AIM:Chemotherapy is given for early-stage breast cancer; however, some patients discontinue before completing all planned cycles. This study investigated the impact of early chemotherapy discontinuation on treatment outcomes. METHODS:This retrospective cohort study used a target trial emulation framework to conduct a causal analysis of the all-cause mortality impact of completing a standard course of chemotherapy. Early-stage breast cancer patients treated with chemotherapy in England between 01/01/2014 and 31/12/2015 were identified from the National Disease Registration Service and Systemic Anti-Cancer Therapy datasets. Five-year OS was estimated for patients completing greater than or equal to six chemotherapy cycles relative to discontinuing chemotherapy early (less than six cycles), representing standard treatment during the study period. A clone-censor-weight approach was used to account for time-related bias and baseline confounding. Absolute risk and hazard ratios (HRs) were calculated. RESULTS:A total of 10 253 patients were included: 68% (n = 7014) received greater than or equal to six chemotherapy cycles, and 32% (n = 3239) received fewer than six cycles. Individuals completing greater than or equal to six cycles showed superior 5-year OS compared with discontinuation less than six cycles (absolute risk difference -1.6, 95% confidence interval [CI], -3.2, -0.1; HR 0.85, 95% CI 0.74, 0.98). Subgroup analyses showed OS benefit in patients diagnosed at stage 2 relative to Stage 3 (HR 0.82, 95% CI 0.69, 0.98), ER+/HER2+ histology (HR 0.46, 95% CI 0.24, 0.96) and Non-White ethnicity (HR 0.56, 95% CI 0.34, 0.91) when receiving six cycles. CONCLUSION:Patients who completed greater than or equal to six cycles showed improved OS compared with those who discontinued before receiving six cycles. These findings support the identification and pre-emptive management of patients at high risk of discontinuing chemotherapy prematurely, to maximize treatment benefit.

Abstract Background Less than 20% of patients diagnosed with advanced lung cancer will survive beyond five years and half of these will suffer a serious adverse event (SAE) caused by systemic anticancer therapy (SACT) that will result in a hospital attendance. As multiple different SACT treatments are available for patients, a risk score that predicts the likelihood of a SAE following each type of SACT treatment would improve both communication with the patient and shared decision making with all those involved in delivering care for patients. There are currently no risk scores available for use in those with advanced stage lung cancer. Aim The overarching aim of this research is to develop and internally validate a risk score that will calculate the individualised risk of SAEs for different SACT treatments for patients with late stage lung cancer. Methods Utilising linked cancer registry data (National Cancer Registration and Analysis Service (NCRAS), England) for over 20,000 late stage lung cancer patients, a risk score will be developed using a multivariable logistic regression model to predict the risk of an acute admission within 30 days of SACT administration. Model performance will be summarised using calibration and discrimination. Internal validation will be used to quantify the degree of optimism due to overfitting, using re-sampling bootstrapping. Heterogeneity will be assessed, and the model will be fine-tuned. Fine-tuning and interrogation will be used to evaluate differences in performance between hospitals. The clinical utility will be assessed through calculating the net benefit in preventing SAEs. Conclusion A developed risk score (under each treatment strategy) has real potential to support individualised treatment decisions and optimise management of SACT-induced SAEs for patients and reduce hospital attendances.

