Lip and oral cavity cancer is leading cause of cancer mortality among Indian men. This study evaluated diagnostic accuracy of mobile health (mHealth) enabled screening for early detection of oral premalignant lesions or oral cancer (OPML/OC). It also described epidemiology of tobacco and other substance use and associated oral lesions in rural northern India.
Methods
A prospective study enrolled 10,101 high-risk individuals from rural settings of Varanasi district, India, between February 2021 and June 2023. Trained field workers captured habits information and oral cavity images and provided screening as suspicious or nonsuspicious on mHealth. Onsite experts and remote specialists provided clinical diagnoses. Diagnostic accuracy of mHealth-enabled screening was evaluated. A subset of 252 participants was followed to assess changes in oral lesions.
Results
Prevalence of substance use was 55.7%, with 21.4% having OPML/OC. Sensitivity of field workers and remote diagnosis for detecting OPML/OC was moderate when compared with onsite expert. Overall, interobserver agreement was substantial. During follow-up, the remote specialists identified 30 new and 13 progressive lesions with a significant decline in the red mean parameter of red, green, and blue colour ratios.
Conclusion
Although mHealth-enabled screening demonstrated lower sensitivity in detecting OPML/OC, their high specificity and expanded access to screening positions mHealth as a valuable tool for improving oral cancer screening coverage in Varanasi. This is particularly crucial given the high burden of oral cancer driven by prevalent smokeless tobacco and areca nut use and the current lack of effective population-based screening programs in this region.
{"title":"A prospective study on diagnostic accuracy of technology-enabled early detection of oral cancer and epidemiology of tobacco and other substances use in rural India","authors":"Divya Khanna MD, Aseem Mishra MCh, Praveen Birur MDS, Tulika Shruti MDS, Keerthi Gurushanth MDS, Nirza Mukhia MDS, Ruchi Pathak DGO, Arjun Gurmeet Singh MDS, Anupama Shetty PhD, Satyajit Pradhan MD, Pankaj Chaturvedi MS","doi":"10.1002/cncr.35702","DOIUrl":"10.1002/cncr.35702","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lip and oral cavity cancer is leading cause of cancer mortality among Indian men. This study evaluated diagnostic accuracy of mobile health (mHealth) enabled screening for early detection of oral premalignant lesions or oral cancer (OPML/OC). It also described epidemiology of tobacco and other substance use and associated oral lesions in rural northern India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective study enrolled 10,101 high-risk individuals from rural settings of Varanasi district, India, between February 2021 and June 2023. Trained field workers captured habits information and oral cavity images and provided screening as suspicious or nonsuspicious on mHealth. Onsite experts and remote specialists provided clinical diagnoses. Diagnostic accuracy of mHealth-enabled screening was evaluated. A subset of 252 participants was followed to assess changes in oral lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prevalence of substance use was 55.7%, with 21.4% having OPML/OC. Sensitivity of field workers and remote diagnosis for detecting OPML/OC was moderate when compared with onsite expert. Overall, interobserver agreement was substantial. During follow-up, the remote specialists identified 30 new and 13 progressive lesions with a significant decline in the red mean parameter of red, green, and blue colour ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although mHealth-enabled screening demonstrated lower sensitivity in detecting OPML/OC, their high specificity and expanded access to screening positions mHealth as a valuable tool for improving oral cancer screening coverage in Varanasi. This is particularly crucial given the high burden of oral cancer driven by prevalent smokeless tobacco and areca nut use and the current lack of effective population-based screening programs in this region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918729","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}
<p>An investigational drug that inhibits a critical driver of cachexia shows promise in improving body weight, muscle mass, quality of life, and physical function in patients with cancer-related cachexia.</p><p>After 12 weeks of treatment, patients with cancer-related cachexia who were treated with ponsegromab, a humanized monoclonal antibody that inhibits GDF-15, had a significant increase in weight gain from the baseline in comparison with patients treated with a placebo.</p><p>When patients were treated with the highest dose of ponsegromab (400 mg), improvements were seen in appetite and cachexia symptoms, physical activity, and muscle mass in comparison with those treated with the placebo. At this dosage, weight increased by a mean of 5.6%. This suggests a clinically important result according to the Cancer Cachexia Endpoints Working Group, which has suggested that a weight gain of more than 5% is clinically important.<span><sup>1</sup></span> </p><p>“Collectively, these results point to the potential for ponsegromab as a novel, targeted therapy to address an unmet medical need of patients with cancer and cachexia,” says the lead author of the study, John D. Groarke, MBBCh, MSc, MPH, senior director of Cardiometabolic Clinical Research in the Internal Medicine Research Unit at Pfizer. The “findings offer hope that a breakthrough targeted treatment is potentially on the horizon for our patients.”</p><p>He also underscores that the findings provide “strong evidence that we have unlocked a mechanism to interrupt a critical driver of cachexia, GDF-15, which has the potential to impact patients with cancer cachexia and other diseases.”</p><p>In the phase 2 study, investigators assessed the safety and efficacy of ponsegromab at three different doses versus a placebo. The study included 187 patients with cancer cachexia who were randomized to 12 weeks of ponsegromab at a dose of 100 (<i>n</i> = 46), 200 (<i>n</i> = 46), or 400 mg (<i>n</i> = 50) or the placebo (<i>n</i> = 45). All patients had experienced involuntary weight loss of >5% within the previous 6 months or >2% with a body mass index of <20 kg/m<sup>2</sup> (the definition of cachexia used in the study) and had a serum GDF-15 level of at least 1500 pg/mL. Most patients had non–small cell lung cancer (40%), which was followed by pancreatic cancer (32%) and colorectal cancer (29%), and most patients (90%) were receiving systemic treatment for their cancer at the time of randomization.</p><p>The primary endpoint of the study was body weight change from the baseline after 12 weeks of treatment. The study also assessed functional outcomes, appetite, and physical activity along with safety.</p><p>At 12 weeks, patients treated with ponsegromab had significantly greater weight gain than those treated with the placebo according to Bayesian statistical analyses that included adjustments for the competing risk of death and other events such as treatment discontinuation. In compar
