Pub Date : 2025-01-17DOI: 10.1016/s1470-2045(24)00678-8
Fabio Y Moraes, Andre G Gouveia, Vanessa Freitas Bratti, Edward C Dee, Juliana Fernandes Pavoni, Laura M Carson, Cecília Félix Penido Mendes de Sousa, Richard Sullivan, Gustavo Nader Marta, Wilma M Hopman, Christopher M Booth, Ajay Aggarwal, Ahmedin Jemal, Timothy P Hanna, Brooke E Wilson, Gustavo Arruda Viani
<h3>Background</h3>The Linear Accelerator Shortage Index (LSI) is a practical tool for prioritising the deployment of linear accelerators (LINACs) in various regions within a country. The LSI reflects the ratio of LINAC demand to current availability. The aim of this study was to use the LSI to predict global LINAC needs and classify countries according to the degree of radiotherapy shortage (LINAC shortage grade).<h3>Methods</h3>In this cross-sectional, population-based study of globally representative, country-level data, we sourced regional LINAC distribution, numbers of radiotherapy centres, and cancer incidence data for 181 countries from the Directory of Radiotherapy Centers and Global Cancer Observatory 2022 databases. Current gross domestic product and gross national income per capita in US dollars were obtained from the World Bank. We calculated an LSI for each country to assess the relative demand and supply of radiotherapy by dividing LINAC use by 450 and multiplying by 100. An LSI of 100 or less indicates no shortage (450 or fewer patients per LINAC), whereas an LSI greater than 100 signals a shortage, with higher values indicating more severe deficits. We categorised countries by LINAC shortage grade: grade 0 (LSI ≤100, no shortage), grade 1 (LSI 101–130, low need), grade 2 (LSI 131–300, high need), grade 3 (LSI >300, excessive need), or grade 4 (no existing LINACs). We estimated LINAC requirements until 2045 using the LSI and Global Cancer Observatory data. We determined future investment costs according to the LSI for each country.<h3>Findings</h3>As of the data cutoff on Sept 15, 2024, the global median LSI was 130 (IQR 96–319), suggesting a shortage of 30% in radiotherapy capacity. Significant disparities in median LSI were observed across income levels: low-income countries had a median LSI of 1523 (528–2247), lower-middle-income countries 399 (183–685), upper-middle-income countries 133 (104–198), and high-income countries 96 (83–127; p<0·0001). The distribution of countries across LINAC shortage grades was 40 (22%) of 181 as grade 0, 32 (18%) as grade 1, 35 (19%) as grade 2, 38 (21%) as grade 3, and 36 (20%) as grade 4 (no LINACs). Most LINAC shortage grade 4 countries were low income (12 [33%]) or lower-middle income (16 [44%]). The median number of new LINACs needed per country by 2045 was estimated at 6 (1–13) for grade 0, 21 (4–102) for grade 1, 22 (8–80) for grade 2, 52 (26–113) for grade 3, and three (2–14) for grade 4. To meet these demands, also including the replacement of obsolete devices, an estimated 30 470 LINACs will be needed by 2045. The median total investment required for new and replacement machines and radiotherapy centres to meet the 2045 demand is projected at US$162 million (49–369) for grade 0, $216 million (54–772) for grade 1, $143 million (64–580) for grade 2, $238 million (126–561) for grade 3, and $16 million (9–59) for grade 4. A significant change in LINAC shortage grade composition between
