British Journal of Cancer最新文献_第10页

Bayesian interim analysis and efficiency of phase III randomized trials. III期随机试验的贝叶斯中期分析和效率。

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-11 DOI: 10.1038/s41416-025-03156-5

Alexander D Sherry, Pavlos Msaouel, Avital M Miller, Timothy A Lin, Gabrielle S Kupferman, Joseph Abi Jaoude, Ramez Kouzy, Molly B El-Alam, Roshal Patel, Alex Koong, Christine Lin, Tomer Meirson, Zachary R McCaw, Ethan B Ludmir

{"title":"Bayesian interim analysis and efficiency of phase III randomized trials.","authors":"Alexander D Sherry, Pavlos Msaouel, Avital M Miller, Timothy A Lin, Gabrielle S Kupferman, Joseph Abi Jaoude, Ramez Kouzy, Molly B El-Alam, Roshal Patel, Alex Koong, Christine Lin, Tomer Meirson, Zachary R McCaw, Ethan B Ludmir","doi":"10.1038/s41416-025-03156-5","DOIUrl":"10.1038/s41416-025-03156-5","url":null,"abstract":"Background: Improving efficiency of phase III trials is paramount for reducing costs, hastening approvals, and mitigating exposure to disadvantageous randomizations. Compared to standard frequentist interim analysis, Bayesian early stopping rules may improve efficiency by the flexibility of differential priors for efficacy and futility coupled with evaluation of clinically meaningful effect sizes.Methods: Individual patient-level data from 184,752 participants across 230 randomized two-arm parallel oncology phase III trials were manually reconstructed from primary endpoint Kaplan-Meier curves. Accrual dynamics, but not patient outcomes, were randomly varied. Bayesian Cohen's κ assessed agreement between the original analysis and the Bayesian interim analysis.Results: Trial-level early closure was recommended based on the Bayesian interim analysis for 82 trials (36%), including 62 trials which had performed frequentist interim analysis and 33 which were already closed early by the frequentist interim analysis. Bayesian early stopping rules were 96% sensitive for detecting trials with a primary endpoint difference, and there was a high level of agreement in overall trial interpretation (κ, 0.95). Moreover, Bayesian interim analysis was associated with reduced enrollment.Conclusions: Bayesian interim analyses seem to improve trial efficiency by reducing enrollment requirements without compromising interpretation.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Why NHS hospital co-morbidity research may be wrong: how clinical coding fails to identify the impact of diabetes mellitus on cancer survival. 为什么NHS医院共发病研究可能是错误的：临床编码如何未能确定糖尿病对癌症生存的影响。

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-09 DOI: 10.1038/s41416-025-03136-9

K Zucker, C McInerney, A Glaser, P Baxter, G Hall

{"title":"Why NHS hospital co-morbidity research may be wrong: how clinical coding fails to identify the impact of diabetes mellitus on cancer survival.","authors":"K Zucker, C McInerney, A Glaser, P Baxter, G Hall","doi":"10.1038/s41416-025-03136-9","DOIUrl":"https://doi.org/10.1038/s41416-025-03136-9","url":null,"abstract":"Background: Significant volumes of research rely on secondary care diagnostic coding to identify comorbidities however little is known about its accuracy at a population level or if this influences subsequent analysis.Methods: Retrospective observational study utilising real world data for all cancers, prostate cancer and breast cancer patients diagnosed at Leeds Cancer Centre from 2005 and 2018. Three different data definitions were used to identify patients with diabetes in each cohort: (1) clinical coding alone, (2) HbA1c blood test alone (3) either clinical coding or abnormal HbA1c. Cohort characteristics, diagnosis dates and Cox derived survival was compared across diabetes definitions.Results: 123,841 cancer patients were identified including 13,964 with diabetes. Clinical coding failed to identify 14.6% of diabetic cancer patients with a temporal misclassification rate of 17.5%. Sole reliance on clinical coding overestimated the negative effect of DM on median survival across all cancers and 3.17 years in breast cancer.Discussion: Clinical coding provides inaccurate diabetes diagnosis date and detection resulting in meaningful differences in analytic outcomes. This supports the use of more detailed comorbidity data definitions. Results casts doubt over research reliant on hospital clinical coding alone and the generalisability of some comorbidity and frailty scoring systems.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

LMP2A regulates S901 phosphorylation of EphA2 to maintain EBV latent infection in gastric cancer. LMP2A调控EphA2的S901磷酸化维持EBV在胃癌中的潜伏感染。

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-09 DOI: 10.1038/s41416-025-03131-0

