JCO Global Oncology最新文献

{"title":"Reply to: Correction Regarding Commentary \"Comprehensive Cancer Infrastructures for the European Union-Coordination and Support Action-CCI4EU CSA\".","authors":"Javier David Benitez Fuentes, Asia Ferrández-Arias, Miguel Borregon Rivilla, Alicia de Luna Aguilar, Alvaro Rodriguez-Lescure","doi":"10.1200/GO-25-00090","DOIUrl":"https://doi.org/10.1200/GO-25-00090","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500090"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972160","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":"Decentralized Point-of-Care Manufacturing of CD19 Chimeric Antigen Receptor T Cells in Mexico.","authors":"Rosario Salazar-Riojas, Dalila M Alvarado-Navarro, Yair O Chávez-Estrada, Ana K Hernández-Navarro, Martha B Ake-Uc, Nidia K Moncada-Saucedo, José C Jaime-Pérez, Sofía I Quezada-Ramírez, Anna C Rodriguez-Zuñiga, David Gómez-Almaguer, Andrés Gómez-De León","doi":"10.1200/GO-24-00581","DOIUrl":"https://doi.org/10.1200/GO-24-00581","url":null,"abstract":"<p><strong>Purpose: </strong>To validate and replicate an automated decentralized CD19 chimeric antigen receptor T (CAR-T) cell manufacturing process from healthy adult volunteers in an academic institution in a middle-income country.</p><p><strong>Methods: </strong>Healthy volunteers were recruited and underwent leukapheresis with the continuous mononuclear cell (MNC) collection protocol. Clinical-grade CAR-T cell manufacturing was performed in a closed system using a second-generation CD19 vector with 41BB costimulatory domain. Quality control was assessed at different points in the production process with prespecified release criteria including product's aspect, sterility, cell viability, impurity, and quantity. The target dose formulation was 1 × 10⁶/kg viable CAR-T cells per volunteer.</p><p><strong>Results: </strong>Five healthy volunteers were recruited, all donated adequate MNC units, and successfully underwent the manufacturing process. After T-cell culture harvest, the products contained a median CAR-T cell concentration of 16.5 × 10⁶/mL (range, 7.7-22.2 × 10⁶/mL), with a median transduction percentage of 44.7% (range, 39.2%-60.5%) and a median CD3⁺ cell viability of 97.7% (range, 90.4%-98.7%). Sterility was maintained throughout the manufacturing process. The quantity of cells harvested per kilogram of body weight was 24.6 MB-CART19.1 cells × 10⁶/kg (range, 9.3-33.1 × 10⁶/mL). The quality was similar in both fresh and cryopreserved units. Dose formulations were 1.1 CAR-T cells × 10⁶/kg (range, 1.0-1.2 CAR-T cells × 10⁶/kg).</p><p><strong>Conclusion: </strong>Our study demonstrates an effective methodology with satisfactory and comparable performance to international reports. Point-of-care manufacturing is a feasible alternative to increase access to CAR-T cells in academic centers.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400581"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063346","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 Hypofractionated Radiation Protocols on Reducing Travel Burden and Improving Patient Satisfaction: When Less Is More.","authors":"Zaheeda Mulla, Hiba Taha, Wsam A Ghandourh, Raniah M Hashem, Majd A Alotaibi, Hanadi F Habibullah, Hatim Z Almarzouki, Zayd Jastaniah","doi":"10.1200/GO-24-00488","DOIUrl":"10.1200/GO-24-00488","url":null,"abstract":"<p><strong>Purpose: </strong>Despite rising cancer incidence and mortality in Saudi Arabia, access to radiotherapy (RT) services is limited in some regions. This study aimed to examine the travel burdens of RT patients and assess the benefits of hypofractionated RT (HFRT).</p><p><strong>Methods: </strong>This multicenter retrospective study included patients with breast cancer (BC) and prostate cancer (PC) treated with HFRT (26 Gy/5 fractions for BC and 60 Gy/20 fractions for PC) between 2020 and 2024. Patient data were collected from electronic records, and an online questionnaire assessed experiences and financial burdens. Google Maps determined the shortest driving distance from patients' residences to our RT center. Descriptive statistics compared accommodation, transportation costs, and time expenditure for shorter versus longer RT courses.</p><p><strong>Results: </strong>A survey of 153 out of 187 patients (average age 57 years for BC, 70 years for PC) revealed significant travel burdens. Notably, 43% traveled from outside Jeddah, averaging 415 km, compared with 17.9 km for those within Jeddah. HFRT offered substantial transportation cost-savings, estimated at $101 in US dollars (USD) for patients with BC (an additional $133 (USD) for those outside Jeddah) and $213 (USD) for patients with PC (an additional $320 (USD) for those outside Jeddah). Median accommodation cost-savings were $733 (USD) for BC and $1,600 (USD) for PC. Median time-savings were 9.25 hours for BC and 30 hours for PC. All patients were satisfied with the treatment duration, with 42% preferring the shorter hospital stay and 8% citing financial reasons.