bluuebunny/crossref_metadata_2025_split huggingface dataset:
Final results of a prospective, observational study of the effectiveness of darbepoetin alfa administered every three weeks for the treatment of chemotherapy-induced anaemia in elderly patients
Authors: Esquerdo G. , Doménech M. , Bermejo J. C. , López P. , Pedro C. , Villadiego K. , Constenla M. , Sánchez-Rovira P. , Gasquet J. A. , Rodríguez C. A. 
Published: August 2020

e20654 Background: Cancer incidence is increasing in elderly but specific treatment data in this population is not often available. The objectives of this study were to evaluate the effectiveness and safety of darbepoetin alfa (DA) administered once every 3 weeks (Q3W) for the treatment of chemotherapy-induced anaemia (CIA) in elderly within routine clinical practice. Methods: Prospective, observational, single-arm, multicentre study performed in 28 centres across Spain. Eligible patients (pts):≥65 years, anaemic (haemoglobin [Hb] 11 g/dl), with non-myeloid malignancies, and scheduled to receive ≥9 weeks (wks) of chemotherapy. Pts were treated with a fixed dose of DA 500 μg Q3W and treatment stopped if Hb levels exceeded 13g/dl. Primary endpoint was hematopoietic response (Hb increase ≥2g/dl or Hb ≥12g/dl without transfusions in the previous 28 days). Secondary endpoints included percentage of pts achieving target Hb (>11g/dl from wk 5 till end of treatment without red blood cell transfusion within 28 days), changes in the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) scale and the incidence of adverse reactions. Results: Data were prospectively collected from 153 pts: women (56.86%), mean (SD) age 73.43 (5.77) years, ECOG Performance Status 0–1 (65.36%) with solid tumors (66.67%) and lymphoproliferative malignancies (33.33%) and stage III/IV (63.40%). Most pts (90.20%) had baseline Hb levels between 9–11g/dL. DA was administered for a median of 9.0 wks (range: 1–22.57). The Kaplan-Meier percentage (KM; 95% CI) of pts who achieved hematopoietic response was 69.70% (56.06–83.34) and 72.22% (57.5–86.94) for pts who achieved target Hb (>11g/dL). FACT-F median score at baseline was 29.00 and 33.00 at the end of the study. Only one (0.7%) non-serious adverse reaction (cutaneous eruption) was reported. Conclusions: These results suggest that DA given at 500 μg Q3W to elderly pts with non-myeloid malignancies is an effective and well-tolerated treatment for CIA. [Table: see text]
Prospective evaluation of incidence and pattern of nausea in patients receiving combined chemotherapy and radiotherapy (RT) above the diaphragm
Authors: Axelrod R. S. , Machtay M. , Werner-Wasik M. , Anne R. , Schlossberg H. , Laudadio M. , Kotak D. 
Published: August 2020

e20676 Background: Nausea (N), vomiting (V) remain distressing effects of chemotherapy. Prevalence of N, V in patients (pts) receiving daily (5/7) RT with weekly (wkly) doublet chemotherapy is not well studied. Methods: We used a modified Functional Living Index Emesis (FLIE) (Lindley and Mullin) to study N, V in pts receiving 2 chemotherapy agents with RT for upper aero-digestive malignancies. Exclusion criteria were: other causes of N,V or RT below the diaphragm. Pts completed a written questionnaire wkly during therapy. A 6 point scale was used, 0 representing no symptoms and 6 representing intolerable or uncontrolled symptoms. Questions addressed N, V, use of medication in daily diary and overall wkly assessment of N, V, ability to eat, effectiveness of medications and effect on daily routine. Results: 21 Patients enrolled: 15 completed 4 weekly questionnaires, 17 completed 3. Most patients received a total of 5 weekly chemotherapy treatments. Participants: 17 M: 4 F with 17 head/neck sites, 4 lung. 6 pts received wkly carboplatin (AUC 2) and paclitaxel (45/m2 for lung, 30/m2 for h/n); 15 pts cisplatin (20/m2) and paclitaxel. All patients received our standard anti emetic therapy (steroids and 5 HT3 receptor antagonist). Pts with early nausea tended to experience continued or worsened symptoms despite anti emetic therapy; at wk 4, more pts experienced V. Selected results are shown in the table . Conclusions: The modified FLIE questionnaire was a useful tool for evaluation. Despite advances in anti emetic therapy, nausea and vomiting resulting from the combination of radiation therapy with dual agent chemotherapy exerts a significant adverse effect on daily comfort but little effect on overall function. [Table: see text] [Table: see text]
Needs in breast cancer patients (pts) during chemotherapy: Customer satisfaction evaluation
Authors: Ferrari V. D. , Ferrari L. , Grisanti S. , Consoli F. , Valcamonico F. , Amoroso V. , Rangoni G. , Vassalli L. , Marpicati P. , Marini G. 
Published: August 2020

