JCO oncology practice最新文献

{"title":"Integration of Remote Monitoring Into Palliative Care for Patients With Advanced Cancer Undergoing Phase I Therapies: A Randomized Clinical Trial.","authors":"David Hui, Ishwaria M Subbiah, David Hong, Penny Stanton, Jennifer Ellefson, Monawar Hosain, Josue Becerra, Vera de la Cruz, Amy Ontai, Ali Haider, Ethan Huang, Sanjay Shete, Eduardo Bruera","doi":"10.1200/OP-25-00442","DOIUrl":"https://doi.org/10.1200/OP-25-00442","url":null,"abstract":"<p><strong>Purpose: </strong>Outpatient specialist palliative care (SPC) referral improves patient outcomes; however, it is unclear whether additional remote monitoring (RM) would provide further benefit. This pilot, parallel-group, single-blind, randomized clinical trial examined the within-group effect of monthly SPC alone or with additional weekly RM on symptom burden in patients with advanced cancer undergoing phase I therapies.</p><p><strong>Methods: </strong>Eligibility criteria included advanced solid tumor diagnosis and moderate-to-high symptom burden (ie, Edmonton Symptom Assessment System [ESAS] score ≥4/10 for ≥1 symptom and Global Distress Score [GDS] ≥20/90) before starting phase I therapies. Patients were randomly assigned 1:1 to either monthly outpatient SPC visits alone or with additional RM, consisting of weekly phone calls and concurrent electronic ESAS assessments between monthly SPC visits. The primary outcome was within-group change in symptom burden (ESAS-GDS) from baseline to 2 weeks; secondary outcomes included within-group change from baseline in ESAS-GDS and health-related quality of life (HRQOL; measured by Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being [FACIT-Sp]) over 12 weeks.</p><p><strong>Results: </strong>Between December 15, 2020, and December 21, 2022, 115 patients consented and 100 were randomly assigned (SPC + RM, n = 57; SPC, n = 43). The mean age (standard deviation) of analyzed patients was 56 (12) years, and 57 (64%) were female. At 2 weeks, SPC + RM had significant within-group improvement in ESAS-GDS (mean change, -5.0 [95% CI, -8.9 to -1.2]; <i>P</i> = .01) and FACIT-Sp (5.6 [95% CI, 1.2 to 10]; <i>P</i> = .01), but SPC alone did not (ESAS-GDS, -2.0 [95% CI, -5.8 to 1.8]; <i>P</i> = .29; FACIT-Sp, -1.1 [95% CI, -7.3 to 5.1]; <i>P</i> = .50). HRQOL improved significantly in SPC + RM compared with SPC at 12 weeks (14 [95% CI, 2.6 to 25]; <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Incorporating RM into SPC may improve symptoms and HRQOL beyond SPC alone for patients with moderate-to-high symptom burden. Our findings are considered preliminary and larger confirmatory trials are needed.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500442"},"PeriodicalIF":4.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130830","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 After Fertility-Sparing Surgery for Early-Stage Cervical Cancer Compared With Nonsparing Surgery: A Nationwide Comparative Study.","authors":"Janneke T Wolswinkel, Petra L M Zusterzeel, Anke Smits, Albert G Siebers, Hans H B Wenzel, Ruud L M Bekkers, Jogchum J Beltman, Christianne A R Lok, Constantijne H Mom, Nienke E van Trommel, Ronald P Zweemer, Jake S F Maurits, Mieke L G Ten Eikelder","doi":"10.1200/OP-25-00131","DOIUrl":"https://doi.org/10.1200/OP-25-00131","url":null,"abstract":"<p><strong>Purpose: </strong>The oncologic safety of fertility-sparing surgery in young women with early-stage cervical cancer is largely based on retrospective data from small series, highlighting the need for larger studies to validate its safety.</p><p><strong>Methods: </strong>We performed a nation-wide retrospective matched cohort study of all patients age 18-45 years with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) 2018 stage IA1 to IB2 cervical cancer who underwent fertility-sparing surgery (FSS; cone biopsy, large loop excision of the transformation zone, or [radical] trachelectomy) between 2000 and 2022 in the Netherlands (fertility-sparing group). These patients were matched 1:2 with women who had a (radical) hysterectomy for early-stage cervical cancer (hysterectomy group). Patients were matched for pretreatment FIGO 2018 stage, histology, and lymph vascular space invasion. We compared data on recurrence-free survival, disease-free survival, and overall survival (OS) between the fertility-sparing group and the hysterectomy-group.