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New immigration laws could undermine cancer research in the UK. 新移民法可能会削弱英国的癌症研究。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-01 DOI: 10.1016/S1470-2045(24)00436-4
Karl Gruber
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引用次数: 0
Ending financial discrimination for cancer survivors: embedding the Right to be Forgotten in legislation across Europe. 消除对癌症幸存者的经济歧视:将 "被遗忘权 "纳入欧洲各国立法。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI: 10.1016/S1470-2045(24)00312-7
Mark Lawler, Grazia Scocca, Françoise Meunier
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引用次数: 0
Peru advances towards universal health care for patients with cancer. 秘鲁在为癌症患者提供全民医疗保健方面取得进展。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-16 DOI: 10.1016/S1470-2045(24)00445-5
Talha Burki
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引用次数: 0
Adaptive radiotherapy (up to 74 Gy) or standard radiotherapy (66 Gy) for patients with stage III non-small-cell lung cancer, according to [18F]FDG-PET tumour residual uptake at 42 Gy (RTEP7-IFCT-1402): a multicentre, randomised, controlled phase 2 trial. 根据 42 Gy 时[18F]FDG-PET 肿瘤残留摄取量,为 III 期非小细胞肺癌患者提供适应性放疗(最高 74 Gy)或标准放疗(66 Gy)(RTEP7-IFCT-1402):一项多中心、随机对照 2 期试验。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-09 DOI: 10.1016/S1470-2045(24)00320-6
Pierre Vera, Sébastien Thureau, Florence Le Tinier, Philippe Chaumet-Riffaud, Sébastien Hapdey, Hélène Kolesnikov-Gauthier, Etienne Martin, Alina Berriolo-Riedinger, Nicolas Pourel, Jean Marc Broglia, Pierre Boissellier, Sophie Guillemard, Naji Salem, Isabelle Brenot-Rossi, Cécile Le Péchoux, Céline Berthold, Etienne Giroux-Leprieur, Damien Moreau, Sophie Guillerm, Khadija Benali, Laurent Tessonnier, Clarisse Audigier-Valette, Delphine Lerouge, Elske Quak, Carole Massabeau, Frédéric Courbon, Patricia Moisson, Anne Larrouy, Romain Modzelewski, Pierrick Gouel, Nadia Ghazzar, Alexandra Langlais, Elodie Amour, Gérard Zalcman, Philippe Giraud
<p><strong>Background: </strong>Thoracic radiation intensification is debated in patients with stage III non-small-cell lung cancer (NSCLC). We aimed to assess the activity and safety of a boost radiotherapy dose up to 74 Gy in a functional sub-volume given according to on-treatment [<sup>18</sup>F]fluorodeoxyglucose ([<sup>18</sup>F]FDG)-PET results.</p><p><strong>Methods: </strong>In this multicentre, randomised, controlled non-comparative phase 2 trial, we recruited patients aged 18 years or older with inoperable stage III NSCLC without EGFR mutation or ALK rearrangement with an Eastern Cooperative Oncology Group performance status of 0-1, and who were affiliated with or a beneficiary of a social benefit system, with evaluable tumour or node lesions, preserved lung function, and who were amenable to curative-intent radiochemotherapy. Patients were randomly