Asia-Pacific journal of clinical oncology最新文献

{"title":"Impact of RAS/RAF Mutations on Metastatic Treatment Response Following Total Neoadjuvant Therapy in Patients With Stage IV Rectal Cancer","authors":"Tracy R. Fitzsimmons,&nbsp;Z. Bunjo,&nbsp;E. L. Neo,&nbsp;A. Badiei,&nbsp;M. Penniment,&nbsp;S. Selva-Nayagam,&nbsp;A. Ruszkiewicz,&nbsp;J. Wong,&nbsp;T. Sammour","doi":"10.1111/ajco.70135","DOIUrl":"10.1111/ajco.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The underlying biology and genetic status of rectal cancer can guide treatment options. However, there is limited understanding of the impact of underlying mutational status of RAS/RAF on TNT response in metastatic rectal cancer. This study aims to determine treatment response to TNT in patients harboring RAS/RAF mutations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective multicenter observational study identified patients diagnosed with synchronous metastatic rectal cancer suitable to receive personalized TNT (pTNT) treated with curative intent between 2019 and 2024. Metastatic treatment response to pTNT was compared between patient groups based on RAS/RAF mutational status. Three-year disease free (DFS) and overall survival (OS) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy Stage IV rectal cancer patients were treated with curative intent and 49 had genetic testing available for inclusion. Among them, 27 (55.1%) patients had mutations (mRAS group) and 22 patients (44.9%) were wild-type (wtRAS group). mRAS patients were older than wtRAS patients (median 65.0 [60.0–71.0] vs. 55.5 years [39.0–69.25] respectively, <i>p</i> = 0.037). Synchronous metastases occurred more commonly in the liver than in the lungs (53.1% vs. 16.3%, <i>p = </i>0.014). Complete metastatic tumor response to TNT was demonstrated in half as many mRAS as wtRAS patients (22.2% vs. 40.9%, <i>p = </i>0.158) and disease progression was higher in patients harboring RAS mutations (37.0% vs. 22.7%, <i>p = </i>0.280), but neither were significant. Differences in 3-year DFS and OS between the two groups did not reach significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RAS/RAF mutations may negatively impact metastatic tumor response rates in curative Stage IV rectal cancer patients treated with pTNT. Larger scale studies are needed to verify these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":"22 6","pages":"817-829"},"PeriodicalIF":2.1,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajco.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single Center Review of Patients Undergoing High-Dose Chemotherapy for Relapsed Germ-Cell Tumors","authors":"Jared Millican,&nbsp;Tania Moujaber,&nbsp;Gaurav Sutrave,&nbsp;Howard Gurney","doi":"10.1111/ajco.70140","DOIUrl":"10.1111/ajco.70140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Germ cell tumors (GCTs) are the most significant cause of cancer-related morbidity and mortality among young males. High-dose chemotherapy (HDCT) has become an important component of the management of relapsed metastatic GCTs. The preferred HDCT regimen has changed over time, and the efficacy of these regimens has not been directly compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective case series of patients from 1997 to 2018 at a single center was analyzed for baseline characteristics, treatment regimen, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two patients received HDCT at this institution. Seven patients received conditioning with ifosfamide-carboplatin-etoposide (ICE), 10 patients received carboplatin-etoposide (CE), and five received other regimens, including busulfan-cyclophosphamide. Patients receiving ICE had a higher median International Prognostic Factor Study Group prognostic score compared to CE and the other regimens (3.0 vs. 1.5 vs. 2.0). Duration of admission was shorter with CE compared with ICE and the other regimens (21 days vs. 29 days vs. 28 days). Duration of neutropenia was shorter with CE and ICE compared with the other regimens (11 days vs. 12 days vs. 16.5 days). ICE was associated with a higher 12-month relapse-free survival (RFS) (71.4% vs. 40.0%) and 36-month overall survival (OS) (71.4% vs. 25.0%) than CE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>At this institution, patients receiving ICE as a conditioning regimen before autologous stem cell rescue appear to have a longer RFS and higher OS than those receiving CE. We consider the use of CE alone as a conditioning regimen to be inadequate, which supports our adoption of the more intense paclitaxel, ifosfamide-carboplatin, etoposide regimen as our standard.