Cancer Medicine最新文献_第7页

Bridging Mammography and Lung Cancer Screening: Eligibility, Uptake and Potential Impact 桥接乳房x光检查和肺癌筛查：资格，吸收和潜在影响。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-20 DOI: 10.1002/cam4.71528

Ali Ajrouch, Yara Khalifeh, Amir F. Beirat, Dana Alhaffar, Ahmad Karkash, Razan Aljaras, Adel Hajj Ali, Nicholas Pettit, Deanna R. Willis, Victoria L. Champion, Lisa Carter-Bawa, Amrou Awaysheh, Kolawole S. Okuyemi

Introduction

Lung cancer (LC) is the top cancer killer in women, yet lung cancer screening (LCS) uptake is substantially lower than mammography. Leveraging the reach of mammography programs may improve LCS uptake, but the potential gain in LC detection from this approach is unknown. This study aimed to determine the proportion of women with LC eligible for both screenings, potential LC detection via integrated screening, and factors influencing each screening uptake among those dually eligible.

Methods

This retrospective cross-sectional study included 345 women newly diagnosed with LC presenting at a Midwestern Comprehensive Cancer Center (2019–2020). Pre-diagnosis LCS-eligibility was determined per 2013 and 2021 USPSTF criteria, LCS-uptake per 2013 criteria, and mammography-eligibility per 2016 criteria. We assessed sociodemographic variables associated with screening uptake among dually eligible women.

Results

Among 345 women (mean [SD] age 64.8 [11.35] years), 73.3% were eligible for mammography, while 43.5% were eligible for LCS (2013), increasing to 49.3% (2021). Mammography uptake (41.5%) substantially exceeded LCS uptake (13.9%). Overall, 45.2% were eligible for both screenings, representing 92.4% (157/170) of all LCS-eligible (2021) cases. Notably, 20.3% were LCS-eligible (2021) and received mammography, that is, 41.2% (70/170) of LCS-eligible cases. Among dually eligible women, rural residency correlated with lower LCS uptake (odds ratio [OR], 0.42; 95% CI = 0.19–0.94; p = 0.031), whereas receiving mammography correlated with higher LCS uptake (OR, 2.67; 95% CI = 1.21–5.87; p = 0.013).

Conclusion

A substantial proportion of women with LC who are LCS-eligible underwent mammography, representing a missed opportunity for earlier LC detection. Integrating these screenings could enhance LC detection, especially for rural residents who experience disparities in LCS but not mammography uptake.

简介：肺癌（LC）是女性的头号癌症杀手，但肺癌筛查（LCS）的吸收率大大低于乳房x光检查。利用乳房x光检查项目的覆盖范围可能会提高LCS的吸收，但这种方法在LC检测方面的潜在收益尚不清楚。本研究旨在确定具有LC的女性同时接受两种筛查的比例，通过综合筛查发现潜在的LC，以及在具有双重筛查资格的女性中影响每种筛查的因素。方法：这项回顾性横断面研究包括345名在中西部综合癌症中心（2019-2020）新诊断为LC的女性。根据2013年和2021年USPSTF标准确定诊断前lcs资格，根据2013年标准确定lcs摄取，根据2016年标准确定乳房x光检查资格。我们评估了与双重符合条件的妇女接受筛查相关的社会人口学变量。结果：345名女性（平均[SD]年龄64.8[11.35]岁）中，73.3%符合乳房x光检查，43.5%符合LCS检查（2013年），增加到49.3%（2021年）。乳房x光检查的使用率（41.5%）大大超过LCS的使用率（13.9%）。总体而言，45.2%的患者符合两项筛查的条件，占所有符合lcs条件（2021）病例的92.4%（157/170）。值得注意的是，20.3%的患者符合lcs条件（2021年）并接受了乳房x光检查，即41.2%（70/170）的患者符合lcs条件。在符合双重条件的妇女中，农村居住与较低的LCS摄取相关（比值比[OR]， 0.42; 95% CI = 0.19-0.94; p = 0.031），而接受乳房x光检查与较高的LCS摄取相关（比值比[OR]， 2.67; 95% CI = 1.21-5.87; p = 0.013）。结论：相当大比例的符合lcs条件的LC患者接受了乳房x光检查，这意味着错过了早期LC检测的机会。整合这些筛查可以提高LC的检测，特别是对于那些经历LCS差异但未接受乳房x光检查的农村居民。

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引用次数: 0

Life's Essential 8 and the Risk of Overall and Specific-Site Cancer Types: A Large-Scale Prospective Cohort Study 生命的必需品与整体和特定部位癌症类型的风险：一项大规模前瞻性队列研究。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-19 DOI: 10.1002/cam4.71518

Li Deng, Xiao-Meng Hao, Zhe Shu, Tong Liu, Qing-Song Zhang, Hong-Tao Wang, Han-Ping Shi

Background

The Life's Essential 8 (LE8) framework, designed to prevent cardiovascular disease, is also linked to cancer risk, but the direct association between LE8 adherence and cancer incidence remains underexplored. Each LE8 component may affect cancer risk differently across organ systems, warranting further investigation into these relationships.

Methods

This prospective cohort study utilized data from the Kailuan Study, comprising 94,239 participants from Tangshan, China. LE8 scores were calculated based on lifestyle and physiological measures, including diet, physical activity, and biomarkers such as blood glucose and cholesterol levels. Incident cancer cases were monitored through biennial health assessments and verified through multiple data sources until December 31, 2022. Cox proportional hazards models and competing risk models adjusted for confounders like age, sex, and lifestyle factors were used to analyze the impact of LE8 as well as each LE8 component on various cancer types.

