rate ≥ 1 (P = .036), and Clark level IV-V (P = .009) than the non-trauma group. Among stage I-II postoperative AM patients, the median recurrence-free survival (RFS) was 33.3 months (95% CI: 18.8-47.8) and 115.6 months (95% CI: 96.3-135.0) in the trauma and non-trauma groups, respectively (P < .001). Similarly, the median overall survival (OS) was 64.6 (95% CI: 54.8-74.4) and not reached (95% CI: NR), respectively (P = .002). Comparatively, no significant differences were observed in RFS or OS between the trauma and non-trauma groups in patients with stage III and IV AM. Multifactorial analysis showed that trauma was an independent risk factor for RFS and OS only in patients with stage I-II AM patients.</p><p><strong>Conclusions: </strong>Postoperative stage I-II patients in the trauma group had significantly worse RFS and OS compared to those in the non-trauma group.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of transgender patients with breast cancer: a single institution experience.","authors":"Ethan Ravetch, Nithya Krishnamurthy, Christina Weltz, Joshua D Safer","doi":"10.1093/oncolo/oyaf087","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf087","url":null,"abstract":"<p><p>Breast cancer presents unique complexities for transgender individuals. This retrospective study characterized breast cancers in 14 transgender and nonbinary patients treated at a specialized transgender health center from 2016 to 2023. Patients with a median age of 53 (31-65 years) were identified using international classification of disease-10 codes. Most (86%) were aged 40 or older and eligible for screening mammography. The cohort included 6 trans men, 7 trans women, and one genderqueer individual. Diagnoses included ductal carcinoma in situ (36%), lobular carcinoma in situ (7%), stage 1 (29%), stage 2 (21%), and breast implant-associated anaplastic large cell lymphoma (7%). Screening mammography diagnosed 29%, 43% presented with a mass, and 29% were detected during pre-surgical imaging. Half had estrogen-based gender-affirming hormone therapy (GAHT) and half testosterone-based, with mean GAHT durations of 16.6 years. Biomarker profiles revealed 67% estrogen receptor (ER)-positive and 33% ER-negative cancers. This study highlights underutilized screening mammography and diverse cancer subtypes in this underserved population.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De-escalating first-line treatment in stage IVB or recurrent cervical cancer: outcomes of immunotherapy alone and systemic review.","authors":"Akram Saad, Alexandra Taylor, Shira Felder, Limor Helpman, Smadar Bauer, Ronnie Shapira, Keren Levanon, Jacob Korach, Ronza Atamneh, Samantha Breslauer, Jeffrey Goldstein, Shira Peleg Hasson","doi":"10.1093/oncolo/oyaf096","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf096","url":null,"abstract":"<p><strong>Introduction: </strong>Chemo-immunotherapy (IO) is the preferred first-line treatment for stage IVB or recurrent cervical cancer. However, limited data exist on the efficacy and safety of using IO-alone as a de-escalation strategy. We report outcomes from a case series of selected patients treated with IO-alone and review the feasibility of de-escalating first-line treatment.</p><p><strong>Methods: </strong>The authors conducted a literature review using Google Scholar and PubMed to identify reports using IO-alone as a de-escalation strategy across malignancies published between 1999 and December 2024 and also reviewed a cervical cancer database from a tertiary academic to identify patients with stage IVB or recurrent disease treated with IO-alone. The authors used the Kaplan-Meier method to estimate progression-free survival (PFS) and overall survival (OS).</p><p><strong>Results: </strong>Among 582 patients treated between 2015 and 2021, 18 met the inclusion criteria. The median age was 43 years (range 28-84); 67% had squamous cell carcinoma, 11% adenocarcinoma, and 80% expressed PD-L1. CPS scores were <1 in 20%, 1--10 in 33%, and >10 in 47%. Most patients had oligo-metastatic disease (83%). Treatment with IO-alone began a median of 7 months after platinum-based chemotherapy. Indications included prior adjuvant (44%) or neoadjuvant (22%) chemotherapy, clinical trial participation (11%), or patient preference (22%). Median PFS and OS were 27 months and 82 months, respectively.</p><p><strong>Conclusions: </strong>These findings support the need for clinical trials evaluating IO-alone as a first-line treatment option for de-escalation in stage IVB or recurrent cervical cancer. Biomarker development is needed to better identify candidates for personalized therapy.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative and end-of-life care in Asian and White patients with metastatic lung cancer.","authors":"Xiao Hu, John W Melson, Stacey S Pan, Yana V Salei, Lori Pai, Susan K Parsons, Yu Cao","doi":"10.1093/oncolo/oyaf065","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf065","url":null,"abstract":"<p><strong>Background: </strong>Data on palliative and end-of-life care for Asian patients with metastatic lung cancer in the United States are limited, though this is the leading cause of cancer death in this group. Early palliative care improved quality of life and survival in patients with metastatic lung cancer treated with chemotherapy. We examined palliative and end-of-life care patterns in Asian and White patients with metastatic lung cancer in the era of novel therapy.