BACKGROUND & AIMS:Increasing evidence suggests sexual dimorphism in treatment effects across cancers; however, its impact in biliary tract cancer (BTC) remains unclear. We compared toxicity and efficacy of palliative and adjuvant chemotherapy between male and female patients with BTC. METHODS:We conducted a retrospective cohort analysis of individual patient data from four randomized controlled trials in BTC and English population-based data. Study outcomes were adverse events and overall survival (OS), compared by sex. RESULTS:Among 994 trial participants (49% male, 51% female) included in time-to-event analyses, 770 were evaluable for adverse events. Population data included 3,953 patients (46% male, 54% female) for OS analysis. Females experienced higher rates of grade 3/4 fatigue (odds ratio [OR] 2.18; 95% CI 1.02-4.67; p = 0.045). Higher rates of grade 3/4 vomiting (OR 1.97; 95% CI 1.00-3.91; p = 0.052), nausea (OR 1.99; 95% CI 0.80-4.97; p = 0.14), and fatigue in BILCAP (OR 2.31; 95% CI 0.77-6.88; p = 0.13) were observed in females but were not statistically significant. OS was similar between sexes in ABC trials (hazard ratio [HR] 0.94; 95% CI 0.79-1.11; p = 0.45) and in population data (HR 1.03; 95% CI 0.79-1.11; p = 0.45). In BILCAP, the HR for adjuvant capecitabine vs. observation was 0.71 in males (95% CI 0.50-1.00; p = 0.048) and 0.91 in females (95% CI 0.63-1.32; p = 0.625). Females with gallbladder cancer demonstrated improved OS compared with males in BILCAP (HR 0.48; 95% CI 0.24-0.98; p = 0.04). CONCLUSION:Sex differences in toxicity were observed, with higher rates of grade 3/4 fatigue in females. Survival outcomes were broadly similar; however, females with gallbladder cancer receiving adjuvant capecitabine showed improved survival compared with males. Although population analyses were limited by sample size, these findings warrant consideration in the design and interpretation of future BTC trials. IMPACT AND IMPLICATIONS:This study investigated the impact of biological sex on treatment outcomes in patients receiving chemotherapy for biliary tract cancers, which are typically associated with poor outcomes. Analysis of ABC and BILCAP clinical trials found a higher incidence of severe grade adverse events in women receiving cisplatin/gemcitabine and adjuvant capecitabine, relative to males, whilst overall survival was superior in women in the BILCAP trial. These findings are important for clinicians treating patients with biliary tract cancers and should be considered in the design and analysis of future clinical trials in biliary tract cancer, as the role of biological sex may an important determinant of chemotherapy response.

Extravasation of anthracyclines is an uncommon but serious complication of systemic anticancer therapy (SACT), potentially causing significant tissue injury, treatment delays and psychological distress. Dexrazoxane is the only licensed pharmacological antidote for anthracycline extravasation; however, its real-world use, dosing adherence and clinical outcomes remain poorly characterised. This systematic review evaluates the clinical efficacy of dexrazoxane, assesses variations in its administration, summarises additional management strategies and describes reported patient outcomes. A systematic search was conducted in MEDLINE, EMBASE and CINAHL for studies published between January 2000 and June 2024. The review protocol was registered with PROSPERO (CRD42024611046). Data extraction captured patient demographics, dexrazoxane use, dosing adherence, surgical interventions, adjunct therapies and outcomes. Risk of bias was assessed using the Joanna-Briggs Institute checklist for case reports. Reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixteen articles describing 21 individual extravasation cases were included, all were categorised as low risk of bias. Dexrazoxane was administered in all cases; but licensed dosing was followed in only 52% (n=11). Variations included modified schedules, delayed administration and use of unlicensed products. Six patients (29%) required surgery in addition to pharmacological management. No limb loss occurred, and all patients recovered, with recovery ranging from days to months. Seven (33%) resumed SACT post-recovery. The range of adjunctive measures reported across the studies, reflected the absence of standardised extravasation management. Significant variation exists in dexrazoxane use and dosing when managing anthracycline extravasation. Given the limited case numbers and heterogeneity, definitive conclusions regarding the efficacy of dexrazoxane cannot be drawn. CRD42024611046

Objective To explore administrators’ and clinicians’ views on the factors that influence their use and adoption of a machine learning clinical decision support system (ML-CDSS) to predict patients’ risk of hepatic and renal deterioration during chemotherapy.Methods and analysis This was a qualitative study that used purposive sampling. 18 participants with administration and clinical backgrounds working in cancer care in England were recruited. Qualitative data were collected by conducting semi-structured interviews and a focus group. Data were analysed thematically using the framework method to identify key themes.Results Participants acknowledged that monitoring blood chemistry is a core component of chemotherapy as it helps clinicians assess patient fitness and treatment response. The ML-CDSS was perceived as a potentially valuable tool for identifying patients at increased risk of hepatic and renal deterioration, supporting clinical decision-making and enhancing care efficiency. However, several concerns were raised regarding its potential implementation in practice. Participants questioned clinicians’ willingness and capacity to integrate the tool into their existing workflows. Participants also believed it was important to demonstrate the ML-CDSS’s sensitivity, specificity and validity in accurately predicting patients’ risk to build clinicians’ trust in the tool, demonstrating evidence of its efficacy and effectiveness in practice.Conclusion Administrators and clinicians recognised the potential benefits of the ML-CDSS to enhance the delivery of chemotherapy by identifying patients at risk for hepatic and renal deterioration. Successful adoption in practice depends on building trust with the tool by being transparent in its development, its effectiveness and impact. Future work should demonstrate the ML-CDSS being used in practice to generate real-world evidence.

