Cancer最新文献

{"title":"Efficacy and safety of pembrolizumab in patients with advanced urothelial carcinoma deemed potentially ineligible for platinum-containing chemotherapy: Post hoc analysis of KEYNOTE-052 and LEAP-011.","authors":"Peter H O'Donnell, Yohann Loriot, Tibor Csoszi, Nobuaki Matsubara, Sang Joon Shin, Se Hoon Park, Vagif Atduev, Mahmut Gumus, Saziye Burcak Karaca, Petros Grivas, Ronald de Wit, Daniel E Castellano, Thomas Powles, Jacqueline Vuky, Yujie Zhao, Karen O'Hara, Chinyere E Okpara, Sonia Franco, Blanca Homet Moreno, Jakub Żołnierek, Arlene O Siefker-Radtke","doi":"10.1002/cncr.35601","DOIUrl":"10.1002/cncr.35601","url":null,"abstract":"<p><strong>Background: </strong>First-line pembrolizumab monotherapy is a standard of care for platinum-ineligible patients with advanced urothelial carcinoma (UC). No global standardized definition of platinum ineligibility exists. This study aimed to evaluate the efficacy and safety of pembrolizumab monotherapy in patients with UC who met various criteria for platinum ineligibility.</p><p><strong>Methods: </strong>Patients from KEYNOTE-052 and LEAP-011 deemed potentially platinum ineligible were pooled for this post hoc exploratory analysis as follows: group 1: Eastern Cooperative Oncology Group performance status (ECOG PS) 2; group 2: ECOG PS 2 and age ≥80 years, renal dysfunction, or visceral disease; and group 3: any two other factors regardless of ECOG PS. Patients received pembrolizumab 200 mg intravenously every 3 weeks. End points included objective response rate (ORR), progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors, version 1.1, by blinded independent central review, overall survival (OS), and safety.</p><p><strong>Results: </strong>A total of 612 patients treated with pembrolizumab from KEYNOTE-052 (n = 370) and LEAP-011 (n = 242) were included; the median (range) follow-up was 56.3 months (51.2-65.3 months) and 12.8 months (0.2-25.1 months), respectively. For group 1, ORR was 26.2%, median PFS was 2.7 months, and median OS was 10.1 months. For group 2, ORR ranged from 23.5% to 33.3%, median PFS ranged from 2.1 to 4.4 months, and median OS ranged from 9.1 to 10.1 months. For group 3, ORR ranged from 25.7% to 27.9%, median PFS ranged from 2.1 to 2.8 months, and median OS ranged from 9.0 to 10.6 months. Treatment-related adverse event rates were consistent across groups.</p><p><strong>Conclusions: </strong>Frontline pembrolizumab has consistent antitumor activity and safety in patients with advanced UC categorized as potentially ineligible for platinum-based chemotherapy, regardless of the variable definitions of platinum ineligibility used.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35601"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of a phase 2 study of all-trans retinoic acid, arsenic trioxide, and gemtuzumab ozogamicin in acute promyelocytic leukemia.","authors":"Wei-Ying Jen, Jennifer Marvin-Peek, Hagop M Kantarjian, Yesid Alvarado, Gautam Borthakur, Elias Jabbour, William Wierda, Tapan M Kadia, Naval G Daver, Courtney D DiNardo, Nicholas J Short, Nitin Jain, Alessandra Ferrajoli, Steven Kornblau, Musa Yilmaz, Maro Ohanian, David McCue, Jan Burger, Danielle Hammond, Keyur Patel, Ghayas C Issa, Naveen Pemmaraju, Koji Sasaki, Abhishek Maiti, Hussein A Abbas, Kelly Chien, Koichi Takahashi, Fadi Haddad, Prithviraj Bose, Lucia Masarova, Guillermo Montalban-Bravo, Mahesh Swaminathan, Mark Brandt, Sherry Pierce, Guillermo Garcia-Manero, Farhad Ravandi","doi":"10.1002/cncr.35662","DOIUrl":"10.1002/cncr.35662","url":null,"abstract":"<p><strong>Background: </strong>All-trans retinoic acid (ATRA) and arsenic trioxide (ATO) combinations have produced excellent outcomes in patients with standard-risk acute promyelocytic leukemia (APL). Herein, the authors update their long-term results with the regimen of ATO-ATRA and gemtuzumab ozogamicin (GO) in standard-risk and high-risk APL.</p><p><strong>Methods: </strong>This was a phase 2 trial of patients with newly diagnosed APL. Induction comprised ATRA 45 mg/m² and ATO 0.15 mg/kg daily. GO 6-9 mg/m² was added for high-risk patients and for standard-risk patients who developed leukocytosis >10 × 10⁹/L. Consolidation consisted of four courses of ATO-ATRA, with GO for patients who had PML::RARA persistence.