892 results match your criteria: "Cleveland Clinic-Taussig Cancer Institute[Affiliation]"

Impact of Clinical Trial Design on Recruitment of Racial and Ethnic Minorities.

J Cancer Educ

October 2024

Department of Hematology and Medical Oncology, Case Comprehensive Cancer Center, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, 44195, USA.

Knowledge related to how oncology treatment trial design influences enrollment of racial and ethnic minorities is limited. Rigorous identification of clinical trial design parameters that associate favorably with minority accrual provides educational opportunities for individuals interested in designing more representative treatment trials. We identified oncology trials with a minimum of 10 patients at an NCI-Designated Comprehensive Cancer Center from 2010 to 2021.

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The NCCN Guidelines for Prostate Cancer include recommendations for staging and risk assessment after a prostate cancer diagnosis and for the care of patients with localized, regional, recurrent, and metastatic disease. These NCCN Guidelines Insights summarize the panel's discussions for the 2024 update to the guidelines with regard to initial risk stratification, initial management of very-low-risk disease, and the treatment of nonmetastatic recurrence.

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  • Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are different forms of the same disease, with similar treatment approaches.
  • Prognostic factors such as undetectable minimal residual disease after treatment can significantly predict better survival outcomes for patients.
  • Treatment decisions depend on disease characteristics, genetic mutations, age, overall health, and the side effects of the treatments, as detailed in the NCCN Guidelines.
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  • - AL amyloidosis is a condition caused by the overproduction of faulty immunoglobulins, leading to harmful amyloid fibrils that primarily affect the heart and kidneys, with symptoms like fatigue and weight loss often causing delayed diagnosis.
  • - The Pavia renal staging model helps predict the need for dialysis, and the combination treatment of daratumumab with cyclophosphamide, bortezomib, and dexamethasone has shown effectiveness in improving kidney function and reducing early mortality in patients, as seen in the ANDROMEDA trial.
  • - Challenges remain in treating relapsed cases due to individual patient differences, but promising indicators like the t(11:14) genetic change may enhance responses to certain therapies,
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  • Vulvar cancer is diagnosed in about 6,470 individuals each year, primarily as squamous cell carcinomas, constituting 5% to 8% of gynecologic cancers.
  • Key risk factors include older age, HPV infection, smoking, inflammatory vulvar conditions, and weakened immune systems.
  • The text reviews NCCN Clinical Practice Guidelines for treatments, surveillance, systemic therapies, and survivorship for those affected by vulvar cancer.
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  • * Pleural mesothelioma is the most common type, accounting for about 85% of all cases.
  • * The NCCN Guidelines for Mesothelioma: Pleural provide updated recommendations on diagnosis, treatment, and follow-up, with recent revisions focusing on disease classification and systemic therapy options.
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NCCN Guidelines® Insights: Kidney Cancer, Version 2.2024.

J Natl Compr Canc Netw

February 2024

35National Comprehensive Cancer Network.

The NCCN Guidelines for Kidney Cancer provide multidisciplinary recommendations for diagnostic workup, staging, and treatment of patients with renal cell carcinoma (RCC). These NCCN Guidelines Insights focus on the systemic therapy options for patients with advanced RCC and summarize the new clinical data evaluated by the NCCN panel for the recommended therapies in Version 2.2024 of the NCCN Guidelines for Kidney Cancer.

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  • - Chronic myeloid leukemia (CML) is identified by the Philadelphia chromosome, resulting from a specific genetic change between chromosomes 9 and 22, leading to a unique fusion gene (BCR::ABL1).
  • - CML has three phases (chronic, accelerated, and blast), with most diagnoses occurring during the chronic phase in developed regions, and treatment mainly involves tyrosine kinase inhibitors (TKIs) to prevent progression.
  • - The manuscript reviews the NCCN Guidelines for diagnosing and managing chronic phase-CML, highlighting that some patients can discontinue TKI therapy under careful supervision.
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Rusfertide, a Hepcidin Mimetic, for Control of Erythrocytosis in Polycythemia Vera.

