Chinese clinical oncology最新文献

{"title":"Epidemiology, biomarkers, and therapeutic approach in early-stage biliary tract cancers.","authors":"Christie Hung, Jerry Kong, Andrew Li, Jennifer Wu","doi":"10.21037/cco-25-103","DOIUrl":"10.21037/cco-25-103","url":null,"abstract":"<p><p>Biliary tract cancer (BTC) represents a heterogeneous group of malignancies, including intrahepatic, perihilar, and distal cholangiocarcinoma, as well as gallbladder cancer. Surgical resection is the only potential curative treatment for early-stage BTC, though outcomes with surgery alone were poor, with high rates of recurrence. In recent years, studies of adjuvant chemotherapy with capecitabine or S-1 have shown improved survival compared to postoperative observation alone. Ongoing clinical trials are incorporating multiple treatment modalities, including radiotherapy, immunotherapy, and targeted therapy. For instance, building on the success of chemo-immunotherapy in the metastatic setting, trials are testing similar designs as adjuvant treatment. The utility of targeted therapies against genetic alterations like FGFR2, IDH1, KRAS, HER2, and SMAD4 in advanced BTC has also spurred exploration of targeted therapy for early-stage BTCs. Various treatment regimens are now also being tested in the neoadjuvant treatment and perioperative setting. The goal of these treatment strategies is to improve surgical outcomes and identify new modalities to reduce recurrence rates of early-stage BTCs. This review provides an overview of the current management landscape of early-stage BTC, presenting the epidemiology and risk factors, reviewing the current management paradigm, and highlighting emerging therapeutic strategies.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 1","pages":"8"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375810","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":"First-line zolbetuximab plus mFOLFOX6 in claudin-18 isoform 2-positive gastric and gastroesophageal junction adenocarcinoma: positioning SPOTLIGHT in the immunotherapy era.","authors":"Shigenori Kadowaki","doi":"10.21037/cco-2025-1-167","DOIUrl":"https://doi.org/10.21037/cco-2025-1-167","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 1","pages":"15"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375903","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":"The present and the future of urological management of prostate cancer.","authors":"Davide Campobasso, Stefano Puliatti, Stefania Ferretti","doi":"10.21037/cco-2025-1-138","DOIUrl":"https://doi.org/10.21037/cco-2025-1-138","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 1","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376149","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":"Preventing unplanned \"whoops\" sarcoma surgery: from technical pearls to early referral and network-level quality metrics.","authors":"Bruno Fuchs, Georg Schelling, Ruben Jaeger","doi":"10.21037/cco-25-122","DOIUrl":"https://doi.org/10.21037/cco-25-122","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"15 1","pages":"17"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376171","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":"Comparison of two validated nomograms in patients with localized soft tissue sarcoma of the extremities and trunk wall.","authors":"Tadashi Iwai, Kiyohito Takamatsu, Sho Dohzono, Hidetomi Terai","doi":"10.21037/cco-25-115","DOIUrl":"https://doi.org/10.21037/cco-25-115","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"14 6","pages":"77"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910736","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":"Nonsurgical hepatocellular carcinoma treated with selective internal radiation therapy and personalized dosimetry: real-life data from French centers.","authors":"Louis Carmarans, Claude Somma, Victoria Ramdour, Olivier Durieux, Alexia Gonzalez, Patrick Chevallier, Guillaume Pénaranda, Margaux Caviezel, Olivia Pietri, Floriane Sellier, Paul Castellani, Albert Tran, Marc Bourlière, René Gerolami, Rodolphe Anty, Xavier Adhoute","doi":"10.21037/cco-25-72","DOIUrl":"10.21037/cco-25-72","url":null,"abstract":"<p><strong>Background: </strong>How selective internal radiation therapy (SIRT) with personalized dosimetry fits with intermediate and advanced hepatocellular carcinoma (HCC) treatment remains unclear. The aims of our study were to investigate the efficacy and safety of SIRT in real-life settings within a nonsurgical HCC population and to identify prognostic factors for survival.</p><p><strong>Methods: </strong>From January 2019 to December 2023, 73 consecutive HCC patients who underwent SIRT with personalized dosimetry at three French centers were retrospectively analyzed. A post-matched comparison with a large single-center cohort of HCC patients (n=1,049) enrolled from January 2007 to December 2023 and treated with other therapeutic modalities was performed. Overall survival (OS) was compared between the two patient groups.