BMJ oncology最新文献

{"title":"Combined immune checkpoint inhibitors and ablative radiotherapy in metastatic cancers: a meta-analysis of prospective clinical trials.","authors":"Eduardo Urias, Jaehoon Lee, Christopher R Weil, Eric Roach, Shane Lloyd, Mia Hashibe, Andrea Facciabene, Amit Maity, Randa Tao","doi":"10.1136/bmjonc-2025-000732","DOIUrl":"https://doi.org/10.1136/bmjonc-2025-000732","url":null,"abstract":"<p><strong>Objective: </strong>To pool data from prospective clinical trials investigating combined stereotactic ablative radiotherapy (SABR) with immune checkpoint inhibitors (ICI) in patients with metastatic cancers.</p><p><strong>Methods and analysis: </strong>PubMed, Scopus and EMBASE were queried for full-length articles of prospective clinical trials involving patients with metastatic solid tumours. Random-effects meta-analysis was performed with the Knapp-Hartung method. Multilevel regression analyses with primary cancers used as random effects and pairwise comparisons with two-tailed test adjusted with Benjamini-Hochberg method were performed. Regression coefficients (β) were calculated to assess the correlation between dose and outcomes.</p><p><strong>Results: </strong>We identified 30 trials and 35 individual treatment arms with a total of 951 patients with at least one outcome metric reported. Large heterogeneity was identified for all outcomes measured (I² range: 75%-86%). The pooled rate of grade 3+ treatment-related adverse events was 18% (95% CI 11% to 24%). The progression-free survival (PFS) and overall survival (OS) at 6 months were 27% (95% CI 19% to 36%) and 67% (95% CI 59% to 76%), respectively. On multilevel regression, we identified improvement in 6-month PFS (β=0.6, p=0.003) and OS (β=1.6, p=0.04) with increasing BED10Gy doses. Combined-target ICI correlated with better 6-month OS when compared with αPD-1/PD-L1 alone.</p><p><strong>Conclusion: </strong>We report a safety profile of combined ICI with SABR in patients with metastatic cancer that is comparable to that of ICI alone. We identified higher doses of radiotherapy and dual-target ICI to be associated with better OS at 6 months. Large heterogeneity and the lack of a control group limit the interpretation of our findings.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000732"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056944","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":"Disease-free survival as a surrogate for overall survival in early-stage pancreatic cancer trials: a correlation meta-analysis.","authors":"Luís Felipe Leite, Luiz F Costa de Almeida, Lucas Diniz da Conceição, Mariana Macambira Noronha, Marcos Belotto, Erick F Saldanha, Thais Baccili Cury Megid, Renata D'Alpino Peixoto, Bishal Gyawali","doi":"10.1136/bmjonc-2025-000766","DOIUrl":"10.1136/bmjonc-2025-000766","url":null,"abstract":"<p><strong>Objective: </strong>Disease-free survival (DFS) is frequently used as the primary endpoint in trials of adjuvant and neoadjuvant therapies for early-stage pancreatic cancer (PC), but its validity as a surrogate for overall survival (OS) remains uncertain. This study evaluates the strength and consistency of DFS as a surrogate for OS in early-stage PC trials.</p><p><strong>Methods and analysis: </strong>This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Trials of early-stage PC involving drug therapy were identified through PubMed, Embase and Cochrane CENTRAL databases, and data on DFS and OS with HR and CIs were extracted. Trial-level surrogacy of DFS for OS was assessed using weighted linear regression, calculating the coefficient of determination (R²) and surrogate threshold effect (STE).</p><p><strong>Results: </strong>29 trials involving 6777 patients were included. In adjuvant trials, HR of DFS strongly correlated with HR of OS (R²=0.70) at trial-level, with the STE of 0.94 indicating the maximum DFS HR beyond which OS benefit was unlikely. The correlation strength differed between phase III (R²=0.71) versus phase II (R²=0.67) trials. This correlation was stronger in trials including radiation therapy (R²=0.81) and trials in the neoadjuvant setting (R²=0.90). No trial in our study was a registration trial of a new molecule and all involved chemotherapy.</p><p><strong>Conclusion: </strong>Treatment effects on DFS had a strong correlation with treatment effects on OS, making DFS a potential surrogate endpoint for OS in early-stage PC trials of cytotoxic chemotherapies, but its use in registration trials requires careful consideration due to variability across treatment settings and trial designs.</p><p><strong>Prospero registration number: </strong>CRD42024595441.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000766"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303811","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":"Correction: Association between rheumatoid arthritis and risk of radiotherapy toxicity: a systematic review.","authors":"","doi":"10.1136/bmjonc-2024-000407corr1","DOIUrl":"https://doi.org/10.1136/bmjonc-2024-000407corr1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1136/bmjonc-2024-000407.].