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

{"title":"Matched Cohort Analysis of Ultra-hypofractionated Versus Standard Fractionation Preoperative Radiation Therapy for Soft Tissue Sarcoma.","authors":"Cong Fan, Lukas Nystrom, Nathan W Mesko, Zachary D Burke, Zachary S Mayo, Chirag S Shah, Shlomo A Koyfman, Jacob Scott, Shauna R Campbell","doi":"10.1097/COC.0000000000001185","DOIUrl":"10.1097/COC.0000000000001185","url":null,"abstract":"<p><strong>Objective: </strong>This study compares toxicity and oncologic outcomes in a matched cohort of soft tissue sarcoma (STS) patients receiving ultra-hypofractionated preoperative radiation therapy (RT) or standard fractionated RT.</p><p><strong>Methods: </strong>This IRB-approved study included patients with STS of the extremity, pelvis, or trunk treated with preoperative RT followed by surgical resection. Patients received either standard RT or ultra-hypofractionated RT (≥30 Gy over 5 fractions) between 2016 and 2023 with intensity-modulated RT at a single institution. Ultra-hypofractionated RT patients proceeded to surgical resection 0 to 7 days after RT and standard fractionated RT group 4 to 6 weeks after completion. The cohorts were matched based on tumor location and type of surgical closure. An inverse propensity weighting (IPW) method was used to balance group covariates.</p><p><strong>Results: </strong>A total of 74 patients were included in this study. 37 patients treated with ultra-hypofractionated RT were matched with 37 patients treated with standard fractionation RT. Median follow-up time was 21.00 [IQR 11.00, 45.00] months for ultra-hypofractionated RT and 29.00 [IQR 13.00, 43.00] months for standard fractionated RT ( P =0.58). Rates of major wound complications (MWC) were 44.4% ultra-hypofractionated RT versus 29.7% standard RT ( P =0.289). On logistic regression, MWC (OR 1.9, 95% CI 0.97-3.76, P =0.06) and wound dehiscence (OR 3.91, 95% CI 1.81-8.73, P =0.0006) were more common in the ultra-hypofractionated RT group. Clinically significant late toxicity (grade ≥2 fibrosis, joint stiffness, or edema) did not differ significantly. There was no difference in local control ( P =1.00) or distant metastases ( P =0.465).</p><p><strong>Conclusions: </strong>Ultra-hypofractionated RT for STS results in excellent disease control. To reduce the risk of MWC, we have adopted delayed surgical resection for ultra-hypofractionated RT patients of 4 to 6 weeks.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"345-350"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659676","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}

{"title":"Navigator-Assisted Hypofractionation (NAVAH) Phase I Clinical Trial of Breast Cancer Patients: Implications for Assessing Personal Versus Familial Financial Toxicity via the Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) Survey Instrument.","authors":"Nimisha Kasliwal, Maya J Stephens, Ursula J Burnette, Louisa Onyewadume, Shearwood McClelland","doi":"10.1097/COC.0000000000001190","DOIUrl":"10.1097/COC.0000000000001190","url":null,"abstract":"<p><strong>Objectives: </strong>The COST-FACIT survey has been used to objectively measure financial toxicity (FT). It consists of 11 questions related to FT of an individual and a 12th question (\"My illness has been a financial hardship to my family and me\"), providing a glimpse beyond individual FT into familial FT. This question does not contribute to the score, and in relation to the first 11 questions, it has not been rigorously evaluated in the past. We present findings from our ongoing phase I clinical trial to evaluate the correlation of familial FT to individual FT.</p><p><strong>Methods: </strong>This study included African-American adult (18+) breast cancer patients with pathologically confirmed breast cancer undergoing adjuvant radiation therapy (RT). Patients were guided by a patient navigator during and after treatment. COST-FACIT results were amalgamated to find FT in patients before RT. Grade 0 (absent) FT is represented by values from 26 to 44, grade 1 (mild) FT is represented by values from 14 to 25, grade 2 (moderate) FT represented by values from 1 to 13, and grade 3 (severe) FT is represented by a value of 0. Question 12 ranges from 0 to 4, with a higher number meaning more familial distress. The r -value of the comparison between the answer to COST-FACIT question 12 and the COST-FACIT FT score was used to identify a relationship between familial FT and the FT experienced by the individual.</p><p><strong>Results: </strong>Nearly 90% of patients experiencing individual FT perceive it in their family. Individual FT is strongly correlated with familial FT ( P =0.0001). Overall, patients with higher levels of individual FT indicate higher levels of familial FT, whereas those with lower levels of individual FT indicate lower levels of familial FT.</p><p><strong>Conclusion: </strong>Our findings indicate a strong correlation between individual FT and familial FT, warranting further investigation into the interconnected impacts on patients and caregivers to better address financial toxicity in cancer care.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"342-344"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711997","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}

