Oncologist最新文献

{"title":"Correction to: Association between sidedness and survival among chemotherapy refractory metastatic colorectal cancer patients treated with trifluridine/tipiracil or regorafenib.","authors":"","doi":"10.1093/oncolo/oyaf009","DOIUrl":"10.1093/oncolo/oyaf009","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506044","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":"Resource utilization and inpatient hospitalization costs associated with thromboembolic events among patients with polycythemia vera.","authors":"Jingbo Yu, Julie Gayle, Ning Rosenthal, Harold Brown, Evan Braunstein, Naveen Pemmaraju","doi":"10.1093/oncolo/oyaf001","DOIUrl":"10.1093/oncolo/oyaf001","url":null,"abstract":"<p><strong>Background: </strong>Healthcare resource utilization (HCRU) and costs are often elevated in patients with polycythemia vera (PV), and this patient population has an increased risk of developing thromboembolic events (TEs). This study describes HCRU, costs, and mortality during TE-related hospitalizations among patients with PV in a contemporary real-world setting in the United States.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included adult inpatients with PV and TE discharged from 623 hospitals between January 1, 2017, and June 30, 2020 with a 2-year follow-up period after the first TE-related (index) hospitalization. Data were abstracted from the PINC AI Healthcare database, which includes 25% of US inpatient discharges.</p><p><strong>Results: </strong>Among 3494 patients (index TE: arterial, 69.1%; venous, 27.1%; both, 3.7%), mean (SD) age was 70.7 (14) years, and most patients were male (58.6%), White (81.2%), with Medicare insurance (72.6%). Mean (SD) Charlson Comorbidity Index score was 3.2 (2.3). Mean total hospitalization costs were $24 403 during the index hospitalization (mean [SD] hospital length of stay [LOS], 7 [9] days). A third (n = 1150) of patients were admitted to the intensive care unit (mean cost, $29 342; mean [SD] LOS, 5 [7] days). During 30 days and 2 years of follow-up, the TE-related readmission rate was 6.4% and 20.0%, respectively. All-cause mortality was 6.2% during index hospitalization; an additional 4.7% occurred during the 2-year follow-up period.</p><p><strong>Conclusion: </strong>Among patients with PV and TE, inpatient hospitalization HCRU, costs, and mortality were substantial. These findings highlight the importance of preventing TEs in the management of PV.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558577","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":"Proceedings of the 1st biannual bridging the gaps in lung cancer conference.","authors":"Narjust Florez, Sandip P Patel, Heather Wakelee, Lyudmila Bazhenova, Erminia Massarelli, Ravi Salgia, Brendon Stiles, Solange Peters, Jyoti Malhotra, Shirish M Gadgeel, Jorge J Nieva, Michelle Afkhami, Fred R Hirsch, Matthew Gubens, Tina Cascone, Benjamin Levy, Joshua Sabari, Hatim Husain, Patrick C Ma, Leah M Backhus, Puneeth Iyengar, Percy Lee, Russell Miller, Jacob Sands, Edward Kim","doi":"10.1093/oncolo/oyae228","DOIUrl":"10.1093/oncolo/oyae228","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer death in the US and globally. The mortality from lung cancer has been declining, due to a reduction in incidence and advances in treatment. Although recent success in developing targeted and immunotherapies for lung cancer has benefitted patients, it has also expanded the complexity of potential treatment options for health care providers. To aid in reducing such complexity, experts in oncology convened a conference (Bridging the Gaps in Lung Cancer) to identify current knowledge gaps and controversies in the diagnosis, treatment, and outcomes of various lung cancer scenarios, as described here. Such scenarios relate to biomarkers and testing in lung cancer, small cell lung cancer, EGFR mutations and targeted therapy in non-small cell lung cancer (NSCLC), early-stage NSCLC, KRAS/BRAF/MET and other genomic alterations in NSCLC, and immunotherapy in advanced NSCLC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141835","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":"The pathologic and genomic evolution of primary malignant phyllodes tumors of the breast: retrospective cohort