European Journal of Cancer最新文献

英文中文

Response to letter re: “Elevated serum magnesium levels prompt favourable outcomes in cancer patients treated with immune checkpoint blockers”

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-05 DOI: 10.1016/j.ejca.2025.115249

Yingfang Feng, Huilai Zhang, Xianhuo Wang

引用次数: 0

A new treatment strategy for mid-low rectal cancer patients exhibiting a clinical complete or near-complete response to neoadjuvant chemoradiotherapy: Transanal endoscopic microsurgery ——A multicenter prospective case-control clinical trial by MONT-R 对新辅助放化疗有临床完全或接近完全反应的中低位直肠癌患者的新治疗策略：经肛门内镜显微手术——由MONT-R进行的一项多中心前瞻性病例对照临床试验。

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-05 DOI: 10.1016/j.ejca.2024.115156

Xiaoyuan Qiu , Jiaolin Zhou , Huizhong Qiu , Zhanlong Shen , Bin Wu , Wenzhuo Jia , Beizhan Niu , Fei Li , Hongwei Yao , Aiwen Wu , Ke Hu , Huadan Xue , Guangxi Zhong , Weixun Zhou , Weijie Chen , Ganbin Li , Guole Lin

Background

Total mesorectal excision is the standard surgery for locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT), but it may lead to high complication rates and poor quality of life. This study evaluates whether transanal endoscopic microsurgery (TEM), as a partial resection procedure, can enhance quality of life for clinical complete response (cCR) or near-cCR patients without compromising survival.

Methods

Between May 2017 to September 2021, 80 patients with T3–4N0M0 or TanyN+M0 mid-low rectal cancer achieving cCR or near-cCR post-nCRT were prospectively included at 6 Chinese centers. Patients underwent either TEM (Group A, n = 38) or radical surgery (Group B, n = 41). Clinicopathological, oncological, and functional outcomes were analyzed.

Results

Postoperative histology revealed 22 ypT0 (57.9 %), 5 ypT1 (13.2 %), 10 ypT2 (26.3 %), and 1 ypT3 (2.6 %) cases in group A and 20 pCR (48.8 %), 1 T0N1 (2.4 %), 5 T1N0 (12.2 %), 12 T2–3N0 (29.3 %), 3 T2–3N1 (7.3 %) cases in group B. After a 60-month median follow-up, local recurrence occurred in 2 patients (5.26 %) in Group A and none in Group B. Distant metastases occurred in 8 patients (21.05 %) in group A and 7 (17.07 %) in group B. There was no significant difference between the two groups in 5-year disease-free survival (P = 0.658) or 5-year overall survival (P = 0.465). Group A showed significantly faster recovery (P < 0.001) and better sphincter function per Wexner (1 vs. 4, P = 0.001) and LARS (0 vs. 17, P < 0.001) scores than Group B.

Conclusion

TEM may be an effective approach for assessing residual tumors in LARC patients with cCR or near-cCR. This approach offers an option for those requiring sphincter preservation, with no significant compromise in long-term oncological outcomes observed in our study.

背景：全肠系膜切除是局部晚期直肠癌（LARC）新辅助放化疗（nCRT）后的标准手术，但其并发症发生率高，生活质量差。本研究评估经肛门内窥镜显微手术（TEM）作为部分切除手术是否可以提高临床完全缓解（cCR）或接近cCR患者的生活质量而不影响生存。方法：2017年5月至2021年9月，在中国6个中心前瞻性纳入80例在ncrt后达到cCR或接近cCR的T3-4N0M0或TanyN+M0中低位直肠癌患者。患者接受TEM （A组，n = 38）或根治性手术（B组，n = 41）。分析临床病理、肿瘤和功能结果。结果:术后组织学：A组ypT0 22例（57.9%）、ypT1 5例（13.2%）、ypT2 10例（26.3%）、ypT3 1例（2.6%）；b组pCR 20例（48.8%）、T0N1 1例（2.4%）、T1N0 5例（12.2%）、T2-3N0 12例（29.3%）、T2-3N1 3例（7.3%）。A组局部复发2例（5.26%），b组无复发。A组远处转移8例（21.05%），b组远处转移7例（17.07%）。两组5年无病生存率（P = 0.658）和5年总生存率（P = 0.465）差异无统计学意义。结论：透射电镜可能是评估LARC合并cCR或近cCR患者残余肿瘤的有效方法。该方法为需要保留括约肌的患者提供了一种选择，在我们的研究中没有观察到长期肿瘤预后的显著妥协。

