European Journal of Cancer最新文献

英文中文

Glucagon-like Peptide‐1 Agonists Reduce Cardiovascular Events in Cancer Patients on Immune Checkpoint Inhibitors 胰高血糖素样肽-1激动剂可减少使用免疫检查点抑制剂的癌症患者的心血管事件。

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-05 DOI: 10.1016/j.ejca.2024.115170

Cho-Han Chiang , Junmin Song , Kuan-Yu Chi , Yu-Cheng Chang , Nutchapon Xanthavanij , Yu Chang , Yuan Ping Hsia , Cho-Hung Chiang , Azin Ghamari , Kerry L. Reynolds , Shuwen Lin , Xiaocao “Haze” Xu , Tomas G. Neilan

Background

Immune checkpoint inhibitors (ICIs) are associated with an increased risk of major adverse cardiovascular events (MACE). Glucagon-like peptide-1 agonists (GLP1a), initially developed for type 2 diabetes mellitus (T2DM), have shown promising results in reducing cardiovascular events. We aimed to investigate the effect of GLP1a on cardiovascular events in patients receiving ICIs.

Methods

We conducted a retrospective, propensity score-matched cohort study using the TriNetX database. We identified adults with cancer and T2DM who received ICIs between April 2013 and May 2023. The primary efficacy outcome was incident MACE, defined as a composite of myocardial infarction, need for coronary revascularization, heart failure, ischemic stroke, and cardiac arrest. The secondary efficacy outcomes were the individual components of MACE as well as myocarditis and pericarditis. Safety outcomes included the occurrence of immune-related adverse events, serious adverse events related to GLP1a use, and all-cause mortality.

Results

We identified 7651 patients eligible for inclusion, among which 479 received GLP1a and 7172 received non-GLP1a diabetes medications. After matching (469 patients each), baseline characteristics were well-balanced. Over a median 12-month follow-up, the GLP1a cohort had a significantly lower MACE incidence than the non-GLP1a cohort (9.0 vs. 17.1 events per 100 patient-years) with a 54 % lower risk of MACE (Hazard ratio (HR),0.46 [95 % CI: 0.32–0.67]). There were reductions in myocardial infarction or need for coronary revascularization, heart failure, and all-cause mortality, with no differences in other cardiovascular events. GLP1a use did not increase risk of adverse events, including pancreatitis, biliary disease, bowel obstruction, gastroparesis, and immune-related adverse events.

Conclusion

GLP1a use in cancer patients with T2DM receiving ICIs was associated with reduced MACE and all-cause mortality without an increased risk in serious adverse events.

背景：免疫检查点抑制剂（ICIs）与主要不良心血管事件（MACE）风险增加相关。胰高血糖素样肽-1激动剂（GLP1a）最初是为2型糖尿病（T2DM）开发的，在减少心血管事件方面显示出有希望的结果。我们的目的是研究GLP1a对接受ICIs患者心血管事件的影响。方法：我们使用TriNetX数据库进行回顾性倾向评分匹配队列研究。我们确定了在2013年4月至2023年5月期间接受ICIs治疗的患有癌症和2型糖尿病的成年人。主要疗效指标是MACE的发生率，定义为心肌梗死、冠状动脉血运重建、心力衰竭、缺血性卒中和心脏骤停的综合指标。次要疗效结果是MACE的各个成分以及心肌炎和心包炎。安全性结局包括免疫相关不良事件的发生、与GLP1a使用相关的严重不良事件和全因死亡率。结果：我们确定了7651例符合纳入条件的患者，其中479例接受GLP1a治疗，7172例接受非GLP1a糖尿病药物治疗。匹配后（各469例），基线特征平衡良好。在中位12个月的随访中，GLP1a队列的MACE发生率显著低于非GLP1a队列（9.0 vs. 17.1事件/ 100患者年），MACE风险降低54%（风险比（HR），0.46 [95% CI: 0.32-0.67]）。心肌梗死、冠状动脉血运重建术、心力衰竭和全因死亡率均有降低，其他心血管事件无差异。GLP1a的使用不会增加不良事件的风险，包括胰腺炎、胆道疾病、肠梗阻、胃轻瘫和免疫相关不良事件。结论：GLP1a在接受ICIs治疗的T2DM癌症患者中使用与降低MACE和全因死亡率相关，且未增加严重不良事件的风险。

