American Journal of Clinical Oncology-Cancer Clinical Trials最新文献

Effect of Rectal Cancer Treatment Timing Standardization on Patient Outcomes. 直肠癌治疗时间标准化对患者预后的影响。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-10 DOI: 10.1097/COC.0000000000001173

James Sun, Jordan D Fredette, Jill S Hasler, Joceline V Vu, Matthew Philp, Juan L Poggio, Andrea S Porpiglia, Stephanie H Greco, Sanjay S Reddy, Jeffrey M Farma, Anthony M Villano

{"title":"Effect of Rectal Cancer Treatment Timing Standardization on Patient Outcomes.","authors":"James Sun, Jordan D Fredette, Jill S Hasler, Joceline V Vu, Matthew Philp, Juan L Poggio, Andrea S Porpiglia, Stephanie H Greco, Sanjay S Reddy, Jeffrey M Farma, Anthony M Villano","doi":"10.1097/COC.0000000000001173","DOIUrl":"10.1097/COC.0000000000001173","url":null,"abstract":"Objectives: The National Accreditation Program for Rectal Cancer (NAPRC) was established in 2017 to decrease rectal cancer treatment variation and improve oncologic outcomes. Initiating curative intent treatment <60 days of first evaluation is one NAPRC standard. We evaluated whether oncologic outcomes improved with timely treatment and factors associated with its receipt.Methods: Using the NCDB, we identified stage I to III rectal cancer patients treated from 2004 to 2020 treated with curative-intent surgery. Patients were stratified into 2 cohorts (timely [<60 d], delayed [≥60 d]) for survival analysis and exploration of variables associated with timely treatment.Results: We included 117,459 patients with a median age of 61 years (interquartile range: 52 to 70 y). Most patients were male (61.1%), White (86.2%), Charlson 0 (77.1%) with stage II (33.5%) or III (44.3%) cancer treated with chemoradiation (58.1%), or surgery (27.0%) first. Timely treatment was associated with improved overall survival (OS; median OS: 153.26 vs. 128.59 m). Patients in the highest income bracket (odds ratio [OR] 1.30) with stage II (OR: 1.27) or III (OR: 1.50) cancer receiving neoadjuvant chemotherapy (OR: 2.24) or chemoradiation (OR: 1.73) as the first treatment received more timely treatment. Patients with Charlson ≥2 (OR: 0.83) of Black (OR: 0.56) or Hispanic (OR: 0.73) race received more delayed treatment (all P <0.01).Conclusions: Timely rectal cancer treatment is associated with improved survival. Socioeconomic disparities limit timely treatment with attendant worse survival, supporting national homogenization of care. As multimodal care for rectal cancer becomes increasingly complex, timely treatment remains paramount.","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"302-309"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Continuous Nutritionist-led Guidance on Bowel Preparation in Patients Undergoing Prostate Stereotactic Body Radiation Treatment With Endorectal Spacing: A Prospective Pilot Trial. 在接受前列腺立体定向直肠内放疗的患者中，持续营养学家指导肠准备的效果：一项前瞻性试点试验。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-18 DOI: 10.1097/COC.0000000000001178

Yonatan Carmeli, Yael Shpatz, Iris Oren-Ivry, Anat Mansano, Ron Lewin, Idan BarOrian, Jacob Mattout, Ilana Weiss, Ory Haisraely, Yaacov Richard Lawrence, Zvi Symon

{"title":"Effect of Continuous Nutritionist-led Guidance on Bowel Preparation in Patients Undergoing Prostate Stereotactic Body Radiation Treatment With Endorectal Spacing: A Prospective Pilot Trial.","authors":"Yonatan Carmeli, Yael Shpatz, Iris Oren-Ivry, Anat Mansano, Ron Lewin, Idan BarOrian, Jacob Mattout, Ilana Weiss, Ory Haisraely, Yaacov Richard Lawrence, Zvi Symon","doi":"10.1097/COC.0000000000001178","DOIUrl":"10.1097/COC.0000000000001178","url":null,"abstract":"Objective: To evaluate the effect of a daily nutritionist consultation on rectal volume, gas, and prostate displacement during Stereotactic Body Radiation Treatment (SBRT) with an endorectal spacer.Methods: Twenty-six consecutive patients receiving 5 fraction SBRT with endorectal spacing were prospectively enrolled for an intensive daily nutritionist intervention utilizing biofeedback based on image guidance from each fraction. A retrospective control cohort receiving a standard bowel preparation was compared. Rectal volume, rectal gas, and prostate displacement were assessed by analysis of cone beam computed tomography. Data was analyzed using the SPSS statistics software.Results: Intense dietary intervention with biofeedback led to a consistently lower rectal gas score over 5 fractions ( P <0.001) and less variability in rectal volume during prostate SBRT indicating a nonsignificant trend for superior preparation in the intervention group compared with controls, particularly for the first 2 fractions. However, there was no significant impact on prostate displacement as measured by couch correction.Conclusions: Intense dietary consultations effectively reduce rectal gas and variation of rectal volume during prostate SBRT with endorectal spacing. However, there was no advantage in reducing prostate displacement. Thus, labor-intensive daily nutritionist intervention with biofeedback is not cost-effective in reducing organ motion in patients with endorectal spacers compared with standard pretreatment dietary advice and is not recommended.","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"314-318"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Censoring Analysis of the INvestigating VorasiDenib In GliOma (INDIGO) Phase III Randomized Controlled Trial. 研究VorasiDenib在胶质瘤（INDIGO） III期随机对照试验的筛选分析。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-14 DOI: 10.1097/COC.0000000000001175

