JCO oncology practice最新文献

{"title":"Why We Should, and How We Can, Reduce the Climate Toxicity of Cancer Care.","authors":"Emer Lynch, Philip Bredin, Catherine S Weadick, Niamh Dorney, Roelof W F Van Leeuwen, Seamus O'Reilly","doi":"10.1200/OP-24-00680","DOIUrl":"https://doi.org/10.1200/OP-24-00680","url":null,"abstract":"<p><p>Climate change is like cancer, delayed action leads to more suffering for patients.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562778","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":"Willingness of Women at Increased Risk of Breast Cancer to Participate in Prevention Trials.","authors":"Cecilia N Mastrogiacomo, Alexa Courtepatte, Anne Moyer, Christina Preece, Patricia Thompson, Alison Stopeck","doi":"10.1200/OP-24-00487","DOIUrl":"10.1200/OP-24-00487","url":null,"abstract":"<p><strong>Purpose: </strong>The factors affecting women's willingness to participate (WTP) in breast cancer (BC) prevention trials are poorly understood. This study aimed to identify the characteristics of interventions associated with a higher WTP among high BC risk women.</p><p><strong>Methods: </strong>Women who self-identified as being at an increased risk of BC were recruited to a cross-sectional study of WTP in BC prevention trials. Responses were dichotomized into more willing (a lot and moderately) and less willing (some, a little, and not at all), and responses were compared by patient characteristics and intervention type.</p><p><strong>Results: </strong>Of 143 participants, 81.2% (116) completed ≥30% of a Likert-type scale questionnaire on WTP in various intervention types for BC prevention. Overall, WTP in BC prevention studies was high, with 82.7% more willing, including 69.0% and 70.7%, respectively, for unspecified physical activity and dietary interventions. WTP differed significantly by the duration of diet-based and physical activity behavior change interventions: decreasing with 12- versus 3-month diet-based interventions (<i>P</i> < .0001) and decreasing for 1 hour versus 30 minutes of low-intensity exercise/day (<i>P</i> < .0001). For interventions involving medication, only 18.1% expressed being more willing to participate, and WTP decreased significantly when side effects were presented. WTP was influenced by BC risk gene mutation status, with WTP among gene carriers higher compared with nongene carriers (52.6% <i>v</i> 30.2%, <i>P</i> = .018).</p><p><strong>Conclusion: </strong>WTP in BC prevention trials was the highest for women with known genetic risk and for interventions involving a behavior change. Medications with side effects had the lowest WTP. For behavior change, WTP was negatively influenced by intervention duration beyond a few months, indicating that individual perception of BC risk and inconvenience strongly influence WTP.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557843","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":"Telephone Survey-Reported Perceptions of Telehealth Visits Among Black and Non-Black Patients Diagnosed With Cancer.","authors":"Ilona Fridman, Christine Neslund-Dudas, Lauren C J Barrow, Matthew R Dunn, Regina Jones, Alan C Kinlaw, Angela B Smith, Jacob N Stein, Samantha Tam, William A Wood, Jennifer Elston Lafata","doi":"10.1200/OP.24.00307","DOIUrl":"https://doi.org/10.1200/OP.24.00307","url":null,"abstract":"<p><strong>Purpose: </strong>Empirical evidence underscores both benefits of telehealth visits and persistent disparities in use for Black adults. Guided by the Technology Acceptance Model, we evaluated perceptions regarding telehealth visits among Black and Non-Black adults receiving cancer care from two academic health systems.</p><p><strong>Methods: </strong>Between April 2022 and October 2023, a survey was conducted among adult patients treated for cancer in the past 3 years. Survey recruitment was stratified by visit type (telehealth or in-person) and race. Before a scheduled oncology visit, respondents completed a telephone survey to assess their perceptions of usefulness, ease of use, and attitudes toward telehealth visits. Frequency differences were estimated using chi-square tests, and prevalence differences using logistic regression.</p><p><strong>Results: </strong>The survey was completed by 773 respondents (42% Black) with a 15% response rate. Black respondents were younger and less likely to report male sex, being married, having a college education, comfortable income, or confidence in medical and e-literacy. Compared with Non-Black respondents, Black respondents perceived telehealth visits as less useful for determining health needs (37% <i>v</i> 48%) and asking questions (9% <i>v</i> 15%). They thought that telehealth visits were less easy with regard to understanding their health care provider (14% <i>v</i> 21%) and the ability to connect (23% <i>v</i> 30%). Black respondents expressed more concern about internet access (26% <i>v</i> 15%), access to electronic devices (17% <i>v</i> 9%), and finding assistance for connecting (24% <i>v</i> 12%). They also found telehealth visits to be less private (19% <i>v</i> 34%).</p><p><strong>Conclusion: </strong>Racial differences in telehealth ease of use and usefulness perceptions highlight the need for oncology practices to couple connectivity support with effective communication strategies to avoid disparities in oncology telehealth services.