Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 30 appraisals
Blood advances
A pilot randomized clinical trial of a peer support intervention for hematopoietic stem cell transplantation
Peer support has been associated with improved patient-reported outcomes (PROs), including reduced psychological distress, among patients undergoing hematopoietic stem cell transplantation (HSCT), but structured interventions are limited. This study assessed the feasibility, acceptability, and preliminary effects of a scalable peer support intervention to reduce psychological distress and enhance quality of life (QOL) post-HSCT. We conducted a pilot randomized clinical trial evaluating the Supporting Transplant Experiences with Peer Program (STEPP), a 5-session, telephone-based intervention delivered by an HSCT survivor offering psychoeducation and coping strategies. Participants were recruited 1 to 2 weeks pre-HSCT admission and randomized to STEPP or usual care. Feasibility was defined as ≥60% enrollment and ≥60% completing ≥3 sessions. Acceptability was assessed using the Client Satisfaction Questionnaire (CSQ; ≥3/4 mean benchmark). PRO measures of anxiety, depression (Hospital Anxiety and Depression Scale), posttraumatic stress (Post-Traumatic Stress Disorder Checklist-Civilian Version), QOL (Functional Assessment of Cancer Therapy-Bone Marrow Transplant), social support (Social Support and Effectiveness Questionnaire), and self-efficacy (Cancer Self-Efficacy Scale) were assessed pre-HSCT and at 30 and 60 days post-HSCT. Mixed-effects models explored preliminary effects. We enrolled 77% (90 of 117) of eligible patients (STEPP, n = 45; usual care, n = 45); 12 became ineligible due to HSCT cancellation or postponement. Among 78 active participants (mean age, 58.9 years [standard deviation, 12.3]; 57.7% women), all STEPP participants completed ≥3 sessions, and the mean CSQ score was 3.5. STEPP showed small-to-moderate improvements in day 30 anxiety (d = -0.36) and day 60 anxiety (d = -0.58), depression (d = -0.25), posttraumatic stress (d = -0.28), QOL (d = 0.48), social support (d = 0.36), and self-efficacy (d = 0.46). STEPP exceeds feasibility and acceptability thresholds, showing promising psychosocial benefits warranting a fully powered multisite efficacy trial. This trial was registered at www.clinicaltrials.gov as NCT06010017.
9 June 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Structured yoga program as supportive care to enhance quality of life in head and neck cancer patients undergoing radiotherapy: a prospective matched controlled study
PURPOSE: Head and neck cancer (HNC) patients undergoing radiotherapy often experience significant deterioration in quality of life (QoL) due to physical and psychological challenges. This study evaluates the effect of a structured yoga program-including physical postures, breathing exercises, and meditation-on QoL among these patients. METHODS: A prospective matched controlled nonrandomized study was conducted at a Tertiary Care Centre in North East India. Then, 140 patients undergoing definitive or adjuvant radiotherapy were equally divided into experimental (yoga intervention) and control groups. QoL was assessed using the EORTC QLQ-C30 questionnaire at baseline, end of treatment, and two months posttreatment. The yoga intervention consisted of thrice-weekly sessions for two months. All primary statistical analysis was done using nonparametric methods. RESULTS: Statistically significant improvement was seen in the experimental group in global health status/QoL (p-value < 0.001), pain (< 0.001), financial difficulties (< 0.001), emotional functioning (0.001), and fatigue aspect (0.024). CONCLUSION: A structured yoga program significantly improved key QoL domains in head and neck cancer patients receiving radiotherapy. Yoga can be considered an effective supportive therapy in this population.
30 May 2026
Read appraisal →BMJ open
Assessment of patient preferences in digital health trials: procedure development and implementation in a preference-based trial
OBJECTIVES: To develop and evaluate a standardised, fully automated assessment procedure for patient treatment preferences suitable for use in randomised controlled trials (RCTs) with remote or digital health interventions. DESIGN: Multiphase developmental study followed by implementation in a fully randomised preference trial (FRPT). SETTING: University and outpatient cancer care settings in Switzerland; implementation in RCTs with a remote digital health intervention. PARTICIPANTS: 50 medical students for pilot testing; 11 patients with cancer for qualitative testing; 124 adult patients with cancer experiencing fatigue or sleep problems in an FRPT with a remote digital health intervention. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome: feasibility and applicability of a standardised digital preference assessment procedure. SECONDARY OUTCOMES: distribution and strength of treatment preferences, reasons for preference. RESULTS: A procedure with three items for assessing treatment preferences was developed and refined based on pilot testing, stakeholder meetings and patient interviews. The stepwise procedure ensured that study participants with an initially unclear preference were finally able to report their preference. The majority of students (91.7%) indicated their preference already in the first assessment step. Similar in the RCT phase, 110 of 124 participants (88.7%) indicated their preference in the first step. Preference drivers included interest, perceived ease and conceptual appeal in addition to expected treatment benefits. CONCLUSIONS: Our fully automated standardised preference assessment with three items appears feasible in trials with digital health interventions. Future trials with two active treatment conditions should consider implementation of such a preference assessment to evaluate non-specific treatment effects driven by the match of patients' preferences with the respective treatment. TRIAL REGISTRATION NUMBERS: DRKS00035596; DRKS00035541; SNCTP000006209.
28 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Effectiveness of eHealth interventions in long-term follow-up care for breast and gynecological cancer survivors: a systematic review
PURPOSE: As survival rates for breast and gynecological cancers improve, many survivors experience persistent long-term challenges, including fatigue, psychological distress, and reduced health-related quality of life (HRQoL). eHealth interventions may offer a scalable and accessible approach to support survivorship care. This systematic review aimed to evaluate the effectiveness of eHealth interventions in long-term follow-up care for breast and gynecological cancer survivors. METHODS: A systematic literature search was conducted across six databases (PubMed, PsycINFO, Web of Science, Cochrane Library, MedRxiv, and PsyArXiv) for studies published between January 2010 and February 2026. Eligible studies included adult breast or gynecological cancer survivors and evaluated eHealth interventions in follow-up care compared with usual care. Outcomes included outcomes such as burden of treatment, HRQoL, self-management, hospital readmissions, complications, infections, fatigue, or malnutrition. Data were extracted, synthesized narratively, and methodological quality was assessed using established risk-of-bias tools. RESULTS: A total of 41 studies were included, predominantly involving breast cancer survivors, with very limited representation of gynecological cancer populations. Overall, methodological quality ranged from low to moderate, with higher risk of bias observed in nonrandomized studies. eHealth interventions were associated with small to moderate improvements in fatigue, anxiety, depression, HRQoL, and treatment adherence, particularly among breast cancer survivors. However, effect sizes were generally smaller in studies with lower risk of bias. Evidence for gynecological cancer survivors was scarce and inconclusive, with only one study exclusively focusing on this population. Long-term outcomes were rarely assessed, and no studies evaluated the defined outcomes infections, malnutrition and unplanned hospital admissions. CONCLUSIONS: eHealth interventions show potential to support long-term survivorship care, particularly in improving psychological outcomes and quality of life among breast cancer survivors. However, the overall evidence base is limited by methodological heterogeneity, short follow-up periods, and the underrepresentation of gynecological cancer populations. Further high-quality, long-term, and cancer-specific research is needed to better establish the effectiveness and generalizability of these interventions in survivorship care. IMPLICATIONS FOR CANCER SURVIVORS: As survivorship care needs continue to increase, eHealth interventions may contribute to more accessible, scalable, and patient-centered models of follow-up care. However, their long-term effectiveness and applicability across diverse cancer populations remain unclear. More rigorous, long-term, and cancer-specific research is required to better define their role in survivorship care.
