Journal of the National Cancer Institute最新文献

{"title":"Statewide surveillance of colorectal cancer screening using geospatial and Multi-Payer claims data","authors":"Katherine E Reeder-Hayes, Bradford E Jackson, Jennifer Lund, Tzy-Mey Kuo, Arrianna Marie Planey, Anisha P Ganguly, Brian J Reich, Daniel S Reuland, Stephanie B Wheeler, Christopher D Baggett","doi":"10.1093/jnci/djag407","DOIUrl":"https://doi.org/10.1093/jnci/djag407","url":null,"abstract":"Background Screening is a key tool to improve colorectal cancer (CRC) outcomes and mitigate disparities, and reliable estimates of screening variation across communities can help prioritize screening interventions. However, existing screening surveillance infrastructure relies on labor-intensive telephone survey methodology. We aimed to develop novel methods of estimating CRC utilization for small geographic areas using North Carolina multi-payer claims data and to identify patterns and determinants of geographic variation in screening adherence. Methods Using data from the Cancer Information and Population Health Resource, a multi-payer claims database, we generated annual screen-eligible cohorts and identified screening procedures. We then used Bayesian spatial models to estimate screening adherence for 1180 zip-code-based small areal units. We used geographic contextual data to re-weight estimates from the insured to the total (uninsured + insured) population. We examined associations between area-level racial composition and screening adherence stratified by age and sex. Results Across all years, the observed proportion of person-years up-to-date among insured age-eligible adults statewide was 80.3%; among all age-eligible adults, 75.8% were estimated to be up-to-date. Model-estimated screening adherence in small areas ranged between 43.1% and 93.1%. Increasing Black racial composition was associated with lower screening adherence across all sexes and age strata. Older age and female sex were associated with higher screening adherence. Conclusions Model-based estimation of CRC adherence from insurance claims and geographic data is feasible at scale and yields comprehensive estimates at small-area levels. There is wide variation in community-level screening adherence, with many areas falling below public health targets.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"290 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293009","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":"Caregivers and legal barriers: navigating care of a family member diagnosed with cancer","authors":"Krista Y Chen, Amanda L Blackford, Monica F Bryant, Joanna F Doran, Nicholas J Odom, Andres Azuero, Gabrielle B Rocque, S M Qasim Hussaini","doi":"10.1093/jnci/djag398","DOIUrl":"https://doi.org/10.1093/jnci/djag398","url":null,"abstract":"Caregivers of patients with cancer frequently coordinate care while navigating insurance, employment, financial, and benefits systems, yet their legal and administrative needs remain poorly characterized. We analyzed caregiver-initiated consultations in national non-profit organization’s Legal & Financial Navigation Program from 2021 to 2024. Among 1,091 consultations, caregivers were predominantly female (67.7%) and working age (19-64y, 60.8%); 10.9% lived in a different state than the patient. Caregivers reported 1,889 legal concerns, most commonly involving health insurance (32.1%), finances (24.0%), disability insurance (14.2%), and employment (11.8%). More than half (51.1%) reported multiple concurrent legal concerns. In adjusted analyses, residence in the South was associated with higher odds of multiple barriers than the Northeast (odds ratio [OR] = 1.60), whereas Marketplace, Medicaid, and Medicare coverage were associated with lower odds relative to employer-sponsored insurance. These findings support caregiver-focused screening, education, and legal navigation as components of supportive oncology care.