Journal of the National Comprehensive Cancer Network最新文献

{"title":"Longitudinal Patient-Reported Outcomes in Older Adults With Aggressive Lymphomas Receiving Chemoimmunotherapy.","authors":"P Connor Johnson, Jeremy S Abramson, Ann S LaCasce, Philippe Armand, Jeffrey Barnes, Reid W Merryman, Jacob Soumerai, Ephraim Hochberg, Ronald W Takvorian, Caron A Jacobson, Jennifer L Crombie, David C Fisher, Joel Schwartz, Robb S Friedman, Julia Stacey, Daniel Yang, Bridget Coffey, Netana Markowitz, Oreofe O Odejide, Areej El-Jawahri","doi":"10.6004/jnccn.2024.7082","DOIUrl":"https://doi.org/10.6004/jnccn.2024.7082","url":null,"abstract":"<p><strong>Background: </strong>Aggressive non-Hodgkin lymphoma (aNHL) is more common in older adults. Although chemoimmunotherapy can yield durable remissions, it is also associated with significant toxicities. Despite this, longitudinal studies assessing patient-reported outcomes (PROs) with chemoimmunotherapy in this population are lacking.</p><p><strong>Patients and methods: </strong>We conducted a longitudinal study of 105 adults aged ≥65 years who initiated up-front chemoimmunotherapy for aNHL across 2 academic centers and their community affiliates between September 2020 and January 2023. Quality of life (QoL) was assessed using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym), physical symptoms via the revised Edmonton Symptom Assessment Scale (ESAS-r), and psychological symptoms with the Hospital Anxiety and Depression Scale (HADS). Assessments were performed at baseline; 6, 12, 18, and 24 weeks post-therapy initiation; and 1 year post-therapy initiation. Frailty status was evaluated at baseline using the Fondazione Italiana Linfomi geriatric assessment (GA) and the Vulnerable Elders Survey-13 (VES-13). Linear mixed models were used to examine the trajectory of PROs over time, and linear regression was employed to identify factors associated with QoL at 1 year.</p><p><strong>Results: </strong>The median patient age was 73 years (range, 64-99), with 41.9% aged ≥75 years. Most patients (53.8%) had an age-adjusted International Prognostic Index (IPI) of 2/3, and 70.5% had diffuse large B-cell lymphoma. Overall, 50.5% and 45.7% were identified as frail or vulnerable on GA and VES-13, respectively. Longitudinal QoL, physical symptoms, anxiety, and depression all significantly improved over time (all P≤.001). QoL improved regardless of age category (65-74 vs ≥75 years) or frailty status. In multivariate analyses, being married/living with partner was associated with better QoL at 1 year (β=11.6; P=.026), whereas frailty on GA (β= -9.90; P=.036) was associated with worse QoL.</p><p><strong>Conclusions: </strong>Older adults with aNHL receiving chemoimmunotherapy experienced significant and durable improvement in QoL, physical symptoms, and psychological health up to 1 year post-therapy initiation, irrespective of age or frailty status. However, frailty was associated with worse QoL at 1 year post-therapy initiation. These findings underscore the importance of integrating GAs into treatment planning for older adults with aNHL.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"1-7"},"PeriodicalIF":14.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life Among Patients With Locally Advanced Pancreatic Cancer: A Prospective Nationwide Multicenter Study.","authors":"Leonard W F Seelen, Simone Augustinus, Thomas F Stoop, Stefan A W Bouwense, Olivier R Busch, Geert A Cirkel, Casper H J van Eijck, Judith de Vos-Geelen, Bas Groot Koerkamp, Nadia Haj Mohammad, Ignace H J T de Hingh, Evelien van Alphen, Marjolein Y V Homs, Mike S L Liem, Maartje Los, Vincent E de Meijer, Leonie J M Mekenkamp, Mirjam A G Sprangers, Martijn W J Stommel, Johanna W Wilmink, Marc G Besselink, Hjalmar C van Santvoort, Hanneke W M van Laarhoven, I Quintus Molenaar","doi":"10.6004/jnccn.2024.7091","DOIUrl":"https://doi.org/10.6004/jnccn.2024.7091","url":null,"abstract":"<p><strong>Background: </strong>Health care providers of patients with cancer should discuss the impact of treatment, such as multiagent chemotherapy and surgery, on quality of life (QoL). However, in the era of shared decision-making, data on QoL in locally advanced pancreatic cancer (LAPC) remain scarce.