bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival outcome of veterans with myelodysplastic syndrome (MDS) treated with statins.
Authors: Abbas Kanza S , Li Ang , Rivero Gustavo , Mitsiades Nicholas , Yellapragada Sarvari 
Published: March 2020

e17018 Background: Recent studies have shown promising risk modifying effects of statin in various hematologic and solid tumors, such as its ability to induce apoptosis in acute myeloid leukemia cells in-vitro. The impact of statin on MDS treatment outcome has not been evaluated. In this retrospective study, we have examined the overall survival (OS) in veteran MDS patients (pts) with and without exposure to statin with the initial hypothesis that it may impact OS. Methods: After IRB approval, data was collected from Michael E DeBakey VAMC Cancer Registry from January 2000 to October 2011. Pts were included if they had morphological evidence of MDS at the time of diagnosis. Statin exposure was defined as concurrent statin use for at least 6 months prior to and at the time of diagnosis. The primary end-point was OS before and after adjustment with MDS Co-morbidity Index (MDS-CI). Prism 5 was used for statistical analysis. Results: 104 pts with MDS were identified with baseline characteristics depicted in the table. OS of pts exposed to statin was significantly longer when compared with pts not exposed to statin (950d vs 419d, p<0.05). This improvement was especially prominent in pts with higher comorbidities (MDS-CI score>2) (1062d vs 219d, p<0.05) and specifically in those with higher cardiac comorbidities. OS in pts with lower MDS-CI scores was higher in patients on statin but there was no statistical significance (901d vs 663d, p=0.57). Conclusions: In this retrospective study, concurrent statin exposure significantly improved OS in pts with MDS. This improvement, however, was statistically significant in pts with higher overall and cardiovascular co-morbidities. These findings suggest a limited direct anti-tumor benefit of statin in MDS, although the results may have been influenced by the sample size and retrospective design. Prospective studies after stratification by IPSS and MDS-CI are needed to further evaluate the risk-modifying effects of statin in MDS. [Table: see text]
Early detection of lung cancer based on three-dimensional, morphometric analysis of cells from sputum following x-ray CT screening.
Authors: Urbine Terry Francis , Meyer Michael , Tourovskaia Anna , Steinhauer David , Hayenga Jon , Presley Chris , Hawthorne Ben , Neumann Thomas , Nelson Alan 
Published: March 2020

e17529 Background: A major advance against lung cancer was made with the announcement of results from the National Lung Cancer Screening Trial. A 20% reduction in mortality was shown in a screened population using low dose CT (LDCT) compared to screened chest x-rays. Approximately 95% of the positive findings of LDCT, however, turned out not to be cancer. We propose to use 3D morphometric analysis of cells from enriched sputum to distinguish benign from malignant nodules found using LDCT and to identify cancers that were not identified with LDCT. Methods: Sputum from 30 patients with non-small cell lung cancer were studied. Fluorescence activated cell sorting was used to enrich sputum for epithelial cells. The enriched cells, stained with hematoxylin, were automatically imaged using VisionGate’s 3D cell imaging system (Cell-CT) which unambiguously renders individual cells with isometric, sub-micron resolution. Image libraries of cells were created and 530 morphology features were computed for each cell. Abnormal (moderate and severe dysplasia and cancer) status for each cell was determined by a cytotechnologist and added to the feature set. Cross-validated classifiers were created that combine a sub-set of the features into a single score that best correlated with the binary cell diagnoses. Results: Study of enriched sputum from cancer patients using the Cell-CT shows cancer cells in at least 75% of the cases with cancer cells present in raw sputum. Classifier cell specificity exceeding 98% and a 70% cancer cell detection rate were measured. A 70% cell detection rate translates into a 90% detection rate for the specimen since multiple abnormal cells are present in sputum. Overall detection rate for cancer cell positive sputum is: 68%, computed by finding the product of the rate of cancer cell positive enriched sputum (0.75) with the rate of detection by the classifier (0.90). Conclusions: Automated, 3D morphometric analysis of cells from sputum provides high sensitivity and specificity detection of lung cancer. Adjunctive use with LDCT will aid in determination of the malignancy status of indeterminate pulmonary nodules.
A strategy to reduce acute toxicity from chemoradiation therapy for limited-stage small cell lung cancer.
Authors: Corradetti Michael Nino , Xanthopoulos Eric , Grover Surbhi , Fernandes Annemarie Therese , Kim Miranda , Simone Charles B. , Christodouleas John Paul , Lin Lilie L. , Rengan Ramesh 
Published: March 2020

