Acta Oncologica最新文献

{"title":"Prevalence and management of immediate drug hypersensitivity observed during antineoplastic drug therapy.","authors":"Trine Holm Rasmussen, Charlotte Gotthard Mortz, Per Pfeiffer, Nina Andersen, Carsten Bindslev-Jensen","doi":"10.2340/1651-226X.2025.43098","DOIUrl":"10.2340/1651-226X.2025.43098","url":null,"abstract":"<p><strong>Background: </strong>Immediate drug hypersensitivity reactions (IDHRs) complicate the treatment of patients with cancer. Rapid drug desensitization (RDD) is not a standard treatment option in Northern Europe as in Southern Europe and the US. Thus, in Denmark, allergists are not involved when cancer treatments are complicated by IDHRs.</p><p><strong>Purpose: </strong>The purpose was to investigate whether Danish patients could benefit from the implementation of an allergy work-up including RDD by investigating the magnitude of the problem with IDHRs in Danish antineoplastic drug therapy, in addition to describe characteristics of IDHRs, re-treatment strategies, and outcomes.</p><p><strong>Patients and methods: </strong>This prospective observational single-center study was conducted at a large university hospital. Patients were included over 17 months. Patients were interviewed during index reaction. Information on culprit drug, infusion procedure, and premedication was obtained, together with reaction phenotype and severity. After 3 months, information on re-treatment strategies and outcome were obtained from medical records.</p><p><strong>Results: </strong>In total, 126 patients experienced IDHRs during the study period. This corresponds to 2.5% of patients receiving antineoplastic drug therapy. Re-treatment, using increased premedication and/or decreased infusion rate, was attempted in 97 patients and tolerated by 69. However, 57 out of 126 patients (45%) discontinued treatment. This corresponds to 1.1% of patients receiving antineoplastic drug therapy. Patients with gynecologic cancers had a particularly high risk.</p><p><strong>Interpretation: </strong>IDHRs are infrequent in antineoplastic drug therapy, but due to the large number of patients with cancer, the number of IDHRs is significant. Patients discontinuing treatment could benefit from an allergy work-up including RDD.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"574-584"},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958380","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":"Pre-treatment tumour PET metrics and clinical outcomes of anal cancer in patients living with and without HIV.","authors":"Michael Pennock, N Patrik Brodin, Christian Velten, Megi Gjini, Nitin Ohri, Chandan Guha, Shalom Kalnicki, Wolfgang A Tome, Madhur K Garg, Rafi Kabarriti","doi":"10.2340/1651-226X.2025.40680","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.40680","url":null,"abstract":"<p><strong>Background/purpose: </strong>To investigate if pre-treatment tumour positron-emission tomography (PET) metrics' prognostic efficacy changes with HIV or viral load (VL) in anal squamous cell carcinoma (ASCC).</p><p><strong>Materials and methods: </strong>Consecutive patients treated with definitive radiation therapy (RT) for non-metastatic ASCC from 2005 to 2021 at one institution were retrospectively identified. Patient demographic and clinical data, including HIV status and pre-treatment VL, were tabulated. Pre-treatment PET metrics were calculated with semi-automatic gradient-based segmentation algorithms. Cox-proportional-hazard and Kaplan-Meier modelling were used to investigate tumour PET metrics and outcomes: overall survival (OS), progression-free survival (PFS), and locoregional control (LRC).</p><p><strong>Results: </strong>A total of 175 patients were included: 110 HIV-negative and 65 patients living with HIV (PLWH). Nineteen PLWH had detectable pre-treatment VL. Median follow-up was 58 months (interquartile range [IQR]: 28-99), with 28 locoregional failures and 31 deaths. Five-year LRC, PFS, and OS was 84%, 73%, and 86%, respectively. There was no significant difference in LRC, PFS, or OS between HIV-negative patients and PLWH. 156 patients had available pre-treatment PET scans. Metabolic tumour volume and total lesion glycolysis were significantly associated with LRC and PFS on multivariate Cox analysis for the entire cohort (p ≤ 0.02), and HIV-negative patients on Cox sub-group analysis (p ≤ 0.01). No association between PET metrics and outcomes was seen for PLWH.</p><p><strong>Interpretation: </strong>Outcomes were comparable between HIV-negative patients and PLWH. Pre-treatment PET metrics were validated as significantly predicting outcomes for the entire cohort and HIV-negative patients, not PLWH. This may be from small numbers of PLWH patients, or non-specific uptake in patients with uncontrolled HIV reducing PET's prognostic efficacy.