JCO oncology practice最新文献

{"title":"Characterizing Patient-Reported Outcome Data Availability for Oral Anticancer Therapies.","authors":"Britny R Brown, Jessica Samuel, Morgan Teeters, Ami Vyas, John Bossaer","doi":"10.1200/OP-25-00770","DOIUrl":"10.1200/OP-25-00770","url":null,"abstract":"<p><strong>Purpose: </strong>Since the first oncology-specific US Food and Drug Administration (FDA) guidance on patient-reported outcomes (PROs) was released in 2016, substantial progress has been made in integrating PROs into clinical trials. Nonetheless, PRO data for many oral anticancer therapies remain unreported at the time of approval, underscoring the need to further streamline data collection and enhance outcome availability.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional review of oral anticancer therapies approved by the US FDA from January 2018 through August 2023. The primary objective was to quantify the rate of PRO data availability for oral anticancer therapies approved by the FDA during the study period. Secondary objectives aimed at identifying factors that influence PRO reporting. Descriptive data analysis and tests for significance of differences were performed using SPSS version 29.</p><p><strong>Results: </strong>Seventy-five percent of FDA approvals during the study period collected PROs, with a median of three PROs collected per approval. Of those that collected PROs, 69.7% (175/251) were reported. PROs that were collected as secondary objectives were more likely to be reported than exploratory objective PROs (80.1% [125/156] <i>v</i> 52.6% [50/95], respectively). The PRO survey used had a significant influence on reporting rates, with functional assessment of cancer therapy (FACT) surveys being the most likely to be reported (20/21; 95.2%) <i>v</i> euroQol 5-dimension Questionnaire (EQ-5D) (30/59; 50.8%) and European Organisation for Research and Treatment of Cancer 30 (44/53; 83.0%). When not reported in the initial publication, the median impact factor of the subsequent PRO publication was lower (7.1), compared with that of the initial publication (158.6).</p><p><strong>Conclusion: </strong>The majority of oral anticancer therapy clinical trials collect PROs; however, there remains an opportunity for increased data availability. Further study is warranted to characterize factors influencing PRO reporting and to provide direction for optimizing timely PRO data availability.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1739-1744"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573649","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: Estimated Glomerular Filtration Rate Equations Overestimate Renal Function Compared With Measured Glomerular Filtration Rate Using 24-Hour Urine Creatinine Clearance.","authors":"Reza Lahiji, Ernest Allen Morton, Lorenzo Storino Ramacciotti, Edouard H Nicaise, Siddharth Marthi, Benjamin N Schmeusser, Alexander Abdollahzadeh, Gregory Steven Palmateer, Khushali Vashi, Subir Goyal, Yuan Liu, Eric Midenberg, Dattatraya Patil, R Donald Harvey, Michael J Connor, Mohammad Hajiha, Kenneth Ogan, Mehmet A Bilen, Viraj A Master","doi":"10.1200/OP-25-01384","DOIUrl":"10.1200/OP-25-01384","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"e8"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933289","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":"Pursuit of Hope Over Reason.","authors":"Bruce Feinberg","doi":"10.1200/OP-25-01251","DOIUrl":"10.1200/OP-25-01251","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1689-1690"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959434","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":"Evaluating Clinical Tools to Monitor Cardiovascular Risk in Men With Prostate Cancer Receiving Hormone Therapy.","authors":"Neha Venkatesh, Pankaj Kumar Chauhan, Sagar S Mukhida, Kabir Grewal, Ana Aparicio, Patrick G Pilie, Sumit K Subudhi, Paul G Corn, Ashwin Sachdeva, Monica Desai, Bilal A Siddiqui, Amado J Zurita, Debanjan Pain, Justin R Gregg, Daniel E Frigo, Christopher J Logothetis, Pavlos Msaouel, Efstratios Koutroumpakis, Andrew W Hahn","doi":"10.1200/OP-25-00506","DOIUrl":"10.1200/OP-25-00506","url":null,"abstract":"<p><strong>Purpose: </strong>Men with prostate cancer face considerable cardiovascular (CV) comorbidity. Androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) elevate this risk, yet no prostate-specific CV monitoring tools exist. Clinicians rely on general calculators such as the American Heart Association (AHA)/American College of Cardiology (ACC) atherosclerotic cardiovascular disease (ASCVD) score, which remain unvalidated in this setting. The purpose of this study is to evaluate changes in the estimated CV risk of men with prostate cancer after 6 months of hormone therapy using clinical tools established for the general population.