{"title":"Potential new treatment for cancer-related cachexia","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35657","DOIUrl":"10.1002/cncr.35657","url":null,"abstract":"<p>An investigational drug that inhibits a critical driver of cachexia shows promise in improving body weight, muscle mass, quality of life, and physical function in patients with cancer-related cachexia.</p><p>After 12 weeks of treatment, patients with cancer-related cachexia who were treated with ponsegromab, a humanized monoclonal antibody that inhibits GDF-15, had a significant increase in weight gain from the baseline in comparison with patients treated with a placebo.</p><p>When patients were treated with the highest dose of ponsegromab (400 mg), improvements were seen in appetite and cachexia symptoms, physical activity, and muscle mass in comparison with those treated with the placebo. At this dosage, weight increased by a mean of 5.6%. This suggests a clinically important result according to the Cancer Cachexia Endpoints Working Group, which has suggested that a weight gain of more than 5% is clinically important.<span><sup>1</sup></span>\u0000 </p><p>“Collectively, these results point to the potential for ponsegromab as a novel, targeted therapy to address an unmet medical need of patients with cancer and cachexia,” says the lead author of the study, John D. Groarke, MBBCh, MSc, MPH, senior director of Cardiometabolic Clinical Research in the Internal Medicine Research Unit at Pfizer. The “findings offer hope that a breakthrough targeted treatment is potentially on the horizon for our patients.”</p><p>He also underscores that the findings provide “strong evidence that we have unlocked a mechanism to interrupt a critical driver of cachexia, GDF-15, which has the potential to impact patients with cancer cachexia and other diseases.”</p><p>In the phase 2 study, investigators assessed the safety and efficacy of ponsegromab at three different doses versus a placebo. The study included 187 patients with cancer cachexia who were randomized to 12 weeks of ponsegromab at a dose of 100 (<i>n</i> = 46), 200 (<i>n</i> = 46), or 400 mg (<i>n</i> = 50) or the placebo (<i>n</i> = 45). All patients had experienced involuntary weight loss of >5% within the previous 6 months or >2% with a body mass index of <20 kg/m<sup>2</sup> (the definition of cachexia used in the study) and had a serum GDF-15 level of at least 1500 pg/mL. Most patients had non–small cell lung cancer (40%), which was followed by pancreatic cancer (32%) and colorectal cancer (29%), and most patients (90%) were receiving systemic treatment for their cancer at the time of randomization.</p><p>The primary endpoint of the study was body weight change from the baseline after 12 weeks of treatment. The study also assessed functional outcomes, appetite, and physical activity along with safety.</p><p>At 12 weeks, patients treated with ponsegromab had significantly greater weight gain than those treated with the placebo according to Bayesian statistical analyses that included adjustments for the competing risk of death and other events such as treatment discontinuation. In compar","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142925915","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}
<p>Men with metastatic castration-resistant prostate cancer (mCRPC) treated with a combination of enzalutamide (ENZ) and the bone-protecting agent <sup>223</sup>Ra (ENZ–RAD) showed significant improvement in radiological progression-free survival in comparison with those treated with ENZ alone according to the first results of the EORTC-GUCG-1333 (PEACE-3) trial presented at the 2024 European Society for Medical Oncology annual meeting in Barcelona.<span><sup>1</sup></span> </p><p>Silke Gillessen Sommer, MD, head of the Medical Oncology Department and medical scientific director of the Oncology Institute of Southern Switzerland at the Ospedale San Giovanni in Bellinzona, who presented the study, says that the findings suggest the potential for a new first-line treatment option for patients with asymptomatic or mildly symptomatic bone mCRPC who have not received a prior androgen receptor pathway inhibitor.</p><p>The international phase 3 trial included 446 patients with mCRPC and bone metastases randomized 1:1 to ENZ–RAD and ENZ alone. None of the patients had received prior treatment with ENZ or RAD or had known visceral metastases. Prior treatment with abiraterone and docetaxel was permitted for patients with metastatic hormone-sensitive prostate cancer. Most of the patients (87.9%) randomized to the ENZ–RAD arm completed the scheduled six cycles of RAD.</p><p>A significant improvement in overall survival also was seen in a preplanned interim analysis, which showed overall survival of 42.3 and 35 months for patients treated with ENZ–RAD and ENZ alone, respectively, with a hazard ratio of 0.69 (95% CI, 0.52–0.90; <i>p</i> = .0031).</p><p>More patients treated with ENZ–RAD had treatment-related adverse events in comparison with those treated with ENZ alone. For example, grade 3 or higher events were reported in 65.6% and 55.8% of patients, respectively, with the most frequent events in patients treated with ENZ–RAD being hypertension (34%), fatigue (6%), anemia (5%), and neutropenia (5%).</p><p>Walter Stadler, MD, the Fred C. Buffett Professor of Medicine and deputy director of the Comprehensive Cancer Center at the University of Chicago Medicine, says that the findings are potentially practice changing, “assuming that the overall survival is improved with longer follow-up.”</p><p>He points out, however, that the findings relate to an increasingly smaller and rarer group of patients who make up the patient population of the study—those with bone mCRPC who have not previously received an androgen receptor signaling inhibitor.</p><p>“Most patients receive combined hormonal therapy in the castrate-sensitive state or develop biochemical progression without demonstrable bone metastases while receiving androgen ablation alone,” he says.</p><p>He also notes that the value of combining ENZ and RAD in patients who have received prior androgen receptor signaling inhibition therapy is unknown in this study because only 2%–3% of the patients in th
