Acta Oncologica最新文献

{"title":"'Crossing borders' in data standardisation: application of OMOP CDM in an international clinical trial network in precision cancer medicine.","authors":"Maria Martin Agudo, Henk Van der Pol, Gabriel Bratseth Stav, Tina Kringelbach, Katarina Puco, Åsmund Flobak, Hans Gelderblom, Kjetil Taskén, Gro Live Fagereng, Eivind Hovig","doi":"10.2340/1651-226X.2026.45120","DOIUrl":"10.2340/1651-226X.2026.45120","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"159-163"},"PeriodicalIF":2.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Realising precision oncology through shared real-world data infrastructure.","authors":"Andreas Bjerrum, Andreas Fanø, Ulrik Lassen","doi":"10.2340/1651-226X.2026.45074","DOIUrl":"10.2340/1651-226X.2026.45074","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"156-158"},"PeriodicalIF":2.7,"publicationDate":"2026-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A conceptual health economic modelling framework to assess the cost-effectiveness of molecular target-driven treatment regimens in oncology.","authors":"Oskar Frisell, Eline Aas, Pia Sofie Henkel, Gro Live Fagereng, Kjetil Taskén, Ebba Hallersjö Hult, Peter Lindgren, Katarina Steen Carlsson","doi":"10.2340/1651-226X.2026.45088","DOIUrl":"10.2340/1651-226X.2026.45088","url":null,"abstract":"<p><strong>Background and purpose: </strong>Molecularly targeted cancer therapies challenge conventional health economic evaluation frameworks that are structured around tumour-specific indications, comparators, and trial designs. Existing models often rely on pooled estimates from heterogeneous early-phase evidence or single-indication analyses, creating uncertainty for reimbursement decision-makers. We propose a conceptual modelling framework that aligns cost-effectiveness analyses with the biological rationale of precision oncology, evaluating therapies according to shared molecular alterations across tumour types. Patient/material and methods: We examined the methodological limitations of conventional partitioned survival models (PSMs) commonly applied in oncology and evaluated their suitability for tumour-agnostic indications. Based on the collected literature, we developed a dynamic, modular PSM framework that integrates multiple tumour sites expressing a common biomarker. The framework supports pooled and tumour-specific analysis of cost-effectiveness and enables progressive disaggregation of subgroups as additional evidence becomes available.</p><p><strong>Results: </strong>The proposed modelling approach facilitates transparent synthesis of heterogeneous evidence across tumour types using epidemiologically informed weighting, while preserving the ability to estimate tumour-specific cost-effectiveness where data permit. It addresses key challenges in tumour-agnostic evaluation, including variation in standard of care, treatment effects, and resource use across cancer sites. The modular design promotes internal consistency, reduces duplication of analytical effort, and enables iterative re-assessment of both overall and subgroup-specific cost-effectiveness.</p><p><strong>Interpretation: </strong>A dynamic, weighted multi-site modelling framework represents a coherent and adaptable extension of current health-technology assessment-practice for tumour-agnostic therapies. By structuring evidence around molecular targets, the framework can improve transparency and robustness of cost-effectiveness estimates, thereby supporting more equitable and efficient reimbursement decisions in the context of precision oncology.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"141-147"},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of resectable distal cholangiocarcinoma in a single-centre Western patient cohort: comparison of the 7th and 8th edition of the UICC/AJCC TNM classification.","authors":"Maia Blomhoff Holm, Sondre Busund, Rahul Rihel, Mushegh A Sahakyan, Ivar Prydz Gladhaug, Caroline S Verbeke, Sheraz Yaqub, Dyre Kleive","doi":"10.2340/1651-226X.2026.44965","DOIUrl":"10.2340/1651-226X.2026.44965","url":null,"abstract":"<p><strong>Background and purpose: </strong>Distal cholangiocarcinoma (CCA) is a rare malignancy with poor prognosis, even after surgical resection. Accurate staging is essential for guiding treatment and predicting outcomes. The 8th edition of the Union for International Cancer Control (UICC)/The American Joint Committee on Cancer (AJCC) TNM classification introduced depth of tumour invasion (DOI) as the criterion for T-staging (T1-T3) and a three-tiered lymph node (N) classification. This study evaluates patient stratification and prognostic accuracy of the 8th versus 7th edition in a single-centre Western cohort and discusses difficulties with measuring DOI. Patient/material and methods: Patients undergoing pancreatoduodenectomy for distal CCA at Oslo University Hospital (2015-2021) were retrospectively analysed. Tumours were restaged according to the 7th and 8th TNM editions. Survival was assessed using Kaplan-Meier estimates and log-rank tests to compare prognostic accuracy.</p><p><strong>Results: </strong>Seventy-one patients were included. Using the 7th edition, most cancers (94.4%, 67 patients) were categorised as T3. With the 8th edition, stage redistribution was notable: T2 included 45 patients (63.4%) and T3 included 22 (31.0%). Five-year survival was significantly better for T2 (31.8%) than T3 (10.5%) according to the 8th edition, demonstrating improved discrimination. The revised N classification provided better prognostic distinction, with median survival of 30 months for N1 (1-3 nodes) and 23 months for N2 (≥4 nodes).