View clinical trials related to Cancer.
Filter by:The purpose of this Phase II study is to determine the feasibility of the dose titration and assessment protocol in the impatient population, in the clinical setting of preventing or managing breakthrough pain, before conducting an appropriately powered phase III study. Thus the primary purpose of this study is to determine the proportion of patients who are successfully titrated to an effective dose of sublingual methadone.
The purpose of this study is to assess the safety and tolerability of the KIT inhibitor XL820 when given orally daily to adults with advanced solid tumors.
Primary Objective: To demonstrate the efficacy of intranasal fentanyl in the treatment of breakthrough pain (BTP) in cancer patients. Secondary Objective: To explore the relationship between the response to the fentanyl dose and the stable background pain opioid dose.
The project is a passive follow-up of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study cohort. Originally, this was a large, randomized, double-blind, placebo-controlled, 2x2 factorial primary prevention trial testing the effects of alpha-tocopherol and beta-carotene supplementation on cancer incidence and mortality. The study was conducted in Finland as a collaboration between the U.S. National Cancer Institute (NCI) and the National Public Health Institute of Finland. NCI has maintained passive surveillance of the cohort through Finnish national registries, including the cancer registry. The primary purpose of the ATBC cohort follow-up is to use the existing risk factor data and biological specimens (i.e., serum, whole blood, DNA, red blood cells, and toenails) to test hypotheses relevant to cancer etiology, survival, early detection, and prevention. These data and biospecimens continue to provide an invaluable resource for the study of biochemical, nutritional, genetic, and molecular hypotheses. These analyses are made all the more informative and powerful by the addition of cases identified annually during the follow-up period, and the research benefits from a longer pre-diagnosis period (now over 30 years).
The chemopreventive efficacy of Se was tested in a 10-year human intervention trial; total and lung cancer mortality, total cancer incidence, colorectal cancer and prostate cancer incidence decreased. This study is designed to compare, via stable isotope tracer studies the kinetics of inorganic and organic Se before and following two years of oral supplementation with L-selenomethionine, to measure forms of Se in the plasma (extracellular Se-dependent glutathione peroxidase [GSHPx], selenoprotein-P [SeP], albumin-bound Se [AlbSe] and nonprotein-bound low molecular weight [LMWSe] fractions), and to determine the effects of supplementation on the ecology of the hindgut microflora. The forms of Se were chosen to resemble the metabolism of the principal forms of Se in mixed American diets. Sodium selenite, an inorganic form, is metabolized by reduction to selenide which is then either used in the co-translational synthesis of SeCys in specific Se-containing proteins (e.g., glutathione peroxidases, diodinases, selenoproteins P and W), or is converted to methylated excretion products; in this sense it resembles the food form selenocysteine (SeCys) which is metabolized to the selenide level. Selenomethionine (SeMet), an organic form, is a major form of Se in many foods, particularly those of plan origin. In addition to being metabolized to selenide, SeMet also enters the metabolic protein pool by competing with the sulfur-containing amino acid, methionine. A study is proposed to assess the impact of selenium (Se) supplementation on its metabolism in humans. A pilot study will be conducted to test recruitment strategies and sample collection, preparation and analysis and to assess the detectability of two stable isotopes given together. Four subjects will receive two 300 ug oral doses consisting of 150 ug of the stable isotope 76Se as selenite and 150 ug of the stable isotope 74Se as selenomethionine on study days one and twelve. Subjects will be followed for six weeks. In the first pharmacokinetics tracer study (PK1), twenty-eight subjects will receive the same two labeled stable isotope doses, and will be followed for 4 months. In addition, two subjects who have been self-supplementing with 200 ug of Se as selenized yeast for two years will take part in PK1 to assess the sensitivity over time of the tracer assay in supplemented subjects. PK1 will be followed by a 2-yr supplementation period, in which all 28 subjects will receive daily doses of 200 ug of L0SeMet; subjects = metabolism is expected to approach a new steady state reflective of long-term supplementation. A second 4-month pharmacokinetic tracer study (PK2) will then be conducted while subjects remain on Se-supplementation with an extension of six monthly blood samples. Extensive sampling of plasma, urine, and feces during PK1 and PK2 will permit both the refinement of existing baseline models for selenite and selenomethionine metabolism in humans and the investigation of changes in metabolism arising from Se-supplementation. The study is designed to detect a difference of 0.75 standard deviation units in pre-versus post-supplementation rate parameters, assuming a two-sided test with an alpha level of 0.05 and a power of 0.80. The non-absorbed portion of Se may favor portions of the normal colonic bacterial microflora that produce certain short-chain fatty acids that colon cells use for energy. To test this hypothesis, fecal specimens will be analyzed for short-chain fatty acids over the course of Se-supplementation. In addition, the sampling of buccal cell-Se and of toenail-Se on a quarterly basis over the course of the study and assay of thyroid hormone levels during the first year of the study will permit the investigation of possible changes in levels resulting from supplementation.
This study will examine DNA from cancer patients previously treated with Gleevec to look for a variation (mutation) of the ABCG2 gene that may render the drug less effective in certain patients. Gleevec is used to treat chronic myeloid leukemia and gastrointestinal tumors. Although most patients respond to treatment, many with advanced disease develop resistance to the drug. It is thought that in some patients this resistance results from the action of a protein that causes Gleevec to be pumped out of the cells, reducing its usefulness. Patients enrolled in clinical trials of Gleevec at the National Cancer Institute and at other participating institutions are eligible for this study. DNA from patients' blood samples are analyzed for the ABCG2 gene and correlated with clinical data, such as the patient's age, race, disease state, weight, height, and body surface area. It will also look at the drug dose, how often the drug is given, the duration of treatment, side effects and other medications taken.
