bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined treatment of patients with incompletely resected invasive thymoma: A retrospective analysis
Authors: Kowalski D. M. , Janowicz-Zebrowska A. , Krzakowski M. J. , Jaskiewicz P. , Zajda K. , Denisso T. , Lasota W. 
Published: March 2020

18193 Background: Although surgery remains the mainstay of therapy for invasive thymoma, complete resection is feasible in only 60% of patients (pts) and adjunctive radiotherapy (RT) or/and chemotherapy (CT) is advocated. Multidisciplinary approach with chemotherapy (CT) and radiotherapy (RT) is an option for unresectable disease. The aim of our study was to evaluate retrospectively the outcome of pts with invasive thymoma submitted to postoperative RT or combined CT and RT. Methods: Pts in our analysis underwent either radical resection followed by RT or they had incomplete resection with subsequent CT and RT. Results: Between March 1996 and September 2005, 32 (18 women; 56.3% and 14 men; 43.7%) pts with invasive thymoma were treated. Median age was 47,8 years (range, 20–75). Clinical stage I, II, III or IVA was diagnosed respectively in 3 (9.4%), 12 (37.5%), 6 (18.7%) and 11 34.4%) pts. Pathologic types of invasive thymoma were as follows: A - 4 pts (12.5%), B - 9 pts (28.1%), AB - 8 pts (25%); pathological type was not specified in 1 pts (3.1%). Type C thymoma was diagnosed in 10 pts (31.3%). Complete resection was performed in 26 pts (81.3%), whereas 1 pt (3.1%) was irradiated only and 5 pts (15.6%) were treated with CT as single modality. Cisplatin-based CT was used in all pts. Twenty pts (62.5%) were irradiated, while RT was not used in 12 pts (37.5%). Median survival time (MST) for all pts was 54.5 months (range: 2–240 months), and median time to progression (MTTP) was 27.5 months (range: 1–221 months). MST for pts on CT was 46.3 months (range: 2–156) in comparison with 54.7 months (range: 2–240) in non-CT group. MTTP for CT group was 35.2 months (range: 2–144) and 51.0 months (range: 2–221) for no CT group. Tolerance of CT was acceptable. Conclusions: Postoperative RT is effective in reducing local recurrence rate and prolonging survival in pts with invasive thymoma. The role of postoperative CT is unclear and deserves further exploration. No significant financial relationships to disclose.
A phase II study of docetaxel (D) plus imatinib (I) in patients with previously treated non-small cell lung cancer
Authors: White L. A. , Schmidt A. M. , Sjak-Shie N. N. , Greco A. O. , Cronin B. , Fisher K. L. , Eckardt J. R. 
Published: March 2020

18200 Background: Docetaxel(D) has been shown to improve overall survival in pts with previously treated NSCLC. Pre-clinical data suggest synergistic activity with the combination of D and I. Paul Matthew; et al demonstrated the safety of this combination in pts with prostate cancer. Methods: This is a Phase II study of the combination of D and I in prev tx NSCLC to determine response rate, toxicity and assess overall survival. Pts must have received at least 1 prior regimen and have an ECOG PS of 2 or less. Prior tx with D was allowed. D was admin at 30 mg/m2 on a weekly schedule for 3 weeks followed by 1 week rest. I was admin at a starting dose of 600 mg/day throughout the study. Results: A total of 10 pts were enrolled. Seven male and 3 female with a median age of 66 years (range 58 - 74). A total of 26 cycles were delivered to 10 pts (mean = 3). Responses included 1 PR/3SD/2PD/4NE. One pt with a PR responded after cycle 4 but progressed after cycle 6. One pt maintained SD for 21 wks then expired due to an unrelated PE (h/o peripheral vascular disease). Grade 4 toxicity included periorbital edema (1 pt), pneumonia (2 pts), diarrhea (1 pt), dehydration (1 pt), dyspnea (1pt), anorexia (1 pt), pleural effusion (1 pt), and neutropenia (2 pts). Grade 3 toxicity included hyponatremia (1 pt), renal failure (1 pt), hypotension (2 pts), mental status changes (1 pt), anorexia (1 pt), azotemia (1 pt), dyspnea (1 pt), herpetic esophageal ulcer (1 pt), pneumonia (1 pt), neutropenia (2 pts), weakness & fatigue (1 pt), and anemia (1 pt). Four of 10 pts received only 1 cycle. (Three of those 4 suffered a fatal adverse event during cycle 1, not felt to be treatment related. The fourth developed herpetic esophageal lesions and was taken off study prior to tumor assessment.) Conclusions: The study was closed before the initial planned pts were enrolled due to low activity and unexpected high tox. Only 1 of 10 pts achieved a PR. Stable disease was observed in 3 pts but was of short duration in 2 of the 3. Despite supportive treatment, nausea, vomiting, diarrhea, and anorexia were difficult to control. Hematologic toxicity was encouragingly infrequent with only 2 pts experiencing Grade 4 neutropenia. Alternative dosing schedules would be recommended before pursuing this combination in NSCLC pts. Study supported by a grant from Novartis. No significant financial relationships to disclose.
Stage III non small lung cancer (NSCLC): Docetaxel (D), gemcitabine (G), and cisplatin (C) as induction chemotherapy, an Italian phase I study
Authors: De Santis S. , Donato V. , Migliorino M. R. , Tedesco B. , Condo S. , De Marinis F. 
Published: March 2020

