Debra P Ritzwoller, Nikki M Carroll, Kris F Wain, Brian P Hixon, Roger Y Kim, Mahesh Maiyani, Julie S Steiner
Background: More than a decade ago, the National Lung Screening Trial led to the recommendation of low-dose computed tomography (CT) for lung cancer screening (LCS). However, few studies have explored how program changes and external factors affect patient outcomes.
Methods: This retrospective study included LCS-eligible individuals from Kaiser Permanente Colorado between May 1, 2014, and December 31, 2024. Rates and proportions of LCS orders, completions, adherence to recommended follow-up after baseline screening, and lung cancer yield were calculated. Multivariable log-binomial regression models estimated the factors associated with baseline LCS completion.
Results: Of 23,602 LCS-eligible individuals, 13,576 (58%) received a baseline LCS order and 8621 (37% of eligible; 64% of orders) completed screening. LCS completion was more likely among Asian/Native Hawaiian/Pacific Islander or Black races, and individuals who formerly smoked, had a 20- to 29-pack-year smoking history, >1 specialty care visit, a family history of lung cancer, or a greater comorbidity burden. Overall adherence to recommended follow-up was 62%; patients with a Lung CT Screening Reporting and Data System (Lung-RADS) score of 4B or 4X had the highest adherence at 88%. LCS yielded 424 cases of lung cancer (5% of screened), with 68% at stage I, II, or IIIA. Cumulative incidence among those with a positive Lung-RADS score was 20% at 10 years. Secular changes in LCS outcomes correlated with changes to LCS navigation processes, technology, and the coronavirus disease 2019 pandemic.
Conclusions: This evaluation of a decade of robust LCS data within a community setting highlights the need for established national quality metrics that incentivize health systems to conduct ongoing program monitoring, evaluation, and adaptation to optimize screening benefits.
{"title":"Examining trends in lung cancer screening over 10 years: Eligibility, participation, cancer detection, and quality implications.","authors":"Debra P Ritzwoller, Nikki M Carroll, Kris F Wain, Brian P Hixon, Roger Y Kim, Mahesh Maiyani, Julie S Steiner","doi":"10.1002/cncr.70211","DOIUrl":"10.1002/cncr.70211","url":null,"abstract":"<p><strong>Background: </strong>More than a decade ago, the National Lung Screening Trial led to the recommendation of low-dose computed tomography (CT) for lung cancer screening (LCS). However, few studies have explored how program changes and external factors affect patient outcomes.</p><p><strong>Methods: </strong>This retrospective study included LCS-eligible individuals from Kaiser Permanente Colorado between May 1, 2014, and December 31, 2024. Rates and proportions of LCS orders, completions, adherence to recommended follow-up after baseline screening, and lung cancer yield were calculated. Multivariable log-binomial regression models estimated the factors associated with baseline LCS completion.</p><p><strong>Results: </strong>Of 23,602 LCS-eligible individuals, 13,576 (58%) received a baseline LCS order and 8621 (37% of eligible; 64% of orders) completed screening. LCS completion was more likely among Asian/Native Hawaiian/Pacific Islander or Black races, and individuals who formerly smoked, had a 20- to 29-pack-year smoking history, >1 specialty care visit, a family history of lung cancer, or a greater comorbidity burden. Overall adherence to recommended follow-up was 62%; patients with a Lung CT Screening Reporting and Data System (Lung-RADS) score of 4B or 4X had the highest adherence at 88%. LCS yielded 424 cases of lung cancer (5% of screened), with 68% at stage I, II, or IIIA. Cumulative incidence among those with a positive Lung-RADS score was 20% at 10 years. Secular changes in LCS outcomes correlated with changes to LCS navigation processes, technology, and the coronavirus disease 2019 pandemic.