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Crisis of Cancer Drug Shortages: Understanding the Causes and Proposing Sustainable Solutions. 癌症药物短缺危机:了解原因并提出可持续解决方案。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-07-01 DOI: 10.1200/OP-25-00381
Jason Westin, Shimere Sherwood, Karen Hagerty, Julie Gralow
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引用次数: 0
Timing and Outcomes of Palliative Care Integration Into Care of Adolescents and Young Adults With Advanced Cancer. 姑息治疗纳入晚期癌症青少年和青年护理的时机和结果。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-13 DOI: 10.1200/OP-24-00907
Jeremiah Bonnet, Colin Cernik, Hajime Uno, Lanfang Xu, Cecile A Laurent, Lauren Fisher, Nancy Cannizzaro, Julie Munneke, Robert M Cooper, Joshua R Lakin, Corey M Schwartz, Mallory Casperson, Andrea Altschuler, Lawrence H Kushi, Chun R Chao, Lori Wiener, Jennifer W Mack

Purpose: Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. We sought to understand the extent to which AYAs are referred to palliative care before death, the timing of referrals, and associations between referral timing and end-of-life care outcomes.

Methods: Review of electronic health data and medical records for 1,918 AYAs age 12-39 years who died after receiving care at one of the three sites between 2003 and 2019. Patients who received palliative care but lacked documentation of referral timing were excluded.

Results: Most included AYAs were White (61%); 12% were Asian, 8% Black, and 27% Hispanic. Nearly three quarters (73%) were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life (P = .001) as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life (P < .001 for all). Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety (P < .001 for all).

Conclusion: Although many AYAs receive intensive measures at the end of life, most are also referred to palliative care. Earlier referrals have potential to reduce care intensity and enhance attention to symptoms and quality of life near death.

目的:青少年和年轻成人(AYA)癌症患者经常在生命结束时接受强化措施;许多人还表达了与姑息疗法相一致的护理目标。我们试图了解AYAs在死亡前被转介到姑息治疗的程度,转诊的时间,以及转诊时间与临终关怀结果之间的关系。方法:回顾2003年至2019年期间在三个地点之一接受治疗后死亡的1,918名年龄在12-39岁的青少年的电子健康数据和医疗记录。接受姑息治疗但缺乏转诊时间记录的患者被排除在外。结果:纳入的aya以白人居多(61%);12%是亚洲人,8%是黑人,27%是西班牙人。近四分之三(73%)的患者在死前接受了姑息治疗。36%的姑息治疗转诊发生在生命的最后90天之前;30%是在生命的最后一个月。姑息治疗转诊和转诊时间与临终时接受的护理有关,更早的转诊与更少的接近死亡的强化措施相关,包括生命最后14天的化疗(P = 0.001)以及生命最后一个月的重症监护病房入住、急诊室就诊和住院(所有P < 0.001)。接受姑息治疗的患者更有可能在生命的最后90天出现症状,包括疼痛、呼吸困难、恶心、腹泻、便秘、抑郁和焦虑(所有P < 0.001)。结论:尽管许多aya在生命结束时接受了强化措施,但大多数人也接受了姑息治疗。早期转诊有可能降低护理强度,加强对濒死症状和生活质量的关注。
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引用次数: 0
Long-Term Quality of Life, Cognitive Function, and Symptom Burden Among Chimeric Antigen Receptor T-Cell Recipients and Associated Cytokine Release Syndrome and Neurotoxicity. 嵌合抗原受体t细胞受体的长期生活质量、认知功能和症状负担及相关细胞因子释放综合征和神经毒性
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-13 DOI: 10.1200/OP-24-00823
Lucy Andersen, Ryan J Quinn, Heather Difilippo, Alfred L Garfall, David L Porter, Salimah H Meghani, Jie Deng

Purpose: Immediate side effects after chimeric antigen receptor (CAR) T-cell therapy are well documented and include cytokine release syndrome (CRS) and immune effector-cell-associated neurotoxicity (ICANS). However, long-term patient-reported outcomes are understudied. Using a social determinants of health (SDoH) framework, we described the long-term health-related quality of life (HRQoL), cognitive function, and symptom burden of patients in sustained remission after CAR T-cell therapy and examined the relationship between acute CRS and ICANS and long-term cognitive function and symptom burden.

Methods: This cross-sectional study included adults in remission after CAR T-cell therapy for multiple myeloma or B-cell lymphoma who were within 1-5 years post-treatment. We used bivariate analyses to measure associations between clinical and SDoH variables and long-term outcomes and linear regression to examine the relationship between ICANS and CRS toxicity and longer-term outcomes.

