Oncologist最新文献

{"title":"A novel referral system to optimize timing to specialized palliative care in patients with advanced cancer: an interventional study.","authors":"Giacomo Massa, Ernesto Zecca, Gabriele Tinè, Alessia Garavaglia, Antonino Tallarita, Andra D Dumitrascu, Eleonora Cristarella, Alessandra Pigni, Rosalba Miceli, Paolo G Casali, Lisa Licitra, Filippo G M deBraud, Cinzia Brunelli, Augusto F T Caraceni","doi":"10.1093/oncolo/oyag428","DOIUrl":"https://doi.org/10.1093/oncolo/oyag428","url":null,"abstract":"<p><strong>Background: </strong>Early integration of specialist palliative care (PC) improves outcomes for patients with advanced cancer, yet implementation of needs-based referral remains inconsistent in routine oncology practice. The Palliative Care Referral System (PCRS) is a digital clinical decision-support tool designed to support referral using patient-reported symptoms, prognostic indicators, and clinical complexity. We evaluated the impact of PCRS implementation on referral patterns, patient-centered outcomes, healthcare utilization, and end-of-life (EoL) care.</p><p><strong>Patients and methods: </strong>In this single-center prospective quasi-experimental pre-post implementation study, 380 patients with advanced solid tumors were enrolled before (Pre-PCRS, n = 190) and after (Post-PCRS, n = 190) PCRS implementation. During the Post-PCRS phase, oncologists completed the PCRS at each outpatient visit. Patient and caregiver satisfaction, quality of life, healthcare utilization, and EoL indicators were assessed monthly for six months. Time to first PC referral was analyzed using competing-risk methods.</p><p><strong>Results: </strong>Overall 24-week referral rates were similar in the Post-PCRS and Pre-PCRS cohorts (21% vs 20%). However, referral timing and patterns changed across tumor types, with earlier referrals in breast and prostate cancer after PCRS implementation. The proportion of patients with at least one hospitalization was numerically lower after implementation (16% vs 27%; OR, 0.53; 95% CI, 0.32-0.88; p = 0.017), but the difference was not significant after correction for multiple comparisons (p = 0.085). No significant differences were observed in patient or caregiver satisfaction, quality of life, emergency department visits, oncology visits, or PC visits. Indicators of aggressive EoL care were not significantly different between cohorts.</p><p><strong>Conclusions: </strong>PCRS implementation did not increase the overall referral rate but was associated with changes in referral timing and patterns across tumor types. Whether these changes reflect more appropriate, needs-based care and translate into lower healthcare utilization requires confirmation in larger studies.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289849","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":"Gabapentinoids for Oncologic Pruritus: A Retrospective Cohort Study.","authors":"Alim Osman, Ian Nykaza, Sarah L Spaulding, Stephen W Dusza, Lavanya Mittal, Allison Gordon, Shamir Geller, Cesar A Virgen, Veronica Rotemberg, Doris M Ponce, Jasmeet C Singh, Jodi Victoria Mones, Alina Markova","doi":"10.1093/oncolo/oyag431","DOIUrl":"https://doi.org/10.1093/oncolo/oyag431","url":null,"abstract":"<p><strong>Background: </strong>Pruritus is a debilitating symptom in oncologic patients which often leads to treatment interruptions or dose reductions and reduced quality of life. Gabapentinoids such as gabapentin and pregabalin approved for postherpetic neuralgia, partial seizures, neuropathic pain, and fibromyalgia have also demonstrated efficacy in treating non-oncologic forms of pruritus. We report on the safety and efficacy of gabapentinoids for oncologic pruritus.</p><p><strong>Patients and methods: </strong>This was a single-center retrospective cohort study conducted at the Memorial Sloan Kettering Cancer Center (MSK). All patients from 4/1/2019-8/1/2024 prescribed gabapentinoids for oncologic pruritus were retrospectively identified.