N Engl J Med

February 2024

From the Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai (M.K., Y.Z.G., R.H.), and the Division of Hematology and Medical Oncology, Weill Cornell Medical College (E.K.R.) - both in New York; the Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL (A.T.K.); the Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston (N.P., S.V.); the Division of Hematology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford (J.G.), and Clinical Research and Development, Protagonist Therapeutics, Newark (A.M., S.R.S, N.B.M., F.H.V., S.K., S.G.) - both in California; the Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland (A.G.); the Mayo Clinic, Phoenix, AZ (J.P.); the Rogel Cancer Center, University of Michigan Health, Ann Arbor (K.P.); All India Institute of Medical Sciences, Rishikesh, India (U.K.N.); and the University of Kansas Cancer Center, Westwood (A.Y.).

Article Synopsis
  • Polycythemia vera is a chronic blood disorder leading to high red blood cell counts, and rusfertide is a treatment that mimics a hormone controlling iron levels, but its safety and effectiveness in these patients were previously unknown.
  • The REVIVE trial tested rusfertide in two parts: a 28-week dose-finding phase involving 70 patients, followed by a 12-week phase where participants received either rusfertide or a placebo.
  • Results showed that patients treated with rusfertide had significantly fewer annual phlebotomies (0.6 vs. 8.7) and a better response rate (60% vs. 17%) compared to the placebo group, along with improvements
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Interferons are cytokines with immunomodulatory properties and disease-modifying effects that have been used to treat myeloproliferative neoplasms (MPNs) for more than 35 years. The initial use of interferons was limited due to difficulties with administration and a significant toxicity profile. Many of these shortcomings were addressed by covalently binding polyethylene glycol to the interferon structure, which increases the stability, prolongs activity, and reduces immunogenicity of the molecule.

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Distinct intratumoral microbiome of young-onset and average-onset colorectal cancer.

EBioMedicine

February 2024

Cleveland Clinic Taussig Cancer Institute, Department of Hematology-Oncology, USA; Case Comprehensive Cancer Center, Cleveland, OH, USA; Center for Young-Onset Colorectal Cancer, Cleveland Clinic, Cleveland, OH, USA. Electronic address:

Background: The unexplained rise of young-onset CRC (yoCRC, age <50 years) is of concern. Evidence suggests that microbial dysbiosis may be a contributing factor, but the tumor microbial profile of yoCRC in comparison to average-onset CRC (aoCRC, age >60) has not been fully investigated.

Methods: 16S rRNA amplicon sequencing was performed in tumor and paired adjacent non-malignant fresh frozen tissue specimens prospectively collected from 136 yoCRC and 140 aoCRC patients.

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Ruxolitinib reduces spleen volume, improves symptoms, and increases survival in patients with intermediate- or high-risk myelofibrosis. However, suboptimal response may occur, potentially because of signaling via the phosphoinositide 3-kinase (PI3K)/protein kinase B pathway. This phase 2 study evaluated dosing, efficacy, and safety of add-on PI3Kδ inhibitor parsaclisib for patients with primary or secondary myelofibrosis with suboptimal response to ruxolitinib.

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  • Study focuses on patients with metastatic urothelial carcinoma (mUC) treated with immune checkpoint inhibitors (ICIs) and their immune-related adverse events (irAEs) that required treatment interruptions or permanent discontinuation.
  • A total of 200 mUC patients were reviewed, with 8% experiencing grade ≥2 irAEs leading to treatment interruptions, highlighting the need for corticosteroids and the outcomes of those who were rechallenged versus those who permanently discontinued therapy.
  • The study revealed that 70% of patients who were rechallenged experienced further irAEs, while those who discontinued showed longer clinical benefits off therapy, indicating diverse survival rates based on treatment decisions.
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The NCCN Guidelines for Merkel Cell Carcinoma (MCC) provide recommendations for diagnostic workup, clinical stage, and treatment options for patients. The panel meets annually to discuss updates to the guidelines based on comments from expert review from panel members, institutional review, as well as submissions from within NCCN and external organizations. These NCCN Guidelines Insights focus on the introduction of a new page for locally advanced disease in the setting of clinical node negative status, entitled "Clinical N0 Disease, Locally Advanced MCC.

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Article Synopsis
  • The treatment options for Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) have expanded with new advancements.
  • The NCCN Guidelines offer a structured approach for diagnosing, treating, and evaluating responses in patients with WM/LPL.
  • These guidelines apply to both newly diagnosed and previously treated individuals, ensuring effective follow-up care.
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Immuno-Oncology Advances in Genitourinary Cancers.

