Oncologist最新文献

{"title":"Exploring immune activation patterns in HER2-low and HER2-ultralow breast cancer subtypes.","authors":"Gyöngyi Munkácsy, Libero Santarpia, Balázs Győrffy","doi":"10.1093/oncolo/oyaf081","DOIUrl":"10.1093/oncolo/oyaf081","url":null,"abstract":"<p><strong>Background: </strong>A deeper understanding of the molecular and clinical characteristics of HER2-low and ultralow breast cancer (BC) subtypes is essential for advancing therapeutic strategies.</p><p><strong>Methods: </strong>Three independent GEO datasets with microarray and IHC/FISH data from 510 BC patients were analyzed to establish reliable HER2 expression cutoff values (>3034 for HER2-positivity and <1780 for HER2-ultralow), defining HER2-positive (HER2+), HER2-low, and HER2-ultralow cohorts. Combined with hormone receptor status, six distinct BC subgroups were identified. Prognosis was evaluated using univariate and multivariate survival analysis in a dataset of 7830 BC patients, alongside correlative analysis of 17 immune-related gene signatures across subgroups. A PubMed literature review compared our findings with existing studies.</p><p><strong>Results: </strong>In hormone receptor-positive (HR+) patients, HER2-low tumors were associated with better prognosis than HER2-ultralow and HER2+ subgroups (P = .0048 for relapse-free survival (RFS) and P = .0015 for distant-metastasis-free survival (DMFS)). No prognostic significance was observed in HR-negative (HR-) patients. Immune gene activation was consistently higher in HR- tumors, with HER2-low (HR+ and HR-) and HR-/HER2+ patients showing significant immune signature overlap. While HR+/HER2-ultralow and HR+/HER2+ patients had modest immune activation, HR-/HER2-ultralow patients exhibited the strongest association with immune signaling, including IFN signaling, T cell-activating cytokines, and cytotoxic effector molecules.</p><p><strong>Conclusions: </strong>These findings, supported by a comprehensive literature review, indicate that patients with HER2-low and HER2-ultralow BC exhibit distinct immune patterns, which supports their classification as unique BC subgroups.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477910","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":"Long-term survival in advanced unresectable HCC treated with transcatheter arterial chemoembolization combined with lenvatinib and PD-1 inhibitors.","authors":"Zhen-Xin Zeng, Hua-Chun Song, Yi-Nan Li, Jia-Yi Wu, Dong Liang, Shu-Qun Li, Zhi-Bo Zhang, Shao-Wu Zhuang, Bin Li, Jian-Yin Zhou, De-Yi Liu, Han Li, Xiang-Ye Ou, Rong-Jian Pan, Jun-Yi Wu, Mao-Lin Yan","doi":"10.1093/oncolo/oyaf058","DOIUrl":"10.1093/oncolo/oyaf058","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter arterial chemoembolization combined with lenvatinib and PD-1 inhibitors (triple therapy) is a promising therapy for unresectable hepatocellular carcinoma (uHCC). We aimed to assess the characteristics and identify predictors of long-term survival (LTS) in advanced uHCC treated with triple therapy.</p><p><strong>Methods: </strong>Retrospectively reviewed patients with uHCC who underwent triple therapy between June 2018 and May 2023 at 8 hospitals in China. LTS was defined as an overall survival (OS) ≥ 24 months. Kaplan-Meier curves were used to estimate survival. Univariate and multivariate logistic regression analyses were performed to identify predictors of LTS.</p><p><strong>Results: </strong>A total of 110 patients were included in this study. With a median follow-up of 31.3 months, the median OS and progression-free survival for the entire cohort were 17.9 months (95% confidence interval [CI], 13.8-21.2) and 11.8 months (95% CI, 9.9-15.3), respectively. Thirty-nine (35.5%) patients had LTS, with 36- and 48-month OS rates of 95.8% and 82.1%, respectively. In contrast, the median OS for patients with non-LTS was 10.9 months (95% CI, 9.9-13.2). The independent predictors of LTS were the absence of portal vein tumor thrombus (odds ratio [OR], 13.71; 95% CI, 3.19-88.08; p < .001), absence of extrahepatic metastasis (OR, 7.81; 95% CI, 2.76-25.82; p < .001), and platelet-albumin-bilirubin grade 1 (OR, 3.15; 95% CI, 1.17-9.15; p = .023).