Oncologist最新文献

{"title":"Genomic Alterations and Associated Outcomes in Patients with PSMA-Positive Metastatic Castration-Resistant Prostate Cancer treated with 177Lu-PSMA-617.","authors":"Justine Panian, Nicholas C Henderson, Daniel Herchenhorn, Pedro C Barata, Mehmet Asim Bilen, Laura Graham, Elisabeth Heath, Clara Hwang, Avery Supernois, Deepak Kilari, Bicky Thapa, Vadim S Koshkin, Tanya Jindal, Jones T Nauseef, Alexandra Sokolova, Taylor Amery, Yousef Zakharia, Michael T Schweizer, Ruben Raychaudhuri, Zachery R Reichert, Tanya Dorff, Andrew J Armstrong, John Wang, Ajjai Alva, Rana R McKay","doi":"10.1093/oncolo/oyaf358","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf358","url":null,"abstract":"<p><strong>Background: </strong>177Lu-PSMA-617 is approved for patients with metastatic castration-resistant prostate cancer (mCRPC). Although treatment is associated with improved outcomes, not all patients benefit and response is heterogeneous. We aim to characterize genomic alterations associated with benefit to 177Lu-PSMA-617.</p><p><strong>Methods: </strong>This study used the Prostate Cancer Precision Medicine Multi-Institutional Collaborative Effort (PROMISE) clinical-genomic database (n = 2445). The primary endpoint was ≥50% PSA decline (PSA50) from baseline with 177Lu-PSMA-617 in molecular subgroups. Secondary endpoints included 90% PSA decline (PSA90). Associations were assessed using Fisher's exact test and Cox regression in multivariable analysis.</p><p><strong>Results: </strong>We identified 183 mCRPC patients treated with 177Lu-PSMA-617. Median number of prior lines of mCRPC therapy was three. Overall, PSA50 was 49%, median progression-free survival was 7.6 months, and median overall survival was 13.9 months. NF1 (n = 8) and FOXA1 alterations (n = 5) were associated with increased PSA50 (88% vs. 47%, p = 0.03 for NF1; 100% vs. 47%, p = 0.03 for FOXA1). Among CRPC sequenced tumors (n = 119), androgen receptor (AR) alterations (n = 58) were associated with lower PSA50 (38% vs. 60%, p = 0.03). While any tumor suppressor genes (TSG) (PTEN, TP53, RB1) (n = 109) or TP53 (n = 83) alteration were associated with lower PSA90 (p = 0.02 for both), NF1 (n = 8) and FOXA1 alterations were associated with higher PSA90 (p = 0.03 and p = 0.003, respectively).</p><p><strong>Conclusions: </strong>This analysis identifies potential genomic predictors of response to 177Lu-PSMA-617, with NF1 and FOXA1 alterations associated with favorable outcomes and AR and TSG alterations with diminished response. These hypothesis-generating findings suggest genomic profiling may inform selection for PSMA-targeted therapy and warrant prospective validation in larger cohorts.</p><p><strong>Implications of practice: </strong>In this study, we evaluate the use of genetic markers to predict response to treatment with 177Lu-PSMA-617 in patients with metastatic prostate cancer. We identified that alterations in the androgen receptor (AR) and tumor suppressor genes (TSG) were associated with a worse response to 177Lu-PSMA-617, which FOXA1 and NF1 alterations were associated with improved outcomes. These data are hypothesis generating and warrant validation in larger studies. Identifying predictive markers to 177Lu-PSMA-617 can better optimize treatment selection for this therapy.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349998","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":"Cancer Interception During Treatment: Using Growth Kinetics to Create a Continuous Variable for Assessing Disease Response.","authors":"Mengxi Zhou, Antonion T Fojo, Lawrence H Schwartz, Susan E Bates, Krastan B Blagoev","doi":"10.1093/oncolo/oyaf353","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf353","url":null,"abstract":"<p><strong>Background: </strong>We applied 11 mathematical models of tumor growth to clinical trial data available from public and private sources. We have previously described the remarkable capacity for a simple biexponential model to describe the kinetics of tumor growth, fit thousands of datasets, and correlate with overall survival. We sought to extend our analysis to additional tumor types and to evaluate whether alternate growth models could describe the time course of disease burden in the small subset of patients in whom the biexponential model failed.