Clinical oncology最新文献

{"title":"Neoadjuvant Chemotherapy and Low Dose Immunotherapy in Resectable Non-small Cell Lung Cancer: A Multi-center Retrospective Cohort Analysis","authors":"M. Shah , V. Noronha , S. Rajamanickam Kulandaivel , B. Poladia , D. Niyogi , N. Menon , R. Kaushal , O. Shetty , T. Pai , A. Tibdewal , M. Vora , D. Shah , D. Vora , S. Shah , S. Goud , A. Shah , K. Maske , A. Shetake , K. Prabhash","doi":"10.1016/j.clon.2025.103795","DOIUrl":"10.1016/j.clon.2025.103795","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"41 ","pages":"Article 103795"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Head and Neck Squamous Cell Carcinoma With N3 Nodal Disease","authors":"L. Wang ,&nbsp;M. Ingle ,&nbsp;L. Oo ,&nbsp;A. Bains ,&nbsp;F. Lam ,&nbsp;A. James ,&nbsp;C. Podesta ,&nbsp;J. Virk ,&nbsp;Z. Awad ,&nbsp;D. Gujral","doi":"10.1016/j.clon.2025.103794","DOIUrl":"10.1016/j.clon.2025.103794","url":null,"abstract":"<div><h3>Aims</h3><div>Radical management of the N3 neck for head and neck squamous cell cancer (HNSCC) remains unclear. We aimed to investigate the use of primary surgery including neck dissection versus primary radiotherapy followed by imaging.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed consecutive patients with HNSCC and N3 nodal disease, excluding nasopharyngeal primaries. Patients had either surgical management of the primary and neck dissection followed by postoperative radiotherapy or primary radiotherapy followed by surveillance if complete response was found on post-treatment imaging. Patients were imaged at a mean of 16 weeks post radiotherapy. Patients identified with presence of resectable residual disease on imaging were treated with neck dissection.</div></div><div><h3>Results</h3><div>Between July 2012 and February 2023, 53 patients with T0-4N3M0 HNSCC were treated radically. The median (range) follow-up was 25.5 (3-146) months, with an opportunity for follow-up of 64 (19-147) months. Twenty-two patients had primary surgical management and 31 had primary radiotherapy. Two-year overall survival was 64% in patients treated with primary surgery, 55% in patients treated with primary radiotherapy, 87% in patients with complete response after radiotherapy, and 92% in complete responders who were p16 positive. Response assessment was done with positron emission tomography-computed tomography (PET-CT) in 77% of patients and predicted subsequent disease-free survival better than computed tomography (CT). p16-positive patients were more likely to achieve complete response (63% vs 25%), but extracapsular spread was not predictive of response.</div></div><div><h3>Conclusion</h3><div>Surveillance for patients with complete response on postradiotherapy PET-CT is a reasonable approach, especially for p16-positive patients, sparing them the morbidity of neck dissection. Patients with p16-negative disease are less likely to achieve a complete response and may be better managed with primary neck dissection.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"41 ","pages":"Article 103794"},"PeriodicalIF":3.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RCR meetings","authors":"","doi":"10.1016/S0936-6555(25)00045-7","DOIUrl":"10.1016/S0936-6555(25)00045-7","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"39 ","pages":"Article 103790"},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"YCLON Journals Advert 15 January 25_01","authors":"","doi":"10.1016/S0936-6555(25)00046-9","DOIUrl":"10.1016/S0936-6555(25)00046-9","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"39 ","pages":"Article 103791"},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mammary Mucoepidermoid Carcinomas: A Population-Based Analysis","authors":"P. Loap,&nbsp;Y. Kirova","doi":"10.1016/j.clon.2025.103792","DOIUrl":"10.1016/j.clon.2025.103792","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103792"},"PeriodicalIF":3.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Long-term Survival Outcomes and Prognostic Factors in Adult grade 4 Astrocytoma: An Institutional Analysis","authors":"K. Narang,&nbsp;T. Kataria,&nbsp;S.S. Bisht,&nbsp;D. Gupta,&nbsp;S. Banerjee,&nbsp;M. Mayank,&nbsp;S. Shishak,&nbsp;V. Kaliyaperumal,&nbsp;S. Tamilselvan,&nbsp;D. Kamaraj,&nbsp;S. Abraham","doi":"10.1016/j.clon.2025.103788","DOIUrl":"10.1016/j.clon.2025.103788","url":null,"abstract":"<div><h3>Aims</h3><div>Astrocytoma grade 4 without isocitrate dehydrogenase (IDH)-based characterisation has been called glioblastoma (GBM) in historical cohorts. There have been significant advancements in diagnostic radiology and pathology, and in the technical aspects of surgery, radiation therapy, and temozolomide (TMZ) used for treatment of this disease. We analysed the outcomes of 267 adult astrocytoma grade 4/GBM patients, consecutively treated between December 2010 and November 2018 using modern techniques at our institute.