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When Cancer Care Is Too Much of a Good Thing

When Cancer Care Is Too Much of a Good Thing | Melanoma Dispatch | Scoop.it

Some routine cancer tests and treatments can do more harm than good. Based on clinical evidence, the American Society of Clinical Oncology highlights cancer care that should be curbed in an annual Top Five List. This year's recommendations include:

  • Not giving antinausea drugs at the beginning of chemotherapies that are only moderately likely to cause nausea;
  • Not treating breast cancers that have spread with combination chemotherapy—unless symptom relief is urgent;
  • Not monitoring for cancer recurrence with advanced imaging technologies—such as positron-emission tomography (PET), computed tomography (CT) and radionuclide bone scans—unless there are symptoms of cancer;
  • Not screening men for prostate cancer unless they are likely to live at least another 10 years; and
  • Not giving people targeted therapies unless their tumor has the specific genetic abnormality that is targeted.
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ASCO Post│Oct 29, 2013

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ASCO Post│Oct 29, 2013

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ASCO Post│Oct 29, 2013

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New Way to Find and Kill Cancer Cells

New Way to Find and Kill Cancer Cells | Melanoma Dispatch | Scoop.it

A tiny new particle could pack a powerful anticancer punch, promising to speed diagnosis and pinpoint drug delivery. Conventional nanoparticles can only carry cancer-fighting materials on their surfaces, limiting their effectiveness. In contrast, the new 'Janus' nanoparticle has a porous interior that lets it carry cancer tests and treatments at the same time. Other uses for the new particle include delivering fluorescent dyes to illuminate cancer cells, making them easier for surgeons to find. This technological advance was presented at the 2013 Materials Science & Technology Conference in Canada.

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Science Daily│Oct 28, 2013

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Science Daily│Oct 28, 2013

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Science Daily│Oct 28, 2013

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Experts Suggest Ways to Increase Cancer Patient Participation in Clinical Trials

Clinical trials are the cornerstone of developing better cancer care. However, less than 5% of cancer patients participate in clinical trials. A recent meeting of cancer experts developed a list of recommendations for increasing clinical trial enrollment. Strategies at the patient and community level include involving patient advocates and community leaders in clinical trial recruitment, simplifying patient consent forms, and providing interpreters. At the physician level, electronic registries may help keep doctors informed about the availability of clinical trials for their patients. Doctors must also work on speaking to their patients about clinical trials in culturally sensitive ways. Finally, at the level of organizations that initiate clinical trials, institutions need to become more efficient about opening and conducting trials.

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Medscape | Oct 25, 2013

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Medscape | Oct 25, 2013

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Medscape | Oct 25, 2013

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Internet Use Linked to Cancer-Preventive Behaviors in Older Adults

Internet Use Linked to Cancer-Preventive Behaviors in Older Adults | Melanoma Dispatch | Scoop.it

A UK survey found that older individuals who use the Internet are more likely to engage in cancer-preventive behaviors. Adults aged 50 years and older who were regular Internet users were 50% more likely to get screened for colorectal cancer than non-users. They were also more physically active, smoked less, and ate more fruits and vegetables. Younger, wealthier, and more educated respondents were more likely to use the Internet, and fewer women and non-white survey participants used the Internet. However, the link between Internet use and cancer-preventive behaviors remained even after controlling for these factors. Given the apparent beneficial influence of Internet use on cancer outcomes, the survey’s authors urge policymakers to promote better Internet access for currently underserved demographics.

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ScienceDaily | Oct 22, 2013

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ScienceDaily | Oct 22, 2013

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ScienceDaily | Oct 22, 2013

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Cancer Insurance Can Protect Against High Costs of Treatment

Cancer Insurance Can Protect Against High Costs of Treatment | Melanoma Dispatch | Scoop.it

The often enormous costs of cancer treatment can financially ruin patients or lead them to end treatment early. To help control expenditures, the American Cancer Society recommends that people become familiar with the terms of their health insurance policies. In addition to traditional health insurance, some companies offer cancer-care supplemental plans. The initial diagnosis benefit, a lump sum paid out if the enrollee is diagnosed with cancer, helps defray the cost of deductibles early on. Transportation benefits can aid patients who have to travel for their treatment. However, cancer-care supplemental plans need to be set up as a protective measure; people usually cannot enroll in them after having been diagnosed with cancer.