</p><p><strong>Methods: </strong>This was a post hoc analysis of sixty-three men with localized high-risk prostate cancer treated with 6 months of preoperative ADT plus apalutamide with or without abiraterone on a trial (ClinicalTrials.gov identifier: NCT03279250). ASCVD risk and metabolic syndrome (MetS) Z scores were calculated at baseline and the end of treatment using AHA/ACC and MetS calculators.</p><p><strong>Results: </strong>After 6 months of ADT plus ARPI, the median ASCVD risk score increased modestly (+0.95), with 21% exhibiting a clinically significant increase (≥2.5%). This was primarily driven by increases in total cholesterol (median, 182-211) and low-density lipoprotein (median, 101-122), whereas blood pressure did not have a clinically significant change. Five patients experienced a major adverse CV event, yet only one had a clinically significant increase in ASCVD risk score. Only 28% of patients experienced an increase in MetS risk.</p><p><strong>Conclusion: </strong>After 6 months of ADT plus ARPI, men with prostate cancer showed worsening lipid profiles and 21% had worsening of their CV risk based on general population tools. These findings highlight the unmet need to develop prostate cancer-specific CV risk assessment tools.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1854-1860"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471071","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":"Impact of AI Scribes on Physician Productivity and Workflow in Medical Oncology.","authors":"Nima Toussi, Caroline Zhang, Jocelyn Kang, Edward J Licitra","doi":"10.1200/OP-25-00612","DOIUrl":"10.1200/OP-25-00612","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence (AI) scribes are being rapidly adopted in oncology, yet their real-world impact on physician productivity, workflow, and workplace satisfaction is understudied. We evaluated the quantitative and qualitative effects of an AI scribe with electronic medical record (EMR) integration in a multisite community oncology practice.</p><p><strong>Methods: </strong>This single-center, multisite study enrolled 22 medical oncologists and three primary care physicians randomly assigned to receiving training and exposure to the Knowtex AI scribe in an initial phase or control phase. Physician billing data were collected for 6 months before the onboarding of intervention arm physicians and for 16 weeks afterward-within the 2024 fiscal year. Surveys administered at baseline and week 8 postexposure assessed documentation burden, quality, EMR experience, and overall documentation satisfaction.</p><p><strong>Results: </strong>All enrolled providers adopted the Knowtex AI scribe during their respective study phase. Intervention arm physicians exhibited an increase in mean visits (β = 3.35, SE = 1.08, <i>P</i> = .010) and mean total billing per working day (β = $433.61 in US dollars, SE = $134.82, <i>P</i> = .007). There was no change in the number of diagnostic codes per visit. Physicians' perceptions of EMR challenges markedly decreased after implementing the AI scribe (<i>P</i> < .001) with no significant change in the quality of documentation. Physicians reported higher satisfaction with documentation workflow, reduced in-clinic documentation hours, and increased time with patients.</p><p><strong>Conclusion: </strong>Adoption of an AI scribe with EMR integration in oncology clinics may enhance certain billing metrics and positively shift physician perceptions of documentation processes and EMR challenges. These findings highlight potential benefits and limitations of AI scribes in improving physician productivity and satisfaction.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1797-1804"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165445","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":"Osimertinib Versus First-Generation Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors for Metastatic EGFR-Mutant Non-Small Cell Lung Cancer: A Target Trial Emulation Study of Real-World Survival and Safety Outcomes.","authors":"Ren-Hua Ye, Hong-Jie Jhou, Hsin-Yu Chen, Li-Ting Kao, Tina Yi-Jin Hsieh, Yu-Han Chen, Xiaoyi Zhang, Ming-Shen Dai, Ching-Liang Ho, Po-Huang Chen, Cho-Hao Lee","doi":"10.1200/OP-25-00788","DOIUrl":"10.1200/OP-25-00788","url":null,"abstract":"<p><strong>Purpose: </strong>Although clinical trials support osimertinib's efficacy over standard epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in metastatic EGFR-mutant non-small cell lung cancer (NSCLC), large real-world comparisons against first-generation TKIs are limited. We compared the real-world effectiveness and safety of first-line osimertinib versus first-generation TKIs (erlotinib, gefitinib) using a target trial emulation approach.</p><p><strong>Methods: </strong>This retrospective cohort study used the TriNetX Research Network global database. We identified adults with newly diagnosed metastatic EGFR-mutant NSCLC initiating first-line EGFR-TKI therapy (January 2014-March 2025). After 1:1 propensity score matching (PSM), overall survival (OS; primary outcome) and safety were compared between treatment arms.