18201 Background: Based on the several clinical trials, combined modality therapy became the standard of care for patients with stage III NSCLC “unresectable” with good performance status (Kathy S. Albain, Educational Book ASCO 2006, 453–461; Thomas E. Stinchcombe, Oncologist 2006, 11, 809–823). The most effective induction chemotherapy has yet to be determined. The objective of this prospective phase I study was to define the maximum tolerated dose (MTD), and to evaluate the activity and safety of one of the third generation triplets as a full dose neoadjuvant regimen in patients (pts) with unresectable Stage III NSCLC. Methods: In this study, chemotherapy-naïve pts with stage IIIA-N2 bulky and IIIB (except malignant pleural effusion) NSCLC were eligible. Inclusion into the trial and treatment decisions were done by multidisciplinary panel involving surgeons, medical oncologists and radiotherapists. All drugs were given intravenously on days 1 and 8, and repeated every 3 weeks up to 2 cycles followed by concurrent chemoradiation. D (30–35 mg/m2) was given first, followed by C (35 mg/m2) and G (1000 mg/m2). Results: From Jan ‘06 to Jul ‘06 twelve eligible pts were enrolled, 10/2 m/f gender; median age 63 (50–72), 1 patient with ECOG PS 0, 11 pts with PS 1; 5 pts with stage IIIA-N2 bulky, 7 pts with stage IIIB NSCLC; nine pts were smokers. All pts were evaluable for toxicity. Toxicity grade 3–4 by CTC criteria was: grade 3 neutropenia in 2/3 patients and grade 3 thrombocytopenia in 1/3 patients on the second dose level of chemotherapy (i.e. docetaxel 35 mg/m2), and was considered dose-limiting. Of 9 pts treated at the MTD (i.e. docetaxel 30 mg/m2), only 1 patient developed grade 4 neutropenia and 1 patient grade 3 thrombocytopenia; 3 patients (30%) had grade 2 neutropenia and grade 2 stomatitis. Of 12 evaluable pts for response, after induction chemotherapy eighty-three percent of patients (9/12 pts) had an objective response and 16,6% (2/9 pts) stable disease. Phase II is continuing for larger patient accrual. Conclusions: The recommended doses for further phase II studies are D (30 mg/m2) followed by C (35 mg/m2) and G (1000 mg/m2) every 3 weeks. This regimen is well tolerated and effective, and appears to be an excellent choice for stage III NSCLC. No significant financial relationships to disclose.
An overview of SELECTTION: Survey of European lung cancer evaluating choice of treatment and tolerability in observed second-line non-small cell lung cancer (NSCLC)
Authors: Smit E. F. , Vergnenegre A. , Arellano J. , Kraaij K. , Kral A. , Langer F. , Visseren-Grul C. 
Published: March 2020

