abstract:

Tumor BRCA1 Reversion Mutation Arising During Neoadjuvant Platinum-Based Chemotherapy in Triple-Negative Breast Cancer Is Associated with Therapy Resistance

BACKGROUND:

In germline BRCA1 or BRCA2 (BRCA1/2) mutation carriers, restoration of tumor BRCA1/2 function by a secondary mutation is recognized as a mechanism of resistance to platinum and PARP inhibitors, primarily in ovarian cancer. We evaluated this mechanism of resistance in newly diagnosed BRCA1/2-mutant breast cancer patients with poor response to neoadjuvant platinum-based therapy.

METHODS:

PrECOG 0105 was a phase II neoadjuvant study of gemcitabine, carboplatin and iniparib in patients with stage I-IIIA triple-negative or BRCA1/2 mutation-associated breast cancer (n=80). All patients underwent comprehensive BRCA1/2 genotyping. For mutation carriers with moderate or extensive residual disease after neoadjuvant therapy, BRCA1/2 status was re-sequenced in the residual surgical breast tumor tissue.

RESULTS:

Nineteen patients had a deleterious germline BRCA1/2 mutation and 4 had moderate residual disease at surgery. BRCA1/2 sequencing of residual tissue was performed on three patients. These patients had BRCA1 1479delAG, 3374insGA and W1712X mutations, respectively, with loss of heterozygosity at these loci in the pre-treatment tumors. In the first case, a new BRCA1 mutation was detected in the residual disease. This resulted in a 14 amino acid deletion and restoration of the BRCA1 reading frame. A local relapse biopsy four months later revealed the identical reversion mutation, and the patient subsequently died of metastatic breast cancer.

CONCLUSIONS:

We report a BRCA1 reversion mutation in a newly diagnosed triple-negative breast cancer patient that developed over 18 weeks of platinum-based neoadjuvant therapy. This was associated with poor therapy response, early relapse and death.

Phase II trial of albumin-bound paclitaxel and granulocyte macrophage colony-stimulating factor as an immune modulator in recurrent platinum resistant ovarian cancer

MDSC (myeloid-derived suppressor cells) are a heterogenous group of immune cells from the myeloid lineage (a family of cells that originate from bone marrow stem cells). MDSCs strongly expand in pathological situations such as chronic infections and cancer, as a result of an altered haematopoiesis (def.: process of blood cell formation.)
                            ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
abstract:
Phase II trial of albumin-bound paclitaxel and granulocyte macrophage colony-stimulating factor as an immune modulator in recurrent platinum resistant ovarian cancer
 

Highlights

• •Low MDSC in peripheral blood correlate with response to chemo-immunotherapy.
• •Increased antigen specific T cells recognizing IGF-1R correlate with responses.
• •There was no advantage in overall survival with this combination compared to nab-paclitaxel alone.

Background

Granulocyte macrophage colony-stimulating factor (GM-CSF) stimulates immunity via recruitment of antigen presenting cells and tumor specific T-cell stimulation. Albumin-bound paclitaxel (nab-paclitaxel) followed by GM-CSF may enhance antitumor responses and prolong remissions in ovarian cancer. Immune phenotypes present before treatment may identify responders to chemo-immunotherapy.

Methods

Recurrent platinum-resistant ovarian, peritoneal, or fallopian tube cancer patients received nab-paclitaxel, 100 mg/m² days 1, 8, 15 followed by GM-CSF 250 μg days 16–26 every 28 days for 6 planned cycles. The primary endpoint was remission duration compared to immediate prior remission. Peripheral blood was evaluated by flow cytometry and interferon-γ ELISPOT.

Results

Twenty-one patients were enrolled. Six patients (29%) achieved a biochemical complete response and 9 (43%) a partial response for an overall response rate of 72%. Median time to progression was 4 months and 10% of patients achieved longer remissions than the immediate prior regimen. Median overall survival (OS) was 16.8 months. Fewer myeloid derived suppressor cells (MDSC) at enrollment significantly associated with complete response (p = 0.05). T-cell responses to IGF1R-p1332–1346 (r = 0.827, p = 0.0003) and IGF1R-p1242–1256 (r = 0.850, p = 0.0001) during treatment correlated with time to progression.

