Cancer最新文献

{"title":"Metformin with neoadjuvant chemotherapy in localized triple-negative and Her2neu-positive breast cancer: A prospective phase 2 open-label randomized controlled trial (McBETH)","authors":"B. M. Mouna DM,&nbsp;Atul Batra DM,&nbsp;Vinod Sharma DM,&nbsp;Babita Kataria DM,&nbsp;Ajay Gogia DM,&nbsp;Jyoti Sharma Mch,&nbsp;Aparna Sharma DM,&nbsp;Ashutosh Mishra Mch,&nbsp;Jyoutishman Saikia Mch,&nbsp;Suryanarayana Deo MD,&nbsp;Supriya Mallick MD,&nbsp;Dayanand Sharma MD,&nbsp;Rajesh Khadgawat DM,&nbsp;Ashish Dutt Upadhyay PhD,&nbsp;Simran Kaur MD,&nbsp;Sandeep Mathur MD,&nbsp;Akash Kumar DM","doi":"10.1002/cncr.70205","DOIUrl":"https://doi.org/10.1002/cncr.70205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>HER2-positive and triple-negative breast cancers (TNBC) are aggressive subtypes with poor outcomes. Metformin, a commonly used antidiabetic agent, has demonstrated anticancer potential in preclinical studies. This trial evaluated whether the addition of metformin to neoadjuvant chemotherapy (NACT) improves pathological complete response (pCR) rates in nondiabetic patients with localized HER2-positive or TNBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In this open-label, phase 2 randomized controlled trial, 242 chemotherapy-naïve, nondiabetic women aged 18–65 years with localized, resectable HER2-positive or TNBC were randomized 1:1 to receive standard NACT with or without metformin (850 mg orally twice daily until surgery). The primary endpoint was pCR (ypT0/ypN0). Secondary endpoints included subgroup pCR rates, clinical response, breast-conserving surgery rates, adverse events, patient-reported outcomes (ESAS-r), and cognitive function (FACT-Cog v3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 112 patients in the metformin arm and 115 in the standard arm underwent surgery and were included in the efficacy analysis. The metformin group had a higher proportion of advanced T3/T4 tumors (55.4% vs. 42.3%). Overall pCR rates were 43.7% in the metformin group and 41.7% in the control group (<i>p</i> = .75). In the HER2-positive subgroup, pCR was higher with metformin (46.3% vs. 36.5%, <i>p</i> = .27). Breast-conserving surgery rates, clinical response, and patient-reported outcomes were similar between groups. Metformin was well tolerated; fewer patients experienced peripheral neuropathy (37.2% vs. 45.5%), but diarrhea was more frequent (26.6% vs. 10.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Metformin did not significantly improve pCR when added to standard NACT. However, trends in HER2-positive patients and reduced neuropathy merit further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemoradiotherapy with temozolomide vs. radiotherapy alone in patients with IDH wild-type and TERT promoter mutation histological grade 2/3 gliomas: An extension retrospective analysis of a randomized controlled trial","authors":"Jing Zhang PhD,&nbsp;Peng Wang MD,&nbsp;Yin Ren MD,&nbsp;Li Chen MD,&nbsp;Jin Feng MD,&nbsp;Fei Liu MD,&nbsp;Kaiwen Deng MD,&nbsp;Zhaoshi Bao MD,&nbsp;Xiaoguang Qiu MD,&nbsp;Yanwei Liu PhD","doi":"10.1002/cncr.70171","DOIUrl":"10.1002/cncr.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the poor prognosis of IDH wild-type (IDH-wt) and telomerase reverse transcriptase promoter mutation (TERTp-mut) histological grade 2 to 3 gliomas, the World Health Organization has reclassified it as molecular glioblastoma. However, the effectiveness of chemoradiotherapy (CRT) in these patients remains unclear, especially in comparison to radiotherapy alone (RT). This study aims to assess CRT's efficacy in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective randomized study was conducted at Beijing Tiantan Hospital from 2016 to 2019, enrolling 37 patients with histologically confirmed grade 2/3 IDH-wt/TERTp-mutant gliomas. Patients were randomly assigned to receive either RT (<i>n</i> = 18) or CRT (<i>n</i> = 19). After preliminary analysis showed a significant overall survival (OS) benefit in the CRT group, the study cohort was expanded from 2020 to 2022 by recruiting an additional 21 patients who all received CRT. Primary endpoints were OS and progression-free survival (PFS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final cohort comprised 58 patients (RT, 18; CRT, 40) with a median follow-up of 43.7 months (range, 7.9–75.1). CRT significantly improved OS compared to RT alone, with a median OS of 25.8 versus 17.2 months (hazard ratio, 0.31; 95% CI, 0.16–0.62; <i>p</i> = .001) and 2-year OS rate of 63.0% versus 16.7%. PFS also favored CRT, showing median PFS of 14.2 versus 7.1 months (hazard ratio, 0.38; 95% CI, 0.21–0.70; <i>p</i> = .002) and 1-year PFS rate of 56.6% versus 33.3%. Multivariable analysis confirmed