中华肿瘤杂志最新文献

The treatment of breast cancer with low expression of human epidermal growth factor receptor 2 (HER-2) has become a focused area in recent years. With the proved therapeutic effect of antibody-drug conjugates on breast cancer patients with HER-2-low expression, who has become a new targeting population in breast cancer. Recent studies have shown that patients with HER-2-ultralow breast cancer can also benefit from novel antibody-drug conjugates. To better standardize the rational clinical diagnosis and treatment of HER-2-low and HER-2-ultralow breast cancer, the Breast Cancer Working Group of the International Medical and Exchange Branch of the Chinese Anti-Cancer Association and the Chinese Medical Doctor Association Oncology Branch reviewed the latest domestic and international clinical studies and important publications in recent years. Integrating the clinical experience of Chinese pathologists and oncologists, and following expert panel discussions, a consensus on the clinical diagnosis and treatment of HER-2-low and HER-2-ultralow breast cancer was developed. This consensus aims to deepen clinicians' understanding of HER-2-low and HER-2-ultralow breast cancer, promote more precise clinical decision-making, and ultimately improve patient survival and quality of life.

Breast cancer is the most common malignancy among women worldwide, with its incidence continuing to rise, posing a serious threat to women's health. In recent years, with the widespread adoption of molecular subtyping in diagnosis and treatment, breast cancer therapy has entered an era of individualized precision medicine. Early-stage breast cancer is primarily managed with surgery, combined with chemotherapy, radiotherapy, endocrine therapy, and targeted therapies (such as trastuzumab and pertuzumab), significantly improving cure rates. However, for recurrent or metastatic breast cancer, particularly refractory subtypes such as triple-negative and HER2-positive breast cancer, the efficacy of traditional treatments remains limited, and patients still face poor prognosis. Antibody-drug conjugates (ADCs), as an innovative targeted therapy strategy, combine the precise targeting of monoclonal antibodies with the potent cytotoxicity of payload drugs, delivering cytotoxic agents directly to tumors through targeted chemotherapy, achieving "precision delivery and efficient killing". ADCs represent a relatively novel class of highly targeted anticancer biologics. In the field of breast cancer treatment, ADCs have made groundbreaking progress. Agents such as T-DM1 and T-DXd have significantly prolonged progression-free survival and overall survival in HER2-positive patients, providing critical treatment options for advanced-stage patients, markedly improving survival outcomes, and are now being explored in earlier lines of therapy, reshaping the treatment landscape of breast cancer. Although ADCs are generally well-tolerated, their unique structure-comprising antibodies, cytotoxic payloads, linkers, and conjugation processes-leads to distinct adverse effects and heterogeneous safety profiles within the class. Based on the latest research advances in ADC therapy for breast cancer and incorporating clinical experience from both domestic and international settings, the Professional Committee on Anticancer Drug Clinical Research of the China Anti-Cancer Association has jointly developed the "Guidelines for managing adverse reactions to antibody-drug conjugates in breast cancer (2025 edition)". This guideline aims to provide healthcare professionals with practical guidance on the early identification, regular assessment, timely management, and follow-up monitoring of ADC-related adverse reactions or events.

In recent years, the incidence of B-cell non-Hodgkin lymphoma (B-NHL) in China has shown a steady increase, accounting for approximately 85%-90% of all lymphomas. Although standard immunochemotherapy regimens such as R-CHOP have led to long-term remission in some patients, approximately 30%-40% still experience relapse or refractory disease, with dismal prognosis and a median survival of less than one year. For patients who fail multiple lines of therapy, conventional options such as chemotherapy, radiotherapy, or hematopoietic stem cell transplantation offer limited benefits, highlighting an urgent need for innovative treatments. Chimeric antigen receptor T-cell (CAR-T) therapy, a breakthrough form of adoptive cellular immunotherapy, modifies autologous T cells to specifically recognize and eliminate malignant B cells, thereby achieving significant survival improvement in patients with relapse or refractory B-NHL. The clinical research and clinical application of CAR-T in the treatment of hematological tumors in China are in a state of rapid development. At present, there are two targeting CD19 CAR-T cells for the treatment of B-cell lymphoma, which gradually changed the diagnosis and treatment practice of lymphoma in China. At the same time, the clinic is actively exploring and improving the whole-process management experience of CAR-T therapy in lymphoma patients. So the Lymphoma Quality Control Expert Committee of the National Cancer Quality Control Center organized experts to form the consensus through discussion and revision many times, aiming to provide better guidance for clinicians to standardize the whole-process management of CAR-T cell therapy for B-cell Lymphoma, and further improve the survival benefits of patients.

