bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience with perioperative chemotherapy (ECC or ECF) for gastroesophageal cancer in British Columbia: A multicenter experience.
Authors: Lim Howard John , Al-Barrak Jasem , Cheung Winson Y. , Peixoto Renata D'Alpino 
Published: March 2020

e15153 Background: In 2006, the MAGIC trial demonstrated a significant overall survival benefit for perioperative ECF among patients with resectable gastro-esophageal cancer when compared to surgery alone. Since 2008, perioperative chemotherapy has become the standard of care for resectable gastro-esophageal cancer in our institution. We report the results of our experience with this protocol. Methods: The BC Cancer Agency is a multi-centre institution treating the majority of oncology patients for the province. A total of 83 consecutive patients with localized gastric, gastro-esophageal junction (GEJ) or lower esophageal cancer who initiated ECC/ECF perioperative chemotherapy from March 2008 to June 2011 were identified using the pharmacy database. Patient’s characteristics were abstracted to an anonymous database and analyzed. Results: In our cohort, 83 patients (66 males and 17 females) with a median age of 62 years (range 37 – 79) began preoperative chemotherapy, of whom 73 (87.9%) completed 3 cycles. The response rate was 49.3%. Among the 83 patients, 78 (93.9%) underwent surgery (2 patients died of chemotherapy toxicities, 1 refused surgery and 2 developed disease progression before surgery), of whom 11 (14.1%) could not have their tumors resected (1 unresectable, 1 with liver metastasis and 9 with peritoneal carcinomatosis). Only one patient died of surgical complications. Six patients (7.69%) achieved pathologic complete response (ypCR) and all of them are alive and recurrence-free. Forty-eight patients (57.8%) subsequently began postoperative chemotherapy, of whom 37 (44.5%) completed 3 cycles. Thirty-nine patients have died as of December 4th, 2012. The observed median survival was 38 months. Conclusions: In our multi-center experience, the results reported in the MAGIC trial were reproduced.
Changes in pulse pressure upon exposure to electromagnetic fields modulated at specific frequencies in healthy individuals, HBsAg positive cancer-free patients (HBsAg+), and patients with advanced hepatocellular carcinoma (HCC).
Authors: Costa Frederico , Parise Edison Roberto , Gumz Brenda Pires , Zanesco Tatiana , Iemma Antonio Francisco , Barbault Alexandre , Pasche Boris 
Published: March 2020

e15155 Background: Werecently described the antiproliferative effects of low levels of electromagnetic fields, amplitude-modulated at disease-specific frequencies (AM EMF) in patients with HCC (Br J Cancer, 2011,105:640) and on HCC cells (Br J Cancer, 2012,106:307). We identified HCC-specific modulation frequencies using a patient based biofeedback approach (J Exp Clin Cancer Res, 2009,28:51). Specific frequencies cause changes in pulse pressure in patients with HCC but not in healthy individuals. The effects of AM EMF in HBsAg+ patients, a pre-malignant condition, are unknown. Methods: 17 healthy individuals and 17 patients (5 HCC and 12 HBsAg+) were exposed to 206 HCC-specific modulation frequencies ranging from 100 Hz to 21 kHz (HCC-frequencies) and 237 random chosen frequencies (non-specific frequencies) within the same frequency range. All participants were exposed to both AM EMF and each frequency was tested separately. Changes in pulse pressure were recorded as previously described (J Exp Clin Cancer Res, 2009, 28:51). Results: HCC-frequencies caused changes in pulse pressure in all HBsAg+ and patients with HCC but no changes were observed in healthy individuals. The median number of frequencies causing changes in pulse pressure in patients with HCC was 175 (range: 97-206) and 7 (range: 3-16) in HBsAg+ patients. The non-specific frequencies did not cause changes in pulse pressure in patients with HCC but it caused changes in pulse pressure in 9 HBsAg+ (75%) with a median number of responding frequencies of 2 (range: 1-6). Non-specific frequencies also caused changes in pulse pressure in 11 healthy individuals (64%) with a median number of responding frequencies of 11 (range: 1-15). The pattern of changes in pulse pressure were significant between the 3 groups (p=0.0001). Conclusions: EMF modulated at specific frequencies cause a significantly different pattern of changes in pulse pressure in the three groups. These findings provide support for the development of EMF as a new diagnostic procedure. Clinical trial information: NCT01641276.
The prognostic VALUE of Ki-67 in gastric cancer.
Authors: Fradique Antonio Caldeira , Bruno Da Costa Ligia , Pupo Alexandra , Quaresma Luisa , Silva Gualdino , Cabrita Fernanda , Marques Mateus , Esteves Jorge , Pina Filomena , Da Silva Guedes , Oliveira Mario 
Published: March 2020

