journal
https://read.qxmd.com/read/37963363/oncology-physician-workforce-diversity-rationale-trends-barriers-and-solutions
#41
JOURNAL ARTICLE
Curtiland Deville, Kenechukwu Charles-Obi, Patricia Mae G Santos, Malcolm D Mattes, Syed M Qasim Hussaini
This chapter will discuss (1) the rationale for physician workforce diversity and inclusion in oncology; (2) current and historical physician workforce demographic trends in oncology, including workforce data at various training and career levels, such as graduate medical education and as academic faculty or practicing physicians; (3) reported barriers and challenges to diversity and inclusion in oncology, such as exposure, access, preparation, mentorship, socioeconomic burdens, and interpersonal, structural, systemic bias; and (4) potential interventions and evidence-based solutions to increase diversity, equity, and inclusion and mitigate bias in the oncology physician workforce...
November 2023: Cancer Journal
https://read.qxmd.com/read/37963362/overlooked-and-damaging-impact-of-structural-racism-and-implicit-bias-on-us-health-care-overarching-policy-implications
#42
JOURNAL ARTICLE
Sybil R Green, Christopher N Cross
Marginalized populations, including racial and ethnic minorities, have historically faced significant barriers to accessing quality health care because of structural racism and implicit bias. A brief review and analysis of past and historic and current policies demonstrate that structural racism and implicit bias continue to underscore a health system characterized by unequal access and distribution of health care resources. Although advances in cancer care have led to decreased incidence and mortality, not all populations benefit...
November 2023: Cancer Journal
https://read.qxmd.com/read/37963361/social-drivers-of-cancer-risk-and-outcomes-among-african-american-men
#43
JOURNAL ARTICLE
Chanita Hughes Halbert
Social risk factors play an important role in minority health and cancer health disparities. Exposure to stress and stress responses are important social factors that are now included in conceptual models of cancer health disparities. This report summarizes results from studies that examined stress exposure and responses among African Americans. Data from studies that were conducted as part of a transdisciplinary and translational research center are also presented to provide additional insight about the nature of racial differences in specific stressors among African American and White prostate cancer patients...
November 2023: Cancer Journal
https://read.qxmd.com/read/37963360/health-care-policy-and-disparities-in-health
#44
JOURNAL ARTICLE
Dina George Lansey, Rohan Ramalingam, Otis W Brawley
The United States has seen a 33% decline in age-adjusted cancer mortality since 1991. Despite this achievement, the United States has some of the greatest health disparities of any developed nation. US government policies are increasingly directed toward reducing health disparities and promoting health equity. These policies govern the conduct of research, cancer prevention, access, and payment for care. Although implementation of policies has played a significant role in the successes of cancer control, inconsistent implementation of policy has resulted in divergent outcomes; poorly designed or inadequately implemented policies have hindered progress in reducing cancer death rates and, in certain cases, exacerbated existing disparities...
November 2023: Cancer Journal
https://read.qxmd.com/read/37963359/building-a-bridge-to-equity-in-health-and-health-care-in-cancer-care
#45
JOURNAL ARTICLE
Lori J Pierce
No abstract text is available yet for this article.
November 2023: Cancer Journal
https://read.qxmd.com/read/37796646/evaluation-of-the-prognostic-role-of-liver-metastases-on-patient-outcomes-systematic-review-and-meta-analysis
#46
JOURNAL ARTICLE
Jessica J Waninger, Vincent T Ma, Zoey Chopra, Ashley N Pearson, Michael D Green
The liver is a common site of metastasis for many primary malignancies, but the quantitative impact on survival is unknown. We performed a systematic review and meta-analysis of 83 studies (604,853 patients) assessing the overall hazard associated with liver metastases by primary tumor type and treatment regimen. The pooled overall survival hazard ratio (HR) for all included studies was 1.77 (95% confidence interval [CI], 1.62-1.93). Patients with breast cancer primaries fared the worst (HR, 2.37; 95% CI, 1...
September 2023: Cancer Journal
https://read.qxmd.com/read/37796645/what-role-does-radiotherapy-play-in-the-molecular-era-for-intrahepatic-cholangiocarcinoma
#47
JOURNAL ARTICLE
Eugene J Koay, Milind Javle, Madeline Belknap, Shrey Derasari, Millicent Roach, Ethan B Ludmir
Intrahepatic cholangiocarcinoma is a rare disease, yet with rising incidence globally. Most patients are not eligible for potentially curative surgical resection, and many patients with unresectable disease die within 12 months of diagnosis, primarily due to liver failure from the primary tumor. Recent prospective and retrospective studies indicate that local control of the primary tumor can be achieved with hypofractionated radiotherapy in patients with unresectable disease, translating into prolonged survival of these patients...