{"title":"Global linear accelerator requirements and personalised country recommendations: a cross-sectional, population-based study","authors":"Fabio Y Moraes, Andre G Gouveia, Vanessa Freitas Bratti, Edward C Dee, Juliana Fernandes Pavoni, Laura M Carson, Cecília Félix Penido Mendes de Sousa, Richard Sullivan, Gustavo Nader Marta, Wilma M Hopman, Christopher M Booth, Ajay Aggarwal, Ahmedin Jemal, Timothy P Hanna, Brooke E Wilson, Gustavo Arruda Viani","doi":"10.1016/s1470-2045(24)00678-8","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00678-8","url":null,"abstract":"<h3>Background</h3>The Linear Accelerator Shortage Index (LSI) is a practical tool for prioritising the deployment of linear accelerators (LINACs) in various regions within a country. The LSI reflects the ratio of LINAC demand to current availability. The aim of this study was to use the LSI to predict global LINAC needs and classify countries according to the degree of radiotherapy shortage (LINAC shortage grade).<h3>Methods</h3>In this cross-sectional, population-based study of globally representative, country-level data, we sourced regional LINAC distribution, numbers of radiotherapy centres, and cancer incidence data for 181 countries from the Directory of Radiotherapy Centers and Global Cancer Observatory 2022 databases. Current gross domestic product and gross national income per capita in US dollars were obtained from the World Bank. We calculated an LSI for each country to assess the relative demand and supply of radiotherapy by dividing LINAC use by 450 and multiplying by 100. An LSI of 100 or less indicates no shortage (450 or fewer patients per LINAC), whereas an LSI greater than 100 signals a shortage, with higher values indicating more severe deficits. We categorised countries by LINAC shortage grade: grade 0 (LSI ≤100, no shortage), grade 1 (LSI 101–130, low need), grade 2 (LSI 131–300, high need), grade 3 (LSI >300, excessive need), or grade 4 (no existing LINACs). We estimated LINAC requirements until 2045 using the LSI and Global Cancer Observatory data. We determined future investment costs according to the LSI for each country.<h3>Findings</h3>As of the data cutoff on Sept 15, 2024, the global median LSI was 130 (IQR 96–319), suggesting a shortage of 30% in radiotherapy capacity. Significant disparities in median LSI were observed across income levels: low-income countries had a median LSI of 1523 (528–2247), lower-middle-income countries 399 (183–685), upper-middle-income countries 133 (104–198), and high-income countries 96 (83–127; p<0·0001). The distribution of countries across LINAC shortage grades was 40 (22%) of 181 as grade 0, 32 (18%) as grade 1, 35 (19%) as grade 2, 38 (21%) as grade 3, and 36 (20%) as grade 4 (no LINACs). Most LINAC shortage grade 4 countries were low income (12 [33%]) or lower-middle income (16 [44%]). The median number of new LINACs needed per country by 2045 was estimated at 6 (1–13) for grade 0, 21 (4–102) for grade 1, 22 (8–80) for grade 2, 52 (26–113) for grade 3, and three (2–14) for grade 4. To meet these demands, also including the replacement of obsolete devices, an estimated 30 470 LINACs will be needed by 2045. The median total investment required for new and replacement machines and radiotherapy centres to meet the 2045 demand is projected at US$162 million (49–369) for grade 0, $216 million (54–772) for grade 1, $143 million (64–580) for grade 2, $238 million (126–561) for grade 3, and $16 million (9–59) for grade 4. A significant change in LINAC shortage grade composition between","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1016/s1470-2045(25)00011-7
Karl Gruber
No Abstract
无摘要
{"title":"Cancer incidence associated with PFAS contamination of drinking water in the USA","authors":"Karl Gruber","doi":"10.1016/s1470-2045(25)00011-7","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00011-7","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1016/s1470-2045(25)00010-5
Sharmila Devi
No Abstract
没有抽象的
