Taylor D. Ellington MPH, Alexis C. Wardell MS, Allison M. Deal MS, Jennifer Mersereau MD, Katie Cameron MD, Steven Spandorfer MD, Gaya Murugappan MD, Valerie L. Baker MD, Carey Anders MD, Sara Mitra MPH, MSW, Chelsea Anderson PhD, Jianwen Cai PhD, Barbara Luke ScD, MPH, Hazel B. Nichols PhD
Background
Fertility preservation counseling is recommended for reproductive-age cancer patients. Gestational carriers are individuals who carry a pregnancy for someone else. This service creates a path to biological children when cancer treatment necessitates the removal of the uterus. The authors examined the involvement of gestational carriers among women diagnosed with cancer.
Methods
Using data from eight statewide cancer registries linked with the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System, the authors identified women with a cancer diagnosis who subsequently initiated in vitro fertilization (IVF) procedures during 2004 to 2018. Modified Poisson models were used to estimate prevalence ratios (PR) and 95% confidence intervals (CI). Discrete Cox regression models were used to calculate hazard ratios (HR) and CI. Multivariable models adjusted for age, state, and calendar year.
Results
Among 1095 women with cancer who used IVF with cryopreserved oocytes or embryos to attempt pregnancy, 19.1% worked with a gestational carrier. Involving gestational carriers was more common among those who initiated IVF for fertility preservation versus after cancer treatment (PR, 1.96; 95% CI, 1.54–2.50) and had chemotherapy versus no chemotherapy (PR, 1.92; 95% CI, 1.50–2.47). Using donor oocytes or embryos (vs. autologous) was more common among women who worked with a gestational carrier (PR, 1.62; 95% CI, 1.17–2.24). Working with a gestational carrier was not associated with conception (HR, 1.06; 95% CI, 0.82–1.37).
Conclusions
Approximately one in five women diagnosed with cancer who used IVF to attempt pregnancy worked with a gestational carrier. The results of this study emphasize the need for information on gestational carriers during fertility preservation counseling.
{"title":"In vitro fertilization with cryopreserved oocytes or embryos after cancer: The role of gestational carriers","authors":"Taylor D. Ellington MPH, Alexis C. Wardell MS, Allison M. Deal MS, Jennifer Mersereau MD, Katie Cameron MD, Steven Spandorfer MD, Gaya Murugappan MD, Valerie L. Baker MD, Carey Anders MD, Sara Mitra MPH, MSW, Chelsea Anderson PhD, Jianwen Cai PhD, Barbara Luke ScD, MPH, Hazel B. Nichols PhD","doi":"10.1002/cncr.35844","DOIUrl":"https://doi.org/10.1002/cncr.35844","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fertility preservation counseling is recommended for reproductive-age cancer patients. Gestational carriers are individuals who carry a pregnancy for someone else. This service creates a path to biological children when cancer treatment necessitates the removal of the uterus. The authors examined the involvement of gestational carriers among women diagnosed with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from eight statewide cancer registries linked with the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System, the authors identified women with a cancer diagnosis who subsequently initiated in vitro fertilization (IVF) procedures during 2004 to 2018. Modified Poisson models were used to estimate prevalence ratios (PR) and 95% confidence intervals (CI). Discrete Cox regression models were used to calculate hazard ratios (HR) and CI. Multivariable models adjusted for age, state, and calendar year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1095 women with cancer who used IVF with cryopreserved oocytes or embryos to attempt pregnancy, 19.1% worked with a gestational carrier. Involving gestational carriers was more common among those who initiated IVF for fertility preservation versus after cancer treatment (PR, 1.96; 95% CI, 1.54–2.50) and had chemotherapy versus no chemotherapy (PR, 1.92; 95% CI, 1.50–2.47). Using donor oocytes or embryos (vs. autologous) was more common among women who worked with a gestational carrier (PR, 1.62; 95% CI, 1.17–2.24). Working with a gestational carrier was not associated with conception (HR, 1.06; 95% CI, 0.82–1.37).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Approximately one in five women diagnosed with cancer who used IVF to attempt pregnancy worked with a gestational carrier. The results of this study emphasize the need for information on gestational carriers during fertility preservation counseling.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824701","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}
