{"title":"Patients gain potential options for treatment of advanced NSCLC: Trials show that ivonescimab combined with chemotherapy improved overall survival, and sunvozertinib improved progression-free survival.","authors":"Leah Lawrence","doi":"10.1002/cncr.70590","DOIUrl":"https://doi.org/10.1002/cncr.70590","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":"e70590"},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew B. Nixon PhD, MBA, Danielle M. Enserro PhD, David P. Bender MD, Yingmiao Liu PhD, Mark D. Starr BS, J. Chris Brady BS, Jesus Gonzalez Bosquet MD, Bobbie J. Rimel MD, Laura L. Holman MD, Colleen Rivard MD, Dan S. Veljovich MD, Julia Fehniger MD, John W. Moroney MD, Floor J. Backes MD, Mark Cadungog MD, Matthew A. Powell MD, Tara Castellano MD, Angeles Alvarez Secord MD, Helen J. MacKay MD
Background
The NRG-GY012 phase 2 trial evaluated olaparib, cediranib, and the combination in 120 patients with recurrent, persistent, or metastatic endometrial cancer (EC). Predictive and prognostic associations between blood-based biomarkers and clinical outcomes were assessed.
Methods
Plasma samples collected at baseline, cycle 4 day 1, and disease progression were analyzed for circulating protein biomarkers (Angiome). The primary analysis evaluated the predictive impact of IL-6 on progression-free survival (PFS) and overall survival (OS). The predictive and prognostic impact of all other markers on PFS and OS were also evaluated.
Results
Ninety-six baseline plasma samples were included in this analysis. Results from GOG-218 identified IL-6 was predictive of clinical benefit using a threshold of 2.9 pg/mL. Although the 2.9 pg/mL cut point did not validate in GY012, IL-6 associated with OS using the median level of 4.2 pg/mL as the cut point. Although patients with >4.2 pg/mL IL-6 had worse prognosis, higher IL-6 levels were associated with longer OS benefit in the cediranib arms (pintx = .085). In secondary analyses, osteopontin (OPN) and placental growth factor (PlGF) potentially predicted benefit. Patients with higher OPN levels had shorter OS in the olaparib arm, whereas patients with lower OPN had longer OS in the cediranib arms (pintx = .035). Patients with higher PlGF benefited more from cediranib (PFS, pintx = .030; OS, pintx = .024). Multiple prognostic markers were also identified.
Conclusions
IL-6 may be predictive of outcome; OPN and PlGF represent novel potential predictive biomarkers, in EC patients receiving anti-angiogenic therapy. Further evaluation is warranted.
{"title":"Blood-based biomarkers in patients with recurrent, persistent, or metastatic endometrial cancer treated with olaparib and cediranib: Results from NRG-GY012","authors":"Andrew B. Nixon PhD, MBA, Danielle M. Enserro PhD, David P. Bender MD, Yingmiao Liu PhD, Mark D. Starr BS, J. Chris Brady BS, Jesus Gonzalez Bosquet MD, Bobbie J. Rimel MD, Laura L. Holman MD, Colleen Rivard MD, Dan S. Veljovich MD, Julia Fehniger MD, John W. Moroney MD, Floor J. Backes MD, Mark Cadungog MD, Matthew A. Powell MD, Tara Castellano MD, Angeles Alvarez Secord MD, Helen J. MacKay MD","doi":"10.1002/cncr.70649","DOIUrl":"10.1002/cncr.70649","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The NRG-GY012 phase 2 trial evaluated olaparib, cediranib, and the combination in 120 patients with recurrent, persistent, or metastatic endometrial cancer (EC). Predictive and prognostic associations between blood-based biomarkers and clinical outcomes were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma samples collected at baseline, cycle 4 day 1, and disease progression were analyzed for circulating protein biomarkers (Angiome). The primary analysis evaluated the predictive impact of IL-6 on progression-free survival (PFS) and overall survival (OS). The predictive and prognostic impact of all other markers on PFS and OS were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-six baseline plasma samples were included in this analysis. Results from GOG-218 identified IL-6 was predictive of clinical benefit using a threshold of 2.9 pg/mL. Although the 2.9 pg/mL cut point did not validate in GY012, IL-6 associated