2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Tae9,Globally, 968 350 new cases and 659 853 deaths from gastric cancer were reported in 2022. In the US, 30 300 new cases and 10 780 deaths were estimated in 2025. Gastric cancer is more common in men, and the median age at diagnosis is 68 years. Most gastric cancers (>90%) are adenocarcinomas. Worldwide, 85% of cases arise from the stomach body or antrum and 15% from the cardia. In the US, more than 90% of patients diagnosed with gastric cancer present with symptoms such as weight loss and abdominal pain. At presentation, approximately 13% have localized disease (limited to the stomach), 15% to 25% have locally advanced disease, defined as a tumor that has spread to regional lymph nodes, and 35% to 65% have metastatic disease. Helicobacter pylori infection is a treatable risk factor associated with 90% of gastric body and antrum cancers globally. Additional modifiable risk factors include smoking, alcohol, obesity, and salt intake. In countries with high incidence such as Japan and Korea, routine endoscopic screening beginning at age 40 years is associated with improved survival. Diagnosis is made by endoscopic biopsy. Patients with localized gastric cancer are treated with surgical resection and have a 5-year relative survival rate of 75% with treatment. Patients with more advanced-stage disease should receive gastrectomy, perioperative chemotherapy with 5-fluorouracil, oxaliplatin, and docetaxel and immunotherapy (durvalumab). Metastatic or unresectable disease may be treated with chemotherapy, immunotherapy, and/or targeted therapy depending on biomarkers, including programmed cell death ligand 1 (PD-L1), human epidermal growth factor receptor 2 (ERBB2; formerly HER2 or HER2/neu), and claudin-18, isoform 2 (CLDN18.2). For PD-L1-expressing gastric cancer, adding immune checkpoint inhibitors, such as nivolumab and pembrolizumab, is associated with an additional 3 months of survival when compared with chemotherapy alone. For gastric cancers overexpressing the ERBB2 or CLDN18.2 proteins, the addition of trastuzumab or zolbetuximab, respectively, is associated with an additional 3 to 4 months' survival. Early supportive care focusing on symptom management and on nutritional and psychosocial support is associated with 3 months of survival benefit. Less than 10% of patients with metastatic gastric cancer survive more than 5 years. Approximately 30 300 new cases of gastric cancer are diagnosed annually in the US. Localized gastric cancer is treated with gastrectomy, and locally advanced disease is treated with surgery and chemoimmunotherapy. For patients with unresectable or metastatic gastric cancer, chemotherapy with immune checkpoint inhibitors and targeted therapies such as trastuzumab or zolbetuximab improves survival by several months.31:Te7b, Importance Globally, 968 350 new cases and 659 853 deaths from gastric cancer were reported in 2022. In the US, 30 300 new cases and 10 780 deaths were estimated in 2025. Observations Gastric cancer is more common in men, and the median age at diagnosis is 68 years. Most gastric cancers (&gt;90%) are adenocarcinomas. Worldwide, 85% of cases arise from the stomach body or antrum and 15% from the cardia. In the US, more than 90% of patients diagnosed with gastric cancer present with symptoms such as weight loss and abdominal pain. At presentation, approximately 13% have localized disease (limited to the stomach), 15% to 25% have locally advanced disease, defined as a tumor that has spread to regional lymph nodes, and 35% to 65% have metastatic disease. Helicobacter pylori infection is a treatable risk factor associated with 90% of gastric body and antrum cancers globally. Additional modifiable risk factors include smoking, alcohol, obesity, and salt intake. In countries with high incidence such as Japan and Korea, routine endoscopic screening beginning at age 40 years is associated with improved survival. Diagnosis is made by endoscopic biopsy. Patients with localized gastric cancer are treated with surgical resection and have a 5-year relative survival rate of 75% with treatment. Patients with more advanced-stage disease should receive gastrectomy, perioperative chemotherapy with 5-fluorouracil, oxaliplatin, and docetaxel and immunotherapy (durvalumab). Metastatic or unresectable disease may be treated with chemotherapy, immunotherapy, and/or targeted therapy depending on biomarkers, including programmed cell death ligand 1 (PD-L1), human epidermal growth factor receptor 2 ( ERBB2 ; formerly HER2 or HER2/neu ), and claudin-18, isoform 2 (CLDN18.2). For PD-L1–expressing gastric cancer, adding immune checkpoint inhibitors, such as nivolumab and pembrolizumab, is associated with an additional 3 months of survival when compared with chemotherapy alone. For gastric cancers overexpressing the ERBB2 or CLDN18.2 proteins, the addition of trastuzumab or zolbetuximab, respectively, is associated with an additional 3 to 4 months’ survival. Early supportive care focusing on symptom management and on nutritional and psychosocial support is associated with 3 months of survival benefit. Less than 10% of patients with metastatic gastric cancer survive more than 5 years. Conclusions and Relevance Approximately 30 300 new cases of gastric cancer are diagnosed annually in the US. Localized gastric cancer is treated with gastrectomy, and locally advanced disease is treated with surgery and chemoimmunotherapy. For patients with unresectable or metastatic gastric cancer, chemotherapy with immune checkpoint inhibitors and targeted therapies such as trastuzumab or zolbetuximab improves survival by several months. 32:T96c,The optimal integration of immunotherapy with definitive chemoradiotherapy (CRT) for unresectable stage III non-small cell lung cancer (NSCLC) remains an area of active investigation. While consolidation immunotherapy is standard, the efficacy and safety of a neoadjuvant approach are not yet established by phase III trials. This real-world study compares outcomes between neoadjuvant immuno-chemotherapy followed by CRT (NEO) and CRT followed by adjuvant immunotherapy (ADJ, the PACIFIC regimen). In this multicenter retrospective analysis, we reviewed data from patients with stage III NSCLC who received radical thoracic radiotherapy and peri-radiotherapy immunotherapy between January 2020 and December 2023. Patients were classified into NEO (n = 321) or ADJ (n = 142) groups. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Secondary endpoints included treatment patterns, recurrence modes, and incidence of pneumonitis. Propensity score matching (PSM) and robust statistical analyses were used to minimize confounding. The median PFS was significantly longer in the NEO group than in the ADJ group (25.0 months vs. 16.3 months; HR = 0.57, 95 % CI: 0.43-0.74; p < 0.001). Median OS was not reached (NR) in the NEO group compared to 41.1 months in the ADJ group (HR = 0.54, 95 % CI: 0.37-0.78; p = 0.001). The survival benefit for the NEO group remained consistent after PSM and multivariable adjustment. The objective response rate to neoadjuvant therapy was 68.4 %. Patterns of recurrence were similar between groups, with distant metastasis being the most common site of first progression. The incidence of grade ≥2 radiation pneumonitis was comparable (31.8 % NEO vs. 30.8 % ADJ, p = 0.925), though a non-significant trend towards higher grade ≥3 radiation pneumonitis was observed in the NEO group (14.0 % vs. 7.5 %, p = 0.071). Rates of checkpoint inhibitor pneumonitis were low and similar between groups. In this large real-world cohort, a treatment sequence incorporating neoadjuvant immuno-chemotherapy prior to definitive CRT was associated with significantly improved PFS and OS compared to the standard adjuvant immunotherapy approach, without a definitive increase in severe pneumonitis. These findings support the further investigation of neoadjuvant immunotherapy strategies in phase III randomized trials for stage III NSCLC.33:T600,In the past few decades, advances in understanding of cancer biology have led to the development of highly effective conventional chemotherapies, targeted therapies that act on specific pathways that are critical to cancer growth, immune-based therapies, and cellular therapies such as haematopoietic cell transplantation and chimeric antigen receptor T cell therapy. However, the nephrotoxic effects of these therapies continue to pose substantial challenges, with many unanswered questions regarding the prevention, diagnosis and management of this nephrotoxicity. Further, a lack of consensus and precise guidance on kidney function estimation and drug dosing for patients with acute kidney disease or chronic kidney disease and for patients receiving kidney replacement therapy limits access to life-saving therapies and jeopardizes outcomes. In this Consensus Statement, we present guidance on the prevention, diagnosis and management of anticancer therapy nephrotoxicity for adult patients that was developed at the 34th Acute Disease Quality Initiative meeting, which convened an international panel of experts in nephrology, haematology, oncology, nephropathology, critical