Results

During a median follow-up of 14.99 years, 5124 incident cancer cases were identified. Compared to poor LE8 adherence, intermediate and ideal adherence groups showed a 13% (HR = 0.87; 95% CI: 0.80–0.96) and 26% (HR = 0.74; 95% CI: 0.65–0.85) decrease in overall cancer incidence, respectively. Improvements in LE8 scores were linked to reduced risks of specific cancers: lung (9%), breast (12%), kidney (18%), colorectal (7%), and endometrial (31%), with hazard ratios of 0.91, 0.88, 0.82, 0.93, and 0.69, respectively. Ideal blood pressure and non-smoking were protective against cancer, while ideal body weight increased the risk. Non-smoking reduced lung and kidney cancer risk, while ideal BMI had mixed effects.

Conclusions

Our findings support the LE8 framework as an effective tool for cancer prevention, with higher adherence linked to lower cancer incidence across various types. The results advocate for the integration of LE8 into broader public health and clinical strategies.

Trial Registration

Kailuan study, ChiCTR–TNRC–11001489. Registered August 24, 2011-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050

背景：旨在预防心血管疾病的生命必需8 （LE8）框架也与癌症风险有关，但坚持LE8与癌症发病率之间的直接关系仍未得到充分探讨。每一种LE8成分对不同器官系统的癌症风险的影响可能不同，因此有必要进一步研究这些关系。方法：这项前瞻性队列研究利用了开滦研究的数据，包括来自中国唐山的94239名参与者。LE8评分是根据生活方式和生理指标计算的，包括饮食、身体活动以及血糖和胆固醇水平等生物标志物。通过两年一次的健康评估监测癌症病例，并通过多个数据源进行核实，直至2022年12月31日。采用Cox比例风险模型和竞争风险模型对年龄、性别和生活方式等混杂因素进行调整，分析LE8及其各组成部分对各种癌症类型的影响。结果：在14.99年的中位随访期间，确定了5124例癌症病例。与较差的LE8依从性相比，中等和理想依从性组的总体癌症发病率分别下降13% （HR = 0.87; 95% CI: 0.80-0.96）和26% （HR = 0.74; 95% CI: 0.65-0.85）。LE8评分的提高与特定癌症风险的降低有关：肺癌（9%）、乳腺癌（12%）、肾癌（18%）、结直肠癌（7%）和子宫内膜癌（31%），风险比分别为0.91、0.88、0.82、0.93和0.69。理想的血压和不吸烟可以预防癌症，而理想的体重则会增加患癌症的风险。不吸烟可以降低肺癌和肾癌的风险，而理想的BMI则有不同的效果。结论：我们的研究结果支持LE8框架作为癌症预防的有效工具，在各种类型中，较高的依从性与较低的癌症发病率相关。研究结果提倡将LE8纳入更广泛的公共卫生和临床战略。试验注册：开滦研究，ChiCTR-TNRC-11001489。2011年8月24日注册-追溯注册，http://www.chictr.org.cn/showprojen.aspx?proj=8050。

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引用次数: 0

A Real-World Analysis of Outcomes in CIC-Rearranged Sarcomas: A Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC) Study cic -重排肉瘤结果的真实世界分析：一项加拿大肉瘤研究和临床合作（cansarc）研究。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-19 DOI: 10.1002/cam4.71495

Talya Wittmann Dayagi, Hagit Peretz Soroka, Alannah Smrke, Rebecca J. Deyell, Xiaolan Feng, Sapna Oberoi, Shantanu Banerji, Jonathan Noujaim, Nicolas Prud'homme, Ramy Saleh, Omar Farooq Khan, Jonathan Willard Bush, Bilal Marwa, Geoffrey Watson, Caroline Holloway, Lingxin Zhang, Abha Anshu Gupta, Jack Brzezinski

Introduction

CIC-rearranged sarcomas (CRS) are rare tumors predominantly affecting young adults. Despite distinct biology, CRS are often treated like Ewing sarcomas with multi-agent chemotherapy, surgery, and radiotherapy, although the benefits of each remain unclear. We report the impact of treatment on response and survival.

Methods

This retrospective multicenter study included patients diagnosed with CRS between 2002 and 2023. Demographic, treatment, and outcome data were collected. Event-free (EFS) and overall survival (OS) were estimated using Kaplan–Meier analysis; risk factors were assessed via log-rank tests and Cox regression. Treatment response was assessed using RECIST.

Results

Among 27 patients (median age 21.5 years; range 8–83), 14 (52%) had localized and 12 (44%) metastatic disease (1 unknown). In the localized group, 6 (43%) received chemotherapy (Response: 2 complete, CR; 1 partial, PR; 1 mixed, MR; 1 stable, SD; 1 progressive disease, PD); 5 (36%) died—3 (21%) had received chemotherapy. Among metastatic patients, 10 (83%) received chemotherapy (1 CR, 5 PR, 2 MR, 1 PD); 9 died (one without chemotherapy). Local control was achieved in 12/14 (86%) localized and 7/12 (56%) metastatic patients. Only surgical resection was associated with improved OS (HR 0.13; p < 0.01) and EFS (HR 0.26; p < 0.01), particularly with R0 resection (EFS HR 0.23; p = 0.02). At median follow-up of 18 months, 2-year EFS was 56% vs. 8% (p = 0.02) and OS was 67% vs. 23% (p = 0.02) for localized vs. metastatic disease.

