Future oncology最新文献

Aims: This study aims to assess whether pre-chemotherapy endogenous plasma metabolome can offer improved predictive values for Capecitabine chemotherapy-related adverse events (CRAEs).

Research design and methods: Plasma samples were collected from 25 colorectal cancer patients at different time points: 0 hours (before), and 1, 2.5, 4 hours after oral Capecitabine administration, to assess individual variations in exposure levels. Additionally, the endogenous metabolome profile was analyzed using UHPLC/Q-TOF-MS.

Results: Capecitabine and its metabolites can predict two CRAEs, with 5-FU, 5'-DFCR, and FUH2 exposures being associated with diarrhea and thrombocytopenia, respectively. In contrast, identified plasma endogenous biomarker metabolites can predict all seven observed CRAEs. These CRAE-related endogenous plasma metabolites are involved in various physiological functions, including cell proliferation, maintenance, and inflammation. Pre-chemotherapy endogenous plasma metabolites established superior predictive performance for CRAEs (AUROC values ranging from 0.718 to 0.998) compared to conventional drug exposure (AUROC values ranging from 0.737 to 0.773). Additionally, the endogenous plasma metabolome demonstrated a strong correlation with drug exposures.

Conclusions: Our study demonstrates that pre-chemotherapy endogenous plasma metabolome serve as superior biomarkers for predicting CRAEs, outperforming drug exposure levels. However, the limited sample size may impact the generalizability of these findings, and validation in larger patient cohorts is warranted.Trial Registration: NCT03030508 (registered at www.clinicaltrials.gov).

Aims: To describe United States real-world oral mucositis/stomatitis (OM/S) management for patients with non-small cell lung cancer (NSCLC) or breast cancer (BC) and document physician awareness of OM/S guidelines, risk factors, and barriers to care.

Patients & methods: This study included a cross-sectional physician survey and retrospective chart review. Physicians completed an electronic survey and abstracted chart data for patients with advanced/metastatic NSCLC or BC who developed treatment-related OM/S on or after 1 January 2021.

Results: Thirty-one physicians abstracted data for 272 patients (146 NSCLC; 126 BC). Median patient age at OM/S event was 66.2 years (NSCLC) and 61.6 years (BC). Systemic treatments included chemotherapy (NSCLC: 86.3%; BC: 67.5%), immunotherapy (NSCLC: 56.8%; BC: 10.3%), and targeted therapy (NSCLC: 9.6%; BC: 46.8%). OM/S-related treatment changes (reduction/interruption/discontinuation) were reported in 20.5% and 35.7% of patients with NSCLC or BC, respectively. A majority of physicians (61.3%) were unaware of published OM/S management guidelines. Physicians identified poor oral hygiene (80.6%) and limited physician awareness of OM/S guidelines (71.0%) as barriers to OM/S management.

Conclusions: OM/S occurs across cancer treatment regimens and can lead to treatment modification. Improvements in OM/S management at the patient and provider level are needed to enhance care and improve clinical outcomes.

Aims: Guidance and regulation for the use of social media (SM) by healthcare professionals (HCPs) is lacking in some parts of the world. This paper explores the significance and barriers of SM in oncology care in regions beyond Europe and North America.

Methods: A cross-sectional survey facilitated by Sermo to explore the use of SM among oncologists in Argentina, Brazil, India, Mexico, Saudi Arabia, Taiwan, Türkiye, and the United Arab Emirates was conducted between 14 June 2023 and 28 June 2023. A panel discussion involving seven digital opinion leaders (DOLs) was also held.

Results: Of 340 respondents, the survey found strong support for SM in public and HCP education with most preferring mobile phones and 88% accessing SM in their free time. SM has an average-to-great impact on the prescribing habits of 52% of respondents. Sixty-four percent of respondents are concerned about potential conflicts of interest with SM. The panel developed a framework of recommendations providing navigational aids for key information, verifying sources to avoid misinformation, disclosing conflicts of interests, and creating visual and bite-sized content.

Conclusion: Opportunities exist to enhance SM use in regions beyond Europe and North America. DOLs in oncology can enhance SM content quality.

Breast cancer (BC) presents a considerable global health challenge and is characterized by increasing mortality and morbidity rates. Prompt screening and accurate diagnosis are crucial for improving patient outcomes. For the assessment of BC, radiographic imaging modalities such as digital breast tomosynthesis (DBT), ultrasound, digital mammography (DM), magnetic resonance imaging (MRI), and nuclear medicine procedures are commonly used. The gold standard for confirming cancer is histopathology. To effectively support the segmentation, diagnosis, and prognosis of BC. Artificial intelligence (AI) technologies show great promise for the quantitative depiction of medical images.This review explores recent strides in AI applications for BC. The literature search from 2018 to 2025 was performed with the PubMed database. It includes rapid breast lesion detection, segmentation, cancer diagnosis and enhanced imaging quality through data augmentation. It also discusses the biological characterization of BC via AI-based classification tools, including subtyping and staging. Furthermore, this review also explores the use of multiomics data to predict clinical outcomes such as survival, treatment response, and metastasis in BC. Additionally, we recognized the challenges faced by AI in BC in real-world applications, including organizing data, model interpretability, and regulatory compliance.

Aims: To develop and validate a deep learning radiomics model to predict non-sentinel lymph node (NSLN) metastases in early-stage breast cancer patients with 1-2 positive sentinel lymph node (SLN) metastases.

