BACKGROUND:Hepatocellular carcinoma(HCC) is the sixth most common cancer and the third leading cause of cancer-related death worldwide. Our updated network meta-analysis aims to compare and rank first-line treatment regimens for advanced HCC. METHODS:We searched PubMed, EMBASE, Scopus, and Cochrane from inception to May 2025 for phase III RCTs investigating first-line systemic therapies for advanced HCC. Derived hazard ratios(HRs) for each study were pooled in a random-effects NMA. The primary outcome was overall survival(OS), progression-free survival(PFS), objective response rate(ORR), and ≥ Grade 3 treatment-related adverse events(TRAE) of the assessed treatment in comparison to Sorafenib and Lenvatinib. Subgroup analysis for OS and PFS was conducted using study-level HRs. P-scores were used to rank the treatment strategies numerically. RESULTS:Seventeen studies involving 12,727 patients were included in the final analysis. Nivolumab-Ipilimumab(HR:0.61,95%CI:0.44-0.84), Atezolizumab-Bevacizumab(HR:0.66,95%CI:0.48-0.90), Durvalumab-Tremelimuma(HR:0.76,95%CI:0.59-0.97), Sintilimab-BevSim(HR:0.57,95%CI:0.41-0.80), and Camrelizumab-Rivoceranib(HR:0.62,95%CI:0.45-0.85) had superior OS compared to Sorafenib. Only Sintilimab-BevSim(HR:0.66,95%CI:0.44-0.99) and Nivolumab-Ipilimumab(HR:0.70,95%CI:0.54-0.92) had superior OS compared to Lenvatinib. Based on p-score rankings only, Nivolumab-Ipilimumab had the highest p-score for OS, PFS, and ORR among the three FDA and EMA approved combination regimens, with similar ≥ Grade 3 TRAE compared to Sorafenib. In the subgroup analysis, Atezolizumab-Cabozantinib has the highest p-score for HBV, Atezolizumab-Bevacizumab the highest for HCV, Durvalumab-Tremelimumab for non-viral aetiology, and Pembrolizumab-Lenvatinib for AFP≥400. CONCLUSION:Our NMA comprehensively compares therapeutic regimens across key clinical outcomes, including OS, PFS, ORR, and ≥ Grade 3 TRAE. The heterogeneity in treatment responses across patient subgroups underscores the importance of personalized approaches in managing HCC.
BACKGROUND:Neighborhood gentrification leads to displacement of people, networks, and resources, and to differences in how income is distributed in the community. Few studies, however, have examined the roles of neighborhood gentrification and income inequality in relation to cancer incidence, particularly among Hispanic/Latino populations. We examined measures of neighborhood gentrification and income distribution in association with cancer risk among Hispanic/Latino adults. METHODS:We included 14,303 adults (ages 18-75 years) from the Hispanic Community Health Study/Study of Latinos with geocoded addresses at baseline in 2008-2011. Incident cancers diagnosed from baseline through 2021 were ascertained via linkages with four state cancer registries. Neighborhood gentrification from 2000-2010 was assessed using the Gentrification Index. Income inequality in 2005-2009 was assessed using the Gini Coefficient. Multivariable survey-weighted Cox regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for the associations between quartiles of gentrification and income inequality and cancer incidence. We also conducted stratified analyses by household-level poverty (FPL), HCHS/SOL field center, and insurance status. RESULTS:A total of 701 incident cancers were diagnosed over a mean follow-up of 10.4 (range=0.1-13.8) years. Those in Gentrification Index Quartile 4 (vs. Q1) had a 43% increase in cancer risk (HR = 1.43; 95%CI=1.02-2.01), and those in Gini coefficient Quartile 4 (vs. Q1) had a 52% increase in cancer risk (HR = 1.52; 95%CI=1.03-2.26). Associations varied by health insurance status, but not by FPL or field center. CONCLUSION:The highest versus lowest levels of neighborhood gentrification and income inequality were associated with increases in cancer risk among Hispanic/Latino adults.