care, paediatric care and pharmacology. We also define a research agenda focused on preventing and mitigating anticancer therapy toxicity, maximizing early detection of nephrotoxicity and enabling optimal drug dosing in patients with kidney disease, with the goal of advancing cancer care and fulfilling the potential of these ground-breaking treatments.34:T2296,The ADQI consensus meeting was sponsored by Alexion, Baxter, Bioporto, BTG/SERB Pharmaceuticals, Calliditas, Medibeacon, Merck, Nova Biomedical, Novartis, Pfizer and SeaStar Medical. Sponsoring entities had no input in the discussions or in the final consensus statements or manuscript preparation. K.B. receives research support to her institution from StemLine Therapeutics. L.C. serves on the advisory boards of SERB and on speaker panels for SERB and Pfizer. She also serves as Editor-in-Chief of the Journal of Onco-Nephrology . R.F. had teaching honoraria from Vifor. M.F. serves on the advisory boards of GlaxoSmithKline and on speaker panels for Fresenius Medical Care, Jafron, B. Braun, Nipro and GlaxoSmithKline. He also serves on the editorial board for Kidney and Blood Pressure Research . L.G.F. reports research support from Baxter, Medibeacon, OrthoDiagnostics, SphingoTec and the NIHR. He has been on speaker panels for Fresenius Medical Care, Cytosorbents, SphingoTec and Vantive. I.G.G. reports an advisory board fee from T-knife Therapeutics, Inc. and support from NIH MSK Core Grant P30CA008748. S.L.G. receives consulting income from SeaStar Medical, BioPorto Diagnostics, Calcimedica, Mozarc Medical, Otsuka, Baxter Healthcare, Renibus Therapeutics and Novartis. He serves as a paid member of the Data Safety Monitoring Board for Silver Creek Therapeutics and Novartis. He serves on Speaker’s Panels for Baxter Healthcare and Fresenius Medical Care. He has stock options from MediBeacon, Inc. and serves as their Director of Clinical Development. He and his employer receive licensing royalties from RAIDAR Health. S.G. reports research support from the NIH, NIDDK K23DK125672 and R03DK141708. She also reports research funding from BTG International, Janssen, GE Healthcare and AstraZeneca, outside the submitted work. She is a consultant for Alexion, Mersana, MediBeacon and Orion Pharma. She founded and is Co-President Emeritus of the American Society of Onconephrology (unpaid). She also received speaker fees from Springer Inc. S.M.H. reports research support from Mayo Clinic Center for Clinical and Translational Science grant number UL1TR002377 and the Fulk Career Development Award. She serves as Review Section Editor for onconephrology for Nephrology Dialysis Transplantation . E.A.J. is supported by NIH grants R01DK129299 and P30CA008748. K.D.J. reports consultancy agreements with Novartis, Otsuka, Calliditas, George Clinicals, Vera Therapeutics and Travere Therapeutics; reports honoraria from the American Society of Nephrology and the International Society of Nephrology; is a paid contributor to UpToDate and is Section Editor for onconephrology for Nephrology Dialysis Transplantation ; serves on the editorial boards of American Journal of Kidney Diseases , CJASN , Clinical Kidney Journal , Frontiers in Nephrology , Journal of Onco-Nephrology and Kidney International ; and serves as the Editor-in-Chief of ASN Kidney News . S.K. reports consultancy agreement with George Clinicals, serves on the editorial boards of Advances in Kidney Disease and Health and Néphrologie et Thérapeutique , as a Review Editor for Frontiers in Nephrology and as a board member for the American Society of Onconephrology. A.K. administers funding from Amgen and Janssen for the University Health Network Onco-Nephrology Fellowship and serves as the President of the American Society of Onconephrology. H.J.L. receives research funding from Alexion (AstraZeneca), Nexcella, Janssen, Abbvie, Prothena and Protego. She has served in consultant/advisory roles to Alexion (AstraZeneca), Nexcella, Karyopharm, Arcellx, Abbvie and Pfizer. D.E.L. is supported by NIH grants R01DK125786, R01DK126685 and U01AG089040, has received research support from BioPorto, BTG International, Metro International Biotech LLC, Renibus Therapeutics, Inc. and Alexion Pharmaceuticals, has served as a consultant for Sidereal Therapeutics, MexBrain, Entrada Therapeutics, CardioRenal Systems, Inc. and Alexion Pharmaceuticals, and served as a Co-Chair of a Safety Monitoring Committee for EMD Serono Research and Development Institute, Inc. P.L. is an Associate Editor for Cardiorenal Medicine , Blood Purification and Frontiers in Nephrology and