CA: A Cancer Journal for Clinicians最新文献

{"title":"Systemic therapy for hormone receptor-positive/human epidermal growth factor receptor 2-negative early stage and metastatic breast cancer","authors":"Laura A. Huppert MD,&nbsp;Ozge Gumusay MD,&nbsp;Dame Idossa MD,&nbsp;Hope S. Rugo MD","doi":"10.3322/caac.21777","DOIUrl":"https://doi.org/10.3322/caac.21777","url":null,"abstract":"<p>Hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer is defined by the presence of the estrogen receptor and/or the progesterone receptor and the absence of HER2 gene amplification. HR-positive/HER2-negative breast cancer accounts for 65%–70% of all breast cancers, and incidence increases with increasing age. Treatment varies by stage, and endocrine therapy is the mainstay of treatment in both early stage and late-stage disease. Combinations with cyclin-dependent kinase 4/6 inhibitors have reduced distant recurrence in the early stage setting and improved overall survival in the metastatic setting. Chemotherapy is used based on stage and tumor biology in the early stage setting and after endocrine resistance for advanced disease. New therapies, including novel endocrine agents and antibody-drug conjugates, are now changing the treatment landscape. With the availability of new treatment options, it is important to define the optimal sequence of treatment to maximize clinical benefit while minimizing toxicity. In this review, the authors first discuss the pathologic and molecular features of HR-positive/HER2-negative breast cancer and mechanisms of endocrine resistance. Then, they discuss current and emerging therapies for both early stage and metastatic HR-positive/HER2-negative breast cancer, including treatment algorithms based on current data.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 5","pages":"480-515"},"PeriodicalIF":254.7,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21777","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6242807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near majority of adults favor R ratings for films with smoking","authors":"Mike Fillon","doi":"10.3322/caac.21776","DOIUrl":"https://doi.org/10.3322/caac.21776","url":null,"abstract":"&lt;p&gt;Study author Kelly D. Blake, ScD, director of the Health Information National Trends Survey (HINTS) and a health scientist in health communication and informatics research at the National Cancer Institute in Bethesda, Maryland, notes that it had been almost a decade since the last nationally representative assessment of public support for R rating designations by the Motion Picture Association (MPA) for movies with cigarette smoking. “Our study adds to prior assessments and suggests that public support among the general population of US adults is gradually trending upward, from 40% in 2003, to 45% in 2013, to 47% in 2020.”&lt;/p&gt;&lt;p&gt;The main goals of this study by National Cancer Institute researchers were to determine the proportion of adults who support, are ambivalent about, or oppose the depiction of smoking as a sufficient criterion for an R rating and to identify characteristics of study participants that were associated with their opinions on this issue.&lt;/p&gt;&lt;p&gt;The researchers used data from the 2020 HINTS, a National Institutes of Health–initiated national, cross-sectional postal survey of 3865 individuals at least 18 years old. This survey included an item that assessed support, opposition, and neutrality regarding the idea that “movies with cigarette smoking should be rated ‘R’ to protect children and youth from seeing cigarette smoking in movies.” Demographic data recorded in HINTS included each participant’s age, gender, and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian, or non-Hispanic other); income; educational level; sexual orientation; geographic location; marital status; child status (whether a participant had children or not); and political leanings. They also asked participants about cigarette smoking and e-cigarette use (both classified as current, former, or never).&lt;/p&gt;&lt;p&gt;A slight majority of the participants were female (50.2%,), whereas more than half (58.7%) were non-Hispanic White. Current cigarette smokers and current e-cigarette users constituted 13.6% and 6.3% of the participants, respectively.&lt;/p&gt;&lt;p&gt;Overall, 20.3% strongly opposed or opposed a policy designating R ratings for movies containing cigarette smoking, 30.3% were neutral, and 47.0% supported or strongly supported this idea.