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Aumolertinib with carboplatin–pemetrexed versus aumolertinib for nonsmall cell lung cancer with EGFR and concomitant tumor suppressor genes (ACROSS2): An open-label, multicenter, randomized phase 3 study 奥莫替尼联合卡铂-培美曲塞与奥莫替尼治疗伴有EGFR和肿瘤抑制基因的非小细胞肺癌(ACROSS2):一项开放标签、多中心、随机的3期研究
IF 254.7 1区 医学 Q1 ONCOLOGY Pub Date : 2026-03-12 DOI: 10.3322/caac.70071
Jian-Chun Duan, Jia Zhong, Bo-Yang Sun, Wen-Hua Zhao, Lin Wu, Kai-Lun Fei, Qian Chu, Qi-Sen Guo, Qi-Bin Song, Yan Yu, Da-Xing Zhu, Xin-Yan Liu, Jun Zhao, Zhi-Xiang Zhan, Shi Li, Lei Nie, Jie Lin, Xiao-Dong Peng, Dian-Sheng Zhong, Jin Zhou, Li-Hua Li, Yun-Fang Chen, Chen Hu, Tony Mok, Zhi-Jie Wang, Jie Wang
Third-generation epidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) are standard first-line therapy for advanced, EGFR-mutated nonsmall cell lung cancer (NSCLC). However, their benefit is limited in patients who have co-existing tumor suppressor gene (TSG) mutations, highlighting a need for intensified strategies to improve outcomes. ACROSS2 (ClinicalTrials.gov identifier NCT04500717) is the first prospective, multicenter, randomized phase 3 study to compare the third-generation EGFR-TKI aumolertinib in combination with carboplatin–pemetrexed versus aumolertinib monotherapy in patients who had NSCLC with EGFR mutations and concomitant TSG mutations. In total, 126 patients were enrolled and randomly assigned to either combination therapy (n = 62) or monotherapy (n = 64). The primary end point was median progression-free survival (PFS). At a median follow-up of 25.3 months, combination therapy significantly prolonged median PFS compared with monotherapy (19.78 vs 16.53 months; hazard ratio, 0.58; 95% confidence interval, 0.34–0.97). Landmark PFS rates at 12, 18, and 24 months were 78.7% versus 65.3%, 67.2% versus 40.8%, and 41.0% versus 29.9%, respectively. Subgroup analyses demonstrated a clear PFS benefit in patients who had co-existing tumor protein p53 (TP53) mutations. Grade 3 or greater adverse events occurred in 25.9% of patients who received combination therapy versus 17.2% of those who received monotherapy; no drug-related deaths were observed. Overall survival data were immature (data maturity, 4%). The ACROSS2 trial provides the first prospective evidence supporting a genotype-directed, chemotherapy-targeted intensification approach favoring aumolertinib plus carboplatin–pemetrexed for this molecularly defined population.
第三代表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)是晚期egfr突变的非小细胞肺癌(NSCLC)的标准一线治疗药物。然而,对于共存肿瘤抑制基因(TSG)突变的患者,它们的益处有限,这突出表明需要强化策略来改善结果。ACROSS2 (ClinicalTrials.gov标识号NCT04500717)是首个前瞻性、多中心、随机3期研究,旨在比较第三代EGFR- tki奥莫替尼联合卡铂-培美曲塞与奥莫替尼单药治疗EGFR突变和TSG突变的NSCLC患者。共有126例患者入组,随机分配到联合治疗组(n = 62)或单药治疗组(n = 64)。主要终点为中位无进展生存期(PFS)。在中位随访25.3个月时,与单药治疗相比,联合治疗显著延长了中位PFS (19.78 vs 16.53个月;风险比为0.58;95%可信区间为0.34-0.97)。12、18和24个月的标志性PFS率分别为78.7%对65.3%,67.2%对40.8%,41.0%对29.9%。亚组分析显示,共存肿瘤蛋白p53 (TP53)突变的患者有明显的PFS益处。接受联合治疗的患者发生3级或以上不良事件的比例为25.9%,而接受单一治疗的患者为17.2%;未观察到与毒品有关的死亡。总体生存数据不成熟(数据成熟度,4%)。ACROSS2试验提供了第一个前瞻性证据,支持基因型导向、化疗靶向强化方法,有利于奥莫替尼加卡铂-培美曲塞治疗这种分子定义的人群。
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引用次数: 0
Targeting tumor suppressor gene co-mutations in EGFR-mutant nonsmall cell lung cancer: How ACROSS2 sharpens the case for early intensification 在egfr突变的非小细胞肺癌中靶向肿瘤抑制基因共突变:ACROSS2如何强化早期强化
