To evaluate costs per responder for patients with triple-class exposed (TCE) relapsed or refractory multiple myeloma (RRMM) receiving talquetamab (Tal) on weekly (QW) and biweekly (Q2W) dosing schedules, compared with usual care from a United States commercial payer's perspective.

A cost per responder model was developed over a 6-month time horizon, incorporating pre-progression and post-progression costs. For Tal QW and Tal Q2W, pre-progression costs included costs of drug acquisition, inpatient step-up doses (hospitalization, pre-medication, and tocilizumab), outpatient visits, and monitoring. Pre-progression costs for usual care were estimated based on a weighted average of the 10 most used regimens in a real-world LocoMMotion/MoMMent study, including costs of acquisition, administration, co-medication, and monitoring. Post-progression costs included subsequent treatment for a subset of patients and terminal care costs prior to death. All costs were reported in 2025 United States Dollars. Clinical data of overall response rate (ORR), progression-free survival, and overall survival were obtained from an indirect treatment comparison using MonumenTAL-1 (September 2024 data cut) and LocoMMotion/MoMMent (October 2022 and August 2023 data cuts) as data sources. Deterministic sensitivity analyses and scenario analyses were conducted to assess the robustness of model results.

Over the 6-month period, the total cost of care was $179,556 for usual care, $295,993 for Tal QW, and $315,135 for Tal Q2W. Despite higher costs, Tal demonstrated superior ORR, resulting in lower cost per responder: $575,962 for usual care, $405,470 for Tal QW, and $443,165 for Tal Q2W, representing a 23-30% reduction in cost per responder with Tal. Sensitivity and scenario analyses showed consistent findings.

Although Tal QW and Q2W are associated with higher total per-patient costs compared with usual care, they offer improved clinical effectiveness, resulting in lower cost per responder. These findings suggest greater economic value for Tal in the treatment of TCE RRMM.

Evidence on the relationship between fertility treatment and non-gynecologic cancers remains limited. This study synthesizes available research on the association between fertility treatments and the risk of non-gynecologic cancers in women with infertility.

We systematically searched MEDLINE, EMBASE, and the Cochrane Library for studies involving women with infertility who received fertility treatment, compared with untreated women or the general population. Primary outcomes included the incidence of thyroid, colorectal, gastric, and lung cancers. Subgroup analyses were conducted by type of ovarian stimulation drug, in vitro fertilization (IVF) status, parity, length of follow-up, and choice of reference group.

Fifteen studies met the inclusion criteria. Fertility treatment was positively, though imprecisely, associated with thyroid cancer (relative risk [RR] = 1.22; 95% confidence interval [CI]: 0.95-1.57). No increased risk of colorectal cancer was observed among treated women. Clomiphene citrate use was associated with a higher risk of thyroid cancer (RR = 1.28; 95% CI: 1.07-1.54) and a lower risk of colorectal cancer (RR = 0.79; 95% CI: 0.65-0.96).

Fertility medications may increase the risk of thyroid cancer while potentially reducing the risk of colorectal cancer in women with infertility. Given the small number of studies and their heterogeneity, these findings should be interpreted cautiously. Further research is needed to clarify these associations.

Generalized myasthenia gravis (gMG) is an antibody mediated autoimmune neuromuscular junction disorder characterized by muscle weakness and fatigue as well as acetylcholine receptor antibody (AChR-Ab) as the main presence. A proportion of patients fail to achieve minimal symptom expression (MSE), furthermore 10-20% of them develop into refractory under conventional immunotherapy. We conducted a retrospective study to explore the effectiveness and safety of telitacicept in gMG and thymoma-associated MG (TAMG) patients. The treatment response was assessed by the variation of QMG, MG-ADL and MG-QOL-15 scores. Time to MSE as well as usage of corticosteroid were also evaluated. In this retrospective study, we included 22 AChR-gMG patients (15 women, 7 men), including 7 refractory and 12 TAMG, who were treated with telitacicept by following-up at least 6 months. Compared to the baseline, a significant decrease in QMG, ADL and MG-QOL-15 scores was observed at every visit, especially for the QMG score with at least 3 points decline in all the patients in week 4. Twenty patients attained MSE and the time to MSE was 4 months during the observed period. At the last follow-up, the dose of prednisone of all the patients treated with telitacicept was ≤ 5 mg/d. The AChR-Ab titers and CD19⁺ B cells significantly decreased from baseline to week 24. Telitacicept is generally well tolerated, the most common (18%) adverse effect was mild and transient injected site swelling. Our study provides evidence to support that telitacicept is beneficial and well tolerated in the management of gMG especially in refractory MG and TAMG. Clinical outcomes showed increased efficacy of telitacicept when used earlier in the disease course, which leads to a sparing of prednisone.