{"title":"Complications of Implant-Based Reconstruction and Postmastectomy Radiation in the Era of Adjuvant CDK4/6 Inhibitors.","authors":"Hamail Iqbal, Badal Juneja, Sophia Chryssofos, Stuti Ahlawat, Steven Bonawitz, A Leilani Fahey, Catherine Loveland-Jones, Leah Steinmetz, Danny Markabawi, Christine Kurian, Anthony E Dragun","doi":"10.1097/COC.0000000000001186","DOIUrl":"https://doi.org/10.1097/COC.0000000000001186","url":null,"abstract":"<p><strong>Objectives: </strong>Abemaciclib is approved for adjuvant use in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. Its toxicity profile is derived from studies favoring patients undergoing breast conservation therapy. This study investigates the impact of abemaciclib on wound complications in the setting of postmastectomy radiation therapy (PMRT) and implant-based reconstruction.</p><p><strong>Methods: </strong>A single-center, retrospective chart review was conducted. Patients who underwent mastectomy, implant-based reconstruction, and PMRT between January 2020 and December 2022 were included. Descriptive statistics characterized the study population and determined rates of any complication, major complications requiring reoperation, and complications by subtype (contracture, extrusion, tissue expander changes, infection, seroma, dermatitis, and pain). χ2 and the Fisher Exact tests assessed associations between abemaciclib use, complications, and potential risk factors.</p><p><strong>Results: </strong>Seventy-five patients were included. Fifteen underwent adjuvant abemaciclib therapy. Thirty-four patients (45.3%) were obese (BMI ≥30), 24 (32.0%) had a smoking history, and 4 (5.3%) had diabetes. The incidences of any complication and major complications were 33.3% and 17.5%, respectively. There was no significant association between abemaciclib use and any complication (P=1.000), major complications (P=0.729), or any complication subtype (P=0.865). There was a significant association between BMI and any complication (P=0.014).</p><p><strong>Conclusions: </strong>The study suggests that the use of adjuvant abemaciclib is not associated with an increased risk of postradiation reconstructive complications in patients undergoing implant-based reconstruction. Continued surveillance of complications associated with abemaciclib is warranted with a larger sample size.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":"48 7","pages":"357-361"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477669","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}

{"title":"Beyond the Clinic: A Social Media Network Analysis of 5466 Posts Reveals the Interconnected Challenges Facing Sarcoma Patients.","authors":"Daniel Schneider, Ethan D L Brown, Jacob Gluski, Akash Mishra, Daniel M Sciubba, Sheng-Fu L Lo","doi":"10.1097/COC.0000000000001191","DOIUrl":"10.1097/COC.0000000000001191","url":null,"abstract":"<p><strong>Objectives: </strong>Social media platforms have increasingly been investigated as a source of patient perspectives that may not emerge in clinical settings. This study aimed to explore how disease status, treatment, and the patient experience interconnect for sarcoma patients posting on a major social media platform.</p><p><strong>Methods: </strong>We conducted a systematic thematic analysis of 5466 posts across 7 health-related subreddits using a framework of 6 major categories: physical symptoms, disease status, treatments, psychosocial impact, support systems, and daily life impact. Theme detection utilized regular expression matching across 27 subthemes, while VADER sentiment analysis assessed emotional valence. The statistical analysis examined theme co-occurrences using Fisher exact tests and sentiment patterns using Mann-Whitney U tests.</p><p><strong>Results: </strong>Treatment-related discussions dominated the discourse, with chemotherapy (65.6%) and radiation therapy (60.2%) strongly associated with work-related impacts (OR=2.85 and 2.47, respectively; all OR P <0.001). Financial discussions and work-related posts demonstrated the highest user engagement. Disease progression was a critical transition point, demonstrating robust relationships with treatment modalities (chemotherapy: OR=3.12; radiation: OR=4.09), anxiety (OR=2.23), and uncertainty (OR=2.13). Support-seeking behavior (34.9%) was positively associated with medical team interactions (OR=2.16). Physical symptoms exhibited negative sentiment (-0.331±0.154), particularly discussions of weakness (-0.589) and breathing difficulties (-0.308). Hope-related discussions showed more positive sentiment than other psychosocial themes (Cohen d =-0.595, P <0.001).</p><p><strong>Conclusions: </strong>This network analysis reveals critical intersections between treatment decisions, financial concerns, and work impact within sarcoma care. Integrated support interventions that address both clinical and practical challenges-particularly treatment transitions and financial toxicity-may improve patient care.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"351-356"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797012","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}