CRT benefits were independent of O6-methylguanine-DNA methyl-transferase (MGMT) status (OS, <i>p</i> = .001; PFS, <i>p</i> = .002). Treatment was well-tolerated with no grade ≥3 toxicities in the CRT group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CRT significantly improves survival in IDH-wt/TERTp-mut grade 2 to 3 gliomas with favorable safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical trial registration</h3>\u0000 \u0000 <p>Trial registry name: CCRT With Temozolomide Versus RT Alone in Patients With IDH Wild-type/TERT Promoter Mutation Grade II/III Gliomas. Registration identification number: NCT02766270. URL for the registry: https://clinicaltrials.gov/study/NCT02766270?cond=NCT02766270&amp;rank=1</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No overall survival benefit to adding venetoclax for patients with RRMM","authors":"Leah Lawrence","doi":"10.1002/cncr.70136","DOIUrl":"10.1002/cncr.70136","url":null,"abstract":"&lt;p&gt;There was no overall survival (OS) advantage to adding venetoclax to bortezomib and dexamethasone for patients with relapsed or refractory multiple myeloma (RRMM) according to results of the phase 3 BELLINI trial published in &lt;i&gt;Lancet Haematology&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The BELLINI trial included 291 patients with RRMM and randomly assigned them 2:1 to bortezomib and dexamethasone plus either a once daily 800-mg dose of venetoclax or a placebo. Shaji K. Kumar, MD, a hematologist at the Mayo Clinic in Rochester, Minnesota, and his colleagues also assessed outcomes in post hoc biomarker subgroups identified from the primary analysis.&lt;/p&gt;&lt;p&gt;The final OS analysis showed that the receipt of a placebo plus bortezomib and dexamethasone was favored. At a median follow-up of 45.6 months, the median OS was not reached in either study arm.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;“Venetoclax was first approved for leukemias (chronic lymphocytic and acute myeloid), and we saw that these BCL2 inhibitors worked well in a subset of patients with myeloma with a translocation of 11;14 [t(11;14)],” explains Ajay K. Nooka, MD, MPH, a professor in the Department of Hematology and Medical Oncology at the Emory University School of Medicine in Atlanta, Georgia. “We then learned in early phase trials that when we used BCL2 inhibition, patients with t(11;14) responded much better than patients with non-translocation t(11;14).”&lt;/p&gt;&lt;p&gt;Unfortunately, Dr Nooka says, the phase 3 trial evaluating BCL2 inhibitor venetoclax was designed to include patients with non-t(11;14) disease.&lt;/p&gt;&lt;p&gt;Earlier analysis of the trial’s primary endpoint, progression-free survival (PFS), showed a significant improvement with the addition of venetoclax. Overall median PFS was 23.4 months with venetoclax and 11.4 months with the placebo (hazard ratio [HR], 0.58; 95% CI, 0.43–0.78; &lt;i&gt;p&lt;/i&gt; = .00026).&lt;/p&gt;&lt;p&gt;“When we isolated the patients with t(11;14), these patients derived much more benefit,” says Dr Nooka.&lt;/p&gt;&lt;p&gt;Among patients with t(11;14), the median PFS was 36.8 months with venetoclax and 9.3 months with the placebo (HR, 0.12; 95% CI, 0.03–0.44). Similarly, in patients with high BCL2 expression, the median PFS was 30.1 months with venetoclax and 9.9 months with the placebo (HR, 0.37; 95% CI, 0.21–0.64).&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;“When we started to look at OS though, the [survival] curves flipped,” says Dr Nooka. “This resulted in regulatory agencies saying that this drug should not be used in non-t(11;14) disease.”&lt;/p&gt;&lt;p&gt;Another randomized phase 3 study, CANOVA (NCT03539744), evaluated venetoclax and dexamethasone (VenDex) versus pomalidomide and dexamethasone (PomDex) among t(11;14) patients with RRMM for the primary endpoint of modified PFS. The primary analysis showed multiple numerically improved efficacy endpoints favoring VenDex over PomDex, but the primary endpoint of modified PFS was not statistically significant.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;However, because of the sign","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145659899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Studies evaluate de-escalation of treatment for certain patients with breast cancer","authors":"Leah Lawrence","doi":"10.1002/cncr.70135","DOIUrl":"10.1002/cncr.70135","url":null,"abstract":"&lt;p&gt;De-escalation of cancer treatment is an important component of the whole-person approach to cancer care that attempts to balance efficacy outcomes, such as survival, with quality of life and minimization of short- and long-term toxicities for patients.