Previous reports indicated still low implementation rates of multigene testing for advanced non-small cell lung cancer (NSCLC) in Japan.
Methods
This is a retrospective study launched at the initiative of lung cancer patients. Patients with stage IV NSCLC from January 2019 to December 2022 were investigated for testing of 8 actionable oncogenic drivers with targeted therapies available as of 2022.
Results
A total of 15,719 patients were included. Between 2019 and 2022, the percentage of patients who were not tested for any actionable oncogenic drivers remained the same, ranging from 21.5% to 33.1%. However, since late 2021, the percentage of patients tested for five or more actionable oncogenic drivers has increased. Across hospital categories and regions, the number of actionable oncogenic drivers tested was similar.
Conclusions
This patient-initiated national survey in Japan reveals the recent nationwide increase in testing rates for actionable oncogenic drivers in Advanced NSCLC.
{"title":"Patient-Initiated Nationwide Survey on Testing for Actionable Oncogenic Drivers in Non-Small Cell Lung Cancer in Japan","authors":"Satoshi Ikeda, Kazuo Hasegawa, Kenta Kachi, Akihiro Yanagisawa, Sachiko Kawakami, Shinsuke Hamasaki, Sachiko Watanabe, Aki Yoshikawa, Takayuki Takahama, Kazuhiko Nakagawa","doi":"10.1002/cam4.70375","DOIUrl":"10.1002/cam4.70375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous reports indicated still low implementation rates of multigene testing for advanced non-small cell lung cancer (NSCLC) in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective study launched at the initiative of lung cancer patients. Patients with stage IV NSCLC from January 2019 to December 2022 were investigated for testing of 8 actionable oncogenic drivers with targeted therapies available as of 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 15,719 patients were included. Between 2019 and 2022, the percentage of patients who were not tested for any actionable oncogenic drivers remained the same, ranging from 21.5% to 33.1%. However, since late 2021, the percentage of patients tested for five or more actionable oncogenic drivers has increased. Across hospital categories and regions, the number of actionable oncogenic drivers tested was similar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This patient-initiated national survey in Japan reveals the recent nationwide increase in testing rates for actionable oncogenic drivers in Advanced NSCLC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiao Ma, Xiaojun Chen, Jing Liang, Jingbo Zhang, Qixi Wu, Dong Wang, Xianghua Huang, Dan Zi, Dexin Chen, Hua Wan, Li Qu, Zhaoyun Jiang, Wenyu Shao, Jie Sun, Luyuan Chang, Yunchao Liu, Qin Zhang, Yanan Li, Yani Ding, Biao Tang, Fang Zhao, Hanqing Zhao, Dongyan Cao
Background
The increasing incidence of endometrial cancer (EC) has highlighted the need for improved early detection methods. This study aimed to develop and validate a novel DNA methylation classifier, EMPap, for EC detection using cervical scrapings.
Methods
EMPap incorporated the methylation status of BHLHE22 and CDO1, along with age and body mass index (BMI), into a logistic regression model to calculate the endometrial cancer methylation (EM) score for identifying EC in cervical scrapings. We enrolled 1297 patients with highly suspected EC, including 196 confirmed EC cases, and assessed the EMPap performance in detecting EC.
Results
EMPap demonstrated robust diagnostic accuracy, with an area under the curve of 0.93, sensitivity of 90.3%, and specificity of 89.3%. It effectively detected EC across various disease stages, grades, and histological subtypes, and consistently performed well across patient demographics and symptoms. EMPap correctly identified 87.5% of the type II ECs and 53.8% of premalignant lesions. Notably, compared with transvaginal ultrasonography (TVS) in patients with postmenopausal bleeding, EMPap exhibited superior sensitivity (100% vs. 82.0%) and specificity (85.2% vs. 38.5%). In asymptomatic postmenopausal women, EMPap maintained high sensitivity (89.5%) and negative predictive value (NPV) (98.3%).
Conclusions
This study demonstrated the potential of EMPap as an effective tool for EC detection. Despite the limited sample size, EMPap showed promise for identifying type II EC and detecting over 50% of premalignant lesions. As a DNA methylation classifier, EMPap can reduce unnecessary uterine interventions and improve diagnosis and outcomes.
