101
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Offenbacher R, Norris S, Loeb DM, Levy A. Delayed Solid Tumor Presentations in Adolescent and Young Adults Patients in the Bronx. J Adolesc Young Adult Oncol 2024; 13:361-363. [PMID: 37870570 DOI: 10.1089/jayao.2023.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
Adolescent and young adults (AYAs) require support from their parents and caregivers. While there are formal programs available for patients with complex medical problems, <20% of pediatric practices are performing transition readiness processes in patients aged 12-17 years to effective transition. Although cancer is the most common cause of disease-related death in AYAs in high-income countries, AYA oncology patients have not attained the same clinical improvements as pediatric patients, and their outcomes remain poorer. While there are published data on an expected degree of lag time for patients presenting with solid tumors, due to the underlying biology and slow growth of the cancer, we have recently witnessed extreme delays in the presentation to medical care. In this article, we share the cases of two young adults.
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Affiliation(s)
- Rachel Offenbacher
- Division of Pediatric Hematology, Oncology and Cellular Therapy, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Sarah Norris
- Division of Pediatric Hematology, Oncology and Cellular Therapy, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA
| | - David M Loeb
- Division of Pediatric Hematology, Oncology and Cellular Therapy, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Adam Levy
- Division of Pediatric Hematology, Oncology and Cellular Therapy, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA
- Department Pediatrics, Einstein, Bronx, New York, USA
- Bristol Myers Squibb Pediatric Center of Excellence, New Brunswick, New Jersey, USA
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102
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Haines ER, Gan H, Kupelian A, Roggenkamp B, Lux L, Kumar B, Davies S. The Development and Implementation of Adolescent and Young Adult Oncology Programs: Teen Cancer America's Strategy. J Adolesc Young Adult Oncol 2024; 13:347-351. [PMID: 37922448 DOI: 10.1089/jayao.2023.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023] Open
Abstract
Reflecting a growing recognition that adolescents and young adults (AYAs) with cancer have unique needs that demand novel approaches to care delivery, AYA-specific cancer programs are emerging across the United States to better serve this population. However, the limited availability of health system funding to support such efforts, in combination with the dearth of guidance that exists to guide AYA program development and implementation, has hampered the effective development and implementation of AYA oncology programs. In this article, we describe Teen Cancer America's strategy for partnering with hospitals to address this gap and improve care and outcomes for AYAs with cancer.
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Affiliation(s)
- Emily R Haines
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Hilary Gan
- Teen Cancer America, Los Angeles, California, USA
| | | | | | - Lauren Lux
- UNC Adolescent and Young Adult Cancer Program, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Bindu Kumar
- Teen Cancer America, Los Angeles, California, USA
| | - Simon Davies
- Teen Cancer America, Los Angeles, California, USA
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103
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Gouda MA, Subbiah V. Tissue-Agnostic Cancer Therapy Approvals. Surg Oncol Clin N Am 2024; 33:243-264. [PMID: 38401908 DOI: 10.1016/j.soc.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
Tumor-agnostic, or histology-agnostic, cancer therapy marks a groundbreaking evolution in the realm of precision oncology. In stark contrast to conventional cancer treatments that categorize malignancies based on their tissue of origin (eg, breast, lung, renal cell, etc), tumor-agnostic therapies transcend histologic boundaries, honing in on the genetic and molecular attributes of tumors, regardless of their location. This article offers a comprehensive review of the current landscape of tissue-agnostic cancer therapies and provides clinical insights to empower surgical oncologists with a deeper understanding of these innovative therapeutic approaches.
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Affiliation(s)
- Mohamed A Gouda
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 455, Houston, TX, USA
| | - Vivek Subbiah
- Early-Phase Drug Development, Sarah Cannon Research Institute, 335 24th Avenue North Suite 300, Nashville, TN 37203, USA.
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104
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Pawlik TM. Precision Oncology and Cancer Surgery. Surg Oncol Clin N Am 2024; 33:xiii-xiv. [PMID: 38401919 DOI: 10.1016/j.soc.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Affiliation(s)
- Timothy M Pawlik
- Professor and Chair, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center, 395 West 12th Avenue, Suite 670, Columbus, OH 43210, USA.
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105
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Demedis J, Reedy J, Chow EJ, Dorsey Holliman B, Peterson PN, Studts CR. Provider perspectives and recommendations on standardized sexual function screening intervention in adolescent/young adult oncology patients. Pediatr Blood Cancer 2024; 71:e30872. [PMID: 38233999 DOI: 10.1002/pbc.30872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/13/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Sexual function (SF) concerns are common among adolescent and young adult (AYA) cancer survivors, are underrecognized and undertreated. This study sought AYA oncology provider input on the implementation of an SF screening tool to address this unmet need. PROCEDURE Semi-structured interviews were completed with oncology providers (n = 25) who care for AYAs at a single institution. Interviews sought to understand barriers to addressing SF, elicit perspectives on use of an established screening tool, and obtain recommendations for SF screening intervention development and implementation. Interviews were developed using the Consolidated Framework for Implementation Research (CFIR); thematic analysis-guided interpretation. RESULTS AYA oncology providers were in favor of using an SF screening tool, but confirmed previously identified barriers and implementation considerations within multiple CFIR domains, including concerns about privacy, patient comfort, provider buy-in, provider knowledge, resource needs, and workflow/capacity constraints. They identified numerous strategies to address barriers through screening intervention design and implementation approaches. For example, provider buy-in could be optimized through education, availability of clinical resources, creation of a dedicated sexual healthcare team, provider engagement in intervention development, and leadership involvement. CONCLUSIONS Development and implementation of an effective SF screening intervention is necessary to improve diagnosis and treatment of sexual dysfunction, with the ultimate goal of improving sexual health-related quality of life in AYA cancer survivors. AYA oncology providers identified numerous intervention and implementation design strategies for the development and implementation of an SF screening intervention, which must be integrated with patient recommendations.
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Affiliation(s)
- Jenna Demedis
- Adult & Child Center for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Julia Reedy
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
| | - Eric J Chow
- Clinical Research and Public Health Sciences Divisions, Fred Hutchinson Cancer Center, Washington, USA
| | - Brooke Dorsey Holliman
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Pamela N Peterson
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Denver Health Medical Center, Denver, Colorado, USA
| | - Christina R Studts
- Adult & Child Center for Health Outcomes Research & Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Cancer and Blood Disorders at Children's Hospital Colorado, Aurora, Colorado, USA
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106
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Williamson FA, Lester JN, Woods C, Kaye EC. Questions to promote child-centered care in racially discordant interactions in pediatric oncology. Patient Educ Couns 2024; 121:108106. [PMID: 38123375 DOI: 10.1016/j.pec.2023.108106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To examine questioning practices in racially discordant interactions and describe how these practices engendered child-centered care. METHODS We used applied conversation analysis to analyze a collection of 300 questions directed to children across 10 cases involving children of color and their families in disease reevaluation appointments in pediatric oncology. RESULTS Our analysis generated two patterns: 1) both the pediatric oncologists' and caregivers built upon one another's talk to enable the child's conversational turn, and 2) the oncologists' reformulated requests as questions to invite the child's permission and cooperation for completing exams and understanding symptoms. CONCLUSION Children, pediatric oncologists, and caregivers coordinated their actions to enable children to participate as recipients of and respondents to questions. The analysis of real-time interactions illuminates practices for centering children in clinical encounters and the benefits of doing so. PRACTICAL IMPLICATIONS This study's findings have implications for defining competencies and practices for fostering child-centered communication, creating training materials based on real-time encounters, and identifying strategies for humanizing pediatric patient experiences.
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Affiliation(s)
| | - Jessica Nina Lester
- Department of Counseling Education and Psychology, Indiana University, Bloomington, USA
| | - Cameka Woods
- St. Jude's Children's Research Hospital, Memphis, USA
| | - Erica C Kaye
- St. Jude's Children's Research Hospital, Memphis, USA
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107
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de Barros LPL, de Oliveira Muniz Koch L, de Oliveira Lima JT, Apolinario TL, Dettino ALA, Petrarca CR, Martins JC, de Souza PMR, Rodrigues M, de Souza E Silva JT, Karnakis T, Junior LAG, Junior MGA, Honorato M, Abalos VR, Alvarado OC, Navarrete G, Rebelatto TF, Soto-Perez-de-Celis E. Development of geriatric oncology in Latin America: A report from the Latin American Cooperative Oncology Group. J Geriatr Oncol 2024; 15:101642. [PMID: 37977899 DOI: 10.1016/j.jgo.2023.101642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/01/2023] [Accepted: 09/28/2023] [Indexed: 11/19/2023]
Abstract
Population aging represents a critical issue for global cancer care, notably in low- and middle-income countries (LMIC). Latin America is a large region composed of 21 countries with notable diversity in both human development and access to quality healthcare. Thus, it is necessary to understand how care for older individuals is being delivered in such large and diverse regions of the world. This review describes the recent advances made in Mexico, Brazil, and Chile, focusing on the creation and implementation of educational, research, and clinical activities in geriatric oncology. These initiatives intend to change healthcare professionals' perceptions about the care for older adults and to improve the way older patients are being treated.
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Affiliation(s)
- Luciola Pontes Leite de Barros
- Oncology and Hematology Department, HCor, São Paulo, Brazil; Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.
| | - Ludmila de Oliveira Muniz Koch
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil; Oncology and Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | - Theodora Karnakis
- Cancer Institute of São Paulo, University of São Paulo, São Paulo, Brazil
| | | | | | - Macarena Honorato
- Department of Geriatrics, Clínica Alemana de Santiago, Santiago, Chile
| | | | - Oscar Calderón Alvarado
- Department of Geriatrics, Clínica Alemana de Santiago, Santiago, Chile; Complejo Asistencial Dr. Sótero del Río, Santiago, Chile
| | - Gonzalo Navarrete
- Hospital Clínico Universidad de Chile, Santiago, Chile; Fundación Arturo Lopez Perez, Santiago, Chile
| | | | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, México City, Mexico
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108
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Pancoe S, Ko EM, Smith AJB. Federal Transportation Regulations Limit Access to Clinical Trials and Oncology Care. JAMA Oncol 2024; 10:425-426. [PMID: 38300547 DOI: 10.1001/jamaoncol.2023.6767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
This Viewpoint discusses how improving accessibility to oncology services will lead to more equitable care for patients with cancer.
