instruction:
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.
question:
Paragraph: This release makes no mention of the costs of the drugs compared in this study, even though the drugs have been in use for years and are widely available. Since the study is a comparison of various treatments for this form of cancer, it seems relevant to offer a cost comparison as well as a comparison of efficacy. It appears that the high dose methotrexate is given over a 24-hour period, presumably in the hospital, while the standard methotrexate is given as a single dose. Also, the high dose methotrexate is followed by leucovorin administration while the standard dose is not. According to the site GoodRx, the cost for methotrexate in low-dose (2.5 mg) pill form averages out to about $50 for a month’s supply. Newer, injectable variations of the drug cost upwards of $500 a month for the 25 mg dose. The release states that patients receiving high doses of the drug methotrexate “had a significantly better outcome, by 5 to 6 percent” than did patients receiving the current standard of care, which is gradually escalating doses of the drug. The release also explains that patients nine years old or younger who were also treated with a steroid called decadron (dexamethasone) for half as long as normal (14 versus 28 days) benefited from the treatment while patients 10 and older did not. We’re not sure of the meaning behind these results as portrayed in the release. Which outcome was better by 5 or 6 percent? The study has several. Does that mean the relapse rate was reduced or is it the event free survival that was better? It would be more meaningful to readers if the release had included the actual relapse and event free survival rates for each group analyzed in terms most people can understand. For example: “relapse rates were 5 percent lower in Group X compared to Group Y.” We’ll give this category a satisfactory rating largely due to the release including information that patients 10 and older receiving dexamethasone “were at much higher risk for a debilitating bone condition called osteonecrosis,” although we would have been happier if that greater risk would have been quantified. However, the published study explains that there were toxicity problems beyond that of dexamethasone and the release would have been stronger including that information as well. The release stated the study was randomized and controlled, and provides a broad overview of the study design, for which we give the release a borderline satisfactory under this criteria. However, these are the superficial results. On deeper delving into the study methodology, the statistical significances of the results were very close to not statistically significant. This is due to their planned interim stopping of the treatment and the fact that they were looking at multiple outcomes in multiple groups. This release doesn’t demonstrate disease-mongering. While the release does say that this clinical trial was run by the Children’s Oncology Group, which is funded by the National Cancer Institute and the National Institutes of Health, it makes no mention of possible conflicts of interest. Compounding that is the fact that the published study says, “Disclosures provided by the authors are available with this article at www.jco.org,” but that information is behind the journal’s paywall for most readers, so it’s unknown if there is, or is not, a conflict. It appears as though five of the authors (out of a total of about 20) have some conflicts of interest, mostly from several types of drug company payments. The release is comparing the efficacy of treatment regimens using different drugs so alternative treatments for B-acute lymphoblastic leukemia are noted. The release makes clear at the end that the treatment of this disease is improving thanks to refinement of the use of existing drug treatments, meaning that they are readily available for patient use. The release suggests the study findings could change the way childhood leukemia is treated. Modifying existing treatments to enhance a patient’s survival is certainly novel enough to warrant a release. There is no use of unjustifiable language in this release. However, the tone may be a bit overly optimistic given the study findings. Claim: Relapses of childhood leukemia improve with high doses of common chemo drug
answer:
This release reports the findings of a large clinical trial testing whether alternative dosing regimens of standard chemotherapeutic drugs can improve the treatment of B-acute lymphoblastic leukemia. The study showed that using high doses of the drug methotrexate, rather than the standard regimen of gradually increasing doses, improved the outcomes for patients with the disease. The study also showed that using the steroid dexamethasone increased a debilitating bone condition in patients 10 and older but not in patients nine or younger. While the study results are promising, they are by no means clear-cut in the release. The release needed some qualifiers in order to give a clear picture of the benefits. The release also neglected to discuss costs and potential conflicts of interest among the investigators. This form of cancer — B-acute lymphoblastic leukemia — is the most common cancer in children and a major cause of cancer death in patients under 40 years old. And while the majority of patients survive with appropriate treatment, anywhere from one-fifth to one-quarter of patients do not. This study showed that refining the dosing of standard cancer drugs may improve the outcome for some high-risk patients.


