Journal Of Clinical Oncology Research Articles

Plain Language Summary of the iNNOVATE study: ibrutinib plus rituximab is well-tolerated and effective in people with Waldenström's macroglobulinemia.

This article provides a short summary of 5-year results from the iNNOVATE trial. The original paper was published in the Journal of Clinical Oncology in October 2021. People with Waldenström's macroglobulinemia (WM) were randomly divided into two groups of 75 people each. One group received a combination treatment composed of two drugs, ibrutinib plus rituximab, and the other group took placebo ("sugar pill") plus rituximab. Ibrutinib (also known by the brand name Imbruvica®) is a drug that reduces cancer cells' ability to multiply and survive. Ibrutinib is an FDA-approved drug for the treatment of WM. Rituximab is a drug that helps the immune system find and kill cancer cells. Participants in the trial were treated and their health monitored for up to 5years (63months). During the 5years of monitoring, more people who took ibrutinib plus rituximab experienced an improvement in their disease and lived longer without their disease getting worse compared to those who took placebo plus rituximab. Side effects from ibrutinib and rituximab were manageable and generally decreased over time. Participants in both study groups reported improvements in quality of life, but those who took ibrutinib plus rituximab reported significantly greater improvement in their quality of life (as measured by FACT-An score) compared to those who took placebo plus rituximab. These results show that ibrutinib plus rituximab is better than rituximab alone in people with WM and that ibrutinib plus rituximab is safe and effective in the long term. This information confirms the role of ibrutinib plus rituximab as a standard of care for WM. Clinical Trial Registration: NCT02165397 (ClinicalTrials.gov).

Frequency and Characteristics of Trials Using Medical Writer Support in High-Impact Oncology Journals

The practice of using medical writers to communicate scientific information has gained popularity, but it may affect how and what information is communicated. To assess characteristics of oncology trials that use medical writers and whether there is an association between the use of medical writers and trial success or the primary outcome evaluated. This cross-sectional study included oncology trials testing a tumor-targeting intervention that were published in The Lancet, The Lancet Oncology, JAMA, JAMA Oncology, Journal of Clinical Oncology, and The New England Journal of Medicine between May 1, 2021, and May 1, 2022. Assistance of medical writers or no assistance. The main outcomes were the percentage of studies with medical writers, the percentage of trial successes reported with medical writers, the association between trial success and medical writer use, and the association between a primary end point and medical writer use. Among 270 studies, 141 (52.2%) included a medical writer and 129 (47.8%) did not include a medical writer. Of the studies that included a medical writer, 83 (58.9%) were successful. Of the studies that did not include a medical writer, 64 (49.6%) were successful (P = .16 for difference). Studies with medical writers were less likely than studies without medical writers to have the end point of overall survival (15 [10.6%] vs 17 [13.2%]) and disease-free or event-free survival (16 [11.3%] vs 29 [22.5%]), whereas studies with a medical writer were more likely to have the end point of progression-free survival (32 [22.7%] vs 17 [13.2%]). Use of medical writer was associated with the conclusions being presented favorably in all studies (113 [80.1%] vs 89 [69.0%]; odds ratio [OR], 1.81 [95% CI, 1.04-3.19]), but when adjusted for other variables, there was no association (OR, 1.84 [95% CI, 0.92-3.72]). In this cross-sectional study, trials using medical writers were more likely to report surrogate end points, such as progression-free survival, and favorable conclusions, but when adjusted for trial phase, randomization, and study funding, there was no association with favorable conclusions. These findings suggest that journals need heightened scrutiny for studies with medical writers and that authorship should be properly acknowledged.

Editorial introductions.

Editorial introductions.

Proteasome Inhibitors Interact Synergistically with BCL2, Histone Deacetylase, BET, and Jak Inhibitors against Cutaneous T-Cell Lymphoma Cells

