Blocking PD-1/PD-L1 in Genitourinary Malignancies: To Immunity and Beyond
Genitourinary malignancies represent a diverse biologic and immunologic landscape. Recently, checkpoint blockade has transformed the treatment paradigms for bladder and kidney cancer. However, continued progress will be essential in bladder and kidney cancer, given response to inhibition of the PD-1/PD-L1 (PD-1/PD-L1) axis remains variable and only a minority of patients respond. In contrast with the clinical trial results in bladder and kidney cancer, studies of anti–PD-1/PD-L1 therapy in prostate cancer have generally been disappointing. Nevertheless, an exciting array of studies is underway that are translating le...
Source: The Cancer Journal - January 1, 2018 Category: Cancer & Oncology Tags: Review Articles Source Type: research

PD-1/PD-L1 Axis in Lung Cancer
Cancer immunotherapies have revolutionized the treatment of non–small cell lung cancer. Yet, only a small subset of patients will benefit from PD-1 or PD-L1 blockade. PD-L1 tumor cell expression is the only approved biomarker at present. Tumor mutational burden and other emerging biomarkers should improve patient selection. Combination therapy approaches with chemotherapy or cytotoxic T-lymphocyte-associated protein 4 blockade may increase the proportion of patients who benefit from immunotherapy. Although use of immunotherapy in lung cancers with targetable oncogenes has not been particularly successful, the benefit...
Source: The Cancer Journal - January 1, 2018 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Clinical Development of PD-1 in Advanced Melanoma
The development of new treatment options has dramatically improved the landscape for patients with advanced melanoma. Part of these advances emerged through the identification of the importance of factors that regulate the immune system, including proteins that negatively modulate T cell–mediated responses termed “immune checkpoints.” Indeed, blockade of the cytotoxic T lymphocyte–associated antigen 4 (CTLA-4) immune checkpoint served as a proof of principle that the manipulation of these molecules could induce robust anticancer effects, yet limited to a small percentage of patients. Targeting a dis...
Source: The Cancer Journal - January 1, 2018 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Preclinical Data Supporting Antitumor Activity of PD-1 Blockade
Antibodies that block the PD-1 coinhibitory receptor on T cells or its primary ligand, PD-L1, have demonstrated unprecedented efficacy across a diverse array of both solid and hematologic malignancies in the clinic. These advances were built on a foundation of murine preclinical tumor model studies, which both demonstrated the therapeutic potential of PD-1/PD-L1 antibody blockade and also provided critical insights into the cellular and molecular processes underlying their capacity to elicit immune-mediated tumor regressions. As the field of immunotherapy moves toward higher-order combinations of agents, effective utilizat...
Source: The Cancer Journal - January 1, 2018 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Introduction by the Guest Editors: The PD-1 Axis in Cancer Therapy The Irony in a Name
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - January 1, 2018 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Symptom Management and Palliative Care in Pancreatic Cancer
Abstract Evidence documents the benefits of palliative care to ameliorate the symptoms of pancreatic cancer as well as those from its treatment. Professional organizations now recommend palliative care for all patients with pancreatic cancer early in the course of illness and concurrently with active treatment. Scrupulous symptom management as well as sensitive communication and advance care planning allow oncologists to provide “primary palliative care” and to care well for patients with pancreatic cancer throughout the course of their illness. (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Clinical Management: Metastatic Disease
Abstract Most patients with pancreatic cancer either present with or eventually develop metastatic disease during the course of their illness. For such individuals, systemic therapy, namely, cytotoxic therapy, represents the mainstay of treatment and is administered with noncurative intent. Of the various chemotherapy options now available for treating metastatic pancreatic cancer, 2 combination regimens, FOLFIRINOX (infusional 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and the doublet of gemcitabine and albumin-bound paclitaxel, have emerged as frontline standards of care, based on phase III studies demons...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Ablative Radiotherapy Doses for Locally Advanced: Pancreatic Cancer (LAPC)