{"title":"New first-line treatment improves progression-free survival for select men with bone mCRPC","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35658","DOIUrl":"10.1002/cncr.35658","url":null,"abstract":"<p>Men with metastatic castration-resistant prostate cancer (mCRPC) treated with a combination of enzalutamide (ENZ) and the bone-protecting agent <sup>223</sup>Ra (ENZ–RAD) showed significant improvement in radiological progression-free survival in comparison with those treated with ENZ alone according to the first results of the EORTC-GUCG-1333 (PEACE-3) trial presented at the 2024 European Society for Medical Oncology annual meeting in Barcelona.<span><sup>1</sup></span>\u0000 </p><p>Silke Gillessen Sommer, MD, head of the Medical Oncology Department and medical scientific director of the Oncology Institute of Southern Switzerland at the Ospedale San Giovanni in Bellinzona, who presented the study, says that the findings suggest the potential for a new first-line treatment option for patients with asymptomatic or mildly symptomatic bone mCRPC who have not received a prior androgen receptor pathway inhibitor.</p><p>The international phase 3 trial included 446 patients with mCRPC and bone metastases randomized 1:1 to ENZ–RAD and ENZ alone. None of the patients had received prior treatment with ENZ or RAD or had known visceral metastases. Prior treatment with abiraterone and docetaxel was permitted for patients with metastatic hormone-sensitive prostate cancer. Most of the patients (87.9%) randomized to the ENZ–RAD arm completed the scheduled six cycles of RAD.</p><p>A significant improvement in overall survival also was seen in a preplanned interim analysis, which showed overall survival of 42.3 and 35 months for patients treated with ENZ–RAD and ENZ alone, respectively, with a hazard ratio of 0.69 (95% CI, 0.52–0.90; <i>p</i> = .0031).</p><p>More patients treated with ENZ–RAD had treatment-related adverse events in comparison with those treated with ENZ alone. For example, grade 3 or higher events were reported in 65.6% and 55.8% of patients, respectively, with the most frequent events in patients treated with ENZ–RAD being hypertension (34%), fatigue (6%), anemia (5%), and neutropenia (5%).</p><p>Walter Stadler, MD, the Fred C. Buffett Professor of Medicine and deputy director of the Comprehensive Cancer Center at the University of Chicago Medicine, says that the findings are potentially practice changing, “assuming that the overall survival is improved with longer follow-up.”</p><p>He points out, however, that the findings relate to an increasingly smaller and rarer group of patients who make up the patient population of the study—those with bone mCRPC who have not previously received an androgen receptor signaling inhibitor.</p><p>“Most patients receive combined hormonal therapy in the castrate-sensitive state or develop biochemical progression without demonstrable bone metastases while receiving androgen ablation alone,” he says.</p><p>He also notes that the value of combining ENZ and RAD in patients who have received prior androgen receptor signaling inhibition therapy is unknown in this study because only 2%–3% of the patients in th","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918761","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}
The addition of the immune checkpoint inhibitor retifanlimab to standard-of-care chemotherapy significantly improved progression-free survival (PFS) in patients with previously untreated and inoperable locally recurrent or metastatic squamous cell carcinoma of the anal canal (SCAC), according to a study presented at the 2024 European Society for Medical Oncology annual meeting in Barcelona.1
Findings from the international phase 3 POD1UM-303/InterAACT 2 study show that patients with inoperable locally recurrent or metastatic SCAC treated with the combination of retifanlimab and standard-of-care chemotherapy (carboplatin and paclitaxel) had a 37% reduced risk of disease progression in comparison with patients treated with the standard of care alone (hazard ratio, 0.63; 95% CI, 0.47–0.84; p = .0006). The median PFS was 9.3 months for the retifanlimab–chemotherapy group and 7.4 months for the chemotherapy-alone group.
A trend in overall survival (OS) also was found. The median OS was 29.2 and 23.0 months for the retifanlimab–chemotherapy and chemotherapy-alone groups, respectively, with a hazard ratio of 0.70 (95% CI, 0.49–1.01; p = .0273).
The findings are based on 308 patients randomized 1:1 to carboplatin and paclitaxel (six cycles) plus a placebo or plus retifanlimab (500 mg delivered intravenously every 4 weeks). Along with meeting its primary endpoint of PFS, the study showed that the combination regimen was well tolerated with no new safety signals. Immune-related side effects linked to retifanlimab included thyroid dysfunction, adrenal insufficiency, and skin toxicity.
Sheela Rao, MBBS, MD, a consultant medical oncologist in the Gastrointestinal Unit at the Royal Marsden Hospital in Sutton, United Kingdom, who presented the findings, said in a follow-up interview that the findings represent a potentially new standard of care for a disease for which there are very few trials. “So, this really does offer a new treatment option for our patients,” she said.2
Commenting on the study, Cathy Eng, MD, the David H. Johnson Endowed Chair in Surgical and Medical Oncology at Vanderbilt–Ingram Cancer Center, says that the findings suggest a potential role for immune checkpoint inhibition for newly diagnosed locally advanced or metastatic anal cancer that is surgically unresectable.
“Oncologists should be made aware that there is promising data of immune checkpoint inhibition with carbo/paclitaxel that may result in a new indication based on progression-free survival,” she says.
Pointing to the National Cancer Institute–sponsored phase 3 EA2176 study in the United States, which has just completed enrollment, she says that if that study is positive, it will “further validate the role of immune checkpoint inhibition in newly diagnosed surgically unresectable locally advanced metastatic anal cancer.”