{"title":"A Multicenter Cohort Study on DNA Methylation for Endometrial Cancer Detection in Cervical Scrapings","authors":"Xiao Ma, Xiaojun Chen, Jing Liang, Jingbo Zhang, Qixi Wu, Dong Wang, Xianghua Huang, Dan Zi, Dexin Chen, Hua Wan, Li Qu, Zhaoyun Jiang, Wenyu Shao, Jie Sun, Luyuan Chang, Yunchao Liu, Qin Zhang, Yanan Li, Yani Ding, Biao Tang, Fang Zhao, Hanqing Zhao, Dongyan Cao","doi":"10.1002/cam4.70361","DOIUrl":"10.1002/cam4.70361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The increasing incidence of endometrial cancer (EC) has highlighted the need for improved early detection methods. This study aimed to develop and validate a novel DNA methylation classifier, EMPap, for EC detection using cervical scrapings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>EMPap incorporated the methylation status of <i>BHLHE22</i> and <i>CDO1</i>, along with age and body mass index (BMI), into a logistic regression model to calculate the endometrial cancer methylation (EM) score for identifying EC in cervical scrapings. We enrolled 1297 patients with highly suspected EC, including 196 confirmed EC cases, and assessed the EMPap performance in detecting EC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EMPap demonstrated robust diagnostic accuracy, with an area under the curve of 0.93, sensitivity of 90.3%, and specificity of 89.3%. It effectively detected EC across various disease stages, grades, and histological subtypes, and consistently performed well across patient demographics and symptoms. EMPap correctly identified 87.5% of the type II ECs and 53.8% of premalignant lesions. Notably, compared with transvaginal ultrasonography (TVS) in patients with postmenopausal bleeding, EMPap exhibited superior sensitivity (100% vs. 82.0%) and specificity (85.2% vs. 38.5%). In asymptomatic postmenopausal women, EMPap maintained high sensitivity (89.5%) and negative predictive value (NPV) (98.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated the potential of EMPap as an effective tool for EC detection. Despite the limited sample size, EMPap showed promise for identifying type II EC and detecting over 50% of premalignant lesions. As a DNA methylation classifier, EMPap can reduce unnecessary uterine interventions and improve diagnosis and outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aya Nakajima, Michio Yoshimura, Shinya Hiraoka, Ryota Nakashima, Yo Kishimoto, Koichi Omori, Takashi Mizowaki
Background
Functional outcomes after hypopharyngeal cancer (HPC) treatment have a significant effect on patients' quality of life and prognosis. This study aimed to identify the predictive factors associated with laryngo-esophageal dysfunction in patients with HPC who received definitive radiotherapy.
Methods
Patients with HPC treated with definitive intensity-modulated radiotherapy between 2007 and 2019 at our institution were retrospectively evaluated. Laryngo-esophageal dysfunction-free survival (LDFS) events were defined as local recurrence, laryngo-esophageal dysfunction (defined as tracheostomy or feeding tube dependence), or death from any cause.
Results
The median follow-up period was 61 months for the 80 patients included in the study. The 5-year LDFS rate was 47%. A clinical T4 stage and lower pretreatment prognostic nutritional index (PNI) were independently associated with a lower LDFS.
Conclusion
A clinical T4 stage and lower pretreatment PNI were identified as predictors of a lower LDFS after definitive radiotherapy for HPC.
{"title":"Preserving Laryngo-Esophageal Function in Patients With Hypopharyngeal Cancer Treated With Radiotherapy: Predictive Factors and Long-Term Outcomes","authors":"Aya Nakajima, Michio Yoshimura, Shinya Hiraoka, Ryota Nakashima, Yo Kishimoto, Koichi Omori, Takashi Mizowaki","doi":"10.1002/cam4.70374","DOIUrl":"10.1002/cam4.70374","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Functional outcomes after hypopharyngeal cancer (HPC) treatment have a significant effect on patients' quality of life and prognosis. This study aimed to identify the predictive factors associated with laryngo-esophageal dysfunction in patients with HPC who received definitive radiotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with HPC treated with definitive intensity-modulated radiotherapy between 2007 and 2019 at our institution were retrospectively evaluated. Laryngo-esophageal dysfunction-free survival (LDFS) events were defined as local recurrence, laryngo-esophageal dysfunction (defined as tracheostomy or feeding tube dependence), or death from any cause.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up period was 61 months for the 80 patients included in the study. The 5-year LDFS rate was 47%. A clinical T4 stage and lower pretreatment prognostic nutritional index (PNI) were independently associated with a lower LDFS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A clinical T4 stage and lower pretreatment PNI were identified as predictors of a lower LDFS after definitive radiotherapy for HPC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stuart L. Cramer, Alyssa Terry Reddy, Charles Gene Minard, Stephan Voss, Elizabeth Fox, Xiaowei Liu, Kristina Denic, Joel M. Reid, Brenda J. Weigel
Background
Nab-sirolimus (ABI-009, nab-rapamycin; Aadi Bioscience Inc. [Aadi]) is a human albumin-bound form of sirolimus nanoparticles, a potent mTOR inhibitor. This phase I trial was conducted to define dose-limiting toxicities (DLT), maximum tolerated or recommended phase II dose (MTD/RP2D), and pharmacokinetics of Nab-sirolimus in combination with temozolomide and irinotecan.
