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Global inequalities in the burden of cancer in adolescents and young women from 1990 to 2021: findings from the Global Burden of Disease Study 2021
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2025.104153
J. Hou , Z. Han , M. Chang , Z. Xu
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引用次数: 0
The Vienna CATScore for predicting cancer-associated venous thromboembolism: an external validation across multiple time points
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104130
C. Englisch , S. Nopp , F. Moik , A.M. Starzer , P. Quehenberger , M. Preusser , A.S. Berghoff , C. Ay , I. Pabinger

Background

Patients with cancer undergoing systemic therapies have a high risk for venous thromboembolism (VTE). Risk assessment models were developed to select high-risk subgroups that might benefit from primary thromboprophylaxis, yet currently available models reportedly underperform in contemporary cancer treatment populations and risk models across multiple time points throughout therapy are not available.

Patients and methods

We, therefore, aimed to validate the Vienna CATScore, a nomogram-based model including tumor type and continuous D-dimer levels, in a prospective cohort study of patients initiating contemporary systemic anticancer therapies. The validity of the model was tested at study inclusion, 3 weeks, and 3 months after start of therapy.

Results

Overall, 598 patients were included [49% women, median age 62 years (interquartile range 53-70 years)]. Most patients had stage IV disease (68.2%). The 6-month cumulative incidence of VTE was 9.2% [95% confidence interval (CI) 6.8% to 11.5%]. The Vienna CATScore demonstrated good discriminatory ability (c-statistics: 0.69, 95% CI 0.61-0.76) at study baseline and across all evaluated time points (c-statistics: 0.68, 95% CI 0.63-0.73). Applying a 6-month predicted VTE risk threshold of 8%, the CATScore effectively distinguished between low- and high-risk groups at study inclusion (7.1% versus 15.1% observed VTE risk, P = 0.004) and across all three time points (6.3% versus 13.6% observed VTE risk, P < 0.001). Assuming a 50% risk reduction with thromboprophylaxis, this threshold resulted in a number needed to treat (NNT) of 13 and 15, respectively, in the high-risk group, while the NNT was 28 and 32, respectively, in the low-risk group.

Conclusions

This external validation of the Vienna CATScore confirms its effectiveness in predicting VTE risk in the initial months of state-of-the-art systemic anticancer therapies and across multiple time points.
{"title":"The Vienna CATScore for predicting cancer-associated venous thromboembolism: an external validation across multiple time points","authors":"C. Englisch ,&nbsp;S. Nopp ,&nbsp;F. Moik ,&nbsp;A.M. Starzer ,&nbsp;P. Quehenberger ,&nbsp;M. Preusser ,&nbsp;A.S. Berghoff ,&nbsp;C. Ay ,&nbsp;I. Pabinger","doi":"10.1016/j.esmoop.2024.104130","DOIUrl":"10.1016/j.esmoop.2024.104130","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cancer undergoing systemic therapies have a high risk for venous thromboembolism (VTE). Risk assessment models were developed to select high-risk subgroups that might benefit from primary thromboprophylaxis, yet currently available models reportedly underperform in contemporary cancer treatment populations and risk models across multiple time points throughout therapy are not available.</div></div><div><h3>Patients and methods</h3><div>We, therefore, aimed to validate the Vienna CATScore, a nomogram-based model including tumor type and continuous D-dimer levels, in a prospective cohort study of patients initiating contemporary systemic anticancer therapies. The validity of the model was tested at study inclusion, 3 weeks, and 3 months after start of therapy.</div></div><div><h3>Results</h3><div>Overall, 598 patients were included [49% women, median age 62 years (interquartile range 53-70 years)]. Most patients had stage IV disease (68.2%). The 6-month cumulative incidence of VTE was 9.2% [95% confidence interval (CI) 6.8% to 11.5%]. The Vienna CATScore demonstrated good discriminatory ability (c-statistics: 0.69, 95% CI 0.61-0.76) at study baseline and across all evaluated time points (c-statistics: 0.68, 95% CI 0.63-0.73). Applying a 6-month predicted VTE risk threshold of 8%, the CATScore effectively distinguished between low- and high-risk groups at study inclusion (7.1% versus 15.1% observed VTE risk, <em>P</em> = 0.004) and across all three time points (6.3% versus 13.6% observed VTE risk, <em>P</em> &lt; 0.001). Assuming a 50% risk reduction with thromboprophylaxis, this threshold resulted in a number needed to treat (NNT) of 13 and 15, respectively, in the high-risk group, while the NNT was 28 and 32, respectively, in the low-risk group.</div></div><div><h3>Conclusions</h3><div>This external validation of the Vienna CATScore confirms its effectiveness in predicting VTE risk in the initial months of state-of-the-art systemic anticancer therapies and across multiple time points.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104130"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Molecular characterization of HER2-negative breast cancers reveals a distinct patient subgroup with 17q12 deletion and heterozygous loss of ERBB2 her2阴性乳腺癌的分子特征揭示了具有17q12缺失和ERBB2杂合缺失的独特患者亚组。
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104111
X. Qiu , P. Tarantino , R. Li , A. Grinshpun , H. Gupta , M.E. Hughes , G. Kirkner , L. Scholl , B.E. Johnson , M. Meyerson , A.D. Cherniack , Y. Jiang , N. Zhou , N.U. Lin , H.W. Long , S.M. Tolaney , R. Jeselsohn