{"title":"Addition of an immune checkpoint inhibitor reduces the risk of disease progression for select patients with anal cancer","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35659","DOIUrl":"10.1002/cncr.35659","url":null,"abstract":"<p>The addition of the immune checkpoint inhibitor retifanlimab to standard-of-care chemotherapy significantly improved progression-free survival (PFS) in patients with previously untreated and inoperable locally recurrent or metastatic squamous cell carcinoma of the anal canal (SCAC), according to a study presented at the 2024 European Society for Medical Oncology annual meeting in Barcelona.<span><sup>1</sup></span>\u0000 </p><p>Findings from the international phase 3 POD1UM-303/InterAACT 2 study show that patients with inoperable locally recurrent or metastatic SCAC treated with the combination of retifanlimab and standard-of-care chemotherapy (carboplatin and paclitaxel) had a 37% reduced risk of disease progression in comparison with patients treated with the standard of care alone (hazard ratio, 0.63; 95% CI, 0.47–0.84; <i>p</i> = .0006). The median PFS was 9.3 months for the retifanlimab–chemotherapy group and 7.4 months for the chemotherapy-alone group.</p><p>A trend in overall survival (OS) also was found. The median OS was 29.2 and 23.0 months for the retifanlimab–chemotherapy and chemotherapy-alone groups, respectively, with a hazard ratio of 0.70 (95% CI, 0.49–1.01; <i>p</i> = .0273).</p><p>The findings are based on 308 patients randomized 1:1 to carboplatin and paclitaxel (six cycles) plus a placebo or plus retifanlimab (500 mg delivered intravenously every 4 weeks). Along with meeting its primary endpoint of PFS, the study showed that the combination regimen was well tolerated with no new safety signals. Immune-related side effects linked to retifanlimab included thyroid dysfunction, adrenal insufficiency, and skin toxicity.</p><p>Sheela Rao, MBBS, MD, a consultant medical oncologist in the Gastrointestinal Unit at the Royal Marsden Hospital in Sutton, United Kingdom, who presented the findings, said in a follow-up interview that the findings represent a potentially new standard of care for a disease for which there are very few trials. “So, this really does offer a new treatment option for our patients,” she said.<span><sup>2</sup></span>\u0000 </p><p>Commenting on the study, Cathy Eng, MD, the David H. Johnson Endowed Chair in Surgical and Medical Oncology at Vanderbilt–Ingram Cancer Center, says that the findings suggest a potential role for immune checkpoint inhibition for newly diagnosed locally advanced or metastatic anal cancer that is surgically unresectable.</p><p>“Oncologists should be made aware that there is promising data of immune checkpoint inhibition with carbo/paclitaxel that may result in a new indication based on progression-free survival,” she says.</p><p>Pointing to the National Cancer Institute–sponsored phase 3 EA2176 study in the United States, which has just completed enrollment, she says that if that study is positive, it will “further validate the role of immune checkpoint inhibition in newly diagnosed surgically unresectable locally advanced metastatic anal cancer.”</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918685","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}
Xia Yin MS, Qiang He MD, Dan Liu MD, Linna Xie MD, Hui Wang MD, Chunyan Chen MD, Chuanli Zhao MD, Ningning Shan MD, Shanshan Shi MD, Haichen Wei MD, Ji Ma MD, Ke Lu MD, Liang Wang MD, Yan Wang MD, Lijie Xing MD, Zengjun Li MD
Background
Double-expressor lymphoma (DEL) has a poorer prognosis than other subtypes of diffuse large B-cell lymphoma (DLBCL). This study is a multicenter, prospective, single-arm, phase 2 clinical study initiated by investigators to evaluate the efficacy and safety of combined zanubrutinib with R-CHOP, which includes rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone for patients with DEL (stage II or more), as well as to explore factors related to efficacy preliminarily.
Methods
From November 2020 to July 2022, 48 newly diagnosed patients were enrolled. All patients received twice-daily oral zanubrutinib (160 mg) for 6 months and standardized R-CHOP regimen for six to eight cycles.
Results
The objective response rate (ORR) was 89.6%, with a complete response rate (CRR) of 83.3%. The median follow-up was 29.3 months. The median progression-free survival (PFS) and overall survival (OS) were not reached. The PFS and OS were 81.25% and 93.75% at 2 years, respectively. Grade ≥3 adverse events (AEs) were reported in 23 of 48 (47.9%) patients. Next-generation sequencing (NGS) results of 33 patients showed that TP53, MYD88, and PIM1 were the most common mutated gene. Multivariate analysis revealed that BCL-6 gene rearrangement was an adverse prognostic factor for both PFS (hazard ratio [HR], 0.247; 95% confidence article [CI], 0.068–0.9; p = .034) and OS (HR, 0.057; 95% CI, 0.006–0.591; p = .016), whereas the number of extranodal involvements also significantly influenced OS (HR, 15.12; 95% CI, 1.07–213.65; p = .044).
Conclusions
Zanubrutinib in combination with R-CHOP is an effective option for DEL patients, and the toxicity of zanubrutinib is entirely acceptable for patients.
