Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
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Question: Paragraph: Cancer patients increasingly are having their care guided by gene tumor boards, a new version of the hospital panels that traditionally decided whether surgery, radiation or chemotherapy would be best. These experts study the patient’s cancer genes and match treatments to mutations that seem to drive the disease. “We dissect the patient’s tumor with what I call the molecular microscope,” said Dr. Razelle Kurzrock, who started a board at the University of California, San Diego, where Cairnes is treated. It’s the kind of care many experts say we should aim for — precision medicine, the right drug for the right person at the right time, guided by genes. There are success stories, but also some failures and many questions: Will gene-guided care improve survival? Does it save money or cost more? What kind of gene testing is best, and who should get it? “I think every patient needs it,” especially if cancer is advanced, said Kurzrock, who consults for some gene-medicine companies. “Most people don’t agree with me — yet. In five years, it may be malpractice not to do genomics.” Few people get precision medicine today, said Dr. Eric Topol, head of the Scripps Translational Science Institute. “The only thing that’s gone mainstream are the words.” HOW IT WORKS NOW If you have a cancer that might be susceptible to a gene-targeting drug, you may be tested for mutations in that gene, such as HER2 for breast cancer. Some breast or prostate cancer patients also might get a multi-gene test to gauge how aggressive treatment should be. Then most patients get usual guideline-based treatments. If there’s no clear choice, or if the disease has spread or comes back, doctors may suggest tumor profiling — comprehensive tests to see what mutations dominate. That’s traditionally been done from a tissue sample, but newer tests that detect tumor DNA in blood — liquid biopsies — are making profiling more common. The tests cost about $6,000 and many insurers consider them experimental and won’t pay. Gene tumor boards analyze what the results suggest about treatment. They focus on oddball cases like a breast cancer mutation in a colon cancer patient, or cancers that have widely spread and are genetically complex. The only options may be experimental drugs or “off-label” treatments — medicines approved for different situations. But as tumor profiling grows, it’s revealing how genetically diverse many tumors are, and that oddball cases are not so rare, said Dr. John Marshall. He heads the virtual tumor board at Georgetown Lombardi Comprehensive Cancer Center that also serves cancer centers in Pennsylvania, North Carolina, Michigan and Tennessee. “There is a little bit of faith” that testing will show the right treatment, but it’s not a sure thing, said Dr. Lee Schwartzberg, who heads one participating center, the West Cancer Center in Memphis. Dr. Len Lichtenfeld, the American Cancer Society’s deputy chief medical officer, is optimistic yet wary. Drugs that target BRAF mutations work well for skin cancers called melanomas, but less well for lung or colon cancers. “Just because a mutation occurs it doesn’t mean that drug is going to work in that cancer,” he said. LUCKY CASES When it does, results can be dramatic. Cairnes’ cancer was between her stomach and esophagus, and had spread to her liver, lungs and lymph nodes. Tissue testing found 10 abnormal genes, but on the liquid biopsy only EGFR popped out as a good target. Two drugs aim at that gene but aren’t approved for her type of cancer. A tumor board advised trying both — Erbitux and Tarceva, the drug her husband also had taken. Within two weeks, she quit using pain medicines. After two months, her liver tumor had shrunk roughly by half. There are signs that cancer may remain, but it is under control. She feels well enough to travel and to take care of her granddaughter. “I’m very, very grateful to have a targeted therapy,” Cairnes said. “I cannot expect a better outcome than what we’re seeing right now,” said her doctor, Shumei Kato. WHAT STUDIES SHOW But is gene-guided treatment better than usual care? French doctors did the first big test, with disappointing results. About 200 patients with advanced cancer were given whatever their doctors thought best or off-label drugs based on tumor profiling. Survival was similar — about two months. Another French study, reported in June, was slightly more encouraging on survival but exposed another problem: No drugs exist for many gene flaws. Tests found treatable mutations in half of the 2,000 participants and only 143 got what a tumor board suggested. Some doctors worry that tumor boards’ recommending off-label treatments diverts patients from research that would benefit all cancer patients. For example, the American Society of Clinical Oncology’s TAPUR study tests off-label drugs and shares results with their makers and federal regulators. LETTING PATIENTS CHOOSE Ann Meffert, who lives on a dairy farm in Waunakee, Wisconsin, endured multiple standard treatments that didn’t defeat her bile duct cancer. “She was going to be referred to hospice; there was not much we could do,” said Dr. Nataliya Uboha, who took the case to a tumor board at the University of Wisconsin-Madison. The panel gave several options, including off-label treatment, and Meffert chose a study that matches patients to gene-targeting therapies and started on an experimental one last October. “Two weeks in, I started feeling better,” she said, and when she saw test results, “I couldn’t believe the difference.” Many lung spots disappeared and the liver tumor shrank 75 percent. She is not cured, though, and doctors are thinking about next steps. And that could involve a fresh look at her tumor genes. ___ Marilynn Marchione can be followed at @MMarchioneAP __ This Associated Press series was produced in partnership with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. Claim: Ultra-personal therapy: Gene tumor boards guide cancer care.

Answer: Doctors were just guessing a decade ago when they gave Alison Cairnes’ husband a new drug they hoped would shrink his lung tumors. Now she takes it, but the choice was no guesswork. Sophisticated gene tests suggested it would fight her gastric cancer, and they were right.


