JCO Global Oncology最新文献

{"title":"Geographical Differences in the Management and Outcomes of Patients With Advanced Urothelial Carcinoma Treated With Pembrolizumab After Progression on Platinum-Based Chemotherapy: Results From ARON-2 Study.","authors":"Mimma Rizzo, Andrey Soares, Shilpa Gupta, Fabio Calabrò, Hideki Takeshita, Maria Teresa Bourlon, Se Hoon Park, Patrizia Giannatempo, Zin War Myint, Thomas Büttner, Enrique Grande, Ondrej Fiala, Daniele Santini, Aristotelis Bamias, Roubini Zakopoulou, Sebastiano Buti, Ravindran Kanesvaran, Pasquale Rescigno, Javier Molina-Cerrillo, Ilana Epstein, Fernando Sabino Marques Monteiro, Francesco Massari, Camillo Porta, Joaquin Bellmunt, Matteo Santoni","doi":"10.1200/GO-24-00564","DOIUrl":"10.1200/GO-24-00564","url":null,"abstract":"<p><strong>Purpose: </strong>Our investigation assessed the impact of geographical disparities in the treatment of patients with advanced urothelial cancer (aUC) included in the international, real-world ARON-2 trial.</p><p><strong>Patients and methods: </strong>The study population comprised 1,137 patients with aUC treated with pembrolizumab for relapsed or progressive disease after platinum-based chemotherapy (PBC) at 63 institutions in 19 countries. Patients were divided into three geographical areas: Europe (area 1: 791 patients), the United States (area 2: 156 patients), and Asia (area 3: 190 patients). Clinicopathologic and treatment data were extracted from medical records. The primary end points were to identify differences in patient and treatment characteristics and to assess overall survival (OS) and progression-free survival (PFS) between the three areas.</p><p><strong>Results: </strong>There were differences in patient characteristics: more patients age 70 years and older in area 1; more patients with BMI ≥25 kg/m², squamous histotype, and T1 neoplasia at diagnosis in area 2; and more pure urothelial carcinoma in area 3. There were differences in treatment characteristics: Bacillus Calmette-Guérin instillations and primary tumor surgery were more common in area 1; neoadjuvant and adjuvant PBC, third-line therapies, and specifically enfortumab vedotin (EV) were less common in area 1. Median OS (mOS) from pembrolizumab initiation was 13.0 months in area 1, 29.1 months in area 2 and 13.2 months in area 3 (<i>P</i> < .001), and median PFS was 4.8 months, 5.2 months, and 3.8 months, respectively (<i>P</i> = .002). In patients receiving EV after progression to PBC and pembrolizumab, mOS was 44.1 months in area 1, 31.7 months in area 2, and 23.8 months in area 3 (<i>P</i> = .267).</p><p><strong>Conclusion: </strong>Real-world data suggest that facilitating and extending access to targeted therapies for patients with aUC in different geographical areas worldwide may lead to a consistent and widespread survival increase.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400564"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591206","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":"Establishing Interventional Radiology in a Low-Resource Setting: Lessons From Obafemi Awolowo University Teaching Hospitals Complex, Nigeria.","authors":"Adeleye D Omisore, Akinola A Odedeyi, Olusola C Famurewa, Adeniyi S Aderibigbe, Roli Y Akinsulore, Folasade M Adeyemi, Adebayo F Adisa, Ernestina C Orji, Abidemi I Ayeni, Anuoluwapo G Towoju, Victoria L Mango, Yolanda Bryce, Oluwatosin Z Omoyiola, Marcia Edelweiss, Farouk Dako, Olusegun I Alatise, Peter T Kingham, Elizabeth J Sutton","doi":"10.1200/GO-24-00637","DOIUrl":"10.1200/GO-24-00637","url":null,"abstract":"<p><strong>Purpose: </strong>The introduction of an interventional radiology (IR) unit at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in 2017 marked a significant advancement in health care delivery in a low-resource setting in Nigeria. This study documents the processes, milestones, services, challenges, innovations, and collaborations that have supported the establishment of an IR unit.</p><p><strong>Methods: </strong>We conducted an institutional review board-approved retrospective case study using archival data from the service records (2017-2024). To supplement our findings, we distributed a structured survey to 51 referring clinicians using Google Forms, with a 100% response rate. We analyzed the data descriptively using Microsoft Excel.