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Kacem H, Cimini A, d’Angelo M, Castelli V. Molecular and Cellular Involvement in CIPN. Biomedicines 2024; 12:751. [PMID: 38672107 PMCID: PMC11048589 DOI: 10.3390/biomedicines12040751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Many anti-cancer drugs, such as taxanes, platinum compounds, vinca alkaloids, and proteasome inhibitors, can cause chemotherapy-induced peripheral neuropathy (CIPN). CIPN is a frequent and harmful side effect that affects the sensory, motor, and autonomic nerves, leading to pain, numbness, tingling, weakness, and reduced quality of life. The causes of CIPN are not fully known, but they involve direct nerve damage, oxidative stress, inflammation, DNA damage, microtubule dysfunction, and altered ion channel activity. CIPN is also affected by genetic, epigenetic, and environmental factors that modulate the risk and intensity of nerve damage. Currently, there are no effective treatments or prevention methods for CIPN, and symptom management is mostly symptomatic and palliative. Therefore, there is a high demand for better understanding of the cellular and molecular mechanisms involved in CIPN, as well as the development of new biomarkers and therapeutic targets. This review gives an overview of the current knowledge and challenges in the field of CIPN, focusing on the biological and molecular mechanisms underlying this disorder.
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Affiliation(s)
| | | | - Michele d’Angelo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (H.K.); (A.C.); (V.C.)
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Zhang T, Wakefield CE, Ren Z, Chen W, Du X, Shi C, Lai L, Zhao C, Gao Y, Chen Z, Zhou Y, Wu T, Cai M. Effects of digital psychological interventions on physical symptoms in cancer patients: A systematic review and meta-analysis. Gen Hosp Psychiatry 2023; 84:47-59. [PMID: 37385139 DOI: 10.1016/j.genhosppsych.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/12/2023] [Accepted: 05/25/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE This meta-analysis was to assess the efficacy of digital psychological interventions to improve physical symptoms (i.e., fatigue, pain, disturbed sleep, and physical well-being) among cancer patients, as well as to evaluate the variables that possibly moderate intervention effects. METHODS Nine databases were searched for the literature up to February 2023. Two reviewers independently conducted a quality assessment. Effect sizes were reported as the standardized mean difference (Hedge's g) and estimated using a random-effects model. RESULTS The meta-analysis included 44 randomized clinical trials comprising 7200 adults with cancer. Digital psychological interventions were associated with significant improvements in short-term fatigue (g = -0.33; 95% CI, -0.58 to -0.07) and disturbed sleep (g = -0.36; 95% CI, -0.57 to -0.15), but with non-significant changes in pain (g = -0.23; 95% CI, -0.68 to 0.21) and physical well-being (g = 0.31; 95% CI, -0.18 to 0.80). Additionally, no alleviation in long-term physical symptoms was observed. In subgroup analysis, results suggest that the country significantly moderated the effectiveness of digital psychological interventions in alleviating fatigue. CONCLUSIONS Digital psychological interventions can be effective for improving short-term fatigue and disturbed sleep in patients with cancer. Clinicians could consider digital psychological interventions as a possible and efficient addition to better manage some of the physical symptoms during and after cancer treatment.
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Affiliation(s)
- Tao Zhang
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Claire Elizabeth Wakefield
- School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW Sydney, Sydney, New South Wales, Australia; Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Zhihong Ren
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China.
| | - Wenke Chen
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Xiayu Du
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Congrong Shi
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Lizu Lai
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Chunxiao Zhao
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhuang Chen
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Yubu Zhou
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Tong Wu
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Manqi Cai
- Key Laboratory of Adolescent Cyberpsychology and Behaviour (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
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Lewis CES, Schutzer-Weissmann J, Farquhar-Smith P. Opioid use disorder in cancer patients. Curr Opin Support Palliat Care 2023; 17:98-103. [PMID: 36866646 DOI: 10.1097/spc.0000000000000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
PURPOSE OF REVIEW The misuse of opioids has increased significantly in recent decades. Historically, cancer patients have not been considered at risk of opioid misuse. However, cancer pain is common, and opioids are often prescribed. Guidelines addressing opioid misuse often exclude cancer patients. Given that misuse is associated with significant harm and a reduction in quality of life, it is important to understand the risk of opioid misuse in cancer patients and how we can recognise and treat it. RECENT FINDINGS Early cancer diagnoses and treatments have improved cancer survival rates, leading to a larger population of cancer patients and survivors. Opioid use disorder (OUD) may precede a cancer diagnosis or may develop during or after treatment. The effect of OUD extends from an individual patient to a societal level. This review examines the increasing incidence of OUD in cancer patients, ways to identify patients with OUD such as behaviour change and screening scales, prevention of OUD such as limited and targeted opioid prescriptions, and evidence-based treatment suggestions for OUD. SUMMARY OUD in cancer patients has only relatively recently been recognised as a growing problem. Early identification, involvement of the multidisciplinary team, and treatment can reduce the negative impact of OUD.
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Affiliation(s)
- Cara E S Lewis
- Department of Anaesthesia, Perioperative Medicine, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, England
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Ellington TD, Henley SJ, Wilson RJ, Senkomago V, Wu M, Benard V, Richardson LC. Cancer survival in the United States 2007-2016: Results from the National Program of Cancer Registries. PLoS One 2023; 18:e0284051. [PMID: 37167241 PMCID: PMC10174513 DOI: 10.1371/journal.pone.0284051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/22/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Cancer survival has improved for the most common cancers. However, less improvement and lower survival has been observed in some groups perhaps due to differential access to cancer care including prevention, screening, diagnosis, and treatment. METHODS To further understand contemporary relative cancer survival (one- and five- year), we used survival data from CDC's National Program of Cancer Registries (NPCR) for cancers diagnosed during 2007-2016. We examined overall relative cancer survival by sex, race and ethnicity, age, and county-level metropolitan and non-metropolitan status. Relative cancer survival by metropolitan and non-metropolitan status was further examined by sex, race and ethnicity, age, and cancer type. RESULTS Among persons with cancer diagnosed during 2007-2016 the overall one-year and five-year relative survival was 80.6% and 67.4%, respectively. One-year relative survival for persons living in metropolitan counties was 81.1% and 77.8% among persons living in non-metropolitan counties. We found that persons who lived in non-metropolitan counties had lower survival than those who lived in metropolitan counties, and this difference persisted across sex, race and ethnicity, age, and most cancer types. CONCLUSION Further examination of the differences in cancer survival by cancer type or other characteristics might be helpful for identifying potential interventions, such as programs that target screening and early detection or strategies to improve access to high quality cancer treatment and follow-up care, that could improve long-term outcomes. IMPACT This analysis provided a high-level overview of contemporary cancer survival in the United States.