Part 2 of the International Consensus Guideline on Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) offers drug-specific consensus recommendations based on both evidence and practical experience. These recommendations build upon the kidney function assessment and classification guidelines established in Part 1 of ADDIKD. Here we illustrate how dosing recommendations differ between ADDIKD and existing guidance for four commonly used drugs: methotrexate, cisplatin, carboplatin and nivolumab. We then describe how the recommendations can be distilled into practice points for methotrexate and cisplatin. While ADDIKD is a significant improvement from previous guidelines, adoption of this new guideline requires further endorsement from key external stakeholders, 'change championing' by clinicians locally and encouraging its integration into existing reference sources, clinical trial protocols and electronic prescribing systems. Funding:Development of the ADDIKD guideline is funded by the NSW Government as part of the Cancer Institute NSW and received no funding from external commercial sources.

BACKGROUND:Fluoropyrimidine chemotherapy is administered first-line for many gastrointestinal cancers. However, patients with cardiovascular disease commonly receive alternative treatment due to cardiotoxicity concerns. OBJECTIVES:This study sought to assess the risks of all-cause mortality and acute cardiovascular events with fluoropyrimidine treatment. METHODS:We conducted an observational cohort study applying a target trial emulation framework to linked national cancer, cardiac, and hospitalization registry data from the Virtual Cardio-Oncology Research Initiative. Adults diagnosed with tumors eligible for fluoropyrimidine-based chemotherapy as first-line therapy were included. All-cause mortality and a composite of hospitalization for acute cardiovascular events (acute coronary syndrome, heart failure, cardiac arrhythmia, cardiac intervention, cardiac arrest, and cardiac death) were compared in patients treated with fluoropyrimidine-based chemotherapy vs alternative management. Adjusted, weighted pooled logistic regression models were used to estimate the 1-year risk difference (RD). RESULTS:Among 103,110 patients (mean age 69.7 years, 59% male), the absolute risk of death at 1 year was significantly lower in fluoropyrimidine-treated patients (RD: -7.7%; 95% CI: -8.7% to -6.7%) with a small increased risk of acute cardiovascular events (RD: 0.9%; 95% CI: 0.0% to 1.9%). This was primarily due to arrhythmias (RD: 0.8%; 95% CI: 0.1% to 1.6%) and cardiac arrest (RD: 0.3%; 95% CI: 0.1% to 0.5%), with no increased risk of acute coronary syndromes including in the subgroup of patients with pre-existing coronary artery disease. CONCLUSIONS:The markedly improved overall survival with fluoropyrimidines in patients with gastrointestinal cancer significantly outweighs the small risk of cardiac arrhythmia and arrest. Oncologists should take this into consideration for decision making to avoid undue clinical conservatism, particularly in patients with cardiovascular disease.

Reduced kidney function (or kidney dysfunction) is commonly an exclusion criterion for randomised controlled trials (RCTs) in cancer. Consequently, high quality evidence for anticancer drug dosing in reduced kidney function is limited and no internationally agreed guidelines exist to inform prescribing decisions in this population. A methodology for guideline development was applied which did not require availability of RCTs but used critical appraisal of existing observational literature and group consensus. An international multidisciplinary working group (n = 38) established consensus recommendations in two parts to form the International Consensus Guideline on Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD). The approach enabled virtual participation worldwide. In Part 1 we developed a standardised approach for assessment and classification of kidney function in patients with cancer using global nephrology standards and working group expertise. Part 2 involved a comprehensive literature search of 59 anticancer drugs followed by a critical appraisal of the evidence certainty through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process and development of dosing recommendations in reduced kidney function. Key external stakeholders (n = 9) invited expert contributors (n = 25), and the working group participated in virtual interactive workshops to vote on the acceptability of these recommendations. The participants were provided with evaluation of the literature, and they engaged in several rounds of virtual discussion (involving robustness of the evidence behind recommendations and their real-world application) and anonymous consensus voting. Adapting the ADDIKD guideline development process to a virtual format enabled engagement with a very broad base of specialised international experts especially during the global pandemic. Combining GRADE methodology with consensus-building approaches was an effective method of producing recommendations (in an area lacking RCTs) by merging critical review of the literature with expert opinion and clinical practice. Funding:Development of the ADDIKD guideline is funded by the Cancer Institute NSW as part of the NSW Government and received no funding from external commercial sources.

