TASK DEFINITION: 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.
PROBLEM: 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.

SOLUTION: 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.

PROBLEM: Paragraph: The Sackler family owns Purdue Pharma, the privately held drug company that has made billions from OxyContin, and Sacklers hold most of the seats on the board. Members of the family have been accused in a case brought by the state of Massachusetts of deceiving patients and doctors about the drug's risks as deaths mounted. And documents recently released in the case shine new light on former Purdue Pharma President Richard Sackler's role in the aggressive marketing of the powerful opioid. As the allegations mount, family members who made their fortunes well before OxyContin even went on the market have sought to distance themselves from their relatives. At the same time, activists have called on institutions to cut ties with the Sacklers, staging protests at museums that have received millions in donations. "The Sackler name is becoming synonymous with the opioid epidemic, and it is damning for these institutions to have their name up," said Nan Goldin, a photographer whose works have been displayed at Harvard's Arthur M. Sackler Museum and at New York's Metropolitan Museum of Art, which has a Sackler Wing. Lost in the outrage: One of the most generous and best known of the Sacklers died in 1987, nearly a decade before OxyContin was released. Arthur M. Sackler made his money from medical research, medical advertising and trade publications. His younger brothers, Raymond and Mortimer, bought out his stake after he died. Arthur Sackler's name is on a gallery at the Smithsonian, a wing of galleries at London's Royal Academy of Arts and a museum at Beijing's Peking University. The Sackler Wing at the Met, which houses the celebrated Temple of Dendur from ancient Egypt, was funded by all three brothers. Richard has likewise donated heavily to various institutions. After a federal investigation, Purdue Pharma and three executives none of them Sacklers pleaded guilty in 2007 and agreed to pay more than $600 million for misleading the public about the risks of OxyContin. The Stamford, Connecticut, company has also been hit with a multitude of lawsuits over its role in the opioid crisis that killed more than 47,000 people in 2017 alone. Arthur's nephew, Richard Sackler, who became president of Purdue Pharma in 1999 and remains on the board, is at the center of the litigation. He and other current and former executives have been accused of hiding the dangers of the drug from doctors and patients, encouraging physicians to prescribe more of the highest doses and minimizing the abuse crisis as it was unfolding. "This is not too bad. It could have been far worse," he wrote to Purdue Pharma executives in 2001 after a federal prosecutor reported that 59 people in one state had died from OxyContin, according to documents released this week in the Massachusetts case. At the launch party for OxyContin in 1996, Richard Sackler boasted the drug would bring a "blizzard of prescriptions that will bury the competition," the documents say. Years later, they say, he sought to shift blame onto drug users themselves, recommending the company "hammer on the abusers in every way possible." "Richard followed that strategy for the rest of his career: collect millions from selling addictive drugs, and blame the terrible consequences on the people who became addicted," attorneys in Massachusetts Attorney General Maura Healey's office wrote. "By their misconduct, the Sacklers have hammered Massachusetts families in every way possible. And the stigma they used as a weapon made the crisis worse." A spokesman for Richard Sackler's family referred questions about the lawsuit to the company. Purdue Pharma said in a statement that Massachusetts' case the first one brought by a state to personally name members of the Sackler family is "littered with biased and inaccurate characterizations." The company said it will "aggressively defend against these misleading allegations." Arthur Sackler's widow and children insist that they never financially benefited from the sale of OxyContin. "It is a gross injustice to connect Arthur to the opioid crisis some 30 years after his death when he had nothing to do with it," Dame Jillian Sackler said in a statement. "It denies the many important contributions he made working to improve world health and to build cultural bridges between peoples." But activists have made no distinction between Arthur and his relatives. In July, dozens of activists led by Goldin held a protest inside the Arthur M. Sackler Museum at Harvard, scattering pill bottles and holding banners that read "SHAME ON SACKLER." Similar demonstrations have been held at the Met and the Smithsonian. Goldin, who was addicted OxyContin for years, said that getting the institutions to act will be difficult. "Who is going to turn down the money? They offer millions to these institutions, and the board members are not necessarily committed to action, so it's going to take a lot," she said. A Met spokesman said that the Sackler family's support began decades before the opioid crisis, but that the museum will be examining its gift acceptance policies. The Guggenheim, home to the Sackler Center for Arts Education, had no comment. A Harvard spokesman said in an email that Arthur Sackler's donation in 1982 paid for the construction of the building that originally housed the museum but that his foundation does not fund the museum. ___ Associated Press reporter Verena Dobnik contributed to this report from New York. ___ Follow Alanna Durkin Richer at http://www.twitter.com/aedurkinricher Claim: Opioid crisis brings unwanted attention to wealthy family.

SOLUTION: The Sackler name is emblazoned on the walls at some of the world's great museums and universities, including the Smithsonian, the Guggenheim and Harvard. But now the family's ties to OxyContin and the painkiller's role in the deadly opioid crisis are bringing the Sacklers a new and unwanted kind of attention and complicating their philanthropic legacy.

PROBLEM: Paragraph: The Arkansas Department of Health issued the public health directive in a Nov. 22 letter that stated students without at least two doses of measles, mumps and rubella vaccine either be vaccinated immediately or be barred from classrooms and school activities for at least 26 days. Brothers Shiloh Isaiah and Benjamin Andrew Bemis asked the Washington County Circuit to issue a temporary injunction, arguing "that the University of Arkansas failed to recognize and uphold our philosophical beliefs as enrolled students -- beliefs which include the choice to abstain from vaccinations." In a one-sentence order, Judge Doug Martin on Tuesday denied their request to be allowed to return to their classes without getting the vaccinations. Martin's order didn't explain the reason for the decision. Shiloh Bemis, 21, told the Arkansas Democrat-Gazette that he's disappointed in the court's order. "On a larger level, we are taking issue with the fact that we don't think we've quite been given a choice that fully takes into account what we believe our rights to be," the third-year architecture student from Fayetteville said. Benjamin Bemis didn't respond to the Democrat-Gazette's request for comment. State law requires vaccinations for students, but it also allows exemptions for medical, religious or philosophical reasons. But the state Health Department said even exempted students must heed the public health directive. "Even if they have an exemption, they still are supposed to be excluded from class and activities, since they are much more susceptible to getting the infection," said Dr. Joel Tumlison, a physician specialist in the health department's outbreak response team. "For any student, whether simply undervaccinated or with an exemption, if they change their mind and get the vaccine, they can then return to class/activities." University spokesman Mark Rushing said the school will continue to follow the health department's instructions. The university has had 26 mumps cases since September, according to health officials. As of last week, 168 students lacked the required vaccinations to attend classes, UA spokesman Zac Brown said. Claim: Arkansas judge denies students' appeal to vaccination policy.

SOLUTION:
A judge has denied two University of Arkansas students' request to block a public health decree that has barred them from attending classes during a mumps outbreak because they don't have the proper vaccinations.