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Surgical Castration as an Alternative to Improve Systemic Treatment for Advanced Prostate Cancer: A Window of Opportunity for Developing Countries. 手术阉割是改善晚期前列腺癌系统治疗的替代方法:发展中国家的机会之窗。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-14 DOI: 10.1200/GO-24-00319
Fernando Sabino Marques Monteiro, Andre Deeke Sasse, Denizar Vianna Araujo, Rana R McKay, Karine Martins da Trindade, Andrey Soares, João Ricardo Alves, Douglas Andreas Valverde, Diogo Assed Bastos, Nicholas D James, Daniel Herchenhorn

Purpose: The Brazilian Public Health System (BPHS) serves approximately 71,730 patients with prostate cancer (PC) every year for which androgen deprivation therapy (ADT) is the primary treatment for patients with advanced hormone-sensitive prostate cancer (aHSPC). Androgen receptor pathway inhibitors (ARPIs) are not accessible through the BPHS. Using the BPHS as a model, this study assesses the long-term economic effect of surgical versus medical castration in aHSPC treatment to strategize cost reduction and the incorporation of ARPI in developing countries.

Patients and methods: Data of patients with aHSPC (ie, TxN1M0 ineligible for local treatment or TxNxM1) from the BPHS database were analyzed from January 1, 2011, to December 31, 2021, using the TECHTRIALS artificial intelligence platform. The main outcomes were quantitative and descriptive analyses as well as a cost analysis of surgical versus chemical castration.

Results: Of the 274,519 patients with aHSPC who received active treatment during the 11-year study period, 90% (n = 246,683) underwent chemical castration and 10% (n = 27,836) underwent bilateral subcapsular orchiectomy (BSO). The median duration of chemical castration was 28 months. The BPHS spent an estimated total of $665,552,091.40 US dollars (USD) on chemical castration and $5,939,348.47 USD on BSO, respectively. The cost per patient was $2,698 USD and $213.37 USD for chemical castration and BSO, respectively. Hypothetically, if all patients with aHSPC had undergone BSO, the total direct cost for the BPHS would have been $42,774,832.20 USD, saving $622,777,259.20 USD over 11 years, making it possible to offer low-dose abiraterone to 65% of aHSPC patients.

Conclusion: On the basis of this extensive financial analysis from the world's largest public health system database, BSO appears to be a valuable alternative to chemical castration for treating aHSPC. In resource-limited environments, the cost savings from using BSO may allow access to drugs that will improve survival such as ARPIs.

目的:巴西公共卫生系统(BPHS)每年为约 71,730 名前列腺癌(PC)患者提供服务,其中雄激素剥夺疗法(ADT)是晚期激素敏感性前列腺癌(aHSPC)患者的主要治疗方法。雄激素受体途径抑制剂 (ARPI) 无法通过 BPHS 获得。本研究以 BPHS 为模型,评估了手术阉割与药物阉割治疗 aHSPC 的长期经济效果,以制定发展中国家降低成本和纳入 ARPI 的战略:使用 TECHTRIALS 人工智能平台,分析了 BPHS 数据库中 2011 年 1 月 1 日至 2021 年 12 月 31 日的 aHSPC 患者数据(即不符合当地治疗条件的 TxN1M0 或 TxNxM1)。主要结果是定量和描述性分析,以及手术阉割与化学阉割的成本分析:在 11 年研究期间接受积极治疗的 274,519 例 aHSPC 患者中,90%(n = 246,683 例)接受了化学阉割,10%(n = 27,836 例)接受了双侧囊下睾丸切除术(BSO)。化学阉割的中位持续时间为 28 个月。据估计,BPHS 在化学阉割和双侧囊下睾丸切除术上分别花费了 665,552,091.40 美元和 5,939,348.47 美元。每名患者的化学阉割和 BSO 费用分别为 2,698 美元和 213.37 美元。假设所有 aHSPC 患者都接受 BSO 治疗,那么 BPHS 的直接成本总额将为 42,774,832.20 美元,11 年内可节省 622,777,259.20 美元,从而有可能为 65% 的 aHSPC 患者提供低剂量阿比特龙治疗:根据世界上最大的公共卫生系统数据库进行的这项广泛的财务分析,BSO 似乎是治疗 aHSPC 的化学阉割的一种有价值的替代疗法。在资源有限的环境中,使用 BSO 所节省的成本可使患者获得提高存活率的药物,如 ARPIs。
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引用次数: 0
Real-World Study on Implementation of Genomic Tests for Advanced Lung Adenocarcinoma in Brazil. 在巴西实施晚期肺腺癌基因组检验的真实世界研究。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-21 DOI: 10.1200/GO-24-00354
Rodrigo Dienstmann, Leonard M da Silva, Fernanda Orpinelli Ramos do Rego, Amanda Muniz Rodrigues, Fernanda Christtanini Koyama, Layla Testa Galindo, Carolina de Bustamante Fernandes, Bruno Batista de Souza, Rafael Duarte Paes, Tatiane Montella, Pedro de Marchi, Breno Jeha Araújo, Bruno Lemos Ferrari, Clarissa Mathias, Emilio Pereira, Mariano Gustavo Zalis, Chesley Leslin, Carlos Gil Ferreira

Purpose: Tissue inadequacy and operational challenges may limit lung cancer comprehensive biomarker testing. Here, we describe the initial implementation of a tailored tissue molecular journey at Oncoclínicas Precision Medicine Laboratory in Brazil, which includes fast-track (FT) non-next-generation sequencing (NGS) assays combined with a broad NGS panel.

Methods: From 2021 to 2023, all nonsquamous lung cancer samples eligible for the patient support program "Lung Mapping Consortium" at Oncoclínicas & Co were evaluated using the FT panel (immunohistochemistry for PD-L1 and anaplastic lymphoma kinase [ALK], polymerase chain reaction for EGFR and BRAF, and fluorescence in situ hybridization for ROS1) plus a broad DNA and RNA sequencing panel of 180 genes (custom ARCHER panel).

Results: From 1,272 samples received by the laboratory, 3% had no tissue for any molecular testing, 20% was not eligible for broad NGS panel as per pathologist assessment (tumor purity and quantity), additional 12% did not reach presequencing analytical thresholds (nucleic acid quantity and/or quality), and 3% had postsequencing failure. Most frequent alterations were KRAS mutations (28.4%, KRASG12C 9.7%), EGFR mutations (23.6%, exon20 insertions 2.9%), ALK fusions (6.4%), MET exon 14 skipping (4.4%), ERBB2 mutations (3.4%), ROS1 fusions (3.1%), and BRAFV600E (1.9%). In 35% of the samples, FT non-NGS tests were the only molecular diagnostics: EGFR mutations (14%), ALK fusions (4.4%), ROS1 fusions (1.8%), and BRAFV600E (0.7%). Overall, high PD-L1 expression (≥50%) was found in 12.3%.

Conclusion: This study provides data on the molecular epidemiology of lung adenocarcinoma in Brazil, confirming high prevalence of EGFR mutations, ALK fusions, and MET exon 14 skipping alteration. Biomarker detection is largely affected by biospecimen collection and processing, with one third of the patients eligible for non-NGS testing only, which presents reduced coverage and sensitivity for actionable drivers.

