bluuebunny/crossref_metadata_2025_split huggingface dataset:
A phase II study with gemcitabine and split-dose cisplatin in patients with advanced non-small cell lung cancer
Authors: Jang H. , Park J. , Kwon J. , Jung J. , Kim H. , Song H. , Zang D. , Lee J. , Park Y. , Kim J. 
Published: March 2020

17115 Background: The combination of gemcitabine and cisplatin is among the most active regimens for the treatment of NSCLC. However, the optimal dose and schedule for administration of the two drugs has not yet been determined. We investigated the activity and toxicity of a gemcitabine and split-dose cisplatin regimen in an outpatient setting for patients with advanced non-small cell lung cancer (NSCLC). Methods: From June 2004 to May 2005 patients with stage IIIB or IV who had not had prior chemotherapy entered the study. Treatment consisted of gemcitabine 1,250 mg/m2 and cisplatin 35 mg/m2, both given intravenously on days 1 and 8 every 21 days. Results: Forty-three patients were entered this study. Patient characteristics were as follows: male/female, 32/11; median age (range), 63 (30–76) years; ECOG PS 0/1/2, 7/28/8; stage IIIB/IV, 17/26. A total of 160 cycles were delivered, with a median of 4 cycles (range, 1–6). All patients were evaluable for toxicity. Grade 3 & 4 toxicities according the NCI toxicity criteria included included neutropenia in 7 patients (17%), anemia in 3 (7%), thrombocytopenia in 6 (14%), and emesis in 1 (2%). Of 40 patients assessable for response, one (2.5%) had CR and 22 (55%) had PR. On intent-to-treat basis, the overall response rate was 53% (95% CI, 39–68%). Median time to progression was 6.0 months (range, 1.2–12.0 months) and median overall survival was 13.1 months (range, 1.4–17 months). Conclusions: This regimen with gemcitabine and split-dose cisplatin using a 21-day schedule appears to be active and very well-tolerated in an outpatients setting for patients with advanced NSCLC. No significant financial relationships to disclose.
Analysis of drug delivery and outcome differences in platinum-based chemotherapy for advanced non-small cell lung cancer (NSCLC)
Authors: Radosavljevic D. Z. , Kezic I. , Jelic S. , Tomasevic Z. , Golubicic I. 
Published: March 2020

17120 Background: Dose intensity (DI) is the dominant treatment design variable with respect to the degree of therapeutic response while total dose (TD) correlates best with the duration of response in an incurable patient population. To further explore the nature of the relationship of response to treatment (RR) and stable disease (SD) with median survival in advanced NSCLC, we performed an analysis of dose intensity and total dose of platinum compounds in first-line treatment of advanced NSCLC. Methods: Individual patient data from three phase 2/3 studies conducted at the Institute for Oncology and Radiology of Serbia from 1990 to 2001 were reviewed to perform an analysis of DI and TD for responding patients (CR+PR) and stable disease ones (SD). All patients were treated with cisplatin (120 mg/m2) or carboplatin (500 mg/m2 and thereafter AUC 6) based doublets or triplets, every four weeks (second-generation regimens). Results: 109 case records were analyzed, 93 patients received cisplatin-based and 16 carboplatin-based regimens. For responding patients (N=36) median DI of cisplatin was 29.84 mg/m2/wk (range 24.17–36.42) and for stable disease patients (N = 57) median DI was 29.94 mg/m2/wk (range 27.11–40.91). Wilcoxon rank sum test p = 0.28. In percentage, responders had DI of 0.985 of planned dose, and stabilizations had DI 0.99 of planned dose. Regarding TD, responders received median of 577.5 mg/m2 of cisplatin (236.1–1070) while stable disease patients received median of 475 mg/m2 (231.3–929.4), Wilcoxon p=0.0045. Median survival for responders was 9.5 months and for SD patients 6.0 months (log-rank test, p = 0.021). For carboplatin-receiving patients (N = 16) median DI was 122.85 mg/m2/wk (111.91–141.04) and median TD 1900.30 mg/m2/wk (1000–3000). Conclusions: Received DI of cisplatin was the same for responders and stable disease patients, but responders received more drug than stable-disease patients and lived significantly longer. The optimal duration of treatment for stable disease patients as probably the most frequent advanced NCSLC population requires careful consideration, especially while we are still in the era of platinum-based chemotherapy. No significant financial relationships to disclose.
Induction chemoradiotherapy and surgical resection for non-small cell lung carcinomas of the superior sulcus (pancoast tumors): Mature results of National Cancer Institute (INCa)-Brazil
Authors: Amaral C. , Small I. , Olmedo D. B. , Sousa A. , Toscano E. , Sousa P. , Pelluso H. , Ferreira C. G. , Sales A. , Zukin M. 
Published: March 2020