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Affiliation(s)
- Sam Pancoe
- Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Emily M Ko
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia
- Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania Health Systems, Philadelphia
| | - Anna Jo Bodurtha Smith
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia
- Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania Health Systems, Philadelphia
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109
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Barbe C, Chorin F. [Prehabilitation through physical activity in oncology]. Soins 2024; 69:33-37. [PMID: 38614517 DOI: 10.1016/j.soin.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
It has now been established that preoperative physical activity plays an essential role in minimizing postoperative complications. Patients who have undergone physical preparation recover their preoperative abilities more quickly. However, only about a third of those with access to such preparation report an improvement in their physical abilities. The modalities of intervention and follow-up, such as the training load and the generic format of the proposed sessions, seem to hinder patient participation in these programs, thus explaining the mixed results. In this context, it seems necessary to individualize prehabilitation in order to improve the functional capacities of people in this phase or in the phase of accelerated recovery after treatment or surgery.
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Affiliation(s)
- Charly Barbe
- Pôle réhabilitation autonomie vieillissement, plateforme Fragilité, Hôpital de Cimiez, 4 avenue Reine-Victoria, 06003 Nice, France.
| | - Frédéric Chorin
- Pôle réhabilitation autonomie vieillissement, plateforme Fragilité, Hôpital de Cimiez, 4 avenue Reine-Victoria, 06003 Nice, France; Université Côte d'Azur, Laboratoire motricité humaine expertise sport santé (Lamhess), Campus STAPS-Sciences du Sport, 261 boulevard du Mercantour BP3259, 06205 Nice cedex 03, France
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110
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Sicklick JK. Precision Oncology and Cancer Surgery. Surg Oncol Clin N Am 2024; 33:xv-xvi. [PMID: 38401920 DOI: 10.1016/j.soc.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Affiliation(s)
- Jason K Sicklick
- Moores Cancer Center, University of California San Diego School of Medicine, 3855 Health Sciences Drive Box# 0987, La Jolla, CA 92093, USA.
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111
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Baird AM, Hays K, Vlazny D. Shaping the future of vascular care: The evolution of advanced practice providers (APPs). Vasc Med 2024; 29:233-237. [PMID: 38506488 PMCID: PMC11010561 DOI: 10.1177/1358863x241237176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Alexandra Moran Baird
- Hospital Corporation of America, Cardiac and Vascular Service Line, Nashville, TN, USA
- Vanderbilt University School of Nursing, Nashville, TN, USA
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112
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Semerci R, Şimşek E, Savaş E, Orhan E, Erbey F. The quality and content analysis of YouTube videos about chemotherapy for children. Pediatr Blood Cancer 2024; 71:e30865. [PMID: 38235928 DOI: 10.1002/pbc.30865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE This study undertook a systematic examination of YouTube videos about chemotherapy for pediatric patients, with a primary focus on assessing the videos' quality, content, and reliability. METHOD The research was conducted by searching YouTube using the keywords "chemotherapy for children" and "chemotherapy for pediatric," employing filters for "worldwide" and "all categories." The top 100 videos, based on popularity, were selected for evaluation according to the power analysis calculation. Two independent experts in pediatric oncology reviewed these videos. Video characteristics were recorded: length, view count, likes, dislikes, view ratio, and video-like ratio. The Video Power Index was calculated to measure video popularity. The modified DISCERN and Global Quality Scale (GQS) assessed the videos for quality and reliability. RESULTS The 100 videos were analyzed. Official health institutions uploaded 54%, while independent users contributed 46%. Independent user uploads garnered significantly more views than official health institutions (p = .006). The number of likes, view ratio, and Video Power Index of independent users' videos were significantly higher than official health institutions' videos (respectively, p = .007, .007, and .008). On the other hand, the modified DISCERN score and GQS were significantly higher in YouTube videos of official health institutions than in independent users (p < .001). A strong correlation was observed between the modified DISCERN score and GQS (r = .879, p < .001). CONCLUSION This study provides valuable insights into the YouTube videos on pediatric chemotherapy, emphasizing the need to improve the quality and reliability of online health information for this vulnerable population.
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Affiliation(s)
- Remziye Semerci
- Department of Pediatric Nursing, School of Nursing, Koç University, Istanbul, Turkey
| | - Enes Şimşek
- Department of Pediatric Nursing, School of Nursing, Koç University, Istanbul, Turkey
| | - Eyşan Savaş
- Department of Pediatric Nursing, School of Nursing, Koç University, Istanbul, Turkey
| | - Eda Orhan
- Nursing Education Department, Koç University Hospital, Istanbul, Turkey
| | - Fatih Erbey
- Department of Pediatric Hematology Oncology & BMT Unit, School of Medicine, Koç University, Istanbul, Turkey
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113
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Dupuis LL, Fisher BT, Sugalski AJ, Grimes A, Nuño M, Ramakrishnan S, Beauchemin MP, Robinson PD, Santesso N, Walsh A, Wrightson AR, Yu L, Parsons SK, Sung L. Clinical practice guideline-inconsistent management of fever and neutropenia in pediatric oncology: A Children's Oncology Group study. Pediatr Blood Cancer 2024; 71:e30880. [PMID: 38291716 PMCID: PMC10937100 DOI: 10.1002/pbc.30880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/29/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND The primary objective was to measure the proportion of episodes where care delivery was inconsistent with selected recommendations of a clinical practice guideline (CPG) on fever and neutropenia (FN) management. The influence of site size on CPG-inconsistent care delivery, and association between patient outcomes and CPG-inconsistent care were described. METHODS This retrospective, multicenter study included patients less than 21 years old with cancer who were at high risk of poor FN outcomes and were previously enrolled to a Children's Oncology Group (COG) study at participating National Cancer Institute Community Oncology Research Program (NCORP) institutions from January 2014 through December 2015. Patients were randomly selected for chart review by participating sites from a COG-generated list. Care delivered in each episode was adjudicated (CPG-consistent or CPG-inconsistent) against each of five selected recommendations. RESULTS A total of 107 patients from 22 sites, representing 157 FN episodes, were included. The most common CPG-inconsistent care delivered was omission of pulmonary computerized tomography in patients with persistent FN (60.3%). Of 74 episodes where assessment of four (episodes without persistent FN) or five (episodes with persistent FN) recommendations was possible, CPG-inconsistent care was delivered with respect to at least one recommendation in 63 (85%) episodes. Site size was not associated with CPG-inconsistent care delivery. No statistically significant association between CPG-inconsistent care and fever recurrence was observed. CONCLUSIONS In this cohort of pediatric patients at high risk of poor FN outcomes, CPG-inconsistent care was common. Opportunities to optimize resource stewardship by boosting supportive care CPG implementation are highlighted.
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Affiliation(s)
- LL Dupuis
- Research Institute, The Hospital for Sick Children, Toronto, Canada
- Department of Pharmacy, The Hospital for Sick Children; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - BT Fisher
- The Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, US
| | - AJ Sugalski
- University of Texas Health Science Center San Antonio, San Antonio, Texas, US
| | - A Grimes
- University of Texas Health Science Center San Antonio, San Antonio, Texas, US
| | - M Nuño
- Children’s Oncology Group, Monrovia, USA
| | | | - MP Beauchemin
- Columbia University Irving Medical Center, New York, USA
| | - PD Robinson
- Pediatric Oncology Group of Ontario, Toronto, Canada
| | - N Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - A Walsh
- Center for Cancer and Blood Disorders, Phoenix Children’s Hospital, Phoenix, USA. University of Arizona, Phoenix, USA
| | - AR Wrightson
- Clinical Research Nurse Coordinator, Nemours Center for Cancer and Blood Disorders, Wilmington, USA
| | - L Yu
- LSUHSC/Children’s Hospital, New Orleans, USA
| | - SK Parsons
- Institute for Clinical Research and Health Policy Studies and Division of Hematology/Oncology, Tufts Medical Center, Boston, MA, USA
| | - L Sung
- Research Institute, The Hospital for Sick Children, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
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114
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Zhuang Q, Zhou S, Ho S, Neo PSH, Cheung YB, Yang GM. Can an Integrated Palliative and Oncology Co-rounding Model Reduce Aggressive Care at the End of Life? Secondary Analysis of an Open-label Stepped-wedge Cluster-randomized Trial. Am J Hosp Palliat Care 2024; 41:442-451. [PMID: 37246153 DOI: 10.1177/10499091231180460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Clinical trial evidence on the effect of palliative care models in reducing aggressive end-of-life care is inconclusive. We previously reported on an integrated inpatient palliative care and medical oncology co-rounding model that significantly reduced hospital bed-days and postulate additional effect on reducing care aggressiveness. OBJECTIVES To compare the effect of a co-rounding model vs usual care in reducing receipt of aggressive treatment at end-of-life. METHODS Secondary analysis of an open-label stepped-wedge cluster-randomized trial comparing two integrated palliative care models within the inpatient oncology setting. The co-rounding model involved pooling specialist palliative care and oncology into one team with daily review of admission issues, while usual care constituted discretionary specialist palliative care referrals by the oncology team. We compared odds of receiving aggressive care at end-of-life: acute healthcare utilization in last 30 days of life, death in hospital, and cancer treatment in last 14 days of life between patients in two trial arms. RESULTS 2145 patients were included in the analysis, and 1803 patients died by 4th April 2021. Median overall survival was 4.90 (4.07 - 5.72) months in co-rounding and 3.75 (3.22 - 4.21) months in usual care, with no difference in survival (P = .12). We found no significant differences between both models with respect to receipt of aggressive care at end-of-life. (Odds Ratio .67 - 1.27; all P > .05). CONCLUSION The co-rounding model within an inpatient setting did not reduce aggressiveness of care at end-of-life. This could be due in part to the overall focus on resolving episodic admission issues.
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Affiliation(s)
- Qingyuan Zhuang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Siqin Zhou
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore
| | - Shirlynn Ho
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Patricia Soek Hui Neo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Yin Bun Cheung
- Program in Health Services and Systems Research and Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Grace Meijuan Yang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
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115
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Trapani D, Girardi F, Cinieri S, Curigliano G. There is no such a thing as a ' biological' basis for cancer disparities: A call to end misreporting of the ultimate determinants of health outcomes. Tumori 2024; 110:82-87. [PMID: 37688414 DOI: 10.1177/03008916231196369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Improved strategies of cancer prevention and control have resulted in tangible benefits for patients with cancer. Disparities in outcome have been reported as a result of inequal access to health care. Historically, differences in health outcomes at population level have been reported according to key characteristics, including race, ethnicity and, more recently, ancestry. These population descriptors have been used to display the differences in the outcome and highlight actionable areas of health disparities, through policy and population health interventions. Yet, they have been commonly mis-intended as ultimate determinants of health outcomes, as recapitulating intrinsic biological differences. A plethora of past literature has described "biological" differences in patients belonging to a specific racial, ethnical or ancestral group, with certain cancers - commonly overlooking the social and economic contextures. The attention has ultimately focused on the existence of intrinsic differences and biological reasons, as opposed to social and economic determinants of disparities in the outcome in disadvantaged or excluded communities, thus nurturing double stigma. In our editorial, we evaluate some key roots of racial attitudes in displaying patient outcomes in oncology epidemiological studies, and call to report ultimate determinants of health - that are, primarily social and economic determinants.