e15172 Background: Gastric carcinoma is the second cause of cancer mortality worldwide. In Portugal, a country with a high incidence of the disease, it is also the second leading cause of cancer mortality. The gravity of this situation and the advanced stage of disease at presentation warrants a search of a new prognostic indicator. We studied in patients (pts) with gastric cancer, both diffuse and intestinal types, several possible prognostic indicators, such as: weight, nutrition status, Ki-67, p53, Cerb2, and cadherin E. The results showed that Ki-67, an indicator of cell proliferation, may play an important role as a prognostic indicator because it is easily assessed by immunohistochemistry, is observed in both intestinal and in diffuse tumor types, and is related with tumor size, depth of invasion and the pattern of lymphatic spread. Methods: A total of 50 pts with gastric carcinoma (25 diffuse and 25 intestinal types) undergoing radical gastrectomy with extended lymphadenectomy (D2 and a few D3 types ) were prospectively studied by immunohistochemistry for the determination of Ki-67 in biopsied tissue and gastrectomy specimens. A relationship between the Ki-67 and various other prognostic factors, like histological tumor type, tumor location, number of involved lymph nodes, depth of invasion, sex and stage was established. Results: A total of 50 tumor specimens and an equal number of biopsies were evaluated for Ki-67 overexpression. Ten tumors (20%) presented a Ki-67 < 50%, 13 tumors (26%) showed a Ki-67 >50% < 74%, and 27 tumors (54%) had a Ki-67 > 75%. It was found that tumors with a low Ki-67 expression have a more proximal location, the histological type was either mixed or diffuse, tend to invade superficially the gastric wall, they don’t have metastases in distal lymph nodes, and are diagnosed in early stages of the disease. Conclusions: In this study, the Ki-67 overexpression showed prognostic value in both diffuse and intestinal type gastric cancer patients.
Efficacy of paclitaxel plus cisplatin in advanced esophageal squamous cell cancer: Further analysis of single center, prospective study.
Authors: Gong Jifang , Zhang Xiaodong , Lu Ming , Li Yan , Li Jie , Li Jian , Zhang Xiaotian , Zhou Jun , Lu Zhihao , Shen Lin 
Published: March 2020

e15174 Background: To evaluate efficacy and toxicity of paclitaxel plus cisplatin in advanced esophageal squamous cell carcinoma (ESCC). Methods: In this single-center, prospective study, chemo-naïve patients with metastastic and recurred ESCC received paclitaxel 175mg/m2 d1 and cisplatin was given on day 1, 2, at a total dose of 75 mg/m2 over 60 minutes, repeated every 21 days. Efficacy was evaluated every 2 cycles. Results: 133 patients were enrolled between June 2006 and November 2010. The median cycles of chemotherapy accepted were only 3. The objective response rate(RR) of paclitaxel and cisplatin in ESCC patients was 34.2%. After a median follow-up of 24.2 months, the progression free survival (PFS) was limited to 7.0 months (95%CI 5.68-8.32), meanwhile the median overall survival (mOS) was 12.0 months (95%CI 9.93-14.07). In the multivariate Cox regression analysis, distant organ metastasis remained an independent predictor of OS with a hazard ratio of 1.460 (95% CI 0.871-2.446, P = 0.041). 31 patients received radiotherapy after chemotherapy with significantly longer PFS than those without (6.8 months vs. 10 months, p = 0.037), but no difference in OS was observed (12.0 vs. 13.0 months, p = 0.23).Adverse events were tolerable. Conclusions: The efficacy of paclitaxel plus cisplatin in esophageal squamous cell carcinoma is promising. Sequencial chemoradiotherapy could release local progression but no help to overall survival.
Retrospective review of modified dose docetaxel, cisplatin, and 5-flourouracil (DCF) for the treatment of first-line metastatic gastric carcinomas.
Authors: Özdemir Nuriye , Aksoy Sercan , Eren Tulay , Abali Huseyin , Oksuzoglu Omur Berna , Zengin Nurullah 
Published: March 2020

