{"title":"Evolving Field of Immunotherapy: Pioneering New Paths in Small-Cell Lung Cancer.","authors":"Antonious Ziad Hazim, Konstantinos Leventakos, Vinicius Ernani","doi":"10.1200/OP-24-00862","DOIUrl":"https://doi.org/10.1200/OP-24-00862","url":null,"abstract":"<p><p>Small-cell lung cancer (SCLC) is an aggressive form of lung cancer that displays rapid proliferation and early metastatic potential. It accounts for approximately 15% of lung cancers and is strongly associated with tobacco carcinogens. Despite patients' initial response to systemic therapy, the majority develop early resistance and relapse. The outcomes of patients with metastatic SCLC are poor, prompting the need for new therapies. Over the past decade, the treatment landscape for NSCLC (non-small cell lung cancer) has significantly changed with the immergence of novel targeted therapies and immunotherapies. However, inroads of these therapies into SCLC have posed significant challenges due to its molecular and genomic heterogeneity. Despite the challenges of this disease, promising new first-in-class immunomodulatory agents have emerged and are currently undergoing extensive research. Herein, we review the current treatment paradigm of immunotherapy in SCLC and discuss future directions of this evolving field.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400862"},"PeriodicalIF":4.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122719","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-08-05DOI: 10.1200/OP.24.00260
Aditi P Singh, Erin P Balogh, Robert W Carlson, Mary Margaret Huizinga, Bradley A Malin, Alexander Melamed, Neal J Meropol, Etta D Pisano, Robert A Winn, K Robin Yabroff, Lawrence N Shulman
{"title":"Re-Envisioning Electronic Health Records to Optimize Patient-Centered Cancer Care, Quality, Surveillance, and Research.","authors":"Aditi P Singh, Erin P Balogh, Robert W Carlson, Mary Margaret Huizinga, Bradley A Malin, Alexander Melamed, Neal J Meropol, Etta D Pisano, Robert A Winn, K Robin Yabroff, Lawrence N Shulman","doi":"10.1200/OP.24.00260","DOIUrl":"10.1200/OP.24.00260","url":null,"abstract":"<p><p>Electronic health records (EHRs) are a significant advancement over paper records. However, the full potential of EHRs for improving care quality, patient outcomes, surveillance, and research in cancer care is yet to be realized. The organic evolution of EHRs has resulted in a number of unanticipated consequences including increased time spent by clinicians interfacing with the EHR for daily workflows. Patient access to clinicians and their records has been an important advancement in patient-centered care; however, this has brought to light additional gaps and challenges in EHRs meeting these needs. A significant challenge for EHR design and physician workflows is how best to meet the complex goals and priorities of various stakeholders including providers, researchers, patients, health systems, payors, and regulatory agencies. The National Cancer Policy Forum convened a 2022 workshop, \"Innovations in Electronic Health Records for Oncology Care, Research and Surveillance,\" to address these challenges and to facilitate collaboration across all user groups with the goal of re-envisioning EHRs that will better support shared goals of improving patient outcomes and advancing cancer care and research without overburdening clinicians with administrative tasks. Here, we summarize the current EHR ecosystem as discussed at the workshop and highlight opportunities to improve EHR contributions to oncology evidence and care.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"128-135"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893415","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-08-21DOI: 10.1200/OP.23.00830
Nerea Lopetegui-Lia, Revati Varma, Jame Abraham, Erin Roesch