Conclusion

Complete resection is critical in CRS. Chemotherapy benefit remains uncertain, underscoring the need for improved local control and novel, biology-driven therapies.

cic重排肉瘤（CRS）是一种罕见的肿瘤，主要发生在年轻人身上。尽管有不同的生物学特性，CRS通常像尤文氏肉瘤一样使用多药化疗、手术和放疗来治疗，尽管每种方法的益处尚不清楚。我们报道治疗对反应和生存的影响。方法：这项回顾性多中心研究纳入了2002年至2023年间诊断为CRS的患者。收集了人口统计学、治疗和结局数据。使用Kaplan-Meier分析估计无事件（EFS）和总生存期（OS）；通过log-rank检验和Cox回归评估危险因素。使用RECIST评估治疗效果。结果：在27例患者（中位年龄21.5岁，范围8-83岁）中，14例（52%）有局部转移性疾病，12例（44%）有转移性疾病（1例未知）。局部组6例（43%）接受化疗(反应：完全缓解2例，CR；部分缓解1例，PR；混合缓解1例，MR；稳定缓解1例，SD；5例（36%）死亡，3例（21%）接受化疗。在转移性患者中，10例（83%）接受化疗（1例CR， 5例PR， 2例MR， 1例PD）；9例死亡（1例未接受化疗）。局部控制在12/14（86%）的局部和7/12（56%）的转移性患者中实现。仅手术切除与改善OS相关（HR 0.13; p）。结论：完全切除对CRS至关重要。化疗的效果仍然不确定，强调需要改进局部控制和新颖的生物学驱动疗法。

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引用次数: 0

Association of Neighborhood Social Vulnerability With Metastatic Cancer at Diagnosis 邻里社会脆弱性与诊断转移性癌症的关系。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-18 DOI: 10.1002/cam4.71426

Muhammad Sohaib Khan, Tammy Leonard, Sean Young, Natalie Williams, Jennie Meier, Gilbert Z. Murimwa, Herbert J. Zeh 3rd, Patricio M. Polanco

Background

Relationships between socioeconomic factors and metastatic cancer at diagnosis have not been well studied. Using CDC's Social Vulnerability Index (SVI) we studied the association of metastatic cancer at initial diagnosis with 16 social factors and their interaction with insurance status.

Methods

California and Texas cancer registries, merged with the SVI database, were used to identify adult patients diagnosed with breast, colorectal, liver, lung, ovarian, pancreatic, or prostate cancer from 2015 to 2019. To determine the association of SVI with metastatic cancer at initial diagnosis, multivariable binary logistic regression analyses were performed.

Results

Of the 654,016 patients included, 149,476 (21.5%) were diagnosed with metastatic cancer at diagnosis. Overall, the adjusted odds of metastasis at diagnosis increased by 5% for every 10 unit increase in SVI. Stratified by cancer type, the odds (95% confidence interval) of metastatic cancer at diagnosis were: breast 1.04 (1.03–1.05), colorectal 1.01 (1.01–1.02), liver 1.03 (1.02–1.05), lung 1.01 (1.01–1.02), pancreatic 1.02 (1.01–1.03), prostate 1.06 (1.05–1.07). Interaction analysis of insurance with SVI revealed that the marginal effect of the association between SVI and the risk of metastasis at initial diagnosis increased most substantially as SVI increased for patients who had insurance. It was relatively constant for uninsured and Medicaid patients, who had the overall highest average risk.

Conclusions

Increased neighborhood social vulnerability is associated with an increased risk of metastatic cancer at initial diagnosis. While uninsured patients or those on Medicaid had a higher risk, patients with other insurance types experienced the largest increases in risk associated with increasing SVI.

背景：社会经济因素与诊断时转移性癌症之间的关系尚未得到很好的研究。利用美国疾病控制与预防中心的社会脆弱性指数（SVI），我们研究了转移性癌症初始诊断与16个社会因素的关系及其与保险状况的相互作用。方法：将加利福尼亚州和德克萨斯州的癌症登记处与SVI数据库合并，用于识别2015年至2019年诊断为乳腺癌、结肠直肠癌、肝癌、肺癌、卵巢癌、胰腺癌或前列腺癌的成年患者。为了确定SVI与初始诊断时转移性癌症的关系，进行了多变量二元logistic回归分析。结果：在纳入的654,016例患者中，149,476例（21.5%）在诊断时被诊断为转移性癌。总体而言，SVI每增加10个单位，诊断时转移的调整几率就增加5%。按癌型分层，诊断时转移癌的几率（95%置信区间）为：乳腺癌1.04（1.03-1.05）、结直肠癌1.01（1.01-1.02）、肝癌1.03（1.02-1.05）、肺癌1.01（1.01-1.02）、胰腺癌1.02（1.01-1.03）、前列腺1.06（1.05-1.07）。保险与SVI的相互作用分析显示，SVI与初始诊断时转移风险之间关联的边际效应随着SVI的增加而显著增加。对于没有保险和医疗补助的患者来说，这一比例相对稳定，他们的总体平均风险最高。结论：社区社会脆弱性的增加与初始诊断时转移性癌症的风险增加有关。虽然没有保险的患者或有医疗补助的患者风险更高，但有其他保险类型的患者与SVI增加相关的风险增幅最大。

