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Real-world efficacy and adverse events of frontline nilotinib in pediatric chronic myeloid leukemia in chronic phase: A prospective multicenter study from SCCCG[PLUS]-CML 2023 一线尼洛替尼治疗儿童慢性髓性白血病慢性期的实际疗效和不良事件:SCCCG[PLUS]-CML 2023的一项前瞻性多中心研究
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-17 DOI: 10.1002/cncr.70225
Zhong Fan MD, Qi-Wen Chen MMed, Xiu-Ya Huang MMed, Qiang Fu MMed, Hui-Rong Mai MD, Xing-Jiang Long MD, Qiao-Ru Li MMed, Li-Li Liu MMed, Ri-Yang Liu MB, Fei He MMed, Bi-Yun Guo MMed, Min-Hui Zeng MMed, Wu-Qing Wan MD, Wei-Na Zhang MD, Hai-Xia Guo MD, Dun-Hua Zhou MD, Ya-Wei Zou MD, Wen-Jie Xiong MMed, Xiao-Bo Zhou MB, Hui-Qin Chen MD, Li-Min Lin MB, Hao-Yan Ren MB, Xin Tian MD, Hong-Ying Wei MD, He-Kui Lan MMed, Jiao Jin MB, Cong Liang MD, Xue-Qun Luo MMed, Li-Bin Huang MD, Li-Hua Yang MD, Xiao-Li Zhang MMed

Background

Chronic myeloid leukemia (CML) is rare in children and often shows more aggressive features than in adults. Real-world data on the efficacy and safety of frontline nilotinib in pediatric CML in chronic phase (CML-CP) remain limited.

Methods

This prospective multicenter real-world study evaluated the efficacy, safety, and pharmacokinetics of frontline nilotinib in newly diagnosed pediatric CML-CP across 26 hospitals in China between January 2023 and April 2025. Patients received nilotinib 230 mg/m2 twice daily. Primary end points were complete cytogenetic response (CCyR) at six cycles and major molecular response (MMR) at 12 cycles. Secondary end points included time to MMR, event-free survival (EFS), and safety.

Results

Among 59 enrolled patients (median age, 10.6 years), 71.8% (28/39) achieved MMR at 12 cycles and all achieved CCyR at six cycles. Median time to MMR was 6.2 (3.3, 12.2) months, and 2-year EFS was 93.3% (84.4%–100%). Nilotinib trough concentrations (Ctrough) correlated negatively with BCR::ABL1 transcript levels at cycles 6 and 12. Patients with Ctrough >950 ng/mL were three to five times more likely to reach MMR, whereas those with Ctrough ≥1500 ng/mL had a 6.5-fold higher risk of hyperbilirubinemia.

Conclusions

Frontline nilotinib thus shows strong efficacy and manageable safety in pediatric CML-CP. Higher drug exposure predicts deeper molecular responses but increases toxicity, supporting the potential role of therapeutic drug monitoring.

背景:慢性髓性白血病(CML)在儿童中很少见,通常表现出比成人更具侵袭性的特征。一线尼洛替尼治疗小儿慢性粒细胞白血病(CML- cp)的有效性和安全性的实际数据仍然有限。方法:这项前瞻性多中心现实世界研究评估了2023年1月至2025年4月期间中国26家医院一线尼罗替尼治疗新诊断的小儿CML-CP的疗效、安全性和药代动力学。患者接受尼罗替尼230mg /m2治疗,每日两次。主要终点为6个周期的完全细胞遗传学反应(CCyR)和12个周期的主要分子反应(MMR)。次要终点包括到达MMR的时间、无事件生存期(EFS)和安全性。结果:在59例入组患者(中位年龄10.6岁)中,71.8%(28/39)在12个周期内实现MMR,所有患者在6个周期内实现CCyR。到MMR的中位时间为6.2(3.3,12.2)个月,2年EFS为93.3%(84.4%-100%)。在循环6和12时,尼洛替尼谷浓度与BCR::ABL1转录物水平负相关。低于bbb50 950 ng/mL的患者达到MMR的可能性高出3 - 5倍,而低于1500ng /mL的患者发生高胆红素血症的风险高出6.5倍。结论:尼罗替尼一线治疗小儿CML-CP具有较强的疗效和可管理的安全性。较高的药物暴露预示着更深层次的分子反应,但增加毒性,支持治疗药物监测的潜在作用。
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引用次数: 0
Examining trends in lung cancer screening over 10 years: Eligibility, participation, cancer detection, and quality implications 10年来肺癌筛查的趋势:资格、参与、癌症检测和质量影响。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-17 DOI: 10.1002/cncr.70211
Debra P. Ritzwoller PhD, Nikki M. Carroll MS, Kris F. Wain PhD, Brian P. Hixon MSPH, Roger Y. Kim MD, MSCE, Mahesh Maiyani MBA, Julie S. Steiner MA