e15175 Background: Docetaxel, cisplatin, and 5FU (DCF) has been shown to be an effective regimen for metastatic gastric carcinomas. However, treatment-related adverse events is quite high with original dose DCF. We evaluated the outcomes of the metastatic gastric carcinomas who treated with modified dose DCF (mDCF) in our institution. Methods: A single institution retrospective review of patients with metastatic gastric cancer treated with three weekly mDCF from 1/2006 to 1/2013 was evaluated. Over this time period a standard order-set was in place in which cisplatin 60 mg/m2, 5FU 600 mg/m2 and docetaxel 60 mg/m2 was given three weekly. Tumor response was calculated retrospectively using RECIST criteria. Results: One hundred and ninety-one patients were included the study. The median age was 55 years (23 to 76), 74% were male, and 82% were chemo-naive. Eighty percent of the patients were metastatic at the time of diagnosis. The median number of cycles administered was 6 (2-10). Hematological toxicity was mild with grade 3/4 granulocytopenia in 25% of the patients, grade 3/4 thrombocytopenia in 4% of the patients, and grade 3/4 anemia in 9% of the patients. Neutropenic infection occurred in 9 (%5) patients. Grade 3/4 nausea/vomiting was reported by 10% of the patients, and diarrhea by 7%. A total of 19 (10%) patients had dose delays or dose reductions related to toxicity. Six (3%) patients had complete response and 43 (23%) patients had partial response. Stable disease were occurred in 83 (45%) patients and 56 (23%) progressive disease. Ninety percent of the patients have died with median follow-up of 8 months. Progression-free survival was 7 months (95% CI 6 to 7.8 m) and overall survival was 10 months (95% CI 8.7 to 11.2 m). Conclusions: mDCF has mild hematological toxicity and overall excellent tolerance in first line metastatic gastric cancer patients. Response rate and the survival of these patients with a minimal toxicity are comparable with the original dose DCF.
Safety and efficacy of modified dose-attenuated FOLFIRINOX chemotherapy in patients over 65 years with advanced pancreatic adenocarcinoma.
Authors: Alessandretti Matheus Bongers , Brandao Erika Pereira , Abrahão Carina Meira , Lino Aline Rocha , Junior Rodnei Macambira , Costa Marcos André , Cruz Marcelo Rocha 
Published: March 2020

e15176 Background: Few data regard efficacy and safety of FOLFIRINOX (oxaliplatin 85 mg/m2, irinotecan 180 mg/m2, fluorouracil bolus of 400 mg/m2 and continuous infusion of 2400 mg/m2 over 46 hours and leucovorin 400 mg/m2) in patients over 65 years with advanced pancreatic adenocarcinoma. Methods: After Ethical Committee approval, consecutive patients age over 65 with biopsy proven pancreatic adenocarcinoma that received at least one cycle of modified dose-attenuated FOLFIRINOX (no bolus FU and reduced dose of at least one agent since first cycle) were selected (São José Hospital database) for a retrospective review for safety, response, and survival. Results: Nineteen consecutive patients were selected from our database. Patients characteristics included 12 (63,1%) males, 7 (36,9 %) females, median age 72,7 (range 66-79). Tumor location was 11 (57,8 %) head of the pancreas, 6 (31,57 %) body and 2 (11 %) in other sites. Grade 3/4 toxicities were reported in 10 patients (52,6 %): nausea/vomiting 1 (5,2 %), diarrhea 1 (5,2 %), fatigue 3 (15,7%), neutropenia 4 (21 %), thrombocytopenia 1 (5,2%) and febrile neutropenia 3 (15,6 %). Elevations in AST and ALT above the upper limit of normality were identified in 5 (26,31%). No deaths reported due to toxicity. Prophylactic granulocyte colony stimulator factor (G-CSF) was given to 14 (73 %). Seventeen patients completed at least four cycles; disease control was obtained in 15 (83, 3 %) with 1 complete response, 5 partial response and 9 stable diseases. Median reductions in doses in the first cycle of chemotherapy by drugs were: oxaliplatin 23,3 % (10%-30%), irinotecan 24,6 % (0%-60%), fluorouracil 20,6% (0%-40%). Median reductions in doses in the fourth cycle of chemotherapy by drugs were: oxaliplatin 20,8 % (0%-42%), irinotecan 24,9 % (0%-75%), fluorouracil 17,6% (0%-40%).With a median follow up of 4.5 months, median overall or progression free survival is not reached. Conclusions: Modified dose-attenuated FOLFIRINOX is a therapeutic option to elderly with advanced pancreatic adenocarcinoma. Although grade 3 and 4 toxicities were reported, they were manageable. Modified attenuated-dose of FOLFIRINOX needs further investigated.
TACE plus sorafenib for the treatment of advanced hepatocellular carcinoma.
Authors: Palwe Vijay Sukhdeo , Nagarkar Rajnish Vasant 
Published: March 2020

