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1.
Farm. hosp ; 48(2): 79-82, Mar-Abr. 2024.
Artigo em Inglês | IBECS | ID: ibc-231616

RESUMO

Introduction: The increased risk of severe and life-threatening toxicity in patients with dihydropyridine dehydrogenase (DPD) deficiency, under treatment with fluoropyrimidines, has been widely studied. An up-to-date overview of systematic reviews summarizing existing literature can add value by highlighting most relevant information and supports decision-making regarding treatment in DPD deficient patients. The main objective of this overview of systematic reviews is to identify published systematic reviews on the association between germline variations in the DPYD gene and fluoropyrimidine toxicity.Methods and analysis: This protocol was developed following the Preferred Reported Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) checklist, and the overview of systematic reviews will be reported in accordance with the PRISMA statement. PubMed, Embase, Scopus, and the Cochrane Library will be searched from inception to 2023. Systematic reviews irrespective of study designs that analyze the association between germline variations in the DPYD and fluoropyrimidine toxicity will be considered. Methodological quality will be assessed using AMSTAR2 checklist (Measurement Tool to Assess Systematic Reviews 2). Two independent investigators will perform the study selection, quality assessment, and data collection. Discrepancies will be solved by a third investigator.(AU)


Introducción: El incremento del riesgo de toxicidad grave y potencialmente mortal en pacientes con deficiencia de dihidropiridina deshidrogenasa (DPD) en tratamiento con fluoropirimidinas ha sido ampliamente estudiado. Una revisión actualizada de las revisiones sistemáticas publicadas, que agrupe la literatura existente, puede añadir valor al resaltar la información más relevante y respaldar la toma de decisiones con respecto al tratamiento en pacientes con deficiencia de DPD. El objetivo principal de esta revisión de revisiones sistemáticas es identificar revisiones sistemáticas publicadas sobre la asociación entre variaciones en el linaje germinal del gen DPYD y la toxicidad de las fluoropirimidinas. Métodos y análisis: Este protocolo se ha desarrollado siguiendo la lista de verificación de los Protocolos para Revisiones Sistemáticas y Metaanálisis Preferidos (PRISMA-P), y la revisión de las revisiones sistemáticas se comunicará de acuerdo con la declaración PRISMA. Se realizará una búsqueda en PubMed, Embase, Scopus y la Biblioteca Cochrane desde su inicio hasta 2023. Se considerarán aquellas revisiones sistemáticas, independientemente de los diseños de estudio, que analicen la asociación entre variaciones en el linaje germinal del gen DPYD y la toxicidad de las fluoropirimidinas. La calidad metodológica se evaluará utilizando la lista de verificación AMSTAR2 (Herramienta de Medición para Evaluar Revisiones Sistemáticas 2). Dos investigadores independientes realizarán la selección de estudios, la evaluación de la calidad y la recopilación de datos. Las discrepancias se resolverán mediante un tercer investigador.(AU)


Assuntos
Humanos , Masculino , Feminino , Protocolos Clínicos , Oncologia , Técnicas de Genotipagem , Di-Hidropiridinas , Antimetabólitos/toxicidade , Neoplasias/tratamento farmacológico
2.
Farm. hosp ; 48(2): T79-T82, Mar-Abr. 2024.
Artigo em Espanhol | IBECS | ID: ibc-231617

RESUMO

Introduction: The increased risk of severe and life-threatening toxicity in patients with dihydropyridine dehydrogenase (DPD) deficiency, under treatment with fluoropyrimidines, has been widely studied. An up-to-date overview of systematic reviews summarizing existing literature can add value by highlighting most relevant information and supports decision-making regarding treatment in DPD deficient patients. The main objective of this overview of systematic reviews is to identify published systematic reviews on the association between germline variations in the DPYD gene and fluoropyrimidine toxicity.Methods and analysis: This protocol was developed following the Preferred Reported Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) checklist, and the overview of systematic reviews will be reported in accordance with the PRISMA statement. PubMed, Embase, Scopus, and the Cochrane Library will be searched from inception to 2023. Systematic reviews irrespective of study designs that analyze the association between germline variations in the DPYD and fluoropyrimidine toxicity will be considered. Methodological quality will be assessed using AMSTAR2 checklist (Measurement Tool to Assess Systematic Reviews 2). Two independent investigators will perform the study selection, quality assessment, and data collection. Discrepancies will be solved by a third investigator.(AU)


