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  • 1
    Online Resource
    Online Resource
    Overall survival (OS) and healthcare utilization results of a randomized controlled trial (RCT) assessing a patient navigation (PN) intervention to increase early access to supportive care (SC) for patients with metastatic cancer in a resource-limited setting.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. 12112-12112
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. 12112-12112
    Abstract: 12112 Background: We previously reported improvements in access to SC, advance directive completion, and pain control in a RCT comparing a patient navigator-led early SC intervention vs. usual care among patients with newly-diagnosed metastatic cancer in Mexico (NCT03293849). We now present results on healthcare utilization and OS. Methods: Patients were randomized to PN or usual oncology care. Patients in the PN arm received SC interventions by a navigator-led multidisciplinary team (palliative care, physical therapy, geriatrics, psychology) in the first 12 weeks after diagnosis. At 12-weeks, patients allocated to usual care were able to cross-over to PN and receive multidisciplinary SC. We analyzed the number (no.) of emergency room (ER) visits, their cause, and whether they were potentially avoidable (as determined by expert consensus), using descriptive statistics and X2 tests. OS was estimated using the Kaplan-Meier method and the log-rank test. Results: 133 patients (median age 60, range 23-93; 52% male) were randomized (66 PN, 67 control) from 08/17 to 04/18. Median follow-up was 22.8 months. 61% had gastrointestinal tumors, and 45% had a calculated life expectancy ≤6 months. 69% of patients randomized to usual care crossed-over to PN and received SC interventions. 80% of patients attended the ER ≥once (median no. of visits = 2). No difference was found between patients randomized to early SC or usual care in ER visits (2.4 vs. 2.3, p = 0.58). Out of a total 316 ER visits, the most common reason was infections (n = 69, 22%), followed by pain (n = 40, 13%), and indwelling catheter-related complications (n = 23, 7%). 41% of ER visits were considered as potentially avoidable, with no difference in avoidable visits found between arms (1.7 vs. 1.7, p = 0.49). No differences between arms were found in no. of hospitalizations (0.8 vs. 0.6 p = 0.82). Survival results were assessed after 64% of patients had died (n = 85), finding no statistically significant OS difference between the early SC intervention and the usual care arms (11.0 vs 13.0 months, p = 0.77) Conclusions: In the context of a limited-resource healthcare system, the early delivery of SC did not improve healthcare utilization, reduce avoidable ER visits, or prolong OS compared to the implementation of SC at a later time, which might be partially explained by the unavailability of hospice or home care, and by high rates of cross-over between arms. Clinical trial information: NCT03293849 .
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.15_suppl.12112
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    Randomized controlled trial (RCT) of a patient navigation (PN) intervention to increase early access to supportive care (SC) for patients with metastatic cancer in a resource-limited setting.
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. 11505-11505
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. 11505-11505
    Abstract: 11505 Background: Early integration of SC to the treatment of advanced cancer can improve outcomes, but this may be challenging in developing countries due to a lack of resources and knowledge. In this RCT, we examined whether PN could improve early access to SC among Mexican patients with metastatic solid tumors as recommended by ASCO guidelines. Methods: Adult patients with newly-diagnosed metastatic cancer were randomly assigned to PN or standard oncologic care. At baseline, a navigator assessed the patients’ SC needs (depression, anxiety, fatigue, pain, caregiver burden) using validated questionnaires administered with an electronic tablet. For those in the PN arm, a personalized SC plan was created and implemented by a multidisciplinary team (palliative care, physical therapy, geriatrics, psychology, psychiatry). The primary outcome was access to SC, defined as receipt of SC interventions in the first 3 months (mo) after diagnosis. Secondary outcomes included advanced directive (AD) completion (for patients with expected survival ≤6 mo in accordance to Mexican law), changes in SC needs, and changes in quality of life (assessed using FACT-G). Results: 133 patients (median age 60, range 23-93; 52% male) were randomized (66 PN, 67 control). 