study and case-control genomic analysis.","authors":"Carmine Valenza, Dario Trapani, Francesca Maria Porta, Edoardo Olmeda, Aurora Gaeta, Luca Boscolo Bielo, Federica Conversano, Tommaso Martino De Pas, Grazia Castellano, Celeste Santoro, Elena Battaiotto, Eltjona Mane, Sara Coppola, Fabio Conforti, Denise Mattar, Sara Gandini, Paolo Veronesi, Elena Guerini Rocco, Elisabetta Pennacchioli, Giuseppe Curigliano","doi":"10.1093/oncolo/oyaf012","DOIUrl":"10.1093/oncolo/oyaf012","url":null,"abstract":"<p><strong>Background: </strong>In patients with phyllodes tumors of the breast, the presence of mediator of RNA polymerase II transcription subunit 12 homolog mutations (MED12m) and a history of previous fibroadenoma may predict better outcomes. To aid in the prognostication of malignant phyllodes tumors of the breast (B-MPT), we assessed the prognostic value of fibroadenoma-like areas (supposed to have stemmed from a pre-existing fibroadenoma) and MED12m, in patients with resected primary B-MPTs.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective, cohort study including all consecutive patients aged ≥18 years old, with non-metastatic B-MPT, who underwent surgery from January 2000 to December 2021. The endpoints were the cumulative incidences of all recurrences, according to the presence of fibroadenoma-like areas, reviewed by 3 reference pathologists. A nested, case-control genomic analysis was performed to evaluate the association between MED12m, the presence of fibroadenoma-like areas, and cancer recurrences.</p><p><strong>Results: </strong>Eight-nine patients were included, with 47% of tumors exhibiting Fibroadenoma-Like Areas (FLA+). These areas were not significantly associated with local recurrence (5-year cumulative incidence in FLA+ vs FLA-: 13.0, 95%CI [4.6-25.9] vs 23.6, 95%CI [11.9-37.5]; P = .14) or distant recurrence (5-year cumulative incidence in FLA+ vs FLA-: 12.5, 95%CI [4.5-25.0] vs 8.9, 95%CI [2.8-19.5], P = .61), at a median follow-up of 6.7 years. MED12m was not associated with distant recurrences or the presence of fibroadenoma-like areas.</p><p><strong>Conclusions: </strong>Half of B-MPTs are characterized by the presence of fibroadenoma-like areas. This pathologic feature is not significantly associated with lower distant and local recurrences nor with the presence of MED12 mutations.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374970","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":"The complex interplay of antibiotic use and immune checkpoint inhibition.","authors":"Lawrence W Wu, Ryan H Moy","doi":"10.1093/oncolo/oyaf010","DOIUrl":"10.1093/oncolo/oyaf010","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411409","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":"Reinventing chemotherapy.","authors":"Bruce A Chabner, Jacob Gehri, Beatrix B Thompson","doi":"10.1093/oncolo/oyae331","DOIUrl":"https://doi.org/10.1093/oncolo/oyae331","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558387","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":"Efficacy of cyclin-dependent kinase inhibitors with concurrent proton pump inhibitors in patients with breast cancer: a systematic review and meta-analysis.","authors":"Zijie Guo, Ziyu Zhu, Mingpeng Luo, Yijia Cao, Xixi Lin, Qingliang Wu, Shenkangle Wang, Linbo Wang, Jichun Zhou","doi":"10.1093/oncolo/oyae320","DOIUrl":"10.1093/oncolo/oyae320","url":null,"abstract":"<p><strong>Background: </strong>The impact of concurrent proton pump inhibitors (PPIs) use on the prognosis of patients with breast cancer undergoing cyclin-dependent kinase inhibitors (CDKIs) treatment is currently uncertain. Considerable divergence exists regarding the clinical studies. In this study, we aim to perform a comprehensive analysis to evaluate the influence of concomitant PPI use on the effectiveness and adverse effects of CDKIs in patients with breast cancer.</p><p><strong>Methods: </strong>This study encompassed all pertinent clinical studies published up to the present, following the PRISMA guidelines. The study used hazard ratio (HR) or odds ratio (OR) as a summary statistic and used fixed or random effects models for pooled estimation.