NCCAM/NCI Phase 1 Study of Mistletoe Extract and Gemcitabine in Patients with Advanced Solid Tumors (breast/colorectal/lung/pancreatic)

Mistletoe Extract and Gemcitabine - open access



Conclusion
The combination of mistletoe and gemcitabine was well tolerated and treatment compliance was high. The MTD was gemcitabine 1380 mg/m2 weekly on day one and eight of a 3-week cycle combined with mistletoe 250 mg daily. Gemcitabine pharmacokinetics were not affected by mistletoe. The lack of febrile neutropenia even at higher gemcitabine doses is noteworthy. The formation of ML antibodies is common. A consistent effect of the study regimen on the serum levels of selected cytokines could not be demonstrated. Clinical response of the combination appeared to be similar to single agent gemcitabine reported previously. 

(focus on MSH6) Functional Analysis in Mouse Embryonic Stem Cells Reveals Wild-Type Activity for Three Msh6 Variants Found in Suspected Lynch Syndrome Patients

open access

Introduction

Lynch Syndrome (LS), also called hereditary non-polyposis colorectal cancer (HNPCC), is an autosomal dominant disorder that is characterized by early onset cancer of the colorectum and endometrium. It furthermore confers an increased risk for cancers of the ovary, small intestine, stomach, ureter, renal pelvis, brain and sebaceous glands [1]. Tumors often show a high rate of microsatellite instability (MSI). The majority of LS cases is caused by inherited mutations in the DNA mismatch repair (MMR) genes MLH1 and MSH2 (70-80% of all LS-associated colorectal cancer (CRC) cases). Mutations in the MMR genes MSH6 and PMS2 account for the remaining 20-30% of LS-associated tumors [2,3]. MMR gene mutation carriers generally have an up to 10-fold increased lifetime risk of developing CRC (70-80%) and endometrial cancer (40-60%) compared to the general population [4].
In contrast to families carrying MLH1 and MSH2 mutations, families carrying mutations in MSH6 often do not fulfill the criteria for LS diagnosis. Tumors in MSH6 mutation carriers frequently show no or low MSI and the observed instability is generally restricted to mononucleotide markers [5–7]. When compared to MLH1 and MSH2 mutation carriers, the age of onset is generally later for MSH6 mutations carriers (approximately 10 years) and they have a lower risk for developing CRC [2,3]. There are reports of increased frequency of endometrial cancer in MSH6 mutation carriers versus MSH2 mutation carriers [8]; however, two large studies found no difference [2] or even a decreased [3] endometrial cancer incidence in patients carrying a mutation in MSH6.....



 

Identification of Ovarian (serous) Cancer Metastatic miRNAs (2013)

open access

Abstract

Serous epithelial ovarian cancer (EOC) patients often succumb to aggressive metastatic disease, yet little is known about the behavior and genetics of ovarian cancer metastasis. Here, we aim to understand how omental metastases differ from primary tumors and how these differences may influence chemotherapy. We analyzed the miRNA expression profiles of primary EOC tumors and their respective omental metastases from 9 patients using miRNA Taqman qPCR arrays. We find 17 miRNAs with differential expression in omental lesions compared to primary tumors. miR-21, miR-150, and miR-146a have low expression in most primary tumors with significantly increased expression in omental lesions, with concomitant decreased expression of predicted mRNA targets based on mRNA expression. We find that miR-150 and miR-146a mediate spheroid size. Both miR-146a and miR-150 increase the number of residual surviving cells by 2–4 fold when challenged with lethal cisplatin concentrations. These observations suggest that at least two of the miRNAs, miR-146a and miR-150, up-regulated in omental lesions, stimulate survival and increase drug tolerance. Our observations suggest that cancer cells in omental tumors express key miRNAs differently than primary tumors, and that at least some of these microRNAs may be critical regulators of the emergence of drug resistant disease.....

Table S1.

Summary of Patient Characteristics.

doi:10.1371/journal.pone.0058226.s009

(XLSX)

 

Prognostic factors for chemotherapy induced nausea and vomiting

abstract

"Purpose: to review the topic of prognostic factors for chemotherapy-induced nausea and vomiting. Multiple patient factors such as age, gender and alcohol intake have been found that affect the likelihood of emesis with a given chemotherapy. Pharmacogenomics has also been explored as a cause for variation in emetic response. In theory these risk factors could be used to optimize antiemetic therapy for individual patients but guidelines for prophylactic antiemetics are based solely upon the type of chemotherapy administered. Attempts to identify subgroups of patients for whom guidelines recommendations are suboptimal have thus far been unsuccessful except for those with a poor experience in a previous cycle of the same chemotherapy. At present, there is no basis for deviating from evidence-based guidelines when prescribing antiemetics prior to the first cycle of chemotherapy." 

