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The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on cancer or other clinical topics then use Trip today.
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Survival differences with immediate versus delayed chemotherapy for asymptomatic incurable metastatic colorectal cancer. BACKGROUND: For patients with asymptomatic, incurable, metastatic colorectal cancer, palliative, systemic treatment can be started immediately, or can be delayed until disease-related symptoms occur. How the potential survival benefit of starting palliative, systemic treatment immediately after diagnosis weighs up against the potential side effects is currently under debate (...) , and was investigated in this review. OBJECTIVES: To assess the effects of immediate versus delayed chemotherapy, with or without targeted therapy, on overall survival, toxicity, quality of life, progression-free survival, and compliance with chemotherapy for individuals with asymptomatic, metastatic, incurable colorectal cancer. SEARCH METHODS: We searched CENTRAL; 2018, Issue 8, MEDLINE Ovid, Embase Ovid, PsycINFO, the World Health Organization International Clinical Trials Registry Platform
Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial. BACKGROUND: The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer, a disease affecting younger patients, is rapidly increasing. Cetuximab, an epidermal growth factor receptor inhibitor, has been proposed for treatment de-escalation in this setting to reduce the toxicity of standard cisplatin treatment (...) , but no randomised evidence exists for the efficacy of this strategy. METHODS: We did an open-label randomised controlled phase 3 trial at 32 head and neck treatment centres in Ireland, the Netherlands, and the UK, in patients aged 18 years or older with HPV-positive low-risk oropharyngeal cancer (non-smokers or lifetime smokers with a smoking history of <10 pack-years). Eligible patients were randomly assigned (1:1) to receive, in addition to radiotherapy (70 Gy in 35 fractions), either intravenous cisplatin
Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial. BACKGROUND: Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma have high survival when treated with radiotherapy plus cisplatin. Whether replacement of cisplatin with cetuximab-an antibody against the epidermal growth factor receptor-can preserve high survival and reduce treatment toxicity (...) is unknown. We investigated whether cetuximab would maintain a high proportion of patient survival and reduce acute and late toxicity. METHODS: RTOG 1016 was a randomised, multicentre, non-inferiority trial at 182 health-care centres in the USA and Canada. Eligibility criteria included histologically confirmed HPV-positive oropharyngeal carcinoma; American Joint Committee on Cancer 7th edition clinical categories T1-T2, N2a-N3 M0 or T3-T4, N0-N3 M0; Zubrod performance status 0 or 1; age at least 18 years
Combining Mutational Signatures, Clonal Fitness, and Drug Affinity to Define Drug-Specific Resistance Mutations in Cancer 30146241 2018 12 07 2451-9448 25 11 2018 Nov 15 Cell chemical biology Cell Chem Biol Combining Mutational Signatures, Clonal Fitness, and Drug Affinity to Define Drug-Specific Resistance Mutations in Cancer. 1359-1371.e2 S2451-9456(18)30265-4 10.1016/j.chembiol.2018.07.013 The emergence of mutations that confer resistance to molecularly targeted therapeutics is dependent (...) upon the effect of each mutation on drug affinity for the target protein, the clonal fitness of cells harboring the mutation, and the probability that each variant can be generated by DNA codon base mutation. We present a computational workflow that combines these three factors to identify mutations likely to arise upon drug treatment in a particular tumor type. The Osprey-based workflow is validated using a comprehensive dataset of ERK2 mutations and is applied to small-molecule drugs
Clinical relevance of screening checklists for detecting cancer predisposition syndromes in Asian childhood tumours 30455982 2018 12 07 2056-7944 3 2018 NPJ genomic medicine NPJ Genom Med Clinical relevance of screening checklists for detecting cancer predisposition syndromes in Asian childhood tumours. 30 10.1038/s41525-018-0070-7 Assessment of cancer predisposition syndromes (CPS) in childhood tumours is challenging to paediatric oncologists due to inconsistent recognizable clinical (...) phenotypes and family histories, especially in cohorts with unknown prevalence of germline mutations. Screening checklists were developed to facilitate CPS detection in paediatric patients; however, their clinical value have yet been validated. Our study aims to assess the utility of clinical screening checklists validated by genetic sequencing in an Asian cohort of childhood tumours. We evaluated 102 patients under age 18 years recruited over a period of 31 months. Patient records were reviewed against