&lt;/p&gt;&lt;p&gt;Using weighted, multivariable logistic regression models to identify characteristics associated with neutrality or opposition, with support as the referent category, the researchers found noteworthy differences by age and race/ethnicity. Older adults (at least 50 years old) were significantly less likely than the younger adults (18–34 years old) to be opposed to or neutral regarding smoking as an R rating criterion. For example, participants aged 50–64 years were only 56% as likely to be opposed to or neutral regarding this proposal, whereas those aged 65–74 years or older than 75 years were 39% and 27% as likely, respectively. The only significant difference by race/ethnicity was that non-Hispa","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 2","pages":"118-119"},"PeriodicalIF":254.7,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21776","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6074004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer survivors at greater risk for bone fractures late in life","authors":"Mike Fillon","doi":"10.3322/caac.21775","DOIUrl":"https://doi.org/10.3322/caac.21775","url":null,"abstract":"&lt;p&gt;Cancer survivors may be more susceptible to frailty-related bone fractures to the pelvis and vertebrae according to a study by American Cancer Society (ACS) researchers.&lt;/p&gt;&lt;p&gt;“Prior to our study, there was some evidence to suggest that cancer survivors may be at a higher risk of bone fractures,” says Erika Rees-Punia, PhD, MPH, senior principal scientist of the Department of Population Science at the ACS in Atlanta, Georgia. “But many prior studies focused on one cancer type, most often breast cancer only; combined all fracture sites together, even though we know that certain fracture sites, like hip and spine, are the costliest and the most likely to be associated with further morbidity and mortality down the road; and only studied cancer survivors immediately after treatment.” The study appears in &lt;i&gt;JAMA Oncology&lt;/i&gt; (doi:10.1001/jamaoncol.2022.5153).&lt;/p&gt;&lt;p&gt;The participants in this study were from the ACS’s Cancer Prevention Study II (CPS-II) Nutrition Cohort (NC) and had provided demographic and lifestyle information in a series of questionnaires since 1992. Cancer incidence information was self-reported by the study participants and verified by the researchers via medical record abstraction and state cancer registries.&lt;/p&gt;&lt;p&gt;Because both CPS-II and Centers for Medicare &amp; Medicaid Services claims databases include a patient’s Social Security number, name, sex, and date of birth, the researchers were able to link data provided to the ACS with Medicare inpatient, outpatient, and physician&lt;/p&gt;&lt;p&gt;claims files, which were used to identify incident pelvic, radial, and vertebral fractures when subjects were at least 65 years old.&lt;/p&gt;&lt;p&gt;“Linking CPS-II data with Medicare Claims data allows us to benefit from both datasets in one study,” says Dr Rees-Punia. “CPS-II has years of validated physical activity, smoking, and diet data (pre- and post-diagnosis for cancer survivors), while Claims data provide an opportunity to identify sites and dates of bone fractures without relying on self-reporting.”&lt;/p&gt;&lt;p&gt;Following cancer survivors for more than 15 years, the study included survivors of all cancer sites and explored the differences in fracture risk by three sites (wrist, pelvis, and vertebrae) that are associated with frailty. “This was important, as we indeed found that the risk of fracture was different by fracture site, and the risk of fracture was elevated for cancer survivors for many years after diagnosis and treatment,” Dr Rees-Punia says.&lt;/p&gt;&lt;p&gt;Participants were classified by their cancer history, including the time since diagnosis and the stage at diagnosis. The researchers then examined potential associations of these and other clinical characteristics with the number of pelvic, radial, and vertebral fractures.&lt;/p&gt;&lt;p&gt;“These analytic decisions align with those made in previous studies of bone health in cancer survivors and with other studies of cancer survivorship within CPS-II NC,” the researchers wrote.&lt;/p&gt;&lt;p&gt;This study used data from ","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 2","pages":"115-117"},"PeriodicalIF":254.7,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6074003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquiring tissue for advanced lung cancer diagnosis and comprehensive biomarker testing: A National Lung Cancer Roundtable best-practice guide","authors":"Adam H. Fox MD, MS,&nbsp;Mizuki Nishino MD,&nbsp;Raymond U. Osarogiagbon MBBS,&nbsp;M. Patricia Rivera MD,&nbsp;Lauren S. Rosenthal MPH,&nbsp;Robert A. Smith PhD,&nbsp;Farhood Farjah MD,&nbsp;Lynette M. Sholl MD,&nbsp;Gerard A. Silvestri MD, MS,&nbsp;Bruce E. Johnson MD","doi":"10.3322/caac.21774","DOIUrl":"https://doi.org/10.3322/caac.21774","url":null,"abstract":"<p>Advances in biomarker-driven therapies for patients with nonsmall cell lung cancer (NSCLC) both