Jessica Y Aduwo, Shearwood McClelland

引用次数: 0

A Meta-analysis on Effects of Chimeric Antigen Receptor T-cell Therapy in Relapsed or Refractory B-cell Acute Lymphoblastic Leukemia. 嵌合抗原受体t细胞治疗复发或难治性b细胞急性淋巴细胞白血病疗效的meta分析。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-17 DOI: 10.1097/COC.0000000000001176

Abdur Jamil, Zaheer Qureshi, Rimsha Siddique, Faryal Altaf, Rohma Jamil, Neehal Wali

{"title":"A Meta-analysis on Effects of Chimeric Antigen Receptor T-cell Therapy in Relapsed or Refractory B-cell Acute Lymphoblastic Leukemia.","authors":"Abdur Jamil, Zaheer Qureshi, Rimsha Siddique, Faryal Altaf, Rohma Jamil, Neehal Wali","doi":"10.1097/COC.0000000000001176","DOIUrl":"10.1097/COC.0000000000001176","url":null,"abstract":"Objectives: This review evaluates the long-term outcomes and adverse events associated with chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed/refractory B-cell acute lymphoblastic leukemia (r/r B-ALL).Methods: We conducted the search in relevant databases up to June 2024. We included clinical trials on CAR T-cell therapy for patients with r/r B-ALL. Meta-analyses were conducted using Comprehensive Meta-Analysis V3 and Review Manager 5.4.Results: Out of 2659 identified studies, 10 were included in this review. The pooled analysis demonstrated a high minimal residual disease-negative complete remission, with an overall event rate (ER) of 70% (95% CI: 61%-78%, I2 =8 8.35%). Anti-CD19 CAR T-cell therapy showed the highest efficacy with an ER of 74.75% (95% CI: 61%-80%, I2 = 89.84%). Combination therapies targeting CD19 and CD22 had an ER of 69% (95% CI: 53%-83%, I2 = 82.56%). Significant adverse effects included cytokine release syndrome with a mean incidence of 81.8% (95% CI: 76.7%-86.9%), neurotoxicity at 33.2% (95% CI: 28.1%-38.3%), and hematologic toxicities at 71.9% (95% CI: 66.4%-77.4%).Conclusions: CAR T-cell therapy is a groundbreaking advancement in treating r/r B-ALL, offering high rates of durable remissions.","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"283-289"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Minimal Residual Diseases Status and Depth of Response on Survival Outcomes in Blinatumomab-Treated Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis. 最小残留疾病状态和反应深度对布利纳单抗治疗急性淋巴细胞白血病生存结局的影响：系统回顾和荟萃分析

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-26 DOI: 10.1097/COC.0000000000001179

Abdur Jamil, Zaheer Qureshi, Rida Riaz, Hamzah Akram, Rohma Jamil, Asim Kichloo, Insija Ilyas Selene

