JCO oncology practice最新文献

{"title":"Evolution of Electronic Health Records in Support of Cancer Care: Challenges and Opportunities.","authors":"Lawrence N Shulman","doi":"10.1200/OP-26-00320","DOIUrl":"https://doi.org/10.1200/OP-26-00320","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600320"},"PeriodicalIF":4.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856242","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":"Video Education With Clinical Genetic Testing Coordinators for the <i>Rapid</i> Evaluation of Patients With Cancers: Real-World Evidence.","authors":"Jill E Stopfer, Miki Horiguchi, Anu Chittenden, Carmen G Tso, Sophie R Cahill, Ryan M Buehler, Audrey K D'Atri, Judy E Garber, Huma Q Rana","doi":"10.1200/OP-25-01367","DOIUrl":"https://doi.org/10.1200/OP-25-01367","url":null,"abstract":"<p><strong>Purpose: </strong>Germline genetic testing is critical for guiding cancer treatment, identifying hereditary syndromes, and enabling cascade testing for at-risk relatives. However, barriers such as limited access to genetic counselors and long wait times may hinder its implementation. This study evaluates the Rapid Access Cancer Genetic Testing Program (<i>Rapid</i>), a streamlined workflow incorporating a pretest video education (VE) process navigation by genetic testing coordinators (GTCs), and targeted involvement of genetic counselors and physicians for patients with pathogenic or likely pathogenic (P/LP) results.</p><p><strong>Methods: </strong>A retrospective review of 2,767 oncology patients who participated in <i>Rapid</i> between May 2021 and May 2023 was conducted. Eligible patients had breast, prostate, pancreatic, ovarian, or colorectal cancer and met National Comprehensive Cancer Network testing guidelines. <i>Rapid</i> visits included VE, pedigree collection, consenting, and genetic testing coordination by GTCs. Patients with P/LP results were seen for follow-up by genetic counselors and cancer genetics physicians.</p><p><strong>Results: </strong>Of the 2,767 patients, 89.1% consented to genetic testing, and 87.9% completed testing. Among those tested, 13.2% had P/LP variants, with those in <i>BRCA2, BRCA1,</i> and <i>CHEK2</i> being the most frequently identified. Disparities in testing completion were observed, with older age (≥50 years), Black or African American race, and pancreatic cancer diagnosis associated with lower odds of testing. Pancreatic and prostate cancer diagnoses, as well as recessive genetic findings, were associated with lower follow-up rates.</p><p><strong>Conclusion: </strong><i>Rapid</i> demonstrated high genetic testing uptake and effective integration into oncology workflows, enabling timely treatment decisions. Although the program optimized resource use and reduced barriers, disparities in testing remain. Future efforts should address these inequities and evaluate the long-term impact of genetic testing on patient outcomes.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2501367"},"PeriodicalIF":4.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837985","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":"Survival, Toxicity, and Economic Outcomes of Osimertinib Versus Second-Generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors in Metastatic Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer.","authors":"Po-Huang Chen, Hong-Jie Jhou, Wei-Cheng Chang, Hsin-Yu Chen, Li-Ting Kao, Tina Yi-Jin Hsieh, Ren-Hua Ye, Shiue-Wei Lai, Jia-Hong Chen, Ching-Liang Ho, Cho-Hao Lee","doi":"10.1200/OP-25-01390","DOIUrl":"https://doi.org/10.1200/OP-25-01390","url":null,"abstract":"<p><strong>Purpose: </strong>Direct real-world comparisons between osimertinib and second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are lacking, particularly regarding the comparative effectiveness, safety, and economic implications of different treatment sequencing strategies.</p><p><strong>Methods: </strong>We emulated a target trial using the TriNetX database to study adults with newly diagnosed metastatic EGFR-mutant non-small cell lung cancer (NSCLC). After 1:1 propensity score matching, 777 patients in the first-line osimertinib arm were compared with 777 patients in the second-generation TKI arm. The primary outcome was overall survival (OS), with secondary outcomes including health care utilization and toxicity.