BMJ oncology最新文献

{"title":"Gender disparities in clinical outcomes of urothelial carcinoma linked to X chromosome geneKDM6Amutation","authors":"Zhao-xia Liu, Kaifeng Jin, Ziyue Xu, Jingtong Xu, Xiao Su, Bingyu Li, Ge Liu, Hailong Liu, Yuan-Ya Chang, Yiwei Wang, Le Xu, Weijuan Zhang, Zewei Wang, Yu Zhu, Jiejie Xu","doi":"10.1136/bmjonc-2023-000199","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000199","url":null,"abstract":"KDM6A, a representative tumour suppressor gene with sex bias, is frequently altered in urothelial carcinoma (UC). The specific impacts ofKDM6Amutations on gender-based clinical outcomes in UC remain poorly understood.We enrolled 2438 patients with UC from seven independent real-world cohorts possessing comprehensive clinical and genomic data. Point mutations and homozygous deletions ofKDM6Aare categorised asKDM6AMut. We assessed the correlation between gender disparities in relation toKDM6Astatus and clinical outcomes, as well as genomic and immunological profiles.KDM6Amutations were identified in 679 of the 2306 patients with UC (29.4%), with 505 of 1768 (28.6%) in men and 174 of 538 (32.3%) in women.KDM6Amutations correlated with enhanced overall survival exclusively in male patients but were linked to improved outcomes following adjuvant chemotherapy only in female patients. Concerning immunotherapeutic responses,KDM6AMutmale patients displayed the most favourable clinical outcomes, whereasKDM6AMutfemale patients demonstrated the least favourable outcomes. Independent of gender variations,KDM6AMutpatients exhibited heightened androgen receptor and diminished oestrogen receptor 1 filtered regulon activity. Additionally,KDM6AMutmale patients showed increased infiltration of T cells, cytotoxic T cells and NK cells with enriched neoantigens, in contrast toKDM6AMutfemale patients who manifested a more pronounced angiogenesis signature.Our findings offer preliminary clinical evidence accentuatingKDM6Aalterations as a promising prognostic and predictive biomarker while elucidating the gender disparities observed in patients with UC.","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139014090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Need for a ‘VR-cebo’ and more robust evaluations of virtual reality intervention","authors":"Katie Flanagan, Mark Taubert, Nicola White","doi":"10.1136/bmjonc-2023-000230","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000230","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139023217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive biomarkers and specific immune responses of COVID-19 mRNA vaccine in patients with cancer: prospective results from the CACOV-VAC trial","authors":"L. Spehner, E. Orillard, A. Falcoz, Quentin Lepiller, A. Bouard, H. Almotlak, Stefano Kim, E. Curtit, G. Meynard, M. Jary, Charlee Nardin, K. Asgarov, S. Abdeljaoued, Ugo Chartral, V. Mougey, Myriam Ben Khelil, Morgane Lopez, Romain Loyon, D. Vernerey, O. Adotévi, Christophe Borg, L. Mansi, M. Kroemer","doi":"10.1136/bmjonc-2023-000054","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000054","url":null,"abstract":"Vaccinated patients with cancer in follow-up studies showed a high seropositivity rate but impaired antibody titres and T cell responses following mRNA vaccine against COVID-19. Besides clinical characteristics and the type of anticancer treatment before vaccination, the identification of patients susceptible to non-response following vaccination using immunological markers is worth to be investigated.All patients (n=138, solid cancers) were included in the CACOV-VAC Study comprising three cohorts ((neo)-adjuvant, metastatic and surveillance). Immune responses were assessed using, respectively, anti-receptor-binding domain (RBD) SARS-CoV-S-IgG assay and interferon-γ ELISpot assay 3 months following the prime vaccination dose. Immunophenotyping of T cells and immunosuppressive cells from peripheral blood was performed before the prime dose. The serological threshold 3563 AU/mL was used to discriminate non-responders or suboptimal responders versus responders.Most patients achieved seroconversion after receiving the two doses of vaccine (97.6%). The median serological level of anti-RBD SARS-CoV-S-IgG was equal to 3029 for patients at the metastatic stage. The patient’s age was the main demographic characteristic that influenced vaccine efficacy. Among the immunological parameters measured at baseline, lower TIGIT (T cell immunoreceptor with Ig and ITIM domains) expression on CD8 T cells was associated with a better vaccine immunogenicity both in terms of humoral and cellular immune responses.Despite a high seroconversion rate, median serological levels of patients with cancer, particularly elderly patients, were below the threshold equal to 3563 AU/mL considered as a humoral correlate of protection against SARS-CoV-2. Our findings suggest that the inhibitory receptor TIGIT might be an interesting predictive biomarker of COVID-19 vaccine immunogenicity and beyond in an anticancer vaccine context.ClinicalTrials.gov Registry (NCT04836793).","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139024188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endpoints for trials of adjuvant anticancer therapies","authors":"A. Pastorino, Alberto Sobrero, Paolo Bruzzi","doi":"10.1136/bmjonc-2023-000179","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000179","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139012963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Godrevy Project’: virtual reality for symptom control and well-being in oncology and palliative care – a non-randomised pre-post interventional trial","authors":"Niall O Moon, Jemima R Henstridge-Blows, Eva A Sprecher, Elizabeth Thomas, Amy Byfield, John McGrane","doi":"10.1136/bmjonc-2023-000160","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000160","url":null,"abstract":"The ‘Godrevy Project’ is an interventional trial designed to determine the effectiveness of immersive virtual reality (VR) on the holistic symptom control and well-being in oncology and palliative care patients. The primary objective of this study was to determine whether VR changed the revised Edmonton Symptom and Assessment System (ESAS-r) score representing an effective improvement in symptom control and well-being.This study reports on 60 participants recruited from hospital inpatient oncology and palliative care lists, to participate in an unblinded, VR intervention. Participants were included aged >18 years with a diagnosis of cancer, receiving inpatient treatment of systemic anticancer therapy. Impact evaluation on symptoms was measured using the ESAS-r pre-VR and post-VR intervention. For ethical reasons, participants were not randomised.From the 60 inpatients recruited, 58 participants were included for analysis. Participants recruited were aged 19–84 years with female (58%) and male (42%) participation. The primary outcome of the study demonstrated significant improvement in ESAS-r scores for symptoms and well-being. Total ESAS-r scores showed an improvement of 42% compared with baseline, with well-being ESAS-r scores improving 51%. The most common side effect was drowsiness. There were no adverse events related to study participation.The ‘Godrevy Project’ successfully demonstrates the feasible, effective use of VR on symptom control and well-being in oncology and palliative care patients. This study demonstrates VR as an effective, patient controlled, non-pharmacological intervention without significant side effects. This interventional trial is well placed to support future research and improve clinical practice.NCT04821466.","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139024653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another piece in the overdiagnosis jigsaw puzzle","authors":"Stephen W Duffy","doi":"10.1136/bmjonc-2023-000225","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000225","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139023533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the gaps in recruitment and retention in cancer trials: sufficient evidence but poor implementation","authors":"Giulia Pellizzari","doi":"10.1136/bmjonc-2023-000195","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000195","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139297353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boosting and broadening recruitment to UK cancer trials: towards a blueprint for action","authors":"V. Nanton, R. Bryan, Anne M Pope, Ana Hughes, Kieran Jefferson, James W F Catto, Allen Knight, J. Gallagher, H. Mintz, S. Pirrie, Wenyu Liu, A. Young, Prashant Patel, Nicholas D. James","doi":"10.1136/bmjonc-2023-000092","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000092","url":null,"abstract":"Recruitment and retention in cancer trials are long-standing issues, exacerbated by the COVID-19 pandemic. The UK National Institute of Health Research and leading clinicians have emphasised the urgency to achieve and surpass prepandemic levels of participation.Data from a recent UK trial demonstrated the impact of COVID-19 and highlighted factors that limited recruitment. In response to this worldwide problem, studies have identified strategies for remediation at the levels of funding, the research environment, study design and trial team-related aspects, yet evidence of progress is lacking.Equality, diversity and inclusivity have become central to UK health and social policy during the 2000s. The need for greater inclusivity in trials has become a particular concern for cancer researchers and funders in the UK and in the USA, in recognition of potential bias in results. In the UK trials, the lack of standardised recording of ethnicity data renders interpretation difficult and caution is required in comparisons with the USA.Recently, the focus of concern has shifted away from the impact of deprivation and low socioeconomic status on trial participation. Barriers created by these factors and their frequent intersection with ethnicity should not be overlooked.The UK has adopted an advisory approach to broadening recruitment, publishing policy documents, guidance and