Results: Participants (n = 58) were a median of 67 years of age (22-88), 72% had lymphoma, 28% had multiple myeloma, and they were a median of 2 years (1-4.7) post-CAR T-cell infusion. Most of the participants reported good HRQoL. Over one third of participants reported mild-to-moderate impairment in physical function, social roles and activities, or pain domains. Higher income and employment were significantly associated with better physical HRQoL (P < .05). Participants reported low symptom burden, with fatigue most commonly reported. Neither CRS nor ICANS toxicity predicted long-term cognitive function or symptom burden.

Conclusion: Patients in long-term remission after CAR T-cell therapy have good HRQoL and cognitive function with minimal symptom burden. Importantly, there was no relationship between CRS and ICANS and long-term symptom burden or cognitive function. Results support the long-term clinical benefit of CAR T-cell therapy.

目的:嵌合抗原受体(CAR) t细胞治疗后的直接副作用有充分的文献记载,包括细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性(ICANS)。然而,患者报告的长期结果尚未得到充分研究。使用健康的社会决定因素(SDoH)框架,我们描述了CAR -t细胞治疗后持续缓解患者的长期健康相关生活质量(HRQoL)、认知功能和症状负担,并检查了急性CRS和ICANS与长期认知功能和症状负担之间的关系。方法:这项横断面研究纳入了CAR -t细胞治疗多发性骨髓瘤或b细胞淋巴瘤后1-5年内缓解的成年人。我们使用双变量分析来测量临床和SDoH变量与长期结果之间的关联,并使用线性回归来检查ICANS和CRS毒性与长期结果之间的关系。结果:参与者(n = 58)的中位年龄为67岁(22-88岁),72%患有淋巴瘤,28%患有多发性骨髓瘤,car - t细胞输注后的中位时间为2年(1-4.7年)。大多数参与者报告了良好的HRQoL。超过三分之一的参与者报告了身体功能、社会角色和活动或疼痛领域的轻度至中度损伤。较高的收入和就业与较好的身体HRQoL显著相关(P < 0.05)。参与者报告症状负担低,最常见的是疲劳。CRS和ICANS毒性均不能预测长期认知功能或症状负担。结论:CAR -t细胞治疗后长期缓解的患者HRQoL和认知功能良好,症状负担轻。重要的是,CRS和ICANS与长期症状负担或认知功能没有关系。结果支持CAR -t细胞疗法的长期临床益处。
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引用次数: 0
Receipt of Alcohol Screening, Brief Intervention, and Treatment Among US Adults With and Without a History of Cancer. 接受酒精筛查、短暂干预和治疗在美国有和没有癌症史的成年人中
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-09 DOI: 10.1200/OP-24-01030
Devon K Check, Zhen Li, Sahar Shibeika, Caroline E Sloan, Andrea Sitlinger, Leah L Zullig, Solomon A Graf, Dan V Blalock

Purpose: Many cancer survivors consume alcohol above recommended limits, increasing their risk of recurrence, second cancers, and cancer-related mortality. Alcohol screening, brief intervention, and referral to treatment (SBIRT) is a guideline-recommended strategy for reducing unhealthy alcohol consumption among adult primary care patients. To our knowledge, no prior studies have evaluated SBIRT's reach among cancer survivors.

Methods: We conducted a cross-sectional study of adults who completed the National Survey on Drug Use and Health from 2015 to 2022. We examined past-year receipt of alcohol screening and-among respondents who endorsed unhealthy alcohol use-brief intervention and treatment. All outcomes were examined among cancer survivors and those with no cancer history. We used modified Poisson regression to assess the associations of cancer history with each outcome, adjusting for sociodemographic characteristics.

Results: The cohort included 86,410 respondents with no history of cancer and 9,963 cancer survivors. The percentages of respondents endorsing past-year receipt of alcohol screening (approximately 40%), brief intervention (approximately 8%), and treatment (approximately 2%) were similarly low in both groups. After adjustment, there was a small but statistically significant difference in alcohol screening, with cancer survivors more likely than people without a history of cancer to receive alcohol screening (adjusted risk ratio [aRR], 1.07; 95% CI, 1.02 to 1.13). Among those with unhealthy alcohol use, cancer survivors were no more or less likely than people without a history of cancer to receive brief alcohol intervention (aRR, 1.00; 95% CI, 0.93 to 1.07) or alcohol treatment (aRR, 0.92; 95% CI, 0.47 to 1.69).

