JCO Global Oncology最新文献

{"title":"Randomized Controlled Trial of Impact of Mobile Health Technologies on Human Papillomavirus Vaccination Uptake in Mothers of Vaccine-Eligible Girls in Lagos, Nigeria (mHealth-HPVac).","authors":"Kehinde Sharafadeen Okunade, Ayomide I Fayinto, Temitope V Adekanye, Matthew J Allsop, Hameed Adelabu, Adaiah Soibi-Harry, Olufemi Thomas-Ogodo, Tonia C Onyeka, Teniola Lawanson, Muisi A Adenekan, Godwin O Akaba, Omolola Salako, Chidinma Magnus Nwogu, Rose I Anorlu, Jonathan S Berek","doi":"10.1200/GO-25-00150","DOIUrl":"10.1200/GO-25-00150","url":null,"abstract":"<p><strong>Purpose: </strong>Expanding high-risk human papillomavirus (HPV) vaccine coverage in resource-constrained settings is critical to bridging the cervical cancer gap and achieving the global action plan for elimination. Mobile health (mHealth) technology via short message services (SMS) has the potential to improve HPV vaccination uptake. The mHealth-HPVac study evaluated the effectiveness of mHealth interventions in increasing HPV vaccine uptake among mothers of unvaccinated girls aged 9-14 years in Lagos, Nigeria.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted at the Lagos University Teaching Hospital between June 2024 and March 2025. We randomly assigned n = 180 eligible mothers to either a text message (intervention) or a usual care (control) arm. The primary analysis was conducted using the intention-to-treat principle. Bivariable and multivariable logistic regression models were performed to compare HPV vaccination uptake between the two arms, adjusting for potential confounders using odds ratios (ORs) and 95% CIs.</p><p><strong>Results: </strong>mHealth intervention significantly increased HPV vaccination uptake among mothers of vaccine-eligible girls (adjusted odds ratio [adj OR], 3.05 [95% CI, 1.61 to 5.77]; <i>P</i> = .001). Higher education level was also significantly associated with increased vaccine uptake (adj OR, 3.35 [95% CI, 1.77 to 6.33]; <i>P</i> < .001). There were no significant interaction effects by baseline characteristics on the association between mHealth intervention and HPV vaccine uptake.</p><p><strong>Conclusion: </strong>The study showed that mHealth interventions significantly improve HPV vaccine uptake. Integrating mHealth strategies into routine immunization programs could be a scalable and cost-effective approach to increasing HPV vaccination coverage. However, future multicenter studies should consider using cluster randomization at the facility level to better optimize mobile interventions for diverse populations, identify the key drivers of successful SMS-based mHealth interventions, and gain deeper insights into the complex barriers to HPV vaccination uptake.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500150"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029848","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":"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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182052","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":"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":"Comprehensive Overview of Breast Cancer in India.","authors":"Tryambak Pratap Srivastava, Isha Goel, Ajay Gogia, Rajinder Parshad, Sukhda Monga, Joyeeta Talukdar, Avdhesh Rai, Ruby Dhar, Subhradip Karmakar","doi":"10.1200/GO-25-00083","DOIUrl":"https://doi.org/10.1200/GO-25-00083","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer remains a significant public health challenge globally, as well as in India, where it is the most frequently diagnosed cancer in females. Significant disparities in incidence, mortality, and access to health care across India's sociodemographically diverse population highlight the need for increased awareness, policy reform, and research.</p><p><strong>Design: </strong>This review consolidates data from national cancer registries, global cancer databases, and institutional findings from a tertiary care center to examine the epidemiology, clinical challenges, and management gaps specific to India. It focuses on early detection barriers, health care infrastructure, and treatment accessibility, while discussing policy-level interventions and evolving models of care delivery.</p><p><strong>Results: </strong>India reports over 1.4 million cancer cases and 0.9 million cancer-related deaths annually. Challenges include a lack of trained health care providers, limited access to screening, delayed diagnosis, and unequal treatment availability. Challenges include a lack of trained health care providers, limited access to screening, delayed diagnosis, and unequal treatment availability. High mortality is compounded by poor penetrance of screening biomarkers, late-stage presentation, and limited access to cost-effective diagnostics. Despite adherence to standard treatment protocols, systemic barriers continue to limit outcomes. Advances in tumor biology and the introduction of tailored, patient-centric approaches such as the hub-and-spoke care model present promising strategies.</p><p><strong>Conclusion: </strong>This article summarizes our current understanding of breast cancer epidemiology, its geographical diversity, and policy amendments needed for effective management in a populous nation like India. Bridging the gap between groundbreaking research and patients with cancer, families, and caregivers, and educating and empowering patients, identifying barriers, and gaining a deeper understanding of the needs of the community are all vehemently needed.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500083"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029840","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":"Nationwide Insights on Immunotherapy in a Low- and Middle-Income Country: Armenia's Struggle for Equitable Cancer Care in an Out-of-Pocket System.","authors":"Amalya Sargsyan, Gevorg Tamamyan, Arman Oganisian, Davit Zohrabyan, Liana Safaryan, Armen Avagyan, Lilit Harutyunayn, Mariam Sargsyan, Martin Harutyunyan, Nune Karapetyan, Naira Janoyan, Levon Badalyan, Mariam Mailian, Haykuhi Geokchyan, Vardan Bardakhchyan, Elen Baloyan, Hasmik Petrosyan, Karine Soghomonyan, Anna Tadevosyan, Karen Bedirian, Shushan Hovsepyan, Samvel Bardakhchyan","doi":"10.1200/GO-25-00040","DOIUrl":"10.1200/GO-25-00040","url":null,"abstract":"<p><strong>Purpose: </strong>In Armenia, a lower-middle-income country, cancer causes 21% of all deaths, with over half of cases diagnosed at advanced stages. Without universal health insurance, patients rely on out-of-pocket payments or black-market channels for costly immunotherapies, underscoring the need for real-world data to inform equitable policy reforms.</p><p><strong>Methods: </strong>We conducted a multicenter, retrospective cohort study of patients who received at least one dose of an immune checkpoint inhibitor (ICI) between January 2017 and December 2023 across six Armenian oncology centers. Eligible patients had histologically confirmed malignancy and ≥6 months of follow-up. Demographic, clinical, biomarker, and treatment data were extracted from records. Overall survival (OS) was estimated by the Kaplan-Meier method; log-rank tests and Cox models evaluated associations. A 6-month landmark analysis adjusted for immortal time bias.</p><p><strong>Results: </strong>Of the 585 patients screened, 373 met inclusion criteria (67% male; median age, 61 years); 68% had stage IV disease. The median OS was 31 months. Liver metastases predicted poorer survival (19 <i>v</i> 26 months, <i>P</i> = .027). Nonsmokers had better OS than smokers (31 <i>v</i> 24 months, <i>P</i> = .019). High PD-L1 expression (≥50%) was associated with improved OS (40 <i>v</i> 16 months, <i>P</i> = .025). Receiving >6 ICI cycles conferred longer OS (45 <i>v</i> 23 months, <i>P</i> < .001), although not significant in landmark analysis (<i>P</i> = .64). Financial hardship and disease progression were key reasons for early discontinuation.</p><p><strong>Conclusion: </strong>Immunotherapy shows promise in Armenia despite financial barriers. Drawing on models from India and China, pooled procurement, negotiated pricing, and partial reimbursement, Armenia could expand biomarker testing, reduce drug costs, and implement tiered insurance. These steps are vital to optimize access and outcomes in this resource-limited setting.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500040"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029812","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":"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}