Background

The approval of trastuzumab deruxtecan has prompted the subgrouping of human epidermal growth factor receptor 2-negative (HER2−) breast cancers (BCs) to HER2 0 and HER2 low on the basis of immunohistochemistry, although the biological significance of these subgroups remains uncertain. This study is aimed to better understand the molecular and genetic differences among HER2− tumors stratified by quantitative levels of HER2.

Patients and methods

We analyzed the transcriptomic and genomic data from the Molecular Taxonomy of BC International Consortium (discovery cohort) and The Cancer Genome Atlas (independent validation cohort). HER2− BCs, including hormone receptor positive and triple negative, were divided into three subgroups based on ERBB2 messenger RNA (mRNA) levels: minimal, moderate and enhanced.

Results

We observed significant differences in mutational and transcriptional profiles across the subgroups. Tumors with enhanced ERBB2 mRNA expression had a higher prevalence of PIK3CA mutations and increased estrogen receptor signaling, while tumors with minimal ERBB2 mRNA expression displayed higher expression of proliferation and immune-related genes. We identified a distinct subgroup of BCs characterized by a large deletion of chromosome 17q12 (17q12del) with heterozygous loss of ERBB2, very low ERBB2 mRNA and HER2 protein expression. This subgroup was also enriched for heterozygous losses of TP53 and other tumor suppressor genes. Analysis of two large real-world cohorts of patients with HER2− metastatic BC (Dana-Farber Cancer Institute cohort n = 1063 and Memorial Sloan Kettering MetTropism cohort n = 1018) showed that patients with 17q12del and heterozygous loss of ERBB2 had poorer overall survival (OS).