</p><p><strong>Methods: </strong>Patients newly diagnosed with metastatic lung cancer from 2014 to 2019 were identified at our institution. Patient and disease characteristics and treatment information were compared between Asian and White patients by Mann-Whitney U test and Chi-square tests. Time-to-palliative care involvement was compared via log-rank test.</p><p><strong>Results: </strong>Both Asian (N = 89) and White (N = 197) patients had low rates of palliative care involvement (38.2% vs 37.6%), with median time from diagnosis to first encounter exceeding a year. The most given frontline systemic therapy was targeted therapy and chemotherapy in Asian and White patients, respectively. Of 22 Asian (24.7%) and 74 White (37.6%) patients who died, Asian patients more often died in-hospital (68.2% vs 32.4%, P = .004), and did not have documented code status discussions with their outpatient oncologists (0% vs 24.3%, P = .010) within 6 months preceding death.</p><p><strong>Conclusion: </strong>Early palliative care appears challenging to implement for Asian and White patients newly diagnosed with metastatic lung cancer in a real-world setting. A more patient-centered approach to integrating palliative and end-of-life care communications and interventions alongside precision oncology warrants further study.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delphi consensus on the management of adverse events in patients with metastatic triple-negative breast cancer treated with sacituzumab govitecan.","authors":"Anna Amela Valsecchi, Simona Pisegna, Andrea Antonuzzo, Grazia Arpino, Giampaolo Bianchini, Laura Biganzoli, Giuseppe Ferdinando Colloca, Carmen Criscitiello, Romano Danesi, Alessandra Fabi, Raffaele Giusti, Loredana Pau, Massimo Di Maio, Daniele Santini","doi":"10.1093/oncolo/oyaf088","DOIUrl":"10.1093/oncolo/oyaf088","url":null,"abstract":"<p><strong>Background: </strong>Metastatic triple-negative breast cancer (BC; mTNBC) is one of the most aggressive cancers, difficult to treat due to the absence of hormone target receptors. Sacituzumab govitecan (SG) is a new therapeutic approach that exploits the combination of an antibody directed against the Trop-2 antigen expressed in solid epithelial tumors and the active metabolite SN-38, to precisely target cancer cells. The development of consensus recommendations requires synthesizing expert opinions, especially when direct evidence is limited.</p><p><strong>Methods: </strong>This study aimed to create a Delphi process to gather the perspectives of a panel of BC and supportive specialists on the use of SG in clinical practice. A scientific board discussed and defined a series of statements that were submitted to the panel through 2 rounds of voting. The process was designed to collect expert opinions to achieve consensus on key points regarding the safety, dosing regimens, and patient management for SG. Each round of the survey included targeted questions informed by current literature. Predefined criteria for consensus were set at ≥75% agreement.</p><p><strong>Results: </strong>In October 2024, 29 experts' opinions were collected by voting on 40 statements and reaching a 67% agreement. The reduction of the initial SG dose and the management of prophylaxis for patients with the UGT1A1 *28/*28 genotype were the most discussed topics.</p><p><strong>Conclusions: </strong>The results provide a foundational framework for clinical decision-making, and highlight the importance of collaborative expert synthesis in forming practice guidelines. Future studies should focus on prospective SG trials to address the identified areas of uncertainty.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding NATALEE and MonarchE eligibility criteria in a real-world cohort of early breast cancer patients.","authors":"Jacopo Canzian, Damiano Gentile, Rita De Sanctis, Flavia Jacobs, Chiara Benvenuti, Mariangela Gaudio, Riccardo Gerosa, Giuseppe Saltalamacchia, Rosalba Torrisi, Giovanna Masci, Corrado Tinterri, Alberto Zambelli","doi":"10.1093/oncolo/oyaf061","DOIUrl":"10.1093/oncolo/oyaf061","url":null,"abstract":"<p><p>The NATALEE trial expanded the use of adjuvant cyclin-dependent kinase 4/6 inhibitors beyond the MonarchE trial's criteria for early breast cancer (eBC). We conducted a retrospective analysis comparing a large real-world (RW) cohort of 762 consecutive eBC patients with those enrolled in the NATALEE and MonarchE randomized controlled trials (RCTs) to evaluate differences in eligibility. Our analysis revealed that 41.7% of RW patients met NATALEE's eligibility criteria, significantly more than the 21.8% who met MonarchE's criteria, reflecting NATALEE's broader indication. Real-world patients were older, had less advanced tumors, and were less likely to be treated with adjuvant chemotherapy compared to the RCT populations. None of the RW patients was deemed eligible for ribociclib based solely on high genomic risk. These findings underscore significant differences in clinical characteristics and potential treatment eligibility, highlighting the need for critical assessment of RCTs results in clinical practice.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 5","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}