US physician perspective on the use of biomarker and ctDNA testing in patients with melanoma.

New treatments have increased survival of patients with melanoma, and methods to monitor patients throughout the disease process are needed. Circulating tumor DNA (ctDNA) is a predictive and prognostic biomarker that may allow routine, real-time monitoring of disease status. We surveyed 44 US physicians to understand their preferences and practice patterns for biomarker and ctDNA testing in their patients with melanoma.

Addressing resistance to PD-1/PD-(L)1 pathway inhibition: considerations for combinatorial clinical trial designs.

With multiple PD-(L)1 inhibitors approved across dozens of indications by the US Food and Drug Administration, the number of patients exposed to these agents in adjuvant, first-line metastatic, second-line metastatic, and refractory treatment settings is increasing rapidly. Although some patients will experience durable benefit, many have either no clinical response or see their disease progress following an initial response to therapy. There is a significant need to identify therapeutic approaches to overcome resistance and confer clinical benefits for these patients.

Influence of melanoma type on incidence and downstream implications of cutaneous immune-related adverse events in the setting of immune checkpoint inhibitor therapy.

Background: Emerging evidence suggests that cutaneous immune-related adverse events (cirAEs) are associated with a survival benefit in the setting of advanced melanoma treated with immune checkpoint inhibitor (ICI) therapy. Previous studies have not examined the role of melanoma subtypes on cirAE development and downstream therapeutic outcomes.

Objective: Examine the impact of melanoma subtypes on cirAE onset and survival among ICI recipients.

Trends in International Cancer Research Investment 2006-2018.

The International Cancer Research Partnership (ICRP) is an active network of cancer research funding organizations, sharing information about funded research projects in a common database. Data are publicly available to enable the cancer research community to find potential collaborators and avoid duplication. This study presents an aggregated analysis of projects funded by 120 partner organizations and institutes in 2006-2018, to highlight trends in cancer research funding.

Melanoma models for the next generation of therapies.

There is a lack of appropriate melanoma models that can be used to evaluate the efficacy of novel therapeutic modalities. Here, we discuss the current state of the art of melanoma models including genetically engineered mouse, patient-derived xenograft, zebrafish, and ex vivo and in vitro models. We also identify five major challenges that can be addressed using such models, including metastasis and tumor dormancy, drug resistance, the melanoma immune response, and the impact of aging and environmental exposures on melanoma progression and drug resistance.

Neoadjuvant Therapy for Melanoma: A U.S. Food and Drug Administration-Melanoma Research Alliance Public Workshop.

Tremendous progress has been made in treating patients with metastatic melanoma over the past decade. In that timeframe, the FDA has approved 12 novel treatments for patients with advanced unresectable melanoma, comprising both kinase-targeted therapies and immune checkpoint inhibitors (ICI), and five treatments for adjuvant (postoperative) use in patients with high-risk resectable stage III melanoma. It is not known whether outcomes can be further improved by administering kinase inhibitors or ICI in the neoadjuvant (presurgical) setting in patients with high-risk resectable melanomas.

Predictors of breast cancer mortality among white and black women in large United States cities: an ecologic study.

Purpose: We employed a city-level ecologic analysis to assess predictors of race-specific (black and white) breast cancer mortality rates.

Methods: We used data from the National Center for Health Statistics and the US Census Bureau to calculate 2010-2014 race-specific breast cancer mortality rates (BCMR) for 47 of the largest US cities. Data on potential city-level predictors (e.

Examination of a paradox: recurrent metastatic breast cancer incidence decline without improved distant disease survival: 1990-2011.

Purpose: Distant relapse metastatic breast cancer (rMBC) incidence and survival are vital measures of breast cancer diagnosis and treatment progress over time.

Methods: We conducted a retrospective cohort study of stage I-III invasive breast cancer, 1990-2011, follow-up through 2016 [N = 8292, rMBC = 964 (12%)] at a community-based institution. Patient and tumor characteristics (treatment, distant recurrence, vital status) from BC registry data were evaluated.

Moonshots and metastatic disease: the need for a multi-faceted approach when studying atypical responses.

Clinical research generally focuses on results involving a statistical mean with little attention in trial design to patients who respond considerably better or worse than average. Exploring the reasons underlying an "atypical response" will increase understanding of the mechanisms involved in cancer progression and treatment resistance, accelerate biomarker identification, and improve precision medicine by allowing clinicians to prospectively select optimal treatments. Based on our review, we suggest two ways to move this field forward.

Estimation of the Number of Women Living with Metastatic Breast Cancer in the United States.

Unlabelled: Distant metastatic breast cancer (MBC), including metastases found at diagnosis () and those occurring later (recurrence), represents the most severe form of the disease, when resource utilization is most intensive. Yet, the number of women living with MBC in the United States is unknown. The objective of this article is to use population-based data to estimate the prevalence of MBC.

Black:white disparities in breast cancer mortality in the 50 largest cities in the United States, 2005-2014.