Hope in Newly Diagnosed Cancer Patients

Hope 

Context

Hope is important to cancer patients as it helps them deal with their diagnosis. Little is known about hope in newly diagnosed cancer patients.

Objectives

Based on the Transcending Possibilities conceptual model of hope, the purpose of this study was to examine the relationship of hope with pain, energy, and psychological and demographic characteristics in newly diagnosed adult oncology outpatients.

Methods

Data from 310 New Patient Assessment Forms from cancer outpatients' health records were collected. Health records from the first six months of 2009 were reviewed and data were collected on hope, energy, pain, depression, anxiety, feeling overwhelmed, and demographic variables. A generalized linear modeling approach was used to study the relationship of hope scores with these variables. Hypothesized variables and variables that were significant at the P = 0.01 level from the univariate analysis were entered into the multivariate model, with hope scores as the dependent variable.

Results

Hope scores were significantly negatively related to age (P = 0.02). More specifically, oncology patients who were 65 years of age or older had significantly less hope than those under the age of 65 years (P = 0.01). Gender (P = 0.009) also was a significant factor, with men having higher hope scores than women. No other variables were significant.

Conclusion

Older adults comprise the majority of persons in Canada with cancer. The lower hope scores found in this age group compared with their younger counterparts underscore the importance of further research. This study provides a foundation for future research in this important area for oncology patients.

 

Breakthrough Cancer Pain: An Observational Study of 1000 European Oncology Patients

abstract

Context

Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients.

Objectives

The aim of this study was to characterize breakthrough pain in a diverse population of cancer patients.

Methods

The study involved 1000 cancer patients from 13 European countries. Patients were screened for breakthrough pain using a recommended diagnostic algorithm and then questioned about the characteristics and management of their pain.

Results

Of the 1000 patients, 44% reported incident pain, 41.5% spontaneous pain, and 14.5% a combination. The median number of episodes was three a day. The median time to peak intensity was 10 minutes, with the median for patients with incident pain being five minutes (P < 0.001). The median duration of untreated episodes was 60 minutes, with the median for patients with incident pain being 45 minutes (P = 0.001). Eight hundred six patients stated that pain stopped them doing something, 66 that it sometimes stopped them doing something, and only 107 that it did not interfere with their activities. Patients with incident pain reported more interference with walking ability and normal work, whereas patients with spontaneous pain reported more interference with mood and sleep. As well, 65.5% of patients could identify an intervention that improved their pain (29.5%, pharmacological; 23%, nonpharmacological; 12%, combination). Regarding medications, 980 patients were receiving an opioid to treat their pain, although only 191 patients were receiving a transmucosal fentanyl product licensed for the treatment of breakthrough pain.

Conclusion

Breakthrough cancer pain is an extremely heterogeneous condition.

 

Role of hyperthermic intraoperative peritoneal chemotherapy in the management of peritoneal metastases

abstract

The peritoneal cavity must be oncologically considered as an organ in its own right and peritoneal metastases (PM) must be treated with the same curative intent (and the same results) as liver metastases. The package combining complete cytoreductive surgery (CCRS) (treating the visible disease) plus hyperthermic intraoperative peritoneal chemotherapy (HIPEC) (treating the remaining non-visible disease) achieves cure in many patients. Twenty years of publication allow us to assemble sufficient background information and data to point out the good and poor indications for CCRS+HIPEC. HIPEC is the standard of care for the treatment of peritoneal pseudomyxomas and peritoneal mesotheliomas and also, recently for the treatment of colorectal PM with limited peritoneal extension. HIPEC is in the evaluation phase for gastric PM and ovarian PM after initially disappointing results, but it is highly probable that it will be useful in particular settings. PM from neuroendocrine tumours are in the same situation. HIPEC is not currently indicated for the treatment of PM from sarcomas, from GIST, and for small round-cell desmoplastic tumours, given the poor results obtained. HIPEC can be useful, on a case-by-case basis, to treat rare tumours complicated by isolated peritoneal diffusion (e.g. Frantz's tumours). HIPEC can be used in the prophylactic setting to prevent PM in patients with a high risk of developing PM, and the first results of the 'second-look' approach are promising. Finally, CCRS+HIPEC appear to be indispensable tools in the oncologist's armentarium. 

