JCO Global Oncology最新文献

{"title":"Comprehensive Genomic Profiling of Indian Patients With Lung Cancer.","authors":"Shivani Sharma, Vanita Noronha, Arti Yadav, Madhvi Mandhania, Sambit K Mohanty, Rahul Katara, Aditi Aggarwal, Sagar Samrat Mohanty, Akash Kumar, Sanjeev Kumar, Vipin Kumar, Kanika Jaggi, Deepak Kumar Sharma, Sanjay Kumar, Vaishalee Apoorva, Akash Pawar, Nandini Menon, Minit Shah, Kumar Prabhash","doi":"10.1200/GO-24-00587","DOIUrl":"https://doi.org/10.1200/GO-24-00587","url":null,"abstract":"<p><strong>Purpose: </strong>Genomic profiling has revolutionized non-small cell lung cancer (NSCLC) therapy, but molecular data on Indian patients with NSCLC are limited.</p><p><strong>Materials and methods: </strong>We analyzed next-generation sequencing (NGS) data of 5,219 Indian patients with lung cancer, tested between May 2022 and August 2023 at CORE Diagnostics, a commercial laboratory in India. Using the PulmoCORE gene panel, we targeted 13 key genes (<i>ALK</i>, <i>BRAF</i>, <i>EGFR</i>, <i>ERBB2</i>, <i>KRAS</i>, <i>MAP2K1</i>, <i>MET</i>, <i>NRAS</i>, <i>PIK3CA</i>, <i>RET</i>, <i>ROS1</i>, <i>TP53</i>, and <i>NTRK</i>) for DNA and RNA sequencing. PD-L1 was tested by immunohistochemistry.</p><p><strong>Results: </strong>Median patient age was 62 years, and 62.5% were male. Common histologies included adenocarcinoma (57.1%), NSCLC not otherwise specified (19.3%), and squamous cell carcinoma (7%). Genomic alterations were detected in 80.6% patients according to the PulmoCORE panel; 64.2% patients had actionable alterations in at least one of the nine biomarkers with Food and Drug Administration-approved targeted therapies, that is, <i>EGFR</i>, <i>KRAS</i>, <i>ALK</i>, <i>ROS1</i>, <i>BRAF</i>, <i>NTRK1/2/3</i>, <i>MET</i>, <i>RET</i>, and <i>ERBB2</i>. Common alterations included <i>TP53</i> (37%), <i>EGFR</i> (34.1%), and <i>KRAS</i> (13.3%), <i>ALK</i> (8.8%), and others below 5%. Alterations were more common in adenocarcinoma (76.4%) than in patients with squamous cell carcinoma (29.9%). Sex and age influenced mutation prevalence, with <i>EGFR</i> mutations more common in females and <i>KRAS</i> in males, while <i>ALK</i>, <i>ROS1</i>, and <i>RET</i> fusions were prevalent in younger adults. Most genomic alterations were mutually exclusive, although 25% patients had co-occurring mutations. PD-L1 positivity was higher in males (28.3%) and more common in patients with squamous cell carcinoma (34.2%).</p><p><strong>Conclusion: </strong>Broad molecular profiling is important to detect actionable alterations in Indian patients with lung cancer, for delivering optimal personalized precision medicine. Our study underscores the fact that NGS should be routinely done before planning therapy in Indian patients with advanced lung cancer.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400587"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a Symptomatic Screening Program for Early Detection of Gastric Cancer in Roatán, Honduras.","authors":"Jade Tso, Susana Galeas, Brendalee Martinez, Kallie Vallecillo, Mustafa Faleh Abidalhassan, Natan Webster, Heidy Leiva, Mustafa Al-Qaraghli, Cameron Gaskill","doi":"10.1200/GO-24-00574","DOIUrl":"https://doi.org/10.1200/GO-24-00574","url":null,"abstract":"<p><strong>Purpose: </strong>Gastric cancer (GC) is a leading cause of cancer-related death in Central America, with late-stage diagnosis common because of nonspecific early symptoms. Symptomatic screening guidelines validated in high-income settings have been used to identify patients requiring urgent referral for upper GI endoscopy.</p><p><strong>Methods: </strong>This tool was piloted to assess feasibility for early detection of GC at a primary care clinic in Roatán, Honduras. If positive, a referral to endoscopy was placed, and patients contacted monthly for up to 4 months to collect information on demographics, GC risk factors, barriers to receiving endoscopy, and if they received an endoscopy. Provider questionnaires assessed endoscopy capacity and perceived patient barriers.