Conclusions

We identified a biologically and clinically distinct subgroup of BCs characterized by a 17q12del with a heterozygous loss of ERBB2 and low ERBB2 mRNA and HER2 protein expression. In two large real-world cohorts of patients with HER2− metastatic BC, this subgroup was associated with poor OS, highlighting its clinical significance.
背景:曲妥珠单抗德鲁西替康的批准促使人表皮生长因子受体2阴性(HER2-)乳腺癌(BCs)在免疫组化的基础上进入HER2 0和HER2低亚组,尽管这些亚组的生物学意义仍不确定。本研究旨在更好地了解通过HER2定量水平分层的HER2-肿瘤的分子和遗传差异。患者和方法:我们分析了来自BC International Consortium Molecular Taxonomy(发现队列)和the Cancer Genome Atlas(独立验证队列)的转录组和基因组数据。HER2- bc包括激素受体阳性和三阴性,根据ERBB2信使RNA (mRNA)水平分为轻度、中度和增强三个亚组。结果:我们观察到亚组间突变和转录谱的显著差异。ERBB2 mRNA表达增强的肿瘤具有更高的PIK3CA突变患病率和雌激素受体信号传导增加,而ERBB2 mRNA表达最低的肿瘤具有更高的增殖和免疫相关基因表达。我们发现了一个独特的bc亚群,其特征是染色体17q12 (17q12del)的大量缺失,ERBB2的杂合缺失,ERBB2 mRNA和HER2蛋白的表达非常低。该亚组中还存在TP53和其他肿瘤抑制基因的杂合缺失。对两大现实世界HER2转移性BC患者队列(Dana-Farber Cancer Institute队列n = 1063和Memorial Sloan Kettering MetTropism队列n = 1018)的分析显示,17q12del和ERBB2杂合缺失的患者总生存期(OS)较差。结论:我们确定了一个生物学和临床上独特的bc亚群,其特征是17q12del杂合缺失ERBB2, ERBB2 mRNA和HER2蛋白表达低。在两个现实世界的HER2转移性BC患者队列中,该亚组与不良OS相关,突出了其临床意义。
{"title":"Molecular characterization of HER2-negative breast cancers reveals a distinct patient subgroup with 17q12 deletion and heterozygous loss of ERBB2","authors":"X. Qiu ,&nbsp;P. Tarantino ,&nbsp;R. Li ,&nbsp;A. Grinshpun ,&nbsp;H. Gupta ,&nbsp;M.E. Hughes ,&nbsp;G. Kirkner ,&nbsp;L. Scholl ,&nbsp;B.E. Johnson ,&nbsp;M. Meyerson ,&nbsp;A.D. Cherniack ,&nbsp;Y. Jiang ,&nbsp;N. Zhou ,&nbsp;N.U. Lin ,&nbsp;H.W. Long ,&nbsp;S.M. Tolaney ,&nbsp;R. Jeselsohn","doi":"10.1016/j.esmoop.2024.104111","DOIUrl":"10.1016/j.esmoop.2024.104111","url":null,"abstract":"<div><h3>Background</h3><div>The approval of trastuzumab deruxtecan has prompted the subgrouping of human epidermal growth factor receptor 2-negative (HER2−) breast cancers (BCs) to HER2 0 and HER2 low on the basis of immunohistochemistry, although the biological significance of these subgroups remains uncertain. This study is aimed to better understand the molecular and genetic differences among HER2− tumors stratified by quantitative levels of HER2.</div></div><div><h3>Patients and methods</h3><div>We analyzed the transcriptomic and genomic data from the Molecular Taxonomy of BC International Consortium (discovery cohort) and The Cancer Genome Atlas (independent validation cohort). HER2− BCs, including hormone receptor positive and triple negative, were divided into three subgroups based on <em>ERBB2</em> messenger RNA (mRNA) levels: minimal, moderate and enhanced.</div></div><div><h3>Results</h3><div>We observed significant differences in mutational and transcriptional profiles across the subgroups. Tumors with enhanced <em>ERBB2</em> mRNA expression had a higher prevalence of <em>PIK3CA</em> mutations and increased estrogen receptor signaling, while tumors with minimal <em>ERBB2</em> mRNA expression displayed higher expression of proliferation and immune-related genes. We identified a distinct subgroup of BCs characterized by a large deletion of chromosome 17q12 (17q12del) with heterozygous loss of <em>ERBB2</em>, very low <em>ERBB2</em> mRNA and HER2 protein expression. This subgroup was also enriched for heterozygous losses of <em>TP53</em> and other tumor suppressor genes. Analysis of two large real-world cohorts of patients with HER2− metastatic BC (Dana-Farber Cancer Institute cohort <em>n</em> = 1063 and Memorial Sloan Kettering MetTropism cohort <em>n</em> = 1018) showed that patients with 17q12del and heterozygous loss of ERBB2 had poorer overall survival (OS).</div></div><div><h3>Conclusions</h3><div>We identified a biologically and clinically distinct subgroup of BCs characterized by a 17q12del with a heterozygous loss of <em>ERBB2</em> and low <em>ERBB2</em> mRNA and HER2 protein expression. In two large real-world cohorts of patients with HER2− metastatic BC, this subgroup was associated with poor OS, highlighting its clinical significance.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104111"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
High expression level of ERBB2 and efficacy of trastuzumab deruxtecan in desmoplastic small round cell tumour: a monocentric case series report
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2025.104133
M. Brahmi , H. Vanacker , A. Dufresne , V. Isnardi , M. Dupont , A. Meurgey , M. Karanian , P. Meeus , M.-P. Sunyach , F. Tirode , J.-Y. Blay