</p><p><strong>Patients and methods: </strong>Data were available from 17,140 patients including imaging data for 3,346 patients and serum levels of tumor markers for 13,794 patients. Data from patients were analyzed using the biexponential model to determine rates of tumor growth (g) and regression (d); for those whose data could not be described by this model, fit of their data was assessed using seven alternative models. The rates of tumor growth (g rate), a continuous variable, were examined for association with the gold-standard of clinical trials, overall survival.</p><p><strong>Results: </strong>As we have previously reported, data from most patients fit a simple model of exponential growth and exponential regression (86%). Data from another 7% of patients fit an alternative model. We found growth rate correlates inversely with overall survival, remarkably even when data from various histologies are considered together. For patients with multiple timepoints of tumor measurement, growth rate could often be estimated even during the phase when only net regression could be discerned.</p><p><strong>Conclusions: </strong>Validation of a simple mathematical model across different cancers and its application to existing clinical data allowed estimation of the rate of growth of a treatment resistant subpopulation of cancer cells. The quantification of available clinical data using the growth rate of tumors in individual patients and its strong correlation with overall survival makes the growth rate an excellent marker of the efficacy of therapy.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350017","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":"Omitting radiotherapy in LUMINA-like breast cancer after breast conserving surgery: 10-year results of a population-based cohort study.","authors":"Shenkangle Wang, Ziyu Zhu, Binbin Cui, Mingpeng Luo, Xixi Lin, Zijie Guo, Qingliang Wu, Linbo Wang, Xiaonan Sun, Jichun Zhou","doi":"10.1093/oncolo/oyaf355","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf355","url":null,"abstract":"<p><strong>Background: </strong>Recently, the LUMINA trial reported 5-year results of omitting radiotherapy in a low-risk cohort after breast-conserving surgery (BCS). This study aimed to validate their 5-year results and investigate 10-year outcomes of patients satisfying their criteria in a population-based cohort.</p><p><strong>Materials and methods: </strong>28,185 eligible patients were identified from the Surveillance, Epidemiology and End Results (SEER) database to establish SEER-LUMINA cohort. The Kaplan-Meier method was employed to estimate recurrence incidence and survival outcomes. Matched cohorts were generated using propensity score matching (PSM). The Cox proportional hazards model was used to generate hazard ratios.</p><p><strong>Results: </strong>6,808 patients of the 28,185 did not receive radiotherapy while 21,377 underwent postoperative radiotherapy. After PSM, each group had 5,954 patients, revealing significant differences in local recurrence incidence (no-radiotherapy group 0.65% at 5 years and 3.68% at 10 years vs. radiotherapy group 0.14% at 5 years and 1.54% at 10 years, P < 0.001), BCSS (no-radiotherapy group 98.51% at 5 years and 96.11% at 10 years vs. radiotherapy group 99.05% at 5 years and 96.34% at 10 years, P = 0.028). No difference was observed in BCSS between the two groups for SEER-LUMINA patients with tumor ≤1.4 cm (the optimal tumor size cutoff value for BCSS) (P = 0.099).</p><p><strong>Conclusion: </strong>Incidence, whether 5-year or 10-year recurrence, was lower than 5% in the SEER-LUMINA cohort. Radiotherapy following BCS reduced the local recurrence statistically significantly for those patients, but the clinical impact of this reduction was modest. Radiotherapy did not result in a difference in BCSS for SEER-LUMINA patients with tumors ≤1.4 cm.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349993","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":"Kinetics and Management of Adverse Events Associated With Lorlatinib After 5 Years of Follow-Up in the CROWN Study.","authors":"Geoffrey Liu, Benjamin J Solomon, Julien Mazieres, Dong-Wan Kim, Diego Cortinovis, Takako Inoue, Richu Sharma, Holger Thurm, Anna Polli, Todd M Bauer","doi":"10.1093/oncolo/oyaf287","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf287","url":null,"abstract":"<p><strong>Background: </strong>With 5 years of follow-up in the phase 3 CROWN study, lorlatinib showed unprecedented improvement in progression-free survival coupled with prolonged intracranial efficacy in patients with ALK-positive metastatic non-small cell lung cancer (mNSCLC). Here we report kinetics and mitigation practices of select adverse events (AEs) to inform therapy management strategies.