Comorbidities are common in older patients with cancer. The Cumulative Illness Rating Scale for Geriatrics (CIRS-G, developed in 1992) provides a comprehensive assessment of comorbidities and is independently associated with the mortality rate, the hospital admission rate and functional limitations. Although the literature data indicate that the CIRS-G's reliability is good to very good, most of the studies were small and did not include cancer patients. Here, we evaluated the CIRS-G's reliability in a large, prospective cohort of cancer patients aged 70 or over. A stratified, random sample of 150 patients was used to assess inter-rater reliability, and a random sample of 30 patients was evaluated by two investigators to assess intra-rater reliability. For inter-rater reliability, the observed intraclass correlation coefficient (ICC) [95% confidence interval] of 0.53 [0.12-0.74] was substantially lower than the literature values. For intra-rater reliability, the ICC was 0.66 [0.40-0.82] for investigator 1 and 0.77 [0.54-0.89) for investigator 2. These findings suggest that applying the CIRS-G consistently across raters and centres may be challenging in real-world oncology settings for older patients with cancer. Revising the scoring guidelines could help improve its reliability.

Patients with diffuse large B-cell lymphoma (DLBCL) frequently experience cancer-related fatigue (CRF), anxiety and depression during chemotherapy, significantly impairing their quality of life. This study evaluates the efficacy of the five-element music therapy combined with mindfulness meditation in alleviating CRF and psychological distress amongst DLBCL patients who are undergoing chemotherapy.

We conducted a retrospective study on 78 DLBCL patients who were treated at the First Affiliated Hospital of Soochow University (June 2022-December 2023). The patients were divided as follows: (1) conventional care group (n = 39) and (2) conventional care + combined five-element music therapy and mindfulness meditation group (combined group, n = 39). The assessed outcomes included the following: Cancer Fatigue Scale, Pittsburgh Sleep Quality Index (PSQI), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Hamilton Depression (HAMD) and Hamilton Anxiety (HAMA) scales, treatment compliance and nursing satisfaction scores.

Compared with the conventional care group, the combined group had lower scores in physical fatigue, emotional fatigue and cognitive fatigue (all P < 0.001); lower scores in HAMD, HAMA and PSQI (all P < 0.001); longer sleep duration (P < 0.001); better compliance (P = 0.023); higher satisfaction (P = 0.042) and a higher score in EORTC QLQ-C30 (all P < 0.001).

The combination of the five-element music therapy with mindfulness meditation reduces CRF, anxiety and depression amongst DLBCL chemotherapy patients whilst enhancing treatment compliance, sleep quality and overall quality of life. This combined non-pharmacological approach demonstrates promise as an adjunctive therapy in oncology care.

This research explored the potential benefits of five-element music in cancer-related fatigue (CRF) and mood disturbances among patients with lung cancer.

This study included 460 hospitalised patients with lung cancer from July 2023 to February 2024. The participants were divided into two arms as follows: 217 received five-element music therapy and conventional nursing care (combined group), whilst 243 were assigned to conventional nursing care (routine group). Outcomes such as adverse reactions, Piper Fatigue Rating Scale (PFS-R) score and psychological status (Self-rating Anxiety Scale [SAS] and Self-rating Depression Scale [SDS] scores) were assessed before and after the care. The logistic regression model was used to explore the influence of five-element music on the above indicators.

Post-care data revealed declines in PFS-R scale scores for both groups, with the combined group exhibiting superior outcomes in cognition, behaviour, body and emotion (all P < 0.001). Psychological metrics (SAS/SDS) similarly favoured the combined group (all P < 0.001). The combined group demonstrated a significantly higher medication compliance rate than the routine group (92.63% vs. 81.48%, P < 0.001), underscoring the therapeutic advantage of the proposed approach. The results of logistic regression showed that significant associations were found between medication compliance and two key factors: anxiety scores (SAS, odds ratio [OR]: 1.055, 95% confidence interval [CI]: 1.013-1.100) and depression scores (SDS, OR: 1.246, 95% CI: 1.178-1.318).

The application of five-element music therapy demonstrates potential benefits for patients with lung cancer, including alleviating CRF, mitigating negative emotions and improving medication compliance.

Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) poses significant health challenges globally, particularly in regions with considerable HBV prevalence such as Egypt. Despite immunisation programmes, HBV remains a leading cause of liver cancer in Egypt, often diagnosed at advanced stages, complicating management and worsening prognosis. This retrospective multicentre study included 365 Egyptian patients diagnosed with HBV-related HCC between February 2007 and July 2023 from six tertiary care centres across Egypt. Clinical, laboratory, tumour characteristics, treatment outcomes and overall survival were collected and analysed. Diagnosis was confirmed according to international guidelines using triphasic CT or dynamic MRI. Treatment responses were assessed using modified RECIST criteria, and survival was analysed using Kaplan-Meier curves. Patients had a median age of 59 years, predominantly male (76.4%), and most (98.4%) presented with cirrhosis at diagnosis. The majority were not receiving antiviral treatment (76.71%) at presentation. Intermediate and advanced BCLC stages (B-D) comprised over 75% of cases. Trans-arterial chemoembolization was the primary treatment modality (34.5%), followed by sorafenib (24.1%) and best supportive care (28.8%). Median overall survival was 13.1 months. Independent factors associated with mortality included high ALBI score, positive HBV DNA at diagnosis, and advanced Child-Pugh classification. In conclusion: this study underscores the advanced stage at which HBV-related HCC is typically diagnosed in Egypt and the resulting poor survival outcomes. Strengthening early detection through surveillance programmes, increasing antiviral therapy coverage and adherence to treatment protocols are critical strategies to enhance patient prognosis.

