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Summary: Two early papers expressing conflicting views on the occurrence of effective immune attack against cancers stimulate an analysis of the gradual development of an understanding of tumour biology. This understanding has led to the development of the strikingly effective check point blocking and CART anti-cancer immunotherapies, and the promise of more widely applicable therapies based on T cell attracting genetically engineered monoclonal antibodies. [ABSTRACT FROM AUTHOR]

The article reports on several research papers related to cancer and its treatment. It informs that loss of the apoptotic response has been implicated in carcinogenesis as a consequence of increased survival of DNA-damage bearing cells. Many cancer cells have an inherent resistance to chemotherapy due to the abnormal expression of anti-apoptosis genes. The increased risk of cancer in immunosuppressed patients after organ transplantation, and in patients with inherited defects in immune function, such as severe combined immune deficiency, was thought to support the immune surveillance hypothesis.

Presents invited papers on cancer. 'Preliminary Results of a MRC Randomised Controlled Trial of Post-Operative Irrigation of Superficial Bladder Cancer,' by P. Whelan, G. Griffiths, M. Stower, D. Wallace, J. Hetherington, T. Hargreave, P. English, P. Weston, M. Parmar; 'New Ways to Exploit Tumour Hypoxia,' by M. Brown; 'Measuring Tumour Hypoxia in the Clinic,' by C. West.

This paper summarises the position of ESGO and EFC on cervical screening based on existing guidelines and opinions of a team of lead experts. HPV test is replacing cytology as this offers greater protection against cervical cancer and allows longer screening intervals. Only a dozen of HPV tests are considered as clinically validated for screening. The lower specificity of HPV test dictates the use of triage tests that can select women for colposcopy. Reflex cytology is currently the only well validated triage test; HPV genotyping and p16 immunostaining may be used in the future, although methylation assays and viral load also look promising. A summary of quality assurance benchmarks is provided, and the importance to audit the screening histories of women who developed cancer is noted as a key objective. HPV-based screening is more cost-effective than cytology or cotesting. HPV-based screening should continue in the post-vaccination era. Only a fraction of the female population is vaccinated, and this varies across countries. A major challenge will be to personalise screening frequency according to vaccination status. Still the most important factor for successful prevention by screening is high population coverage and organised screening. Screening with self-sampling to reach under-screened women is promising. [ABSTRACT FROM AUTHOR]

The article presents several studies related to cancer research. Certain alkylating agents because of their toxic properties, are also used for cancer chemotherapy. These affect very different target cell populations. Results on its study demonstrate that global cellular responses to alkylation damage are far more complex than first thought. It also discusses about replicating adenoviruses that target colon cancer. Adenoviruses that were developed, selectively replicate in cells with activated Wnt signaling by inserting binding sites for the Tcf family of transcription factors in the early promoters of human adenovirus 5.

The article reports on several research papers related to cancer and its treatment. It states that intensive, high dose therapy with meiphalan yields high remission rates but evidence on survival benefits has been inconclusive. It also focuses on the roles of adjuvant chemoradiotherapy and adjuvant chemotherapy in pancreatic cancer remain uncertain. The article also reveals that removing the internal mammary nodes remains a difficult routine procedure. Due to the relatively small percentage of patients that have positive internal mammary nodes with negative axillary status. The roles of adjuvant chemoradiotherapy and adjuvant chemotherapy in pancreatic cancer remain uncertain.

Immunotherapy with checkpoint inhibitors against programmed cell death receptor (PD-1) and programmed cell death ligand (PD-L1) has been implemented in the treatment pathway of patients with non-small cell lung cancer (NSCLC) from locally advanced disease to the metastatic setting. This approach has resulted in improved survival and a more favourable toxicity profile when compared with chemotherapy. Following the successful introduction of single-agent immunotherapy, current clinical trials are focusing on combination treatments with chemotherapy or radiotherapy or even other immunotherapeutic agents. However, most of the data available from these trials are derived from, and therefore might be more applicable to younger and fitter patients rather than older and often frail lung cancer real-world patients. This article provides a detailed review of these immunotherapy agents with a focus on the data available regarding older NSCLC patients and makes recommendations to fill evidence gaps in this patient population. [ABSTRACT FROM AUTHOR]

Summarizes the proceedings of the UKCCCR Trials Committee related to management of elderly cancer patients and their entry into clinical trials. Terms of reference set by the working group of UKCCCR; Problems related to clinical trials of elderly cancer patients; Representation of elderly patients in trials; Reasons for poor entry of elderly in clinical trials; Problems related to toxicity of treatment.