</p><p><strong>Results: </strong>Following PSM, a total of 3,168 patients (1,584 per arm) were analyzed. The median OS was significantly longer with osimertinib compared with first-generation TKIs (1,505 <i>v</i> 901 days; hazard ratio [HR], 0.612 [95% CI, 0.549 to 0.683]; <i>P</i> < .001). Survival benefits were consistent across subgroups, particularly pronounced in Asian patients (HR, 0.439). First-generation TKIs had higher rates of dermatologic toxicities, severe infections, and hospitalizations. Osimertinib showed higher rates of abnormal ECG findings and thrombocytopenia. Sensitivity analyses confirmed the robustness of the primary findings.</p><p><strong>Conclusion: </strong>In this large real-world comparative effectiveness study using target trial emulation, first-line osimertinib was associated with substantially prolonged OS and a favorable safety profile, including lower rates of severe infections and hospitalizations, compared with first-generation EGFR-TKIs in patients with metastatic EGFR-mutant NSCLC.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1844-1853"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714353","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":"Influenza Vaccination Among Patients With Cancer Treated With Checkpoint Inhibitors: Association With Survival Outcomes and Immune-Related Adverse Events.","authors":"Anthoula Koliadi, Evangelos Digkas, Ali Inan El-Naggar, Gustav Ullenhag, Antonis Valachis","doi":"10.1200/OP-25-00660","DOIUrl":"10.1200/OP-25-00660","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with cancer receiving immune checkpoint inhibitors (CPIs) may experience immune-related adverse events (IRAEs) due to immune system overactivation. Concurrently, infections such as seasonal influenza can be more severe in cancer patients because of their compromised immune function, making influenza vaccination particularly important. In this multicenter retrospective study, we investigated whether influenza vaccination during CPI treatment influences CPI effectiveness and rates of IRAEs.</p><p><strong>Patients and methods: </strong>We conducted a retrospective cohort study across three Swedish centers involving patients with metastatic cancer treated with CPIs-either PD-1/PD-L1 inhibitors or combination immunotherapy-between January 1, 2016, and December 31, 2021. To address immortal time bias in time-to-event outcomes, different statistical strategies were employed including time-dependent Cox regression and landmark analyses.</p><p><strong>Results: </strong>In total, 587 patients treated with CPIs during the study period were identified. The most common malignancy was non-small cell lung cancer (NSCLC; 34.4%), followed by cutaneous malignant melanoma (CMM; 32.5%). Time-dependent Cox regression analysis showed that real-world progression-free survival was significantly longer in influenza-vaccinated patients compared with unvaccinated in overall cohort (hazard ratio [HR], 0.59 [95% CI, 0.44 to 0.79]). No statistically significant differences in the occurrence of any grade IRAEs (48.4% <i>v</i> 51.2%, <i>P</i> = .455) or multiple IRAEs (15.1% <i>v</i> 19.2%, <i>P</i> = .297) between the vaccinated and unvaccinated groups were observed. The survival benefit was more pronounced in patients with CMM, whereas no statistically significant effect was observed in patients with NSCLC.</p><p><strong>Conclusion: </strong>Our findings suggest a potential association between influenza vaccination and improved survival in CPI-treated patients, without a corresponding increase in IRAEs, supporting current vaccination recommendations. The observed association in patients with CMM may reflect underlying biological mechanisms and is hypothesis-generating for further investigation.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1805-1811"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149698","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":"Single-Fraction Radiation for Early-Stage Non-Small Cell Lung Cancer: Translating Data Into Practice.","authors":"Chirag Shah, Athanasios Colonias","doi":"10.1200/OP-25-01184","DOIUrl":"10.1200/OP-25-01184","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1683-1684"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714370","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":"<i>Epic</i> Patient Portal Adoption Among Vulnerable Oncology Patients in the Era of Oral Anticancer Medications.","authors":"Yenong Cao, Marie Noelle Bate Baiyee, Johnson Ching, Rachel Murphy-Banks, Feng Qing Wang, Antonia Maloney, Angie Mae Rodday, Susan K Parsons","doi":"10.1200/OP-25-00630","DOIUrl":"10.1200/OP-25-00630","url":null,"abstract":"<p><strong>Purpose: </strong>We characterized patient portal signup in the electronic health record and messaging use among vulnerable oncology patients identified as having newly initiated an oral anticancer medication (OAM), evaluating opportunities to improve patient portal adoption and thus patient communication with their oncology care teams.