provide opportunities to improve the treatment (and thus outcomes) for patients and pose new challenges for equitable care delivery. Over the last decade, the continuing development of new biomarker-driven therapies and evolving indications for their use have intensified the importance of interdisciplinary communication and coordination for patients with or suspected to have lung cancer. Multidisciplinary teams are challenged with completing comprehensive and timely biomarker testing and navigating the constantly evolving evidence base for a complex and time-sensitive disease. This guide provides context for the current state of comprehensive biomarker testing for NSCLC, reviews how biomarker testing integrates within the diagnostic continuum for patients, and illustrates best practices and common pitfalls that influence the success and timeliness of biomarker testing using a series of case scenarios.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 4","pages":"358-375"},"PeriodicalIF":254.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21774","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6027184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer statistics, 2023","authors":"Rebecca L. Siegel MPH,&nbsp;Nikita Sandeep Wagle MBBS, MHA, PhD,&nbsp;Andrea Cercek MD,&nbsp;Robert A. Smith PhD,&nbsp;Ahmedin Jemal DVM, PhD","doi":"10.3322/caac.21772","DOIUrl":"https://doi.org/10.3322/caac.21772","url":null,"abstract":"<p>Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every 3 years, the American Cancer Society provides an update of CRC statistics based on incidence from population-based cancer registries and mortality from the National Center for Health Statistics. In 2023, approximately 153,020 individuals will be diagnosed with CRC and 52,550 will die from the disease, including 19,550 cases and 3750 deaths in individuals younger than 50 years. The decline in CRC incidence slowed from 3%–4% annually during the 2000s to 1% annually during 2011–2019, driven partly by an increase in individuals younger than 55 years of 1%–2% annually since the mid-1990s. Consequently, the proportion of cases among those younger than 55 years increased from 11% in 1995 to 20% in 2019. Incidence since circa 2010 increased in those younger than 65 years for regional-stage disease by about 2%–3% annually and for distant-stage disease by 0.5%–3% annually, reversing the overall shift to earlier stage diagnosis that occurred during 1995 through 2005. For example, 60% of all new cases were advanced in 2019 versus 52% in the mid-2000s and 57% in 1995, before widespread screening. There is also a shift to left-sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019. CRC mortality declined by 2% annually from 2011–2020 overall but increased by 0.5%–3% annually in individuals younger than 50 years and in Native Americans younger than 65 years. In summary, despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum. Progress against CRC could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high-quality screening and treatment among all populations, especially Native Americans.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 3","pages":"233-254"},"PeriodicalIF":254.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21772","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6016710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating energy balance research from the bench to the clinic to the community: Parallel animal-human studies in cancer","authors":"Miriam B. Garcia DO,&nbsp;Keri L. Schadler PhD,&nbsp;Joya Chandra PhD,&nbsp;Steven K. Clinton MD, PhD,&nbsp;Kerry S. Courneya PhD,&nbsp;Zobeida Cruz-Monserrate PhD,&nbsp;Carrie R. Daniel PhD, MPH,&nbsp;Andrew J. Dannenberg MD,&nbsp;Wendy Demark-Wahnefried PhD, RD,&nbsp;Mark W. Dewhirst DVM, PhD,&nbsp;Carol J. Fabian MD,&nbsp;Stephen D. Hursting PhD,&nbsp;Melinda L. Irwin PhD, MPH,&nbsp;Neil M. Iyengar MD,&nbsp;Jennifer L. McQuade MD,&nbsp;Kathryn H. Schmitz PhD, MPH,&nbsp;Karen Basen-Engquist PhD, MPH","doi":"10.3322/caac.21773","DOIUrl":"https://doi.org/10.3322/caac.21773","url":null,"abstract":"<p>Advances in energy balance and cancer research to date have largely occurred in siloed work in rodents or patients. However, substantial benefit can be derived from parallel studies in which animal models inform the design of clinical and population studies or in which clinical observations become the basis for animal studies. The conference <i>Translating Energy Balance from Bench to Communities: Application of Parallel Animal-Human Studies in Cancer,</i> held in July 2021, convened investigators from basic, translational/clinical, and population science research to share knowledge, examples of successful parallel studies, and strong research to move the field of energy balance and cancer toward practice changes. This review summarizes key topics discussed to advance research on the role of energy balance, including physical activity, body composition, and dietary intake, on cancer development, cancer outcomes, and healthy survivorship.