</div></div><div><h3>Materials and methods</h3><div>All patients underwent surgical resection, histopathology review, and O6-methylguanine-DNA methyltransferase (MGMT) methylation testing, volumetric modulated arc therapy (VMAT)-based radiation therapy using institute-specific target-delineation guidelines and image guidance, and TMZ according to Stupp protocol. Serial multiparametric magnetic resonance imaging–based follow-up ensured early detection of disease progression. Appropriate salvage therapy was determined based on clinicopathological attributes. Kaplan-Meier survival plots, log-rank test, and Cox regression analysis were performed on the prospectively recorded dataset to estimate survival and the factors affecting it.</div></div><div><h3>Results</h3><div>At a median follow-up of 72 months, the median progression-free survival (PFS), 1-year PFS, and 2-year PFS were 10 months, 37.8%, and 17.5%, respectively. MGMT-methylation, a radiation dose ≥54 Gy, and ≥4 adjuvant TMZ cycles were associated with favourable PFS. Median overall survival (OS), 2-year OS and 5-year OS were 24 months, 48%, and 18%, respectively. MGMT-methylation and 1-year disease control were associated with favourable OS. Salvage treatment could be offered to 69.2% patients, with use of all the three treatment modalities in 12.4%. Salvage reirradiation could be used in 30.8% patients. Haematological toxicity ≥grade 2 was evident in 6% patients during concurrent radiation-TMZ phase and in 9% patients in adjuvant TMZ phase. Postradiation neurocognitive deficits were noted in 20.1% patients, with onset at a median duration of 10 months.</div></div><div><h3>Conclusion</h3><div>Modern diagnostic and therapeutic techniques affected a near-doubling of survival and acceptable late toxicity, as compared to historical data.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103788"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning–Driven Identification of Molecular Subgroups in Medulloblastoma via Gene Expression Profiling","authors":"H. Hourfar ,&nbsp;P. Taklifi ,&nbsp;M. Razavi ,&nbsp;B. Khorsand","doi":"10.1016/j.clon.2025.103789","DOIUrl":"10.1016/j.clon.2025.103789","url":null,"abstract":"<div><h3>Aims</h3><div>Medulloblastoma (MB) is the most prevalent malignant brain tumour in children, characterised by substantial molecular heterogeneity across its subgroups. Accurate classification is pivotal for personalised treatment strategies and prognostic assessments. In this study, we aimed to build machine learning models to classify MB subgroups.</div></div><div><h3>Materials and Methods</h3><div>This study utilised machine learning (ML) techniques to analyse RNA sequencing data from 70 paediatric MB samples. Five classifiers—K-nearest neighbors (KNN), decision tree (DT), support vector machine (SVM), random forest (RF), and naive Bayes (NB)—were used to predict molecular subgroups based on gene expression profiles. Feature selection identified gene subsets of varying sizes (750, 75, and 25 genes) to optimise classification accuracy.</div></div><div><h3>Results</h3><div>Initial analyses with the complete gene set lacked discriminative power. However, reduced feature sets significantly enhanced clustering and classification performance, particularly for group 3 and group 4 subgroups. The RF, KNN, and SVM classifiers consistently outperformed the DT and NB classifiers, achieving classification accuracies exceeding 90% in many scenarios, especially in group 3 and group 4 subgroups.</div></div><div><h3>Conclusion</h3><div>This study highlights the efficacy of ML algorithms in classifying MB subgroups using gene expression data. The integration of feature selection techniques substantially improves model performance, paving the way for enhanced personalised approaches in MB management.