Optimal timing for initiating first-line palliative systemic
therapy in asymptomatic metastatic esophagogastric cancer:
Insights from a European Delphi study

J 2025

Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study

KAMP, Denice; Anne M MAY; Antoine ADENIS; Andreia CAPELA; Sarah DERKS et. al.

Základní údaje

Originální název

Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study

Autoři

Vydání

European Journal of Cancer, London, ELSEVIER, 2025, 0959-8049

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 7.600 v roce 2023

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.ejca.2025.115278

UT WoS

001428190100001

EID Scopus

2-s2.0-85216854250

Klíčová slova anglicky

Esophageal cancer; Gastric cancer; Metastasis; Delphi Technique; Chemotherapy; Palliative medicine

Štítky

14110811, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 2. 4. 2025 10:52, Mgr. Tereza Miškechová

Anotace

V originále

Background: The enhanced application of imaging techniques is resulting in the diagnosis of more patients with asymptomatic metastatic esophagogastric cancer (mEGC). We conducted a Delphi study to gather insights from European experts on the optimal timing for initiating palliative systemic therapy for these patients. Methods: An online survey featured 14 scenarios where physicians chose their preferred timing for initiating systemic therapy: immediate(<3 weeks) or deferred. The standard scenario was a 65-year-old male, WHO/ECOG 0 with asymptomatic mEGC, 2 metastases in each lung, HER2 -, PDL1-CPS 2. In every subsequent case, one characteristic was modified. To investigate the fortitude of the physicians' preference for an immediate start, scenarios also included a patient who was motivated to start but preferred to defer if the physician deemed it judicious. Consensus was defined as >= 75 % agreement; scenarios without consensus were re-evaluated in Delphi round 2. Results: Thirty-nine physicians participated in the first round, and 33 in the second round. Consensus to start treatment immediately was reached in 12 (86 %) scenarios. When patients preferred to defer, the consensus was to still advise to start palliative systemic treatment immediately in half (n = 7) of the scenarios. Only 2 scenarios (pre-existent WHO/ECOG 2 or 78 years old) reached the consensus that treatment could be deferred. Conclusions: In asymptomatic mEGC, immediate start of treatment is preferred by European experts. Consensus was established that treatment can be deferred for patients who prefer deferral and either have a pre-existent WHO/ECOG performance status of 2 or are of advanced age.

Citovat

KAMP, Denice; Anne M MAY; Antoine ADENIS; Andreia CAPELA; Sarah DERKS; De Felice FRANCESCA; Nina Fokter DOVNIK; Cinta HIERRO; Aysegul ILHAN-MUTLU; Florian LORDICK; Radka LORDICK OBERMANNOVÁ; Angelica PETRILLO; Alberto PUCCINI; Ana RAIMUNDO; Giandomenico ROVIELLO; Alexander SIEBENHUNER; Marije SLINGERLAND; Elizabeth C SMYTH; Hanneke W M LAARHOVEN a Nadia Haj MOHAMMAD. Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study. European Journal of Cancer. London: ELSEVIER, 2025, roč. 218, March 2025, s. 1-7. ISSN 0959-8049. Dostupné z: https://dx.doi.org/10.1016/j.ejca.2025.115278.

@article{2488522,
   author = {Kamp, Denice and May, Anne M and Adenis, Antoine and Capela, Andreia and Derks, Sarah and Francesca, De Felice and Dovnik, Nina Fokter and Hierro, Cinta and IlhanandMutlu, Aysegul and Lordick, Florian and Lordick Obermannová, Radka and Petrillo, Angelica and Puccini, Alberto and Raimundo, Ana and Roviello, Giandomenico and Siebenhuner, Alexander and Slingerland, Marije and Smyth, Elizabeth C and Laarhoven, Hanneke W M and Mohammad, Nadia Haj},
   article_location = {London},
   article_number = {March 2025},
   doi = {http://dx.doi.org/10.1016/j.ejca.2025.115278},
   keywords = {Esophageal cancer; Gastric cancer; Metastasis; Delphi Technique; Chemotherapy; Palliative medicine},
   language = {eng},
   issn = {0959-8049},
   journal = {European Journal of Cancer},
   title = {Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study},
   url = {https://www.sciencedirect.com/science/article/pii/S0959804925000590?via%3Dihub},
   volume = {218},
   year = {2025}
}