</p><p><strong>Results: </strong>First-line osimertinib demonstrated significantly longer median OS compared with second-generation TKIs (53.4 <i>v</i> 33.2 months; hazard ratio [HR], 0.618). Although sequential therapy (second-generation TKI followed by osimertinib) achieved similar OS, it was associated with significantly higher toxicity. Patients with brain metastases derived greater benefit from osimertinib (HR, 0.563). Osimertinib also significantly reduced rates of hospitalization, intensive care unit admission, and severe infections, generating substantial health care savings ($5.73 million per 1,000 patients) despite higher drug costs.</p><p><strong>Conclusion: </strong>First-line osimertinib provides prolonged OS and meaningful economic benefits over second-generation TKIs. Given the higher toxicity burden of sequential therapy despite similar survival outcomes, our findings support the implementation of first-line osimertinib to optimize patient experience and reduce health care utilization in metastatic EGFR-mutant NSCLC.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2501390"},"PeriodicalIF":4.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838009","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":"340B Drug Pricing Program: An Updated ASCO Policy Statement.","authors":"Blase Polite, Niharika Dixit, John Hennessy, Marissa Rivera, Ashley Sumrall, Wade Swenson, Kashyap Patel, Natalie Dickson, Jonathan Phillips, Azam Masood, Allyn Moushey","doi":"10.1200/OP-26-00105","DOIUrl":"https://doi.org/10.1200/OP-26-00105","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600105"},"PeriodicalIF":4.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837921","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":"Real-World Analysis of Adverse Events in Patients With Triple-Negative Breast Cancer Receiving Therapy per KEYNOTE-522.","authors":"Mara Lacy Hofherr, Andrew A Davis, Spenser January, Farah Raheem, Lauren Lyons, Jerline Hsin, Shawna Kraft, Allison J Schepers, Jodi Taraba, Jon Blazawski, Colleen Bohnenkamp, Shelly Hummert, Lisa Grate, Sidney V Keisner, Jacob Hobbs, Todd Davis, Traci White, Avneek Singh Sandhu, Fouad Boulbol, Kelsey Finch, Olivia Fahey, Yonatan Resnick, Kayla Harwood, Emily Armgardt, Douglas Mazewski, Alison Svoboda, Aimee Keegan, Wai Yu, Meredith Watson-Rose, Katherine Madden, Suganya Arunachalam Karikalan, Charlie Upton, Lida Mina, Emily J Owen, Katherine Clifton","doi":"10.1200/OP-24-00819","DOIUrl":"https://doi.org/10.1200/OP-24-00819","url":null,"abstract":"<p><strong>Purpose: </strong>Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer. Early-stage, high-risk patients with TNBC are treated with chemotherapy and pembrolizumab per the KEYNOTE-522 regimen. This report examines real-world clinical effectiveness and toxicity of this regimen.</p><p><strong>Methods: </strong>This 19-site retrospective analysis included all patients who received at least one dose of the KEYNOTE-522 regimen. Safety, efficacy, and health care encounters were collected.</p><p><strong>Results: </strong>675 patients from 19 sites in the United States who received chemotherapy and pembrolizumab for early-stage TNBC were included. 547 (81.0%) patients underwent surgery and 250 (54.7%) patients had a pathologic complete response (pCR). No baseline characteristics were predictive of pCR status. 224 patients (33.2%) had an adverse drug event resulting in ≥1 dose reduction of chemotherapy and were significantly more likely to have residual disease. Immune-related adverse events (irAEs) were observed in 388 (57.5%) patients and grade 3+ irAEs were observed in 176 (26.1%) patients. There was no difference in pCR status between provider's choice chemotherapy schedules. There was no difference of pCR rate between Black and White patients (55.6% <i>v</i> 51.6%, <i>P</i> = .489). White patients were significantly more likely to have any grade and grade 3+ irAEs. Older patients (age ≥65 years) had similar pCR rates compared with younger patients; however, older patients were significantly more likely to have grade 3+ irAEs.</p><p><strong>Conclusions: </strong>In this multi-institutional real-world cohort, we observed a lower pCR rate, higher rates of toxicity, frequent emergency health care utilization, and the reporting of rare irAEs at higher frequency than the KEYNOTE-522 regimen. These findings have important implications for clinical management of patients with early-stage TNBC and warrant further validation with real-world data sets.