Oncologist最新文献

{"title":"Real-world use of tafasitamab for relapsed or refractory diffuse large B-cell lymphoma among racial and ethnic minorities in the United States.","authors":"Narendranath Epperla, Loretta J Nastoupil, Bruce Feinberg, John Galvin, Prathamesh Pathak, Theresa Amoloja, Danielle Gentile, Parisa Asgarisabet, Kim Saverno","doi":"10.1093/oncolo/oyag357","DOIUrl":"10.1093/oncolo/oyag357","url":null,"abstract":"<p><strong>Background: </strong>Outcomes may differ among patients with diffuse large B-cell lymphoma (DLBCL) based on race and ethnicity; however, individuals from diverse racial and ethnic backgrounds have historically been underrepresented in clinical trials. This study describes the real-world characteristics, treatment patterns, and outcomes of patients treated with tafasitamab, an anti-CD19 monoclonal antibody for relapsed or refractory (R/R) DLBCL, by race and ethnicity.</p><p><strong>Methods: </strong>A descriptive subgroup analysis by race and ethnicity was conducted from a retrospective, physician-abstracted medical chart review study. Patients were aged ≥18 years, initiated tafasitamab treatment for R/R DLBCL on/after October 21, 2020, and had ≥4 months follow-up; patients who died during follow-up were included. Data were collected from February 22 to March 29, 2023, and from December 18, 2023 to January 31, 2024.</p><p><strong>Results: </strong>The analysis included 181 patients: 64.1% White, 22.1% Black or African American, 7.7% Other (race other than White, Black or African American, or unknown), 6.1% were of unknown race; 82.3% non-Hispanic, 17.1% Hispanic, and 0.6% were of unknown ethnicity. The median (Q1-Q3) follow-up time for the overall study population from tafasitamab initiation was 14.7 (8.5-17.1) months and was relatively similar for all subgroups. Most patients (71.8%) received tafasitamab in second-line and this was true across subgroups. Real-world overall response rates (95% CI) were 73.3% (65.2-81.3), 82.5% (70.7-94.3), 74.5% (67.5-81.5), and 67.7% (51.3-84.2) for White, Black or African American, non-Hispanic, and Hispanic patients, respectively.</p><p><strong>Conclusions: </strong>Findings suggest effectiveness outcomes among patients receiving tafasitamab for R/R DLBCL were consistent across racial and ethnic groups.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world treatment landscape and clinical outcomes in first-line advanced or metastatic gastroesophageal adenocarcinoma in the United States.","authors":"Jin Gu, Shivani K Mhatre, Daniel O Koralek, Ravindra Gupta, Jaffer A Ajani","doi":"10.1093/oncolo/oyag350","DOIUrl":"10.1093/oncolo/oyag350","url":null,"abstract":"<p><strong>Background: </strong>Contemporary real-world evidence in advanced gastric, gastroesophageal junction, or esophageal adenocarcinoma (GC/GEJC/EAC) remains limited. This study evaluated real-world treatment patterns and clinical outcomes in patients with advanced GC/GEJC/EAC treated with first-line therapy in the United States.</p><p><strong>Patients and methods: </strong>Treatment patterns were assessed in adults from the Flatiron database with advanced or metastatic HER2-negative GC/GEJC/EAC who initiated first-line treatment between May 1, 2021, and July 31, 2025 (overall cohort). Clinical outcomes were assessed using the Kaplan-Meier method in a subcohort with ≥6 months of follow‑up.</p><p><strong>Results: </strong>Among 2340 eligible patients, the most common first-line regimen was IO+FOLFOX/CAPOX (31.6%). This regimen was used in 47.6% of patients with programmed cell death ligand 1 (PD-L1) combined positive score (CPS) ≥ 1 expression. Starting in 2024, zolbetuximab+FOLFOX/CAPOX was administered more frequently in patients with CPS <1 vs ≥1 (6.1% vs 1.9%) and CPS <5 vs ≥5 (4.6% vs 0.8%) expression. In the subcohort (n = 2117), IO+FOLFOX/CAPOX vs FOLFOX/CAPOX was associated with significantly longer median (months; hazard ratio [95% CI]) real-world overall survival (12.3 vs 11.3; 0.81 [0.69-0.94]), time to next treatment or death (8.0 vs 6.1; 0.64 [0.55-0.75]), and time to treatment discontinuation (6.0 vs 3.0; 0.54 [0.47-0.63]). Differences in outcomes were driven by patients with CPS ≥1 expression, with no differences in patients with CPS <1 expression.