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:T55e,Of 254 611 patients with mNSCLC, the cohort median (IQR) age was 73 (68-80) years, with 133 635 (52.5%) male individuals; a total of 9512 (3.7%) were Asian, 26 546 (10.4%) were Black, 4553 (1.8%) were Hispanic, 205 381 (80.7%) were White, and 8619 (3.4%) were another or unknown race. A total of 119 197 patients (46.8%) ever received systemic treatment. Of the 100 367 (39.8%) who died within 90 days of diagnosis, 13.2% were treated compared with 69% of those surviving more than 90 days. The treated proportion increased only slightly between 2006 and 2021. In a competing risk model, referral to oncology specialists was associated with treatment (hazard ratio [HR], 2.5; 95% CI, 2.41-2.67; P < .001) which corresponded to a 30.3% greater cumulative incidence of treatment at 180 days (CIF180) compared with those without a referral. Similarly, those with biomarker testing had a 17.8% greater CIF180, whereas those older than 80 years had a 15.4% lower CIF180 compared to those aged 65 to 69 years. Patients with NSCLC not otherwise specified histologic findings had a 12.8% lower CIF180 compared with those with adenocarcinoma histologic findings. Other factors associated with significant but smaller differences in receipt of treatment included comorbidity burden, marital status, Medicare Part C or Part D coverage, rurality, and race and ethnicity.31:Tac5,Metastatic non-small cell lung cancer (mNSCLC) has very high mortality rates, and comprises approximately half of new cases of lung cancer; however, highly effective and better tolerated treatments have become available in recent decades. Nevertheless, population-level treatment of mNSCLC is poorly characterized in the era of rapid treatment advances. To characterize treatment rates, trends, and factors associated with treatment of mNSCLC. This population-based study used linked Surveillance Epidemiology and End Results (SEER) and Medicare claims data and the analysis included patients 65 years and older diagnosed with mNSCLC from January 2006 to December 2021. Data were analyzed from October 2025 to February 2026. Sociodemographic variables, comorbidity burden, histologic type, referral to subspecialist, enrollment in Medicare Part D, and biomarker testing. The primary outcome was receipt of systemic treatment. Statistical analyses included summary statistics and a competing risk proportional hazards model for receipt of systemic treatment. Of 254 611 patients with mNSCLC, the cohort median (IQR) age was 73 (68-80) years, with 133 635 (52.5%) male individuals; a total of 9512 (3.7%) were Asian, 26 546 (10.4%) were Black, 4553 (1.8%) were Hispanic, 205 381 (80.7%) were White, and 8619 (3.4%) were another or unknown race. A total of 119 197 patients (46.8%) ever received systemic treatment. Of the 100 367 (39.8%) who died within 90 days of diagnosis, 13.2% were treated compared with 69% of those surviving more than 90 days. The treated proportion increased only slightly between 2006 and 2021. In a competing risk model, referral to oncology specialists was associated with treatment (hazard ratio [HR], 2.5; 95% CI, 2.41-2.67; P < .001) which corresponded to a 30.3% greater cumulative incidence of treatment at 180 days (CIF180) compared with those without a referral. Similarly, those with biomarker testing had a 17.8% greater CIF180, whereas those older than 80 years had a 15.4% lower CIF180 compared to those aged 65 to 69 years. Patients with NSCLC not otherwise specified histologic findings had a 12.8% lower CIF180 compared with those with adenocarcinoma histologic findings. Other factors associated with significant but smaller differences in receipt of treatment included comorbidity burden, marital status, Medicare Part C or Part D coverage, rurality, and race and ethnicity. In this cohort study of older adults with mNSCLC, despite advances in therapy in recent decades, almost half of patients never received systemic therapy, and the proportion treated only minimally improved over time. Approximately one-fifth of those with the most favorable clinical profiles did not receive systemic therapy.32:T101a, Importance Metastatic non–small cell lung cancer (mNSCLC) has very high mortality rates, and comprises approximately half of new cases of lung cancer; however, highly effective and better tolerated treatments have become available in recent decades. Nevertheless, population-level treatment of mNSCLC is poorly characterized in the era of rapid treatment advances. Objective To characterize treatment rates, trends, and factors associated with treatment of mNSCLC. Design, Setting, and Participants This population-based study used linked Surveillance Epidemiology and End Results (SEER) and Medicare claims data and the analysis included patients 65 years and older diagnosed with mNSCLC from January 2006 to December 2021. Data were analyzed from October 2025 to February 2026. Exposures Sociodemographic variables, comorbidity burden, histologic type, referral to subspecialist, enrollment in Medicare Part D, and biomarker testing. Main Outcomes The primary outcome was receipt of systemic treatment. Statistical analyses included summary statistics and a competing risk proportional hazards model for receipt of systemic treatment. Results Of 254 611 patients with mNSCLC, the cohort median (IQR) age was 73 (68-80) years, with 133 635 (52.5%) male individuals; a total of 9512 (3.7%) were Asian, 26 546 (10.4%) were Black, 4553 (1.8%) were Hispanic, 205 381 (80.7%) were White, and 8619 (3.4%) were another or unknown race. A total of 119 197 patients (46.8%) ever received systemic treatment. Of the 100 367 (39.8%) who died within 90 days of diagnosis, 13.2% were treated compared with 69% of those surviving more than 90 days. The treated proportion increased only slightly between 2006 and 2021. In a competing risk model, referral to oncology specialists was associated with treatment (hazard ratio [HR], 2.5; 95% CI, 2.41-2.67; P &lt; .001) which corresponded to a 30.3% greater cumulative incidence of treatment at 180 days (CIF180) compared with those without a referral. Similarly, those with biomarker testing had a 17.8% greater CIF180, whereas those older than 80 years had a 15.4% lower CIF180 compared to those aged 65 to 69 years. Patients with NSCLC not otherwise specified histologic findings had a 12.8% lower CIF180 compared with those with adenocarcinoma histologic findings. Other factors associated with significant but smaller differences in receipt of treatment included comorbidity burden, marital status, Medicare Part C or Part D coverage, rurality, and race and ethnicity. Conclusions and Relevance In this cohort study of older adults with mNSCLC, despite advances in therapy in recent decades, almost half of patients never received systemic therapy, and the proportion treated only minimally improved over time. Approximately one-fifth of those with the most favorable clinical profiles did not receive systemic therapy. