Seminars in oncology最新文献

{"title":"The psychosocial and emotional experiences of cancer patients during the COVID-19 pandemic: A systematic review","authors":"A. Muls,&nbsp;S. Georgopoulou,&nbsp;E. Hainsworth,&nbsp;B. Hartley,&nbsp;G. O'Gara,&nbsp;S. Stapleton,&nbsp;S. Cruickshank","doi":"10.1053/j.seminoncol.2022.08.001","DOIUrl":"10.1053/j.seminoncol.2022.08.001","url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 was declared a pandemic by the World Health Organization on March 11th, 2020. Global social lockdowns were instigated to reduce spread and prevent health-services from becoming overwhelmed. People having treatment for cancer are known to have heightened psychological/emotional burden. The combined impact of managing pandemic regulations alongside this may present additional burden. The purpose of this systematic review is to examine current evidence of the psychological and emotional impact of COVID-19 on people with cancer, early in the pandemic.</p></div><div><h3>Methods</h3><p>Five electronic databases were searched (Embase, Global Health, HMIC, PsychINFO, CINAHL) from September 2019 to October 2021. Qualitative, quantitative and mixed-method primary research studies exploring emotional and psychological impacts of COVID-19 on cancer patients, limited to English language, were included. Quality appraisal was conducted using the MMAT.</p></div><div><h3>Results</h3><p>Fifty-one papers, with 27,356 people from 21 countries treated for cancer, were included. 43 studies were quantitative with a survey method approach, six studies qualitative and four used a mixed methods design. MMAT score was mostly two or three. Four themes were identified: Emotional aspects and Quality of Life; Psychosocial aspects; Impact of COVID-19 on self; Impact of COVID-19 on cancer, with themes overlapping.</p></div><div><h3>Conclusion</h3><p>Whilst emotional/psychological impacts such as anxiety, isolation, employment fears, and uncertainty about the future were potentially universal concerns early in the pandemic, they may have been particularly acute for people living with cancer and represent complex, overlapping factors. As COVID-19 continues to impact health-services and society, it is important to focus on any ongoing impact to the experience of cancer patients. Most of the studies reviewed used tools that do not provide deeper understanding of how and why emotional states of people with cancer were affected. Further qualitative work may reveal patterns of what was unique to cancer patients during the pandemic, compared to general populations.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 371-382"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9554234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Under-representation of women in Randomized Clinical Trials testing anticancer immunotherapy may undermine female patients care. A call to action","authors":"Laura Pala ,&nbsp;Tommaso De Pas ,&nbsp;Fabio Conforti","doi":"10.1053/j.seminoncol.2022.09.004","DOIUrl":"10.1053/j.seminoncol.2022.09.004","url":null,"abstract":"<div><p><span><span>Immunotherapy<span> with immune-checkpoint inhibitors (ICIs) has revolutionized the landscape of cancer treatment, dramatically improving the prognosis of patients with several </span></span>solid tumors. </span>Sex and gender<span><span><span> are variables that affect immune responses to both foreign and self-antigens and growing preclinical and clinical evidence show that they also affect efficacy and tolerability of anticancer immunotherapy </span>in patients<span> with several advanced solid tumors. Despite such strong biological rationale and available evidence highlighting the need to take into account sex-based differences in the context of both research and clinical practice for anticancer immunotherapy, we described here an impressive under-representation of women enrolled in randomized clinical trials (RCTs) testing such </span></span>drugs<span> over the last 10 years. We critically discuss limitations the under-representation of women has on the generalization of results of RCTs to female patients, as well as the importance in the future of ensuring increased enrollment of women in trials, including sex as stratifying factor in trials design, and guaranteeing sex-specific analysis of efficacy and safety results, in order to avoid less than optimal treatment of women with cancer.