JCO oncology practice最新文献

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Rechallenge With an Epidermal Growth Factor Receptor Inhibitor in Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis. 表皮生长因子受体抑制剂在转移性结直肠癌中的再挑战:系统回顾和荟萃分析。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-10-01 Epub Date: 2025-12-15 DOI: 10.1200/OP-25-00646
Amy H Huang, Gin Yi Lee, Chuan Angel Lu, Ibrahim Halil Sahin, Gentry T King, Rachael A Safyan, Stacey A Cohen, David B Zhen, Veena Shankaran, William P Harris, Andrew L Coveler, Jyoti Malhotra, Victoria E Forbes, Philip J Gold, E Gabriela Chiorean, Ronan W Hsieh
{"title":"Rechallenge With an Epidermal Growth Factor Receptor Inhibitor in Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.","authors":"Amy H Huang, Gin Yi Lee, Chuan Angel Lu, Ibrahim Halil Sahin, Gentry T King, Rachael A Safyan, Stacey A Cohen, David B Zhen, Veena Shankaran, William P Harris, Andrew L Coveler, Jyoti Malhotra, Victoria E Forbes, Philip J Gold, E Gabriela Chiorean, Ronan W Hsieh","doi":"10.1200/OP-25-00646","DOIUrl":"10.1200/OP-25-00646","url":null,"abstract":"<p><strong>Purpose: </strong>Clonal evolution is a mechanism of treatment resistance against epidermal growth factor receptor inhibitors (EGFRi) in metastatic colorectal cancer (mCRC). When EGFRi is discontinued, EGFRi-resistant tumor subclones decay with time, allowing for EGFRi rechallenge at later time. We conducted a meta-analysis to investigate the efficacy of EGFRi rechallenge in mCRC.</p><p><strong>Methods: </strong>Clinical trials and observational studies investigating the efficacy of EGFRi rechallenge in mCRC were included from PubMed and Embase from inception to December 8, 2024. Hazard ratios (HRs) of overall survival (OS) and progression-free survival (PFS) were aggregated using Bayesian random-effects models. Objective response rates (ORRs) were aggregated using meta-random-effects models.</p><p><strong>Results: </strong>Twenty-nine studies were included. The pooled median PFS, median OS, and ORR were 3.83 months (95% CI, 3.25 to 4.50), 10.43 months (95% CI, 8.14 to 13.36), and 14.61% (95% CI, 8.70 to 23.51), respectively. EGFRi rechallenge was associated with significantly longer pooled PFS (HR, 0.54 [95% CI, 0.31 to 0.93]) and numerically longer pooled OS (HR, 0.71 [95% CI, 0.46 to 1.09]) than non-EGFRi systemic therapy. Patients without detectable RAS/RAF mutations by circulating tumor DNA (ctDNA) at the time of EGFRi rechallenge had significantly longer OS (HR, 0.43 [95% CI, 0.24 to 0.75]) and PFS (HR, 0.40 [95% CI, 0.26 to 0.62]) than those with ctDNA RAS/RAF mutations. Studies with EGFRi-free intervals ≥4 months before rechallenge (18.77%) had a numerically greater pooled ORR than those with EGFRi-free intervals <4 months (6.60%). No unexpected adverse events were reported, and treatment discontinuation because of adverse events was 2.7%.</p><p><strong>Conclusion: </strong>EGFRi rechallenge is associated with significantly longer PFS, numerically longer OS, and clinically meaningful ORR as compared with non-EGFRi systemic therapy in mCRC, particularly for ctDNA RAS/RAF wild-type mCRC.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1701-1712"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762792","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}
引用次数: 0
Real-World Comparative Effectiveness of Abiraterone, Apalutamide, Enzalutamide, and Docetaxel Doublets for Metastatic Hormone-Sensitive Prostate Cancer. 阿比特龙、阿帕鲁胺、恩杂鲁胺和多西他赛双药治疗转移性激素敏感前列腺癌的实际疗效比较。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-10-01 DOI: 10.1200/OP-26-00493
Ifechukwu B Nwogu, Noemi Kreif, Hiba M Khan, Ruth Etzioni, Josh J Carlson