Chemotherapy-induced nausea and vomiting are among the most distressing side effects of cancer therapy. Younger age is a risk factor for chemotherapy-induced nausea and vomiting, and cancer incidence is rising among young adults ages 18-39 years. However, the comparative burden of chemotherapy-induced nausea and vomiting in young adults vs non-young adults remains insufficiently understood. This study compared acute and delayed chemotherapy-induced nausea and vomiting between young adults and non-young adults (ie, ages 40 years and older) after the first infusion of moderately or highly emetogenic chemotherapy. Of 1609 participants, 159 (10%) were young adults. Rates of guideline-consistent antiemetic prophylactic care were similar between groups (65% young adults, 71% non-young adults; P = .11). Despite this, acute nausea was more prevalent (69% vs 40%; P < .001) and severe (mean [SD] = 3.9 [2.6] vs mean = 3.0 [2.3] on 0-10 scale; P < .001) among young adults vs non-young adults. Similarly, delayed nausea was more prevalent (85% vs 69%; P < .001) and severe (mean = 4.5 [2.4] vs mean = 3.7 [2.5]; P < .001) among young adults. Findings may inform clinical approaches to managing chemotherapy-induced nausea and vomiting among young adults.
Artificial intelligence (AI) is increasingly being integrated into oncology for applications including cancer detection, risk stratification, treatment planning, and clinical documentation. Concerningly, growing evidence demonstrates that AI systems can reproduce or amplify existing disparities across patient populations. Although considerable effort has focused on developing computational methods to reduce algorithmic bias, many challenges surrounding fairness extend beyond technical implementation. In this commentary, we examine algorithmic fairness in oncology from both technical and normative perspectives. We review common sources of bias throughout the machine learning pipeline, discuss major statistical definitions of fairness, including demographic parity, calibration, and equalized odds, and highlight the inherent trade-offs among these metrics. We further explore how fairness often conflicts with overall predictive performance, arguing that model selection inevitably reflects ethical judgments rather than purely technical optimization. We discuss the limitations of current bias mitigation strategies and contend that many disparities rooted in historical and structural inequities cannot be resolved through algorithmic interventions alone. Finally, we outline priorities for the responsible development and deployment of clinical AI, including greater transparency in fairness decisions, context-specific evaluation standards, ongoing post-deployment auditing, and stronger regulatory oversight. Achieving equitable AI in oncology will require coordinated efforts among developers, clinicians, regulators, and patients to ensure that these technologies improve outcomes without perpetuating existing inequities.
BACKGROUND:Despite effective antiretroviral therapy, people living with human immunodeficiency virus (HIV) (PLWH) remain at a higher risk of developing Hodgkin lymphoma (HL). Further, survival disparities persist despite similar treatment recommendations. METHODS:Herein, we present a global retrospective cohort study including data of adults (≥18 years) diagnosed with HL between 2015 and 2025 from the TriNetX database to evaluate the survival outcomes of Hodgkin lymphoma in HIV-infected vs non-HIV-infected patients and analyze the associated risk factors. Patients were stratified according to HIV status and matched 1:1 for age, sex, race, and comorbidities. Overall survival (OS) was analyzed using Kaplan-Meier and Cox proportional hazards models. RESULTS:A total of 927 matched HIV-infected and non-HIV-infected patients were included. Overall, HIV-positive status was associated with significantly inferior OS (HR 1.42; 95% CI 1.10-1.84; P = .033). Among PLWH, cerebrovascular disease, hepatitis C virus infection, and chronic kidney disease independently predicted increased mortality. In a matched subgroup of patients treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy (n = 154 per group), OS did not differ significantly between the HIV-positive and HIV-negative groups (HR 1.37; 95% CI 0.73-2.56; P = .247). CONCLUSION:In conclusion, HIV-infected patients with HL experienced worse OS compared with non-HIV-infected individuals, but the outcomes were comparable when treated with ABVD chemotherapy, highlighting the importance of optimal treatment delivery and comorbidity management in PLWH.