IF 254.7 1区 医学 Q1 ONCOLOGY Pub Date : 2026-03-12 DOI: 10.3322/caac.70072
Krishna S. Gunturu, Hina Khan, Gilberto de Lima Lopes
<p>The treatment landscape for <i>EGFR</i>-mutated nonsmall cell lung cancer (NSCLC) continues to evolve with welcome speed. With the advent of third-generation tyrosine kinase inhibitors (TKIs) like osimertinib, treatment has improved systemic and central nervous system control. However, patients who have NSCLC harboring concomitant tumor suppressor gene alterations, particularly <i>TP53</i> mutations, represent a biologically distinct subgroup with a poor prognosis and limited therapeutic options. TP53 co-mutations in <i>EGFR</i>-mutated NSCLC range from 40% to 68% in the real-world setting. These <i>co-mutated</i> tumors often behave aggressively, relapse earlier, and exhibit shorter lasting responses to targeted monotherapy.<span><sup>1, 2</sup></span> In one retrospective study, 5753 patients with <i>EGFR</i>-mutant NSCLC specimens were molecularly profiled.<span><sup>3</sup></span> Patients younger than 50 years who had classical <i>EGFR</i> mutations had the longest median overall survival (OS) with osimertinib compared with both older adults with classical <i>EGFR</i> mutations (40 vs. 32 months; hazard ratio [HR], 0.692; <i>p</i> < .01) and older adults with atypical <i>EGFR</i> mutations (40 vs. 21 months; HR, 0.47; <i>p</i> < .0001), independent of <i>TP53</i> mutation status. However, compared with older adults (older than 50 years) with atypical <i>EGFR</i> mutations, older adults with classical mutations had longer OS only in the absence of concurrent <i>TP53</i> mutations (median OS, 39 vs. 28 months; HR, 0.735; <i>p</i> < .0001). In addition, <i>TP53</i> co-mutations were enriched in the younger adult population (younger than 50 years; 76% vs. 62%, <i>q</i> < .05) compared with older adults.</p><p>One strategy to improve outcomes is upfront treatment intensification combining an <i>EGFR</i> TKI and chemotherapy. Contemporary randomized phase 3 trials, specifically FLAURA2 and MARIPOSA (ClinicalTrials.gov identifiers NCT04035486 and NCT04487080, respectively), have established that upfront treatment intensification improves disease control beyond what can be achieved with TKI monotherapy alone. In this evolving therapeutic landscape, the prospective ACROSS2 trial (ClinicalTrials.gov identifier NCT03400717) adds important confirmatory evidence. Rather than redefining standards of care, the trial reinforces an emerging consensus across studies: early treatment intensification is associated with improved outcomes in most patients, and no clearly delineated subgroup has been identified for whom initial monotherapy is preferred.</p><p>In this issue of <i>CA: A Cancer Journal for Clinicians</i>, investigators from the ACROSS2 phase 3 trial<span><sup>4</sup></span> offer a compelling, thoughtfully designed attempt to improve outcomes in advanced <i>EGFR</i>-mutant NSCLC with tumor suppressor gene co-mutations. By selectively enrolling patients with <i>EGFR</i> exon 19 deletion or L858R NSCLC who also harbor tumor suppressor