Background

Desmoplastic small round cell tumours (DSRCTs) represent an ultra-rare subtype of soft tissue sarcoma characterized by a recurrent EWSR1::WT1 oncogenic translocation. Considered as an extremely aggressive cancer, the prognosis remains poor with a median overall survival not exceeding 24-36 months and a 5-year survival <10%.

Patients and methods

We analysed ERBB2/human epidermal growth factor receptor 2 (HER2) expression levels in a series of 13 DSRCT patients, using whole-exome RNA sequencing on formalin-fixed paraffin-embedded samples from a local biopathological database. In addition, a retrospective case series describes the clinical outcome of three successive DSRCT patients treated with trastuzumab deruxtecan (T-DXd).

Results

The gene expression analysis demonstrated a consistent high RNA expression level of ERBB2 in DSRCT, with elevated levels [>5 log2(transcripts per million + 1)] across all samples of the cohort and the expression level was the highest compared with all other sarcoma subtypes. In addition to these results, T-DXd showed a marked activity in all three DSRCT patients who presented with metastatic disease refractory to previous standard chemotherapy. So far, the treatment has been overall well tolerated and is currently pursued in the three patients (duration of response >3 months for all three), which warrants additional investigation.

Conclusions

This case series presents a major information, suggesting that HER2 is a therapeutic target in DSRCT and T-DXd might represent a novel therapeutic option. Those results require to be rapidly shared with the scientific community and confirmed in a prospective clinical trial in this context of very poor prognosis disease and urgent unmet need.
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引用次数: 0
Corrigendum to “Fruquintinib in refractory metastatic colorectal cancer: a multicenter real-world study”
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104124
D. Xu , S. Zeng , W. Qiu , G. Wang , Z. Qin , Y. Liu , S. Zhou , Z. Zhang , W. Chang , Q. Feng , J. Xu
{"title":"Corrigendum to “Fruquintinib in refractory metastatic colorectal cancer: a multicenter real-world study”","authors":"D. Xu ,&nbsp;S. Zeng ,&nbsp;W. Qiu ,&nbsp;G. Wang ,&nbsp;Z. Qin ,&nbsp;Y. Liu ,&nbsp;S. Zhou ,&nbsp;Z. Zhang ,&nbsp;W. Chang ,&nbsp;Q. Feng ,&nbsp;J. Xu","doi":"10.1016/j.esmoop.2024.104124","DOIUrl":"10.1016/j.esmoop.2024.104124","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104124"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Corrigendum to “mFOLFOX6 versus mFOLFOX6 + aflibercept as neoadjuvant treatment in MRI-defined T3-rectal cancer: a randomized phase-II-trial of the German Rectal Cancer Study Group (CAO/ARO/AIO 0214) and the ABCSG (R-06)”
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104095
R.-D. Hofheinz , F. Herrle , T. Dechow , L.F. von Weikersthal , M. Welslau , S. Lettmaier , C. Burkart , S. Kubicka , L. Kochen , K. Merx , K. Krause , M. Ebert , C. Rödel , E. Fokas , M. Ghadimi , C. Reissfelder , T. Gaiser
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引用次数: 0
Atezolizumab plus bevacizumab as first-line treatment of unresectable hepatocellular carcinoma: interim analysis results from the phase IIIb AMETHISTA trial
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104110
F. Piscaglia , G. Masi , E. Martinelli , G. Cabibbo , M. Di Maio , A. Gasbarrini , M. Iavarone , L. Antonuzzo , V. Mazzaferro , A. Ballestrero , C. Garufi , F. Bergamo , C. Celsa , D. Marino , F. Tovoli , F.R. Ponziani , T. Pressiani , C. Astolfi , G.C. Gazzoli , F. Ciardiello , L. Rimassa