question:
Paragraph: The trial results on patients with a gene anomaly known as NTRK fusion, which occurs in less than 1 percent across a range of tumor types, were presented at the annual congress of the European Society for Medical Oncology (ESMO) in Munich on Sunday. Germany’s Bayer and U.S. partner Loxo, in turn, released data for their rival compound larotrectinib, which slightly improved on previous high-efficacy readings in an enlarged trial. Traditionally, oncologists have made treatment decisions based on where in the body a tumor started, increasingly helped by the growing knowledge of cancer’s complex genetic drivers. Under the tumor-agnostic approach, also known as pan-tumor, drugmakers skip the organ-of-origin perspective and regroup patients based only on signature genetic mutations, but success in real life will depend on the fast spread of comprehensive gene-sequencing tools for tissue samples. Individually, the mutations are so rare that cancer units are seen as unlikely to run dedicated tests for each. Roche’s Foundation Medicine supplies the comprehensive kits, competing with Thermo Fisher Scientific and Caris Life Sciences. “It’s one of the reasons we acquired Foundation Medicine, to make this comprehensive genomic profiling routine and upfront in the course of the disease,” said Daniel O’Day, the head of Roche’s Pharmaceuticals division. Loxo’s larotrectinib pill, co-developed with Bayer, was last year shown to shrink tumors in 75 percent of patients with the NTRK fusion gene anomaly, occurring in the lung, pancreas, or more than a dozen other organs. On Sunday, the response rate to larotrectinib within an enlarged group of 122 trial participants - up from 55 initially and now spanning 24 tumor types - was shown to be 81 percent. Roche said the readings from the two NTRK fusion trials were not comparable because they are made up of different patient types. Loxo’s study, for instance, included some cancers in children, while Roche plans to investigate those separately. The Roche compound is designed to tackle several oncogenic mutations and last month, it unveiled data here on entrectinib pushing back tumors in 77 percent of lung cancer patients with a mutation called ROS1. Merck & Co’s Keytruda in May last year became the first drug to win approval for pan-tumor use, though that remains a relatively small market for the mega-selling drug. Bayer and Loxo are testing a second pan-tumor drug, LOXO-195. Roche Pharmaceutical’s O’Day welcomed a wider field. “Both things have to happen: You need genomic profiling and you need enough targeted medicines to encourage physicians to make that diagnosis upfront very complete. This is the world we’re entering,” he said. Though response rates could encourage a race for more such drugs, the need for suitable gene mutations or fusions will be a tall order, said oncologist Ulrik Lassen of Copenhagen’s Rigshospitalet, who co-authored the larotrectinib study. “You need to screen a lot of patients to find the needle in the haystack and the method is complicated, costly and time-consuming. When we get better at using these technologies, we can find more oncogenic fusions and companies will be smart enough to find the agents that target them.”  Roche acquired entrectinib as part of its takeover deal with U.S. cancer drug specialist Ignyta Inc for $1.7 billion, agreed in December last year. Immuno-oncology remains another major business area for Roche, which also released positive results on using its Tecentriq drug in a group of breast cancer patients with a particularly poor prognosis. Claim: Roche takes on Loxo, Bayer in gene-defined cancer class.
answer:
Roche’s entrectinib cancer pill was shown to shrink tumors in 57 percent of patients within a group that can only be identified via genetic profiling, as the Swiss drugmaker challenges an alliance of Bayer and Loxo Oncology in a new targeted treatment area.


question:
Paragraph: "Texas Attorney General Greg Abbott drew heat for a Feb. 4 2014, speech in which he likened official corruption scandals in Texas-Mexico border counties to ""third-world practices,"" a comment PolitiFact Texas unpacked in a Feb. 11 In Context article. His comparison drew criticism from lawmakers, the McAllen newspaper and his main opponent in the governor’s race, Democratic state Sen. Wendy Davis, who said, ""Abbott even went as far as comparing the Texas border to a third-world country."" (Abbott soon after won the Republican gubernatorial nomination in the March 2014 primary.) Responding to such criticism, Abbott said in a Feb. 10 opinion article in the McAllen Monitor that his concerns about corruption expressed in his speech ""apply wherever corruption is found."" ""Public service is a public trust,"" Abbott wrote. ""As attorney general, I have prosecuted judges, district attorneys and other public officials across Texas who violated that trust, who have been corrupted."" We were curious about that because the attorney general’s office doesn’t focus on battling violent crime. That’s the purview of local prosecutors and police departments. As the Texas Constitution makes clear, the primary job of the attorney general is representing the state in civil matters. Still, state law permits the attorney general to help prosecute a criminal case if a local prosecutor requests assistance. For such purposes, state lawmakers have allowed the attorney general to employ peace officers and lawyers with backgrounds in criminal prosecution to pitch in on occasion. We asked Abbott’s office for information on the prosecutions he referred to in his commentary. Spokeswoman Lauren Bean emailed us a list of 104 prosecutions handled by the agency since Abbott became attorney general in late 2002. The AG’s office was the lead prosecutor in the vast majority of the cases, she told us by phone. The list included cases involving public officials from dog catcher (a child pornography case that ended in a guilty verdict) through higher city and county officials, tax assessors, sheriffs, justices of the peace, judges, assistant district attorneys and one former district attorney (who pleaded guilty to paying himself and others more than $2 million illegally while in office). Crimes involving child pornography and taking public funds are certainly violations of the public trust, though we also wondered how many of Abbott’s