Int. J. Cancer [JOURNAL]
Sun
200 papers
Real-World Outcomes of Induction Immunochemotherapy Followed by Surgery for Advanced Non-Small Cell Lung Cancer.
Mi X, Zhang X, Lai H … +8 more , Zheng Q, Dai Z, Xing Y, Xie Y, Ji P, Mei J, Liu L, Pu Q
Int J Cancer · 2026 May · PMID 42158979 · Publisher ↗
To evaluate the efficacy, surgical safety, and prognosis of induction immunochemotherapy followed by surgery for advanced nonsmall cell lung cancer (NSCLC). We retrospectively analyzed 143 patients with clinical stage II...
To evaluate the efficacy, surgical safety, and prognosis of induction immunochemotherapy followed by surgery for advanced nonsmall cell lung cancer (NSCLC). We retrospectively analyzed 143 patients with clinical stage IIB-IVA NSCLC who received induction immunochemotherapy using data from a prospectively maintained database. Survival outcomes were assessed using the Kaplan-Meier method and Cox proportional hazards models. The cohort (N = 143) was predominantly male (92.3%), with clinical stage III-IV (86.7%). Following induction immunochemotherapy, surgical resection was performed in 139 patients (97.2%), with an R0 resection rate of 99.3%. Pathological complete response (pCR) and major pathological response (MPR) rates were 38.8% and 62.6%, respectively, both significantly higher in squamous cell carcinoma (SCC) than in adenocarcinoma (ADC) (p = 0.006). Video-assisted thoracoscopic surgery (VATS) was performed in 87.1% of resections, with a 14.0% conversion rate. Postoperative complications occurred in 33.1% of patients, mostly Clavien-Dindo grade I-II, with no perioperative mortality. At a median follow-up of 23.0 months, the 2-year event-free survival (EFS) and overall survival (OS) rates were 80.1% and 91.8%, respectively. Achieving pCR or MPR and SCC histology were associated with significantly better EFS (p < 0.05). Adjuvant immunotherapy was administered to 59.7% of patients; however, it did not significantly improve survival, regardless of whether patients achieved pCR. Induction immunochemotherapy followed by surgery demonstrates highly effective for advanced NSCLC, achieving encouraging pathological response, favorable survival and a manageable safety profile, particularly in patients with SCC. These results provide a rationale for further prospective validation.
Residence Near Agricultural Crops at Birth and Risk of Adult Testicular Germ Cell Tumors: A French Nationwide Case-Control Study Using Historical Aerial GIS Data.
Danjou AMN, Coste A, Grassot L … +10 more , Faure E, Crispim-Junior C, Tougne Rodet L, Pérol O, Béranger R, Perrin J, Charbotel B, Schüz J, Fervers B, TESTIS study group
Int J Cancer · 2026 May · PMID 42152549 · Publisher ↗
Early life exposure to pesticides, in particular through pesticides drift in residents nearby agricultural crops, is suspected to increase testicular germ cell tumors (TGCT) risk. We conducted a hospital-based case-contr...
Early life exposure to pesticides, in particular through pesticides drift in residents nearby agricultural crops, is suspected to increase testicular germ cell tumors (TGCT) risk. We conducted a hospital-based case-control study of 472 TGCT cases and 683 matched controls aged 18-45 years in France and estimated adult TGCT risk associated with agricultural surfaces around residence as a surrogate for environmental exposure to agricultural pesticides at time of birth. Surface of arable lands, orchards and vineyards in 500 m buffer around the participants' residential address at birth was assessed using geographic information system (GIS) methods and software semi-automatic processing of historical aerial images. Odds ratios (OR) for TGCT (overall and by histological subtype) and 95% confidence intervals (CI) were estimated using conditional logistic regression. No increased risk of TGCT was observed for presence of arable lands (OR = 1.14, CI = 0.86-1.52), vineyards (OR = 0.88, CI = 0.56-1.36) and agricultural surfaces overall (OR = 1.13, CI = 0.84-1.51) in 500 m buffer around residence at birth. Presence of orchards (prevalence: 8.7%) was associated with a modest increase in TGCT risk (OR = 1.51, 95% CI = 0.99-2.32), slightly stronger for seminoma (OR = 1.78, 1.07-2.97) and in participants conceived or in their first trimester after conception during spring-summer (OR = 1.70, 1.03-2.82). In conclusion, the study found no overall association between adult TGCT risk and agricultural crops around residence at birth, except for the presence of orchards, with a possible increase in seminoma risks, as well as TGCT risk in participants for whom the first trimester after conception fell into spring-summer.
Burden and Correlates of Multiple Chronic Infections and Their Associations With Cancer Incidence in Chinese Adults: A Large Case-Cohort Study.
