Oncologist最新文献

{"title":"Independent cancer research in low- and middle-income countries: why it matters and how to build it.","authors":"Oscar Arrieta, Eduardo Rios-Garcia, Cittim B Palomares-Palomares, Alejandro Aranda-Gutierrez, Regina Barragan-Carrillo, Carlos H Barrios, Andrés F Cardona, Luis Corrales, Narjust Florez, Juan-Manuel Hernandez-Martinez, Claudio Martin, Jackson Orem, Luis Eduardo Pino, Ricardo Plancarte, Gustavo Werutsky, C S Pramesh","doi":"10.1093/oncolo/oyag356","DOIUrl":"10.1093/oncolo/oyag356","url":null,"abstract":"<p><p>By 2030, an estimated 75% of cancer deaths will occur in low- and middle-income countries (LMICs). Weak surveillance systems and limited research infrastructure often hide the true magnitude of this burden. Thus, independent, locally led research is essential for generating high-quality data, addressing regional disease patterns, and informing context-specific strategies for cancer control. Low national investment, heavy reliance on industry-sponsored trials, and a scarcity of trained clinician scientists hinder independent cancer research in LMICs. In this narrative review, we synthesize the published literature and present a descriptive analysis of oncology trials registered on ClinicalTrials.gov (accessed July 2025), categorized by country, funding source, and tumor site and normalized to disease burden, drawing on illustrative examples from Africa, Asia, and Latin America. We highlight the transformative impact of context-sensitive research initiatives, explore disparities in sponsorship by country and tumor type, and outline ways to strengthen the research infrastructure. These include the establishment of population-based cancer registries, regional funding mechanisms, streamlined regulatory frameworks, and workforce development through formal research training and protected time. Finally, we propose strategies to enhance international collaboration and amplify LMIC participation in setting global cancer research priorities.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908040","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":"RASolute 302: lessons learned and the road ahead in pancreatic cancer.","authors":"Andrew H Ko","doi":"10.1093/oncolo/oyag346","DOIUrl":"10.1093/oncolo/oyag346","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852120","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 secret-shopper study evaluating logistic barriers to care among young adults with acute lymphoblastic leukemia.","authors":"Samuel Greenwald, Muna Hassan, Lori Muffly, Kate Miller, Jerry Luo, Amy Zhang, Theresa H M Keegan, Helen M Parsons","doi":"10.1093/oncolo/oyag363","DOIUrl":"10.1093/oncolo/oyag363","url":null,"abstract":"<p><p>Adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) experience inferior survival relative to children. As access barriers may increase outcome disparities, we conducted a secret-shopper study to identify logistical burdens when initiating care for AYAs. We developed scripts describing hypothetical AYAs with ALL seeking initial oncology appointments and, from February 2024 to March 2025, used data from population-based cancer registries to call facilities treating AYAs with ALL. Outcomes included number of attempts (up to 3) and transfers, call time, and required documentation for scheduling. Data were summarized descriptively. Of 424 facilities, 276 could schedule oncology appointments via phone. Of these, 36.2% required ≥2 attempts. Across attempts, 43.5% required ≥2 transfers. Median call time was 8 minutes, but 19.6% of facilities required ≥15 minutes. Only 20.7% would schedule without a referral or medical records. AYAs with ALL face logistical burdens when scheduling appointments, requiring additional efforts to streamline care.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931967","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":"Feasibility of EHR-based prescreening for an adjuvant breast cancer trial in a safety-net health system.","authors":"Hussain Alkhafaji, Lindsay C K Reynolds, Melissa Howell, Jerry D Henderson, Dedra Preece, Kari J Teigen, David E Gerber, Kalyani Narra","doi":"10.1093/oncolo/oyag339","DOIUrl":"10.1093/oncolo/oyag339","url":null,"abstract":"<p><strong>Introduction: </strong>Racial and ethnic inequities persist in oncology clinical trial participation, while safety-net health systems may face resource and data limitations that complicate candidate identification. We evaluated the feasibility of an electronic health record (EHR)-assisted prescreening workflow for EMBER-4, a phase 3 adjuvant breast cancer trial, at a safety-net health system.</p><p><strong>Methods: </strong>Structured Query Language (SQL) queries applied to Epic Clarity identified potential candidates using diagnosis codes, receptor-status codes, endocrine therapy medication records, recent oncology follow-up, and appointment data. Research staff then manually reviewed pathology reports, treatment history, comorbidities, and other protocol criteria to determine full eligibility.