Hematuria Patients Rarely Referred for Cancer Screening

Hematuria Patients

Benefits, issues, and recommendations for personalized medicine in oncology in Canada

open access

▶ Decoding Annie Parker - Trailer 1 - YouTube

YouTube

Ovarian Masses in Children and Adolescents - An Analysis of 521 Clinical Cases

abstract
 J Pediatr Adolesc Gynecol

OBJECTIVE:

To analyze the clinical characteristics of ovarian masses in children and adolescents.

MATERIALS AND METHODS:

We performed a retrospective analysis of patients less than 20 years of age who were treated at the Obstetrics and Gynecology Hospital of Fudan (China) University between March 2003 and January 2012. Medical records were reviewed for age at operation, including presentation of symptoms and signs; the levels of tumor markers; imaging examinations; pathologic findings; the size of masses; treatment; and outcome. Data management and descriptive analyses were performed using SPSS 16.0.

RESULTS:

A total of 521 patients were included in this study. Among them, 92 had non-neoplastic lesions, 382 had benign neoplasms, and 47 had malignant tumors. The mean age of the patients was 16.3 ± 2.2 years. The primary presenting symptoms and signs were abdominal pain (39.5%), menstrual disorder (31.1%), abdominal swelling (5.4%), and an enlarged abdominal perimeter (3.3%). Malignant tumors tended to be larger than benign neoplasms (17.3 ± 8.6 cm vs 9.0 ± 5.7 cm; P = .000). There was no age difference between patients with benign neoplasms (16.3 ± 2.1 y) and those with malignant tumors (15.7 ± 2.5 y). The operations included salpingo-oophorectomy, ovarian cystectomy, and oophorectomy. Two patients with malignant tumors had bilateral salpingo-oophorectomy, and 2 patients who had tumor metastasis underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Forty-one cases of malignant tumors received postoperative chemotherapy.

CONCLUSIONS:

Germ cell tumors are the most common malignancy, and mature teratomas are the most common benign neoplasms in children and adolescents. Abdominal pain and menstrual disorder are the main reasons for doctor's visit. Although examination by ultrasound is the preferred auxiliary in the diagnosis of ovarian pathology, it could not distinguish between benign and malignant tumors. However, tumor size and tumor markers are helpful to identify the properties of masses. Surgery is usually better for treatment, and it is preferable to attempt conservative, fertility-sparing surgery in adolescents. Postoperative chemotherapy is necessary for malignant tumors.


 

(18)F-FDG Is a Surrogate Marker of Therapy Response and Tumor Recovery after Drug Withdrawal during Treatment with a Dual PI3K/mTOR Inhibitor in a Preclinical Model of Cisplatin-Resistant Ovarian Cancer

abstract (small animal testing)

AIM:

Targeting the phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway is a potential means of overcoming chemoresistance in ovarian cancer. We investigated the capability of (18)F-fluororodeoxyglucose ((18)F-FDG) small-animal positron emission tomography (SA-PET) to predict the effects of a dual PI3K/mTOR inhibitor (BEZ-235) in a cisplatin-resistant ovarian cancer model.

A prospective comparison of integrated FDG-PET/contrast-enhanced CT and contrast-enhanced CT for pretreatment imaging of advanced epithelial ovarian cancer

Abstract

Highlights

•

Compared to CT, PET/CT did not provide additional clinical value to preoperative treatment planning in this prospective study

•

Neither CT nor PET/CT are sensitive enough for an accurate estimation of disease in the abdominal cavity

•

PET/CT is more effective for the detection of extra-abdominal metastasis in patients with EOC

---

Objective

The use of tumor debulking surgery in the management of epithelial ovarian cancer (EOC), which is often disseminated in the peritoneal cavity at the time of diagnosis, has a significant impact on prognosis. We compared ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/contrast-enhanced computed tomography (PET/CT) to contrast-enhanced CT for the detection of dissemination into the abdominal cavity preventing successful primary debulking surgery.

