JCO Global Oncology最新文献

{"title":"Barriers and Facilitators to Cancer Clinical Trial Participation: Perspectives of Patients in the ICON-3 Practice-Based Research Network, Nigeria.","authors":"Ngozi Idemili-Aronu, Babayemi O Olakunde, Tara M Friebel-Klingner, Adaeze Chike-Okoli, Ijeoma U Itanyi, Tonia C Onyeka, Anne F Rositch, Richard B S Roden, Tzyy-Choou Wu, Echezona E Ezeanolue, Kimberly Levinson","doi":"10.1200/GO-25-00181","DOIUrl":"https://doi.org/10.1200/GO-25-00181","url":null,"abstract":"<p><strong>Purpose: </strong>Africa faces a growing burden of cancer yet remains under-represented in global cancer clinical trials. This disparity limits the generation of population-specific evidence needed to improve cancer outcomes. Recruitment and retention in cancer clinical trials are particularly challenging because of various systemic and individual barriers in Nigeria. This study explores patients' perspectives on barriers and facilitators to recruitment and retention in cancer clinical trials.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods design was used, which comprised a cross-sectional survey and a descriptive qualitative approach. Participants were recruited from multiple oncology centers and secondary facilities within Nigeria's ICON-3 Practice-Based Research Network. Quantitative data were collected through interviewer-administered questionnaires, whereas qualitative data were gathered via semistructured interviews and analyzed thematically.</p><p><strong>Results: </strong>A total of 317 patients participated in the quantitative survey, 18 of whom participated in interviews. Barriers included limited understanding of clinical trials, logistical challenges such as transportation and visit frequency, distrust in researchers and the health care system, and lack of family support. Facilitators included effective communication, incentives, flexible research visits, and culturally tailored interventions.</p><p><strong>Conclusion: </strong>To optimize cancer clinical trial participation in low-resource settings, interventions must be tailored to local contexts, addressing structural and cultural barriers. Enhanced communication, community involvement, and supportive policies can significantly improve trial participation and outcomes.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500181"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251031","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":"Budget Impact of the Oncotype DX Test in Early-Stage Breast Cancer for the Brazilian Private Health Care System.","authors":"Carlos Alberto da Silva Magliano, Ivan R Zimmermann, Leandro Jonata de Carvalho Oliveira, Marcia Gisele Santos da Costa, Tomás Reinert, Carlos Henrique Dos Anjos, Daniela D Rosa, Julio A P Araújo, Andrea K Shimada, Daniele Assad-Suzuki, Max S Mano, Gustavo Póvoa Dos Santos, Sergio Cordeiro de Oliveira, Virginia Areal, Steve Millen","doi":"10.1200/GO-25-00245","DOIUrl":"https://doi.org/10.1200/GO-25-00245","url":null,"abstract":"<p><strong>Purpose: </strong>Adjuvant chemotherapy decisions for early-stage hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer remain challenging, requiring a balance between treatment efficacy and avoiding overtreatment. Gene expression signatures, such as the Oncotype DX assay, are valuable tools to predict recurrence risk and guide chemotherapy use. This study estimates the budget impact of incorporating the Oncotype DX test into clinical practice for patients with HR+/HER2- early-stage breast cancer in Brazil's private health care system.</p><p><strong>Methods: </strong>A budget impact analysis was performed using a hybrid decision tree-Markov model with transitions between recurrence-free survival, distant recurrence, acute myeloid leukemia, and death. The eligible population was derived from epidemiologic data. Subgroup analyses included node-negative (N0) patients stratified by age and clinical risk and node-positive (N1) patients stratified by menopausal status. The model assessed direct medical costs over 5 years without applying a discount rate. Two scenarios were analyzed: scenario 1, with progressive market uptake (40%-80% over 5 years), and scenario 2, with universal testing.</p><p><strong>Results: </strong>The introduction of the Oncotype DX test was associated with 5-year cost savings of approximately $19.3 million US dollars (USD; scenario 1) to $26.7 million USD (scenario 2). Incremental costs were observed only in N0 low-risk patients 50 years and younger ($9.5-$16.9 million USD) and premenopausal N1 patients ($2.2-$4.4 million USD).</p><p><strong>Conclusion: </strong>Incorporating the Oncotype DX test is expected to optimize chemotherapy recommendations, reduce overtreatment, and generate cost savings in most subgroups. In Brazil's private health care system, the reduction in chemotherapy-related costs is anticipated to fully or partially offset the cost of testing.