Pub Date : 2024-06-01DOI: 10.1016/j.esmorw.2024.100045
H. Jourdain , I. Mansouri , A. Di Meglio , M. Zureik , N. Haddy
Background
Trastuzumab emtansine (T-DM1), the first antibody–drug conjugate targeting human epidermal growth factor receptor 2 (HER2), has provided new alternatives for metastatic breast cancer (mBC) treatment, and for early-stage breast cancer (esBC) since 2020. We characterized T-DM1 users and assessed the risk of hospitalisation for certain adverse events.
Materials and methods
Using data from the French National Health Data System (SNDS), we identified patients receiving T-DM1 from 2014 to 2022. Sociodemographic data, medical history, and overall survival were described by indication. The risk of adverse event-related hospitalisation was quantified.
Results
We included 12 822 patients initiating T-DM1 treatment in the study: 9232 (72%) with mBC (median age: 59 years, 54.6% with at least one comorbid condition) and 3590 (28%) with esBC (median age: 54 years, 33.9% with at least one comorbid condition). In mBC, median overall survival was 32.6 months, showing a gradual improvement over the years. At 1 year, 75.8% of patients had discontinued treatment and 22.0% had died. Patients in the study faced higher hospitalisation risks than those with incident breast cancer, with increases of 5.7 and 10.5 times for thrombocytopenia, 3.0 and 4.5 times for interstitial lung disease, 3.3 and 5.9 times for acute liver injury, and 2.3 and 7.3 times for sepsis, for esBC and mBC, respectively.
Conclusions
Real-world T-DM1 users frequently present with comorbid conditions and prior treatments, with a higher risk of hospitalisation for severe toxicity events than the general population of incident breast cancers. This study highlights the importance of monitoring treated patients to manage the risk of toxicity and prevent treatment discontinuation.
{"title":"Utilization and safety of trastuzumab emtansine (T-DM1): a nationwide population-based study using the French National Health Data System","authors":"H. Jourdain , I. Mansouri , A. Di Meglio , M. Zureik , N. Haddy","doi":"10.1016/j.esmorw.2024.100045","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100045","url":null,"abstract":"<div><h3>Background</h3><p>Trastuzumab emtansine (T-DM1), the first antibody–drug conjugate targeting human epidermal growth factor receptor 2 (HER2), has provided new alternatives for metastatic breast cancer (mBC) treatment, and for early-stage breast cancer (esBC) since 2020. We characterized T-DM1 users and assessed the risk of hospitalisation for certain adverse events.</p></div><div><h3>Materials and methods</h3><p>Using data from the French National Health Data System (SNDS), we identified patients receiving T-DM1 from 2014 to 2022. Sociodemographic data, medical history, and overall survival were described by indication. The risk of adverse event-related hospitalisation was quantified.</p></div><div><h3>Results</h3><p>We included 12 822 patients initiating T-DM1 treatment in the study: 9232 (72%) with mBC (median age: 59 years, 54.6% with at least one comorbid condition) and 3590 (28%) with esBC (median age: 54 years, 33.9% with at least one comorbid condition). In mBC, median overall survival was 32.6 months, showing a gradual improvement over the years. At 1 year, 75.8% of patients had discontinued treatment and 22.0% had died. Patients in the study faced higher hospitalisation risks than those with incident breast cancer, with increases of 5.7 and 10.5 times for thrombocytopenia, 3.0 and 4.5 times for interstitial lung disease, 3.3 and 5.9 times for acute liver injury, and 2.3 and 7.3 times for sepsis, for esBC and mBC, respectively.</p></div><div><h3>Conclusions</h3><p>Real-world T-DM1 users frequently present with comorbid conditions and prior treatments, with a higher risk of hospitalisation for severe toxicity events than the general population of incident breast cancers. This study highlights the importance of monitoring treated patients to manage the risk of toxicity and prevent treatment discontinuation.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000237/pdfft?md5=797b441616020f8749e03aac43cba041&pid=1-s2.0-S2949820124000237-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.esmorw.2024.100043
C. Courtinard , V. Barbet , R. Schiappa , F. Pilleul , S. Michiels , S. Dabakuyo , S. Gourgou , A. Jaffre , B. Asselain , L. Bosquet , K. Dunton , M. Rosenlund , Z. Liang , J. Cathcart , S. Delaloge
Background
Real-world data (RWD) can contextualize clinical trial data. We present real-world evidence that supplemented the single-arm DESTINY-Breast01 trial, which assessed the efficacy and safety of trastuzumab deruxtecan (T-DXd) in patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (mBC) previously treated with trastuzumab emtansine (T-DM1).
Patients and methods
Patients from the French Epidemiology Strategy and Medical Economics (ESME) mBC database who initiated treatment for HER2+ mBC between 1 January 2008 and 31 December 2016, and received one or more treatment lines following T-DM1 were propensity score matched 1 : 1 to patients from DESTINY-Breast01 to create an ESME DB-01 matched cohort. Treatment patterns, real-world best overall response, real-world objective response rate (rwORR), real-world disease control rate (rwDCR), real-world progression-free survival (rwPFS), and overall survival (OS) were estimated, including by prior pertuzumab exposure and de novo/relapsed mBC status.
