bluuebunny/crossref_metadata_2025_split huggingface dataset:
Melanoma survivor treatment severity and correlates of psychosocial and physical health.
Authors: Bugos Kelly , Gerry Arianna Aldridge , Palesh Oxana , Swetter Susan M. , McGurk Katherine L. , Greco Ralph Steven 
Published: March 2020

e20026 Background: Melanoma survivors’ psychosocial needs and physical symptoms are not well understood, despite nearly 1 million melanoma survivors in the US. In addition, there is a paucity of support available as it is generally believed that cutaneous melanoma survivors don’t suffer long term health consequences. Methods: As part of the new Stanford Cancer Survivorship Program, melanoma survivors previously treated at Stanford Cancer Center were asked to complete a quality improvement survey to explore the value of a melanoma survivorship clinic. 21% of 893 invited survivors responded to the electronic survey. We compared survivors based on treatments received: surgical excision only (SX) vs. surgical excision plus (SX+) one or more of the following: sentinel lymph node biopsy, lymph node dissection, skin graft, interferon, chemotherapy, or radiation therapy. Results: 161 melanoma survivors (SX+: 32% vs. SX: 68%) completed the survey. Those who received surgery plus additional treatment were predominantly male (SX+: 68% vs. SX: 32%, p = 0.003) and slightly older (SX+: 67 years vs. SX: 60 years, p = 0.004). Survivors who received SX+ reported greater fatigue (p < 0.001), weight loss (p < 0.001), arm or leg swelling (p < 0.001), weakness (p = 0.001), numbness/tingling (p = 0.009), pain (p = 0.015), and nausea and/or vomiting (p = 0.039) than SX survivors. Similarly, SX+ survivors reported reduced vitality (24% vs. 6%, p = 0.004), worse social functioning (12% vs. 5%, p = 0.032), and worse sexual functioning (20% vs. 6%, p = 0.017) following treatment. Related to patient care, health care providers were less likely to address these symptoms in SX survivors relative to SX+ survivors (75% vs. 57%, p = 0.019). More SX than SX+ survivors wanted education on how to protect their skin from further damage (24% vs. 8%, p= 0.016). Conclusions: Melanoma survivors receiving SX+ for more advanced disease experienced greater psychosocial and physical symptoms following treatment. However, survivors treated with excision alone for cutaneous melanoma wanted provider attention for their treatment-related symptoms and improved education on skin protection.
A phase II randomized study of adjuvant imatinib versus high-dose interferon alpha-2b for resected high-risk c-kit mutated melanoma.
Authors: Si Lu , Wang Xuan , Kong Yan , Lian Bin , Chi Zhi Hong , Cui Chuan Liang , Sheng Xi Nan , Mao Li Li , Tang Bi Xia , Li Si Ming , Yan Qiao Xie , Guo Jun 
Published: March 2020

e20027 Background: Imatinib, a selective inhibitor targeting Abl as well as C-Kit and the platelet-derived growth factor receptor, has been tested for the efficacy and toxicities in metastatic melanoma patients harboring mutations in C-Kit gene. High-dose interferon for one year (HDI) is the FDA approved adjuvant therapy for patients (pts) with high-risk melanoma. This study (NCT01782508) aims to see whether imatinib is more effective than interferon alfa-2b in adjuvant therapy for patients with C-Kit mutated melanomas. Methods: This study enrolled C-Kit mutated(exon 9,11 or 13)pts who were high risk (stage IIB to stage IIIC) and randomized them to receive either imatinib (400mg daily for a year) or HDI (interferon a-2b 15X106 U/m2 d1–5/wX4w + 9X106U tiwX48w) in the absence of disease progression or unacceptable toxicity. 40 pts of each group were planned to enroll. Routine tests including blood tests, medical history updates, physical exams and Brain/Chest/Abdomen/Pelvic CT were performed every 2 months. The endpoints were recurrence-free survival (RFS) and overall survival. Results: Through Jan 2013,7 pts were recruited F3 in imatinib arm and 4 in HDI arm. The three pts received imatinib haven’t had recurrence or metastasis. The RFS were 6m+ (Exon 11: W577S), 5m+ (Exon 11: L576P), 5m+ (Exon 11: L576P) respectively. Two pts have already had lung or regional lymphnode at 4 months (Exon 13: K642E) and 5 months (Exon 11: V560D) in the HDI arm. The other two pts (both Exon 11: 579 insert) in the HDI arm were still disease free for 6 months. The toxicities were consistent with the usual reported studies. Conclusions: In the C-Kit mutated melanoma pts, it’s promising that imatinib may provide more beneficial effect than HDI for high-risk melanomas. (Supported by the National Natural Science Foundation of China (30973483, 81172196, 81102068.) Clinical trial information: NCT01782508.
Intermittent intensified high-dose intravenous interferon alpha 2b (IFNa2b) for adjuvant treatment of stage III malignant melanoma: Pooled analysis of two randomized phase III trials (NCT00226408 and ISRCTN75125874) with 980 patients.
Authors: Weichenthal Michael , Chiarion-Sileni Vanna , Hauschild Axel , Del Bianco Paola , Trefzer Uwe , Guida Michele , Enk Alexander , Romanini Antonella , Loquai Carmen , Ridolfi Ruggero , Schadendorf Dirk , Mandala Mario , Koller Josef , Silvestri Barbara , Gogas Helen , Medici Michele , Dummer Reinhard , De Salvo Gian Luca , Mohr Peter 
Published: March 2020