Hagop Kantarjian MD, Yifan Zhai MD, PhD, Vivian G. Oehler MD, Omer Jamy MD, Paul B. Koller MD, Fadi G. Haddad MD, Koji Sasaki MD, Elias J. Jabbour MD
Once considered an incurable disease with a poor prognosis (median survival, 3–6 years), chronic myeloid leukemia (CML) is now managed with a diverse clinical armamentarium that includes BCR::ABL1 tyrosine kinase inhibitors (TKIs), which have largely normalized life expectancy in most patients in the chronic phase of the disease (CML-CP). Clinical challenges remain, including ABL1 mutation–driven treatment resistance (under the selection pressures exerted by TKIs), as well as treatment intolerance, which can involve potentially serious arterial occlusive events. Olverembatinib is a third-generation TKI approved in China for TKI-resistant CML-CP and accelerated-phase CML with the T135I mutation, as well as for CML-CP resistant to or intolerant of first- and/or second-generation TKIs. Olverembatinib exhibits a broad coverage of ABL1 mutants, including the gatekeeper T315I variant and compound mutations. In preclinical models, olverembatinib inhibited multiple downstream protein kinases, which has potentially opened avenues for future management of other malignancies, including acute myeloid and lymphoid leukemias, gastrointestinal tumors, and others. The pharmacokinetic profile of olverembatinib is compatible with alternate-day dosing. In clinical trials, olverembatinib exerted potent antileukemic effects in heavily pretreated patients with CML, including those with ponatinib or asciminib resistance or intolerance, and was well tolerated. Future studies include the phase 3 registrational POLARIS-1 (NCT06051409; in patients with newly diagnosed Philadelphia chromosome–positive acute lymphoblastic leukemia), POLARIS-2 (NCT06423911; in patients with CML with or without the T315I mutation), and POLARIS-3 (NCT06640361; in patients with succinate dehydrogenase–deficient gastrointestinal stromal tumors) clinical trials.
{"title":"Olverembatinib in chronic myeloid leukemia—Review of historical development, current status, and future research","authors":"Hagop Kantarjian MD, Yifan Zhai MD, PhD, Vivian G. Oehler MD, Omer Jamy MD, Paul B. Koller MD, Fadi G. Haddad MD, Koji Sasaki MD, Elias J. Jabbour MD","doi":"10.1002/cncr.35832","DOIUrl":"https://doi.org/10.1002/cncr.35832","url":null,"abstract":"<p>Once considered an incurable disease with a poor prognosis (median survival, 3–6 years), chronic myeloid leukemia (CML) is now managed with a diverse clinical armamentarium that includes BCR::ABL1 tyrosine kinase inhibitors (TKIs), which have largely normalized life expectancy in most patients in the chronic phase of the disease (CML-CP). Clinical challenges remain, including <i>ABL1</i> mutation–driven treatment resistance (under the selection pressures exerted by TKIs), as well as treatment intolerance, which can involve potentially serious arterial occlusive events. Olverembatinib is a third-generation TKI approved in China for TKI-resistant CML-CP and accelerated-phase CML with the T135I mutation, as well as for CML-CP resistant to or intolerant of first- and/or second-generation TKIs. Olverembatinib exhibits a broad coverage of <i>ABL1</i> mutants, including the gatekeeper T315I variant and compound mutations. In preclinical models, olverembatinib inhibited multiple downstream protein kinases, which has potentially opened avenues for future management of other malignancies, including acute myeloid and lymphoid leukemias, gastrointestinal tumors, and others. The pharmacokinetic profile of olverembatinib is compatible with alternate-day dosing. In clinical trials, olverembatinib exerted potent antileukemic effects in heavily pretreated patients with CML, including those with ponatinib or asciminib resistance or intolerance, and was well tolerated. Future studies include the phase 3 registrational POLARIS-1 (NCT06051409; in patients with newly diagnosed Philadelphia chromosome–positive acute lymphoblastic leukemia), POLARIS-2 (NCT06423911; in patients with CML with or without the T315I mutation), and POLARIS-3 (NCT06640361; in patients with succinate dehydrogenase–deficient gastrointestinal stromal tumors) clinical trials.