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Novel Insights in Venous Thromboembolism Risk Assessment Methods in Ambulatory Cancer Patients: From the Guidelines to Clinical Practice.

Many cancer patients will experience venous thromboembolism (VTE) at some stage, with the highest rate in the initial period following diagnosis. Novel cancer therapies may further enhance the risk. VTE in a cancer setting is associated with poor prognostic, a decreased quality of life, and high healthcare costs. If thromboprophylaxis in hospitalized cancer patients and perioperative settings is widely accepted in clinical practice and supported by the guidelines, it is not the same situation in ambulatory cancer patient settings. The guidelines do not recommend primary thromboprophylaxis, exc

Castleman Disease and Kaposi Sarcoma: A Review of the Literature and a Case Series.

Castleman disease and Kaposi sarcoma (KS) are both associated with infection by human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus (KSHV). This virus plays a critical role in the pathogenesis of both conditions, particularly in immunocompromised individuals, such as those with HIV/AIDS. Multicentric Castleman disease (MCD) generally presents with systemic inflammatory symptoms, lymphadenopathy, and organ dysfunction, while Kaposi sarcoma typically appears as vascular tumors on the skin, with occasional involvement of mucous membranes or internal organs. We prese

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… In our experience, the core multidisciplinary team should include dermatologists, oncologists, infectious disease specialists, and hematologists. … Additional input from radiation oncologists, surgeons, dietitians, psychologists, and radiologists may also be required, depending on the clinical scenario. Figure 3 illustrates the patient evaluation process. Figure 4 shows dermatological findings on the arms and legs. …

Relationship between Medication-Related Osteonecrosis of the Jaw and CDK4/6 Inhibitors in Breast Cancer.

OBJECTIVE: We aimed to evaluate the use of CDK4/6 inhibitors as a risk factor for medication-related osteonecrosis of the jaw (MRONJ) in a cohort of patients with metastatic breast cancer treated with denosumab. METHODS: This was a multicentre, retrospective, observational study. All patients with breast cancer treated with denosumab (January 2011-December 2022) were included. The relationship between CDK4/6 inhibitors and MRONJ was analysed. RESULTS: A total of 243 patients were included, ninety-five (44.2%) of whom used a CDK4/6 inhibitor. There were 21 patients with MRONJ. In patients tre

Nanotechnology in Lung Cancer Therapeutics: A Narrative Review.

To date, cancer continues to be one of the biggest challenges for medical science. Nanotechnology has enabled us to overcome some of the limitations of conventional treatment in lung cancer therapeutics. Recently, US Food and Drug Administration (FDA) has approved certain nanomedicines for clinical administration against lung cancer. This article presents a narrative review of approved nanomedicines in lung cancer with a special focus on the results of recently concluded and ongoing clinical trials. The limitations associated with using nanomaterials as anti-lung cancer therapeutic agents and

Use of MASCC score in the inpatient management of febrile neutropenia: a single-center retrospective study.

PurposeThe Multinational Association for Supportive Care in Cancer (MASCC) score is used to risk stratify outpatients with febrile neutropenia (FN). However, it is rarely used in hospital settings. We aimed to describe management, use of MASCC score, and outcomes among hospitalized patients with FN.MethodsWe conducted a retrospective cohort study of patients with cancer and FN. We collected patient demographics, cancer characteristics, microbiological profile, MASCC score, utilization of critical care therapies, documentation of goals of care (GOC), and inpatient deaths. Outcomes associated wi

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… FN admissions are commonly managed by hospitalists or internists rather than oncologists in the community; a tool like the MASCC score could be used to guide them around risk for clinical deterioration or death [ 22 ]. … Internists may believe that goals are best discussed by the primary oncologist treating a patient’s cancer. …

Geriatric assessment in older patients with a hematologic malignancy: a systematic review.

The aim of this systematic review is to give an update of all currently available evidence on the relevance of a geriatric assessment in the treatment of older patients with hematologic malignancies. A systematic search in MEDLINE and EMBASE was performed to find studies in which a geriatric assessment was used to detect impaired geriatric domains or to address the association between geriatric assessment and survival or clinical outcome measures. The literature search included 4,629 reports, of which 54 publications from 44 studies were included. Seventy-three percent of the studies were publ

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… In daily practice, oncologists are able to detect obviously frail patients by clinical judgment. … Geriatric assessment is superior to oncologists’ clinical judgement in identifying frailty. Br J Cancer. 2017;117(4):470–477. 75. Hamaker ME, te Molder M, Thielen N, van Munster BC, Schiphorst AH, van Huis LH. …

End-of-Life Trajectories of Patients With Hematological Malignancies and Patients With Advanced Solid Tumors Visiting the Emergency Department: The Need for a Proactive Integrated Care Approach.