Conclusion: Results reveal an important opportunity to improve SBIRT uptake across the board and especially for cancer survivors, who are at increased risk of alcohol-related adverse health effects and, potentially, more motivated to change cancer-related health behaviors.

目的:许多癌症幸存者的饮酒量超过推荐限度,增加了他们的复发、二次癌症和癌症相关死亡率的风险。酒精筛查、短暂干预和转诊治疗(SBIRT)是指南推荐的减少成人初级保健患者不健康饮酒的策略。据我们所知,之前没有研究评估过SBIRT在癌症幸存者中的作用。方法:对2015 - 2022年完成全国药物使用与健康调查的成年人进行横断面研究。我们检查了过去一年酒精筛查的收据,并在支持不健康饮酒的受访者中进行了简短的干预和治疗。所有结果都在癌症幸存者和没有癌症病史的人中进行了检查。我们使用修正泊松回归来评估癌症病史与每个结果的关联,并根据社会人口统计学特征进行调整。结果:该队列包括86410名无癌症病史的受访者和9963名癌症幸存者。在两组中,赞同过去一年接受酒精筛查(约40%)、短暂干预(约8%)和治疗(约2%)的受访者百分比同样较低。调整后,酒精筛查的差异虽小但有统计学意义,癌症幸存者比无癌症史的人更有可能接受酒精筛查(调整风险比[aRR], 1.07;95% CI, 1.02 ~ 1.13)。在不健康饮酒的人群中,癌症幸存者接受短暂酒精干预的可能性并不比没有癌症史的人多或少(aRR, 1.00;95% CI, 0.93 ~ 1.07)或酒精治疗(aRR, 0.92;95% CI, 0.47 ~ 1.69)。结论:研究结果揭示了一个重要的机会,可以全面提高SBIRT的吸收,特别是对于癌症幸存者来说,他们面临着酒精相关不良健康影响的风险增加,并且可能更有动力改变与癌症相关的健康行为。
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引用次数: 0
Fertility Preservation Services for Adolescents and Young Adults: 2022 National Cancer Institute Community Oncology Research Program Landscape Assessment. 青少年和年轻人的生育能力保存服务:2022年国家癌症研究所社区肿瘤研究项目景观评估。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-06-04 DOI: 10.1200/OP-24-01017
Erin M Mobley, Julie Anna Wolfson, Jennifer Levine, Lingyun Ji, Subhash Ramakrishnan, Chandylen L Nightingale, Emily V Dressler, Carol Kittel, David R Freyer, Aaron J Sugalski, Pinki Kumari Prasad, Jessica Sheth Bhutada, Karly Murphy, Wade Kyono, Michael E Roth, Susan K Parsons, Melissa P Beauchemin

Purpose: Given the impact of cancer treatment on fertility among adolescents and young adults (AYAs: 15-39 years), it is important to ensure AYAs access to fertility preservation (FP). However, the availability of FP services for AYAs treated in community settings is unknown. We examined FP access at National Cancer Institute Community Oncology Research Program (NCORP) practice groups.

Methods: The 2022 NCORP Landscape Assessment survey captured available resources and cancer care services including FP services at practice groups. We described FP services as accessible (on-site or off-site) versus not accessible by AYA-treating status (as previously defined). Univariable and multivariable analyses were used to evaluate associations between FP services and practice characteristics (NCORP classification [minority/underserved or community] and proportion of Medicaid or uninsured above/below the national average).

Results: Among 271 practice groups responding to the survey, 100 were categorized as AYA-treating, of which 32% had neither male nor female FP services available. Sperm banking was available at 59 AYA-treating practices, among which 43 (73%) referred for sperm banking off-site. Although approximately half of AYA-treating practices reported accessible female FP services (embryo = 54%, oocyte = 55%, ovarian tissue = 40%), most of them referred patients off-site (embryo = 72%, oocyte = 80%, ovarian tissue = 83%). The odds of access to male FP were lower at minority/underserved practices (odds ratio, 0.34 [95% CI, 0.13 to 0.88]; P = .026; ref = community); however, this same relationship was not seen for females.

Conclusion: Despite guidelines surrounding FP discussions before cancer therapy, and strong consensus regarding the importance of FP access, many AYA-treating practices in community settings lack access to FP services. Understanding how to leverage available services and broadly expand access is urgently needed to facilitate guideline-concordant, high-quality cancer care for AYAs.