Abstract Standard palliative doses of radiation for locally advanced unresectable pancreatic cancer have had minimal to no impact on survival. Randomized trials evaluating these palliative doses have not shown a significant survival benefit with the use of radiation as consolidation after chemotherapy. Results from nonrandomized studies of 3- to 5-fraction low-dose stereotactic radiation (SBRT) have likewise had a minimal impact, but with less toxicity and a shorter treatment time. Doses of SBRT have been reduced to half the level that is necessary (biological equivalent dose, BED of 53 Gy) to achieve tumor ablation in t...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Clinical Management: Resectable Disease
Abstract Despite the identification of more active systemic therapy combinations for pancreatic cancer, cures remain elusive and feasible only in patients with localized, operable disease. When examining outcome data from phase III adjuvant trials conducted during the past decade, the survival for patients with localized disease has improved, likely owing to a combination of factors including more active adjuvant therapy and improved surgical and perioperative care. Perhaps the greatest recent change in the care of patients with localized pancreatic cancer has been the extension of surgery to tumors previously thought to...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Diagnosis and Detection of Pancreatic Cancer
Abstract Computed tomography is the first-line imaging modality for suspected pancreatic cancer. Magnetic resonance cholangiopancreatography is a second-line modality for suspected pancreatic cancer and is usually reserved for equivocal cases. Both computed tomography and MR are highly sensitive in the detection of pancreatic cancer, with up to 96% and 93.5% sensitivity, respectively. Computed tomography is superior to MR in the assessment of tumor resectability, with accuracy rates of up to 86.8% and 78.9%, respectively. Close attention to secondary signs of pancreatic cancer, such as pancreatic duct dilatation, abrupt ...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Understanding Disease Biology and Informing the Management of Pancreas Cancer With Preclinical Model Systems
Abstract Recent advances in cytotoxic therapies for pancreatic ductal adenocarcinoma (PDA) are overshadowed by stalled clinical progress of more targeted strategies, the vast majority of which have failed in clinical trials. Inability to translate preclinical promise into clinical efficacy derives, in part, from imperfect disease modeling and mismatches between preclinical and clinical study design and execution. Into these gaps fall our patients who enter the clinical trial landscape expectantly and bear the brunt of its inadequacies. If improving patient survival is paramount, then it must be acknowledged that the fail...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Pancreatic Cancer Microenvironment
Abstract Pancreatic ductal adenocarcinoma (PDAC) is composed of a minority of malignant cells within a microenvironment of extracellular matrix, fibroblasts, endothelial cells, and immune cells. Therapeutic failures of chemotherapy, targeted therapy, and immunotherapy have all been attributed to the PDAC microenvironment. In this review, we dissect the components of the microenvironment and explain how each cell type contributes to form a highly immunosuppressive, hypoxic, and desmoplastic cancer. New efforts in single-cell profiling will enable a better understanding of the composition of the microenvironment in primary...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Advances in the Genetics and Biology of Pancreatic Cancer
Abstract Pancreatic ductal adenocarcinoma (PDA) remains one of the most devastating diagnoses in modern medicine. While the clinical management of the disease has improved, the complex biologic underpinnings of PDA enable both its aggressive nature and slow clinical translational progress. In this review, we provide an overview of the key features of PDA genetics and biology, highlighting translational challenges and providing a framework for improved diagnostic and therapeutic approaches. (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Oral Health and the Oral Microbiome in Pancreatic Cancer: An Overview of Epidemiological Studies
Conclusions Overall, the data present a plausible but complex relationship among pancreatic cancer, the oral microbiome, periodontal disease, and other risk factors that might be explained by systemic effects on immune and inflammatory processes. Larger comprehensive studies that examine serially collected epidemiological/clinical data and blood, tissue, and various microbial samples are needed to definitively determine how and whether oral health–related factors contribute to pancreatic cancer risk. (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Introduction: Pancreatic AdenocarcinomaThe Emperor of All Cancer Maladies
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Symptom Management and Palliative Care in Pancreatic Cancer