PurposePatients with hematological malignancies (HM) have more unpredictable disease trajectories compared to patients with advanced solid tumors (STs) and miss opportunities for a palliative care approach. They often undergo intensive disease-directed treatments until the end of life with frequent emergency department (ED) visits and in-hospital deaths. Insight into end-of-life trajectories and quality of end-of-life care can support arranging appropriate care according to patients' wishes.MethodMortality follow-back study to compare of end-of-life trajectories of HM and ST patients who died

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… Ann Oncol . 2015 ; 26 ( 7 ): 1440 – 1446 . 26041765 10.1093/annonc/mdv028 PMC4855240 5 Odejide OO Salas Coronado DY Watts CD Wright AA Abel GA End-of-life care for blood cancers: a series of focus groups with hematologic oncologists . … Oncologist . 2012 ; 17 ( 12 ): 1574 – 1580 . 23220843 10.1634/theoncologist.2012-0192 PMC3528390 8 O’Connor NR Hu R Harris PS Ache K Casarett DJ Hospice admissions for cancer in the final days of life: independent predictors and implications for quality measures . …

Predicting cumulative incidence of adverse events in older patients with cancer undergoing first-line palliative chemotherapy: Korean Cancer Study Group (KCSG) multicentre prospective study.

BackgroundOlder patients have increased risk of toxicity from chemotherapy. Current prediction tools do not provide information on cumulative risk.MethodsPatients aged ≥ 70 years with solid cancer were prospectively enrolled. A prediction model was developed for adverse events (AEs) ≥ Grade 3 (G3), based on geriatric assessment (GA), laboratory, and clinical variables.Results301 patients were enrolled (median age, 75 years). Median number of chemotherapy cycles was 4. During first-line chemotherapy, 53.8% of patients experienced AEs ≥ G3. Serum protein ConclusionsThis prediction tool could ide

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… Hurria A Role of age and health in treatment recommendations for older adults with breast cancer: the perspective of oncologists and primary care providers J. Clin. Oncol. 2008 26 5386 5392 10.1200/JCO.2008.17.6891 18955446 PMC2651077 3. … Kornblith AB Survey of oncologists’ perceptions of barriers to accrual of older patients with breast carcinoma to clinical trials Cancer 2002 95 989 996 10.1002/cncr.10792 12209681 5. …

Guidelines for the use of survivorship care plans: a systematic quality appraisal using the AGREE II instrument.

BackgroundSurvivorship care plans (SCPs) are written treatment summaries and follow-up care plans that are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers. A growing number of guidelines for the use of SCPs exist, yet SCP use in the United States remains limited. Limited use of SCPs may be due to poor quality of these guidelines. The purpose of the study was to evaluate the quality of guidelines for SCP use, tools that are intended to promote evidence-based medicine.MethodsWe conducted a comprehensive search of th

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… What are the respective roles of oncologists, primary care physicians, and nurses? What economic strategies could encourage implementation of care planning? What barriers exist to creating the care plan? How can they be overcome? [ 25 ]. … In some cases, “oncology providers” referred to the primary oncologist [ 2 , 32 ]; in other cases, “oncology providers” referred to the oncologist responsible for the last course of treatment [ 32 ], oncology nurses [ 31 , 32 ], or some combination of physicians and nursing staff [ 25 ]. …

Venous thromboembolism in the cancer population: pathology, risk, and prevention.