egfr突变的非小细胞肺癌(NSCLC)的治疗前景继续以令人欢迎的速度发展。随着第三代酪氨酸激酶抑制剂(TKIs)如奥西替尼的出现,治疗改善了全身和中枢神经系统的控制。然而,伴有肿瘤抑制基因改变(尤其是TP53突变)的非小细胞肺癌患者是一个生物学上独特的亚群,预后差,治疗选择有限。在现实环境中,egfr突变的NSCLC中TP53共突变的比例从40%到68%不等。这些共突变的肿瘤通常表现出侵略性,复发较早,并且对靶向单药治疗表现出较短的持续反应。在一项回顾性研究中,对5753例egfr突变的NSCLC患者标本进行了分子谱分析与经典EGFR突变的老年人(40个月vs 32个月;风险比[HR], 0.692; p < 0.01)和非典型EGFR突变的老年人(40个月vs 21个月;风险比,0.47;p < 0.0001)相比,50岁以下的经典EGFR突变患者使用奥西替尼的中位总生存期(OS)最长,与TP53突变状态无关。然而,与非典型EGFR突变的老年人(50岁以上)相比,经典突变的老年人只有在没有并发TP53突变的情况下才有更长的生存期(中位生存期,39个月vs 28个月;HR, 0.735; p < 0.0001)。此外,与老年人相比,TP53共突变在年轻人(小于50岁;76% vs. 62%, q < 0.05)中富集。改善预后的一种策略是前期治疗强化结合EGFR TKI和化疗。当前的随机3期试验,特别是FLAURA2和MARIPOSA(分别为ClinicalTrials.gov标识号NCT04035486和NCT04487080)已经确定,前期强化治疗可以改善疾病控制,而不是单独使用TKI单药治疗。在这个不断发展的治疗领域,前瞻性的ACROSS2试验(ClinicalTrials.gov标识符NCT03400717)增加了重要的证实性证据。该试验并没有重新定义治疗标准,而是强化了研究中出现的共识:在大多数患者中,早期强化治疗与改善预后相关,并且没有明确划分的亚组被确定为首选初始单药治疗。在这一期的CA: A Cancer Journal for clinical中,来自ACROSS2 iii期试验的研究人员提供了一个令人信服的,精心设计的尝试,以改善晚期egfr突变的非小细胞肺癌的肿瘤抑制基因共突变的结果。通过选择性地招募EGFR外显子19缺失或L858R NSCLC患者,这些患者也有肿瘤抑制基因改变(最常见的是TP53,但也有RB1、PTEN、APC等),ACROSS2与FLAURA2和MARIPOSA等更广泛的、所有患者的联合试验不同。这种基因组富集策略代表了一个生物学理性和临床重要的问题。结果令人鼓舞。与单药治疗相比,奥莫替尼联合铂-培美曲塞在无进展生存期(PFS)方面有临床意义的改善(19.78 vs. 16.53个月;HR, 0.58; 95%可信区间[CI], 0.34-0.97)。这些结果显示了显著的PFS改善(HR, 0.58),绝对延长了3.3个月,尽管这是一种更难治疗的癌症,但其相对获益程度与FLAURA2试验(HR, 0.71)相似。作者的探索性分析检查了TP53突变域和功能分类,为这一分子定义亚群的异质性提供了额外的见解。虽然这些分析受到统计能力不足的限制,但它们确实为未来生物标志物驱动的临床试验的设计奠定了基础。
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引用次数: 0
Colorectal cancer statistics, 2026. 结直肠癌统计,2026。
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-03-01 DOI: 10.3322/caac.70067
Rebecca L Siegel, Nikita Sandeep Wagle, Jessica Star, Tyler B Kratzer, Robert A Smith, Ahmedin Jemal

Colorectal cancer (CRC) is the second most common cancer-related death in the United States and ranks first in adults younger than 50 years. Every 3 years, the American Cancer Society reports on CRC occurrence based on incidence from population-based cancer registries and mortality from the National Center for Health Statistics. Overall, CRC incidence declined by 0.9% annually during 2013-2022 driven by decreases of 2.5% annually in adults aged 65 years and older. In sharp contrast, incidence rates increased by 3% annually in adults aged 20-49 years and by 0.4% annually in adults aged 50-64 years dominated by tumors in the distal colon and rectum. Consequently, overall rectal cancer incidence increased by 1% annually from 2018 to 2022 after decades of decline and now accounts for 32% of all CRC, up from 27% in the mid-2000s. Increasing CRC incidence in adults aged 50-64 years was confined to regional and distant-stage diagnosis (1.1%-1.3% annually during 2013-2022), likely contributing to an upturn in mortality in this age group of 1% annually since 2019 that was steepest (2.3% annually) in White individuals. Mortality has increased in adults younger than 50 years by 1% annually since 2004, whereas rates have decreased in adults 65 years and older by 2.3% annually since 2012. Despite steady progress for older adults, both CRC incidence and mortality are increasing in adults younger than 65 years who are in the prime of life, underscoring an urgent need for etiologic research to discover the cause of the rising trend. Meanwhile, morbidity and mortality could be mitigated with earlier diagnosis, through screening and educating clinicians and the general public about CRC symptoms, and greater attention to the unique needs of younger patients, including discussion about the preservation of fertility and sexual health.

