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The Lancet Oncology
Journal Prestige (SJR): 16.085
Citation Impact (citeScore): 10
Number of Followers: 199  
 
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ISSN (Print) 1470-2045 - ISSN (Online) 1474-5488
Published by Elsevier Homepage  [3184 journals]
  • 5-year outcome after complete mesocolic excision for right-sided colon
           cancer: a population-based cohort study
    • Abstract: Publication date: Available online 13 September 2019Source: The Lancet OncologyAuthor(s): Claus A Bertelsen, Anders U Neuenschwander, Jens E Jansen, Jutaka R Tenma, Michael Wilhelmsen, Anders Kirkegaard-Klitbo, Else R Iversen, Birgitte Bols, Peter Ingeholm, Leif A Rasmussen, Lars V Jepsen, Pernille W Born, Bent Kristensen, Jakob KleifSummaryBackgroundThe benefits of extensive lymph node dissection as performed in complete mesocolic excision are still debated, although recent studies have shown an association with improved long-term outcomes. However, none of these studies had an intention-to-treat design or aimed to show a causal effect; therefore in this study, we aimed to estimate the causal oncological treatment effects of complete mesocolic excision on right-sided colon cancer.MethodsWe did a population-based cohort study involving prospective data collected from four hospitals in Denmark. We compared the oncological outcome data of patients at one centre performing central lymph node dissection and vascular division after almost complete exposure of the proximal part of the superior mesenteric vein (ie, the complete mesocolic excision group) with three other centres performing conventional resections with unstandardised and limited lymph node dissection (ie, non-complete mesocolic excision; control group). We included data for all patients in the Capital Region of Denmark undergoing elective curative-intent right-sided colon resections for stages I–III colon cancer, as categorised by the Union for International Cancer Control (UICC; 5th edition), from June 1, 2008, to Dec 31, 2013. Patients were followed-up for 5·2 years after surgery. The primary outcome was the cumulative incidence of recurrence after 5·2 years of surgery. Inverse probability of treatment weighting and competing risk analyses were used to estimate the possible causal effects of complete mesocolic excision. This study is registered with ClinicalTrials.gov, number NCT03754075.Findings1069 patients (813 in the control group and 256 in the complete mesocolic excision group) underwent curative-intent elective surgery for right-sided colon cancer during the study period. None of the patients were lost to follow-up regarding survival or recurrence status, and consequently no patient was censored in the analyses. The 5·2-year cumulative incidence of recurrence was 9·7% (95% CI 6·3–13·1) in the complete mesocolic excision group compared with 17·9% (15·3–20·5) in the control group, and the absolute risk reduction of complete mesocolic excision after 5·2 years was 8·2% (95% CI 4·0–12·4; p=0·00015). In the control group, 145 (18%) of 813 patients were diagnosed with a recurrence and 281 (35%) died during follow-up, whereas in the complete mesocolic excision group 25 (10%) of 256 patients were diagnosed with a recurrence and 75 (29%) died during follow-up.InterpretationThis study shows a causal treatment effect of central mesocolic lymph node excision on risk of recurrence after resection for right-sided colon adenocarcinoma. Complete mesocolic excision has the potential to reduce the risk of recurrence and improve long-term outcome after resection for all UICC stages I–III of right-sided colon adenocarcinomas.FundingThe Tvergaard Fund, Helen Rude Fund, Krista and Viggo Petersen Fund, Olga Bryde Nielsen Fund, and Else and Mogens Wedell-Wedellsborg Fund.
       
  • Complete mesocolic excision for colon cancer: is now the time for a change
           in practice'
    • Abstract: Publication date: Available online 13 September 2019Source: The Lancet OncologyAuthor(s): Nicholas P West
       
  • Expansion of bulk-buy drug programme in China
    • Abstract: Publication date: Available online 12 September 2019Source: The Lancet OncologyAuthor(s): Susan Rahimi
       
  • Metformin plus EGFR TKIs for lung adenocarcinoma
    • Abstract: Publication date: Available online 12 September 2019Source: The Lancet OncologyAuthor(s): Robert Stirrups
       
  • Targeting lineage plasticity in prostate cancer
    • Abstract: Publication date: Available online 9 September 2019Source: The Lancet OncologyAuthor(s): Emmanuel S Antonarakis
       
  • CDK4/6 inhibitors: taking the place of chemotherapy'
    • Abstract: Publication date: Available online 4 September 2019Source: The Lancet OncologyAuthor(s): Azadeh Nasrazadani, Adam M Brufsky
       
