Clinical oncology最新文献

{"title":"Response to Letter Commenting on: ‘Evaluation of Gross Tumour Volume in Head and Neck Cancers on Contrast-Enhanced Computed Tomography Vs Magnetic Resonance Imaging and its Implications on Dice Similarity Coefficients and Dose-Volume Parameters’","authors":"M. Deshmukh, P. Kalbande , N.R. Datta","doi":"10.1016/j.clon.2025.103948","DOIUrl":"10.1016/j.clon.2025.103948","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103948"},"PeriodicalIF":3.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353953","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":"Haematotoxicity of Craniospinal Radiochemotherapy for Metastatic Paediatric High-Grade Glioma","authors":"C. Valentini ,&nbsp;T. Perwein ,&nbsp;B. Bison ,&nbsp;G.H. Gielen ,&nbsp;F. Knerlich-Lukoschus ,&nbsp;H.C. Bock ,&nbsp;C. Seidel ,&nbsp;R.D. Kortmann ,&nbsp;D. Sturm ,&nbsp;M. Benesch ,&nbsp;G. Nussbaumer ,&nbsp;J.M. Krischer ,&nbsp;A. v Bueren ,&nbsp;M. Eyrich ,&nbsp;L.L. Friker ,&nbsp;M. Hoffmann ,&nbsp;E. Gkika ,&nbsp;A. Wittig-Sauerwein ,&nbsp;J. Hörner-Rieber ,&nbsp;R. Schwarz ,&nbsp;M. Krause","doi":"10.1016/j.clon.2025.103956","DOIUrl":"10.1016/j.clon.2025.103956","url":null,"abstract":"<div><h3>Aims</h3><div>Paediatric high-grade gliomas (pedHGGs) have a dismal prognosis, often characterised by early and diffuse disease progression. Novel treatment approaches are urgently needed to improve outcomes. The upcoming SIOPE-HGG (High Grade Glioma)-01 trial will investigate upfront craniospinal radiochemotherapy (CSI-RCT) for newly diagnosed, nonmetastatic diffuse midline glioma/diffuse intrinsic pontine glioma (DMG/DIPG). As CSI-RCT is frequently avoided due to concerns over haematotoxicity, real-world feasibility data are critically needed.</div></div><div><h3>Materials and methods</h3><div>We retrospectively assessed haematological toxicity in 19 patients (aged 3-21 years) with metastatic pedHGG treated with CSI-RCT within the hirn tumor glioblastoma trial (HIT-HGG) and hospital in trial-glioblastoma (HIT-GBM) trial programmes (2002–2024). All patients received craniospinal irradiation (median dose: 35.2 Gy) using photon- or proton-based techniques, with concurrent chemotherapy: temozolomide (TMZ; n = 14) or PEI (cisplatin, etoposide, ifosfamide; n = 5). Haematological toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0.</div></div><div><h3>Results</h3><div>Grade 3 to 4 haematotoxicity was observed in 7 of 19 patients (36.8%). Chemotherapy was discontinued in two cases—one due to TMZ-induced aplastic anaemia (TIAA) and another due to thrombocytopaenia. The remaining patients tolerated full-dose CSI-RCT with manageable side effects, and no unplanned radiotherapy interruptions occurred. The haematotoxicity rate was comparable to or lower than previous reports, indicating that CSI-RCT is feasible with appropriate monitoring and management.</div></div><div><h3>Conclusion</h3><div>This is the largest cohort to date assessing haematological toxicity of upfront CSI-RCT in metastatic pedHGG. Despite notable haematotoxicity, treatment was largely feasible and well-tolerated. These findings support the integration of CSI-RCT into future clinical trials for newly diagnosed DMG/DIPG and provide a foundation for the upcoming SIOPE HGG-01 trial. Proton therapy may further reduce toxicity and warrants prospective evaluation.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103956"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145463425","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":"Pioneering Change in Radiotherapy With Biological Adaptive Radiotherapy for Lung Volumetric Modulated Radiotherapy (VMAT) Patients","authors":"D. Kawahara ,&nbsp;A.S. Koganezawa ,&nbsp;H. Yamaguchi ,&nbsp;T. Wada ,&nbsp;Y. Murakami","doi":"10.1016/j.clon.2025.103957","DOIUrl":"10.1016/j.clon.2025.103957","url":null,"abstract":"<div><h3>Aims</h3><div>To introduce a Biological Adaptive Radiotherapy (BART) framework that incorporates biological effects into adaptive planning, quantify the impact of a short intrafraction interruption on biologically effective dose (BED) in stage III non-small cell lung cancer treated with volumetric modulated arc therapy (VMAT), and evaluate a compensation strategy designed to restore target BED while respecting organs-at-risk (OAR) constraints.</div></div><div><h3>Methods</h3><div>We analysed lung non-small cell cancer patients with stage III treated using VMAT with two full arcs. A microdosimetric kinetic model (MKM) was used to calculate BED reductions caused by a 120-minute interruption after the first arc. Compensation plans were generated by converting deviations in biological dose into physical dose adjustments, which were optimised using a treatment planning system (TPS). Dose–volume histograms (DVHs) and other metrics were compared for plans with and without interruptions and after BART compensation.