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Systemic Therapy: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Systemic Therapy (modality). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/modality/Systemic%20Therapy\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Modalities\",\"item\":\"https://www.reachrx.ai/hub/tag/modality\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Systemic Therapy\",\"item\":\"https://www.reachrx.ai/hub/tag/modality/Systemic%20Therapy\"}]}}"}}]],["$","$L2f",null,{"title":"Systemic Therapy: Research & Clinical Takeaways","description":"Review evidence by treatment modality: Systemic Therapy — concise summaries and practical next steps.","papers":[{"doi":"10.1093/ced/llag377","pmid":"42663292","title":"Extramammary Paget Disease: A Review","journal_title":"Clinical and Experimental Dermatology","journal_issn":"0307-6938","published_at":"2026-08-28T00:00:00.000Z","url":"https://doi.org/10.1093/ced/llag377","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-04T06:22:16.881Z","updated_at":"2026-09-04T06:22:16.881Z","tags":[{"paper_doi":"10.1093/ced/llag377","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"condition","value":"Extramammary Paget Disease","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"modality","value":"Radiotherapy","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"modality","value":"Surgery","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"modality","value":"Topical Therapy","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"warning","value":"5-year survival figure is anchored to a single diagnosis cohort year (2013); more recent outcomes may differ.","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"warning","value":"Incidence and survival data are derived exclusively from England (2013–2020) and may not reflect global epidemiology.","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"warning","value":"No specific sample size (patient N) is provided in the abstract for the England dataset; sample_size tag was omitted.","value_numeric":null},{"paper_doi":"10.1093/ced/llag377","tag_type":"warning","value":"Sex distribution of affected patients is not reported in the abstract; sex tag was omitted.","value_numeric":null}],"summaries":{"what_studied":"This review covers extramammary Paget disease (EMPD) — a rare adenocarcinoma of apocrine gland-rich skin — including its history, classification, epidemiology, aetiology, pathogenesis, diagnosis, malignancy screening, and management strategies.","key_result":"England data (2013–2020) show a crude incidence of 0.17 per 100,000 person-years; 5-year net survival was 90.9% for cases diagnosed in 2013, comparable to melanoma (89.6%), prostate (85.8%), and breast cancer (85.9%). Recurrence rates reach up to 50% across treatment modalities.","limitations":"Epidemiological data are drawn from England only, limiting global generalizability. Survival figures reflect a single diagnosis year (2013), which may not represent current outcomes. As a narrative review, it does not perform systematic evidence synthesis or meta-analysis.","practice_takeaway":"Screen all EMPD patients for underlying visceral malignancy, as risk varies by anatomical site. Counsel patients on the high recurrence rate (up to 50%) regardless of treatment chosen, and maintain close long-term surveillance."}},{"doi":"10.1200/jco-26-00410","pmid":"42485589","title":"International Myeloma Working Group Recommendations for the Diagnosis and Management of Solitary Plasmacytomas","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-07-22T00:00:00.000Z","url":"https://doi.org/10.1200/jco-26-00410","source_score":20,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:37:16.535Z","updated_at":"2026-07-31T13:37:16.535Z","tags":[{"paper_doi":"10.1200/jco-26-00410","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"condition","value":"Extramedullary Plasmacytoma","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"condition","value":"Solitary Bone Plasmacytoma","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"condition","value":"Solitary Plasmacytoma","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"modality","value":"Radiation Therapy","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"warning","value":"No sample size is reported — this is a consensus guideline, not a primary data study. The impact_flag 'practice_changing' reflects updated IMWG consensus incorporating new diagnostic tools, but is based on expert opinion rather than new RCT-level evidence.","value_numeric":null},{"paper_doi":"10.1200/jco-26-00410","tag_type":"warning","value":"The abstract does not specify which imaging modalities or BM assessment methods are recommended; detailed recommendations are in the full text only.","value_numeric":null}],"summaries":{"what_studied":"The International Myeloma Working Group (IMWG) provides updated consensus recommendations for the diagnosis, evaluation, treatment, and response assessment of solitary plasmacytomas (SPs) — both solitary bone plasmacytoma and extramedullary plasmacytoma — incorporating advances in imaging, bone marrow assessment, and systemic therapy.","key_result":"~50% of SPs progress to symptomatic multiple myeloma within 5 years of definitive local radiotherapy; local radiotherapy remains the standard of care, while the added benefit of systemic therapy remains poorly defined.","limitations":"This is a consensus guideline, not a clinical trial — recommendations reflect expert opinion and existing data rather than new prospective evidence. The benefit of systemic therapy is explicitly noted as poorly defined due to limited trial data.","practice_takeaway":"Diagnose SP only after rigorously excluding multiple myeloma using advanced imaging, sensitive bone marrow assessment, and blood/urine tests. Local radiotherapy remains first-line treatment; routine use of systemic MM therapies is not yet supported by sufficient clinical evidence."