18204 Background: In addition to established second-line treatments for NSCLC in Europe, docetaxel and pemetrexed; erlotinib, has recently been approved. The only study directly comparing alternative options in second-line NSCLC showed no significant difference in efficacy between docetaxel and pemetrexed (median survival 7.9 vs 8.3 months, p = 0.226) but significant differences in toxicity profile (Hanna et al, 2004). It is of interest to observe how different second-line treatment options are used in real life settings, particularly length of therapy, reasons for discontinuation and its impact on patient’s outcomes. Methods: In observational studies patients are not assigned to different treatments at random and physicians and patients decide on treatment. A careful design is paramount to ensure the correct interpretation of data obtained. SELECTTION is the first observational, non-interventional, prospective study to be carried out in Europe in second-line NSCLC treatment. The primary objective of SELECTTION is to assess the time from treatment initiation to treatment discontinuation. Secondary objectives are to observe the reasons for treatment discontinuation and assess its impact on patient’s outcomes. A total of 13 countries will participate including: France, Portugal, Germany, Denmark, and UK with approximately 200 sites enrolling 950 patients. Information regarding patients and disease characteristics and treatment history are collected. Patients may be enrolled if they have received first-line chemotherapy for locally advanced or metastatic NSCLC, and have subsequently progressed, are at least 18 years old and are about to initiate second line treatment. Treatment cohorts will be constructed based on the distribution of patients across second-line treatments by physician decision. Results: At this stage details about design and analyses planned as well as evolution of the study, will be presented. Conclusions: SELECTTION will provide a unique set of data on how patients with stage IIIb\/IV NSCLC previously treated with chemotherapy, are treated in routine clinical practice. No significant financial relationships to disclose.
Stage III and stage IV non-small cell carcinoma patients triple chemotherapy combination (carboplatin, paclitaxel, and gemcitabine) in good performance status
Authors: Webb R. T. , Gill L. M. 
Published: March 2020

18205 Background: Triple drug chemotherapy combinations for nonsmall cell lung cancer (NSCLC) have most recently begun to show promising results in regards to response rate and time to progression (TTP) of disease. This abstract presents data from 99 patients with advanced unresectable disease who were not felt to be candidates for concurrent radiation and chemotherapy for 1999 to 2005 treated with a split dose regimen of paclitaxel 65mg/m2 (d1, 8,15 q29 days), carboplatin AUC 2 (d1, 8,15 q29days), and gemcitabine 650 mb/m2 (d1, 8 or15 q29 days). All patients have completed a minimum of 3 courses of therapy. Methods: 57 males with mean age 72 years, and 42 females, mean age of 69 yrs with performance status of < 1. Stage III A&B-33 patients and Stage IV-56 patients. The regimen was well tolerated with 4% grade 3 to 4 neutropenia, 30% 2-to3 thrombocytopenia. There were no septic deaths, grade 3 to 4 nonhematologic toxicity included alopecia, universally, fatigue at 24% and emesis at 8%. Results: CR-14.4%, PR-31%, minimal/stable-26% with 27.6% progressive/resistant disease with a median survival time of 20.5 months. 37 patients did receive radiation therapy to the primary lesion. Conclusions: This 3-drug regimen administered in split dosing has proven to be highly active and well tolerated in good performance status patients seen in a community practice setting. This cohort of patients was representative and typical for the 85% of patients seen in community oncology practices. No significant financial relationships to disclose.
Mitomycin (M) in combination with cisplatin (P) or vinorelbine (V) and erythropoietin (Epo) in patients with in field relapse after radiation therapy of non-small cell lung cancer: A phase II study of the AIO
Authors: Griesinger F. , Stenger I. , Tomala C. , Olgemoeller U. , Koerber W. , Fischer B. , Sebastian M. , Overbeck T. 
Published: March 2020

18208 Background: Therapy for in radiation field relapse of NSCLC is challenging. Tumors are regularly resistant to chemotherapy, most likely due to a high proportion of hypoxic tumor. Mitomycin (M) is effective in hypoxic environment. However, in outer regions of the tumor, normoxic conditions might exist. Therefore, a combination of M and cytotoxic agents (cisplatin (P) and vinorelbine (V)) which are effective under normoxic conditions as well as Epo which decreases tumor hypoxia might represent an effective way to treat in radiation field relapses. Therefore, this approach was investigated in a multicenter phase II trial. Patients and Methods: 12 patients with a progressing symptomatic relapse within the radiation field have been enrolled in the study as of yet: 12 male, 0 female, 8 squamous cell, 4 adenocarcinoma, 5 stage IIIB, 7 stage IV, median age 63 y. Pts were to receive 4 cycles M 8 mg/m2 d1 and V 25 mg/m2 d1, 8 q22 days in case of P pretreatment, or M 8 mg/m2 and P 40 mg/m2 d1,8 q22 days in case of no P pre-treatment. Epo 40.000 IE s.c. q7 days was administered to maintain Hb levels between 12 and 13.0 g%. Response (WHO criteria), time to progression, survival and toxicities, Hb values, as well as quality of life (not shown) were evaluated. Results: A median of 2 cycles were administered (1–4). Stable disease was observed in 7/12 evaluable patients (58%, 95% CI 28–84%). Median time to progression was 2.3 months (1.0–2.9 months), median survival was 3.8 months (2.9–6.2 months). Grade 3/4 toxicities were: dyspnea 1/12, loss of appetite 1/12, leukocytopenia 4/12, lymphocytopenia 1/12, neutropenia 3/12, nausea 1/12. Median Hb levels were maintained above 12 g%. Discussion: Cinical benefit was observed in 58% of patients with in radiation field relapse. To the knowledge of the authors, this is the first study specifically addressing the efficacy of chemotherapy for in radiation field relapses of NSCLC. M in combination with P or V and Epo results in similar response rates as second line chemotherapy for chemotherapy pretreated relapses. These results warrant further studies in NSCLC relapsing within radiation fields. No significant financial relationships to disclose.
Rituximab-induced viral infections in lymphoma patients
Authors: Aksoy S. , Harputluoglu H. , Kilickap S. , Sener Dede D. , Dizdar O. , Altundag K. , Barista I. 
Published: March 2020