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Affiliation(s)
- Taylor D Ellington
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Virginia Senkomago
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vicki Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Şeker Karatoprak G, Küpeli Akkol E, Yücel Ç, Bahadır Acıkara Ö, Sobarzo-sánchez E, Malaguti M. Advances in Understanding the Role of Aloe Emodin and Targeted Drug Delivery Systems in Cancer. Oxidative Medicine and Cellular Longevity 2022; 2022:1-20. [PMID: 35087619 PMCID: PMC8789423 DOI: 10.1155/2022/7928200] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/06/2021] [Accepted: 12/18/2021] [Indexed: 12/20/2022]
Abstract
Cancer is one of the important causes of death worldwide. Despite remarkable improvements in cancer research in the past few decades, several cancer patients still cannot be cured owing to the development of drug resistance. Natural sources might have prominence as potential drug candidates. Among the several chemical classes of natural products, anthraquinones are characterized by their large structural variety, noticeable biological activity, and low toxicity. Aloe emodin, an anthraquinone derivative, is a natural compound found in the roots and rhizomes of many plants. This compound has proven its antineoplastic, anti-inflammatory, antiangiogenic, and antiproliferative potential as well as ability to prevent cancer metastasis and potential in reversing multidrug resistance of cancer cells. The anticancer property of aloe emodin, a broad-spectrum inhibitory agent of cancer cells, has been detailed in many biological pathways. In cancer cells, these molecular mechanisms consist of inhibition of cell growth and proliferation, cell cycle arrest deterioration, initiation of apoptosis, antimetastasis, and antiangiogenic effect. In accordance with the strategy of developing potential drug candidates from natural products, aloe emodin's low bioavailability has been tried to be overcome by structural modifications and nanocarrier systems. Consequently, this review summarizes the antiproliferative and anticarcinogenic properties of aloe emodin, as well as the enhanced activity of its derivatives and the advantages of drug delivery systems on bioavailability.
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Burgess J, Ferdousi M, Gosal D, Boon C, Matsumoto K, Marshall A, Mak T, Marshall A, Frank B, Malik RA, Alam U. Chemotherapy-Induced Peripheral Neuropathy: Epidemiology, Pathomechanisms and Treatment. Oncol Ther 2021; 9:385-450. [PMID: 34655433 PMCID: PMC8593126 DOI: 10.1007/s40487-021-00168-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This review provides an update on the current clinical, epidemiological and pathophysiological evidence alongside the diagnostic, prevention and treatment approach to chemotherapy-induced peripheral neuropathy (CIPN). FINDINGS The incidence of cancer and long-term survival after treatment is increasing. CIPN affects sensory, motor and autonomic nerves and is one of the most common adverse events caused by chemotherapeutic agents, which in severe cases leads to dose reduction or treatment cessation, with increased mortality. The primary classes of chemotherapeutic agents associated with CIPN are platinum-based drugs, taxanes, vinca alkaloids, bortezomib and thalidomide. Platinum agents are the most neurotoxic, with oxaliplatin causing the highest prevalence of CIPN. CIPN can progress from acute to chronic, may deteriorate even after treatment cessation (a phenomenon known as coasting) or only partially attenuate. Different chemotherapeutic agents share both similarities and key differences in pathophysiology and clinical presentation. The diagnosis of CIPN relies heavily on identifying symptoms, with limited objective diagnostic approaches targeting the class of affected nerve fibres. Studies have consistently failed to identify at-risk cohorts, and there are no proven strategies or interventions to prevent or limit the development of CIPN. Furthermore, multiple treatments developed to relieve symptoms and to modify the underlying disease in CIPN have failed. IMPLICATIONS The increasing prevalence of CIPN demands an objective approach to identify at-risk patients in order to prevent or limit progression and effectively alleviate the symptoms associated with CIPN. An evidence base for novel targets and both pharmacological and non-pharmacological treatments is beginning to emerge and has been recognised recently in publications by the American Society of Clinical Oncology and analgesic trial design expert groups such as ACTTION.
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Affiliation(s)
- Jamie Burgess
- Department of Cardiovascular and Metabolic Medicine, The Pain Research Institute, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool University Hospital NHS Trust, Liverpool, UK.
- Clinical Sciences Centre, Aintree University Hospital, Longmoor Lane, Liverpool, L9 7AL, UK.
| | - Maryam Ferdousi
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, NIHR/Wellcome Trust Clinical Research Facility, Manchester, UK
| | - David Gosal
- Department of Neurology, Salford Royal NHS Foundation Trust, Salford, UK
| | - Cheng Boon
- Department of Clinical Oncology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Kohei Matsumoto
- Department of Cardiovascular and Metabolic Medicine, The Pain Research Institute, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool University Hospital NHS Trust, Liverpool, UK
| | - Anne Marshall
- Department of Cardiovascular and Metabolic Medicine, The Pain Research Institute, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool University Hospital NHS Trust, Liverpool, UK
| | - Tony Mak
- Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Andrew Marshall
- Faculty of Health and Life Sciences, Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
- Faculty of Health and Life Sciences, The Pain Research Institute, University of Liverpool, Liverpool, L9 7AL, UK
- Department of Pain Medicine, The Walton Centre, Liverpool, L9 7LJ, UK
| | - Bernhard Frank
- Department of Pain Medicine, The Walton Centre, Liverpool, L9 7LJ, UK
| | - Rayaz A Malik
- Research Division, Qatar Foundation, Weill Cornell Medicine-Qatar, Education City, Doha, Qatar
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Uazman Alam
- Department of Cardiovascular and Metabolic Medicine, The Pain Research Institute, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool University Hospital NHS Trust, Liverpool, UK.
- Division of Endocrinology, Diabetes and Gastroenterology, University of Manchester, Manchester, M13 9PT, UK.
- Clinical Sciences Centre, Aintree University Hospital, Longmoor Lane, Liverpool, L9 7AL, UK.
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Motataianu A, Maier S, Andone S, Barcutean L, Serban G, Bajko Z, Balasa A. Ischemic Stroke in Patients with Cancer: a Retrospective Cross-Sectional Study. J Crit Care Med (Targu Mures) 2021; 7:54-61. [PMID: 34722904 DOI: 10.2478/jccm-2021-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/05/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction An increasing trend of cancer associated stroke has been noticed in the past decade. Objectives To evaluate the risk factors and the incidence of neoplasia in stroke patients. Material and Method A retrospective, observational study was undertaken on 249 patients with stroke and active cancer (SAC) and 1563 patients with stroke without cancer (SWC). The general cardiovascular risk factors, the site of cancer, and the general clinical data were registered and evaluated. According to the “Oxfordshire Community Stroke Project” (OCSP) classification, all patients were classified into the clinical subtypes of stroke. The aetiology of stroke was considered as large-artery atherosclerosis, small vessel disease, cardio-embolic, cryptogenic or other determined cause. Results The severity of neurological deficits at admission were significantly higher in the SAC group (p<0.01). The haemoglobin level was significantly lower, and platelet level and erythrocyte sedimentation rate were significantly higher in the SAC group. Glycaemia, cholesterol and triglycerides levels were significantly higher in the SWC group. The personal history of hypertension was more frequent in the SWC group. In the SAC group, 28.9% had a cryptogenic aetiology, compared to 9.1% in SWC group. Cardio-embolic strokes were more frequent in the SAC group (24%) than the SWC group (19.6%). In the SAC group, 15,6% were diagnosed with cancer during the stroke hospitalization, and 78% of the SAC patients were without metastasis. Conclusions The most frequent aetiologies of stroke in cancer patients were cryptogenic stroke, followed by large-artery atherosclerosis. SAC patients had more severe neurological deficits and worse clinical outcomes than SWC patients. Stroke in cancer patients appears to be more frequently cryptogenic, probably due to cancer associated thrombosis. The association between stroke and cancer is important, especially in stroke of cryptogenic mechanism, even in the presence of traditional cardiovascular risk factors.