Results
A total of 137 patients from the ESME mBC database (78 received prior pertuzumab, 59 did not) were matched to 137 patients from DESTINY-Breast01. In the ESME DB-01 matched cohort, 73.7% received an anti-HER2 drug after T-DM1 treatment. The rwORR was 12.2% (95% confidence interval [CI] 6.2% to 18.2%; only partial responses) and rwDCR was 73.9% (95% CI 65.9% to 81.9%). The median rwPFS was 4.7 months (95% CI 3.8-6.0 months) and similar regardless of prior pertuzumab exposure or de novo/relapsed mBC status. The median OS was 24.1 months (95% CI 18.5-26.4 months) and longer in patients naive to versus exposed to pertuzumab and in patients with de novo versus relapsed mBC.
Conclusion
These RWD contextualized results of DESTINY-Breast01 and demonstrated an unmet medical need in patients with HER2+ mBC after T-DM1 treatment.
{"title":"Real-world effectiveness of post-trastuzumab emtansine treatment for human epidermal growth factor receptor 2-positive metastatic breast cancer: a multicenter, matched cohort analysis from the Epidemiology Strategy and Medical Economics database (2008-2018)","authors":"C. Courtinard , V. Barbet , R. Schiappa , F. Pilleul , S. Michiels , S. Dabakuyo , S. Gourgou , A. Jaffre , B. Asselain , L. Bosquet , K. Dunton , M. Rosenlund , Z. Liang , J. Cathcart , S. Delaloge","doi":"10.1016/j.esmorw.2024.100043","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100043","url":null,"abstract":"<div><h3>Background</h3><p>Real-world data (RWD) can contextualize clinical trial data. We present real-world evidence that supplemented the single-arm DESTINY-Breast01 trial, which assessed the efficacy and safety of trastuzumab deruxtecan (T-DXd) in patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (mBC) previously treated with trastuzumab emtansine (T-DM1).</p></div><div><h3>Patients and methods</h3><p>Patients from the French Epidemiology Strategy and Medical Economics (ESME) mBC database who initiated treatment for HER2+ mBC between 1 January 2008 and 31 December 2016, and received one or more treatment lines following T-DM1 were propensity score matched 1 : 1 to patients from DESTINY-Breast01 to create an ESME DB-01 matched cohort. Treatment patterns, real-world best overall response, real-world objective response rate (rwORR), real-world disease control rate (rwDCR), real-world progression-free survival (rwPFS), and overall survival (OS) were estimated, including by prior pertuzumab exposure and <em>de novo</em>/relapsed mBC status.</p></div><div><h3>Results</h3><p>A total of 137 patients from the ESME mBC database (78 received prior pertuzumab, 59 did not) were matched to 137 patients from DESTINY-Breast01. In the ESME DB-01 matched cohort, 73.7% received an anti-HER2 drug after T-DM1 treatment. The rwORR was 12.2% (95% confidence interval [CI] 6.2% to 18.2%; only partial responses) and rwDCR was 73.9% (95% CI 65.9% to 81.9%). The median rwPFS was 4.7 months (95% CI 3.8-6.0 months) and similar regardless of prior pertuzumab exposure or <em>de novo</em>/relapsed mBC status. The median OS was 24.1 months (95% CI 18.5-26.4 months) and longer in patients naive to versus exposed to pertuzumab and in patients with <em>de novo</em> versus relapsed mBC.</p></div><div><h3>Conclusion</h3><p>These RWD contextualized results of DESTINY-Breast01 and demonstrated an unmet medical need in patients with HER2+ mBC after T-DM1 treatment.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000213/pdfft?md5=a06f050004d7530764c9bb5bb625b611&pid=1-s2.0-S2949820124000213-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.1016/j.esmorw.2024.100041
E. Shachar , S. Peleg-Hasson , D. Vorobiof , N. Moisa , E. Waller , T. Safra , I. Wolf
Background
Health-related quality of life is commonly used as an endpoint in clinical trials. While it evaluates the presence of symptoms, it does not measure patients’ ability to maintain normal daily life activities (DLA). We designed a daily life assessment tool, validated among actively treated cancer patients at a single center before the coronavirus 2019 pandemic. We discovered that most patients reported compromised daily activities. In this study we aimed to examine DLA in an international cohort.
Methods
A locally validated questionnaire was distributed internationally using the Belong.life digital health platform. We examined real-world patient-reported practices. The survey consisted of demographic, clinical, behavioral parameters and sources guiding and supporting patient practices.
Results
The study comprised 1395 patient-reported outcomes. The majority of participants (1005, 73%) reported at least one adopted limitation in daily activities, and 305 (22%) maintained more than half of these constraints. Daily life restrictions included avoiding sun exposure (779, 58%), international travel (417, 33%), indoor public places (431, 33%), hair dyeing (271, 23%), domestic tourism (284, 22%), contact with friends and family (231, 18%), children and grandchildren (202, 16%), public spaces (190, 14.62%), and contact with pets (135, 10%). Multiple sources were implicated by patients guiding their behavior, including healthcare professionals (951, 66%), non-medical authorities [(internet, patient forums, partners, friends, and family (171, 12%)], and both non-medical authorities and the healthcare team (320, 22.19%). There was no association between country of origin (P = 0.12), and education level (P = 0.36) across patients who maintained strict (≥50% of the limitations) and less strict restrictions (<50% of the limitations). A significant association was noted between younger age (P = 0.001), female sex (P = 0.01) and primary cancer site (P < 0.0001), and the adoption of strict restrictions.
