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Fertility-sparing treatment and follow-up in patients with cervical cancer, ovarian cancer, and borderline ovarian tumours: guidelines from ESGO, ESHRE, and ESGE. 宫颈癌、卵巢癌和边缘性卵巢肿瘤患者的保胎治疗和随访:ESGO、ESHRE 和 ESGE 指南。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-08-28 DOI: 10.1016/S1470-2045(24)00262-6
Philippe Morice, Giovanni Scambia, Nadeem R Abu-Rustum, Maribel Acien, Alessandro Arena, Sara Brucker, Ying Cheong, Pierre Collinet, Francesco Fanfani, Francesca Filippi, Ane Gerda Zahl Eriksson, Sebastien Gouy, Philipp Harter, Xavier Matias-Guiu, George Pados, Maja Pakiz, Denis Querleu, Alexandros Rodolakis, Christine Rousset-Jablonski, Artem Stepanyan, Antonia Carla Testa, Kirsten Tryde Macklon, Dimitrios Tsolakidis, Michel De Vos, François Planchamp, Michaël Grynberg

The European Society of Gynaecological Oncology, the European Society of Human Reproduction and Embryology, and the European Society for Gynaecological Endoscopy jointly developed clinically relevant and evidence-based guidelines focusing on key aspects of fertility-sparing strategies and follow-up of patients with cervical cancers, ovarian cancers, and borderline ovarian tumours. The developmental process of these guidelines is based on a systematic literature review and critical appraisal involving an international multidisciplinary development group consisting of 25 experts from relevant disciplines (ie, gynaecological oncology, oncofertility, reproductive surgery, endoscopy, imaging, conservative surgery, medical oncology, and histopathology). Before publication, the guidelines were reviewed by 121 independent international practitioners in cancer care delivery and patient representatives. The guidelines comprehensively cover oncological aspects of fertility-sparing strategies during the initial management, optimisation of fertility results and infertility management, and the patient's desire for future pregnancy and beyond.

欧洲妇科肿瘤学会、欧洲人类生殖与胚胎学学会和欧洲妇科内镜学会联合制定了与临床相关的循证指南,重点关注宫颈癌、卵巢癌和边缘卵巢肿瘤患者的保胎策略和随访的关键环节。这些指南的制定过程以系统的文献回顾和批判性评估为基础,由来自相关学科(即妇科肿瘤学、不孕症、生殖外科、内窥镜、影像学、保守性手术、肿瘤内科学和组织病理学)的 25 位专家组成的国际多学科制定小组参与其中。指南出版前,121 位独立的国际癌症治疗从业人员和患者代表对指南进行了审阅。该指南全面涵盖了初期治疗、生育结果优化和不孕不育管理以及患者对未来怀孕及其他方面的愿望等方面的肿瘤保留生育策略。
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引用次数: 0
President Biden taking Cancer Moonshot global. 拜登总统将 "癌症专项行动 "推向全球。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-26 DOI: 10.1016/S1470-2045(24)00534-5
Sharmila Devi
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引用次数: 0
AACR highlights advances and threats to US cancer research. AACR 强调了美国癌症研究的进步和威胁。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-27 DOI: 10.1016/S1470-2045(24)00535-7
Tony Kirby
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引用次数: 0
Organisations withdraw from cancer conference over tobacco link. 各组织因与烟草有关而退出癌症会议。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-09-26 DOI: 10.1016/S1470-2045(24)00533-3
Emma Wilkinson
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引用次数: 0
European Commission approval for Dutch investment in radiopharmaceuticals. 欧盟委员会批准荷兰投资放射性药物。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-05 DOI: 10.1016/S1470-2045(24)00496-0
Karl Gruber
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引用次数: 0
World's first lung cancer vaccine trial launched in the UK. 全球首个肺癌疫苗试验在英国启动。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-30 DOI: 10.1016/S1470-2045(24)00324-3
