Oncologist最新文献

{"title":"Early follow-up of outpatients with oral anticancer therapy in the ONCORAL multidisciplinary community-hospital program.","authors":"Claire Lattard, Chloé Herledan, Thibaut Reverdy, Gabriel Antherieu, Anne-Gaelle Caffin, Marie-Anne Cerfon, Magali Maire, Marine Rivat, Stéphanie France, Hervé Ghesquières, Benoit You, Gilles Freyer, Florence Ranchon, Catherine Rioufol","doi":"10.1093/oncolo/oyae241","DOIUrl":"10.1093/oncolo/oyae241","url":null,"abstract":"<p><strong>Background: </strong>Healthcare professionals are faced with the new challenges of preventing and managing drug-related problems (DRPs) with oral anticancer therapy (OAT): side-effects, drug-drug interactions (DDIs), non-adherence, or medication errors. This study aims to assess the impact of ONCORAL, a real-life multidisciplinary care plan for cancer patients based on community and hospital follow-up, for the first OAT cycle.</p><p><strong>Methods: </strong>A prospective cohort study was conducted between October 1, 2021 and October 1, 2022 including all outpatients starting OAT treatment. During the first OAT cycle, the program consists of 6 weekly scheduled face-to-face or phone consultations to prevent and manage DRPs. Nurse and pharmacist interventions (NPIs) are realized to optimize treatments (primary outcomes). Secondary outcomes included the relative dose intensity (RDI) of the first cycle.</p><p><strong>Results: </strong>A total of 562 NPIs were performed by the ONCORAL team: that is, 87.1% of the 209 patients included, for a mean of 3.1 ± 2.2 NPIs/patient. NPIs-concerned DRPs detected by the nurse and pharmacist (346, 61.6%), symptoms and/or adverse effects reported as PROs by the patient or family (138, 24.6%), or pathway issues (78, 13.9%). Seventy-three DDIs were detected and managed during medication review, in a quarter of patients (n = 54/209), leading to the discontinuation of a daily concomitant medication in 30 cases. The mean RDI at the end of the first cycle, calculated for 209 patients, was 83.1 ± 23.9% (17.56-144.23).</p><p><strong>Conclusion: </strong>In these ambulatory cancer patients, the interest in tailored monitoring of DRPs as a whole, including the prevention and management of drug interactions in addition to symptoms and adverse effects, is highlighted.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301164","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":"Phase Ib study of anti-PD-L1 monoclonal antibody socazolimab in combination with nab-paclitaxel as first-line therapy for advanced urothelial carcinoma.","authors":"Bixia Tang, Jun Xiao, Zhihong Chi, Rong Duan, Chuanliang Cui, Lu Si, Yixun Liu, Xuechun Hu, Zhi Liu, Ping Xiang, Siming Li, Xieqiao Yan, Li Zhou, Juan Li, Yujie Li, Xiaohui Yu, Xiangrong Dai, Xiaoyi Li, Jun Guo, Xinan Sheng","doi":"10.1093/oncolo/oyae260","DOIUrl":"10.1093/oncolo/oyae260","url":null,"abstract":"<p><strong>Background: </strong>PD-1/PD-L1 immune checkpoint inhibitors (ICIs) have demonstrated activity in the post-platinum and platinum-ineligible settings for advanced urothelial carcinoma (aUC). As only around 50% of patients with aUC can tolerate platinum-containing treatment, treatments combining first-line ICIs with non-platinum drugs are urgently needed. Therefore, we assessed the safety and efficacy of the anti-PD-L1 monoclonal antibody Socazolimab in combination with nab-paclitaxel as first-line therapy in aUC (NCT04603846).</p><p><strong>Methods: </strong>This was a multi-center, single-arm, phase Ib study that enrolled patients with treatment-naive aUC. Patients received Socazolimab (5 mg/kg) and nab-paclitaxel (260 mg/m2) Q3w. The primary endpoint was safety and tolerability of the combination regimen. Second endpoints were the objective response rate (ORR) and progression-free survival.</p><p><strong>Results: </strong>Between September, 2020 and September, 2021, 20 patients with urothelial carcinoma were enrolled, arising from renal pelvis (5), bladder (8), and ureter (7). After a median follow-up of 17 months, the median number of treatment cycles was 12. No patients had dose limiting toxicity. All patients had treatment-related adverse events (TRAEs), most of which were grade 1 or 2. The common TRAEs (≥20%) were peripheral neurotoxicity, alopecia, rash, increased ALT, weight loss, weakness, pruritus, increased AST, increased γGT, increased ALP, neutropenia, emesis, and anorexia. Nine patients (45%) developed grade 3 TRAEs including peripheral neurotoxicity (30.0%), increased ALT (10.0%), and increased γGT (5.0%). Two patients (10%) discontinued treatment because of grade 3 mouth ulcer (n = 1) and grade 2 lung fibrosis (n = 1). No grade 4-5 TRAEs were observed. Among the 17 patients who had received at least one tumor assessment, ORR was 58.8% (95% CI, 32.9%-81.6%) and the median progression-free survival was 8.3 months (95% CI, 5.2-19.5). The median duration of response was 13.3 months (95% CI, 2.0-20.1), and the overall survival was 19.5 months (95% CI, 11.2-not reached).