Managing Patient Expectations: Integrative, Not Alternative
Expectations and beliefs about complementary and integrative medicine are the main predictors of its use in cancer patients. These expectations are rarely informed by consultation with a health care provider but are, rather, a result of family endorsement and information from nonmedical sources. As a rising number of cancer patients pursue integrative medicine, it is of increasing importance that health care providers understand their patients' expectations and motivations. These can range from symptom management to unrealistic hopes for cure. Complementary and integrative medicine can be used to complement criterion-stand...
Source: The Cancer Journal - September 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Introduction
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - September 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Errors in Genetic Testing: The Fourth Case Series
Discussion
As genetic testing continues to become more common and complex, it is clear that we must ensure that appropriate testing is ordered and that results are interpreted and used correctly. Access to certified genetic counselors continues to be an issue for some because of workforce limitations. Potential solutions involve action on multiple fronts: new genetic counseling delivery models, expanding the genetic counseling workforce, improving genetics and genomics education of nongenetics health care professionals, addressing health care policy barriers, and more. Genetic counselors have also positioned themselves i...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Original Articles Source Type: research
Future Approaches to Precision Oncology–Based Clinical Trials
The last 2 decades have seen a rapid advance of the precision oncology paradigm—from its early singular successes to becoming the prevailing model of cancer therapy. As the treatment of cancer moves away from traditional chemotherapy, so too will oncology clinical trials have to move away from the traditional model of phase I to phase III progression of drug development. Achieving this goal of individualized care will involve a concerted effort by the entire cancer care community to fundamentally change the design and implementation of oncology clinical trials. We envision that the next 2 decades will be a period of evol...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Defining, Identifying, and Understanding “Exceptional Responders” in Oncology Using the Tools of Precision Medicine
Widely available molecular profiling technology, including next-generation sequencing has changed the landscape of drug development in cancer. An increasing number of clinical trials in early drug development require patient selection based on molecular alterations. Concurrently, efforts to identify molecular alterations in tumors that exhibited exceptional response after systemic treatment with standard or investigational agents have been published or are in progress. These discoveries may ultimately serve as predictive markers or “actionable mutations” for future therapies. To test the feasibility of collecting the a...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Precision Cancer Trials With Immunomodulatory Agents: Personalizing Histology Agnostic Approaches
We present a review and discussion of the progress in biomarker-defined approaches to drug development in immunology. (Source: The Cancer Journal)
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Basket Trials and the MD Anderson Precision Medicine Clinical Trials Platform
Precision medicine incorporates information regarding tumor biology involved in patients' carcinogenesis and individualized treatment of patients using drugs that inhibit the molecular basis of their disease. Implementation of precision medicine accelerated the drug approval process, translating discoveries in basic science and biotechnology into patient care. Clinical trials with innovative or adaptive design including “basket” and “umbrella” trials explore personalized therapies against in selected tumor types and/or across tumor types. In 2007, we started the Initiative for Molecular Profiling and Advanced Cance...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
National Cancer Institute Basket/Umbrella Clinical Trials: MATCH, LungMAP, and Beyond
This article describes these trials, ALCHEMIST, LungMAP, NCI/NRG ALK Trial, MPACT, NCI-MATCH, and pediatric MATCH, and their contributions to the area of precision medicine. (Source: The Cancer Journal)
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Clinical Applications of Next-Generation Sequencing in Precision Oncology
The ability of next-generation sequencing (NGS) to comprehensively assess the molecular profile of a tumor specimen has transformed the clinical testing landscape in oncology. Accordingly, recent years have seen broad uptake of clinical NGS to inform cancer patient management. However, significant challenges remain. The annotation and clinical interpretation of variants identified by NGS tests often require rigorous review and may vary between laboratories. While a clearer regulatory path has emerged, reimbursement for NGS tests remains a subject of continuing debate. Basket clinical studies such as the National Cancer Ins...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Biostatistical and Logistical Considerations in the Development of Basket and Umbrella Clinical Trials
Oncology clinical trials are undergoing transformation to evaluate targeted therapies addressing a wider variety of biologically defined cancer subgroups. Multiarm basket and umbrella trials conducted under master protocols have become more prominent mechanisms for the clinical evaluation of promising new biologically driven anticancer therapies that are integral to precision oncology medicine. These new trial designs permit efficient clinical evaluation of multiple therapies in a variety of histologically and biologically defined cancers. These complex trials require extensive planning and attention to many factors, inclu...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
From the Broad Phase II Trial to Precision Oncology: A Perspective on the Origins of Basket and Umbrella Clinical Trial Designs in Cancer Drug Development
Oncologic phase II trials that evaluate the activity of new therapeutic agents have evolved dramatically over the past 50 years. The standard approach beginning in the late 1960s focused on individual studies that evaluated new anticancer agents against a wide range of both solid and hematopoietic malignancies often in a single “broad phase II trial” that included hundreds of patients; such studies efficiently established the landscape for subsequent development of a specific drug with respect to likely disease focus, toxicity, dose, and schedule. In the 1980s and 1990s, emphasis on histological context drove an explos...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Introduction by the Guest Editor: Oncologic Precision Medicine and the Use of Basket and Umbrella Clinical Trials
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Glycemic Variation and Cancer Occurrence—A New Paradigm
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Original Articles Source Type: research
Visit-to-Visit Hemoglobin A1c Variability Is Associated With Later Cancer Development in Patients With Diabetes Mellitus
Conclusions
These results demonstrated that visit-to-visit HbA1c variability is a potential risk factor for later tumorigenesis. The association may be mediated by oxidative stress or hormone variability. Routine cancer screening may be suggested for diabetic patients with unstable glycemic control. (Source: The Cancer Journal)
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Original Articles Source Type: research
Adverse Events in Genetic Testing: The Fourth Case Series
Discussion
As genetic testing continues to become more common and complex, it is clear that we must ensure that appropriate testing is ordered and that results are interpreted and used correctly. Access to certified genetic counselors continues to be an issue for some because of workforce limitations. Potential solutions involve action on multiple fronts: new genetic counseling delivery models, expanding the genetic counseling workforce, improving genetics and genomics education of nongenetics health care professionals, addressing health care policy barriers, and more. Genetic counselors have also positioned themselves i...
Source: The Cancer Journal - July 1, 2019 Category: Cancer & Oncology Tags: Original Articles Source Type: research