{"title":"Hiring freezes within the NHS impact cancer care","authors":"Sharmila Devi","doi":"10.1016/s1470-2045(25)00010-5","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00010-5","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<h3>Background</h3>Vascular endothelial growth factor (VEGF) is overexpressed in nasopharyngeal carcinoma and suppresses the anti-tumour immune response. Previous studies have shown that adding anti-VEGF treatment to PD-1 inhibition treatment strategies improves tumour response. We aimed to compare the efficacy of pembrolizumab, a PD-1 inhibitor, with or without bevacizumab, a VEGF inhibitor, in nasopharyngeal carcinoma.<h3>Methods</h3>In this randomised, open-label, phase 2 trial done at two hospitals (National University Cancer Institute and Tan Tock Seng Hospital) in Singapore, patients with platinum-resistant recurrent or metastatic nasophayngeal carcinoma were eligible if they were aged 21 years or older and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1. Patients were assigned (1:1; using random permuted blocks with varying sizes of 4 and 6) to receive either intravenous pembrolizumab (200 mg) every 21 days or a combination of pembrolizumab with intravenous bevacizumab (7·5 mg/kg) administered 1 week prior to each dose, until radiographic disease progression, unacceptable toxicity, completion of 32 cycles, or withdrawal of consent. The study was open label, therefore no masking of treatment assignment was implemented. The primary endpoint was objective response rate, assessed using RECIST (version 1.1) by independent radiologists and analysed in the intention-to-treat population (ie, all randomly assigned patients). This trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT03813394</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, and enrolment has closed.<h3>Findings</h3>Between May 13, 2019, and Dec 6, 2023, we assessed 60 individuals for eligibility, 12 were excluded, and 48 were randomly allocated to pembrolizumab alone (n=24) or a combination of bevacizumab and pembrolizumab (n=24). The median age was 56 years (IQR 48–65), and 40 (83%) of 48 patients were male and eight (17%) were female. The median follow-up was 28·3 months (IQR 15·1–55·9). The objective response rate was significantly higher in the bevacizumab and pembrolizumab group (58·3% [95% CI 36·6–77·9] than in the pembrolizumab group (12·5% [2·7–32·4]; unadjusted RR 4·67 [95% CI 1·54–14·18]; p=0·0010). Grade 3 treatment-related adverse events occurred in two (8%) of 24 patients in the pembrolizumab group and in seven (29%) of 24 patients in the bevacizumab and pembrolizumab group; the most common severe or grade 3–4 treatment-related adverse events were thrombosis or bleeding (four [17%] of 24 patients in the bevacizumab and pembrolizumab group <em>vs</em> none o
背景血管内皮生长因子（VEGF）在鼻咽癌中过度表达，并抑制抗肿瘤免疫反应。先前的研究表明，在 PD-1 抑制治疗策略中加入抗血管内皮生长因子治疗可改善肿瘤反应。我们旨在比较 PD-1 抑制剂 pembrolizumab 与血管内皮生长因子抑制剂贝伐珠单抗的疗效。方法 在新加坡的两家医院（国立大学癌症研究所和陈笃生医院）进行的这项随机、开放标签的 2 期试验中，铂耐药复发性或转移性鼻咽癌患者只要年龄在 21 岁或以上，且东部合作肿瘤学组（ECOG）表现状态为 0-1 级，就符合条件。患者被分配（1:1；使用4和6个不同大小的随机排列区块）接受静脉注射pembrolizumab（200毫克），每21天一次，或在每次给药前1周接受pembrolizumab与静脉注射贝伐珠单抗（7-5毫克/千克）的联合治疗，直至出现放射学疾病进展、不可接受的毒性、完成32个周期或撤销同意。该研究为开放标签研究，因此不对治疗分配进行掩蔽。主要终点是客观反应率，由独立放射科专家使用 RECIST（1.1 版）进行评估，并在意向治疗人群（即所有随机分配的患者）中进行分析。该试验已在ClinicalTrials.gov上注册，编号为NCT03813394，注册已结束。研究结果在2019年5月13日至2023年12月6日期间，我们评估了60人的资格，12人被排除在外，48人被随机分配到彭博利珠单抗（n=24）或贝伐单抗和彭博利珠单抗的组合（n=24）。中位年龄为 56 岁（IQR 48-65），48 名患者中有 40 名（83%）男性，8 名（17%）女性。中位随访时间为 28-3 个月（IQR 15-1-55-9）。贝伐单抗和pembrolizumab组的客观反应率（58-3% [95% CI 36-6-77-9]）明显高于pembrolizumab组（12-5% [2-7-32-4]；未调整RR 4-67 [95% CI 1-54-14-18]；P=0-0010）。Pembrolizumab组24例患者中有2例（8%）发生了3级治疗相关不良事件，贝伐珠单抗和Pembrolizumab组24例患者中有7例（29%）发生了3级治疗相关不良事件；最常见的严重或 3-4 级治疗相关不良事件是血栓或出血（贝伐单抗和 Pembrolizumab 组 24 名患者中有 4 例[17%]，而 Pembrolizumab 组 24 名患者中没有）、其他毒性反应包括转氨酶炎（无 vs 1 [4%]）、结肠炎（1 [4%] vs 无）、细胞减少症（无 vs 1 [4%]）、皮肤毒性（1 [4%] vs 无）、高血压（1 [4%] vs 无）和蛋白尿（1 [4%] vs 无）。两组患者均未出现4级治疗相关不良事件或治疗相关死亡病例。释义Pembrolizumab联合贝伐单抗治疗铂类耐药鼻咽癌比pembrolizumab单药疗效更好，且毒性可控。如果在三期试验中得到验证，这种联合疗法可能会成为这一患者群体的新治疗标准。
