bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced diagnosis in suggested malignant pleural effusion using combined modality of genetic and biochemical tumor markers
Authors: Chang J. 
Published: March 2020

17137 Background: Cancer is influenced by oncogenes and tumor suppressor genes. Several tumor markers have been applied clinically in malignancy. A malignant pleural effusion may be an initial presentation of cancer and the presence of malignancy is confirmed by pleural cytology and biopsy. However, other diagnostic modalities are limited and not defined clearly, especially in cases of negative results from traditional diagnostic tool. Here, I investigated p53 and FHIT mutations and microsatellite alterations(MA) in the pleural effusion associated with malignancy(ME). Also, the diagnostic values of CEA, NSE, and CYFRA 21–1 as markers of malignant pleural effusion in lung cancer were assessed together. Methods: The genetic analyses of pleural fluid were done in 40 patients with ME and in the pleural fluid of 17 patients with tuberculous pleurisy(TB) as a control group. Levels of CEA, NSE, and CYFRA 21–1 were measured by immunoassay in the serum and pleural fluid of 34 patients with primary lung cancer and of 16 patients with TB. Results: p53 mutations were detected in 13% of ME and 0% of TB, and FHIT mutations were detected in 18% of ME and 12% of TB. Among 4 microsatellite markers; D3S1234, D3S1285, D9S171, and TP53, loss of heterozygosity(LOH) and microsatellite instability(MI) were observed for each group. MA including LOH and MI in at least one marker was seen 63% of ME cases vs. 35% of TB cases. Patients with lung cancer were found to have significantly higher serum and pleural fluid levels of CEA and CYFRA 21–1 than patients with tuberculous pleurisy. Using cut-off values of 5 ng/ml, 20 ng/ml, and 45 ng/ml for pleural fluid CEA, NSE, and CYFRA 21–1, the sensitivities and specificities were as follows: CEA; 82% and 94%, NSE; 36% and 94%, and CYFRA 21–1; 61% and 81%. A combination of pleural fluid CEA and NSE increased sensitivity and specificity. Conclusions: Although still limited in terms of sensitivity and specificity, this study shows that the determinations of CEA and NSE in pleural fluid enhance diagnostic yield better than all the other combination of tumor markers in malignant pleural effusion, especially in lung cancer and molecular diagnostic strategies including microsatellite alterations are possibly applied for the diagnosis of malignant effusion. No significant financial relationships to disclose.
Palliative treatment with gefitinib (G) in advanced and heavy pre-treated non-small cell lung cancer (NSCLC)
Authors: Tamburini E. , Nicoletti S. , Papi M. , Fantini M. , Possenti C. , Pasquini E. , Nicolini M. , Fabbri P. , Fattori P. , Tassinari D. , Ravaioli A. 
Published: March 2020

17139 Background: G has demonstrated to be active in patients with advanced NSCLC pretreated with chemotherapy. We report our experience about activity and safety of G in patients with advanced, heavily pre-treated NSCLC or chemotherapy-naive patients with a low performance status. Methods: The records of the patients treated with G were reviewed; all the patients pre-treated with at least one course of a platinum-containing regimen or with low performance status were considered eligible and enrolled in the trial. All the patients were treated with G 250 mg/die until progression of the disease or intractable toxicity. All the patients were evaluated every 21 days for toxicity and every 2 months for survival. Primary end point was time to progression (TTP); secondary ones were overall survival (OS) and safety. Results: Till today 56 patients were considered eligible and enrolled in the trial; the results are summarised in the table . *: using Kaplan-Meyer test. No significant differences in OS were observed between the patients chemotherapy-naive with low performance status or pre-treated with one line of chemotherapy vs heavily pretreated ones (respectively 170 days vs 120 days, p = 0.85 using the Log-Rank test). Toxicity was mild with no haematological side effects and grade IV diarrhoea in 1 patient (1.7%). Conclusions: G seems to represent an interesting option in patients with NSCLC with low performance status or heavily pre-treated with chemotherapy. Our data seem to confirm that G is an active and safe treatment in such a subset of patients, opening a novel dimension in the treatment of pre-treated NSCLC (supported by IOR). [Table: see text] No significant financial relationships to disclose.