</p><p><strong>Results: </strong>Five hundred patients were screened over 12 months. Nine screened positive, with seven clinically relevant to GC. Of these, four (57%) were female, average age was 49 years (IQR, 18), average number of years lived in Roatán was 29 (IQR, 34), and hypertension (57%) and hyperlipidemia (29%) were the most reported comorbidities. Two (29%) had a family history of cancer, four (57%) had a previous H. pylori infection, six (71%) took medication for acid reflux, and four (57%) had dietary risk factors for GC. All patients cited cost as a barrier to care, while two (29%) each reported difficulty traveling to a facility, lack of knowledge on which facilities did endoscopy, and uncertainty of whether they needed the procedure as other barriers.</p><p><strong>Conclusion: </strong>Although symptomatic screening guidelines are feasible for screening GC in Honduras, limitations in endoscopy access and capacity pose barriers to early diagnosis. These findings highlight the need to increase diagnostic capacity and address financial barriers to endoscopy.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400574"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thirty-Year Trends (1991-2020) in Breast Cancer Incidence Rates: Hanoi, Vietnam.","authors":"Giang Nguyen Huong, Hoa L Nguyen, Robert J Goldberg, Mara M Epstein, Jeroan J Allison, Loc Quang Pham, Le Minh Giang, Sang Minh Nguyen, Ngoc Dac Nguyen, Linh Thi Thuy Nguyen, Quang Le Van, Thuan Tran Van, Tran Thanh Huong","doi":"10.1200/GO-24-00570","DOIUrl":"https://doi.org/10.1200/GO-24-00570","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer is the most common cancer in Vietnam, yet there are limited data on long-term trends and factors influencing its incidence. This study examines 30-year trends (1991-2020) in breast cancer incidence among women in Hanoi, focusing on age, period, and cohort effects.</p><p><strong>Methods: </strong>Data from 28,298 breast cancer cases registered in the Hanoi Cancer Registry between 1991 and 2020 were analyzed. Trend analysis using Joinpoint regression was performed to calculate the average annual percent change (AAPC) in incidence rates, and an age-period-cohort analysis was used to explore underlying trends.</p><p><strong>Results: </strong>The age-standardized incidence rate of breast cancer rose from 15.2 per 100,000 in 1991 to 40.6 per 100,000 in 2020, with an overall AAPC of 4.1% (95% CI, 2.9 to 5.4). Women age 70 years and older experienced the highest increase (AAPC, 6.4% [95% CI, 2.5 to 10.4]) compared with those age 40-49 years (AAPC, 2.6% [95% CI, 2.1 to 3.1]). Incidence rates during 2016-2020 were 1.6 times higher than in 2001-2005. Women born between 1976 and 1980 exhibited significantly higher incidence rates compared with earlier cohorts.</p><p><strong>Conclusion: </strong>Breast cancer incidence in Hanoi has more than doubled over three decades, with significant age, period, and cohort effects. These findings provide insights for the development of targeted breast cancer control strategies, including tailored screening, prevention efforts, and resource allocation to address the growing burden of this disease in Vietnam.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400570"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Outcomes of Combination Anthracycline and Taxane Adjuvant Therapies in Early Triple-Negative Breast Cancer: A Moroccan Retrospective Analysis.","authors":"Hassan Abdelilah Tafenzi, Farah Choulli, Ismail Essaadi, Rhizlane Belbaraka","doi":"10.1200/GO-24-00650","DOIUrl":"https://doi.org/10.1200/GO-24-00650","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant chemoimmunotherapy followed by adjuvant immunotherapy is the gold standard for treating patients with higher risk early triple-negative breast cancer (TNBC); however, in some cases, these patients undergo surgery followed by chemotherapy-based anthracyclines and taxanes without adhering to the guidelines.