</p><p><strong>Results: </strong>One hundred forty-six patients (median age, 53.0 years; range, 19.3-83.9 years) were treated, including 106 patients (72.6%) with standard-risk APL and 40 (27.4%) with high-risk APL. GO was administered to 68 standard-risk patients (64.2%) for leukocytosis. The complete remission rate was 93.8% (95% confidence interval [CI], 92.2%-98.5%). Negative measurable residual disease status was achieved in 97.1% of patients who attained complete remission. At a median follow-up of 61.8 months (95% CI, 4.7-128.4 months), the 5-year event-free survival, disease-free survival, and overall survival rates were 92.4% (95% CI, 87.9%-97.1%), 93.6% (95% CI, 89.5%-97.8%), and 93.1% (95% CI, 88.9%-97.7%), respectively. Induction mortality was 2.7%. The most common severe adverse events were elevated transaminases in 41.0% of patients and infection in 13.7%. There were no cases of veno-occlusive disease.</p><p><strong>Conclusions: </strong>The combination of ATO-ATRA and GO was curative in 94% of patients who had APL with a favorable safety profile (ClinicalTrials.gov identifier NCT01409161).</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35662"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Tuskegee: A contemporary qualitative assessment of barriers to research participation among Black women.","authors":"Jeuneviette E Bontemps-Jones, Lauren E McCullough, Elizabeth G Kirkland, Lauren R Teras, Peter Briggs, Melicia C Whitt-Glover, Shavon Arline-Bradley, Jamal Winn, Jason Lett, Alpa V Patel","doi":"10.1002/cncr.35648","DOIUrl":"10.1002/cncr.35648","url":null,"abstract":"<p><strong>Background: </strong>Health care inequities have partially contributed to the existing racial gaps in health. Despite having lower incidence rates of breast cancer, Black women have a 41% higher mortality rate than White women. Black individuals remain underrepresented in research. Diversity in research is paramount to the improvement of clinical care practices and subgroup-specific guidelines.</p><p><strong>Methods: </strong>Black women from various community venues across geographic regions of the United States were invited via email, online fliers, social media platforms, and word of mouth to participate in focus groups. Six online focus groups of six to 10 Black women aged 25-65 years (N = 38) with and without a history of cancer were conducted with an in-depth semistructured discussion guide.</p><p><strong>Results: </strong>Most participants were college educated (32 of 38; 84.2%), aged 50 years or older (31 of 38; 81.6%), and had an annual income of $50,000 or more (26 of 38; 68.4%). Several barriers to research participation were identified. They included a lack of empathy and respect in health care settings, apprehension regarding the sharing of personal information, mistrust of medical research, and logistical/technical barriers. Alternatively, building individual and community trust and communicating the value of conducting research beneficial to the Black community were viewed as facilitators to research participation.</p><p><strong>Conclusions: </strong>Successful engagement of Black women in research requires the acknowledgment and consideration of the numerous barriers that affect their ability to participate. Black women are more inclined to participate in research when the research team is knowledgeable, has experience within their communities, and engages trusted community partners. Additionally, the research must be meaningful and impactful to future generations of Black women.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35648"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of health insurance coverage disruptions and breast and colorectal cancer screening.","authors":"Kewei Sylvia Shi, Xuesong Han, Jessica Star, Jingxuan Zhao, K Robin Yabroff","doi":"10.1002/cncr.35584","DOIUrl":"10.1002/cncr.35584","url":null,"abstract":"<p><strong>Background: </strong>Health insurance coverage is critical for ensuring access to recommended health care in the United States. This study investigated the associations of health insurance coverage disruptions, also known as coverage churn, and receipt of breast and colorectal cancer screening.