</p><p><strong>Conclusions: </strong>This evaluation of a decade of robust LCS data within a community setting highlights the need for established national quality metrics that incentivize health systems to conduct ongoing program monitoring, evaluation, and adaptation to optimize screening benefits.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":"e70211"},"PeriodicalIF":5.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766680","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":"Correction to \"Intratumoral vidutolimod as monotherapy or in combination with pembrolizumab in patients with programmed cell death 1 blockade-resistant melanoma: Final analysis from a phase 1b study\".","authors":"","doi":"10.1002/cncr.70188","DOIUrl":"10.1002/cncr.70188","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":"e70188"},"PeriodicalIF":5.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761711","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":"Generate shows nab-paclitaxel plus gemcitabine still an effective regimen for metastatic pancreatic cancer: In this study, mFOLFIRINOX and S-IROX did not demonstrate superior outcomes compared to GnP in patients aged 75 years or younger with metastatic pancreatic cancer.","authors":"Leah Lawrence","doi":"10.1002/cncr.70144","DOIUrl":"https://doi.org/10.1002/cncr.70144","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":"e70144"},"PeriodicalIF":5.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766635","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":"Diffuse midline gliomas get first FDA-approved drug.","authors":"Leah Lawrence","doi":"10.1002/cncr.70146","DOIUrl":"https://doi.org/10.1002/cncr.70146","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":"e70146"},"PeriodicalIF":5.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766685","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}
PengXin Zhang, DaQuan Wang, ShaoHan Yin, YuMei Dong, ShiHong Wei, FangJie Liu, HaoTing Zhang, Biao Xia, Yu SiTu, MengRu Wang, Yi Hu, QianWen Liu, LiKun Chen, Bo Qiu, Hui Liu
Background: To evaluate the efficacy and safety of magnetic resonance (MR)-guided split-course hypo-fractionated radiotherapy (hypo-RT) with concurrent chemotherapy followed by consolidative immunotherapy (CIT) in locally advanced non-small cell lung cancer (LA-NSCLC).
Methods: In this phase 2 trial, patients with unresectable stage IIIA-C NSCLC (18-75 years old, Eastern Cooperative Oncology Group 0-1) received MR-guided split-course hypo-RT (30 Gy in six fractions, repeated after 4 weeks for a total of 60 Gy) with concurrent weekly docetaxel (25 mg/m2) and cisplatin (25 mg/m2). The primary end point was progression-free survival (PFS); secondary end points included overall survival (OS), objective response rate (ORR), and toxicities.
Results: Between July 2020 and January 2023, 104 patients were enrolled with a median follow-up of 34.4 months. Split-course hypo-concurrent chemoradiotherapy (CCRT) was completed in 101 (97.1%) patients, and 74 (71.2%) received CIT. The median PFS was 27.5 months (95% confidence interval [CI], 18.9-36.0 months), and the 1- and 2-year PFS rates were 76.9% (95% CI, 69.2%-85.5%) and 54.7% (95% CI, 45.9%-65.1%), respectively. The 1- and 2-year OS were 87.5% (95% CI, 81.4%-94.1%) and 65.3% (95% CI, 56.8%-75.2%), respectively. The most common grade 3-4 adverse event was lymphopenia (35.6%). Grade 2-3 pneumonitis was observed in eight patients (7.7%) during hypo-CCRT and in seven patients (6.7%) during CIT. Grade 3 esophagitis occurred in three patients (2.8%), and one grade 5 hemoptysis was reported (0.9%).
Conclusion: The MR-guided split-course hypo-CCRT delivered at 5 Gy per fraction to a total dose of 60 Gy followed by CIT yielded encouraging survival outcomes with manageable toxicities in patients with LA-NSCLC.