</p><p><strong>Methods: </strong>Post hoc safety analyses from the CROWN study assessed the incidence, prevalence, time to onset, duration, management, and resolution of hyperlipidemia, edema, weight gain, central nervous system (CNS) AEs, and peripheral neuropathy in the lorlatinib group (n = 149).</p><p><strong>Results: </strong>After 5 years of follow-up, no new safety signals were observed. All-cause any-grade and grade 3/4 AEs occurred in 100% and 77% of patients, respectively; AEs led to lorlatinib dose reduction in 23% of patients, dose interruption in 62%, and permanent discontinuation in 11%. The median time to onset of any-grade hyperlipidemia was 0.5 months; 71% of events were managed with lipid-lowering agents. Median time to onset of any-grade edema, weight gain, CNS AEs, and peripheral neuropathy ranged from 2 to 4 months. Most weight gain events (95%) were mitigated with lifestyle modifications. Incidence and prevalence of CNS AEs did not increase over time; 58% of events did not require medical intervention.</p><p><strong>Conclusion: </strong>This post hoc analysis suggests that with longer lorlatinib exposure, no new safety signals emerged, and treatment discontinuation due to AEs remained low after 5 years of follow-up. Most AEs were effectively managed with dose modifications, indicating that current management strategies can be effective to mitigate toxicity.</p><p><strong>Clinicaltrials.gov: </strong>NCT03052608.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350003","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":"Randomized controlled trial on eurythmy therapy versus slow-paced physical exercises for the treatment of fatigue in metastatic breast cancer patients.","authors":"Eliane Timm, Ilana Berlowitz, Ursula Wolf","doi":"10.1093/oncolo/oyaf343","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf343","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related fatigue is among the most taxing symptoms of breast cancer patients, but there is currently no established treatment standard. This study assessed the effect of eurythmy therapy (ERYT), a tailored mindful movement therapy, compared to slow-paced physical exercises (CoordiFit) on fatigue in metastatic breast cancer patients.</p><p><strong>Methods: </strong>We used a randomized controlled, open-label, multi-center, two-arm design. Ten certified oncology centers across Switzerland participated in the trial. Women with metastatic breast cancer who agreed to participate in the study were randomly allocated to one of the two study arms in a 1:1 ratio. The intervention sessions in both groups followed the same schedule in terms of frequency and duration over a period of 20 weeks. Outcomes were assessed using standard clinical assessment scales at baseline, weeks 8, 14, and 20, as well as at 6- and 12-months follow-up. The primary endpoint was the change in cancer-related fatigue (baseline to end of intervention), whereas secondary endpoints included quality of life, pain, sleep quality, depression, anxiety, distress, and arm mobility. Data was analyzed using two-way mixed ANOVA.</p><p><strong>Results: </strong>The study was terminated before its completion due to insufficient enrollment. Prior to its closure, a total of 19 patients (median age: 59.5, range 51-82) agreed to participate in the study, of whom 10 completed the full intervention (n = 5 per group). Although the small sample size limits the possibility of statistical inference, tentative analyses pointed to significant improvements in fatigue in response to both experimental and control interventions (F(1,8)=14.176, p = 0.006), with no difference between groups. Among secondary endpoints we found a main group effect in quality of life, which was significantly higher in the ERYT group (F(1,8)=7.179, p=.028), as well as an interaction effect in pain interference, the latter significantly improving in the ERYT group but not the CoordiFit group (F(1,8)=7.977, p=.022).</p><p><strong>Conclusion: </strong>While the results show a promising decrease in cancer-related fatigue in response to ERYT, this held true also for the movement-based control intervention, suggesting ERYT to be valuable, but not superior to other movement-based approaches for cancer-related fatigue. However, the small sample size limits the conclusions that can be drawn.