</p><p><strong>Methods: </strong>We performed a prospective multicenter study involving patients with LAPC across 13 Dutch centers. These patients were included in both the LAPC registry and the Dutch Pancreatic Cancer Project (PACAP; ClinicalTrials.gov identifier: NCT03513705). The study evaluated QoL over time and assessed the impact of treatment. The primary outcome was global health status (GHS) based on the EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Secondary outcomes included functioning and symptom scores from the EORTC QLQ-C30 and the EORTC QLQ Pancreatic Cancer Module (QLQ-PAN26). Outcomes were measured at diagnosis and at 3-month intervals up to 12 months. Outcomes were compared over time and between groups, with both statistical and clinical significance (Δ ≥10 points) evaluated.</p><p><strong>Results: </strong>A total of 170 patients completed at least one QoL-questionnaire. Most patients (n=152; 89%) received tumor-directed treatment, including 116 (68%) who received chemotherapy (± radiotherapy) alone and 36 (21%) who underwent chemotherapy (± radiotherapy) followed by resection; 18 (11%) patients received best supportive care (BSC). At baseline, GHS was highest among patients who received chemotherapy + resection (mean [SD], 70 [16]) compared with those receiving chemotherapy alone (mean [SD], 64 [20]) and BSC (mean [SD], 48 [21]) (P=.001). The overall mean [SD] GHS at baseline was 63 [20] and remained stable over time (P=.27), including in patients receiving tumor-directed treatment (P=.57). One-third of the QoL subscales (9/28) showed statistically and clinically significant changes over time. Improvements were observed in appetite loss, pancreatic pain, and hepatic symptoms, although patients reported increased diarrhea, flatulence, altered bowel habits, and financial difficulties. Over time, patients reported reduced fear of future health, but a decline in health care satisfaction.</p><p><strong>Conclusions: </strong>This multicenter study demonstrated that general QoL remained stable during the first year in patients with LAPC, 89% of whom received tumor-directed treatment. Certain symptoms worsened and deserve greater attention from health care providers. These findings can guide shared decision-making and improve symptom management.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"1-8"},"PeriodicalIF":14.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Off-Label\" Use of Checkpoint Inhibitors in Patients With Negative or Unknown PD-L1 Status in Advanced Head and Neck Cancer.","authors":"Margaret Stalker, Kewen Qu, Roger B Cohen, Ronac Mamtani, Wei-Ting Hwang, Lova Sun","doi":"10.6004/jnccn.2024.7085","DOIUrl":"https://doi.org/10.6004/jnccn.2024.7085","url":null,"abstract":"<p><strong>Background: </strong>The KEYNOTE-048 study established the checkpoint inhibitor (CPI) pembrolizumab, with/without chemotherapy, as frontline treatment for recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). However, pembrolizumab monotherapy has limited efficacy in PD-L1-negative disease. Clinical practice patterns regarding PD-L1 combined positive score (CPS) testing and PD-L1-guided treatment selection remain unknown.</p><p><strong>Patients and methods: </strong>This retrospective analysis included patients who initiated treatment for R/M HNSCC from 2011 to 2023 in a nationwide electronic health record-derived deidentified database. Frontline therapy was categorized as CPI monotherapy, CPI with chemotherapy, or chemotherapy ± cetuximab without CPI. A subset of patients treated in 2019 and beyond (2019+ cohort) were analyzed to investigate PD-L1 testing rates, treatment patterns following FDA approval of pembrolizumab, and the proportion receiving \"off-label\" CPI monotherapy (single-agent use in patients with metastatic HNSCC and negative/unknown PD-L1 status). Factors associated with \"off-label\" use were identified using multivariable logistic regression.