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.
{"title":"Examining trends in lung cancer screening over 10 years: Eligibility, participation, cancer detection, and quality implications","authors":"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","doi":"10.1002/cncr.70211","DOIUrl":"10.1002/cncr.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>More than a decade ago, the National Lung Screening Trial led to the recommendation of low-dose computed tomography (CT) for lung cancer screening (LCS). However, few studies have explored how program changes and external factors affect patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included LCS-eligible individuals from Kaiser Permanente Colorado between May 1, 2014, and December 31, 2024. Rates and proportions of LCS orders, completions, adherence to recommended follow-up after baseline screening, and lung cancer yield were calculated. Multivariable log-binomial regression models estimated the factors associated with baseline LCS completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 23,602 LCS-eligible individuals, 13,576 (58%) received a baseline LCS order and 8621 (37% of eligible; 64% of orders) completed screening. LCS completion was more likely among Asian/Native Hawaiian/Pacific Islander or Black races, and individuals who formerly smoked, had a 20– to 29–pack-year smoking history, >1 specialty care visit, a family history of lung cancer, or a greater comorbidity burden. Overall adherence to recommended follow-up was 62%; patients with a Lung CT Screening Reporting and Data System (Lung-RADS) score of 4B or 4X had the highest adherence at 88%. LCS yielded 424 cases of lung cancer (5% of screened), with 68% at stage I, II, or IIIA. Cumulative incidence among those with a positive Lung-RADS score was 20% at 10 years. Secular changes in LCS outcomes correlated with changes to LCS navigation processes, technology, and the coronavirus disease 2019 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This evaluation of a decade of robust LCS data within a community setting highlights the need for established national quality metrics that incentivize health systems to conduct ongoing program monitoring, evaluation, and adaptation to optimize screening benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<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。”
{"title":"Generate shows nab-paclitaxel plus gemcitabine still an effective regimen for metastatic pancreatic cancer","authors":"Leah Lawrence","doi":"10.1002/cncr.70144","DOIUrl":"10.1002/cncr.70144","url":null,"abstract":"<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","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<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.
{"title":"Diffuse midline gliomas get first FDA-approved drug","authors":"Leah Lawrence","doi":"10.1002/cncr.70146","DOIUrl":"10.1002/cncr.70146","url":null,"abstract":"<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.","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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。
{"title":"Correction to “Determinants of geographic variation in the incidence of adult nonmalignant meningioma in the United States, 2010–2019”","authors":"","doi":"10.1002/cncr.70206","DOIUrl":"10.1002/cncr.70206","url":null,"abstract":"<p>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. <i>Cancer</i>. 2025 Sep 15;131(18):e70042. doi: 10.1002/cncr.70042</p><p>In Table 2, several negative signs for regression coefficients and credible intervals were omitted in the typesetting process. The table should have read:\u0000 </p><p>We apologize for this error.</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.70206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761631","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}
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}
{"title":"What we can learn from a national tumor pathology registry","authors":"Jordan Infield MD, Daniel J. George MD","doi":"10.1002/cncr.70221","DOIUrl":"10.1002/cncr.70221","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PengXin Zhang 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.
{"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, 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","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}
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.
{"title":"The effect of common medications on the efficacy of immune checkpoint inhibitors","authors":"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","doi":"10.1002/cncr.70222","DOIUrl":"10.1002/cncr.70222","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors identified Veterans Health Administration (VHA) patients with stage IV NSCLC treated with first- or second-line ICI therapy (<i>n</i> = 3739) or chemotherapy (<i>n</i> = 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 (<i>p</i> < .05), the same analysis was repeated in the chemotherapy group to test for nonspecific effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12701955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Del Yazzie MPH, Dornell Pete PhD, MPH, Curtis Briscoe BS, Melissa A. Jim MPH, Angela Meisner MPH, Charles Wiggins PhD, Dana Doyle MPH, Georgia Yee BSW, ODS-C, Carol Goldtooth MPH, Priscilla R. Sanderson PhD, Chesleigh Nicole Keene PhD, Melinda Smith PhD, Hannah Sehn MMSc, Shawnell Damon MPH, MSc, Chelsea L. Kettering DrPH, MPH, Marc Emerson PhD, Caleigh Curley MPH, Jennifer Bea PhD, Sheldwin Yazzie PhD, MPH, MS, Natalie Joe PhD, MPH, Jennifer Doherty PhD, Hendrik Dirk de Heer PhD, MPH, Navajo Cancer Workgroup
Background
American Indian/Alaska Native (AI/AN) people in the United States experience cancer disparities, but little is known about cancer patterns specific to each Tribal Nation. This study describes cancer incidence (2014–2018), trends (1998–2018), and stage of diagnosis across the Navajo Nation, one of the largest sovereign tribal nations worldwide.
