JCO oncology practice最新文献

{"title":"Erratum: Analysis of the Implementation of Telehealth Visits for Care of Patients With Cancer in Houston During the COVID-19 Pandemic.","authors":"Jorge G Darcourt, Kalia Aparicio, Phillip M Dorsey, Joe E Ensor, Eva M Zsigmond, Stephen T Wong, Chika F Ezeana, Mamta Puppala, Kirk E Heyne, Charles E Geyer, Robert A Phillips, Roberta L Schwartz, Jenny C Chang","doi":"10.1200/OP-25-00136","DOIUrl":"https://doi.org/10.1200/OP-25-00136","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500136"},"PeriodicalIF":4.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663291","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":"Facilitated Versus Patient-Directed Advance Care Planning Among Patients With Advanced Cancer: A Randomized Clinical Trial.","authors":"Yael Schenker, Shane C Belin, Tianxiu Wang, Rebecca L Sudore, Bernard Hammes, Robert M Arnold, Roberta Flowers, Eric Chiu, Julian Hall, Yvette Dudley-Morrissey, Betty Ferrell, Megan Crowley-Matoka, Adam Brufsky, Edward Chu, Vikram Gorantla, Dhaval Mehta, Roby Thomas, Melissa Yee, Douglas White","doi":"10.1200/OP-25-00046","DOIUrl":"https://doi.org/10.1200/OP-25-00046","url":null,"abstract":"<p><strong>Purpose: </strong>Guidelines recommend advance care planning (ACP) to improve patient-centered care near the end of life (EOL), but the optimal approach is unknown. This single-blind, patient-level, randomized comparative effectiveness trial compared two patient-facing ACP interventions that are widely used but differ in costs and complexity.</p><p><strong>Methods: </strong>Adult patients with advanced solid tumors and their caregivers were recruited from academic and community oncology clinics. Participants were randomly assigned to facilitated ACP using trained nurse facilitators versus patient-directed ACP using written and web-based tools. The primary outcome was patient-reported ACP engagement (assessed at baseline and 12 weeks using a 15-item validated survey; range, 0-5; higher scores indicate higher engagement). Secondary outcomes included advance directive completion and communication about EOL wishes.</p><p><strong>Results: </strong>A total of 400 patients enrolled (mean [SD] age, 67.9 [10.5] years; 192 women [48%]). At 12 weeks, patients in the facilitated versus patient-directed group reported higher ACP engagement (4.34 [0.78] <i>v</i> 4.08 [0.82]; adjusted mean difference, 0.25 [95% CI, 0.1 to 0.4]; <i>P</i> = .0014) and higher odds of completing an advance directive (74.8% <i>v</i> 60.6%; OR, 2.52 [95% CI, 1.27 to 5.0]; <i>P</i> = .008). There were no significant differences between the facilitated and patient-directed groups in the odds of having a conversation about EOL wishes with family or friends (88.9% <i>v</i> 88%; OR, 1.13 [95% CI, 0.5 to 2.6]; <i>P</i> = .76) or physicians (49.6% <i>v</i> 40.6%; OR, 1.53 [95% CI, 0.9 to 2.7]; <i>P</i> = .13), and all ACP behaviors increased significantly from baseline in both groups.</p><p><strong>Conclusion: </strong>Facilitated ACP resulted in greater increases in ACP engagement and advance directive completion than patient-directed written and web-based materials. Although some patients with advanced cancer may engage in self-directed ACP, some may need additional facilitator support.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500046"},"PeriodicalIF":4.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663296","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":"Cancer Patient Perspectives on Clinical Trial Discussion and Informed Consent Through Telemedicine.","authors":"Yasin Khadem Charvadeh, Sahil D Doshi, Kenneth Seier, Erin M Bange, Bobby Daly, Allison Lipitz-Snyderman, Fernanda C G Polubriaginof, Michael Buckley, Gilad Kuperman, Peter D Stetson, Deb Schrag, Michael J Morris, Katherine S Panageas","doi":"10.1200/OP-24-00764","DOIUrl":"10.1200/OP-24-00764","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical trials are integral for patients with cancer but remain inaccessible to many because of barriers including geographic and transportation challenges. This study aimed to evaluate cancer patients' preferences for telemedicine versus in-person visits for clinical trial discussions and informed consent (IC).</p><p><strong>Methods: </strong>An electronic survey was administered to first-time telemedicine users at Memorial Sloan Kettering Cancer Center from 2021 to 2023. The survey assessed patients' preferences for telemedicine versus in-person visits for the IC process and their comfort with discussing clinical trials virtually. The primary outcome was the proportion of patients who indicated that they preferred a telemedicine visit for the IC process. Patient comfort and preference for discussing clinical trials through telemedicine versus an in-person visit was also explored. Structured responses provided quantitative data over the 2021-2023 observation period and demographic variations. To gain a more detailed understanding, unstructured free-text responses describing clinical trial discussions were also analyzed through language modeling.</p><p><strong>Results: </strong>Overall, 57% of patients (540/955) preferred telemedicine, 26% (249/955) had no preference, and 17% (166/955) preferred in-person visits for the IC process. The preference for telemedicine remained consistent across the 2021-2023 observation period. Most patients reported no difference between a telemedicine versus in-person visit for clinical trial discussion, including asking questions, sharing concerns, declining participation, and asking for more time to make a decision. Language modeling analysis revealed areas for improvement.