JCO oncology practice最新文献

{"title":"Impact of Publicly Reported Outcomes on Patient Selection for Hematopoietic Cell Transplantation.","authors":"Christopher Strouse, Mark Juckett, Brent R Logan, Noel Estrada-Merly, Andrew Peterson, Jaime M Preussler, Tony H Truong, Jesse D Troy, Nandita Khera, William A Wood, Hemalatha G Rangarajan, Luke P Akard, Neel S Bhatt, Akshay Sharma, J Douglas Rizzo, Wael Saber","doi":"10.1200/OP-25-00115","DOIUrl":"10.1200/OP-25-00115","url":null,"abstract":"<p><strong>Purpose: </strong>Public reporting of health care outcomes can have unintended effects such as inappropriate risk aversion in patient selection.</p><p><strong>Methods: </strong>The center-specific survival analysis annually assigns all hematopoietic cell transplantation (HCT) centers in the United States a +1, -1, or 0 score for observed outcomes that are above, below, or within a center-specific predicted range of outcome. For each index year (2012-2016), centers receiving a -1 score after 0 scores in the preceding 2 years were compared with contemporaneous centers with as-predicted outcomes (0 score). Changes in the patient population characteristics in the 3 years before versus the 3 years after the index years were compared between the newly below-expected centers (NBCs) and the controls. A multivariate model adjusted for baseline patient population characteristics and center volume.</p><p><strong>Results: </strong>No differences in patient selection behavior were identified when comparing the NBCs with the controls across eight key patient population characteristics. For the statistically modeled (predicted) 1-year overall survival (OS), reflecting a holistic measure of centers' patient population risk, we observed no statistically significant difference in change (-0.23% [95% CI, -1.4 to 0.9]; <i>P</i> = .70). The observed OS increased in both NBCs and controls by 0.9% and 4.5%, respectively, without statistically significant difference in change.</p><p><strong>Conclusion: </strong>Centers receiving a -1 score were not observed to deviate significantly from patient selection trends in the HCT field. These findings suggest that public reporting of HCT outcomes in the United States does not result in unintended bias against HCT for high-risk patients.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500115"},"PeriodicalIF":4.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Evaluation of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.","authors":"Mirthe Ubink, Henk M W Verheul, Cornelis Verhoef, Pieter J Tanis","doi":"10.1200/OP-25-00530","DOIUrl":"https://doi.org/10.1200/OP-25-00530","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500530"},"PeriodicalIF":4.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Checkbox Format for Electronic Remote Symptom Monitoring After Surgery.","authors":"Norma E Farrow, Rebecca Yu, Melissa Assel, Thomas Atkinson, Peter Stetson, Richard S Matulewicz, Sigrid V Carlsson, Andrew J Vickers, Jennifer R Cracchiolo","doi":"10.1200/OP-25-00210","DOIUrl":"https://doi.org/10.1200/OP-25-00210","url":null,"abstract":"<p><strong>Purpose: </strong>Comparative studies demonstrate that patients who use electronic patient-reported outcomes (ePROs) experience better outcomes; however, research comparing ePRO designs to determine optimal strategies for routine clinical practice is limited. We aimed to determine the impact of a novel checkbox format for presenting items in a postoperative symptom-assessment ePRO tool.</p><p><strong>Methods: </strong>Patients undergoing prostatectomy, nephrectomy, mastectomy, hysterectomy, or thyroidectomy at a tertiary cancer hospital ambulatory surgery center through July 2024 were included. All patients were assigned the ePRO tool for 10 days postoperatively to assess surgical recovery. Historically, patients were asked to rate severity of all symptoms in the tool. An updated checkbox format was then implemented that asked if symptoms were present (yes/no) before eliciting qualitative severity ratings only for selected symptoms. An interrupted time-series design was used to compare patient engagement and psychometric properties before and after implementation of the checkbox format.