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Chua IS, Fratt E, Ho JJ, Roldan CS, Gundersen DA, Childers J. Primary Addiction Medicine Skills for Hospice and Palliative Medicine Physicians: A Modified Delphi Study. J Pain Symptom Manage 2021; 62:720-729. [PMID: 33677071 DOI: 10.1016/j.jpainsymman.2021.02.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 01/22/2023]
Abstract
CONTEXT Hospice and palliative medicine (HPM) physicians frequently care for patients with substance use disorders (SUDs), but there is no consensus on which primary addiction medicine (AM) skills are essential. OBJECTIVES Identify key primary AM skills that physicians should acquire during an ACGME-accredited HPM fellowship program. METHODS A modified Delphi study consisting of 18 experts on SUD in HPM and medical education. A literature review and expert input identified initial AM skills. In three Delphi rounds, participants rated each skill on a nine-point scale from "not at all important to include" to "crucial to include." We calculated medians (IQRs), analyzed panelists' comments, and grouped skills using the RAND / UCLA appropriateness method. RESULTS Among 62 proposed AM skills, 53 skills were rated as appropriate to include (38 of which achieved agreement), and nine skills were rated as uncertain. AM skills most relevant to HPM included 1) defining chemical coping, median 8.5 (IQR 2); 2) balancing life expectancy with risks of opioid use for patients with SUD, 9 (IQR 0); 3) explaining best practices to dispose unused opioids postmortem, 8 (IQR 2); 4) managing pain for hospice patients with SUD, 9 (IQR 0.75); and 5) partnering with hospice to manage patients on methadone and buprenorphine, 9 (IQR 2). Experts did not achieve consensus on whether HPM physicians should be encouraged to learn to prescribe buprenorphine for patients with opioid use disorder, 6 (IQR 3). CONCLUSION HPM fellowships should consider incorporating the primary AM skills identified in this study in their curricula.
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Affiliation(s)
- Isaac S Chua
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
| | - Ellie Fratt
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - J Janet Ho
- Division of Palliative Medicine, University of California San Francisco, San Francisco, California, USA
| | - Claudia S Roldan
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Daniel A Gundersen
- Division of Population Health Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Julie Childers
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Massachusetts, USA; Section for Treatment, Research, and Education in Addiction Medicine, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Massachusetts, USA
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Sekine M, Enomoto T. Precision medicine for hereditary tumors in gynecologic malignancies. J Obstet Gynaecol Res 2021; 47:2597-2606. [PMID: 34036697 DOI: 10.1111/jog.14861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 12/12/2022]
Abstract
Genomic medicine for gynecologic tumors is characterized by hereditary breast and ovarian cancer (HBOC) and Lynch syndrome (LS). Poly ADP-ribose polymerase (PARP) inhibitor, olaparib, and the immune checkpoint inhibitor, pembrolizumab, which are drugs that show sensitivity to each hereditary tumor, have begun to spread in clinical practice for gynecologic malignancies. In clinical use, platinum sensitivity is used as a clinical surrogate marker for olaparib sensitivity, and microsatellite instability is used as a biological surrogate marker for pembrolizumab sensitivity. BRCA genetic testing and microsatellite instability test have been used as companion diagnostics before starting olaparib and pembrolizumab treatment, respectively. Homologous recombination deficiency test could be used for companion diagnostic of olaparib combination with bevacizumab in first-line maintenance treatment and niraparib without re-administration of platinum agents in the treatment of recurrence. The approval of the three drugs has been changing the treatment of gynecologic malignancies. Furthermore, preventive medical care has been covered by insurance since April 2020 for breast and/or ovarian cancer patients with germline BRCA1/2 mutation in Japan. This review article outlines the current status and future prospects of precision medicine for gynecologic hereditary tumors focusing on HBOC and LS.
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Affiliation(s)
- Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Su WC, Kao WY, Chang TK, Tsai HL, Huang CW, Chen YC, Li CC, Hsieh YC, Yeh HJ, Chang CC, Wang JY. Stool DNA test targeting methylated syndecan-2 (SDC2) as a noninvasive screening method for colorectal cancer. Biosci Rep 2021; 41:BSR20201930. [PMID: 33393623 DOI: 10.1042/BSR20201930] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 12/01/2020] [Accepted: 12/24/2020] [Indexed: 12/24/2022] Open
Abstract
Despite the steadily increasing worldwide incidence of colorectal cancer (CRC), an effective noninvasive approach for early detection of CRC is still under investigation. The guaiac-based fecal occult blood test (FOBT) and fecal immunochemical test (FIT) have gained popularity as noninvasive CRC screening tests owing to their convenience and relatively low costs. However, the FOBT and FIT have limited sensitivity and specificity. To develop a noninvasive tool for the detection of CRC, we investigated the sensitivity, specificity, and accuracy of a stool DNA test targeting methylated syndecan-2 (SDC2), which is frequently methylated in patients with CRC. The present study enrolled 62 patients diagnosed as having stage 0-IV CRC and 76 healthy participants between July 2018 and June 2019 from two institutions. Approximately 4.5 g of stool sample was collected from each participant for detection of human methylated SDC2 gene. In total, 48 of 62 (77.4%) patients with CRC showed positive results, whereas 67 out of 76 (88.2%) healthy participants showed negative results. The area under the curve of the receiver operating characteristic curve constructed was 0.872 for discrimination between patients with CRC and healthy individuals. The present study highlights the potential of the fecal methylated SDC2 test as a noninvasive detection method for CRC screening with a relatively favorable sensitivity of 77.4%, a specificity of 88.2% and a positive predictive value of 84.2% compared with other available fecal tests. Further multicenter clinical trials comprising subjects of varied ethnicities are required to validate this test for the mass screening of patients with CRC.
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Yao H, Li T, Chen W, Lei S, Liu K, Jin X, Zhou J. Safety and Feasibility of Robotic Natural Orifice Specimen Extraction Surgery in Colorectal Neoplasms During the Initial Learning Curve. Front Oncol 2020; 10:1355. [PMID: 33072544 PMCID: PMC7533530 DOI: 10.3389/fonc.2020.01355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/29/2020] [Indexed: 01/18/2023] Open
Abstract
Aim: To analyze the learning curve (LC) for robotic natural orifice specimen extraction surgery (NOSES) for colorectal neoplasms and evaluate safety and feasibility during the initial LC. Method: Patients who consecutively underwent robotic NOSES performed by two surgeons between March 2016 and October 2019 were analyzed retrospectively. The operation time was evaluated using the cumulative sum method to analyze the LC. The clinicopathological data before and after the completion of LC were extracted and compared to evaluate safety and feasibility. Results: In total, 99 and 66 cases were scheduled for robotic NOSES by Prof. Yao and Prof. Li, respectively. The peak points of LC were observed at the 42nd and 15th cases of Yao and Li, respectively, then operation time began to decrease. Only the operation time for Yao before the completion of LC (213.3 ± 67.0 min) was longer than that after the completion of LC (143.8 ± 33.3 min). For Yao nor for Li, other indices, such as postoperative hospital stay, intraoperative blood loss, conversion to laparotomy, incidence of anastomotic leakage, reoperation rate, and 90-day mortality rate lacked significant statistical differences(P > 0.05). In terms of feasibility, the number of lymph nodes harvested, positive resection margin rate, and total cost before and after the completion of LC had no significant statistical difference (P > 0.05). Conclusion: The cases before the completion of LC for robotic NOSES in colorectal neoplasms varied from 15 cases to 42 cases. Robotic NOSES is safe and feasible during the initial LC.