{"title":"Zanubrutinib plus R-CHOP for the treatment of newly diagnosed double-expressor lymphoma: A phase 2 clinical study","authors":"Xia Yin MS, Qiang He MD, Dan Liu MD, Linna Xie MD, Hui Wang MD, Chunyan Chen MD, Chuanli Zhao MD, Ningning Shan MD, Shanshan Shi MD, Haichen Wei MD, Ji Ma MD, Ke Lu MD, Liang Wang MD, Yan Wang MD, Lijie Xing MD, Zengjun Li MD","doi":"10.1002/cncr.35697","DOIUrl":"10.1002/cncr.35697","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Double-expressor lymphoma (DEL) has a poorer prognosis than other subtypes of diffuse large B-cell lymphoma (DLBCL). This study is a multicenter, prospective, single-arm, phase 2 clinical study initiated by investigators to evaluate the efficacy and safety of combined zanubrutinib with R-CHOP, which includes rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone for patients with DEL (stage II or more), as well as to explore factors related to efficacy preliminarily.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From November 2020 to July 2022, 48 newly diagnosed patients were enrolled. All patients received twice-daily oral zanubrutinib (160 mg) for 6 months and standardized R-CHOP regimen for six to eight cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The objective response rate (ORR) was 89.6%, with a complete response rate (CRR) of 83.3%. The median follow-up was 29.3 months. The median progression-free survival (PFS) and overall survival (OS) were not reached. The PFS and OS were 81.25% and 93.75% at 2 years, respectively. Grade ≥3 adverse events (AEs) were reported in 23 of 48 (47.9%) patients. Next-generation sequencing (NGS) results of 33 patients showed that <i>TP53</i>, <i>MYD88</i>, and <i>PIM1</i> were the most common mutated gene. Multivariate analysis revealed that <i>BCL-6</i> gene rearrangement was an adverse prognostic factor for both PFS (hazard ratio [HR], 0.247; 95% confidence article [CI], 0.068–0.9; <i>p</i> = .034) and OS (HR, 0.057; 95% CI, 0.006–0.591; <i>p</i> = .016), whereas the number of extranodal involvements also significantly influenced OS (HR, 15.12; 95% CI, 1.07–213.65; <i>p</i> = .044).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Zanubrutinib in combination with R-CHOP is an effective option for DEL patients, and the toxicity of zanubrutinib is entirely acceptable for patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918775","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}
Madison K. Krischak MD, Catherine S. Nam MD, Amy N. Luckenbaugh MD, Lindsey A. Herrel MD, MS
Women now comprise over 50% of medical school graduates and over one-third of practicing physicians in the United States. Despite this progress, significant barriers to career advancement and leadership persist, particularly in male-dominated fields like urology and oncology. Women physicians are linked to improved patient outcomes and are critical to addressing the projected physician shortage, which is expected to be exaggerated in oncology specialties. This review highlights progress, challenges, and future directions for gender equity in urology, urologic oncology, and oncology subspecialties. Urology and urologic oncology have seen growth in female representation, whereas radiation oncology remains stagnant, and medical oncology has reached near gender parity among trainees. However, leadership roles across all these fields continue to reflect gender inequities. Key barriers include the gender pay gap, insufficient maternal leave policies, workplace harassment, and lack of mentorship and sponsorship for women physicians. Moving forward, efforts to advance gender equity must include transparent pay structures, supportive maternal leave, and robust antiharassment policies. Promoting women in leadership and fostering mentorship are also essential to retaining and advancing women in these fields. By addressing these issues, the health care community can progress toward gender equity, strengthen the physician workforce, and improve patient outcomes. Institutional and national advocacy is crucial for creating an equitable and effective medical community.
{"title":"Gender equity in oncology: Progress, challenges, and the path forward in urologic oncology and oncologic specialties","authors":"Madison K. Krischak MD, Catherine S. Nam MD, Amy N. Luckenbaugh MD, Lindsey A. Herrel MD, MS","doi":"10.1002/cncr.35690","DOIUrl":"10.1002/cncr.35690","url":null,"abstract":"<p>Women now comprise over 50% of medical school graduates and over one-third of practicing physicians in the United States. Despite this progress, significant barriers to career advancement and leadership persist, particularly in male-dominated fields like urology and oncology. Women physicians are linked to improved patient outcomes and are critical to addressing the projected physician shortage, which is expected to be exaggerated in oncology specialties. This review highlights progress, challenges, and future directions for gender equity in urology, urologic oncology, and oncology subspecialties. Urology and urologic oncology have seen growth in female representation, whereas radiation oncology remains stagnant, and medical oncology has reached near gender parity among trainees. However, leadership roles across all these fields continue to reflect gender inequities. Key barriers include the gender pay gap, insufficient maternal leave policies, workplace harassment, and lack of mentorship and sponsorship for women physicians. Moving forward, efforts to advance gender equity must include transparent pay structures, supportive maternal leave, and robust antiharassment policies. Promoting women in leadership and fostering mentorship are also essential to retaining and advancing women in these fields. By addressing these issues, the health care community can progress toward gender equity, strengthen the physician workforce, and improve patient outcomes. Institutional and national advocacy is crucial for creating an equitable and effective medical community.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918758","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}
Yan Gao MD, Yunhong Huang MD, Qingyuan Zhang MD, Haiyan Yang MD, Yufu Li MD, Yan Li MD, Min Zhou MD, Runxiang Yang MD, Bing Xu MD, Lihong Liu MD, Yu Yang MD, Zhigang Peng MD, Ding Yu MD, Hui Zhou MD, Rongyan Zhang MD, Huilai Zhang MD, Junyuan Qi MD, Yaming Xi MD, Xiaojing Xing MD, Zhao Wang MD, Hongmei Jing MD, Yuerong Shuang MD, Xiaohong Zhang MD, Liping Ma MD, Hongyan Jin MD, Li’e Lin MD, Chunlei Li PhD, Jianfei Xue MS, Yanping Liu MS, Jing Yuan MS, Huiqiang Huang MD
Introduction
The prognosis of relapsed or refractory mature T- and natural killer (NK)-cell lymphoma remains dismal. Novel agents are urgently needed to improve the outcomes for this population.
Methods
In this phase 2, multicenter, open-label, single-arm study (NCT03776279), the authors report the efficacy and safety of liposomal mitoxantrone (Lipo-MIT) monotherapy in patients with relapsed or refractory mature T- and NK-cell lymphoma. Lipo-MIT was administered intravenously at 20 mg/m2 once every 4 weeks. The primary end points were the objective response rate (ORR) determined by the independent review committee (IRC) and investigators. Secondary end points included duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety.