61% of patients had gastrointestinal tumors. 94% of patients in the PN arm completed baseline assessments and received recommendations from the navigator. At 3 mo, 37 patients died or were lost to follow-up (16 PN, 21 control; p = 0.45), and 96 completed assessments. SC interventions were provided to 73% of patients in the PN arm and 24% of controls (p 〈 0.01). In the PN arm, 48% of 29 eligible patients completed AD, compared to 0% of eligible controls (p 〈 0.01). At 3 mo, patients in the PN arm were significantly less likely to report moderate/severe pain than controls (10 vs 33%, p = 0.006). There were no significant differences in other symptoms or in FACT-G scores (76 vs 76.3, p = 0.46) between PN and control arms at 3 mo. Conclusions: PN can lead to significant improvements in early access to SC, AD completion, and pain control among patients with metastatic cancer treated in a resource-limited setting. Clinical trial information: NCT03293849.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2019.37.15_suppl.11505
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
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  • 3
    Online Resource
    Online Resource
    Patient Navigation to Improve Early Access to Supportive Care for Patients with Advanced Cancer in Resource-Limited Settings: A Randomized Controlled Trial
    Oxford University Press (OUP) ; 2021
    In:  The Oncologist Vol. 26, No. 2 ( 2021-02-01), p. 157-164
    Details
    In: The Oncologist, Oxford University Press (OUP), Vol. 26, No. 2 ( 2021-02-01), p. 157-164
    Abstract: The early integration of supportive care in oncology improves patient-centered outcomes. However, data are lacking regarding how to achieve this in resource-limited settings. We studied whether patient navigation increased access to multidisciplinary supportive care among Mexican patients with advanced cancer. Materials and Methods This randomized controlled trial was conducted between August 2017 and April 2018 at a public hospital in Mexico City. Patients aged ≥18 years with metastatic tumors ≤6 weeks from diagnosis were randomized (1:1) to a patient navigation intervention or usual care. Patients randomized to patient navigation received personalized supportive care from a navigator and a multidisciplinary team. Patients randomized to usual care obtained supportive care referrals from treating oncologists. The primary outcome was the implementation of supportive care interventions at 12 weeks. Secondary outcomes included advance directive completion, supportive care needs, and quality of life. Results One hundred thirty-four patients were randomized: 67 to patient navigation and 67 to usual care. Supportive care interventions were provided to 74% of patients in the patient navigation arm versus 24% in usual care (difference 0.50, 95% confidence interval [CI] 0.34–0.62; p & lt; .0001). In the patient navigation arm, 48% of eligible patients completed advance directives, compared with 0% in usual care (p & lt; .0001). At 12 weeks, patients randomized to patient navigation had less moderate/severe pain (10% vs. 33%; difference 0.23, 95% CI 0.07–0.38; p = .006), without differences in quality of life between arms. Conclusion Patient navigation improves access to early supportive care, advance care planning, and pain for patients with advanced cancer in resource-limited settings. Implications for Practice The early implementation of supportive care in oncology is recommended by international guidelines, but this might be difficult to achieve in resource-limited settings. This randomized clinical trial including 134 Mexican patients with advanced cancer demonstrates that a multidisciplinary patient navigation intervention can improve the early access to supportive and palliative care interventions, increase advance care planning, and reduce symptoms compared with usual oncologist-guided care alone. These results demonstrate that patient navigation represents a potentially useful solution to achieve the adequate implementation of supportive and palliative care in resource-limited settings globally.