</p><p><strong>Results: </strong>224 patients were included; the average age of the cohort was 63.2 ± 15 years and were mostly male (54%). Patients were treated for pruritus secondary to drug-induced causes (60.3%), malignancy/paraneoplastic (15.2%), cutaneous graft-versus-host disease (13.4%), and other etiologies (11.2%). Pregabalin was more frequently prescribed than gabapentin (80.8% vs. 19.2%). Ninety percent of patients (n = 202) experienced ≥1 grade improvement in CTCAE grade, at a median dosage 50 mg and 300 mg for pregabalin and gabapentin, respectively. The median time to patient-reported initial symptom improvement was 18.5 days. The median time to the documented ≥1 CTCAE grade improvement was 3.5 months (95% CI: 3.0-4.7), with no significant difference observed between pruritus etiologies. Adverse events were reported in 14.7% of patients, most commonly sedation (8.5%). Only three patients discontinued gabapentinoids due to adverse events.</p><p><strong>Conclusion: </strong>Our results demonstrate that gabapentinoids are a safe and effective way to treat oncologic pruritus.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289813","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":"Outcomes of Chemoimmunotherapy in Metastatic Pancreatic Neuroendocrine Carcinoma: A Single-Center Clinicopathologic Study.","authors":"Drew Moss, Catherine A O'Connor, Marc Hilmi, Nuray Tezcan, Rohit Thummalapalli, Joanne F Chou, Maria Perry, Daniel Muldoon, Chaitanya Bandlamudi, Tae-Hyung Kim, Danny N Khalil, Geoffrey Ku, James Harding, Zoe Goldberg, Ziv Etay, Christine Iacobuzio, Olca Basturk, Marinela Capanu, Nitya Raj, Eileen M O'Reilly, Wungki Park","doi":"10.1093/oncolo/oyag429","DOIUrl":"https://doi.org/10.1093/oncolo/oyag429","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic neuroendocrine carcinomas (PanNECs) are a rare, aggressive subtype of pancreatic neuroendocrine neoplasms. Based upon similarities to small cell lung cancer (SCLC), advanced PanNECs are commonly treated with platinum and etoposide chemotherapy; however, outcomes remain poor. Although first-line chemoimmunotherapy has improved survival in SCLC, its role in PanNEC is not well defined.</p><p><strong>Methods: </strong>We report on a retrospective cohort of 13 patients with metastatic PanNEC treated at Memorial Sloan Kettering with either first-line combined chemoimmunotherapy or first-line chemotherapy alone.</p><p><strong>Results: </strong>In the first-line metastatic setting, patients who received chemoimmunotherapy (N = 5) demonstrated longer median progression-free survival (17.0 months vs. 2.8 months, P = 0.002) and overall survival (31.0 months vs. 16.0 months, P = 0.031) compared with those who received chemotherapy alone (N = 8). In the second line or later setting, five patients received immunotherapy-containing regimens with a median progression free survival of only 3.0 months (95% confidence interval 1.4 months, Not Reached). Radiologic responses observed in patients receiving chemoimmunotherapy in the first-line metastatic setting were 2 complete responses and 3 partial responses. Germline variants included one patient with a BRCA2 mutation, one patient with co-existing BRCA2 and ATM mutations, and one patient with a MUTYH mutation. Exploratory genomic analyses showed common mutations in TP53, RB1, and KRAS, low tumor mutational burden, and microsatellite stability. Exploratory multiplex immunofluorescence demonstrated heterogenous immune cell infiltrates without a consistent biomarker pattern associated with response.</p><p><strong>Conclusion: </strong>In this single-center cohort, early incorporation of chemoimmunotherapy in PanNEC was associated with improved survival. These findings are hypothesis-generating and support prospective, multicenter evaluation of first-line chemoimmunotherapy strategies in PanNEC (SWOG S2012, NCT05058651) [1].