JCO oncology practice最新文献

{"title":"Evaluation of End-of-Life Quality Care Between American Indian and White North Carolina Decedents Diagnosed With Lung Cancer, 2003-2020.","authors":"Bradford E Jackson, Chris D Baggett, Lisa P Spees, Daniel Carrizosa, Marc A Emerson, Soroush Fariman, Ana I Salas, Ronny A Bell, Stephanie B Wheeler","doi":"10.1200/OP-24-00580","DOIUrl":"10.1200/OP-24-00580","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer mortality rates for American Indians (AIs) are the highest among US race groups. End-of-life (EOL) care presents opportunities to limit aggressive and potentially unnecessary treatment. We evaluated differences in EOL quality of care between AI and White (WH) decedents with lung cancer.</p><p><strong>Methods: </strong>Our cohort included adult AI and WH decedents diagnosed with lung cancer (2003-2020) in North Carolina, who had health insurance claims during the month of and the month preceding death. EOL outcomes assessed during the last 30 days of life included intravenous chemotherapy, hospital admission, hospice initiation, ICU admission, >one emergency department (ED) visit, and in-hospital death. We used Poisson regression models to estimate risk ratios (RRs) and 95% CLs for each outcome comparing AI with WH, adjusting for rural/urban residence, age at diagnosis, insurance status, sex, histology, and diagnosis year. We also evaluated associations in the metastatic lung cancer subcohort.</p><p><strong>Results: </strong>Our cohort comprised 594 AI and 49,296 WH decedents. Compared with WH decedents, AIs were younger at diagnosis (66 <i>v</i> 71 years), more frequently Medicaid-insured (24% <i>v</i> 11%), and more frequently rural residents (51% <i>v</i> 30%). During the last 30 days of life, compared with WH decedents, AIs had higher risks of hospital admissions (RR, 1.14 [1.07-1.22]), ICU admissions (RR, 1.24 [1.08-1.42]), >one ED visits (RR, 1.27 [1.09-1.47]), and in-hospital death (RR, 1.22 [1.06-1.40]).</p><p><strong>Conclusion: </strong>Indicators of inappropriate EOL care (hospital, ICU, and ED admissions) were notably higher during the last month of life for AI decedents with lung cancer. These findings highlight EOL care as an area where more interventions are needed to improve AI cancer care.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1344-1353"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970773","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":"OK Computer! Reflections on How Artificial Intelligence Saved Cancer Care.","authors":"Jeffrey Peppercorn","doi":"10.1200/OP-25-00746","DOIUrl":"https://doi.org/10.1200/OP-25-00746","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":"21 9","pages":"1215-1217"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040217","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 Financial Toxicity on Treatment Adherence and Quality of Life in Pancreatic Cancer.","authors":"Lauren E Schleimer, Emeline Aviki, Hannah L Kalvin, Josephine Magnin, Stefania S Sokolowski, T Peter Kingham, Eileen M O'Reilly, Anna M Varghese, Kevin C Soares, Jeffrey Drebin, Michael I D'Angelica, William R Jarnagin, Mithat Gonen, Bridgette Thom, Alice C Wei","doi":"10.1200/OP-24-00528","DOIUrl":"10.1200/OP-24-00528","url":null,"abstract":"<p><strong>Purpose: </strong>Financial toxicity (FT) is increasingly recognized as a major issue in cancer care. We evaluated the prevalence and risk factors for FT in patients with pancreatic ductal adenocarcinoma (PDAC) and FT associations with treatment adherence and quality of life (QOL).</p><p><strong>Methods: </strong>A screening questionnaire based on the Comprehensive Score for Financial Toxicity (COST) was implemented at our National Cancer Institute-designated comprehensive cancer center. Respondents with pathologic diagnosis of PDAC who completed >50% of prompts between June 2022 and June 2023 were analyzed. COST ≤16 was categorized as FT. Associations between FT and demographic and clinical factors were assessed using logistic regression, and QOL was assessed using linear regression.</p><p><strong>Results: </strong>Of the 1,888 patients with PDAC, 1,162 completed the COST questionnaire, and 1,079 met the inclusion criteria. The prevalence of FT was 23% (n = 245); 37% of patients with FT reported medication nonadherence due to cost. Demographic factors and poor performance status were associated with FT. Treatment-naïve patients were more likely to report FT compared with those on induction, adjuvant, or palliative therapy (<i>P</i> = .049). Patients experiencing FT reported worse QOL, with a median score of 5 (IQR, 4-7) versus 8 (IQR, 6-9) without FT. This relationship persisted after adjusting for demographic and clinical factors; the effect size of FT (β = -1.5; 95% CI, -1.1 to -1.9) was nearly double that of poor performance status (β = -.8; 95% CI, -1.3 to -0.4).