Oncology

Framework to define estimands and handle PRO missingness from progression in oncology trials

Defines a practical framework to specify estimands for longitudinal PRO endpoints when disease progression causes missing data. Compares hypothetical versus treatment-policy strategies and shows implementations: multiple imputation, joint modelling, and control-based imputation. Recommends supplementary analyses to assess robustness and improve interpretability of QoL treatment effects despite ICEs. Applicability is to oncology trials with PROs and progression-related missingness; choose method consistent with the estimand. 1

Real-world immunotherapy linked to longer survival than chemotherapy in advanced NSCLC

In 684 Greek patients with advanced NSCLC, immunotherapy (±chemotherapy) was associated with longer OS than chemotherapy alone (17.5 vs. 8.6 months; HR 0.51). Benefit persisted in landmark analyses and was independent in multivariable models (adjusted HR 0.50). Time to next treatment was longer with immunotherapy in first and second lines (TTNT1 10.0 vs. 6.8 months). Interpretation limited by incomplete molecular and PD-L1 testing across the cohort. 2

Community health worker–led education increases precision medicine knowledge and testing

In a randomized trial of 110 low-income, diverse oncology patients, adding a 12-month CHW education intervention improved precision-medicine knowledge (mean difference 4.17, p<0.001). Intervention participants had higher activation and satisfaction and received more molecular testing and targeted therapy than controls. They also had fewer emergency department visits and hospitalizations during follow-up. Findings support patient-level education to reduce care delivery gaps in community oncology settings. 3