{"title":"Glucagon-like Peptide‐1 Agonists Reduce Cardiovascular Events in Cancer Patients on Immune Checkpoint Inhibitors","authors":"Cho-Han Chiang , Junmin Song , Kuan-Yu Chi , Yu-Cheng Chang , Nutchapon Xanthavanij , Yu Chang , Yuan Ping Hsia , Cho-Hung Chiang , Azin Ghamari , Kerry L. Reynolds , Shuwen Lin , Xiaocao “Haze” Xu , Tomas G. Neilan","doi":"10.1016/j.ejca.2024.115170","DOIUrl":"10.1016/j.ejca.2024.115170","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) are associated with an increased risk of major adverse cardiovascular events (MACE). Glucagon-like peptide-1 agonists (GLP1a), initially developed for type 2 diabetes mellitus (T2DM), have shown promising results in reducing cardiovascular events. We aimed to investigate the effect of GLP1a on cardiovascular events in patients receiving ICIs.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, propensity score-matched cohort study using the TriNetX database. We identified adults with cancer and T2DM who received ICIs between April 2013 and May 2023. The primary efficacy outcome was incident MACE, defined as a composite of myocardial infarction, need for coronary revascularization, heart failure, ischemic stroke, and cardiac arrest. The secondary efficacy outcomes were the individual components of MACE as well as myocarditis and pericarditis. Safety outcomes included the occurrence of immune-related adverse events, serious adverse events related to GLP1a use, and all-cause mortality.</div></div><div><h3>Results</h3><div>We identified 7651 patients eligible for inclusion, among which 479 received GLP1a and 7172 received non-GLP1a diabetes medications. After matching (469 patients each), baseline characteristics were well-balanced. Over a median 12-month follow-up, the GLP1a cohort had a significantly lower MACE incidence than the non-GLP1a cohort (9.0 vs. 17.1 events per 100 patient-years) with a 54 % lower risk of MACE (Hazard ratio (HR),0.46 [95 % CI: 0.32–0.67]). There were reductions in myocardial infarction or need for coronary revascularization, heart failure, and all-cause mortality, with no differences in other cardiovascular events. GLP1a use did not increase risk of adverse events, including pancreatitis, biliary disease, bowel obstruction, gastroparesis, and immune-related adverse events.</div></div><div><h3>Conclusion</h3><div>GLP1a use in cancer patients with T2DM receiving ICIs was associated with reduced MACE and all-cause mortality without an increased risk in serious adverse events.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"216 ","pages":"Article 115170"},"PeriodicalIF":7.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876427","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

Could intratumoural microbiota be key to unlocking treatment responses in hepatocellular carcinoma? 肿瘤内微生物群可能是开启肝癌治疗反应的关键吗？

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-05 DOI: 10.1016/j.ejca.2024.115195

Kin Lam Yu , Sj Shen

Hepatocellular carcinoma (HCC) is the third cause of cancer-related mortality worldwide. Current treatments include surgery and immunotherapy with variable response. Despite aggressive treatment, disease progression remains the biggest contributor to mortality. Thus, there is an urgent unmet need to improve current treatments through a better understanding of HCC tumourigenesis. The gut microbiota has been intensively examined in the context of HCC, with evidence showing gut modulation has the potential to modulate tumourigenesis and prognosis. In addition, recent literature suggests the presence of an intratumoural microbiota that may exert significant impacts on the development of solid tumours including HCC. By drawing parallels between the gut and hepatic/tumoural microbiota, we explore in the present review how the hepatic microbiota is established, its impact on tumourigenesis, and how modulation of the gut and hepatic microbiota may be key to improving current treatments of HCC. In particular, we highlight key bacteria that have been discovered in HCC tumours, and how they may affect the tumour immune microenvironment and HCC tumourigenesis. We then explore current therapies that target the intratumoural microbiota. With a deeper understanding of how the intratumoural microbiota is established, how different bacteria may be involved in HCC tumourigenesis, and how they can be targeted, we hope to spark future research in validating intratumoural microbiota as an avenue for improving treatment responses in HCC.