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":"22 6","pages":"830-839"},"PeriodicalIF":2.1,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“It Will Only Work If Everyone is on Board”: A Needs and Context Assessment to Inform Exercise Oncology Implementation Within a Public Healthcare Organisation","authors":"Georgia L. White,&nbsp;Mary A. Kennedy,&nbsp;Bryan A. Chan,&nbsp;Hattie Wright,&nbsp;Grace L. Rose","doi":"10.1111/ajco.70158","DOIUrl":"10.1111/ajco.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Exercise has well-established benefits across the cancer continuum for people living with and beyond cancer, yet the exercise oncology field faces a research-to-practice gap. Understanding the factors that influence implementation in any given context is essential to ensure implementation strategies have the greatest likelihood of success. The study mapped onsite exercise oncology services, staff-reported implementation barriers and facilitators, organisational readiness, and experiences reported by people living with or beyond cancer, across a large public healthcare organisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Staff and people living with and beyond cancer across cancer care centres within the public healthcare organisation completed an online survey. Data were analysed using descriptive statistics and manifest content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 10 regions, 115 participants completed the survey (59 staff and 56 people living with and beyond cancer). Although both groups valued and viewed exercise as important, organisation-wide and region-specific constraints were evident, particularly the absence of onsite exercise professionals and absent or unclear referral pathways. Among people living with and beyond cancer, 54% received an exercise discussion and 13% received a referral.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Across the organisation, strong support for exercise did not translate into action, as mainly outer and inner setting barriers restricted routine discussions, referrals and service delivery. Although regions within the same organisation shared several contextual factors, region-specific conditions that hindered or facilitated implementation were present. Findings reinforce that the development of implementation strategies and plans depends on a clear understanding of the context in which they will occur. These findings are informing an implementation plan in a pilot region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":"22 6","pages":"870-880"},"PeriodicalIF":2.1,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajco.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ki-67 Dynamics and Biomarker Conversion as Prognostic Factors in Residual Breast Cancer","authors":"Ömer Faruk Elçiçek,&nbsp;Eyyüp Çavdar,&nbsp;Özge Yalıcı,&nbsp;Ezel Gedik,&nbsp;Meltem Öznur,&nbsp;Yıldız Garip Bilen,&nbsp;İlker Karaduman,&nbsp;Okan Avcı,&nbsp;Erdoğan Selçuk Şeber","doi":"10.1111/ajco.70134","DOIUrl":"10.1111/ajco.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neoadjuvant chemotherapy (NAC) exerts selective pressure on tumor biology, frequently altering the expression of ER, PR, and HER2 in residual disease. While guidelines mandate re-biopsy to guide adjuvant therapy, whether these biomarker conversions represent a true prognostic deterioration or a manageable adaptation remains controversial. This study investigates the relative prognostic weight of biomarker conversion and proliferative dynamics (Ki-67) in determining patient survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 338 patients with invasive breast cancer who had residual disease following standard NAC and curative surgery. Paired biomarker status (pre-NAC vs. post-NAC) for ER, PR, HER2, and Ki-67 was evaluated. Adjuvant therapy was adapted according to the residual tumor profile, including targeted therapy for patients acquiring HER2 positivity. Survival outcomes were analyzed using Cox regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Biomarker conversion was substantial, with conversion rates of 13.9% for ER, 18% for PR, and 27% for HER2. However, despite this high frequency of receptor conversion, changes in receptor status (loss or gain) did not translate into statistically significant differences in disease-free survival (DFS) or overall survival (OS) (all <i>p</i> &gt; 0.05). In sharp contrast, Ki-67 dynamics emerged as the significant independent prognostic factor. Patients who converted from high-to-low proliferation (Ki-67 &lt; 18%) achieved significantly superior DFS (HR: 0.45, 95% CI: 0.24–0.84, <i>p</i> = 0.011) and OS (HR: 0.36, 95% CI: 0.15–0.85, <i>p</i> = 0.020) compared to those with persistent high expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While biomarker conversion is a frequent event in residual breast cancer, it does not compromise survival outcomes when adjuvant treatment is adjusted according to the post-NAC immunohistochemical (IHC) profile. Instead, prognosis is predominantly driven by the tumor's proliferative response. These findings suggest that persistent high Ki-67, rather than biomarker conversion, should be the primary marker for escalating adjuvant therapy and risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":"22 6","pages":"808-816"},"PeriodicalIF":2.1,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Retrospective Analysis of Daratumumab for Relapsed or Refractory Multiple Myeloma in Regional Australia","authors":"Benjamin Reardon,&nbsp;Ian Kerridge,&nbsp;Tasman Armytage","doi":"10.1111/ajco.70143","DOIUrl":"10.1111/ajco.70143","url":null,"abstract":"<p>Daratumumab is widely used for relapsed or refractory multiple myeloma, yet outcomes from regional Australian centers remain underreported. This retrospective study evaluated real-world treatment patterns between 2018 and 2023 and survival outcomes among patients receiving daratumumab-based therapy in two regional tertiary centers. Fifty-two patients were included. Median age was 74 years, and 59% had high-risk cytogenetics. Most patients received a combination of daratumumab, bortezomib, and dexamethasone (60%, 32). The overall response rate was 35%, including 10% complete responses and 25% very good partial responses. Median progression-free survival (PFS) was 13 months. Patients who received daratumumab at greater than first relapse had significantly longer PFS (hazard ratio 4.29, 95% confidence interval 1.94–9.47, <i>p</i> &lt; 0.001). Median overall survival (OS) was 27 months. Prior autologous stem cell transplantation was not associated with differences in PFS or OS. Daratumumab-based combinations were feasible in a regional setting and yielded meaningful clinical outcomes in an older cohort with a high proportion of adverse cytogenetics.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":"22 6","pages":"840-843"},"PeriodicalIF":2.1,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajco.70143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum 7-Year Follow-Up of a Prospective Phase II Trial of Preoperative S-1 Plus Oxaliplatin Chemotherapy for Clinical Stage III Gastric Cancer.","authors":"Sayuri Konishi, Dai Manaka, Yuji Yoshida, Shu Yamamoto, Kota Yamashita, Ryo Kudo, Michina Morioka, Ryo Takahashi, Daisuke Yamaguchi, Shigehiko Fujii","doi":"10.1111/ajco.70214","DOIUrl":"https://doi.org/10.1111/ajco.70214","url":null,"abstract":"<p><strong>Aim: </strong>We report long-term outcomes from a prospective Phase II trial of two cycles of preoperative S-1 plus oxaliplatin (SOX) chemotherapy in patients with clinical Stage III gastric cancer (GC), with at least 7 years of follow-up for all surviving patients.</p><p><strong>Methods: </strong>Patients received two cycles of preoperative SOX followed by laparoscopic D2 gastrectomy and postoperative adjuvant therapy. Overall survival (OS), relapse-free survival (RFS), treatment compliance, and clinically documented late adverse events were evaluated. Associations between clinicopathological factors and survival were explored using Kaplan-Meier analysis and the log-rank test.</p><p><strong>Results: </strong>Thirty-four patients were analyzed. Preoperative SOX completion was 100%, with clinical and pathological response rates of 73.5% and 58.8%, respectively. R0 resection was achieved in 97.1%, and adjuvant therapy was initiated in 94.1% and completed in 61.8%. At analysis, 18 patients had died and 16 remained alive; all survivors had at least 7 years of follow-up and none were lost to follow-up. Five-year OS and RFS were 61.8% and 58.8%, respectively. In exploratory analyses, ypN0-1 status and a preoperative neutrophil-to-lymphocyte ratio < 4.3 were associated with better OS and RFS. No severe treatment-related late adverse events were documented during routine follow-up, although late toxicities were not systematically assessed.</p><p><strong>Conclusion: </strong>Two-cycle preoperative SOX was highly feasible, with high treatment compliance and favorable long-term outcomes in this prospective single-arm cohort. Associations of ypN status and preoperative neutrophil-to-lymphocyte ratio with long-term outcomes were exploratory and require validation in larger comparative studies.</p><p><strong>Trial registration: </strong>UMIN000036139.