INTRODUCTION:Curative-intent treatment for pancreatic ductal adenocarcinoma (PDAC) necessitates major surgery and chemotherapy, yet many patients do not undergo resection. Frailty may contribute to this phenomenon, but its prevalence and association with pancreatectomy in PDAC remains poorly defined. This study describes the distribution of frailty and its association with curative-intent surgery in a nationally representative cohort of patients with non-metastatic PDAC. METHODS:Using SEER-Medicare data (2013-2019), we identified patients ≥66-years-old with non-metastatic PDAC. Frailty was categorized as non-frail, pre-frail, mildly frail, or moderately-to-severely frail using the Claims-based Frailty Index over the 12 months preceding diagnosis. We evaluated frailty distributions via kernel density estimation. We assessed the association between frailty category and receipt of surgery via logistic regression. RESULTS:Among 8,237 patients (mean age 78, 57.6% female, 77.4% White), 2,486 underwent curative-intent pancreatectomy (30.2%). Surgery was performed in 39.7% of non-frail and 30.7% of pre-frail patients; after adjustment, pre-frail patients had similar odds of resection compared to non-frail patients [aOR = 1.01, 95% CI = (0.89-1.16)]. In contrast, 15.8% of mildly frail and 5.7% of moderately-to-severely frail patients underwent surgery; both groups had significantly lower odds of surgery versus non-frail patients [mildly frail aOR = 0.53, 95% CI = (0.43-0.66); moderately-to-severely frail aOR = 0.18, 95% CI = (0.11-0.30)]. CONCLUSIONS:Remarkably, less than 40% of non-frail patients with non-metastatic PDAC underwent surgery, suggesting that curative-intent treatment remains infrequent even amongst lower-risk adults. Frailty is also common and strongly associated with decreased odds of surgical resection.
BACKGROUND:Stomach cancer presents complex etiologic heterogeneity. Ethanol in alcoholic beverages and its metabolite acetaldehyde are carcinogens causally linked to several cancers, but their role in gastric carcinogenesis has not been established. We analyzed harmonized, individual-level prospective data to examine associations between alcohol intake and risk of stomach cancer and its subtypes. METHODS:2,009,951 participants in 20 cohorts (mean follow-up=9-29 years) within the Pooling Project of Prospective Studies of Diet and Cancer (n = 8,357 incident invasive gastric adenocarcinomas) were included. We used Cox regression to assess associations between alcohol intake and risk of stomach cancer overall and by anatomical and histological subtype and population subgroup, adjusting for confounders. RESULTS:Evidence for an association between alcohol intake and overall stomach cancer risk was weak (hazard ratio, HR, for ≥30 v 0.1-<5 g/day: 1.06 [95% confidence interval, CI, 0.96 to 1.16], P between-studies heterogeneity=0.43). Positive associations with stomach cancer risk were observed in never smokers (HR, for ≥30 v 0.1-<5 g/day: 1.20 [95% CI, 1.02 to 1.42]; P interaction=0.02) and for Asian studies (HR, 1.21 [95% CI, 1.02 to 1.42]; P interaction=0.01). Modest increased risks were observed for non-cardia cancers such as those of the fundus, body and greater curvature, but not distally located non-cardia cancers. HRs did not differ materially between diffuse- and intestinal-type cancers (P heterogeneity>0.05). CONCLUSION:There was little evidence of an overall association between alcohol intake and stomach cancer risk, although modest positive associations were observed among never smokers and in Asian cohorts.
BACKGROUND:Aboriginal and Torres Strait Islander peoples experience greater cancer incidence rates, unmet information needs, and poorer cancer outcomes compared to the general Australian population. This environmental scan evaluated cancer websites for Aboriginal and Torres Strait Islander peoples in Australia. METHODS:An environmental scan using 8 Google searches was conducted in July 2025 to identify cancer-related websites targeted toward Aboriginal and Torres Strait Islander peoples in Australia. Patient-facing resources were assessed for readability, understandability, and actionability using grade level assessments of readability and the Patient Education Materials Assessment Tool. Cultural relevance was assessed using an Aboriginal cultural relevance measure. RESULTS:Of 239 search results, 12 websites were patient facing and contained material for Aboriginal and Torres Strait Islander readers, primarily on common cancers. Readability generally exceeded the recommended Grade 6 reading level, with only one resource below Grade 6 level. Resources were considered understandable with scores of >80% for 7/12 websites (range 50-100%); 2/12 included summaries and 7/12 plain language. Actionability scores ranged from 0% to 100% (M = 63.6%, SD = 37.0), with wide variation. Cultural relevance averaged 3.8/7 (SD = 1.9) with only one resource meeting all criteria (7/7). Most lacked cultural specificity and did not provide Aboriginal and Torres Strait Islander languages translations. CONCLUSION:Our results necessitate co-design with Aboriginal and Torres Strait Islander peoples for resources appropriate to community needs and including information on a broad range of cancers. Websites should optimize the readability and cultural safety of information for Aboriginal and Torres Strait Islander peoples seeking cancer information.