e15178 Background: Hepatocellular carcinoma (HCC) is considered to be a hypervascular tumor. Therefore, Trans Arterial Chemo Embolization (TACE) and inhibition of angiogenesis appear rational treatment strategies for those patients who have localised disease not amenable to surgical resection. TACE causes increased hypoxia leading to an up regulation in hypoxia inducible factor-1α (HIF-1α), which in turn up regulates vascular endothelial growth factor (VEGF), platelet-derived growth factor receptor, and increases tumor angiogenesis. The present study investigated for the combination of TACE and Sorafenib, a multikinase inhibitor with anti-angiogenic activities approved for the treatment of HCC. Methods: Patients included histologically confirmed, unresectable hepatocellular carcinoma beyond Milan criteria, no extrahepatic spread, Child Pugh score ≤8, ECOG PS 0-2, platelets >100K/µl, and bilirubin <2.5 mg/dl. We present our experience with 42 patients of HCC treated with Trans Arterial Chemo Embolisation (TACE) with Cisplatin, Lipodol and PVA of which 14 pts received TACE along with Sorafenib. Results: Between May 2007 to Jan 2013, 42 patients were enrolled. Patients received a mean of 1.45 TACE interventions (range 1-4). The longest survival was 53 months after 1stTACE and median overall survival was 443 days. Grade 3 and 4 toxicities were noted in 18% and 7% of patients. Conclusions: TACE is a very good method for palliation of unresectable hepatocellular carcinoma (HCC) with improved survival and quality of life.The combination of TACE with sorafenib is tolerable for most patients and associated with a promising rate of radiographic response and OS.
Health care utilization and treatment patterns for patients (pts) with gastric cancer (GC) in China.
Authors: Jianfei Jeff , Du Wenmin , Chu Laura , Wang Xiaopei , Pruemer Jane 
Published: March 2020

e15185 Background: GC is the third most common cancer in China with ~0.3 million deaths and 0.4 million new cases annually. Objective: To describe treatment patterns and survival for pts with GC, and to assess treatment outcomes and associated factors including health insurance coverage, gastric-intestinal disease, clinical comorbidities and family genetic or demographic factors. Methods: A retrospective cohort study was conducted. Primary data sources were medical records collected from multiple major Shanghai medical centers with timeframe of Jan2004 - Mar2010. Treatment outcomes included ‘improvement’ and ‘recovery or cure’ (as documented in the pts’ record), and death. Classical logistic regression and COX proportional hazard regression analysis were performed to assess the relationship between health outcomes and associated factors. Results: A total of 2249 GC pts were identified with mean age 65.9 and 36% female. Average follow-up was 26.3 months since GC index date (1stGC diagnosis date). During the study period, 518 (23%) pts died. GC treatments included surgical procedure (28%), radiation (2%), chemotherapy (14%), and traditional Chinese medicine/herbal regimens (21%). Major chemotherapy included 5-FU, cisplatin, etoposide, leucovorin, mitomycin, oxaliplatin, and semustine. From multivariable models, pts more likely to achieve recovery or cure were those who received surgical procedures (OR=15.0, 95% CI 11.3-19.9), radiation (OR=2.4, 95% CI 1.2-4.9), any chemotherapy (OR=2.7, 95% CI 1.9-3.9), and were covered by public health insurance (OR=3.5, 95% CI 2.3-5.3) or collaborative insurance (OR=3.5, 95% CI 2.1-5.8). Higher risk of mortality was significantly associated with key factors like advanced age (OR=1.0, 95% CI 1.0-1.0), late-stage cancer (OR=9.8, 95% CI 5.1-19.0), and liver disease (OR=1.9, 95% CI 1.4-2.6). A lower risk of mortality was associated with surgical procedure treatment (OR=0.6, 95% CI 0.5-0.7) and chemotherapy (OR=0.6, 95% CI 0.4-0.9). Conclusions: Multiple treatment regimens for GC are available in China. Surgical procedure, chemotherapy, TCM/herbal, and health insurance coverage are associated with positive treatment outcome and survival duration.
Sequential neoadjuvant chemotherpy with nab-paclitaxel plus gemcitabine and FOLFIRINOX in locally advanced pancreatic cancer (LAPC): A PILOT study.
Authors: Kunzmann Volker , Hartlapp Ingo , Scheurlen Michael , Einsele Hermann , Mueller Justus , Kenn Werner , Steger Ulrich , Germer Christoph T. 
Published: March 2020

