Oncologist最新文献

{"title":"Integrating ctDNA-based ESR1m monitoring into first-line care for ER+, HER2- advanced breast cancer: a consensus workflow.","authors":"Yara Abdou, Amber Cipriani, Trevor Feinstein, Ryan Haumschild, Mabel Mardones, Joanne Mortimer, Eric Vail","doi":"10.1093/oncolo/oyag411","DOIUrl":"10.1093/oncolo/oyag411","url":null,"abstract":"<p><p>Circulating tumor DNA (ctDNA) is an emerging tool in precision oncology that enables noninvasive tumor profiling, detection of minimal residual disease, and treatment monitoring. Furthermore, routine ctDNA analyses offer the potential to support more personalized and dynamic cancer care. In advanced breast cancer (aBC), ctDNA-based monitoring has been investigated across multiple studies as a tool for detecting emerging resistance mechanisms, predicting treatment responses and informing biomarker-guided treatment decisions. One example, investigated in the phase III PADA-1 and SERENA-6 trials, is monitoring for emergent estrogen receptor alpha mutations (ESR1m) during first-line endocrine therapy in estrogen-receptor positive, human epidermal growth factor receptor 2-negative (ER+, HER2-) aBC. While not yet widely adopted in clinical practice, broader implementation of routine ctDNA-based monitoring for ESR1m is anticipated and will require standardized diagnostic workflows, encompassing both institutional operational processes and patient-centered scheduling pathways. Insights and recommendations were gathered from multidisciplinary experts across academic and community practices in the United States regarding the feasibility, barriers, and operational requirements for implementing ESR1m monitoring during first-line treatment of aBC. Here, we present practical, experience-informed considerations, supplemented by an opinion-based consensus workflow model designed to provide clinicians with a flexible framework for implementing ctDNA-based ESR1m monitoring during first-line care for ER+, HER2- aBC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197828","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":"Immune checkpoint inhibitors in resectable and locoregionally advanced HNSCC: past lessons, present evidence, and future directions.","authors":"Kaewta Jeerapradit, Bhumsuk Keam, Nuttapong Ngamphaiboon","doi":"10.1093/oncolo/oyag366","DOIUrl":"10.1093/oncolo/oyag366","url":null,"abstract":"<p><p>The integration of ICIs has reshaped therapeutic strategies in head and neck squamous cell carcinoma (HNSCC). ICIs are established in recurrent/metastatic (R/M) HNSCC and have been extensively evaluated in resectable and locoregionally advanced (LA) disease, without success until the recent KEYNOTE-689 and NIVOPOSTOP studies. These pivotal trials demonstrate that perioperative and adjuvant ICIs can improve clinical outcomes and change clinical practice. Their implementation in resectable HNSCC may raise several unanswered questions, including optimal sequencing with surgery and radiotherapy, patient selection, and management of patients who progress to R/M disease after (neo)adjuvant therapy. This review summarizes the most recent evidence on ICIs in LA-HNSCC, highlighting both successes and challenges in clinical development, clinical practice implications, unresolved questions, and emerging strategies. We provide an overview of ongoing studies exploring ICI-based approaches and combinations for neoadjuvant adaptive response, surgical strategies including surgical conversion and organ preservation, and radiotherapy optimization. Additionally, we review ongoing clinical trials evaluating ICIs in combination with chemotherapy, antibody-drug conjugates, targeted therapy, radiotherapy-including stereotactic body radiotherapy (SBRT), novel ICIs, and therapeutic cancer vaccines targeting HPV or tumor neoantigens.