Megan H. Goh BS, Marcos R. Gonzalez MD, Hillary M. Heiling PhD, Emanuele Mazzola PhD, Joseph J. Connolly BS, Edwin Choy MD PhD, Gregory M. Cote MD PhD, Dimitrios Spentzos MD MMSc, Santiago A. Lozano-Calderon MD PhD
Introduction
The role of adjuvant chemotherapy in localized, resectable soft tissue sarcomas (STSs) remains controversial. Despite positive findings reported in previous meta-analyses, the majority of randomized controlled trials (RCTs) fail to show a meaningful benefit. We conducted an updated meta-analysis to reassess the role of adjuvant chemotherapy in treating localized, resectable STSs.
Methods
A comprehensive literature review was conducted to identify RCTs that compared local therapy (surgery with or without radiotherapy) to local therapy with adjuvant chemotherapy. Articles were independently reviewed, and risk of bias was assessed by two authors. The outcomes assessed were overall survival (OS) and disease-free survival (DFS). The meta-analysis was performed using a random effects model (to account for possible heterogeneity across studies) for survival endpoints with the inverse-variance method, in which each study is weighted with the inverse of the variance of its effect estimate.
Results
A total of 19 RCTs comprising 2128 patients were included. Our study found that adjuvant chemotherapy improved OS (hazard ratio [HR], 0.80; p = .002) and DFS (HR, 0.78; p = .002). Doxorubicin-based monotherapy significantly improved OS (HR, 0.80; p = .01) and DFS (HR, 0.74; p = .0003), whereas doxorubicin-ifosfamide combined therapy did not significantly improve OS (HR, 0.78; p = .078) or DFS (HR, 0.94; p = .770). Doxorubicin-based ifosfamide combined therapy had moderate heterogeneity across studies.
Conclusion
This study partially supports the benefit of adjuvant chemotherapy in the treatment of localized, resectable STSs. Nevertheless, because of the heterogeneity of STSs, the benefit and the risks of treatment with adjuvant chemotherapy need to be evaluated on an individual benefit–risk basis.
{"title":"Adjuvant chemotherapy in localized, resectable extremity and truncal soft tissue sarcoma and survival outcomes – A systematic review and meta-analysis of randomized controlled trials","authors":"Megan H. Goh BS, Marcos R. Gonzalez MD, Hillary M. Heiling PhD, Emanuele Mazzola PhD, Joseph J. Connolly BS, Edwin Choy MD PhD, Gregory M. Cote MD PhD, Dimitrios Spentzos MD MMSc, Santiago A. Lozano-Calderon MD PhD","doi":"10.1002/cncr.35792","DOIUrl":"https://doi.org/10.1002/cncr.35792","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The role of adjuvant chemotherapy in localized, resectable soft tissue sarcomas (STSs) remains controversial. Despite positive findings reported in previous meta-analyses, the majority of randomized controlled trials (RCTs) fail to show a meaningful benefit. We conducted an updated meta-analysis to reassess the role of adjuvant chemotherapy in treating localized, resectable STSs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review was conducted to identify RCTs that compared local therapy (surgery with or without radiotherapy) to local therapy with adjuvant chemotherapy. Articles were independently reviewed, and risk of bias was assessed by two authors. The outcomes assessed were overall survival (OS) and disease-free survival (DFS). The meta-analysis was performed using a random effects model (to account for possible heterogeneity across studies) for survival endpoints with the inverse-variance method, in which each study is weighted with the inverse of the variance of its effect estimate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 19 RCTs comprising 2128 patients were included. Our study found that adjuvant chemotherapy improved OS (hazard ratio [HR], 0.80; <i>p</i> = .002) and DFS (HR, 0.78; <i>p</i> = .002). Doxorubicin-based monotherapy significantly improved OS (HR, 0.80; <i>p</i> = .01) and DFS (HR, 0.74; <i>p</i> = .0003), whereas doxorubicin-ifosfamide combined therapy did not significantly improve OS (HR, 0.78; <i>p</i> = .078) or DFS (HR, 0.94; <i>p</i> = .770). Doxorubicin-based ifosfamide combined therapy had moderate heterogeneity across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study partially supports the benefit of adjuvant chemotherapy in the treatment of localized, resectable STSs. Nevertheless, because of the heterogeneity of STSs, the benefit and the risks of treatment with adjuvant chemotherapy need to be evaluated on an individual benefit–risk basis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527711","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}
