User:MCDB40Student81/sandbox

Article Evaluation

VAMP regimen (evaluated 2/11/18)

Although everything in this article was on topic and neutrally reporting facts, I found several problems with it, and it is easy to see why it is currently listed as a snub article. First of all, there is no formal introduction section, nor are there any subsections. Instead, there is a one sentence definition, followed by four bulleted examples of what the regimens include. The viewpoints that are included need to be expanded more fully and more completely, and there are sections that are obviously missing from the article; a subsection about the history and development of the VAMP regimen would be a good addition to the article, and the article does not discuss or discuss the successes and drawbacks of VAMP as a means of treating cancer. In terms of sources, the ones used are neutral and reliable, and each fact in the article is supported with references. However, it seems like too many of the sources are too specific to give enough general information about the topic (and this fact is reflected in the articles' lack of broad information about VAMP). Scientific studies are great sources, but an article like this could use some more background that it is entirely missing at this point. The talk page is completely empty, which is also a sign that probably only one person was working on this article.

Content Gaps

According to Wikipedia's education dashboard, content gaps are pieces of information that are currently missing from Wikipedia. This could refer to articles that do not completely cover their topics, or it could also refer to entire articles and topics that have yet to be written about. There are several possible ways to identify these gaps. Gaps can be identified within articles by peer evaluations of articles by fellow Wikipedia editors, as my exercise above showed; when I was reading the VAMP article, I asked myself what information I knew about VAMP and what information I would want to know more about VAMP and checked if the article included it. Content gaps could also be found by searching on the internet for information about a topic and finding that there is no Wikipedia article about that topic.

Content gaps emerge for a couple of different reasons. Sometimes, gaps are due to a fault of the article writers, if they fail to cover a major aspect of their topic that there is ample information about. Sometimes, however, there are subjects about which it is currently not possible to have a perfect article, either because the topic is too heavily contested to talk about objectively, or because there is not enough reliable information to write about a topic (e.g. a new medical treatment that needs to go through clinical trials or that is in the early stages of development). If content gaps are a result of poorly written articles, these can be fixed and more thoroughly researched by Wikipedia editors.

Excellent job on these answers grade A RJBazell (talk) 18:17, 12 February 2018 (UTC)

It does matter who writes on Wikipedia because biases need to be controlled for. Someone who is involved directly with a topic should not write about that topic, because it is not possible to write completely objectively on something that you yourself are working on. In fact, even sources from people directly involved with a topic should not be used because Wikipedia articles are meant to present unbiased facts, so they should be supported by unbiased evidence.

To be unbiased on Wikipedia means to be presenting a completely neutral, unpersuasive presentation of facts about a subject. To write an unbiased Wikipedia article, one has to carefully and rigorously evaluate their sources for bias, and only work from sources that themselves are neutral. Unlike in many other forms of academic writing, no interpretive work should be done on the part of the article writer. In this way, Wikipedia has a more strict interpretation of bias than the way I usually think about it. In the past research papers I have written, the prompts have asked me to come up with an 'impartial' answer to a contested issue by looking carefully at both sides and then arguing for my own stance on the issue; but, of course, this task is not impartial at all! By looking at biased sources, I formed my own subjective view on the topic, and then my final papers made persuasive arguments biased by my personal view on the subject. The task of Wikipedia writers is entirely different. Wikipedia aims to eliminate all opinions and biased viewpoints from their presentation of a subject, and to distill each subject into pure facts conveying what we currently know about the topic.

Discussion

• Blog posts and press releases are poor sources of information because they are both subjective and usually unsupported by rigorous evidence. As a rule, it is much better to look at general reviews, books, and encyclopedia articles. With both of these types of sources, there is no good way to verify where the authors got their information from, and that is problematic when presenting information that the general public will read and trust.

• Using a company's website as a source for an article about that company has obvious bias problems; the way that a company presents itself is never going to be unbiased and will always be trying to display impressiveness and an (often exaggeratedly) optimistic view of itself. One should instead find neutral sources that can look at a company from an unbiased lens.
• Copyright infringement and plagiarism are both words given to stealing property that isn't yours and passing it off as if it were. However, copyright infringement usually refers to physical or tangible objects; for the purposes of wikipedia this usually means pictures. Plagiarism refers to the stealing of intellectual property, pretending ideas that you got from somewhere are your own; even if sources are cited, one can plagiarize by paraphrasing too closely.
• Both plagiarism and copyright infringement are obviously wrong, and they are also easily avoidable. Don't use pictures that are not found in Wikimedia Commons, and cite all sources carefully and without paraphrasing. Generally it is a good idea to not have the exact wording of your sources in front of you so that you are not plagiarizing or paraphrasing too closely; instead, jot shorthand notes on the big ideas of the article and, when necessary, statistics and data, and work off of those notes.

