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Systematic review and meta-analysis comparing zoledronic acid administered at 12-week and 4-week intervals in patients with bone metastasis.

Zoledronic acid is used to treat patients with bone metastasis, but the optimal dosing interval remains controversial. We therefore performed a systematic review and meta-analysis to compare the efficacy and safety of a 12-week interval of zoledronic acid with the standard 4-week interval. Three randomized controlled trials comprising 2650 patients were analyzed. Using a random-effects model, pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. No differences in the occurrence of skeletal-related events (SREs: RR = 0.98; 95% CI = 0.86-1.12; P = 0.80) or grade 3/4 advers

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… Oncologists are increasingly interested in determining the optimal dosing interval that not only ensures the efficacy, but also reduces the toxicity of zoledronic acid [ 23 ]. … De-escalated administration of bone-targeted agents in patients with breast and prostate cancer-A survey of Canadian oncologists. J Bone Oncol. 2013;2:77–83. doi: 10.1016/j.jbo.2013.03.001. https://doi.org/10.1016/j.jbo.2013.03.001 . 21. Kimmel DB. …

Skeletal Metastasis as Detected by 18F-FDG PET with Negative CT of the PET/CT: Frequency and Impact on Cancer Staging and/or Management.

ObjectivesThe aim of our study is to assess the frequency of detection of PET-positive computed tomography (CT)-negative skeletal metastases (SM) and determine the impact of such detection on staging and/or management in patients who had FDG PET/CT as part of the cancer work-up.MethodsWe retrospectively reviewed 2000 18F-FDG PET/CT scans of known cancer patients. A log was kept to record cases of suspected SM with or without bone changes from the low-dose non-contrast CT. The presence or absence of SM was evaluated based on available pathological and clinical data. The impact of detection of s

The End-of-Life Experience of Patients With Rare Cancers and Their Caregivers.

Little is known about the end-of-life (EOL) experience of patients with rare cancers (PRC) or their caregivers. From September 2002 to August 2008, 618 stage IV cancer patients [195 PRC and 423 patients with common cancers (PCC)] and their caregivers participated in an interview-based cohort study. Patients were interviewed about EOL preferences, planning, medical care, and followed until death. Interviews with caregivers at baseline assessed caregiver mental and physical health; and postmortem, assessed EOL patient care. PRC were four times more likely than PCC to be receiving both radiation

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… Therefore, based on clinical experience, we hypothesized that oncologists may communicate differently about rare versus common cancers. … We hypothesized that, compared to patients with common cancers, rare cancer patients with advanced disease would be more likely to: i) receive care in a tertiary or referral cancer center, reflecting a perception by patients and caregivers that tertiary-center-based oncologists have more experience treating …

Drug assumption and awareness about adverse drug reactions. The right to know. The case of the bone-modyfing agents: a systematic review.

INTRODUCTION: Medication-related osteonecrosis of the Jaw (MRONJ) is an adverse drug reaction that affects the mandible and maxilla of patients exposed to BMA and AA therapies, causing the progressive destruction and death of bone. To date, oral health preventive measures remain the most effective strategy to reduce MRONJ incidence, and, in this sense, the major goal is to diagnose, treat, and eradicate any oral diseases that could compromise oral health. The present systematic review aims to investigate the awareness of MRONJ among patients assuming BMAs. METHODS: A systematic literature sea

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… Among health specialists, those who most informed patients about the risk of MRONJ were physicians (26.1%), followed by oncologists (23.9%), dentists (18.5%), and general practitioners (8.7%). … Patients at risk of MRONJ are generally managed by a multidisciplinary team comprising the prescribing physician (e.g., bone experts, oncologist), oral health care specialists, and pharmacist. …

Cutaneous adverse events to systemic antineoplastic therapies: a retrospective study in a public oncologic hospital.

BackgroundMucocutaneous adverse events are common during anticancer treatment, with variable consequences for the patient and their therapeutic regimen.ObjectiveTo evaluate the most common adverse events, as well as the drugs associated with their appearance and the consequences for cancer treatment.MethodsA retrospective study was carried out through the analysis of patients treated at the Clinical Dermatology Unit of a public oncologic hospital.ResultsA total of 138 patients with 200 adverse events were evaluated. The most commonly identified adverse events were nail and periungual changes (

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… In 18 patients, treatments were interrupted or modified by the oncologist, prior to the dermatological consultation, one of which could be reintroduced after specialized evaluation (vandetanib, responsible for a papulopustular eruption). … Because the database comprises only patients referred for dermatological evaluation, the number of less common adverse reactions may have been inflated because they are less known by oncologists. …

Multidisciplinary Approach to Older Adults with Hematologic Malignancies-a Paradigm Shift.