27 May 2026
Read appraisal →PloS one
Timely Integration of specialist palliative care into oncology care for patients receiving radiotherapy for bone metastases: A study protocol for the TIPZO-RT Randomized Controlled Trial
BACKGROUND: Patients living with advanced cancer often benefit from palliative care. Timely referral to specialist palliative care improves quality of life and reduces potentially inappropriate end-of-life care. Despite these benefits, specialist palliative care is frequently introduced late and inconsistently. This study evaluates whether systematically offering a consultation with the hospital palliative care consultation team (PCCT) to all patients referred for radiotherapy for symptomatic bone metastases improves satisfaction with care. PATIENTS AND METHODS: The Timely Integration of Palliative Care in Oncology care for patients referred for palliative RadioTherapy (TIPZO-RT) trial follows the Trials within Cohorts design and is embedded within the PRospective Evaluation of interventional StudiEs on boNe meTastases (PRESENT+) cohort. Following cohort enrollment, 246 patients will be randomized (1:1) to either the intervention or control group. Patients in the intervention group are offered a PCCT consultation, which they may accept or refrain from. Patients in the control group are not informed about the trial and continue to receive usual care. After four weeks, patient satisfaction with care (affective behavior, EORTC Satisfaction with Cancer Care core questionnaire (EORTC PATSAT-C33)) will be compared between the groups. Secondary outcomes include symptom burden, quality of life, overall survival, and palliative care utilization. Additionally, in the intervention group, patients' experiences with the consultation are evaluated. DISCUSSION: Integrating palliative care into oncological care for patients with advanced cancer is essential to deliver comprehensive, patient-centered care that addresses physical, psychosocial and spiritual needs. This pragmatic study may provide evidence to support timely integration of specialist palliative care for all patients with bone metastases who may benefit from specialist palliative care. Using the Trials within Cohorts design, this study generates real-world evidence on the acceptance or need for a consultation with the PCCT, while minimizing disappointment or response bias, as patients in the control group are not informed. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT06805396. Registered on 25-03-2025.
24 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Factors associated with unplanned healthcare encounters in pediatric cancer patients.
INTRODUCTION: Pediatric cancer therapies can cause complications that drive unplanned healthcare encounters (e.g., emergency visits and unplanned admissions). Characterizing their frequency and risk factors is important for resource planning, family counseling, and targeted mitigation strategies. In a secondary analysis of data from a cluster-randomized controlled trial of symptom monitoring in pediatric cancer patients, the primary objective was to describe the characteristics of unplanned healthcare encounters. The secondary objective was to identify risk factors associated with unplanned healthcare encounters. METHODS: This was a sub-analysis of a cluster-randomized trial of 10 sites randomized to symptom screening and 10 sites randomized to usual care. We included English- or Spanish-speaking pediatric patients newly diagnosed with cancer who were 8-18 years of age receiving any cancer treatment. At symptom screening sites, enrolled participants were reminded to complete symptom screening with Symptom Screening in Pediatrics Tool (SSPedi), a validated symptom screening and assessment, three times weekly for 8 weeks. The healthcare team was notified for severely bothersome symptoms. Emergency department visits, and unplanned clinic visits and admissions were determined from families and charts. Encounter documentation was reviewed to determine if the unplanned encounter was related to SSPedi symptoms. RESULTS: Among the 444 participants from 20 participating sites, there were 652 unplanned encounters and the most common were emergency room visits (n = 269) followed by unplanned clinic visits (n = 143) and unplanned admissions (n = 240). Pain was the primary reason for emergency room visits (59, 13.3%), unplanned clinic visits (52, 11.7%), and unplanned admissions (19, 4.3%). Nausea/vomiting was the next most common symptom for emergency room visits (40, 9.0%), unplanned clinic visits (4, 0.9%), and unplanned admissions (14, 3.2%). In multivariable analysis, leukemia diagnosis (P = 0.0003), site randomization (P = 0.018), and increasing physician full-time equivalents per 100 new cancer diagnoses (P = 0.032) were associated with more unplanned encounters. CONCLUSIONS: Unplanned healthcare utilization is common among newly diagnosed pediatric cancer patients. The association between unplanned healthcare utilization and standardized symptom screening and increasing physical full-time equivalents warrant further investigation. Key aspects to the implementation of routine symptom screening among pediatric patients with cancer will be resource allocation to prevent and manage common symptoms including those that may lead to unplanned healthcare visits.
22 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Nutritional prehabilitation in patients with head and neck cancer: an evidence mapping analysis
BACKGROUND: Head and neck cancer patients are often at high risk of malnutrition due to the disease and its treatment, and pretreatment nutritional prehabilitation is an important strategy for improving prognosis; however, the existing evidence still needs to be systematically synthesized. PURPOSE: To systematically describe and evaluate the evidence related to pretreatment nutritional prehabilitation in patients with head and neck cancer through evidence mapping to provide a basis for clinical practice. METHODS: Computerized searches of CNKI, Wan-fang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, Embase, and CINAHL were performed from the time of database construction to May 2025, to include systematic review/meta-analysis of nutritional prehabilitation of patients with head and neck cancer, randomized controlled trials, and observational studies. The Risk of Bias Tool, Newcastle-Ottawa Scale (NOS), and AMSTAR-2 scale were used to evaluate the methodological quality of the included studies, respectively, and the current status of the studies was demonstrated using a combination of text and graphs. RESULT: Then, 6 systematic evaluations/meta-analyses, 13 randomized controlled trials, and 4 observational studies were finally included. The largest number of studies was published in China, and all study populations consisted exclusively of patients with head and neck cancer. Interventions include pretreatment immunonutritional interventions, nutritional risk screening-guided interventions, standard enteral nutritional support, disease-specific nutritional formula support, nutritional counseling, and pretreatment swallow training. The outcome indicators mainly focused on the patients' nutritional status, complication rates, length of hospital stay, body weight, and BMI, etc. However, the methodological quality of the included studies needs to be improved. The results of the studies all showed that nutritional prehabilitation benefits the prognosis of patients with head and neck cancer. CONCLUSION: Overall evidence suggests that nutritional prehabilitation can improve patients' nutritional status and enhance their prognosis and quality of life, showing beneficial effects. More high-quality, large-sample clinical studies should be conducted in the future to guide the clinical implementation of nutritional prehabilitation.