18509 Background: Recently, a chimeric mouse human monoclonal antibody, rituximab, has been used successfully to treat cases of B-cell non-Hodgkin’s lymphoma (NHL) and some autoimmune diseases. However, several viral infections related to rituximab have been reported in literature, but not well characterized. Methods: To further investigate this topic, relevant English language studies were identified through Medline. For our search we used the generic name rituximab, and the key phrases virus/virus infection. The references from the identified articles were reviewed for additional sources. Results: There were 64 previously reported cases (26 male, 23 female, and 15 gender not reported) that had experienced serious viral infection after rituximab treatment. The median age of the cases was 61 years (range; 21–79 years). The median time period from the start of rituximab treatment to viral infection diagnosis was 5.0 months (range, 1–20). Most frequently experienced viral infections were hepatitis B virus infection in 25 (39.1%) cases, Cytomegalovirus infection in 15 (23.4%) cases, varicella zoster infection in 6 (9.4%) cases, and other viral infections in 18 (28.1%) cases. Thirteen (52.0%) of the patients with hepatitis B virus infection died due to hepatic failure. Thirty-nine of the cases had viral infections other than HBV and 13 of them died due to these specific infections. Conclusions: Viral infections after the rituximab treatment in lymphoma patients are important to recognize and treat early because of their association with substantial morbidity and mortality. In these case series, about 40% of these viral infections resulted in death. Close monitoring for viral infections in patients receiving rituximab is necessary. [Table: see text] No significant financial relationships to disclose.
Outcome of localized and advanced diffuse large B-cell non-Hodgkin bone lymphoma (DBL)
Authors: Aubin F. , Isler M. , Turcotte R. , Ducruet T. , Beaudet J. 
Published: March 2020

18527 Background: DBL represents less than 2% of all lymphomas in adults. Over the years, combined-modality treatment (CMT) using an anthracycline-based chemotherapy regimen (ChT) and radiotherapy (RT) has emerged for the treatment of localized DBL (LDBL). Methods: Data were collected from the HMR oncology orthopaedic data bank. Thirty patients with localized and advanced DBL at diagnosis treated at HMR between December 1993 and August 2004 were included. Primary end-points were event-free survival (EFS) and overall survival (OS). Statistical analyses were performed using Kaplan-Meier and Cox proportional hazard models. Results: The median follow-up was 38.6 months. Fourteen patients had limited stage I-II disease while 16 patients had stage IV disease. Femur (33%) and spine (33%) were the most frequently involved bone sites. Ten patients had bulky disease (>10cm). Patients were treated as followed: 50% with CMT, 33% ChT alone and 17% only RT. CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) was the only chemotherapy regimen used. Four patients received rituximab (R-) combined with CHOP. Patients received an average of 5 cycles of ChT (range 1–8). RT dose was between 30 and 40 Gy for 70% of patients. Doses of 30 Gy and higher show a tendency to offer an OS advantage (hazard ratio (HR) =0.2, 95%CI 0.03- 1.35). The 5-year estimates EFS and OS were respectively 48% (95%CI 27%-71%) and 60% (95%CI 38%-82%) for the whole group and 70% (95%CI 50%-99%) and 81% (95%CI 57%-99%) for patients with LDBL. All four patients treated with R-CHOP have a sustained complete remission (CR). Patients receiving CMT have significantly improved EFS (p=0.02, HR=0.25, 95%CI0.08–0.83) but not OS. Patients with advanced disease may benefit from CMT for EFS (HR=0.23, 95%CI 0.05–1.12). Factors which adversely affect EFS and/or OS (univariate analyses) are: stage IV disease (p<0.05 EFS/OS), axial localisation (p<0.05 EFS) and IPI 4 (p=0.072 EFS, p<0.05 OS). Conclusion: This study supports CMT as an efficient treatment for DBL. Patients treated with R-CHOP have a favourable outcome. RT dose of 30–40 Gy appears sufficient to obtain a prolonged CR. No significant financial relationships to disclose.
Cytokine expression profiles of patients with acute myelogenous leukemia (AML) and non-Hodgkin lymphoma (NHL) detected by multiplex assay
Authors: Reddy V. B. , Oelschlager D. K. , Nolan J. S. , Taylor K. L. , Post J. , Grizzle W. E. , Manne U. 
Published: March 2020