</p><p><strong>Clinicaltrials.gov identifier: </strong>#NCT04024267.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350027","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":"Clinician documentation of social circumstances of older and younger women receiving chemotherapy for early breast cancer.","authors":"Suniti Mohan, Allison M Deal, Wenqing Zhu, Alexis C Wardell, Allison Ross, Kirsten A Nyrop, Hyman B Muss","doi":"10.1093/oncolo/oyaf357","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf357","url":null,"abstract":"<p><strong>Background: </strong>The Institute of Medicine (IOM) recommends that essential aspects of a patient's sociodemographic, psychological and behavioral characteristics be documented in the electronic health record (EMR).</p><p><strong>Patients and methods: </strong>For this study of women receiving chemotherapy for early breast cancer (Stage I-III), EMR clinician notes were queried with regard to documentation of the patient's current (1) living situation, (2) caregiver responsibilities, and (3) accompaniment during chemotherapy. Descriptive statistics for patient sociodemographic and tumor characteristics, and clinician-reported social circumstances were reported for older and younger patients and compared between two age groups using Fisher's exact tests for categorical variables and t-tests for continuous variables.</p><p><strong>Results: </strong>The sample includes 104 women aged 65 or older (range 65-83) (17% Black) and 250 under age 65 (range 23-64) (22% Black). Mean number of comorbidities was 3.7 (range 0-8) among older patients and 1.7 (range 0-9) among younger patients (p<.0001). There were no significant inter-group differences in breast cancer stage or phenotype. Clinician notes affirmatively documented that the patient was living with someone (70% older/85% younger) (p=.002), the patient had caregiver responsibilities (12% older/44% younger) (p<.0001) and was accompanied by someone during chemotherapy (79% older/89% younger) (p=.02).</p><p><strong>Conclusion: </strong>Clinician notes pertaining to younger patients as compared to older patients more often provided affirmative and specific documentation that the patient was living with someone, a caregiver for someone, and accompanied by someone during the chemotherapy infusion visit. These three factors are important to document and monitor in patients of all ages as they can impact treatment experience and quality of life during and after chemotherapy.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349980","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":"Survival outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer patients.","authors":"Chengshi Wang, Jianhui Zhang, Juecai Chen, Xiaoyan Zhang, Songbo Zhang, Purong Zhang, Junjie Li","doi":"10.1093/oncolo/oyaf356","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf356","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NACT) has been widely used in breast cancer patients. The aim of the study was to compare survival outcomes between breast cancer patients receiving NACT, with and without complete pathologic response (pCR), and those receiving adjuvant chemotherapy (ACT).</p><p><strong>Methods: </strong>Based on the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study including 48,350 breast cancer patients, 15,525 of whom with pCR after NACT, and 124,202 patients after ACT during the period of 2010-2021. In comparison with patients in ACT group, we assessed hazard ratios (HRs) of breast cancer-specific and overall mortality among individuals in NACT using Cox regression.</p><p><strong>Results: </strong>During the period of follow-up (median 5 years), 4,800 and 8,257 breast cancer-related deaths were identified among patients in NACT and ACT group, respectively. Patients in NACT group had unfavorable molecular type (human epidermal growth factor receptor 2 overexpression, triple negative), more advanced tumor features (higher grade and stage) and was more likely to undergo mastectomy and radiotherapy. Moreover, patients undergoing NACT had higher cumulative mortality rate of breast cancer (19.60% vs 10.46%), compared with those receiving ACT. After controlling for covariates, NACT patients were at increased risk of breast cancer-specific mortality (HR 1.47, 95% CI 1.41-1.53) compared with ACT patients. In contrast, NACT patients with pCR were associated with an improved breast cancer-specific survival (HR 0.59, 95% CI 0.54-0.64). The elevated risk was obviously greater among NACT patients in NACT-disfavored subgroups including lobular/mixed histology, well/moderately differentiated grade, local cancer stage, or HR+/HER2- molecular subtype (HRs 1.63-1.93).