BACKGROUND:Prostate cancer disproportionately affects vulnerable populations. The All of Us Research Program (AoURP) is a database that aims to encapsulate the diversity of the United States. To explore the utility of this dataset in assessing prostate cancer disparities, we investigated whether treatment usage, disease progression, and genomic research participation vary across sociodemographic factors among AoURP participants with prostate cancer. METHODS:We identified AoURP participants with prostate cancer. Genomic research participation in AoURP, treatment usage, time-to-treatment, and time-to-metastasis were assessed by demographics and distance from a National Cancer Institute-designated comprehensive cancer center. Multivariable logistic regression and Cox proportional hazards regression were performed to evaluate treatment usage and time-to-treatment and time-to-metastasis, respectively. RESULTS:We observed lower genomic data availability in Black vs White patients (P < .001). In multivariable analyses, patients residing more than 80 miles from an NCI-designated comprehensive cancer center were less likely to receive androgen receptor pathway inhibitors (odds ratio [OR] = 0.30, 95% CI = 0.14 to 0.66; P = .002) and bone targeting agents (OR = 0.46, 95% CI = 0.30 to 0.70; P < .001) but more likely to undergo prostatectomy (OR = 1.97, 95% CI = 1.43 to 2.71; P < .001) than those residing less than 40 miles away. These patients also initiated treatment faster (hazard ratio [HR] = 1.54, 95% CI = 1.27 to 1.87; P < .001) and developed metastasis slower (HR = 0.58, 95% CI = 0.40 to 0.86; P = .006). Black patients were less likely to receive radiation (OR = 0.45, 95% CI = 0.23 to 0.88; P = .020), prostatectomy (OR = 0.65, 95% CI = 0.44 to 0.96; P = .028), and bone targeting agents (OR = 0.65, 95% CI = 0.45 to 0.93; P = .018) than White patients. CONCLUSIONS:Prostate cancer treatment usage, disease progression, and genomic research participation varied between demographic populations. As AoURP matures, additional studies may leverage future data releases to confirm these findings.
BACKGROUND:While the ProtecT randomized trial demonstrated comparable oncologic outcomes between radical prostatectomy (RP) and radiation therapy (RT) for localized prostate cancer, several retrospective studies have reported mixed findings. In this study, we investigated whether non-randomized studies tend to favor RP or RT and assessed whether the specialty of leading authors-urologists or radiation oncologists-correlates with study conclusions. METHODS:We identified non-randomized clinical studies published between 1993 and 2024 that compared RP and RT for localized prostate cancer and reported oncologic outcomes including biochemical, metastasis, and/or survival outcomes. Author specialty was determined based on whether the first and senior authors were affiliated with urology or radiation oncology departments. Studies in which a urologist and radiation oncologist were first and senior authors were excluded. Each study's conclusion was categorized as favoring surgery, favoring radiation, or reporting no conclusive difference in oncologic outcomes. Multivariate logistic regression was used to evaluate predictors of study conclusions. RESULTS:A total of 105 studies met inclusion criteria. Nearly half (44%) reported no conclusive difference in outcomes, while 42% favored RP and 14% favored RT. Multivariate analysis showed that use of national databases (P = .01) and urology author specialty (P = .01) predicted conclusions aligning with the author's specialty. In a subgroup excluding studies relying solely on biochemical recurrence-free survival outcomes, author specialty remained associated with conclusions, with urologists more likely to favor RP (P = .006). CONCLUSION:Author specialty was associated with the direction of study conclusions. Further research is needed to understand how these patterns may influence interpretation and decision-making in prostate cancer treatment.