  • Health-related quality of life and neurocognitive functioning with
           lomustine–temozolomide versus temozolomide in patients with newly
           diagnosed, MGMT-methylated glioblastoma (CeTeG/NOA-09): a randomised,
           multicentre, open-label, phase 3 trial
    • Abstract: Publication date: Available online 2 September 2019Source: The Lancet OncologyAuthor(s): Johannes Weller, Theophilos Tzaridis, Frederic Mack, Joachim Peter Steinbach, Uwe Schlegel, Peter Hau, Dietmar Krex, Oliver Grauer, Roland Goldbrunner, Oliver Bähr, Martin Uhl, Clemens Seidel, Ghazaleh Tabatabai, Stefanie Brehmer, Lars Bullinger, Norbert Galldiks, Christina Schaub, Sied Kebir, Walter Stummer, Matthias SimonSummaryBackgroundThe CeTeG/NOA-09 trial showed significantly longer overall survival with combined lomustine–temozolomide therapy compared with standard temozolomide for patients with glioblastoma with methylated MGMT promoter. The trial also aimed to investigate the effect of lomustine–temozolomide therapy on health-related quality of life (HRQOL) and neurocognitive function, which we report here.MethodsIn this randomised, multicentre, open-label, phase 3 trial, newly diagnosed, chemoradiotherapy-naive patients with MGMT-methylated glioblastoma, aged 18–70 years, with a Karnofsky performance score of 70% or higher, were recruited and enrolled at 17 university hospitals in Germany. Patients received standard radiotherapy (60 Gy) and were randomly assigned (1:1, stratified by centre by allocating complete blocks of six to a centre, without masking) to either six 6-week courses of oral combined lomustine (100 mg/m2 on day 1) plus temozolomide (100–200 mg/m2 on days 2–6) or standard oral temozolomide (75 mg/m2 daily during radiotherapy plus six 4-week courses of temozolomide [150–200 mg/m2] on days 1–5, every 4 weeks). The primary endpoint was overall survival. HRQOL, assessed using the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire core-30 and the EORTC brain cancer module (BN20); and neurocognitive function, assessed using the Mini Mental State Examination (MMSE), plus a neurocognitive test battery (NOA-07), including Trail Making Test A and B (TMT-A and B), working memory tests, and tests for lexical (Controlled Oral Word Association [COWA]) and semantic verbal fluency, were secondary endpoints analysed in the modified intention-to-treat population (mITT; all randomly assigned patients who received at least one dose of study chemotherapy). We used linear mixed-model analyses to investigate differences between treatment groups regarding HRQOL (clinically relevant ≥10 points) and MMSE scores (clinically relevant ≥3 points). The trial is registered with ClinicalTrials.gov, NCT01149109.FindingsBetween June 17, 2011 and April 8, 2014, 141 patients were randomly assigned and 129 patients began treatment and were included in the mITT population (63 in the temozolomide and 66 in the lomustine–temozolomide group). Median follow-up for HRQOL (the item global health) was 19·4 months (IQR 7·8–38·6), for MMSE was 15·3 months (4·1–29·6), and for COWA was 11·0 months (0–27·5). We found no significant impairment regarding any item of HRQOL in the lomustine–temozolomide group (difference between the groups for global health 0·30 [95% CI −0·23 to 0·83]; p=0·26). Differences in MMSE were in favour of the temozolomide group (difference −0·11 [95% CI −0·19 to −0·03]; p=0·0058) but were not clinically relevant (1·76/30 points over 4 years). We found no significant difference between the groups in any subtest of the neurocognitive test battery (difference for COWA 0·04 [95% CI −0·01 to 0·09]; p=0·14).InterpretationThe absence of systematic and clinically relevant changes in HRQOL and neurocognitive function combined with the survival benefit of lomustine–temozolomide versus temozolomide alone suggests that a long-term net clinical benefit exists for patients with newly diagnosed glioblastoma with methylation of the MGMT promoter and supports the use of lomustine–temozolomide as a treatment option for these patients.FundingGerman Federal Ministry of Education and Research.
       
  • Correction to Lancet Oncol 2019; 20: e503–21
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s):
       
  • Correction to Lancet Oncol 2019; 20: 1273–85
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s):
       
  • Correction to Lancet Oncol 2019; 20: 1171–82
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s):
       
  • Correction to Lancet Oncol 2019; 20: 1148–59
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s):
       
  • Chemoimmunotherapy for stage IV non-small-cell lung cancer –
           Authors' reply
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s): Federico Cappuzzo, Howard West
       
  • Chemoimmunotherapy for stage IV non-small-cell lung cancer
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s): Dipesh Uprety
       
  • MRI versus mammography for breast cancer screening in women with familial
           risk (FaMRIsc)
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s): Steven A Narod
       
  • Collection of routine cancer data from private health-care providers
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s): Katie Spencer, Eva Morris
       
  • Disability in cancer care: time for change'
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s): The Lancet Oncology
       
  • Bone metastases as initial presentation of hepatocellular carcinoma
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s): Andrea Belli, Michele Gallo, Mauro Piccirillo, Francesco Izzo
       
  • A European paediatric cancer mission: aspiration or reality'
    • Abstract: Publication date: September 2019Source: The Lancet Oncology, Volume 20, Issue 9Author(s): Pamela R Kearns, Gilles Vassal, Ruth Ladenstein, Martin Schrappe, Andrea Biondi, Patricia Blanc, Angelika Eggert, Anita Kienesberger, Olga Kozhaeva, Rob Pieters, Kjeld Schmiegelow
       
  • Pyrotinib versus lapatinib in HER2-positive breast cancer
    • Abstract: Publication date: Available online 30 August 2019Source: The Lancet OncologyAuthor(s): Elizabeth Gourd
       