</p><p><strong>Conclusions: </strong>NACT patients have worse survival, compared with their ACT counterparts. Although patients with pCR after NACT derive significant survival benefits, NACT-disfavored subgroups may gain limited benefit from NACT, and alternative approaches should be considered.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349949","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":"Is lymph node metastasis an advanced event of gastrointestinal stromal tumor?","authors":"Qi Jiang, Peng Zhang, Weili Yang, Xiaodong Gao, Yingfeng Fu, Jun Zhang, Bo Zhang, Fan Feng, Gang Zhai, Yang Fu, Xin Wu, Xinhua Zhang, Xiaojun Wu, Zhidong Gao, Han Liang, Yanbing Zhou, Heli Liu, Kaixiong Tao","doi":"10.1093/oncolo/oyaf351","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf351","url":null,"abstract":"<p><strong>Background: </strong>The clinicopathological features and outcome of gastrointestinal stromal tumors (GISTs) with lymph node metastasis remain controversial owing to their low incidence. A multicenter retrospective cohort study was conducted to compare the clinicopathological features and oncologic outcomes of GIST without metastasis, with lymph node metastasis and with distant metastasis.</p><p><strong>Method: </strong>The medical records of patients with GISTs in 16 large medical centers in China from January 2014 to December 2022 were reviewed. Patients were divided into four groups: no metastasis (988 cases, 89.1%), lymph node metastasis without distant metastasis (75 cases, 6.8%), distant metastasis without lymph node metastasis (36 cases, 3.2%), and distant metastasis with lymph node metastasis group (10 cases, 0.9%). Propensity score matching (PSM) was performed to reduce confounding factors.</p><p><strong>Result: </strong>A total of 1109 cases of primary GIST were included in this study, comprising 607 males (54.7%) and 502 females (45.3%), with a mean age of 56.6 ± 11.9 years. Compared to that in GIST without lymph node metastasis, the proportion of non-gastric GIST was higher in GIST with lymph node metastasis (52.9% vs. 40.7%) with a larger tumor diameter (>10 cm: 36.5% vs. 18.1%) and more patients with distant metastasis (11.8% vs. 3.5%). Tumor location not in the stomach, the largest tumor diameter, and distant metastasis were independent risk factors for GIST with lymph node metastasis (all P < 0.05). After PSM, 96, 48, 24 patients comprised no metastasis, lymph node metastasis without distant metastasis, and distant metastasis without lymph node metastasis, respectively. The relapse-free survival (RFS) of the lymph node metastasis group was comparable to that of the distant metastasis group without lymph node metastasis (P = 0.368) and significantly inferior to that of no metastases (P = 0.042).</p><p><strong>Conclusion: </strong>The RFS of patients with GIST with lymph node metastasis was comparable to those with distant metastasis and significantly worse than those without metastasis. Lymph node metastasis is an advanced event in GIST.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309979","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":"Comparison of Clinicopathological Features and Survival in Triple-Negative and Non-Triple Negative Breast Cancer Patients in Tanzania.","authors":"Eulade Rugengamanzi, Nazima Dharsee, Emmanuel L Lugina, Jesse Jonathan Kashabano, Gad Murenzi, Alan Paciorek, Godfrey Malangwa, Mathias Banzi, Glory Makupa, Godwin Nnko, Leila Mwakipunda, Amie Y Lee","doi":"10.1093/oncolo/oyaf345","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf345","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer is a heterogeneous disease with a wide spectrum of subtypes, each with distinct biological features. Data on tumor subtypes in East Africa is sparse despite the rising incidence of breast cancer in this region. We aimed to determine the prevalence of triple-negative breast cancer (TNBC) and to compare clinicopathological features, overall survival (OS), and factors affecting OS of patients with TNBC and non-TNBC in Tanzania.