-
Current Problems in Cancer Oct 2023High-quality communication is essential for the optimal care of children with cancer and their families. There are opportunities for pediatric oncologists to engage in... (Review)
Review
High-quality communication is essential for the optimal care of children with cancer and their families. There are opportunities for pediatric oncologists to engage in clear and compassionate prognostic communication across the disease trajectory including at the time of diagnosis, disease recurrence or progression, and end of life. Contrary to previously held beliefs, prognostic disclosure supports parental hope and meets the needs and expectations of families who prefer honest conversations about prognosis. These communication encounters can be challenging with many oncologists having little training in this important skill. In this summary, we aim to provide practical guidance for prognostic communication in pediatric cancer across the illness trajectory giving phrases we have found helpful including a brief overview of some published communication frameworks utilized in the care of pediatric oncology patients and families.
Topics: Child; Humans; Communication; Medical Oncology; Neoplasms; Parents; Prognosis
PubMed: 37838548
DOI: 10.1016/j.currproblcancer.2023.101009 -
Seminars in Radiation Oncology Oct 2023The concept of informed consent has evolved considerably over the course of the 20th century, leading to its establishment as a foundational ethical principle for the... (Review)
Review
The concept of informed consent has evolved considerably over the course of the 20th century, leading to its establishment as a foundational ethical principle for the conduct of biomedical research in the United States. Even though it is now a highly regulated part of cancer research, the process of obtaining informed consent is often impeded by systemic, clinician, and patient factors that require both small- and large-scale intervention. New challenges and considerations continue to emerge due to innovations in clinical trial design, increases in utilization of genomic sequencing, and advances in genomic editing and artificial intelligence. We present a review of the history, policy, pragmatic challenges, and evolving role of the central ethical tenet of informed consent in clinical trials.
Topics: Humans; Artificial Intelligence; Clinical Trials as Topic; Informed Consent; Neoplasms
PubMed: 37684064
DOI: 10.1016/j.semradonc.2023.06.001 -
International Journal of Molecular... May 2024Cancer heterogeneity presents a major obstacle in clinical practice that grants tumor cells remarkable levels of resilience, adaptability, and invasiveness [...].
Cancer heterogeneity presents a major obstacle in clinical practice that grants tumor cells remarkable levels of resilience, adaptability, and invasiveness [...].
Topics: Humans; Neoplasms; Precision Medicine; Medical Oncology
PubMed: 38891765
DOI: 10.3390/ijms25115577 -
Revue Medicale de Liege May 2024Clinical research is summarizing scientific trials performed in human aiming to improve biological and medical knowledges. The management of such an activity has to be... (Review)
Review
Clinical research is summarizing scientific trials performed in human aiming to improve biological and medical knowledges. The management of such an activity has to be conducted in a secured environment in terms of expertise, competency and professionalism of involved actors. In the field of cancer, multidisciplinarity is key in the treatment of malignant disease and plays a major role sequentially or concomitantly. In the 90s, clinical research in radiation oncology obtained historical successes, which remain validated guidelines for national societies in a significant number of clinical situations. They concern not only technological improvements but also combined modality treatments with chemotherapy, hormonal therapy and potentially new targeted agents. Radiotherapy, in a palliative or in a curative setting, benefited from dramatic technological improvements aiming to address patient quality of life after radiation therapy. Actually, the emergence of artificial intelligence is willing to modify our current practice historically based on old concepts of clinical evaluation.
Topics: Humans; Radiation Oncology; Biomedical Research; Neoplasms
PubMed: 38778642
DOI: No ID Found -
Pediatric Blood & Cancer Sep 2023The Children's Oncology Group (COG) Epidemiology Committee has a primary focus on better understanding the etiologies of childhood cancers. Over the past 10 years, the...
The Children's Oncology Group (COG) Epidemiology Committee has a primary focus on better understanding the etiologies of childhood cancers. Over the past 10 years, the committee has leveraged the Childhood Cancer Research Network, and now more recently Project:EveryChild (PEC), to conduct epidemiologic assessments of various childhood cancers, including osteosarcoma, neuroblastoma, germ cell tumors, Ewing sarcoma, rhabdomyosarcoma, and Langerhans cell histiocytosis. More recent studies have utilized questionnaire data collected as part of PEC to focus on specific characteristics and/or features, including the presence of congenital disorders and the availability of stored cord blood. Members of the COG Epidemiology Committee have also been involved in other large-scale National Institutes of Health efforts, including the Childhood Cancer Data Initiative and the Gabriella Miller Kids First Pediatric Research Program, which are improving our understanding of the factors associated with childhood cancer risk. Future plans will focus on addressing questions surrounding health disparities, utilizing novel biospecimens in COG epidemiology studies, exploring the role of environmental factors on the etiologies and outcomes of childhood cancer, collaborating with other COG committees to expand the role of epidemiology in childhood cancer research, and building new epidemiologic studies from the Molecular Characterization Initiative-all with the ultimate goal of developing novel prevention and intervention strategies for childhood cancer.