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Affiliation(s)
- Dario Trapani
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Fabio Girardi
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Saverio Cinieri
- Department of Medical Oncology, Perrino Hospital, ASL Brindisi, Brindisi, Italy
- Associazione Italiana di Oncologia Medica (AIOM), Milan, Italy (President)
| | - Giuseppe Curigliano
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Chen Y, Deng S, Xu J, Yan Y, Lan S, Guo M. Research status and hotspots on the mechanisms of liver X receptor in cancer progression: A bibliometric analysis. Medicine (Baltimore) 2024; 103:e37126. [PMID: 38552096 PMCID: PMC10977575 DOI: 10.1097/md.0000000000037126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/10/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The mechanism of liver X receptor in cancer has been gradually revealed in recent years. This study is committed to analyzing the current research status of the mechanism of liver × receptor in cancer progression by using bibliometric methods and to explore the development trend of liver × receptor related research in the future, in order to provide some reference for further exploration in this field. METHODS The Web of Science core collection database was used to carry out the original data retrieval. Excel software was used for data statistics. Vosviewer and CiteSpace software were used to analyze the publication situation, cooperation network, reference co-citation, keyword and term co-occurrence, term bursts, and cluster analysis, and draw visual maps. RESULTS A total of 631 publications meeting the research criteria were included by December 2022, with an average of 32.5 citations per paper. The main research fields were molecular biology, oncology and cell biology, and the papers were mainly published in journals about molecular, biology and immunology. Cell is the journal with the highest citation. The United States is the most influential country, the University of California, Los Angeles is the main research institution, and Gustafsson, Jan-ake is the author with the highest output. In reference co-citation clustering, cluster#2 "cancer development" is the main cluster, and the period from 2014 to 2018 is an important stage of relevant theoretical progress. "Tumor microenvironment" with high burst and novelty became the most noteworthy term in term burst. CONCLUSION Using bibliometric methods to reveal the current status of LXR and cancer mechanisms, and making predictions of possible future hotspots based on the analysis of the current situation, the translation of LXR anti-cancer research to clinical applications, the impact on the tumor microenvironment as a whole and more immune pathways, and the formation of a systematic cognition of the effects of more cancer cell lines and oncogenic signaling crosstalk, which is a possible direction for future research.
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Affiliation(s)
- Yukun Chen
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Siqi Deng
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiexia Xu
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yu Yan
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shuwen Lan
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Mingzhang Guo
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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117
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Wang F, Ruan DY, Xu RH. Challenges and opportunities in oncology drug development and clinical research in China. Cell 2024; 187:1578-1583. [PMID: 38552607 DOI: 10.1016/j.cell.2024.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/19/2024] [Accepted: 02/28/2024] [Indexed: 04/02/2024]
Abstract
As one of the world's most populous countries, China bears a heavy burden and a broad spectrum of cancers, including unique types, providing a unique environment for drug research and development. In recent years, China has leapt forward in oncology drug development and clinical trials, presenting new opportunities and challenges.
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Affiliation(s)
- Feng Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University, Guangzhou 510060, P.R. China; Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou 510060, P.R. China
| | - Dan-Yun Ruan
- Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou 510060, P.R. China; Department of Clinical Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University, Guangzhou 510060, P.R. China
| | - Rui-Hua Xu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University, Guangzhou 510060, P.R. China; Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou 510060, P.R. China.
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Verkerk K, Voest EE. Generating and using real-world data: A worthwhile uphill battle. Cell 2024; 187:1636-1650. [PMID: 38552611 DOI: 10.1016/j.cell.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/04/2024] [Accepted: 02/09/2024] [Indexed: 04/02/2024]
Abstract
The precision oncology paradigm challenges the feasibility and data generalizability of traditional clinical trials. Consequently, an unmet need exists for practical approaches to test many subgroups, evaluate real-world drug value, and gather comprehensive, accessible datasets to validate novel biomarkers. Real-world data (RWD) are increasingly recognized to have the potential to fill this gap in research methodology. Established applications of RWD include informing disease epidemiology, pharmacovigilance, and healthcare quality assessment. Currently, concerns regarding RWD quality and comprehensiveness, privacy, and biases hamper their broader application. Nonetheless, RWD may play a pivotal role in supplementing clinical trials, enabling conditional reimbursement and accelerated drug access, and innovating trial conduct. Moreover, purpose-built RWD repositories may support the extension or refinement of drug indications and facilitate the discovery and validation of new biomarkers. This perspective explores the potential of leveraging RWD to advance oncology, highlights its benefits and challenges, and suggests a path forward in this evolving field.
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Affiliation(s)
- K Verkerk
- Department of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands
| | - E E Voest
- Department of Molecular Oncology & Immunology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam 1066 CX, the Netherlands.
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Pedretti L, Leardini D, Muratore E, Capoferri G, Massa S, Rahman S, Esposito S, Masetti R. Managing the Risk of Foodborne Infections in Pediatric Patients with Cancer: Is the Neutropenic Diet Still an Option? Nutrients 2024; 16:966. [PMID: 38613000 PMCID: PMC11013746 DOI: 10.3390/nu16070966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Infections pose a significant threat to morbidity and mortality during treatments for pediatric cancer patients. Efforts to minimize the risk of infection necessitate preventive measures encompassing both environmental and host-focused strategies. While a substantial number of infections in oncologic patients originate from microorganisms within their native microbiological environment, such as the oral cavity, intestines, and skin, the concrete risk of bloodstream infections linked to the consumption of contaminated food and beverages in the community cannot be overlooked. Ensuring food quality and hygiene is essential to mitigating the impact of foodborne illnesses on vulnerable patients. The neutropenic diet (ND) has been proposed to minimize the risk of sepsis during neutropenic periods. The ND aims to minimize bacterial entry into the gut and bacterial translocation. However, a standardized definition for ND and consensus guidelines for specific food exclusions are lacking. Most centers adopt ND during neutropenic phases, but challenges in achieving caloric intake are common. The ND has not demonstrated any associated benefits and does not ensure improved overall survival. Consequently, providing unified and standardized food safety instructions is imperative for pediatric patients undergoing hematopoietic cell transplantation (HCT). Despite the lack of evidence, ND is still widely administered to both pediatric and adult patients as a precautionary measure. This narrative review focuses on the impact of foodborne infections in pediatric cancer patients and the role of the ND in comparison to food safety practices in patients undergoing chemotherapy or HCT. Prioritizing education regarding proper food storage, preparation, and cooking techniques proves more advantageous than merely focusing on dietary limitations. The absence of standardized guidelines underscores the necessity for further research in this field.
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Affiliation(s)
- Laura Pedretti
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (G.C.); (S.M.); (S.R.)
| | - Davide Leardini
- Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (D.L.); (E.M.); (R.M.)
| | - Edoardo Muratore
- Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (D.L.); (E.M.); (R.M.)
| | - Gaia Capoferri
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (G.C.); (S.M.); (S.R.)
| | - Serena Massa
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (G.C.); (S.M.); (S.R.)
| | - Sofia Rahman
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (G.C.); (S.M.); (S.R.)
| | - Susanna Esposito
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (G.C.); (S.M.); (S.R.)
| | - Riccardo Masetti
- Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (D.L.); (E.M.); (R.M.)
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Arulraj T, Wang H, Ippolito A, Zhang S, Fertig EJ, Popel AS. Leveraging multi-omics data to empower quantitative systems pharmacology in immuno-oncology. Brief Bioinform 2024; 25:bbae131. [PMID: 38557676 PMCID: PMC10982948 DOI: 10.1093/bib/bbae131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Understanding the intricate interactions of cancer cells with the tumor microenvironment (TME) is a pre-requisite for the optimization of immunotherapy. Mechanistic models such as quantitative systems pharmacology (QSP) provide insights into the TME dynamics and predict the efficacy of immunotherapy in virtual patient populations/digital twins but require vast amounts of multimodal data for parameterization. Large-scale datasets characterizing the TME are available due to recent advances in bioinformatics for multi-omics data. Here, we discuss the perspectives of leveraging omics-derived bioinformatics estimates to inform QSP models and circumvent the challenges of model calibration and validation in immuno-oncology.
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Affiliation(s)
- Theinmozhi Arulraj
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Hanwen Wang
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Alberto Ippolito
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Shuming Zhang
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Elana J Fertig
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Oncology, and the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Aleksander S Popel
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Oncology, and the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Bouvier C, Lawrence R, Cavallo F, Xolalpa W, Jordan A, Hjerpe R, Rodriguez MS. Breaking Bad Proteins-Discovery Approaches and the Road to Clinic for Degraders. Cells 2024; 13:578. [PMID: 38607017 PMCID: PMC11011670 DOI: 10.3390/cells13070578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/12/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Proteolysis-targeting chimeras (PROTACs) describe compounds that bind to and induce degradation of a target by simultaneously binding to a ubiquitin ligase. More generally referred to as bifunctional degraders, PROTACs have led the way in the field of targeted protein degradation (TPD), with several compounds currently undergoing clinical testing. Alongside bifunctional degraders, single-moiety compounds, or molecular glue degraders (MGDs), are increasingly being considered as a viable approach for development of therapeutics, driven by advances in rational discovery approaches. This review focuses on drug discovery with respect to bifunctional and molecular glue degraders within the ubiquitin proteasome system, including analysis of mechanistic concepts and discovery approaches, with an overview of current clinical and pre-clinical degrader status in oncology, neurodegenerative and inflammatory disease.
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Affiliation(s)
- Corentin Bouvier
- Laboratoire de Chimie de Coordination LCC-UPR 8241-CNRS, 31077 Toulouse, France; (C.B.); (M.S.R.)
| | - Rachel Lawrence
- Sygnature Discovery, Bio City, Pennyfoot St., Nottingham NG1 1GR, UK (F.C.); (A.J.)
| | - Francesca Cavallo
- Sygnature Discovery, Bio City, Pennyfoot St., Nottingham NG1 1GR, UK (F.C.); (A.J.)
| | - Wendy Xolalpa
- Departamento de Ingeniería Celular y Biocatálisis, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62209, Morelos, Mexico;
| | - Allan Jordan
- Sygnature Discovery, Bio City, Pennyfoot St., Nottingham NG1 1GR, UK (F.C.); (A.J.)
| | - Roland Hjerpe
- Sygnature Discovery, Bio City, Pennyfoot St., Nottingham NG1 1GR, UK (F.C.); (A.J.)
| | - Manuel S. Rodriguez
- Laboratoire de Chimie de Coordination LCC-UPR 8241-CNRS, 31077 Toulouse, France; (C.B.); (M.S.R.)