{"title":"Pembrolizumab with or without bevacizumab in platinum-resistant recurrent or metastatic nasopharyngeal carcinoma: a randomised, open-label, phase 2 trial","authors":"Wan-Qin Chong, Jia-Li Low, Joshua K Tay, Thi Bich Uyen Le, Grace Shi-Qing Goh, Kenneth Sooi, Hui-Lin Teo, Seng-Wee Cheo, Regina Tong-Xin Wong, Jens Samol, Ming-Yann Lim, Hao Li, Niranjan Shirgaonkar, Shumei Chia, Lingzhi Wang, Anil Gopinathan, Donovan Kum-Chuen Eu, Raymond King-Yin Tsang, Kwok-Seng Loh, Han-Chong Toh, Boon-Cher Goh","doi":"10.1016/s1470-2045(24)00677-6","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00677-6","url":null,"abstract":"<h3>Background</h3>Vascular endothelial growth factor (VEGF) is overexpressed in nasopharyngeal carcinoma and suppresses the anti-tumour immune response. Previous studies have shown that adding anti-VEGF treatment to PD-1 inhibition treatment strategies improves tumour response. We aimed to compare the efficacy of pembrolizumab, a PD-1 inhibitor, with or without bevacizumab, a VEGF inhibitor, in nasopharyngeal carcinoma.<h3>Methods</h3>In this randomised, open-label, phase 2 trial done at two hospitals (National University Cancer Institute and Tan Tock Seng Hospital) in Singapore, patients with platinum-resistant recurrent or metastatic nasophayngeal carcinoma were eligible if they were aged 21 years or older and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1. Patients were assigned (1:1; using random permuted blocks with varying sizes of 4 and 6) to receive either intravenous pembrolizumab (200 mg) every 21 days or a combination of pembrolizumab with intravenous bevacizumab (7·5 mg/kg) administered 1 week prior to each dose, until radiographic disease progression, unacceptable toxicity, completion of 32 cycles, or withdrawal of consent. The study was open label, therefore no masking of treatment assignment was implemented. The primary endpoint was objective response rate, assessed using RECIST (version 1.1) by independent radiologists and analysed in the intention-to-treat population (ie, all randomly assigned patients). This trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT03813394</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, and enrolment has closed.<h3>Findings</h3>Between May 13, 2019, and Dec 6, 2023, we assessed 60 individuals for eligibility, 12 were excluded, and 48 were randomly allocated to pembrolizumab alone (n=24) or a combination of bevacizumab and pembrolizumab (n=24). The median age was 56 years (IQR 48–65), and 40 (83%) of 48 patients were male and eight (17%) were female. The median follow-up was 28·3 months (IQR 15·1–55·9). The objective response rate was significantly higher in the bevacizumab and pembrolizumab group (58·3% [95% CI 36·6–77·9] than in the pembrolizumab group (12·5% [2·7–32·4]; unadjusted RR 4·67 [95% CI 1·54–14·18]; p=0·0010). Grade 3 treatment-related adverse events occurred in two (8%) of 24 patients in the pembrolizumab group and in seven (29%) of 24 patients in the bevacizumab and pembrolizumab group; the most common severe or grade 3–4 treatment-related adverse events were thrombosis or bleeding (four [17%] of 24 patients in the bevacizumab and pembrolizumab group <em>vs</em> none o","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-13DOI: 10.1016/s1470-2045(24)00645-4
Lincoln Nadauld, Charles H McDonnell, Christina A Dilaveri, Eric A Klein, Robert Reid, Catherine R Marinac, Karen C Chung, Margarita Lopatin, Eric T Fung, Deborah Schrag, Donald L Patrick
<h3>Background</h3>PATHFINDER was a prospective cohort study of multicancer early detection (MCED) testing in an outpatient ambulatory population. The aim of this study is to report the patient-reported outcomes (PROs) collected as secondary and exploratory measures in the PATHFINDER study.