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"564-573"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955827","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":"The use of pegylated liposomal doxorubicin in metastatic soft tissue sarcoma.","authors":"Trang Pham, Hanne Krogh Rose, Philip Rossen, Ninna Aggerholm Pedersen","doi":"10.2340/1651-226X.2025.43263","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43263","url":null,"abstract":"<p><strong>Background: </strong>Soft tissue sarcoma (STS) is a heterogeneous group of rare malignancies with limited response to conventional chemotherapy. Among these, epithelioid haemangioendothelioma (EHE) and angiosarcoma represent rare vascular sarcomas with distinct clinical behaviours, challenging treatment approaches, and poor prognoses. Doxorubicin remains the standard first-line therapy for metastatic STS, but its use is constrained by dose-dependent cardiotoxicity. Pegylated liposomal doxorubicin (PLD) has been proposed as an alternative.</p><p><strong>Material and method: </strong>This retrospective, registry-based cohort study investigates the efficacy of PLD in patients with locally advanced or metastatic STS treated at Aarhus University Hospital, Denmark, between 2008 and 2023. Patients were identified from a regional database, and progression-free survival (PFS) and overall survival (OS) were analysed.</p><p><strong>Results: </strong>A total of 38 patients were included, with 6 diagnosed with EHE and 16 with angiosarcoma. Among EHE patients, all had metastatic disease at diagnosis, with a median PFS of 7.8 months and OS of 1.5 years from the start of PLD treatment. Two patients remained progression-free for over 5 years. In angiosarcoma patients, the median PFS was 7.4 months, and the median OS was 2.4 years. Other STS subtype including solitary fibrous tumours (SFT), showed minimal benefit from PLD, with a median PFS of 2.8 months.</p><p><strong>Interpretation: </strong>Pegylated liposomal doxorubicin demonstrated clinically relevant activity in angiosarcoma and EHE. It may be considered a therapeutic option for patients with these aggressive vascular sarcomas. Further prospective studies are warranted to confirm its efficacy and optimised treatment strategies.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"558-563"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955449","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":"Survival outcomes in hormone receptor-negative breast cancer among BRCA carriers versus noncarriers in western Sweden.","authors":"Anna-Karin Tzikas, Erik Holmberg, Toshima Z Parris, Anikó Kovács, Lovisa Lovmar, Per Karlsson","doi":"10.2340/1651-226X.2025.43109","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43109","url":null,"abstract":"<p><strong>Background and purpose: </strong>BRCA-related hormone receptor (HR)-negative breast cancers (BC) are reported to have aggressive tumor biology but also exhibit chemosensitivity. However, the impact of BRCA1/2 pathogenetic variants (PV) on BC outcomes remains unclear. This study compares survival outcomes for HR-negative BC between BRCA carriers and noncarriers.</p><p><strong>Patients/material and methods: </strong>From 489 female BRCA-carriers prospectively registered in western Sweden (1996-2017), those with primary HR-negative BC who underwent breast surgery until 2019 were included in the BRCA cohort. For each BRCA-carrier, three BRCA-noncarriers with HR-negative BC were matched based on age, time of diagnosis, and follow-up duration. Overall survival (OS) was analyzed using Kaplan‑Meier estimates and Cox proportional hazard ratios after adjustment for stage, chemotherapy, and surgical technique. A sensitivity analysis was performed to investigate the effect of HER2 status on HR-negative BC diagnosed after 2007.</p><p><strong>Results: </strong>Among the 106 BRCA carriers, 101 (95%) had a BRCA1 and 5 (5%) a BRCA2 PV. Most of the BRCA-carriers (89/106, 84%) were diagnosed with BC prior to genetic screening. Surgical techniques were similar between BRCA-carriers (n = 106) and noncarriers (n = 318). Chemotherapy was more common among BRCA-carriers (87% vs. 72%, p < 0.001). No significant difference in OS was found between BRCA-carriers and noncarriers among patients with HR-negative BC (adjusted HR: 0.81 [95% confidence interval [CI]: 0.43-1.53], p = 0.51) or considering HER2 status (adjusted HR 0.95 [95% CI: 0.43-2.07], p = 0.89).</p><p><strong>Interpretation: </strong>This study suggests that BRCA1/2 pathogenic variants do not independently impact survival outcomes in HR-negative BC. However, a moderate association between BRCA status and OS cannot be ruled out.