Abstract Evidence documents the benefits of palliative care to ameliorate the symptoms of pancreatic cancer as well as those from its treatment. Professional organizations now recommend palliative care for all patients with pancreatic cancer early in the course of illness and concurrently with active treatment. Scrupulous symptom management as well as sensitive communication and advance care planning allow oncologists to provide “primary palliative care” and to care well for patients with pancreatic cancer throughout the course of their illness. (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Clinical Management: Metastatic Disease
Abstract Most patients with pancreatic cancer either present with or eventually develop metastatic disease during the course of their illness. For such individuals, systemic therapy, namely, cytotoxic therapy, represents the mainstay of treatment and is administered with noncurative intent. Of the various chemotherapy options now available for treating metastatic pancreatic cancer, 2 combination regimens, FOLFIRINOX (infusional 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and the doublet of gemcitabine and albumin-bound paclitaxel, have emerged as frontline standards of care, based on phase III studies demons...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Ablative Radiotherapy Doses for Locally Advanced: Pancreatic Cancer (LAPC)
Abstract Standard palliative doses of radiation for locally advanced unresectable pancreatic cancer have had minimal to no impact on survival. Randomized trials evaluating these palliative doses have not shown a significant survival benefit with the use of radiation as consolidation after chemotherapy. Results from nonrandomized studies of 3- to 5-fraction low-dose stereotactic radiation (SBRT) have likewise had a minimal impact, but with less toxicity and a shorter treatment time. Doses of SBRT have been reduced to half the level that is necessary (biological equivalent dose, BED of 53 Gy) to achieve tumor ablation in t...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Clinical Management: Resectable Disease
Abstract Despite the identification of more active systemic therapy combinations for pancreatic cancer, cures remain elusive and feasible only in patients with localized, operable disease. When examining outcome data from phase III adjuvant trials conducted during the past decade, the survival for patients with localized disease has improved, likely owing to a combination of factors including more active adjuvant therapy and improved surgical and perioperative care. Perhaps the greatest recent change in the care of patients with localized pancreatic cancer has been the extension of surgery to tumors previously thought to...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Diagnosis and Detection of Pancreatic Cancer
Abstract Computed tomography is the first-line imaging modality for suspected pancreatic cancer. Magnetic resonance cholangiopancreatography is a second-line modality for suspected pancreatic cancer and is usually reserved for equivocal cases. Both computed tomography and MR are highly sensitive in the detection of pancreatic cancer, with up to 96% and 93.5% sensitivity, respectively. Computed tomography is superior to MR in the assessment of tumor resectability, with accuracy rates of up to 86.8% and 78.9%, respectively. Close attention to secondary signs of pancreatic cancer, such as pancreatic duct dilatation, abrupt ...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Understanding Disease Biology and Informing the Management of Pancreas Cancer With Preclinical Model Systems
Abstract Recent advances in cytotoxic therapies for pancreatic ductal adenocarcinoma (PDA) are overshadowed by stalled clinical progress of more targeted strategies, the vast majority of which have failed in clinical trials. Inability to translate preclinical promise into clinical efficacy derives, in part, from imperfect disease modeling and mismatches between preclinical and clinical study design and execution. Into these gaps fall our patients who enter the clinical trial landscape expectantly and bear the brunt of its inadequacies. If improving patient survival is paramount, then it must be acknowledged that the fail...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Pancreatic Cancer Microenvironment
Abstract Pancreatic ductal adenocarcinoma (PDAC) is composed of a minority of malignant cells within a microenvironment of extracellular matrix, fibroblasts, endothelial cells, and immune cells. Therapeutic failures of chemotherapy, targeted therapy, and immunotherapy have all been attributed to the PDAC microenvironment. In this review, we dissect the components of the microenvironment and explain how each cell type contributes to form a highly immunosuppressive, hypoxic, and desmoplastic cancer. New efforts in single-cell profiling will enable a better understanding of the composition of the microenvironment in primary...
