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Erratum: Evaluation of Regorafenib in Newly Diagnosed and Recurrent Glioblastoma: GBM AGILE Phase II/III Bayesian Randomized Platform Trial

Journal of Clinical Oncology Patrick Y. Wen, Donald A. Berry, Meredith B. Buxton et al. Jun 10, 2026 DOI: 10.1200/jco-26-01027

Atomic Imaging of Ion-Triggered Flexibility and Local Electric Field Response in Zeolite Rings

Journal of the American Chemical Society Qiang Chen, Zhao-Bin Ding, Pengfei Cao et al. Jun 10, 2026 DOI: 10.1021/jacs.5c22979

Modulation of Neuronal Ensembles Switches Memory Flexibility via Hippocampal Network Resynchronization

Journal of Neuroscience Chao Liu, Qingna Hao, Yang Cui et al. Jun 10, 2026 DOI: 10.1523/jneurosci.2340-25.2026

Engram cells are formed during learning and store memory information. However, little is known about the modulation of engram cells on time-dependent memory flexibility. Employing a male mouse model, we demonstrated that a temporal factor dictates the memory state, driving either pattern separation or pattern completion. Reengagement of engram cells in the dentate gyrus (DG) during memory retrieval in altered contexts was higher during pattern separation than during pattern completion, concomitant with a time-dependent reduction in synaptic transmission. Specific activation of DG engrams promoted pattern separation, whereas their inhibition accelerated pattern completion. Furthermore, activating DG engrams not only prolonged sharp-wave ripple (SWR) duration and enhanced theta–gamma phase–amplitude coupling (PAC) in CA1 but also strengthened cross-regional theta (DG) –gamma (CA1) PAC and gamma (DG–CA1) coherence. Conversely, their inhibition resulted in diminished SWR durations, attenuated these PACs, and reduced DG–CA1 gamma coherence. Finally, elevated Rac1 activity within DG engrams accelerated pattern completion, while reduced activity facilitated pattern separation. These findings show that engram cells drive time-dependent memory flexibility via neural network resynchronization.

Controlled polymerization of methyl acrylate in the presence of copper MOF (Basolite®C300): strategy and characterization

Scientific Reports Edina Rusen, Cristina Stavarache, Aurel Diacon et al. Jun 10, 2026 DOI: 10.1038/s41598-026-57663-3

Durvalumab monotherapy versus active monitoring for resected primary renal cell carcinoma in RAMPART: An international, phase 3, randomized controlled trial.

Journal of Clinical Oncology James M.G. Larkin, Thomas Powles, Elena Frangou et al. Jun 10, 2026 DOI: 10.1200/jco.2026.44.17_suppl.lba4511

LBA4511 Background: RAMPART is evaluating one year of immune checkpoint inhibitor therapy versus active monitoring in patients with renal cell carcinoma (RCC) at intermediate or high risk of recurrence following nephrectomy according to the Leibovich Score (LS) or following complete resection of limited metastatic disease (M1NED). The trial has already shown that durvalumab and tremelimumab improves disease free survival (DFS), largely driven by effect in the higher risk population (LS high and M1NED). Methods: We recruited participants (pts) from 80 sites and randomised them in a 3:2:2 ratio between: Arm A, active monitoring; Arm B, 1 year (13 cycles) of durvalumab (1500mg); or Arm C, 1 year (13 cycles) of durvalumab (1500mg) plus tremelimumab (75mg, cycles 1 and 2 only). Based on the results of the KEYNOTE-564 trial, pembrolizumab became a treatment option for many of the patients who would be eligible for RAMPART, and recruitment was stopped earlier than planned. We revised the RAMPART design without knowledge of the accumulating trial results. In the modified design there is 80% power to detect a hazard ratio (HR) for the primary outcome of DFS of 0.60 for arm B vs. A, and of 0.55 for arm C vs. A. The overall familywise type I error rate remains strongly controlled at 2.5% (1-sided) across all primary analyses. The analysis plan includes a pre-specified, pre-powered analysis by risk of relapse. Results: Between October 2018 and June 2023, we randomised 790 pts (340, 225, and 225 to arms A, B, and C) from the UK (70%), France (21%), Australia (5%) and Spain (4%). Baseline characteristics were balanced across arms. Median age (range) was 60 (22, 83) years, 72% were male, 84% clear cell histology. Treatment with durvalumab (Arm B) was associated with a 26% relative reduction in the hazard of disease recurrence or death; conventional statistical significance was not reached (DFS HR = 0.74; 95% CI 0.53–1.04; 1p=0.041). DFS at 3 years was 78% with Arm B vs 72% Arm A. In the pre-specified DFS analysis by risk of recurrence, no evidence of a treatment-by-subgroup interaction was observed. This contrasts with the results of Arm C vs Arm A. Table 1 summarises results of the two RAMPART primary analyses. Exposure to treatment, safety, quality of life, overall survival and efficacy in non-clear cell subtypes will be presented. Conclusion: In RAMPART, durvalumab plus tremelimumab was associated with a statistically significant improvement in DFS, which was not observed with durvalumab monotherapy. Clinical trial information: NCT03288532 . Primary analysis results. Arm C vs A Arm B vs A All pts N=565; HR=0.65, 95%CI 0.45-0.93 N=565; HR=0.74, 95 CI 0.53–1.04 Higher Risk N=311; HR=0.52, 95%CI 0.34-0.80 N=312, HR=0.77, 95%CI 0.53–1.12 Intermediate Risk N=254, HR= 1.19, 95% CI 0.61-2.32 N=253, HR= 0.64, 95%CI 0.30–1.34 Test for Interaction HR=0.43, 95%CI 0.19-0.95 HR=1.20, 95%CI 0.52-2.74