allocated using a central interactive web-response system in a non-masked method (1:1; minimisation method used [random factor of 0·8]; stratified by radiotherapy technique [intensity-modulated radiotherapy vs three-dimensional conformal radiotherapy] and by centre at which patients were treated) either to the experimental adaptive radiotherapy group A, in which only patients with positive residual metabolism on [<sup>18</sup>F]FDG-PET at 42 Gy received a boost radiotherapy (up to 74 Gy in 33 fractions), with all other patients receiving standard radiotherapy dosing (66 Gy in 33 fractions over 6·5 weeks), or to the standard radiotherapy group B (66 Gy in 33 fractions) over 6·5 weeks. All patients received two cycles of induction platinum-based chemotherapy cycles (paclitaxel 175 mg/m<sup>2</sup> intravenously once every 3 weeks and carboplatin area under the curve [AUC]=6 once every 3 weeks, or cisplatin 80 mg/m<sup>2</sup> intravenously once every 3 weeks and vinorelbine 30 mg/m<sup>2</sup> intravenously on day 1 and 60 mg/m<sup>2</sup> orally [or 30 mg/m<sup>2</sup> intravenously] on day 8 once every 3 weeks). Then they concomitantly received radiochemotherapy with platinum-based chemotherapy (three cycles for 8 weeks, with once per week paclitaxel 40 mg/m<sup>2</sup> intravenously and carboplatin AUC=2 or cisplatin 80 mg/m<sup>2</sup> intravenously and vinorelbine 20 mg/m<sup>2</sup> intravenously on day 1 and 40 mg/m<sup>2</sup> orally (or 20 mg/m<sup>2</sup> intravenously) on day 8 in 21-day cycles). The primary endpoint was the 15-month local control rate in the eligible patients who received at least one dose of concomitant radiochemotherapy. This RTEP7-IFCT-1402 trial is registered with ClinicalTrials.gov (NCT02473133), and is ongoing.</p><p><strong>Findings: </strong>From Nov 12, 2015, to July 7, 2021, we randomly assigned 158 patients (47 [30%] women and 111 [70%] men) to either the boosted radiotherapy group A (81 [51%]) or to the standard radiotherapy group B (77 [49%)]. In group A, 80 (99%) patients received induction chemotherapy and 68 (84%) received radiochemotherapy, of whom
背景:对于III期非小细胞肺癌(NSCLC)患者的胸腔放射强化治疗存在争议。我们的目的是根据治疗时[18F]氟脱氧葡萄糖([18F]FDG)-PET的结果,评估在功能亚体积内给予最高74Gy增强放疗剂量的活性和安全性:在这项多中心、随机对照、非比较性2期试验中,我们招募了年龄在18岁或18岁以上、无法手术的III期NSCLC患者,这些患者没有表皮生长因子受体(EGFR)突变或ALK重排,东方合作肿瘤学组(Eastern Cooperative Oncology Group)的表现状态为0-1级,隶属于社会福利系统或为社会福利系统的受益人,有可评估的肿瘤或结节病变,肺功能保留,可接受以治愈为目的的放化疗。患者通过中央交互式网络应答系统以非掩蔽方式进行随机分配(1:1;采用最小化方法[随机因子为0-8];根据放疗技术[调强放疗与三维适形放疗]和患者接受治疗的中心进行分层)分配到实验性自适应放疗A组,其中只有[18F]FDG-PET检测结果为42 Gy的残留代谢阳性患者接受增强放疗(33次分次,每次最多74 Gy),其他患者接受标准放疗剂量(66 Gy,33次分次,每次6-5周);或分配到标准放疗B组(66 Gy,33次分次,每次6-5周)。所有患者均接受两个周期的铂类诱导化疗(紫杉醇 175 mg/m2 静脉注射,每 3 周一次,卡铂曲线下面积 [AUC]=6 每 3 周一次;或顺铂 80 mg/m2 静脉注射,每 3 周一次,长春瑞滨 30 mg/m2 静脉注射,第 1 天口服 60 mg/m2 [或 30 mg/m2 静脉注射],第 8 天口服 60 mg/m2 [或 30 mg/m2 静脉注射],每 3 周一次)。