</p><p><strong>Conclusion: </strong>Socazolimab combined with nab-paclitaxel has shown good safety and promising antitumor activity as first-line therapy in patients with advanced urothelial carcinoma.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481145","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":"Management of vasomotor symptoms in cancer patients.","authors":"Ling Zhu, Tammy T Hshieh, Tara K Iyer, Alicia K Morgans, Ole-Petter R Hamnvik","doi":"10.1093/oncolo/oyaf002","DOIUrl":"10.1093/oncolo/oyaf002","url":null,"abstract":"<p><p>Many cancer treatments can lead to reduced levels of sex hormones, which in turn may cause vasomotor symptoms (VMS) such as hot flashes. These symptoms are associated with impaired quality of life, as well as suboptimal tolerability of and adherence to cancer treatment. Hormone therapy, performed by increasing estradiol or testosterone levels, is the gold standard for treatment of VMS. However, this approach is generally contraindicated in patients with hormone-sensitive cancers. Nonhormone agents with low to moderate efficacy in controlling VMS are available, but their use may be limited by side effects and tolerability. In this narrative review, the approach to VMS in cancer patients will be discussed. The evidence for various treatment options, including novel agents such as fezolinetant that target the hypothalamic thermoregulatory pathway, will be evaluated. Finally, special considerations in different patient populations based on cancer types (eg, breast, prostate) and age groups (eg, older adults) will be explored.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558878","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":"Patients' psychosocial attributes and aggressiveness of cancer treatments near the end of life.","authors":"Léa Restivo, Philippe Rochigneux, Anne-Déborah Bouhnik, Thomas Arciszewski, Aurélie Bourmaud, Géraldine Capodano, Agnès Ducoulombier, Julien Mancini, Florence Duffaud, Anthony Gonçalves, Thémis Apostolidis, Aurélien Proux","doi":"10.1093/oncolo/oyae317","DOIUrl":"10.1093/oncolo/oyae317","url":null,"abstract":"<p><strong>Background: </strong>While the use of chemotherapy near the end of life (EOL) has been identified as a relevant criterion for assessing quality of cancer care and has been estimated as non-beneficial, a trend of aggressiveness in cancer care during the last period of life remains. Both patients' sociodemographic characteristics and physicians' practice setting are associated with this use. The role of patients' psychosocial characteristics has however been understudied. The objectives were to study oncologists' intention to recommend chemotherapy or therapeutic abstention in an EOL patient's case and to examine the factors associated with this decision.</p><p><strong>Methods: </strong>A clinical vignette-based questionnaire survey was conducted. While the case presented to the participating oncologists of a patient with EGFR-mutated lung cancer, progressing after osimertinib, ECOG 3, with leptomeningeal disease (N = 146), was strictly equivalent in terms of medical aspects and age, 4 patients' non-medical characteristics were manipulated: gender, marital status, parenthood, and psychosocial characteristics (\"nice\" patients, patients \"making strong demands,\" or control patients).</p><p><strong>Results: </strong>77.4% of the oncologists surveyed stated that they would recommend chemotherapy in this situation. Only scenarios with nice patients or patients making strong demands were associated with less recommendation of chemotherapy (70.8% for the nice/making strong demands scenarios together vs 87.7%, for the control scenario P = .017). Medical oncologists with previous experience of similar cases were also less keen to recommend chemotherapy (73% vs 100%, P = .007). Of the 76.7% of respondents declaring that they would think of other therapeutic options, 49.1% mentioned \"other treatments\" without mentioning palliative care.</p><p><strong>Conclusion: </strong>Developing physicians' awareness of the psychosocial aspects at stake in their medical decisions in these sensitive situations may improve EOL care.