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Medical Record-Keeping Then and Now. 医疗记录保存的过去与现在
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1200/OP-24-00683
Irene Kuter

The electronic health record has affected how physicians document patient care, and presents challenges.

电子病历影响了医生记录病人护理的方式,也带来了挑战。
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引用次数: 0
Real-World Immune-Related Adverse Events in Patients With Early Triple-Negative Breast Cancer Who Received Pembrolizumab. 接受 Pembrolizumab 治疗的早期三阴性乳腺癌患者真实世界中与免疫相关的不良事件。
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1200/OP.24.00371
Athira Jayan, Jasmine S Sukumar, Benjamin Fangman, Tejal Patel, Akshara Singareeka Raghavendra, Diane Liu, Sarah Pasyar, Ronald Rauch, Karen Basen-Engquist, Debasish Tripathy, Yinghong Wang, Sonya S Khan, Carlos H Barcenas

Purpose: The addition of pembrolizumab to chemotherapy in high-risk early triple-negative breast cancer (TNBC) improves cancer outcomes. However, pembrolizumab induces varied immune-related adverse events (irAEs) where some can be severe or lifelong. This retrospective study describes real-world patterns of irAEs in patients with TNBC who received pembrolizumab.

Methods: We evaluated irAEs in patients with TNBC from a comprehensive cancer center and a community hospital who received pembrolizumab with chemotherapy between 2021 and 2023, excluding those enrolled in clinical trials. We used national guidelines to grade toxicities. Logistic regression assessed the effect of clinicopathologic variables on irAEs adjusting for covariates.

Results: We identified 233 patients with a median age of 51 years, 62% had stage II TNBC, 35% had stage III TNBC, 25% were Hispanic, 21% were Black, and 42% were White. Eighty patients (34%) developed 100 separate irAEs. The most common irAEs were endocrinopathies (52%) and GI (23%); there were 26 grade ≥3 irAEs, which all resulted in hospitalization, the most common being GI (13 instances); 45 required systemic steroids, 16 required additional immunosuppressive therapy, and 32 patients discontinued pembrolizumab because of irAEs. Two patients who developed colitis eventually died due to complications. Most (67 instances) irAEs were unresolved at the time of last follow-up, but 55% (37/67) had improved to grade 1. No clinicopathologic factors were associated with the development or severity of irAEs.

Conclusion: In this real-world diverse population, we observed rates of irAEs comparable with KEYNOTE-522, where endocrinopathies were the most prevalent, but GI irAEs were also prevalent and severe. This emphasizes a critical issue as pembrolizumab is increasingly being used in early TNBC and could have long-term survivorship implications.

目的:在高风险早期三阴性乳腺癌(TNBC)化疗中加入 pembrolizumab 可改善癌症预后。然而,pembrolizumab 会诱发各种免疫相关不良事件(irAEs),其中一些可能是严重的或终身性的。这项回顾性研究描述了接受pembrolizumab治疗的TNBC患者发生irAEs的真实情况:我们评估了一家综合癌症中心和一家社区医院在2021年至2023年间接受pembrolizumab联合化疗的TNBC患者的irAEs,不包括参加临床试验的患者。我们采用国家指南对毒性进行分级。逻辑回归评估了临床病理变量对irAEs的影响,并对协变量进行了调整:我们确定了 233 名患者,中位年龄为 51 岁,62% 为 TNBC II 期,35% 为 TNBC III 期,25% 为西班牙裔,21% 为黑人,42% 为白人。80名患者(34%)出现了100种不同的虹膜AE。最常见的irAE是内分泌疾病(52%)和消化道疾病(23%);26例≥3级irAE均导致住院治疗,其中最常见的是消化道疾病(13例);45例患者需要全身使用类固醇,16例患者需要额外的免疫抑制治疗,32例患者因irAE停用了pembrolizumab。两名出现结肠炎的患者最终死于并发症。在最后一次随访时,大多数(67 例)irAEs 尚未缓解,但 55%(37/67)的irAEs 已改善至 1 级。没有临床病理因素与虹膜AE的发生或严重程度相关:结论:在这一真实世界的不同人群中,我们观察到的irAEs发生率与KEYNOTE-522相当,其中内分泌疾病最为普遍,但消化道irAEs也很普遍且严重。这强调了一个关键问题,即随着pembrolizumab越来越多地用于早期TNBC,它可能会对患者的长期生存产生影响。
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引用次数: 0
Creating a Learning Health System in a Cancer Center: Generalizability of an Electronic Health Record Phenotype for Advanced Solid Cancer. 在癌症中心创建学习型医疗系统:晚期实体癌电子健康记录表型的推广性。
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1200/OP.24.00389
Anne M Walling, Karl A Lorenz, Anita Yuan, Claire E O'Hanlon, Michael McClean, Benjamin Fayyazuddin Ljungberg, Karleen F Giannitrapani, Selen Bozkurt, Sidharth Anand, John Glaspy, Neil S Wenger, Charlotta Lindvall

Purpose: To test the generalizability of an electronic health record (EHR) phenotype for patients with advanced solid cancer, which was previously developed in a single cancer center.