    Type of Medium: Online Resource
    ISSN: 1083-7159 , 1549-490X
    URL: Article
    DOI: 10.1002/onco.13599
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2023829-0
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  • 4
    Online Resource
    Online Resource
    Historia de los receptores hormonales y de la terapia hormonal en cáncer de mama
    Academia Nacional de Medicina (Colombia) ; 2021
    In:  Medicina Vol. 43, No. 1 ( 2021-04-20), p. 189-207
    Details
    In: Medicina, Academia Nacional de Medicina (Colombia), Vol. 43, No. 1 ( 2021-04-20), p. 189-207
    Abstract: El cáncer de mama (CM) es la segunda neoplasia más común a nivel mundial y el cáncer más frecuente en mujeres. En los últimos años se han logrado diversos avances en la detección temprana, tratamiento y comprensión de la biología de esta enfermedad. La heterogeneidad biológica del CM tiene implicaciones tanto en el pronóstico, como en la toma de decisiones terapéuticas. Probablemente uno de los éxitos más importantes a principios del siglo XX, fue la alteración del entorno endócrino interno tumoral a través de la terapia hormonal. El descubrimiento de la terapia endocrina permitió pasar de tratamientos ablativos quirúrgicos y quimioterapias agresivas, a administrar terapias dirigidas, mejor toleradas y que mejoran la calidad de vida en mujeres con CM hormonodependiente. El fundamento de la terapia endocrina es la dependencia bien demostrada de la mama a la estimulación hormonal. En los años 1970’s, el modulador selectivo del receptor de estrógeno, tamoxifeno emerge como una nueva terapia para mujeres con CM avanzado; en las décadas subsecuentes, surgen numerosas y diversas terapias endocrinas selectivas, como los agonistas de la liberación de hormona luteinizante y los inhibidores de aromatasa, como una estrategia adicional en el tratamiento de esta enfermedad. Estas terapias fueron estudiadas de manera inicial en el escenario metastásico y posteriormente fueron adoptadas en el escenario adyuvante, en mujeres con enfermedad temprana. De manera más reciente se han descubierto los inhibidores de cinasa dependiente de ciclina, que asociados a la terapia hormonal han logrado una mejoría significativa en desenlaces clínicos y tasas de respuestas. En este artículo realizaremos una revisión cronológica de los principales hitos en la evolución de la terapia endocrina a lo largo de los últimos 100 años, destacando cada clase de agente y los ensayos claves que han llevado a cambios en la práctica moderna.
    Type of Medium: Online Resource
    ISSN: 2389-8356 , 0120-5498
    URL: Article
    DOI: 10.56050/01205498.1594
    Language: Unknown
    Publisher: Academia Nacional de Medicina (Colombia)
    Publication Date: 2021
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  • 5
    Online Resource
    Online Resource
    Communication of genetic testing results and cascade testing among Mexican carriers of cancer-associated variants and their families.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 15_suppl ( 2020-05-20), p. e13541-e13541
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. e13541-e13541
    Abstract: e13541 Background: Most hereditary cancer syndromes exhibit autosomal dominant inheritance. Therefore, communicating results to family members and performing cascade testing is crucial in order to identify individuals at risk and offer them appropriate risk-reducing strategies. The process of communicating medical information within families is highly variable and might be affected by several factors (including culture, education, understanding of results, and family conflicts) which remain understudied among individuals living in developing countries. We sought to investigate communication of results and cascade testing reach within the families of Mexican individuals carrying cancer-associated pathogenic variants (PVs). Methods: Individuals seen at a single center in Mexico City carrying a cancer-associated PV and enrolled in the Clinical Cancer Genomics Community Research Network (CCGCRN) were included. Carriers received genetic counseling at the time of results disclosure, a family letter was provided to facilitate the communication of results, and cascade testing was offered. After 〉 3 months from results disclosure, participants were surveyed regarding genetic testing results communication patterns, performance of cascade testing, and surveillance behaviors. Data was analyzed using descriptive statistics. Results: Among 354 probands, 53 (15%) were identified as carriers of a cancer-associated PV. Mean age was 48.3 (range 21-82) years. Cascade testing (≥1 family member) was initiated in 74% of families (n = 39), with a median of 3 (range 0-16) family members tested per proband. 53 carriers responded the survey (29 probands and 24 relatives). 