</p><p><strong>Conclusions: </strong>IO+FOLFOX/CAPOX was the most frequent first-line regimen in advanced or metastatic GC/GEJC/EAC and showed improved real-world outcomes vs FOLFOX/CAPOX. Despite these gains, overall survival remains poor, underscoring unmet needs and the importance of biomarker-informed treatment selection.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant chemotherapy in women with triple-negative breast cancer: real world results from Western Kenya.","authors":"Hussain I Rangoonwala, Naftali Busakhala, Hillary Kiprono, Loice Sitienei, Erick Chesori, Katherine Niemeyer, Winnie Sabul, Jesse Opakas, Anne Ngelel, Felix Pabon-Rodriguez, Kibet Keitany, Elias Melly, Joanna Hunter-Squires, Kathy D Miller, Nicholas Kisilu, Patrick J Loehrer, Jennifer S Morgan","doi":"10.1093/oncolo/oyag325","DOIUrl":"10.1093/oncolo/oyag325","url":null,"abstract":"<p><strong>Background: </strong>Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype for which neoadjuvant chemotherapy (NACT) is used for locally advanced (LA) disease. Patients with TNBC who experienced a pathologic complete response (pCR) following NACT have been found to have extended overall survival (OS) compared to patients with residual disease. Sparse data exist on the frequency and impact of pCR following NACT for TNBC in East Africa.</p><p><strong>Methods: </strong>We retrospectively reviewed patients diagnosed with LA TNBC who received NACT between 2018 and 2022 at Moi Teaching and Referral Hospital in Eldoret, Kenya. After NACT, patients underwent mastectomy in which specimens were reviewed histologically as either pCR or residual disease in the breast and/or axilla. Clinical data were analyzed using descriptive statistics and Kaplan-Meier methods.</p><p><strong>Results: </strong>Sixty-nine women with LA TNBC were included. Patient characteristics at diagnosis: Median age = 51 years (IQR 44-60); T4 disease = 34 (49%); and nodal involvement = 62 (91%). Forty-six patients (67%) received anthracycline/taxane-based chemotherapy with a median of 8 cycles (IQR 6-8), and 47 (68%) underwent mastectomy, with only 7% achieving pCR. Assuming all lost to follow-up died, the worst-case OS was 83% and 56% at 1 and 2 years, respectively.</p><p><strong>Conclusions: </strong>In this LMIC setting, patients who presented with LA TNBC had lower pCR rates following NACT than observed in high-income countries. Our findings highlight the critical need for innovative, cost-effective programs focused on early detection of breast cancer, linkage of care, and delivery of more effective therapies to improve outcomes in the region.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular tumor board: H3K27M diffuse midline glioma diagnosed during pregnancy by cerebrospinal fluid next-generation sequencing.","authors":"Jason B Sherman, Thaddeus D Harbaugh, Alexander Sisto, Zohaib Sherwani, Imraan Jan, Jacqueline Norrell, Jonathan H Sherman, Vindhya Udhane, Kala F Schilter, Qian Nie, Honey V Reddi, Morana Vojnic","doi":"10.1093/oncolo/oyag282","DOIUrl":"10.1093/oncolo/oyag282","url":null,"abstract":"<p><strong>Background: </strong>Diffuse midline glioma (DMG) with the H3K27M mutation is an aggressive WHO grade 4 central nervous system tumor characterized by diffuse infiltration of midline structures and a poor prognosis. Molecular characterization is essential for diagnosis and treatment planning; however, obtaining tissue can be infeasible, particularly in anatomically inaccessible locations or medically complex situations, like pregnancy.</p><p><strong>Patient presentation: </strong>A 34-year-old G2P1 woman at 19 weeks' gestation presented with progressive right-sided numbness and weakness. Magnetic resonance imaging demonstrated an infiltrative lesion in the left midbrain extending to the pons and thalamus with intralesional hemorrhage. Differential considerations included diffuse midline glioma and inflammatory demyelinating disease.</p><p><strong>Molecular findings: </strong>Because of the lesion location and concerns regarding stereotactic biopsy during pregnancy, cerebrospinal fluid (CSF) next-generation sequencing was pursued. CSF profiling identified an H3K27M mutation, establishing the diagnosis of DMG.