目的:组织不足和操作挑战可能会限制肺癌综合生物标记物检测。在此,我们介绍了巴西 Oncoclínicas 精确医学实验室(Oncoclínicas Precision Medicine Laboratory)量身定制的组织分子之旅的初步实施情况,其中包括快速通道(FT)非下一代测序(NGS)测定与广泛的 NGS 面板相结合:从 2021 年到 2023 年,Oncoclínicas & Co 公司使用 FT 面板(PD-L1 和无性淋巴瘤激酶 [ALK]的免疫组化、EGFR 和 BRAF 的聚合酶链反应以及 ROS1 的荧光原位杂交)加上包含 180 个基因的广泛 DNA 和 RNA 测序面板(定制 ARCHER 面板)对所有符合 "肺部图谱联盟 "患者支持计划的非鳞状肺癌样本进行评估:在实验室收到的 1,272 份样本中,3% 的样本没有进行任何分子检测的组织,20% 的样本根据病理学家的评估(肿瘤纯度和数量)不符合进行广泛 NGS 面板检测的条件,另外 12% 的样本未达到测序前分析阈值(核酸数量和/或质量),3% 的样本测序后失败。最常见的改变是KRAS突变(28.4%,KRASG12C 9.7%)、EGFR突变(23.6%,exon20插入2.9%)、ALK融合(6.4%)、MET外显子14跳越(4.4%)、ERBB2突变(3.4%)、ROS1融合(3.1%)和BRAFV600E(1.9%)。在 35% 的样本中,FT 非 NGS 检测是唯一的分子诊断方法:表皮生长因子受体突变(14%)、ALK 融合(4.4%)、ROS1 融合(1.8%)和 BRAFV600E(0.7%)。总体而言,12.3%的患者存在PD-L1高表达(≥50%):这项研究提供了巴西肺腺癌分子流行病学的数据,证实了表皮生长因子受体(EGFR)突变、ALK融合和MET第14外显子跳变的高患病率。生物标志物检测在很大程度上受到生物样本采集和处理的影响,三分之一的患者只符合非 NGS 检测条件,这降低了可操作驱动因素的覆盖率和灵敏度。
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引用次数: 0
Beliefs on Causes of Cancer in the General Population, and the Association With Risk Perception and Lifestyle in a Multiethnic Setting. 在多种族环境中,普通人群对癌症病因的看法及其与风险意识和生活方式的关系。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-07 DOI: 10.1200/GO.24.00129
Nur-Nadiatul-Asyikin Bujang, Yek-Ching Kong, Mahmoud Danaee, Murallitharan Munisamy, Ranjit Kaur, Harenthri Devy Alagir Rajah, Hariharan Menon, Shridevi Subramaniam, Kelly Lai Ming Ying, Ros Suzanna Bustamam, Cheng-Har Yip, Nirmala Bhoo Pathy

Purpose: Beliefs on causes of cancer, although sometimes aligned with known risk factors, may be influenced by personal experiences, cultural narratives, and misinformation. We investigated the prevalence of beliefs on causes of cancer and their association with cancer risk perception and lifestyle in a multiethnic Asian population.

Methods: In total, 2,008 Malaysian adults with no previous cancer were surveyed using a 42-item questionnaire adapted from the Awareness Measure and the Cancer Awareness Measure-Mythical Causes Scale. Partial least squares structural equation modeling was used to evaluate measurement models.

Results: Despite high educational attainment, only about half of the respondents believed that 7 of the 21 listed established risk factors caused cancer. Factors associated with accurate beliefs included higher socioeconomic status (SES) and having family or friends with cancer. However, 14 of the 21 listed mythical/unproven factors were correctly believed as not cancer-causing by the majority. Women and those with lower SES were more likely to hold misconceptions. Beliefs on established risk factors were significantly associated with perceived risk of cancer. Individuals with stronger beliefs in established risk factors were less likely to be associated with healthy behaviors. Conversely, stronger beliefs in mythical or unproven factors were more likely to be associated with healthy lifestyles.

Conclusion: Findings highlight the importance of prioritizing cancer literacy as a key action area in national cancer control plans. The counterintuitive associations between cancer beliefs and lifestyle emphasize the complexity of this relationship, necessitating nuanced approaches to promote cancer literacy and preventive behaviors.

目的:对癌症成因的看法虽然有时与已知的风险因素一致,但可能会受到个人经历、文化叙事和错误信息的影响。我们调查了多种族亚洲人群中对癌症成因的看法及其与癌症风险认知和生活方式的关系:方法:我们使用改编自 "癌症认知量表 "和 "癌症认知量表--神话病因量表 "的 42 个项目的调查问卷,对总共 2 008 名没有患过癌症的马来西亚成年人进行了调查。采用偏最小二乘结构方程模型对测量模型进行评估:结果:尽管受访者受教育程度较高,但只有大约一半的受访者认为,在列出的 21 个既定风险因素中,有 7 个因素会导致癌症。与准确信念相关的因素包括较高的社会经济地位(SES)和家人或朋友患有癌症。然而,在列出的 21 个神话/未经证实的因素中,有 14 个因素被大多数人正确地认为不会导致癌症。女性和社会经济地位较低的人更有可能持有错误观念。对既定风险因素的信念与感知到的癌症风险有显著关联。对既定风险因素有较强信念的人较少有健康行为。相反,对神话或未经证实的因素有较强信念的人则更有可能与健康的生活方式有关:研究结果凸显了将癌症知识普及作为国家癌症控制计划中一个关键行动领域的重要性。癌症信念与生活方式之间的反直觉关联强调了这种关系的复杂性,因此有必要采取细致入微的方法来促进癌症知识普及和预防行为。
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引用次数: 0
Evaluation of the Stronger Together Peer Mentoring Model Among Patients With Breast and Gynecologic Cancer in Viet Nam. 越南乳腺癌和妇科癌症患者 "强强联手 "同伴指导模式评估。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-14 DOI: 10.1200/GO.24.00031
PhuongThao D Le, Carolyn Taylor, Mai T Do, Rachel Monahan, Sang Lee, Meenakshi Sigireddi, Cong Wang, Anna Cabanes, Ophira Ginsburg, Thanh Huong T Tran

Purpose: Stronger Together is a peer mentoring model that seeks to address the severe lack of mental health and psychosocial support for patients with cancer in many low- and middle-income countries (LMICs). This article presents the results of the Stronger Together pilot study among patients with breast and gynecologic cancer in Viet Nam (VN).

Methods: Eligible participants comprised women age 25 years or older with a diagnosis of breast or gynecologic cancers and receiving treatment at four participating hospitals. Participants were asked whether they wanted to proceed with usual care or be matched with a trained and supervised peer mentor (a cancer survivor). Surveys were administered at baseline (0) and 2, 4, and 6 months and assessed depression, anxiety, stress, mental health and physical health components of quality of life (QOL), self-efficacy, and social support. We computed and compared 2-, 4-, and 6-month changes in scores from baseline and conducted difference-in-difference analyses to estimate the intervention effect at 6 months.

Results: The sample size included N = 186 participants. Mentees (n = 91) exhibited improvements in depression, anxiety, stress, and mental health QOL across all time points, whereas usual care participants (n = 95) experienced these improvements at later periods (4 and 6 months). Compared with usual care participants, mentees reported greater improvements in depression at 2 and 4 months, mental health QOL at all time points, and self-efficacy and social support at 4 and 6 months. Greater improvements in stress were also seen in the breast cancer subsample.