Methods
Using a rolling 6 design, Nab-sirolimus was administered intravenously (IV) on days (D) 1 and 8 of cycle (C) 1. In subsequent cycles, Nab-sirolimus was administered D1 and D8 in combination with temozolomide (125 mg/m2/dose, maximum 250 mg/dose) and irinotecan (90 mg/m2/dose) orally, daily on D1–5. Cycle duration was 21 days. Three dose levels (DL) of Nab-sirolimus were investigated (DL1: 35 mg/m2/dose, DL-1: 20 mg/m2/dose, and DL-2: 15 mg/m2/dose). The observation period for estimating the MTD/RP2D was defined by cycles 1 and 2.
Results
Thirty-three patients were enrolled, 32 were eligible. Dose determination included 17 evaluable patients, median (range) age 12 (2–20) years and six additional patients were enrolled (four evaluable for toxicity) on a pharmacokinetic cohort. C1 or C2 DLTs were primarily thrombocytopenia including 2/5 patients at DL1, 2/6 patients at DL-1, and 1/6 patients at DL-2. One patient (DL1) with Ewing Sarcoma had a partial response and remained on study for 35 cycles. Rapamycin clearance was dose dependent. Irinotecan clearance and its active metabolite SN-38 exposure were not affected by coadministration with Nab-sirolimus.
Conclusion
The MTD for Nab-sirolimus was 15 mg/m2/dose IV on D1 and D8 in combination with temozolomide 125 mg/m2/dose and oral irinotecan 90 mg/m2/dose daily for 5 days during 21D cycles.
{"title":"A Phase 1 Study of ABI-009 (Nab-sirolimus) in Combination With Temozolomide and Irinotecan in Pediatric Patients With Recurrent or Refractory Solid Tumors, Including CNS Tumors—A Children's Oncology Group Pediatric Early Phase Clinical Trial Network Study ADVL1514","authors":"Stuart L. Cramer, Alyssa Terry Reddy, Charles Gene Minard, Stephan Voss, Elizabeth Fox, Xiaowei Liu, Kristina Denic, Joel M. Reid, Brenda J. Weigel","doi":"10.1002/cam4.70376","DOIUrl":"10.1002/cam4.70376","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Nab</i>-sirolimus (ABI-009, <i>nab</i>-rapamycin; Aadi Bioscience Inc. [Aadi]) is a human albumin-bound form of sirolimus nanoparticles, a potent mTOR inhibitor. This phase I trial was conducted to define dose-limiting toxicities (DLT), maximum tolerated or recommended phase II dose (MTD/RP2D), and pharmacokinetics of <i>Nab</i>-sirolimus in combination with temozolomide and irinotecan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a rolling 6 design, <i>Nab</i>-sirolimus was administered intravenously (IV) on days (D) 1 and 8 of cycle (C) 1. In subsequent cycles, <i>Nab</i>-sirolimus was administered D1 and D8 in combination with temozolomide (125 mg/m<sup>2</sup>/dose, maximum 250 mg/dose) and irinotecan (90 mg/m<sup>2</sup>/dose) orally, daily on D1–5. Cycle duration was 21 days. Three dose levels (DL) of <i>Nab</i>-sirolimus were investigated (DL1: 35 mg/m<sup>2</sup>/dose, DL-1: 20 mg/m<sup>2</sup>/dose, and DL-2: 15 mg/m<sup>2</sup>/dose). The observation period for estimating the MTD/RP2D was defined by cycles 1 and 2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-three patients were enrolled, 32 were eligible. Dose determination included 17 evaluable patients, median (range) age 12 (2–20) years and six additional patients were enrolled (four evaluable for toxicity) on a pharmacokinetic cohort. C1 or C2 DLTs were primarily thrombocytopenia including 2/5 patients at DL1, 2/6 patients at DL-1, and 1/6 patients at DL-2. One patient (DL1) with Ewing Sarcoma had a partial response and remained on study for 35 cycles. Rapamycin clearance was dose dependent. Irinotecan clearance and its active metabolite SN-38 exposure were not affected by coadministration with <i>Nab</i>-sirolimus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MTD for <i>Nab</i>-sirolimus was 15 mg/m<sup>2</sup>/dose IV on D1 and D8 in combination with temozolomide 125 mg/m<sup>2</sup>/dose and oral irinotecan 90 mg/m<sup>2</sup>/dose daily for 5 days during 21D cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier NCT02975882</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70376","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linda Nissi, Sanni Tuominen, Johannes Routila, Teemu Huusko, Petra Ketonen, Maria Sundvall, Ilmo Leivo, Heikki Irjala, Heikki Minn, Tove J. Grönroos, Sami Ventelä
Background
xCT, also known as SLC7A11 (solute carrier Family 7 Member 11), is a cystine/glutamate antiporter protein that mediates regulated cell death and antioxidant defense. The aim of this study was to investigate the effect of xCT on the outcome of patients diagnosed with new head and neck squamous cell carcinoma (HNSCC).