</p><p><strong>Methods: </strong>Adults who were age-eligible and younger than 65 years (range, 50-64 years) for breast (n = 17,128 women) and colorectal (n = 32,562 individuals) cancer screening were identified from 5 years of the National Health Interview Survey. Adults were categorized into five groups based on insurance type at survey (private, public, none) and prior coverage disruptions within the past year. Screening outcomes included: (1) ever-screened, (2) past-year screening, and (3) guideline-concordant screening. Separate multivariate logistic regression models were used to evaluate the associations between insurance coverage disruptions and cancer screening.</p><p><strong>Results: </strong>Among adults who had coverage at the time of the survey, 3.1% with private insurance and 6.5% with public insurance reported prior coverage disruptions. Individuals without health insurance coverage had the lowest level of screening. Among individuals who had private coverage, prior disruptions were associated with lower guideline-concordant screening in adjusted analyses (breast cancer screening: adjusted prevalence ratio [aPR], 0.82; 95% confidence interval [CI], 0.75-0.89; colorectal cancer screening: aPR, 0.78; 95% CI, 0.72-0.86); among those who had public coverage, prior disruptions were also associated with lower guideline-concordant breast cancer screening (aPR, 0.73; 95% CI, 0.60-0.89) and colorectal cancer screening (aPR, 0.84; 95% CI, 0.72-0.99).</p><p><strong>Conclusions: </strong>Health insurance coverage disruptions were associated with lower past-year and guideline-concordant breast and colorectal cancer screening. The current findings underscore the importance of stable health insurance coverage to improve cancer screening and early detection when treatment is most effective.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35584"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142363571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive autonomy and breastfeeding in young breast cancer survivors.","authors":"Fedro A Peccatori, Romana Prosperi Porta, Hatem A Azim","doi":"10.1002/cncr.35602","DOIUrl":"10.1002/cncr.35602","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35602"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142454012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification in the clinical application of minimal residual disease assessment in acute myeloid leukemia.","authors":"Congxiao Zhang, Runxia Gu, Huijun Wang, Chunlin Zhou, Yan Li, Yuntao Liu, Shuning Wei, Dong Lin, Kaiqi Liu, Qiuyun Fang, Xiaoyuan Gong, Benfa Gong, Shaowei Qiu, Guangji Zhang, Bingcheng Liu, Ying Wang, Yingchang Mi, Hui Wei, Jianxiang Wang","doi":"10.1002/cncr.35641","DOIUrl":"10.1002/cncr.35641","url":null,"abstract":"<p><strong>Background: </strong>In acute myeloid leukemia (AML), further investigation is warranted to integrate measurable residual disease (MRD) with genetic characteristics for formulating a dynamic prognostic system for predicting response and selecting appropriate postremission therapeutic strategies.</p><p><strong>Methods: </strong>The authors incorporated MRD with genetic risk classification and assessed its impact on transplantation decision making within different risk cohorts, comprising 769 patients with newly diagnosed AML across three clinical trials. Only patients who achieved complete remission (CR) within two courses of chemotherapy were selected.</p><p><strong>Results: </strong>In the favorable-risk and intermediate-risk groups, patients who underwent transplantation according to the protocol experienced significant 3-year overall survival (OS) benefits compared with those who did not (favorable-risk group: hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20-0.73l p = .004; intermediate-risk group: HR, 0.53; 95% CI, 0.33-0.85; p = .008). In the intermediate-risk group, early detection of MRD positivity, even after the initial course of chemotherapy, was associated with a significantly elevated cumulative incidence of relapse (47.2% vs. 36.0%; p = .009) and a notable extension of OS with allogeneic hematopoietic stem cell transplantation (HR, 0.47; 95% CI, 0.28-0.79; p = .004). Conversely, patients who achieved MRD negativity at either of the two time points had comparable OS in the favorable-risk and intermediate-risk groups, regardless of whether they underwent transplant or not. In the adverse-risk group, allogeneic hematopoietic stem cell transplantation led to improvements in OS irrespective of MRD status (HR, 0.51; 95% CI, 0.38-0.69; p < .001).