Audio and slides for this presentation are available on YouTube: http://youtu.be/6W_xoH4s-Yk
Dr. Patrick Wen, of Dana-Farber Cancer Institute's Center for Neuro-Oncology, discusses current clinical trial options for brain tumor patients and some of the new therapies available in neuro-oncology. This presentation was originally given at Dana-Farber Cancer Institute on Dec. 4, 2013.
Side Effects Management for the Ovarian Cancer Communitybkling
Dr. William Tew of Memorial Sloan Kettering Cancer Center discusses how to manage side effects of targeted therapies for ovarian cancer. Dr. Tew also discusses the severity of your side effects, communicating them to your doctor, and the latest information on symptom-tracking tools.
Cancer is a leading cause of death in developed countries. In this webcast Dr. Andreas Scherer will explain how personalized medicine can transform our approach to fighting this disease. He will also discuss current roadblocks and diagnostic challenges, and the pivotal role of Next Gen Sequencing to overcome these challenges.
The webcast will inform about best practices to design and implement a cancer testing pipeline: from sample preparation, to sequencing, to secondary and tertiary analysis of sequencing data. The goal is to rapidly identify clinically actionable data that allows an oncologist to quickly determine the best available treatment options.
The webcast will include demonstrations of the Golden Helix VarSeq software in the context of analyzing cancer gene panels and somatic mutations.
SHARE: Metastatic Breast Cancer: Cutting-Edge Research from National Cancer w...bkling
Patricia Steeg, PhD, Chief of Women's Cancers Section at the Center for Cancer Research at NCI, will present her novel research relating to metastatic breast cancer, including the development of experimental models of brain metastasis. Join SHARE and Dr. Steeg for this nformative webinar.
Side Effects Management for the Ovarian Cancer Communitybkling
Dr. William Tew of Memorial Sloan Kettering Cancer Center discusses how to manage side effects of targeted therapies for ovarian cancer. Dr. Tew also discusses the severity of your side effects, communicating them to your doctor, and the latest information on symptom-tracking tools.
Cancer is a leading cause of death in developed countries. In this webcast Dr. Andreas Scherer will explain how personalized medicine can transform our approach to fighting this disease. He will also discuss current roadblocks and diagnostic challenges, and the pivotal role of Next Gen Sequencing to overcome these challenges.
The webcast will inform about best practices to design and implement a cancer testing pipeline: from sample preparation, to sequencing, to secondary and tertiary analysis of sequencing data. The goal is to rapidly identify clinically actionable data that allows an oncologist to quickly determine the best available treatment options.
The webcast will include demonstrations of the Golden Helix VarSeq software in the context of analyzing cancer gene panels and somatic mutations.
SHARE: Metastatic Breast Cancer: Cutting-Edge Research from National Cancer w...bkling
Patricia Steeg, PhD, Chief of Women's Cancers Section at the Center for Cancer Research at NCI, will present her novel research relating to metastatic breast cancer, including the development of experimental models of brain metastasis. Join SHARE and Dr. Steeg for this nformative webinar.
What's the latest in breast cancer treatment and research? Erica Mayer, MD, MPH, a medical oncologist in the Susan F. Smith Center for Women's Cancers, shares the latest breast cancer news.
This presentation was originally given on Oct. 16, 2015, at the annual Young Women with Breast Cancer Forum, hosted by the Program for Young Women with Breast Cancer in the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, in Boston, Mass.
Learn more: http://www.susanfsmith.org
On April 5, 2014 the MRF partnered with Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Center to provide a free educational event dedicated to melanoma patients and the people who support them.
Dr. Jennifer Wargo presents the latest on research biopsies and translational research in melanoma at the MRF's Patient Symposium at MD Anderson Cancer Center on January 31, 2015.
Triple Negative Breast Cancer and Women of Color (Slide 1)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month.
