Adjuvant chemotherapy in older patients with stage II and III colon cancers: Is less more?

Background: Guidelines recommend adjuvant chemotherapy (AC) for patients with high-risk stage II and III colon cancers. However, the use of multi-agent chemotherapy (MAC) in older patients remains controversial. This study aimed to assess whether the survival benefit of single-agent chemotherapy (SAC) and MAC in stage II and III colon cancers diminishes with age.

Comparing the time spent in clinic by patients receiving, subcutaneous and intravenous formulations of cancer drugs: A pilot study.

Background: Subcutaneous (SC) formulations of cancer-directed and supportive care drugs are associated with time savings relative to their intravenous (IV) formulations in clinical trials, but it is unclear if these time savings apply in routine practice.

Methods: We performed a retrospective study of adults with breast cancer treated at a single U.S.

Oncologist perspectives on the acceptability, appropriateness, and feasibility of the Cancer and Aging Research Group (CARG) chemotherapy toxicity prediction tool for older adults.

Introduction: The clinical uptake of validated chemotherapy toxicity predictor tools for older adults with cancer remains low. In this qualitative study, we sought to evaluate oncologist perspectives on the acceptability, appropriateness, and feasibility of the Cancer and Aging Research Group (CARG) chemotherapy toxicity predictor tool.

Materials And Methods: We conducted semi-structured qualitative interviews with 18 medical oncologists in the M Health Fairview system to understand barriers to CARG tool use and implementation solutions.

Case Report: Metastatic small bowel adenocarcinoma with DNA mismatch repair deficiency in an organ transplant recipient treated with anti-PD-1 immunotherapy.

We present a case of a 65-year-old woman with a history of kidney and pancreas transplants for type 1 diabetes mellitus who presented with small bowel obstruction and was found to have a poorly differentiated small bowel adenocarcinoma with multifocal osseous and nodal metastases. Plasma-based next generation circulating tumor deoxyribonucleic acid (DNA) sequencing revealed mismatch repair deficiency and an exceptionally high tumor mutational burden (TMB) of 1069 mutations/megabase (mut/Mb). Initial management consisted of cytotoxic chemotherapy (FOLFOX; 5-fluorouracil, leucovorin, and oxaliplatin) given the urgent need for a clinical response.

Telehealth and Health Care Contact Days Among Patients With Advanced Cancer After COVID-19.

Importance: The COVID-19 pandemic led to widespread telemedicine adoption, but its impact on time toxicity, ie, the time burden of interacting with the health care system, among patients with advanced cancer remains unclear.

Objective: To evaluate the association of the COVID-19 pandemic with time toxicity for patients with advanced cancer who died within 1 year of diagnosis, focusing on changes in health care use, including telehealth.

Design, Setting, And Participants: This retrospective cohort study included patients with stage 4 cancer who died within 1 year of diagnosis, with follow-up limited to 1 year.

The association of health care contact days with economic measures in the CCTG LY.12 trial.

Background: Given the intensive resources required to conduct economic analyses in clinical trials, a key need is identifying scalable measures of costs. Contact days-days with health care contact outside the home-may represent such a practical measure.

Methods: We conducted a secondary analysis of a trial that evaluated two pre-transplant chemotherapy regimens for lymphoma.

Current concepts in patient specific implants for reverse shoulder arthroplasty.

In light of the increasing prevalence of reverse shoulder arthroplasty, it has become clear that standard off the shelf implants provide insufficient glenoid fixation in challenging primary and revision cases. Recent advancements in computed tomography scanning, software automation tools, and additive manufacturing have paved the way for patient specific implants in difficult cases for reverse shoulder arthroplasty. This review article aims to provide an overview of the current state of patient specific implants in reverse shoulder arthroplasty, discussing their design principles, manufacturing techniques, short-term clinical outcomes, and future directions.

Logistic and time burdens reported by gynecologic and breast cancer survivors.

Background: We assessed the effect of the time requirements of cancer care on other life activities and time burden reduction priorities among breast and gynecologic cancer survivors.

Methods: A total of 224 participants with gynecologic or breast cancer from two cohort studies completed a cross-sectional survey regarding logistic and time burdens of cancer care. We compared agreement with the importance of minimizing travel time, wait time, and trips to the cancer center as well as whether cancer care visits interfered with other activities (dependent care, chores, leisure activities) by employment, education, cancer type, cancer treatment status, dependent status, rural-urban residence, and income.

Combined semi-constrained total distal radioulnar joint (DRUJ) arthroplasty and radial head arthroplasty for severe, concomitant rheumatoid disease of the wrist and elbow joints.

Semi-constrained total distal radioulnar joint (DRUJ) arthroplasty with Aptis-Scheker implant has demonstrated excellent results in patients with end-stage rheumatoid arthritis (RA) of the wrist. However, clinical success of the Scheker implant in restoring range of motion may be limited in patients with concomitant degenerative disease at the proximal radioulnar joint and radiocapitellar joint, which work in tandem with the DRUJ to allow pronosupination of the forearm. Among treatment options for elbow arthritis, standalone radial head arthroplasty remains poorly studied in the context of RA, despite being used widely in trauma patients.

Days spent with healthcare contact by patients with metastatic castrate resistant prostate cancer in the last year of life.