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Tahlequah Daily Press | Oct 23, 2013

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Tahlequah Daily Press | Oct 23, 2013

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Tahlequah Daily Press | Oct 23, 2013

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New Test May Show When BRAF Inhibitors Work

New Test May Show When BRAF Inhibitors Work | Melanoma Dispatch | Scoop.it

Even though about half of melanomas have BRAF mutations, some of these still fail to respond to BRAF inhibitors. Now, there may be a way to tell whether BRAF inhibitors are working, according to findings presented at the 2013 International Conference on Molecular Targets and Cancer Therapeutics. The researchers found that a BRAF inhibitor kept tumors from growing in six out of nine people with BRAF-mutant melanomas, and that those who benefitted from the treatment also had less activation of a protein called S6 at 2 weeks. If this link is verified in large clinical trials, S6 activation levels could predict BRAF inhibitor effectiveness during the early stages of treatment.

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American Association for Cancer Research | Oct 22, 2013

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Experimental Melanoma Immunotherapy Continues to Hold Promise

In keeping with results from other studies, new research supports treating melanomas with the experimental immunotherapy nivolumab. This drug blocks a protein—called PD-1—that lets tumor cells evade the immune system. In a phase I clinical trial, nivolumab shrank tumors in 25% of 90 people with melanomas that had spread. Some of these tumors had not responded to the U.S. Food and Drug Administration (FDA)-approved immunotherapy ipilimumab. In addition, some tumors that did not respond to nivolumab did respond to ipilimumab. Taken together, these findings suggest that melanomas could be treated with these two drugs either in combination or sequentially.

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Journal of Clinical Oncology │Oct 20, 2013

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Immunotherapy Promises Breakthroughs in Cancer Treatment

Immunotherapy Promises Breakthroughs in Cancer Treatment | Melanoma Dispatch | Scoop.it

Researchers have begun to identify the mechanisms that tumors use to protect themselves from the body’s immune system. Disrupting these mechanisms frees the immune system to attack the cancer, offering the hope of effective therapies for otherwise hard-to-treat cancers. Among the first such treatments is ipilimumab (Yervoy), which was approved for treatment of melanoma in 2011. Additional immunotherapy drugs are currently under investigation for lung cancer treatment. Overall, these drugs produce modest increases in average survival. However, some patients respond dramatically: 20% of melanoma patients treated with Yervoy in a clinical trial are still alive up to 10 years later. In others, immunotherapy can cause the immune system to attack healthy cells also, leading to dangerous or even fatal reactions. Further research aims to uncover the reasons behind these different responses.

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New York Times | Oct 14, 2013

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New York Times | Oct 14, 2013

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Too Little or Too Much: Medication Adherence Problems with Oral Cancer Drugs

Too Little or Too Much: Medication Adherence Problems with Oral Cancer Drugs | Melanoma Dispatch | Scoop.it

New cancer drugs that can be taken orally allow patients to take their medication at home, making treatment significantly more convenient. However, moving treatment out of the controlled hospital environment increases the risk of medication mistakes. A review found that 20% to 80% of patients taking oral cancer drugs deviated from the correct dose. Problems included both underadherence (taking less medication than prescribed) and overadherence (taking too much medication). Reasons for overadherence included patients continuing to take their medication during 'rest cycles' intended to be drug-free or overcompensating for missed doses. Under- and overadherence were more likely in patients with complex drug regimens. Overadherence was associated with more side effects, while underadherence decreased side effects, but risked undermining the effectiveness of the cancer treatment.

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MedPage Today | Oct 13, 2013

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MedPage Today | Oct 13, 2013

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MedPage Today | Oct 13, 2013

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Melanoma Doesn't Keep People Out of the Sun

Melanoma Doesn't Keep People Out of the Sun | Melanoma Dispatch | Scoop.it

Even though ultraviolet (UV) radiation is a major cause of skin cancer, people with melanoma may still get plenty of sun. A new Danish study compared sun exposure in 20 individuals with melanoma to 20 without this skin cancer, giving each portable devices that detected UV doses and asking them to keep sun exposure diaries. While UV exposure was steady in people without melanoma, it rose with time in people with melanoma: by 25% from the first to second summer after diagnosis and by 33% from the first to the third summer. Moreover, people with melanoma got more sun while on vacation and when traveling to other countries.

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JAMA Dermatology│Oct 2, 2013

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Virus Shrinks Melanomas by Bursting Cells

Virus Shrinks Melanomas by Bursting Cells | Melanoma Dispatch | Scoop.it

A cancer-killing virus may shrink melanomas in people, according to new results from an ongoing clinical trial presented at the 2013 European Cancer Congress in Amsterdam, Netherlands. The virus—called talimogene laherparepvec or T-VEC—is injected into tumors, where it divides until the cells pop. The phase III trial has more than 400 people with melanoma; T-VEC shrank tumors in nearly one-third of them. Moreover, tumors didn't grow again for at least 9 months in two-thirds of those who responded to the virus. That said, 26% of those treated with T-VEC had serious side effects including fevers and bacterial skin infections.