&lt;/p&gt;&lt;p&gt;Two recent studies explored areas of possible therapy de-escalation for women diagnosed with breast cancer.&lt;/p&gt;&lt;p&gt;The phase 3 ASTER 70s trial enrolled patients aged 70 years or older who had estrogen receptor (ER)–positive and HER2-negative breast cancer. Etienne Brain, MD, a professor of medicine at the Institut Curie in Saint-Cloud, France, and his colleagues used the genomic grade index to identify 1089 patients with high-risk tumors and randomly assigned them to either four cycles of adjuvant taxane-based or anthracycline-based chemotherapy followed by hormonotherapy or hormonotherapy alone.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;No significant differences were found in overall survival rates between the group receiving chemotherapy plus hormonotherapy and the group receiving hormonotherapy alone at 4 years (90.5% vs. 89.3%) or at 8 years (72.7% vs. 68.3%). There was also no significant difference in rates of invasive-free survival or breast cancer-specific survival.&lt;/p&gt;&lt;p&gt;“We were not able to identify a subgroup of patients with clinically meaningful differences in outcomes from the addition of adjuvant chemotherapy,” Dr Brain says.&lt;/p&gt;&lt;p&gt;Additionally, patients assigned to the chemotherapy group had higher rates of adverse events, grade 3 adverse events, and serious adverse events in comparison with the hormonotherapy alone group. Patients who did not receive chemotherapy had a longer time until a definitive deterioration of quality of life.&lt;/p&gt;&lt;p&gt;“Use of chemotherapy can still be discussed when there might be aggressive tumor features, but with discernment and caution. Having a high-risk disease is certainly not enough to make a decision in favor of adjuvant chemotherapy in an older patient, where the common and increasing frailty associated with aging cannot be ignored,” Dr Brain says.&lt;/p&gt;&lt;p&gt;Looking at the bigger picture, Dr Brain says that these results demonstrate the risk of taking results from studies using similar strategies but in younger populations—which most often exclude patients aged 70 years or older—and extrapolating them to older patients.&lt;/p&gt;&lt;p&gt;Commenting on the results, Ruth M. O’Regan, MD, chair of medicine at the University of Rochester in New York, says that her institution has a very active geriatric oncology group that has shown if a patient is older than 65 years, receipt of chemotherapy negatively affects quality of life and increases frailty.&lt;/p&gt;&lt;p&gt;“We are always trying to balance treating the cancer with not giving the patients any permanent, long-term side effects,” Dr O’Regan says. “De-escalation of treatment is definitely something that older patients are often interested in, and generally, this age population is pretty happy to not have to get chemotherapy.”&lt;/p&gt;","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145659957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APOLLO trial confirms ATRA–ATO use for patients with high-risk APL","authors":"Leah Lawrence","doi":"10.1002/cncr.70137","DOIUrl":"10.1002/cncr.70137","url":null,"abstract":"&lt;p&gt;Event-free survival (EFS) was significantly improved among patients with high-risk acute promyelocytic leukemia (APL) who were treated with the combination of all-trans retinoic acid and arsenic trioxide (ATRA–ATO) in comparison with standard ATRA plus anthracycline-based chemotherapy according to the results of the APOLLO trial.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;ATRA plus anthracycline-based chemotherapy once was considered the standard of care for patients with APL, a rare and aggressive subtype of disease that occurs in approximately 5%–15% of patients with acute myelogenous leukemia. Unfortunately, anywhere from 15% to 30% of patients treated with that combination can develop a resistance to ATRA, and all patients are at increased risk for secondary malignancies and cardiovascular complications as a result of anthracycline use.&lt;/p&gt;&lt;p&gt;In patients with non–high-risk APL, which is defined as a white blood cell count at diagnosis of ≤10 × 10&lt;sup&gt;9&lt;/sup&gt;/L, the ATRA–ATO combination was shown to improve survival and lower relapse rates in comparison with ATRA plus chemotherapy.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The phase 3 APOLLO trial was designed to test this combination in patients with high-risk disease.&lt;/p&gt;&lt;p&gt;The APOLLO trial included 133 patients with newly diagnosed high-risk APL who were randomly assigned to ATRA–ATO or ATRA plus chemotherapy. The primary endpoint was EFS at 2 years. The study was closed early in August 2022 because of slow recruitment during the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;Despite that early closure, at a median follow-up of 3 years, patients assigned to ATRA–ATO had significantly higher 2-year EFS than patients assigned to ATRA plus chemotherapy (88% vs. 71%; hazard ratio, 0.4; 95% CI, 0.17–0.92).