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545487","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":"Effect of Prednisone Dosing on Mineralocorticoid-Related Side Effects With Abiraterone in Prostate Cancer.","authors":"Maksym Goryachok, Andrew Nicklawsky, Hiba Ahmad, Christopher Geiger, Simon Kim, Thomas W Flaig","doi":"10.1200/OP-24-00472","DOIUrl":"https://doi.org/10.1200/OP-24-00472","url":null,"abstract":"<p><strong>Purpose: </strong>Abiraterone use for prostate cancer can cause mineralocorticoid excess syndrome (MES; eg, hypertension and hypokalemia). Prednisone mitigates these effects; however, the optimal dose level is unclear. This study examines MES effects from abiraterone with 5 mg of prednisone once daily versus 5 mg twice daily.</p><p><strong>Methods: </strong>Data for 1,410 abiraterone-treated patients from 2011 to 2022 were identified from a large academic/community hospital system. Three hundred and fifty-three patients were excluded for missing medication data and use of an alternative steroid; 1,057 patients remained (5 mg once daily, n = 550, 5 mg twice daily, n = 507). Prednisone dose was treated as a time-varying covariate. Hypokalemia and hypertension incidence over 24 weeks after abiraterone initiation was analyzed via Cox proportional hazard models using Common Terminology Criteria for Adverse Events (v5.0) grading via direct clinical measurements and International Classification of Diseases (ICD)-10 code outcomes.</p><p><strong>Results: </strong>Patients receiving 5 mg of prednisone twice daily had a statistically significant decrease in cumulative hazard for experiencing at least one MES event (hypertension and/or hypokalemia) via direct clinical measurement (hazard ratio [HR], 0.79 [CI, 0.68 to 0.91]; <i>P</i> = .002) and by ICD-10 code (HR, 0.65 [CI, 0.54 to 0.79]; <i>P</i> < .001) analysis. This finding was durable with individual end point analysis of hypertension and hypokalemia. There were no changes to BMI or hyperglycemia (>140 mg/dL) between the cohorts.</p><p><strong>Conclusion: </strong>This retrospective analysis shows a decrease in risk for the development of at least one episode of hypertension or hypokalemia with abiraterone using 5 mg twice-daily prednisone in the study population. Assessments of metabolic impacts (BMI, hyperglycemia) did not show differences with prednisone dosing. These findings may merit consideration when determining an optimal prednisone dosing regimen.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465660","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":"Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is NOT a Last Resort: Rationale for Early Surgical Referral.","authors":"Leah E Hendrick, Seth Felder, Iman Imanirad, Sean P Dineen","doi":"10.1200/OP-24-00504","DOIUrl":"https://doi.org/10.1200/OP-24-00504","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465659","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":"Impact of the Affordable Care Act and Medicaid Expansion Among Patients With HIV-Associated Aggressive B-Cell Non-Hodgkin Lymphomas.","authors":"Naveen Premnath, Yulun Liu, Heather Reves, Urvashi Pandey, Rasmi G Nair, Julia Anderson, Aimaz Afrough, Larry D Anderson, Stephen S Chung, Gurbakhash Kaur, Adeel M Khan, Kiran A Kumar, Yazan F Madanat, Heather R Wolfe, Elif Yilmaz, Farrukh T Awan, John Sweetenham, Praveen Ramakrishnan Geethakumari","doi":"10.1200/OP.24.00354","DOIUrl":"https://doi.org/10.1200/OP.24.00354","url":null,"abstract":"<p><strong>Purpose: </strong>To study the influence of the Affordable Care Act (ACA) policy and its Medicaid expansion on insurance status and survival in patients with HIV with aggressive lymphoma.</p><p><strong>Methods: </strong>We used the National Cancer Database, a hospital-based national registry, to identify adults age 18-64 years with HIV-associated aggressive B-cell non-Hodgkin lymphomas (HIV-a-B-NHLs), diagnosed during 2007 to 2016. Survival analysis was performed on a subset of patients with HIV-a-B-NHL for whom location data were available who resided in Medicaid expansion-adopted and nonadopted states. Using a quasi-experimental difference-in-difference model, the difference in adjusted 2-year survival rates obtained with a flexible parametric Weibull model was compared for states that adopted the Medicaid expansion of ACA against those that did not adopt the expansion.</p><p><strong>Results: </strong>We identified 8,231 patients with HIV-a-B-NHL and 50,650 non-HIV patients with a-B-NHL. We found that a lower proportion of individuals were uninsured at diagnosis in the expansion states compared with nonexpansion states. We also found that the ACA policy adoption led to a reduction in the proportion of uninsured individuals with HIV-a-B-NHL in expansion states of 34.9%, compared with 15.9% in non-expansion-adopted states. There was a statistically significant improvement in the 2-year survival rate among patients with HIV-a-B-NHL in the expansion compared with nonexpansion states with the adoption of ACA (7.17% <i>v</i> 1.58%, <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Using a novel quasi-experimental model, we found that the ACA policy corresponded with a greater survival improvement in patients with HIV-a-B-NHL within Medicaid expansion-adopted states compared with nonexpansion states. We believe that this evidence should be taken into consideration in future policy making.