</p><p><strong>Management and outcome: </strong>Following multidisciplinary discussion involving neuro-oncology, neurology, neurosurgery, radiation oncology, and maternal-fetal medicine, the patient underwent fractionated radiotherapy beginning at 22 weeks' gestation using pregnancy-shielding techniques. Postpartum dordaviprone (ONC201) therapy was initiated and well tolerated. Follow-up imaging demonstrated radiographic improvement and neurological stabilization, with ongoing response at 12 months post-diagnosis.</p><p><strong>Conclusions: </strong>The case highlights the utility of CSF liquid biopsy in establishing a molecular diagnosis of diffuse midline glioma when tissue biopsy is contraindicated or deferred. The case also demonstrates how molecular profiling can guide precision oncology in medically complex situations like pregnancy.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive effect of goshajinkigan on paclitaxel-induced peripheral neuropathy: an open-label, randomized phase II study (OLCSG2101).","authors":"Takaaki Tanaka, Go Makimoto, Naoki Nakamura, Yuka Kato, Isao Oze, Toshihide Yokoyama, Shoichi Kuyama, Satoru Senoo, Koji Inoue, Hirohisa Ichikawa, Yoshinobu Maeda, Yosuke Togashi, Katsuyuki Hotta","doi":"10.1093/oncolo/oyag352","DOIUrl":"10.1093/oncolo/oyag352","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of paclitaxel (PTX)-containing regimens, and no preventive strategy has been established. We evaluated goshajinkigan (GJG), a traditional Japanese herbal medicine (Kampo), for preventing CIPN during PTX-containing chemotherapy.</p><p><strong>Materials and methods: </strong>In this open-label, randomized phase II trial across 7 institutions in Japan, patients with malignant tumors scheduled for ≥4 courses of carboplatin plus PTX (≥150 mg/m²) were randomized 1:1 to GJG or control, with minimization by cancer type and age. The primary endpoint was grade ≥2 CIPN incidence within 4 courses. The protocol-prespecified primary analysis used an unstratified 2-sided log-rank test (α = 0.10); a supportive stratified analysis accounted for the minimization factors.</p><p><strong>Results: </strong>Sixty-five patients were randomized (GJG, 32; control, 33); 52 (80.0%) had lung cancer. Grade ≥2 CIPN occurred in 28.1% (9/32) of the GJG arm vs 51.5% (17/33) of the control arm; the protocol-prespecified unstratified log-rank P value was .013, with a corresponding HR of 0.34 (90% CI, 0.16-0.72). In the stratified analysis accounting for cancer type and age, the estimate remained in favor of GJG but was attenuated and less precise (HR, 0.48; 90% CI, 0.22-1.02; stratified log-rank P = .101). Grade 3-5 adverse-event incidence was similar between arms.</p><p><strong>Conclusion: </strong>GJG was associated with fewer grade ≥2 CIPN events in this predominantly lung-cancer population. Given the open-label design and uncertainty in the stratified analysis, these findings represent a phase II preventive signal warranting confirmation in a double-blind, placebo-controlled phase III trial.</p><p><strong>Clinical trial registration number: </strong>Japan Registry of Clinical Trials (jRCTs061210047).</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In reply.","authors":"Yuhan Ma, Yang Li","doi":"10.1093/oncolo/oyag310","DOIUrl":"10.1093/oncolo/oyag310","url":null,"abstract":"","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost, context, and confounding: rethinking real-world data generation and interpretation in advanced NSCLC.","authors":"Mehmet Mutlu Çatlı, Arif Hakan Önder","doi":"10.1093/oncolo/oyag106","DOIUrl":"10.1093/oncolo/oyag106","url":null,"abstract":"<p><strong>Background: </strong>As immunotherapy becomes entrenched in the frontline management of advanced NSCLC, post-progression treatment decisions face increasing uncertainty. A recent JAMA Network Open study using Flatiron Health data suggested that rechallenging with pembrolizumab may offer survival benefit after chemo immunotherapy progression. However, these findings raise fundamental questions about how real-world data (RWD) should be interpreted and operationalized in health economics.