{"title":"Advancing MRD Detection in Multiple Myeloma: Technologies, Applications, and Future Perspectives.","authors":"Binbin Chen, Qiongqiong Pan, Yuqing Dong","doi":"10.1097/COC.0000000000001197","DOIUrl":"10.1097/COC.0000000000001197","url":null,"abstract":"<p><p>Multiple myeloma (MM) is a malignant hematologic tumor of plasma cells that presents significant challenges in treatment and management. Despite the advent of novel therapies in recent years, which have improved patient outcomes, complete eradication of the disease remains an elusive goal. This underscores the critical need for in-depth research and ongoing innovation to tackle MM. Minimal residual disease (MRD) detection has emerged as a vital tool for evaluating treatment efficacy and predicting prognosis in MM patients, garnering extensive attention and application in recent years. This paper provides a comprehensive review of recent advancements in major MRD detection methods for MM patients, including multiparametric flow cytometry (MFC), allele-specific oligonucleotide real-time quantitative PCR (ASO-qPCR), and next-generation sequencing (NGS). It delves into the clinical applications of MRD detection, anticipates future developments, and offers valuable insights for improving diagnostic and therapeutic strategies. Through persistent research and innovation, we hope to bring better therapeutic prospects to MM patients.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"376-380"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of Tumor Testing for BRCA Pathogenic Variants in Epithelial Ovarian Cancer.","authors":"Sarah E Taylor, Phuong L Mai, Heidi Donovan, Sarah G Bell, Shannon K Rush, Robert P Edwards, Ronald J Buckanovich, Kenneth J Smith","doi":"10.1097/COC.0000000000001187","DOIUrl":"10.1097/COC.0000000000001187","url":null,"abstract":"<p><strong>Objectives: </strong>Approximately 15% of women with epithelial ovarian cancer (EOC) have a germline BRCA1/2 pathogenic variant. Genetic testing for BRCA is recommended for all EOC patients, but not routinely performed. This study estimates the cost-effectiveness of BRCA screening with primary tumor testing versus routine germline testing.</p><p><strong>Methods: </strong>The model used literature-based probability estimates and published cost data. Effectiveness was the probability of testing completion for each strategy, providing cost per additional woman tested. A strategy was favored if it cost ≤$5000 per additional woman tested, reflecting costs of 100% receiving germline testing and 85% subsequently receiving tumor testing.</p><p><strong>Results: </strong>In the base case, primary tumor testing costs $3057 per additional woman tested. While more costly, primary tumor testing increased efficacy 2.67-fold with an incremental cost of $1500. In sensitivity analyses, results were most sensitive to varying testing costs. Tumor testing costs ≤$5000 per additional woman tested when individually varying all parameters through clinically plausible ranges. Primary germline testing was favored in >60% of cases (base case 30%) when it occurred. In probabilistic sensitivity analysis, varying all parameters simultaneously over plausible ranges 5000 times, tumor testing cost ≤$5000 per additional woman tested in 100% of model iterations.</p><p><strong>Conclusion: </strong>Cost effectiveness data already support BRCA1/2 screening for EOC with clear implications for cancer prevention. On the basis of this model, primary tumor testing leads to a 2.67-fold increase in testing with an incremental cost of $1500, supporting this strategy as a cost-effective way to improve BRCA testing.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"365-371"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732936","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}

