2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T773,Failure to complete cancer treatment is associated with worse oncologic outcomes. This 2-year prospective National Quality Improvement (QI) Collaborative aimed to decrease patient- and program-level rates of missed radiotherapy appointments by 20% at American College of Surgeons (ACS)-accredited cancer programs. One hundred ninety-four accredited cancer programs scheduled 99,057 patients for radiotherapy while voluntarily participating in the ACS Breaking Barriers National QI Collaborative from March 2023 to December 2024. Programs identified patients who missed 3 or more planned radiotherapy treatments, completed community needs assessments, engaged in educational webinars and peer learning discussions, and implemented system-level strategies to improve treatment adherence using an ACS toolkit. Chi-square tests assessed differences in rates of missed radiotherapy treatments, barriers addressed, and interventions implemented. Reductions of 39.8% (from 8.3% to 5.0%) and 31.7% (from 8.2% to 5.6%) were seen in no-show rates at the patient and program levels, respectively. Reductions were demonstrated for all program types, for most census regions, and for breast, gynecologic, and gastrointestinal cancers. The most frequently addressed barriers were transportation (62.3%) and patient illness unrelated to toxicity (37.1%). The most frequently implemented interventions included the development of a workflow and/or protocol related to identified barriers (68.9%) and the creation of internal resources to address these barriers (54.3%). Breaking Barriers is the largest prospective study to decrease rates of missed radiotherapy appointments across multiple program types, census regions, and disease sites. These findings demonstrate the strength of ACS-led National QI Collaborative as an effective large-scale approach to address modifiable barriers to high-quality cancer care delivery.31:T9c7, BACKGROUND: Failure to complete cancer treatment is associated with worse oncologic outcomes. This 2-year prospective National Quality Improvement (QI) Collaborative aimed to decrease patient- and program-level rates of missed radiotherapy appointments by 20% at American College of Surgeons (ACS)–accredited cancer programs. STUDY DESIGN: One hundred ninety-four accredited cancer programs scheduled 99,057 patients for radiotherapy while voluntarily participating in the ACS Breaking Barriers National QI Collaborative from March 2023 to December 2024. Programs identified patients who missed 3 or more planned radiotherapy treatments, completed community needs assessments, engaged in educational webinars and peer learning discussions, and implemented system-level strategies to improve treatment adherence using an ACS toolkit. Chi-square tests assessed differences in rates of missed radiotherapy treatments, barriers addressed, and interventions implemented. RESULTS: Reductions of 39.8% (from 8.3% to 5.0%) and 31.7% (from 8.2% to 5.6%) were seen in no-show rates at the patient and program levels, respectively. Reductions were demonstrated for all program types, for most census regions, and for breast, gynecologic, and gastrointestinal cancers. The most frequently addressed barriers were transportation (62.3%) and patient illness unrelated to toxicity (37.1%). The most frequently implemented interventions included the development of a workflow and/or protocol related to identified barriers (68.9%) and the creation of internal resources to address these barriers (54.3%). CONCLUSIONS: Breaking Barriers is the largest prospective study to decrease rates of missed radiotherapy appointments across multiple program types, census regions, and disease sites. These findings demonstrate the strength of ACS-led National QI Collaborative as an effective large-scale approach to address modifiable barriers to high-quality cancer care delivery. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Gastrointestinal Cancer: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Gastrointestinal Cancer (condition). Clinician-written summaries and actionable practice insights. 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CAM use was most strongly linked to pancreatic (aOR 10.22) and liver cancer (aOR 10.09).","limitations":"CAM users (alone or combined) represented <0.1% of the cohort, raising concerns about ascertainment bias and very small sample sizes in those groups (n=197 and n=193). The NCDB does not capture granular CAM type or patient intent, limiting causal inference. Residual confounding by performance status, patient preference, and disease severity is likely.","practice_takeaway":"Patients with GI cancer who rely on CAM alone face significantly worse survival than those receiving standard treatment — counsel them proactively, especially those with pancreatic or liver cancer. Adding CAM to traditional therapy does not appear to worsen survival, so discussion should focus on replacing, not supplementing, standard care."