Future oncology最新文献

Background: Small cell lung cancer (SCLC) is an aggressive malignancy with limited treatment options. While surgery is increasingly considered for early-stage disease, its prognostic implications remain poorly characterized, and validated predictive tools are lacking.

Methods: This retrospective study analyzed 7718 patients from the SEER database and 237 patients from Tianjin Medical University General Hospital. Clinical variables including surgical approach, TNM stage, and adjuvant therapies were evaluated. Prognostic factors were identified through Cox regression, and a nomogram was developed from SEER data with external validation in the independent cohort.

Results: Surgical resection was associated with improved survival in stage I-IIIA patients but showed no benefit in stage IIIB-IV disease. Multivariate analysis identified TNM stage, lobectomy (versus sublobar resection), and postoperative chemotherapy as independent prognostic factors. The nomogram demonstrated strong predictive performance, with 1-, 3-, and 5-year AUC values of 0.871/0.727/0.725 in the development cohort and 0.775/0.744/0.723 in the validation cohort.

Conclusions: Our findings support surgical consideration for early-stage SCLC and provide a validated prognostic tool for clinical decision-making. The nomogram incorporating TNM stage, surgical extent, and adjuvant therapy effectively predicts survival outcomes, offering practical guidance for treatment planning.

MDX2001 is a tetraspecific T-cell engager-expander antibody engineered to recognize four distinct antigens: cellular mesenchymal-epithelial transition factor (c-MET) and trophoblast antigen 2 (TROP2) to direct T cells to tumor cells, CD3 to activate T cells, and CD28 to enhance T-cell survival and proliferation. MDX2001 has demonstrated potent antitumor activity in nonclinical studies over a wide range of tumor types. Here, we present the protocol design for study MDX-2001-101, a multicenter, open-label, phase I/IIa clinical trial designed to evaluate the safety, tolerability, and antitumor effects of MDX2001 in patients with advanced solid tumors. The study comprises a phase Ia dose escalation guided by a Bayesian optimal interval design with a targeted maximum tolerated dose toxicity rate of 30%, a phase Ib dose expansion, and a phase IIa indication expansion.

Introduction: Although immune checkpoint inhibitor (ICI) therapy for patients with extensive-stage small cell lung cancer (ES-SCLC) has shown promising results in clinical trials, it is not as widely used as for other cancers. Thus, investigating the association between ICI therapy and overall survival and treatment patterns of patients with ES-SCLC provides a new perspective regarding the introduction of ICI.

Materials & methods: This retrospective cohort study identified patients newly diagnosed with SCLC between January 2015 and January 2023 who received first-line treatment with etoposide from a nationwide database in Japan. Patients were divided into those who received ICI and conventional chemotherapy. Overall survival was assessed with a Cox proportional hazards model weighted by the inverse propensity score. The treatment patterns were visualized using a Sankey diagram.

Results: Of the 4537 patients, 2433 received conventional chemotherapy and 2104 received ICI therapy. The hazard ratio for mortality with ICI therapy was 0.892 (95% CI, 0.797-0.998). Less than half of the patients received ICI therapy as first-line treatment. Older patients tended to receive conventional chemotherapy.

Conclusions: Compared with conventional chemotherapy, ICI therapy was associated with increased overall survival in patients with ES-SCLC. However, clinical implementation of ICI therapy was delayed, particularly in older patients.

Background: Familial cancer test referral rates for rare tumors are suboptimal and follow a social gradient; while cancer registries are legally mandated to collect comprehensive clinical pathological data which could be used to inform clinical practice. We aimed to investigate consumer acceptability of and preferred approach for a cancer registry-driven familial cancer testing notification pathway.

Methods: A qualitative study using semi-structured interviews informed by the Theoretical Framework of Acceptability was conducted.

Results: Nineteen individuals recently disclosed to the Victorian Cancer Registry diagnosed with a cancer meeting local familial cancer testing criteria were interviewed. Participants supported being notified directly by the cancer registry to inform them about familial cancer testing, as they welcomed using existing health data in new ways to optimize health care. Key considerations included the timing, tone, language, information provided in the registry communication, and minimizing the onus on the patient. Assuring data security and verifying the legitimacy of the registry were raised.

Conclusion: Individuals diagnosed with cancer found the service model acceptable. Participants preferred either to action the findings independently, with supporting resources, or permit the cancer registry to directly inform treating clinicians. Ongoing and consumer-informed work is required to develop processes and resources including digital options.

