Acta Oncologica最新文献

{"title":"IMPRESS-Norway: improving public cancer care by implementing precision medicine in Norway; inclusion rates and preliminary results.","authors":"Katarina Puco, Gro Live Fagereng, Sigmund Brabrand, Pitt Niehusmann, Egil Støre Blix, Eli Sihn Samdal Steinskog, Åse Haug, Cecilie Fredvik Torkildsen, Irja Alida Oppedal, Sebastian Meltzer, Åsmund Flobak, Kajsa Anna Margareta Johansson, Line Bjørge, Geir Olav Hjortland, Astrid Dalhaug, Jo-Åsmund Lund, Bjørnar Gilje, Marte Grønlie Cameron, Randi Hovland, Ragnhild S Falk, Sigbjørn Smeland, Hege Elisabeth Giercksky Russnes, Kjetil Taskén, Åslaug Helland","doi":"10.2340/1651-226X.2024.28322","DOIUrl":"10.2340/1651-226X.2024.28322","url":null,"abstract":"<p><strong>Background and purpose: </strong>In Norway, comprehensive molecular tumour profiling is implemented as part of the public healthcare system. A substantial number of tumours harbour potentially targetable molecular alterations. Therapy outcomes may improve if targeted treatments are matched with actionable genomic alterations. In the IMPRESS-Norway trial (NCT04817956), patients are treated with drugs outside the labelled indication based on their tumours molecular profile.</p><p><strong>Patients and methods: </strong>IMPRESS-Norway is a national, prospective, non-randomised, precision cancer medicine trial, offering treatment to patients with advanced-stage disease, progressing on standard treatment. Comprehensive next-generation sequencing, TruSight Oncology 500, is used for screening. Patients with tumours harbouring molecular alterations with matched targeted therapies available in IMPRESS-Norway, are offered treatment. Currently, 24 drugs are available in the study. Primary study endpoints are percentage of patients offered treatment in the trial, and disease control rate (DCR) defined as complete or partial response or stable disease in evaluable patients at 16 weeks (W16) of treatment. Secondary endpoint presented is DCR in all treated patients.</p><p><strong>Results: </strong>Between April 2021 and October 2023, 1,167 patients were screened, and an actionable mutation with matching drug was identified for 358 patients. By the data cut off 186 patients have initiated treatment, 170 had a minimum follow-up time of 16 weeks, and 145 also had evaluable disease. In patients with evaluable disease, the DCR was 40% (58/145). Secondary endpoint analysis of DCR in all treated patients, showed DCR of 34% (58/170).</p><p><strong>Interpretation: </strong>Precision cancer medicine demonstrates encouraging clinical effect in a subset of patients included in the IMPRESS-Norway trial.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"379-384"},"PeriodicalIF":2.7,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080170","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 national precision cancer medicine implementation initiative for Finland.","authors":"Katriina J Jalkanen, Erika Alanne, Sanna Iivanainen, Okko-Sakari Kääriäinen, Minna Tanner, Annika Auranen, Jussi Koivunen, Timo K Nykopp, Pia Vihinen, Mika Mustonen","doi":"10.2340/1651-226X.2024.32661","DOIUrl":"10.2340/1651-226X.2024.32661","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"395-397"},"PeriodicalIF":2.7,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080069","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 evolution of precision oncology: The ongoing impact of the Drug Rediscovery Protocol (DRUP).","authors":"Soemeya F Haj Mohammad, Hans J L Timmer, Laurien J Zeverijn, Birgit S Geurts, Ilse A C Spiekman, Karlijn Verkerk, Florentine A J Verbeek, Henk M W Verheul, Emile E Voest, Hans Gelderblom","doi":"10.2340/1651-226X.2024.34885","DOIUrl":"10.2340/1651-226X.2024.34885","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Drug Rediscovery Protocol (DRUP) is a Dutch, pan-cancer, nonrandomized clinical trial that aims to investigate the efficacy and safety of targeted and immunotherapies outside their registered indication in patients with advanced or metastatic cancer.</p><p><strong>Patients: </strong>Patients with advanced or metastatic cancer are eligible when there are no standard of care treatment options left and the tumor possesses a molecular genomic variant for which commercially available anticancer treatment is accessible off-label in DRUP. Clinical benefit is the study's primary endpoint, characterized by a confirmed objective response or stable disease after at least 16 weeks of treatment.</p><p><strong>Results: </strong>More than 2,500 patients have undergone evaluation, of which over 1,500 have started treatment in DRUP. The overall clinical benefit rate (CBR) remains 33%. The nivolumab cohort for patients with microsatellite instable metastatic tumors proved highly successful with a CBR of 63%, while palbociclib or ribociclib in patients with tumors harboring CDK4/6 pathway alterations showed limited efficacy, with a CBR of 15%. The formation of two European initiatives (PCM4EU and PRIME-ROSE) strives to accelerate implementation and enhance data collection to broaden equitable access to anticancer treatments and gather more evidence.