In this session, H. Kim Lyerly, MD, FACS, Director of the Center of Applied Therapeutics at Duke University, discussed research in tumor dormancy in breast cancer. Topics included the role of disseminated tumor cells, the bone marrow, and the potential for immune responses to control or prevent recurrences. Q&A period followed
Opportunities for Immune Therapy and Preventionbkling
Dr. Margaret Gatti-Mays of the National Cancer Institute, a Staff Clinician of Laboratory of Tumor Immunology and Biology and the Co-Director of the Clinical Trial Group, explores the future of immunotherapy in breast cancer treatment.
Geoffrey Oxnard, MD, discusses the latest research in targeted therapies and molecular testing to treat lung cancer.
This presentation was originally given as part of "Living with Lung Cancer: A Forum for Patients and Caregivers" on Nov. 14, 2015 at Dana-Farber Cancer Institute in Boston, Mass.
This slidedeck presents an up-to-date disease overview of BCC, reviews current treatment options in BCC, explains the hedgehog signaling pathway and its role in BCC, review recent data of the first-in-class hedgehog inhibitor, vismodegib, and other novel agents in clinical trials. Faculty will also review recently approved novel agents in melanoma, to include treatment planning and managing adverse events. Case studies will demonstrate the practical application of current and emerging clinical evidence for the treatment of BCC and melanoma. During the panel discussion, faculty will discuss the importance of cross-communication in the treatment planning process and strategies to optimize the continuum of care for patients with BCC.
Alphabet Soup - Biomarker testing for colon and rectal cancer patients - KRAS...Fight Colorectal Cancer
Dr. Cathy Eng's presentation regarding biomarkers. Explaining why colon and rectal cancer patients should undergo testing for KRAS, NRAS and other tumor tests.
Anna F. Farago, MD, PhD, prepared useful Practice Aids pertaining to TRK fusions for this CME/MOC activity titled "The TRK to Tumor-Agnostic Care in Solid Tumors: A Pathology-Focused Guide to the Clinical Role of TRK Fusions in Personalizing Cancer Therapy." For the full presentation, monograph, complete CME/MOC information, and to apply for credit, please visit us at http://bit.ly/2B5pvJy. CME/MOC credit will be available until February 6, 2020.
Melinda Yushak, MD, MPH, a medical oncologist at Winship Cancer Institute of Emory University presents How to Approach Systemic Treatment for Metastatic Disease (Ocular Melanoma) at the 2016 CURE OM Patient & Caregiver Symposium.
Audio and slides for this presentation are available on YouTube: http://youtu.be/0xdxTYeGwTE
Dana-Farber nutritionist Stacy Kennedy, MPH, RD, provides nutrition tips for brain tumor patients and survivors, including recipes and meal suggestions. This presentation was originally given at Dana-Farber Cancer Institute on March 21, 2014.
Audio and slides for this presentation are available on YouTube: http://youtu.be/FyL7sCDc4Zc
Mikael Rinne, MD, PhD, of Dana-Farber Cancer Institute's Center for Neuro-Oncology, discusses the science and genetics behind brain tumors. Rinne covers how scientists can discover DNA alterations in cancer, which alterations are found in brain tumors, and what scientists can do about the alterations.
This talk was originally given at Dana-Farber's "Living with Brain Tumors" forum on Sept. 7, 2013.
For more information, visit the website for Dana-Farber's Center for Neuro-Oncology: http://bit.ly/13nlpEv
What's the latest in breast cancer treatment and research? Erica Mayer, MD, MPH, a medical oncologist in the Susan F. Smith Center for Women's Cancers, shares the latest breast cancer news.
This presentation was originally given on Oct. 16, 2015, at the annual Young Women with Breast Cancer Forum, hosted by the Program for Young Women with Breast Cancer in the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, in Boston, Mass.
Learn more: http://www.susanfsmith.org
On April 5, 2014 the MRF partnered with Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Center to provide a free educational event dedicated to melanoma patients and the people who support them.
Dr. Jennifer Wargo presents the latest on research biopsies and translational research in melanoma at the MRF's Patient Symposium at MD Anderson Cancer Center on January 31, 2015.