e20028 Background: Adjuvant high-dose interferon (HDI) treatment of patients (pts) with malignant melanoma (MM) consists of 4 weeks intravenous (IV) induction with 20 MU/m² interferon (IFN) alpha 2b followed by 11 months of 10 Mio IU/m² IFN subcutaneously (sc). It is unclear whether both parts of the regimen are mandatory for the efficacy of HDI treatment. The adjuvant phase III trials DeCOG MM-ADJ-5 and the Italian Melanoma Intergroup (IMI) trial evaluated intermittent IV HDI (iHDI) regimens as compared to standard HDI. In both trials, the experimental arm consisted of iHDI for 3 or 4 cycles, respectively. To gain more insight into the role of iHDI in the adjuvant setting we performed a pooled analysis of both trials. Methods: Based on the intent-to-treat populations, the German DeCOG trial contributed data on 627 MM pts. with stage III (AJCC 2002) resected intransit or lymph node metastasis. From the Italian IMI trial 330 pts. with stage III regional lymph node metastasis excluding intransit metastasis were evaluable. We performed a combined analysis with respect to relapse free survival (RFS) and overall survival (OS), and toxicity using Cox regression models. Results: Median follow-up was 4.6 years in the DeCOG trial and 7.2 years in the IMI trial. There were 320 relapses in the DeCOG trial (51%) and 179 relapses in the IMI trial (54%) resulting in a combined hazard ratio (HR) for RFS of 1.11 (95% CI 0.93; 1.33) comparing iHDI vs.conventional HDI. OS was similar for iHDI vs. conventional HDI (HR 1.04; 95% CI 0.84; 1.29). There was no significant heterogeneity comparing different substages (IIIA vs. IIIB vs. IIIC) or ulcerated versus non-ulcerated primary tumors. In both studies more patients discontinued treatment due to toxicity or impairment of quality of life with conventional HDI as compared to iHDI (DeCOG: 31.0% vs. 16.7%; IMI: 31.2% vs. 23.8%). Conclusions: The pooled analysis of the two pulsed adjuvant HDI treatments showed no significant differences for RFS or OS as compared to conventional HDI. There is a favorable safety profile and less overall toxicity in the pulsed regimens.
Risk of skin cancer in multiple myeloma patients: A retrospective cohort study.
Authors: Robinson Austin A , Kitto Alex , Cheema Simrin K , Madden Erik K , Norberg Adam S , Fors Darron H , Diehl Joseph W , Waterman Gabriel N. , Hilger James D. , Swift Regina A. , Berenson James R. 
Published: March 2020

e20044 Background: Multiple myeloma (MM) patients (pts) have shown a higher risk of developing other cancers, although the type, time course, and relationship to MM treatment of these cancers are less clear. In this study, we determined the risk of specific skin cancer (CA) types among MM patients and its relationship to onset of MM and treatment. Methods: MM pts and unrelated age, sex, and race-matched companions (controls) seen at a MM clinic were enrolled in a retrospective cohort study. Information regarding baseline characteristics of MM and history of skin CA was obtained from medical records. Overall skin CA prevalence and types were compared between groups; among MM patients, the occurrence of skin CA was analyzed relative to date of diagnosis and treatment regimens, with stratification according to treatment duration. Results: We enrolled 205 MM pts and 201 controls with 27.3% and 14.9% demonstrating skin CA, respectively (p < 0.001). Specific types of skin CA included 60 and 37 basal cell carcinomas (BCC), 50 and 17 squamous cell carcinomas (SCC), and 9 and 5 melanomas in the MM pts and controls, respectively. The standardized incidence ratios (SIR) were SCC: 2.88 (p< 0.001), BCC: 1.59 (p<0.001), and melanoma: 1.76 (p = 0.074). SCC SIR was elevated (p<0.001) across each yearly time point from 10 years prior to MM diagnosis through 10 years subsequent to MM diagnosis. BCC SIR was elevated (p <0.002) from 7 through 10 years following MM diagnosis. The SIR markedly increased over time following the diagnosis of MM for both SCC and BCC. Relative risk (RR) was determined for pts treated with bortezomib, immunomodulatory agents, alkylating agents, glucocorticoids, and anthracyclines. There was no significant increase in RR overall or for any specific type of skin CA in relationship to the type or duration of MM treatment. Conclusions: MM pts show an increased risk of skin CA (there was no increase in melanoma incidence), including SCC and BCC. SCC occurred before and following the diagnosis of MM whereas BCC followed the diagnosis of MM. The post-MM diagnosis increase in skin CA was not related to specific drugs used to treat MM.
Consequential administration of intralesional (intratumoral) GM-CSF and IL-2 in the management of metastatic and primary invasive cutaneous melanoma.
Authors: Elias E. George , Sharma Bhuvnesh K 
Published: March 2020

