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.

Aim: Programmed death (ligand) 1 inhibitors (e.g., avelumab, pembrolizumab, and retifanlimab) are first-line treatment options for patients with locally advanced or metastatic Merkel cell carcinoma (MCC). In the absence of comparative and randomized trials, we aimed to systematically identify and synthesize real-world evidence (RWE) on the effectiveness and safety of immunotherapies in patients with advanced MCC.

Methods & materials: MEDLINE and Embase searches were conducted for observational RWE studies in locally advanced or metastatic MCC from January 2017 to December 2023. Avelumab was the only immunotherapy with sufficient data for analysis. Landmark 12-month overall survival (OS) and progression-free survival (PFS) were assessed by meta-analysis.

Results: Screening of 1731 records identified 37 publications eligible for inclusion (16 unique studies), of which eight were included in the meta-analysis. In line with results from the JAVELIN Merkel 200 trial, pooled 12-month OS rates of 77.7% in stage III and 63.0% in stage IV MCC and 12-month PFS rates of 53.3% and 39.3%, respectively, were estimated. Although safety data were insufficient for meta-analysis, two retrospective studies reported lower adverse event rates than JAVELIN Merkel 200.

Conclusions: The results of this study support broader use of avelumab in advanced MCC.

Most myelofibrosis (MF) patients treated with ruxolitinib fail to achieve optimal response (i.e., spleen volume reduction  ≥35% [SVR35] and improvement in total symptom score ≥50% [TSS50], and instead experience suboptimal reductions in spleen volume and constitutional symptoms. Maximizing SVR and TSS is critical for MF patients, as both are associated with improved quality of life (QoL) and overall survival (OS). Navtemadlin is a potent, selective, oral MDM2 inhibitor that restores p53 activity, inducing apoptosis of malignant TP53 wild-type (TP53^WT) CD34⁺ MF progenitor cells. In vitro and clinical data demonstrated navtemadlin's synergy with ruxolitinib and disease-modifying potential. POIESIS is a global, randomized, double-blind phase III trial (NCT06479135) evaluating navtemadlin versus placebo as add-on to ruxolitinib in JAK inhibitor-naïve TP53^WT MF patients with suboptimal response to ruxolitinib. The study includes a ruxolitinib monotherapy run-in period, followed by randomization of suboptimal responders to add-on navtemadlin or placebo to their stable ruxolitinib dose. Study objectives are to isolate the contribution of add-on navtemadlin by assessing SVR and TSS 24-weeks after randomization from the pre-randomization baseline and to demonstrate that this contribution is clinically meaningful using established SVR and TSS endpoints from the pre-ruxolitinib treatment baseline. Secondary endpoints include progression-free survival, leukemia-free survival, and OS.Clinical Trial Registration: NCT06479135 (ClinicalTrials.gov); EUCT 2023-504724-25-00 (EUClinicalTrials.EU).

Background: Relapsed/refractory (R/R) follicular lymphoma (FL) often requires multiple lines of therapy.

Objective: To compare time to next treatment (TTNT), treatment-free interval (TFI), healthcare resource utilization (HRU), and downstream costs among R/R FL patients treated with CAR T versus non-CAR T therapy.

Methods: Adult R/R FL patients with ≥2 prior lines of therapy were stratified into CAR T and non-CAR T cohorts. The Index Date was CAR T infusion (CAR T) or 3L initiation (non-CAR T). Outcomes included TTNT, TFI, HRU, and costs. Analyses were descriptive, incorporating Kaplan-Meier methods and multivariable models.

Results: 335 CAR T and 4,342 non-CAR T patients were included. Median TTNT was not reached for CAR T, with longer TFIs observed in descriptive analyses. Adjusted analyses showed lower pharmacy costs at both 3L+ (CR 0.32; 95% CI 0.21-0.48; p < 0.0001)and 4L+ (CR 0.26; 95% CI 0.16-0.42; p < 0.0001), and post-CAR T medical costs at 4L+ (CR 0.69; 95% CI 0.51-0.94; p = 0.017).

Conclusions: In this real-world analysis, CAR T was associated with longer TTNT, longer TFI, and lower downstream FL-related costs compared with non-CAR T therapy, with interpretation informed by differences in follow-up time and treatment context.

People living with cancer, and their caregivers and families, have access to many sources of health information. This brings both positives and challenges. Some information is not easy to understand and it can be difficult to know what is relevant to an individual's situation. It can also be difficult to know what sources are trustworthy, how to check accuracy, and what might be false information (misinformation or disinformation). This podcast brings together the perspectives of a medical oncologist, a patient advocate, and a recipient of risk-mitigating cancer care who also brings experience of caregiving and volunteering for an organization that provides information to support those at risk of developing cancer. They discuss various approaches to help people find relevant and trustworthy health information, and consider how healthcare providers can support this. An accompanying infographic provides a patient's guide to cancer-focused medical journals, which can be shared with people with cancer and their caregivers to help open the door to the patient-friendly content that is sometimes published by these journals. Overall, people are encouraged to seek support from their healthcare providers to find and interpret cancer information, with consideration of relevance to their own situation and the validity of the source.

Background: Concurrent chemoradiotherapy followed by immune consolidation therapy (cCRT+IO, the PACIFIC regimen) is the standard treatment for unresectable stage III non-small cell lung cancer (NSCLC). However, the optimal timing of combining radiotherapy with immunotherapy remains unexplored. This study compared the efficacy and safety of induction chemoimmunotherapy followed by radiotherapy (ICT+RT) with cCRT+IO.

Methods: This study included patients with unresectable stage III NSCLC who received cCRT+IO or ICT+RT between January 2021 and August 2023. Efficacy outcomes and safety profiles were assessed.

Results: A total of 183 eligible patients were enrolled; 108 (59.0%) received cCRT+IO, and 75 (41.0%) received ICT+RT. The median progression-free survival (PFS) was 26.8 months in the cCRT+IO group and 16.4 months in the ICT+RT group (hazard ratio [HR] 0.66; 95%CI 0.45-0.97; p = 0.031). The median overall survival (OS) was 45.4 months in the cCRT+IO group and was not reached in the ICT+RT group (HR 0.57, 95%CI 0.32-0.99; p = 0.046). In the cCRT+IO group, the incidence of grade 3 pneumonitis was 6.48%, whereas it was 13.33% in the ICT+RT group (p = 0.116).

Conclusion: Compared with ICT+RT, cCRT+IO demonstrated superior efficacy with a manageable safety profile in unresectable stage III NSCLC.

Aim: To compare triple and dual therapies for efficacy and safety in metastatic hormone-sensitive prostate cancer (mHSPC). Methods: A Bayesian network meta-analysis was conducted to indirectly compare overall survival, progression-free survival and adverse events in mHSPC patients with triple and dual therapies. Results: Triple and dual therapies were related to considerably higher overall survival than androgen-deprivation therapy (ADT), and darolutamide + docetaxel + ADT (hazard ratio [HR]: 0.54; 95% CI: 0.39-0.76; P score = 0.89) emerged as the best option. In terms of progression-free survival, abiraterone + prednisolone + docetaxel + ADT (HR: 0.33; 95% CI: 0.19-0.53; P score = 0.92) emerged as the best option. Apalutamide + ADT had the lowest odds of adverse events. Conclusion: Triple therapies were particularly effective in mHSPC patients, but the incidence of adverse events was significantly high.