</p><p><strong>Conclusion: </strong>FT affected nearly one in four patients with PDAC at a high-volume cancer center and was associated with worse QOL and medication nonadherence. Universal screening and interventions to reduce FT are warranted. Clinical trials investigating QOL as an end point must account for potential confounding due to FT.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1325-1334"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869304","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":"Engage: A Survivorship Program to Improve Childhood Cancer Survivors' Self-Efficacy and Quality of Life.","authors":"Christina Signorelli, Jordana McLoone, Claire Wakefield, Mark Donoghoe, Joseph Elliot Alchin, Karen Johnston, Rachael Baldwin, Elysia Thornton-Benko, Kate Webber, Tali Foreman, Kristen Neville, Richard Cohn","doi":"10.1200/OP-24-00815","DOIUrl":"10.1200/OP-24-00815","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated a survivorship program Engage, aimed at improving childhood cancer survivors' health-related self-efficacy and their health-related quality of life (HRQoL).</p><p><strong>Materials and methods: </strong>Engage provides (1) a telehealth nurse-led health assessment, (2) a remote multidisciplinary case review, (3) personalized recommendations and care plan for survivors and their primary care physician (PCP), and (4) a telehealth nurse-led consultation to promote survivors' understanding of the recommendations. We recruited survivors >5 years postdiagnosis of any age who had not received cancer-related care in the past 24 months. We assessed survivors' outcomes pre-intervention and at 1-, 6-, 12-, and 24-month follow-ups.</p><p><strong>Results: </strong>Seventy-eight survivors participated: 62% male, median age = 30 years, and 14% lived regionally/rurally. Participating survivors' self-efficacy scores improved from baseline to 1 month and were maintained at 6-, 12-, and 24-month follow-ups (<i>P</i> < .001). Survivors' HRQoL remained similar from baseline to postintervention, as did the proportion of survivors reporting a regular PCP or engaging in health/risky behaviors (eg, exercise). Survivors' distress, anxiety, and anger significantly decreased pre- to 6 months postintervention. Survivors' satisfaction with care increased by 28% (<i>P</i> < .001) and was maintained across follow-up (<i>P</i> = .002). Information needs reduced from baseline to 1 month postintervention (<i>P</i> = .023) although they were similar at further follow-up.</p><p><strong>Conclusion: </strong>Survivors' self-efficacy, satisfaction with care, and some psychosocial outcomes improved after participating in Engage. Further effort is needed to improve survivors' primary care engagement and health behaviors.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1274-1286"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467961","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":"Systemic Therapies for Advanced Hepatocellular Carcinoma: Which Gaps Should We Try to Fill?","authors":"Eleonora Cioli, Lorenzo Gervaso, Nicola Fazio","doi":"10.1200/OP-25-00253","DOIUrl":"10.1200/OP-25-00253","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1221-1223"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969905","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":"Artificial Intelligence in Oncology: Fulfilling Its Promise While Avoiding Its Peril.","authors":"Chirag Shah, Stephen M Karlovits","doi":"10.1200/OP-25-00079","DOIUrl":"10.1200/OP-25-00079","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1227-1228"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624588","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":"Exploring Barriers and Facilitators to the Buy-In of Multi-Cancer Early Detection Tests.","authors":"Nicole L Henderson, Tanvi V Padalkar, Ana Falcão, Indya Starks, Hennessy Williams, Courtney P Williams, Rebecca Arend, Gabrielle B Rocque","doi":"10.1200/OP-25-00203","DOIUrl":"https://doi.org/10.1200/OP-25-00203","url":null,"abstract":"<p><strong>Purpose: </strong>Multi-cancer early detection (MCED) tests are a novel approach to cancer screening, offering potential to detect multiple cancers through a single blood draw. This study explored the barriers and facilitators to buy-in of MCED tests and to develop a communication tool to support informed decision making.