</p><p><strong>Interpretation: </strong>The 8th edition provides more accurate prognostic stratification of distal CCA compared to the 7th edition but requires meticulous, standardised pathology assessment to ensure accurate prognosis and appropriate post-surgical management.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"148-155"},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-treatment infection prediction in CLL using domain adaptation of lymphoma electronic health records.","authors":"Mehdi Parviz, Christian Brieghel, Mikkel Werling, Thomas Lacoppidan, Emelie Rotbain, Carsten U Niemann, Rudi Agius","doi":"10.2340/1651-226X.2026.44569","DOIUrl":"10.2340/1651-226X.2026.44569","url":null,"abstract":"<p><strong>Background and purpose: </strong>Infections are the leading cause of morbidity and mortality in patients with chronic lymphocytic leukemia (CLL) and occur during and after treatment. When deciding on the type of CLL treatment, the risk of infections is typically assessed based only on age and comorbidities; therefore, there is a need to develop a predictive model that incorporates information from multiple data sources. However, training an effective machine learning model requires a large sample size. Patient/material and methods: In this study, we developed a machine learning approach using domain adaptation (DA) to predict the risk of severe infection during treatment in patients with CLL. We implemented a DA strategy using lymphoma patient data and compared it with a domain-specific (DS) strategy across multiple models.</p><p><strong>Results: </strong>The DA strategy outperformed the DS strategy across all models, with an odds ratio of 4.43 for infection risk between high-risk and low-risk groups, compared with an odds ratio of 3.69 for the best DS model and 2.27 for the CLL-IPI alone. Explainability analysis identified predictive features for both the DA and DS models, including medication data and biochemistry tests. Specifically, C-reactive protein levels and non-therapeutic drugs were common features identified by both DA and DS models, while the DA models relied more heavily on alimentary tract drugs, solvents and diluting agents, and antibacterial medications.</p><p><strong>Interpretation: </strong>These findings highlight the value of integrating data from different diseases (lymphoma) to improve predictions in a target disease (CLL), and represent a step toward data-driven identification of CLL patients at high risk of infection during treatment.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"109-118"},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SWE-NEO: Swedish NEO-adjuvant trial comparing anti-PD-1 monotherapy to combined anti-CTLA-4/anti-PD-1 blockade in resectable stage III melanoma: study protocol for a phase III open-label multi-centre trial.","authors":"Hildur Helgadottir, Ana Carneiro, Francesca Portelli, Konstantinos Papadakis, Karl Björkström, Muyi Yang, Iva Johansson, Ingela Skogvall Svensson, Allan Jazrawi, Amanda Hallgren, Katja Harbst, Rusana Bark, Suzanne Egyhazi Brage, Anders Berglund, Karolin Isaksson, Stina Wickström, Jonas Nilsson, Lars Ny, Göran Jönsson, Roger Olofsson Bagge","doi":"10.2340/1651-226X.2026.45174","DOIUrl":"10.2340/1651-226X.2026.45174","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"126-130"},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FIN-EGFRprint: a Finnish real-world study on treatments and outcomes in advanced NSCLC with common EGFR mutations.","authors":"Aija Knuuttila, Lalli O Nurmi, Petri M Vänni, Eija K Heikkilä, Joanne Edwards, Monica H Ekblom, Irene Luccarini, Maria Silvoniemi","doi":"10.2340/1651-226X.2026.44731","DOIUrl":"10.2340/1651-226X.2026.44731","url":null,"abstract":"<p><strong>Background and purpose: </strong>The treatment of advanced non-small cell lung cancer (aNSCLC) with common epidermal growth factor receptor (cEGFR) mutations has evolved substantially over the last 15 years, with the discovery of activating epidermal growth factor receptor (EGFR) mutations and introduction of first-, second- and third generation (gen) EGFR tyrosine kinase inhibitors (TKIs) as first-line therapy. This retrospective observational study aimed to evaluate whether the introduction of these treatments has led to improved 'real-world' outcomes over time by analysing time to next treatment (TTNT) and overall survival (OS). Patient/material and methods: Patients (n = 379) with EGFR exon 19 deletion (Del19) or exon 21 L858R (L858R) substitution and aNSCLC were identified from two Finnish university hospital data lakes between 2010 and 2023. TTNT and OS were analysed from first-line treatment initiation using Kaplan-Meier survival and multivariable Cox regression analyses. Patients were stratified into three cohorts based on date of diagnosis and which TKIs were available at that time (1st-gen: 2010-2016, 2nd-gen: 2017-2020 and 3rd-gen: 2020-2023).</p><p><strong>Results: </strong>The use of chemotherapy as first-line therapy declined from 32% (2010-2016) to 6% (2020-2023), while 80% of patients received 3rd-gen TKIs as first-line treatment in 2020-2023. Median TTNT improved over time (9.7 to 13.2 to 21.6), with a significant improvement in 2020-2023 versus 2010-2016 (HR: 0.46; 95% CI: 0.33-0.64; p < 0.001). Median OS also increased over time (19.1 to 23.9 to 29.3 months) and was significantly higher in 2020-2023 versus 2010-2016 (HR: 0.56; 95% CI: 0.39-0.82; p = 0.002).