September 2023: Cancer Journal
https://read.qxmd.com/read/37796644/evolution-of-response-based-radiotherapy-for-hepatocellular-cancer
#48
REVIEW
Ameer L Elaimy, Yue Cao, Theodore S Lawrence
Stereotactic body radiation therapy has emerged as a safe and effective treatment modality for properly selected hepatocellular cancer (HCC) patients with normal liver function. However, many HCC patients have reduced baseline liver function due to underlying cirrhosis or prior liver-directed therapies. Therefore, because of the increased risk of hepatotoxicity, the use of stereotactic body radiation therapy for patients with reduced liver function has been approached with caution. Individualized, response-based radiotherapy incorporates models, imaging tools, and biomarkers that determine the dose-response relationship of the liver before, during, and after treatment and has been useful in reducing the likelihood of liver damage without sacrificing tumor control...
September 2023: Cancer Journal
https://read.qxmd.com/read/37796643/hepatocellular-carcinoma-southeast-asia-updates
#49
JOURNAL ARTICLE
Satender Pal Singh, Vinod Arora, Tushar Madke, Shiv Kumar Sarin
Hepatocellular carcinoma (HCC) is one of the leading cancers worldwide. Classically, HCC develops in genetically susceptible individuals who are exposed to risk factors, especially in the presence of liver cirrhosis. Significant temporal and geographic variations exist for HCC and its etiologies. Over time, the burden of HCC has shifted from the low-moderate to the high sociodemographic index regions, reflecting the transition from viral to nonviral causes. Geographically, the hepatitis viruses predominate as the causes of HCC in Asia and Africa...
September 2023: Cancer Journal
https://read.qxmd.com/read/37796642/hepatocellular-carcinoma-genetic-classification
#50
JOURNAL ARTICLE
Zurabi Lominadze, Mohammed Rifat Shaik, Dabin Choi, Duha Zaffar, Lopa Mishra, Kirti Shetty
Hepatocellular carcinoma (HCC) represents a significant global burden, with management complicated by its heterogeneity, varying presentation, and relative resistance to therapy. Recent advances in the understanding of the genetic, molecular, and immunological underpinnings of HCC have allowed a detailed classification of these tumors, with resultant implications for diagnosis, prognostication, and selection of appropriate treatments. Through the correlation of genomic features with histopathology and clinical outcomes, we are moving toward a comprehensive and unifying framework to guide our diagnostic and therapeutic approach to HCC...
September 2023: Cancer Journal
https://read.qxmd.com/read/37471616/the-utility-of-interim-positron-emission-tomography-imaging-to-inform-adaptive-radiotherapy-for-head-and-neck-squamous-cell-carcinoma
#51
JOURNAL ARTICLE
Benjamin S Rosen, Neil Vaishampayan, Yue Cao, Michelle L Mierzwa
In this article, as part of this special issue on biomarkers of early response, we review the current evidence to support the use of positron emission tomography (PET) imaging during chemoradiation therapy to inform biologically adaptive radiotherapy for head and neck squamous cell carcinoma. We review literature covering this topic spanning nearly 3 decades, including the use of various radiotracers and discoveries of novel predictive PET biomarkers. Through understanding how observational trials have informed current interventional clinical trials, we hope that this review will encourage researchers and clinicians to incorporate PET response criteria in new trial designs to advance biologically optimized radiotherapy...
July 2023: Cancer Journal
https://read.qxmd.com/read/37471615/is-apparent-diffusion-coefficient-established-as-an-imaging-biomarker-for-stereotactic-body-radiation-therapy-assessment-in-hepatocellular-carcinoma
#52
JOURNAL ARTICLE
Yue Cao, Kyle C Cuneo, Joseph Evans, Randall K Ten Haken, Daniel T Chang, Theodore S Lawrence
In this article, as part of this special issue on biomarkers of early response, we review currently available reports regarding magnetic resonance imaging apparent diffusion coefficient (ADC) changes in hepatocellular carcinoma (HCC) in response to stereotactic body radiation therapy. We compare diffusion image acquisition, ADC analysis, methods for HCC response assessment, and statistical methods for prediction of local tumor progression by ADC metrics. We discuss the pros and cons of these studies. Following detailed analyses of existing investigations, we cannot conclude that ADC is established as an imaging biomarker for stereotactic body radiation therapy assessment in HCC...
July 2023: Cancer Journal
https://read.qxmd.com/read/37471614/tumor-derived-exosomes-and-the-role-of-liquid-biopsy-in-human-papillomavirus-oropharyngeal-squamous-cell-carcinoma
#53
JOURNAL ARTICLE
Michael M Allevato, Joshua D Smith, Michael J Brenner, Steven B Chinn
The global incidence of human papillomavirus-positive (HPV+) head and neck squamous cell carcinoma (HNSCC) has surged in recent decades, with HPV+ HNSCC accounting for >70% of oropharynx cancers in the United States. Its incidence in men has surpassed that of HPV+ cervical cancer in women, and reliable assays are needed for early detection and to monitor response to therapy. Human papillomavirus-positive OPSCC has a more favorable response to therapy and prognosis than HPV-negative (HPV-) HNSCC, motivating regimens to deintensify curative surgery or chemoradiotherapy protocols...
