Oncologist最新文献

{"title":"Consideration of Baseline Comorbidities in Studies on HER2-Positive Metastatic Breast Cancer.","authors":"Amir Reza Akbari, Benyamin Alam","doi":"10.1093/oncolo/oyaf335","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf335","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240288","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":"Chatbot assistance in precision oncology treatment decision-making.","authors":"Hannah Burnette, Kylie Fletcher, Christine Micheel, Ben Ho Park, Daniel H Johnson, John Cole, Kevan Simms, Marc Matrana, Douglas B Johnson","doi":"10.1093/oncolo/oyaf316","DOIUrl":"10.1093/oncolo/oyaf316","url":null,"abstract":"<p><p>Artificial intelligence chatbots have shown promise in medical settings, but their ability to interpret complex molecular data is not clear. Here, we assessed 50 different patient scenarios with clinical and molecular data and found that chatbots provided mostly accurate and comprehensive recommendations, although key treatment options were omitted occasionally, and non-data driven treatments were recommended in cases with multiple mutations.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180175","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":"A cohort study of circulating biomarkers to predict the efficacy and prognosis of immune combination therapy in non-small-cell lung cancer.","authors":"Yanxia Liu, Xiaomi Li, Minghang Zhang, Yuan Gao, Ying Wang, Mingming Hu, Shaofa Xu, Tongmei Zhang","doi":"10.1093/oncolo/oyaf306","DOIUrl":"10.1093/oncolo/oyaf306","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) bring significant clinical benefits to non-small-cell lung cancer (NSCLC), and convenient peripheral blood markers are still lacking. Human circulating cytokines play an important role in tumor growth and metastasis, and exploring their value in NSCLC immunotherapy helps to achieve precise treatment of patients.</p><p><strong>Methods: </strong>This study was a mixed design of prospective blood collection and retrospective data collection. Patients with NSCLC who received the first ICI combined with chemotherapy were included, and plasma samples were collected at baseline and after 2 cycles of treatment. MILLIPLEX MAP technology was used to detect the levels of a panel of cancer biomarkers and to explore the predictive potential of cytokines for survival and treatment response in such patients.</p><p><strong>Results: </strong>Baseline blood samples were collected from 79 NSCLC patients in this study, and survival analysis showed that high expression of 4 cytokines, carbohydrate antigen 125 (CA125), cytokeratin 19 fragment (CYFRA 21-1), human epididymis protein 4 (HE4), and hepatocyte growth factor (HGF), was associated with shorter overall survival (OS) and progression-free survival (PFS), low levels of stem cell factor (SCF) tended to have better OS than patients with high levels of SCF, and multivariate Cox regression showed that high levels of HGF were independent risk factors for OS (HR = 1.92, 95% CI: 1.02-3.70, P = .042) and PFS (HR = 3.23, 95% CI: 1.75-5.88, P < .001). HGF was more predictive of 1-year survival and 6-month PFS than programmed death ligand 1 expression. In addition, we collected blood samples from 53 patients after 2 cycles of treatment, CYFRA 21-1, HGF, interleukin-8 (IL-8), and tumor necrosis factor-related apoptosis-inducing ligand were associated with patient survival, and patients with increased HGF after treatment had shorter survival. In patients whose tumors responded to treatment, CA125 and CYFRA 21-1 levels increased from baseline, whereas soluble apoptosis-related factor (sFas) levels decreased.</p><p><strong>Conclusions: </strong>Soluble cytokines, especially HGF, have certain clinical value in immunotherapy combination therapy and prognosis of NSCLC patients and are worthy of validation in a larger prospective cohort and exploration of their potential mechanisms.