{"title":"Real-World Comparative Effectiveness of Abiraterone, Apalutamide, Enzalutamide, and Docetaxel Doublets for Metastatic Hormone-Sensitive Prostate Cancer.","authors":"Ifechukwu B Nwogu, Noemi Kreif, Hiba M Khan, Ruth Etzioni, Josh J Carlson","doi":"10.1200/OP-26-00493","DOIUrl":"https://doi.org/10.1200/OP-26-00493","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the real-world comparative effectiveness of androgen receptor pathway inhibitors (ARPIs)-abiraterone, apalutamide, enzalutamide-and docetaxel, plus androgen-deprivation therapy (ADT) for metastatic hormone-sensitive prostate cancer (mHSPC).</p><p><strong>Methods: </strong>We identified US men with mHSPC who initiated ADT within 4 months of diagnosis and were treated with abiraterone, apalutamide, enzalutamide, or docetaxel within 4 months of ADT initiation between January 2019 and December 2023, with follow-up through June 2025. Primary outcomes were progression-free survival (PFS) and overall survival (OS). Secondary outcomes included time to metastatic castration-resistant prostate cancer (mCRPC) progression (TTP) and time to new treatment initiation (TTNT). Cox proportional hazard and Fine-Gray models with overlapping propensity score weights were used to estimate primary and secondary outcomes, respectively. Subgroup analyses by timing of metastasis and sensitivity analyses using inverse probability of treatment weights were conducted for primary outcomes.</p><p><strong>Results: </strong>Among 9,141 US men with mHSPC, ARPI doublets demonstrated superior PFS versus docetaxel doublets (abiraterone: adjusted hazard ratio [aHR], 0.60 [95% CI, 0.55 to 0.66]; apalutamide: aHR, 0.64 [95% CI, 0.56 to 0.73]; enzalutamide: aHR, 0.57 [95% CI, 0.51 to 0.64]), with no significant differences among ARPI regimens. OS was comparable among all doublet regimens. Neither PFS nor OS differed by timing of disease. TTP (abiraterone: aHR, 0.52 [95% CI, 0.47 to 0.58]; apalutamide: aHR, 0.59 [95% CI, 0.52 to 0.68]; enzalutamide: aHR, 0.51 [95% CI, 0.45 to 0.57]) and TTNT (abiraterone: aHR, 0.46 [95% CI, 0.42 to 0.51]; apalutamide: aHR, 0.53 [95% CI, 0.46 to 0.61]; enzalutamide: aHR, 0.47 [95% CI, 0.42 to 0.53]) showed similar patterns favoring ARPI doublets. Sensitivity analyses showed consistent findings.</p><p><strong>Conclusion: </strong>ARPI doublets demonstrated superior PFS but similar OS compared with docetaxel doublet, with no differences among individual ARPIs. Patients receiving ARPI doublets were less likely to progress to mCRPC or initiate new treatment.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600493"},"PeriodicalIF":5.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109584","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}
引用次数: 0
Contemporary Patterns of Medicare Part B Spending on Immune Checkpoint Inhibitors (2018-2022). 当代医疗保险B部分在免疫检查点抑制剂上的支出模式(2018-2022)。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-29 DOI: 10.1200/OP-26-00461
Vidit Majmundar, Charmi Bhanushali, Sharanya Tripathi, Pragya Jain, Vidhi Bhanushali, Bradley Switzer
{"title":"Contemporary Patterns of Medicare Part B Spending on Immune Checkpoint Inhibitors (2018-2022).","authors":"Vidit Majmundar, Charmi Bhanushali, Sharanya Tripathi, Pragya Jain, Vidhi Bhanushali, Bradley Switzer","doi":"10.1200/OP-26-00461","DOIUrl":"https://doi.org/10.1200/OP-26-00461","url":null,"abstract":"<p><strong>Purpose: </strong>Immune checkpoint inhibitors (ICIs) have transformed cancer care but impose a growing financial burden on Medicare. We characterized Medicare Part B spending and utilization patterns for ICIs from 2018 to 2022 to quantify expenditure trends and identify key cost drivers.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the Centers for Medicare & Medicaid Services (CMS) Medicare Part B Spending by Drug public summary files (aggregated Healthcare Common Procedure Coding System [HCPCS] drug-year data) from 2018 through 2022. For eight ICIs, we extracted total gross program spending, total dosage units (HCPCS billing units), and unique beneficiaries and calculated average spending per dosage unit, average spending per beneficiary, and growth metrics over time.