Conclusion
The majority of patients globally reported compromised daily activities, which are likely attributed to misconceptions about therapy and disease. These findings call for the assessment of an overlooked measure, DLA reflecting real-life quality of life, as an additional endpoint of clinical trials, aiming to achieve the ultimate benefit for our patients, a measure of a full and meaningful life.
{"title":"Real-world behavioral practices of cancer patients: misconceptions compromising daily life activities","authors":"E. Shachar , S. Peleg-Hasson , D. Vorobiof , N. Moisa , E. Waller , T. Safra , I. Wolf","doi":"10.1016/j.esmorw.2024.100041","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100041","url":null,"abstract":"<div><h3>Background</h3><p>Health-related quality of life is commonly used as an endpoint in clinical trials. While it evaluates the presence of symptoms, it does not measure patients’ ability to maintain normal daily life activities (DLA). We designed a daily life assessment tool, validated among actively treated cancer patients at a single center before the coronavirus 2019 pandemic. We discovered that most patients reported compromised daily activities. In this study we aimed to examine DLA in an international cohort.</p></div><div><h3>Methods</h3><p>A locally validated questionnaire was distributed internationally using the Belong.life digital health platform. We examined real-world patient-reported practices. The survey consisted of demographic, clinical, behavioral parameters and sources guiding and supporting patient practices.</p></div><div><h3>Results</h3><p>The study comprised 1395 patient-reported outcomes. The majority of participants (1005, 73%) reported at least one adopted limitation in daily activities, and 305 (22%) maintained more than half of these constraints. Daily life restrictions included avoiding sun exposure (779, 58%), international travel (417, 33%), indoor public places (431, 33%), hair dyeing (271, 23%), domestic tourism (284, 22%), contact with friends and family (231, 18%), children and grandchildren (202, 16%), public spaces (190, 14.62%), and contact with pets (135, 10%). Multiple sources were implicated by patients guiding their behavior, including healthcare professionals (951, 66%), non-medical authorities [(internet, patient forums, partners, friends, and family (171, 12%)], and both non-medical authorities and the healthcare team (320, 22.19%). There was no association between country of origin (<em>P</em> = 0.12), and education level (<em>P</em> = 0.36) across patients who maintained strict (≥50% of the limitations) and less strict restrictions (<50% of the limitations). A significant association was noted between younger age (<em>P</em> = 0.001), female sex (<em>P</em> = 0.01) and primary cancer site (<em>P</em> < 0.0001), and the adoption of strict restrictions.</p></div><div><h3>Conclusion</h3><p>The majority of patients globally reported compromised daily activities, which are likely attributed to misconceptions about therapy and disease. These findings call for the assessment of an overlooked measure, DLA reflecting real-life quality of life, as an additional endpoint of clinical trials, aiming to achieve the ultimate benefit for our patients, a measure of a full and meaningful life.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000195/pdfft?md5=cd73ed96e136733c4817e31a712ca505&pid=1-s2.0-S2949820124000195-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.1016/j.esmorw.2024.100042
B.L. Fabre , M.A.F. Magalhaes Filho , P.N. Aguiar Jr , F.M. da Costa , B. Gutierres , W.N. William Jr , A. Del Giglio
Background
Artificial intelligence (AI) and natural language processing (NLP) advancements have led to sophisticated tools like GPT-4.0, allowing clinicians to explore its utility as a health care management support tool. Our study aimed to assess the capability of GPT-4 in suggesting definitive diagnoses and appropriate work-ups to minimize unnecessary procedures.
Materials and methods
We conducted a retrospective comparative analysis, extracting clinical data from 10 cases published in the New England Journal of Medicine after 2022 and inputting this data into GPT-4 to generate diagnostic and work-up recommendations. Primary endpoint: the ability to correctly identify the final diagnosis. Secondary endpoints: its ability to list the definitive diagnosis as the first of the five most likely differential diagnoses and determine an adequate work-up.
Results
The AI could not identify the definitive diagnosis in 2 out of 10 cases (20% inaccuracy). Among the eight cases correctly identified by the AI, five (63%) listed the definitive diagnosis at the top of the differential diagnosis list. In terms of diagnostic tests and exams, the AI suggested unnecessary procedures in two cases, representing 40% of the cases where it failed to correctly identify the final diagnosis. Moreover, the AI could not suggest adequate treatment for seven cases (70%). Among them, the AI suggested inappropriate management for two cases, and the remaining five received incomplete or non-specific advice, such as chemotherapy, without specifying the best regimen.
Conclusions
Our study demonstrated GPT-4’s potential as an academic support tool, although it cannot correctly identify the final diagnosis in 20% of the cases and the AI requested unnecessary additional diagnostic tests for 40% of the patients. Future research should focus on evaluating the performance of GPT-4 using a more extensive and diverse sample, incorporating prospective assessments, and investigating its ability to improve diagnostic and therapeutic accuracy.
