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

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Proceedings of the American Radium Society® 107th Annual Meeting.
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-06 DOI: 10.1097/COC.0000000000001256
{"title":"Proceedings of the American Radium Society® 107th Annual Meeting.","authors":"","doi":"10.1097/COC.0000000000001256","DOIUrl":"https://doi.org/10.1097/COC.0000000000001256","url":null,"abstract":"","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245822","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
Inavolisib for HR-Positive, HER2-Negative Advanced Breast Cancer: Clinical Trials and Patient Access Implication. hr2阳性,her2阴性晚期乳腺癌:临床试验和患者获取意义
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-01 Epub Date: 2025-07-11 DOI: 10.1097/COC.0000000000001209
Arman Arabshomali, Swarnali Goswami, Prajakta P Masurkar
{"title":"Inavolisib for HR-Positive, HER2-Negative Advanced Breast Cancer: Clinical Trials and Patient Access Implication.","authors":"Arman Arabshomali, Swarnali Goswami, Prajakta P Masurkar","doi":"10.1097/COC.0000000000001209","DOIUrl":"10.1097/COC.0000000000001209","url":null,"abstract":"<p><strong>Objectives: </strong>Breast cancer remains the most prevalent cancer among women in the United States, with hormone receptor-positive (HR+) and HER2-negative subtypes comprising a significant proportion of cases. Despite advancements in treatment, resistance to endocrine therapies remains a substantial clinical challenge, especially in patients with mutations in the PIK3CA gene.</p><p><strong>Methods: </strong>A literature review was conducted to evaluate the safety and efficacy of inavolisib in breast cancer. Studies published through November 2024 were identified using PubMed, Google Scholar, and ClinicalTrials.gov. Phases I to III clinical trials in English were included. The review focused on safety outcomes (eg, serious adverse events) and efficacy outcomes (eg, progression-free survival), which were summarized narratively.</p><p><strong>Results: </strong>Inavolisib, a selective PI3Kα inhibitor, presents a promising option for patients with PIK3CA-mutated HR+HER2-negative advanced or metastatic breast cancer. In the INAVO120 trial, inavolisib combined with palbociclib and fulvestrant significantly extended progression-free survival (PFS) in patients with PIK3CA mutations. The median PFS was 15.0 months for the treatment arm compared with 7.3 months in the placebo group (hazard ratio: 0.43, P <0.001). The objective response rate (ORR) was 58.4% in the treatment arm, underscoring the drug's antitumor efficacy. Safety profiles revealed manageable adverse events, primarily hyperglycemia, neutropenia, and stomatitis. The incidence of these side effects was notable but manageable with appropriate supportive care. Inavolisib offers a new treatment for HR+HER2-negative advanced breast cancer, showing promising efficacy and safety. However, implementation challenges include high costs, insurance coverage issues, and limited access to required genetic testing through FoundationOne Liquid CDx assay, potentially creating barriers to equitable patient access.</p><p><strong>Conclusions: </strong>Inavolisib represents a significant advancement in the treatment of advanced HR+HER2-negative breast cancer, offering an effective option for patients with PIK3CA mutations. However, to fully realize its potential, health care systems must address challenges related to patient access, insurance coverage, and the availability of companion diagnostics. Further long-term studies will be essential to assess the enduring impact of this treatment on patient outcomes.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"496-500"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610252","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
Research Progress of SBRT Combined With Immunotherapy in Locally Advanced Head and Neck Cancer. SBRT联合免疫治疗局部晚期头颈部肿瘤的研究进展。
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-01 Epub Date: 2025-05-05 DOI: 10.1097/COC.0000000000001204
Yumei Feng, Ping Zhou, Xirui Duan, Qin Ye, Ke Xie