Outcome of non small cell lung carcinoma patients receiving chemotherapy in Kartal State Hospital, Turkey
Authors: Kocak M. , Mayadagli A. , Ozkan A. , Gumus M. , Marti A. , Demir O. , Parlak C. , Aliustaoglu M. 
Published: March 2020

17142 Background: Lung cancer has been the leading cause of cancer deaths in men worldwide, and is the second most common cause of cancer deaths in women. Non-small cell histology comprises about 70–80% of every diagnosis of lung cancer. Despite advances in the detection and treatment, the long-term survival of patients with advanced non-small cell lung cancer (NSCLC) remains poor, with a 5-year survival of less than 5%. We conducted this trial to determine the influence of treatment with docetaxel given in combination with cisplatin on survival and time to progression, and to evaluate its tolerability in chemotherapy naive patients with metastatic NSCLC. Methods: Patients with histological or cytological confirmed stage IV NSCLC who met the following criteria were eligible for the study: suitable for first-line chemotherapy with no previous chemotherapy, Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0–2, an objective measurable disease, an adequate bone marrow reserve, a normal hepatic and renal function. Cisplatin and docetaxel were delivered to the patients at one dose level through the courses repeated every 3 weeks for 4–6 cycles. Each patient received docetaxel at the doses of 75 mg/m2/day and cisplatin at the doses of 75 mg/m2/day both on day 1. Results: Fifty eligible patients with stage 4 NSCLC were enrolled into the study from June 2003 to September 2005. Median follow-up time was 6 months (1–21). Median age was 61.5 (39–75). Forty eight patients (96%) were male, and 2 patients (8%) were female. Histological type was squamous cell carcinoma in 21 patients (42%), adenocarcinoma in 11 patients (22%) and undifferentiated histologies in 18 patients (36%). The median overall survival time was 16 months (95%CI: 8–24). One-year survival rate was 56.3%. Overall response rate was 44% with 40% partial (PR), 4% complete response (CR). Twenty eight percent of patients had stable disease, and 28% of patients showed disease progression. The median time to progression was 4 months (95%CI: 2.4–5.5). Conclusion: Docetaxel/cisplatin demonstrated efficacy comparable to other platinum agent doublets. No significant financial relationships to disclose.
The docetaxel (DOC) and gemcitabine (GEM) combination as adjuvant chemotherapy in patients with non-small cell lung cancer (NSCLC): A multi-institutional phase II trial
Authors: Kawamura M. , Eguchi K. , Izumi Y. , Kobayashi K. , Sakaguchi H. , Koike T. 
Published: March 2020

17157 Background: As clinical phase II studies with non-platinum doublet for adjuvant chemotherapy after complete resection of NSCLC has been scarcely reported, this clinical study was designed to evaluate the toxicity profile and the efficacy of the adjuvant chemotherapy with non-platinum doublet of DOC+GEM. Methods: Eligibility criteria included: completely resected NSCLC, pathological stage II and IIIA, younger than 76 years old, and performance status 0–1. Patients treated preoperatively were excluded. Treatment consisted of DOC, 60 mg/m2, on day 8, and GEM, 1000 mg/m2, on day 1, 8, and 15 every 4 week (4 cycles). Dose of GEM was decreased to 800 mg/m2 after the initial 21patients because interstitial pneumonitis (IP) occurred in 3 among them. Results: Between August 2000 and August 2002, 35 patients (M/F: 21/14) were enrolled. The median age was 62 years (range 47–74) were enrolled with 5 patients (14.3%) over the age of 70. 34 patients had ECOG PS of 0. 28 patients had adenocarcinomas, 6 had squamous cell carcinomas, and one had adenosquamous carcinoma. Pathological stages were stage IIA in 5 patients, stage IIB in 1 and stage IIIA in 29 (82.9%). All patients received at least one cycle of chemotherapy. 29 patients received 3 cycles of chemotherapy and 23 (66%) completed 4 cycles. The main grade 3/4 toxicity (according to WHO scale) consisted of leukocytopenie (n = 19, 54.3%), thrombocytopenia (n = 3, 8.6%), appetiteloss (n = 4, 11.4%), dyspnea (n = 3, 8.6%), and vomiting (n = 1, 2.9%). IP, which caused dyspnea in these 3 patients, were well treated with steroid and suspension of chemotherapy. There was no treatment related death. Median follow-up period was 52 months. The 4 year recurrent free survival rate was 42.9% and the 4 year survival rate was 65.8%. Conclusions: Non-platinum doublet regimen with DOC+GEM as adjuvant chemotherapy for the NSCLC patients with complete resection was feasible and showed good compliance besides IP. No significant financial relationships to disclose.