{"title":"Current and Novel Treatment Options in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer.","authors":"Nerea Lopetegui-Lia, Revati Varma, Jame Abraham, Erin Roesch","doi":"10.1200/OP.23.00830","DOIUrl":"10.1200/OP.23.00830","url":null,"abstract":"<p><p>Metastatic breast cancer (mBC) remains an incurable disease, and most patients will experience disease progression during their treatment course. Although endocrine therapy remains the mainstay of treatment for hormone receptor-positive/human epidermal growth factor receptor 2-negative mBC, significant progress has been and continues to be made in the treatment of this BC subtype. The discovery of molecular markers, mutations in key cellular pathways, and genomic signatures have led to the development of novel and targeted agents, such as antibody-drug conjugates, oral selective estrogen receptor downregulators, and inhibitors of the PI3K/AKT/mTOR pathway. This has resulted in significant improvements in the survival and quality of life of patients. With the increasing number of treatment options for patients, appropriate drug sequencing remains a challenge. Treatment discussions should involve patient-physician shared decision making, with consideration of genomic data, previous lines of therapy, side effect profiles, and clinical trial enrollment.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"145-154"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017415","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-10-10DOI: 10.1200/OP-24-00683
Irene Kuter
{"title":"Medical Record-Keeping Then and Now.","authors":"Irene Kuter","doi":"10.1200/OP-24-00683","DOIUrl":"10.1200/OP-24-00683","url":null,"abstract":"<p><p>The electronic health record has affected how physicians document patient care, and presents challenges.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"111-113"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400278","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-07-25DOI: 10.1200/OP.23.00813
Jonathan Sussman, Joshua O Cerasuolo, Gregory R Pond, Daryl Bainbridge, Hsien Seow
{"title":"Patterns of Survivorship Follow-Up Care Among Patients With Breast Cancer: A Retrospective Population-Based Cohort Study in Ontario, Canada, Between 2006 and 2016.","authors":"Jonathan Sussman, Joshua O Cerasuolo, Gregory R Pond, Daryl Bainbridge, Hsien Seow","doi":"10.1200/OP.23.00813","DOIUrl":"10.1200/OP.23.00813","url":null,"abstract":"<p><strong>Purpose: </strong>Many cancer survivors have ongoing follow-up with their oncologist(s), despite evidence that this care can be competently managed by primary care and transitioning well survivors could relieve growing pressure on cancer care systems. We analyzed population-based administrative data from Ontario, Canada, to examine rates of transition to primary care-led follow-up care during the survivorship phase, including clinical and demographic predictors associated with being transitioned.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study to describe the patterns of survivorship follow-up care among all patients with breast cancer in Ontario from 2006 to 2016. Data were derived from the Ontario Cancer Registry and other linked data sets. We defined the survivorship phase of care beginning at 2 years after initial diagnosis. Logistic regression was used to explore factors potentially prognostic of no oncology visits in each of the years after survivorship.</p><p><strong>Results: </strong>Our survivorship cohort was composed of 71,719 patients with breast cancer, 42% of whom were considered to have transitioned from oncology to primary care 2 years after diagnosis. Although the number of patients having oncology visits diminished over time, a quarter of the cohort continued being seen in year 5 of survivorship. Regression analysis found older age, early cancer stage, living farther from a cancer center, not receiving radiation or chemotherapy, and high well-being to be associated with transitioning to primary care.</p><p><strong>Conclusion: </strong>Our findings contribute to the development of low-risk profiles among survivors to inform optimal transition from oncology to primary care. Further research examining qualitative perspectives from oncologists, cancer survivors, and primary care is also required to illuminate other sentinel factors to be considered when transitioning during follow-up.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"188-198"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758784","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-07-30DOI: 10.1200/OP.24.00390
Ramy Sedhom, Thomas J Smith, J Brian Cassel, Sarina R Isenberg
{"title":"What Is the Value of Palliative Care for Inpatients With Cancer?","authors":"Ramy Sedhom, Thomas J Smith, J Brian Cassel, Sarina R Isenberg","doi":"10.1200/OP.24.00390","DOIUrl":"10.1200/OP.24.00390","url":null,"abstract":"<p><p>@ramsedhom and colleagues highlight the opportunity of palliative care to bend the cost (and value) curve in cancer. Enhanced, early, and expanded access to PC offers benefits to inpatients with cancer and cost savings to health systems and payors.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"114-117"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855472","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-12-03DOI: 10.1200/OP-24-00923