Introducción: El incremento del riesgo de toxicidad grave y potencialmente mortal en pacientes con deficiencia de dihidropiridina deshidrogenasa (DPD) en tratamiento con fluoropirimidinas ha sido ampliamente estudiado. Una revisión actualizada de las revisiones sistemáticas publicadas, que agrupe la literatura existente, puede añadir valor al resaltar la información más relevante y respaldar la toma de decisiones con respecto al tratamiento en pacientes con deficiencia de DPD. El objetivo principal de esta revisión de revisiones sistemáticas es identificar revisiones sistemáticas publicadas sobre la asociación entre variaciones en el linaje germinal del gen DPYD y la toxicidad de las fluoropirimidinas. Métodos y análisis: Este protocolo se ha desarrollado siguiendo la lista de verificación de los Protocolos para Revisiones Sistemáticas y Metaanálisis Preferidos (PRISMA-P), y la revisión de las revisiones sistemáticas se comunicará de acuerdo con la declaración PRISMA. Se realizará una búsqueda en PubMed, Embase, Scopus y la Biblioteca Cochrane desde su inicio hasta 2023. Se considerarán aquellas revisiones sistemáticas, independientemente de los diseños de estudio, que analicen la asociación entre variaciones en el linaje germinal del gen DPYD y la toxicidad de las fluoropirimidinas. La calidad metodológica se evaluará utilizando la lista de verificación AMSTAR2 (Herramienta de Medición para Evaluar Revisiones Sistemáticas 2). Dos investigadores independientes realizarán la selección de estudios, la evaluación de la calidad y la recopilación de datos. Las discrepancias se resolverán mediante un tercer investigador.(AU)


Assuntos
Humanos , Masculino , Feminino , Protocolos Clínicos , Oncologia , Técnicas de Genotipagem , Di-Hidropiridinas , Antimetabólitos/toxicidade , Neoplasias/tratamento farmacológico
3.
Actas dermo-sifiliogr. (Ed. impr.) ; 115(3): 237-245, Mar. 2024. mapas, tab
Artigo em Espanhol | IBECS | ID: ibc-231395

RESUMO

Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos. (AU)


Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain. (AU)


Assuntos
Humanos , Equidade , Preparações Farmacêuticas , Psoríase , Dermatite Atópica , Oncologia , Dermatologistas , Espanha , Estudos Transversais
4.
Actas dermo-sifiliogr. (Ed. impr.) ; 115(3): t237-t245, Mar. 2024. mapas, tab
Artigo em Inglês | IBECS | ID: ibc-231396

RESUMO

Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain. (AU)


Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos. (AU)


Assuntos
Humanos , Equidade , Preparações Farmacêuticas , Psoríase , Dermatite Atópica , Oncologia , Dermatologistas , Espanha , Estudos Transversais
5.
Med. clín (Ed. impr.) ; 162(6): 265-272, Mar. 2024. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-VR-235