Hematologic malignancies are most likely to present in the seventh and eighth decades of life. Continued population growth will lead to increasing numbers of older adults with hematologic malignancies. Oncology care for older adults is complex and must account for the effect of aging on disease biology and treatment tolerance. Multidisciplinary oncology care has been utilized in solid tumor oncology for decades, initially driven by the need for multi-modality treatment. In this review, we make the case for multidisciplinary oncogeriatric care for older adults with hematologic malignancies in o

Critically ill patients with cancer: chances and limitations of intensive care medicine-a narrative review.

This narrative review deals with the challenge of defining adequate therapy goals and intensive care unit (ICU) admission criteria for critically ill patients with cancer. Several specific complications of critically ill patients with cancer require close collaborations of intensive care and cancer specialists. Intensivists require a basic understanding of the pathophysiology, diagnosis and therapy of common cancer-specific problems. Cancer specialists must be knowledgeable in preventing, detecting and treating imminent or manifest organ failures. In case of one or more organ dysfunctions, ICU

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… Furthermore, haematologists/oncologists ought to be knowledgeable in preventing, detecting and treating imminent or manifest organ dysfunctions. … Dissenting perspectives on the adequacy of an ICU admission in individual patients among intensive care specialists and haematologists/oncologists may be solved by an ‘ICU trial’. …

Perspectives to mitigate payer uncertainty in health technology assessment of novel oncology drugs.

Reimbursement decisions on new oncology drugs are now often made while uncertainty remains about a drug's risk-benefit profile. One consequence of this is a delay in patient access to valuable new medicines. We share our perspectives on strategies to mitigate sources of uncertainty in the health technology assessment process. These include flexible approaches for evaluating the additional benefit, such as better use of surrogate endpoints and health-related quality of life data, and renewed research efforts to define the optimal target population and generate real-world evidence post-authorisa

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… Oncologist . 2017 ; 22 ( 7 ): 726 – 767 . 10.1634/theoncologist.2017-0152 PMC5507655 28576856 [5] Jönsson B Bringing in health technology assessment and cost-effectiveness considerations at an early stage of drug development . … The perspectives of oncologists, health care policy makers, patients, and the general population . …

Cancer in Pregnancy: Therapeutic Decisions at the Intersection of Two Lives.

Background: Cancer during pregnancy is a rare but increasingly encountered condition due to delayed childbearing and improved survival of women with cancer. The coexistence of malignancy and pregnancy poses complex diagnostic and therapeutic challenges, requiring careful balance between maternal prognosis and fetal safety. Objective: This review aims to summarize current evidence on the diagnosis and multidisciplinary management of cancer during pregnancy, focusing on the safe use of oncologic therapies, obstetric decision-making, and maternal and fetal outcomes. Methods: A narrative review wa

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… The multidisciplinary team should include, at a minimum, a maternal–fetal medicine specialist, clinical oncologist, perinatologist, gynecologic oncologist, pediatrician, radiation oncologist, and psychologist or social worker. … Obstetric Management The timing of delivery should be coordinated by a multidisciplinary team comprising obstetricians, oncologists, surgical oncologists, and neonatologists. …

Critically ill cancer patient's resuscitation: a Belgian/French societies' consensus conference.

To respond to the legitimate questions raised by the application of invasive methods of monitoring and life-support techniques in cancer patients admitted in the ICU, the European Lung Cancer Working Party and the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique, set up a consensus conference. The methodology involved a systematic literature review, experts' opinion and a final consensus conference about nine predefined questions1. Which triage criteria, in terms of complications and considering the underlying neoplastic disease and possible therapeutic limitations, should be

Diversity, Equity, and Inclusion in Multiple Myeloma: A Call to Action.