</p><p><strong>Conclusion: </strong>Patients with cancer in Saudi Arabia travel significant distances for RT. HFRT using shorter RT courses reduces patient-related costs, enhances satisfaction, and may improve access by addressing logistical challenges.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400488"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999122","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 Data on Metastatic Lung Cancer: Cost Analyses in Brazil From a Private Insurance Company's Perspective.","authors":"Rodrigo Afonso da Silva Sardenberg, Mariana Ribeiro Monteiro, Cinthia Leite Frizzera Borges Bognar, Victor Braga Gondim Teixeira, Rodrigo de Carvalho Moreira, Henry Sznejder, Riad Naim Younes","doi":"10.1200/GO-24-00253","DOIUrl":"10.1200/GO-24-00253","url":null,"abstract":"<p><strong>Purpose: </strong>Non-small cell lung cancer (NSCLC) is often diagnosed at late stages, leading to escalated treatment expenses. This study aimed to elucidate the costs of lung cancer treatment in a private health care setting in Brazil.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study, regarding costs, survival, and quality of care of stage IV NSCLC in a private health company in Brazil.</p><p><strong>Results: </strong>A total of 819 individuals were included, with median age 64.9 years. With a 1-year follow-up, patients had a median of four hospital admissions, with a median length of stay in of 6.2 days. Survival rates were higher for patients treated with targeted therapy (hazard ratio [HR], 0.38 [95% CI, 0.25 to 0.56]), immunotherapy (HR, 0.52 [95% CI, 0.40 to 0.68]), or both treatments sequentially (0.41 [95% CI, 0.25 to 0.68]). Patients submitted to sequentially targeted therapy and immunotherapy had the higher total costs (mean, $172,828 USD) compared with patients treated with immunotherapy (mean, $138,125 USD), targeted therapy (mean, $117,068 USD), and only chemotherapy (mean, $47,625 USD). As expected, longer survival was translated into more third-line therapy (<i>P</i> < .001), and higher mean costs with cancer-related hospital admissions ($24,554 USD chemo, $31,835 USD immuno, $28,228 USD targeted, and $35,494 USD for both therapies). However, costs did not increase in proportion to the survival benefit. Despite longer survival, patients undergoing targeted therapy or immunotherapy had median number of hospital admissions and length of stay similar to those who underwent chemotherapy alone.</p><p><strong>Conclusion: </strong>Higher survival rates and costs were found for patients exposed to modern treatments for advanced NSCLC. Cost-effectiveness thresholds definitions are warranted for managing costs, particularly in developing countries.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400253"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735952","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":"Quality of Care and Survival Outcomes Among Patients With Clinically Localized Prostate Cancer in Nigeria.","authors":"Musliu Adetola Tolani, Christian Agbo Agbo, Alan Paciorek, Shehu Salihu Umar, Rufus Wale Ojewola, Faruk Mohammed, Ernie Kaninjing, Muhammed Ahmed, Rebecca DeBoer","doi":"10.1200/GO-24-00504","DOIUrl":"10.1200/GO-24-00504","url":null,"abstract":"<p><strong>Purpose: </strong>Optimal survival outcomes of prostate cancer are best achieved through high-quality care for curable disease. In Nigeria, various barriers may impede the curative treatment of prostate cancer, yet their impact on care and patient outcomes remains anecdotal. This study assessed treatment quality, survival outcomes, and interhospital differences of these metrics among patients with clinically localized prostate cancer in Nigeria.</p><p><strong>Methods: </strong>A retrospective study of patients with clinical stage T1-T3a, M0 prostate cancer at three tertiary hospitals in Nigeria over a 3-year period was conducted. Data on hospital sites, sociodemographics, clinicopathologic characteristics, quality metrics, imaging used, treatment, and survival status were collected. The primary end point was time from diagnosis to first treatment. Secondary end points were time from presentation to diagnosis, other prostate cancer quality metrics, all-cause survival, and interhospital differences in these metrics. Quality of diagnostics, treatments, and other outcomes were described and compared using Cox regression.</p><p><strong>Results: </strong>This study included 110 patients with a median age of 67 years. Most (n = 66, 61%) had high-risk disease. The median time from tertiary hospital presentation to diagnosis was 31 days. Median time from diagnosis to first treatment of any type was 68 days, with radical radiotherapy was 117 days, and with radical prostatectomy was 104 days. Eighteen percent (n = 20) had guideline-concordant imaging for tumor staging, 67 patients (61%) received any treatment or active surveillance, and retention in care was 42%. Three-year all-cause survival was 41%. There was a significant difference in most quality metrics including guideline-concordant imaging and treatment across the hospital sites.