RESUMO

Antecedentes y objetivo: La historia reproductiva influye en el riesgo de cáncer de mama. Hemos analizado su asociación con el subtipo tumoral y la supervivencia en mujeres premenopáusicas. Pacientes y métodos: Estudio observacional, retrospectivo, de mujeres premenopáusicas con carcinoma de mama, estadios I-III, en los últimos 20 años. Revisión de la historia reproductiva, de los datos clínicos y de los tratamientos en las historias de salud. Resultados: En 661 mujeres premenopáusicas (32,40% de 1.377 totales), la mediana de edad fue de 47 años (19-53), de la menarquia 12 (7-17), del primer parto 28 (16-41) y de número de partos 2 (0-9). Fueron nulíparas 111 (18,20%). Emplearon lactancia natural 359 (58,80%) con mediana de duración de 6 meses. Consumieron anovulatorios 271 (44,40%), con mediana de 36 meses. Se halló asociación entre menarquia <10 años y menos riesgo de subtipo luminal (OR: 0,52; IC 95%: 0,28-0,94; p=0,03), entre menarquia >11 años y menos riesgo de subtipo HER2 (OR: 0,50; IC 95%: 0,26-0,97; p=0,04) y entre primer parto >30 años y menos riesgo de subtipo triple negativo (OR: 0,40; IC 95%: 0,17-0,93; p=0,03). La probabilidad de supervivencia global y libre de enfermedad a 20 años fue de 0,80 (IC 95%: 0,71-0,90) y 0,72 (IC 95%: 0,64-0,79), respectivamente. Las pacientes con uno o más de un parto presentaron mejor supervivencia global que las nulíparas (HR: 0,51; IC 95%: 0,27-0,96, p=0,04). Conclusiones: Los hallazgos sugieren que existe asociación entre edad de la menarquia y del primer parto y subtipo de cáncer de mama. La nuliparidad está asociada con peor supervivencia.(AU)


Background and objective: Reproductive history influences breast cancer risk. We analysed its association with tumour subtype and survival in premenopausal women. Patients and methods: Retrospective, observational study of premenopausal women with stage I-III breast carcinoma in the last 20 years. Review of reproductive history, clinical data, and treatments in health records.Results: In 661 premenopausal women (32.40% of 1377 total cases), median age was 47 years (19-53), menarche 12 (7-17), first delivery 28 (16-41) and number of deliveries 2 (0-9). One hundred and eleven (18.20%) were nulliparous. Three hundred and fifty-nine (58.80%) used natural lactation, with a median duration of 6 months. Anovulatory drugs were used by 271 (44.40%), with a median duration of 36 months. Associations were found between menarche <10 years and lower risk of luminal subtype (OR: 0.52, 95% CI: 0.28-0.94; P=.03), between menarche >11 years and lower risk of HER2 subtype (OR: 0.50, 95% CI: 0.26-0.97; P=.04) and between first birth >30 years and lower risk of triple negative subtype (OR: 0.40, 95% CI: 0.17-0.93; P=.03). The 20-year overall and disease-free survival probabilities were 0.80 (95% CI: 0.71–0.90) and 0.72 (95% CI: 0.64-0.79) respectively. Patients with ≥1 delivery had better overall survival than nulliparous patients (HR: 0.51, 95% CI: 0.27-0.96, P=.04). Conclusions: The findings suggest an association between age at menarche and age at first delivery and breast cancer subtype. Nulliparity is associated with worse survival.(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama , História Reprodutiva , Pré-Menopausa , Sobreviventes de Câncer , Medicina Clínica , Estudos Retrospectivos , Ginecologia , Oncologia , Epidemiologia Descritiva
6.
ESMO Open ; 9(3): 102937, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38471241