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world characteristics and outcomes of ERBB2-mutant NSCLC in Latin American patients (CLICaP).","authors":"Erick F Saldanha, Vladmir C Cordeiro de Lima, Aline Fares, Marcelo Corassa, Leonardo Gil-Santana, Oscar Arrieta, Joao Soler, Diego F Chamorro, July Rodrigues, Helano Carioca Freitas, Leonardo Rojas, Jairo Zuluaga, Andres F Cardona","doi":"10.1093/oncolo/oyae347","DOIUrl":"10.1093/oncolo/oyae347","url":null,"abstract":"<p><strong>Introduction: </strong>ERBB2-mutant non-small cell lung cancer (NSCLC) represents approximately 1%-4% of all lung adenocarcinomas (LUADs) and has emerged as a distinct molecular subtype. Little is known about NSCLC harboring ERBB2 mutations in Latin America. This study aimed to characterize the real-world clinical characteristics and outcomes of ERBB2-mutant NSCLC in Latin America.</p><p><strong>Materials and methods: </strong>Patients with NSCLC harboring ERBB2 mutations detected by next-generation sequencing in tumors or cfDNA were identified in databanks from 3 Latin American countries (Brazil, Colombia, and Mexico). Demographic, clinical, and pathological data were retrieved from electronic medical records.</p><p><strong>Results: </strong>Of 1245 patients with NSCLC included from January 2015 to September 2022, 35 (2.8%) patients had tumors with ERBB2 mutations. The median age was 60 years (IQR: 49-69), 54.2% of patients were females, 59.4% were never smokers, 51.3% had baseline performance status ECOG 0, 91.5% were diagnosed with stage IV disease, and 29.7% had de novo brain metastasis. The most common ERBB2 mutations were A775_G776insYVMA (40%) and G780_P781dupGSP (20%). The most often co-mutated gene was TP53 (17.1%), and the median tumor mutation burden was 2 mut/Mb (IQR: 1-4). PD-L1 tumor proportion score was ≥50%, 1%-49%, and <1% in 11.4%, 54.2%, and 31.4%, respectively. Regarding treatment patterns, 74.2% of patients received chemotherapy (CT) plus immune checkpoint blockade (ICB) in the first line, and 42.8% received antibody-drug conjugates (ADC) targeting ERBB2 in further lines of therapy, especially trastuzumab emtansine (37.1%) and trastuzumab deruxtecan (5.7%). The median real-world progression-free survival (rwPFS) to the first line was 6.7 months (95%CI, 5.65-8.48). The median real-world overall survival (rwOS) for the entire cohort was 25.9 months (95% CI, 24.4-27.9).</p><p><strong>Conclusion: </strong>This study demonstrated that ERBB2-mutant NSCLC is uncommon among Latin American patients. Despite the vast majority of patients being treated with chemo-immunotherapy (ICB) in the first line, the median rwOS was similar to that reported for non-oncogene-addicted NSCLC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558051","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":"Predictors of advanced-stage presentation among patients with a diagnosis of breast and cervical cancer in Ethiopia.","authors":"Birtukan Shewarega, Sefonias Getachew, Nigussie Assefa Kassaw, Abdu Adem Yesufe, Josephin Trabizsch, Yonas Dandena, Biruck Gashawbeza Batu, Adamu Addissie, Eva Johanna Kantelhardt, Muluken Gizaw","doi":"10.1093/oncolo/oyaf019","DOIUrl":"10.1093/oncolo/oyaf019","url":null,"abstract":"<p><strong>Background: </strong>Breast and cervical cancers are the most common causes of cancer incidence and mortality in women in Africa. Women with breast and cervical cancers in Sub-Saharan Africa are frequently diagnosed with their disease at advanced stages. Delays in seeking health, diagnosis, and treatment are contributing factors to high mortality in Ethiopia. This study aimed to assess predictors of advanced stage presentation among patients with breast and cervical cancer attending public hospitals in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with a total of 418 patients at Tikur Anbessa specialized hospital and Saint Pauls' Hospital Millennium Medical College from October to November 2021. Stages III and IV were considered advanced stages. Data were collected by reviewing medical records and face-to-face interviews with a structured questionnaire. Bivariate and multivariable analyses were performed to examine the association between independent and outcome variables.</p><p><strong>Results: </strong>A total of 269 patients with breast cancer and 149 patients with cervical cancer were included in the study, and the mean age was 44 years (SD = 10.9 years) and 50 years (SD = 11.2) years, respectively. About 66.9% of breast cancers and 71.1% of cervical cancers were diagnosed at an advanced disease stage. Rural residence (adjusted odds ratio [AOR] = 2.041, 95% CI, 1.108-3.758), indirect referral (AOR = 3.8, 95% CI, 1.485-9.946), financial difficulty (AOR = 10, 95% CI,1.859-56.495), and cancer screening recommended during their visit (AOR = 4.029 95% CI, 1.658-10.102) were independent predictors of advanced-stage presentation.