The Lancet Oncology最新文献

{"title":"Cancer care, education, and research in the South Asian Association for Regional Cooperation (SAARC) countries","authors":"Cheryl Reeves, David Collingridge","doi":"10.1016/s1470-2045(24)00662-4","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00662-4","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759960","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":"Capturing the true effect of anti-PD-1 therapy on patients’ health-related quality of life – Authors' reply","authors":"Emanuel Bührer, Michal Kicinski, Madeline Pe, Corneel Coens, Alexander M M Eggermont","doi":"10.1016/s1470-2045(24)00642-9","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00642-9","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759986","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":"Cancer education and training within the South Asian Association for Regional Cooperation (SAARC) countries","authors":"M Saiful Huq, Sandhya C Acharya, Simit Sapkota, Sudhir R Silwal, Manish Gautam, Susmita Sharma, Saugat Poudyal, Mostafa A Sumon, Tasneem Hossain, A F M Kamal Uddin, Sanjeeva Gunasekara, K Govind Babu, Hemant Malhotra, Ugyen Tshomo, Ahmad J Safi, Ahmed I Masood, Shaila Purvin, Mohammad A Hai, Syed MA Islam, Towhidul Islam, Krishni Wijesooriya","doi":"10.1016/s1470-2045(24)00517-5","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00517-5","url":null,"abstract":"The education and training of the oncological health-care workforce is vital for building effective health-care systems that deliver optimal care to patients with cancer. In the South Asian Association for Regional Cooperation (SAARC) nations, there is a notable shortage of both physician and non-physician oncology professionals, including oncologists, medical physicists, radiotherapy technologists, and oncology nurses. This shortage is primarily caused by inadequate education and training programmes. Oncology professionals across SAARC countries face several challenges, including a scarcity of trained personnel, poor health-care infrastructure (including resources and equipment), and insufficient educational opportunities. This Series paper examines the current state of oncology education and training programmes within the SAARC region, identifies the challenges faced by oncology professionals, and offers recommendations for improvement. Short-term strategies focus on developing a skilled, multidisciplinary oncology workforce and enhancing existing training programmes. In the long term, the goals are to establish self-sufficient cancer care systems, promote regional collaboration, and strengthen research infrastructure. Achieving these objectives will require comprehensive approaches, increased financial resources, advanced cancer care infrastructure, and innovative educational models. Regional and international collaborations are essential to raise awareness of cancer as a major public health concern, advance prevention and early detection efforts, and bolster research initiatives.","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"484 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142760274","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":"Cancer care and outreach in the South Asian Association for Regional Cooperation (SAARC) region: overcoming barriers and addressing challenges","authors":"M Saiful Huq, Sandhya C Acharya, Saugat Poudyal, Susmita Sharma, Sudhir R Silwal, Simit Sapkota, Manish Gautam, Mohammad M Haque, A F M Kamal Uddin, Sanjeeva Gunasekara, K Govind Babu, Ugyen Tshomo, Ahmad J Safi, Ahmed I Masood, Mostafa A Sumon, Shaila Purvin, Mohammad A Hai, Heath Devin Skinner, Stephen Avery, Wilfred Ngwa, Krishni Wijesooriya","doi":"10.1016/s1470-2045(24)00514-x","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00514-x","url":null,"abstract":"Cancer care in countries in the South Asian Association for Regional Cooperation (SAARC) is hindered by many challenges, including inadequate infrastructure, a shortage of skilled health-care professionals, and economic constraints. These factors contribute to disparities in timely diagnosis and treatment, leading to poorer health outcomes. Health-care systems within the region vary considerably, ranging from free public health care in Sri Lanka to predominantly out-of-pocket expenses in Bangladesh, highlighting inequities in financial access and service delivery for patients within this region. The absence of comprehensive national health insurance systems imposes substantial financial burdens on patients with cancer and their families, often resulting in catastrophic health-care costs. Paediatric oncology services reflect these disparities with greater clarity. Although Bangladesh has developed multiple treatment centres, issues such as delayed diagnoses and financial barriers persist. By contrast, countries such as Afghanistan and the Maldives have few specialised paediatric oncology services, necessitating costly referrals abroad that place large strains on families. Geriatric oncology remains underdeveloped across most SAARC nations, with few dedicated services and guidelines. Despite progress in India and Sri Lanka, gaps in specialised training and holistic care for older patients remain. Addressing these disparities requires coordinated efforts, including improving health-care infrastructure, expanding insurance coverage, and fostering regional collaborations. Implementing comprehensive national cancer control programmes across SAARC nations, leveraging intercountry networks, and ensuring political commitment are essential to achieving equitable cancer care and advancing Sustainable Development Goals in the region.","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142760276","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":"Anticipating the future of cancer care in Trump's America","authors":"","doi":"10.1016/s1470-2045(24)00669-7","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00669-7","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759976","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":"Cancer research in South Asian Association for Regional Cooperation (SAARC) countries","authors":"M Saiful Huq, Sandhya C Acharya, Manish Gautam, Sudhir R Silwal, Simit Sapkota, Saugat Poudyal, Susmita Sharma, K Govind Babu, Taslima Nigar, Shahana Pervin, Seema Gulia, Sanjeeva Gunasekara, A F M Kamal Uddin, Ugyen Tshomo, Ahmad J Safi, Mohammad S Nadeem, Ahmed I Masood, Mostafa A Sumon, Shaila Purvin, Mohammad A Hai, Krishni