Elizabeth Gourd
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引用次数: 0
Belzutifan for patients with von Hippel-Lindau disease-associated CNS haemangioblastomas (LITESPARK-004): a multicentre, single-arm, phase 2 study. 贝珠替凡治疗von Hippel-Lindau病相关中枢神经系统血管母细胞瘤(LITESPARK-004):一项多中心、单臂、2期研究。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-13 DOI: 10.1016/S1470-2045(24)00389-9
Othon Iliopoulos, Ane B Iversen, Vivek Narayan, Benjamin L Maughan, Kathryn E Beckermann, Stephane Oudard, Tobias Else, Jodi K Maranchie, Cynthia Muller Goldberg, Wei Fu, Rodolfo F Perini, Yanfang Liu, W Marston Linehan, Ramaprasad Srinivasan, Eric Jonasch
<p><strong>Background: </strong>The first-in-class hypoxia-inducible factor-2α inhibitor, belzutifan, showed clinically meaningful antitumour activity in von Hippel-Lindau (VHL) disease-associated neoplasms in the ongoing, single-arm, phase 2 LITESPARK-004 study. We aimed to investigate antitumour activity with an additional 16 months of follow-up and present updated results for the subgroup of patients with CNS haemangioblastomas.</p><p><strong>Methods: </strong>In the multicentre, single-arm, phase 2 LITESPARK-004 study, adults (aged ≥18 years) from 11 cancer centres or hospitals in the USA, Denmark, France, and the UK, with germline VHL alterations, at least one measurable renal cell carcinoma tumour, no renal cell carcinoma tumour greater than 3 cm requiring immediate surgical intervention, an Eastern Cooperative Oncology Group performance status 0 or 1, and no previous systemic therapy received oral belzutifan 120 mg once daily until unacceptable toxicity, disease progression, or patient decision to withdraw. The primary endpoint, evaluated in patients with CNS haemangioblastomas, was the proportion of patients with an objective response per RECIST version 1.1 by an independent review committee. We assessed response using two approaches. In approach 1, we evaluated all measurable (≥1 cm maximum diameter) or non-measurable lesions at baseline, including both the solid lesion and the associated cystic component if present. In approach 2, we evaluated only baseline lesions with a measurable (≥1 cm maximum diameter) solid lesion. Antitumour activity was assessed in all patients who received at least one dose of belzutifan. This study is no longer recruiting but is ongoing, and is registered with Clinicaltrials.gov, NCT03401788.</p><p><strong>Findings: </strong>Between May 31, 2018, and March 29, 2019, of 67 patients screened, 61 (32 [52%] male and 29 [48%] female) were enrolled; 50 (82%) had at least one CNS haemangioblastoma evaluable at baseline (184 total lesions). Median follow-up for the 50 patients with CNS haemangioblastomas was 38·0 months (IQR 36·7-40·1). In approach 1, 22 of 50 patients (44% [95% CI 30-59]) had an objective response. In approach 2, 19 of 25 patients (76% [55-91] had an objective response. 23 (46%) of 50 patients had a grade 3-5 all-cause adverse event. 19 (38%) patients reported grade 3 adverse events, the most common of which was anaemia (in 6 [12%] patients). Two of 50 patients (4%) reported grade 4 events (retinal vein occlusion and embolism). Two patients died owing to adverse events not considered treatment-related (suicide and toxicity to various agents).</p><p><strong>Interpretation: </strong>Belzutifan showed meaningful antitumour activity in VHL disease-associated CNS haemangioblastomas that was sustained for more than 3 years of treatment. These results continue to support belzutifan as a systemic treatment option for patients with VHL disease-related CNS haemangioblastomas.</p><p><strong>Funding: </strong>Me