{"title":"Association of Neighborhood Social Vulnerability With Metastatic Cancer at Diagnosis","authors":"Muhammad Sohaib Khan, Tammy Leonard, Sean Young, Natalie Williams, Jennie Meier, Gilbert Z. Murimwa, Herbert J. Zeh 3rd, Patricio M. Polanco","doi":"10.1002/cam4.71426","DOIUrl":"10.1002/cam4.71426","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Relationships between socioeconomic factors and metastatic cancer at diagnosis have not been well studied. Using CDC's Social Vulnerability Index (SVI) we studied the association of metastatic cancer at initial diagnosis with 16 social factors and their interaction with insurance status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>California and Texas cancer registries, merged with the SVI database, were used to identify adult patients diagnosed with breast, colorectal, liver, lung, ovarian, pancreatic, or prostate cancer from 2015 to 2019. To determine the association of SVI with metastatic cancer at initial diagnosis, multivariable binary logistic regression analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 654,016 patients included, 149,476 (21.5%) were diagnosed with metastatic cancer at diagnosis. Overall, the adjusted odds of metastasis at diagnosis increased by 5% for every 10 unit increase in SVI. Stratified by cancer type, the odds (95% confidence interval) of metastatic cancer at diagnosis were: breast 1.04 (1.03–1.05), colorectal 1.01 (1.01–1.02), liver 1.03 (1.02–1.05), lung 1.01 (1.01–1.02), pancreatic 1.02 (1.01–1.03), prostate 1.06 (1.05–1.07). Interaction analysis of insurance with SVI revealed that the marginal effect of the association between SVI and the risk of metastasis at initial diagnosis increased most substantially as SVI increased for patients who had insurance. It was relatively constant for uninsured and Medicaid patients, who had the overall highest average risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Increased neighborhood social vulnerability is associated with an increased risk of metastatic cancer at initial diagnosis. While uninsured patients or those on Medicaid had a higher risk, patients with other insurance types experienced the largest increases in risk associated with increasing SVI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12813268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996798","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

Rising Incidence of Tongue Cancer Surgeries Among Middle-Aged and Older Women in Japan: A Nationwide Claims-Based Analysis From 2014 to 2022 日本中老年妇女舌癌手术发病率上升：2014年至2022年全国索赔分析

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-18 DOI: 10.1002/cam4.71547

Masamitsu Kido, Takahiro Tsujikawa, Kengo Yoshii, Shigeyuki Mukudai, Koichi Yoshizawa, Shota Sugaya, Sumiyo Saburi, Katsutoshi Shoda, Alisa Kimura, Shigeru Hirano

Background

This study investigated recent trends and demographic patterns in tongue cancer surgeries in Japan using nationwide insurance claims data.

Methods

Annual surgery counts and rates (per 100,000 person-years) were analyzed using medical (2014–2022) and dental (2016–2022) claims. Trends were evaluated using linear and Poisson regression to estimate annual risk ratios (RRs).

Results

An average of 4470.7 surgeries per year was observed (rate: 3.4). The male-to-female ratio was 1.6:1 overall but nearly 1:1 under 40s and over 2.0:1 in the 60s–70s. Surgery rates peaked at ages 75–79 in males (12.0) and 75–84 in females (5.9). Age-adjusted surgery counts rose significantly from 2014 to 2022. Rates increased significantly among all females (RR = 1.020) and overall (RR = 1.010). Significant increases were seen in females aged 40–44 and 60–64 (RR = 1.083 and 1.055).

Conclusions

Distinct age- and sex-related trends were identified, particularly rising rates among middle-aged and older females.

背景：本研究利用日本全国保险索赔数据调查了舌癌手术的最新趋势和人口模式。方法：使用医疗（2014-2022）和牙科（2016-2022）索赔分析年度手术计数和比率（每10万人年）。使用线性和泊松回归评估趋势，以估计年风险比（rr）。结果：平均4470.7例/年（发生率：3.4）。男女比例总体为1.6:1，但40岁以下接近1:1,60 -70岁超过2.0:1。男性75-79岁手术率最高（12.0），女性75-84岁手术率最高（5.9）。从2014年到2022年，年龄调整手术数量显著上升。所有女性（RR = 1.020）和总体（RR = 1.010）的发病率均显著升高。40-44岁和60-64岁的女性发病率显著升高（RR = 1.083和1.055）。结论：确定了明显的年龄和性别相关趋势，特别是中老年女性的发病率上升。

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引用次数: 0

SULF1 in Cancer Associated Fibroblasts Promotes Invasion in Head and Neck Cancer Cell Lines 癌症相关成纤维细胞中的SULF1促进头颈部癌细胞系的侵袭。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-18 DOI: 10.1002/cam4.71540

Pritha Mukherjee, Julius Benicky, Aswini Panigrahi, Laurie Ailles, Radoslav Goldman

Background

Cancer-associated fibroblasts (CAFs) significantly influence tumor behavior in head and neck squamous cell carcinoma (HNSCC) and other malignancies. We identified the extracellular sulfatase SULF1 as a key stromal factor highly expressed in CAFs and associated with poor prognosis.

Methods and Results

Using CRISPR/Cas9-edited SULF1-knockout primary HNSCC CAFs, we demonstrate that loss of SULF1 reduces fibroblast proliferation and markedly impairs cancer cell migration and invasion in vitro. Two-photon microscopy in 3D spheroid cocultures revealed that SULF1-deficient CAFs fail to support invasiveness of Cal33 cells, resulting in spheroids with fewer invasive projections and altered morphology. Proteomic analysis confirmed the absence of SULF1 in the knockout cell cultures and revealed that SULF2, expressed in tumor cells, does not compensate for its loss.

Conclusion

These findings highlight the importance of CAF-derived SULF1 in regulating tumor invasion and suggest that SULF1 is a promising therapeutic target in HNSCC.