e17534 Background: The standard of care for limited stage SCLC as outlined in the Intergroup 0096 trial involves twice daily radiation therapy, delivered to two out of four fields at a time, which results in high rates of clinically significant acute toxicity. This study examines acute esophagitis and treatment breaks in patients treated with radiation therapy as outlined by Intergroup 0096 vs those treated with a slight modification to this technique. Methods: We identified SCLC patients who received 45 Gy in 1.5 Gy bid fractions from an institutional database. Associations were assessed via Chi-squared test. A break was defined as an interruption of 3+ days. Results: 74 SCLC patients were treated with 3D-conformal radiation therapy from 2004 to 2010. 16 patients did not satisfy criteria described in the Methods and were excluded. 28 patients were treated per Intergroup 0096 with AP/PA fields bid for 1 week followed by AP/PA treatment in the AM and 2 oblique fields in the PM for 2 weeks. 28 patients were treated with the same approach except all four fields were treated with each fraction. Patient characteristics were well distributed as outlined below (Table). 54% of patients had CTCAE grade 3 esophagitis with the Intergroup 0096 approach vs 23% in patients treated with a 4-field approach (p = 0.01). 29% vs 7% patients had a treatment break (p = 0.03). 32% of grade 3 esophagitis patients had breaks vs 8% with esophagitis grades 0 – 2 (p = 0.02). There was no difference in survival or distant/local failure. Conclusions: Grade 3 esophagitis and treatment breaks were reduced in patients receiving continuous 4-field treatment. Future investigation is required to determine whether the observed reduction in breaks could translate to a local control or survival benefit if applied to a larger patient sample. [Table: see text]
Bronchial neuroendocrine tumors: A retrospective review of management and outcomes in 116 patients.
Authors: Pericleous Marinos , Lumgair Heather , Reiner Johnathan , Marelli Laura , Caplin Martyn , Meyer Tim , Toumpanakis Christos 
Published: March 2020

e17543 Background: Bronchial neuroendocrine tumours, represent 1–3% of all primary lung tumours and 25% of all neuroendocrine tumours (NETs). They are classified into: typical carcinoids (TC), atypical carcinoids (AC), large cell neuroendocrine carcinomas (LCNEC) and small cell lung carcinomas (SCLC). The aim of our study was to assess diagnostic features, management and outcome, focusing on the differences between TC and AC. Methods: 116 patients were identified from our NET database. WHO histopathological classification was used. Follow-up was complete in all patients (mean follow-up 59.8 months). Disease-free survival (DFS), and progression-free survival (PFS) were evaluated for each therapy. Results: The average age of presentation was 55.30 years (range 16-85 years, M:F ratio=1:1.5). The commonest presenting symptom was cough (19%) followed by haemoptysis (18%). 36% were TC, 45% AC, and 19% LCNEC/SCLC. 16% TC and 28% AC patients had metastases at diagnosis. Octreoscan was positive in 76% TC and 66% AC. In 2 patients with TC and negative Octreoscan, Ga-68 Octreotate PET showed avid uptake in lung lesions. 46 patients had surgery. In 35 of AC, the disease relapsed (DFS=29.8 months) compared to 24% TC (DFS=48months). 12 patients received somatostatin analogues (SSTA) with PFS for TC 60 months and AC 21 months. 16 patients received systemic chemotherapy with PFS for TC 72 months and AC 21 months. 4/5 patients achieved disease stability with 90Yttrium-DOTAoctreotate. 5-years survival after surgery, chemotherapy or SSTA, was 91%, 86% and 81% respectively. Overall five year survival was 91% (100 % TC, 75% AC). Conclusions: AC and SCLC/LCLC more often present with metastatic disease with shorter DFS and PFS compared to TC. Molecular imaging is helpful for staging and predicting appropriateness for SSTA or radionuclide targeted therapy. Surgery confers the best survival rates. AC have higher relapse rates and metastatic potential. Further clinical trials are required to define the best treatment algorithm.
Surgical pathology findings of neoadjuvant full-dose irinotecan and cisplatin (IP) with concurrent thoracic radiation therapy (C-TRT) in stage III non-small cell lung cancer (NSCLC).
Authors: Walker Paul R. , Ben-Or Sharon , Moran Jon , Williams Richard Fred , Biswas Tithi , Fried Daniel B. , Rosenman Julian , Russo Suzanne M. , Aljumaily Raid , Bowling Mark , Eubanks Susan , Nelson Zenith , Parent Teresa 
Published: March 2020