{"title":"Research Progress of SBRT Combined With Immunotherapy in Locally Advanced Head and Neck Cancer.","authors":"Yumei Feng, Ping Zhou, Xirui Duan, Qin Ye, Ke Xie","doi":"10.1097/COC.0000000000001204","DOIUrl":"10.1097/COC.0000000000001204","url":null,"abstract":"<p><p>The incidence of head and neck cancer ranks sixth among malignant tumors in the world. According to the GLOBOCAN 2020 database, there are about 930,000 new cases and 467,000 deaths per year. Among malignant head and neck tumors, head and neck squamous cell carcinoma (HNSCC) comprises approximately 90% of cases. Between 70% and 80% of HNSCC patients are diagnosed at an advanced stage (III or IV). Following comprehensive treatment, the recurrence rate within 2 years ranges from 40% to 60%. In cases of recurrent or metastatic HNSCC, the median survival period after traditional chemotherapy or targeted therapy is about 1 year, with a 5-year survival rate below 10%. However, several current trials are examining new tactics, such as better prediction biomarkers and combination strategies with chemotherapy, targeted therapy, additional immunotherapy, or radiotherapy, given the relatively poor response rate of immune checkpoint inhibitor monotherapy. Consequently, the research on stereotactic body radiation therapy (SBRT) in conjunction with immunotherapy for locally advanced head and neck tumors is reviewed in this article.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"488-495"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038733","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}
引用次数: 0
The Balance and Imbalance of Microbial Communities: Oral-Gut Microbiota and Colorectal Cancer. 微生物群落的平衡与不平衡:口腔肠道微生物群与结直肠癌。
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-01 Epub Date: 2025-05-05 DOI: 10.1097/COC.0000000000001213
Zihui Zhao, Zhikun Yuan, Yanhui Li, Xiaochun Huang
{"title":"The Balance and Imbalance of Microbial Communities: Oral-Gut Microbiota and Colorectal Cancer.","authors":"Zihui Zhao, Zhikun Yuan, Yanhui Li, Xiaochun Huang","doi":"10.1097/COC.0000000000001213","DOIUrl":"10.1097/COC.0000000000001213","url":null,"abstract":"<p><p>The microbiome is a significant multimicrobial community that coexists with the human body in a symbiotic relationship. These microbial communities participate in mechanisms, such as defense against infections, absorption of nutrients, and maintenance of internal homeostasis. Although the microbiome is involved in physiological processes that are beneficial to host health, it can also lead to serious problems. Despite being far apart, the oral cavity and colon are both highly colonized by different microbial communities. Studies have shown that oral bacteria can migrate to and colonize the colon, which is most evident in diseases such as periodontitis. These oral pathogenic bacteria, which contain a large number of carcinogenic factors such as Fusobacterium nucleatum and Porphyromonas gingivalis , can penetrate the large intestine and cause intestinal microbial imbalance and dysfunction, thereby stimulating carcinogenesis. Increasing evidence suggests that oral microbiota, especially certain periodontal pathogens, may be used as biomarkers for colorectal cancer (CRC). Understanding the exact mechanisms of microbiome interactions and their impact on CRC will provide future opportunities for the prevention and treatment of colorectal cancer, and is an important prerequisite for its use as a precise noninvasive biomarker, which is crucial for the early detection of CRC. This review aims to summarize the current research status of oral microbiota, gut microbiota, and their association with CRC, and to evaluate the effectiveness of oral microbiome-derived biomarkers.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"501-508"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039164","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}
引用次数: 0
Evaluating the Safety and Efficacy of Adding Liver-Directed Radiation Therapy to Atezolizumab and Bevacizumab in Advanced Hepatocellular Carcinoma: A Single-Center Retrospective Cohort Analysis. 评估Atezolizumab和Bevacizumab加肝定向放疗治疗晚期肝细胞癌的安全性和有效性:单中心回顾性队列分析
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-01 Epub Date: 2025-04-30 DOI: 10.1097/COC.0000000000001214
Timothy J Brown, Uri Amit, Rohi Gheewala, Edgar Ben-Josef, Thomas B Karasic
{"title":"Evaluating the Safety and Efficacy of Adding Liver-Directed Radiation Therapy to Atezolizumab and Bevacizumab in Advanced Hepatocellular Carcinoma: A Single-Center Retrospective Cohort Analysis.","authors":"Timothy J Brown, Uri Amit, Rohi Gheewala, Edgar Ben-Josef, Thomas B Karasic","doi":"10.1097/COC.0000000000001214","DOIUrl":"10.1097/COC.0000000000001214","url":null,"abstract":"<p><strong>Objectives: </strong>Radiation therapy (RT) may potentiate an antitumor immune response when combined with immunotherapy in advanced hepatocellular carcinoma (HCC) but carries the potential risk of bowel toxicity and impaired liver function. We describe our single-center experience of adding liver-directed RT to atezolizumab and bevacizumab (A/B) in patients with advanced HCC.