JMIR Cancer最新文献

{"title":"Usability, Acceptability, and Barriers to Implementation of a Collaborative Agenda-Setting Intervention (CASI) to Promote Person-Centered Ovarian Cancer Care: Development Study.","authors":"Rachel A Pozzar, James A Tulsky, Donna L Berry, Jeidy Batista, Paige Barwick, Charlotta J Lindvall, Patricia C Dykes, Michael Manni, Ursula A Matulonis, Nadine J McCleary, Alexi A Wright","doi":"10.2196/66801","DOIUrl":"10.2196/66801","url":null,"abstract":"<p><strong>Background: </strong>People with advanced ovarian cancer and their caregivers report unmet supportive care needs. We developed a Collaborative Agenda-Setting Intervention (CASI) to elicit patients' and caregivers' needs through the patient portal before a clinic visit and to communicate these needs to clinicians using the electronic health record.</p><p><strong>Objective: </strong>We aimed to assess the usability and acceptability of the CASI and identify barriers to and facilitators of its implementation.</p><p><strong>Methods: </strong>We recruited English- and Spanish-speaking patients, caregivers, and clinicians from the gynecologic oncology program at a comprehensive cancer center. Participants used the CASI prototype and then completed individual cognitive interviews and surveys. We assessed usability with the System Usability Scale (scores range 0-100, scores ≥70 indicate acceptable usability) and acceptability with the Acceptability of Intervention Measure and Intervention Appropriateness Measure (scores for both measures range from 1 to 5, higher scores indicate greater acceptability). Interviews were audio recorded, transcribed, and analyzed using directed content analysis. Domains and constructs from the Consolidated Framework for Implementation Research comprised the initial codebook. We analyzed survey data using descriptive statistics and compared usability and acceptability scores across patients, caregivers, and clinicians using analyses of variance.</p><p><strong>Results: </strong>We enrolled 15 participants (5 patients, 5 caregivers, and 5 clinicians). The mean System Usability Scale score was 72 (SD 16). The mean Acceptability of Intervention Measure and Intervention Appropriateness Measure scores were 3.9 (SD 1.0) and 4.1 (SD 0.8), respectively. Participants viewed the CASI content and format positively overall. Several participants appreciated the CASI's integration into the clinical workflow and its potential to increase attention to psychosocial concerns. Suggestions to refine the CASI included removing redundant items, simplifying item language, and adding options to request a conversation or opt out of supportive care referrals. Key barriers to implementing the CASI include its complexity and limited resources available to address patients' and caregivers' needs.</p><p><strong>Conclusions: </strong>The CASI is usable and acceptable to patients with advanced ovarian cancer, caregivers, and clinicians. We identified several barriers to and facilitators of implementing the CASI. In future research, we will apply these insights to a pilot randomized controlled trial to assess the feasibility of comparing the CASI to usual care in a parallel group-randomized efficacy trial.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e66801"},"PeriodicalIF":3.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting a Self-Guided eHealth Intervention Into a Tailored Therapist-Guided eHealth Intervention for Survivors of Colorectal Cancer.","authors":"Johanne Dam Lyhne, Allan 'Ben' Smith, Tina Birgitte Wisbech Carstensen, Lisa Beatty, Adeola Bamgboje-Ayodele, Britt Klein, Lars Henrik Jensen, Lisbeth Frostholm","doi":"10.2196/63486","DOIUrl":"10.2196/63486","url":null,"abstract":"<p><strong>Unlabelled: </strong>Therapist-guided eHealth interventions have been shown to engage users more effectively and achieve better outcomes than self-guided interventions when addressing psychological symptoms. Building on this evidence, this viewpoint aimed to describe the adaptation of iConquerFear, a self-guided eHealth intervention targeting fear of cancer recurrence, into a therapist-guided version (TG-iConquerFear) tailored specifically for survivors of colorectal cancer (CRC). The goal was to optimize patient outcomes while minimizing the need for extensive resources. The adaptation process followed the Information System research framework, which facilitated a systematic integration of knowledge and iterative testing. Drawing on insights from the original iConquerFear development, as well as feedback from end users, oncologists, and therapists, we began by identifying areas for improvement. These insights formed the foundation for the