目的:考虑到癌症治疗对青少年和年轻成人(年龄:15-39岁)生育能力的影响,确保青少年获得生育保护(FP)非常重要。然而,目前尚不清楚在社区环境中接受治疗的未成年人能否获得计划生育服务。我们检查了国家癌症研究所社区肿瘤研究计划(NCORP)实践小组的FP获取情况。方法:2022年NCORP景观评估调查收集了现有资源和实践小组的癌症护理服务,包括计划生育服务。我们将FP服务描述为可访问(现场或非现场),而不是按aya处理状态(如前所定义)不可访问。单变量和多变量分析用于评估计划生育服务与实践特征之间的关系(NCORP分类[少数/服务不足或社区]和医疗补助或未保险比例高于/低于全国平均水平)。结果:在271个回应调查的实践组中,100个被归类为aya治疗,其中32%既没有男性也没有女性计划生育服务。59家aya治疗诊所提供精子库,其中43家(73%)转诊到非现场精子库。虽然大约一半的人工授精治疗实践报告可获得女性计划生育服务(胚胎= 54%,卵母细胞= 55%,卵巢组织= 40%),但其中大多数将患者转到非现场(胚胎= 72%,卵母细胞= 80%,卵巢组织= 83%)。少数民族/服务不足的诊所获得男性计划生育的几率较低(优势比,0.34 [95% CI, 0.13至0.88];P = 0.026;Ref = community;然而,在女性身上却没有发现同样的关系。结论:尽管在癌症治疗前有关于计划生育讨论的指导方针,并且对计划生育获取的重要性有强烈的共识,但许多社区环境中的aya治疗实践缺乏计划生育服务。迫切需要了解如何利用现有服务并广泛扩大可及性,以促进符合指南的高质量aya癌症护理。
{"title":"Fertility Preservation Services for Adolescents and Young Adults: 2022 National Cancer Institute Community Oncology Research Program Landscape Assessment.","authors":"Erin M Mobley, Julie Anna Wolfson, Jennifer Levine, Lingyun Ji, Subhash Ramakrishnan, Chandylen L Nightingale, Emily V Dressler, Carol Kittel, David R Freyer, Aaron J Sugalski, Pinki Kumari Prasad, Jessica Sheth Bhutada, Karly Murphy, Wade Kyono, Michael E Roth, Susan K Parsons, Melissa P Beauchemin","doi":"10.1200/OP-24-01017","DOIUrl":"10.1200/OP-24-01017","url":null,"abstract":"<p><strong>Purpose: </strong>Given the impact of cancer treatment on fertility among adolescents and young adults (AYAs: 15-39 years), it is important to ensure AYAs access to fertility preservation (FP). However, the availability of FP services for AYAs treated in community settings is unknown. We examined FP access at National Cancer Institute Community Oncology Research Program (NCORP) practice groups.</p><p><strong>Methods: </strong>The 2022 NCORP Landscape Assessment survey captured available resources and cancer care services including FP services at practice groups. We described FP services as accessible (on-site or off-site) versus not accessible by AYA-treating status (as previously defined). Univariable and multivariable analyses were used to evaluate associations between FP services and practice characteristics (NCORP classification [minority/underserved or community] and proportion of Medicaid or uninsured above/below the national average).</p><p><strong>Results: </strong>Among 271 practice groups responding to the survey, 100 were categorized as AYA-treating, of which 32% had neither male nor female FP services available. Sperm banking was available at 59 AYA-treating practices, among which 43 (73%) referred for sperm banking off-site. Although approximately half of AYA-treating practices reported accessible female FP services (embryo = 54%, oocyte = 55%, ovarian tissue = 40%), most of them referred patients off-site (embryo = 72%, oocyte = 80%, ovarian tissue = 83%). The odds of access to male FP were lower at minority/underserved practices (odds ratio, 0.34 [95% CI, 0.13 to 0.88]; <i>P</i> = .026; ref = community); however, this same relationship was not seen for females.</p><p><strong>Conclusion: </strong>Despite guidelines surrounding FP discussions before cancer therapy, and strong consensus regarding the importance of FP access, many AYA-treating practices in community settings lack access to FP services. Understanding how to leverage available services and broadly expand access is urgently needed to facilitate guideline-concordant, high-quality cancer care for AYAs.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"112-121"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults: ASCO-SNO Guideline Rapid Recommendation Update Clinical Insights. 成人弥漫性星形细胞和少突胶质细胞肿瘤的治疗:ASCO-SNO指南快速推荐更新临床见解
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-04-29 DOI: 10.1200/OP-25-00185
Nimish A Mohile, Andrew B Lassman, David Schiff, Jaishri Blakeley
{"title":"Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults: ASCO-SNO Guideline Rapid Recommendation Update Clinical Insights.","authors":"Nimish A Mohile, Andrew B Lassman, David Schiff, Jaishri Blakeley","doi":"10.1200/OP-25-00185","DOIUrl":"10.1200/OP-25-00185","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"16-18"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983961","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
Low-Intensity Vibration to Reduce Symptoms and Improve Physical Functioning in Cancer Survivors With Chemotherapy-Induced Peripheral Neuropathy: A Pilot Randomized Trial. 低强度振动减轻化疗诱导周围神经病变癌症幸存者的症状和改善身体功能:一项试点随机试验
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-15 DOI: 10.1200/OP-24-00961
Stephanie M Krasnow, Clinton T Rubin, Eric J Roeland, Fay B Horak, Sydnee A Stoyles, Nathan F Dieckmann, Kendra N Braun, Kerri M Winters-Stone