肝细胞癌（HCC）是全球癌症相关死亡的第三大原因。目前的治疗方法包括手术和免疫治疗。尽管进行了积极的治疗，但疾病进展仍然是导致死亡的最大因素。因此，迫切需要通过更好地了解HCC的肿瘤发生来改善目前的治疗方法。在HCC的背景下，肠道微生物群已被深入研究，有证据表明肠道调节具有调节肿瘤发生和预后的潜力。此外，最近的文献表明，肿瘤内微生物群的存在可能对包括HCC在内的实体肿瘤的发展产生重大影响。通过比较肠道和肝脏/肿瘤微生物群之间的相似之处，我们在本综述中探讨了肝脏微生物群是如何建立的，它对肿瘤发生的影响，以及肠道和肝脏微生物群的调节如何可能是改善当前HCC治疗的关键。我们特别强调了在HCC肿瘤中发现的关键细菌，以及它们如何影响肿瘤免疫微环境和HCC肿瘤发生。然后我们探索目前针对肿瘤内微生物群的治疗方法。随着对肿瘤内微生物群如何建立，不同细菌如何参与HCC肿瘤发生以及它们如何被靶向的更深入了解，我们希望激发未来的研究，以验证肿瘤内微生物群作为改善HCC治疗反应的途径。

{"title":"Could intratumoural microbiota be key to unlocking treatment responses in hepatocellular carcinoma?","authors":"Kin Lam Yu , Sj Shen","doi":"10.1016/j.ejca.2024.115195","DOIUrl":"10.1016/j.ejca.2024.115195","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) is the third cause of cancer-related mortality worldwide. Current treatments include surgery and immunotherapy with variable response. Despite aggressive treatment, disease progression remains the biggest contributor to mortality. Thus, there is an urgent unmet need to improve current treatments through a better understanding of HCC tumourigenesis. The gut microbiota has been intensively examined in the context of HCC, with evidence showing gut modulation has the potential to modulate tumourigenesis and prognosis. In addition, recent literature suggests the presence of an intratumoural microbiota that may exert significant impacts on the development of solid tumours including HCC. By drawing parallels between the gut and hepatic/tumoural microbiota, we explore in the present review how the hepatic microbiota is established, its impact on tumourigenesis, and how modulation of the gut and hepatic microbiota may be key to improving current treatments of HCC. In particular, we highlight key bacteria that have been discovered in HCC tumours, and how they may affect the tumour immune microenvironment and HCC tumourigenesis. We then explore current therapies that target the intratumoural microbiota. With a deeper understanding of how the intratumoural microbiota is established, how different bacteria may be involved in HCC tumourigenesis, and how they can be targeted, we hope to spark future research in validating intratumoural microbiota as an avenue for improving treatment responses in HCC.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"216 ","pages":"Article 115195"},"PeriodicalIF":7.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893156","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

Extracorporeal photopheresis effective in immune-related capillary leak/polyserositis in splenectomized patient 体外光疗治疗脾切除术患者免疫相关性毛细血管渗漏/多浆液炎的疗效。

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-05 DOI: 10.1016/j.ejca.2024.115189

C. Ertl, M. Kroiss, L.E. French, L. Heinzerling

引用次数: 0

Feasibility of AI as first reader in the 4-IN-THE-LUNG-RUN lung cancer screening trial: impact on negative-misclassifications and clinical referral rate AI作为4-IN-THE-LUNG-RUN肺癌筛查试验第一阅读器的可行性：对阴性误分类和临床转诊率的影响

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-05 DOI: 10.1016/j.ejca.2024.115214