Bani Tamraz, Alan P Venook
{"title":"Reply to: \"Give Patients the Choice to Test for DPD Deficiency Before Fluoropyrimidine Chemotherapy,\" \"Large-Scale DPD Testing Should Be More Than an Option,\" and \"A Big Problem With a Feasible Solution, Not a Small Problem With a Complex Solution\".","authors":"Bani Tamraz, Alan P Venook","doi":"10.1200/OP-24-00923","DOIUrl":"10.1200/OP-24-00923","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"265-266"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769070","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-12-03DOI: 10.1200/OP.24.00443
Ken Surprenant, Lindsay Murray, Karen Merritt, Maria Hopkins, Joanne McIntyre
{"title":"Give Patients the Choice to Test for DPD Deficiency Before Fluoropyrimidine Chemotherapy.","authors":"Ken Surprenant, Lindsay Murray, Karen Merritt, Maria Hopkins, Joanne McIntyre","doi":"10.1200/OP.24.00443","DOIUrl":"10.1200/OP.24.00443","url":null,"abstract":"<p><p>Patients, not physicians, should decide if DPYD screening is right for them before FU/Xeloda chemotherapy.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"264-265"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769081","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}
JCO oncology practicePub Date : 2025-02-01Epub Date: 2024-07-22DOI: 10.1200/OP.24.00299
Mary C Boulanger, Ayo S Falade, Kelly Hsu, Robert K Sommer, Ashley Zhou, Roshni Sarathy, Donald Lawrence, Ryan J Sullivan, Lara Traeger, Joseph A Greer, Jennifer S Temel, Laura A Petrillo
{"title":"Patient and Caregiver Experience With the Hope and Prognostic Uncertainty of Immunotherapy: A Qualitative Study.","authors":"Mary C Boulanger, Ayo S Falade, Kelly Hsu, Robert K Sommer, Ashley Zhou, Roshni Sarathy, Donald Lawrence, Ryan J Sullivan, Lara Traeger, Joseph A Greer, Jennifer S Temel, Laura A Petrillo","doi":"10.1200/OP.24.00299","DOIUrl":"10.1200/OP.24.00299","url":null,"abstract":"<p><strong>Purpose: </strong>Immunotherapy has improved survival for patients with melanoma and non-small cell lung cancer (NSCLC). Yet, as responses vary widely, immunotherapy also introduces challenges in prognostic communication. In this study, we sought to explore how patients and caregivers learned about the goal of immunotherapy and their experience of living with uncertainty.</p><p><strong>Materials and methods: </strong>We conducted a qualitative study of patients with stage III or IV melanoma or stage IV NSCLC within 12 weeks of initiating or 12 months of discontinuing immunotherapy, and their caregivers. We conducted in-depth interviews with participants to explore how they learned about immunotherapy from oncology clinicians and how they experienced uncertainty. We used a framework approach to analyze interview transcripts and synthesized concepts into themes.</p><p><strong>Results: </strong>Forty-two patients and 10 caregivers participated; median age was 67 years and most were male (68%), white (95%), married (61%), and had melanoma (62%). We identified four themes: (1) the oncology team shaped participants' hopeful expectations of immunotherapy, including as a potential cure among those with melanoma; (2) distress related to prognostic uncertainty particularly affected patients who experienced toxicity or progressive disease; (3) patients who did not have long-term responses experienced overwhelming disappointment; and (4) some patients and caregivers had conflicting preferences for prognostic information. Participants provided suggestions to improve education and underscored unmet psychosocial needs.</p><p><strong>Conclusion: </strong>Patients and caregivers held optimistic expectations of immunotherapy, which resulted in heightened disappointment among the subset with progression or toxicity. Clinicians should elicit information preferences of both patients and caregivers, as these may be disparate. Our results highlight the need to optimize prognostic communication and support for living with uncertainty among patients receiving immunotherapy.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"178-187"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748163","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}