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StreetInsider.com│Sep 30, 2013

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Molecular Profiling Helps Guide Treatment of Cancers of Unknown Origin

In cases of cancer that has spread throughout the body, it can sometimes be difficult to determine where the cancer originally developed. A large, new study found that in such cases, molecular profiling of the cancer tissue, even if it is not from the original ('primary') tumor, can meaningfully guide the choice of treatment. Such profiling identified useful biomarkers in 77% of the examined patients, including various genetic mutations, along with over- or underexpression of different proteins. These biomarkers then informed the selection of targeted therapies, which were highly effective in many cases. Indeed, determining the molecular profile of the cancer tissue appeared to be more useful than finding out which body part the cancer originated from.

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Medscape | Sep 29, 2013

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Medscape | Sep 29, 2013

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Medscape | Sep 29, 2013

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Ipilimumab Gives Some Melanoma Patients 10 More Years

People with melanomas that have spread can live as long as a decade when treated with the U.S Food and Drug Administration (FDA)-approved immunotherapy drug Yervoy (ipilimumab), according to a report at a cancer conference in Amsterdam, Netherlands. Ipilimumab activates the immune system's attack on tumor cells, which is normally inhibited. The researchers evaluated 12 ipilimumab trials totaling more than 1,800 people with melanoma, making this the largest follow-up skin cancer study ever. They found that 22% survived at 3 years and 17% survived at 7 years and were still alive at up to 10 years. Now, Yervoy manufacturer Bristol-Myers is testing the combination of ipilimumab with an experimental immunotherapy drug called nivolumab, which blocks a protein (PD-1) that lets tumor cells evade the immune system. So far, the combo treatment outperforms ipilimumab alone in an early trial, extending life to a year in 82% of 53 people with melanoma.

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Bloomberg│Sep 27, 2013

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'Quality-of-Life' Care Extends Life for People with Cancer

'Quality-of-Life' Care Extends Life for People with Cancer | Melanoma Dispatch | Scoop.it

Improving the quality of life—palliative care—for people with cancer can also increase survival, according a new pilot study. These findings will be presented at the American Society of Clinical Oncology's 2013 Quality Care Symposium. Palliative care addresses uncontrolled symptoms, helps guide decision-making, and coordinates treatment. This service is underused and the researchers found that routinely offering it to people makes them twice as likely to take advantage of it (82% vs 41%). With palliative care, hospital readmissions dropped from 36% to 17% and hospice use rose from 14% to 25%. Best of all, people who got palliative care lived longer, with the ratio of expected to actual deaths dropping from 1.35 to 0.59.

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Mount Sinai Medical Center│Oct 29, 2013

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Mount Sinai Medical Center│Oct 29, 2013

Tambre Leighn's curator insight, November 2, 2013 2:13 AM

Just as the definition of palliative care has, until recently, had a limited viewpoint of being somehow related to only hospice, tying "quality of life" to palliative care can lead to similar limitations. 

 

Quality of life must include ALL areas of life, not just medical symptoms or health challenges.  Often stress, anxiety and worries come from the impact cancer has on other areas such as finances, relationships, career and more. 

Tambre Leighn's curator insight, November 2, 2013 2:13 AM

Just as the definition of palliative care has, until recently, had a limited viewpoint of being somehow related to only hospice, tying "quality of life" to palliative care can lead to similar limitations. 

 

Quality of life must include ALL areas of life, not just medical symptoms or health challenges.  Often stress, anxiety and worries come from the impact cancer has on other areas such as finances, relationships, career and more.

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Compassionate Use of Unapproved Drugs Raises Difficult Ethical Issues

Compassionate Use of Unapproved Drugs Raises Difficult Ethical Issues | Melanoma Dispatch | Scoop.it

Patients with terminal illnesses, including late-stage cancer patients, are understandably eager to try still-unapproved experimental drugs once other options have been exhausted. The U.S. Food and Drug Administration (FDA) recently created a program to make it easier for drug companies to grant 'compassionate use,' which allows patients in extraordinary need access to otherwise unauthorized treatments. However, the decision to dispense experimental drugs is left to the companies, which are often reluctant to take this risky step. Experimental drugs are just that–experimental; they may have catastrophic side effects or simply not work. When these drugs are given outside the framework of a well-designed clinical trial, it becomes impossible to decisively judge whether they actually work. And if all patients could bypass clinical trials, there would be no incentive for anyone to enroll in these clinical trials, meaning that new drugs would never be properly studied and approved. Compassionate use therefore needs to be approved by experienced medical professionals on a case-by-case basis, and remain an option of last resort only.