e20052 Background: Patients with dermal and subdermal metatases as well as invasive primary melanoma allow a great opportunity to evaluate the local and systemic response to intralesional therapy. Methods: Ten patients were studied and completed 2½ years of of follow-up. Four had multiple small intransit metastases each measured 3mm-1cm with 3 to >100 lesions per patient, three had large coalesced sclerotic lesions, and two had distant metastases with palpable subcutaneous nodules. Each received intralesional GM-CSF 500 μg weekly, and in case of failure, IL-2 was substituted at 18 million IU weekly. One patient with invasive primary melanoma and a satellite lesion received both cytokines at the skin lesions one week preoperatively. All the patients had flow cytometric analysis of the peripheral blood before and during therapy. All resected tissues were examined histopathologically and by immunohistochemistry. Results: This was safe and nontoxic program. Three of the four patints with small lesions had complete response (CR) to GM-CSF and one failed but had CR to IL-2. All four patients are alive free of disease for 31-45 months. The three patients with sclerotic lesions failed to respond to either agents. One of the two patients with distant metastases had CR for 6 months. The resected tissues from the patient with primary and satellite lesions revealed complete tumor necrosis with massive histiocytosis and overexpression of CD8+, CD83+ and CD25+ cells at the injection sites and regional lymph nodes and is alive free of disease for over 32 months. The flow cytometric analysis showed no significant changes in white cell differentiation and no dendritic cells were identified before or during therapy. Conclusions: Consequential intralesional administration of GM-CSF and IL-2 seems to have a role in the management of some high-risk patients. While GM-CSF can stimulate autologous dendritic cells, IL-2 activates T cells in the presence of patient own tumor. Such combination can activate a strong antitumor response specific to the patient, which is taken-up by the lymphatics.
An evaluation of lifestyle changes in Turkish cancer patients after diagnosis.
Authors: Yumuk Perran Fulden , Kahraman Benan , Yilmaz Merve , Koyyeri Melike , Binici Merve , Turhal Nazim S. 
Published: March 2020

e20503 Background: To determine lifestyle changes in cancer patients after the diagnosis of malignancy. Methods: Between March 16th and September 30th, 2011, a questionnaire consisting of 20 questions was administered via a face-to-face interview to 150 patients at the Marmara University Hospital Oncology Unit. Each patient was queried during the administration of their chemotherapy. Six of the questions were independent choices, and 14 were dependent (multiple choice). A local ethical committee approval is obtained. Results: Of the 150 patients, 70 (46%) were male and 80 were female, and their median age was 55 (range 22-82) years old. An unusually large percentage (28%) of the patients reported that they did not know their diagnosis, and in another question 25% reported that they did not want to talk about their illness. Following their diagnosis, 71% of males and 50% of females reported that they were complying with guidelines for a healthy lifestyle, and 19% of the patients said that they were eating healthier food. At the time they filled out the questionnaire, 61% said that they were hopeful; however, close to 10% said that they felt hopeless. Approximately 53% of the participants said that following their diagnosis, they had a more sympathetic view of the underserved and underprivileged. Conclusions: It was surprising that an unexpectedly high percentage of the respondents reported that they did not make any changes in their lifestyles after their diagnosis of cancer, including eating healthier food. It appears Turkish cancer patients are coping with cancer in different means and ways than we expected of them.
Psychotherapy for adjustment disorder in oncological patients: A systematic review.
Authors: Lopez Pablo , Gercovich Daniela , Bortolato Diego , Margiolakis Patricia , Morgenfeld Mirta , Rosell Laura , Musini Silvina Laura , Gil Deza Ernesto 
Published: March 2020