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) can have deleterious effects on mobility and quality of life in people with cancer. Vibration therapy shows promise as a CIPN intervention but is understudied. We investigated the feasibility and preliminary efficacy of low-intensity vibration (LIV) in cancer survivors with CIPN.

Methods: We conducted a pilot randomized controlled trial in adult cancer survivors with persistent CIPN symptoms. Participants were randomly assigned to twice-daily LIV sessions (10 min/session; 30 Hz, 0.4 g) for 12 weeks or usual care (UC). We assessed feasibility by accrual, retention, adherence, and adverse event (AE) reporting. We evaluated preliminary efficacy by changes in patient-reported CIPN symptoms (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity), pain (Brief Pain Inventory), fatigue (Patient-Reported Outcome Measurement Information System Fatigue), and physical functioning (Late-Life Function and Disability Instrument) and objectively measured physical functioning (chair stand time, gait speed), stability (postural sway), and mobility (Timed-Up-and-Go). Linear regression models were used to generate effect size estimates (Cohen's d).

Results: We accrued 95% of our target sample (n = 38, mean age: 62.6 ± 9.9 years, 89% female, median time since chemotherapy completion: 18 [6-39] months), with 20 participants randomly assigned to LIV and 18 to UC. Trial retention was 97% and mean adherence to LIV was 77% ± 18%. There were no serious AEs. Compared with UC, LIV participants reported greater improvements in sensory neuropathy symptoms (LIV, +1.4 ± 3.3 points; UC, +0.2 ± 2.8 points; Cohen's d = 0.45) and basic lower extremity function (LIV, +5.3 ± 8.5 points; UC, -0.7 ± 9.2 points; Cohen's d = 0.80), with moderate-to-large effect sizes for changes in stability, mobility, and gait (Cohen's d = 0.60-0.66).

Conclusion: LIV is safe, feasible, and shows preliminary efficacy for CIPN symptom relief and improving physical functioning in cancer survivors with CIPN.

