BMJ oncology最新文献

{"title":"Microbial imprints on colorectal cancer: the epigenetic silencing of PHLPP1 as a prognostic nexus.","authors":"Xiangsheng Huang, Faraz Bishehsari","doi":"10.1136/bmjonc-2025-000883","DOIUrl":"10.1136/bmjonc-2025-000883","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000883"},"PeriodicalIF":0.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786065","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":"Real-world experience on efficacy and safety of different adjuvant chemotherapy regimens in locoregionally advanced nasopharyngeal carcinoma.","authors":"Jie Chen, Hui Cheng, Yi-Fu Li, Yu-Chen Li, Hao-Xiang Long, Jie-Yi Lin, Chun Fung Tse, Bo-Wen Shen, Pan Wang, Sai-Lan Liu, Shan-Shan Guo, Shu-Ming Liang, Qiu-Yan Chen, Lin-Quan Tang, Hai-Qiang Mai, Li-Ting Liu","doi":"10.1136/bmjonc-2024-000718","DOIUrl":"10.1136/bmjonc-2024-000718","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the efficacy and toxicity of various adjuvant chemotherapy (AC) regimens for treating locoregionally advanced nasopharyngeal carcinoma.</p><p><strong>Methods and analysis: </strong>In this retrospective study, the patients received either intravenous AC regimens (cisplatin-fluorouracil (PF) or cisplatin-gemcitabine (GP)) or oral regimens (capecitabine or tegafur, gimeracil and oteracil potassium capsule (S-1)) following concurrent chemoradiotherapy (CCRT). The primary endpoint was progression-free survival (PFS).</p><p><strong>Results: </strong>A total of 229 patients were documented in the oral administration group (127 patients received capecitabine and 102 received S-1), whereas 241 patients were recorded in the intravenous group (164 patients received the PF regimen and 77 received the GP regimen). There was no significant difference in PFS between the intravenous and oral groups (n=154 each) after propensity score matching (3-year PFS rate: 76.3% vs 73.9%; HR, 0.803; 95% CI 0.523 to 1.233, p=0.316). However, based on the overall cohort, the GP regimen showed a superior 3-year PFS rate (89.1%) compared with PF (74.6%), capecitabine (76.0%) and S-1 (74.3%) regimen (p=0.005, 0.012 and 0.003, respectively), while multivariable analyses also demonstrated that the GP regimen (HR_PFS, 0.38; 95% CI 0.18 to 0.81, p=0.012) was associated with better survival. Additionally, the intravenous group, which included PF and GP, exhibited a higher incidence of grade≥3 leucocytopenia (50.0% vs 22.7%), neutropenia (30.5% vs 18.2%), anaemia (16.2% vs 3.9%), hyponatraemia (3.2% vs 0) and hypokalaemia (12.3% vs 4.5%) than the oral group.</p><p><strong>Conclusion: </strong>For patients treated with upfront CCRT, AC should be considered, and intravenous GP is preferred, although patients should be counselled about an increased risk of haematological toxicities. For patients treated with induction chemotherapy and CCRT, oral chemotherapy, either with capecitabine or S-1, was efficacious and tolerable.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000718"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786066","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":"Chemotherapy and radiotherapy use in patients with lung cancer in Australia, Canada, the UK and Norway 2012-2017: an ICBP population-based study.","authors":"Matthew E Barclay, Sean McPhail, Shane A Johnson, Ruth Swann, Christian J Finley, John Butler, Riaz Alvi, Andriana Barisic, Damien B Bennett, Oliver Bucher, Nicola Creighton, Cheryl A Denny, Ron A Dewar, David W Donnelly, Jeff J Dowden, Laura Downie, Norah Finn, Steven Habbous, Dyfed W Huws, S Eshwar Kumar, Leon May, Carol A McClure, Bjørn Møller, David S Morrison, Grace Musto, Yngvar Nilssen, Nathalie Saint-Jacques, Sabuj Sarker, Lorraine Shack, Luc Te Marvelde, Xiaoyi Tian, Robert Js Thomas, Catherine S Thomson, Richard Walton, Haiyan Wang, Tommy Hon Ting Wong, Ryan R Woods, Hui You, Bin Zhang, Georgios Lyratzopoulos","doi":"10.1136/bmjonc-2025-000800","DOIUrl":"10.1136/bmjonc-2025-000800","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Background: </strong>International variation in lung cancer survival may be partly explained by variation in stage-specific treatment use, but relevant comparative evidence is sparse. As part of the International Cancer Benchmarking Partnership, we examined use of chemotherapy and radiotherapy in population-based cancer registry data.