</p><p><strong>Conclusion: </strong>Time to treatment was delayed beyond international benchmarks; quality of staging, treatment, and care process were suboptimal; and survival was poor amid geographical disparities in care.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400504"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase II Evaluation of Ultra-Hypofractionated Postoperative Radiation Therapy for Breast Cancer: Toxicity and Efficacy in a Single-Center Nonrandomized Prospective Study.","authors":"Marcel Fang, Vinicius de Carvalho Gico, Lucas Casimiro, Bruno Takatsu, Elson Santos Neto, Rossana Veronica Mendoza Lopez, Gustavo Vilela Costa Pinto, Gustavo Nader Marta","doi":"10.1200/GO-24-00277","DOIUrl":"10.1200/GO-24-00277","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the toxicity profile and efficacy of postoperative ultra-hypofractionated radiation therapy in elderly patients with breast cancer.</p><p><strong>Materials and methods: </strong>This is a nonrandomized, single-center, prospective Phase II trial. Patients with breast cancer older than 65 years were treated with ultra-hypofractionated radiation therapy in 5 fractions of 5.7 Gy on alternate days in the breast or chest wall, or regional lymph nodes. The primary end point was acute toxicity.</p><p><strong>Results: </strong>A total of 60 patients were analyzed, with a median follow-up of 42.5 months (range, 13.8-66.2). Most patients presented pathologic stage I (56.6%, n = 34) or stage II (33.3%, n = 20) disease. Regional lymph node irradiation was performed in 22% (n = 13) of patients. During treatment, 51% (n = 31) of patients experienced grade 1 or 2 acute toxicity, with no cases of grade 3 acute toxicity reported. Late toxicity included 1.7% (n = 1) of patients developing grade 3 fibrosis and 1.7% (n = 1) developing grade 3 pneumonitis. Regional lymph node irradiation was not associated with a statistically significant increase in toxicity risk (<i>P</i> = .194). Cosmesis evaluations revealed no significant changes when comparing pretreatment assessments with evaluations at 10 weeks (<i>P</i> = .223) and 26 weeks (<i>P</i> = .615) post-treatment. Quality of life was not adversely affected, regardless of whether regional lymph nodes were irradiated. Recurrence rates included two patients with both locoregional and distant recurrence and five patients with distant recurrence. The 3-year disease-free survival probability was 81.7%, and the 3-year overall survival probability was 86.7%.</p><p><strong>Conclusion: </strong>This study demonstrates the safety of ultra-hypofractionated radiation therapy in terms of toxicity in patients with breast cancer. The findings for side effects, cosmesis, quality of life, and survival outcomes are consistent with those observed in moderately hypofractionated radiation therapy regimens, suggesting its use as a viable treatment option in this demographic.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400277"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575750","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":"High-Dose Methotrexate Usage Without Drug-Level Monitoring in Advanced Pediatric Mature B-Cell Non-Hodgkin Lymphoma in a Resource-Limited Setting in Malawi.","authors":"Rizine R Mzikamanda, Loviisa Mulanje, Casey L McAtee, Apatsa Matatiyo, Zoe Mwale, Grace Chirwa, Watipaso Wanda, Atupele Miranda Mpasa, Stella Wachepa, Minke H W Huibers, Steve Martin, Tamiwe Tomoka, Maurice Mulenga, Yuri Fedoriw, Gugulethu Mapurisa, Julie M Gastier Foster, Nader El-Mallawany, Katherine D Westmoreland, Peter Wasswa, Carl E Allen, Nmazuo Ozuah","doi":"10.1200/GO-24-00591","DOIUrl":"10.1200/GO-24-00591","url":null,"abstract":"<p><strong>Purpose: </strong>Excellent survival for advanced (stages II with high lactate dehydrogenase, III, and IV) pediatric mature B-cell non-Hodgkin lymphoma (MB-NHL) has been achieved with intensive regimens, but adoption in sub-Saharan Africa is limited by inadequate supportive care. We provide real-world data on treating advanced MB-NHL with high-dose methotrexate (HD-MTX; ≥1,000 mg/m²/cycle) where real-time serum MTX monitoring is unavailable.</p><p><strong>Methods: </strong>We identified two cohorts-a retrospective (January 2017-December 2020) cohort treated with 1,000 or 3,000 mg/m²/cycle of HD-MTX and a prospective (July 2022-July 2023) cohort-with a modified LMB96 protocol containing 3,000 mg/m²/cycle of HD-MTX. All doses of HD-MTX were given over 3 hours. Estimates of 12-month event-free survival (EFS) and overall survival (OS) were calculated with abandonment as an event. Clinical toxicity data were available for the prospective cohort.