</p><p><strong>Conclusions: </strong>The absence of portal vein tumor thrombus, absence of extrahepatic metastasis, and platelet-albumin-bilirubin grade 1 were significantly associated with LTS. These findings help guide treatment decisions in advanced uHCC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477911","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":"Postoperative adjuvant chemotherapy and chemoimmunotherapy after radical resection for biliary tract cancer: a retrospective study.","authors":"Yuhuai Peng, Guoyi Xia, Yufeng Li, Jia Zhou, Sulai Liu, Chuang Peng, Yuewei Tao, Ou Li, Yinghui Song","doi":"10.1093/oncolo/oyaf163","DOIUrl":"10.1093/oncolo/oyaf163","url":null,"abstract":"<p><strong>Background and objectives: </strong>The prognosis of biliary tract cancers (BTC) after radical resection is still unsatisfactory. However, the clinical value of adjuvant therapy remains controversial. This retrospective study aimed to evaluate the clinical value of adjuvant chemotherapy and adjuvant chemoimmunotherapy in patients with BTC after radical resection.</p><p><strong>Methods: </strong>Data from BTC patients who underwent radical resection were retrospectively obtained from Hunan Provincial People's Hospital between January 2020 and July 2024. Patients were divided into observation group, adjuvant chemotherapy group, and adjuvant chemoimmunotherapy group according to the treatment received by the patient after surgery. Survival curves were determined by the Kaplan-Meier method. The COX proportional hazards regression model was used to determine independent prognostic risk factors. The adjuvant chemotherapy group and adjuvant chemoimmunotherapy group were analyzed by PSM at a 1:1 ratio.</p><p><strong>Results: </strong>A total of 219 patients with BTC were reenrolled in this study, with 108 cases of iCCA, 39 cases of pCCA, 15 cases of DCCA, and 57 cases of GBC. Eighty-seven patients (39.73%) received surgery alone, 69 patients (31.51%) received postoperative adjuvant chemotherapy, and 63 patients (28.77%) received postoperative adjuvant chemoimmunotherapy. There was no different significance for median recurrence-free survival (RFS) in the 3 groups (13.20 vs 20.40 vs 19.68 months; P = .195). The median overall survival (OS) was the longest in the chemoimmunotherapy group (29.20 vs 31.5 vs 43.27 months; P = .003). After propensity score matching (PSM), there was no difference in median RFS in the 2 adjuvant groups (22.03 vs 19.87 months; P = .350). The median OS was longer in the chemoimmunotherapy group (45.27 vs 29.40 months; P = .015). In Cox analysis, lymph node metastasis, differentiation, and adjuvant treatment were the independent predictors of OS in patients with BTC. The most common adverse events were of any grade of hematologic toxicity. No drug-related deaths occurred in either group.</p><p><strong>Conclusions: </strong>The safety of chemoimmunotherapy was acceptable and could significantly prolong the overall survival of BTC. These data provided a basis for an additional prospective clinical trial to evaluate the efficacy of chemoimmunotherapy in adjuvant therapy for BTC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200857","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":"REFINE: a database of linked clinical data and genomic biomarkers in renal cell carcinoma patients receiving immunotherapy-based treatment regimens.","authors":"Jeffrey Zhong, Albert Jang, Bashar Abuqayas, Arnab Basu, David J Benjamin, Vineel Bhatlapenumarthi, Mehmet Asim Bilen, Dhvani Buch, Mark Chang, Erica Chin, Sourat Darabi, Nagendra Dhanikonda, Pooja Ghatalia, Claud M Grigg, Abby L Grier, Tanya Jindal, Joannah Jung, Deepak Kilari, Hamsa L S Kumar, Suzanna Lee, Brittany Neelands, Chinmayi Pandya, Jeff Pawalek, Jaimee Staggers, Ahmet Yildirim, Yousef Zakharia, Kevin K Zarrabi, Michael Zimmerman, George Sledge, David Spetzler, Andrew Elliott, Rana R McKay, Pedro C Barata","doi":"10.1093/oncolo/oyaf135","DOIUrl":"10.1093/oncolo/oyaf135","url":null,"abstract":"<p><p>The REnal cancer consortium for Focused Investigation of Novel biomarkers and Expression (REFINE) consortium represents an important initiative in integrating clinical data with molecular sequencing in patients with advanced renal cell carcinoma (RCC) treated with immunotherapy-based approaches. By leveraging real-world evidence and genomic analysis, this consortium aims to explore putative predictive biomarkers with the potential to inform personalized treatment strategies. Findings from the REFINE database may further contribute to our understanding of disease courses of immunotherapy-based approaches for various molecular subtypes of RCC, associations of race and ethnicity with RCC treatment and outcomes with representation of patient populations underrepresented in clinical trials, and optimizing treatment sequencing.