Edmund M. Ricci, PhD, Larry L. Schenken, PhD, Susan M. Rakfal, MD, FACRO, and Dwight E. Heron, MD, FACRO Institute for Evaluation Science in Community Health, Graduate School of Public Health, University of Pittsburgh, Professional Education-ROCOG Program, UPMC McKeesport, Division of Radiation Oncology, UPMC McKeesport, Radiation Oncology Services, University of Pittsburgh Cancer Institute, Principal Investigator ROCOG Program
Edmund M. Ricci博士，Larry L. Schenken博士，Susan M. Rakfal医学博士，FACRO社区健康评估科学研究所，匹兹堡大学公共卫生研究生院，专业教育-ROCOG项目，UPMC McKeesport，放射肿瘤学部门，UPMC McKeesport，放射肿瘤学服务，匹兹堡大学癌症研究所，ROCOG项目首席研究员
{"title":"A planning and evaluation program for assessing telecommunications applications in community radiation oncology programs","authors":"E. Ricci, L. L. Schenken, S. Rakfal, D. Heron","doi":"10.12788/j.cmonc.0026","DOIUrl":"https://doi.org/10.12788/j.cmonc.0026","url":null,"abstract":"Edmund M. Ricci, PhD, Larry L. Schenken, PhD, Susan M. Rakfal, MD, FACRO, and Dwight E. Heron, MD, FACRO Institute for Evaluation Science in Community Health, Graduate School of Public Health, University of Pittsburgh, Professional Education-ROCOG Program, UPMC McKeesport, Division of Radiation Oncology, UPMC McKeesport, Radiation Oncology Services, University of Pittsburgh Cancer Institute, Principal Investigator ROCOG Program","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"325-332"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66798075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Bold, Marlene von Friederichs-Fitzwate, J. Kugelmass, L. Heifetz, Scott Christiansen, R. deVere, F. Meyers
{"title":"Virtual tumor boards: community–university collaboration to improve quality of care","authors":"R. Bold, Marlene von Friederichs-Fitzwate, J. Kugelmass, L. Heifetz, Scott Christiansen, R. deVere, F. Meyers","doi":"10.12788/J.CMONC.0064","DOIUrl":"https://doi.org/10.12788/J.CMONC.0064","url":null,"abstract":"","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"310-315"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66799518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diffuse large B-cell lymphoma of the lung in a 63-year-old man with left flank pain","authors":"Vinay Minocha, Fauzia N Rana","doi":"10.12788/j.cmonc.0062","DOIUrl":"https://doi.org/10.12788/j.cmonc.0062","url":null,"abstract":"","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"333-336"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66799025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. L. Schenken, S. Rakfal, D. Heron, J. Proctor, Steven S. Wilson, E. Ricci
Rapidly increasing volume and complexity of information used for multidisciplinary cancer treatment requires carefully evolving communications with programmatic planning, detailed evaluation, and new methodologies and technical approaches to enhance the impact and efficacy of medical conferencing systems. We designed, implemented, and evaluated cost-effective and appropriate remote learning optimize oncology practice techniques in community hospitals. Our experience over the course of more than 7 years demonstrated simple and inexpensive communication solutions for both professional and lay education, satisfying information-dense needs of multimodality cancer care. We describe how potential complexities may be resolved with inexpensive devices and software programs. Staff teamwork and creativity are always required to implement constantly evolving technologies. We provide both quantitative and qualitative data describing activities and resulting staff responses resulting in 6,520 personnel with more than 391 aggregate credit hours of continuing medical education and continuing education credit activities with enhanced collegial participant satisfaction levels and heightened interactions/professionalism among regional oncology staff. We noted significant cost reductions for communications in all our three partnered hospitals. We demonstrated both increased satisfaction levels and heightened levels of behavioral changes (Impacts) in participants. Always, activities must be cost effective and responsive to changing medical needs. Community focused efforts with regional partners should be similar, assuring evolving successes.