{"title":"Evaluating GPT-4 as an academic support tool for clinicians: a comparative analysis of case records from the literature","authors":"B.L. Fabre , M.A.F. Magalhaes Filho , P.N. Aguiar Jr , F.M. da Costa , B. Gutierres , W.N. William Jr , A. Del Giglio","doi":"10.1016/j.esmorw.2024.100042","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100042","url":null,"abstract":"<div><h3>Background</h3><p>Artificial intelligence (AI) and natural language processing (NLP) advancements have led to sophisticated tools like GPT-4.0, allowing clinicians to explore its utility as a health care management support tool. Our study aimed to assess the capability of GPT-4 in suggesting definitive diagnoses and appropriate work-ups to minimize unnecessary procedures.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective comparative analysis, extracting clinical data from 10 cases published in the <em>New England Journal of Medicine</em> after 2022 and inputting this data into GPT-4 to generate diagnostic and work-up recommendations. Primary endpoint: the ability to correctly identify the final diagnosis. Secondary endpoints: its ability to list the definitive diagnosis as the first of the five most likely differential diagnoses and determine an adequate work-up.</p></div><div><h3>Results</h3><p>The AI could not identify the definitive diagnosis in 2 out of 10 cases (20% inaccuracy). Among the eight cases correctly identified by the AI, five (63%) listed the definitive diagnosis at the top of the differential diagnosis list. In terms of diagnostic tests and exams, the AI suggested unnecessary procedures in two cases, representing 40% of the cases where it failed to correctly identify the final diagnosis. Moreover, the AI could not suggest adequate treatment for seven cases (70%). Among them, the AI suggested inappropriate management for two cases, and the remaining five received incomplete or non-specific advice, such as chemotherapy, without specifying the best regimen.</p></div><div><h3>Conclusions</h3><p>Our study demonstrated GPT-4’s potential as an academic support tool, although it cannot correctly identify the final diagnosis in 20% of the cases and the AI requested unnecessary additional diagnostic tests for 40% of the patients. Future research should focus on evaluating the performance of GPT-4 using a more extensive and diverse sample, incorporating prospective assessments, and investigating its ability to improve diagnostic and therapeutic accuracy.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000201/pdfft?md5=f32f81c8fc771b7987718bc67be461a8&pid=1-s2.0-S2949820124000201-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1016/j.esmorw.2024.100040
N. Marschner , T. Seufferlein , K. Potthoff , M.-O. Zahn , J. Uhlig , S. Dörfel , A. Karcher , A. Sauer , C. Maintz , S. Fruehauf , U. Hutzschenreuter , S. Tech , M. Grafetstätter , L. Kruggel , M. Jänicke
Background
Results from recent clinical trials, showing median survival times of >30 months for patients with metastatic colorectal cancer (mCRC), set a new benchmark for first-line treatment. As, however, most patients are treated outside of trials, evidence from population-based studies is warranted to evaluate whether survival times translate to real world.
Patients and methods
Data on treatment and outcome of 3816 patients with mCRC, observed between 2006 and 2022, were collected from 166 sites in Germany into the prospective Tumor Registry Colorectal Cancer. Data were analyzed according to start of first-line palliative treatment, divided into three time periods (2006-2010, 2011-2014 and 2015-2018). Overall survival (OS) was estimated using the Kaplan–Meier method.
Results
Most patients received doublet chemotherapy (CTx) across all time periods (about 82%). The use of triplet combination CTx increased over time from 0.9% (2006-2010), over 1.3% (2011-2014) to 5.6% (2015-2018). More patients received anti-epidermal growth factor receptor antibodies over time (2006-2010: 6.5%; 2011-2014: 18.7%; 2015-2018: 25.3%). Median OS for patients who started palliative treatment between 2006 and 2010, 2011 and 2014 and 2015 and 2018 was 21.4 months [95% confidence interval (CI) 20.3-23.1 months], 21.9 months (95% CI 20.8-23.4 months) and 22.9 months (95% CI 21.8-24.9 months), respectively.
Conclusion
Since the successful introduction of doublet chemotherapy with monoclonal antibodies, median OS of patients with mCRC in clinical practice remained unchanged at about 22 months over a period of 16 years. As such, our data highlight the need for new treatment options to further improve survival of patients with mCRC.
