JCO Global Oncology最新文献

{"title":"Erratum: Regional Patterns of Invasive Interventions for Unresectable Liver Cancer: Perspectives of Elective and Urgent Care in Brazil.","authors":"Luiza da Silva de Carvalho, Alana Bruna Krug, Laynara Vitória da Silva Vieira, Beatriz da Silva Meneses, Marcella Eduarda de Aguiar Tavares, Luana Baptistele Dornelas, Marcos Bettini Pitombo","doi":"10.1200/GO-24-00478","DOIUrl":"https://doi.org/10.1200/GO-24-00478","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400478"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965530","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":"Pediatric Medical Tourism: International Patients Seeking Treatment in the United States for Malignancy and Serious Hematologic Disorders. A Review of the St Jude Experience.","authors":"Saman K Hashmi, Sierra Klein, Rushil Acharya, Suraj Sarvode Mothi, Jacklyn Boggs, Tracy Dodd, Liza-Marie Johnson","doi":"10.1200/GO-24-00454","DOIUrl":"https://doi.org/10.1200/GO-24-00454","url":null,"abstract":"<p><strong>Purpose: </strong>Medical tourism is defined as travel outside one's home country to seek medical care. International travel for medical care can have financial, logistical, and ethical implications for patients, families, and accepting institutions. Data on medical tourism in pediatrics are sparse, especially for care of rare or life-threatening diseases such as cancer. To our knowledge, this study provides the first description of international patients seeking medical care in the United States for oncologic and hematologic diseases.</p><p><strong>Methods: </strong>We performed a retrospective review of international patients seen at St Jude Children's Research Hospital from August 2, 2009, through June 30, 2019. These included patients with acceptance obtained through the referral process and those who arrived without approval (walk-in patients). Demographic and clinical data were collected and analyzed using descriptive statistics.</p><p><strong>Results: </strong>Of the 372 international patients seen, most identified as White (n = 258; 69.4%) and not Hispanic (n = 232; 62.4%). A minority (n = 23; 6.2%) arrived as walk-in patients. The highest number of patients was from the Latin America and Caribbean region (n = 181; 48.7%) and from upper-middle-income countries (UMICs) (n = 182; 48.9%). Six patients (1.6%) were from low-income countries (LICs). Oncologic diagnoses were the most common reason for referral, with a similar distribution of accepted patients across hematologic, CNS, and non-CNS solid tumors although hematologic malignancies predominated among walk-in patients (n = 17; 81%).</p><p><strong>Conclusion: </strong>International patients came to the United States from across the world, mostly through formal acceptance. However, there were more patients from UMICs at our institution than from low- and middle-income countries and LICs. Additional studies are needed to investigate this observation which supports the continuous need for global capacity-building collaborations in pediatric oncology.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400454"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005795","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":"Treatment Trends in Metastatic Renal Clear Cell Carcinoma in Argentina.","authors":"Federico Cayol, Gabriela Gatica, Pablo Companys, Carolina Passarella, Rodrigo Sanchez, Ernesto Korbenfeld, Jose Zarba, Omar Carranza, Ruben Kowalyszyn, Gonzalo Taetti, Martín Richardet, Ezequiel Espamer, Mauricio Fernandez Lazaro, Laura Pelagatti, Nicolas Mainardi, Matías Cortes, José Peñaloza, Hernan Cutuli, María Pía Dominguez, Harold Somerville, Florencia Sarru, Juan Pablo Sade, Augusto Ferreyra Camacho, Emiliano Menna, Ivan Macharashvili, Rosalía Hinojosa Altamirano, Andrea Marchioni, Federico Losco, Pamela López, Tomas Soule, Mariano Aymar, Ignacio Jerez, Juan Ignacio Hernández Morán, María Natalia Gandur Quiroga, Martín Angel","doi":"10.1200/GO-24-00342","DOIUrl":"https://doi.org/10.1200/GO-24-00342","url":null,"abstract":"<p><strong>Purpose: </strong>Renal cell carcinoma (RCC) accounts for 2%-3% of adult cancers globally. In Argentina, RCC is the fifth most common cancer, with over 2,000 new patients annually. This study aims to evaluate treatment trends for patients with metastatic renal cell carcinoma (mRCC) in Argentina.