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400819"},"PeriodicalIF":4.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837876","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":"Characterizing Relationships Between Daily Pain, Opioid Use, and Mood in Patients With Advanced Cancer Using Ecological Momentary Assessments.","authors":"Jian Zhao, Meng Chen, Kristin L Schreiber, Jenna M Wilson, Arvina Grahl, Sara DeForge, Hailey Bulls, Robert R Edwards, Matthew Allsop, Michael Businelle, Andrea C Enzinger, Desiree R Azizoddin","doi":"10.1200/OP-25-01124","DOIUrl":"https://doi.org/10.1200/OP-25-01124","url":null,"abstract":"<p><strong>Purpose: </strong>In advanced cancer, pain symptoms, opioid use, and cognitive-emotional processes fluctuate day to day and may mutually reinforce one another. We used 28-day ecological momentary assessments (EMAs) to quantify within-person associations between daily pain and (a) interference, (b) opioid use and perceived efficacy, and (c) mood, and to test whether variability in pain catastrophizing moderates these associations.</p><p><strong>Methods: </strong>Patients with advanced cancer receiving outpatient oncology care at a comprehensive cancer center completed once-daily EMAs for 28 days (N = 26 analyzed). Measures included worst/average/least pain, pain interference, short-acting opioid tablets (count) and perceived opioid efficacy, negative and positive affect, and daily catastrophizing. Multilevel models estimated same-day within-person associations, controlling for study day and between-person mean pain. Individuals' standard deviation of daily catastrophizing changes (catastrophizing variability) was tested as a moderator.</p><p><strong>Results: </strong>Across 477 daily assessments (median 21/28 per participant), higher-than-usual worst pain was consistently associated with worse pain interference, higher short-acting opioid use, lower perceived opioid efficacy, and higher negative affect (all <i>P</i> < .01); Average and least pain showed smaller or nonsignificant effects. Greater day-to-day variability in catastrophizing was associated with worse pain. Among individuals whose pain catastrophizing fluctuated more, there was a stronger relationship between pain severity and interference, affect, and perceived opioid efficacy (inverse; <i>P</i> ≤ .01).</p><p><strong>Conclusion: </strong>Greater day-to-day fluctuations in pain catastrophizing were associated with magnified correspondence of pain severity with interference, mood disruption, and perceived opioid inefficacy. Routine monitoring of pain severity combined with tracking catastrophizing variability may help identify high-risk days and inform in-the-moment support to better personalize pain management.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2501124"},"PeriodicalIF":4.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837907","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":"Efficacy of Renin-Angiotensin System Inhibitors in Long-Term Oncologic Outcomes of Patients With Stage II/III Colon Cancer and Hypertension: A Target Trial Emulation.","authors":"Kaiwen Chen, Donghao Xu, Zhiyuan Zhang, Fei Liang, Guodong He, Jianmin Xu, Qingyang Feng","doi":"10.1200/OP-25-01296","DOIUrl":"https://doi.org/10.1200/OP-25-01296","url":null,"abstract":"<p><strong>Purpose: </strong>Renin-angiotensin system inhibitors (RASIs) have been reported to exert anticancer effects. However, there is still a lack of persuasive evidence for their role in improving postoperative long-term oncologic outcomes of colorectal cancer. This retrospective cohort study emulated a hypothetical randomized controlled trial to evaluate the efficacy of RASIs in improving postoperative long-term oncologic outcomes of patients with stage II/III colon cancer and hypertension.</p><p><strong>Methods: </strong>Patients were consecutively enrolled from multicenter databases, which contained data from medical centers in Shanghai, China. Eligible criteria were adults with radical resected stage II or III colon adenocarcinoma and hypertension. Eligible patients were classified into the RASI group or the no-RASI group, and propensity score was matched at a 1:1 ratio. The primary outcome was the 3-year disease-free survival (DFS) rate.