Tumor invasion and metastasis are the primary causes of cancer-related mortality and have a profound impact on patient prognosis. This review comprehensively examines the application of Metal-Organic Frameworks (MOFs) in anti-metastatic therapy and establishes a theoretical foundation for their clinical translation. A systematic literature analysis clarifies the structural and therapeutic profile of MOFs. These materials show significant promise for anti-metastatic therapy, leveraged by their high loading capacity, tunable responsiveness, and modifiable surface properties. This review discusses MOF-based multi-targeted strategies to combat metastasis, including tumor microenvironment modulation, targeting of key metastatic cells, and multimodal synergistic therapies. These approaches have demonstrated success in applications such as drug delivery, photodynamic therapy, and immune activation. The discussion further addresses critical challenges in biosafety and targeting efficiency for clinical translation, while recognizing how MOFs' structural versatility sustains their therapeutic development. This reviewaims to provide a theoretical foundation and practical framework for the innovative design and clinical translation of MOFs in anti-metastatic therapy.
{"title":"Metal–Organic Frameworks Against Tumor Metastasis: Therapeutic Targets, Strategies, and Challenges for Clinical Translation","authors":"Jiahui Wang, Xiuxiu Qiu, Ruoyu Wang, Beibei Hong, Hegen Li, Zhanxia Zhang","doi":"10.1002/cam4.71349","DOIUrl":"10.1002/cam4.71349","url":null,"abstract":"<p>Tumor invasion and metastasis are the primary causes of cancer-related mortality and have a profound impact on patient prognosis. This review comprehensively examines the application of Metal-Organic Frameworks (MOFs) in anti-metastatic therapy and establishes a theoretical foundation for their clinical translation. A systematic literature analysis clarifies the structural and therapeutic profile of MOFs. These materials show significant promise for anti-metastatic therapy, leveraged by their high loading capacity, tunable responsiveness, and modifiable surface properties. This review discusses MOF-based multi-targeted strategies to combat metastasis, including tumor microenvironment modulation, targeting of key metastatic cells, and multimodal synergistic therapies. These approaches have demonstrated success in applications such as drug delivery, photodynamic therapy, and immune activation. The discussion further addresses critical challenges in biosafety and targeting efficiency for clinical translation, while recognizing how MOFs' structural versatility sustains their therapeutic development. This reviewaims to provide a theoretical foundation and practical framework for the innovative design and clinical translation of MOFs in anti-metastatic therapy.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12641060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585464","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}
Tropomyosin 3 (TPM3), one of the four tropomyosin genes, is predominantly expressed in eukaryotic cells. As a crucial regulatory protein, TPM3 associates with actin within thin myofilaments, thereby playing an essential role in the regulation of muscle contraction. Beyond its fundamental function in muscle physiology, TPM3 is implicated in oncogenesis.
Objective
This review elucidates the molecular mechanisms underpinning TPM3 gene fusions, delineates the tumor types associated with these fusions, and examines their clinical implications.
Findings
Gene fusions such as TPM3—NTRK1, TPM3—ALK, and TPM3—ROS1 have been identified as oncogenic drivers in various cancers. These fusions promote constitutive activation of tyrosine kinases, disrupt normal cellular signaling, and consequently accelerate tumorigenesis. Malignancies harboring TPM3 fusions encompass several tumor categories. With the advent of tyrosine kinase inhibitors (TKIs) targeting NTRK1, ALK, and ROS1 fusions, these rearrangements have gained significant therapeutic relevance. However, resistance mechanisms and tumor heterogeneity pose ongoing challenges to targeted therapy.
Conclusion
By synthesizing current evidence, this review aims to provide insights into the diagnostic, prognostic, and therapeutic landscape of TPM3—related gene fusions, fostering advancements in precision oncology.