Conclusions

Nab-paclitaxel combined with GM-CSF demonstrated biochemical responses in a majority of patients, although responses were not sustained. This combination did not demonstrate an advantage in OS over prior studies of nab-paclitaxel monotherapy. Agents that modulate MDSC should be studied as potential adjuvants to therapy. Strategies to expand T cells recognizing tumor-associated antigens biologically significant in ovarian cancer should also continue to be investigated.

Chemotherapy completion in elderly women with ovarian, primary peritoneal or fallopian tube cancer – An NRG oncology/Gynecologic Oncology Group study - Gynecologic Oncology

abstract:
Chemotherapy completion in elderly women with ovarian, primary peritoneal or fallopian tube cancer – An NRG oncology/Gynecologic Oncology Group study 

Highlights

• •IADL was correlated with completion of 4 cycles of chemotherapy. (Instrumental Activities of Daily Living (IADL))
• •ADL, social activity, and QOL improved over time.
• •IADL was associated with overall survival in those receiving CP.

Purpose

A simple measure to predict chemotherapy tolerance in elderly patients would be useful. We prospectively tested the association of baseline Instrumental Activities of Daily Living (IADL) score with ability to complete 4 cycles of first line chemotherapy without dose reductions or >7 days delay in elderly ovarian cancer patients.

Patients and methods

Patients' age ≥70 along with their physicians chose between two regimens: CP (Carboplatin AUC 5, Paclitaxel 135 mg/m²) or C (Carboplatin AUC 5), both given every 3 weeks either after primary surgery or as neoadjuvant chemotherapy (NACT) with IADL and quality of life assessments performed at baseline, pre-cycle 3, and post-cycle 4.

Results

Two-hundred-twelve women were enrolled, 152 selecting CP and 60 selecting C. Those who selected CP had higher baseline IADL scores (p < 0.001). After adjusting for age and PS, baseline IADL was independently associated with the choice of regimen (p = 0.035). The baseline IADL score was not found to be associated with completion of 4 cycles of chemotherapy without dose reduction or delays (p = 0.21), but was associated with completion of 4 cycles of chemotherapy regardless of dose reduction and delay (p = 0.008) and toxicity, with the odds ratio (OR) of grade 3+ toxicity decreasing 17% (OR: 0.83; 95%CI: 0.72–0.96; p = 0.013) for each additional activity in which the patient was independent. After adjustment for chemotherapy regimen, IADL was also associated with overall survival (p = 0.019) for patients receiving CP.

Conclusion

Patients with a higher baseline IADL score (more independent) were more likely to complete 4 cycles of chemotherapy and less likely to experience grade 3 or higher toxicity.

Contribution of age to clinical trial enrollment and tolerance with ovarian cancer

abstract

Highlights

• •Older patients with ovarian cancer are less likely to enroll on clinical trial.
• •Women ≥ 70 tolerated chemotherapy on trial as well as their younger counterparts
• •Age ≥ 70 is an independent predictor of shorter overall survival in ovarian cancer.

Introduction

Increasing age has been correlated with shorter survival in ovarian cancer patients, a finding attributed to diminished tolerance of standard therapy. Elderly patients, however, are less likely to enroll on clinical trials; thus, limited data exists to evaluate their response to front line treatment. This study describes how elderly patients on trial fared, with respect to toxicity and response, compared to younger women.

Methods

A retrospective cohort study was performed of ovarian cancer patients enrolled in front line chemotherapy trials at our institution between 2000 and 2013. Patients were dichotomized by age: <70 and ≥70 years. Clinical, pathologic, and treatment characteristics were recorded and analyzed using SAS version 9.3.