</p><p><strong>Results: </strong>31,702 patients undergoing 38,929 operations were assigned the ePRO tool with (n = 17,432) or without (n = 21,497) the checkbox format. Without checkboxes, 75% of patients completed at least one questionnaire; mean completion time was 2 minutes. With checkboxes, completion rates improved by an adjusted absolute difference of 13% (95% CI, 12% to 14%; <i>P</i> < .001) and completion times decreased by 44 seconds (95% CI, 42 to 46; <i>P</i> < .001). Symptom scores were lower in the checkbox group and had better correlation with known predictors.</p><p><strong>Conclusion: </strong>Presenting ePRO items in a conditional checkbox format improved patient engagement, reduced survey burden, and was associated with better psychometric properties. The checkbox format should be standard for ePRO delivery in settings such as after surgery, where patients are likely to report only a subset of possible symptoms.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500210"},"PeriodicalIF":4.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Arm Investigator-Initiated Clinical Trial to Improve Germline Testing in At-Risk Patients With Prostate Cancer (IMPRINT).","authors":"Juan Javier-DesLoges, Ana Flores Pimentel, Samuel Pena, Yasoda Satpathy, Yu-Wei Chen, Michael James Randall, Tyler Stewart, Christopher J Kane, Aditya Bagrodia, Clara Hwang, Lin Lu, Matthew Savage, Lisa Madlensky, Rana R McKay","doi":"10.1200/OP-25-00266","DOIUrl":"https://doi.org/10.1200/OP-25-00266","url":null,"abstract":"<p><strong>Purpose: </strong>Germline testing is recommended for patients with high-risk localized, locally advanced, and metastatic prostate cancer; however, implementation remains suboptimal. Novel strategies are needed to engage oncology clinicians and patients in germline testing.</p><p><strong>Methods: </strong>A single-arm investigator-initiated study, conducted from October 1, 2022, to December 31, 2023, used video education as pretest counseling for patients meeting National Cancer Comprehensive Network germline testing criteria. Patients attended a one-on-one in-person session with an educational video, followed by prevideo and postvideo questionnaires assessing knowledge and satisfaction. The primary end point was the proportion who underwent germline testing after intervention, compared with a contemporaneous standard-of-care (SOC) group. Secondary end points included changes in knowledge and perceptions.</p><p><strong>Results: </strong>All 50 enrolled patients completed the intervention. Patients were predominantly White (78.0%), non-Hispanic (92.0%), English-speaking (98.0%), and college-educated (70%). Most had high-risk localized (46.0%) or metastatic hormone-sensitive prostate cancer (26.0%). Germline testing uptake was significantly higher in the intervention group (82.0%, 41/50) compared with the SOC group (37.94%, 107/282, <i>P</i> < .001). In the intervention group, urologists ordered 22.5% of tests and medical oncologists ordered 77.5%. Pathogenic/likely pathogenic alterations were identified in 10.0% of patients. Most participants (64%) indicated that the most important factor in their decision was whether results could guide treatment. Those who declined testing cited lack of clinical value. Most scored high on the prevideo genetic knowledge test (mean 9.1/11.0) with no statistical difference postvideo (<i>P</i> = .88). Most found the video satisfactory and useful (94%).</p><p><strong>Conclusion: </strong>Germline testing uptake was high after video education. Most patients had high baseline genetic knowledge but were more likely to pursue testing after intervention if it influenced their treatment. Virtual educational aids should be integrated into clinical practice to increase testing rates.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500266"},"PeriodicalIF":4.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Beyond Infusion: Real-World Insights Into Infusion-Related Reactions in Monoclonal Antibody Therapy.","authors":"Elise J Smolders, Elianne C S de Boer, Helle-Brit Fiebrich-Westra, Remco van der Galiën, Peter M J Plomp, Jan Willem B de Groot, Jan Gerard Maring","doi":"10.1200/OP-25-01037","DOIUrl":"https://doi.org/10.1200/OP-25-01037","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2501037"},"PeriodicalIF":4.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-Evaluating Established Prognostic Models in the Era of Immunotherapy in Renal Cell Carcinoma.","authors":"Claud M Grigg, James Symanowski","doi":"10.1200/OP-25-00697","DOIUrl":"https://doi.org/10.1200/OP-25-00697","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500697"},"PeriodicalIF":4.