</p><p><strong>Methods: </strong>Patients with previously untreated stage I, II, and III TNBC who received adjuvant therapy with either doxorubicin and cyclophosphamide (AC) + docetaxel (AC-D), AC + weekly paclitaxel (AC-WP), epirubicin and cyclophosphamide (EC) + docetaxel (EC-D), or EC + WP (EC-WP); older than 18 years; and diagnosed between January 1st, 2011, and December 31st, 2022, were eligible for the study. Disease-free survival (DFS) is the primary reported end point. Overall survival (OS) and safety were the secondary end points.</p><p><strong>Results: </strong>We included 272 female patients. At a prespecified event-driven data cutoff, with a median follow-up of 26.3 months, the 5-year DFS was 49% (95% CI, 38 to 63) in the AC-D group, 45% (95% CI, 29 to 70) in the AC-WP group, 73% (95% CI, 61 to 100) in the EC-D group, and 72% (95% CI, 44 to 100) in the EC-WP group (hazard ratio [HR], 0.2 [95% CI, 0.06 to 0.67]; <i>P</i> = .08). The 7-year OS was 52% (95% CI, 32 to 83) in the AC-D group, 88% (95% CI, 78 to 99) in the AC-WP group, 95% (95% CI, 88 to 100) in the EC-D group, and 83% (95% CI, 58 to 100) in the EC-WP group (HR, 0.19 [95% CI, 0.06 to 0.66]; <i>P</i> = .03). Most of the grade 3-4 adverse events occurred in the AC-D group, primarily neutropenia, nausea-vomiting, and alopecia.</p><p><strong>Conclusion: </strong>EC-D was linked to a slightly longer survival free of invasive, noninvasive, or distant disease and a significantly longer OS with fewer adverse events. Further studies are needed to confirm and establish long-term clinical benefits.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400650"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Characterization of Papillary Thyroid Cancer Reveals Germline Mutations Associated With Congenital Hypothyroidism.","authors":"Vaishakhi Trivedi, Hitesh Kore, Disha Poojary, Vanita Noronha, Munita Bal, Pratik Chandrani, Anuradha Choughule, Priyanka Pange, Vinod Gupta, Nandini Menon, Vijay Patil, Minit Shah, Pankaj Chaturvedi, Kumar Prabhash, Amit Dutt","doi":"10.1200/GO-25-00043","DOIUrl":"https://doi.org/10.1200/GO-25-00043","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid dyshormonogenesis, a form of congenital hypothyroidism, is characterized by defects in thyroid hormone synthesis genes, affecting both children and adults. However, the potential link between such genetic defects and the development of papillary thyroid cancer (PTC) remains unclear.</p><p><strong>Methods: </strong>We conducted whole-exome sequencing on 100 (N = 100) tumor-normal paired and orphan tumor samples of PTC from Indian patients, characterizing both germline and somatic molecular alterations.</p><p><strong>Results: </strong>We identified significant germline mutations in the <i>DUOX2</i> gene (approximately 8.8%), commonly associated with congenital hypothyroidism and thyroid dyshormonogenesis, and found these mutations to correlate with poor prognosis in PTC. Additionally, hallmark somatic mutations were detected in genes such as <i>BRAF</i> (35.4%), <i>KRAS</i> (3.8%), <i>HRAS</i> (5.1%), and <i>NRAS</i> (17.7%), which are well-known drivers of PTC. Importantly, we identified a distinct molecular subtype termed independent of BRAF-RAS (iBR), characterized by nonhallmark alterations and associated with a higher recurrence rate and poorer recurrence-free survival in Indian patients with PTC, highlighting the clinical significance of these molecular insights in prognosis and treatment strategies.</p><p><strong>Conclusion: </strong>Our analysis of PTC among Indians revealed novel genetic alterations and molecular subtypes. We identified a germline mutation in the <i>DUOX2</i> gene, associated with congenital hypothyroidism, as a potential risk factor of PTC. Additionally, we characterized distinct molecular subtypes, <i>BRAF-RAS</i> driven and iBR driven, and their clinical implications. These findings provide valuable insights into the genetic landscape of thyroid cancer in Indian patients and offer potential avenues for targeted therapies.