RESUMO

BACKGROUND: There is a concern that terminally ill cancer patients may be aggressively treated due to the rapidly growing possibilities of anticancer treatment. The aim of this study was to evaluate the use of anticancer treatment at the end of life (EoL). MATERIALS AND METHODS: This retrospective study included adult patients with advanced solid cancers who were treated at the Institute of Oncology Ljubljana and died of cancer between January 2015 and December 2019. A multiple logistic regression model was used to assess an association between the aggressiveness of anticancer treatment (i.e. systemic therapy, radiotherapy and surgery) in the last 2 weeks of life and year of death, age at death, sex, prognosis of cancer and enrolment into the specialist palliative care (SPC). RESULTS: We included 1736 patients in our analysis. Overall, 13.7% of patients were enrolled into the SPC and 14.4% received anticancer treatment in the last 2 weeks of life. The odds of receiving anticancer treatment significantly increased over time [odds ratio (OR) 1.15, 95% confidence interval (CI) 1.04-1.27]. There was an increased use of novel systemic therapy (e.g. small-molecule targeted therapy and immunotherapy) at the EoL. Older patients had significantly lower odds to receive anticancer treatment in the last 2 weeks of life as compared to younger patients (OR 0.96, 95% CI 0.95-0.98). As compared to patients receiving only a standard oncology care, those also enrolled into the SPC had significantly lower odds for anticancer treatment in the last 2 weeks of life (OR 0.22, 95% CI 0.12-0.43). CONCLUSIONS: Terminally ill cancer patients have increased odds for receiving anticancer treatment, especially novel systemic therapies, in the last 2 weeks of life. Younger patients and those not enrolled into the SPC are at particular risk for anticancer treatment at the EoL.


Assuntos
Neoplasias , Assistência Terminal , Adulto , Humanos , Cuidados Paliativos , Estudos Retrospectivos , Neoplasias/terapia , Oncologia
7.
BMJ Open ; 14(3): e081326, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38508653

RESUMO

INTRODUCTION: Little is known regarding how non-specialist nurses communicate with patients living with cancer when the patients are receiving care outside of their cancer units/teams. This scoping review aims to identify, examine and report on the currently available evidence about communication by non-specialist nurses when caring for adults living with cancer outside of their cancer care unit/teams. METHODS AND ANALYSIS: A scoping review following the JBI methodology for scoping reviews will be conducted. We will search for empirical studies that meet the inclusion criteria in six databases (MEDLINE, PubMed, CINAHL, Embase, Scopus and PsycINFO). Handsearching in references of included articles will be performed to find additional articles. The population of interest will be non-specialist nurses. Three concepts will be explored, namely (1) all adult patients living with cancer, (2) a focus on three stages of the cancer continuum of care (cancer diagnosis, treatment and survivorship) and (3) a focus on communication between non-specialist nurses and patients living with cancer. We will include studies describing all healthcare settings outside patients' specialised cancer units or oncology teams. After article selection, two reviewers will independently screen titles and abstracts and perform a full-text article review, risk of bias assessments and data extraction. A third reviewer will resolve all disagreements. A narrative summary will provide an overview of how the results relate to the research aims and questions. The included articles will be limited to English and published between 2012 and 2023. ETHICS AND DISSEMINATION: No ethical approval is required since we will use publicly available empirical research sources. This review will provide current research on communication by non-specialist nurses with patients with a cancer diagnosis outside of an oncology setting, evidence that will support effective communication. As such, we aim to disseminate the findings in academic conferences and peer-reviewed journals.


Assuntos
Neoplasias , Adulto , Humanos , Neoplasias/terapia , Neoplasias/diagnóstico , Atenção à Saúde , Comunicação , Oncologia , Pesquisa Empírica , Projetos de Pesquisa , Literatura de Revisão como Assunto
8.
Psychooncology ; 33(3): e6335, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38526517

RESUMO

BACKGROUND: Adolescents and young adults (AYAs; ages 15-29 years) diagnosed with cancer are increasingly recognized as an oncology population with distinct psychosocial needs. However, few specialized psychosocial interventions for AYAs currently exist. This study reports on the development of a novel group-based psychotherapy intervention to address the psychosocial needs of AYAs. The objective was to evaluate the acceptability, feasibility, and preliminary effects of the intervention. METHODS: The manualized group psychotherapy program is delivered virtually over an 8-week period by registered psychologists. Four groups (n = 5-11 AYAs per group) with a total of N = 33 participants (Mage = 20.97 years, SD = 3.68, range = 15-29 years, 76% women) were conducted. Recruitment and retention data assessed intervention feasibility. Patient-reported psychosocial outcomes were measured at baseline and immediately following the intervention to assess preliminary effects. Acceptability was assessed following the intervention using a self-report measure of participant satisfaction. RESULTS: Overall, the completion rate of the intervention was 85% (n = 28). All participants "strongly agreed" (88%) or "agreed" (13%) that they were satisfied with the group. Meeting, sharing experiences, and expressing feelings with other AYAs were identified as the most helpful aspects. Participants reported significant improvements in emotional (p < 0.05) and functional (p < 0.01) quality of life from baseline to immediately post-intervention with medium effect sizes (d = 0.58-0.70). CONCLUSIONS: Findings suggest that the intervention is feasible, acceptable, and shows promise for improving psychosocial outcomes for AYAs. Further research will refine the intervention and establish efficacy in a randomized trial.