e17550 Background: Neoadjuvant C-TRT in stage IIIA NSCLC has become a standard of care. C-TRT sterilizes N2 nodes far better than primary tumors. TRT dose does seem to make a difference. In Intergroup 0139 with 45 Gy pre-op TRT, ypT0N0 was 18% and ypN0 46% (Albain et al Lancet 2009). Pre-op TRT dose escalation to 60+ Gy improves ypN0 clearance up to 80% and ypT0N0 to 45% (Sonett et al Ann Thorac Surg 2004; Cerfolio et al Ann Thorac Surg 2005). However there is no known difference in pathologic response and outcome with different chemotherapy approaches. Irinotecan with radiation therapy has been studied in locally advanced NSCLC with similar outcomes as with any cisplatin doublet and no undue toxicities (Langer et al J Thorac Oncol 2007; Bastos et al J Thorac Oncol 2010). We reviewed our multidisciplinary thoracic oncology program experience with neoadjuvant full-dosing IP and C-TRT in stage IIIA NSCLC assessing ypTN response. Methods: All patients with stage IIIA NSCLC undergoing pre-operative IP and C-TRT between September 2008 and December 2011 were searched through our program database and included. 14 patients were identified. Irinotecan 65mg/m2 and cisplatin 30mg/m2 D1 and D8 q 21 days with C-TRT 60-66 Gy was administered followed by surgical resections. Pathologic response (ypT0N0) was assessed. Results: Median age 61 (36-72). 85% males; 85% squamous. PET N2 positive in 85% with 2 patients T3N1. 6/14 (43%) pathologic complete response (pCR)/ypT0N0; plus 4 with < 10% primary tumor viability (one isolated tumor cells on IHC staining, two with just 3 mm residual islands); 70% of patients had a pCR or had < 10% primary tumor viability. 11/12 (91%) downstaged PET N2 to ypN0. Conclusions: Full dose IP with C-TRT 60+ Gy is a very effective neoadjuvant treatment with very high pathologic complete responses and N2 clearance in squamous cell lung cancers. Just as in stage IV NSCLC, histology-based chemotherapy in stage IIIA/IIIB NSCLC C-TRT could well achieve outcome differences.
Outcomes of non-small cell lung cancer patients with adenocarcinoma histology compared with other histologies: SEER registry data 2004-2008.
Authors: Joshi Monika , Varlotto John M. , Ali Suhail M. , Toth Jennifer , Reed Michael , Lipton Allan , Belani Chandra Prakash 
Published: March 2020

e17560 Background: For convenience, the majority of lung cancers are commonly lumped together as non-small lung cancer (NSCLC). Patients with adenocarcinoma of the lung have a higher incidence of driver mutation as compared to those with squamous histology. In addition pemetrexed containing regimens have preferential activity in this histology and agents such as bevacizumab are administered to this subgroup only based on toxicity. The currentanalysis was performed to compare outcomes for patients in the SEER database between 2004 and 2008 with adenocarcinoma (Adenoca), squamous cell carcinoma (SCCA) and NSCLC not otherwise specified (NOS). Methods: Data for 161,175 patients was available in SEER database between 2004 and 2008 with 38 different histology ICD codes. 134,947 patients (83.7%) were included in the study. NSCLC NOS (ICD-3 8046) n=36,408, SCCA (ICD-3 8070) n= 36, 454 and Adenoca (ICD-3 8140) n=62,085. Overall survival (OS) and lung cancer specific survival (LCSS) were analyzed using cox proportional Hazard model for the 3 groups. Results: Patients in the three groups were age-matched. Male gender was more common in patients who had SCCA compared to Adenoca (62.6% vs. 49.5%). Percentage of poorly differentiated tumors was higher in patients with SCCA (35.9%) compared to NSCLC NOS (32%) and Adenoca (27.5%). SCCA had fewer stage IV patients at diagnosis (29.5%) vs. 51.4 % for NSCLC NOS and 45% for Adenoca. OS and LCSS are listed in the table below with Hazard ratio (HR) and p value. Total of 23.54% (n=31,768) patients underwent surgical resection. Stage I patients who underwent surgery (n=18,517) also had similar results. Conclusions: NSCLC patients who have adenocarcinoma histology have significantly better overall outcome when compared to other histologies. The difference is more pronounced in an earlier stage disease. [Table: see text]
Predicting the risk of secondary malignancies associated with stereotactic body radiation therapy.
Authors: Horowitz David Paul , Ng John , Shuryak Igor , Chao K. S. Clifford , Brenner David J. , Cheng Simon 
Published: March 2020