with OS using the median level of 4.2 pg/mL as the cut point. Although patients with >4.2 pg/mL IL-6 had worse prognosis, higher IL-6 levels were associated with longer OS benefit in the cediranib arms (<i>p</i><sub>intx</sub> = .085). In secondary analyses, osteopontin (OPN) and placental growth factor (PlGF) potentially predicted benefit. Patients with higher OPN levels had shorter OS in the olaparib arm, whereas patients with lower OPN had longer OS in the cediranib arms (<i>p</i><sub>intx</sub> = .035). Patients with higher PlGF benefited more from cediranib (PFS, <i>p</i><sub>intx</sub> = .030; OS, <i>p</i><sub>intx</sub> = .024). Multiple prognostic markers were also identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IL-6 may be predictive of outcome; OPN and PlGF represent novel potential predictive biomarkers, in EC patients receiving anti-angiogenic therapy. Further evaluation is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelsey E. Breen MS, MSc, Shagun Vashisth MD, Ying L. Liu MD, MPH
The BRCA1 and BRCA2 tumor suppressor genes are integral to the repair of DNA double-strand breaks. Therefore, germline pathogenic variants (PVs) in either of these genes are associated with an increased risk of developing hereditary cancers. For over 30 years, studies have demonstrated a well established and markedly increased lifetime risk of female breast cancer and ovarian cancer for individuals with a PV in BRCA1 or BRCA2. Additional canonical cancers include prostate cancer, pancreatic cancer for males and females, and male breast cancer. Several noncanonical cancers have also been reported in association with BRCA1 or BRCA2, including stomach cancer and endometrial cancer. This review summarizes the established and evolving cancer risks associated with germline PVs in BRCA1 or BRCA2 as well as current clinical management recommendations. With increased uptake and diversified utility of germline genetic testing, this summary provides a current overview for clinical management of both male and female individuals with a PV in BRCA1 or BRCA2.
{"title":"Cancer risks associated with BRCA1 and BRCA2: Overview and management","authors":"Kelsey E. Breen MS, MSc, Shagun Vashisth MD, Ying L. Liu MD, MPH","doi":"10.1002/cncr.70635","DOIUrl":"10.1002/cncr.70635","url":null,"abstract":"<p>The <i>BRCA1</i> and <i>BRCA2</i> tumor suppressor genes are integral to the repair of DNA double-strand breaks. Therefore, germline pathogenic variants (PVs) in either of these genes are associated with an increased risk of developing hereditary cancers. For over 30 years, studies have demonstrated a well established and markedly increased lifetime risk of female breast cancer and ovarian cancer for individuals with a PV in <i>BRCA1</i> or <i>BRCA2</i>. Additional canonical cancers include prostate cancer, pancreatic cancer for males and females, and male breast cancer. Several noncanonical cancers have also been reported in association with <i>BRCA1</i> or <i>BRCA2</i>, including stomach cancer and endometrial cancer. This review summarizes the established and evolving cancer risks associated with germline PVs in <i>BRCA1</i> or <i>BRCA2</i> as well as current clinical management recommendations. With increased uptake and diversified utility of germline genetic testing, this summary provides a current overview for clinical management of both male and female individuals with a PV in <i>BRCA1</i> or <i>BRCA2</i>.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard D. Kim MD, Nikolas Naleid MD, PharmD, Adrian Bubie MSc, Nicole Zhang MPH, Keelia Clemens PhD, CGC
Background
Comprehensive genomic profiling (CGP) is recommended for advanced cholangiocarcinoma (aCCA). Circulating tumor DNA (ctDNA) testing provides a noninvasive alternative with concordance to tissue. Standard first-line (1L) therapy is gemcitabine and cisplatin (GemCis) with or without immune checkpoint inhibitors (ICIs). Data suggest that patients with isocitrate dehydrogenase 1 (IDH1) mutations may derive less benefit from ICIs. This study evaluated outcomes with 1L GemCis versus GemCis + ICI in ctDNA-identified IDH1-mutant (IDH1+) aCCA.