Results

336 patients were enrolled. Of these, 79 (23.5%) were ≥70 yrs. Demographics were similar between the two groups. Compared to patients <70, those ≥70 completed a comparable number of chemotherapy cycles (p = 0.16) and had similar numbers of dose modifications (p = 0.40) and delays (p = 0.26). Both hematologic and non-hematologic toxicities occurred at similar rates as well. Age ≥ 70 (HR 1.8, 95% CI 1.27–2.54, p = 0.0009), stage III/IV (HR 3.44, 95% CI 1.08–10.95, p = 0.036), and residual disease (HR 2.63, 95% CI 1.82–3.78, p < 0.0001) were independently predictive of shorter overall survival.

Conclusion

Our data continues to support reports of shorter survival for older women with ovarian cancer. With physician bias removed and similar chemotherapy tolerance noted, our study suggests that inherent tumor biology may be a significant contributor. Further research is needed to identify the mechanisms which contribute to the inequality that age imposes on outcomes.

I Had a 9 Percent Chance. Plus Hope (cancer stats/hope)

Blogger's Note: not specific to ovarian cancer

The New York Times

  Before I got cancer, I used to collect $2 bills. They were rare, and I thought that meant they were lucky, but rare and lucky are not the same thing.....I immediately wanted to know my odds of survival. My oncologist wouldn’t say, leaving me to perform the rite of passage of looking up survival rates on the American Cancer Society website....

Right Care (series) the Lancet

Right Care
 Published: January 8, 2017

Executive Summary

Many countries struggle with the question about sustainability, fairness, and equity of their health systems. With the focus firmly on universal health coverage as a central part to the UN Sustainable Development Goals, there is an opportunity to examine how to achieve optimum access to, and delivery of, health care and services. Underuse and overuse of medical and health services exist side-by-side with poor outcomes for health and wellbeing. This Series of four papers and accompanying comments examines the extent of overuse and underuse worldwide, highlights the drivers of inappropriate care, and provides a framework to begin to address overuse and underuse together to achieve the right care for health and wellbeing. The authors argue that achieving the right care is both an urgent task and an enormous opportunity.

17yr (Canada) stage 3 ovarian cancer

media
 

But after rushing to a clinic, a pregnancy test came back negative — puzzling both the 17-year-old and her concerned mother.
“The nurse at the clinic thought that even after the test I might still be pregnant,” she said.

“He was so blunt about it. He mentioned cancer, and then used the word surgery. I was in shock, so I just ran out and went across the road onto a stranger’s front lawn and started crying.”


Ruby decided to share her experience and journey on Reddit, because too many people go through cancer and treatment without a hand to hold........Following Ruby’s Reddit post which she posted on Tuesday, her story was met with mostly positive responses. But she said that there were a select few who felt the images that accompanied her experience made her look “like a whore”.

Search of: liquid biopsy Open Studies ClinicalTrials.gov

ClinicalTrials.gov

 151 studies found for:    liquid biopsy | Open Studies | Studies with Female Participants | Adult, Senior

Trends, Charts, and Maps - ClinicalTrials.gov

ClinicalTrials.gov

 Locations of Recruiting Studies
The chart below shows the distribution of locations for recruiting studies registered on ClinicalTrials.gov.

Percentage of Recruiting Studies by Location (as of January 13, 2017)
Total N = 40,604 studies

	Non-U.S. only (56%)
	U.S. only (39%)
	Both U.S. and non-U.S. (5%)

Location	Number of Recruiting Studies and Percentage of Total (as of January 13, 2017)

who was reading what and from where? stats - Ovarian Cancer and Us

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Top 10 most viewed posts past week:

#1: Requests for placement of ads on Ovarian Cancer an...
#2: Genital use of talc and risk of ovarian cancer: a ...
#3: (BRCA2) Prostate cancer team cracks genetic code t...
#4: Apply by 1/23: PCORI grant to fund e-patients at p...
#5: Medicine X 2017 ePatient Scholarship Program – Sta...
#6: MyChart/Editorial/Paper: Detection of Upper Tract ...
#7: Medscape Lifestyle Report 2017: Race and Ethnicity...
#8: Women’s Health Issues for BRCA Mutation Carriers A...
#9: OA: Caring for cancer survivors: perspectives of o...
#10: A study of over 35,000 women with breast cancer te... By Country: (high to low - top10):   United States Germany Canada Romania France Portugal Poland Netherlands Ukraine India How?:

(includes comments) Academics are getting reeled in by scam journals | University Affairs

University Affairs

Beall’s List: Potential, possible, or probable predatory scholarly open-access publishers

Blogger's Note: I scanned through a few of the sites per Beall's List - some were obvious, 1 no longer exists (url not found), 1 blocked by anti-virus and was fooled by a few - eg. a couple of sites had no information on 'about us' or 'contact us' had no info (as examples) - worthwhile having a look for patients/survivors researching their cancer/s
                  ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

LIST OF PUBLISHERS | Scholarly Open Access
as at December 2016

Beall’s List:

Potential, possible, or probable predatory scholarly open-access publishers

This is a list of questionable, scholarly open-access publishers. We recommend that scholars read the available reviews, assessments and descriptions provided here, and then decide for themselves whether they want to submit articles, serve as editors or on editorial boards.  In a few cases, non-open access publishers whose practices match those of predatory publishers have been added to the list as well. The criteria for determining predatory publishers are here.

Impact of Payer Constraints on Access to Genetic Testing (BRCA)

abstract

BACKGROUND:

With increased demand for hereditary cancer genetic testing, some large national health-care insurance payers (LNHPs) have implemented policies to minimize inappropriate testing by mandating consultation with a geneticist or genetic counselor (GC). We hypothesized such a restriction would reduce access and appropriate testing.

METHODS:

Test cancellation rates (ie, tests ordered that did not result in a reported test result), mutation-positive rates, and turnaround times for comprehensive BRCA1/2 testing for a study LNHP that implemented a GC-mandate policy were determined over the 12 months before and after policy implementation (excluding a 4-month transition period). Cancellation rates were evaluated based on the reason for cancellation, National Comprehensive Cancer Network testing criteria, and self-identified ancestry. A control LNHP was evaluated over the same period for comparison.

RESULTS:

The study LNHP cancellation rate increased from 13.3% to 42.1% ( P < .001) after policy implementation. This increase was also observed when only individuals who met National Comprehensive Cancer Network criteria for hereditary breast and ovarian cancer testing were considered (9.5% to 37.7%; P < .001). Cancellation rates increased after policy introduction for all ancestries; however, this was more pronounced among individuals of African or Latin American ancestry, for whom cancellation rates rose to 48.9% and 49.6%, respectively, compared with 33.9% for individuals of European ancestry. Over this same time period, control LNHP cancellation rates decreased or stayed the same for all subgroups.

CONCLUSION:

These findings demonstrate that a GC-mandate policy implemented by a LNHP substantially decreased access to appropriate genetic testing, disproportionately impacting minority populations without any evidence that inappropriate testing was decreased.

Deceptive curcumin offers cautionary tale for chemists : Nature News

Nature News

Spice extract dupes assays and leads some drug hunters astray.

11 January 2017

Turmeric — a source of wasted effort and funding.

Inside the golden-yellow spice turmeric lurks a chemical deceiver: curcumin, a molecule that is widely touted as having medicinal activity, but which also gives false signals in drug screening tests. For years, chemists have urged caution about curcumin and other compounds that can mislead naive drug hunters.
Now, in an attempt to stem a continuing flow of muddled research, scientists have published the most comprehensive critical review yet of curcumin — concluding that there’s no evidence it has any specific therapeutic benefits, despite thousands of research papers and more than 120 clinical trials. The scientists hope that their report will prevent further wasted research and alert the unwary to the possibility that chemicals may often show up as ‘hits’ in drug screens, but be unlikely to yield a drug.
“Curcumin is a cautionary tale,” says Michael Walters, a medicinal chemist at the University of Minnesota in Minneapolis, and lead author of the review (K. M. Nelson et al. J. Med. Chem. http://dx.doi.org/10.1021/acs.jmedchem.6b00975; 2017), published on 11 January. Commonly used drug screens detect whether a chemical latches on to a binding site of a protein implicated in disease — a hint that it may be the starting point for a drug. But some molecules, such as curcumin, seem to show such specific activity when there is none.