e17562 Background: Treatment of early-stage non-small cell lung cancer (NSCLC) with stereotactic body radiation therapy (SBRT) is associated with high rates of local control and long-term overall survival. With increasing frequency, SBRT is a treatment option for operable tumors which raises the question of the risk of long-term toxicities such as radiation-induced secondary malignancies. There has been no previous risk assessment or epidemiological studies of secondary malignancies with high-dose hypofractionated SBRT. In this study, we seek to quantify the predicted rates of secondary lung malignancies in patients treated with SBRT for stage I-II NSCLC. Methods: Treatment plans for 14 stage I-II NSCLC patients treated with definitive-intent SBRT at Columbia University Medical Center were retrospectively assessed. Median patient age was 73 years (range 54 - 86) with median tumor size of 2.8 cm (range 1.2 - 5.0). SBRT doses ranged from 40-60 Gy in 3-5 fractions. Dose-volume histograms for target PTV and normal lung were generated from planning CT scans. A biologically-based mathematical model of spontaneous and radiation-induced carcinogenesis was used to determine the excess absolute risk and the median lifetime estimated relative risk of secondary lung malignancies for each plan. These risks were then compared using 2-sided t-tests. Results: For all patients, the median lifetime estimated absolute risk of secondary lung malignancy was 1.06% (95% CI 0.62%-1.98%), and the median lifetime estimated relative risk of secondary lung malignancy was 1.61 (95% CI 1.47-1.75) after SBRT. For patients aged less than 65 years, median estimated absolute risk of secondary malignancies was higher (2.8%) than for patients age 65 and older (0.37%), p < 0.001. PTV volume less than 50 cc vs greater than 50 cc, T1 vs T2 tumors, and gender were not significantly associated with differences in estimated absolute risk or estimated relative risk of secondary malignancies. Conclusions: As SBRT is potentially indicated in younger medically operable patients, the long-term late toxicities need to be determined. This study suggests that the risk of second lung malignancies from high-dose SBRT even in younger patients would be minimal.
Qol and adherence to i.v. or oral chemotherapy treatment in elderly patients with advanced NSCLC.
Authors: Bordonaro Sebastiano , Butera Alfredo , Spinnato Francesca , Antonelli Giovanna , Gebbia Vittorio , Caruso Michele , Sciacca Dorotea , Tralongo Paolo 
Published: March 2020

e18002 Background: In elderly patients with advanced stage NSCLC the identification of the best treatment-related quality of life becomes the main discriminating endpoint. Methods: In this multicentre study, 53 elderly (≥ 70 yrs) patients with advanced (IIIB-IV) NSCLC were randomly allocated to receive as first-line treatment either Gemcitabine intravenously (1000 mg/m2) or oral Vinorelbine (60 mg/m2) both on days 1 and 8, every 21 days. The primary objective was the evaluation of the QoL, while the secondary one was the assessment of treatment adherence. The EORTC QLQ-C30 v 2.0 and QLQ-LC13 questionnaires have been used to evaluate the quality of life and an “ad hoc” questionnaire for the estimate of adherence/compliance to treatment in patients receiving oral Vinorelbine. The questionnaires were filled in at baseline and every 3 cycles. Results: Forty-one patients (thirty-six males), median age of 75.7 years, have been considered suitable for evaluation. All patients filled in the QoL questionnaires at baseline, 18 of them after three cycles of treatment. Differences of mean score values of items recorded at each assessment were calculated. Referring to QLQ-C30, patients enrolled in the Vinorelbine arm displayed higher mean scores as compared to those of Gemcitabine. There was a gain of 5.6 points as regards Physical Function and 16.9 points for Social Function in the Vinorelbine arm as compared to 3 and 1.6 points in the Gemcitabine arm. A higher improvement of the symptoms Nausea and Vomiting and Sleep Disturbance in the Vinorelbine arm in comparison with Gemcitabine (- 7 vs. + 3.2 and – 21.3 vs. + 7.7, respectively) was also observed. Patients treated with oral Vinorelbine showed improvements of the majority of QLQ-LC13 scores and completed a higher number of cycles as compared to Gemcitabine. Most patients (93.5%) responded positively to the satisfaction questionnaire of oral Vinorelbine. Conclusions: Oral Vinorelbine may provide an advantage in terms of patient preference since, without reducing the effectiveness, is able to maintain an acceptable toxicity profile which results in a gain of the level of quality of life.
Phase II trial of bevacizumab plus docetaxel in patients with previously treated nonsquamous non-small cell lung cancer.
Authors: Ohyanagi Fumiyoshi , Tanimoto Azusa , Sakatani Toshio , Kawano Yuko , Saito Ryota , Kaburaki Kyohei , Yanagitani Noriko , Kudo Keita , Horiike Atsushi , Hagiwara Sachiko , Horai Takeshi , Nishio Makoto 
Published: March 2020