<p>Despite being a preventable disease, cervical cancer continues to be a leading cause of death among women globally. In 2022, there were an estimated 660,000 new cases and 350,000 deaths globally.<span><sup>1</sup></span> Women living with social inequities, particularly those residing in low- and middle-income countries, face the highest burdens of disease.<span><sup>2, 3</sup></span> In May 2018, the World Health Organization (WHO) Director General announced a global call for action to eliminate cervical cancer, urging nations to target and maintain an incidence rate below 4 per 100,000 women. To achieve this goal, strategic targets were established under the “90-70-90” framework: vaccination (90% of girls fully vaccinated with the human papillomavirus [HPV] vaccine by the age of 15 years), screening (70% of women screened using a high-performance test by the age of 35 years, and again by the age of 45 years), and treatment (90% of women with precancer treated and 90% of women with invasive cancer managed).<span><sup>4</sup></span> These objectives rest on the estimate that if each country met the 90-70-90 targets by 2030, cervical cancer could be eliminated within the next century.<span><sup>5</sup></span></p><p>Stigma, a powerful social process involving negative labeling and stereotyping of certain human characteristics as socially undesirable, remains a significant but often overlooked barrier to cervical cancer prevention efforts.<span><sup>6</sup></span> Although the understanding that the HPV infection acquired through sexual contact was the cause of cervical cancer was a major scientific breakthrough, this discovery also linked stigma surrounding the female reproductive tract, sexual contact, and promiscuity to cancer prevention efforts.<span><sup>7-10</sup></span> Cancer stigma is being increasingly recognized as an issue to be addressed in global cancer control efforts.<span><sup>10, 11</sup></span> Addressing challenges specific to cervical cancer stigma can potentially provide an opportunity to enhance cancer control efforts.</p><p>The origins of the word stigma can be traced to the classical Greek, where the term was used to describe the branding of outcast groups as a permanent mark of their status. Stigma lowers an individual’s status in society by differentiating those who are viewed to be normal from those who are different. This process results in social inequality, marking the boundaries that define outsiders, and labeling “us” versus “them.”<span><sup>6, 12-14</sup></span> Cultural, social norms drive and facilitate the resultant power dynamics that include isolation, status loss, and discrimination.<span><sup>6, 15, 16</sup></span> As a harmful influence on behavior, stigma serves to reinforce inequities by impeding access to health care resources.<span><sup>17</sup></span></p><p>Cancer stigma can be conceptualized using an eco-social multilevel framework, categorizing the manifestations on individual, interpersonal, comm
{"title":"Cervical cancer stigma – A silent barrier to the elimination of cervical cancer","authors":"Hyo Sook Bae PhD, MD, MH, Sarah M. Temkin MD","doi":"10.1002/cncr.35776","DOIUrl":"https://doi.org/10.1002/cncr.35776","url":null,"abstract":"<p>Despite being a preventable disease, cervical cancer continues to be a leading cause of death among women globally. In 2022, there were an estimated 660,000 new cases and 350,000 deaths globally.<span><sup>1</sup></span> Women living with social inequities, particularly those residing in low- and middle-income countries, face the highest burdens of disease.<span><sup>2, 3</sup></span> In May 2018, the World Health Organization (WHO) Director General announced a global call for action to eliminate cervical cancer, urging nations to target and maintain an incidence rate below 4 per 100,000 women. To achieve this goal, strategic targets were established under the “90-70-90” framework: vaccination (90% of girls fully vaccinated with the human papillomavirus [HPV] vaccine by the age of 15 years), screening (70% of women screened using a high-performance test by the age of 35 years, and again by the age of 45 years), and treatment (90% of women with precancer treated and 90% of women with invasive cancer managed).