目的:化疗诱导的周围神经病变(CIPN)可对癌症患者的活动能力和生活质量产生有害影响。振动疗法作为CIPN干预有希望,但尚未得到充分研究。我们研究了低强度振动(LIV)在CIPN癌症幸存者中的可行性和初步疗效。方法:我们在有持续CIPN症状的成年癌症幸存者中进行了一项随机对照试验。参与者被随机分配到每天两次的LIV疗程(10分钟/次;30 Hz, 0.4 g), 12周或常规护理(UC)。我们通过累积、保留、依从性和不良事件(AE)报告来评估可行性。我们通过患者报告的CIPN症状(癌症治疗功能评估/妇科肿瘤组神经毒性)、疼痛(简短疼痛量表)、疲劳(患者报告的结果测量信息系统疲劳)和身体功能(晚期功能和残疾仪器)的变化来评估初步疗效,并客观地测量身体功能(椅子站立时间、步态速度)、稳定性(姿势摇摆)和机动性(time - up -and- go)。线性回归模型用于产生效应大小估计(Cohen’s d)。结果:我们收集了95%的目标样本(n = 38,平均年龄:62.6±9.9岁,89%为女性,化疗完成后的中位时间:18[6-39]个月),其中20名参与者随机分配到LIV和18名UC。试验保留率为97%,平均依从性为77%±18%。没有严重的ae。与UC相比,LIV参与者报告感觉神经病变症状的改善更大(LIV, +1.4±3.3分;UC, +0.2±2.8分;Cohen’s d = 0.45)和下肢基本功能(LIV, +5.3±8.5分;UC, -0.7±9.2分;Cohen’s d = 0.80),对稳定性、活动性和步态的变化有中等到较大的影响(Cohen’s d = 0.60-0.66)。结论:LIV是安全可行的,对CIPN癌症幸存者CIPN症状缓解和身体功能改善有初步疗效。
{"title":"Low-Intensity Vibration to Reduce Symptoms and Improve Physical Functioning in Cancer Survivors With Chemotherapy-Induced Peripheral Neuropathy: A Pilot Randomized Trial.","authors":"Stephanie M Krasnow, Clinton T Rubin, Eric J Roeland, Fay B Horak, Sydnee A Stoyles, Nathan F Dieckmann, Kendra N Braun, Kerri M Winters-Stone","doi":"10.1200/OP-24-00961","DOIUrl":"10.1200/OP-24-00961","url":null,"abstract":"<p><strong>Purpose: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) can have deleterious effects on mobility and quality of life in people with cancer. Vibration therapy shows promise as a CIPN intervention but is understudied. We investigated the feasibility and preliminary efficacy of low-intensity vibration (LIV) in cancer survivors with CIPN.</p><p><strong>Methods: </strong>We conducted a pilot randomized controlled trial in adult cancer survivors with persistent CIPN symptoms. Participants were randomly assigned to twice-daily LIV sessions (10 min/session; 30 Hz, 0.4 g) for 12 weeks or usual care (UC). We assessed feasibility by accrual, retention, adherence, and adverse event (AE) reporting. We evaluated preliminary efficacy by changes in patient-reported CIPN symptoms (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity), pain (Brief Pain Inventory), fatigue (Patient-Reported Outcome Measurement Information System Fatigue), and physical functioning (Late-Life Function and Disability Instrument) and objectively measured physical functioning (chair stand time, gait speed), stability (postural sway), and mobility (Timed-Up-and-Go). Linear regression models were used to generate effect size estimates (Cohen's d).</p><p><strong>Results: </strong>We accrued 95% of our target sample (n = 38, mean age: 62.6 ± 9.9 years, 89% female, median time since chemotherapy completion: 18 [6-39] months), with 20 participants randomly assigned to LIV and 18 to UC. Trial retention was 97% and mean adherence to LIV was 77% ± 18%. There were no serious AEs. Compared with UC, LIV participants reported greater improvements in sensory neuropathy symptoms (LIV, +1.4 ± 3.3 points; UC, +0.2 ± 2.8 points; Cohen's d = 0.45) and basic lower extremity function (LIV, +5.3 ± 8.5 points; UC, -0.7 ± 9.2 points; Cohen's d = 0.80), with moderate-to-large effect sizes for changes in stability, mobility, and gait (Cohen's d = 0.60-0.66).</p><p><strong>Conclusion: </strong>LIV is safe, feasible, and shows preliminary efficacy for CIPN symptom relief and improving physical functioning in cancer survivors with CIPN.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"100-111"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment Patterns and Real-World Outcomes of Molecular Subgroups in Patients With AML Receiving Frontline Venetoclax-Based Therapy. 接受一线venetoclax治疗的AML患者分子亚组的治疗模式和实际结果
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-08 DOI: 10.1200/OP-24-00983
Curtis A Lachowiez, Anna Barcellos, Christina M Zettler, Andrew J Belli, Laura L Fernandes, Eric Hansen, Ching Kun Wang, Henry F Owusu, Amer M Zeidan, Eytan M Stein, Ronan Swords

Purpose: For patients with newly diagnosed AML not suitable for intensive induction chemotherapy, venetoclax (VEN) plus azacitidine (AZA) is a standard of care therapy. This study describes real-world (rw) treatment patterns and outcomes of patients with AML receiving initial VEN-based therapy.

Methods: Patients age ≥18 years diagnosed with AML who received first-line (1L) VEN-based therapy and had available dosing information were included from the COTA rw, electronic health records-based database. Patients with missing/imprecise key study dates were excluded. The index date for the study was the date of 1L initiation, unless otherwise noted. Rw time to next treatment, rw event-free survival, and rw overall survival (rwOS) were analyzed using the Kaplan-Meier method.