{"title":"Tropomyosin 3 Gene Fusions in Cancers: From Mechanisms to Treatments—A Comprehensive Review","authors":"Anjie Chen, Sixin Li, Chen Guo, Chenwei Gu, Jiandong Gui, Yujie Deng, Xichen Feng, Yuanyuan Mi","doi":"10.1002/cam4.71407","DOIUrl":"10.1002/cam4.71407","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tropomyosin 3 (TPM3), one of the four tropomyosin genes, is predominantly expressed in eukaryotic cells. As a crucial regulatory protein, TPM3 associates with actin within thin myofilaments, thereby playing an essential role in the regulation of muscle contraction. Beyond its fundamental function in muscle physiology, TPM3 is implicated in oncogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This review elucidates the molecular mechanisms underpinning TPM3 gene fusions, delineates the tumor types associated with these fusions, and examines their clinical implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Gene fusions such as TPM3—NTRK1, TPM3—ALK, and TPM3—ROS1 have been identified as oncogenic drivers in various cancers. These fusions promote constitutive activation of tyrosine kinases, disrupt normal cellular signaling, and consequently accelerate tumorigenesis. Malignancies harboring TPM3 fusions encompass several tumor categories. With the advent of tyrosine kinase inhibitors (TKIs) targeting NTRK1, ALK, and ROS1 fusions, these rearrangements have gained significant therapeutic relevance. However, resistance mechanisms and tumor heterogeneity pose ongoing challenges to targeted therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By synthesizing current evidence, this review aims to provide insights into the diagnostic, prognostic, and therapeutic landscape of TPM3—related gene fusions, fostering advancements in precision oncology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585423","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}
Norma Malavasi, Leonardo Ferrara, Lorenza Di Marco, Alessia Saviola, Raffaella Postiglione, Flavia Cantile, Gloria Acquaviva, Laura Galassi, Andrea Bergonzini, Claudia Fiorani, Laura Scarabelli, Massimo Dominici, Mario Luppi, Giuseppe Longo
Background
The management of severe complications arising from newly diagnosed or existing cancer, as well as acute therapy-related side effects, is traditionally provided by General Emergen-cy Departments (GED). To address the specific needs of oncologic and hematologic patients, the University Hospital of Modena established a dedicated Oncology-Hematology Emergency Room (OHER) in 2001 as an integral part of the Oncology and Hematology Department.
Aim and Methods
This study aims to analyze the clinical characteristics and outcomes of cancer patients admitted to OHER between 2009 and 2019, including hospitalization rates, and compare them with those of cancer patients admitted to GED over the same period. A dedicated electronic tool was developed to process medical records. The OHER staff includes oncologists and hematol-ogists trained in internal medicine, supported by a specialized nurse who is available during daytime workdays.
Result
A total of 28.680 OHER admissions were recorded, involving 11.239 patients. Among them, 5.326 (47%) had a single visit, while 165 (0.6%) died during their monitoring in OHER. Admis-sions peaked in January (10%; 2,900 visits) and were lowest in December (6.8%; 1,952 visits). The busiest day was Monday (6,926 visits), at least in terms of hospitalization and mortality rates. At our Center, OHER serves as the primary point of reference for oncology and hematological patients who present with unexpected clinical deterioration.
Conclusion
Our analysis aims to provide clinical data from a dedicated oncology and hematology emergency room, comparing them with those observed in the general emergency room. In our ex-perience, the OHER enhances the delivery of patient-centered oncology care and the quality of comprehensive oncology and hematology care through its innovative integration of various clinical and organizational aspects.
{"title":"A Decade of Specialized Acute Care: Clinical Impact of an Oncology-Hematology Emergency Room Compared to General Emergency Services","authors":"Norma Malavasi, Leonardo Ferrara, Lorenza Di Marco, Alessia Saviola, Raffaella Postiglione, Flavia Cantile, Gloria Acquaviva, Laura Galassi, Andrea Bergonzini, Claudia Fiorani, Laura Scarabelli, Massimo Dominici, Mario Luppi, Giuseppe Longo","doi":"10.1002/cam4.71377","DOIUrl":"https://doi.org/10.1002/cam4.71377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The management of severe complications arising from newly diagnosed or existing cancer, as well as acute therapy-related side effects, is traditionally provided by General Emergen-cy Departments (GED). To address the specific needs of oncologic and hematologic patients, the University Hospital of Modena established a dedicated Oncology-Hematology Emergency Room (OHER) in 2001 as an integral part of the Oncology and Hematology Department.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim and Methods</h3>\u0000 \u0000 <p>This study aims to analyze the clinical characteristics and outcomes of cancer patients admitted to OHER between 2009 and 2019, including hospitalization rates, and compare them with those of cancer patients admitted to GED over the same period. A dedicated electronic tool was developed to process medical records. The OHER staff includes oncologists and hematol-ogists trained in internal medicine, supported by a specialized nurse who is available during daytime workdays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>A total of 28.680 OHER admissions were recorded, involving 11.239 patients. Among them, 5.326 (47%) had a single visit, while 165 (0.6%) died during their monitoring in OHER. Admis-sions peaked in January (10%; 2,900 visits) and were lowest in December (6.8%; 1,952 visits). The busiest day was Monday (6,926 visits), at least in terms of hospitalization and mortality rates. At our Center, OHER serves as the primary point of reference for oncology and hematological patients who present with unexpected clinical deterioration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our analysis aims to provide clinical data from a dedicated oncology and hematology emergency room, comparing them with those observed in the general emergency room. In our ex-perience, the OHER enhances the delivery of patient-centered oncology care and the quality of comprehensive oncology and hematology care through its innovative integration of various clinical and organizational aspects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572564","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}
Head and neck cancer (HNC) comprises a heterogeneous group of malignancies with significant variation in epidemiology, clinical features, and treatment responses. However, large-scale data on the clinical epidemiology of HNC and the prognostic impact of human papillomavirus (HPV) infection have not yet been reported.
