Clinical oncology最新文献

{"title":"Breast cancer MDT streamlining: Current oncology UK practice","authors":"E. Scott , A. Chowdhury , M. Beresford , M. Sibbering , A. Makris","doi":"10.1016/j.clon.2024.103724","DOIUrl":"10.1016/j.clon.2024.103724","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103724"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429118","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":"An updated survival analysis for men with low secreting prostate cancer","authors":"E. Saad , A. Choudhury , P. Hoskin , A. Hudson , Y. Song , P. Maitre","doi":"10.1016/j.clon.2024.10.023","DOIUrl":"10.1016/j.clon.2024.10.023","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Pages 7-8"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429189","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":"Does the Presence of Ductal Carcinoma in situ Affect Prognostic Outcomes After Neoadjuvant Therapy in Invasive Ductal Carcinoma of the Breast?","authors":"S. Zhou ,&nbsp;Y. Shi ,&nbsp;Z. Huang ,&nbsp;Y. Teng ,&nbsp;W. Xing","doi":"10.1016/j.clon.2025.103781","DOIUrl":"10.1016/j.clon.2025.103781","url":null,"abstract":"<div><h3>Aims</h3><div>The presence of ductal carcinoma in situ (DCIS) alongside invasive ductal carcinoma (IDC) of the breast is common in clinical practice and affects clinical outcomes and treatment strategies. This study aimed to compare the clinicopathological characteristics and prognosis of patients with IDC coexisting with DCIS versus pure IDC after neoadjuvant therapy (NAT) and to explore the risk factors for residual DCIS following NAT.</div></div><div><h3>Material and methods</h3><div>Patients with Stage II-III IDC who underwent NAT followed by radical surgery between January 2015 and December 2022 were included. Baseline data, clinical characteristics, preoperative treatment, surgical approach, pathological outcomes, and prognostic information were collected and analysed.</div></div><div><h3>Results</h3><div>A total of 852 patients were enrolled in this study, with 279 and 573 patients in the IDC + DCIS and IDC groups, respectively. Compared with patients in the IDC group, those in the IDC + DCIS group had a lower proportion of triple-negative molecular type (15.1% vs. 33.9%, <em>P</em> &lt; 0.001), better histological grade (52.0% vs. 37.7%, <em>P</em> &lt; 0.001), and higher residual rate of DCIS (71.3% vs. 38.7%, <em>P</em> &lt; 0.001). The 5-year disease-free survival (DFS) (85.2% vs. 82.4%, <em>P</em> = 0.188) and overall survival (OS) (93.2% vs. 93.0%, <em>P</em> = 0.810) rates of patients in the IDC + DCIS group were similar to those in the IDC group. However, in the triple-negative breast cancer population, the DFS (88.6% vs. 75.8%, <em>P</em> = 0.032) of patients with IDC + DCIS was significantly better than that of patients with IDC. For patients with IDC + DCIS, age ≥40 years (odds ratio [OR] = 0.421; 95% confidence interval [CI], 0.163–0.889, <em>P</em> = 0.035) and HR+/HER2-molecular subtype (OR=3.347; 95% CI, 1.237–6.577, <em>P</em> = 0.047) were independent preoperative predictors for residual DCIS after NAT.</div></div><div><h3>Conclusion</h3><div>The presence of DCIS in IDC demonstrated less tumour aggressiveness than pure IDC. However, a survival benefit was only observed in patients with triple-negative IDC combined with DCIS after NAT. Furthermore, patients with IDC + DCIS have a higher risk of residual DCIS after NAT, and age &lt;40 years and the luminal subtype are risk factors for residual DCIS after NAT in patients with IDC + DCIS.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103781"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421200","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":"Response Letter to Ameya et al. Correspondence to the Editor: Reirradiation in Paediatric Tumours of the Central Nervous System: Outcome and Side Effects after Implementing National Guidelines","authors":"A. Asklid ,&nbsp;M.P. Nilsson ,&nbsp;J. Engellau ,&nbsp;I. Kristensen ,&nbsp;M. Blomstrand ,&nbsp;C. Fröjd ,&nbsp;M. Agrup ,&nbsp;A. Flejmer ,&nbsp;U. Martinsson ,&nbsp;A.-M. Svärd ,&nbsp;E. Almhagen ,&nbsp;A. Embring","doi":"10.1016/j.clon.2025.103771","DOIUrl":"10.1016/j.clon.2025.103771","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103771"},"PeriodicalIF":3.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402655","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":"Comparing the Effectiveness and Safety of First-line Interventions in Patients With Advanced Epidermal Growth Factor Receptor-mutant Non-small Cell Lung Cancer, With Particular Focus on Brain Metastatic Status: A Systematic Review and Network Meta-analysis","authors":"T. Mei ,&nbsp;T. Wang ,&nbsp;T. Xu ,&nbsp;Q. Zhou","doi":"10.1016/j.clon.2025.103776","DOIUrl":"10.1016/j.clon.2025.103776","url":null,"abstract":"<div><h3>Aims</h3><div>This network meta-analysis (NMA) aimed to identify the most effective first-line intervention (FLI) for advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC), particularly in patients with varying brain metastasis (BM) status.