98% (n = 43) had shared results with their family, and 53% (24/45) had shared them with their treating physicians. Most respondents were receiving active surveillance (n = 36, 80%); with 43% (n = 15) reporting having at least one barrier for complying with surveillance (financial: n = 8; distance to the hospital: n = 3). Around half of the carriers perceived their cancer risk to be of ≥50%. Conclusions: Our results show that both the communication of genetic testing results and the proportion of cascade testing within Mexican families are high. Family involvement in health care decision-making is common in Mexico, as in other Latin American countries, which might lead to improved family communication. However, strategies to improve communication with providers are needed in order to tackle barriers and improve surveillance of individuals carrying cancer associated PVs.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.15_suppl.e13541
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 6
    Online Resource
    Online Resource
    MASCC/ISOO expert opinion on the management of oral problems in patients with advanced cancer
    Springer Science and Business Media LLC ; 2022
    In:  Supportive Care in Cancer Vol. 30, No. 11 ( 2022-11), p. 8761-8773
    Details
    In: Supportive Care in Cancer, Springer Science and Business Media LLC, Vol. 30, No. 11 ( 2022-11), p. 8761-8773
    Abstract: The Palliative Care Study Group in conjunction with the Oral Care Study Group of the Multinational Association for Supportive Care in Cancer (MASCC) formed a sub-group to develop evidence-based guidance on the management of common oral problems in patients with advanced cancer. Methods This guidance was developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews and trials, respectively. Guidance was categorised by the level of evidence, and “category of guideline” (i.e., “recommendation”, “suggestion” or “no guideline possible”). Results Twelve generic suggestions (level of evidence – 5), three problem-specific recommendations and 14 problem-specific suggestions were generated. The generic suggestions relate to oral hygiene measures, assessment of problems, principles of management, re-assessment of problems and the role of dental/oral medicine professionals. Conclusions This guidance provides a framework for the management of common oral problems in patients with advanced cancer, although every patient requires individualised management.
    Type of Medium: Online Resource
    ISSN: 0941-4355 , 1433-7339
    URL: Article
    DOI: 10.1007/s00520-022-07211-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463166-0
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  • 7
    Online Resource
    Online Resource
    Caregiver burden of patients with advanced cancer in Mexico.
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 28_suppl ( 2022-10-01), p. 181-181
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 28_suppl ( 2022-10-01), p. 181-181
    Abstract: 181 Background: Caregivers of patients with advanced cancer often face significant physical, social, and emotional distress. In many Latin American cultures, family plays a particularly important role in the decision-making process of patients with cancer, and relatives often assume the role of unpaid caregivers. However, there is limited research about the burden associated with cancer unpaid caregiving among patients living in Latin America. We aimed to describe the profile of caregivers and to identify patient-related factors associated with caregiver burden in a third-level cancer center in Mexico City. Methods: We conducted a cross-sectional analysis of baseline data from patients with advanced cancer and their caregivers included in a multidisciplinary patient navigator-led supportive care program in Mexico City ( Te Acompañamos). At the time of enrollment in the program, caregivers completed a short version of the Zarit Burden scale and patients completed a series of screening questionnaires including assessments of quality of life (FACT-G), depression (PHQ-9), and anxiety (GAD-7). Life expectancy was calculated using the palliative performance scale (PPS). We used descriptive statistics, chi-square tests, and multivariate logistic regression analyses to understand which patient factors were associated with higher caregiver burden. Results: A total of 321 patients with advanced cancer (58% women; average age 63.3 +/- 14 years; 32.7 with hepatopancreatobiliary tumors) and 321 caregivers (67.1% women; 44% were the patient’s son/daughter; 29% were their spouses) were included. Sixty-four caregivers (20%) had a high caregiver burden (score 〉 16 in the Zarit scale). Caregiver burden was more common among the patients’ spouses (24.1 %) followed by brothers/sisters (23.6%). On univariate analysis, moderate/severe levels of depression (p = 0.001), moderate/severe levels of anxiety (p = 0.02), and lower PPS scores (p = 0.002) were associated with a high caregiver´s burden. Multivariate analysis showed that only PPS 〈 180 days was associated with increased odds of having caregiver burden (2.0; 95% CI 1.8-3.7); p = 0.02). Conclusions: A significant proportion of unpaid caregivers of Mexican patients with advanced cancer report high levels of caregiver burden, and the odds of having caregiver burden are increased when the patient has a calculated life expectancy of 〈 6 months. These results suggest targets for future supportive care interventions to improve caregiver wellbeing in Latin American and Hispanic populations.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.28_suppl.181