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327761","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 Oncologist, 2025, Vol, XX, Issue XX Predictive role of ARID1A and B2M mutations and the antigen presentation pathway in the efficacy of definitive chemoradiotherapy for cervical cancer.","authors":"Chenjing Zhu, Zhen Gong, Ping Yin, Jian Huang, Dan He, Biqing Zhu, Yaqin Wu, Hairong Wang, Yaru Zhang, Qifan Jing, Jiani C Yin, Yue Li, Jianyao Liu, Huanhuan Hu, Shuyue Xiao, Zhihua Sun, Hanzi Xu","doi":"10.1093/oncolo/oyaf133","DOIUrl":"10.1093/oncolo/oyaf133","url":null,"abstract":"<p><strong>Background and purpose: </strong>Definitive chemoradiotherapy (dCRT) is the standard treatment for locally advanced cervical cancer (LACC), yet patients experience considerable variability in disease-free survival (DFS). This study aimed to identify molecular biomarkers associated with response to dCRT in cervical cancer.Materials and methods: We retrospectively analyzed targeted next-generation sequencing data from tumor biopsy samples of 31 patients diagnosed with FIGO stage IIB-IVA LACC. Genetic alterations in cancer-related genes and pathways were assessed to determine associations with DFS. Immune cell infiltration and gene expression were analyzed using data from The Cancer Genome Atlas.</p><p><strong>Results: </strong>Genetic alterations were frequently detected in PIK3CA (45.2%), EP300 (25.8%), RB1 (19.4%), FBXW7 (19.4%), and FAT1 (16.1%). Multivariate analysis identified mutations in ARID1A and B2M as independent predictors of poor DFS. Alterations in the antigen processing and presentation pathway were also associated with reduced survival rates. Patients with ARID1A and B2M mutations exhibited decreased immune cell infiltration and impaired antigen presentation, indicating a compromised immune response.</p><p><strong>Conclusion: </strong>ARID1A and B2M mutations may serve as potential biomarkers for predicting treatment outcomes in cervical cancer patients undergoing dCRT. Testing for these mutations could help identify patients at higher risk of poor outcomes, guiding personalized treatment strategies to improve survival rates.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327762","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":"Multimodal rehabilitation to improve quality of life and fatigue after radiotherapy in esophageal cancer patients: a randomized trial.","authors":"Xianyan Chen, Linjun Zhong, Jiao Wang, Tingting Dai, Mingxia Li, Jiao Luo, Lin Zhu, Xinchi Liu, Lin Tao, Linjuan Li, Hongyan Du, Ruyu Ge, Shiqi Tao, Cheng Yi, Yan Fu, Youling Gong","doi":"10.1093/oncolo/oyaf073","DOIUrl":"10.1093/oncolo/oyaf073","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of nurse-led multimodal rehabilitation with conventional rehabilitation on quality of life and physical recovery during adjuvant radiotherapy for postoperative esophageal cancer.</p><p><strong>Methods: </strong>Seventy participants were randomized into a control group (N = 35) receiving conventional care and a multimodal group (N = 35) receiving nurse-led multimodal rehabilitation. Outcomes including quality of life, dyspnea index, fatigue, sleep quality, nutrition, anxiety, and depression status were recorded before the start of radiotherapy (T0), after completion of radiotherapy (T1), and 6 months (T2) and 12 months (T3) after completion of radiotherapy. Data were analyzed using intention-to-treat principles and linear mixed models.</p><p><strong>Results: </strong>The multimodal group significantly increased the global health scores compared to the control group at T1 (p < 0.001), with differences remaining significant at T2 (p = 0.002) and T3 (p = 0.005). The weight of the multimodal group was also significantly higher than that of the control group at T1 (p = 0.008), with the difference remaining significant at T2 (p = 0.033) and T3 (p = 0.020). The fatigue score of the multimodal group decreased significantly at T1 (p < 0.001) and remained significant at T2 (p < 0.001) and T3 (p = 0.005). The anxiety and depression status of the multimodal group improved significantly at T1, and the difference remained significant at T2 (all p < 0.05).</p><p><strong>Conclusion: </strong>Nurse-led multimodal rehabilitation significantly improved quality of life, sleep quality, nutrition, fatigue, anxiety, and depression status in patients undergoing postoperative radiotherapy for esophageal cancer.