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149292872","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":"Subgroup variations in benefit from telehealth palliative care for advanced lung cancer","authors":"Kathryn E Post, Chardria S Trotter, Amy M Munankarmi, Phalaen Chang, Toby C Campbell, Michael W Rabow, Laura C Hanson, Lori Spoozak, Carl Grey, Leslie Blackhall, Elaine Chen, Ramona Rhodes, Amelia Cullinan, Nora K Horick, Dustin J Rabideau, Areej El-Jawahri, Jennifer S Temel, Joseph A Greer","doi":"10.1093/jnci/djag408","DOIUrl":"https://doi.org/10.1093/jnci/djag408","url":null,"abstract":"We examined whether the impact on quality of life (QOL) of early palliative care delivered via video versus in-person visits varied across patients with advanced non-small cell lung cancer (NSCLC). Between 6/2018 and 5/2023, 1250 patients with advanced NSCLC enrolled in a randomized trial comparing early palliative care delivered via video or in-person visits at 22 cancer centers. Using the Functional Assessment of Cancer Therapy-Lung scale, we examined whether the effect of palliative care delivery modality on patient-reported QOL at 24 weeks post-enrollment varied by baseline sociodemographic and other factors. Black patients, Hispanic/Latino patients, and those with incomes <$50,000 reported better QOL in the video visit group versus the in-person group. However, Asian patients in the video visit group reported worse QOL than the in-person group. Early palliative care delivered via video may provide greater QOL benefits for Black and Hispanic/Latino patients with advanced NSCLC and those with lower incomes. Trial Registration: NCT03375489","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293010","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":"Employment after curative breast cancer treatment: the breast cancer and the workforce cohort study","authors":"Victoria S Blinder, Yashasvini Sampathkumar, Sujata Patil, Carolyn E Eberle, Jennifer Suarez, Bharat Narang, Valeria Lastra Osorio, Andrea V Filgueira, Jackie Finik, Antonia V Bennett, Manmeet K Malik, Gabriel H Jung, Caroline Hwang, Francesca Gany","doi":"10.1093/jnci/djag384","DOIUrl":"https://doi.org/10.1093/jnci/djag384","url":null,"abstract":"Purpose Breast cancer can disrupt employment, with a disproportionate negative impact on women from low-income, immigrant, or minoritized groups. Despite known associations between job loss, financial hardship, and inferior clinical outcomes, there is limited information on post-treatment employment among diverse populations. Methods Breast Cancer and the Workforce (BCW) is a prospective cohort study of pre-diagnosis employed women aged 18–64 undergoing treatment for stage I–III breast cancer in New York City. Participants completed surveys at baseline and 4 months post-treatment completion; work status was reassessed 1 and 2 years later. We additionally compared 4-month post-treatment work status between breast cancer survivors and their peers without cancer to control for disparities in noncancer unemployment. Multivariable logistic regression was used to assess predictors of working 4 months post-treatment. Results Among 489 participants, 68.6% were working 4 months post-treatment, 76.1% at 1 year, and 77.3% at 2 years. Compared to non-Latina white women, Black, Chinese, and Latina women were less likely to be working at 4 months (benchmarked to their same race/ethnicity peers), indicating a disparate negative impact of cancer on work status. In multivariable analyses, older age, receipt of chemotherapy, and demands at work were inversely associated with working at 4 months, while higher income, sick leave access, and an accommodating employer were positively associated. Race/ethnicity was not associated with working. Conclusion Breast cancer can negatively impact employment, especially among certain subpopulations. Increased access to workplace accommodations, including paid sick leave, may be a critical target to improve equitable survivorship outcomes.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231435","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":"Modeling the survival impact of the Inflation Reduction Act out-of-pocket cap in multiple myeloma","authors":"Han Zhao, Stanley Teng, Cynthia Dong, Ziyun Meng, Qingyuan Tan, Rong Wang, Mengmeng Ji, Martin W Schoen, Kristen M Sanfilippo, Mark A Fiala, Shi-Yi Wang, Su-Hsin Chang","doi":"10.1093/jnci/djag396","DOIUrl":"https://doi.org/10.1093/jnci/djag396","url":null,"abstract":"Background Oral immunomodulatory imide drugs (IMiDs) have become standard of care for newly diagnosed multiple myeloma (NDMM), but high out-of-pocket (OOP) costs may hinder treatment adherence. In 2025, the Inflation Reduction Act introduced a $2,000 annual OOP cost cap (IRAOOPcap) for Medicare Part D beneficiaries. In the absence of post-implementation data, we used comparative