<h3>Methods</h3>PATHFINDER is a prospective, multicentre, cohort study that enrolled existing healthy ambulatory outpatients at seven health networks in the USA, including hospitals, academic medical centres, and integrated health systems. Enrolled adults were aged 50 years or older without clinical suspicion of cancer, with or without additional cancer risk factors (smoking history, genetic predisposition, or previous cancer diagnosis). The primary objective was time to diagnostic resolution after an MCED cancer signal detected (CSD) result and extent of testing pursued. The objectives of the 12-month PATHFINDER study reported here were assessment of patient-reported outcomes and perceptions with MCED testing (the effect of the MCED test result disclosure, general anxiety symptoms, health-related quality of life, and satisfaction with the MCED test). PRO instruments used included an adapted Multidimensional Impact of Cancer Risk Assessment (MICRA) for distress, uncertainty, and positive experience at MCED test result disclosure; PRO Measurement Information System (PROMIS) Anxiety short-form for anxiety symptoms; and Short Form 12-Item Health Survey (SF-12v2) for health-related quality of life. Intentions towards adherence to guideline recommended screening was also assessed as an exploratory objective. This study is registered at <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT04241796</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, and is complete.<h3>Findings</h3>Between Dec 12, 2019, and Dec 4, 2020, 6662 participants were recruited and 6621 eligible participants had analysable MCED test results (n=92 CSD and n=6529 no CSD [NCSD]). The majority of participants were women (4204 [63·5%] of 6621) and White (6071 [91·7%] of 6621). For participants who completed the MICRA at results disclosure, the mean total MICRA score was 28·4 (SD 14·9) for the 50 patients with a CSD result and 8·8 (7·2) for those with an NCSD result (n=5864 completed the full questionnaire). Mean general anxiety scores increased in true-positive and false-positive groups at results disclosure. The PROMIS anxiety true-positive group baseline score of 46·2 (SD 6·5; n=35) increased to 48·4 (7·3; n=19) and the scores in the false-positive group increased from 47·3 (7·3; n=52) to 49·7 (7·7; n=30). Mean scores in both groups ret
{"title":"Psychosocial impact associated with a multicancer early detection test (PATHFINDER): a prospective, multicentre, cohort study","authors":"Lincoln Nadauld, Charles H McDonnell, Christina A Dilaveri, Eric A Klein, Robert Reid, Catherine R Marinac, Karen C Chung, Margarita Lopatin, Eric T Fung, Deborah Schrag, Donald L Patrick","doi":"10.1016/s1470-2045(24)00645-4","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00645-4","url":null,"abstract":"<h3>Background</h3>PATHFINDER was a prospective cohort study of multicancer early detection (MCED) testing in an outpatient ambulatory population. The aim of this study is to report the patient-reported outcomes (PROs) collected as secondary and exploratory measures in the PATHFINDER study.<h3>Methods</h3>PATHFINDER is a prospective, multicentre, cohort study that enrolled existing healthy ambulatory outpatients at seven health networks in the USA, including hospitals, academic medical centres, and integrated health systems. Enrolled adults were aged 50 years or older without clinical suspicion of cancer, with or without additional cancer risk factors (smoking history, genetic predisposition, or previous cancer diagnosis). The primary objective was time to diagnostic resolution after an MCED cancer signal detected (CSD) result and extent of testing pursued. The objectives of the 12-month PATHFINDER study reported here were assessment of patient-reported outcomes and perceptions with MCED testing (the effect of the MCED test result disclosure, general anxiety symptoms, health-related quality of life, and satisfaction with the MCED test). PRO instruments used included an adapted Multidimensional Impact of Cancer Risk Assessment (MICRA) for distress, uncertainty, and positive experience at MCED test result disclosure; PRO Measurement Information System (PROMIS) Anxiety short-form for anxiety symptoms; and Short Form 12-Item Health Survey (SF-12v2) for health-related quality of life. Intentions towards adherence to guideline recommended screening was also assessed as an exploratory objective. This study is registered at <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT04241796</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, and is complete.