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500043"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Global Enrollment on Race, Ethnicity, and Age Representation in Pivotal Gynecologic Cancer Trials Leading to US Food and Drug Administration Drug Approvals.","authors":"Maheen H Khan, Kristen R Ibanez, Courtney Bowen, Duncan Donohue, Ann Oluloro, Elizabeth M Swisher, Jung-Min Lee","doi":"10.1200/GO-24-00636","DOIUrl":"https://doi.org/10.1200/GO-24-00636","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of international enrollment in landmark gynecologic cancer (Gyn-Ca) trials that supported the US Food and Drug Administration (FDA) drug approvals.</p><p><strong>Methods: </strong>We examined the FDA drug approval database for approved Gyn-Ca agents between January 2014 and June 2024. We then extracted clinical trial identifiers supporting these approvals using FDA safety labels. Expected enrollment was calculated using gynecologic disease site incidence data from the US Cancer Statistics Program and compared with actual trial enrollment reported on ClinicalTrials.gov.</p><p><strong>Results: </strong>From 2014 to 2024, 30 Gyn-Ca trials supporting 28 FDA approvals were conducted in US/international (86.7%), international-only (10%), and US-only sites (3.3%) and enrolled 15,294 patients, with 14,053 remaining (74.0% White, 4.1% Black, 12.7% Asian, 8.7% other) after screening for trials not reporting race. Black (-11.0%; <i>P</i> < .0001), Hispanic/Latino (-3.5%; <i>P</i> < .0001), and elderly (-12.6%; <i>P</i> < .0001) participants were under-represented, whereas Asians (+6.8%; <i>P</i> < .0001) were over-represented. Asian (18.3% <i>v</i> 3.5% in trials with or without East Asian sites; odds ratio [OR], 6.19 [95% CI, 5.29 to 7.25]; <i>P</i> < .0001) and Hispanic/Latino (18.6% <i>v</i> 4.6% in trials with or without South American sites; OR, 4.75 [95% CI, 4.00 to 5.63]; <i>P</i> < .0001) enrollment was higher in trials that included East Asian and South American sites, respectively. Black enrollment did not improve despite trials including recruitment in Africa (3.2% <i>v</i> 4.1% Black enrollment in trials with or without African sites; OR, 0.83 [95% CI, 0.38 to 1.83]; <i>P</i> = .53).</p><p><strong>Conclusion: </strong>Black, Hispanic/Latino, and elderly patients were under-represented in pivotal Gyn-Ca trials, whereas Asian patients were over-represented, compared with expected enrollment proportions. Postmarketing studies on under-represented groups should be considered to assess drug efficacy and safety in these populations.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400636"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on Cervical Cancer Treatment Delays in Botswana.","authors":"Surbhi Grover, Gauthami G Moorkanat, Rebecca Ketlametswe, Barati Monare, Priya Puri, Alexander Seiphetlheng, Gaobakwe Ramontshonyana, Tara M Friebel-Klingner, Rohini Bhatia, Memory Bvochora-Nsingo, Sebathu Chiyapo, Lisa Bazzett-Matabele, Peter Vuylsteke, Katharine A Rendle","doi":"10.1200/GO-24-00300","DOIUrl":"https://doi.org/10.1200/GO-24-00300","url":null,"abstract":"<p><strong>Purpose: </strong>Although the majority of cervical cancer cases are in sub-Saharan Africa, little is known regarding how the COVID-19 pandemic affected cancer care in this context. Drawing from robust longitudinal data, this study aimed to assess cervical cancer treatment patterns in Botswana before and during the pandemic.</p><p><strong>Methods: </strong>Longitudinal clinical and patient-reported data from a cohort of over 1,000 patients seen at a gynecologic oncology multidisciplinary team clinic in Botswana were used to evaluate treatment initiation patterns before (April 2018-December 2019) and during (April 2020-December 2021) the pandemic. The primary outcome was timeliness of treatment, defined as the number of days between the patient's first clinic visit and treatment initiation date, and categorized as timely (≤30 days), delayed (>30 days), or no treatment. The primary exposure was time of visit (pre-COVID-19 <i>v</i> COVID-19), defined by the month of the clinic visit.