TY  - JOUR
ID  - 2488522
AU  - Kamp, Denice - May, Anne M - Adenis, Antoine - Capela, Andreia - Derks, Sarah - Francesca, De Felice - Dovnik, Nina Fokter - Hierro, Cinta - Ilhan-Mutlu, Aysegul - Lordick, Florian - Lordick Obermannová, Radka - Petrillo, Angelica - Puccini, Alberto - Raimundo, Ana - Roviello, Giandomenico - Siebenhuner, Alexander - Slingerland, Marije - Smyth, Elizabeth C - Laarhoven, Hanneke W M - Mohammad, Nadia Haj
PY  - 2025
TI  - Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study
JF  - European Journal of Cancer
VL  - 218
IS  - March 2025
SP  - 1-7
EP  - 1-7
PB  - ELSEVIER
SN  - 09598049
KW  - Esophageal cancer
KW  - Gastric cancer
KW  - Metastasis
KW  - Delphi Technique
KW  - Chemotherapy
KW  - Palliative medicine
UR  - https://www.sciencedirect.com/science/article/pii/S0959804925000590?via%3Dihub
N2  - Background: The enhanced application of imaging techniques is resulting in the diagnosis of more patients with asymptomatic metastatic esophagogastric cancer (mEGC). We conducted a Delphi study to gather insights from European experts on the optimal timing for initiating palliative systemic therapy for these patients. Methods: An online survey featured 14 scenarios where physicians chose their preferred timing for initiating systemic therapy: immediate(<3 weeks) or deferred. The standard scenario was a 65-year-old male, WHO/ECOG 0 with asymptomatic mEGC, 2 metastases in each lung, HER2 -, PDL1-CPS 2. In every subsequent case, one characteristic was modified. To investigate the fortitude of the physicians' preference for an immediate start, scenarios also included a patient who was motivated to start but preferred to defer if the physician deemed it judicious. Consensus was defined as >= 75 % agreement; scenarios without consensus were re-evaluated in Delphi round 2. Results: Thirty-nine physicians participated in the first round, and 33 in the second round. Consensus to start treatment immediately was reached in 12 (86 %) scenarios. When patients preferred to defer, the consensus was to still advise to start palliative systemic treatment immediately in half (n = 7) of the scenarios. Only 2 scenarios (pre-existent WHO/ECOG 2 or 78 years old) reached the consensus that treatment could be deferred. Conclusions: In asymptomatic mEGC, immediate start of treatment is preferred by European experts. Consensus was established that treatment can be deferred for patients who prefer deferral and either have a pre-existent WHO/ECOG performance status of 2 or are of advanced age.
ER  -

KAMP, Denice; Anne M MAY; Antoine ADENIS; Andreia CAPELA; Sarah DERKS; De Felice FRANCESCA; Nina Fokter DOVNIK; Cinta HIERRO; Aysegul ILHAN-MUTLU; Florian LORDICK; Radka LORDICK OBERMANNOVÁ; Angelica PETRILLO; Alberto PUCCINI; Ana RAIMUNDO; Giandomenico ROVIELLO; Alexander SIEBENHUNER; Marije SLINGERLAND; Elizabeth C SMYTH; Hanneke W M LAARHOVEN a Nadia Haj MOHAMMAD. Optimal timing for initiating first-line palliative systemic therapy in asymptomatic metastatic esophagogastric cancer: Insights from a European Delphi study. \textit{European Journal of Cancer}. London: ELSEVIER, 2025, roč.~218, March 2025, s.~1-7. ISSN~0959-8049. Dostupné z: https://dx.doi.org/10.1016/j.ejca.2025.115278.

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