结直肠癌(CRC)是美国第二常见的癌症相关死亡,在50岁以下的成年人中排名第一。每3年,美国癌症协会根据基于人群的癌症登记的发病率和国家卫生统计中心的死亡率报告结直肠癌的发病率。总体而言,在2013-2022年期间,由于65岁及以上成年人每年下降2.5%,结直肠癌发病率每年下降0.9%。与此形成鲜明对比的是,20-49岁的成年人发病率每年增加3%,50-64岁以远端结肠和直肠肿瘤为主的成年人发病率每年增加0.4%。因此,在经历了几十年的下降之后,从2018年到2022年,直肠癌的总发病率每年增加1%,目前占所有结直肠癌的32%,高于2000年代中期的27%。50-64岁成年人CRC发病率的增加仅限于区域和远期诊断(2013-2022年期间每年1.1%-1.3%),这可能导致该年龄组自2019年以来死亡率每年上升1%,其中白人死亡率上升最快(每年2.3%)。自2004年以来,50岁以下成年人的死亡率每年增加1%,而自2012年以来,65岁及以上成年人的死亡率每年下降2.3%。尽管老年人的CRC发病率和死亡率稳步上升,但65岁以下正值壮年的成年人CRC发病率和死亡率都在上升,这表明迫切需要进行病因学研究,以发现这一上升趋势的原因。同时,发病率和死亡率可以通过早期诊断,通过筛查和教育临床医生和公众关于结直肠癌的症状,更多地关注年轻患者的独特需求,包括关于保留生育能力和性健康的讨论,来减轻。
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引用次数: 0
Global cancer statistics for children: Two decades of change and projections to 2050. 全球儿童癌症统计:二十年的变化和到2050年的预测。
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-03-01 DOI: 10.3322/caac.70069
Wangzhong Li, Shanzhou Huang, Qiyue Chen, Ting Wang, Guanming Lu, Xing Niu, Qiong Song, Yilin Xu, Ke Mo, Chunhui Cui, Run Zhang, Wei Du, Feiying He, Lei Shi, Yan Lin, Qiu Wei, Li Jiang, Yongsheng Chen, Baiyang Song, Huijuan Zhang, Zhenli Fu, Wenjing Liao, Jiancong Sun, Wenhui Guan, Weitao Zhuang, Nanshan Zhong, Chengzhi Zhou, Wenhua Liang, Min Kang, Jianxing He

Reliable, contemporary estimates of the global childhood cancer burden remain scarce, particularly in the post-coronavirus disease 2019 (COVID-19) era. By using data from the Global Burden of Disease 2021 and Global Cancer Observatory 2022 projects, the authors evaluated the childhood cancer burden at global, regional, and national levels, characterizing temporal and projected trends, and analyzed the data according to disparities by geography and socioeconomic development. From 2000 to 2021, the age-standardized incidence rate (ASIR) and the age-standardized mortality rate (ASMR) of childhood cancer declined overall (average annual percent change, -0.88 and -2.13, respectively), especially during the COVID-19 pandemic. During this period, the disparities in childhood cancer burden were mainly concentrated in countries/territories with a lower Sociodemographic Index. In 2022, an estimated 202,164 new cases and 77,182 deaths from childhood cancer occurred worldwide (ASIR and ASMR, 10.3 and 3.9 per 100,000 children, respectively). Countries/territories with higher a Human Development Index (HDI) had a higher incidence (ASIR, 8.0 [low HDI] vs. 15.3 [very high HDI] per 100,000), whereas those with a lower HDI had higher mortality (ASMR, 4.4 [low HDI] vs. 2.8 [very high HDI] per 100,000). Analyses indicated that, by 2050, there will be 204,925 projected new cases and 78,210 deaths globally, with increases only in low HDI countries/territories, exacerbating existing health inequities. Childhood cancer remains a global health challenge, with notable geographic and socioeconomic disparities. These data serve as the impetus for governments and policymakers to prioritize resources and equitable access to interventions, particularly in regions with lower levels of development, while addressing health care vulnerabilities exposed by global crises like the COVID-19 pandemic.