first design cycle. Initial internal testing revealed the need for several adjustments to enhance the intervention. While the core concept of iConquerFear remained unchanged, we made significant modifications to improve access by optimizing the platform for mobile devices, to support adherence by expanding the exercises, and to equip therapists with tools such as reflective questions and a monitoring control panel. External field testing with 5 survivors of CRC provided further validation. Participants reported a high level of acceptability, and their feedback guided additional minor points to consider incorporating in future versions. This study illustrates how a self-guided eHealth intervention can be successfully adapted into a therapist-guided format for fear of cancer recurrence, tailored to meet the needs of survivors of CRC. The described approach serves as a valuable framework for integrating therapist guidance into similar interventions, ensuring their relevance and effectiveness for targeted populations.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e63486"},"PeriodicalIF":3.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Media as a Platform for Cancer Care Decision-Making Among Women: Internet Survey-Based Study on Trust, Engagement, and Preferences.","authors":"Anna Rose Johnson, Grace Anne Longfellow, Clara N Lee, Benjamin Ormseth, Gary B Skolnick, Mary C Politi, Yonaira M Rivera, Terence Myckatyn","doi":"10.2196/64724","DOIUrl":"10.2196/64724","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Decision aids improve patient and clinician decision-making but are underused and often restricted to clinical settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Given limited studies analyzing the feasibility of disseminating decision aids through social media, this study aimed to evaluate the acceptability, trust, and engagement of women with social media as a tool to deliver online decision aids for cancer treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;To prepare for potential dissemination of a breast cancer decision aid via social media, a cross-sectional survey in February 2023 was conducted via Prime Panels, an online market research platform, of women aged 35-75 years in the United States. Demographics, health, cancer information-seeking behaviors, social media use, trust in social media for health information, as well as the likelihood of viewing cancer-related health information and clicking on decision aids through social media, were assessed. Statistical analyses included descriptive statistics, correlations, and multivariable ordinal regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 607 respondents, 397 (65.4%) had searched for cancer information, with 185 (46.6%) using the internet as their primary source. Facebook (Meta) was the most popular platform (511/607, 84.2%). Trust in social media for health information was higher among Black (14/72, 19.4%) and Asian respondents (7/27, 25.9%) than among White respondents (49/480, 10.2%; P=.003). Younger respondents aged 35-39 years (17/82, 20.7%) showed higher trust than those aged 70-79 years (12/70, 17.1%; P&lt;.001). Trust in social media for health information was linked to a higher likelihood of viewing cancer information and accessing a decision aid online (P&lt;.001). Participants who rated social media as \"Trustworthy\" (n=73) were more likely to view cancer information (61/73, 83.6%) and click on decision aids (61/73, 83.6%) than those who found it \"Untrustworthy\" (n=277; view: 133/277, 48.0%; click: 125/277, 45.1%). Engagement with social media positively correlated with viewing online cancer information (Spearman ρ=0.20, P&lt;.001) and willingness to use decision aids (ρ=0.21, P&lt;.001). Multivariable ordinal regression analyses confirmed that perception of social media's trustworthiness is a significant predictor of engagement with decision aids (untrustworthy vs trustworthy β=-1.826, P&lt;.001; neutral vs trustworthy β=-0.926, P=.007) and of viewing cancer information (untrustworthy vs trustworthy β=-1.680, P&lt;.001, neutral vs trustworthy β=-0.581, P=.098), while age and employment status were not significant predictors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This exploratory study suggests that social media platforms may increase access to health information and decision aids. No significant differences were observed between demographic variables and the use or trust in social media for health information. However, trust in social media emerged as a mediating factor between de","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e64724"},"PeriodicalIF":3.