背景最近的临床试验结果显示，转移性结直肠癌（mCRC）患者的中位生存时间为30个月，为一线治疗树立了新的标杆。然而，由于大多数患者是在试验之外接受治疗的，因此有必要通过基于人群的研究来评估生存时间是否与实际情况相符。患者和方法在前瞻性肿瘤登记结直肠癌中收集了德国166个地点的数据，其中包括2006年至2022年间观察到的3816名mCRC患者的治疗情况和结果。数据根据一线姑息治疗的开始时间进行分析，分为三个时间段（2006-2010 年、2011-2014 年和 2015-2018 年）。结果在所有时间段内，大多数患者都接受了双联化疗（CTx）（约占82%）。随着时间的推移，三联联合化疗（CTx）的使用率从0.9%（2006-2010年）、1.3%（2011-2014年）增至5.6%（2015-2018年）。随着时间的推移，更多患者接受了抗表皮生长因子受体抗体治疗（2006-2010年：6.5%；2011-2014年：18.7%；2015-2018年：25.3%）。2006年至2010年、2011年至2014年、2015年至2018年期间开始接受姑息治疗的患者的中位OS分别为21.4个月[95%置信区间（CI）20.3-23.1个月]、21.9个月（95% CI 20.8-23.4个月）和22.9个月（95% CI 21.8-24.9个月）。结论自成功引入单克隆抗体双联化疗以来，16年间临床实践中mCRC患者的中位OS一直保持在22个月左右。因此，我们的数据突出表明，需要新的治疗方案来进一步提高mCRC患者的生存率。
{"title":"Changes in survival of >3800 patients with metastatic colorectal cancer in Germany: results from a 16-year prospective longitudinal real-world data analysis","authors":"N. Marschner , T. Seufferlein , K. Potthoff , M.-O. Zahn , J. Uhlig , S. Dörfel , A. Karcher , A. Sauer , C. Maintz , S. Fruehauf , U. Hutzschenreuter , S. Tech , M. Grafetstätter , L. Kruggel , M. Jänicke","doi":"10.1016/j.esmorw.2024.100040","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100040","url":null,"abstract":"<div><h3>Background</h3><p>Results from recent clinical trials, showing median survival times of >30 months for patients with metastatic colorectal cancer (mCRC), set a new benchmark for first-line treatment. As, however, most patients are treated outside of trials, evidence from population-based studies is warranted to evaluate whether survival times translate to real world.</p></div><div><h3>Patients and methods</h3><p>Data on treatment and outcome of 3816 patients with mCRC, observed between 2006 and 2022, were collected from 166 sites in Germany into the prospective Tumor Registry Colorectal Cancer. Data were analyzed according to start of first-line palliative treatment, divided into three time periods (2006-2010, 2011-2014 and 2015-2018). Overall survival (OS) was estimated using the Kaplan–Meier method.</p></div><div><h3>Results</h3><p>Most patients received doublet chemotherapy (CTx) across all time periods (about 82%). The use of triplet combination CTx increased over time from 0.9% (2006-2010), over 1.3% (2011-2014) to 5.6% (2015-2018). More patients received anti-epidermal growth factor receptor antibodies over time (2006-2010: 6.5%; 2011-2014: 18.7%; 2015-2018: 25.3%). Median OS for patients who started palliative treatment between 2006 and 2010, 2011 and 2014 and 2015 and 2018 was 21.4 months [95% confidence interval (CI) 20.3-23.1 months], 21.9 months (95% CI 20.8-23.4 months) and 22.9 months (95% CI 21.8-24.9 months), respectively.</p></div><div><h3>Conclusion</h3><p>Since the successful introduction of doublet chemotherapy with monoclonal antibodies, median OS of patients with mCRC in clinical practice remained unchanged at about 22 months over a period of 16 years. As such, our data highlight the need for new treatment options to further improve survival of patients with mCRC.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000183/pdfft?md5=994c9a3bf3cc448503ebc671405b55ea&pid=1-s2.0-S2949820124000183-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.esmorw.2024.100038
A.D. Coles , C.D. McInerney , K. Zucker , S. Cheeseman , O.A. Johnson , G. Hall
Background
Cancer recurrences are poorly recorded within electronic health records around the world. This hinders research into the efficacy of cancer treatments. Currently, the retrospective identification of recurrence/progression diagnosis dates is achieved by staff who manually review patients’ health records. This is expensive, time-consuming, and inefficient. Machine Learning models may expedite the review of health records and facilitate the assessment of alternative cancer therapies.
Materials and methods
This paper evaluates the use of four machine learning models (random forests, conditional inference trees, decision trees, and logistic regression) in identifying proxy dates of epithelial ovarian cancer recurrence/progression from chemotherapy data, in 531 patients at Leeds Teaching Hospital Trust.
Results
The random forest achieved the highest F1 score of 0.941 (95% confidence interval 0.916-0.968) when identifying recurrence events. Both the random forest and decision tree models’ classifications closely conform to chart-reviewed time to next treatment, serving as a surrogate for recurrence-free survival. Additionally, all models reached an F1 score >0.940 when identifying patients whose cancer recurred/progressed.
Conclusions
Our models proficiently identify both proxy dates for recurrence/progression diagnoses and patients whose cancer recurred/progressed. Considering the similar performance of the random forest and decision tree, model preference should be determined by the interpretability required to assist chart review and the ease of implementation into existing architecture.
