America's investment in cancer research has vastly expanded and deepened our understanding of the many diseases called cancer. Some of the genetic and environmental factors and biologic mechanisms that cause or contribute to cancer development, progression, and spread have been elucidated. This knowledge has led to the development of diverse interventions to reduce risk of cancer and more effectively treat some cancers, enabling many individuals to survive diseases that previously were almost universally fatal. Although notable, these achievements do not obscure the fact that cancer prevention and cure remain largely elusive. Given the complex nature of cancer and the lack of screening methods to detect most types of cancer, progress against some cancers has been slower than for others. Between September 2010 and, February 2011, the President's Cancer Panel (the Panel) convened four meetings to evaluate opportunities to accelerate the development of Innovations with the potential to dramatically improve cancer outcomes. The Panel received testimony from 47 experts from the academic, industnal. not-for-profit, and public sectors. The speakers Included basic, translational. clinical. and population science researchers and research program administrators; voluntary sector research sponsors; health and science policy specialists; representatives from the cancer advocacy community; professional and industry association representatives; and Federal Government regulators and administrators.

关键词：癌症;医学研究;会议;科技创新;流行病学;基因

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关键词：前列腺癌;放射学;放射性药物;放疗;化学;测定;药物

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Mental health disorders affect a person's emotional, social, and behavioral well-being. As a result of the Patient Protection and Affordable Care Act, beginning in 2014, mental health disorder services will be part of the essential benefits package, a set of health care service categories that must be covered by certain plans, including all insurance policies that will be offered through state-based exchanges and Medicaid. This Statistical Brief presents estimates based on the Household Component of the Medical Expenditure Panel Survey (MEPS-HC) on the use of and expenditures for all medical care, ambulatory care (office-based provider and hospital outpatient visits), and prescribed medicines to treat mental health disorders among school-age children in the U.S. civilian noninstitutionalized population. Average annual estimates for 2007-2009 are shown by type of service and source of payment.

关键词：卫生保健支出;精神障碍;儿童;平民人口管控

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This Statistical Brief provides descriptive statistics on expenditures for the top five therapeutic classes of outpatient prescription drugs, ranked by total expenses in 2009 for adults age 18 and older in the U.S. civilian noninstitutionalized population. Prescription drug therapeutic classes are defined according to the Multum Lexicon therapeutic classification system. In 2009, 18 broad therapeutic classifications were identified.

关键词：处方药;门诊;治疗;成年人;费用;人口;家庭

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CXCR4 and its chemokine ligand CXCL12 are potential targets for molecular therapy of ovarian cancer. Receptor CXCR4 is expressed by ovarian cancer cells in approximately 50of patients. High levels of CXCL12 are present in ascites of patients with ovarian cancer, providing a local source of chemokine ligand in the tumor microenvironment. CXCL12 signaling through CXCR4 activates pathways that could promote tumor growth, invasion, metastasis, and resistance to chemotherapy. To advance clinical translation of CXCR4 inhibitors for therapy of ovarian cancer, we developed molecular imaging reporters for CXCR4 signaling that can be used for cell-based assays and real-time imaging studies in mouse xenograft models of ovarian cancer. After validating that these reporters correspond with biochemical measures of CXCL12-CXCR4 signaling, we used optical imaging to quantify pharmacodynamics of therapy for CXCR4 targeted inhibitors in mice with ovarian cancer. Treatment studies established that inhibiting CXCR4 prolonged survival of mice with ovarian cancer and potentially could improve treatment efficacy of a standard chemotherapeutic drug, cisplatin.

关键词：细胞(生物学),化疗药物,临床医学;卵巢癌;生物化学

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How leukemia stem cells gained resistance to radiation and chemotheraphy is poorly defined, yet critically determines how leukemia cells tolerate conventional leukemia therapy. Normal hematopoietic stem cells and leukemia initiating cells are known to share many functional properties. Therefore, they are supposed to utilize many common mechanistic pathways for their survival and migration. Using genetically engineered mice we demonstrated the functional roles of P2Y14 in preserving regenerative capacity by constraining senescence induction and molecular events governing it. Since P2Y14 is highly expressed in differentiation-resistant leukemia cells, P2Y14 expression in leukemia cells may also function in modulating the resistance to conventional cancer treatment. Our results strongly suggest that P2Y14/UDP-Glc axis plays an important role in stress-induced senescence and motility of HSPCs. As the expression of P2Y14 is preferentially high in drug-resistant leukemia cells, we anticipate that P2Y14/UDP-Glc axis governs the resistance and motility also in leukemia stem/progenitor cells.