Malnutrition and metabolic disorders occur in a high proportion of oncology patients, and malnutrition has a significant impact on both treatment and prognosis, resulting in a heavy disease and economic burden. In recent years, as awareness of the nutritional status of oncology patients has improved, especially the multiple negative effects of malnutrition, it has highlighted the lack of clinical treatment and insufficient knowledge of adverse effects, leading to the lack of special medical use foods for oncology patients as well as irregularities in their use. In order to further promote the clinical and family standardised application of special medical purpose foods for oncology patients, the expert group collects and collates high-quality evidence in recent years, and discusses and summarises the opinions on clinical application, and consolidates the consensus "Expert consensus on clinical application of whole nutritional oncology foods for special medical purposes (2025 edition)", aiming to promote the standardisation of oncology nutritional treatment, meet the special nutritional needs of oncology patients, improve the clinical knowledge on the application of special medical purpose foods for oncology, and provide detailed and practical guidance on clinical operation.

Amivantamab is the first fully humanized bispecific antibody approved for the treatment of non-small cell lung cancer (NSCLC) in the world. Amivantamab can block epidermal growth factor receptor (EGFR) pathway and mesenchymal-epithelial transformation factor (MET) pathway simultaneously, trigger the internalization and degradation of EGFR and MET, and activate the antitumor immune response. Amivantamab has been approved by the National Medical Products Administration for the treatment of adult patients with locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutation, EGFR exon 19 deletion or exon 21 L858R substitution mutation, and is expected to be widely used in clinical practice soon. How to reasonably manage the adverse reactions related to amivantamab and maximize its efficacy is an urgent problem to be solved. Based on the existing medical evidence, combined with clinical experience, the expert group of this consensus finally formulated this "Expert consensus on amivantamab clinical application and adverse reaction management (2025 edition)" after multiple discussions. The contents of the consensus include the clinical use and management of adverse reactions of amivantamab. The recommendations focus on the prevention of infusion-related reactions, skin adverse reactions, venous thromboembolism, peripheral edema, oral mucositis, ocular toxicity and interstitial lung disease, amivantamab dose adjustment and treatment when adverse events occur, in order to provide guidance for clinicians to correctly use amivantamab and manage related adverse reactions.

Objective: To analyze the predictive model of lymph node metastasis rate (LNR) in patients with intrahepatic cholangiocarcinoma and its relationship with prognosis. Methods: This study included clinical characteristics and prognostic information of 172 patients with intrahepatic cholangiocarcinoma. Receiver operating characteristic (ROC) curves were used to calculate the optimal cutoff values for groups. Kaplan Meier survival curves were plotted using R language, and critical factors affecting prognosis were determined by Cox regression analysis. A prognostic prediction model was constructed and visualized using nomogram, and this model was validated using the SEER database. Results: Through ROC curve analysis, with 3-year overall survival (OS) as the benchmark, an LNR of 0.15 was identified as the optimal cutoff value for predicting the prognosis of intrahepatic cholangiocarcinoma patients, with an area under the curve of 0.764 (95% CI: 0.690, 0.838). Patients were divided into a low LNR group (LNR＜0.15, n=97) and a high LNR group (LNR≥0.15, n=75) based on the LNR value. Statistically significant differences were observed between the two groups in terms of carbohydrate antigen 19-9, tumor size, lymph node metastasis, tumor number, and stage (all P＜0.05). The median survival time of the high LNR group was 20 months (95% CI: 13-23), significantly shorter than that of the low LNR group, which was 36 months (95% CI: 21-43) (P＜0.001). Multivariate analysis revealed that a high LNR value (HR=0.55, 95% CI: 0.32-0.95, P=0.033), age＞60 years (HR=0.53, 95% CI: 0.35-0.81, P=0.004), and tumor diameter＞5.5 cm (HR=0.62, 95% CI: 0.41-0.93, P=0.022) were independent factors affecting OS. A prognostic prediction model was established based on these independent factors, and the predicted 1-year, 2-year, and 3-year survival rates were close to the actual observed values. Validation using the SEER database also demonstrated the high predictive accuracy of this model. Conclusion: The clinical prognostic model based on lymph node metastasis rate can effectively predict the postoperative survival of patients with intrahepatic cholangiocarcinoma and provide important basis for clinical decision.