Material and Methods
Data on HNC cases with known HPV status were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics of HNC were summarized based on HPV status, primary site, and metastatic site. To elucidate the prognostic role of HPV status in HNC, we calculated the relative survival rate (RSR) and conducted Cox regression analysis following propensity score matching by HPV status.
Results
A total of 14,855 HNC cases were included in this study, comprising 10,128 HPV-positive and 4727 HPV-negative cases. Clinical characteristics varied based on HPV status, primary site, and metastatic site. HPV positivity was generally associated with better prognosis, except in cases of nasopharyngeal carcinoma and cancers originating from the gum, as indicated by RSRs. Subgroup Cox regression analysis demonstrated significantly improved survival for HPV-positive cases compared to their HPV-negative counterparts across most categories.
Conclusion
HNC encompasses a diverse group of heterogeneous diseases, with HPV positivity generally associated with a better prognosis.
{"title":"Epidemiology and Prognostic Role of HPV Infection in Head and Neck Cancer: A Population-Based Study of the SEER Database","authors":"Kangwen Guo, Jinmei Li, Haiyin Ye, Xiaoqiong Yi","doi":"10.1002/cam4.71322","DOIUrl":"10.1002/cam4.71322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Head and neck cancer (HNC) comprises a heterogeneous group of malignancies with significant variation in epidemiology, clinical features, and treatment responses. However, large-scale data on the clinical epidemiology of HNC and the prognostic impact of human papillomavirus (HPV) infection have not yet been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Data on HNC cases with known HPV status were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics of HNC were summarized based on HPV status, primary site, and metastatic site. To elucidate the prognostic role of HPV status in HNC, we calculated the relative survival rate (RSR) and conducted Cox regression analysis following propensity score matching by HPV status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 14,855 HNC cases were included in this study, comprising 10,128 HPV-positive and 4727 HPV-negative cases. Clinical characteristics varied based on HPV status, primary site, and metastatic site. HPV positivity was generally associated with better prognosis, except in cases of nasopharyngeal carcinoma and cancers originating from the gum, as indicated by RSRs. Subgroup Cox regression analysis demonstrated significantly improved survival for HPV-positive cases compared to their HPV-negative counterparts across most categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HNC encompasses a diverse group of heterogeneous diseases, with HPV positivity generally associated with a better prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572752","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}
Jieshan Lin, Xiaoying Dong, Wenfang Tang, Shuangxin Liu
Aim
The high burden of lung cancer in developing countries has led to the widespread use of EGFR inhibitors like osimertinib. However, little is known about the prevalence and risk factors of renal injury associated with osimertinib use. Therefore, this study aims to investigate the incidence, severity and risk factors of renal injury in patients receiving osimertinib in the real world.
Methods
We retrospectively analyzed 1138 patients with lung cancer treated with osimertinib. Renal injury was defined as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m2 and/or the presence of proteinuria. Multivariable logistic regression models were used to identify independent risk factors for renal injury.
Results
Totally, 215 (18.89%) patients developed renal injury during follow-up. Most cases of renal injury were transient (149/1138, 13.09%), while sustained renal injury accounted for 5.8% (66/1138) of the total cohort. Impaired renal function (eGFR < 60 mL/min/1.73m2) was observed in 136 (11.95%) patients, predominantly at a moderate stage (eGFR 30–59), and proteinuria was present in 100 (8.79%) patients, primarily of mild severity. Among patients with renal injury, 73.53% had a mild creatinine elevation (< 50% increase from baseline). Moreover, the mean time to renal injury onset was 7.92 months (SD 8.34), with a mean recovery time of 4.21 months (SD 6.31). Importantly, age ≥ 60 years (OR = 2.307, 95% CI: 1.348–3.947, p = 0.002) and baseline renal injury (OR = 20.942, 95% CI: 8.398–52.223, p < 0.001) were significant independent risk factors for sustained renal injury.
Conclusions
This study demonstrates that renal injury is not rare in lung cancer patients treated with osimertinib, particularly in patients aged ≥ 60 years or with pre-existing renal injury. Although most cases are reversible, regular monitoring of renal function is strongly recommended for these patients.