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793393","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":"A second look at the status quo for secondary acute myeloid leukemia after hypomethylating agents","authors":"Daniel T. Peters MD, Joshua F. Zeidner MD","doi":"10.1002/cncr.35838","DOIUrl":"https://doi.org/10.1002/cncr.35838","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793506","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":"Top advances of the year: Acute myeloid leukemia","authors":"Rahul K. Thakur MD, Eunice S. Wang MD","doi":"10.1002/cncr.35834","DOIUrl":"https://doi.org/10.1002/cncr.35834","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793510","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}
Asya Agulnik MD, MPH, Maricela Robles-Murguia MS, MSM, Yichen Chen PhD, Hilmarie Muñiz-Talavera PhD, Linh Pham MS, Angela Carrillo PhD, Adolfo Cardenas-Aguirre MD, Juliana Costa MD, Alejandra Mendez Aceituno MD, Carlos Acuña Aguirre MD, Ana Berenice Aguilar Roman MD, Shillel Yahamy Alvarez Arellano RN, Leticia Aradi Andrade Sarmiento MD, Daniela Arce Cabrera MD, Erika Esther Blasco Arriaga MD, Claudia María De León Gutiérrez MD, Rosdali Diaz-Coronado MD, Maria do Céu Diniz Borborema MD, Mariana do Nascimento Othero Campacci MD, Leticia Drumond Alberto MD, Natalia Soledad Gonzalez MD, Martha Herrera Almanza MD, Valentine Jimenez Antolinez MD, Merle Denisse Laffont Ortiz MD, Laura Lemos De Mendonça E. Fontes MD, Norma Araceli López Facundo MD, Claudia Beatriz López Vázquez MD, Idalia Margarita Lozano Lozano MD, Jose Miguel Mijares Tobias MD, Lupe Nataly Mora Robles MD, Berenice Noriega Acuña MD, Fernanda Paula Endo Marques MD, Clara Krystal Pérez Fermín MD, Monica Lorena Quijano Lievano RN, Andreia Ribeiro Pereira Aguiar De Paula MD, Ligia Rios MD, Jocelyn Rivera MD, Marcela Alejandra Sahonero MD, Beatriz Salas Mendoza MD, María Sánchez-Martín MD, Jennifer Sepúlveda Ramírez RN, Verónica Soto Chávez MD, Daniela María Velásquez Cabrera MS, Erika Elena Villanueva Hoyos MD, Luz Yadira Zuñiga Quijano MD, Meenakshi Devidas PhD, Carlos Rodriguez-Galindo MD, for the Escala de Valoracion de Alerta Temprana Study Group
Background
Hospitalized pediatric hematology-oncology patients have frequent clinical deterioration events (CDEs) requiring intensive care unit (ICU) interventions and resulting in high mortality, particularly in resource-limited settings. This study identifies independent risk factors for CDE mortality in hospitals providing childhood cancer care in Latin America and Spain.
Methods
Centers implemented a prospective CDE registry, defined as unplanned transfer to a higher level of care, use of ICU-level interventions on the ward, or nonpalliative ward death. The authors analyzed registry data from April 2017 to December 2022. The primary outcome was CDEs mortality, defined as death occurring during ICU admission, <24 hours of ICU discharge, or end of ward-based ICU interventions. Multilevel modeling identified event-, patient-, and hospital-level independent risk factors for CDE mortality.
Results
Among 69 participating hospitals in 18 countries, 4134 CDEs were reported in 3319 pediatric hematology-oncology patients with an event mortality of 26.8% (1108 events). Of all CDEs, 33.7% used ICU interventions on the ward and 87.5% were transferred to a higher level of care. In multilevel modeling, significant independent risk factors for event mortality present at the start of deterioration included patient (disease relapse) and event (e.g., reason for hospital admission, use of ICU intervention on wards, abnormal lactate, platelets, or C-reactive protein, reason for deterioration, and number of organs with dysfunction); hospital factors were not significant predictors of mortality.
Conclusions
Hospitalized pediatric hematology-oncology patients with CDE have high mortality with significant variability across centers. Mortality, however, is largely driven by modifiable event-level factors, demonstrating the need for targeted interventions to improve survival.