Introduction: This paper presents race-specific breast cancer mortality rates and the corresponding rate ratios for the 50 largest U.S. cities for each of the 5-year intervals between 2005 and 2014.

Pregnancy-associated breast cancer in women from Shanghai: risk and prognosis.

Breast cancer (BC) has been associated with pregnancy if diagnosed within 5-10 years after delivery (pregnancy-associated BC, PABC). PABC carries a poor prognosis compared to sporadic BC in Western populations. Data are limited regarding PABC in Asian populations, where longer periods of breastfeeding, higher birth rates and a lower median age of BC at diagnosis have been noted, all of which are known to influence prognosis.

First pregnancy events and future breast density: modification by age at first pregnancy and specific VEGF and IGF1R gene variants.

Purpose: Pregnancy characteristics have been associated with breast cancer risk, but information is limited on their relationship with breast density. Our objective was to examine the relationship between first pregnancy characteristics and later life breast density, and whether the association is modified by genotype.

Methods: The Marin Women's Study was initiated to examine breast cancer in a high-incidence mammography population (Marin County, CA).

Challenges to effective cancer control in China, India, and Russia.

Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections.

Increasing Black:White disparities in breast cancer mortality in the 50 largest cities in the United States.

Introduction: This paper presents race-specific breast cancer mortality rates and the corresponding rate ratios for the 50 largest U.S. cities for each of the 5-year intervals between 1990 and 2009.

Women's responses to changes in U.S. Preventive Task Force's mammography screening guidelines: results of focus groups with ethnically diverse women.

Background: The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50.

Assessing the level of breast cancer awareness among recently diagnosed patients in Ain Shams University Hospital.

Unlabelled: Breast cancer is the leading female malignancy among Egyptian women. The majority of Egyptian breast cancer patients present at late stages of the disease with a large tumor size compared to Western countries. Low breast cancer awareness, social and cultural factors were suggested to play crucial role in late presentation of breast cancer among Egyptians.

Improving completion rates for client intake forms through Audio Computer-Assisted Self-Interview (ACASI): results from a pilot study with the Avon Breast Health Outreach Program.

This study compares rates of completion of client intake forms (CIFs) collected via three interview modes: audio computer-assisted self-interview (ACASI), face-to-face interview (FFI), and self-administered paper-based interview (SAPI). A total of 303 clients served through the Avon Breast Health Outreach Program (BHOP) were sampled from three U.S.

Planning cancer control in Latin America and the Caribbean.

Non-communicable diseases, including cancer, are overtaking infectious disease as the leading health-care threat in middle-income and low-income countries. Latin American and Caribbean countries are struggling to respond to increasing morbidity and death from advanced disease. Health ministries and health-care systems in these countries face many challenges caring for patients with advanced cancer: inadequate funding; inequitable distribution of resources and services; inadequate numbers, training, and distribution of health-care personnel and equipment; lack of adequate care for many populations based on socioeconomic, geographic, ethnic, and other factors; and current systems geared toward the needs of wealthy, urban minorities at a cost to the entire population.

Reducing barriers to breast cancer care through Avon patient navigation programs.

Context: Avon Foundation for Women grantees provide breast cancer services through patient navigation (PN) in an effort to alleviate barriers to care among underserved women.

Objective: To gain a better understanding of how PN programs function, this study explores variations in the use of navigators, types of services offered, description of clients they serve, tracking of treatment completion, and evaluation mechanisms.

Participants: Fifty-six Avon PN programs funded since 2008 throughout the United States were contacted.

The racial disparity in breast cancer mortality in the 25 largest cities in the United States.

Introduction: Although the racial disparity in breast cancer mortality is widely discussed there are no studies that analyze this phenomenon at the city level.

Methods: We used national death files, abstracting those cases for which the cause was malignant neoplasm of the breast (ICD-10=C50) for the numerators and American Community Survey data for the denominators. The 25 largest cities in the US were the units of analysis.

Use of evidence-based strategies to promote mammography among medically underserved women.

Background: Several web-based resources recommend effective intervention strategies to promote use of mammography but there is limited information on whether the strategies are used, particularly by organizations that serve medically underserved women.

Purpose: In 2010, data collected by the Avon Breast Health Outreach Program (BHOP) were analyzed to examine the diffusion of evidence-based intervention strategies among funded organizations.

Methods: Data on intervention strategies were obtained from a 2009 survey of Avon BHOP organizations funded during 2006-2009.

Induction of medulloblastomas in mice by sonic hedgehog, independent of Gli1.

The Sonic hedgehog (Shh) signaling pathway plays a critical role in normal cerebellar development and has been implicated in medulloblastomas, common malignant childhood tumors of the cerebellum. To test whether Shh mis-expression is sufficient for medulloblastoma formation, we used ultrasound biomicroscopy-guided in utero injection of a Shh-expressing retrovirus into the cerebellum of 13.5-day mouse embryos to show that direct activation of the Shh pathway can lead to tumor formation.