Results: A total of 331 patients met the inclusion criteria, of which the majority were male, White, and treated in community practices. In patients with available molecular data for the given marker, 8.8%, 19.7%, 11.0%, and 19.7% had mutations in IDH1, IDH2, FLT3-ITD, and NPM1, respectively. Following 1L, 115 patients initiated second-line (2L) therapy, of which 26.1% received intensive chemotherapy, 60.9% received low-intensity regimens, and 8.7% received investigational therapy. The median rwOS overall was 13.9 months and differed by mutation status (13.1 months for IDH1-positive patients, 42.0 months for IDH2-positive patients, not reached for FLT3-ITD-positive patients, and 42.0 months for NPM1-positive patients).

Conclusion: The median rwOS for this study was comparable with results in the VIALE-A trial, despite the community-based nature of these data. There was no clear standard of care for patients who received 2L+ therapy. These data highlight the need for novel treatment for patients with AML following 1L VEN-based therapy.

目的:对于新诊断的急性髓性白血病不适合强化诱导化疗的患者,venetoclax (VEN)联合阿扎胞苷(AZA)是一种标准的护理治疗。这项研究描述了真实世界(rw)的治疗模式和AML患者接受初始基于静脉注射的治疗的结果。方法:年龄≥18岁诊断为急性髓系白血病(AML)的患者,接受一线(1L)基于vin的治疗,并有可用的剂量信息,从基于电子健康记录的数据库COTA rw中纳入。排除了关键研究日期缺失/不精确的患者。除非另有说明,本研究的索引日期为1L起始日期。使用Kaplan-Meier方法分析Rw到下一次治疗的时间、Rw无事件生存期和Rw总生存期(rwOS)。结果:共有331例患者符合纳入标准,其中大多数为男性,白人,在社区实践中治疗。在已知标记物分子数据的患者中,分别有8.8%、19.7%、11.0%和19.7%的患者存在IDH1、IDH2、FLT3-ITD和NPM1突变。1L后,115例患者开始二线(2L)治疗,其中26.1%接受强化化疗,60.9%接受低强度化疗,8.7%接受研究性治疗。总体中位rwOS为13.9个月,因突变状态而异(idh1阳性患者为13.1个月,idh2阳性患者为42.0个月,flt3 - itd阳性患者未达到,npm1阳性患者为42.0个月)。结论:该研究的中位rwOS与VIALE-A试验的结果相当,尽管这些数据是基于社区的。对于接受2L+治疗的患者,没有明确的护理标准。这些数据强调了在接受1L vin为基础的治疗后,AML患者需要新的治疗方法。
{"title":"Treatment Patterns and Real-World Outcomes of Molecular Subgroups in Patients With AML Receiving Frontline Venetoclax-Based Therapy.","authors":"Curtis A Lachowiez, Anna Barcellos, Christina M Zettler, Andrew J Belli, Laura L Fernandes, Eric Hansen, Ching Kun Wang, Henry F Owusu, Amer M Zeidan, Eytan M Stein, Ronan Swords","doi":"10.1200/OP-24-00983","DOIUrl":"10.1200/OP-24-00983","url":null,"abstract":"<p><strong>Purpose: </strong>For patients with newly diagnosed AML not suitable for intensive induction chemotherapy, venetoclax (VEN) plus azacitidine (AZA) is a standard of care therapy. This study describes real-world (rw) treatment patterns and outcomes of patients with AML receiving initial VEN-based therapy.</p><p><strong>Methods: </strong>Patients age ≥18 years diagnosed with AML who received first-line (1L) VEN-based therapy and had available dosing information were included from the COTA rw, electronic health records-based database. Patients with missing/imprecise key study dates were excluded. The index date for the study was the date of 1L initiation, unless otherwise noted. Rw time to next treatment, rw event-free survival, and rw overall survival (rwOS) were analyzed using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 331 patients met the inclusion criteria, of which the majority were male, White, and treated in community practices. In patients with available molecular data for the given marker, 8.8%, 19.7%, 11.0%, and 19.7% had mutations in <i>IDH1</i>, <i>IDH2</i>, <i>FLT3</i>-ITD, and <i>NPM1</i>, respectively. Following 1L, 115 patients initiated second-line (2L) therapy, of which 26.1% received intensive chemotherapy, 60.9% received low-intensity regimens, and 8.7% received investigational therapy. The median rwOS overall was 13.9 months and differed by mutation status (13.1 months for <i>IDH1</i>-positive patients, 42.0 months for <i>IDH2</i>-positive patients, not reached for <i>FLT3</i>-ITD-positive patients, and 42.0 months for <i>NPM1</i>-positive patients).</p><p><strong>Conclusion: </strong>The median rwOS for this study was comparable with results in the VIALE-A trial, despite the community-based nature of these data. There was no clear standard of care for patients who received 2L+ therapy. These data highlight the need for novel treatment for patients with AML following 1L VEN-based therapy.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"66-73"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981206","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
Management of Testicular Cancer. 睾丸癌的治疗。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-23 DOI: 10.1200/OP-25-00211
Daniele Raggi, Deep Chakrabarti, Walter Cazzaniga, Razia Aslam, Marija Miletic, Clare Gilson, Robert Holwell, Penny Champion, Alison King, Erik Mayer, David Nicol, Alison Reid, Robert A Huddart