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500245"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345328","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":"Beyond the Numbers: Inflammation as the Missing Link in Decayed, Missing, Filled Teeth-Based Buccal Mucosa Cancer Risk Models.","authors":"Efsun Somay, Erkan Topkan, Ugur Selek","doi":"10.1200/GO-25-00445","DOIUrl":"https://doi.org/10.1200/GO-25-00445","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500445"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345327","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":"Reply to: Beyond the Numbers: Inflammation as the Missing Link in Decayed, Missing, Filled Teeth-Based Buccal Mucosa Cancer Risk Models.","authors":"Grace Sarah George, Rajesh Dikshit, Anil Chaturvedi, Pankaj Chaturvedi, Sharayu Mhatre","doi":"10.1200/GO-25-00487","DOIUrl":"https://doi.org/10.1200/GO-25-00487","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500487"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345333","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":"Less Is More: Hypofractionation for Equitable and Sustainable Cancer Care.","authors":"Sierra Silverwood, Alyssa Asaro, Pratiksha Shahi, Eman Suliman, Maria S Musa, Joseph Weygand, Kari Tanderup, Katie E Lichter, Rohini K Bhatia","doi":"10.1200/GO-25-00153","DOIUrl":"https://doi.org/10.1200/GO-25-00153","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500153"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251193","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 in Anaplastic Lymphoma Kinase-Positive Advanced Non-Small Cell Lung Cancer in Argentina: A Multicenter Retrospective Study (GAOT-ALK001).","authors":"Luis Basbus, Maite Queral, Delfina Peralta Tanco, Mara Bonet, Patricio Levit, Gabriela Malcervelli, Carlos Brocca, Susana Sena, Vanina Wainsztein, Diego Kaen, Sebastian Cinquini, Manglio Rizzo, Nicolas Castagneris, Enrique Aman, Gonzalo Di Mario, Richard Serna, Florencia Tsou, Ivan Macharashvili, Yamila Ferreira, Diego Enrico, Carmen Pupareli, Ignacio Robledo Salas, Florencia Guerra, Carlos Picón, Danisa Fariña, Cintia Novas, Rosario Pasquinelli, Aldo Perfetti, Lorena Lupinacci, Claudio Martin","doi":"10.1200/GO-25-00014","DOIUrl":"https://doi.org/10.1200/GO-25-00014","url":null,"abstract":"<p><strong>Purpose: </strong>In Argentina, anaplastic lymphoma kinase (ALK) gene rearrangements occur in approximately 6.1% of non-small cell lung cancer (NSCLC) cases. Given the availability of second- and third-generation ALK inhibitors, real-world data are needed to inform optimal treatment strategies. However, access to these therapies remains limited for many patients.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study of patients with metastatic ALK-positive NSCLC (ALKp) treated with first-line tyrosine kinase inhibitors (TKIs) from January 2014 to February 2024. Demographics, treatment patterns, clinical outcomes, and factors affecting treatment accessibility were analyzed.</p><p><strong>Results: </strong>We identified 104 patients with ALKp. The median age was 55 years (IQR, 45-67); 86% had Eastern Cooperative Oncology Group ≤1, 58% were women, and 57% were nonsmokers. Brain metastases were present at diagnosis in 29%, with 50% receiving local treatment. First-line TKIs included alectinib (42%), crizotinib (30%), lorlatinib (16%), and brigatinib (12%). Crizotinib use was frequently due to limited access to new-generation TKIs. Adverse events occurred in 54%, with 21% grade 3 to 4. The objective response rate was 73%. At a median follow-up of 42 months, 48% experienced progression. Crizotinib was associated with higher risk of progression or death compared with newer TKIs (hazard ratio, 3.09 [95% CI, 1.75 to 5.5]; <i>P</i> = .01). CNS progression occurred in 18%, more often with crizotinib (42% <i>v</i> 8%, <i>P</i> = .04). Among those progressing, 82% received second-line therapy, most commonly lorlatinib or alectinib. The overall survival at 24 months was 81%, with 27% of patients deceased at data cutoff.</p><p><strong>Conclusion: </strong>This real-world study describes outcomes and treatment patterns among patients with ALKp in Argentina. It highlights disparities in access to optimal therapies and reinforces the need for equitable access to new-generation ALK inhibitors to improve clinical outcomes.