Anna N.H. Walstra , Harriet L. Lancaster , Marjolein A. Heuvelmans , Carlijn M. van der Aalst , Juul Hubert , Dana Moldovanu , Sytse F. Oudkerk , Daiwei Han , Jan Willem C. Gratama , Mario Silva , Harry J. de Koning , Matthijs Oudkerk

Background

Lung cancer screening (LCS) with low-dose CT (LDCT) reduces lung-cancer-related mortality in high-risk individuals. AI can potentially reduce radiologist workload as first-read-filter by ruling-out negative cases. The feasibility of AI as first reader was evaluated in the European 4-IN-THE-LUNG-RUN (4ITLR) trial, comparing its negative-misclassifications (NMs) to those of radiologists and the impact on referral rates.

Methods

NMs were collected from 3678 baseline LDCTs of the 4ITLR-dataset. LDCTs were read independently by radiologists and dedicated AI software (AVIEW-LCS, v1.1.42.92, Coreline-Soft, Seoul, Korea). A case was designated as NM when nodules > 100 mm³ were present and either radiologist or AI gave a negative-classification (only nodules <100 mm³ or no nodules), with an expert-panel as reference standard. A distinction was made between an indeterminate (100–300mm³), and positive (>300 mm³) classification, warranting referral for clinical-workup. Overall, there were 102 referrals (2.8 %) at baseline.

Results

Of the 3678 baseline scans, 438 NMs (11.9 %) were identified (age individuals: 68 (IQR: 64–73) years, 241 men); 31 (0.8 %) by AI and 407 (11.1 %) by radiologists. Among the 31 AI-NMs, 3 were classified positive and 28 indeterminate. Among the 407 radiologist-NMs, 4 were classified positive, and 403 were indeterminate, of which 8 were classified positive after receiving a three-month follow-up CT. Radiologists, as first reader, would have led to 12/102 (11.8 %) missed referrals, higher than the 3/102 (2.9 %) of AI.

Conclusion

This study showed AI outperforms radiologists with significantly less NMs and therefore shows promise as first reader in a LCS program at baseline, by independently ruling-out negative cases without substantially increasing the risk of missed clinical referrals.

背景：肺癌筛查（LCS）低剂量CT （LDCT）可降低高危人群肺癌相关死亡率。人工智能可以通过排除阴性病例来减少放射科医生作为第一读过滤器的工作量。在欧洲4-IN-THE-LUNG-RUN （4ITLR）试验中评估了人工智能作为第一阅读器的可行性，将其阴性错误分类（NMs）与放射科医生的分类进行了比较，并对转诊率产生了影响。方法：从4itlr数据集的3678个基线ldct中收集NMs。ldct由放射科医生和专用人工智能软件（AVIEW-LCS, v1.1.42.92, coline - soft, Seoul, Korea）独立读取。当出现结节> 100 mm3，放射科医生或人工智能给出阴性分类（仅结节3或无结节）时，指定为NM，并以专家小组作为参考标准。区分不确定（100-300mm3）和阳性（>300 mm3），需要转诊进行临床检查。总体而言，基线时有102例转诊（2.8 %）。结果：在3678次基线扫描中，确定了438例NMs(11.9 %)（年龄：68 （IQR: 64-73）岁，241例男性）；人工智能31例（0.8 %），放射科医生407例（11.1 %）。31例AI-NMs中，3例阳性，28例不确定。407名放射科医生中，4名诊断为阳性，403名不确定，其中8名在随访3个月CT后诊断为阳性。放射科医生，作为第一读者，将导致12/102（11.8 %）错过转诊，高于人工智能的3/102（2.9 %）。结论：该研究表明，人工智能的表现明显优于具有较少NMs的放射科医生，因此在基线时，通过独立排除阴性病例而不会显著增加错过临床转诊的风险，人工智能有望成为LCS项目的第一读者。