</p><p><strong>Main argument: </strong>In this viewpoint, we critically analyze the methodological and interpretive assumptions behind retrospective RWD-based cost-effectiveness modeling. We argue that unadjusted survival metrics absent stratification for PD-L1 status, tumor burden, or clinical performance may artificially elevate ICER/QALY estimates and misguide reimbursement decisions. Using the Velcheti et al. study as a case anchor, we highlight how structural biases in RWD can lead to premature or inflated conclusions about the value of immunotherapy rechallenge. We also propose a visual framework to distinguish between plausible clinical signals and policy-grade evidence.</p><p><strong>Implications: </strong>Health systems and stakeholders must apply greater rigor when translating RWD into economic models. We advocate for analytic transparency, pre-registered sensitivity analyses, and adjustment for patient-level variables before using RWD to inform value-based oncology.</p><p><strong>Conclusion: </strong>RWD are powerful hypothesis generators, not substitutes for controlled evidence. Without methodological discipline, their policy application risks becoming speculative rather than strategic.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nilotinib revisited in GIST: salvage use in patients with severe imatinib toxicity.","authors":"Johanna Falkenhorst, Peter Hohenberger, Giorgia Mancino, Andrea Scrima, Franka Menge, Benjamin S Fletcher, Carina Reiff, Valerie Lange, Rainer Hamacher, Stefanie Bertram, Fiona M Rau, Yasmin Zaun, Moritz Kaths, Jürgen Treckmann, Jens Jakob, Thomas Mühlenberg, Susanne Grunewald, Dawid Krzeciesa, Daniel Rauh, Sebastian Bauer","doi":"10.1093/oncolo/oyag345","DOIUrl":"10.1093/oncolo/oyag345","url":null,"abstract":"<p><strong>Background: </strong>Severe imatinib toxicity is a rare, but relevant event in GIST patients. Other approved treatments were not evaluated within a first-line setting and exhibit severe adverse events that limit QoL. Nilotinib was evaluated within this setting in GIST with a safety profile comparable to imatinib and effectiveness within KIT-exon-11-mutant GIST subgroup (ENESTg1).</p><p><strong>Materials, patients, and methods: </strong>This is a retrospective case series reporting the outcome and side effects of 20 patients treated with nilotinib following severe imatinib toxicity. Nilotinib efficacy was tested in GIST cell lines carrying common primary and resistance mutations in KIT. Inhibitory profile of nilotinib was characterized using in silico modeling.</p><p><strong>Results: </strong>In our retrospective analysis of 1263 patients, 7.3% of patients discontinued imatinib due to toxicity. In 20 patients who received nilotinib, reasons were skin (n = 11) and liver (n = 4) toxicity, followed by cardiac (n = 2) and gastrointestinal toxicities (n = 2). No cross-toxicities were observed with nilotinib treatment. Nilotinib was effective after imatinib intolerance. A secondary KIT Exon 9 mutation was found in a progressing lesion. In vitro viability assays showed effectiveness in KIT-Exon-11-mutant cell lines, but not in Exon 9 or imatinib-resistant mutations in doses deemed clinically achievable. In silico modeling revealed steric hindrance by Exon 9 or imatinib resistance mutations.</p><p><strong>Conclusion: </strong>Nilotinib exhibits no cross toxicity with imatinib and represents an important alternative in imatinib-sensitive, KIT-exon-11-mutant GIST given its excellent toxicity profile. There is no biological rationale for the use of nilotinib in imatinib-resistant GIST with secondary KIT mutations.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional brain network alterations linked to cancer-related cognitive impairment in breast cancer patients.","authors":"Alberto Benelli, Julianne Reilly, Jorge Ortega-Márquez, Michael Parsons, Jorg Dietrich, Giulia Sprugnoli, Felipe Fregni, Emiliano Santarnecchi","doi":"10.1093/oncolo/oyag070","DOIUrl":"10.1093/oncolo/oyag070","url":null,"abstract":"<p><strong>Background: </strong>Life expectancy for cancer patients has improved due to new therapies, but many survivors experience long-lasting side effects, including cancer-related cognitive impairment (CRCI). CRCI symptoms-such as difficulties with attention, memory, processing speed, fatigue, and concentration-can persist for years post-treatment. While clinical evidence of CRCI exists, its underlying mechanisms and neural correlates remain unclear. This study aimed to identify functional brain networks associated with CRCI in breast cancer (BC) patients using structural and functional neuroimaging data.