对全球儿童癌症负担的当代可靠估计仍然很少,特别是在2019年冠状病毒病后(COVID-19)时代。作者利用全球疾病负担2021和全球癌症观察2022项目的数据,评估了全球、区域和国家层面的儿童癌症负担,描述了时间和预测趋势,并根据地理和社会经济发展的差异分析了数据。从2000年到2021年,儿童癌症的年龄标准化发病率(ASIR)和年龄标准化死亡率(ASMR)总体下降(年均变化百分比分别为-0.88和-2.13),特别是在COVID-19大流行期间。在此期间,儿童癌症负担的差异主要集中在社会人口指数较低的国家/地区。2022年,全球估计有202164例儿童癌症新发病例和77182例儿童癌症死亡(ASIR和ASMR分别为每10万名儿童10.3例和3.9例)。人类发展指数(HDI)较高的国家/地区发病率较高(ASIR, 8.0[低HDI]对15.3[非常高HDI] / 10万人),而HDI较低的国家/地区死亡率较高(ASMR, 4.4[低HDI]对2.8[非常高HDI] / 10万人)。分析表明,到2050年,预计全球将有204 925例新病例和78 210例死亡,只有人类发展指数低的国家/地区才会增加,从而加剧现有的卫生不公平现象。儿童癌症仍然是一项全球健康挑战,存在明显的地理和社会经济差异。这些数据将推动各国政府和政策制定者优先考虑资源和公平获得干预措施,特别是在发展水平较低的地区,同时解决COVID-19大流行等全球危机暴露的卫生保健脆弱性。
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引用次数: 0
Ethical considerations of genetic and genomic testing in pediatric oncology: A narrative review. 儿科肿瘤学中基因和基因组检测的伦理考虑:叙述性回顾。
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-03-01 DOI: 10.3322/caac.70075
Brittany L Greene, Jonathan M Marron

Genomics-and genomic testing in particular-has transformed oncology, facilitating both targeted therapies and personalized care. In pediatric oncology, unique clinical and ethical considerations arise. Compared with adults, children and adolescents are affected by more limited evidence regarding test performance, variant interpretation, and the clinical utility of genomically informed interventions. Nevertheless, genomic findings may have implications beyond the patient, affecting their parents, siblings, and other relatives and raising questions around consent, assent, privacy, and psychosocial impact. This narrative review examines how ethical dimensions of genetic and genomic testing evolve across the pediatric cancer continuum, from diagnosis and treatment through survivorship and transition to adult care. Attention is given to communication strategies, interdisciplinary support, and equity concerns that influence the responsible integration of genomic medicine. The authors also identify priority areas for future inquiry, including incorporation of children's perspectives, longitudinal approaches to recontact and reconsent, and better understanding of how genomic information affects treatment decision-making. Pediatric genetic and genomic testing in oncology holds great promise, but its benefits can only be realized through thoughtfully developed and standardized communication practices, careful ethical deliberation, and equitable implementation. By proactively addressing these issues, pediatric oncologists can harness genomic advances in ways that respect and support children and their families.