</p><p><strong>Methods: </strong>A retrospective study was conducted involving 689 patients with mRCC treated in Argentina between 2015 and 2022. The study analyzed treatment patterns and outcomes over time.</p><p><strong>Results: </strong>Access to combination treatments for mRCC in Argentina has increased significantly, with 87% of patients receiving such therapies during the 2021-2022 period. The real-world data demonstrated that combination treatments in this Latin American population resulted in prolonged progression-free survival and improved overall response rate.</p><p><strong>Conclusion: </strong>The results underscore the importance of ensuring access to combination therapies for patients with mRCC in Latin America. These findings should inform public health policies aimed at guaranteeing access to effective combination therapies.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400342"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063571","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":"Germline Genetic Variants in Cancer Predisposition Genes in Patients From Latin America and the Caribbean.","authors":"Talia Wegman-Ostrosky, Lucia Taja-Chayeb, Zyanya Lucia Zatarain-Barrón, Catalina Trejo-Becerril, Alfredo Ramirez-Gonzalez, Jimena Romo-Huerta, Lisa Ximena Rodriguez-Rojas, Isabel Espino-Gutiérrez, Zacil Ha Vilchis-Zapata, Sylvia Harari-Arakindji, José Elías García-Ortiz, Alejandro Ruiz-Patiño","doi":"10.1200/GO-24-00433","DOIUrl":"https://doi.org/10.1200/GO-24-00433","url":null,"abstract":"<p><p>The importance of having region-specific data when planning health interventions has become evident in recent years. Nonetheless, several world regions, including Latin America and the Caribbean (LAC), still face significant challenges. These regions need to develop strategies specifically designed to consider the inherent characteristics of their population composite and sociodemographic characteristics. More than 20% of the global cancer incidence arises in LAC. Yet, treatment, prevention, and follow-up guidelines in the area are frequently based on studies that mainly include patients from North America, Europe, and Asia. As personalized approaches become ubiquitous in medical practice, the amount of information emerging from LAC has risen considerably. In this review, we seek to present a comprehensive summary of the frequency of germline genetic variants in hereditary cancer syndromes in patients from LAC. The data highlight relevant differences in variants associated with LAC patients, including founder and recurrent variants, while showcasing potential features that might be relevant in oncology practices.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400433"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012417","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":"Invisible Populations: The Need for Race and Ethnicity Data in Cancer Control.","authors":"Mei Ling Yap, Nirmala Bhoo-Pathy, Beverley M Essue, Maryam Naghsh-Nejad, Vikneswary Batumalai, Otuto Amarauche Chukwu, Kapel Dowe, Jennifer Moodley, Dingle Spence, Fiona F Stanaway","doi":"10.1200/GO-25-00049","DOIUrl":"https://doi.org/10.1200/GO-25-00049","url":null,"abstract":"","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2500049"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967749","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":"Palliative Radiotherapy Near the End of Life: An Analysis of Factors Influencing the Administration of Radiotherapy in Advanced Tumor Disease.","authors":"Nguyen-Son Le, Asli Zeybek, Klaus Hackner, Cornelia Gallauner, Josef Singer, Felix Schragel, Petra Georg, Sandra Gottsauner-Wolf, Martin Pecherstorfer, Gudrun Kreye","doi":"10.1200/GO-24-00500","DOIUrl":"https://doi.org/10.1200/GO-24-00500","url":null,"abstract":"<p><strong>Purpose: </strong>Palliative radiotherapy (PRT) toward the end of life (EOL) in advanced tumor disease is contentious. Although EOL RT can alleviate cancer-related symptoms, relief typically occurs weeks to months after treatment, potentially compromising the quality of life of patients during the final stages. This study aims to assess factors influencing the decision-making process regarding EOL RT.