  • Nelfinavir with concurrent chemoradiotherapy in NSCLC
    • Abstract: Publication date: Available online 30 August 2019Source: The Lancet OncologyAuthor(s): Manjulika Das
       
  • Selinexor–dexamethasone for refractory multiple myeloma
    • Abstract: Publication date: Available online 30 August 2019Source: The Lancet OncologyAuthor(s): Robert Stirrups
       
  • Chemotherapy-free, but not quite free chemotherapy
    • Abstract: Publication date: Available online 29 August 2019Source: The Lancet OncologyAuthor(s): John O Schorge
       
  • The many roads to universal health care in the USA
    • Abstract: Publication date: Available online 28 August 2019Source: The Lancet OncologyAuthor(s): Greg Jones, Hagop KantarjianSummaryHealth-care systems in different countries have evolved along different paths, with some countries offering private insurance, some universal health care, and some a mixture between the two. In most high-income countries, health care is considered a human right and is provided universally, typically free at the point-of-care. The USA has developed a fractured for-profit system that is substantially more expensive than those of its European counterparts and delivers poorer outcomes than the health-care systems in other high-income countries, while leaving a substantial proportion of Americans without health coverage. This Personal View discusses the current health-care system in the USA and offers a roadmap towards the achievement of universal health care for the USA. Three key components of the roadmap are: support and improve the Affordable Care Act; maintain the existing private insurance system; offer in parallel a government-sponsored health-care insurance, or gradually expand Medicare to more people, and ultimately to all Americans not covered under existing health-care insurances.
       
  • Solid organ transplantations in childhood cancer survivors: an unrealised
           research potential
    • Abstract: Publication date: Available online 27 August 2019Source: The Lancet OncologyAuthor(s): Jeanette F Winther, Ida Maria Schmidt, Emilio D Poggio
       
  • Solid organ transplantation after treatment for childhood cancer: a
           retrospective cohort analysis from the Childhood Cancer Survivor Study
    • Abstract: Publication date: Available online 27 August 2019Source: The Lancet OncologyAuthor(s): Andrew C Dietz, Kristy Seidel, Wendy M Leisenring, Daniel A Mulrooney, Jean M Tersak, Richard D Glick, Cathy A Burnweit, Daniel M Green, Lisa R Diller, Susan A Smith, Rebecca M Howell, Marilyn Stovall, Gregory T Armstrong, Kevin C Oeffinger, Leslie L Robison, Amanda M TermuhlenSummaryBackgroundSerious chronic medical conditions occur in childhood cancer survivors. We aimed to investigate incidence of and risk factors for end-organ damage resulting in registration on a waiting list for or receiving a solid organ transplantation and 5-year survival following these procedures.MethodsThe Childhood Cancer Survivor Study (CCSS) is a retrospective cohort of individuals who survived at least 5 years after childhood cancer diagnosed at younger than 21 years of age, between Jan 1, 1970, and Dec 31, 1986, at one of 25 institutions in the USA. We linked data from CCSS participants treated in the USA diagnosed between Jan 1, 1970, and Dec 31, 1986 (without solid organ transplantation before cohort entry) to the Organ Procurement and Transplantation Network—a database of all US organ transplants. Eligible participants had been diagnosed with leukaemia, lymphoma, malignant CNS tumours, neuroblastoma, Wilms' tumours, and bone and soft tissue sarcomas. The two primary endpoints for each type of organ transplant were date of first registration of a transplant candidate on the waiting list for an organ and the date of the first transplant received. We also calculated the cumulative incidence of being placed on a waiting list or receiving a solid organ transplantation, hazard ratios (HRs) for identified risk factors, and 5-year survival following transplantation.FindingsOf 13 318 eligible survivors, 100 had 103 solid organ transplantations (50 kidney, 37 heart, nine liver, seven lung) and 67 were registered on a waiting list without receiving a transplant (21 kidney, 25 heart, 15 liver, six lung). At 35 years after cancer diagnosis, the cumulative incidence of transplantation or being on a waiting list was 0·54% (95% CI 0·40–0·67) for kidney transplantation, 0·49% (0·36–0·62) for heart, 0·19% (0·10–0·27) for liver, and 0·10% (0·04–0·16) for lung. Risk factors for kidney transplantation were unilateral nephrectomy (HR 4·2, 95% CI 2·3–7·7), ifosfamide (24·9, 7·4–83·5), total body irradiation (6·9, 2·3–21·1), and mean kidney radiation of greater than 15 Gy (>15–20 Gy, 3·6 [1·5–8·5];>20 Gy 4·6 [1·1–19·6]); for heart transplantation, anthracycline and mean heart radiation of greater than 20 Gy (dose-dependent, both p
       
  • TCR gene therapy for HPV-associated epithelial cancers
    • Abstract: Publication date: Available online 22 August 2019Source: The Lancet OncologyAuthor(s): Talha Khan Burki
       
  • Non-radioactive imaging for SLN detection in melanoma
    • Abstract: Publication date: Available online 22 August 2019Source: The Lancet OncologyAuthor(s): Manjulika Das
       