{"title":"Death From Infection Among Patients Living With Cancer.","authors":"Mckenzee Chiam, Kyle Mani, Xi Wang, Ming Wang, Daniel M Trifiletti, Leslie J Parent, Daniel E Spratt, Leila Tchelebi, Nicholas G Zaorsky","doi":"10.1097/COC.0000000000001182","DOIUrl":"10.1097/COC.0000000000001182","url":null,"abstract":"<p><strong>Objectives: </strong>Early identification of patients living with cancer at higher risk of death from an infection is critical in infection mortality prevention. We characterize patients living with cancer at the highest risk of dying from an infection.</p><p><strong>Methods: </strong>7,529,481 US cancer survivors (1992 to 2015) were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Standardized mortality ratios (SMRs) and 95% CIs were calculated. Fine-gray survival analysis was performed to calculate hazard ratios by adjusting for the effects of competing risks (eg, deaths due to causes other than infection).</p><p><strong>Results: </strong>Among 7,529,481 patients living with cancer (1992 to 2015), 101,167 (1.3%) died of infection. The rate of infection-specific mortality was 27.19/10,000 person-years, with an SMR of 3.29 (95% CI: 3.26-3.32, P <0.001). Patients who were older, male, black, and unmarried were at a greater risk of fatal infection. Overall, the risk of infection-specific mortality for patients living with cancer is greatest 1 year after diagnosis compared with the general population (SMR: 8.68, 95% CI: 8.53-8.84; P< 0.0001), and this risk decreases with follow-up time (SMR at >10 y after diagnosis: 2.93, 95% CI: 2.87-3.00; P< 0.0001). Among patients with Hodgkin Lymphoma, Non-Hodgkin Lymphoma, and Kaposi Sarcoma, 9.2%, 11.5%, and 82.2% of all deaths within the first year after cancer diagnosis occurred due to acute infectious disease. In contrast, for patients with liver cancer, the relative percentage of infection-specific mortality increases with follow-up time from 3.5% at <1 year after cancer diagnosis and 10.4% at 10+ years of follow-up.</p><p><strong>Conclusion: </strong>The results of this study characterize infection mortality in patients living with cancer, which can guide more targeted research and interventions in this population.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"327-335"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781353","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}

{"title":"Prospective Validation of An Inpatient Metastatic Spine Neoplasm Score To Assess the Optimal Radiation Therapy Intervention Modality.","authors":"Shearwood McClelland","doi":"10.1097/COC.0000000000001184","DOIUrl":"10.1097/COC.0000000000001184","url":null,"abstract":"<p><strong>Objectives: </strong>Metastatic spine disease is typically treated with conventional external beam radiation therapy (EBRT) or stereotactic body radiation therapy (SBRT). Recently, an inpatient metastatic spine score evaluated retrospectively produced promising results in selecting patients with prognoses favorable enough to benefit from the durability advantages of SBRT over EBRT, with scores of 0 to 3 warranting recommendation of SBRT over EBRT compared with scores of 4 to 7 yielding median survival <90 days. This study represents a prospective evaluation of this algorithm to further assess its potential utility.</p><p><strong>Methods: </strong>From July to November 2023, 11 spine metastases referred for inpatient radiation oncology consultation were prospectively assessed according to the inpatient metastatic spine score: scores of 0 to 3 were recommended for SBRT, and 4 to 7 for EBRT or no radiation therapy. The timeframe from consultation to death/hospice was correlated with the cumulative score.</p><p><strong>Results: </strong>The median age was 68.5 years. Patients with a score of 0 to 3 (n=5) had a median survival of 278 days, compared with scores of 4 to 7 (n=6) having a median survival of 37.5 days; this difference was statistically significant ( P =0.0146).</p><p><strong>Conclusions: </strong>Prospective validation of the inpatient metastatic spine score reveals the prognosis of patients with scores of 4 to 7 have median survival too brief to benefit from the durability advantages of SBRT over EBRT, while scores of 0 to 3 have a prognosis long enough to benefit from SBRT. These results concur with previous retrospective evaluation, and indicate that the inpatient metastatic spine score is a reliable tool for determining which inpatients with spine metastases are appropriate for SBRT over EBRT.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"336-338"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538056","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}