Triple Negative Breast Cancer and Women of Color (Slide 1)bkling
In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month.
In this session, H. Kim Lyerly, MD, FACS, Director of the Center of Applied Therapeutics at Duke University, discussed research in tumor dormancy in breast cancer. Topics included the role of disseminated tumor cells, the bone marrow, and the potential for immune responses to control or prevent recurrences. Q&A period followed
Opportunities for Immune Therapy and Preventionbkling
Dr. Margaret Gatti-Mays of the National Cancer Institute, a Staff Clinician of Laboratory of Tumor Immunology and Biology and the Co-Director of the Clinical Trial Group, explores the future of immunotherapy in breast cancer treatment.
Geoffrey Oxnard, MD, discusses the latest research in targeted therapies and molecular testing to treat lung cancer.
This presentation was originally given as part of "Living with Lung Cancer: A Forum for Patients and Caregivers" on Nov. 14, 2015 at Dana-Farber Cancer Institute in Boston, Mass.
This slidedeck presents an up-to-date disease overview of BCC, reviews current treatment options in BCC, explains the hedgehog signaling pathway and its role in BCC, review recent data of the first-in-class hedgehog inhibitor, vismodegib, and other novel agents in clinical trials. Faculty will also review recently approved novel agents in melanoma, to include treatment planning and managing adverse events. Case studies will demonstrate the practical application of current and emerging clinical evidence for the treatment of BCC and melanoma. During the panel discussion, faculty will discuss the importance of cross-communication in the treatment planning process and strategies to optimize the continuum of care for patients with BCC.
Alphabet Soup - Biomarker testing for colon and rectal cancer patients - KRAS...Fight Colorectal Cancer
Dr. Cathy Eng's presentation regarding biomarkers. Explaining why colon and rectal cancer patients should undergo testing for KRAS, NRAS and other tumor tests.
Anna F. Farago, MD, PhD, prepared useful Practice Aids pertaining to TRK fusions for this CME/MOC activity titled "The TRK to Tumor-Agnostic Care in Solid Tumors: A Pathology-Focused Guide to the Clinical Role of TRK Fusions in Personalizing Cancer Therapy." For the full presentation, monograph, complete CME/MOC information, and to apply for credit, please visit us at http://bit.ly/2B5pvJy. CME/MOC credit will be available until February 6, 2020.
Melinda Yushak, MD, MPH, a medical oncologist at Winship Cancer Institute of Emory University presents How to Approach Systemic Treatment for Metastatic Disease (Ocular Melanoma) at the 2016 CURE OM Patient & Caregiver Symposium.
Audio and slides for this presentation are available on YouTube: http://youtu.be/0xdxTYeGwTE
Dana-Farber nutritionist Stacy Kennedy, MPH, RD, provides nutrition tips for brain tumor patients and survivors, including recipes and meal suggestions. This presentation was originally given at Dana-Farber Cancer Institute on March 21, 2014.
Audio and slides for this presentation are available on YouTube: http://youtu.be/FyL7sCDc4Zc
Mikael Rinne, MD, PhD, of Dana-Farber Cancer Institute's Center for Neuro-Oncology, discusses the science and genetics behind brain tumors. Rinne covers how scientists can discover DNA alterations in cancer, which alterations are found in brain tumors, and what scientists can do about the alterations.
This talk was originally given at Dana-Farber's "Living with Brain Tumors" forum on Sept. 7, 2013.
For more information, visit the website for Dana-Farber's Center for Neuro-Oncology: http://bit.ly/13nlpEv
Dana-Farber exercise physiologist Nancy Campbell, MS, provides exercise and fitness tips that can help brain tumor survivors stay healthy during and after treatment. This talk was originally given at Dana-Farber Cancer Institute on March 21, 2014. To view the presentation with audio, visit this link: http://youtu.be/0xdxTYeGwTE
Power Foods for the Brain, a new book by noted nutrition researcher and New York Times best-selling author Neal Barnard, M.D., reveals how simple diet changes can shield the brain from memory loss, stroke, and Alzheimer’s.