</p><p><strong>Results: </strong>In total, 1,446 patients were included: 482 treated with FSS and 964 with a (radical) hysterectomy; 57.5% had stage 1A1 or 1A2, and 42.5% had IB1 or IB2 cervical cancer. The median follow-up was 8.9 years (IQR, 4.4-13.7). During the study period, 4.8% of patients developed a recurrence: 7.1% in the fertility-sparing group and 3.6% in the hysterectomy group (hazard ratio [HR], 2.21 [95% CI, 1.38 to 3.56]).The OS in both groups did not differ (HR, 1.06 [95% CI, 0.62 to 1.80]).</p><p><strong>Conclusion: </strong>Women treated with FSS had a significantly higher recurrence rate than patients who had the uterus completely removed. However, since the increased recurrence rate did not affect OS, fertility-sparing surgery appears to be a potentially safe treatment option.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500131"},"PeriodicalIF":4.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130842","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":"Training Health Care Practitioners to Effectively Communicate With Older Adults With Cancer and Their Caregivers.","authors":"Patricia A Parker, Smita C Banerjee, Yesne Alici, Christian J Nelson, Koshy Alexander, Elizabeth Schofield, Faith S Fasakin, Nessa Coyle, Andrew J Roth, Ruth Manna, Javier Gonzalez, Rebecca Ewert, Beatriz Korc-Grodzicki","doi":"10.1200/OP-25-00546","DOIUrl":"10.1200/OP-25-00546","url":null,"abstract":"<p><strong>Purpose: </strong>Providing medical care to older adults with cancer is complex. In addition to their cancer diagnosis, many older adults have various factors such as frailty, comorbidities, cognitive decline, sensory and functional issues, and polypharmacy that increase the complexity of their medical care. However, few health care practitioners (HCPs) receive adequate training in geriatric principles or in effective communication with older adults with cancer and their caregivers.</p><p><strong>Methods: </strong>To meet this significant and growing need, we developed and conducted an evidence-based educational training program in geriatric oncology, Geriatric Oncology: Cognition and Communication (Geri Onc CC). The goal of this study was to examine its efficacy in terms of participants' ratings of the program, self-efficacy, knowledge, and attitudes, as well as skill uptake of general and geriatric-specific communication skills. Participants completed questionnaires and standardized patient and caregiver assessments before and after their participation.</p><p><strong>Results: </strong>Two hundred eighty-two HCPs representing more than eight disciplines, working in varied types of health care settings and locations, participated in the 2-day in-person or virtual training program. Participants rated the program as having high value and reported high satisfaction. After participating in the program, they demonstrated increased knowledge (<i>P</i> < .001), greater self-efficacy (<i>P</i> < .001), and significant increase in communication skills use from pre- to post-training in five skill categories (agenda setting, checking, questioning, information organization, and empathy) as well as geriatric-specific skills (all <i>P</i> values < .001).</p><p><strong>Conclusion: </strong>The Geri Onc CC Training Program improved participants' knowledge and skills. This program fills an important gap in HCPs' education for this population.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500546"},"PeriodicalIF":4.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091799","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":"Reply to: From Discussion to Direction: Tumor Boards Need Clinical Editorial Leadership.","authors":"Miguel Borregón Rivilla, María Torrente, Álvaro Rodríguez-Lescure, Javier-David Benitez-Fuentes","doi":"10.1200/OP-25-00825","DOIUrl":"https://doi.org/10.1200/OP-25-00825","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500825"},"PeriodicalIF":4.