Cancer journal最新文献

{"title":"Key Drivers and Mitigation Strategies of Oncology Drug Shortages 2023 to 2025.","authors":"Mariana P Socal, Joy Acha, Chia-Yu Yang, Yunxiang Sun, Maqbool Dada, Tinglong Dai, Gerard Anderson, Jeromie Ballreich","doi":"10.1097/PPO.0000000000000791","DOIUrl":"10.1097/PPO.0000000000000791","url":null,"abstract":"<p><p>Drug shortages remain a problem in the United States, jeopardizing patient care. To help inform solutions, this study reviewed recent oncology drug shortages for causes and mitigation strategies. Using the FDA's Drug Shortage Database, 15 oncology drugs with shortages between 2023 and 2025 were identified. Twelve drugs had shortages lasting >2 years (maximum: >13 y). Searches of PubMed and Google Scholar, online media sources, and FDA documents uncovered 9 main causes: manufacturing quality problems, limited-source dependency, regulatory bottlenecks, global over-reliance, absence of buffer stocks, demand surges, low economic incentives, active pharmaceutical ingredient shortages, and shelf-life constraints. Mitigation strategies involved 4 stakeholders: regulators (expedited regulatory action, importation, expiration extensions), manufacturers (capacity expansion), providers (dose-sparing regimens, therapeutic alternative protocols, allocation prioritization), and purchasers-distributors including GPOs (supply collaboration). Policies to mitigate drug shortages should include new approaches to identify vulnerable markets and involve multiple stakeholders. Factors identified in this study also offer pathways for shortage prevention.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 5","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147875","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":"Oncology Drug Shortages: Impacts, Policy Reforms, and Advocacy Imperatives.","authors":"Marissa Malta, Matthew Christian, Amy B Cadwallader","doi":"10.1097/PPO.0000000000000784","DOIUrl":"10.1097/PPO.0000000000000784","url":null,"abstract":"<p><p>Oncology drug shortages have reached unprecedented levels and have had a substantial impact on the treatment of cancer patients, which can include medication rationing, delayed treatments, and inferior therapeutic substitutions. This manuscript outlines systemic drivers of supply chain vulnerabilities that lead to drug shortages, presents medicines supply chain data analyses of ongoing shortages, and proposes actionable policy reforms for advocacy to address patient needs and build resilience and sustainable change in the pharmaceutical supply chain.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 5","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147924","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":"Tumor Evolution Driving Genome Instability, Immune Interactions, and Response to Radiotherapy.","authors":"George Seed, France Truong, Rahma Riahi, Ben O'Leary","doi":"10.1097/PPO.0000000000000777","DOIUrl":"10.1097/PPO.0000000000000777","url":null,"abstract":"<p><p>This review article explores the role of immuno-radiotherapy in the context of genome instability and tumor evolution. Genomic changes in tumors exist in a delicate balance with the immune system, offering evolutionary pathways to adapt and grow but risking provoking an immune response. Rapid developments across both immunotherapy and radiotherapy have raised questions about the potential benefits combination therapy, and how best to identify ideal treatment populations. Here we discuss foundational studies of genomic instability and tumor evolution, how these paradigms translate into immune surveillance and evasion, and subsequently go on to explore recent preclinical and clinical studies of both treatment modalities. Understanding how cancers evolve in the context of the immune system could provide a key insight in delivering better therapies that could overcome treatment resistance.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793524","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":"Are we Only Doing Good? Long-term Psychosocial Effects of Fertility Preservation (or Lack Thereof) on Survivors of Cancer During Adolescence and Young Adulthood.","authors":"Vicky Lehmann, Niels van Poecke, Leah Waterman, Christianne A R Lok, Catharina C M Beerendonk, Ellen M A Smets","doi":"10.1097/PPO.0000000000000774","DOIUrl":"10.1097/PPO.0000000000000774","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose/background: &lt;/strong&gt;Patients diagnosed with cancer at reproductive age can be offered fertility preservation, which includes options of freezing sperm (male patients), oocytes, embryos, or ovarian tissue (female patients). This is intended to provide survivors with a chance to have biological children later in life (e.g., through utilizing assisted reproductive technologies, ART). However, psychosocial effects of no or completed fertility preservation remain largely unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 48 survivors completed semi-structured interviews (Mage = 34 y). They had been diagnosed with cancer during adolescence and young adulthood (AYA; between age 12 and 39 y), were &lt;1 to 18 years (M = 5 y) from diagnosis, and had completed active cancer treatment. Survivors were asked about perceived consequences of having or not having completed fertility preservation. Answers were qualitatively analyzed with template analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Almost half of the survivors had completed fertility preservation at diagnosis. During interviews, all survivors described an emotional impact of no or completed fertility preservation, which caused positive or negative feelings, or was described as minor/absent. These feelings can change over time, as they were determined by past, present, or possibly future events. Such events clustered into a disruption in family building, followed by a phase of exploration of reproductive health posttreatment. This phase included much uncertainty, which triggered the exploration of survivors' fertility status, reproduction/pregnancies, and options of ART. Hope for natural conception prevailed irrespective of completed fertility preservation and was still abstract for various survivors. Utilization of ART was scarce and physically and emotionally burdensome. Alternatives to biological parenthood were deemed unfeasible. Uncertainty and phases of exploration, together with learning more about their fertility status (e.g., uncovering infertility/having problems conceiving, unexpected pregnancies) changed survivors' outlook on life and affected their romantic relationships, partner communication, and dating profoundly.