Conclusion: Stronger Together is a promising model to improve mental health and psychosocial outcomes among patients with breast and gynecologic cancer in VN and can help fill gaps in cancer peer support interventions in many LMICs.

目的:Stronger Together 是一种同伴指导模式,旨在解决许多中低收入国家(LMIC)癌症患者严重缺乏心理健康和社会心理支持的问题。本文介绍了在越南(VN)乳腺癌和妇科癌症患者中开展的 "强强联手 "试点研究的结果:符合条件的参与者包括年龄在 25 岁或以上、确诊患有乳腺癌或妇科癌症并在四家参与医院接受治疗的女性。参与者被问及是愿意继续接受常规治疗,还是愿意与经过培训并接受监督的同伴导师(癌症幸存者)配对。在基线(0)和 2、4、6 个月时进行调查,评估抑郁、焦虑、压力、生活质量 (QOL) 的心理健康和身体健康组成部分、自我效能和社会支持。我们计算并比较了 2 个月、4 个月和 6 个月的基线分数变化,并进行了差异分析,以估计 6 个月时的干预效果:样本量包括 N = 186 名参与者。在所有时间点上,被辅导者(n = 91)的抑郁、焦虑、压力和心理健康QOL都有所改善,而常规护理参与者(n = 95)在后期(4个月和6个月)才有所改善。与常规护理参与者相比,被指导者在 2 个月和 4 个月时的抑郁程度、所有时间点的心理健康 QOL 以及 4 个月和 6 个月时的自我效能和社会支持方面均有较大改善。在乳腺癌子样本中,压力方面的改善也更明显:结论:"强强联手 "是一种很有前景的模式,可改善越南乳腺癌和妇科癌症患者的心理健康和心理社会结果,并有助于填补许多低收入国家癌症同伴支持干预的空白。
{"title":"Evaluation of the Stronger Together Peer Mentoring Model Among Patients With Breast and Gynecologic Cancer in Viet Nam.","authors":"PhuongThao D Le, Carolyn Taylor, Mai T Do, Rachel Monahan, Sang Lee, Meenakshi Sigireddi, Cong Wang, Anna Cabanes, Ophira Ginsburg, Thanh Huong T Tran","doi":"10.1200/GO.24.00031","DOIUrl":"10.1200/GO.24.00031","url":null,"abstract":"<p><strong>Purpose: </strong>Stronger Together is a peer mentoring model that seeks to address the severe lack of mental health and psychosocial support for patients with cancer in many low- and middle-income countries (LMICs). This article presents the results of the Stronger Together pilot study among patients with breast and gynecologic cancer in Viet Nam (VN).</p><p><strong>Methods: </strong>Eligible participants comprised women age 25 years or older with a diagnosis of breast or gynecologic cancers and receiving treatment at four participating hospitals. Participants were asked whether they wanted to proceed with usual care or be matched with a trained and supervised peer mentor (a cancer survivor). Surveys were administered at baseline (0) and 2, 4, and 6 months and assessed depression, anxiety, stress, mental health and physical health components of quality of life (QOL), self-efficacy, and social support. We computed and compared 2-, 4-, and 6-month changes in scores from baseline and conducted difference-in-difference analyses to estimate the intervention effect at 6 months.</p><p><strong>Results: </strong>The sample size included N = 186 participants. Mentees (n = 91) exhibited improvements in depression, anxiety, stress, and mental health QOL across all time points, whereas usual care participants (n = 95) experienced these improvements at later periods (4 and 6 months). Compared with usual care participants, mentees reported greater improvements in depression at 2 and 4 months, mental health QOL at all time points, and self-efficacy and social support at 4 and 6 months. Greater improvements in stress were also seen in the breast cancer subsample.</p><p><strong>Conclusion: </strong>Stronger Together is a promising model to improve mental health and psychosocial outcomes among patients with breast and gynecologic cancer in VN and can help fill gaps in cancer peer support interventions in many LMICs.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400031"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immigrant Health and Early-Onset Colorectal Cancer Disparities: Results From the Spanish Early-Onset Colorectal Cancer Consortium. 移民健康与早发结直肠癌差异:西班牙早发结直肠癌联合会的研究结果。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-21 DOI: 10.1200/GO-24-00393
José Perea, Marc Martí-Gallostra, Ariadna García-Rodríguez, Rosario Vidal-Tocino, José A Alcázar, Irene López-Rojo, Sara Encinas García, Elena Hurtado, Luis M Jiménez, Edurne Álvaro, Ana Burdaspal, Gonzalo Sanz, Rodrigo Sanz López, Marta Jiménez Toscano, Mar Iglesias Comas, Fernando Jiménez, Adriana Cavero, Francesc Balaguer, María Daca, Araceli Ballestero, Javier Die Trill, Sirio Melone, José A Rueda, Sergio Hernández-Villafranca, Damián García-Olmo, Carlos Pastor, Alicia Alvarellos, Lorena Brandáriz, Cristina Viyuela, Alfredo Vivas, Paula Muñoz, Rogelio González-Sarmiento, Andreana N Holowatyj

Purpose: To better understand immigration disparities among a Spanish Early-Onset Colorectal Cancer (SECOC) subset, according to the country of origin.

Patients and methods: We selected 250 consecutive participants from the SECOC consortium. Data on baseline patient and tumor characteristics, family history of colorectal cancer (CRC), and follow-up were collected. The presence of mismatch repair deficiency was also assessed. Special data regarding country of origin, time of stay in Spain in case of other different country, and a 10-year cutoff that specifies the obtaining of Spanish nationality defined the variables of interest for comparison.

Results: Seventy-five percent of patients with early-onset CRC (EOCRC) (188) were born in Spain, whereas the other 25% were born outside of Spain. The mean time of living in Spain until the EOCRC diagnosis was 16.5 years. Comparatively, most of the analyzed features showed equivalent proportions between cohorts. Only Spanish patients appeared to have more familial cancer component in first degree in general (32.3%; P = .01), compared with non-Spaniards, which showed a predominant sporadic component (56.4%; P < .001). Among immigrants, those patients living in Spain before CRC diagnosis ≤10 years were younger at diagnosis (39.1 v 42.5), more frequently male (77.8 v 47.7), were in more advanced stages (88.8% diagnosed at stage III and IV [P = .01]), and had a worse prognosis regarding recurrence rates (29.4% v 6.3%).

Conclusion: Although there were few differences between Spanish and non-Spanish EOCRC, the most remarkable difference was that linked with the situation of those immigrants who have recently arrived in Spain, in relation to their lower health coverage, which could be associated with the delay in the diagnosis and their subsequent worse prognosis.