Methods

Forty-one women with EOC underwent preoperative whole-body low-dose FDG-PET/CT followed by diagnostic high dose contrast-enhanced CT scan, and the results were compared with systematically recorded surgical findings as a reference standard. Both site-based and patient-based analyses were conducted.

Results

FDG-PET/CT was superior to conventional CT for the detection of carcinomatosis in subdiaphragmatic peritoneal surfaces (p = 0.020) and in the bowel mesentery (p = 0.001). Patient-based analysis of upper abdominal areas requiring extensive surgical procedures showed no significant differences between the two imaging methods. The sensitivity of PET/CT and CT was poor in certain areas of the peritoneal cavity (64% vs. 27% in the small bowel mesentery and 65% vs. 55% in the right upper abdomen). Extra-abdominal disease spread was detected by PET/CT in 32 patients and by CT in 25 patients.

Conclusions

PET/CT was not superior to CT for the detection of intra-abdominal disease spread. Patients with suspected EOC should be referred for upfront radical surgery regardless of the results of preoperative imaging studies. PET/CT is more effective for the detection of extra-abdominal disease than CT, but the clinical significance of this finding is unclear.

 

Aspirin Blocks EGF-stimulated Cell Viability in a COX-1 Dependent Manner in Ovarian Cancer Cells

Abstract

open access (full paper)

Objective: Although aspirin has been associated with a reduction of the risk of cancer when used as a nonsteroidal anti-inflammatory drug, its use to reduce the risk of ovarian cancer is controversial. Ovarian cancer cells usually express high levels of cyclooxygenase-1 (COX)-1. Because aspirin is a rather selective inhibitor of COX-1, the ability of aspirin to reduce the risk of ovarian cancer may be dependent on the level of COX-1 expression in those cells. Furthermore, epidermal growth factor receptor (EGFR) is frequently overexpressed in the malignant phenotype of ovarian cancer leading to increased cell proliferation and survival. Here we investigated if aspirin attenuates EGFR-activated ovarian cancer cell growth in a COX-1 dependent manner.  

Conclusions: Taken together, aspirin inhibits viability of ovarian cancer cells by blocking phosphorylation of Akt and Erk activated by EGF. Thus it may potentiate the therapeutic efficacy of drugs used to treat COX-1 positive ovarian cancer subsets.  

Vitamin D receptor rs2228570 polymorphism and susceptibly to ovarian cancer: a meta-analysis

abstract

The role of vitamin D receptor (VDR) rs2228570 polymorphism on the risk of ovarian cancer has been studied in many studies, but the relationship between VDR rs2228570 polymorphism and ovarian cancer is still unclear. We thus performed a meta-analysis of published studies to provide a comprehensive assessment of the association. Fourteen individual studies with a total of 10,964 subjects were finally included into the meta-analysis. We assessed the association by calculating the pooled odds ratio (OR) with 95 % confidence intervals (95 % CI). There was no heterogeneity among those included studies. Meta-analysis of 14 studies showed that the VDR rs2228570 polymorphism was associated with risk of ovarian cancer under three main comparison models (T versus C: OR = 1.09, 95 % CI 1.03 to 1.15, P = 0.004; TT versus CC: OR = 1.17, 95 % CI 1.04 to 1.32, P = 0.01; and TT/CT versus CC: OR = 1.12, 95 % CI 1.03 to 1.21, P  = 0.007). Subgroup analysis in Caucasians further identified the obvious association. There was no evidence of publications bias. These data from the meta-analysis suggest that VDR rs2228570 polymorphism is associated with risk of ovarian cancer in Caucasians. More studies are warranted to assess the association between the VDR rs2228570 polymorphism and ovarian cancer in Asians and Africans. 

The impact of pelvic retroperitoneal invasion and distant nodal metastases in epithelial ovarian cancer

abstract

Background

The absence of disease after debulking surgery is the most important prognostic factor in the treatment of advanced epithelial ovarian cancer (EOC). Occasionally, the presence of extra-abdominal disease complicates the ability to obtain a complete surgery, considering some locations of the metastatic disease as unresectable. The objective of the study was to estimate the survival impact of pelvic retroperitoneal invasion and extrapelvic and aortic distant nodal metastases in EOC patients. The anatomical landmarks of primary cytoreductive surgery will be discussed.