{"title":"Feasibility of AI as first reader in the 4-IN-THE-LUNG-RUN lung cancer screening trial: impact on negative-misclassifications and clinical referral rate","authors":"Anna N.H. Walstra , Harriet L. Lancaster , Marjolein A. Heuvelmans , Carlijn M. van der Aalst , Juul Hubert , Dana Moldovanu , Sytse F. Oudkerk , Daiwei Han , Jan Willem C. Gratama , Mario Silva , Harry J. de Koning , Matthijs Oudkerk","doi":"10.1016/j.ejca.2024.115214","DOIUrl":"10.1016/j.ejca.2024.115214","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer screening (LCS) with low-dose CT (LDCT) reduces lung-cancer-related mortality in high-risk individuals. AI can potentially reduce radiologist workload as first-read-filter by ruling-out negative cases. The feasibility of AI as first reader was evaluated in the European 4-IN-THE-LUNG-RUN (4ITLR) trial, comparing its negative-misclassifications (NMs) to those of radiologists and the impact on referral rates.</div></div><div><h3>Methods</h3><div>NMs were collected from 3678 baseline LDCTs of the 4ITLR-dataset. LDCTs were read independently by radiologists and dedicated AI software (AVIEW-LCS, v1.1.42.92, Coreline-Soft, Seoul, Korea). A case was designated as NM when nodules > 100 mm<sup>3</sup> were present and either radiologist or AI gave a negative-classification (only nodules <100 mm<sup>3</sup> or no nodules), with an expert-panel as reference standard. A distinction was made between an indeterminate (100–300mm<sup>3</sup>), and positive (>300 mm<sup>3</sup>) classification, warranting referral for clinical-workup. Overall, there were 102 referrals (2.8 %) at baseline.</div></div><div><h3>Results</h3><div>Of the 3678 baseline scans, 438 NMs (11.9 %) were identified (age individuals: 68 (IQR: 64–73) years, 241 men); 31 (0.8 %) by AI and 407 (11.1 %) by radiologists. Among the 31 AI-NMs, 3 were classified positive and 28 indeterminate. Among the 407 radiologist-NMs, 4 were classified positive, and 403 were indeterminate, of which 8 were classified positive after receiving a three-month follow-up CT. Radiologists, as first reader, would have led to 12/102 (11.8 %) missed referrals, higher than the 3/102 (2.9 %) of AI.</div></div><div><h3>Conclusion</h3><div>This study showed AI outperforms radiologists with significantly less NMs and therefore shows promise as first reader in a LCS program at baseline, by independently ruling-out negative cases without substantially increasing the risk of missed clinical referrals.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"216 ","pages":"Article 115214"},"PeriodicalIF":7.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926608","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

Cemiplimab in recurrent cervical cancer: Final analysis of overall survival in the phase III EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9 trial EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9 III期临床试验总生存期的最终分析

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-02-05 DOI: 10.1016/j.ejca.2024.115146

Ana Oaknin , Bradley J. Monk , Andreia Cristina de Melo , Hee Seung Kim , Yong Man Kim , Alla S. Lisyanskaya , Vanessa Samouëlian , Domenica Lorusso , Fernanda Damian , Chih-Long Chang , Evgeniy Gotovkin , Shunji Takahashi , Daniella Ramone , Beata Maćkowiak-Matejczyk , Laura Polastro , Eva Maria Guerra Alia , Nicoletta Colombo , Yulia Makarova , Jeffrey C. Goh , Kosei Hasegawa , Krishnansu S. Tewari

Aim

Cemiplimab has demonstrated significantly longer survival than physician’s choice of chemotherapy in patients with recurrent cervical cancer after first-line platinum-containing chemotherapy. We report the final survival analysis from the phase III randomized study (EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9).

Methods

Cemiplimab (n = 304) or chemotherapy (n = 304) were administered every 3 weeks. The primary endpoint was overall survival (OS). Patients were included regardless of programmed cell death-ligand 1 (PD-L1) status.

Results

At a median follow-up of 47.3 months (data cut-off: April 20, 2023), median OS was 11.7 versus 8.5 months for patients treated with cemiplimab and chemotherapy, respectively (hazard ratio 0.67, 95 % confidence interval 0.56–0.80, p < .00001). OS benefit was seen in PD-L1 positive and negative populations, even though more patients with PD-L1 < 1 % (n = 92), had poor performance status in the cemiplimab arm than the chemotherapy arm (61.4 % vs 47.9 %).