</p><p><strong>Results: </strong>From 2,640 eligible patients, 2,292 were included in the primary analysis after matching: 1,146 in the RASI group and 1,146 in the no-RASI group. The median follow-up time was 46.3 months. The RASI group had a higher 3-year DFS rate (83.4% <i>v</i> 78.3%; <i>P</i> = .001; hazard ratio [HR], 0.736 [95% CI, 0.617 to 0.878]). The RASI group also had a lower 3-year distant metastasis rate (15.6% <i>v</i> 20.5%; <i>P</i> < .001; HR, 0.717 [95% CI, 0.596 to 0.863]) and a higher 3-year overall survival rate (92.4% <i>v</i> 89.6%; <i>P</i> = .001; HR, 0.682 [95% CI, 0.539 to 0.864]).</p><p><strong>Conclusion: </strong>RASIs may improve the postoperative long-term oncologic outcomes for patients with stage II/III colon cancer and hypertension.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2501296"},"PeriodicalIF":4.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837912","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":"Immunomodulatory Agent Adherence Trajectories and Survival Among Older Patients With Multiple Myeloma.","authors":"Rong Wang, Mengmeng Ji, Natalia Neparidze, Xiaomei Ma, Su-Hsin Chang, Shi-Yi Wang","doi":"10.1200/OP-25-00615","DOIUrl":"https://doi.org/10.1200/OP-25-00615","url":null,"abstract":"<p><strong>Purpose: </strong>Immunomodulatory agents (IMiDs) are critical in treating multiple myeloma (MM). We aimed to identify patterns of adherence to IMiD treatment, patient characteristics associated with adherence, and the corresponding survival among Medicare beneficiaries with newly diagnosed MM.</p><p><strong>Methods: </strong>Using group-based trajectory modeling, we identified distinct adherence groups among patients with MM in the SEER-Medicare database. Multinomial logistic regression models were used to identify factors associated with each adherence group. Cox proportional hazards regression models were sued to evaluate the impact of different adherence groups on survival.</p><p><strong>Results: </strong>We identified four distinct adherence groups among 4,452 patients with newly diagnosed MM between 2007 and 2019: (1) persistently-high (33.1%), (2) quick-decline-then-increase (17.5%), (3) moderate-decline (21.2%), and (4) quick-decline (28.2%). Factors related to poor-adherence groups included early treatment initiation years, patients with multiple comorbid conditions, hypercalcemia, renal failure, anemia, and bone disease and receiving a low-income subsidy. Patients age ≥85 years had higher odds of being in groups 3 and 4 than those age 66-69 years. Additionally, non-Hispanic Black patients were more likely to be in the quick-decline group than non-Hispanic White patients. Mortality was significantly associated with adherence. Patients in poor-adherence groups had a >20% increased mortality risk, compared with the persistently-high group.</p><p><strong>Conclusion: </strong>Old age, low-income subsidy recipients, and those with high comorbidity burden are less likely to be adherent to the IMiD treatment, and their survival outcomes are inferior compared with those in the high adherence group. Targeted intervention to assist adherence to their IMiD treatment may improve the survival for these populations with newly diagnosed MM.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500615"},"PeriodicalIF":4.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837893","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":"Repurposing Renin-Angiotensin System Inhibitors in Colon Cancer: Signal, Plausibility, and the Need for Prospective Validation.","authors":"Muhammet Ozer, Timothy J Brown","doi":"10.1200/OP-26-00192","DOIUrl":"https://doi.org/10.1200/OP-26-00192","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600192"},"PeriodicalIF":4.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838014","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":"Guidelines Can Be Lifesaving: The Vermont Model of Thromboprophylaxis Implementation.","authors":"Dana Angelini, Alok A Khorana","doi":"10.1200/OP-26-00262","DOIUrl":"https://doi.org/10.1200/OP-26-00262","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600262"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815263","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}