toolkits. In the USA, by contrast, action on inclusion is increasingly mandated. Within the UK paradigm, the cancer research community is strongly encouraged to adopt a coordinated approach towards standardised digital data collection and embed and evaluate innovative, cocreated, locally relevant strategies.","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139299708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PACT-UK (PAncreatic Cancer reporting Template–UK): a cross-specialty multi-institutional consensus panel development of a standardised radiological reporting proforma for pancreatic cancer","authors":"John Moir, Ganesh Radhakrishna, Juan W Valle, A. Al-Adhami, R. Albazaz","doi":"10.1136/bmjonc-2023-000055","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000055","url":null,"abstract":"Appropriate staging of pancreatic cancer is essential to ensure patients are offered all treatment options. This multispecialty national collaborative consensus project aimed to develop a succinct radiological reporting template, using the concept of structured reporting, to allow a more standardised means of reporting pancreatic cancer and ultimately optimise both patient care and research protocol design.In stage one, a core group of stakeholders (oncologists, radiologists and surgeons) identified the current landscape of radiological reporting, including a blinded radiological validation study and a national survey of consultant HPB surgeons. Stage two used consensus panel development methodology to generate a provisional template draft. Stage three involved trialling the template across all UK HPB units, with feedback assisting the development of a final version of the template.Stage one results identified a core dataset to develop a provisional template. Every UK Hepatopancreatobiliary (HPB) unit trialled this in clinical practice, leading to further refinements via consensus meetings. Ideal factors regarding tumour staging, extent of vascular involvement and response to systemic anticancer therapy were identified. This resulted in the generation of the PACT-UK (PAncreatic Cancer reporting Template–UK) template that is presented within the manuscript, as well as a user guide.This project has successfully produced the first consensus-driven radiological reporting template for pancreatic cancer, with the aim of its use becoming standard practice in the UK, while upcoming workshops facilitated by Royal College of Radiologists/British Society of Gastrointestinal and Abdominal Radiology will establish buy-in from radiologists at all HPB units. Plans for the use of PACT-UK within national audit and clinical trials are underway.","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139305827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do tumours outside the gastrointestinal tract respond to dietary fibre supplementation?","authors":"Fatima Asim, Lowenna Clarke, Elizabeth Donnelly, Fouzia Rahana Jamal, Lucrezia Maria Piccicacchi, Mahanoor Qadir, Nain Tara Raja, Cyrus Samadi, Chee Kin Then, Anne E Kiltie","doi":"10.1136/bmjonc-2023-000107","DOIUrl":"https://doi.org/10.1136/bmjonc-2023-000107","url":null,"abstract":"Cancer remains one of the leading causes of death worldwide, despite advances in treatments such as surgery, chemotherapy, radiotherapy and immunotherapy. The role of the gut microbiota in human health and disease, particularly in relation to cancer incidence and treatment response, has gained increasing attention. Emerging evidence suggests that dietary fibre, including prebiotics, can modulate the gut microbiota and influence antitumour effects. In this review, we provide an overview of how dietary fibre impacts the gut–tumour axis through immune and non-immune mechanisms. Preclinical evidence shows that β-glucan or inulin effectively suppress extraintestinal tumour growth via immunomodulation. Other fibres such as resistant starch, modified citrus pectin and rye bran may confer antitumour effects through metabolic regulation, production of metabolites or downregulation of the insulin/insulin-like growth factor 1 axis. Additionally, we highlight the potential for dietary fibre to modify the response to immunotherapy, chemotherapy and radiotherapy, as shown by inulin increasing the abundance of beneficial gut bacteria, such as Bifidobacterium , Akkermansia , Lactobacillus and Faecalibacterium prausnitzii , which have been associated with enhanced immunotherapy outcomes, particularly in melanoma-bearing mice. Furthermore, certain types of dietary fibre, such as psyllium, partially hydrolysed guar gum, hydrolysed rice bran and inulin plus fructooligosaccharide, have been shown to mitigate gastrointestinal toxicities in patients with cancer undergoing pelvic radiotherapy. Despite the proven benefits, it is noteworthy that most adults do not consume enough dietary fibre, underscoring the importance of promoting dietary fibre supplementation in patients with cancer to optimise their treatment responses.","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135614797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}