{"title":"Inexpensive solutions to enhance remote cancer care in community hospitals","authors":"L. L. Schenken, S. Rakfal, D. Heron, J. Proctor, Steven S. Wilson, E. Ricci","doi":"10.12788/J.CMONC.0017","DOIUrl":"https://doi.org/10.12788/J.CMONC.0017","url":null,"abstract":"Rapidly increasing volume and complexity of information used for multidisciplinary cancer treatment requires carefully evolving communications with programmatic planning, detailed evaluation, and new methodologies and technical approaches to enhance the impact and efficacy of medical conferencing systems. We designed, implemented, and evaluated cost-effective and appropriate remote learning optimize oncology practice techniques in community hospitals. Our experience over the course of more than 7 years demonstrated simple and inexpensive communication solutions for both professional and lay education, satisfying information-dense needs of multimodality cancer care. We describe how potential complexities may be resolved with inexpensive devices and software programs. Staff teamwork and creativity are always required to implement constantly evolving technologies. We provide both quantitative and qualitative data describing activities and resulting staff responses resulting in 6,520 personnel with more than 391 aggregate credit hours of continuing medical education and continuing education credit activities with enhanced collegial participant satisfaction levels and heightened interactions/professionalism among regional oncology staff. We noted significant cost reductions for communications in all our three partnered hospitals. We demonstrated both increased satisfaction levels and heightened levels of behavioral changes (Impacts) in participants. Always, activities must be cost effective and responsive to changing medical needs. Community focused efforts with regional partners should be similar, assuring evolving successes.","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"316-324"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66797511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There has been a rapid paradigm shift in cancer management from intravenous to oral oncolytics in recent years. Oral oncolytics currently represent the fastest growing segment of the oncology drug market. Although they allow patients greater convenience, they are associated with poorer adherence. Furthermore, the shift from IV to oral oncology therapy reduces the revenue community practices obtain from IV therapy. This reduction in revenue coupled with the erosion of reimbursement in the current health care environment is threatening the viability of many community oncology practices. To sustain the independence of community oncology practices, a diversified revenue stream is critical. Oncology pharmacies, including physician dispensing pharmacies and retail pharmacies incorporated within community oncology practices, provide an integrated approach to patient care across the spectrum of treatment modalities. In addition, they may provide a valuable, additional revenue stream that can promote the independence of community oncology practices in this upsurge of oral oncolytic use. More importantly, the incorporation of a practice-owned oncology retail pharmacy into community oncology practices has the potential to significantly improve patient care and outcomes by providing an opportunity to reproduce the patient outcomes and experience associated with the IV infusion suite in the oral therapeutic arena. About 35%-40% of the oncology drugs in development are oral, and an estimated 17% of oncology patients in the United States receiving chemotherapy are prescribed oral oncolytics. Although oral oncolytics allow patients greater convenience, they are associated with poorer adherence. Furthermore, as the shift from intravenous to oral therapies continues to grow, the negative financial impact on community practices will continue to mount. An important consideration for community practices to improve patient care as well as develop an additional revenue stream is the incorporation of practice-owned oncology retail pharmacies into community oncology practices.