</p><p><strong>Results: </strong>Patients treated with SIRT had mostly Child-Pugh (CP) grade A cirrhosis and multifocal and unilobar HCCs, which were classified as Barcelona Clinic Liver Cancer (BCLC) stage B or C with vascular invasion (49%) or metastases (5%). SIRT was a first-line therapy in half of the patients and was used in combination for nearly one-quarter of the patients. In total, 94% of the patients received a tumor dose of 205 Gy or higher. After a median follow-up of 11.9 (6.2-21.1) months, 53% of patients treated with SIRT died. Stage B and C HCC patients had median OS times of 35.2 (6.5-infinite) and 12.8 (6.8-infinite) months, respectively. A comparative analysis of the two cohorts revealed the superiority of SIRT in terms of OS for advanced-stage HCCs with unilateral intrahepatic portal vein tumor thrombosis and the similarity of SIRT for intermediate-stage HCCs compared with other modalities. No significant difference in OS was observed after matching BCLC B/C HCC patients who received SIRT with those who did not after a median follow-up of approximately 12 months. The independent prognostic variables for survival following SIRT therapy were CP grade, largest tumor size and hemoglobin level. No deaths occurred in the SIRT group.</p><p><strong>Conclusions: </strong>This study revealed that SIRT following personalized dosimetry is used in current practice as a therapeutic solution for advanced and intermediate HCC, typically in combination therapies and beyond first-line treatment. Our results support SIRT as an alternative therapeutic option for intermediate-stage HCC and as an effective therapeutic solution for advanced HCC with intrahepatic vascular invasion, with a good safety profile.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"66"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803226","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":"Gleason score discrepancies between prostate biopsy and radical prostatectomy in prostate cancer patients: a retrospective single-center analysis.","authors":"Yuhan Chen, Jun Luo, Qifei Dong, Tao Zhou, Changming Wang, Jun Xiao","doi":"10.21037/cco-25-21","DOIUrl":"https://doi.org/10.21037/cco-25-21","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is one of the leading malignancies in males worldwide. Accurate assessment of Gleason scores (GSs) preoperatively is critical for making appropriate treatment decisions. However, GS discrepancies between biopsy and post-surgery pathology are common. This study aimed to evaluate the incidence of GS upgrading and downgrading and to identify related clinical and pathological factors. Understanding the clinical and pathological factors associated with GS upgrading and downgrading is essential to enhance predictive accuracy and optimize PCa management.</p><p><strong>Methods: </strong>This study retrospectively analyzed 218 PCa patients diagnosed by transperineal prostate biopsy and subsequent treated with radical prostatectomy from January 2021 to February 2024. Patients were categorized into upgrading, downgrading, or concordant groups based on GS comparisons. Univariate analysis was adopted to identify predictive factors.</p><p><strong>Results: </strong>Among the 218 patients included in this study, 80 (36.7%) exhibited pathological upgrading postoperatively, 39 (17.9%) showed pathological downgrading, and 99 (45.4%) maintained consistent pathological results. Pathological upgrading was more frequently observed in patients with a biopsy GS 3+3 (P<0.001) and was associated with the total number of biopsy cores (P=0.043). In contrast, pathological downgrading was more common in patients with biopsy GS 4+3, 5+3, 3+5, or 4+4 (P=0.03) and correlated with the number of positive biopsy cores (P=0.03) and the positive core percentage (P=0.02). Most discrepancies involved ±1 grade group shifts (89, 40.8%), with ≥2 grade group changes occurring in only 13.8% of cases. For patients with GS 3+3 in biopsy, univariate analysis revealed that prostate-specific antigen (PSA), PSA density (PSAD), and the total number of biopsy cores were factors influencing pathological upgrading. Furthermore, 7 (9.8%) of upgraded GS 3+3 cases presented with locally advanced PCa vs. 0% in non-upgraded patients.</p><p><strong>Conclusions: </strong>These findings highlight significant limitations of pre-surgery biopsy-based grading evaluation. The high rate of upgrading or downgrading suggests current risk stratification systems may underestimate or overestimate clinical impact. This study identified several variables that may assist clinicians in accurately determining the true pathological GS of PCa. This may help to optimize clinical-decisions and improving cancer-specific outcomes in Chinese PCa patients.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"14 6","pages":"68"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910716","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":"Radiation therapy in the era of precision medicine: a narrative review.","authors":"Yingqi Gu, Yujin Peng, Xiaofang Li","doi":"10.21037/cco-25-59","DOIUrl":"10.21037/cco-25-59","url":null,"abstract":"<p><strong>Background and objective: </strong>Radiotherapy (RT) not only induces lethal DNA damage in tumor cells but also modulates the tumor immune microenvironment (TIME). It enhances the release of pro-inflammatory mediators and promotes infiltration of cytotoxic immune cells. However, RT can also lead to the accumulation of immunosuppressive cells, such as M2 macrophages, myeloid-derived suppressor cells (MDSCs), and regulatory T cells (Tregs), which may contribute to an immunosuppressive milieu. In this review, we aim to delineate the principal issues pertaining to the immunoregulatory effects of RT.