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  • 1
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  JCO Global Oncology Vol. 6, No. Supplement_1 ( 2020-07), p. 65-65
    In: JCO Global Oncology, American Society of Clinical Oncology (ASCO), Vol. 6, No. Supplement_1 ( 2020-07), p. 65-65
    Abstract: The Northern Cape Province is the largest province in South Africa; however, it has the fewest resources for cancer care. There is a high incidence and prevalence of mesothelioma and lung cancer as a result of the previous indiscriminate mining of asbestos without proper legislation for the protection of miners and the environment. Mine dumps remain near villages and schools after the banning of asbestos mining, resulting in continuous exposure to asbestos fibers. Unfortunately, majority of cancers are diagnosed in late stages because of a lack of awareness and the misdiagnosis of lung cancer and mesothelioma as tuberculosis. METHODS The Northern Cape Department of Health, Bristol-Myers Squibb Foundation, and Cancer Charity Workers formed a collaboration in May 2017 to reduce disparities and inequities in cancer care and for cancer control. The Northern Cape Department of Health also collaborated with Project ECHO at the University of New Mexico to use the ECHO model for training community health care workers, training in palliative care, and mentorship and empowerment of doctors and nurses in rural areas. The aim is to recognize early symptoms and signs of cancers affecting the lung and to make referrals for early diagnosis and treatment. RESULTS An advocacy group has engaged the Provincial and National Department of Mining and Environmental Affairs for rehabilitation of asbestos mine dumps. Community health care workers have been trained and are assisting with community awareness and patient navigation. Doctors have been trained in palliative care and are training other health care workers in palliative care. A center of excellence for the diagnosis and treatment of lung cancer, palliative care, survivorship, and research has been established. Retention of doctors and nurses in rural areas for cancer care and early referral is improving. A lung cancer research laboratory is being set up. CONCLUSION Effective collaborative projects can help address disparities in cancer care and effective cancer control in areas with limited resources.
    Type of Medium: Online Resource
    ISSN: 2687-8941
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 3018917-2
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  • 2
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. 6075-6075
    Abstract: 6075 Background: OM is a common, painful, and costly toxicity associated with cytotoxic regimens used to treat H & N cancers, which may result in radiotherapy treatment interruptions to negatively impact tumor control. There are currently no approved interventions to successfully prevent or delay OM onset among patients being treated with radiation therapy, with or without concomitant chemotherapy (CRT). Oxidative stress is a critical event in OM’s pathogenesis. Through its effect on Nrf2, ST-617 has marked anti-oxidative activity/properties. Supportive Therapeutics is developing ST-617, a dithioethione, for the attenuation of OM onset, duration and severity. The objective of this trial was to assess the safety, tolerability, PK, PD and efficacy of ST-617 in patients at high risk of severe OM (SOM). Methods: A dose escalation trial in which ST-617 administered as an oral suspension, 1-2 hours before the administration of daily RT fractions was performed at 9 study sites in South Africa and Australia. Eighteen patients with diagnoses of oral or oropharyngeal CA were enrolled (up to 6 pts/dose). Patients received concomitant cisplatin either weekly or tri-weekly. ST-617 was administered 3 days prior to CRT, and then continuing daily until the end of treatment. Safety outcomes, using CTCAE criteria (v 4.03) were used. Dose escalation occurred in the absence of toxicity. OM occurrence and severity were assessed by trained and validated evaluators using WHO, NCI-CTC and RTOG criteria; scores were centrally assigned. The primary efficacy endpoints included the incidence and duration of SOM (WHO grades 3 or 4) vs historical controls. PD tracking measured total ROS/RNS, GSH/GSSG, regulation in plasma and buccal epithelial cells. Results: 17 pts completed the 50, 100 and 150mg/day with no safety issues. No early dose limiting toxicity (DLT) or serious Adverse Event linked to ST-617 were observed. AEs observed were mainly nausea which is usually associated with CRT as expected. The 100 mg/day dose has been well tolerated with no grade 4 OM. No CRT dose interruptions or delays due to OM has been observed. Total ROS/RNS levels in plasma and buccal samples show significant decrease with increased ST-617 dosing from 50 to 100 mg/day. Conclusions: ST-617 administration was safe at all doses tested. The course and severity of patients treated with ST-617 compared favorably with historical controls. Mechanistic correlation between ROS/RNS levels was seen. A randomized, controlled, double blind trial is planned with the recommended dose of 100mg/day. Clinical trial information: 20180138.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
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  • 3
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 32, No. 6_Supplement ( 2023-06-01), p. 92-92
