Journal of geriatric oncology最新文献

{"title":"Patterns of presentation, treatment, and survival among older adults with metastatic breast cancer: Results from a large prospective registry","authors":"Alexandra B. Newman ,&nbsp;Alyssa R. Martin ,&nbsp;Melissa E. Hughes ,&nbsp;Amanda Higgins ,&nbsp;Gregory J. Kirkner ,&nbsp;Janet Files ,&nbsp;Molly Skeffington ,&nbsp;McKenna Moore ,&nbsp;Sarah Strauss ,&nbsp;Nicole Kuhnly ,&nbsp;Lindsey Crowley ,&nbsp;Sara M. Tolaney ,&nbsp;Nancy U. Lin ,&nbsp;Rachel A. Freedman","doi":"10.1016/j.jgo.2025.102261","DOIUrl":"10.1016/j.jgo.2025.102261","url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults with breast cancer experience worse survival than their younger counterparts. However, data are limited on the patterns of presentation, treatment, and outcomes for older patients with metastatic breast cancer (MBC) outside of registry studies and selected clinical trial populations.</div></div><div><h3>Materials and Methods</h3><div>We identified patients aged ≥60 years from a single, NCI-designated cancer center with MBC diagnosed between 1999 and 2022. Using Chi-square testing, we compared clinicopathologic characteristics by age. We also examined treatment patterns and reasons for treatment discontinuation; overall survival (OS) was examined by subtype and age using Kaplan-Meier methods.</div></div><div><h3>Results</h3><div>The final analytic cohort included 1115 patients with a median follow-up of 2.9 years (1.0–18.5); median age at metastatic diagnosis was 66.3 (60.0–95.4). Disease subtypes included: 70.7 % hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-), 11.9 % any HR/HER2+, 17.4 % triple negative (TN). In those with HR+/HER2- disease receiving first-line (1 L) therapy (<em>n</em> = 783), 1 L endocrine-based therapy was frequent (79.3 % for ages 60–65, 94.7 % for &gt;80), and administration of 1 L chemotherapy varied by age (21.0 % in ages 60–65, 5.3 % in &gt;80). Among those with TN and HER2+ disease, ≥84 % received a 1 L chemotherapy or trastuzumab-containing regimen. Across subtypes, most patients (80.5 %) discontinued 1 L therapy for progression, not toxicity. Among patients ages 60–65, 16.5 % stopped treatment after 1 L therapy; 42.2 % of those &gt;age 80 received treatment after 1 L. Clinical trial enrollment declined with age (40 % in 60–65 vs. 13 % for &gt;80; <em>p</em> = 0.0004), as did median OS (4.4 years in ages 60–65 vs. 2.7 years for &gt;80; <em>p</em> &lt; 0.005). For ages 60–65, 37.8 %, 17.1 %, and 40.3 % with HR + HER2-, TN, and HER2+ disease, respectively, were alive at two years. For ages &gt;80, 23.7 %, 0 %, and 33.3 % with HR + HER2-, TN, and HER2+ disease, respectively, were alive at two years.</div></div><div><h3>Discussion</h3><div>In a unique, large prospective cohort of older adults with MBC, the number of treatment lines decreased with increasing age, and OS outcomes were poor, particularly for those &gt;80 years where most patients were not alive at two years after MBC diagnosis. Therapeutic approaches, with improved supportive care, are urgently needed to optimize outcomes in the oldest patients with MBC.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102261"},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the impact of adherence on real-world comparisons between abiraterone and enzalutamide","authors":"Amir Reza Akbari ,&nbsp;Benyamin Alam","doi":"10.1016/j.jgo.2025.102263","DOIUrl":"10.1016/j.jgo.2025.102263","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102263"},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with and beyond cancer: What older adults tell us about healthy aging","authors":"Ailsa C. Sirois ,&nbsp;Kristin L. Campbell ,&nbsp;Schroder Sattar ,&nbsp;Margaret Rudolf ,&nbsp;Kristen R. Haase","doi":"10.1016/j.jgo.2025.102259","DOIUrl":"10.1016/j.jgo.2025.102259","url":null,"abstract":"<div><h3>Introduction</h3><div>Healthy aging is a process that allows for optimal functional ability and wellbeing, but little is known about older adults' experiences living with and beyond cancer (also called survivorship). The purpose of this study was to explore the experiences and perceptions of healthy aging among older adults living with and beyond cancer.</div></div><div><h3>Materials and Methods</h3><div>Community-dwelling older adults diagnosed with cancer at age ≥ 65 were recruited to participate in a series of in-depth semi-structured interviews. We used interpretive description and patient-oriented research methods. Data were thematically analyzed.