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1.
Gan To Kagaku Ryoho ; 46(8): 1230-1234, 2019 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-31501362

RESUMO

Patient participation is defined as incorporation of opinions by patients and citizens when clinical trials are planning. It has been early established in the USA and the UK. The Japan Clinical Oncology Group(JCOG)has recently launched a subcommittee of patient participation and has tried to input opinions of patients and citizens in clinical trials. We, Hepatobiliary and Pancreatic Oncology Group in JCOG, has held 3 meetings of patient participation for 3 years. We introduced our policy and clinical trials and discussed off-label drugs or treatments. In the third meeting in 2019, we have discussed precision medicine using genome analysis and clinical trials which are currently planning in our group. There are some significances and expectations to patient participation from the points of views of researchers. It is meaning to pick up clinicalunmet medicalneeds from patient participation and input requests and opinions of patients to a protocol. Opinions of patients and citizens may be useful to make informed consent form easy to read and understand for patients and their family. In order to accelerate recruitment of patients in clinical trials, it is important that patients and citizens understand exactly clinical trials through patient participation. Patient participation has just begun in Japan. It is expected to establish Japanese patient participation in the near future. It is important for not only researchers but also patients to obtain some benefits from patient participation.


Assuntos
Neoplasias/terapia , Humanos , Consentimento Livre e Esclarecido , Japão , Oncologia , Médicos , Medicina de Precisão
2.
Stud Health Technol Inform ; 264: 950-953, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438064

RESUMO

With the novel approach of molecularly stratified therapies based on genetic characteristics of individual tumors, the need for databases providing information on molecular alterations and targeted treatment options is increasing rapidly. In Molecular Tumor Boards (MTB) professionals discuss molecular alterations and provide biological context for therapeutic options using external knowledge databases. The identification of informative databases and the information on their specific contents can greatly facilitate and standardize the functioning of a MTB. In this work we present a list of databases which have been deemed useful and relevant for MTB in a clinical setting. We describe workflows to recommend the use of specific databases at different steps in the clinical curation process. Information obtained from these databases is a necessary prerequisite to evaluate molecular alterations and devise rational targeted therapies in MTB.


Assuntos
Neoplasias , Medicina de Precisão , Humanos , Oncologia , Padrão de Cuidado , Fluxo de Trabalho
3.
Stud Health Technol Inform ; 264: 634-638, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438001

RESUMO

Cancer is a major public health challenge in low and middle income countries (LMICs). In this paper, we describe work in progress to develop functionality within an open-source electronic medical records system to support safe and standardized cancer care in low-resource settings. We engaged cancer care providers from LMICs to elicit and prioritize requirement, and following a rapid application development approach we developed chemotherapy prescription and documentation functionality within OpenMRS.


Assuntos
Sistemas de Computação , Registros Eletrônicos de Saúde , Oncologia
5.
Stud Health Technol Inform ; 262: 35-38, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349259

RESUMO

Brazil has a complex situation in cancer treatment services. The incidence rates have reached around 600.000 new cases each year. The development of an Oncology Decision Support System (ODSS) that support cancer treatment is amongst the priorities in the cancer control program. The purpose of this article is to study the ODSS deployment at the Brazilian National Cancer Institute. The implementation of this Clinical Decision Support System employed on the management, processing, and analysis of Brazilian cancer clinical data can be considered a disruptive innovation which changes the clinical decision-making process radically.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Oncologia , Brasil , Assistência à Saúde , Humanos
6.
Stud Health Technol Inform ; 262: 79-82, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349270

RESUMO

In the field of oncology, survival analysis is one of the most important tools in terms of measuring therapy success, evaluating risk or prognostic factors. Within this work, a variety of common survival analyses were embedded into a real-time analysis platform based on a comprehensive oncological dataset. The analysis platform utilizes an in-memory database, therefore allowing spontaneous adjustments of the survival curves to selections and stratifications. In contrast to classical statistics, where individual scripts have to be formulated for every possible request, the running system allows the deduction of instantaneous results.