Methods: We compared an algorithm to identify patients with advanced solid cancer from a random sample of patients with active cancer in the Veterans Health Administration (VA) and an academic cancer center with a human-coded reference standard between January 1, 2016, and December 31, 2019.

Results: Compared with the human-coded reference standard, the algorithm had high specificity (93%; 95% CI, 87 to 99 and 97%; 95% CI, 93 to 100) and reasonable sensitivity (85%; 95% CI, 76 to 94 and 87%; 95% CI, 77 to 97) in the VA and academic cancer center populations, respectively. Patients with advanced cancer (compared with those with active nonadvanced cancer) had higher mortality at the VA and academic cancer center (29.2% and 17.0% 6-month mortality v 6.8% and 3.5%), respectively.

Conclusion: This EHR phenotype can be used to measure and improve the quality of palliative care for patients with advanced cancer within and across health care settings.

目的:测试晚期实体癌患者电子健康记录(EHR)表型的通用性:我们比较了退伍军人健康管理局(VA)和一家学术癌症中心在 2016 年 1 月 1 日至 2019 年 12 月 31 日期间从活动性癌症患者随机抽样中识别晚期实体癌患者的算法与人工编码参考标准:与人类编码参考标准相比,该算法在退伍军人健康管理局和学术癌症中心人群中分别具有较高的特异性(93%;95% CI,87 至 99 和 97%;95% CI,93 至 100)和合理的灵敏度(85%;95% CI,76 至 94 和 87%;95% CI,77 至 97)。在退伍军人事务部和学术癌症中心,晚期癌症患者(与活动性非晚期癌症患者相比)的死亡率较高(6 个月死亡率分别为 29.2% 和 17.0% 对 6.8% 和 3.5%):这种电子病历表型可用于衡量和改善医疗机构内部和医疗机构之间晚期癌症患者姑息治疗的质量。
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引用次数: 0
Multidisciplinary Management of Pregnancy-Associated Breast Cancer. 妊娠相关性乳腺癌的多学科管理。
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-09 DOI: 10.1200/OP-24-00453
Erin Roesch, Amanda Maggiotto, Stephanie A Valente

Breast cancer during pregnancy is uncommon; however, it is one of the most common malignancies affecting pregnant women. Pregnancy-associated breast cancer (PABC) is a complex entity characterized by unique risk factors, presentation, and pathology. Furthermore, although management generally aims to mirror that for nonpregnant patients, there are distinct aspects of oncologic care delivery specific to PABC. The focus is on optimizing maternal outcomes while maximizing maternal and fetal safety. A multidisciplinary approach is key, and the timing of various treatment modalities is critical. Postdelivery care and counseling are also imperative to address issues such as contraception, breastfeeding, and future fertility. In the present review, we discuss the current knowledge base and the diagnostic and treatment landscape for PABC, including recent literature and practice pattern updates.

妊娠期乳腺癌并不常见,但却是影响孕妇的最常见恶性肿瘤之一。妊娠相关性乳腺癌(PABC)是一个复杂的实体,具有独特的风险因素、表现和病理特征。此外,虽然治疗方法一般都与非妊娠期患者相同,但妊娠相关性乳腺癌的肿瘤治疗也有其独特之处。重点在于优化孕产妇的预后,同时最大限度地保障孕产妇和胎儿的安全。多学科方法是关键,各种治疗方式的时机选择也至关重要。产后护理和咨询对于解决避孕、母乳喂养和未来生育等问题也至关重要。在本综述中,我们讨论了 PABC 目前的知识基础和诊断与治疗情况,包括近期文献和实践模式的更新。
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引用次数: 0
Three Versus Six Months of Adjuvant Oxaliplatin-Containing Chemotherapy for Patients With Stage III Colorectal Cancer: A Contemporary Real-World Analysis. III 期结直肠癌患者接受含奥沙利铂辅助化疗三个月还是六个月?当代真实世界分析
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-09 DOI: 10.1200/OP-24-00492
Tharani Krishnan, Emily Leung, Joao Paulo Solar Vasconcelos, Howard Lim, Jonathan M Loree, Janine Davies, Karamjit Gill, Sharlene Gill