{"title":"Magnetic resonance-guided split-course hypo-fractionated radiotherapy with concurrent chemotherapy and consolidative immunotherapy in locally advanced non-small cell lung cancer: A single arm, phase 2 study.","authors":"PengXin Zhang, DaQuan Wang, ShaoHan Yin, YuMei Dong, ShiHong Wei, FangJie Liu, HaoTing Zhang, Biao Xia, Yu SiTu, MengRu Wang, Yi Hu, QianWen Liu, LiKun Chen, Bo Qiu, Hui Liu","doi":"10.1002/cncr.70223","DOIUrl":"10.1002/cncr.70223","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the efficacy and safety of magnetic resonance (MR)-guided split-course hypo-fractionated radiotherapy (hypo-RT) with concurrent chemotherapy followed by consolidative immunotherapy (CIT) in locally advanced non-small cell lung cancer (LA-NSCLC).</p><p><strong>Methods: </strong>In this phase 2 trial, patients with unresectable stage IIIA-C NSCLC (18-75 years old, Eastern Cooperative Oncology Group 0-1) received MR-guided split-course hypo-RT (30 Gy in six fractions, repeated after 4 weeks for a total of 60 Gy) with concurrent weekly docetaxel (25 mg/m<sup>2</sup>) and cisplatin (25 mg/m<sup>2</sup>). The primary end point was progression-free survival (PFS); secondary end points included overall survival (OS), objective response rate (ORR), and toxicities.</p><p><strong>Results: </strong>Between July 2020 and January 2023, 104 patients were enrolled with a median follow-up of 34.4 months. Split-course hypo-concurrent chemoradiotherapy (CCRT) was completed in 101 (97.1%) patients, and 74 (71.2%) received CIT. The median PFS was 27.5 months (95% confidence interval [CI], 18.9-36.0 months), and the 1- and 2-year PFS rates were 76.9% (95% CI, 69.2%-85.5%) and 54.7% (95% CI, 45.9%-65.1%), respectively. The 1- and 2-year OS were 87.5% (95% CI, 81.4%-94.1%) and 65.3% (95% CI, 56.8%-75.2%), respectively. The most common grade 3-4 adverse event was lymphopenia (35.6%). Grade 2-3 pneumonitis was observed in eight patients (7.7%) during hypo-CCRT and in seven patients (6.7%) during CIT. Grade 3 esophagitis occurred in three patients (2.8%), and one grade 5 hemoptysis was reported (0.9%).</p><p><strong>Conclusion: </strong>The MR-guided split-course hypo-CCRT delivered at 5 Gy per fraction to a total dose of 60 Gy followed by CIT yielded encouraging survival outcomes with manageable toxicities in patients with LA-NSCLC.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":"e70223"},"PeriodicalIF":5.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12704701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761708","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}
Del Yazzie MPH, Dornell Pete PhD, MPH, Curtis Briscoe BS, Melissa A. Jim MPH, Angela Meisner MPH, Charles Wiggins PhD, Dana Doyle MPH, Georgia Yee BSW, ODS-C, Carol Goldtooth MPH, Priscilla R. Sanderson PhD, Chesleigh Nicole Keene PhD, Melinda Smith PhD, Hannah Sehn MMSc, Shawnell Damon MPH, MSc, Chelsea L. Kettering DrPH, MPH, Marc Emerson PhD, Caleigh Curley MPH, Jennifer Bea PhD, Sheldwin Yazzie PhD, MPH, MS, Natalie Joe PhD, MPH, Jennifer Doherty PhD, Hendrik Dirk de Heer PhD, MPH, Navajo Cancer Workgroup
Background
American Indian/Alaska Native (AI/AN) people in the United States experience cancer disparities, but little is known about cancer patterns specific to each Tribal Nation. This study describes cancer incidence (2014–2018), trends (1998–2018), and stage of diagnosis across the Navajo Nation, one of the largest sovereign tribal nations worldwide.
Methods
Cases from six Arizona, New Mexico, and Utah counties covering most of the Navajo Nation were identified by population-based cancer registries and linked with Indian Health Services patient registrations. Cancer incidence and stage at diagnosis were compared between Navajo and non-Hispanic White persons in the same counties. Trends from 1998 through 2018 were analyzed using Joinpoint regression.
