Oncologist最新文献

{"title":"Perioperative therapy for resectable and borderline resectable pancreatic adenocarcinoma: an Academic Gastrointestinal Cancer Consortium Study.","authors":"Deirdre J Cohen, Judith D Goldberg, Lawrence Leichman, Tsivia Hochman, Elliot Newman, Kevin Du, Alec Megibow, Paul Oberstein, Raed Al-Rajabi, Aaron J Scott, Tanios Bekaii-Saab, Wells A Messersmith, Colin Weekes","doi":"10.1093/oncolo/oyaf271","DOIUrl":"10.1093/oncolo/oyaf271","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection without visible or residual microscopic disease (R0 resection) is known as the optimal path to cure localized pancreatic cancer (PDAC). Neoadjuvant therapy (NAT) is used to improve R0 resection rates; however, the optimal regimen is unclear. We assessed the safety and efficacy of peri-operative gemcitabine/nab-paclitaxel (GEM/NAB) and pre-operative stereotactic body radiotherapy (SBRT) in patients with resectable (R-PDAC) and borderline resectable PDAC (BR-PDAC).</p><p><strong>Patients and methods: </strong>This was a prospective, multicenter single arm phase 2 study in patients with R-PDAC and BR-PDAC. Patients received three cycles of GEM/NAB prior to SBRT followed by surgery and three cycles of adjuvant GEM/NAB. Primary endpoint was R0 surgical resection rate in each cohort. Secondary endpoints included safety and overall survival (OS).</p><p><strong>Results: </strong>Eighty-six patients consented and following radiologic screening, 49 were enrolled into two cohorts: R-PDAC (n = 20) and BR-PDAC (n = 29) between June 2016 and April 2021. Seventy percent of R-PDAC (14/20) and 55.2% of BR-PDAC patients (16/29) completed all NAT. Eleven R-PDAC (55.0%) and 11 BR-PDAC patients (37.9%) underwent surgical resection. Nine R-PDAC (45.0%) and 9 BR-PDAC patients (31.0%) had R0 resections. The median OS for R-PDAC and BR-PDAC patients with R0 resections was 22 months (95% CI: 17.7 months-NA) and 39 months (95%CI: 13.21 months-NA), respectively.</p><p><strong>Conclusion: </strong>While the trial failed to meet one of its primary objectives as only 45% of R-PDAC patients had an R0 resection, the objective of 30% R0 resection for the BR-PDAC group was met. NAT should be part of current therapeutic strategies for BR-PDAC; however, our trial does not answer what is the best NAT for BR-PDAC.</p><p><strong>Trial registration: </strong>NCT02723331.</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/PMC12526980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093094","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":"Real-world management and outcomes of immune-related adverse events in German cancer care: A multicenter analysis using the SERIO registry.","authors":"Carolin Ertl, Dirk Tomsitz, Filippo Rizzo, Dirk Hempel, Lucie Heinzerling, Valeria Milani","doi":"10.1093/oncolo/oyaf275","DOIUrl":"10.1093/oncolo/oyaf275","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) are widely used in cancer therapy, yet diagnosing and managing immune-related adverse events (irAEs) remains challenging in clinical practice. Differences in healthcare structures between university hospitals (UH) and private practices (PP) influence irAE presentation and management, often excluding the latter from analyses.</p><p><strong>Patients and methods: </strong>This retrospective study included 604 cancer patients treated with ICIs between 2014 and 2023: 323 from UH and 281 from PP. In total, 302 irAEs were reported in the Side Effect Registry Immuno-Oncology (SERIO; http://www.serio-registry.org), with 230 cases from UH and 72 from PP. Demographics, irAE characteristics, management, and outcomes were compared between settings.</p><p><strong>Results: </strong>The UH and PP cohorts showed substantial differences. IrAEs were less frequent in the PP cohort (19% vs. 51%) and less severe (grade 3/4: 35% PP vs. 40% UH). Time to diagnosis was longer in PP (136 vs. 86 days), but treatment response rates were comparable (90% PP vs. 84% UH). UH patients experienced better symptom control (24% vs. 16%) and fewer long-term sequelae (6% vs. 10%). No irAE-related mortality occurred in either group.