TVO interview: Treating Canada's Health Care System (Paikin/Dr Danielle Martin)

TVO interview - Danielle Martin (29.33 min)

Air Date: 

Jan 11, 2017

Length: 

29:35

About this Video

When Dr. Danielle Martin spoke before a U.S. Senate subcommittee a few years ago, she taught Americans a thing or two about universal health coverage. Her defence of Canada's health-care system made Canadians proud and dispelled some myths Americans may have believed about socialized medicine. But there's more to Danielle Martin than just being a staunch defender of Medicare. She is also a pragmatist who works both sides of the health-care system: she's a clinician at a general family practice at Women's College Hospital in Toronto, as well as the hospital's vice-president. She joins The Agenda to discuss her new book, "Better Now: Six Big Ideas to Improve Health Care for All Canadians."

A study of over 35,000 women with breast cancer tested with a 25-gene panel of hereditary cancer genes - Buys - 2017 - Cancer - Wiley Online Library

Abstract
 Version of Record online: 13 JAN 2017

Funded by Myriad Genetic Laboratories

BACKGROUND

As panel testing becomes more common in clinical practice, it is important to understand the prevalence and trends associated with the pathogenic variants (PVs) identified. This is especially true for genetically heterogeneous cancers, such as breast cancer (BC), in which PVs in different genes may be associated with various risks and cancer subtypes. The authors evaluated the outcomes of genetic testing among women who had a personal history of BC.

METHODS

A total of 35,409 women with a single diagnosis of BC who underwent clinical genetic testing with a 25-gene panel were included in the current analysis. Women with multiple BCs and men with BC were excluded. The frequency and distribution of PVs were assessed for the overall cohort, among women with triple-negative BC (TNBC) (n = 4797), and by age at diagnosis.

RESULTS

PVs were identified in 9.3% of women tested; 51.5% of PVs were identified in genes other than breast cancer 1 (BRCA1) and BRCA2, including checkpoint kinase 2 (CHEK2) (11.7%), ataxia telangiectasia mutated (ATM; ATM serine/threonine kinase) (9.7%), and partner and localizer of BRCA2 (PALB2) (9.3%). The prevalence of PVs in BRCA1, PALB2, BRCA1-associated RING domain 1 (BARD1), BRCA1-interacting protein C-terminal helicase 1 (BRIP1), and RAD51 paralog C (RAD51C) was statistically higher among women with TNBC. The PV rate was higher among women aged <40 years, lower among women aged >59 years, and relatively constant (8.5%-9.0%) among women who were diagnosed between ages 40 and 59 years.

CONCLUSIONS

These results demonstrate that panel testing increased the number of women identified as carrying a PV in this cohort compared with BRCA testing alone. Furthermore, the proportion of women identified who carried a PV in this cohort did not decrease between ages 40 and 59 years.

the fifth estate: Jan 13, 2017 The High Cost of Pharmaceuticals: Canada’s Drug Problem

the fifth estate - CBC News
 Next Episode - January 13, 2017 9PM

The High Cost of Pharmaceuticals: Canada’s Drug Problem

Canada's health system is a source of pride for many Canadians. But we pay more for prescription drugs than almost every other country in the world -- and rising drug costs are taking their toll on people across the country. Canada is the only country in the world that has universal health care but no universal drug coverage. That means millions of Canadians cannot afford live-saving medication: they are splitting their pills, cutting back on their prescriptions, going deep into debt– and sometimes, even dying. The Fifth Estate investigates the rising cost of pharmaceuticals in Canada.