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.

背景:十多年前,国家肺部筛查试验推荐使用低剂量计算机断层扫描(CT)进行肺癌筛查(LCS)。然而,很少有研究探讨方案变化和外部因素如何影响患者预后。方法:本回顾性研究纳入2014年5月1日至2024年12月31日来自科罗拉多州凯撒医疗机构的符合lcs条件的个体。计算LCS订单、完成情况、基线筛查后推荐随访的依从性和肺癌的发生率和比例。多变量对数二项回归模型估计与基线LCS完成相关的因素。结果:在23,602名符合LCS条件的个体中,13,576人(58%)接受了基线LCS命令,8621人(37%的符合条件,64%的订单)完成了筛查。LCS的完成更可能发生在亚洲/夏威夷原住民/太平洋岛民或黑人,以及以前吸烟、有20- 29包年吸烟史、1次专科护理就诊、有肺癌家族史或有更大合并症负担的个体中。推荐随访的总体依从性为62%;肺CT筛查报告和数据系统(Lung- rads)评分为4B或4X的患者依从性最高,为88%。LCS共产生424例肺癌(占筛查的5%),其中68%处于I、II或IIIA期。肺- rads评分阳性的患者10年累积发病率为20%。LCS结果的长期变化与LCS导航过程、技术和2019年冠状病毒大流行的变化相关。结论:对十年来社区环境中可靠的LCS数据的评估强调了建立国家质量指标的必要性,以激励卫生系统进行持续的项目监测、评估和调整,以优化筛查效益。
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引用次数: 0
Generate shows nab-paclitaxel plus gemcitabine still an effective regimen for metastatic pancreatic cancer Generate显示nab-紫杉醇加吉西他滨仍然是治疗转移性胰腺癌的有效方案:在这项研究中,mFOLFIRINOX和S-IROX在75岁或75岁以下的转移性胰腺癌患者中没有表现出优于GnP的结果。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-17 DOI: 10.1002/cncr.70144
Leah Lawrence
<p>First-line treatment with modified FOLFIRINOX (mFOLFIRINOX) or S-1, irinotecan, and oxaliplatin (S-IROX) was not superior to nab-paclitaxel plus gemcitabine (GnP) for patients with metastatic or recurrent pancreatic cancer, according to results from the Japanese GENERATE study.<span><sup>1</sup></span></p><p>The phase 2 and 3 GENERATE trial enrolled 527 patients with metastatic or recurrent pancreatic cancer from 45 centers in Japan. Patients were randomly assigned to receive mFOLFIRINOX, S-IROX, or GnP. The primary endpoint was overall survival (OS).</p><p>“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,” says study researcher Makoto Ueno, MD, of the Department of Gastroenterology at the Kanagawa Cancer Center in Yokohama, Japan.</p><p>The median OS was numerically longer for patients assigned to GnP. The median OS was 14.0 months with mFOLFIRINOX, 13.6 months with S-IROX, and 17.1 months with GnP. The median progression-free survival was 6.7 months with GnP, 5.8 months with mFOLFIRINOX, and 6.7 months with S-IROX.</p><p>Additionally, gastrointestinal toxicity was more frequent in patients assigned to mFOLFIRINOX or S-IROX. Compared with patients assigned to mFOLFIRINOX or S-IROX, patients assigned to GnP experienced lower rates of anorexia (22.8% and 27.6% vs. 5.2%) and diarrhea (8.8% and 23.0% vs. 1.1%).</p><p>“Caution is required in interpreting these results, as the trial design did not demonstrate the superiority of GnP,” Dr Ueno says. “However, it is a fact that GnP demonstrated favorable outcomes, and in Japan, this trial has led to GnP being administered more frequently.”