背景世界各地的电子健康记录中对癌症复发的记录很少。这阻碍了对癌症治疗效果的研究。目前，复发/进展诊断日期的回顾性识别是由工作人员手动查看患者的健康记录来实现的。这种方法成本高、耗时长、效率低。材料与方法本文评估了四种机器学习模型（随机森林、条件推理树、决策树和逻辑回归）在识别利兹教学医院信托基金 531 名患者化疗数据中上皮性卵巢癌复发/进展替代日期方面的应用。随机森林模型和决策树模型的分类结果与图表显示的下次治疗时间非常吻合，可作为无复发生存期的替代指标。此外，在识别癌症复发/进展患者时，所有模型的 F1 分数都达到了 0.940。考虑到随机森林和决策树的性能相似，应根据协助病历审查所需的可解释性以及在现有架构中实施的难易程度来决定是否选择模型。
{"title":"Evaluation of machine learning methods for the retrospective detection of ovarian cancer recurrences from chemotherapy data","authors":"A.D. Coles , C.D. McInerney , K. Zucker , S. Cheeseman , O.A. Johnson , G. Hall","doi":"10.1016/j.esmorw.2024.100038","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100038","url":null,"abstract":"<div><h3>Background</h3><p>Cancer recurrences are poorly recorded within electronic health records around the world. This hinders research into the efficacy of cancer treatments. Currently, the retrospective identification of recurrence/progression diagnosis dates is achieved by staff who manually review patients’ health records. This is expensive, time-consuming, and inefficient. Machine Learning models may expedite the review of health records and facilitate the assessment of alternative cancer therapies.</p></div><div><h3>Materials and methods</h3><p>This paper evaluates the use of four machine learning models (random forests, conditional inference trees, decision trees, and logistic regression) in identifying proxy dates of epithelial ovarian cancer recurrence/progression from chemotherapy data, in 531 patients at Leeds Teaching Hospital Trust.</p></div><div><h3>Results</h3><p>The random forest achieved the highest F1 score of 0.941 (95% confidence interval 0.916-0.968) when identifying recurrence events. Both the random forest and decision tree models’ classifications closely conform to chart-reviewed time to next treatment, serving as a surrogate for recurrence-free survival. Additionally, all models reached an F1 score >0.940 when identifying patients whose cancer recurred/progressed.</p></div><div><h3>Conclusions</h3><p>Our models proficiently identify both proxy dates for recurrence/progression diagnoses and patients whose cancer recurred/progressed. Considering the similar performance of the random forest and decision tree, model preference should be determined by the interpretability required to assist chart review and the ease of implementation into existing architecture.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294982012400016X/pdfft?md5=037748083c08b03abbc66eb0cbc15421&pid=1-s2.0-S294982012400016X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140816946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.1016/j.esmorw.2024.100037
D. van de Wal , D. den Hollander , I.M.E. Desar , H. Gelderblom , A.W. Oosten , A.K.L. Reyners , N. Steeghs , W.T.A. van der Graaf , O. Husson
Background
Treatment and follow-up (FU) care procedures for gastrointestinal stromal tumors (GISTs) impose great challenges on patients and could potentially affect their health-related quality of life (HRQoL). The aims of our study were to (i) assess HRQoL among patients with GIST in different treatment phases and settings and to compare this with the HRQoL of an age- and sex-matched normative population, (ii) determine the occurrence of disease- and treatment-specific symptoms, and (iii) investigate which sociodemographic and clinical characteristics and symptoms were associated with HRQoL.
Methods
A total of 328 Dutch patients with GIST (response rate 63%) completed a one-time survey including the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), which was used to assess HRQoL. HRQoL scores are presented as means and standard deviations (mean ± SD), and were compared with those of an age- and sex-matched normative population.
Results
The global QoL of patients receiving imatinib in a curative setting (mean ± SD 81.2 ± 12.6) was comparable with the normative population (mean ± SD 77.1 ± 18.2), while patients who had completed their curative treatment [including those discharged from FU (mean ± SD 85.2 ± 14.0) and still in FU (mean ± SD 82.7 ± 15.0)] had a significant better global QoL with comparable functioning scores. Patients on tyrosine kinase inhibitors in a palliative setting scored significantly lower on global QoL (mean ± SD 71.6 ± 19.4) and all functioning scales compared with the normative population. HRQoL was most affected by fatigue, in addition to pain, dyspnea, and financial difficulties, which all occurred more often in patients treated in a palliative setting compared with patients in the curative setting.
Conclusion
With these results, medical oncologists can reassure patients with GIST treated in an adjuvant setting that their HRQoL will not be permanently affected by imatinib and provide appropriate support to patients in the palliative setting.
{"title":"Health-related quality of life in patients with gastrointestinal stromal tumor: data from a real-world cohort compared with a normative population","authors":"D. van de Wal , D. den Hollander , I.M.E. Desar , H. Gelderblom , A.W. Oosten , A.K.L. Reyners , N. Steeghs , W.T.A. van der Graaf , O. Husson","doi":"10.1016/j.esmorw.2024.100037","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100037","url":null,"abstract":"<div><h3>Background</h3><p>Treatment and follow-up (FU) care procedures for gastrointestinal stromal tumors (GISTs) impose great challenges on patients and could potentially affect their health-related quality of life (HRQoL). The aims of our study were to (i) assess HRQoL among patients with GIST in different treatment phases and settings and to compare this with the HRQoL of an age- and sex-matched normative population, (ii) determine the occurrence of disease- and treatment-specific symptoms, and (iii) investigate which sociodemographic and clinical characteristics and symptoms were associated with HRQoL.</p></div><div><h3>Methods</h3><p>A total of 328 Dutch patients with GIST (response rate 63%) completed a one-time survey including the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), which was used to assess HRQoL. HRQoL scores are presented as means and standard deviations (mean ± SD), and were compared with those of an age- and sex-matched normative population.</p></div><div><h3>Results</h3><p>The global QoL of patients receiving imatinib in a curative setting (mean ± SD 81.2 ± 12.6) was comparable with the normative population (mean ± SD 77.1 ± 18.2), while patients who had completed their curative treatment [including those discharged from FU (mean ± SD 85.2 ± 14.0) and still in FU (mean ± SD 82.7 ± 15.0)] had a significant better global QoL with comparable functioning scores. Patients on tyrosine kinase inhibitors in a palliative setting scored significantly lower on global QoL (mean ± SD 71.6 ± 19.4) and all functioning scales compared with the normative population. HRQoL was most affected by fatigue, in addition to pain, dyspnea, and financial difficulties, which all occurred more often in patients treated in a palliative setting compared with patients in the curative setting.</p></div><div><h3>Conclusion</h3><p>With these results, medical oncologists can reassure patients with GIST treated in an adjuvant setting that their HRQoL will not be permanently affected by imatinib and provide appropriate support to patients in the palliative setting.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000158/pdfft?md5=9b727b1bb57d82eff8476753d6b9791d&pid=1-s2.0-S2949820124000158-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-15DOI: 10.1016/j.esmorw.2024.100036
M.J. Emmett , J.C.F. Quintanilha , R.P. Graf , G. Li , H. Tukachinsky , A.B. Schrock , S. Morley , V.A. Fisher , G.R. Oxnard , C.H. Lieu , P.A. Myer , S.J. Klempner
Background
Patients with metastatic colorectal cancer (mCRC) with RAS- or BRAF-mutant tumors do not benefit from epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) therapy. Among patients with RAS/BRAF wild-type (WT) tumors, a substantial portion still do not benefit from EGFR mAb treatment. Using real-world clinicogenomic data, we investigated the impact of primary and acquired genomic resistance alterations upon treatment outcomes and determined the prevalence of alterations before and after EGFR mAb treatment.