Methods
This retrospective cohort study utilized a population-based dataset, comprising all patients (n = 1033) diagnosed with new HNSCC during 2005–2015 in a population of 697,000 people. All patients (n = 585) with a tumor tissue sample available for immunohistochemical (IHC) staining were included. The follow-up rates were 97% and 81% at 3 and 5 years, respectively. Also, the specificity of the anti-xCT antibody was validated.
Results
The expression level and prognostic significance of xCT were strongly dependent on tumor location. In oropharyngeal squamous cell carcinoma (OPSCC) patients, xCT expression was a significant prognostic factor for 5-year overall survival (OAS) (HR: 2.71; 95% CI 1.67–4.39; p < 0.001), disease-specific survival (DSS) (HR: 2.58; 95% CI 1.47–4.54; p = 0.001), and disease-free survival (DFS) (HR: 2.69; 95% CI 1.55–4.64; p < 0.001). Five-year survival rates for OPSCC patients with high and low levels of xCT were OAS 34% versus 62%; DSS 51% versus 73%; DFS 43% versus 73%, respectively. According to a multivariate model adjusted for age, T-class, nodal positivity, and tobacco consumption, xCT was an independent prognostic factor for 3-year survival, in which it outperformed p16 IHC. Similar associations were not observed in squamous cell carcinomas of oral cavity or larynx. Regarding treatment modalities, xCT was most predictive in HNSCC patients who received radiotherapy.
Conclusions
High xCT expression was associated with poor prognosis in OPSCC. Our findings suggest that joint analysis of xCT and p16 may add significant value in OPSCC treatment stratification.
{"title":"xCT as a Predictor for Survival in a Population-Based Cohort of Head and Neck Squamous Cell Carcinoma","authors":"Linda Nissi, Sanni Tuominen, Johannes Routila, Teemu Huusko, Petra Ketonen, Maria Sundvall, Ilmo Leivo, Heikki Irjala, Heikki Minn, Tove J. Grönroos, Sami Ventelä","doi":"10.1002/cam4.70371","DOIUrl":"10.1002/cam4.70371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>xCT, also known as SLC7A11 (solute carrier Family 7 Member 11), is a cystine/glutamate antiporter protein that mediates regulated cell death and antioxidant defense. The aim of this study was to investigate the effect of xCT on the outcome of patients diagnosed with new head and neck squamous cell carcinoma (HNSCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study utilized a population-based dataset, comprising all patients (<i>n</i> = 1033) diagnosed with new HNSCC during 2005–2015 in a population of 697,000 people. All patients (<i>n</i> = 585) with a tumor tissue sample available for immunohistochemical (IHC) staining were included. The follow-up rates were 97% and 81% at 3 and 5 years, respectively. Also, the specificity of the anti-xCT antibody was validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The expression level and prognostic significance of xCT were strongly dependent on tumor location. In oropharyngeal squamous cell carcinoma (OPSCC) patients, xCT expression was a significant prognostic factor for 5-year overall survival (OAS) (HR: 2.71; 95% CI 1.67–4.39; <i>p</i> < 0.001), disease-specific survival (DSS) (HR: 2.58; 95% CI 1.47–4.54; <i>p</i> = 0.001), and disease-free survival (DFS) (HR: 2.69; 95% CI 1.55–4.64; <i>p</i> < 0.001). Five-year survival rates for OPSCC patients with high and low levels of xCT were OAS 34% versus 62%; DSS 51% versus 73%; DFS 43% versus 73%, respectively. According to a multivariate model adjusted for age, T-class, nodal positivity, and tobacco consumption, xCT was an independent prognostic factor for 3-year survival, in which it outperformed p16 IHC. Similar associations were not observed in squamous cell carcinomas of oral cavity or larynx. Regarding treatment modalities, xCT was most predictive in HNSCC patients who received radiotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High xCT expression was associated with poor prognosis in OPSCC. Our findings suggest that joint analysis of xCT and p16 may add significant value in OPSCC treatment stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this study was to evaluate the predictors of deterioration of the Child-Pugh classification 1 month after transcatheter arterial chemo-embolization (TACE) in patients with treatment-naive hepatocellular carcinoma (HCC).
Methods
Between 2010 and 2020, consecutive patients who underwent conventional TACE using epirubicin as the initial treatment were enrolled. Patients with Barcelona Clinic Liver Cancer stage-0, A or B and Child-Pugh class A were included. The Child-Pugh score was evaluated before treatment and 1 month after TACE. The following variables were analyzed by univariate and multivariate analyses as predictors of deterioration of the Child-Pugh class from A to B: age, sex, etiology, serum albumin, bilirubin, prothrombin time (PT), encephalopathy, ascites, largest tumor diameter, tumor number, tumor location, α-fetoprotein, protein induced by vitamin K absence or antagonist-II, epirubicin dosage, ethiodized oil dosage, and number of treated liver segments.