Assuntos
Bases de Dados Factuais , Oncologia , Humanos , Análise de Sobrevida
7.
Anticancer Res ; 39(7): 3971-3973, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31262930

RESUMO

BACKGROUND/AIM: Biosimilar agents are biologic products that have no clinically meaningful differences in terms of quality, efficacy, safety and immunogenicity compared to an already approved reference biological product, with the potential to reduce the costs of biologics. Considering the increasing numbers of oncology biosimilars, it is important to calculate the economic impact of biosimilars in oncology and hemathology, considering trastuzumab and rituximab as examples, with their greatest budgetary impact in Oncology and Hematology Units, respectively. The present analysis was conducted to assess the pharmacological costs of trastuzumab and rituximab originator versus the corresponding approved biosimilars. MATERIALS AND METHODS: Pivotal phase III randomized controlled trials (RCTs) were considered for the approved indications in neoadiuvant breast cancer (BC) and in first-line treatment for advanced follicular lymphoma. Pharmacological costs necessary to get the benefit in the cancer outcomes: i) time to treatment failure (TTF) and ii) pathological complete response (pCR) in biosimilars and originators were calculated. The costs of drugs are at the Pharmacy of our Hospital and are expressed in euros (€). RESULTS: Our analysis evaluated 5 phase III RCTs, including 2,362 patients. The economic advantage of biosimilars versus (vs.) originator is 274 € (rituximab) and from 3,283 € to 6,310 € (trastuzumab) per month for TTF (about 40% less than the originator). CONCLUSION: Combining pharmacological costs of drugs with the measure of efficacy represented by TTF and pCR, biosimilars of rituximab and trastuzumab are cost-effective treatments for advanced follicular lymphoma and breast cancer.


Assuntos
Antineoplásicos Imunológicos/economia , Medicamentos Biossimilares/economia , Rituximab/economia , Trastuzumab/economia , Antineoplásicos Imunológicos/uso terapêutico , Medicamentos Biossimilares/uso terapêutico , Ensaios Clínicos Fase III como Assunto , Hematologia/economia , Humanos , Oncologia/economia , Ensaios Clínicos Controlados Aleatórios como Assunto , Rituximab/uso terapêutico , Trastuzumab/uso terapêutico
8.
Tumori ; 105(4_suppl): 3-12, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31264522

RESUMO

In the past two decades, the treatment landscape for patients with metastatic renal cell carcinoma has significantly changed thanks to the approval of several targeted molecular therapies (VEGF and mTOR inhibitors) and recently immune-checkpoint inhibitors. The Italian Association of Medical Oncology (AIOM) Renal Cell Cancer (RCC) Guidelines Panel has developed clinical guidelines to provide evidence-based information and recommendations to oncologists, urologists and all professionals involved in the management of patients with renal cell cancer.


Assuntos
Neoplasias Renais/tratamento farmacológico , Oncologia/normas , Carcinoma/tratamento farmacológico , Carcinoma de Células Renais/tratamento farmacológico , Humanos , Itália
9.
Tumori ; 105(5_suppl): 3-14, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31264531

RESUMO

The treatment landscape of metastatic non-small cell lung cancer (NSCLC) has dramatically evolved in recent years, since the recognition of several clinical-biological entities requiring personalized treatment approaches, leading to significant improvements in patients' survival outcomes. In particular, targeted therapies acting against EGFR, ALK, and ROS1, and immunotherapeutic agents modulating the PD-1/PD-L1 axis, represent new milestones in the treatment of advanced disease, supporting a chemotherapy backbone within a multidisciplinary model. The Italian Association of Medical Oncology (AIOM) has developed evidence-based guidelines for the management of lung tumors. Given the epidemiologic relevance, this report is dedicated to the treatment of advanced/metastatic NSCLC. These guidelines serve as a practical tool for oncologists, physicians, and other healthcare professionals to easily embrace the updated key points of NSCLC treatment strategies. Considering the upcoming introduction of potential new standards of care in several disease settings, these guidelines represent a benchmark from which to move forward.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Oncologia/normas , Pessoal de Saúde/normas , Humanos , Itália
10.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46622