21 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Effects of activity pacing-related interventions on cancer-related fatigue and classification of behavior change techniques: A systematic review and meta-analysis
PURPOSE: Although physical activity is recommended for managing cancer-related fatigue (CRF), activity pacing (AP) and energy conservation are also implemented to balance activity and rest. This systematic review assessed the effectiveness of AP-related interventions and behavior change techniques (BCTs) employed in AP-related interventions for CRF management. METHODS: We searched PubMed, CINAHL, CENTRAL, and Ichu-shi databases for articles published up to February 28, 2026. After assessing the risk of bias, we performed meta-analyses for quantitative synthesis. We also identified and classified BCTs using data from the Behavior Change Technique Taxonomy version 1. RESULTS: Among the 1257 identified studies, 10 (7 randomized controlled trials [RCTs] and 3 non-RCTs) met the inclusion criteria. The effect size was small but not significant (standardized mean differences [SMD] = - 0.36; 95% confidence intervals [CI]: - 0.73 to 0.00; 5 studies; 617 participants), with substantial heterogeneity (I2 = 66%). Compared with controls, the intervention showed a moderate, statistically significant effect in the subgroup of patients undergoing chemotherapy (SMD = - 0.58; 95% CI: - 0.87 to - 0.29; three studies; 197 participants with breast cancer). The primary BCTs used in AP-related interventions were "goal setting," "social support," and "graded tasks." CONCLUSION: AP-related interventions may provide some benefit in improving CRF, particularly during chemotherapy. However, the certainty of the current evidence is extremely low. Although these interventions represent useful approaches, further RCTs are needed, and digitization of AP-related intervention programs incorporating effective BCTs may be beneficial.
17 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Acupuncture for chemotherapy-induced dysgeusia (AcuDysg): a randomized controlled trial
PURPOSE: The study investigated the effectiveness of dysgeusia-specific acupuncture combined with self-acupressure compared to supportive acupuncture and self-acupressure for chemotherapy-induced dysgeusia in cancer patients with cancer-related fatigue (CRF) and dysgeusia. METHODS: This multicenter, randomized, controlled, two-armed parallel-group, single-blind trial included cancer patients with CRF and dysgeusia during chemotherapy. All participants received CRF treatment consisting of eight acupuncture sessions over 8 weeks and had access to an eLearning course for self-acupressure. Patients in the intervention group received additional dysgeusia-specific acupuncture treatment and an eLearning with instructions to acupressure points, whereas the control group received an intervention focused solely on addressing CRF. The main outcome was perceived dysgeusia over 8 weeks, measured weekly after each acupuncture session on a numeric rating scale from 1 to 10. Other outcomes included taste and smell tests, and assessments of perceived dysgeusia, fatigue, distress, and quality of life. Due to a small sample size, results can be only judged exploratory. The study was approved by the Cantonal Ethics Committee (CEC) (Kanton Zürich Kantonale Ethikkommission) (approval no. KEK-ZH-Nr. 2020-01900). RESULTS: Since we included only twenty-one patients (11 intervention, 10 control, 90% female) instead of the target sample size of 130, no confirmatory effectiveness analyses were conducted. All participants showed a substantial decrease in dysgeusia over time, regardless of treatment type (estimated mean reduction per session - 0.30; 95% CI - 0.43 to - 0.18), reflecting a 0.30-point reduction per session. Quality of life and cancer-related fatigue improved over time. The exploratory analyses did not show substantial differences between groups in any outcomes. No serious adverse events occurred. CONCLUSIONS: Exploratory findings showed no substantial differences between the study groups in perceived dysgeusia, but both study groups improved over time. TRIAL REGISTRATION NUMBER: DRKS00023348 at 03.11.2020, SNCTP000004128.
14 May 2026
Read appraisal →The oncologist
Characterization and clinical management of adverse events following treatment with repotrectinib: a TRIDENT-1 analysis
BACKGROUND: Repotrectinib, a next-generation ROS1/TRK tyrosine kinase inhibitor, is approved for ROS1 fusion-positive non-small cell lung cancer and NTRK fusion-positive solid tumors. Its side effects and safety management strategies require further characterization. PATIENTS AND METHODS: The safety profile of repotrectinib (treatment-emergent/related adverse events [TEAEs/TRAEs]) was established in patients who initiated treatment at the recommended dose (160 mg daily [QD] for 14 days, then 160 mg twice daily [BID]) across all cohorts of the global, multicenter phase 1/2 TRIDENT-1 study. AE management strategies were outlined. RESULTS: In 472 patients, the most common TRAEs (dizziness [58%] and dysgeusia [50%]) were likely TRK inhibition-related. Median relative dose intensity was 90%; 14% (n = 66/472) of patients did not increase their initial QD dose to BID (mostly due to CNS AEs). Rates of dizziness (median onset, 7 days) were similar in patients with/without baseline brain metastases. Dose modifications downgraded severity or resolved dizziness in 78% of patients; 58% of patients had pharmacologic intervention without dose modification. Dizziness was downgraded/resolved in 62% (n = 120/195) of patients who did not receive dose modification or pharmacologic intervention. Treatment-related cognitive impairment and weight gain occurred in 19% and 12% of patients, respectively. Treatment-emergent withdrawal pain occurred in 14% of patients (median resolution time, 2.1 weeks). Dose interruption and reduction from TRAEs occurred in 39% and 38% of patients, respectively; 10% reported later re-escalation back to 160 mg BID. CONCLUSION: Many repotrectinib AEs, including neurological AEs secondary to TRK inhibition, were mitigated with appropriate management, including dose modification and/or pharmacologic intervention.
12 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
A Noddings' caring theory-based intervention to enhance coping with death competence in advanced lung cancer patients: a randomized controlled trial
PURPOSE: This randomized controlled trial aimed to evaluate the effects of a Noddings' caring theory-based intervention on coping with death competence (CDC), death attitudes, and psychological distress in patients with advanced lung cancer. METHODS: Seventy inpatients were randomly allocated to the intervention group (n = 35) or the control group (n = 35). The 3-week intervention comprised modeling, dialogue, practice, and recognition phases. Outcomes, including CDC, attitude toward death, anxiety, and depression, were assessed at baseline (T0), post-intervention (T1), and 1-month follow-up (T2). RESULTS: No significant between-group differences were observed at baseline. Following the intervention, patients in the intervention group demonstrated significantly higher CDC total and subscale scores, more positive death attitudes, and lower anxiety and depression scores than those in the control group at both post-intervention and 1-month follow-up. CONCLUSION: The Noddings-based program effectively enhanced death-coping competence, improved death attitudes, and reduced psychological distress in patients with advanced lung cancer. TRIAL REGISTRATION: ChiCTR2600118530, 2/6/2026 retrospectively registered.