    Abstract: Purpose: Sub-Saharan Africa has huge disparities and inequities in cancer care. Some low resource countries have no facilities or trained oncologists and other healthcare professionals for cancer care. Patients often must travel long distances to access specialised cancer care such as radiotherapy, chemotherapy and palliative care. Patients with cancer in Lesotho who needed chemotherapy had to be flown to India; those who needed radiotherapy were referred to South Africa. Majority of the cancers diagnosed in the Northern cape province and Lesotho are in late stages and need treatment with chemotherapy and radiotherapy as part of the multimodality therapy. Methods: The Northern Cape Cancer Centre of Excellence and Research (NCCanCER) at Kimberley Hospital in South Africa collaborated with the Senkatana Hospital in Lesotho. Oncologists, specialist oncology nurses and IT personnel were trained at Project ECHO Institute in Albuquerque, NM to use the ECHO model for training, transfer of skills and mentorship. NCCanCER assisted Lesotho to set up a chemotherapy facility at Senkatana Hospital. An initial visit to the Kimberley Hospital Oncology Department for benchmarking was done by oncology staff from Lesotho. NCCanCER oncology staff went to Lesotho to provide on-site training in chemotherapy administration. Weekly virtual ECHO clinics were run from the Hub at Kimberley with spoke sites in Lesotho, Upington, Springbok and Kuruman. At the ECHO clinics, management of patients are discussed using evidence-based management protocols for continued training, transfer of skills, support and mentorship. Results: Doctors, nurses, pharmacists, social workers, clinical psychologists and community healthcare workers have been trained to provide cancer care and palliative care services in the underprivileged and underserved areas of the Northern cape and Lesotho. The first chemotherapy facility was opened in Lesotho in July 2022 and patients in Lesotho are no longer flown to India for chemotherapy. Patients in remote areas of the Northern cape province of South Africa can now receive chemotherapy and palliative care closer to their homes. There is continuous training, transfer of skills, expertise and mentorship of oncology staff. Conclusion: The ECHO model is useful in democratizing knowledge, transfer skills and expertise to improve care to patients in low resource countries. Citation Format: Daniel Osei-Fofie, Kabelo Mputsoe Cekwane, Mobashshar Hassan, Sophie Victoria Masuabi, Pearl Ntsekhe. Using Innovative Technology and Collaborative Efforts to Reduce Disparities and Inequities in Cancer Care and Improve the Lives of Patients in Low-Middle Income Countries in Sub-Saharan Africa: South African and Lesotho Experience of the ECHO Model [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 92.
    Type of Medium: Online Resource
    ISSN: 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 4
    In: Global Public Health, Informa UK Limited, Vol. 15, No. 10 ( 2020-10-02), p. 1537-1550
    Type of Medium: Online Resource
    ISSN: 1744-1692 , 1744-1706
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2020
    detail.hit.zdb_id: 2234129-8
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  • 5
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  JCO Global Oncology Vol. 8, No. Supplement_1 ( 2022-05), p. 11-11
    In: JCO Global Oncology, American Society of Clinical Oncology (ASCO), Vol. 8, No. Supplement_1 ( 2022-05), p. 11-11
    Abstract: The Northern Cape province is the largest province in South Africa. However, it has the least resources for cancer care. Patients have to travel very long distances to access cancer care. Cancers are diagnosed in late stages due to lack of resources including trained health care personnel. There was the need for an innovative model for training health care personnel, mentorship and empowerment to enable provision of cancer care in the rural areas of the province. METHODS In 2017, the Northern Cape Health Department had a collaboration with the Project ECHO Institute, University of New Mexico. An Immersion training in ECHO was provided in Albuquerque under the sponsorship of Bristol Myers Squibb Foundation and the Project ECHO Institute. An ECHO Hub was established at the tertiary cancer center with spoke sites in two district hospitals. The first cancer ECHO in Africa was launched at Kimberley Hospital in July 2018 to provide training and mentorship in Lung cancer and Mesothelioma care. In 2020, during the COVID-19 pandemic, the ECHO clinics were used on a more regular basis for patients' management. RESULTS Doctors, nurses and community healthcare workers have been trained using the ECHO model to provide cancer care in all the district hospitals. The ECHO clinics have now been expanded to cover other cancers. Palliative care ECHO has also been launched to improve provision of palliative care services. There has been retention of staff in the rural areas to provide cancer care due to mentorship and empowerment using the ECHO model. CONCLUSION ECHO is an effective innovative model to democratize knowledge and help reduce disparities and inequities in cancer care and for cancer control in low-middle income countries. In the era of the COVID-19 pandemic, ECHO clinics can assist with effective patient care.
    Type of Medium: Online Resource
    ISSN: 2687-8941
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 3018917-2
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