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Relationship Between Rural-Urban Status and Use of Digital Health Technology Among Older Cancer Survivors Based on the Health Information National Trends Survey: Cross-Sectional Analysis.","authors":"Samantha J Werts-Pelter, Zhao Chen, Jennifer W Bea, Amanda E Sokan, Cynthia A Thomson","doi":"10.2196/66636","DOIUrl":"10.2196/66636","url":null,"abstract":"<p><strong>Background: </strong>Though telehealth has been a promising avenue for engaging cancer survivors with health care and lifestyle programming, older and rural-dwelling cancer survivors may have additional challenges in accessing digital devices and tools that have not yet been described. This study aimed to use a robust, nationally representative sample collected in 2022 to provide an updated view of digital technology use and the use of technology for health in this population.</p><p><strong>Objective: </strong>This study aimed to examine the prevalence of digital technology use for health-related activities among older cancer survivors in both rural and urban settings. The primary outcomes of interest included (1) internet access and use for health-related activities, (2) digital device ownership and use as a tool for health behaviors, (3) use of social media for health, and (4) use of telehealth.</p><p><strong>Methods: </strong>A cross-sectional analysis of the National Cancer Institute's Health Information National Trends Survey Cycle 6 (HINTS 6) was completed to examine the prevalence of digital technology use among older cancer survivors. For analysis, the sample was restricted to cancer survivors over the age of 60 years (n=710). Unadjusted and adjusted logistic regression models were used to test the association between rurality and digital health tool use.</p><p><strong>Results: </strong>Overall, 17% (125/710) of the sample lived in a rural area of the United States and the mean sample age was 73 (SD 8.2) years. Older cancer survivors, regardless of rural-urban status, reported a high prevalence of internet usage (n=553, 79.9%), digital device ownership (n=676, 94.9%), and social media use (n=448, 66.6%). In unadjusted models, rural survivors were less likely than urban survivors to report that they had used a health or wellness application in the previous year (odds ratio [OR] 0.56, 95% CI 0.32-0.97; P=.04). In adjusted models, rural survivors were more likely to report that they had shared personal health information on social media (OR 2.64, 95% CI 1.13-6.19; P=.03). There were no differences in the proportion of rural and urban respondents who reported receiving health services through telehealth in the previous year.</p><p><strong>Conclusions: </strong>Regardless of the residential status, older cancer survivors report high internet and technology use for health-related activities. These results show promise for the feasibility of using digital technologies to implement supportive care and wellness programming with older cancer survivors.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e66636"},"PeriodicalIF":3.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Cancer Screening Participation and Internet Search Activity in a Japanese Population: Decade-Long Time-Series Study.","authors":"Noriaki Takahashi, Mutsuhiro Nakao, Tomio Nakayama, Tsutomu Yamazaki","doi":"10.2196/64020","DOIUrl":"10.2196/64020","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a major health concern in various countries. Routine mammography screening has been shown to reduce breast cancer mortality, and Japan has set national targets to improve screening participation and increase public attention. However, collecting nationwide data on public attention and activity is not easy. Google Trends can reveal changes in societal interest, yet there are no reports on the relationship between internet search volume and nationwide participation rates in Japan.</p><p><strong>Objective: </strong>This study aims to reveal and discuss the relationship between public awareness and actual behavior in breast cancer screening by examining trends in internet search volume for the keyword \"breast cancer screening\" and participation rates over a decade-long period.</p><p><strong>Methods: </strong>This time-series study evaluated the association between internet search volume and breast cancer screening participation behavior among women aged 60-69 years in Japan from 2009 to 2019. Relative search volume (RSV) data for the search term \"breast cancer screening (nyuugan-kenshin)\" were extracted from Google Trends as internet search volume. Breast cancer screening and further assessment participation rates were based on government municipal screening data. Joinpoint regression analyses were conducted with weighted BIC to evaluate the time trends. An ethics review was not required because all data were open.