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139396","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":"Anal cancer incidence among women with a history of vulvar cancer by histology, age, and time since diagnosis.","authors":"Haluk Damgacioglu, Kalyani Sonawane, Gary M Clifford, Joel M Palefsky, Gweneth B Lazenby, Brian C Orr, Jane R Montealegre, Elizabeth Y Chiao, Keith M Sigel, Ashish A Deshmukh","doi":"10.1093/oncolo/oyaf307","DOIUrl":"10.1093/oncolo/oyaf307","url":null,"abstract":"<p><p>Women with a history of vulvar cancer face a high risk of anal cancer; however, incidence according to histology, age-at, and time since vulvar cancer diagnosis remains unexplored. Using data from SEER-8 and SEER-17 registries, we identified 21,230 women with vulvar cancer, with 154,825 person-years follow-up from 1975 to 2021. We observed 95 anal cancer cases, resulting in an incidence of 61.4 per 100,000 person-years (95% CI, 49.6-75.0). Incidence was higher among women with vulvar squamous cell carcinoma (SCC) (78.7; 95% CI, 62.9-97.1) than vulvar non-SCC (19.8; 95% CI, 9.0-37.6). The highest incidence (>100 per 100,000) was observed in women <45 years old with vulvar SCC and those >10 years post-diagnosis. These findings could inform anal cancer screening guidelines, as women with vulvar cancer, particularly those diagnosed with SCC, may substantially benefit from heightened surveillance or targeted screening.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132805","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":"Integrative multiomic and immune profiling of lung adenocarcinoma: molecular landscapes, gene expression, and treatment response insights.","authors":"Honghong Dong, Yahui Tian, Yujie Guo, Shaowei Xin, Suxin Jiang, Zitong Wan, Huaiyu Wang, Yong Han","doi":"10.1093/oncolo/oyaf191","DOIUrl":"10.1093/oncolo/oyaf191","url":null,"abstract":"<p><strong>Background: </strong>Lung adenocarcinoma (LUAD) is a major cause of cancer death. Traditional histopathological classification overlooks molecular heterogeneity, limiting personalized treatment. This study used multiomic data to define LUAD subtypes, assess prognostic significance, and analyze immune features, aiming to improve targeted therapy and clinical outcomes.</p><p><strong>Methods: </strong>This study used Consensus Clustering and Gap Statistics to analyze LUAD multiomic data, including mRNA, lncRNA, miRNA, DNA methylation, and mutations. Clustering was validated by silhouette plots and heatmaps. Molecular characterization involved regulon activity, immune and metabolic profiling. Functional assays (qPCR, WB, CCK-8, flow cytometry) assessed neuronal differentiation factor (NDNF)'s role in LUAD.</p><p><strong>Results: </strong>Two molecular LUAD subtypes showed distinct clustering and survival outcomes. One subtype had worse prognosis and unique immune features, including checkpoint expression and microenvironment differences. Gene signatures and metabolism varied by subtype. Neuronal differentiation factor was downregulated in tumors; its overexpression suppressed LUAD cell viability and promoted apoptosis, suggesting tumor-suppressive function.</p><p><strong>Conclusions: </strong>This study identifies 2 LUAD subtypes with distinct molecular and immune features linked to prognosis and therapy response. Neuronal differentiation factor downregulation and its tumor-suppressive effects highlight its therapeutic potential. These findings support improved LUAD stratification and personalized treatment strategies.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12526892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487174","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":"Lenvatinib after progression on pemigatinib and futibatinib in FGFR2 fusion-positive biliary tract cancer with an acquired kinase point mutation.","authors":"Fabian Kleinhenz, Nicole Pfarr, Lisa Steinhelfer, Alisa M Lörsch, Henriette Bendz, Mathias Friedrich, Lea Liesenfeld, Melissa Barroux, Carlo Maurer, Patrick Wenzel, Angelika Kestler, Mai-Lan Koppermann, Carolin Mogler, Stephan Spahn, Anna L Illert, Roland M Schmid, Michael Bitzer, Sebastian Lange","doi":"10.1093/oncolo/oyaf322","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf322","url":null,"abstract":"<p><p>Biliary tract cancers (BTC) represent a heterogeneous group of malignancies with a poor prognosis and rising incidence. Oncogenic FGFR2 fusions are one of several actionable molecular alterations. In this context, selective FGFR tyrosine kinase inhibitors have demonstrated promising and durable response rates and are now approved and included in clinical guidelines. However, secondary kinase mutations frequently arise over time, leading to resistance against these drugs. We present the case of a 41-year-old male patient with metastatic BTC who underwent molecular analysis after disease progression to various established chemotherapy combinations. Testing identified an oncogenic FGFR2 fusion (FGFR2::BICC1). The patient was treated with pemigatinib for 14 months. Upon disease progression, the resistance-associated FGFR2 p. E565A variant was detected in a follow-up biopsy. Treatment was switched to futibatinib, resulting in rapid disease progression. Lacking other therapeutic options, the patient was treated with lenvatinib, supported by previously published data suggesting a potential benefit in similar settings. The treatment was well tolerated, with only a mild increase in transaminases, and the patient remained on treatment with noteworthy effects for 15 months to date. With a growing incidence of BTC and growing use of targeted therapies for FGFR2 alterations, the emergence of secondary resistance-causing point mutations following treatment with approved inhibitors is becoming increasingly challenging. Beyond selective inhibitors, lenvatinib may represent a viable therapeutic option.