{"title":"A new treatment strategy for mid-low rectal cancer patients exhibiting a clinical complete or near-complete response to neoadjuvant chemoradiotherapy: Transanal endoscopic microsurgery ——A multicenter prospective case-control clinical trial by MONT-R","authors":"Xiaoyuan Qiu , Jiaolin Zhou , Huizhong Qiu , Zhanlong Shen , Bin Wu , Wenzhuo Jia , Beizhan Niu , Fei Li , Hongwei Yao , Aiwen Wu , Ke Hu , Huadan Xue , Guangxi Zhong , Weixun Zhou , Weijie Chen , Ganbin Li , Guole Lin","doi":"10.1016/j.ejca.2024.115156","DOIUrl":"10.1016/j.ejca.2024.115156","url":null,"abstract":"<div><h3>Background</h3><div>Total mesorectal excision is the standard surgery for locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT), but it may lead to high complication rates and poor quality of life. This study evaluates whether transanal endoscopic microsurgery (TEM), as a partial resection procedure, can enhance quality of life for clinical complete response (cCR) or near-cCR patients without compromising survival.</div></div><div><h3>Methods</h3><div>Between May 2017 to September 2021, 80 patients with T3–4N0M0 or TanyN+M0 mid-low rectal cancer achieving cCR or near-cCR post-nCRT were prospectively included at 6 Chinese centers. Patients underwent either TEM (Group A, n = 38) or radical surgery (Group B, n = 41). Clinicopathological, oncological, and functional outcomes were analyzed.</div></div><div><h3>Results</h3><div>Postoperative histology revealed 22 ypT0 (57.9 %), 5 ypT1 (13.2 %), 10 ypT2 (26.3 %), and 1 ypT3 (2.6 %) cases in group A and 20 pCR (48.8 %), 1 T0N1 (2.4 %), 5 T1N0 (12.2 %), 12 T2–3N0 (29.3 %), 3 T2–3N1 (7.3 %) cases in group B. After a 60-month median follow-up, local recurrence occurred in 2 patients (5.26 %) in Group A and none in Group B. Distant metastases occurred in 8 patients (21.05 %) in group A and 7 (17.07 %) in group B. There was no significant difference between the two groups in 5-year disease-free survival (P = 0.658) or 5-year overall survival (P = 0.465). Group A showed significantly faster recovery (P < 0.001) and better sphincter function per Wexner (1 vs. 4, P = 0.001) and LARS (0 vs. 17, P < 0.001) scores than Group B.</div></div><div><h3>Conclusion</h3><div>TEM may be an effective approach for assessing residual tumors in LARC patients with cCR or near-cCR. This approach offers an option for those requiring sphincter preservation, with no significant compromise in long-term oncological outcomes observed in our study.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"216 ","pages":"Article 115156"},"PeriodicalIF":7.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Generative AI chatbots for reliable cancer information: Evaluating web-search, multilingual, and reference capabilities of emerging large language models

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-03 DOI: 10.1016/j.ejca.2025.115274

Bradley D. Menz , Natansh D. Modi , Ahmad Y. Abuhelwa , Warit Ruanglertboon , Agnes Vitry , Yuan Gao , Lee X. Li , Rakchha Chhetri , Bianca Chu , Stephen Bacchi , Ganessan Kichenadasse , Adel Shahnam , Andrew Rowland , Michael J. Sorich , Ashley M. Hopkins

Recent advancements in large language models (LLMs) enable real-time web search, improved referencing, and multilingual support, yet ensuring they provide safe health information remains crucial. This perspective evaluates seven publicly accessible LLMs—ChatGPT, Co-Pilot, Gemini, MetaAI, Claude, Grok, Perplexity—on three simple cancer-related queries across eight languages (336 responses: English, French, Chinese, Thai, Hindi, Nepali, Vietnamese, and Arabic). None of the 42 English responses contained clinically meaningful hallucinations, whereas 7 of 294 non-English responses did. 48 % (162/336) of responses included valid references, but 39 % of the English references were.com links reflecting quality concerns. English responses frequently exceeded an eighth-grade level, and many non-English outputs were also complex. These findings reflect substantial progress over the past 2-years but reveal persistent gaps in multilingual accuracy, reliable reference inclusion, referral practices, and readability. Ongoing benchmarking is essential to ensure LLMs safely support global health information dichotomy and meet online information standards.