</p><p><strong>Results: </strong>The source population with a diagnosis of breast cancer included 829 patients: 29% Hispanic, 30% Black, 31% non-Hispanic White, and 9.7% others. Primary language was English in 75% and Spanish in 18%. The SQL query identified 123 potential candidates; manual review confirmed 18 eligible patients comprising 67% Hispanic and 44% Spanish language, yielding a positive predictive value of 15%. Clinicians identified 3 additional eligible patients missed by the query, for 21 known eligible patients overall. Eleven declined participation, one did not attend the scheduled clinic visit, and 9 consented. One patient withdrew before randomization and 8 were enrolled. Six enrolled patients were Hispanic, 1 was non-Hispanic White and 1 was Black.</p><p><strong>Conclusions: </strong>In a safety-net oncology setting, her-assisted prescreening was feasible but required manual verification and clinician involvement. The workflow identified most known eligible patients, although incomplete structured data and low positive predictive value limited its utility as a standalone screening method.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867940","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 with ipilimumab in combination with nivolumab in advanced sarcoma: a retrospective analysis including ultra-rare sarcomas.","authors":"Benjamin Snyder, Casey Wendorff, Korbin Davis, Lauren Blackwell, Jason Childress, Taylor Stethen, Ani Toklu, Heather Burney, Sarah Spargo, Bharathi Muthusamy, Daniel A Rushing, Samantha A Armstrong","doi":"10.1093/oncolo/oyag348","DOIUrl":"10.1093/oncolo/oyag348","url":null,"abstract":"<p><strong>Background: </strong>Patients with locally advanced or metastatic sarcoma have a poor prognosis and limited efficacious treatment options. Phase 2 trials have demonstrated efficacy for the combination of ipilimumab and nivolumab in select sarcoma histologies, but real-world data is limited.</p><p><strong>Methods: </strong>In this single-institution retrospective analysis, patients with metastatic or unresectable sarcoma treated with the combination of immune checkpoint inhibitors (ICIs) ipilimumab and nivolumab were assessed for response by iRECIST criteria and were correlated with clinical outcomes. The Kaplan-Meier method was used for survival analysis.</p><p><strong>Results: </strong>From 2019 to 2024, 90 patients with advanced sarcoma were treated with combination ICI and were evaluable for outcomes. The observed objective response rate (ORR) was 16.7% with clinical benefit rate (CBR) of 30%. The best response was partial response (PR) in 14.4%, stable disease (SD) in 23.3%, and progressive disease (PD) in 62.2%. Median overall survival (OS) (95% confidence interval [CI] 14.4-NE months) and median progression-free survival (mPFS) (95% CI, 9.6-NE months) were not reached for patients achieving an objective response. OS was superior in patients who experienced immune-related adverse events (irAEs). Both mPFS and median overall survival were superior in patients with thyroid irAEs. Highest ORR were seen in angiosarcoma, malignant peripheral nerve sheath tumor, leiomyosarcoma, undifferentiated pleomorphic sarcoma, and chondrosarcoma.</p><p><strong>Conclusions: </strong>Real-world analysis of combination ICI in a large cohort of heavily pretreated patients with advanced sarcomas demonstrates clinical benefit in a meaningful number of patients, including historically unresponsive histologies, though predictive factors remain elusive. The development of irAEs, specifically thyroid dysfunction, was associated with improved survival. Sustained responses were observed in patients who achieved an objective response.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867870","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":"Apatinib monotherapy for pretreated advanced squamous cell carcinoma of the penis: a phase 2 trial.","authors":"Juan Zhou, Wenfeng Li, Mingjuan Sun, Sheng Zhang","doi":"10.1093/oncolo/oyag349","DOIUrl":"10.1093/oncolo/oyag349","url":null,"abstract":"<p><strong>Background: </strong>Treatment options for patients with advanced penile squamous cell carcinoma who have disease progression on systemic chemotherapy are scarce. Antiangiogenic drugs have shown antitumor effects in case series. This phase 2 trial evaluated the activity and safety of apatinib (a Vascular Endothelial Growth Factor (VEGF) receptor inhibitor) in such patients.</p><p><strong>Methods: </strong>This investigator-initiated, single-arm, phase 2 trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN000021849) and performed at a tertiary cancer center in Shanghai, China. Eligible patients had histologically confirmed penile squamous cell carcinoma, were not candidates for surgery with curative intent, had measurable disease, had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, pretreated with one or more kinds of systemic treatment. Patients were prescribed oral apatinib 500 mg daily with the option of dose reduction to manage adverse events. The primary endpoint was the investigator-assessed overall response rate (ORR) assessed in all patients who received at least one dose of study drug.