{"title":"Impact of Minimal Residual Diseases Status and Depth of Response on Survival Outcomes in Blinatumomab-Treated Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis.","authors":"Abdur Jamil, Zaheer Qureshi, Rida Riaz, Hamzah Akram, Rohma Jamil, Asim Kichloo, Insija Ilyas Selene","doi":"10.1097/COC.0000000000001179","DOIUrl":"10.1097/COC.0000000000001179","url":null,"abstract":"Objectives: Acute lymphoblastic leukemia (ALL) is a common hematological malignancy that occurs due to blockage of B-lymphocyte maturation at an early stage of development and differentiation. The Food and Drug Administration approved blinotumomab to manage relapsed/refractory ALL (R/R ALL). This review aimed to determine the comparative efficacy of blinatumomab in treating R/R ALL.Methods: Two reviewers searched 3 electronic databases, PubMed, ScienceDirect, and CENTRAL, for all relevant articles published until July 2024. All the articles that met the inclusion criteria were included in the review.Results: Four hundred thirty-seven articles were found from the electronic search; however, only 21 articles met the inclusion criteria. A pooled analysis of the outcomes found that blinatumomab resulted in an improvement in both the OS (HR: 0.65; 95% CI: 0.51, 0.82; P =0.0003) and the DFS (HR: 0.57; 95% CI: 0.41, 0.80; P =0.001). Further analysis showed that the CR rate and MRD response of ALL patients to blinatumomab was 51.6% (95% CI: 48.5%, 54.6%; P =0.319) and 64.6% (95% CI: 53.4%, 74.3%; P =0.011), respectively. The safety analysis indicated that the incidence of serious AEs was comparable in patients receiving blinotumomab and those receiving standard chemotherapy (OR: 1.34; 95% CI; 0.91, 1.97; P =0.14).Conclusions: The findings show that blinatumomab is superior to standard chemotherapy in improving the OS and DFS of patients with R/R ALL. Furthermore, it has a more favorable safety profile, making it an effective alternative to conventional chemotherapy for managing R/R ALL.","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"290-301"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Establishing Feasibility of the Navigator-assisted Hypofractionation (NAVAH) Program to Address Radiation Therapy Access Disparities Facing African-Americans With Prostate Cancer. 建立导航辅助低分割（NAVAH）计划的可行性，以解决非洲裔美国人前列腺癌患者接受放射治疗的差异。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-05-22 DOI: 10.1097/COC.0000000000001172

Shearwood McClelland, Erica Fleming-Hall, Tamika K Smith, Louisa Onyewadume, Ursula J Burnette, Dante A Sanders, Abizairie Sanchez-Feliciano, Maya J Stephens, Daniel E Spratt, Angela Y Jia, Chesley W Cheatham

引用次数: 0

On the Origin of Treatment Paradigms. 论治疗范式的起源。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-20 DOI: 10.1097/COC.0000000000001181

Matthew McFarlane, Whitney Beeler, Matthew Ward, Chirag Shah

引用次数: 0

Establishing a Protocol to Increase Racial/Ethnic Under-Represented Minority Enrollment on an Active Radiation Oncology Multicenter Randomized Clinical Trial. 建立一个方案，以增加种族/民族代表性不足的少数民族纳入积极的放射肿瘤学多中心随机临床试验。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-11 DOI: 10.1097/COC.0000000000001174

Ulysses G Gardner, Otis W Brawley, Elizabeth E Obi, Kristin J Redmond, Shearwood McClelland

{"title":"Establishing a Protocol to Increase Racial/Ethnic Under-Represented Minority Enrollment on an Active Radiation Oncology Multicenter Randomized Clinical Trial.","authors":"Ulysses G Gardner, Otis W Brawley, Elizabeth E Obi, Kristin J Redmond, Shearwood McClelland","doi":"10.1097/COC.0000000000001174","DOIUrl":"10.1097/COC.0000000000001174","url":null,"abstract":"Objectives: In the United States, under-represented racial/ethnic groups lack ample enrollment in clinical trials, yielding ungeneralizable trial results. Barriers to increasing minority enrollment include decreased awareness of clinical trials, lack of access, financial burden and toxicity, medical system mistrust, and discordant physician-patient demographics.The ongoing Spine Patient Optimal Radiosurgery Treatment for Symptomatic MEtastatic Neoplasms (SPORTSMEN) clinical trial (NCT05617716 on clinicaltrials.gov) has a study design to actively accrue minority patients. We present our protocol addressing key targets to increase minority enrollment on this randomized, phase II clinical trial.Methods: Adults with evidence of symptomatic spine metastases are eligible. Baseline demographics (including race/ethnicity) are reported for statistical analysis. Our protocol seeks to minimize barriers to minority enrollment and targets 5 key areas including clinical trial design, access to care, financial toxicity, community engagement, and patient-centered care.Results and conclusions: Increasing clinical trial diversity is a challenge that must be addressed with meaningful intent to present robust level I data that broadens the understanding of treatment response in all demographics. Our protocol takes a patient-centered approach to achieve the objective of concordant racial/ethnic representation in a randomized clinical trial.","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"310-313"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcome Predictors of Hardware Complications in Head and Neck Free Flap Reconstruction. 头颈部游离皮瓣重建中硬体并发症的预后预测因素。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-02-19 DOI: 10.1097/COC.0000000000001180

