Pub Date : 2024-10-01Epub Date: 2024-09-15DOI: 10.1016/S1470-2045(24)00440-6
Arun A Azad, Mathias Bressel, Hsiang Tan, Mark Voskoboynik, Aneta Suder, Andrew J Weickhardt, Alexander Guminski, Roslyn J Francis, Javad Saghebi, Nattakorn Dhiantravan, Anthony M Joshua, Louise Emmett, Lisa Horvath, Declan G Murphy, Edward Hsiao, Bavanthi Balakrishnar, Peter Lin, Andrew Redfern, William Macdonald, Siobhan Ng, Sze-Ting Lee, David A Pattison, David Nadebaum, Ian D Kirkwood, Michael S Hofman
<p><strong>Background: </strong>Lutetium-177 [<sup>177</sup>Lu]Lu-prostate-specific membrane antigen (PSMA)-617 improves survival and quality of life in patients with metastatic castration-resistant prostate cancer, but whether it confers a benefit in hormone-sensitive disease is unknown. We aimed to evaluate [<sup>177</sup>Lu]Lu-PSMA-617 before docetaxel treatment in patients with de-novo high-volume metastatic hormone-sensitive prostate cancer.</p><p><strong>Methods: </strong>UpFrontPSMA was an investigator-initiated, multicentre, open-label, randomised, phase 2 trial done at 11 Australian hospitals. Eligible patients had prostate adenocarcinoma without clinically significant neuroendocrine differentiation or small-cell histology, were aged 18 years or older, had less than 4 weeks on androgen deprivation therapy, had an Eastern Cooperative Oncology Group performance status of 0-2, and had high-volume PSMA-avid disease on [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT with no major discordance on 2-[<sup>18</sup>F] fluorodeoxyglucose-PET-CT. Patients were randomly assigned (1:1) to the experimental treatment ([<sup>177</sup>Lu]Lu-PSMA-617 followed 6 weeks later by docetaxel) or standard-of-care treatment (docetaxel alone) using computer-based block randomisation with random block sizes, stratified by disease volume by conventional imaging and duration of androgen deprivation therapy at the time of registration. Neither patients nor investigators were masked to treatment assignment. Patients in the experimental group received two cycles of [<sup>177</sup>Lu]Lu-PSMA-617 7·5 GBq every 6 weeks intravenously, followed 6 weeks later by six cycles of docetaxel 75 mg/m<sup>2</sup> every 3 weeks intravenously, whereas patients in the standard-of-care treatment group received six cycles of docetaxel 75 mg/m<sup>2</sup> every 3 weeks intravenously. All patients received continuous androgen deprivation therapy. The primary endpoint was undetectable prostate-specific antigen (≤0·2 ng/mL) at 48 weeks, assessed using a modified intention-to-treat analysis. The trial is registered with ClinicalTrials.gov, NCT04343885.</p><p><strong>Findings: </strong>Between May 5, 2020, and April 18, 2023, 130 patients were randomly assigned, 63 (48%) to [<sup>177</sup>Lu]Lu-PSMA-617 plus docetaxel and 67 (52%) to docetaxel alone. All patients were male and no race or ethnicity data were collected. Median follow-up was 2·5 years (IQR 1·8-3·0). Four patients in the docetaxel alone group withdrew consent after randomisation and no data beyond screening were collected. An additional four patients were not evaluable for the primary endpoint at 48 weeks (two in each group). 25 (41%) of 61 patients (95% CI 30-54) in the [<sup>177</sup>Lu]Lu-PSMA-617 plus docetaxel group had undetectable PSA at 48 weeks compared with ten (16%) of 61 patients (9-28) in the docetaxel alone group (OR 3·88, 95% CI 1·61-9·38; p=0·0020). The most common grade 3 or 4 treatment-related adverse events were febrile neutro