</p><p><strong>Results: </strong>Between 2016 and 2023, we enrolled 23 patients, all of whom received at least one dose of study treatment. Of the 23 patients, 16 had an ECOG performance status of 2. Only 6 patients had human papillomavirus-positive tumors. Five patients had a partial response (ORR = 22% [95% CI, 10%-42%]). The median progression-free survival was 3.8 months, and median overall survival was 7.2 months. Treatment-related adverse events of grade 3 or worse occurred in 7 (30%) of 23 patients. The most common grade 3 or 4 treatment-related adverse events were hand-foot syndrome (13%), hypertension (9%), and increase in serum alanine aminotransferase (9%).</p><p><strong>Conclusion: </strong>Apatinib in pretreated advanced penile cancer showed limited efficacy with a manageable safety profile.</p><p><strong>Clinicaltrials.gov identifier: </strong>UMIN000021849.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907991","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":"Ten-year survival of women with invasive breast cancer by stage, molecular subtype, and grade combined: a population-based study.","authors":"Fabiola Giudici, Diego Serraino, Fabio Puglisi, Samuele Massarut, Lorenzo Gerratana, Serena Scomersi, Federica Toffolutti, Ettore Bidoli, Luigino Dal Maso","doi":"10.1093/oncolo/oyag338","DOIUrl":"10.1093/oncolo/oyag338","url":null,"abstract":"<p><strong>Background: </strong>Stage at diagnosis, histologic grade, and molecular subtypes are established prognostic indicators for women with breast cancer (BC), but their impact on population-based survival estimates is poorly documented. This study assessed long-term BC survival trends according to these factors.</p><p><strong>Methods: </strong>We identified women aged <75 years diagnosed with stage I-IV invasive BC between 2004 and 2014 from the Friuli Venezia Giulia (north-eastern Italy) Cancer Registry (N = 10 467). Follow-up through 2023 was used to estimate overall and net survival (NS) according to combinations of prognostic factors.</p><p><strong>Results: </strong>The highest 10-year NS (10-NS) was observed in women with stage I HR+/HER2- subtype (98.8%), while it was 35.1% for stage III triple-negative (TN) subtype. Among women with stage IV BC, 10-NS was 18.9% for those HR-/HER2+, 11.5% for those HR+/HER2+, 8.3% for HR+/HER2-, and 6.7% for TN. For each stage, NS decreased with increasing grade. Comparing periods of diagnosis (2004-2009 vs 2010-2014), 10-NS remained >90% for women with stage I BC, but improved for stage III and aggressive subtypes (HR-/HER2+ and TN). In women with stage III HR-/HER2+ BC, 10-NS increased from 48.6% to 87.9% (+39 percentage points), while when diagnosis was stage III TN BC it rose from 28.8% to 42.3.</p><p><strong>Conclusion: </strong>Population-based estimates of long-term BC survival by combined stage, grade, and molecular subtype can inform the interpretation of evolving therapeutic strategies and improve risk stratification for patient follow-up.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820268","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 treatment patterns and outcomes in metastatic clear cell renal cell carcinoma following immune checkpoint inhibitor progression (2018-2023).","authors":"Neil J Shah, Rahul Ravilla, Andrew J Osterland, Karen Todoroff, Ching-Yu Wang, Pratik Rane, Hakim Saal, Paul R Conkling, Ding Wang, Robert J Motzer","doi":"10.1093/oncolo/oyag326","DOIUrl":"10.1093/oncolo/oyag326","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICI) have become standard of care for renal cell carcinoma (RCC) in the adjuvant, first-line and pre-treated settings. However, treatment patterns and outcomes of patients with RCC that progresses following ICI treatment are not well characterized.</p><p><strong>Methods: </strong>A retrospective review of electronic health records from a US community oncology network included patients with metastatic clear cell RCC (mccRCC) that progressed after an initial ICI-containing regimen and received subsequent systemic therapy (index) between 01/01/2018 and 01/31/2023. Patient characteristics and treatment patterns were described. Real-world progression-free survival (rwPFS) and overall survival (OS) were analyzed using Kaplan-Meier method by line of therapy (LOT) of the first ICI-containing regimen and index regimen class.</p><p><strong>Results: </strong>Overall, 299 patients were included (median [IQR] age 68 [60-75] years, 73% male, 85% white, 87% intermediate or poor IMDC risk, median follow-up 11.3 months) with the first ICI-containing regimen initiated in the adjuvant (n = 5, 2%), first-line (n = 203, 68%) or second-line (n = 91, 30%) settings. Vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) monotherapy was the most common index (post-IO) regimen class (62% any VEGFR-TKI, 46% cabozantinib). Median (95% CI) rwPFS and OS were 6.0 (5.4, 6.8) and 14.3 (12.1, 16.4) months, respectively. No differences were observed in rwPFS and OS by LOT of the first ICI-containing regimen (P = 0.763, P = 0.885, respectively) or index regimen class (P = 0.721, P = 0.747, respectively).