</p><p><strong>Conclusions: </strong>This study revealed a high prevalence of advanced-stage breast and cervical cancer diagnosis in Ethiopia, like data collected 10 years ago, despite the introduction of a cancer control plan in 2015. For better implementation, interventions should aim to improve referral pathways, adapt screening and early detection services, and increase cancer awareness at the community level in a culturally accepted way.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558879","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":"Updated overall survival in patients with prior checkpoint inhibitor therapy in the phase III TIVO-3 study.","authors":"Miguel Zugman, David F McDermott, Bernard J Escudier, Thomas E Hutson, Camillo Porta, Elena Verzoni, Michael B Atkins, Brian Rini, Sumanta K Pal","doi":"10.1093/oncolo/oyae369","DOIUrl":"10.1093/oncolo/oyae369","url":null,"abstract":"<p><strong>Background: </strong>The phase III TIVO-3 study demonstrated improvement in progression-free survival (PFS) with tivozanib compared with sorafenib in patients with 2-3 prior systemic regimens for metastatic renal cell carcinoma (mRCC).</p><p><strong>Methods: </strong>The TIVO-3 trial enrolled patients with measurable mRCC who had received 2 or more prior systemic therapies, including a vascular endothelial growth factor tyrosine kinase inhibitor (VEGF-TKI). Patients were stratified by International Metastatic RCC Database Consortium risk score and type of prior treatment and were randomized 1:1 to receive tivozanib or sorafenib. Efficacy was assessed using Response Evaluation Criteria in Solid Tumors version 1.1 criteria, with PFS as the primary endpoint. Safety was evaluated using Common Terminology Criteria for Adverse Events version v4.03, and statistical analyses included Cox regression for overall survival (OS) and descriptive statistics for duration of response (DOR). The current post-hoc long-term follow-up analysis consists of an assessment of OS in the previously stratified subpopulation of patients with prior CPI exposure.</p><p><strong>Results: </strong>Between May 2016, and August 2017, 350 patients were randomized, of which 26% had prior CPI exposure, with final analysis data cut off on June 21, 2021. In patients previously treated with CPIs (n = 91), the median PFS of tivozanib was 7.3 months versus 5.1 months with sorafenib and hazard ratio (HR) of 0.55 (95% CI, 0.32-0.94). The OS HR in the CPI-treated subset was 0.69 (95% CI, 0.43-1.11, P =.0992) favoring tivozanib, although with a median OS of 18.1 and 20.9 months, for tivozanib and sorafenib, respectively. Tivozanib demonstrated a longer median DOR of 20.3 versus 5.7 months for sorafenib in the subset previously treated with CPIs. The safety profile favored tivozanib, with lower rates of VEGF-TKI class-related grade ≥3 adverse events compared with sorafenib. However, in the subset of patients previously treated with CPIs, the incidence of grade ≥3 adverse events was higher, at 58% for tivozanib and 67% for sorafenib, compared with the ITT population, at 46% and 55%, respectively.</p><p><strong>Conclusions: </strong>In this long-term post-hoc update of the TIVO-3 trial, we show that in CPI-resistant mRCC, the PFS benefit of tivozanib over sorafenib is accompanied with improved OS data, although not statistically significant, and durable responses.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257440","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":"Comparative effectiveness of netupitant-palonosetron plus dexamethasone versus aprepitant-based regimens in mitigating chemotherapy-induced nausea and vomiting: a meta-analysis of randomized controlled trials.","authors":"Wun-Ting Luo, Chia-Lun Chang, Tsai-Wei Huang, Made Satya Nugraha Gautama","doi":"10.1093/oncolo/oyae233","DOIUrl":"10.1093/oncolo/oyae233","url":null,"abstract":"<p><strong>Background: </strong>Despite guidelines for managing chemotherapy-induced nausea and vomiting (CINV), there remains a need to clarify the optimal use of neurokinin-1 (NK1) receptor antagonists. Comparing the effectiveness of NEPA (netupitant-palonosetron) plus dexamethasone with other NK1 antagonist-based regimens combined with a 5HT3 receptor antagonist and dexamethasone is crucial for informed decision-making and improving patient outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review of the literature to assess randomized controlled trials (RCTs) comparing the efficacy, safety, and cost-effectiveness of NEPA plus dexamethasone and other NK1 antagonist-based regimens combined with a 5HT3 receptor antagonist and dexamethasone. PubMed, Embase, and the Cochrane Library databases were systematically searched, with the latest update performed in December 2023. Data on patient demographics, chemotherapy regimen characteristics, and outcomes were extracted for meta-analysis using a random-effects model.