背景:在正在进行的单臂2期LITESPARK-004研究中,第一类低氧诱导因子-2α抑制剂belzutifan显示了对von Hippel-Lindau(VHL)疾病相关肿瘤有临床意义的抗肿瘤活性。我们的目的是在额外16个月的随访中研究抗肿瘤活性,并提供中枢神经系统血管母细胞瘤患者亚组的最新结果:在多中心、单臂、2 期 LITESPARK-004 研究中,来自美国、丹麦、法国和英国 11 家癌症中心或医院的成年人(年龄≥18 岁)均接受了治疗、接受口服贝珠替凡 120 毫克,每天一次,直至出现不可接受的毒性反应、疾病进展或患者决定退出为止。主要终点是中枢神经系统血管母细胞瘤患者的客观反应比例,由独立评审委员会根据 RECIST 1.1 版进行评估。我们采用两种方法评估反应。在方法 1 中,我们评估了基线时所有可测量(最大直径≥1 厘米)或不可测量的病灶,包括实体瘤和相关囊性成分(如果存在)。在方法 2 中,我们只评估了基线病灶中可测量(最大直径≥1 厘米)的实体病灶。我们对所有至少接受过一次贝珠替凡治疗的患者进行了抗肿瘤活性评估。该研究已停止招募,但仍在进行中,已在Clinicaltrials.gov注册,编号为NCT03401788.研究结果:2018年5月31日至2019年3月29日期间,在67名接受筛查的患者中,有61名(32[52%]名男性和29[48%]名女性)入选;50名(82%)患者至少有一个中枢神经系统血管母细胞瘤可在基线时进行评估(病灶总数为184个)。50 名中枢神经系统血管母细胞瘤患者的中位随访时间为 38-0 个月(IQR 36-7-40-1)。在方法 1 中,50 名患者中有 22 人(44% [95% CI 30-59])获得了客观反应。在方法 2 中,25 例患者中有 19 例(76% [55-91] 有客观反应。50 例患者中有 23 例(46%)发生了 3-5 级全因不良事件。19名患者(38%)报告了3级不良事件,其中最常见的是贫血(6名[12%]患者)。50 名患者中有 2 名(4%)报告了 4 级不良事件(视网膜静脉闭塞和栓塞)。两名患者死于与治疗无关的不良事件(自杀和各种药物中毒):贝珠替凡对VHL病相关的中枢神经系统血管母细胞瘤显示出有意义的抗肿瘤活性,且持续治疗时间超过3年。这些结果继续支持将belzutifan作为VHL病相关中枢神经系统血管母细胞瘤患者的系统治疗选择:默沙东公司、美国国立卫生研究院和美国国立癌症研究所。
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引用次数: 0
The UK needs to be a leader, not a lagger, in the global cancer effort. 英国需要成为全球癌症防治工作的领导者,而不是落伍者。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-20 DOI: 10.1016/S1470-2045(24)00448-0
Mark Lawler, Ajay Aggarwal, Julie Gralow, Richard Sullivan, Pat Price
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引用次数: 0
Atezolizumab, venetoclax, and obinutuzumab combination in Richter transformation diffuse large B-cell lymphoma (MOLTO): a multicentre, single-arm, phase 2 trial. Atezolizumab、venetoclax和obinutuzumab联合治疗里氏转化弥漫大B细胞淋巴瘤(MOLTO):一项多中心、单臂、2期试验。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-10 DOI: 10.1016/S1470-2045(24)00396-6
Alessandra Tedeschi, Anna Maria Frustaci, Adalgisa Condoluci, Marta Coscia, Roberto Chiarle, Pier Luigi Zinzani, Marina Motta, Gianluca Gaidano, Giulia Quaresmini, Lydia Scarfò, Gioacchino Catania, Marina Deodato, Rebecca Jones, Valentina Tabanelli, Valentina Griggio, Georg Stüssi, Angelica Calleri, Katia Pini, Roberto Cairoli, Thorsten Zenz, Alessio Signori, Emanuele Zucca, Davide Rossi, Marco Montillo
<p><strong>Background: </strong>The diffuse large B-cell lymphoma (DLBCL) variant of Richter transformation (DLBCL-RT) is typically chemoresistant with poor prognosis. Aiming to explore a chemotherapy-free treatment combination that triggers anti-tumour immune responses, we conducted a phase 2 study of atezolizumab (a PD-L1 inhibitor) in combination with venetoclax and obinutuzumab in patients with DLBCL-RT.</p><p><strong>Methods: </strong>This was a prospective, open-label, multicentre, single-arm, investigator-initiated, phase 2 study in 15 hospitals in Italy and Switzerland. Eligible patients had a confirmed diagnosis of chronic lymphocytic leukaemia or small lymphocytic lymphoma as per the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria with biopsy-proven transformation to DLBCL; had not previously received treatment for DLBCL-RT, although they could have received chronic lymphocytic leukaemia therapies; were aged 18 years or older; and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2. No previous treatment with any of the drugs in the triplet combination was allowed. Patients