</p><p>In the United States, the current standard first-line treatment for metastatic pancreatic cancer is typically FOLFIRINOX or GnP according to Dana B. Cardin, MD, MSCI, an associate professor of medicine at Vanderbilt–Ingram Cancer Center in Nashville, Tennessee.</p><p>“These two combination regimens came out around the same time, and both were tested in studies that compared them to gemcitabine alone as a control,” Dr Cardin says, noting that the S-IROX regimen is not used in the United States. “Since then, there have been a lot of questions about the use of these regimens and if we should compare them.”</p><p>“NALIRIFOX, which is similar to FOLFIRINOX, is also a good regimen to consider, with the positive data from NAPOLI-3 showing that it does have some survival benefit over GnP in all-comers with metastatic pancreatic cancer,” says Dr Somasundaram.<span><sup>2</sup></span> The median OS in NAPOLI-3 was 11 months with NALIRIFOX and 9 months with GnP.</p><p>With these prior studies in mind, the results of the GENERATE trial went against what expectations might have been, Dr Somasundaram says.</p><p>Dr Cardin points to the higher-than-expected OS rates in GENERATE. For example, the median OS with GnP was 17 months in GENERATE, but in NAPOLI-3, it w
根据日本GENERATE研究的结果,对于转移性或复发性胰腺癌患者,一线治疗改良FOLFIRINOX (mFOLFIRINOX)或S-1、伊立替康和奥沙利铂(S-IROX)并不优于nab-紫杉醇加吉西他滨(GnP)。2期和3期GENERATE试验招募了来自日本45个中心的527例转移性或复发性胰腺癌患者。患者被随机分配接受mFOLFIRINOX、S-IROX或GnP治疗。主要终点是总生存期(OS)。“在这项研究中,mFOLFIRINOX和S-IROX在75岁或75岁以下的转移性胰腺癌患者中没有表现出优于GnP的结果,”日本横滨神奈川癌症中心消化内科的研究人员Makoto Ueno医学博士说。分配到GnP的患者的中位OS在数值上更长。mFOLFIRINOX组的中位生存期为14.0个月,S-IROX组为13.6个月,GnP组为17.1个月。中位无进展生存期为:GnP组6.7个月,mFOLFIRINOX组5.8个月,S-IROX组6.7个月。此外,胃肠道毒性在分配给mFOLFIRINOX或S-IROX的患者中更常见。与分配给mFOLFIRINOX或S-IROX的患者相比,分配给GnP的患者厌食症(22.8%和27.6% vs. 5.2%)和腹泻(8.8%和23.0% vs. 1.1%)的发生率较低。“在解释这些结果时需要谨慎,因为试验设计并没有证明GnP的优越性,”上野博士说。“然而,事实是GnP显示出了良好的效果,而且在日本,这项试验导致GnP被更频繁地使用。”在美国,根据田纳西州纳什维尔范德比尔特-英格拉姆癌症中心医学副教授Dana B. Cardin医学博士的说法,目前转移性胰腺癌的标准一线治疗通常是FOLFIRINOX或GnP。卡丹博士说:“这两种联合方案几乎同时出现,并且都在研究中进行了测试,将它们与单独使用吉西他滨作为对照进行了比较。”他指出,S-IROX方案在美国没有使用。“从那以后,关于这些疗法的使用,以及我们是否应该比较它们,出现了很多问题。”somasundaramam博士说:“与FOLFIRINOX类似的NALIRIFOX也是一个值得考虑的好方案,NAPOLI-3的阳性数据表明,对于转移性胰腺癌的所有患者,NALIRIFOX的生存期确实比GnP有一定的改善。”Somasundaram博士说,考虑到这些先前的研究,GENERATE试验的结果可能与预期相反。卡丁博士指出了GENERATE中高于预期的OS率。例如,在GENERATE中,GnP的中位OS为17个月,但在NAPOLI-3中为9个月。“这是一个相当显著的差异,”卡丹博士说。总的来说,Somasundaram博士说:“结果表明,对于所有患者来说,GnP仍然是一个非常合理的一线治疗方案。”那么肿瘤学家应该如何为病人决定合适的治疗方案呢?“一般来说,我们确实认为mFOLFIRINOX可能比GnP更难忍受,所以我们会选择在更健壮或更健康的患者中使用它,”Cardin博士说。“然而,患者可能会读到像[GENERATE]这样的结果,并强调接受mFOLFIRINOX是一种较差的治疗方案。”最终,研究结果表明,肿瘤学家永远无法确切知道每种肿瘤对这些治疗方案的反应。来自不同国家的不同患者的不同肿瘤可能有不同的反应。“我们可以知道的是,如果我们选择GnP或mFOLFIRINOX,我们可能不会剥夺患者获得有效治疗的机会,”卡丹博士说,“而且我们可能不会造成过度的伤害。”