Abstract Background Clinical trials are essential to the development of healthcare innovations that advance life expectancy and improve quality of life. However, there exists a pronounced disparity in ethnic representation among trial participants. This imbalance, particularly in relation to minority ethnic groups, can lead to a limited understanding of how therapies affect diverse populations. The present systematic literature review (SLR) aims to identify the factors that both hinder and facilitate the participation of minority ethnic groups in clinical trials. Methods This review involved a systematic search of keywords across four databases: Web of Science, PubMed, CINAHL Plus and The Cochrane Library. The review was not restricted by language or study site; however, the date of publication was limited between 1st January 2017 and 1st October 2022. Studies discussing or outlining the involvement of minority ethnic groups in clinical trials, and those outlining inclusive recruitment and participation procedures were targeted. Results A total of 43 articles were included in the review. Of these, 36 articles were from the United States (US), 20 articles reported on oncology trials and 39 articles reported information from the patient’s perspective. Reported barriers included a lack of researchers from minority ethnic groups implementing and conducting clinical research, inadequate funding for clinical trial efforts in geographical areas serving minority populations and a lack of awareness and education among research staff regarding which underrepresented groups to target for recruitment and the strategies to employ in reaching out to them. Several recommendations were suggested by the articles included in the review to address these barriers. Prominently, the use of patient navigators or community liaison roles was highly recommended as a way of supporting patients through the research recruitment process. The articles also highlighted the benefits of translating study materials and interventions into multiple languages and actively involving diverse communities in the development of health education materials. Lastly, leveraging technologies to address socioeconomic barriers, such as the use of virtual approaches to avoid lengthy travel, may also help to improve diversity in trials. Conclusions Ensuring representation of minority ethnic groups in clinical trials is critical to developing therapies with generalisable efficacies. While progress has been made in enhancing outreach of wider racial groups and fortifying educational resources, there remains a pressing need to delve deeper into the obstacles impeding the recruitment of a diverse participant base, particularly in regions outside the US, where relevant studies are scarce. Registration The review protocol was registered on PROSPERO (CRD42022368106) (1).

BACKGROUND:Cancers of the oesophagus and stomach are a major cause of morbidity and mortality. Research is crucial to improving outcomes. However, to maximise value and impact, areas of focus should be prioritised in partnership with patients. OBJECTIVE:We undertook a comprehensive analysis of UK and Ireland patient and healthcare professional (HCP) priorities for research into oesophagogastric cancers across the domains of prevention, diagnosis and staging, treatment, palliative care and survivorship. DESIGN:A scoping exercise sourced research questions from patients and HCPs. These were consolidated and then confirmed by systematic review to represent a true research uncertainty. Research questions were scored on potential impact by an interdisciplinary group of HCPs and prioritised using a weighting derived from a patient survey. RESULTS:There were 835 (395 HCP, 440 patient) respondents to the scoping (n=455) and prioritisation (n=380) surveys. Across these, 4295 suggested research uncertainties were consolidated to 92 uncertainties that were prioritised. HCP respondents represented 25 professional groups from community and hospital settings. Patient weighting changed 22.2-46.3% of priority rankings established by HCPs. All domains were represented by the 20 highest priority questions, 5 of which focused on personalising and optimally combining treatment modalities. Two other key themes related to optimising nutrition and improving quality of life during and after treatment, including in patients not cured of their cancer. CONCLUSION:This work highlights the impact of patient input on HCP-ranked research priorities and provides a robust list of priorities to guide funders, policymakers and researchers to support and undertake impactful research.