</p><p><strong>Conclusion: </strong>DRUP persists in improving patients access to off-label targeted or immunotherapy in the Netherlands and beyond. The expansion of DRUP-like clinical trials across Europe provides countless opportunities for broadening the horizon of precision oncology.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"368-372"},"PeriodicalIF":2.7,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080176","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 Tumor Immune Microenvironment in Breast Cancer Progression.","authors":"Marit Otterlei Fjørtoft, Kanutte Huse, Inga Hansine Rye","doi":"10.2340/1651-226X.2024.33008","DOIUrl":"10.2340/1651-226X.2024.33008","url":null,"abstract":"<p><strong>Background: </strong>The tumor microenvironment significantly influences breast cancer development, progression, and metastasis. Various immune cell populations, including T cells, B cells, NK cells, and myeloid cells exhibit diverse functions in different breast cancer subtypes, contributing to both anti-tumor and pro-tumor activities.</p><p><strong>Purpose: </strong>This review provides an overview of the predominant immune cell populations in breast cancer subtypes, elucidating their suppressive and prognostic effects. We aim to outline the role of the immune microenvironment from normal breast tissue to invasive cancer and distant metastasis.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted to analyze the involvement of immune cells throughout breast cancer progression.</p><p><strong>Results: </strong>In breast cancer, tumors exhibit increased immune cell infiltration compared to normal tissue. Variations exist across subtypes, with higher levels observed in triple-negative and HER2+ tumors are linked to better survival. In contrast,  ER+ tumors display lower immune infiltration, associated with poorer outcomes. Furthermore, metastatic sites commonly exhibit a more immunosuppressive microenvironment.</p><p><strong>Conclusion: </strong>Understanding the complex interaction between tumor and immune cells during breast cancer progression is essential for future research and the development of immune-based strategies. This comprehensive understanding may pave the way for more effective treatment approaches and improved patients outcomes.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"359-367"},"PeriodicalIF":2.7,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080179","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":"Desmoplastic non-infantile ganglioglioma mimicking diffuse leptomeningeal glioneuronal tumor: precision diagnostics and therapeutic implications.","authors":"Pitt Niehusmann, Henning Leske, Vigdis Nygaard, Hege G Russnes, Sen Zhao, Anna Latysheva, Ulrikke Straume Wiig, Birute Stankuniene, Aina Ulvmoen","doi":"10.2340/1651-226X.2024.31720","DOIUrl":"10.2340/1651-226X.2024.31720","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"392-394"},"PeriodicalIF":2.7,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080168","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":"Treatment of vulvar cancer recurrence with electrochemotherapy: a case-control study.","authors":"Gregor Vivod, Masa Omerzel, Nina Kovacevic, Gorana Gasljevic, Ines Cilensek, Gregor Sersa, Maja Cemazar, Sebastjan Merlo","doi":"10.2340/1651-226X.2024.33241","DOIUrl":"10.2340/1651-226X.2024.33241","url":null,"abstract":"<p><strong>Background: </strong>Electrochemotherapy (ECT) is a combined treatment method based on electroporation and simultaneous chemotherapy. In cases where radiotherapy has previously been used, surgery is often the only treatment option for vulvar cancer recurrence with potential resection of clitoris, vagina, urethra or anal sphincter. The unique advantage of ECT is its selectivity for cancer cells while sparing the surrounding healthy tissue. The aim of the study was to compare the ECT treatment of vulvar cancer recurrence for non-palliative purposes with surgical treatment.</p><p><strong>Materials and methods: </strong>Eleven patients with single vulvar cancer recurrence were treated with ECT and followed up for 12 months. As a control group, 15 patients with single vulvar cancer recurrence were treated with wide local excision. The following data were collected, analyzed and compared: Age, body mass index, comorbidities, histological type, location and size of vulvar cancer recurrence, treatment history, details of procedures and hospital stay.