{"title":"Medical Racism and Physician Trust Impressions of African-American Breast Cancer Patients Enrolled on the Navigator-Assisted Hypofractionation (NAVAH) Phase I Clinical Trial.","authors":"Kamryn J Davis, Ursula J Burnette, Yilun Sun, Maya J Stephens, Louisa Onyewadume, Shearwood McClelland","doi":"10.1097/COC.0000000000001183","DOIUrl":"10.1097/COC.0000000000001183","url":null,"abstract":"<p><strong>Objectives: </strong>The historical distrust between the African-American community and the medical system, rooted in systemic racism, continues to affect health care outcomes today. Although Caucasian women have the largest incidence of breast cancer diagnoses, African-American women have the highest mortality rate. Furthermore, studies show African-American women are less likely to receive hypofractionated radiation therapy (RT). The Navigation-Assisted Hypofractionation (NAVAH) program was designed to identify the barriers preventing equal access to adjuvant hypofractionated RT while also addressing the inequities by utilizing patient navigation services to improve breast cancer survivorship in African-American women. This study explored patients' perceptions of racism in medicine, offering new insights into this critical, yet understudied aspect of health care disparities.</p><p><strong>Methods: </strong>This is a prospective study of African-American breast cancer patients enrolled in the ongoing NAVAH phase I clinical trial. Following consent to receive RT, pretreatment surveys were administered. Surveys assessed participants' distrust of medical professionals and if care was impacted as a result. Each patient answered a series of questions with responses on a scale from strongly agree to strongly disagree. The significance of patients' views on medical racism and physician trust was evaluated using the Kendall tau correlation. A P -value of ≤0.05 was considered statistically significant.</p><p><strong>Results: </strong>The Kendall tau test was used to analyze the data accounting for the possible nonlinear, monotonic nature of the data. Patients believing harmful events have taken place at medical centers were significantly less likely to trust doctors ( P =0.03). Of the remaining sets of questions assessed, only the correlation between the belief that African-Americans receive the same care as other patients and the likelihood of following hospital-given advice approached statistical significance ( P =0.055).</p><p><strong>Lessons: </strong>Patients' perception of treatment within the medical system can greatly impact their decision to seek care and adhere to treatment, which in return can have a substantial impact on oncologic outcomes. Our findings indicate that patient trust in physicians is significantly impacted by patient perceptions of the likelihood of harmful event occurrence at medical centers, with the correlation of perceived medical racism and obeying hospital-given advice trending towards significance.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05978232.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"339-341"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538110","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}

{"title":"Early Cancer Screening Impressions of African-American Breast Cancer Patients Enrolled on the Navigator-Assisted Hypofractionation (NAVAH) Trial.","authors":"Jessica Y Aduwo, Ursula J Burnette, Louisa Onyewadume, Maya J Stephens, Kamryn J Davis, Shearwood McClelland","doi":"10.1097/COC.0000000000001189","DOIUrl":"10.1097/COC.0000000000001189","url":null,"abstract":"<p><strong>Objectives: </strong>African-Americans have the highest cancer mortality rates and the lowest survival rates compared with other racial groups in the US. The Navigator-Assisted Hypofractionation (NAVAH) program includes a culturally sensitive survey to assess the impact of patient navigation on access to hypofractionated radiation therapy (RT) for African-American breast cancer patients. This study reports cancer screening impressions of participants enrolled in the ongoing NAVAH phase I clinical trial, marking a significant first in this field.</p><p><strong>Methods: </strong>After a referral for RT from a multidisciplinary tumor board, trial-eligible patients were invited to participate in the NAVAH trial. Surveys were administered before RT to assess overall cancer screening knowledge, categorizing responses as outstanding (18 to 23 points), excellent (24 to 29 points), good (30 to 35 points), average (36 to 42 points), or below average (>43 points). Knowledge was further stratified through 3 specific criteria: early screening, prognosis, and toxicity awareness with responses categorized as excellent, good, or average for each domain. Correlations between education levels and responses were analyzed using variance analysis ( P <0.05).</p><p><strong>Results: </strong>An initial cohort of 35 trial participants was assessed. The average cancer screening and treatment knowledge score was 27.6. Participants showed excellent understanding of early screening and prognosis and good knowledge of toxicity. There was no significant correlation between educational attainment and cancer knowledge or income levels. This ongoing phase I clinical trial highlights a relative deficiency in toxicity knowledge compared with prognosis and early screening.</p><p><strong>Conclusions: </strong>Early impressions indicate that African-American breast cancer patients have an overall excellent knowledge of cancer screening and treatment, not correlated with socioeconomic or educational status, except treatment toxicity knowledge. Future education initiatives should focus on treatment toxicity to optimize patient awareness before adjuvant breast cancer RT.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"362-364"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711994","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}