12 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Impact of novel systemic cancer therapies on osseointegration and dental implant outcomes: a systematic review
PURPOSE: Advances in systemic cancer therapies such as immune checkpoint inhibitors (ICIs), tyrosine kinase inhibitors (TKIs), and anti-angiogenic agents have markedly improved survival in patients with solid and hematologic malignancies. As survivorship increases, oral rehabilitation with dental implants is increasingly sought to restore quality of life. However, these therapies may adversely affect bone healing, angiogenesis, and immune regulation, raising concerns regarding implant-related complications. This systematic review aimed to evaluate reported dental implant outcomes and complications in patients receiving novel systemic cancer therapies, emphasizing the implications for supportive oncology. METHODS: This review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251142681). PubMed/MEDLINE, Scopus, ScienceDirect, and the Cochrane Library were searched for English-language clinical reports describing dental implant outcomes in patients treated with ICIs, TKIs, or anti-angiogenic agents. Study selection, data extraction, and quality appraisal using the Joanna Briggs Institute checklist for case reports were performed independently by two reviewers. RESULTS: Seven case reports (2017-2024) were included, representing Level IV evidence. Two cases involving TKIs reported successful osseointegration and long-term survival. In contrast, five cases described adverse outcomes including early failure and MRONJ predominantly associated with anti-angiogenic agents, either alone or in combination with ICIs and antiresorptive agents. These complications often resulted in significant functional morbidity and the need for invasive surgical intervention. CONCLUSION: Based on limited case report evidence, anti-angiogenic therapies were more frequently observed in cases with adverse outcomes, including implant-related MRONJ and failure, while TKIs were associated with favorable outcomes in limited cases. The role of ICIs remains unclear due to sparse data, particularly regarding monotherapy effects. Given the preliminary nature of current evidence derived from case reports, prospective studies with appropriate control groups are urgently needed to establish evidence-based guidelines. PROSPERO NUMBER AND DATE OF REGISTRATION: CRD420251142681; 08/09/2025.
12 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Night-time compression with a Mobiderm® auto-adjustable arm-sleeve in addition to daytime compression was superior to daytime compression alone for maintenance therapy of upper limb lymphedema in breast cancer patients in a randomized controlled trial: LYMphoNIGHT study.
PURPOSE: To assess the benefit of night-time compression in addition to daytime compression on arm excess volume after 3 months of maintenance treatment in patients with secondary upper limb breast cancer-related lymphedema (BCRL). METHODS: This multicenter, controlled, randomized study was carried out in six centers in France and Turkey. Women with upper limb BCRL who had undergone the intensive phase of decongestive lymphedema therapy (DLT) were randomized into two groups: the Control group wore a daytime compression sleeve without any night compression for 3 months and the MOBIDERM Autofit (MobA) group used a night-time compression sleeve in addition to the daytime compression. The primary outcome was the change in arm excess volume between day 0 (D0) and D90. The main secondary endpoints were: quality of life (QoL), sleep quality, skin thickness and suppleness, satisfaction, compliance, and safety. RESULTS: Fifty-six patients were recruited (mean (± SD) age: 61.4 ± 12.3 years). Between D0 and D90, the mean excess volume decreased by 29.2% in the MobA group and increased by 10.7% in the Control group (p = 0.001). Only 3.6% of patients in the MobA group presented with treatment failure vs. 23.1% in the Control group. At D90, patients in the MobA group had a significantly greater improvement in QoL (p < 0.05), sleep quality (p = 0.018), skin suppleness (p = 0.01) reduced skin thickness (p = 0.025) compared with the Control group. CONCLUSION: MOBIDERM Autofit used in addition to daytime compression for 3 months during the maintenance phase after DLT was superior to daytime compression alone for the reduction of arm excess volume. Registered on ClinicalTrials.gov (NCT04203069; 17/12/2019).
11 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Telemedicine adoption, pandemic-related fear, and treatment adherence in cancer care during COVID-19: a prospective cohort study
PURPOSE: To evaluate the impact of telemedicine adoption and pandemic-related fear on treatment adherence, healthcare utilization, and supportive care processes among patients undergoing cancer therapy during the COVID-19 pandemic. METHODS: In this prospective cohort study, we followed 149 cancer patients over two years to evaluate telemedicine utilization, treatment modifications, and COVID-19-related fear. We employed validated psychometric tools, including the COVID-19 Fear Scale. RESULTS: Telemedicine adoption (24.8% of patients) was associated with fewer hospital visits (7.3 ± 3.2 vs 9.4 ± 4.1, p = 0.004) and reduced emergency room utilization (16.2% vs 46.4%, p < 0.001). Treatment modifications occurred in 55.9% of patients, predicted by COVID-19 infection (OR = 2.8, 95% CI:1.7-4.6) and neutropenia (OR = 2.1, 95% CI:1.3-3.4). High fear scores were linked to increased mortality (8.1% vs 2.7%, p = 0.032), disease progression (37.8% vs 21.4%, p = 0.018), lower treatment adherence (75.7% vs 87.5%, p = 0.041), and higher hospitalization rates (51.3% vs 24.1%, p < 0.001). CONCLUSION: This study demonstrates that telemedicine can reduce acute care utilization while treatment modifications and high pandemic-related fear significantly worsen cancer outcomes. These findings highlight the need for oncology teams to proactively integrate remote care strategies and targeted psychological support to maintain treatment adherence and mitigate adverse outcomes during health crises.
10 May 2026
Read appraisal →European journal of cancer (Oxford, England : 1990)
Sex differences in efficacy and toxicity of first-line treatment of metastatic colorectal cancer: An analysis of 18,041 patients in the ARCAD CRC database.
BACKGROUND: Greater toxicity of adjuvant chemotherapy in females has been reported previously, but the impact of patients' sex on chemotherapy (CT)+/-targeted therapies for non-resectable, metastatic colorectal cancer (mCRC) has remained unclear. We compared efficacy and toxicity of first-line chemotherapy, with or without targeted therapies, between male and female mCRC patients. METHODS: Twenty-seven randomized trials from the ARCAD CRC database were included. Primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS), overall response rate, toxicity (according to NCI-CTCAE). Analyses were performed within three treatment groups: A) CT alone, B) CT+bevacizumab, and C) CT+epidermal growth factor receptor inhibitor. OS and PFS were estimated using Kaplan-Meier method. Associations with sex were assessed using study-stratified Cox models adjusted for age, performance status, body mass index, and CT backbone. RESULTS: Baseline data from 18,041 patients were analysed; among 15,271 included in outcome analyses, no sex differences in OS or PFS were observed. Adjusted OS hazard ratios (95% confidence interval) for females versus (vs.) males were: A: 1.01 (0.95-1.08, P = .69), B: 0.96 (0.89-1.04, P = .36), C: 0.97 (0.87-1.10, P = .67). Females experienced higher toxicity, including grade 1-4 and 3-4 nausea (71.8% vs. 60.5% and 7.5% vs. 4.8%), vomiting (47.7% vs. 35.5% and 6.6% vs. 4.4%), and neutropenia (52.4% vs. 44.4% and 29.2% vs. 18.8%) (P < .001). Conversely, rash (grade 1-4 and 3-4) was more frequent in males (29.6% vs. 24.3% and 5.1% vs. 3.7%, P < .001). CONCLUSIONS: Despite higher chemotherapy-related toxicity in females, treatment efficacy was similar between sexes. Rash was more common in males, highlighting that patients' sex modulates toxicity profiles in both directions. Strategies to reduce adverse events in female patients are warranted.