</p><p><strong>Results: </strong>The total cohort included 7,657 patients with a median age of 65 years (IQR, 58-72); 67% were White, 78% had a history of smoking, 66% had an ECOG performance status (PS) of 0-1, and 31% were HPV-positive. The 2019+ subset included 3,395 patients, of whom nearly half (47%) did not have a known PD-L1 CPS prior to systemic treatment initiation. The most common frontline treatment in the total cohort was CPI monotherapy (43%). CPI monotherapy use was even higher in patients aged ≥75 years (54%) and those with ECOG PS ≥2 (52%). Among the 2019+ subgroup with PD-L1 CPS negative/unknown tumors (n=1,926), 536 (28%) received CPI monotherapy \"off-label.\" Factors associated with \"off-label\" use on multivariable regression included age ≥75 years (odds ratio [OR], 1.4), community practice setting (OR, 1.5), and earlier year of treatment (OR, 1.3 per year) (all P<.05).</p><p><strong>Conclusions: </strong>Most US patients with R/M HNSCC are now receiving CPI-based therapy in the frontline setting; however, PD-L1 testing remains underutilized. \"Off-label\" use of CPI monotherapy in PD-L1-negative/unknown HNSCC is common, particularly among elderly patients.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"1-7"},"PeriodicalIF":14.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Nonfatal Self-Injury and Survival Following a Cancer Diagnosis: A Comparative Population-Based Cohort Study.","authors":"Antoine Eskander, Rinku Sutradhar, Elie Isenberg-Grzeda, Rui Fu, Alyson Mahar, Simone N Vigod, James Bolton, Julie Deleemans, Wing C Chan, Natalie G Coburn, Julie Hallet","doi":"10.6004/jnccn.2024.7083","DOIUrl":"https://doi.org/10.6004/jnccn.2024.7083","url":null,"abstract":"<p><strong>Background: </strong>Nonfatal self-injury (NFSI) following a cancer diagnosis is a very serious mental health sequalae. Whether NFSI has an impact on patient outcomes is unknown. To help determine the impact and burden of NFSI in cancer care, this study examined the association between NFSI following a cancer diagnosis and subsequent overall survival (OS).</p><p><strong>Methods: </strong>A retrospective population-based cohort study using linked administrative health care included patients with a new cancer diagnosis in 2007 through 2019. The exposure was NFSI (emergency department visit for self-injury of intentional or undetermined intent), treated as time-varying. The outcome was OS, as death from any cause measured from cancer diagnosis. Extended Cox multivariable models examined the association between NFSI and OS, adjusting for patient, cancer, and mental health history characteristics.</p><p><strong>Results: </strong>Of 806,910 patients, 2,482 (0.31%) had NFSI at a median of 29 months (IQR, 11-57) from cancer diagnosis. Of those, 81 had >1 NFSI event. Patients with NFSI had inferior OS compared with those who had not yet experienced an NFSI (adjusted hazard ratio [HR], 1.73; 95% CI, 1.61-1.85). When treating NFSI as a count variable, there was an association between each additional NFSI and OS (adjusted HR, 1.17; 95% CI, 1.08-1.26).</p><p><strong>Conclusions: </strong>NFSI following a cancer diagnosis was independently associated with inferior OS. This finding highlights NFSI as a crucial event for patients with cancer and supports the importance of identifying and providing treatment for patients with cancer with cancer-related distress, such as marked by higher risk of NFSI.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"1-6"},"PeriodicalIF":14.