</p><p><strong>Conclusion: </strong>Structural differences between UH and PP impact the frequency, severity, and management of irAEs. Including underrepresented care settings in real-world analysis is essential for generating robust, generalizable evidence. By enhancing collaboration between academic institutions and community-based practitioners, we aim to improve irAE outcomes and promote more equitable, evidence-based care in immuno-oncology.</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/PMC12530884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034653","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":"Phase I study of palbociclib with cisplatin or carboplatin in the management of patients with advanced pancreatic cancer.","authors":"Olatunji B Alese, Robert Donald Harvey, Christina Wu, Elise Hitron, Hannah Collins, Suzanne Scott, Conor Steuer, Mehmet A Bilen, Bradley C Carthon, Jeffrey M Switchenko, Suresh S Ramalingam, Taofeek K Owonikoko","doi":"10.1093/oncolo/oyaf284","DOIUrl":"10.1093/oncolo/oyaf284","url":null,"abstract":"<p><strong>Importance: </strong>The addition of agents targeting critical signal mediators of cancer cell proliferation such as cyclin-dependent kinases (CDK) potentiates the efficacy of platinum chemotherapy.ObjectiveTo determine the safety and efficacy of palbociclib combined with cisplatin (cis) or carboplatin (carbo) in advanced solid malignanciesDesignEnrollment on dose escalation (part I) proceeded using the Bayesian adaptive design Escalation with Overdose Control (EWOC).SettingSingle institution investigator initiated trial.</p><p><strong>Participants: </strong>Patients with any advanced cancer after at least one prior therapy were enrolled on dose escalation to determine recommended phase II doses (RP2D). Expansion cohorts were then opened for pancreaticobiliary tract cancers.InterventionEscalating doses of palbociclib in combination with different doses of cisplatin or carboplatin.Main Outcomes and MeasuresPrimary endpoint was objective response rate (ORR). Secondary endpoints included safety, overall survival (OS), and progression-free survival (PFS).</p><p><strong>Results: </strong>We enrolled 39 patients on dose escalation (part I) and 32 additional patients on dose expansion (part II). RP2D of palbociclib 100 mg on Day 2-22 + Cisplatin (cis) 60 mg/m2 IV on Day 1 Q4W (Arm A); and palbociclib 75 mg on Day 2-22 + Carboplatin (carbo) AUC 6 IV on Day 1 Q4W (Arm B). ORR for Part I were 12.5% (Arm A) and 25% (Arm B). Median PFS and OS for dose expansion were 2.1 and 4.9 months, respectively. For PDAC, mPFS was 1.9 months (95% CI: 1.7, 2.4), and OS was 3.7 months (95% CI: 2.7, 5.7). Most common treatment-related adverse events (TRAEs-all grade %): Arm A-neutropenia (66%), thrombocytopenia (26%), nausea, fatigue, and anemia (20% each); Arm B-neutropenia (64.7%), thrombocytopenia (53%), and anemia (29%). There were no grade 4-5 TRAEs.</p><p><strong>Conclusions and relevance: </strong>The combination of palbociclib with cisplatin or carboplatin had an acceptable safety profile and clinical responses in some treatment refractory advanced cancers. There was no objective response, but about half of PDAC patients had disease stabilization. Additional efforts are needed to exploit CDK abnormalities in these patients. Clinical trial registration number: NCT02897375.</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/PMC12517333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093101","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":"Intrathecal pemetrexed for leptomeningeal metastasis from lung adenocarcinoma: a clinical efficacy and multiplex liquid proteomics exploration study.","authors":"Zhi Wang, Peng Ding, Hongxia Zhou, Bohua Kuang, Ruiguang Zhang, Lingjuan Chen, Xing Zhang, Minghui Ge, Yaqin Liu, Fan Tong, Xiaorong Dong","doi":"10.1093/oncolo/oyaf291","DOIUrl":"10.1093/oncolo/oyaf291","url":null,"abstract":"<p><strong>Background: </strong>Leptomeningeal metastasis (LM) is an advanced complication of lung cancer with a poor prognosis. It remains unknown whether intrathecal pemetrexed (IP) can improve the outcomes of patients with LM from lung adenocarcinoma (LUAD). This study explored the efficacy of intrathecal pemetrexed (IP) and proteomic biomarkers in LM from LUAD.