JCO oncology practice最新文献

{"title":"Real-World Evidence of Combination Therapy Use in Metastatic Hormone-Sensitive Prostate Cancer in the United States From 2017 to 2023.","authors":"Amit D Raval, Orsolya Lunacsek, Matthew J Korn, Natasha Littleton, Niculae Constantinovici, Daniel J George","doi":"10.1200/OP-24-00690","DOIUrl":"10.1200/OP-24-00690","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has evolved with robust clinical trial evidence on the benefits of combining androgen-deprivation therapy (ADT) with androgen receptor pathway inhibitors (ARPIs; abiraterone, apalutamide, darolutamide, and enzalutamide) and/or docetaxel (DOC). To understand current treatment approaches in clinical practice, we examined combined therapy for mHSPC in US real-world practice.</p><p><strong>Methods: </strong>This retrospective study used administrative claims in the Komodo Research Dataset (January 2016-September 2023). Individuals with mHSPC were identified on the basis of their earliest claim for metastasis on/after prostate cancer diagnosis date without evidence of castration resistance. Index date was the earliest ADT claim after mHSPC. Combination therapy included the addition of ARPI, DOC, or both to ADT within 4 months of index date. Multinomial regression was used to examine factors associated with combination therapy.</p><p><strong>Results: </strong>Study population consisted of 10,717 individuals, with a median age of 65 years and a majority of de novo mHSPC cases at diagnosis (62%). Overall, 28% received combination therapy with ARPI (18% abiraterone; 10% apalutamide, darolutamide, or enzalutamide), 9% with DOC, and 2.5% with ARPI plus DOC. From 2017 to 2023, combined hormonal therapy with ARPI increased from 13% to 47% and with ARPI plus DOC from 0.8% to 15%, whereas use of ADT plus DOC declined from 12% to 3% and ADT alone from 74% to 36%. Key factors associated with combination therapy were younger age, fewer chronic comorbidities, de novo mHSPC, and bone metastases.</p><p><strong>Conclusion: </strong>Although one third of men received ADT alone in 2023, the use of combination hormonal therapy with ARPI and/or DOC increased between 2017 and 2023, highlighting uptake of guideline-recommended treatment, driven by available clinical evidence, disease burden, and tolerability.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1174-1184"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370272","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":"Changing What Can Be Changed: Validating Navigation as Essential Care in Modern Oncology.","authors":"David L Schwartz, Christopher Brett, John P Gleysteen","doi":"10.1200/OP-25-00020","DOIUrl":"10.1200/OP-25-00020","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1070-1072"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730085","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":"Navigating Disagreements on Health Information: How Patients With Cancer Perceive Health Care Providers' Approaches to Discussing Patient-Identified Information.","authors":"Ilona Fridman, Cambray Smith, Amy Barrett, Skyler Johnson, Amrita Bhowmick, Sara Hayes, Jennifer Elston Lafata","doi":"10.1200/OP.24.00071","DOIUrl":"10.1200/OP.24.00071","url":null,"abstract":"<p><strong>Purpose: </strong>Although publicly available cancer-related information online and offline could help patients make informed decisions, it also poses challenges due to prevalent misinformation. Patients need proper provider guidance to ensure they use valid and relevant information in decisions. We identify effective communication approaches for providers when (1) discussing patient-identified information and (2) disagreeing with it.</p><p><strong>Methods: </strong>From June to August 2023, people living with cancer were reached via online communities and asked first about their actual experiences discussing patient-identified information with their providers. Respondents were then randomly assigned into an experiment with three hypothetical scenarios where providers disagreed with patient-identified information. Provider responses included (1) dismissal, (2) explanation, and (3) explanation with relationship-building elements. Pearson correlation and multivariable analysis of variance were used to evaluate differences in patient perceptions.</p><p><strong>Results: </strong>One hundred seventy-five respondents completed the survey. Mean age: 53 years; 45% female; and 88% White, 10% Black, and 2% others. Forty-six percent held Bachelor's degrees or higher, 11% lived rurally, 36% reported financial difficulties, and 46% rated their health as good/excellent. Between 31% and 37% of respondents reported their provider used communication approaches that negatively correlated with discussion outcomes. The approaches included avoidance of such conversations due to limited time, discouragement of future information searches, or judgmental comments. In the experiment, respondents randomly assigned to receive relationship-building elements were significantly more comfortable sharing information, felt more satisfied, respected, and trusted their provider's opinion more than those receiving the dismissal scenario. The explanation scenario was not perceived differently compared with the dismissal scenario.