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemithyroidectomy Versus Total Thyroidectomy for Sporadic Medullary Thyroid Cancer: A Chinese Nationwide Large-Scale Cohort Study.","authors":"Xiao Shi, Cenkai Shen, Chuqiao Liu, Likun Zhang, Yuxin Du, Hao Zhang, Hongwei Liu, Jianbiao Wang, Chuang Chen, Yijun Wu, Chunyan Zhang, Zimeng Li, Haitao Tang, Min Yin, Xiaoqi Mao, Shuyi Liu, Yaoting Sun, Yan Zhou, Wenjun Wei, Naisi Huang, Zhihong Wang, Zhiqiang Gui, Hanqing Liu, Jiaxi Wang, Jian Li, Cuiwei Li, Shiyu Xiang, Liang Guo, Yan Zhang, Yi He, Tiannan Guo, Qinghai Ji, Zhiyan Liu, Yu Wang","doi":"10.6004/jnccn.2024.7088","DOIUrl":"https://doi.org/10.6004/jnccn.2024.7088","url":null,"abstract":"<p><strong>Background: </strong>Medullary thyroid cancer (MTC) is a rare thyroid malignancy, with 70% to 80% of cases being sporadic (sMTC). Current guidelines recommend total thyroidectomy (TT) for all preoperatively suspicious sMTC, though there has been increasing support for reducing the surgical extent in recent years. However, relevant data are limited. This study aimed to comprehensively evaluate the safety of hemithyroidectomy (HT) in sMTC.</p><p><strong>Patients and methods: </strong>This study included 797 patients with MTC who received curative-intent initial surgery at 19 participating referral centers. Genetic testing was performed to identify disease heredity. We evaluated the safety of HT in sMTC across 5 aspects: (1) prevalence of occult bilateral foci, (2) prevalence of contralateral lobe recurrence, (3) biochemical response, (4) structural recurrence-free survival (SRFS), and (5) overall survival (OS).</p><p><strong>Results: </strong>Of the 797 patients, 648 were genetically confirmed as having sMTC. HT and TT were performed as the index surgery in 232 (35.8%) and 416 (64.2%) patients, respectively. In the TT group, bilateral foci were found in 34 (8.2%) patients, of whom only 10 (2.4%) had sonographically occult foci, and of these, only 3 (0.72%) had a maximal tumor size ≤2 cm. In the HT group, only 1.7% (4/232) had recurrence in the preserved lobe, with only 1 (0.43%) having a maximal tumor size ≤2 cm. After propensity score matching, 230 pairs of patients were included in further analysis. No significant differences were found in OS (log-rank: P=.484; Cox regression: P=.380), SRFS (log-rank: P=.914; Cox regression: P=.309), or biochemical response (chi-square: P=.744; logistic regression: P=.818) between the 2 groups. Subgroup analyses showed that HT conferred comparable structural and biochemical outcomes with TT in small (≤2 cm) sMTCs, even for patients with high-risk factors such as high preoperative calcitonin, multifocal disease, lymph node metastases, RETM918T mutation, and desmoplasia.</p><p><strong>Conclusions: </strong>For small unilateral sMTCs, HT may be considered an alternative treatment that does not compromise prognosis while avoiding additional complications associated with TT.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":"1-8"},"PeriodicalIF":14.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SHIFTing to Better Address Sexual Health in Cancer Survivors.","authors":"Betty K Hamilton","doi":"10.6004/jnccn.2025.7002","DOIUrl":"https://doi.org/10.6004/jnccn.2025.7002","url":null,"abstract":"","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":"23 2","pages":"63-64"},"PeriodicalIF":14.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burdens of Gastroenteropancreatic Neuroendocrine Neoplasm by Diverse Race and Ethnicities- A Rigorous Structural Equation Modeling.","authors":"Alan Paciorek, Claire Mulvey, Meg McKinley, Li Zhang, Iona Cheng, Farhana Moon, Bryan Khuong Le, Brandon E Shih, Julia Whitman, Emily Bergsland","doi":"10.6004/jnccn.2024.7080","DOIUrl":"10.6004/jnccn.2024.7080","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether patients of all races and ethnicities with gastroenteropancreatic (GEP) neuroendocrine neoplasm (NEN) have equivalent incidence and cancer-specific survival.</p><p><strong>Patients and methods: </strong>Using the California Cancer Registry, all patients with GEP-NEN in California's large and diverse population from 1992 to 2019 were identified. Age-adjusted incidence rates (AIRs) and cancer-specific mortality (CSM) risks were compared across racial and ethnic subgroups using structural equation modeling.