Patient cancer information seeking preferences by age and source: A comparison of the 2003, 2005, and 2007 Health Information National Trends Survey

Title: Patient Cancer Information Seeking Preferences by Age and Source: A Comparison of the 2003, 2005, and 2007 Health Information National Trends Survey Purpose/Procedure: Patient education enhances the patient's ability to actively participate in the healthcare decisions leading to an improved level of understanding. Modern technology provides society with access to a seemingly unlimited number of informative resources. Most Americans are bombarded with information from all angles; through newspapers, magazines, television, advertising, and especially the Internet. Therefore when an illness arises, a wide variety of information sources are readily available to most individuals. The rapid advancement of technology over the past decade has potentially created a generation gap in accessing information from the Internet. Older individuals may not have the same resources or skills as those in the younger generation in reference to obtaining electronic medical information. The purpose of this retrospective, secondary data analysis of information obtained from the 2003, 2005 and 2007 Health Information National Trends Survey (HINTS) conducted by the National Cancer Institute (NCI) is to compare the frequencies of patient cancer information seeking preferences by age ranges and source to evaluate the self-reported trust level of the participants in reference to the medical information provided. Results: 66% of participants claim to have never searched for cancer information in 2007, but 77% did search for some type of healthcare information. In 2003 the most common primary sources of cancer information were the Internet, books, and a healthcare provider. By 2007 the 4 library was cited as the most utilized source and a healthcare provider was one of the least cited sources. Overall the participants aged 18 - 49 years were more likely to first search for medical information at the library, while participants aged 50 and above cited the Internet as a primary resource. As participants grew older, they were also more likely to seek cancer information from a healthcare provider, magazines, and the radio. Participants who did seek cancer information appear evenly divided regarding concerns about the quality of the information sought. The most trusted source of cancer information was reported to be a doctor and the least trusted source was the radio. Conclusions: • Since 2003, patients have shifted to searching first in a Library or Book before the Internet. • Healthcare providers and Magazines dropped from being one of the first searched places to one of the last. • This study showed a trend of older age groups preferences to use the Internet as a primary source of information. • The Library was used as a primary source for those 18-34 and 35-49 • As participants grew older, they were more likely to approach a healthcare provider. • Participants showed the most trust in Physicians as a source. • The least reliable source from the survey results was the Radio. • The Internet evolved and changed in trust levels over the course of the 3 surveys.No embarg

Targeting intratumoral B cells with rituximab in addition to CHOP in angioimmunoblastic T-cell lymphoma. A clinicobiological study of the GELA.

Background In angioimmunoblastic T-cell lymphoma, symptoms linked to B-lymphocyte activation are common, and variable numbers of CD20(+) large B-blasts, often infected by Epstein-Barr virus, are found in tumor tissues. We postulated that the disruption of putative B-T interactions and/or depletion of the Epstein-Barr virus reservoir by an anti-CD20 monoclonal antibody (rituximab) could improve the clinical outcome produced by conventional chemotherapy. DESIGN AND METHODS: Twenty-five newly diagnosed patients were treated, in a phase II study, with eight cycles of rituximab + chemotherapy (R-CHOP21). Tumor infiltration, B-blasts and Epstein-Barr virus status in tumor tissue and peripheral blood were fully characterized at diagnosis and were correlated with clinical outcome. RESULTS: A complete response rate of 44% (95% CI, 24% to 65%) was observed. With a median follow-up of 24 months, the 2-year progression-free survival rate was 42% (95% CI, 22% to 61%) and overall survival rate was 62% (95% CI, 40% to 78%). The presence of Epstein-Barr virus DNA in peripheral blood mononuclear cells (14/21 patients) correlated with Epstein-Barr virus score in lymph nodes (P<0.004) and the detection of circulating tumor cells (P=0.0019). Despite peripheral Epstein-Barr virus clearance after treatment, the viral load at diagnosis (>100 copy/μg DNA) was associated with shorter progression-free survival (P=0.06). Conclusions We report here the results of the first clinical trial targeting both the neoplastic T cells and the microenvironment-associated CD20(+) B lymphocytes in angioimmunoblastic T-cell lymphoma, showing no clear benefit of adding rituximab to conventional chemotherapy. A strong relationship, not previously described, between circulating Epstein-Barr virus and circulating tumor cells is highlighted

GA101 (obinutuzumab) monocLonal Antibody as Consolidation Therapy In CLL (GALACTIC) trial: study protocol for a phase II/III randomised controlled trial

Background: Chronic lymphocytic leukaemia (CLL) is the most common adult leukaemia. Achieving minimal residual disease (MRD) negativity in CLL is an independent predictor of survival even with a variety of different treatment approaches and regardless of the line of therapy. Methods/design: GA101 (obinutuzumab) monocLonal Antibody as Consolidation Therapy In CLL (GALACTIC) is a seamless phase II/III, multi-centre, randomised, controlled, open, parallel-group trial for patients with CLL who have recently responded to chemotherapy. Participants will be randomised to receive either obinutuzumab (GA-101) consolidation or no treatment (as is standard). The phase II trial will assess safety and short-term efficacy in order to advise on continuation to a phase III trial. The primary objective for phase III is to assess the effect of consolidation therapy on progression-free survival (PFS). One hundred eighty-eight participants are planned to be recruited from forty research centres in the United Kingdom. Discussion: There is evidence that achieving MRD eradication with alemtuzumab consolidation is associated with improvements in survival and time to progression. This trial will assess whether obinutuzumab is safe in a consolidation setting and effective at eradicating MRD and improving PFS. Trial registration: ISRCTN, 64035629. Registered on 12 January 2015. EudraCT, 2014-000880-42. Registered on 12 November 2014