Results
Navajo people had significantly higher incidence than non-Hispanic White people of gallbladder (incidence rate ratio [RR] = 6.25), stomach (RR = 3.19), kidney (RR = 1.89), myeloma (RR = 1.80), and liver cancers (RR = 1.79) and a lower incidence of cancers of the lung (RR = 0.16), female breast (RR = 0.49), leukemia (RR = 0.49), prostate (RR = 0.62), pancreas (RR = 0.79), and non-Hodgkin lymphoma (RR = 0.79). Diagnostic stage was not different for breast, cervical, and colorectal cancers, but two thirds of patients with cervical and colorectal cancer were diagnosed in later/unknown stages. Although all-site cancer rates did not change significantly from 1998 through 2018 among Navajo people, a significant decrease was found from 2010 through 2018 (–2.1% annual percentage change, p < .01).
Conclusions
Navajo people experience a higher incidence of kidney, stomach, liver, myeloma, and gallbladder cancers and a lower incidence of cancers of the breast, prostate, lung, non-Hodgkin lymphoma, and leukemia. Tailored and targeted prevention efforts may help reduce cancer disparities in the Navajo Nation.
{"title":"Cancer incidence, stage at diagnosis, and trends across the Navajo Nation, 2014–2018","authors":"Del Yazzie MPH, Dornell Pete PhD, MPH, Curtis Briscoe BS, Melissa A. Jim MPH, Angela Meisner MPH, Charles Wiggins PhD, Dana Doyle MPH, Georgia Yee BSW, ODS-C, Carol Goldtooth MPH, Priscilla R. Sanderson PhD, Chesleigh Nicole Keene PhD, Melinda Smith PhD, Hannah Sehn MMSc, Shawnell Damon MPH, MSc, Chelsea L. Kettering DrPH, MPH, Marc Emerson PhD, Caleigh Curley MPH, Jennifer Bea PhD, Sheldwin Yazzie PhD, MPH, MS, Natalie Joe PhD, MPH, Jennifer Doherty PhD, Hendrik Dirk de Heer PhD, MPH, Navajo Cancer Workgroup","doi":"10.1002/cncr.70202","DOIUrl":"10.1002/cncr.70202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>American Indian/Alaska Native (AI/AN) people in the United States experience cancer disparities, but little is known about cancer patterns specific to each Tribal Nation. This study describes cancer incidence (2014–2018), trends (1998–2018), and stage of diagnosis across the Navajo Nation, one of the largest sovereign tribal nations worldwide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cases from six Arizona, New Mexico, and Utah counties covering most of the Navajo Nation were identified by population-based cancer registries and linked with Indian Health Services patient registrations. Cancer incidence and stage at diagnosis were compared between Navajo and non-Hispanic White persons in the same counties. Trends from 1998 through 2018 were analyzed using Joinpoint regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Navajo people had significantly higher incidence than non-Hispanic White people of gallbladder (incidence rate ratio [RR] = 6.25), stomach (RR = 3.19), kidney (RR = 1.89), myeloma (RR = 1.80), and liver cancers (RR = 1.79) and a lower incidence of cancers of the lung (RR = 0.16), female breast (RR = 0.49), leukemia (RR = 0.49), prostate (RR = 0.62), pancreas (RR = 0.79), and non-Hodgkin lymphoma (RR = 0.79). Diagnostic stage was not different for breast, cervical, and colorectal cancers, but two thirds of patients with cervical and colorectal cancer were diagnosed in later/unknown stages. Although all-site cancer rates did not change significantly from 1998 through 2018 among Navajo people, a significant decrease was found from 2010 through 2018 (–2.1% annual percentage change, <i>p</i> < .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Navajo people experience a higher incidence of kidney, stomach, liver, myeloma, and gallbladder cancers and a lower incidence of cancers of the breast, prostate, lung, non-Hodgkin lymphoma, and leukemia. Tailored and targeted prevention efforts may help reduce cancer disparities in the Navajo Nation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740124","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}
Ashely Aller MD, Shiyun Zhu MPH, Liisa Lyon MS, Laurel A. Habel PhD, Aida Shirazi PhD, MS, RPh, Scott D. Casey MD, MS, Raymond Liu MD
Background
Trial Assigning Individualized Options for Treatment (TAILORx) redefined the Oncotype DX (ODX) risk stratification scores. This study describes the clinical application of ODX in the post-TAILORx era in relation to chemotherapy.