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgen Deprivation Therapy Practice Patterns in High-Risk Prostate Cancer Treated With Definitive Radiotherapy: Prospective Results From a Statewide Quality Consortium.","authors":"Michael P Dykstra, Samuel N Regan, Huiying Maggie Yin, Patrick William McLaughlin, Mark Zaki, Mazen Mislmani, Steven R Miller, Vrinda Narayana, Danielle Kendrick, Murshed Khadija, Daniel Dryden, Dale W Litzenberg, Melissa Mietzel, David K Heimburger, Matthew Schipper, William C Jackson, Robert T Dess","doi":"10.1200/OP-25-00489","DOIUrl":"https://doi.org/10.1200/OP-25-00489","url":null,"abstract":"<p><strong>Purpose: </strong>The 2022 AUA/ASTRO guidelines recommend 18-36 months of androgen deprivation therapy (ADT) with definitive radiotherapy for localized, high-risk prostate cancer. The STAMPEDE M0 trial supports intensification with androgen receptor pathway inhibitors (ARPIs) for patients with ≥2 cT3/T4, Grade Group [GG] 4-5, prostate-specific antigen (PSA) ≥40 ng/mL, or cN1. Given advances in imaging, risk stratification, and treatment delivery, we characterized contemporary practice patterns using prospective data from the Michigan Radiation Oncology Quality Consortium (MROQC).</p><p><strong>Methods: </strong>Patients enrolled in MROQC with intact, high-risk M0/N0-1 prostate cancer were included. Clinical information, including intended ADT duration and ARPI use, was prospectively collected. The primary outcome was intended guideline-concordant ADT (GC-ADT, ≥18 months). Multivariable analyses (MVA) assessed associations between clinical factors and GC-ADT recommendations. We compared the adoption of ARPI with standard therapies before and after the publication of STAMPEDE M0. Facility-level variability was evaluated using a mixed-effects model, with the treatment site as a random intercept.</p><p><strong>Results: </strong>Between June 2020 and November 2024, 553 patients across 26 centers were included: cT3/4 (13.3%), cN1 (19.9%), GG 4-5 (75.0%), and PSA ≥20 ng/mL (40.0%). Overall, 91.3% were recommended ADT, with 67.0% being guideline-concordant. On MVA, GC-ADT was significantly associated with cN1 (odds ratio [OR], 2.94 [95% CI, 1.44 to 5.99]), GG (GG4 OR, 6.23 [95% CI, 2.85 to 13.62]; GG5 OR, 9.45 [95% CI, 4.46 to 20.06]), and PSA ≥40 (OR, 3.64 [95% CI, 1.22-10.87]). Facility-level variability persisted in the MVA (<i>P</i> < .0001). Among the 27.9% who met meeting STAMPEDE criteria, ARPI recommendations increased from 0% prepublication to 23.2% afterward.</p><p><strong>Conclusion: </strong>Within a statewide quality consortium, guideline-concordant ADT recommendations occurred in two thirds of patients, with ARPI intensification in under 25% among STAMPEDE-eligible patients. These findings highlight the need for individualized ADT strategies and collaborative efforts to standardize high-quality care.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500489"},"PeriodicalIF":4.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Critical Difference Between Understanding and Consent: Lessons From Germline and Somatic Testing for Metastatic Prostate Cancer.","authors":"Shane Kronstedt, Kevin Rice, Izak Faiena, Brian F Chapin","doi":"10.1200/OP-25-00564","DOIUrl":"https://doi.org/10.1200/OP-25-00564","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500564"},"PeriodicalIF":4.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benchmarking the Current Landscape: Insights From an Association of American Cancer Institutes Survey on Academic Cancer Service Lines.","authors":"Paula M Fracasso, Nicole L Simone, Stephanie J Si Lim, Karen L Reckamp, Julie Ann Sosa, Christopher Lieu, Carrie Lee, Theresa L Werner, Quan P Ly, Julie M Vose, Julia White, Hailey Honeycutt, Kate Shaw, Kendra Cameron, Donna M O'Brien, Lee G Wilke","doi":"10.1200/OP-25-00073","DOIUrl":"https://doi.org/10.1200/OP-25-00073","url":null,"abstract":"<p><strong>Purpose: </strong>A cancer service line (CSL) in academic medical centers provides a patient-centered approach aimed at enhancing the patient experience and clinical outcomes, managing financial operations, increasing access to clinical research, and reducing health disparities. In 2023, the Association of American Cancer Institutes (AACI) Physician Clinical Leadership Initiative (PCLI) Steering Committee conducted a survey to evaluate the current state of CSLs with respect to governance, leadership, organizational, and financial structure and function.