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of CSF1R Inhibitors for Recurrent or Unresectable Tenosynovial Giant Cell Tumor: A Systematic Review and Meta-Analysis of Phase III Randomized Controlled Trials.","authors":"Mehmood Ahmad, Kanza Farhan, Anwar Ali Khan, Hanzala Amir, Muhammad Saad Hashmi, Muhammad Hammad Ali, Abdul Nafay Ali, Bismah Azam Ali, Amna Farhan, Ahmed Asad Raza","doi":"10.1111/ajco.70211","DOIUrl":"https://doi.org/10.1111/ajco.70211","url":null,"abstract":"<p><strong>Aim: </strong>Tenosynovial giant cell tumor (TGCT) is a rare, locally aggressive neoplasm driven by overexpression of colony-stimulating factor 1 (CSF1). We performed a meta-analysis of the efficacy and safety of CSF1 receptor inhibitors (CSF1Ri) versus placebo in recurrent or unresectable TGCT, defined as symptomatic disease for which surgery would cause worsening functional limitation or severe morbidity.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Scopus, Google Scholar, CENTRAL, and the ClinicalTrials.gov registry were searched from inception to March 25, 2026 for phase III randomized controlled trials (RCTs) comparing any CSF1Ri with placebo in adults with histologically confirmed TGCT. The primary outcome was objective response rate (ORR); secondary outcomes were physical function (PROMIS-PF), range of motion (ROM), pain, health-related quality of life (EQ-VAS), and Grade 3 or higher adverse events. Risk of bias (RoB 2) and certainty (GRADE) were assessed; estimates were pooled using random-effects models (RevMan 5.4.1), with fixed-effect, Hartung-Knapp-Sidik-Jonkman, risk-difference, and leave-one-out sensitivity analyses.</p><p><strong>Results: </strong>Three RCTs were included (ENLIVEN, MOTION, MANEUVER; n = 337), all at low risk of bias. CSF1Ri significantly improved ORR (RR 25.55 [95% CI 6.43-101.52]; risk difference 0.43 [0.36-0.50]), PROMIS-PF (MD 3.81 [2.28-5.34]), relative ROM (MD 11.43 [6.53-16.34] percentage points), and EQ-VAS (MD 7.63 [4.03-11.23]) (all I² = 0%, p < 0.001), and reduced pain (SMD -1.03 [-1.65 to -0.42]; p = 0.0009; I² = 76%). Grade 3 or higher adverse events were more frequent with CSF1Ri (RR 4.08 [2.31-7.21]; p < 0.001; I² = 0%). Certainty was high for functional outcomes, moderate for ORR and Grade 3 or higher adverse events, and low for pain.</p><p><strong>Conclusions: </strong>In recurrent or unresectable TGCT, CSF1Ri produce clinically meaningful improvements in tumor response, function, and quality of life compared with placebo, at the cost of more frequent severe adverse events, the nature of which differed between trials. The included trials did not compare agents directly, so the relative efficacy and safety of individual CSF1Ri remain uncertain.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Decision Support Interventions on Treatment Decision-Making in Patients With Prostate Cancer: A Systematic Review and Network Meta-Analysis.","authors":"Yue Wen, Yanqiu Li, Suhua Zheng, Juan Li, Xin Huang, Yaqian Zhang, Ying Jin","doi":"10.1111/ajco.70213","DOIUrl":"https://doi.org/10.1111/ajco.70213","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effectiveness of decision support interventions on treatment decision-making outcomes among men with prostate cancer.</p><p><strong>Methods: </strong>A systematic review of randomized controlled trials was conducted. Electronic databases were searched from inception to March 2026. Eligible studies evaluated decision support interventions delivered during the prostate cancer treatment decision-making phase, including booklet-based, digital, and multimodal formats. The primary outcome was decision conflict. Secondary outcomes included decision regret, knowledge, decision readiness, and psychological distress. Bayesian network meta-analysis and conventional pairwise meta-analysis were used to compare intervention effects.</p><p><strong>Results: </strong>Thirteen randomized controlled trials were included. Decision support interventions were categorized into three types: booklet-based, digital, and multimodal interventions. Network meta-analysis showed that booklet-based interventions reduced decision conflict (SMD = -0.98, 95% CI -1.60 to -0.24). No statistically significant effects were observed for decision regret or knowledge level. Pairwise meta-analysis showed that decision support interventions improved decision readiness but had limited effects on psychological distress.</p><p><strong>Conclusions: </strong>Decision support interventions showed outcome-specific effects in patients with prostate cancer facing treatment decisions, with booklet-based interventions providing the clearest signal for reducing decision conflict and overall interventions improving decision readiness. These findings support further evaluation of accessible, low-burden, and age-friendly decision support formats in prostate cancer treatment decision-making.