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study of patients with HCC naive to systemic therapy who received A/B with or without liver-directed RT from January 1, 2020 until May 1, 2023. We assessed safety outcomes, the real-world response rate (rwRR), overall survival (OS), and time-to-progression (TTP) from initiation of A/B. Time-to-event outcomes were analyzed by Kaplan-Meier methodology. Given anticipated baseline imbalances between cohorts, no formal comparisons were performed.</p><p><strong>Results: </strong>We identified 49 patients (n=34 control, n=15 RT) who met the inclusion criteria. The cohorts differed in the presence of ascites, baseline liver dysfunction, infection with hepatitis B, and alcoholic liver disease. Two patients in the control group (5.8%) and 1 patient in the RT group (6.7%) experienced clinically significant bleeding. One patient (6.7%) developed possible RT-induced liver disease. The rwRR in the RT group was 73.3% (11/15) compared with 17.6% (6/34) in the control group. The median OS in the RT group was 14.4 months, and 10.8 months in the control group. Median TTP was 6.4 months with RT compared with 5.8 months in the control group.</p><p><strong>Conclusions: </strong>The addition of liver RT to A/B resulted in limited additional toxicity with increased response rates, although significant differences in baseline characteristics limit a full interpretation of this data. Ongoing trials and trials under development will provide informative data regarding the addition of RT to A/B, particularly to assess the impact on OS and TTP.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"517-525"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057524","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 Chemotherapy on Financial Toxicity in African American Breast Cancer Patients: Early Findings From the Navigator-Assisted Hypofractionation Phase I Clinical Trial. 化疗对非裔美国乳腺癌患者财务毒性的影响:导航辅助低分割I期临床试验的早期发现
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-01 Epub Date: 2025-07-31 DOI: 10.1097/COC.0000000000001241
Maya J Stephens, Nimisha Kasliwal, Ursula J Burnette, Louisa Onyewadume, Tamika K Smith, Corey W Speers, Cynthia Owusu, Shearwood McClelland
{"title":"Impact of Chemotherapy on Financial Toxicity in African American Breast Cancer Patients: Early Findings From the Navigator-Assisted Hypofractionation Phase I Clinical Trial.","authors":"Maya J Stephens, Nimisha Kasliwal, Ursula J Burnette, Louisa Onyewadume, Tamika K Smith, Corey W Speers, Cynthia Owusu, Shearwood McClelland","doi":"10.1097/COC.0000000000001241","DOIUrl":"10.1097/COC.0000000000001241","url":null,"abstract":"<p><strong>Objectives: </strong>With the rising cost of chemotherapy, the financial toxicity (FT) of systemic therapy can substantially impair patient quality of life. FT is also associated with various socioeconomic factors, one being race. Patients of African American race often bear the worst burden of cancer treatment-related FT, with a 40% increased mortality from breast cancer. The degree to which chemotherapy before radiation therapy (RT) impacts FT has yet to be formally quantified. We report early FT findings among African American breast cancer patients before receipt of adjuvant RT on the ongoing Navigator-Assisted Hypofractionation (NAVAH) phase I clinical trial to assess the impact of chemotherapy on FT.</p><p><strong>Methods: </strong>African American breast cancer patients undergoing RT were eligible if age 18+ with pathologically confirmed breast cancer following resection. FT was measured using the validated 12-item COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) survey instrument. Values from 26 to 44 represent grade 0 FT (none), 14 to 25 grade 1 FT (mild), 1 to 13 grade 2 FT (moderate), and 0 represents grade 3 FT (severe). The χ 2 test assessed statistically significant differences ( P < 0.05) between patients who received chemotherapy versus no chemotherapy before RT receipt.</p><p><strong>Results: </strong>Mean COST-FACIT score was 25 (±10.4); 61% experienced mild to severe FT. Of the 38 patients, 53% underwent chemotherapy before RT. Patients with prior chemotherapy treatment reported 16% grade 0 FT, 53% grade 1 FT, 26% grade 2 FT, and 5% grade 3 FT. The relationship between adjuvant chemotherapy and FT was statistically significant ( P = 0.0028).</p><p><strong>Conclusions: </strong>Over 60% of participants in this study experienced some degree of meaningful FT. These results from an ongoing phase I clinical trial indicate a subsection of patients may benefit from proactive financial assistance to reduce the detrimental effect of FT on their breast cancer treatment, highlighting patients requiring chemotherapy before RT being more likely to experience FT.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"526-528"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762229","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
