Although patient navigation was introduced 2 decades ago, there remains a lack of consensus regarding its definition, the necessary qualifications of patient navigators, and its impact on the continuum of cancer care. This review provides an update to the 2008 review by Wells et al on patient navigation. Since then, there has been a significant increase in the number of published studies dealing with cancer patient navigation. The authors of the current review conducted a search by using the keywords "navigation" or "navigator" and "cancer." Thirty-three articles published from November 2007 through July 2010 met the search criteria. Consistent with the prior review, there is building evidence of some degree of efficacy of patient navigation in terms of increasing cancer screening rates. However, there is less recent evidence concerning the benefit of patient navigation with regard to diagnostic follow-up and in the treatment setting, and a paucity of research focusing on patient navigation in cancer survivorship remains. Methodological limitations were noted in many studies, including small sample sizes and a lack of control groups. As patient navigation programs continue to develop across North America and beyond, further research will be required to determine the efficacy of cancer patient navigation across all aspects of the cancer care continuum.

https://onlinelibrary.wiley.com/doi/pdf/10.3322/caac.20111

Patient navigation: An update on the state of the science

Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in a variety of tumour cells through activation of TRAIL-R1 and TRAIL-R2 death signalling receptors. Here, we describe the characterisation and activity of HGS-ETR1, the first fully human, agonistic TRAIL-R1 mAb that is being developed as an antitumour therapeutic agent. HGS-ETR1 showed specific binding to TRAIL-R1 receptor. HGS-ETR1 reduced the viability of multiple types of tumour cells in vitro, and induced activation of caspase 8, Bid, caspase 9, caspase 3, and cleavage of PARP, indicating activation of TRAIL-R1 alone was sufficient to induce both extrinsic and intrinsic apoptotic pathways. Treatment of cell lines in vitro with HGS-ETR1 enhanced the cytotoxicity of chemotherapeutic agents (camptothecin, cisplatin, carboplatin, or 5-fluorouracil) even in tumour cell lines that were not sensitive to HGS-ETR1 alone. In vivo administration of HGS-ETR1 resulted in rapid tumour regression or repression of tumour growth in pre-established colon, non-small-cell lung, and renal tumours in xenograft models. Combination of HGS-ETR1 with chemotherapeutic agents (topotecan, 5-fluorouracil, and irinotecan) in three independent colon cancer xenograft models resulted in an enhanced antitumour efficacy compared to either agent alone. Pharmacokinetic studies in the mouse following intravenous injection showed that HGS-ETR1 serum concentrations were biphasic with a terminal half-life of 6.9–8.7 days and a steady-state volume of distribution of approximately 60 ml kg−1. Clearance was 3.6–5.7 ml−1 day−1 kg−1. These data suggest that HGS-ETR1 is a specific and potent antitumour agent with favourable pharmacokinetic characteristics and the potential to provide therapeutic benefit for a broad range of human malignancies.

/pdf/hgs-etr1-a-fully-human-trail-receptor-1-monoclonal-antibody-32ifjs63zk.pdf

HGS-ETR1, a fully human TRAIL-receptor 1 monoclonal antibody, induces cell death in multiple tumour types in vitro and in vivo.

In this article, the American Cancer Society estimates the number of new cancer cases and deaths for African Americans and compiles the most recent data on cancer incidence, mortality, survival, and screening prevalence based upon incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. It is estimated that 176,620 new cases of cancer and 64,880 deaths will occur among African Americans in 2013. From 2000 to 2009, the overall cancer death rate among males declined faster among African Americans than whites (2.4% vs 1.7% per year), but among females, the rate of decline was similar (1.5% vs 1.4% per year, respectively). The decrease in cancer death rates among African American males was the largest of any racial or ethnic group. The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of nearly 200,000 deaths from cancer among African Americans. Five-year relative survival is lower for African Americans than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Overall, progress in reducing cancer death rates has been made, although more can and should be done to accelerate this progress through ensuring equitable access to cancer prevention, early detection, and state-of-the-art treatments.

Cancer statistics for African Americans, 2013

The therapeutic antibodies market to 2008.

Objectives:Early hospital readmission is a common and costly problem in the Medicare population. In 2009, the Centers for Medicaid and Medicare Services began mandating hospital reporting of disease-specific readmission rates. We sought to determine the rate and predictors of readmission after colec

/pdf/readmission-after-colectomy-for-cancer-predicts-one-year-33jhn6pqla.pdf

Readmission after colectomy for cancer predicts one-year mortality.

Therapeutic Applications of Monoclonal Antibodies

Racial disparities in colorectal cancer.

T he finding that black Americans, compared with white Americans, have inferior 5-year survival rates and death rates from cancer has been noted for more than 40 years. Disparities in other causes of death were noted even earlier. Race and differences in health outcomes have been topics for politicians and scientists ever since. In many respects, the academic field of health outcomes research owes its creation to concerns about disparate outcomes among the races. In America, race is a difficult, volatile topic. Medical science and the interpretation of data have been affected greatly by America’s obsession with race. The finding that there are disparities in cancer incidence and mortality is incontrovertible. The reasons for the disparities and even how to define the populations with disparities are not as clear and, indeed, are quite controversial. However populations are categorized, there are disparate influences on the cause of the disease. the course of the disease, and the outcome of the disease. Defining these influences is the most scientifically appropriate way to develop and test the interventions that may overcome these disparities.

Cancer and disparities in health: perspectives on health statistics and research questions.

Access to Health Coverage, Parity Compliance May Help Improve Youth Mental Health Services.

As Dr. Lozano recognizes [1], the increasing frequency of climate-related disasters highlights the need for proactive efforts to address the current and future impacts of climate change and promote environmental sustainability. Lessons from the COVID-19 pandemic, which has impacted key blood supplies and blood donations, likewise highlight the importance of additional planning and preparedness for the health impacts of climate change [2]. Two important steps can support the blood sector’s efforts to mitigate impacts on systems, providers and patients. First, more attention should be given to blood and blood product supply chains. Such steps as stockpiling key supplies before disasters and emergencies, identifying vulnerable areas and populations, ensuring a resilient and ‘diverse’ network of suppliers and conducting emergency preparedness training and exercises at the facility and public health systems levels can help to ensure emergency and disaster preparedness. Healthcare systems and blood establishments can work to assess their risks and develop plans and responses for climate-change-related and other emergencies [3, 4]. Second, interdependencies within the blood sector, broader public health system and other critical infrastructure areas (e.g., electricity/ energy, water, communications) require collaboration and partnership within the blood sector and with other health and public health professionals and organizations, private businesses, emergency management, national and international environmental organizations, regulatory agencies and others to further assess climate change impacts and prevention, preparedness, mitigation and response activities. The World Health Organization and others rightly emphasize an all-hazards, whole-of-society/ whole-of-government approach as common actions and partnerships can bolster preparedness for a wide range of potential emergency and disaster situations [5]. Many resources exist to aid blood sector professionals in their understanding of climate change and potential steps to mitigate how these changes ultimately affect the supply of blood and blood products (see e.g., https://www.lancetcountdown.org/). Dr. Lozano’s call for additional steps by blood sector professionals to address the climate crisis and its impacts hopefully will not pass unheeded.

Mitchell Berger

Papers

Therapeutic Applications of Monoclonal Antibodies

Racial disparities in colorectal cancer.

Cancer and disparities in health: perspectives on health statistics and research questions.

Access to Health Coverage, Parity Compliance May Help Improve Youth Mental Health Services.

Climate change impacts blood supply resilience