</div></div><div><h3>Results</h3><div>Interruption An interruption caused BED reductions in planning target volume, with the dose difference of the D_98% and D_2% differences of 15.7%-16.5% and 5.2%-14.5%, respectively. For a normal lung, volume differences at 5 Gy (V_5Gy) and 20 Gy (V_20Gy) ranged from 0.7% to 2.2% and 0.3% to 4.7%, respectively. With dose compensation, the dose differences reduced to 0.8%-1.4% for the D_98% and 1.4%-8.3% for the D_2%. The difference of the V_5Gy and V_20Gy also decreased to 1.0%-4.1% and 0.4%-2.6%, respectively. Spinal cord dose constraints were met across all plans.</div></div><div><h3>Conclusion</h3><div>The BART framework effectively compensates for BED reductions due to short-term treatment interruptions, preserving therapeutic efficacy and adhering to organ at risk (OAR) constraints. This innovative approach represents a transformative advancement in adaptive radiation therapy by integrating biological considerations, enhancing treatment precision and personalisation.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103957"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399975","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":"Long-Term Weight Loss After Head and Neck Radiotherapy: Especially Considering Survivorship and Quality of Life","authors":"S. Haider","doi":"10.1016/j.clon.2025.103955","DOIUrl":"10.1016/j.clon.2025.103955","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103955"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145360094","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":"CODAK: Real-World Clinical Outcomes of Patients With Unresectable, Stage III Non–Small Cell Lung Cancer Treated With Durvalumab After Chemoradiotherapy in the United Kingdom","authors":"K. Franks ,&nbsp;D. Smith ,&nbsp;P. Shaw ,&nbsp;G.L. Banna ,&nbsp;M. Cominos ,&nbsp;T. Talbot ,&nbsp;B.T. Blak ,&nbsp;L. Lindqvist-Brown ,&nbsp;M. Ahmed","doi":"10.1016/j.clon.2025.103949","DOIUrl":"10.1016/j.clon.2025.103949","url":null,"abstract":"<div><h3>Aims</h3><div>The aim of this study was to describe the clinical outcomes, demographics, and clinical characteristics of patients with locally advanced, unresectable, stage III non–small cell lung cancer (NSCLC) treated with durvalumab as part of the UK early access programme or post reimbursement.</div></div><div><h3>Materials and methods</h3><div>CODAK (NCT04667312) was a multicentre, noninterventional, cohort study of patients (N = 114) with locally advanced, unresectable, stage III NSCLC initiated on durvalumab between 1 September 2017 and 31 December 2019 following concurrent or sequential chemoradiotherapy (CRT) in the UK, with retrospective data collection from 10 clinical centres. The primary outcome was the real-world overall survival (rwOS) rate at 12 and 24 months post durvalumab initiation.</div></div><div><h3>Results</h3><div>Of the 114 patients included, 47 (41.2%) were aged ≥70 years and 67 (58.7%) were male. Median follow-up time from durvalumab initiation was 22 months. The 12-month rwOS rate was 80.2% (95% confidence interval [CI]: 73.1-88.0), and the 24-month rate was 63.0% (54.1-73.4). Median rwOS was 35.9 months (95% CI: 35.9 to not reached [NR]) in the overall cohort. Before durvalumab initiation, 85.1% (97/114) received concurrent CRT and 13.2% (15/114) received sequential CRT (two unknown). In the overall cohort, median real-world progression-free survival was 28.5 months (95% CI: 16.4-NR). The median time to durvalumcab treatment discontinuation was 8.7 months (95% CI: 6.2-11.2). Thirty-three patients (28.9%) discontinued durvalumab treatment due to adverse events (AEs). Pneumonitis/interstitial lung disease (ILD) was the most common AE leading to discontinuation among all patients (19/114 [16.7%]). Eleven patients (9.6%) had at least one interruption due to pneumonitis/ILD.</div></div><div><h3>Conclusion</h3><div>CODAK provides data from the UK that add to real-world evidence showing that durvalumab following CRT is an effective standard of care for patients with unresectable, stage III NSCLC.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103949"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145360092","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":"Association Between Dose Reduction of Cyclin-dependent Kinase 4/6 Inhibitors and Survival in Advanced Breast Cancer: A Systematic Review and Meta-analysis","authors":"F. Petrelli ,&nbsp;A. Ghidini ,&nbsp;L. Dottorini","doi":"10.1016/j.clon.2025.103950","DOIUrl":"10.1016/j.clon.2025.103950","url":null,"abstract":"<div><h3>Aims</h3><div>The integration of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors into the treatment regimen for advanced breast cancer (BC), specifically oestrogen receptor–positive (ER+) subtypes, marks a significant stride in oncological therapy. These inhibitors have demonstrated substantial clinical benefits and are generally well tolerated compared to other targeted therapies. Our study evaluated the effects of dosage reductions on progression-free survival (PFS) and overall survival (OS) in patients undergoing CDK4/6 inhibitor therapy.