For more information: http://nealbarnard.org/books/
Implementation of CDISC ADAM in The Pharmacokinetics DepartmentSGS
SGS Life Science Services as a leading CRO, is one of the pioneers in the implementation of CDISC standards. Given the positive experiences in the SGS Data Management and Biostatistics Departments (implementation of SDTM and ADaM respectively), the Pharmacokinetics (PK) Department recently decided to adopt the CDISC standards as well.
In an SDTM database, pharmacokinetic data is stored as one record per subject, per time point (PC domain) or per pharmacokinetic parameter (PP domain). For the PK analysis, the generation of Tables, Listings and Figures, and the statistical analysis on PK parameters, ‘analysis ready’ datasets are created.
Biological responses to tumor hypoxia & their potential as therapeutic targetsMAASTRO clinic
Lecture by Dr. Brad Wouters in the context of the Course: "Tumour Hypoxia: From Biology to Therapy III".
For the complete e-Course see http://www.myhaikuclass.com/MaastroClinic/metoxia
SDTM (Study Data Tabulation Model) defines a standard structure for human clinical trial (study) data tabulations and for nonclinical study data tabulations that are to be submitted as part of a product application to a regulatory authority such as the United States Food and Drug Administration (FDA).
Open Source Pharma /Genomics and clinical practice / Prof Hosur opensourcepharmafound
Access to Research
Date 11-08-2018
Venue Conference HAll NIAS IISc campus
Conference and workshops for clinical practitioners to introduce them to modern tools and an alternative approach to modern scientific research.
Purpose
1. Build a network of physicians across the country
2 Train physicians to analyse clinical data and restructure it to make it compatible with research standards
3. Introduce modern tools to understand the mechanism of actions of medicine
4. Introduce artificial intelligence and machine learning to clinical practitioners to support decision-making processes
Access to Science
Clinical experience and traditional knowledge are important sources of data that affect decision making processes in modern healthcare systems. This data should be made accessible for scientific evaluation and validation to improve healthcare worldwide. The Open Source Pharma Foundation believes that clinical practitioners from various disciplines should have the right to access research so that they can help identify problems, contribute their scientific knowledge, and support the discovery ecosystem.
Background
The majority of medical practitioners working on the ground level with patients do not take part in open clinical research worldwide. However, the data collected and owned by them plays an important role in establishing better discovery pathways. Through this workshop, we seek to open opportunities to enhance health care systems around the world and to overcome the following challenges faced by medical practitioners.
1. Regulatory limitations
2. Academic limitations
3. Time constraints
4. Lack of access to modern tools
5. Lack of access to research facilities
Don't miss our upcoming webinars! Subscribe today!
Presented by: Dr. Poul Sorensen, MD, PhD, FRCPC; Dr. Muhammad Zulfiqar, MD; Ted Taylor, Patient Advocate
In this webinar, we will hear from Dr. Sorensen about his groundbreaking discovery and how it contributed to the development of tumour agnostic treatments. Dr. Zulfiqar, a medical oncologist at the BC Cancer Agency, will further discuss TRK fusion cancers and how he has been able to treat patients. Lastly, we will hear from Ted Taylor, a TRK fusion cancer patient diagnosed with glioblastoma (GBM) multiform being treated with Vitrakvi.
Watch the YouTube video: https://youtu.be/RAkItUeZ23Q
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Final presentation for BIOL405, NSC, Spring 2014. Presented by Kevin Hugins and Duy-Khiem Chanh Pham. This presentation addressed the use of Chimeric Antigen Receptors for gene therapy for cancer. Gene therapy was first conceptualized to alter debilitating fates of genetic diseases. Gene therapy technology can help introduce new functional DNA to replace mutated genes. The idea first arose in 1972 when Friedmann and Roblin authored a paper, “Gene therapy for human genetic disease?”, demonstrating that exogenous DNA can be taken up by mammalian cells (1). They proposed that the same procedure could be done on humans to correct genetic defects by introducing therapeutic DNA. Currently, genetic modification of T lymphocytes has been the major area of research for treating malignant tumors. This technique seeks to create chimeric antigen receptor (CAR) in T cells by genetically modifying them in vitro and reintroduce them back into blood circulation. The T cells are unique to every patient and the chimeric antigen receptors are unique to the tumor that it is targeting.