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 4","pages":"425-442"},"PeriodicalIF":254.7,"publicationDate":"2023-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21773","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6018610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer statistics, 2023","authors":"Rebecca L. Siegel MPH,&nbsp;Kimberly D. Miller MPH,&nbsp;Nikita Sandeep Wagle MBBS, MHA, PhD,&nbsp;Ahmedin Jemal DVM, PhD","doi":"10.3322/caac.21763","DOIUrl":"https://doi.org/10.3322/caac.21763","url":null,"abstract":"<p>Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries and mortality data collected by the National Center for Health Statistics. In 2023, 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States. Cancer incidence increased for prostate cancer by 3% annually from 2014 through 2019 after two decades of decline, translating to an additional 99,000 new cases; otherwise, however, incidence trends were more favorable in men compared to women. For example, lung cancer in women decreased at one half the pace of men (1.1% vs. 2.6% annually) from 2015 through 2019, and breast and uterine corpus cancers continued to increase, as did liver cancer and melanoma, both of which stabilized in men aged 50 years and older and declined in younger men. However, a 65% drop in cervical cancer incidence during 2012 through 2019 among women in their early 20s, the first cohort to receive the human papillomavirus vaccine, foreshadows steep reductions in the burden of human papillomavirus-associated cancers, the majority of which occur in women. Despite the pandemic, and in contrast with other leading causes of death, the cancer death rate continued to decline from 2019 to 2020 (by 1.5%), contributing to a 33% overall reduction since 1991 and an estimated 3.8 million deaths averted. This progress increasingly reflects advances in treatment, which are particularly evident in the rapid declines in mortality (approximately 2% annually during 2016 through 2020) for leukemia, melanoma, and kidney cancer, despite stable/increasing incidence, and accelerated declines for lung cancer. In summary, although cancer mortality rates continue to decline, future progress may be attenuated by rising incidence for breast, prostate, and uterine corpus cancers, which also happen to have the largest racial disparities in mortality.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 1","pages":"17-48"},"PeriodicalIF":254.7,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6206635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minority groups underrepresented in hematologic cancer trials","authors":"Mike Fillon","doi":"10.3322/caac.21769","DOIUrl":"https://doi.org/10.3322/caac.21769","url":null,"abstract":"&lt;p&gt;A new study finds that patient participation in clinical trials (CTs) leading to approval for hematologic cancer indications significantly underrepresents certain at-risk demographic groups in comparison with their incidence of these diseases. These disparities are most prominent and most consistent for Black, Hispanic, and Native American patients.&lt;/p&gt;&lt;p&gt;In their article, which appears in the &lt;i&gt;Journal of Clinical Oncology&lt;/i&gt; (doi:10.1200/JCO.22.00504), researchers from the Medical College of Georgia at Augusta University in Augusta, Georgia, point out that, as of 2021, hematologic cancers represent only 10% of cancers diagnosed in the United States. This is one reason, they write, that these cancers often are not examined separately from other malignancies when disparities in oncology drug approval CTs are being explored. Filling this gap was a key reason for their new study.&lt;/p&gt;&lt;p&gt;The study focused on CTs leading to drug approval by the US Food and Drug Administration (FDA) for multiple myeloma (MM); myelodysplastic syndrome and myeloproliferative neoplasms; and leukemias, including acute myeloid leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia (CML), and acute lymphoblastic leukemia (ALL).&lt;/p&gt;&lt;p&gt;The researchers identified potentially relevant CTs from the FDA’s Oncology (Cancer)/Hematologic Malignancies Approval Notifications and Novel Drug Approvals databases. Participants’ demographic information and CT geographic site locations were obtained from studies on ClinicalTrials.gov and from articles found in PubMed via the drug name and CT numbers. Population-based incidence and mortality rates, delineated by race, ethnicity, and gender, came from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 21 registries and US census population estimates for more than 21 locations from 2014 to 2018. The researchers excluded CTs of pediatric populations, lymphomas, and rare hematologic cancers with data insufficient for statistical analysis.