{"title":"The Incidence, Severity and Risk Factors of Renal Injury in Lung Cancer Patients Receiving Osimertinib Therapy: A Real-World Study","authors":"Jieshan Lin, Xiaoying Dong, Wenfang Tang, Shuangxin Liu","doi":"10.1002/cam4.71382","DOIUrl":"https://doi.org/10.1002/cam4.71382","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The high burden of lung cancer in developing countries has led to the widespread use of EGFR inhibitors like osimertinib. However, little is known about the prevalence and risk factors of renal injury associated with osimertinib use. Therefore, this study aims to investigate the incidence, severity and risk factors of renal injury in patients receiving osimertinib in the real world.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 1138 patients with lung cancer treated with osimertinib. Renal injury was defined as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m<sup>2</sup> and/or the presence of proteinuria. Multivariable logistic regression models were used to identify independent risk factors for renal injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Totally, 215 (18.89%) patients developed renal injury during follow-up. Most cases of renal injury were transient (149/1138, 13.09%), while sustained renal injury accounted for 5.8% (66/1138) of the total cohort. Impaired renal function (eGFR < 60 mL/min/1.73m<sup>2</sup>) was observed in 136 (11.95%) patients, predominantly at a moderate stage (eGFR 30–59), and proteinuria was present in 100 (8.79%) patients, primarily of mild severity. Among patients with renal injury, 73.53% had a mild creatinine elevation (< 50% increase from baseline). Moreover, the mean time to renal injury onset was 7.92 months (SD 8.34), with a mean recovery time of 4.21 months (SD 6.31). Importantly, age ≥ 60 years (OR = 2.307, 95% CI: 1.348–3.947, <i>p</i> = 0.002) and baseline renal injury (OR = 20.942, 95% CI: 8.398–52.223, <i>p</i> < 0.001) were significant independent risk factors for sustained renal injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates that renal injury is not rare in lung cancer patients treated with osimertinib, particularly in patients aged ≥ 60 years or with pre-existing renal injury. Although most cases are reversible, regular monitoring of renal function is strongly recommended for these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572562","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}
This study aims to develop and validate an explainable machine learning model for predicting postoperative survival in patients with locally advanced gastric cancer (LAGC), optimizing predictive accuracy while ensuring clinical applicability to facilitate personalized prognostication for patients.
Methods
The study utilized data from 8616 LAGC patients who underwent gastrectomy (2004–2015) in the Surveillance, Epidemiology, and End Results (SEER) database for model development and validation, with external validation performed using 235 postoperative LAGC cases (2016–2022) from Maoming People's Hospital (Maoming, China). Five predictive models—Cox proportional hazards model (CoxPH), random survival forest (RSF), extreme gradient boosting (XGBoost), gradient boosting machine (GBM), and DeepSurv—were developed using the training set. Model performance was evaluated using the concordance index (C-index), area under the receiver operating characteristic curve (AUROC), and Brier score. Additionally, 1-, 3-, and 5-year receiver operating characteristic curves (ROC), calibration curves, and decision curve analysis (DCA) were employed for further assessment. The optimal model was interpreted using explainability tools such as SurvSHAP and SurvLIME. Finally, an interactive prediction tool was created to provide personalized survival evaluation for LAGC patients.
Results
RSF exhibited the highest predictive performance, with a C-index of 0.732 (95% CI: 0.720–0.745) in the validation set and 0.723 (95% CI: 0.696–0.755) in the external validation set. The 1-, 3-, and 5-year AUROCs were 0.771, 0.803, and 0.809 in the validation set, and 0.802, 0.711, and 0.721 in the external validation set. Explainability analysis identified lymph node ratio (LNR), AJCC stage, and age as the most influential prognostic factors. An interactive prediction tool was developed to provide individualized prognosis visualization.
Conclusion
This study developed an RSF-based model to predict postoperative survival in LAGC patients, emphasizing the prognostic significance of LNR, AJCC stage, and age. The interactive prediction tool enhances clinical utility, facilitating personalized treatment decision-making for physicians.