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Affiliation(s)
- Hongliang Yao
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tiegang Li
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Weidong Chen
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sanlin Lei
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Kuijie Liu
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoxin Jin
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jiangjiao Zhou
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
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Shaish H, Aukerman A, Vanguri R, Spinelli A, Armenta P, Jambawalikar S, Makkar J, Bentley-Hibbert S, Del Portillo A, Kiran R, Monti L, Bonifacio C, Kirienko M, Gardner KL, Schwartz L, Keller D. Radiomics of MRI for pretreatment prediction of pathologic complete response, tumor regression grade, and neoadjuvant rectal score in patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation: an international multicenter study. Eur Radiol 2020; 30:6263-6273. [PMID: 32500192 DOI: 10.1007/s00330-020-06968-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/17/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate whether pretreatment MRI-based radiomics of locally advanced rectal cancer (LARC) and/or the surrounding mesorectal compartment (MC) can predict pathologic complete response (pCR), neoadjuvant rectal (NAR) score, and tumor regression grade (TRG). METHODS One hundred thirty-two consecutive patients with LARC who underwent neoadjuvant chemoradiation and total mesorectal excision (TME) were retrospectively collected from 2 centers in the USA and Italy. The primary tumor and surrounding MC were segmented on the best available T2-weighted sequence (axial, coronal, or sagittal). Three thousand one hundred ninety radiomic features were extracted using a python package. The most salient radiomic features as well as MRI parameter and clinical-based features were selected using recursive feature elimination. A logistic regression classifier was built to distinguish between any 2 binned categories in the considered endpoints: pCR, NAR, and TRG. Repeated k-fold validation was performed and AUCs calculated. RESULTS There were 24, 87, and 21 T4, T3, and T2 LARCs, respectively (median age 63 years, 32 to 86). For NAR and TRG, the best classification performance was obtained using both the tumor and MC segmentations. The AUCs for classifying NAR 0 versus 2, pCR, and TRG 0/1 versus 2/3 were 0.66 (95% CI, 0.60-0.71), 0.80 (95% CI, 0.74-0.85), and 0.80 (95% CI, 0.77-0.82), respectively. CONCLUSION Radiomics of pretreatment MRIs can predict pCR, TRG, and NAR score in patients with LARC undergoing neoadjuvant treatment and TME with moderate accuracy despite extremely heterogenous image data. Both the tumor and MC contain important prognostic information. KEY POINTS • Machine learning of rectal cancer on images from the pretreatment MRI can predict important patient outcomes with moderate accuracy. • The tumor and the tissue around it both contain important prognostic information.
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Affiliation(s)
- Hiram Shaish
- Department of Radiology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA.
| | - Andrew Aukerman
- Department of Pathology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Rami Vanguri
- Department of Pathology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Manzoni, 113 20089, Rozzano, Milano, Italy.,Division Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center - IRCCS -, Via Manzoni, 56 20089, Rozzano, Milano, Italy
| | | | - Sachin Jambawalikar
- Department of Radiology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Jasnit Makkar
- Department of Radiology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Stuart Bentley-Hibbert
- Department of Radiology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Armando Del Portillo
- Department of Pathology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Ravi Kiran
- Department of Surgery, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Lara Monti
- Division Colon and Rectal Surgery Unit, Humanitas Clinical and Research Center - IRCCS -, Via Manzoni, 56 20089, Rozzano, Milano, Italy
| | - Christiana Bonifacio
- Division of Radiology, Humanitas Clinical and Research Center, Via Manzoni, 56 20089, Rozzano, Milano, Italy
| | - Margarita Kirienko
- Department of Biomedical Sciences, Humanitas University, Via Manzoni, 113 20089, Rozzano, Milano, Italy
| | - Kevin L Gardner
- Department of Pathology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Lawrence Schwartz
- Department of Radiology, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
| | - Deborah Keller
- Department of Surgery, Columbia University Medical Center, 630 West 168th Street, New York, NY, 10016, USA
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Abstract
Rectal cancer treatment has evolved during the past 40 years with the use of a standardized surgical technique for tumour resection: total mesorectal excision. A dramatic reduction in local recurrence rates and improved survival outcomes have been achieved as consequences of a better understanding of the surgical oncology of rectal cancer, and the advent of adjuvant and neoadjuvant treatments to compliment surgery have paved the way for a multidisciplinary approach to disease management. Further improvements in imaging techniques and the ability to identify prognostic factors such as tumour regression, extramural venous invasion and threatened margins have introduced the concept of decision-making based on preoperative staging information. Modern treatment strategies are underpinned by accurate high-resolution imaging guiding both neoadjuvant therapy and precision surgery, followed by meticulous pathological scrutiny identifying the important prognostic factors for adjuvant chemotherapy. Included in these strategies are organ-sparing approaches and watch-and-wait strategies in selected patients. These pathways rely on the close working of interlinked disciplines within a multidisciplinary team. Such multidisciplinary forums are becoming standard in the treatment of rectal cancer across the UK, Europe and, more recently, the USA. This Review examines the essential components of modern-day management of rectal cancer through a multidisciplinary team approach, providing information that is essential for any practising colorectal surgeon to guide the best patient care.
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Affiliation(s)
- Deborah S Keller
- Department of Surgery, New York-Presbyterian, Columbia University Medical Centre, New York, NY, USA
| | - Mariana Berho
- Department of Pathology and Laboratory Medicine, Cleveland Clinic Florida, Weston, Florida, USA
| | | | - Steven D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - Manish Chand
- Wellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS); University College London, London, UK.
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Abstract
BACKGROUND In the past decades the right colon cancer showed a higher incidence rate than left colon cancer. This trend is known as "proximal shift" or "rightwards shift." We evaluated rightward shift phenomenon in our region. METHODS We collected data from 1101 colorectal cancer patients who underwent curative surgery at Parma University Hospital from 01 January 2004 through 01 January 2018. We divided patients into seven subgroups according to the time of surgery to evaluate epidemiological changes through the years of colon cancer. RESULTS We found a non-linear rightward shift trend of CRC. The incidence of RCC was the 40% between 2004-2005 and 51% in the biennium 2016-2017 (60% in 2012-2013 and 57% in 2014-2015). The patients with RCC were significantly older than patients with LCC. RCCs have poor differentiated tumors. Metastatic disease showed a similar distribution both in left and right CRCs. Peritoneum was the most common metastasis location from right-sided colon cancer. CONCLUSIONS Data suggest the existence of two different tumor entities in CRC between right-sided colon cancer and left-sided colon cancer. The proximal shift may be a reflection of improved screening programs, diagnostic accuracy and population aging. Ethnicity, gender, diet, environment, and socioeconomic status contribute to CRC incidence and prevalence in different regions.