Material and methods

we reviewed data from 116 consecutive Mayo Clinic patients with epithelial ovarian cancer (EOC) stage IIIC and IV, undergoing primary cytoreduction surgery between 1996 and 2000. Univariate and multivariate analysis for patients with positive distant nodes and pelvic retroperitoneal invasion was performed, including 57 patients with no residual disease after surgery. Kaplan-Meier curves were used to estimate the probability of survival.

Results

the median patient's age was 65 years (range 24-87 years). The 5 years overall survival was 44.8% (range 30.1-57.9 months) and the median length of survival was 39.9 months (range 0.13-60 months, 95% confidence interval: 30.1-57.9). Pelvic retroperitoneal invasion was present in 22 EOC patients (18.9%) and distant positive nodes were noted in 11 (9.5%): suprarenal/celiac (5.2%), inguinal (4.3%) and supraclavicular (0.9%). Univariate and multivariate Cox regression analysis, identified distant positive lymph nodes and pelvic retroperitoneal invasion as factors statistically associated with overall survival (p=0.002 and p=0.025, respectively).

Conclusions

metastatic distant nodes and pelvic retroperitoneal invasion are independent prognostic factors for survival in patients with advanced EOC.

 

A multicentric trial (Olympia–MITO 13) on the accuracy of laparoscopy to assess peritoneal spread in ovarian cancer

Abstract

Objective

The objective of the study was to prospectively evaluate the accuracy of laparoscopy performed in satellite centers (SCs) to describe intraabdominal diffusion of advanced ovarian cancer (AOC).

Study Design

Patients with a clinical/radiological suspicion of AOC were included in the protocol. SCs were selected among those surgeons, spending a short intensive training period at the coordinator center (CC) to learn the application of staging laparoscopy (S-LPS) in AOC. All women underwent S-LPS at the SCs, and the surgical procedure was recorded and blindly reviewed at the CC.....

Results

One hundred sixty-eight cases were considered eligible for the study. A per-protocol analysis was performed on 120 cases. The worst laparoscopic assessable feature was mesenteric retraction, whereas the remaining variables ranged from 99.2% (peritoneal carcinomatosis) to 90% (bowel infiltration). All but 1 SC (SC number 4) reached an accuracy rate of 80% or greater for both single parameters and overall score.....

Conclusion

S-LPS allows an accurate and reliable assessment of intraperitoneal diffusion of disease in AOC patients in trained gynecological oncology centers.

 

audio 15:55 min: Implementing Patient-Centered Outcomes in Cancer Trials

audio

oday we are speaking with Dr. Ethan Basch, an oncologist who also does research on health services and drug regulatory policy at the University of North Carolina Comprehensive Cancer Center and the UNC School of Public Health. In a recent editorial in the New England Journal of Medicine, Dr. Basch wrote about a path toward including patient-reported outcomes, such as symptoms, in both labels for cancer drugs and in the published papers of trial outcomes. Dr. Basch is joining us to discuss his own experience with treating cancer patients, why patient-centered research is important, and why this type of information is frequently ignored. - See more at: http://www.cancernetwork.com/podcasts/implementing-patient-centered-outcomes-cancer-trials?GUID=59A6C40A-05D9-4E87-A0FC-1850E2FF60E0&rememberme=1&ts=25102013#sthash.oxrpW8On.dpuf

 

oday we are speaking with Dr. Ethan Basch, an oncologist who also does research on health services and drug regulatory policy at the University of North Carolina Comprehensive Cancer Center and the UNC School of Public Health. In a recent editorial in the New England Journal of Medicine, Dr. Basch wrote about a path toward including patient-reported outcomes, such as symptoms, in both labels for cancer drugs and in the published papers of trial outcomes. Dr. Basch is joining us to discuss his own experience with treating cancer patients, why patient-centered research is important, and why this type of information is frequently ignored. - See more at: http://www.cancernetwork.com/podcasts/implementing-patient-centered-outcomes-cancer-trials?GUID=59A6C40A-05D9-4E87-A0FC-1850E2FF60E0&rememberme=1&ts=25102013#sthash.oxrpW8On.dpuf

oday we are speaking with Dr. Ethan Basch, an oncologist who also does research on health services and drug regulatory policy at the University of North Carolina Comprehensive Cancer Center and the UNC School of Public Health. In a recent editorial in the New England Journal of Medicine, Dr. Basch wrote about a path toward including patient-reported outcomes, such as symptoms, in both labels for cancer drugs and in the published papers of trial outcomes. Dr. Basch is joining us to discuss his own experience with treating cancer patients, why patient-centered research is important, and why this type of information is frequently ignored. - See more at: http://www.cancernetwork.com/podcasts/implementing-patient-centered-outcomes-cancer-trials?GUID=59A6C40A-05D9-4E87-A0FC-1850E2FF60E0&rememberme=1&ts=25102013#sthash.oxrpW8On.dpuf