</p><p><strong>Results: </strong>Seven RCTs were analyzed. NEPA plus dexamethasone showed superior efficacy in achieving complete response in the overall (risk ratio [RR], 1.15; 95% CI, 1.02--1.30) and delayed phases (RR, 1.20; 95% CI, 1.03-1.41) of chemotherapy. It was more effective in controlling nausea (overall phase RR, 1.20; 95% CI, 1.05-1.36; delayed phase RR, 1.21; 95% CI, 1.05-1.40) and reducing rescue therapy use (overall phase RR, 1.45; 95% CI, 1.07-1.95; delayed phase RR, 1.75; 95% CI, 1.10-2.78). Adverse event rates were comparable (RR, 1.03; 95% CI, 0.96-1.10). Subgroup analysis indicated NEPA's particular efficacy in patients receiving moderately emetogenic chemotherapy (RR, 1.31; 95% CI, 1.07-1.60).</p><p><strong>Conclusion: </strong>NEPA plus dexamethasone regimens exhibit superior efficacy in preventing CINV, supporting their preferential inclusion in prophylactic treatment protocols. Its effective symptom control, safety profile, and cost-effectiveness endorse NEPA-based regimens as a beneficial option in CINV management.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic myelomonocytic leukemia with NPM1 mutation or acute myeloid leukemia?","authors":"Sandra Castaño-Díez, José Ramón Álamo, Mònica López-Guerra, Marta Gómez-Hernando, Inés Zugasti, Carlos Jiménez-Vicente, Francesca Guijarro, Irene López-Oreja, Daniel Esteban, Paola Charry, Víctor Torrecillas, Lucia Mont-de Torres, Albert Cortés-Bullich, Álex Bataller, Ares Guardia, Daniel Munárriz, Esther Carcelero, Gisela Riu, Ana Triguero, Natalia Tovar, Dolors Vela, Silvia Beà, Dolors Costa, Dolors Colomer, Maria Rozman, Jordi Esteve, Marina Díaz-Beyá","doi":"10.1093/oncolo/oyae246","DOIUrl":"10.1093/oncolo/oyae246","url":null,"abstract":"<p><p>The 2022 WHO revision and the ICC classification have recently modified the diagnostic criteria for chronic myelomonocytic leukemia (CMML) and acute myeloid leukemia. However, there is no consensus on whether CMML with NPM1 mutation (NPM1mut) should be diagnosed as AML. Nowadays, it is a subject of discussion because of its diagnostic and therapeutic implications. Therefore, we describe a case of a patient diagnosed with CMML NPM1mut and briefly review the literature to highlight the uncertainty about how to classify a CMML with NPM1 mutation. We emphasize the importance of a comprehensive molecular study, which is crucial to optimize the individualized treatment of patients, enabling them to access targeted therapies.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332556","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":"Travel burden and carbon dioxide emission reductions through a model of cancer care closer to the patient.","authors":"Luigi Cavanna, Chiara Citterio, Costanza Bosi, Stefano Vecchia, Manuela Proietto, Patrizia Mordenti","doi":"10.1093/oncolo/oyaf021","DOIUrl":"10.1093/oncolo/oyaf021","url":null,"abstract":"<p><strong>Background: </strong>Traveling to healthcare facilities, particularly in the case of patients requiring frequent visits and repeated treatments, such as cancer patients, is associated with substantial carbon dioxide (CO2) emissions. Moreover, travel burdens can delay diagnosis and negatively influence prognosis.</p><p><strong>Materials and methods: </strong>In 2004, a programme called territorial oncology care (TOC) was initiated in the province of Piacenza (northern Italy) to relieve travel burdens by providing treatment closer to patients' residences. Patient management is performed by oncologists traveling from the city hospital's oncologic ward to rural centers. Patients are managed at 3 rural hospitals and a health center called Casa della Salute. In this study, we retrospectively analyzed all files containing the schedules of patients enrolled in the TOC programme from 2 January 2017 to 31 December 2022. We calculated the driving distance (in kilometers) to the outpatient facility closest to each patient's residence and the CO2 emissions saved compared with the distance to the city hospital.</p><p><strong>Results: </strong>A total of 2132 cancer patients on active treatment were enrolled in the TOC programme during the study period. The total travel saved by treating patients closer to their residences over this 6-year period amounted to 1 975 105 km, representing carbon emission savings of 241.56 tonnes.</p><p><strong>Conclusion: </strong>Our findings show a significant reduction (241.56 tonnes) of CO2 emissions for the entire cohort of patients over a period of 6 years.Cancer patients' travel burdens and associated carbon emissions can be substantially reduced by programmes such as TOC.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":"30 2","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442764","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}