<h3>Findings</h3>Between Dec 12, 2019, and Dec 4, 2020, 6662 participants were recruited and 6621 eligible participants had analysable MCED test results (n=92 CSD and n=6529 no CSD [NCSD]). The majority of participants were women (4204 [63·5%] of 6621) and White (6071 [91·7%] of 6621). For participants who completed the MICRA at results disclosure, the mean total MICRA score was 28·4 (SD 14·9) for the 50 patients with a CSD result and 8·8 (7·2) for those with an NCSD result (n=5864 completed the full questionnaire). Mean general anxiety scores increased in true-positive and false-positive groups at results disclosure. The PROMIS anxiety true-positive group baseline score of 46·2 (SD 6·5; n=35) increased to 48·4 (7·3; n=19) and the scores in the false-positive group increased from 47·3 (7·3; n=52) to 49·7 (7·7; n=30). Mean scores in both groups ret","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-13DOI: 10.1016/s1470-2045(24)00667-3
Jon Emery
No Abstract
没有抽象的
{"title":"The psychological impact of screening with a multicancer early detection test","authors":"Jon Emery","doi":"10.1016/s1470-2045(24)00667-3","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00667-3","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-09DOI: 10.1016/s1470-2045(25)00002-6
Tony Kirby
No Abstract
没有抽象的
{"title":"US Surgeon General calls for cancer warning labels on alcohol","authors":"Tony Kirby","doi":"10.1016/s1470-2045(25)00002-6","DOIUrl":"https://doi.org/10.1016/s1470-2045(25)00002-6","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-06DOI: 10.1016/s1470-2045(24)00710-1
Katharine Herbert, Elizabeth C Smyth
Therapeutic options for patients with advanced gastric or gastro-oesophageal junction adenocarcinomas are rapidly evolving.1 Although chemotherapy alone results in a median survival of less than a year, the majority (approximately 75%) of gastric and gastro-oesophageal junction adenocarcinoma tumours express molecular targets that are amenable to personalised antibody-based therapies.2 These targeted treatments, if combined with cytotoxic chemotherapy, extend overall survival. Established monoclonal antibody targets include HER2 (also known as ERBB2) and PD-L1, with claudin-18.2 (CLD18.2) emerging as an addition within the past year. Zolbetuximab, a first-in-class monoclonal antibody targeting CLD18.2, improved overall survival when added to platinum-fluoropyrimidine chemotherapy in patients with CLD18.2-positive, advanced, untreated gastric or gastro-oesophageal junction adenocarcinoma.3 The positive results of SPOTLIGHT and GLOW validate CLD18.2 as a therapeutic target and established a basis for an expansive pipeline of next-generation CLD18.2-directed therapies.4, 5
{"title":"Expanding therapeutic options targeting claudin-18.2","authors":"Katharine Herbert, Elizabeth C Smyth","doi":"10.1016/s1470-2045(24)00710-1","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00710-1","url":null,"abstract":"Therapeutic options for patients with advanced gastric or gastro-oesophageal junction adenocarcinomas are rapidly evolving.<span><span><sup>1</sup></span></span> Although chemotherapy alone results in a median survival of less than a year, the majority (approximately 75%) of gastric and gastro-oesophageal junction adenocarcinoma tumours express molecular targets that are amenable to personalised antibody-based therapies.