e20679 Background: Satisfied patients demonstrate higher levels of compliance for the course of their treatment and the probability of successful treatment completion thus considerably increases. Analysis of pts needs is the base of pts satisfaction. The present analysis aims to identify the needs of our in-outpatients who received chemotherapy. Methods: 134 pts with breast cancer who underwent chemotherapy during 3 months (from 15 September to 30 November) were eligible for study. We administered the “Need Evaluation Questionnaire” (NED) validated by U.O. Psiconcologia Istituto Nazionale Tumori Mi) to 125 pts after consent, 9 pts (7%) refused to answer items. NED was built on 23 items in 7 domains of necessity: 1) information on diagnoses, prognoses, diagnostics tests and treatments (items 1–4); 2) relationship between pts and physicians or nurses (items 5–8), 3) nursing and supportive care (items 9 -13) 4) Hospital service (item 14); 5) economical aspects (items 15–16); 6) psychological, ethical, spiritual care (items 17,18,19,23); 7) relationship with relative. NED makes a quantitative evaluation of necessity with simple questions. Eligibility criteria required age ≥ 18 yrs (median age of pts was 55 yrs), histologically proven breast cancer; at lest 1 completed cycles of neoadjuvant or adjuvant or palliative chemotherapy. 96 (77%) pts completed questionnaire by their self, and 29 pts (23%) were helped because of practical problems (infusional therapy, no glasses at so on ). We choose a descriptive quantitative statistical evaluation for every item. Results: 93 % of pts completed NED questionnaire. More significant data were reported afterward and answers were allocated among the 7 domains: 1) more information about prognosis was required by 52 % of pts; 2) 90 % of pts thought that physicians embroiled them in therapeutic choices, but 36% of pts required information about future and quality of life 3) 96% of pts considered very good nursing care; 4) positive for all pts 5) 26% of pts required more informations about insurance, tickets 6) 13 and 14 % of pts required psychological or spiritual relationship; 7) women generally had support by relatives. Conclusions: this analysis shows that needs of our pts generally received responses, but answers also emphasized assurances on pts’ future. No significant financial relationships to disclose.
Factors influencing in-hospital length of stay and mortality in cancer patients suffering from febrile neutropenia
Authors: Lal A. , Kumar P. , Bhurgri Y. , Rizvi N. , Shaikh A. J. , Adil S. , Masood N. , Virwani M. 
Published: August 2020

e20716 Background: Febrile neutropenia (FN) is a major complication of chemotherapy, costly in terms of morbidity, mortality and associated financial expenditure. The present study was conducted with the goal of highlighting FN as a serious problem in Pakistan, with the longer term objective of improved cancer survival, reduction in length of stay (LOS) in hospital, morbidity, mortality and costs in our existing developing country scenario. Methods: A cross-sectional descriptive study was conducted on patients, >18 years, admitted with FN as a consequence of chemotherapy at a referral hospital in Karachi from 1st September 2006 to 30th April 2007. Results: A total of 80 patients [43 (53.8%) males and 37 (46.2%) females] were selected. The mean age was 47.4 (SD ±16.6; range 18–79) years. Sixty eight patients (86%) were < 65 years, 50% were < 50 years. Overall, in hospital mortality was 11%; 4% for patients on granulocyte colony stimulating factor (G-CSF) prophylaxis as against 20% for those without. The cause of death was either pneumonia or septic shock. Mean LOS was 7.53 (SD ±3.8; range 2–17) days. Hematological malignancies, older age, severity of dehydration, pneumonia and culture positivity were significantly associated with LOS and death. Those above 50 years of age were 1.5 times as likely to be hospitalized longer and > three times as likely to die. Bacteremia conferred a 5-fold and pneumonia an 8-fold increase in the risk of death. Conclusions: The results of this study indicate that age, vital instability, dehydration, high creatinine, culture positivity and hematological malignancies are high risk factors in chemotherapy induced FN. Identification of FN risk factors with poor outcomes may help in devising protocols for modified dosage or including GCFs initially. This may help reduce the cost of cancer care as well as mortality and morbidity. Prospective studies of FN in multiple centers in Pakistan may be beneficial in evaluating these risk factors further. No significant financial relationships to disclose.
Nurse practitioner-led breast cancer survivorship clinic
Authors: Cureton A. , Pritham W. , Royce M. , Zahn K. 
Published: August 2020