</p><p><strong>Results: </strong>In 2022, total Medicare Part B spending across the eight ICIs was approximately $8.49 billion US dollars (USD). Pembrolizumab accounted for the largest spending ($4.94 billion USD) and beneficiary utilization (67,022 beneficiaries), followed by nivolumab ($1.85 billion USD; 26,957 beneficiaries). Average spending per beneficiary in 2022 (the primary cost metric, capturing dose frequency and treatment duration) ranged from $53,508 USD (durvalumab) to $80,705 USD (atezolizumab). Average spending per dosage unit varied widely as a secondary pricing measure, from $27.02 USD (cemiplimab) to $216.09 USD (dostarlimab).</p><p><strong>Conclusion: </strong>Medicare Part B spending on ICIs is highly concentrated among pembrolizumab and nivolumab, and is driven primarily by beneficiary volume, with substantial heterogeneity in per-beneficiary spending across agents. As indications and utilization continue to expand, these therapies' fiscal impact warrants ongoing evaluation to inform Medicare payment policy and value-based oncology care.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600461"},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080844","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}
引用次数: 0
Clinical Trial Access in Renal Cell Carcinoma: When Innovation Does Not Reach the Communities That Need It. 肾细胞癌的临床试验准入:当创新不能到达需要它的社区时。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-29 DOI: 10.1200/OP-26-01037
Varun Nandakumar, Tejita Agarwal, Sumati Gupta, Umang Swami
{"title":"Clinical Trial Access in Renal Cell Carcinoma: When Innovation Does Not Reach the Communities That Need It.","authors":"Varun Nandakumar, Tejita Agarwal, Sumati Gupta, Umang Swami","doi":"10.1200/OP-26-01037","DOIUrl":"https://doi.org/10.1200/OP-26-01037","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2601037"},"PeriodicalIF":5.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080857","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}
引用次数: 0
Cardiovascular Risk Triage Schema for Patients With Prostate Cancer Treated With Hormone Therapy. 前列腺癌激素治疗患者心血管风险分类方案
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-28 DOI: 10.1200/OP-26-00312
Avirup Guha, Ana Barac, Michael James Ryan, Randala Hamdan, Geeta Devgan, Catherine H Marshall, Silke Gillessen, Stacy Loeb, Rana R McKay, Emmanuel S Antonarakis, Zachary Klaassen, Meenakshi Davuluri, Alan H Bryce, Yun Rose Li, Nader El-Chaar, Stephanie Braun, Maha Hussain, Pedro Barata, Martin W Schoen, Cora N Sternberg, Tamara Jamaspishvili, Samuel L Washington, Neal D Shore, David Morris, Jack R Andrews, Irbaz Bin Riaz, Daniel George, Soumyajit Roy, Gina B Carithers, Phillip Koo, Neeraj Agarwal, Andrew W Hahn
{"title":"Cardiovascular Risk Triage Schema for Patients With Prostate Cancer Treated With Hormone Therapy.","authors":"Avirup Guha, Ana Barac, Michael James Ryan, Randala Hamdan, Geeta Devgan, Catherine H Marshall, Silke Gillessen, Stacy Loeb, Rana R McKay, Emmanuel S Antonarakis, Zachary Klaassen, Meenakshi Davuluri, Alan H Bryce, Yun Rose Li, Nader El-Chaar, Stephanie Braun, Maha Hussain, Pedro Barata, Martin W Schoen, Cora N Sternberg, Tamara Jamaspishvili, Samuel L Washington, Neal D Shore, David Morris, Jack R Andrews, Irbaz Bin Riaz, Daniel George, Soumyajit Roy, Gina B Carithers, Phillip Koo, Neeraj Agarwal, Andrew W Hahn","doi":"10.1200/OP-26-00312","DOIUrl":"https://doi.org/10.1200/OP-26-00312","url":null,"abstract":"<p><strong>Importance: </strong>Cardiovascular disease (CVD) is a leading noncancer cause of death among patients with prostate cancer (PC). Population-based risk calculators do not account for treatment-related effects of androgen-deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPis), and they have not been validated across PC treatment states.