e20504 Background: Many previous studies argue that the Adjustment Disorder is the most prevalent mental syndrome in patients with cancer. However the research about the psychological treatment for this disorder is scarce. The aim of this study was to evaluate the efficacy of psychological treatments in Adjustment Disorder for oncological patients. We systematically reviewed the randomized controlled trials of psychological interventions for this specific population. Previous related reviews include less specific studies in terms of patients and interventions selected. Methods: Electronic searches were carried out. To identify randomized studies that were published up to 2012, we have searched in the following databases: PubMed, PsycINFO and the Cochrane Central Register of Controlled Trials. The search strategy included the following terms: cancer, adjustment disorder, oncology, psychotherapy, psychosocial interventions and stress. Additionally, we have searched in Scholar Google to find gray literature. The study designs, participants, treatments and outcome characteristics of the studies were coded and evaluated by two independent researchers, following the established selection and inclusion criteria. Results: Following the criteria, we found only one randomized study about the efficacy of psychological treatment for Adjustment Disorder in cancer patients, published in 1998. Conclusions: Considering that the Adjustment Disorder is the most prevalent mental illness in cancer patients, the lack of evidence about the efficacy of psychological treatment represents a significant public health issue. This review reveals that such lack of evidence exists, indicating a serious need of increasing studies about psychological treatments for this specific population.
Efficacy of zoledronic acid in postmenopausal Japanese women with early breast cancer receiving adjuvant letrozole: 36-month results.
Authors: Takahashi Shunji , Iwase Takuji , Kohno Norio , Ishikawa Takashi , Kim Seung Jin , Hosoda Mitsuchika , Horiguchi Jun , Yamauchi Hideko , Hozumi Yasuo , Okada Morihito , Fukunaga Masao , Noguchi Shinzaburo 
Published: March 2020

e20510 Background: We reported 12-month results of upfront zoledronic acid (ZOL) therapy, which prevented bone loss in postmenopausal Japanese women who were receiving adjuvant letrozole, confirming the Z-FAST and ZO-FAST studies results. But the examination in the long term of aromatase inhibitor-associated bone loss has not been proved in the Japanese or Asia women. Methods: Postmenopausal women with hormone receptor positive early breast cancer (BC) patients receiving adjuvant letrozole were randomly assigned to receive either upfront or delayed-start ZOL (4mg intravenously every 6 months) for 5 years. The delayed group received ZOL when lumbar spine (L2-L4) BMD decreased to less than young adult mean (YAM) – 2.0 S.D or when a nontraumatic fractured occurred. The primary endpoint of this study was to compare the changes in L1-L4 BMD at month 12 between the groups. Secondary endpoints, measured at other predetermined timepoints, included comparing changes in L1-L4, L2-L4and total hip (TH) BMD and markers of bone turnover, fracture incidence, and time to disease recurrence. We report the results of 36-month interim analysis. Results: At 36 months, mean change in L1-L4 BMD was 10.7% higher in the upfront group than in the delayed group ( 95% CI, 9.2% to 12.1%; p< 0.001 ), L2-L4BMD was 10.9% higher ( 95% CI, 9.3% to 12.5%; p< 0.001 ), and TH BMD was 6.7% higher ( 95% CI, 5.3% to 8.1%; p< 0.001 ). The incidence of fracture was not significantly different between each group (upfront, 1(1.0%) vs. delayed, 4(4.1%)). Disease recurrence was reported in 3 upfront (3.1%) and 1 delayed (1.0%) patients. By month 36, 11 patients (11.3%) in the delayed group initiated ZOL therapy. There was no significant difference of adverse events other than fever with ZOL at the first treatment between the two groups. Conclusions: Upfront ZOL seems to be the preferred treatment strategy versus delayed administration, as it significantly and progressively increases BMD in postmenopausal Japanese women with early BC who were receiving adjuvant letrozole for 36 months. Clinical trial information: UMIN000001104.
Impact of skeletal-related events on pain and analgesic use in patients with solid tumors and bone metastases.
Authors: Fallowfield Lesley , Cleeland Charles S. , Von Moos Roger , Patrick Donald , Body Jean-Jacques , Egerdie Blair , Stopeck Alison , Brown Janet Elizabeth , Marx Gavin M. , Palazzo Felipe , Damyanov Danail I , Zhou Ying , Braun Ada , Balakumaran Arun , Qian Yi 
Published: March 2020

