BMJ oncology最新文献

{"title":"Reduced duration adjuvant trastuzumab in the treatment of patients with HER2-positive breast cancer: a meta-analysis of randomised controlled non-inferiority trials including IPD data.","authors":"Helena M Earl, Louise Hiller, Janet A Dunn, Mubarak Patel, PierFranco Conte, Roberto D'Amico, Valentina Guarneri, Heikki Joensuu, Teppo Huttunen, Dora Hatzidaki, Vassilis Georgoulias, Jean E Abraham, David Miles, David A Cameron, Andrew M Wardley, Xavier Pivot","doi":"10.1136/bmjonc-2025-000810","DOIUrl":"10.1136/bmjonc-2025-000810","url":null,"abstract":"<p><strong>Objectives: </strong>Adjuvant trastuzumab in combination with chemotherapy has significantly improved survival in patients with HER2-positive early breast cancer but, since introduction in 2005, the 12 months duration has been questioned and trials have tested shorter durations.</p><p><strong>Methods and analysis: </strong>A systematic review and meta-analysis using individual patient data (IPD) (when available) from non-inferiority trials of reduced duration trastuzumab was carried out according to PRISMA-IPD guidelines. Primary outcome was invasive disease-free survival (IDFS); secondary outcomes were distant relapse-free survival (DRFS) and overall survival (OS). Estimated survival was calculated using random-effects and fixed-effects modelling, reported by 5 year rates and analysed using non-inferiority methods. Illustrative comparative risks were also tabled as in Cochrane Systematic Reviews.</p><p><strong>Results: </strong>Five trials were identified: PERSEPHONE, PHARE and HORG compared 12 months (m) with 6 m; SOLD and Short-HER compared 12 m with 9 weeks. In the 5-trial analysis (11 389 patients), and in the SOLD and Short-HER (3428 patients) analysis, non-inferiority of the shorter duration was not confirmed. In contrast, for the comparison of 12 m versus 6 m (7961 patients), non-inferiority was confirmed with a 2.5% critical margin, for IDFS, DRFS and OS. The Kaplan-Meier curves demonstrated overlap of credibility intervals throughout follow-up. For every 1000 patients given 6 m trastuzumab, by 5 years, there might be 11 extra IDFS events (in addition to 141 expected for 12 m), 12 more DRFS events (in addition to 106) and nine more deaths (in addition to 73).</p><p><strong>Conclusions: </strong>We have demonstrated that 6 m trastuzumab in early HER2-positive breast cancer is not inferior to 12 m and is an option for patients.</p><p><strong>Prospero registration number: </strong>CRD42020172267.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000810"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer incidence and diagnostic characteristics in people with intellectual disabilities in the Netherlands: a national registry-based cohort study.","authors":"Maarten Cuypers, Jenneken Naaldenberg, Amina Banda, Lynette Oost, Haiko Bloemendal, Geraline Leusink","doi":"10.1136/bmjonc-2024-000686","DOIUrl":"10.1136/bmjonc-2024-000686","url":null,"abstract":"<p><strong>Objective: </strong>People with intellectual disabilities (ID) face notable health disparities, also affecting cancer care. This study is among the first to use nationwide population and cancer registry databases to compare cancer incidence in the population with ID and the general population.</p><p><strong>Methods and analysis: </strong>A population-based cohort study enrolled all Dutch adults (18+) with indicators of ID (N=187 149) and a 1:4 random general population sample without ID (N=760 907). All cancer diagnoses from 1 January 2015 until 31 December 2020 were collected from the national cancer registry to compare incidence and diagnostic details.</p><p><strong>Results: </strong>Overall, fewer incident cancer cases were found among individuals with ID than without ID (51.0 vs 104.1/10 000 person-years; adjusted OR (adj.OR) 0.79 (0.76-0.81)), with cases occurring at younger ages and being diagnosed more often at a more advanced stage than in the general population. Key distinctions from the general population include reduced odds of skin cancer (adj.OR 0.39 (0.36-0.43)) and elevated odds of cancer of unknown primary (OR 1.60 (1.29-1.98)). The fewest cancer diagnoses occurred among those entitled to long-term ID care (adj.OR 0.63 (0.60-0.66)), with those living independently being at greater risk for cancers of digestive, respiratory and female genital organs.