{"title":"Multilevel mortality risk factors among pediatric hematology-oncology patients with deterioration","authors":"Asya Agulnik MD, MPH, Maricela Robles-Murguia MS, MSM, Yichen Chen PhD, Hilmarie Muñiz-Talavera PhD, Linh Pham MS, Angela Carrillo PhD, Adolfo Cardenas-Aguirre MD, Juliana Costa MD, Alejandra Mendez Aceituno MD, Carlos Acuña Aguirre MD, Ana Berenice Aguilar Roman MD, Shillel Yahamy Alvarez Arellano RN, Leticia Aradi Andrade Sarmiento MD, Daniela Arce Cabrera MD, Erika Esther Blasco Arriaga MD, Claudia María De León Gutiérrez MD, Rosdali Diaz-Coronado MD, Maria do Céu Diniz Borborema MD, Mariana do Nascimento Othero Campacci MD, Leticia Drumond Alberto MD, Natalia Soledad Gonzalez MD, Martha Herrera Almanza MD, Valentine Jimenez Antolinez MD, Merle Denisse Laffont Ortiz MD, Laura Lemos De Mendonça E. Fontes MD, Norma Araceli López Facundo MD, Claudia Beatriz López Vázquez MD, Idalia Margarita Lozano Lozano MD, Jose Miguel Mijares Tobias MD, Lupe Nataly Mora Robles MD, Berenice Noriega Acuña MD, Fernanda Paula Endo Marques MD, Clara Krystal Pérez Fermín MD, Monica Lorena Quijano Lievano RN, Andreia Ribeiro Pereira Aguiar De Paula MD, Ligia Rios MD, Jocelyn Rivera MD, Marcela Alejandra Sahonero MD, Beatriz Salas Mendoza MD, María Sánchez-Martín MD, Jennifer Sepúlveda Ramírez RN, Verónica Soto Chávez MD, Daniela María Velásquez Cabrera MS, Erika Elena Villanueva Hoyos MD, Luz Yadira Zuñiga Quijano MD, Meenakshi Devidas PhD, Carlos Rodriguez-Galindo MD, for the Escala de Valoracion de Alerta Temprana Study Group","doi":"10.1002/cncr.35818","DOIUrl":"https://doi.org/10.1002/cncr.35818","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hospitalized pediatric hematology-oncology patients have frequent clinical deterioration events (CDEs) requiring intensive care unit (ICU) interventions and resulting in high mortality, particularly in resource-limited settings. This study identifies independent risk factors for CDE mortality in hospitals providing childhood cancer care in Latin America and Spain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Centers implemented a prospective CDE registry, defined as unplanned transfer to a higher level of care, use of ICU-level interventions on the ward, or nonpalliative ward death. The authors analyzed registry data from April 2017 to December 2022. The primary outcome was CDEs mortality, defined as death occurring during ICU admission, <24 hours of ICU discharge, or end of ward-based ICU interventions. Multilevel modeling identified event-, patient-, and hospital-level independent risk factors for CDE mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 69 participating hospitals in 18 countries, 4134 CDEs were reported in 3319 pediatric hematology-oncology patients with an event mortality of 26.8% (1108 events). Of all CDEs, 33.7% used ICU interventions on the ward and 87.5% were transferred to a higher level of care. In multilevel modeling, significant independent risk factors for event mortality present at the start of deterioration included patient (disease relapse) and event (e.g., reason for hospital admission, use of ICU intervention on wards, abnormal lactate, platelets, or C-reactive protein, reason for deterioration, and number of organs with dysfunction); hospital factors were not significant predictors of mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hospitalized pediatric hematology-oncology patients with CDE have high mortality with significant variability across centers. Mortality, however, is largely driven by modifiable event-level factors, demonstrating the need for targeted interventions to improve survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35818","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793511","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}
Thi Xuan Mai Tran PhD, Min Sung Chung MD, PhD, Chihwan Cha MD, Boyoung Park MD, PhD
{"title":"Reply to “Mental disorders and mortality in cancer survivors: Key unaddressed factors”","authors":"Thi Xuan Mai Tran PhD, Min Sung Chung MD, PhD, Chihwan Cha MD, Boyoung Park MD, PhD","doi":"10.1002/cncr.35839","DOIUrl":"https://doi.org/10.1002/cncr.35839","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793514","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":"Mental disorders and mortality in cancer survivors: Key unaddressed factors","authors":"Sheng Li MD, Zuyin Ge MD","doi":"10.1002/cncr.35837","DOIUrl":"https://doi.org/10.1002/cncr.35837","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787081","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":"Prospects for radioimmunotherapy panaceas in gynecologic oncology","authors":"Charles A. Kunos MD, PhD, Aman Chauhan MD","doi":"10.1002/cncr.35841","DOIUrl":"https://doi.org/10.1002/cncr.35841","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793512","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}
Hannah Goulart MD, Hagop Kantarjian MD, Gautam Borthakur MD, Naval Daver MD, Courtney D. DiNardo MD, Elias Jabbour MD, Naveen Pemmaraju MD, Yesid Alvarado MD, Himachandana Atluri MD, Musa Yilmaz MD, Fadi G. Haddad MD, Kayleigh R. Marx PharmD, Caitlin Rausch PharmD, Sanam Loghavi MD, Nitin Jain MD, Guillermo Garcia-Manero MD, Farhad Ravandi-Kashani MD, Tapan M. Kadia MD
Background
The treatment of relapsed and/or refractory (R/R) acute myeloid leukemia (AML) remains challenging because of poor responses to chemotherapy. Efforts to improve outcomes have included the use of high-dose cytarabine in combination with nucleoside analogs, such as cladribine. The authors evaluated combined cladribine, idarubicin, and cytarabine (CLIA) in a phase 2 trial of 66 patients with R/R AML.