cases involved corruption like the examples he presented in his ""third-world"" speech: a former state district judge sentenced to six years in prison for his role in a cash-for-favors scheme, a former sheriff’s captain who took bribes from drug traffickers; and law enforcement officials who stole drugs and resold them to dealers. Abbott also noted in his Feb. 10 opinion piece that the Monitor had reported that ""cases of public officials on the take have spiked."" And, Abbott said, ""there have been other stories about law enforcement officers in other Texas counties involved in money laundering, drug smuggling and accepting bribes to protect the cartels and their smuggling routes."" Texas Penal Code Chapter 1, Section 1.09, says the attorney general’s office can aid county or district attorneys in prosecuting certain criminal offenses including misuse of state property or funds and abuse of office, according to the office’s website. Public corruption, bribery and abuse of office were specifically cited in some of Abbott’s prosecutions. We set aside those that did not immediately appear to relate to misusing a public office. Deleting DWI cases, child pornography or indecency, murder, assault/injury, sexual offenses and gambling left 61 prosecutions. Eleven of those 61 prosecutions cited theft by a public servant. Others fell into criminal offense categories including bribery, (breach of) public integrity, official oppression, election violations, fraud and abuse of official capacity, as well as misappropriation or misallocation of public funds or property. The type of case in one prosecution involving an assistant county auditor was specifically given as ""public corruption."" So certainly some of the prosecutions involved what ordinary citizens might regard as corruption. We sought expert advice. Two attorneys suggested it’s not easy to decide when a criminal case involves corruption in office. Director Gregg Cox of the Travis County district attorney’s special prosecutions division, which investigates allegations of wrongdoing by public officials, told us by email, ""There is no definition of ‘corruption’ in the Penal Code or Code of Criminal Procedure, and because the way that term is used can differ from office to office, I would just not be comfortable commenting on that."" George Dix, a criminal law expert and University of Texas law professor, said via email, ""I'm not sure what are 'corruption' cases. As far as I know, that is not a term of art. I suppose the term could mean a prosecution for a crime that requires proof of some official malfeasance."" Finally, we looked at whether the prosecutions occurred across Texas, as Abbott wrote, and at whether the prosecuted individuals included judges and district attorneys, as he said. The 104 prosecutions occurred in about one-fourth of Texas’ 254 counties -- six on the border and 193 scattered elsewhere across the state. Nine of Abbott’s public-official prosecutions involved a judge, assistant district attorney, county attorney and district attorney (at the time of his crimes). Four seemed not to be related to abuse of office: a child pornography case, two drunken-driving cases and one case involving misdemeanor offensive contact with an employee. The remaining five prosecutions: State v. David McCoy A Feb. 21, 2008, Amarillo Globe-News news story said, ""Suspended 100th District Court Judge David McCoy concluded an agreement with the state Attorney General's office Thursday afternoon that will prevent him from facing felony charges. … A Childress County Grand Jury indicted him on two felony indictments: abuse of official capacity and theft by a public servant."" News reports provided no additional detail. State v. Emil Karl Prohl An April 29, 2010, Facebook post by the Kerrville Daily Times said, ""Former 198th district judge Emil Karl Prohl has pled guilty to charges of misapplication of funds. He gets two years probation for taking double reimbursement for travel expenses out of several district and county accounts."" State vs. Joe Frank Garza A May 9, 2011, Corpus Christi Caller-Times news story said, ""Former 79th District Attorney Joe Frank Garza began serving a six-month stint behind bars on Monday for illegally paying himself and his employees more than $2 million from his office's drug forfeiture fund."" In re: Judge Christopher Dupuy A Sept. 19, 2013, Houston Chronicle news story said, ""A suspended Galveston judge pleaded guilty Thursday to two misdemeanors in exchange for two years of probation. County Court-at-Law Judge Christopher Dupuy pleaded guilty to abuse of office and perjury in exchange for two years of deferred adjudication. … The petition for removal accuses Dupuy of failing to obey an order from a state appeals court, abusing his authority by retaliating against attorneys and threatening the district clerk while attempting to interfere in his own divorce case."" State vs. Scott Tidwell An Oct. 5, 2011, Associated Press news story said, ""A former West Texas county attorney will spend four months in jail for retaliating against two nurses who made an anonymous complaint about a doctor to state medical regulators. … The nurses were fired from their jobs at a hospital in Kermit and charged with felonies."" Our ruling Abbott said, ""As attorney general, I have prosecuted judges, district attorneys and other public officials across Texas who violated that (public) trust, who have been corrupted."" During Abbott’s decade-plus as attorney general, his office has helped prosecute 104 cases against public officials across Texas -- 61 of them appearing to involve public corruption and five of those against judges, a county attorney and a DA. The statement is accurate and there’s nothing significant missing." Claim: As attorney general, I have prosecuted judges, district attorneys and other public officials across Texas who violated that (public) trust, who have been corrupted.
answer:

"Abbott said, ""As attorney general, I have prosecuted judges, district attorneys and other public officials across Texas who violated that (public) trust, who have been corrupted."" During Abbott’s decade-plus as attorney general, his office has helped prosecute 104 cases against public officials across Texas -- 61 of them appearing to involve public corruption and five of those against judges, a county attorney and a DA."