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Advances in the Genetics and Biology of Pancreatic Cancer
Abstract Pancreatic ductal adenocarcinoma (PDA) remains one of the most devastating diagnoses in modern medicine. While the clinical management of the disease has improved, the complex biologic underpinnings of PDA enable both its aggressive nature and slow clinical translational progress. In this review, we provide an overview of the key features of PDA genetics and biology, highlighting translational challenges and providing a framework for improved diagnostic and therapeutic approaches. (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Oral Health and the Oral Microbiome in Pancreatic Cancer: An Overview of Epidemiological Studies
Conclusions Overall, the data present a plausible but complex relationship among pancreatic cancer, the oral microbiome, periodontal disease, and other risk factors that might be explained by systemic effects on immune and inflammatory processes. Larger comprehensive studies that examine serially collected epidemiological/clinical data and blood, tissue, and various microbial samples are needed to definitively determine how and whether oral health–related factors contribute to pancreatic cancer risk. (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Introduction: Pancreatic AdenocarcinomaThe Emperor of All Cancer Maladies
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Epigenetic Regulation of Dendritic Cell Development and Function
Abstract: The immune system is characterized by the generation of structurally and functionally heterogeneous immune cells that constitute complex innate and adaptive immunity. This heterogeneity of immune cells results from changes in the expression of genes without altering DNA sequence. To achieve this heterogeneity, immune cells orchestrate the expression and functional status of transcription factor (TF) networks, which can be broadly categorized into 3 classes: pioneer TFs that facilitate initial commitment and differentiation of hematopoietic cells, subset-specific TFs that promote the generation of selected cell li...
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Targeting Histone Methylation in Cancer
Abstract: Most, if not all, human cancers exhibit altered epigenetic signatures that promote aberrant gene expression that contributes to cellular transformation. Historically, attempts to pharmacologically intervene in this process have focused on DNA methylation and histone acetylation. More recently, genome-wide studies have identified histone and chromatin regulators as one of the most frequently dysregulated functional classes in a wide range of cancer types. These findings have provided numerous potential therapeutic targets including many that affect histone methylation. These include histone lysine methyltransferas...
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Targeting Histone Acetylation: Readers and Writers in Leukemia and Cancer
Abstract: Chromatin packaging of DNA provides a framework for transcriptional regulation. Modifications to DNA and histone proteins in nucleosomes lead to conformational changes, alterations in the recruitment of transcriptional complexes, and ultimately modulation of gene expression. We provide a focused review of control mechanisms that help modulate the activation and deactivation of gene transcription specifically through histone acetylation writers and readers in cancer. The chemistry of these modifications is subject to clinically actionable targeting, including state-of-the-art strategies to inhibit basic oncogenic ...
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

DNA Methyltransferase Inhibitors in Myeloid Cancer: Clonal Eradication or Clonal Differentiation?
Abstract: DNA methyltransferase inhibitors, so-called hypomethylating agents (HMAs), are the only drugs approved for the treatment of higher-risk myelodysplastic syndromes and are widely used in this context. However, it is still unclear why some patients respond to HMAs, whereas others do not. Recent sequencing efforts have identified molecular disease entities that may be specifically sensitive to these drugs, and many attempts are being made to clarify how HMAs affect the malignant clone during treatment. Here, we review the most recent data on the clinical effects of HMAs in myeloid malignancies. (Source: The Cancer Journal)
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

DNA Methylation–Targeted Drugs
Abstract: Targeting DNA hypermethylation, using nucleoside analogs, is an efficient approach to reprogram cancer cell epigenome leading to reduced proliferation, increased differentiation, recognition by the immune system, and ultimately cancer cell death. DNA methyltransferase inhibitors have been approved for the treatment of myelodysplastic syndromes, chronic myelomonocytic leukemia, and acute myelogenous leukemia. To improve clinical efficacy and overcome mechanisms of drug resistance, a second generation of DNA methyltransferase inhibitors has been designed and is currently in clinical trials. Although efficient in mo...
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Epigenetics and Precision Oncology
Abstract: Epigenetic alterations such as DNA methylation defects and aberrant covalent histone modifications occur within all cancers and are selected for throughout the natural history of tumor formation, with changes being detectable in early onset, progression, and ultimately recurrence and metastasis. The ascertainment and use of these marks to identify at-risk patient populations, refine diagnostic criteria, and provide prognostic and predictive factors to guide treatment decisions are of growing clinical relevance. Furthermore, the targetable nature of epigenetic modifications provides a unique opportunity to alter t...
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Roles of DNA Methylation in the Stages of Cancer
Abstract: Next year will mark 60 years since Dr. Leslie Foulds outlined his hypothesis that cancer is “a dynamic process advancing through stages that are qualitatively different,” leading the way to our view of cancer progression as we know it today. Our understanding of the mechanisms of these stages has been continuously evolving this past half-century, and there has always been an active discussion of the roles of both genetic and epigenetic changes in directing this progression. In this review, we focus on the roles one particular epigenetic mark—DNA methylation—plays in these various “di...