Background

The treatment of advanced hepatocellular carcinoma (HCC) with atezolizumab and bevacizumab led to significant improvements in overall survival (OS), progression-free survival (PFS), and response rate compared with sorafenib in the phase III IMbrave150 trial. The etiology of background liver disease can differ between Eastern and Western populations, leading to a potentially different impact of systemic therapies; therefore the unequal representation must be considered in the IMbrave150 trial. To provide further data on the safety and effectiveness of atezolizumab and bevacizumab, the phase IIIb AMETHISTA (Atezolizumab plus bevacizumab in METastatic HCC Italian Safety TriAl) ran in a Western (Italian) population of patients with advanced HCC. The results of the interim analysis are presented in this paper.

Methods

AMETHISTA is a multicenter, phase IIIb, single-arm study evaluating the safety and effectiveness of atezolizumab and bevacizumab in an Italian population of patients with systemic treatment-naive HCC (ClinicalTrials.gov: NCT04487067). The primary objective was safety (incidence of grade 3-5 bleeding/hemorrhages). The main secondary objective was effectiveness.

Results

A total of 152 patients were enrolled and 149 were treated. At the cut-off date, the median observation time was 13.4 months (interquartile range 8.3-15.5 months). The incidence of grade 3-5 bleeding/hemorrhages was 11.4%. Besides, results of other safety endpoints were consistent with the safety profile of atezolizumab plus bevacizumab, and the underlying disease, without any new safety observation. The median OS was 18.2 months (95% confidence interval 15.4 months to not evaluable); the median PFS was 8.5 months (95% confidence interval 7.5-11.2 months).