A Bifunctional Aminoxyl–Bipyridine Peptide Catalyst for the Atroposelective Copper-Catalyzed Aerobic Oxidation of Biaryl Diols

Journal of the American Chemical Society Halle M. Marvich, Olivia C. Langner, Nicolò Tampellini et al. Jun 10, 2026 DOI: 10.1021/jacs.6c04560

Developing a fully automated imaging biomarker for HCC risk assessment via MRI-based tumor segmentation and EPM

Scientific Reports Awj Twam, Shane A. Smith, Mohamed Eltaher et al. Jun 10, 2026 DOI: 10.1038/s41598-026-54177-w

TALAPRO-3: Talazoparib (TALA) + enzalutamide (ENZA) compared with placebo (PBO) + ENZA for the treatment of patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) harboring homologous recombination repair (HRR) gene alterations.

Journal of Clinical Oncology Neeraj Agarwal, Nobuaki Matsubara, Arun Azad et al. Jun 10, 2026 DOI: 10.1200/jco.2026.44.17_suppl.lba5007

LBA5007 Background: In the Phase 3 TALAPRO-2 trial, adding the poly(ADP-ribose) polymerase inhibitor TALA to the androgen-receptor pathway inhibitor (ARPI) ENZA significantly improved radiographic progression-free survival (rPFS) and overall survival (OS) in pts with metastatic castration-resistant prostate cancer (mCRPC), with the HRR-deficient cohort experiencing the greatest benefit. The TALAPRO-3 trial investigates the efficacy and safety of TALA + ENZA in men with mCSPC bearing HRR gene alterations. Methods: In the Phase 3, double-blind TALAPRO-3 trial, pts were randomized 1:1 to TALA 0.5 mg (0.35 mg if moderate renal impairment) or PBO plus ENZA 160 mg once daily, stratified by de novo vs relapsed mCSPC, high- vs low-volume disease, and BRCA vs non- BRCA mutational status. Key eligibility criteria are ECOG PS 0 or 1, presence of HRR gene alteration(s) ( ATM , ATR , BRCA1 , BRCA2 , CDK12 , CHEK2 , FANCA , MLH1 , MRE11A , NBN , PALB2 , RAD51C ) confirmed by tumor tissue and/or circulating tumor DNA testing, ongoing androgen deprivation therapy (ADT), no prior treatment with docetaxel (protocol amendment in Sept 2021), and ≤3 mo of ADT with or without an approved ARPI for mCSPC. Primary endpoint is investigator-assessed rPFS; OS is the alpha-protected key secondary endpoint. Results: 599 pts were randomized (300 to TALA + ENZA; 299 to PBO + ENZA). At a median follow-up of 37.6 mo (TALA + ENZA) and 37.7 mo (PBO + ENZA) at data cutoff (Feb 18, 2026), TALA + ENZA significantly improved rPFS vs PBO + ENZA (HR, 0.481; 95% CI, 0.357–0.647; 2-sided P <0.0001; median rPFS not reached vs 45.8 mo). The HR for rPFS was 0.368 (95% CI, 0.222–0.609) in the BRCA -mutated subgroup (n=207; 34.6%) and 0.567 (95% CI, 0.392–0.819) in the non- BRCA -mutated subgroup (n=392; 65.4%). Interim analysis of OS favored TALA + ENZA but has not reached statistical significance (74 deaths TALA + ENZA, 91 deaths PBO + ENZA; HR, 0.767; 95% CI, 0.564–1.044). The most common all-grade TEAEs in the TALA + ENZA group were anemia (71.2%), fatigue (28.4%), neutrophil count decreased (27.1%), neutropenia (22.1%), asthenia (21.4%) and white blood cell count decreased (21.4%), with no new safety signals identified. TEAEs were generally manageable with dose modifications; 56 pts (18.7%) discontinued TALA due to TEAEs. Conclusions: Treatment with TALA+ENZA led to a statistically significant and clinically meaningful improvement in the primary endpoint of rPFS with a trend towards improved OS vs standard-of-care ENZA in pts with HRR-deficient mCSPC. The safety profile was generally manageable and consistent with those for TALA and ENZA. Clinical trial information: NCT04821622 .