</p><p><strong>Results: </strong>Of the 559 patients with cervical cancer diagnosed during the study period, 336 were seen pre-COVID-19, and 223 were seen during the COVID-19 period. During the pandemic, a higher proportion of patients experienced treatment delays (66.4%) or received no treatment (24.2%), compared with the pre-COVID-19 period (35.7% and 9.8%, respectively; <i>P</i> < .001). Multivariable regression models indicated that patients seen during the pandemic were 10 times more likely to experience treatment delays (adjusted odds ratio [aOR], 10.01 [95% CI, 5.69 to 17.62]) and 14 times more likely to receive no treatment (aOR, 14.16 [95% CI, 7.14 to 28.10]).</p><p><strong>Conclusion: </strong>The pandemic exacerbated treatment delays for patients with cervical cancer in Botswana. There is a need for evidence-based strategies to address these treatment delays, considering the disproportionate burden of disease and persistent disparities in access to care in Botswana and other low- and middle-income countries.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400300"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights Into Cancer Awareness and Health Practices in Rural Kenya: A Cross-Sectional Study of Esophageal, Breast, Prostate, Cervical, and Colorectal Cancers.","authors":"Rosebella Iseme-Ondiek, Joseph Abuodha, Anthony Ngugi, Innocent Abayo, Mansoor Saleh","doi":"10.1200/GO-24-00421","DOIUrl":"https://doi.org/10.1200/GO-24-00421","url":null,"abstract":"<p><strong>Purpose: </strong>In sub-Saharan Africa (SSA), there has been an epidemiologic transition from infectious diseases to noncommunicable diseases, including a projected doubling in incidence of cancer. Understanding the underlying factors driving this surge is crucial for designing effective strategies to mitigate the cancer burden. This study focuses on assessing knowledge, attitudes, screening practices, and health behaviors related to five most prevalent cancers in SSA: prostate, breast, cervical, esophageal, and colorectal-among a predominantly rural coastal population in Kenya.</p><p><strong>Materials and methods: </strong>We used a cross-sectional study design targeting 1,500 adult respondents randomly selected from an existing community health and demographic surveillance system. Face-to-face interviewer-administered questionnaires were used to collect data.</p><p><strong>Results: </strong>One thousand four hundred fifty-two adults participated in the final survey. Breast cancer awareness was highest (69.1%), while awareness of colorectal cancer was lowest (34.6%). Given a list of possible risk factors and symptoms, most respondents (>50%) could only recognize one to two per cancer type. Perceptions of survival from colorectal cancer were particularly pessimistic, with <70% recognizing early detection as a means to improve survival outcomes. In terms of cancer-associated risk factors, more men engaged in tobacco and alcohol use (20.5% and 22.4%, respectively). Additionally, fewer than 10% of eligible participants had ever undergone cancer screening.</p><p><strong>Conclusion: </strong>This study addresses a gap in population-level Knowledge, Attitudes, and Practices studies in rural SSA, offering insights crucial for cancer prevention, early detection, and treatment. The low awareness and knowledge levels and unhealthy behaviors emphasize a need for targeted educational campaigns at community level and enhanced understanding of barriers to uptake of screening if we are to effectively combat the growing cancer burden in this region.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400421"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Breast Cancer Diagnosis and Management in Ghana per the Global Breast Cancer Initiative Key Performance Indicators.","authors":"Samuel Mensah, Ishmael Kyei, Kwabena Agbedinu, Joshua Shiako, Dennis Afful Yorke, Adam Gyedu","doi":"10.1200/GO-24-00653","DOIUrl":"https://doi.org/10.1200/GO-24-00653","url":null,"abstract":"<p><strong>Purpose: </strong>The WHO's Global Breast Cancer Initiative (GBCI) described three key performance indicators (KPIs) to reduce breast cancer deaths worldwide. We assessed the management of breast cancer in Ghana against the GBCI KPIs to inform necessary steps for system-wide improvement.