}},{"doi":"10.1038/s41577-026-01312-3","pmid":"42230788","title":"Hallmarks and correlates of effective adoptive cell immunotherapy for cancer","journal_title":"Nature Reviews Immunology","journal_issn":"1474-1733","published_at":"2026-06-02T00:00:00.000Z","url":"https://doi.org/10.1038/s41577-026-01312-3","source_score":19,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:52.510Z","updated_at":"2026-06-11T13:42:52.510Z","tags":[{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"condition","value":"Gastrointestinal Cancer","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"condition","value":"Melanoma","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"condition","value":"Metastatic Solid Tumors","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"modality","value":"Adoptive Cell Transfer","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"modality","value":"TCR-Engineered T Cell Therapy","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"modality","value":"Tumour-Infiltrating Lymphocyte Therapy","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"warning","value":"Full text body appears truncated — only page metadata and abstract were available; summary is based primarily on the abstract. Clinical trial data, specific response rates, and correlate details could not be verified from the full text.","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"warning","value":"No sample size is applicable as this is a review article; the sample_size tag has been omitted.","value_numeric":null},{"paper_doi":"10.1038/s41577-026-01312-3","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the review's framing of ACT as an emerging standard for select refractory solid tumors, but this is a review article and not a primary clinical trial.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates the mechanisms, historical progress, and emerging correlates of response for adoptive cell transfer (ACT) therapies — specifically tumour-infiltrating lymphocytes (TILs) and TCR-engineered T cells (TCR-T cells) — targeting neoantigens in metastatic solid tumours including melanoma, breast, and gastrointestinal cancers.","key_result":"ACT using TIL or TCR-T cells targeting neoantigens has achieved tumour regression in patients with multiple types of metastatic solid tumours; the review synthesizes correlates of response and next-generation engineering strategies integrating immunogenomics, systems immunology, and genome editing.","limitations":"This is a narrative review without systematic meta-analysis; clinical evidence is largely drawn from selected case series and trials in a limited set of tumour types; generalizability to broader solid tumour types remains unclear.","practice_takeaway":"For clinicians managing refractory metastatic solid tumours, neoantigen-directed ACT (TIL or TCR-T) represents a maturing strategy with demonstrated regressions across tumour types. Integrating tumour genomics and T cell engineering into treatment planning may identify patients most likely to benefit."}},{"doi":"10.1001/jamaoncol.2026.0072","pmid":"41784985","title":"Outcomes of Older Adults With Advanced Cancer Who Prefer Quality of Life vs Prolonging Survival","journal_title":"JAMA Oncology","journal_issn":"2374-2437","published_at":"2026-03-05T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12964252/","source_score":83,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:02.021Z","updated_at":"2026-05-24T13:23:02.021Z","tags":[{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"condition","value":"Advanced Cancer","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"condition","value":"Gastrointestinal Cancer","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"condition","value":"Genitourinary Cancer","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"condition","value":"Lung Cancer","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"condition","value":"Lymphoma","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"modality","value":"Systemic Cancer Therapy","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"sample_size","value":"n=706","value_numeric":706},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"study_design","value":"Secondary Analysis of Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"warning","value":"~20% of patients did not fall into either stated preference cohort (8.4% survival + 71.7% QoL = 80.1%); the disposition of the remaining ~20% is not described in the available text.","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"warning","value":"Full text is under PMC embargo until March 2027; summary is based solely on the abstract and results excerpt provided.","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"warning","value":"The survival-preference group was very small (n=59, 8.4%), which limits the precision of all comparative estimates.","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0072","tag_type":"warning","value":"This is an exploratory secondary analysis; the original GAP70+ trial was not powered to detect differences by preference subgroup, so null findings should be interpreted cautiously.","value_numeric":null}],"summaries":{"what_studied":"This secondary analysis of the GAP70+ cluster RCT examined treatment outcome preferences (survival vs quality of life) among adults ≥70 years with advanced/incurable solid tumors or lymphoma starting new systemic therapy, and whether stated preference was associated with treatment modifications, grade 3–5 TRAEs, hospitalization, or survival at 6 months and 1 year.","key_result":"Only 8.4% (59/706) of older adults prioritized extending survival; 71.7% (506/706) prioritized maintaining QoL. Patient preference was not significantly associated with treatment modifications (RR 1.03), grade 3–5 TRAEs (HR 0.84), hospitalization (HR 0.74), or survival at 6 months (HR 0.72) or 1 year (HR 1.18).","limitations":"- Exploratory secondary analysis of an RCT not powered for these comparisons, so results may be underpowered.