Methods
A cohort of 8017 early-stage breast cancer patients considered guideline-eligible for ODX testing were identified between 2015 and 2021. Clinical factors associated with ODX testing and adjuvant chemotherapy were found through descriptive analysis and multivariable logistic regression modeling. Models were adjusted for age, race/ethnicity, tumor size and grade, progesterone (PR) status, and Charlson Comorbidity Index. The Cochran-Armitage test was used to evaluate the probability of ODX testing during the study period.
Results
ODX testing increased over time (from 45% in 2015 to 80% in 2021; p < .0001). The likelihood of chemotherapy use increased by an estimated 5% annually (adjusted odds ratio [aOR], 1.05; 95% CI, 1.01–1.09). Testing was more likely in younger than older patients (e.g., aOR 1.90 among 18 to <40 vs. 0.30 among 70 to <80 as compared to 60 to <70). The association of ODX testing with chemotherapy was modified by age. Although younger patients were more likely to receive chemotherapy, testing was associated with less chemotherapy use in younger patients and more chemotherapy in older patients (p value for interaction <.001).
Conclusions
In the post-TAILORx era, younger age was associated with substantially more ODX testing. The association of testing with chemotherapy varied substantially by age. The impact of age on ODX testing and use of chemotherapy is substantial and warrants further study.
{"title":"Is age just a number? Oncotype DX testing and chemotherapy use in the post-TAILORx era","authors":"Ashely Aller MD, Shiyun Zhu MPH, Liisa Lyon MS, Laurel A. Habel PhD, Aida Shirazi PhD, MS, RPh, Scott D. Casey MD, MS, Raymond Liu MD","doi":"10.1002/cncr.70218","DOIUrl":"10.1002/cncr.70218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trial Assigning Individualized Options for Treatment (TAILORx) redefined the Oncotype DX (ODX) risk stratification scores. This study describes the clinical application of ODX in the post-TAILORx era in relation to chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of 8017 early-stage breast cancer patients considered guideline-eligible for ODX testing were identified between 2015 and 2021. Clinical factors associated with ODX testing and adjuvant chemotherapy were found through descriptive analysis and multivariable logistic regression modeling. Models were adjusted for age, race/ethnicity, tumor size and grade, progesterone (PR) status, and Charlson Comorbidity Index. The Cochran-Armitage test was used to evaluate the probability of ODX testing during the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ODX testing increased over time (from 45% in 2015 to 80% in 2021; <i>p</i> < .0001). The likelihood of chemotherapy use increased by an estimated 5% annually (adjusted odds ratio [aOR], 1.05; 95% CI, 1.01–1.09). Testing was more likely in younger than older patients (e.g., aOR 1.90 among 18 to <40 vs. 0.30 among 70 to <80 as compared to 60 to <70). The association of ODX testing with chemotherapy was modified by age. Although younger patients were more likely to receive chemotherapy, testing was associated with less chemotherapy use in younger patients and more chemotherapy in older patients (<i>p</i> value for interaction <.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the post-TAILORx era, younger age was associated with substantially more ODX testing. The association of testing with chemotherapy varied substantially by age. The impact of age on ODX testing and use of chemotherapy is substantial and warrants further study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740194","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}
Miguel Arguello-Tomas MD, Elionor Lynton-Pons MSc, Nil Albiol MD, Anna López-Ferrer MD, PhD, Jorge Sierra MD, PhD, Esther Moga MD, PhD, Carol Moreno MD, PhD
Background
Autoimmune disorders (AIDs) are frequent in patients with chronic lymphocytic leukemia (CLL). There is little information on the clinical characteristics and pathogenesis of nonhematologic AIDs in patients with CLL, although both entities present immunologic alterations in their clinical onset.