- Pharmadev, UMR 152, Université de Toulouse, IRD, UT3, 31400 Toulouse, France
- B Molecular, Centre Pierre Potier, Canceropôle, 31106 Toulouse, France
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Freeman E, Patel D, Odeniyi F, Pasquinelli M, Jain S. Where Do Oncology Patients Seek and Share Health Information? Survey Study. J Med Internet Res 2024; 26:e36441. [PMID: 38526546 PMCID: PMC11002738 DOI: 10.2196/36441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/16/2023] [Accepted: 07/04/2023] [Indexed: 03/26/2024] Open
Affiliation(s)
- Eric Freeman
- College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Darshilmukesh Patel
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Folasade Odeniyi
- College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Mary Pasquinelli
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Shikha Jain
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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Lotze MT, Cottrell T, Bifulco C, Chow L, Cope L, Gnjatic S, Maecker HT, Yeong Poh Shen J. SITC Clinical Immuno-Oncology Network (SCION) commentary on measurement and interpretation of essential biomarkers in early clinical trials. J Immunother Cancer 2024; 12:e008655. [PMID: 38519056 PMCID: PMC10961490 DOI: 10.1136/jitc-2023-008655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 03/24/2024] Open
Abstract
Abstract
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Affiliation(s)
- Michael T Lotze
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tricia Cottrell
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
| | - Carlo Bifulco
- Providence Portland Medical Center, Portland, Oregon, USA
| | - Laura Chow
- The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Leslie Cope
- Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Sacha Gnjatic
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Holden T Maecker
- Stanford University School of Medicine, Stanford, California, USA
| | - Joe Yeong Poh Shen
- Division of Pathology, Singapore General Hospital, Singapore
- Institute of Molecular and Cell Biology (IMCB), A*STAR, Singapore
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Paul TK, Reddy Y, Gnanakumar A, England R, Superdock A, Malipeddi D, Wrigley J, Reardon E, Weaver MS, Kaye EC. Narrative medicine interventions for oncology clinicians: a systematic review. Support Care Cancer 2024; 32:241. [PMID: 38512594 DOI: 10.1007/s00520-024-08434-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE As narrative medicine interventions are integrated increasingly into medical practice, growing evidence indicates benefits for healthcare professionals. Presently, the prevalence and impact of narrative medicine interventions in the field of oncology remain unknown. This systematic review synthesizes published data on narrative medicine interventions in oncology and reports current knowledge on feasibility, acceptability, and impact on cancer care professionals. METHODS Following PRISMA guidelines, we searched Ovid Medline, Embase, Scopus, Web of Science, Cochrane, and ClinicalTrials.gov databases from inception through February 2024. Eligible articles were published in English and contained original data on feasibility, acceptability, and/or impact of a narrative medicine intervention for oncology professionals. Database searches identified 2614 deduplicated articles, from which 50 articles were identified for full-text assessment and 11 articles met inclusion criteria. Two additional articles were identified through manual review of references. RESULTS Thirteen articles described 12 unique narrative medicine interventions targeting cancer care professionals. All studies described their respective interventions as feasible, acceptable, and impactful for participants. Interventions involved writing, reading, reflection, and other narrative-based strategies. Standardized validated tools evaluated outcomes including burnout, empathy expression, secondary trauma, quality of humanistic care, and well-being. Participants reported appreciation of opportunities for reflection, perspective sharing, and bearing witness, which they perceived to strengthen wellness and community. CONCLUSION Narrative medicine interventions are feasible and acceptable and may bolster oncology clinicians' functioning across domains. Multi-site, prospective, randomized studies are needed to investigate the broader impact of narrative medicine interventions and advance the science of narrative medicine in oncology. TRIAL REGISTRATION ClinicalTrials.gov Identifier: CRD42022369432.
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Affiliation(s)
- Trisha K Paul
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA.
| | | | | | - Rebecca England
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Alexandra Superdock
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
| | | | - Jordan Wrigley
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
| | | | | | - Erica C Kaye
- Department of Oncology, Division of Quality of Life and Palliative Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 260, Memphis, TN, USA
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Alhajahjeh A, Abdulelah AA, Hmeidan M, Kakish D, Sukerji R, Qtaishat L, Awamlh B, Dobbs RW, Al Sukhun S, Laguna P, Shahait M. Gender inequality in genitourinary malignancies clinical trials leadership. World J Urol 2024; 42:174. [PMID: 38506931 DOI: 10.1007/s00345-024-04893-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Over the past 2 decades, there has been a growing interest in the significance of gender roles in healthcare and several efforts and initiatives have focused on increasing female representation in the medical field. Clinical trials play a very important role in shaping medical practice; moreover, the leaders of clinical trials often represent the upper echelon of researchers in any designated field. Presently, there is no data regarding women's representation in urological oncology clinical trials leadership. Therefore, the aim of this study is to examine the extent of female representation in leading urological clinical trials. METHODOLOGY To thoroughly examine the representation of females as principal investigators (PIs) in urological cancer clinical trials between 2000 and 2020, we conducted a comprehensive search of completed trials focused on kidney, prostate, and bladder cancer on ClinicalTrials.gov. We extracted relevant information regarding the PIs and analyzed the data using univariate analyses to identify any significant differences between male and female PIs. RESULTS A total of 9145 cancer clinical trials were conducted over the last 2 decades, and 11.3% (n = 1033) of them were urological cancer clinical trials. We were able to obtain detailed information about the principal investigators (PI) in 79.0% (n = 816) of the clinical trials, and we found that 16.8% (n = 137) of them were led by female investigators. Upon evaluating the characteristics of the PIs, female PIs had a significantly lower median age and median total citations as compared to male PIs (55.0 vs 59.0 and 5333 vs 7902; p-value < 0.001 and 0.006, respectively). However, there was no statistically significant difference between the termination rate, publication rate, funding source, cancer type, and the subject of conducting the clinical trials between male and female PIs. CONCLUSION Between 2000 and 2020, only 16.8% of urological cancer clinical trials were led by a female PI, perhaps reflective of a low percentage of senior female researchers in the fields of urology, oncology and radiation oncology. Universities, research institutes and funding agencies should work to improve mentorship, representation and opportunities for female investigators to encourage more involvement for female researchers in these clinical trials.
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Affiliation(s)
- Abdulrahman Alhajahjeh
- Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- University of Jordan; School of Medicine, Amman, Jordan
| | - Ahmed A Abdulelah
- Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | | | - Diala Kakish
- Department of Urology, Vanderbilt University Medical Center, A-1302 Medical Center Drive, Nashville, TN, 37232, USA
| | - Razan Sukerji
- Department of Urology, Vanderbilt University Medical Center, A-1302 Medical Center Drive, Nashville, TN, 37232, USA
| | - Leen Qtaishat
- University of Jordan; School of Medicine, Amman, Jordan
| | - Bashir Awamlh
- Department of Urology, Vanderbilt University Medical Center, A-1302 Medical Center Drive, Nashville, TN, 37232, USA
| | - Ryan W Dobbs
- Cook County Health & Hospitals System Chicago, Chicago, IL, 60612, USA
| | - Sana Al Sukhun
- Al Hyatt Oncology Practice, 40 Ibn Khaldoon St., Amman, 11183, Jordan
| | - Pilar Laguna
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
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Kachimanga C, McGlashan J, Cunningham N, Hoyle L. Communication to adult patients undergoing cancer care by non-specialist nurses: a scoping review protocol. BMJ Open 2024; 14:e081326. [PMID: 38508653 PMCID: PMC10961544 DOI: 10.1136/bmjopen-2023-081326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Little is known regarding how non-specialist nurses communicate with patients living with cancer when the patients are receiving care outside of their cancer units/teams. This scoping review aims to identify, examine and report on the currently available evidence about communication by non-specialist nurses when caring for adults living with cancer outside of their cancer care unit/teams. METHODS AND ANALYSIS A scoping review following the JBI methodology for scoping reviews will be conducted. We will search for empirical studies that meet the inclusion criteria in six databases (MEDLINE, PubMed, CINAHL, Embase, Scopus and PsycINFO). Handsearching in references of included articles will be performed to find additional articles. The population of interest will be non-specialist nurses. Three concepts will be explored, namely (1) all adult patients living with cancer, (2) a focus on three stages of the cancer continuum of care (cancer diagnosis, treatment and survivorship) and (3) a focus on communication between non-specialist nurses and patients living with cancer. We will include studies describing all healthcare settings outside patients' specialised cancer units or oncology teams. After article selection, two reviewers will independently screen titles and abstracts and perform a full-text article review, risk of bias assessments and data extraction. A third reviewer will resolve all disagreements. A narrative summary will provide an overview of how the results relate to the research aims and questions. The included articles will be limited to English and published between 2012 and 2023. ETHICS AND DISSEMINATION No ethical approval is required since we will use publicly available empirical research sources. This review will provide current research on communication by non-specialist nurses with patients with a cancer diagnosis outside of an oncology setting, evidence that will support effective communication. As such, we aim to disseminate the findings in academic conferences and peer-reviewed journals.
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Ramsey SD, Onar-Thomas A, Wheeler SB. Real-World Database Studies in Oncology: A Call for Standards. J Clin Oncol 2024; 42:977-980. [PMID: 38320235 DOI: 10.1200/jco.23.02399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 11/30/2023] [Indexed: 02/08/2024] Open
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Asfaw S, Matys S, Muluneh B. Targeted Drug Therapies: Beyond Blood Counts and Chemistries. Clin J Oncol Nurs 2024; 28:215-219. [PMID: 38511918 DOI: 10.1188/24.cjon.215-219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Although the field of oncology pharmacotherapy has progressed rapidly with the introduction of novel targeted therapies, there are many unintended side effects that require knowledge of laboratory monitoring for appropriate m.