{"title":"Retail pharmacies within community oncology practices: a win-win for patients and practices","authors":"J. Patton, W. Harwin, S. McCullough","doi":"10.12788/j.cmonc.0050","DOIUrl":"https://doi.org/10.12788/j.cmonc.0050","url":null,"abstract":"There has been a rapid paradigm shift in cancer management from intravenous to oral oncolytics in recent years. Oral oncolytics currently represent the fastest growing segment of the oncology drug market. Although they allow patients greater convenience, they are associated with poorer adherence. Furthermore, the shift from IV to oral oncology therapy reduces the revenue community practices obtain from IV therapy. This reduction in revenue coupled with the erosion of reimbursement in the current health care environment is threatening the viability of many community oncology practices. To sustain the independence of community oncology practices, a diversified revenue stream is critical. Oncology pharmacies, including physician dispensing pharmacies and retail pharmacies incorporated within community oncology practices, provide an integrated approach to patient care across the spectrum of treatment modalities. In addition, they may provide a valuable, additional revenue stream that can promote the independence of community oncology practices in this upsurge of oral oncolytic use. More importantly, the incorporation of a practice-owned oncology retail pharmacy into community oncology practices has the potential to significantly improve patient care and outcomes by providing an opportunity to reproduce the patient outcomes and experience associated with the IV infusion suite in the oral therapeutic arena. About 35%-40% of the oncology drugs in development are oral, and an estimated 17% of oncology patients in the United States receiving chemotherapy are prescribed oral oncolytics. Although oral oncolytics allow patients greater convenience, they are associated with poorer adherence. Furthermore, as the shift from intravenous to oral therapies continues to grow, the negative financial impact on community practices will continue to mount. An important consideration for community practices to improve patient care as well as develop an additional revenue stream is the incorporation of practice-owned oncology retail pharmacies into community oncology practices.","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"306-308"},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66798771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bruton’s tyrosine kinase (BTK) is a critical component of B-cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of chronic lymphocytic leukemia (CLL) cells. Ibrutinib is a first-in-class oral covalent inhibitor of BTK designed for the treatment of B-cell cancers. In a phase 1b/2 study reported by Byrd and colleagues, ibrutinib treatment was found to produce high rates of durable responses in patients with relapsed or refractory CLL or small lymphocytic lymphoma. In the multicenter study of 82 patients with relapsed or refractory CLL and 3 patients with small lymphocytic lymphoma, 51 patients received continuous ibrutinib once daily at 420 mg and 34 patients received 840 mg. Patients had a median age of 66 years and 76% were men. Patients had received a median of 4 prior therapies and the median time from last treatment was 3 months (range, 1-98 months). The most common prior treatments were rituximab (98%), nucleoside analogues (95%), and alkylators (89%). Most patients (65%) had high-risk disease (Rai stage III or IV) and unmutated immunoglobulin variableregion heavy-chain genes (81%). Bulky nodes of 5 mm and 10 mm in diameter were present in 52% and 15% of patients, respectively. High-risk cytogenetic abnormalities consisted of 17p13.1 deletion in 33% of patients and 11q22.3 deletion in 36%. Response was observed in 36 of 51 patients (71%) in the 420-mg group (including 2 complete responses) and 24 of 34 (71%) in the 840-mg group (all partial responses). In addition, 10 patients (20%) in the 420-mg group and 5 (15%) in the 840-mg group had a partial response with persistent lymphocytosis. Response was independent of baseline clinical and genomic risk factors, including advanced-stage disease, number of previous therapies, and the 17p13.1 deletion. At 26 months, the estimated progression-free survival (PFS) rate was 75% and the overall survival (OS) rate was 83%. Among patients with 17p13.1 deletion, estimated 26-month PFS was 57% and OS was 70%. Disease progression occurred in 11 patients (13%) during follow-up, with 7 having progression by biologic transformation. The median time from diagnosis to transformation was 98 months (range,