目的:更好地了解西班牙早发结直肠癌(SECOC)子集中根据原籍国不同而存在的移民差异:我们从SECOC联盟中挑选了250名连续参与者。我们收集了患者和肿瘤的基线特征、结直肠癌(CRC)家族史和随访数据。还评估了是否存在错配修复缺陷。有关原籍国的特殊数据、在西班牙停留的时间(如果是在其他不同国家),以及规定获得西班牙国籍的 10 年分界线定义了比较感兴趣的变量:75%的早发性 CRC(EOCRC)患者(188 人)出生在西班牙,而另外 25% 的患者出生在西班牙以外的国家。从在西班牙生活到确诊为 EOCRC 的平均时间为 16.5 年。相比之下,大多数分析特征在不同组群之间显示出相同的比例。与非西班牙籍患者相比,只有西班牙籍患者的一级癌症家族遗传率较高(32.3%;P = .01),而非西班牙籍患者则以散发性为主(56.4%;P < .001)。在移民中,确诊 CRC 前在西班牙生活≤10 年的患者在确诊时更年轻(39.1 对 42.5),更多是男性(77.8 对 47.7),处于更晚期(88.8% 确诊为 III 期和 IV 期 [P=0.01]),复发率预后更差(29.4% 对 6.3%):尽管西班牙籍和非西班牙籍 EOCRC 患者之间的差异不大,但最显著的差异与新近抵达西班牙的移民的情况有关,因为他们的医疗保险较低,这可能与诊断延迟和随后的预后较差有关。
{"title":"Immigrant Health and Early-Onset Colorectal Cancer Disparities: Results From the Spanish Early-Onset Colorectal Cancer Consortium.","authors":"José Perea, Marc Martí-Gallostra, Ariadna García-Rodríguez, Rosario Vidal-Tocino, José A Alcázar, Irene López-Rojo, Sara Encinas García, Elena Hurtado, Luis M Jiménez, Edurne Álvaro, Ana Burdaspal, Gonzalo Sanz, Rodrigo Sanz López, Marta Jiménez Toscano, Mar Iglesias Comas, Fernando Jiménez, Adriana Cavero, Francesc Balaguer, María Daca, Araceli Ballestero, Javier Die Trill, Sirio Melone, José A Rueda, Sergio Hernández-Villafranca, Damián García-Olmo, Carlos Pastor, Alicia Alvarellos, Lorena Brandáriz, Cristina Viyuela, Alfredo Vivas, Paula Muñoz, Rogelio González-Sarmiento, Andreana N Holowatyj","doi":"10.1200/GO-24-00393","DOIUrl":"https://doi.org/10.1200/GO-24-00393","url":null,"abstract":"<p><strong>Purpose: </strong>To better understand immigration disparities among a Spanish Early-Onset Colorectal Cancer (SECOC) subset, according to the country of origin.</p><p><strong>Patients and methods: </strong>We selected 250 consecutive participants from the SECOC consortium. Data on baseline patient and tumor characteristics, family history of colorectal cancer (CRC), and follow-up were collected. The presence of mismatch repair deficiency was also assessed. Special data regarding country of origin, time of stay in Spain in case of other different country, and a 10-year cutoff that specifies the obtaining of Spanish nationality defined the variables of interest for comparison.</p><p><strong>Results: </strong>Seventy-five percent of patients with early-onset CRC (EOCRC) (188) were born in Spain, whereas the other 25% were born outside of Spain. The mean time of living in Spain until the EOCRC diagnosis was 16.5 years. Comparatively, most of the analyzed features showed equivalent proportions between cohorts. Only Spanish patients appeared to have more familial cancer component in first degree in general (32.3%; <i>P</i> = .01), compared with non-Spaniards, which showed a predominant sporadic component (56.4%; <i>P</i> < .001). Among immigrants, those patients living in Spain before CRC diagnosis ≤10 years were younger at diagnosis (39.1 <i>v</i> 42.5), more frequently male (77.8 <i>v</i> 47.7), were in more advanced stages (88.8% diagnosed at stage III and IV [<i>P</i> = .01]), and had a worse prognosis regarding recurrence rates (29.4% <i>v</i> 6.3%).</p><p><strong>Conclusion: </strong>Although there were few differences between Spanish and non-Spanish EOCRC, the most remarkable difference was that linked with the situation of those immigrants who have recently arrived in Spain, in relation to their lower health coverage, which could be associated with the delay in the diagnosis and their subsequent worse prognosis.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400393"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Germline Genetic Susceptibility Testing Among Emirati Nationals at Risk for Hereditary Breast and Ovarian Cancer Syndrome. 对有遗传性乳腺癌和卵巢癌综合征风险的阿联酋国民进行种系遗传易感性检测。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-14 DOI: 10.1200/GO-24-00352
Rifaat R Rawashdeh, Holly Pederson, Rafal Iskanderian, Fawad Khan, Basel Altrabulsi, Stephanie Ricci, Charis Eng, Bassel Jallad, Asma Ibrahim Al Mannaei, Mohamed Salem Alameri, Azza Attia, Stephen R Grobmyer

Purpose: Breast cancer among Emirati patients is characterized by early-onset disease and later stages at presentation. Little is known about the germline genetic variants that may contribute to these observations. The goal of this study is to characterize the rate and implications of germline genetic variants among a cohort of Emirati patients at risk for hereditary breast and ovarian cancer syndrome.

Materials and methods: A retrospective study was performed to analyze the results of clinical germline genetic testing (March 2020-January 2023) among a cohort of consecutive Emirati patients at risk for hereditary breast and ovarian cancer syndrome: group A: patients with personal history of breast or ovarian cancer (n = 135); group B: unaffected patients with family history of breast or ovarian cancer (n = 37); and group C: patients presenting for cascade testing (n = 20). Management of patients identified to have pathogenic/likely pathogenic (P/LP) variants was analyzed.

Results: The rate of P/LP germline variants for each group was: group A: 17.3%, group B: 16.6%, group C: 57.9%. BRCA1 gene was the most commonly identified gene harboring P/LP variants, followed by BRCA2, among this cohort. Four unrelated patients had a recurrent BRCA1 pathogenic variant: c.4065_4068del (p.Asn1355Lysfs*10). Only two patients in this series elected risk-reducing mastectomy and four patients elected risk-reducing bilateral salpingo-oophorectomy.

Conclusion: A higher rate of P/LP variants is seen among Emirati patients at risk for hereditary breast and ovarian cancer syndrome compared with reports of similar patients from Western populations. Efforts to increase utilization and awareness of germline genetic testing are warranted among Emirati patients.

