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Summary: Background: A student‐run free clinic (SRFC) is a health care delivery system in which undergraduate medical students assume the responsibility of an outpatient health clinic. This provides a unique opportunity for early exposure to patients in a student's pre‐clinical years. Methods: Pre‐ and post‐experience electronic surveys were sent out to first‐year medical students who were required to complete a minimum of three sessions as a volunteer at one of two SRFCs in the metro Detroit area. The Fisher's exact test was used to assess for a significant change after clinic experience with p < 0.05. Results: Thirty‐one students completed the pre‐experience survey. Twenty‐five students completed the post‐experience survey. The Fisher's exact test demonstrated a significant increase in the proportion of positive answers for questions concerning comfort with taking a medical history (p = 0.002) and comfort with using an electronic medical record (EMR) (p = 0.048). There was no significant difference in comfort working as part of a team (p = 0.581), discussing a patient with a physician (p = 0.602) or interacting with different socio‐economic backgrounds (p = 0.720). Conclusion: SRFCs provide a beneficial opportunity for early patient and clinical exposure for pre‐clinical medical students, including practice using an EMR, which is an essential tool in our electronic era. More research, however, is needed to determine the most effective way to teach skillful EMR use. [ABSTRACT FROM AUTHOR]

Objective: To assess the role of serial FLT-PET scans during early neoadjuvant treatment as a prognostic marker of response to treatment and survival.Methods: This study is a prospective cohort study which draws from a larger original study which examined the utility of FLT-PET imaging across multiple cancers. Our cohort consisted of patients who had biopsy-confirmed breast cancer amenable to surgical resection. These patients underwent serial FLT-PET scans: the first scan prior to starting neoadjuvant chemotherapy (NAC), and a second scan shortly after starting NAC. SUVmean was derived using an isocontour ROI drawn approximately half way between the SUVmax and background on three planes for each scan. The change in mean standardized uptake value (SUVmean) for the primary tumor between these two scans was then calculated, and patients were stratified into "responder" and "non-responder" groups based on a cut-off of 20% arithmetic decrease in SUVmean between the two scans. The rates of pathologic complete response (pCR) on subsequent surgical excision, overall survival (OS), and progression-free survival (PFS) were then compared between the two groups to assess for significant difference between responders and non-responders.Results: 16 patients (n = 16) met criteria for inclusion and successfully underwent FLT-PET scans in the prescribed sequence of events. Seven of these patients had a decrease of 20% or larger between the two serial PET scans, making them "responders". The remaining nine patients were "non-responders" to NAC based on PET imaging. Between responders and non-responders, there was no significant difference in median PFS (7.9 years versus 3.7 years; p = 0.425) and median OS (7.5 years versus 5.0 years; p = 0.944). In the 14 patients who underwent surgical resection (n = 14), there was no significant difference in the rate of achieving pCR (33% vs. 14%; p = 0.5846) between responders and non-responders.Conclusion: Further study of a larger sample size is needed to examine the potential role for FLT-PET in predicting response to neoadjuvant treatment, particularly in correlating with long-term overall and progression-free survival. Our study is limited by small sample size, but does suggest that FLT-PET has a role in the long-term prognosis of breast cancer treated with NAC and surgical resection which is worthy of further study. [ABSTRACT FROM AUTHOR]

Objective: Multicancer early detection panels have recently become available to patients with healthcare provider prescriptions and available funds. These tests utilize circulating tumor DNA (ctDNA) to screen more than 50 cancers using a single blood sample. However, perspectives and data on how the deployment of these tests may impact the practices of primary care providers in terms of implementation, interpretation, documentation, and costs are limited. This study aimed to assess the perspectives of primary care providers regarding the integration of multicancer early detection panels into clinical practice., Methods: We used a survey to assess the opinions and perspectives of primary care providers, including physicians, nurse practitioners, and physician assistants, across a multistate, tertiary healthcare system. We used a single form consisting of novel questions on familiarity with multi-cancer early detection panels, cost, healthcare equity, documentation, medicolegal, and other concerns. The subgroup analysis was consistent with stratification based on familiarity with ctDNA-based tests and their roles in clinical practice., Results: Most respondents were unfamiliar with multicancer early detection panels and had not used ctDNA-based tests. Most primary care providers suggested that they would reorder multicancer early detection panel testing at 1- to 5-year intervals and prefer subspecialists for both ordering multicancer early detection panels as well as interpreting their results. Relative concerns differed between physicians and nonphysicians., Conclusion: The integration of multicancer early detection panels into primary care practice requires careful planning and consideration for the management of increased clinical load, interpretation of results, and cost management.