Methods
This single-center series included 907 patients with CLL who had a median follow-up of 6.6 years (range, 0.1–36.4 years).
Results
In total, 156 patients developed an AID, including 99 patients (10.9%) with nonhematologic AIDs, 46 (5.1%) with autoimmune cytopenia (AIC), and 11 (1.2%) with both; autoimmune hypothyroidism and psoriasis were the most frequent AIDs. Patients with nonhematologic AIDs had low-risk genetic features and were related to a better time to first treatment than patients with AIC (13.8 vs. 5.5 years; p < .001). Patients with both CLL and psoriasis had the lowest risk of progression. The authors performed a T-cell/natural killer-cell and cytokine assessment among patients who had CLL with and without psoriasis. An unsupervised hierarchical clustering revealed a distinct cluster characterized by an expansion of T-helper 17 cells, T-regulatory cells, interleukin-17F, and interleukin-23.
Conclusions
The current findings suggest that nonhematologic AIDs are prevalent in patients with CLL, and these patients have a better prognosis than patients who have AIC. The expansion of interleukin-17F–producing cells in patients with psoriasis may explain their good prognosis.
{"title":"Clinical and immunologic characteristics of nonhematologic autoimmune disorders in chronic lymphocytic leukemia","authors":"Miguel Arguello-Tomas MD, Elionor Lynton-Pons MSc, Nil Albiol MD, Anna López-Ferrer MD, PhD, Jorge Sierra MD, PhD, Esther Moga MD, PhD, Carol Moreno MD, PhD","doi":"10.1002/cncr.70216","DOIUrl":"10.1002/cncr.70216","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autoimmune disorders (AIDs) are frequent in patients with chronic lymphocytic leukemia (CLL). There is little information on the clinical characteristics and pathogenesis of nonhematologic AIDs in patients with CLL, although both entities present immunologic alterations in their clinical onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center series included 907 patients with CLL who had a median follow-up of 6.6 years (range, 0.1–36.4 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 156 patients developed an AID, including 99 patients (10.9%) with nonhematologic AIDs, 46 (5.1%) with autoimmune cytopenia (AIC), and 11 (1.2%) with both; autoimmune hypothyroidism and psoriasis were the most frequent AIDs. Patients with nonhematologic AIDs had low-risk genetic features and were related to a better time to first treatment than patients with AIC (13.8 vs. 5.5 years; <i>p</i> < .001). Patients with both CLL and psoriasis had the lowest risk of progression. The authors performed a T-cell/natural killer-cell and cytokine assessment among patients who had CLL with and without psoriasis. An unsupervised hierarchical clustering revealed a distinct cluster characterized by an expansion of T-helper 17 cells, T-regulatory cells, interleukin-17F, and interleukin-23.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current findings suggest that nonhematologic AIDs are prevalent in patients with CLL, and these patients have a better prognosis than patients who have AIC. The expansion of interleukin-17F–producing cells in patients with psoriasis may explain their good prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720231","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}
Pooja Karukonda MD, Brian G. Czito MD, Eileen Duffy RN, BSN, Hope E. Uronis MD, Thomas A. D'Amico MD, John H. Strickler MD, Donna Niedzwiecki PhD, Christopher G. Willett MD, Manisha Palta MD
Introduction
Esophagogastric cancers are common and carry a poor prognosis. A standard option for locally advanced disease has been neoadjuvant chemoradiation (CRT) followed by surgical resection. The primary goal of this study was to investigate whether the addition of pembrolizumab to neoadjuvant CRT improves pathologic complete response (pCR) rates, compared to historical controls.