&lt;/p&gt;&lt;p&gt;Minimal residual disease (MRD) negativity was achieved in only 17% of patients assigned to ATRA–ATO and in 23% of patients assigned to ATRA plus chemotherapy after the induction cycle; this confirmed that deep MRD-negative remissions in APL often can take several months. At medians of 7.8 and 12.1 months from MRD negativity, molecular relapse occurred in only 1.5% of patients assigned to ATRA–ATO and in 12.3% of patients assigned to ATRA plus chemotherapy (&lt;i&gt;p&lt;/i&gt; = .014).&lt;/p&gt;&lt;p&gt;Patients assigned to ATRA–ATO (32%) experienced serious treatment-emergent adverse events in comparison with patients assigned to ATRA plus chemotherapy (68%) (&lt;i&gt;p&lt;/i&gt; &lt; .01).&lt;/p&gt;&lt;p&gt;Based on these results, researchers led by Uwe Platzbecker, MD, a hematologist at the University Hospital Carl Gustav Carus and TU Dresden in Germany, concluded that the regimen used in APOLLO should “become the new standard of care for patients with newly diagnosed high-risk APL.”&lt;/p&gt;&lt;p&gt;Commenting on the results, Courtney D. DiNardo, MD, MSCE, a professor in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas, agrees.&lt;/p&gt;&lt;p&gt;“The superior EFS and improved toxicity seen with ATRA–ATO reinforces the data shown in prior cooperati","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145659839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term recurrence risk and temporal dynamics after resection of intracranial meningiomas: A multicenter cohort study with up to 15 years of follow-up","authors":"Haibo Teng MD,&nbsp;Jiaxin Yu MD,&nbsp;Yilin Pang MD,&nbsp;Ouying Yan MD,&nbsp;Danyang Jie MD,&nbsp;Xueying Li MD,&nbsp;Jianguo Xu MD,&nbsp;Zhiyong Liu MD","doi":"10.1002/cncr.70200","DOIUrl":"10.1002/cncr.70200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Meningiomas are the most common primary intracranial tumors, accounting for approximately one third of central nervous system neoplasms. Although most are benign, recurrence remains a clinical concern, particularly in cases of subtotal resection (STR) where complete tumor removal is not feasible due to involvement of critical structures. Adjuvant Gamma Knife radiosurgery (GKRS) is often considered in these patients, yet the long-term effectiveness of GKRS and the temporal dynamics of recurrence beyond 10 years are not well characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter retrospective cohort study, 949 adult patients who underwent surgical resection for intracranial meningiomas between 2009 and 2017 at two tertiary centers in China were followed through 2024. The primary exposure was extent of resection (gross total resection vs subtotal resection [STR]) and postoperative GKRS. The primary outcome was recurrence-free survival (RFS); secondary outcomes included overall survival, annualized recurrence risk, and biomarker-based stratification. Analyses included Cox models and competing-risk approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median follow-up for RFS was 8.8 years. The 15-year RFS rate was 79.2% (95% CI, 74.2–84.6). In STR cases, a second recurrence peak emerged at 7 to 10 years. GKRS was associated with lower recurrence risk (hazard ratio = 0.50; 95% CI, 0.27–0.90), especially in convexity tumors. Ki-67 &gt; 5% and progesterone receptor negativity showed nonsignificant trends toward higher recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this large cohort with extended follow-up, STR patients exhibited a second recurrence peak at 7 to 10 years postoperatively. Adjuvant GKRS showed long-term benefit, supporting its selective use and long-term surveillance beyond 10 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lobular carcinoma and endocrine biology: Lessons learned and future directions","authors":"Benjamin O. Anderson MD, FACS,&nbsp;Christopher I. Li MD, PhD","doi":"10.1002/cncr.70194","DOIUrl":"https://doi.org/10.1002/cncr.70194","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported overall well-being and physical function among chemotherapy and surgery patients across six institutions","authors":"Michael J. Hassett MD, MPH,&nbsp;Christine M. Cronin MHA,&nbsp;Angela C. Tramontano MPH,&nbsp;Sandra L. Wong MD, MS,&nbsp;Hajime Uno PhD,&nbsp;Roshan Paudel PhD,&nbsp;Jessica J. Bian MD,&nbsp;Don S. Dizon MD,&nbsp;Hannah Hazard-Jenkins MD,&nbsp;Raymond U. Osarogiagbon MD,&nbsp;Deb Schrag MD, MPH","doi":"10.1002/cncr.70185","DOIUrl":"https://doi.org/10.1002/cncr.