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992529","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":"Pembrolizumab combined with disitamab vedotin in human epidermal growth factor receptor 2-positive metastatic colorectal cancer.","authors":"Xiaojing Xu, Minzhi Lv, Luoyan Ai, Qing Wang, Yuehong Cui, Wei Li, Qing Liu, Xi Tang, Xi Chen, Shan Yu, Mengzhou Guo, Yiyi Yu, Tianshu Liu","doi":"10.1093/oncolo/oyag385","DOIUrl":"10.1093/oncolo/oyag385","url":null,"abstract":"<p><strong>Background: </strong>Late-line treatment options for microsatellite stable (MSS)/proficient mismatch repair (pMMR) metastatic colorectal cancer (mCRC) are limited. PD-1 blockade alone has minimal clinical benefit in this population. Human epidermal growth factor receptor 2 (HER2)-targeted therapies represent an emerging strategy for HER2-expressing mCRC. This study evaluated the efficacy and safety of pembrolizumab combined with disitamab vedotin (DV), an anti-HER2 antibody-drug conjugate (ADC), in pretreated patients with HER2-positive mCRC.</p><p><strong>Methods: </strong>This multicenter, single-arm, phase II study enrolled patients with MSS/pMMR, HER2-positive mCRC who received 2 prior lines of systemic therapy. Patients received pembrolizumab 400 mg every 6 weeks plus DV 2.5 mg/kg every 2 weeks until disease progression, unacceptable toxicity, or death. The primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety.</p><p><strong>Results: </strong>Between December 2022 and May 2024, 15 patients (median age 59.0 years; 60.0% male) were enrolled. Fourteen patients (93.3%) had HER2 IHC 3+ expressions, and 2 had received prior anti-HER2 therapy. Two patients achieved partial response (ORR = 13.3%; 95% CI, 1.7%-40.5%). With a median follow-up of 26.7 months, median PFS was 2.9 months (95% CI, 2.3 to not reached). Median OS was not reached (95% CI, 16.7 to NR). The 6-month OS rate was 92.9% (95% CI: 6.9%-80.3%), and the 1-year OS rate was 71.4% (95% CI: 51.3%-99.5%). The most common treatment-related adverse events (TRAEs) included nausea, anorexia, alanine aminotransferase elevation, aspartate aminotransferase elevation, and alopecia. Grade 3-4 TRAEs occurred in 2 patients (14.3%), both neutropenia.</p><p><strong>Conclusions: </strong>Pembrolizumab plus disitamab vedotin showed limited antitumor activity in pretreated HER2-positive mCRC.</p><p><strong>Clinicaltrials.gov identifier: </strong>NCT05333809.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118636","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":"Expression of Concern: Multifocality as a marker of aggressiveness in medullary thyroid carcinoma: a retrospective cohort analysis of lymph node metastasis and recurrence.","authors":"","doi":"10.1093/oncolo/oyag383","DOIUrl":"10.1093/oncolo/oyag383","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"31 11","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225391","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":"Immune checkpoint inhibitors induced autoimmune hemolytic anemia in patients with malignant cancer.","authors":"Aoxi Liang, Yuanqiang Wu, Shengchi Chen, Jisheng Li, Yue Pan, Yixing Luo, Yue Zeng, Shijiao Yao, Shuxing Wang, Chunhong Hu, Xianling Liu, Fang Wu","doi":"10.1093/oncolo/oyag395","DOIUrl":"10.1093/oncolo/oyag395","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune hemolytic anemia (AIHA) is a rare but potentially life-threatening hematologic immune-related adverse event (irAE) associated with immune checkpoint inhibitors (ICIs). This study reports 3 new cases of ICI-induced AIHA from three medical centers in China and places them in the context of existing literature.</p><p><strong>Methods: </strong>Three patients with AIHA following ICI therapy were identified from The Second Xiangya Hospital, Qilu Hospital, and Nanping First Hospital. A PubMed search up to June 1, 2026, was conducted to collect previously reported cases with sufficient clinical details.</p><p><strong>Results: </strong>A total of 51 cases were analyzed, including three new patients and 48 from published reports. The mean age was 65.2 years, and 47.1% were male. The most common tumor types were melanoma (49.0%) and non-small cell lung cancer (27.5%). Most cases were associated with anti-PD-1 agents, particularly pembrolizumab and nivolumab, and AIHA typically developed early during ICI therapy. Corticosteroids were the primary treatment, with 92.2% achieving hematologic recovery or improvement. Four deaths (7.8%) were attributed to severe hemolysis. All three newly identified patients had pre-existing anemia before ICI initiation.