Yang L, Clarke J, Kröller L … +17 more , Kartsonaki C, Fry H, Jeske R, Gordon A, Clark S, Hill M, Avery D, Chen Y, Du H, Lv J, Sun D, Yu C, Li L, Millwood IY, Waterboer T, Chen Z, China Kadoorie Biobank Collaborative Group
Int J Cancer · 2026 May · PMID 42152523 · Publisher ↗
Several oncogenic pathogens cause specific cancers, but uncertainties remain about many other chronic infections, combined pathogen effects and evidence from non-European populations. We conducted a case-cohort study of...
Several oncogenic pathogens cause specific cancers, but uncertainties remain about many other chronic infections, combined pathogen effects and evidence from non-European populations. We conducted a case-cohort study of ~30,000 site-specific incident cancer cases and > 8000 subcohort participants nested within the China Kadoorie Biobank. Baseline plasma was assayed for IgG antibodies against 47 antigens from 20 pathogens (16 viruses, 3 bacteria, 1 parasite) using an Automated Multiplex Serology assay. We described seroprevalence by age, sex, areas and lifestyle factors; estimated adjusted odd ratios for correlates of pathogen seropositivity in the subcohort using multivariable logistic regression and adjusted hazard ratios for overall and selected cancers using Prentice-weighted Cox models. Among subcohort participants, seroprevalence for most pathogens varied and was significantly associated with sex, region and birth cohort. Participants were seropositive for a mean of ~10 pathogens. Compared with seronegative participants, those seropositive for seven pathogens had significantly higher overall cancer risk, particularly for HCV (HR = 2.18, 95% CI: 1.90-2.49), CMV (1.23, 1.08-1.40) and HSV-2 (1.14, 1.09-1.18) and HPV-16 oncogenes (e.g., E6: 1.57, 1.40-1.75). Lower risks were observed for HSV-1 (0.88, 0.81-0.95) and among those with fewer co-infections. There were expected positive associations of liver cancer with HBV (2.29, 2.06-2.54) and HCV (7.05, 4.31-11.54) and of stomach cancer with H. pylori (1.91, 1.68-2.17). In Chinese adults, multiple chronic infections were associated with risk of overall and certain selected cancers. Further research is warranted to investigate pathogen-specific and co-infection-related risks of site-specific cancers.
Treatment Adequacy and Baseline Risk Modify the Association Between Adjuvant Chemotherapy and Survival After Pathological Complete Response in Rectal Cancer.
Wang C, Zhang X, An Y … +5 more , Liu C, Wu B, Xiao Y, Lu J, Lin G
Int J Cancer · 2026 May · PMID 42144888 · Publisher ↗
The role of adjuvant chemotherapy (ACT) in patients with locally advanced rectal cancer (LARC) who achieve pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) remains controversial, and it is...
The role of adjuvant chemotherapy (ACT) in patients with locally advanced rectal cancer (LARC) who achieve pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) remains controversial, and it is unclear whether pCR represents a uniformly low-risk state with respect to long-term outcomes. We retrospectively analyzed consecutive LARC patients who achieved pCR following nCRT and radical surgery between 2017 and 2022. Survival outcomes were assessed according to postoperative ACT administration, treatment adequacy (≥ 4 cycles vs. < 4 cycles), and baseline risk features. Among 1069 patients treated with nCRT and surgery, 251 (23.5%) achieved pCR. After a median follow-up of 49 months, no statistically significant differences in overall survival (OS) or disease-free survival (DFS) were observed between patients who received ACT and those who did not. In contrast, patients who completed an adequate course of ACT (≥ 4 cycles) demonstrated improved 4-year OS and DFS compared with those receiving fewer cycles or no ACT. This association was largely confined to patients with baseline high-risk features, while no significant survival differences were observed between different ACT regimens. These findings suggest that pCR does not represent a biologically homogeneous or uniformly low-risk condition in LARC. Adequate postoperative chemotherapy may confer survival benefit in selected high-risk patients. A risk-adapted approach to ACT warrants further investigation and prospective validation.
Molecular Tumor Boards in Malignant Melanoma: Uncovering Challenges and Opportunities in a Bicenter Retrospective Analysis in Germany.
Geidel G, Lowinus T, Metzger P … +24 more , Czurda R, Schipperges V, Paul U, Rünger A, Kött J, Heidrich I, Lehr S, Kühn J, Becker H, Miething C, Werner M, Laßmann S, Duyster J, Brummer T, Simon R, Alsdorf W, Christopeit M, Bokemeyer C, Eyerich K, Schneider SW, Rafei D, Börries M, Meiss F, Gebhardt C
Int J Cancer · 2026 May · PMID 42141746 · Publisher ↗
Despite therapeutic advancements, approximately 50% of advanced melanoma patients succumb to metastatic disease. Molecular tumor boards (MTB) aim to identify targetable molecular alterations to guide individualized treat...