Topics: Child; Humans; Neoplasms; Sarcoma, Ewing; Medical Oncology; Rhabdomyosarcoma; Osteosarcoma; Bone Neoplasms
PubMed: 37449937
DOI: 10.1002/pbc.30566 -
Surgical Oncology Clinics of North... Apr 2024Pediatric precision oncology has provided a greater understanding of the wide range of molecular alterations in difficult-to-treat or rare tumors with the aims of... (Review)
Review
Pediatric precision oncology has provided a greater understanding of the wide range of molecular alterations in difficult-to-treat or rare tumors with the aims of increasing survival as well as decreasing toxicity and morbidity from current cytotoxic therapies. In this article, the authors discuss the current state of pediatric precision oncology which has increased access to novel targeted therapies while also providing a framework for clinical implementation in this unique population. The authors evaluate the targetable mutations currently under investigation-with a focus on pediatric solid tumors-and discuss the key surgical implications associated with novel targeted therapies.
Topics: Child; Humans; Neoplasms; Precision Medicine; Medical Oncology; Antineoplastic Agents; Mutation; Molecular Targeted Therapy
PubMed: 38401917
DOI: 10.1016/j.soc.2023.12.008 -
Cellular Oncology (Dordrecht) Jun 2024In the past decades, cancer enigmatical heterogeneity at distinct expression levels could interpret disparities in therapeutic response and prognosis. It built... (Review)
Review
BACKGROUND
In the past decades, cancer enigmatical heterogeneity at distinct expression levels could interpret disparities in therapeutic response and prognosis. It built hindrances to precision medicine, a tactic to tailor customized treatment informed by the tumors' molecular profile. Single-omics analysis dissected the biological features associated with carcinogenesis to some extent but still failed to revolutionize cancer treatment as expected. Integrated omics analysis incorporated tumor biological networks from diverse layers and deciphered a holistic overview of cancer behaviors, yielding precise molecular classification to facilitate the evolution and refinement of precision medicine.
CONCLUSION
This review outlined the biomarkers at multiple expression layers to tutor molecular classification and pinpoint tumor diagnosis, and explored the paradigm shift in precision therapy: from single- to multi-omics-based subtyping to optimize therapeutic regimens. Ultimately, we firmly believe that by parsing molecular characteristics, omics-based typing will be a powerful assistant for precision oncology.
Topics: Humans; Precision Medicine; Neoplasms; Medical Oncology; Biomarkers, Tumor; Genomics; Proteomics
PubMed: 38294647
DOI: 10.1007/s13402-023-00912-8 -
Innere Medizin (Heidelberg, Germany) May 2024Precision oncology is a field of personalized medicine in which tumor biology forms the basis for tailored treatments. The preferred approach currently applied in... (Review)
Review
Precision oncology is a field of personalized medicine in which tumor biology forms the basis for tailored treatments. The preferred approach currently applied in clinical practice is based on the concept of malignant tumors as genetic diseases that are caused by mutations in oncogenes and tumor suppressors. On the one hand, these can be targeted by molecular drugs, while on the other hand, next-generation sequencing allows for comprehensive analysis of all relevant aberrations, thus enabling the matching of appropriate treatments across entities based on molecular information. Rational molecular therapies are developed and annotated with supporting evidence by molecular tumor boards, which have been established at various academic centers in recent years. Advancing precision oncology to a new standard of care requires improved applicability of personalized molecular therapies and thorough scientific evaluation of precision oncology programs.
Topics: Humans; High-Throughput Nucleotide Sequencing; Medical Oncology; Molecular Targeted Therapy; Neoplasms; Precision Medicine
PubMed: 38652307
DOI: 10.1007/s00108-024-01689-0 -
Seminars in Oncology Nursing Apr 2024
Topics: Humans; Patient Navigation; Neoplasms; Oncology Nursing
PubMed: 38360499
DOI: 10.1016/j.soncn.2024.151591 -
The British Journal of Radiology Oct 2023Multiomics data including imaging radiomics and various types of molecular biomarkers have been increasingly investigated for better diagnosis and therapy in the era of... (Review)
Review
Multiomics data including imaging radiomics and various types of molecular biomarkers have been increasingly investigated for better diagnosis and therapy in the era of precision oncology. Artificial intelligence (AI) including machine learning (ML) and deep learning (DL) techniques combined with the exponential growth of multiomics data may have great potential to revolutionize cancer subtyping, risk stratification, prognostication, prediction and clinical decision-making. In this article, we first present different categories of multiomics data and their roles in diagnosis and therapy. Second, AI-based data fusion methods and modeling methods as well as different validation schemes are illustrated. Third, the applications and examples of multiomics research in oncology are demonstrated. Finally, the challenges regarding the heterogeneity data set, availability of omics data, and validation of the research are discussed. The transition of multiomics research to real clinics still requires consistent efforts in standardizing omics data collection and analysis, building computational infrastructure for data sharing and storing, developing advanced methods to improve data fusion and interpretability, and ultimately, conducting large-scale prospective clinical trials to fill the gap between study findings and clinical benefits.
Topics: Humans; Artificial Intelligence; Neoplasms; Multiomics; Prospective Studies; Precision Medicine; Machine Learning
PubMed: 37660402
DOI: 10.1259/bjr.20230211