Methods
Cases from six Arizona, New Mexico, and Utah counties covering most of the Navajo Nation were identified by population-based cancer registries and linked with Indian Health Services patient registrations. Cancer incidence and stage at diagnosis were compared between Navajo and non-Hispanic White persons in the same counties. Trends from 1998 through 2018 were analyzed using Joinpoint regression.
Results
Navajo people had significantly higher incidence than non-Hispanic White people of gallbladder (incidence rate ratio [RR] = 6.25), stomach (RR = 3.19), kidney (RR = 1.89), myeloma (RR = 1.80), and liver cancers (RR = 1.79) and a lower incidence of cancers of the lung (RR = 0.16), female breast (RR = 0.49), leukemia (RR = 0.49), prostate (RR = 0.62), pancreas (RR = 0.79), and non-Hodgkin lymphoma (RR = 0.79). Diagnostic stage was not different for breast, cervical, and colorectal cancers, but two thirds of patients with cervical and colorectal cancer were diagnosed in later/unknown stages. Although all-site cancer rates did not change significantly from 1998 through 2018 among Navajo people, a significant decrease was found from 2010 through 2018 (–2.1% annual percentage change, p < .01).
Conclusions
Navajo people experience a higher incidence of kidney, stomach, liver, myeloma, and gallbladder cancers and a lower incidence of cancers of the breast, prostate, lung, non-Hodgkin lymphoma, and leukemia. Tailored and targeted prevention efforts may help reduce cancer disparities in the Navajo Nation.
{"title":"Cancer incidence, stage at diagnosis, and trends across the Navajo Nation, 2014–2018","authors":"Del Yazzie MPH, Dornell Pete PhD, MPH, Curtis Briscoe BS, Melissa A. Jim MPH, Angela Meisner MPH, Charles Wiggins PhD, Dana Doyle MPH, Georgia Yee BSW, ODS-C, Carol Goldtooth MPH, Priscilla R. Sanderson PhD, Chesleigh Nicole Keene PhD, Melinda Smith PhD, Hannah Sehn MMSc, Shawnell Damon MPH, MSc, Chelsea L. Kettering DrPH, MPH, Marc Emerson PhD, Caleigh Curley MPH, Jennifer Bea PhD, Sheldwin Yazzie PhD, MPH, MS, Natalie Joe PhD, MPH, Jennifer Doherty PhD, Hendrik Dirk de Heer PhD, MPH, Navajo Cancer Workgroup","doi":"10.1002/cncr.70202","DOIUrl":"10.1002/cncr.70202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>American Indian/Alaska Native (AI/AN) people in the United States experience cancer disparities, but little is known about cancer patterns specific to each Tribal Nation. This study describes cancer incidence (2014–2018), trends (1998–2018), and stage of diagnosis across the Navajo Nation, one of the largest sovereign tribal nations worldwide.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cases from six Arizona, New Mexico, and Utah counties covering most of the Navajo Nation were identified by population-based cancer registries and linked with Indian Health Services patient registrations. Cancer incidence and stage at diagnosis were compared between Navajo and non-Hispanic White persons in the same counties. Trends from 1998 through 2018 were analyzed using Joinpoint regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Navajo people had significantly higher incidence than non-Hispanic White people of gallbladder (incidence rate ratio [RR] = 6.25), stomach (RR = 3.19), kidney (RR = 1.89), myeloma (RR = 1.80), and liver cancers (RR = 1.79) and a lower incidence of cancers of the lung (RR = 0.16), female breast (RR = 0.49), leukemia (RR = 0.49), prostate (RR = 0.62), pancreas (RR = 0.79), and non-Hodgkin lymphoma (RR = 0.79). Diagnostic stage was not different for breast, cervical, and colorectal cancers, but two thirds of patients with cervical and colorectal cancer were diagnosed in later/unknown stages. Although all-site cancer rates did not change significantly from 1998 through 2018 among Navajo people, a significant decrease was found from 2010 through 2018 (–2.1% annual percentage change, <i>p</i> < .01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Navajo people experience a higher incidence of kidney, stomach, liver, myeloma, and gallbladder cancers and a lower incidence of cancers of the breast, prostate, lung, non-Hodgkin lymphoma, and leukemia. Tailored and targeted prevention efforts may help reduce cancer disparities in the Navajo Nation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashely Aller MD, Shiyun Zhu MPH, Liisa Lyon MS, Laurel A. Habel PhD, Aida Shirazi PhD, MS, RPh, Scott D. Casey MD, MS, Raymond Liu MD
Background
Trial Assigning Individualized Options for Treatment (TAILORx) redefined the Oncotype DX (ODX) risk stratification scores. This study describes the clinical application of ODX in the post-TAILORx era in relation to chemotherapy.