}},{"doi":"10.1016/j.jhep.2026.04.024","pmid":null,"title":"Systemic therapy for HCC: Doublets, triplets and beyond","journal_title":"Journal of Hepatology","journal_issn":"0168-8278","published_at":"2026-07-02T00:00:00.000Z","url":"https://doi.org/10.1016/j.jhep.2026.04.024","source_score":27,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-04T13:26:26.604Z","updated_at":"2026-07-04T13:26:26.604Z","tags":[{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"study_design","value":"Review","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"warning","value":"Only bibliographic metadata was provided — no abstract, body text, or results were included. All structured fields requiring clinical data (key result, practice takeaway, sample size, drugs, sex, age group, impact flag) have been omitted or set to null as they cannot be verified from the source.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"warning","value":"Study design is assumed to be a narrative or structured review based on the title framing ('Doublets, triplets and beyond'); this could not be confirmed from the source text.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.024","tag_type":"warning","value":"The DOI year (2026) is consistent with the publication date; however, this appears to be a very recently published article and full-text access was not available for deeper extraction.","value_numeric":null}],"summaries":{"what_studied":"This paper reviews the evolving landscape of systemic therapy for hepatocellular carcinoma (HCC), focusing on combination regimens including doublets, triplets, and emerging multi-agent strategies.","limitations":"The source text provided contains only the title, DOI, journal, and publication date — no abstract, methods, results, or conclusions are available for extraction."}},{"doi":"10.1016/s2468-1253(26)00041-5","pmid":"42155511","title":"Management of colorectal cancer in older adults: an expert panel recommendation to guide daily clinical practice","journal_title":"The Lancet Gastroenterology & Hepatology","journal_issn":"2468-1253","published_at":"2026-05-19T00:00:00.000Z","url":"https://doi.org/10.1016/s2468-1253(26)00041-5","source_score":16,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-23T13:24:49.998Z","updated_at":"2026-05-23T13:24:49.998Z","tags":[{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"condition","value":"Colorectal Cancer","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"modality","value":"Geriatric Assessment","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"modality","value":"Surgical Oncology","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"study_design","value":"Expert Panel Consensus / Narrative Review","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"warning","value":"No sample size is applicable — this is a narrative expert panel review, not an original trial.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"warning","value":"Study design is a hybrid expert consensus and narrative review; level of evidence is approximate (5) based on the absence of primary data.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00041-5","tag_type":"warning","value":"The paper was published May 19, 2026 and today is May 23, 2026 — this is a very recent publication; recommendations have not yet been externally validated or incorporated into major guidelines.","value_numeric":null}],"summaries":{"limitations":"Older adults are under-represented in the clinical trials that define standard treatment; recommendations rely heavily on expert consensus rather than age-specific RCT data; functional heterogeneity among older patients limits generalizability of any single framework.","what_studied":"This expert panel review evaluates the current therapeutic landscape for colorectal cancer in older adults (aged ≥70 years), focusing on how geriatric assessment and emerging treatment modalities can guide pragmatic, patient-centred clinical decision making in this under-represented population.","key_result":"Growing evidence supports the use of geriatric assessment and management in older adults with colorectal cancer, offering patient-centred benefits and the potential to improve outcomes alongside expanding treatment options — though this group remains systematically under-represented in clinical trials.","practice_takeaway":"Incorporate geriatric assessment routinely when managing colorectal cancer in patients aged ≥70, as it can reveal functional impairment and comorbidities that should shape treatment decisions. Avoid defaulting to under-treatment — the evidence base is evolving and newer options may be appropriate with careful patient selection."}},{"doi":"10.1016/j.eururo.2026.04.001","pmid":"42120219","title":"Management of Lymph Node–Positive Renal Cell Carcinoma: Updated Recommendations from the European Association of Urology Renal Cell Carcinoma Guidelines Panel","journal_title":"European Urology","journal_issn":"0302-2838","published_at":"2026-05-12T00:00:00.000Z","url":"https://doi.org/10.1016/j.eururo.2026.04.001","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-20T13:23:23.643Z","updated_at":"2026-05-20T13:23:23.643Z","tags":[{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"condition","value":"Lymph Node-Positive Renal Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"condition","value":"Renal Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"modality","value":"Surgical Resection","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"warning","value":"Level of evidence assigned as '3' is an estimate based on guideline study design; the actual EAU evidence grading is not stated in the abstract.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"warning","value":"Only the abstract is available; specific recommendation grades, supporting evidence, and outcome data cannot be extracted.