然后,他们同时接受放射化疗和铂类化疗(三个周期,共 8 周,每周一次,紫杉醇 40 毫克/平方米静脉注射,卡铂 AUC=2 或顺铂 80 毫克/平方米静脉注射,长春瑞滨 20 毫克/平方米静脉注射,第 1 天口服 40 毫克/平方米(或 20 毫克/平方米静脉注射),第 8 天口服 40 毫克/平方米(或 20 毫克/平方米静脉注射),21 天为一个周期)。主要终点是至少同时接受一次放化疗的合格患者15个月的局部控制率。这项RTEP7-IFCT-1402试验已在ClinicalTrials.gov(NCT02473133)注册,目前正在进行中:从2015年11月12日至2021年7月7日,我们将158名患者(女性47人[30%],男性111人[70%])随机分配到增强放疗A组(81人[51%])或标准放疗B组(77人[49%])。在 A 组中,80 名患者(99%)接受了诱导化疗,68 名患者(84%)接受了放化疗,其中 48 名患者(71%)在 42 Gy 后仍有[18F]FDG-PET 摄取,接受了增强放疗。在 B 组中,所有 77 名患者都接受了诱导化疗,73 人(95%)接受了放化疗。最终分析结果显示,接受放化疗的合格患者(n=140)的中位随访时间为 45-1 个月(95% CI 39-3-48-3)。A组68名患者中有20名(29%)和B组73名患者中有33名(45%)出现急性(放化疗开始后90天内)3-4级不良事件,其中A组有5名(7%)和B组有10名(14%)患者出现严重不良事件。最常见的 3-4 级不良事件是发热性中性粒细胞减少(A 组 68 人中有 7 人[10%],B 组 73 人中有 16 人[22%])和贫血(5 人[7%],9 人[12%])。在急性期,B组有两人死亡(3%)(一人死于与化疗有关的脓毒性休克,另一人死于与研究治疗无关的血型异常),A组无死亡病例。90天后,A组又有一人死于与治疗无关的疾病,B组有两人死亡(一人死于放射性肺炎,一人死于与治疗无关的肺炎):根据中期[18F]FDG-PET进行的胸部放疗增强可获得有意义的局部控制率,两组在危险器官的不良事件方面没有差异,这与之前的胸部放疗增强尝试不同,因此有必要对III期NSCLC患者在[18F]FDG-PET指导下的放疗剂量调整进行随机3期评估:2014年国家临床研究医院计划。
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引用次数: 0
Enhancing cardiovascular disease risk management in childhood cancer survivors. 加强儿童癌症幸存者的心血管疾病风险管理。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.1016/S1470-2045(24)00346-2
Lan Yang, Jinlong Jiang, Shijie Guo
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引用次数: 0
Multimodality imaging of a large incidental papillary fibroelastoma. 偶发巨大乳头状纤维瘤的多模式成像。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.1016/S1470-2045(24)00392-9
Wiaam Elkhatib, Prajwal Reddy
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引用次数: 0
Trastuzumab deruxtecan in patients with HER2-positive advanced colorectal cancer (DESTINY-CRC02): primary results from a multicentre, randomised, phase 2 trial. 曲妥珠单抗德鲁司坦治疗 HER2 阳性晚期结直肠癌患者(DESTINY-CRC02):一项多中心、随机、2 期试验的初步结果。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-05 DOI: 10.1016/S1470-2045(24)00380-2
Kanwal Raghav, Salvatore Siena, Atsuo Takashima, Takeshi Kato, Marc Van den Eynde, Filippo Pietrantonio, Yoshito Komatsu, Hisato Kawakami, Marc Peeters, Thierry Andre, Sara Lonardi, Kensei Yamaguchi, Jeanne Tie, Cristina Gravalos Castro, Hung-Chih Hsu, John H Strickler, Tae-You Kim, Yongjun Cha, Daniel Barrios, Qi Yan, Takahiro Kamio, Kojiro Kobayashi, Aislyn Boran, Makito Koga, John D Allard, Takayuki Yoshino
<p><strong>Background: </strong>Trastuzumab deruxtecan has shown encouraging activity in patients with treatment-refractory HER2-positive, RAS wild-type and BRAF wild-type metastatic colorectal cancer. Dose optimisation and further antitumour assessments in patients with RAS mutations and those with previous anti-HER2 therapy are warranted. We aimed to evaluate two doses of trastuzumab deruxtecan (5·4 mg/kg and 6·4 mg/kg) to establish the recommended dose in patients with pretreated HER2-positive, RAS wild-type or mutant metastatic colorectal cancer.