Patients with cancer have an increased risk of developing venous thromboembolism (VTE) and the incidence of these events has been increasing over the past decade. Venous thromboembolic events include both deep venous thrombosis and pulmonary embolism. These events contribute to higher morbidity and mortality rates. Understanding the complex pathogenesis of and risk factors for cancer-associated VTE will help guide advanced practitioners to improve outcomes with prophylaxis. The American Society of Clinical Oncology, the National Comprehensive Cancer Network, and the European Society of Medical

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… Implications for the Advanced Practitioner Despite an increasing awareness of cancer-associated VTE and the publication of evidence-based guidelines, surgical oncologists report only 52% use of prophylaxis, and medical oncologists report its use in less than 5% of their patients (Kakkar, Levine, Pinedo … The oncologist 2003 8 381 388 12897335 10.1634/theoncologist.8-4-381 19 Karimi M. Cohan N. Cancer-associated thrombosis The Open Cardiovascular Medicine Journal 2010 4 59 63 10.2174/1874192401004020078 PMC2847209 20360976 20 Kessler C. M. Cap A. P. …

Development of a clinical trial knowledge management application for community oncology.

IntroductionParticipation in cancer clinical trials is low in community oncology settings, partly because institution-specific trial information is fragmented. We evaluated feasibility of embedding curated trial content in an AI-enabled knowledge management application.Materials and methodsAt a regional community oncology network, coordinators and disease teams compiled actively recruiting trials. Core elements (title, conditions, biomarkers, stage/line, and recruiting status) were structured for point-of-care display and uploaded. AI-assisted extraction generated protocol summaries and eligib

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… Cancer center leadership, oncologists, and trial coordinators further refined content to optimize clarity for point-of-care decision making. … J Clin Oncol . 2023 ; 41 : e13549 . 10.1200/JCO.2023.41.16_suppl.e13549 6 Wong AR , Sun V , George K , et al Barriers to participation in therapeutic clinical trials as perceived by community oncologists . …

Psychological Impact in Individuals with Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple Myeloma.

In our study of 246 newly diagnosed individuals with MGUS or SMM (115 MGUS, 131 SMM), we found that 19% reported anxiety, with no significant difference between the MGUS and SMM groups (22% vs. 17%). Those with a history of psychiatric disorders or belonging to certain racial groups were more likely to experience anxiety. Initial coping responses included religious coping, denial, frustration, irritability, and seeking social support. Given anxiety's detrimental effects, our findings emphasize the importance of incorporating psychosocial assessments to optimize care for MGUS and SMM patients.

A modified method for reducing renal injury in zoledronic Acid treatment of hypercalcemia and adverse skeletal events.

AimsIn this paper, we have reported a previously undescribed risk factor of deterioration of renal function in zoledronic acid treatment of skeletal metastasis - high serum calcium level. Based on this consideration, a modified method of treatment of hypercalcemia (HCM) with zoledronic acid is suggested in this paper.Material and methodsBone scan findings of 1090 cancer patients were analyzed, of which 26 had intense renal parenchymal uptake as a result of HCM or bone metastases. Subsequently, a total of 56 bone metastases patients with zoledronic acid treatment were divided into three groups:

Measuring the Unseen Burden: Immunotherapy and Targeted Therapy Reduce Treatment-Related Time Toxicity in Incurable Malignancies.

BackgroundTreatment-related time toxicity (TrTT) poses a cumulative burden on quality of life. We aimed to analyze and quantify the impact of the TrTT on patients with incurable malignancies in our ambulatory oncology clinic.MethodsWe performed a retrospective observational analysis of the TrTT for individuals with incurable solid cancers at a regional safety-net oncology office that focuses on underserved communities. Time toxicity is calculated as the number of days a patient spent with any healthcare-related encounters during the initial 12-week period of the most recent line of therapy fro

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… Author and reference | Year of publication | Study design | Country of study | Sample size | Study population | Time toxicity metric | Findings Guy and Richardson [ 13 ] | 2012 | Payment claim data from the National Ambulatory Medical Care Survey | USA | 2,470 | Any cancer diagnosis | Minutes spent with oncologists … Objective data from wearables related to sleep quality, physical activity, and caloric intake, can help oncologists monitor tolerance and compliance, and tailor treatment intensity. …

Pathogenesis of Oral Toxicities Associated with Targeted Therapy and Immunotherapy.

Targeted therapy and immunotherapy have redefined cancer treatment. While they have enhanced tumor response and improved survival rates in many cancer types, toxicities continue to occur, and these often involve the oral cavity. Broadly reported as "mucositis" or "stomatitis," oral toxicities induced by targeted therapies differ clinically and mechanistically from those associated with conventional chemotherapy. Manifesting primarily as mucosal lesions, salivary gland hypofunction, or orofacial neuropathies, these oral toxicities may nonetheless lead to significant morbidity and impact patient

Fostering Patient Choice Awareness and Presenting Treatment Options Neutrally: A Randomized Trial to Assess the Effect on Perceived Room for Involvement in Decision Making.