</p><p><strong>Methods: </strong>Linked population-based data sources were used to describe use and time to first treatment for either chemotherapy or radiotherapy in patients with lung cancer diagnosed in study periods during 2012-2017 in 16 jurisdictions of Australia, Canada, the UK and Norway.</p><p><strong>Results: </strong>There was large variation in the proportions of patients with lung cancer receiving chemotherapy (ranging from 23% in Northern Ireland to 45% in Norway) and radiotherapy (ranging from 32% in England to 48% in New South Wales and 50% in Newfoundland and Labrador). Across jurisdictions, chemotherapy use decreased steeply with increasing age, regardless of stage at diagnosis. For radiotherapy use, in stage 1-3 cancer three patterns were observed: (a) steep decrease with increasing age (UK jurisdictions, Saskatchewan-Manitoba); (b) a relatively flat pattern (Norway, Alberta, British Columbia, Atlantic Canada, New South Wales) and (c) increasing use with increasing age (Ontario).Time to radiotherapy initiation was longer in the UK jurisdictions than elsewhere; time to chemotherapy was longer in the UK and Canadian jurisdictions except Ontario.</p><p><strong>Discussion: </strong>Use of chemotherapy and radiotherapy in patients with lung cancer varied substantially between jurisdictions during the mid-2010s within age-stage strata. Reasons for these variations are unclear. Differences in non-surgical treatment use are plausibly associated with international variation in lung cancer survival.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000800"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638825","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":"Elucidating the mechanisms of lifestyle interventions in mitigating radiotherapy adverse effects: a scoping review.","authors":"Oliver Chalmers, Alex Waddell, Ananya Choudhury, Craig Sale, Amy E Harwood","doi":"10.1136/bmjonc-2024-000615","DOIUrl":"10.1136/bmjonc-2024-000615","url":null,"abstract":"<p><p>The aim of this work was to review the literature on the mechanisms by which lifestyle interventions attenuate radiation therapy-induced side effects. A scoping review based on the Joanna Briggs Institute methodological framework was undertaken. MEDLINE, CINAHL and CENTRAL were searched up until 13 March 2024. Studies assessing the potential mechanistic effects of lifestyle interventions on outcomes in adult (>18 years of age) cancer patients undergoing radiotherapy, including any cancer type or intervention timing (before, during, after radiotherapy), were included. Data were extracted regarding study design, intervention characteristics and included outcome measures. Nine studies were included in the review. Study populations included patients with a range of cancers, including head and neck, prostate, breast, lung, lower gastrointestinal, rectal, pelvic and leukaemia. Lifestyle interventions consisted primarily of nutritional supplements, diets or traditional Chinese medicinal ingredients. Exercise programmes were also included. Those that were available involved either resistance training alone or in combination with aerobic exercise. The most common side effects included site-specific toxicity, with some interventions noting improvements to symptoms, alongside alterations to inflammatory cytokine and lymphocyte concentrations. Radiation-induced weight loss and frailty were noted, which may be prevented with interventions that target skeletal muscle metabolism. With more research to fully elucidate the potential mechanisms and consistent evidence of efficacy, lifestyle interventions may present promising non-pharmacological therapeutic options to alleviate some of the side effects of radiotherapy.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000615"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638826","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":"Extending the functional lifespan of natural killer (NK) cells: towards durable cytotoxicity in NK-cell based immunotherapy.","authors":"Kimberly Luddy, Hannah Newman","doi":"10.1136/bmjonc-2025-000857","DOIUrl":"10.1136/bmjonc-2025-000857","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000857"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577036","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":"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}