bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infection profile in patients developing febrile neutropenia after high-dose chemotherapy and stem cell transplantation.
Authors: Ozaydin Sukru , Ozturk Mustafa , Eser Mithat , Karadurmus Nuri , Erdem Gokhan , Arpaci Fikret 
Published: March 2020

e18016 Background: Febril neutropenia is absorved in all patients after stem cell transplantation (SCT) antibiotic and antifungal prophlaxis is recommended to patients after the transplantation. The aim of this study was to evaluate the infection agents in patients developing febrile neutropenia after high dose chemotherapy (HDC) and SCT. Methods: Patients who underwent HDC and auto- and allogenic SCT between 2003-2012 in the GATA medical oncology department were investigated for infection agents. After the development of fever in the neutropenic period of SCT blood and urine cultures were taken and antibiotics was started. Data of 278 patients were reached who were eligible for evaluation. Of these 67 patients cultural examination were positive. 8 allogeneic SCT, 59 autologous SCT patients consisted of NHL (n=20), testicular cancer (n=11), multiple myeloma (n=10), Hodgkin Lymphoma (n=9), AML (n=4), ALL (n=2) and other diognosis (n=11). Results: When the agents identified according to standart blood culture examinations 44.5 % were coagulase neg. staph, 24% were gram neg. bacils and 15% consisted of candidas. When the results of urine culture was observed: 66.8% were gram neg. bacils, 11.1% were coagulase neg. Staph and 5.5% consisted of candidas. Gram neg. bacilli growth was present in 80% of the blood cultures of Hodgkin’s Lymphoma patients and coagulase neg. Staph growth were observed in 20% of the patients. Coagulase neg. Staph consisted 66.8% of the catheter culture results, 13.2% consisted of Acinetobacter beumonii and 6.6% consisted of enterococci. Conclusions: Physicians who are working in SCT area should be aware of different kind of infections, which is reported in this study. [Table: see text]
Does anatomic segmentectomy have better outcomes than wedge resections in stage I NSCLC patients treated by sub-lobar resection?
Authors: Lim Bora , Ali Suhail M. , Varlotto John M. , Higgins Kristin , DeCamp Malcolm M. , Recht Abram , Flickinger John Charles , Reed Michael , Toth Jennifer , Kelsey Christopher Ryan 
Published: March 2020

e18506 Background: As compared to wedge resection (WR), anatomic segmentectomy (AS) may result in a more thorough resection because it allows bronchial and vascular dissection in a manner similar to a lobectomy and greater access for lymphadedectomy. The purpose of our study is to assess if AS allows for lower loco-regional (LR)/distant (DR) recurrences, improved overall survival (OS), and greater ability to resect lymph nodes as compared to WR. Methods: A multi-institutional database of consecutive patients undergoing surgical resection with negative margins for Stage I NSCLC FROM 1998-2009 was used. 2,300 patients had stage I NSCLC(<4cm) underwent surgical resection from which 267 received either AS or WR and were investigated. Variables studied to assess their impact on LR, DR, and OS included age, sex, surgical procedure, hilar node (N1) sampling, histology, LVI, tumor size, tumor grade, and visceral pleural involvement. Cox proportional hazard modeling was used for multivariate analysis. Results: Median follow-up was 188 weeks. The frequency of AS and WR were 3.3% and 12.7%, respectively. We compared LR and DR. There were higher numbers of N1 and N2 removed nodes in patients who underwent AS (p<0.05). There was no significant difference in rates of LR (p=0.58), DR (p=0.4), or OS (p =0.24) between WR and AS in multivariate analysis. Conclusions: Despite more extensive lymphadenectomy, AS is associated with similar rates of LR, DR and OS as WR. [Table: see text]
Determination of thresholds for the assessment of response to therapy relying on volume-based tumor burden in pulmonary CT images.
Authors: Beaumont Hubert , Labatte Jean Marc , Souchet Simon , Iannessi Antoine , Wormanns Dag 
Published: March 2020