  • Correction to Lancet Oncol 2019; published online Aug 16.
           http://dx.doi.org/10.1016/S1470-2045(19)30413-9
    • Abstract: Publication date: Available online 21 August 2019Source: The Lancet OncologyAuthor(s):
       
  • Renal cell carcinoma treatment after first-line combinations
    • Abstract: Publication date: Available online 16 August 2019Source: The Lancet OncologyAuthor(s): Camillo Porta, Manuela Schmidinger
       
  • AZD1775 plus chemoradiotherapy for pancreatic cancer
    • Abstract: Publication date: Available online 16 August 2019Source: The Lancet OncologyAuthor(s): Talha Khan Burki
       
  • Should we use combination therapy for all advanced renal cell
           carcinoma'
    • Abstract: Publication date: Available online 16 August 2019Source: The Lancet OncologyAuthor(s): Giuseppe Procopio, Pierangela Sepe, Melanie Claps, Filippo de Braud, Elena Verzoni
       
  • Four-year survival with nivolumab in patients with previously treated
           advanced non-small-cell lung cancer: a pooled analysis
    • Abstract: Publication date: Available online 14 August 2019Source: The Lancet OncologyAuthor(s): Scott J Antonia, Hossein Borghaei, Suresh S Ramalingam, Leora Horn, Javier De Castro Carpeño, Adam Pluzanski, Marco A Burgio, Marina Garassino, Laura Q M Chow, Scott Gettinger, Lucio Crinò, David Planchard, Charles Butts, Alexander Drilon, Joanna Wojcik-Tomaszewska, Gregory A Otterson, Shruti Agrawal, Ang Li, John R Penrod, Julie BrahmerSummaryBackgroundPhase 3 clinical data has shown higher proportions of patients with objective response, longer response duration, and longer overall survival with nivolumab versus docetaxel in patients with previously treated advanced non-small-cell lung cancer (NSCLC). We aimed to evaluate the long-term benefit of nivolumab and the effect of response and disease control on subsequent survival.MethodsWe pooled data from four clinical studies of nivolumab in patients with previously treated NSCLC (CheckMate 017, 057, 063, and 003) to evaluate survival outcomes. Trials of nivolumab in the second-line or later setting with at least 4 years follow-up were included. Comparisons of nivolumab versus docetaxel included all randomised patients from the phase 3 CheckMate 017 and 057 studies. We did landmark analyses by response status at 6 months to determine post-landmark survival outcomes. We excluded patients who did not have a radiographic tumour assessment at 6 months. Safety analyses included all patients who received at least one dose of nivolumab.FindingsAcross all four studies, 4-year overall survival with nivolumab was 14% (95% CI 11–17) for all patients (n=664), 19% (15–24) for those with at least 1% PD-L1 expression, and 11% (7–16) for those with less than 1% PD-L1 expression. In CheckMate 017 and 057, 4-year overall survival was 14% (95% CI 11–18) in patients treated with nivolumab, compared with 5% (3–7) in patients treated with docetaxel. Survival subsequent to response at 6 months on nivolumab or docetaxel was longer than after progressive disease at 6 months, with hazard ratios for overall survival of 0·18 (95% 0·12–0·27) for nivolumab and 0·43 (0·29–0·65) for docetaxel; for stable disease versus progressive disease, hazard ratios were 0·52 (0·37–0·71) for nivolumab and 0·80 (0·61–1·04) for docetaxel. Long-term data did not show any new safety signals.InterpretationPatients with advanced NSCLC treated with nivolumab achieved a greater duration of response compared with patients treated with docetaxel, which was associated with a long-term survival advantage.FundingBristol-Myers Squibb.
       
  • Immune checkpoint inhibitors: a game changer for metastatic non-small-cell
           lung cancer
    • Abstract: Publication date: Available online 14 August 2019Source: The Lancet OncologyAuthor(s): Pierre-Jean Souquet, Sébastien Couraud
       
  • Choosing surgery or radiotherapy for oropharyngeal squamous cell
           carcinoma: is the issue definitely settled'
    • Abstract: Publication date: Available online 12 August 2019Source: The Lancet OncologyAuthor(s): Vincent Grégoire, Piero Nicolai
       
  • A new screening tool for FGFR inhibitor treatment'
    • Abstract: Publication date: Available online 9 August 2019Source: The Lancet OncologyAuthor(s): Aung Naing
       
  • Ibrutinib and rituximab for chronic lymphocytic leukaemia
    • Abstract: Publication date: Available online 8 August 2019Source: The Lancet OncologyAuthor(s): Robert Stirrups
       
  • Overcoming endocrine resistance in neoadjuvant endocrine therapy for early
           breast cancer
    • Abstract: Publication date: Available online 8 August 2019Source: The Lancet OncologyAuthor(s): Christian Jackisch
       
  • Correction to Lancet Oncol 2019; published online July 29.
           http://dx.doi.org/10.1016/S1470-2045(19)30530-3
    • Abstract: Publication date: Available online 6 August 2019Source: The Lancet OncologyAuthor(s):
       