Testicular cancer is the most common malignancy in males age 15-40 years and one of the most curable cancers, with a cumulative 10-year survival rate exceeding 90%. Management strategies depend on the histologic subtype, stage at diagnosis, sites of disease, tumor markers, and risk classification. Germ cell tumors, including seminomas and nonseminomas, constitute the majority of testicular cancers and require distinct therapeutic approaches. For localized disease, radical orchidectomy remains the cornerstone of treatment, followed by active surveillance, chemotherapy, or primary retroperitoneal lymph node dissection, depending on the histology and the risk of relapse. Seminomas are highly curable, with low-stage patients often managed through surveillance or postoperative single-agent carboplatin. By contrast, nonseminomas typically require adjuvant multiagent chemotherapy, such as bleomycin, etoposide, and cisplatin, particularly in higher-risk patients. For metastatic disease, chemotherapy remains the standard of care, achieving excellent cure rates even in patients with bulky tumors. Surgical resection of residual masses is especially critical in nonseminomatous germ cell tumors to remove viable cancer or teratoma components. The treatment of refractory or relapsed disease frequently involves second-line standard-dose or high-dose chemotherapy with autologous stem-cell transplantation, ideally performed in specialized high-volume centers. Before, during, and after treatment, multidisciplinary care is essential to addressing psychosocial challenges, optimizing fertility preservation, and enhancing quality of life. After curative treatments, long-term management involves regular follow-up to monitor for recurrence, late toxicities, and secondary malignancies, with survivorship programs playing a crucial role in meeting patients' ongoing needs. Advances in molecular diagnostics for early relapse detection and the introduction of targeted therapies continue to improve outcomes, particularly in resistant patients.

睾丸癌是15-40岁男性最常见的恶性肿瘤,也是最容易治愈的癌症之一,累积10年生存率超过90%。管理策略取决于组织学亚型、诊断阶段、疾病部位、肿瘤标志物和风险分类。生殖细胞肿瘤,包括精原细胞瘤和非精原细胞瘤,构成了大多数睾丸癌,需要不同的治疗方法。对于局限性疾病,根治性睾丸切除术仍然是治疗的基础,其次是积极监测、化疗或原发性腹膜后淋巴结清扫,这取决于组织学和复发的风险。精原细胞瘤是高度可治愈的,低期患者通常通过监测或术后单药卡铂治疗。相比之下,非精原细胞瘤通常需要辅助多药化疗,如博来霉素、依托泊苷和顺铂,特别是在高危患者中。对于转移性疾病,化疗仍然是标准的治疗方法,即使在体积较大的肿瘤患者中也能获得极好的治愈率。手术切除残留肿块对于非半原性生殖细胞肿瘤尤其重要,以去除存活的肿瘤或畸胎瘤成分。难治性或复发性疾病的治疗通常涉及二线标准剂量或高剂量化疗与自体干细胞移植,理想情况下在专门的大容量中心进行。在治疗之前、期间和之后,多学科护理对于解决心理社会挑战、优化生育能力保存和提高生活质量至关重要。在治愈性治疗后,长期管理包括定期随访以监测复发、晚期毒性和继发性恶性肿瘤,生存计划在满足患者持续需求方面起着至关重要的作用。用于早期复发检测的分子诊断的进展和靶向治疗的引入继续改善预后,特别是在耐药患者中。
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引用次数: 0
Show Me the Way: The Importance of Diagnosis at the Molecular Level in Oncology Practice. 给我指路:肿瘤实践中分子水平诊断的重要性。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2026-01-13 DOI: 10.1200/OP-25-01306
Jeffrey Peppercorn
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引用次数: 0
期刊
JCO oncology practice
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