目的:阿联酋患者乳腺癌的特点是发病早、病程晚。人们对可能导致这些现象的种系遗传变异知之甚少。本研究的目的是描述有遗传性乳腺癌和卵巢癌综合征风险的阿联酋患者种系遗传变异的发生率及其影响:研究人员开展了一项回顾性研究,分析了一组连续的阿联酋遗传性乳腺癌和卵巢癌综合征高危患者的临床种系基因检测结果(2020 年 3 月至 2023 年 1 月):A 组:有乳腺癌或卵巢癌个人病史的患者(n = 135);B 组:未受影响但有乳腺癌或卵巢癌家族史的患者(n = 37);C 组:接受级联检测的患者(n = 20)。分析了对已确定具有致病/可能致病(P/LP)变异的患者的处理情况:各组 P/LP 基因变异率分别为:A 组:17.3%;B 组:16.6%;C 组:57.9%。BRCA1 基因是本组中最常见的携带 P/LP 变异的基因,其次是 BRCA2。四名无亲属关系的患者有一个复发性 BRCA1 致病变异:c.4065_4068del (p.Asn1355Lysfs*10)。该系列中只有两名患者选择了降低风险的乳房切除术,四名患者选择了降低风险的双侧输卵管切除术:结论:与西方国家类似患者的报告相比,阿联酋遗传性乳腺癌和卵巢癌综合征高危患者中P/LP变异率较高。应努力提高阿联酋患者对种系遗传检测的利用率和认识。
{"title":"Germline Genetic Susceptibility Testing Among Emirati Nationals at Risk for Hereditary Breast and Ovarian Cancer Syndrome.","authors":"Rifaat R Rawashdeh, Holly Pederson, Rafal Iskanderian, Fawad Khan, Basel Altrabulsi, Stephanie Ricci, Charis Eng, Bassel Jallad, Asma Ibrahim Al Mannaei, Mohamed Salem Alameri, Azza Attia, Stephen R Grobmyer","doi":"10.1200/GO-24-00352","DOIUrl":"https://doi.org/10.1200/GO-24-00352","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer among Emirati patients is characterized by early-onset disease and later stages at presentation. Little is known about the germline genetic variants that may contribute to these observations. The goal of this study is to characterize the rate and implications of germline genetic variants among a cohort of Emirati patients at risk for hereditary breast and ovarian cancer syndrome.</p><p><strong>Materials and methods: </strong>A retrospective study was performed to analyze the results of clinical germline genetic testing (March 2020-January 2023) among a cohort of consecutive Emirati patients at risk for hereditary breast and ovarian cancer syndrome: group A: patients with personal history of breast or ovarian cancer (n = 135); group B: unaffected patients with family history of breast or ovarian cancer (n = 37); and group C: patients presenting for cascade testing (n = 20). Management of patients identified to have pathogenic/likely pathogenic (P/LP) variants was analyzed.</p><p><strong>Results: </strong>The rate of P/LP germline variants for each group was: group A: 17.3%, group B: 16.6%, group C: 57.9%. <i>BRCA1</i> gene was the most commonly identified gene harboring P/LP variants, followed by <i>BRCA2</i>, among this cohort. Four unrelated patients had a recurrent <i>BRCA1</i> pathogenic variant: c.4065_4068del (p.Asn1355Lysfs*10). Only two patients in this series elected risk-reducing mastectomy and four patients elected risk-reducing bilateral salpingo-oophorectomy.</p><p><strong>Conclusion: </strong>A higher rate of P/LP variants is seen among Emirati patients at risk for hereditary breast and ovarian cancer syndrome compared with reports of similar patients from Western populations. Efforts to increase utilization and awareness of germline genetic testing are warranted among Emirati patients.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400352"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health-Related Quality of Life and Financial Burden in Ethiopian Patients With Chronic Myeloid Leukemia Receiving Tyrosine Kinase Inhibitors: A Cross-Sectional Study. 接受酪氨酸激酶抑制剂治疗的埃塞俄比亚慢性粒细胞白血病患者与健康相关的生活质量和经济负担:一项横断面研究。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-14 DOI: 10.1200/GO-24-00281
Fisihatsion Tadesse, Francesco Sparano, Amha Gebremedhin, Abdulaziz Abubeker, Alfonso Piciocchi, Marta Cipriani, Daniela Krepper, Lalise Gemechu, Atalay Mulu, Getahun Asres, Fabio Efficace

Purpose: Health-related quality of life (HRQoL) is now an important goal of therapy for patients with chronic myeloid leukemia (CML). However, there is paucity of data for patients living in low-income countries (LICs) and on factors associated with their HRQoL profile. The primary objective was to compare the HRQoL of patients with CML living in an LIC (Ethiopia) with that of patients living in a high-income country (HIC).

Methods: Adult patients with CML treated with tyrosine kinase inhibitors in Ethiopia were considered eligible for this study. To assess their HRQoL and symptom burden, eligible patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the EORTC Quality of Life Questionnaire Chronic Myeloid Leukemia 24 (QLQ-CML24). A matched case-control analysis was applied to compare the HRQoL profile of the herein-recruited Ethiopian cohort with a sample of patients with CML from an HIC (Italy).

Results: Overall, 395 Ethiopian patients were enrolled between February 2021 and June 2021. Except for dyspnea and satisfaction with care, the Ethiopian patients reported lower HRQoL and functioning and higher symptom burden compared with patients with CML living in an HIC. A remarkable proportion of Ethiopian patients (n = 353, 89.4%) reported financial toxicity (FT). Compared with patients without FT, those with FT reported a higher prevalence of clinically important problems and symptoms across all the QLQ-C30 scales. For example, the prevalence of clinically important impairment of social functioning was almost sixfold higher for patients with FT compared with those without FT (41.8%, 7.1%, respectively).

Conclusion: Our results indicate that the HRQoL profile of patients with CML living in Ethiopia may be worse across several important functional and symptom domains than that of their peers living in an HIC. In addition, FT is highly prevalent among these patients and it is associated with poorer HRQoL outcomes.