RESUMO

O Programa Nacional de Apoio à Atenção Oncológica (PRONON) e o Programa Nacional de Apoio à Atenção da Saúde da Pessoa com Deficiência (PRONAS/PCD) foram desenvolvidos para incentivar ações e serviços desenvolvidos por entidades, associações e fundações privadas sem fins lucrativos, que atuam no campo da oncologia e da pessoa com deficiência. O intuito é ampliar a oferta de serviços e expandir a prestação de serviços médico-assistenciais; apoiar a formação, o treinamento e o aperfeiçoamento de recursos humanos – em todos os níveis; e realizar pesquisas clínicas, epidemiológicas, experimentais e socioantropológicas.


Assuntos
Oncologia , Saúde da Pessoa com Deficiência , Sistema Único de Saúde , Programas Nacionais de Saúde
12.
Rev Med Suisse ; 15(654): 1188-1192, 2019 Jun 05.
Artigo em Francês | MEDLINE | ID: mdl-31166671

RESUMO

With the emergence of new antitumoral agents and their benefit on patient survival, general practitioners are increasingly facing the challenges of managing patients with oncologic conditions. As a result, they have a key role in the follow-up of these patients, who may be more vulnerable than general population due to their relative immunodeficiency, which has to be evaluated. In this article, we will review the preventive measures adapted to this specific population: vaccination, travel medicine, antimicrobial prophylaxis and lifestyle interventions.


Assuntos
Clínicos Gerais , Oncologia , Humanos , Medicina de Viagem , Vacinação
13.
Anticancer Res ; 39(6): 3137-3140, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177159

RESUMO

BACKGROUND/AIM: Because aggressive oncological management just prior to death constitutes a substantial proportion of end-of-life (EOL) costs, we investigated patterns of EOL oncologic care for stage IV non-small cell lung cancer (NSCLC) in USA to better determine at which point in the patient's management new treatments were being initiated. MATERIALS AND METHODS: The National Cancer Database was queried for stage IV NSCLC patients who received any cancer-directed therapy with known timing thereof. RESULTS: A total of 281,990 stage IV NSCLC patients were analyzed. Of all patients, 10.8% commenced any first-course cancer therapy within four weeks of death, and 24.5% within eight weeks of death. CONCLUSION: 10-15% of stage IV NSCLC patients start cancer therapy within four weeks of death, and 25-30% within eight weeks. This represents a population for whom cancer therapy may not be required, which has implications on reducing EOL healthcare costs.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/terapia , Neoplasias Pulmonares/terapia , Oncologia/tendências , Oncologistas/tendências , Avaliação de Processos e Resultados (Cuidados de Saúde)/tendências , Cuidados Paliativos/tendências , Padrões de Prática Médica/tendências , Assistência Terminal/tendências , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/economia , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Bases de Dados Factuais , Feminino , Custos de Cuidados de Saúde/tendências , Humanos , Neoplasias Pulmonares/economia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Oncologia/economia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Oncologistas/economia , Avaliação de Processos e Resultados (Cuidados de Saúde)/economia , Cuidados Paliativos/economia , Padrões de Prática Médica/economia , Assistência Terminal/economia , Fatores de Tempo , Resultado do Tratamento , Estados Unidos
14.
Medicine (Baltimore) ; 98(25): e16050, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232941