Methods
A cohort of 8017 early-stage breast cancer patients considered guideline-eligible for ODX testing were identified between 2015 and 2021. Clinical factors associated with ODX testing and adjuvant chemotherapy were found through descriptive analysis and multivariable logistic regression modeling. Models were adjusted for age, race/ethnicity, tumor size and grade, progesterone (PR) status, and Charlson Comorbidity Index. The Cochran-Armitage test was used to evaluate the probability of ODX testing during the study period.
Results
ODX testing increased over time (from 45% in 2015 to 80% in 2021; p < .0001). The likelihood of chemotherapy use increased by an estimated 5% annually (adjusted odds ratio [aOR], 1.05; 95% CI, 1.01–1.09). Testing was more likely in younger than older patients (e.g., aOR 1.90 among 18 to <40 vs. 0.30 among 70 to <80 as compared to 60 to <70). The association of ODX testing with chemotherapy was modified by age. Although younger patients were more likely to receive chemotherapy, testing was associated with less chemotherapy use in younger patients and more chemotherapy in older patients (p value for interaction <.001).
Conclusions
In the post-TAILORx era, younger age was associated with substantially more ODX testing. The association of testing with chemotherapy varied substantially by age. The impact of age on ODX testing and use of chemotherapy is substantial and warrants further study.
{"title":"Is age just a number? Oncotype DX testing and chemotherapy use in the post-TAILORx era","authors":"Ashely Aller MD, Shiyun Zhu MPH, Liisa Lyon MS, Laurel A. Habel PhD, Aida Shirazi PhD, MS, RPh, Scott D. Casey MD, MS, Raymond Liu MD","doi":"10.1002/cncr.70218","DOIUrl":"10.1002/cncr.70218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trial Assigning Individualized Options for Treatment (TAILORx) redefined the Oncotype DX (ODX) risk stratification scores. This study describes the clinical application of ODX in the post-TAILORx era in relation to chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of 8017 early-stage breast cancer patients considered guideline-eligible for ODX testing were identified between 2015 and 2021. Clinical factors associated with ODX testing and adjuvant chemotherapy were found through descriptive analysis and multivariable logistic regression modeling. Models were adjusted for age, race/ethnicity, tumor size and grade, progesterone (PR) status, and Charlson Comorbidity Index. The Cochran-Armitage test was used to evaluate the probability of ODX testing during the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ODX testing increased over time (from 45% in 2015 to 80% in 2021; <i>p</i> < .0001). The likelihood of chemotherapy use increased by an estimated 5% annually (adjusted odds ratio [aOR], 1.05; 95% CI, 1.01–1.09). Testing was more likely in younger than older patients (e.g., aOR 1.90 among 18 to <40 vs. 0.30 among 70 to <80 as compared to 60 to <70). The association of ODX testing with chemotherapy was modified by age. Although younger patients were more likely to receive chemotherapy, testing was associated with less chemotherapy use in younger patients and more chemotherapy in older patients (<i>p</i> value for interaction <.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the post-TAILORx era, younger age was associated with substantially more ODX testing. The association of testing with chemotherapy varied substantially by age. The impact of age on ODX testing and use of chemotherapy is substantial and warrants further study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 24","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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