目的:与健康相关的生活质量(HRQoL)现已成为慢性髓性白血病(CML)患者治疗的一个重要目标。然而,生活在低收入国家(LICs)的患者及其 HRQoL 相关因素的数据却很少。研究的主要目的是比较生活在低收入国家(埃塞俄比亚)的 CML 患者与生活在高收入国家(HIC)的患者的 HRQoL:埃塞俄比亚接受酪氨酸激酶抑制剂治疗的成年 CML 患者被认为符合本研究的条件。为了评估他们的 HRQoL 和症状负担,符合条件的患者填写了欧洲癌症研究和治疗组织生活质量问卷-核心 30 (EORTC QLQ-C30) 和 EORTC 生活质量问卷慢性粒细胞白血病 24 (QLQ-CML24)。我们采用了匹配病例对照分析法,以比较在此招募的埃塞俄比亚队列与来自高收入国家(意大利)的慢性粒细胞白血病患者样本的 HRQoL 情况:2021年2月至2021年6月期间,共招募了395名埃塞俄比亚患者。与生活在高收入国家的 CML 患者相比,除了呼吸困难和对护理的满意度外,埃塞俄比亚患者的 HRQoL 和功能较低,症状负担较重。很大一部分埃塞俄比亚患者(n = 353,89.4%)报告了经济毒性(FT)。与没有财务毒性的患者相比,有财务毒性的患者在所有 QLQ-C30 量表中报告的临床重要问题和症状的发生率更高。例如,与无 FT 患者相比,有 FT 患者的临床重要社会功能损害发生率几乎高出六倍(分别为 41.8%、7.1%):我们的研究结果表明,与生活在高收入国家的同龄人相比,生活在埃塞俄比亚的 CML 患者在几个重要功能和症状领域的 HRQoL 情况可能更差。此外,FT 在这些患者中非常普遍,而且与较差的 HRQoL 结果有关。
{"title":"Health-Related Quality of Life and Financial Burden in Ethiopian Patients With Chronic Myeloid Leukemia Receiving Tyrosine Kinase Inhibitors: A Cross-Sectional Study.","authors":"Fisihatsion Tadesse, Francesco Sparano, Amha Gebremedhin, Abdulaziz Abubeker, Alfonso Piciocchi, Marta Cipriani, Daniela Krepper, Lalise Gemechu, Atalay Mulu, Getahun Asres, Fabio Efficace","doi":"10.1200/GO-24-00281","DOIUrl":"https://doi.org/10.1200/GO-24-00281","url":null,"abstract":"<p><strong>Purpose: </strong>Health-related quality of life (HRQoL) is now an important goal of therapy for patients with chronic myeloid leukemia (CML). However, there is paucity of data for patients living in low-income countries (LICs) and on factors associated with their HRQoL profile. The primary objective was to compare the HRQoL of patients with CML living in an LIC (Ethiopia) with that of patients living in a high-income country (HIC).</p><p><strong>Methods: </strong>Adult patients with CML treated with tyrosine kinase inhibitors in Ethiopia were considered eligible for this study. To assess their HRQoL and symptom burden, eligible patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the EORTC Quality of Life Questionnaire Chronic Myeloid Leukemia 24 (QLQ-CML24). A matched case-control analysis was applied to compare the HRQoL profile of the herein-recruited Ethiopian cohort with a sample of patients with CML from an HIC (Italy).</p><p><strong>Results: </strong>Overall, 395 Ethiopian patients were enrolled between February 2021 and June 2021. Except for dyspnea and satisfaction with care, the Ethiopian patients reported lower HRQoL and functioning and higher symptom burden compared with patients with CML living in an HIC. A remarkable proportion of Ethiopian patients (n = 353, 89.4%) reported financial toxicity (FT). Compared with patients without FT, those with FT reported a higher prevalence of clinically important problems and symptoms across all the QLQ-C30 scales. For example, the prevalence of clinically important impairment of social functioning was almost sixfold higher for patients with FT compared with those without FT (41.8%, 7.1%, respectively).</p><p><strong>Conclusion: </strong>Our results indicate that the HRQoL profile of patients with CML living in Ethiopia may be worse across several important functional and symptom domains than that of their peers living in an HIC. In addition, FT is highly prevalent among these patients and it is associated with poorer HRQoL outcomes.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400281"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Biosimilar Cetuximab Versus Innovator Cetuximab in Indian Patients With Head and Neck Cancer: A Multicenter, Randomized, Double-Blind, Phase III Trial. 印度头颈癌患者使用西妥昔单抗生物仿制药与西妥昔单抗创新药的疗效和安全性:多中心、随机、双盲、III 期试验。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-14 DOI: 10.1200/GO.24.00059
Kumar Prabhash, Chetan Deshmukh, Hemant Malhotra, Atul Sharma, Minish Jain, Nilesh Dhamne, Rajnish Nagarakar, Prasantha Ganesan, Vijay K Mahobia, Chandan K Das, Rejnish Kumar, Prakash S Shivanna, Manu P Avaronnan, Puligundla K Chaithanya, Vaibhav Chaudhary, Kartar Singh, Suhas Aagre, Bellala Ravishankar, Dhruv Mehta, Kandipalli Shilpa, Vashishth Maniar, Koushik Chatterjee, Saroj D Majumdar, Rohitashwa Dana, Vanita Noronha, Nandini Menon, Akhilesh Sharma, Roshan Pawar, Vinayaka Shahavi, Rajiv Yadav, Amol Aiwale

Purpose: Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer, with approximately 225,419 new cases with over 125,000 deaths annually in India. This trial compared the efficacy and safety of biosimilar cetuximab versus innovator cetuximab (IC) in combination with platinum-based chemotherapy in patients with recurrent locoregional or metastatic SCCHN.

Methods: This phase III trial is a multicenter, randomized, double-blind and parallel group study performed in Indian patients with recurrent locoregional or metastatic SCCHN. Patients were randomly assigned in 2:1 ratio to receive biosimilar cetuximab and IC in combination with cisplatin and fluorouracil via intravenous infusions. The primary end points were disease control rate (DCR) and overall response rate (ORR) as per response evaluation criteria in solid tumors version 1.1. The secondary end points included pharmacokinetics (PK), immunogenicity, safety, and tolerability.

Results: Of 180 patients enrolled, 120 patients received biosimilar cetuximab and 60 patients received IC treatment. No significant statistical difference was observed in the primary outcomes between two groups. Treatment difference in DCR and ORR response was found to be -5.21 (90% CI, -8.94 to -1.48) and -4.79 (90% CI, -19.42 to 9.84), respectively, indicating noninferiority to reference product. The incidence of treatment-emergent adverse events (AEs; biosimilar cetuximab: 89.2% v IC: 91.7%; P = .8364) and serious AEs (biosimilar cetuximab: 23.3% v IC: 13.3%; P = .0603) and PK parameters were comparable between treatment groups. The immunogenicity findings showed higher incidence of anticetuximab antibodies in the biosimilar cetuximab group compared with the IC group at the end of Study.

Conclusion: The findings of this study demonstrated noninferiority along with comparable PK, safety, and immunogenicity of biosimilar cetuximab and IC in patients with recurrent or metastatic SCCHN.