</p><p><strong>Materials and methods: </strong>This retrospective study of a real-world cohort included 684 consecutive patients with a diagnosis of a solid tumor who died between 2017 and 2021. In these patients, factors potentially influencing the administration of EOL RT were analyzed.</p><p><strong>Results: </strong>Of the 684 patients, 164 received PRT, with 60 (36.6%) receiving EOL RT within the last 30 days of life. The median time from the last RT session to death was 55 days. Significant factors influencing EOL RT administration were age ≤65 years (odds ratio [OR], 1.75 [95% CI, 1.02 to 3.01]), Union for International Cancer Control stage IV (OR, 2.77 [95% CI, 1.41 to 5.46]), lung cancer (OR, 2.16 [95% CI, 1.00 to 4.68]), palliative care referral (OR, 1.80 [95% CI, 0.98 to 3.30]), systemic anticancer treatment ≤30 days before death (OR, 1.87 [95% CI, 1.05 to 3.33]), and Eastern Cooperative Oncology Group performance status ≥2 (OR, 3.73 [95% CI, 1.88 to 7.40]). Furthermore, RT near the EOL was more likely administered at multiple sites (OR, 2.08 [95% CI, 1.00 to 4.29]) and with ≤5 fractions (OR, 2.37 [95% CI, 1.23 to 4.57]), while being associated with lower response rates (OR, 0.43 [95% CI, 0.21 to 0.86]) and increased therapy discontinuation (OR, 4.40 [95% CI, 1.45 to 13.37]).</p><p><strong>Conclusion: </strong>These findings highlight varying RT patterns influenced by specific factors, demonstrating the complexity of EOL treatment decisions in advanced cancer care. Identifying key factors for personalized, patient-centered EOL RT decisions warrants further investigation.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400500"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991134","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":"Can Elective Neck Dissection for Oral Cancer Be Planned on the Basis of Depth of Invasion? Retrospective Analysis.","authors":"Kinjal S Majumdar, Thaduri Abhinav, Achyuth Panuganti, Rajkumar K Seenivasagam, Manu Malhotra","doi":"10.1200/GO-24-00451","DOIUrl":"https://doi.org/10.1200/GO-24-00451","url":null,"abstract":"<p><strong>Purpose: </strong>The literature suggests that elective neck dissection (END) may be avoided in primaries with a depth of invasion (DOI) <3 mm. This study evaluated the accuracy of DOI in predicting nodal metastases (lymph node metastasis [LNM]) in oral squamous cell carcinoma (OSCC).</p><p><strong>Materials and methods: </strong>In this retrospective institutional chart review, pathologic N classification (pN) was correlated with DOI using Spearman's rank-order (pN1-3) and point-biserial (pN0 <i>v</i> pN+) correlation statistics. The receiver operating characteristic (ROC) curve was analyzed to determine the accuracy of DOI in predicting LNM. Chi-square statistics were used to measure the association between the DOI groups and pN status (pN0; pN+). Post hoc analysis of variance with Bonferroni statistics was used to compare the three DOI groups.</p><p><strong>Results: </strong>DOI failed to demonstrate a strong positive correlation with the pN classification (ρ = 0.31; <i>P</i> < .001). DOI was not strongly correlated with pN status (<i>r</i>_pb = 0.27; <i>P</i> < .001). ROC curve analysis suggested a poor accuracy of DOI in predicting nodal metastases (AUC = 0.67 [95% CI, 0.6 to 0.73]). A statistically significant difference in LNM (pN+) was found between the DOI >10 mm and DOI ≤10 mm primaries (<i>P</i> < .001 for DOI ≤5 mm; <i>P</i> = .016 for DOI >5 mm and ≤10 mm). However, the sensitivity and specificity achieved by ROC analysis for a DOI cutoff value of 10 mm in the present cohort were 69.3% and 57.9%, respectively.