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 8
    Online Resource
    Online Resource
    Spectrum of germline pathogenic variants among patients with cancer in Mexico.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 10620-10620
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 10620-10620
    Abstract: 10620 Background: Up to 10% of patients with cancer harbor pathogenic germline variants (PVs) in one or more cancer susceptibility genes. Genetic cancer risk assessment (GCRA) is an important tool for the management of patients with cancer. It allows the identification of candidates for structured screening protocols, risk reduction strategies, targeted therapies and cascade testing. Knowledge about the prevalence and spectrum of PVs is limited among underrepresented populations. We studied the prevalence of germline PVs in a cohort of Mexican patients with cancer. Methods: Between April 2017 and September 2022, patients with diagnosis of cancer who met clinical criteria for GCRA according to international guidelines (NCCN) and were enrolled in the international Clinical Cancer Genomics Community Research Network (CCGCRN) registry at Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran were included. Cancer risk counseling and germline multi-gene panel testing were performed. Post-test counseling and cascade testing with known PV analysis was offered. Results: 1322 patients met inclusion criteria (probands n = 1027, relatives n = 295). Among the probands, 72.4% (744/1027) were women, median age at cancer diagnosis was 48.2 years (range 1-88) and 9.8% (n = 101) had more than one primary tumor. 14.5% (149/1027) of probands had a positive result in which 152 PV were identified ( BRCA1 n = 39, BRCA2 n = 33, ATM n = 11, CHEK2 n = 11, MLH1 n = 11, TP53 n = 7, PALB2 n = 7, NF1 n = 6, MSH2 n = 5, MSH6 n = 3, PTEN n = 3, APC n = 2, BRIP1 n = 2, CDH1 n = 2, RB1 n = 2 and 1 PV in the genes: CDKN2A, MAX, MUTYH, NBN, PTCH1, RAD50, SDHA and SDHB). The frequency of PV according to cancer diagnosis was: breast 15.5% (82/527), prostate 2% (4/198), ovarian 15.6% (12/77), colorectal 26.6% (16/60) and pancreatic 11.9% (5/42). The frequency of recurrent, potentially founder PVs in their respective genes was as follows: BRCA1 del(exons9-12) 30.7% (12/39) and CHEK2 c.707T 〉 C 81.8% (9/11). Among the relatives referred for cascade testing the frequency of PV was 40% (118/295), 18.6% (55/295) had personal history of cancer with a median age at diagnosis of 47 years. Conclusions: Our results show a wide spectrum and a variable frequency of PVs among one of the largest examined cohorts of Mexican patients with cancer, with a high frequency of PVs among cases of breast, ovarian, and colorectal cancer. In contrast to reports from other populations, there was very low frequency of PVs among patients with prostate cancer. The outcomes of this study add to our understanding of the genetic epidemiology of cancer in the Mexican population, and support creating GCRA programs to improve access to multi-gene panel testing among underrepresented patients in limited resource settings.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.10620
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 9
    Online Resource
    Online Resource
    Rates of potentially actionable germline variants in homologous recombination repair genes in a large international cohort outside of the United States.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 10590-10590
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 10590-10590