10 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Prevalence of antibody drug conjugated-induced nausea and vomiting (ADCINV) in patients with cancer
INTRODUCTION: Antibody-drug conjugates (ADC) have emerged as an important part of systemic treatment across disease sites. To date, there is no robust pooled prevalence estimate of nausea and vomiting induced by ADCs. Establishing such estimates is essential to determine if ADC-induced nausea and vomiting (ADCINV) represents a clinically significant problem warranting further research into antiemetic prophylaxis. Our aim is to report the prevalence of reported ADCINV across literature. METHODS: A systematic search of Medline, Embase, Cochrane CENTRAL and Web of Science was conducted from database inception until September 24, 2025. Articles were included if they reported nausea and/or vomiting due to ADCs used in cancer treatment, in the abstract. Pooled prevalence was reported. Subgroup analysis was conducted by ADC. Meta-regression was conducted by age and sex. Quality assessment was conducted. Type I error was set at 0.05. RESULTS: A total of 209 studies with 15,493 patients were included. Thirty-nine percent (95%CI, 36-42%) of patients experience any nausea, and 26% (95%CI, 23-29%) experience any vomiting. Younger patients are more likely to experience nausea; each 10-year increase in age is associated with a 12% decrease in nausea rates. Higher emetogenic ADCs include trastuzumab deruxtecan, sacituzumab govitecan, brentuximabvedotin and patritumab deruxtecan. Lower emetogenic agents include disitimab vedotin, telisotuzumab vedotin and rovalpituzumab tesirine. DISCUSSION: This is the first study to report prevalence of ADCINV across ADCs. It is a prevalent adverse effect akin to chemotherapy-induced nausea and vomiting that should be viewed as clinically relevant and further investigated to help develop optimal strategies related to antiemetics.
10 May 2026
Read appraisal →BMJ supportive & palliative care
Hand-foot syndrome prevention: pharmacological interventions-systematic review and network meta-analysis
INTRODUCTION: Hand-foot syndrome (HFS) is a dermatological side effect of chemotherapies such as capecitabine and pegylated liposomal doxorubicin. Over recent years, numerous randomised controlled trials (RCTs) have investigated various pharmacological strategies to prevent HFS. Although urea cream and celecoxib have shown promising results, the efficacy of topical diclofenac remains unclear. To provide a comprehensive comparison of pharmacological interventions for HFS prevention in cancer patients undergoing chemotherapy, we conducted a network meta-analysis (NMA). METHODS: We systematically searched PubMed, Cochrane and Scopus for relevant RCTs published up to November 2024. The primary outcome was the incidence of moderate to severe HFS (grade 2-3), while secondary outcomes included the occurrence of all-grade HFS (grade≥1) and chemotherapy modifications. Risk ratios (RR) with 95% CIs were estimated for all outcomes using NMA. RESULTS: Thirteen RCTs comprising 1983 patients, most of whom received capecitabine (n=1849) were included, evaluating five pharmacological interventions. Both topical diclofenac (RR 0.26, 95% CI 0.10 to 0.66) and celecoxib (RR 0.46, 95% CI 0.26 to 0.84) significantly reduced the risk of moderate to severe HFS compared with placebo. Notably, topical diclofenac was the only intervention that significantly reduced the incidence of all-grade HFS and the need for chemotherapy modifications. CONCLUSION: Our NMA demonstrates that topical diclofenac provides the most robust protective effect among available pharmacological interventions for HFS prevention and is also associated with fewer chemotherapy modifications. These findings support its consideration as a preferred preventative strategy for patients at risk of HFS during chemotherapy. PROSPERO REGISTRATION NUMBER: CRD42025643635.
3 May 2026
Read appraisal →BMJ supportive & palliative care
Memantine efficacy in chemotherapy-induced peripheral neuropathy: double-blind placebo-controlled randomised clinical trial
BACKGROUND AND AIMS: Chemotherapy-induced peripheral neuropathy (CIPN) is a detrimental side effect of chemotherapeutic agents. If left untreated, CIPN can persist for several years following the chemotherapy. CIPN management may enhance the quality of life of the affected patients. This study evaluated the efficacy of memantine, an antagonist of N-methyl-D-aspartate, in CIPN management. METHODS: This double-blinded randomised clinical trial was performed on 176 individuals with CIPN. Patients were randomised to either the memantine or placebo groups (88 in each). The memantine group received a single daily dose of 5 mg for the initial 3 days. Subsequently, the dosage was increased to 20 mg per day, with 5 mg increments every 3 days. The placebo group received tablets of equal shape and size. All individuals received medications for 8 weeks. The McGill pain questionnaire and tuning fork test were used to evaluate the severity of neuropathic pain in patients, both at baseline and after the intervention ended. RESULTS: Based on tuning fork test results, significant improvement in neuropathy was observed among patients who received memantine compared with those who received placebo (p<0.001 vs 0.665). McGill pain questionnaire score revealed a significant difference between memantine and placebo groups (p<0.001 for both groups). This difference was also significant after performing intention-to-treat analysis. Moreover, a higher proportion of patients in the memantine group achieved minimal clinically important difference. CONCLUSION: The use of memantine mitigated the CIPN intensity. Thus, it appears that memantine is a promising option for the management of patients experiencing CIPN.
3 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Conducting a randomized controlled clinical trial on palliative care in patients with glioblastoma - what are the challenges?