</div></div><div><h3>Results</h3><div>A total of 20 older adults living with and beyond cancer (mean age 74) in British Columbia, Canada, participated. Coping with cancer and age-related changes in older age was important for healthy aging and quality of life. Older adults coped by adapting to maintain their health and function, accepting and rejecting barriers, and defying ageist norms about cancer in older age. Participants reported discrepancies between their own priorities for healthy aging and their perceptions of healthcare providers' priorities for them. For example, older adults identified a lack of attention to quality of life and minimal integration of psychosocial supports in cancer treatment and survivorship care. Our findings also address the nuances of how cancer influences health behaviours in the context of pursuing healthy aging.</div></div><div><h3>Discussion</h3><div>Understanding the experiences and perceptions of healthy aging among older adults living with and beyond cancer is critical to promoting health for this growing population. Our findings highlight the need for individualized care and the importance of quality of life for older adults living with and beyond cancer. This work can inform interventions to support healthy aging.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102259"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric assessment in older adults with acute myeloid leukemia: A Young International Society of Geriatric Oncology narrative review","authors":"Andrea Sebastiano Ciccone ,&nbsp;Vincent Thibaud ,&nbsp;Kelly Pugh ,&nbsp;Bochra Sedaki ,&nbsp;Vanya Slavova-Boneva ,&nbsp;Adolfo Gonzalez Serrano ,&nbsp;Nina Neuendorff ,&nbsp;Thomas Cluzeau ,&nbsp;Kah Poh Loh","doi":"10.1016/j.jgo.2025.102254","DOIUrl":"10.1016/j.jgo.2025.102254","url":null,"abstract":"<div><div>The therapeutic landscape of acute myeloid leukemia (AML) in older adults has been transformed by the advent of targeted therapies, including venetoclax (a B-cell lymphoma-2 inhibitor), gilteritinib (a FMS-like tyrosine kinase 3 inhibitor), ivosidenib, and enasidenib (isocitrate dehydrogenase 1/2 inhibitors). These agents, in combination with hypomethylating agents, have significantly improved outcomes among patients aged 60 years and older, however, overall survival remains very poor. Hence, the management of AML in this population requires a nuanced approach to balance overall survival, treatment-related toxicities, quality of life, and the preservation of functional independence.</div><div>In recent years, geriatric assessment (GA) has emerged as a critical strategy to identify vulnerabilities that may not be captured in routine oncology evaluations. This assessment helps guide tailored interventions to optimize the fitness of older adults, allowing for better risk stratification and thereby informing treatment plans. This review discusses available evidence for each domain within the GA, feasibility of GA in clinical trials, and gaps in knowledge and future directions to fill those gaps.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102254"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent chemotherapy for older patients with locoregionally advanced nasopharyngeal carcinoma: A randomized clinical trial","authors":"Caineng Cao,&nbsp;Yuting Fang,&nbsp;Feng Jiang,&nbsp;Qifeng Jin,&nbsp;Ting Jin,&nbsp;Shuang Huang,&nbsp;Qiaoying Hu,&nbsp;Yuanyuan Chen,&nbsp;Yongfeng Piao,&nbsp;Yonghong Hua,&nbsp;Xinglai Feng,&nbsp;Xiaozhong Chen","doi":"10.1016/j.jgo.2025.102246","DOIUrl":"10.1016/j.jgo.2025.102246","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to evaluate the efficacy of two different radiotherapy strategies in elderly patients with locally advanced nasopharyngeal carcinoma (NPC) using geriatric assessment.</div></div><div><h3>Materials and Methods</h3><div>We conducted a randomized phase 2 trial for older patients (≥ 65 years) with stage III-IVA NPC. Patients were randomized into either intensity-modulated radiotherapy (IMRT) alone (RT Arm) or concurrent chemoradiotherapy (CCRT Arm). The primary endpoint was therapeutic success. The secondary endpoints were survival, safety and geriatric assessment.</div></div><div><h3>Results</h3><div>Between June 1, 2017 and June 11, 2019, 22 patients were allocated to the RT arm and 19 to the CCRT arm. There was therapeutic success in 11 patients (57.9 %) in the CCRT arm and 18 patients (81.8 %) in the RT arm. The median follow-up time was 60.4 months (interquartile range [IQR], 49.8–67.8) months. The five-year locoregional relapse-free survival, cancer-specific survival, and overall survival rates for patients in the CCRT and RT arms were 93.8 % and 85.7 % (<em>p</em> = 0.77), 93.8 % and 80.7 % (<em>p</em> = 0.12), 78.9 % and 56.8 % (<em>p</em> = 0.09), respectively. The five-year distant metastasis-free survival rates for patients in the CCRT and RT arms were 100.0 % and 76.6 % (<em>p</em> = 0.002), respectively. Compared with the CCRT arm, lower incidence of acute toxicities was observed in the RT arm, including grade 1 or higher vomiting, nausea, anemia, and leukopenia (<em>p</em> &lt; 0.05).