This study examined cancer research stories on the BBC web archive (July 1998-June 2006). There were about 260 BBC stories per year, of which about 170 were classed as relevant to reports of cancer research. The stories focused heavily on breast cancer, and over one-third of them mentioned this (compared with a cancer disease burden of 13%); the next most covered sites were lung and prostate cancers, although the former was much less mentioned than its cancer disease burden of almost 20% would have suggested. The focus of the stories was often on new or improved drugs or vaccines (20% of stories), with lifestyle choices (12%), genetic developments (9%), and food and drink (8%) also featuring fairly prominently. The BBC stories cited about 1380 research papers that could be identified as journal articles. About three-quarters of the cited papers were in the field of cancer. The papers of these authors came from over 60 countries, and 40% were from the United Kingdom and 36% from the United States. UK cancer research was heavily overcited, by about 6:1, relative to its presence in world oncology research and US research was cited about in proportion. That of most other countries, especially Japan, Germany, and Austria, was relatively undercited. These cited papers also acknowledged more funding bodies. Most of the BBC stories were put in context by external commentators, of whom the large majority was from the UK's cancer research charities. [ABSTRACT FROM AUTHOR]

There has been a substantially increased interest in biomedical research impact assessment over the past 5 years. This can be studied by a number of methods, but its influence on clinical guidelines must rank as one of the most important. In cancer, there are 43 UK guidelines (and associated Health Technology Assessments) published (up to October 2006) across three series, each of which has an evidence base in the form of references, many of which are papers in peer-reviewed journals. These have all been identified and analysed to determine their geographical provenance and type of research, in comparison with overall oncology research published in the peak years of guideline references (1999-2001). The UK papers were cited nearly three times as frequently as would have been expected from their presence in world oncology research (6.5%). Within the United Kingdom, Edinburgh and Glasgow stood out for their unexpectedly high contributions to the guidelines' scientific base. The cited papers from the United Kingdom acknowledged much more explicit funding from all sectors than did the UK cancer research papers at the same research level. [ABSTRACT FROM AUTHOR]

Presents information on several research papers on cancer. Assessment of the roles of adjuvant chemotherapy and adjuvant chemoradiation in pancreatic cancer; Comparison of efficacy and toxicity of adriamycin and mitoxantrone in the treatment of lymphoma.

The article presents several studies related to cancer research. Firstly, it discusses the minimal initial chemotherapy plus involved field radiotherapy (RT) versus mantle field RT for clinical stage IA/IIA supra-diaphragmatic Hodgkin's disease. Results of the lymphoma group LY07 trial in Great Britain is stated. Also the ABC trial tested the added benefits of ovarian ablation and/or chemotherapy in women with early breast cancer prescribed tamoxifen 20mg daily for 5 years.

This paper outlines the impact of the COVID-19 pandemic on cancer services in the UK including screening, symptomatic diagnosis, treatment pathways and projections on clinical outcomes as a result of these care disruptions. A restoration of cancer services to pre-pandemic levels is not likely to mitigate this adverse impact, particularly with an ageing population and increased cancer burden. New cancer cases are projected to rise to over 500,000 per year by 2035, with over 4 million people living with and beyond cancer. This paper calls for a strategic transformation to prioritise effort on the basis of available datasets and evidence—in particular, to prioritise cancers where an earlier diagnosis is feasible and clinically useful with a focus on mortality benefit by preventing emergency presentations by harnessing data and analytics. This could be delivered by a focus on underperforming groups/areas to try and reduce inequity, linking near real-time datasets with clinical decision support systems at the primary and secondary care levels, promoting the use of novel technologies to improve patient uptake of services, screening and diagnosis, and finally, upskilling and cross-skilling healthcare workers to expand supply of diagnostic and screening services. [ABSTRACT FROM AUTHOR]