Results
From April 26, 2018, to August 10, 2022, 108 eligible patients were enrolled and treated at 26 study centers in China. The ORRs were 41.7% (95% confidence interval [CI], 32.3–51.5%) per IRC and 46.3% (95% CI, 36.7%–56.2%) per investigators; 25 (23.1%) and 15 (13.9%) patients, respectively, achieved complete response. With a median follow-up of 29.5 months, median PFS per IRC was 8.5 months (95% CI, 6.0–11.9); median OS was 23.3 months (95% CI, 12.0–not evaluable); median DoR per IRC was not reached. The most frequent treatment-emergent adverse events were decreased white blood cell count (75, 69.4%), decreased neutrophil count (73, 67.6%), and decreased platelet count (47, 43.5%).
Conclusions
Lipo-MIT monotherapy showed robust and durable antitumor activity with a manageable safety profile, representing a new therapeutic option in relapsed or refractory mature T- and NK-cell lymphoma.
导言：复发或难治性成熟T细胞和自然杀伤（NK）细胞淋巴瘤的预后仍然不容乐观。迫切需要新型药物来改善这一人群的预后：在这项2期、多中心、开放标签、单臂研究（NCT03776279）中，作者报告了脂质体米托蒽醌（Lipo-MIT）单药治疗复发或难治性成熟T细胞和NK细胞淋巴瘤患者的疗效和安全性。脂质体-米托蒽醌以20毫克/平方米的剂量静脉注射，每4周一次。主要终点是由独立审查委员会（IRC）和研究人员确定的客观反应率（ORR）。次要终点包括反应持续时间（DoR）、无进展生存期（PFS）、总生存期（OS）和安全性：2018年4月26日至2022年8月10日，中国26个研究中心共招募并治疗了108名符合条件的患者。IRC的ORR为41.7%（95%置信区间[CI]，32.3%-51.5%），研究者的ORR为46.3%（95%置信区间，36.7%-56.2%）；分别有25例（23.1%）和15例（13.9%）患者获得完全应答。中位随访时间为 29.5 个月，每位研究者的中位 PFS 为 8.5 个月（95% CI，6.0-11.9）；中位 OS 为 23.3 个月（95% CI，12.0-无法评估）；每位研究者的中位 DoR 未达到。最常见的治疗突发不良事件是白细胞计数减少（75例，69.4%）、中性粒细胞计数减少（73例，67.6%）和血小板计数减少（47例，43.5%）：脂质-MIT单药疗法显示出强大而持久的抗肿瘤活性，且安全性可控，是复发或难治性成熟T细胞和NK细胞淋巴瘤的一种新疗法。
{"title":"Liposomal mitoxantrone monotherapy in patients with relapsed or refractory mature T-cell and natural killer-cell neoplasms: A phase 2, multicenter, open-label, single-arm trial","authors":"Yan Gao MD, Yunhong Huang MD, Qingyuan Zhang MD, Haiyan Yang MD, Yufu Li MD, Yan Li MD, Min Zhou MD, Runxiang Yang MD, Bing Xu MD, Lihong Liu MD, Yu Yang MD, Zhigang Peng MD, Ding Yu MD, Hui Zhou MD, Rongyan Zhang MD, Huilai Zhang MD, Junyuan Qi MD, Yaming Xi MD, Xiaojing Xing MD, Zhao Wang MD, Hongmei Jing MD, Yuerong Shuang MD, Xiaohong Zhang MD, Liping Ma MD, Hongyan Jin MD, Li’e Lin MD, Chunlei Li PhD, Jianfei Xue MS, Yanping Liu MS, Jing Yuan MS, Huiqiang Huang MD","doi":"10.1002/cncr.35672","DOIUrl":"10.1002/cncr.35672","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The prognosis of relapsed or refractory mature T- and natural killer (NK)-cell lymphoma remains dismal. Novel agents are urgently needed to improve the outcomes for this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this phase 2, multicenter, open-label, single-arm study (NCT03776279), the authors report the efficacy and safety of liposomal mitoxantrone (Lipo-MIT) monotherapy in patients with relapsed or refractory mature T- and NK-cell lymphoma. Lipo-MIT was administered intravenously at 20 mg/m<sup>2</sup> once every 4 weeks. The primary end points were the objective response rate (ORR) determined by the independent review committee (IRC) and investigators. Secondary end points included duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From April 26, 2018, to August 10, 2022, 108 eligible patients were enrolled and treated at 26 study centers in China. The ORRs were 41.7% (95% confidence interval [CI], 32.3–51.5%) per IRC and 46.3% (95% CI, 36.7%–56.2%) per investigators; 25 (23.1%) and 15 (13.9%) patients, respectively, achieved complete response. With a median follow-up of 29.5 months, median PFS per IRC was 8.5 months (95% CI, 6.0–11.9); median OS was 23.3 months (95% CI, 12.0–not evaluable); median DoR per IRC was not reached. The most frequent treatment-emergent adverse events were decreased white blood cell count (75, 69.4%), decreased neutrophil count (73, 67.6%), and decreased platelet count (47, 43.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lipo-MIT monotherapy showed robust and durable antitumor activity with a manageable safety profile, representing a new therapeutic option in relapsed or refractory mature T- and NK-cell lymphoma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918759","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}
Serena Rajabiun PhD, MPH, MA, Howard J. Cabral PhD, MPH, Clara A. Chen MHS, Christine Lloyd-Travaglini MPH, Julianne N. Dugas MPH, Deborah Amburgey BS, Madyson Fitzgerald BS, Stephenie C. Lemon PhD, MS, Jennifer S. Haas MD, MSc, Karen M. Freund MD, MPH, Tracy Battaglia MD, MPH, for the TRIP Consortium
<div> <section> <h3> Background</h3> <p>Patient navigation is an evidence-based intervention for reducing delays in cancer care for underserved populations. There are limited economic evaluations of patient navigation in the US health care system and few have considered costs at various phases along the implementation spectrum. Having economic data, including costs and cost savings, can support sustainability of patient navigation programs. This study presents findings from a cost and activity analysis of a citywide hospital-based patient navigation program to engage women in timely breast cancer treatment post-diagnosis.</p> </section> <section> <h3> Methods</h3> <p>This study was conducted as part of Translating Research Into Practice (TRIP), a citywide patient navigation hybrid effectiveness-implementation research study conducted at five cancer care hospitals in Boston, Massachusetts. The authors surveyed participating patient navigators and supervisors about their tasks and level of effort over consecutive 10-day periods from 2019 to 2021. Patient navigators documented the time spent on activities in accordance with an 11-step protocol across five sites. Cost data were collected from annual fiscal year end expenditure hospital administrative databases at concurrent time frames. Descriptive analyses were used to calculate average time on tasks, cost per activity and cost per outcome. Cost savings were estimated by calculating the additional persons engaged in timely entry to treatment compared to a matched control group with respect to hospitalization and emergency room costs averted.