serves on the editorial board for the AKI section of the Journal of Nephrology . He has participated in speaker panels or advisory boards sponsored by AstraZeneca, Bayer, Jafron and GSK. J.M. is an editorial board member of Nephrology Dialysis Transplantation (Transplantation section). G.M. serves on the editorial boards of Kidney International , Kidney International Reports and the Journal of Onco-Nephrology . N.M. reports research support from NIH, R01DK137980; is a consultant for Otsuka, Asahi Kasei, Akebia and Sanofi; received honorarium from Elsevier; serves on the editorial board of Transplantation . M.O. received research funding from bioMérieux and Baxter, which was paid to the institution. A.P. has served on the advisory boards of GlaxoSmithKline, Otsuka, Astellas, and Teva Pharma and participated in speaker panels for Amgen, Menarini, AstraZeneca, Bayer, Alexion and Boehringer Lilly. Additionally, he serves on the editorial board for the Journal of Onco-Nephrology . M.A.P. serves as co-Editor-in-Chief of the Journal of Onco-Nephrology , Deputy Editor of Kidney360 and AKI Series Editor of Clinical Nephrology . He serves on editorial boards for Kidney International , KI Reports , the Journal of Nephrology and the American Journal of Medicine . D.R. served on advisory boards of Novartis and Alexion, had teaching honorariums from GSK, BMS, Roche, Novartis and Alexion, and is an UpToDate contributor. C.R. reports serving as Editor-in-Chief of Blood Purification and Cardiorenal Medicine and serving as speaker and having consultancy agreements with AstraZeneca, Aferetica, Asahi, Bayer, B. Braun, Baxter, bioMérieux, CytoSorbents, GE, Medica and Jafron. E.S. acts as a consultant for D.E. Shaw Research and serves on the Advisory Board for Mallinckrodt Pharmaceuticals. B.S. is Theme Editor for onconephrology for the Clinical Kidney Journal and on the editorial board of the Journal of Onco-Nephrology and Glomerular Diseases . V.Tesař is on the editorial board of the Clinical Kidney Journal and is Editor-in-Chief of Frontiers in Nephrology . He also served on the advisory board or received honoraria from AstraZeneca, Boehringer Ingelheim, Novartis, Otsuka, Travere and Vera. V.Torres serves as Academic Editor for PLoS One and is coordinator of the GFR Research Group of the American Society of Onconephrology. R.W. serves as an Associate Editor for the Journal of Onco-Nephrology and the Clinical Kidney Journal . B.T.W. serves as a consultant for Otsuka. D.Z.-O. reports research support from the NIH NCI R01CA291827, R01CA243014, R44CA268314, R44CA232954, R01DK138101. She has intellectual property with Galera Therapeutics and Perspective Therapeutics outside the submitted work. A.D.R., D.E.G., S.L., A.R., A.W. and M.H.R. declare no competing interests.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Cytotoxic Chemotherapy: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Cytotoxic Chemotherapy (modality). Clinician-written summaries and actionable practice insights. 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The 'confirms_prior' impact flag reflects consistency with prior literature, not definitive causal evidence.","value_numeric":null}],"summaries":{"what_studied":"This study examined whether prior chemotherapy (or radiotherapy, age, smoking, obesity) was associated with clonal hematopoiesis of indeterminate potential (CHIP) in 189 stage I–III breast cancer survivors, with blood drawn a median of 136.5 months (~11 years) after diagnosis, using buffy-coat whole-exome sequencing and a 100-gene hematopoietic-driver panel.","key_result":"CHIP was detected in 54/189 (28.6%) survivors by panel and 67/189 (35.4%) exome-wide, with DNMT3A and TET2 as dominant genes. Prior chemotherapy was not associated with panel-defined CHIP (OR 0.77; 95% CI 0.40–1.48; p = 0.432) or exome-wide variant positivity (OR 0.89; 95% CI 0.48–1.67; p = 0.721); no clinical variable tested reached significance.","limitations":"- Single time-point blood draw limits ability to track CHIP emergence or clonal dynamics longitudinally.\n- The cohort is limited to female breast cancer survivors, restricting generalizability to other cancers or sexes.\n- Relatively modest sample size (n=189) may limit power to detect smaller subgroup effects (e.g., by chemotherapy regimen type).","practice_takeaway":"Long-term breast cancer survivors do not appear to have a higher burden of CHIP attributable to prior chemotherapy at roughly 11 years post-diagnosis. Clinicians using blood-based genomics in this population should be aware that CHIP is common (~29–35%) but likely reflects background aging rather than treatment-related clonal selection."