Am Soc Clin Oncol Educ Book

January 2024

Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.

Immuno-oncology (IO) has made monumental gains in the past decade in the genitourinary space. In this review, we highlight advances with IO in renal cell carcinoma where it now has become standard-of-care frontline therapy in the metastatic setting but also discuss challenges with the initial approach. In urothelial carcinoma, we discuss the growing use of IO including exciting recent updates with IO-based regimens that may soon become the new standard of care.

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Background: The Center for International Blood and Marrow Transplant Research (CIBMTR) provides a 1-year overall survival calculator to estimate outcomes for individual patients before they undergo allogeneic hematopoietic cell transplantation (HCT) to inform risk. The calculator considers pre-HCT clinical and demographic characteristics, but not patient-reported outcomes (PROs). Because pre-HCT PRO scores have been associated with post-HCT outcomes, the authors hypothesized that adding PRO scores to the calculator would enhance its predictive power.

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Purpose: National Cancer Institute (NCI) and nonprofit organization (NPO) funding is critical for research and advocacy but may not be equitable across cancers.

Methods: This study evaluated funding from the NCI and NPOs supporting lung, breast, colorectal, pancreatic, hepatobiliary, prostate, ovarian, cervical and endometrial cancers, leukemia, lymphoma, and melanoma from 2015 to 2018. The primary objectives were to assess for funding disparities across different cancers compared with their incidence and mortality and across racial groups.

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Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by clonal proliferation of hematopoietic progenitor cells and is associated with an increased risk of thrombotic events (TEs). Established risk factors for TEs in patients with PV include advanced age, TE history, and elevated hematocrit. Although an association of TE with elevated white blood cell (WBC) counts has been suggested by retrospective studies, this relationship needs further validation.

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Article Synopsis
  • - The treatment landscape for relapsed/refractory multiple myeloma has expanded significantly with new options like second generation proteasome inhibitors, immunomodulators, monoclonal antibodies, and CAR T cells, among others.
  • - Due to the nature of multiple myeloma, many patients will experience multiple relapses and require various combination therapies that consider their specific resistance patterns and individual factors such as age and health conditions.
  • - The NCCN Guidelines for multiple myeloma offer a structured approach to help healthcare providers make informed decisions regarding diagnosis, treatment, and monitoring for patients with relapsed/refractory multiple myeloma.
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Background: Acquired ESR1 mutations in estrogen receptor-positive (ER+) metastatic breast cancer (mBC) drive treatment resistance and tumor progression; new treatment strategies are needed. Lasofoxifene, a next-generation, oral, endocrine therapy and tissue-specific ER antagonist, provided preclinical antitumor activity, alone or combined with a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) in ESR1-mutated mBC.

Patients And Methods: In the open-label, phase II, ELAINE 2 trial (NCT04432454), women with ESR1-mutated, ER+/human epidermal growth factor receptor 2-negative (HER2-) mBC who progressed on prior therapies (including CDK4/6i) received lasofoxifene 5 mg/day and abemaciclib 150 mg b.

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Importance: Young women with breast cancer who have germline pathogenic variants in BRCA1 or BRCA2 face unique challenges regarding fertility. Previous studies demonstrating the feasibility and safety of pregnancy in breast cancer survivors included limited data regarding BRCA carriers.

Objective: To investigate cumulative incidence of pregnancy and disease-free survival in young women who are BRCA carriers.

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Background: This study examined real-world patients with locally advanced or metastatic urothelial carcinoma considered ineligible for platinum-containing chemotherapy in the first-line setting.

Methods: This retrospective observational study used data from a nationwide (United States) de-identified patient-level electronic health record-derived database. Eligible adults (aged 18 years and older) had a locally advanced or metastatic urothelial carcinoma diagnosis on or after January 1, 2016, and initiated first-line systemic treatment at least 90 days before December 31, 2021.

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Purpose: Malignant melanoma represents the most lethal skin cancer with germline predispositions thought to comprise 10% to 15% of all melanoma cases. No studies to date examine the immunologic features that may differentiate survival differences between germline pathogenic variant (gPV)-positive patients with melanoma from gPV-negative patients with melanoma.

Experimental Design: Adult patients with melanoma and clinical characteristics suggesting hereditary predisposition to cancer were prospectively recruited to undergo germline testing and flow cytometric analysis of peripheral immune suppressor cells.

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