Methods
Patients received induction with cladribine 5 mg/m2 intravenously (days 1–5), cytarabine 1000 mg/m2 intravenously (days 1–5), and idarubicin 10 mg/m2 intravenously (days 1–3; CLIA). Sorafenib 400 mg twice daily (days 1–14) was added for FLT3-mutated AML.
Results
The composite response rate (complete remission [CR] plus complete remission with incomplete hematologic recovery [CRi]) was 33%; salvage 1 (S1) patients (n = 35) had a CR/CRi rate of 49%. After a 61-month median follow-up, the median overall survival (OS) was 7.9 months, with a median relapse-free survival (RFS) of 9.1 months for those in CR/CRi. The median OS for S1 patients was 12 months, with a median RFS of 10.3 months. For those who received CLIA with sorafenib (n = 22), the CR/CRi rate was 41%, median OS was 8.8 months, and median RFS was 3.8 months. Landmark analysis demonstrated superior OS for patients who proceeded to transplantation compared with patients who did not (median OS, 78 vs. 8.8 months, respectively; p < .001). The 4-week and 8-week mortality rates were 6% and 17%, respectively. Most grade >3 adverse events were related to infection and elevated liver function tests.
Conclusions
CLIA is effective for patients with R/R AML and offers a safety profile similar to that of other intensive regimens (ClinicalTrials.gov identifier NCT02115295).
{"title":"Cladribine, idarubicin, and cytarabine (CLIA) for patients with relapsed and/or refractory acute myeloid leukemia: A single-center, single-arm, phase 2 trial","authors":"Hannah Goulart MD, Hagop Kantarjian MD, Gautam Borthakur MD, Naval Daver MD, Courtney D. DiNardo MD, Elias Jabbour MD, Naveen Pemmaraju MD, Yesid Alvarado MD, Himachandana Atluri MD, Musa Yilmaz MD, Fadi G. Haddad MD, Kayleigh R. Marx PharmD, Caitlin Rausch PharmD, Sanam Loghavi MD, Nitin Jain MD, Guillermo Garcia-Manero MD, Farhad Ravandi-Kashani MD, Tapan M. Kadia MD","doi":"10.1002/cncr.35840","DOIUrl":"https://doi.org/10.1002/cncr.35840","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The treatment of relapsed and/or refractory (R/R) acute myeloid leukemia (AML) remains challenging because of poor responses to chemotherapy. Efforts to improve outcomes have included the use of high-dose cytarabine in combination with nucleoside analogs, such as cladribine. The authors evaluated combined cladribine, idarubicin, and cytarabine (CLIA) in a phase 2 trial of 66 patients with R/R AML.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients received induction with cladribine 5 mg/m<sup>2</sup> intravenously (days 1–5), cytarabine 1000 mg/m<sup>2</sup> intravenously (days 1–5), and idarubicin 10 mg/m<sup>2</sup> intravenously (days 1–3; CLIA). Sorafenib 400 mg twice daily (days 1–14) was added for <i>FLT3</i>-mutated AML.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The composite response rate (complete remission [CR] plus complete remission with incomplete hematologic recovery [CRi]) was 33%; salvage 1 (S1) patients (<i>n</i> = 35) had a CR/CRi rate of 49%. After a 61-month median follow-up, the median overall survival (OS) was 7.9 months, with a median relapse-free survival (RFS) of 9.1 months for those in CR/CRi. The median OS for S1 patients was 12 months, with a median RFS of 10.3 months. For those who received CLIA with sorafenib (<i>n</i> = 22), the CR/CRi rate was 41%, median OS was 8.8 months, and median RFS was 3.8 months. Landmark analysis demonstrated superior OS for patients who proceeded to transplantation compared with patients who did not (median OS, 78 vs. 8.8 months, respectively; <i>p</i> < .001). The 4-week and 8-week mortality rates were 6% and 17%, respectively. Most grade >3 adverse events were related to infection and elevated liver function tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CLIA is effective for patients with R/R AML and offers a safety profile similar to that of other intensive regimens (ClinicalTrials.gov identifier NCT02115295).</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793513","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}
Nur Zeinomar PhD MPH, Marley Perlstein MS, Bo Qin PhD, Hari S. Iyer ScD, Jesse J. Plascak PhD, Coral O. Omene MD PhD, Christine B. Ambrosone PhD, Kitaw Demissie MD PhD, Chi-Chen Hong PhD, Elisa V. Bandera MD PhD
Background
Racial discrimination has been associated with decreased health-related quality of life (QOL) in the general population; however, its impact on QOL in cancer survivors is unclear. This study aims to examine how experiences of discrimination (EOD) impact QOL in breast cancer survivors and whether these associations vary by individual- and structural-level factors.