背景：癌症相关成纤维细胞（CAFs）显著影响头颈部鳞状细胞癌（HNSCC）和其他恶性肿瘤的肿瘤行为。我们发现细胞外硫酸酯酶SULF1是一个关键的基质因子，在CAFs中高度表达，并与不良预后相关。方法和结果：使用CRISPR/ cas9编辑的SULF1敲除原代HNSCC CAFs，我们证明SULF1的缺失减少了成纤维细胞的增殖，并显著损害了癌细胞在体外的迁移和侵袭。双光子显微镜在三维球体共培养中发现，缺乏suld1的CAFs不能支持Cal33细胞的侵袭性，导致球体具有较少的侵袭性突起和形态改变。蛋白质组学分析证实了敲除细胞培养中SULF1的缺失，并揭示了肿瘤细胞中表达的sul2不能弥补其缺失。结论：这些发现突出了ca衍生的SULF1在调节肿瘤侵袭中的重要性，并提示SULF1是一种有希望的治疗HNSCC的靶点。

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引用次数: 0

Plasma Fibrinogen Predicts Response to Immune Checkpoint Inhibitor by Inflammatory Tumor Microenvironment in Esophageal Cancer 血浆纤维蛋白原预测食管癌炎性肿瘤微环境对免疫检查点抑制剂的反应。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-18 DOI: 10.1002/cam4.71548

Keiso Ho, Satoru Matsuda, Eisuke Booka, Wataru Soneda, Jun Okui, Shota Hoshino, Masashi Takeuchi, Kazumasa Fukuda, Sara Horie, Yuki Saito, Yasunori Kogure, Hirofumi Kawakubo, Kensuke Hara, Hajime Okita, Keisuke Kataoka, Shigeki Sekine, Hiroya Takeuchi, Yuko Kitagawa

Background

Plasma fibrinogen (FNG) is a prognostic marker in esophageal squamous cell carcinoma (ESCC). However, its predictive value for immune checkpoint inhibitor (ICI) efficacy and the underlying mechanisms remain unclear. This study aimed to evaluate the clinical significance of plasma FNG levels in ICI-treated ESCC patients and investigate its association with tumor-associated neutrophils (TANs) and genomic alterations.

Methods

A retrospective, multicenter analysis of 167 ESCC patients treated with ICIs was performed. TANs were quantified via immunohistochemistry using CD11b and CD66b staining, and PD-L1 expression was assessed using the tumor proportion score (TPS). Whole-exome and RNA sequencing were conducted to analyze genomic and transcriptomic profiles.

Results

Elevated plasma FNG levels correlated with lower ICI response rates and decreased survival. In first-line treatment, chemo-ICI therapy demonstrated superior efficacy compared to dual-ICI therapy in high-FNG patients, while the reverse trend was observed in low-FNG patients. High-FNG tumors showed increased TAN infiltration, independent of PD-L1 expression. RNA sequencing revealed enrichment of neutrophil activation and extravasation pathways in high-FNG tumors.

Conclusions

Elevated plasma FNG levels predict poor prognosis and reduced ICI efficacy in ESCC. They may be potential biomarkers for first-line ICI-based therapy and correlate with TAN infiltration. Further validation and mechanistic investigations are warranted.

背景：血浆纤维蛋白原（FNG）是食管鳞状细胞癌（ESCC）的预后指标。然而，其对免疫检查点抑制剂（ICI）疗效的预测价值及其潜在机制尚不清楚。本研究旨在评估ci治疗ESCC患者血浆FNG水平的临床意义，并探讨其与肿瘤相关中性粒细胞（TANs）和基因组改变的关系。方法：对167例接受ICIs治疗的ESCC患者进行回顾性、多中心分析。采用免疫组化CD11b和CD66b染色定量TANs，采用肿瘤比例评分（tumor proportion score， TPS）评估PD-L1表达。全外显子组和RNA测序分析基因组和转录组谱。结果：血浆FNG水平升高与ICI反应率降低和生存率降低相关。在一线治疗中，化疗- ici治疗在高fng患者中表现出优于双ici治疗的疗效，而在低fng患者中观察到相反的趋势。高fng肿瘤显示TAN浸润增加，与PD-L1表达无关。RNA测序显示高fng肿瘤中中性粒细胞活化和外渗途径的富集。结论：血浆FNG水平升高预示ESCC预后不良和ICI疗效降低。它们可能是一线ci治疗的潜在生物标志物，并与TAN浸润相关。进一步的验证和机理研究是必要的。

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引用次数: 0

Advantage of Scheduled Upfront Lenvatinib Administration Followed by Transarterial Chemoembolization Therapy Over Lenvatinib Monotherapy in Patients With Unresectable Intermediate-Stage Hepatocellular Carcinoma: A Multicenter Cohort Study 一项多中心队列研究：在不可切除的中期肝细胞癌患者中，预先给药Lenvatinib后经动脉化疗栓塞治疗优于Lenvatinib单药治疗。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-16 DOI: 10.1002/cam4.71503

Nobuhito Taniki, Keisuke Ojiro, Ryosuke Kasuga, Yukie Nakadai, Takaya Tabuchi, Po-Sung Chu, Shingo Usui, Hitomi Hoshi, Fumihiko Kaneko, Akihiro Yamaguchi, Jun Koizumi, Hirotoshi Ebinuma, Masashi Tamura, Jitsuro Tsukada, Masanori Inoue, Seishi Nakatsuka, Yasushi Hasegawa, Yuta Abe, Minoru Kitago, Masahiro Jinzaki, Yuko Kitagawa, Takanori Kanai, Nobuhiro Nakamoto

Background and Aim

Combining systemic chemotherapy with transarterial chemoembolization (TACE) has demonstrated improved outcomes, with promising results for the efficacy of lenvatinib pretreatment combined with TACE in single-arm studies involving patients with hepatocellular carcinoma (HCC). This study aimed to evaluate the efficacy of a scheduled upfront lenvatinib combined with a TACE regimen in patients with HCC, representing both the first study to comparatively analyze this approach and to focus specifically on patients unsuitable for TACE.