Question: Paragraph: "The cost of the drug wasn’t mentioned – a big oversight. Other news stories pegged it at about $35,000 a year. Adequate job. The story explained: ""But experts stress that Benlysta is not a miracle drug: It only worked in 35 percent of North American patients tested and was not effective for patients with the deadliest form of the disease. Additionally, it did not show positive results in African Americans, who are disproportionately affected by lupus."" There was no discussion of harms. An NPR story, by comparison, pointed out that ""There are side effects, of course, and some of them are pretty serious. In clinical tests involving about 2,100 people, 11 taking Benlysta died compared with 4 getting placebo. About 6 percent of people taking Benlysta got serious infections compared with 5.2 percent on placebo."" The story offered an interesting historical perspective on the evidence: ""The company originally tested Benlysta, known generically as belimumab, as a treatment for rheumatoid arthritis. When a mid-stage trial in lupus patients failed to meet researchers’ goals in 2006, many analysts wrote the drug off and downgraded the company’s stock. But when scientists reanalyzed the data they found that the drug helped block the antibodies that cause lupus symptoms in a subset of patients."" No disease mongering of lupus. Two independent sources were quoted. Not applicable. With no other new drug approved for lupus in 56 years, there’s not been much to compare it with. The story did state that some experts thought this ""could prompt development of other drugs that are even more effective in treating the debilitating immune system disorder."" The focus of the story is FDA approval of the new drug. The headline explains that the FDA approved the first new drug for lupus in 56 years. It’s clear the story did not rely solely on a news release." Claim: FDA approves first new drug for lupus in 56 years

Answer: "Good caveats, including in the patient profiled, who said, ""It’s a bittersweet thing for me because I have friends with lupus for whom this drug won’t work. There’s no one-size-fits-all for lupus and I’m just extremely fortunate that my lupus is mild and is helped by Benlysta."" The story should have discussed potential harms and costs. As the story explained, this was not only the first new lupus drug approved in 56 years, but it could be ""a milestone that medical experts say could prompt development of other drugs that are even more effective in treating the debilitating immune system disorder."""


Question: Paragraph: The Marjory Stoneman Douglas High School Public Safety Commission, meeting in Orlando, found that the state’s mental health system is too often a revolving door. Under Florida’s Baker Act, which allows a police officer, judge or mental health professional to involuntarily commit a person for a 72-hour evaluation, less than 1% of the 200,000 people examined last year received long-term treatment, the commission found. Many were released in less than a day despite repeated commitments because the system is set up to treat the immediate crisis that led to the Baker Act being implemented and not toward long-term treatment, the commission found. It also found that Florida ranks near the bottom among states in per capita spending on mental health at about $36 annually per resident, which the commission said contributes to short-term fixes instead of long-term solutions. Pinellas County Sheriff Bob Gualtieri, the commission’s chairman, said his department is now dealing with a 14-year-old who has threatened to commit a school massacre, rape teachers and shoot police officers. He said the boy has been committed under the Baker Act 35 times since age 8 and arrested 14 times, but is always released. Gualtieri said records compiled by law enforcement, schools and the mental health system are often kept separately, so it wasn’t until recently when an analyst in his office did a threat assessment of the teen that a full picture was compiled. He compared the boy to Nikolas Cruz, who is charged with killing 17 people in last year’s Stoneman Douglas shooting. Cruz had severe emotional and behavioral issues but was never hospitalized. “There was no holistic view of this child and, importantly, nobody owned the problems with this kid,” Gualtieri said of the Pinellas County teen. “When I read that threat assessment report, there was just a big pause. ... There was nothing in the system to say, ‘Hold on, there is something seriously, seriously wrong here.’” Commissioner Mike Carroll, former head of the state’s Department of Children and Families, said the system lacks accountability for both the child and the parents. A judge can order a program addressing the child’s behavioral or emotional problems, but has no power to impose consequences if the program isn’t followed, he said. That must change, he said. “If I had diabetes and went to the doctor, no one would ask why this program isn’t working if the person wouldn’t take their insulin shots,” Carroll said. Gualtieri said many teens and adults when confronted by police have learned to act as if they are severely mentally ill to avoid arrest. Then when they are evaluated under the Baker Act by a medical professional, they act normal and are released, he said. For many, the process repeats over and over, he said. “We are on the hamster wheel,” Gualtieri said. “People have this idea that if you Baker Act, you are going to solve all the problems.” The 15-member commission is composed of law enforcement, education and mental health professionals, a legislator and the fathers of two students slain in the massacre. It is completing its second annual report aimed at preventing future school shootings. Cruz, 21, had a long history of mental health issues, court records show. Those included making threats at school, fights, vandalism, and other inappropriate behavior. He spent years being periodically assigned to a school for students with behavioral and emotional problems before he was allowed to briefly attend Stoneman Douglas. He was kicked out in early 2017. Cruz’s attorneys have said he would plead guilty in exchange for a life sentence, an offer prosecutors have declined. They are seeking the death penalty. Claim: Florida commission says mental health system needs overhaul.

Answer:
Florida’s mental health system is underfunded and needs to be overhauled, with better coordination between providers, law enforcement and educators, the commission investigating last year’s high school massacre recommended to the legislature Wednesday.