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引用次数: 0
Diffuse midline gliomas get first FDA-approved drug 弥漫性中线胶质瘤获fda批准
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-17 DOI: 10.1002/cncr.70146
Leah Lawrence
<p>Patients with diffuse midline gliomas now have a US Food and Drug Administration (FDA)-approved treatment option. In August 2025, the FDA granted accelerated approval to the protease activator dordaviprone for patients aged 1 year or older with diffuse midline glioma with an <i>H3 K27M</i> mutation that has progressed after prior therapy.<span><sup>1</sup></span> This is the first FDA-approved systemic therapy for this rare brain tumor.</p><p>“Diffuse midline gliomas are devastating tumors that have no effective treatment options,” says Ryan Merrell, MD, an associate professor of neuro-oncology at Vanderbilt University Medical Center in Nashville, Tennessee. “Radiation is the only treatment, but it usually only delays growth of the tumor for months.”</p><p>Diffuse midline gliomas are unique, Dr Merrell says, because they occur in both children and adults.</p><p>“The childhood prototype tumor is diffuse infiltrating pontine glioma, or DIPG,” Dr Merrell says. “This tumor is associated with a survival of 15 months; the adult tumors have similar survival.”</p><p>The FDA’s approval of dordaviprone was based on results from 50 patients (four pediatric patients and 46 adults) with recurrent <i>H3 K27M</i>-mutant diffuse midline glioma from five open-label, nonrandomized clinical trials.<span><sup>2</sup></span> Isabel Arrillaga-Romany, MD, PhD, director of neuro-oncology clinical trials at Massachusetts General Hospital in Boston, was the lead author of an article on the integrated analysis.</p><p>Adult patients received 625 mg of dordaviprone as oral capsules (125 mg each). For pediatric patients, the adult dose was allometrically scaled by body weight. The studies had different administration frequencies and treatment cycle lengths. The primary endpoint was the overall response rate by Response Assessment in Neuro-Oncology criteria for high-grade glioma.