e18508 Background: Image-based biomarkers play an increasing role in the assessment of response to therapy. The widely adopted Response Evaluation Criteria in Solid Tumor (RECIST) mainly rely on the assessment of the Longest Axial Diameter (LAD) of tumors. A growing community suggests that quantifying the tumor volume addresses some of the RECIST limitations. However no consensus has yet emerged regarding the applicable thresholds classifying volume-based response. This study aims at determining such threshold values for tumors observable in pulmonary CT images. Methods: Our study is based on published data from the Quantitative Imaging Biomarker Alliance (QIBA) which reports a 15% variability in measuring the tumor volume. We analyzed additional clinical data in a retrospective study involving 10 patients with Non-Small Cell Lung Cancer (NSCLC), followed over 7 time points in average with CT. 2 expert radiologists and 5 imaging scientists measured the volume of each tumor at each time point. Response evaluation was modelled according to statistical inference of the ratio of two longitudinal measurements by the Geary-Hinkley (GH) transformation. We hypothesised a normal distribution of the measurements. Results: The study confirmed the previously published 15% variability in measuring tumor volume. From our data, the GH transformation appeared suitable to infer the evaluation while considering a normal distribution of the variability.We found that, using the volume of lesions, a tumor burden reduction corresponds to a decrease of at least -35 %, whereas a tumor burden growth is associated with an increase of at least +55%. These thresholds featured a 5% type I error. Applying the model to clinical data, we confirmed the impact on inter-reader agreement. Conclusions: Based on a well established evaluation of the variability of measurement and relying on an analytical model, we determined thresholds required to classify patient’s response to treatment when monitoring the volume of lesions. Our approach provides a couple of threshold values for given precisions of measurements and Type I error, making our approach generic and applicable to other longitudinal evaluations.
Survival results and prognostic factors in T4 N0-3 non-small cell lung cancer patients according to the AJCC 7th edition staging system.
Authors: Arslan Deniz , Bozcuk Hakan Sat , Tatli Ali Murat , Gunduz Seyda , Uysal Mukremin , Goksu Sema Sezgin , Koral Lokman , Coskun Hasan Senol , Savas Burhan 
Published: March 2020

e18517 Background: In our study, we evaluated the survival results and prognostic factors among T4 local advanced non-small cell lung cancer (LA-NSCLC) patients in a large heterogeneous group, in accordance with the new staging system. Methods: We retrospectively evaluated the files of LA-NSCLC patients who have been treated at two centers between November 2003 and June 2012. One hundred twenty two T4 N0-3 M0 LA-NSCLC patients, identified according to the new staging system, were included in the study. Results: Median OS was 18.3 months, 1 year overall survival (OS) rate was 72%, 5 year OS rate was 28%. The median follow-up period was 17.4 months. Statistically significant predictors of survival were (p<0.20) ECOG-PS, age, subgroups of T4 factor, stage and primary treatment in OS univariate analysis. It was found that the statistically significant variables in multivariate analysis of OS rate were ECOG-PS (p=0.001), diagnostic stage (p=0.021), and primary treatment (p=0.004). In the group given non-curative treatment, the median OS was 11.0 months, 19.0 months in the definitive RT group as for 26.6 months in the curative treatment group. While there was a significant difference between the non-curative group and the groups which had definitive RT and curative operations (respectively p<0.001 and P=0.001) in terms of OS, no statistically significant difference (p=0.22) was found between the groups which had definitive RT and curative operations. Median EFS rate was 9.9 months, 46% in 1 year EFS rate, 19% in 3 years and 15% in 5 years. In univariate analysis of EFS rate with ECOG-PS, weight loss and staging, statistical significances were found only in PET-CT use, stage and primary treatment (p<0.20). In multivariate analysis with EFS, only the primary treatment was statistically significant (p=0.001). In the group that was approached with non-curative treatment, the median EFS was 10.5 months and in the curative operation group it was 14.7 months. Conclusions: Independent prognostic factors among this heterogeneous group of T4 N0-3 M0 122 LA-NSCLC patients were diagnosis age, ECOG-PS, stage and primary treatment. Primary treatment was a significant prognostic indicator of EFS rate.
Repopulation of tumor cells after neoadjuvant chemotherapy in non-small cell lung cancer and head and neck cancer: A neglected factor.
Authors: Xu Shanlin , Yue Jinbo , Liu Jing , Yang Jia , Sun Jujie , Mu Dianbin , Yu Jinming 
Published: March 2020

e18533 Background: Neoadjuvant chemotherapy (NAC) has been widely used to patients with locally advanced Non-Small Cell Lung Cancer (NSCLC) or Head and Neck Cancer(HNC).Less is known about repopulation in human cancer after chemotherapy. It is hypothesized that NAC might be the preceding stimulus to activate the epidermal growth factor receptor (EGFR), which may trigger cellular repopulation. We aim to ananlyze whether NAC could trigger repopulation of surviving cells and evaluate the potential role of EGFR in molecular mechanisms that underlie accelerated repopulation after chemotherapy. Methods: Fifty-two patients with locally advanced NSCLC (28 cases) and HNC(24 cases) were studied. received platinum-based NACImmunohistochemical expressions of ki67 and EGFR were measured from biopsy before NAC and surgical specimens after NAC. Spearman rank correlation analysis and Chi-square test was used to determine whether pretreatment clinicopathological characteristics and time between last day of last chemotherapy and surgery are predictive of tumor cells repopulation. Results: The median duration between the last day of last chemotherapy and surgery was 15 days (range, 1–53 days).Twenty-one (40%) of fifty-two patients showed an increased Ki67 proliferative index PI after chemotherapy.The increased PI were significantly associated with poor clinical response and longer interval between last chemotherapy and surgery. No significant relationship was found between the change of Ki67 and clinicopathological characteristics including the location of the tumor, clinical stage, and histological grade,as well as the change of EGFR expression. A delay greater than 14 days produced greater increases in Ki-67 change ( p =0.028) than lesser delays. Conclusions: Our results suggest that tumor cell repopulation may frequently occur in patients with longer interval,especially greater than 14 days between the last day of last chemotheraoy and surgery. Our results did not suggest a higher EGFR expression lead to increased proliferation.
Feasibility of using the drug-induced apoptosis assay (MiCK assay) in mesothelioma as compared to non-small cell lung cancer (NSCLC).
Authors: Wigle Dennis A. , Hallquist Allan , Presant Cary , Molina Julian R. 
Published: March 2020