Background: The glucose-to-lymphocyte ratio (GLR) has recently gained attention as a composite biomarker reflecting systemic inflammation and metabolic dysregulation. While its prognostic value has been reported in various malignancies, its clinical utility in endometrial cancer remains unknown. This study aimed to evaluate the prognostic relevance of GLR in surgically treated patients with endometrial cancer.

Methods: We retrospectively analyzed 165 patients who underwent total abdominal hysterectomy for endometrial cancer between January 2021 and January 2025. GLR was calculated by dividing fasting glucose levels by absolute lymphocyte count. Patients were classified into GLR-high and GLR-low groups using the median value (3.70). Disease-free survival (DFS) and overall survival (OS) were compared using Kaplan - Meier curves and Cox regression analysis.

Results: The median follow-up was 17.4 months. High GLR was independently associated with shorter DFS (HR: 2.05; 95% CI: 1.08-3.89; p = 0.029). A trend toward shorter OS was also noted (HR: 2.29; p = 0.056). Additional factors linked to poorer survival included absence of adjuvant radiotherapy, high tumor grade, and advanced stage.

Conclusion: GLR is an independent prognostic factor for DFS in endometrial cancer and may serve as a readily available, cost-effective biomarker. Further prospective studies are needed for validation.

Aims: Self-expanding metal stents (SEMS) are widely used as a bridge to surgery in obstructive colon cancer, offering short-term benefits by reducing postoperative complications and avoiding emergency stoma creation. Additionally, early initiation of systemic chemotherapy may improve oncological outcomes. However, the safety and feasibility of preoperative chemotherapy following SEMS placement remain unclear. This study aims to evaluate the safety and efficacy of neoadjuvant CAPOX chemotherapy after SEMS placement in patients with obstructive colon cancer.

Patients & methods: This is a prospective, multicenter, single-arm Phase II trial involving patients with clinical stage II or III obstructive colon cancer. Eligible patients undergo successful SEMS placement followed by two cycles of CAPOX chemotherapy prior to elective surgery. The primary endpoint is the incidence of severe perioperative complications, defined as a composite of stent-related adverse events and Clavien - Dindo Grade III or higher postoperative complications. Secondary endpoints include chemotherapy-related adverse events, pathological response, and 2-year relapse-free survival. A total of 75 patients are planned for enrollment across 16 hospitals in Japan over 1.5 years. The study is registered in the Japan Registry of Clinical Trials (jRCTs051240077).

Objective: This study aims to develop a machine learning (ML) model to predict the risk of central lymph node metastasis (CLNM) in patients with papillary thyroid microcarcinoma (PTMC) using a combination of clinical and ultrasound features.

Methods: Multiple ML models were integrated, with least absolute shrinkage and selection operator regression applied for feature selection and a LightGBM model optimized for prediction. Clinical and ultrasound features were used to construct the predictive model.

Results: The model demonstrated high predictive accuracy in the validation cohort, with an area under the curve of 0.87. Key features associated with CLNM risk included tumor size, extrathyroidal extension and vascularization.

Conclusions: The ML model showed strong potential for predicting CLNM in PTMC, and interpretability analysis enhanced model transparency. These findings provide valuable support for personalized treatment strategies in clinical practice.

Background: The clinical benefit of PD-1/PD-L1-based immunotherapy in gastric signet ring cell carcinoma (GSRCC) remains unclear. This study evaluated the efficacy of first-line immunotherapy in advanced GSRCC.

Methods: This single-center retrospective cohort study assessed the clinical response of patients with advanced GC diagnosed from November 2019 to January 2025 after receiving first-line immunotherapy combined with chemotherapy and/or target therapy, concurrently comparing therapeutic outcomes in GSRCC and non-GSRCC cohorts.

Results: This study included 230 patients, with objective response rate (ORR) achieving 43.9%. Among the 150 non-GSRCC patients, the ORR was 50.7%, compared to 31.3% in the 80 GSRCC patients. Non-GSRCC patients had longer median progression-free survival (PFS: 10.0 vs 7.9 months; p = 0.002) and overall survival (OS: 17.4 vs 15.3 months; p = 0.039). Peritoneal metastasis was independently associated with rapid progression and poor survival (HR 2.63, 95% CI 1.52-5.53; p = 0.001). Among GSRCC patients, those with peritoneal metastasis had significantly shorter PFS (6.6 vs 13.6 months; p < 0.001) and OS (11.0 vs 19.4 months; p = 0.001).

Conclusions: The findings suggest that GSRCC is associated with resistance to immunotherapy in advanced GC. Furthermore, peritoneal metastasis is significantly associated with poor prognosis in GSRCC patients.