}},{"doi":"10.1016/j.urolonc.2026.04.010","pmid":"42120273","title":"Contemporary management of adrenocortical carcinoma: A narrative review","journal_title":"Urologic Oncology: Seminars and Original Investigations","journal_issn":"1078-1439","published_at":"2026-05-12T00:00:00.000Z","url":"https://doi.org/10.1016/j.urolonc.2026.04.010","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-22T13:22:21.639Z","updated_at":"2026-05-22T13:22:21.639Z","tags":[{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"condition","value":"Adrenocortical Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"generic","value":"cisplatin","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"generic","value":"doxorubicin","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"generic","value":"etoposide","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"generic","value":"mitotane","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"modality","value":"Adrenalectomy","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"modality","value":"Adrenocortical Suppressant","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"modality","value":"Alkylating Agent","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"modality","value":"Cytotoxic Chemotherapy","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"modality","value":"Immunotherapy","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"modality","value":"Radiation Therapy","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"warning","value":"No sample size is reported; this is a narrative review, not a primary study.","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"warning","value":"Publication date (May 2026) is very recent; some referenced guideline data may not yet be widely accessible for verification.","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"warning","value":"Sex distribution of the studied population is not reported.","value_numeric":null},{"paper_doi":"10.1016/j.urolonc.2026.04.010","tag_type":"warning","value":"The study design is narrative rather than systematic, so selection bias in included literature cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This narrative review evaluates current strategies for diagnosing, staging, and treating adrenocortical carcinoma (ACC), including surgery, adjuvant mitotane, radiation, systemic chemotherapy, and emerging molecular/immunotherapeutic approaches, drawing from PubMed, Scopus, and international guidelines.","key_result":"Complete surgical resection (adrenalectomy with lymph node dissection) remains the only curative option; adjuvant mitotane plus radiation is standard post-surgery for high-risk features (incomplete resection, high grade, Ki67 >10%); EDP (etoposide-doxorubicin-cisplatin) plus mitotane is the standard of care for advanced disease.","limitations":"Narrative review design limits systematic appraisal of evidence; ACC rarity restricts large-scale RCTs, leaving many recommendations based on limited data; role of adjuvant chemotherapy remains undefined pending ongoing studies.","practice_takeaway":"For ACC with high-risk features (incomplete resection, high grade, Ki67 >10%), add adjuvant mitotane and radiation therapy post-surgery. For advanced disease, use the EDP–mitotane regimen and consider enrolling eligible patients in trials investigating targeted or immunotherapy approaches."}},{"doi":"10.1007/s10120-026-01746-7","pmid":"42043496","title":"Total versus subtotal gastrectomy following neoadjuvant flot chemotherapy for distal diffuse gastric adenocarcinoma: an international cohort study","journal_title":"Gastric Cancer","journal_issn":"1436-3291","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1007/s10120-026-01746-7","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-10T13:20:35.546Z","updated_at":"2026-05-10T13:20:35.546Z","tags":[{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"condition","value":"Diffuse Gastric Adenocarcinoma","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"generic","value":"docetaxel","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"generic","value":"fluorouracil","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"generic","value":"leucovorin","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"generic","value":"oxaliplatin","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"modality","value":"Cytotoxic Chemotherapy","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"modality","value":"Gastrectomy","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"sample_size","value":"n=482","value_numeric":482},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"study_design","value":"International