Assuntos
Neoplasias , Psicoterapia de Grupo , Humanos , Adolescente , Feminino , Adulto Jovem , Adulto , Masculino , Estudos de Viabilidade , Qualidade de Vida , Neoplasias/terapia , Oncologia
10.
Bull Cancer ; 111(4): 363-370, 2024 Apr.
Artigo em Francês | MEDLINE | ID: mdl-38438283

RESUMO

INTRODUCTION: The announcement of a cancer diagnosis is traumatic for the patient. In France, an announcement system has been in place, providing medical time for announcement and treatment proposal, nursing time for support, without including the pharmacist. In order to improve management of patients treated with intravenous anticancer drugs, we set up introductory pharmaceutical consultations in digestive oncology. The aims were to assess the situation one year after the introduction of these consultations, and to assess their contribution. METHODS: When a patient was diagnosed with digestive cancer and receiving intravenous treatment, a pharmaceutical initiation consultation was scheduled. Indicators of activity (number of consultations, average duration, average preparation time and various delays) and results (number and type of pharmaceutical interventions, patient satisfaction) were collected in order to assess activity. RESULTS: Forty-seven pharmaceutical initiation consultations were carried out. The average duration of the consultations was 39.3minutes. Consultations were carried out on average 12.1 days after the medical consultation and 9.6 days before the first chemotherapy treatment. Twenty-nine patients responded to the satisfaction questionnaire. All were satisfied, and the majority of patients said they had improved their knowledge of cancer treatment. DISCUSSION: This activity enables us to review with patients essential aspects of their care, such as implanting an implantable chamber catheter, anti-cancer treatment and managing potential side effects and improve their self-care skills.


Assuntos
Antineoplásicos , Oncologia , Humanos , Hospitais de Ensino , Antineoplásicos/efeitos adversos , Encaminhamento e Consulta , Preparações Farmacêuticas
11.
JCO Precis Oncol ; 8: e2300507, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38513166

RESUMO

PURPOSE: Precision oncology clinical trials often struggle to accrue, partly because it is difficult to find potentially eligible patients at moments when they need new treatment. We piloted deployment of artificial intelligence tools to identify such patients at a large academic cancer center. PATIENTS AND METHODS: Neural networks that process radiology reports to identify patients likely to start new systemic therapy were applied prospectively for patients with solid tumors that had undergone next-generation sequencing at our center. Model output was linked to the MatchMiner tool, which matches patients to trials using tumor genomics. Reports listing genomically matched patients, sorted by probability of treatment change, were provided weekly to an oncology nurse navigator (ONN) coordinating recruitment to nine early-phase trials. The ONN contacted treating oncologists when patients likely to change treatment appeared potentially trial-eligible. RESULTS: Within weekly reports to the ONN, 60,199 patient-trial matches were generated for 2,150 patients on the basis of genomics alone. Of these, 3,168 patient-trial matches (5%) corresponding to 525 patients were flagged for ONN review by our model, representing a 95% reduction in review compared with manual review of all patient-trial matches weekly. After ONN review for potential eligibility, treating oncologists for 74 patients were contacted. Common reasons for not contacting treating oncologists included cases where patients had already decided to continue current treatment (21%); the trial had no slots (14%); or the patient was ineligible on ONN review (12%). Of 74 patients whose oncologists were contacted, 10 (14%) had a consult regarding a trial and five (7%) enrolled. CONCLUSION: This approach facilitated identification of potential patients for clinical trials in real time, but further work to improve accrual must address the many other barriers to trial enrollment in precision oncology research.


