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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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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.
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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.


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Paragraph: A significant drop in immunisation over the last few years has made Samoa highly vulnerable to outbreaks of the disease, with the World Health Organisation (WHO) saying vaccine coverage is just about 31% there. Schools have been shut and a mass vaccination effort launched in the nation of just 200,000 located south of the equator halfway between Hawaii and New Zealand, with its government saying 50,068 people have been vaccinated. The health ministry said 3,149 cases of measles have been reported, with 213 during the last 24 hours. Of 197 victims in hospital, 20 are critically ill children and three are pregnant women, it added. Deaths in the outbreak have now reached 42, the majority of them children under the age of four, the government said. Neighbouring New Zealand said it was sending more supplies and personnel, including emergency medical assistance teams, nurse vaccinators, intensive care specialists and Samoan-speaking medical professionals. “The Samoan health system is under serious strain with growing numbers of people, many of whom are very young, needing complex care as a result of the measles outbreak,” said New Zealand’s foreign minister, Winston Peters. New Zealand would also fund 100,000 more vaccines for measles and rubella, Peters added in a statement. Britain said a group of British doctors and nurses left on Friday to help Samoa’s efforts to rein in the outbreak, while Australia said it had also sent medical personnel and supplies. Measles is caused by a highly contagious virus that spreads easily through coughing and sneezing. Other nations in the Pacific, such as Tonga and Fiji, are also grappling with a spike in the number of measles cases. Tonga has said its outbreak followed the return of a squad of its rugby players from New Zealand, where Auckland, the biggest city, is tackling a growing number of cases. Measles cases are rising worldwide, even in wealthy nations such as Germany and the United States, as parents shun immunisation for philosophical or religious reasons, or fears, debunked by doctors, that such vaccines could cause autism. Claim: Samoa measles toll hits 42 as nations dispatch medical teams, supplies.
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More nations were flying medical staff and supplies to Samoa on Friday to battle a measles outbreak that prompted the Pacific island nation to declare a state of emergency this month, as the death toll rose to 42, most of them children younger than four.


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Paragraph: Novartis, with exclusive rights to the drug in Europe while cooperating with Amgen in the United States, said it was “disappointed” in the National Institute for Health and Care Excellence’s (NICE) conclusion. It marks the second time within months the UK agency has rejected reimbursement for a key medicine from the Swiss drugmaker. Novartis, whose U.K. price for Aimovig is about 5,000 pounds ($6,374) annually but which was offering discounts, is counting on the medicine to be a foundation of its neuroscience business and a key part of boosting revenue as older medicines lose patent protection. Some analysts see 2022 sales nearing $1 billion, according to Refinitiv. While NICE said the medicine demonstrated clinical effectiveness, the agency concluded there was not enough evidence to suggest it is more effective than botulinum toxin type A, which is marketed by Allergan as Botox. NICE also raised questions about long-term effectiveness. “We will work with the company to ensure that they are given every opportunity to address the issues highlighted in these provisional recommendations,” NICE said. Novartis, which pledged to work with NICE to address outstanding questions, said patients would lack new treatment options if the decision remains unchanged. “The UK already lags significantly behind other European countries in the ability for patients to access new medicines,” Novartis said. In September, NICE also issued draft guidance concluding Novartis’s cancer cell therapy Kymriah, offered with an undisclosed discount to its list price of 282,000 pounds, was too expensive to recommend to treat adults with lymphoma. Novartis is also seeking to reverse that decision. Claim: Novartis migraine drug not cost effective - UK price watchdog.
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Britain’s drug price watchdog on Thursday rejected Novartis’s migraine drug Aimovig for now, concluding in a draft decision that the medicine was not a cost-effective use of National Health Service resources.