Despite therapeutic advancements, approximately 50% of advanced melanoma patients succumb to metastatic disease. Molecular tumor boards (MTB) aim to identify targetable molecular alterations to guide individualized treatment strategies. Yet, real-world data on patient selection, referral timing, recommendation rates, implementation, and clinical impact remain limited. In this exploratory retrospective bicenter analysis, we evaluated 80 patients with advanced melanoma who presented at institutional MTBs of two comprehensive cancer centers. Clinical and molecular tumor data were analyzed using bioinformatic tools to characterize mutation profiles, treatment recommendations, and their real-world implementation. Most patients (88.3%) had stage IV melanoma at the time of presentation and had received a median of three prior systemic treatment lines. Actionable treatment recommendations were formulated in 77.9% of eligible cases, yet only 33.7% of recommendations were implemented. Non-implementation was most commonly attributable to early patient death or regulatory barriers. Importantly, when recommended therapies were applied, patients experienced significantly improved progression-free survival (7.85 vs. 4.34 months; PFS ratio 1.8) and overall survival (10.64 vs. 5.06 months) compared with patients in whom recommended treatments were not implemented. Among patients with implemented MTB recommendations (n = 26), the median intra-patient PFS ratio was 1.68, and 14 of 26 patients (53.8%) achieved a PFS ratio ≥ 1.3. These findings indicate that MTBs frequently generate clinically actionable recommendations for metastatic melanoma, but late-stage referral substantially limits their real-world implementation. When applied, molecularly guided treatment strategies may confer meaningful clinical benefit, underscoring the importance of earlier integration of MTBs into melanoma care pathways.
The Addition of Concurrent Immune Checkpoint Inhibitors for Chemoradiotherapy With Consolidative Immune Checkpoint Inhibitors in Unresectable Cancers: A Systematic Review and Meta-Analysis.
Tong X, Liu Z, Zhou X … +2 more , Bi N, Gao Y
Int J Cancer · 2026 May · PMID 42135603 · Publisher ↗
Following the success of chemoradiotherapy (CRT) combined with consolidative immune checkpoint inhibitors (ICIs) in locally advanced tumors, over 30 ongoing randomized controlled trials (RCTs) are investigating the poten...
Following the success of chemoradiotherapy (CRT) combined with consolidative immune checkpoint inhibitors (ICIs) in locally advanced tumors, over 30 ongoing randomized controlled trials (RCTs) are investigating the potential benefits of adding concurrent ICIs. To investigate the differences in efficacy and safety between adding and not adding concurrent ICIs to CRT followed by consolidative ICIs, a literature search was conducted in PubMed, Embase, and the Cochrane Library, incorporating RCTs comparing CRT combined with consolidative ICIs versus CRT alone, or CRT with both concurrent and consolidative ICIs versus CRT alone. The primary outcomes were overall survival (OS) and progression-free survival (PFS). To reduce potential bias, an additional mirror-design analysis was performed through network meta-analysis. A total of 13 RCTs comprising 6868 patients and 14 cohort studies comprising 4724 patients were included. While patients treated with CRT and consolidative ICIs demonstrated significantly superior OS and PFS to patients treated with CRT alone in RCTs (HR of OS, 0.743, 95% CI, 0.654-0.843; HR of PFS, 0.674, 95% CI, 0.577-0.786), CRT and concurrent-plus-consolidative ICIs did not improve OS and PFS compared with CRT alone (HR of OS, 0.942, 95% CI, 0.782-1.134; HR of PFS, 0.880, 95% CI, 0.752-1.030). Significant differences were detected in OS (p = 0.038) and PFS (p = 0.017) between CRT combined with consolidative ICIs treatment versus CRT combined with concurrent and consolidative ICIs treatment from RCTs. In conclusion, adding concurrent ICIs may dampen the survival benefits of CRT combined with consolidative ICIs. This evidence informs future RCT design strategies.
Early-Life Exposures and Risk of Multiple Myeloma: A Population-Based Case-Control Study in Australia.
Sun Z, Bassett JK, Cheah S … +8 more , Bruinsma FJ, Cozen W, Harrison SJ, Prince HM, Wong Doo N, Giles GG, Milne RL, Lynch BM
Int J Cancer · 2026 May · PMID 42135593 · Publisher ↗
Multiple myeloma (MM) is a hematologic malignancy with few known modifiable risk factors. Early-life exposures may influence immune system development and, in turn, affect cancer susceptibility. We examined whether expos...
Multiple myeloma (MM) is a hematologic malignancy with few known modifiable risk factors. Early-life exposures may influence immune system development and, in turn, affect cancer susceptibility. We examined whether exposures while in utero or during early childhood were associated with MM risk. We conducted a population- and family-based case-control study with 782 MM cases and 1121 controls. Early-life exposures including maternal smoking, being breastfed, childhood growth patterns, household living arrangements, and pet ownership were self-reported. Multivariable logistic regression models, adjusted for age at enrolment, sex, country of birth, socioeconomic position, rural-urban residence and birth weight, were fitted using multiple imputation by chained equations to handle missing data. Living in a home with five or more children was associated with a lower risk of MM (OR = 0.57, 95% CI: 0.38-0.86). Sharing a bedroom before age 11 years (OR = 0.80, 95% CI: 0.64-1.00) and pet ownership in early childhood (OR = 0.76, 95% CI: 0.60-0.98) were also inversely associated with MM risk. No clear associations were observed for maternal smoking during pregnancy (OR = 1.09, 95% CI: 0.79-1.51), being breastfed (OR = 0.96, 95% CI: 0.72-1.28), or height relative to peers at age 7 or 11 (7 years: OR = 1.10, 95% CI: 0.86-1.41; 11 years: OR = 1.06, 95% CI: 0.83-1.34). Our findings support the hypothesis that early-life immune stimulation through environmental exposures may reduce the risk of MM. Further studies are needed to elucidate the biological mechanisms underlying these associations and to explore potential preventive strategies.