Genital use of talc and risk of ovarian cancer: a meta-analysis

Genital use of talc and risk of ovarian cancer: a meta-analysis
(abstract) January 11, 2017

Some epidemiological studies suggest an association between genital use of talc powders and increased risk of ovarian cancer, but the evidence is not consistent. We performed a meta-analysis of epidemiological studies to formally evaluate this suspected association. A systematic search was conducted in Medline, Embase, and Scopus, leading to the identification of 24 case-control studies and three cohort studies, including 302 705 women with ovarian cancer. In the meta-analysis, we used a random-effect model to calculate summary estimates of the association between genital use of talc and occurrence of ovarian cancer. We assessed potential sources of between-study heterogeneity and presence of publication bias. The summary relative risk (RR) for ever use of genital talc and ovarian cancer was 1.22 [95% confidence interval (CI): 1.13-1.30]. The RR for case-control studies was 1.26 (95% CI: 1.17-1.35) and for cohort studies was 1.02 (95% CI: 0.85-1.20, Pheterogeneity=0.007). Serous carcinoma was the only histologic type for which an association was detected (RR: 1.24; 95% CI: 1.15-1.34). There was no trend in RR with either duration or frequency of genital talc use. This meta-analysis resulted in a weak but statistically significant association between genital use of talc and ovarian cancer, which appears to be limited to serous carcinoma. The heterogeneity of results by study design and the lack of a trend for duration and frequency of use, however, detract from a causal interpretation of this association.

MyChart/Editorial/Paper: Detection of Upper Tract Urothelial Malignancies by CT Urography in Patients Referred for Hematuria at a Large Tertiary Referral Center

Blogger's Note: the paper and editorial (per links below) were of obvious interest to me. I have partially copied my clinical records so that others who have an interest in this area, including UTUC urology patients, Lynch Syndrome patients and those with MPM (multiple primary malignancies), may be aware of exceptions/rare incidents in the research.

(partial) Radiology report: 

• The CT urogram was performed including precontrast scans
• Clinical Information: microhematuria/Lynch syndrome/ovarian Ca/XRT/precancerous bowel polyps 
• EPR: Cystoscopy August 17, 2012- cytology negative for malignancy) Comparison: No prior available. 

An elongated noncalcified soft tissue mass measuring 1 x 1.1 x 2.4 cm is seen at the level of the iliac vessels crossing

(partial) Pathology report:

 



                         ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Editorial
 Published online: January 12, 2017
 In the absence of clearly identifiable benign causes (ie, urinary tract infection), the American Urologic Association recommends evaluation of microscopic hematuria with cystoscopy in conjunction with upper urinary tract radiological imaging (particularly computed tomography [CT] urography).¹ Gross or macroscopic hematuria warrants a similar investigation, particularly owing to a greater likelihood of identifying underlying benign or malignant abnormalities.² Indeed, CT urography has the highest diagnostic yield in accurate diagnosis of upper tract urothelial carcinoma (UTUC) lesions albeit with inherent cost and radiation exposure.

Detection of Upper Tract Urothelial Malignancies by Computed Tomography Urography in Patients Referred for Hematuria at a Large Tertiary Referral Center

Abstract: Published online: January 12, 2017

 Objective

To evaluate the age-stratified prevalence of upper tract urothelial malignancies diagnosed on computed tomography urography in a large cohort of patients referred for initial evaluation of hematuria.

Materials and Methods

A total of 1123 consecutive adults without a history of urothelial cancer underwent initial computed tomography urography for gross hematuria (n = 652), microscopic hematuria (n = 457), or unspecified hematuria (n = 14) at a single institution from October 2006 to October 2012. Imaging findings suggestive of urothelial lesions were correlated with clinical information, including cystoscopy, cytology, and surgical pathology reports. Patients subsequently diagnosed with urothelial cancer following a normal radiographic evaluation were identified and analyzed. Age, gender, smoking history, and location and type of malignancy were analyzed.

Results

Upper tract urothelial cancer was detected in 4 (0.36%) patients, with a mean age of 66.5 years. All 4 patients presented with gross hematuria and were current or former smokers. None of the 535 patients under age 55 who underwent computed tomography urography were diagnosed with upper tract disease regardless of age, smoking history, or degree of hematuria. Likewise, no upper tract cancers were detected in patients referred for microscopic hematuria, regardless of age.

Conclusion

Detection of upper tract urothelial cancer by computed tomography urography is exceedingly rare in patients presenting at a tertiary referral center with hematuria, particularly in the lower risk strata (younger age, microscopic hematuria). Further investigation into risk-stratified approaches to imaging for hematuria workup is warranted to minimize unnecessary costs and radiation exposure.