Conclusion

Results from the interim analysis are consistent with data from the IMbrave150 trial, and further confirm first-line atezolizumab plus bevacizumab as a standard of care for patients with systemic treatment-naive advanced and unresectable HCC.
{"title":"Atezolizumab plus bevacizumab as first-line treatment of unresectable hepatocellular carcinoma: interim analysis results from the phase IIIb AMETHISTA trial","authors":"F. Piscaglia ,&nbsp;G. Masi ,&nbsp;E. Martinelli ,&nbsp;G. Cabibbo ,&nbsp;M. Di Maio ,&nbsp;A. Gasbarrini ,&nbsp;M. Iavarone ,&nbsp;L. Antonuzzo ,&nbsp;V. Mazzaferro ,&nbsp;A. Ballestrero ,&nbsp;C. Garufi ,&nbsp;F. Bergamo ,&nbsp;C. Celsa ,&nbsp;D. Marino ,&nbsp;F. Tovoli ,&nbsp;F.R. Ponziani ,&nbsp;T. Pressiani ,&nbsp;C. Astolfi ,&nbsp;G.C. Gazzoli ,&nbsp;F. Ciardiello ,&nbsp;L. Rimassa","doi":"10.1016/j.esmoop.2024.104110","DOIUrl":"10.1016/j.esmoop.2024.104110","url":null,"abstract":"<div><h3>Background</h3><div>The treatment of advanced hepatocellular carcinoma (HCC) with atezolizumab and bevacizumab led to significant improvements in overall survival (OS), progression-free survival (PFS), and response rate compared with sorafenib in the phase III IMbrave150 trial. The etiology of background liver disease can differ between Eastern and Western populations, leading to a potentially different impact of systemic therapies; therefore the unequal representation must be considered in the IMbrave150 trial. To provide further data on the safety and effectiveness of atezolizumab and bevacizumab, the phase IIIb AMETHISTA (Atezolizumab plus bevacizumab in METastatic HCC Italian Safety TriAl) ran in a Western (Italian) population of patients with advanced HCC. The results of the interim analysis are presented in this paper.</div></div><div><h3>Methods</h3><div>AMETHISTA is a multicenter, phase IIIb, single-arm study evaluating the safety and effectiveness of atezolizumab and bevacizumab in an Italian population of patients with systemic treatment-naive HCC (ClinicalTrials.gov: <span><span>NCT04487067</span><svg><path></path></svg></span>). The primary objective was safety (incidence of grade 3-5 bleeding/hemorrhages). The main secondary objective was effectiveness.</div></div><div><h3>Results</h3><div>A total of 152 patients were enrolled and 149 were treated. At the cut-off date, the median observation time was 13.4 months (interquartile range 8.3-15.5 months). The incidence of grade 3-5 bleeding/hemorrhages was 11.4%. Besides, results of other safety endpoints were consistent with the safety profile of atezolizumab plus bevacizumab, and the underlying disease, without any new safety observation. The median OS was 18.2 months (95% confidence interval 15.4 months to not evaluable); the median PFS was 8.5 months (95% confidence interval 7.5-11.2 months).</div></div><div><h3>Conclusion</h3><div>Results from the interim analysis are consistent with data from the IMbrave150 trial, and further confirm first-line atezolizumab plus bevacizumab as a standard of care for patients with systemic treatment-naive advanced and unresectable HCC.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104110"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Health networking on cancer in the European Union: a ‘green paper’ by the EU Joint Action on Networks of Expertise (JANE)
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104126
P.G. Casali , H. Antoine-Poirel , S. Berrocoso , J.-Y. Blay , T. Dubois , A. Ferrari , A. Fullaondo , E. Hovig , P. Jagodzińska-Mucha , I. Ługowska , S. Kaasa , D. Nicoară , V. Pletsa , S. Provenzano , M. Santoro , M. Šekerija , W. Van Hoof , M. Vyas , A. Trama , Malvika Vyas
Health networking is in principle a formidable instrument to address many challenges posed by cancer, one of the two most common and most lethal non-communicable chronic diseases. The European Union (EU)’s Beating Cancer Plan foresaw the addition of new health networks to the four already existing European Reference Networks on rare cancers: the Network of Comprehensive Cancer Centres and several networks of expertise (NoEs), which will be shortly deployed on items as complex and poor-prognosis cancers, palliative care, survivorship, personalised primary and secondary prevention, omic technologies, hi-tech medical resources, and cancers in adolescents and young adults. The community of experts of the EU Joint Action, due to build such NoEs, has drafted this ‘green paper’, incorporating 13 open questions, in an effort to foster discussion on some open questions about health networking on cancer in the EU. These affect highly diverse issues such as the following: how gaps in research into the instrument of health networking may be filled; which items lend themselves more to health networking in the EU; what degree of cooperation and harmonisation should be required of EU member states to best exploit health networking and give rise to European networks of national/regional networks; how the idea of subsidiarity may be best interpreted to support health networking in the context of EU treaties, which basically do not include health; how health networks should be funded and with what degree of cooperation between the EU and national levels; whether EU health networks should be shaped as legal entities or could give rise to secondary legal entities, also with a view to fundraising; how health networks should be best shaped to advance