Avastin 25mg/ml concentrate for solution for infusion

Avastin 

On 15 May 2013, safety information on Avastin was issued. Necrotising fasciitis, including fatal cases, has been reported in patients receiving Avastin in both clinical trials and in the post-marketing setting. It is recommended that Avastin is discontinued and appropriate therapy initiated promptly upon diagnosis of necrotising fasciitis.
Further information is available on the MHRA website.

Table of Contents

• 1. Name of the medicinal product
• 2. Qualitative and quantitative composition
• 3. Pharmaceutical form
• 4. Clinical particulars
• 4.1 Therapeutic indications
• 4.2 Posology and method of administration
• 4.3 Contraindications
• 4.4 Special warnings and precautions for use
• 4.5 Interaction with other medicinal products and other forms of interaction
• 4.6 Fertility, pregnancy and lactation
• 4.7 Effects on ability to drive and use machines
• 4.8 Undesirable effects
• 4.9 Overdose
• 5. Pharmacological properties
• 5.1 Pharmacodynamic properties
• 5.2 Pharmacokinetic properties
• 5.3 Preclinical safety data
• 6. Pharmaceutical particulars
• 6.1 List of excipients
• 6.2 Incompatibilities
• 6.3 Shelf life
• 6.4 Special precautions for storage
• 6.5 Nature and contents of container
• 6.6 Special precautions for disposal and other handling
• 7. Marketing authorisation holder
• 8. Marketing authorisation number(s)
• 9. Date of first authorisation/renewal of the authorisation
• 10. Date of revision of the text

 

Breast cancer in BRCA mutation carriers: breast-conserving therapy or bilateral mastectomy?,

abstract

SUMMARY BRCA mutation carriers who are diagnosed with breast cancer can be overwhelmed with decisions. The choice between breast-conserving therapy, mastectomy or a bilateral mastectomy is often the first to be made by patients. Those who choose breast-conserving therapy are faced with an increased risk of ipsilateral breast tumor recurrence and contralateral breast cancer; however, choosing more extensive surgery increases surgical morbidity without a proven survival advantage. Additional factors that influence surgical decision-making are the use of adjuvant therapy, the role of risk-reducing salpingo-oophorectomy and the biology of the breast cancer. Advances in surgical techniques, breast reconstruction and screening must also be considered when choosing the surgical treatment for breast cancer patients with a BRCA mutation. 

Improvements to the FIGO staging for ovarian cancer: reconsideration of lymphatic spread and intraoperative tumor rupture

open access

Conclusion The modified FIGO staging for ovarian carcinoma appears superior to the current staging for discriminating survival outcomes of patients with surgical spillage, retroperitoneal LN metastasis without extrapelvic peritoneal involvement, or distant metastasis to supraclavicular LNs.

See the editorial "Staging of ovarian cancer: time to subdivide more?" in volume 24 on page 293 

Editorial: Staging of ovarian cancer: time to subdivide more?

Editorial: open access

  2013. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology



See the article "Improvements to the FIGO staging for ovarian cancer: reconsideration of lymphatic spread and intraoperative tumor rupture. J Gynecol Oncol. 2013 October; 24(4); 352" in volume 24 on page 352

JMIR--Integrating Patient Reported Outcomes With Clinical Cancer Registry Data: A Feasibility Study of the Electronic Patient-Reported Outcomes From Cancer Survivors (ePOCS) System (UK)

open access

Patients Not Included * | The Health Care Blog

Patients Not Included * | The Health Care Blog

Myriad slaps Quest with BRCA cancer test patent suit

litigation 

Editorial :: Cochrane and Wikipedia: the collaborative potential for a quantum leap in the dissemination and uptake of trusted evidence

Editorial: Cochrane and Wikipedia

October 22, 2013

 