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340650","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":"COVID-19 burden of illness in people who are immunocompromised due to cancer: an expert opinion review.","authors":"Igor Aurer, Paul Moss, Michel Goldman, Mark Tuthill, Hermann Einsele, Carolina Casañas I Comabella, Samantha James, Katarzyna Borkowska, Fungwe Jah, Sabada Dube, Sarah Klein, Walid Kandeil, Renata Yokota, Antonio Pagliuca, Gkikas Magiorkinis, Sofie Arnetorp, Lennard Lee","doi":"10.1093/oncolo/oyaf074","DOIUrl":"10.1093/oncolo/oyaf074","url":null,"abstract":"<p><p>From the beginning of the pandemic, people with cancer have experienced a high burden from COVID-19 compared with the general population, both in terms of severe COVID-19-related outcomes and reduced health-related quality of life and mental health. This review presents and discusses expert views on the burden of COVID-19 in individuals with cancer throughout the pandemic. The literature suggests that early in the pandemic, people with cancer had a disproportionately high risk of COVID-19-related hospitalization compared with the general population. This trend continued throughout the pandemic, even after the availability of vaccinations (including boosters) and the emergence of less virulent strains. Rates of hospitalization, intensive care unit admission, and mechanical ventilation varied across studies but were all seen to be higher in people with cancer and COVID-19 compared with the general population or those with cancer alone. Moreover, studies indicated worsened quality of life and mental health in these people during the pandemic and lockdown periods compared with prepandemic or postlockdown periods. Although COVID-19 has entered the endemic phase and is no longer a global health emergency, it remains a significant risk for people with cancer. Generally, COVID-19 continues to increase healthcare resource use, impair mental health, and reduce quality of life in this population, highlighting the need for continued real-world studies. Ongoing research is essential to evaluate the impact of COVID-19 on vaccinated people with cancer, particularly those undergoing systemic cancer therapy who may require continued guidance on preventive measures and treatments to mitigate the risk of severe COVID-19.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318736","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":"Medicare spending and use of subcutaneous biologic formulations with hyaluronidase.","authors":"John Kim, Aaron S Kesselheim, Edward R Scheffer Cliff, Benjamin N Rome","doi":"10.1093/oncolo/oyaf149","DOIUrl":"10.1093/oncolo/oyaf149","url":null,"abstract":"<p><p>Several intravenously administered biologic drugs have been reformulated with hyaluronidase to enable subcutaneous delivery. This offers greater convenience and fewer infusion reactions while also increasing overall spending if biosimilar competition for the subcutaneous versions begins later than for the original intravenous versions. As of December 2024, at least 9 biologics had investigational or approved hyaluronidase versions. Medicare spending on these drugs totaled $10.3B in 2022. For 4 of these drugs, hyaluronidase versions accounted for 5%-83% of Medicare spending in 2022, with hyaluronidase versions accounting for the highest share of spending for pertuzumab-trastuzumab and daratumumab and a lower share of spending for 2 drugs that had biosimilar competition for the original versions: rituximab and trastuzumab. The benefits of subcutaneous hyaluronidase versions must be balanced against the challenges that come with higher prices if these versions are introduced before biosimilar competition begins for the original versions. Policymakers should ensure manufacturers cannot use \"hyaluronidase hopping\" to delay biosimilar competition or eligibility for Medicare price negotiation.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295377","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 experience of postoperative adjuvant chemoimmunotherapy in patients with pancreatobiliary subtype ampullary adenocarcinoma.","authors":"Jiahao Xue, Xinjun Lu, Xiangde Shi, Kenglong Huang, Yanfang Ye, Qibin Tang, Xianhuan Yu, Chao Liu","doi":"10.1093/oncolo/oyaf104","DOIUrl":"10.1093/oncolo/oyaf104","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of chemotherapy combined with programmed cell death protein-1 (PD-1) inhibitors in postoperative adjuvant therapy of pancreatobiliary subtype ampullary adenocarcinoma (AAC) are uncertain. This study aims to evaluate the effect of such treatment on the survival of this patient population.</p><p><strong>Methods: </strong>We retrospectively collected patients with pancreatobiliary subtype AAC who underwent surgical treatment at the Sun Yat-sen Memorial Hospital from January 2018 to December 2022. Patients with high-risk recurrence factors after surgery were divided into surgery alone group, adjuvant chemotherapy group, and adjuvant chemoimmunotherapy group. The Kaplan-Meier method was used to plot survival curves, and the Log-Rank method was used to compare the differences in overall survival (OS) and recurrence-free survival (RFS) between groups.