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500014"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225402","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":"Encouraging LGBTQIA+ Inclusive Cancer Care in Hospital Settings: A Critically Integral Part for Equitable Oncology.","authors":"Nabin Pathak, Manoj Panthi Kanak, Manisha Dhakal, Simit Sapkota, Sunil Shrestha","doi":"10.1200/GO-25-00403","DOIUrl":"https://doi.org/10.1200/GO-25-00403","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500403"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300707","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":"Cancer Health Disparities Among Patients With Early-Stage Estrogen Receptor-Positive Breast Cancer: Impact of Public Versus Private Health Care on Diagnosis-to-Treatment Interval in Brazil.","authors":"Romualdo Barroso-Sousa, Danielle Laperche-Santos, Heloisa Resende, Fernanda Cesar Moura, Sulene Cunha Sousa Oliveira, Andrea Kazumi Shimada, Renata Arakelian, Anna Luiza Zapalowski Galvão, Bruno Santos Wance de Souza, Amanda Guimarães Castro Custodio, Monalisa Ceciliana Freitas Moreira de Andrade, Yuri Cardoso Rodrigues Beckedorff Bittencourt, Maria Cristina Figueroa Magalhães, Cristiano de Pádua Souza, Carlos Eduardo Paiva, Poliana Albuquerque Signorini, Daniela Jessica Pereira, Angélica Nogueira-Rodrigues, Daniela Dornelles Rosa, Brittany Bychkovsky, Daniele Assad-Suzuki","doi":"10.1200/GO-25-00012","DOIUrl":"https://doi.org/10.1200/GO-25-00012","url":null,"abstract":"<p><strong>Purpose: </strong>In 2013, Brazil implemented a federal law (Law 12.732/2012) mandating cancer treatment to begin within 60 days of diagnosis. Among women with newly diagnosed estrogen receptor-positive (ER+) nonmetastatic breast cancer, we describe the diagnosis-to-treatment interval, patient and tumor characteristics, and the type of treatment received, and we assess these metrics by public versus private health care setting.</p><p><strong>Methods: </strong>The study included patients with early-stage ER+ breast cancer from 14 centers in Brazil who had completed locoregional care and received >6 months of adjuvant endocrine therapy (ET). Patient, tumor, and treatment characteristics were abstracted from clinical documentation and collected in REDCap. Qualitative variables were compared between groups using the chi-square or Fisher exact tests. For quantitative variables, the nonparametric Mann-Whitney test was used. <i>P</i> < .05 was considered significant.</p><p><strong>Results: </strong>From June 2021 to March 2024, 774 women enrolled in the study. The mean age at diagnosis was 56.5 years, and 55.2% received public health care. Women who received care at public institutions were more likely to be premenopausal at diagnosis (45.3% public <i>v</i> 29.2% private, <i>P</i> < .0001), living with no partner (45.6% public <i>v</i> 34.7% private, <i>P</i> = .002), and have lower educational levels (43.6% public <i>v</i> 6.8% private, <i>P</i> < .0001). Women treated in the public sector had more advanced disease with stage III tumors (29.3% public <i>v</i> 13.5% private, <i>P</i> < .0001) and were more likely to receive mastectomies (36.8% public <i>v</i> 29.8% private, <i>P</i> = .0003), axillary dissections (43.1% public <i>v</i> 18.1% private, <i>P</i> < .0001), chemotherapy (73.8% public <i>v</i> 58.5% private, <i>P</i> < .0001), and radiotherapy (87.0% public <i>v</i> 78.7% private, <i>P</i> = .002). Regarding adjuvant ET, women treated in the public sector had lower ovarian function suppression (6.8% public <i>v</i> 18.8% private, <i>P</i> < .0001) and higher tamoxifen use (52.4% public <i>v</i> 29.4% private, <i>P</i> < .0001). The diagnosis-to-treatment interval was longer in the public versus private system (93 <i>v</i> 41 days, <i>P</i> < .0001).</p><p><strong>Conclusion: </strong>Our study revealed significant disparities in cancer care between patients with stage I to III ER+ breast cancer treated in public versus private health care systems in Brazil. Law 12.732/2012 has proven ineffective for patients treated in the public sector and is not being adequately observed or enforced by Brazilian authorities.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500012"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251054","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":"Implementation of Real-World Diagnostic Strategies in Taiwan for the Identification of Targetable Oncogenic Driver Alterations in Non-Small Cell Lung Cancer.","authors":"Wan-Shan Li, Meng-Yun Hung, Yu-Hsuan Kuo, Shu-Farn Tey, Rachel Yi-Chen Liu, Connie Pei-Shan Hung, Chloe Lo-Ho Chen, Iris M Simon, Chien-Feng Li","doi":"10.1200/GO-25-00144","DOIUrl":"https://doi.org/10.1200/GO-25-00144","url":null,"abstract":"<p><strong>Purpose: </strong>Next-generation sequencing is optimal for testing advanced/metastatic non-small cell lung cancer (NSCLC) biomarkers; however, implementation and access are often hindered across Asia by turnaround time (TAT), logistics, and reimbursement. This study aimed to implement a multigene biomarker testing algorithm for the comprehensive detection of actionable NSCLC biomarkers.</p><p><strong>Methods: </strong>The AmoyDx PLC Panel, a multigene polymerase chain reaction (PCR), was used in testing, with an optimal workflow developed in Chi Mei Medical Center, Taiwan. Tests were conducted on 897 NSCLC samples between June 2022 and November 2023.