</p><p><strong>Results: </strong>The establishment of the IR unit in the OAUTHC was driven by structured training, international collaborations, and innovative solutions to overcome infrastructural limitations. The unit began with breast intervention services and was expanded to offer diverse ultrasound- and computed tomography-guided body intervention services. Breast biopsies (31.4%) and liver biopsies (23.5%) constituted the majority of IR referrals. Survey respondents (78.4%; 40 of 51) acknowledged the significant impact of IR services in reducing the need for invasive surgeries, with 84.3% (43 of 51) suggesting the need for increased procedure availability to address long waiting times. Despite challenges such as limited procedural options (56.9%) and long waiting times (41.2%), clinicians rated the IR unit's contributions to patient care as very important (41.2%) or moderately important (52.9%). Key lessons include the importance of structured training programs, leveraging international partnerships to overcome resource gaps, and implementing adaptive strategies to meet local needs.</p><p><strong>Conclusion: </strong>The IR unit transformed patient care at the OAUTHC. This is a replicable model for building sustainable IR programs in other Nigerian hospitals and low-resource settings.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400637"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540261","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":"Primary Mediastinal Germ Cell Tumors: A Real-World Analysis of Clinical Characteristics, Treatment, and Survival Outcomes From Two Tertiary Cancer Centers in India.","authors":"Bharath Gangadhar, Chitrakshi Nagpal, Aparna Sharma, Bivas Biswas, Somnath Roy, Aditya Bhagwat, Deepam Pushpam, Sameer Bakhshi, Sunil Kumar, Kunhi Parambath Haresh, Atul Batra","doi":"10.1200/GO-25-00099","DOIUrl":"10.1200/GO-25-00099","url":null,"abstract":"<p><strong>Purpose: </strong>Mediastinal germ cell tumors (GCTs) are rare malignancies, predominantly affecting young males, with limited real-world data on treatment outcomes in India. This study aimed to evaluate the clinical characteristics, treatment patterns, and survival outcomes of patients with mediastinal GCTs, emphasizing the effectiveness of first-line chemotherapy regimens.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 81 patients diagnosed with mediastinal GCTs at two tertiary cancer centers in India from 2005 to 2023. Data on demographics, histological subtypes, presenting symptoms, treatment regimens, and outcomes were collected. Kaplan-Meier analysis was used to calculate progression-free survival (PFS) and overall survival (OS).</p><p><strong>Results: </strong>The median age at diagnosis was 26 years, with a male predominance (96.3%). Common histological subtypes included seminoma (34.3%) and yolk sac tumor (31.3%). First-line chemotherapy comprised bleomycin, etoposide, and cisplatin (BEP; 60.5%) and etoposide, ifosfamide, and cisplatin (VIP; 27.8%). Response rates included complete response (25.3%) and partial response (54.4%). After a median follow-up of 15 months, the median PFS and OS were not reached, with 2-year PFS and OS rates of 92.7% and 93.3%, respectively. Seminomas demonstrated better PFS compared with nonseminomatous GCTs (<i>P</i> = .004). Severe toxicities were observed in 48.1% of patients, with febrile neutropenia being the most common.</p><p><strong>Conclusion: </strong>This study highlights the effectiveness of BEP and VIP chemotherapy in achieving high response rates and favorable survival outcomes in mediastinal GCTs. Early diagnosis, appropriate histological classification, and aggressive multimodal treatment strategies are essential for improving long-term outcomes in this predominantly young patient population. Further research is warranted to validate these findings and optimize therapeutic approaches.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500099"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612162","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":"Expanding the Pediatric Neuro-Oncology Teleconference Experience: From Twinning to International Cases Discussions.","authors":"Essra' Al Badarin, Omar Chamdine, Moatasem Elayadi, Abeer Al-Battashi, Mohammed Al Nuaimi, Eman Taryam Alshamsi, Laila Hessissen, Hiba Al-Tarrah, Eslam Maher, Roula Farah, Ata Maaz, Waleed Said, Ruba Hazaimeh, Maher Khader, Khadra Salami, Cynthia Hawkins, Mohamed S Abdelbaki, Ute Bartels, Uri Tabori, Eric Bouffet, Nisreen Amayiri","doi":"10.1200/GO-25-00023","DOIUrl":"https://doi.org/10.1200/GO-25-00023","url":null,"abstract":"<p><strong>Purpose: </strong>Video teleconferencing in neuro-oncology is feasible and sustainable. The well-established, 20-year long monthly teleconference between King Hussein Cancer Center (KHCC), Jordan, and SickKids, Canada, is an example. Since 2018, several regional centers joined these meetings to discuss their patients' management plans. We aim to evaluate this experience.