{"title":"Explainable Machine Learning Model for Predicting Postoperative Survival in Patients With Locally Advanced Gastric Cancer","authors":"Zhijie Gong, Liping Zhou, Yinghao He, Yanjie Deng, Jun Zhou, Weiwei Wang, Qiangbang Yang, Jian Pan, Yingze Li, Xiaolu Yuan, Minghui Ma","doi":"10.1002/cam4.71408","DOIUrl":"https://doi.org/10.1002/cam4.71408","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to develop and validate an explainable machine learning model for predicting postoperative survival in patients with locally advanced gastric cancer (LAGC), optimizing predictive accuracy while ensuring clinical applicability to facilitate personalized prognostication for patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study utilized data from 8616 LAGC patients who underwent gastrectomy (2004–2015) in the Surveillance, Epidemiology, and End Results (SEER) database for model development and validation, with external validation performed using 235 postoperative LAGC cases (2016–2022) from Maoming People's Hospital (Maoming, China). Five predictive models—Cox proportional hazards model (CoxPH), random survival forest (RSF), extreme gradient boosting (XGBoost), gradient boosting machine (GBM), and DeepSurv—were developed using the training set. Model performance was evaluated using the concordance index (C-index), area under the receiver operating characteristic curve (AUROC), and Brier score. Additionally, 1-, 3-, and 5-year receiver operating characteristic curves (ROC), calibration curves, and decision curve analysis (DCA) were employed for further assessment. The optimal model was interpreted using explainability tools such as SurvSHAP and SurvLIME. Finally, an interactive prediction tool was created to provide personalized survival evaluation for LAGC patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RSF exhibited the highest predictive performance, with a C-index of 0.732 (95% CI: 0.720–0.745) in the validation set and 0.723 (95% CI: 0.696–0.755) in the external validation set. The 1-, 3-, and 5-year AUROCs were 0.771, 0.803, and 0.809 in the validation set, and 0.802, 0.711, and 0.721 in the external validation set. Explainability analysis identified lymph node ratio (LNR), AJCC stage, and age as the most influential prognostic factors. An interactive prediction tool was developed to provide individualized prognosis visualization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study developed an RSF-based model to predict postoperative survival in LAGC patients, emphasizing the prognostic significance of LNR, AJCC stage, and age. The interactive prediction tool enhances clinical utility, facilitating personalized treatment decision-making for physicians.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572563","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}
Beck Gold, Dana Rosenberg, Megan A. Mullins, Milena E. Insalaco, Edward J. Miech, Charles Kamen, Mandi L. Pratt-Chapman
Importance
Sexual orientation and gender identity (SOGI) data are vital, but inconsistently collected among cancer centers.
Objective
This study aims to identify themes from a large set of interviews regarding the collection of sexual orientation and gender identity (SOGI) data in oncology practice.
Setting
Oncology care settings in diverse geopolitical regions in the United States.
Participants
Sixty-two semi-structured interviews across 23 cancer centers in the United States were conducted from September 1, 2022 to August 31, 2023. Interview transcripts were transcribed and double-coded using thematic analysis and emergent coding.
Main Outcomes and Measures
We used inductive, open coding thematic qualitative analysis with no predetermined constructs.
Results
Key themes included: (1) barriers to SOGI data collection include stigma and bias, generational and geopolitical resistance, fragmented workflows, competing priorities and institutional inertia; (2) the importance of staff exposure to lesbian, gay, bisexual, queer, and intersex (LGBTQI) individuals in understanding SOGI's clinical relevance; and (3) structural challenges to equitable care for transgender patients, including electronic health record (EHR) limitations and billing issues. Taken together, these findings reveal a complex interplay of sociocultural, institutional, and systemic barriers that impede routine SOGI data collection in cancer care.
{"title":"Sexual Orientation and Gender Identity Data in Oncology: Thematic Analysis From a National Qualitative Interview Study","authors":"Beck Gold, Dana Rosenberg, Megan A. Mullins, Milena E. Insalaco, Edward J. Miech, Charles Kamen, Mandi L. Pratt-Chapman","doi":"10.1002/cam4.71360","DOIUrl":"https://doi.org/10.1002/cam4.71360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Importance</h3>\u0000 \u0000 <p>Sexual orientation and gender identity (SOGI) data are vital, but inconsistently collected among cancer centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to identify themes from a large set of interviews regarding the collection of sexual orientation and gender identity (SOGI) data in oncology practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Oncology care settings in diverse geopolitical regions in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Sixty-two semi-structured interviews across 23 cancer centers in the United States were conducted from September 1, 2022 to August 31, 2023. Interview transcripts were transcribed and double-coded using thematic analysis and emergent coding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes and Measures</h3>\u0000 \u0000 <p>We used inductive, open coding thematic qualitative analysis with no predetermined constructs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Key themes included: (1) barriers to SOGI data collection include stigma and bias, generational and geopolitical resistance, fragmented workflows, competing priorities and institutional inertia; (2) the importance of staff exposure to lesbian, gay, bisexual, queer, and intersex (LGBTQI) individuals in understanding SOGI's clinical relevance; and (3) structural challenges to equitable care for transgender patients, including electronic health record (EHR) limitations and billing issues. Taken together, these findings reveal a complex interplay of sociocultural, institutional, and systemic barriers that impede routine SOGI data collection in cancer care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547200","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}
This study aimed to evaluate the cost-effectiveness of pembrolizumab in combination with trastuzumab and chemotherapy (PEM + TRAS + Chemo) as a first-line treatment for patients with advanced HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma from the perspective of the Chinese healthcare system.