Methods
This is a single-institution, prospective, single-arm phase 2 trial (NCT03064490). Patients received three cycles of pembrolizumab (200 mg every 3 weeks) concurrent with neoadjuvant CRT (45 Gy/25 fractions, concurrent weekly carboplatin and paclitaxel), followed by surgical resection. Patients were eligible to receive three additional cycles of adjuvant pembrolizumab if they did not experience significant toxicity during neoadjuvant treatment. Pathologic response and acute toxicities were evaluated. Survival and recurrence data were tabulated.
Results
A total of 35 patients were enrolled over 5 years, with 30 patients completing prescribed neoadjuvant treatment followed by surgical resection. Eleven of 30 patients (36·7%) experienced a pCR and 15/30 patients (50%) experienced a major pathologic response. Rates of grade 3-4 toxicity were comparable to historical controls, and there were no grade 5 toxicities. Median progression-free and overall survival were numerically higher in patients who experienced a major pathologic response.
Conclusion
The addition of pembrolizumab to neoadjuvant CRT followed by surgical resection was overall well-tolerated and resulted in numerically higher rates of pCR compared to historical controls. Further studies with optimized patient selection are warranted to validate the efficacy of this treatment paradigm.
{"title":"Pembrolizumab, Radiotherapy, and Chemotherapy in Neoadjuvant Treatment of Malignant Esophago-gastric Diseases (PROCEED): A single-arm phase 2 trial","authors":"Pooja Karukonda MD, Brian G. Czito MD, Eileen Duffy RN, BSN, Hope E. Uronis MD, Thomas A. D'Amico MD, John H. Strickler MD, Donna Niedzwiecki PhD, Christopher G. Willett MD, Manisha Palta MD","doi":"10.1002/cncr.70213","DOIUrl":"10.1002/cncr.70213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Esophagogastric cancers are common and carry a poor prognosis. A standard option for locally advanced disease has been neoadjuvant chemoradiation (CRT) followed by surgical resection. The primary goal of this study was to investigate whether the addition of pembrolizumab to neoadjuvant CRT improves pathologic complete response (pCR) rates, compared to historical controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single-institution, prospective, single-arm phase 2 trial (NCT03064490). Patients received three cycles of pembrolizumab (200 mg every 3 weeks) concurrent with neoadjuvant CRT (45 Gy/25 fractions, concurrent weekly carboplatin and paclitaxel), followed by surgical resection. Patients were eligible to receive three additional cycles of adjuvant pembrolizumab if they did not experience significant toxicity during neoadjuvant treatment. Pathologic response and acute toxicities were evaluated. Survival and recurrence data were tabulated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 35 patients were enrolled over 5 years, with 30 patients completing prescribed neoadjuvant treatment followed by surgical resection. Eleven of 30 patients (36·7%) experienced a pCR and 15/30 patients (50%) experienced a major pathologic response. Rates of grade 3-4 toxicity were comparable to historical controls, and there were no grade 5 toxicities. Median progression-free and overall survival were numerically higher in patients who experienced a major pathologic response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The addition of pembrolizumab to neoadjuvant CRT followed by surgical resection was overall well-tolerated and resulted in numerically higher rates of pCR compared to historical controls. Further studies with optimized patient selection are warranted to validate the efficacy of this treatment paradigm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720080","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}
Maryse J. Luijendijk MSc, Philippe R. Lee Meeuw Kjoe PhD, Noor Wortelboer MSc, Annemiek van Ommen-Nijhof PhD, A. Elise van Leeuwen-Stok PhD, Joost A. Agelink van Rentergem PhD, Ivar E. Vermeulen PhD, Inge R. Konings MD, PhD, Agnes Jager MD, PhD, Gabe S. Sonke MD, PhD, Elsken van der Wall MD, PhD, Sanne B. Schagen PhD
Background
Endocrine treatment for breast cancer may adversely affect cognition. Given the widespread use of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i), assessing the cognitive effects of this combination is important.