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New York Times | Oct 31, 2013

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New York Times | Oct 31, 2013

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New York Times | Oct 31, 2013

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Three Metastasis Myths, Debunked

Three Metastasis Myths, Debunked | Melanoma Dispatch | Scoop.it

Persistent rumors claim that a needle biopsy – a procedure in which a surgeon removes a small part of a suspected tumor using a needle – can cause cancer to spread. However, there is no evidence that this is the case. On the contrary, biopsies often allow early diagnosis and timely treatment of cancers. Likewise, there is no evidence that massage promotes cancer spread. Indeed, massage therapy for cancer patients can reduce pain, muscle tension, mental stress, and nausea. Cancer spread is driven by biological changes inside the cancer cells, not outside mechanical forces like a biopsy needle or a massage. Finally, sugar does not “feed” cancer. Excess sugar consumption can contribute to obesity, which is associated with increased risk of several cancers, but by itself, sugar does not have any effect on cancer spread.

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ScienceDaily | Oct 25, 2013

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ScienceDaily | Oct 25, 2013

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ScienceDaily | Oct 25, 2013

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Sharing Clinical Trial Data: Benefits and Concerns

Sharing Clinical Trial Data: Benefits and Concerns | Melanoma Dispatch | Scoop.it

Policymakers and regulatory agencies are increasingly pushing for more public access to clinical trial information. Requiring clinical trial sponsors to be more transparent about their findings would provide greater accountability and discourage unethical trial practices, suppression or selective reporting of results, or misleading analyses. Data sharing would also prevent unnecessary duplication of studies. However, disclosing clinical trial data also risks compromising the privacy of trial participants. Moreover, making a sponsor’s trial data freely available could give unfair advantages to competitors, who could potentially use the data without incurring the cost of producing it. This may discourage companies from performing trials altogether. Clinical trial data sharing therefore needs to incorporate reasonable safeguards for participant privacy and companies’ intellectual property.

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New England Journal of Medicine | Oct 21, 2013

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New England Journal of Medicine | Oct 21, 2013

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New England Journal of Medicine | Oct 21, 2013

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U.S. Doctors Begin to Question High Cost of Cancer Medicines

U.S. Doctors Begin to Question High Cost of Cancer Medicines | Melanoma Dispatch | Scoop.it

Cancer drug prices have risen dramatically since the early 2000s, especially in the U.S. Some doctors are beginning to balk at medications that, in some cases, can cost over $10,000 a month and often offer only marginal improvements in survival. Other drugs do produce dramatic increases in life expectancy, but accumulating expenses force patients to stop treatment. Several aspects of the U.S. drug market contribute to high prices, including long patent durations that shield drug makers from competition, and Medicare’s inability to negotiate better prices with drug makers. Health authorities in several other countries have started to refuse coverage for drugs that, in their estimation, do not offer enough benefit to warrant their high cost. Notably, cancer drug prices in those countries are significantly lower than in the U.S. In 2012, Memorial Sloan-Kettering Cancer Center became the first major U.S. hospital to refuse offering a cancer drug–zif-aflibercept (Zaltrap)–due to price concerns.

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New York Magazine | Oct 20, 2013

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New York Magazine | Oct 20, 2013

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New York Magazine | Oct 20, 2013

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Better Way to Detect BRAF Mutations

Better Way to Detect BRAF Mutations | Melanoma Dispatch | Scoop.it

A new test for BRAF mutations outshines the standard method, according to results reported at the 2013 International Conference on Molecular Targets and Cancer Therapeutics. There are more than 30 known different versions of BRAF mutations, which occur mostly in melanomas but are also found in other types of cancer. The standard test for BRAF mutations requires a lot of sample preparation and usually takes 3 to 4 weeks. In contrast, the new test—called MDx—skips sample preparation and gives accurate results in as little as 90 minutes. Ultimately, the researchers plan to extend this approach to other cancer mutations with U.S. Food and Drug Administration (FDA)-approved targeted therapies.

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American Association for Cancer Research│Oct 22, 2013

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New Drug May Overcome Cancer Treatment Resistance

An experimental drug could keep melanomas and breast cancer from resisting targeted therapies, according to findings reported at the 2013 International Conference on Molecular Targets and Cancer Therapeutics. Called LEE011, the new drug inhibits proteins called cyclin-dependent kinases (CDKs), which make cells divide. The targeted CDKs are abnormally active in many cancers, including melanomas with BRAF mutations and breast cancers with PIK3CA mutations. The researchers found that LEE011 keeps cultured tumor cells from dividing and that combining the drug with targeted treatments prevents resistance in melanomas and breast cancer in mice. Now, these combination treatments are being tested in several phase I clinical trials on a variety of cancers in adults, as well as in children.