The relationship between insufficient sleep and prostate cancer incidence is unclear. Our goal was to investigate the association of sleep duration, restless sleep, and prostate cancer incidence and aggressiveness, and whether race influences any sleep-prostate cancer association.

The Southern Community Cohort Study (SCCS) recruited study participants from 12 Southeastern states from 2002 to 2009. The cohort included nearly 35,000 males, predominantly African American (AA, 67%). Sleep exposures were measured via a baseline questionnaire at enrollment, which captured weekday and weekend sleep duration, weighted average sleep duration, and restless sleep. We used Cox proportional hazards models and multinomial logistic regression models to estimate associations between sleep and prostate cancer incidence and aggressiveness.

During follow-up (median 10.9 years), 1345 men developed prostate cancer. Shorter sleep duration (< 6 h), in comparison to optimal duration (7-8 h), was suggestively associated with a decreased risk of prostate cancer in the overall cohort (adjusted hazard ratio (HR) = 0.83, (95% confidence interval (CI): 0.68-1.01) for sleep average; HR = 0.79, 95% CI: 0.65-0.95 for sleep weekdays; and HR = 0.81, 95% CI: 0.66-0.99 for sleep weekends), and among Black men (HR = 0.77, 95% CI: 0.62-0.97 for sleep average; HR = 0.76, 95% CI: 0.61-0.94 for sleep weekdays; and HR = 0.74, 95% CI: 0.59-0.94 for sleep weekends) when stratified by racial groups. Sleep duration and restless sleep were not associated with prostate cancer aggressiveness overall.

Shorter sleep duration was suggestively associated with a decreased risk of prostate cancer, but sleep duration was not associated with aggressive prostate cancer. Stratified analysis suggests a reduction of prostate cancer risk among Non-Hispanic Black men with < 6 h of sleep, compared to those sleeping 7-8 h. This is an intriguing finding, and further research is needed to assess the impact of confounding factors on racial differences in prostate cancer development.

BackgroundTumour biomarkers have become increasingly important in oncology, shaping cancer diagnostics, classification, and patient management. Despite their potential, the use of cancer biomarkers in clinical settings remains limited.ObjectiveThis paper aims to outline biomarker development, from classical, serum protein markers to emerging tumour biomarkers, including meta-biomarkers, to show their diversity and point out the challenges in their development, reporting, and implementation in clinical practice as well as their relevance in evidence-based pathology and cancer classification.MethodsA literature-based analysis, incorporating insights from our ongoing research, is presented.ResultsAlthough numerous potential biomarkers, biomarker signatures, and meta-biomarkers, are being discovered, existing innovations are often not supported by sufficiently rigorous research methodologies and standardised reporting practices to enable their translation into clinical practice.ConclusionsTo ensure that biomarker discoveries are both scientifically sound and clinically useful, improved research and validation methods, along with adherence to established reporting standards, are essential. We propose the use of the Hierarchy of Evidence for Tumour Pathology as a framework to evaluate and map existing evidence and identify knowledge gaps and research priorities.

Persistent high-risk Human Papillomavirus (HPV) infection causes anogenital and oropharyngeal cancers across all genders. The primary cancer associated with HPV is cervical cancer and the HPV vaccination before sexual exposure is recommended for cervical cancer elimination globally. This scoping review aims to map the preliminary evidence regarding the determinants of adolescent HPV vaccine acceptance and hesitancy during the COVID-19 pandemic in high income countries. A scoping review was conducted as per the updated Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Using the PCC (Population, Concept, and Context) framework, search keywords and search strategies were developed. Electronic databases were searched using specific search terms and the last search date noted as February 8, 2025. A thematic content analysis was carried out to identify the themes and subthemes by a deductive approach. Fourteen studies were included as the potential sources of evidence in this review. The study population included 493,819 adolescents from Australia, Hong Kong, Italy, Poland, Saudi Arabia, and the USA. The themes identified were inequity, attitude and behaviour, knowledge and communication, and engagement and influence. The COVID-19 pandemic generated a negative parental attitude towards HPV vaccines for a brief period. The adolescent HPV vaccine acceptance mainly depended on strong parental support and appropriate access to healthcare professionals and vaccination services. Travel restrictions, lockdowns, school closures, and social distancing contributed to significant HPV vaccine hesitancy in high income countries.