{"title":"BTK inhibitor ibrutinib in CLL and mantle cell lymphoma","authors":"J. Abraham, M. Stenger","doi":"10.12788/J.CMONC.0061","DOIUrl":"https://doi.org/10.12788/J.CMONC.0061","url":null,"abstract":"Bruton’s tyrosine kinase (BTK) is a critical component of B-cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of chronic lymphocytic leukemia (CLL) cells. Ibrutinib is a first-in-class oral covalent inhibitor of BTK designed for the treatment of B-cell cancers. In a phase 1b/2 study reported by Byrd and colleagues, ibrutinib treatment was found to produce high rates of durable responses in patients with relapsed or refractory CLL or small lymphocytic lymphoma. In the multicenter study of 82 patients with relapsed or refractory CLL and 3 patients with small lymphocytic lymphoma, 51 patients received continuous ibrutinib once daily at 420 mg and 34 patients received 840 mg. Patients had a median age of 66 years and 76% were men. Patients had received a median of 4 prior therapies and the median time from last treatment was 3 months (range, 1-98 months). The most common prior treatments were rituximab (98%), nucleoside analogues (95%), and alkylators (89%). Most patients (65%) had high-risk disease (Rai stage III or IV) and unmutated immunoglobulin variableregion heavy-chain genes (81%). Bulky nodes of 5 mm and 10 mm in diameter were present in 52% and 15% of patients, respectively. High-risk cytogenetic abnormalities consisted of 17p13.1 deletion in 33% of patients and 11q22.3 deletion in 36%. Response was observed in 36 of 51 patients (71%) in the 420-mg group (including 2 complete responses) and 24 of 34 (71%) in the 840-mg group (all partial responses). In addition, 10 patients (20%) in the 420-mg group and 5 (15%) in the 840-mg group had a partial response with persistent lymphocytosis. Response was independent of baseline clinical and genomic risk factors, including advanced-stage disease, number of previous therapies, and the 17p13.1 deletion. At 26 months, the estimated progression-free survival (PFS) rate was 75% and the overall survival (OS) rate was 83%. Among patients with 17p13.1 deletion, estimated 26-month PFS was 57% and OS was 70%. Disease progression occurred in 11 patients (13%) during follow-up, with 7 having progression by biologic transformation. The median time from diagnosis to transformation was 98 months (range,","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"282-284"},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66798959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
“I am tired of your pink ribbons!” one of my leukemia doctors said half jokingly in a meeting. He is not alone. Some people think there is too much hype about October as the breast cancer awareness month. If there is one color, one disease, and one month that is clearly etched in public memory, is the pink ribbon and breast cancer awareness during the month of October. From grocery stores to National Football League teams, the message of breast cancer awareness during that month takes precedence. Is it too much to talk about one disease? Are we commercializing this message and perhaps detracting from the intended purpose? National breast cancer awareness month was started in 1985 by a partnership between American Cancer Society and AstraZeneca (then known as Imperial Chemical Industries). The initial focus was on screening for breast cancer and early detection of disease, and it has now evolved into a platform to “promote a national dialogue on breast cancer.” The story of the pink ribbon as the symbol of breast cancer is also interesting. Evelyn Lauder, an executive at Estee Lauder Inc, started the Breast Cancer Research Foundation in 1993 and together with a friend selected the pink ribbon as the foundation’s symbol. But even before that, in 1991, the Susan G. Komen Foundation had given the pink ribbon to participants in a race in New York City for breast cancer survivors. Breast cancer awareness month is now a global event. The plea for greater awareness of breast cancer, more research and the quest for a cure reached the White House in October 2012, when President Obama said in a proclamation, “This month, we stand with the mothers, daughters, sisters, aunts, and friends who have been affected by breast cancer, and we recognize the ongoing efforts of dedicated advocates, researchers, and health care providers who strive each day to defeat this terrible disease. In memory of the loved ones we have lost and inspired by the resilience of those living with the disease, let us strengthen our resolve to lead our Nation toward a future free from cancer in all its forms. I encourage citizens, government agencies, private businesses, nonprofit organizations, and all other interested groups to join in activities that will increase awareness of what Americans can do to prevent breast cancer.” I don’t dispute that the pink ribbon gets excessive exposure during the month October, but as a breast cancer doctor who cares for young and elderly patients with this devastating illness, how can I tell the 1.3 million women around the world, including the 232,340 women in the United States, who will be diagnosed in 2013 with breast cancer that they are getting undue attention during October? How can I explain this to the survivors of the half a million women worldwide (39,620 of those in the United States) who succumbed to the disease this year? How we can I tell those mothers, sisters, and daughters that they are getting too much attention? As a result of this s