</p><p><strong>Conclusions: </strong>Early clearance of MRD demonstrated significant prognostic value, particularly for patients in the favorable-risk and intermediate-risk groups. Positive MRD status after two courses of intensive chemotherapy were associated with a higher relapse rate and inferior OS, necessitating allogeneic hematopoietic stem cell transplantation.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35641"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of isolated limb infusion/perfusion, immune checkpoint inhibitors, and intralesional therapy as first-line treatment for patients with melanoma in-transit metastases.","authors":"Danielle K DePalo, Michelle M Dugan, Syeda Mahrukh Hussnain Naqvi, David W Ollila, Tina J Hieken, Matthew S Block, Winan J van Houdt, Michel W J M Wouters, Sophie J M Reijers, Nethanel Asher, Kristy K Broman, Zoey Duncan, Matilda Anderson, David E Gyorki, Hayden Snow, Jenny Held, Jeffrey M Farma, John T Vetto, Jane Y C Hui, Madison Kolbow, Robyn P M Saw, Serigne N Lo, Georgina V Long, John F Thompson, Youngchul Kim, Lilit Karapetyan, Lars Ny, Alexander C J van Akkooi, Roger Olofsson Bagge, Jonathan S Zager","doi":"10.1002/cncr.35636","DOIUrl":"10.1002/cncr.35636","url":null,"abstract":"<p><strong>Background: </strong>Isolated limb infusion and perfusion (ILI/ILP) has been a mainstay treatment for unresectable melanoma in-transit metastases (ITM), but increased use of immune checkpoint inhibitors (ICI) and intralesional therapy (talimogene laherparepvec [TVEC]) introduced several different management options. This study compares first-line ILI/ILP, ICI, and TVEC.</p><p><strong>Methods: </strong>Retrospective review from 12 international institutions included patients treated from 1990 to 2022 with first-line ILI/ILP, ICI, or TVEC for unresectable melanoma ITM.</p><p><strong>Results: </strong>A total of 551 patients were treated, with ILI/ILP (n = 356), ICI (n = 125), and TVEC (n = 70) with median follow-up of 5.5 years. Tumor burden was highest with ILI/ILP and lowest with TVEC (p = .002). Breslow thickness was lowest with TVEC (p = .007). TVEC was mostly used in stage IIIB disease versus IIIC for ILI/ILP and ICI (p = .01). Using ICI as the reference category, TVEC had the highest odds of a complete response (CR) (odds ratio, 1.96; p = .029) and a longer local progression-free survival (PFS) (hazard ratio [HR], 0.40; p = .003). ILI/ILP had shorter local PFS (HR, 1.72; p = .012), PFS (HR, 1.79; p < .001), distant metastasis-free survival (DMFS) (HR, 1.75; p = .014), overall survival (HR, 1.82; p = .009), and melanoma-specific survival (HR, 2.29; p = .004). Stage IIIB disease had longer DMFS (HR, 0.24; p < .001) compared to IIIC/D.</p><p><strong>Conclusions: </strong>TVEC as first-line therapy for unresectable melanoma ITM was associated with superior CR rates and local PFS. Notably, TVEC was used in patients with a lower Breslow thickness, disease stage, and tumor burden. Therefore, when compared to ILI/ILP and ICI, TVEC should be considered as first-line therapy for unresectable stage IIIB melanoma ITM with minimal tumor burden and lower Breslow thickness.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35636"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No news, bad news: When the result of a clinical biomarker is \"no result available\".","authors":"Ignacio Romero","doi":"10.1002/cncr.35692","DOIUrl":"https://doi.org/10.1002/cncr.35692","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":"e35692"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial toxicity in early-phase cancer clinical trial participants.","authors":"Sienna M Durbin, Debra Lundquist, Andrea Pelletier, Laura A Petrillo, Viola Bame, Victoria Turbini, Hope Heldreth, Kaitlyn Lynch, Mary Boulanger, Anh Lam, Casandra McIntyre, Betty R Ferrell, Rachel Jimenez, Dejan Juric, Ryan D Nipp","doi":"10.1002/cncr.35586","DOIUrl":"10.1002/cncr.35586","url":null,"abstract":"<p><strong>Background: </strong>Little is known about financial toxicity in early-phase clinical trial (EP-CT) participants. This study sought to describe financial toxicity in EP-CT participants and assess associations with patient characteristics and patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>Prospectively enrolled EP-CT participants from were followed from April 2021 through January 2023. Participants completed the Comprehensive Score for Financial Toxicity (<26 = financial toxicity) at time of treatment. Quality of life (QOL), symptoms, coping, and resource concerns were surveyed. Associations of financial toxicity with patient characteristics, PROs, and clinical outcomes were explored.