Journal of Cancer Policy最新文献

{"title":"Press releases of industry-sponsored clinical trials in oncology: Characteristics, timing and financial impact","authors":"Anna Amela Valsecchi ,&nbsp;Cecilia Conte ,&nbsp;Nicola Maria Fiore ,&nbsp;Maria Lucia Iacovino ,&nbsp;Daniele Ierace ,&nbsp;Letizia Galeasso ,&nbsp;Eleonora Paganoni ,&nbsp;Oriana Ciani ,&nbsp;Francesco Perrone ,&nbsp;Massimo Di Maio","doi":"10.1016/j.jcpo.2025.100587","DOIUrl":"10.1016/j.jcpo.2025.100587","url":null,"abstract":"<div><h3>Background</h3><div>Press releases (PRs) anticipate the results of a clinical trial, possibly without providing detailed data. The purpose of this analysis was to describe the characteristics of PRs in oncology, delays in the availability of results and the impact on the financial market.</div></div><div><h3>Materials and methods</h3><div>PRs published between 2018 and 2022 about solid tumors, archived on the websites of the top 20 oncology pharmaceutical companies, were screened. Information about PR content, time between PRs and scientific meeting, paper publication and approval by regulatory agencies were collected. Market reactions on the event days of the PRs were examined.</div></div><div><h3>Results</h3><div>Out of 159 PRs, 157 were eligible. The most represented tumor was lung cancer (28 %). In most cases (117, 74.5 %), PRs announced that the study met its primary endpoint. Among these, 13 % of PRs included specific results, while the remaining 102 (87 %) contained only generic sentences. 85 % of PRs contained sentences supporting the clinical relevance of the results. Median time from PR to meeting presentation and full paper publication was 3.1 and 8 months, respectively. After a median follow-up of 48 months, 79 % were approved by FDA and 74 % by EMA. Median time from PR to approval by FDA and EMA was 10 and 15.9 months, respectively. Most events analyzed showed no statistically significant market reactions, with abnormal returns generally neutral or slightly positive.</div></div><div><h3>Conclusions</h3><div>Most PRs announce firstly the positivity of a clinical trial, without detailed results. The market appears to absorb this information with minimal stock price adjustments.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100587"},"PeriodicalIF":2.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859209","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":"Suicide rates of cervical cancer patients in the United States – Who is most at risk? A retrospective study of 69,493 patients","authors":"Kyra S. Hunsberger ,&nbsp;Daniel S. Kapp ,&nbsp;John K. Chan ,&nbsp;Chase M. Irwin ,&nbsp;Dana M. Chase","doi":"10.1016/j.jcpo.2025.100586","DOIUrl":"10.1016/j.jcpo.2025.100586","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify demographic and treatment factors associated with suicide risk among cervical cancer patients in the United States.</div></div><div><h3>Methods</h3><div>Data were obtained from the SEER database (2000–2020). Women with cervical cancer and follow-up time were included. Demographics and treatment history for women who died by suicide were compared to those who did not using chi-square tests. Suicide rates were compared to age-matched U.S. WHO 2019 data with the Mantel-Haenszel test. Univariate logistic regression estimated odds ratios for suicide risk, and Kaplan-Meier survival analysis examined overall survival (excluding suicide) by demographic and treatment factors. Linear regression assessed the link between time from diagnosis to treatment and time from diagnosis to suicide.</div></div><div><h3>Results</h3><div>Among 69,493 cervical cancer patients diagnosed from 2000 to 2020, most were White (75.9 %), aged 30–49 (46.4 %), lower-middle income (52.0 %), from metropolitan counties (88.0 %), and had localized disease (35.0 %). Fifty-eight patients died by suicide, with a suicide risk 8.8 times higher than the general population. Younger age groups (15–29 and 30–49) had the highest risk, being 18.9 and 11.2 times more likely to die by suicide, respectively. Suicide risk was significantly associated with age, ethnicity, stage, year of diagnosis, and chemotherapy, with highest risk in younger, Non-Hispanic, localized stage, diagnosed from 2000 to 2005, and no chemotherapy (p &lt; 0.05). Delayed treatment correlated with shorter time from diagnosis to suicide (R² = 0.124; p = 0.015).</div></div><div><h3>Conclusions</h3><div>Suicide rates are significantly elevated among cervical cancer patients, especially in young, Non-Hispanic patients with localized disease and no chemotherapy. Delayed treatment was linked to shorter time to suicide, emphasizing the need for targeted mental health support.