modeling to predict its survival impact. Methods The survival submodels of two independent Cancer Intervention and Surveillance Modeling Network (CISNET) natural history of multiple myeloma models were used. The models were parameterized using data from Surveillance, Epidemiology, and End Results (SEER)-Medicare, 2012–2021. We simulated survival among Medicare Part D beneficiaries with NDMM aged 66–75 and ≥76 years, under hypothetical scenarios shifting 0% (pre-IRAOOPcap) to 100% (best-case) of patients to IMiD use with high adherence and a realistic scenario using published data. We computed life-years gained (LYG) by comparing life expectancy (LE) under each scenario with that of the pre-IRAOOPcap scenario. Results Across models, the realistic/best-case scenario yielded LYG of 0.17–0.18/1.10–1.35 among patients aged 66–75 years, and 0.20–0.26/1.29–1.53 for those aged ≥76 years. These translated into 4,164–5,005/26,893–32,347 LYG at the population level for beneficiaries with NDMM in 2025. Conclusion The IRAOOPcap may improve survival through increasing IMiD utilization and adherence among Medicare Part D beneficiaries with NDMM. The projected gains represent a meaningful proportion of contemporary survival for patients. Future research should validate these gains when real-world data are available and inform future policy adaptation and extension.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231436","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":"Foundation models for cancer: advancing diagnosis, prognosis, and treatment response—an NCI workshop report","authors":"Asif Rizwan, Hala R Makhlouf, Ana I Robles, Sean E Hanlon, Subhashini Jagu, Mugdha Samant, Shannon Silkensen, Miguel Ossandon, Umit Topaloglu, Dana L Wolff-Hughes, Lyndsay N Harris, Brian S Sorg","doi":"10.1093/jnci/djag397","DOIUrl":"https://doi.org/10.1093/jnci/djag397","url":null,"abstract":"From March 24–26, 2026, the National Cancer Institute convened the Foundation Models for Cancer Workshop, bringing together more than thirty speakers from academia, government, and industry and attracting more than 2,000 registrants worldwide. The workshop examined the current state and future potential of foundation models and related artificial intelligence (AI) technologies in oncology. Presentations spanned single-cell biology, computational pathology, medical imaging, electronic health records, drug discovery, federated learning, and clinical decision support. Several themes emerged across the three-day meeting. First, the development of robust foundation models depends on access to high-quality, multimodal cancer datasets that are representative of the patient populations, disease stages, and clinical settings encountered in routine care. Second, prospective validation and evaluation in real-world clinical environments are essential for establishing the reliability, generalizability, and utility of AI-enabled tools. Third, while technical advances continue at a rapid pace, successful translation into cancer research and patient care will also require attention to implementation, workflow integration, interpretability, and data governance. Collectively, the workshop highlighted both the opportunities and challenges associated with applying foundation models to cancer research and clinical care and provided a forum for discussing future directions for the field.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"237 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229897","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":"Novel framework for the validation of intermediate clinical endpoints in oncology real-world data","authors":"Chris Labaki, Ziad Bakouny, Thibaut Sanglier, Eddy Saad, Miguel Valero Martin, Paolo Tarantino, Andrew L Schmidt, Jinjoo Shim, David A Braun, Fanny Bouquet, Maureen Joyce, Marc Machaalani, Eliezer M Van Allen, Wanling Xie, Sara M Tolaney, Toni K Choueiri","doi":"10.1093/jnci/djag390","DOIUrl":"https://doi.org/10.1093/jnci/djag390","url":null,"abstract":"Introduction The role of real-world data in oncology has been substantially increasing, helping to answer clinically unmet needs. No valid framework for real-world data is currently available for the evaluation of surrogate endpoints, with no intermediate clinical endpoint (ICE) being validated as a surrogate for overall survival (OS) across most cancer types. Methods A real-world retrospective