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de Valois B, Young T, Zollman C, Appleyard I, Ben-Arye E, Cummings M, Green R, Hoffman C, Lacey J, Moir F, Peckham R, Stringer J, Veleber S, Weitzman M, Wode K. Acupuncture in cancer care: recommendations for safe practice (peer-reviewed expert opinion). Support Care Cancer 2024; 32:229. [PMID: 38483623 PMCID: PMC10940387 DOI: 10.1007/s00520-024-08386-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/16/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Up-to-date recommendations for the safe practice of acupuncture in integrative oncology are overdue with new cancer treatments and an increase in survivors with late effects of disease; 17 years have elapsed since Filshie and Hester's 2006 guidelines. During 2022/2023 an expert panel assembled to produce updated recommendations aiming to facilitate safe and appropriate care by acupuncturists working with people with cancer. METHODS A core development team comprising three integrative oncology professionals comprehensively updated pre-existing unpublished recommendations. Twelve invited international experts (senior acupuncturists with and without experience of working in oncology settings, oncologists, physicians and nurses trained in integrative oncology, researchers, academics, and professional body representatives) reviewed the recommendations. In multiple iterations, the core team harmonised comments for final ratification. To aid dissemination and uptake the panel represents national and international integrative oncology associations and major cancer treatment centres in Europe, USA, Australia, and the Middle East. RESULTS These recommendations facilitate safe care by articulating contra-indications, cautions, and risks for patients both on and off treatment (surgery, SACT, radiotherapy). Situations where acupuncture may be contra-indicated or practices need adapting are identified. "Red and Amber Flags" highlight where urgent referral is essential. CONCLUSION These are the first international, multidisciplinary peer-reviewed recommendations for safe acupuncture practice in integrative oncology. Concerns about safety remain a significant barrier to appropriate referral from oncology teams, to use by acupuncturists and to uptake by patients. Disseminating trustworthy, widely accessible guidance should facilitate informed, confident practice of acupuncture in and outside of oncology healthcare settings.
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Affiliation(s)
- Beverley de Valois
- Supportive Oncology Research Team (SORT), East and North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Northwood, Middlesex, UK.
| | - Teresa Young
- Supportive Oncology Research Team (SORT), East and North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Northwood, Middlesex, UK
| | | | | | | | - Mike Cummings
- British Medical Acupuncture Society, London Office, London, UK
| | - Ruth Green
- Imaging, Royal National Orthopaedic NHS Trust, Stanmore, Middlesex, UK
| | | | - Judith Lacey
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse Comprehensive Cancer Hospital, Sydney, NSW, Australia
| | | | | | | | - Susan Veleber
- Integrative Medicine, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Matthew Weitzman
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathrin Wode
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Metzcar J, Jutzeler CR, Macklin P, Köhn-Luque A, Brüningk SC. A review of mechanistic learning in mathematical oncology. Front Immunol 2024; 15:1363144. [PMID: 38533513 PMCID: PMC10963621 DOI: 10.3389/fimmu.2024.1363144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
Mechanistic learning refers to the synergistic combination of mechanistic mathematical modeling and data-driven machine or deep learning. This emerging field finds increasing applications in (mathematical) oncology. This review aims to capture the current state of the field and provides a perspective on how mechanistic learning may progress in the oncology domain. We highlight the synergistic potential of mechanistic learning and point out similarities and differences between purely data-driven and mechanistic approaches concerning model complexity, data requirements, outputs generated, and interpretability of the algorithms and their results. Four categories of mechanistic learning (sequential, parallel, extrinsic, intrinsic) of mechanistic learning are presented with specific examples. We discuss a range of techniques including physics-informed neural networks, surrogate model learning, and digital twins. Example applications address complex problems predominantly from the domain of oncology research such as longitudinal tumor response predictions or time-to-event modeling. As the field of mechanistic learning advances, we aim for this review and proposed categorization framework to foster additional collaboration between the data- and knowledge-driven modeling fields. Further collaboration will help address difficult issues in oncology such as limited data availability, requirements of model transparency, and complex input data which are embraced in a mechanistic learning framework.
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Affiliation(s)
- John Metzcar
- Intelligent Systems Engineering, Luddy School of Informatics, Computing, and Engineering, Bloomington, IN, United States
- Informatics, Luddy School of Informatics, Computing, and Engineering, Bloomington, IN, United States
| | - Catherine R. Jutzeler
- Department of Health Sciences and Technology (D-HEST), Eidgenössische Technische Hochschule Zürich (ETH), Zürich, Switzerland
- Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - Paul Macklin
- Intelligent Systems Engineering, Luddy School of Informatics, Computing, and Engineering, Bloomington, IN, United States
| | - Alvaro Köhn-Luque
- Oslo Centre for Biostatistics and Epidemiology, Faculty of Medicine, University of Oslo, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Sarah C. Brüningk
- Department of Health Sciences and Technology (D-HEST), Eidgenössische Technische Hochschule Zürich (ETH), Zürich, Switzerland
- Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
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Zhu C, Wu Q, Li Y, Da M. Research trends and hotspots of sleep disorder and cancer: a bibliometric analysis via VOSviewer and CiteSpace. Support Care Cancer 2024; 32:223. [PMID: 38472562 DOI: 10.1007/s00520-024-08425-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/05/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE The purpose of this research is to further understand the research status and summarize the research hotspots of sleep disorder and cancer, so as to provide insights into future researches. METHODS In this research, the publications pertaining to sleep disorders and cancer from 1992 to 2022 was retrieved from SCIE and SSCI databases in the Web of Science Core Collection. The subject, journal, country/regions, institutions, author, and citations of publications were descriptively analyzed and visual analysis. RESULTS From 1992 to December 2022, a total of 732 relevant literatures were retrieved from WOS SCIE and SSCI databases, the number of publications showed an increasing trend year by year. These articles were published in 252 journals, and the three most productive journals included Supportive Care in Cancer (80 publications), Psycho-oncology (32 publications), and Journal of Pain and Symptom Management (32 publications). The three most productive countries included the USA (367 publications, 50.1%), China (133 publications, 18.2%), and Canada (97 publications, 13.25%), with total citations of 12,684, 1866, and 5263. The three latest hot keywords in this field were sleep duration, validity, and inflammation. CONCLUSION The USA, China, and Canada produced a lot of literature in the research field of sleep disorders and cancer, and had relatively great academic influence from 1992 to 2022. Researchers could pay more attention to the published in journals such as Journal of Clinical Oncology, Sleep, and Supportive Care in Cancer to timely grasp the latest progress and expand the breadth and depth in this area. Looking at the history of tumor and sleep disorder research in the past 20 years, the clinical treatment of sleep disorder caused by tumor and the direct bidirectional mechanism of the two may be a new focus of future research.
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Affiliation(s)
- Chenglou Zhu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
| | - Qiong Wu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
| | - Yaoqi Li
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, China.
| | - Mingxu Da
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China.
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, China.
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Marshall AL, Masselink LE, Kouides PA, Davies FE, Farooqui A, Nagalla S, Herrera A, Mortier N, Brodsky R, Erikson CE. Advanced practice providers in hematology: actionable findings from national paired APP and physician surveys. Blood Adv 2024; 8:1179-1189. [PMID: 38127271 PMCID: PMC10910059 DOI: 10.1182/bloodadvances.2023011927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
ABSTRACT Advanced practice providers (APPs) are critical to the hematology workforce. However, there is limited knowledge about APPs in hematology regarding specialty-specific training, scope of practice, challenges and opportunities in APP-physician interactions, and involvement with the American Society of Hematology (ASH). We conducted APP and physician focus groups to elucidate major themes in these areas and used results to inform development of 2 national surveys, 1 for APPs and 1 for physicians who work with APPs. The APP survey was distributed to members of the Advanced Practitioner Society of Hematology and Oncology, and the physician survey was distributed to physician members of ASH. A total of 841 APPs and 1334 physicians completed the surveys. APPs reported most hematology-specific knowledge was obtained via on-the-job training and felt additional APP-focused training would be helpful (as did physicians). Nearly all APPs and physicians agreed that APPs were an integral part of their organizations and that physician-APP collaborations were generally positive. A total of 42.1% of APPs and 29.3% of physicians reported burnout, and >50% of physicians felt that working with APPs had reduced their burnout. Both physicians and APPs reported interest in additional resources including "best practice" guidelines for APP-physician collaboration, APP access to hematology educational resources (both existing and newly developed resources for physicians and trainees), and greater APP integration into national specialty-specific professional organizations including APP-focused sessions at conferences. Professional organizations such as ASH are well positioned to address these areas.
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Affiliation(s)
- Ariela L. Marshall
- Division of Hematology Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | - Leah E. Masselink
- Fitzhugh Mullan Institute for Health Workforce Equity, The George Washington University, Washington, DC
- Department of Health Policy and Management, George Washington University Milken Institute School of Public Health, Washington, DC
| | | | - Faith E. Davies
- Pearlmutter Cancer Center, New York University Langone Health, New York, NY
| | - Azam Farooqui
- Department of Hematology and Oncology, Ironwood Cancer & Research Centers, Chandler, AZ
| | | | - Alex Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, CA
| | - Nicole Mortier
- Sickle Cell Disease Clinical Trials Network, ASH Research Collaborative, Washington, DC
| | - Robert Brodsky
- Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Clese E. Erikson
- Fitzhugh Mullan Institute for Health Workforce Equity, The George Washington University, Washington, DC
- Department of Health Policy and Management, George Washington University Milken Institute School of Public Health, Washington, DC
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Hoier D, Groß-Ophoff-Müller C, Franklin C, Hallek M, von Stebut E, Elter T, Mauch C, Kreuzberg N, Koll P. Digital decision support for structural improvement of melanoma tumor boards: using standard cases to optimize workflow. J Cancer Res Clin Oncol 2024; 150:115. [PMID: 38457085 PMCID: PMC10923955 DOI: 10.1007/s00432-024-05627-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/18/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Choosing optimal cancer treatment is challenging, and certified cancer centers must present all patients in multidisciplinary tumor boards (MDT). Our aim was to develop a decision support system (DSS) to provide treatment recommendations for apparently simple cases already at conference registration and to classify these as "standard cases". According to certification requirements, discussion of standard cases is optional and would thus allow more time for complex cases. METHODS We created a smartphone query that simulated a tumor conference registration and requested all information needed to provide a recommendation. In total, 111 out of 705 malignant melanoma cases discussed at a skin cancer center from 2017 to 2020 were identified as potential standard cases, for which a digital twin recommendation was then generated by DSS. RESULTS The system provided reliable advice in all 111 cases and showed 97% concordance of MDT and DSS for therapeutic recommendations, regardless of tumor stage. Discrepancies included two cases (2%) where DSS advised discussions at MDT and one case (1%) with deviating recommendation due to advanced patient age. CONCLUSIONS Our work aimed not to replace clinical expertise but to alleviate MDT workload and enhance focus on complex cases. Overall, our DSS proved to be a suitable tool for identifying standard cases as such, providing correct treatment recommendations, and thus reducing the time burden of tumor conferences in favor for the comprehensive discussion of complex cases. The aim is to implement the DSS in routine tumor board software for further qualitative assessment of its impact on oncological care.