</p><p>One in five of the included patients responded to dordaviprone. One patient had a complete response, and nine patients had partial responses to therapy. The disease control rate was 40%.</p><p>Responses appeared durable, with a median duration of response of 11.2 months. The progression-free survival rate at 6 months was 35.1%. The overall survival (OS) rate was 57.3% at 12 months and 34.7% at 24 months. The median OS was 13.7 months.<span><sup>2</sup></span></p><p>“There are no drug therapies for diffuse midline glioma, and dordaviprone is the first drug to show favorable results,” Dr Merrell says. “Even though the results are modest, it is a breakthrough. The fact that results were seen in multiple studies is significant, even though the studies were non-randomized.”</p><p>The study researchers noted that although the median time to response was 8.3 months, clinical benefits could occur before patients achieved an objective response. For example, corticosteroid responses occurred at a median of 3.7 months, and Karnofsky/Lansky performance status responses occurred at a median of 3.5 months.
弥漫性中线胶质瘤患者现在有一种美国食品和药物管理局(FDA)批准的治疗方案。2025年8月,FDA加速批准蛋白酶激活剂dordaviprone用于1岁或以上的弥漫性中线胶质瘤H3 K27M突变患者,该患者在先前治疗后进展这是fda批准的首个针对这种罕见脑肿瘤的全身疗法。“弥漫性中线胶质瘤是一种毁灭性的肿瘤,没有有效的治疗选择,”田纳西州纳什维尔范德比尔特大学医学中心神经肿瘤学副教授Ryan Merrell医学博士说。“放疗是唯一的治疗方法,但它通常只能延缓肿瘤生长几个月。”弥漫性中线神经胶质瘤是独特的,Merrell博士说,因为它在儿童和成人中都有发生。Merrell博士说:“儿童肿瘤的原型是弥漫性浸润性脑桥神经胶质瘤(DIPG)。”“这种肿瘤与15个月的生存有关;成人肿瘤也有类似的存活率。”FDA批准dordaviprone是基于50名复发性H3 k27m突变弥漫性中线胶质瘤患者(4名儿童患者和46名成人患者)的结果,这些患者来自5项开放标签、非随机临床试验Isabel arillaga - romany,医学博士,波士顿马萨诸塞州总医院神经肿瘤学临床试验主任,是一篇综合分析文章的主要作者。成年患者接受625毫克dordaviprone口服胶囊(每份125毫克)。对于儿科患者,成人剂量按体重异速缩放。这些研究有不同的给药频率和治疗周期长度。主要终点是神经肿瘤学标准中对高级别胶质瘤的反应评估的总缓解率。在纳入的患者中,有五分之一的人对抑郁倾向有反应。1名患者对治疗有完全反应,9名患者有部分反应。疾病控制率为40%。反应似乎是持久的,中位反应持续时间为11.2个月。6个月无进展生存率为35.1%。12个月的总生存率为57.3%,24个月的总生存率为34.7%。中位OS为13.7个月。“目前还没有针对弥漫性中线神经胶质瘤的药物治疗方法,dordaviprone是第一种显示出良好效果的药物,”Merrell博士说。“尽管结果不大,但这是一个突破。尽管这些研究是非随机的,但在多项研究中都看到了这一结果,这一事实很重要。”研究人员指出,虽然中位反应时间为8.3个月,但在患者达到客观反应之前,临床获益可能会发生。例如,皮质类固醇反应的中位时间为3.7个月,Karnofsky/Lansky表现状态反应的中位时间为3.5个月。除了一名患者外,所有患者都经历了至少一种治疗引起的不良事件(TEAE),其中最常见的是疲劳(46%),恶心(36%)和头痛(32%)。没有4级治疗相关teae或治疗相关死亡。dordaviprone的继续批准将取决于其在3期ACTION试验中的安全性和有效性验证。
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引用次数: 0
Correction to “Determinants of geographic variation in the incidence of adult nonmalignant meningioma in the United States, 2010–2019” 修正了“2010-2019年美国成人非恶性脑膜瘤发病率地理差异的决定因素”。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-16 DOI: 10.1002/cncr.70206