cohort study was conducted using the nationwide US Flatiron Health database. Four ICEs were evaluated real-world progression-free survival (rwPFS), and three exposure-derived endpoints: Time to Next line of Therapy (TTNT), Time to Last Treatment Administration (TTLA) of first line therapy, and Time to End of First-Line Therapy (TTEFL). Two conditions were evaluated to establish surrogacy: correlation between ICE and OS (condition 1), and correlation of group effects (condition 2). Results A total of 19,164 patients with metastatic breast cancer (MBC) were included. Median OS was 36.3 (95%CI, 35.6-37.2) months across the study population. For condition 1, a high correlation was found between each of rwPFS, TTNT and TTLA, and OS (Kendall’s tau [τ] ≥ 0.5; R2 ≥ 0.7 between 36-month OS and 12-month rates for each ICE across subgroups of interest). For condition 2, group effects were found to be strongly correlated only between rwPFS and OS (R2 ≥ 0.7 across each subgroup comparison). Conclusion Among patients with MBC, rwPFS is a strong surrogate for OS. This study establishes a novel framework applicable to real-world data for the validation of intermediate clinical endpoints. This study can serve as a blueprint for future efforts of real-world data analysis.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221379","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":"Identification of prediagnostic proteomic biomarkers for colon and rectal cancer in 3 prospective cohorts","authors":"Xinyuan Zhang, Jonathan M Downie, David A Drew, Keming Yang, Suzanne G Orchard, John Zalcberg, Meir J Stampfer, Edward Giovannucci, Shuji Ogino, Robert E Gerszten, Jeffrey A Meyerhardt, Erica T Warner, Robyn L Woods, Rory Wolfe, Peter Gibbs, Mingyang Song, Yin Cao, Andrew T Chan","doi":"10.1093/jnci/djag217","DOIUrl":"https://doi.org/10.1093/jnci/djag217","url":null,"abstract":"Background Large-scale proteomics may reveal circulating biomarkers of colorectal cancer (CRC) years before diagnosis, yet cross-cohort reproducibility and anatomic site-specificity remain unclear. Methods We conducted nested case-control studies in three prospective cohorts with banked blood and cancer follow-up (median 7 years), totaling 851 incident CRC cases matched 1:1 to controls, with 1,801 pre-diagnostic plasma proteins from Olink panels. Results Twelve proteins showed significant paired differences between CRC cases and controls (FDR <0.1), with modest effect sizes. These included previously implicated CRC-biomarkers (e.g., higher GDF15 and TFF2) as well as less established associations (e.g., lower LEPR and BCAN). Paired protein differences are significantly distinct in colon vs. rectal cancer pairs (P = 0.005), driven by genes enriched in leukocyte activation, cell activation, and extracellular components. In stratified analysis, for colon cancer, 11 out of 12 proteins were lower in cases (FDR <0.1), including BCAN with 0.83 (0.74–0.94) odds ratio (OR, with 95% CI) per 1-unit increase in quantile-normalized NPX level, with cross-cohort consistency (I2 <0.01). For rectal cancer, 25 out of 28 proteins were higher in cases, including HDGF (OR 1.75 [1.15–2.66], I2 <0.01). HDGF could partially mediate BMI–rectal cancer risk (25.0%, FDR=0.044). Overall, we found that pre-diagnostic plasma proteomics identified proteins and pathways with modest effect sizes and clear differences between future risk of colon and rectal cancer. Conclusion These findings provide insight for future mechanistic validation of pre-diagnostic plasma proteins as CRC biomarkers and motivate site-specific biomarker discovery that distinguishes colon from rectal cancer.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218454","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":"Time trends of human papillomavirus-attributable head and neck cancers: the BROADEN study","authors":"Tim Waterboer, Fanghui Zhao, Anna Giuliano, Miquel Àngel Pavón, YouLin Qiao, Haïtham Mirghani, Hisham Mehanna, Ken-Ichi Nibu, Nobuhiko Oridate, Shaokai Zhang, Daniela Höfler, Lea Schroeder, Gema Carretero, Omar Clavero, Montserrat Roset, Núria Lara, Marta Forés Maresma, Marisa Felsher, Vivian Wang, Jacque Spitzer, Ya-Ting Chen, Craig Roberts, Edith Morais, Laia Alemany","doi":"10.1093/jnci/djag375","DOIUrl":"https://doi.org/10.1093/jnci/djag375","url":null,"abstract":"Background The incidence of human papillomavirus (HPV)-driven oropharyngeal