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Affiliation(s)
- David Hoier
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | | | - Cindy Franklin
- Department of Dermatology and Venereology, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Esther von Stebut
- Department of Dermatology and Venereology, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Thomas Elter
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Cornelia Mauch
- Department of Dermatology and Venereology, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Nicole Kreuzberg
- Department of Dermatology and Venereology, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Philipp Koll
- Department of Dermatology and Venereology, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Van Loon K, Breithaupt L, Ng D, DeBoer RJ, Buckle GC, Bialous S, Hiatt RA, Volberding P, Hermiston ML, Ashworth A. A roadmap to establishing global oncology as a priority initiative within a National Cancer Institute-designated cancer center. J Natl Cancer Inst 2024; 116:345-351. [PMID: 38060289 PMCID: PMC10919326 DOI: 10.1093/jnci/djad255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/06/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023] Open
Abstract
As the burden of cancers impacting low- and middle-income countries is projected to increase, formation of strategic partnerships between institutions in high-income countries and low- and middle-income country institutions may serve to accelerate cancer research, clinical care, and training. As the US National Cancer Institute and its Center for Global Health continue to encourage cancer centers to join its global mission, academic cancer centers in the United States have increased their global activities. In 2015, the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco, responded to the call for international partnership in addressing the global cancer burden through the establishment of the Global Cancer Program as a priority initiative. In developing the Global Cancer Program, we galvanized institutional support to foster sustained, bidirectional, equitable, international partnerships in global cancer control. Our focus and intent in disseminating this commentary is to share experiences and lessons learned from the perspective of a US-based, National Cancer Institute-designated cancer center and to provide a roadmap for other high-income institutions seeking to strategically broaden their missions and address the complex challenges of global cancer control. Herein, we review the formative evaluation, governance, strategic planning, investments in career development, funding sources, program evaluation, and lessons learned. Reflecting on the evolution of our program during the first 5 years, we observed in our partners a powerful shift toward a locally driven priority setting, reduced dependency, and an increased commitment to research as a path to improve cancer outcomes in resource-constrained settings.
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Affiliation(s)
- Katherine Van Loon
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Lindsay Breithaupt
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Dianna Ng
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Pathology, UCSF, San Francisco, CA, USA
| | - Rebecca J DeBoer
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Geoffrey C Buckle
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Stella Bialous
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- School of Nursing, UCSF, San Francisco, CA, USA
| | - Robert A Hiatt
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA
| | - Paul Volberding
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA
| | - Michelle L Hermiston
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, UCSF, San Francisco, CA, USA
| | - Alan Ashworth
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, Division of Hematology/Oncology, UCSF, San Francisco, CA, USA
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Baksh F, Carvalho F. The experiences of patients using a cancer hotline service. Br J Nurs 2024; 33:S12-S15. [PMID: 38446506 DOI: 10.12968/bjon.2024.33.5.s12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND The present study aimed to evaluate oncology patients' experiences with a hotline service in a tertiary cancer centre, identifying areas for local improvement and to inform the work of the hotline. METHODS A link to an online platform to complete a survey was sent through bulk messaging to 3028 mobile numbers. The survey answers and results were saved and consolidated in the online platform. FINDINGS The survey received 368 responses: 49% of participants had their calls answered within 10 minutes, while 18% (n=66) waited 30 minutes or more. Eighty-two per cent were satisfied with the length of time they waited to speak with a nurse and 71% reported that their overall experience was very good. Ninety-seven per cent of participants felt listened to and were offered support and 91% felt that their reason for calling was adequately addressed. CONCLUSION The present study offers persuasive evidence indicating that oncology patients are largely satisfied with the hotline service; nonetheless, it is recognised that a more robust evaluation is needed. Regardless, the need for certain improvements has been identified to offer the potential to enhance patients' experience.
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Affiliation(s)
- Farzana Baksh
- Matron for Centre for Urgent Care, Acute Oncology Service, The Royal Marsden Macmillan Hotline and Pleural Specialist Nurses, The Royal Marsden NHS Foundation Trust, London
| | - Filipe Carvalho
- Nurse Consultant in Colorectal Disease, Homerton Healthcare NHS Foundation Trust, London
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Alqudimat MR, Toupin April K, Jibb L, Victor C, Nathan PC, Stinson J. Assessment of complementary health approaches use in pediatric oncology: Modification and preliminary validation of the "Which Health Approaches and Treatments Are You Using?" (WHAT) questionnaires. PLoS One 2024; 19:e0294393. [PMID: 38446765 PMCID: PMC10917275 DOI: 10.1371/journal.pone.0294393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 11/01/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE Complementary Health Approaches (CHA) are commonly used by children with cancer; however, a few health care providers (HCPs) inquire about the use of CHA. A standardized questionnaire could facilitate such clinical discussions. We aimed to adapt and determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT) child and parent-report questionnaires in pediatric oncology. METHODS An electronic Delphi survey that included children with cancer (8-18 years), parents, and HCPs and CHA researchers was conducted to reach consensus on the content of the WHAT questionnaires in pediatric oncology. Children and parents from the Hospital for Sick Children (SickKids), and HCPs and researchers from the International Society of Pediatric Oncology and Pediatric Complementary and Alternative Medicine Research and Education Network completed the survey. To determine the face and content validity of the questionnaires, two iterative cycles of individual interviews were conducted with purposive samples of children (8-18 years), parents, and HCPs from SickKids. RESULTS Consensus was reached on all domains and items of the original WHAT questionnaires after one Delphi cycle (n = 61). For face and content validity testing, the first cycle of interviews (n = 19) revealed that the questionnaires were mostly comprehensive and relevant. However, the paper-based format of the original WHAT was not user-friendly, and generic items were vague and not aimed at facilitating clinical dialogues about CHA use. The WHAT questionnaires were then modified into electronic cancer-specific self- and proxy-report questionnaires including 13 and 15 items, respectively. The second cycle (n = 21) showed no need for further changes. CONCLUSIONS The modified electronic cancer-specific WHAT questionnaires showed adequate face and content validity. The next step is to determine inter-rater reliability, construct validity, and feasibility of administration of the modified WHAT questionnaires in pediatric oncology.
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Affiliation(s)
- Mohammad R. Alqudimat
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluation Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karine Toupin April
- School of Rehabilitation Sciences and Department of Pediatrics, Children’s Hospital of Eastern Ontario Research Institute and Institute du Savoir Montfort, University of Ottawa, Ottawa, Ontario, Canada
| | - Lindsay Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluation Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Charles Victor
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Paul C. Nathan
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Stinson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluation Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
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Ermshaus A, Piechotta M, Rüter G, Keilholz U, Leser U, Benary M. preon: Fast and accurate entity normalization for drug names and cancer types in precision oncology. Bioinformatics 2024; 40:btae085. [PMID: 38383060 PMCID: PMC10918631 DOI: 10.1093/bioinformatics/btae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 02/23/2024] Open
Abstract
MOTIVATION In precision oncology (PO), clinicians aim to find the best treatment for any patient based on their molecular characterization. A major bottleneck is the manual annotation and evaluation of individual variants, for which usually a range of knowledge bases are screened. To incorporate and integrate the vast information of different databases, fast and accurate methods for harmonizing databases with different types of information are necessary. An essential step for harmonization in PO includes the normalization of tumor entities as well as therapy options for patients. SUMMARY preon is a fast and accurate library for the normalization of drug names and cancer types in large-scale data integration. AVAILABILITY AND IMPLEMENTATION preon is implemented in Python and freely available via the PyPI repository. Source code and the data underlying this article are available in GitHub at https://github.com/ermshaua/preon/.
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Affiliation(s)
- Arik Ermshaus
- Institute for Computer Science, Humboldt-Universität zu Berlin, Berlin 10099, Germany
| | - Michael Piechotta
- Institute for Computer Science, Humboldt-Universität zu Berlin, Berlin 10099, Germany
| | - Gina Rüter
- Charite Comprehensive Cancer Center, Charite—Universitätsmedizin Berlin, Berlin 10115, Germany
| | - Ulrich Keilholz
- Charite Comprehensive Cancer Center, Charite—Universitätsmedizin Berlin, Berlin 10115, Germany
| | - Ulf Leser
- Institute for Computer Science, Humboldt-Universität zu Berlin, Berlin 10099, Germany
| | - Manuela Benary
- Charite Comprehensive Cancer Center, Charite—Universitätsmedizin Berlin, Berlin 10115, Germany
- Core Unit Bioinformatics (CUBI), Berlin Institute of Health, Charite—Universitätsmedizin Berlin, Berlin 10115, Germany
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Griessbach A, Schönenberger CM, Taji Heravi A, Gloy V, Agarwal A, Hallenberger TJ, Schandelmaier S, Janiaud P, Amstutz A, Covino M, Mall D, Speich B, Briel M. Characteristics, Progression, and Output of Randomized Platform Trials: A Systematic Review. JAMA Netw Open 2024; 7:e243109. [PMID: 38506807 PMCID: PMC10955344 DOI: 10.1001/jamanetworkopen.2024.3109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/24/2024] [Indexed: 03/21/2024] Open
Abstract
Importance Platform trials have become increasingly common, and evidence is needed to determine how this trial design is actually applied in current research practice. Objective To determine the characteristics, progression, and output of randomized platform trials. Evidence Review In this systematic review of randomized platform trials, Medline, Embase, Scopus, trial registries, gray literature, and preprint servers were searched, and citation tracking was performed in July 2022. Investigators were contacted in February 2023 to confirm data accuracy and to provide updated information on the status of platform trial arms. Randomized platform trials were eligible if they explicitly planned to add or drop arms. Data were extracted in duplicate from protocols, publications, websites, and registry entries. For each platform trial, design features such as the use of a common control arm, use of nonconcurrent control data, statistical framework, adjustment for multiplicity, and use of additional adaptive design features were collected. Progression and output of each platform trial were determined by the recruitment status of individual arms, the number of arms added or dropped, and the availability of results for each intervention arm. Findings The search identified 127 randomized platform trials with a total of 823 arms; most trials were conducted in the field of oncology (57 [44.9%]) and COVID-19 (45 [35.4%]). After a more than twofold increase in the initiation of new platform trials at the beginning of the COVID-19 pandemic, the number of platform trials has since declined. Platform trial features were often not reported (not reported: nonconcurrent control, 61 of 127 [48.0%]; multiplicity adjustment for arms, 98 of 127 [77.2%]; statistical framework, 37 of 127 [29.1%]). Adaptive design features were only used by half the studies (63 of 127 [49.6%]). Results were available for 65.2% of closed arms (230 of 353). Premature closure of platform trial arms due to recruitment problems was infrequent (5 of 353 [1.4%]). Conclusions and Relevance This systematic review found that platform trials were initiated most frequently during the COVID-19 pandemic and declined thereafter. The reporting of platform features and the availability of results were insufficient. Premature arm closure for poor recruitment was rare.