  • Cancer control in the Caribbean island countries and territories: some
           progress but the journey continues
    • Abstract: Publication date: Available online 5 August 2019Source: The Lancet OncologyAuthor(s): Dingle Spence, Rachel Dyer, Glennis Andall-Brereton, Michael Barton, Susannah Stanway, M Austin Argentieri, Freddie Bray, Shamir Cawich, Sophia Edwards-Bennett, Christopher Fosker, Owen Gabriel, Natalie Greaves, Barrie Hanchard, James Hospedales, Silvana Luciani, Damali Martin, Marisa Nimrod, Camille Ragin, Donald Simeon, Guillermo Tortolero-LunaSummaryCancer causes a fifth of deaths in the Caribbean region and its incidence is increasing. Incidence and mortality patterns of cancer in the Caribbean reflect globally widespread epidemiological transitions, and show cancer profiles that are unique to the region. Providing comprehensive and locally responsive cancer care is particularly challenging in the Caribbean because of the geographical spread of the islands, the frequently under-resourced health-care systems, and the absence of a cohesive approach to cancer control. In many Caribbean countries and territories, cancer surveillance systems are poorly developed, advanced disease presentations are commonplace, and access to cancer screening, diagnostics, and treatment is often suboptimal, with many patients with cancer seeking treatment abroad. Capacity building across the cancer-control continuum in the region is urgently needed and can be accomplished through collaborative efforts and increased investment in health care and cancer control.
       
  • Cancer control in small island nations: from local challenges to global
           action
    • Abstract: Publication date: Available online 5 August 2019Source: The Lancet OncologyAuthor(s): Diana Sarfati, Rachel Dyer, Paula Vivili, Josephine Herman, Dingle Spence, Richard Sullivan, David Weller, Freddie Bray, Sarah Hill, Christopher Bates, Sunia Foliaki, Neal Palafox, Silvana Luciani, Alec Ekeroma, James HospedalesSummaryCancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population sizes that make sustainable workforce and service development problematic, and the unavailability of specialised cancer services to large parts of the population. Action is required to prevent large human and economic costs relating to cancer. This final Series paper highlights the challenges and opportunities for small island nations, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities to strengthen cancer-related health systems to improve sharing of technical assistance for research, surveillance, workforce, and service development, and to support small island nations with policy changes to reduce the consumption of commodities (eg, tobacco and unhealthy food products) that increase cancer risk.
       
  • Cancer management in the Pacific region: a report on innovation and good
           practice
    • Abstract: Publication date: Available online 5 August 2019Source: The Lancet OncologyAuthor(s): Alec Ekeroma, Rachel Dyer, Neal Palafox, Kiki Maoate, Jane Skeen, Sunia Foliaki, Andrew J Vallely, James Fong, Merilyn Hibma, Glen Mola, Martina Reichhardt, Livinston Taulung, George Aho, Toakase Fakakovikaetau, David Watters, Pamela J Toliman, Lee Buenconsejo-Lum, Diana SarfatiSummaryPacific island countries and territories (PICTs) face the challenge of a growing cancer burden. In response to these challenges, examples of innovative practice in cancer planning, prevention, and treatment in the region are emerging, including regionalisation and coalition building in the US-affiliated Pacific nations, a point-of-care test and treat programme for cervical cancer control in Papua New Guinea, improving the management of children with cancer in the Pacific, and surgical workforce development in the region. For each innovation, key factors leading to its success have been identified that could allow the implementation of these new developments in other PICTs or regions outside of the Pacific islands. These factors include the strengthening of partnerships within and between countries, regional collaboration within the Pacific islands (eg, the US-affiliated Pacific nations) and with other regional groupings of small island nations (eg, the Caribbean islands), a local commitment to the idea of change, and the development of PICT-specific programmes.
       
  • Cancer control in the Pacific: big challenges facing small island states
    • Abstract: Publication date: Available online 5 August 2019Source: The Lancet OncologyAuthor(s): Diana Sarfati, Rachel Dyer, Filipina Amosa-Lei Sam, Michael Barton, Freddie Bray, Eka Buadromo, Alec Ekeroma, Sunia Foliaki, James Fong, Josephine Herman, Linda Huggins, Kiki Maoate, Ineke Meredith, Glen Mola, Neal Palafox, Viliami Puloka, Hai-Rim Shin, Jane Skeen, Wendy Snowdon, Malama Tafuna'iSummaryThis Series paper describes the current state of cancer control in Pacific island countries and territories (PICTs). PICTs are diverse but face common challenges of having small, geographically dispersed, isolated populations, with restricted resources, fragile ecological and economic systems, and overburdened health services. PICTs face a triple burden of infection-related cancers, rapid transition to lifestyle-related diseases, and ageing populations; additionally, PICTs are increasingly having to respond to natural disasters associated with climate change. In the Pacific region, cancer surveillance systems are generally weaker than those in high-income countries, and patients often present at advanced cancer stage. Many PICTs are unable to provide comprehensive cancer services, with some patients receiving cancer care in other countries where resources allow. Many PICTs do not have, or have poorly developed, cancer screening, pathology, oncology, surgical, and palliative care services, although some examples of innovative cancer planning, prevention, and treatment approaches have been developed in the region. To improve cancer outcomes, we recommend prioritising regional collaborative approaches, enhancing cervical cancer prevention, improving cancer surveillance and palliative care services, and developing targeted treatment capacity in the region.
       