BackgroundAlthough advancements in multiple myeloma therapy have rapidly evolved, pervasive racial and social inequities prevent uniform benefit across diverse patient populations. This affects access to US Food and Drug Administration-approved treatments and to clinical studies. The impact of health-care inequities is not well understood and thus, the development of effective strategies is inadequate. We identify different disparities including race, age, socioeconomic status, and sexual preference/orientation and their effect on patient care. We explore recommendations for the advanced pract

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… The Oncologist, 10(3), 198–204. 10.1634/theoncologist.10-3-198 Adams, K., Guerrieri, L., & Tariman, J. (2018). Systematic review: Diversity of enrollment in multiple myeloma drug trials among different ethnicities. … An evaluation of self-perceived knowledge, attitudes and behaviours of UK oncologists about LGBTQ+ patients with cancer. European Society of Medical Oncologists Open, 5(6), e000906. 10.1136/esmoopen-2020-000906 Bhatnagar, B., Kohlschmidt, J., Mrózek, K., Zhao, Q., Fisher, J. …

The Cost-Effectiveness Analysis of Transplant-Ineligible Myeloma Patients with Bortezomib plus Thalidomide plus Dexamethasone (VTD) or Bortezomib plus Melphalan plus Prednisolone (VMP) Treatment in Southern Taiwan.

BackgroundThis study aimed to evaluate the cost-effectiveness of treating transplant-ineligible myeloma patients with either a bortezomib plus thalidomide plus dexamethasone (VTD) or a bortezomib plus melphalan plus prednisolone (VMP) treatment in Taiwan.MethodsNewly diagnosed, transplant-ineligible myeloma patients with VTD or VMP therapy were enrolled from two medical centers in southern Taiwan. Quality-adjusted life years (QALYs) were used as the measurement unit of the effectiveness evaluation, and the incremental cost-effectiveness ratio (ICER) was used for comparison between the two grou

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… The availability of novel agents currently used by hematologists and oncologists, including proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies has improved the outcomes of newly diagnosed and relapsed/refractory MM patients significantly. … Efficient allocation of novel agents in multiple myeloma: A work in progress Oncologist 2013 18 5 7 10.1634/theoncologist.2012-0484 23299778 PMC3556256 26. Morabito F. Bringhen S. Larocca A. Wijermans P. Victoria Mateos M. Gimsing P. Mazzone C. Gottardi D. Omede P. Zweegman S. …

Arrhythmia in tumor lysis syndrome and associated in-hospital mortality: A nationwide inpatient analysis.

BackgroundTumor lysis syndrome (TLS) is a life-threatening oncologic emergency associated with fatal complications including arrhythmia. The epidemiology and mortality outcomes of arrhythmia in TLS are scarcely studied in the literature.MethodsWe used the National Inpatient Sample (NIS) to study the prevalence and outcome of arrhythmia in patients hospitalized with TLS (ICD-9 code 277.88) from 2009 to 2014. Baseline characteristics, burden of arrhythmia, and pertinent outcomes were analyzed. Multivariable regression analysis was performed to identify the impact of underlying malignancy in pred

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… Risk stratification of cancer patients is very important and there should be increased collaboration between oncologists and cardiologists under cardio‐oncology specialty. … Oncologist. 2017;22(12):1506–9. 13. Buza V, Rajagopalan B, Curtis AB. Cancer treatment‐induced arrhythmias: focus on chemotherapy and targeted therapies. Circ Arrhythm Electrophysiol. 2017;10(8):e005443. 14. O'Neal WT, Lakoski SG, Qureshi W, Judd SE, Howard G, Howard VJ, et al. …

Patterns of Care of Cancers and Radiotherapy in Ethiopia.

PURPOSE: Radiotherapy (RT) is an essential component of cancer treatment. There is a lack of RT services in sub-Saharan Africa as well as limited knowledge regarding clinical practices. The purpose of this study was to identify and describe the patterns for RT treatment in Ethiopia. METHODS AND MATERIALS: We performed a retrospective analysis of 1,823 patients treated with cobalt RT at a large referral hospital in Addis Ababa, Ethiopia, from May 2015 through January 2018. Paper charts were reviewed for patient and treatment characteristics. Descriptive statistics were computed using SPSS (IBM

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… There were 6 radiation oncologists and 28 residents by the end of the study. There were 4 medical physicists, 5 radiation therapists, and 26 oncology nurses on staff. … Oncologist. 2018;23:1024–1032. doi: 10.1634/theoncologist.2017-0271. 29. Fortin A, Bairati I, Albert M, et al. Effect of treatment delay on outcome of patients with early-stage head-and-neck carcinoma receiving radical radiotherapy. …

Optimizing the post-CAR T monitoring period in recipients of axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel.