Wijesooriya","doi":"10.1016/s1470-2045(24)00518-7","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00518-7","url":null,"abstract":"Cancer is a major global health threat, with 35 million new cases projected by 2050, predominantly in low-income and middle-income-countries. Within South Asian Association for Regional Cooperation (SAARC) countries, a notable gap in cancer research investment and output compared with high-income countries highlights the need to strengthen research capacity. The rising cancer incidence across SAARC countries is not being matched by local research, particularly in clinical trials in molecular biology, targeted therapy, immunotherapy, and cancer vaccines. This paucity of research is problematic as guidelines and therapies developed in high-income countries might not be directly applicable to low-income and middle-income countries due to distinct regional sociocultural, genetic, and environmental factors and are often impractical in these countries due to cost and implementation challenges. This Series paper examines the cancer research landscape within SAARC countries, focusing on Bangladesh, Nepal, Sri Lanka, India, Pakistan, Afghanistan, Bhutan, and Maldives. We analyse PubMed publication rates and examine available infrastructure, current research (including clinical trials), and limitations and disparities among SAARC countries in terms of cancer research. Key challenges include disparities in health-care access, cultural and economic barriers, and little funding and infrastructure. Strengthening cancer research in SAARC countries requires building collaborative networks, improving research facilities and training, focusing on local epidemiological studies, and developing affordable technologies and treatments. Effective policy and stakeholder engagement could greatly advance cancer care in the region.","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759977","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":"Use of the ESMO-Magnitude of Clinical Benefit Scale to guide HTA recommendations on coverage and reimbursement for cancer medicines: a retrospective analysis","authors":"Panos Kanavos, Erica Visintin, Aris Angelis","doi":"10.1016/s1470-2045(24)00505-9","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00505-9","url":null,"abstract":"<h3>Background</h3>Recommendations by countries’ health technology assessment (HTA) agencies are used to decide which new therapies warrant the allocation of limited health-care resources to make them available through publicly funded health systems. This process is of public health importance for balancing the dual aims of optimising patient outcomes while ensuring financial sustainability. We evaluated which factors affect HTA outcomes and the time to positive HTA outcome, focussing on the role of clinical benefit evaluated with the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS).<h3>Methods</h3>In this retrospective analysis, data were extracted from publicly available HTA reports and related sources from six country settings and their respective HTA agencies (Australia, Canada, England, France, the Canadian province of Quebec, and Scotland). We evaluated new cancer medicines for treating solid tumours in a non-curative setting with published ESMO-MCBS scores and that had been assessed by at least three HTA agencies between Jan 1, 2011, and Dec 31, 2020. Using ESMO-MCBS score as an independent variable, we did descriptive and multivariable regression analyses to evaluate: (1) factors associated with the time between marketing authorisation and positive (unrestricted [List] and restricted [List with Constraints]) HTA outcome; and (2) factors associated with HTA outcomes.<h3>Findings</h3>67 medicine–indication pairs used in non-curative settings were identified, totalling 360 HTA submissions (medicine–indication–country triplets) reviewed by the six HTA agencies. Factors significantly associated with a reduced interval between marketing authorisation and a positive (unrestricted or restricted) HTA outcome included a high ESMO-MCBS score (ie, 4 or 5, <em>vs</em> a low or average score of 1–3; hazard ratio [HR] per 1 month increment 1·42 [95% CI 1·11–1·81], p=0·0055), parallel review (<em>vs</em> standard marketing authorisation process; HR 1·69 [1·13–2·54], p=0·011), having a risk-sharing agreement or special funding arrangements (<em>vs</em> no funding agreement, HR 4·62 [95% CI 2·51–8·51], p<0·0001, and HR 4·16 [2·03–8·50], p=0·0001, respectively), and assessment by particular HTA agencies (pan-Canadian Oncology Drug Review <em>vs</em> National Institute for Health and Care Excellence [NICE], HR 2·82 [1·68–4·75], p=0·0001; and Haute Autorité de Santé <em>vs</em> NICE, HR 5·70 [2·87–11·33], p<0·0001). Accelerated marketing authorisation was significantly associated with a longer time to positive HTA outcome (<em>vs</em> standard authorisation process; HR 0·70 [95% CI 0·51–0·95], p=0·024). Positive HTA outcomes (both unrestricted and restricted) were significantly associated with a high ESMO-MCBS score (<em>vs</em> low or average ESMO-MCBS score; relative risk ratio [RRR] 14·10 [95% CI 3·54–56·20], p=0·0002, and RRR 4·52 [1·90–10·75], p=0·0006, respectively) and acknowledgment of unmet medical need (<em","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759988","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":"Decentralised clinical trials: a game changer for improved access to clinical trials","authors":"Craig Underhill, Sabe Sabesan, Elizabeth Wilson","doi":"10.1016/s1470-2045(24)00595-3","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00595-3","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142760046","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":"Capturing the true effect of anti-PD-1 therapy on patients’ health-related quality of life","authors":"Mees D Egeler, Lonneke V van de Poll-Franse","doi":"10.1016/s1470-2045(24)00601-6","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00601-6","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142760275","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 for hepatic cancer pain","authors":"Chi Yan Wong, Kwok Ying Chan, Kwok Wai Tsang, Wai Kit Lam","doi":"10.1016/s1470-2045(24)00572-2","DOIUrl":"https://doi.org/10.1016/s1470-2045(24)00572-2","url":null,"abstract":"No Abstract","PeriodicalId":22865,"journal":{"name":"The Lancet Oncology","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759965","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}