17124 Background: The established treatment for T3 Pancoast tumors, radiation plus surgery, leads to a 50% R0 resection rate and a 30% 5 year survivals. T4 tumors are usually unresectable and incurable. Our group retrospectively analyzed the feasibility and efficacy of induction chemoradiotherapy plus surgery for T3 and T4 tumors. Methods: Eligible patients (pts) had biopsy proven, untreated, T3–4N0–1 Pancoast tumors. Induction therapy was cisplatin (50 mg/m2, days 1,8,29,36) and etoposide (50 mg/m2, days 1–5, 29–33) (PE) given concurrently with radiation (45 Gy, 25 daily fractions). Thoracotomy was done within 5 weeks of induction therapy for stable or responding disease. All pts were to receive postoperative chemotherapy (PE ×2). Median follow up was 19 months. Results: From 4/01–6/05, 13 eligible pts were enrolled: 6 men, 7 women, median age 53 years; 9 T3, 4 T4. All pts (100%) completed induction therapy. Grade 3–4 toxicities were neutropenia (n = 2), anemia (n = 1), fatigue (n = 1), esophagitis (n = 5). All pts had thoracotomy, 13 had R0 resection. Pathologic CR was found in 3 (23.1%), minimal microscopic disease in 1 (7.7%). Postoperative chemotherapy completed by only 1/13 pts. Median survival was not reached and Median Disease free (DFS) and 2 year overall survivals (OS) were 26 months (CI 95% 13.6–38.4) 67% for all pts, respectively. Relapse sites were brain only (n = 3) and local only (n = 1). Conclusion: This combined modality therapy was well tolerated and leads to high rates of complete resection, OS and local control that are strikingly better than with radiation and surgery. These results obtained in a population with T3 and T4 tumors reproduced those of the SWOG study in terms of resectability, safety and short-term survival Of note is the poor adherence to postoperative chemotherapy in this population. No significant financial relationships to disclose.
Retrospective analysis of gefitinib versus docetaxel in never-smoking patients with previously treated non-small-cell lung cancer (NSCLC)
Authors: Kogure Y. , Ueda S. , Nakamura Y. , Ebisawa M. , Asai G. , Takahashi T. , Yamamoto N. 
Published: March 2020

17154 Background: Docetaxel has been standard for second line treatment of NSCLC. In ISEL study, subgroup analyses showed significantly longer survival in the gefitinib group than the placebo group for never-smokers and Asians. It is not clear whether gefitinib has the clinical advantage in these selected patients with NSCLC. We aimed to compare the clinical benefit of gefitinib with that of docetaxel in never smoker previously treated with chemotherapy, retrospectively. Methods: We reviewed patients from August 2002 to September 2005 in Shizuoka Cancer Center. Patients with following conditions were analyzed: NSCLC, received gefitinib or docetaxel, never-smoker, not chemo-naived. We assessed the response rate, progression free survival (PFS) and over all survival for gefitinib and docetaxel respectively. Survival curves were calculated using the Kaplan Meier-method. Prognostic factors were estimated using multivariate analysis. Results: 108 patinets were selected. 69 patients were treated with gefitinib and 39 patients were treated with docetaxel. 28 patients overlapped each other. The patients treated with gefitinib following docetaxel and those with docetaxel following gefitinib were 17 and 13, respectively. 69 patients with gefitinib: the median age, 62 years (31–79); stage IIIB/IV, 14/55; ad/sq/ others, 61/3/5; PS 0/1/2/3, 19/35/13/2; prior therapy containing platinum regimen, 58. The response rate was 36%. 39 patients with docetaxel: the median age, 63 years (31–76); stage IIIB/IV, 8/31; ad/sq/others, 29/7/3; PS 0/1/2/3, 18/19/1/1; prior therapy containing platinum regimen, 34. The response rate was 10%. Gefitinib was superior in longer median PFS (148 days vs 43 days, p = 0.0002). Over all survivals were not significant between two arms. In multivariate analysis for PFS, following factors were significant: gefitinib therapy (hazard ratio 0.375, p = 0.0002); male (hazard ratio 1.854, p = 0.0011); good performance status (hazard ratio 0.450, p = 0.0057). Conclusions: Our results suggested that gefitinib therapy is very attractive for never smoker in the point of PFS. Many patients received cross-over therapies made difficult to analyze over all survival. No significant financial relationships to disclose.
Gender difference in susceptibility to smoking in Korean lung cancer patients having smoking habits
Authors: Ryu J. , Lee H. , Cho J. , Kwak S. , Lee H. , Lee M. , Lee M. , Kim C. 
Published: March 2020

