The 2010 Health Care Reform Act: A Potential Opportunity to Advance Cancer Research by Taking Cancer Personally

Dalton, William S.; Sullivan, Daniel M.; Yeatman, Timothy J.; Fenstermacher, David

doi:10.1158/1078-0432.ccr-10-1216

Cited by 15 publications

(14 citation statements)

References 33 publications

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“…The successful factors for improvement of the cancer registration in Taiwan may be due to the enactment of the Cancer Control Act; excellent collaboration among governmental agencies, hospitals and TSCR; and easy and free accessibility to healthcare of cancer patients. In addition to cancer registration information, it is important to develop a health information system to provide a network of healthcare providers, governmental agencies and researchers who may contribute and share information from individual patients to ultimately improve the care of all patients by learning from the experience of others (6). The ultimate goal is to use big databases to create a platform that will assemble expertise and make cancer care more accessible to more people.…”

Section: Future Developments Of Cancer Registry In Taiwanmentioning

confidence: 99%

Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review

Chiang

You

Chen

et al. 2015

Japanese Journal of Clinical Oncology

232

191

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Cancer registration provides core information for cancer surveillance and control. The populationbased Taiwan Cancer Registry was implemented in 1979. After the Cancer Control Act was promulgated in 2003, the completeness (97%) and data quality of cancer registry database has achieved at an excellent level. Hospitals with 50 or more beds, which provide outpatient and hospitalized cancer care, are recruited to report 20 items of information on all newly diagnosed cancers to the central registry office (called short-form database). The Taiwan Cancer Registry is organized and funded by the Ministry of Health and Welfare. The National Taiwan University has been contracted to operate the registry and organized an advisory board to standardize definitions of terminology, coding and procedures of the registry's reporting system since 1996. To monitor the cancer care patterns and evaluate the cancer treatment outcomes, central cancer registry has been reformed since 2002 to include detail items of the stage at diagnosis and the first course of treatment (called long-form database). There are 80 hospitals, which count for >90% of total cancer cases, involved in the long-form registration. The Taiwan Cancer Registry has run smoothly for >30 years, which provides essential foundation for academic research and cancer control policy in Taiwan.

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Section: Future Developments Of Cancer Registry In Taiwanmentioning

confidence: 99%

Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review

Chiang

You

Chen

et al. 2015

Japanese Journal of Clinical Oncology

232

191

View full text Add to dashboard Cite

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“…The RIE is able to use web services to link to external data sources such as National Center for Biotechnology Information (NCBI) that allows researchers to access the latest information while not requiring these resources be managed and maintained locally. In addition, MCC is exploring new ways to integrate data from other healthcare provides and caregivers to continue the evolution of the RIE through the creation of comprehensive longitudinal patient records through a federated network data model (15). The RIE along with resources under development such as clinical pathways will form the foundation to create evidence-based guidelines for personalized cancer treatment and facilitate the development of rapid learning systems (16).…”

Section: Data Management: Creation Of a Research Information Exchangementioning

confidence: 99%

Implementing Personalized Medicine in a Cancer Center

Fenstermacher

Wenham²,

Rollison³

et al. 2011

The Cancer Journal

Self Cite

127

107

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In 2006, the Moffitt Cancer Center partnered with patients, community clinicians, industry, academia, and seventeen hospitals in the United States to begin a personalized cancer care initiative called Total Cancer Care™ . Total Cancer Care was designed to collect tumor specimens and clinical data throughout a patient’s lifetime with the goal of finding “the right treatment, for the right patient, at the right time.” Because Total Cancer Care is a partnership with the patient and involves collection of clinical data and tumor specimens for research purposes, a formal protocol and patient consent process was developed and an information technology platform was constructed to provide a robust “warehouse” for clinical and molecular profiling data. To date, over 76,000 cancer patients from Moffitt and consortium medical centers have been enrolled in the protocol. The TCC initiative has developed many of the capabilities and resources that are building the foundation of personalized medicine.

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“…Most importantly, we must understand what our obligation is to each of the four stakeholders, with the foremost being the patient. As discussed by Dalton and colleagues (26) elsewhere in this CCR FOCUS series, the enactment of the 2010 United States Health Care Reform Act offers potential opportunities for realizing the promise of translational research and personalized medicine. By helping to define select patient subsets, which may allow a candidate drug to either move forward or halt development early on, investigators and patients may be able to contribute much more to the treatment of the cancer patient population, while also satisfying the financial stakeholders who stand to benefit from more efficiently executed studies.…”

Section: The Future Of Phase I Trialsmentioning

confidence: 99%

Making the Investigational Oncology Pipeline More Efficient and Effective: Are We Headed in the Right Direction?

LoRusso

Anderson

Boerner

et al. 2010

Clinical Cancer Research

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Advances in our knowledge of the molecular mechanisms involved in cancer biology have contributed to an increase in novel target-specific oncology therapeutics. Unfortunately, clinical development of new drugs is an expensive and slow process, and the patient and financial resources needed to study the vast number of potential therapies are limited, requiring novel approaches to clinical trial design and patient recruitment. In addition, traditional efficacy endpoints may not be adequate to fully determine the therapeutic worth of the new classes of targeted agents. In this new era of drug development, it has become increasingly clear that new clinical trial design paradigms that examine nontraditional endpoints have become necessary to assist in prioritizing the development of the most promising agents. It is also vital that individual patient management be considered, and the subpopulations of patients most likely to derive benefit or experience harm from a new therapy be identified as early as possible. Phase I and II clinical trials allow investigators doing clinical research the opportunity to define these critical endpoints and subpopulations early on, before conducting large-scale randomized phase III clinical trials, which require an abundance of financial and patient resources. Clin Cancer Res; 16(24); 5956-62. Ó2010 AACR.Principles driving oncology clinical trial design were primarily developed in the 1970s, during the introduction of many cytotoxic anticancer therapies. In the current era of molecularly targeted therapy, these traditional clinical trial design principles and trial endpoints are being reconsidered. At present, the most widely accepted metric for therapeutic utility remains improvement in the length of survival. However, alternate endpoints, such as time to disease progression, durable overall response rate, or improvement in disease-related symptoms, may be more appropriate endpoints for different classes of agents being evaluated. A major goal in clinical cancer drug development is to obtain regulatory approval for an efficacious agent and, to reach this goal, developers must often evaluate a novel therapy through a pivotal randomized control trial (RCT). As the proliferation of molecularly targeted agents has increased, it is important to refine the critical steps that lead to RCT design and execution. This article proposes innovative approaches to earlier phase I and II trials, which may ultimately yield change in how we design, conduct, and inform RCTs as we advance into the next generation of oncology clinical trials. Phase I Trials: Novel Designs and Impact on Patient Outcome(s)Currently, nearly 900 novel cancer agents are undergoing investigation in more than 6,000 clinical trials (1-3). Owing to this large number of investigational agents, a critical lack of financial and patient resources significantly reduces the chances for adequate development of many of these agents. As a result, clinical drug developers require continual innovation in their approaches to best dete...

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The 2010 Health Care Reform Act: A Potential Opportunity to Advance Cancer Research by Taking Cancer Personally

Cited by 15 publications

References 33 publications

Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review

Quality assessment and improvement of nationwide cancer registration system in Taiwan: a review

Implementing Personalized Medicine in a Cancer Center

Making the Investigational Oncology Pipeline More Efficient and Effective: Are We Headed in the Right Direction?

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