PURPOSE: Patients with glioblastoma represent a highly vulnerable cohort as they often experience rapid health deterioration with severe symptom burden including neurological, (neuro)psychological, and psychiatric symptoms. The aim of this sub-analysis of the "Early Palliative Care for Patients with Glioblastoma" (EPCOG) trial was to investigate the specific challenges of conducting a multicenter, randomized, controlled, clinical trial in glioblastoma patients testing a specialized palliative care (PC) intervention. METHODS: We analyzed screening protocols and protocol deviations with respect to number and reasons for non-participation, skipped/delayed visits and attrition using descriptive statistics and content analysis of free-text comments. RESULTS: In total, 41.5% of 556 screened patients were enrolled. Main reasons for non-participation were lack of interest (25.7%) and low functional status (11.5%). Attrition due to death (57.6%) was higher than due to illness (5.2%) or other reasons (21.2%). Main reasons for visit deviations were structural issues (in > 50% of neurosurgical visits), health status, and patient request. Protocol deviations showed that specialized PC intervention visits were least frequently skipped (4.5%) compared to study-specific outcome assessment (10.1%) and neurosurgical (43.3%) visits. Further, only 11.0% of the specialized PC intervention visits were delayed compared to 22.3% of the outcome assessment and 56.4% of the neurosurgical visits. CONCLUSION: In this clinical trial involving glioblastoma patients, a high level of motivation among the study participants could be reached, as reflected by low protocol deviations during the specialized PC intervention and study-specific outcome assessment visits. Reasons for this might be a close guidance as well as a patient and caregiver-oriented communication, e.g., by a personal contact of the PC team in the intervention group, personal outcome assessment visits at patients' whereabouts, or the inclusion of a study nurse at each site. Considering the high vulnerability of glioblastoma patients is crucial when designing and conducting clinical trials.
2 May 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Implementing an electronic health record workflow to identify parents with cancer and implications for supportive oncology care
PURPOSE: Parents with cancer face unique psychosocial challenges as they navigate treatment while caring for dependent children, yet parenthood status is rarely captured in oncology workflows. This initiative evaluated the feasibility and outcomes of a new electronic health record (EHR)-based workflow to systematically identify parents with cancer and then connect them to family-focused assessment and supportive care. METHODS: A two-phase quality improvement initiative was conducted at an NCI-designated comprehensive cancer center. Phase 1 included process mapping, analysis of tumor registry and distress screening data, and development of an EHR screening item assessing parenting status. Phase 2 implemented the item ("Patient is a parent/caregiver with child/ren < 22 years of age?") into oncology workflows, linking identified parents to a new supportive care program, Family Circle, which includes psychosocial assessment, navigation, and family-centered support. Training for oncology clinicians included in-service education. Analyses examined prevalence estimates and associations between parenting, distress, anxiety, and depression and reports of quality improvement metrics. RESULTS: Among N = 2,172 screened patients, 20.6% identified as parents; the age-adjusted prevalence of parenting with children under 21 was 16.9%, consistent with national estimates. Parents reported significantly higher distress (odds ratio [OR] = 1.35, 95% confidence interval [CI] = 1.11-1.64, p = 0.003) and anxiety (OR = 1.28, 95% CI = 1.06-1.52, p = 0.009) than matched non-parents. Parents with younger children exhibited greater anxiety than those with older children (F = 4.32, df = 2, 393, p = .01). During implementation, N = 431 parents were identified in 6 months (79.4% through the EHR item). CONCLUSION: Embedding parenting status screening into the EHR is feasible, accurate, and critical for linking parents with cancer to supportive care. Wider implementation of such workflows may enhance psychosocial oncology practice and improve cancer parenting outcomes.
24 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Artificial intelligence in cancer survivorship: evaluating ChatGPT's performance in rehabilitation-related queries
PURPOSE: This study aimed to evaluate the performance of ChatGPT in responding to patient-centered queries related to cancer rehabilitation. It examined the accuracy, completeness, and overall quality of ChatGPT's responses across major domains of cancer rehabilitation from a physical therapy perspective. METHODS: Fifteen representative patient queries covering eight domains of cancer rehabilitation-including general exercise, fatigue, bone metastasis, neuropathy, balance and falls, breast cancer, women's health, and pediatric cancer-were developed by two licensed physical therapists. Each query was input into ChatGPT-4, and responses were independently evaluated for accuracy, completeness, and global quality based on established clinical practice guidelines and expert consensus. RESULTS: ChatGPT demonstrated a mean accuracy score of 3.93 (SD = 1.10) on a 5-point scale, a mean completeness score of 2.13 (SD = 0.83) on a 3-point scale, and a mean global quality score of 3.60 (SD = 1.12) on a 5-point scale. Responses were generally accurate and clinically relevant but often lacked details regarding exercise dosage, safety precautions, and guideline-concordant recommendations. CONCLUSION: ChatGPT shows potential as an accessible tool for general cancer rehabilitation education but requires refinement to ensure accuracy, contextual relevance, and safety. IMPLICATIONS FOR CANCER SURVIVORS: AI-driven conversational models may improve patient access to rehabilitation information and self-management support when used under professional oversight and guided by evidence-based frameworks.
19 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
The effectiveness of electroacupuncture in the treatment of cancer-related fatigue: a systematic review
INTRODUCTION: Cancer-related fatigue (CRF) is a frequent, subjective, and difficult-to-manage symptom, for which few interventions have proven effective. Recent evidence suggests that electroacupuncture (EA) can reduce fatigue, although specific studies on this technique remain scarce. OBJECTIVE: To evaluate the efficacy of EA in treating CRF in cancer patients. METHODS: A systematic review registered in PROSPERO was conducted, including clinical trials assessing the effects of EA in patients with CRF. Searches were performed in the PubMed, Embase, Virtual Health Library, Scopus, and CAPES databases, with no restrictions on date, language, sex, ethnicity, or type of cancer. We assessed the methodological quality using the PEDro scale and evaluated the risk of bias using the RoB-2 tool. RESULTS: A total of 2,110 studies were identified. After applying inclusion criteria, five trials were included: three randomized, one non-randomized, and one single-arm clinical trial. In total, 251 patients were analyzed, 132 of whom received EA treatment. Interventions varied from two to three weekly sessions, each lasting 20 to 30 minutes, over a period of four to eight weeks. Acupuncture points and electrical frequencies (0.2-25 Hz) differed between studies. Outcomes were measured by the Brief Fatigue Inventory, Functional Assessment of Cancer Therapy - Fatigue, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Despite the potential benefits observed in EA-treated groups, the findings remain inconsistent. CONCLUSION: EA shows promising therapeutic potential for managing CRF. However, the small number of studies, methodological heterogeneity, and small sample sizes limit generalizability. Multicenter clinical trials with larger samples and standardized protocols are needed to confirm efficacy.