Duo Shi, Wen Liu, Lingling Sun, Xia Zhao, Mengwen Lv, Yan Zhang, Bing Luo

{"title":"LMP2A regulates S901 phosphorylation of EphA2 to maintain EBV latent infection in gastric cancer.","authors":"Duo Shi, Wen Liu, Lingling Sun, Xia Zhao, Mengwen Lv, Yan Zhang, Bing Luo","doi":"10.1038/s41416-025-03131-0","DOIUrl":"https://doi.org/10.1038/s41416-025-03131-0","url":null,"abstract":"Background: EBV infection is closely related to the occurrence and development of gastric cancer (GC). EphA2 is an important oncogenic protein in the progression of a variety of tumors. However, the relationship between EphA2 and EBV in EBV-associated GC (EBVaGC) remains unclear.Methods: Immunohistochemical and molecular experiments were performed to compare EphA2 expression between EBVaGC and EBV-negative gastric cancer (EBVnGC). The role of LMP2A in EphA2 expression was evaluated by transfection of LMP2A plasmid or siRNA. The S901 and Y772 phosphorylation site mutant plasmids of EphA2 were constructed to study their biological functions.Results: EphA2 expression was significantly downregulated in EBVaGC tissues and cell lines. LMP2A down-regulates EphA2 expression through the PI3K/AKT signaling pathway and autophagy pathway. pS901-EphA2 and pY772-EphA2 promote the malignant function of GC cells. In addition, pS901-EphA2 promotes the lytic reactivation of EBV by activating the JNK signaling pathway.Conclusions: Our data suggests that pS901-EphA2 and pY772-EphA2 play a role in the malignant characteristics of GC, and that pS901-EphA2 induced phosphorylation of JNK is a potential mechanism by which EphA2 promotes the lytic reactivation of EBV. LMP2A is involved in EBVaGC progression and maintenance of EBV latent infection by down-regulating EphA2 expression.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term cancer risk after kidney transplantation: a German primary care cohort study 肾移植后长期癌症风险：一项德国初级保健队列研究

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-08 DOI: 10.1038/s41416-025-03153-8

Karel Kostev, Bernhard MW Schmidt, Zhejia Tian

引用次数: 0

Oncogenic NFE2L2 mutations in plasma ctDNA and tumors are predictors and prognosticators of chemoradiation therapy in resectable esophageal squamous cell carcinoma 血浆ctDNA和肿瘤中致癌的NFE2L2突变是可切除食管鳞状细胞癌放化疗的预测因素和预后因素。

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-08 DOI: 10.1038/s41416-025-03113-2

Josephine Mun-Yee Ko, Chen Guo, Alvin Ka-Kiu Leung, Steve Chun-Yin Chan, Anthony Wing-Ip Lo, Lihua Tao, Hoi-Yan Ng, Carissa Wing-Yan Wong, Simon Law, Ian Yu-Hong Wong, Claudia Lai-Yin Wong, Fion Siu-Yin Chan, Kwan Kit Chan, Tsz Ting Law, Ka-On Lam, Dora Lai-Wan Kwong, Wei Dai, Alfred King-Yin Lam, Maria Li Lung

{"title":"Oncogenic NFE2L2 mutations in plasma ctDNA and tumors are predictors and prognosticators of chemoradiation therapy in resectable esophageal squamous cell carcinoma","authors":"Josephine Mun-Yee Ko, Chen Guo, Alvin Ka-Kiu Leung, Steve Chun-Yin Chan, Anthony Wing-Ip Lo, Lihua Tao, Hoi-Yan Ng, Carissa Wing-Yan Wong, Simon Law, Ian Yu-Hong Wong, Claudia Lai-Yin Wong, Fion Siu-Yin Chan, Kwan Kit Chan, Tsz Ting Law, Ka-On Lam, Dora Lai-Wan Kwong, Wei Dai, Alfred King-Yin Lam, Maria Li Lung","doi":"10.1038/s41416-025-03113-2","DOIUrl":"10.1038/s41416-025-03113-2","url":null,"abstract":"The poor prognosis of resectable esophageal squamous cell carcinoma (ESCC) poses an unmet need to identify early predictive and prognostic genomic biomarkers to improve treatment outcome and risk stratification. Mutational profiling was performed for 171 ESCC patients receiving curative neoadjuvant chemoradiation treatment (nCRT). The discovery cohort included 100 ESCC formalin-fixed paraffin-embedded (FFPE) tumor specimens; the validation FFPE cohort consisted of serial ctDNA samples from 71 patients. The discovery cohort identified hot-spot oncogenic NFE2L2 mutations exclusively localized at DLG and ETGE KEAP1-binding motifs in poor responders associated with incomplete pathological response (P = 0.004). Patients with NFE2L2 mutations in two independent FFPE cohorts had about 2-fold higher risk of death and recurrence. Serial ctDNA analysis further demonstrated oncogenic NFE2L2 mutations detected at post-nCRT were independent prognosticators for recurrence (HR = 5.90; P = 0.005) and survival (HR = 4.75; P = 0.013). Risk stratification based on pathological T and N stages, positive FFPE (HR = 4.50) and ctDNA NFE2L2 mutations (HR = 8.50) identified high-risk groups for recurrence (P = 0.001). Combined FFPE and ctDNA NFE2L2 mutation status predicted nCRT responses (P = 0.05) by ROC analysis. Tracking oncogenic NFE2L2 mutations at pre-treatment and post-surgery or serial ctDNA monitoring during treatment are useful nCRT predictors and independent prognosticators of survival for locally advanced ESCC.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":"133 7","pages":"1046-1055"},"PeriodicalIF":6.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physiological and psychological symptom management based on electronic patient-reported outcomes: the TD-WELLBEING randomized clinical trial 基于电子患者报告结果的生理和心理症状管理：TD-WELLBEING随机临床试验。

