Introduction: Learning health networks (LHNs) improve clinical outcomes by applying core tenets of continuous quality improvements (QI) to reach community-defined outcomes, data-sharing, and empowered interdisciplinary teams including patients and caregivers. LHNs provide an ideal environment for the rapid adoption of evidence-based guidelines and translation of research and best practices at scale. When an LHN is established, it is critical to understand the needs of all stakeholders.
View Article and Find Full Text PDFPoly(adenosine diphosphate ribose) polymerase (PARP) inhibitors, such as olaparib, talazoparib, rucaparib, and niraparib, comprise a therapeutic class that targets PARP proteins involved in DNA repair. Cancer cells with homologous recombination repair defects, particularly BRCA alterations, display enhanced sensitivity to these agents because of synthetic lethality induced by PARP inhibitors. These agents have significantly improved survival outcomes across various malignancies, initially gaining regulatory approval in ovarian cancer and subsequently in breast, pancreatic, and prostate cancers in different indications.
View Article and Find Full Text PDFBackground: Radiation oncologists closely monitor patients during weekly on-treatment visits (OTVs). This study examines whether routine patient-reported outcome measures (PROMs) during OTVs change physicians' perceptions of treatment-toxicity and inform symptom-management.
Patient And Methods: IMPROVE is a single-arm prospective multicenter trial, conducted from 2020 to 2023.
Photodiagnosis Photodyn Ther
December 2024
Oral cancer rates in India surpass those in any other nation, with patients manifesting varied disease stages, including pre-malignant phases. Tobacco chewing promotes field cancerization, and related surgical interventions can be remarkably morbid. Advanced-stage patients with frequent recurrences undergo treatments that significantly degrade their quality of life.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
November 2024
Purpose: Local and distant progression remains common following resection of resectable pancreatic ductal adenocarcinoma (PDAC) despite adjuvant multiagent chemotherapy. We report a prospective institutional phase 1 trial incorporating adjuvant GVAX vaccine, low-dose cyclophosphamide (Cy), and stereotactic body radiation therapy (SBRT) followed by FOLFIRINOX (FFX) among patients who underwent resection of high-risk PDAC.
Patients And Methods: The study design was a modified 3+3.
Background And Objectives: Intermittent androgen deprivation therapy (iADT) may result in measurable improvements in quality of life over continuous ADT in patients with advanced prostate cancer (aPC). Here, we studied time to castration and testosterone recovery in real-world patients with aPC undergoing iADT with relugolix.
Methods And Design: Eligibility criteria for this retrospective study were histologically confirmed through the diagnosis of aPC and initiation of iADT with relugolix.
Purpose: To evaluate the feasibility of implementation of structured reporting in the setting of a high-volume pancreatic multidisciplinary clinic (PMDC) and to assess its value by comparing the accuracy of structured reports with expert imaging reviews.
Methods: A single institutional prospective cohort study was conducted during March 2022 to May 2024 to understand the feasibility of implementation of structured reporting (SR) for all patients who were seen in our weekly PMDC. Descriptive and regression analyses were performed to find an association between SR and difference in vascular involvement of the primary pancreatic tumor between the radiology report and expert radiologist review (gold standard) during PMDC.
Purpose: Dose-escalated radiation therapy is increasingly used in the treatment of pancreatic cancer; however, approaches to target delineation vary widely. We present the first North American cooperative group consensus contouring atlas for dose-escalated pancreatic cancer radiation therapy.
Methods And Materials: An expert international panel comprising 15 radiation oncologists, 2 surgeons, and 1 radiologist was recruited.
Periodontal diseases are prevalent worldwide and pose a significant public health burden. With the advent of artificial intelligence (AI), there has been growing interest in leveraging AI technologies to improve diagnosis, treatment planning, and management of periodontal conditions. This review aims to provide a comprehensive overview of the applications of AI in periodontics, including its potential benefits, challenges, and future directions.