Cutaneous T-cell lymphoma (CTCL) is often refractory to treatment at advanced stages with blood involvement ( Dummer et al., 2021 Dummer R. Vermeer M.H. Scarisbrick J.J. Kim Y.H. Stonesifer C. Tensen C.P. et al. Cutaneous T cell lymphoma. Nature Reviews Disease Primers. 2021; 7: 61 Crossref PubMed Scopus (22) Google Scholar ). We have previously revealed the synergistic cytotoxic effects of inhibiting BCL2, HDAC, BET, and/or JAK in patient-derived CTCL cells and CTCL cell lines, suggesting potential advantages of a spectrum of combination treatment strategies for this disease ( Cyrenne et al., 2017 Cyrenne B.M. Lewis J.M. Weed J.G. Carlson K.R. Mirza F.N. Foss F.M. et al. Synergy of BCL2 and histone deacetylase inhibition against leukemic cells from cutaneous T-cell lymphoma patients. Blood. 2017; 130: 2073-2083 Crossref PubMed Scopus (36) Google Scholar , Kim et al., 2018 Kim S.R. Lewis J.M. Cyrenne B.M. Monico P.F. Mirza F.N. Carlson K.R. et al. BET inhibition in advanced cutaneous T cell lymphoma is synergistically potentiated by BCL2 inhibition or HDAC inhibition. Oncotarget. 2018; 9: 29193-29207 Crossref PubMed Scopus (35) Google Scholar , Yumeen et al., 2020 Yumeen S. Mirza F.N. Lewis J.M. King A.L.O. Kim S.R. Carlson K.R. et al. JAK inhibition synergistically potentiates BCL2, BET, HDAC, and proteasome inhibition in advanced CTCL. Blood Adv. 2020; 4: 2213-2226 Crossref PubMed Scopus (19) Google Scholar ). Proteasome inhibitors target multiple pathways including protein degradation to cause cytotoxicity and have been utilized in other hematologic malignancies. They have demonstrated efficacy as a single agent in a small phase II trial of patients with relapsed or refractory CTCL ( Zinzani et al., 2007 Zinzani P.L. Musuraca G. Tani M. Stefoni V. Marchi E. Fina M. et al. Phase II Trial of Proteasome Inhibitor Bortezomib in Patients With Relapsed or Refractory Cutaneous T-Cell Lymphoma. Journal of Clinical Oncology. 2007; 25: 4293-4297 Crossref PubMed Scopus (236) Google Scholar ), as well as in limited combinations during preclinical studies ( Yumeen et al., 2020 Yumeen S. Mirza F.N. Lewis J.M. King A.L.O. Kim S.R. Carlson K.R. et al. JAK inhibition synergistically potentiates BCL2, BET, HDAC, and proteasome inhibition in advanced CTCL. Blood Adv. 2020; 4: 2213-2226 Crossref PubMed Scopus (19) Google Scholar ) and early clinical trials ( Holkova et al., 2017 Holkova B. Yazbeck V. Kmieciak M. Bose P. Ma S. Kimball A. et al. A phase 1 study of bortezomib and romidepsin in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma, indolent B-cell lymphoma, peripheral T-cell lymphoma, or cutaneous T-cell lymphoma. Leuk Lymphoma. 2017; 58: 1349-1357 Crossref PubMed Scopus (15) Google Scholar ). Herein, we share our expanded preclinical assessment of the synergistic activity of proteasome inhibitors when used with the BCL2 inhibitor venetoclax, HDAC inhibitor vorinostat, BET inhibitor mivebresib, or JAK inhibitor fedratinib. We reveal that the cytotoxic effects from combination treatment were greater than additive when assessed in patient-derived CTCL cells. Furthermore, we demonstrate an increase in apoptosis pathway activation with combination treatment and explore the gene expression changes underlying these synergistic effects.

Visual analysis of global research on immunotherapy for gastric cancer: A literature mining from 2012 to 2022

ABSTRACT Gastric cancer (GC) is one of the most common malignancies. Immunotherapy becomes an indispensable part of GC. This study conducts bibliometric analysis of immunotherapy for GC to clarify the research status and identify potential new research directions. VOS viewer and CiteSpace visualization software were used to demonstrate collaborations and correlations. A total of 1141 English publications from 2012 to 2022 were included. The number of publications increased year by year. The publications were mainly from China (n = 579, 50.70%), followed by the United States. Fudan University published the most publications (n = 48, 4.21%). Frontiers in Oncology and Journal of Clinical Oncology ranked first in cited and co-cited journals, respectively. Kim Kyoung-Mee published the most publications on immunotherapy for GC (n = 14). The clustering of timeline view and co-cited references show the hotspot transformation on immunotherapy for GC. Initially, the hot topic was “cytokine-induced killer cells” and “myeloid-derived suppressor cells.” In recent years, the focus has turned to “targeted therapy.” “CAR-T” has become the hottest topic, and GC has entered precision therapy phase. Screening patients who can benefit from immunotherapy is key to improving prognosis. The combination of immunotherapy with other treatment options, such as chemotherapy and targeted therapy, is currently the focus of research. Chimeric antigen receptor T cell will be further studied in the future.

Minority groups underrepresented in hematologic cancer trials

Minority groups underrepresented in hematologic cancer trials

Plain Language Summary - Development and validation of risk calculators for people with "thin" melanomas on their skin to predict the likelihood that their cancer will return.