Materials and methods
This study utilized a de-identified mCRC clinicogenomic database from ∼280 US cancer clinics between March 2014 and April 2023. We examined real-world progression-free survival (rwPFS) and overall survival (rwOS) between patients with and those without pre-specified genomic alterations (PSGAs) by Cox models and an adjusted risk score. Genomic alterations were also compared between samples collected before and after EGFR mAb therapy.
Results
Nearly, one-third of microsatellite stable (MSS) RAS/BRAF WT tumors harbor intrinsic resistance alterations before treatment. MSS mCRC patients with WT RAS/BRAF tumors having resistance alterations within the PSGA set [non-canonical RAS/RAF/MAPK and PI3K/PTEN/AKT pathway components; ERBB2 alterations; alternative receptor tyrosine kinases (RTKs) including FGFR1, FGFR2, EGFR, MET, RET, PDGFRA, and NRTK1 fusion] demonstrated decreased rwPFS and/or rwOS on first-line EGFR mAb treatment. The prevalence of RAS/RAF/MAPK and RTK alterations was higher in samples collected after EGFR mAb therapy. The risk of acquiring an RTK resistance alteration increased with the total duration of EGFR mAb treatment.
Conclusions
Detection of genomic resistance alterations in MSS RAS/BRAF WT patients confers less favorable EGFR mAb treatment outcomes. The duration of EGFR mAb treatment increased the risk of emergence of an acquired resistance alteration.
背景RAS或BRAF突变的转移性结直肠癌（mCRC）患者无法从表皮生长因子受体（EGFR）单克隆抗体（mAb）治疗中获益。在RAS/BRAF野生型（WT）肿瘤患者中，仍有相当一部分患者无法从表皮生长因子受体单克隆抗体（EGFR mAb）治疗中获益。利用真实世界的临床基因组学数据，我们调查了原发性和获得性基因组耐药改变对治疗结果的影响，并确定了EGFR mAb治疗前后耐药改变的发生率。我们通过 Cox 模型和调整后的风险评分，研究了有和没有预先指定的基因组改变（PSGAs）的患者之间的实际无进展生存期（rwPFS）和总生存期（rwOS）。结果近三分之一的微卫星稳定（MSS）RAS/BRAF WT肿瘤在治疗前存在内在耐药改变。具有WT RAS/BRAF肿瘤的MSS mCRC患者在接受PSGA组[非典型RAS/RAF/MAPK和PI3K/PTEN/AKT通路成分；ERBB2改变；替代受体酪氨酸激酶（RTKs），包括FGFR1、FGFR2、EGFR、MET、RET、PDGFRA和NRTK1融合]治疗后的rwPFS和/或rwOS下降。在表皮生长因子受体 mAb 治疗后采集的样本中，RAS/RAF/MAPK 和 RTK 基因改变的发生率较高。获得RTK耐药改变的风险随着表皮生长因子受体mAb治疗总持续时间的延长而增加。表皮生长因子受体 mAb 治疗的持续时间增加了出现获得性耐药改变的风险。
{"title":"Toward optimizing patient selection for EGFR antibody therapies in metastatic colorectal cancer: outcomes and resistance features in real-world data","authors":"M.J. Emmett , J.C.F. Quintanilha , R.P. Graf , G. Li , H. Tukachinsky , A.B. Schrock , S. Morley , V.A. Fisher , G.R. Oxnard , C.H. Lieu , P.A. Myer , S.J. Klempner","doi":"10.1016/j.esmorw.2024.100036","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100036","url":null,"abstract":"<div><h3>Background</h3><p>Patients with metastatic colorectal cancer (mCRC) with <em>RAS</em><em>-</em> or <em>BRAF</em>-mutant tumors do not benefit from epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) therapy. Among patients with <em>RAS/BRAF</em> wild-type (WT) tumors, a substantial portion still do not benefit from EGFR mAb treatment. Using real-world clinicogenomic data, we investigated the impact of primary and acquired genomic resistance alterations upon treatment outcomes and determined the prevalence of alterations before and after EGFR mAb treatment.</p></div><div><h3>Materials and methods</h3><p>This study utilized a de-identified mCRC clinicogenomic database from ∼280 US cancer clinics between March 2014 and April 2023. We examined real-world progression-free survival (rwPFS) and overall survival (rwOS) between patients with and those without pre-specified genomic alterations (PSGAs) by Cox models and an adjusted risk score. Genomic alterations were also compared between samples collected before and after EGFR mAb therapy.</p></div><div><h3>Results</h3><p>Nearly, one-third of microsatellite stable (MSS) <em>RAS/BRAF</em> WT tumors harbor intrinsic resistance alterations before treatment. MSS mCRC patients with WT <em>RAS/BRAF</em> tumors having resistance alterations within the PSGA set [non-canonical RAS/RAF/MAPK and PI3K/PTEN/AKT pathway components; ERBB2 alterations; alternative receptor tyrosine kinases (RTKs) including <em>FGFR1</em>, <em>FGFR2</em>, <em>EGFR</em>, <em>MET</em>, <em>RET</em>, <em>PDGFRA</em>, <em>and NRTK1</em> fusion] demonstrated decreased rwPFS and/or rwOS on first-line EGFR mAb treatment. The prevalence of RAS/RAF/MAPK and RTK alterations was higher in samples collected after EGFR mAb therapy. The risk of acquiring an RTK resistance alteration increased with the total duration of EGFR mAb treatment.</p></div><div><h3>Conclusions</h3><p>Detection of genomic resistance alterations in MSS <em>RAS/BRAF</em> WT patients confers less favorable EGFR mAb treatment outcomes. The duration of EGFR mAb treatment increased the risk of emergence of an acquired resistance alteration.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"4 ","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000146/pdfft?md5=0dfbceb2f2a77c9b421cd2bce220ba31&pid=1-s2.0-S2949820124000146-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.esmorw.2024.100028