</p><p><strong>Conclusion: </strong>DOI is a poor indicator of LNM in OSCC. The decision to perform END should not be based on the tumor DOI.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400451"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077892","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 Oral Levofloxacin Versus Amoxicillin-Clavulanate/Ciprofloxacin for Outpatient Management of Low-Risk Febrile Neutropenia in Children With Cancer in Egypt.","authors":"Reham Abdelaziz Khedr, Ebtehal Ali, Zeinab Ahmad Elshafei, Hadir Ahmed El-Mahallawy, Nashwa Ezz Eldeen","doi":"10.1200/GO.24.00182","DOIUrl":"https://doi.org/10.1200/GO.24.00182","url":null,"abstract":"<p><strong>Purpose: </strong>Febrile neutropenia (FN) is a common cancer complication in children. A growing body of evidence suggests that home-based care with oral antibiotics is safe and effective in carefully selected children with low-risk (LR) FN. This study aimed to assess the efficacy and safety of oral levofloxacin versus oral amoxicillin-clavulanate/ciprofloxacin in the management of LR-FN in children with cancer over a time horizon of 7 days from the National Cancer Institute (NCI) perspective.</p><p><strong>Patients and methods: </strong>This is a randomized controlled study conducted at the NCI from December 2021 to September 2022, including children and adolescents age between 3 and 18 years who presented to the emergency room with LR-FN criteria with the exclusion of patients younger than 3 years and patients with Down syndrome. One hundred LR-FN episodes were enrolled in each arm. Patient demographics, microbiologic data, and outcomes were collected at different time points. A decision analytic model was created to compare the two treatment strategies. The outcome measures included quality-adjusted FN episodes, costs, and incremental cost-effectiveness ratios.</p><p><strong>Results: </strong>Levofloxacin was a safe and effective treatment option for LR-FN. It proved to be the dominant strategy against amoxicillin-clavulanate/ciprofloxacin with an incremental quality-adjusted life-year (QALY) of 0.0001 and a lower cost of 62.4996 Egyptian pounds (EGPs) in the treatment of home-based LR-FN with a willingness to pay a threshold of 77,520 EGPs per QALY (1 gross domestic product/capita).</p><p><strong>Conclusion: </strong>For the treatment of FN in pediatric patients with cancer, levofloxacin offers a cost-saving option with improved survival benefits over a 7-day time horizon from the NCI perspective. These findings will help health care decisions regarding the allocation of health care system resources to improve supportive care for patients with LR-FN.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400182"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990494","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":"Adjuvant Anti-PD-1 Monotherapy Versus Observation for Stage III Acral Melanoma of the Sole: A Multicenter Retrospective Study in Japanese Patients.","authors":"Shigeru Koizumi, Naoya Yamazaki, Yuki Ichigozaki, Hiroshi Kitagawa, Yukiko Kiniwa, Sayuri Sato, Toshihiro Takai, Reiichi Doi, Takamichi Ito, Masahito Yasuda, Yutaka Kuwatsuka, Takeo Maekawa, Jun Asai, Takuya Miyagawa, Shigeto Matsushita, Takeru Funakoshi, Yosuke Yamamoto, Takashi Inozume, Akiko Kishi, Tatsuya Takenouchi, Hiraku Kokubu, Shusaku Ito, Yoshiyasu Umeda, Yuki Yamamoto, Shoichiro Ishizuki, Shiro Iino, Hiroshi Uchi, Tomoe Nakagawa, Kazuhiro Inafuku, Takahiro Haga, Takahide Kaneko, Masahiro Nakagawa, Hideki Kamiya, Masaru Arima, Toshihiko Hoashi, Azusa Hiura, Nobuo Kanazawa, Keiko Manabe, Masashi Ishikawa, Kenji Asagoe, Utsugi Iwasawa, Takafumi Kadono, Naohito Hatta, Shoichiro Minami, Eiji Nakano, Dai Ogata, Satoshi Fukushima, Hisashi Uhara, Kenta Nakama, Yasuhiro Nakamura","doi":"10.1200/GO-24-00644","DOIUrl":"10.1200/GO-24-00644","url":null,"abstract":"<p><strong>Purpose: </strong>Adjuvant anti-PD-1 (adj PD-1) antibodies are extensively used to improve survival in patients with resected melanoma. Clinical trials on adj PD-1 antibodies have revealed significant improvements in recurrence-free survival (RFS); however, few of these trials have included patients with acral melanoma (AM).