背景：镥-177[177Lu]-前列腺特异性膜抗原（PSMA）-617能提高转移性阉割耐药前列腺癌患者的生存率和生活质量，但它是否对激素敏感性疾病有益尚不清楚。我们的目的是在多西他赛治疗前，评估[177Lu]Lu-PSMA-617对新发高容量转移性激素敏感性前列腺癌患者的治疗效果：UpFrontPSMA是一项由研究者发起的多中心、开放标签、随机2期试验，在澳大利亚11家医院进行。符合条件的患者均为前列腺腺癌，无临床上明显的神经内分泌分化或小细胞组织学特征，年龄在18岁或18岁以上，接受雄激素剥夺治疗的时间少于4周，东部合作肿瘤学组表现状态为0-2，[68Ga]Ga-PSMA-11 PET-CT显示为高体积PSMA-avid疾病，2-[18F]氟脱氧葡萄糖-PET-CT显示无重大差异。患者被随机分配（1:1）到实验治疗（[177Lu]Lu-PSMA-617，6 周后再接受多西他赛治疗）或标准治疗（仅接受多西他赛治疗），采用基于计算机的分块随机化，分块大小随机，根据常规成像的疾病体积和登记时雄激素剥夺治疗的持续时间进行分层。患者和研究人员均不对治疗分配进行蒙蔽。实验组患者接受两个周期的[177Lu]Lu-PSMA-617 7-5 GBq治疗，每6周静脉注射一次，6周后再接受6个周期的多西他赛75 mg/m2治疗，每3周静脉注射一次，而标准治疗组患者接受6个周期的多西他赛75 mg/m2治疗，每3周静脉注射一次。所有患者均接受持续雄激素剥夺治疗。主要终点是48周时检测不到前列腺特异性抗原（≤0-2 ng/mL），采用改良意向治疗分析法进行评估。该试验已在ClinicalTrials.gov上注册，编号为NCT04343885.研究结果：2020年5月5日至2023年4月18日期间，130名患者被随机分配，其中63人（48%）接受[177Lu]Lu-PSMA-617联合多西他赛治疗，67人（52%）接受单用多西他赛治疗。所有患者均为男性，未收集种族或民族数据。中位随访时间为 2-5 年（IQR 1-8-3-0）。单用多西他赛组中有四名患者在随机分组后撤回同意，因此未收集筛选后的数据。另有四名患者在 48 周时无法进行主要终点评估（每组各两名）。在[177Lu]Lu-PSMA-617加多西他赛组的61名患者中，有25人（41%）（95% CI 30-54）在48周时检测不到PSA，而在单用多西他赛组的61名患者中，有10人（16%）（9-28）检测不到PSA（OR 3-88，95% CI 1-61-9-38；P=0-0020）。最常见的3级或4级治疗相关不良事件是发热性中性粒细胞减少症（[177Lu]Lu-PSMA-617联合多西他赛组63例患者中7例[11%]与单用多西他赛组63例患者中6例[10%]）和腹泻（63例患者中4例[6%]与无腹泻）。[177Lu]Lu-PSMA-617加多西他赛组（无一例与[177Lu]Lu-PSMA-617明确相关）和单用多西他赛组分别有16例（25%）患者发生严重不良事件。没有发生与治疗相关的死亡病例：与单用多西他赛相比，[177Lu]Lu-PSMA-617联合多西他赛可提高新发高体积转移性激素敏感性前列腺癌患者的抗肿瘤活性，且不会增加毒性反应。我们的数据可能支持[177Lu]Lu-PSMA-617在转移性激素敏感性前列腺癌中发挥作用：前列腺癌研究联盟（Movember 基金会和澳大利亚政府医学研究未来基金）、美国国防部影响奖-临床试验、Endocyte/高级加速器应用公司（诺华公司旗下公司）、澳大利亚核科学技术组织、维多利亚癌症机构、墨尔本大学和彼得-麦克卡勒姆癌症基金会。
{"title":"Sequential [<sup>177</sup>Lu]Lu-PSMA-617 and docetaxel versus docetaxel in patients with metastatic hormone-sensitive prostate cancer (UpFrontPSMA): a multicentre, open-label, randomised, phase 2 study.","authors":"Arun A Azad, Mathias Bressel, Hsiang Tan, Mark Voskoboynik, Aneta Suder, Andrew J Weickhardt, Alexander Guminski, Roslyn J Francis, Javad Saghebi, Nattakorn Dhiantravan, Anthony M Joshua, Louise Emmett, Lisa Horvath, Declan G Murphy, Edward Hsiao, Bavanthi Balakrishnar, Peter Lin, Andrew Redfern, William Macdonald, Siobhan Ng, Sze-Ting Lee, David A Pattison, David Nadebaum, Ian D Kirkwood, Michael S Hofman","doi":"10.1016/S1470-2045(24)00440-6","DOIUrl":"10.1016/S1470-2045(24)00440-6","url":null,"abstract":"<p><strong>Background: </strong>Lutetium-177 [<sup>177</sup>Lu]Lu-prostate-specific membrane antigen (PSMA)-617 improves survival and quality of life in patients with metastatic castration-resistant prostate cancer, but whether it confers a benefit in hormone-sensitive disease is unknown. We aimed to evaluate [<sup>177</sup>Lu]Lu-PSMA-617 before docetaxel treatment in patients with de-novo high-volume metastatic hormone-sensitive prostate cancer.</p><p><strong>Methods: </strong>UpFrontPSMA was an investigator-initiated, multicentre, open-label, randomised, phase 2 trial done at 11 Australian hospitals. Eligible patients had prostate adenocarcinoma without clinically significant neuroendocrine differentiation or small-cell histology, were aged 18 years or older, had less than 4 weeks on androgen deprivation therapy, had an Eastern Cooperative Oncology Group performance status of 0-2, and had high-volume PSMA-avid disease on [<sup>68</sup>Ga]Ga-PSMA-11 PET-CT with no major discordance on 2-[<sup>18</sup>F] fluorodeoxyglucose-PET-CT. Patients were randomly assigned (1:1) to the experimental treatment ([<sup>177</sup>Lu]Lu-PSMA-617 followed 6 weeks later by docetaxel) or standard-of-care treatment (docetaxel alone) using computer-based block randomisation with random block sizes, stratified by disease volume by conventional imaging and duration of androgen deprivation therapy at the time of registration. Neither patients nor investigators