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Introduction: Cancer as an Epigenetic Disease
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - September 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Cancer Screening in the Elderly: A Review of Breast, Colorectal, Lung, and Prostate Cancer Screening
Abstract: There are relatively limited data on outcomes of screening older adults for cancer; therefore, the decision to screen older adults requires balancing the potential harms of screening and follow-up diagnostic tests with the possibility of benefit. Harms of screening can be amplified in older and frail adults and include discomfort from undergoing the test itself, anxiety, potential complications from diagnostic procedures resulting from a false-positive test, false reassurance from a false-negative test, and overdiagnosis of tumors that are of no threat and may result in overtreatment. In this paper, we review the...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Managing Cancer Pain in Older Adults
Abstract: Managing cancer pain in older adults can be complex and challenging. Understanding the unique needs of older patients with cancer is important to safe and effective pain management. The goals of this review are to discuss the assessment of older adults with cancer-related pain, treatment of cancer pain, and adverse effects or potential risks from treatment that are unique to older patients. A detailed pain assessment and when possible utilizing the geriatric assessment are vital to developing a cancer pain management plan. The geriatric assessment can help clinicians uncover problems not routinely assessed in the...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Early Stage Cancer in Older Adults: Prostate—Avoiding Overtreatment and Undertreatment
Abstract: The diagnosis of prostate cancer in elderly men is likely to increase over the next several decades, owing to changing demographics and a rising population of men older than 65 years. Given the heterogeneity and well-documented challenges in screening, diagnosing, and managing indolent versus aggressive prostate cancer, the geriatric patient population is particularly vulnerable to prostate cancer treatment nuances. Clinicians must become familiar with geriatric assessment tools to better answer life-expectancy questions prior to counseling patients on treatment options. The preferences and values of patients and...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Treatment Minimization in Older Patients With Early-Stage Breast Cancer
Abstract: The management of early-stage breast cancer in older patients is complex and requires a careful balance of the risk of cancer death with the competing risks of comorbidities and treatment-related toxicity in women with largely favorable disease. As the US population continues to age, oncologists will increasingly encounter this clinical challenge. Several strategies involving each core component of breast cancer therapy have been investigated to minimize treatment in these patients while still maintaining acceptable outcomes. These include omission of primary tumor resection, surgical axillary evaluation, systemi...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Changing Paradigm of Radiotherapy in the Elderly Population
Abstract: There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques. Despite the fact that the elderly are a growing significant proportion of cancer patients, and the need f...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Cancer Immunotherapy in Older Patients
Abstract: Advancing age remains one of the most significant risk factors for cancer development. Changes in the immune system occur with aging, and likely play a role in the increased incidence of malignancy in older patients. With the advent of immune checkpoint inhibitors, and their use in a variety of malignancies, there has been an explosion of clinical trials evaluating their use. Unfortunately, these trials have not shown consistent results in elderly patients, nor have age-specific outcomes been consistently reported. Further evaluation of the efficacy and toxicity of these agents in the elderly is needed, as they a...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Impact of Polypharmacy on Patient Outcomes in Older Adults With Cancer
Abstract: Polypharmacy is prevalent in older adults with cancer and may be advantageous for the management of certain chronic disease states, but uncertainty exists regarding potential hazards and consequences. Cancer-related therapy adds to the prevalence of polypharmacy, which can lead to compromised cancer management plans (i.e., postoperative complications, treatment delays, and/or premature treatment discontinuation). Polypharmacy has been identified as one of the domains commonly included in the Comprehensive Geriatric Assessment likely because of the potential influence on health outcomes. This review summarizes exi...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Geriatric Assessment and Tools for Predicting Treatment Toxicity in Older Adults With Cancer
Abstract: Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The geriatric assessment is a multidisciplinary evaluation that provides detailed information about a patient’s functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function. Among older patien...