Background:Literature reviews of cancer trials have highlighted the need for better understanding of phase II statistical designs. Understanding the key elements associated with phase II design and knowledge of available statistical designs is necessary to enable appropriate phase II trial design.Methods:A systematic literature review was performed to identify phase II trial designs applicable to oncology trials. The results of the review were used to create a library of currently available designs, and to develop a structured approach to phase II trial design outlining key points for consideration.Results:A total of 122 papers describing new or adapted phase II trial designs were obtained. These were categorised into nine levels, reflecting the practicalities of implementation, and form a library of phase II designs. Key design elements were identified by data extraction. Along with detailed description of the key elements and the library of designs, a structured thought process was developed to form a guidance document for choice of phase II oncology trial design.Conclusion:The guidance offers researchers a structured and systematic approach to identifying phase II trial designs, highlighting key issues to be considered by both clinicians and statisticians and encouraging an interactive approach to more informed trial design. [ABSTRACT FROM AUTHOR]

Background: To implement distress screening in routine radiotherapy practice and to compare computerised and paper-and-pencil screening in terms of acceptability and utility.Methods: We used the Stress Index RadioOncology (SIRO) for screening. In phase 1, 177 patients answered both a computerised and a paper version, and in phase 2, 273 patients filled out either the computerised or the paper assessment. Physicians received immediate feedback of the psycho-oncological results. Patients, nurses/radiographers (n=27) and physicians (n=15) evaluated the screening procedure.Results: The agreement between the computerised and the paper assessment was high (intra-class correlation=0.92). Patients' satisfaction did not differ between the two administration modes. Nurses/radiographers rated the computerised assessment less time consuming (3.7 vs 18.5%), although the objective data did not reveal a difference in time demand. Physicians valued the psycho-oncological results as interesting and informative (46.7%). Patients and staff agreed that the distress screening did not lead to an increase in the discussion of psychosocial issues in clinician-patient encounters.Conclusion: The implementation of a distress screening was feasible and highly accepted, regardless of the administration mode. Communication trainings should be offered in order to increase the discussion of psychosocial topics in clinician-patient encounters. [ABSTRACT FROM AUTHOR]

Background: We proposed the Physical Activity and Cancer Control (PACC) framework in 2007 to help organise, focus, and stimulate research on physical activity in eight cancer control categories: prevention, detection, treatment preparation/coping, treatment coping/effectiveness, recovery/rehabilitation, disease prevention/health promotion, palliation, and survival. Methods: This perspective paper provides a high-level overview of the scientific advances in physical activity research across cancer control categories, summarises current guidelines, updates the PACC framework, identifies remaining and emerging knowledge gaps, and provides future research directions. Results: Many scientific advances have been made that are reflected in updated physical activity guidelines for six of the cancer control categories apart from detection and palliation. Nevertheless, the minimal and optimal type, dose, and timing of physical activity across cancer control categories remain unknown, especially for the understudied population subgroups defined by cancer type, age, race/ethnicity, and resource level of regions/countries. Conclusion: To achieve the full benefit of physical activity in cancer control, future research should use innovative study designs that include diverse at-risk populations and understudied cancer sites. Additionally, effective behaviour change strategies are needed to increase physical activity levels across populations that use implementation science to accelerate the translation from evidence generation into practical, real-world interventions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought unplanned service disruption for breast cancer diagnostic, treatment and support services. This scoping review describes these changes and their impact in the UK and the Republic of Ireland based on studies published between January 2020 and August 2023. Thirty-four of 569 papers were included. Data were extracted and results thematically organized. Findings include fewer new cases; stage shift (fewer early- and more late-stage disease); and changes to healthcare organization, breast screening and treatment. Examples are accepting fewer referrals, applying stricter referral criteria and relying more on virtual consultations and multi-disciplinary meetings. Screening service programs paused during the pandemic before enacting risk-based phased restarts with longer appointment times to accommodate reduced staffing numbers and enhanced infection-control regimes. Treatments shifted from predominantly conventional to hypofractionated radiotherapy, fewer surgical procedures and increased use of bridging endocrine therapy. The long-term impact of such changes are unknown so definitive guidelines for future emergencies are not yet available. Cancer registries, with their large sample sizes and population coverage, are well placed to monitor changes to stage and survival despite difficulties obtaining definitive staging during diagnosis because surgery and pathological assessments are delayed. Multisite longitudinal studies can also provide guidance for future disaster preparedness. [ABSTRACT FROM AUTHOR]