</p><p><strong>Results: </strong>The RSV for \"breast cancer screening (nyuugan-kenshin)\" peaked in June 2017 (100) and showed clear spikes in June 2016 (94), September (69), and October (77) 2015. No RSVs above 60 were observed except around these three specific periods, and the average RSV for the entire period was 30.7 (SD 16.2). Two statistically significant joinpoints were detected, rising in December 2013 and falling in June 2017. Screening participation rates showed a temporary increase in 2015 in a slowly decreasing trend, and no joinpoints were detected. Further assessment participation rates showed a temporary spike in 2015 in the middle of an increasing trend, with a statistically significant point of slowing increase detected in 2015. Post hoc manual searches revealed that Japanese celebrities' breast cancer diagnoses were announced on the relevant dates, and many Japanese media reports were found.</p><p><strong>Conclusions: </strong>This study found a notable association between internet search activity and celebrity cancer media reports and a temporal association with screening participation in breast cancer screening in Japan. Celebrity cancer media reports triggered internet searches for cancer screening, but this did not lead to long-term changes in screening participation behavior. This finding suggests what information needs to be provided to citizens to encourage participation in screening.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e64020"},"PeriodicalIF":3.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Overall Survival in Patients with Male Breast Cancer: Nomogram Development and External Validation Study.","authors":"Wen-Zhen Tang, Shu-Tian Mo, Yuan-Xi Xie, Tian-Fu Wei, Guo-Lian Chen, Yan-Juan Teng, Kui Jia","doi":"10.2196/54625","DOIUrl":"10.2196/54625","url":null,"abstract":"<p><strong>Background: </strong>Male breast cancer (MBC) is an uncommon disease. Few studies have discussed the prognosis of MBC due to its rarity.</p><p><strong>Objective: </strong>This study aimed to develop a nomogram to predict the overall survival of patients with MBC and externally validate it using cases from China.</p><p><strong>Methods: </strong>Based on the Surveillance, Epidemiology, and End Results (SEER) database, male patients who were diagnosed with breast cancer between January 2010, and December 2015, were enrolled. These patients were randomly assigned to either a training set (n=1610) or a validation set (n=713) in a 7:3 ratio. Additionally, 22 MBC cases diagnosed at the First Affiliated Hospital of Guangxi Medical University between January 2013 and June 2021 were used for external validation, with the follow-up endpoint being June 10, 2023. Cox regression analysis was performed to identify significant risk variables and construct a nomogram to predict the overall survival of patients with MBC. Information collected from the test set was applied to validate the model. The concordance index (C-index), receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and a Kaplan-Meier survival curve were used to evaluate the accuracy and reliability of the model.</p><p><strong>Results: </strong>A total of 2301 patients with MBC in the SEER database and 22 patients with MBC from the study hospital were included. The predictive model included 7 variables: age (hazard ratio [HR] 1.89, 95% CI 1.50-2.38), surgery (HR 0.38, 95% CI 0.29-0.51), marital status (HR 0.75, 95% CI 0.63-0.89), tumor stage (HR 1.17, 95% CI 1.05-1.29), clinical stage (HR 1.41, 95% CI 1.15-1.74), chemotherapy (HR 0.62, 95% CI 0.50-0.75), and HER2 status (HR 2.68, 95% CI 1.20-5.98). The C-index was 0.72, 0.747, and 0.981 in the training set, internal validation set, and external validation set, respectively. The nomogram showed accurate calibration, and the ROC curve confirmed the advantage of the model in clinical validity. The DCA analysis indicated that the model had good clinical applicability. Furthermore, the nomogram classification allowed for more accurate differentiation of risk subgroups, and patients with low-risk MBC demonstrated substantially improved survival outcomes compared with medium- and high-risk patients (P<.001).</p><p><strong>Conclusions: </strong>A survival prognosis prediction nomogram with 7 variables for patients with MBC was constructed in this study. The model can predict the survival outcome of these patients and provide a scientific basis for clinical diagnosis and treatment.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e54625"},"PeriodicalIF":3.