First-line pembrolizumab for metastatic NSCLC in lower-middle-income countries: bridging the efficacy-effectiveness gap.

Introduction: Pembrolizumab is a standard first-line therapy for advanced/metastatic non-small cell lung cancer (a/mNSCLC) lacking actionable mutations. Data from lower-middle-income countries (LMICs) remain scarce.

Methods: From January 2019 to June 2024, we prospectively analyzed 78 a/mNSCLC patients receiving pembrolizumab-based first-line therapy.

Leveraging Cancer Registry Survival Data to Estimate Lung Cancer Recurrence.

Population-based insights into the risk of metastatic recurrence are typically unavailable due to the absence of recurrence-specific data in cancer registries. This study presents an innovative method for estimating recurrence risk using disease-specific survival data from cancer registries. The methodology integrates an illness-death model with a mixture-cure framework for net cancer survival.

Machine learning model for predicting DIBH non-eligibility in left-sided breast cancer radiotherapy: Development, validation and clinical impact analysis.

Objective: Multi-day assessments accurately identify patients with left-sided breast cancer who are ineligible for irradiation in Deep Inspiration Breath Hold (DIBH) and minimise on-couch treatment time in those who are eligible. The challenge of implementing multi-day assessments in resource-constrained settings motivated the development of a machine learning (ML) model using data only from the 1st day of assessment to predict DIBH ineligibility.

Methods: This prospective cohort study used data from 202 patients collected between January and December 2023 for model development.

Identification of variables and development of a prediction model for DIBH eligibility in left-sided breast cancer radiotherapy: a prospective cohort study with temporal validation.

Objective: To identify variables associated with a patients' ability to reproducibly hold their breath for deep-inspiration breath-hold (DIBH) radiotherapy (RT) and to develop a predictive model for DIBH eligibility.

Methods: This prospective, single-institution, IRB-approved observational study included women with left-sided breast cancer treated between January 2023 and March 2024. Patients underwent multiple breath-hold sessions over 2-3 consecutive days.

Is it too early to recommend local treatment in oligometastatic non-small cell lung cancer: a plea for equipoise.

Oligometastatic non-small cell lung cancer (OMD NSCLC) has been proposed to bridge the spectrum between non-metastatic and widely metastatic states and is perceived as an opportunity for potential cure if removed. Twelve clinical trials on local treatment have been reported, yet none are conclusive. These trials informed the development of a joint clinical practice guideline by the American & European Societies for Radiation Oncology, which endorses local treatment for OMD NSCLC.

Risk-Adapted Target Delineation for Breast Cancer: Controversies and Considerations.

The advent of computed tomography-based planning coupled with modern tools for target delineation and hypofractionated treatment schedules has increased efficiency and throughput for patients with breast cancer. While the benefit of adjuvant radiation therapy (RT) in reducing locoregional recurrences is established, disentangling local versus regional recurrence risks with modern treatment protocols has become an area of active research to de-escalate treatment. Delineation guidelines for nodal regions either attempt to replicate results of conventional RT techniques by translating bony landmarks to clinical target volumes or use landmarks based on the fact that lymphatic channels run along the vasculature.

Tri-modality therapy in advanced esophageal carcinoma: long-term results and insights from a developing world, institutional cohort.

Objective: To evaluate treatment outcomes in patients from a low-middle income country (LMIC) with esophageal carcinoma who underwent esophagectomy after neoadjuvant chemoradiation (NACRT/S).

Methods: Between 2010 and 2020, 254 patients (median follow-up: 53 months) met our inclusion criteria. Out-of-field nodal regions were determined by reviewing individual radiotherapy plans.

Plan quality assessment of modern radiotherapy delivery techniques in left-sided breast cancer: an analysis stratified by target delineation guidelines.

Objective: This study compares planning techniques stratified by consensus delineation guidelines in patients undergoing whole-breast radiotherapy based on an objective plan quality assessment scale.

Methods: 10 patients with left-sided breast cancer were randomly selected, and target delineation for intact breast was performed using Tangent (RTOG 0413), ESTRO, and RTOG guidelines. Consensus Plan Quality Metric (PQM) scoring was defined and communicated to the physicist before commencing treatment planning.

Malignant esophagorespiratory fistulas: a comparative effectiveness survival analysis.

Objectives: To analyse the survival of patients with malignant esophagorespiratory fistulas (ERF) and perform a comparative effectiveness analysis of ERF-directed interventions.

Methods: Fifty-five patients met our inclusion criteria, and data on ERF-directed interventions (stent placement, surgical repair and best supportive care) and their outcomes, along with clinical and treatment details, were recorded. The primary endpoints were overall survival (OS) and survival after developing ERF (F-OS).

Pathways to diagnosis of non-small cell lung cancer: a descriptive cohort study.

Little has been published on the diagnostic and referral pathway for lung cancer in Australia. This study set out to quantify general practitioner (GP) and lung specialist attendance and diagnostic imaging in the lead-up to a diagnosis of non-small cell lung cancer (NSCLC) and identify common pathways to diagnosis in New South Wales (NSW), Australia. We used linked health data for participants of the 45 and Up Study (a NSW population-based cohort study) diagnosed with NSCLC between 2006 and 2012.

Oncology Information System Data - Implications for 'Big Data'.

Our Oncology Information Systems (OIS) with local User Documentation manages the medical data explored in this 26 item report of a minimal medical dataset. Over 10 years to 2016, 12906 diagnoses were registered (ICD10: C00-C80), with 18.84% of cases, and 63.

Development and Feasibility Testing of PROMPT-Care, an eHealth System for Collection and Use of Patient-Reported Outcome Measures for Personalized Treatment and Care: A Study Protocol.

Background: Patient-reported outcome (PRO) measures have been used widely to screen for depression, anxiety, and symptoms in cancer patients. Computer-based applications that collect patients' responses and transfer them to the treating health professional in real time have the potential to improve patient well-being and cancer outcomes.

Objective: This study will test the feasibility and acceptability of a newly developed eHealth system which facilitates PRO data capture from cancer patients, data linkage and retrieval to support clinical decisions and patient self-management, and data retrieval to support ongoing evaluation and innovative research.

A contemporary case study illustrating the integration of health information technologies into the organisation and clinical practice of radiation oncology.

The development of software in radiation oncology departments has seen the increase in capability from the Record and Verify software focused on patient safety to a fully-fledged Oncology Information System (OIS). This paper reports on the medical aspects of the implementation of a modern Oncology Information System (IMPAC MultiAccess, also known as the Siemens LANTIS) in a New Zealand hospital oncology department. The department was successful in translating paper procedures into electronic procedures, and the report focuses on the changes in approach to organisation and data use that occurred.