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.001","tag_type":"warning","value":"Publication date (2026-05-12) is recent and this appears to be an updated guideline; prior EAU RCC guideline versions may differ in recommendations.","value_numeric":null}],"summaries":{"what_studied":"Updated EAU guidelines panel recommendations for the management of lymph node–positive renal cell carcinoma (RCC), addressing surgical vs. systemic therapy approaches.","key_result":"Patients with bulky or multiple nodal metastases behave similarly to those with metastatic RCC and may benefit more from upfront systemic therapy than from surgery alone.","limitations":"Abstract-only content is available; specific evidence levels, patient numbers, and outcome data underlying the recommendations are not reported here.","practice_takeaway":"For lymph node–positive RCC with bulky or multiple nodal disease, consider upfront systemic therapy rather than surgery alone. Recognize this as a heterogeneous condition requiring individualized treatment planning."}},{"doi":"10.1001/jamaoncol.2026.1080","pmid":"42096214","title":"Rates of Systemic Treatment for Metastatic Non–Small Cell Lung Cancer Among Older Adults","journal_title":"JAMA Oncology","journal_issn":"2374-2437","published_at":"2026-05-07T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13154025/","source_score":68,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1001/jamaoncol.2026.1080","days":"7","issn":"2374-2437","rank":"2","field":"Clinical Medicine","score":"68","category":"Oncology","categories":["Oncology"],"_categories":["Oncology"]},"pubmed":{"doi":"10.1001/jamaoncol.2026.1080","title":"Rates of Systemic Treatment for Metastatic Non-Small Cell Lung Cancer Among Older Adults.","journal":"JAMA oncology","methods":"","results":"$30","abstract":"$31","keywords":[],"pubmed_id":"42096214","conclusions":"","publication_date":"2026-05-07T00:00:00"},"crossref":{"DOI":"10.1001/jamaoncol.2026.1080","URL":"https://doi.org/10.1001/jamaoncol.2026.1080","ISSN":["2374-2437"],"link":[{"URL":"https://jamanetwork.com/journals/jamaoncology/articlepdf/2848634/jamaoncology_fox_2026_oi_260018_1778001885.35235.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Rates of Systemic Treatment for Metastatic Non–Small Cell Lung Cancer Among Older Adults"],"author":[{"given":"Adam H.","family":"Fox","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston"}]},{"given":"Ralph C.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Medical University of South Carolina, Charleston"}]},{"given":"Mariam","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Medical University of South Carolina, Charleston"}]},{"given":"Raymond U.","family":"Osarogiagbon","sequence":"additional","affiliation":[{"name":"Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, Tennessee"}]},{"given":"Robert A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Center for Early Cancer Detection Science, American Cancer Society, Atlanta, Georgia"}]},{"given":"Jamie L.","family":"Studts","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora"}]},{"given":"Gerard A.","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston"}]},{"given":null,"family":null,"sequence":"additional","affiliation":[]},{"given":"Lauren S.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"for the American Cancer Society National Lung Cancer Roundtable (NLCRT)"}]}],"issued":{"date-parts":[[2026,5,7]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":null,"created":{"date-time":"2026-05-07T15:30:32Z","timestamp":1778167832000,"date-parts":[[2026,5,7]]},"indexed":{"date-time":"2026-05-07T16:15:32Z","timestamp":1778170532856,"date-parts":[[2026,5,7]]},"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamaoncology/fullarticle/2848634"}},"subtitle":[],"deposited":{"date-time":"2026-05-07T15:30:33Z","timestamp":1778167833000,"date-parts":[[2026,5,7]]},"issn-type":[{"type":"print","value":"2374-2437"}],"published":{"date-parts":[[2026,5,7]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.3322/caac.70043","key":"coi260018r1","year":"2026","issue":"1","author":"Siegel","volume":"76","first-page":null,"unstructured":null,"article-title":"Cancer statistics, 2026.","journal-title":"CA Cancer J Clin","doi-asserted-by":"publisher"},{"DOI":"10.1097/JTO.0000000000000667","key":"coi260018r2","year":"2015","issue":"11","author":"Noonan","volume":"10","first-page":"1523","unstructured":null,"article-title":"The Influence of the evolution of first-line chemotherapy on steadily improving survival in advanced non-small-cell lung cancer clinical trials.","journal-title":"J Thorac Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.1999.17.10.3188","key":"coi260018r3","year":"1999","issue":"10","author":"Cullen","volume":"17","first-page":"3188","unstructured":null,"article-title":"Mitomycin, ifosfamide, and cisplatin in unresectable non-small-cell lung cancer: effects on survival and quality of life.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa011954","key":"coi260018r4","year":"2002","issue":"2","author":"Schiller","volume":"346","first-page":"92","unstructured":null,"article-title":"Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.2007.15.0375","key":"coi260018r5","year":"2008","issue":"21","author":"Scagliotti","volume":"26","first-page":"3543","unstructured":null,"article-title":"Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1002/cncr.31077","key":"coi260018r6","year":"2018","issue":"4","author":"Cassidy","volume":"124","first-page":"775","unstructured":null,"article-title":"Health care disparities among octogenarians and nonagenarians with stage III lung cancer.","journal-title":"Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jtho.2016.11.2221","key":"coi260018r7","year":"2017","issue":"3","author":"David","volume":"12","first-page":"437","unstructured":null,"article-title":"Increasing rates of no treatment in advanced-stage non-small cell lung cancer patients: a propensity-matched analysis.","journal-title":"J Thorac Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.2011.39.5269","key":"coi260018r8","year":"2012","issue":"13","author":"Wang","volume":"30","first-page":"1447","unstructured":null,"article-title":"Impact of age and comorbidity on non-small-cell lung cancer treatment in older veterans.