16 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Mepitel Film versus StrataXRT for the prevention of radiation dermatitis in post-mastectomy radiotherapy: a systematic review and meta-analysis of randomized controlled trials
BACKGROUND: Radiation dermatitis (RD) affects up to 90% of patients receiving post-mastectomy radiotherapy, with moist desquamation causing significant morbidity. Barrier films and dressings such as Mepitel Film and StrataXRT have been shown to be effective compared to moisturizers, but their relative effectiveness remains debated. This systematic review and meta-analysis compares these interventions for preventing RD. METHODS: Following PRISMA guidelines, we systematically searched MEDLINE, Embase, and Cochrane Library through March 14, 2026. An additional grey literature search was performed in clinicaltrials.gov and Google Scholar. Eligible studies were RCTs directly comparing StrataXRT and Mepitel Film in breast cancer patients receiving adjuvant radiation therapy. Two reviewers independently screened studies, extracted data, and assessed risk of bias using RoB 2.0 and certainty of evidence with the GRADE appraoch. Meta-analysis used random-effects models to pool risk ratios (RR) for moist desquamation, and incidence of grade 2 and 3 RD, with I2 statistics quantifying heterogeneity. RESULTS: From 33 screened records, two intra-patient, non-inferiority RCTs (n = 120) met inclusion criteria. Both studies randomized medial/lateral chest wall halves to each intervention in post-mastectomy patients. Pooled analysis revealed no significant difference in moist desquamation incidence between StrataXRT (21.7%) and Mepitel Film (20.0%) (RR 1.03; 95% CI 0.52-2.04; P = 0.93), with low heterogeneity (I2 = 35%). Secondary outcomes showed Mepitel Film significantly reduced grade 2 or 3 RD (RR 1.34, 95% CI 1.10-1.64, P = 0.004). However, Mepitel Film trended toward higher incidence of itchiness (10.8% vs. 5.0%, P = 0.11). Patient preference data were conflicting, with one trial favoring StrataXRT for ease of use and the other showing no clear preference. CONCLUSION: While StrataXRT and Mepitel Film demonstrated similar efficacy for preventing moist desquamation, Mepitel Film offered superior protection against grade 2 to 3 RD. However, this conclusion should be interpreted with caution given the underlying methodological limitations of the included studies, including small and potentially underpowered sample sizes, and variations in radiation fractionation schedules and RT techniques.
15 Apr 2026
Read appraisal →PloS one
Development and evaluation of a multimodal feature-based predictive model for radiotherapy-induced oral mucositis in nasopharyngeal carcinoma
BACKGROUND: Accurate prediction of radiation-induced oral mucositis is crucial for personalized treatment in head and neck cancer. However, developing robust predictive models utilizing high-dimensional multimodal data (CT imaging, dose distribution, and clinical features) remains challenging, particularly in cohorts with limited sample sizes. OBJECTIVE: This study aimed to rigorously evaluate and compare the multi-class predictive performance of traditional machine learning algorithms and deep learning architectures under a small-cohort setting. METHODS: Multimodal data from 108 patients were collected. A comprehensive evaluation framework incorporating nine traditional machine learning algorithms and two deep learning models (a dimensionality-reduced 1D-CNN and a multimodal 3D-CNN) was established. To ensure robust evaluation, a stratified 5-fold cross-validation was employed. Model performance was comprehensively quantified using mean ± standard deviation (SD) across multiple metrics, including the Area Under the Curve (AUC), accuracy, and Matthews Correlation Coefficient (MCC). RESULTS: Inter-rater reliability for RIOM grading was excellent (Cohen's kappa = 0.82, 95% CI: 0.73-0.91). Among traditional machine learning approaches, the Extra Trees (ET) algorithm achieved the highest discriminative capacity (AUC: 0.956 ± 0.046), while Logistic Regression (LR) demonstrated optimal overall accuracy (0.832 ± 0.155) and stability. Regarding deep learning, the lightweight 1D-CNN utilizing fused low-dimensional features exhibited highly competitive and robust performance (AUC: 0.900 ± 0.072; Accuracy: 0.732 ± 0.140). In stark contrast, the high-dimensional multimodal 3D-CNN suffered from severe overfitting and mode collapse phenomenon, yielding significantly inferior results (AUC: 0.568 ± 0.090; MCC: -0.025 ± 0.031). CONCLUSIONS: For small-cohort radiomics and dosimetric analyses, ensemble learning models (e.g., ET) and appropriately regularized linear models (e.g., LR) remain highly effective. While deep learning holds promise, high-dimensional architectures like 3D-CNNs are highly susceptible to mode collapse without massive datasets. Instead, employing feature dimensionality reduction combined with lightweight networks (1D-CNN) is a vastly superior strategy to extract reliable predictive patterns from limited clinical data.
10 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
A trifold prehabilitation model prior to induction chemotherapy in patients with leukemia: a randomized controlled trial
PURPOSE: A trifold prehabilitation program that integrates exercise, nutritional support, and psychological care has not yet been incorporated into routine care for leukemia patients prior to induction chemotherapy. This study aimed to evaluate the safety and feasibility of this trifold intervention and to further examine its potential impact on physical fitness, nutritional risk, and psychological health. METHODS: In a single-blind, parallel-group randomized trial, 86 newly diagnosed leukemia patients at a tertiary hospital in China were randomly assigned to a 12-week prehabilitation group (n = 43) or usual care (n = 43). Primary outcomes were recruitment, attrition, and safety. Secondary outcomes included the 6-min walk test (6MWT), exercise self-efficacy, cancer-related fatigue (CRF), anxiety, depression, and nutrition. Assessments occurred at baseline (T0), pre-chemotherapy (T1), and 1 (T2) and 3 months (T3) post-chemotherapy. RESULTS: The recruitment rate was 60.14%, with an attrition rate of 20.93%, and no serious adverse events occurred. Compared with controls, the intervention group showed significantly greater improvements in 6-min walk distance and cancer-related fatigue from T1 to T3 (all p < 0.05). Improvements in exercise self-efficacy were significant at T2 and T3 but not at T1. Nutritional status improved at T3 (p = 0.033). Anxiety and depression levels were consistently lower across all follow-up points (p < 0.01). CONCLUSIONS: This study demonstrates that prehabilitation is safe, feasible, and potentially beneficial for physical, nutritional, and psychological outcomes in leukemia patients. TRIAL REGISTRATION: China Clinical Trials Registration Platform: ChiCTR2500105061, date of registration: June 27, 2025 (retrospectively registered).
10 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Transitioning to adolescent and young adult or adult cancer survivorship care: A systematic review of contemporary guidelines and trials
BACKGROUND: Health service transitions of child, adolescent, and young adult cancer survivors between paediatric and adult cancer care services are pervasively fragmented, resulting in poor coordination, reduced satisfaction, and adverse outcomes for cancer survivors and significant others (e.g., caregivers and family members). Numerous trials and clinical guidelines have been developed to support care transitions, but their convergence, divergence, and methodological quality remain unclear. To advance clinical practice and quality research about care transitions, a synthesis of trials and guidelines on child, adolescent, and young adult care transition across age-appropriate cancer services is required to inform future research, practice, guideline, and policy development. METHODS: A systematic review (CRD420251029796) was conducted. Studies were identified from searches of six bibliographic databases, four trial registers, and grey literature. Inclusion criteria focused on clinical guidelines or trials published between January 2020 and April 2025 that addressed age-related transitional cancer care. RESULTS: A total of 3706 records were identified. After screening, 18 records met the inclusion criteria: 10 clinical guidelines, 4 completed trials, and 4 ongoing trials with registrations. While general recommendations between guidelines were consistent, they diverged in detail relating to their local contexts. Only two ongoing trials, and no completed studies, included independent control groups. CONCLUSION: Completed trials were limited and highly variable in approach, components, and outcome measures, suggesting regionally specific guidelines enhance relevance, applicability, and transition practices. Future research should develop core outcome sets for care transition trials to facilitate comparison of outcomes and should develop robust study designs, including control groups.