AbstractCD19-directed chimeric antigen receptor T-cell (CAR T) therapies, including axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), and lisocabtagene maraleucel (liso-cel), have transformed the treatment landscape for B-cell non-Hodgkin lymphoma, showcasing significant efficacy but also highlighting toxicity risks such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). The US Food and Drug Administration has mandated patients remain close to the treatment center for 4 weeks as part of a Risk Evaluation and Mitigation Strategy

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… Given that the risk of infections and mortality due to infections persists beyond the stringent 4-week monitoring period, robust supportive care to minimize the risk of infections along with strategies to educate and collaborate with community oncologists to reduce the risk of infectious complications … Engagement and educational initiatives with community oncologists may facilitate such a monitoring strategy beyond the early observation period in patients with LBCL undergoing CAR T. …

Insights into the Impact of Hesitancy on Cancer Care and COVID-19.

World Health Organization findings indicate that the COVID-19 pandemic adversely affected cancer diagnosis and management. The COVID-19 pandemic disrupted the optimal management of outpatient appointments, scheduled treatments, and hospitalizations for cancer patients because of hesitancy among patients and health-care providers. Travel restrictions and other factors likely affected medical, surgical, and radiation treatments during the COVID-19 pandemic. Cancer patients were more likely to be affected by severe illness and complications if they contracted COVID-19. A compromised immune system

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… Mitigation Strategies There was a positive correlation between vaccination status and the trust respondents had for their oncologist, federal agencies, and pharmaceutical companies. It was reported that oncologists and primary care physicians were the most trusted sources of vaccines [ 40 ]. … Parent acceptance toward inactivated COVID-19 vaccination in children with acute lymphoblastic leukemia: The power of oncologist and alliance. Vaccines. 2022;10:2016. doi: 10.3390/vaccines10122016. 42. …

A decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care.

BackgroundConcerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experiences serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prioritizing insured services offers a valuable strategy for informing Medicare coverage policy. We designed and evaluated a decision exercise that allowed cancer patients and family members to choose Medicare benefits for advanced cancer patients.MethodsThe decision tool, Choosing Health plans All Together (CHAT) was modified to select services fo

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… The American Society for Clinical Oncology has recognized that the costs of cancer care are burdensome for patients and their families and has recommended that oncologists discuss the costs of cancer treatments with their patients. … Alexandria, Virginia: American Society of Clinical Oncologists; 2012. Reducing the cost of cancer care: How to bend the curve downward; pp. e46–e51. …

Palliative care follow-up for cancer patients combining day-hospital visits and telemedicine: What feasibility?

BackgroundDue to the increasing life expectancy of patients with cancer, palliative care services are increasingly solicited to provide follow-up for individuals living at home. The implementation of teleconsultations represents a potential solution to extend access to palliative care follow-up to a larger number of patients. The aim of this study is to demonstrate the a priori acceptance of teleconsultations among all patients admitted to palliative care, as well as the feasibility of their implementation. We therefore initially explored whether a specific patient profile might limit acceptan

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… Patients with chronic cancer are typically followed at regular intervals by their oncologist before being referred to a palliative care team, who assumes ongoing management [ 4 – 6 ]. … French hospitals are considering follow-up strategies for these patients, initially in parallel with the referring oncologists and palliative care teams, and later exclusively by palliative care teams. …

Cardiotoxicity of Biological Therapies in Cancer Patients: An In-depth Review.

Cardiotoxicity from chemotherapy regimens has been long reported. However, the understanding of cardiac side effects of biological therapies is rapidly evolving. With cancer patients achieving higher life expectancy due to the use of personalized medicine and novel targeted anticancer agents, the occurrence of cardiotoxicity is becoming more significant. Novel biological therapies include anti-HER2 antibodies, tyrosine kinase inhibitors, bruton kinase inhibitors, antivascular endothelial growth factors, proteasome inhibitors, immunomodulator drugs, and immune checkpoint inhibitors. Potential c

Cancer survivorship: understanding the patients' journey and perspectives on post-treatment needs.

BackgroundCancer treatments have many adverse effects on patient's health leading to poor cardiorespiratory capacity, muscular- degeneration, fatigue, loss of strength and physical function, altered body-composition, compromised immune-function, peripheral neuropathy, and reduced quality of life (QOL). Exercise programs can significantly increase functional capacity when tailored to individual needs, thus improving health. Exercise interventions in cancer rehabilitation, when supported by appropriate nutrition can be effective in attaining a healthy weight and body-composition. The successful