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"550-557"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958508","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":"Quality of life in older patients with cancer and related unmet needs: a scoping review.","authors":"Franziska Springer, Ayumu Matsuoka, Kyoko Obama, Anja Mehnert-Theuerkauf, Yosuke Uchitomi, Maiko Fujimori","doi":"10.2340/1651-226X.2025.42602","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.42602","url":null,"abstract":"<p><strong>Background: </strong>Older patients form the largest group of cancer patients yet remain underrepresented in clinical research. This scoping review aims to synthesize findings on quality of life (QoL) in older adults with cancer, comparing them to younger counterparts and older individuals without cancer, and identifying associated factors.</p><p><strong>Methods: </strong>PubMed and PsychINFO databases were searched for articles published until January 2024. Studies were included with exclusively older adults with cancer (≥ 65 years), age-mixed samples (mean/median ≥ 70 years), or that report results separately for older and younger adults with cancer. Out of 6, 397 identified studies, 87 met the inclusion criteria.</p><p><strong>Results: </strong>Most studies were cross-sectional, conducted in 14 countries with a mean age of 74.2 years. Physical QoL (PQoL) demonstrates an age-related decline, primarily influenced by comorbidity burden, physical activity, and lifestyle. In contrast, mental QoL (MQoL) remained stable or increased with advancing age, reflecting resilience and effective coping by older patients. While cognitive and role functioning tended to show stable or declining values with age, findings regarding social functioning were mixed. Socioeconomic factors, e.g. education, income, or marital status, mainly impacted MQoL, as well as other QoL domains. Symptom management and social support represent unmet needs that contribute to QoL impairments. Older adults with cancer underreport symptoms they perceive as normal for their age, experience ageism in healthcare, and reduced social participation.</p><p><strong>Interpretation: </strong>Comprehensive, multidisciplinary cancer care is essential for older adults with cancer, focusing on the prevention of functional health decline, geriatric assessment, socioeconomic health disparities, and enhancing symptom management.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"516-526"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958504","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":"Treating intrahepatic cholangiocarcinoma with pemigatinib: two case reports of Nordic patients.","authors":"Vesa T Väliaho, Iben Spanggaard","doi":"10.2340/1651-226X.2025.42073","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.42073","url":null,"abstract":"<p><strong>Background: </strong>Cholangiocarcinoma (CCA) is a diverse group of aggressive liver tumors with up to 20% being intrahepatic CCA (iCCA). Up to 15% of patients with iCCA have fibroblast growth factor receptor 2 (FGFR2) fusions or rearrangements. Here we evaluated iCCA treatment with pemigatinib, a selective inhibitor of FGFR1-3, in two patients from Denmark and Finland.</p><p><strong>Patients: </strong>We identified a total of two Nordic patients with iCCA in our clinics, who received first-line cisplatin/gemcitabine before initiating pemigatinib.</p><p><strong>Results: </strong>Case 1 was a 34-year-old woman with aggressive, metastatic iCCA upon presentation, who progressed on cisplatin/gemcitabine. Pemigatinib was initiated after FGFR2 fusion detection by genomic testing. She had a partial response after three cycles (9 weeks) of pemigatinib but experienced disease progression after three more pemigatinib cycles. Adverse events were primarily managed by supportive care and dose reduction, except hyperphosphatemia, which was complicated by food allergies and required medication. She received subsequent chemotherapy but deteriorated rapidly and died 1 month later. Case 2 was an 81-year-old man with unresectable iCCA who achieved stable disease with first-line chemotherapy. He switched to pemigatinib after FGFR2 fusion detection by next-generation sequencing. The tumor shrank by 20% after three pemigatinib cycles and completely calcified with continued treatment. Adverse events were managed by two dose adjustments. Treatment has continued for 57 months and is ongoing.</p><p><strong>Interpretation: </strong>CCA is an aggressive disease that requires early molecular testing of abundant biopsy tissue so not to delay second-line therapies, such as pemigatinib. Variability in treatment outcomes is expected.