</div></div><div><h3>Materials and Methods</h3><div>We conducted an exhaustive literature review across several databases, including PubMed, Embase, and Cochrane, considering studies published up to September 30, 2023. The selection criteria were based on the Patients Interventions Comparisons Outcomes (PICOS) framework, focussing on studies involving ER+ BC patients treated with CDK4/6 inhibitors in combination with endocrine therapy. Both retrospective and prospective studies were included involving adult patients treated with standard doses of CDK4/6 inhibitors for approved indications.</div></div><div><h3>Results</h3><div>The systematic review included 33 retrospective studies and one phase 2 study, encompassing 7,767 patients. Analysis revealed significant improvements in both OS (hazard ratio [HR] = 0.75, 95% confidence interval [CI]: 0.61-0.93; <em>P</em> &lt; .01) and PFS (HR = 0.87, 95% CI: 0.76-0.98; <em>P</em> = .02) among patients who underwent dosage reduction. The data exhibited low heterogeneity across studies, strengthening the reliability of our findings.</div></div><div><h3>Conclusion</h3><div>Our research provides valuable insights into the dosage optimisation of CDK4/6 inhibitors and its impact on patient outcomes. The findings suggest that when clinically indicated, dose reductions do not compromise treatment efficacy and may even improve survival outcomes. These results offer a promising direction for future clinical practices and research in oncology, particularly in personalising treatment approaches for patients with ER+ advanced BC.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103950"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318020","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":"The Delivery of Stereotactic Radiosurgery for Intracranial Metastatic Disease: Insights from a Survey of UK Hospitals Through the Tessa Jowell Academy","authors":"J. King ,&nbsp;C. Barker ,&nbsp;A. Wright ,&nbsp;B. Allen ,&nbsp;N. Huskens ,&nbsp;J. Cahill","doi":"10.1016/j.clon.2025.103947","DOIUrl":"10.1016/j.clon.2025.103947","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>The use of stereotactic radiosurgery (SRS) to treat patients with intracranial metastatic disease is increasing. Despite efforts to standardise practice across the centres delivering SRS in the UK, evidence suggests that patient selection, treatment volumes, and clinical practice vary significantly. This study aimed to understand the current SRS service provision and identify challenges to support more consistent, high-quality care.</div></div><div><h3><em>Materials and</em> <em>methods</em></h3><div>In 2023, the Tessa Jowell Academy SRS working group distributed a national survey to centres delivering SRS for brain metastases. The survey covered service configuration, treatment protocols, imaging practices, and challenges. Responses were collected from October 2023 to March 2024, with 20 centres participating (17 in England, two in Scotland, and one in Wales).</div></div><div><h3><em>Results</em></h3><div>Substantial variation was reported in service size and delivery. Weekly SRS multidisciplinary team caseloads ranged 3 to 25 patients, and referral rates (adjusted to catchment area) varied five-fold. Most centres used Linac systems (n = 15), followed by Gamma Knife (n = 4) and Cyberknife (n = 3); only two centres had multiple machine types. Six of the 20 centres (30%) referred patients externally, mainly for Gamma Knife treatment. Treatment criteria varied widely: centres treated from ≤5 to &gt;50 lesions, with maximum treated volumes for a single fraction varying substantially. The time from imaging to treatment ranged from within the same day to within two weeks. Variation was also noted in approaches to radionecrosis imaging, treatment margins, and steroid use.</div><div>The key challenges reported included workforce capacity (reported by 50% of centres), imaging access (40%), and inappropriate referrals (15%). Encouragingly, five centres (25%) reported no major barriers to service delivery.</div></div><div><h3><em>Conclusion</em></h3><div>The findings highlight a significant variation in SRS practice across the UK. The Tessa Jowell Academy will use these insights to promote standardisation, support clinical teams, and reduce unwarranted variation—ensuring equitable access to high-quality SRS for patients with brain metastases.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103947"},"PeriodicalIF":3.