</p><p><strong>Conclusion: </strong>A majority of patients at a comprehensive cancer center who participated in clinical trial discussions through telemedicine reported a preference for telemedicine to complete the IC process. Telemedicine thus represents a valuable tool for reducing barriers to clinical trial participation, particularly in reducing travel and time barriers.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400764"},"PeriodicalIF":4.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656735","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":"Improvement in Quality of Life and Dysphagia After Palliative External Beam Radiotherapy for Malignant Esophageal Stenosis of Esophageal Cancer.","authors":"Katsuyuki Sakanaka, Kota Fujii, Masaki Kokubo, Masakazu Ogura, Satoshi Itasaka, Takashi Sakamoto, Norio Araki, Takehisa Takagi, Yasuhiro Kosaka, Setsuko Okumura, Chikako Yamauchi, Hiroyuki Inoo, Hiroyasu Abe, Hideki Ishikawa, Takashi Mizowaki","doi":"10.1200/OP.24.00429","DOIUrl":"https://doi.org/10.1200/OP.24.00429","url":null,"abstract":"<p><strong>Purpose: </strong>This multi-institutional prospective cohort trial aimed to demonstrate the changes in physician-evaluated dysphagia and patient-reported outcomes (PROs) after palliative external beam radiotherapy (EBRT) in patients with incurable esophageal cancer presenting with dysphagia.</p><p><strong>Materials and methods: </strong>We evaluated the rates of freedom from physician-evaluated dysphagia progression and improvement along with longitudinal changes in PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of Life-Core 30 Questionnaire [QLQ-C30] and OES-18) after palliative EBRT. Multivariate analysis was used to identify the factors associated with freedom from physician-evaluated dysphagia progression at week 13.</p><p><strong>Results: </strong>A total of 519 patients with esophageal cancer were screened; the full analysis set comprised 93 patients with a baseline median dysphagia score of 2 (IQR, 1-3) whose possible range was 1-4. Squamous cell carcinoma accounted for 94% of the full analysis set. The median prescribed dose of palliative EBRT was 40 Gy (IQR, 37.5-50). The rates of freedom from physician-evaluated dysphagia progression and improvement at 13 weeks were 76% (95% CI, 66 to 85) and 50% (95% CI, 39 to 60), respectively. Multivariate analysis suggested that high-dose palliative EBRT was more effective in preventing deterioration of physician-evaluated dysphagia than the low-dose one. Role functioning, fatigue, dyspnea, and appetite were worsened at week 4 but recovered at week 13. Patient-reported dysphagia, as represented in EORTC OES-18, demonstrated clinically significant improvement from weeks 13 through 52, relieving dysphagia-associated symptoms and enhancing global health.</p><p><strong>Conclusion: </strong>Palliative EBRT could relieve physician-evaluated and patient-reported dysphagia and dysphagia-associated symptoms and enhance global health in patients with incurable esophageal cancer, especially for squamous cell carcinoma despite transient dysfunction and aggravations of symptoms attributable to acute toxicity from palliative EBRT.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400429"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624594","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":"Screening and Referral for Health-Related Social Needs and Financial Distress: Current Processes Among National Cancer Institute Community Oncology Research Program Practices.","authors":"Matthew P Banegas, Chandylen L Nightingale, Emily V Dressler, Mary E Cooley, Charles Kamen, Lynne I Wagner, Carol A Kittel, Efren J Flores, Ruth Carlos, Arissa Milton, Elyse Park, Susan K Parsons, Eden Gurganus Wood, Kah Poh Loh, Scott Ramsey","doi":"10.1200/OP-24-00902","DOIUrl":"https://doi.org/10.1200/OP-24-00902","url":null,"abstract":"<p><strong>Purpose: </strong>Health-related social needs (HRSNs) are associated with adverse cancer health outcomes. We assessed the processes for screening and responding to both HRSNs and financial distress and described the methods used across National Cancer Institute Community Oncology Research Program (NCORP) practices.</p><p><strong>Methods: </strong>The NCORP 2022 Landscape Assessment survey focused on services to screen for and respond to HRSNs and financial distress within a national network of community oncology practices. We calculated the proportions of oncology practices that screened for and responded to HRSNs and financial distress, separately, and described the staff, tools, and methods used for each process. Multivariable logistic regression models estimated the associations between oncology practice characteristics and screening for HRSNs and financial distress.</p><p><strong>Results: </strong>The majority of community oncology practices reported screening for HRSNs (79%), and of those, most inquired about transportation (96%), family and social support (93%), housing (80%), and food security (80%). Most oncology practices reported screening for financial distress (78%). Social worker evaluation was the most common method used to screen for both HRSNs (77%) and financial distress (65%). Most oncology practices reported social work referral as the method for responding to HRSNs (89%) and financial distress (96%). Oncology practice characteristics such as having a survivorship clinic and geographic region were associated with screening for HRSNs and financial distress.</p><p><strong>Conclusion: </strong>Research is needed to understand the impact of different HRSN screening and referral approaches on care delivery, clinic costs, care quality, and health outcomes of patients with cancer. These efforts are critical to generate evidence to inform best practices, clinical guidelines, and novel interventions aimed to improve cancer health equity.