</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289854","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":"Rethinking Radiation Therapy in the Era of RAS Inhibition for Pancreatic Cancer.","authors":"Michael D Chuong, Eileen M O'Reilly","doi":"10.1093/oncolo/oyag433","DOIUrl":"https://doi.org/10.1093/oncolo/oyag433","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289819","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":"Exceptional Long-Term Responses in Metastatic Androgen Pathway-Modulation Sensitive Prostate Cancer.","authors":"Varun Nandakumar, Georges Gebrael, Neeraj Agarwal","doi":"10.1093/oncolo/oyag412","DOIUrl":"https://doi.org/10.1093/oncolo/oyag412","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277226","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":"Pelvic Insufficiency Fractures After Chemoradiotherapy for Cervical Cancer: Incidence, Long-Term Outcomes, and Survivorship Management.","authors":"Akram Saad, Jeffrey Goldstein, Ronza Atamneh, Limor Helpman, Ronnie Shapira, Omer Berner, Ofir Morag, Oded Jacobi, Dana Oren, Hanifa J Abu-Toamih Atamni, Reut Mordechai, Itay Goor Aryeh, Alexandra Taylor, Shira Peleg Hasson, Shira Felder","doi":"10.1093/oncolo/oyag427","DOIUrl":"https://doi.org/10.1093/oncolo/oyag427","url":null,"abstract":"<p><strong>Background: </strong>Pelvic insufficiency fractures, a late complication of chemoradiotherapy for cervical cancer, can cause pain and functional impairment. Although most studies have reported incidence rates and risk factors, few have examined clinical presentation, long-term symptom burden, or the impact on survivorship.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients with cervical cancer treated with chemoradiotherapy from 2018 to 2024. We extracted clinical characteristics, treatment details, dosimetric parameters, imaging studies documenting pelvic insufficiency fractures, and clinical outcomes from the electronic medical record. We used the Kaplan-Meier method to estimate the probability of pelvic insufficiency fractures and univariate Cox regression to assess clinical and dosimetric factors associated with their development.</p><p><strong>Results: </strong>The cohort comprised 153 patients (median follow-up: 41.4 months). After chemoradiotherapy, 18 patients (11.8%) developed radiologically confirmed pelvic insufficiency fractures (median time to diagnosis: 9.5 months; probability of pelvic insufficiency fracture at 24 months: 11.4%). PET-CT and/or MRI showed that most pelvic insufficiency fractures involved the sacrum. No statistically significant clinical or dosimetric predictors of pelvic insufficiency fractures were identified. All symptomatic patients (n = 15, 83%) required referral to pain-management services (median observed duration of symptoms: 37 months). No symptomatic patient achieved documented complete symptom resolution during the available follow-up.</p><p><strong>Conclusions: </strong>Most pelvic insufficiency fractures presented with new-onset pelvic or sacral pain within two years of completing chemoradiotherapy. The lack of clinical or dosimetric predictors suggests a multifactorial etiology of fracture risk. Persistent pain, despite multimodal supportive care, led to long-term morbidity. These findings underscore the need for prospective studies to develop evidence-based preventive strategies, survivorship assessments, and management pathways.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277214","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":"Targeting the MTAP-PRMT5 axis: from synthetic lethality to emerging therapeutic opportunities.","authors":"Vassilis Genoud, Maxime Borgeaud, Mihaela Aldea, Thibaud Koessler, Alfredo Addeo","doi":"10.1093/oncolo/oyag425","DOIUrl":"https://doi.org/10.1093/oncolo/oyag425","url":null,"abstract":"<p><p>Homozygous deletion of MTAP, one of the most frequent somatic copy-number alterations in cancer, creates a context of synthetic lethal vulnerability. MTAP loss leads to the accumulation of MTA which partly inhibits PRMT5, and induces a dependency on residual PRMT5 activity; a dependency that can be pharmacologically exploited. This review describes the MTAP-PRMT5 synthetic lethal axis from molecular biology to clinical