were masked to treatment assignment. Patients in the experimental group received two cycles of [<sup>177</sup>Lu]Lu-PSMA-617 7·5 GBq every 6 weeks intravenously, followed 6 weeks later by six cycles of docetaxel 75 mg/m<sup>2</sup> every 3 weeks intravenously, whereas patients in the standard-of-care treatment group received six cycles of docetaxel 75 mg/m<sup>2</sup> every 3 weeks intravenously. All patients received continuous androgen deprivation therapy. The primary endpoint was undetectable prostate-specific antigen (≤0·2 ng/mL) at 48 weeks, assessed using a modified intention-to-treat analysis. The trial is registered with ClinicalTrials.gov, NCT04343885.</p><p><strong>Findings: </strong>Between May 5, 2020, and April 18, 2023, 130 patients were randomly assigned, 63 (48%) to [<sup>177</sup>Lu]Lu-PSMA-617 plus docetaxel and 67 (52%) to docetaxel alone. All patients were male and no race or ethnicity data were collected. Median follow-up was 2·5 years (IQR 1·8-3·0). Four patients in the docetaxel alone group withdrew consent after randomisation and no data beyond screening were collected. An additional four patients were not evaluable for the primary endpoint at 48 weeks (two in each group). 25 (41%) of 61 patients (95% CI 30-54) in the [<sup>177</sup>Lu]Lu-PSMA-617 plus docetaxel group had undetectable PSA at 48 weeks compared with ten (16%) of 61 patients (9-28) in the docetaxel alone group (OR 3·88, 95% CI 1·61-9·38; p=0·0020). The most common grade 3 or 4 treatment-related adverse events were febrile neutro","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1267-1276"},"PeriodicalIF":41.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-09-10DOI: 10.1016/S1470-2045(24)00485-6
Othman Al-Sawaf, Barbara Eichhorst
{"title":"Treatment of Richter transformation-immunotherapy to the rescue?","authors":"Othman Al-Sawaf, Barbara Eichhorst","doi":"10.1016/S1470-2045(24)00485-6","DOIUrl":"10.1016/S1470-2045(24)00485-6","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1248-1249"},"PeriodicalIF":41.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-09-02DOI: 10.1016/S1470-2045(24)00483-2
David Collingridge, Pierre Blanchard
{"title":"Radiation oncology: a call for papers for ESTRO 2025.","authors":"David Collingridge, Pierre Blanchard","doi":"10.1016/S1470-2045(24)00483-2","DOIUrl":"10.1016/S1470-2045(24)00483-2","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1254-1255"},"PeriodicalIF":41.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-25DOI: 10.1016/S1470-2045(24)00433-9
Paul Adepoju
{"title":"Over US$100 million pledged to improve cancer care across Africa.","authors":"Paul Adepoju","doi":"10.1016/S1470-2045(24)00433-9","DOIUrl":"10.1016/S1470-2045(24)00433-9","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1119"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-29DOI: 10.1016/S1470-2045(24)00339-5
Kirsten Bouchelouche, Peter L Choyke
{"title":"Use of PROMISE criteria on PSMA-PET for prediction of overall survival in prostate cancer.","authors":"Kirsten Bouchelouche, Peter L Choyke","doi":"10.1016/S1470-2045(24)00339-5","DOIUrl":"10.1016/S1470-2045(24)00339-5","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1107-1108"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-08-06DOI: 10.1016/S1470-2045(24)00350-4
Jana de Boniface, Matilda Appelgren, Robert Szulkin, Sara Alkner, Yvette Andersson, Leif Bergkvist, Jan Frisell, Oreste Davide Gentilini, Michalis Kontos, Thorsten Kühn, Dan Lundstedt, Birgitte Vrou Offersen, Roger Olofsson Bagge, Toralf Reimer, Malin Sund, Peer Christiansen, Lisa Rydén, Tove Filtenborg Tvedskov