Assuntos
Neoplasias , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/genética , Inteligência Artificial , Medicina de Precisão , Oncologia , Projetos Piloto
13.
Front Immunol ; 15: 1297542, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38444854

RESUMO

Background: Neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) remains the cornerstone of treatment for muscle-invasive bladder cancer (MIBC). While platinum-based regimens have demonstrated benefits in tumor downstaging and improved long-term survival for selected patients, they may pose risks for those who are ineligible or unresponsive to chemotherapy. Objective: We undertook a bibliometric analysis to elucidate the breadth of literature on NAC in bladder cancer, discern research trajectories, and underscore emerging avenues of investigation. Methods: A systematic search of the Web of Science Core Collection (WoSCC) was conducted to identify articles pertaining to NAC in bladder cancer from 1999 to 2022. Advanced bibliometric tools, such as VOSviewer, CiteSpace, and SCImago Graphica, facilitated the examination and depicted the publication trends, geographic contributions, institutional affiliations, journal prominence, author collaborations, and salient keywords, emphasizing the top 25 citation bursts. Results: Our analysis included 1836 publications spanning 1999 to 2022, indicating a growing trend in both annual publications and citations related to NAC in bladder cancer. The United States emerged as the predominant contributor in terms of publications, citations, and international collaborations. The University of Texas was the leading institution in publication output. "Urologic Oncology Seminars and Original Investigations" was the primary publishing journal, while "European Urology" boasted the highest impact factor. Shariat, Shahrokh F., and Grossman, H.B., were identified as the most prolific and co-cited authors, respectively. Keyword analysis revealed both frequency of occurrence and citation bursts, highlighting areas of concentrated study. Notably, the integration of immunochemotherapy is projected to experience substantial growth in forthcoming research. Conclusions: Our bibliometric assessment provides a panoramic view of the research milieu surrounding neoadjuvant chemotherapy for bladder cancer, encapsulating the present state, evolving trends, and potential future directions, with a particular emphasis on the promise of immunochemotherapy.


Assuntos
Terapia Neoadjuvante , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/tratamento farmacológico , Bibliometria , Imunoterapia , Oncologia
14.
Br J Nurs ; 33(5): S12-S15, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38446506

RESUMO

BACKGROUND: The present study aimed to evaluate oncology patients' experiences with a hotline service in a tertiary cancer centre, identifying areas for local improvement and to inform the work of the hotline. METHODS: A link to an online platform to complete a survey was sent through bulk messaging to 3028 mobile numbers. The survey answers and results were saved and consolidated in the online platform. FINDINGS: The survey received 368 responses: 49% of participants had their calls answered within 10 minutes, while 18% (n=66) waited 30 minutes or more. Eighty-two per cent were satisfied with the length of time they waited to speak with a nurse and 71% reported that their overall experience was very good. Ninety-seven per cent of participants felt listened to and were offered support and 91% felt that their reason for calling was adequately addressed. CONCLUSION: The present study offers persuasive evidence indicating that oncology patients are largely satisfied with the hotline service; nonetheless, it is recognised that a more robust evaluation is needed. Regardless, the need for certain improvements has been identified to offer the potential to enhance patients' experience.