Morphologomics - Challenges for Surgical Pathology in the Genomic Age by Dr. ...Cirdan
This presentation introduces and discussesthe concept of ‘morphologomics’ that is omics approaches critically reimagined and reappraised from the viewpoint of classic morphology.
It was delivered by Dr. Anthony Gill at the Pathology Horizons 2017 conference in Cairns, Australia.
introduce and discuss the concept of ‘morphologomics’ that is omics approaches critically reimagined and reappraised from the viewpoint of classic morphology.
Sex-Based Difference in Gene Alterations and Biomarkers in Anal Squamous Cell...semualkaira
anal squamous cell carcinoma (ASCC) is a relatively rare malignancy ac-counting for about 2-3% of all the gastrointestinal tumors. The standard of treatment for localized disease is chemoradiotherapy
Similar to Clinical Trials for Brain Tumor Patients (20)
Commonly thought of as a childhood cancer, leukemia is actually much more common in adults. While symptoms of the disease are consistent among each, researchers are beginning to understand more about underlying biological factors that influence the different ways leukemia develops in children and adults. What are other differences and similarities?
An overview of Clinical Trials for Metastatic HER2-positive Breast Cancer by Dr. Ian Krop, MD, PhD, Chief and Clinical Research Director, Breast Oncology Center at Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute
Overview of clinical trials for metastatic triple-negative breast cancer by Sara M. Tolaney, MD, MPH, Associate Director and Associate Director of Clinical Research at Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute.
Research increasingly shows that “energy balance” is important in breast cancer. Learn why exercise, weight, and diet are important for breast cancer patients.
Prostate cancer is a disease in which cancer forms in the tissues of the prostate, a male gland just below the bladder and in front of the rectum. Prostate cancer is rare in men younger than 50 years of age, and the chance of developing prostate cancer increases as men get older. In the United States, a man has a one in five chance of being diagnosed with prostate cancer in his lifetime.
There are many different pediatric brain tumor types and classifications based upon the tumor’s cell structure, composition, rate of growth, location, and other characteristics. A child’s tumor may have the same microscopic appearance to an adult tumor, but the mutations that cause its growth are completely different.
Soft tissue sarcoma refers to cancer that begins in the muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. View the slideshow to learn more about signs and symptoms of this cancer, as well as risk factors.
Cancer-related fatigue is one of the most common problems patients face. Patients often report feeling wiped out during cancer treatments like chemotherapy and radiation, and for many, feeling tired or worn out continues into life after cancer treatment.
Here are 10 tips for alleviating treatment-related fatigue, through methods such as energy preservation and exercise – the latter of which is now known to be an effective strategy for combating this prevalent side effect.
There are more than 120 different types of brain tumors that may occur in adults. Learn about the five most common types.
For more on brain tumors, visit www.dana-farber.org/braintumor
Multiple myeloma is a type of cancer that begins in plasma cells, white blood cells that produce antibodies. It is also called Kahler's disease, myelomatosis or plasma cell myeloma.
Integrative therapies range from individual treatments, such as acupuncture, massage, and Reiki, to group programs for movement, meditation, and creative arts, as well as exercise and nutritional consultations.
Research conducted by Dana-Farber investigators and others has shown that, when used in conjunction with traditional cancer care, integrative therapies can help ease cancer-related symptoms and improve your quality of life.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Light House Retreats: Plant Medicine Retreat Europe
Clinical Trials for Brain Tumor Patients
1. Clinical Trials In Neuro-Oncology
Patrick Y. Wen, M.D.