</p><p><strong>Results: </strong>Among the tested samples, 83.0% were adenocarcinoma, with 74.4% at stage IV. Most samples were successfully analyzed for additional biomarkers, with 1.3% and 2.1% of samples having insufficient tissue or DNA quality, and insufficient RNA quality, respectively. This study reflected clinical reality, with most samples tested at initial diagnosis (72.0%). Other patients had previous single-gene testing for epidermal growth factor receptor (<i>EGFR</i>)/anaplastic lymphoma kinase (<i>ALK</i>)/ROS proto-oncogene 1, receptor tyrosine kinase (<i>ROS1</i>) with negative results (11.2%), and others were tested after progression on tyrosine kinase inhibitors (16.8%). The median testing TAT was short (4 days). Of the patients tested at diagnosis (n = 638), 50.6% had <i>EGFR</i> mutations and 79 (12.4%) patients had alterations in Kirsten RAat Sarcoma viral oncogene homolog (<i>KRAS</i>) G12C (2.4%), v-raf murine sarcoma viral oncogene homolog B1 (<i>BRAF</i>) (0.9%), human epidermal growth factor receptor 2 (<i>HER2</i>) (3.5%), mesenchymal-epithelial transition factor (<i>MET</i>) (2.4%), <i>ALK</i> (1.3%), <i>ROS1</i> (1.6%), and rearranged during transfection (<i>RET</i>) (0.5%). Among the 99 patients who had previously tested negative for <i>EGFR/ALK/ROS1</i>, 47 (47.5%) patients had biomarker alterations that were potentially targetable by available drugs.</p><p><strong>Conclusion: </strong>This study highlighted the effectiveness of multigene PCR testing in identifying actionable NSCLC biomarkers for low failure rate, short TAT, and minimal tissue requirements, enabling timely, personalized interventions. The workflow implemented at Chi Mei Medical Center provides a model that other hospitals can adopt to overcome testing barriers and improve precision oncology access.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500144"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300671","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":"Challenges and Opportunities in the Treatment of Invasive Cervical Cancer in Low-Resource Settings: A Survey of the International Gynecologic Cancer Society Fellowship Programs.","authors":"Parisa N Fallah, Natalie Medley, Malede Birara Fanta, Maryam H Shaki, Christopher Daley, Biruck Gashawbeza Batu, Tran Thi Nhu Quynh, Husnia Hussen Lobi, Anisa Mburu, Ngoc Phan, Faiza A Nassir, Dawit Worku, Pius Mulamira, Ricardina Rangeiro, Dercia Idite Changule, Mukatimui Kalima-Munalula, Martin Origa, Mohammed Taha Hussein Alsayed, Erick E Estrada, Julius Nkalubo Kyemwa, Saida Bowe, Mubiru Musa, Adrian Mitchell, Saujanya Karmacharya, Paul Mitchell, Henry Chege, Bethel Dereje, Edward L Trimble, Susan Ralph, Linus Chuang, Joseph Ng, Asima Mukhopadhyay, Michael A Steller, Kathleen M Schmeler, Thomas C Randall","doi":"10.1200/GO-25-00015","DOIUrl":"https://doi.org/10.1200/GO-25-00015","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical cancer remains a leading cause of cancer mortality in low- and middle-income countries (LMICs). The International Gynecologic Cancer Society (IGCS) Global Gynecologic Oncology Fellowship aims to build human capacity to address the burden of cervical cancer in LMICs. This study assesses resource constraints experienced at fellowship sites with regard to management of cervical cancer.</p><p><strong>Methods: </strong>From September to December 2020, one fellow from each of the 12 existing IGCS fellowship programs participated in a survey that assessed capacity for cervical cancer management, including access to care, diagnostics and treatment, cancer surveillance, and palliative care. Descriptive statistics were used for analysis.</p><p><strong>Results: </strong>Patients at IGCS sites experienced significant delays to care, especially for chemotherapy and radiation therapy. Less than half of the sites had a gynecology-trained pathologist, and only 58% of sites had access to a magnetic resonance imaging machine, though with many delays in obtaining imaging reads. For treatment, neoadjuvant chemotherapy is not commonly used. Access to radiation therapy is poor, with 58% of sites reporting wait times of 5-8 weeks or more. The radiation machine downtime ranges from 1 to 3 months per year, creating gaps where no patients can access this treatment. Palliative care is practiced by variable members of the health care team although hospice services are rare.</p><p><strong>Conclusion: </strong>This study demonstrates significant resource constraints experienced by gynecologic oncology providers in various LMICs when managing cervical cancer. This includes delays to diagnosis, poor access to chemoradiation services, and need for palliative care. Despite these limitations, the IGCS Global Gynecologic Oncology Fellowships have built workforce capacity to manage cervical cancer, serving as local champions to address this disease.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500015"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345329","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}