Methods
Real-world data were analyzed from the InfinityAI Data Library, which links claims data with CGP results from Guardant360. Patients with IDH1+ aCCA identified between April 2019 and February 2025 who received 1L GemCis or GemCis + ICI were included. Outcomes were real-world time to next treatment (rwTTNT), real-world time to treatment discontinuation (rwTTD), and real-world overall survival (rwOS), compared via Kaplan–Meier estimates and log-rank tests.
Results
Among 416 IDH1+ patients, 155 received GemCis and 113 received GemCis + ICI. No significant differences were observed in rwTTNT (hazard ratio [HR], 0.75; p = .13) or rwTTD (HR, 1.12; p = .40); however, rwOS was worse with GemCis + ICI compared with GemCis alone (16.0 months [95% CI, 13.6–19.9 months] vs. 30.0 months [95% CI, 24.1–41.0 months]; HR, 0.40; p < .001). In the GemCis + ICI aCCA cohort (N = 1150), IDH1+ patients (n = 113) had numerically shorter rwOS than non-IDH1+ patients (n = 1037) (HR, 0.75; p = .06).
Conclusions
In IDH1+ aCCA, addition of immunotherapy to GemCis was associated with inferior rwOS. These findings support obtaining ctDNA-based CGP before initiating 1L therapy, and underscore the need for prospective studies.
{"title":"Real-world outcomes in circulating tumor DNA–detected isocitrate dehydrogenase 1–mutant cholangiocarcinoma: First-line gemcitabine and cisplatin with versus without immunotherapy","authors":"Richard D. Kim MD, Nikolas Naleid MD, PharmD, Adrian Bubie MSc, Nicole Zhang MPH, Keelia Clemens PhD, CGC","doi":"10.1002/cncr.70646","DOIUrl":"10.1002/cncr.70646","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Comprehensive genomic profiling (CGP) is recommended for advanced cholangiocarcinoma (aCCA). Circulating tumor DNA (ctDNA) testing provides a noninvasive alternative with concordance to tissue. Standard first-line (1L) therapy is gemcitabine and cisplatin (GemCis) with or without immune checkpoint inhibitors (ICIs). Data suggest that patients with isocitrate dehydrogenase 1 (<i>IDH1</i>) mutations may derive less benefit from ICIs. This study evaluated outcomes with 1L GemCis versus GemCis + ICI in ctDNA-identified <i>IDH1</i>-mutant (<i>IDH1</i>+) aCCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Real-world data were analyzed from the InfinityAI Data Library, which links claims data with CGP results from Guardant360. Patients with <i>IDH1</i>+ aCCA identified between April 2019 and February 2025 who received 1L GemCis or GemCis + ICI were included. Outcomes were real-world time to next treatment (rwTTNT), real-world time to treatment discontinuation (rwTTD), and real-world overall survival (rwOS), compared via Kaplan–Meier estimates and log-rank tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 416 <i>IDH1</i>+ patients, 155 received GemCis and 113 received GemCis + ICI. No significant differences were observed in rwTTNT (hazard ratio [HR], 0.75; <i>p</i> = .13) or rwTTD (HR, 1.12; <i>p</i> = .40); however, rwOS was worse with GemCis + ICI compared with GemCis alone (16.0 months [95% CI, 13.6–19.9 months] vs. 30.0 months [95% CI, 24.1–41.0 months]; HR, 0.40; <i>p</i> < .001). In the GemCis + ICI aCCA cohort (<i>N</i> = 1150), <i>IDH1</i>+ patients (<i>n</i> = 113) had numerically shorter rwOS than non-<i>IDH1</i>+ patients (<i>n</i> = 1037) (HR, 0.75; <i>p</i> = .06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In <i>IDH1</i>+ aCCA, addition of immunotherapy to GemCis was associated with inferior rwOS. These findings support obtaining ctDNA-based CGP before initiating 1L therapy, and underscore the need for prospective studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Allo MD, Joshua Leutiger MD, Catherine Leyh MD, Christian Möhring MD, Ann-Kristin Zöller MD, Vera Himmelsbach MD, Gianluca Ciarlo MD, Maryam Barsch MD, Christoph Neumann-Haefelin MD, Bertram Bengsch MD, Fabian Finkelmeier MD, Mohamad Murad MD, Cennet Sahin MD, Marie-Luise Berres MD, Maria A. Gonzalez-Carmona MD, Christoph Roderburg MD, Arndt Weinmann MD, Anna Saborowski MD, Arndt Vogel MD, Dirk Waldschmidt MD
Background
Reliable prognostic biomarkers for treatment response in patients with biliary tract cancer (BTC) who receive chemoimmunotherapy are still lacking. The objective of this study was to evaluate the potential of early C-reactive protein (CRP) kinetics as a tool for predicting survival in these patients.