Lisocabtagene maraleucel in follicular lymphoma: The phase 2 TRANSCEND FL study

An unmet need exists for patients with relapsed/refractory (R/R) follicular lymphoma (FL) and high-risk disease features, such as progression of disease within 24 months (POD24) from first-line immunochemotherapy or disease refractory to both CD20-targeting agent and alkylator (double refractory), due to no established standard of care and poor outcomes. Chimeric antigen receptor (CAR) T cell therapy is an option in R/R FL after two or more lines of prior systemic therapy, but there is no consensus on its optimal timing in the disease course of FL, and there are no data in second-line (2L) treatment of patients with high-risk features. Lisocabtagene maraleucel (liso-cel) is an autologous, CD19-directed, 4-1BB CAR T cell product. The phase 2 TRANSCEND FL study evaluated liso-cel in patients with R/R FL, including 2L patients who all had POD24 from diagnosis after treatment with anti-CD20 antibody and alkylator ≤6 months of FL diagnosis and/or met modified Groupe d\u27Etude des Lymphomes Folliculaires criteria. Primary/key secondary endpoints were independent review committee-assessed overall response rate (ORR)/complete response (CR) rate. At data cutoff, 130 patients had received liso-cel (median follow-up, 18.9 months). Primary/key secondary endpoints were met. In third-line or later FL (n = 101), ORR was 97% (95% confidence interval (CI): 91.6‒99.4), and CR rate was 94% (95% CI: 87.5‒97.8). In 2L FL (n = 23), ORR was 96% (95% CI: 78.1‒99.9); all responders achieved CR. Cytokine release syndrome occurred in 58% of patients (grade ≥3, 1%); neurological events occurred in 15% of patients (grade ≥3, 2%). Liso-cel demonstrated efficacy and safety in patients with R/R FL, including high-risk 2L FL. ClinicalTrials.gov identifier: NCT04245839

On the relative importance of thermal and chemical buoyancy in regular and impact-induced melting in a Mars-like planet

We ran several series of two-dimensional numerical mantle convection simulations representing in idealized form the thermochemical evolution of a Mars-like planet. In order to study the importance of compositional buoyancy of melting mantle, the models were set up in pairs of one including all thermal and compositional contributions to buoyancy and one accounting only for the thermal contributions. In several of the model pairs, single large impacts were introduced as causes of additional strong local anomalies, and their evolution in the framework of the convecting mantle was tracked. The models confirm that the additional buoyancy provided by the depletion of the mantle by regular melting can establish a global stable stratification of the convecting mantle and throttle crust production. Furthermore, the compositional buoyancy is essential in the stabilization and preservation of local compositional anomalies directly beneath the lithosphere and offers a possible explanation for the existence of distinct, long-lived reservoirs in the martian mantle. The detection of such anomalies by geophysical means is probably difficult, however; they are expected to be detected by gravimetry rather than by seismic or heat flow measurements. The results further suggest that the crustal thickness can be locally overestimated by up to ~20 km if impact-induced density anomalies in the mantle are neglected.Comment: 29 pages, 10 figure

Phase III study of ACVBP versus ACVBP plus rituximab for patients with localized low-risk diffuse large B-cell lymphoma (LNH03-1B)

Background The superiority of a chemotherapy with doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisone (ACVBP) in comparison with cyclophosphamide, doxorubicin, vincristin and prednisone plus radiotherapy for young patients with localized diffuse large B-cell lymphoma (DLBCL) was previously demonstrated. We report the results of a trial which evaluates the role of rituximab combined with ACVBP (R-ACVBP) in these patients. Patients and methods Untreated patients younger than 66 years with stage I or II DLBCL and no adverse prognostic factors of the age-adjusted International Prognostic Index were randomly assigned to receive three cycles of ACVBP plus sequential consolidation with or without the addition of four infusions of rituximab. Results A total of 223 patients were randomly allocated to the study, 110 in the R-ACVBP group and 113 in the ACVBP group. After a median follow-up of 43 months, our 3-year estimate of event-free survival was 93% in the R-ACVBP group and 82% in the ACVBP group (P = 0.0487). Three-year estimate of progression-free survival was increased in the R-ACVBP group (95% versus 83%, P = 0.0205). Overall survival did not differ between the two groups with a 3-year estimates of 98% and 97%, respectively (P = 0.686). Conclusion In young patients with low-risk localized DLBCL, rituximab combined with three cycles of ACVBP plus consolidation is significantly superior to ACVBP plus consolidation alon