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Affiliation(s)
- Alexandra Griessbach
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christof Manuel Schönenberger
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ala Taji Heravi
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Viktoria Gloy
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Arnav Agarwal
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Stefan Schandelmaier
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Perrine Janiaud
- Pragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Alain Amstutz
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Manuela Covino
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - David Mall
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Benjamin Speich
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias Briel
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Sherry AD, Hahn AW, McCaw ZR, Abi Jaoude J, Kouzy R, Lin TA, Minsky B, Fuller CD, Meirson T, Msaouel P, Ludmir EB. Differential Treatment Effects of Subgroup Analyses in Phase 3 Oncology Trials From 2004 to 2020. JAMA Netw Open 2024; 7:e243379. [PMID: 38546648 PMCID: PMC10979321 DOI: 10.1001/jamanetworkopen.2024.3379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/04/2024] [Indexed: 04/01/2024] Open
Abstract
Importance Subgroup analyses are often performed in oncology to investigate differential treatment effects and may even constitute the basis for regulatory approvals. Current understanding of the features, results, and quality of subgroup analyses is limited. Objective To evaluate forest plot interpretability and credibility of differential treatment effect claims among oncology trials. Design, Setting, and Participants This cross-sectional study included randomized phase 3 clinical oncology trials published prior to 2021. Trials were screened from ClinicalTrials.gov. Main Outcomes and Measures Missing visual elements in forest plots were defined as a missing point estimate or use of a linear x-axis scale for hazard and odds ratios. Multiplicity of testing control was recorded. Differential treatment effect claims were rated using the Instrument for Assessing the Credibility of Effect Modification Analyses. Linear and logistic regressions evaluated associations with outcomes. Results Among 785 trials, 379 studies (48%) enrolling 331 653 patients reported a subgroup analysis. The forest plots of 43% of trials (156 of 363) were missing visual elements impeding interpretability. While 4148 subgroup effects were evaluated, only 1 trial (0.3%) controlled for multiple testing. On average, trials that did not meet the primary end point conducted 2 more subgroup effect tests compared with trials meeting the primary end point (95% CI, 0.59-3.43 tests; P = .006). A total of 101 differential treatment effects were claimed across 15% of trials (55 of 379). Interaction testing was missing in 53% of trials (29 of 55) claiming differential treatment effects. Trials not meeting the primary end point were associated with greater odds of no interaction testing (odds ratio, 4.47; 95% CI, 1.42-15.55, P = .01). The credibility of differential treatment effect claims was rated as low or very low in 93% of cases (94 of 101). Conclusions and Relevance In this cross-sectional study of phase 3 oncology trials, nearly half of trials presented a subgroup analysis in their primary publication. However, forest plots of these subgroup analyses largely lacked essential features for interpretation, and most differential treatment effect claims were not supported. Oncology subgroup analyses should be interpreted with caution, and improvements to the quality of subgroup analyses are needed.
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Affiliation(s)
- Alexander D. Sherry
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Andrew W. Hahn
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Zachary R. McCaw
- Insitro, South San Francisco, San Francisco, California
- Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Joseph Abi Jaoude
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Ramez Kouzy
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Timothy A. Lin
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bruce Minsky
- Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - C. David Fuller
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Tomer Meirson
- Davidoff Cancer Center, Rabin Medical Center, Petach Tikva, Israel
| | - Pavlos Msaouel
- Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston
- Department of Translational Molecular Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Ethan B. Ludmir
- Department of Gastrointestinal Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
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140
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Wahlen S, Breuing J, Becker M, Bühn S, Hauprich J, Könsgen N, Meyer N, Blödt S, Carl G, Follmann M, Frenz S, Langer T, Nothacker M, Schaefer C, Pieper D. Use, applicability, and dissemination of patient versions of clinical practice guidelines in oncology in Germany: a qualitative interview study with healthcare providers. BMC Health Serv Res 2024; 24:272. [PMID: 38439061 PMCID: PMC10913627 DOI: 10.1186/s12913-024-10626-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND People with cancer have high information needs; however, they are often inadequately met. Patient versions of clinical practice guidelines (PVGs), a special form of evidence-based information, translate patient-relevant recommendations from clinical practice guidelines into lay language. To date, little is known about the experience of PVGs from healthcare providers' perspective in healthcare. This study aims to investigate the use, applicability, and dissemination of PVGs in oncology from the healthcare providers' perspective in Germany. METHODS Twenty semi-structured telephone interviews were conducted with oncological healthcare providers in Germany between October and December 2021. Interviews were recorded and transcribed verbatim. Mayring's qualitative content analysis with MAXQDA software was utilised to analyse the data. RESULTS A total of 20 healthcare providers (14 female, 6 male), mainly working as psychotherapists/psycho-oncologists and physicians, participated. Most participants (75%) were aware of the existence of PVGs. The content was predominantly perceived as comprehensible and relevant, whereas opinions on the design and format were mixed. The perceived lack of up-to-date information limited participants' trust in the content. Most felt that PVGs positively impact healthcare owing to the fact that they improve patients' knowledge about their disease. Additionally, PVGs served as a guide and helped healthcare providers structure physician-patient talks. Healthcare provider's unawareness of the existence of PVGs was cited as an obstructive factor to its dissemination to patients. CONCLUSION Limited knowledge of the existence of PVGs among healthcare providers, coupled with alternative patient information, hinders the use and dissemination of PVGs in healthcare. However, the applicability of PVGs seemed to be acceptable owing to their content and good comprehensibility, especially with respect to physician-patient communication.
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Affiliation(s)
- Sarah Wahlen
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
| | - Jessica Breuing
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Monika Becker
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Stefanie Bühn
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Julia Hauprich
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Nadja Könsgen
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Nora Meyer
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
| | - Susanne Blödt
- Institute for Medical Knowledge Management c/o Philipps University Marburg, Association of the Scientific Medical Societies in Germany, Marburg/Berlin, Germany
| | - Günther Carl
- German Prostate Cancer Support Group, Bonn, Germany
| | - Markus Follmann
- Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany
| | - Stefanie Frenz
- Frauenselbsthilfe Krebs-Bundesverband e.V., Bonn, Germany
| | - Thomas Langer
- Office of the German Guideline Program in Oncology (GGPO), c/o German Cancer Society, Berlin, Germany
| | - Monika Nothacker
- Institute for Medical Knowledge Management c/o Philipps University Marburg, Association of the Scientific Medical Societies in Germany, Marburg/Berlin, Germany
| | | | - Dawid Pieper
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health System Research, Rüdersdorf, Germany
- Centre for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf, Germany
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141
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Yoon NR, Na YJ, Lee JH, Song I, Lee EK, Park MH. Evaluation of changes in the clinical benefits of oncology drugs over time following reimbursement using the ASCO-VF and the ESMO-MCBS. J Cancer Res Clin Oncol 2024; 150:113. [PMID: 38436796 PMCID: PMC10912263 DOI: 10.1007/s00432-023-05587-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/22/2023] [Indexed: 03/05/2024]
Abstract
PURPOSE This study aims to estimate changes in the value of oncology drugs over time from initial data of the reimbursement decisions to subsequent publications in Korea, using two value frameworks. METHODS We retrieved primary publications assessed for reimbursement between 2007 and July 2021 from the decision documents of Health Insurance Review and Assessment and subsequent publications made available following reimbursement decision from ClinicalTrials.Gov and PubMed databases. Changes in the clinical benefit scores were assessed using the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). A paired t test was performed to test whether there was a difference in the scores between primary and subsequent publications. RESULTS Of 73 anticancer product/indication pairs, 45 (61.6%) had subsequent publications, of which 62.5% were released within 1 year of reimbursement decision. The mean ESMO-MCBS and ASCO-VF Net Health Benefit scores increased from primary to subsequent publications, although the differences were not significant. The mean ASCO-VF bonus score significantly increased from 15.91 to 19.09 (p = 0.05). The ESMO-MCBS and bonus scores increased by 0.25 and 0.21, respectively, and the bonus score had a greater impact on the ESMO-MCBS score than the preliminary score did. CONCLUSION The value of drugs demonstrated in subsequent publications varies considerably among oncology drugs, depending on uncertainty associated with the initial evidence and the availability of updated evidence. As decision-making in the face of uncertainty becomes more prevalent, the value frameworks can serve as simple screening tools for re-evaluation in these cases.
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Affiliation(s)
- Na Ri Yoon
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Young Jin Na
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Jong Hwan Lee
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Inmyung Song
- College of Nursing and Health, Kongju National University, 56 Gongjudaehak-ro, Gongju, Republic of Korea
| | - Eui-Kyung Lee
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea.
| | - Mi-Hai Park
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, Republic of Korea.
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142
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Mac Eochagain C, Barrell A, Murphy J, Pattwell M, Cumming J, Slavova-Boneva V, Edmondson A, Ring A, Battisti NML. "What matters to you?" Patient-reported treatment goals in geriatric oncology: A cross-sectional survey. J Geriatr Oncol 2024; 15:101641. [PMID: 37813781 DOI: 10.1016/j.jgo.2023.101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Affiliation(s)
| | - Anne Barrell
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jane Murphy
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Megan Pattwell
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | | | - Alistair Ring
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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143
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Singer EA. "Published abstracts from the 24th Annual Meeting of the Society of Urologic Oncology". Urol Oncol 2024; 42S:S1. [PMID: 38320934 DOI: 10.1016/j.urolonc.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Affiliation(s)
- Eric A Singer
- The Ohio State University Comprehensive Cancer Center, Columbus, OH.
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144
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Mehler-Klamt AC, Naegele M, Lippach K. [Assessments in the initial nursing consultation-starting point for interprofessional cooperation in oncology]. Urologie 2024; 63:288-294. [PMID: 38416169 DOI: 10.1007/s00120-024-02299-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Most oncology patients are not adequately screened for symptoms during the admission process. As a result, their needs are not properly assessed and included in their treatment. OBJECTIVE To investigate which assessments are already used by different nursing, medical, and social services at oncology centers and how these could be centralized in order to include the different services involved in the care of patients in a bundled way. MATERIALS AND METHODS Interviews were conducted with nursing, medical, and social services of an oncology center. Hereby, a main focus was put on their individual screenings. Furthermore, the special features of the services for oncological patients were elaborated. RESULTS AND CONCLUSION Symptom assessments are currently only performed if the nursing, medical, or social service concerned is actively involved in the care of the patient. This usually happens only once a problem arises. This could be counteracted by a needs and requirements analysis integrated into the admission process, in which the assessments are used in a bundled manner. In this way, a comprehensive picture of the individual could be created even before a problem arises. Based on the analysis by nursing experts, the various nursing, medical, and social services could then be involved in the care of the patient right at the start of treatment. This would significantly improve the quality of care for patients.