Optical Genome Mapping Reveals Frequent Cryptic Structural Aberrations in Normal Karyotype Acute Myeloid Leukemia.
Turtinen T, Valkama A, Wray C … +5 more , Vorimo S, Räsänen H, Savolainen ER, Pylkäs K, Mantere T
Int J Cancer · 2026 May · PMID 42132347 · Publisher ↗
Approximately half of newly diagnosed acute myeloid leukemia (AML) cases are cytogenetically normal (CN) when analyzed with conventional karyotyping. However, CN-AML exhibits a wide range of clinical heterogeneity, which...
Approximately half of newly diagnosed acute myeloid leukemia (AML) cases are cytogenetically normal (CN) when analyzed with conventional karyotyping. However, CN-AML exhibits a wide range of clinical heterogeneity, which may partly be explained by structural variants (SVs) that are not detected with current standard cytogenetic techniques. Here, 48 CN-AML cases were analyzed using optical genome mapping (OGM) for comprehensive SV assessment and to identify novel candidate gene alterations. Abnormalities were detected in 22 of 48 cases (46%). Large SVs, or those affecting leukemia-associated genes, were identified in 16 cases (33%), encompassing 18 abnormalities. Copy-neutral loss-of-heterozygosity regions were detected in seven cases (15%), and they were mutually exclusive with the presence of SVs in all but one case. SVs included eight deletions, six partial tandem duplications, two balanced translocations, and two complex rearrangements. The most frequently altered genes were KMT2A (5 cases) and RUNX1 (3 cases), followed by deletions of NF1 and the 13q14 (DLEU) region (2 cases each). Single alterations included NUP98::NSD1 and deletions of TET2, PRPF8, and FLT3. In addition, as a novel finding, we identified a balanced translocation t(3;20)(p13;q13.12) leading to a putative FOXP1::EYA2 fusion. Notably, the presence of OGM-detected abnormalities was associated with worse disease-specific survival (Mantel-Cox test, p = 0.007). Overall, this study demonstrates that a significant proportion of CN-AML cases harbor clinically relevant SVs, especially those associated with adverse prognosis, that escape detection by standard techniques. Our results support the use of OGM as a streamlined, genome-wide tool for both research and diagnostic applications in AML.
Cardiovascular disease incidence and cancer risk in two large European prospective cohorts.
Fontvieille E, Viallon V, Peruchet-Noray L … +23 more , Gan Q, Onland-Moret NC, Koop Y, Tjønneland A, Bondonno NP, Katzke V, Kaaks R, Schulze MB, Schiborn C, Saieva C, Simeon V, Agnoli C, Tumino R, Ricceri F, Luján-Barroso L, Sánchez MJ, Moreno-Iribas C, Tsilidis KK, Gunter MJ, Butterworth A, Riboli E, Freisling H, Ferrari P
Int J Cancer · 2026 May · PMID 42132299 · Publisher ↗
Our study investigated the association between incident cardiovascular disease (CVD) and subsequent cancer risk in two large European prospective cohorts. We included 568,926 adults from the European Prospective Investig...
Our study investigated the association between incident cardiovascular disease (CVD) and subsequent cancer risk in two large European prospective cohorts. We included 568,926 adults from the European Prospective Investigation into Cancer and Nutrition and United Kingdom Biobank, all of whom were free of CVD, cancer and type 2 diabetes at baseline. Multivariable Cox proportional hazards regression models were used to estimate cancer hazard ratios (HRs) and 95% confidence intervals (CIs) in relation to incident CVD events. CVD was treated as a time-varying exposure, and models accounted for time since CVD diagnosis and other lifestyle factors. Study-specific estimates were pooled using meta-analysis. Over a median follow-up of 10.9 years, 51,559 participants developed cancer, including 2344 with a prior CVD diagnosis. In men and women combined, CVD was associated with a higher risk of cancer within the first year after diagnosis of CVD (hazard ration [HR] = 1.65, 95% CI: 1.46-1.86), but not between 1 and 5 years (HR = 1.05, 95% CI: 0.94-1.19) or after 5 years of CVD diagnosis (HR = 1.01, 95% CI: 0.93-1.09). Results were consistent across both cohorts. In sex-specific analyses, CVD was associated with an increased cancer risk 1-5 years post-diagnosis in women (HR = 1.13, 95% CI: 1.06-1.21), while in men, no such association was observed (HR = 1.02, 95% CI: 0.90-1.16). Men with a newly diagnosed CVD had a higher cancer risk within the first year of CVD, likely due to overdiagnosis, but no association was observed beyond 1 year. In women, a diagnosis of CVD was associated with an increased risk of cancer for up to 5 years post-diagnosis, suggesting that cancer overdiagnosis is less likely. These findings should be interpreted given the lack of CVD medication data.