e15193 Background: Nab-Paclitaxel (nab-P) + Gemcitabin (G) and FOLFIRINOX have both shown promising activity in metastatic pancreatic cancer (mPC). Our group has developed sequential usage of both regimens in order to exploit the stromal depletion effects of nab-P and increase global efficacy of chemotherapy in the neoadjuvant setting of LAPC. Methods: This pilot study evaluated patients with cytological/histological confirmed diagnosis of locally advanced pancreatic ductal adenocarcinoma without evidence of metastatic disease (stage III). nab-P+G was administered for 2 cycles (nab-P 125 mg/m2, G 1000 mg/ 2; on days 1, 8, 15; every 28 days) followed by 2 cycles of FOLFIRINOX (as reported by Conroy et al., NEJM 2011). Results: We report the preliminary analysis of 8 pts treated in our institution. Patients characteristics were M/F: 5/3; median age 63 (46-79); PS 0/1: 6/2. 3 pts (37%) had a biliary stent before starting treatment. All pts received the planned 4 cycles of neoadjuvant chemotherapy without dose reductions. There were no treatment-related deaths and none of pts stopped treatment due to toxicity. Grade 3-4 toxicities were neutropenia (50 %), nausea (12%), diarrhea (12%) and thrombopenia (25%). Grade 2-3 sensory neuropathy occured in 25% of pts. Prior nab-P+G did not result in increased hematological or non-hematological toxicity of FOLFIRINOX. Among the 8 patients evaluable so far, 5 partial responses (63%) and 3 stable disease (37%) have been observed, resulting in a disease control rate of 100%. After sequential chemotherapy 3 pts (37%) underwent radical surgical resection. Of note, all resected patients pts showed regression of the tumor (Evans Regression Score 2-4) with 1 patient fullfilling the criteria of a complete pathological remission (pCR). 4 pts received concomitant chemo-radiotherapy and 1 pt underwent an explorative laparotomy with evidence of occult (micronodular) peritoneal metastasis. Conclusions: Sequential neoadjuvant chemotherapy with nab-P+G and FOLFIRINOX seems to be highly active with manageable toxicity profile and may allow to achieve pCR in LAPC. These results are encouraging to test this approach in a prospective phase II trial.
Comparative effectiveness of second-line targeted therapies for metastatic renal cell carcinoma: Analysis of two practice-based chart reviews.
Authors: Signorovitch James E. , Vogelzang Nicholas J. , Pal Sumanta Kumar , Lin Peggy L. , George Daniel J. , Wong Michael K.K. , Liu Zhimei , Wang Xufang , Culver Kenneth W. , Scott Jeffrey A. , Jonasch Eric 
Published: March 2020

e15504 Background: Second-line targeted therapies for metastatic renal cell carcinoma (mRCC) include mammalian target of rapamycin (mTOR) inhibitors and tyrosine kinase inhibitors (TKIs). This study aimed to compare practice-based effectiveness of these therapies in a recent chart review, and to compare findings with a previous chart review (Yang et al., 2012. ASCO). Methods: Community-based medical oncologists/hematologists (N=36) reviewed charts for ≤ 15 patients each. Included patients were aged ≥ 18 years, received a 1st-line TKI and initiated 2nd-line targeted therapy in 2010 or later. The primary outcome was time from 2nd-line initiation to treatment failure (TTF; discontinuation, physician-assessed progression, or death, whichever occurred first). TTF was compared among patients receiving 2nd-line everolimus (EVE), temsirolimus (TEM), or TKI as a class (sunitinib, sorafenib, pazopanib or axitinib), using a multivariable Cox proportional hazards model adjusting for characteristics including type of initial TKI and response, histological subtype, performance status, and sites of metastasis. Hazard ratios (HRs) for TTF were pooled with previously-reported HRs for progression-free survival (PFS) from a previous chart review in a meta-analysis. Results: A total of 138, 64 and 79 patients received 2nd-line therapy with EVE, TEM or a TKI, respectively. Mean age was 63 years, mean duration of mRCC 13.5 months, and median follow-up 6 months. After adjusting for baseline characteristics, EVE was associated with a 28% and 26% reduction in the hazard of TTF compared to TEM and TKI, respectively. Pooling both studies, EVE was associated with significantly reduced hazards of TTF compared to TEM and TKI (Table). TTF differences between TEM and TKI were not significant. Conclusions: In two retrospective chart reviews EVE was associated with consistently reduced hazards of 2nd-line treatment failure in mRCC compared to TEM and TKIs. [Table: see text]