Center For Neuro-Oncology, Dana-Farber Cancer Institute
Division of Cancer Neurology, Department of Neurology
Brigham and Women’s Hospital
Harvard Medical School
2. Clinical Trials
• Phase I
• Find the maximum safe dose
• Phase II
• Determine efficacy of drug at the maximum safe dose
• Phase III
• Compare effectiveness of drug to standard of care
6. Frequent genetic alterations
in three critical signalling
pathways.
The Cancer Genome Atlas Research Network Nature 000, 1-8 (2008) doi:10.1038/nature07385
7.
8.
9. PATIENTS WITH SAME DIAGNOSIS ARE NOT ALL THE SAME
Predicted good
response to drug or
combination of drugs
Predicted poor or no
response to drug or
combination of drugs
Increased likelihood of
toxicity of drug or
combination of drugs
CHANGE DRUGS
CHANGE DRUGS
10. PATIENTS WITH SAME DIAGNOSIS ARE NOT ALL THE SAME
Predicted good
response to drug or
combination of drugs
Predicted poor or no
response to drug or
combination of drugs
Increased likelihood of
toxicity of drug or
combination of drugs
CHANGE DRUGS
CHANGE DRUGS
11. PATIENTS WITH SAME DIAGNOSIS ARE NOT ALL THE SAME
Predicted good
response to drug or
combination of drugs
Predicted poor or no
response to drug or
combination of drugs
Increased likelihood of
toxicity of drug or
combination of drugs
CHANGE DRUGS
CHANGE DRUGS
12. PATIENTS WITH SAME DIAGNOSIS ARE NOT ALL THE SAME
Predicted good
response to drug or
combination of drugs
Predicted poor or no
response to drug or
combination of drugs
Increased likelihood of
toxicity of drug or
combination of drugs
CHANGE DRUGS
CHANGE DRUGS
13. Personalized Medicine
The Right Drug for the Right Person at the Right Time
This is the overarching goal of Dana-Farber’s research
14. Dramatic clinical responses to drugs
targeting BRAF
only in patients with the BRAF mutation!
Baseline
Day 15
Flaherty et al., ASCO 2009 (abstract #9000)
15. Sequencing
Epigenetic Analysis
Set of activated
kinases and
pathways
Combinations of
appropriate drugs
Ivy Foundation Early Phase
Clinical Trials Consortium
DF/HCC
MSKCC
UCLA
UCSF
MDACC
U Utah
17. DFCI/BWH “Living” Tissue Bank Program
CNS Tumor Patient
Primary tumor
Gentle
Dissociation
Papain
Tumorsphere culture
- Hydrogel
Comprehensive Analysis
- EGF and FGF
Laminin culture
- Laminin coating
- EGF and FGF
IHC
Stem/Lineage Assessment
RNA Expression
Affy U133 2.0 Plus
Whole Genome Copy Number
Agilent aCGH 1M
Somatic Mutation
Sequenom
Xenograft
- Orthotopic (striatum)
- SCID mice
- Serial passage
Sphere culture for GBM – Howard A. Fine, Cancer Cell 06
Laminin - Peter Dirks, Cell Stem Cell 09
Slide courtesy of Keith Ligon MD
18. GBM Patient-derived Cell Lines Reproduce Key
Features of GBM as in vivo preclinical models
A
Infiltrating borders
BT112
Necrosis
BT112
B
Pushing borders
BT189
Microvascular
Proliferation
BT187
C
Gliomatosis
BT179
Numa
Intratumoral
Hemorrhage
BT189
Slide courtesy of Keith Ligon MD
40. Single cell from neural tube
“neurosphere”
disaggregate & subcultivate
plate onto adherent surface
in factor-fee medium
Neuron
Astrocyte
Oligodendrocyte
42. Grow as neurospheres in vitro.
Neurospheres are multipotent
Highly tumorigenic in SCID mice.