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Biology of Aging and Cancer: Frailty, Inflammation, and Immunity
This article provides an overview of basic biology of aging and its relationship with cancer. After a brief introduction about the definition and mechanisms of aging, as well as age-related biological and physiological changes, the discussion mainly focuses on recent development and insights into the relationship of frailty, inflammation, and immunity with cancer, highlighting how the new knowledge can help further improve assessment and treatment of older patients with malignancies and promote cancer research. (Source: The Cancer Journal)
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Introduction: Decision Making With Older Cancer Patients
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - July 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Affordable Care Act and Cancer Care for Young Adults
This article reviews the studies that have evaluated the impacts of the ACA on access to cancer care and outcomes for young adults aged 19 to 25 years. Current literature shows that the ACA increased insurance rate and cancer diagnosis at early stage for young adults. There is also evidence of the ACA’s positive effects on initiation and completion of human papillomavirus vaccination and receipt of fertility-sparing treatment for cervical cancer among young women. Several avenues of future research on the ACA and cancer care are suggested. (Source: The Cancer Journal)
Source: The Cancer Journal - May 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Affordable Care Act and End-of-Life Care for Patients With Cancer
Abstract: The Affordable Care Act (ACA) expanded access to high-quality end-of-life care for Americans with serious illness, including cancer. Before the ACA was enacted in 2010, nearly 715,000 patients died in hospitals annually,1 despite evidence that most Americans prefer to die at home.2 Moreover, fewer than half of Medicare beneficiaries used hospice before death, despite evidence that hospice services improve cancer patients’ quality of life near death and caregivers’ bereavement outcomes.3–6 The ACA-stipulated programs and subsequent efforts were designed to address these deficiencies in access to ...
Source: The Cancer Journal - May 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Impact of the Affordable Care Act on Cancer Survivorship
Abstract: In 2010, the Patient Protection and Affordable Care Act (ACA) was implemented with the aim of expanding access to quality, affordable care. In this review, we describe the ACA provisions that are most relevant for cancer survivors, provide available published evidence, and offer insights for future research. We found that provisions focusing on access to preventive care, access to quality and coordinated care, and coverage expansion and increased affordability suggest beneficial effects. However, we identified research gaps specifically addressing the intended and unintended consequences of the ACA on cancer surv...
Source: The Cancer Journal - May 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Out-of-Pocket Spending Under the Affordable Care Act for Patients With Cancer
Abstract: The Patient Protection and Affordable Care Act (ACA) included several key provisions aimed at lowering the out-of-pocket cost burden for patients. In this review, we summarize the effect of 3 provisions under Medicaid, Medicare, and commercial insurance, respectively: expansion of Medicaid eligibility, closing the doughnut hole for Medicare Part D beneficiaries, and requiring an annual limit on out-of-pocket spending for commercially insured patients. Through this review, we find early evidence that these 3 ACA provisions have reduced the out-of-pocket burden or increased access to health insurance for many patie...
Source: The Cancer Journal - May 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

Effects of Affordable Care Act Marketplaces and Medicaid Eligibility Expansion on Access to Cancer Care
Conclusions: Significant changes to the ACA will affect oncology treatment choices of everyone with health insurance—not only the 10 million people newly covered by ACA health plans and the 70 million people with Medicaid coverage. (Source: The Cancer Journal)
Source: The Cancer Journal - May 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The Affordable Care Act and Cancer Care Delivery
Abstract: The Affordable Care Act (ACA) has reformed US health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with preexisting condition clauses, have helped more than 20 million Americans gain health care coverage. Accountable care organizations, oncology patient-centered medical homes, an...
Source: The Cancer Journal - May 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research

The ACA and Cancer Screening and Diagnosis
This article reviews relevant quantitative studies published since the ACA’s passage to assess whether the goal of increasing access to preventive services has been met. Because of lags in data availability, most studies examined only a short period post-ACA. Findings on changes in screening in the general population were mixed, although impacts were greatest among those with lower education and income, as well as groups that previously faced the highest cost barriers to screening. Furthermore, multiple studies found evidence of increases in early-stage diagnoses for certain cancers. Thus, certain targeted population...
Source: The Cancer Journal - May 1, 2017 Category: Cancer & Oncology Tags: Review Articles Source Type: research