Herceptin® (trastuzumab) in HER2-positive early breast cancer: a systematic review and cumulative network meta-analysis. BACKGROUND: Originator trastuzumab (Herceptin®; H) is an antibody-targeted therapy to treat patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (EBC). We investigated the overall survival (OS) advantage conferred by the addition of H to chemotherapy for HER2+ EBC patients and how the OS advantage changed over time. METHODS: A systematic
21-Gene assay as predictor of chemotherapy benefit in HER2-negative breast cancer 30456299 2018 12 07 2374-4677 4 2018 NPJ breast cancer NPJ Breast Cancer 21-Gene assay as predictor of chemotherapy benefit in HER2-negative breast cancer. 37 10.1038/s41523-018-0090-6 The NSABP B-20 prospective-retrospective study of the 21-gene Oncotype DX Breast Cancer Recurrence Score® test predicted benefit from addition of chemotherapy to tamoxifen in node-negative, estrogen-receptor positive breast cancer (...) as originally employed, and with RS > 25 employed in TAILORx. Geyer Charles E CE Jr NRG Oncology/NSABP (NSABP Legacy trials are now part of the NRG Oncology portfolio), Pittsburgh, PA USA. 2Massey Cancer Center, Virginia Commonwealth University, Richmond, VA USA. 0000 0004 0458 8737 grid.224260.0 Tang Gong G NRG Oncology/NSABP (NSABP Legacy trials are now part of the NRG Oncology portfolio), Pittsburgh, PA USA. 3The University of Pittsburgh, Pittsburgh, PA USA. 0000 0001 0650 7433 grid.412689.0 Mamounas
Moxibustion for alleviating side effects of chemotherapy or radiotherapy in people with cancer. BACKGROUND: Moxibustion, a common treatment in traditional Chinese medicine, involves burning herbal preparations containing Artemisia vulgaris on or above the skin at acupuncture points. Its intended effect is to enhance body function, and it could reduce the side effects of chemotherapy or radiotherapy and improve quality of life (QoL) in people with cancer. OBJECTIVES: To assess the effects (...) of moxibustion for alleviating side effects associated with chemotherapy, radiotherapy or both in people with cancer. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE via Ovid, Embase via Ovid and AMED (Allied and Complementary Medicine Database) from their inception to February 2018. We also searched databases in China including the Chinese BioMedical Literature Database (CBM), Chinese Medical Current Contents (CMCC), TCMonline
Socioeconomic Differences in the Epidemiologic Transition From Heart Disease to Cancer as the Leading Cause of Death in the United States, 2003 to 2015: An Observational Study. Background: Recent data suggest that the United States is in the midst of an epidemiologic transition in the leading cause of death. Objective: To examine county-level sociodemographic differences in the transition from heart disease to cancer as the leading cause of death in the United States. Design: Observational (...) study. Setting: U.S. death records, 2003 to 2015. Participants: Decedents aged 25 years or older, classified by racial/ethnic group. Measurements: All-cause, heart disease, and cancer mortality stratified by quintiles of county median household income. Age- and sex-adjusted mortality rates and average annual percentage of change were calculated. Results: Heart disease was the leading cause of death in 79% of counties in 2003 and 59% in 2015. Cancer was the leading cause of death in 21% of counties
Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease. BACKGROUND: It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovascular disease, and data from randomized trials are limited. METHODS: We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D 3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1 g per day (...) for the prevention of cancer and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo. RESULTS
Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer. BACKGROUND: Higher intake of marine n-3 (also called omega-3) fatty acids has been associated with reduced risks of cardiovascular disease and cancer in several observational studies. Whether supplementation with n-3 fatty acids has such effects in general populations at usual risk for these end points is unclear. METHODS: We conducted a randomized, placebo-controlled trial, with a two-by-two factorial design (...) , of vitamin D 3 (at a dose of 2000 IU per day) and marine n-3 fatty acids (at a dose of 1 g per day) in the primary prevention of cardiovascular disease and cancer among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes) and invasive cancer of any type. Secondary end points included individual components of the composite cardiovascular
mTORC1 is a key mediator of RON-dependent breast cancermetastasis with therapeutic potential 30456298 2018 12 07 2374-4677 4 2018 NPJ breast cancer NPJ Breast Cancer mTORC1 is a key mediator of RON-dependent breast cancermetastasis with therapeutic potential. 36 10.1038/s41523-018-0091-5 Metastasis is the biggest challenge in treating breast cancer, and it kills >40,000 breast cancer patients annually in the US. Aberrant expression of the RON receptor tyrosine kinase in breast tumors (...) correlates with poor prognosis and has been shown to promote metastasis. However, the molecular mechanisms that govern how RON promotes metastasis, and how to block it, are still largely unknown. We sought to determine critical effectors of RON using a combination of mutational and pharmacologic strategies. High-throughput proteomic analysis of breast cancer cells upon activation of RON showed robust phosphorylation of ribosomal protein S6. Further analysis revealed that RON strongly signals through
Comparative safety of immune checkpoint inhibitors in cancer: systematic review and network meta-analysis. OBJECTIVE: To provide a complete toxicity profile, toxicity spectrum, and a safety ranking of immune checkpoint inhibitor (ICI) drugs for treatment of cancer. DESIGN: Systematic review and network meta-analysis. DATA SOURCES: Electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) were systematically searched to include relevant studies published in English between (...) , and sensitivity analyses implied that nivolumab is the best option in terms of safety, especially for the treatment of lung cancer. CONCLUSIONS: Compared with other ICI drugs used to treat cancer, atezolizumab had the best safety profile in general, and nivolumab had the best safety profile in lung cancer when taking an integrated approach. The safety ranking of treatments based on ICI drugs is modulated by specific treatment-related adverse events. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017082553
Effect of testing for cancer on cancer- or venous thromboembolism (VTE)-related mortality and morbidity in people with unprovoked VTE. BACKGROUND: Venous thromboembolism (VTE) is a collective term for two conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). A proportion of people with VTE have no underlying or immediately predisposing risk factors and the VTE is referred to as unprovoked. Unprovoked VTE can often be the first clinical manifestation of an underlying malignancy (...) . This has raised the question of whether people with an unprovoked VTE should be investigated for an underlying cancer. Treatment for VTE is different in cancer and non-cancer patients and a correct diagnosis would ensure that people received the optimal treatment for VTE to prevent recurrence and further morbidity. Furthermore, an appropriate cancer diagnosis at an earlier stage could avoid the risk of cancer progression and lead to improvements in cancer-related mortality and morbidity
30-day mortality after the start of systemic anticancer therapy for lung cancer: is it really a useful performance indicator? 30406123 2018 11 14 2312-0541 4 4 2018 Oct ERJ open research ERJ Open Res 30-day mortality after the start of systemic anticancer therapy for lung cancer: is it really a useful performance indicator? 00030-2018 10.1183/23120541.00030-2018 Systemic treatment is the standard treatment for unresectable stage III and IV lung cancer. Nevertheless, a 5-10% death rate has been (...) described within 30 days after the last systemic treatment, suggesting that these patient did not benefit. We analysed the 30-day mortality after start of systemic therapy. Data were retrieved from the Netherlands National Cancer Registry. From 2010 to 2015, 26 277 patients were included. 56% were men. The median age was 65 years and 31% of patients were aged ≥70 years. 27% involved small cell lung cancer and 73% nonsmall cell lung cancer. Overall mortality within 30 days after the start of systemic