目的:头颈部鳞状细胞癌(SCCHN)是印度第六大常见癌症,每年新增病例约 225,419 例,死亡人数超过 125,000 人。这项试验比较了生物仿制药西妥昔单抗与创新药西妥昔单抗(IC)联合铂类化疗治疗复发性局部或转移性SCCHN患者的疗效和安全性:这项III期试验是一项多中心、随机、双盲和平行分组研究,在印度复发性局部或转移性SCCHN患者中进行。患者按 2:1 的比例随机分配,接受生物仿制药西妥昔单抗和 IC 联合顺铂和氟尿嘧啶静脉输注治疗。根据实体瘤反应评价标准1.1版,主要终点为疾病控制率(DCR)和总反应率(ORR)。次要终点包括药代动力学(PK)、免疫原性、安全性和耐受性:在 180 名入组患者中,120 名患者接受了生物类似物西妥昔单抗治疗,60 名患者接受了 IC 治疗。两组患者的主要结果无明显统计学差异。DCR和ORR反应的治疗差异分别为-5.21(90% CI,-8.94至-1.48)和-4.79(90% CI,-19.42至9.84),表明与参比产品相比无劣效性。治疗组之间的治疗突发不良事件(AEs;生物类似药西妥昔单抗:89.2%对IC:91.7%;P = .8364)和严重AEs(生物类似药西妥昔单抗:23.3%对IC:13.3%;P = .0603)发生率以及PK参数相当。免疫原性研究结果显示,在研究结束时,生物类似物西妥昔单抗组的抗西妥昔单抗抗体发生率高于IC组:本研究结果表明,生物类似药西妥昔单抗和IC在复发性或转移性SCCHN患者中的疗效非劣效性,且PK、安全性和免疫原性相当。
{"title":"Efficacy and Safety of Biosimilar Cetuximab Versus Innovator Cetuximab in Indian Patients With Head and Neck Cancer: A Multicenter, Randomized, Double-Blind, Phase III Trial.","authors":"Kumar Prabhash, Chetan Deshmukh, Hemant Malhotra, Atul Sharma, Minish Jain, Nilesh Dhamne, Rajnish Nagarakar, Prasantha Ganesan, Vijay K Mahobia, Chandan K Das, Rejnish Kumar, Prakash S Shivanna, Manu P Avaronnan, Puligundla K Chaithanya, Vaibhav Chaudhary, Kartar Singh, Suhas Aagre, Bellala Ravishankar, Dhruv Mehta, Kandipalli Shilpa, Vashishth Maniar, Koushik Chatterjee, Saroj D Majumdar, Rohitashwa Dana, Vanita Noronha, Nandini Menon, Akhilesh Sharma, Roshan Pawar, Vinayaka Shahavi, Rajiv Yadav, Amol Aiwale","doi":"10.1200/GO.24.00059","DOIUrl":"10.1200/GO.24.00059","url":null,"abstract":"<p><strong>Purpose: </strong>Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer, with approximately 225,419 new cases with over 125,000 deaths annually in India. This trial compared the efficacy and safety of biosimilar cetuximab versus innovator cetuximab (IC) in combination with platinum-based chemotherapy in patients with recurrent locoregional or metastatic SCCHN.</p><p><strong>Methods: </strong>This phase III trial is a multicenter, randomized, double-blind and parallel group study performed in Indian patients with recurrent locoregional or metastatic SCCHN. Patients were randomly assigned in 2:1 ratio to receive biosimilar cetuximab and IC in combination with cisplatin and fluorouracil via intravenous infusions. The primary end points were disease control rate (DCR) and overall response rate (ORR) as per response evaluation criteria in solid tumors version 1.1. The secondary end points included pharmacokinetics (PK), immunogenicity, safety, and tolerability.</p><p><strong>Results: </strong>Of 180 patients enrolled, 120 patients received biosimilar cetuximab and 60 patients received IC treatment. No significant statistical difference was observed in the primary outcomes between two groups. Treatment difference in DCR and ORR response was found to be -5.21 (90% CI, -8.94 to -1.48) and -4.79 (90% CI, -19.42 to 9.84), respectively, indicating noninferiority to reference product. The incidence of treatment-emergent adverse events (AEs; biosimilar cetuximab: 89.2% <i>v</i> IC: 91.7%; <i>P</i> = .8364) and serious AEs (biosimilar cetuximab: 23.3% <i>v</i> IC: 13.3%; <i>P</i> = .0603) and PK parameters were comparable between treatment groups. The immunogenicity findings showed higher incidence of anticetuximab antibodies in the biosimilar cetuximab group compared with the IC group at the end of Study.</p><p><strong>Conclusion: </strong>The findings of this study demonstrated noninferiority along with comparable PK, safety, and immunogenicity of biosimilar cetuximab and IC in patients with recurrent or metastatic SCCHN.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400059"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive Factors of Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer: A Decision Tree Model Approach. 乳腺癌化疗诱发周围神经病变的预测因素:决策树模型方法
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-14 DOI: 10.1200/GO.24.00160
Juan Adrian Wiranata, Yufi Kartika Astari, Meita Ucche, Susanna Hilda Hutajulu, Dewi Kartikawati Paramita, Dian Caturini Sulistyoningrum, Yudiyanta Siswohadiswasana, Ahmad Asmedi, Mardiah Suci Hardianti, Kartika Widayati Taroeno-Hariadi, Johan Kurnianda, Ibnu Purwanto

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) poses a substantial challenge in breast cancer (BC) chemotherapy, affecting the patient's quality of life. Recent studies have focused on exploring predictors and patterns of CIPN occurrence. We aimed to develop a prediction model for CIPN occurrence using a classification and regression tree (CART) algorithm.

Methods: In this prospective study of 170 patients with BC undergoing chemotherapy, patient-reported adaptation of the Common Terminology Criteria for Adverse Events version 4.0 was used to assess CIPN occurrence. Multivariable analysis using the CART model was tuned using 10-fold cross-validation to identify baseline predictors for CIPN throughout chemotherapy. A receiver operating characteristic curve analysis was conducted for the CART model. A multivariable logistic regression was conducted from the variables included in the CART model to assess the strength and direction of the association.

Results: The prevalence of CIPN was 64.7% (n = 110). The most decisive predictor of CIPN occurrence in the CART model was the subject's C-reactive protein (CRP) level. CRP level >3.91 mg/dL, BMI >21.85 kg/m2, and a marital status of unmarried have predicted a probability of 100% in CIPN occurrence. The CART model showed an accuracy of 65.9%, sensitivity of 51.7%, specificity of 73.2%, and an area under the curve of 0.705. A CRP level of >3.91 mg/dL and a neutrophil-to-lymphocyte ratio (NLR) of >2.82 are significantly associated with the occurrence of CIPN (odds ratio [OR], 2.01 [95% CI, 1.01 to 4.01]; P = .046, OR, 2.09 [95%, CI, 1.02 to 4.24]; P = .042, respectively).

Conclusion: Baseline CRP, NLR, BMI level, and marital status are significant predictors of CIPN occurrence throughout chemotherapy. Our CART model was better at ruling out individuals who would not experience CIPN. The CART model may provide insight into the future development of individualized patient care and prevention strategies.

目的:化疗诱发的周围神经病变(CIPN)是乳腺癌(BC)化疗中的一大挑战,会影响患者的生活质量。最近的研究主要集中在探索 CIPN 发生的预测因素和模式。我们的目标是利用分类和回归树(CART)算法建立一个 CIPN 发生的预测模型:在这项对170名接受化疗的BC患者进行的前瞻性研究中,采用患者报告的《不良事件通用术语标准4.0版》来评估CIPN的发生情况。使用 10 倍交叉验证对 CART 模型进行了多变量分析,以确定整个化疗过程中 CIPN 的基线预测因素。对 CART 模型进行了接收者操作特征曲线分析。根据CART模型中的变量进行多变量逻辑回归,以评估关联的强度和方向:结果:CIPN的发病率为64.7%(n = 110)。在 CART 模型中,对 CIPN 发生率最具决定性的预测因素是受试者的 C 反应蛋白(CRP)水平。CRP水平>3.91 mg/dL、体重指数>21.85 kg/m2和未婚婚姻状况预测CIPN发生的概率为100%。CART 模型的准确率为 65.9%,灵敏度为 51.7%,特异性为 73.2%,曲线下面积为 0.705。CRP水平>3.91 mg/dL和中性粒细胞与淋巴细胞比值(NLR)>2.82与CIPN的发生显著相关(几率比[OR],2.01 [95% CI,1.01至4.01];P = .046;OR,2.09 [95% CI,1.02至4.24];P = .042):结论:基线CRP、NLR、BMI水平和婚姻状况是整个化疗过程中CIPN发生的重要预测因素。我们的 CART 模型能更好地排除不会出现 CIPN 的个体。CART 模型可为今后制定个体化患者护理和预防策略提供启示。
{"title":"Predictive Factors of Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer: A Decision Tree Model Approach.","authors":"Juan Adrian Wiranata, Yufi Kartika Astari, Meita Ucche, Susanna Hilda Hutajulu, Dewi Kartikawati Paramita, Dian Caturini Sulistyoningrum, Yudiyanta Siswohadiswasana, Ahmad Asmedi, Mardiah Suci Hardianti, Kartika Widayati Taroeno-Hariadi, Johan Kurnianda, Ibnu Purwanto","doi":"10.1200/GO.24.00160","DOIUrl":"https://doi.org/10.1200/GO.24.00160","url":null,"abstract":"<p><strong>Purpose: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) poses a substantial challenge in breast cancer (BC) chemotherapy, affecting the patient's quality of life. Recent studies have focused on exploring predictors and patterns of CIPN occurrence. We aimed to develop a prediction model for CIPN occurrence using a classification and regression tree (CART) algorithm.</p><p><strong>Methods: </strong>In this prospective study of 170 patients with BC undergoing chemotherapy, patient-reported adaptation of the Common Terminology Criteria for Adverse Events version 4.0 was used to assess CIPN occurrence. Multivariable analysis using the CART model was tuned using 10-fold cross-validation to identify baseline predictors for CIPN throughout chemotherapy. A receiver operating characteristic curve analysis was conducted for the CART model. A multivariable logistic regression was conducted from the variables included in the CART model to assess the strength and direction of the association.</p><p><strong>Results: </strong>The prevalence of CIPN was 64.7% (n = 110). The most decisive predictor of CIPN occurrence in the CART model was the subject's C-reactive protein (CRP) level. CRP level >3.91 mg/dL, BMI >21.85 kg/m<sup>2</sup>, and a marital status of unmarried have predicted a probability of 100% in CIPN occurrence. The CART model showed an accuracy of 65.9%, sensitivity of 51.7%, specificity of 73.2%, and an area under the curve of 0.705. A CRP level of >3.91 mg/dL and a neutrophil-to-lymphocyte ratio (NLR) of >2.82 are significantly associated with the occurrence of CIPN (odds ratio [OR], 2.01 [95% CI, 1.01 to 4.01]; <i>P</i> = .046, OR, 2.09 [95%, CI, 1.02 to 4.24]; <i>P</i> = .042, respectively).</p><p><strong>Conclusion: </strong>Baseline CRP, NLR, BMI level, and marital status are significant predictors of CIPN occurrence throughout chemotherapy. Our CART model was better at ruling out individuals who would not experience CIPN. The CART model may provide insight into the future development of individualized patient care and prevention strategies.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400160"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Teleophthalmology Through Online Mentorship Over a 20-Year Period: Education and Capacity Building. 20 年间通过在线指导实现远程眼科:教育和能力建设。
IF 3.2 Q2 ONCOLOGY Pub Date : 2024-11-01 Epub Date: 2024-11-14 DOI: 10.1200/GO-24-00297
Sarah E Huemmer, Jennifer L Patnaik, Susan Ybarra, Nathan Congdon, David H Cherwek, Matthew W Wilson