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100586"},"PeriodicalIF":2.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850560","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":"Racial and urban-rural disparities in lung cancer care: Insight from a Latent Class Growth Analysis","authors":"Sohrab Jaferian ,&nbsp;Tanzy Love ,&nbsp;Sharad Kumar Singh ,&nbsp;Yunna Xie ,&nbsp;Elaine Hill ,&nbsp;Julie Ryan Wolf","doi":"10.1016/j.jcpo.2025.100585","DOIUrl":"10.1016/j.jcpo.2025.100585","url":null,"abstract":"<div><h3>Background</h3><div>Reducing health disparities is crucial for improving health outcomes. In cancer care, disparities persist across regions, socioeconomic groups, and racial populations. To better understand health disparities in lung cancer, the leading cause of cancer mortality in the U.S., we developed a novel method to visualize healthcare disparities by analyzing the sequence of care received, referred to as care paths. This approach aims to identify how variations in care paths among different patient groups are linked to poorer outcomes.</div></div><div><h3>Methods</h3><div>Using Latent Class Growth Analysis on visit sequences of lung cancer patients, we grouped patients into three classes. Then, we employed hazard modeling to predict adverse outcome probabilities for each class.</div></div><div><h3>Findings</h3><div>We identified three classes within our lung cancer cohort (N = 729) using the heterogeneity in their healthcare utilization patterns during 2016 and 2017. The results indicate differences between racial and urban/rural distributions across the classes (p = 0·004 and &lt;0·0005, respectively). Black patients consistently had higher Social Deprivation Index (SDI) scores compared to Whites within each class, with significantly greater SDI in Classes 2 and 3 (p &lt; 0·05 for both comparisons). Rural patients had significantly higher SDI scores than urban patients (p &lt; 0·05 for each class). The area under the risk trajectory curve indicated greater total longitudinal risk of adverse outcome was larger for Black and urban patients in each class than their White and rural counterparts.</div></div><div><h3>Interpretation</h3><div>Our research indicates that Black individuals experienced less favorable adverse outcome risk trajectories compared to White patients based on their care path sequences. Rural patients demonstrated better outcomes than urban patients despite exposure to more social deprivation.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100585"},"PeriodicalIF":2.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834122","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":"Achieving digital transformation in cancer care across Europe: Practical recommendations from the TRANSiTION project","authors":"Dimitrios Protogiros ,&nbsp;Constantina Cloconi ,&nbsp;Theologia Tsitsi ,&nbsp;Iolie Nicolaidou ,&nbsp;Efthyvoulos Kyriacou ,&nbsp;Norbert Couespel ,&nbsp;Deborah Moreno-Alonso ,&nbsp;Carme Carrión ,&nbsp;Ana Claveria ,&nbsp;Andreas Charalambous","doi":"10.1016/j.jcpo.2025.100584","DOIUrl":"10.1016/j.jcpo.2025.100584","url":null,"abstract":"<div><h3>Background</h3><div>Digital transformation in cancer care requires a comprehensive integration of digital technologies, data analytics, and innovative processes to enhance the delivery of healthcare services. Achieving digital transition relies on the appropriate preparation of the oncology workforce through adequate education and training in digital solutions. The aim of the current paper was to develop a recommendations scheme for digital transition in oncology through healthcare professionals’ and health managers’ digital training.</div></div><div><h3>Methods</h3><div>A mixed methods approach including a rapid literature review on relevant articles, guideline papers and statements of European organisations that was incorporated in expert’s panel survey was performed. This paper is part of the EU funded project entitled “TRANSiTION” - Digital TRANSition and dIgiTal resiIlience in Oncology.</div></div><div><h3>Results</h3><div>Four levels of recommendations arisen from the current study and include actions in the following areas: (i.) policy, (ii.) education (iii.) clinical practice and (iv.) research. These recommendations are interrelated and collaboration between all relevant stakeholders is crucial on a national, transnational and European level.