</p><p><strong>Methods: </strong>We reviewed studies on CRCI-related brain changes assessed via diffusion tensor imaging (DTI, n = 282), voxel-based morphometry (VBM, n = 177), and functional MRI (fMRI, n = 328). Using the Yeo 7-network resting-state functional atlas, we evaluated the overlap between CRCI-related brain alterations and known functional networks. Overlapping percentages were calculated, and statistical independence tests assessed associations between CRCI and specific networks.</p><p><strong>Results: </strong>Based on inclusion criteria, six DTI, six VBM, and ten fMRI studies were selected. Chi-square analyses revealed significant associations between CRCI-related changes and several networks: the Dorsal Attention Network (DAN, χ2 = 17.71, P = .0001), Default Mode Network (DMN, χ2 = 21.08, P = .0000002), Frontoparietal Network (FPN, χ2 = 110.63, P = .000002), and Ventral Attention Network (VAN, χ2 = 8.203, P = .01).</p><p><strong>Conclusions: </strong>Findings highlight network-specific alterations linked to CRCI symptoms in breast cancer survivors. These results enhance understanding of CRCI and may guide targeted therapeutic strategies.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic disparities in sarcoma diagnosis, expert center access, and advocacy group awareness: a multicenter study in Southern Europe.","authors":"Pau Mascaró-Baselga, Víctor Navarro, Ana Sebio, Rosa Álvarez, Sara Carvalho, María Ángeles Sala-González, Gloria Marquina, Javier Martínez-Trufero, Juana María Cano, Andrés Redondo, Aurea Molina-Díaz, Diego Gomez-Puerto, Carlo María Cicala, Miguel Henriques-Abreu, Claudia Valverde, Guillermo Villacampa, César Serrano","doi":"10.1093/oncolo/oyag358","DOIUrl":"10.1093/oncolo/oyag358","url":null,"abstract":"<p><strong>Background: </strong>Management of sarcoma in expert centers (SECs) improves outcomes, and patient advocacy groups provide information, support, and representation of patients' needs; however, access to both remains uneven. We aimed to identify factors associated with patient referral and advocacy group awareness in Spain and Portugal, 2 universal healthcare systems with distinct sarcoma pathways.</p><p><strong>Materials and methods: </strong>Between April and December 2023, we conducted a survey-based study of adults with sarcoma under active treatment or follow-up across 9 Spanish hospitals (5 SECs) and one Portuguese hospital. Sociodemographic and clinical data, referral patterns, and advocacy group awareness/contact were analyzed.</p><p><strong>Results: </strong>A total of 415 patients were included (Spain, n = 365; Portugal, n = 50). In Spain, lower income (odds ratio [OR] 2.38; 95% CI, 1.16-5.03) was associated with longer diagnostic delays. Rural residence (OR 3.48; 1.79-7.04) and longer diagnostic delays (OR 2.41; 1.26-4.66) were associated with referral to other hospitals. Cancer advocacy group awareness was lower among patients with lower income (OR 0.38; 0.17-0.81) and higher with longer diagnostic delays (OR 2.08; 1.05-4.25). Sarcoma-specific advocacy group awareness was generally low (20%) but higher with university education (OR 4.27; 1.56-12.35). Few patients contacted cancer (14%) or sarcoma-specific groups (7%); contact was more frequent with longer diagnostic delays (OR 2.27; 1.11-4.63) or symptomatic presentation (OR 2.50; 1.04-5.97). Compared with the Portuguese cohort, Spanish patients were referred less frequently and had greater awareness of advocacy groups.</p><p><strong>Conclusion: </strong>Socioeconomic disparities affect sarcoma diagnosis, referral, and advocacy group engagement, even within universal healthcare systems. Equity-oriented care requires timely SEC referral and advocacy group visibility.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}