JCO oncology practice最新文献

{"title":"Randomized Trial of Enhanced Versus Standard Navigation to Promote Timely Initiation of Adjuvant Radiotherapy for Head and Neck Cancer.","authors":"Evan M Graboyes, Reid DeMass, Katherine R Sterba, Bhisham S Chera, Emily Kistner-Griffin, Elizabeth G Hill, Jessica McCay, Jason G Newman, W Greer Albergotti, Alex E Kejner, Judith M Skoner, Jennifer L Harper, John Kaczmar, Byung Joo Lee, Savannah A Zimmerman, Graham W Warren, Anthony J Alberg, Elizabeth A Calhoun, Brian Nussenbaum, Chanita Hughes Halbert","doi":"10.1200/OP-24-00901","DOIUrl":"10.1200/OP-24-00901","url":null,"abstract":"<p><strong>Purpose: </strong>National Comprehensive Cancer Network Guidelines recommend initiating postoperative radiation therapy (PORT) within 6 weeks of surgery for patients with head and neck squamous cell carcinoma (HNSCC), but delays affect 50% of patients, disproportionately burden minoritized groups, and contribute to worse oncologic outcomes. This trial evaluates the efficacy of Navigation for Disparities and Untimely Radiation thErapy (NDURE), an enhanced navigation-based intervention, relative to usual care (UC) patient navigation for starting timely PORT.</p><p><strong>Methods: </strong>Adults with locally advanced HNSCC planning to undergo surgery and PORT were randomly assigned 1:1 to standard multidisciplinary head and neck oncology care and either NDURE, a multilevel navigation-based intervention to enhance key processes of care and overcome barriers to timely PORT, or UC, which consisted of standard patient navigation. The primary end point, initiation of timely PORT, defined as ≤6 weeks after surgery, was evaluated using a generalized linear model binary regression with identity link, adjusting for random assignment stratification variables (race, predicted PORT location). Secondary end points were time to PORT (TTP) and treatment package time (TPT; the time from surgery to PORT completion).</p><p><strong>Results: </strong>Among 176 eligible patients randomly assigned to NDURE (n = 88) or UC (n = 88), 145 (NDURE, n = 67; UC, n = 78) underwent surgery, had a pathologic indication for PORT, and were evaluable for the primary end point. NDURE improved initiation of timely PORT relative to UC (model-based initiation of timely PORT, 74% <i>v</i> 39%; risk difference, 35% [90% CI, 23 to 48]). NDURE increased the rate of PORT initiation (TTP hazard ratio [HR], 1.82 [90% CI, 1.32 to 2.50]) and treatment package completion (TPT HR, 1.67 [90% CI, 1.22 to 2.29]) relative to UC.</p><p><strong>Conclusion: </strong>In this randomized clinical trial of patients with HNSCC undergoing surgery and PORT, NDURE improved initiation of timely PORT, TTP, and TPT.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1153-1164"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575495","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":"If We Build It, Why They Do Not Come? An American College of Surgeons National Quality Improvement Collaborative to Understand Barriers to Completion of Cancer Treatment.","authors":"Lauren M Janczewski, Anthony D Yang, Eileen Reilly, Kelley Chan, Tashae Coates, Shayla Scarlett, Susan Hedlund, Rebecca A Snyder, Bruce Haffty, Charles Shelton, Laurie J Kirstein","doi":"10.1200/OP-24-00745","DOIUrl":"10.1200/OP-24-00745","url":null,"abstract":"<p><strong>Purpose: </strong>Many patients face barriers to cancer care, leading to disparities in cancer-specific outcomes. Specifically, missing multiple radiation treatments can be associated with increased locoregional recurrence. We sought to assess the frequency and reasons for missed radiotherapy among accredited cancer programs participating in a national quality improvement (QI) collaborative addressing barriers to care.</p><p><strong>Methods: </strong>The Breaking Barriers National QI Collaborative conducted through the American College of Surgeons Cancer Programs enrolled 342 accredited cancer programs, prospectively recording patients scheduled for a 15-45-day course of radiotherapy over five separate, 60-day data collection periods (March-December 2023). Programs identified those who missed ≥three treatments, referred to as at risk of worse outcomes, and queried reasons for missed radiotherapy. Kruskal-Wallis tests assessed differences in rates of missed treatments.</p><p><strong>Results: </strong>In total, 332 programs (97.1%) identified at-risk patients, totaling 5,221 patients who missed ≥three treatments. The median percentage of at-risk patients per program was 9.4% (IQR, 4.5-16.5). Programs located in the Northeast (median, 11.3% [IQR, 5.4-17.3]) had the highest proportion of at-risk patients (<i>P</i> = .014). Patients with rectal (13.0%) and gynecologic (11.4%) cancers were most frequently at risk (<i>P</i> < .001). Overall, 91.0% of hospitals reported missed radiation treatments due to illness unrelated to treatment, 71.7% due to transportation, 54.2% due to conflicting appointments, and 53.0% due to no longer wishing to pursue treatment.