This is a summary of an article describing the development of risk calculators for use in people who develop a type of melanoma on their skin called "thin" melanoma to predict the likelihood that their cancer will return. The article was originally published in the Journal of Clinical Oncology in 2021. Calculations were performed to predict the chance of people with thin melanomas surviving without their melanoma recurring. Three graphical prediction calculators (called nomograms) were developed, along with easy-to-use online calculators using the same underlying calculation methods. The model was developed using data for 25,930 Dutch people diagnosed with thin melanomas (called the "development set"). To test its ability to predict melanoma recurrence, it was then compared with data for 2,968 Australian people with melanoma (the "validation set"). The calculators developed in the Dutch patients were found to accurately predict the risk of melanoma recurring for people with melanoma in the Australian "validation" group. The calculators provide estimates of the risk of the melanoma returning for people with thin melanomas. The easy-to-use online calculators are freely available on a smartphone, tablet or computer, and will assist in providing accurate estimates of recurrence risks for individuals with thin melanomas, allowing more intensive follow-up of those whose predicted risk of their melanoma returning is high.

Thanking all peer reviewers.

Journal Article Thanking all peer reviewers Get access Japanese Journal of Clinical Oncology, Volume 52, Issue 12, December 2022, Pages 1359–1362, https://doi.org/10.1093/jjco/hyac187 Published: 05 December 2022

"JJCO Best Reviewer Award".

Journal Article “JJCO Best Reviewer Award” Get access Japanese Journal of Clinical Oncology, Volume 52, Issue 12, December 2022, Page 1364, https://doi.org/10.1093/jjco/hyac172 Published: 05 December 2022

Research trends on anti-PD-1/PD-L1 immunotherapy for esophageal cancer: A bibliometric analysis.

The study aims to summarize publication characteristics of anti-programmed cell death protein 1 (PD-1)/programmed cell death 1 ligand 1 (PD-L1) immunotherapy for esophageal cancer and create scientific maps to explore hotspots and emerging trends with bibliometric methods. The publications between 2012 and 2021 were retrieved from the Web of Science Core Collection (WoSCC) on June 20, 2022. Bibliometric tools including HistCite, VOSviewer, and CiteSpace were used for statistical analysis. Data on the trend of the annual output, countries/regions, institutions, journals, authors, subject categories, keywords, and co-cited references were presented in this study. A total of 552 publications written by 3,623 authors of 872 institutions, 44 countries/regions in 250 journals were included in the bibliometric study. China, USA and Japan were the key countries in this field. Kato Ken, Bang Yung-Jue, Frontiers in Oncology, Journal of Clinical Oncology and Natl Canc Ctr were the top 1 productive author, co-cited author, productive journal, co-cited journal and prolific institution, respectively. The top 4 most present keywords were esophageal cancer, immunotherapy, esophageal squamous cell carcinoma and PD-L1. Neoadjuvant chemotherapy, response, PD-1 blockade and CD8+ T cell were four latest research frontiers. The keywords reflected the progress from PD-1/PD-L1 expression to the clinical application of PD-1/PD-L1 inhibitors. The current researches mainly focus on neoadjuvant immunotherapy for esophageal cancer and development of biomarkers. Further research is warranted to determine effective predictive biomarkers or models, illustrate the molecular mechanism of combined treatment, and construct the optimal therapeutic strategy. This study visually analyzed the global trend and hotspots of anti-PD-1/PD-L1 immunotherapy for esophageal cancer over the past decade. The results could guide scientists to comprehensively understand the global frontiers and determine future directions.

Real-World Patient-Reported Outcomes Among Recipients of Axicabtagene Ciloleucel for Relapsed/Refractory Large B Cell Lymphoma

Introduction: Limited data exist regarding patient-reported outcomes (PROs) of chimeric antigen receptor (CAR) T-cell therapy, with no published longitudinal studies to our knowledge reporting on patients treated as standard of care. The goal of the current study was to report on real-world changes in PROs (i.e., patient-reported symptoms and quality of life) in the first year after treatment with axicabtagene ciloleucel (axi-cel). Methods: Patients scheduled to receive axi-cel outside the context of a clinical trial were recruited between March 2020 and June 2022. They completed a baseline questionnaire at recruitment prior to conditioning chemotherapy before axi-cel. Patients completed subsequent questionnaires at 14, 30, 60, 90, 180 and 360 days post-infusion of axi-cel. PROs were assessed using the EORTC QLQ-C30. Mixed models evaluated change in EORTC global quality of life and subscales using all available data. Meaningful change was defined as a difference of 10 points, consistent with previous studies.1 Results: A total of 50 patients participated [mean age 62 (SD=13); 64% male; 72% diffuse large B cell lymphoma; 14% transformed follicular lymphoma, 14% follicular lymphoma]. The majority of patients (64%) would have been eligible at apheresis for the ZUMA-1 pivotal axi-cel trial; those who were ineligible typically had follicular lymphoma, poor performance status, and/or comorbidity. Regarding PROs, despite transient worsening at day 14, statistically-significant improvements in global quality of life (Panel 1), physical functioning, role functioning, social functioning, fatigue, insomnia, appetite loss, and constipation were observed over the course of the year (p values <0.05). Of these, clinically-significant improvements were observed at day 360 relative to baseline in global quality of life, role functioning, fatigue, insomnia, appetite loss, and constipation. Pain and financial concerns demonstrated statistically and clinically meaningful improvements to day 180, then worsened to baseline (i.e., pre-conditioning) levels or slightly below at day 360 (p values <0.05). Conclusions: Real-world data suggest that axi-cel is associated with transient worsening of quality of life and symptoms at day 14, with statistically and clinically significant improvements thereafter in overall quality of life and several functional and symptom domains. These data are generally consistent with PROs reported from clinical trials of CAR T-cell therapy. However, these findings extend previous research by reporting on patients' perspectives on CAR T-cell therapy received as standard of care in the real-world setting. 1Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139-144. Panel 1. Change in overall quality of life in the year following receipt of axicabtagene ciloleucel as part of standard of care. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Radiation Therapy for Low-Risk Breast Cancer: Whole, Partial, or None?