</p><p><strong>Methods: </strong>We conducted a cross-sectional qualitative study using grounded theory. Twenty participants, including primary care patients and caregivers of patients with cancer from the University of Alabama at Birmingham, were interviewed between January and August 2024. Semi-structured interviews examined participants' knowledge, beliefs, and behaviors related to cancer screening and MCED testing. Interviews were analyzed using grounded theory and a constant comparative method to identify themes, and findings informed the development of a communication tool highlighting critical aspects of MCED testing.</p><p><strong>Results: </strong>Participants expressed interest in early cancer detection, citing benefits such as improved health outcomes and peace of mind. However, enthusiasm was tempered by concerns about overdiagnosis, emotional distress from ambiguous results, test accuracy, financial burden, and uncertainties surrounding MCED testing. On the basis of these findings, a preliminary communication tool was developed to address critical aspects of MCED testing, including test accuracy and reliability, scope of testing, emotional implications, costs and insurance, follow-up care, and privacy concerns. This prototype was designed to facilitate patient-provider discussions by prioritizing the domains identified as essential for informed decision making.</p><p><strong>Conclusion: </strong>Although MCED tests are viewed as promising, their adoption requires addressing key barriers, including emotional, financial, and logistical challenges. The identified communication domains, and the preliminary communication tool informed by these findings, provide an initial framework for supporting patient-centered discussions and integration of MCED screening into clinical practice. Future research should focus on testing and refining the tool to evaluate its effectiveness in diverse populations.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500203"},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954290","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":"Assessing an eHealth Intervention on Quality of Life in Patients With Chronic Lymphocytic Leukemia and Myelodysplastic Syndromes: The MyPal Randomized Controlled Trial.","authors":"Thomas Chatzikonstantinou, Maria Vasilopoulou, Dimitrios Kyrou, Georgios Karakatsoulis, Panagiotis Argyropaidas, Sotiria Besikli-Dimou, Panos Bonotis, Maria Chatzimina, Jana Didi, Christos Dimosthenous, Tina Garani-Papadatos, Stefan Hoffman, Christine Kakalou, Eleni Kazantzaki, Stephan Kiefer, Lefteris Koumakis, Julie Ling, Christos Maramis, Marcel Meyerheim, Cathy Payne, Christina Papangelou, Sheila Payne, Charalampos Pontikoglou, Riley Reston, Harriet Ryblom, Annette Sander, Fatima Schera, Karin E Smedby, George Zacharioudakis, Anastasia Chatzidimitriou, Michael Doubek, Niki Stavroyianni, Paolo Ghia, Helen A Papadaki, Richard Rosenquist, Norbert Graf, Pantelis Natsiavas, Kostas Stamatopoulos, Christina Karamanidou, Lydia Scarfò","doi":"10.1200/OP-25-00087","DOIUrl":"https://doi.org/10.1200/OP-25-00087","url":null,"abstract":"<p><strong>Purpose: </strong>The MyPal study (ClinicalTrials.gov identifier: NCT04370457) is a randomized controlled clinical trial assessing an eHealth intervention on the quality of life (QoL) of patients with chronic lymphocytic leukemia (CLL) and myelodysplastic syndromes (MDS).</p><p><strong>Methods: </strong>Patients who were receiving or had previously received treatment for CLL or MDS were randomly assigned (1:1) to access the MyPal digital health platform versus standard of care. The MyPal platform included a smartphone application used to report QoL status and symptoms via standardized questionnaires or spontaneous reporting. The primary end point was QoL at 12 months, assessed by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 General Questionnaire and the EuroQol EQ-5D-3L. Secondary end points included physical and emotional functioning, measured by the Integrated Palliative Care Outcome Scale (IPOS) scale, satisfaction with care, measured by the EORTC PATSAT-C33, and overall survival (OS). Additionally, the Edmonton Symptom Assessment System (ESAS), Brief Pain Inventory (BPI), and Emotion Thermometers (ET) QoL questionnaires were assessed only in the intervention group.