</div></div><div><h3>Conclusions</h3><div>The recommendations proposed in this paper could have an impact on the digital transformation in cancer care across Europe. Strong leadership on a policy level, coordination and cooperation among the relevant stakeholders is the stepping stone to a successful and swift digital transition in healthcare systems.</div></div><div><h3>Policy summary</h3><div>The recommendations aims to impact several key policies and policy improvements in Europe, including regulatory frameworks on digital health technologies; data sharing and interoperability; digital literacy among both patients and healthcare professionals and health managers and the use of digital tools for patient-centered care, to harness the full potential of digital transformation in cancer care, ultimately leading to better patient outcomes and more efficient healthcare systems.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100584"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816419","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":"Challenges and opportunities in ovarian cancer care: A qualitative study of clinician perspectives from 24 low- and middle-income countries","authors":"Anmol Bajwa ,&nbsp;Runcie C.W. Chidebe ,&nbsp;Tracey Adams ,&nbsp;Garth Funston ,&nbsp;Isabelle Soerjomataram ,&nbsp;Robin Cohen ,&nbsp;Rafe Sadnan Adel ,&nbsp;Ngoc Phan ,&nbsp;Dilyara Kaidarova ,&nbsp;Raikhan Bolatbekova ,&nbsp;Basel Refky ,&nbsp;Florencia Noll ,&nbsp;Mary Eiken ,&nbsp;Martin Origa ,&nbsp;Asima Mukhopadhyay ,&nbsp;Sara Nasser ,&nbsp;Iren Lau ,&nbsp;Thomas Konney ,&nbsp;Afrin Fatima Shaffi ,&nbsp;Precious Takondwa Makondi ,&nbsp;Frances Reid","doi":"10.1016/j.jcpo.2025.100582","DOIUrl":"10.1016/j.jcpo.2025.100582","url":null,"abstract":"<div><h3>Background</h3><div>Ovarian cancer poses a significant and growing burden, particularly in low- and middle-income countries (LMICs) where incidence and mortality are projected to increase by over 50 % by 2050. However, there is a critical lack of qualitative data on the challenges and opportunities for improvement in treatment and care for women with ovarian cancer in these regions. The aim of this research is to investigate clinicians’ perspectives on the matter in 24 LMICs.</div></div><div><h3>Methods</h3><div>As part of the multi-country observational Every Woman Study™ (EWS), semi-structured interviews were conducted with clinicians between June 2022 and June 2023. The interview guide was developed by the EWS LMIC Oversight Committee, including patients, clinicians and data specialists. Relational content and inductive thematic analyses were employed and categories synthesized using the World Health Organization’s six building blocks of the Health Systems Framework.</div></div><div><h3>Results</h3><div>24 clinicians (54 % female; 79 % gynaecologic oncologists, 8 % gynaecologists, 8 % clinical oncologists not specializing in gynaecological cancers, and 4 % clinical oncologists specializing in gynaecological cancers; 42 % from Africa, 29 % from Asia, 29 % from Latin America) participated. Six dominant themes were identified: “Poor Ovarian Cancer Data'', “Inequity in Access to Treatment”, “In-Country Inequities in Access to Care”, “Role of Cultural Norms on Women's Health”, “Increased Engagement of Men in Ovarian Cancer Control”, and “Advocacy and Education for Empowering Women”. Content analysis revealed system-level challenges such as delayed drug payments, lack of population-based cancer data, and limited imaging facilities. Patient-level challenges included disparities in access to specialists, limited medication affordability, poor symptom recognition, and reliance on alternative treatments.</div></div><div><h3>Conclusions and policy summary</h3><div>This study reveals the complexity of ovarian cancer treatment and care in LMICs and the need to mitigate disparities in these regions, underscoring the need for patient-centred, context specific and intersectoral strategies to be considered in cancer planning to improve ovarian cancer care quality and equity in LMICs.