Global Trends in Childhood Acute Lymphoblastic Leukemia Burden and Quality of Care Inequalities Across Regions, 1990 to 2021: A Systematic Analysis Using Global Burden of Disease Study 2021 Data. 1990年至2021年儿童急性淋巴细胞白血病负担和各地区护理质量不平等的全球趋势:使用2021年全球疾病负担研究数据的系统分析
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-01 Epub Date: 2025-05-19 DOI: 10.1097/COC.0000000000001210
Ying Huang, Xiaoxia Chen, Cailing Gao
{"title":"Global Trends in Childhood Acute Lymphoblastic Leukemia Burden and Quality of Care Inequalities Across Regions, 1990 to 2021: A Systematic Analysis Using Global Burden of Disease Study 2021 Data.","authors":"Ying Huang, Xiaoxia Chen, Cailing Gao","doi":"10.1097/COC.0000000000001210","DOIUrl":"10.1097/COC.0000000000001210","url":null,"abstract":"<p><strong>Objective: </strong>To reveal the global trends in the burden and quality of care for childhood ALL from 1990 to 2021, along with inequalities in quality of care across regions, thus identifying regions requiring targeted interventions for optimizing health care resource allocation.</p><p><strong>Methods: </strong>Utilizing Global Burden of Disease Study 2021 data, this research analyzed the temporal trends in the global burden of childhood ALL from 1990 to 2021. The quality of care index (QCI) was used to quantify care quality, and the gender disparity ratio (GDR) was used to assess gender disparities. Trend analyses were conducted using the estimated annual percentage change (EAPC), and the associations between QCI, GDR, and the sociodemographic index (SDI) were explored. Inequalities in QCI and GDR across regions were evaluated using the slope index of inequality (SII) and health inequality concentration index.</p><p><strong>Results: </strong>From 1990 to 2021, the incidence and death rates, as well as disability-adjusted life years (DALYs) and years of life lost (YLLs) due to childhood ALL, significantly decreased. However, the number of prevalence and prevalence crude rate increased by 66.818% and 37.923%, respectively. Global care quality continued to improve, with an EAPC of 2.566 (95% CI: 2.488-2.645). In 2021, regions with high QCI were concentrated in high-income areas like Western Europe, while low QCI regions were primarily in low-income areas like sub-Saharan Africa and Oceania. Although the health inequality concentration index of global quality of care decreased from 0.550 in 1990 to 0.395 in 2021, the SII increased from 35.396 to 87.141. Care quality was consistently higher in females than in males, particularly in low and low-middle SDI regions, while the disparities in high and middle SDI regions were gradually narrowing.</p><p><strong>Conclusion: </strong>Despite the gradual decrease in the burden of childhood ALL globally and the steady improvement in quality of care, absolute inequalities remain a significant challenge. Future efforts should focus on increasing health care resource allocation in low SDI regions, enhancing international cooperation, improving the quality and accessibility of care in priority regions, and promoting global health equity.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"509-516"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095780","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
Standard Versus Extended Pelvic Lymphadenectomy in Patients With Bladder Cancer: A Systematic Review and Meta-analysis. 标准与扩展盆腔淋巴结切除术在膀胱癌患者中的应用:一项系统回顾和荟萃分析。
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-10-01 Epub Date: 2025-04-21 DOI: 10.1097/COC.0000000000001206
Hunaina Aman, Muhammad Hamza, Asad Ramzan, Mariam Saqib, Zain Ul Abideen, Abdul Haseeb, Hira Habib, Aiza Bint-E-Shafqat, Abdul Azeez Umar Azad, Hira Waris, Mushood Ahmed, Muhammad Ayyan, Nouman Aziz
{"title":"Standard Versus Extended Pelvic Lymphadenectomy in Patients With Bladder Cancer: A Systematic Review and Meta-analysis.","authors":"Hunaina Aman, Muhammad Hamza, Asad Ramzan, Mariam Saqib, Zain Ul Abideen, Abdul Haseeb, Hira Habib, Aiza Bint-E-Shafqat, Abdul Azeez Umar Azad, Hira Waris, Mushood Ahmed, Muhammad Ayyan, Nouman Aziz","doi":"10.1097/COC.0000000000001206","DOIUrl":"10.1097/COC.0000000000001206","url":null,"abstract":"<p><strong>Objectives: </strong>For decades, pelvic lymph node dissection (PLND) has been a critical component of radical cystectomy in patients with bladder cancer. Although its role in curative surgery for high-risk non-muscle-invasive and muscle-invasive cases is well-established, the therapeutic advantages of extended PLND remain a topic of ongoing debate.