Results
A total of 152 patients were retrospectively enrolled. The deterioration rate of the Child-Pugh class from A to B was 8.6%. Multivariable analysis showed that serum albumin ≤ 3.8 g/dL, PT ≤ 80%, and largest tumor diameter ≥ 3.8 cm were predictors of deterioration of the Child-Pugh class. The deterioration rate to Child-Pugh class B was 0% in patients with up to one of these factors, 14.3% in those with two factors, and 70% in those with three factors.
Conclusions
A combination of serum albumin ≤ 3.8 g/dL, PT ≤ 80%, and largest tumor diameter ≥ 3.8 cm can predict the immediate deterioration of the Child-Pugh classification from A to B following TACE.
目的：本研究旨在评估未经治疗的肝细胞癌（HCC）患者经导管动脉化疗栓塞术（TACE）1个月后Child-Pugh分级恶化的预测因素：方法： 2010年至2020年期间，对接受了以表柔比星为初始治疗的传统TACE的连续患者进行了登记。纳入的患者均为巴塞罗那临床肝癌分期为0、A或B期且Child-Pugh分级为A级的患者。在治疗前和TACE后1个月对Child-Pugh评分进行评估。通过单变量和多变量分析，对以下变量进行了分析，以预测Child-Pugh分级从A级恶化到B级：年龄、性别、病因、血清白蛋白、胆红素、凝血酶原时间（PT）、脑病、腹水、最大肿瘤直径、肿瘤数量、肿瘤位置、α-胎儿蛋白、维生素K缺失或拮抗剂-II诱导的蛋白质、表柔比星用量、乙碘油用量和治疗肝段数量：结果：共有 152 名患者接受了回顾性治疗。Child-Pugh 分级从 A 到 B 的恶化率为 8.6%。多变量分析显示，血清白蛋白≤3.8 g/dL、PT≤80%和最大肿瘤直径≥3.8 cm是预测Child-Pugh分级恶化的因素。在只有一个上述因素的患者中，Child-Pugh B 级的恶化率为 0%，两个因素的恶化率为 14.3%，三个因素的恶化率为 70%：结论：血清白蛋白≤3.8 g/dL、PT≤80%和最大肿瘤直径≥3.8 cm可预测TACE后Child-Pugh分级从A级立即恶化为B级。
{"title":"Predictors of Immediate Deterioration of the Child-Pugh Classification From A to B After Transcatheter Arterial Chemo-Embolization for Treatment-Naive Hepatocellular Carcinoma","authors":"Kazuo Asano, Ken Kageyama, Akira Yamamoto, Atsushi Jogo, Mariko Nakano, Kazuki Murai, Yoshimi Yukawa-Muto, Naoshi Odagiri, Kohei Kotani, Ritsuzo Kozuka, Etsushi Kawamura, Hideki Fujii, Sawako Uchida-Kobayashi, Masaru Enomoto, Norifumi Kawada, Yukio Miki","doi":"10.1002/cam4.70367","DOIUrl":"10.1002/cam4.70367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate the predictors of deterioration of the Child-Pugh classification 1 month after transcatheter arterial chemo-embolization (TACE) in patients with treatment-naive hepatocellular carcinoma (HCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2010 and 2020, consecutive patients who underwent conventional TACE using epirubicin as the initial treatment were enrolled. Patients with Barcelona Clinic Liver Cancer stage-0, A or B and Child-Pugh class A were included. The Child-Pugh score was evaluated before treatment and 1 month after TACE. The following variables were analyzed by univariate and multivariate analyses as predictors of deterioration of the Child-Pugh class from A to B: age, sex, etiology, serum albumin, bilirubin, prothrombin time (PT), encephalopathy, ascites, largest tumor diameter, tumor number, tumor location, α-fetoprotein, protein induced by vitamin K absence or antagonist-II, epirubicin dosage, ethiodized oil dosage, and number of treated liver segments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 152 patients were retrospectively enrolled. The deterioration rate of the Child-Pugh class from A to B was 8.6%. Multivariable analysis showed that serum albumin ≤ 3.8 g/dL, PT ≤ 80%, and largest tumor diameter ≥ 3.8 cm were predictors of deterioration of the Child-Pugh class. The deterioration rate to Child-Pugh class B was 0% in patients with up to one of these factors, 14.3% in those with two factors, and 70% in those with three factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A combination of serum albumin ≤ 3.8 g/dL, PT ≤ 80%, and largest tumor diameter ≥ 3.8 cm can predict the immediate deterioration of the Child-Pugh classification from A to B following TACE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amrit Baral, Bria-Necole A. Diggs, Ranya Marrakchi El Fellah, Connor McCarley, Frank Penedo, Claudia Martinez, Denise C. Vidot
Objective
This study aims to describe patterns, sources, and reasons for cannabis use among cancer patients during active treatment (+CDTX) compared to no-use during active treatment (−CDTX).