Methods
The authors retrospectively analyzed patients with BTC who received chemoimmunotherapy at eight tertiary centers and evaluated CRP kinetic models with regard of their prognostic ability within the first 3 months of treatment.
Results
Progression-free survival (PFS) and overall survival (OS) differed according to CRP dynamics. The median PFS was not reached (95% confidence interval [CI], not reached to not reached) for patients with consistently normal CRP, 11.0 months (95% CI, 6.7–15.3 months) for those with initially normal CRP, 6.0 months (95% CI, 3.6–8.4 months) for those with subsequent CRP normalization, and 2.0 months (95% CI, 0.9–3.1 months) for those with persistently elevated CRP. The corresponding median OS was not reached (95% CI, not reached to not reached) for patients with consistently normal CRP, 26 months (95% CI,15.5–36.5 months) for those with initially normal CRP, 23 months (95% CI, 12.0–34.0 months) for those with subsequent normalization, and 9.0 months (95% CI, 6.3–11.7 months) for those with persistently elevated CRP (PFS, log-rank p < .001; OS, p = .005). The overall response rates were 50%, 33.3%, 36.0%, and 21.2%, respectively. The prognostic performance of this model remained stable when subgroup definitions were based on 6-week cutoffs.
Conclusions
CRP kinetics may be a valuable prognostic tool for early response assessment in patients with BTC who receive chemoimmunotherapy. However, these findings require prospective external validation in larger cohorts.
{"title":"Evaluation of early C-reactive protein kinetics as an early response marker in biliary tract cancer treated with combined chemoimmunotherapy: A multicenter observational study","authors":"Gabriel Allo MD, Joshua Leutiger MD, Catherine Leyh MD, Christian Möhring MD, Ann-Kristin Zöller MD, Vera Himmelsbach MD, Gianluca Ciarlo MD, Maryam Barsch MD, Christoph Neumann-Haefelin MD, Bertram Bengsch MD, Fabian Finkelmeier MD, Mohamad Murad MD, Cennet Sahin MD, Marie-Luise Berres MD, Maria A. Gonzalez-Carmona MD, Christoph Roderburg MD, Arndt Weinmann MD, Anna Saborowski MD, Arndt Vogel MD, Dirk Waldschmidt MD","doi":"10.1002/cncr.70644","DOIUrl":"10.1002/cncr.70644","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Reliable prognostic biomarkers for treatment response in patients with biliary tract cancer (BTC) who receive chemoimmunotherapy are still lacking. The objective of this study was to evaluate the potential of early C-reactive protein (CRP) kinetics as a tool for predicting survival in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors retrospectively analyzed patients with BTC who received chemoimmunotherapy at eight tertiary centers and evaluated CRP kinetic models with regard of their prognostic ability within the first 3 months of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Progression-free survival (PFS) and overall survival (OS) differed according to CRP dynamics. The median PFS was <i>not reached</i> (95% confidence interval [CI], not reached to not reached) for patients with consistently normal CRP, 11.0 months (95% CI, 6.7–15.3 months) for those with initially normal CRP, 6.0 months (95% CI, 3.6–8.4 months) for those with subsequent CRP normalization, and 2.0 months (95% CI, 0.9–3.1 months) for those with persistently elevated CRP. The corresponding median OS was not reached (95% CI, not reached to not reached) for patients with consistently normal CRP, 26 months (95% CI,15.5–36.5 months) for those with initially normal CRP, 23 months (95% CI, 12.0–34.0 months) for those with subsequent normalization, and 9.0 months (95% CI, 6.3–11.7 months) for those with persistently elevated CRP (PFS, log-rank <i>p</i> < .001; OS, <i>p</i> = .005). The overall response rates were 50%, 33.3%, 36.0%, and 21.2%, respectively. The prognostic performance of this model remained stable when subgroup definitions were based on 6-week cutoffs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CRP kinetics may be a valuable prognostic tool for early response assessment in patients with BTC who receive chemoimmunotherapy. However, these findings require prospective external validation in larger cohorts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Proton therapy offers a distinct physical advantage over photon radiotherapy through the Bragg peak dose concentration in target with both lower integral dose and finite path length, and sharper penumbra as compared to