</p> </section> <section> <h3> Results</h3> <p>Average time spent per day on TRIP-specific navigation activities was approximately 3 hours (range, 0–8 hours) and the average time per patient per day was 25 minutes (<i>n</i> = 7 navigators). Total costs for clinical site interventions were $218,394 for startup and $392,407 for maintenance costs over the study period. A total of 223 patients were served during the intervention period with an average cost per patient of $979 for startup and $1759 for maintenance. Potential costs savings with the TRIP navigation program from averted hospitalization and emergency room visits for 63 additional patients who received timely treatment is estimated at $21,798–$30,429 and $2536–$5692 per patient, respectively, compared to treatment as usual.</p> </section> <section> <h3> Conclusions</h3> <p>The economic evaluation in this study provides insight into startup and implementation costs for uptake and scalability of navigation pro
{"title":"Cost and activity analysis for a citywide patient navigation intervention to engage underserved patients in breast cancer treatment: Findings from the Translating Research Into Practice study","authors":"Serena Rajabiun PhD, MPH, MA, Howard J. Cabral PhD, MPH, Clara A. Chen MHS, Christine Lloyd-Travaglini MPH, Julianne N. Dugas MPH, Deborah Amburgey BS, Madyson Fitzgerald BS, Stephenie C. Lemon PhD, MS, Jennifer S. Haas MD, MSc, Karen M. Freund MD, MPH, Tracy Battaglia MD, MPH, for the TRIP Consortium","doi":"10.1002/cncr.35671","DOIUrl":"10.1002/cncr.35671","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patient navigation is an evidence-based intervention for reducing delays in cancer care for underserved populations. There are limited economic evaluations of patient navigation in the US health care system and few have considered costs at various phases along the implementation spectrum. Having economic data, including costs and cost savings, can support sustainability of patient navigation programs. This study presents findings from a cost and activity analysis of a citywide hospital-based patient navigation program to engage women in timely breast cancer treatment post-diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted as part of Translating Research Into Practice (TRIP), a citywide patient navigation hybrid effectiveness-implementation research study conducted at five cancer care hospitals in Boston, Massachusetts. The authors surveyed participating patient navigators and supervisors about their tasks and level of effort over consecutive 10-day periods from 2019 to 2021. Patient navigators documented the time spent on activities in accordance with an 11-step protocol across five sites. Cost data were collected from annual fiscal year end expenditure hospital administrative databases at concurrent time frames. Descriptive analyses were used to calculate average time on tasks, cost per activity and cost per outcome. Cost savings were estimated by calculating the additional persons engaged in timely entry to treatment compared to a matched control group with respect to hospitalization and emergency room costs averted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Average time spent per day on TRIP-specific navigation activities was approximately 3 hours (range, 0–8 hours) and the average time per patient per day was 25 minutes (<i>n</i> = 7 navigators). Total costs for clinical site interventions were $218,394 for startup and $392,407 for maintenance costs over the study period. A total of 223 patients were served during the intervention period with an average cost per patient of $979 for startup and $1759 for maintenance. Potential costs savings with the TRIP navigation program from averted hospitalization and emergency room visits for 63 additional patients who received timely treatment is estimated at $21,798–$30,429 and $2536–$5692 per patient, respectively, compared to treatment as usual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The economic evaluation in this study provides insight into startup and implementation costs for uptake and scalability of navigation pro","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918703","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":"Favorable transplantation outcome of patients with de novo chronic myeloid leukemia in blast phase (lymphoid and myeloid)","authors":"Koji Sasaki MD, PhD","doi":"10.1002/cncr.35704","DOIUrl":"10.1002/cncr.35704","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918706","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}
Melissa Bolier MD, Demi T.C. de Winter MD, Vincent G. Pluimakers MD, PhD, Marta Fiocco PhD, Sjoerd A.A. van den Berg PhD, Dorine Bresters MD, PhD, Eline van Dulmen-den Broeder PhD, Margriet van der Heiden-van der Loo PhD, Imo Höfer MD, Geert O. Janssens MD, PhD, Leontien C.M. Kremer MD, PhD, Jacqueline J. Loonen MD, PhD, Marloes Louwerens MD, Heleen J. van der Pal MD, PhD, Saskia M.F. Pluijm PhD, Wim J.E. Tissing MD, PhD, Hanneke M. van Santen MD, PhD, Andrica C.H. de Vries MD, PhD, Aart-Jan van der Lely MD, PhD, Marry M. van den Heuvel-Eibrink MD, PhD, Sebastian J.C.M.M. Neggers MD, PhD
Background
Because the occurrence of metabolic syndrome (MetS) might contribute to childhood cancer survivor’s excess risk of cardiovascular disease, the authors assessed the prevalence and determinants of MetS in the Dutch Childhood Cancer Survivor Study (DCCSS-LATER2) cohort.