Nimotuzumab Combined With Concurrent Curative Radiotherapy and S-1 in 75 Years and Older Patients With Stage II-IVB Esophageal Squamous Cell Carcinoma: A Phase II Study.
Xia X, Yan J, Xu L … +3 more , Sun X, Ge X, Chen H
Int J Cancer · 2026 May · PMID 42129967 · Publisher ↗
Concurrent chemoradiotherapy is the standard treatment for inoperable, locally advanced esophageal cancer. However, older patients often have reduced tolerance to radiotherapy and concurrent intravenous chemotherapy due...
Concurrent chemoradiotherapy is the standard treatment for inoperable, locally advanced esophageal cancer. However, older patients often have reduced tolerance to radiotherapy and concurrent intravenous chemotherapy due to declining physical function and multiple comorbidities. This prospective, single-center, phase II study assessed the efficacy and safety of nimotuzumab, an epidermal growth factor receptor antagonist, combined with concurrent radiotherapy and S-1 in patients 75 years and older. A total of 56 patients were enrolled, with the primary endpoint being progression-free survival (PFS), while secondary endpoints included overall survival (OS), objective response rate, disease control rate, treatment-related adverse events, nutritional indicators, and quality of life (QOL). Most nutritional indicators remained stable after treatment. As of June 2024, the median follow-up duration was 24.1 months (8.8-34.1). Eleven patients achieved complete response, 39 achieved partial response, five had stable disease, and one experienced progressive disease. The median PFS was 25.3 months (95% CI, 16.5-34.1), while the median OS was 28.2 months (95% CI, 24.1-32.3). Most adverse events were grade 1-2 (85.7%). Among survivors, 45.5% reported high satisfaction with their QOL, and 84.8% did not experience weight loss. This combination therapy demonstrated promising efficacy and safety, suggesting it may be a viable treatment option for this patient population.
Cancer Risk in Marfan Syndrome: A Swedish Population-Based Cohort Study.
Nordgren I, Nordenvall AS, Wachtmeister A … +6 more , Taylan F, Lu Y, Norrby C, Lindstrand A, Grigelioniene G, Tettamanti G
Int J Cancer · 2026 May · PMID 42129962 · Publisher ↗
Marfan syndrome is an autosomal dominant connective tissue disorder caused by pathogenic variants in the fibrillin-1-encoding gene. The cancer risk in Marfan syndrome is not fully understood, but recent reports have sugg...
Marfan syndrome is an autosomal dominant connective tissue disorder caused by pathogenic variants in the fibrillin-1-encoding gene. The cancer risk in Marfan syndrome is not fully understood, but recent reports have suggested an increased risk in adults. This study assessed cancer risk in Marfan syndrome using population-based data from the Swedish National registers. We performed a register-based nationwide matched cohort study of 1544 individuals with Marfan syndrome, born 1930-2017. Each individual was matched to 50 comparisons by birth year, sex and birth county. Cancer risk was estimated using Cox proportional hazard models, expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). All cancer cases diagnosed before age 20 years were classified as childhood cancer, and those diagnosed at age 20 years or older were classified as adult cancer. The overall risk of adult cancer was not increased in individuals with Marfan syndrome (HR 1.00, 95% CI 0.78-1.27). However, there was an increased risk of endocrine tumours in adults with Marfan syndrome (HR 2.86, 95% CI 1.40-5.85). Furthermore, an over two-fold increased risk of cancer was observed among children with Marfan syndrome (HR 2.44, 95% CI 1.25-4.80). In this study, we found an increased cancer risk in children with Marfan syndrome. In contrast to previous reports, we did not detect an increased overall cancer risk in adults with Marfan syndrome, but an elevated site-specific risk of endocrine tumours. Further, larger studies are warranted to evaluate the lifetime cancer risk in Marfan syndrome at different ages.
Diurnal Patterns of Accelerometer-Measured Physical Activity and Sleep in Relation to Cancer Risk: Findings From a Nationally Representative Study.
Chen B, Wu Y, Li Y … +4 more , Wang Y, Yang Y, Liu S, Zhao J
Int J Cancer · 2026 May · PMID 42129954 · Publisher ↗
Physical activity (PA) and sleep are modifiable lifestyle factors, yet their circadian patterns in relation to cancer risk remain unclear. This study investigated their independent and joint associations with cancer risk...