</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000407corr1"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029230","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":"Supercharged NK cells, unlike primary activated NK cells, effectively target ovarian cancer cells irrespective of MHC-class I expression.","authors":"Sara Huerta-Yepez, Po-Chun Chen, Kawaljit Kaur, Yash Jain, Tanya Singh, Favour Esedebe, Yi Jou Liao, Gabriella DiBernardo, Neda A Moatamed, Ao Mei, Subramaniam Malarkannan, Thomas G Graeber, Sanaz Memarzadeh, Anahid Jewett","doi":"10.1136/bmjonc-2024-000618","DOIUrl":"10.1136/bmjonc-2024-000618","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the significance of supercharged natural killer (sNK) cells to target aggressive gynecological tumours.</p><p><strong>Methods and analysis: </strong>We used cell cultures of peripheral blood-derived mononuclear cells (PBMCs) and purified NK cells alone and in the presence of tumours. MHC-class gene expression assessments of ovarian tumours were performed using gene set enrichment analysis (GSEA). Secretion and expression levels of cytokines in PBMCs and NK cells were determined using ELISA and scRNA seq analysis, respectively. A flow cytometer was used for surface marker analysis. ⁵¹Cr and eSight were used to determine the killing activity of NK cells.</p><p><strong>Results: </strong>We have observed a significant decrease in the numbers and functions of NK cells in patients with ovarian cancer. GSEA revealed differently expressed genes, decreased differentiation- and immune-related genes, and increased genes for cell cycle analysis in recurrent tumours compared with chemo-naive ovarian tumours. Increased gene expression as well as secretion of interferon-γ and tumour necrosis factor-α and increased avidity in binding to tumour cells by sNK cells was observed. Unlike primary interleukin (IL)-2-activated NK cells, sNK cells effectively lysed OVCAR8 ovarian poorly differentiated cancer stem-like cells (PDCSCs) and well-differentiated OVCAR4 tumours. Primary ovarian tumours with lower MHC-class I expression were highly susceptible to both primary IL-2-activated NK and sNK cells, whereas the well-differentiated tumours with high expression of MHC-class I were only susceptible to sNK cells.</p><p><strong>Conclusion: </strong>The use of sNK cells in immunotherapy emerges as a potentially effective strategy to target and eliminate the majority of ovarian tumour clones, thereby providing a potential therapeutic opportunity in preventing the recurrence of the disease.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000618"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805015","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":"Souped-up natural killer (NK) cells for treating tough cancers.","authors":"Jennifer Wu","doi":"10.1136/bmjonc-2024-000685","DOIUrl":"10.1136/bmjonc-2024-000685","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000685"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805009","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":"Mental healthcare utilisation among individuals with colorectal cancer: population-based cohort studies.","authors":"Vicki Cheng, Eric C Sayre, Vienna Cheng, Jonathan M Loree, Sharlene Gill, Rachel A Murphy, Alyssa Howren, Mary A De Vera","doi":"10.1136/bmjonc-2024-000690","DOIUrl":"10.1136/bmjonc-2024-000690","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with colorectal cancer (CRC) have an increased risk of mental disorders, yet mental healthcare utilisation has not been adequately examined. We evaluated mental healthcare utilisation and receipt of minimally adequate treatments for anxiety and/or depression among individuals with and without CRC.</p><p><strong>Methods and analysis: </strong>We used administrative health databases from British Columbia, Canada, comprised of individuals with CRC and individuals without CRC, matched (1:1 ratio) on age, sex and incident mental disorder(s) (ie, occurring after CRC diagnosis/matched date). Primary outcomes were minimally adequate antidepressant pharmacotherapy (≥84 days' supply) and psychological (≥4 services) treatment.</p><p><strong>Results: </strong>Among individuals with CRC, 1462 had incident anxiety (mean age 64.6±12.5 years, 59.2% females), 4640 had incident depression (mean age 66.3±12.3 years, 51.2% females). Approximately one in four individuals with CRC were diagnosed with anxiety (23.4%) and/or depression (23.2%) in the first year after CRC diagnosis. Minimally adequate antidepressant pharmacotherapy (36.2%) and psychological treatment (15.9%) for anxiety were significantly lower in CRC patients than in those without CRC (pharmacotherapy adjusted OR (aOR) 0.74; 95% CI 0.61, 0.88; psychological treatment aOR 0.74; 95% CI 0.58, 0.95). Similar findings were observed for depression (pharmacotherapy aOR 0.81; 95% CI 0.74, 0.90). Among individuals with CRC, mental healthcare utilisation persisted up to 10 years post-mental disorder diagnosis.</p><p><strong>Conclusions: </strong>Individuals with CRC receive less mental health treatment for anxiety and/or depression, compared with those without CRC. Findings raise awareness for the need for ongoing mental healthcare throughout and beyond CRC.