e20723 Background: The 2.5 million breast cancer survivors in the US demands increasing awareness of and need for healthcare organizations to address survivorship issues. Cancer survivorship care has become a specialty emphasizing health promotion, disease prevention, and patient satisfaction. It is a natural setting for advanced practice nurses to be leaders. This abstract presents a model for a nurse practitioner-led breast cancer survivorship clinic. Methods: Eligible patients are those previously diagnosed with invasive and/or in situ breast cancer and at least 5 years post-diagnosis without recurrence. Eligible survivors are identified annually through the University of New Mexico Tumor Registry. Clinic notes are reviewed to confirm the patient has not had a recurrence, new diagnosis, or death. Letters are sent to eligible survivors introducing the Breast Cancer Survivorship Clinic (Clinic) and inviting them to participate, and oncologists are encouraged to transfer eligible patients into the Clinic. Results: Eighty-six survivors are currently participating in the Clinic. Survivors are seen on an annual basis after mammogram. Each survivor receives a personalized Survivorship Care Plan at the first visit. The care plan was developed by a multi-disciplinary team of a breast oncologist, psychologist, social worker, nutritionist, and patient educator to provide input on the issues that survivors face. Components of Survivorship Care Plan: pathologic and genetic findings, summary of treatment, bloodwork, bone health, lymphedema, secondary malignancies, health maintenance recommendations, psychological assessment, nutrition/weight assessment. Conclusions: The establishment of the Clinic has several advantages: Breast cancer survivors are being followed in this specialty clinic after 5 years instead of being discharged from the Cancer Center. The Clinic has allowed oncologists more time for patients actively on therapy and more time to accommodate newly diagnosed patients. The Clinic addresses the unique issues faced by long term survivors, which could increase patient satisfaction. A multi-disciplinary team is key to developing a care plan for a survivorship clinic. However, the day-to-day operation of the clinic can be effectively led by a nurse practitioner. No significant financial relationships to disclose.
Rates of psychiatric illness in patients with cancer: An analysis of a psycho-oncology service
Authors: Devitt P. , Breathnach O. , Grogan L. , Cotter D. , MacHale S. 
Published: August 2020

e20731 Background: The diagnosis of cancer represents a major physical and psychological challenge for patients and their families. Psycho-oncology services are limited throughout the country. We assess the service profile of patients assessed between 1/2003 and 6/2008 to determine how the needs of patients have changed. Methods: Case notes from all patients referred by medical oncologists, clinical nurse specialists and/or social workers to the psycho-oncology service were reviewed for the period 7/07 to 6/08. Demographic details, cancer diagnosis and stage, time since diagnosis, psychiatric diagnosis (past/current), and need for psychiatric intervention were collected. This data was compared to a similar review performed from 1/03 to 12/03. Results: 106 patients were psychiatrically assessed during the period 07/08 compared with 63 from 2003, representing a 68% increase in activity. All major cancers were represented. There was a 30% increase in patients assessed with lung cancer (14% in 07/08 vs. 11% in 2003). More patients were referred with localised disease in 07/08 than in 2003 (37.5% vs .19%, p=0.012).Patients with a past history of psychiatric disorder were more likely to be referred in 07/08 compared to 2003 (54% vs. 32% p=0.005). There was a significant decrease in the numbers diagnosed with depression in 07/08 (29% vs. 51%, p= 0.004) with a corresponding increase in the diagnosis of adjustment disorder (26% vs. 6%). Conclusions: Psycho-oncology services remain an important component of care for patients with cancer. The increased rate of referrals may reflect an increased awareness amongst oncology staff of psychological distress in this vulnerable population. No significant financial relationships to disclose.
The use of intrathecal ziconotide to manage refractory malignant pain: Five case studies
Authors: McDowell G. C. , Mitchell J. W. , Moore T. D. 
Published: August 2020