Screening for Lung Cancer: CHEST Guideline and Expert Panel Report Screening for Lung Cancer CHEST Guideline and Expert Panel Report Peter J. Mazzone, MD, MPH, FCCP; Gerard A. Silvestri, MD, FCCP; Sheena Patel, MPH; Jeffrey P. Kanne, MD, FCCP; Linda S. Kinsinger, MD; Renda Soylemez Wiener, MD, MPH; Guy Soo Hoo, MD, FCCP; and Frank C. Detterbeck, MD, FCCP BACKGROUND: Low-dose chest CTscreening for lung cancer has becomeastandard ofcare in the United States in the past few years, in large part (...) addressed resulting in six graded recommendations and nine ungraded consensus based statements. CONCLUSIONS: Evidence suggests that low-dose CT screening for lung cancer results in a favorable but tenuous balance of bene?t and harms. The selection of screen-eligible patients, thequalityofimagingandimageinterpretation,themanagementofscreen-detected?ndings, and the effectiveness of smoking cessation interventions can affect this balance. Additional research is needed to optimize the approach to low-dose
Guidance for Kyphoplasty and Vertebroplasty for Cancer Patients in Ontario GUIDANCE FOR KYPHOPLASTY AND VERTEBROPLASTY FOR CANCER PATIENTS IN ONTARIO: Recommendations Report 2017 Kyphoplasty and Vertebroplasty Working Group Interventional Oncology Steering Committee Page 1 of 16 Document Date: October 5, 2018 Contents Background 2 Value for Money 2 Recommendations for Vertebral Augmentation involving Kyphoplasty or Vertebroplasty for Cancer-Related Vertebral Compression Fractures 3 Clinical (...) Criteria 3 Rationale 4 Role of Radiation Treatment 4 Absolute Contraindications 4 Service Provider Requirements 4 Multidisciplinary Care 4 Volume Recommendations 7 Training Recommendations 8 Quality Assurance 8 Conclusions 8 References 9 Appendices 10 Appendix A: Kyphoplasty and Vertebroplasty Working Group Members 10 Appendix B: Malignant Potential Diagnosis Codes 10 Appendix C: Kyphoplasty and Vertebroplasty for Cancer Patients Referral Checklist 13 Document Revision History Document Date Revision
Atezolizumab (non-small cell lung cancer) ? Benefit assessment according to §35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.5 of the dossier assessment Atezolizumab (nicht kleinzelliges Lungenkarzinom) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 27 December 2017). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. IQWiG Reports (...) – Commission No. A17-50 Atezolizumab (non-small cell lung cancer) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A17-50 Version 1.0 Atezolizumab (non-small cell lung cancer) 27 December 2017 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Atezolizumab (non-small cell lung cancer) – Benefit assessment according to §35a Social Code Book V Commissioning agency
First-Line Trastuzumab Plus an Aromatase Inhibitor, With or Without Pertuzumab, in Human Epidermal Growth Factor Receptor 2-Positive and Hormone Receptor-Positive Metastatic or Locally Advanced Breast Cancer (PERTAIN): A Randomized, Open-Label Phase II Tr 30106636 2018 09 26 1527-7755 36 28 2018 Oct 01 Journal of clinical oncology : official journal of the American Society of Clinical Oncology J. Clin. Oncol. First-Line Trastuzumab Plus an Aromatase Inhibitor, With or Without Pertuzumab (...) , in Human Epidermal Growth Factor Receptor 2-Positive and Hormone Receptor-Positive Metastatic or Locally Advanced Breast Cancer (PERTAIN): A Randomized, Open-Label Phase II Trial. 2826-2835 10.1200/JCO.2017.76.7863 To assess pertuzumab plus trastuzumab and an aromatase inhibitor (AI) in patients with human epidermal growth factor receptor 2 (HER2)-positive and hormone receptor-positive metastatic/locally advanced breast cancer (MBC/LABC). The PERTAIN trial (NCT01491737) is an ongoing randomized, open
CNS Response to Osimertinib Versus Standard Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients With Untreated EGFR-Mutated Advanced Non-Small-Cell Lung Cancer 30153097 2018 08 28 1527-7755 2018 Aug 28 Journal of clinical oncology : official journal of the American Society of Clinical Oncology J. Clin. Oncol. CNS Response to Osimertinib Versus Standard Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients With Untreated EGFR-Mutated Advanced Non-Small-Cell (...) Lung Cancer. JCO2018783118 10.1200/JCO.2018.78.3118 Purpose We report CNS efficacy of osimertinib versus standard epidermal growth factor receptor ( EGFR) tyrosine kinase inhibitors (TKIs) in patients with untreated EGFR-mutated advanced non-small-cell lung cancer from the phase III FLAURA study. Patients and Methods Patients (N = 556) were randomly assigned to osimertinib or standard EGFR-TKIs (gefitinib or erlotinib); brain scans were not mandated unless clinically indicated. Patients