translation. First-generation non-selective PRMT5 inhibitors were limited by hematological toxicity and reduced potency in MTA-rich environments. Second-generation MTA-cooperative inhibitors, which overcome these constraints by selectively stabilizing the inactive PRMT5-MTA complex, are characterized by tumor selectivity. Early-phase clinical data for MTA cooperative PRMT5 inhibitors showed encouraging signals of efficacy with manageable safety profiles in early phase trials, establishing clinical proof of concept. Various agents have now entered next steps of clinical development either alone or in combination. In this review we also discuss the biomarker challenges, essential to.</p><p><strong>Patient: </strong>selection, including the limitations of different methods, as well as emerging resistance mechanisms to PRMT5 inhibitors. Molecular testing standardization, pharmacodynamic endpoint integration, and prospective resistance characterization are identified as priorities for next phases of development of PRMT5 inhibition.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277277","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":"Sequential Therapy with Anlotinib and Radioiodine for Distant Metastatic Differentiated Thyroid Cancer: A Phase II Clinical Trial.","authors":"Hongjun Song, Chentian Shen, Youben Fan, Zhiyan Liu, Yonggang Wang, Quanyong Luo, Libo Chen","doi":"10.1093/oncolo/oyag426","DOIUrl":"https://doi.org/10.1093/oncolo/oyag426","url":null,"abstract":"<p><strong>Background: </strong>Radioiodine (RAI) alone exhibited limited efficacy in distant metastatic differentiated thyroid cancer (DTC). We hypothesized that pretreatment with anlotinib, a potent antiangiogenic tyrosine kinase inhibitor, would reduce tumor burden and improve therapeutic response.</p><p><strong>Methods: </strong>This prospective, single-arm phase II trial enrolled patients with measurable distant metastatic DTC. All patients received anlotinib 12 mg/day orally for 12 weeks. After confirmation of RAI-avid target lesions on diagnostic ¹³¹I-WBS, patients were treated with 7.4 GBq RAI and followed up for another 12 weeks. Sequential therapy continued until no effect of RAI could be anticipated. Primary endpoints were objective response rate (ORR) and safety. Registered with the Chinese Clinical Trial Registry (ChiCTR2100045178; https://www.chictr.org.cn).</p><p><strong>Results: </strong>24 patients were enrolled. 14 (58%) were excluded due to non-RAI-avid target lesions; 10 (42%) with RAI-avid lesions received sequential therapy (median, 4.5 cycles). ORR was 60% (all partial responses), disease control rate 100%. With median follow-up 34.5 months, no disease progression or death occurred. In the subgroup of eight patients with bone target lesions, ORR was 50%. Grade 3 anlotinib-related adverse events occurred in 30% of patients; no grade 4/5 toxicities or grade ≥2 RAI-related events were observed.</p><p><strong>Conclusion: </strong>Sequential anlotinib followed by RAI therapy demonstrated promising antitumor activity (ORR 60%) and favorable safety in RAI-avid distant metastatic DTC, particularly in bone metastases. These findings are hypothesis-generating and require validation in a randomized trial with an RAI monotherapy control arm.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247433","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":"Real-World Comparative Effectiveness of FOLFOX, FOLFIRI, and CapOx as Second-Line Chemotherapy for Advanced Biliary Tract Cancer.","authors":"Chun-Yang Chao, Kuan-Yu Tseng, Hsin-Chen Lin, Yu-Hsuan Shih","doi":"10.1093/oncolo/oyag424","DOIUrl":"https://doi.org/10.1093/oncolo/oyag424","url":null,"abstract":"<p><strong>Background: </strong>Advanced biliary tract cancer (BTC) has a poor prognosis following progression on first-line gemcitabine plus cisplatin. However, evidence comparing second-line chemotherapy regimens remains limited. This study aimed to compare the effectiveness and safety of fluorouracil, leucovorin, and oxaliplatin (FOLFOX); fluorouracil, leucovorin, and irinotecan (FOLFIRI); and capecitabine plus oxaliplatin (CapOx).