e20737 Background: Chronic malignant pain is often difficult to manage. Intrathecal (IT) ziconotide monotherapy has been shown to be effective in treating patients with chronic pain associated with malignancy. Intrathecal admixtures containing ziconotide may also be viable treatment options for refractory malignant pain. Methods: The medical records of 5 patients with malignant pain managed with IT ziconotide as monotherapy or as a component of combination therapy were reviewed. Patient characteristics, medical history, IT drug doses, Numeric Pain Intensity (NPI: 0–10 scale, with higher scores indicating greater pain intensity) scores, and clinical observations (including adverse events [AEs]) were identified. Results: Four women (aged 27, 31, 46, and 68 years) with metastatic breast cancer and a 61-year-old man with metastatic prostate cancer were intolerant of or experienced inadequate analgesia with systemic analgesics and/or IT opioids with or without clonidine or bupivacaine. Ziconotide was either started as monotherapy or used in combination with an IT opioid with or without bupivacaine. Initial ziconotide doses of 0.46 to 1.50 mcg/d were titrated upward to 1.16 to 7.26 mcg/d at the last assessments. Although the 46-year-old woman experienced substantial pain relief (55.6% reduction in NPI score) and quality of life improvement during ∼3 months of ziconotide therapy, she died of cancer complications that were unrelated to ziconotide. From baseline to last assessment, the remaining 4 patients experienced 25% to 83% reductions in NPI scores with ziconotide therapy. Meaningful improvements in patient mobility and functionality were evident. The 68-year-old patient experienced transient dizziness after a 3-mcg bolus trial of ziconotide but did not experience any AEs during continuous infusion of ziconotide. No other ziconotide-related AEs were reported. Conclusions: These cases suggest that ziconotide, alone or in combination with other IT agents, can be a viable treatment option for patients with refractory malignant pain. [Table: see text]
Oncologic patients in the emergency room
Authors: Pajares I. , Tobeña M. , Ferrer A. , Serrano S. , Vidal M. , Lopez D. , Lambea J. , Ruiz-Echarri M. , Millastre E. , Tres A. 
Published: August 2020

e20748 Background: Cancer is a very frequent pathology with a gradual increase of its prevalence. Oncologic patients are exposed to suffer many complications which may need emergency attention. The aim of this study is to describe patients which consult in the emergency room and frecuency of different causes of complaint. Methods: Between October 2007 and October 2008, we collected all oncologic patients who consulted in our emergency room. We describe tumor location and causes of complaint. Results: 560 oncologic patients were attended in 12 months (median 12 per week). By tumor location, 134 (23,9%) patients had not small cell lung cancer (NSCLC), 101 (18%) colorrectal cancer, 64 (11.4%) breast cancer, and 261 (53%) other malignancies. Of all patients, 440 (82.7%) had stage IV disease and 318 (56.8%) were receiving chemotherapy treatment The most common causes to complaint were oncologic pain (22.5%), fever (17.5%), dysphnea (12.7%), neurologic symptoms (9.1%), and asthenia (8.6%). Conclusions: Oncologic patients consult frecuently in the emergency room, mainly those with NSCLC and colorrectal cancer. Metastasic disease and chemotherapy treatment are common too. Oncologic pain, fever and dysphnea are the most frequent causes of complaint,with an important impact on their quality of life. No significant financial relationships to disclose.
MRI evaluation of soft tissue sarcomas
Authors: Faizi N. , Sharma R. , Sharma S. , Chandrashekhara S. , Shukla N. K. , Malhotra A. , Kumar R. , Deo S. V. , Thulkar S. 
Published: August 2020

e21523 Background: Althouth soft tissue constitute large part of the body, STS are rare (1% of all neoplasms) and can arise anywhere in the body. Imaging is require to confirm the diagnosis and for staging. We conducted a prospective study to evaluate the role of MRI scan in characterization and staging of the tumor. Methods: This study between 2006 and 2008 included 20 patients with histologically proven soft tissue sarcoma in whom preoperative MRI of the local site was performed and the findings were correlated with the surgical and histopathological findings. Only those patients in whom surgical and histopathological findings were available were included in the study. All MRI were performed on 1.5 T MRI using body and appropriate surface coil. T1W, T2W, and STIR sequences were acquired in axial, coronal, and sagittal planes. Contrast enhanced MRI was performed in four patients. Surgical findings were recorded by the operating surgeon and resected specimens were analyzed by pathologist for assessing extent and histologic typing. All demographic data of the patient, the clinical features, preoperative imaging analysis, operative and histopathological findings were tabulated as per the given proforma. Results: Age of the patients was 16 - 72 years (mean age 44.4 years). Male female ratio was 2.3:1 . Eleven cases were recurrent. Most common histologic type was MFH (30%) while synovial sarcoma was second most common (20%) type of the STS in our study. Eighteen of 20 soft tissue sarcomas were of high grade. Average size on MRI was 9.25 cm (range) and operative size was 9.8 cm (range). Statistically significant agreement existed between MR and operative size. The sensitivity of MRI for individual muscle involvement was 92.3% and specificity was 96.5%. MRI had a sensitivity of 93% and specificity of 100% in predicting fascial involvement. MRI had 100% sensitivity and specificity in showing skin and subcutaneous tissue involvement. MRI had 100% negative predictive value in predicting NV bundle involvement. None of the patients had bone or joint involvement. No distant parenchymal metastases were seen. Specific diagnosis based on MRI image characteristics was suggested in 35% patients. Conclusions: Overall staging accuracy of MRI was 75% in staging of STS when correlated with surgical and histopathological MSKCC staging. No significant financial relationships to disclose.
Characterization of triple-negative breast cancer utilizing microarray-based gene-expression profiling
Authors: Schmidt M. , Daniel B. , Lebrecht A. , Koelbl H. , Hengstler J. G. , Gehrmann M. 
Published: August 2020