Purpose: Based on the International Duration Evaluation of Adjuvant Chemotherapy analysis, 3 months of adjuvant chemotherapy with capecitabine and oxaliplatin (CAPOX) is an option for stage III colorectal cancer (colorectal cancer [CRC]), with cost and toxicity benefits. We examined the patterns of uptake of CAPOX versus fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and chemotherapy duration in a contemporary real-world cohort of patients in Canada.

Methods: The provincial pharmacy database was used to identify patients with resected stage III CRC receiving adjuvant chemotherapy between January 2021 and December 2022. Demographic, tumor, and treatment information was collected and compared.

Results: Of 452 patients, 234 (52%) and 218 (48%) were planned to receive 3 and 6 months of chemotherapy, respectively. Within the 3-month group, 226 (97%) received CAPOX. Within the 6-month group, there was a 51%-49% split between CAPOX and FOLFOX. Age >70 years (P = .039), well/moderately differentiated (P = .005), and low-risk disease (P < .0001) were significantly associated with 3 months. Performance status, ileostomy, or preexisting neuropathy did not affect treatment choice. Of patients planned for 6 months, 29% had low-risk disease, with 52% of these receiving CAPOX. Patients receiving 6 months were more likely to report neuropathy (68 v 36%, P < .0001) and to stop oxaliplatin early (54 v 31%, P < .0001). The most likely reason for early adjuvant discontinuation was neuropathy in the 6-month group and gastrointestinal toxicity in the 3-month group (P < .0001). Irrespective of duration, mean time from consult to starting chemotherapy was longer for FOLFOX versus CAPOX (24 v 19 days, P = .007).

Conclusion: In this contemporary cohort, 6 months chemotherapy is still being offered to patients with low-risk disease and is associated with more neuropathy. Exploration of patient preferences and resource costs may improve adoption of reduced duration adjuvant CAPOX in stage III CRC.

目的:根据国际辅助化疗持续时间评估分析,3 个月的卡培他滨和奥沙利铂辅助化疗(CAPOX)是 III 期结直肠癌(colorectal cancer [CRC])的一种选择,具有成本和毒性优势。我们研究了加拿大当代真实世界患者队列中 CAPOX 与氟尿嘧啶、亮菌素和奥沙利铂(FOLFOX)的使用模式以及化疗持续时间:方法:利用省级药房数据库来识别2021年1月至2022年12月期间接受辅助化疗的切除III期CRC患者。收集并比较了人口统计学、肿瘤和治疗信息:在452名患者中,分别有234人(52%)和218人(48%)计划接受3个月和6个月的化疗。在 3 个月组中,226 人(97%)接受了 CAPOX 化疗。在 6 个月组中,CAPOX 和 FOLFOX 的比例为 51%-49%。年龄大于 70 岁(P = .039)、分化良好/中度(P = .005)和低风险疾病(P < .0001)与 3 个月的疗程显著相关。表现状态、回肠造口术或已有的神经病变并不影响治疗选择。在计划接受 6 个月治疗的患者中,29% 患有低风险疾病,其中 52% 接受了 CAPOX 治疗。接受 6 个月治疗的患者更有可能报告神经病变(68 对 36%,P < .0001)和提前停用奥沙利铂(54 对 31%,P < .0001)。6个月组患者最有可能提前停用辅助药物的原因是神经病变,3个月组患者最有可能提前停用辅助药物的原因是胃肠道毒性(P < .0001)。无论疗程长短,FOLFOX与CAPOX相比,从就诊到开始化疗的平均时间更长(24天对19天,P = .007):结论:在这一现代队列中,6 个月的化疗仍在提供给低风险疾病患者,并且与更多的神经病变相关。对患者偏好和资源成本的探讨可能会改善 CAPOX 辅助化疗在 III 期 CRC 中的应用。
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引用次数: 0
Guide to Understanding and Supporting International Medical Graduates in Hematology/Oncology by the ASCO International Medical Graduates Community of Practice. 由 ASCO 国际医学毕业生实践社区编写的《了解和支持血液学/肿瘤学国际医学毕业生指南》。
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-07 DOI: 10.1200/OP-24-00565
Nazli Dizman, Ziad Bakouny, Tarek Haykal, Ivy Riano, Aakash Desai, Ayesha Butt, Arnab Basu, Dan Zhao, Eddy Saad, Renee Maria Saliby, Rohit Gosain, Rahul Gosain, Fatemeh Ardeshir, Lei Deng, Laurie Matt-Amaral, Konstantinos Arnaoutakis, Tanios Bekaii-Saab, Rami Manochakian, Ariela Marshall, Patrick Forde, Martina Murphy, Vivek Subbiah, Mariana Chavez-MacGregor, Taofeek K Owonikoko, Gilberto Lopes, Charu Aggarwal, Alfred I Lee, Toni K Choueiri

