Metastatic triple-negative breast cancer (TNBC) is associated with aggressive clinical behavior and poor survival, particularly in patients with brain and visceral metastases. We describe an exceptionally durable treatment-free remission in a young woman with metastatic TNBC and a subsequently identified pathogenic germline BRCA1 variant. We retrospectively reviewed the patient’s clinical course, radiological and histopathological findings, systemic and local treatments, genetic testing, and long-term follow-up. In 2008, the patient was diagnosed with grade 3 triple-negative invasive ductal carcinoma and hepatic lesions considered metastatic based on computed tomography (CT), magnetic resonance imaging (MRI), and multidisciplinary assessment. Following six cycles of fluorouracil, doxorubicin, and cyclophosphamide (FAC), the hepatic lesions regressed. In 2009, she developed a solitary, histologically confirmed left frontal brain metastasis, which was surgically resected and treated with postoperative radiotherapy. Subsequent breast and hepatic disease progression was treated with 15 cycles of docetaxel plus bevacizumab, resulting in a marked radiological response. Following isolated locoregional progression in 2011, without radiologically active distant disease, she underwent modified radical mastectomy with axillary dissection followed by locoregional radiotherapy. A pathogenic germline BRCA1 variant was identified in 2020. She has received no systemic anticancer therapy since December 2010 and remained in complete clinical and radiological remission as of June 2026, more than 17 years after diagnosis of the brain metastasis. This case documents an exceptionally prolonged treatment-free remission in metastatic TNBC despite a history of radiologically diagnosed hepatic metastases and a histologically confirmed brain metastasis. Although the contributions of tumor biology and individual treatments cannot be established, the clinical course highlights the heterogeneity of metastatic TNBC and the importance of individualized multidisciplinary management.
Given China’s high disease burden, Chinese physicians have accumulated substantial real-world experience in managing locally advanced cervical cancer (LACC). Accordingly, the study aims were to evaluate treatment patterns and decision-making drivers for Chinese patients with LACC and to identify unmet needs. Subgroup data from mainland China (n = 80) were analyzed from a broader Asia–Pacific study conducted across five regions. This prospective cross-sectional study used a two-phase approach (literature review and physician interviews). Outcomes included treatment regimens, patient characteristics, treatment choice drivers, and unmet patient needs. Responses were obtained from 20 medical oncologists and 60 gynecologists/gynecologic oncologists. LACC accounted for approximately 37
The second-generation Bruton tyrosine kinase inhibitors (BTKis) zanubrutinib and acalabrutinib have improved outcomes in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) patients but comparative evidence is limited. This study assessed treatment patterns and clinical outcomes among patients with CLL/SLL initiating zanubrutinib or acalabrutinib in diverse real-world healthcare settings. Adults with CLL/SLL receiving zanubrutinib or acalabrutinib monotherapy within the University of California Health system (01/01/2021–11/30/2025) were eligible. Baseline characteristics and treatment patterns were analyzed descriptively. Real-world time to treatment discontinuation (TTD), time to next treatment (TTNT), and overall survival (OS) were analyzed using Kaplan–Meier methods and univariate Cox models. The adjusted impact of sociodemographic and clinical factors on time-to-event outcomes was assessed using multivariate Cox models. In an exploratory subgroup analysis, a large language model (LLM) was used to extract adverse events (AEs) and reasons for BTKi discontinuation from unstructured electronic health records. A total of 481 patients were included (zanubrutinib cohort, n = 175; acalabrutinib cohort, n = 306). Median follow-up was 30.7 months. Median TTD was significantly longer in patients receiving zanubrutinib than in those on acalabrutinib (31.8 vs. 14.4 months; P = 0.002). Differences in TTD were statistically significant in unadjusted (hazard ratio [HR] 0.66, 95
Targeted treatment in children, especially with sarcomas, has limited utility due to small numbers of patients with driving mutations. Multimodal combination treatment and patient-centered approach combine treatment modalities administered based on comprehensive biological and empirical factors. Together, they extend precision oncology beyond a single molecular target. This is a single-institution real-world study of children and young adults diagnosed between 2004 and 2021, with relapsed/refractory and/or primary metastasizing high-risk solid tumors who underwent molecular tumor board. Patients underwent comprehensive biological examination of the tumor. A treatment recommendation was made subsequently combining empirical and biological data. All progressive/recurrent events during disease follow-up were analyzed using a hierarchical survival modeling approach combining individual patient time series in a meta-analytic framework for comparative analysis of treatment effects. A total of 93 patients were included in the analysis who experienced 189 events. Overall survival was 7.5 years. A comparative analysis utilizing event-free survival (EFS) ratio was possible in an ultra-high-risk subset of 66 patients with relapsed/progressive disease. Effectiveness was demonstrated in the treatment of sarcomas by empirical treatment (HR 0.57, p = 0.005), which consisted mainly of orally administered cyclophosphamide, vinblastine, and celecoxib, and by sunitinib or pazopanib (HR = 0.66, p = 0.032) in biologically guided administration. This study demonstrates that individualized treatment offers effective treatment options to a wide range of patients with high-risk cancers even for tumors without known high-level evidence molecular targets. We have shown that an alternative analytical approach based on the n-of-1-inspired framework is needed and applicable to demonstrate the effectiveness.
For patients with advanced/metastatic non–small cell lung cancer (aNSCLC) without actionable genomic alterations (AGAs) and with programmed death-ligand 1 (PD-L1) ≥ 50