cancer research and how the EU regulatory system should be updated to exploit such impulse to health networks, in view of the EU General Data Protection Regulation and the new EU Health Data Space; how artificial intelligence can be exploited today within health networks and to what extent it will be able to overcome challenges such as the current lack of interoperability of electronic health records and the language barrier across the EU; and how health networks should involve patients and their groups, with regard to their formal role within EU health networks as well as their ability to have a say in items such as production of clinical practice guidelines, the design of investigator-driven clinical trials, EU regulatory decisions on medicines and devices, health service data governance, and identification of unmet needs.
{"title":"Health networking on cancer in the European Union: a ‘green paper’ by the EU Joint Action on Networks of Expertise (JANE)","authors":"P.G. Casali ,&nbsp;H. Antoine-Poirel ,&nbsp;S. Berrocoso ,&nbsp;J.-Y. Blay ,&nbsp;T. Dubois ,&nbsp;A. Ferrari ,&nbsp;A. Fullaondo ,&nbsp;E. Hovig ,&nbsp;P. Jagodzińska-Mucha ,&nbsp;I. Ługowska ,&nbsp;S. Kaasa ,&nbsp;D. Nicoară ,&nbsp;V. Pletsa ,&nbsp;S. Provenzano ,&nbsp;M. Santoro ,&nbsp;M. Šekerija ,&nbsp;W. Van Hoof ,&nbsp;M. Vyas ,&nbsp;A. Trama ,&nbsp;Malvika Vyas","doi":"10.1016/j.esmoop.2024.104126","DOIUrl":"10.1016/j.esmoop.2024.104126","url":null,"abstract":"<div><div>Health networking is in principle a formidable instrument to address many challenges posed by cancer, one of the two most common and most lethal non-communicable chronic diseases. The European Union (EU)’s Beating Cancer Plan foresaw the addition of new health networks to the four already existing European Reference Networks on rare cancers: the Network of Comprehensive Cancer Centres and several networks of expertise (NoEs), which will be shortly deployed on items as complex and poor-prognosis cancers, palliative care, survivorship, personalised primary and secondary prevention, omic technologies, hi-tech medical resources, and cancers in adolescents and young adults. The community of experts of the EU Joint Action, due to build such NoEs, has drafted this ‘green paper’, incorporating 13 open questions, in an effort to foster discussion on some open questions about health networking on cancer in the EU. These affect highly diverse issues such as the following: how gaps in research into the instrument of health networking may be filled; which items lend themselves more to health networking in the EU; what degree of cooperation and harmonisation should be required of EU member states to best exploit health networking and give rise to European networks of national/regional networks; how the idea of subsidiarity may be best interpreted to support health networking in the context of EU treaties, which basically do not include health; how health networks should be funded and with what degree of cooperation between the EU and national levels; whether EU health networks should be shaped as legal entities or could give rise to secondary legal entities, also with a view to fundraising; how health networks should be best shaped to advance cancer research and how the EU regulatory system should be updated to exploit such impulse to health networks, in view of the EU General Data Protection Regulation and the new EU Health Data Space; how artificial intelligence can be exploited today within health networks and to what extent it will be able to overcome challenges such as the current lack of interoperability of electronic health records and the language barrier across the EU; and how health networks should involve patients and their groups, with regard to their formal role within EU health networks as well as their ability to have a say in items such as production of clinical practice guidelines, the design of investigator-driven clinical trials, EU regulatory decisions on medicines and devices, health service data governance, and identification of unmet needs.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104126"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Treatment with infliximab and tacrolimus in steroid-refractory pneumonitis secondary to anti-HER2 therapy
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104128
O. Fakih , E. Ahmed , M. Paravasthu , J. Pearson , L.G. Spencer , C. Palmieri
{"title":"Treatment with infliximab and tacrolimus in steroid-refractory pneumonitis secondary to anti-HER2 therapy","authors":"O. Fakih ,&nbsp;E. Ahmed ,&nbsp;M. Paravasthu ,&nbsp;J. Pearson ,&nbsp;L.G. Spencer ,&nbsp;C. Palmieri","doi":"10.1016/j.esmoop.2024.104128","DOIUrl":"10.1016/j.esmoop.2024.104128","url":null,"abstract":"","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"10 2","pages":"Article 104128"},"PeriodicalIF":7.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Nivolumab combination therapies in patients with advanced gastric and gastroesophageal junction cancer: the phase II FRACTION gastric cancer study Nivolumab联合治疗晚期胃癌和胃食管结癌患者:II期FRACTION胃癌研究
IF 7.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.esmoop.2024.104107
G. Ku , G.M. Haag , H. Park , V.K. Lam , T.J. George , S.S. Kim , M. Gutierrez , V. Shankaran , S. Stein , C.S. Denlinger , E. Elimova , A. Nagrial , A.R. He , M.B. Sawyer , H.H. Yoon , R. Geva , J. Starr , G. Curigliano , T. Golan , R. von Moos , M. Di Bartolomeo