</p><p><strong>Methods: </strong>We reviewed the minutes of 56 meetings (2018-2023). Preconference local treatment plans were compared with postconference recommendations. We documented the implementation of recommendations and the impact perceived by the treating oncologists.</p><p><strong>Results: </strong>Two hundred fifty-one patients were discussed: 137 from Jordan and 114 from eight other countries. Four of the 14 participating oncologists had formal pediatric neuro-oncology training. Of the 227 patients (90%), where the local multidisciplinary team had suggested a preconference plan, the teleconference recommendations concurred with the proposed plan in 50% of cases, agreed on it and proposed an alternative option in 18%, and disagreed in 32%. The difference in recommendations mostly affected the proposed treatment modality. In 64% of discordant plans and 50% of alternative plans, the treating team applied the recommendations. The main challenges in applying the recommendations were attributed to patient-related factors (51%), local team consensus on a different plan (26%), or logistic difficulties (23%). The high patient load, longer involvement in teleconferencing, formal neuro-oncology training, and well-established multidisciplinary team helped the KHCC team formulate more concordant plans.</p><p><strong>Conclusion: </strong>This experience illustrates the potential benefit for physicians to get an expert opinion on challenging cases. The participating oncologists valued the shared educational experience, especially those related to molecular testing and treatment implications. Joining such regional teleconferences is of particular importance to centers with small patient volume or those lacking a pediatric neuro-oncologist.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500023"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612160","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":"Charting Postoperative Trajectories in Patients With Cancer: Perspectives From a Resource-Constrained Setting in Northeast India.","authors":"Bhavana Kulkarni, Laxman Kumar Mahaseth, Tanu Anand, Arun Seshachalam, Surendran Veeraiah, Ritesh Tapkire, Ravi Kannan","doi":"10.1200/GO-24-00528","DOIUrl":"https://doi.org/10.1200/GO-24-00528","url":null,"abstract":"<p><strong>Purpose: </strong>Perioperative monitoring in critical care facility is a major determinant of postoperative outcome. However, critical care resources are finite and expensive. Thus, identifying those most likely to benefit is of great importance in resource-constrained settings. Hence, this study aims to identify prognostic factors predicting postoperative mortality and morbidity for patients in surgical units. This may help in identifying high-risk patients and developing an approach to reduce mortality.</p><p><strong>Methods: </strong>This was a cohort study involving secondary data of all patients with cancer age 18 years and older and admitted to the critical care. Preoperative, intraoperative, and postoperative parameters were extracted in Excel from the cloud physician electronic database. Descriptive analysis and log-binomial regression were used to analyze the data using STATA version 12. 1. Poor postoperative outcomes were defined as the occurrence of morbidity (unplanned postoperative course) or mortality.</p><p><strong>Results: </strong>The study included 421 patients with a mean age of 58.02 years (SD, 12.85). The majority of the patients were in the age range of 41-60 years (53%), 29% were older than 60 years, and 88% were found to use tobacco. Of all patients, 287 (68%) had significant postoperative morbidity and 13 patients (3%) died. Acute Physiology and Chronic Health Evaluation (APACHE-II) score >15 (adjusted relative risk [RR], 4.5 [95% CI, 1.48 to 14.01]), surgeon's experience <10 years (adjusted RR, 1.7 [95% CI, 1.06 to 2.94]), and blood loss more than 100 ml (adjusted RR, 2.42 [95% CI, 1.43 to 4.10]) were found to be significant predictors of poor postoperative outcomes.