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-07 DOI: 10.1038/s41416-025-03110-5

Pengyu Jing, Ying Liang, Zhijun Tan, Xiaolong Yan, Jie Lei, Yunfeng Ni, Ximing Zhu, Chun Qiu, Jian Wang, Peng Ge, Yong Zhang, Lv Wang, Nan Zhao, Yong Zhang, Juan Wang, Yan Wang, Chunlong Zheng, Qiongjie Shao, Haiyue Zhang, Zhe Yang, Haichao Li, Jiangjiang Fan, Siming Liu, Kyriacos Kyriacou, Lei Shang, Zhongping Gu

{"title":"Physiological and psychological symptom management based on electronic patient-reported outcomes: the TD-WELLBEING randomized clinical trial","authors":"Pengyu Jing, Ying Liang, Zhijun Tan, Xiaolong Yan, Jie Lei, Yunfeng Ni, Ximing Zhu, Chun Qiu, Jian Wang, Peng Ge, Yong Zhang, Lv Wang, Nan Zhao, Yong Zhang, Juan Wang, Yan Wang, Chunlong Zheng, Qiongjie Shao, Haiyue Zhang, Zhe Yang, Haichao Li, Jiangjiang Fan, Siming Liu, Kyriacos Kyriacou, Lei Shang, Zhongping Gu","doi":"10.1038/s41416-025-03110-5","DOIUrl":"10.1038/s41416-025-03110-5","url":null,"abstract":"One-third of all lung cancer cases globally are reported in China. This study evaluated the symptom management efficacy of an electronic patient-reported outcomes (ePRO)-based intervention for postoperative symptoms like pain and psychological distress after lung cancer surgery. We included lung cancer surgery patients (April 2022–October 2023; age, 18–75 years) with ECOG scores of 0–2 and expected survival of >6 months and randomized them into control and intervention groups. The latter completed MDASI-LC and QLQ-C30 questionnaires, wherein high symptom scores prompted treatment recommendations; the former received routine care. Changes in symptom scores, daily function, and quality of life were evaluated over 12 weeks and 1 year through surveys and interviews for ePRO-based symptom management efficacy assessments. Herein, 355 participants comprised intervention (n = 182) and control groups (n = 173). At 12 weeks, the former had significantly lower symptoms threshold [0 (0–1) vs. 1 (0–3)], lower symptom scores [adjusted mean difference, −0.527 (95% CI: −0.788 to −0.266)], and higher QOL scores (emotional function: 2.908; 95% CI: 0.600–5.216, P = 0.014; global health: 6.775; 95% CI: 3.967–9.583). ePRO-based collaborative management effectively lessened postoperative burden and improved QOL beyond 6 months.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":"133 7","pages":"937-944"},"PeriodicalIF":6.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41416-025-03110-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Isoform-level analyses of 6 cancers uncover extensive genetic risk mechanisms undetected at the gene-level 6种癌症的异构体水平分析揭示了在基因水平上未被发现的广泛的遗传风险机制。

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-07 DOI: 10.1038/s41416-025-03141-y

Yung-Han Chang, Sean T. Bresnahan, S. Taylor Head, Tabitha A. Harrison, Yao Yu, Chad D. Huff, Bogdan Pasaniuc, Sara Lindström, Arjun Bhattacharya