Combination of local tumor invasiveness (LTI) and International Prognostic Index (IPI) provides better predictive value in extranodal NK/T-cell lymphoma, nasal type (NTCL)
Authors: Kim T. , Lee S. , Kim D. , Lee S. , Im S. , Kim T. , Kim C. , Bang Y. , Heo D. 
Published: March 2020

17503 Background: In contrast to B-cell lymphomas, NK/T-cell lymphomas have unique clinical pattern (local invasiveness; Blood. 2005;106:3785). Prognostic factors were evaluated according to IPI as well as LTI and compared with the other prognostic model (Lee J, et al JCO 2006). Methods: 176 patients diagnosed with NTCL between 1992 and 2004 were analyzed. Overall survival (OS) and progression-free survival (PFS) were compared according to IPI, IPI combined with LTI, and the other model. LTI was briefly defined as follows: bony invasion or perforation or skin invasion (upper aerodigestive tract); serosal invasion or perforation (gastrointestinal tract); tumor more than 5cm or invasion of deep extradermal structures (skin); and neurovascular or bony invasion (muscle). Results: After a median follow-up period of 80 months, 5-year (y) OS and PFS were 33% and 25%, respectively. The IPI risk group was predictive of OS and PFS (5-y OS 52%, 23%, 10%, and 4%, respectively, P < .0001; 2-y PFS 47%, 31%, 5%, and 4%, respectively, P < .0001) but failed to show survival differences between the high-intermediate and high risk groups (P = .0737). However, once both IPI and LTI are combined, there were significant differences in OS and PFS between the IPI score 0–2/LTI-, IPI score 0–2/LTI+, IPI score 3–5/LTI-, and IPI score 3–5/LTI+ groups (5-y OS 60%, 14%, 7%, and 4%, respectively, P < .0001; 2-y PFS 53%, 21%, 9%, and 4%, respectively, P < .0001). OS and PFS were also affected by the other prognostic model but this model failed to show survival differences among the risk groups (P = .1382). Conclusions: Combination of local tumor invasiveness and International Prognostic Index provides better predictive value in extranodal NK/T-cell lymphoma, nasal type. No significant financial relationships to disclose.
Renal toxicity associated with zoledronic acid and pamidronate in multiple myeloma patients: A retrospective study
Authors: Nickolas T. L. , Chen L. , Markowitz G. , Green J. , Wintfeld N. , Neary M. , Duh M. 
