BMJ oncology最新文献

{"title":"Whole-body integral dose and post-radiotherapy lymphocytopaenia in solid tumours.","authors":"Nuradh Joseph, Lanka Alagiyawanna, Thilina Ruwanpura, Sanjeeva Gunasekera, Lakitha Ruvinda, Sampath Madushan, Ananya Choudhury","doi":"10.1136/bmjonc-2024-000522","DOIUrl":"10.1136/bmjonc-2024-000522","url":null,"abstract":"<p><strong>Objective: </strong>Since modern radiotherapy techniques such as intensity-modulated radiotherapy (IMRT) pivot on a strategy of dose redistribution, it may increase integral dose and consequently worsening of lymphocytopaenia. In this study, our objective was twofold: first to validate the correlation between integral body dose and post-treatment lymphocytopaenia in a cohort of patients treated with curative-intent radiotherapy and second to validate its prognostic impact.</p><p><strong>Methods and analysis: </strong>Patients treated with curative intent radiotherapy with complete blood counts were included in the study. Data on the following variables were collected: treatment site, prescribed dose, use of concurrent chemotherapy, mean body dose, mean body volume, treatment technique and disease-free survival.</p><p><strong>Results: </strong>A total of 116 patients were included for analysis. There was a significant decline in lymphocyte counts after radiotherapy (2.2×10⁹/L vs 0.8×10⁹/L; p<0.001). Multivariate linear regression analysis of post-treatment lymphocytopaenia revealed a significant correlation with pretreatment lymphocyte counts, integral body dose, use of IMRT and use of concurrent radiosensitising chemotherapy. Univariate survival analysis was performed in 37 patients with squamous cell carcinoma of the head and neck. In the Cox proportional hazards model, post-treatment lymphocyte count was statistically significant as a continuous variable (Hazard Ratio=0.998, p=0.01) and as a dichotomous variable.</p><p><strong>Conclusion: </strong>The negative correlation between integral body dose and post-treatment lymphocytopaenia was validated, and post-treatment lymphocytopaenia is an adverse prognostic factor in patients with head and neck cancer treated with curative-intent radiotherapy.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000522"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569158","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":"Long-term outcomes of bilateral salpingo-oophorectomy in women with personal history of breast cancer.","authors":"Hend Hassan, Tameera Rahman, Andrew Bacon, Craig Knott, Isaac Allen, Catherine Huntley, Lucy Loong, Yvonne Walburga, Eva Morris, Steven Hardy, Bethany Torr, Diana M Eccles, Clare Turnbull, Marc Tischkowitz, Paul Pharoah, Antonis C Antoniou","doi":"10.1136/bmjonc-2024-000574","DOIUrl":"10.1136/bmjonc-2024-000574","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between bilateral salpingo-oophorectomy (BSO) and long-term health outcomes in women with a personal history of breast cancer.</p><p><strong>Methods and analysis: </strong>We used data on women diagnosed with invasive breast cancer between 1995 and 2019 from the National Cancer Registration Dataset (NCRD) in England. The data were linked to the Hospital Episode Statistics-Admitted Patient Care dataset to identify BSO delivery. Long-term health outcomes were selected from both datasets. Multivariable Cox regression was used to examine the associations, with BSO modelled as a time-dependent covariate. The associations were investigated separately by age at BSO.</p><p><strong>Results: </strong>We identified 568 883 women, 23 401 of whom had BSO after the breast cancer diagnosis. There was an increased risk of total cardiovascular diseases with an HR of 1.10 (95% CI 1.04 to 1.16) in women who had BSO<55 years and 1.07 (95% CI 1.01 to 1.13) for women who had BSO≥55 years. There was an increased risk of ischaemic heart diseases, but there was no association with cerebrovascular diseases. BSO at any age was associated with an increased risk of depression (HR 1.20, 95% CI 1.12 to 1.28) and increased risk of second non-breast cancer in older women (HR 1.21, 95%CI 1.08 to 1.35). BSO in older women was associated with reduced risk of all-cause mortality (HR 0.92, 95% CI 0.87 to 096), but not in women who had BSO<55 years.</p><p><strong>Conclusion: </strong>In women with a personal history of breast cancer, BSO before and after the age of 55 years is associated with an increased risk of long-term outcomes. BSO after 55 years is associated with reduced all-cause mortality. Family history or genetic predisposition may confound these associations.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000574"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569117","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":"UK-based clinical testing programme for somatic and germline BRCA1/2, ATM and CDK12 mutations in prostate cancer: first results.","authors":"D Gareth Evans, George Burghel, Helene Schlecht, Ashwin Sachdeva, Andrew Hudson, Omi Parikh, Fiona Lalloo, Robert Bristow, Emma R Woodward","doi":"10.1136/bmjonc-2024-000592","DOIUrl":"10.1136/bmjonc-2024-000592","url":null,"abstract":"<p><strong>Objective: </strong>Germline <i>BRCA2</i> pathogenic variants (PVs) are known to cause ~4% of prostate cancer, but other homologous repair genes, <i>BRCA1, ATM, PALB2</i> and Lynch syndrome genes are also involved. Our objective was to assess the contribution of germline and somatic gene variants to prostate cancer.</p><p><strong>Methods and analysis: </strong>We reviewed germline/tumour DNA testing from 450 localised or metastatic prostate cancer cases in NW England mainly from 2022 to 2024. ORs for additional genes used detection rates in controls from the BRIDGES study.