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100582"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834123","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":"The role of the acute oncology service in a comprehensive cancer management pathway","authors":"H. Williams,&nbsp;E. Marshall,&nbsp;A. Lillis,&nbsp;C. O’Doherty,&nbsp;R. Christmas,&nbsp;O. Minton","doi":"10.1016/j.jcpo.2025.100583","DOIUrl":"10.1016/j.jcpo.2025.100583","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100583"},"PeriodicalIF":2.0,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800054","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":"Research on the issue of financial toxicity in cancer: A systematic review of the literature","authors":"Loukas Sideris,&nbsp;Eleftheria Karampli,&nbsp;Kostas Athanasakis","doi":"10.1016/j.jcpo.2025.100581","DOIUrl":"10.1016/j.jcpo.2025.100581","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;This review aims to investigate Financial Toxicity (FT) among cancer patients across several different healthcare systems. It identifies factors that contribute to FT and proposes policies to mitigate its effects on cancer patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Articles published between January 1st 2017 and March 31st 2022, describing Financial Toxicity experienced by cancer patients, were identified using PubMed, Scopus, Springer, and Science Direct databases. Papers written in English language, quantitative papers describing studies conducted in countries with public and mixed healthcare systems were considered eligible.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Based on 7917 records screened, 61 publications met our inclusion criteria. According to our findings, the referred prevalence of financial toxicity among cancer patients was up to 54 % in the United States, 44.7 % in high-income nations with public healthcare systems, and 80.4 % in low-income nations. Worse financial toxicity is linked to age under 65 years, low income, insurance status, high monthly out-of-pocket expenses, and cancer-related factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Financial toxicity is a widespread issue among cancer patients, and it is influenced by both socioeconomic and cancer-related factors, even in different countries and healthcare systems.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain language summary&lt;/h3&gt;&lt;div&gt;Patients who suffer from cancer often face very serious financial problems. The source of these problems is the increased cost of both the treatments and the drugs that they have to take for long periods and often for their entire lives, so there is a risk that patients do not have the necessary income to cover these costs, leading to patients’ developing coping mechanisms such as not fully adhering doctors' instructions for treatment or even forgoing treatment, hence, putting their lives in immediate danger. This phenomenon is called financial toxicity.&lt;/div&gt;&lt;div&gt;The cost of treatments as well as the financial burden borne by patients is not the same for everyone and depends both on the coverage of these expenses provided by each country's health system and on the personal characteristics of each patient such as age, amount of income, the existence or not of insurance coverage, daily out-of-pocket expenses as well as characteristics of the cancer such as the stage, type and metastatic disease.&lt;/div&gt;&lt;div&gt;To improve the situation, it will be necessary to implement coordinated efforts between patients, providers, health systems, payers, and policy makers at multiple levels.&lt;/div&gt;&lt;div&gt;For example, to tackle financial toxicity among cancer patients, tools could be implemented to identify those most vulnerable, considering factors like income, insurance coverage, and treatment costs. Hospitals could also establish financial counseling structures to help patients make the best treatment decisions based on to their financial status.&lt;/div","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100581"},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774428","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":"“But if you don't know what my needs are, you can't help me\": Health seeking experiences of older Black and Latinx cancer survivors","authors":"Candidus Nwakasi ,&nbsp;Jyotsana Parajuli ,&nbsp;Sarah Ahmed ,&nbsp;Obinna Odo ,&nbsp;Kingsley Udeh ,&nbsp;Chizobam Nweke","doi":"10.1016/j.jcpo.2025.100579","DOIUrl":"10.1016/j.jcpo.2025.100579","url":null,"abstract":"<div><h3>Background</h3><div>More research on minoritized individuals’ health-seeking experiences is necessary to address disparities in cancer survivorship. To fill this critical gap in the literature, this study explored the health-seeking experiences of older Black and Latinx populations in the United States (U.S.), guided by the intersectionality framework.