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Affiliation(s)
- A C Mehler-Klamt
- Institut für Pflegewissenschaft, LMU Klinikum München, Marchinoninistr. 15, 81377, München, Deutschland.
| | - M Naegele
- Netzwerk Onkologie, Kantonsspital St. Gallen, St. Gallen, Schweiz
- Zertifizierungs-AG der Konferenz onkologischer Krankenpflege (KOK), Berlin, Deutschland
| | - K Lippach
- Institut für Pflegewissenschaft, LMU Klinikum München, Marchinoninistr. 15, 81377, München, Deutschland
- Zertifizierungs-AG der Konferenz onkologischer Krankenpflege (KOK), Berlin, Deutschland
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145
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Abu Rous F, Desai A, Singhi EK. Clinical Trials for Patients With Cancer. JAMA Oncol 2024; 10:416. [PMID: 38270965 DOI: 10.1001/jamaoncol.2023.5778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
This JAMA Oncology Patient Page explains clinical trials and what patients should consider regarding enrollment.
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Affiliation(s)
- Fawzi Abu Rous
- Hematology/Oncology, Henry Ford Hospital, Detroit, Michigan
| | - Aakash Desai
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham
| | - Eric K Singhi
- Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
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146
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Jacobs MF, Goldman JW, Austin S, Koeppe ES, Murad AM, Koschmann CJ, Chinnaiyan AM, Mody RJ. Family Recall of and Response to Germline Pathologic Variants Found on Paired Tumor-Germline Sequencing in Pediatric Oncology. JCO Precis Oncol 2024; 8:e2300539. [PMID: 38484211 PMCID: PMC10954074 DOI: 10.1200/po.23.00539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 03/19/2024] Open
Abstract
PURPOSE Paired tumor-germline sequencing can identify somatic variants for targeted therapy and germline pathogenic variants (GPVs) causative of hereditary cancer/tumor predisposition syndromes. It is unknown how patients/families in pediatric oncology use information about an identified GPV. We assessed recall of germline results and actions taken on the basis of findings. METHODS We completed phone surveys with patients (and/or their parent) with GPVs identified via a single academic medical center's paired tumor-germline sequencing study. Seven hundred forty pediatric (aged 0-25 years) oncology patients were enrolled in this sequencing study between May 2012 and August 2021. Ninety-six participants (13.0%) had at least one GPV identified and were therefore eligible for this survey. The parent/guardian (for patients younger than 18 years or deceased patients) or patients themselves (if 18 years or older) were contacted. Survey topics included germline result recall, experience with genetic counseling, changes to patient's cancer treatment/screening, sharing of results with family members, and lifestyle changes. RESULTS Fifty-three surveys (response rate, 55.2%) were completed between October 2021 and June 2022. Thirty-seven (69.8%) respondents correctly recalled the identified GPV. Discussing results with a genetic counselor (P = .0001), having a GPV related to the cancer/tumor diagnosis (P = .002), and non-Hispanic White race/ethnicity (P = .02) were associated with accurate recall. Twenty-five respondents (47.2%) reported a change in the child's cancer treatment and/or screening recommendations, 17 respondents (32.1%) made a lifestyle change on the basis of the results, and 44 respondents (83.0%) shared results with at least one family member. CONCLUSION While most respondents remembered that a GPV was identified in the patient, some did not recall having a GPV found, and others recalled germline findings incorrectly. Future work may determine patient/family preferences for timing/method of result return to optimize patient recall and use of germline results.
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Affiliation(s)
- Michelle F. Jacobs
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | | | - Sarah Austin
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | - Erika S. Koeppe
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | | | | | - Arul M. Chinnaiyan
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI
| | - Rajen J. Mody
- Department of Pediatrics, University of Michigan, Ann Arbor, MI
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147
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Koole SN, Huisman AH, Timmers L, Westgeest HM, van Breugel E, Sonke GS, van Waalwijk van Doorn-Khosrovani SB. Lessons learned from postmarketing withdrawals of expedited approvals for oncology drug indications. Lancet Oncol 2024; 25:e126-e135. [PMID: 38423058 DOI: 10.1016/s1470-2045(23)00592-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 03/02/2024]
Abstract
In the past decade, there have been a record number of oncology therapy approvals by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Besides the EMA's conditional marketing authorisation programme and the FDA's Accelerated Approval Program, we observe a tendency towards fast approval for exploratory studies with non-randomised, uncontrolled designs and surrogate endpoints. This issue raises concerns about the robustness and effectiveness of accepted treatments, leaving patients and health-care professionals in a state of uncertainty. A substantial number of accelerated approvals have recently been withdrawn in the USA, with some still authorised in Europe, emphasising discrepancies in regulatory standards that affect both patients and society as a whole. We highlight examples of drugs, authorised on the basis of surrogate endpoints, that were later withdrawn due to an absence of overall survival benefit. Our findings address the challenges and consequences of accelerated approval pathways in oncology. In conclusion, this Policy Review calls for regulatory bodies to better align their procedures and insist on robust evidence, preferably through unbiased randomised controlled trials. Drug approval processes should prioritise patient benefit, overall survival, and quality of life to minimise risks and uncertainties for patients.
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Affiliation(s)
- Simone N Koole
- Medical Advisory Department, ONVZ Health Insurance, Houten, Netherlands.
| | | | - Lonneke Timmers
- Care Department, National Health Care Institute, Diemen, Netherlands
| | - Hans M Westgeest
- Department of Internal Medicine, Amphia Hospital, Breda, Netherlands
| | - Edwin van Breugel
- Medical Advisory Department, VGZ Health Insurance, Arnhem, Netherlands
| | - Gabe S Sonke
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
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148
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Steinhoff T, Guyer D, Almhanna K. Is every psychiatrist an oncology psychiatrist?-Special needs for special populations: a scoping review. Ann Palliat Med 2024; 13:287-300. [PMID: 38199800 DOI: 10.21037/apm-22-1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/20/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND The evolution of psychiatric care for patients with cancer has played out over the last century. The first collaboration of psychiatry, oncology surgery, and radiation-oncology occurred in the mid-1950s and represented the early seeds of psycho-oncology. The role of a psychiatrist specializing in treating patients with cancer, a psychosocial oncologist or psycho-oncologist, spans the care continuum from prevention to end of life. The specific needs of patients with gastrointestinal (GI) malignancies range from management of anxiety and depression to focused management for adjustment to an ostomy to sexual dysfunction to treatment in the face of a neuroendocrine tumor (NET). METHODS This is a scoping review; we compiled and summarized psychiatric illnesses commonly encountered in care of patients with cancer in addition to unique GI oncology-related issues. We conducted an electronic PubMed search between 1990-2022. We are presenting the data and providing our insight into psychosocial oncology care for this special population. RESULTS The field of psycho-oncology is relatively new. We failed to identify any randomized prospective studies, the majority of the studies were retrospective or longitudinal. The majority of the publications were in the form of review. We reviewed the GI literature to identify the psychological impact of ostomies, sexual impairment and metabolically active NETs. We provide suggested treatment interventions targeting the biological, psychological, and social aspects of patient and family lives. CONCLUSIONS The role of a psychosocial oncologist as part of the collaborative multidisciplinary treatment team provides nuanced care with attention to unique cancer-related issues that arise during the disease course. The psycho-oncologist brings expertise in combining targeted therapeutic strategies with pharmacologic interventions to address the multi-dimensional symptomatology patients experience. Using a layered approach, patients with mild symptoms can be supported by the general team, while those with moderate to severe symptoms require specialty psychiatric consultation.
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Affiliation(s)
- Timothy Steinhoff
- Lifespan Cancer Institute, Providence, RI, USA; The Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry and Human Behavior, Lifespan, Providence, RI, USA
| | - Dana Guyer
- Lifespan Cancer Institute, Providence, RI, USA; The Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Palliative Care and Hospice Medicine, Lifespan, Providence, RI, USA
| | - Khaldoun Almhanna
- Lifespan Cancer Institute, Providence, RI, USA; The Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Oncology, Lifespan, Providence, RI, USA
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149
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Massaccesi M, Fontana A, Palumbo I, Argenone A, De Santis MC, Masiello V, Pontoriero A, Ciabattoni A. Pattern of practice of re-irradiation for ipsilateral breast tumor recurrence in Italy: a survey by the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Clin Transl Oncol 2024; 26:644-652. [PMID: 37515701 DOI: 10.1007/s12094-023-03289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE The Re-irradiation and the Breast Cancer Working Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) conducted a survey to provide an overview of the policies for breast cancer (BC) re-irradiation (re-RT) among the Italian radiotherapy (RT) centers. METHODS In October 2021, 183 RT centers were invited to answer a survey: after an initial section about general aspects, the questionnaire focused on radiation oncologists' (ROs) attitude toward re-RT in three different scenarios: ipsilateral breast tumor recurrence (IBTR) treated with second conservative surgery, IBTR treated with mastectomy and inoperable IBTR. Surveyed ROs were also asked to express their interest in being involved in a prospective trials. RESULTS Seventy-seven/183 (42.0%) centers answered the Survey, only one RO per center was requested to answer. In particular, 86.5% ROs declared to have performed "curative" re-RT for IBTR during the previous two years (2019-2020): 76.7% respondents administered re-RT after second BCS, 50.9% after mastectomy, and 48.1% for inoperable IBTR. Re-RT practice varied widely among centers in terms of treatment volumes, dose and fractionation schedules, techniques and dose-volume constraints for organs at risks (OARs). Forty-six participants (59.7%) expressed their interest in participating in a prospective study investigating BC re-RT. CONCLUSIONS About one out of three RT centers in Italy delivered re-RT for IBTR. Nevertheless, practice of re-RT varied widely among centers highlighting the needs for prospective studies to improve knowledge in this field.
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Affiliation(s)
- Mariangela Massaccesi
- Radiation Oncology Unit, Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Antonella Fontana
- Radiotherapy Department, Santa Maria Goretti Hospital, Latina, Italy
| | - Isabella Palumbo
- Radiation Oncology Section, Department of Medicine and Surgery, Sant'Andrea delle Fratte, University of Perugia and Perugia General Hospital, 06156, Perugia, Italy.
| | | | - Maria Carmen De Santis
- Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Valeria Masiello
- Radiation Oncology Unit, Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Antonio Pontoriero
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
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150
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Pawar VV, Farooqui S. Revolutionizing oral oncology: The role of artificial intelligence. Oral Oncol 2024; 150:106702. [PMID: 38271777 DOI: 10.1016/j.oraloncology.2024.106702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 01/27/2024]
Affiliation(s)
- Vikas V Pawar
- Dr. D. Y. Patil Vidyapeeth, Centre for Online Learning Sant-Tukaram Nagar, Pimpri, Pune 411018, MH, India.
| | - Safia Farooqui
- Dr. D. Y. Patil Vidyapeeth, Centre for Online Learning Sant-Tukaram Nagar, Pimpri, Pune 411018, MH, India
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