{"title":"Generative AI chatbots for reliable cancer information: Evaluating web-search, multilingual, and reference capabilities of emerging large language models","authors":"Bradley D. Menz , Natansh D. Modi , Ahmad Y. Abuhelwa , Warit Ruanglertboon , Agnes Vitry , Yuan Gao , Lee X. Li , Rakchha Chhetri , Bianca Chu , Stephen Bacchi , Ganessan Kichenadasse , Adel Shahnam , Andrew Rowland , Michael J. Sorich , Ashley M. Hopkins","doi":"10.1016/j.ejca.2025.115274","DOIUrl":"10.1016/j.ejca.2025.115274","url":null,"abstract":"<div><div>Recent advancements in large language models (LLMs) enable real-time web search, improved referencing, and multilingual support, yet ensuring they provide safe health information remains crucial. This perspective evaluates seven publicly accessible LLMs—ChatGPT, Co-Pilot, Gemini, MetaAI, Claude, Grok, Perplexity—on three simple cancer-related queries across eight languages (336 responses: English, French, Chinese, Thai, Hindi, Nepali, Vietnamese, and Arabic). None of the 42 English responses contained clinically meaningful hallucinations, whereas 7 of 294 non-English responses did. 48 % (162/336) of responses included valid references, but 39 % of the English references were.com links reflecting quality concerns. English responses frequently exceeded an eighth-grade level, and many non-English outputs were also complex. These findings reflect substantial progress over the past 2-years but reveal persistent gaps in multilingual accuracy, reliable reference inclusion, referral practices, and readability. Ongoing benchmarking is essential to ensure LLMs safely support global health information dichotomy and meet online information standards.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"218 ","pages":"Article 115274"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Letter Re: Germline NGS targeted analysis in adult patients with sporadic adrenocortical carcinoma

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-02 DOI: 10.1016/j.ejca.2025.115276

Lucas Bouys, Victor Gravrand, Anne Jouinot, Bruno Ragazzon, Jérôme Bertherat

引用次数: 0

Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-01 DOI: 10.1016/j.ejca.2025.115278

Denice Kamp , Anne M. May , Antoine Adenis , Andreia Capela , Sarah Derks , Francesca De Felice , Nina Fokter Dovnik , Cinta Hierro , Aysegul Ilhan-Mutlu , Florian Lordick , Radka Lordick Obermannova , Angelica Petrillo , Alberto Puccini , Ana Raimundo , Giandomenico Roviello , Alexander Siebenhüner , Marije Slingerland , Elizabeth C. Smyth , Hanneke W.M. van Laarhoven , Nadia Haj Mohammad

Background

The enhanced application of imaging techniques is resulting in the diagnosis of more patients with asymptomatic metastatic esophagogastric cancer (mEGC). We conducted a Delphi study to gather insights from European experts on the optimal timing for initiating palliative systemic therapy for these patients.

Methods

An online survey featured 14 scenarios where physicians chose their preferred timing for initiating systemic therapy: immediate(<3 weeks) or deferred. The standard scenario was a 65-year-old male, WHO/ECOG 0 with asymptomatic mEGC, 2 metastases in each lung, HER2 -, PDL1-CPS 2. In every subsequent case, one characteristic was modified. To investigate the fortitude of the physicians’ preference for an immediate start, scenarios also included a patient who was motivated to start but preferred to defer if the physician deemed it judicious. Consensus was defined as ≥ 75 % agreement; scenarios without consensus were re-evaluated in Delphi round 2.

Results

Thirty-nine physicians participated in the first round, and 33 in the second round. Consensus to start treatment immediately was reached in 12 (86 %) scenarios. When patients preferred to defer, the consensus was to still advise to start palliative systemic treatment immediately in half (n = 7) of the scenarios. Only 2 scenarios (pre-existent WHO/ECOG 2 or 78 years old) reached the consensus that treatment could be deferred.

Conclusions

In asymptomatic mEGC, immediate start of treatment is preferred by European experts. Consensus was established that treatment can be deferred for patients who prefer deferral and either have a pre-existent WHO/ECOG performance status of 2 or are of advanced age.