</p><p><strong>Conclusion: </strong>Although the overall incidence of cancer in the population with ID appears lower than in the general population, significant variations exist across ID subgroups and cancer types. These differences indicate varying exposures, lower cancer awareness and barriers to healthcare for individuals with ID. Addressing these differences requires customised strategies for public health, long-term care and oncology care.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000686"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer in people with intellectual disability: lower incidence, later-stage diagnosis - who counts? who cares?","authors":"Martin McMahon, June O'Reilly","doi":"10.1136/bmjonc-2025-000845","DOIUrl":"10.1136/bmjonc-2025-000845","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000845"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptoms, side effects, quality of life and financial toxicity matter to patients with cancer, we need to do a better job of capturing and reporting these concepts in trials and clinical care.","authors":"Melanie Calvert, Roger Wilson, John Devin Peipert","doi":"10.1136/bmjonc-2025-000879","DOIUrl":"10.1136/bmjonc-2025-000879","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000879"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes (PROs) in clinical trials and in clinical practice: report from the XXI national conference of the Italian Association of Medical Oncology (AIOM).","authors":"Alberto Puccini, Giuseppe Viscardi, Oriana Ciani, Fabio Efficace, Angela Piattelli, Giordano Domenico Beretta, Davide Petruzzelli, Patrizia Popoli, Francesco De Lorenzo, Francesco Longo, Marco Zibellini, Lara Gitto, Antonella Brunello, Evaristo Maiello, Alberto Servetto, Martina Pagliuca, Alessandra Raimondi, Laura Marandino, Saverio Cinieri, Elisabetta Iannelli, Carla Ida Ripamonti, Paolo Bossi, Gianmauro Numico, Tiziana Latiano, Carmine Pinto, Silvana Quaglini, Laura Locati, Gualberto Gussoni, Gianluca Mignone, Pricivel M Carrera, Ethan Basch, Massimo Di Maio, Francesco Perrone","doi":"10.1136/bmjonc-2025-000783","DOIUrl":"10.1136/bmjonc-2025-000783","url":null,"abstract":"<p><strong>Objective: </strong>Patient-reported outcomes (PROs) are considered the gold standard for the assessment of subjective symptoms, quality of life (QoL) and patient well-being in both clinical trials and clinical practice. Here, we report key discussions and findings from the 21st National Conference of the Italian Association of Medical Oncology, held in Bologna on 21-22 June 2024, with a focus on the integration and impact of PROs in oncology research and clinical practice.</p><p><strong>Methods and analysis: </strong>Leading national and international experts presented and analysed data regarding the use of PROs in clinical trials and routine oncology care. Topics included the role of electronic PROs (ePROs), digital therapeutics, financial toxicity as a PRO and methodologies for standardising QoL assessment. Insights were drawn from expert presentations, consensus discussions and practical experiences shared during the conference sessions.</p><p><strong>Results: </strong>Experts emphasised that PROs should be included as key endpoints in clinical trials, with timely publication of results and standardised methodologies for analysis and interpretation. The conference highlighted the critical importance of incorporating PROs and QoL measures throughout the cancer care continuum-from screening to survivorship. In clinical practice, PROs improve patient-centred care and communication, particularly when oncologists are trained to interpret QoL data. The use of ePROs was noted as a valuable tool to support digital health interventions. Financial toxicity emerged as a significant PRO, with screening tools recommended to identify and support at-risk patients. Key organisational challenges were identified, including technological barriers, resource constraints and the need for responsive infrastructure to support real-time PRO integration.