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Health Information Seeking Behaviors Among Targeted Social Media Users Using an Infotainment Video About a Cancer Clinical Trial: Population-Based Descriptive Study.","authors":"Jonathan Sommers, Don S Dizon, Mark A Lewis, Erik Stone, Richard Andreoli, Vida Henderson","doi":"10.2196/56098","DOIUrl":"10.2196/56098","url":null,"abstract":"<p><strong>Background: </strong>The lack of information and awareness about clinical trials, as well as misconceptions about them, are major barriers to cancer clinical trial participation. Digital and social media are dominant sources of health information and offer optimal opportunities to improve public medical awareness and education by providing accurate and trustworthy health information from reliable sources. Infotainment, material intended to both entertain and inform, is an effective strategy for engaging and educating audiences that can be easily disseminated using social media and may be a novel way to improve awareness of and recruitment in clinical trials.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate whether an infotainment video promoting a clinical trial, disseminated using social media, could drive health information seeking behaviors.</p><p><strong>Methods: </strong>As part of a video series, we created an infotainment video focused on the promotion of a specific cancer clinical trial. We instituted a dissemination and marketing process on Facebook to measure video engagement and health information seeking behaviors among targeted audiences who expressed interest in breast cancer research and organizations. To evaluate video engagement, we measured reach, retention, outbound clicks, and outbound click-through rate. Frequencies and descriptive statistics were used to summarize each measure.</p><p><strong>Results: </strong>The video substantially increased health information seeking behavior by increasing viewership from 1 visitor one month prior to launch to 414 outbound clicks from the video to the clinical trial web page during the 21-day social media campaign period.</p><p><strong>Conclusions: </strong>Our study shows that digital and social media tools can be tailored for specific target audiences, are scalable, and can be disseminated at low cost, making it an accessible educational, recruitment, and retention strategy focused on improving the awareness of clinical trials.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e56098"},"PeriodicalIF":3.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes From Erlotinib and Gefitinib in Advanced Epidermal Growth Factor Receptor-Mutated Nonsquamous Non-Small Cell Lung Cancer in Aotearoa New Zealand From 2010 to 2020: Nationwide Whole-of-Patient-Population Retrospective Cohort Study.","authors":"Phyu Sin Aye, Joanne Barnes, George Laking, Laird Cameron, Malcolm Anderson, Brendan Luey, Stephen Delany, Dean Harris, Blair McLaren, Elliott Brenman, Jayden Wong, Ross Lawrenson, Michael Arendse, Sandar Tin Tin, Mark Elwood, Philip Hope, Mark James McKeage","doi":"10.2196/65118","DOIUrl":"10.2196/65118","url":null,"abstract":"<p><strong>Background: </strong>Health care system-wide outcomes from routine treatment with erlotinib and gefitinib are incompletely understood.</p><p><strong>Objective: </strong>The aim of the study is to describe the effectiveness of erlotinib and gefitinib during the first decade of their routine use for treating advanced epidermal growth factor receptor (EGFR) mutation-positive nonsquamous non-small cell lung cancer in the entire cohort of patients treated in Aotearoa New Zealand.</p><p><strong>Methods: </strong>Patients were identified, and data collated from national pharmaceutical dispensing, cancer registration, and mortality registration electronic databases by deterministic data linkage using National Health Index numbers. Time-to-treatment discontinuation and overall survival were measured from the date of first dispensing of erlotinib or gefitinib and analyzed by Kaplan-Meier curves. Associations of treatment outcomes with baseline factors were evaluated using univariable and multivariable Cox regressions.</p><p><strong>Results: </strong>Overall, 752 patients were included who started treatment with erlotinib (n=418) or gefitinib (n=334) before October 2020. Median time-to-treatment discontinuation was 11.6 (95% CI 10.8-12.4) months, and median overall survival was 20.1 (95% CI 18.1-21.6) months. Shorter time-to-treatment discontinuation was independently associated with high socioeconomic deprivation (hazard ratio [HR] 1.3, 95% CI 1.1-1.5 compared to the New Zealand Index of Deprivation 1-4 group), EGFR L858R mutations (HR 1.3, 95% CI 1.1-1.6 compared to exon 19 deletion), and distant disease at cancer diagnosis (HR 1.4, 95% CI 1.2-1.7 compared to localized or regional disease). The same factors were independently associated with shorter overall survival. Outcome estimates and predictors remained unchanged in sensitivity analyses.