Background: Days spent with healthcare contact during cancer treatment, or "time toxicity," may be particularly relevant to patients with end-stage malignancies, including metastatic castrate resistant prostate cancer (mCRPC), considering further cancer-directed therapies near the end-of-life.

Patients And Methods: We retrospectively assessed healthcare contact days (ie, days with healthcare contact outside the home) in the last 12 months of 96 patients with mCRPC at an academic cancer center. We compared contact days in the 90-day period between 12 and 9 months prior to death ("first quarter") and the 90-day period prior to death ("last quarter") using the Wilcoxon signed rank test, with additional univariate analyses focused on clinicodemographic variables, particularly systemic treatments.

Genetic Drivers of Quality of Life in Prostate Cancer: An Evaluation of Genetic Polymorphisms and Patient-reported Outcomes in the E3805 CHAARTED trial.

Background And Objective: The rs4680 single-nucleotide polymorphism (SNP) of the COMT gene leads to a reduction in dopamine clearance, resulting in better mood and a decrease in symptoms in noncancer populations, but its influence on quality of life (QOL) during cancer treatment is undefined. We hypothesized that in comparison to wildtype (WT) COMT, the rs4680 SNP is associated with better QOL among men with metastatic hormone-sensitive prostate cancer receiving androgen deprivation therapy ± docetaxel (ADT ± D).

Methods: In this post hoc analysis, we tested the association between COMT rs4680 status and Functional Assessment of Cancer Therapy-Prostate (overall QOL), Functional Assessment of Chronic Illness Therapy-Fatigue, and Brief Pain Inventory scores at baseline and at 3, 6, 9, and 12 mo using Fisher's exact test and the Wilcoxon rank-sum test.

Health Care Contact Days and Outcomes in Clinical Trials vs Routine Care Among Patients With Non-Small Cell Lung Cancer.

Importance: Although patients enrolled in trials have superior survival outcomes compared with those in routine practice, it is unknown whether such differences extend to contact days, a measure of time toxicity.

Objective: To evaluate differences in contact days for patients with advanced stage non-small cell lung cancer (NSCLC) receiving care in trials or routine practice.

Design, Setting, And Participants: This population-based, retrospective, matched cohort study assessed adults from Ontario, Canada, who were diagnosed with advanced-stage NSCLC between January 1, 2010, and December 31, 2017, and who died between January 1, 2010, and December 31, 2019.

Health Care Contact Days for Older Adults Enrolled in Cancer Clinical Trials.

Importance: Contact days-days with health care contact outside the home-are a measure of how much of a patient's life is consumed by health care. Clinical trials, with a more uniform patient mix and protocolized care, provide a unique opportunity to assess whether burdens differ by individuals' sociodemographic backgrounds.

Objective: To characterize patterns of contact days for older adults with cancer participating in clinical trials.

Enhanced Laser Cooling of a Mechanical Resonator via Zero-Photon Detection.

Throughout quantum science and technology, measurement is used as a powerful resource for nonlinear operations and quantum state engineering. In particular, single-photon detection is commonly employed for quantum-information applications and tests of fundamental physics. By contrast, and perhaps counterintuitively, measurement of the absence of photons also provides useful information, and offers significant potential for a wide range of new experimental directions.

Association of Financial Wellness with Patterns of Medical Cannabis Use and Patient-Reported Outcomes in Adults with Cancer.

Objective: Despite increasing use of medical cannabis to manage cancer-related symptoms, U.S. payers do not reimburse medical cannabis, leaving patients responsible for all associated costs.

The Role of Crutches and Bracing in Preventing Secondary Meniscal Tears After Anterior Cruciate Ligament Injury in Pediatric Patients.

Background: Secondary meniscal tears are a well-described sequela of delay in anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL injury. This study aimed to evaluate whether preoperative conservative interventions (ie, crutches, bracing, and physical therapy) are associated with a reduced risk of secondary meniscal pathology in pediatric patients.

Hypothesis: Preoperative conservative interventions of the ACL-deficient knee would be associated with fewer secondary meniscal tears in pediatric patients undergoing delayed (≥8 weeks postinjury) ACLR.

"The biggest challenge is there's never a routine": a qualitative study of the time burdens of cancer care at home.

Purpose: As cancer care is increasingly delivered in the home, more tasks and responsibilities fall on patients and their informal care partners. These time costs can present significant mental, physical, and financial burdens, and are undercounted in current measures of time toxicity that only consider care received in formal healthcare settings.

Methods: Semi-structured qualitative interviews were conducted with patients with gastrointestinal cancer and informal care partners at a single tertiary cancer center between March and October 2023.

Social and Legal Needs in Patients and Families With Cancer: Interaction With Patient-Level Financial Toxicity.

Adverse financial burden and its effect on patients resulting from the costs associated with cancer care, both direct and indirect, is known as financial toxicity. This review explores the interplay between financial toxicity and key social and legal needs in cancer care. Drawing from the WHO's framework and the ASCO's policy statement on social determinants of health, we propose a conceptual model that discusses five key needs-housing insecurity, food insecurity, transportation and access barriers, employment disruptions, and psychosocial needs-which interact with, and are affected by financial toxicity, and adversely influence patients' well-being and adherence to treatment.