RESUMO

BACKGROUND: miR-222 is one of the most consistently overexpressed miRNAs in papillary thyroid carcinoma (PTC). Previous studies demonstrated that miR-222 overexpression conferred high-risk features in PTC patients, suggesting its value in risk-stratification. However, studies in term of miR-222's utility on stratifying PTCs are lacking. METHODS: One hundred patients including 10 with multinodular goiter and 90 with PTC were enrolled. Formalin-fixed paraffin-embedded samples were exploited for miR-222 quantitative reverse transcriptase- polymerase chain reaction (RT-PCR) analysis. Correlations between miR-222 expression and different clinicopathological features, Tumor-node-metastasis (TNM) staging and ATA risk level were analyzed. RESULTS: miR-222 expression of the PTC group was significantly higher than that of the goiter group (P < .001). Furthermore, miR-222 expression was significantly higher in PTCs with advanced features like larger tumor, capsular invasion, vascular invasion and lymph nodes metastasis. The majority of patients (61%) were in stage I group (similar to ATA low-risk) by TNM staging system. As to the ATA system, the majority (73%) were in intermediate-risk group (similar to TNM stage II and III roughly). Contrary to previous report, here we found that miR-222 expression was correlated with the ATA risk level (P < .001), but not with the TNM staging (P = .122). CONCLUSION: In the present study, we demonstrated that miR-222 overexpression was correlated with advanced features like capsular invasion, vascular invasion, larger tumor size and lymph node metastasis in PTCs. Most importantly, miR-222 expression was correlated with ATA risk levels, suggesting its potential value in PTC risk-stratification.


Assuntos
MicroRNAs/análise , Medição de Risco/métodos , Câncer Papilífero da Tireoide/classificação , Adolescente , Adulto , Idoso , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/biossíntese , Biomarcadores Tumorais/sangue , China , Feminino , Humanos , Masculino , Oncologia/organização & administração , MicroRNAs/biossíntese , MicroRNAs/sangue , Pessoa de Meia-Idade , Prognóstico , Câncer Papilífero da Tireoide/sangue
15.
Adv Exp Med Biol ; 1073: 77-123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31236840

RESUMO

Since the birth of proteomics science in the 1990, the number of applications and of sample preparation methods has grown exponentially, making a huge contribution to the knowledge in life science disciplines. Continuous improvements in the sample treatment strategies unlock and reveal the fine details of disease mechanisms, drug potency, and toxicity as well as enable new disciplines to be investigated such as forensic science.This chapter will cover the most recent developments in sample preparation strategies for tissue proteomics in three areas, namely, cancer, toxicology, and forensics, thus also demonstrating breath of application within the domain of health and well-being, pharmaceuticals, and secure societies.In particular, in the area of cancer (human tumor biomarkers), the most efficient and multi-informative proteomic strategies will be covered in relation to the subsequent application of matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) and liquid extraction surface analysis (LESA), due to their ability to provide molecular localization of tumor biomarkers albeit with different spatial resolution.With respect to toxicology, methodologies applied in toxicoproteomics will be illustrated with examples from its use in two important areas: the study of drug-induced liver injury (DILI) and studies of effects of chemical and environmental insults on skin, i.e., the effects of irritants, sensitizers, and ionizing radiation. Within this chapter, mainly tissue proteomics sample preparation methods for LC-MS/MS analysis will be discussed as (i) the use of LC-MS/MS is majorly represented in the research efforts of the bioanalytical community in this area and (ii) LC-MS/MS still is the gold standard for quantification studies.Finally, the use of proteomics will also be discussed in forensic science with respect to the information that can be recovered from blood and fingerprint evidence which are commonly encountered at the scene of the crime. The application of proteomic strategies for the analysis of blood and fingerprints is novel and proteomic preparation methods will be reported in relation to the subsequent use of mass spectrometry without any hyphenation. While generally yielding more information, hyphenated methods are often more laborious and time-consuming; since forensic investigations need quick turnaround, without compromising validity of the information, the prospect to develop methods for the application of quick forensic mass spectrometry techniques such as MALDI-MS (in imaging or profiling mode) is of great interest.