Withrow DR, Boyle J, Linet MS, Pittman Ballard CA, Cioffi G, Kruchko C, Miller DL, Petkov VI, Price M, Waite K, Ostrom QT. Determinants of geographic variation in the incidence of adult nonmalignant meningioma in the United States, 2010–2019. Cancer. 2025 Sep 15;131(18):e70042. doi: 10.1002/cncr.70042

In Table 2, several negative signs for regression coefficients and credible intervals were omitted in the typesetting process. The table should have read:

We apologize for this error.

Withrow DR, Boyle J, Linet MS, Pittman Ballard CA, Cioffi G, Kruchko C, Miller DL, Petkov VI, Price M, Waite K, Ostrom QT. 2010-2019年美国成人非恶性脑膜瘤发病率地理差异的决定因素。2025年9月15日;131(18):e70042。doi: 10.1002 / cncr。70042在表2中,在排版过程中省略了回归系数和可信区间的几个负号。表格应该是:我们为这个错误道歉。
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引用次数: 0
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” 对“在程序性细胞死亡1型阻断抵抗性黑色素瘤患者中瘤内单药或联合派姆单抗治疗:来自1b期研究的最终分析”的修正。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-16 DOI: 10.1002/cncr.70188

Milhem MM, Zakharia Y, Davar D, et al. 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. Cancer. 2025;131(15):e70022. doi:10.1002/cncr.70022

In Figure 2B, x-axis (solid line) has been shifted to intercept the y-axis at 0 and the dotted lines have been shifted to align with RECIST 1.1 responses. These were mislocated before. The corrected figure is shown below:

Minor grammatical and spacing errors have also been corrected in the published version of the article.

We apologize for these errors.

Milhem MM, Zakharia Y, Davar D,等。瘤内维托利莫德单药治疗或联合派姆单抗治疗程序性细胞死亡1型阻断抵抗性黑色素瘤:来自1b期研究的最终分析癌症。2025;131 (15):e70022。doi: 10.1002 / cncr。70022在图2B中,x轴(实线)已移位以与y轴在0处相交,虚线已移位以与RECIST 1.1响应对齐。这些之前都放错了位置。更正后的图如下所示:在文章的发表版本中,轻微的语法和间距错误也得到了纠正。我们为这些错误道歉。
{"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":"<p>Milhem MM, Zakharia Y, Davar D, et al. 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. <i>Cancer.</i> 2025;131(15):e70022. doi:10.1002/cncr.70022</p><p>In Figure 2B, x-axis (solid line) has been shifted to intercept the y-axis at 0 and the dotted lines have been shifted to align with RECIST 1.1 responses. These were mislocated before. The corrected figure is shown below:</p><p></p><p>Minor grammatical and spacing errors have also been corrected in the published version of the article.</p><p>We apologize for these errors.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70188","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What we can learn from a national tumor pathology registry 我们可以从国家肿瘤病理登记中学到什么。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-15 DOI: 10.1002/cncr.70221
Jordan Infield MD, Daniel J. George MD
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引用次数: 0
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 局部晚期非小细胞肺癌的磁共振引导分疗程低分级放疗联合化疗和巩固免疫治疗:单组2期研究
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-15 DOI: 10.1002/cncr.70223
PengXin Zhang MD, DaQuan Wang MD, ShaoHan Yin MD, YuMei Dong MD, ShiHong Wei MD, FangJie Liu MD, HaoTing Zhang PhD, Biao Xia MD, Yu SiTu MS, MengRu Wang MS, Yi Hu MD, QianWen Liu MD, LiKun Chen MD, Bo Qiu MD, Hui Liu MD

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.