</p><p><strong>Methods: </strong>Clinical data were retrospectively collected from Japanese patients who underwent resection of stage III sole AM between 2014 and 2021. Survival outcomes, including RFS, distant metastasis-free survival (DMFS), and overall survival (OS), were compared between patients without adjuvant therapy (OBS group) and those receiving adj PD-1 group.</p><p><strong>Results: </strong>This study included 139 patients (OBS: 79; adj PD-1: 60), with a median follow-up of 2.6 years. The baseline characteristics were comparable, except for age and nodal metastasis. No significant differences in survival were observed between the OBS and adj PD-1 groups (3-year RFS: 36.7% <i>v</i> 27.5%, <i>P</i> = .13; 3-year DMFS: 51.0% <i>v</i> 45.3%, <i>P</i> = .51; 3-year OS: 65.3% <i>v</i> 67.4%, <i>P</i> = .45). Multivariate analysis showed no survival benefit of adj PD-1 (RFS: hazard ratio [HR], 1.25, <i>P</i> = .29; DMFS: HR, 1.03, <i>P</i> = .89; and OS: HR, 0.69, <i>P</i> = .23). Each survival outcome after propensity score matching confirmed no significant difference between the matched OBS group (n = 52) and adj PD-1 group (n = 52; 3-year RFS: 34.3% <i>v</i> 25.9%, <i>P</i> = .22; 3-year DMFS: 45.6% <i>v</i> 46.5%, <i>P</i> = .85; 3-year OS: 60.7% <i>v</i> 68.9%, <i>P</i> = .29).</p><p><strong>Conclusion: </strong>Adj PD-1 did not improve the prognosis in sole AM. However, further studies are essential to evaluate the efficacy of the adj anti-PD-1 antibody in AM.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400644"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784524","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":"Automated Detection of Kaposi Sarcoma-Associated Herpesvirus-Infected Cells in Immunohistochemical Images of Skin Biopsies.","authors":"Iftak Hussain, Juan Boza, Robert Lukande, Racheal Ayanga, Aggrey Semeere, Ethel Cesarman, Jeffrey Martin, Toby Maurer, David Erickson","doi":"10.1200/GO-24-00536","DOIUrl":"10.1200/GO-24-00536","url":null,"abstract":"<p><strong>Purpose: </strong>Immunohistochemical staining for the antigen of Kaposi sarcoma (KS)-associated herpesvirus, latency-associated nuclear antigen (LANA), is helpful in diagnosing KS. A challenge lies in distinguishing anti-LANA-positive cells from morphologically similar brown counterparts. This work aims to develop an automated framework for localization and quantification of LANA positivity in whole-slide images (WSI) of skin biopsies.</p><p><strong>Methods: </strong>The proposed framework leverages weakly supervised multiple-instance learning (MIL) to reduce false-positive predictions. A novel morphology-based slide aggregation method is introduced to improve accuracy. The framework generates interpretable heatmaps for cell localization and provides quantitative values for the percentage of positive tiles. The framework was trained and tested with a KS pathology data set prepared from skin biopsies of KS-suspected patients in Uganda.</p><p><strong>Results: </strong>The developed MIL framework achieved an area under the receiver operating characteristic curve of 0.99, with a sensitivity of 98.15% and specificity of 96.00% in predicting anti-LANA-positive WSIs in a test data set.</p><p><strong>Conclusion: </strong>The framework shows promise for the automated detection of LANA in skin biopsies, offering a reliable and accurate tool for identifying anti-LANA-positive cells. This method may be especially impactful in resource-limited areas that lack trained pathologists, potentially improving diagnostic capabilities in settings with limited access to expert analysis.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"11 ","pages":"e2400536"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009907","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}