基因组学——尤其是基因组检测——已经改变了肿瘤学,促进了靶向治疗和个性化护理。在儿科肿瘤学中,出现了独特的临床和伦理考虑。与成人相比,儿童和青少年在测试表现、变异解释和基因组知情干预的临床应用方面受到的影响更为有限。然而,基因组学的发现可能会对患者以外的人产生影响,影响到他们的父母、兄弟姐妹和其他亲属,并引发关于同意、同意、隐私和社会心理影响的问题。这篇叙述性综述探讨了遗传和基因组检测的伦理维度如何在儿童癌症连续体中发展,从诊断和治疗到生存和过渡到成人护理。关注影响基因组医学负责任地整合的传播策略、跨学科支持和公平问题。作者还确定了未来研究的优先领域,包括纳入儿童的观点,重新接触和重新同意的纵向方法,以及更好地理解基因组信息如何影响治疗决策。儿科肿瘤基因和基因组检测前景广阔,但其益处只能通过深思熟虑的发展和标准化的沟通实践、仔细的伦理审议和公平的实施来实现。通过积极地解决这些问题,儿科肿瘤学家可以以尊重和支持儿童及其家庭的方式利用基因组学的进步。
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引用次数: 0
Correction to "American Cancer Society's report on the status of cancer disparities in the United States, 2025". 更正“美国癌症协会关于2025年美国癌症差异状况的报告”。
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-03-01 DOI: 10.3322/caac.70080
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引用次数: 0
Improved survival, disparate outcomes contemporaneously define the modern worldwide burden of childhood cancers. 生存率的提高,不同的结果同时定义了现代世界儿童癌症的负担。
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-03-01 DOI: 10.3322/caac.70073
Matthew R Kudek, Hao Wang
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引用次数: 0
Researchers use pooled analysis to define a cure in colon cancer 研究人员使用汇总分析来确定结肠癌的治愈方法
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-02-23 DOI: 10.3322/caac.70064
Carrie Printz
<p>Oncologists have long struggled with the challenges of defining cure in cancer, and colon cancer is no exception. Although recurrences of stage II and III colon cancer are rare once patients survive 5 years after treatment, no clear definition of a cure exists. As a result, most patients continue to undergo long-term surveillance for the disease.</p><p>Scientists note that neither relapse-free survival nor disease-free survival provides a precise definition of a cure. Instead, they emphasize the need for a specific endpoint that focuses only on local and distant recurrences of the primary colon cancer that is assessed over an extended follow-up period. These would be study endpoints for clinical trials versus actual definitions of a cancer cure.</p><p>In a pooled analysis of 15 randomized clinical trials, researchers attempted to determine a definition of a cure in stage II and III colon cancer after surgery and adjuvant therapy. The primary objective was to determine the point at which cancer recurrence risk becomes negligible, which was predefined as a threshold of 1%. Findings showed that a recurrence risk below 0.5% at 6 years after treatment provides a clinically meaningful definition of a cure.</p><p>The study appears in <i>JAMA Oncology</i> (doi: 10.1001/jamaoncol.2025.3760).</p><p>All patients in the trials underwent radical surgery for colon cancer and received adjuvant chemotherapy. They had a median follow-up of at least 6 years. Researchers assessed the Adjuvant Colon Cancer Endpoints and International Duration Evaluation of Adjuvant Chemotherapy databases that included adjuvant studies conducted between 1996 and 2015. Chemotherapy regimens varied across the trials and included fluoropyrimidines alone or in combination with oxaliplatin or biologic agents.</p><p>Of the 35,213 patients included in the analysis, 54.9% were male, and the mean age was 60.2 years. In the original studies, disease and survival follow-up included imaging every 6 months during the first 3 years and then annually afterward, which is the standard of care. Long-term recurrences and survival outcomes were captured by all trials, whereas secondary primary cancer data were reported in a subset of trials.