</div></div><div><h3>Materials and Methods</h3><div>Data were collected from randomized controlled trials (RCTs) evaluating first-line EGFR-tyrosine kinase inhibitors (EGFR-TKIs), either alone or in combination, for EGFR-mutated advanced NSCLC (EMAN) patients. The sources included EMBASE, Web of Science, Cochrane Library, PubMed, and relevant conference abstracts from inception until December 2023.</div></div><div><h3>Results</h3><div>A total of 37 RCTs, encompassing 24 intervention options, were included in the NMA. Osimertinib combined with chemotherapy (CT) significantly improved progression-free survival (PFS) compared to aumolertinib (HR, 0.61; 95% CI, 0.40–0.93), furmonertinib (HR, 0.64; 95% CI, 0.41–0.98), lazertinib (HR, 0.64; 95% CI, 0.41–0.98), osimertinib alone (HR, 0.62; 95% CI, 0.48–0.80), osimertinib + bevacizumab (HR, 0.72; 95% CI, 0.51–1.00), befotertinib (HR, 0.57; 95% CI, 0.36–0.90), and zorifertinib (HR, 0.61; 95% CI, 0.39–0.93). Further, amivantamab + lazertinib showed slightly better PFS compared to aumolertinib, furmonertinib, zorifertinib, and osimertinib + bevacizumab (HR &lt;1, but <em>P</em> &gt;0.05). Regarding overall survival (OS), amivantamab + lazertinib demonstrated superior results relative to furmonertinib (HR, 0.54; 95% CI, 0.30–0.95) and befotertinib (HR, 0.43; 95% CI, 0.24–0.77). No significant OS differences were observed among osimertinib, osimertinib + bevacizumab, osimertinib + CT, lazertinib, and amivantamab + lazertinib. In BM patients, osimertinib + CT significantly enhanced PFS compared to osimertinib (HR, 0.47; 95% CI, 0.33–0.66), furmonertinib (HR, 0.44; 95% CI, 0.21–0.90), befotertinib (HR, 0.45; 95% CI, 0.21–1.00), and zorifertinib (HR, 0.47; 95% CI, 0.25–0.89). However, no noticeable PFS differences were observed between osimertinib + CT and amivantamab + lazertinib or aumolertinib. Lastly, osimertinib + CT and zorifertinib were associated with higher rates of all-grade adverse events (AEs) and grade ≥3 AEs, respectively.</div></div><div><h3>Conclusions</h3><div>In EMAN patients, osimertinib + CT and amivantamab + lazertinib were associated with optimal PFS and OS, respectively. Among BM patients, osimertinib + CT offered the best PFS benefits. These findings may assist in clinical decision-making and personalized care for EMAN and BM patients.</div><div>The study is registered on PROSPERO (CRD42024506995).</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103776"},"PeriodicalIF":3.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402654","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":"Impact of Delay in Healthcare Access on Anal Cancer Diagnosis","authors":"A.S. Taggar ,&nbsp;J. Dhaliwal ,&nbsp;P. Mann ,&nbsp;K. Chan ,&nbsp;D.K. Dinakaran ,&nbsp;K.J. Martell ,&nbsp;S. Wong","doi":"10.1016/j.clon.2025.103773","DOIUrl":"10.1016/j.clon.2025.103773","url":null,"abstract":"<div><h3>Aims</h3><div>COVID-19 pandemic caused a significant disruption in healthcare services, leading to a reduction in routine check-ups as well as a shift towards virtual care. This resulted in many patients delaying or avoiding seeking medical attention for symptoms, which led to delay in diagnosis, especially for conditions such as anal cancer that require a physical examination and diagnostic endoscopy. This study aimed to highlight the impact of healthcare disruptions and resultant impact on advanced stage of anal cancer diagnosis.</div></div><div><h3>Materials and Methods</h3><div>This is an audit of all patients at a large academic centre who presented with anal canal squamous cell carcinoma between 2018 and 2022. Time/year of presentation, tumour size, presence of nodal and metastatic disease, and primary treatment at the time of presentation was collected for analysis. Kruskal–Wallis, Fisher-Freeman-Halton, and Chi-square tests were used as statistical measures to compare tumour sizes and overall stage.</div></div><div><h3>Results</h3><div>One hundred forty-five patients with histological diagnosis of anal canal squamous cell carcinoma were seen between 2018 and 2022. A significantly higher proportion of patients presented with locally advanced, nodal, or distant metastatic disease in the years during and after COVID-19 healthcare delivery disruption (1/4/2020–31/3/2023). In the years post-COVID-19, a higher proportion of patients were diagnosed with metastatic disease at presentation. Furthermore, patients were more likely to be treated with palliative intent radiotherapy and chemotherapy in later years of healthcare disruption compared to years prior to restrictions placed by COVID-19.</div></div><div><h3>Conclusion</h3><div>This data suggests that changes in patient messaging and limited healthcare access during the COVID-19 pandemic negatively impacted the presentation of anal cancer patients. After the onset of the COVID-19 pandemic, disruptions in normal patient care led to patients presenting with more advanced disease and specifically metastatic disease.