</p><p><strong>Observations: </strong>This Prostate Cancer Foundation-sponsored clinician-industry consensus and narrative review proposes a pragmatic identification and triage schema for point-of-care use. The schema supports rapid risk capture, tier assignment, and referral or risk-factor optimization triggers; it does not provide cardiovascular therapeutic algorithms. We synthesize evidence on baseline cardiometabolic burden, ADT-associated adiposity and muscle-strength changes, plaque progression, ARPi-associated hypertension and cardiac events, suboptimal real-world risk-factor control, and social-needs barriers. Patients are classified as high risk when they have prior major cardiovascular events or established clinical atherosclerotic CVD; intermediate risk when they have no prior event but at least two uncontrolled or adverse risk factors; and low risk when neither criterion is met. We clarify cutpoints, the rationale for operational thresholding, essential versus optional intake elements, and capacity-sensitive referral pathways.</p><p><strong>Conclusion and relevance: </strong>The proposed three-tier schema should be viewed as a hypothesis-generating checklist for oncology, urology, radiation oncology, primary care, and cardiovascular teams. Prospective validation, workflow testing, calibration of referral thresholds, and inclusion of patient and clinic-staff stakeholders are required before broad implementation.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600312"},"PeriodicalIF":5.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074845","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}
引用次数: 0
Financial Toxicity and Quality of Life After Bone Marrow Transplant: A Longitudinal, Prospective Study. 骨髓移植后的经济毒性和生活质量:一项纵向前瞻性研究。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-23 DOI: 10.1200/OP-26-00421
S M Qasim Hussaini, Supriya Maheshwari, Luqin Deng, Sanghee Hong, Lauren Bohannon, Dinesh Pal Mudaranthakam, Rachel Forcino, Manuel R Espinoza-Gutarra, Andres Azuero, Courtney P Williams, Gabrielle B Rocque, Anthony D Sung
{"title":"Financial Toxicity and Quality of Life After Bone Marrow Transplant: A Longitudinal, Prospective Study.","authors":"S M Qasim Hussaini, Supriya Maheshwari, Luqin Deng, Sanghee Hong, Lauren Bohannon, Dinesh Pal Mudaranthakam, Rachel Forcino, Manuel R Espinoza-Gutarra, Andres Azuero, Courtney P Williams, Gabrielle B Rocque, Anthony D Sung","doi":"10.1200/OP-26-00421","DOIUrl":"https://doi.org/10.1200/OP-26-00421","url":null,"abstract":"<p><strong>Purpose: </strong>Financial toxicity is common after bone marrow transplant (BMT) and is associated with worse quality of life, but longitudinal patterns remain poorly understood.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of insured adults undergoing allogeneic BMT (2018-2023). Financial toxicity (Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy) and quality of life (Functional Assessment of Cancer Therapy [FACT]-General, FACT-BMT) were assessed at baseline and at days (D) 90, 180, and 365. Longitudinal trends were analyzed using mixed-effects models. Relative risks (RR) for financial toxicity and hazard ratios (HR) for post-BMT mortality were estimated using generalized linear mixed-effects and time-varying Cox models.</p><p><strong>Results: </strong>Among 214 transplanted patients, the median age was 58 years (IQR 46-66 year), 62% were male, and 80% were White; 47% had leukemia, 27% myelodysplastic syndrome, and 9% lymphoma; and 31% died by D365. At baseline, 56% reported none/minimal, 26% mild, and 18% moderate/high financial toxicity. Financial toxicity was associated with more cost-cutting behaviors, including reduced spending on food or clothing, use of savings, and prescription nonadherence. Expected probability of ≥mild financial toxicity reduced over time (39% baseline, 34% D90, 30% D180, 26% D365). Across time points, age >65 years and income >$90,000 in US dollars (USD) had 66% and 67% decreased risk of financial toxicity, respectively, compared with counterparts (n = 148, RR, 0.34, 95% CI [0.19 to 0.59]; RR, 0.33 [0.20 to 0.57]). Quality of life (n = 119 alive and with data by D365) with none/minimal or mild financial toxicity improved after transplant compared with baseline but significantly worsened for those with moderate/high financial toxicity over 1 year. Following adjustment for covariables, financial toxicity was not significantly associated with premature death after transplant (n = 214, HR, 1.10 [0.62-1.96]).