<span><span><sup>2</sup></span></span> These targeted treatments, if combined with cytotoxic chemotherapy, extend overall survival. Established monoclonal antibody targets include HER2 (also known as ERBB2) and PD-L1, with claudin-18.2 (CLD18.2) emerging as an addition within the past year. Zolbetuximab, a first-in-class monoclonal antibody targeting CLD18.2, improved overall survival when added to platinum-fluoropyrimidine chemotherapy in patients with CLD18.2-positive, advanced, untreated gastric or gastro-oesophageal junction adenocarcinoma.<span><span><sup>3</sup></span></span> The positive results of SPOTLIGHT and GLOW validate CLD18.2 as a therapeutic target and established a basis for an expansive pipeline of next-generation CLD18.2-directed therapies.<span><span>4</span></span>, <span><span>5</span></span>","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<h3>Background</h3>CMG901 is a novel first-in-class antibody–drug conjugate with a humanised anticlaudin 18.2 antibody linked to microtubule-disrupting agent monomethyl auristatin E. We aimed to assess the antitumour activity and safety of CMG901 in patients with advanced gastric or gastro-oesophageal junction cancer and other solid tumours.<h3>Methods</h3>KYM901 is a multicentre, open-label, single-arm, phase 1 trial consisting of dose-escalation and dose-expansion stages. Patients with advanced solid tumours, including gastric or gastro-oesophageal junction and pancreatic cancers, were recruited from 31 hospital sites in China. Eligible patients were aged 18 years or older, were refractory to standard therapy or had no available standard-of-care regimen, and had an Eastern Cooperative Oncology Group performance status score of 0–1, a life expectancy of at least 3 months, and at least one measurable lesion. Patients received intravenous CMG901 every 3 weeks (0·3–3·4 mg/kg in dose escalation and 2·2–3·0 mg/kg in dose expansion) until disease progression, unacceptable toxic effects, initiation of new antitumour therapy, study withdrawal, or death. Primary endpoints were adverse events and dose-limiting toxic effects in the dose-escalation phase, and objective response rate and recommended phase 2 dose in the dose-expansion phase. Confirmed objective response was defined as a partial or complete response that was verified by follow-up imaging at least 4 weeks after the initial assessment. Safety was assessed in all patients who received at least one dose of CMG901 with at least one post-dose safety evaluation. Antitumour activity was assessed in all patients who received at least one dose of CMG901 (full analysis set) and in all CMG901-treated patients with at least one post-dose imaging evaluation and no major protocol deviations (efficacy analysis set). Dose-expansion data for patients with pancreatic cancer will be published separately. Due to small sample sizes, results in patients with other solid tumours (n=2) are not planned for publication. This ongoing trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT04805307</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>.<h3>Findings</h3>Between Dec 24, 2020, and Feb 23, 2023, 27 patients were enrolled in the dose-escalation phase (median age 57·0 years [IQR 48·0–63·0]; 14 [52%] male, 13 [48%] female) and 107 patients with gastric or gastro-oesophageal junction cancer in the dose-expansion phase (median age 56·0 years [44·0–64·0]; 57 [53%] male, 50 [47%] female). As of Feb 24, 2024, one dose-limiting toxic effect
{"title":"Claudin 18.2-targeting antibody–drug conjugate CMG901 in patients with advanced gastric or gastro-oesophageal junction cancer (KYM901): a multicentre, open-label, single-arm, phase 1 trial","authors":"Dan-Yun Ruan, Fu-Rong Liu, Xiao-Li Wei, Su-Xia Luo, Zhi-Xiang Zhuang, Zhen-Ning Wang, Fu-Nan Liu, Yan-Qiao Zhang, Jian-Wei Yang, Zhen-Dong Chen, Yong-Sheng Wang, Jun-Ye Wang, Xiao-Hua Liang, Xiao-Jie Wu, Yu-Long Zheng, Jian Liu, Xi Shi, Rakesh Kumar, Wei Liu, Bo Chen, Rui-Hua Xu","doi":"10.1016/s1470-2045(24)00636-3","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00636-3","url":null,"abstract":"<h3>Background</h3>CMG901 is a novel first-in-class antibody–drug conjugate with a humanised anticlaudin 18.2 antibody linked to microtubule-disrupting agent monomethyl auristatin E. We aimed to assess the antitumour activity and safety of CMG901 in patients with advanced gastric or gastro-oesophageal junction cancer and other solid tumours.