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103789"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding the Article “PTV Margins in MR-guided and Beam-gated SBRT of Liver Metastases: GTV Dose Escalation Can Reduce the Required PTV”","authors":"A. Viswanathan,&nbsp;P.S. Ganesh,&nbsp;R.K. Gopal","doi":"10.1016/j.clon.2025.103787","DOIUrl":"10.1016/j.clon.2025.103787","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103787"},"PeriodicalIF":3.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Relevance of Immunohistochemical Subtypes in Early-Stage, Lymph Node-negative Breast Cancer. Results of a Large Cohort Study","authors":"J.J. Jobsen ,&nbsp;H. Struikmans ,&nbsp;E. Siemerink ,&nbsp;J. van der Palen","doi":"10.1016/j.clon.2025.103786","DOIUrl":"10.1016/j.clon.2025.103786","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to provide the association of immunohistochemical (IHC) subtypes of early-stage, lymph node–negative breast cancer with clinical outcomes. The relevance of adjuvant systemic therapy (AST) with respect to triple-negative cancers was given special attention.</div></div><div><h3>Materials and methods</h3><div>We used the data of 1,959 breast-conserving therapies (BCTs) in 1,861 women diagnosed with early-stage unilateral, lymph node–negative breast cancer treated between 2004 and 2015.</div></div><div><h3>Results</h3><div>Overall, IHC subtypes were not associated with disease-specific survival (DSS) or overall survival (OS) in multivariate analyses. Looking at the influence of AST, administered according to current guidelines, we noted that triple-negativity compared to luminal A demonstrated a better DSS (hazard ratio [HR]: 0.4, 95% confidence interval [CI]: 0.1-1.1). For those without AST, outcomes for all subtypes did not differ. Difference in outcome of triple-negative tumours for without and with AST was mainly due the presence of patients bearing histological grade 3 cancers in those without AST.</div></div><div><h3>Conclusion</h3><div>In early-stage, lymph node–negative breast cancer treated with BCT and AST, according to existing guidelines, triple-negativity demonstrated a better outcome in DSS. However, for those without AST, no differences were seen in outcome between the various subtypes.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103786"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Immunochemotherapy in Advanced Triple-negative Breast Cancer: A Meta-analysis of Randomised Clinical Trials","authors":"J. Shen,&nbsp;X. Ye,&nbsp;H. Hou,&nbsp;Y. Wang","doi":"10.1016/j.clon.2025.103783","DOIUrl":"10.1016/j.clon.2025.103783","url":null,"abstract":"<div><h3>Aims</h3><div>Based on the existing controversial clinical research results, this study conducted a comprehensive meta-analysis of relevant literature to clarify the benefits of immunochemotherapy (ICT)—which combines immune checkpoint inhibitors and chemotherapy (CT)—for patients with advanced triple-negative breast cancer (aTNBC).</div></div><div><h3>Materilas and methods</h3><div>A thorough literature search was conducted up to February 15, 2024. Subsequently, meta-analyses were performed to aggregate hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS), odds ratios (ORs) for objective response rate (ORR) and relative risks (RRs) for adverse events (AEs).</div></div><div><h3>Results</h3><div>Six randomised clinical trials (RCTs) involving 3,105 patients met the inclusion criteria. In comparison with CT, ICT yielded significant enhancements in PFS (HR, 0.80; 95%CI: 0.73–0.87), OS (HR, 0.87; 95%CI: 0.80–0.96), and ORR (OR, 1.34; 95%CI: 1.15–1.55) in the intention-to-treat population. However, ICT also exhibited an increase in grade ≥3 AEs (RR, 1.11; 95%CI: 1.04–1.19) and severe AEs (RR, 1.40; 95%CI: 1.18–1.66). Subgroup analyses revealed that ICT significantly improved PFS (HR, 0.67; 95%CI: 0.58–0.77), OS (HR, 0.75; 95%CI: 0.64–0.87), and ORR (OR, 1.47; 95%CI: 1.16–1.84) within the PD-L1-positive subgroup, whereas no statistically significant differences were detected for PD-L1-negative population.</div></div><div><h3>Conclusion</h3><div>ICT demonstrates superior efficacy over conventional CT in the treatment of aTNBC, albeit accompanied by heightened toxicity. Notably, the assessment of PD-L1 status may serve as a valuable biomarker in discerning aTNBC patients who are particularly predisposed to derive benefit from ICT.</div></div><div><h3>PROSPERO number</h3><div>CRD42024513270.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103783"},"PeriodicalIF":3.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}