{"title":"Lessons from the pink ribbon","authors":"J. Abraham","doi":"10.12788/j.cmonc.0067","DOIUrl":"https://doi.org/10.12788/j.cmonc.0067","url":null,"abstract":"“I am tired of your pink ribbons!” one of my leukemia doctors said half jokingly in a meeting. He is not alone. Some people think there is too much hype about October as the breast cancer awareness month. If there is one color, one disease, and one month that is clearly etched in public memory, is the pink ribbon and breast cancer awareness during the month of October. From grocery stores to National Football League teams, the message of breast cancer awareness during that month takes precedence. Is it too much to talk about one disease? Are we commercializing this message and perhaps detracting from the intended purpose? National breast cancer awareness month was started in 1985 by a partnership between American Cancer Society and AstraZeneca (then known as Imperial Chemical Industries). The initial focus was on screening for breast cancer and early detection of disease, and it has now evolved into a platform to “promote a national dialogue on breast cancer.” The story of the pink ribbon as the symbol of breast cancer is also interesting. Evelyn Lauder, an executive at Estee Lauder Inc, started the Breast Cancer Research Foundation in 1993 and together with a friend selected the pink ribbon as the foundation’s symbol. But even before that, in 1991, the Susan G. Komen Foundation had given the pink ribbon to participants in a race in New York City for breast cancer survivors. Breast cancer awareness month is now a global event. The plea for greater awareness of breast cancer, more research and the quest for a cure reached the White House in October 2012, when President Obama said in a proclamation, “This month, we stand with the mothers, daughters, sisters, aunts, and friends who have been affected by breast cancer, and we recognize the ongoing efforts of dedicated advocates, researchers, and health care providers who strive each day to defeat this terrible disease. In memory of the loved ones we have lost and inspired by the resilience of those living with the disease, let us strengthen our resolve to lead our Nation toward a future free from cancer in all its forms. I encourage citizens, government agencies, private businesses, nonprofit organizations, and all other interested groups to join in activities that will increase awareness of what Americans can do to prevent breast cancer.” I don’t dispute that the pink ribbon gets excessive exposure during the month October, but as a breast cancer doctor who cares for young and elderly patients with this devastating illness, how can I tell the 1.3 million women around the world, including the 232,340 women in the United States, who will be diagnosed in 2013 with breast cancer that they are getting undue attention during October? How can I explain this to the survivors of the half a million women worldwide (39,620 of those in the United States) who succumbed to the disease this year? How we can I tell those mothers, sisters, and daughters that they are getting too much attention? As a result of this s","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"17 1","pages":"277-278"},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66799582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Patt, Sara Toth, Ashley Hennegham, Sabrina Q. Mikan
In 2012, the United States had an estimated 12 million cancer survivors. In November 2005 the Institute of Medicine (IOM) issued a call to action on cancer survivorship for health care professionals to recognize challenges, treat conditions, and support our patients more comprehensively after their diagnosis with cancer. This support begins with educating patients about their disease and treatment, their follow-up plan, and potential complications. It involves an assessment for potential complications of disease and treatment, and intervention when warranted. Survivorship programs have emerged throughout the country, but the composition of the programs and operational process by which they are implemented are widely varied. There is some divergence about what defines a cancer survivor, though most current programs treat individuals who have undergone early stage disease treatment through palliation. The site of service where survivorship programs are delivered varies from hospital to center to clinic. The structure of the delivery mechanism can be as a consultation, assuming individuals will have usually 1 survivorship visit, or as longitudinal, setting the precedent that patients will follow up at some regular interval for continued survivorship care. The most striking variation in survivorship programs is the depth and breadth of services that they provide to their patients.
{"title":"How to begin a survivorship program in your community oncology practice","authors":"D. Patt, Sara Toth, Ashley Hennegham, Sabrina Q. Mikan","doi":"10.12788/J.CMONC.0058","DOIUrl":"https://doi.org/10.12788/J.CMONC.0058","url":null,"abstract":"In 2012, the United States had an estimated 12 million cancer survivors. In November 2005 the Institute of Medicine (IOM) issued a call to action on cancer survivorship for health care professionals to recognize challenges, treat conditions, and support our patients more comprehensively after their diagnosis with cancer. This support begins with educating patients about their disease and treatment, their follow-up plan, and potential complications. It involves an assessment for potential complications of disease and treatment, and intervention when warranted. Survivorship programs have emerged throughout the country, but the composition of the programs and operational process