Leveraging the Mammography Setting to Raise Awareness and Facilitate Referral to Lung Cancer Screening: A Qualitative Analysis.

Purpose: Despite compelling support for the benefits of low-dose CT (LDCT) screening for lung cancer among high-risk individuals, awareness of LDCT screening and uptake remain low. The aim of this project was to explore the perspectives of ACR mammography screening program directors (MPDs) regarding efforts to raise LDCT screening awareness and appropriate referrals by identifying high-risk individuals participating in routine mammography.

Methods: MPDs were recruited from ACR-accredited mammography facilities to participate in semistructured interviews after the completion of an online survey.

Pulmonary Carcinosarcoma: A Surveillance, Epidemiology, and End Results (SEER) Analysis.

Introduction: Pulmonary carcinosarcoma (PC) is a rare malignant neoplasm composed of epithelial and mesenchymal components. It accounts for < 1% of thoracic cancers and is not fully understood. This study examined Surveillance, Epidemiology, and End Results (SEER) data to describe demographic and clinical characteristics of patients with PC and assessed survival outcomes by treatment modality and stage.

Critical Aspects of a Sustainable Clinical Research Program in the Community-Based Oncology Practice.

Increasing enrollment into clinical trials is a top priority across the field of oncology. Because the vast majority of those afflicted with cancer receive their care in the community, creating strong clinical research programs in the community-based setting is important. This article comprehensively outlines the most important elements of creating and sustaining a successful community-based research program.

Implementing Precision Medicine Programs and Clinical Trials in the Community-Based Oncology Practice: Barriers and Best Practices.

There has been a rapid uptick in the pace of oncology precision medicine advancements over the past several decades as a result of increasingly sophisticated technology and the ability to study more patients through innovative trial designs. As more precision oncology approaches are developed, the need for precision medicine trials is increasing in the community setting, where most patients with cancer are treated. However, community-based practices, as well as some academic centers, may face unique barriers to implementing precision medicine programs and trials within their communities.

Treatment Decisions for Advanced Non-Squamous Non-Small Cell Lung Cancer: Patient and Physician Perspectives on Maintenance Therapy.

Introduction: Advanced non-small cell lung cancer (NSCLC) is a severe disease with burdensome symptoms and traditionally poor outcomes. The treatment of advance disease is based on chemotherapy, with the recent addition of immunotherapy. Patients who respond to initial treatment can opt to receive maintenance therapy (MT).

Modernizing Clinical Trial Eligibility: Recommendations of the American Society of Clinical Oncology-Friends of Cancer Research Minimum Age Working Group.

Purpose Children have historically been excluded from first-in-human studies of promising new cancer drugs and later phase adult clinical trials. Delays in evaluation may result in off-label use without dosing information as the only access to new drugs. A multistakeholder workshop was convened in May 2016 by ASCO and Friends of Cancer Research to identify opportunities for when it would be scientifically appropriate to expand trial eligibility to include children younger than age 18 years in first-in-human and other adult cancer clinical trials.

Clinical Pathways and the Patient Perspective in the Pursuit of Value-Based Oncology Care.

The art of practicing oncology has evolved substantially in the past 5 years. As more and more diagnostic tests, biomarker-directed therapies, and immunotherapies make their way to the oncology marketplace, oncologists will find it increasingly difficult to keep up with the many therapeutic options. Additionally, the cost of cancer care seems to be increasing.

The effect of radiation therapy in the treatment of adult soft tissue sarcomas of the extremities: a long-term community-based cancer center experience.

The aim of the study was to determine the effect of external beam radiotherapy (RT) in the treatment of extremity soft tissue sarcoma (STS) before or after limb-sparing surgery (LSS) in a community-based setting. Patients presenting to our institution from 1992 to 2010 and meeting eligibility criteria were stratified into low (G1) or high (G2, G3) pathologic grade and evaluated. Major complication events, including amputation, radiation-induced sarcoma, and pathologic fracture, were assessed.

Knowledge of, attitudes toward, and use of low-dose computed tomography for lung cancer screening among family physicians.

Background: The results of the National Lung Screening Trial showed a 20% reduction in lung cancer mortality and a 6.7% reduction in all-cause mortality when high-risk patients were screened with low-dose computed tomography (LDCT) versus chest x-ray (CXR). The US Preventive Services Task Force has issued a grade B recommendation for LDCT screening, and the Centers for Medicare and Medicaid Services and private insurers now cover the screening cost under certain conditions.

Transforming Clinical Trial Eligibility Criteria to Reflect Practical Clinical Application.

Historically, oncology clinical trials have focused on comparing a new drug's efficacy to the standard of care. However, as our understanding of molecular pathways in oncology has evolved, so has our ability to predict how patients will respond to a particular drug, and thus comparison with a standard therapy has become less important. Biomarkers and corresponding diagnostic testing are becoming more and more important to drug development but also limit the type of patient who may benefit from the therapy.

Management of hyperglycemia from epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) targeting T790M-mediated resistance.

Epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) patients are associated with sensitivity to small molecule tyrosine kinase inhibitors (TKIs) such as erlotinib, gefitinib, and afatinib. Although studies show an increased progression free survival (PFS) with use of EGFR TKIs in the first-line setting, most patients will develop resistance to therapy after the first 8-16 months. T790M is an acquired resistance mutation reported in 60-70% of patients who initially responded to a prior EGFR TKI.