</p><p><strong>Conclusion: </strong>More than a third of respondents reported negative communication when sharing patient-identified information with their provider. Provider prioritization of relationship-building alongside explanations could foster trust and facilitate open information exchange, supporting informed decisions.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1193-1202"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058888","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":"Food for Cancer Health Equity: A Qualitative Study Among People With Cancer Who Are Low-Income, Latino or Hispanic, Immigrant, and Individuals With Multiple Minoritized Races and Ethnicities.","authors":"Maria Hanna, Emily H Wood, Andrés Noyola Perez, Gerardo Villicana, Lesly Lopez Guzman, Jajaira Reynaga, Chardria Trotter, Zachary M Koontz, Manali I Patel","doi":"10.1200/OP.24.00322","DOIUrl":"10.1200/OP.24.00322","url":null,"abstract":"<p><strong>Purpose: </strong>Food insecurity is prevalent among patients with cancer. Gaps in our understanding of preferences for food assistance among Latino or Hispanic, immigrant, and people with multiple races and ethnicities limit uptake of food assistance interventions among these populations. We aimed to deeply understand the needs and preferences and barriers to food assistance intervention uptake among low-income, predominantly Latino or Hispanic, immigrant, and people with multiple races and ethnicities and cancer to inform development of tailored interventions.</p><p><strong>Methods: </strong>Participants were recruited among low-income adult patients with cancer who screened positive for food insecurity using the two-item Hunger Vital Sign as part of an ongoing parent randomized controlled trial evaluating a precision medicine intervention. Semi-structured interviews were conducted to assess dietary habits, barriers to food security, and preferences for intervention. Interview responses were transcribed, translated, and thematically analyzed using an inductive-deductive iterative approach.</p><p><strong>Results: </strong>Among 40 (36.4%) participants in the parent randomized trial who screened positive for food insecurity, 20 (50%) were randomly selected to participate in this study. The mean age of participants was 56 years, 17 (85%) self-identified as Latino or Hispanic, 17 (85%) identified Spanish as their preferred language, 13 (65%) reported annual household income <$34,000 in US dollars, and 12 (60%) were unemployed. Three main themes emerged: (1) individualized nutritional needs and culturally specific food preferences; (2) financial, logistical, and emotional barriers to food security; and (3) self-efficacy, autonomy, and approaches to reduce stigma in food assistance interventions.</p><p><strong>Conclusion: </strong>Assessing and integrating the needs and preferences for food assistance is crucial for the development and uptake of food assistance interventions among Latino or Hispanic, immigrant, and other racial and ethnic minoritized individuals with cancer.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1203-1211"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948993","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":"No Versus Know: Patient Empowerment Through Shared Decision Making.","authors":"Beatrice T B Preti","doi":"10.1200/OP-25-00500","DOIUrl":"https://doi.org/10.1200/OP-25-00500","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500500"},"PeriodicalIF":4.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760074","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":"Development of Ambulatory Oncology Clinical Pharmacy Key Performance Indicators Using a Modified Delphi Consensus Approach.","authors":"Thomas McFarlane, Rozhannaa Sothilingam, Olavo Fernandes, Sherilyn K D Houle, Jennifer Lo, Shirin Abadi, Scott Edwards, Michael LeBlanc, Jason Wentzell, Bryanna Tibensky, Carlo DeAngelis, Lauren Steeves","doi":"10.1200/OP-25-00353","DOIUrl":"https://doi.org/10.1200/OP-25-00353","url":null,"abstract":"<p><strong>Purpose: </strong>To develop evidence-based ambulatory oncology clinical pharmacy key performance indicators (AOcpKPIs).</p><p><strong>Methods: </strong>A systematic, modified Delphi process was used to reach consensus on AOcpKPIs. Following an environmental scan of current oncology pharmacy practices across Canada, a literature review identified critical activities linked to patient-centered outcomes. A panel of oncology pharmacists engaged in three Delphi rounds and a virtual live meeting, assessing and refining candidate AOcpKPIs on the basis of predefined criteria. A total of 17 candidate AOcpKPIs were evaluated.