&lt;/p&gt;&lt;p&gt;Of the 61 CTs (with 13,731 participants), 67.2% reported data on race, and 48.8% also included ethnicity.&lt;/p&gt;&lt;p&gt;Of the 7287 patients in MM CTs, 80.3% were White, 4.7% were Black, 10.7% were Asian/Pacific Islander (API), &lt;0.1% were Native American, and 2.9% were Hispanic. The corresponding percentages for MM incidence in SEER registries were 68.7%, 27.4%, 3.4%, 0.2%, and 17.5%. All of&lt;/p&gt;&lt;p&gt;these disparities in CT representation were statistically significant.&lt;/p&gt;&lt;p&gt;For the 1629 patients in acute myeloid leukemia trials, the percentages for CT participation and SEER incidence were 79.6% and 77.3%, respectively, for Whites; 3.8% and 12.3%, respectively, for Blacks; 8.8% and 5.6%, respectively, for APIs; 0.1% and 1.5%, respectively, for Native Americans; and 6.3% and 15.3%, respectively, for Hispanics. Again, all of these comparisons were statistically significant.&lt;/p&gt;&lt;p&gt;Varying levels of White and API overrepresentation, in contrast to Black, Native American,","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 1","pages":"6-7"},"PeriodicalIF":254.7,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21769","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6206631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team approach for nonmedical opioid use","authors":"Mike Fillon","doi":"10.3322/caac.21770","DOIUrl":"https://doi.org/10.3322/caac.21770","url":null,"abstract":"<p>Although no one disputes the efficacy of opioids for the relief of pain related to cancer and its therapies, there is alarm over nonmedical opioid use (NMOU) and its substantial adverse impacts on patients, their families, and their communities. A new study reports on an approach called Compassionate High-Alert Team (CHAT) to counteract NMOU.</p><p>“Non-medical opiate use is a frequent and devastating complication for patients with advanced cancer. Patience with these conditions is distressing and time demanding for clinicians,” says study researcher Eduardo Bruera, MD, the McGraw Chair in the Department of Palliative, Rehabilitation, &amp; Integrative Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas. “Our study found a major reduction in non-medical abuse behaviors accompanied by high adherence to the intervention among these patients.”</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 1","pages":"3-5"},"PeriodicalIF":254.7,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21770","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5657682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chimeric antigen receptor T-cell therapy in multiple myeloma: A comprehensive review of current data and implications for clinical practice","authors":"Rujul H. Parikh MD,&nbsp;Sagar Lonial MD","doi":"10.3322/caac.21771","DOIUrl":"https://doi.org/10.3322/caac.21771","url":null,"abstract":"<p>Multiple myeloma (MM) is a hematologic malignancy defined by the clonal proliferation of transformed plasma cells. Despite tremendous advances in the treatment paradigm of MM, a cure remains elusive for most patients. Although long-term disease control can be achieved in a very large number of patients, the acquisition of tumor resistance leads to disease relapse, especially in patients with triple-class refractory MM (defined as resistance to immunomodulatory agents, proteosome inhibitors, and monoclonal antibodies). There is an unmet need for effective treatment options in these patients. Chimeric antigen receptor (CAR) T-cell therapy is a novel approach that has demonstrated promising efficacy in the treatment of relapsed, refractory MM (RRMM). These genetically modified cellular therapies have demonstrated deep and durable remissions in other B-cell malignancies, and current efforts aim to achieve similar results in patients with RRMM. Early studies have demonstrated remarkable response rates with CAR T-cell therapy in RRMM; however, durable responses with CAR T-cell therapies in myeloma have yet to be realized. In this comprehensive review, the authors describe the development of CAR T-cell therapies in myeloma, the outcomes of notable clinical trials, the toxicities and limitations of CAR T-cell therapies, and the strategies to overcome therapeutic challenges of CAR T cells in the hope of achieving a cure for multiple myeloma.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"73 3","pages":"275-285"},"PeriodicalIF":254.7,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21771","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6225076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}