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Friday, June 03, 2011

NHQR State Snapshots - Performance Measures





Summary measures of quality of care and States' performances relative to all States and the region by:

Overall health care quality
Types of care (preventive, acute, and chronic)
Settings of care (hospitals, ambulatory care, nursing home, and home health)
Five clinical conditions (cancer, diabetes, heart disease, maternal and child health, and respiratory diseases)
Special focus areas on diabetes, asthma, Healthy People 2010, clinical preventive services, disparities, payer, and variation over time

Cancer's Last Stand? The Genome Solution - Wielding Genomes in the Fight Against Cancer - NYTimes.com



"The researchers agreed that there should be global clinical trials of new cancer drugs, and that all patients should have genetic information about their tumors entered into databases that researchers everywhere could study. Dr. Lander said that concerns about genetic privacy had been “fetishized,” and that the potential harm to patients from releasing their genetic information paled next to the harm threatened by their disease."

media: Terry Fox’s mom (Canada) ‘seriously ill’ but not with cancer, family says



FYI - (wiki) Terry Fox legacy - Marathon of Hope

press release: EntreMed's ENMD-2076 Demonstrates Clinical Activity in Recurrent, Platinum-Resistant Ovarian Cancer Patients Phase 2 Data Presented in ASCO Poster Discussion Session



phase 2 study with ENMD-2076 in platinum-resistant ovarian cancer patients

Search Results: 'biomarkers' 'ovarian' 2011 ASCO Abstracts



Find ALL words: biomarkers ovarian

Found 22 documents

Genomics|Update|Current





Does it run in the family? Toolkit will soon be available at federal health centers nationwideExternal Web Site Icon, Genetic Alliance, June 2



New Blog Post (click on image below)

What is Public Health Genomics? A Day in the Invisible Life of Public Health Genomics.



  

Search Results - 'lmp ovarian' 'borderline ovarian' 2011 ASCO abstract



Find EXACT phrase: lmp ovarian

Found 1 document.

A multivariate longitudinal algorithm for early detection of ovarian cancer using multiple biomarker

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Find EXACT phrase: borderline ovarian
Found 2 documents, showing 1 - 2



  1. Regulation of the tumor suppressor gene PAEP in the transition from serous borderline ovarian tumors to low-grade serous ovarian carcinomas. | 2011 ASCO Annual Meeting Abstracts
    ... from serous borderline ovarian tumors to low-grade serous ovarian carcinomas. | 2011 ASCO ...
    ... Background: Serous borderline ovarian tumors (SBOT) and low grade serous ovarian carcinomas (LG) ...
  2. Elevation of HE4 and CA 125 in symptomatic patients with invasive epithelial ovarian cancer. | 2011 ASCO Annual Meeting Abstracts
    ... were malignant. Borderline ovarian tumors were excluded from the analyses. A total of 115 cases ...

Search Results: 'sporadic ovarian cancer' 2011 ASCO Abstracts



Find ALL words: sporadic ovarian cancer

Found 9 documents

Search Results: gynae/gynecologic oncologist - 2011 ASCO Abstracts



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Search Results: 'family history' 2011 ASCO Abstracts



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Found 42 documents

Mutational analysis and clinical correlation of 185 consecutive metastatic colorectal patients: Similarities and differences between colon and rectal patients| 2011 ASCO Abstract



Conclusions:

Rectal and colon patients have similar rates of KRAS and PIK3CA mutations. However, BRAF mutations are more common in colon cancer. NRAS mutations are exclusively found in rectosigmoid cancers and may have a different biology than other colorectal cancers. These data suggest that primary tumor location may provide a means to enrich a population for a genotype-directed study.

