Observational studyNature medicine2025
Macrovascular tumor infiltration and circulating tumor cell cluster dynamics in patients with cancer approaching the end of life.
Observational study in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- High-quantity capture of heterogeneous circulating tumor cellsMaterials today. Bio · 2026Article
- Neoadjuvant Stereotactic Ablative Radiotherapy Before Inferior Vena Cava Thrombectomy for Renal Cell Carcinoma: A Phase 2 Nonrandomized Clinical Trial.JAMA oncology · 2026Article
- Article
- The year in cardiovascular medicine 2025: the top 10 papers in cardio-oncology.European heart journal · 2026Article
- Efficacy of Lenvatinib versus Bevacizumab in Triple Therapy with Immune Checkpoint Inhibitors and Interventional Therapy for Hepatocellular Carcinoma with Macrovascular Invasion: A Multi-Center Real-World Retrospective Study.Journal of hepatocellular carcinoma · 2026Article
- The tumor microenvironment as a key regulator of radiotherapy response.Frontiers in immunology · 2026Review
- Understanding end-of-life cancer biology.Nature medicine · 2025Article
Corrections and comments
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Authors and funding
45 authors.
Funding
Abstract
End-of-life events related to carcinoma lethality are poorly characterized. Herein we conducted an observational, prospective, case-control study enrolling 21 patients with solid tumors and 10 patients without known malignancy, complemented by a retrospective validation cohort of 1,250 patients with cancer. In our prospective cohort, we observed spikes in circulating tumor cell (CTC) counts, particularly clusters, immediately before death (P < 0.0001), as well as pathological evidence of macrovascular infiltration and large-vessel occlusion obtained through rapid autopsy. In the validation cohort, radiological evidence of macrovascular infiltration emerged as the strongest predictor of poor survival-independent of metastasis-in treatment-homogeneous patients with colorectal, lung, ovarian, hepatocellular or pancreatic cancer (hazard ratios = 4.0-22.4). Collectively, these findings suggest that macrovascular infiltration and spikes in CTC clusters with consequent vascular failure could be pivotal end-of-life events associated with cancer lethality, providing a rationale for future trials aimed at curbing infiltration into large vessels.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.