</p><p><strong>Conclusion: </strong>Barriers to completing radiotherapy are prevalent among accredited cancer programs nationwide. Future work developing interventions in response to identified barriers in this national QI collaborative may be scalable to other areas of cancer care to improve outcomes.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1185-1192"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Overcoming Barriers to Cancer-Associated Cachexia Diagnosis and Management.","authors":"Marcus D Goncalves, Tobias Janowitz","doi":"10.1200/OP-25-00108","DOIUrl":"10.1200/OP-25-00108","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1213-1214"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming Barriers to Cancer-Associated Cachexia Diagnosis and Management.","authors":"Alessio Molfino, Giovanni Imbimbo","doi":"10.1200/OP-25-00060","DOIUrl":"10.1200/OP-25-00060","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1212-1213"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Supportive Care Interventions to Enhance Surgical Outcomes for Older Adults With Cancer: A Systematic Review.","authors":"Anh B Lam, Luke Sorensen, Vanessa A Moore, Max J Bouvette, Adolfo Diaz Barba, Shari Clifton, Andrea Wismann, Katie Keyser, Myrick C Shinall, Ryan David Nipp","doi":"10.1200/OP-24-00762","DOIUrl":"10.1200/OP-24-00762","url":null,"abstract":"<p><strong>Purpose: </strong>Older adults with cancer have unique needs, which likely influence surgical outcomes in the geriatric oncology population. We conducted a systematic review to describe the literature focused on perioperative supportive care interventions for older adults with cancer undergoing surgery.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a comprehensive search using the Ovid MEDLINE, CINAHL, and Embase databases for literature published from January 2010 to October 2023. We included randomized controlled trials (RCTs) focusing on supportive care interventions that enrolled adults older than 60 years with cancer.</p><p><strong>Results: </strong>We included 11 RCTs with 2,177 patients in this review. Patients' age ranged from 60 to 95, and the median number of patients per study was 147 (range, 44-690). Most studies included patients with colorectal cancer (81.8%). Half of the studies (54.5%) evaluated exercise interventions, and the remaining assessed geriatric assessment-guided interventions (27.2%), nutrition optimization (9.1%), and patient empowerment (9.1%). Primary outcomes included postoperative complications, quality of life, feasibility of exercise programs, inspiratory muscle endurance, and hospital length of stay, among others. All studies had postoperative complications as a primary or secondary outcome. We found implementation challenges that influenced several studies, including high dropout rates and intervention fidelity.</p><p><strong>Conclusion: </strong>We found 11 studies focused on perioperative supportive care interventions in older adults with cancer undergoing surgery. Notably, interventions involved exercise, geriatric assessment-guided care, nutrition optimization, and patient empowerment. We also found heterogeneity in intervention modality and outcome assessment, thus demonstrating a need for ongoing work to address the unique needs of the geriatric oncology population.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1106-1117"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032685","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":"Inpatient Immunotherapy Outcomes Study: A Multicenter Retrospective Analysis.","authors":"Fauzia Riaz, John L Vaughn, Huili Zhu, James C Dickerson, Hoda E Sayegh, Samantha Brongiel, Elena Baldwin, Melanie W Kier, Jacob Zaemes, Caleb Hearn, Osama Abdelghany, Roger B Cohen, Ravi B Parikh, Joshua E Reuss, Elizabeth Prsic, Deborah B Doroshow","doi":"10.1200/OP-24-00788","DOIUrl":"10.1200/OP-24-00788","url":null,"abstract":"<p><strong>Purpose: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized the care of patients with cancer, but use among hospitalized patients is controversial as a result of questionable benefit and high costs. To evaluate the role of ICIs in the inpatient (IP) setting, we conducted the Inpatient Immunotherapy Outcomes Study (IIOS) to describe characteristics and outcomes of patients who received IP ICIs.</p><p><strong>Methods: </strong>IIOS is a retrospective study of patients treated with ICIs during hospitalization between 2012 and 2021 at five academic institutions. Data collection was performed using each institution's electronic medical record. We estimated overall survival (OS) from the first administration of ICI using the Kaplan-Meier method and used adjusted Cox proportional hazards models to explore associations between clinicodemographic variables and OS.