Methods
In total, 2338 adult childhood cancer survivors (CCS) were cross-sectionally assessed for the prevalence of MetS, using the Lifelines cohort (N = 132,226 adults without a history of cancer) as references. The prevalence of MetS was clinically assessed using existing classifications, as well as an alternative method using dual-energy x-ray absorptiometry fat% instead of waist circumference to define abdominal adiposity. Logistic regression models, adjusted for age and sex, were used to investigate the association between the presence of MetS and both cohorts. Demographic, lifestyle, and treatment determinants of MetS were identified through multivariable logistic regression.
Results
The survivor cohort (median age, 34.7 years, median follow-up time, 27.1 years) showed increased adjusted odds ratio (aOR) for MetS (modified National Cholesterol Education Program Adult Treatment Panel III criteria), as compared to the reference cohort (aOR, 2.07; 95% confidence interval [CI], 1.85–2.32). Compared to these criteria, the alternative method identified 57 additional survivors with MetS (395 of 2070 [19.1%] vs. 452 of 1960 [23.1%], respectively). Age (odds ratio [OR], 1.07; 95% CI, 1.04–1.10, per year increase), smoking (OR, 1.46; 95% CI, 1.04–2.04), low physical activity (OR, 1.48; 95% CI, 1.05–2.09), abdominal radiotherapy (OR, 2.13; 95% CI, 1.01–4.31; >30 Gy), cranial radiotherapy (OR, 2.89; 95% CI, 1.67–4.96; 1–25 Gy; and OR, 2.44; 95% CI, 1.30–4.47; >25 Gy), total body irradiation (OR, 6.17; 95% CI, 3.20–11.76), and underlying central nervous system tumor (OR, 1.78; 95% CI, 1.21–2.60) were associated with MetS.
Conclusion
The high risk of MetS in CCS, combined with several potential modifiable factors, underscores the need for timely identification and intervention strategies to mitigate the long-term cardiovascular risks in CCS.
{"title":"Prevalence and determinants of metabolic syndrome in 2338 childhood cancer survivors: A Dutch Childhood Cancer Survivor LATER 2 study","authors":"Melissa Bolier MD, Demi T.C. de Winter MD, Vincent G. Pluimakers MD, PhD, Marta Fiocco PhD, Sjoerd A.A. van den Berg PhD, Dorine Bresters MD, PhD, Eline van Dulmen-den Broeder PhD, Margriet van der Heiden-van der Loo PhD, Imo Höfer MD, Geert O. Janssens MD, PhD, Leontien C.M. Kremer MD, PhD, Jacqueline J. Loonen MD, PhD, Marloes Louwerens MD, Heleen J. van der Pal MD, PhD, Saskia M.F. Pluijm PhD, Wim J.E. Tissing MD, PhD, Hanneke M. van Santen MD, PhD, Andrica C.H. de Vries MD, PhD, Aart-Jan van der Lely MD, PhD, Marry M. van den Heuvel-Eibrink MD, PhD, Sebastian J.C.M.M. Neggers MD, PhD","doi":"10.1002/cncr.35681","DOIUrl":"10.1002/cncr.35681","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Because the occurrence of metabolic syndrome (MetS) might contribute to childhood cancer survivor’s excess risk of cardiovascular disease, the authors assessed the prevalence and determinants of MetS in the Dutch Childhood Cancer Survivor Study (DCCSS-LATER2) cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 2338 adult childhood cancer survivors (CCS) were cross-sectionally assessed for the prevalence of MetS, using the Lifelines cohort (<i>N</i> = 132,226 adults without a history of cancer) as references. The prevalence of MetS was clinically assessed using existing classifications, as well as an alternative method using dual-energy x-ray absorptiometry fat% instead of waist circumference to define abdominal adiposity. Logistic regression models, adjusted for age and sex, were used to investigate the association between the presence of MetS and both cohorts. Demographic, lifestyle, and treatment determinants of MetS were identified through multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The survivor cohort (median age, 34.7 years, median follow-up time, 27.1 years) showed increased adjusted odds ratio (aOR) for MetS (modified National Cholesterol Education Program Adult Treatment Panel III criteria), as compared to the reference cohort (aOR, 2.07; 95% confidence interval [CI], 1.85–2.32). Compared to these criteria, the alternative method identified 57 additional survivors with MetS (395 of 2070 [19.1%] vs. 452 of 1960 [23.1%], respectively). Age (odds ratio [OR], 1.07; 95% CI, 1.04–1.10, per year increase), smoking (OR, 1.46; 95% CI, 1.04–2.04), low physical activity (OR, 1.48; 95% CI, 1.05–2.09), abdominal radiotherapy (OR, 2.13; 95% CI, 1.01–4.31; >30 Gy), cranial radiotherapy (OR, 2.89; 95% CI, 1.67–4.96; 1–25 Gy; and OR, 2.44; 95% CI, 1.30–4.47; >25 Gy), total body irradiation (OR, 6.17; 95% CI, 3.20–11.76), and underlying central nervous system tumor (OR, 1.78; 95% CI, 1.21–2.60) were associated with MetS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The high risk of MetS in CCS, combined with several potential modifiable factors, underscores the need for timely identification and intervention strategies to mitigate the long-term cardiovascular risks in CCS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918763","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}
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