received 35 cycles of 21 days of intravenous obinutuzumab (100 mg on day 1, 900 mg on day 2, 1000 mg on day 8 and day 15 of cycle 1; 1000 mg on day 1 of cycles 2-8) and intravenous atezolizumab (1200 mg on day 2 of cycle 1 and 1200 mg on day 1 of cycles 2-18), and continuous oral venetoclax (ramp-up from 20 mg/day on day 15 of cycle 1 according to chronic lymphocytic leukaemia schedule, then 400 mg/day from day 1 of cycle 3 to day 21 of cycle 35). The primary endpoint was overall response rate at day 21 of cycle 6 in the intention-to-treat population. We considered an overall response rate of 67% or more to be clinically active, rejecting the null hypothesis of a response of 40% or less. The study is registered with ClinicalTrials.gov, NCT04082897, and has been completed.</p><p><strong>Findings: </strong>Between Oct 9, 2019, and Oct 19, 2022, 28 patients were enrolled (12 [43%] male patients and 16 [57%] female patients). Median follow-up was 16·8 months (IQR 7·8-32·0). At cycle 6, 19 of 28 patients showed a response, yielding an overall response rate of 67·9% (95% CI 47·6-84·1). Treatment-emergent adverse events that were grade 3 or worse were reported in 17 (61%; 95% CI 40·6-78·5) of 28 patients, with neutropenia being the most frequent (11 [39%; 21·5-59·4] of 28 patients). Serious treatment-emergent adverse events were reported in eight (29%; 14·2-48·7) patients, which were most commonly infections (five [18%; 6·1-36·9] of 28 patients). There were two (7%) deaths attributable to adverse events during the study: one from sepsis and one from fungal pneumonia, which were not considered as directly treatment-related by the investigators. Six (21·4%) patients had immune-related adverse events, none of which led to discontinuation. No tumour lysis syndrome was observed.</p><p><strong>Interpretation: </strong>The atezol
背景:弥漫大B细胞淋巴瘤(DLBCL)里氏变异型(DLBCL-RT)通常具有化疗耐药性,预后较差。为了探索一种能引发抗肿瘤免疫反应的无化疗联合治疗方法,我们开展了一项阿特珠单抗(PD-L1抑制剂)联合韦尼妥珠单抗和奥比妥珠单抗治疗DLBCL-RT患者的2期研究:这是一项前瞻性、开放标签、多中心、单臂、研究者发起的2期研究,在意大利和瑞士的15家医院进行。符合条件的患者必须根据2008年慢性淋巴细胞白血病国际研讨会(IWCLL)标准确诊为慢性淋巴细胞白血病或小淋巴细胞淋巴瘤,并经活检证实转化为DLBCL;既往未接受过DLBCL-RT治疗,但可能接受过慢性淋巴细胞白血病治疗;年龄在18岁或以上;东部合作肿瘤学组(ECOG)的表现状态为0-2。既往未接受过三联疗法中任何一种药物的治疗。患者接受35个周期、为期21天的静脉注射奥比妥珠单抗(第1周期第1天100毫克,第2周期第2天900毫克,第1周期第8天和第15天1000毫克,第2周期第2-8天1000毫克);第2-8周期第1天1000毫克)和静脉注射atezolizumab(第1周期第2天1200毫克,第2-18周期第1天1200毫克),以及持续口服venetoclax(根据慢性淋巴细胞白血病时间表,从第1周期第15天起每天20毫克,然后从第3周期第1天至第35周期第21天每天400毫克)。主要终点是意向治疗人群中第6周期第21天的总体应答率。我们认为总体应答率达到或超过 67% 即为临床活跃,拒绝应答率达到或低于 40% 的零假设。该研究已在 ClinicalTrials.gov 注册,编号为 NCT04082897,并已完成:2019年10月9日至2022年10月19日期间,28名患者入组(12名[43%]男性患者和16名[57%]女性患者)。中位随访时间为 16-8 个月(IQR 7-8-32-0)。在第 6 个周期,28 例患者中有 19 例出现应答,总应答率为 67-9%(95% CI 47-6-84-1)。28例患者中有17例(61%;95% CI 40-6-78-5)出现3级或更严重的治疗突发不良事件,其中以中性粒细胞减少最为常见(28例患者中有11例[39%;21-5-59-4])。有 8 名患者(29%;14-2-48-7)报告了严重的治疗突发不良事件,其中最常见的是感染(28 名患者中有 5 名[18%;6-1-36-9])。研究期间有两例(7%)死亡病例可归因于不良事件:一例死于败血症,一例死于真菌性肺炎,研究人员认为这与治疗没有直接关系。6名患者(21-4%)出现了免疫相关不良反应,但无一导致停药。未观察到肿瘤溶解综合征:atezolizumab、venetoclax和obinutuzumab三联疗法具有活性和安全性,表明这种无化疗方案可成为DLBCL-RT患者新的一线治疗方法:罗氏公司。
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引用次数: 0
Families of cancer victims wait for benefits decades after the World Trade Center attack. 世贸中心袭击事件发生几十年后,癌症受害者家属仍在等待补助金。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-19 DOI: 10.1016/S1470-2045(24)00526-6
Karl Gruber
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引用次数: 0
期刊
Lancet Oncology
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