</p><p><strong>Results: </strong>The non-Hispanic (NH) Black population had the highest rate of diagnosis every year (AIR2019, 7.4 per 100,000; 95% CI, 6.4-8.5). The AIRs across races and ethnicities and primary sites vary, and in 2019 statistically significantly increased for stomach, small intestine, pancreatic, and rectal NEN and for only the NH White population. Risk of mortality was neutral across many races and ethnicities for many primary sites. The only statistically significant disparity was a higher CSM rate for Hispanic patients compared with NH Black patients with small intestine NEN (subdistribution hazard ratio, 1.45; 95% CI, 1.10-1.91; P=.008). Findings suggest a higher CSM among NH Black and NH White patients with rectal NEN. Disparities in who presents with GEP-NEN were revealed across racial and ethnic populations and primary sites. The NH Black population incurred the highest rate overall consistently every year. This is the first study to evaluate cancer-specific survival disparities in all GEP-NEN primary sites across the Asian American/Native Hawaiian/Pacific Islander, Hispanic, NH Black, and NH White racial and ethnic populations. Many clinical and sociodemographic measures associated with risk of mortality differed across race and ethnicities. After careful control of those imbalances, there were few racial and ethnic disparities in risk of CSM.</p><p><strong>Conclusions: </strong>There is room to improve equity in the health care system and close the gap in diagnoses for the NH Black population with all GEP-NEN and in mortality for the Hispanic population with small intestine NEN.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":"23 2","pages":"27-32"},"PeriodicalIF":14.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of Fertility Discussions and Counseling Before, During, and After Anticancer Treatments.","authors":"Verity Chadwick, Georgia Mills, Catherine Tang, Antoinette Anazodo, Rachel Dear, Rachael Rogers, Orly Lavee, Samuel Milliken, Georgia McCaughan, Nada Hamad","doi":"10.6004/jnccn.2024.7068","DOIUrl":"10.6004/jnccn.2024.7068","url":null,"abstract":"<p><strong>Background: </strong>Cancer treatment can significantly reduce reproductive potential in female patients. This study sought to explore the incidence of fertility counseling in women of childbearing potential before, during, and after anticancer therapies.</p><p><strong>Methods: </strong>We conducted a retrospective medical record review at a major Australian cancer center of premenopausal females aged 18 to 49 years diagnosed with cancer between 2017 and 2020.</p><p><strong>Results: </strong>A total of 143 patients met inclusion criteria. Of these patients, only 12.6% had a reproductive health history documented at the first consult and just more than half (58%) had a fertility preservation discussion documented with their primary hematologist or oncologist. A quarter (25.9%) saw a specialist gynecologist to discuss fertility preservation options, and 11.2% were offered a referral but declined.</p><p><strong>Conclusions: </strong>In an Australian major cancer center, only half of women with a new malignancy diagnosis had documented reproductive counseling. Promoting and facilitating reproductive counseling needs to be addressed through strengthening working relationships between fertility preservation specialists and oncologists/hematologists, implementing technology systems to ensure fertility preservation documentation, and improving staff education.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":"23 2","pages":"21-26"},"PeriodicalIF":14.