</p><p>The rate of recurrence (6.4%) peaked between 6 and 12 months after treatment. It decreased continuously until year 10 of follow-up and never exceeded 0.5%. Appearing to increase again after year 10, the recurrence rate peaked at 2.0% between 12.5 and 13 years; however, that pattern was observed only in the MOSAIC trial, which assessed adding oxaliplatin to fluorouracil plus leucovorin to treat metastatic colon cancer. Researchers determined through competing-event analysis that death and secondary primary tumors inflated that increased recurrence rate, particularly in older patients.</p><p>The overall cumulative incidence of relapse with death as a competing risk was lower in female patients (hazard ratio, 0.58; 95% CI, 0.45–0.76; <i>p</i> < .001).</p><p
长期以来,肿瘤学家一直在努力应对癌症治愈的挑战,结肠癌也不例外。尽管II期和III期结肠癌患者在治疗后存活5年后很少复发,但没有明确的治愈定义。因此,大多数患者继续接受疾病的长期监测。科学家指出,无复发生存期和无疾病生存期都不能提供治愈的精确定义。相反,他们强调需要一个特定的终点,只关注原发结肠癌的局部和远处复发,并在延长的随访期间进行评估。这些是临床试验的研究终点,而不是癌症治愈的实际定义。在对15项随机临床试验的汇总分析中,研究人员试图确定II期和III期结肠癌在手术和辅助治疗后治愈的定义。主要目的是确定癌症复发风险可以忽略不计的临界点,即预先设定的1%的阈值。研究结果显示,治疗后6年的复发风险低于0.5%,这是临床有意义的治愈定义。这项研究发表在JAMA Oncology (doi: 10.1001/ jamaoncology .2025.3760)上。
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引用次数: 0
PORTEC-3 trial finds that adjuvant chemoradiotherapy significantly improves 10-year survival for patients with high-risk endometrial cancer PORTEC-3试验发现,辅助放化疗可显著提高高危子宫内膜癌患者的10年生存率
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-02-23 DOI: 10.3322/caac.70063
Carrie Printz
<p>Approximately 15%–20% of patients with high-risk endometrial cancer present with high-risk disease, and they have an increased risk of recurrence and death. The standard adjuvant treatment for this group is pelvic radiation therapy. In the international PORTEC-3 trial, researchers sought to determine whether adding chemotherapy to pelvic radiotherapy would improve overall survival (OS) and recurrence-free survival (RFS) for these patients.</p><p>Results from a 10-year follow-up study, published in <i>The Lancet Oncology</i> (doi: 10.1016/S1470-2045(25)00379-1), support earlier 5-year findings: Adjuvant chemoradiotherapy significantly improves outcomes in patients with high-risk endometrial cancer in comparison with radiotherapy alone.</p><p>In addition, researchers reported primary outcomes by molecular subgroup in a post hoc analysis. Molecular classification of tumors was available for 62% of the patients. They found that patients with <i>p53</i>-abnormal cancers benefited the most from chemoradiotherapy versus radiotherapy alone.</p><p>“It’s very reassuring that the long-term results confirm a persistent overall survival benefit to using chemoradiotherapy in stage III and <i>p53</i>-mutated disease,” says Gini Fleming, MD, medical director of gynecologic oncology at the University of Chicago Medicine in Illinois. “Although the subset analysis of molecular subtypes (other than <i>p53</i> mutant) is very promising, I do not think this update will be able to change practice at this point.”</p><p>PORTEC-3 was an open-label, randomized, international phase 3 trial. Between November 2006 and December 2013, 660 eligible and evaluable patients were recruited at 103 centers in six clinical groups across seven countries. The median follow-up was 10.1 years.