</p><p><strong>Results: </strong>The retrospective cohort had 108 patients who received HD-MTX 1,000 mg/m² (n = 98, 91%) or 3,000 mg/m² per cycle. The 12-month EFS and OS were 39% (95% CI, 30 to 50) and 54% (95% CI, 44 to 64), respectively. HD-MTX at 3,000 mg/m² had superior EFS: 69% (95% CI, 49 to 96) versus 33% (95% CI, 24 to 46), <i>P</i> = .004. The prospective cohort had 38 patients. Two ≥grade 3 mucositis, one acute kidney injury, and three treatment-related deaths (8%) occurred. Seven (18%) abandoned treatment. With a median follow-up of 14.5 months, 12-month EFS and OS were 45% (95% CI, 32 to 65) and 59% (95% CI, 45 to 79), respectively. Most relapses were stage IV: EFS 20% versus 51% (non-stage IV; <i>P</i> = .057). Severe malnutrition was associated with OS of 33% versus 58% (normal) or 76% (moderate; <i>P</i> = .055).</p><p><strong>Conclusion: </strong>HD-MTX dosed at 3,000 mg/m²/cycle is feasible in low-resource settings where routine MTX monitoring is unavailable. Stage IV disease and severe malnutrition may contribute to poorer outcomes.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400591"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Research Capacity Enhancement to Develop and Implement National Standard-of-Care Treatment Protocols in Pakistan.","authors":"Mohiba A Khowaja, Alia Ahmad, Sadaf Altaf, Sadia Anwar, Mahwish Faizan, Tariq Ghafoor, Uzma Imam, Zulfiqar Ali Rana, Rabia Wali, Nuzhat Yasmeen, Asim F Belgaumi","doi":"10.1200/GO-24-00443","DOIUrl":"10.1200/GO-24-00443","url":null,"abstract":"<p><strong>Purpose: </strong>Utilization of clinical research methodology as a means for improvement in pediatric cancer outcomes is well established. Toward achievement of its WHO-Global Initiative for Childhood Cancer (GICC) goals in Pakistan, the Pakistan Society of Pediatric Oncology (PSPO) has used this methodology to develop and implement standard-of-care (SOC) protocols nationally, with centralized research and data management support. This article describes the strategy for its implementation and provides a foundation for future advancements in cancer care in Pakistan.</p><p><strong>Methods: </strong>The following steps were used to achieve the objectives: Central Support: A central PSPO office was established with minimal required staffing for provision of support to clinicians for protocol development and implementation and housing data and documents. Clinical protocols: multi-institutional teams, supported by central staff, developed SOC protocols on the basis of international evidence and local experience for six GICC target diagnoses. These went through an iterative consultation and revision process and were finally approved by the PSPO Board. Protocol implementation: case report forms and databases were developed using RedCap software and tested for functionality. Education and training were provided to institutional principal investigators and data entry personnel on the disease, protocol, use of RedCap, and data entry. Data quality maintenance: a system was established for ongoing data quality maintenance through central support and augmented by virtual and on-site audits. Where required, targeted training was provided. Interim analyses are being performed to assess data quality and early outcomes.</p><p><strong>Results: </strong>Development and implementation of protocols occurred over 26 months. Each protocol is currently active in at least seven centers. Almost 2,000 patients have been enrolled. Interim analysis of ALL data shows 85% data accuracy.</p><p><strong>Conclusion: </strong>Research infrastructure and capacity building for implementation of multi-institutional treatment protocols in low- and middle-income countries with modest resources is feasible.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400443"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624718","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":"Prospective Evaluation of the Pathologic Diagnosis and Treatment Outcomes of Pediatric Burkitt Lymphoma in the Central American Pediatric Hematology-Oncology Association Consortium.","authors":"Priya Kumar, Monika L Metzger, John K Choi, Godwin Job, Teresa C Santiago, Armando Peña, Miguela A Caniza, Asya Agulnik, Pascale Y Gassant, Wendy C Gómez García, Patricia J Calderón, Claudia Garrido, Roy Rosado, Soad Fuentes Alabí, Valentino Conter, Meenakshi Devidas, Angela K Carrillo, Yichen Chen, Paola Friedrich, Carlos Rodriguez Galindo, Guillermo L Chantada, Victor M Santana","doi":"10.1200/GO-24-00491","DOIUrl":"10.1200/GO-24-00491","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical and histopathologic diagnosis of pediatric mature B-cell lymphomas (eg, Burkitt lymphoma [BL]) must be accurate to select appropriate risk-based treatment. The Central American Pediatric Hematology-Oncology Association (AHOPCA) in 2000 implemented standardized, resource-adapted treatments for these lymphomas. We evaluated the concordance of local histopathologic diagnoses through central review, determined the impact on therapy selection, and described the clinical characteristics and outcomes of pediatric patients with these lymphomas. We suggest recommendations to improve the accuracy of diagnoses.