</p><p><strong>Patients and methods: </strong>We conducted a retrospective survival analysis of 157 confirmed LM patients (54 IP vs 103 non-IP). To balance the baseline, propensity score matching (PSM) was implemented. We investigated clinical baseline characteristics and treatment factors to identify those influencing the outcomes of LM patients. Plasma and cerebrospinal fluid (CSF) samples underwent proteomic profiling using Olink Immuno-Oncology panels to identify IP response biomarkers and build a prediction model.</p><p><strong>Results: </strong>After PSM, 82 patients were included in two matched cohort (41 IP vs 41 non-IP). IP treatment (HR = 0.427, P = .022) and ECOG performance status (HR = 2.737, P = .005) were independent predictors of overall survival (OS). Stratified analysis showed IP significantly improved OS in patients with poor performance status (ECOG 3-4: IP vs non-IP, 11.2 vs 2.5 months, P = .0029). Proteomics revealed low plasma MCP-2 (AUC = 0.873) and high CSF ARG1 (AUC = 0.875) levels distinguished IP responders from nonresponders.</p><p><strong>Conclusions: </strong>IP therapy improves OS in LUAD patients with LM, particularly offering significant benefit as salvage treatment for those with ECOG 3-4. Proteomic analysis suggests plasma MCP-2 and CSF ARG1 are promising predictive biomarkers for IP response. The small sample size in biomarker analysis may limit these findings, necessitating validation through multicenter 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/PMC12539920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132827","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 Single Institution Study Evaluating the Fertility of Young Adults with Malignancy Treated with Immunotherapy.","authors":"Jenny D Gong, Kathryn Coyne, Matthew Mirsky, Katherine Daunov, Rebecca Flyckt, Iris Y Sheng","doi":"10.1093/oncolo/oyaf310","DOIUrl":"https://doi.org/10.1093/oncolo/oyaf310","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) are increasingly used among multiple types of cancers, but there are limited studies on the long-term effects of ICIs on fertility. Our study examines reproductive outcomes following ICI treatment and details experiences with fertility services at a single tertiary institution. A total of 184 female patients between the ages of 18-45 with documented diagnoses of malignancies were treated with ICIs from January 2012 to December 2023 at a single tertiary medical center. Demographics, oncologic, and fertility data were collected. Of 184 patients, 68 (37.0%) had documented fertility discussions prior to initiation of ICIs and 36 (19.6%) patients were referred to reproductive medicine. Of the referred patients, the median age at time of ICI therapy was 32 years. 27 (75%) were Caucasian and 6 (16.7%) were African American. The most common cancers were breast adenocarcinoma (52.8%), hematologic malignancies (25%), and melanoma (13.9%). 21 (58.3%) underwent a fertility preservation cycle (oocyte or embryo cryopreservation). There were 3 individuals with successful pregnancies. One individual used in vitro fertilization (IVF) to conceive, resulting in 2 full-term live births. The other two conceived via natural conception, resulting in one full-term live birth each. Time to conception ranged from 12-27 months following ICI completion. All 3 patients underwent treatment with nivolumab, 2 of whom received chemotherapy treatment beforehand. Successful conception following treatment with immunotherapy is possible. Larger multi-institutional studies are needed to further delineate the long-term effect of ICIs on fertility.</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":"145202140","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":"Impact of treatment patterns and sequencing on clinical and economic outcomes in patients with metastatic urothelial cancer: IMPACT UC II study.","authors":"Mehmet A Bilen, Brandon Diessner, John White, Louise Murphy, Amy Nguyen, Melissa Kirker, Norbek Gharibian, Valerie Morris, Abhijeet Bhanegaonkar","doi":"10.1093/oncolo/oyaf249","DOIUrl":"10.1093/oncolo/oyaf249","url":null,"abstract":"<p><strong>Importance: </strong>Real-world data about treatment sequencing and economic and clinical outcomes in patients with metastatic urothelial cancer (mUC) are limited.