Physical activity (PA) and sleep are modifiable lifestyle factors, yet their circadian patterns in relation to cancer risk remain unclear. This study investigated their independent and joint associations with cancer risk. We analyzed data from 9038 adults aged ≥ 20 years in the 2011-2014 National Health and Nutrition Examination Survey. Circadian patterns of PA and sleep were derived from accelerometer data using k-means clustering. Weighted logistic regression assessed their independent and joint associations with cancer risk. Diurnal patterns were identified as early-morning (n = 2981), midday (n = 3497), and late-afternoon (n = 2560) for PA, and as morning lark (n = 4851), night owl (n = 2949), and irregular (n = 1238) for sleep. After adjusting for confounders, the early-morning PA pattern was associated with a 26% lower cancer risk compared with the midday PA pattern (OR = 0.74, 95% CI: 0.61-0.90), while the combined early-morning PA and morning lark sleep pattern conferred an even stronger protective effect compared with the midday PA and morning lark sleep joint pattern, corresponding to a 31% reduction (OR = 0.69, 95% CI: 0.49-0.96). Stratified analyses indicated that the inverse association of the early-morning PA pattern with cancer risk was stronger in females. No significant associations were observed between diurnal patterns of sleep and the risk of cancer. This study demonstrates that an early-morning PA pattern is associated with reduced cancer risk, with synergistically enhanced effects when combined with a morning lark sleep chronotype.
Chemoimmunotherapy With or Without Thoracic Radiotherapy for Elderly Patients in Advanced Non-Small Cell Lung Cancer.
Gao Z, Yang L, Wang L
Int J Cancer · 2026 May · PMID 42121314 · Publisher ↗
The optimal integration of thoracic radiotherapy (TRT) with first-line chemoimmunotherapy for elderly patients with driver-negative advanced non-small cell lung cancer (NSCLC) remains undefined. We conducted a real-world...
The optimal integration of thoracic radiotherapy (TRT) with first-line chemoimmunotherapy for elderly patients with driver-negative advanced non-small cell lung cancer (NSCLC) remains undefined. We conducted a real-world study to assess the efficacy and safety of this triple-modality therapy specifically in patients aged ≥ 65 years. We designed a retrospective analysis of elderly patients with stage IV, mutation-negative NSCLC who underwent first-line platinum-based chemotherapy combined with immunotherapy at our institution between November 2019 and September 2024. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method, and differences between groups were compared with the log-rank test. After a median follow-up of 22.34 months, the addition of TRT yielded numerically longer but statistically non-significant median PFS (12.20 vs. 10.17 months; p = 0.24) and OS (29.67 vs. 18.65 months; p = 0.09). Subgroup analysis suggested a potential survival trend with triple therapy in patients aged 65-70 years, whereas no benefit was observed in those aged ≥ 70 years. Notably, treatment discontinuation due to adverse events was significantly more frequent in the Chemo+ICI+TRT group, with pneumonia being the predominant cause. For elderly patients with advanced NSCLC, particularly those aged ≥ 70 years, incorporating TRT into first-line chemoimmunotherapy did not significantly improve survival but substantially increased toxicity, often leading to treatment interruption. A potential benefit observed in patients aged 65-70 years requires prospective validation. These results highlight the critical need for personalized treatment intensity in geriatric oncology.
Comments on "Trends and Epidemiology of Human Papillomavirus-Related Oropharyngeal Cancer in Chinese Populations From 2010 to 2024".
Liu H, Zhang T, Wu L … +1 more , Shen Z
Int J Cancer · 2026 May · PMID 42121229 · Publisher ↗
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Risk-Benefit of Phase 2 Monotherapy Trials in Adult Solid Cancers: A Systematic Review and Meta-Analysis.
Ouimet C, Rosu M, Kimmelman J
Int J Cancer · 2026 May · PMID 42117884 · Publisher ↗
Phase 2 (and phase 1 dose expansion, which we label phase 2 for the purposes of this study) cancer trials are the first direct tests of a new drug's efficacy. Because efficacy evidence is lacking, the therapeutic status...
Phase 2 (and phase 1 dose expansion, which we label phase 2 for the purposes of this study) cancer trials are the first direct tests of a new drug's efficacy. Because efficacy evidence is lacking, the therapeutic status of drug administration during ethical review is uncertain. We compared the efficacy and safety of cancer monotherapies in phase 2 with phase 3, where clinical equipoise underwrites a therapeutic status for drug administration. In this systematic review and meta-analysis, we searched Clinicaltrials.gov for phase 2 and 3 investigational monotherapy drug trials in six solid malignancies, with primary completion dates 2015-2020, inclusive. Two independent reviewers completed data extraction. Effects were estimated using an inverse-variance weighted random-effects model meta-analysis of proportions using the R package meta. We analyzed 130 phase 2 and 52 phase 3 trial arms, enrolling 6665 and 18,694 patients. The pooled objective response rate was 7% (95% CI 5%-11%) in phase 2 versus 24% in phase 3 (95% CI 17%-31%; p < 0.0001). The median PFS and OS were shorter in phase 2 compared to phase 3 (3.23 vs. 5.43 months, p < 0.0001; 9.46 vs. 14.44 months, p = 0.0001). The pooled rate of drug-related grade 3-4 adverse events was 30% (95% CI 23%-37%) in phase 2 and 25% (95% CI 19%-32%) in phase 3. Monotherapies delivered in phase 2 cancer trials present diminished risk-benefit compared with phase 3 and align with historic estimates for phase 1. Though there may be exceptions, risks for drug administration in phase 2 should generally be justified by appeals to research rather than therapeutic value.