</p><p><strong>Conclusions: </strong>ICI-induced AIHA usually occurs early during ICI therapy and responds favorably to corticosteroid-based treatment. Pre-existing anemia in our cases should be regarded as a hypothesis-generating observation rather than evidence of a specific risk factor, underscoring the need for early hemolysis work-up and close monitoring when anemia worsens after ICI exposure.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139073","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":"Comparative safety of concurrent adjuvant trastuzumab emtansine vs trastuzumab with radiotherapy in HER2-positive early breast cancer.","authors":"Mine Aysan, Bahadir Koylu, Ayberk Bayramgil, Dilek Unal, Banu Karaalioğlu, Ahmet Bilici, Fatih Selçukbiricik, Ozcan Yildiz, Ömer Fatih Olmez","doi":"10.1093/oncolo/oyag372","DOIUrl":"10.1093/oncolo/oyag372","url":null,"abstract":"<p><strong>Background: </strong>Real-world comparative data on the safety of adjuvant trastuzumab emtansine (T-DM1) vs trastuzumab with concurrent radiotherapy (RT) in HER2-positive early breast cancer (BC) remain limited.</p><p><strong>Methods: </strong>In this retrospective, multicenter study, we included 133 patients with HER2-positive early-stage BC treated with neoadjuvant therapy, surgery, and adjuvant systemic therapy administered concurrently with RT at 4 hospitals. Patients received adjuvant T-DM1 (n = 50) if residual disease was present, or trastuzumab (n = 83) if a pathologic complete response was achieved. Toxicities were graded according to CTCAE criteria. A post-hoc power analysis indicated 80% power to detect an absolute between-group difference in toxicity rates of ≥ 25%.</p><p><strong>Results: </strong>The T-DM1 group had poorer performance status, higher nodal stage, and more intensive neoadjuvant regimens. RT parameters were balanced between groups (median dose 50 Gy, 25 fractions; P > .05 for all comparisons). T-DM1 was associated with higher rates of thrombocytopenia (70% vs 36.1%, P < .001), ALT elevation (20% vs 4.8%, P = .008), AST elevation (24.5% vs 2.4%, P < .001), and early pulmonary toxicity (48.8% vs 24.1%, P = .017), with events predominantly grade 1. In sensitivity analyses adjusting for pertuzumab exposure, T-DM1 associations remained significant for thrombocytopenia (adjusted odds ratio [OR] = 3.85, P = .001), ALT elevation (adjusted OR = 4.12, P = .026), and early pulmonary toxicity (adjusted OR = 2.64, P = .034).</p><p><strong>Conclusion: </strong>Concurrent adjuvant T-DM1 and RT demonstrated higher but manageable hematologic, hepatic, and pulmonary toxicity compared with trastuzumab. These hypothesis-generating findings require validation in prospective studies.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018832","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":"Overweight BMI compromises survival and correlates with aggressive phenotypes in early-onset but not late-onset rectal cancer patients.","authors":"Jinlin Cai, Tuoyang Li, Jingrong Weng, Ziye Zhang, Junyi Han, Ziming Li, Zhihao Xu, Ying Du, Jinxin Lin, Meijin Huang, Xiaolin Wang, Yanxin Luo, Huichuan Yu","doi":"10.1093/oncolo/oyag380","DOIUrl":"10.1093/oncolo/oyag380","url":null,"abstract":"<p><strong>Background: </strong>The incidence of early-onset colorectal cancer (EOCRC) is rising globally, presenting unique clinical challenges due to its aggressive nature compared to late-onset cases. While obesity is a known risk factor for carcinogenesis, its prognostic significance specifically on the EOCRC population remains underexplored. We hypothesized that the association of metabolic dysregulation with tumor aggressiveness and survival may depend on the age of onset.</p><p><strong>Methods: </strong>A total of 324 patients with stage II/III rectal cancer from the FOWARC trial were stratified by BMI (using the Asian overweight cut-off of 24 kg/m2) and age of onset (early-onset <50 years vs. late-onset ≥50 years). The clinicopathologic characteristics, treatment response, complications, and survival outcomes were compared.