Methods
The association of EOD assessed at baseline (∼12 months post-diagnosis) was assessed in the Women’s Circle of Health Follow-up Study, a population-based longitudinal cohort study of Black breast cancer survivors in New Jersey. QOL was assessed at follow-up (∼24 months postdiagnosis) using the Functional Assessment of Cancer Therapy – Breast (FACT-B). Multivariable linear regression models adjusted for confounders assessed the association of EOD (none, low, high) with QOL. We also examined statistical interaction by individual-level factors (coping and spirituality) and structural-level factors (neighborhood socioeconomic status and residential segregation).
Results
Of 216 study participants, 74% reported experiencing discrimination. In fully adjusted models, women with high EOD had lower overall QOL (no discrimination, mean FACT-B: 114.8; 95% CI, 107.9–121.7; high discrimination, mean FACT-B: 101.1; 95% CI, 94.2–108.0). Although no evidence was observed of statistically significant interaction, women with high spirituality had better overall QOL, regardless of EOD (high spirituality/low discrimination: 128.2; 95% CI, 121.9–134.5; high spirituality/high discrimination: 115.4; 95% CI, 108.5–122.3; low spirituality/no discrimination: 103.5; 95% CI, 93.8–113.2).
Conclusions
Among Black breast cancer survivors, discrimination was associated with poorer QOL. Spirituality may mitigate the harmful effects, as women with high spirituality, even in the context of high discrimination, reported higher QOL.
{"title":"Associations between experiences of discrimination and quality of life in Black breast cancer survivors","authors":"Nur Zeinomar PhD MPH, Marley Perlstein MS, Bo Qin PhD, Hari S. Iyer ScD, Jesse J. Plascak PhD, Coral O. Omene MD PhD, Christine B. Ambrosone PhD, Kitaw Demissie MD PhD, Chi-Chen Hong PhD, Elisa V. Bandera MD PhD","doi":"10.1002/cncr.35836","DOIUrl":"https://doi.org/10.1002/cncr.35836","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Racial discrimination has been associated with decreased health-related quality of life (QOL) in the general population; however, its impact on QOL in cancer survivors is unclear. This study aims to examine how experiences of discrimination (EOD) impact QOL in breast cancer survivors and whether these associations vary by individual- and structural-level factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The association of EOD assessed at baseline (∼12 months post-diagnosis) was assessed in the Women’s Circle of Health Follow-up Study, a population-based longitudinal cohort study of Black breast cancer survivors in New Jersey. QOL was assessed at follow-up (∼24 months postdiagnosis) using the Functional Assessment of Cancer Therapy – Breast (FACT-B). Multivariable linear regression models adjusted for confounders assessed the association of EOD (none, low, high) with QOL. We also examined statistical interaction by individual-level factors (coping and spirituality) and structural-level factors (neighborhood socioeconomic status and residential segregation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 216 study participants, 74% reported experiencing discrimination. In fully adjusted models, women with high EOD had lower overall QOL (no discrimination, mean FACT-B: 114.8; 95% CI, 107.9–121.7; high discrimination, mean FACT-B: 101.1; 95% CI, 94.2–108.0). Although no evidence was observed of statistically significant interaction, women with high spirituality had better overall QOL, regardless of EOD (high spirituality/low discrimination: 128.2; 95% CI, 121.9–134.5; high spirituality/high discrimination: 115.4; 95% CI, 108.5–122.3; low spirituality/no discrimination: 103.5; 95% CI, 93.8–113.2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among Black breast cancer survivors, discrimination was associated with poorer QOL. Spirituality may mitigate the harmful effects, as women with high spirituality, even in the context of high discrimination, reported higher QOL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 8","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35836","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793515","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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