</p><p><strong>Patients and methods: </strong>Adults with advanced BTC who received first-line gemcitabine plus cisplatin followed by second-line FOLFOX, FOLFIRI, or CapOx between January 2010 and July 2025 were identified from the TriNetX Global Collaborative Network. Patients who subsequently received molecularly targeted therapies were excluded. The study included 825 patients receiving FOLFOX, 184 receiving FOLFIRI, and 149 receiving CapOx; after 1:1 propensity score matching, the respective comparisons included 182 and 149 patients per group. Overall survival (OS) and treatment-related adverse events were compared between the matched cohorts.</p><p><strong>Results: </strong>The median OS was comparable between FOLFOX and FOLFIRI (5.7 months vs. 5.8 months, P=.958) and between FOLFOX and CapOx (5.7 months vs. 5.8 months, P=.803). The overall adverse event profiles were also comparable. However, FOLFOX was associated with lower rates of neutropenia but higher rates of thrombocytopenia than FOLFIRI. In contrast, FOLFOX and CapOx demonstrated similar toxicity despite modest differences in anemia and thrombocytopenia.</p><p><strong>Conclusion: </strong>This real-world study demonstrates comparable survival outcomes among FOLFOX, FOLFIRI, and CapOx as second-line chemotherapies for advanced BTC. These findings support individualized regimen selection based on patient characteristics and toxicity profiles.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240370","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":"Characteristics and Outcomes of NATALEE- and monarchE-Eligible Early Breast Cancer in Finland: A Regional Real-world Cohort Study.","authors":"Sari Voutilainen, Samuli Tuominen, Liisa Ukkola-Vuoti, Sari Hernesniemi, Mia Engström-Risku, Björn Paulsson, Maija Wolf, Peeter Karihtala","doi":"10.1093/oncolo/oyag419","DOIUrl":"https://doi.org/10.1093/oncolo/oyag419","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant CDK4/6 inhibitors have improved outcomes in hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) early breast cancer (eBC) in the NATALEE and monarchE trials. However, real‑world evidence on the proportion of candidates for adjuvant CDK4/6 inhibitors and their outcomes within these trial-defined populations remains limited.</p><p><strong>Materials and methods: </strong>We conducted a retrospective, population‑based cohort study including all patients diagnosed with HR+/HER2- eBC in the Hospital District of Helsinki and Uusimaa, Finland, between January 2014 and June 2023. Patients were classified according to NATALEE and/or monarchE eligibility criteria. Outcomes assessed were invasive disease‑free survival (iDFS), distant disease‑free survival (DDFS), and overall survival (OS).</p><p><strong>Results: </strong>Among 8,911 patients with HR+/HER2- eBC and a median follow-up of 5.2 years, 40.4% met the NATALEE eligibility criteria and 15.0% met the monarchE criteria. Eligible patients were younger and had higher‑grade tumors and greater proliferation rate than non-eligible patients. Five‑year outcomes were consistently worse in eligible than ineligible patients (NATALEE: iDFS 82.5% vs. 89.6%, DDFS 88.3% vs. 94.5%, OS 90.9% vs. 95.6%; monarchE: iDFS 76.8% vs. 88.4%, DDFS 82.3% vs. 93.8%, OS 86.8% vs. 94.9%). Metastatic progression occurred three‑ to six‑fold more often in eligible patients. In multivariable models, both NATALEE and monarchE eligibility were associated with distant metastasis, and mortality.</p><p><strong>Conclusion: </strong>Real-world outcomes among NATALEE and monarchE-eligible patients are consistent with results from phase III trial comparator arms. Trial‑defined eligibility criteria reliably identify patients with substantially poorer prognosis, supporting risk‑adapted adjuvant strategies and the integration of CDK4/6 inhibitors into clinical practice.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229427","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}