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamaoncol.2021.4932","key":"coi260018r9","year":"2021","issue":"12","author":"Ganti","volume":"7","first-page":"1824","unstructured":null,"article-title":"Update of incidence, prevalence, survival, and initial treatment in patients with non-small cell lung cancer in the US.","journal-title":"JAMA Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1093/jncics/pkz020","key":"coi260018r10","year":"2019","issue":"3","author":"Maguire","volume":"3","first-page":null,"unstructured":null,"article-title":"First-line systemic treatments for stage IV non-small cell lung cancer in California: patterns of care and outcomes in a real-world setting.","journal-title":"J Natl Cancer Inst Cancer Spectr","doi-asserted-by":"publisher"},{"DOI":"10.1093/jncics/pkz021","key":"coi260018r11","year":"2019","issue":"2","author":"Sineshaw","volume":"3","first-page":null,"unstructured":null,"article-title":"Treatment patterns among de novo metastatic cancer patients who died within 1 month of diagnosis.","journal-title":"J Natl Cancer Inst Cancer Spectr","doi-asserted-by":"publisher"},{"DOI":"10.1136/bmj.317.7161.771","key":"coi260018r12","year":"1998","issue":"7161","author":"Silvestri","volume":"317","first-page":"771","unstructured":null,"article-title":"Preferences for chemotherapy in patients with advanced non-small cell lung cancer: descriptive study based on scripted interviews.","journal-title":"BMJ","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJM200201103460211","key":"coi260018r13","year":"2002","issue":"2","author":"Carney","volume":"346","first-page":"126","unstructured":null,"article-title":"Lung cancer–time to move on from chemotherapy.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1186/1471-2407-12-184","key":"coi260018r14","year":"2012","issue":null,"author":"Chambers","volume":"12","first-page":"184","unstructured":null,"article-title":"A systematic review of the impact of stigma and nihilism on lung cancer outcomes.","journal-title":"BMC Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1007/s00520-016-3428-3","key":"coi260018r15","year":"2017","issue":"2","author":"Dunn","volume":"25","first-page":"497","unstructured":null,"article-title":"Barriers to lung cancer care: health professionals’ perspectives.","journal-title":"Support Care Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1007/s13187-014-0677-z","key":"coi260018r16","year":"2015","issue":"1","author":"Tran","volume":"30","first-page":"62","unstructured":null,"article-title":"Perceptions of lung cancer and potential impacts on funding and patient care: a qualitative study.","journal-title":"J Cancer Educ","doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(18)32409-7","key":"coi260018r17","year":"2019","issue":"10183","author":"Mok","volume":"393","first-page":"1819","unstructured":null,"article-title":"Pembrolizumab versus chemotherapy for previously untreated, PD-L1-expressing, locally advanced or metastatic non-small-cell lung cancer (KEYNOTE-042): a randomised, open-label, controlled, phase 3 trial.","journal-title":"Lancet","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1913662","key":"coi260018r18","year":"2020","issue":"1","author":"Ramalingam","volume":"382","first-page":"41","unstructured":null,"article-title":"Overall survival with osimertinib in untreated, EGFR-mutated advanced NSCLC.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1916623","key":"coi260018r19","year":"2020","issue":"7","author":"Howlader","volume":"383","first-page":"640","unstructured":null,"article-title":"The effect of advances in lung-cancer treatment on population mortality.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(23)00774-2","key":"coi260018r20","year":"2023","issue":"10400","author":"Lee","volume":"402","first-page":"451","unstructured":null,"article-title":"First-line atezolizumab monotherapy versus single-agent chemotherapy in patients with non-small-cell lung cancer ineligible for treatment with a platinum-containing regimen (IPSOS): a phase 3, global, multicentre, open-label, randomised controlled study.","journal-title":"Lancet","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.annonc.2020.04.478","key":"coi260018r21","year":"2020","issue":"8","author":"Mok","volume":"31","first-page":"1056","unstructured":null,"article-title":"Updated overall survival and final progression-free survival data for patients with treatment-naive advanced ALK-positive non-small-cell lung cancer in the ALEX study.","journal-title":"Ann Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1186/s12874-023-01994-6","key":"coi260018r22","year":"2023","issue":"1","author":"Pluchart","volume":"23","first-page":"256","unstructured":null,"article-title":"Comparison of seven comorbidity scores on four-month survival of lung cancer patients.","journal-title":"BMC Med Res Methodol","doi-asserted-by":"publisher"},{"DOI":"10.3390/ijerph191811262","key":"coi260018r23","year":"2022","issue":"18","author":"Oterino-Moreira","volume":"19","first-page":"11262","unstructured":null,"article-title":"Comparison of three comorbidity measures for predicting in-hospital death through a clinical administrative nacional database.","journal-title":"Int J Environ Res Public Health","doi-asserted-by":"publisher"},{"DOI":"10.1097/MLR.0000000000000326","key":"coi260018r24","year":"2015","issue":"4","author":"Thompson","volume":"53","first-page":"374","unstructured":null,"article-title":"A new Elixhauser-based comorbidity summary measure to predict in-hospital mortality.","journal-title":"Med Care","doi-asserted-by":"publisher"},{"DOI":"10.1186/s12913-020-05999-5","key":"coi260018r25","year":"2021","issue":"1","author":"Sharma","volume":"21","first-page":"13","unstructured":null,"article-title":"Comparing Charlson and Elixhauser comorbidity indices with different weightings to predict in-hospital mortality: an analysis of national inpatient data.","journal-title":"BMC Health Serv Res","doi-asserted-by":"publisher"},{"DOI":"10.1097/MLR.0b013e31819432e5","key":"coi260018r26","year":"2009","issue":"6","author":"van