Future oncology最新文献

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).

Aim: This study aimed to predict axillary metastasis using radiology features in dynamic contrast-enhanced MRI. Methods: This study included 243 breast lesions confirmed as malignant based on axillary status. Most outcome-predictive features were selected using four machine-learning algorithms. Receiver operating characteristic analysis was used to reflect diagnostic performance. Results: Least absolute shrinkage and selection operator was used to dimensionally reduce 1137 radiomics features to three features. Three optimal radiomics features were used to model construction. The logistic regression model achieved an accuracy of 97% and 85% in the training and test groups. Clinical utility was evaluated using decision curve analysis. Conclusion: The novel combination of radiomics analysis and machine-learning algorithm could predict axillary metastasis and prevent invasive manipulation.

Background: Adjuvant chemotherapy decision-making in stage II colon cancer remains challenging. Although multidisciplinary tumor boards (MDTs) guide treatment, their recommendations vary. Artificial intelligence (AI) tools such as ChatGPT may support decision-making, but direct comparative evidence with MDTs is limited.

Methods: We retrospectively analyzed 179 patients with stage II colon cancer who underwent surgery between 2019-2024. MDT recommendations (observation, fluoropyrimidine monotherapy, or oxaliplatin-based chemotherapy) were compared with ChatGPT-5 outputs. Clinical factors - including age, ECOG performance status (PS), tumor stage, minor risk factors, and mismatch repair (MMR) status - were incorporated. Agreement was evaluated using Cohen's kappa (κ) and McNemar's test.

Results: Across the three treatment categories, agreement between MDT and AI was moderate (70.4%, κ = 0.542, p < 0.001), while in the binary comparison of adjuvant therapy versus observation, concordance improved to substantial (91.1%, κ = 0.719, p < 0.001). Discordance mainly reflected AI's tendency to escalate therapy. Agreement decreased in patients ≥70 years, those with ECOG PS 2, and those with multiple risk factors.

Conclusions: AI showed moderate agreement with MDTs in detailed three-category recommendations but substantial concordance in binary adjuvant decisions. While AI may serve as a supportive tool, clinical judgment remains essential, particularly for elderly and frail patients.

Goal: To present data from published clinical trials of treatment of patients with prostate cancer with enzalutamide described in plain language and in a dashboard format available at: https://clinical-trials.dimensions.ai/enzalutamide-clinical-review/.

Rationale: Treatments that are clinically active in advanced prostate cancer may benefit patients as they are treated earlier in the disease.

Objective: To show how overall survival improves as patients are treated with enzalutamide earlier in the disease.

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.

Background: Atezolizumab plus bevacizumab (atezo+bev) is a standard-of-care 1L treatment for unresectable hepatocellular carcinoma (uHCC). Understanding its adoption and use, clinical outcomes, and subsequent therapies are needed.

Methods: This retrospective cohort study included 550 patients with uHCC in the US who initiated 1L atezo+bev between June 2020 and April 2023. Medical records were abstracted to describe treatment patterns and outcomes.

Results: Of 294 patients who discontinued 1L therapy, 176 patients initiated 2L therapy (2L cohort) and 48 patients didn't initiate 2L therapy after ≥8 weeks of follow-up (No 2L cohort). More of the No 2L cohort had Stage IVb tumors, BCLC stage D, ECOG-PS ≥2, ascites, and hepatic encephalopathy at baseline. The 2L cohort were more likely to discontinue atezo+bev due to disease progression (92.1% vs. 56.3%), and less likely due to toxicity/intolerability (4.0% vs. 10.4%) than the No 2L cohort. OS from 1L atezo+bev initiation was significantly longer in the 2L cohort vs. No 2L cohort (median 23.0 vs. 14.3 months; p < 0.001]).

Conclusions: 1L Atezo+bev was clinically active with 256 patients remaining on therapy at last follow-up. Patients who progressed after 1L atezo+bev benefited from additional systemic therapies. Future research analyzing the comparative effectiveness of 2L therapies is needed.