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Affiliation(s)
- Paolo Del Rio
- Unit of General Surgery, Parma University Hospital, Parma, Italy
| | - Matteo Rossini
- Unit of General Surgery, Parma University Hospital, Parma, Italy -
| | - Mario Giuffrida
- Unit of General Surgery, Parma University Hospital, Parma, Italy
| | - Federico Cozzani
- Unit of General Surgery, Parma University Hospital, Parma, Italy
| | - Elena Guarnieri
- Unit of General Surgery, Parma University Hospital, Parma, Italy
| | - Paolo Dell'abate
- Unit of General Surgery, Parma University Hospital, Parma, Italy
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15
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Meng X, Wang W, Lan T, Yang W, Yu D, Fang X, Wu H. A Purified Aspartic Protease from Akkermansia Muciniphila Plays an Important Role in Degrading Muc2. Int J Mol Sci 2019; 21:E72. [PMID: 31861919 DOI: 10.3390/ijms21010072] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/16/2022] Open
Abstract
Akkermansia muciniphila can produce various mucin-degrading proteins. However, the functional characteristics of these proteins and their role in mucin degradation are unclear. Of the predicted protein-coding genes, Amuc_1434, which encodes for a hypothetical protein, is the focus in this study. A recombinant enzyme Amuc_1434 containing the 6× His-tag produced in Escherichia coli (hereinafter termed Amuc_1434*) was isolated to homogeneity and biochemically characterised. Results showed that the enzyme can hydrolyse hemoglobin with an activity of 17.21 U/μg. The optimal pH and temperature for hemoglobin hydrolysis of Amuc_1434* were found to be around 8.0 and 40 °C, respectively. Amuc_1434* is identified as a member of the aspartic protease family through the action of inhibitor pepstatin A. Amuc_1434* promotes the adhesion of colon cancer cell line LS174T, which can highly express Muc2. Significantly Amuc_1434* can degrade Muc2 of colon cancer cells. Amuc_1434 is mainly located in the colon of BALB/c mice. These results suggest that the presence of Amuc_1434 from Akkermansia muciniphila may be correlated with the restoration of gut barrier function by decreasing mucus layer thickness.
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McDaniel JT, Albright D, Lee HY, Patrick S, McDermott RJ, Jenkins WD, Diehr AJ, Jurkowski E. Rural–urban disparities in colorectal cancer screening among military service members and Veterans. Journal of Military, Veteran and Family Health 2019. [DOI: 10.3138/jmvfh.2018-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Little is known about rural–urban disparities in colorectal cancer (CRC) screening rates among the military service member and Veteran (SMV) population in the United States. Given that health care access is a challenge in rural areas, we sought to determine whether rural-dwelling Veterans were less likely to be screened for CRC than urban-dwelling Veterans. Methods: Secondary data for this cross-sectional study were retrieved from the 2016 Behavioral Risk Factor Surveillance System for a national sample of non-institutionalized SMVs ( N = 63,919). The influence of rurality on CRC screening among SMVs was determined using maximum likelihood multiple logistic regression. Results: After controlling for relevant covariates, rurality was independently associated with decreased likelihood of meeting guidelines for CRC screening among SMVs (odds ratio = 0.83, 95% confidence interval, 0.76–0.90). Discussion: Innovative interventions for CRC screening should target SMVs in rural areas because doing so may lower mortality from CRC.
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Affiliation(s)
- Justin T. McDaniel
- Department of Public Health and Recreation Professions, Southern Illinois University, Carbondale, Illinois, USA
| | - David Albright
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| | - Sarah Patrick
- Jackson County Health Department, Murphysboro, Illinois, USA
| | - Robert J. McDermott
- Department of Public Health and Recreation Professions, Southern Illinois University, Carbondale, Illinois, USA
| | - Wiley D. Jenkins
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Aaron J. Diehr
- Department of Public Health and Recreation Professions, Southern Illinois University, Carbondale, Illinois, USA
| | - Elaine Jurkowski
- School of Social Work, Southern Illinois University, Carbondale, Illinois, USA
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Li C, Liu T, Yin L, Zuo D, Lin Y, Wang L. Prognostic and clinicopathological value of MUC1 expression in colorectal cancer: A meta-analysis. Medicine (Baltimore) 2019; 98:e14659. [PMID: 30817589 PMCID: PMC6831235 DOI: 10.1097/md.0000000000014659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 01/22/2019] [Accepted: 01/30/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Accumulating evidence supports the overexpression of mucin 1 (MUC1) in colorectal cancer (CRC), but the value of elevated MUC1 expression remains controversial. Here, we evaluated the prognostic and clinicopathological value of MUC1 expression in CRC. MATERIALS AND METHODS The Web of Science, PubMed, Embase, Cochrane Library, and Wanfang databases, as well as the China Biology Medicine disc (CBMdisc) and China National Knowledge Infrastructure (CNKI) were searched for studies on MUC1 expression and prognosis of CRC through July 20, 2018. The pooled relative risks (RRs) and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated to evaluate the prognostic and clinicopathological value of MUC1 expression in CRC. The Revman version 5.3 package and STATA, version 12 were employed for pooled analysis and analysis of publication bias. RESULTS This meta-analysis included 16 published studies. The combined analysis showed that CRC patients with high MUC1 expression had a worse clinical outcome in overall survival (OS) (HR = 1.51, 95% CI = 1.30-1.75, P <.00001). In addition, high MUC1 expression was associated with higher TNM stage (RR = 1.44, 95% CI = 1.17-1.77, P = .0007), greater depth of invasion (RR = 1.30, 95% CI = 1.10-1.53, P = .002), and lymph node metastasis (RR = 1.47, 95% CI = 1.20-1.80, P = .0002) of CRC. However, the elevated MUC1 expression was not related to disease-free survival/recurrence-free survival (DFS/RFS) (HR = 1.51, 95% CI = 0.78-2.89, P = .22), histological grade (RR = 1.15, 95% CI = 0.96-1.38, P = .12), gender (RR = 0.95; 95% CI = 0.83-1.08, P = .44), tumor size (RR = 1.11, 95% CI = 0.85-1.44, P = .44), tumor site (RR = 1.01, 95% CI = 0.88-1.16, P = .84), or mucinous component (RR = 0.83, 95% CI = 0.60-1.14, P = .24) in CRC. CONCLUSION Our findings indicated that high MUC1 expression represents a marker of poor prognosis in CRC. Meanwhile, elevated MUC1 expression was associated with advanced TNM stage, greater depth of invasion, and lymph node metastasis.
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Affiliation(s)
- Chao Li
- Department of Colorectal and Anal Surgery
| | - Tao Liu
- Department of Colorectal and Anal Surgery
| | - Libin Yin
- Department of Colorectal and Anal Surgery
| | - Didi Zuo
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Yuyang Lin
- Department of Colorectal and Anal Surgery
| | - Lei Wang
- Department of Colorectal and Anal Surgery
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van Roeden SE, Wever PC, Kampschreur LM, Gruteke P, van der Hoek W, Hoepelman AIM, Bleeker-Rovers CP, Oosterheert JJ. Chronic Q fever-related complications and mortality: data from a nationwide cohort. Clin Microbiol Infect 2018; 25:1390-1398. [PMID: 30543852 DOI: 10.1016/j.cmi.2018.11.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/12/2018] [Accepted: 11/26/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Chronic infection with Coxiella burnetii (chronic Q fever) can cause life-threatening conditions such as endocarditis, infected vascular prostheses, and infected arterial aneurysms. We aimed to assess prognosis of chronic Q fever patients in terms of complications and mortality. METHODS A large cohort of chronic Q fever patients was assessed to describe complications, overall mortality and chronic Q fever-related mortality. Chronic Q fever-related mortality was expressed as a case fatality rate (number of chronic Q fever-related deaths/number of chronic Q fever patients). RESULTS Complications occurred in 166 of 439 (38%) chronic Q fever patients: in 61% of proven (153/249), 15% of probable (11/74), and 2% of possible chronic Q fever patients (2/116). Most frequently observed complications were acute aneurysms (14%), heart failure (13%), and non-cardiac abscesses (10%). Overall mortality was 38% (94/249) for proven chronic Q fever patients (median follow-up 3.6 years) and 22% (16/74) for probable chronic Q fever patients (median follow-up 4.7 years). The case fatality rate was 25% for proven (63/249) chronic Q fever patients and 4% for probable (3/74) chronic Q fever patients. Overall survival was significantly lower in patients with complications, compared to those without complications (p <0.001). CONCLUSIONS In chronic Q fever patients, complications occur frequently and contribute to the mortality rate. Patients with proven chronic Q fever have the highest risk of complications and chronic Q fever-related mortality. Prognosis for patients with possible chronic Q fever is favourable in terms of complications and mortality.