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145360093","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":"Oncoflash","authors":"F. Holt ,&nbsp;R. Simoes","doi":"10.1016/j.clon.2025.103946","DOIUrl":"10.1016/j.clon.2025.103946","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103946"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250046","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":"The BRAFV600E Mutation Enhances Age-Based Prognostic Stratification in Radioiodine-Treated Papillary Thyroid Cancer: A Retrospective Cohort Study","authors":"J. Cao ,&nbsp;H. Liang ,&nbsp;X. Li ,&nbsp;X. Guan ,&nbsp;Y.Z. Ma ,&nbsp;J. Li","doi":"10.1016/j.clon.2025.103945","DOIUrl":"10.1016/j.clon.2025.103945","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate whether BRAF^V600E mutation status enhances the value of age in predicting clinical outcomes for papillary thyroid carcinoma (PTC) patients receiving radioactive iodide (RAI) therapy.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective analysis of 1160 PTC patients treated with RAI therapy. Patients were stratified by age (≤18, 18-55, and ≥55 years) and BRAF^V600E status. Clinicopathological characteristics, treatment responses, and risk factors for poor outcomes (biochemical/structural incomplete response biochemical incomplete response/structural incomplete response [BIR/SIR]) were analysed using logistic regression.</div></div><div><h3>Results</h3><div>BRAF^V600E-positive patients aged ≤18 years showed aggressive features, including larger tumour size, higher lymph node metastasis rates, elevated thyroglobulin levels (TgAb-negative), and worse 6-month/3-year outcomes (all <em>P</em> &lt; .05). Multivariate analysis confirmed high-risk subtypes, distant metastasis, and elevated Tg levels as independent BIR/SIR predictors. BRAF^V600E-negative patients showed no significant age-related clinical characteristics and outcomes (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>BRAF^V600E mutation status significantly modifies the impact of age in PTC patients with RAI therapy. Patients aged ≤18 years with BRAF^V600E-positive exhibit distinct aggressive behaviours and poorer RAI therapy responses. These findings support integrating BRAF^V600E testing with age stratification to refine risk assessment and therapeutic strategies.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103945"},"PeriodicalIF":3.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248008","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 Impact of Next-Generation Sequencing–Guided Targeted Therapies in Advanced Cancer: A Systematic Review and Meta-Analysis","authors":"F. Kazmi ,&nbsp;R. Katyal ,&nbsp;T.F.D. Liu ,&nbsp;P. Gkogkou ,&nbsp;S.P. Blagden ,&nbsp;S. Lord ,&nbsp;D. Dodwell ,&nbsp;N. Shrestha","doi":"10.1016/j.clon.2025.103943","DOIUrl":"10.1016/j.clon.2025.103943","url":null,"abstract":"<div><h3>Aims</h3><div>Precision oncology, driven by next-generation sequencing (NGS), enables the use of matched targeted therapies (MTTs) tailored to tumour-specific genomic alterations. While benefits in early-stage cancer are well-established, the impact of MTTs in relapsed or metastatic settings remains unclear. This systematic review and meta-analysis (PROSPERO ID: CRD42023471466) evaluates the efficacy and safety of NGS-guided MTTs in patients with advanced solid and haematological tumours.</div></div><div><h3>Materials and methods</h3><div>Searches of CENTRAL, MEDLINE, EMBASE (to 30 October 2024), reference lists, and conference proceedings identified randomized controlled trials (RCTs) comparing NGS-guided MTTs (alone or combined with standard of care systemic treatment [SOC]) versus SOC alone in patients with advanced cancers that had progressed after at least one prior systemic therapy. Primary outcomes were progression-free survival (PFS), overall survival (OS), and grade ≥3 adverse events. Data extraction and bias assessment were conducted independently by two reviewers. Random-effects meta-analysis was performed using the DerSimonian-Laird method.</div></div><div><h3>Results</h3><div>Thirty RCTs (7393 patients) were included that collectively enrolled patients with eight different cancer types. With a median follow-up ranging from 12 months to 62.3 months, MTTs were associated with a 30–40% reduction in the risk of disease progression. No consistent OS benefit was observed with MTT monotherapy. However, combining MTTs with SOC resulted in improved OS, particularly in patients with prostate and urothelial cancer, but conferred PFS gain without OS improvement in those with breast and ovarian cancer. In terms of adverse events, we observed MTTs increased toxicity risk compared to SOC, specifically, in combination regimens. Most studies were at high risk of bias, with performance and detection bias being common limitations.</div></div><div><h3>Conclusion</h3><div>NGS-guided MTTs significantly enhance PFS, especially when combined with SOC, with OS benefits being more tumour-specific. Increased toxicity rates with MTTs underscore the need for careful in patient selection. Furthermore, genomic profiling should be routinely integrated into the management of patients with advanced or recurrent cancers.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"48 ","pages":"Article 103943"},"PeriodicalIF":3.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307056","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}