Search Results: 'endometrioid' 'ovarian' 2011 ASCO Abstracts



Find ALL words: endometrioid ovarian

Found 11 documents

Search Results: 'serous' 'ovarian' 2011 ASCO Abstracts



Find ALL words: serous ovarian

Found 30 documents

Search Results: 'mucinous' 'ovarian' |2011 ASCO Abstracts



Find ALL words: mucinous ovarian

Found 8 documents

Search Results: 'avastin' 'ovarian' 2011 ASCO Abstracts



Search: avastin ovarian

Found 313 documents

Search Results: parp - 2011 ASCO Abstracts



Search: parp

Found 141 documents

Search Results: ca125 - 2011 ASCO Abstracts



Search: ca125

Found 27 documents

Search Results: 'advocate' |2011 ASCO Abstracts



Search: advocate

Found 13 documents

Search Results: 'advocacy' 2011 ASCO Abstracts



Search: advocacy

Found 7 documents

Thursday, June 02, 2011

Search Results: palliative vs hospice 2011 ASCO Abstractsts



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Found 35 documents, showing

Search Results: clear cell ovarian | 2011 ASCO abstracts



Note: search term of 'clear cell' resulted in numerous renal clear cell abstracts

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Search Results: hereditary nonpolyposis colorectal cancer 2011 ASCO Abstracts



Find EXACT phrase: hereditary nonpolyposis colorectal cancer

Found 1 document

Does maternal or paternal inheritance of BRCA mutation affect the age of cancer diagnosis? 2011 ASCO Abstract




Search Results: Lynch Syndrome | 2011 ASCO Annual Meeting Abstracts



Find EXACT phrase: lynch syndrome

Found 6 documents

Search Results: brca | 2011 ASCO Annual Meeting Abstracts



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Found 110 documents

Search Results "ovarian cancer" | 2011 ASCO Annual Meeting Abstracts



Find EXACT phrase: ovarian cancer

Found 246 documents

abstract #1501: Is hormone replacement therapy (HRT) following risk-reducing salpingo-oophorectomy (RRSO) in BRCA1 (B1)- and BRCA2 (B2)-mutation carriers associated with an increased risk of breast cancer? | 2011 ASCO Annual Meeting Abstracts




University of Pennsylvania School of Medicine - Women with BRCA mutations can take hormone-replacement therapy safely after ovary removal



CHICAGO) ––

Women with the BRCA1 or BRCA2 gene mutations, which are linked to a very high risk of breast and ovarian cancer, can safely take hormone-replacement therapy (HRT) to mitigate menopausal symptoms after surgical removal of their ovaries, according to new research from the Perelman School of Medicine at the University of Pennsylvania which will be presented Monday, June 6 during the American Society for Clinical Oncology's annual meeting (Abstract #1501). Results of the prospective study indicated that women with BRCA mutations who had their ovaries removed and took short-term HRT had a decrease in the risk of developing breast cancer...............

Domchek says some of the confusion about the role of HRT in cancer risk elevation comes from the fact that the risks and benefits associated with HRT depend on the population of women studied. In this group of women – who have BRCA1/2 mutations and who have had their ovaries removed while they are quite young – HRT should be discussed and considered an option for treating menopausal symptoms. "People want to make hormone replacement therapy evil, so they can say 'Don't do it,'" she says. "But there isn't one simple answer. The devil is in the details of the studies."

By contrast, Penn researchers and their collaborators in the PROSE consortium have shown definitively that oophorectomy reduces ovarian and breast cancer incidence in these women, and reduces their mortality due to those cancers. But paying attention to the role that hormone depletion following preventive oophorectomy plays in women's future health (blogger's note: eg. cardiovascular) is also important............"

Changes in Oncology Practice Could Save Billions




press release: Pfizer Licenses PARP Inhibitor To Clovis Oncology (PF-01367338)



"...PF-01367338 would be developed by Clovis as both a monotherapy and in combination with chemotherapeutic agents for the potential treatment of selected cancer patients.
PF-01367338 is currently in a Phase 1 clinical trial examining the maximum tolerated dose of oral PF-01367338 that can be combined with intravenous platinum chemotherapy in the treatment of solid tumors.
Supplementing this trial are two ongoing trials, currently using the IV formulation, a Phase 1/2 study in germline BRCA-mutant (gBRCA) breast and ovarian cancer and a Phase 2 study in the adjuvant treatment of triple negative breast cancer. Clovis intends to replace the IV formulation with the oral formulation in these studies.
Clovis was founded by former executives of Pharmion Corp., which was acquired by Celgene Corporation in 2008. The company is headquartered in Boulder, Colorado, and has additional offices in San Francisco and London."