</p><p><strong>Results: </strong>A total of 171 patients (97 and 74 in the control and intervention arms, respectively) who answered multiple questionnaires were analyzed. The intervention group reported a significant decrease in pain (β₂ = -0.48 [-0.77 to -0.19], <i>P</i> < .001) compared with the control group (β₁ = 0.3 [0.09 to 0.5], <i>P</i> = .01). Communication and pain measured by IPOS reduced equally in both groups (β₂ = 0 [-0.03 to 0.02], <i>P</i> = .82; β₂ = -0.01 [-0.02 to 0], <i>P</i> = .1, respectively). Family involvement significantly increased over time only for the intervention group. The other items of EORTC QLQ-C30, EuroQol EQ-5D-3L, IPOS, and PATSAT-C33 remained unchanged in both groups. The intervention group displayed a significant improvement in all ESAS, BPI, and ET scales. OS was similar in both groups.</p><p><strong>Conclusion: </strong>The MyPal intervention improved several QoL aspects and led to a statistically significant decrease in pain compared with the control group.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500087"},"PeriodicalIF":4.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954344","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":"Objective Performance Status: Enhancing Cancer Patient Fitness Assessment With Wearable Technology.","authors":"Joseph W McCollom, Mazie Tsang","doi":"10.1200/OP-25-00601","DOIUrl":"https://doi.org/10.1200/OP-25-00601","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500601"},"PeriodicalIF":4.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954362","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":"Self-Reported Adherence to Cancer Therapy: Development and Validation of the Domains of Subjective Extent of Nonadherence-Cancer Measure.","authors":"Yashasvini Sampathkumar, Corrine I Voils, Gina L Mazza, Lauren Rogak, Brenda F Ginos, Elizabeth D Kantor, Antonia V Bennett, Yulianny De Los Santos, Jennifer Suarez, Camila Lopez, Bharat Narang, Javier González, Kathleen Killoran, Patricia A Spears, Anna P Wolf, Anna Weiss, Stephanie B Wheeler, Bryce B Reeve, Ethan Basch, Francesca Gany, Victoria Blinder","doi":"10.1200/OP-25-00477","DOIUrl":"10.1200/OP-25-00477","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with cancer take different types of medications with varying schedules and settings. They are also sometimes instructed to stop medications due to toxicity. To measure self-reported nonadherence in this heterogeneous population, we modified and evaluated a measure originally developed to assess nonadherence to daily oral antihypertensives, the Domains of Subjective Extent of Nonadherence (DOSE-Nonadherence).</p><p><strong>Methods: </strong>The measure was refined in an iterative process incorporating feedback from patient investigators and participant interviews in English and Spanish. Branching logic was added for participant selection of medication administration setting: (1) only home, (2) only clinic, or (3) partly home/partly clinic. Participants reported their adherence to medications taken over a setting-specific reference period (1 week for home, 1 month for clinic medications). Participants who missed medications then reported on reasons for nonadherence. Adherence was dichotomized for analysis (complete adherence <i>v</i> any nonadherence). For participants who received clinic-administered medications, concordance between chart-abstracted and self-reported adherence was evaluated.</p><p><strong>Results: </strong>Seventy-three participants completed the measure (68% English; 32% Spanish; 86% female; 44% age ≥60 years). The majority had breast cancer; 64% had metastatic disease. Twenty-six percent (15/58) of participants who received medication in clinic and 24% (11/46) of those who took medication at home reported nonadherence. Participants felt able to respond accurately to both reference periods and perceived all reasons for nonadherence to be relevant. Among participants who completed the final version of the measure for clinic-administered medication, 96% (26/27) accurately reported their adherence compared with chart-abstracted data.</p><p><strong>Conclusion: </strong>Our results support the validity of the DOSE-Nonadherence-Cancer for assessing cancer treatment nonadherence. This measure can be used to assess nonadherence in patients with cancer receiving a broad array of systemic therapies.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500477"},"PeriodicalIF":4.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882896","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}