</p><p><strong>Methods: </strong>The survey was electronically sent to cancer center directors and administrative directors at 107 of AACI's 108-member cancer centers, achieving a response rate of 70%. Survey participation was voluntary, and no compensation was provided.</p><p><strong>Results: </strong>Fifty-eight (77%) of the 75 survey respondents (which included 40 National Cancer Institute-designated cancer centers) had a defined CSL with only 35 (60%) using a formal charter. All CSL leadership teams included physician leaders, and 44 (76%) centers included their cancer center director within this leadership. More than 28 key services were identified as parts of the CSL structures. Most respondents reported that strategic planning (88%), quality and safety (83%), and regional alignment (78%) were key responsibilities. Twenty-six (45%) centers reported a policy defining a funds flow from the health system to the cancer center. Performance assessment for the CSLs included metrics related to growth and finance, access and services, quality and outcomes, and academics.</p><p><strong>Conclusion: </strong>These results demonstrate the diverse nature of CSLs across academic medical systems within the United States. Furthermore, given the complexity faced by academic cancer centers in establishing and expanding their CSLs, AACI remains committed to working closely with its members to identify best practices focused on innovative and value-based cancer care.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500073"},"PeriodicalIF":4.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Utilization and Follow-Up Care in Young Adult Breast Cancer Survivors.","authors":"Shakirah N Ssebyala, Yue Zheng, Elizabeth Riley, Kathryn J Ruddy, Rulla M Tamimi, Jeffrey M Peppercorn, Lidia Schapira, Steven E Come, Virginia F Borges, Ann H Partridge, Shoshana M Rosenberg","doi":"10.1200/OP-25-00288","DOIUrl":"https://doi.org/10.1200/OP-25-00288","url":null,"abstract":"<p><strong>Purpose: </strong>Given the extended survivorship of young adults with breast cancer, characterizing health care utilization and adherence to surveillance guidelines can inform gaps in care.</p><p><strong>Patients and methods: </strong>Patients age 40 years and younger at diagnosis of stage 0-III breast cancer enrolled in a prospective cohort study completed a survey 7 years after diagnosis assessing receipt of care and surveillance. We evaluated factors associated with transition to a primary care provider (PCP) for cancer-related follow-up and adherence to mammography and bone density scans.</p><p><strong>Results: </strong>Among 660 women, 92% reported having a PCP, although for cancer-related follow-up, 57% saw only an oncology provider, 29% saw both a PCP and oncology provider. In the past 2 years, 68% reported getting a flu shot, 76% a pap test/pelvic examination, 56% cholesterol screening, and 42% (n = 232 endocrine therapy [ET] users) a bone density scan. Among women who had a unilateral mastectomy or lumpectomy (n = 356), 82% reported a mammogram in the past year. In multivariate analyses, those with stage 0 (<i>v</i> I disease) were more likely to see a PCP for follow-up (<i>v</i> PCP + oncology provider); ET users and those more concerned about recurrence were less likely. Patients with human epidermal growth factor receptor 2-positive (HER2) disease were more likely to adhere to mammography; those with a <i>BRCA</i> mutation and those with a unilateral mastectomy were less likely. Patients with a <i>BRCA</i> mutation and who had chemotherapy were more likely to report a bone density scan.</p><p><strong>Conclusion: </strong>Although most have a PCP, over half of young survivors continue to see an oncology provider for follow-up in long-term survivorship. Mammography uptake was high; uptake of other health maintenance practices was lower. Identification of barriers/facilitators to receipt of guideline-concordant care may inform strategies to optimize survivorship.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500288"},"PeriodicalIF":4.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}