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091750","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":"AML Care at Home: An Evidence-Based Toolkit to Personalize the Care Setting for Recovery From Pediatric AML Chemotherapy.","authors":"Alix E Seif, Sara L McDonough, Emily M Becker-Haimes, Katelyn E Oranges, Danielle Clerico, Jacob Hartman, Kelly Rodock, Lisa A Schwartz, Caitlin W Elgarten, Regina M Myers, Rachael O Puszczynski, Susan R Rheingold, Julie W Stern, Tracey F Jubelirer, Erin A Armideo, Nicholas F Evageliou, R Jennifer Randall, Kathrin M Bernt, Anne F Reilly, Sarah K Tasian, Rosemary K Diamant, Brian T Fisher, Kelly D Getz, Richard Aplenc","doi":"10.1200/OP-25-00314","DOIUrl":"https://doi.org/10.1200/OP-25-00314","url":null,"abstract":"<p><strong>Purpose: </strong>Current care guidelines for children with AML recommend hospitalization during severe neutropenia. However, selected patients discharged before neutrophil recovery have similar chemotherapy course-specific bacteremia and mortality rates to those who remain hospitalized. On the basis of published literature, we developed a toolkit to guide outpatient care after myelosuppressive AML chemotherapy and piloted its implementation at a single institution. We present the pilot clinical and implementation outcomes.</p><p><strong>Methods: </strong>The AML Care at Home toolkit includes a discharge eligibility assessment tool and outpatient management guidelines for pediatric patients with AML and was implemented on November 15, 2022. Toolkit reach, defined as the proportion of postinduction 1 courses with toolkit use (target: 60%), was the coprimary implementation outcome, and total inpatient days per course was the coprimary clinical outcome. Chart abstractions were used to ascertain total inpatient days per course and other clinical outcome designations.</p><p><strong>Results: </strong>During this pilot implementation program, 22 patients underwent 48 postinduction 1 chemotherapy courses. The toolkit was used in 33 (68.8%) courses. Appropriate toolkit use allowed for early discharge in 21 (43.8%) courses and directed inpatient recovery in 11 (22.9%). Median total inpatient days were markedly fewer for toolkit-guided early-discharge courses (8 days, IQR, 5.5-14.5) than toolkit-guided inpatient-only courses (26 days, IQR, 22-39) or when the toolkit was not used as intended (31 days, IQR, 25.3-34.8).</p><p><strong>Conclusion: </strong>Pilot implementation of the AML Care at Home toolkit exceeded our target reach goal and led to fewer inpatient days per course than expected on the basis of previous studies of outpatient neutropenia management. These data reflect the utility of a toolkit created on the basis of published data to identify and support appropriate patients for early hospital discharge and safe outpatient monitoring.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500314"},"PeriodicalIF":4.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091784","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":"From Discussion to Direction: Tumor Boards Need Clinical Editorial Leadership.","authors":"Mehmet Mutlu Çatlı, Arif Hakan Önder","doi":"10.1200/OP-25-00595","DOIUrl":"https://doi.org/10.1200/OP-25-00595","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500595"},"PeriodicalIF":4.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091790","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":"Toward Better End-of-Life Care: Strategies to Reduce Hospital Utilization and Improve Quality in Metastatic Cancer.","authors":"Sarah B Bateni, Gabrielle Rocque","doi":"10.1200/OP-25-00400","DOIUrl":"https://doi.org/10.1200/OP-25-00400","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500400"},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085223","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":"ONS/ASCO Guideline on the Management of Antineoplastic Extravasation.","authors":"Tanya Thomas, Caroline Clark, Chelsea Backler, Kari Bohlke, Deena Centofanti, Aparna C Jotwani, Diane G Cope, Kerri A Dalton, Celestine G Gochett, Victoria Henney, Gwen King, Donald C Moore, Hannah Dzimitrowicz McManus, Holly M Anderson, Kerri A Moriarty, Karen DiValerio Gibbs, Rebecca L Morgan","doi":"10.1200/OP-25-00579","DOIUrl":"https://doi.org/10.1200/OP-25-00579","url":null,"abstract":"<p><strong>Purpose: </strong>Extravasation is an uncommon but high-risk adverse event that occurs when an agent with the potential to cause tissue damage leaks out of the intended administration space into the surrounding area. This guideline presents evidence-based side effect management recommendations to support interprofessional teams in decision making to minimize severity or progression of extravasation injury from antineoplastic treatment in individuals with cancer.