</p><p><strong>Conclusion: </strong>Financial toxicity improved overtime with BMT, but persistent financial hardship was associated with quality of life. These findings support longitudinal screening and financial interventions across the transplant continuum.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600421"},"PeriodicalIF":5.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030588","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}
引用次数: 0
Personalized Therapy in Advanced Cholangiocarcinoma: Contemporary Treatment Approaches and Future Directions. 晚期胆管癌的个性化治疗:当代治疗方法和未来方向。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-23 DOI: 10.1200/OP-26-00539
Fen Saj, Camila Braganca Xavier, Lipika Goyal, Milind Javle, Shubham Pant
{"title":"Personalized Therapy in Advanced Cholangiocarcinoma: Contemporary Treatment Approaches and Future Directions.","authors":"Fen Saj, Camila Braganca Xavier, Lipika Goyal, Milind Javle, Shubham Pant","doi":"10.1200/OP-26-00539","DOIUrl":"https://doi.org/10.1200/OP-26-00539","url":null,"abstract":"<p><p>Cholangiocarcinoma (CCA) includes a heterogeneous group of malignancies arising from the biliary epithelium, anatomically classified into intrahepatic, perihilar, and distal disease, with subtype-specific molecular features and treatment implications. Intrahepatic CCA is further subclassified into small- and large-duct variants. Most patients present with advanced, unresectable disease, and 5-year survival rates remain poor. For over a decade, gemcitabine-cisplatin (Gem-Cis) combination chemotherapy was the only established first-line standard of care. More recently, the addition of immune checkpoint inhibitors (IO), durvalumab and pembrolizumab, to Gem-Cis in the TOPAZ-1 and KEYNOTE-966 trials, respectively, improved overall survival, establishing chemoimmunotherapy as the new first-line therapy. Given the high prevalence of actionable alterations in CCA, comprehensive molecular profiling has become indispensable for second-line treatment selection and front-line clinical trial eligibility. <i>FGFR2</i> fusions, <i>IDH1</i> mutations, and <i>HER2</i> amplification are among the most relevant, with several targeted agents now available in the second-line setting. Despite this progress, most patients exhaust treatment options within the first year, highlighting the need for further therapeutic advances. Emerging strategies include novel targeted agents, antibody-drug conjugates, locoregional approaches for liver-limited disease, and circulating tumor DNA monitoring for real-time treatment adaptation. The immunosuppressive tumor microenvironment and the absence of reliable predictive biomarkers for IO response remain key challenges that ongoing research aims to address. This review summarizes current evidence for the management of advanced CCA, focusing on molecular profiling, treatment sequencing, and emerging therapies.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600539"},"PeriodicalIF":5.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030622","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}
引用次数: 0
Missed Precision: Gaps in Molecular Profiling Among Medicaid Patients With Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer. 精确性缺失:雌激素受体阳性,人表皮生长因子受体2阴性的乳腺癌医疗补助患者分子谱的差距。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-22 DOI: 10.1200/OP-26-00255
