JCO oncology practice最新文献

{"title":"Assessing Clinical Value of New Treatment Strategies: ESMO-MCBS and ASCO-VF Evaluation in Phase III Trials at ASCO Annual Meeting 2022.","authors":"Sofie Seghers, Pablo Mandó, Marc Eid, Charles J Tan, Aarthi Jayraj, Karan Jatwani, Muhammad Salman Faisal, Vi Luong, Joanna A Young, Laure-Anne Teuwen, Hans Prenen, Eva Segelov","doi":"10.1200/OP-24-00739","DOIUrl":"10.1200/OP-24-00739","url":null,"abstract":"<p><strong>Purpose: </strong>The European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) and the ASCO Value Framework (ASCO-VF) are tools designed to assess the value of anticancer therapies. International conferences are the primary venues for sharing trial outcomes, often influencing clinical practices even before full publications are available. This analysis compares the ESMO-MCBS and ASCO-VF in evaluating the benefit of all phase III trials presented at the 2022 ASCO Annual Meeting (AM) and to examine the level of agreement between these scales.</p><p><strong>Methods: </strong>A systematic search of abstracts from the 2022 ASCO AM was conducted, focusing on phase III trial data presented. The clinical benefit of each abstract was assessed using both ESMO-MCBS and ASCO-VF, and Cohen's κ coefficients were calculated to analyze concordance between the tools.</p><p><strong>Results: </strong>Out of 239 phase III trial abstracts, 90 trials involving 49,721 patients met the inclusion criteria. Of these, 36 (40%) could not be graded by ESMO-MCBS, mainly because of nonsignificant results. Among the 54 gradable abstracts, 61.1% (n = 33) were deemed to provide substantial clinical benefit. ASCO-VF was unable to grade 40 (44.4%) abstracts, with nonsignificant results being the leading cause. Of the 50 gradable abstracts, 20% (n = 10) were considered to offer substantial clinical benefit. Moderate agreement between ESMO-MCBS and ASCO-VF was observed (Cohen's kappa, 0.4783 [95% CI, 0.3673 to 0.6034]). No significant association was found between clinical benefit and research funding or the economic status of the trial's origin country.</p><p><strong>Conclusion: </strong>Both frameworks showed a high rate of nongradable studies, primarily because of nonsignificant results. ESMO-MCBS identified more studies with substantial clinical benefit, and the agreement between the two tools was moderate.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1335-1343"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523507","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":"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":"1257-1264"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242842/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Present to Future: The Shifting Paradigm of Advanced Hepatocellular Carcinoma.","authors":"Naveen Kumar Kushwaha, Nihanthy D Sreenath","doi":"10.1200/OP-25-00198","DOIUrl":"10.1200/OP-25-00198","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1218-1220"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024050","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":"Death, Dying, and Disrespect: Failing to Honor Voices Due to Systemic Barriers and Medicalization of End-of-Life Care.","authors":"Manali I Patel","doi":"10.1200/OP-25-00180","DOIUrl":"10.1200/OP-25-00180","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1229-1231"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784489","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":"Prostate Cancer Foundation White Paper on Combination Therapy for Metastatic Hormone-Sensitive Prostate Cancer.","authors":"Sigrid V Carlsson, Pedro C Barata, Alan H Bryce, Daniel J George, Silke Gillessen, Stacy Loeb, Bruce Montgomery, David Morris, Irbaz Bin Riaz, Ganesh Palapattu, Martin W Schoen, Samuel L Washington Iii, Brad Cornell, Rebecca Levine, Pankaj Aggarwal, Tracy McGowan, Matthew Cotter, Betty Thompson, Geeta Devgan, David Russell, Gaston Kuperman, Enrique Lenero, Kenneth Iwata, Andrea K Miyahira, Howard R Soule, Gina Carithers, William K Oh, Neeraj Agarwal","doi":"10.1200/OP-25-00050","DOIUrl":"10.1200/OP-25-00050","url":null,"abstract":"<p><p>Despite several randomized controlled trials demonstrating the benefits of combination therapies for metastatic hormone-sensitive prostate cancer (mHSPC), a significant treatment gap persists. This initiative by the Prostate Cancer Foundation (PCF) convened stakeholders from academia, community practices, industry, and patient advocacy groups to address critical challenges in mHSPC care. Expert discussions and a review of real-world evidence and meta-analyses informed the