<p><strong>Background: </strong>In luminal breast cancer, adjuvant CDK4/6 inhibitors (eg, abemaciclib) improve invasive disease-free survival. In patients with T1-2, grade 1-2 tumours, and one or two sentinel lymph node metastases, completion axillary lymph node dissection (cALND) is the only prognostic tool available that can reveal four or more nodal metastases (pN2-3), which is the only indication for adjuvant abemaciclib in this setting. However, this technique can lead to substantial arm morbidity in patients. We aimed to pragmatically describe the potential benefit and harm of this strategy on the individual patient level in patients from the ongoing SENOMAC trial.</p><p><strong>Methods: </strong>In the randomised, phase 3, SENOMAC trial, patients aged 18 years or older, of any performance status, with clinically node-negative T1-T3 breast cancer and one or two sentinel node macrometastases from 67 sites in five European countries (Denmark, Germany, Greece, Italy, and Sweden) were randomly assigned (1:1), via permutated block randomisation (random block size of 2 and 4) stratified by country, to either cALND or its omission (ie, they had a sentinel lymph node biopsy only). The primary outcome is overall survival, which is yet to be reported. In this post-hoc analysis, patients from the SENOMAC per-protocol population, with luminal oestrogen-receptor positive, HER2-negative, T1-2, histological grade 1-2 breast cancer, with tumour size of 5 cm or smaller were selected to match the characteristics of cohort 1 of the monarchE trial who would only have an indication for adjuvant abemaciclib if found to have 4 or more nodal metastases. The primary study objective was to determine the number of patients who developed patient-reported severe or very severe impairment of physical arm function after cALND (as measured by the Lymphedema Functioning, Disability, and Health [Lymph-ICF] Questionnaire) 1 year after surgery to avoid one invasive disease-free survival event at 5 years with 2 years of adjuvant abemaciclib, using invasive disease-free survival event data from cohort 1 of the monarchE trial. The SENOMAC trial is registered with ClincialTrials.gov, NCT02240472, and is closed to accrual and ongoing.</p><p><strong>Findings: </strong>Between Jan 31, 2015, and Dec 31, 2021, 2766 patients were enrolled in SENOMAC and randomly assigned to cALND (n=1384) or sentinel node biopsy only (n=1382), of whom 2540 were included in the per-protocol population. 1705 (67%) of 2540 patients met this post-hoc study's eligibility criteria, of whom 802 (47%) had a cALND and 903 (53%) had a sentinel lymph node biopsy only. Median age at randomisation was 62 years (IQR 52-71), 1699 (>99%) of 1705 patients were female, and six (<1%) were male. Among 1342 patients who responded to questionnaires, after a median follow-up of 45·2 months (IQR 25·6-59·8; data cutoff Nov 17, 2023), patient-reported severe or very severe impairment of physical arm function was reported in 84
{"title":"Completion axillary lymph node dissection for the identification of pN2-3 status as an indication for adjuvant CDK4/6 inhibitor treatment: a post-hoc analysis of the randomised, phase 3 SENOMAC trial.","authors":"Jana de Boniface, Matilda Appelgren, Robert Szulkin, Sara Alkner, Yvette Andersson, Leif Bergkvist, Jan Frisell, Oreste Davide Gentilini, Michalis Kontos, Thorsten Kühn, Dan Lundstedt, Birgitte Vrou Offersen, Roger Olofsson Bagge, Toralf Reimer, Malin Sund, Peer Christiansen, Lisa Rydén, Tove Filtenborg Tvedskov","doi":"10.1016/S1470-2045(24)00350-4","DOIUrl":"10.1016/S1470-2045(24)00350-4","url":null,"abstract":"<p><strong>Background: </strong>In luminal breast cancer, adjuvant CDK4/6 inhibitors (eg, abemaciclib) improve invasive disease-free survival. In patients with T1-2, grade 1-2 tumours, and one or two sentinel lymph node metastases, completion axillary lymph node dissection (cALND) is the only prognostic tool available that can reveal four or more nodal metastases (pN2-3), which is the only indication for adjuvant abemaciclib in this setting. However, this technique can lead to substantial arm morbidity in patients. We aimed to pragmatically describe the potential benefit and harm of this strategy on the individual patient level in patients from the ongoing SENOMAC trial.</p><p><strong>Methods: </strong>In the randomised, phase 3, SENOMAC trial, patients aged 18 years or older, of any performance status, with clinically node-negative T1-T3 breast cancer and one or two sentinel node macrometastases from 67 sites in five European countries (Denmark, Germany, Greece, Italy, and Sweden) were randomly assigned (1:1), via permutated block randomisation (random block size of 2 and 4) stratified by country, to either cALND or its omission (ie, they had a sentinel lymph node biopsy only). The primary outcome is overall survival, which is yet to be reported. In this post-hoc analysis, patients from the SENOMAC per-protocol population, with luminal oestrogen-receptor positive, HER2-negative, T1-2, histological grade 1-2 breast cancer, with tumour size of 5 cm or smaller were selected to match the characteristics of cohort 1 of the monarchE trial who would only have an indication for adjuvant abemaciclib if found to have 4 or more nodal metastases. The primary study objective was to determine the number of patients who developed patient-reported severe or very severe impairment of physical arm function after cALND (as measured by the Lymphedema Functioning, Disability, and Health [Lymph-ICF] Questionnaire) 1 year after surgery to avoid one invasive disease-free survival event at 5 years with 2 years of adjuvant abemaciclib, using invasive disease-free survival event data from cohort 1 of the monarchE trial. The SENOMAC trial is registered with ClincialTrials.gov, NCT02240472, and is closed to accrual and ongoing.</p><p><strong>Findings: </strong>Between Jan 31, 2015, and Dec 31, 2021, 2766 patients were enrolled in SENOMAC and randomly assigned to cALND (n=1384) or sentinel node biopsy only (n=1382), of whom 2540 were included in the per-protocol population. 1705 (67%) of 2540 patients met this post-hoc study's eligibility criteria, of whom 802 (47%) had a cALND and 903 (53%) had a sentinel lymph node biopsy only. Median age at randomisation was 62 years (IQR 52-71), 1699 (>99%) of 1705 patients were female, and six (<1%) were male. Among 1342 patients who responded to questionnaires, after a median follow-up of 45·2 months (IQR 25·6-59·8; data cutoff Nov 17, 2023), patient-reported severe or very severe impairment of physical arm function was reported in 84 ","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1222-1230"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-08-07DOI: 10.1016/S1470-2045(24)00403-0
Ryan A Denu, Neeta Somaiah
{"title":"Imatinib in advanced GIST: if it's working, don't stop a good thing.","authors":"Ryan A Denu, Neeta Somaiah","doi":"10.1016/S1470-2045(24)00403-0","DOIUrl":"10.1016/S1470-2045(24)00403-0","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1105-1107"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/S1470-2045(24)00130-X