Methods
Data are from 385 surveys collected via REDCap during phase I of an ongoing study among adult cancer patients seen at an NCI-designated comprehensive cancer center within the last 5 years of treatment. A harmonized survey was created with 11 other NCI centers to assess cannabis use patterns, sources, and reasons for use. Sociodemographics and cancer details were also collected via self-report. Descriptive statistics were calculated and stratified by +/−CDTX. Chi-squared tests were conducted to compare proportions between groups.
Results
Among the sample [49.5 years (SD 15.9); 53.0% male; and 41.6% Hispanic/Latino], 41.0% + CDTX and 59.0% −CDTX. A majority (71.8%) of +CDTX initiated use before diagnosis versus 44.1% in −CDTX (p < 0.0001); patients diagnosed with stage 4 cancer had a statistically significant higher prevalence of +CDTX (60.0%; p = 0.003); 53.3% in radiation reported +CDTX compared to 42.8% in chemotherapy, and 36.4% in immunotherapy. Dispensaries and local dealers were the top sources of cannabis in both groups. Among +CDTX, 44.3% consumed cannabis at least once a day DTX, dominant cannabinoids used were CBD (35.2%), Delta-8-THC (18.3%), and CBD + THC ratio (14.1%); 12.7% were unsure what they consumed. Joints were the most common inhalation method (61.5%), and store-bought candy was the most common edible (39.2%). Depression/mood, pain, and enjoyment were the top three reasons for +CDTX compared to enjoyment, depression/mood, and nausea/upset stomach in −CDTX (p = 0.02).
Conclusions
Patterns, sources, and reasons for cannabis use varied between +CDTX and -CDTX. Future studies should examine the impacts of cannabis and specific cannabinoids on cancer treatment, drug interactions, survival outcomes, and quality of life.
{"title":"Cannabis Use Among Cancer Patients During Active Treatment: Findings From a Study at an NCI-Designated Cancer Center","authors":"Amrit Baral, Bria-Necole A. Diggs, Ranya Marrakchi El Fellah, Connor McCarley, Frank Penedo, Claudia Martinez, Denise C. Vidot","doi":"10.1002/cam4.70384","DOIUrl":"10.1002/cam4.70384","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to describe patterns, sources, and reasons for cannabis use among cancer patients during active treatment (+CDTX) compared to no-use during active treatment (−CDTX).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data are from 385 surveys collected via REDCap during phase I of an ongoing study among adult cancer patients seen at an NCI-designated comprehensive cancer center within the last 5 years of treatment. A harmonized survey was created with 11 other NCI centers to assess cannabis use patterns, sources, and reasons for use. Sociodemographics and cancer details were also collected via self-report. Descriptive statistics were calculated and stratified by +/−CDTX. Chi-squared tests were conducted to compare proportions between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the sample [49.5 years (SD 15.9); 53.0% male; and 41.6% Hispanic/Latino], 41.0% + CDTX and 59.0% −CDTX. A majority (71.8%) of +CDTX initiated use before diagnosis versus 44.1% in −CDTX (<i>p</i> < 0.0001); patients diagnosed with stage 4 cancer had a statistically significant higher prevalence of +CDTX (60.0%; <i>p</i> = 0.003); 53.3% in radiation reported +CDTX compared to 42.8% in chemotherapy, and 36.4% in immunotherapy. Dispensaries and local dealers were the top sources of cannabis in both groups. Among +CDTX, 44.3% consumed cannabis at least once a day DTX, dominant cannabinoids used were CBD (35.2%), Delta-8-THC (18.3%), and CBD + THC ratio (14.1%); 12.7% were unsure what they consumed. Joints were the most common inhalation method (61.5%), and store-bought candy was the most common edible (39.2%). Depression/mood, pain, and enjoyment were the top three reasons for +CDTX compared to enjoyment, depression/mood, and nausea/upset stomach in −CDTX (<i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patterns, sources, and reasons for cannabis use varied between +CDTX and -CDTX. Future studies should examine the impacts of cannabis and specific cannabinoids on cancer treatment, drug interactions, survival outcomes, and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Piero Bettoli, Evangelina Röling, Moises Russo, María Fernanda Sánchez, Inti Paredes, Jorge Sapunar
Purpose and Objective
Salvage radiotherapy (sRT) can have similar outcomes to adjuvant radiotherapy (aRT) if administered at the earliest evidence of biochemical recurrence. RADICALS-RT was the first trial to support this hypothesis and a policy of observation after radical prostatectomy (RP) with early sRT has become the new standard of care since then. This study assessed the impact of RADICALS-RT in the clinical practice regarding the timing of sRT for prostate cancer initially treated with RP.
Methods
Data from 297 patients who underwent sRT after radical RP were retrospectively collected. Two groups were created and analyzed on the basis of the date of RADICALS-RT presentation at ESMO. After these results were released in October 2021, our institutional postoperative radiotherapy policy was revisited, and a third group was created and analyzed separately.