cancer (OPC) is increasing in several Western countries, but this trend is less well understood in other geographical regions and for other head and neck cancers (HNC). The BROADEN (absolute BuRden Of HPV relAteD hEad and Neck) study assessed HPV-attributable fractions (HPV-AFs) of HNC including OPC in France, Germany, Italy, Portugal, Spain, China, and Japan over a 10-year period. Methods This retrospective study included patients diagnosed with HNC (oropharynx, oral cavity, nasopharynx, hypopharynx, and larynx cancer) in two time periods, 2008–2009 and 2018–2019. Formalin-fixed tissue samples were centrally tested for HPV-DNA, HPV-E6*I mRNA, and p16INK4a immunohistochemistry. HPV attributability required positive results in two of the three tests for OPC, and both HPV-DNA and HPV-E6*I mRNA positivity for other HNC. Results Among 6043 patients from 88 hospitals, the HPV-AF in OPC shown an increasing trend across all countries, with an HPV-AF ranging between 0% in Portugal and 44.2% in Japan in 2008-2009, and 20.0% and 51.7%, respectively, in 2018-2019. The increasing trend reached the statistical significance at 0.05 in all countries except China and Japan. Japan had the highest HPV-AF in 2008-2009. Other HNC showed lower HPV-AF (≤5%) with no time trends. Conclusion BROADEN is the first and largest study to date to investigate HPV causality and its time trends across five HNCs in seven countries. These results support the understanding of time trends and geographic variation in HPV-AF and are essential for global HNC prevention and treatment.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218455","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":"Cardio-protection and monitoring for early phase clinical trials: Recommendations from the therapeutic advances in childhood leukemia and lymphoma (TACL) consortium","authors":"Susan I Colace, Lauren Pommert, Kasey J Leger, Teresa Rushing, Kristine R Crews, Colleen Annesley, M Brooke Bernhardt, Laura B Ramsey, Nicole Kaiser, Deepa Bhojwani, Alan S Wayne, Todd M Cooper, Susan R Rheingold, Andrew E Place, Bill H Chang, Maria Luisa Sulis, Melinda Pauly, Paul S Gaynon, Ritu Sachdeva, Eric S Schafer, Himalee S Sabnis","doi":"10.1093/jnci/djag393","DOIUrl":"https://doi.org/10.1093/jnci/djag393","url":null,"abstract":"Background Many effective anti-cancer modalities potentially induce cardiotoxicity. Pediatric patients with relapsed/refractory hematologic malignancies are often excluded from anthracycline-containing regimens based on historical data showing population-level risk of heart failure after cumulative doses of anthracyclines without considering individual patient risk variability, modernized cumulative anthracycline equivalence ratios, novel anthracycline formulations, and use of supportive cardio-protectant medications. Additionally, standard guidelines are lacking for patients with a history of prior cardiotoxicity or previous anthracycline exposure. Methods The Therapeutic Advances in Childhood Leukemia and Lymphoma (TACL) consortium convened a task force to review the relevant literature and create evidence-based cardiac eligibility recommendations for patients who enroll on TACL relapse clinical trials. Results Recommendations for assessment of cardiotoxicity risk, cardiac monitoring, supportive care, management of cardiac dysfunction during therapy, and considerations for clinical trial design were created. Key guidance includes: 1) excluding potential subjects from therapies with cardiotoxic risk should be based on individual risk factors and real-time cardiac function assessments rather than past cardiotoxic exposures; 2) comprehensive subject-based cardiac monitoring before, during and after therapy is essential; 3) the liberal use of cardioprotective measures is encouraged; 4) uniform and evidence-based approaches for management of cardiac dysfunction during protocol therapy are crucial; 5) correlative cardiac aims should accompany protocols with potentially cardiotoxic therapies. Conclusions Adoption of these updated recommendations should allow more accurate and inclusive study eligibility criteria for TACL’s clinical trials and inform future trial development while ultimately improving both quality and interpretability of study data, patient safety, treatment, and outcomes.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218457","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}