K.S. Olsen , M. Lukic
{"title":"Commentary to Corti et al.: Exploring the utility and limitations of ChatGPT in scientific literature searches","authors":"K.S. Olsen , M. Lukic","doi":"10.1016/j.esmorw.2024.100028","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100028","url":null,"abstract":"","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"3 ","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000067/pdfft?md5=d11f4ab2023c5b86bf72c87642c01916&pid=1-s2.0-S2949820124000067-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140030111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.esmorw.2024.100026
P.-E. Heudel , H. Crochet , J.-Y. Blay
Background
The integration of Artificial Intelligence (AI) in oncology is a developing field, impacting the doctor-patient relationship and the efficacy of cancer care. While AI’s role in improving clinical efficiency and personalized care through the analysis of vast medical datasets is acknowledged, its full scope and impact are not yet completely understood.
Materials and methods
This article synthesizes empirical studies and expert opinions to offer a comprehensive understanding of AI’s current role in oncology. The methodology focuses on exploring the balance between technological advancements and the essential elements of patient-centered care.
Results
The paper hypothesizes that AI can enhance the quality of cancer care, but notes challenges such as potential depersonalization, data privacy issues, and ethical dilemmas. It also highlights AI’s potential in facilitating Shared Decision-Making, empowering patients and assisting oncologists in making more informed decisions. However, the risk of AI-driven paternalism and the need for balancing AI recommendations with patient autonomy are discussed.
Conclusions
AI holds significant potential to transform cancer care. The paper concludes that for AI to be beneficial, its integration should be collaborative and patient-centered, ensuring that technological advancements support and enhance the quality of the doctor-patient relationship, rather than undermining it. The article emphasizes the importance of transparent communication, patient education about AI, and the need for oncologists to effectively understand and convey AI-generated data.
{"title":"Impact of artificial intelligence in transforming the doctor–cancer patient relationship","authors":"P.-E. Heudel , H. Crochet , J.-Y. Blay","doi":"10.1016/j.esmorw.2024.100026","DOIUrl":"https://doi.org/10.1016/j.esmorw.2024.100026","url":null,"abstract":"<div><h3>Background</h3><p>The integration of Artificial Intelligence (AI) in oncology is a developing field, impacting the doctor-patient relationship and the efficacy of cancer care. While AI’s role in improving clinical efficiency and personalized care through the analysis of vast medical datasets is acknowledged, its full scope and impact are not yet completely understood.</p></div><div><h3>Materials and methods</h3><p>This article synthesizes empirical studies and expert opinions to offer a comprehensive understanding of AI’s current role in oncology. The methodology focuses on exploring the balance between technological advancements and the essential elements of patient-centered care.</p></div><div><h3>Results</h3><p>The paper hypothesizes that AI can enhance the quality of cancer care, but notes challenges such as potential depersonalization, data privacy issues, and ethical dilemmas. It also highlights AI’s potential in facilitating Shared Decision-Making, empowering patients and assisting oncologists in making more informed decisions. However, the risk of AI-driven paternalism and the need for balancing AI recommendations with patient autonomy are discussed.</p></div><div><h3>Conclusions</h3><p>AI holds significant potential to transform cancer care. The paper concludes that for AI to be beneficial, its integration should be collaborative and patient-centered, ensuring that technological advancements support and enhance the quality of the doctor-patient relationship, rather than undermining it. The article emphasizes the importance of transparent communication, patient education about AI, and the need for oncologists to effectively understand and convey AI-generated data.</p></div>","PeriodicalId":100491,"journal":{"name":"ESMO Real World Data and Digital Oncology","volume":"3 ","pages":"Article 100026"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949820124000043/pdfft?md5=1d72afab5acab3adfb261564dca341e6&pid=1-s2.0-S2949820124000043-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140030971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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