PurposeShared decision making calls for clinician communication strategies that aim to foster choice awareness and to present treatment options neutrally, such as by not showing a preference. Evidence for the effectiveness of these communication strategies to enhance patient involvement in treatment decision making is lacking. We tested the effects of 2 strategies in an online randomized video-vignettes experiment.MethodsWe developed disease-specific video vignettes for rheumatic disease, cancer, and kidney disease showcasing a physician presenting 2 treatment options. We tested the strategies

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… Assessing cancer patients’ trust in their oncologist: development and validation of the Trust in Oncologist Scale (TiOS). Support Care Cancer. 2012;20:1787–95. 48. Visser LN, Hillen MA, Verdam MG, Bol N, de Haes HC, Smets EM. … Effect of a skills training for oncologists and a patient communication aid on shared decision making about palliative systemic treatment: a randomized clinical trial. Oncologist. 2020;25:e578–88. 58. Labrie NH, Schulz PJ. …

Medication Experience and Adherence to Oral Chemotherapy: A Qualitative Study of Patients' and Health Professionals' Perspectives.

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients' experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals' perspectives. We carried out an exploratory qualitative study in the University Hospital of

Molecular profiling of cancer patients enables personalized combination therapy: the I-PREDICT study.

Cancer treatments have evolved from indiscriminate cytotoxic agents to selective genome- and immune-targeted drugs that have transformed the outcomes of some malignancies1. Tumor complexity and heterogeneity suggest that the 'precision medicine' paradigm of cancer therapy requires treatment to be personalized to the individual patient2-6. To date, precision oncology trials have been based on molecular matching with predetermined monotherapies7-14. Several of these trials have been hindered by very low matching rates, often in the 5-10% range15, and low response rates. Low matching rates may be

Applications of Structural Expert Elicitations for Economic Evaluations: A Systematic Review Update.

BackgroundStructured expert elicitation (SEE) has become increasingly important in health technology assessment and economic evaluations. Complementing previous work, we aimed to synthesize recent developments in published SEE applications within health economics over the past 8 years.MethodsA systematic literature search was conducted in Medline and Embase databases from April 2017 to February 2026, supplemented with snowball sampling, to identify applications of SEE as part of economic evaluations. Data extraction and synthesis focused on expert selection, elicitation methods, and analytical

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… and clinical experience | Purposive sampling | 7 (all 7 for operational parameters, 5 for TAU improvement parameters and 4 for long-term efficacy judgements) | VIM | Plausible lower and upper limits, fixed-interval probability allocation | Mathematical | NA | NA Lee et al. (2025) [ 46 ] | Clinical oncologists … and hematologists | Purposive sampling | 6 | FIM | MLVs, LPLs, UPLs, CrIs, variance, CIs: expert interval width for truncated distribution variance | Consensus | No | NA Paly et al. (2022) [ 44 ] | Clinical experts in advanced melanoma (oncologists) | Purposive sampling, | 2 | FIM | Lower bound, best …

Management of Multiple Myeloma in the Middle East: Unmet Needs, Challenges and Perspective.

Multiple myeloma (MM) is a prevalent hematological malignancy. Resource-constrained settings such as the Middle East are particularly burdened by the increasing trends in MM morbidity and mortality in addition to challenges in the management of MM. It thus becomes necessary to identify and address debatable areas of current practice and gaps in the management of MM in the Middle East. With a special focus on the Lebanese situation, the first-line treatment of the very elderly (> 80 years old) is discussed, in addition to the impact of relapse type (biochemical or clinical relapse) on maintenan

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… With the continuously shifting paradigm of MM management, educational gaps emerge and targeted initiatives are needed to guide oncologists in the personalization of treatment and the translation of evidence-based recommendations into real-world practice [ 12 ]. … Ludwig H European perspective on multiple myeloma treatment strategies in 2014 Oncologist 2014 19 8 829 844 10.1634/theoncologist.2014-0042 25063227 PMC4122482 27. …