<span><sup>4</sup></span> These objectives rest on the estimate that if each country met the 90-70-90 targets by 2030, cervical cancer could be eliminated within the next century.<span><sup>5</sup></span></p><p>Stigma, a powerful social process involving negative labeling and stereotyping of certain human characteristics as socially undesirable, remains a significant but often overlooked barrier to cervical cancer prevention efforts.<span><sup>6</sup></span> Although the understanding that the HPV infection acquired through sexual contact was the cause of cervical cancer was a major scientific breakthrough, this discovery also linked stigma surrounding the female reproductive tract, sexual contact, and promiscuity to cancer prevention efforts.<span><sup>7-10</sup></span> Cancer stigma is being increasingly recognized as an issue to be addressed in global cancer control efforts.<span><sup>10, 11</sup></span> Addressing challenges specific to cervical cancer stigma can potentially provide an opportunity to enhance cancer control efforts.</p><p>The origins of the word stigma can be traced to the classical Greek, where the term was used to describe the branding of outcast groups as a permanent mark of their status. Stigma lowers an individual’s status in society by differentiating those who are viewed to be normal from those who are different. This process results in social inequality, marking the boundaries that define outsiders, and labeling “us” versus “them.”<span><sup>6, 12-14</sup></span> Cultural, social norms drive and facilitate the resultant power dynamics that include isolation, status loss, and discrimination.<span><sup>6, 15, 16</sup></span> As a harmful influence on behavior, stigma serves to reinforce inequities by impeding access to health care resources.<span><sup>17</sup></span></p><p>Cancer stigma can be conceptualized using an eco-social multilevel framework, categorizing the manifestations on individual, interpersonal, comm","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35776","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513748","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}
Rima B. Patel MD, Tianxiang Sheng MSc, Marcio A. Diniz PhD, Joseph A. Sparano MD, Amy Tiersten MD
Background
Black race is associated with poorer prognosis in hormone receptor (HR)–positive, HER2-negative early breast cancer (EBC). The impact of race/ethnicity on the risk distribution and prognostic information provided by the 70-gene MammaPrint assay was evaluated.
Methods
Women with HR-positive EBC with tumors up to 5 cm in size and zero to three involved lymph nodes, who were diagnosed between 2009 and 2018, and who had an available MammaPrint result were identified in the National Cancer Data Base (NCDB). t-tests and χ2 tests were used to compare patient characteristics, whereas log-rank tests assessed differences in overall survival (OS) between racial/ethnic subgroups.
Results
Of the 6137 women included, 82.8% (n = 5084) were non-Hispanic White, 8.9% (n = 545) were non-Hispanic Black (NHB), 4.8% (n = 292) were Hispanic, and the remainder were other/unknown (n = 216). Of these women, 58.4% (n = 3587) were MammaPrint low risk and 41.6% (n = 2550) were MammaPrint high risk. NHB and Hispanic women were more likely to have a high-risk MammaPrint result (p < .001) than other racial/ethnic subgroups. Five-year OS was worse for the MammaPrint high-risk versus low-risk group (92.6% vs. 96.6%; p < .0001). There were no significant differences in OS on the basis of race/ethnicity in the MammaPrint low-risk (p = .34) or high-risk (p = .79) subgroups. However, Black race did not affect mortality in the overall population (hazard ratio, 1.15; 95% confidence interval, 0.84–1.58).
Conclusions
NHB and Hispanic women were more likely to have high-risk MammaPrint results in this NCDB cohort. Although there were no differences in survival by race/ethnicity in the MammaPrint low- and high-risk groups, these findings are limited by the lack of association between race/ethnicity and mortality in the overall population when adjusting for other clinicopathologic prognostic covariates.