Multicenter Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"warning","value":"Findings are not generalizable to CDH1-mutated or other hereditary gastric cancer syndromes where total gastrectomy is standard.","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"warning","value":"Follow-up duration (median 26.4 months) is relatively short for definitive 5-year survival conclusions in gastric cancer.","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"warning","value":"Retrospective design means the choice of TG vs SG reflects surgeon/institutional preference, not randomization — selection bias may persist despite multivariate adjustment.","value_numeric":null},{"paper_doi":"10.1007/s10120-026-01746-7","tag_type":"warning","value":"The observed OS advantage of SG over TG is not fully explained by oncological factors; the authors hypothesize long-term morbidity and nutritional consequences of TG as contributors, but this is speculative. Residual confounding from unmeasured factors (e.g., true tumor size, surgeon volume) cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This international multicenter cohort study (SPACE-FLOT, 43 centers, 12 countries, 2017–2022) compared total gastrectomy (TG, n=188) versus subtotal gastrectomy (SG, n=294) in patients with locally advanced distal diffuse gastric adenocarcinoma (≥5 cm from the GEJ) who received perioperative FLOT chemotherapy, with a median follow-up of 26.4 months post-surgery.","key_result":"After multivariable adjustment, SG and TG had comparable surgical margin positivity (OR 1.28, 95% CI 0.70–2.34) and time-to-recurrence (HR 1.29, 95% CI 0.95–1.75). However, TG was associated with more major complications (OR 1.55, 95% CI 1.05–2.30), longer hospital stay (8.5 vs 7.0 days), and worse overall survival (adjusted HR 1.69, 95% CI 1.20–2.38, p=0.003) compared to SG.","limitations":"- Retrospective design with inherent selection bias; the rationale for choosing TG vs SG per patient was not captured.\n- Heterogeneity in surgical technique and perioperative management across 43 centers.\n- No patient-reported outcomes or quality-of-life data were collected.","practice_takeaway":"For distal diffuse gastric adenocarcinoma ≥5 cm from the GEJ treated with perioperative FLOT, subtotal gastrectomy offers comparable oncological control with lower morbidity and better overall survival than total gastrectomy — multidisciplinary teams should default to a gastric-conserving approach when oncologically feasible. Total gastrectomy should not be performed routinely for all distal diffuse gastric cancers."}},{"doi":"10.1001/jama.2025.20034","pmid":"41499132","title":"Gastric Cancer","journal_title":"JAMA","journal_issn":"0098-7484","published_at":"2026-01-07T00:00:00.000Z","url":"https://doi.org/10.1001/jama.2025.20034","source_score":190,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-12","doi":"10.1001/jama.2025.20034","days":"7","issn":"0098-7484","rank":"9","field":"Clinical Medicine","score":"190","category":"Medicine, General & Internal","categories":["Medicine, General & Internal"],"_categories":["Medicine, General & Internal"]},"pubmed":{"doi":"10.1001/jama.2025.20034","title":"Gastric Cancer: A 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It reports incidence (968,350 new cases and 659,853 deaths worldwide in 2022; 30,300 cases and 10,780 deaths in the US in 2025) and biomarker-driven management.","key_result":"At diagnosis, about 13% have localized, 15%–25% locally advanced, and 35%–65% metastatic disease; resection of localized cancer yields a 5-year relative survival of 75%, while fewer than 10% with metastatic disease live 5 years. In PD-L1–expressing tumors, adding nivolumab or pembrolizumab to chemotherapy adds ~3 months of survival; adding trastuzumab (ERBB2) or zolbetuximab (CLDN18.2) adds 3–4 months; early supportive care adds ~3 months; routine endoscopic screening from age 40 in high-incidence countries is associated with improved survival.","practice_takeaway":"Test for PD-L1, ERBB2, and CLDN18.2 in unresectable or metastatic gastric cancer to select immunotherapy or targeted therapy that can extend survival by several months. Use gastrectomy for localized disease and perioperative 5-fluorouracil/oxaliplatin/docetaxel plus durvalumab for more advanced resectable disease; initiate early supportive care, and in high-incidence regions, employ routine endoscopic screening from age 40."