Results
Median PSA for Groups 1, 2, and 3 were 0.33, 0.27, and 0.2, respectively. Less than one-third of patients in Groups 1 and 2 had a postoperative PSA of 0.2 ng/mL or less at the time of sRT. Group 3 showed statistically significant differences in median PSA at the time of sRT compared with Groups 1 and 2.
Conclusions
RADICALS-RT demonstrated a significant impact on clinical practice only after being complemented with real local evidence.
{"title":"Shaping Clinical Policy for Salvage Radiotherapy After Radical Prostatectomy in Prostate Cancer: Bridging the Gap Between Clinical Trials and Daily Practice","authors":"Piero Bettoli, Evangelina Röling, Moises Russo, María Fernanda Sánchez, Inti Paredes, Jorge Sapunar","doi":"10.1002/cam4.70362","DOIUrl":"10.1002/cam4.70362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose and Objective</h3>\u0000 \u0000 <p>Salvage radiotherapy (sRT) can have similar outcomes to adjuvant radiotherapy (aRT) if administered at the earliest evidence of biochemical recurrence. RADICALS-RT was the first trial to support this hypothesis and a policy of observation after radical prostatectomy (RP) with early sRT has become the new standard of care since then. This study assessed the impact of RADICALS-RT in the clinical practice regarding the timing of sRT for prostate cancer initially treated with RP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 297 patients who underwent sRT after radical RP were retrospectively collected. Two groups were created and analyzed on the basis of the date of RADICALS-RT presentation at ESMO. After these results were released in October 2021, our institutional postoperative radiotherapy policy was revisited, and a third group was created and analyzed separately.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median PSA for Groups 1, 2, and 3 were 0.33, 0.27, and 0.2, respectively. Less than one-third of patients in Groups 1 and 2 had a postoperative PSA of 0.2 ng/mL or less at the time of sRT. Group 3 showed statistically significant differences in median PSA at the time of sRT compared with Groups 1 and 2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RADICALS-RT demonstrated a significant impact on clinical practice only after being complemented with real local evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kevin Wang Leong So, Evan Mang Ching Leung, Tommy Ng, Rachel Tsui, Jason Pui Yin Cheung, Siu-Wai Choi
Introduction: The aim of this study was to find the most appropriate variables to input into machine learning algorithms to identify those patients with primary lung malignancy with high risk for metastasis to the bone.
Patient inclusion: Patients with either histological or radiological diagnoses of lung cancer were included in this study.
Results: The patient cohort comprised 1864 patients diagnosed from 2016 to 2021. A total of 25 variables were considered as potential risk factors. These variables have been identified in previous studies as independent risk factors for bone metastasis. Treatment methods for lung cancer were taken into account during model development. The outcome variable was binary, (presence or absence of bone metastasis) with follow-up until death or 12-month survival, whichever is the sooner. Results showed that American Joint Committee on Cancer staging, the use of EGFR inhibitor, age, T-staging, and lymphovascular invasion were the five input features contributing the most to the model algorithm. High AJCC staging (OR 1.98; p < 0.05), the use of EGFR inhibitor (OR 6.14; p < 0.05), high T-staging (OR 1.47; p < 0.05), and the presence of lymphovascular invasion (OR 4.92; p < 0.05) increase predicted risk of bone metastasis. Conversely, older age reduces predicted bone metastasis risk (OR 0.98; p < 0.05).
Conclusion: The machine learning model developed in this study can be easily incorporated into the hospital's Clinical Management System so that input variables can be immediately utilized to give an accurate prediction of bone metastatic risk, therefore informing clinicians on the best treatment strategy for that individual patient.
{"title":"Machine Learning Models to Predict Bone Metastasis Risk in Patients With Lung Cancer.","authors":"Kevin Wang Leong So, Evan Mang Ching Leung, Tommy Ng, Rachel Tsui, Jason Pui Yin Cheung, Siu-Wai Choi","doi":"10.1002/cam4.70383","DOIUrl":"10.1002/cam4.70383","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to find the most appropriate variables to input into machine learning algorithms to identify those patients with primary lung malignancy with high risk for metastasis to the bone.</p><p><strong>Patient inclusion: </strong>Patients with either histological or radiological diagnoses of lung cancer were included in this study.</p><p><strong>Results: </strong>The patient cohort comprised 1864 patients diagnosed from 2016 to 2021. A total of 25 variables were considered as potential risk factors. These variables have been identified in previous studies as independent risk factors for bone metastasis. Treatment methods for lung cancer were taken into account during model development. The outcome variable was binary, (presence or absence of bone metastasis) with follow-up until death or 12-month survival, whichever is the sooner. Results showed that American Joint Committee on Cancer staging, the use of EGFR inhibitor, age, T-staging, and lymphovascular invasion were the five input features contributing the most to the model algorithm. High AJCC staging (OR 1.98; p < 0.05), the use of EGFR inhibitor (OR 6.14; p < 0.05), high T-staging (OR 1.47; p < 0.05), and the presence of lymphovascular invasion (OR 4.92; p < 0.05) increase predicted risk of bone metastasis. Conversely, older age reduces predicted bone metastasis risk (OR 0.98; p < 0.05).</p><p><strong>Conclusion: </strong>The machine learning model developed in this study can be easily incorporated into the hospital's Clinical Management System so that input variables can be immediately utilized to give an accurate prediction of bone metastatic risk, therefore informing clinicians on the best treatment strategy for that individual patient.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 22","pages":"e70383"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We aimed to examine the effectiveness of a nurse-led, screening-triggered early specialized palliative care intervention program for patients with advanced lung cancer.