</p><p><strong>Patients and methods: </strong>This retrospective nested case-control study included patients with histologically proven breast cancer treated at Ocean Road Cancer Institute (ORCI) in Tanzania from January 2018 to December 2019. Logistic regression was used to determine factors associated with TNBC, and Cox proportional hazards regression was used to determine the factors independently associated with overall survival.</p><p><strong>Results: </strong>TNBC constituted 23.3% of all breast cancer diagnoses. Patients in the TNBC group were younger (median age 46 vs 53 years p < 0.001) and more often presented with stage IV disease (12% vs 4%, p = 0.001). Three-year overall survival (OS) was significantly lower in the TNBC group (36%) compared to the non-TNBC group (57%) (p = 0.004) and remained lower for the TNBC group across every tumor stage. Brain metastasis was higher in the TNBC group (34% vs 7%, p < 0.001). Factors associated with improved survival included shorter symptom duration (0.53, (0.36-0.78), earlier stage (0.23, (0.12-0.46)), use of neoadjuvant chemotherapy (0.59 (0.40-0.86)), and surgery with clean margins (0.34 (0.19-0.60)).</p><p><strong>Conclusions: </strong>TNBC accounted for nearly a quarter of the breast cancers at ORCI. TNBC was associated with younger age, more aggressive clinicopathologic features, and worse survival. Efforts toward earlier diagnosis and optimized therapies will be critical to improving TNBC outcomes in Tanzania.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310005","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":"Different prognosis for stage IIB cervical cancer patients with unilateral or bilateral parametrial invasion treated with concurrent chemoradiotherapy.","authors":"Xi-Lin Yang, Li-Chun Wei, Jian-Li He, Tie-Jun Wang, Li Ran, Li-Juan Zou, Xiao-Ge Sun, Xiao-Mei Li, Zi Liu, Yong-Gang Shi, Sha Li, Feng-Ju Zhao, Kun Gao, Wei Zhong, Guang-Hui Cheng, Ya-Li Gao, Bao-Sheng Sun, Jun-Fang Yan, Fu-Quan Zhang","doi":"10.1093/oncolo/oyaf329","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf329","url":null,"abstract":"<p><strong>Objective: </strong>To compare the survival difference between 2018 International Federation of Gynecology and Obsterics (FIGO) stage IIB cervical cancer (CC) patients with Unilateral parametrial invasion (UL) and Bilateral parametrial invasion (BL) disease and explore the significant role of parametrial invasion (PI) in prognosis prediction.</p><p><strong>Methods: </strong>A total of 506 stage IIB CC patients were identified from the multi-center study and patients were divided into UL and BL groups according to gynecological and radiological examination. Survival outcomes were estimated and compared between two groups before and after Propensity Scoring Matching (PSM). The role of upper 2/3 vaginal invasion (VI) in impacting survival probability was also assessed. The random forest (RF) model was constructed and validated to select important features related to survival outcomes and predict prognosis for these patients. The SHapley Additive exPlanation (SHAP) was further introduced to provide better understanding towards the findings from RF model.</p><p><strong>Results: </strong>Significant better 5-year overall survival (OS) was observed among patients with UL disease whether before [BL : 61.7% (95%CI : 57.0%-66.4%); UL : 84.8% (95%CI : 82.4%-87.2%); HR = 2.83, 95%CI : 1.90-4.20, P < 0.001] or after PSM [BL : 61.3% (95%CI : 56.6%-66.0%); UL : 81.2% (95%CI : 77.3%-85.1%); HR = 2.51, 95%CI : 1.56-4.04, P < 0.001]. Similar findings could also be observed in terms of progression free survival (PFS). The presence of VI didn't significantly impair the survival probability whether in UL or BL group (All P > 0.05). RF model was constructed, which possessed decent predictive ability both in the training (AUC = 0.893; 95%CI : 0.874-0.912) and validation cohort (AUC = 0.879; 95%CI : 0.801-0.957). PI was identified to be the paramount feature in affecting the survival outcomes for stage IIB CC patients through the Beeswarm summary plot and bar chart in SHAP analysis.</p><p><strong>Conclusion: </strong>Our findings demonstrated that 2018 FIGO stage IIB CC patients with BL disease had worse prognosis than those with UL disease and PI was the most significant feature in prognosis prediction for these patients.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304354","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}