关键词：白血病;干细胞;老化(生理学);血液细胞,癌症;化疗;造血细胞

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Rising health care costs in general and prescribed medicine costs in particular continue to be a concern for U.S. policymakers and consumers of care. Breaking down total prescription drug costs into therapeutic classes and subclasses provides decision makers and the public with an understanding of the costs and extent to which specific therapeutic classes and subclasses of drugs are contributing to the upturn in total costs. This Brief provides trends for one therapeutic subclass of prescribed drugs--dermatological agents. This Brief presents trends in utilization and expenditures for outpatient prescription dermatological agents for the years 1999 and 2008. The estimates are for the U.S. civilian noninstitutionalized population and are derived from the 1999 and 2008 Household Component of the Medical Expenditure Panel Survey (MEPS-HC).

关键词：卫生保健支出;皮肤;皮肤病;药物;平民人口管控

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Rising health care costs in general and prescribed medicine costs in particular continue to be a concern for U.S. policymakers and consumers of care. Analyzing total prescription drug costs by therapeutic classes and subclasses provides decision makers and the public with an understanding of the costs and extent to which specific therapeutic classes and subclasses of drugs are contributing to the upturn in total costs. This Statistical Brief provides trends for one therapeutic subclass of prescribed drugs--urinary antispasmodics. This Brief presents trends in utilization and expenditures for outpatient prescription urinary antispasmodics for the years 2000 and 2010. The estimates are for the U.S. civilian noninstitutionalized population and are derived from the 2000 and 2010 Household Component of the Medical Expenditure Panel Survey (MEPS-HC). The Brief compares outpatient prescription urinary antispasmodics for 2000 and 2010, using the number of persons obtaining at least one prescription, total expenditures, and total number of prescriptions, as well as average annual cost per person and average drug cost. Only prescriptions purchased or obtained in an outpatient setting are included in these estimates. Prescription medicines administered in an inpatient setting or in a clinic or physician's office are excluded.

关键词：卫生保健支出;尿抗痉挛;成本;医疗利用率

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Breast cancer is the most common cancer in women and the second deadliest. There is a great need to finding new targeted therapies and to improve the efficacy of existing therapies. The TNF Related Apoptosis Inducing Ligand (TRAIL) pathway is part of the body s natural tumor surveillance program, preventing formation of tumors and metastasis while sparing normal cells. The TRAIL pathway has been exploited in clinical trials but resistance to TRAIL is common, limiting the efficacy of therapy. The mechanisms underlying TRAIL resistance are largely unknown and there is of yet not a good way to screen for TRAIL sensitivity. We have found that the gene Six1, which is overexpressed in over half of all breast cancers and in as much as 90of metastatic lesions, confers resistance to TRAIL. In addition, by screening a genome wide shRNA library we have identified 4 novel TRAIL resistance gene including the solute carrier family 26 (sulfate transporter), member 2 (SLC26A2). The role of these genes in TRAIL resistance and metastatic spread are being investigated, with the ultimate aim of identifying TRAIL resistance and circumventing it through targeted combination therapies.

关键词：乳腺癌;凋亡;基因;基因;转移;耐药性;治疗

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While much advancement has been made in breast cancer treatment, metastatic breast cancer remains an incurable disease. MUC1 is a glycoprotein expressed on normal glandular epithelial but is over-expressed and underglycosylated in over 90of human breast tumors and 100of metastatic lesions, which lead to its ranking by NCI as the second most targetable antigen. Vaccines against tumor antigens have several benefits, including the chance to eliminate metastatic lesions that express the vaccinating tumor antigen. To this end, we have proposed vaccinating with peptides from the MUC1 protein core, which is only visible to the immune system on the tumor- associated form of the protein. Previous work from our lab has demonstrated that this vaccine does elicit a MUC1-specific immune response that can only be functional if the immunosuppressive tumor microenvironment is altered to allow efficient killing of tumor cells. Thus, we investigated the effectiveness of MUC1 vaccination in combination with drugs known to inhibit immunosuppression to determine which drug is the most effective. Methods: Mice that are transgenic for human MUC1 (MUC1.Tg) mice were orthotopically injected with a syngenic breast cancer cell line expressing human MUC1 (Mtag.MUC1). Mice were vaccinated after palpable tumor formation with the vaccine cocktail, consisting of two MHC class I-restricted MUC1 tandem repeat peptides and a class II pan helper peptide mixed with GM-CSF and CpG ODN, in incomplete Freund s adjuvant. Previous work in our lab has shown that blocking the cyclooxygenase pathway (COX) resulted in an inhibition of immunosuppression. Thus we used the following drugs in combination with the MUC1-vaccine therapy: Indomethacin (COX1 and COX2 inhibitor), Celecoxib (COX2 inhibitor), 1-methyl tryptophan (indoleamine 2,3 dioxygenase inihibitor), and AH6809 (EP2 receptor antagonist). Mice were euthanized and tissue was collected post the final vaccination.

关键词：乳腺癌;糖蛋白;免疫抑制;转移;镇痛药;抗原

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