Trisha Lal, Long Vu, Reine Abou Zeidane, Courtney Pisano, Jamie Shoag, Richard S Hoehn, Siran M Koroukian, Johnie Rose, Corey Speers
{"title":"Missed Precision: Gaps in Molecular Profiling Among Medicaid Patients With Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer.","authors":"Trisha Lal, Long Vu, Reine Abou Zeidane, Courtney Pisano, Jamie Shoag, Richard S Hoehn, Siran M Koroukian, Johnie Rose, Corey Speers","doi":"10.1200/OP-26-00255","DOIUrl":"https://doi.org/10.1200/OP-26-00255","url":null,"abstract":"<p><strong>Purpose: </strong>Molecular profiling (MP) informs precision oncology in estrogen receptor-positive, human epidermal growth factor receptor 2-negative (ER+/HER2-) breast cancer, yet uptake within Medicaid is poorly characterized. We assessed MP receipt and associated factors among Ohio Medicaid beneficiaries with nonmetastatic ER+/HER2- breast cancer.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using linked Ohio Cancer Incidence Surveillance System and Medicaid claims data. Study patients were age 18-65 years, diagnosed between 2016 and 2020 with localized or regional-stage ER+/HER2- breast cancer, and continuously enrolled in Medicaid for ≥6 months following diagnosis or until death. The primary outcome was MP (Oncotype DX or MammaPrint) within 6 months of diagnosis. Multivariable logistic regression estimated adjusted odds ratios (aORs) for MP by stage, sociodemographics, Medicaid enrollment features (stable enrollment, long-term care [LTC] status), and neighborhood opportunity (Ohio Opportunity Index [OOI]).</p><p><strong>Results: </strong>Among 1,988 patients, 752 (37.8%) received MP. In adjusted analyses, MP receipt was lower in regional versus localized disease (aOR, 0.35, 95% CI, 0.28 to 0.42), among Black versus White women (aOR, 0.72, 95% CI, 0.56 to 0.91), among patients with income above versus below the federal poverty level (aOR, 0.73, 95% CI, 0.57 to 0.94), and among Medicaid LTC enrollees versus nonenrollees (aOR, 0.47, 95% CI, 0.33 to 0.66). MP receipt was higher among married versus single patients (aOR, 1.30, 95% CI, 1.01 to 1.67). Stable Medicaid enrollment showed a positive trend (aOR, 1.24, 95% CI, 0.98 to 1.58). OOI was not associated with MP.</p><p><strong>Conclusion: </strong>Fewer than 40% of Ohio Medicaid beneficiaries with localized or regional-stage ER+/HER2- breast cancer received MP, with variation by clinical stage and sociodemographic factors. As Medicaid programs face fiscal and policy pressures, health systems should prioritize consistent implementation of clinically indicated MP, particularly among patients with regional-stage disease, Black patients, and long-term Medicaid enrollees.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2600255"},"PeriodicalIF":5.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024810","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}
引用次数: 0
How Do I Treat the Very Elderly With Advanced Bladder Cancer as We Have so Many New Agents? 我们有这么多新药,我该如何治疗高龄晚期膀胱癌?
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-22 DOI: 10.1200/OP-26-01009
Ian D Davis
{"title":"How Do I Treat the Very Elderly With Advanced Bladder Cancer as We Have so Many New Agents?","authors":"Ian D Davis","doi":"10.1200/OP-26-01009","DOIUrl":"https://doi.org/10.1200/OP-26-01009","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2601009"},"PeriodicalIF":5.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024833","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}
引用次数: 0
Erratum: Multidisciplinary Management of Esophageal Cancer. 勘误:食管癌的多学科管理。
IF 5.5 3区 医学
JCO oncology practice Pub Date : 2026-09-21 DOI: 10.1200/OP-26-01205
Anas M Barabrah, Cindy M Pabon, William Jin, Wayne Hofstetter, Kyle G Mitchell, Nathaniel Deboever, Jenny Li, Mariela A Blum Murphy
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