development of strategies to improve care delivery. Evaluation of the data from global registries, such as IRONMAN, and large community databases was used to assess treatment utilization patterns and disparities. Combination therapies with two agents-androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI)-or three agents-ADT + ARPI + docetaxel-demonstrate significant survival improvements while preserving quality of life for patients with mHSPC, yet adoption remains inconsistent. Of the eligible patients, 20%-60% remain undertreated, with geographic, financial, and systemic barriers contributing to inconsistencies in care. Younger, White, urban-dwelling patients with fewer comorbidities are more likely to receive combination treatment, highlighting disparities across populations. Meta-analyses identified a lack of standardization due to varying inclusion criteria and comparators across trials. Real-world evidence underscored disparities influenced by geographic location, practice type, and access to specialty care. Initiatives such as the PANTHER study highlight improved outcomes in Black patients treated with combination therapies, emphasizing the importance of including diverse populations in clinical trials. To bridge gaps in care, this initiative prioritizes awareness, standardization, and equitable access to evidence-based therapies. Proposed solutions include targeted knowledge dissemination strategies, development of educational resources, and advocacy for policy changes to promote guideline-concordant care. By leveraging collaborative efforts, organizations, including PCF, can contribute to enhancing survival outcomes and quality of life for all patients with mHSPC.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1240-1246"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988216","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":"Time Toxicity of Systemic Anticancer Therapy for Metastatic Lung Cancer in Routine Clinical Practice: A Nationwide Cohort Study.","authors":"Anne Gulbech Ording, Flemming Skjøth, Laurids Østergaard Poulsen, Weronika Maria Szejniuk, Erik Jakobsen, Thomas Decker Christensen, Simon Noble, Thure Filskov Overvad","doi":"10.1200/OP-24-00526","DOIUrl":"10.1200/OP-24-00526","url":null,"abstract":"<p><strong>Purpose: </strong>The concept of time toxicity of cancer treatment, defined as proportion of days from physical contact with the health care system, has been suggested as simple, patient-centered measure useful for shared decision making, particularly in incurable cancer. We investigated the extent of health care contacts in clinical practice in Danish patients with stage IV lung cancer starting first-line systemic anticancer therapies.</p><p><strong>Methods: </strong>This is a nationwide cohort study of newly diagnosed patients with stage IV lung cancer in Denmark who initiated treatment during 2019-2021 and followed for up to 1 year. The time toxicity after treatment initiation was calculated as the proportion and mean cumulative number of days with physical health care system contacts recorded in Danish registries. The remaining days without any physical contact were defined as home days. One-year cumulative mortality was also assessed.</p><p><strong>Results: </strong>We included 4,384 patients with stage IV lung cancer. One year survival was 45% after treatment initiation. Of days alive, the mean cumulative number of days with physical health care contacts was 56 days within 1 year. The corresponding number of home days was 198. Overall, 22% of days alive involved physical contact with the health care system, broadly similar for patients with non-small cell lung cancer (22%) and small cell lung cancer (24%). For specific regimens, the corresponding proportions were chemotherapy (24%), immunotherapy (21%), immunochemotherapy (21%), and targeted therapy (16%).</p><p><strong>Conclusion: </strong>More than 1 in 5 days after initiation of systemic treatment for metastatic lung cancer was spent in physical contact with the health care system. This information may aid shared decision making by informing about expected burdens in relation to cancer therapy.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1316-1324"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869320","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":"Real-World Tolerability of Capecitabine and Oxaliplatin in Patients in the United States With Localized Colorectal Cancer Undergoing Curative-Intent Treatment.","authors":"Veronica Mears, Nikolas Naleid, Omkar Pawar, Jennifer Eva Selfridge, Madison Conces, Melissa Lumish, David Bajor, Amit Mahipal, Sakti Chakrabarti","doi":"10.1200/OP-24-00647","DOIUrl":"10.1200/OP-24-00647","url":null,"abstract":"<p><strong>Purpose: </strong>The combination of capecitabine and oxaliplatin (CAPOX) is commonly used in patients with localized colorectal cancer (CRC) receiving curative-intent treatment. Our study aimed to assess the real-world tolerability of CAPOX in a single-institution cohort of patients with localized CRC.