BACKGROUND:Circulating levels of Cancer Antigen (CA) 15-3 have been associated with distant breast cancer (bc) recurrence; data on bc subtypes is sparse. We examined associations of CA 15-3 with outcomes across immunohistochemically defined bc subtypes in MA.32. METHODS:3649 participants with T1-3, N0-1, M0 bc were randomized; 2740 (75.1%) provided blood at entry (mean 278 days post diagnosis) and 6 months later. Prognostic associations of baseline and 6-month change in CA 15-3 with distant recurrence free survival (DRFS) were examined in luminal (ER/PgR positive, HER2 negative), triple negative (ER, PgR, HER2 negative) and HER2 positive (any ER/PgR) bc using Cox proportional hazards models. RESULTS:Mean age was 52 years. bc was luminal in 1589 (58.7%), triple negative in 655 (24.2%) and HER2 positive in 464 (17.1%). Median follow-up was 96 months. CA 15-3 at study entry was not associated with outcome in any subtype. Rising CA 15-3 at 6 months was associated with poor DRFS in luminal and triple negative bc (HR per 25% increase = 1.41, P < 0.0001 and 1.35, P < 0.0001, respectively). New elevations in CA 15-3 at 6 months were adversely associated with DRFS in those with luminal or triple negative bc (HR 4.14, 95% CI 2.69-6.38, P < 0.001 and HR 3.57, 95% CI 1.59-7.99, P = 0.002, respectively). In HER2+ bc, CA15-3 was not associated with DRFS. CONCLUSION:Rising CA 15-3 was associated with reduced DRFS in luminal and triple negative bc but not in HER2 positive bc. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov NCT01101438.
COVID-19 pandemic-related disruptions may have altered pediatric cancer detection in the United States. Using the National Childhood Cancer Registry, we compared observed incidence rates among individuals aged 0-17 years during 2020-2022 with expected rates with 95% credible intervals (CrIs) derived from pre-pandemic trends. Rates were evaluated overall and by race/ethnicity, cancer site, and stage-at-diagnosis. Among 27 996 cancers diagnosed in 2020-2022, total incidence was 17.44 per 100 000, similar to the expected rate of 17.39 (95% CrI = 16.80-17.98). Annual patterns showed an incidence reduction in 2020, followed by modestly higher-than-expected rates in 2021-2022. Pandemic-era late-stage incidence was significantly higher than expected, however (10.58 vs 10.19 per 100 000). Overall, pediatric cancer incidence during the COVID-19 pandemic matched expectations, but late-stage diagnoses increased, underscoring the need to restore timely evaluation and maintain diagnostic access during health-system disruptions.
BACKGROUND:Engaging community stakeholders in clinical trials planning identifies participation barriers and facilitators to support future trial success. We assessed interest and perceived capacity of the National Cancer Institute Community Oncology Research Program (NCORP) practices and engaged stakeholders to inform a future multisite clinical trial involving caregivers. METHODS:A cross-sectional survey of NCORP practices (WF-2300CD) assessed interest (somewhat or very likely to participate) and capacity (ie, criteria: ≥5 eligible dyad accruals per quarter, identification of necessary study implementers) and barriers and facilitators to participating in a future cancer caregiver-focused trial. Interest and capacity were estimated with 95% confidence intervals (CIs), and logistic regression was used to identify statistically significant predictors. Free-text responses were analyzed using content analysis. RESULTS:Among 136 initial responding practices, 126 (92%) completed the survey (November 2023-April 2024), 56% saw at least 1000 new patient cases annually, 13.5% served at least 30% racial and ethnic minority patients, and 13.5% were designated critical access hospitals. Overall, 84.9% (95% CI = 77.5% to 90.1%) expressed interest in a caregiver-focused trial, but only 37.3% (95% CI = 28.9% to 46.4%) met all capacity criteria; capacity was the sole predictor of interest (adjusted odds ratio [OR] = 5.79, 95% CI = 1.23 to 27.13). Most (88.9%) practices estimated 5 or more eligible caregiver-patient dyads per quarter, but only 44.4% believed they could accrue that amount. Key participation barriers included staffing limitations and challenges related to eligibility and recruitment. Practices emphasized clear guidance on dyad eligibility, recruitment materials, workflow training, and resource considerations to improve trial participation. CONCLUSION:Early stakeholder engagement identified actionable barriers and produced practice-aligned strategies to enhance caregiver trial participation in community oncology settings. Targeted capacity building may improve participation for future caregiver-focused trials.