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Affiliation(s)
- S E van Roeden
- University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - P C Wever
- Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | | | - P Gruteke
- Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - W van der Hoek
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Rashed WM, Saad A, Al-Husseini M, Galal AM, Ismael AM, Al-Tayep AM, El Shafie A, Ali MA, Alfaar AS. Incidence of adrenal gland tumor as a second primary malignancy: SEER-based study. Endocr Connect 2018; 7:EC-18-0304. [PMID: 30139816 PMCID: PMC6198183 DOI: 10.1530/ec-18-0304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 08/02/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022]
Abstract
PURPOSE Advances in cancer treatment achieved during the past decades have resulted in increased survival of most pediatric and adult patients that suffered from different adrenal tumor types. This article reviews the incidence and survival of adrenal gland tumors as second primary tumors, according to data from the Surveillance, Epidemiology, and End Results (SEER) database. METHOD The SEER 13 Registries Database from 1992 to 2013 was used. All primary cancer sites were selected using the Multiple Primary Standardized Incidence Ratios (MP-SIR) session. RESULTS Data for a total of 2,887,468 persons with cancer were reviewed. 117 of whom had suffered second primary adrenal tumors. The overall standardized incidence ratio (SIR) of adrenal gland tumor as a second primary was 1.49. A high incidence ratio of the event was also detected in specific primary tumor sites: hypopharynx (Observed/Expected(O/E) = 44.59); other endocrine tissue (including the thymus) (O/E=38.27); chronic myeloid leukemia (O/E=11.15); small intestine (O/E=8.86); liver (O/E=8.74); stomach (O/E=4.95); nodal NHL (O/E=3.79); kidney and renal pelvis (O/E=3.19); and breast (O/E=1.78). CONCLUSION The underlying shared mechanisms should be investigated between adrenal tumors and hypopharyngeal, endocrine and other tumors. Racial disparity is an important challenge in cancer treatment at US and should be taken into consideration in the design of cancer prevention programs. This could be achieved through follow-up programs at specialized national cancer networks, especially for rare tumors like adrenal gland.
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Affiliation(s)
- Wafaa M Rashed
- Research DepartmentChildren’s Cancer Hospital Egypt (CCHE-57357), Cairo, Egypt
- Armed Forces College of MedicineCairo, Egypt
| | - Anas Saad
- Faculty of MedicineDamascus University, Damascus, Syria
| | | | | | | | | | | | | | - Ahmad Samir Alfaar
- Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Ophthalmology DepartmentBerlin, Germany
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Li C, Zuo D, Yin L, Lin Y, Li C, Liu T, Wang L. Prognostic Value of MUC2 Expression in Colorectal Cancer: A Systematic Review and Meta-Analysis. Gastroenterol Res Pract 2018; 2018:6986870. [PMID: 29967641 DOI: 10.1155/2018/6986870] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/15/2018] [Accepted: 04/22/2018] [Indexed: 12/17/2022] Open
Abstract
Background The reliability of MUC2 as a prognostic marker in colorectal cancer (CRC) is controversial. This study evaluated the association between MUC2 expression levels in CRC tissues and prognosis. Methods The PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc (CBMdisc), Wanfang Database, and China National Knowledge Infrastructure (CNKI) databases were searched to identify studies exploring the relationship between MUC2 expression in CRC tissues and overall survival (OS). Pooled hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were used to evaluate the associations between MUC2 expression levels and prognosis and MUC2 expression levels and CRC clinicopathological characteristics, respectively. Results The meta-analysis included 11 studies (2619 patients). Low MUC2 expression level was significantly associated with poor OS (HR, 1.67; 95% CI, 1.43–1.94; P < 0.00001) and disease-free survival (DFS)/recurrence-free survival (RFS) (HR, 1.60; 95% CI, 1.21–2.12; P = 0.001) in patients with CRC. Low MUC2 expression level was associated with advanced TNM stage (RR, 1.42; 95% CI, 1.26–1.60; P < 0.00001), lymph node metastasis (RR, 1.41; 95% CI, 1.25–1.60; P < 0.00001), lymphatic invasion (RR,1.64; 95% CI, 1.26–2.12; P = 0.0002), rectal tumor site (RR, 1.26; 95% CI, 1.09–1.46; P = 0.001), and large tumor size (RR,1.32; 95% CI, 1.02–1.70; P = 0.03). There were no associations between low MUC2 expression level and gender, histological grade, depth of invasion, and distant metastasis. Conclusion The low levels of MUC2 in CRC tissues are poor prognostic factor independent of stage or other well-recognized markers of later-stage disease. Large well-designed cohort studies are required to validate MUC2 as a biomarker for poor prognosis in CRC.
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Navi BB, Howard G, Howard VJ, Zhao H, Judd SE, Elkind MSV, Iadecola C, DeAngelis LM, Kamel H, Okin PM, Gilchrist S, Soliman EZ, Cushman M, Muntner P. New diagnosis of cancer and the risk of subsequent cerebrovascular events. Neurology 2018; 90:e2025-e2033. [PMID: 29728524 DOI: 10.1212/wnl.0000000000005636] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/22/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We aimed to evaluate the association between cancer and cerebrovascular disease in a prospective cohort study with adjudicated cerebrovascular diagnoses. METHODS We analyzed participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who were 45 years and older and had Medicare coverage for 365 days before their baseline study visit. Participants with a history of cancer or cerebrovascular events were excluded. The time-dependent exposure was a new diagnosis of malignant cancer identified through Medicare claims algorithms. Participants were prospectively followed from their baseline study visit (2003-2007) through 2014 for the outcome of a neurologist-adjudicated cerebrovascular event defined as a composite of stroke (ischemic or hemorrhagic) or TIA. Cox regression was used to evaluate the association between a new cancer diagnosis and subsequent cerebrovascular events. Follow-up time was modeled in discrete time periods to fulfill the proportional hazard assumption. RESULTS Among 6,602 REGARDS participants who met eligibility criteria, 1,149 were diagnosed with cancer during follow-up. Compared to no cancer, a new cancer diagnosis was associated with subsequent cerebrovascular events in the first 30 days after diagnosis (hazard ratio 6.1, 95% confidence interval 2.7-13.7). This association persisted after adjustment for demographics, region of residence, and vascular risk factors (hazard ratio 6.6, 95% confidence interval 2.7-16.0). There was no association between cancer diagnosis and incident cerebrovascular events beyond 30 days. Cancers considered high risk for venous thromboembolism demonstrated the strongest associations with cerebrovascular event risk. CONCLUSION A new diagnosis of cancer is associated with a substantially increased short-term risk of cerebrovascular events.