{"title":"Impact of race/ethnicity on MammaPrint genomic assay risk and prognosis in early breast cancer: A National Cancer Data Base analysis","authors":"Rima B. Patel MD, Tianxiang Sheng MSc, Marcio A. Diniz PhD, Joseph A. Sparano MD, Amy Tiersten MD","doi":"10.1002/cncr.35771","DOIUrl":"https://doi.org/10.1002/cncr.35771","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Black race is associated with poorer prognosis in hormone receptor (HR)–positive, HER2-negative early breast cancer (EBC). The impact of race/ethnicity on the risk distribution and prognostic information provided by the 70-gene MammaPrint assay was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women with HR-positive EBC with tumors up to 5 cm in size and zero to three involved lymph nodes, who were diagnosed between 2009 and 2018, and who had an available MammaPrint result were identified in the National Cancer Data Base (NCDB). <i>t</i>-tests and χ<sup>2</sup> tests were used to compare patient characteristics, whereas log-rank tests assessed differences in overall survival (OS) between racial/ethnic subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 6137 women included, 82.8% (<i>n</i> = 5084) were non-Hispanic White, 8.9% (<i>n</i> = 545) were non-Hispanic Black (NHB), 4.8% (<i>n</i> = 292) were Hispanic, and the remainder were other/unknown (<i>n</i> = 216). Of these women, 58.4% (<i>n</i> = 3587) were MammaPrint low risk and 41.6% (<i>n</i> = 2550) were MammaPrint high risk. NHB and Hispanic women were more likely to have a high-risk MammaPrint result (<i>p</i> < .001) than other racial/ethnic subgroups. Five-year OS was worse for the MammaPrint high-risk versus low-risk group (92.6% vs. 96.6%; <i>p</i> < .0001). There were no significant differences in OS on the basis of race/ethnicity in the MammaPrint low-risk (<i>p</i> = .34) or high-risk (<i>p</i> = .79) subgroups. However, Black race did not affect mortality in the overall population (hazard ratio, 1.15; 95% confidence interval, 0.84–1.58).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NHB and Hispanic women were more likely to have high-risk MammaPrint results in this NCDB cohort. Although there were no differences in survival by race/ethnicity in the MammaPrint low- and high-risk groups, these findings are limited by the lack of association between race/ethnicity and mortality in the overall population when adjusting for other clinicopathologic prognostic covariates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513486","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}
Lauren E. McCullough PhD, Robert A. Winn MD, Lauren R. Teras PhD, Alpa V. Patel PhD
{"title":"The American Cancer Society launches the VOICES of Black Women, a longitudinal population cohort study","authors":"Lauren E. McCullough PhD, Robert A. Winn MD, Lauren R. Teras PhD, Alpa V. Patel PhD","doi":"10.1002/cncr.35775","DOIUrl":"https://doi.org/10.1002/cncr.35775","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143496933","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}
Laura E. Stamm PhD, Kristefer Stojanovski PhD, MPH, Milena E. Insalaco BA, Laura Wright MIS, Charles Kamen PhD, MPH, Chunkit Fung MD
Transgender and gender-diverse (TGD) populations experience health disparities across all areas of health care due to issues of bias, discrimination, and structural barriers to care. Existing literature on cancer screening in TGD populations demonstrates significant gaps in care; for example, transgender men receive Pap smears at lower rates than cisgender women. Because of known disparities in cancer screening, and gaps in our understanding in terms of diagnosis, treatment, and survivorship, the authors conducted a rapid review of the literature to examine cancer care continuum (screening, treatment, and survivorship) disparities among TGD persons. The results reported disparities across the cancer care continuum. Although there is currently limited research on cancer diagnosis, treatment, and survivorship, the available evidence indicates TGD patients are diagnosed with cancer at later stages than cisgender patients. TGD patients were also less likely than cisgender patients to receive treatment for some types of cancer. The results of this rapid review demonstrate the need for more research across the cancer care continuum for TGD patients with significant gaps in knowledge for cancer treatment and survivorship.