</div></div><div><h3>Discussion</h3><div>CCRT was not more efficacious than IMRT alone but was more likely to cause acute toxicities in older patients with locally advanced NPC. CCRT should only be used in selected older patients with locally advanced NPC.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102246"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of G8 screening tool with prognosis and survival in patients with non-small cell lung cancer: A retrospective analysis from a single institution","authors":"Antonello Veccia ,&nbsp;Stefania Kinspergher ,&nbsp;Elena Zambotti ,&nbsp;Roberta Biondi ,&nbsp;Stefano Pontalti ,&nbsp;Renza Triolo ,&nbsp;Orazio Caffo","doi":"10.1016/j.jgo.2025.102258","DOIUrl":"10.1016/j.jgo.2025.102258","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102258"},"PeriodicalIF":3.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age and comorbidity in relation to treatment and survival outcomes in triple-negative breast cancer: A Swedish nationwide registry-based study","authors":"Jenny Nyqvist-Streng ,&nbsp;Josef Somi ,&nbsp;Jari Martikainen ,&nbsp;Maxim Olsson ,&nbsp;Khalil Helou ,&nbsp;Chaido Chamalidou ,&nbsp;Anikó Kovács ,&nbsp;Toshima Z. Parris","doi":"10.1016/j.jgo.2025.102255","DOIUrl":"10.1016/j.jgo.2025.102255","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with cancer and comorbidities often experience a longer time-to-diagnosis and significantly worse clinical outcomes. Here, we evaluate the association between age, Charlson Comorbidity Index (CCI), treatment given, and patient survival, thereby identifying common non-breast cancer-related causes of death in patients with triple-negative breast cancer (TNBC).</div></div><div><h3>Materials and Methods</h3><div>Population-based registry data were retrieved for patients diagnosed with primary invasive TNBC in Sweden between 2007 and 2021 (<em>n</em> = 7145). Multivariable Cox regression analyses were performed for disease-specific survival and overall survival was calculated using a landmark time set at six months post-diagnosis, the likely timeframe for treatment initiation. Multivariable logistic regression models were computed for age, comorbidity, and treatment. Weighted CCI (CCIw) was stratified into CCIw 0, CCIw 1–3, and CCIw 4–10.</div></div><div><h3>Results</h3><div>Approximately 42 % of patients were ≥ 65 years of age and 30 % had comorbidities (27 % CCIw 1–3 and 3 % CCIw 4–10). Two or more comorbidities were common in patients ≥65 years. Patients in the CCIw 4–10 group were significantly older (72 years vs. 68 years for CCIw 1–3 vs. 58 years for CCIw 0) and had locoregional spread and larger tumors. Individuals with comorbidities were less likely to receive neoadjuvant chemotherapy, breast-conserving surgery, or postoperative treatment, and had a higher risk of death due to non-breast cancer-related causes. Patients ≥75 years had a higher risk of breast cancer-related death up to eight years after the landmark time and death from other causes thereafter. Furthermore, older (≥75 years) and patients with comorbidities had the lowest five-year survival probabilities. Other neoplasms (26 %; e.g., lung, pancreas, and ovarian cancer) and cardiovascular disease (24 %) were the leading causes of non-breast-cancer-related death, particularly in patients ≥50 years of age.</div></div><div><h3>Discussion</h3><div>Patients with TNBC and comorbidities are less likely to receive specific treatment modalities and experience worse survival outcomes. Other malignant neoplasms are the leading cause of death for patients ≥50 years of age.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102255"},"PeriodicalIF":3.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary experience supporting older adults with breast cancer: Successes, challenges, and next steps for a program embedded in a breast oncology center","authors":"Madeleine Ling ,&nbsp;Karen Ruderman ,&nbsp;Sydney Simo ,&nbsp;Bonnie McGrath ,&nbsp;Craig Snow ,&nbsp;Kathryn Rigby ,&nbsp;Amal Arnaout ,&nbsp;Tammy T. Hshieh ,&nbsp;Christina Minami ,&nbsp;Rachel A. Freedman","doi":"10.1016/j.jgo.2025.102243","DOIUrl":"10.1016/j.jgo.2025.102243","url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults diagnosed with cancer often have functional vulnerability and increased risk for treatment-related toxicity and poor outcomes, with emergent clinical strategies to mitigate these risks. The geriatric assessment (GA) is a widely recommended platform in the clinic to help inform treatment decisions and toxicity risk and initiate referrals, but incorporating the GA into busy clinical practice remains challenging.