</p><p><strong>Conclusion: </strong>The implementation of PROs, including ePROs and financial toxicity assessments, is essential for advancing quality cancer care. Standardisation, digital innovation and targeted clinician education are critical to integrating PROs effectively in both research and clinical settings. Addressing infrastructural and technological challenges will be vital for optimising patient outcomes and ensuring optimal care across the cancer journey.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000783"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoclast-expanded supercharged NK cells perform superior antitumour effector functions.","authors":"Meng-Wei Ko, Ao Mei, Emanuela Senjor, Milica Perišić Nanut, Lucy Wanrong Gao, Paul Wong, Po-Chun Chen, Whitaker Cohn, Julian P Whitelegge, Janko Kos, Kawaljit Kaur, Subramaniam Malarkannan, Anahid Jewett","doi":"10.1136/bmjonc-2024-000676","DOIUrl":"10.1136/bmjonc-2024-000676","url":null,"abstract":"<p><strong>Objective: </strong>Natural killer (NK) cells are the largest innate lymphocyte subset with potent antitumour and antiviral functions. However, clinical utilisation of human NK cells is hampered due to a lack of reliable methods to augment their antitumour potential. We demonstrated technology in which human NK cells were cocultured with osteoclasts in the presence of probiotic bacteria. This approach significantly augmented the antitumour cytotoxicity and polyfunctionality of human NK cells, resulting in the generation of supercharged NK (sNK) cells.</p><p><strong>Methods and analysis: </strong>We explored the proteomic, transcriptomic and functional characterisation of sNK cells using cell imaging, flow cytometric analysis, 51-chromium release cytotoxicity assay, ELISA, ELIspot, IsoPLexis single-cell secretome analysis, proteomic analysis, RNA analysis, western blot and enzyme kinetics.</p><p><strong>Results: </strong>We found that sNK cells were less susceptible to split anergy and tumour-induced exhaustion. Proteomic analyses revealed that sNK cells significantly increased their cell motility and proliferation. Single-cell transcriptomes uncovered sNK cells undertaking a unique differentiation trajectory and turning on STAT1, JUN, BHLHE40, ELF1, MAX and MYC regulons essential for augmenting antitumour effector functions and proliferation, respectively. Both proteomic and single-cell transcriptomes revealed that an increase in Cathepsin C helped to augment the quantity and function of Granzyme B.</p><p><strong>Conclusions: </strong>These results support that this unique method produces potent NK cells for clinical utilisation and delineate the molecular mechanisms associated with this process.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000676"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap between guidelines and practice in Lynch syndrome screening for endometrial cancer.","authors":"Hiroshi Yoshida","doi":"10.1136/bmjonc-2025-000821","DOIUrl":"10.1136/bmjonc-2025-000821","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000821"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mismatch in testing: a retrospective analysis of mismatch repair testing in endometrial cancer and Lynch syndrome diagnosis in multiple specialist centres in the UK and Ireland (March 2022-March 2023).","authors":"Neil Ryan, Kane Alexander Lennie, Adam Naskretski, Craig Anderson, Lorena Mihaita, Sanduni Abeysuriya, Maria Ashworth, Victoria Cullimore, Lucy Dobson, Nathan Graham, Radha Graham, Shaun Haran, Zuzanna Holwek, Ashton Hunt, Ben Johnston, Rebecca Karkia, Georgios Kouklidis, Elaine Leung, Aiste McCormick, Josh McMullan, Aileen Mohan, Alison Montgomery, Claire Newton, Manolis Nikolopoulos, Catriona Norden, Charlotte Nott, Gemma Owens, Phillip Rolland, Sammuel Ricketts, Vanitha Sivalingam, David Smith, Freweini Tesfai, Laura Tookman, Chenai Whacha, Peter Sanderson","doi":"10.1136/bmjonc-2024-000688","DOIUrl":"10.1136/bmjonc-2024-000688","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the implementation of Lynch syndrome testing in endometrial cancer (EC) across the UK and Ireland, identify diagnostic gaps and evaluate adherence to the National Institute for Health and Care Excellence (NICE) guidelines recommending routine mismatch repair (MMR) deficiency testing.