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Affiliation(s)
- Babak B Navi
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington.
| | - George Howard
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Virginia J Howard
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Hong Zhao
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Suzanne E Judd
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Mitchell S V Elkind
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Costantino Iadecola
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Lisa M DeAngelis
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Hooman Kamel
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Peter M Okin
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Susan Gilchrist
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Elsayed Z Soliman
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Mary Cushman
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
| | - Paul Muntner
- From the Department of Neurology (B.B.N., C.I., L.M.D., H.K.) and Feil Family Brain and Mind Research Institute (B.B.N., C.I., L.M.D., H.K.), Weill Cornell Medicine, New York; Department of Neurology (B.B.N., L.M.D.), Memorial Sloan Kettering Cancer Center, New York, NY; Departments of Biostatistics (G.H., S.E.J.) and Epidemiology (V.J.H., H.Z., P.M.), School of Public Health, University of Alabama at Birmingham; Department of Neurology (M.S.V.E.), Columbia College of Physicians and Surgeons, New York, NY; Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York; Department of Medicine (P.M.O.), Division of Cardiology, Weill Cornell Medicine, New York, NY; Department of Clinical Cancer Prevention (S.G.), MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine (E.Z.S.), Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC; and Department of Medicine (M.C.), Division of Hematology and Oncology, University of Vermont, Burlington
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Navi BB, Iadecola C. Ischemic stroke in cancer patients: A review of an underappreciated pathology. Ann Neurol 2018; 83:873-883. [PMID: 29633334 PMCID: PMC6021225 DOI: 10.1002/ana.25227] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 04/02/2018] [Accepted: 04/02/2018] [Indexed: 02/06/2023]
Abstract
Currently 1 in 10 patients with ischemic stroke have comorbid cancer, and this frequency is expected to increase with continued advances in cancer therapeutics prolonging median survival. Well known for its association with venous thrombosis, cancer has recently emerged as a significant risk factor for arterial thromboembolism, including stroke; however, the underlying mechanisms are uncertain. In addition, the optimal strategies to prevent and acutely treat stroke in cancer patients are yet to be established. This review summarizes the current evidence on ischemic stroke risk, biomarkers, pathophysiology, treatments, and prognosis in cancer patients, emphasizing knowledge gaps and the potential strategies to address them. Ann Neurol 2018;83:873-883.
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Affiliation(s)
- Babak B Navi
- Department of Neurology
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Costantino Iadecola
- Department of Neurology
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine
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23
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Richards TB, Henley SJ, Puckett MC, Weir HK, Huang B, Tucker TC, Allemani C. Lung cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:5079-5099. [PMID: 29205305 DOI: 10.1002/cncr.31029] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Results from the second CONCORD study (CONCORD-2) indicated that 5-year net survival for lung cancer was low (range, 10%-20%) between 1995 and 2009 in most countries, including the United States, which was at the higher end of this range. METHODS Data from CONCORD-2 were used to analyze net survival among patients with lung cancer (aged 15-99 years) who were diagnosed in 37 states covering 80% of the US population. Survival was corrected for background mortality using state-specific and race-specific life tables and age-standardized using International Cancer Survival Standard weights. Net survival was estimated for patients diagnosed between 2001 and 2003 and between 2004 and 2009 at 1, 3, and 5 years after diagnosis by race (all races, black, and white); Surveillance, Epidemiology, and End Results Summary Stage 2000; and US state. RESULTS Five-year net survival increased from 16.4% (95% confidence interval, 16.3%-16.5%) for patients diagnosed 2001-2003 to 19.0% (18.8%-19.1%) for those diagnosed 2004-2009, with increases in most states and among both blacks and whites. Between 2004 and 2009, 5-year survival was lower among blacks (14.9%) than among whites (19.4%) and ranged by state from 14.5% to 25.2%. CONCLUSIONS Lung cancer survival improved slightly between the periods 2001-2003 and 2004-2009 but was still low, with variation between states, and persistently lower survival among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment should reduce the differences in survival by race and state. Cancer 2017;123:5079-99. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Thomas B Richards
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary C Puckett
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah K Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bin Huang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Thomas C Tucker
- Markey Cancer Center, Kentucky Cancer Registry, and College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Shapiro JA, Bobo JK, Church TR, Rex DK, Chovnick G, Thompson TD, Zauber AG, Lieberman D, Levin TR, Joseph DA, Nadel MR. A Comparison of Fecal Immunochemical and High-Sensitivity Guaiac Tests for Colorectal Cancer Screening. Am J Gastroenterol 2017; 112:1728-1735. [PMID: 29016558 PMCID: PMC6077997 DOI: 10.1038/ajg.2017.285] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 07/25/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Annual testing using either a high-sensitivity guaiac fecal occult blood test (HS-gFOBT) or a fecal immunochemical test (FIT) is recommended for screening average-risk people for colorectal cancer. We compared the performance characteristics of the HS-gFOBT Hemoccult II SENSA and two FITs (InSure FIT and OC FIT-CHEK) for detecting advanced colorectal neoplasia. METHODS The study included 1,006 asymptomatic patients, aged 50-75 years, who were scheduled to receive a screening colonoscopy at gastroenterology practices in the Minneapolis and Indianapolis metropolitan areas. Each participant was asked to complete all three stool tests before their colonoscopy. Each test's performance characteristics were evaluated using the screening colonoscopic results as the reference standard. RESULTS Sensitivity for detecting advanced colorectal neoplasia was highest for InSure FIT (26.3%, 95% confidence interval (CI) 15.9-40.7), followed by OC FIT-CHEK (15.1%, 95% CI 6.7-26.1) and Hemoccult II SENSA (7.4%, 95% CI 1.9-17.0). InSure FIT was statistically significantly more sensitive than both OC FIT-CHEK (absolute difference in sensitivity=11.2%, 95% CI 0.4-24.2) and Hemoccult II SENSA (difference in sensitivity=18.9%, 95% CI 10.2-32.6). Specificities were relatively high for all tests (between 96.8% and 98.6%). CONCLUSIONS Our results suggest that some FITs are more sensitive than the HS-gFOBT Hemoccult II SENSA, but these results need to be confirmed in larger asymptomatic populations. Comparisons between the FITs examined in this study and other FITs are needed to determine the best tests for population screening.
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Affiliation(s)
- Jean A. Shapiro
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janet K. Bobo
- Battelle Health and Analytics, Seattle, Washington, USA
| | - Timothy R. Church
- Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Douglas K. Rex
- Department of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Gary Chovnick
- Battelle Health and Analytics, Seattle, Washington, USA
| | - Trevor D. Thompson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ann G. Zauber
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | | | - Djenaba A. Joseph
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marion R Nadel
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Abstract
AIM Several studies have implicated increased risk of malignancy in patients with immunoglobulin G4-related disease (IgG4-RD). Hence, we first evaluated the risk and the type of malignancy in Korean IgG4-RD patients. METHOD Clinical and laboratory results of patients fulfilling the comprehensive diagnostic criteria for IgG4-RD were retrospectively collected between January 2006 and November 2015. One hundred and eighteen patients were included, and 35 were classified as having definite, 83 as possible/probable IgG4-RD. We compared baseline clinical and laboratory variables between patients with definite and those with possible/probable IgG4-RD and calculated standardized incidence ratios (SIRs) for malignancies. RESULTS The median age was 60 years old and 91 patients (77.1%) were male. Malignancies were found in 12 of 118 patients (10.1%), and lymphoma (4, 25.0%) was the most frequent malignancy related to IgG4-RD. Definite IgG4-RD patients had higher serum IgG levels and frequent multiple organ involvement. The overall incidence of malignancy was increased in patients with IgG4-RD compared to the general population (SIR 23.08 [95% CI 11.92-40.31]), and the overall risk of SIRs was highest in non-Hodgkin lymphoma (SIR 400.00 [95% CI 109.00-1024.00]). CONCLUSION Our data showed that increased risk of malignancy, especially lymphomas, was observed in Korean IgG4-RD patients.