</p><p><strong>Methods: </strong>A PubMed search was conducted for articles from the past decade using the terms: (radiation therapy or conformal radiotherapy) AND (immunogenic cell death, cyclic GMP-AMP synthase, tumor immune microenvironment, anoxia, immune checkpoint inhibition, or low-dose radiotherapy).</p><p><strong>Key content and findings: </strong>This review provides a comprehensive analysis of the immunostimulatory effects of RT, emphasizing its ability to induce immunogenic cell death (ICD), activate the cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) pathway, and modulate immune cell populations within the tumor microenvironment (TME). It also explores how different radiation doses, fractionation schemes, and planning parameters influence these biological effects. Importantly, conformal RT remains integral to cancer treatment by enabling the delivery of higher radiation doses precisely to tumors while sparing surrounding healthy tissues.</p><p><strong>Conclusions: </strong>RT exerts anti-tumor effects by triggering ICD, activating the cGAS/STING signaling pathway, and reshaping the TIME. These effects vary depending on radiation dose and fractionation. Conformal RT optimizes therapeutic outcomes by targeting tumors with high precision, minimizing toxicity to normal tissues.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"75"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803271","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":"Patient-reported outcomes in LITESPARK-005: a timely step toward patient-centered metrics in advanced renal cell carcinoma.","authors":"Firas Hatoum, Brandon Dyer, Nadine Mahmoud, Houssein Safa, Jad Chahoud","doi":"10.21037/cco-25-97","DOIUrl":"10.21037/cco-25-97","url":null,"abstract":"","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":" ","pages":"78"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720862","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 apatinib for the treatment of extensive-stage small cell lung cancer in Chinese patients: a single-arm systematic review and meta-analysis.","authors":"Tingting Nan, Ruina Cai, Siheng Lian, Xiaohong Wu, Xianni Wei, Xiaoyun Ye, Yumei Cai, Yonglong Su, Jinbao Wei","doi":"10.21037/cco-25-34","DOIUrl":"https://doi.org/10.21037/cco-25-34","url":null,"abstract":"<p><strong>Background: </strong>At present, the prognosis for patients with extensive-stage small cell lung cancer (ES-SCLC) has remained poor. If standard treatment for ES-SCLC fails, these patients face rapid disease progression and high mortality. Thus, current treatment strategies are limited, and new treatments are urgently needed. Apatinib, a novel tyrosine kinase inhibitor (TKI) specifically targeting vascular endothelial growth factor receptor-2 (VEGFR-2), has been increasingly reported as a treatment for ES-SCLC, showing different clinical efficacy and related adverse reactions. Therefore, we performed this meta-analysis on existing studies to evaluate the efficacy and safety of apatinib in patients with ES-SCLC.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Embase, Web of Science (WOS), and the Cochrane Central Register of Controlled Trials were searched for related studies. The main outcomes were objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS), and adverse events (AEs). Methodological Index for Non-Randomized Studies (MINORS) and Joanna Briggs Institute (JBI) were adopted for quality assessment, and STATA 16.0 for data analysis.</p><p><strong>Results: </strong>This single-arm meta-analysis included 13 studies involving 489 Chinese patients with ES-SCLC treated with apatinib. Given substantial heterogeneity, random-effects models were used throughout. Subgroup analyses were performed by apatinib treatment line (first-line vs. second-line/later) and regimen type (monotherapy vs. combination therapy). The results of subgroup analysis showed that the ORR, DCR, median OS (mOS), and median PFS (mPFS) of apatinib used as first-line therapy (combination therapy or maintenance therapy) were 71%, 88%, 14.52 months, and 4.09 months, respectively. For second-line and beyond, the combined ORR was 17%, DCR was 82%, mOS was 8.01 months, and mPFS was 4.34 months. The ORR, DCR, and mPFS were superior when apatinib was combined with chemotherapy or immunotherapy compared to apatinib monotherapy (ORR: 43% vs. 17%, DCR: 87% vs. 82%, mPFS: 4.52 vs. 4.13 months), while there was no significant difference in mOS between the two groups (8.82 vs. 9.29 months). The primary AEs of apatinib included hypertension (45%), hand-foot syndrome (33%), proteinuria (31%), fatigue (30%), and anemia (31%). Only neutropenia (12%) and hypertension (11%) had grade 3 or higher AEs occurring at a rate exceeding 10%.</p><p><strong>Conclusions: </strong>Apatinib has shown promising efficacy and tolerability in the treatment of ES-SCLC. Compared with monotherapy, apatinib combined with chemotherapy or immunotherapy may offer enhanced therapeutic benefits.</p>","PeriodicalId":9945,"journal":{"name":"Chinese clinical oncology","volume":"14 6","pages":"67"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910705","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}