<h3>Methods</h3>KYM901 is a multicentre, open-label, single-arm, phase 1 trial consisting of dose-escalation and dose-expansion stages. Patients with advanced solid tumours, including gastric or gastro-oesophageal junction and pancreatic cancers, were recruited from 31 hospital sites in China. Eligible patients were aged 18 years or older, were refractory to standard therapy or had no available standard-of-care regimen, and had an Eastern Cooperative Oncology Group performance status score of 0–1, a life expectancy of at least 3 months, and at least one measurable lesion. Patients received intravenous CMG901 every 3 weeks (0·3–3·4 mg/kg in dose escalation and 2·2–3·0 mg/kg in dose expansion) until disease progression, unacceptable toxic effects, initiation of new antitumour therapy, study withdrawal, or death. Primary endpoints were adverse events and dose-limiting toxic effects in the dose-escalation phase, and objective response rate and recommended phase 2 dose in the dose-expansion phase. Confirmed objective response was defined as a partial or complete response that was verified by follow-up imaging at least 4 weeks after the initial assessment. Safety was assessed in all patients who received at least one dose of CMG901 with at least one post-dose safety evaluation. Antitumour activity was assessed in all patients who received at least one dose of CMG901 (full analysis set) and in all CMG901-treated patients with at least one post-dose imaging evaluation and no major protocol deviations (efficacy analysis set). Dose-expansion data for patients with pancreatic cancer will be published separately. Due to small sample sizes, results in patients with other solid tumours (n=2) are not planned for publication. This ongoing trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT04805307</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>.<h3>Findings</h3>Between Dec 24, 2020, and Feb 23, 2023, 27 patients were enrolled in the dose-escalation phase (median age 57·0 years [IQR 48·0–63·0]; 14 [52%] male, 13 [48%] female) and 107 patients with gastric or gastro-oesophageal junction cancer in the dose-expansion phase (median age 56·0 years [44·0–64·0]; 57 [53%] male, 50 [47%] female). As of Feb 24, 2024, one dose-limiting toxic effect","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-02DOI: 10.1016/s1470-2045(24)00627-2
Axel Hauschild, Claus Garbe, Paolo Antonio Ascierto, Lev Demidov, Brigitte Dreno, Reinhard Dummer, Alexander Eggermont, Ana-Maria Forsea, Christoffer Gebhardt, Jeffrey E Gershenwald, Omid Hamid, Christoph Hoeller, Lidija Kandolf, Roland Kaufmann, John M Kirkwood, Celeste Lebbé, Georgina V Long, Josep Malvehy, Salvador Martin-Algarra, Grant McArthur, Paolo Nuti
No Abstract
没有抽象的
{"title":"Neoadjuvant or perioperative therapy for melanoma metastasis in clinical practice: an international survey","authors":"Axel Hauschild, Claus Garbe, Paolo Antonio Ascierto, Lev Demidov, Brigitte Dreno, Reinhard Dummer, Alexander Eggermont, Ana-Maria Forsea, Christoffer Gebhardt, Jeffrey E Gershenwald, Omid Hamid, Christoph Hoeller, Lidija Kandolf, Roland Kaufmann, John M Kirkwood, Celeste Lebbé, Georgina V Long, Josep Malvehy, Salvador Martin-Algarra, Grant McArthur, Paolo Nuti","doi":"10.1016/s1470-2045(24)00627-2","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00627-2","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"363 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142917335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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