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103773"},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562960","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":"Patient Selection and Outcomes in Reirradiation for Head and Neck Cancers: A Prospective Cohort Study","authors":"S. Ghosh Laskar ,&nbsp;A. Kumar ,&nbsp;R. Salunkhe ,&nbsp;J.P. Agarwal ,&nbsp;M. Upasani ,&nbsp;S. Sinha ,&nbsp;S. Mohanty ,&nbsp;O.R. Chowdhury ,&nbsp;C. Johnny ,&nbsp;A. Budrukkar ,&nbsp;M. Swain ,&nbsp;D. Chaukar ,&nbsp;P. Pai ,&nbsp;P. Chaturvedi ,&nbsp;G. Pantvaidya ,&nbsp;S. Nair ,&nbsp;D. Nair ,&nbsp;A. Deshmukh ,&nbsp;S. Thiagarajan ,&nbsp;R. Vaish ,&nbsp;F. Khan","doi":"10.1016/j.clon.2025.103772","DOIUrl":"10.1016/j.clon.2025.103772","url":null,"abstract":"<div><h3>Aims</h3><div>Reirradiation (re-RT) in head and neck cancers requires careful patient selection. This study aimed to identify factors influencing re-RT decisions, analyse survival outcomes, and evaluate toxicities.</div></div><div><h3>Materials and methods</h3><div>From 2013 to 2017, 250 patients previously treated with radical RT for head and neck cancers were prospectively included. Exclusions were prior RT dose &lt;50 Gy, distant metastasis or prior RT within six months. The median disease-free interval (DFI) was 45.5 months, with a median follow-up of 52 months. Factors affecting survival were analysed, comparing outcomes between re-RT recipients and non-recipients in a propensity score-matched cohort.</div></div><div><h3>Results</h3><div>Among 250 patients, 177 (70.8%) were advised re-RT. Long DFI (67%) was the most common reason for re-RT, while significant late sequelae (49%) often led to denial. Advanced recurrence stage (HR 1.549, <em>p</em> = 0.04), non-surgical intervention (HR 3.455, <em>p</em> &lt; 0.005), non-recipients of re-RT (HR 4.459, <em>p</em> &lt; 0.005) and organ dysfunction (HR 2.187, <em>p</em> &lt; 0.005) predicted worse survival. For 162 re-RT recipients vs. non-recipients, the 3-year locoregional control, event-free survival and OS were 56.1% vs. 39.9% (<em>p</em> = 0.002), 42.1% vs. 26.7% (<em>p</em> = 0.002), and 57.1% vs. 31.3% (<em>p</em> &lt; 0.001), respectively. After propensity matching, the re-RT group showed better 3-year OS (48.8% vs. 31.3%, <em>p</em> = 0.04) despite increased toxicities.</div></div><div><h3>Conclusion</h3><div>Effective patient selection is vital for successful re-RT. Surgery followed by adjuvant RT yields optimal outcomes. Despite technical advancements, managing toxicities remains challenging. These findings provide valuable insights for clinicians facing the complex decision of re-RT in head and neck cancer patients.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103772"},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421201","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":"In the Nexus of Transformation: Innovations, Challenges and the Future of Digital Oncology","authors":"M. Khan ,&nbsp;S. Hindocha","doi":"10.1016/j.clon.2025.103763","DOIUrl":"10.1016/j.clon.2025.103763","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"39 ","pages":"Article 103763"},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350213","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":"Sex-Based Bias in Artificial Intelligence-Based Segmentation Models in Clinical Oncology","authors":"F.X. Doo ,&nbsp;W.G. Naranjo ,&nbsp;T. Kapouranis ,&nbsp;M. Thor ,&nbsp;M. Chao ,&nbsp;X. Yang ,&nbsp;D.C. Marshall","doi":"10.1016/j.clon.2025.103758","DOIUrl":"10.1016/j.clon.2025.103758","url":null,"abstract":"<div><div>Artificial intelligence (AI) advancements have accelerated applications of imaging in clinical oncology, especially in revolutionizing the safe and accurate delivery of state-of-the-art imaging-guided radiotherapy techniques. However, concerns are growing over the potential for sex-related bias and the omission of female-specific data in multi-organ segmentation algorithm development pipelines. Opportunities exist for addressing sex-specific data as a source of bias, and improving sex inclusion to adequately inform the development of AI-based technologies to ensure their fairness, generalizability and equitable distribution. The goal of this review is to discuss the importance of biological sex for AI-based multi-organ image segmentation in routine clinical and radiation oncology; sources of sex-based bias in data generation, model building and implementation and recommendations to ensure AI equity in this rapidly evolving domain.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"39 ","pages":"Article 103758"},"PeriodicalIF":3.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058190","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":"Correspondence to the Editor: Reirradiation in Paediatric Tumors of the Central Nervous System: Outcome and Side Effects After Implementing National Guidelines","authors":"K.P. Ameya,&nbsp;D. Sekar","doi":"10.1016/j.clon.2025.103759","DOIUrl":"10.1016/j.clon.2025.103759","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"39 ","pages":"Article 103759"},"PeriodicalIF":3.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032329","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}