e18004 Background: The additional effects of bevacizumab (B) as first line chemotherapy for non-squamous (Nsq) non-small cell lung cancer (NSCLC) have been established. However, the efficacy of bevacizumab as a second- or more line chemotherapeutic agent has not been well examined. Docetaxel (D) is a standard second line treatment for NSCLC, a synergistic effect of the combination of D and B being shown in preclinical models. Therefore, this phase II study was conducted to evaluate the efficacy and safety of DB in patients with previously treated Nsq NSCLC. Methods: Patients with histologically or cytologically confirmed Nsq NSCLC, 20 to 74 years of age, ECOG performance status 0-2, with at least one prior chemotherapy, were eligible for the study. Patients were treated with D (60 mg/m²) and B (15 mg/kg) on day 1, repeated every 3 weeks until progressive disease (PD)or unacceptable toxicity occurred. The primary endpoint was the response rate (RR), and planned sample size was 28 patients. Results: Between May 2010 and July 2011, 28 patients (16 males/12 females; median age 65 years; PS 0/1/2: 19/9/0; ad/other: 22/6, no. of prior chemotherapy 1/2/3/4/5: 16/5/2/1/4) were enrolled in the study. Among these patients, 28 were included in analysis of toxicities and 27 patients were evaluated for response. Objective response was observed in 18 patients (PR; 18, SD; 8, PD 1), the response rate and disease control rate being 66.7% and 96%, respectively. With a median follow-up of 12.7 months, the median progression free survival was 7.9 months and overall survival did not reach median. Main toxicities of this regimen were myelosuppression (G3/4 neutropenia 85.7% and febrile neutropenia 21%). Mild non-hematological toxicity with no severe bleeding was also observed. Conclusions: The combination of D plus B is a very active regimen in previously treated Nsq NSCLC, warranting further study.
Bevacizumab in combination with first-line metastatic chemotherapy in patients with advanced nonsquamous non-small cell lung cancer (NSCLC): Results from the cohort study EOLE.
Authors: Chouaid Christos , Schott Roland , Falchero Lionel , Bonnetain Franck , Neaume Julien , Bennouna Jaafar , Tagieva Naila 
Published: March 2020

e18005 Background: EOLE, a large cohort of 423 patients included in 1 year (July 2010 – July 2010) with locally advanced, metastatic or recurrent non-squamous NSCLC, aimed to describe the targeted population receiving first-line bevacizumab (Bev) in addition to chemotherapy with regards to progression-free survival, overall survival, safety and quality of life in real clinical practice. Methods: Patients who received physician’s choice of 1st-line Bev-containing treatment were included in this cohort study. Results: This analysis describes the inclusion data of 417 patients consisting of adenocarcinoma (92%), large cell carcinoma (4%), undifferentiated carcinoma in predominantly non-squamous (3%), bronchoalveolar carcinoma (1%). Patient characteristics were as follow: the median age being 60 (years) [32; 84], more males than females (68%), 40% had a baseline ECOG Performance Status (PS) 0, 47% of PS 1 and 12% of PS 2, most patients had Stage IV disease (91%), 13% of patients had never smoked. Tumor location was reported as central for 17% of patents and among them 4% was in contact with the large vessels. For 3% of the lesions a cavitation was notified; and 20% of included patients had brain metastases. The main comorbidities at the inclusion were: cardiovascular (45%), arterial thromboembolic and /or venous (20%) with pulmonary embolism (3%); related to the tumor lesion - bloody sputum (4%) and hemoptysis (1%). 68% of patients have received the dose of Bev 7.5mg/kg q3w; for 49% of patients Bev was combined with cisplatin/pemetrexed, 24% with carboplatin/paclitaxel, 13% with carboplatin/pemetrexed and 7% with cisplatin/gemcitabine. The EGFR mutation analysis was carried out for about 50% of patients. Conclusions: Compared to AVAil and SAil studies, EOLE cohort included more patients classified as having: a baseline PS of 2 (p <0.0001, Fisher test), a never smoked status (p<0.0001, chi2 test) and an adenocarcinoma (92%) (p<0.0001, chi2 test). Around a half of included patients received combination Bev - cisplatin /pemetrexed.