BACKGROUND:Although survival rates for acute lymphoblastic leukemia (ALL) in developed countries have reached up to 80%, outcomes remain considerably lower in emerging nations. This study aimed to evaluate the 10-year survival of pediatric patients with ALL treated at a public hospital using the HP 09 protocol, adapted from the BFM 95 protocol. METHODS:We included patients under 17 years of age diagnosed with ALL and treated with the HP 09 protocol between January 2010 and December 2020. Patients were stratified into 3 risk groups according to clinicobiological characteristics. RESULTS:A total of 253 patients were analyzed. The cohort demonstrated a 10-year overall survival (OS) rate of 58.1% (90.4 ± 4.8 months) and an event-free survival (EFS) rate of 56.9% (78.2 ± 5.0 months). By risk group, the 10-year OS was 41% in the high-risk group, 61.9% in the intermediate-risk group, and 85.7% in the standard-risk group. Corresponding 10-year EFS rates were 55.2%, 57.1%, and 59.7%. Cox regression analysis identified older age (>10 years; OR = 2.11, 95% CI = 1.36 to 3, P = .001), leukocyte count >50 × 109/L (OR = 1.89, 95% CI = 1.22 to 2.93, P = .004), and prior steroid exposure before diagnosis (OR = 2.30, 95% CI = 1.16 to 4.58, P = .017) as significant predictors of relapse. CONCLUSIONS:This study highlights a substantial disparity in survival rates among pediatric patients with ALL in Mexico compared with international benchmarks. The gap likely reflects differences in chemotherapy efficacy, disease biology, and systemic healthcare limitations.
BACKGROUND:Colorectal cancer (CRC) survival is improving, yet long-term survivors remain at risk for cancer- and treatment-related late effects, which may emerge many years after diagnosis and treatment. We aimed to summarize evidence on late effects and their risk factors reported ≥5 years after CRC diagnosis, compared to cancer-free controls. METHODS:The literature search for this scoping review was conducted in PubMed, EMBASE, and Web of Science from inception to November 18, 2025. Primary research studies investigating late effects and providing relative risk estimates specifically ≥5 years after diagnosis were included. Risk of bias was assessed with the Newcastle-Ottawa-Scale. The study was registered with Open Science Framework, 10.17605/OSF.IO/JY6DX. RESULTS:We identified 9 observational studies that reported relative risk estimates for late effects. Seven studies had a low risk of bias and 2 were at moderate risk. The most frequently investigated late effect was incidence of diabetes (5 studies). The highest relative risks were reported for immunity disorders (5-10 years hazard ratio [HR] = 4.56, 99% CI = 1.36 to 15.31), depression (>5 years HR = 2.65, 95% CI =1.61 to 4.36), and nutritional deficiency (5-10 years HR = 1.69, 99% CI = 1.38 to 2.08). Comorbidities at diagnosis, age at diagnosis, and treatment were the most common risk factors associated with late effects. CONCLUSIONS:This scoping review found that even ≥5 years after diagnosis late effects requiring treatment are considerably more common among CRC survivors than cancer-free controls. The small number of studies and the broad spectrum of identified late effects highlight the need for extensive research to characterize late effects to improve long-term survivorship care.
BACKGROUND:Research suggests that burnout and work-related quality of life are concerns for pediatric oncology professionals, with limited supportive resources. This study aimed to address this resource gap through an intervention promoting hope and targeting burnout and quality of life in this group. METHODS:A single-arm pilot study of the intervention was conducted at Rady Children's Hospital San Diego. The intervention was delivered as a single-session workshop, followed by reinforcement through a mobile application. Feasibility was assessed through recruitment and retention metrics, application usage data, and informal participant acceptability feedback. Exploratory efficacy analyses were conducted on measures of hope and perceived control (intervention mechanisms), occupational burnout and professional quality of life (primary outcomes), and empathy (secondary outcome) at baseline and 1, 4, and 12 weeks post-intervention. RESULTS:Twenty participants were consented and 18 participated, with 13 (72%) completing 12-week surveys. A total of 15 participants (83%) opted to receive daily push notifications, but only 3 (20%) engaged in daily booster questions. Positive feedback suggested acceptability. Exploratory findings suggested changes in emotional exhaustion (baseline to 1 week, P = .02; baseline to 4 weeks, P = .01), a sub-construct of burnout, and secondary traumatic stress (baseline to 4 weeks, P = .01; baseline to 12-week scores, P = .01), a sub-construct of professional quality of life. CONCLUSIONS:The Hopetimize intervention was feasible for pediatric oncology health-care professionals, although daily application usage was limited. Exploratory findings suggested that a randomized controlled trial would be beneficial to delineate intervention effects on the proposed mechanisms and outcomes.