CDK19 +ovarian cancer - Google Scholar (excl'd patents/since 2016)

CDK19 +ovarian cancer - Google Scholar

cdk8 +ovarian cancer - Google Scholar (excl'd patents/since 2016)

cdk8 +ovarian cancer - Google Scholar

(CDK8/CDK19) Scientists raise warning over drugs targeting key cancer mechanism

Medical News
 January 12, 2016

Scientists have expressed concerns about developing drugs against two molecular targets that had been considered highly promising, after finding that specifically blocking their function adversely affected normal body systems.
The molecular targets CDK8 and CDK19 - members of an important family known as kinases - have a key role in turning on cancer-causing genes and have been implicated in the development of several cancers, including those of the bowel and blood.
But researchers found that specifically blocking the function of CDK8/19 - using highly potent and selective prototype drugs - could not be tolerated in animal studies at doses high enough to have convincing anti-cancer activity in laboratory models of those diseases.
They have shown that blocking CDK8/19 causes too many effects on genes involved in normal cellular function to be viable as cancer treatments - specifically when given continuously at doses needed to block growth of bowel and blood cancers in the lab.....

ASCO Releases Principles for Patient-Centered Health-Care Reform - Jan 12th

The ASCO Post

OA: Caring for cancer survivors: perspectives of oncologists, general practitioners and patients in Italy

Future Oncology, Future Medicine
 Published online: 12 September 2016
 

EXECUTIVE SUMMARY

• There are a growing number of cancer survivors but a gold standard in surveillance management is currently lacking.
• We conducted a national survey: an online questionnaire was filled by 329 medical oncologists, 380 general practitioners (GPs) and 350 patients.
• The questionnaire included demographic information, adherence to guidelines, continuity and coordination of care, opinion on follow-up strategy and patients’ satisfaction.
• Most GPs claim that follow-up should be provided by the collaboration between GPs and medical oncologists, after 2–3 years of disease-free survival.
• The majority of medical oncologists report to have a poor relationship with GPs.
• Patients tend to trust their GPs, but collaboration between medical oncologists and GPs is perceived as poor.
• According to answers provided, the collaboration between oncologists and GPs is considered poor and needs to be improved.
• Analyzing the feedbacks coming from all the actors that take part in this process could help in designing common guidelines that optimize both resources and efficiency.

Apply by 1/23: PCORI grant to fund e-patients at palliative care summit!

e-Patients.net


The Coalition for Compassionate Care of California (CCCC) is inviting e-Patients to apply for a scholarship to our 9th Annual Palliative Care Summit in Sacramento, California, on March 13-14, 2017. Scholarship options range from discounted registration to full financial scholarships (including travel and lodging).
The deadline to submit an application is January 23, 2017.

USE THIS FORM
to apply for a patient scholarship

Now in its 9th year, the Coalition for Compassionate Care of California Annual Palliative Care Summit is aimed at providers caring for people of all ages—children, adolescents, teenagers, young adults, adults and seniors—and was designed for physicians, nurses, social workers, nursing home administrators, chaplains, patients and consumers who are interested in palliative care best practices, quality and policy.

Attendees will learn from and engage with thought leaders in palliative care, including:

• Eric J. Cassell, MD, MACP, author of The Nature of Suffering and the Goals of Medicine
• Betty Ferrell, RN, PhD, City of Hope Medical Center
• Jennifer Kent, Director, California Department of Health Care Services
• BJ Miller, MD, University of California, San Francisco
• SPM member Jessica Nutik Zitter, MD, Highland Hospital, Oakland

---

Again, visit their whole post for full details.