Methods
In the SONIA trial, patients with hormone receptor–positive, HER2-negative (HR+HER2−) advanced breast cancer (ABC) starting first-line treatment with an aromatase inhibitor were randomized to treatment with (arm A) or without (arm B) CDK4/6i. Cognitive function was assessed at baseline and after 9 months with the online Amsterdam Cognition Scan. Standardized z scores at baseline and regression-based change scores at 9 months were computed on the basis of matched cancer-free controls. Rates of clinically meaningful decline were compared with estimated false-positive rates of observing decline by chance.
Results
Altogether, 260 patients (arm A, N = 130; arm B, N = 130) and 130 matched controls participated at baseline; 199 patients (arm A, N = 108; arm B, N = 91) and 120 matched controls completed the follow-up. At baseline, patients performed significantly worse than controls across all cognitive domains. Over the course of 9 months, no group-level decline in cognitive function occurred in either treatment arm, with minimal differences between treatment arms. At the individual level, however, the rate of clinically meaningful decline in patients (arm A, 15.7%; arm B, 14.3%) but not in controls (6.7%) was significantly higher than the false-positive rate (7.5%), which indicates decline in a small subset of patients.
Conclusions
Patients with HR+HER2− ABC showed impaired cognitive function at initial diagnosis compared to cancer-free controls. During first-line endocrine treatment with aromatase inhibitors, cognitive function declined in a small group of patients, regardless of the addition of CDK4/6i.
{"title":"Cognitive function during endocrine treatment with or without cyclin-dependent kinase 4/6 inhibitors for advanced breast cancer","authors":"Maryse J. Luijendijk MSc, Philippe R. Lee Meeuw Kjoe PhD, Noor Wortelboer MSc, Annemiek van Ommen-Nijhof PhD, A. Elise van Leeuwen-Stok PhD, Joost A. Agelink van Rentergem PhD, Ivar E. Vermeulen PhD, Inge R. Konings MD, PhD, Agnes Jager MD, PhD, Gabe S. Sonke MD, PhD, Elsken van der Wall MD, PhD, Sanne B. Schagen PhD","doi":"10.1002/cncr.70212","DOIUrl":"10.1002/cncr.70212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endocrine treatment for breast cancer may adversely affect cognition. Given the widespread use of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i), assessing the cognitive effects of this combination is important.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the SONIA trial, patients with hormone receptor–positive, HER2-negative (HR<sup>+</sup>HER2<sup>−</sup>) advanced breast cancer (ABC) starting first-line treatment with an aromatase inhibitor were randomized to treatment with (arm A) or without (arm B) CDK4/6i. Cognitive function was assessed at baseline and after 9 months with the online Amsterdam Cognition Scan. Standardized <i>z</i> scores at baseline and regression-based change scores at 9 months were computed on the basis of matched cancer-free controls. Rates of clinically meaningful decline were compared with estimated false-positive rates of observing decline by chance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether, 260 patients (arm A, <i>N</i> = 130; arm B, <i>N</i> = 130) and 130 matched controls participated at baseline; 199 patients (arm A, <i>N</i> = 108; arm B, <i>N</i> = 91) and 120 matched controls completed the follow-up. At baseline, patients performed significantly worse than controls across all cognitive domains. Over the course of 9 months, no group-level decline in cognitive function occurred in either treatment arm, with minimal differences between treatment arms. At the individual level, however, the rate of clinically meaningful decline in patients (arm A, 15.7%; arm B, 14.3%) but not in controls (6.7%) was significantly higher than the false-positive rate (7.5%), which indicates decline in a small subset of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with HR<sup>+</sup>HER2<sup>−</sup> ABC showed impaired cognitive function at initial diagnosis compared to cancer-free controls. During first-line endocrine treatment with aromatase inhibitors, cognitive function declined in a small group of patients, regardless of the addition of CDK4/6i.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720210","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}
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