</p><p><strong>Results: </strong>A total of 71 people were enrolled, including 24 patients received surgery alone, 31 patients received adjuvant chemotherapy, and 16 patients received adjuvant chemoimmunotherapy. The median time of clinical follow-up was 17.8 [IQR 8.3-28.4] months. The 1-year OS rates of the surgery alone group, adjuvant chemotherapy group, and adjuvant chemoimmunotherapy were 41.7%, 71.0%, and 93.3%, respectively. The 2-year OS rates were 28.6%, 47.7%, and 84.0%, respectively. The median OS was 6.8 months and 22.1 months, but the adjuvant chemoimmunotherapy group did not reach (P = .0002). The median RFS was 4.7 months, 15.7 months, and 14.8 months, respectively, but the differences were not statistically significant (P = .0613). Univariate and multivariate Cox analysis results showed that tumor size >2.3 cm (HR = 2.06, 95% CI, 1.06-4.04; P = .034) and the treatment regimen were independent factors affecting prognosis, compared to surgery alone and adjuvant chemotherapy (HR = 0.521, 95% CI, 0.26-1.04; P = .065), adjuvant chemoimmunotherapy (HR = 0.106, 95% CI, 0.02-0.47; P = .003) significantly improves patient survival. There was no statistically significant difference in any complications between the 3 groups (P > .05). Compared with the adjuvant chemotherapy group, patients in the adjuvant chemoimmunotherapy group are more likely to experience hypothyroidism (P = .044) and pruritus (P = .022). There is no statistically significant difference in other AEs between the 2 groups (P > .05).</p><p><strong>Conclusion: </strong>Compared with surgery alone or adjuvant chemotherapy, patients with pancreatobiliary subtype AAC who received adjuvant chemoimmunotherapy showed better OS, and the drug-related toxicity was acceptable.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217544","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":"Pre-existing and emerging immune-mediated diseases in patients with breast cancer undergoing cyclin-dependent kinases 4/6 inhibitors and endocrine therapy.","authors":"Flavia Jacobs, Mariangela Gaudio, Chiara Andreottola, Riccardo Borroni, Chiara Benvenuti, Giuseppe Saltalamacchia, Riccardo Gerosa, Jacopo Canzian, Paola Tiberio, Rosalba Torrisi, Giovanna Masci, Chiara Miggiano, Alberto Zambelli, Armando Santoro, Rita De Sanctis","doi":"10.1093/oncolo/oyaf123","DOIUrl":"10.1093/oncolo/oyaf123","url":null,"abstract":"<p><strong>Background: </strong>CDK4/6 inhibitors (CDK4/6i) are cornerstone therapies in Hormone Receptor Positive (HR+)/Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Breast Cancer (BC) and emerging evidence suggests that they may influence immune function, potentially enhancing antitumor immunity but also triggering autoimmune reactions. This study aims to investigate the prevalence of autoimmune diseases (AD) in patients with HR+/HER2- BC to identify potential predictive biomarkers and to assess the impact of AD on disease progression.</p><p><strong>Patients and methods: </strong>This retrospective-prospective cohort study included consecutive HR+/HER2- BC patients treated with CDK4/6i at Humanitas Research Hospital. Clinical-pathological features, treatment data, AD occurrence, and blood test values were collected. Descriptive statistics were used to determine AD prevalence, Kaplan-Meier method to estimate progression-free survival (PFS), and log-rank test to compare survival curves.</p><p><strong>Results: </strong>352 patients (median age: 54 years) were enrolled, of which 87.2% had metastatic disease and received palbociclib, abemaciclib, or ribociclib (45.2%, 31.0%, and 23.9%, respectively). 12.8% of patients had early BC and received abemaciclib. ADs were identified in 49 patients: most had pre-existing conditions (38 stable and 4 flaring during treatment) while 7 developed new-onset ADs. The most frequent AD were Hashimoto thyroiditis, vitiligo, and rheumatoid arthritis. In the metastatic setting, the median PFS was significantly longer in patients with AD compared to those without (P = .0013), with patients with flaring or new-onset AD showing a better PFS (P = .0015). No significant predictive biomarkers for AD evolution were found.</p><p><strong>Conclusion: </strong>CDK4/6i therapy is feasible in patients with pre-existing AD. Interestingly, the onset or flaring of AD during treatment is associated with improved PFS, suggesting a potential immune activation induced by CDK4/6i. However, further robust and prospective studies are required to validate these findings and explore the underlying mechanisms.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 6","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276723","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}