Philipp Karschnia, Jasper K W Gerritsen, Nico Teske, Daniel P Cahill, Asgeir S Jakola, Martin van den Bent, Michael Weller, Oliver Schnell, Einar O Vik-Mo, Niklas Thon, Arnaud J P E Vincent, Michelle M Kim, Guido Reifenberger, Susan M Chang, Shawn L Hervey-Jumper, Mitchel S Berger, Joerg-Christian Tonn
Glioma resection is associated with prolonged survival, but neuro-oncological trials have frequently refrained from quantifying the extent of resection. The Response Assessment in Neuro-Oncology (RANO) resect group is an international, multidisciplinary group that aims to standardise research practice by delineating the oncological role of surgery in diffuse adult-type gliomas as defined per WHO 2021 classification. Favourable survival effects of more extensive resection unfold over months to decades depending on the molecular tumour profile. In tumours with a more aggressive natural history, supramaximal resection might correlate with additional survival benefit. Weighing the expected survival benefits of resection as dictated by molecular tumour profiles against clinical factors, including the introduction of neurological deficits, we propose an algorithm to estimate the oncological effects of surgery for newly diagnosed gliomas. The algorithm serves to select patients who might benefit most from extensive resection and to emphasise the relevance of quantifying the extent of resection in clinical trials.
{"title":"The oncological role of resection in newly diagnosed diffuse adult-type glioma defined by the WHO 2021 classification: a Review by the RANO resect group.","authors":"Philipp Karschnia, Jasper K W Gerritsen, Nico Teske, Daniel P Cahill, Asgeir S Jakola, Martin van den Bent, Michael Weller, Oliver Schnell, Einar O Vik-Mo, Niklas Thon, Arnaud J P E Vincent, Michelle M Kim, Guido Reifenberger, Susan M Chang, Shawn L Hervey-Jumper, Mitchel S Berger, Joerg-Christian Tonn","doi":"10.1016/S1470-2045(24)00130-X","DOIUrl":"https://doi.org/10.1016/S1470-2045(24)00130-X","url":null,"abstract":"<p><p>Glioma resection is associated with prolonged survival, but neuro-oncological trials have frequently refrained from quantifying the extent of resection. The Response Assessment in Neuro-Oncology (RANO) resect group is an international, multidisciplinary group that aims to standardise research practice by delineating the oncological role of surgery in diffuse adult-type gliomas as defined per WHO 2021 classification. Favourable survival effects of more extensive resection unfold over months to decades depending on the molecular tumour profile. In tumours with a more aggressive natural history, supramaximal resection might correlate with additional survival benefit. Weighing the expected survival benefits of resection as dictated by molecular tumour profiles against clinical factors, including the introduction of neurological deficits, we propose an algorithm to estimate the oncological effects of surgery for newly diagnosed gliomas. The algorithm serves to select patients who might benefit most from extensive resection and to emphasise the relevance of quantifying the extent of resection in clinical trials.</p>","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"25 9","pages":"e404-e419"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-25DOI: 10.1016/S1470-2045(24)00432-7
Karl Gruber
{"title":"Improving cancer control initiatives in Indigenous people.","authors":"Karl Gruber","doi":"10.1016/S1470-2045(24)00432-7","DOIUrl":"10.1016/S1470-2045(24)00432-7","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1117-1118"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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