Chosen Article: VAMP Regimen

I have chosen to work on the VAMP regimen article for the remainder of this semester. The article is listed under medium importance of medical articles and as a stub, so I think I will produce something that will be seen by a decent amount of people, which is exciting. It is very lacking in information and organization, and there is much room for general improvement. More specific comments about this article are above, because this was the article that I evaluated in previous part of my Wikipedia Training. I will reference these comments as I begin to work on and improve the article.

Bibliography for VAMP Regimen

Mukherjee, Siddhartha (2010). The Emperor of all Maladies. Scribbler.

DeVita, Vincent (November 2008). [ http://cancerres.aacrjournals.org/content/68/21/8643 "A History of Cancer Chemotherapy"] Check |url= value (help). American Association for Cancer Research. 68: 8643–8653.

Pritchard, Justin R.; Lauffenburger, Douglas A.; Hemann, Michael T. (2012-10). "Understanding Resistance to Combination Chemotherapy". Drug resistance updates : reviews and commentaries in antimicrobial and anticancer chemotherapy. 15 (0): 249–257. doi:10.1016/j.drup.2012.10.003. ISSN 1368-7646. PMC 3975170 . PMID 23164555. Check date values in: |date= (help)

Forgeson, G. V.; Selby, P.; Lakhani, S.; Zulian, G.; Viner, C.; Maitland, J.; McElwain, T. J. (October 1988). "Infused vincristine and adriamycin with high dose methylprednisolone (VAMP) in advanced previously treated multiple myeloma patients". British Journal of Cancer. 58 (4): 469–473. ISSN 0007-0920. PMC 2246797 . PMID 3207601.

Stuart, N. S.; Blackledge, G. R.; Child, J. A.; Fletcher, J.; Perren, T. J.; O'Brien, C. J.; Jones, E. L.; Ellis, I. O.; Kavanagh, J. A. (1988). "A new approach to the treatment of advanced high-grade non-Hodgkin's lymphoma--intensive two-phase chemotherapy". Cancer Chemotherapy and Pharmacology. 22 (2): 141–146. ISSN 0344-5704. PMID 3409445.

Lead Section and Outline for Body Edits

Outline for my edits to the article:

In addition to fixing up the lead section, I plan to add a few other sections to this article to make it more complete. I will add a section about the development of VAMP, elaborating on the history of the drug, and discussion in a neutral manner the controversy over these trials. I will also add a mechanism of action section, where I will discuss the mechanisms behind each of the four drugs in the original VAMP combination more thoroughly; I will also use this section to discuss the synergistic effects of combination chemotherapy as opposed to single chemotherapy drugs.

Original article copied from VAMP regimen:

VAMP regimen or VAMP chemotherapy is a combination chemotherapy regimen including Vincristine. It was developed by Frei and Freireich at the National Cancer Institute, with its first trial in 1961.

VAMP chemotherapy can refer to any of :

• Vincristine for 4 days, doxorubicin (Adriamycin) for 4 days and methylprednisolone for 5 days per cycle. e.g. for kidney disease. - With the addition of cyclophosphamide this becomes C-VAMP.
• Vincristine, doxorubicin (Adriamycin), methotrexate and prednisone used in combination with radiation therapy for the treatment of low-risk childhood Hodgkin lymphoma.
• Vincristine, amethopterin, 6-mercaptopurine, and prednisone for leukemia.

The VAMP regimen is used in the treatment of cancer. It serves as a type of treatment for Hodgkin lymphoma.