Enantiospecific Magnetoconductance Asymmetry in a Racemic Conglomerate Driven by Surface-Assisted Symmetry Breaking

Journal of the American Chemical Society Shammi Rana, Maurizio Mastropasqua Talamo, Navathej Preetha Genesh et al. Jun 10, 2026 DOI: 10.1021/jacs.6c05771

Acute effects of foam rolling versus passive rest following a single bout of explosive squat jump exercise

Scientific Reports Coşkun Rodoplu, Josef Fischer, Christian Burger et al. Jun 10, 2026 DOI: 10.1038/s41598-026-57044-w

Safety and dosimetry of <sup>177</sup> Lu-rosopatamab tetraxetanplus SoC in patients with metastatic castration-resistant prostate cancer: Preliminary results from part 1 of phase 3 ProstACT Global study.

Journal of Clinical Oncology Pedro C. Barata, Gary Tincknell, David Michael Gill et al. Jun 10, 2026 DOI: 10.1200/jco.2026.44.17_suppl.lba5009

LBA5009 Background: ProstACT Global is a Phase 3 study of 177 Lu-rosopatamab + standard of care (SoC) for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). We present preliminary safety, dosimetry, &amp; pharmacokinetics results from Part 1 (Lead-In). Methods: Eligible pts had PSMA+ mCRPC (confirmed on 68 Ga-PSMA-11 PET/CT) with disease progression on ≥12w prior therapy on their 1 st androgen receptor pathway inhibitor in metastatic castration-sensitive PCa, non-mCRPC, or mCRPC setting. Pts may have received docetaxel in mCSPC setting if ≥6 months prior. Pts received 2 single IV injections 177 Lu-rosopatamab (76 mCi each), 14d apart, with assigned SoC (Cohort 1, +abiraterone; Cohort 2, +enzalutamide; Cohort 3, followed by docetaxel; planned n=10 each). Pts were monitored for treatment-emergent adverse events (TEAEs; onset on or after initiation of study treatment). Pts underwent serial SPECT/CT imaging after 1 77 Lu-rosopatamab administration (4, 24, 96, 168, 360h) for dosimetry &amp; blood sampling for pharmacokinetics (PK). Co-primary endpoints were safety &amp; dosimetry of 177 Lu-rosopatamab + SoC. Analyses were preplanned, descriptive, &amp; overseen by IDMC. No formal statistics were performed. Dosimetry &amp; biodistribution were evaluated using observed values without formal hypothesis testing. Results: Data from 36 pts (baseline median PSA: 18.18 ng/mL) who received any study treatment was included (Cohorts 1, 2, 3: n=11, 11, 14, resp.). 55.6% pts had Gleason score 8-10, 72% pts were 2L mCRPC, &amp; 25% pts had previous taxane exposure. No new safety signals were identified; TEAEs were predominantly transient &amp; manageable hematologic events. Hematologic TEAEs (% pts any grade; Grade ≥3) included thrombocytopenia (77.8%; 44.4%), neutropenia (63.9%; 47.2%), &amp; lymphopenia (55.6%;41.7%). Non-hematologic TEAEs were all Grade ≤2, except for 1 Grade 3 dizziness. Fatigue (19 events) was most common. Only 9 xerostomia events reported (all Grade 1). No Grade 5 treatment-related TEAEs reported. Blood activity concentration over time demonstrated bi-exponential clearance kinetics. Liver received highest absorbed radiation (range, 1.62-5.08 mGy/MBq), with lower doses received by kidneys (0.336-0.961 mGy/MBq) &amp; salivary glands (0.001-0.104 mGy/MBq). Lesion activity concentrations were higher than in normal tissues &amp; detectable at last imaging timepoint (15d). Conclusions: 177 Lu-rosopatamab + SoC for pts with mCRPC demonstrates a manageable safety &amp; tolerability profile; predictable PK profile with prolonged tumor residence; &amp; organ radiation exposure below recommended thresholds. Radiation absorbed dose was highest for liver (clearance organ), which is comparatively radioresistant. Data support continued investigation in Part 2. Disclosure: This study is sponsored by Telix Pharmaceuticals. Clinical trial information: NCT06520345 .