Detecting cancer early is essential to improving cancer outcomes. Minoritized groups remain underrepresented in early detection cancer research, which means that findings and interventions are not generalisable across the population, thus exacerbating disparities in cancer outcomes. In light of these challenges, this paper sets out twelve recommendations to build relations of trust and include minoritized groups in ED cancer research. The Recommendations were formulated by a range of stakeholders at the 2022 REPRESENT consensus-building workshop and are based on empirical data, including a systematic literature review and two ethnographic case studies in the US and the UK. The recommendations focus on: Long-term relationships that build trust; Sharing available resources; Inclusive and accessible communication; Harnessing community expertise; Unique risks and benefits; Compensation and support; Representative samples; Demographic data; Post-research support; Sharing results; Research training; Diversifying research teams. For each recommendation, the paper outlines the rationale, specifications for how different stakeholders may implement it, and advice for best practices. Instead of isolated recruitment, public involvement and engagement activities, the recommendations here aim to advance mutually beneficial and trusting relationships between researchers and research participants embedded in ED cancer research institutions. [ABSTRACT FROM AUTHOR]

In current clinical practice, radiotherapy (RT) is prescribed as a pre-determined total dose divided over daily doses (fractions) given over several weeks. The treatment response is typically assessed months after the end of RT. However, the conventional one-dose-fits-all strategy may not achieve the desired outcome, owing to patient and tumor heterogeneity. Therefore, a treatment strategy that allows for RT dose personalization based on each individual response is preferred. Multiple strategies have been adopted to address this challenge. As an alternative to current known strategies, artificial intelligence (AI)-derived mechanism-independent small data phenotypic medicine (PM) platforms may be utilized for N-of-1 RT personalization. Unlike existing big data approaches, PM does not engage in model refining, training, and validation, and guides treatment by utilizing prospectively collected patient's own small datasets. With PM, clinicians may guide patients' RT dose recommendations using their responses in real-time and potentially avoid over-treatment in good responders and under-treatment in poor responders. In this paper, we discuss the potential of engaging PM to guide clinicians on upfront dose selections and ongoing adaptations during RT, as well as considerations and limitations for implementation. For practicing oncologists, clinical trialists, and researchers, PM can either be implemented as a standalone strategy or in complement with other existing RT personalizations. In addition, PM can either be used for monotherapeutic RT personalization, or in combination with other therapeutics (e.g. chemotherapy, targeted therapy). The potential of N-of-1 RT personalization with drugs will also be presented. [ABSTRACT FROM AUTHOR]

A sound knowledge base is required to target resources to reduce workplace exposure to carcinogens. This project aimed to provide an objective estimate of the burden of cancer in Britain due to occupation. This volume presents extensive analyses for all carcinogens and occupational circumstances defined as definite or probable human occupational carcinogens by the International Agency for Research on Cancer. This article outlines the structure of the supplement - two methodological papers (statistical approach and exposure assessment), eight papers presenting the cancer-specific results grouped by broad anatomical site, a paper giving industry sector results and one discussing work-related cancer-prevention strategies. A brief summary of the methods and an overview of the updated overall results are given in this introductory paper. A general discussion of the overall strengths and limitations of the study is also presented. Overall, 8010 (5.3%) total cancer deaths in Britain and 13, 598 cancer registrations were attributable to occupation in 2005 and 2004, respectively. The importance of cancer sites such as mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin cancer, bladder, oesophagus, soft tissue sarcoma and stomach cancers are highlighted, as are carcinogens such as asbestos, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists, as well as occupational circumstances such as shift work and occupation as a painter or welder. The methods developed for this project are being adapted by other countries and extended to include social and economic impact evaluation. [ABSTRACT FROM AUTHOR]