Lung cancer biomarkers, targeted therapies and clinical assays.

Until recently, the majority of genomic cancer research has been in discovery and validation; however, as our knowledge of tumor molecular profiling improves, the idea of genomic application in the clinic becomes increasingly tangible, paralleled with the drug development of newer targeted therapies. A number of profiling methodologies exist to identify biomarkers found within the patient (germ-line DNA) and tumor (somatic DNA). Subsequently, commercially available clinical assays to test for both germ-line and somatic alterations that are prognostic and/or predictive of disease outcome, toxicity or treatment response have significantly increased.

Geographic Access to Mammography and Its Relationship to Breast Cancer Screening and Stage at Diagnosis: A Systematic Review.

Introduction: A review was conducted to summarize the current evidence and gaps in the literature on geographic access to mammography and its relationship to breast cancer-related outcomes.

Methods: Ovid, Medline, and PubMed were searched for articles published between January 1, 2000, and April 1, 2013, using Medical Subject Headings and key terms representing geographic accessibility and breast cancer-related outcomes. Owing to a paucity of breast cancer treatment and mortality outcomes meeting the criteria (N = 6), outcomes were restricted to breast cancer screening and stage at diagnosis.

Modernizing Eligibility Criteria for Molecularly Driven Trials.

As more clinical trials of molecularly targeted agents evolve, the number of eligibility criteria seems to be increasing. The importance and utility of eligibility criteria must be considered in the context of the fundamental goal of a clinical trial: to understand the risks and benefits of a treatment in the intended-use patient population. Although eligibility criteria are necessary to define the population under study and conduct trials safely, excessive requirements may severely restrict the population available for study, and often, this population is not reflective of the general population for which the drug would be prescribed.

Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010.

Background: To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults.

Methods: Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level.

Reliability and predictors of resistive load detection in children with persistent asthma: a multivariate approach.

Objective: Resistive load detection tasks enable analysis of individual differences in psychophysical outcomes. The purpose of this study was to determine both the reliability and predictors of resistive load detection in children with persistent asthma who completed multiple testing sessions.

Methods: Both University of North Carolina (UNC) Charlotte and Ohio University institutional review boards approved the research protocol.

Does amount of weight gain during pregnancy modify the association between obesity and cesarean section delivery?

Background: Two-thirds of reproductive-aged women in the United States are overweight or obese and at risk for numerous associated adverse pregnancy outcomes. This study examined whether the amount of weight gained during pregnancy modifies the prepregnancy body mass index (BMI)-cesarean delivery association.

Methods: A total of 2,157 women aged 18-45 who participated in the 2008-2009 North Carolina Pregnancy Risk Assessment Monitoring System had complete information on prepregnancy BMI, maternal weight gain, and mode of delivery on infant birth certificates.

The association between contraceptive use at the time of conception and hypertensive disorders during pregnancy: a retrospective cohort study of prams participants.

Each year approximately 7 % of women experience hypertensive disorders during pregnancy which can result in adverse events for both the mother and child. Previous research suggests that contraception at the time of conception can also predispose one to hypertensive disorders during pregnancy. The objective of this study was to examine the association between contraceptive use at the time of conception and hypertensive complications during pregnancy.

Effects of feedback on the perception of inspiratory resistance in children with persistent asthma: a signal detection approach.

Objective: Accurate perception of asthma episodes increases the likelihood that they will be managed effectively. The purpose of the study was to examine the effect of feedback in a signal detection task on perception of increased airflow obstruction in children with persistent asthma.

Methods: The effect of feedback training on the perception of resistive loads was evaluated in 155 children with persistent asthma between 8 and 15 years of age.

Perceptions of contraceptive responsibility among female college students: an exploratory study.

Purpose: An important, although understudied, area related to contraceptive use is perceptions of contraceptive responsibility. The purpose of this exploratory study was to investigate these perceptions among female college students.

Methods: Web-based or mailed questionnaires were completed by 326 students from 2006-2007.

Satisfaction and discontinuation of contraception by contraceptive method among university women.

This study examined the association between contraceptive method and satisfaction and discontinuation. Few studies have examined these issues in the university setting and how they may potentially impact unintended pregnancy rates. This study examined data from 172 college women aged 18-36 years enrolled in the Study on Contraceptive Knowledge in Students, a cross-sectional study conducted at a large, public university.

Contraceptive use among sexually active university students.

Aims: The purpose of this exploratory study was to investigate factors related to contraceptive use and nonuse among a group of sexually active women attending a university.

Methods: From October 2006 to August 2007, 326 female students participated in a cross-sectional study at a large, public university. Women self-reported information on contraceptive behaviors via web-based and postal mail questionnaires.

Physical activity prior to and during pregnancy and risk of postpartum depressive symptoms.

Objective: To examine the relationship between physical activity before and during the last trimester of pregnancy and postpartum depressive symptoms.

Design: Secondary analysis of data from the 2004 and 2005 Pregnancy Risk Assessment Monitoring System.

Settings: Mailed questionnaire or telephone interview of new mothers in North Carolina.