ICLAC Register Version 14: A Continuing Legacy of the International Journal of Cancer.
Weiskirchen R
Int J Cancer · 2026 May · PMID 42108423 · Publisher ↗
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The Relevance of Curative-Intent Metastasectomy in Colorectal Cancer Patients: Real-World Insights From a Certified Comprehensive Cancer Center in Germany.
Holch JW, Eisenburger JA, Weber A … +16 more , Kammermeier-Wehlau I, Wiberg Y, Allmendinger F, Heinrich K, Weiss L, Westphalen CB, Krenmayr V, Dorman K, Zhang D, Fey T, Berger-Thürmel K, Wirth U, Kühn F, von Bergwelt-Baildon M, Werner J, Heinemann V
Int J Cancer · 2026 May · PMID 42104745 · Publisher ↗
Long-term survival in metastatic colorectal cancer (mCRC) can be achieved by curative-intent metastasectomy. Patients ineligible for upfront (primary) metastasectomy (PM) may become candidates for secondary metastasectom...
Long-term survival in metastatic colorectal cancer (mCRC) can be achieved by curative-intent metastasectomy. Patients ineligible for upfront (primary) metastasectomy (PM) may become candidates for secondary metastasectomy (SM) following response to primary chemotherapy (PCT), still with curative intent. Most studies focus either on resectable or unresectable mCRC, limiting insights into differential subgroup benefits. Here, real-world data offer a comprehensive evaluation of PM, SM, and PCT. We analyzed real-world data from mCRC patients treated at the certified Comprehensive Cancer Center of the LMU Hospital (CCC Munich) from 2007 to 2021, following ESMO's guidance for real-world evidence (GROW). Overall survival (OS) data were matched with the Bavarian Cancer Registry. OS was assessed using Kaplan-Meier estimates and Cox regression analysis, adjusting for prognostic factors, including primary tumor sidedness and number of metastatic sites. Of 840 evaluable patients, 166 (20%) underwent PM, 520 (62%) received PCT, and 109 (13%) became eligible for SM after response to systemic treatment. OS was significantly longer for PM versus PCT (82.3 vs. 41.6 months, HR = 0.47, p < 0.0001). Multivariate analysis confirmed PM benefit across all subgroups, including high-risk patients (e.g., right-sided and multisite mCRC). OS was comparable between PM and SM (82.3 vs. 80.9 months), whereas patients ineligible for local treatments had the worst OS (25 months). Both PM and SM were associated with excellent OS, also for patients with high-risk mCRC. Our findings underscore the importance of initial evaluation and continuous reassessment of resectability throughout the course of treatment against mCRC, as implemented at the CCC Munich.
Integrating Shared Decision-Making Into Breast Cancer Postmastectomy Reconstruction: A Systematic Review of Evidence, Barriers, and Real-World Implementation.
Maes-Carballo M, de-la-Puente-Mota N, Sampol-Ramírez L … +2 more , Martínez-Martínez C, Gómez-Fandiño Y
Int J Cancer · 2026 May · PMID 42098969 · Publisher ↗
This systematic review synthesizes empirical evidence on the development, effectiveness, patient experience, and implementation of decision aids (DAs) for postmastectomy breast reconstruction (PMBR) and to evaluate the r...
This systematic review synthesizes empirical evidence on the development, effectiveness, patient experience, and implementation of decision aids (DAs) for postmastectomy breast reconstruction (PMBR) and to evaluate the role of pre-consultation educational interventions in supporting shared decision-making (SDM). Following PRISMA guidelines and a preregistered protocol (OSF: https://osf.io/mu9hv), six electronic databases and gray literature sources were searched for studies on PMBR DAs through November 2025. Eligible studies were categorized using a five-domain framework aligned with IPDAS and MRC guidance: (1) DA development and early evaluation, (2) randomized controlled trials (RCTs), (3) qualitative/mixed-methods studies, (4) implementation and practice-improvement studies, and (5) pre-consultation educational interventions. Study quality was assessed using the QualSyst tool. Thirty-two studies met the inclusion criteria, comprising 16 RCTs, 10 observational designs, and 6 qualitative or mixed-methods investigations. Across formats (digital, paper-based, and multimedia), DAs consistently improved patient knowledge (mean increase 15%-30%), reduced decisional conflict (20%-50% reduction), and enhanced values clarification, with high acceptability. Effects on SDM behaviors, consultation dynamics, and long-term outcomes were more variable, often constrained by workflow integration challenges and heterogeneity in clinician engagement. Implementation studies demonstrated feasibility and usability but emphasized the need for structured incorporation into clinical encounters. Qualitative findings highlighted persistent informational gaps, expectation misalignment, and psychosocial influences on decision satisfaction. In conclusion, PMBR DAs reliably enhance knowledge, reduce decisional conflict, and support value-concordant decision-making. Despite strong evidence from high-quality RCTs, further research is needed to optimize implementation, integrate DAs into routine workflows, and tailor interventions to psychosocial and equity-related patient needs.