</p><p><strong>Results: </strong>The probability curves for local tumor control did not differ between the ECT group and the surgical group (p = 0.694). The mean hospital stay and the mean duration of procedure were statistically significantly shorter in the ECT group (p < 0.001). There were no statistically significant differences between the ECT and surgical groups in terms of mean body mass index, associated diseases, previous treatments, presence of lichen sclerosus, p16 status, gradus, anatomical site of the tumor, and type of anesthesia.</p><p><strong>Conclusion: </strong>In this case-control study, treatment of vulvar cancer recurrence with ECT for non-palliative purposes was comparable to surgical treatment in terms of effectiveness. The results need to be confirmed in larger randomized trials.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"351-357"},"PeriodicalIF":2.7,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141069611","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":"Evaluation of sex inequity in lung-cancer-specific survival.","authors":"Dan Lærum, Trond-Eirik Strand, Odd Terje Brustugun, Frode Gallefoss, Ragnhild Falk, Michael T Durheim, Lars Fjellbirkeland","doi":"10.2340/1651-226X.2024.27572","DOIUrl":"10.2340/1651-226X.2024.27572","url":null,"abstract":"<p><strong>Background: </strong>Whether sex is an independent prognostic factor in lung cancer survival is the subject of ongoing debate. Both large national registries and single hospital studies have shown conflicting findings. In this study, we explore the impact of sex on lung-cancer-specific survival in an unselected population that is well-characterized with respect to stage and other covariates.</p><p><strong>Material and methods: </strong>All patients diagnosed with lung cancer at a single hospital serving a whole and defined region in Southern Norway during the 10 years 2007-2016 were included. Follow-up data were available for at least 56 months for all patients. Analyses were adjusted for stage, treatment, performance status, smoking, age, histology, epidermal growth factor receptor/anaplastic lymphoma kinase/immunotherapy treatment and period. Differences in lung-cancer-specific survival by sex were explored using restricted mean survival times (RMST).</p><p><strong>Results: </strong>Of the 1,261 patients diagnosed with lung cancer, 596 (47%) were females and 665 (53%) males, with mean ages of 68.5 and 69.5 years, respectively. The observed 5-year lung-cancer-specific survival rate was 27.4% (95% CI 23.7, 31.2) in females and 21.4% (95% CI 18.2, 24.8) in males. However, after adjustment for covariates, no significant differences by sex were observed. The 5-year RMST was 0.9 months shorter (95% CI -2.1, 0.31, p = 0.26) in males compared to females.</p><p><strong>Interpretation: </strong>In this cohort, sex was not associated with a difference in lung-cancer-specific survival after adjusting for clinical and biological factors. Imbalance in stage at diagnosis was the main contributor to the observed difference in lung-cancer-specific survival by sex.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"343-350"},"PeriodicalIF":2.7,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943664","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 different 2D muscle indexes measured at the level of the 3rd lumbar vertebra in survival prediction in patients with renal cell carcinoma.","authors":"Oona Janhunen, Otto Jokelainen, Robin Peltoniemi, Timo K Nykopp, Otso Arponen","doi":"10.2340/1651-226X.2024.27450","DOIUrl":"10.2340/1651-226X.2024.27450","url":null,"abstract":"<p><strong>Background: </strong>Low computed tomography (CT)-determined muscle mass, commonly determined with height-adjusted muscle indexes (MIs), predicts worse survival in several cancers and has been suggested as a prognostic assessment tool. Although several MIs measured at the level of the 3rd lumbar vertebra (L3) are commonly used, it remains unestablished how different L3-determined MIs perform in survival prognostication compared to each other. The objective of this study was to investigate the performance of different MIs for survival prognostication in renal cell carcinoma (RCC).</p><p><strong>Methods: </strong>We retrospectively enrolled 214 consecutive patients with RCC. We determined three L3-MIs (psoas muscle index (PMI), psoas muscle index and erector spinae index (PMI+ESI), and whole skeletal muscle index (SMI)) from preoperative CT scans. Categorization of those with low and normal muscle mass was based on the Youden Index sex-specific MI cut-offs. We determined sensitivity, specificity, and accuracy metrics for predicting 1-year, 5-year, and overall survival (OS) using Cox regression models.