背景:评价磁共振(MR)引导下分程低分级放疗(hyport)联合化疗合并巩固免疫治疗(CIT)治疗局部晚期非小细胞肺癌(LA-NSCLC)的疗效和安全性。方法:在这项2期试验中,不可切除的IIIA-C期NSCLC患者(18-75岁,东部合作肿瘤组0-1)接受mr引导的分疗程低放疗(30 Gy分6次,4周后重复,共60 Gy),同时每周多西他赛(25 mg/m2)和顺铂(25 mg/m2)。主要终点为无进展生存期(PFS);次要终点包括总生存期(OS)、客观缓解率(ORR)和毒性。结果:2020年7月至2023年1月,104例患者入组,中位随访时间为34.4个月。101例(97.1%)患者完成了分疗程次同步放化疗(CCRT), 74例(71.2%)患者接受了CIT,中位PFS为27.5个月(95%可信区间[CI], 18.9-36.0个月),1年和2年PFS率分别为76.9% (95% CI, 69.2%-85.5%)和54.7% (95% CI, 45.9%-65.1%)。1年和2年的OS分别为87.5% (95% CI, 81.4%-94.1%)和65.3% (95% CI, 56.8%-75.2%)。最常见的3-4级不良事件是淋巴细胞减少(35.6%)。低ccrt期间8例(7.7%)患者出现2-3级肺炎,CIT期间7例(6.7%)患者出现3级食管炎(2.8%),1例5级咯血(0.9%)。结论:mr引导的分疗程低ccrt以每分次5gy至总剂量60gy的剂量进行,然后进行CIT,在LA-NSCLC患者中获得了令人鼓舞的生存结果和可控的毒性。
{"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 MD,&nbsp;DaQuan Wang MD,&nbsp;ShaoHan Yin MD,&nbsp;YuMei Dong MD,&nbsp;ShiHong Wei MD,&nbsp;FangJie Liu MD,&nbsp;HaoTing Zhang PhD,&nbsp;Biao Xia MD,&nbsp;Yu SiTu MS,&nbsp;MengRu Wang MS,&nbsp;Yi Hu MD,&nbsp;QianWen Liu MD,&nbsp;LiKun Chen MD,&nbsp;Bo Qiu MD,&nbsp;Hui Liu MD","doi":"10.1002/cncr.70223","DOIUrl":"10.1002/cncr.70223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"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}
引用次数: 0
The effect of common medications on the efficacy of immune checkpoint inhibitors 常用药物对免疫检查点抑制剂疗效的影响。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-14 DOI: 10.1002/cncr.70222
Daria Brinzevich MD, Virginia Falvello MD, Sadiq S. Rehmani MD, Garth W. Strohbehn MD, MPhil, Nithya Ramnath MBBS, Michael P. Dykstra MD, Luke M. Higgins MD, David Elliott MD, Matthew J. Schipper PhD, Michael D. Green MD, PhD, Alex K. Bryant MD, MAS

Background

Medications such as proton pump inhibitors (PPIs), antihistamines, and nonsteroidal anti-inflammatory drugs have been linked to immune checkpoint inhibitor (ICI) efficacy in patients with non–small cell lung cancer (NSCLC), but these associations may reflect unmeasured confounding rather than true pharmacologic effects. This study evaluated whether commonly prescribed medications influence ICI outcomes, using a national patient sample and a negative control cohort.

Methods

The authors identified Veterans Health Administration (VHA) patients with stage IV NSCLC treated with first- or second-line ICI therapy (n = 3739) or chemotherapy (n = 6585) from 2005 to 2023. Baseline use of 20 common medication classes and an immunomodulatory drug score were assessed. Propensity-weighted Cox regression evaluated associations between each medication class and overall survival (OS) or time-to-next treatment (TTNT) in the ICI group. For any medication with a nominally significant association (p < .05), the same analysis was repeated in the chemotherapy group to test for nonspecific effects.

Results

After propensity weighting, 14 of 20 medication classes showed no association with OS or TTNT in the ICI cohort. Loop diuretics, anticoagulants, opioids, penicillin antibiotics, and fluoroquinolone antibiotics were associated with worse outcomes, but similar effects were seen in the chemotherapy group. A higher immunomodulatory drug score was also associated with inferior outcomes among ICI patients, but this association was likewise present in the chemotherapy cohort.

Conclusion

In this study, commonly prescribed medications did not appear to alter ICI efficacy in stage IV NSCLC. Prior associations reported in the literature may be attributable to unmeasured confounding rather than true drug–immunotherapy interactions.