Penpulimab and Gemcitabine With or Without Anlotinib in Metastatic Nasopharyngeal Carcinoma: A Randomized, Open-Label, Multicenter Phase 2 Study.
Huang S, Han YQ, Yang KY … +5 more , Qu S, Qu SH, Qiang MY, Cao CN, Chen XZ
Int J Cancer · 2026 May · PMID 42093316 · Publisher ↗
This prospective exploratory phase 2 study employed a three-cohort, two-phase design to evaluate the potential of anlotinib as a substitute for cisplatin in gemcitabine-penpulimab combinations for metastatic nasopharynge...
This prospective exploratory phase 2 study employed a three-cohort, two-phase design to evaluate the potential of anlotinib as a substitute for cisplatin in gemcitabine-penpulimab combinations for metastatic nasopharyngeal carcinoma (NPC) patients who were previously treated with cisplatin-based chemoradiotherapy. Patients enrolled in the study were randomized in a 1:1:1 ratio during the lead-in phase to one of three treatment arms: gemcitabine, cisplatin, penpulimab, and anlotinib (GP-PA, n = 8); gemcitabine, cisplatin, and penpulimab (GP-P, n = 6); or gemcitabine, penpulimab, and anlotinib (GAP, n = 6). The expansion phase enriched the optimal cohort, with stratification based on PD-L1 expression. The primary endpoints were safety and objective response rate (ORR), while the secondary endpoints included duration of response, disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). In the lead-in phase, grade ≥ 3 treatment-emergent adverse events (TEAEs) occurred in 87.5% (GP-PA), 100% (GP-P), and 66.7% (GAP) patients, predominantly hematologic toxicities. ORR/DCR were 62.5%/87.5% (GP-PA), 83.3%/100% (GP-P), and 100%/100% (GAP). At median 20.2-month follow-up, median PFS/OS were 4.1/18.4 months for GP-PA and not reached for GP-P/GAP. In the expansion phase, a total of 14 patients received GAP, with an ORR of 93.3% and grade ≥ 3 TEAEs in 71.4% of patients. At data cut-off point, the median PFS had not been reached, and the 12-month PFS and OS rates were 53.8% and 78.6%, respectively. The GAP regimen demonstrated a favorable safety and efficacy profile, compared to the GP-PA and GP-P regimens in patients with metastatic NPC. These findings suggest that substituting cisplatin with anlotinib may offer a viable therapeutic strategy for this patient population.
Can Response Outcomes Predict Survival in Paediatric Patients Receiving Treatment for Relapsed and Refractory Rhabdomyosarcoma? Results From the Living-REFoRMS Systematic Review.
Muthukumar P, Shepherd L, Anwer S … +2 more , Evans C, Morgan JE
Int J Cancer · 2026 Aug · PMID 42093305 · Full text
The relationship between radiological response and survival outcomes has been studied in upfront treatment in paediatric rhabdomyosarcoma and adult cancer settings. However, the extent of the relationship between these o...
The relationship between radiological response and survival outcomes has been studied in upfront treatment in paediatric rhabdomyosarcoma and adult cancer settings. However, the extent of the relationship between these outcomes is unknown in children and young people (CYP) with relapsed and refractory rhabdomyosarcoma. Studies included in the Living-REFoRMS systematic review were analysed using Pearson correlation and linear regression to assess the relationship between objective response rate (ORR) and disease control rate (DCR), and progression-free survival (PFS) and overall survival (OS). Post hoc sensitivity analyses were conducted to assess the impact of removing cohorts that only included one evaluable CYP with rhabdomyosarcoma. Thirty-one studies (18% of total Living-REFoRMS dataset) reporting 46 cohorts with a total of 419 evaluable CYP were eligible for this analysis. Forty-eight percent of cohorts included only one evaluable CYP with rhabdomyosarcoma. ORR and DCR were positively correlated with PFS (p < 0.0001). ORR and DCR were positively correlated with OS, though this was not statistically significant in ORR (p = 0.276). All correlations were statistically significant in the sensitivity analyses, highlighting the impact that cohorts including a single CYP with rhabdomyosarcoma evaluable for response had on the results. These results illustrate a positive correlation between tumour shrinkage and control, and the duration of survival in relapsed and refractory rhabdomyosarcoma. We encourage the reporting of both ORR and DCR (or the elements required to calculate these) by tumour type within study reports to facilitate these aspects of clinical decision making.
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