</p><p><strong>Methods: </strong>Pathology samples and reports were submitted by six AHOPCA sites to St Jude Children's Research Hospital for central review. The concordance of sample assessments was evaluated using three criteria: histologic diagnosis, morphology, and immunohistochemistry. Clinical characteristics, treatment, and outcomes were also analyzed.</p><p><strong>Results: </strong>Of the 68 eligible patients, 53 (78%) received an accurate pathologic diagnosis of BL. For nine (13%) patients, diagnoses changes with therapy implications were made upon central review, while in six patients, there was a minor disagreement with no therapy implications. Most (87%) patients presented with advanced disease. Detailed cellular features were absent in many reports, and immunohistochemistry was routinely performed at only one site. Of the 50 patients whose treatment data were reported, 44 (88%) completed therapy, five died during treatment, and one abandoned treatment. Treatment outcome was satisfactory: 3-year event-free survival was 74% (SE ± 11%), and overall survival was 73% (SE ± 11%).</p><p><strong>Conclusion: </strong>Pathology laboratories in limited-resource hospitals and regions need further optimization to increase accurate diagnoses of mature B-cell lymphomas. Creating regional pathology networks will enhance diagnostic support. Despite resource limitations and advanced disease at presentation, the AHOPCA sites' adapted treatment strategies have improved patient outcomes.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400491"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575758","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":"Going Back Home: Understanding the Challenges and Discrimination of Early and Mid-Career International and Puerto Rican Medical Graduates in Oncology Fields in the United States.","authors":"Coral Olazagasti, Claudia Villa Celi, Arun Mahtani, Ana I Velazquez, Lauren Kiel, Arthi Sridhar, Miki Horiguchi, Mariana Gonzalez, Carolina Bernabe, Oyepeju Abioye, Nazli Dizman, Narjust Florez","doi":"10.1200/GO-24-00513","DOIUrl":"10.1200/GO-24-00513","url":null,"abstract":"<p><strong>Purpose: </strong>Although international medical graduates (IMGs) and Puerto Rican Medical Graduates (PRMGs) comprise an integral part of the health care workforce, these individuals, particularly women, frequently face numerous types of discrimination throughout medical training and independent practice. To our knowledge, we conducted the first cross-sectional study to understand the journeys and consequences of migration faced by IMGs and PRMGs in the US oncology workforce.</p><p><strong>Methods: </strong>We developed a cross-sectional, online survey consisting of 51 multiple choice and open-ended questions that captured demographic information, professional status, period of migration to the United States, location within the United States that participants migrated to, reasons for migration, cultural adaptation, experiences of discrimination during training, and overall professional experiences in the United States.</p><p><strong>Results: </strong>The majority of participants cited better education, professional gains, and a lack of opportunities in participants' home country as primary reasons for migration to the United States. However, most participants, particularly women, experienced staunch assimilation to fit the mold of professional American standards; women were also particularly likely to report experiences of racial/ethnic, language, and gender discrimination during oncology training in the United States, which only marginally improved during independent practice. Despite such discrimination, most participants reported excellent professional satisfaction during training and independent practice, although only moderate personal satisfaction. Most participants decided to stay in the United States, citing reasons pertaining to enhanced professional opportunities, whereas those that returned home valued reasons relating to family and quality of life.</p><p><strong>Conclusion: </strong>Our sobering findings underscore the need for institutional enforcement of an inclusive environment encompassing cultural humility, enactment of programs addressing barriers to socialization, immigration laws, and financial support, creation of IMG-specific support networks, and the sponsorship and promoting of minority women physicians.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400513"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669891","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}