Assuntos
Linhas Diretas , Neoplasias , Humanos , Neoplasias/terapia , Oncologia , Emoções , Pacientes
15.
Cancer Med ; 13(4): e7009, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38457258

RESUMO

BACKGROUND: Although oncology clinical practice guidelines recognize the need and benefits of exercise, the implementation of these services into cancer care delivery remains limited. We developed and evaluated the impact of a clinically integrated 8-week exercise and education program (CaRE@ELLICSR). METHODS: We conducted a mixed methods, prospective cohort study to examine the effects of the program. Each week, participants attended a 1-h exercise class, followed by a 1.5-h education session. Questionnaires, 6-min walk tests (6MWT), and grip strength were completed at baseline (T0), 8 weeks (T1), and 20 weeks (T2). Semi-structured interviews were conducted with a sub-sample of participants about their experience with the program. RESULTS: Between September 2017 and February 2020, 277 patients enrolled in the program and 210 consented to participate in the research study. The mean age of participants was 55 years. Participants were mostly female (78%), white/Caucasian (55%) and half had breast cancer (50%). Participants experienced statistical and clinically meaninful improvements from T0 to T1 in disability, 6MWT, grip strength, physical activity, and several cancer-related symptoms. These outcomes were maintained 3 months after program completion (T2). Qualitative interviews supported these findings and three themes emerged from the interviews: (1) empowerment and control, (2) supervision and internal program support, and (3) external program support. CONCLUSIONS: This study demonstrates the impact of overcoming common organizational barriers to deliver exercise and rehabilitation as part of routine care. CaRE@ELLICSR demonstrated clinically meaningful improvements in patient-reported and functional outcomes and was considered beneficial and important by participants for their recovery and wellbeing.


Assuntos
Neoplasias da Mama , Qualidade de Vida , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Prospectivos , Exercício Físico , Oncologia , Terapia por Exercício/métodos
16.
Curr Opin Oncol ; 36(2): 93-101, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38441149

RESUMO

PURPOSE OF REVIEW: The future of medicine is aimed to equip the physician with tools to assess the individual health of the patient for the uniqueness of the disease that separates it from the rest. The integration of omics technologies into clinical practice, reviewed here, would open new avenues for addressing the spatial and temporal heterogeneity of cancer. The rising cancer burden patiently awaits the advent of such an approach to personalized medicine for routine clinical settings. RECENT FINDINGS: To weigh the translational potential, multiple technologies were categorized based on the extractable information from the different types of samples used, to the various omic-levels of molecular information that each technology has been able to advance over the last 2 years. This review uses a multifaceted classification that helps to assess translational potential in a meaningful way toward clinical adaptation. SUMMARY: The importance of distinguishing technologies based on the flow of information from exploration to actuation puts forth a framework that allows the clinicians to better adapt a chosen technology or use them in combination to enhance their goals toward personalized medicine.


Assuntos
Neoplasias , Medicina de Precisão , Humanos , Oncologia , Neoplasias/genética , Neoplasias/terapia
17.
PLoS One ; 19(3): e0294393, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38446765

RESUMO

OBJECTIVE: Complementary Health Approaches (CHA) are commonly used by children with cancer; however, a few health care providers (HCPs) inquire about the use of CHA. A standardized questionnaire could facilitate such clinical discussions. We aimed to adapt and determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT) child and parent-report questionnaires in pediatric oncology. METHODS: An electronic Delphi survey that included children with cancer (8-18 years), parents, and HCPs and CHA researchers was conducted to reach consensus on the content of the WHAT questionnaires in pediatric oncology. Children and parents from the Hospital for Sick Children (SickKids), and HCPs and researchers from the International Society of Pediatric Oncology and Pediatric Complementary and Alternative Medicine Research and Education Network completed the survey. To determine the face and content validity of the questionnaires, two iterative cycles of individual interviews were conducted with purposive samples of children (8-18 years), parents, and HCPs from SickKids. RESULTS: Consensus was reached on all domains and items of the original WHAT questionnaires after one Delphi cycle (n = 61). For face and content validity testing, the first cycle of interviews (n = 19) revealed that the questionnaires were mostly comprehensive and relevant. However, the paper-based format of the original WHAT was not user-friendly, and generic items were vague and not aimed at facilitating clinical dialogues about CHA use. The WHAT questionnaires were then modified into electronic cancer-specific self- and proxy-report questionnaires including 13 and 15 items, respectively. The second cycle (n = 21) showed no need for further changes. CONCLUSIONS: The modified electronic cancer-specific WHAT questionnaires showed adequate face and content validity. The next step is to determine inter-rater reliability, construct validity, and feasibility of administration of the modified WHAT questionnaires in pediatric oncology.