{"title":"Isoform-level analyses of 6 cancers uncover extensive genetic risk mechanisms undetected at the gene-level","authors":"Yung-Han Chang, Sean T. Bresnahan, S. Taylor Head, Tabitha A. Harrison, Yao Yu, Chad D. Huff, Bogdan Pasaniuc, Sara Lindström, Arjun Bhattacharya","doi":"10.1038/s41416-025-03141-y","DOIUrl":"10.1038/s41416-025-03141-y","url":null,"abstract":"Integrating genome-wide association study (GWAS) and transcriptomic datasets can identify mediators for genetic risk of cancer. Traditional methods often are insufficient as they rely on total gene expression measures and overlook alternative splicing, which generates different transcript-isoforms with potentially distinct effects. We integrate multi-tissue isoform expression data from the Genotype Tissue-Expression Project with GWAS summary statistics (all N > ~20,000 cases) to identify isoform- and gene-level associations with six cancers (breast, endometrial, colorectal, lung, ovarian, prostate) and six related cancer subtype classifications (N = 12 total). Directly modeling isoforms using transcriptome-wide association studies (isoTWAS) significantly improves discovery of genetic associations compared to gene-level approaches, identifying 164% more significant associations (6163 vs. 2336) with isoTWAS-prioritized genes enriched 4-fold for evolutionarily-constrained genes. isoTWAS tags transcriptomic associations at 52% more independent GWAS loci across the six cancers. Isoform expression mediates an estimated 63% greater proportion of cancer risk SNP heritability compared to gene expression. We highlight several isoTWAS associations that demonstrate GWAS colocalization at the isoform level but not at the gene level, including CLPTM1L (lung cancer), LAMC1 (colorectal), and BABAM1 (breast). These results underscore the importance of modeling isoforms to maximize discovery of genetic risk mechanisms for cancers.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":"133 6","pages":"874-885"},"PeriodicalIF":6.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41416-025-03141-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of risk-based screening for upper gastrointestinal cancers: a multi-center real-world study 基于风险的上消化道癌症筛查的效果：一项多中心真实世界研究

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-05 DOI: 10.1038/s41416-025-03138-7

Hongrui Tian, Mengfei Liu, Zhen Liu, Chao Shi, Lei Chen, Yine Zhang, Mei Li, Xiaoli Li, Yincheng Ma, Xiaoming Ma, Yingying Liang, Ruichun Shi, Hongli Liu, Hongchen Zheng, Wenlei Yang, Yaqi Pan, Huanyu Chen, Jinhan Lv, Zhonghu He, Yang Ke

{"title":"Effect of risk-based screening for upper gastrointestinal cancers: a multi-center real-world study","authors":"Hongrui Tian, Mengfei Liu, Zhen Liu, Chao Shi, Lei Chen, Yine Zhang, Mei Li, Xiaoli Li, Yincheng Ma, Xiaoming Ma, Yingying Liang, Ruichun Shi, Hongli Liu, Hongchen Zheng, Wenlei Yang, Yaqi Pan, Huanyu Chen, Jinhan Lv, Zhonghu He, Yang Ke","doi":"10.1038/s41416-025-03138-7","DOIUrl":"10.1038/s41416-025-03138-7","url":null,"abstract":"To evaluate the feasibility, effectiveness, and cost-effectiveness of risk-based sequential screening for upper gastrointestinal (UGI) cancer via questionnaire-based quantitative models. We applied the risk-based screening strategy to the ongoing government-administered screening project in two areas (Longde and Litong) of Ningxia Hui Autonomous Region, China. Through epidemiological investigation, participants assessed as high-risk were invited for endoscopic screening. A total of 9492 participants were enroled and completed questionnaire-based assessment, and 2552 (26.89%) participants were evaluated as high-risk. Among the high-risk subjects, 1198 (46.94%) individuals further received endoscopic examination. The detection rate of risk-based screening was 2.28 times as high as that of historical data of universal screening (p = 0.002) (Longde: 2.15% vs. 0.99%; Litong: 1.18% vs. 0.38%), with a similar early detection rate of ~60–70%. The average cost for detecting one case and the average cost for detecting one early case were 30.76% lower (Longde: $12,919 vs. $16,783; Litong: $21,836 vs. $45,512) and 28.99% lower (Longde: $20,993 vs. $24,475; Litong: $30,570 vs. $75,854), respectively, than those for universal screening. This real-world, multi-centre study demonstrates that risk-based sequential screening is feasible and cost-effective in detecting UGI cancers, and is expected to be applied in other areas.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":"133 7","pages":"1038-1045"},"PeriodicalIF":6.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Moving beyond cytotoxicity in cancer immunotherapy: embracing tumor microenvironment remodeling for durable control. 在癌症免疫治疗中超越细胞毒性：拥抱肿瘤微环境重塑以实现持久控制。