Methods

We conducted a multicenter retrospective study between 2018 and 2024, enrolling 41 patients with unresectable Barcelona Clinic Liver Cancer intermediate-stage HCC who were considered unsuitable for TACE owing to factors such as exceeding the up-to-7 criteria, having infiltrative HCC, or multiple asynchronous recurrent HCC. Of these patients, 25 received upfront lenvatinib administration prior to TACE (LEN-TACE group), followed by continuous lenvatinib and on-demand TACE, and 16 received lenvatinib monotherapy.

Results

Radiological evaluation revealed significantly higher complete response (CR) and objective response rates (ORR) in the LEN-TACE group than in the lenvatinib group. The median overall survival (OS) was not reached in the LEN-TACE group, whereas it was 16.2 months in the lenvatinib monotherapy group, indicating a significantly superior OS in the LEN-TACE group (hazard ratio [HR]: 2.99; 95% CI: 1.01–8.95; p = 0.0496). Superiority in both PFS and OS was also observed in the propensity score-matched (PSM) cohort for the LEN-TACE group.

Conclusion

Scheduled upfront lenvatinib combined with TACE is superior to lenvatinib monotherapy for intermediate-stage HCC, particularly in patients unsuitable for TACE.

背景与目的：全身化疗联合经动脉化疗栓塞（TACE）已显示出改善的结果，在肝细胞癌（HCC）患者的单臂研究中，lenvatinib预处理联合TACE的疗效很有希望。本研究旨在评估lenvatinib联合TACE方案在HCC患者中的疗效，这是第一个比较分析这种方法的研究，也是第一个专门针对不适合TACE的患者的研究。方法：我们在2018 - 2024年间进行了一项多中心回顾性研究，纳入了41例因超过7级标准、浸润性HCC或多发非同步复发性HCC等因素而被认为不适合进行TACE治疗的巴塞罗那临床肝癌中期HCC患者。在这些患者中，25名患者在TACE之前接受了lenvatinib的前期治疗（LEN-TACE组），随后持续lenvatinib和按需TACE， 16名患者接受lenvatinib单药治疗。结果：放射学评价显示LEN-TACE组的完全缓解率（CR）和客观缓解率（ORR）明显高于lenvatinib组。LEN-TACE组未达到中位总生存期（OS），而lenvatinib单药治疗组为16.2个月，表明LEN-TACE组的OS明显优于LEN-TACE组（风险比[HR]: 2.99; 95% CI: 1.01-8.95; p = 0.0496）。在LEN-TACE组的倾向评分匹配（PSM）队列中也观察到PFS和OS的优势。结论：计划的lenvatinib联合TACE治疗中期HCC优于lenvatinib单药治疗，特别是在不适合TACE的患者中。

{"title":"Advantage of Scheduled Upfront Lenvatinib Administration Followed by Transarterial Chemoembolization Therapy Over Lenvatinib Monotherapy in Patients With Unresectable Intermediate-Stage Hepatocellular Carcinoma: A Multicenter Cohort Study","authors":"Nobuhito Taniki, Keisuke Ojiro, Ryosuke Kasuga, Yukie Nakadai, Takaya Tabuchi, Po-Sung Chu, Shingo Usui, Hitomi Hoshi, Fumihiko Kaneko, Akihiro Yamaguchi, Jun Koizumi, Hirotoshi Ebinuma, Masashi Tamura, Jitsuro Tsukada, Masanori Inoue, Seishi Nakatsuka, Yasushi Hasegawa, Yuta Abe, Minoru Kitago, Masahiro Jinzaki, Yuko Kitagawa, Takanori Kanai, Nobuhiro Nakamoto","doi":"10.1002/cam4.71503","DOIUrl":"10.1002/cam4.71503","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Combining systemic chemotherapy with transarterial chemoembolization (TACE) has demonstrated improved outcomes, with promising results for the efficacy of lenvatinib pretreatment combined with TACE in single-arm studies involving patients with hepatocellular carcinoma (HCC). This study aimed to evaluate the efficacy of a scheduled upfront lenvatinib combined with a TACE regimen in patients with HCC, representing both the first study to comparatively analyze this approach and to focus specifically on patients unsuitable for TACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicenter retrospective study between 2018 and 2024, enrolling 41 patients with unresectable Barcelona Clinic Liver Cancer intermediate-stage HCC who were considered unsuitable for TACE owing to factors such as exceeding the up-to-7 criteria, having infiltrative HCC, or multiple asynchronous recurrent HCC. Of these patients, 25 received upfront lenvatinib administration prior to TACE (LEN-TACE group), followed by continuous lenvatinib and on-demand TACE, and 16 received lenvatinib monotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Radiological evaluation revealed significantly higher complete response (CR) and objective response rates (ORR) in the LEN-TACE group than in the lenvatinib group. The median overall survival (OS) was not reached in the LEN-TACE group, whereas it was 16.2 months in the lenvatinib monotherapy group, indicating a significantly superior OS in the LEN-TACE group (hazard ratio [HR]: 2.99; 95% CI: 1.01–8.95; <i>p</i> = 0.0496). Superiority in both PFS and OS was also observed in the propensity score-matched (PSM) cohort for the LEN-TACE group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Scheduled upfront lenvatinib combined with TACE is superior to lenvatinib monotherapy for intermediate-stage HCC, particularly in patients unsuitable for TACE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12811626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987355","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

Clinical and Echocardiographic Insights Into Right Heart Masses: A Retrospective Study in China (2010–2023) 中国2010-2023年右心肿块的临床和超声心动图分析。

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-15 DOI: 10.1002/cam4.71530

Lei Liu, Peng Teng, Fudong Fan, Hui Chen, Yanfei Mo, Jing Yao, Xuelin Yang, Aijuan Fang

Background

This study aimed to analyze the clinical and echocardiographic characteristics, pathological profiles, and outcomes of right heart masses, and to explore the role of echocardiography in the evaluation of these masses.