Assuntos
Medicina Legal , Oncologia , Proteômica , Manejo de Espécimes/métodos , Toxicologia , Cromatografia Líquida , Humanos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Espectrometria de Massas em Tandem
16.
Vet Clin North Am Small Anim Pract ; 49(5): 933-947, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31253427

RESUMO

Stereotactic radiotherapy (SRT) involves the precise delivery of highly conformal, dose-intense radiation to well-demarcated tumors. Special equipment and expertise are needed, and a unique biological mechanism distinguishes SRT from other forms of external beam radiotherapy. Families find the convenient schedules and minimal acute toxicity of SRT appealing. Common indications in veterinary oncology include nasal, brain, and bone tumors. Many other solid tumors can also be treated, including spinal, oral, lung, heart-base, liver, adrenal, and prostatic malignancies. Accessibility of SRT is improving, and new data are constantly emerging to define parameters for appropriate case selection, radiation dose prescription, and long-term follow-up."


Assuntos
Doenças do Gato/radioterapia , Doenças do Cão/radioterapia , Neoplasias/veterinária , Animais , Gatos , Cães , Oncologia , Neoplasias/radioterapia , Radioterapia (Especialidade)/métodos , Radiocirurgia/métodos , Radiocirurgia/veterinária , Radioterapia/métodos , Radioterapia/veterinária , Dosagem Radioterapêutica/veterinária , Medicina Veterinária
17.
Vet Clin North Am Small Anim Pract ; 49(5): 967-979, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31176458

RESUMO

Tumor microenvironment represents a key obstacle for the effectiveness of anticancer drugs. Electrochemotherapy involves the systemic or local delivery of lipophobic drugs such as bleomycin and cisplatin, with the application of permeabilizing electric pulses having appropriate amplitude and waveforms. This greatly enhances the uptake of these drugs by an estimated factor of 700-fold for bleomycin and 4 to 8 times for cisplatin. Because of its efficacy and limited morbidity, this therapeutic option is becoming more and more available in veterinary oncology either as an adjuvant to surgery or as first line of treatment with palliative or curative purposes.


Assuntos
Antineoplásicos/uso terapêutico , Doenças do Gato/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Eletroquimioterapia/veterinária , Neoplasias/veterinária , Animais , Gatos , Cães , Eletroquimioterapia/métodos , Oncologia , Neoplasias/tratamento farmacológico , Medicina Veterinária
18.
Vet Clin North Am Small Anim Pract ; 49(5): 917-931, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31186124

RESUMO

Advances in molecular biology have permitted a much more detailed understanding of cellular dysfunction at the molecular and genetic levels in cancer cells. This has resulted in the identification of novel targets for therapeutic intervention, including proteins that regulate signal transduction, gene expression, and protein turnover. In many instances, small molecules are used to disrupt the function of these targets, often through competitive inhibition of ATP binding or the prevention of necessary protein-protein interactions. More than 40 small molecule inhibitors are now approved to treat a variety of human cancers, substantially impacting patient outcomes.


Assuntos
Antineoplásicos/uso terapêutico , Doenças do Gato/terapia , Doenças do Cão/terapia , Terapia de Alvo Molecular/veterinária , Neoplasias/veterinária , Inibidores de Proteínas Quinases/uso terapêutico , Animais , Gatos , Cães , Oncologia/métodos , Terapia de Alvo Molecular/métodos , Neoplasias/terapia , Medicina Veterinária
19.
Drugs Today (Barc) ; 55(6): 407-415, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31250844

RESUMO

The theme for this year's meeting of the American Association of Clinical Oncology (ASCO) was 'Caring for Every Patient, Learning from Every Patient'. The meeting consisted of oral, plenary and educational sessions, as well as poster presentations and discussions about important topics in the field of oncology, such as precision medicine, the latest in cancer research impacting patient care, new treatment options and insights for improving access to care. This 55th ASCO annual meeting was held from May 31 to June 4 in Chicago, Illinois, and was attended by over 40,000 cancer experts from around the world who followed a robust program providing opportunities to teach, engage and, most importantly, bring the oncology field together with the aim of improving care for patients with a cancer diagnosis. This report covers some of the later-stage developments and results presented at the meeting.


Assuntos
Oncologia , Neoplasias , Sociedades Médicas , Chicago , Humanos , Medicina de Precisão
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