18530 Background: To determine the cytokine expression profiles of patients with AML and NHL using a sensitive bead-based Luminex multiplex assay in a routine clinical diagnostic setting. Methods: Blood (plasma/serum) samples were collected from ten AML and five NHL patients. Six control samples from patients diagnosed as non-neoplastic/non-autoimmune/non-inflammatory were also analyzed for comparison. All samples were frozen prior to analysis. Using a bead-based Luminex assay (Human Cytokine 8-Plex Assay, Bio- Rad, Hercules, CA) we analyzed these samples for a panel of cytokines (IL-2, IL-4, IL-6, IL-10, GM-CSF, IFN-gamma, and TNF-alpha). This assay uses polystyrene microspheres, which provides simultaneous quantitation of these cytokines in a single sample. The expression levels were presented in picograms/mL. Average values for each of these markers were obtained for each group of patients (AML versus NHL versus Controls), and their expression levels were compared using χ2 analysis. Results: Overall, there was a significant difference in the expression profiles of all these cytokines among three patients groups (χ2, P < 0.001). All cytokines were consistently expressed at low levels in NHL patients as compared to control group. However, the levels of IL-6 and IL-8 were increased by 2.7 and 5.8 times, respectively in AML patients as compared to controls. Conclusions: The low levels of cytokines in NHL and AML patients suggest suppressed immune system in these two disease conditions; however, these findings warrant further studies to explore the underlying mechanisms for the increased levels of IL-6 and IL-8 in AML patients. Currently, studies are in progress to compare the levels of cytokines measured by Luminiex assay in different stages of leukemias and lymphomas (initial, post treatment and recovery phase etc.). These studies are partially funded by grants from the National Institute of Health/National Cancer Institute (RO1-CA98932–01 and U24-CA086359). No significant financial relationships to disclose.
Thyroid lymphoma: A single institution’s experience
Authors: Wallace E. M. , Power D. G. , Leonard G. D. , Carney D. N. 
Published: March 2020

18533 Background: Extranodal lymphomas account for a significant proportion of non-Hodgkin’s lymphomas. Thyroid lymphoma accounts for <2% of these. Lymphoma represents approximately 2% of all malignant thyroid tumours and is almost always of B-cell lineage. The main presenting symptom is a rapidly enlarging goiter and approximately half present with disease limited to the thyroid gland, designated stage IE. Due to its rarity, there is limited information with regard to prognosis or management. Pre-existing chronic autoimmune (Hashimoto’s) thyroiditis is the only known risk factor. Methods: We retrospectively reviewed all cases of thyroid lymphoma found in our institution over a 15 year period (1985–2000). Eleven patients were identified as suitable for analysis. Diagnosis and staging involved a full history and physical examination with relevant serology. Radiological imaging included computerized tomography, plain radiographs and ultrasound. Bone marrow aspirate and biopsy were performed in ten of the patients and patients were then staged according to the Ann Arbour Classification. We specifically analysed patients for their epidemiological features, presentation, treatment and their overall outcome. We compared our data to those from earlier series. Results: Seven of the 11 patients were female with a median age of diagnosis of 56. Most patients complained of neck swelling for a number of months but dysphagia, dyspnoea and hoarseness (80%) were the symptoms that prompted presentation. Hashimoto’s thyroiditis was not found. The commonest histological subtype was diffuse large B cell lymphoma (45% of cases). Seven patients had stage I disease, 3 stage II and 1 stage IV. Nine patients received chemotherapy and radiotherapy was administered in the adjuvant setting to nearly half of the patients. No correlation between presentation and other diagnostic tests or survival was found. Two-year survival for our patients was 100% and no cases died from their disease. Conclusion: Thyroid lymphoma is a rare disease and valuable information on this subject has been provided by single institution studies. Our encouraging survival figures are likely a combination of the predominance of early stage disease and the use of combined modality therapy. The use of monoclonal antibodies may provide a further benefit to these patients. No significant financial relationships to disclose.