Methods

We retrospectively analyzed 171 patients with echocardiographically diagnosed and pathologically confirmed right heart masses from two centers (2010–2023). Data on clinical presentation, echocardiographic features, pathology, and follow-up were collected. Survival analysis using Kaplan–Meier curves and multivariable Cox regression was performed to identify prognostic factors.

Results

Among 171 patients, 114 had primary cardiac tumors (82 benign, 30 malignant, and 2 of uncertain biological behavior), 41 had metastatic tumors, and 16 had thrombi or other lesions. Myxomas (63.4%) and angiosarcomas (63.3%) were the most common benign and malignant tumors, respectively. Patients with benign tumors had significantly better survival than those with malignant tumors, metastases, or thrombi (all p < 0.01). In the primary tumor subgroup (n = 112), better survival was associated with pedunculated morphology, well-defined margins, high mobility, and absence of metastasis (all p < 0.01). Multivariable analysis identified malignant tumor type (HR = 10.072, p < 0.001; reference: benign tumor), absence of a pedicle (HR = 2.610, p = 0.044; reference: presence of a pedicle), and presence of metastasis (HR = 3.210, p = 0.025; reference: no metastasis) as independent prognostic factors. The median follow-up was 26 months, with a recurrence rate of 4.7% and overall mortality of 35.7%.

Conclusion

Tumor type, pedicle presence, and metastasis are key prognostic factors for primary right heart tumors. Echocardiography is essential for diagnosis and differential diagnosis of right heart masses.

背景：本研究旨在分析右心肿块的临床及超声心动图特征、病理特点及转归，探讨超声心动图在评价右心肿块中的作用。方法：回顾性分析2010-2023年两个中心经超声心动图诊断和病理证实的171例右心肿块患者。收集临床表现、超声心动图特征、病理和随访资料。采用Kaplan-Meier曲线和多变量Cox回归进行生存分析，以确定预后因素。结果：171例患者中，114例为原发性心脏肿瘤（良性82例，恶性30例，生物学行为不确定2例），41例为转移性肿瘤，16例为血栓或其他病变。黏液瘤（63.4%）和血管肉瘤（63.3%）是最常见的良恶性肿瘤。良性肿瘤患者的生存率明显高于恶性肿瘤、转移、血栓患者（均p）。结论：肿瘤类型、有无蒂、转移是原发性右心肿瘤预后的关键因素。超声心动图对右心肿块的诊断和鉴别诊断具有重要意义。

{"title":"Clinical and Echocardiographic Insights Into Right Heart Masses: A Retrospective Study in China (2010–2023)","authors":"Lei Liu, Peng Teng, Fudong Fan, Hui Chen, Yanfei Mo, Jing Yao, Xuelin Yang, Aijuan Fang","doi":"10.1002/cam4.71530","DOIUrl":"10.1002/cam4.71530","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to analyze the clinical and echocardiographic characteristics, pathological profiles, and outcomes of right heart masses, and to explore the role of echocardiography in the evaluation of these masses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 171 patients with echocardiographically diagnosed and pathologically confirmed right heart masses from two centers (2010–2023). Data on clinical presentation, echocardiographic features, pathology, and follow-up were collected. Survival analysis using Kaplan–Meier curves and multivariable Cox regression was performed to identify prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 171 patients, 114 had primary cardiac tumors (82 benign, 30 malignant, and 2 of uncertain biological behavior), 41 had metastatic tumors, and 16 had thrombi or other lesions. Myxomas (63.4%) and angiosarcomas (63.3%) were the most common benign and malignant tumors, respectively. Patients with benign tumors had significantly better survival than those with malignant tumors, metastases, or thrombi (all <i>p</i> < 0.01). In the primary tumor subgroup (<i>n</i> = 112), better survival was associated with pedunculated morphology, well-defined margins, high mobility, and absence of metastasis (all <i>p</i> < 0.01). Multivariable analysis identified malignant tumor type (HR = 10.072, <i>p</i> < 0.001; reference: benign tumor), absence of a pedicle (HR = 2.610, <i>p</i> = 0.044; reference: presence of a pedicle), and presence of metastasis (HR = 3.210, <i>p</i> = 0.025; reference: no metastasis) as independent prognostic factors. The median follow-up was 26 months, with a recurrence rate of 4.7% and overall mortality of 35.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tumor type, pedicle presence, and metastasis are key prognostic factors for primary right heart tumors. Echocardiography is essential for diagnosis and differential diagnosis of right heart masses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12806106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984160","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

Emergence of BRCA Reversion Mutations in Prostate Cancer Prior to PARP Inhibitor Exposure: Clinical and Therapeutic Implications PARP抑制剂暴露前前列腺癌中BRCA逆转突变的出现：临床和治疗意义

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine

Pub Date : 2026-01-15 DOI: 10.1002/cam4.71489

Douglas I. Lin, Elizabeth Lawrence, Natalie Danziger, Huihui Ye, Brennan Decker, Ole Gjoerup, Ryon P. Graf, Jeffrey S. Ross, Richard S. P. Huang, Julia A. Elvin, Douglas A. Mata, Rana R. McKay

Background

Inactivating BRCA1/2 mutations confer sensitivity to poly(ADP-ribose) polymerase inhibitors (PARPi) in prostate cancer (PCA). However, secondary BRCA1/2 reversion mutations (BRCArev) can restore BRCA function and mediate acquired PARPi resistance. While BRCArev typically arise under PARPi selective pressure, their occurrence in PARPi-naïve settings remains incompletely understood. We sought to characterize the frequency, clinical context, and therapeutic correlates of BRCArev detection in men with advanced PCA, including those without prior PARPi exposure.