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Electronic patient-reported outcomes (ePROs) mitigate symptom burden among cancer patients. This study hypothesized that two single-item quality of life measures, overall well-being (OWB) and physical function (PFN), could provide distinct information that augment ePROs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>eSyM, an electronic symptom management program, was deployed across six institutions for patients receiving chemotherapy or surgery for a suspected or confirmed thoracic, gastrointestinal, or gynecologic malignancy. eSyM prompts patients one to three times weekly to complete a 12-item symptom questionnaire and two pictogram questions assessing OWB and PFN. The study identified characteristics associated with OWB/PFN; described correlations between OWB/PFN, severe symptoms, and total symptom burden; and characterized relationships between OWB/PFN and clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From September 2019 to February 2024, 10,176 patients (3669 chemotherapy and 6507 surgery) submitted 78,433 questionnaires. The plurality reported mild impairment for OWB (chemotherapy, 41%; surgery, 45%) and PFN (chemotherapy, 43%; surgery, 39%). OWB and PFN were moderately correlated with each other (chemotherapy, 0.62; surgery, 0.58); with total symptom burden (chemotherapy: OWB 0.57, PFN 0.52; surgery: OWB 0.63, PFN 0.53); and with pain, fatigue, and decreased appetite (0.39–0.61). OWB and PFN varied by employment status and institution, and were associated with emergency department visits, admissions, and survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Self-reported OWB and PFN were moderately correlated with common symptoms, offered discriminant and face validity, and were associated with clinical outcomes. These measures supplemented information from a multi-item questionnaire and may guide management for cancer patients by contextualizing symptom reports and functioning as a brief screen to identify patients at risk for moderate–severe symptoms or other serious outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of magnetic resonance imaging-detected extraprostatic extension in localized prostate cancer","authors":"Abhishek Kumar MD, MAS,&nbsp;Dominic A. LaBella MD,&nbsp;Michael C. Snider MD,&nbsp;Scarlett M. Acklin-Wehnert MD,&nbsp;Rajan T. Gupta MD,&nbsp;Joseph K. Salama MD,&nbsp;Matthew J. Boyer MD, PhD","doi":"10.1002/cncr.70191","DOIUrl":"10.1002/cncr.70191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Magnetic resonance imaging (MRI) findings are not currently included in prostate cancer (PC) staging. Yet the presence of MRI-detected extraprostatic extension (EPE) may indicate higher risk disease. The purpose of this study was to assess the prevalence of MRI-EPE and prognostic ability in localized PC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with T1-T2N0M0 PC diagnosed between 2000 and 2021 having a prostate MRI before definitive treatment were identified from the Veterans Affairs Prostate Data Core. MRI reports were assessed for major capsule abutment (MCA), extracapsular extension (ECE), seminal vesicle invasion (SVI), or organ invasion (OI). Any of these findings were considered EPE. Predictors of MRI-detected EPE were assessed with a multivariable logistic regression. The impact of MRI findings on distant metastasis (DM) by multivariable Fine-Gray competing-risks regression was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 2275 patients were included. Most pretreatment MRIs (85%) occurred after 2016. Approximately half the patients were Black. A total of 480 (21%) patients had palpable disease. Median follow-up time was 5.1 years. The 5-year cumulative incidence of metastasis was 4.8% (95% confidence interval [CI] 3.9%–5.7%). MRI indicated 468 (21%) patients had EPE: MCA (7%), ECE (10%), SVI (3%), and OI (1%). On multivariable analysis, the presence of MCA, ECE, SVI, and OI were each independently associated with worse DM. Findings of a digital rectal examination were also prognostic. Limitations included lack of centralized review of MRI images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MRI-detected EPE, including MCA, is common in localized PC and independently prognostic. MRI findings should be considered in the next iteration of PC staging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145601411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking cancer clinical trial eligibility—Inclusion is a scientific and moral imperative","authors":"Nupur Mittal MD","doi":"10.1002/cncr.70182","DOIUrl":"10.1002/cncr.70182","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 23","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145601424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}