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000690"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774719","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":"Geographic, socioeconomic and demographic inequalities in the incidence of metastatic prostate cancer at time of diagnosis in England: a population-based evaluation.","authors":"Joanna Dodkins, Adrian Cook, Emily Mayne, Marina Parry, Julie Nossiter, Heather Payne, Thomas E Cowling, Alison Tree, Ajay Aggarwal, Noel Clarke, Jan van der Meulen","doi":"10.1136/bmjonc-2024-000643","DOIUrl":"10.1136/bmjonc-2024-000643","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the area-based incidence of metastatic prostate cancer at diagnosis, reflecting the risk of late-stage diagnosis, and overall prostate cancer incidence, reflecting the risk of over-diagnosis, in a country without a formal screening programme.</p><p><strong>Methods and analysis: </strong>National study of annual prostate cancer incidence between 2015 and 2019. Mixed-effects regression estimated area-based incidence, adjusted for age, ethnicity and socioeconomic deprivation. Linear regression assessed the association between metastatic and overall cancer incidence.</p><p><strong>Results: </strong>National annual incidence of metastatic prostate cancer was 5.7 per 10 000 men and overall incidence was 43.9. Higher incidence of both metastatic and overall cancer were observed in areas with older populations and with more men with black ethnicity (both p<0.0001). Greater socioeconomic deprivation was linked to higher metastatic but lower overall cancer incidence (p<0.0001). Metastatic incidence varied across the country from 4.0 to 6.8, and prostate cancer overall from 37.9 to 50.1 per 10 000 men. Areas with higher metastatic cancer incidence had lower overall cancer incidence (p<0.0001).</p><p><strong>Conclusions: </strong>There is significant geographic variation in metastatic prostate cancer incidence at diagnosis, with a higher incidence of metastatic cancer observed in areas with a lower overall prostate cancer incidence and in more socioeconomically deprived neighbourhoods, which likely contributes to poorer long-term outcomes. The findings highlight the need for a targeted, risk-based diagnostic approach as well as improved diagnostic facilities and referral pathways. Further research is needed to understand the factors driving this variation in order to reduce metastatic presentations and tackle inequalities in prostate cancer outcomes.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000643"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774777","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":"Air pollution and its impact on cancer incidence, cancer care and cancer outcomes.","authors":"Roselle De Guzman, Joan Schiller","doi":"10.1136/bmjonc-2024-000535","DOIUrl":"10.1136/bmjonc-2024-000535","url":null,"abstract":"<p><p>Air pollution is an under-recognised global health threat linked to an increased risk of cancers and is due primarily to the burning of fossil fuels. This review provides a high-level overview of the associations between outdoor and indoor air pollution and cancer risk and outcomes. Outdoor air pollutants are largely due to the burning of fossil fuels from human activities, although there is growing data implicating outdoor pollution from wildfire smoke. Indoor air pollution is primarily caused by burning solid fuel sources such as wood, coal and charcoal for household cooking and heating. There is a growing number of pieces of evidence linking exposure to pollution and the risk of developing cancers. The strongest evidence is seen on the positive association of air pollution, particularly particulate matter 2.5 with lung cancer. Emerging data implicate exposure to pollutants in the development of breast, gastrointestinal and other cancers. The mechanisms underlying these associations include oxidative stress, inflammation and direct DNA damage facilitated by pollutant absorption and distribution in the body. References were identified through a PubMed search for articles published in 2000 to October 2024 using the terms 'air pollution' or 'pollutants' and 'carcinoma' or ''cancer'. Air pollution poses significant risks to health. Its health impacts, including cancer risks, are often underestimated. Hazardous pollutants have been studied in several epidemiological cohort studies. Despite the mounting evidence, air pollution is often overlooked in predictive cancer risk models and public health intervention.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000535"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756144","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":"Does radiation-induced lymphocytopenia matter? Developing a radiotherapy dosimetric strategy for immune preservation and improved survival.","authors":"Mohammed Abdul-Latif, John Conibear, Niluja Thiruthaneeswaran, Yat Man Tsang","doi":"10.1136/bmjonc-2025-000745","DOIUrl":"10.1136/bmjonc-2025-000745","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000745"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712139","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":"Understandable, individualised information about risk is essential to help patients make fully informed decisions about breast cancer treatment.","authors":"Shelley Potter","doi":"10.1136/bmjonc-2025-000762","DOIUrl":"10.1136/bmjonc-2025-000762","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000762"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701522","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}