{"title":"Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study","authors":"Denice Kamp , Anne M. May , Antoine Adenis , Andreia Capela , Sarah Derks , Francesca De Felice , Nina Fokter Dovnik , Cinta Hierro , Aysegul Ilhan-Mutlu , Florian Lordick , Radka Lordick Obermannova , Angelica Petrillo , Alberto Puccini , Ana Raimundo , Giandomenico Roviello , Alexander Siebenhüner , Marije Slingerland , Elizabeth C. Smyth , Hanneke W.M. van Laarhoven , Nadia Haj Mohammad","doi":"10.1016/j.ejca.2025.115278","DOIUrl":"10.1016/j.ejca.2025.115278","url":null,"abstract":"<div><h3>Background</h3><div>The enhanced application of imaging techniques is resulting in the diagnosis of more patients with asymptomatic metastatic esophagogastric cancer (mEGC). We conducted a Delphi study to gather insights from European experts on the optimal timing for initiating palliative systemic therapy for these patients.</div></div><div><h3>Methods</h3><div>An online survey featured 14 scenarios where physicians chose their preferred timing for initiating systemic therapy: immediate(<3 weeks) or deferred. The standard scenario was a 65-year-old male, WHO/ECOG 0 with asymptomatic mEGC, 2 metastases in each lung, HER2 -, PDL1-CPS 2. In every subsequent case, one characteristic was modified. To investigate the fortitude of the physicians’ preference for an immediate start, scenarios also included a patient who was motivated to start but preferred to defer if the physician deemed it judicious. Consensus was defined as ≥ 75 % agreement; scenarios without consensus were re-evaluated in Delphi round 2.</div></div><div><h3>Results</h3><div>Thirty-nine physicians participated in the first round, and 33 in the second round. Consensus to start treatment immediately was reached in 12 (86 %) scenarios. When patients preferred to defer, the consensus was to still advise to start palliative systemic treatment immediately in half (n = 7) of the scenarios. Only 2 scenarios (pre-existent WHO/ECOG 2 or 78 years old) reached the consensus that treatment could be deferred.</div></div><div><h3>Conclusions</h3><div>In asymptomatic mEGC, immediate start of treatment is preferred by European experts. Consensus was established that treatment can be deferred for patients who prefer deferral and either have a pre-existent WHO/ECOG performance status of 2 or are of advanced age.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"218 ","pages":"Article 115278"},"PeriodicalIF":7.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143300057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Response to letter to the editor on “Germline NGS targeted analysis in adult patients with sporadic adrenocortical carcinoma”

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-01 DOI: 10.1016/j.ejca.2025.115277

Maria Scatolini, Salvatore Grisanti, Soraya Puglisi, Pasquale Tomaiuolo, Alfredo Berruti, Massimo Terzolo

引用次数: 0

Paradigm shift in early detection: Lung cancer screening to comprehensive CT screening

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-01-31 DOI: 10.1016/j.ejca.2025.115264

James L. Mulshine , Bruce Pyenson , Cheryl Healton , Carolyn Aldige , Riccardo S. Avila , Torsten Blum , Matthew Cham , Harry J. de Koning , Sean B. Fain , John K. Field , Raja Flores , Maryellen L. Giger , Ilya Gipp , Frederic W. Grannis , Jan Willem C. Gratama , Ella A. Kazerooni , Karen Kelly , Harriet L. Lancaster , Luis Montuenga , Kyle J. Myers , Matthijs Oudkerk

Large-scale lung cancer screening implementation combined with improvements in early detection techniques for three major tobacco-related diseases presents a rare opportunity to markedly improve population health outcomes for millions of people. Chest CT enables routine detection of early lung cancer as well as characterizing coronary calcium and detecting early emphysema in the course of lung cancer screening. Integrated preventive care centered on comprehensive chest CT screening has the potential to bring large benefits across co-morbid diseases with a common etiology. The current one-disease/ silo paradigm of medical practice is an obstacle to maximizing chest CT screening’s benefits.

The large potential for improved health outcomes across the world demands careful public health, quality assurance, and health policy considerations. A systematic analysis of imaging and health data from ongoing chest CT screening could accelerate this paradigm shift through sustained optimization of screening detection, quantitation and management for the three most lethal tobacco-related co-morbidities. To coordinate this effort to advance progress with implementing the full benefit of comprehensive chest CT screening, a new multi- disciplinary professional and advocacy consortium has been developed to foster collaboration to realize the future of multi-disease chest CT screening.