Conclusion

This final analysis confirms that cemiplimab maintains survival benefit compared with chemotherapy in recurrent cervical cancer after progression on first-line platinum therapy, regardless of PD-L1 expression. The safety profile was consistent with published data; incidences of adverse events were similar between cemiplimab and chemotherapy groups. These results support the use of second-line cemiplimab for patients with recurrent cervical cancer.

目的：在一线含铂化疗后复发的宫颈癌患者中，Cemiplimab的生存期明显长于医生选择的化疗。我们报告III期随机研究（EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9）的最终生存分析。方法：每3周给予头孢米单抗（n = 304）或化疗（n = 304）。主要终点是总生存期（OS）。无论患者的程序性细胞死亡-配体1 （PD-L1）状态如何，均纳入研究。结果：中位随访47.3个月（数据截止日期：2023年4月20日），接受塞米单抗和化疗的患者中位OS分别为11.7个月和8.5个月（风险比0.67,95%可信区间0.56-0.80,p）。结论：该最终分析证实，无论PD-L1表达如何，在一线铂治疗进展的复发性宫颈癌患者中，与化疗相比，塞米单抗保持了生存获益。安全性与已发表的数据一致；化疗组和西米单抗组的不良事件发生率相似。这些结果支持在复发性宫颈癌患者中使用二线头孢米单抗。

{"title":"Cemiplimab in recurrent cervical cancer: Final analysis of overall survival in the phase III EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9 trial","authors":"Ana Oaknin , Bradley J. Monk , Andreia Cristina de Melo , Hee Seung Kim , Yong Man Kim , Alla S. Lisyanskaya , Vanessa Samouëlian , Domenica Lorusso , Fernanda Damian , Chih-Long Chang , Evgeniy Gotovkin , Shunji Takahashi , Daniella Ramone , Beata Maćkowiak-Matejczyk , Laura Polastro , Eva Maria Guerra Alia , Nicoletta Colombo , Yulia Makarova , Jeffrey C. Goh , Kosei Hasegawa , Krishnansu S. Tewari","doi":"10.1016/j.ejca.2024.115146","DOIUrl":"10.1016/j.ejca.2024.115146","url":null,"abstract":"<div><h3>Aim</h3><div>Cemiplimab has demonstrated significantly longer survival than physician’s choice of chemotherapy in patients with recurrent cervical cancer after first-line platinum-containing chemotherapy. We report the final survival analysis from the phase III randomized study (EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9).</div></div><div><h3>Methods</h3><div>Cemiplimab (n = 304) or chemotherapy (n = 304) were administered every 3 weeks. The primary endpoint was overall survival (OS). Patients were included regardless of programmed cell death-ligand 1 (PD-L1) status.</div></div><div><h3>Results</h3><div>At a median follow-up of 47.3 months (data cut-off: April 20, 2023), median OS was 11.7 versus 8.5 months for patients treated with cemiplimab and chemotherapy, respectively (hazard ratio 0.67, 95 % confidence interval 0.56–0.80, p < .00001). OS benefit was seen in PD-L1 positive and negative populations, even though more patients with PD-L1 < 1 % (n = 92), had poor performance status in the cemiplimab arm than the chemotherapy arm (61.4 % vs 47.9 %).</div></div><div><h3>Conclusion</h3><div>This final analysis confirms that cemiplimab maintains survival benefit compared with chemotherapy in recurrent cervical cancer after progression on first-line platinum therapy, regardless of PD-L1 expression. The safety profile was consistent with published data; incidences of adverse events were similar between cemiplimab and chemotherapy groups. These results support the use of second-line cemiplimab for patients with recurrent cervical cancer.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"216 ","pages":"Article 115146"},"PeriodicalIF":7.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970174","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

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

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

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

European Journal of Cancer

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