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.The following case represents a relatively common clinical scenario of a postmenopausal female patient who presents with low-risk, estrogen receptor-positive/progesterone receptor-positive/human epidermal growth factor receptor 2-negative, early-stage, left-sided breast cancer to discuss the role of postoperative radiation (RT) following wide local excision (WLE) and sentinel node biopsy. The spectrum of choices, ranging from omission of RT, accelerated partial breast irradiation (PBI), whole-breast radiation therapy, and the nuances of various dose/fractionation regimens for each option, are discussed in the context of the Danish Breast Cancer Study Group (DBCSG) PBI trial published in this issue, with additional review of other key trials that inform these treatment recommendations. After consideration of the clinical-pathologic features in the framework of the existing data and an in-depth discussion taking into consideration the patient's preferences/goals, the decision was made to deliver moderately hypofractionated RT (40 Gy/15 fractions) to a PBI volume, in concordance with the DBCSG-PBI trial.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

Open science and conflict of interest policies of medical and health sciences journals before and during the COVID-19 pandemic: A repeat cross-sectional study: Open science policies of medical journals.

To audit the transparent and open science standards of health and medical sciences journal policies and explore the impact of the COVID-19 pandemic. Repeat cross-sectional study. 19 journals listed in Google Scholar's Top Publications for health and medical sciences. Blood, Cell, Circulation, European Heart Journal, Gastroenterology, Journal of Clinical Oncology, Journal of the American College of Cardiology, Nature Genetics, Nature Medicine, Nature Neuroscience, Neuron, PLoS ONE, Proceedings of the National Academy of Sciences, Science Translational Medicine, The British Medical Journal, The Journal of the American Medical Association, The Lancet, The Lancet Oncology, and The New England Journal of Medicine. We used the Transparency and Openness Promotion (TOP) guideline and the International Committee of Medical Journal Editors (ICMJE) requirements for disclosing conflicts of interest (COIs) to evaluate journals standards. TOP scores slightly improved during the COVID-19 pandemic, from a median of 5 (IQR: 2-12.5) out of a possible 24 points in February 2020 to 7 (IQR: 4-12) in May 2021, but overall, scores were very low at both time points. Journal policies scored highest for their adherence to data transparency and scored lowest for preregistration of study protocols and analysis plans and the submission of replication studies. Most journals fulfilled all ICMJE provisions for reporting COIs before (84%; n = 16) and during (95%; n = 18) the COVID-19 pandemic. The COVID-19 pandemic has highlighted the importance of practising open science. However, requirements for open science practices in audited policies were overall low, which may impede progress in health and medical research. As key stakeholders in disseminating research, journals should promote a research culture of greater transparency and more robust open science practices.

When the Screen Retracts.

Susan J. Sample is the writer-in-residence at Huntsman Cancer Institute, University of Utah Health Sciences Center, in Salt Lake City, where she works with patients, family members, nurses, physicians, and social workers writing about their experiences. Her poetry has appeared in Tupelo Quarterly, JAMA, and the Journal of Clinical Oncology, among others. She is the author of Voices of Teenage Transplant Survivors: Miracle-Like (Emerald Publishing, 2021), and two chapbooks, Terrible Grace and Some Unsayable Blue (Finishing Line Press, 2011 and 2019). “When the Screen Retracts” © 2022 by Susan J. Sample. Contact author: [email protected]. Art of Nursing is coordinated by Diane Szulecki, editor: [email protected].

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

The AACR Journals: Advancing Progress Toward the AACR's 115-Year Mission.

Editorial introductions.

Editorial introductions.