Purpose: International medical graduates (IMGs) are an essential component of the oncology workforce in the United States, comprising a third of all practicing oncologists and almost half of hematology/oncology fellows. In this article, we discuss the contributions of IMGs in the US oncology workforce, review unique challenges faced by IMGs, and propose potential solutions to overcome these challenges.

Methods: ASCO's IMG Community of Practice was established with the mission to connect, mentor, guide, raise awareness, and overcome the challenges unique to IMGs interested in pursuing medical oncology in the United States. The content of this article is based on discussions at the IMG Community of Practice meetings at ASCO's 2023 and 2024 Annual Meetings.

Results: IMGs bring an inherent diversity of thought and experience to the oncology workforce. They provide high-quality, culture- and language-concordant care to a diverse population of patients with cancer. However, IMGs in oncology face significant hardships throughout their careers, including visa-related restrictions, psychosocial and cultural struggles, as well as differential treatment while applying for residency and fellowship training, and early career positions. Greater awareness of these challenges among the members of the hematology/oncology community, along with institutional and individual efforts to support IMGs, is warranted.

Conclusion: We encourage oncology professionals and institutions to join our efforts in recognizing the unique paths of IMGs and providing support and advocacy to maximize the potential of IMGs in the US oncology workforce.

目的:国际医学毕业生(IMGs)是美国肿瘤学人才队伍的重要组成部分,占所有执业肿瘤学家的三分之一,几乎占血液学/肿瘤学研究员的一半。在这篇文章中,我们讨论了 IMG 在美国肿瘤学队伍中的贡献,回顾了 IMG 面临的独特挑战,并提出了克服这些挑战的潜在解决方案:ASCO的IMG实践社区成立的宗旨是为有意在美国从事肿瘤内科工作的IMG提供联系、指导、引导、提高意识,并克服他们所面临的独特挑战。本文内容基于 ASCO 2023 年和 2024 年年会上 IMG 实践社区会议的讨论结果:IMG为肿瘤医生队伍带来了固有的思想和经验多样性。他们为不同的癌症患者提供高质量、文化和语言相一致的医疗服务。然而,肿瘤学领域的 IMG 在整个职业生涯中都面临着巨大的困难,包括与签证相关的限制、社会心理和文化方面的挣扎,以及在申请住院医师和研究员培训以及早期职业职位时受到的不同待遇。血液学/肿瘤学界成员应进一步认识到这些挑战,同时机构和个人也应努力支持IMGs:我们鼓励肿瘤学专业人士和机构与我们共同努力,认识到 IMGs 的独特道路,并提供支持和宣传,最大限度地发挥 IMGs 在美国肿瘤学人才队伍中的潜力。
{"title":"Guide to Understanding and Supporting International Medical Graduates in Hematology/Oncology by the ASCO International Medical Graduates Community of Practice.","authors":"Nazli Dizman, Ziad Bakouny, Tarek Haykal, Ivy Riano, Aakash Desai, Ayesha Butt, Arnab Basu, Dan Zhao, Eddy Saad, Renee Maria Saliby, Rohit Gosain, Rahul Gosain, Fatemeh Ardeshir, Lei Deng, Laurie Matt-Amaral, Konstantinos Arnaoutakis, Tanios Bekaii-Saab, Rami Manochakian, Ariela Marshall, Patrick Forde, Martina Murphy, Vivek Subbiah, Mariana Chavez-MacGregor, Taofeek K Owonikoko, Gilberto Lopes, Charu Aggarwal, Alfred I Lee, Toni K Choueiri","doi":"10.1200/OP-24-00565","DOIUrl":"https://doi.org/10.1200/OP-24-00565","url":null,"abstract":"<p><strong>Purpose: </strong>International medical graduates (IMGs) are an essential component of the oncology workforce in the United States, comprising a third of all practicing oncologists and almost half of hematology/oncology fellows. In this article, we discuss the contributions of IMGs in the US oncology workforce, review unique challenges faced by IMGs, and propose potential solutions to overcome these challenges.</p><p><strong>Methods: </strong>ASCO's IMG Community of Practice was established with the mission to connect, mentor, guide, raise awareness, and overcome the challenges unique to IMGs interested in pursuing medical oncology in the United States. The content of this article is based on discussions at the IMG Community of Practice meetings at ASCO's 2023 and 2024 Annual Meetings.</p><p><strong>Results: </strong>IMGs bring an inherent diversity of thought and experience to the oncology workforce. They provide high-quality, culture- and language-concordant care to a diverse population of patients with cancer. However, IMGs in oncology face significant hardships throughout their careers, including visa-related restrictions, psychosocial and cultural struggles, as well as differential treatment while applying for residency and fellowship training, and early career positions. Greater awareness of these challenges among the members of the hematology/oncology community, along with institutional and individual efforts to support IMGs, is warranted.</p><p><strong>Conclusion: </strong>We encourage oncology professionals and institutions to join our efforts in recognizing the unique paths of IMGs and providing support and advocacy to maximize the potential of IMGs in the US oncology workforce.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
State of Geographic Access to Cancer Treatment Trials in the United States: Are Studies Located Where Patients Live? 美国癌症治疗试验的地理分布状况:研究是否位于患者居住地?
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-02 DOI: 10.1200/OP.24.00261
M Kelsey Kirkwood, Caroline Schenkel, Dominique C Hinshaw, Suanna S Bruinooge, David M Waterhouse, Jeffrey M Peppercorn, Ishwaria M Subbiah, Laura A Levit