Background

Nivolumab-based therapies are efficacious with acceptable safety in patients with gastric cancer (GC) and gastroesophageal junction cancer (GEJC). Novel nivolumab-based combination immunotherapies may offer enhanced efficacy in these indications. FRACTION-GC was a signal-seeking, randomized, open-label, phase II adaptive-design trial assessing efficacy and safety of nivolumab in combination with ipilimumab [cytotoxic T lymphocyte antigen-4 (CTLA-4) antibody], relatlimab (lymphocyte-activation gene 3 antibody), or IDO1i (BMS986205, an indoleamine-2,3-dioxygenase-1 inhibitor) in patients with unresectable, advanced/metastatic GC/GEJC.

Patients and methods

Previously treated patients with GC/GEJC were randomized to receive nivolumab + ipilimumab, nivolumab + relatlimab, or nivolumab + IDO1i across two tracks: anti-programmed death-(ligand) 1/anti-CTLA-4-naïve (track 1) and -experienced (track 2). Primary endpoints were objective response rate (ORR) by investigator per RECIST v1.1, duration of response, and progression-free survival (PFS) rate at 24 weeks. Secondary endpoint was safety.

Results

Eighty-one patients in track 1 and 81 in track 2 received one combination therapy. With a median follow-up of 50.2 months, ORR [95% confidence interval (CI)] by investigator for nivolumab + ipilimumab, nivolumab + relatlimab, and nivolumab + IDO1i in track 1 was 4% (0.1% to 21.9%), 5% (0.1% to 24.9%), and 13% (4.4% to 28.1%), and for track 2 was 9% (1.1% to 28.0%), 6% (0.7% to 18.7%), and 0% (0% to 15.4%), respectively. PFS rate at 24 weeks (95% CI) was 24% (11% to 39%) for nivolumab + IDO1i track 1, 17% (16% to 32%) for nivolumab + relatlimab track 2, and not estimable for other treatment arms. Grade 3/4 treatment-related adverse events were reported in 22%, 5%, and 18% of patients receiving nivolumab + ipilimumab, nivolumab + relatlimab, and nivolumab + IDO1i in track 1 and in 35%, 11%, and 18% of patients in track 2, respectively. No treatment-related deaths were reported.

Conclusions

While ORR did not meet prespecified expansion criteria in any treatment arm, the safety profile of the combinations was manageable. FRACTION-GC represents a novel adaptive protocol for testing multiple combination immunotherapies.
背景:以尼伏单抗为基础的治疗方法对胃癌(GC)和胃食管结癌(GEJC)患者有效,安全性可接受。新型的以纳鲁单抗为基础的联合免疫疗法可能在这些适应症中提供更高的疗效。分数-GC是一项信号寻求、随机、开放标签、II期适应性设计试验,评估nivolumab联合ipilimumab(细胞毒性T淋巴细胞抗原-4 (CTLA-4)抗体)、relatlimab(淋巴细胞活化基因3抗体)或IDO1i(吲哚胺-2,3-双加氧酶-1抑制剂BMS986205)治疗不可切除的晚期/转移性GC/GEJC患者的疗效和安全性。患者和方法:先前接受过GC/GEJC治疗的患者随机接受纳武单抗+伊匹单抗、纳武单抗+相对单抗或纳武单抗+ IDO1i治疗,分为两组:抗程序性死亡-(配体)1/anti-CTLA-4-naïve(轨道1)和-经验(轨道2)。主要终点是研究者根据RECIST v1.1的客观缓解率(ORR)、缓解持续时间和24周无进展生存(PFS)率。次要终点是安全性。结果:81例1轨患者和81例2轨患者接受了一次联合治疗。在中位50.2个月的随访中,研究者对nivolumab + ipilimumab, nivolumab + relatlimumab和nivolumab + IDO1i在1号轨中的ORR[95%置信区间(CI)]分别为4%(0.1%至21.9%),5%(0.1%至24.9%)和13%(4.4%至28.1%),而2号轨的ORR分别为9%(1.1%至28.0%),6%(0.7%至18.7%)和0%(0%至15.4%)。尼武单抗+ IDO1i第1轨道24周的PFS率(95% CI)为24%(11%至39%),尼武单抗+相对单抗第2轨道为17%(16%至32%),其他治疗组无法估计。3/4级治疗相关不良事件在第1研究区分别为22%、5%和18%接受纳武单抗+伊匹单抗、纳武单抗+相对单抗和纳武单抗+ IDO1i治疗的患者和在第2研究区分别为35%、11%和18%的患者。没有与治疗相关的死亡报告。结论:虽然任何治疗组的ORR都没有达到预先设定的扩展标准,但联合用药的安全性是可控的。分数- gc代表了一种新的自适应方案,用于测试多种联合免疫疗法。
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引用次数: 0
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ESMO Open
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