e20514 Background: Skeletal-related events (SREs) including pathological fracture (PF), surgery (SB) or radiotherapy to bone (RB), or spinal cord compression (SCC) occur frequently in patients (pts) with advanced cancer and bone metastases and may cause debilitating clinical sequelae for pts. Pooled results from 3 clinical trials showed denosumab was superior to zoledronic acid (ZA) for prevention of SREs. We now evaluate the burden of SREs through pt-reported pain and analgesic use. Methods: Randomized (1:1) pts in the phase III, double-blind, placebo-controlled trials received denosumab (120 mg SC) or ZA (4 mg IV, adjusted for renal function) monthly. In this posthoc analysis, data from pts with solid tumors in the 2 treatment arms were pooled. At baseline (BL) and each monthly visit, pain was assessed via the Brief Pain Inventory (BPI; 0 no pain to 10 severe pain), and pts’ analgesic use with the Analgesic Quantification Algorithm (AQA; 0 no analgesics to 7 > 600 mg oral morphine equivalent/day). Pain and analgesic use for pts with SREs were assessed from 6 months before to 6 months after the 1st on-study SRE. A control group was comprised of all pts without SREs; the index time was defined as the median time to each SRE type. SRE impact was assessed using a stratified Cox proportional hazards model adjusting for SREs, as time-dependent covariates, and other baseline characteristics, and reported as HR and 95% CI. Results: 1,925 pts had an on-study SRE (first SRE type: 923 PF; 829 RB, 119 SCC, 54 SB), and 3,618 pts did not. A greater proportion of pts with SREs had a BPI worst pain score > 4 (moderate/severe pain) or an AQA score ≥ 3 (strong opioid use) than did pts with no SREs. The development of SRE was associated with significantly greater risk of pain progression from no/mild pain at BL to moderate/severe pain on study (PF 1.29 [1.07, 1.57], P = 0.009; RB 2.51 [2.03, 3.10], P < 0.001; SCC 3.07 [1.83, 5.13], P < 0.001; and SB 2.75 [1.19, 6.33], P = 0.018). Conclusions: Pts who experienced on-study SREs had increased pain severity requiring stronger analgesic use. Effective treatments that delay or prevent SREs can reduce pain and the need for palliation with opioids. Clinical trial information: NCT00321464, NCT00321620, and NCT00330759.
Psychosocial outcomes in cancer survivors treated at a comprehensive cancer center or a minority-serving institution.
Authors: Friedman Debra L. , Sanderson Maureen , Hull Pamela , Wujcik Debra , Ashworth Dira R , Okafor Amaka , Kennedy Jane , Hill Paula , Conner Nalini , Shen Miller David , Wolff Steven N. 
Published: March 2020

e20523 Background: Cancer health disparities are well described for incidence, diagnosis and treatment. Little is known about disparities among long-term survivors. Methods: At Vanderbilt-Ingram Cancer Center (VICC), an NCI-designated comprehensive cancer center and Meharry Medical College (MMC), minority serving institutional partner, we evaluated quality of life (QOL) using the FACT-G, FACT-B, FACT-L, and FACT-P; posttraumatic stress disorder (PTSD) using the PTSD Checklist (PCL); and posttraumatic growth (PTG) using the PTG Inventory (PTGI) among breast, lung or prostate cancer survivors. We used linear regression to compare the scale mean values by institution while adjusting for confounding variables. Results: Among 111 breast, 53 lung and 68 prostate cancer survivors, mean age was 62 years, 61% were female, 33% were black, 65% were married, 22% and 67% respectively had a high school degree or some college/higher education, 36% were employed and 94% were insured. MMC survivors were younger (p = 0.0005), more likely to be black (p <0.0001), less likely to be married (p < 0.0001), less educated (p<0.0001) and more likely to be uninsured (p < 0.0001). After adjusting for race, insurance status and educational level, there were no significant differences in cancer-related QOL between VICC and MMC survivors. MMC survivors did score significantly higher than VICC survivors on the PCL (33.9 vs. 28.3; p = 0.01) and the PTGI (75.9 vs. 62.5; p = 0.002). A total of 19 (8.3%) survivors met criteria for PTSD with a score of 50 or more (18.1% MMC, 3.8% VICC, p =0.003). Scores were significantly increased for MMC survivors relative to VICC survivors on all PTG subscales, especially the appreciation for life subscale (p = 0.0005). Conclusions: Cancer health disparities extend into the survivorship period. Although overall QOL did not differ, survivors treated at an underserved institution had significantly higher PTSD than those treated at a comprehensive cancer center. Underserved survivors also exhibited higher degrees of PTG. Further evaluation will identify the most significant sources of stress and resilience in order to design interventions to improve psychosocial wellbeing and decrease disparities.