Background: Bispecific antibodies (BsAbs) are effective treatments for relapsed/refractory multiple myeloma (RRMM), but uptake remains inequitable. Outpatient step-up dosing protocols have increased access in community hospitals, but barriers such as patient awareness, understanding and acceptance of new treatments remain. This may contribute to disparities in access, particularly for underserved and racially diverse populations who already experience inequities in health care. To address these concerns, the EMMBRAce group conducted patient and public involvement engagement (PPIE) aiming to explore awareness, gather insight of lived experience, understand perceived barriers, and co-develop practical recommendations for equitable access to BsAbs. Methods: This work was embedded within the EMMBRAce project assessing BsAbs readiness across the UK. Eleven sessions-four focus groups and seven one-to-one interviews-were conducted with 20 people living with MM. Participants were recruited via the EMMBRAce steering group and patient advocacy groups to ensure inclusion of ethnically diverse and underserved communities. Discussions were audio-recorded, transcribed and transcripts analysed using thematic analysis. Findings would guide future service development initiatives, referral templates, and educational resources for both patients and healthcare professionals to support equitable access of novel treatments. Results: 20 participants were interviewed with an average age of 54 years (range 30-70), there were more women (55%) than men (45%). Racial identity was reflective of the UK population: White (70%), Black(15%) and South Asian(15%). All had relapsed and were receiving second line or beyond treatment with 30% currently receiving BsAbs. Those receiving BsAbs were above 40 years of age and having treatment at a tertiary centre, with one participant travelling over 2 hours across the English border to receive treatment in Wales. Interviews were held until no new discussion themes were raised. The core themes which emerged were: 1. Lack of awareness and health literacy: Many participants had limited or no knowledge of BsAbs, expressing a desire for simple, culturally appropriate educational resources. Most were unfamiliar with BsAbs and their therapeutic role. Many felt that existing patient education materials were overly complex, not culturally tailored, and not readily accessible. There was a strong call for co-created, jargon-free, multilingual resources using trusted community channels with accommodation for patients without internet access. 2. Structural and cultural barriers to access: Participants from minority backgrounds described deep-rooted mistrust in the healthcare system, shaped by experiences of racism, unconscious bias, and poor communication with clinicians. Language barriers, inadequate use of interpretation services, and culturally insensitive interactions were reported as major impediments to accessing care. These issues were seen especially at critical decision points such as at diagnosis and changing treatment. Several participants discussed chronic understaffing, impacting access to senior doctors and specialist nurses, which led patients to adapt by seeking early appointments or private care. Without addressing such systemic issues, participants felt that the quality of myeloma care will continue to be compromised. 3. Variability in service access and support: Concerns were raised about geographic disparities, limited availability of specialist nurses and support services, lack of support navigating treatment options, and lack of transparent guidance on BsAbs eligibility and pathways for patients. Participants emphasised the emotional toll of navigating complex systems alone, especially for older or socially isolated individuals. Recommendations: improving patient education and awareness of BsAbs; enhancing cultural competency in clinical settings; standardising BsAbs implementation across regions; engage underserved communities in research and clinical trials; improving trial inclusion for ethnic minorities; and incorporating PPIE feedback into local policy and practice. Conclusions: Our work highlights ongoing inequities in access to BsAbs and demonstrates the value of engaging patients and communities in identifying barriers and shaping solutions. For BsAbs to fulfil their transformative potential, strategies must be equity-driven, community-informed, and systematically embedded in cancer care delivery.

The kidney disease: Improving Global Outcomes (KDIGO) guideline recommends assessing kidney function using glomerular filtration rate (GFR) either through direct measurement or through estimation (eGFR) and describes a standardised classification of reduced kidney function. KDIGO guidelines have been adopted by most internal medicine specialities for the assessment and classification of kidney function, but not by cancer medicine. The development of the International Consensus Guideline on Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) aims to overcome the perceived challenges with KDIGO recommendations by describing their utility in patients with cancer. Two virtual, consensus building workshops were held consecutively, involving international, multidisciplinary participants (Part 1 of ADDIKD development). During these workshops, three consensus recommendations were agreed upon based on KDIGO's principles; to standardise kidney function assessment, classify kidney function, and determine a uniform approach to dose anticancer drugs in patients with reduced kidney function. Cancer clinicians attending the workshops identified issues regarding the adoption of KDIGO's recommendations. These issues were addressed by nephrologists, clinical pharmacologists, and other clinicians with extensive experience in the contemporary assessment of kidney function. The key concern for cancer specialists was a hesitancy to move away from the familiar and long-standing practice of using the Cockcroft-Gault equation to estimate creatinine clearance. The consensus building within the two multidisciplinary workshops allowed a thorough assessment of the evidence and clarified how directly measured GFR and eGFR, rather than creatinine clearance, could be optimally utilised in cancer care. The development of Part 1 of the ADDIKD guideline represents a standardised, contemporary approach to the assessment, classification, and utility of kidney function in the setting of cancer care and it harmonises with the approach used in other areas of medicine internationally. Funding:Development of the ADDIKD guideline is funded by the Cancer Institute NSW as part of the NSW Government and received no funding from external commercial sources.