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Affiliation(s)
- Sung Soo Ahn
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jason Jungsik Song
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong-Beom Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Abstract
A health disparity is defined as an increased burden of an adverse health outcome or health determinant within a specific subset of the population. There are well-documented racial and ethnic disparities throughout health care at the patient, provider, and health care system levels. As the minority populations within the United States grow to record numbers, it is increasingly important to invest in efforts to characterize, understand, and end racial and ethnic disparities in health care. Inequities in health outcomes and care pose real threats to the entire nation's well-being. Eliminating health disparities is fundamental to the well-being, productivity, and viability of the entire nation.
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Abstract
Advances in cancer treatment and patient survival are associated with increasing number of these patients requiring intensive care. Over the last 2 decades, there has been a steady improvement in the outcomes of critically ill patients with cancer. This review provides data on the use of the intensive care unit (ICU) and short and long-term outcomes of critically ill patients with cancer, the ICU system practices that influence patients outcomes, and the role of the different clinical variables in predicting the prognosis of these patients.
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Affiliation(s)
- Ayman O Soubani
- Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, 3990 John R- 3 Hudson, Detroit, MI 48201, USA.
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Affiliation(s)
- Judith A. Paice
- Northwestern University Feinberg School of Medicine, Chicago, IL; American Society of Clinical Oncology, Alexandria, VA; and The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Christina Lacchetti
- Northwestern University Feinberg School of Medicine, Chicago, IL; American Society of Clinical Oncology, Alexandria, VA; and The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Eduardo Bruera
- Northwestern University Feinberg School of Medicine, Chicago, IL; American Society of Clinical Oncology, Alexandria, VA; and The University of Texas MD Anderson Cancer Center, Houston, TX
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Paice JA, Portenoy R, Lacchetti C, Campbell T, Cheville A, Citron M, Constine LS, Cooper A, Glare P, Keefe F, Koyyalagunta L, Levy M, Miaskowski C, Otis-Green S, Sloan P, Bruera E. Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 2016; 34:3325-45. [PMID: 27458286 DOI: 10.1200/jco.2016.68.5206] [Citation(s) in RCA: 346] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To provide evidence-based guidance on the optimum management of chronic pain in adult cancer survivors. METHODS An ASCO-convened expert panel conducted a systematic literature search of studies investigating chronic pain management in cancer survivors. Outcomes of interest included symptom relief, pain intensity, quality of life, functional outcomes, adverse events, misuse or diversion, and risk assessment or mitigation. RESULTS A total of 63 studies met eligibility criteria and compose the evidentiary basis for the recommendations. Studies tended to be heterogeneous in terms of quality, size, and populations. Primary outcomes also varied across the studies, and in most cases, were not directly comparable because of different outcomes, measurements, and instruments used at different time points. Because of a paucity of high-quality evidence, many recommendations are based on expert consensus. RECOMMENDATIONS Clinicians should screen for pain at each encounter. Recurrent disease, second malignancy, or late-onset treatment effects in any patient who reports new-onset pain should be evaluated, treated, and monitored. Clinicians should determine the need for other health professionals to provide comprehensive pain management care in patients with complex needs. Systemic nonopioid analgesics and adjuvant analgesics may be prescribed to relieve chronic pain and/or to improve function. Clinicians may prescribe a trial of opioids in carefully selected patients with cancer who do not respond to more conservative management and who continue to experience distress or functional impairment. Risks of adverse effects of opioids should be assessed. Clinicians should clearly understand terminology such as tolerance, dependence, abuse, and addiction as it relates to the use of opioids and should incorporate universal precautions to minimize abuse, addiction, and adverse consequences. Additional information is available at www.asco.org/chronic-pain-guideline and www.asco.org/guidelineswiki.
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Affiliation(s)
- Judith A Paice
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Russell Portenoy
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Christina Lacchetti
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Toby Campbell
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Andrea Cheville
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Marc Citron
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Louis S Constine
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Andrea Cooper
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Paul Glare
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Frank Keefe
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Lakshmi Koyyalagunta
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Michael Levy
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Christine Miaskowski
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Shirley Otis-Green
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Paul Sloan
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
| | - Eduardo Bruera
- Judith A. Paice, Northwestern University Feinberg School of Medicine, Chicago, IL; Russell Portenoy, MJHS Institute for Innovation in Palliative Care; Paul Glare, Memorial Sloan Kettering Cancer Center, New York; Marc Citron, ProHealth Care Assoc, Lake Success; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Toby Campbell, University of Wisconsin, Madison, WI; Andrea Cheville, Mayo Clinic, Minnesota, MO; Andrea Cooper, Mercy Medical Center, Baltimore, MD; Frank Keefe, Duke University, Durham, NC; Lakshmi Koyyalagunta and Eduardo Bruera, MD Anderson Cancer Center, Houston, TX; Michael Levy, Fox Chase Cancer Center, Philadelphia, PA; Christine Miaskowski, University of California-San Francisco, San Francisco; Shirley Otis-Green, Coalition for Compassionate Care of California, Sacramento, CA; and Paul Sloan, University of Kentucky, Lexington, KY
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Dizon DS, Krilov L, Cohen E, Gangadhar T, Ganz PA, Hensing TA, Hunger S, Krishnamurthi SS, Lassman AB, Markham MJ, Mayer E, Neuss M, Pal SK, Richardson LC, Schilsky R, Schwartz GK, Spriggs DR, Villalona-Calero MA, Villani G, Masters G. Clinical Cancer Advances 2016: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology. J Clin Oncol 2016; 34:987-1011. [PMID: 26846975 PMCID: PMC5075244 DOI: 10.1200/jco.2015.65.8427] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Don S Dizon
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Lada Krilov
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE.
| | - Ezra Cohen
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Tara Gangadhar
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Patricia A Ganz
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Thomas A Hensing
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Stephen Hunger
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Smitha S Krishnamurthi
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Andrew B Lassman
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Merry Jennifer Markham
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Erica Mayer
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Michael Neuss
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Sumanta Kumar Pal
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Lisa C Richardson
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Richard Schilsky
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Gary K Schwartz
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - David R Spriggs
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Miguel Angel Villalona-Calero
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Gina Villani
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
| | - Gregory Masters
- Don S. Dizon, Massachusetts General Hospital, Boston; Erica Mayer, Dana-Farber Cancer Institute, Boston, MA; Lada Krilov and Richard Schilsky, American Society of Clinical Oncology, Alexandria, VA; Ezra Cohen, University of California San Diego, San Diego; Patricia A. Ganz, University of California Los Angeles, Los Angeles; Sumanta Kumar Pal, City of Hope Comprehensive Cancer Center, Duarte, CA; Tara Gangadhar, University of Pennsylvania; Stephen Hunger, Children's Hospital Center of Philadelphia, Philadelphia, PA; Thomas A. Hensing, University of Chicago, Evanston, IL; Smitha S. Krishnamurthi, Case Western Reserve University, Cleveland, OH; Andrew B. Lassman and Gary K. Schwartz, Columbia University; David R. Spriggs, Memorial Sloan Kettering Cancer Center; Gina Villani, Ralph Lauren Center for Cancer Care and Prevention, New York, NY; Merry Jennifer Markham, University of Florida, Gainesville; Miguel Angel Villalona-Calero, Miami Cancer Institute, Miami, FL; Michael Neuss, Vanderbilt-Ingram Cancer Center, Nashville, TN; Lisa C. Richardson, Centers for Disease Control and Prevention, Atlanta, GA; and Gregory Masters, Helen F. Graham Cancer Center and Research Institute, Newark, DE
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