Published: March 2020

17515 Background: Patients (pts) with multiple myeloma (MM) are at an increased risk of renal impairment as part of disease progression. Herein we compared rates of renal toxicity in MM pts treated with zoledronic acid (ZO), pamidronate (PA), and no bisphosphonate (BP) treatment (NT). Methods: Medical and pharmacy claims and laboratory data were reviewed from >35 managed care plans between 01/2000 and 12/2004. Inclusion criteria were ≥2 claims for MM, no gap in health coverage, and serum creatinine readings before and after first ZO or PA infusion. MM pts who received NT served as a separate reference group. Observation periods extended from initial BP infusion to health plan disenrollment (BP monotherapy) or BP switch. Renal impairment was defined as a ≥25% decrease in glomerular filtration rate (GFR,abbreviated MDRD formula) from baseline. Andersen-Gill model, adjusted for demographics and baseline comorbidities, was used to analyze multiple events in a given pt, as physician practice patterns indicate that administration of both BPs continues even after the development of a first renal event. Results: The study population comprised 122 ZO-treated pts, 90 PA-treated pts, and 213 NT pts. Baseline characteristics of ZO and PA groups were similar except the ZO group had a significantly better baseline GFR and higher previous nephrotoxic drug use (both p < 0.01). After treatment, ZO and PA groups had similar renal impairment rates that were significantly higher than the NT group and increased with treatment duration (ZO 21.7%, PA 22.9%, NT 17.0% in pts treated for <6 months; increasing to ZO 53.8%, PA 50.0%, NT 33.7% in pts treated for ≥18 months). Mean renal impairment events per person-year were significantly higher for ZO than PA (1.83 vs 0.78, p < 0.001). Multiple-event analysis found a 2.6 times risk of renal impairment for ZO than PA (p < 0.0001). Compared with PA, ZO-treated pts had a steeper decrease in mean GFR from baseline by 8.5% (p = 0.03). Conclusions: This retrospective observational study suggests that in MM patients, both ZO and PA are associated with a similar higher risk of renal impairment than NT, but ZO-treated pts are significantly more likely to experience multiple impairment events upon repeated administrations. [Table: see text]
The autologous hemopoietic stem cell transplantation in adult patients with lymphoma: Turkish Bone Marrow Transplantation Registry Results
Authors: Turkish T. 
Published: March 2020

17517 Background: Turkish bone marrow transplantation registry (TBMTR) was established in 1995. Since 1992, data of adult lymphoma patients from fifteen transplant centers were collected and analyzed by TBMTR. Methods: A total of 437 adult lymphoma patients (185 Hodgkin’s and 252 non-Hodgkin’s lymphoma) undergoing autologous hemopoietic stem cell transplantation (HSCT) were registered by TBMTR from 1992 to 2002. Results: Peripheral blood was used in 94% of the transplantations as a source of stem cells. Non-TBI conditioning regimens were administered in 88% of the cases. The 100-day transplant related mortality was 11% in relapsed and in primary refractory Hodgkin’s lymphoma patients; while transplant-related mortality (TRM) was found to be 9% and 30% in non-Hodgkin’s lymphoma patients in first remission and in primary refractory cases, respectively. Infection was the most common cause of TRM. Overall (long-term) survival rates were 50% and 49% in relapsed cases and primary refractory cases with Hodgkin’s lymphoma, respectively; while in non-Hodgkin’s lymphoma patients the survival rates were 65% in cases in first remission, 50% in sensitive relapse, 0% in resistant relapse and 24% in primary refractory cases. Conclusions: In conclusion, TBMTR results are comparable to EBMT and IBMTR results. Therefore, autologous HSCT may provide long-term survival in patients with Hodgkin’s lymphoma as well as in patients with non-Hodgkin lymphoma in first remission and in sensitive relapse. Contributing authors and centers: F. Arpaci1, S. Ataergin1, G. Gurman2, S. Cagirgan3, M. Arat2, A. Ozet1, M. Ayli4, M. Ozcan2, A. Unal5, T. Soysal6, Y. Koc7, A. Buyukcelik8, A. Ozturk9, E. Ovali10, H. Goker11, B. Sahin12, S. Kalayoglu Besisik13, M. Bayik14, Z. Bolaman15, S. Bavbek16, M. Turan1 1GATA; 2Ankara University Hematology; 3Ege University; 4Numune Hospital, Ankara; 5Erciyes University; 6Cerrahpasa University; 7Hacettepe University Institute of Oncology; 8Ankara University Medical Oncology; 9GATA Haydarpasa; 10Karadeniz University; 11Hacettepe University; 12Cukurova University; 13Istanbul University Hematology; 14Marmara University; 15A.Menderes University; 16Istanbul University Institute of Oncology. No significant financial relationships to disclose.