</div></div><div><h3>Method</h3><div>Using a qualitative descriptive design, participants were recruited from the New England region of the U.S. Inclusion criteria were: a) 50 years or older, b) Black or Latinx person or both, c) a history of cancer diagnosis, and d) could speak English or Spanish. A semi-structured interview guide was used for data collection, and data were analyzed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>A total of 17 (4 men and 13 women) cancer survivors with a mean age of 63.9 years participated in this study. Three main themes relating to health-seeking emerged from the study: 1) views about cancer as stigmatizing or not (“Because you can see how people are staying away from you”); 2) the impact of being a Black or Latinx cancer survivor (“America is a complex one that sometimes you could be neglected”); and the impact of being an immigrant (“If I had no help, why didn't I go back to my country”).</div></div><div><h3>Conclusion</h3><div>Minoritized older cancer survivors may experience what we term the <em>triple jeopardy on health seeking</em> due to the disabling effect of cancer, race/ethnicity, and immigration status/situation.</div></div><div><h3>Policy summary</h3><div>To strengthen health-seeking and eliminate cancer health disparities, it is important to design or enhance policies that address structural inequities, including racism and xenophobia, and support community-oriented programs to reduce cancer-related stigma.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100579"},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734969","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":"Corrigendum to \"Sociodemographic, political, and policy contexts of cancer care: A comparative analysis of countries with the highest survival rates\" [J. Cancer Policy 43 (2025) 100559].","authors":"Alejandra Fuentes-García, Carla Flores-Figueroa, Alondra Castillo-Delgado","doi":"10.1016/j.jcpo.2025.100577","DOIUrl":"https://doi.org/10.1016/j.jcpo.2025.100577","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":" ","pages":"100577"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744298","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":"Mismatch between evidence and related clinical recommendations about the treatment of advanced esophageal cancer patients with anticancer drugs: A critical historical review","authors":"Xavier Bonfill Cosp ,&nbsp;Olga Savall-Esteve ,&nbsp;Javier Bracchiglione ,&nbsp;Carolina Requeijo ,&nbsp;Marilina Santero ,&nbsp;Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC-Study) Research Group","doi":"10.1016/j.jcpo.2025.100580","DOIUrl":"10.1016/j.jcpo.2025.100580","url":null,"abstract":"<div><h3>Purpose</h3><div>to analyze the most robust research and recommendations that have informed the potential superiority of treatments with anticancer drugs over any type of supportive care for advanced esophageal cancer (EC).</div></div><div><h3>Methods</h3><div>We conducted a critical historical review. First, we identified randomized clinical trials (RCTs) from a previous scoping review conducted by our research group, ASTAC, updating the search strategy. Second, we searched for the most important and recognized international clinical practice guidelines (CPGs) in advanced EC. Finally, we performed a systematic document analysis to compare whether the recommendations proposed in the CPGs were supported by the previously identified relevant evidence.</div></div><div><h3>Results</h3><div>We identified and assessed 15 RCTs and 11 CPGs from ESMO (eight), ASCO (two), and NICE (one) published over the last 40 years. There is a clear mismatch between these guidelines' recommendations and the available RCTs regarding the efficacy of anticancer drugs compared to best supportive care (BSC).</div></div><div><h3>Conclusion</h3><div>There is a lack of consistent evidence to support the treatment of advanced EC patients with anticancer drugs, and a notable mismatch exists between the available evidence and the recommendations made by relevant CPGs. As a result, these guidelines may be biased in favoring the use of anticancer drugs over supportive care and in consequence it is advisable to be very prudent when proposing systemic treatments to patients with advanced EC. Further rigorous and independent research is needed to better evaluate the true benefits of anticancer treatments in advanced EC and to update the CPGs accordingly.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"44 ","pages":"Article 100580"},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732079","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}