Templating Rules for Mechanically Interlocked Carbon Nanotubes

Journal of the American Chemical Society Sara Moreno-Da Silva, Manuel Pérez-Escribano, Gloria Tobajas-Curiel et al. Jun 10, 2026 DOI: 10.1021/jacs.6c05995

Enhancement on thermal, electrical and waterproof performances of cellulose insulating paper with Ar/OMCTS/BN plasma

Scientific Reports Lei Zhu, Honghua Xu, Rui Chen et al. Jun 10, 2026 DOI: 10.1038/s41598-026-57750-5

Abstract Cellulose paper plays the key role in the oil-paper insulation system ensuring safe and reliable operation of power systems, which faces challenges related to its inherent low thermal conductivity, high dielectric constant and hydrophilicity. Herein, polymerization reactions are induced on the surface and within the bulk of the cellulose insulating paper via atmospheric-pressure low-temperature plasma with a precursor formed by incorporating BN powders into octamethylcyclotetrasiloxane (OMCTS). As indicated by SEM, EDS, FTIR, and XPS results, a low-polarity cross-linking network is constructed within intrinsic porous structures of the paper, comprehensively improving thermal, electrical and waterproof performances. The thermal conductivity is increased by 15.9%, thereby enabling a significant enhancement in the heat dissipation capability. The relative dielectric constant of the insulating paper is decreased by 27.3%, maintaining effective dielectric adaptation with insulating oil. The surface and bulk insulation performance of the oil-impregnated paper is reinforced, with a 9.4% increase in the flashover voltage and a 17.5% improvement in bulk breakdown strength. The wetting property is changed from hydrophilic to hydrophobic, reducing water absorption by 32.6%, inhibiting the transport of water molecules. This work provides a promising approach for developing high-performance insulating paper for safe and stable power transmission.

Neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy followed by D2 gastrectomy and adjuvant chemotherapy for locally advanced gastric cancer (Neo-CRAG): A randomized, multicenter, phase 3 trial.

Journal of Clinical Oncology Rui-Hua Xu, Wei Wang, Yu-Jing Zhang et al. Jun 10, 2026 DOI: 10.1200/jco.2026.44.17_suppl.lba4075