{"title":"Disparities in the cancer continuum experienced by transgender and gender-diverse patients: A rapid review","authors":"Laura E. Stamm PhD, Kristefer Stojanovski PhD, MPH, Milena E. Insalaco BA, Laura Wright MIS, Charles Kamen PhD, MPH, Chunkit Fung MD","doi":"10.1002/cncr.35788","DOIUrl":"https://doi.org/10.1002/cncr.35788","url":null,"abstract":"<p>Transgender and gender-diverse (TGD) populations experience health disparities across all areas of health care due to issues of bias, discrimination, and structural barriers to care. Existing literature on cancer screening in TGD populations demonstrates significant gaps in care; for example, transgender men receive Pap smears at lower rates than cisgender women. Because of known disparities in cancer screening, and gaps in our understanding in terms of diagnosis, treatment, and survivorship, the authors conducted a rapid review of the literature to examine cancer care continuum (screening, treatment, and survivorship) disparities among TGD persons. The results reported disparities across the cancer care continuum. Although there is currently limited research on cancer diagnosis, treatment, and survivorship, the available evidence indicates TGD patients are diagnosed with cancer at later stages than cisgender patients. TGD patients were also less likely than cisgender patients to receive treatment for some types of cancer. The results of this rapid review demonstrate the need for more research across the cancer care continuum for TGD patients with significant gaps in knowledge for cancer treatment and survivorship.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489792","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}
Justin C. Brown PhD, Chao Ma MS, Qian Shi PhD, Leonard B. Saltz MD, Anthony F. Shields MD, Jeffrey A. Meyerhardt MD, MPH
Background
Colon cancer patients have inferior overall survival than a matched general population (MGP). It is unknown if physical activity is associated with a reduction in this survival disparity.
Methods
Data were analyzed from two National Cancer Institute–sponsored postoperative treatment trials in stage III colon cancer, Cancer and Leukemia Group B (CALGB) 89803 and 80702, with 2876 patients who self-reported physical activity. Physical activity was converted to metabolic equivalents (MET-hours/week). The MGP was derived from the National Center for Health Statistics and matched on age, sex, and year.
Results
In CALGB 89803, among patients who were alive at 3 years, those with <3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −17.1% (95% confidence interval [CI], −22.4 to −11.8) and −3.5% (95% CI, −7.7 to 0.3) lower than MGP, respectively. In CALGB 80702, among patients who were alive at 3 years, those with <3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −10.8% (95% CI, −15.4 to −6.9) and −4.4% (95% CI, −7.6 to −1.6) lower than MGP, respectively. In pooled analyses, among patients who were alive and did not have tumor recurrence by year 3 (n = 1908), those with <3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −3.1% (95% CI, −6.2 to −0.3) lower and 2.9% (95% CI, 1.5–4.2) higher than MGP, respectively.
Conclusions
Physical activity is associated with an attenuation of the survival disparity between patients with stage III colon cancer participating in clinical trials and MGP. Colon cancer survivors who are physically active may achieve survival that approximates the MGP.
{"title":"The association of physical activity with survival in colon cancer versus a matched general population: Data from Cancer and Leukemia Group B 89803 and 80702 (Alliance)","authors":"Justin C. Brown PhD, Chao Ma MS, Qian Shi PhD, Leonard B. Saltz MD, Anthony F. Shields MD, Jeffrey A. Meyerhardt MD, MPH","doi":"10.1002/cncr.35727","DOIUrl":"https://doi.org/10.1002/cncr.35727","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colon cancer patients have inferior overall survival than a matched general population (MGP). It is unknown if physical activity is associated with a reduction in this survival disparity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were analyzed from two National Cancer Institute–sponsored postoperative treatment trials in stage III colon cancer, Cancer and Leukemia Group B (CALGB) 89803 and 80702, with 2876 patients who self-reported physical activity. Physical activity was converted to metabolic equivalents (MET-hours/week). The MGP was derived from the National Center for Health Statistics and matched on age, sex, and year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In CALGB 89803, among patients who were alive at 3 years, those with <3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −17.1% (95% confidence interval [CI], −22.4 to −11.8) and −3.5% (95% CI, −7.7 to 0.3) lower than MGP, respectively. In CALGB 80702, among patients who were alive at 3 years, those with <3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −10.8% (95% CI, −15.4 to −6.9) and −4.4% (95% CI, −7.6 to −1.6) lower than MGP, respectively. In pooled analyses, among patients who were alive and did not have tumor recurrence by year 3 (<i>n</i> = 1908), those with <3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −3.1% (95% CI, −6.2 to −0.3) lower and 2.9% (95% CI, 1.5–4.2) higher than MGP, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Physical activity is associated with an attenuation of the survival disparity between patients with stage III colon cancer participating in clinical trials and MGP. Colon cancer survivors who are physically active may achieve survival that approximates the MGP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475534","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}
Eitan Kugler MD, PhD, Hagop Kantarjian MD, Elias Jabbour MD, Niranjan Khaire MBBS, MD, Nicholas J. Short MD, Tapan M. Kadia MD, Fadi G. Haddad MD, Koji Sasaki MD, PhD, Rashmi Kanagal Shamanna MD, Rebecca Garris MS, Farhad Ravandi MD, Nitin Jain MD
Background
The BCR::ABL1 tyrosine kinase inhibitors (TKIs) have significantly improved the outcomes of patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL). However, the optimal duration of TKI therapy in patients who achieve a complete molecular response (CMR; undetectable BCR::ABL1 transcripts) and who do not undergo allogeneic stem cell transplantation (allo-SCT) remains undefined.
Methods
The authors conducted a retrospective analysis of patients with Ph-positive ALL in first complete remission who achieved a CMR and discontinued TKI therapy, most commonly due to treatment-related side effects.
Results
In total, 14 patients were identified. The regimen of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine was the primary backbone chemotherapy and was received by 12 patients (86%) combined with either imatinib (14%), dasatinib (43%), or ponatinib (29%) during induction. Two patients received blinatumomab and ponatinib. The median duration of TKI therapy was 60 months. The median CMR duration before TKI discontinuation was 46.1 months (range, 2.7–121.3 months). After a median follow-up of 42.5 months from TKI discontinuation, three patients (21%) experienced relapse (two molecular, one morphologic), whereas 11 patients (79%) maintained treatment-free remission. The median time to relapse was 6.4 months (range, 4–16 months), and two of three relapsed patients regained CMR after resuming TKI therapy. Importantly, none of the six patients with a CMR duration >48 months before TKI discontinuation relapsed.
Conclusions
The current findings suggest that TKI discontinuation may be safe for highly selected patients with Ph-positive ALL in first complete remission who maintain CMR for at least 48 months. Larger studies are needed to confirm these findings.
{"title":"Treatment-free remission in nontransplanted patients with Philadelphia chromosome-positive acute lymphoblastic leukemia","authors":"Eitan Kugler MD, PhD, Hagop Kantarjian MD, Elias Jabbour MD, Niranjan Khaire MBBS, MD, Nicholas J. Short MD, Tapan M. Kadia MD, Fadi G. Haddad MD, Koji Sasaki MD, PhD, Rashmi Kanagal Shamanna MD, Rebecca Garris MS, Farhad Ravandi MD, Nitin Jain MD","doi":"10.1002/cncr.35773","DOIUrl":"https://doi.org/10.1002/cncr.35773","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The BCR::ABL1 tyrosine kinase inhibitors (TKIs) have significantly improved the outcomes of patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL). However, the optimal duration of TKI therapy in patients who achieve a complete molecular response (CMR; undetectable <i>BCR::ABL1</i> transcripts) and who do not undergo allogeneic stem cell transplantation (allo-SCT) remains undefined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors conducted a retrospective analysis of patients with Ph-positive ALL in first complete remission who achieved a CMR and discontinued TKI therapy, most commonly due to treatment-related side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 14 patients were identified. The regimen of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine was the primary backbone chemotherapy and was received by 12 patients (86%) combined with either imatinib (14%), dasatinib (43%), or ponatinib (29%) during induction. Two patients received blinatumomab and ponatinib. The median duration of TKI therapy was 60 months. The median CMR duration before TKI discontinuation was 46.1 months (range, 2.7–121.3 months). After a median follow-up of 42.5 months from TKI