photons, collectively reducing radiation exposure to surrounding normal tissues and potentially improving the therapeutic ratio. However, this advantage is tempered by uncertainties, including range uncertainty and variable relative biological effectiveness. In this review, the authors summarize contemporary evidence supporting proton therapy across pediatric, central nervous system (CNS), head and neck, thoracic, breast, gastrointestinal, genitourinary, and hematologic malignancies, as well as reirradiation. The strength of evidence varies substantially by disease site. Proton therapy is well established in pediatric cancers and selected CNS tumors, where minimizing integral dose and late toxicity is especially important. Randomized trials have demonstrated clinically meaningful benefits in selected settings, including improved disease control and survival with proton craniospinal irradiation for leptomeningeal metastases and reduced toxicity with preserved disease control and survival benefit in oropharyngeal cancer. Conversely, randomized data in localized prostate cancer have not shown improved patient reported outcomes compared with intensity modulated photon therapy. Ongoing phase 3 trials across multiple disease sites are expected to further define the role of protons by clarifying comparative effectiveness, toxicity reduction, and cost-effectiveness relative to advanced photon techniques. Future progress will depend on improved patient selection, robust treatment planning, and emerging technologies including adaptive proton therapy, proton arc therapy, and FLASH radiotherapy.
{"title":"Evolving role of proton therapy in contemporary oncology","authors":"Emily S. Lebow MD, Helen A. Shih MD","doi":"10.1002/cncr.70622","DOIUrl":"10.1002/cncr.70622","url":null,"abstract":"<p>Proton therapy offers a distinct physical advantage over photon radiotherapy through the Bragg peak dose concentration in target with both lower integral dose and finite path length, and sharper penumbra as compared to photons, collectively reducing radiation exposure to surrounding normal tissues and potentially improving the therapeutic ratio. However, this advantage is tempered by uncertainties, including range uncertainty and variable relative biological effectiveness. In this review, the authors summarize contemporary evidence supporting proton therapy across pediatric, central nervous system (CNS), head and neck, thoracic, breast, gastrointestinal, genitourinary, and hematologic malignancies, as well as reirradiation. The strength of evidence varies substantially by disease site. Proton therapy is well established in pediatric cancers and selected CNS tumors, where minimizing integral dose and late toxicity is especially important. Randomized trials have demonstrated clinically meaningful benefits in selected settings, including improved disease control and survival with proton craniospinal irradiation for leptomeningeal metastases and reduced toxicity with preserved disease control and survival benefit in oropharyngeal cancer. Conversely, randomized data in localized prostate cancer have not shown improved patient reported outcomes compared with intensity modulated photon therapy. Ongoing phase 3 trials across multiple disease sites are expected to further define the role of protons by clarifying comparative effectiveness, toxicity reduction, and cost-effectiveness relative to advanced photon techniques. Future progress will depend on improved patient selection, robust treatment planning, and emerging technologies including adaptive proton therapy, proton arc therapy, and FLASH radiotherapy.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Increased risk of stroke after a new cancer diagnosis—Where are the knowledge gaps currently?","authors":"Weam Almasaud MD, Ronda Lun MD, MSc","doi":"10.1002/cncr.70645","DOIUrl":"10.1002/cncr.70645","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bessie X. Zhang MD, MBA, Tal Sella MD, Yue Zheng MS, Gregory J. Kirkner MPH, Kathryn J. Ruddy MD, MPH, Shoshana M. Rosenberg ScD, MPH, Virginia F. Borges MD, MMSc, Lidia Schapira MD, Steven E. Come MD, Jeffrey M. Peppercorn MD, MPH, Laura Collins MD, Ann H. Partridge MD, MPH, Kristen D. Brantley PhD, MPH
Background
Breast cancer (BC) in young patients is often identified at later stages, which can result in poor prognosis. It is important to investigate the factors influencing care delays and how delays affect outcomes.
