Oncology

Families value precision-medicine recommendations, but recall is incomplete.

In the Australian PRISM trial, 87% of parents expected benefit and 68% expected treatment recommendations at enrolment. Seventy percent of parents received a recommendation, but only about half recalled it after results disclosure. Parents reported high decision involvement (93/100) and satisfaction (95/100). Receiving a recommendation was not associated with regret about trial participation. 1

Longitudinal PRO deterioration often precedes relapse and boosts survival prediction when combined with PFS.

Across 2,738 breast cancer patients and 445,239 PRO entries, 89.2% had PRO deterioration before radiographic relapse (median timing difference reported). PRO worsening correlated with metastatic burden, tumor size, and survival; appetite loss linked to tumor size, pain and diarrhea prognostic for OS and PFS. Machine learning combining PRO deterioration times with PFS produced an OS AUC of 0.932, outperforming PROs or PFS alone. These data support PROs as early, noninvasive complementary biomarkers for monitoring breast cancer. 2

Cardio-oncology prevention trials show modest, inconsistent benefits, usually subclinical.

Randomized trials of pharmacologic and nonpharmacologic prevention report modest, inconsistent effects mainly on subclinical cardiac measures or biomarkers. Reductions in clinically meaningful outcomes such as overt heart failure or cardiovascular mortality remain limited or uncertain. Trials often exclude patients with existing cardiac disease and use heterogeneous event definitions, limiting external validity. The authors call for risk-enriched designs, broader inclusion, standardized safety monitoring, and clinically relevant endpoints. 3