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"534-539"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959494","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":"Comparison of nab-paclitaxel, paclitaxel, and oxaliplatin-induced peripheral neuro-pathy: a cross-sectional cohort study.","authors":"Terry Trinh, Kimberley Au, Arun V Krishnan, Hannah C Timmins, Tiffany Li, Peter Grimison, David Goldstein, Susanna B Park","doi":"10.2340/1651-226X.2025.42935","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.42935","url":null,"abstract":"<p><strong>Background and purpose: </strong>There remains limited evidence regarding the relative neurotoxic potential of nab-paclitaxel long-term. This cross-sectional matched cohort study aimed to compare the severity and natural history of chemotherapy-induced peripheral neuropathy (CIPN) between patients treated with nab-paclitaxel and patients treated with oxaliplatin or paclitaxel using a suite of clinical, patient reported, and neurophysiological assessments.</p><p><strong>Patients and methods: </strong>CIPN assessments included the total neuropathy score (TNSc), grooved pegboard assessment, sensory assessments (grating orientation task and Von-Frey assessment), patient-reported outcome measures, and neurophysiological studies. The matched cohort included 72 patients (24 nab-paclitaxel, 24 paclitaxel, and 24 oxaliplatin); each stratified into two groups by time post-treatment, 0-4 months, and > 6 months.</p><p><strong>Results: </strong>Chronic neuropathy was reported by 71% of nab-paclitaxel-treated patients, most prominently numbness in the lower limbs. Longer time post-treatment was associated with significantly better TNSc scores (p = 0.044). Neuropathy severity was similar for nab-paclitaxel and paclitaxel. Neuropathy severity was worse for oxaliplatin compared to nab-paclitaxel, as measured by sensory function (p < 0.05) and sural amplitude (p = 0.003), but similar for patient-reported and neurological-graded assessments.</p><p><strong>Interpretation: </strong>These findings underscore the importance of inclusion of a range of multimodal CIPN assessments to characterize relative burden of toxicity between chemotherapy agents. CIPN severity was similar between nab-paclitaxel and paclitaxel cohorts, but more severe in oxaliplatin-treated patients.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"527-533"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955757","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":"Long-term trends in the clinical management and outcomes of patients with gastroesophageal cancer in Norway.","authors":"Alexander Kolstad, Gabrielle Emanuel, Geir Olav Hjortland, Yngvar Nilssen, Maria Ulvestad, Ali Areffard, Eirik Kjus Aahlin","doi":"10.2340/1651-226X.2025.43167","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43167","url":null,"abstract":"<p><strong>Background and purpose: </strong>Gastroesophageal cancers are highly prevalent internationally, with many patients diagnosed with metastatic disease, leading to challenging treatment and poor survival. This study uses real-world evidence from a population-level database to describe demographics, clinical characteristics, initial treatment patterns, and survival for patients with gastroesophageal cancer in Norway.</p><p><strong>Material and methods: </strong>Individual patient data was sourced from the Cancer Registry of Norway for patients diagnosed with oesophageal squamous cell carcinoma (ESCC), oesophageal adenocarcinoma (EAC), gastroesophageal junction cancer (GEJC), and gastric cancer from 2001 to 2021, with follow-up from diagnosis to death or last follow-up. Treatment patterns were captured from 2010 to 2022, defined as curative or palliative based on surgery, chemotherapy, and radiotherapy.</p><p><strong>Results and interpretation: </strong>The cohort included 14,334 Norwegian patients with gastroesophageal cancer; predominantly male, mean age 69-73 years, with a median follow-up of 9-11 months across cancer subtypes. Approximately 40% of patients received curative treatment, and multi-modality treatments increased for EAC, GEJC, and ESCC. Median survival ranged from 6 to 11 months for patients treated palliatively, and 17-95 months for those treated with curative intent. Interestingly, median survival was higher for patients with EAC and GEJC treated with neoadjuvant chemotherapy (86.1 and 75.1 months) versus neoadjuvant chemoradiotherapy (49.1 and 42.1 months), which was confirmed by a multivariate Cox regression model adjusted for age, sex, and disease stage. This study demonstrates that multimodal treatment strategies, consisting of chemotherapy and surgery, may be associated with improved survival outcomes for gastroesophageal cancers. Future studies are required to identify optimum treatment strategies for gastroesophageal cancer subtypes.