The promise of scalable symptom surveillance with stepped collaborative care in oncology
Cancer mortality rates by detailed occupation among US working-age adults between 2020 and 2023: a population-based study
Despite overall reductions in high-income countries, cancer mortality rates for some cancer types are rising among working-age adults. This study aimed to generate cancer mortality rates by sex, cancer type, and detailed occupation among working-age adults in the USA.
Electronic health record-facilitated symptom surveillance and collaborative care intervention in oncology (E2C2): a cluster-randomised, population-level, stepped-wedge, pragmatic trial
Patient-reported outcome measure (PROM) surveillance and collaborative care improve cancer symptom control. However, human resource requirements constrain their implementation and reach. Electronic health record (EHR) facilitation reduces resource needs and might allow population-level scaling. We aimed to assess the effect of EHR facilitation of PROM-directed collaborative care on clinical and health services outcomes.
SISAQOL-IMI consensus-based guidelines to design, analyse, interpret, and present patient-reported outcomes in cancer clinical trials
Standardising the implementation of patient-reported outcomes (PROs) in clinical trials is crucial for evaluating the benefits and risks of cancer treatments. The Setting International Standards in Analysing Patient-Reported Outcomes and Quality of Life Endpoints in Cancer Clinical Trials-Innovative Medicines Initiative (SISAQOL-IMI) has developed 146 consensus-based recommendations for designing, analysing, interpreting, and presenting PROs in cancer clinical trials. This initiative, undertaken from 2021 to 2025, involved experts, including statisticians, PRO measurement experts, clinicians, and patient representatives from 41 organisations representing regulatory agencies, academia, the pharmaceutical industry, health-technology assessment bodies, and patient advocates. SISAQOL-IMI provides guidance on the implementation of PROs in randomised controlled trials and single-arm trials, terminology, definitions and the selection of PRO score interpretation thresholds, and for visualising PRO results for different audiences. To facilitate the implementation of these standards, in addition to this Policy Review, four key outputs are available: an interactive table, a guidebook, plain language materials, and a glossary.
Microbubble-enhanced transcranial focused ultrasound with temozolomide for patients with high-grade glioma (BT008NA): a multicentre, open-label, phase 1/2 trial
Brain-infiltrating tumour cells from high-grade glioma remain shielded from drug treatments by the blood-brain barrier, leading to inevitable recurrence. Microbubble-enhanced transcranial focused ultrasound (MB-FUS) enables controlled blood-brain barrier opening (BBBO), permitting localised drug delivery. We aimed to assess safety and feasibility of MB-FUS plus standard-of-care chemotherapy for individuals with high-grade glioma.
Pembrolizumab plus lenvatinib as second-line treatment in patients with pleural mesothelioma (PEMMELA): cohort 2 of a single-arm, phase 2 study
Pembrolizumab (anti-PD-1 antibody) plus lenvatinib (multityrosine kinase inhibitor) showed high clinical activity in PEMMELA cohort 1 in patients with pleural mesothelioma pre-treated with platinum-based chemotherapy. This study (cohort 2) aimed to investigate the clinical activity of this combination in patients with pleural mesothelioma who progressed after first-line nivolumab plus ipilimumab.
Vebreltinib in MET amplification-driven advanced non-small-cell lung cancer (KUNPENG): a single-arm, multi-cohort, multicentre, phase 2 study
MET amplification is recognised as a de novo driver alteration in non-small-cell lung cancer (NSCLC) but treatment responses with existing MET inhibitors remain largely unsatisfactory. We aimed to investigate the antitumour activity and safety of vebreltinib, a potent and highly selective MET inhibitor, in patients with MET amplification-driven NSCLC.
SunRISe-4 perioperative safety and TURBT stratification - Authors' reply
Misclassification of p16-positive, HPV-negative patients biases de-escalation trials
Misclassification of p16-positive, HPV-negative patients biases de-escalation trials - Authors' reply
Neurocognitive outcomes in patients with brain metastases: a systematic review
Multimodality therapy, including surgery, radiotherapy, and systemic therapy, has significantly improved overall survival for patients with brain metastases. However, treatment-related neurocognitive sequelae remain a major challenge in survivorship. Although advances in radiotherapy delivery techniques have reduced toxicity, the potential interaction with chemotherapy, targeted therapy, and immunotherapy, and the consequent effect on neurocognitive outcomes is poorly characterised. We conducted a systematic review of clinical trials reporting neurocognitive endpoints in patients with brain metastases receiving radiotherapy with or without other concurrent systemic therapies. Neurocognitive outcomes were manually extracted from published reports. 39 studies from 1997 to 2024 involving 6617 patients met inclusion criteria (n=27 whole-brain radiotherapy; n=12 radiosurgery), including six studies evaluating combined-modality therapy. Baseline neurocognitive disability was frequently observed, and the majority of randomised trials evaluating advanced radiotherapy delivery techniques (hippocampal avoidance and radiosurgery) compared with whole-brain radiotherapy reported reduced cognitive decline and improved quality of life. There was no signal for increased toxicity with combined-modality therapy, including radiotherapy with concurrent systemic therapy, although evaluable trials were few in number. Given improvements in survival for patients with brain metastases, characterisation of long-term neurocognitive outcomes is growing in importance. There is an urgent need for targeted research to resolve evidence gaps around modality-specific neurocognitive toxicity and optimal sequencing of therapies. Systemic issues, such as integration of routine neuropsychological screening or assessment and incorporation of rehabilitation strategies into neuro-oncology care pathways, warrant evaluation. Exploration of emerging strategies, ranging from neuroprotectants to dose-sparing radiotherapy techniques, could further mitigate long-term adverse effects.
UK-US drug pricing deal to cost NHS £3 billion as NICE increases new medicines threshold
The Lucerne Toolbox 3: digital health and artificial intelligence to optimise the patient journey in early breast cancer-a multidisciplinary consensus
The Lucerne Toolbox 3 initiative addresses the pressing need for evidence-based integration of digital health and artificial intelligence (AI) technologies in early breast cancer care. The multidisciplinary consortium identified and prioritised 15 crucial medical knowledge gaps across the patient journey, from diagnosis to treatment and survivorship, using a modified Delphi consensus process with 112 unique members from 27 countries and 16 medical societies, trial groups, and patient organisations. The knowledge gaps include AI-based mammography screening, personalised screening strategies, digital knowledge databases, AI-driven treatment optimisation, and digitally delivered monitoring and supportive care. The consortium developed 13 trial designs in the Population, Intervention, Comparison, and Outcome format to address these gaps, achieving consensus or majority vote in 98% of statements. The recommendations emphasise precision medicine, patient-centred care, and interdisciplinary collaboration to improve outcomes, efficiency, and equity in breast cancer care. By presenting a roadmap for actionable trials, Lucerne Toolbox 3 sets a foundation for advancing digital health in breast cancer care.
Gavi hits HPV vaccine milestone early but concerns surround future funding