Turn The Towns Teal®

Turn The Towns Teal®

 

OA: (Ireland) BRCA1/2 germline testing in non-mucinous epithelial ovarian carcinoma: changing international practice/implications for service provision

open access:
European Journal of Human Genetics - BRCA1/2 germline testing in non-mucinous epithelial ovarian carcinoma: changing international practice and implications for service provision

 Ovarian carcinoma is the fourth most common cancer for women in Republic of Ireland, with an average of 361 cases per year.¹ The association with germline mutations in BRCA1/2 genes in non-mucinous ovarian cancer risk is well established.² Determining the BRCA status of ovarian cancer patients has important prognostic and therapeutic implications for individual patients.³ The frequency of BRCA1/2 germline mutations in non-mucinous ovarian carcinoma is estimated at 14–15%,² with previous studies finding a higher rate of 16.6% in serous ovarian carcinoma and 17.1% in high-grade serous carcinoma.³ Family history has been shown not to be sufficiently accurate to predict mutation status.^{2, 3} In Ireland, as in most European countries, and the United States, the current recommendation is that patients with a family history of breast/ovarian cancer should be offered full mutation screening of the BRCA1/2 genes as appropriate following the assessment by a clinical genetics service.^4.....

Women’s Health Issues for BRCA Mutation Carriers ASCO ed book

2016 Educational Book | Meeting Library

Additionally, in an ideal world, there would be no repercussions to mastectomy and early surgical menopause. However, these ideals run counter to the realities of life for many. In high-income countries, the median age of first birth is rising,¹¹ with many women not starting a family until after their 35th birthday. Surgery and surgical menopause can cause morbidity and can be life altering.

PNC-27 | An Important Protein in the Fight Against Cancer - Dr. Ehsan Sarafraz-Yazdi

PNC-27 

 Dr. Sarafraz-Yazdi is an Assistant Professor in the Division of Gynecologic Oncology at State University of New York (SUNY).
His research in the field of Anti-Cancer Drug Design has been recognized by the 2011 Furchgott Award for Excellence in Research and the 2010 Outstanding Clinical Scholar award from the American Association for Cancer Research and the pharmaceutical company, GlaxoSmithKline (GSK).

Information for Patients

Information for Physicians

FDA warns cancer patients not to use PNC-27 products for treatment

Drug Safety and Availability > FDA 

 
[1/10/2017] The Food and Drug Administration is warning consumers not to purchase or use PNC-27, a product promoted and sold through http://PNC27.com, as a treatment or cure for cancer. An FDA laboratory discovered the bacteria Variovorax paradoxus in a PNC-27 solution sample for inhalation.
Consumers who use a contaminated product are at risk for serious, potentially life-threatening infections. Consumers at higher risk include vulnerable populations, such as young children, elderly people, pregnant women, and individuals with weakened immune systems.
PNC-27 may be available in various dosage forms, such as a nebulized solution, intravenous solution, vaginal suppository, or rectal suppository. FDA has not evaluated or approved PNC-27 as safe and effective to treat any disease, including any form of cancer.
FDA recommends patients with cancer discuss treatment options with a licensed health care professional. Patients who have used any PNC-27 product and have concerns should contact their health care provider as soon as possible.
The agency has not received reports of illnesses or serious adverse events related to PNC-27. FDA encourages health care professionals and consumers to report any adverse events possibly related to the use of a PNC-27 product to FDA’s MedWatch Adverse Event Reporting Program:

• Complete and submit the report online at www.fda.gov/medwatch/report.htm; or
• Download and complete the form, then submit it via fax at 1-800-FDA-0178.

OA: Patient advocate perspectives on involvement in HTA: an international snapshot (small study)

Research Involvement and Engagement | Full Text
health technology assessment (HTA) organisations

 Of 16 individuals who received the survey, 15 responded. Three, from Italy, Israel and Japan, were not involved in HTA in their country. Respondents from the following countries reported involvement in HTA processes: Canada, England, Scotland, and Wales, The Netherlands, Australia, Taiwan.

Unexpectedly, snowballing of responses occurred in one of the countries (Canada) – the survey invitation was passed on by the original recipient to fellow ‘patient representatives’ on an HTA appraisal committee. This has led to this country having a high proportion of the total responses. 

 Issues around patient and public involvement in HTA are often discussed under the single umbrella of ‘PPI’, however, a distinction needs to be drawn between patients and the public as their interests are not necessarily aligned and at times may even conflict [13].

How to (seriously) read a scientific paper

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