</p><p><strong>Results: </strong>Consensus was achieved on 14 AOcpKPIs. These AOcpKPIs reflect critical pharmacist activities including clinical order review, patient education, medication adherence assessment, and management of drug therapy problems. This suite of AOcpKPIs provides a standardized approach for evaluating oncology pharmacist activities in ambulatory care, facilitating benchmarking and supporting evidence-based improvements in patient outcomes.</p><p><strong>Conclusion: </strong>This study represents a significant advancement in defining quality metrics for ambulatory oncology pharmacy practice. The consensus-based AOcpKPIs provide a foundation for enhanced patient care, professional accountability, and continuous quality improvement within oncology pharmacy. Implementing these AOcpKPIs has the potential to elevate oncology pharmacy practice, supporting pharmacists in meeting evolving health care demands and fostering evidence-based patient outcomes.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500353"},"PeriodicalIF":4.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753363","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":"Teaching Communication Skills and Developing Comfort With Difficult Conversations: A Combined Palliative Care-Oncology Simulation Session for Hematology/Oncology Fellows.","authors":"Megan M Dupuis, Katherine J Walsh, Rajiv Agarwal","doi":"10.1200/OP-25-00104","DOIUrl":"https://doi.org/10.1200/OP-25-00104","url":null,"abstract":"<p><strong>Purpose: </strong>ASCO strongly endorses the integration of palliative care (PC) to improve outcomes and support patients in their cancer trajectories. Developing core PC skills for trainees is essential, with few Accreditation Council of Graduate Medical Education-approved pilot programs offering combined fellowship training. Our institution's hematology/oncology (Heme/Onc) fellows reported a need for additional education in leading difficult conversations.</p><p><strong>Methods: </strong>We designed and piloted a didactic simulation (sim) session for each fellowship class, led by a faculty member who is dual board-certified in Medical Oncology and Hospice/Palliative Medicine. Sessions included an overview of validated communication tools, suggested oncology-specific language, small-group case-based role-play with faculty supervision and feedback, and concluded with class reflection. Pre- and post-sim surveys assessed self-reported awareness of communication tools and comfort in discussing difficult oncology-specific topics.</p><p><strong>Results: </strong>In year 1, 16 (76.2%) of 21 fellows completed pre- and post-sim surveys. In year 2, 15 (71.4%) of 21 and 19 (90.4%) of 21 completed pre- and post-sim surveys, respectively. Fellow awareness of communication tools in year 1 increased from 21.9% pre-sim to 79.7% post-sim (<i>P</i> < .05); whereas in year 2, baseline awareness was much higher at 62.6% but still increased to 76.3% post-sim, with notable increase for prognostic discussion tools (<i>P</i> < .05). Comfort increased across multiple domains of difficult conversations in both years 1 and 2 (<i>P</i> < .05). Overall, trainees reported that the sim sessions were useful. Those who participated in the pilot year confirmed application of communication techniques in their clinical practice.</p><p><strong>Conclusion: </strong>Dedicated and iterative communication teaching in Heme/Onc fellowship is imperative for the development of future generations of oncologists. Our sim session leads to sustained improvement in trainee awareness of communication tools and comfort for leading difficult oncology conversations.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500104"},"PeriodicalIF":4.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742108","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: Real-World Adherence Patterns of Comprehensive Genomic Profiling to Biomarker Recommended Therapies in Patients With Advanced Non-Small Cell Lung Cancer.","authors":"Rotem Ben-Shachar, Kaveri Nadhamuni, Luis E Raez, Mark Carty, Akash Mitra, Halla Nimeiri, Ira Klein, Rafi Pelossof, Daniel Morgensztern","doi":"10.1200/OP-25-00718","DOIUrl":"https://doi.org/10.1200/OP-25-00718","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500718"},"PeriodicalIF":4.