</p><p><strong>Methods: </strong>A comprehensive literature search of major bibliographic databases was performed from inception to November 2024. Studies comparing extended PLND (extended or super extended) with standard PLND were identified. Data for clinical outcomes was extracted and pooled estimates were calculated using a random effects model with RevMan 5.4.</p><p><strong>Results: </strong>A total of 11 studies (2 RCTs and 9 observational) were included reporting data for 4001 patients. The pooled analysis demonstrated that extended PLND was associated with significantly better recurrence-free survival (HR=0.67, 95% CI: 0.60-0.74). Standard PLND led to significantly higher 5-year recurrence rates (RR=1.44, 95% CI: 1.28-1.62) compared with the extended approach. The pooled estimates for disease-specific survival (HR=0.86, 95% CI: 0.62-1.19), overall survival (HR=0.99, 95% CI: 0.86-1.16), and complications remained comparable.</p><p><strong>Conclusions: </strong>Extended PLND can lead to favorable recurrence-free survival and 5-year recurrence rates. However, retrospective observational studies mainly drive the evidence, and additional RCTs are required to reach a definitive conclusion.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"479-487"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065245","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
The Impact of Patient, Disease, and Social Determinants of Health on Receipt of Nonoperative Management for Patients With Rectal Adenocarcinoma. 患者、疾病和健康的社会决定因素对直肠腺癌患者接受非手术治疗的影响
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-09-22 DOI: 10.1097/COC.0000000000001243
Keaton A Rummel, Christopher L Hallemeier, Zhaohui Jin, Kenneth W Merrell, Hao Xie, Kellie L Mathis, Nicholas P McKenna, Mark R Waddle, Michael G Haddock, Cameron M Callaghan, Krishan R Jethwa
{"title":"The Impact of Patient, Disease, and Social Determinants of Health on Receipt of Nonoperative Management for Patients With Rectal Adenocarcinoma.","authors":"Keaton A Rummel, Christopher L Hallemeier, Zhaohui Jin, Kenneth W Merrell, Hao Xie, Kellie L Mathis, Nicholas P McKenna, Mark R Waddle, Michael G Haddock, Cameron M Callaghan, Krishan R Jethwa","doi":"10.1097/COC.0000000000001243","DOIUrl":"https://doi.org/10.1097/COC.0000000000001243","url":null,"abstract":"<p><strong>Objectives: </strong>For locally advanced rectal adenocarcinoma (R-ACA), a nonoperative management (NOM) approach has emerged as a guideline-supported treatment option. However, the variables associated with NOM receipt are unknown.</p><p><strong>Methods: </strong>Utilizing the National Cancer Database, we performed a retrospective cohort study of adults with stage 1 to 3 R-ACA managed with curative intent from 2004 to 2018. The primary outcome was the proportion of patients receiving NOM versus surgery. The secondary outcome was survival among NOM patients.</p><p><strong>Results: </strong>A total of 128,297 patients were included. In all, 115,888 (90.3%) received surgery and 12,409 (9.7%) received NOM. Receipt of NOM was associated with age above 70, Charlson-Deyo score of 0, race (Black, Asian or Pacific Islander, or other vs. White), insurance status, geographical region, treatment in a community facility, year of diagnosis (2012-2018 vs. 2004-2011), tumor grade 1 versus ≥ 2, clinical T-stage ≥ 2, and clinical N1 or N2 versus N0. In the NOM cohort, poorer overall survival was associated with age 70 and above, male sex, Charlson-Deyo score ≥ 1, insurance status, geographical region, rural urban density versus metro/urban, treatment in a community facility, year of diagnosis (2004-2011 vs. 2012-2018), clinical T4 versus T1, clinical N1 or N2 versus N0, grade 3 versus 1, treatment with a radiotherapy dose <45 Gy versus 45 to 54 Gy, and omission of chemotherapy.</p><p><strong>Conclusions: </strong>Several demographic factors and social determinants of health were associated with receipt of NOM and overall survival. With the increasing utilization of NOM, it will be important to understand the drivers of treatment decisions and influences on access to the desired treatment approach.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114979","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
Logistic Model in Clinical and Health Research-the Elephant and Blind Men. 临床与健康研究中的Logistic模型——大象与盲人。
IF 1.8 4区 医学
American Journal of Clinical Oncology-Cancer Clinical Trials Pub Date : 2025-09-15 DOI: 10.1097/COC.0000000000001251
Ying Cao, Aaron J Katz, Xinglei Shen, Ryan T Morse, Christopher E Lominska, Ronald C Chen
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