</p><p><strong>Methods: </strong>We reviewed patients diagnosed with breast cancer in 2021 calendar year at Ghana's second largest tertiary hospital. Relevant data were extracted from the electronic medical records to determine the stage of breast cancer at diagnosis, duration to confirm diagnosis from initial presentation, and proportion of patients completing recommended treatment without abandonment. Data were presented as descriptive statistics and compared with GBCI KPI benchmarks.</p><p><strong>Results: </strong>Of 319 patients undergoing biopsy of suspicious breast lesions, 243 were diagnosed with breast cancer. Most (98.7%) were female, with a median age of 49 years and median symptom duration of 24 weeks. Diagnosis was confirmed for all patients within 31 days of initial presentation. Only 22 of 214 patients (10.3%) undergoing staging were diagnosed as early breast cancer (stage I or II), 50% at stage III, and 39.3% at stage IV. Forty-five of 139 patients (32.4%) initiating recommended treatment completed without abandonment, and 45 of 243 patients (18.5%) with a confirmed breast cancer completed recommended treatment without abandonment.</p><p><strong>Conclusion: </strong>Ghana met the GBCI KPI for timely diagnosis (<60 days of presentation) but fell short in early detection (≥60% early breast cancer) and treatment completion without abandonment (>80%). Our findings provide baseline data for planning system-wide improvements toward the GBCI's goal of reducing breast cancer mortality by 2.5% annually.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400653"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Dose Anti-PD1 Immune Checkpoint Inhibitors in Relapsed/Refractory Hodgkin Lymphoma: A Systematic Review.","authors":"Héctor A Vaquera-Alfaro, José Emiliano Montelongo-Cepeda, Antonio Vega-Mateos, Anahí Morales-Pedraza, Haydeé Verduzco-Aguirre, David Gómez Almaguer, Luis Villela, Perla R Colunga-Pedraza","doi":"10.1200/GO-24-00538","DOIUrl":"https://doi.org/10.1200/GO-24-00538","url":null,"abstract":"<p><strong>Purpose: </strong>Blockage of PD-1 with drugs such as nivolumab (Nivo) and pembrolizumab (Pembro) has been successfully implemented in the treatment of Hodgkin lymphoma among other types of tumors. Exorbitant costs hinder access for many patients living in low- and middle-income countries (LMICs). Dose reductions on the basis of pharmacodynamic studies have been used to allow access to these drugs to patients with no further options because of economic constraints. In this study, we aimed to systematically review and assess evidence regarding the efficacy and safety of this adapted intervention.</p><p><strong>Methods: </strong>An expert librarian designed and conducted a literature search in MEDLINE, Scopus, Web of Science, EMBASE, Cochrane Central, and clinicaltrials.gov. Screening was conducted in a title/abstract and full-text phase independently and in duplicate. Primary outcomes were overall survival, overall response rates (ORRs), and incidence of adverse events (AEs). Data extraction was performed independently and in duplicate as well. A qualitative synthesis was performed and reported in the results.</p><p><strong>Results: </strong>Six studies investigated Nivo as an intervention, two Pembro, and 1 both therapies, with a total of 161 patients overall. One study had a single-arm prospective trial design and the rest a retrospective cohort design. ORR ranged from 66% to 100%, with complete response rates between 38% and 75%. The incidence of AEs was mostly high across all studies ranging from 27% to 93%, most of it composed of grade 1-2 AEs (27%-80%). No study reported health-related quality-of-life outcomes.</p><p><strong>Conclusion: </strong>Low-dose anti-PD1 immune checkpoint inhibitors have shown to be adequate candidates for testing of their efficacy in randomized trials and could improve access to these high-cost medications for patients with Hodgkin lymphoma both in LMICs and high-income countries.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400538"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}