9 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Real-world incidence of nausea and vomiting induced by antineoplastic agents: insights and future directions from the Japanese adverse drug event report database
PURPOSE: Antineoplastic treatment commonly leads to nausea and vomiting (NV), which considerably affects the quality of life and adherence to therapy of patients. This study aimed to analyze the incidence of NV induced by antineoplastic agents using the Japanese Adverse Drug Event Report (JADER) database and to explore novel antiemetic therapies for oral antineoplastic agents. METHODS: Data from April 2004 to March 2023 were extracted from the JADER database. The analysis considered guideline-recommended antiemetics and involved the temporal evaluation of cases with NV. The onset patterns of NV were analyzed for each oral antineoplastic agent. The reported odds ratio was used to identify adjunctive medications that showed inverse associations with these symptoms. RESULTS: A large number of NV cases were reported for platinum compounds and irinotecan. Among the oral agents, a notable incidence of NV was induced by antimetabolites and tyrosine kinase inhibitors. A decreasing trend in the use of single-agent antiemetic therapy was observed from 2010. Distinct NV patterns were identified. Silodosin and meropenem emerged as potential adjunct therapies to suppress NV induced by oral agents. CONCLUSION: Although there is a trend toward improvement in NV management with increased adherence to antiemetic therapies, a substantial gap remains between guidelines and actual practice. The need for tailored management strategies based on the onset patterns of NV for specific agents has been emphasized. Investigating the mechanisms underlying the antiemetic effects of adjunctive therapies, such as silodosin and meropenem, may pave the way for new antiemetic options for oral antineoplastic agents.
9 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
User experiences of digital health interventions among older adults with cancer: a systematic review of qualitative data
PURPOSE: The aim of this review was to synthesize and analyze the results of several qualitative studies to understand the perceptions of older adults with cancer using digital health interventions to manage cancer in a digital context. METHODS: Six databases were systematically queried to identify qualitative studies of digital health interventions in older cancer populations, published from the inception of the databases until December 10, 2024. Studies that met the inclusion and exclusion criteria were selected, and the quality of the literature was assessed according to established guidelines. The results were synthesized using a thematic synthesis approach. RESULTS: A total of 12 papers were included. Three analytic themes emerged, (1) positive experiences, (2) barriers to use, (3) user expectations. The first theme was with three descriptive themes, including "improved self-management," "safe and accessible support," and "better access to health information"; the second theme with three descriptive themes, including "inadequate content design," "technical difficulties," and negative user perceptions and behaviors"; the third theme with two descriptive themes: "enhanced functionality" and "optimized user experience." CONCLUSIONS: This study found that older adults with cancer recognize the benefits of digital health Interventions in improving their health. However, their experiences are influenced by various factors. Patients expressed diverse needs regarding the functionality, information support, and social support aspects of digital health interventions.
6 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
A systematic review of the implementation of cancer-specific holistic needs assessment (HNA) in adult clinical practice, and applicability to the brain tumour population
PURPOSE: This review aimed to identify and review any brain tumour-specific holistic needs assessment (HNA) and the clinical implementation of any HNAs in an adult cancer population. METHODS: A systematic review and narrative synthesis. Five electronic databases were searched from 2008 to 2023 and updated in January 2025. Reference lists of systematic reviews were screened for relevant studies. Two independent reviewers performed study selection, critical appraisal, and data extraction. RESULTS: Four HNA tools implemented in clinical practice, across 9 studies, were included. One study was adapted for brain tumour patients. Evidence of widespread implementation in clinical practice was limited and varied evidence, relating to the timing, location and mode of delivering. Patients were more likely to report on physical rather than psychosocial needs, with limited evidence of patient and staff satisfaction with the use of HNA. CONCLUSION: There is limited and varied evidence of HNAs being successfully implemented in brain tumour and the wider cancer healthcare settings. Tailored interventions for the needs of people with brain tumour have the potential to address the complexities this population faces. However, clear evidence-based guidance to develop relevant HNAs for successful implementation in clinical settings is needed.
4 Apr 2026
Read appraisal →Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Preventive effects of dexamethasone oral solution on radiation-induced mucositis in patients with head and neck cancer: a randomized, triple-blind, parallel-group trial
PURPOSE: Radiation-induced oral mucositis is a frequent and debilitating complication of curative radiotherapy for head and neck cancer. This randomized, triple-blind, placebo-controlled, parallel-group trial evaluated whether a topical dexamethasone oral solution (0.5 mg/10 mL) used as a prophylactic mouthwash reduces the incidence and severity of radiation-induced oral mucositis. METHODS: Fifty-four patients with non-metastatic head and neck squamous cell carcinoma scheduled to receive ≥ 60 Gy radiotherapy were randomized 1:1 to dexamethasone mouthwash or placebo and instructed to gargle 10 mL four times daily during radiotherapy. The primary endpoint was the incidence and maximum severity of oral mucositis occurring during radiotherapy, defined as the highest grade recorded using the WHO Oral Toxicity Scale and NCI-CTCAE criteria v. 5. Secondary endpoints included patient-reported pain (VAS), dysphagia, treatment discontinuation, and mucositis status at 2 months. Fifty patients completed the study (25 per arm); four patients discontinued (reasons reported in Results). RESULTS: The dexamethasone group had significantly lower mucositis severity at all time points by WHO and CTCAE scales (all p < 0.01), a delayed peak severity (week 5 vs week 3), lower pain scores from weeks 4-7 (median VAS 0-3 versus 4-6; p < 0.01), and lower dysphagia at 2 months (32% vs 72%; p = 0.01). No grade 4 mucositis occurred in the dexamethasone arm; two grade 4 events occurred in placebo. There were no statistically significant differences in treatment discontinuation. Topical dexamethasone was well tolerated; no signal of treatment-related systemic steroid toxicity or increased oral infections was observed. CONCLUSION: In this phase II study, prophylactic topical dexamethasone mouthwash reduced the severity and delayed the onset of radiation-induced oral mucositis and improved patient-reported pain. These findings are promising but require confirmation in larger multicenter trials with longer follow-up and formal patient-reported outcomes (e.g., EORTC QLQ-H&N35, OMAS) and comparison with guideline-recommended strategies such as photobiomodulation. TRIAL REGISTRATION NUMBER: Iranian Registry of Clinical Trials; trial registration number: IRCT20240525061893N1; date of registration: 21 July 2024.
4 Apr 2026
Read appraisal →