\n- The survival-preference cohort was very small (n=59), limiting statistical precision.\n- Preferences were measured at a single time point; they may shift over the treatment course.","practice_takeaway":"The vast majority of older patients with advanced cancer prioritize QoL over survival, yet their care does not differ meaningfully from those who prioritize survival — suggesting oncology practice is not consistently aligning treatment with stated patient goals. Clinicians should actively elicit and document treatment outcome preferences and use them to drive concrete care decisions."}},{"doi":"10.1097/xcs.0000000000001637","pmid":"41217348","title":"Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US","journal_title":"Journal of the American College of Surgeons","journal_issn":"1072-7515","published_at":"2025-11-11T00:00:00.000Z","url":"https://doi.org/10.1097/xcs.0000000000001637","source_score":246,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-12-23","doi":"10.1097/xcs.0000000000001637","days":"30","issn":"1072-7515","rank":"2","field":"Clinical Medicine","score":"246","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1097/XCS.0000000000001637","title":"Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US.","journal":"Journal of the American College of Surgeons","methods":"","results":"Reductions of 39.8% (from 8.3% to 5.0%) and 31.7% (from 8.2% to 5.6%) were seen in no-show rates at the patient and program levels, respectively. Reductions were demonstrated for all program types, for most census regions, and for breast, gynecologic, and gastrointestinal cancers. The most frequently addressed barriers were transportation (62.3%) and patient illness unrelated to toxicity (37.1%). The most frequently implemented interventions included the development of a workflow and/or protocol related to identified barriers (68.9%) and the creation of internal resources to address these barriers (54.3%).","abstract":"$30","keywords":[],"pubmed_id":"41217348","conclusions":"","publication_date":"2025-11-11T00:00:00"},"crossref":{"DOI":"10.1097/xcs.0000000000001637","URL":"https://doi.org/10.1097/xcs.0000000000001637","ISSN":["1072-7515","1879-1190"],"link":[{"URL":"https://journals.lww.com/10.1097/XCS.0000000000001637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"247-256","type":"journal-article","issue":"1","score":1,"title":["Results of an American College of Surgeons Prospective National Quality Improvement Collaborative to Successfully Overcome Barriers to Cancer Care Across the US"],"author":[{"given":"Kelley","family":"Chan","sequence":"first","affiliation":[{"name":"From the American College of Surgeons 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abstract-level methods are provided; details on timing and statistical approach beyond chi-squared tests are limited.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001637","tag_type":"warning","value":"The abstract mentions both “no-shows” and identifying patients with ≥3 missed treatments; definitions and thresholds are not fully detailed.","value_numeric":null}],"summaries":{"what_studied":"A two-year prospective national quality improvement collaborative across 194 ACS-accredited cancer programs (March 2023–December 2024) to cut missed radiotherapy appointments by 20% among 99,057 scheduled patients, using needs assessments, education, peer learning, and an ACS toolkit.","key_result":"Patient-level no-shows fell 39.8% from 8.3% to 5.0%, and program-level rates fell 31.7% from 8.2% to 5.6%. Transportation (62.3%) and patient illness unrelated to toxicity (37.1%) were the most addressed barriers; common interventions were new workflows/protocols (68.9%) and creation of internal resources (54.3%).","practice_takeaway":"An ACS-led, structured QI approach with standardized workflows and resources was associated with large drops in missed radiotherapy visits across program types and regions, including breast, gynecologic, and GI cancers. Targeting transportation and non-toxicity illness barriers were frequent and feasible actions."}}],"initialOffset":4,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Gastrointestinal Cancer"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Gastrointestinal Cancer"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Gastrointestinal Cancer"}}}]]

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