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-08-04 DOI: 10.1038/s41416-025-03133-y

Nicholas Koelsch, Masoud H Manjili

{"title":"Moving beyond cytotoxicity in cancer immunotherapy: embracing tumor microenvironment remodeling for durable control.","authors":"Nicholas Koelsch, Masoud H Manjili","doi":"10.1038/s41416-025-03133-y","DOIUrl":"10.1038/s41416-025-03133-y","url":null,"abstract":"The quest for a curative cancer immunotherapy remains elusive, hindered by a longstanding focus on tumor cell elimination through cytotoxic mechanisms. However, mounting evidence points to an underappreciated dimension of immune function: its capacity for tissue remodeling and homeostasis, which can shape a tumor-inhibitory microenvironment. This perspective review highlights the adaptation model of immunity, which reframes the immune response as a dual force capable of both preserving and disrupting tissue integrity. Central to this model is Signal IV, a novel pathway in which self-reactive immune cells interact with adaptation receptors (AdRs) on tissue cells through adaptation ligands (AdLs) on immune cells. This interaction activates anti-apoptotic pathways in target cells, enabling immune responses to promote tissue survival and homeostasis even in the presence of cytotoxic mediators. Crucially, the downregulation of AdRs in stromal cells, while preserved in malignant cells, creates a tumor-promoting microenvironment, whereas the reverse fosters tumor rejection. This paradigm challenges conventional approaches by shifting the focus from tumor cell destruction to restoring tissue integrity, offering a revolutionary framework for immunotherapy. By targeting the AdR-AdL axis to reprogram the tumor microenvironment, the adaptation model proposes a transformative strategy for harnessing immune responses to achieve durable cancer control.","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Randomised phase-2 screening trial of intermittent energy restriction plus resistance exercise versus resistance exercise alone during chemotherapy for advanced breast cancer 晚期乳腺癌化疗期间间歇性能量限制加阻力运动与单独阻力运动的随机2期筛选试验

IF 6.8 1区医学

British Journal of Cancer Pub Date : 2025-07-31 DOI: 10.1038/s41416-025-03129-8

Michelle Harvie, Mary Pegington, Anthony Howell, Yit Lim, Karen Livingstone, Danielle Rose, Debbie McMullan, Anthony Maxwell, Emma Barrett, Katharine Sellers, Suzanne Krizak, Sacha J. Howell

{"title":"Randomised phase-2 screening trial of intermittent energy restriction plus resistance exercise versus resistance exercise alone during chemotherapy for advanced breast cancer","authors":"Michelle Harvie, Mary Pegington, Anthony Howell, Yit Lim, Karen Livingstone, Danielle Rose, Debbie McMullan, Anthony Maxwell, Emma Barrett, Katharine Sellers, Suzanne Krizak, Sacha J. Howell","doi":"10.1038/s41416-025-03129-8","DOIUrl":"10.1038/s41416-025-03129-8","url":null,"abstract":"Weight control and energy restriction could improve survival in patients with advanced breast cancer (ABC) but randomised data are lacking. A randomised screening trial was conducted to assess an intermittent energy restricted diet and resistance exercise intervention (IER + RE) vs RE alone (RE) on progression free survival (PFS), toxicity and Quality of Life (QoL) during chemotherapy for ABC. Sixty-eight women were randomised to IER + RE (n = 35) or RE (n = 33) with one-sided significance assessed at the 20% threshold. The primary end point was PFS secondary endpoints included chemotherapy toxicity, weight change and QoL. The adjusted hazard rate for progression comparing IER + RE vs RE was 0.729 (0.391–1.361) and the median PFS 42.0 vs 26.1 weeks respectively (p = 0.160). Toxicity was low and comparable between groups. Comparing IER + RE vs RE alone at cycle 3 the median (interquartile range) changes were: weight –1.8 kg (–4.2 to –0.7) vs +0.2 kg (–0.74, 2.59) (p < 0.001), FACT-B + 4.0 (–0.8, 11) vs +1.0 (–4.0, 4.0) (p = 0.031) and Hospital Anxiety Depression Score –2.0 (–3.5, +0.5) vs +1.0 (–2, 3.5) (p = 0.022). IER + RE improved PFS and QoL without evidence of harms warranting a further larger randomised study in ABC. https://www.isrctn.com/ISRCTN12841416 .","PeriodicalId":9243,"journal":{"name":"British Journal of Cancer","volume":"133 7","pages":"1010-1019"},"PeriodicalIF":6.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41416-025-03129-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0