Negative control:
(hemispherectomy tissue)
Oligodendrocyte
Astrocyte
Neuron
43.
44. GDC-0449
D. D. Von Hoff et al., N. Eng. J. Med. 164, 1164(2009).
Science 23 October 2009:
Vol. 326. no. 5952, pp. 572 - 574
DOI: 10.1126/science.1179386
51. Vander Heiden et al, 2009.
Teicher et al.
Clin Cancer Res
2012;18:5537-5545
52. IDH1 and IDH2 Mutations in Human Gliomas
Yan H et al. N Engl J Med 2009;360:765-773
53. Survival of Adult Patients with Malignant Gliomas with or without IDH Gene Mutations
Median Survival
31 mo vs 15 mo
Median Survival
65 mo vs 25 mo
Yan H et al. N Engl J Med 2009;360:765-773
54. IDH 1 & 2 as a Therapeutic Targets
Reitman et al, 2010.
The pharmacogenetics has many clinical potentials. Patients with the same diagnosis are typically treated with the same manner, although their responses to drug therapy will not be the same. Phamacogenetics has the potential to provide a tool for predicting those patients who are likely to have the desired response to the drug, those who are likely to have little or no benefit and those at risk for toxicity. This will allow tailored therapy that should reduce adverse reactions to drugs and increase efficacy rates.
The pharmacogenetics has many clinical potentials. Patients with the same diagnosis are typically treated with the same manner, although their responses to drug therapy will not be the same. Phamacogenetics has the potential to provide a tool for predicting those patients who are likely to have the desired response to the drug, those who are likely to have little or no benefit and those at risk for toxicity. This will allow tailored therapy that should reduce adverse reactions to drugs and increase efficacy rates.
The pharmacogenetics has many clinical potentials. Patients with the same diagnosis are typically treated with the same manner, although their responses to drug therapy will not be the same. Phamacogenetics has the potential to provide a tool for predicting those patients who are likely to have the desired response to the drug, those who are likely to have little or no benefit and those at risk for toxicity. This will allow tailored therapy that should reduce adverse reactions to drugs and increase efficacy rates.
The pharmacogenetics has many clinical potentials. Patients with the same diagnosis are typically treated with the same manner, although their responses to drug therapy will not be the same. Phamacogenetics has the potential to provide a tool for predicting those patients who are likely to have the desired response to the drug, those who are likely to have little or no benefit and those at risk for toxicity. This will allow tailored therapy that should reduce adverse reactions to drugs and increase efficacy rates.
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Inhibitor of smoothened, also showed benefit in basal cell carcinoma
The team found that a point mutation in Smoothened, a G-to-C substitution at position 1697 along the protein's length, prevented GDC-0449 from binding but did not alter the ability of Smoothened to switch on the Hedgehog pathway.
Fig. 2. Schematic representation of the differences between oxidative phosphorylation, anaerobic glycolysis, and aerobic glycolysis (Warburg effect).
In the presence of oxygen, nonproliferating (differentiated) tissues first metabolize glucose to pyruvate via glycolysis and then completely oxidize most of that pyruvate in the mitochondria to CO2 during the process of oxidative phosphorylation. Because oxygen is required as the final electron acceptor to completely oxidize the glucose, oxygen is essential for this process. When oxygen is limiting, cells can redirect the pyruvate generated by glycolysis away from mitochondrial oxidative phosphorylation by generating lactate (anaerobic glycolysis). This generation of lactate during anaerobic glycolysis allows glycolysis to continue (by cycling NADH back to NAD+), but results in minimal ATP production when compared with oxidative phosphorylation. Warburg observed that cancer cells tend to convert most glucose to lactate regardless of whether oxygen is present (aerobic glycolysis). This property is shared by normal proliferative tissues. Mitochondria remain functional and some oxidative phosphorylation continues in both cancer cells and normal proliferating cells. Nevertheless, aerobic glycolysis is less efficient than oxidative phosphorylation for generating ATP. In proliferating cells, ~10% of the glucose is diverted into biosynthetic pathways upstream of pyruvate production.