Bone metastasis from lung cancer is one of the common complications in patients with advanced lung cancer, which can lead to pathological fractures, spinal cord compression, bone surgery, bone radiotherapy, and other skeletal related events (SREs), severely affecting the quality of life and prognosis of patients. The Non-Small Cell Lung Cancer Committee of the Chinese Society of Clinical Oncology convened a multidisciplinary expert panel comprising specialists from respiratory medicine, oncology, orthopedics, radiation oncology, nuclear medicine, radiology, and oral and maxillofacial surgery to develop this consensus. It is based on domestic and international evidence-based medicine and clinical practice experience, and was formulated through repeated consultations and thorough discussions. The consensus provides nine recommendations from six perspectives: diagnosis, screening, treatment strategies, bone-targeted drug treatment strategies and management of adverse reactions, local treatment, and efficacy evaluation. These recommendations are intended for reference and used by relevant medical personnel. The development of this consensus aims to provide scientific and practical guidance for clinicians, with the expectation of improving the quality of life and prognosis of patients.

Objective: Exploring the therapeutic value of ovarianectomy in patients with colorectal cancer accompanied by ovarian metastasis and simultaneous multiple organ distant metastasis. Methods: A retrospective analysis was conducted on the clinical pathological data of 125 patients with colorectal cancer and ovarian metastasis accompanied by multiple organ distant metastasis, who were treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2014 to December 2023. Based on whether ovarianectomy was performed, patients were divided into a surgical group (95 cases, 76.0%) and a non-surgical group (30 cases, 24.0%). The effectiveness of systemic treatment and overall survival (OS) were compared between the two groups. Results: Among the 95 patients in the surgical group, 8 patients (8.4%) experienced minor postoperative complications, with no instances of systemic treatment being affected by postoperative complications. Within the surgical group, 11 patients (11.6%) underwent preoperative neoadjuvant therapy. Postoperative pathological reports from these patients revealed that ovarian metastases exhibited the poorest treatment response compared to tumor foci in other sites, all demonstrating only mild therapeutic effects. All 95 patients in the surgical group received postoperative systemic treatment (chemotherapy±targeted therapy), and the efficacy was assessed. Among them, 16 patients (16.8%) had partial remission (PR), 57 patients (60.0%) had stable disease (SD), 3 patients (3.2%) had disease progression (PD), and 19 patients (20.0%) could not be evaluated. In the non-surgical group of 30 patients, 7 (23.3%) had SD and 23 (76.7%) had PD. The difference in efficacy between the two groups was statistically significant (P＜0.001). The median OS for all patients was 28 months (95% CI: 21.5-34.5), with 1-, 3-, and 5-year survival rates of 84.5%, 40.7%, and 23.9%, respectively. The median OS for patients in the surgical group was 35 months (95% CI: 23.9-46.1), with 1-, 3-, and 5-year survival rates of 87.1%, 45.0%, and 26.4%, respectively. The median OS for patients in the non-surgical group was 23 months (95% CI: 16.6-29.4), with 1-, 3-, and 5-year survival rates of 76.2%, 27.8%, and 13.9%, respectively. The prognosis of patients in the surgical group was significantly better than that in the non-surgical group (P=0.034). Conclusion: Performing ovarianectomy in patients with colorectal cancer and ovarian metastases accompanied by multiple organ distant metastases can prolong survival, improve the efficacy of systemic treatment, and enhance quality of life, resulting in significant overall clinical benefits.