July 2023: Cancer Journal
https://read.qxmd.com/read/37471613/the-current-role-of-human-papillomavirus-circulating-tumor-dna-in-oropharynx-cancer
#54
REVIEW
Samuel N Regan, Michelle L Mierzwa
Human papillomavirus infection is currently implicated in the majority of oropharyngeal squamous cell carcinoma cases diagnosed in the United States. Circulating tumor DNA (ctDNA) has emerged as a potential biomarker for human papillomavirus-related oropharyngeal squamous cell carcinoma and has the opportunity to improve the diagnosis, treatment, and surveillance of patients with this disease. Changes in ctDNA levels during and after primary therapy may be related to disease response, which can possibly have implications for treatment intensification or de-escalation strategies...
July 2023: Cancer Journal
https://read.qxmd.com/read/37471612/recent-advances-in-blood-based-liquid-biopsy-approaches-in-prostate-cancer
#55
JOURNAL ARTICLE
Andi K Cani, Simpa S Salami
The advent of high-throughput technologies has enabled the analysis of minute amounts of tumor-derived material purified from body fluids, termed "liquid biopsies." Prostate cancer (PCa) management, like in many other cancer types, has benefited from liquid biopsies at several stages of the disease. Although initially describing circulating tumor cells in blood, the term "liquid biopsy" has come to more prominently include cell-free, circulating tumor DNA, as well as RNA, proteins, and other molecules. They provide tumor molecular information representing the entire, often-heterogeneous disease, relatively noninvasively and longitudinally...
July 2023: Cancer Journal
https://read.qxmd.com/read/37471611/circulating-tumor-dna-in-human-papillomavirus-mediated-oropharynx-cancer-leveraging-early-data-to-inform-future-directions
#56
REVIEW
Molly E Heft Neal, Heather M Walline, Catherine T Haring
Circulating tumor DNA (ctDNA) has become an area of intense study in many solid malignancies including head and neck cancer. This is of particular interest for human papillomavirus-mediated oropharyngeal squamous cell carcinoma as this cohort of patients has excellent survival and is undergoing current clinical trials aimed at treatment de-escalation. Recent studies have demonstrated the prognostic implications of pretreatment ctDNA and the utility of monitoring ctDNA during and posttreatment; however, there is a need for a more critical understanding of ctDNA as it is beginning to be incorporated into clinical trials...
July 2023: Cancer Journal
https://read.qxmd.com/read/37471610/survival-of-the-fittest-how-adaptive-medicine-can-enhance-cancer-treatment
#57
JOURNAL ARTICLE
J Chad Brenner
No abstract text is available yet for this article.
July 2023: Cancer Journal
https://read.qxmd.com/read/37195777/evolution-of-therapeutic-benefit-measurement-criteria-in-myelodysplastic-syndromes-neoplasms
#58
REVIEW
Jessica M Stempel, Zhuoer Xie, Jan Philipp Bewersdorf, Maximilian Stahl, Amer M Zeidan
Myelodysplastic syndromes/neoplasms (MDS) are heterogeneous, clonal myeloid neoplasms characterized by ineffective hematopoiesis, progressive cytopenias, and an increased risk of progression to acute myeloid leukemia. The diversity in disease severity, morphology, and genetic landscape challenges not only novel drug development but also therapeutic response assessment. The MDS International Working Group (IWG) response criteria were first published in the year 2000 focusing on measures of blast burden reduction and hematologic recovery...
May 2023: Cancer Journal
https://read.qxmd.com/read/37195776/novel-approaches-and-future-directions-in-myelodysplastic-syndrome-treatment
#59
JOURNAL ARTICLE
Jan Philipp Bewersdorf, Zhuoer Xie, Amer M Zeidan
Myelodysplastic syndromes/neoplasms (MDSs) constitute a heterogeneous group of clonal disorders that are clinically characterized by dysplastic changes in multiple hematopoietic lineages, cytopenias, and a variable risk of progression to acute myeloid leukemia. Patients with MDS are classified as either lower- or higher-risk based on risk stratification tools such as the International Prognostic Scoring System and its revised version, which continue to be the basis for prognosis and treatment selection. Although anemic patients with lower-risk MDS are currently treated with an erythropoiesis-stimulating agent, luspatercept, and transfusions, the telomerase inhibitor imetelstat and the hypoxia-inducible factor α inhibitor roxadustat have shown encouraging early results and are now in phase III clinical trials...
May 2023: Cancer Journal
https://read.qxmd.com/read/37195775/novel-therapies-in-myelodysplastic-syndrome-where-do-venetoclax-and-isocitrate-dehydrogenase-inhibitors-fit-in
#60
REVIEW
Yasmin Abaza, Anand Ashwin Patel
Myelodysplastic syndromes (MDSs) are a heterogeneous group of clonal hematopoietic stem cell disorders with treatment approaches tailored to the presence of cytopenias, disease risk, and molecular mutation profile. In higher-risk MDSs, the standard of care are DNA methyltransferase inhibitors, otherwise referred to as hypomethylating agents (HMAs), with consideration for allogeneic hematopoietic stem cell transplantation in appropriate candidates. Given modest complete remission rates (15%-20%) with HMA monotherapy and median overall survival of approximately 18 months, there is much interest in the investigation of combination and targeted treatment approaches...
May 2023: Cancer Journal
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