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American Association for Cancer Research │Oct 20, 2013

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Immunotherapies Against Melanoma Get Into Shape

Immunotherapies Against Melanoma Get Into Shape | Melanoma Dispatch | Scoop.it

In an attempt to boost our natural immune response to cancer, some researchers have tried putting pieces of tumor proteins on tiny artificial particles and mixing them with immune system cells. When the immune cells come into contact with the particles, they 'learn' what tumors look like, so that they will seek out and attack tumors in the body. The technique sounds great in theory, but has been disappointing in practice so far. Now, new research shows that the shape of these artificial particles makes all the difference. The spherical particles that are typically used hardly touch immune system cells. But the overlap is far greater with elongated particles—and these also shrink tumors better. Spherical particles shrank melanomas in mice by 50%, while elongated particles shrank them by 75%. Even better, while none of the mice treated with spherical particles survived for a month, 25% of those treated with elongated particles did.

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Biomaterials│Oct 5, 2013

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ClinicalTrials.gov Reopens Despite U.S. Government Shutdown

ClinicalTrials.gov Reopens Despite U.S. Government Shutdown | Melanoma Dispatch | Scoop.it

Numerous federal services in the U.S. have been suspended due to the ongoing government shutdown. Among the services affected was the federal registry of clinical trials, accessible via the website ClinicalTrials.gov. New trials were not being entered into the registry and made available for enrollment. As a result, many people, including patients with advanced cancer, were unable to enroll in studies offering potentially lifesaving experimental treatments. However, after a U.S. Congressman contacted the National Institutes of Health (NIH), which administers the database, a small number of furloughed workers was called back to reopen the website. While the website is not fully operational, processing of clinical trial registrations has resumed, along with updates of the most critical information.

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Science Insider | Oct 4, 2013

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Science Insider | Oct 4, 2013

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Science Insider | Oct 4, 2013

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Blood Pressure Drug Boosts Chemotherapy Delivery in Mice

Blood Pressure Drug Boosts Chemotherapy Delivery in Mice | Melanoma Dispatch | Scoop.it

One reason chemotherapies fail is that blood vessels are collapsed in the middle of tumors, blocking the delivery of anticancer drugs. Now, new research suggests that a blood pressure drug called losartan may facilitate chemotherapy throughout tumors. Losartan decompresses tumor blood vessels, increasing blood flow and chemotherapy drug delivery in mouse models of breast and pancreatic cancer. To see if these findings will also hold for people, a phase II clinical trial of pancreatic cancer patients is underway. This trial is currently accepting new participants.

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Nature Communications │Oct 1, 2013

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Nature Communications │Oct 1, 2013

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Nature Communications │Oct 1, 2013

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New Combo-Targeted Treatment for Melanoma Wows in Early Trial

New Combo-Targeted Treatment for Melanoma Wows in Early Trial | Melanoma Dispatch | Scoop.it

Results are encouraging in an ongoing clinical trial of a BRAF inhibitor combined with a MEK inhibitor, according to a presentation at the 2013 European Cancer Congress in Amsterdam, Netherlands. The BRAF inhibitor is vemurafenib, which is approved by the U.S. Food and Drug Administration (FDA), and the MEK inhibitor is cobimetinib (GDC-0973/XL518), which is experimental. The phase I trial has 128 people with melanomas that have BRAFV600 mutations; about half had been treated with BRAF inhibitors previously, while the other half had not. Tumors shrank in 15% of participants and didn't grow in 43% of those who had been previously treated with BRAF inhibitors. Even better, tumors disappeared in 10%, shrank in 75%, and didn't grow in 13% of those who had not been previously treated with BRAF inhibitors.

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Business Wire│Sep 28, 2013

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Higher Healthcare Spending Associated with Fewer Cancer Deaths

The more a country’s government spends on healthcare, the lower the rate of deaths from cancer in that nation, a study in the European Union (EU) found. Higher gross domestic product (GDP), a higher percentage of GDP invested in healthcare, and more health expenditure per person per year were all linked to fewer deaths from cancer. EU member nations who score higher on these factors actually record a higher incidence of cancer, possibly because of better screening programs that detect more cases of cancer. However, in these countries, a significantly lower proportion of those diagnosed with cancer die from it.

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ScienceDaily | Sep 27, 2013

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ScienceDaily | Sep 27, 2013

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ScienceDaily | Sep 27, 2013