Purpose: In this study, we describe the geographic distribution of US cancer treatment trials to identify disparities and opportunities for targeted improvements in access to research for people with cancer.

Methods: US-based phase I-III cancer treatment trials registered on ClinicalTrials.gov were tabulated for the years they were open to enrollment (2017-2022), overall and by county, and supplemented with data from the US Census Bureau, National Cancer Institute, Centers for Disease Control and Prevention, and US Department of Agriculture. We evaluated geographic differences in trial availability. We assessed 5-year trends in trials per capita and mapped 1-hour drive time areas around sites.

Results: A total of 6,710 trials were open to enrollment in 2022 across 1,836 sites. Trials increased by 4%, whereas sites decreased by 3% annually per capita from 2017. Seventy percent of US counties had no reported active trials in 2022 (2,211/3,143), representing 19% of people age ≥55 years. Eighty-six percent of nonmetropolitan counties had no trials versus 44% of metropolitan counties. Trial availability varied by county-level cancer mortality and social vulnerability (an index derived from demographic and socioeconomic data from the US Census). Eighteen percent of counties without trials had oncologist care sites (n = 618). Notably, 26% of people age ≥55 years lived beyond an hour drive of a site with ≥100 trials.

Conclusion: Most US counties have limited to no trial offerings, a disparity magnified in counties that are nonmetropolitan, with high social vulnerability, and with high cancer mortality. Effort to facilitate diverse site participation is needed to promote equitable access to trials and to ensure patients participating in trials match the characteristics of patients who will receive interventions once approved. Counties with oncology care sites but no trials provide potential expansion areas.

目的:在本研究中,我们描述了美国癌症治疗试验的地理分布情况,以确定差距和有针对性地改善癌症患者获得研究机会的机会:我们对在 ClinicalTrials.gov 上注册的美国 I-III 期癌症治疗试验开放注册的年份(2017-2022 年)的总体情况和各县的情况进行了统计,并补充了美国人口普查局、国家癌症研究所、美国疾病控制和预防中心以及美国农业部的数据。我们评估了试验可用性的地域差异。我们评估了人均试验次数的 5 年趋势,并绘制了试验点周围 1 小时车程范围的地图:结果:2022年,共有6,710项试验在1,836个地点开放注册。与2017年相比,试验增加了4%,而试验点每年人均减少了3%。2022年,美国70%的县没有报告活跃试验(2,211/3,143),占年龄≥55岁人口的19%。86%的非大都会县没有试验,而大都会县的这一比例为44%。各县的癌症死亡率和社会脆弱性(根据美国人口普查的人口和社会经济数据得出的指数)不同,试验的可获得性也不同。在没有试验的县中,有 18% 的县拥有肿瘤专家护理点(n = 618)。值得注意的是,在年龄≥55岁的人群中,有26%的人居住在距离试验点≥100个小时车程以外的地方:结论:美国大多数县的试验项目有限或根本没有,这种差距在非大都市、社会脆弱性高和癌症死亡率高的县中更为明显。需要努力促进不同医疗机构的参与,以促进公平的试验机会,并确保参与试验的患者符合获批后将接受干预的患者的特征。拥有肿瘤治疗点但没有试验的县提供了潜在的扩展区域。
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引用次数: 0
2023 Snapshot: State of the Oncology Workforce in America. 2023 年快照:美国肿瘤学从业人员状况。
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-02 DOI: 10.1200/OP.24.00262
{"title":"2023 Snapshot: State of the Oncology Workforce in America.","authors":"","doi":"10.1200/OP.24.00262","DOIUrl":"https://doi.org/10.1200/OP.24.00262","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When You Get to the Fork in the Road, Take It: The Challenges in Managing Patients With Advanced Prostate Cancer. 当你走到岔路口时,请抓住它:管理晚期前列腺癌患者的挑战。
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 DOI: 10.1200/OP-24-00591
Paul Viscuse, William P Skelton, Michael M Devitt, Robert Dreicer