by which they are implemented are widely varied. There is some divergence about what defines a cancer survivor, though most current programs treat individuals who have undergone early stage disease treatment through palliation. The site of service where survivorship programs are delivered varies from hospital to center to clinic. The structure of the delivery mechanism can be as a consultation, assuming individuals will have usually 1 survivorship visit, or as longitudinal, setting the precedent that patients will follow up at some regular interval for continued survivorship care. The most striking variation in survivorship programs is the depth and breadth of services that they provide to their patients.","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"272-276"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66798895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Study in 5 adults with relapsed B-cell ALL Brentjens and colleagues found that molecular remission was rapidly induced in patients with relapsed B-cell ALL using autologous T cells modified to express a CD19specific CD28/CD3dual-signaling chimeric antigen receptor (CAR; 19-18z CAR-modified T cells). Five adult patients (age range, 23-66 years) who had not previously received allogeneic hematopoietic stem cell transplantation (HSCT) received the adoptive T-cell therapy after conditioning therapy with cyclophosphamide. Treatment consisted of an infusion of 1.5-3.0 10 autologous 19-18z CAR-modified T cells/kg. Eligible patients subsequently underwent allogeneic HSCT. Of the 5 patients, 2 had persistent chemotherapyrefractory disease after salvage therapy (63% and 70% blasts in bone marrow). Two others had achieved morphologic complete remission (CR) during salvage therapy with evidence of minimal residual disease (MRD) on deep sequencing polymerase chain reaction (PCR) and fluorescence-activated cell sorting (FACS), and 1 patient was MRD negative after salvage therapy. All of the patients were MRD negative on PCR after adoptive T-cell therapy. Of the 2 patients with persistent refractory disease after salvage therapy, 1 achieved morphologic CR by day 11 after T-cell infusion and MRD-negative status by day 59, and the other achieved both morphologic CR and MRD-negative status by day 8. Of the 2 other MRD-positive patients, 1 was MRD negative by day 28 and the other was MRD negative at day 30 and remained MRD negative up to the time of allogeneic HSCT at 122 days. Four patients underwent allogeneic HSCT at 1 to 4 months after T-cell therapy. One patient, who was ineligible for allogeneic HSCT (due to multiple pre-existing comorbidities) and additional T-cell therapy, relapsed at
{"title":"Chimeric antigen receptor-modified t-cells in acute lymphoblastic leukemia","authors":"J. Abraham, M. Stenger","doi":"10.12788/J.CMONC.0059","DOIUrl":"https://doi.org/10.12788/J.CMONC.0059","url":null,"abstract":"Study in 5 adults with relapsed B-cell ALL Brentjens and colleagues found that molecular remission was rapidly induced in patients with relapsed B-cell ALL using autologous T cells modified to express a CD19specific CD28/CD3dual-signaling chimeric antigen receptor (CAR; 19-18z CAR-modified T cells). Five adult patients (age range, 23-66 years) who had not previously received allogeneic hematopoietic stem cell transplantation (HSCT) received the adoptive T-cell therapy after conditioning therapy with cyclophosphamide. Treatment consisted of an infusion of 1.5-3.0 10 autologous 19-18z CAR-modified T cells/kg. Eligible patients subsequently underwent allogeneic HSCT. Of the 5 patients, 2 had persistent chemotherapyrefractory disease after salvage therapy (63% and 70% blasts in bone marrow). Two others had achieved morphologic complete remission (CR) during salvage therapy with evidence of minimal residual disease (MRD) on deep sequencing polymerase chain reaction (PCR) and fluorescence-activated cell sorting (FACS), and 1 patient was MRD negative after salvage therapy. All of the patients were MRD negative on PCR after adoptive T-cell therapy. Of the 2 patients with persistent refractory disease after salvage therapy, 1 achieved morphologic CR by day 11 after T-cell infusion and MRD-negative status by day 59, and the other achieved both morphologic CR and MRD-negative status by day 8. Of the 2 other MRD-positive patients, 1 was MRD negative by day 28 and the other was MRD negative at day 30 and remained MRD negative up to the time of allogeneic HSCT at 122 days. Four patients underwent allogeneic HSCT at 1 to 4 months after T-cell therapy. One patient, who was ineligible for allogeneic HSCT (due to multiple pre-existing comorbidities) and additional T-cell therapy, relapsed at","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"10 1","pages":"255-257"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66798936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A new prospective on immunotherapy","authors":"M. Craig","doi":"10.12788/J.CMONC.0060","DOIUrl":"https://doi.org/10.12788/J.CMONC.0060","url":null,"abstract":"","PeriodicalId":72649,"journal":{"name":"Community oncology","volume":"1 1","pages":"254-254"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66798943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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