Assuntos
Oncologia , Neoplasias , Criança , Humanos , Reprodutibilidade dos Testes , Diretivas Antecipadas , Consenso , Neoplasias/diagnóstico , Neoplasias/terapia
18.
Gan To Kagaku Ryoho ; 51(2): 125-131, 2024 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-38449395

RESUMO

The life that a person with cancer leads is called the cancer journey. As cancer treatment advances and specialization progresses, a trend toward integrating each specialty from the perspective of the cancer journey is emerging. In this paper, we consider task-sharing and task-shifting from the perspective of integrating oncology and primary care. Although oncologists and primary care physicians have different specialties, we believe that task-sharing and task-shifting can be achieved and lead to smooth transitional care by strengthening collaboration and sharing knowledge and experience, while taking advantage of their respective characteristics as medical professionals working with people with cancer. For this purpose, I would like both oncologists and primary care physicians to collaborate with a high perspective and a broad viewpoint to improve the quality of life of people with cancer, without making it an objective to pursue their respective specialties.


Assuntos
Oncologistas , Médicos de Atenção Primária , Humanos , Qualidade de Vida , Oncologia
19.
J Cancer Res Clin Oncol ; 150(3): 113, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38436796

RESUMO

PURPOSE: This study aims to estimate changes in the value of oncology drugs over time from initial data of the reimbursement decisions to subsequent publications in Korea, using two value frameworks. METHODS: We retrieved primary publications assessed for reimbursement between 2007 and July 2021 from the decision documents of Health Insurance Review and Assessment and subsequent publications made available following reimbursement decision from ClinicalTrials.Gov and PubMed databases. Changes in the clinical benefit scores were assessed using the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). A paired t test was performed to test whether there was a difference in the scores between primary and subsequent publications. RESULTS: Of 73 anticancer product/indication pairs, 45 (61.6%) had subsequent publications, of which 62.5% were released within 1 year of reimbursement decision. The mean ESMO-MCBS and ASCO-VF Net Health Benefit scores increased from primary to subsequent publications, although the differences were not significant. The mean ASCO-VF bonus score significantly increased from 15.91 to 19.09 (p = 0.05). The ESMO-MCBS and bonus scores increased by 0.25 and 0.21, respectively, and the bonus score had a greater impact on the ESMO-MCBS score than the preliminary score did. CONCLUSION: The value of drugs demonstrated in subsequent publications varies considerably among oncology drugs, depending on uncertainty associated with the initial evidence and the availability of updated evidence. As decision-making in the face of uncertainty becomes more prevalent, the value frameworks can serve as simple screening tools for re-evaluation in these cases.


Assuntos
Seguro Saúde , Oncologia , Humanos , Bases de Dados Factuais , Qualidade da Assistência à Saúde
20.
Virchows Arch ; 484(2): 263-272, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38429607

RESUMO

Neoplasias of the hepatopancreatobiliary tract are growing in numbers, have the poorest prognosis of all major cancer entities, and thus represent a rising clinical problem. Their molecular diagnostic has dramatically improved, contributing to tumor subtyping, definition of malignancy, and uncovering cases with hereditary predisposition. Most of all, predictive molecular testing allows to identify cases amenable to treatment with the rising number of approved targeted drugs, immune-oncological treatment, and clinical trials. In this review, the current state of molecular testing and its contribution to clinical decision-making are outlined.


Assuntos
Neoplasias Pancreáticas , Patologia Molecular , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Predisposição Genética para Doença , Técnicas de Diagnóstico Molecular , Oncologia
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