Serum LDH predicts response rate, response duration, and survival of patients (pts) with relapsed/refractory non-Hodgkin’s lymphoma (NHL) treated with 131I-tositumomab (131I-Tab) or 90Y ibritumomab tiuxetan (90Y-Iab) radioimmunotherapy (RIT)
Authors: Taylor Diangi Y. , Andreadis C. , Svoboda J. , Nasta S. D. , Tsai D. E. , Luger S. M. , Stadtmauer E. A. , Downs L. H. , Dadparvar S. , Alavi A. , Schuster S. J. 
Published: March 2020

17520 Background: Although both 131I-Tab and 90Y-Iab are approved for treatment of pts with relapsed or refractory low-grade, follicular, or transformed NHL, a prospective randomized comparison of these two forms of RIT has not been performed. We retrospectively reviewed our experience using either agent in pts with NHL. Methods: Sixty-one pts with NHL who were treated with a single course of 131I-Tab (N = 22) or 90Y-Iab (N = 39) between 1999 and 2005 were included in this analysis. The median age was 61 y (range 21–83 y) and the median number of prior therapies was 5 (range 1–13). Overall, 27 pts had indolent NHL (20 follicular grade 1/2, 4 small lymphocytic, and 3 marginal zone), while 34 pts had aggressive NHL (22 diffuse large cell, 10 mantle cell, and 2 follicular grade 3). Among pts, 75% had stage III/IV disease, 52% had an elevated serum LDH, and 38% had bulky disease (>5 cm). These characteristics were similar for pts receiving either 131I-Tab or 90Y-Iab, with the exception of elevated serum LDH (64% vs. 33%, p = 0.02). Median follow up was 21 mos (range 3–55). Results: The overall response rate (ORR) was 44% with complete response (CR) in 21% of pts. The median time to progression (TTP) was 5 mos for all pts, 9 mos for responders, and 14 mos for CRs (range 4–55). Patients with indolent NHL had no difference in ORR, CR, or TTP from pts with aggressive NHL, but had a significantly longer OS (HR 0.37, p = 0.01). Elevated LDH was the only significant predictor of ORR (31% vs. 57%, p = 0.04). In multivariable analysis, elevated LDH was adversely associated with TTP (HR 2.0, p = 0.02) and OS (HR 2.7, p = 0.02) among both subgroups of NHL. We did not discern a difference in ORR, CR, TTP, or OS between 131I-Tab and 90Y-Iab, even when stratifying for serum LDH. Conclusions: RIT produced high response rates in heavily pre-treated pts with indolent or aggressive NHL. Elevated LDH is the most significant prognostic factor for ORR, TTP and OS in this population. Patients with an elevated LDH should be considered for alternative treatment approaches or clinical trials, including RIT in combination with chemotherapy or transplant. [Table: see text]
Safety analysis of a phase II study of cyclophosphamide, vincristine, non-pegilated liposomal doxorubicin (Myocet), and prednisone + rituximab in biweekly regimen (R-COMP-14) as primary treatment of non-Hodgkin lymphoma
Authors: Garcia Arroyo F. R. , Herrero J. , Provencio M. , Gómez-Codina J. , Rueda A. , Llanos M. 