</p><p><strong>Interpretation: </strong>'Real-world' treatment outcomes for aNSCLC with cEGFR mutations have improved over time likely due to the transition from 1st- to 3rd-gen TKIs. However, real-world survival with TKIs remains lower than clinical trials results emphasizing the unmet need.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"119-125"},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 outcome of neoadjuvant therapy with or without pembrolizumab for triple-negative breast cancer.","authors":"Meeri Maunu, Juho Lähteenmaa, Peeter Karihtala, Suvi Tuohinen, Joonas Laaksolilja, Anders Ståhls, Tuomo Meretoja, Johanna Mattson","doi":"10.2340/1651-226X.2026.44896","DOIUrl":"10.2340/1651-226X.2026.44896","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neoadjuvant therapy (NAT) has become standard therapy for early triple-negative breast cancer (TNBC). The aim of this study was to report real-world outcome of TNBC treated with NAT with or without pembrolizumab and to identify predictive factors for achieving pathologic complete response (pCR) in the pembrolizumab cohort. Patient/material and methods: The data of 75 consecutive TNBC patients treated with neoadjuvant chemotherapy and pembrolizumab at the Helsinki University Hospital Comprehensive Cancer Center were retrospectively collected. Treatment outcome and predictive factors for pCR were analyzed. Additionally, the outcome of nonmatched 102 consecutive TNBC patients treated without pembrolizumab during the preceding years is reported.</p><p><strong>Results: </strong>Forty-two patients (56.0%) achieved pCR to pembrolizumab-based NAT, while 47 patients (46.1%) without pembrolizumab had pCR. Lymph node metastasis (p = 0.011) and multifocality (p < 0.001) were inversely associated with pCR in the pembrolizumab cohort. Thirty-four patients (45.3%) had immune-related adverse events (irAEs), and 11 patients (14.7%) had grade 1-2 myocarditis in the pembrolizumab cohort. Due to adverse events (AEs), pembrolizumab was discontinued in 22 patients (29.3%) in the neoadjuvant setting, not started postoperatively in 21 patients (28%) and discontinued postoperatively in eight patients (10.7%). The number of preoperative pembrolizumab cycles was not associated with pCR.</p><p><strong>Interpretation: </strong>Despite higher incidence of myocarditis and interruption of the systemic therapy due to irAEs, higher pCR rates were seen with pembrolizumab. Even though the number of  preoperative pembrolizumab cycles was not associated with pCR monitoring and limiting AEs is important.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"131-140"},"PeriodicalIF":2.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nordic Society of Paediatric Haematology and Oncology (NOPHO) Radiotherapy Working Group consensus guidelines on radiotherapy for paediatric low-grade gliomas.","authors":"Anna Embring, Tanja Skyttä, Jacob Engellau, Irina Kerna, Daiva Sendiuliene, Malin Blomstrand, Daniel J Indelicato, Beate Timmermann, Yasmin Lassen-Ramshad, Henriette Magelssen","doi":"10.2340/1651-226X.2026.44815","DOIUrl":"10.2340/1651-226X.2026.44815","url":null,"abstract":"<p><strong>Background and purpose: </strong>Paediatric low-grade gliomas (pLGG) are the most common brain tumours in children. Radiotherapy, once the standard treatment for unresectable pLGG, is now used less frequently due to concerns about late side effects. The Nordic Society of Paediatric Haematology and Oncology (NOPHO) Radiotherapy Working Group aims to provide consensus guidelines on the use of radiotherapy for pLGG, addressing the current controversies and facilitating decision-making. Patient/material and methods: The guidelines were developed by clinical/radiation oncologists from the Nordic and Baltic countries and two international experts during a 2-day working group meeting. The meeting included presentations from the international experts and was preceded by a survey on radiotherapy practices and a non-systematic review of the literature on pLGG.</p><p><strong>Results: </strong>We present consensus-based recommendations for radiotherapy of pLGG. The guidelines discuss indications and timing of radiotherapy, age-related considerations, and the impact of genetic predisposition disorders such as neurofibromatosis type 1. Modern radiotherapy techniques, such as proton therapy, are highlighted for their potential to reduce long-term side effects.</p><p><strong>Interpretation: </strong>Radiotherapy remains the most effective treatment for unresectable pLGG, but its use must be carefully weighed against the risk of long-term side effects. The guidelines emphasise a personalised treatment approach, considering the evolving field of targeted therapies and the importance of multidisciplinary input in decision-making.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"101-108"},"PeriodicalIF":2.7,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selecting patients with rectal cancer for total neoadjuvant therapy based on clinical lymph node status: do we dare?","authors":"Anna Baech Slipsager, Michael Bødker Lauritzen, Laura Katrine Buskov, Laurids Østergaard Poulsen","doi":"10.2340/1651-226X.2026.45125","DOIUrl":"10.2340/1651-226X.2026.45125","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"97-100"},"PeriodicalIF":2.7,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}