open access (U.S.) Annual Report to the Nation on the status of cancer, 1975-2008, featuring cancers associated with excess weight and lack of sufficient physical activity - Eheman - 2012 - Cancer - Wiley Online Library

Annual Report to the Nation on the status of cancer, 1975-2008, featuring cancers associated with excess weight and lack of sufficient physical activity - 2012 - Cancer

BACKGROUND:

Annual updates on cancer occurrence and trends in the United States are provided through collaboration between the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This year's report highlights the increased cancer risk associated with excess weight (overweight or obesity) and lack of sufficient physical activity (<150 minutes of physical activity per week).......

Letter: Bevacizumab in Ovarian Cancer — NEJM

Bevacizumab in Ovarian Cancer — NEJM

Correspondence

Bevacizumab in Ovarian Cancer

N Engl J Med 2012; 366:1256-1258  March 29, 2012

Article

To the Editor:

In their article on the findings of the Gynecologic Oncology Group study GOG-0218 (ClinicalTrials.gov number, NCT00262847), Burger et al. (Dec. 29 issue)1 state, as have others in a similar context,2 that the potential to see differences in overall survival in an ovarian cancer trial is limited by post-progression therapies, including crossover to the experimental agent bevacizumab. Post-progression therapies will attenuate differences in overall survival that would be seen if such therapies did not exist, but the observed attenuated differences are the correct measure of clinical benefit for the patients provided that standard-of-care post-progression therapies are used in both treatment groups.3,4

This would seem to be the case in the Gynecologic Cancer InterGroup (GCIG) International Collaboration on Ovarian Neoplasms (ICON7) bevacizumab trial (NCT00483782) reported by Perren et al. (also in the Dec. 29 issue),5 in which less than 4% of the patients in the control group received post-progression antiangiogenic treatments. To interpret the GOG-0218 results, one would need to know how many patients received post-progression antiangiogenic treatments. However, if one considered bevacizumab a standard treatment for progressing (recurrent) ovarian cancer given that it has shown activity, is recommended by National Comprehensive Cancer Network guidelines, and is covered by Medicare, then the observed difference in overall survival seen in the GOG-0218 and ICON7 trials1,5 is the appropriate estimate of clinical benefit for overall survival, regardless of post-progression treatments.

Edward L. Korn, Ph.D.
Boris Freidlin, Ph.D.
Jeffrey S. Abrams, M.D.
National Cancer Institute, Bethesda, MD
korne@ctep.nci.nih.gov

(2nd article) Medicare's Readmissions-Reduction Program — A Positive Alternative — NEJM

Medicare's Readmissions-Reduction Program — A Positive Alternative — NEJM

Hospital readmissions are receiving increasing attention as a largely correctable source of poor quality of care and excessive spending. According to a 2009 study, nearly 20% of Medicare beneficiaries are rehospitalized within 30 days after discharge, at an annual cost of $17 billion.1 Causes of avoidable readmissions include hospital-acquired infections and other complications; premature discharge; failure to coordinate and reconcile medications; inadequate communication among hospital personnel, patients, caregivers, and community-based clinicians; and poor planning for care transitions........

Thirty-Day Readmissions — Truth and Consequences — NEJM

Thirty-Day Readmissions — Truth and Consequences — NEJM

Reducing hospital readmission rates has captured the imagination of U.S. policymakers because readmissions are common and costly and their rates vary — and at least in theory, a reasonable fraction of readmissions should be preventable. Policymakers therefore believe that reducing readmission rates represents a unique opportunity to simultaneously improve care and reduce costs. As part of the Affordable Care Act (ACA), Congress directed the Centers for Medicare and Medicaid Services (CMS) to penalize hospitals with “worse than expected” 30-day readmission rates. This part of the law has stimulated hospitals, professional societies, and independent organizations to invest substantial resources in finding and implementing solutions for the “readmissions problem.”..........

Medscape: Targeting the Epigenome in Ovarian Cancer: Abstract and Introduction

Targeting the Epigenome in Ovarian Cancer: Abstract and Introduction

From Future Oncology

Targeting the Epigenome in Ovarian Cancer

Susan K Murphy

Authors and Disclosures

Posted: 03/28/2012; Future Oncology. 2012;8(2):151-164. © 2012 Future Medicine Ltd.

• Abstract and Introduction
• Ovarian Cancer
• Treatment
• Potential for Epigenetic Therapies
• Epigenome Characterization & Clinical Utility
• Progress in Using Epigenetic Therapies
• Current Limitations of Epigenetic Therapy
• Conclusion
• Future Perspective

• References