(Vander Heiden et al, 2009)
Fig. 3. Metabolic pathways active in proliferating cells are directly controlled by signaling pathways involving known oncogenes and tumor suppressor genes.
This schematic shows our current understanding of how glycolysis, oxidative phosphorylation, the pentose phosphate pathway, and glutamine metabolism are interconnected in proliferating cells. This metabolic wiring allows for both NADPH production and acetyl-CoA flux to the cytosol for lipid synthesis. Key steps in these metabolic pathways can be influenced by signaling pathways known to be important for cell proliferation. Activation of growth factor receptors leads to both tyrosine kinase signaling and PI3K activation. Via AKT, PI3K activation stimulates glucose uptake and flux through the early part of glycolysis. Tyrosine kinase signaling negatively regulates flux through the late steps of glycolysis, making glycolytic intermediates available for macromolecular synthesis as well as supporting NADPH production. Myc drives glutamine metabolism, which also supports NADPH production. LKB1/AMPK signaling and p53 decrease metabolic flux through glycolysis in response to cell stress. Decreased glycolytic flux in response to LKB/AMPK or p53 may be an adaptive response to shut off proliferative metabolism during periods of low energy availability or oxidative stress. Tumor suppressors are shown in red, and oncogenes are in green. Key metabolic pathways are labeled in purple with white boxes, and the enzymes controlling critical steps in these pathways are shown in blue. Some of these enzymes are candidates as novel therapeutic targets in cancer. Malic enzyme refers to NADP+-specific malate dehydrogenase [systematic name (S)-malate:NADP+ oxidoreductase (oxaloacetate-decarboxylating)].
(Vander Heiden et al, 2009)
Figure 1. IDH1 and IDH2 Mutations in Human Gliomas. Panel A shows mutations at codon R132 in IDH1 and R172 in IDH2 that were identified in human gliomas, along with the number of patients who carried each mutation. Codons 130 to 134 of IDH1 and 170 to 174 of IDH2 are shown. Panel B shows the number and frequency of IDH1 and IDH2 mutations in gliomas and other types of tumors. The roman numerals in parentheses are the tumor grades, according to histopathological and clinical criteria established by the World Health Organization. CNS denotes central nervous system.
Figure 3. Survival of Adult Patients with Malignant Gliomas with or without IDH Gene Mutations. For patients with glioblastomas, the median survival was 31 months for the 14 patients with mutated IDH1 or IDH2, as compared with 15 months for the 115 patients with wild-type IDH1 or IDH2 (Panel A). For patients with anaplastic astrocytomas, the median survival was 65 months for the 38 patients with mutated IDH1 or IDH2, as compared with 20 months for the 14 patients with wild-type IDH1 or IDH2 (Panel B). Patients with both primary and secondary tumors were included in the analysis. For patients with secondary glioblastomas, survival was calculated from the date of the secondary diagnosis. Survival distributions were compared with the use of the log-rank test.
Figure 1. Mutations in the Active Site of IDH1 and IDH2 Lead to a Neomorphic Enzyme Activity
Wild-type IDH1 and IDH2 normally catalyze the conversion of isocitrate to a-KG (left reaction) and at the same time reduce NADP+ to NADPH and produce CO2. R132 in wild-type IDH1, as well as R140 and R172 in wild- type IDH2, form hydrogen bonds with the b-carboxyl (green) of isocitrate. Cancer-derived mutations affecting these residues cause the enzymes to instead convert a-KG to 2HG while at the same time oxidizing NADPH to NADP+ (right reaction). 2HG and isocitrate share an identical chemical back- bone but differ solely in the presence of the b-carboxyl on isocitrate, but not 2HG. IDH1 R132, IDH2 R140, and IDH2 R172 mutation apparently favors conversion to 2HG rather than isocitrate given that 2HG lacks this group.
(Reitman et al, 2010).