</p><p><strong>Methods and analysis: </strong>A multi-centre, cross-sectional retrospective study conducted in line with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Secondary care cancer centres across the UK and Republic of Ireland were identified with support from the ARGO (Audit and Research in Gynaecological Oncology) Collaborative and invited to complete a bespoke data collection tool.</p><p><strong>Results: </strong>Data from 2716 histologically confirmed EC cases treated between March 2022 and March 2023 were collected. After excluding misdiagnosed and inconsistent cases, 2549 were analysed. The cohort had a mean age of 66.3 years and a mean body mass index of 33.43 kg/m²; 69.3% had endometrioid EC histology. MMR testing was performed in 91% of cases, with 27.6% classified as MMR deficient, mainly due to MLH1/PMS2 loss (77.4%). Of the 510 cases requiring hypermethylation analysis, results were missing for 62. Of the 181 participants eligible for genetic counselling, 64% were referred and 48% underwent germline testing, identifying 19 new Lynch syndrome cases. MMR-deficient tumours were diagnosed at earlier stages and lower grades compared with MMR-proficient tumours.</p><p><strong>Conclusions: </strong>While tumour based MMR testing is widely performed, diagnostic attrition significantly impairs the pathway to definitive Lynch syndrome diagnosis. Addressing barriers to genetic counselling and germline testing is crucial for improving patient outcomes and the cost-effectiveness of Lynch syndrome screening.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000688"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of protein biomarker candidates associated with organ-specific immune-related toxicity and response to management by plasma proteomics.","authors":"Anders Handrup Kverneland, Ole Østergaard, Joel Emanuel Sohlin, Inge Mansfield Noringriis, Rebecca S Jurlander, Jesper Velgaard Olsen, Inge Marie Svane","doi":"10.1136/bmjonc-2024-000696","DOIUrl":"10.1136/bmjonc-2024-000696","url":null,"abstract":"<p><strong>Objective: </strong>Immune-related adverse events (irAEs) are a growing challenge with checkpoint inhibitors (CPIs) and are complicated by the lack of suitable response biomarkers in many irAEs. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) based proteomics is a system-wide unbiased analysis method suited for biomarker discovery. In this study, plasma samples from patients suffering from irAEs were analysed using MS-based proteomics.</p><p><strong>Methods and analysis: </strong>The discovery cohort consisted of 37 melanoma patients experiencing an irAE (colitis, hepatitis and nephritis) collected around irAE management. The validation cohort consisted of 34 irAE patients (colitis, hepatitis, nephritis and pneumonitis) at management, with a control group consisting of 34 patients treated with CPIs without an irAE. The plasma samples were processed with bottom-up proteomics and analysed on an Orbitrap Astral Mass Spectrometer with short LC gradients.</p><p><strong>Results: </strong>During an irAE, we found upregulation of multiple acute-phase protein reactants. The level of these was higher in patients in combination CPI therapy-also observed in the control cohort without irAE. We found multiple hepatic proteins associated with immune-related hepatitis, including fructose-biphosphate aldolase B (ALDOB), showing the widest dynamic range. Further, we found a correlation of lipocalin-2/neutrophil gelatinase-associated lipocalin (LCN2/NGAL) to nephritis and colitis with a significant correlation to the clinical toxicity grade confirmed by an immunoassay. Finally, high levels of angiotensinogen (AGT), chitinase-3-like protein 1 (CHI3L1) and lectin mannose-binding 2 (LMAN2) showed a significant association with poor prednisolone response.</p><p><strong>Conclusion: </strong>In conclusion, using LC-MS/MS-based plasma proteomics, we identified several irAE-related biomarker candidates to be further assessed for toxicity grading and management in the context of monitoring irAEs.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000696"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conclusion about colorectal cancer incidence in people who smoke.","authors":"Rodney J Scott","doi":"10.1136/bmjonc-2025-000855","DOIUrl":"10.1136/bmjonc-2025-000855","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000855"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}