{"title":"Paradigm shift in early detection: Lung cancer screening to comprehensive CT screening","authors":"James L. Mulshine , Bruce Pyenson , Cheryl Healton , Carolyn Aldige , Riccardo S. Avila , Torsten Blum , Matthew Cham , Harry J. de Koning , Sean B. Fain , John K. Field , Raja Flores , Maryellen L. Giger , Ilya Gipp , Frederic W. Grannis , Jan Willem C. Gratama , Ella A. Kazerooni , Karen Kelly , Harriet L. Lancaster , Luis Montuenga , Kyle J. Myers , Matthijs Oudkerk","doi":"10.1016/j.ejca.2025.115264","DOIUrl":"10.1016/j.ejca.2025.115264","url":null,"abstract":"<div><div>Large-scale lung cancer screening implementation combined with improvements in early detection techniques for three major tobacco-related diseases presents a rare opportunity to markedly improve population health outcomes for millions of people. Chest CT enables routine detection of early lung cancer as well as characterizing coronary calcium and detecting early emphysema in the course of lung cancer screening. Integrated preventive care centered on comprehensive chest CT screening has the potential to bring large benefits across co-morbid diseases with a common etiology. The current one-disease/ silo paradigm of medical practice is an obstacle to maximizing chest CT screening’s benefits.</div><div>The large potential for improved health outcomes across the world demands careful public health, quality assurance, and health policy considerations. A systematic analysis of imaging and health data from ongoing chest CT screening could accelerate this paradigm shift through sustained optimization of screening detection, quantitation and management for the three most lethal tobacco-related co-morbidities. To coordinate this effort to advance progress with implementing the full benefit of comprehensive chest CT screening, a new multi- disciplinary professional and advocacy consortium has been developed to foster collaboration to realize the future of multi-disease chest CT screening.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"218 ","pages":"Article 115264"},"PeriodicalIF":7.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Total neoadjuvant treatment, non-operative management and radiotherapy-free strategies: New approaches for the management of proficient mismatch repair/microsatellite stable locally advanced rectal cancer. A narrative review and evidence-based algorithm

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-01-31 DOI: 10.1016/j.ejca.2025.115261

Roberto Moretto , Chiara Boccaccio , Matteo Landi , Gianluca Masi , Chiara Cremolini

In recent years, new therapeutic approaches have emerged in addition to classical neoadjuvant (chemo)radiotherapy for the treatment of locally advanced rectal cancer (LARC): total neoadjuvant treatment, non-operative management, and radiotherapy-free strategy. While the introduction of these approaches in a relatively short timeframe has quickly increased our therapeutic armamentarium, on the other hand it has complicated the decision-making process regarding the choice of the most appropriate treatment strategy for each patient with LARC. Therefore, a tool to interpret the evidence from clinical trials and to translate them into daily practice is highly demanded. In the present review, we address how these new developments are changing the multimodal treatment of LARC and offer an algorithm to integrate them into clinical practice.

引用次数: 0

Diagnosis and treatment of dermatofibrosarcoma protuberans. European interdisciplinary guideline – update 2024

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-01-30 DOI: 10.1016/j.ejca.2025.115265

Philippe Saiag , Celeste Lebbe , Lieve Brochez , Jean-François Emile , Ana Maria Forsea , Catherine Harwood , Axel Hauschild , Antoine Italiano , Lidija Kandolf , Nicole WJ Kelleners-Smeets , Aimilios Lallas , Ulrike Leiter , Beatriz Llombart , Caterina Longo , Josep Malvehy , Zeljko Mijuskovic , David Moreno-Ramirez , Klara Mosterd , Luca Tagliaferri , Selma Ugurel , Claus Garbe

Dermatofibrosarcoma protuberans (DFSP) is a cutaneous fibroblastic tumour that is locally aggressive, with a tendency for local recurrence, but rarely metastasizes. A collaboration of multi-disciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), the European Union of Medical Specialists (UEMS) and the European Academy of Dermatology and Venereology (EADV) was formed to update recommendations on DFSP diagnosis and treatment, based on current literature reviews and the experts' consensus. Diagnosis is suspected clinically and confirmed by pathology report, which should specify whether a transformation in higher-grade fibrosarcoma occurred. Detection of specific chromosomal translocations and/or fusion gene transcripts is useful to confirm diagnosis. Treatment is mainly surgical, intending to achieve complete resection of the tumour. To reduce the recurrence rate, the treatment of choice in DFSP is micrographically controlled surgery. Standard excision with a lateral safety margin of 2–3 cm is an acceptable alternative where only standard histopathological procedures are available. Imatinib is approved in Europe for treating inoperable primary tumours, locally inoperable recurrent disease, and metastatic DFSP. Use of imatinib has also been reported in extensive, difficult-to-operate tumours for preoperative reduction of tumour size, but clinical trials or large register data are required to confirm the usefulness of this approach. Therapeutic decisions for patients with fibrosarcomatous DFSP should be primarily made by an interdisciplinary oncology team ('tumour board').