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"540-549"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955758","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":"Cardiotoxicity in patients with metastatic melanoma treated with BRAF/MEK inhibitors: a real-world analysis of incidence, risk factors, and reversibility.","authors":"Jonas K Oddershede, Ida K Meklenborg, Lars Bastholt, Louise M Guldbrandt, Henrik Schmidt, Rasmus B Friis","doi":"10.2340/1651-226X.2025.42567","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.42567","url":null,"abstract":"<p><strong>Background: </strong>BRAF/MEK inhibitors (BRAFi/MEKi) improve outcome in patients with BRAF-mutated metastatic melanoma but are associated with cardiotoxicity, leading to a decline in left ventricular ejection fraction (LVEF). This study aimed to evaluate the incidence, timeline, risk factors, and reversibility of BRAFi/MEKi-induced cardiotoxicity in a real-world setting.</p><p><strong>Patients/materials and methods: </strong>Patients with metastatic melanoma (n = 170) treated with Encorafenib/Binimetinib, Vemurafenib/Cobimetinib, or Dabrafenib/Trametinib at Aarhus and Odense University Hospital, Denmark, from 2015 to 2023 were included. Cardiac function was assessed at baseline and every 3 months during treatment with either echocardiograms or multigated acquisition scans. Cardiotoxicity was defined as a reduction of LVEF by ≥10 percentage points (pp) to an LVEF < 50% (Major cardiotoxicity) or a reduction of LVEF by ≥15 pp but remaining > 50% (Minor cardiotoxicity).</p><p><strong>Results: </strong>Cardiotoxicity occurred in 21% of patients, with 14% experiencing major cardiotoxicity. The mean time to LVEF decline was 187 days, with 92% of major cardiotoxicity cases occurring within the first year. Cardiotoxicity was reversible in 79% of patients following dose reduction, treatment pauses, heart failure therapy, or continued treatment with monitoring. Baseline atrial fibrillation (odds ratio 13.67, p = 0.008) was identified as a risk factor for major cardiotoxicity.</p><p><strong>Interpretation: </strong>BRAFi/MEKi-induced cardiotoxicity is a significant but manageable complication, often reversible with timely interventions. Routine LVEF monitoring is recommended. The majority (92%) of major cardiac events were diagnosed within the first year of treatment, which might warrant a discontinuation of routine LVEF monitoring after 1 year of BRAFi/MEKi treatment.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"507-515"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963391","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":"Association of health literacy with cancer survival: a single-centre prospective cohort study.","authors":"Niclas Sandström, Antti Jekunen, Mikael Johansson, Heidi Andersén","doi":"10.2340/1651-226X.2025.42557","DOIUrl":"10.2340/1651-226X.2025.42557","url":null,"abstract":"<p><strong>Background and purpose: </strong>Health literacy is defined as the ability to find, understand and use health information for informed decision. The role of health literacy in treatment decisions and outcome remains largely unexplored. This study sought out to assess the effect of individual health literacy on overall survival (OS) in cancer patients in Ostrobothnia.</p><p><strong>Material and methods: </strong>The present study is a follow-up of a cross-sectional survey study performed during December 2021 and March 2022. The survey assessed socioeconomic factors, lifestyle factors and self-reported health literacy. The follow-up included data on recorded death, cause of death, performance status (PS), clinical frailty scale, Charlson comorbidity index and body mass index. The sample size for this study was 400 participants, and any participant with a malignancy was eligible for the study.</p><p><strong>Results: </strong>Low health literacy was associated with increased risk of death. The disparity remained after adjustments for age, sex, comorbidities, PS, stage and hazard ratios (HR) = 1.47 (1.01-2.14). After adjustments for lifestyle patterns, the disparity remained, HR = 1.49 (1.03-2.17). The difference diminished after adjustments for cancer types. The median OS was 3.6 months longer for those with medium-high health literacy than those with low health literacy.</p><p><strong>Interpretation: </strong>The results indicated health literacy having a direct, clinically significant, effect on OS, which is likely not explained by differences in cancer entity alone. Future studies should focus on assessing whether an intervention aiming to improve health literacy may improve overall cancer survival.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"499-506"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762739","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}