</p><p><strong>Methods: </strong>DESTINY-CRC02 was a multicentre, randomised, two-stage, two-arm, phase 2 study done in 53 research hospitals and medical centres in Australia, Belgium, France, Italy, Japan, South Korea, Spain, Taiwan, the UK, and the USA. Eligible patients were aged 18 years and older or 20 years and older (depending on region) with pretreated pathologically documented, unresectable, recurrent, or metastatic HER2-positive, and RAS wild-type or mutant colorectal cancer. Patients were required to have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 and have received previous chemotherapy, and anti-EGFR, anti-VEGF, or anti-PD-L1 therapy, if clinically indicated. In stage 1, patients were randomly assigned (1:1), via a secure interactive response technology system, to receive 5·4 mg/kg or 6·4 mg/kg trastuzumab deruxtecan administered intravenously every 21 days. Stratification factors were ECOG performance status, HER2 status, and RAS status. In stage 2, patients were assigned into the 5·4 mg/kg treatment group only. The primary endpoint was confirmed objective response rate by blinded independent central review, assessed in all patients for whom treatment was assigned (full analysis set). Safety was assessed in all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, NCT04744831, and is ongoing (not recruiting).</p><p><strong>Findings: </strong>Between March 5, 2021, and March 29, 2022, 135 patients were centrally screened, 122 of whom were enrolled. In stage 1, 40 patients each were randomly assigned to receive trastuzumab deruxtecan 5·4 mg/kg and 6·4 mg/kg. In stage 2, an additional 42 patients were enrolled in the 5·4 mg/kg group. 64 (52%) participants were male and 58 (48%) were female. The median duration of follow-up was 8·9 months (IQR 6·7-10·5) in the 5·4 mg/kg group and 10·3 months (5·9-12·7) in the 6·4 mg/kg group. The confirmed objective response rate by blinded independent central review was 37·8% (31/82 [95% CI 27·3-49·2]) in the 5·4 mg/kg group and 27·5% (11/40 [14·6-43·9]) in the 6·4 mg/kg group. 34 (41%) of 83 patients in the 5·4 mg/kg group and 19 (49%) of 39 in the 6·4 mg/kg group had grade 3 or worse drug-related treatment-emergent adverse events. The most common grade 3 or worse drug-related treatment-emergent adverse events were neutrophil count decreased (13 [16%] of 83 patients), anaemia
背景:曲妥珠单抗德鲁司坦在治疗难治性 HER2 阳性、RAS 野生型和 BRAF 野生型转移性结直肠癌患者中显示出令人鼓舞的活性。有必要对RAS突变患者和既往接受过抗HER2治疗的患者进行剂量优化和进一步的抗肿瘤评估。我们旨在评估两种剂量的曲妥珠单抗德鲁司坦(5-4 mg/kg和6-4 mg/kg),以确定HER2阳性、RAS野生型或突变型转移性结直肠癌患者的推荐剂量:DESTINY-CRC02是一项多中心、随机、两阶段、两臂、二期研究,在澳大利亚、比利时、法国、意大利、日本、韩国、西班牙、台湾、英国和美国的53家研究医院和医疗中心进行。符合条件的患者年龄在 18 岁及以上或 20 岁及以上(视地区而定),病理记录显示为不可切除、复发或转移性 HER2 阳性、RAS 野生型或突变型结直肠癌。患者的东部合作肿瘤学组(ECOG)表现为 0 或 1,既往接受过化疗,并在有临床指征的情况下接受过抗 EGFR、抗 VEGF 或抗 PD-L1 治疗。在第一阶段,患者通过安全互动反应技术系统随机分配(1:1)接受每21天静脉注射5-4 mg/kg或6-4 mg/kg曲妥珠单抗。分层因素包括 ECOG 表现状态、HER2 状态和 RAS 状态。