</p><p><strong>Conclusion: </strong>In real-world patients with mccRCC that progressed to the post-ICI setting, VEGFR-TKI monotherapies were the most common post-ICI regimens and differences in clinical outcomes were not observed by LOT of the first ICI-containing regimen or index regimen class. There is high unmet need for novel therapies in the post-ICI setting.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972379","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":"Osimertinib plus anlotinib in untreated, EGFR-mutated, advanced non-small-cell lung cancer with concurrent alterations: a multicenter phase II study.","authors":"Xiaojun Yang, Qinquan Tan, Shiyuan Chen, Jieyun Xie, Yihong Zeng, Ruinian Zheng, Qinglin Tan, Wan Zhang, Churen Yu, Ziying Hong, Xinpei Yu, Guanming Jiang","doi":"10.1093/oncolo/oyag344","DOIUrl":"10.1093/oncolo/oyag344","url":null,"abstract":"<p><strong>Background: </strong>The standard first-line treatment for advanced EGFR-mutated non-small cell lung cancer (NSCLC) is EGFR tyrosine kinase inhibitors. However, concurrent mutations facilitate resistance evolution in EGFR-mutant lung adenocarcinoma and combination therapies may offer a superior approach. This study explores the efficacy and safety of osimertinib plus anlotinib as first-line treatment for advanced NSCLC with EGFR co-mutations.</p><p><strong>Materials and methods: </strong>This study prospectively enrolled patients with advanced NSCLC harboring EGFR (19Del/21L858R) mutations and ≥1 mutation in TP53, PIK3CA, or RB1, who had not undergone systemic treatment. Kaplan-Meier survival analysis tested the differences among patients with different concurrent mutations. ctDNA test was administered before and after treatment and its correlation with efficacy.</p><p><strong>Results: </strong>A total of 38 patients were enrolled, with co-mutations in TP53 (76.3%), PIK3CA (26.3%), and RB1 (2.6%). With a median follow-up of 25.6 months, the median progression-free survival (PFS) was 29.0 months (95% CI, 18.6-NR), and 1-year PFS rate was 85% (95% CI, 70.4%-94.5%). Objective response rate was 73.7% (95% CI, 56.9%-86.3%), and disease control rate was 100.0% (95% CI, 90.7%-100.0%). Adverse events of any grade occurred in all patients. Seven (18.4%) patients experienced grade 3 treatment-related adverse events (TRAEs), with no grade 4 TRAEs or treatment-related deaths.</p><p><strong>Conclusion: </strong>Osimertinib plus anlotinib shows promising efficacy and manageable toxicity as first-line treatment for advanced NSCLC with EGFR co-mutations (ChiCTR2300070023).</p><p><strong>Clinical trial registration: </strong>This study was registered in the Chinese Clinical Trial Registry (ChiCTR) under the registration number ChiCTR2300070023 on March 31, 2023 (https://www.chictr.org.cn).</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842256","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":"MEK inhibitor-based genomically matched combinatorial targeted therapies in metastatic pancreatic adenocarcinoma with KRAS alterations.","authors":"Elizabeth D Auckley, Stephanie Yohay, Grace Ying, Aniko Szabo, Jacquelyn Wittmann, Justin Grahl, Mohammed Aldakkak, Samih Z Thalji, Thomas McFall, Razelle Kurzrock, Ben George, Mandana Kamgar","doi":"10.1093/oncolo/oyag040","DOIUrl":"10.1093/oncolo/oyag040","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic ductal adenocarcinoma (PDAC) is often caused by mutations in multiple genes, including KRAS (activating the Ras-Raf-MEK-ERK pathway). This study evaluated the role of MEK inhibitor (MEKi)-based combinatorial targeted therapies in patients with PDAC.</p><p><strong>Methods: </strong>This is a retrospective/prospective observational, single-institution study, including 29 patients with metastatic PDAC with KRAS alterations, treated with MEKi therapies between 2022 and 2024.</p><p><strong>Results: </strong>Ten patients had KRAS G12R (34.5%), ten G12D (34.5%), and nine G12V (31%). The majority of patients received MEKi therapy as third-line and beyond (KRAS G12R/G12D/G12V: 60%/50%/78%, respectively). Median overall survival from MEKi initiation for KRAS G12R/G12D/G12V was 8.2/5.1/4.7 months (P = .5), respectively, and median progression-free survival was 4.4/2.3/1.4 months (P = .11). Six (21%) patients discontinued at least one drug in the treatment combination due to toxicity.</p><p><strong>Conclusions: </strong>MEKi-based combinatorial therapies had modest disease control in patients with KRAS G12R, and minimal disease control in patients with KRAS G12D/V in the late-line setting.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214833","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}