LBA4075 Background: Neoadjuvant chemoradiotherapy (CRT) has been proposed to improve tumor response over neoadjuvant chemotherapy (CT) in patients with locally advanced gastric cancer (LAGC). However, there are limited phase III clinical trials to confirm its survival benefit. Methods: The Neo-CRAG study is a multicenter phase III trial conducted in China. Patients with stage cT3N2/N3M0, cT4aN+M0, or cT4bNanyM0 gastric or esophagogastric junction (EGJ, Siewert type II/III) adenocarcinoma were randomly assigned (1:1) to the CRT or CT group. All patients received 3 cycles of preoperative XELOX, followed by D2 gastrectomy and adjuvant XELOX. In CRT group, radiotherapy (45Gy/25Fx) started after the first CT cycle, dose modifications were made with concurrent CRT (oxaliplatin: 130 to 100 mg/m²; capecitabine: 1000 to 825 mg/m²). The radiation target volume chiefly included moderate mucosal CTV expansion (3cm) beyond primary tumor (fasting state), and comprehensive elective regional lymph node irradiation (station 16a2 as the lower border). The primary endpoint was disease-free survival (DFS). The secondary endpoints were overall survival (OS), pathological complete response (pCR), R0 resection, and safety. Results: Between 2013-2022, 620 patients (310 per group) were enrolled from 13 referral hospitals, including 225 (36.3%) patients with EGJ primary. Median follow-up was 69.7 months (IQR, 49.6–97.4). The primary endpoint of DFS was met (HR 0.750, 95%CI 0.607-0.928; P=0.008). The 3-year DFS rate was 55.6% (95% CI, 50.1 - 61.1) in the CRT group and 42.4% (36.9 - 47.9) in the CT group, and median DFS was 52.7 months with CRT versus 24.4 months with CT. Meanwhile, the 5-year OS rate was 50.1% versus 44.2% (HR 0.781, 95% CI 0.628-0.970; P=0.025) and the median OS was 67.5 months with CRT compared to 37.6 months with CT. Subgroup analyses showed that the survival benefit of CRT over CT was consistent. 448 patients underwent D2 gastrectomy. pCR was achieved in 33/223 (14.8%) of patients in the CRT group and 14/225 (6.2%) in the CT group. ypN0 rates were 125/223 (56.1%) in the CRT group and 82/225 (36.4%) in the CT group. Tumor downstaging (ypT0-2) occurred in 95/223 (42.6%) of CRT group and 53/225 (23.6%) of CT group. In patients who underwent R0 resection, lower locoregional recurrence rate was observed in the CRT group (20/213, 9.4%), compared with the CT group (38/208, 18.3%). The safety population comprised 603 patients. Grade 3+ hematologic toxicity was relatively higher in the CRT group (44/302 [14.6%] vs 31/301 [10.3%]). Grade 3+ postoperative complication rates were comparable (20/223 [9.0%] vs 17/225 [7.6%]). Conclusion: For patients with LAGC, intensifying perioperative CT with preoperative radiotherapy improves survival and is an effective strategy for high-risk cases in need of enhanced locoregional control. Clinical trial information: NCT01815853 .

A Target-And-Activate Magnetic Resonance Imaging Strategy for Precision Imaging of Intratumoral Bacteria and Screening Antibiotics to Suppress Breast Cancer Metastasis

Journal of the American Chemical Society Shuang Wu, Weitao Yang, Zhuoyao Wu et al. Jun 10, 2026 DOI: 10.1021/jacs.6c03081

Active volume scaling of gold vapor laser oscillating in ultraviolet and deep ultraviolet spectral ranges

Scientific Reports Ivan Kirilov Kostadinov, Krassimir Angelov Temelkov, Lidia Todorova Popova et al. Jun 10, 2026 DOI: 10.1038/s41598-026-57658-0

Amivantamab Monotherapy in Chemorefractory <i>RAS</i> / <i>BRAF</i> Wild-Type Metastatic Colorectal Cancer: Results From OrigAMI-1, an Open-Label, Phase Ib/II Study

Journal of Clinical Oncology Paul E. Oberstein, J. Randolph Hecht, Kanwal Raghav et al. Jun 10, 2026 DOI: 10.1200/jco-25-02187