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 400-404"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394883","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":"TOC","authors":"","doi":"10.1053/S0093-7754(22)00082-3","DOIUrl":"https://doi.org/10.1053/S0093-7754(22)00082-3","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages A3-A4"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000823/pdfft?md5=3d7176292a4285c904bcca67bc32010b&pid=1-s2.0-S0093775422000823-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137270168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which future for de-intensified treatments in HPV-related oropharyngeal carcinoma?","authors":"Stefano Cavalieri ,&nbsp;Imperia Nuzzolese ,&nbsp;Lisa Licitra","doi":"10.1053/j.seminoncol.2022.09.007","DOIUrl":"10.1053/j.seminoncol.2022.09.007","url":null,"abstract":"<div><p><span><span><span><span><span>The development of deintensified therapies aiming at reducing the treatment-related toxicity while not impairing the outcome is an unmet need in HPV+ oropharyngeal carcinoma patients. Several deintensification approaches have been explored in this setting, including </span>induction chemotherapy with reduced </span>chemoradiation<span> dose in responding pts. The findings of the studies conducted so far show that the available deescalated therapy should be based on the disease risk profile. At present, we still lack robust high level data to infer that the cited interventions are equivalent or superior to standard of care treatments. However, literature data suggest that approximately 70% of low-risk patients might receive a deintensified approach by including either surgery or induction chemotherapy. In the context of high-risk disease, more than 80% of patients may undergo a deintensified loco-regional treatment by neoadjuvant systemic therapy. </span></span>Epidemiological data suggest that in the next decades, most of the HPV-related </span>OPSCC patients will be made of old and possibly frail individuals. However, this patient population was excluded from most of the studies conducted so far. Therefore, there is a strong need for </span>clinical trials to define risk-based deescalation strategies in this population and in younger patients as well.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 405-408"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33512346","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":"IO-IO vs IO-TKI efficacy in metastatic kidney cancer patients: A structured systematic review over time","authors":"Benedikt Hoeh ,&nbsp;Rocco Simone Flammia ,&nbsp;Lukas Hohenhorst ,&nbsp;Gabriele Sorce ,&nbsp;Andrea Panunzio ,&nbsp;Stefano Tappero ,&nbsp;Zhe Tian ,&nbsp;Fred Saad ,&nbsp;Michele Gallucci ,&nbsp;Alberto Briganti ,&nbsp;Carlo Terrone ,&nbsp;Shahrokh F. Shariat ,&nbsp;Markus Graefen ,&nbsp;Derya Tilki ,&nbsp;Alessandro Antonelli ,&nbsp;Marina Kosiba ,&nbsp;Luis A. Kluth ,&nbsp;Andreas Becker ,&nbsp;Felix K.H. Chun ,&nbsp;Pierre I. Karakiewicz","doi":"10.1053/j.seminoncol.2022.10.001","DOIUrl":"10.1053/j.seminoncol.2022.10.001","url":null,"abstract":"<div><p><span><span>Multiple systemic immune-oncology (IO) combination therapies have demonstrated overall survival (OS) benefits in metastatic renal clear cell carcinoma<span> (mRCC). However, the magnitude of benefits over time has not been compared in a structured fashion. To assess OS and progression free survival (PFS) efficacy as reflected by hazard ratios [HR]) according to the duration of follow-up over time for each of four IO combination therapies. A systematic PubMed (MEDLINE) literature review was performed (January, 1, 2016 to February, 20, 2022). Only phase III </span></span>randomized clinical trials<span> with proven OS benefit relative to sunitinib were included. These search criteria yielded four eligible </span></span>RCTs: CheckMate 214 (nivolumab plus ipilimumab), Keynote 426 (pembrolizumab plus axitinib), CheckMate 9ER (nivolumab plus cabozantinib), CLEAR (lenvatinib plus pembrolizumab). OS and PFS HRs were tabulated for all four studies including all reported timepoints. Median follow-up ranged from 25–68 months for CheckMate 214 (5 timepoints), 13–43 months for Keynote 426 (3 timepoints), 18–33 months for CheckMate 9ER (3 timepoints) and 27–34 months for CLEAR (2 timepoints). Respective OS and PFS HRs were 0.68–0.72 and 0.98–0.86, 0.53–0.73 and 0.69–0.68, 0.60–0.70 and 0.51–0.56, 0.66–0.72 and 0.39–0.47 for CheckMate 214, Keynote 426, CheckMate 9ER and CLEAR. Regarding OS HRs virtually no change was recorded over time for CheckMate 214, but a decrease in magnitude occurred in the three IO-TKI remaining studies. Regarding PFS HRs, no benefit was recorded for CheckMate 214. Statistically significant benefit was recorded in the remaining IO-TKI studies. However, it also decreased with longer follow-up. It remains to be seen, whether further ‘slippage’ of efficacy will persist as the data matures further for all IO-TKI combinations.