  • Cancer control in small island nations: too often overlooked
    • Abstract: Publication date: Available online 5 August 2019Source: The Lancet OncologyAuthor(s): Katherine Gourd, David Collingridge
       
  • Advancing cancer care and prevention in the Caribbean: a survey of
           strategies for the region
    • Abstract: Publication date: Available online 5 August 2019Source: The Lancet OncologyAuthor(s): Dingle Spence, M Austin Argentieri, Glennis Andall-Brereton, Benjamin O Anderson, Catherine Duggan, Curt Bodkyn, Freddie Bray, Tracey Gibson, Wendy Gomez Garcia, Natalie Greaves, Sumit Gupta, Virginia Hobday, Felicia McLean, Les Mery, Marisa Nimrod, Oscar Ocho, Corrine Sin Quee-Brown, Guillermo Tortolero-Luna, Alexandra E ShieldsSummaryCancer is now the second leading cause of death in the Caribbean. Despite this growing burden, many Caribbean small island nations have health systems that struggle to provide optimal cancer care for their populations. In this Series paper, we identify several promising strategies to improve cancer prevention and treatment that have emerged across small island nations that are part of the Caribbean Community. These strategies include the establishment of a Caribbean cancer registry hub, the development of resource-appropriate clinical guidelines, innovations in delivering specialty oncology services (eg, paediatric oncology and palliative care), improving access to opioids, and developing regional training capacity in palliative medicine. These developments emphasise the crucial role of public–private partnerships in improving health care for the region and show how fostering strategic collaborations with colleagues and centres in more developed countries, who can contribute specialised expertise and improve regional collaboration, can improve care across the cancer control continuum.
       
  • Radical surgery for cervical cancer
    • Abstract: Publication date: Available online 2 August 2019Source: The Lancet OncologyAuthor(s): Francesco Raspagliesi, Giorgio Bogani
       
  • Erdafitinib for advanced urothelial carcinoma
    • Abstract: Publication date: Available online 1 August 2019Source: The Lancet OncologyAuthor(s): Talha Khan Burki
       
  • Zanubrutinib in B-cell malignancies
    • Abstract: Publication date: Available online 1 August 2019Source: The Lancet OncologyAuthor(s): Manjulika Das
       
  • Combining PARP inhibition with PD-1 inhibitors
    • Abstract: Publication date: Available online 1 August 2019Source: The Lancet OncologyAuthor(s): Ulrik Lassen
       
  • US Government targets foreign researchers
    • Abstract: Publication date: Available online 1 August 2019Source: The Lancet OncologyAuthor(s): Bryant Furlow
       
  • Correction to Lancet Oncol 2019; 20: e417–33
    • Abstract: Publication date: Available online 30 July 2019Source: The Lancet OncologyAuthor(s):
       
  • The emerging role of PET-CT scan after radical prostatectomy: still a long
           way to go
    • Abstract: Publication date: Available online 30 July 2019Source: The Lancet OncologyAuthor(s): Nicola Fossati, Giorgio Gandaglia, Alberto Briganti, Francesco Montorsi
       
  • The growing burden of cancer in the Gaza Strip
    • Abstract: Publication date: August 2019Source: The Lancet Oncology, Volume 20, Issue 8Author(s): Bowirrat Abdalla, Mohammed Mansour, Mustafa Ghanim, Bowirrat Aia, Mustafa Yassin
       
  • Treatment of tenosynovial giant-cell tumour types
    • Abstract: Publication date: August 2019Source: The Lancet Oncology, Volume 20, Issue 8Author(s): Yoshihiro Nishida, Kunihiro Ikuta
       
  • Treatment of tenosynovial giant-cell tumour types
    • Abstract: Publication date: August 2019Source: The Lancet Oncology, Volume 20, Issue 8Author(s): Tang Haijun, Liu Yun, Zhan Xinli, Xiao Zengming
       
  • Cancer and night shift work: what we still do not know and why
    • Abstract: Publication date: August 2019Source: The Lancet Oncology, Volume 20, Issue 8Author(s): Kevin McConway
       
  • Are results from clinical trials reliable'
    • Abstract: Publication date: August 2019Source: The Lancet Oncology, Volume 20, Issue 8Author(s): The Lancet Oncology
       
  • Asbestos exposure: the dust cloud lingers
    • Abstract: Publication date: August 2019Source: The Lancet Oncology, Volume 20, Issue 8Author(s): The Lancet Oncology
       
  • Global burden of childhood cancer: growing, but controllable
    • Abstract: Publication date: Available online 29 July 2019Source: The Lancet OncologyAuthor(s): Charles A Stiller
       
  • Palbociclib: a new partner for cetuximab'
    • Abstract: Publication date: Available online 24 July 2019Source: The Lancet OncologyAuthor(s): Garth W Strohbehn, Everett E Vokes
       