Methods: Patients with advanced lung cancer who underwent initial chemotherapy were randomized to intervention and usual care groups between January 2017 and September 2019. The intervention comprised comprehensive needs assessments, counseling, and service coordination by advanced-level nurses. Patients in the usual care group received the usual oncological care. The primary end point was a change in the trial outcome index (TOI) scores from baseline to 12 weeks. The secondary end-points were TOI scores at week 20, depression, anxiety, and survival.
Results: In total, 102 patients were assigned to each group. Compared with the usual care group, no significant improvement in TOI scores was observed at 12 weeks in the intervention group (mean group difference: 2.13; 90% confidence interval: -0.70, 4.95; p = 0.107, one-sided), whereas significant improvement was observed at 20 weeks (3.58; 90% confidence interval: 0.15, 7.00; p = 0.043). There were no significant differences in the change from baseline depression and anxiety between the groups from baseline at week 12 and 20 weeks (depression: p = 0.60 and 0.10, anxiety: p = 0.78 and 0.067). Survival did not significantly differ between the groups (median survival time: 12.1 vs. 11.1 months; p = 0.302).
Conclusions: Nurse-led, screening-triggered, early specialized palliative care did not show significant superiority over usual care during the 12-week study period. However, it may have yielded delayed clinical benefits, such as improved quality of life and this feasible model can be acceptable in clinical practice.
Trial registration: The University Hospital Medical Information Network Clinical Trials Registry: UMIN000025491.
{"title":"Nurse-Led Screening-Triggered Early Specialized Palliative Care Program for Patients With Advanced Lung Cancer: A Multicenter Randomized Controlled Trial.","authors":"Yoshihisa Matsumoto, Shigeki Umemura, Ayumi Okizaki, Daisuke Fujisawa, Takuhiro Yamaguchi, Shunsuke Oyamada, Tempei Miyaji, Tomoe Mashiko, Naoko Kobayashi, Eriko Satomi, Daisuke Kiuchi, Tatsuya Morita, Yosuke Uchitomi, Koichi Goto, Yuichiro Ohe","doi":"10.1002/cam4.70325","DOIUrl":"10.1002/cam4.70325","url":null,"abstract":"<p><strong>Background: </strong>We aimed to examine the effectiveness of a nurse-led, screening-triggered early specialized palliative care intervention program for patients with advanced lung cancer.</p><p><strong>Methods: </strong>Patients with advanced lung cancer who underwent initial chemotherapy were randomized to intervention and usual care groups between January 2017 and September 2019. The intervention comprised comprehensive needs assessments, counseling, and service coordination by advanced-level nurses. Patients in the usual care group received the usual oncological care. The primary end point was a change in the trial outcome index (TOI) scores from baseline to 12 weeks. The secondary end-points were TOI scores at week 20, depression, anxiety, and survival.</p><p><strong>Results: </strong>In total, 102 patients were assigned to each group. Compared with the usual care group, no significant improvement in TOI scores was observed at 12 weeks in the intervention group (mean group difference: 2.13; 90% confidence interval: -0.70, 4.95; p = 0.107, one-sided), whereas significant improvement was observed at 20 weeks (3.58; 90% confidence interval: 0.15, 7.00; p = 0.043). There were no significant differences in the change from baseline depression and anxiety between the groups from baseline at week 12 and 20 weeks (depression: p = 0.60 and 0.10, anxiety: p = 0.78 and 0.067). Survival did not significantly differ between the groups (median survival time: 12.1 vs. 11.1 months; p = 0.302).</p><p><strong>Conclusions: </strong>Nurse-led, screening-triggered, early specialized palliative care did not show significant superiority over usual care during the 12-week study period. However, it may have yielded delayed clinical benefits, such as improved quality of life and this feasible model can be acceptable in clinical practice.</p><p><strong>Trial registration: </strong>The University Hospital Medical Information Network Clinical Trials Registry: UMIN000025491.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 22","pages":"e70325"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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