Walraven","volume":"47","first-page":"626","unstructured":null,"article-title":"A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data.","journal-title":"Med Care","doi-asserted-by":"publisher"},{"DOI":"10.1080/01621459.1999.10474144","key":"coi260018r27","year":"1999","issue":"446","author":"Fine","volume":"94","first-page":"496","unstructured":null,"article-title":"A proportional hazards model for the subdistribution of a competing risk.","journal-title":"J Am Stat Assoc","doi-asserted-by":"publisher"},{"DOI":"10.7326/M16-2607","key":"coi260018r28","year":"2017","issue":"4","author":"VanderWeele","volume":"167","first-page":"268","unstructured":null,"article-title":"Sensitivity analysis in observational research: introducing the E-value.","journal-title":"Ann Intern Med","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1606774","key":"coi260018r29","year":"2016","issue":"19","author":"Reck","volume":"375","first-page":"1823","unstructured":null,"article-title":"Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1801005","key":"coi260018r30","year":"2018","issue":"22","author":"Gandhi","volume":"378","first-page":"2078","unstructured":null,"article-title":"Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.21.01626","key":"coi260018r31","year":"2022","issue":"6","author":"Tan","volume":"40","first-page":"611","unstructured":null,"article-title":"Targeted therapies for lung cancer patients with oncogenic driver molecular alterations.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.18632/oncotarget.28114","key":"coi260018r32","year":"2021","issue":"23","author":"Allen","volume":"12","first-page":"2308","unstructured":null,"article-title":"Anaplastic lymphoma kinase rearrangement prevalence in patients with advanced non-small cell lung cancer in the United States: retrospective real world data.","journal-title":"Oncotarget","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.2014.3741","key":"coi260018r33","year":"2014","issue":"19","author":"Kris","volume":"311","first-page":"1998","unstructured":null,"article-title":"Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.22.01990","key":"coi260018r34","year":"2023","issue":"11","author":"Novello","volume":"41","first-page":"1999","unstructured":null,"article-title":"Pembrolizumab plus chemotherapy in squamous non-small-cell lung cancer: 5-year update of the phase III KEYNOTE-407 study.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.21037/tlcr-24-198","key":"coi260018r35","year":"2024","issue":"8","author":"Se","volume":"13","first-page":"2095","unstructured":null,"article-title":"Clinical insights: five-year follow-up of KEYNOTE-189 trial outcomes and more.","journal-title":"Transl Lung Cancer Res","doi-asserted-by":"publisher"},{"DOI":"10.1186/1472-684X-10-14","key":"coi260018r36","year":"2011","issue":null,"author":"Saito","volume":"10","first-page":"14","unstructured":null,"article-title":"The effect on survival of continuing chemotherapy to near death.","journal-title":"BMC Palliat Care","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.2011.35.7996","key":"coi260018r37","year":"2012","issue":"4","author":"Greer","volume":"30","first-page":"394","unstructured":null,"article-title":"Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1093/jnci/djy202","key":"coi260018r38","year":"2019","issue":"4","author":"Kehl","volume":"111","first-page":"431","unstructured":null,"article-title":"Race, poverty, and initial implementation of precision medicine for lung cancer.","journal-title":"J Natl Cancer Inst","doi-asserted-by":"publisher"},{"DOI":"10.1093/jncics/pkac013","key":"coi260018r39","year":"2022","issue":"2","author":"Veluswamy","volume":"6","first-page":null,"unstructured":null,"article-title":"Immunotherapy outcomes in individuals with non-small cell lung cancer and poor performance status.","journal-title":"J Natl Cancer Inst Cancer Spectr","doi-asserted-by":"publisher"},{"DOI":"10.1158/1055-9965.EPI-11-0437","key":"coi260018r40","year":"2011","issue":"10","author":"Beeken","volume":"20","first-page":"2127","unstructured":null,"article-title":"Cancer fatalism: deterring early presentation and increasing social inequalities?","journal-title":"Cancer Epidemiol Biomarkers Prev","doi-asserted-by":"publisher"},{"DOI":"10.1007/s00520-015-3014-0","key":"coi260018r41","year":"2016","issue":"5","author":"Shen","volume":"24","first-page":"2093","unstructured":null,"article-title":"Association between patient-provider communication and lung cancer stigma.","journal-title":"Support Care Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1158/1055-9965.EPI-14-0969","key":"coi260018r42","year":"2015","issue":"4","author":"Lyratzopoulos","volume":"24","first-page":"720","unstructured":null,"article-title":"The association between fatalistic beliefs and late stage at diagnosis of lung and colorectal cancer.","journal-title":"Cancer Epidemiol Biomarkers Prev","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.chest.2021.06.027","key":"coi260018r43","year":"2021","issue":"6","author":"Fox","volume":"160","first-page":"2293","unstructured":null,"article-title":"Knowledge and practice patterns among pulmonologists for molecular biomarker testing in advanced non-small cell lung cancer.","journal-title":"Chest","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.chest.2024.06.001","key":"coi260018r44","year":"2024","issue":"5","author":"Fox","volume":"166","first-page":"1229","unstructured":null,"article-title":"Pulmonologists’ attitudes and role in precision medicine biomarker testing for non-small cell lung cancer.","journal-title":"Chest","doi-asserted-by":"publisher"},{"DOI":"10.1002/cncr.34926","key":"coi260018r45","year":"2024","issue":"24","author":"Roy-Chowdhuri","volume":"130","first-page":"4200","unstructured":null,"article-title":"The American Cancer Society National Lung Cancer Roundtable strategic plan: methods for improving turnaround time of comprehensive biomarker testing in non-small cell lung cancer.","journal-title":"Cancer","doi-asserted-by":"publisher"},{"DOI":"10.3322/caac.21774","key":"coi260018r46","year":"2023","issue":"4","author":"Fox","volume":"73","first-page":"358","unstructured":null,"article-title":"Acquiring tissue for advanced lung cancer diagnosis and comprehensive biomarker