}},{"doi":"10.1016/j.lungcan.2025.108883","pmid":"41421036","title":"Neoadjuvant immunotherapy plus chemotherapy in locally advanced stage III NSCLC patients undergoing definitive chemo-radiotherapy---a real‑world multicenter retrospective study","journal_title":"Lung Cancer","journal_issn":"0169-5002","published_at":"2025-12-21T00:00:00.000Z","url":"https://doi.org/10.1016/j.lungcan.2025.108883","source_score":14,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-12-21","doi":"10.1016/j.lungcan.2025.108883","days":"30","issn":"0169-5002","rank":"5","field":"Clinical Medicine","score":"14","category":"Respiratory System","categories":["Respiratory System"],"_categories":["Respiratory System"]},"pubmed":{"doi":"10.1016/j.lungcan.2025.108883","title":"Neoadjuvant immunotherapy plus chemotherapy in locally advanced stage III NSCLC patients undergoing definitive chemo-radiotherapy---a real‑world multicenter retrospective study.","journal":"Lung cancer (Amsterdam, Netherlands)","methods":"","results":"The median PFS was significantly longer in the NEO group than in the ADJ group (25.0 months vs. 16.3 months; HR = 0.57, 95 % CI: 0.43-0.74; p < 0.001). Median OS was not reached (NR) in the NEO group compared to 41.1 months in the ADJ group (HR = 0.54, 95 % CI: 0.37-0.78; p = 0.001). The survival benefit for the NEO group remained consistent after PSM and multivariable adjustment. The objective response rate to neoadjuvant therapy was 68.4 %. Patterns of recurrence were similar between groups, with distant metastasis being the most common site of first progression. The incidence of grade ≥2 radiation pneumonitis was comparable (31.8 % NEO vs. 30.8 % ADJ, p = 0.925), though a non-significant trend towards higher grade ≥3 radiation pneumonitis was observed in the NEO group (14.0 % vs. 7.5 %, p = 0.071). Rates of checkpoint inhibitor pneumonitis were low and similar between groups.","abstract":"$32","keywords":["Carcinoma","Chemoradiotherapy","Immunotherapy","Neoadjuvant therapy","Non-small-cell lung"],"pubmed_id":"41421036","conclusions":"In this large real-world cohort, a treatment sequence incorporating neoadjuvant immuno-chemotherapy prior to definitive CRT was associated with significantly improved PFS and OS compared to the standard adjuvant immunotherapy approach, without a definitive increase in severe pneumonitis. These findings support the further investigation of neoadjuvant immunotherapy strategies in phase III randomized trials for stage III NSCLC.","publication_date":"2025-12-21T00:00:00"},"crossref":{"DOI":"10.1016/j.lungcan.2025.108883","URL":"https://doi.org/10.1016/j.lungcan.2025.108883","ISSN":["0169-5002"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S0169500225007755?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S0169500225007755?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":"108883","type":"journal-article","issue":null,"score":1,"title":["Neoadjuvant immunotherapy plus chemotherapy in locally advanced stage III NSCLC patients undergoing definitive chemo-radiotherapy---a real‑world multicenter retrospective 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Reported risks include AKI in nearly 1 in 10 patients on systemic therapy; cisplatin nephrotoxicity 25–30%, ifosfamide 3–30%, methotrexate 2–30%, gemcitabine‑TMA 2–4%; VEGF‑inhibitor hypertension 30–80% and proteinuria 20–63% (nephrotic syndrome 2–6%); and ICI‑AKI 2–5%.","limitations":"This is expert consensus, not an interventional study; many recommendations lack randomized validation and some depend on resource availability (for example, access to measured GFR and drug monitoring). Incidence estimates vary across studies owing to heterogeneous AKD definitions and populations.","practice_takeaway":"Adopt KHA/KHR workflows: use CKD‑EPI creatinine–cystatin C (or measured GFR when estimates are unreliable), check kidney labs before dosing and within ~1 week after exposure, and tailor surveillance by agent. For VEGF inhibitors, monitor blood pressure early and often and check urine protein each cycle; for ICIs, avoid PPIs, pause therapy for suspected AKD and start glucocorticoids early; for cytotoxics, use established measures (e.g., urine alkalinization and drug‑level–guided leucovorin/glucarpidase for high‑dose methotrexate; check and replace magnesium with cisplatin)."}}],"initialOffset":6,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Cytotoxic Chemotherapy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Cytotoxic Chemotherapy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Cytotoxic Chemotherapy"}}}]]

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