</p><p><strong>Results: </strong>Of 261 eligible patients, 197 completed baseline assessments (75.5%, median age = 63.4 years [31.8-88.6], 57.4% female). Most common cancers were gastrointestinal (33.0%) and breast (20.8%). More than one third (34.0%) of patients reported financial toxicity. Patients with financial toxicity were more likely to be <65 years (70.2% vs 48.5%, p = .004), unemployed (45.5% vs 16.9%, p < .001), not have attended college (53.1% vs 26.4%, p = .002), and have income <$60,000 (59.7% vs 25.4%, p < .001). In adjusted models, patients with financial toxicity reported lower QOL (B = -6.66, p = .004) and acceptance (B = -0.78, p = .002), and increased self-blame (B = 0.87, p < .001). They were more likely to have concerns regarding housing (10.6% vs 2.3%, p = .025), bills (31.8% vs 3.8%, p < .001), food (9.1% vs 0.8%, p = .006), and employment (21.2% vs 1.5%, p < .001). There was no difference in time on trial (hazard ratio, 1.03; p = .860) or survival (hazard ratio, 1.16; p = .496).</p><p><strong>Conclusions: </strong>More than one third of EP-CT participants reported financial toxicity. Factors associated with financial toxicity and demonstrated novel associations among financial toxicity with QOL, coping, and resource concerns were identified, highlighting the need to address financial toxicity among this population.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35586"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142386612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes following off-site remote systemic cancer therapy administration.","authors":"Abram S Arnold, Samia Asif, Valerie Shostrom, Mridula Krishnan, Apar Kishor Ganti","doi":"10.1002/cncr.35616","DOIUrl":"10.1002/cncr.35616","url":null,"abstract":"<p><strong>Background: </strong>The Veterans Affairs Nebraska Western Iowa Health Care System (VA-NWIHCS) uses teleoncology and remote systemic cancer therapy services to expand care to veterans in rural Nebraska via remote sites in Lincoln and Grand Island. This study compares clinical outcomes in patients receiving care at these remote sites to those at the primary site in Omaha.</p><p><strong>Methods: </strong>Data were retrospectively reviewed for 151 patients who received first-line systemic therapy at VA sites in Omaha, Lincoln, or Grand Island between January 1, 2018, and December 31, 2020. This included patient demographics, malignancy type and stage, survival, systemic therapy received, treatment intent and toxicities, missed or delayed cycles, and frequency of hospitalizations or emergency department visits. SAS version 9.4 was used for analysis.</p><p><strong>Results: </strong>The study population included 108 patients who received their systemic therapy in Omaha, whereas 43 received therapy at the remote sites. The demographic of both populations was predominantly male with a median age of 69 years and Eastern Cooperative Oncology Group Performance Status of 0 to 1. The two groups were comparable in terms of comorbidities. Both populations had a similar distribution of cancer types, proportion of patients with stage IV disease, and treatment with curative intent. There was no difference in 1- and 2-year survival, systemic therapy-related toxicity classification and prevalence, number of delayed/missed cycles, and hospitalization/emergency department visits.</p><p><strong>Conclusion: </strong>Evaluated outcomes in patients treated in Omaha versus remote sites via teleoncology under the same providers were similar. Effective oncology care, including systemic therapy, can be provided via teleoncology, and this model can help mitigate issues with access to care.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":" ","pages":"e35616"},"PeriodicalIF":6.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}