Purpose: Telemedicine is widely used for diabetic retinopathy, retinopathy of prematurity, and other ophthalmic diseases. However, there is limited research on the use of teleophthalmology in retinoblastoma. The goal of this study was to explore how Orbis Cybersight affected the capacity for treatment and management of children with retinoblastoma through online mentorship and to assess the efficacy of online mentoring through disease-specific knowledge change over time.

Methods: A retrospective review of Orbis Cybersight retinoblastoma consultations from 2004 to 2023 was conducted. Each participant was scored from 0 to 39 points on the basis of information provided throughout the consultation. These points were separated into six categories: patient history, clinical findings, grouping/staging, diagnostic findings, treatment plan, and patient and ocular outcomes. Data were analyzed by linear regression models to identify changes over time.

Results: Among 653 patients from 38 different mentees, significant improvement in total points over time was observed (β = .012 [SE, 0.004]; P = .009). The mean score for total points at first consult was 17.7 (standard deviation [SD], 3.5) and at fifth consult was 19.8 (SD, 5.2). Three management categories showed significant improvement: clinical findings (P = .005), grouping/staging (P < .0001), and patient and ocular outcomes (P = .002). However, there was a significant decline in patient history points over time (P = .0006).

Conclusion: Mentorship via Orbis Cybersight improved retinoblastoma disease-specific knowledge and management over a 20-year period. Tele-education provides an opportunity for disease-specific capacity building in low- and middle-income countries for the treatment of retinoblastoma.

目的:远程医疗被广泛应用于糖尿病视网膜病变、早产儿视网膜病变和其他眼科疾病。然而,有关远程眼科在视网膜母细胞瘤中应用的研究却十分有限。本研究旨在探讨 Orbis Cybersight 如何通过在线指导影响视网膜母细胞瘤患儿的治疗和管理能力,并通过特定疾病知识随时间的变化评估在线指导的效果:对2004年至2023年的Orbis Cybersight视网膜母细胞瘤咨询进行了回顾性审查。根据咨询过程中提供的信息,为每位参与者打 0 到 39 分。这些分数被分为六个类别:患者病史、临床发现、分组/分期、诊断结果、治疗计划以及患者和眼部结果。数据通过线性回归模型进行分析,以确定随时间的变化:结果:在来自 38 个不同被指导者的 653 名患者中,观察到总分随着时间的推移有显著提高(β = .012 [SE, 0.004]; P = .009)。首次咨询时总分的平均值为 17.7(标准差 [SD],3.5),第五次咨询时总分的平均值为 19.8(标准差,5.2)。三个管理类别有明显改善:临床结果(P = .005)、分组/分期(P < .0001)以及患者和眼部结果(P = .002)。然而,随着时间的推移,患者病史点数明显下降(P = .0006):结论:通过 Orbis Cybersight 进行的指导在 20 年间改善了视网膜母细胞瘤疾病的特定知识和管理。远程教育为中低收入国家提高治疗视网膜母细胞瘤的特定疾病能力提供了机会。
{"title":"Teleophthalmology Through Online Mentorship Over a 20-Year Period: Education and Capacity Building.","authors":"Sarah E Huemmer, Jennifer L Patnaik, Susan Ybarra, Nathan Congdon, David H Cherwek, Matthew W Wilson","doi":"10.1200/GO-24-00297","DOIUrl":"https://doi.org/10.1200/GO-24-00297","url":null,"abstract":"<p><strong>Purpose: </strong>Telemedicine is widely used for diabetic retinopathy, retinopathy of prematurity, and other ophthalmic diseases. However, there is limited research on the use of teleophthalmology in retinoblastoma. The goal of this study was to explore how Orbis Cybersight affected the capacity for treatment and management of children with retinoblastoma through online mentorship and to assess the efficacy of online mentoring through disease-specific knowledge change over time.</p><p><strong>Methods: </strong>A retrospective review of Orbis Cybersight retinoblastoma consultations from 2004 to 2023 was conducted. Each participant was scored from 0 to 39 points on the basis of information provided throughout the consultation. These points were separated into six categories: patient history, clinical findings, grouping/staging, diagnostic findings, treatment plan, and patient and ocular outcomes. Data were analyzed by linear regression models to identify changes over time.</p><p><strong>Results: </strong>Among 653 patients from 38 different mentees, significant improvement in total points over time was observed (β = .012 [SE, 0.004]; <i>P</i> = .009). The mean score for total points at first consult was 17.7 (standard deviation [SD], 3.5) and at fifth consult was 19.8 (SD, 5.2). Three management categories showed significant improvement: clinical findings (<i>P</i> = .005), grouping/staging (<i>P</i> < .0001), and patient and ocular outcomes (<i>P</i> = .002). However, there was a significant decline in patient history points over time (<i>P</i> = .0006).</p><p><strong>Conclusion: </strong>Mentorship via Orbis Cybersight improved retinoblastoma disease-specific knowledge and management over a 20-year period. Tele-education provides an opportunity for disease-specific capacity building in low- and middle-income countries for the treatment of retinoblastoma.</p>","PeriodicalId":14806,"journal":{"name":"JCO Global Oncology","volume":"10 ","pages":"e2400297"},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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JCO Global Oncology
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