</p><p><strong>Objective: </strong>The IMPACT UC II study evaluated real-world overall survival (OS), first-line (1L) to second-line (2L) progression, and healthcare resource utilization (HCRU) and costs in patients with mUC before US approval of avelumab 1L maintenance in June 2020.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>US insurance claims data from the Optum Research Database.</p><p><strong>Participants: </strong>Adults diagnosed with mUC from July 2015 to June 2020, observed until death, disenrollment, or study end (August 2021).</p><p><strong>Intervention(s) or exposure(s): </strong>Three cohorts were defined based on 1L treatment received: cisplatin-based chemotherapy, carboplatin-based chemotherapy, or immuno-oncology (IO) monotherapy.</p><p><strong>Main outcome(s) and measure(s): </strong>Analyses included OS (multivariable Cox proportional hazards),1L-to-2L progression (incidence rates), HCRU and costs (medians), and multivariable-adjusted cumulative 24-month predicted costs (Lin regression models).</p><p><strong>Results: </strong>Of 3006 patients with mUC, 1037 received 1L treatment: cisplatin-based in 365 (35.2%), carboplatin-based in 337 (32.5%), and IO in 335 (32.3%). Compared with 1L cisplatin-based chemotherapy, mortality risk (hazard ratio [95% CI]) was doubled with IO monotherapy (2.0 [1.6-2.5]) and 1.5-times higher with carboplatin-based chemotherapy (1.5 [1.3-1.9]). The 1L-to-2L progression rate per 100 person-years was highest in patients receiving carboplatin-based chemotherapy (74.4) compared with cisplatin-based chemotherapy (51.9) and IO monotherapy (29.8). All-cause HCRU was lowest with carboplatin-based chemotherapy. Median all-cause and mUC-related costs were highest with IO monotherapy (mUC-related per patient per month: IO, $9739; cisplatin-based, $6687; carboplatin-based, $5219) as were cumulative 24-month predicted costs (mUC-related: IO, $157 595; cisplatin-based $122 351; carboplatin-based, $112 412).</p><p><strong>Conclusions: </strong>Approximately one-third of patients with mUC in this population received 1L therapy. Mortality, HCRU, and costs were higher with IO monotherapy vs platinum-based chemotherapy.</p><p><strong>Relevance: </strong>Results provide baseline data for future studies evaluating the impact of newer treatment options for patients with mUC.</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/PMC12517744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838601","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":"Correction to: Long-term safety of selpercatinib for Rearranged during transfection (RET)-activated advanced solid tumors in LIBRETTO-001: differing patterns of adverse events over time.","authors":"","doi":"10.1093/oncolo/oyaf068","DOIUrl":"10.1093/oncolo/oyaf068","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 10","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350099","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":"Real-world evaluation of CDK4/6 inhibitors in hormone receptor-positive metastatic breast cancer: prognostic effect of proton pump inhibitor use.","authors":"Bo-Fang Chen, Jiun-I Lai, Yi-Fang Tsai, Pei-Ju Lien, Yen-Shu Lin, Chin-Jung Feng, Yen-Jen Chen, Han-Fang Cheng, Ta-Chung Chao, Chun-Yu Liu, Ling-Ming Tseng, Chi-Cheng Huang","doi":"10.1093/oncolo/oyaf268","DOIUrl":"10.1093/oncolo/oyaf268","url":null,"abstract":"<p><strong>Importance: </strong>This study highlights the potential negative impact of the co-administration of proton pump inhibitors (PPI) on treatment outcomes in patients with hormone receptor-positive (HR+) metastatic and recurrent breast cancer who were receiving CDK4/6 inhibitor (CDK4/6i) treatment, providing real-world evidence to guide treatment strategies.</p><p><strong>Objective: </strong>To determine whether the co-administration of proton pump inhibitors (PPI) affects treatment outcomes, including progression-free survival (PFS) and overall survival (OS), in patients with HR+ metastatic and recurrent breast cancer receiving CDK4/6i treatment.