  • 5-year results for pembrolizumab treatment of advanced melanoma
    • Abstract: Publication date: Available online 22 July 2019Source: The Lancet OncologyAuthor(s): Jessica C Hassel
       
  • Management of high-risk endometrial cancer: are we there yet'
    • Abstract: Publication date: Available online 22 July 2019Source: The Lancet OncologyAuthor(s): Marcus Randall
       
  • Adjuvant chemoradiotherapy versus radiotherapy alone in women with
           high-risk endometrial cancer (PORTEC-3): patterns of recurrence and
           post-hoc survival analysis of a randomised phase 3 trial
    • Abstract: Publication date: Available online 22 July 2019Source: The Lancet OncologyAuthor(s): Stephanie M de Boer, Melanie E Powell, Linda Mileshkin, Dionyssios Katsaros, Paul Bessette, Christine Haie-Meder, Petronella B Ottevanger, Jonathan A Ledermann, Pearly Khaw, Romerai D'Amico, Anthony Fyles, Marie-Helene Baron, Ina M Jürgenliemk-Schulz, Henry C Kitchener, Hans W Nijman, Godfrey Wilson, Susan Brooks, Sergio Gribaudo, Diane Provencher, Chantal HanzenSummaryBackgroundThe PORTEC-3 trial investigated the benefit of combined adjuvant chemotherapy and radiotherapy versus pelvic radiotherapy alone for women with high-risk endometrial cancer. We updated the analysis to investigate patterns of recurrence and did a post-hoc survival analysis.MethodsIn the multicentre randomised phase 3 PORTEC-3 trial, women with high-risk endometrial cancer were eligible if they had International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage I, endometrioid grade 3 cancer with deep myometrial invasion or lymphovascular space invasion, or both; stage II or III disease; or stage I–III disease with serous or clear cell histology; were aged 18 years and older; and had a WHO performance status of 0–2. Participants were randomly assigned (1:1) to receive radiotherapy alone (48·6 Gy in 1·8 Gy fractions given on 5 days per week) or chemoradiotherapy (two cycles of cisplatin 50 mg/m2 given intravenously during radiotherapy, followed by four cycles of carboplatin AUC5 and paclitaxel 175 mg/m2 given intravenously), by use of a biased coin minimisation procedure with stratification for participating centre, lymphadenectomy, stage, and histological type. The co-primary endpoints were overall survival and failure-free survival. Secondary endpoints of vaginal, pelvic, and distant recurrence were analysed according to the first site of recurrence. Survival endpoints were analysed by intention-to-treat, and adjusted for stratification factors. Competing risk methods were used for failure-free survival and recurrence. We did a post-hoc analysis to analyse patterns of recurrence with 1 additional year of follow-up. The study was closed on Dec 20, 2013; follow-up is ongoing. This study is registered with ISRCTN, number ISRCTN14387080, and ClinicalTrials.gov, number NCT00411138.FindingsBetween Nov 23, 2006, and Dec 20, 2013, 686 women were enrolled, of whom 660 were eligible and evaluable (330 in the chemoradiotherapy group, and 330 in the radiotherapy-alone group). At a median follow-up of 72·6 months (IQR 59·9–85·6), 5-year overall survival was 81·4% (95% CI 77·2–85·8) with chemoradiotherapy versus 76·1% (71·6–80·9) with radiotherapy alone (adjusted hazard ratio [HR] 0·70 [95% CI 0·51–0·97], p=0·034), and 5-year failure-free survival was 76·5% (95% CI 71·5–80·7) versus 69·1% (63·8–73·8; HR 0·70 [0·52–0·94], p=0·016). Distant metastases were the first site of recurrence in most patients with a relapse, occurring in 78 of 330 women (5-year probability 21·4%; 95% CI 17·3–26·3) in the chemoradiotherapy group versus 98 of 330 (5-year probability 29·1%; 24·4–34·3) in the radiotherapy-alone group (HR 0·74 [95% CI 0·55–0·99]; p=0·047). Isolated vaginal recurrence was the first site of recurrence in one patient (0·3%; 95% CI 0·0–2·1) in both groups (HR 0·99 [95% CI 0·06–15·90]; p=0·99), and isolated pelvic recurrence was the first site of recurrence in three women (0·9% [95% CI 0·3–2·8]) in the chemoradiotherapy group versus four (0·9% [95% CI 0·3–2·8]) in the radiotherapy-alone group (HR 0·75 [95% CI 0·17–3·33]; p=0·71). At 5 years, only one grade 4 adverse event (ileus or obstruction) was reported (in the chemoradiotherapy group). At 5 years, reported grade 3 adverse events did not differ significantly between the two groups, occurring in 16 (8%) of 201 women in the chemoradiotherapy group versus ten (5%) of 187 in the radiotherapy-alone group (p=0·24). The most common grade 3 adverse event was hypertension (in four [2%] women in both groups). At 5 years, grade 2 or worse adverse events were reported in 76 (38%) of 201 women in the chemoradiotherapy group versus 43 (23%) of 187 in the radiotherapy-alone group (p=0·002). Sensory neuropathy persisted more often after chemoradiotherapy than after radiotherapy alone, with 5-year rates of grade 2 or worse neuropathy of 6% (13 of 201 women) versus 0% (0 of 187). No treatment-related deaths were reported.InterpretationThis updated analysis shows significantly improved overall survival and failure-free survival with chemoradiotherapy versus radiotherapy alone. This treatment schedule should be discussed and recommended, especially for women with stage III or serous cancers, or both, as part of shared decision making between doctors and patients. Follow-up is ongoing to evaluate long-term survival.FundingDutch Cancer Society, Cancer Research UK, National Health and Medical Research Council, Project Grant, Cancer Australia Grant, Italian Medicines Agency, and the Canadian Cancer Society Research Institute.
       