</p><p><strong>Results: </strong>The prognostic profile was heterogeneous between patients with high and low BMI. Notably, age had opposing prognostic value in the two groups. In the early-onset subgroups, patients with high BMI exhibited more prevalent aggressive phenotypes, including T4 stage, MRF+, elevated tumor length/thickness, and pretreatment CEA. However, in the late-onset subgroups, those phenotypes were less in the patients with high BMI. For short-term outcome, the incidence of pathological complete response after neoadjuvant treatment and complications was similar between two groups. In the early-onset subgroups, the overall (P = .003) and disease-free (P = .001) survival outcomes were significantly worse in the patients with high BMI compared to those with low BMI. However, this difference was not observed in the late-onset subgroups.</p><p><strong>Conclusion: </strong>The association of overweight and obesity with aggressive tumor phenotypes and poor survival outcomes is specifically observed in early-onset rectal cancer, which highlights the need for BMI-specific therapeutic strategies and weight management interventions in these vulnerable cases.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065123","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":"Resilience in symptom response as an adaptive capacity: methodological and theoretical clarifications.","authors":"Zhihong Zhang, Marie Flannery","doi":"10.1093/oncolo/oyag410","DOIUrl":"10.1093/oncolo/oyag410","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13691378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186274","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":"Reconsidering the incremental prognostic value of variant allele frequency-based stratification beyond European LeukemiaNet 2022 in acute myeloid leukemia.","authors":"Yu Fu, Shasha Qiu","doi":"10.1093/oncolo/oyag406","DOIUrl":"10.1093/oncolo/oyag406","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170274","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":"Chemotherapy backbone and outcomes of immune checkpoint inhibitor combinations across solid tumors: a pan-tumor network meta-analysis.","authors":"Luisana Sisca, Mariam Grazia Polito, Alessio Cortellini, Marco Russano, Marianna Silletta, Roberta Scafetta, Silvia Calagna, Michele Iuliani, Silvia Cavaliere, Sonia Simonetti, Bruno Vincenzi, Giuseppe Tonini, Francesco Pantano","doi":"10.1093/oncolo/oyag365","DOIUrl":"10.1093/oncolo/oyag365","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) combined with chemotherapy represent a first-line standard across multiple solid tumors; however, the contribution of chemotherapy backbone to the efficacy of chemo-immunotherapy remains uncertain.</p><p><strong>Methods: </strong>We conducted a systematic review and network meta-analysis of phase II-III randomized trials comparing ICI-chemotherapy vs chemotherapy alone, with the aim of evaluating whether chemotherapy backbone selection was associated with differences in clinical outcomes across tumor types.</p><p><strong>Results: </strong>Thirty-nine trials including over 30 000 patients were analyzed. Detailed characteristics of included trials by tumor type are reported in Tables S1-S6. Chemo-immunotherapy significantly improved progression-free survival (hazard ratio [HR] 0.69, 95% CI 0.66-0.72) and overall survival (HR 0.78, 95% CI 0.76-0.81). Among the evaluated chemotherapy backbones, platinum-pemetrexed was associated with the greatest relative survival benefit (HR 0.66), followed by platinum-taxane and fluoropyrimidine-platinum regimens (HR 0.78), whereas platinum-gemcitabine showed comparatively lower benefit (HR 0.83). Anti-PD-1 regimens demonstrated numerically greater benefit than anti-PD-L1 therapies, although these findings should be interpreted in light of the non-random distribution of treatment regimens across tumor types. Because chemotherapy backbones were closely linked to tumor-specific standards of care, these differences cannot be interpreted as evidence of superiority across tumor types. All combinations increased grade ≥3 adverse events.</p><p><strong>Conclusion: </strong>Differences in outcomes were observed across chemotherapy backbones; however, these findings likely reflect the combined influence of tumor-specific treatment paradigms, underlying disease biology, and potentially the chemotherapy backbone itself. Therefore, the results should be considered hypothesis-generating and warrant prospective validation within individual tumor types.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992498","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}