</p><p><strong>Results: </strong>450 cases underwent <i>BRCA1/2</i> germline/somatic testing with 2 germline PVs in <i>BRCA1</i> (0.4%) and 27 in <i>BRCA2</i> (6.0%)-total 6.4% and 6/328 (1.8%) in <i>ATM</i>. There were 280 metastatic prostate cancer samples tested with 11 (4%) somatic <i>BRCA2</i> and 7 (2.7%) somatic <i>ATM</i> identified with 1 somatic <i>BRCA1</i>. Total PVs in <i>BRCA2</i> were 31/280 (11%), including germline and indeterminate. <i>CDK12</i> somatic PVs were found in 9/220 (4.1%), including 2 digenic with <i>BRCA2</i> and 2 which were biallelic.</p><p><strong>Conclusion: </strong>In this continuous clinical evaluation, <i>BRCA2</i> is the most frequently identified prostate cancer gene with over 10% involvement in metastatic disease. <i>BRCA2</i> and <i>CDK12</i> somatic PVs do not appear to be mutually exclusive. <i>BRCA1</i> does not appear to be a significant contributor to prostate cancer progression.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000592"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569155","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":"Evaluating the genetic landscape of prostate cancer: new insights from BRCA1/2, ATM and CDK12 mutations.","authors":"Fumihiko Urabe, Kosuke Takemura","doi":"10.1136/bmjonc-2024-000717","DOIUrl":"10.1136/bmjonc-2024-000717","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000717"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568981","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":"Predicting short-term risk of colorectal cancer using primary care records, genetics and lifestyle factors.","authors":"Christiana Kartsonaki","doi":"10.1136/bmjonc-2024-000637","DOIUrl":"10.1136/bmjonc-2024-000637","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000637"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569152","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":"Genetics, primary care records and lifestyle factors for short-term dynamic risk prediction of colorectal cancer: prospective study of asymptomatic and symptomatic UK Biobank participants.","authors":"Samantha Ip, Hannah Harrison, Juliet A Usher-Smith, Matthew E Barclay, Jonathan Tyrer, Joe Dennis, Xin Yang, Michael Lush, Cristina Renzi, Nora Pashayan, Spiros Denaxas, Georgios Lyratzopoulos, Antonis C Antoniou, Angela M Wood","doi":"10.1136/bmjonc-2024-000336","DOIUrl":"10.1136/bmjonc-2024-000336","url":null,"abstract":"<p><strong>Objectives: </strong>To quantify the contributions of polygenic scores, primary care records (presenting symptoms, medical history and common blood tests) and lifestyle factors, for short-term risk prediction of colorectal cancer (CRC) in general and symptomatic individuals.</p><p><strong>Methods and analysis: </strong>This prospective cohort study used data from the UK Biobank with follow-up until 2018. It included 160 507 participants with linked primary care records and a subcohort of 42 782 participants with recent CRC-related symptoms. The outcome was the first-recorded CRC diagnosis within 2 years. Dynamic risk models with time-varying predictors were derived using a super-landmark framework. Model discrimination was assessed through Harrel's C-index, and predictor contributions to model discrimination were evaluated using inclusion-order-agnostic Shapley values.</p><p><strong>Results: </strong>C-indices (95% CIs) were 0.73 (0.72 to 0.73) and 0.69 (0.68 to 0.70) for the general and symptomatic participants, respectively. Shapley contributions to model discrimination (95% CIs) were core predictors (eg, age, sex) 33% (25% to 42%) (symptomatic: 34% (9% to 75%)), polygenic scores 16% (8% to 26%) (8% (-21% to 35%)), primary care blood tests 32% (19% to 43%) (41% (16% to 73%)), medical history 11% (4% to 17%) (9% (-25% to 37%)), lifestyle factors 6% (0% to 11%) (-5% (-32% to 13.4%)) and symptoms 3% (-2% to 7%) (13% (-19% to 41%)).</p><p><strong>Conclusions: </strong>Polygenic scores contribute substantially to short-term risk prediction for CRC in both general and symptomatic populations; however, the contribution of information in primary care records (including presenting symptoms, medical history and common blood tests) is greater. Lifestyle factors not routinely collected in primary care contribute minimally.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000336"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568986","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":"Patina of precision: risk models for lung cancer screening eligibility.","authors":"Peter B Bach, Benjamin L Mazer","doi":"10.1136/bmjonc-2024-000663","DOIUrl":"10.1136/bmjonc-2024-000663","url":null,"abstract":"","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000663"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569126","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":"Molecular and immune landscape of tumours in geriatric patients with non-small cell lung cancer, melanoma and renal cell carcinoma.","authors":"Khalil Choucair, Andrew Elliott, Matthew James Oberley, Phillip Walker, April K Salama, Azhar Saeed, Hirva Mamdani, Dipesh Uprety, Wafik S El-Deiry, Himisha Beltran, Stephen V Liu, Chul Kim, Abdul Rafeh Naqash, Emil Lou, Lujia Chen, Anwaar Saeed","doi":"10.1136/bmjonc-2024-000551","DOIUrl":"10.1136/bmjonc-2024-000551","url":null,"abstract":"<p><strong>Objective: </strong>Cancer patients aged ≥80 years present unique characteristics affecting response to immune checkpoint inhibitors (ICIs), with unidentified molecular differences. This study aimed to explore potential biomarkers of response to ICI in patients ≥80 years.