</p><p><strong>Results: </strong>This study incorporated 10 research articles involving 2993 participants. Among patients with breast cancer undergoing treatment with CDKIs, the simultaneous administration of PPIs was associated with a notable reduction in overall survival (HR = 2.00; 95% CI, 1.35-2.96). Nevertheless, no substantial correlation was observed between the simultaneous utilization of PPIs and the progression-free survival (PFS) of patients (HR = 1.30; 95% CI, 0.98-1.74). PFS did not change significantly when considering different drugs, treatment lines, or regions alone. Furthermore, the simultaneous administration of PPIs was found to result in a notable decrease in the incidence of grades 3/4 risk factors (OR = 0.63, 95% CI, 0.46-0.85).</p><p><strong>Conclusion: </strong>The concurrent administration of PPIs did not result in significant alterations in the risk of disease advancement among patients with breast cancer undergoing CDKIs treatment. The utilization of PPIs led to a decrease in the adverse effects linked to the administration of CDKIs.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442756","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":"Systemic inflammation and changes in physical well-being in patients with breast cancer: a longitudinal study in community oncology settings.","authors":"Nikesha Gilmore, Yue Li, Christopher L Seplaki, Michael Sohn, Ying Yang, Chin-Shang Li, Kah Poh Loh, Po-Ju Lin, Amber Kleckner, Mostafa Mohamed, Paula Vertino, Luke Peppone, Karen Mustian, Sindhuja Kadambi, Steven W Corso, Benjamin Esparaz, Jeffrey K Giguere, Supriya Mohile, Michelle C Janelsins","doi":"10.1093/oncolo/oyae212","DOIUrl":"10.1093/oncolo/oyae212","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy adversely affects physical well-being and inflammation may be related to changes in physical well-being. We evaluated the association of systemic inflammation with changes in physical well-being.</p><p><strong>Methods: </strong>In a prospective study of 580 patients with stages I-III breast cancer we assessed immune cell counts, neutrophil:lymphocyte ratio (NLR), lymphocyte:monocyte ratio (LMR), and platelet:lymphocyte ratio (PLR) within 7 days before chemotherapy (pre-chemotherapy). Physical well-being was assessed using the Functional Assessment of Cancer Therapy: General-Physical Well-being subscale (FACT-PWB) pre-chemotherapy and 1 month and 6 months post-chemotherapy. Clinically meaningful decline in physical well-being was determined as decreasing FACT-PWB by more than one point from pre-chemotherapy level, and non-resilience defined as having decline post-chemotherapy and not returning to within one-point of pre-chemotherapy FACT-PWB by 6 months post-chemotherapy. Multivariable logistic regressions examined the association between inflammation and changes in physical well-being, adjusting for sociodemographic and clinical characteristics.</p><p><strong>Results: </strong>Fifty-nine percent (310/529) and 36% (178/501) of participants had physical well-being decline post-chemotherapy and 6 months post-chemotherapy, respectively. Fifty percent (147/294) were non-resilient. Low NLR and PLR were associated with 1.78 (P = .01) and 1.66 (P = .02) fold greater odds of having a decline in physical well-being 6 months post-chemotherapy compared to those with high NLR and PLR, respectively. Low NLR and PLR were associated with 1.92 (P = .02) and 2.09 (P = 0.01) fold greater odds of being non-resilient 6 months post-chemotherapy compared to those with high NLR and PLR, respectively.</p><p><strong>Conclusion: </strong>Low NLR and PLR were associated with chemotherapy-induced changes in physical well-being independent of sociodemographic and clinical risk factors.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037769","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":"Detrimental effect of an early exposure to antibiotics on the outcomes of immunotherapy in a multi-tumor cohort of patients.","authors":"Patricia Guerrero, Víctor Albarrán, Carlos González-Merino, Coral García de Quevedo, Pilar Sotoca, Jesús Chamorro, Diana Isabel Rosero, Ana Barrill, Víctor Alía, Juan Carlos Calvo, Jaime Moreno, Patricia Pérez de Aguado, Pablo Álvarez-Ballesteros, María San Román, Juan José Serrano, Ainara Soria, María Eugenia Olmedo, Cristina Saavedra, Alfonso Cortés, Ana Gómez, Yolanda Lage, Álvaro Ruiz, María Reyes Ferreiro, Federico Longo, Eva Guerra, Íñigo Martínez-Delfrade, Pilar Garrido, Pablo Gajate","doi":"10.1093/oncolo/oyae284","DOIUrl":"10.1093/oncolo/oyae284","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICI) have changed the therapeutic landscape of many solid tumors. Modulation of the intestinal microbiota by antibiotics (Abx) has been suggested to impact on ICI outcomes.