</p><p>Eligible participants had high-risk endometrial cancer, which was defined as (1) endometrioid histology stage I (International Federation of Gynecology and Obstetrics 2009) and grade 3 with deep myometrial invasion and/or any lymphovascular space invasion, (2) endometrioid stage II or III, or (3) stage I–III with serous or clear-cell histology. Participants were 18 years old or older and had a World Health Organization performance score of 0–2. They were randomly assigned (1:1) to either pelvic radiotherapy (48.6 Gy in 1.8-Gy fractions; <i>n</i> = 330) or chemoradiotherapy (<i>n</i> = 330), which included radiotherapy combined with two cycles of cisplatin (50 mg/m<sup>2</sup> intravenously in Weeks 1 and 4) followed by four cycles of carboplatin (area under the curve = 5) and paclitaxel (175 mg/m<sup>2</sup> intravenously at 3-week intervals).</p><p>Molecular analysis was performed for 411 patients (62%): 210 patients (64%) in the chemoradiotherapy group and 201 patients (61%) in the radiotherapy group.</p><p>Findings showed that the estimated 10-year OS rate was 74.4% (95% CI, 69.8–79.4) in the chemoradiotherapy group and 67.3% (95% CI, 62.3–72.7) in the radiotherapy group (adjusted hazard
大约15%-20%的高危子宫内膜癌患者存在高危疾病,并且他们的复发和死亡风险增加。这一组的标准辅助治疗是盆腔放射治疗。在国际porc -3试验中,研究人员试图确定在盆腔放疗中加入化疗是否会提高这些患者的总生存期(OS)和无复发生存期(RFS)。发表在《柳叶刀肿瘤学》(doi: 10.1016/S1470-2045(25)00379-1)上的一项为期10年的随访研究结果支持了早期5年的发现:与单独放疗相比,辅助放化疗可显著改善高危子宫内膜癌患者的预后。此外,研究人员在事后分析中报告了分子亚组的主要结果。62%的患者可进行肿瘤分子分类。他们发现p53异常癌症患者从放化疗中获益最多,而不是单纯的放疗。伊利诺斯州芝加哥医学院妇科肿瘤学主任吉尼·弗莱明医学博士说:“长期结果证实,在III期和p53突变疾病中使用放化疗可以持续提高总体生存率,这是非常令人放心的。”“尽管分子亚型的亚群分析(除了p53突变体)非常有前途,但我不认为这次更新能够改变目前的做法。”与单纯放疗相比,接受辅助放化疗的高危子宫内膜癌患者的10年总生存率和无复发生存率显著提高。p53异常癌症患者的绝对获益最大。对于没有特异性分子谱的雌激素受体阴性癌症患者,应考虑放化疗而不是单独化疗或放疗。激素治疗和免疫检查点抑制剂可能是特定子宫内膜癌亚型的相关治疗方法。
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引用次数: 0
Correction to “Advances in the noninvasive diagnosis of melanoma—40 years beyond the ABCDs” 对“黑素瘤无创诊断的进展——abcd后40年”的更正
IF 232.4 1区 医学 Q1 ONCOLOGY Pub Date : 2026-02-19 DOI: 10.3322/caac.70074

Burshtein J, Witkowski A, Zakria D, et al. Advances in the noninvasive diagnosis of melanoma—40 years beyond the ABCDs. CA Cancer J Clin. 2026;e70065. doi:10.3322/caac.70065

Table 1 and Table 2 were incorrectly switched. Table 1, “First- and second-level non-invasive detection devices for triage of pigmented skin lesions”, should be:

Table 2, “Comparison of Dermoscopy Algorithms”, should be:

Additionally, the affiliation of Joanna Ludzik was reported incorrectly. The correct affiliation should read: Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland.

We apologize for these errors.

李建军,李建军,李建军,等。黑素瘤无创诊断的进展-超过abcd 40年。中华肿瘤杂志,2011;01 - 01。doi: 10.3322 /民航总局。70065表1和表2切换错误。表1“用于色素皮肤病变分诊的一级和二级无创检测设备”应该是:表2“皮肤镜检查算法的比较”应该是:另外,Joanna Ludzik的隶属关系报告错误。正确的隶属关系应该是:波兰克拉科夫雅盖隆大学医学院生物信息学和远程医疗系。我们为这些错误道歉。
{"title":"Correction to “Advances in the noninvasive diagnosis of melanoma—40 years beyond the ABCDs”","authors":"","doi":"10.3322/caac.70074","DOIUrl":"10.3322/caac.70074","url":null,"abstract":"<p>Burshtein J, Witkowski A, Zakria D, et al. Advances in the noninvasive diagnosis of melanoma—40 years beyond the ABCDs. CA Cancer J Clin. 2026;e70065. doi:10.3322/caac.70065</p><p>Table 1 and Table 2 were incorrectly switched. Table 1, “First- and second-level non-invasive detection devices for triage of pigmented skin lesions”, should be:</p><p>Table 2, “Comparison of Dermoscopy Algorithms”, should be:</p><p>Additionally, the affiliation of Joanna Ludzik was reported incorrectly. The correct affiliation should read: Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland.</p><p>We apologize for these errors.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146223198","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
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CA: A Cancer Journal for Clinicians
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