</p><p><strong>Results: </strong>There were 55.7% patients in the no-antacid group, 33.1% in the PPI group, and 11.1% in the H2-blocker only group. Patients receiving PPI in combination with CDK4/6i and endocrine therapy had significantly shorter PFS (hazard ratio [HR] = 2.298, P < 0.001) and OS (HR = 3.03, P < 0.001). The H2 blocker group also showed a trend toward poorer PFS (HR = 1.987, P < 0.001) and OS compared with those without antacid use (HR = 3.380, P = 0.226). These trends were shown in both the overall cohort and first-line treatment, regardless of the specific CDK4/6i used. No significant differences were observed between types of PPIs. Additionally, increased PPI usage time proportion during CDK4/6i treatment was associated with a higher risk of disease progression and mortality.</p><p><strong>Conclusion and relevance: </strong>The use of PPIs and H2 blockers, in combination with CDK4/6i, was associated with adverse effects on PFS and OS in patients with HR+ metastatic or recurrent breast cancer in a real-world setting. Clinicians should exercise caution when prescribing PPIs to patients undergoing CDK4/6i therapy.</p><p><strong>Key points: </strong>In this retrospective analysis of 359 patients, the co-administration of PPIs with CDK4/6i was associated with significantly shorter PFS and OS. Clinicians should be cautious when prescribing PPIs to patients receiving CDK4/6i therapy due to the potential for adverse effects on treatment outcomes.</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/PMC12505142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978860","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":"Sacituzumab govitecan in the first-line treatment of triple-negative breast cancer: balancing therapeutic sequencing with patient-relevant benefits.","authors":"Dario Trapani, Carmine Valenza, Giuseppe Curigliano","doi":"10.1093/oncolo/oyaf295","DOIUrl":"10.1093/oncolo/oyaf295","url":null,"abstract":"","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/PMC12527420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126186","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":"Lymph node ratio predicts adjuvant chemotherapy benefit in esophageal squamous cell carcinoma.","authors":"Jun Peng, Yi Wang, Haoyue Hu, Lei Wu, Wei Dai, Yehan Zhou, Na Li, Lin Peng, Xuefeng Leng, Xiang Zhuang, Qifeng Wang, Xiang Wang","doi":"10.1093/oncolo/oyaf315","DOIUrl":"10.1093/oncolo/oyaf315","url":null,"abstract":"<p><strong>Background: </strong>The lymph node ratio (LNR) has emerged as an important prognostic factor in various cancers, including esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the utility of LNR in guiding decisions for adjuvant chemotherapy in ESCC patients following resection.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 2267 patients who underwent potentially curative surgery for ESCC at Sichuan Cancer Hospital and Institute between January 2010 and December 2017. Univariate and multivariate Cox proportional hazards regressions were used to assess factors influencing overall survival (OS), with LNR analyzed using restricted cubic splines (RCS) to explore its relationship with treatment and survival outcomes. Propensity score matching (PSM) was employed to adjust for biases between treatment groups.</p><p><strong>Results: </strong>Among the patients, 1416 underwent surgery alone (S group) and 851 received surgery plus adjuvant chemotherapy (S + CT group). The median LNR was 3%, with an interquartile range of 0%-12%. RCS analysis identified an LNR threshold of 11%, below which patients showed a significant OS benefit from adjuvant chemotherapy (hazard ratio [HR]: 0.57; 95% CI: 0.46-0.71; P < 0.001). However, patients with an LNR above 11% did not derive any OS benefit from chemotherapy (HR: 0.87; 95% CI: 0.70-1.09; P = 0.238).</p><p><strong>Conclusion: </strong>These findings suggest that LNR is a valuable marker for identifying ESCC patients who would benefit from postoperative adjuvant chemotherapy. A threshold LNR of 11% can help personalize treatment strategies, and patients with higher LNRs may require more intensive approaches like chemoradiotherapy to improve survival. Further prospective studies are needed to validate these results.</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/PMC12527439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139362","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}