17158 Background: There were some controversies whether women were more or less susceptible to the carcinogenic effect of cigarette smoke and the decline of forced expiratory volume in 1 second (FEV1) to pack-years compared to men. Methods: In this study, we included all lung cancer patients having smoking habits who was histologically diagnosed and performed pulmonary function testing at the time of diagnosis from September 2001 through December 2005. We estimated individual susceptibility to smoking using a formula (SI, susceptibility index) of (100% predicted FEV1)/pack-years. Results: Of 858 lung cancer patients, sex ratio (M/F) was 14.6 (803/55). Past smokers were in 236 (29.3%) for men, 11 (20.0%) for women. Most common hsitologic type was squamous cell carcinoma (477), adenocarcinoma (191), small cell carcinoma (147), adenosquamous cell carcinoma (14), large cell carcinoma (14), NSCLC cell type not specified (15). Pack-years were 41.3 ± 18.9 for men, 29.2 ± 20.4 for women (P = 0.000). FEV1 % was 78.7 ± 23.3 for men, 79.4 ± 22.9 for women (P = 0.832). As for SI, there were no differences between men (0.65 ± 1.1) and women (0.72 ± 1.6) (P = 0.688). Conclusions: Although lung cancer women having smoking habits showed lower pack-years, there were no gender differences in terms of FEV1 decline to cigarette smoking. No significant financial relationships to disclose.
Prognostic implications of caspase-3 expression in patients with diffuse large B-cell lymphoma (DLBCL)
Authors: Elsawy W. H. , Abdel Kader M. , Elfar A. , Gharib A. , Eltrhony S. , Dorgham Y. 
Published: March 2020

17500 Background: Caspase-3 activation is an essential step in programmed cell death (apoptosis) and cytotoxic drug-induced apoptosis is mediated by caspase-2 and caspase-3. The following study was designed to evaluate the correlation between Caspase-3 and the clinical outcome in patients with diffuse large B-cell lymphoma. Methods: Caspase-3 was determined by both immunohistochemistry and by quantitative reverse-transcription PCR in 49 previously untreated patients with diffuse large B-cell lymphoma. Results: Caspase-3 was positive in 69.4% of the patients by immunostaining and Tumor cells displayed a diffuse cytosolic expression in 51% of patients. The median value of Caspase-3mRNA within the group by quantitative PCR was 1. Caspase-3mRNA level was μ1 in 28 patients and <1 in 21 patients. Caspase-3 expression was associated with higher tumor stage (P = 0.03), elevated serum lactate dehydrogenase levels (P = 0.02), and the International Prognostic Index (P = 0.0001). Patients with Caspase-3-positive immunostaining had a significantly higher complete response rate to chemotherapy and a longer overall survival than Caspase-3-negative patients. Also, patients with tumor cells expressing diffuse cytosolic immunostaining for caspase-3 had a poor prognosis when compared with those expressing a punctate staining (P > 0.0004 log-rank). A low caspase-3 mRNA expression by quantitative RT-PCR was also associated with a poor prognosis, although this was not statistically significant. In addition, patients with a high TUNEL positivity had a low survival probability (P > 0.02). Conclusions: Our results suggest that Caspase-3 activation or its lack may be a powerful independent predictor of response and survival in previously untreated diffuse large B-cell lymphomas. No significant financial relationships to disclose.
Rituximab resistance and its association with changes in the internal domain of CD20 antigen and down-regulation of pro-apoptotic protein Bax and Bak in both rituximab-resistant cell lines (RRCL) and diffuse large B-cell lymphoma (DLBCL) patient (pt) samples
Authors: Reddy N. M. , Hernandez-Ilizaliturri F. J. , Olejniczak S. , Knight J. , Czuczman M. S. 
Published: March 2020