Family history of cancer is an important possible indicator of inherited cancer susceptibility, which has helped identify individuals and families at high risk of inherited cancers in research studies and clinical practice. While there are also various potential uses of family history of cancer data in cancer surveillance, the completeness and accuracy of family history of cancer data collected from the general population is unclear. In an effort to evaluate the feasibility of conducting a national surveillance study to determine the prevalence of family history of cancer in the U.S. population, the Risk Factor Monitoring and Methods Branch will undertake a pilot study, entitled the Family Health Study, that examines issues of data quality. In this study, a family history of cancer questionnaire (FHCQ) will be developed for surveillance purposes and administered to a random digit dial (RDD) sample of households in the state of Connecticut. Positive and negative reports of common cancers in the respondent's families will be validated against records of the Connecticut Tumor Registry (CTR) and other data sources. The objectives are to: 1) assess the agreement between respondent reports of specific cancers in first and second degree relatives and medical record-based reports, as measured by percent concordance; 2) quantify the sensitivity, specificity and predictive value of the FHCQ by cancer site; 3) evaluate the possible predictors of reporting accuracy, including cancer site, year of diagnosis, kinship relation of the relative to the respondent and the frequency and quality of their contact, overall family cohesiveness, respondent's own history of cancer, and demographic factors; 4) describe the completeness and reliability of family structure data. Validation of selected relatives' cancer status will be done through data linkage to the Connecticut Tumor Registry, other selected cancer registries, the National Death Index, Medicare claims data bases, state death certificate registries, or by obtaining consent to review available medical records from physicians and health care facilities. Self-reports of respondents' cancer status will also be validated since this may be a predictor of ability to accurately report family history. A pre-established tracing algorithm will be used to triage cancer reports into the medical records systems where true cancer status is most likely to be verified by the highest quality data. Validated cancer outco...
Research and development in genetic testing for cancer susceptibility genes has advanced rapidly in recent years, allowing healthy individuals, cancer patients, and their families to determine if they carry mutations which increase their risk of breast, ovarian, prostate, colon, and other cancers. Initial efforts have unfolded primarily in academic medical centers targeting families at high risk for cancer. There is currently no information available for assessing the prevalence of genetic testing for cancer susceptibility genes at the national level, or for evaluating the knowledge of and attitudes toward such testing among primary care physicians. The objectives of this survey are to determine the utilization of genetic tests by physicians at the national level; to ascertain physician knowledge of available genetic tests for specific cancer susceptibility genes, to examine physicians' general attitudes toward testing, and; to explore possible variation in utilization and knowledge/attitudes by medical specialty, type of practice, year of training completion, board status, urbanicity, and geographic region. The primary research question that this survey will address is what is the prevalence of use of genetic testing for cancer susceptibility among primary care physicians in the U.S.? The survey will also assess whether there are statistically significant differences in 1) self-reported knowledge, current use of, and future intentions to use genetic testing for cancer susceptibility, and 2) perceptions of barriers to testing, among primary care physicians by their type and location of practice, and recency of training. Primary care physicians (internists, obstetrician/gynecologist, family and general practitioners) will also be compared with specialty groups (gastroenterologists, surgeons, urologists) and oncologists with respect to their use, attitudes towards, and knowledge of, genetic testing for cancer susceptibility. A questionnaire is being administered by mail, telephone, facsimilie or Internet to a nationally representative sample of 2,100 physicians. Responding physicians select their preferred response mode. Study participants are primary care and specialty physicians with active licenses to practice medicine in the U.S. A data file with personal identifiers deleted will be prepared for statistical analysis to estimate the prevalence and determine predictors of use and intentions to genetic tests for inherited cancer susceptibility.
The purpose of this study is to evaluate the hematologic response, safety, and clinical outcomes of PROCRIT administered once a week in anemic cancer patients receiving chemotherapy.
This study will construct tissue microarrays (TMAs) pertaining to childhood cancer. TMA technology is a recently developed one that allows for evaluating hundreds of tissue samples simultaneously on the DNA, RNA, and protein levels. The goal is to identify a potential molecular signature. Cancer drug discovery is currently focused on identifying drugs targeted at the molecular level. Such drugs would be more selective and specific for proteins and signaling pathways that are directly involved in the origin of tumors. However, the origin of cancer among adults differs from that of cancer diagnosed in children. The overall approach by the pharmaceutical industry in developing drugs is not likely to be aimed at low-incidence cancers, such as childhood cancers. Thus, the researchers in this study propose to create a childhood cancer TMA that include specimens from a wide range of solid tumors that present a poor prognosis for patients. This TMA would in turn be used to identify antibodies and lead to developing molecularly targeted drugs that would reach clinical trials in adults. TMAs are created robotically. Small tissue cores are taken from paraffin-embedded tissue blocks and are implanted into new paraffin blocks. The recipient blocks are then processed to produce several hundred specimens that can be evaluated on a single glass slide. Specimens representing 17 distinct kinds of pediatric solid tumors will be used in this study. Also included will be samples of plexiform neurofibroma-that is, benign growths of nervous and connective tissues. Tissue specimens will come from patients who were age 25 or younger at the time of diagnosis of their cancer or plexiform neurofibroma. No procedures will be performed for the sole purpose of obtaining tissue for this study. The TMA developed in this study will not be commercialized. The results for individuals whose tumor specimens are used in the array will not be sent to patients or their treating physicians.