</p><p><strong>Conclusion: </strong>Higher APACHE-II scores, significant blood loss, and operated by less experienced surgeon were the major determinants of poor postoperative outcomes and necessitate postoperative monitoring in critical care facilities.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400528"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753414","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: Critical Review: Efficacy and Safety of Biosimilar Cetuximab Versus Innovator Cetuximab in Indian Patients With Head and Neck Cancer.","authors":"Kumar Prabhash, Roshan Pawar, Vijaya Gunjal","doi":"10.1200/GO-25-00216","DOIUrl":"https://doi.org/10.1200/GO-25-00216","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500216"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698553","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":"Cost-Effectiveness of Lung Cancer Screening in a High-Risk Population in Brazil.","authors":"Clarissa Baldotto, Wolfgang W Schmidt Aguiar, Francisco Martins Neto, Vladmir Cordeiro de Lima, Eldsamira Mascarenhas, Thiago Lins Fagundes Sousa, Tamiê de Camargo Martins, Mauricio Cristiano Rocha-Junior, Cintia Kurokawa La Scala de Oliveira, Nelson Francisco Correa-Netto, Gustavo Faibischew Prado","doi":"10.1200/GO-25-00097","DOIUrl":"https://doi.org/10.1200/GO-25-00097","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to assess whether lung cancer (LC) screening with low-dose computed tomography (LDCT) is cost effective in a high-risk population (current or former smokers-who stopped smoking within <15 years-age 50-80 years, with a smoking history of at least 20 pack-years) in the Brazilian public health setting.</p><p><strong>Methods: </strong>To estimate the size of the population eligible for screening, we used Brazilian 2020 census data and information provided by the nationwide surveillance system of risk factors for chronic diseases. For comparison, we used a nonscreened population of LC cases from the São Paulo state registry. We characterized patient journeys and estimated direct and indirect costs using the nationwide public health system database, DATASUS, and expert opinion from an ad hoc panel. We used Markov models for economic evaluations that considered treatment costs (in Brazilian currency, R$) and outcomes.</p><p><strong>Results: </strong>Adopting an LC screening strategy with LDCT in this high-risk population would be associated with an incremental cost-effectiveness ratio (ICER) of R$ 133,327 per quality-adjusted life year. For the life year outcome, the ICER was R$ 9,579 per life year gained. For both outcomes, the values were below the cost-effectiveness threshold considered (three times the per-capita gross domestic product, which corresponds to R$ 143,406.06 or $24,735.99 US dollars).</p><p><strong>Conclusion: </strong>Our study confirms that implementing LC screening with LDCT in a high-risk population is cost effective in the Brazilian public health system.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500097"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698551","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":"Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective.","authors":"Sarah Nietz, Jenny Edge, Ines Buccimazza, Georgia Demetriou, Mariza Tunmer, Jacqueline Smilg, Duvern Ramiah, Peter Schoub, Shane A Norris, Paul Ruff","doi":"10.1200/GO-25-00168","DOIUrl":"https://doi.org/10.1200/GO-25-00168","url":null,"abstract":"<p><strong>Purpose: </strong>In South Africa, breast care lacks governance and standardization, necessitating urgent improvements in patient outcomes. Quality improvement initiatives are urgently needed in low- and middle-income countries (LMICs), but requirements for breast centers in lower resource settings remain undefined and must be tailored to local environments. This consensus document outlines the role and requirements of breast centers in LMICs and presents a step-by-step implementation plan.</p><p><strong>Methods: </strong>The literature was systematically reviewed, and the primary review team tabulated international accreditation standards alongside the 2018 South African Clinical Guidelines for Breast Cancer Control and Management from the South African National Department of Health, along with proposed South African standards. The broader consensus panel consisted of 29 clinical experts and representatives from societies, advocacy, and funders.