Medical News: Group Issues Gyn Cancer Follow-Up Guidance - MedPage Today



For ovarian (epithelial)  cancer, the committee recommended:
  • Physical exam and review of symptoms: Every three months for two years, followed by increasing intervals
  • Pap test: Not indicated
  • CA-125: Optional
  • Radiographic imaging: Insufficient data to support routine use
  • Suspected recurrence: CT and/or PET, plus CA-125
The recommendations differ for non-epithelial ovarian cancer:
  • Physical exam and review of symptoms: Every two to four months for two years, then every six months or annually depending on histology
  • Serum tumor markers: Every two to four months for two years, then every six months for sex-cord stromal tumors but no longer indicated for germ-cell tumors
  • Radiographic imaging: Generally, not indicated or data lacking to support routine use
  • Suspected recurrence: CT and tumor markers
Noting a trend toward transitioning more patients from oncologists to primary care physicians, the committee pointed to evidence that many primary care physicians do not feel comfortable with post-treatment surveillance, particularly during the first two years after treatment. (blogger's note: search blog for past papers on these issues, also the 2 years post treatment is based on old data)


Moreover, a survey of primary care providers showed that respondents believed transition of oncology patients could be improved with individualized patient summaries, guidelines for surveillance, and expedited referral for suspected recurrence, the committee members noted.

"Thus, the provision of up-to-date information and the education of both patients and physicians are mandatory," they wrote.



"Action Points

Point out that this report indicates that there is very little evidence that either routine cytologic procedures or imaging are sufficiently useful to detect ovarian and endometrial cancer recurrence and alter response rates to salvage therapy.

Note that this report suggests that the most effective method to detect recurrences is a taking a thorough history, performing a detailed physical examination, and educating patients about relevant symptoms."

SGO sets new standards to monitor recurrence of gynecologic cancer more effectively



"The article is “Post treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology recommendations: by Ritu Salani, MD, MBA; Floor J. Backes, MD; Michael Fung Kee Fung, MB, BS; Christine H. Holschneider, MD; Lynn P. Parker, MD; Robert E. Bristow, MD, MBA; and Barbara A. Goff, MD (doi: 10.1016/j.ajog.2011.03.008). It will appear in the American Journal of Obstetrics & Gynecology, Volume 204, Issue 6 (June 2011) published by Elsevier."

Tuesday, May 31, 2011

Patient Page: BRCA Genes and Breast Cancer — JAMA



PROGNOSIS With screening mammograms and breast MRIs, timely treatment, and/or prophylactic surgery, the life expectancy in BRCA carriers approaches the life span of noncarriers.

Editorial/link to paper: The Use and Misuse of ICU Telemedicine — JAMA



"....A large, multicenter study published recently showed no demonstrable clinical benefit, 4 and a recent meta-analysis found no beneficial association between ICU telemedicine and in-hospital mortality. 5 These results have left clinicians, hospital administrators, and policy makers wondering how to best use this technology, if at all."

extract only: A New Frontier in Patient Safety - McCannon and Berwick — JAMA Partnership for Patients



Note: this is a pay-per-view article ($$$)

Comparison of Effect Sizes Associated With Biomarkers Reported in Highly Cited Individual Articles and in Subsequent Meta-analyses — JAMA



Context Many biomarkers are proposed in highly cited studies as determinants of disease risk, prognosis, or response to treatment, but few eventually transform clinical practice.
Objective To examine whether the magnitude of the effect sizes of biomarkers proposed in highly cited studies is accurate or overestimated.................
Conclusion Highly cited biomarker studies often report larger effect estimates for postulated associations than are reported in subsequent meta-analyses evaluating the same associations. 

conference announcement: (UK) Molecular Diagnostics for Cancer Drug Development




Author Insights: Beware of Overestimating Biomarker Validity - JAMA