Methods: This retrospective and prospective study encompassed 1,647 patients. Clinical, pathological information, and axillary ultrasound (AUS) findings, collected. Radiomic features of breast cancer lesions were extracted from the ultrasound images. We developed predictive models based on clinical factors alone (C model), clinical factors coupled with AUS (CA model), and clinical factors integrated with both AUS and radiomic features (CAR model). The predictive performance of each model was evaluated via the area under the curve (AUC), decision curve analysis (DCA), and calibration curve analysis.

Results: The AUC values for the C model, CA model and CAR model in the test cohort were 0.812, 0.850, and 0.994, respectively. Notably, the CAR model exhibited significantly superior predictive capability compared to both the C model and CA model. In subgroups analyses, the CAR model also achieved the optimal predictive performance. The DCA curve confirmed that the CAR model possessed significant clinical implications.

Conclusions: The CAR model had the capability to predict NSLN metastases in early-stage breast cancer with 1-2 positive SLN metastases.

Aims: Lack of diversity in clinical trial populations often results in healthcare inequity. This retrospective analysis presents the impact of implementing inclusive research practices on the diversity of the MyTACTIC trial population.

Patients & methods: Adult patients with advanced solid tumors were enrolled from large academic centers or community cancer clinics and a number of inclusive research practices were implemented to diversify patient recruitment. We summarized race/ethnicity data of the study population related to the sites' catchment area.

Results: Overall, 252 patients were enrolled (83% White). Community clinics represented 95% of screening sites (enrolled 249/252 patients). The proportion of patients from racial/ethnic minorities was generally higher in study centers from ethnically diverse catchment areas. Streamlining the protocol and implementing a free transport scheme to improve patient recruitment yielded positive feedback from site staff; 14 patients (5.5%) used the transportation service.

Conclusion: Findings from the MyTACTIC trial suggest that running trials at community oncology sites does not, by itself, increase patient diversity; other efforts are also necessary. NCT04632992.

Aim: To evaluate the real-world incidence of cardiovascular adverse events (CVAE) and clinical outcomes among patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) treated with covalent Bruton's Tyrosine Kinase inhibitors (cBTKis).

Methods: Patients initiating cBTKi treatment from 1 January 2020 to 1 January 2023 were identified using claims data. Demographics, first-line (1L) and second-line or later (2L+) therapy, incident CVAEs, and clinical outcomes were assessed.

Results: In total, 2,163 patients (81.4% in 1L and 18.6% in 2L+) were identified with a mean age of 73.8 $\pm$ 9.2 years and 40.6% female. The most common incident CVAEs were hypertension (23.4%), atrial fibrillation (10.2%), ventricular arrhythmias (10.1%), heart failure (8.5%), and atrial flutter (4.2%). Those with CVAEs experienced higher switching to next treatment + death and worse overall survival than those without CVAEs. Incidence rates were ~2-3 fold lower with acalabrutinib than ibrutinib for hypertension, atrial fibrillation, and atrial flutter. Kaplan-Meier estimates for the likelihood of not experiencing a CVAE were 83% (acalabrutinib) and 72% (ibrutinib) at 12-months.

Conclusions: Despite improvements in 2nd-generation cBTKi cardiotoxicity, patients with CLL/SLL receiving cBTKis have a considerable cardiovascular disease burden. These findings highlight the unmet need for CLL/SLL treatment options with improved efficacy and safety profiles.

Aims: Cancer patients face a higher risk of adverse effects from coronavirus disease 2019 (COVID-19) compared to the general population. However, the safety of restarting antitumor therapy following COVID-19 recovery remains unclear.

Methods: In this prospective, multicenter study conducted between January 1 and 30 March 2023, 419 eligible cancer patients who had recovered from COVID-19 were screened across four medical centers. The primary endpoint was the incidence of treatment-emergent adverse events (TEAEs) during the first cycle of antitumor therapy resumed within 3 months after COVID-19 recovery. Changes in clinical laboratory parameters were assessed as secondary endpoints.

Results: A total of 270 eligible participants were included in this study. The common grade 3 or worse TEAEs were fatigue (3.3%), anemia (1.1%), leukopenia (0.7%), and elevated alanine transaminase (0.3%). No severe cardiac toxicity and significant abnormalities on the chest computed tomography (CT) were observed. D-dimer and cardiac troponin I (cTNI) were significantly increased after treatment (p < 0.05). Increased inflammatory cytokines of peripheral blood could be observed after administration of oxaliplatin and trastuzumab.

Conclusions: Restarting systemic antitumor therapy in solid tumor patients after COVID-19 recovery is generally safe. Systemic inflammatory and coagulation function of patients should be monitored during treatment.

Lung cancer is the first cause of mortality and the third most common cancer worldwide. In the United Arab Emirates (UAE), lung cancer ranks third in terms of cancer-related mortality and sixth in terms of incidence. In order to strengthen and to improve the management of this cancer in the UAE, a panel of 15 oncologist and pathologist experts in the field of lung cancer developed the first UAE consensus recommendations for the diagnosis and management of early and advanced lung cancer. A total of thirty-three, statements were drafted, discussed, and voted on, using a modified Delphi process. This consensus meeting acts as a cornerstone for the management of cancers in the UAE and highlights the importance of optimized, evidence-based, and patient-centered practices.