Abhinav Talwar, Shravan Asthana, Jennifer Silva-Nash, Laila A Gharzai, Sandeep Samant, Urjeet Patel, Katelyn Stepan

{"title":"Outcome Predictors of Hardware Complications in Head and Neck Free Flap Reconstruction.","authors":"Abhinav Talwar, Shravan Asthana, Jennifer Silva-Nash, Laila A Gharzai, Sandeep Samant, Urjeet Patel, Katelyn Stepan","doi":"10.1097/COC.0000000000001180","DOIUrl":"10.1097/COC.0000000000001180","url":null,"abstract":"Objectives: Osteocutaneous free flap reconstruction can be complicated by hardware failure. The present study investigates the frequency and predictors of hardware failure in head and neck osteocutaneous reconstruction.Methods: Patients who underwent osteocutaneous head and neck free flap reconstruction between the years of 2014 and 2022 were identified at our institution. Hardware failure was defined as hardware infection, screw plate loosening, exposed hardware, migration, deformation, or fracture.Results: We identified 47 patients who met the inclusion criteria for this study. Common indications for intervention included squamous cell carcinoma (35, 74%) and osteoradionecrosis (8, 17%). Most operations used fibular flaps (31, 66%) or osteocutaneous radial forearm flaps (12, 26%). The median age at the time of reconstruction was 66 years (IQR: 59 to 72). In total, 17 (36%) patients experienced hardware failure in the postoperative period. On univariable analysis, estimated blood loss ( P =0.01) and early postoperative infectious complication ( P =0.03) were the only significant predictors of hardware failure. On multivariable analysis, these factors retained significance. Estimated blood loss had an OR of 1.004 (95% CI: 1.001-1.008; P =0.01), and infectious complication had an OR of 5.22 (95% CI: 1.28-24.84; P =0.03).Conclusion: The incidence of hardware failure among patients who undergo head and neck osteocutaenous free flap reconstruction is high (36%). Patients with infectious complications and high estimated blood loss may be more likely to develop hardware failure.Level of evidence: Level III.","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"319-324"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unlocking the Mysteries of Breast Cancer: The Role of Epigenetics in Diagnosis, Treatment, and Beyond. 揭开乳腺癌的神秘面纱：表观遗传学在诊断、治疗及其他方面的作用》。

IF 1.6 4区医学

American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-06-01 Epub Date: 2025-03-03 DOI: 10.1097/COC.0000000000001177

Zaheer Qureshi, Faryal Altaf, Abdur Jamil, Rimsha Siddique

{"title":"Unlocking the Mysteries of Breast Cancer: The Role of Epigenetics in Diagnosis, Treatment, and Beyond.","authors":"Zaheer Qureshi, Faryal Altaf, Abdur Jamil, Rimsha Siddique","doi":"10.1097/COC.0000000000001177","DOIUrl":"10.1097/COC.0000000000001177","url":null,"abstract":"Objectives: Breast cancer is an intricate and varied disease exhibiting a range of molecular subgroups and clinical consequences. Epigenetic alterations have become essential players in the pathophysiology of breast cancer because they control gene expression without changing the DNA sequence. This review provides a comprehensive overview of epigenetics' diagnostic, prognostic, and therapeutic implications in breast cancer. This review aims to present a comprehensive study of the function of epigenetics in breast cancer, emphasizing current developments and potential avenues for future research.Methods: A narrative review methodology involved an extensive literature search and selection to gather relevant studies and trial data. PubMed, Embase, and Web of Science databases were searched using relevant keywords such as \"epigenetics,\" \"breast cancer,\" \"DNA methylation,\" \"histone modification,\" \"noncoding RNA,\" and \"linical trials.\" Relevant studies and clinical trial data were selected and synthesized to summarize the topic comprehensively.Results: The review synthesizes critical findings from current research, underscoring the pivotal role of epigenetic mechanisms in breast cancer initiation, progression, and therapeutic response. It highlights the potential of epigenetic biomarkers for diagnosis and prognosis and the promise of epigenetic-targeted therapies in breast cancer management. Furthermore, the review outlines future directions for research, emphasizing the importance of elucidating the dynamic interplay between epigenetic alterations and tumor microenvironments in shaping breast cancer phenotypes.Conclusions: Epigenetic modifications influence breast cancer progression, diagnosis, and therapy. Emerging biomarkers and targeted treatments hold promise, but further research is essential to refine their clinical application and improve personalized cancer management strategies.","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"276-282"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0