</p><p><strong>Conclusions: </strong>Outcomes from routine treatment with erlotinib and gefitinib in New Zealand patients with advanced EGFR-mutant nonsquamous non-small cell lung cancer are comparable with those reported in randomized trials and other health care system-wide retrospective cohort studies. Socioeconomic status, EGFR mutation subtype, and disease extent at cancer diagnosis were independent predictors of treatment outcomes in that setting.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e65118"},"PeriodicalIF":3.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Artificial Intelligence in Cardio-Oncology Imaging for Cancer Therapy-Related Cardiovascular Toxicity: A Systematic Review.","authors":"Hayat Mushcab, Mohammed Al Ramis, Abdulrahman AlRujaib, Rawan Eskandarani, Tamara Sunbul, Anwar AlOtaibi, Mohammed Obaidan, Reman Al Harbi, Duaa Aljabri","doi":"10.2196/63964","DOIUrl":"https://doi.org/10.2196/63964","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is a revolutionary upcoming tool yet to be fully integrated into several healthcare sectors, including medical imaging. AI can transform how medical imaging is conducted and interpreted, especially in cardio-oncology.</p><p><strong>Objective: </strong>This study aims to systematically review the available literature on the use of AI in cardio-oncology imaging to predict cardiotoxicity and describe the possible improvement of different imaging modalities that can be achieved if AI is successfully deployed to routine practice.</p><p><strong>Methods: </strong>We conducted a database search in PubMed, Ovid Medline, Cochrane Library, CINHAL and Google Scholar from inception to 2023 using the AI research assistant tool (Elicit) to search for original studies reporting AI outcomes in adult patients diagnosed with any cancer and undergoing cardiotoxicity assessment. Outcomes included incidence of cardiotoxicity, left ventricular ejection fraction (LVEF), risk factors associated with cardiotoxicity, heart failure, myocardial dysfunction, signs of cancer therapy-related cardiovascular toxicity, echocardiography, and cardiac magnetic resonance imaging. Descriptive information about each study was recorded, including imaging technique, AI Model, outcomes, and limitations.</p><p><strong>Results: </strong>The systematic search resulted in seven studies conducted between 2018 and 2023, which are included in this review. Most of these studies were conducted in the USA (71%), included breast cancer patients (86%), and used magnetic resonance imaging (MRI) as the imaging modality (57%). The quality assessment of the studies had an average of 86% compliance in all of the tool's sections. In conclusion, this systematic review demonstrates the potential of artificial intelligence (AI) to enhance cardio-oncology imaging for predicting cardiotoxicity in cancer patients.</p><p><strong>Conclusions: </strong>Our findings suggest that AI can enhance the accuracy and efficiency of cardiotoxicity assessments. However, further research through larger, multicenter trials is needed to validate these applications and refine AI technologies for routine use, paving the way for improved patient outcomes in cancer survivors at risk of cardiotoxicity.</p><p><strong>Clinicaltrial: </strong>Review registration number: PROSPERO CRD42023446135.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598090","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":"Leveraging Patient-Reported Outcome Measures for Optimal Dose Selection in Early Phase Cancer Trials.","authors":"Bill Byrom, Anthony Everhart, Paul Cordero, Chris Garratt, Tim Meyer","doi":"10.2196/64611","DOIUrl":"10.2196/64611","url":null,"abstract":"<p><strong>Unlabelled: </strong>While patient-reported outcome measures are regularly incorporated into phase 3 clinical trials, they have been infrequently used in early phase trials. However, the patient's perspective is vital to fully understanding dose toxicity and selecting an optimal dose. This viewpoint paper reviews the rationale for and practical approach to collecting patient-reported outcome data in early phase oncology drug development and the rationale for electronic collection.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"11 ","pages":"e64611"},"PeriodicalIF":3.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}