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Acute Lymphoblastic Leukemia, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology.","authors":"Hiroto Inaba, David Teachey, Colleen Annesley, Sandeep Batra, Jill Beck, Susan Colace, Stacy Cooper, Mari Dallas, Satiro De Oliveira, Kara Kelly, Carrie Kitko, Mira Kohorst, Matthew Kutny, Norman Lacayo, Cathy Lee-Miller, Kathleen Ludwig, Lisa Madden, Kelly Maloney, David Mangum, Stephanie Massaro, David McCall, Perry Morocco, Brad Muller, Lindsey Murphy, Valentina Nardi, Jenna Rossoff, Laura Schuettpelz, Bijal Shah, Jessica Sun, Victor Wong, Gregory Yanik, Ajibola Awotiwon, Katie Stehman","doi":"10.6004/jnccn.2025.0006","DOIUrl":"10.6004/jnccn.2025.0006","url":null,"abstract":"<p><p>The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Pediatric Acute Lymphoblastic Leukemia (ALL) were developed as a result of meetings convened by a multidisciplinary panel of pediatric ALL experts, with the goal of providing recommendations on standard treatment approaches based on current evidence. The NCCN Guidelines for pediatric ALL focus on risk assessment and stratification of risk-adapted therapy; treatment strategies for BCR::ABL1 (Philadelphia chromosome [Ph])-negative and BCR::ABL1-positive B-cell lineage, T-cell lineage, and infant ALL; and supportive care considerations. This selection from the NCCN Guidelines for pediatric ALL focuses on the diagnosis of and management of pediatric T-ALL.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":"23 2","pages":"41-62"},"PeriodicalIF":14.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Digital Intervention to Address Sexual Health in Hematopoietic Stem Cell Transplant Survivors.","authors":"Areej El-Jawahri, Jennifer B Reese, Lara Traeger, Don Dizon, Corey Cutler, Sharon Bober, Joseph A Greer, Julie Vanderklish, Dustin J Rabideau, Katherine Cronin, Mathew Reynolds, Nneka Ufere, Julia Rice, Madison Clay, Richard Newcomb, Zachariah DeFilipp, Vincent Ho, Robert J Soiffer, Nicole Pensak, Yi-Bin Chen, Jennifer S Temel","doi":"10.6004/jnccn.2024.7076","DOIUrl":"10.6004/jnccn.2024.7076","url":null,"abstract":"<p><strong>Background: </strong>Interventions to address sexual health in hematopoietic stem cell transplant (HSCT) survivors are limited.</p><p><strong>Methods: </strong>We conducted a pilot randomized trial of a digital app, SHIFT (Sexual Health and Intimacy Following Transplant), to address sexual dysfunction in HSCT survivors who were ≥3 months post autologous or allogeneic HSCT. Patients were randomly assigned to SHIFT or enhanced usual care. All participants first underwent a brief physical examination by a trained HSCT clinician. Participants assigned to the intervention received access to SHIFT for 8 weeks. SHIFT consists of 5 modules addressing the biological, interpersonal, social, and psychological causes of sexual dysfunction. The primary endpoint was feasibility, defined a priori as ≥60% enrollment of eligible patients, and 60% of those assigned to SHIFT completing ≥70% of the modules. We assessed patient satisfaction with sex, interest in sex, orgasm pleasure (using the Patient-Reported Outcomes Measurement Information System [PROMIS]), quality of life (QoL; using the Functional Assessment of Cancer Therapy - Bone Marrow Transplant [FACT-BMT]), and anxiety and depression symptoms (using the Hospital Anxiety and Depression Scale [HADS]) at baseline, 8 weeks, and 12 weeks. The preliminary effects of SHIFT on study outcomes were explored using analysis of covariance (ANCOVA) and estimates of effect size at 8 weeks (Cohen's d).</p><p><strong>Results: </strong>We enrolled 64.2% (61/95) of eligible patients. Of those assigned to the intervention, 70.0% completed 4 of the 5 SHIFT modules and 66.7% completed all SHIFT modules. At 8 weeks, SHIFT participants reported improved satisfaction with sex (14.6 vs 12.3; d=0.46), interest in sex (6.7 vs 5.7; d=0.59), orgasm pleasure (9.7 vs 8.3; d=0.37), QoL (115.6 vs 108.3; d=0.45), and symptoms of anxiety (4.5 vs 6.4; d=0.47) and depression (3.6 vs 5.4; d=0.62) compared with the control group.</p><p><strong>Conclusions: </strong>The SHIFT digital app to address sexual dysfunction demonstrated feasibility and promising preliminary efficacy in improving sexual health outcomes, QoL, and psychological distress for HSCT survivors.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":"23 2","pages":""},"PeriodicalIF":14.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}