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730993","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":"Artful Oncology: A Comprehensive Psychosocial Oncology Curriculum for Hematology/Oncology Fellows.","authors":"Jafar Al-Mondhiry, Kimberly Lowery Walker, Jennifer Bires, Leigh Ann Caulkins, Cheryl Hughes, Denise Mohess, Raymond Wadlow","doi":"10.1200/OP-25-00114","DOIUrl":"https://doi.org/10.1200/OP-25-00114","url":null,"abstract":"<p><strong>Purpose: </strong>Forty-six percent of patients with cancer experience significant psychosocial distress, a factor linked to higher morbidity, mortality, and costs of care. Oncologists also face high psychosocial distress, particularly during fellowship training. Herein, we describe a novel curriculum aimed at improving the professional well-being, communication skills (CS), and attitudes toward psychosocial patient care among hematology/oncology (H/O) fellows.</p><p><strong>Methods: </strong>Artful Oncology is an innovative, multimodal, longitudinal curriculum for H/O fellows consisting of four pillars: (1) monthly psychosocial oncology didactics; (2) bimonthly narrative medicine seminars; (3) quarterly CS training simulations; and (4) monthly cancer survivorship support group facilitation. This curriculum was introduced with the inaugural H/O fellowship class in 2021 with formal assessments added in 2022-2023 (total six fellows). Outcomes were measured through self-assessed CS, scored feedback for each didactic, annual Physician Belief Scale (PBS) surveys, quarterly Professional Quality of Life (ProQOL)-Health, and abbreviated Maslach Burnout Inventory (MBI) surveys.</p><p><strong>Results: </strong>Fellows rated didactics as being relevant to their work, prepared to implement the skills learned into clinical practice, and would recommend these sessions to others (average 4.59, 4.48, and 4.67 of 5-point Likert scale, respectively). PBS scores numerically improved from 2022 to 2023 (78 to 68.8 of 160). MBI and ProQOL Health scores were largely unchanged (<2 point difference on average). Self-assessed CS averaged across rising fellows increased from 4.38 to 7.44 of 10 between 2022 and 2023.</p><p><strong>Conclusion: </strong>Self-assessed CS and physician attitudes regarding psychosocial care numerically improved after participation in the Artful Oncology curriculum. Didactic sessions were rated as highly relevant, actionable, and recommended by H/O fellows. Study of this curriculum over a longer timeframe with larger numbers of fellows is ongoing to better evaluate effects.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500114"},"PeriodicalIF":4.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730992","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":"Unmet Social Needs Among Cancer Survivors Who Were Concomitant Caregivers: A Cross-Sectional Analysis of the Health Information National Trends Survey.","authors":"Qian Wang, Zhiting Tang, Hui Xie, Chi Wen, Yannan Li, Changchuan Jiang, Lauren Chiec, Sara L Douglas, Melinda L Hsu","doi":"10.1200/OP-25-00388","DOIUrl":"https://doi.org/10.1200/OP-25-00388","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine the impact of social determinants of health (SDOH) barriers, including food, housing, and transportation insecurities, on cancer survivors who also serve as caregivers (dual roles), compared with cancer survivors only, caregivers only, and the general population. A secondary aim was to assess their comfort level in sharing these barriers with health care providers.</p><p><strong>Methods: </strong>Data were obtained from the 2022 National Cancer Institute Health Information National Trends Survey (HINTS 6), which collected information on SDOH outcomes, including food, housing, and transportation insecurities, as well as participants' comfort level in sharing their SDOH concerns with providers. We compared these outcomes across four groups: dual roles, cancer survivors only, caregivers only, and the general population. Weighted multivariable logistic regression models were used to calculate the adjusted odds ratio (aOR) of SDOH factors by cancer survivor/caregiver status.</p><p><strong>Results: </strong>Overall, 49.1% of dual roles reported facing at least one form of food, housing, or transportation insecurities. Dual roles were 4.61 (aOR, 4.61 [95% CI, 2.71 to 7.84]) and 9.45 (aOR, 9.45 [95% CI, 4.45 to 20.07]) times more likely to report one or more of the above SDOH barriers compared with the general population and cancer survivors only, respectively. However, dual roles did not appear to feel more comfortable in sharing their barriers with health care providers compared with other groups.</p><p><strong>Conclusion: </strong>Our study highlights the significant unmet needs of cancer survivors who also serve as caregivers, as they face higher levels of SDOH barriers than both the general population and cancer survivors only. However, they did not have a greater comfort level in sharing them with providers, underscoring the necessity for targeted strategies to address the unique challenges faced by this vulnerable population.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500388"},"PeriodicalIF":4.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715071","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}