Methods

We restrospectively analyzed clinical liquid biopsy results from men with PCA using FoundationOneLiquid CDx between January and December 2023. BRCArev were defined as sequence alterations predicted to restore open reading frame of BRCA1 or BRCA2 harboring pathogenic inactivating variants. Clinical and treatment histories, including chemotherapy and PARPi exposure, were abstracted from medical records.

Results

Over a one-year period, we identified 10 PCA patients with inactivating BRCA1/2 alterations, BRCArev and available treatment history. BRCArev were detected in three of 10 (30%) patients who had not received prior PARPi therapy. All three PARP-naïve patients had previously received chemotherapy (platinum or docetaxel) and radiation, and each exhibited multiple BRCArev events. The remaining 7 patients (70%) had prior olaparib exposure. Among these, the duration of PARPi response was longer in chemo-naïve patients compared with previously treated with chemotherapy (median: 22 vs. 7.5 months, respectively).

Conclusions

BRCArev can emerge in PCA in the absence of prior PARPi therapy, particularly following exposure to cytotoxic chemotherapy and radiation. These findings support that DNA-damaging therapies may promote BRCArev formation, potentially predisposing to primary PARPi resistance. Early integration of PARPi therapy before chemotherapy may enhance clinical benefit and circumvent emergence of primary resistance.

背景：失活BRCA1/2突变赋予前列腺癌（PCA）患者对聚（adp -核糖）聚合酶抑制剂（PARPi）的敏感性。然而，继发性BRCA1/2逆转突变（BRCArev）可以恢复BRCA功能并介导获得性PARPi抗性。虽然BRCArev通常在PARPi的选择压力下出现，但它们在PARPi-naïve环境中的发生情况仍不完全清楚。我们试图描述BRCArev检测在晚期PCA男性中的频率、临床背景和治疗相关性，包括那些之前没有PARPi暴露的男性。方法：回顾性分析2023年1月至12月使用FoundationOneLiquid CDx的男性PCA患者的临床液体活检结果。BRCArev被定义为能够恢复BRCA1或BRCA2中含有致病性失活变体的开放阅读框的序列改变。临床和治疗史，包括化疗和PARPi暴露，从医疗记录中摘录。结果：在一年的时间里，我们确定了10例具有失活BRCA1/2改变、BRCArev和可用治疗史的PCA患者。10例未接受PARPi治疗的患者中有3例（30%）检测到BRCArev。所有三位PARP-naïve患者先前都接受过化疗（铂或多西紫杉醇）和放疗，并且每个患者都表现出多次BRCArev事件。其余7例患者（70%）既往有奥拉帕尼暴露史。其中，chemo-naïve患者的PARPi反应持续时间比先前接受化疗的患者更长（中位数分别为22个月和7.5个月）。结论：BRCArev可以在没有PARPi治疗的情况下出现在PCA中，特别是在暴露于细胞毒性化疗和放疗后。这些发现支持dna损伤疗法可能促进BRCArev的形成，潜在地诱发原发性PARPi耐药。化疗前早期整合PARPi治疗可提高临床获益，避免原发性耐药的出现。

{"title":"Emergence of BRCA Reversion Mutations in Prostate Cancer Prior to PARP Inhibitor Exposure: Clinical and Therapeutic Implications","authors":"Douglas I. Lin, Elizabeth Lawrence, Natalie Danziger, Huihui Ye, Brennan Decker, Ole Gjoerup, Ryon P. Graf, Jeffrey S. Ross, Richard S. P. Huang, Julia A. Elvin, Douglas A. Mata, Rana R. McKay","doi":"10.1002/cam4.71489","DOIUrl":"10.1002/cam4.71489","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inactivating <i>BRCA1/2</i> mutations confer sensitivity to poly(ADP-ribose) polymerase inhibitors (PARPi) in prostate cancer (PCA). However, secondary <i>BRCA1/2</i> reversion mutations (<i>BRCA</i>rev) can restore <i>BRCA</i> function and mediate acquired PARPi resistance. While <i>BRCA</i>rev typically arise under PARPi selective pressure, their occurrence in PARPi-naïve settings remains incompletely understood. We sought to characterize the frequency, clinical context, and therapeutic correlates of <i>BRCA</i>rev detection in men with advanced PCA, including those without prior PARPi exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We restrospectively analyzed clinical liquid biopsy results from men with PCA using FoundationOneLiquid CDx between January and December 2023. <i>BRCA</i>rev were defined as sequence alterations predicted to restore open reading frame of <i>BRCA1</i> or <i>BRCA2</i> harboring pathogenic inactivating variants. Clinical and treatment histories, including chemotherapy and PARPi exposure, were abstracted from medical records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a one-year period, we identified 10 PCA patients with inactivating <i>BRCA1/2</i> alterations, <i>BRCA</i>rev and available treatment history. <i>BRCA</i>rev were detected in three of 10 (30%) patients who had not received prior PARPi therapy. All three PARP-naïve patients had previously received chemotherapy (platinum or docetaxel) and radiation, and each exhibited multiple <i>BRCA</i>rev events. The remaining 7 patients (70%) had prior olaparib exposure. Among these, the duration of PARPi response was longer in chemo-naïve patients compared with previously treated with chemotherapy (median: 22 vs. 7.5 months, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>BRCA</i>rev can emerge in PCA in the absence of prior PARPi therapy, particularly following exposure to cytotoxic chemotherapy and radiation. These findings support that DNA-damaging therapies may promote <i>BRCA</i>rev formation, potentially predisposing to primary PARPi resistance. Early integration of PARPi therapy before chemotherapy may enhance clinical benefit and circumvent emergence of primary resistance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12806140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984185","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