testing: a National Lung Cancer Roundtable best-practice guide.","journal-title":"CA Cancer J Clin","doi-asserted-by":"publisher"},{"DOI":"10.1002/cncr.34628","key":"coi260018r47","year":"2024","issue":"24","author":"Fox","volume":"130","first-page":"4188","unstructured":null,"article-title":"The American Cancer Society National Lung Cancer Roundtable strategic plan: advancing comprehensive biomarker testing in non-small cell lung cancer.","journal-title":"Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1634/theoncologist.12-12-1456","key":"coi260018r48","year":"2007","issue":"12","author":"Jatoi","volume":"12","first-page":"1456","unstructured":null,"article-title":"Does marital status impact survival and quality of life in patients with non-small cell lung cancer? observations from the Mayo Clinic Lung Cancer cohort.","journal-title":"Oncologist","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.2013.49.6489","key":"coi260018r49","year":"2013","issue":"31","author":"Aizer","volume":"31","first-page":"3869","unstructured":null,"article-title":"Marital status and survival in patients with cancer.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.21037/tlcr-23-407","key":"coi260018r50","year":"2024","issue":"1","author":"Duncan","volume":"13","first-page":"76","unstructured":null,"article-title":"Racial disparities in staging, treatment, and mortality in non-small cell lung cancer.","journal-title":"Transl Lung Cancer Res","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMp1811499","key":"coi260018r51","year":"2019","issue":"16","author":"Pallok","volume":"380","first-page":"1489","unstructured":null,"article-title":"Structural racism—a 60-year-old Black woman with breast cancer.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1093/jncics/pkae085","key":"coi260018r52","year":"2024","issue":"5","author":"Guadamuz","volume":"8","first-page":null,"unstructured":null,"article-title":"Mediators of racial and ethnic inequities in clinical trial participation among patients with cancer, 2011-2023.","journal-title":"J Natl Cancer Inst Cancer Spectr","doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(17)30569-X","key":"coi260018r53","year":"2017","issue":"10077","author":"Bailey","volume":"389","first-page":"1453","unstructured":null,"article-title":"Structural racism and health inequities in the USA: evidence and interventions.","journal-title":"Lancet","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMsa040609","key":"coi260018r54","year":"2004","issue":"6","author":"Bach","volume":"351","first-page":"575","unstructured":null,"article-title":"Primary care physicians who treat blacks and whites.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1093/jncimonographs/lgz030","key":"coi260018r55","year":"2020","issue":"55","author":"Warren","volume":"2020","first-page":"60","unstructured":null,"article-title":"Sensitivity of Medicare data to identify oncologists.","journal-title":"J Natl Cancer Inst Monogr","doi-asserted-by":"publisher"},{"DOI":"10.1097/01.mlr.0000196978.34283.a6","key":"coi260018r56","year":"2006","issue":"2","author":"Du","volume":"44","first-page":"124","unstructured":null,"article-title":"External validation of Medicare claims for breast cancer chemotherapy compared with medical chart reviews.","journal-title":"Med Care","doi-asserted-by":"publisher"}],"short-title":[],"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Oncology"],"reference-count":56,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,7]]},"references-count":56,"short-container-title":["JAMA Oncol"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1001/jamaoncol.2026.1080","is_oa":true,"title":"Rates of Systemic Treatment for Metastatic Non–Small Cell Lung Cancer Among Older Adults","updated":"2026-05-12T08:54:10+00:00","published_date":"2026-05-07","best_oa_location":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13154025/","pmh_id":"oai:pubmedcentral.nih.gov:13154025","url_for_pdf":null,"url_for_landing_page":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13154025/"}}},"created_at":"2026-05-12T13:18:04.171Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"condition","value":"Metastatic Non-Small Cell Lung Cancer","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"sample_size","value":"n=254611","value_numeric":254611},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"study_design","value":"Population-Based Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"warning","value":"Full text was not accessible; summary is based entirely on the abstract and results section provided.","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"warning","value":"The competing risk model accounts for early death as a competing event, which is important given that ~40% of patients died within 90 days — readers should interpret cumulative incidence figures in this context.","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.1080","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — the study reveals a persistent care gap rather than a new intervention, but the scale and clarity of findings have strong potential to drive system-level change.","value_numeric":null}],"summaries":{"what_studied":"This population-based cohort study examined rates, trends, and predictors of systemic treatment receipt among 254,611 Medicare patients aged ≥65 with metastatic NSCLC diagnosed from 2006–2021, using linked SEER-Medicare data.","key_result":"Only 46.8% (n=119,197) ever received systemic treatment, a proportion that barely changed from 2006 to 2021. Oncology referral was the strongest predictor (HR 2.5; +30.3% cumulative incidence at 180 days); biomarker testing added +17.8%, while age >80 years reduced treatment likelihood by 15.4%. Even among the most favorable clinical profiles, ~20% went untreated.","limitations":"Study is limited to adults ≥65 on Medicare, so findings may not generalize to younger patients or those with other insurance. Claims data cannot fully capture reasons for not treating (e.g., patient preference, performance status). The 'NOS' histology group may mask heterogeneous disease biology.","practice_takeaway":"Prompt referral to an oncology specialist and early biomarker testing are the two most modifiable factors linked to patients actually receiving treatment — clinicians and health systems should prioritize both, especially for patients over 80 and those in rural areas."