</p><p><strong>Methods: </strong>This is a single-institution retrospective study that included patients with localized CRC receiving neoadjuvant or adjuvant CAPOX. The primary end point was completion rate of intended number (obtained by chart review) of CAPOX cycles irrespective of dose levels. Secondary outcome measures included the rate of grade ≥3 adverse events, hospital admission rate, and dose reductions.</p><p><strong>Results: </strong>The study included 153 patients with a median age of 61 years; 49% were female and 78.4% had stage III CRC. The proportion of patients (95% CI) who completed all planned CAPOX cycles was 44.4% (36 to 52) in the entire cohort and 34.6% (23 to 45) among female patients. Independent variables associated with treatment completion in multivariable analysis were race, sex, and intended number of cycles. Notably, the therapy completion rates (95% CI) were 55% (43 to 66) and 33% (20 to 45) in patients intended to receive four and eight cycles of CAPOX, respectively. The rate of grade ≥3 adverse events and hospitalization because of CAPOX-related toxicity were 30.7% (95% CI, 23 to 38) and 17.6% (95% CI, 11 to 23), respectively.</p><p><strong>Conclusion: </strong>This study highlights that a substantial number of patients with localized CRC undergoing curative-intent treatment with CAPOX do not complete the planned cycles of chemotherapy because of toxicity. These findings underscore the need for careful patient selection and appropriate supportive care to optimize the therapeutic benefit of CAPOX in this setting.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1355-1363"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556663","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":"Management of Advanced Hepatocellular Carcinoma: A Review and Practical Guide.","authors":"Vishnu Nagalapuram, Niveditha Popuri, Ryan D Nipp, Susanna V Ulahannan, Kelsey S Lau-Min","doi":"10.1200/OP-24-00872","DOIUrl":"10.1200/OP-24-00872","url":null,"abstract":"<p><p>Global incidence of hepatocellular carcinoma (HCC) is rising along with its mortality burden, and more than half of the patients require systemic therapy for advanced disease. There is an ongoing epidemiologic shift in risk factors for HCC from hepatotropic virus-related liver disease to alcohol and metabolic dysfunction-associated steatotic liver disease. Although a diagnosis of HCC can be made with noninvasive radiologic criteria, tissue biopsy is gaining a role, at least within the realm of clinical trials. Despite advances in targeted therapies, the role of molecular testing in HCC remains unclear. Liver function continues to play a vital role in the management of HCC across all stages. With the approval of immune checkpoint inhibitors and tyrosine kinase inhibitors targeting tumor angiogenesis, the treatment landscape of advanced HCC has evolved considerably in the past decade, leading to improvements in patient outcomes. However, optimal sequencing of these agents is not well defined. There are several ongoing trials evaluating systemic therapies with novel mechanisms of action including adoptive cell therapy. This review aims to provide practicing oncologists with a comprehensive overview of recent developments in systemic therapy for the management of advanced HCC.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1247-1256"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604779","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":"A Fifth of Their Days: The Time Commitments of Advanced Cancer and Its Care.","authors":"Whitney V Johnson, Melinda L Hsu, Arjun Gupta","doi":"10.1200/OP-24-01085","DOIUrl":"10.1200/OP-24-01085","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1232-1234"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005478","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":"Threading the Needle With Palliative Radiotherapy for Esophageal Cancer.","authors":"Ted K Yanagihara","doi":"10.1200/OP-25-00220","DOIUrl":"10.1200/OP-25-00220","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1224-1226"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991079","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}