Background Disparities have been identified in many aspects of the cancer care pathway for people from minority ethnic groups (MEGs). Adherence to systemic anticancer therapies (SACTs) has been shown to impact morbidity and mortality, and therefore, inequitable experiences can have a detrimental effect on outcomes. Objectives To identify interventions that focused on improving the experiences and clinical outcomes in people from MEG receiving SACT treatments. Methods A scoping review was conducted according to Arksey and O’Malley’s methodological framework to map the available literature. A comprehensive search was performed using three electronic databases (Medline, Embase and CINAHL). Standard scoping review methodology following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was used. Studies were included that assessed interventions to improve MEG patients’ experience with SACT. Study types included in the review were evaluation studies, randomised/non-randomised controlled trials and all observational studies. Exclusion criteria were applied to studies including opinion pieces, literature and systematic reviews, non-English studies, conference abstracts and studies that were not describing an intervention. Independent duplicate screening, study selection, data extraction and quality assessment were undertaken. Results of the studies were synthesised using a published equity framework. Results Searches yielded 1356 articles. Nine studies were included after exclusion criteria were applied. Studies described six digital, two in-person and one hybrid intervention employing different research methodologies, ranging from randomised controlled trials (RCTs), feasibility studies and mixed methods studies. The majority of interventions in this study were delivered remotely, using digital platforms such as websites, recorded educational training materials as well as social media. These interventions were conducted in the USA and primarily targeted patients with early breast cancer from African American backgrounds. Conclusions This scoping review showed that there has been a very small number of studies investigating interventions to optimise SACT treatment experiences in people from MEG. We found evidence of interventions incorporating the equity domains that reported improved patient engagement and experience. This new knowledge will help to implement future SACT interventions, addressing health inequities across the cancer continuum.

Disparities in health outcomes for cancer patients from ethnic minority backgrounds have been reported, as consequence of direct care received or poorer access to services. As part of cancer care, patients are educated on treatments to minimise harm and maximise treatment benefit. Our evaluation was designed to understand gaps in cultural awareness of practitioners educating patients as part of their clinical practice, focussing on Black and South Asian women. This mixed methods study involved a questionnaire containing 30 questions with specific statements based on awareness, knowledge and connectivity to patients of different ethnicities, which was completed by practitioners working with patients with cancer. The questionnaire was followed by focus groups inviting patients treated with systemic anti-cancer therapy (SACT), who were >18 years of age and able to communicate for themselves. Rapid evaluation techniques were used to transcribe and analyse focus group data. Ninety practitioners across the UK completed the questionnaire. Most participants were pharmacists (70

Oesophagogastric (OG) cancers are a major cause of morbidity and mortality. Research is crucial to improving outcomes but to maximise value and impact, areas of focus should be prioritised in partnership with patients. We undertook the first comprehensive analysis of patient and healthcare professional (HCP) priorities for research across the domains of prevention, diagnosis and staging, treatment, palliative care and survivorship. An initial scoping survey sought research uncertainties from HCPs and patients. These were consolidated into true research uncertainties, each confirmed by systematic review, and their potential impact scored by HCPs. A domain-specific weighting reflecting patient values was then applied to prioritise identified uncertainties. In total, 835 (395 HCP, 440 patient) responses were received, with 3906 suggested priorities consolidated to 92 true research uncertainties. HCP respondents represented 19 community and hospital professions and specialties involved in OG cancer care. Across the domains, patient weighting changed 22.2%-46.3% of the priority rankings established by HCP scoring. There was a high degree of agreement between individual HCPs as well as between HCPs and patients for the highest-ranked research uncertainties. These focused on selecting those who should be screened, identifying causes for late diagnosis, determining the most effective treatment combinations, optimizing nutrition across multiple settings and evaluating the long-term impact of prehabilitation. This work highlights the impact of patient input on HCP-ranked research priorities and provides a robust list of priorities to guide funders, policy makers and researchers to support and undertake impactful research focused on OG cancer.