discontinuation, three patients (21%) experienced relapse (two molecular, one morphologic), whereas 11 patients (79%) maintained treatment-free remission. The median time to relapse was 6.4 months (range, 4–16 months), and two of three relapsed patients regained CMR after resuming TKI therapy. Importantly, none of the six patients with a CMR duration >48 months before TKI discontinuation relapsed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current findings suggest that TKI discontinuation may be safe for highly selected patients with Ph-positive ALL in first complete remission who maintain CMR for at least 48 months. Larger studies are needed to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455888","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}
Amy J. Wisdom MD, PhD, Chandrajit P. Raut MD, MS, Candace L. Haddox MD, Jason L. Hornick MD, PhD, Jyothi P. Jagannathan MD, Corrie A. Painter PhD, Elizabeth H. Baldini MD, MPH
Soft tissue sarcomas are a rare group of mesenchymal malignancies, with greater than 100 histologic subtypes. Advancements in understanding these subtypes has enabled histology-tailored management. This primer describes the workup and management of generalized soft tissue sarcomas of the extremity, trunk, and retroperitoneum while also highlighting the unique attributes of many subtypes. The subtypes chosen for review include those that are most common as well as those demonstrating unique behaviors or targets for management. The focus is on initial management of localized disease; however, for situations in which novel systemic agents have been discovered, the treatment of metastatic disease is discussed. This report is a reference to be used in addition to other comprehensive reviews, such as guidelines from the National Comprehensive Cancer Network, the European Society for Medical Oncology, and the American Society for Radiation Oncology. It is not a substitute for referral to an expert sarcoma center for critical pathology review and management by an experienced team. Importantly, patients who are treated at expert sarcoma centers have better outcomes than those who are not.
{"title":"Clinician's primer for soft tissue sarcomas: Nuances of histologic subtypes","authors":"Amy J. Wisdom MD, PhD, Chandrajit P. Raut MD, MS, Candace L. Haddox MD, Jason L. Hornick MD, PhD, Jyothi P. Jagannathan MD, Corrie A. Painter PhD, Elizabeth H. Baldini MD, MPH","doi":"10.1002/cncr.35772","DOIUrl":"https://doi.org/10.1002/cncr.35772","url":null,"abstract":"<p>Soft tissue sarcomas are a rare group of mesenchymal malignancies, with greater than 100 histologic subtypes. Advancements in understanding these subtypes has enabled histology-tailored management. This primer describes the workup and management of generalized soft tissue sarcomas of the extremity, trunk, and retroperitoneum while also highlighting the unique attributes of many subtypes. The subtypes chosen for review include those that are most common as well as those demonstrating unique behaviors or targets for management. The focus is on initial management of localized disease; however, for situations in which novel systemic agents have been discovered, the treatment of metastatic disease is discussed. This report is a reference to be used in addition to other comprehensive reviews, such as guidelines from the National Comprehensive Cancer Network, the European Society for Medical Oncology, and the American Society for Radiation Oncology. It is not a substitute for referral to an expert sarcoma center for critical pathology review and management by an experienced team. Importantly, patients who are treated at expert sarcoma centers have better outcomes than those who are not.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455886","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":"Intravenous opioids and the risk of addiction in individuals with cancer","authors":"Kendall Downer MD, Julie Childers MD, MS","doi":"10.1002/cncr.35765","DOIUrl":"https://doi.org/10.1002/cncr.35765","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455889","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}
Kimia Sorouri MD, MPH, Karen Glass MD, Kathryn J. Ruddy MD, MPH, Ellen Warner MD, MSc, Ann H. Partridge MD, MPH
{"title":"Anti-Müllerian hormone for assessing ovarian toxicity of cancer treatment in young women: It’s complicated","authors":"Kimia Sorouri MD, MPH, Karen Glass MD, Kathryn J. Ruddy MD, MPH, Ellen Warner MD, MSc, Ann H. Partridge MD, MPH","doi":"10.1002/cncr.35774","DOIUrl":"https://doi.org/10.1002/cncr.35774","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455950","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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