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifocal Glioblastoma Managed With Primary Temozolomide as a Strategy to Delay Radiation Therapy: Clinical and Radiological Outcomes.","authors":"Chun Khai Loh, Helen Wheeler, Adrian Lee, Matthew Wong, Malmaruha Arasaratnam, Nicola Cove, Marina Kastelan, Michael Back","doi":"10.1111/ajco.70210","DOIUrl":"https://doi.org/10.1111/ajco.70210","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the clinical and radiological outcomes of upfront temozolomide (TMZ) monotherapy in deferring radiotherapy for multifocal glioblastoma (GBM).</p><p><strong>Methods: </strong>We analysed 18 consecutive adult patients with newly diagnosed, multifocal GBM treated with upfront TMZ monotherapy between 2016 and 2024. The primary endpoint was a 6-month progression-free survival (PFS). Secondary endpoints were overall survival (OS) and radiological tumor response.</p><p><strong>Results: </strong>The median age of the cohort was 69 years. The median follow-up was 12 months. Thirteen (72.2%) patients had O⁶-methylguanine-DNA methyltransferase (MGMT)-methylated tumors. Bi-hemispheric disease was present in 16 patients (88.9%) at baseline. Patients received a median of six TMZ cycles. Disease relapse occurred in 94.4% (n = 17) of cases, with 47.0% of failures involving distant sites. The 6-month PFS was 61% (95% CI: 42.3%-88.3%), and the median OS was 12.2 months (95% CI: 11.2-31.1). MGMT-methylated tumors demonstrated a significant volumetric reduction at 3 months compared to unmethylated cases (median -34.2% vs. +114.0%; p = 0.007). Survival outcomes trended in favour of the methylated cohort (6-month PFS 69.2% vs. 40.0%; median OS 12.3 vs. 11.2 months), though these associations did not reach statistical significance (p = 0.480).</p><p><strong>Conclusion: </strong>This study provides valuable insights into the use of primary TMZ as an exploratory strategy for short-term modulation in highly selected patients with extensive multifocal GBM. Whilst this approach facilitates a strategic delay in large-volume radiation, the high relapse rate underscores that upfront TMZ serves as a temporary window for deferring neurotoxicity rather than achieving durable disease control.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective Serotonin Receptor (5-HT3) Antagonist Prescribing in Cancer Inpatients: A Retrospective Clinical Audit.","authors":"Henshaw Corey, Matthew Gray, Kim Tam Bui, Anthony Linton","doi":"10.1111/ajco.70208","DOIUrl":"https://doi.org/10.1111/ajco.70208","url":null,"abstract":"<p><strong>Aim: </strong>Selective serotonin receptor (5-HT3) antagonists are first-line antiemetics for chemotherapy-induced, radiotherapy-induced, and post-operative nausea and vomiting; other causes of nausea in advanced cancer warrant alternative agents. We aimed to determine patterns of inpatient 5-HT3 antagonist prescribing and its guideline concordance.</p><p><strong>Methods: </strong>We retrospectively reviewed electronic medical records of all patients admitted under Medical Oncology at a single metropolitan hospital over 6 months who were prescribed a 5-HT3 antagonist. Data on demographics, cancer, and the prescription (agent, indication, prescriber, duration, administration) were extracted and reviewed for guideline concordance. Analyses were descriptive.</p><p><strong>Results: </strong>Of 210 patients admitted between January and June 2025, 81 (38.6%) were prescribed a 5-HT3 antagonist. Mean age was 64.2 years (range 24-87); 41 (50.6%) were female, and 62 (76.5%) had metastatic cancer. Of 137 prescriptions written, 134 (97.8%) were for ondansetron. Nausea was documented in 104 (75.9%), but a specific cause in only 55/104 (52.9%). The most common prescribers were Emergency (62, 45.3%) and After-Hours (32, 23.4%) doctors. Prescriptions were brief (median 1 day); 82 (59.9%) were administered at least once, and 62/82 (75.6%) were single-dose. Overall, 93 (67.9%) were non-concordant. Concordance was 10/14 (71.4%) in Medical Oncology, 20/21 (95.2%) in anesthetics and intensive care, 4/4 (100%) in Radiation Oncology, and 4/4 (100%) in Palliative Care, but 2/62 (3.2%) in Emergency and 4/32 (12.5%) in After-Hours prescribers.</p><p><strong>Conclusion: </strong>5-HT3 antagonists were frequently prescribed outside guideline recommendations, particularly by clinicians less familiar with cancer. Targeted education, electronic order-set redesign, and structured documentation of the suspected mechanism of nausea may improve guideline-concordant antiemetic prescribing.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}