Methods
This study included women aged ≤40 years at diagnosis of stage 0–IV BC in the Young Women’s Breast Cancer Study enrolled between 2006 and 2016. Associations between patient and tumor factors and presentation delay (first symptom to provider visit, ≥90 days), diagnostic delay (presentation to diagnosis, ≥90 days), and treatment delay (diagnosis to treatment, ≥60 days) were estimated via logistic regression. Multivariable logistic models for delays were constructed via backward selection (p ≤ .05 retained). Multivariable Cox proportional hazards models tested the association between delays and disease-free survival (DFS) and overall survival (OS). Analyses were stratified by tumor subtype and stage.
Results
Among 1071 women, there were 153 presentation, 120 diagnostic, and 228 treatment delays. In multivariable models, lower annual income was associated with higher odds of presentation delay, whereas pregnancy at diagnosis, family history of BC, and triple-negative (TN) subtype were associated with lower odds. In HER2-positive luminal B tumors, presentation delays were associated with later stage (p < .001). Odds of diagnostic delay were higher for younger patients and lower for those with TN tumors. Patients with more aggressive tumor subtypes were less likely to have treatment delays. Delays were not associated with DFS or OS.
Conclusions
In this cohort of young patients with BC, demographic and tumor factors were associated with delays in care. It is reassuring that delays did not influence disease outcomes.
{"title":"Delays in breast cancer presentation, diagnosis, and treatment in young women","authors":"Bessie X. Zhang MD, MBA, Tal Sella MD, Yue Zheng MS, Gregory J. Kirkner MPH, Kathryn J. Ruddy MD, MPH, Shoshana M. Rosenberg ScD, MPH, Virginia F. Borges MD, MMSc, Lidia Schapira MD, Steven E. Come MD, Jeffrey M. Peppercorn MD, MPH, Laura Collins MD, Ann H. Partridge MD, MPH, Kristen D. Brantley PhD, MPH","doi":"10.1002/cncr.70594","DOIUrl":"10.1002/cncr.70594","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast cancer (BC) in young patients is often identified at later stages, which can result in poor prognosis. It is important to investigate the factors influencing care delays and how delays affect outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included women aged ≤40 years at diagnosis of stage 0–IV BC in the Young Women’s Breast Cancer Study enrolled between 2006 and 2016. Associations between patient and tumor factors and presentation delay (first symptom to provider visit, ≥90 days), diagnostic delay (presentation to diagnosis, ≥90 days), and treatment delay (diagnosis to treatment, ≥60 days) were estimated via logistic regression. Multivariable logistic models for delays were constructed via backward selection (<i>p</i> ≤ .05 retained). Multivariable Cox proportional hazards models tested the association between delays and disease-free survival (DFS) and overall survival (OS). Analyses were stratified by tumor subtype and stage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1071 women, there were 153 presentation, 120 diagnostic, and 228 treatment delays. In multivariable models, lower annual income was associated with higher odds of presentation delay, whereas pregnancy at diagnosis, family history of BC, and triple-negative (TN) subtype were associated with lower odds. In HER2-positive luminal B tumors, presentation delays were associated with later stage (<i>p</i> < .001). Odds of diagnostic delay were higher for younger patients and lower for those with TN tumors. Patients with more aggressive tumor subtypes were less likely to have treatment delays. Delays were not associated with DFS or OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this cohort of young patients with BC, demographic and tumor factors were associated with delays in care. It is reassuring that delays did not influence disease outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"132 20","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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