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 394-399"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40681333","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":"Influence of Cancer on COVID-19 Incidence, Outcomes, and Vaccine Effectiveness: A Prospective Cohort Study of U.S. Veterans","authors":"Harshraj Leuva ,&nbsp;Mengxi Zhou ,&nbsp;Norbert Brau ,&nbsp;Sheldon T. Brown ,&nbsp;Prabhjot Mundi ,&nbsp;Ta-Chueh Melody Rosenberg ,&nbsp;Carol Luhrs ,&nbsp;Susan E. Bates ,&nbsp;Yeun-Hee Anna Park ,&nbsp;Tito Fojo","doi":"10.1053/j.seminoncol.2022.07.005","DOIUrl":"10.1053/j.seminoncol.2022.07.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Coronavirus disease 2019 (COVID-19) has been a constant health threat since its emergence. Amongst risk factors proposed, a diagnosis of cancer has been worrisome. We report the impact of cancer and other risk factors in US Veterans receiving care at Veterans Administration (VA) Hospitals, their adjusted odds ratio (aOR) for infection and death, and report on the impact of vaccines on the incidence and severity of COVID-19 infections in Veterans without/with cancer.</p></div><div><h3>Methods</h3><p>We conducted a cohort study of US Veterans without/with cancer by mining VA COVID-19 Shared Data Resource (CSDR) data using the VA Informatics and Computing Infrastructure (VINCI). Our observation period includes index dates from 14DEC2020 to 25JAN2022, encompassing both the delta and omicron waves in the US.</p></div><div><h3>Results</h3><p>We identified 915,928 Veterans, 24% of whom were African Americans who had undergone COVID testing–688,541 were and 227,387 were not <em>vaccinated</em>. 157,072 had a cancer diagnosis in the preceding two years. Age emerged as the major risk factor, with gender, BMI, and (Elixhauser) comorbidity contributing less. Among veterans with solid tumors other than lung cancer, risks of infection and death within 60 days were comparable to Veterans without cancer. However, those with hematologic malignancies fared worse. Vaccination was highly effective across all cancer cohorts; the respective rates of infection and death after infection were 8% and 5% among the <em>vaccinated</em> compared to 47% and 10% in the <em>unvaccinated</em>. Amongst <em>vaccinated</em>, increased risk of infection was noted in both, Veterans with hematologic malignancy treated with chemotherapy (HR, 2.993, <em>P</em> &lt; 0.0001) or targeted therapies (HR, 1.781, <em>P</em> &lt; 0.0001), and in solid tumors treated with either chemotherapy (HR 2.328, 95%CI 2.075–2.611, <em>P</em> &lt; 0.0001) or targeted therapies (HR 1.328, <em>P</em> &lt; 0.0001) when compared to those not on treatment.</p></div><div><h3>Conclusions</h3><p>Risk for COVID-19 infection and death from infection vary based on cancer type and therapies administered. Importantly and encouragingly, the duration of protection from infection following vaccination in Veterans with a diagnosis of cancer was remarkably like those without a cancer diagnosis. Veterans with hematologic malignancies are especially vulnerable, with lower vaccine effectiveness (VE).</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 363-370"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9353607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10359541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel targeted therapies for advanced non-small lung cancer","authors":"Omar Abughanimeh ,&nbsp;Anahat Kaur ,&nbsp;Badi El Osta ,&nbsp;Apar Kishor Ganti","doi":"10.1053/j.seminoncol.2022.03.003","DOIUrl":"10.1053/j.seminoncol.2022.03.003","url":null,"abstract":"<div><p>Non-small cell lung cancer (NSCLC) is the most common type of lung cancer accounting for almost 80%–85% of all lung cancer cases. Unfortunately, more than half of the patients will be diagnosed with advanced disease at the time of presentation, which makes their disease incurable. Historically, the 5 year overall survival for advanced NSCLC was 5%. However, there has been a significant increase in our understanding of the genetic basis of NSCLC, which has led to development of both immunotherapy and targeted therapy agents. This has improved the 5 year overall survival to become within the range of 15%–50% depending on certain mutations and biomarkers. Over the last decade the United States Food and Drug Administration (FDA) has approved almost 20 new targeted therapies and clinical trials are still undergoing to evaluate more novel agents. In this review, we will present recent updates on novel targeted therapies.