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465661","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":"Reply to Importance of Identifying Physical Manifestations That Are Associated With Hereditary Cancer Predisposition: <i>AXIN2</i> Mutation in an African-American Patient.","authors":"William Fostier, Ari Horton, Ingrid Winship, Neil Rajan","doi":"10.1200/OP-24-00713","DOIUrl":"https://doi.org/10.1200/OP-24-00713","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465665","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":"Importance of Identifying Physical Manifestations That Are Associated With Hereditary Cancer Predisposition: AXIN2 Mutation in an African American Patient.","authors":"Al-Hafis Adegun, Reid Schalet, Ivan Berezowski, Marie L Borum","doi":"10.1200/OP-24-00609","DOIUrl":"https://doi.org/10.1200/OP-24-00609","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465662","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":"Reimagining Deintensification for Low-Risk Breast Cancer.","authors":"Chirag Shah, Megan Kruse, Zahraa Al-Hilli","doi":"10.1200/OP-24-00538","DOIUrl":"https://doi.org/10.1200/OP-24-00538","url":null,"abstract":"<p><p>As outcomes for low-risk breast cancer continue to improve, research and clinical paradigms are increasingly focused on appropriate deintensification with the goal of improving the therapeutic ratio of breast cancer treatment. These deintensification approaches span across disciplines including breast surgery, radiation therapy, and systemic therapy. With regard to breast surgery, studies have continued to push deintensification when it comes to surgical margins with breast conservation, reducing re-excision rates, whereas deintensification of axillary surgery has reduced the rates of axillary lymph node dissection and increasingly the need for any axillary surgery, including sentinel lymph node biopsy for low-risk patients. With regard to radiation therapy, studies have allowed for a drastic reduction in treatment duration, whereas approaches that reduce the target of treatment have led to a change from from treatment daily for 5-7 weeks to many low-risk patients completing treatment in just five treatments. With regard to systemic therapy, use of genomic assays and tumor biology has led to reduced utilization of cytotoxic chemotherapy, with studies also allowing for dose reduction of endocrine therapy for patients with ductal carcinoma in situ. Moving forward, greater focus should be placed on interdisciplinary deintensification approaches such as the consideration of radiation therapy alone as compared with endocrine therapy alone for low-risk breast cancers.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465664","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":"Racial/Ethnic Disparities in Hospitalization Outcomes by Palliative Care Utilization and Trends Among Women With Metastatic Breast Cancer in the United States.","authors":"Inimfon Jackson, Qian Lu, Debasish Tripathy","doi":"10.1200/OP.24.00434","DOIUrl":"https://doi.org/10.1200/OP.24.00434","url":null,"abstract":"<p><strong>Purpose: </strong>We examined the trends in palliative care utilization, racial/ethnic disparities in hospitalization outcomes among adult women with a diagnosis of metastatic breast cancer (MBC), and effect modification by palliative care utilization.</p><p><strong>Methods: </strong>Retrospective cohort analyses were conducted using the Agency for Healthcare Research and Quality sponsored Healthcare Cost and Utilization Project-National Inpatient Sample database from 2016 to 2020. Regression analyses were used to evaluate palliative care trends, and the association between race/ethnicity and in-hospital mortality, length of stay, total hospital charges, and discharge disposition. Stratified analyses were conducted by palliative care use.</p><p><strong>Results: </strong>Palliative care consultations in the study population increased from 16.4% in 2016 to 20.3% in 2020. Black (adjusted odds ratio [AOR], 1.25 [95% CI, 1.16 to 1.34]) and Hispanic (AOR, 1.12 [95% CI, 1.01 to 1.23]) female patients with MBC had higher in-hospital mortality compared with the White patients. Among those who received palliative care, Blacks had similar odds (AOR, 1.08 [95% CI, 0.97 to 1.20]) of in-hospital mortality when compared with Whites. Black women were more likely to have longer hospital stays relative to White women. Although Black women had similar odds (AOR, 0.98 [95% CI, 0.92 to 1.04]) of discharge to a short-term/skilled nursing facility versus routine discharge compared with White women, Blacks who received palliative care had 19% (95% CI, 0.70 to 0.95) lower odds of discharge to a facility.</p><p><strong>Conclusion: </strong>Our findings emphasize the importance of palliative care use among patients with MBC and highlight the need to raise awareness of its benefits, especially in minority populations. Further studies are needed to explore ways to narrow the gap in existing disparities and to test these interventions on care metrics and patient outcomes.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465663","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}