</p><p><strong>Methods and analysis: </strong>We analysed tumour samples (n=24 123) from patients ≥80 (versus<80) with non-small cell lung cancer (NSCLC), melanoma (MEL), and renal cell cancer (RCC). Using gene expression deconvolution, we investigated differences in tumour microenvironment (TIME) composition. Then, using next-generation sequencing and programmed death-ligand 1 (PD-L1) assessment, we evaluated gene expression differences between age groups and across tumour types, with a focus on ageing-related processes such as DNA damage response (DDR), immune checkpoint (IC) and metabolism-related genes. In a subset of patients ≥80 (n=1013), gene clustering and differential gene expression analyses were carried out to identify potential tumour-type specific expression patterns in responders to ICI.</p><p><strong>Results: </strong>Significant differences in TIME composition were seen in patients with NSCLC and MEL. In patients ≥80, tumour mutational burden was lower in patients with NSCLC, higher in MEL and RCC had fewer PD-L1+tumours. DDR, IC and metabolism-related gene enrichments were distinct in patients ≥80. In patients ≥80 treated with ICIs (n=1013), there were no significant differences in survival between gene clusters, but differential gene expression analysis identified potential tumour-type specific expression patterns in responders.</p><p><strong>Conclusion: </strong>Our findings reveal tumour type-specific expression profiles, TIMEs and response signatures to ICIs in patients ≥80, supporting further biomarker investigations in this population.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000551"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070011","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":"Thirty years from FDA approval of pegylated liposomal doxorubicin (Doxil/Caelyx): an updated analysis and future perspective.","authors":"Alberto A Gabizon, Shira Gabizon-Peretz, Shadan Modaresahmadi, Ninh M La-Beck","doi":"10.1136/bmjonc-2024-000573","DOIUrl":"10.1136/bmjonc-2024-000573","url":null,"abstract":"<p><p>In 2025, it will be 30 years since the initial clinical approval of pegylated liposomal doxorubicin (PLD) by the Food and Drug Administration. PLD predated the field of nanomedicine and became a model nanomedicine setting key pharmacological principles (prolonged circulation, slow drug release and the enhanced permeability and retention (EPR) effect) for clinical application of other nano-drugs in cancer therapy. The impressive reduction of cardiotoxicity conferred by PLD is the most valuable clinical asset. While PLD has gained a strong foothold in relapsed ovarian cancer and metastatic breast cancer, it has not been extensively tested in primary (neoadjuvant) and adjuvant therapy and has not fulfilled the expectations from the results in animal models efficacy-wise. This discrepancy may be due to the large dose gap between mice and humans and the apparent variability of the EPR effect in human cancer. PLD is a complex product and we are still in a learning curve regarding a number of factors such as its interaction with the complement system and its immune modulatory properties, as well as its integration in multimodality therapy that may potentiate its value and role in cancer therapy.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000573"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070014","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":"Advancing cancer care through digital access in the USA: a state-of-the-art review of patient portals in oncology.","authors":"Uday Suresh, Jessica Ancker, Liz Salmi, Lisa Diamond, Trent Rosenbloom, Bryan Steitz","doi":"10.1136/bmjonc-2024-000432","DOIUrl":"10.1136/bmjonc-2024-000432","url":null,"abstract":"<p><p>Patient portal use among patients with cancer has increased significantly in recent years. This state-of-the-art review seeks to address and analyse literature involving patient portal use by patients with cancer and their care partners. In this review, we queried articles from PubMed published between January 2018 and April 2024 that describe recent trends and the current presence of portals in cancer care for patients, proxy users and/or care partners. We searched for articles addressing three overarching themes: (1) trends and disparities in portal adoption and use among patients with cancer, (2) use of specific portal components and functions in cancer care and (3) associations between portal use and cancer-related outcomes. Our search identified 278 unique studies, of which 82 were relevant empiric studies that met inclusion criteria and were included in this review. These papers aligned with 12 subthemes, including disparities in patient portal access, growing use of telemedicine via patient portal and patient access to immediately available to electronic health information. Our findings indicate that patient portals play an increasingly important role in helping patients manage their cancer care, despite few disparities that contribute to inequitable use. However, despite consistent growth in use over recent years, there are many areas for improvement in how portals support patients with cancer and a demand for functionality to continually evolve with patient needs.</p>","PeriodicalId":72436,"journal":{"name":"BMJ oncology","volume":"4 1","pages":"e000432"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574860","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}