</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of patients who newly initiated an OAM at Tufts Medical Center between October 1, 2022, and March 31, 2024. Vulnerability was defined as meeting at least one of the following criteria: age ≥75 years; non-English language; or subsidized insurance (Medicaid only or Medicare with Medicaid as a secondary insurance). Active portal use was defined as having at least one message in the portal; meaningful use was defined as patient-provider bidirectional messaging. Portal messaging proxy use was determined by message content screening. Fisher's exact test evaluated the impact of vulnerability on portal signup rate. Logistic regression was performed to identify factors associated with portal signup and meaningful use.</p><p><strong>Results: </strong>Among the study population (N = 280), 56% met the criteria of vulnerability. Although the overall portal signup rate was 74%, it was 64% among vulnerable patients and 87% in nonvulnerable patients (<i>P</i> < .0001). Non-English language was associated with lower rate of portal signup (<i>P</i> < .0001), but none of the vulnerable characteristics were associated with decreased meaningful use. Messaging by proxy was used by 17% of vulnerable versus 2.8% of nonvulnerable patients who signed up for portal. Among patients who signed up, 31% used the portal to communicate about OAM.</p><p><strong>Conclusion: </strong>Although patient portal signup was lower among vulnerable patients, once adopted, vulnerable patients demonstrated comparable meaningful use and greater proxy engagement. Fostering patient portal adoption requires a targeted approach with patient navigation and patient proxy engagement.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1820-1825"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557032","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":"Estimated Glomerular Filtration Rate Equations Overestimate Renal Function Compared With Measured Glomerular Filtration Rate Using 24-Hour Urine Creatinine Clearance.","authors":"Reza Lahiji, Ernest Allen Morton, Lorenzo Storino Ramacciotti, Edouard H Nicaise, Siddharth Marthi, Benjamin N Schmeusser, Alexander Abdollahzadeh, Gregory Steven Palmateer, Khushali Vashi, Subir Goyal, Yuan Liu, Eric Midenberg, Dattatraya Patil, R Donald Harvey, Michael J Connor, Mohammad Hajiha, Kenneth Ogan, Mehmet A Bilen, Viraj A Master","doi":"10.1200/OP-25-00895","DOIUrl":"10.1200/OP-25-00895","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate assessment of renal function is critical in the management of renal cell carcinoma (RCC), influencing surgical planning, systemic therapy eligibility, and clinical trial inclusion. Estimated glomerular filtration rate (eGFR) equations are commonly used in clinical practice but may not reflect true kidney function when compared with more accurate methods of determining renal function such as measured GFR using 24-hour urine creatinine clearance.</p><p><strong>Methods: </strong>In this prospective study, 72 patients with nonmetastatic RCC undergoing preoperative evaluation completed serum creatinine, cystatin C, and 24-hour urine collections. eGFR values were calculated using multiple established equations, both race-inclusive and race-neutral. The agreement between eGFR and measured GFR was assessed using Passing-Bablok regression. Linear regression estimated the discrepancy between eGFR and measured GFR at clinically relevant cutoffs of 45 and 60 mL/min/1.73 m².</p><p><strong>Results: </strong>Across all equations, eGFR consistently overestimated renal function compared with measured GFR. At a measured GFR of 45, corresponding eGFR values ranged from 53 to 59 mL/min/1.73 m²; at a measured GFR of 60, eGFR values ranged from 63 to 68 mL/min/1.73 m². The greatest overestimation was observed with race-neutral Chronic Kidney Disease Epidemiology Collaboration 2021 equations.</p><p><strong>Conclusion: </strong>eGFR equations significantly overestimate renal function in patients with renal masses when compared with 24-hour CrCl-derived measured GFR, particularly near clinically meaningful thresholds. This misclassification may result in inappropriate exposure to potentially harmful treatments, including nephrotoxic chemotherapy and radical nephrectomy. Confirmatory measured GFR testing should be considered in patients with renal function within a ±10 mL/min/1.73 m² range of clinically significant cutoff values to ensure accurate, safe, and appropriate therapeutic decision making. Clinical guidance should specify whether physicians should use eGFR or measured GFR when determining eligibility.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1812-1819"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768112","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}