The lancet oncology
-
The lancet oncology · May 2022
ReviewImaging response assessment for CNS germ cell tumours: consensus recommendations from the European Society for Paediatric Oncology Brain Tumour Group and North American Children's Oncology Group.
Homogeneous and common objective disease assessments and standardised response criteria are important for better international clinical trials for CNS germ cell tumours. Currently, European protocols differ from those of North America (the USA and Canada) in terms of criteria to assess radiological disease response. ⋯ New clinical imaging standards were defined for the most common sites of CNS germ cell tumour and for the definition of locoregional extension. These new standards will allow the evaluation of response to therapy in patients with CNS germ cell tumours to be more consistent, and facilitate direct comparison of treatment outcomes across international studies.
-
The lancet oncology · May 2022
ReviewTime to deterioration of symptoms or function using patient-reported outcomes in cancer trials.
Time-to-event endpoints for patient-reported outcomes, such as time to deterioration of symptoms or function, are frequently used in cancer clinical trials. Although time-to-deterioration endpoints might seem familiar to cancer researchers for being similar to survival or disease-progression endpoints, there are unique considerations associated with their use. ⋯ Challenges including the consideration of intercurrent events, the difficulty in maintaining adequate completion rates, and considerable patient and trial burden from long-term, serial, patient-reported outcome measurements render time to deterioration a problematic approach for widespread use. For trials in which a comparative benefit in symptoms or function is an objective, an analysis at pre-specified relevant timepoints could be a better approach.
-
The lancet oncology · May 2022
ReviewEquity in national cancer control plans in the region of the Americas.
Many social determinants that are outside an individual's control affect their exposure to cancer risk factors and access to high-quality care. There is increasing recognition that national cancer control plans are fundamental tools to address cancer burden and promote equitable care. To investigate how policies in the WHO region of the Americas promote equity in cancer care, we evaluated 46 cancer-related health plans covering 34 countries. ⋯ Our results suggest that equity is not sufficiently integrated in national cancer control plans in the region. 17 documents defined inequity as a problem mainly related to difficulties in the access to care. Although 25 countries had designed equitable interventions, none had dedicated a budget for their implementation. Countries still need to translate their expressed concern with equity in health into funded, targeted interventions that accompany patients throughout the entire cancer care continuum.