PURPOSE Amivantamab, an EGFR-MET bispecific antibody with immune cell–directing activity, is approved in non–small cell lung cancer (NSCLC). Effective treatments are limited for chemorefractory metastatic colorectal cancer (mCRC). METHODS OrigAMI-1 (ClinicalTrials.gov identifier: NCT05379595 ) is a phase Ib/II study evaluating amivantamab monotherapy in chemorefractory (2-3 prior lines) mCRC. Participants had centrally confirmed RAS / BRAF / EGFR ectodomain wild-type status, without ERBB2 / HER2 amplification. Participants with left-sided mCRC without (cohort A) or with (cohort B) prior anti-EGFR antibody treatment, or right-sided mCRC (cohort C) regardless of prior anti-EGFR treatment, received intravenous amivantamab 1,050 mg (1,400 mg for ≥80 kg) once every 2 weeks. The primary end point was objective response rate (ORR) per RECIST v1.1. RESULTS By October 31, 2024, 94 participants received amivantamab monotherapy (median follow-up, 11.9 months). The median age was 60 years, and 65% of participants were male, with a median of 2 prior lines (94%, prior bevacizumab). In left-sided cohorts, the ORR was 29% (5 of 17) in cohort A and 19% (10 of 54) in cohort B; the median duration of response (DoR) was 9.0 months and 6.1 months, and the median progression-free survival (PFS) was 5.7 months and 4.6 months, respectively. In the right-sided cohort, the ORR was 22% (10 of 23; 43% had prior anti-EGFR), the median DoR was 9.8 months, and the median PFS was 3.7 months. Most frequent treatment-related grade ≥3 adverse events (AEs) were rash (7%), dermatitis acneiform (4%), and hypoalbuminemia (4%). One participant discontinued amivantamab because of a treatment-related AE. CONCLUSION Amivantamab monotherapy demonstrated promising, durable antitumor activity in chemorefractory mCRC, regardless of prior anti-EGFR therapy and the primary tumor location. The amivantamab safety profile in mCRC is consistent with experience in NSCLC. Amivantamab plus chemotherapy is currently being explored in two phase III studies in first-line and second-line mCRCs.

Targeted Coacervates Enabled by Polyphenol–Peptide Networks for Therapeutic Delivery

Journal of the American Chemical Society Linli Jiang, Qiantao Song, Zhixing Lin et al. Jun 10, 2026 DOI: 10.1021/jacs.6c06722

An empirical study of machine learning robustness and scalability for imbalanced tabular clinical data in emergency and critical care

Scientific Reports Yusuf Brima, Marcellin Atemkeng Jun 10, 2026 DOI: 10.1038/s41598-026-56413-9

Abstract Every year, millions of patients pass through emergency departments and intensive care units where clinicians must make life-altering decisions under time pressure and uncertainty. Advances in machine learning is poised to offer support for clinical decision-making, including prediction of patient deterioration, triage guidance, and identification of rare but clinically critical outcomes. Yet a persistent impediment limits its utilization in these settings: clinical data are often severely imbalanced, with critical outcomes occurring far less frequently than routine ones. This skewness can bias models toward majority classes, degrading performance. Developing models that are both robust to such imbalance and computationally efficient enough for deployment in time-sensitive environments remains an open and practically important challenge. In this paper, we empirically studied the robustness and scalability of six model families spanning classical machine learning, deep learning, and tabular foundation models on imbalanced tabular data from two large-scale clinical datasets (MIMIC-IV-ED and eICU). Class imbalance was quantified using three complementary metrics, and we compared tree-based methods (Decision Tree, Random Forest, XGBoost), the TabNet deep learning model, and two tabular foundation models (TabICL and TabPFN v2.6). All trainable models were evaluated under a unified experimental protocol using Bayesian hyperparameter optimization for trainable models, while foundation models were assessed in their pretrained inference regime without task-specific optimization or reweighting. All models were assessed on predictive performance (Macro F1-score), robustness to increasing imbalance, and computational scalability across seven clinically relevant prediction tasks. Results differed across databases. On MIMIC-IV-ED, foundation-based models (TabPFN v2.6 and TabICL) attained the strongest average Macro F1-score ranks, with XGBoost and other tree-based ensembles remaining competitive. On eICU, XGBoost consistently led, followed by other tree-based methods, while foundation models occupied intermediate positions. Across both datasets, TabNet exhibited the sharpest performance degradation under increasing imbalance and the highest computational costs. Training time analyses showed that classical and tree-based methods scale most favorably with dataset size, while foundation models achieved low per-task cost through their inference-based paradigm. These findings indicate that model selection for imbalanced clinical tabular data is context-dependent: no single family dominated across both datasets and all tasks. Nonetheless, recent advances in tabular foundation models suggest a rapidly narrowing performance gap with strong classical baselines such as XGBoost, while offering a distinct computational profile characterized by low per-task adaptation cost. This efficiency–performance trade-off may become increasingly relevant for deployment in resource-constrained clinical environments. Rather than prescribing a universal solution, this work provides clinical stakeholders with an empirically grounded framework for navigating the trade-offs between predictive robustness, computational scalability, and clinical feasibility in high-stakes, time-sensitive care environments.