</p><p><strong>Results: </strong>We categorized requirements into eight broader categories and achieved unanimous consensus on all requirement components, except for 1 abstention in the general specialist and expertise category. We were unable to reach consensus on the patient volume requirements for radiologists as well as for medical and clinical/radiation oncologists. Volume requirements for clinical and radiation oncologists were later provided by the South African Society of Clinical and Radiation Oncology (SASCRO), along with the volume requirements submitted by the participating radiologists. We also achieved unanimous consensus for the Breast Interest Group of Southern Africa (BIGOSA) to house the initial project implementation. This consensus document is endorsed by BIGOSA, SASCRO, and the Cancer Association of South Africa.</p><p><strong>Conclusion: </strong>We emphasize the importance and necessity of breast centers in resource-constrained environments, outline the first set of requirements for breast centers tailored to LMICs in sub-Saharan Africa, and present a feasible and detailed plan for initial implementation.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500168"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325757","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":"Erratum: Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study.","authors":"Erika Arnold, Devin Laubscher, Huzaifa Saeed, Osama Ahmed, Ayesha Bashir, Haji Chalchal, Gary Groot, Duc Le, Mita Manna, Pamela Meiers, Prosanta Mondal, Shahid Ahmed","doi":"10.1200/GO-25-00277","DOIUrl":"10.1200/GO-25-00277","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500277"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289445","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":"Bone Mineral Density in Black South African Women Newly Diagnosed With Breast Cancer Living With and Without HIV.","authors":"Lindor Qunaj, Maureen Joffe, Alfred I Neugut, Lisa K Micklesfield","doi":"10.1200/GO-25-00122","DOIUrl":"10.1200/GO-25-00122","url":null,"abstract":"<p><strong>Purpose: </strong>Worsening bone mineral density (BMD)-and the corresponding increase in osteoporotic fractures-is an important and well-established source of morbidity and mortality in women receiving treatment of breast cancer, as well as those living with HIV. However, there are comparatively few reports on pretreatment bone health in women newly diagnosed with breast cancer, especially in predominantly Black populations, across sub-Saharan Africa (SSA), and among individuals living with HIV. Therefore, we sought to characterize bone health in a cohort of Black South African women with and without HIV before the initiation of systemic breast cancer therapy, in particular chemotherapy and/or aromatase inhibitors.</p><p><strong>Methods: </strong>Building on the South African Breast Cancer and HIV Outcomes study, we recruited consecutive women newly diagnosed with stage I-III breast cancer who were to start systemic cancer therapy at the Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, between June 2021 and August 2024. In addition to collecting extensive demographic and clinical information, we conducted dual energy X-ray absorptiometry (DXA) scans on each patient to measure BMD of the lumbar spine, femoral neck, and total hip.</p><p><strong>Results: </strong>We enrolled a total of 378 women, 32.3% of whom (n = 122) were living with HIV. Among women aged 50 years and older (n = 156), 64.1% had osteopenia or osteoporosis; HIV infection and vitamin D insufficiency/deficiency-but no breast cancer characteristics-were associated with a higher risk of osteoporosis. By contrast, 3.6% of women younger than 50 years had BMD below the expected range for age.</p><p><strong>Conclusion: </strong>Especially in low-resource clinical settings, such as public hospitals in SSA, understanding which women are at highest risk of osteoporosis and fragility fracture before the initiation of breast cancer systemic therapy is critical. Our study provides a foundation for identifying relevant risk factors and ultimately designing interventional studies that target high-risk women for intensified osteoporosis screening and management.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500122"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325754","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}