}},{"doi":"10.1200/jco-25-01958","pmid":"42085620","title":"Metastatic Trajectories in Non–Small Cell Lung Cancer Guide Local and Systemic Therapies","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-05-05T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-01958","source_score":41,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-12T13:24:35.205Z","updated_at":"2026-06-12T13:24:35.205Z","tags":[{"paper_doi":"10.1200/jco-25-01958","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"condition","value":"Metastatic Non-Small Cell Lung Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"condition","value":"Non-Small Cell Lung Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"modality","value":"Image-Guided Ablation","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"modality","value":"Radiotherapy","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"modality","value":"Surgical Resection","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"warning","value":"Age group tagged as 'adult' by inference from NSCLC context; paper does not explicitly restrict to adults.","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"warning","value":"No sample size is applicable; the paper is a narrative review.","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"warning","value":"The 'practice_changing' flag is aspirational—the framework requires prospective validation before direct clinical adoption.","value_numeric":null},{"paper_doi":"10.1200/jco-25-01958","tag_type":"warning","value":"This is a conceptual/opinion framework paper with no primary patient data; the 'practice_changing' impact flag reflects the novelty of the proposed framework, not validated clinical outcomes.","value_numeric":null}],"summaries":{"limitations":"This is a narrative/conceptual review without prospective clinical validation; no patient cohort or outcome data are presented; proposed standardized reporting parameters and biomarker tools require external validation across studies.","what_studied":"This paper introduces 'metastatic trajectories'—a framework characterizing spatiotemporal dynamics of response and progression across individual lesions in metastatic NSCLC—to guide adaptive local (radiotherapy, surgery, ablation) and systemic therapies beyond existing single-state oligometastatic classifications.","key_result":"No clinical trial data are reported; the paper proposes a conceptual framework covering dimensions such as response magnitude, resistance mechanisms, organotropism, and progression pace, along with standardized reporting parameters and biomarker strategies (ctDNA, radiomics, integrative genomics/imaging) for trajectory tracking.","practice_takeaway":"Consider evaluating lesion-level response patterns—not just overall disease state—when selecting patients for local therapies like SBRT or ablation in metastatic NSCLC. Emerging tools such as ctDNA and radiomic signatures may soon help predict which lesions will progress and guide treatment timing."}},{"doi":"10.1016/j.eururo.2026.03.022","pmid":"42049595","title":"European Association of Urology and American Society of Clinical Oncology Guidelines on Penile Cancer: A Summary of the 2026 Guidelines Update","journal_title":"European Urology","journal_issn":"0302-2838","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1016/j.eururo.2026.03.022","source_score":10,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-04T13:26:24.820Z","updated_at":"2026-07-04T13:26:24.820Z","tags":[{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"condition","value":"Penile Cancer","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"modality","value":"Surgical Oncology","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"modality","value":"Systemic Therapy","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"modality","value":"Ultrasound-Guided Biopsy","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"warning","value":"Full text of the paper was not accessible — the publisher page returned a CAPTCHA challenge. The summary is based solely on the abstract provided. Specific recommendation grades, evidence levels for individual recommendations, and detailed systemic therapy data could not be verified.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"warning","value":"No sample size is applicable as this is a guideline summary document, not a primary study.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.022","tag_type":"warning","value":"Publication date (2026-04-27) is in the future relative to most training data; this is flagged as a prospective guideline, not a clinical trial.","value_numeric":null}],"summaries":{"what_studied":"A summary and critical appraisal of the 2026 EAU-ASCO joint guideline update on penile cancer, covering diagnosis, staging, treatment, quality of life, and emerging personalised approaches, compared against prior guideline versions.","key_result":"Major updates include refined pathological risk stratification, routine ultrasound-guided nodal assessment, broader organ-preserving surgery guidance, selective genomic testing, new nodal management flow diagrams, expanded systemic therapy evidence, and greater emphasis on survivorship and centralisation of care. Many recommendations remain based on retrospective data and expert consensus due to disease rarity.","limitations":"Most recommendations are informed by retrospective data and expert consensus rather than prospective trials, reflecting the rarity of penile cancer and limited high-quality evidence.","practice_takeaway":"Clinicians should adopt routine US-guided nodal assessment and favour organ-preserving strategies where feasible, guided by refined pathological risk stratification. Centralising care and integrating shared decision-making with survivorship planning are now explicitly reinforced by the updated guidelines."}}],"initialOffset":8,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Systemic Therapy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Systemic Therapy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Systemic Therapy"}}}]]

Papers