Methods
Clinical data from the KEYNOTE-811 trial were used to develop a partitioned survival model for HER2-positive gastric or GEJ adenocarcinoma. The model estimated quality-adjusted life years (QALYs), life years (LYs), and total lifetime costs. The primary outcome was the Incremental Cost-Effectiveness Ratio (ICER), reflecting the cost per additional QALY. Only direct medical costs were considered, with drug prices sourced from the China Drug Bidding Database and other costs and utility values derived from published literature. Uncertainty analyses were conducted to test the robustness of the model, and subgroup analyses were performed to assess cost-effectiveness in different patient populations.
Results
In the base-case analysis, the PEM + TRAS + Chemo regimen increased LYs by 0.17 and QALYs by 0.19, at an additional cost of $9874.08, resulting in an ICER of $53,160.95/QALY, which exceeds three times the per capita GDP of China ($39,999.86). Subgroup analysis based on the patient's programmed death-ligand 1 (PD-L1) combined positive score (CPS) showed that for PD-L1 (CPS ≥ 1) patients, the ICER was $49,849.43 per QALY. Uncertainty analysis indicated that the proportion of patients receiving subsequent systemic treatment had the most significant impact on the model results.
Conclusion
In China, for first-line treatment of HER2-positive advanced gastric or GEJ adenocarcinoma, the PEM + TRAS + Chemo regimen is not cost-effective when compared to the TRAS + Chemo regimen, unless the price of pembrolizumab is reduced.
目的本研究旨在从中国医疗保健系统的角度，评估派姆单抗联合曲妥珠单抗联合化疗（PEM + TRAS + Chemo）作为晚期her2阳性胃或胃食管交界处（GEJ）腺癌患者一线治疗的成本-效果。方法利用KEYNOTE-811试验的临床数据，建立her2阳性胃腺癌或GEJ腺癌的分区生存模型。该模型估计了质量调整寿命年（QALYs）、寿命年（LYs）和总寿命成本。主要结果是增量成本-效果比（ICER），反映每增加质量质量的成本。仅考虑直接医疗成本，药品价格来源于中国药品招标数据库，其他成本和效用值来源于已发表的文献。进行不确定性分析以检验模型的稳健性，并进行亚组分析以评估不同患者群体的成本效益。结果在基本病例分析中，PEM + TRAS + Chemo方案使LYs增加0.17，QALY增加0.19，额外成本为9874.08美元，导致ICER为53,160.95美元/QALY，超过中国人均GDP（39,999.86美元）的三倍。基于患者程序性死亡-配体1 （PD-L1）联合阳性评分（CPS）的亚组分析显示，对于PD-L1 （CPS≥1）患者，ICER为49,849.43美元/ QALY。不确定性分析表明，接受后续全身治疗的患者比例对模型结果的影响最为显著。结论在中国，对于her2阳性晚期胃或GEJ腺癌的一线治疗，PEM + TRAS + Chemo方案与TRAS + Chemo方案相比并不具有成本效益，除非降低派姆单抗的价格。
{"title":"Cost-Effectiveness of Pembrolizumab Plus Trastuzumab and Chemotherapy Versus Trastuzumab Plus Chemotherapy as First-Line Treatment of HER2-Positive Gastric or Gastroesophageal Junction Adenocarcinoma in China","authors":"Yifang Liang, Yuyanzi Zhang, Hongfei Hu, Yan Li, Aixia Ma, Xin Guan","doi":"10.1002/cam4.71379","DOIUrl":"https://doi.org/10.1002/cam4.71379","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the cost-effectiveness of pembrolizumab in combination with trastuzumab and chemotherapy (PEM + TRAS + Chemo) as a first-line treatment for patients with advanced HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma from the perspective of the Chinese healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data from the KEYNOTE-811 trial were used to develop a partitioned survival model for HER2-positive gastric or GEJ adenocarcinoma. The model estimated quality-adjusted life years (QALYs), life years (LYs), and total lifetime costs. The primary outcome was the Incremental Cost-Effectiveness Ratio (ICER), reflecting the cost per additional QALY. Only direct medical costs were considered, with drug prices sourced from the China Drug Bidding Database and other costs and utility values derived from published literature. Uncertainty analyses were conducted to test the robustness of the model, and subgroup analyses were performed to assess cost-effectiveness in different patient populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the base-case analysis, the PEM + TRAS + Chemo regimen increased LYs by 0.17 and QALYs by 0.19, at an additional cost of $9874.08, resulting in an ICER of $53,160.95/QALY, which exceeds three times the per capita GDP of China ($39,999.86). Subgroup analysis based on the patient's programmed death-ligand 1 (PD-L1) combined positive score (CPS) showed that for PD-L1 (CPS ≥ 1) patients, the ICER was $49,849.43 per QALY. Uncertainty analysis indicated that the proportion of patients receiving subsequent systemic treatment had the most significant impact on the model results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In China, for first-line treatment of HER2-positive advanced gastric or GEJ adenocarcinoma, the PEM + TRAS + Chemo regimen is not cost-effective when compared to the TRAS + Chemo regimen, unless the price of pembrolizumab is reduced.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547206","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}