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Uncertainty about fertility and reproductive options is universal, irrespective of whether survivors had completed fertility preservation or not. If completed, fertility preservation can provide survivors with positive feelings (e.g., hope/reassurance), but uncertainties and worries surrounding reproduction/ART can add substantial burden throughout survivorship. Survivors' perception of no/completed fertility preservation can change over time and largely depends on whether ART is needed and its outcome. Thus, fertility preservation cannot always buffer negative effects, and if survivors remain without (additional) children unintentionally, emotional burden and grief can be significant. Health care providers should address any conc","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793515","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":"Evolving Paradigms in the Management of HPV-positive Oropharyngeal Squamous Cell Carcinoma: Integrating Surgical Innovation, Radiation De-escalation, and Biomarker-driven Precision Oncology.","authors":"Irini Yacoub, Nancy Lee","doi":"10.1097/PPO.0000000000000771","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000771","url":null,"abstract":"","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214933","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":"The Current Landscape for Human Papillomavirus Vaccination in Oropharyngeal Carcinoma.","authors":"Nivedha Kumar, James S Butler, Jay Vashisht","doi":"10.1097/PPO.0000000000000767","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000767","url":null,"abstract":"<p><p>Human papillomavirus is associated with the development of malignancies in the head and neck region, particularly oropharyngeal carcinoma. In recent years, there has been a significant increase in these virally mediated cancers, largely due to HPV strains 16 and 18. Existing literature supports a reduction in oral HPV infection following vaccination, and the FDA recently expanded the indication for the nonvalent Gardasil vaccine for use in HPV-related head and neck cancers in both men and women. The objectives of this paper are to review the evidence supporting the use of HPV vaccination in head and neck cancer, introduce HPV vaccinations currently being investigated in clinical trials, and assess barriers to production and widespread use of these vaccinations.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215024","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":"The Change in Paradigm for Surgical Management of HPV-positive Oropharynx Cancer.","authors":"Daniel W Scholfield, Ian Ganly","doi":"10.1097/PPO.0000000000000770","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000770","url":null,"abstract":"<p><p>Traditional surgical approaches to all oropharyngeal cancer included open surgery via mandibulotomy or mandibular swing procedures-extensive surgery that often led to tracheostomy, gastrostomy tube dependence, and prolonged hospital stay. As HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) began to increase in prevalence, it became clear that this new disease entity was associated with improved survival. There was therefore a strong desire from surgeons and oncologists to reduce the morbidity associated with its management. The paradigm shift to transoral robotic surgery and transoral laser microsurgery for selected patients with HPV oropharynx cancer has allowed for avoidance of tracheostomy, mandibulotomy, and feeding tube while preserving speech and swallow function. Current research focuses on de-escalating adjuvant treatment in appropriate cases to reduce morbidity without impacting oncologic outcome.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214936","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":"Radiation Techniques for HPV+ Oropharyngeal Cancer.","authors":"Anika Patel, Anna Lee","doi":"10.1097/PPO.0000000000000772","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000772","url":null,"abstract":"<p><p>Standard of care for locoregionally advanced HPV-positive OPSCC is definitive chemoradiation with doses up to 70 Gy and concurrent cisplatin. Radiation techniques have evolved considerably from 3D conformal radiotherapy (3D CRT) to the now widely used intensity-modulated radiotherapy (IMRT) and volumetric modulated arc radiotherapy (VMAT). Many centers are also incorporating stereotactic body radiation therapy (SBRT) and proton therapy to deliver even more conformal treatments that can minimize dose to normal organs at risk, thereby improving the therapeutic ratio. We review here the advancements and current landscape of radiation therapy for HPV+ OPSCC.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214935","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":"Personalizing Approaches to Management of HPV+ Oropharyngeal Cancer.","authors":"Fan Zhu, Musaddiq Awan","doi":"10.1097/PPO.0000000000000768","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000768","url":null,"abstract":"<p><p>HPV+ oropharyngeal cancer represents a unique disease entity in the realm of head and neck cancer with distinct incidence and prevalence, pathogenesis, and treatment outcome. Management of this disease needs to be personalized in consideration of a combination of factors of both patient and disease characteristics. Overall outcomes in this patient population are excellent. Therefore, late side effects of treatment are gaining increasing importance and attention. Here we present a brief overview of personalized approaches for this patient population, illustrated by a discussion of several cases.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214934","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":"Advances in Systemic and Immunotherapies for Human Papillomavirus-Mediated Oropharyngeal Cancers.","authors":"Niema B Razavian","doi":"10.1097/PPO.0000000000000766","DOIUrl":"https://doi.org/10.1097/PPO.0000000000000766","url":null,"abstract":"<p><p>This review highlights recent advances in systemic and immunotherapy for patients with HPV-mediated oropharynx cancer. Over the last 20 years, therapies have evolved from cytotoxic agents alone to those that target mechanisms of treatment resistance and/or activate the immune system. This article discusses therapies used in definitive and/or recurrence/metastatic treatment. For each setting, current standards of care and areas of active clinical investigation are discussed.</p>","PeriodicalId":9655,"journal":{"name":"Cancer journal","volume":"31 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214932","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}