e22014 Background: Triple-negative breast cancer (TNBC) is characterized by lack of expression of estrogen receptor (ER), progesterone receptor (PR) and HER-2. This makes it one of the most challenging subgroups for clinical decision-making. Methods: We analyzed gene-expression profiles of 200 node-negative breast cancer patients utilizing the Affymetrix HG-U133A array. After performing an unsupervised hierarchical cluster analysis using 2579 genes selected for variable expression within our dataset, we constructed metagenes for five dominant cluster (basal-like, luminal, proliferation, T-cell, B-cell). The interrelation of the median expression of these metagenes between TNBC and those cancer specimens expressing at least one of those receptors was analysed with the Wilcoxon-Mann-Whitney test. An intrinsic gene list was used to define basal-like breast cancer (BLBC). Sensitivity and specificity of TNBC to correctly classify BLBC was calculated. Metastasis-free survival (MFS) at 5 years was calculated according to Kaplan Meier. Results: Of the 200 node-negative breast cancer patients, 33 (16.5%) were triple-negative and 20 (10%) basal-like. Sensitivity of TNBC to correctly predict BLBC was 100%, specificity was 93.1%. TNBC showed an overexpression of the basal-like metagene (P=7.905e-13), an inverse relation with the luminal metagene (p=1.151e-12) and had higher proliferation and higher expression of T-cell (P=6.316e-5) and B-cell (P=3.551e-6) metagene. A higher expression of the B-cell metagene was associated with longer MFS in both TNBC (P=0.048) and BLBC (P=0.041). Conclusions: Characterization of TNBC reveals marked differences in gene-expression. Overexpression of mRNA transcripts related to the humoral immune system might serve as a protective factor in this particular subgroup. No significant financial relationships to disclose.
High-sensitivity KRAS mutation detection in colorectal and lung cancer using SURVEYOR Nuclease scanning
Authors: Koul M. , Mahurkar S. , Legendre B. , Jiang J. , Kaldjian E. 
Published: August 2020

e22023 Background: Mutations of the KRAS gene in colorectal and lung cancers have been associated with lack of response to epidermal growth factor receptor (EGFR) inhibitor therapies. Here we describe a highly sensitive assay that identifies mutations by scanning the entire coding region of KRAS exons 2 and 3 using SURVEYOR Nuclease, an endonuclease that cleaves double-stranded heteroduplex DNA at base pair mismatch sites. Methods: DNA was extracted from formalin-fixed paraffin- embedded tissue sections from a set of 30 colorectal and lung cancer samples. Two amplicons covering the coding and splice junction regions of the KRAS gene exons 2 and 3 were PCR-amplified, hybridized to allow heteroduplex formation, incubated with SURVEYOR Nuclease and analyzed on the WAVE-HS DHPLC system. The sensitivity of SURVEYOR Nuclease mutation detection was assessed by creating serial dilutions of 50:50 mixtures of original PCR products from mutant samples with wild type amplicons from control DNA. Results: 6 samples were identified as KRAS mutant by WAVE-HS profiles containing two fragment peaks in addition to the full length amplicon peak, indicating SURVEYOR Nuclease cleavage at a mismatch site. Mutations were found in both exon 2 (codons 12, 13) and exon 3 (codon 59). Sequencing confirmed the KRAS mutations in these samples. Levels of mutant DNA as low as 2% (1 ng/ul) were identified by this method, consistent with other SURVEYOR-based assays. Conclusions: SURVEYOR Nuclease technology is a sensitive and comprehensive method for detecting mutation in KRAS. [Table: see text]