17509 Background: Resistance to rituximab (R) has been observed in lymphoma pts. To define the molecular basis for rituximab resistance we developed various RRCL and previously demonstrated changes in CD20 structure, membrane reorganization following rituximab exposure and deregulation of pro-apoptotic proteins Bax/Bak leading to rituximab/chemotherapy resistance. In our current work we evaluated changes in the structure/expression of CD20 and/or pro-apoptotic proteins in primary tumor specimens from DLBCL pts treated with rituximab in combination with CHOP (R-CHOP). Methods: We obtained frozen lymphoid material from patients with DLBCL who achieved a remission (sensitive lymphoma) or failed (resistant lymphoma) R-CHOP therapy. Protein lysates were obtained from each sample. Structural changes in CD20 were determined by Western blotting using various antibodies recognizing epitopes located in the internal (GST77 and 1439) and external domain (rituximab) of CD20. In addition, we studied the expression of Bax and Bak. Results: Variability in the expression and structure of CD20 was found in the pt samples. Rituximab binding to its surface CD20 antigen was preserved in all patients. However, differences in C- and N-terminal expression were found across DLBCL specimens. In addition, down-regulation of Bax/Bak was observed in some pts with resistant lymphomas. Patients who responded to R-CHOP were noted to either have an intact CD20 and/or express Bax/Bak. On the other hand, resistant lymphomas had altered CD20 isoforms and a downregulation of Bax/Bak. Conclusions: Our current preliminary data suggests a positive correlation to our pre-clinical data generated from B-cell NHL cell-lines and will be evaluated in a larger number of primary NHL tumor specimens. No significant financial relationships to disclose.
Body mass index (BMI) and physical activity in long-term lymphoma survivors: A pilot study
Authors: Thompson C. A. , Cerhan J. R. , Laplant B. R. , Maurer M. J. , Clark M. M. , Sloan J. A. , Rummans T. A. , Thomas R. J. , Habermann T. M. 
Published: March 2020

17511 Background: There is no published data regarding BMI changes in survivors of adult lymphoma. Methods: In October of 2004, we mailed a 23-page survey to 95 randomly selected patients from a population of 2,485 of patients from the Mayo Tumor Registry who had survived lymphoma from 5 to 20 years. 56 completed the survey for a 68% participation rate. Body mass index (BMI) was calculated using clinical height and weight in the medical record at the time of diagnosis and self-reported weight in the survey response. Physical activity was self-reported. Based on their pattern of response, patients were categorized into a stage of change of current exercise (precontemplation, contemplation, preparation, action, or maintenance). Mood disturbance (depression, anxiety, and distress) and quality of life (QOL) were self-reported using the CES-D, POMS, STAI, FACT-G, and LASA questionnaires. Scores were transformed to a scale of 0–100 (higher score meaning higher functioning) to allow comparisons with a difference of 10 points considered significant. Results: The median age at completion of the questionnaire was 62 years (range: 25–85). The median time since diagnosis was 11 years (range: 6–20). Regular fitness, defined as a stage of change for exercise of action or maintenance, was reported by 48% of the respondents. The median BMI at diagnosis was 25.6 and the median at time of questionnaire was 27.0, which is a statistically significant change. Change in BMI, BMI at diagnosis, and BMI at time of questionnaire had no correlation with level of physical activity. Obese patients had a mean score of 72 points on the LASA, which was significantly lower than normal and underweight patients (mean 86) and overweight patients (mean 84). Conclusions: A small, but significant increase in body mass index was noted in long-term lymphoma survivors from the time of diagnosis to long-term follow-up. Patients who were obese at time of diagnosis may have lower quality of life down-the-road, as measured by the LASA years following treatment. This data represents the first information about body mass index in survivors of adult lymphoma. Further larger studies are needed to confirm these preliminary data and to evaluate other aspects of health behavior in long-term survivors of lymphoma. No significant financial relationships to disclose.
Prediction of response to therapy with clarithromycin/lenalidomide/dexamethasone (BIRD) in multiple myeloma using FDG-PET
Authors: Coleman M. , Kostakoglu L. , Goldsmith S. J. , Liu M. , Christos P. , Jayabalan D. S. , Niesvizky R. 
Published: March 2020