</p><p><strong>Methods: </strong>The Oncology Nursing Society and American Society of Clinical Oncology appointed health care professionals and patient representative members to a panel for guideline development focused on antineoplastic vesicants and irritants with vesicant properties. The panel applied GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology and followed the National Academies of Sciences, Engineering, and Medicine criteria for trustworthy guidelines. A systematic review of studies examining outcomes of antineoplastic agent extravasation in adults informed the guideline. The panel assessed the certainty of the evidence using the GRADE approach.</p><p><strong>Results: </strong>The panel agreed on recommendations related to the use of antidotes for antineoplastic vesicants and irritants with vesicant properties, thermal compress application and duration, and early surgical referral or escalation to specialty care for central venous access device extravasation.</p><p><strong>Recommendations: </strong>This guideline summarizes evidence-based interventions for the management of extravasation of antineoplastic vesicants or irritants with vesicant properties to guide clinical care.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500579"},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086207","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":"Beyond Efficacy: Cost and Resource Implications of First-Line Systemic Therapies for Metastatic Renal Cell Carcinoma.","authors":"Michael W Bacchus, Luis A Esparza Miranda, Shawn Dason","doi":"10.1200/OP-25-00690","DOIUrl":"https://doi.org/10.1200/OP-25-00690","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500690"},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080566","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":"Defining the Rates of Cytokine Release Syndrome Associated With Talquetamab Step-up Doses.","authors":"Issam S Hamadeh, Lisa Modelevsky, Amelia Chan, Aaron Mitchell, Ross S Firestone, Alice X Wang, Tala Shekarkhand, Neha Korde, Malin L Hultcrantz, Alexander M Lesokhin, Sham Mailankody, Hani Hassoun, Urvi A Shah, Kylee Maclachlan, Sridevi Rajeeve, Hamza Hashmi, Dhwani Patel, Gunjan L Shah, Michael Scordo, Heather J Landau, Sergio Giralt, Saad Z Usmani, Carlyn R Tan","doi":"10.1200/OP-25-00224","DOIUrl":"https://doi.org/10.1200/OP-25-00224","url":null,"abstract":"<p><strong>Purpose: </strong>Talquetamab is a G protein-coupled receptor class C group 5 member D T-cell-engaging antibody, approved for relapsed/refractory multiple myeloma (RRMM). In the MonumenTAL-1 clinical trial, cytokine release syndrome (CRS) occurred at a frequency of 77%; however, there was no assessment of CRS rates by step-up dose. The primary objective of this study was to characterize CRS rates after each talquetamab step-up dose in a real-world setting.</p><p><strong>Methods: </strong>Patients with RRMM who completed the talquetamab once a week or once every 2 weeks step-up dosing schedule between September 2023 and November 2024 were identified via the institutional database. CRS rate after each talquetamab step-up dose was compared using the chi-square/Fisher's exact test. The Kruskal-Wallis test was used to compare difference in median time to the CRS onset. Multivariate logistic regression analysis was performed to identify predictors of CRS.</p><p><strong>Results: </strong>Fifty patients completed the talquetamab step-up dosing phase during the study period; CRS occurred at a rate of 80%. Pairwise comparisons revealed significant differences in CRS rates between the fourth dose (4%) and each of step-up dose 1 (28%, <i>P</i> = .014) and 2 (34%, <i>P</i> = .003). The only CRS event with fourth dose was grade 1. The median time to onset of first CRS did not differ significantly between step-up doses (<i>P</i> = .441). Previous exposure to T-cell-redirecting therapy had no impact on CRS incidence (odds ratio: 0.20 [95% CI, 0.03 to 1.10]).</p><p><strong>Conclusion: </strong>Our findings suggested that the fourth talquetamab dose could be administered in outpatient settings given its high tolerability. The reduced hospitalization period for talquetamab step-up dosing could reduce health care expenses.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500224"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075175","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}