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202130","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":"PARP inhibitors in gastric cancer: unlocking precision oncology.","authors":"Derek Tai, Vitor Goes, Sharanya Kumar, Pranati Shah, Farris Al-Manaseer, Daniel Park, Christiana Crook, Sofia Guzman, Xiaolin Zhu, Daneng Li, Dani Castillo","doi":"10.1093/oncolo/oyaf283","DOIUrl":"10.1093/oncolo/oyaf283","url":null,"abstract":"<p><p>Gastric cancer (GC) demonstrates frequent alterations in homologous recombination repair (HRR) genes, and preclinical studies have demonstrated a clear synthetic lethality between HRR deficiency (HRD) and PARPi. While such preclinical synthetic lethality has translated into clinical benefits of PARPi in patients with HRD breast, ovarian, pancreatic, or prostate cancer, the therapeutic role of PARPi in GC remains unclear due to molecular heterogeneity and lack of validated biomarkers for patient selection. This review summarizes the mechanistic foundation for PARPi sensitivity in HRR-deficient GC tumors and evaluates emerging biomarkers, including genomic instability scores, RAD51 foci formation, mutational signatures, and candidate genes such as BRCA1/2, PALB2, and BARD1. We highlight key clinical trials and ongoing research aimed at refining patient selection, optimizing combination strategies, and identifying predictive biomarkers. Improving biomarkers to identify bona fide HRD is essential to optimizing PARPi as a valuable treatment option for patients with GC. We outline a pathway for biomarker-guided adoption of PARPi in GC management. Early-phase clinical trials of PARPi monotherapy in GC have yielded limited efficacy, likely due to variable HRD status and other mechanisms of primary resistance. Combining PARPi with chemotherapy, immune checkpoint inhibitors, or anti-angiogenic agents offers strategies to potentially increase the tumor susceptibility to PARPi and overcome resistance.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093092","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":"Factors associated with sleep disturbance in breast cancer survivors over time.","authors":"Paulina S Marell, Robert A Vierkant, Nicole L Larson, Shawna L Ehlers, Kristine A Donovan, Daniela L Stan, Stacy D D'Andre, Fergus J Couch, Janet E Olson, Kathryn J Ruddy","doi":"10.1093/oncolo/oyaf297","DOIUrl":"10.1093/oncolo/oyaf297","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) survivors frequently experience sleep disturbances, which may persist for many years after treatment. This study aimed to describe trends in sleep-related symptoms over time and identify factors that may be associated with sleep disturbances in BC survivors.</p><p><strong>Patients and methods: </strong>Adult patients from the Mayo Clinic Breast Disease Registry were surveyed annually for up to 7 years post-diagnosis. Sleep disturbance severity was assessed using numeric rating scales for difficulty falling and staying asleep. Data from 3354 unique patients were analyzed, excluding those with metastatic disease or recurrence. Univariable and multivariable analyses were performed at the 1-year survey timepoint to evaluate disease and patient-related factors that were associated with increased sleep-related symptoms, and these factors were also assessed in relationship to sleep-related symptoms over time.</p><p><strong>Results: </strong>In multivariable analyses, more trouble falling asleep was associated with financial insecurity, higher clinical stage, more cigarettes smoked per day, and less weekly exercise. More trouble staying asleep was associated with older age, race, advanced education, financial insecurity, and higher clinical stage. Over time, there was a nonsignificant trend toward increased trouble falling asleep and fluctuations in trouble staying asleep. Higher clinical stage and receipt of radiotherapy were associated with decreased severity in trouble falling asleep over time, while more cigarettes smoked per day was linked to increased severity in trouble staying asleep.