The Cochrane Collaboration has played a pioneering role over the past 20 years in the production and dissemination of high-quality, timely, synthesised research evidence across many areas of health care. However, in order to fully realise Cochrane's vision of a world where this can lead to better health for everyone, proactive strategic alliances are needed to ensure wider dissemination of Cochrane evidence in a manner that better meets the needs of users worldwide.
Wikipedia, the web-based, multilingual, free-content encyclopaedia, is the sixth most visited site, and the most used medical resource, on the Internet.[1,2] In the 12 years since its creation, Wikipedia has grown into one of the largest reference websites, attracting over 500 million unique visitors monthly.[3] With more than 80,000 active voluntary contributors working on over 26 million articles in 285 languages, the potential for Cochrane to reach previously unreached audiences by forging a strategic partnership with Wikipedia is enormous.
There are remarkable similarities in the vision, mission, principles, and strategic goals of the Wikimedia Foundation (the not-for-profit, charitable organisation that manages Wikipedia) and Cochrane. This sets the stage for a working partnership that could help realise the aspirations of both organisations. Wikimedia Foundation's vision of "a world in which every single human being can freely share in the sum of all knowledge,"[4] echoes the altruism and hope enshrined in Cochrane's vision, and its values of freedom, accessibility and quality, independence, commitment to openness and diversity, transparency, and community as an asset mirror many of Cochrane's founding principles.[5,6] The core policies governing Wikipedia content are that articles should state a neutral point of view (be unbiased); be verifiable (supported by high-quality secondary sources), and contain no original research.[7].....
 

Hereditary colorectal cancer registries in Canada: report from the Colorectal Cancer Association of Canada consensus meeting; Montreal, Quebec; October 28, 2011

open access

Current Oncology—Volume 20, Number 5, October 2013

Schedule of Events | ASHG 2013 Annual Meeting

Schedule of Events

 

Researchers Spar Over Tests for Breast Cancer Risks | Science/AAAS | News

Science/AAAS | News

"A heated discussion broke out here today at the annual meeting of the American Society of Human Genetics over a hot-button topic: When will we know enough about rare cancer risk genes to begin routinely testing for them in patients with a family history of cancer?
On one side of the debate was a team led by breast cancer geneticist Mary-Claire King, who discovered the first inherited breast cancer risk gene, BRCA1. King’s group now wants to routinely test certain women for other cancer-linked genes. Other researchers, however, argued that it is premature to test for these other genes, which are less well understood.....
 

BROCA sequencing approach evaluates all 24 genes implicated in breast cancer (and ovarian)

press release

 "Carriers of mutations in some of the genes were at significantly increased risk of ovarian cancer for women and increased risk of breast cancer in men as well as in women."

Compliance Rates and Outcomes Associated with a Restrictive Transfusion Policy in Gynecologic Oncology Patients

abstract

Objectives

Blood products are scarce but essential medical resources. Initially transfusions showed increased perioperative complications, prolonged hospitalizations, and higher mortality. Recently developed restrictive transfusion policies have not shown those adverse affects in critically ill patients. Hospitals adopted these policies to guide blood product administration. The objective of this study is to determine compliance with a restrictive transfusion policy in gynecologic oncology patients.

Methods

A retrospective chart review of gynecologic oncology patients undergoing transfusion with packed red blood cells (pRBCs) from 12/2008-9/2011 was performed. Cancer type and stage, surgical procedure, hemoglobin values, pRBC transfusions, intraoperative blood loss, and postoperative complications were collected. Each transfusion was classified as compliant or noncompliant.

Results

582 patients requiring 2,276 blood transfusions were identified. The mean age was 55.9 years. Ovarian and endometrial cancers were the most common malignancies. Gynecologic oncologists were 81.1% compliant with the restrictive transfusion policy; 59.0% of transfusions were secondary to exceptions. Noncompliant transfusions were commonly given on the day of surgery when intraoperative blood loss was < 1500 cc and for asymptomatic anemia. Only 64.7% of the transfusions were ordered in single unit increments. There was no significant difference in postoperative infections, thrombotic events, and mortality between compliant and noncompliant transfusions.

Conclusion

The majority of gynecologic oncology patients receive transfusions compliant with the restrictive transfusion policy. Morbidity and mortality are not increased with a restrictive transfusion policy. Efforts to improve compliance should focus on limiting transfusions when the hemoglobin is ≥ 7 g/dL and transfusing in single pRBCs unit increments.

 

Updating the Links to Cancer Prevention - American Institute for Cancer Research (AICR (2014 ovarian cancer + other cancers)

Updating the Links to Cancer Prevention