<div> <section> <h3> Background</h3> <p>Approximately 83,000 new cases of bladder cancer (BC) in the United States and 23,000 in Japan are confirmed per year, and the number of new BC cases increases every year. While the prognosis for localized cancer is favorable, treatment options for metastatic cancer are limited, and the prognosis is extremely poor.</p> </section> <section> <h3> Aim</h3> <p>Although the prevention of metastasis and the development of novel treatments for metastatic cancer are urgent challenges, the molecules contributing to BC metastasis and prognosis remain largely unknown. This study aimed to identify and analyze novel therapeutic target molecules for metastatic BC.</p> </section> <section> <h3> Materials and Methods</h3> <p>We collected gene expression datasets for BC cell lines from Gene Expression Omnibus and selected genes highly expressed in advanced BC cell lines. We also extracted genes highly expressed in metastatic BC patients from The Cancer Genome Atlas. We performed integrated analysis on these genes and combined it with Kaplan-Meier analysis to identify genes involved in BC progression. The results revealed that CDH11 is involved in bladder cancer progression. We established CDH11 knockdown (KD) using shRNA in advanced bladder cancer cell lines and performed analyses of cell proliferation, invasion, and migration; gene expression analysis via RNA-seq; tumor formation via xenografts; metabolic analysis using the Flux analyzer; and therapeutic effect analysis using low-molecular-weight compounds.</p> </section> <section> <h3> Results</h3> <p>While CDH11 KD did not alter cell proliferation, invasion, or migration in vitro, CDH11 KD significantly suppressed tumor growth in an in vivo subcutaneous xenograft mouse model. RNA-seq revealed that CDH11 KD cells decreased the expression of genes related to mitochondrial metabolism, and a metabolic flux analyzer confirmed decreased mitochondrial activity in the KD cells. Furthermore, use of a CDH11 inhibitor resulted in decreased mitochondrial activity in vitro, and CDH11 inhibitor resulted in inhibition of tumor growth in vivo.</p> </section> <section> <h3> Discussion</h3> <p>Our findings suggest that CDH11 is highly expressed in advanced BC and may regulate the TME by interacting with other cell types and regulating mitochondrial energy metabolism.</p> </section> <section> <h3> Conclusion</h3>
{"title":"CDH11 Contributes to Bladder Cancer Progression via Regulation of Mitochondrial Energy Metabolism","authors":"Osuke Arai, Yuta Yanagihara, Haruna Arai, Ryuta Watanabe, Noriyoshi Miura, Tadahiko Kikugawa, Takashi Saika, Yuuki Imai","doi":"10.1002/cam4.71399","DOIUrl":"https://doi.org/10.1002/cam4.71399","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Approximately 83,000 new cases of bladder cancer (BC) in the United States and 23,000 in Japan are confirmed per year, and the number of new BC cases increases every year. While the prognosis for localized cancer is favorable, treatment options for metastatic cancer are limited, and the prognosis is extremely poor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although the prevention of metastasis and the development of novel treatments for metastatic cancer are urgent challenges, the molecules contributing to BC metastasis and prognosis remain largely unknown. This study aimed to identify and analyze novel therapeutic target molecules for metastatic BC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We collected gene expression datasets for BC cell lines from Gene Expression Omnibus and selected genes highly expressed in advanced BC cell lines. We also extracted genes highly expressed in metastatic BC patients from The Cancer Genome Atlas. We performed integrated analysis on these genes and combined it with Kaplan-Meier analysis to identify genes involved in BC progression. The results revealed that CDH11 is involved in bladder cancer progression. We established CDH11 knockdown (KD) using shRNA in advanced bladder cancer cell lines and performed analyses of cell proliferation, invasion, and migration; gene expression analysis via RNA-seq; tumor formation via xenografts; metabolic analysis using the Flux analyzer; and therapeutic effect analysis using low-molecular-weight compounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>While CDH11 KD did not alter cell proliferation, invasion, or migration in vitro, CDH11 KD significantly suppressed tumor growth in an in vivo subcutaneous xenograft mouse model. RNA-seq revealed that CDH11 KD cells decreased the expression of genes related to mitochondrial metabolism, and a metabolic flux analyzer confirmed decreased mitochondrial activity in the KD cells. Furthermore, use of a CDH11 inhibitor resulted in decreased mitochondrial activity in vitro, and CDH11 inhibitor resulted in inhibition of tumor growth in vivo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings suggest that CDH11 is highly expressed in advanced BC and may regulate the TME by interacting with other cell types and regulating mitochondrial energy metabolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 ","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547251","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}
Clément Grosnon, Lauren Seknazi, Djamel Ghebriou, Anne Sabaila, David Buob, Mariana Nedelcu, Marjolaine Le Gac, Mathieu Jamelot, Coralie Prebet, Jean-Pierre Lotz, Joseph Gligorov, Marc-Antoine Benderra
Introduction
The Oncotype DX Breast Recurrence Score test was designed for HR+, HER2− early breast cancer (eBC) to assist in the decision-making process for de-escalating adjuvant chemotherapy (CT). Its validity and utility have been demonstrated prospectively across multiple studies, though data on older patients remain limited.