</p><p><strong>Results: </strong>Two hundred fifteen patients received IP ICIs (median age 60 years; 55% White; 14% Black; 13% Hispanic). Thoracic and head and neck (24%), GI (21%), and hematologic (19%) malignancies were most common. Most of the patients were ICI-naïve (75%), had stage IV solid malignancies (75%) at the time of IP ICI initiation, and had no radiographic response to ICI therapy (88%). Median OS from the first IP ICI dose was 1.55 months (95% CI, 1.08 to 1.81) for all patients and 1.28 months (95% CI, 0.95 to 1.80) for patients with advanced solid malignancies. Multivariable Cox proportional hazards model analysis found no clinicodemographic variables associated with improved OS after IP ICI administration.</p><p><strong>Conclusion: </strong>IIOS is the largest multi-institutional effort to describe outcomes after IP ICI administration. Clinical outcomes are poor after IP ICI use and IP ICIs should be used with caution.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1165-1173"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407880","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":"Call to Action for Treatment of Food Insecurity: A Vital Element of Equitable Cancer Care.","authors":"Francesca M Gany","doi":"10.1200/OP-25-00092","DOIUrl":"10.1200/OP-25-00092","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1053-1056"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669851","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 Patient-Reported Outcome Measure Implementation: Challenges and Successes of a Pan-Canadian Initiative to Improve the Future of Patient-Centered Cancer Care.","authors":"Sylvie Lambert, Michael McKenzie, Andrea C Coronado, Amanda Caissie, Linda Tracey, Linda Watson, Andrea Deiure, Raquel Shaw-Moxam, Jean Ann Ryan, Marianne Arab, Bryan Jorgensen, Ashley Crump, Lisa Rayner, Mireille Lecours, Peter Shaw Howatt","doi":"10.1200/OP-24-00551","DOIUrl":"10.1200/OP-24-00551","url":null,"abstract":"<p><strong>Purpose: </strong>Implementation of patient-reported outcome measures (PROMs) in routine care continues to be limited, despite their demonstrated efficacy and substantial investments. We report on the lessons learned and the challenges of the concerted implementation of the same PROMs across teams in nine provinces/territories (jurisdictions) in Canada, as well as the solutions to move implementation forward despite cost containments and the COVID-19 pandemic.</p><p><strong>Methods: </strong>Each team from nine jurisdictions submitted a final report describing their PROM implementation project. Reports were analyzed for themes on lessons learned, challenges, and solutions. Themes were compared for similarities and differences. The Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines were used.</p><p><strong>Results: </strong>Six key lessons learned were identified from eight challenges. To address these challenges, 27 solutions were used. The six lessons learned were as follows: Harness the power of change management, ensure consistent stakeholder engagement at all levels for success, establish buy-in as soon as possible, plan to maintain buy-in through changing circumstances, identify ways to make technology the solution, and optimal implementation includes a sustainability plan. Examples of solutions included the following: develop a multipronged, multilevel communication plan; include change management experts on the team; identify champions; restructure and reprioritize as needed; leverage existing technology; and leave a permanent trace of the project.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first analysis to synthesize lessons learned from real-world PROM implementation across geographically diverse jurisdictions. We identified generalizable solutions that other health care managers and policymakers can use to accelerate PROM implementation, despite pervasive implementation barriers. Future studies can integrate these solutions with methods and tools from implementation science (eg, theoretical frameworks, implementation strategies) for more successful spread and scale of PROMs.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1087-1096"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416778","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":"Role of Oncology in the Centers for Medicare & Medicaid Services Innovation Center's Comprehensive Specialty Strategy.","authors":"Alexandra Chong, Batsheva Honig, Elizabeth Fowler, Purva Rawal, Sarah Fogler, Kate Blackwell","doi":"10.1200/OP-24-00746","DOIUrl":"10.1200/OP-24-00746","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1079-1083"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948997","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":"Oral Immune-Related Adverse Events Secondary to Immune Checkpoint Inhibitors: Call to Action.","authors":"Alessandro Villa, Bryan J Schneider, Christina Lacchetti, Thomas K Oliver, Douglas E Peterson","doi":"10.1200/OP-24-00812","DOIUrl":"10.1200/OP-24-00812","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1073-1078"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467971","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}