</p><p><strong>Results: </strong>Low PMI, PMI+ESI, and SMI significantly predicted decreased 1-year, 5-year, and OS in uni- and multivariate models. PMI+ESI and SMI were more accurate than PMI in males, and PMI and PMI+ESI were more accurate than SMI in females in the prediction of 1-year survival. However, there were no differences in accuracies between MIs in 5-year and OS prediction.</p><p><strong>Interpretation: </strong>PMI+ESI performed well overall in short-term prognostication, but there were no differences between the MIs in long-term prognostication. We recommend the use of PMI+ESI for muscle evaluation, particularly when SMI cannot be evaluated.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"330-338"},"PeriodicalIF":2.7,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920836","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":"Progress against lung cancer, Denmark, 2008-2022.","authors":"Marianne Steding-Jessen, Henriette Engberg, Erik Jakobsen, Torben Riis Rasmussen, Henrik Møller","doi":"10.2340/1651-226X.2024.26180","DOIUrl":"10.2340/1651-226X.2024.26180","url":null,"abstract":"<p><strong>Background and purpose: </strong>There has been marked progress against lung cancer in Denmark. To gain further insight into the different aspects of the improvement, we examined the stage-specific incidence rates, stage-specific survival and mortality rates.</p><p><strong>Materials and methods: </strong>We used information from the Danish Lung Cancer Registry on date of diagnosis and clinical stage to calculate age-standardised incidence rates and patient survival by sex, period and stage. Information about age-standardised lung cancer-specific mortality rates by sex and period was extracted from The Danish Health Data Authority.</p><p><strong>Results: </strong>Firstly, the decrease in incidence rates was due to a reduction in the rates of advanced stages. Secondly, there was a gradual increase in survival across all stages, and thirdly, the mortality rates gradually decreased over time.</p><p><strong>Interpretation: </strong>The improvements in survival and mortality from lung cancer were due to decreasing incidence rates of advanced cancer and improvement in survival at all stages of the disease.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"339-342"},"PeriodicalIF":2.7,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920840","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":"Implementation of perioperative FLOT compared to ECX/EOX chemotherapy regimens in resectable esophagogastric adenocarcinomas: an analysis of real-world data.","authors":"Kristian Egebjerg, Tobias Sørup Andersen, Lene Bæksgaard, Rajendra Garbyal, Mette Siemsen, Michael Achiam, Paul Morten Mau-Sørensen","doi":"10.2340/1651-226X.2024.35431","DOIUrl":"10.2340/1651-226X.2024.35431","url":null,"abstract":"<p><strong>Background and purpose: </strong>Perioperative 5-FU, leucovorin, oxaliplatin, and docetaxel (FLOT) is recommended in resectable esophagogastric adenocarcinoma based on randomised trials. However, the effectiveness of FLOT in routine clinical practice remains unknown as randomised trials are subject to selection bias limiting their generalisability. The aim of this study was to evaluate the implementation of FLOT in real-world patients.</p><p><strong>Methods: </strong>Retrospectively collected data were analysed in consecutive patients treated before or after the implementation of FLOT. The primary endpoint was complete pathological response (pCR) and secondary endpoints were margin-free resection (R0), overall survival (OS), relapse-free survival (RFS) tolerability of chemotherapy and surgical complications.</p><p><strong>Results: </strong>Mean follow-up time for patients treated with FLOT (n = 205) was 37.7 versus 47.0 months for epirubicin, cis- or oxaliplatin, and capecitabine (ECX/EOX, n = 186). Surgical resection was performed in 88.0% versus 92.0%; pCR were observed in 3.8% versus 2.4%; and R0 resections were achieved in 78.0% versus 86.0% (p = 0.03) in the ECX/EOX and FLOT cohorts, respectively. Survival analysis indicated no significant difference in RFS (p = 0.17) or OS (p = 0.37) between the cohorts with a trend towards increased OS in performance status 0 (hazard ratio [HR] = 0.73, 95% confidence interval [CI]: 0.50-1.04). More patients treated with ECX/EOX completed chemotherapy (39% vs. 28%, p = 0.02). Febrile neutropenia was more common in the FLOT cohort (3.8% vs. 11%, p = 0.0086). 90-days mortality (1.2% vs. 0%) and frequency of anastomotic leakage (8% vs. 6%) were equal and low.</p><p><strong>Interpretation: </strong>Patients receiving FLOT did not demonstrate improved pCR, RFS or OS. However, R0 rate was improved and patients in good PS trended towards improved OS.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"322-329"},"PeriodicalIF":2.7,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920838","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}