Selinexor plus ruxolitinib in JAK inhibitor–naïve myelofibrosis: Phase 3 SENTRY trial.

Journal of Clinical Oncology John Mascarenhas, Haris Ali, Haifa Kathrin Al-Ali et al. Jun 10, 2026 DOI: 10.1200/jco.2026.44.17_suppl.lba6500

LBA6500 Background: Myelofibrosis (MF) is a debilitating myeloproliferative neoplasm marked by splenomegaly, constitutional symptoms, and reduced life expectancy. JAK inhibitors (JAKi), such as ruxolitinib (R), are standard frontline therapy; however, only ~1/3 of R-treated patients (pts) achieve spleen volume reduction ≥35% (SVR35). Despite observed symptom improvements, durable modification of underlying disease biology, including reductions in variant allele frequency (VAF), is limited. Importantly, gains in overall survival remain modest, highlighting a critical unmet need. Selinexor (S), an inhibitor of XPO1-mediated nuclear export, has biologic activity in MF and synergy with R in MPN models. SENTRY evaluated S+R in pts with JAKi–naïve MF. Methods: Pts with JAKi-naïve MF were randomized 2:1 to S 60 mg weekly plus R (per label) or placebo plus R, stratified by DIPSS risk, spleen volume, and baseline platelet count. Eligibility included spleen volume ≥450 cm³, active symptoms, DIPSS Int-1 or higher and platelets ≥100×10⁹/L. Co-primary endpoints were SVR35 and absolute mean change in TSS (AbsTSS; excluding fatigue) at Week 24. SVR35 used a stratified Cochran–Mantel–Haenszel test; TSS used a mixed-effects model for repeated measures. Hierarchical testing (one-sided α=0.025) evaluated SVR35 then AbsTSS. Secondary endpoints included safety and overall survival (OS). Changes in VAF were exploratory. Results: 353 pts were randomized (S+R n=235; R n=118). Baseline characteristics were balanced. At Week 24 SVR35 was achieved in 49.8% of pts in S+R vs 28.0% in R (difference, 21.8%; OR 2.58; 95% CI 1.60 to 4.17; P &lt; .0001). Responses occurred early and were sustained, with SVR35 rates of 49.4% vs 20.3% at Week 12 and 46.9% vs 23.0% at Week 36. SVR35 was achieved at any time in 67.7% vs 44.9%. Mean percent change in spleen volume at Week 24 was −40.0% vs −26.7%. Mean (95% CI) AbsTSS change at Week 24 was −9.9 (−11.2 to −8.6) vs −10.9 (−12.6 to −9.1); adjusted mean difference 0.97 (95% CI -1.07 to 3.02; P = .825). As of Feb 20, 2026, 224 (95.3%) pts in S+R and 106 (89.8%) in R were alive. With median follow-up of 11.6 and 12.6 months, OS favored S+R (HR 0.43; 95% CI 0.19 to 1.00; nominal P = .022) with early separation of Kaplan–Meier curves emerging around Month 9. VAF reduction ≥20% at Week 24 occurred in 32.0% vs 23.9% and correlated with SVR35 response. TEAEs occurred in 99.1% in S+R and 97.4% in R (grade ≥3 in 70.1% vs 50.0%); however, TEAEs leading to treatment discontinuation were low (14.5% and 8.6%). TEAEs leading to death occurred in 0.9% vs 2.6%. Confirmed leukemic transformation was 1.7% in each arm. Conclusions: S+R significantly improved spleen response vs R alone with earlier, deeper, and sustained response rates, comparable symptom improvement from baseline, and a manageable safety profile. The improved spleen response, early OS signal, and VAF reductions observed in SENTRY position S+R as a novel combination approach for frontline treatment of MF. Clinical trial information: NCT04562389 .