{"title":"Diagnosis and treatment of dermatofibrosarcoma protuberans. European interdisciplinary guideline – update 2024","authors":"Philippe Saiag , Celeste Lebbe , Lieve Brochez , Jean-François Emile , Ana Maria Forsea , Catherine Harwood , Axel Hauschild , Antoine Italiano , Lidija Kandolf , Nicole WJ Kelleners-Smeets , Aimilios Lallas , Ulrike Leiter , Beatriz Llombart , Caterina Longo , Josep Malvehy , Zeljko Mijuskovic , David Moreno-Ramirez , Klara Mosterd , Luca Tagliaferri , Selma Ugurel , Claus Garbe","doi":"10.1016/j.ejca.2025.115265","DOIUrl":"10.1016/j.ejca.2025.115265","url":null,"abstract":"<div><div>Dermatofibrosarcoma protuberans (DFSP) is a cutaneous fibroblastic tumour that is locally aggressive, with a tendency for local recurrence, but rarely metastasizes. A collaboration of multi-disciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), the European Union of Medical Specialists (UEMS) and the European Academy of Dermatology and Venereology (EADV) was formed to update recommendations on DFSP diagnosis and treatment, based on current literature reviews and the experts' consensus. Diagnosis is suspected clinically and confirmed by pathology report, which should specify whether a transformation in higher-grade fibrosarcoma occurred. Detection of specific chromosomal translocations and/or fusion gene transcripts is useful to confirm diagnosis. Treatment is mainly surgical, intending to achieve complete resection of the tumour. To reduce the recurrence rate, the treatment of choice in DFSP is micrographically controlled surgery. Standard excision with a lateral safety margin of 2–3 cm is an acceptable alternative where only standard histopathological procedures are available. Imatinib is approved in Europe for treating inoperable primary tumours, locally inoperable recurrent disease, and metastatic DFSP. Use of imatinib has also been reported in extensive, difficult-to-operate tumours for preoperative reduction of tumour size, but clinical trials or large register data are required to confirm the usefulness of this approach. Therapeutic decisions for patients with fibrosarcomatous DFSP should be primarily made by an interdisciplinary oncology team ('tumour board').</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"218 ","pages":"Article 115265"},"PeriodicalIF":7.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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

Efficacy and safety of immune checkpoint inhibition combined with concurrent chemoradiotherapy in patients with stage III unresectable non-small cell lung cancer: A systematic review and meta-analysis

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-01-30 DOI: 10.1016/j.ejca.2025.115266

Fabian Acker , Martin Reck , Daniel Martin , Stefan Rieken , Sophie Heinzen , Maximilian Rost , Lukas Aguinarte , Hanna Schulte , Hubert Serve , Thomas Oellerich , Martin Sebastian , Friederike C. Althoff

Background

In patients with unresectable, stage III non-small cell lung cancer (NSCLC), durvalumab maintenance after concurrent chemoradiotherapy (cCRT) was shown to improve survival over placebo. As subgroup analyses indicated better outcomes with earlier start of durvalumab, several trials evaluated concomitant checkpoint inhibition (CPI) with cCRT. However, this may introduce an increased risk of treatment-related pulmonary toxicity.

Methods

We conducted a systematic review and meta-analysis of clinical trials of combined cCRT plus CPI followed by CPI maintenance in patients with stage III NSCLC. Endpoints included incidence of pneumonitis by any cause, objective response rate (ORR), progression-free (PFS), and overall survival (OS).

Results

A total of 7 trials comprising 653 patients were included. In trials of single-agent CPI with cCRT, pneumonitis occurred in 33 % of patients (95 % confidence interval [CI], 28–39) with 7 % (5−9) having CTCAE grade 3–5. In one trial, double CPI (PD-1 and CTLA4) plus cCRT was associated with excessive pneumonitis-related mortality of 16 % (4−40). Across all trials, ORR was 69 % (63−76). Median PFS and OS were 16.3 (95 % CI, 14.0–20.5) and 39.5 months (35.3–45.9), respectively. Three-year PFS and OS were 36.8 % (95 % CI, 32.7–41.4) and 53.1 % (49.1–57.4). Sensitivity analysis showed that induction chemoimmunotherapy prior cCRT plus CPI was associated with improved PFS of 48.0 % at 3 years (95 % CI, 40.7–56.7) in one trial.

Discussion

Addition of single-agent CPI to cCRT is manageable in selected patients with stage III NSCLC. Efficacy outcomes appear to be in line with previous data of cCRT followed by CPI maintenance.

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