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400902"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624614","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":"Opportunities for Artificial Intelligence in Oncology: From the Lens of Clinicians and Patients.","authors":"Krunal Pandav, Sahar Almahfouz Nasser, Kristen H Kimball, Kristin Higgins, Anant Madabhushi","doi":"10.1200/OP-24-00797","DOIUrl":"https://doi.org/10.1200/OP-24-00797","url":null,"abstract":"<p><p>Much work has been published on artificial intelligence (AI) and oncology, with many focusing on an algorithm perspective. However, very few perspective articles have explicitly discussed the role of AI in oncology from the perspectives of the stakeholders-the clinicians and the patients. In this article, we delve into the opportunities of AI in oncology from the clinician's and patient's lens. From the clinician's perspective, we discuss reducing burnout, enhancing decision making, and leveraging vast data sets to provide evidence-based recommendations, eventually affecting diagnostic accuracy and treatment planning. From the patient's perspective, we discuss AI virtual concierge, which could improve the cancer care journey by facilitating patient education, mental health support, and personalized lifestyle wellness recommendations promoting a holistic approach to care. We aim to highlight the stakeholders' unmet needs and guide institutions to create innovative AI solutions in oncology. By addressing these perspectives, our article aims to bridge the gap between technological research advancements and their real-world AI-focused clinical applications in cancer care. Understanding and prioritizing the needs of the stakeholders will foster the development of impactful AI tools and intentional utilization of such technology, with an aim for clinical implementation and integration into workflows.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400797"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624596","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":"Antimicrobial Stewardship in Patients With Cancer: Interventions and Future Directions to Combat the Rise of Antimicrobial Resistance.","authors":"Aneela Majeed, Thomas Rust","doi":"10.1200/OP-25-00124","DOIUrl":"https://doi.org/10.1200/OP-25-00124","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500124"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624512","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":"Overcoming Barriers to Cancer-Associated Cachexia Diagnosis and Management.","authors":"Alessio Molfino, Giovanni Imbimbo","doi":"10.1200/OP-25-00060","DOIUrl":"https://doi.org/10.1200/OP-25-00060","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500060"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624599","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: Overcoming Barriers to Cancer-Associated Cachexia Diagnosis and Management.","authors":"Marcus D Goncalves, Tobias Janowitz","doi":"10.1200/OP-25-00108","DOIUrl":"https://doi.org/10.1200/OP-25-00108","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500108"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624612","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":"System-Level Transformations to Increase Patient Participation in Clinical Trials.","authors":"Nicole E Caston, Luqin Deng, Courtney P Williams, Emily B Levitan, Andres Azuero, Russell Griffin, Karen L Smith, Antonio C Wolff, Michelle E Melisko, Eileen H Shinn, Kathleen Gallagher, Rebekah Angove, Stephanie B Wheeler, Gabrielle B Rocque","doi":"10.1200/OP-24-00736","DOIUrl":"https://doi.org/10.1200/OP-24-00736","url":null,"abstract":"<p><strong>Purpose: </strong>Over the course of the COVID-19 pandemic, the Food and Drug Administration allowed cancer clinical trials to make modifications. As policymakers consider sustaining these modifications, understanding patient perspectives on impact is critical.</p><p><strong>Methods: </strong>This cross-sectional study used survey data collected between August 2021 and September 2021 by the Translational Breast Cancer Research Consortium and December 2022 by Patient Advocate Foundation among female breast cancer survivors. Respondents reported how changes to location, telemedicine, convenience, and opting out of certain procedures would affect their willingness to participate in a trial. Respondents' county-level vulnerability was determined using five-digit Federal Information Processing Standard codes to link to the Social Vulnerability Index (SVI) overall theme (range, 0-1). According to the SVI, the most vulnerable counties are those in the upper 10% of the overall theme. Model-estimated odds ratios (ORs) and 95% CIs were estimated using multinomial logistic regression models to explore the association between county-level social vulnerability and willingness to participate.</p><p><strong>Results: </strong>Overall, 573 women were included, 12% lived in the most vulnerable counties, and 18% had previous trial participation. Over half (53%) reported that they would be very willing to participate in a trial that offered medication delivery to the home. When compared with all other counties, respondents in most vulnerable counties did not have increased willingness to participate in a trial using telemedicine (OR, 0.21 [95% CI, 0.07 to 0.63]). Results were similar for all other trial modifications, though not statistically significant.</p><p><strong>Conclusion: </strong>Our sample of breast cancer survivors viewed trial modifications favorably. However, respondents in the most vulnerable counties were less likely to be influenced by these modifications. Research is needed to understand if additional modifications would influence participation of this vulnerable population.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400736"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624615","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}