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 326-336"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000240/pdfft?md5=d001b3b5176390baacf43ec31dd4c016&pid=1-s2.0-S0093775422000240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42737179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-small cell lung cancer in the era of immunotherapy","authors":"Quillan Huang ,&nbsp;Jan Kemnade ,&nbsp;Loraine Cornwell ,&nbsp;Farrah Kheradmand ,&nbsp;Anita L. Sabichi ,&nbsp;Devika Das","doi":"10.1053/j.seminoncol.2022.06.009","DOIUrl":"10.1053/j.seminoncol.2022.06.009","url":null,"abstract":"<div><p>Immunotherapy for non-small cell lung cancer (NSCLC) has revolutionized treatment for those with advanced disease, and recent data have emerged providing evidence for its benefits in earlier stages of the disease. Several pivotal clinical trials provide compelling data that adaptive immune cells may be highly effective and possibly even curative for NSCLC. Immune checkpoint inhibitors (ICIs) can unleash highly reactive memory immune responses to tumor antigens with durable effects against advanced or recurrent disease. Despite these encouraging results, many critical questions remain in the field including, for example, how to identify the subsets of NSCLC patients who most benefit from ICI treatment, and how ICI efficacy might be enhanced by utilizing combinations or sequencing of agents. A deeper understanding of biological mechanisms involved in lung cancer offers a unique opportunity to further explore the interaction between the adaptive immune landscape and NSCLC. Given the high incidence of lung cancer in Veterans and many Veterans being treated with immunotherapy for this disease, it is timely to have their adequate representation in future clinical trials. New clinical trials focused on Veterans can assist in exploring ways to mitigate resistant mechanisms as well as to investigate predictive and prognostic biomarkers for response to ICIs and other treatments. This paper will review current data and indications for immunotherapy in NSCLC, introduce new areas of research within immunotherapy, and discuss its applicability to the Veteran population.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 337-343"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000495/pdfft?md5=81b075500210afaff9fbe90409644ce4&pid=1-s2.0-S0093775422000495-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40553965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity and life expectancy in shared decision making for lung cancer screening","authors":"Brett Bade ,&nbsp;Mary Gwin ,&nbsp;Matthew Triplette ,&nbsp;Renda Soylemez Wiener ,&nbsp;Kristina Crothers","doi":"10.1053/j.seminoncol.2022.07.003","DOIUrl":"10.1053/j.seminoncol.2022.07.003","url":null,"abstract":"<div><p>Shared decision making (SDM) is an important part of lung cancer screening (LCS) that includes discussing the risks and benefits of screening, potential outcomes, patient eligibility and willingness to participate, tobacco cessation, and tailoring a strategy to an individual patient. More than other cancer screening tests, eligibility for LCS is nuanced, incorporating the patient's age as well as tobacco use history and overall health status. Since comorbidities and multimorbidity (ie, 2 or more comorbidities) impact the risks and benefits of LCS, these topics are a fundamental part of decision-making. However, there is currently little evidence available to guide clinicians in addressing comorbidities and an individual's “appropriateness” for LCS during SDM visits. Therefore, this literature review investigates the impact of comorbidities and multimorbidity among patients undergoing LCS. Based on available evidence and guideline recommendations, we identify comorbidities that should be considered during SDM conversations and review best practices for navigating SDM conversations in the context of LCS. Three conditions are highlighted since they concomitantly portend higher risk of developing lung cancer, potentially increase risk of screening-related evaluation and treatment complications and can be associated with limited life expectancy: chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, and human immunodeficiency virus infection.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 220-231"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000574/pdfft?md5=32fe283765c04ac5522625aeecd3b378&pid=1-s2.0-S0093775422000574-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Cancer Screening and Precision Oncology","authors":"Susan E. Bates MD (Series Editor)","doi":"10.1053/j.seminoncol.2022.09.006","DOIUrl":"10.1053/j.seminoncol.2022.09.006","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 3","pages":"Pages 189-190"},"PeriodicalIF":4.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775422000744/pdfft?md5=6870da0b76a3c74d269eab625e3b0c55&pid=1-s2.0-S0093775422000744-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48757624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}