在第二阶段,患者仅被分配到5-4 mg/kg治疗组。主要终点是通过盲法独立中央审查确认的客观反应率,评估对象是所有接受治疗的患者(完整分析集)。对所有至少接受过一次治疗的患者进行了安全性评估。该试验已在 ClinicalTrials.gov 注册,编号为 NCT04744831,目前正在进行中(未招募):2021年3月5日至2022年3月29日期间,集中筛选了135名患者,其中122人被纳入。在第一阶段,随机分配40名患者分别接受5-4毫克/千克和6-4毫克/千克的曲妥珠单抗德鲁司坦治疗。在第二阶段,又有42名患者被纳入5-4毫克/千克组。64名参与者(52%)为男性,58名参与者(48%)为女性。5-4 mg/kg组的中位随访时间为8-9个月(IQR为6-7-10-5),6-4 mg/kg组为10-3个月(5-9-12-7)。经盲法独立中央审查确认的客观反应率为:5-4 mg/kg组37-8%(31/82 [95% CI 27-3-49-2]),6-4 mg/kg组27-5%(11/40 [14-6-43-9])。5-4 mg/kg组83名患者中有34名(41%)和6-4 mg/kg组39名患者中有19名(49%)出现了3级或更严重的药物相关治疗突发不良事件。在5-4毫克/千克组中,最常见的3级或更严重的药物相关治疗突发不良事件是中性粒细胞计数减少(83名患者中有13人[16%])、贫血(6人[7%])、恶心(6人[7%])和白细胞计数减少(5人[6%]);中性粒细胞计数减少(39 名患者中有 10 人[26%])、贫血(8 人[21%])、血小板计数减少(4 人[10%])和白细胞计数减少(4 人[10%])。在5-4毫克/千克组的83名患者中,有11人(13%)发生了与药物相关的严重不良事件;在6-4毫克/千克组的39名患者中,有6人(15%)发生了与药物相关的严重不良事件;在5-4毫克/千克组,最常见的不良事件是恶心(3人[4%]),在6-4毫克/千克组,最常见的不良事件是疲劳(2人[5%])、中性粒细胞减少(2人[5%])和血小板减少(2人[5%])。5-4毫克/千克组有一名(1%)患者发生了与药物相关的治疗突发不良事件,导致死亡(肝功能衰竭)。5-4毫克/千克组有7名患者(8%)发生了与药物相关的间质性肺病或肺炎事件(均为1级或2级),6-4毫克/千克组有5名患者(13%)发生了与药物相关的间质性肺病或肺炎事件(4例为1级或2级,1例为5级):曲妥珠单抗德鲁司坦5-4毫克/千克的抗肿瘤活性和良好的安全性支持将其作为HER2阳性转移性结直肠癌预处理患者的最佳单药剂量,包括RAS突变、既往接受过抗HER2治疗或两者兼有的患者:资金来源:第一三共公司和阿斯利康公司。
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引用次数: 0
Disappointment facing patients with breast cancer as trastuzumab deruxtecan too expensive for NHS. 由于曲妥珠单抗德鲁司坦对国民医疗服务体系而言过于昂贵,乳腺癌患者面临失望。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-08 DOI: 10.1016/S1470-2045(24)00446-7
Elizabeth Gourd
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引用次数: 0
Legacies of conflict and humanitarian crises on cancer care. 冲突和人道主义危机对癌症护理的影响。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.1016/S1470-2045(24)00453-4
The Lancet Oncology
{"title":"Legacies of conflict and humanitarian crises on cancer care.","authors":"The Lancet Oncology","doi":"10.1016/S1470-2045(24)00453-4","DOIUrl":"https://doi.org/10.1016/S1470-2045(24)00453-4","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":"25 9","pages":"1103"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108848","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}
引用次数: 0
Measuring success of adjuvant treatment for patients with melanoma. 衡量黑色素瘤患者辅助治疗的成功率。
IF 41.6 1区 医学 Q1 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-12 DOI: 10.1016/S1470-2045(24)00372-3
Brent O'Carrigan, Pippa G Corrie
{"title":"Measuring success of adjuvant treatment for patients with melanoma.","authors":"Brent O'Carrigan, Pippa G Corrie","doi":"10.1016/S1470-2045(24)00372-3","DOIUrl":"10.1016/S1470-2045(24)00372-3","url":null,"abstract":"","PeriodicalId":17942,"journal":{"name":"Lancet Oncology","volume":" ","pages":"1109-1110"},"PeriodicalIF":41.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988302","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}
引用次数: 0
期刊
Lancet Oncology
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