</p><p><strong>Methods: </strong>Retrospective analysis of 475 patients with advanced solid tumors treated with ICI from 2015 to 2022. For each patient, the use of Abx was recorded from 1 month before ICI initiation until disease progression or death. The impact of Abx on objective response rates (ORR), disease control rates (DCR), progression-free survival (PFS), and overall survival (OS) was analyzed. Kaplan-Meier and log-rank tests were used to compare survival outcomes.</p><p><strong>Results: </strong>In total 475 patients with advanced solid tumors were evaluated. Median age was 67.5 years and performance status (PS) was 0-1 in 84.6%. 66.5% of patients received Abx during treatment with ICI, mainly beta-lactams (53.8%) and quinolones (35.9%). The early exposure to Abx (from 60 days before to 42 days after the first cycle of ICI) was associated with a lower ORR (27.4% vs 39.4%; P < .01), a lower DCR (37.3% vs 57.4%; P < .001), lower PFS (16.8 m vs 27.8 m; HR 0.66; P < .001]) and lower OS (2.5 m vs 6.6 m; HR 0.68; P = .001]). The negative impact of Abx on OS and PFS was confirmed by a multivariable analysis. This effect was not observed among patients receiving Abx after 6 weeks from ICI initiation.</p><p><strong>Conclusions: </strong>Our results validate the hypothesis of a detrimental effect of an early exposure to Abxon the efficacy of ICI in a multi-tumor cohort of patients.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481137","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":"Differentiating between renal medullary and clear cell renal carcinoma with a machine learning radiomics approach.","authors":"Rahim Jiwani, Koustav Pal, Iwan Paolucci, Bruno Odisio, Kristy Brock, Nizar M Tannir, Daniel D Shapiro, Pavlos Msaouel, Rahul A Sheth","doi":"10.1093/oncolo/oyae337","DOIUrl":"10.1093/oncolo/oyae337","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to develop and validate a radiomics-based machine learning (ML) model to differentiate between renal medullary carcinoma (RMC) and clear cell renal carcinoma (ccRCC).</p><p><strong>Methods: </strong>This retrospective Institutional Review Board -approved study analyzed CT images and clinical data from patients with RMC (n = 87) and ccRCC (n = 93). Patients without contrast-enhanced CT scans obtained before nephrectomy were excluded. A standard volumetric software package (MIM 7.1.4, MIM Software Inc.) was used for contouring, after which 949 radiomics features were extracted with PyRadiomics 3.1.0. Radiomics analysis was then performed with RadAR for differential radiomics analysis. ML was then performed with extreme gradient boosting (XGBoost 2.0.3) to differentiate between RMC and ccRCC. Three separate ML models were created to differentiate between ccRCC and RMC. These models were based on clinical demographics, radiomics, and radiomics incorporating hemoglobin electrophoresis for sickle cell trait, respectively.</p><p><strong>Results: </strong>Performance metrics for the 3 developed ML models were as follows: demographic factors only (AUC = 0.777), calibrated radiomics (AUC = 0.915), and calibrated radiomics with sickle cell trait incorporated (AUC = 1.0). The top 4 ranked features from differential radiomic analysis, ranked by their importance, were run entropy (preprocessing filter = original, AUC = 0.67), dependence entropy (preprocessing filter = wavelet, AUC = 0.67), zone entropy (preprocessing filter = original, AUC = 0.67), and dependence entropy (preprocessing filter = original, AUC = 0.66).</p><p><strong>Conclusion: </strong>A radiomics-based machine learning model effectively differentiates between ccRCC and RMC. This tool can facilitate the radiologist's ability to suspicion and decrease the misdiagnosis rate of RMC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442669","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}