</div></div><div><h3>Materials and Methods</h3><div>To promote a consistent approach in conducting the GA and connecting older adults with relevant resources and services while acknowledging the specific care needs for those with breast cancer, our National Cancer Institute-designated center launched the Program for Older Adults with Breast Cancer (OABC) in May 2022, embedded within the Breast Oncology Center. The OABC coordinator offers approached patients an introduction to program services and an opportunity to undergo the GA. The coordinator uses the GA responses to facilitate appropriate geriatrics and supportive care referrals, with recommendations and utilization of services tracked in the program database. We report the initial findings from systematic GA administration within a high-volume breast cancer program.</div></div><div><h3>Results</h3><div>From 2022 to 2024, 362 patients were approached to enroll in OABC; 108 completed a GA. Overall, 32.1 % were aged 70–75 and 10 % were aged ≥86, and most (2/3) had non-metastatic disease. Approximately 30 % were hospitalized in the year before enrollment, 19 % had recent falls, and the majority reported having social supports for emotional and physical needs (&gt;65 % for each). Based on the GA (<em>n</em> = 108), the most frequently recommended services were geriatrics (67 %) and social work (36 %). However, only 60 % of patients who completed the GA agreed to one or more referrals to any of the recommended supportive care services.</div></div><div><h3>Discussion</h3><div>OABC systematically reaches patients at high risk for aging-relevant needs. Coordination of services was successful, but patient declines for geriatrics and supportive resources referrals were common despite having dedicated program staff. Further efforts will increase uptake of the GA and these important services.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 5","pages":"Article 102243"},"PeriodicalIF":3.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three lessons from “The Fox and the Grapes” to inform precision oncology in the older adult","authors":"Gabriel Aleixo ,&nbsp;Teja Voruganti ,&nbsp;Ramy Sedhom","doi":"10.1016/j.jgo.2025.102186","DOIUrl":"10.1016/j.jgo.2025.102186","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 4","pages":"Article 102186"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the status of online social support for older adults with cancer: A scoping review","authors":"Fei Liu ,&nbsp;Sophie Pilleron ,&nbsp;India Pinker","doi":"10.1016/j.jgo.2024.102182","DOIUrl":"10.1016/j.jgo.2024.102182","url":null,"abstract":"<div><h3>Introduction</h3><div>The number of new cancer cases among older adults is rising, yet their social support needs remain unmet due to diminishing social networks with age. Since the COVID-19 pandemic, online technologies have provided increased opportunities for social support for this demographic via digital platforms such as online peer support groups, online communities, and chat rooms. This scoping review explores the current state of the use of online social support for older adults with cancer.</div></div><div><h3>Materials and Methods</h3><div>This scoping review was based on the Arksey and O'Malley methodological framework with the extension proposed by Levac and colleagues. The protocol was registered on Open Science Framework (OSF). PubMed, Elsevier Embase (including Medline), and EBSCO CINAHL Complete were searched to identify eligible studies. The review findings were presented in a narrative synthesis.</div></div><div><h3>Results</h3><div>Out of 6542 references, we included three studies. Two studies investigated older patients' preferences for different types of peer support through surveys and questionnaires, and the third examined the feasibility of an online platform for older women with breast cancer. Barriers identified include a lower interest and familiarity, sense of involvement, and emotional impact of a new diagnosis. However, factors such as socio-demographic characteristics and positive motivation for using online peer support act as facilitators.</div></div><div><h3>Discussion</h3><div>This scoping review is the first to examine the literature on online social support specifically for older adults with cancer, revealing a paucity of research. Further research is required to understand the potential need and interest in online social support for this population, especially as technology becomes more integrated into daily life post-COVID.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 4","pages":"Article 102182"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}