</p><p><strong>Conclusions: </strong>These findings highlight the complex interplay of clinical, lifestyle, and demographic factors in sleep disturbances among BC survivors, underscoring the need for tailored sleep management strategies.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093058","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":"Determining the Cancer Center priorities at the Wilmot Cancer Institute: A proposed framework informed by an academic-community collaborative approach.","authors":"Francisco Cartujano-Barrera, Ana Paula Cupertino, Emily Hayes, Candice Lucas, Electra D Paskett, Erin Kobetz, Jeffrey Freeman, Karen Hermance, Nikisha Ridgeway, Charles S Kamen","doi":"10.1093/oncolo/oyaf282","DOIUrl":"10.1093/oncolo/oyaf282","url":null,"abstract":"<p><p>Current National Cancer Institute (NCI) Cancer Center Support Grant guidelines include a Community Outreach and Engagement merit descriptor related to the justification of Cancer Center priorities. Unfortunately, there is limited guidance and published literature on the process of determining the Cancer Center priorities. The purpose of this commentary is to propose a framework for Cancer Center prioritization, informed by the academic-community collaborative approach that the Wilmot Cancer Institute (Wilmot) at the University of Rochester implemented as part of a successful application for NCI designation. We first defined Wilmot's catchment area and curated data on the cancer burden in that area. We then collaborated with program leaders to assess Wilmot's capacity to address the cancer burden in its catchment area. We iteratively worked with our Community Cancer Action Council (CCAC) to determine the Cancer Center priorities. Cancer incidence, mortality, risk factors, and screening data, as well as ongoing research from Wilmot's scientific programs, were the factors that Wilmot leaders and CCAC partners considered to make this determination. Thus, (1) tobacco-related cancers (ie, bladder, esophageal, head and neck, larynx, and lung cancers; including addressing tobacco prevention and cessation, and promoting lung cancer screening), (2) hematologic malignancies (ie, leukemia and lymphoma), and (3) pancreatic and hepatobiliary cancers were determined as the Cancer Center priorities. These Cancer Center priorities have informed research and outreach at Wilmot.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093079","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":"Retrospective study of elderly patients with advanced ovarian cancer who did not undergo surgery.","authors":"Hui Qu, QianXue Wei, Wen Gu, Zhenhua Du, Xiuqin Li, Yu Xia","doi":"10.1093/oncolo/oyaf290","DOIUrl":"10.1093/oncolo/oyaf290","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes of elderly patients with advanced ovarian cancer who did not undergo surgery and received chemotherapy with or without maintenance therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 15 patients with advanced high-grade serous ovarian cancer who were treated at our hospital between 2018 and 2023. These patients either had multiple comorbidities or refused surgery. Data collected included patient demographics, treatment regimens, chemotherapy cycles, clinical response, progression-free survival (PFS), and overall survival (OS).</p><p><strong>Results: </strong>The median age of the patients was 73 years (range, 50-86 years). Fourteen patients received platinum-based chemotherapy combined with paclitaxel or liposomal doxorubicin, with or without bevacizumab, for 3 to 6 cycles. Twelve patients who achieved disease control received PARP inhibitor maintenance therapy. The overall response rate (ORR) was 80.0%, or 12/15 patients achieved partial response (PR); nobody achieved complete response. The disease control rate (DCR) was 100%. The median PFS1 was 19.0 months (95% CI, 11.85-26.15), and the median PFS2 was 10 months. The 3-year OS rate was 65.2%, with a median OS of 57.0 months (95% CI, 13.00-100.99).</p><p><strong>Conclusions: </strong>Chemotherapy with or without bevacizumab, followed by PARP inhibitor maintenance therapy, is a viable alternative for elderly or surgically ineligible patients with advanced ovarian cancer. The findings of this study should be considered exploratory and require validation through large-scale studies.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093064","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}