背景:质子泵抑制剂(PPIs)、抗组胺药和非甾体抗炎药等药物与非小细胞肺癌(NSCLC)患者的免疫检查点抑制剂(ICI)疗效有关,但这些关联可能反映了未测量的混杂因素,而不是真正的药理作用。本研究使用全国患者样本和阴性对照队列,评估常用处方药是否影响ICI结局。方法:作者确定了2005年至2023年在退伍军人健康管理局(VHA)接受一线或二线ICI治疗(n = 3739)或化疗(n = 6585)的IV期NSCLC患者。评估20种常用药物的基线使用情况和免疫调节药物评分。倾向加权Cox回归评估了ICI组中每种药物类别与总生存期(OS)或下一次治疗时间(TTNT)之间的关系。结果:倾向加权后,在ICI队列中,20种药物类别中有14种与OS或TTNT没有关联。循环利尿剂、抗凝血剂、阿片类药物、青霉素抗生素和氟喹诺酮类抗生素与较差的结果相关,但化疗组也出现了类似的效果。在ICI患者中,较高的免疫调节药物评分也与较差的预后相关,但这种关联同样存在于化疗队列中。结论:在这项研究中,常用处方药物似乎没有改变IV期NSCLC的ICI疗效。文献中报道的先前关联可能归因于未测量的混杂,而不是真正的药物-免疫治疗相互作用。
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引用次数: 0
Cancer incidence, stage at diagnosis, and trends across the Navajo Nation, 2014–2018 2014-2018年纳瓦霍族的癌症发病率、诊断阶段和趋势
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2025-12-12 DOI: 10.1002/cncr.70202
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.

背景:美国印第安人/阿拉斯加原住民(AI/AN)经历了癌症的差异,但对每个部落国家特有的癌症模式知之甚少。这项研究描述了全球最大的主权部落国家之一纳瓦霍民族的癌症发病率(2014-2018年)、趋势(1998-2018年)和诊断阶段。方法:来自亚利桑那州、新墨西哥州和犹他州六个县的病例,覆盖了纳瓦霍族的大部分地区,通过基于人群的癌症登记处确定,并与印第安健康服务患者登记处联系起来。对同一县的纳瓦霍人和非西班牙裔白人的癌症发病率和诊断阶段进行了比较。使用Joinpoint回归分析了1998年至2018年的趋势。结果:纳瓦霍人的胆囊癌(RR = 6.25)、胃癌(RR = 3.19)、肾癌(RR = 1.89)、骨髓瘤(RR = 1.80)、肝癌(RR = 1.79)的发病率明显高于非西班牙裔白人,肺癌(RR = 0.16)、女性乳腺癌(RR = 0.49)、白血病(RR = 0.49)、前列腺癌(RR = 0.62)、胰腺癌(RR = 0.79)和非霍奇金淋巴瘤(RR = 0.79)的发病率较低。乳腺癌、宫颈癌和结直肠癌的诊断阶段没有差异,但三分之二的宫颈癌和结直肠癌患者被诊断为晚期/未知阶段。尽管从1998年到2018年,纳瓦霍人的全部位癌症发病率没有显著变化,但从2010年到2018年,纳瓦霍人的癌症发病率显著下降(-2.1%)。结论:纳瓦霍人的肾癌、胃癌、肝癌、骨髓瘤和胆囊癌的发病率较高,乳腺癌、前列腺癌、肺癌、非霍奇金淋巴瘤和白血病的发病率较低。量身定制和有针对性的预防措施可能有助于减少纳瓦霍族的癌症差异。
{"title":"Cancer incidence, stage at diagnosis, and trends across the Navajo Nation, 2014–2018","authors":"Del Yazzie MPH,&nbsp;Dornell Pete PhD, MPH,&nbsp;Curtis Briscoe BS,&nbsp;Melissa A. Jim MPH,&nbsp;Angela Meisner MPH,&nbsp;Charles Wiggins PhD,&nbsp;Dana Doyle MPH,&nbsp;Georgia Yee BSW, ODS-C,&nbsp;Carol Goldtooth MPH,&nbsp;Priscilla R. Sanderson PhD,&nbsp;Chesleigh Nicole Keene PhD,&nbsp;Melinda Smith PhD,&nbsp;Hannah Sehn MMSc,&nbsp;Shawnell Damon MPH, MSc,&nbsp;Chelsea L. Kettering DrPH, MPH,&nbsp;Marc Emerson PhD,&nbsp;Caleigh Curley MPH,&nbsp;Jennifer Bea PhD,&nbsp;Sheldwin Yazzie PhD, MPH, MS,&nbsp;Natalie Joe PhD, MPH,&nbsp;Jennifer Doherty PhD,&nbsp;Hendrik Dirk de Heer PhD, MPH,&nbsp;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> &lt; .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}
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Cancer
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