View Article and Find Full Text PDFTemporary Childbirth Migration (TCM) involves women returning to their natal homes during or after pregnancy, a common but understudied practice in India and South Asia. This study examines social support practices influencing TCM decisions among Indian women. Factors such as family support, especially from husband, in-laws and parents, play a crucial role in migration decisions during the perinatal period.
View Article and Find Full Text PDFIntroduction Proximity of organs at risk (OAR) hinders radiation dose escalation for the treatment of pancreatic cancer. To address this limitation, there is interest in protracted-fractionation (PF: 15 to 25 fractions) courses employing moderate hypofractionation (MHF: 3-4 Gy/fraction). However, there persists underdosing where tumor interfaces with OAR.
View Article and Find Full Text PDFBackground: Cabozantinib, a tyrosine kinase inhibitor (TKI), is a prevalent second-line (2 L) therapy and was approved for use after progression on TKIs. However, the 1 L treatment setting has changed since the approval of cabozantinib monotherapy in salvage therapy settings.
Objective: To assess the differential effectiveness of cabozantinib after prior progression on 1 L ipilimumab with nivolumab (IPI + NIVO) compared to programmed death receptor-1 (PD-1) or PD-1 ligand (PD-L1) inhibitors (PD1/L1i) with TKIs.
Introduction: Around 25% of patients with advanced prostate cancer harbor alterations in the homologous recombination/DNA damage repair (HRR) pathway. Inhibiting poly (ADP-ribose) polymerase (PARP) in these patients leads to synthetic lethality, making PARP inhibitors (PARPi), including talazoparib, a promising treatment for metastatic castration-resistant prostate cancer (mCRPC) and potentially for metastatic hormone-sensitive prostate cancer (mHSPC).
Areas Covered: This article examines the mechanism of action, chemical properties, pharmacokinetics, pharmacodynamics, and clinical safety and efficacy data of different PARPis, including talazoparib in prostate cancer.
The global prevalence rate of diabetes in 2021 was 6.1% making diabetes one of the top 10 causes of death. Prolonged use of antidiabetic medications is associated with various side effects; therefore, alternative treatment strategies for diabetes need exploration.
View Article and Find Full Text PDFBackground: Optimal anticoagulation management in patients with myeloproliferative neoplasms (MPN) experiencing splanchnic vein thrombosis (SpVT) requires balancing risks of bleeding and recurrent thrombosis.
Objectives: We conducted a systematic review and meta-analysis to assess the incidence of bleeding and thrombosis recurrence in patients with MPN-SpVT.
Methods: We included retrospective or prospective studies in English with ≥10 adult patients with MPN-SpVT.
Introduction: Patients with localized pancreatic adenocarcinoma (PDAC) benefit from multi-modality therapy. Whether care patterns and oncologic outcomes vary if a patient was seen through a pancreatic multi-disciplinary clinic (PMDC) versus only individual specialty clinics is unclear.
Methods: Using institutional Pancreatic Cancer Registry, we identified patients with localized PDAC from 2019- 2022 who eventually underwent resection.
The proximity of a pancreas head tumor to the duodenum often limits delivery of an ablative dose of radiation therapy. This study evaluated the feasibility and safety of using an injectable polyethylene glycol (PEG) hydrogel between the head of the pancreas and duodenum. In a multi-site feasibility cohort study of patients with localized pancreatic cancer, PEG hydrogel was injected under endoscopic ultrasound guidance to temporarily position the duodenum away from the pancreas.
View Article and Find Full Text PDFThe use of radiation therapy (RT) for pancreatic cancer continues to be controversial, despite recent technical advances. Improvements in systemic control have created an evolving role for RT and the need for improved local tumor control, but currently, no standardized approach exists. Advances in stereotactic body RT, motion management, real-time image guidance, and adaptive therapy have renewed hopes of improved outcomes in this devastating disease with one of the lowest survival rates.
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