My edits:

VAMP regimen or VAMP chemotherapy is a four-drug combination chemotherapy regimen, used today in the treatment of Hodgkin lymphoma. It was one of the earliest uses of combination chemotherapy, originally developed as a treatment for childhood leukemia by Frei and Freireich at the National Cancer Institute, with its initial trial in 1961. Because it was the first time that four chemotherapeutic agents were used at once, more drugs than had ever been combined into one treatment before, it was a highly controversial trial. Although new combination chemotherapy regimens have replaced the use of VAMP in the treatment of childhood leukemia, VAMP represents an important precursor to modern treatments, confirming the effectiveness of combination chemotherapy and leading to the use of combination chemotherapy regimens on other forms of cancer.

The VAMP regimen developed by Freireich and Frei was a combination of vincristine, amethopterin, mercaptopurine, and prednisone. Now, other combinations and doses that are referred to as VAMP, including C-VAMP and a VAMP regimen that replaces the mercaptopurine of the original combination with doxorubicin. All these regimens take advantage of the synergistic effects of combining multiple chemotherapy agents. These benefits are two-fold. First, utilizing multiple drugs at once overcomes the problem of drug resistance. Second, combination chemotherapy allows multiple independently-acting drugs to be administered at their maximum dose, which increases the treatments toxicity to cancer cells without being deadly to the patient.

History

By 1960, several chemotherapeutic agents had emerged, among these nitrogen mustards, folic acid inhibitors, and purine analogs, each with its own individual history and development. It had also been established that the use of combination chemotherapy, the use of multiple chemotherapy drugs at once, provided synergistic benefits over single agents. VAMP emerged amid a period of methodical testing of various combinations of these agents. Due to the immense possibilities of combinations, this trial process was slow and, in the view of some, inefficient.

Emil Frei and Emil Friedrich took decisive and bold action and proposed a regimen of four chemotherapeutic drugs, larger than had been attempted before. The aggressiveness and potential lethal toxicity of this proposal was alarming to many fellow members of the National Cancer Institute, who felt that Frei and Freireich were making a dangerous break with the methodical trial processes that characterized the leukemia group of the NCI. But Frei and Freireich felt that the current pace of the NCI was too slow to make progress.

Initially, the leukemia group rejected the VAMP proposal, denying funding until many of their current trials had been completed. However, the reached an arrangement that involved the VAMP trial being run separately from the rest of the leukemia group at the NCI. The trial began in 1961 on children with leukemia.

The initial weeks were grueling. The children were pushed to the brink of death by the toxicity of VAMP's four drugs, each cytotoxic on its own. Then, after a few weeks, the children's marrow healed, remissions came, and leukemia was undetectable in many of the patients. These remissions astounded Frei and Freirdrich's peers, and gained supporters even from those who formerly resisted the trial. The remission rate ultimately increased to 60%, of which around half were years long, far longer than normal remissions.

Ultimately, however, the remissions were not permanent for most. Because none of the components of VAMP could cross the blood–brain barrier, there was nothing stopping the leukemia from reemerging in the nervous system and invading the brain. These relapses proved deadly.

Mechanisms of Action

VAMP includes four drugs, vincristine, amethopterine, methotrexate, and prednisone, operating under independent pathways, which work in concert with one another as an anti-tumor therapy:

Vincristine is a drug isolated from the Madagascar periwinkle, first discovered by the Eli Lilly company in 1958 in a search process that involved testing thousands of plant extracts. It was initially planned to be an antidiabetic drug. However, it was soon found to be an effective anti-leukemia agent even at small doses. Vincristine functions by binding to and inhibiting microtubule production in the mitotic spindle necessary for the cellular replication, halting cell division in metaphase.

Methotrexate, or amethopterin, is a drug first used by Sidney Farber. It operates by inhibiting the production of folic acid, a molecule that is a precursor to cellular DNA, and, as such, is necessary for cellular replication. It accomplishes this inhibition by interfering with several major enzymes involved in folic acid production, and as a result also disrupting DNA synthesis.

Mercaptopurine, or 6-MP is an analog of guanine, and inhibits cellular replication through multiple mechanisms. 6-MP halts purine synthesis, and also products of the metabolism of 6-MP become incorporated during DNA replication, leading to a mismatching of nucleotides that triggers apoptosis through the cell's DNA repair mechanisms.

Prednisone is a corticosteroid that is used to treat a variety of medical conditions. Generally, it reduces redness and swelling, but its use in cancer involves inducing apoptosis in lymphocytes. More research remains to be done to determine the exact mechanism of prednisone-induced apoptosis.