Methods
This prospective cohort study included patients over 70 years with eBC treated between 2018 and 2023 at Tenon Hospital, Paris, France. Characteristics of populations eligible for the test and those with RS ≤ or > 25 were collected, along with oncogeriatric assessment and treatments; statistical analysis was performed for IDFS and OS.
Results
Of the 365 patients > 70 years, mean age was 77.6 years (range 70–96), with 84.4% diagnosed with HR+/HER2− eBC. Oncotype DX testing was performed in 85 patients (27.9% of HR+/HER2− eBC), revealing a Recurrence Score (RS) result > 25 in 14 patients (15%). The RS > 25 group had more grade 3 tumors, more pT2 tumors, and a higher Ki67 > 20%. In the RS > 25 group, 9 patients (64%) had oncogeriatric consultations, and 7 (50%) started the recommended adjuvant CT. Four patients received taxane-cyclophosphamide (TC) and 3 adriamycin-cyclophosphamide-taxane (AC-T), with 2 discontinuing due to taxane-induced neuropathy. Median IDFS was significantly lower in the RS > 25 group (p = 0.0023), with 4 of 5 recurrences occurring in patients who did not receive adjuvant CT. OS showed no significant difference by RS group (p = 0.87).
Conclusion
This observational study highlights that the Oncotype DX test supports therapeutic de-escalation in patients with RS ≤ 25 and serves as a prognostic marker. Oncogeriatric evaluations are essential to guide adjuvant treatments in older breast cancer patients prior to using genomic signatures.
{"title":"Oncotype Dx Breast Cancer Assay in Older Patients: A Real Life Cohort","authors":"Clément Grosnon, Lauren Seknazi, Djamel Ghebriou, Anne Sabaila, David Buob, Mariana Nedelcu, Marjolaine Le Gac, Mathieu Jamelot, Coralie Prebet, Jean-Pierre Lotz, Joseph Gligorov, Marc-Antoine Benderra","doi":"10.1002/cam4.71386","DOIUrl":"https://doi.org/10.1002/cam4.71386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Oncotype DX Breast Recurrence Score test was designed for HR+, HER2− early breast cancer (eBC) to assist in the decision-making process for de-escalating adjuvant chemotherapy (CT). Its validity and utility have been demonstrated prospectively across multiple studies, though data on older patients remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study included patients over 70 years with eBC treated between 2018 and 2023 at Tenon Hospital, Paris, France. Characteristics of populations eligible for the test and those with RS ≤ or > 25 were collected, along with oncogeriatric assessment and treatments; statistical analysis was performed for IDFS and OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 365 patients > 70 years, mean age was 77.6 years (range 70–96), with 84.4% diagnosed with HR+/HER2− eBC. Oncotype DX testing was performed in 85 patients (27.9% of HR+/HER2− eBC), revealing a Recurrence Score (RS) result > 25 in 14 patients (15%). The RS > 25 group had more grade 3 tumors, more pT2 tumors, and a higher Ki67 > 20%. In the RS > 25 group, 9 patients (64%) had oncogeriatric consultations, and 7 (50%) started the recommended adjuvant CT. Four patients received taxane-cyclophosphamide (TC) and 3 adriamycin-cyclophosphamide-taxane (AC-T), with 2 discontinuing due to taxane-induced neuropathy. Median IDFS was significantly lower in the RS > 25 group (<i>p</i> = 0.0023), with 4 of 5 recurrences occurring in patients who did not receive adjuvant CT. OS showed no significant difference by RS group (<i>p</i> = 0.87).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This observational study highlights that the Oncotype DX test supports therapeutic de-escalation in patients with RS ≤ 25 and serves as a prognostic marker. Oncogeriatric evaluations are essential to guide adjuvant treatments in older breast cancer patients prior to using genomic signatures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 22","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547205","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号