    Abstract: 10590 Background: Identification of pathogenic germline variants (PGVs) in homologous recombination repair (HRR) genes among patients (pts) with breast (BC), ovarian (OC), pancreatic (PaC), and prostate cancer (PrC) is critical to determine potential eligibility for targeted therapies such as PARP inhibitors (PARPi). It is important to evaluate the frequency and patterns of PGVs across different regions of the World to help inform the counseling of pts and implementation of precision medicine. Methods: A retrospective analysis of pts with BC, OC, PaC, and/or PrC cancer undergoing GGT through a single laboratory was conducted. The location of the ordering provider determined the assigned region, which included: Asia-Pacific (APAC), Latin America (LATAM), Middle East and African (MEA), and United Kingdom and Europe (UKEU). Analyses were limited to pts tested for PARPi-eligible (in the US) HRR genes and PGV analysis to the 10 most frequent genes for that cancer type. Descriptive statistics and Chi square with Yates correction were utilized. Significance was set at p 〈 0.05. Results: The cohort consisted of 40,539 pts with an average age at testing of 51 years, the majority of whom had BC (81%) (Table). The median number of genes tested ranged from 14-85 (Table). BRCA1 and BRCA2 were the most frequent genes with PGVs (3,358 pts, 8%). LATAM BC pts had significantly higher rates of BRCA1/2 PGVs (10%) than the other 3 regions ( p 〈 0.0007). OC BRCA1/2 rates were high, and statistically similar, across regions (15-17%, p 〉 0.08). Rates of BRCA1/2 and PALB2 in PaC pts did not differ between regions (4-7%, p 〉 0.08), nor did rates of BRCA1/2, CHEK2, ATM, and PALB2 in PrC pts (7-11%, p 〉 0.16) (Table). In sum, 3,434 pts (9% of those tested for the eligible genes) had PGVs in the above PARPi-eligible HRR genes. A notable limitation is that pts were ascertained by cancer type but information on other PARPi eligibility, namely metastatic/advanced disease, was not available. Conclusions: 1 in 12 pts were found to carry PARPi-eligible PGVs across the 4 cancer types and regions analyzed. Knowledge of these PGVs can help inform public health policies, current and future treatment strategies, and identify at-risk family members. In some countries, GGT may represent a more cost-effective and accessible pathway to targeted therapies compared to tumor profiling due to ease of sample collection and lower cost of testing. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.10590
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 10
    Online Resource
    Online Resource
    Risk of malnutrition and predisposing factors among Mexican patients with advanced cancer.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 12033-12033
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 12033-12033
    Abstract: 12033 Background: Malnutrition is a predictor of cancer survival independent of cancer site. However, routine screening for malnutrition is underutilized. Advanced cancer accounts for 60% of cancer cases in developing countries of which approximately 52 % have malnutrition. This study aimed to describe factors associated with risk of malnutrition among patients with advanced cancer. Methods: We conducted a cross-sectional analysis of baseline data from patients with recently diagnosed advanced cancer included in a multidisciplinary patient navigator-led supportive care program in Mexico City (Te Acompañamos). At the time of enrollment in the program, patients completed a series of questionnaires including assessments of quality of life (FACT-G), various symptoms and the validated malnutrition screening tool (MST). Clinic and demographic characteristics were obtained from the patient chart. Descriptive statistics were used for analysis and factors associated with risk of malnutrition were analyzed by bivariate testing. Results: Between August 2017 and December 2022, a total of 601 patients were included. Mean age was 62 years (range 18-94), 57.2% were women, 56% had gastrointestinal and 28% gynecological malignancies. 72 % screened positive for malnutrition on the MST and 49 % reported nausea on FACT-G. Patients with an ECOG performance status ≥3 were more likely to screen positive for malnutrition (OR 5.9 95%CI 2.5- 13) as well as those with baseline nausea (OR 2.99; 95%CI 1.9-4.7). On the other hand, patients with active chemotherapy (OR 1.4 95%CI, 1.016-1.95) and those receiving antiemetic treatment with a single medication (OR 1.63 95%CI, 1.1-2.4) were more likely to have nausea. No other clinical or demographic characteristics were significantly associated with screening positive for malnutrition or reporting nausea, including gender, age, history of smoking or alcohol abuse, type of neoplasia, or oncologic treatment. Conclusions: Our results show that a high proportion of patients with advanced cancer are at increased risk for malnutrition and report nausea. Poor functional status and nausea were strongly associated with a higher risk of malnutrition, while receiving insufficient antiemetic medication was associated with increased odds of nausea. This suggests that appropriate treatment of nausea and nutritional interventions should be prioritized early in the management of patients with advanced cancer regardless of the type of cancer treatment in order to avoid malnutrition and improve patient well-being.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.12033
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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