Published: March 2020

17532 Background: Gold standard treatment of CD20+ aggressive B-cell non-Hodgkin lymphoma, R-CHOP, has been suggested to improve outcome when administered as dose-dense regimen supported with G-CSF. The non-pegylated liposomal doxorubicin (Myocet) has an improved safety profile compared to standard formulations of doxorubicin. Standard R-CHOP regimen has been modified replacing doxorubicin with Myocet, administered on a biweekly basis (R-COMP-14) looking for an increase in efficacy without impairing tolerability Methods: Single arm, multicentric, 2-step (Simon design) phase II trial. Newly diagnosed, diffuse large B-cell lymphoma, stages III, IV or I, II with IPI ≥ 1, CD20+, eligible patients (Pt) were treated with Myocet 50 mg/m2, cyclophosphamide 750 mg/m2, vincristine 1.4 mg/m2 (max. 2 mg), rituximab 375 mg/m2 and prednisone 100 mg/d d1–5 in biweekly cycles. Pegilated filgastrim (Neulasta™) was administered on day 2 of the cycle. Response was assessed after 3 cycles, and patients with PR or CR received 5 additional cycles. A safety analysis was planned by protocol with data of first patients included Results: The median age of the 13 Pt included was 59 (range 28–64). At baseline 53.9% Pt had III-IV stage and 41.7% had extraganglionar involvement. Median basal LVEF was 66% (range 44–79). A median of 7 cycles of R-COMP were administered. The median relative dose intensity per week for Myocet was 94.9%. 6.2% of the cycles were delayed and 8.6% of the cycles were dose reduced. There were 2 episodes of febrile neutropenia. G3 asthenia, G3 neurotoxicity and G3 related infection were found in one cycle each. One patient had G3 hepatic toxicity resolved with dose reduction. At the end of treatment the median LVEF was 65.52% (range 52–76), there was no cardiac event related to the treatment. 84.6% of Pt had complete or partial response (7 RC, 2 uRC, 2 PR, 1 SD, 1 PD) at the end of the study Conclusions: In this small safety group of Pt that received the dose-dense regimen, the preliminary results suggest that R-COMP-14 supported with Neulasta is a well tolerated and effective regimen. Recruitment will proceed as planned (75 Pt). No significant financial relationships to disclose.
Phase II study of dexamethasone, ascorbic acid, thalidomide and arsenic trioxide (DATA) in high risk previously untreated (PU) and relapsed/refractory (RR) multiple myeloma (MM)
Authors: Baz R. C. , Kelly M. , Reed J. , Karam M. , Faiman B. , Andresen S. , Hussein M. A. 
Published: March 2020

17535 Background: The combination of Thalidomide (T) and Dexamethasone (D) is often used first line in patients with MM. Arsenic trioxide (ATO) is active and well tolerated in patients with RR MM. ATO, D and T have non-overlapping toxicity. We therefore initiated a phase II study to assess the efficacy and toxicity of this combination in patients with high risk PU MM (serum B2 microglobulin>5.5, chromosome 13 or 14 abnormalities by FISH or the presence of peripheral plasma cells) and RR MM. Methods: On week 1, ATO was given at a dose of 0.25mg/kg IV on days 1–5. On weeks 2–12, ATO was given at the same dose twice weekly. On weeks 13–16, the patients did not receive treatment. Ascorbic acid 1000mg IV was given after each ATO infusion. D was given at a dose of 20mg orally on days 1–4 of a 28 days cycle, and T was started at a dose of 50mg daily and increased as tolerated to a dose of 100mg daily. A similar 16 weeks consolidation course was given. Maintenance included ATO 0.25mg/kg on days 1,8,15 and 22 every 12 weeks in addition to the above schedule for D, T and Ascorbic acid. Results: Sixteen patients were enrolled (3 with PU and 13 RR), 13 are evaluable for response. The median age was 57 years and 62% were males. The median number of prior chemotherapy regimen is 2 (range 0–6), 7 patients had received a prior T containing regimen, and 2 patients had received an ATO-containing regimen. Seven, seven and two patients had SWOG stages 2, 3 and 4 respectively. The mean serum B2 microglobulin was 7.1-mg/dL (s.d. 4.4). After a median follow up of 9.5 months (range 1–12), 9 patients progressed and 5 died. The median progression free survival was 9.4 months. The median progression free survival for responder has not been reached. Four patients had a PR (31%), 8 had stable disease (62%), and 1 had progressive disease. No patient had a QT>500 or a cardiac arrhythmia. Grade 3 leukopenia, anemia, neuropathy and renal failure occurred in 3, 2, 1 and 1 patients respectively. Three patients had a venous thromboembolic event (2 DVT and 1 PE). Conclusions: The addition of T to the combination of ATO, Ascorbic acid and D is safe, well tolerated and results in 30% PR and 61% stable disease in patients with poor risk MM. [Table: see text]