17530 Background: End points based on functional imaging data hold promise to better define and stratify response. As a metabolic imaging modality, FDG-PET can characterize tumor aggressiveness and thus can serve as an early surrogate for therapy response. The combination therapy with BIRD augments tumor mass reduction and improves response in patients with multiple myeloma (MM). The purpose of this study is to determine the value of pre-therapy FDG-PET in predicting therapy response in MM patients undergoing BIRD therapy. Methods: A total of 13 patients with MM (mean age: 60 ± 11) underwent a whole body FDG-PET scan at initial staging prior to BIRD therapy. FDG uptake was qualitatively evaluated in 5 different patterns:minimally diffuse (score 1), focal (score 2), multifocal (score 3), diffuse (score 4) and extramedullary (score 5). Standardized uptake values (SUVmax) were obtained in osseous and extramedullary lesions for quantitative evaluation. Mean SUVmax were also calculated in 14 representative anatomic sites in the axial and appendicular skeleton in 20 age-matched control patients with no osseous malignancy. Ratios of the mean lesion SUVmax to the mean SUVmax in corresponding osseous sections from the control group were calculated. A score was obtained for each patient to reflect disease extent or severity by adding the ratios for each individual lesion. The qualitative and quantitative scores were correlated with the standard response criteria. Results: The results are summarized in the following Table . The pre-therapy qualitative and quantitative scores correlated well with the percent therapy response to BIRD regimen (r = −0.58, p = 0.04 and r = −0.53, p = 0.06, respectively). Conclusions: The pre-therapy FDG-PET scoring system we have developed appears to correlate with the subsequent therapy response to BIRD regimen. Expanded number of patients are warranted to confirm the results of this study. [Table: see text] No significant financial relationships to disclose.
Hodgkin’s lymphoma among veterans: Does race matter?
Authors: Komrokji R. S. , Mekan S. F. , Safa M. M. , Nahleh Z. A. , Pancoast J. R. , Muhleman A. F. , Jazieh A. R. 
Published: March 2020

17538 Background: Racial disparities in Hodgkin’s lymphoma (HL) are not well studied. Earlier studies suggested that black patients received less treatment and had worse outcome. The VA health care system offers a platform to study those racial differences given similar other variables and socioeconomic status among those patients. Methods: This was a retrospective analysis. The VA Central Cancer Registry (VACCR) database was used to identify patients with HL diagnosed between 1995 and 2005. There are approximately 120 VA medical centers diagnosing and/or treating patients with cancer. Data are entered by tumor registrars at the VA medical centers. This site aggregates the data collected by the medical centers’ cancer registries. Data was extrapolated and analyzed using bio-statistical software SPSS. Results: There were 1009 patients with HL at the VA system, 801 white and 183 black patients. Twenty-five patients from other racial groups were excluded from this analysis. The median age of presentation among blacks was 50.8 years compared to 53.8 years among whites (P-value 0.026). More white patients had family history of HL. Black patients had a higher incidence lymphocyte depleted histological subtype 33 (18.0%) vs. 75 (9.4%) and whites had a higher prevalence of nodular sclerosing subtype, 260 (32.5%) vs. 32 (17.5%). Other baseline characteristics such as sex, history of smoking, alcohol, and radiation exposure were similar. Presence of bulky disease and stage of lymphoma at presentation were also similar. Similar proportion of patients received chemotherapy among the two groups, 70 % for blacks and 69% for whites. Among blacks 19.7 % of patients received radiation while 25.5 % white patients did (P-value 0.24). The 5-year overall survival of blacks was 53 % years as opposed to 54% for whites (P-value 0.93) Conclusions: The presenting features, risk factors are similar across black and white races among VA population. Blacks are more likely to present with lymphocyte depleted type of HD. The treatment and outcome of HL among blacks are not different from whites within the VA system. No significant financial relationships to disclose.