  • Fusion gene-oriented precision medicine in soft tissue sarcoma
    • Abstract: Publication date: Available online 19 July 2019Source: The Lancet OncologyAuthor(s): Nobuhito Araki
       
  • The necessity for rigour in rare disease study design
    • Abstract: Publication date: Available online 19 July 2019Source: The Lancet OncologyAuthor(s): Laurence H Baker
       
  • Neoadjuvant radiotherapy improves hepatectomy survival
    • Abstract: Publication date: Available online 18 July 2019Source: The Lancet OncologyAuthor(s): Elizabeth Gourd
       
  • Improving affordability of new Essential Cancer Medicines
    • Abstract: Publication date: Available online 11 July 2019Source: The Lancet OncologyAuthor(s): Ellen 't Hoen, Salomé Meyer, Patrick Durisch, Wilbert Bannenberg, Katrina Perehudoff, Tim Reed, Melissa J Barber
       
  • Ramucirumab plus pembrolizumab: can we make the maths work'
    • Abstract: Publication date: Available online 10 July 2019Source: The Lancet OncologyAuthor(s): Samuel J Klempner, Zev A Wainberg
       
  • Of microbes and women: BRCA1, vaginal microbiota, and ovarian
           cancer
    • Abstract: Publication date: Available online 9 July 2019Source: The Lancet OncologyAuthor(s): Hans Verstraelen
       
  • Nanoparticle augmentation of radiotherapy in sarcoma
    • Abstract: Publication date: Available online 8 July 2019Source: The Lancet OncologyAuthor(s): Daniel P Nussbaum
       
  • Omitting radiotherapy after head and neck cancer surgery
    • Abstract: Publication date: Available online 4 July 2019Source: The Lancet OncologyAuthor(s): Elizabeth Gourd
       
  • Carcinogenicity of night shift work
    • Abstract: Publication date: Available online 4 July 2019Source: The Lancet OncologyAuthor(s): Elizabeth M Ward, Dori Germolec, Manolis Kogevinas, David McCormick, Roel Vermeulen, Vladimir N Anisimov, Kristan J Aronson, Parveen Bhatti, Pierluigi Cocco, Giovanni Costa, David C Dorman, Loning Fu, Anne Helene Garde, Pascal Guénel, Johnni Hansen, Mikko I Härmä, Kazuaki Kawai, Evgenii A Khizkhin, Anders Knutsson, Francis Lévi
       
  • Clofarabine and cytarabine for acute myeloid leukaemia
    • Abstract: Publication date: Available online 4 July 2019Source: The Lancet OncologyAuthor(s): Robert Stirrups
       
  • Study evidence confirms current clinical practice in refractory metastatic
           colorectal cancer: the ReDOS trial
    • Abstract: Publication date: Available online 28 June 2019Source: The Lancet OncologyAuthor(s): Ralf-Dieter Hofheinz, Sebastian Stintzing
       
  • SNMMI 2019 Annual Meeting
    • Abstract: Publication date: Available online 27 June 2019Source: The Lancet OncologyAuthor(s): David Collingridge
       
  • Lapatinib with chemotherapy for gastroesophageal cancer
    • Abstract: Publication date: Available online 27 June 2019Source: The Lancet OncologyAuthor(s): Robert Stirrups
       
  • A new agent in the family of antibody–drug conjugates
    • Abstract: Publication date: Available online 27 June 2019Source: The Lancet OncologyAuthor(s): Xavier Pivot, Thierry Petit
       
  • Improving selection of individuals into lung cancer screening programmes
    • Abstract: Publication date: Available online 26 June 2019Source: The Lancet OncologyAuthor(s): Christine D Berg
       
  • Anti-KIR3DL2 therapy in the treatment of Sézary syndrome
    • Abstract: Publication date: Available online 25 June 2019Source: The Lancet OncologyAuthor(s): Pietro Quaglino
       
  • Echoes of a failure: what lessons can we learn'
    • Abstract: Publication date: Available online 17 June 2019Source: The Lancet OncologyAuthor(s): Vernon K Sondak, Nikhil I Khushalani
       
  • Underdiagnosis is the main challenge in breast cancer screening
    • Abstract: Publication date: Available online 17 June 2019Source: The Lancet OncologyAuthor(s): Christiane K Kuhl
       
 
 
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