As is the case with most solid tumors, the heterogeneity of the disease biology of prostate cancer presents clinicians managing this disease with daily challenges. However, in contrast to other common cancers such as breast, lung, and colorectal cancers, there are unique challenges in prostate cancer management, including the variety of clinicians who manage aspects of the disease (urologists, medical oncologist, radiation oncologists) and the striking absence of prospective comparative data to inform the optimal sequence of systemic therapy in patients with metastatic castration-resistant disease. The purpose of this review is to attempt to assist practicing oncologists with sorting through the myriad of prostate cancer disease subsets and the challenges in making therapeutic decisions in multiple data-free zones given the absence of level 1 comparative clinical trials in the metastatic hormone-sensitive and castration-resistant states.

与大多数实体瘤一样,前列腺癌疾病生物学的异质性也给临床医生带来了日常的挑战。然而,与乳腺癌、肺癌和结肠直肠癌等其他常见癌症相比,前列腺癌的治疗面临着独特的挑战,包括管理该疾病的临床医生(泌尿科医生、肿瘤内科医生、肿瘤放射科医生)的多样性,以及前瞻性对比数据的严重缺乏,无法为转移性耐受性阉割疾病患者的最佳系统治疗顺序提供依据。本综述的目的是试图帮助执业肿瘤学家理清前列腺癌疾病的众多子集,以及在转移性激素敏感和阉割耐药状态下缺乏一级对比临床试验的情况下,在多个无数据区做出治疗决策所面临的挑战。
{"title":"When You Get to the Fork in the Road, Take It: The Challenges in Managing Patients With Advanced Prostate Cancer.","authors":"Paul Viscuse, William P Skelton, Michael M Devitt, Robert Dreicer","doi":"10.1200/OP-24-00591","DOIUrl":"https://doi.org/10.1200/OP-24-00591","url":null,"abstract":"<p><p>As is the case with most solid tumors, the heterogeneity of the disease biology of prostate cancer presents clinicians managing this disease with daily challenges. However, in contrast to other common cancers such as breast, lung, and colorectal cancers, there are unique challenges in prostate cancer management, including the variety of clinicians who manage aspects of the disease (urologists, medical oncologist, radiation oncologists) and the striking absence of prospective comparative data to inform the optimal sequence of systemic therapy in patients with metastatic castration-resistant disease. The purpose of this review is to attempt to assist practicing oncologists with sorting through the myriad of prostate cancer disease subsets and the challenges in making therapeutic decisions in multiple data-free zones given the absence of level 1 comparative clinical trials in the metastatic hormone-sensitive and castration-resistant states.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Palliative Care for Patients With Cancer: ASCO Guideline Clinical Insights. 癌症患者的姑息治疗:ASCO 指南的临床见解。
IF 4.7 3区 医学 Q1 ONCOLOGY Pub Date : 2024-10-01 Epub Date: 2024-05-15 DOI: 10.1200/OP.24.00225
Betty R Ferrell, Janice I Firn, Sarah Temin, Justin J Sanders
{"title":"Palliative Care for Patients With Cancer: ASCO Guideline Clinical Insights.","authors":"Betty R Ferrell, Janice I Firn, Sarah Temin, Justin J Sanders","doi":"10.1200/OP.24.00225","DOIUrl":"10.1200/OP.24.00225","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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JCO oncology practice
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