Journal of the National Cancer Institute
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J. Natl. Cancer Inst. · May 2008
ReviewDesign and endpoints of clinical trials in hepatocellular carcinoma.
The design of clinical trials in hepatocellular carcinoma (HCC) is complex because many patients have concurrent liver disease, which can confound the assessment of clinical benefit. There is an urgent need for high-quality trials in this disease. An expert panel was convened by the American Association for the Study of Liver Diseases to develop guidelines that provide a common framework for designing trials to facilitate comparability of results. ⋯ Further research is needed to incorporate biomarkers and molecular imaging into clinical research in HCC. These surrogate markers may help to enrich study populations and maximize the cost-benefit ratio of trial execution. Design and conduct of phase 3 trials should be coordinated by centers with appropriate expertise in HCC.
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J. Natl. Cancer Inst. · May 2008
Residual treatment disparities after oncology referral for rectal cancer.
Black patients with rectal cancer are considerably less likely than white patients to receive adjuvant therapy. We examined the hypothesis that the lower treatment rate for blacks is due to underreferral to medical and radiation oncologists. ⋯ Racial differences in oncologist consultation rates do not explain disparities in the use of adjuvant treatment for rectal cancer. A better understanding of patient preferences, patient-provider interactions, and potential influences on provider decision making is necessary to develop strategies to increase the use of adjuvant treatment for rectal cancer among black patients.
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Women who have had a first-degree relative diagnosed with breast cancer (ie, a positive family history) have a rate of breast cancer that is approximately twice that of all women their age, but it is unclear how they should perceive this risk at different ages or if they should be considered at higher risk for the remainder of their lifetime. ⋯ Women who have a sister diagnosed with breast cancer have an increased risk of breast cancer throughout much of their lifetimes.