e18538 Background: The drug-induced apoptosis MiCK assay has been predictive of outcomes in acute myelocytic leukemia, ovarian cancer, and a variety of solid tumors including breast cancer (Cancer Research 2012; 72:3901). We compared MiCK assay results in mesothelioma patients (pts) with NSCLC pts. Methods: Specimens from tissue or effusions were submitted to a central lab, processed to purify neoplastic cells, and a MiCK assay was performed as described (Cancer 2012; 118: 4877). Best chemotherapy regimens are defined as drugs/combinations with highest kinetic units (KU) of apoptosis +/- 1 SD compared to other drugs (this definition was predictive of outcomes in ovarian cancer). Active drugs have results over 1.0 KU of apoptosis. Results: 10 specimens have been submitted and 7 have been successful. Mean age was 69 and mean number of prior lines of therapy were 0.7 in 3 mesothelioma pts and 2.0 in 4 NSCLC pts. Mean number of drugs or combinations assayed successfully were 41 in mesothelioma and 20 in NSCLC. In mesothelioma, best active chemotherapy regimens (>1.0 KU) have been pemetrexed+doxorubicin, epirubicin, idarubicin, cyclophosphamide, ifosfamide, and dactinomycin. In NSCLC, best active regimens have been doxorubicin+cisplatin, irinotecan, and cyclophosphamide+doxorubicin+vincristine. In mesothelioma pts, the assay has been able to identify unexpected significant activity of several drugs: epirubicin, idarubicin, daunorubicin, dactinomycin, bendamustine, melphalan, vincristine, topotecan, azacytidine and bortezomib. Conclusions: Use of the MiCK assay in mesothelioma is at least as successful in the laboratory as it is in NSCLC. Unexpected new leads for innovative therapeutic strategies have been identified by the in vitro results. This feasibility study justifies a prospective controlled trial of the MiCK assay in mesothelioma and NSCLC pts. Clinical trials of drugs with unexpected activity are warranted in mesothelioma pts. Clinical trial information: NCT 01770665.
Efficacy and safety of oral etoposide maintenance therapy following cisplatin plus etoposide in advanced small cell lung cancers (Study of the Anatolian Society of Medical Oncology).
Authors: Urakci Zuhat , Kaplan Muhammet Ali , Unal Olcun Umit , Kucukoner Mehmet , Sevinc Alper , Oztop Ilhan , Suner Ali , Eren Tulay , Inanc Mevlude , Koca Dogan , Yazici Omer Kamil , Isikdogan Abdurrahman 
Published: March 2020

e18546 Background: Small cell lung cancers (SCLC) constitute a mean of 15% of lung cancers and present with advanced disease at time of diagnosis in 60% of cases. Cisplatin plus etoposide schedule is the standard treatment in these patients , whereas the role of maintenance therapy is debated. We assessed the efficacy and safety of oral etoposide maintenance therapy following cisplatin plus etoposide in advanced SCLC. Methods: Demographic features, treatment response, survival rate, and toxicity rate were assessed in our patients who were followed up for advanced SCLC between 2006 and 2012, had a ECOG performance status of 0-1, and were given oral etoposide maintenance therapy (50mg/day, given 14 days of a 21-day cycle, a total of 6 cycles) following 6 courses of cisplatin (75 mg/m2, 1 day) and etoposide (100mg/m2, 3 days). Results: A total of 51 patients were studied, 46 (90.2%) of whom were male; the mean age was 59 (28-78) years at diagnosis. Forty-four (86.2%) patients had partial remission while 7 (13.7%) had complete remission. Nine (17.6%) developed neutropenic fever while grade 3-4 toxicities, neutropenia, anemia, thrombocytopenia, neuropathy, diarrhea, nausea and vomiting were present in 39.2%, 9.8%, 5.9%, 1.9%, 3.9%, 3.9%, and 1.9% respectively. Chemotherapy was postponed in fourteen (27.4%) patients due to toxicity. Six (11.7%) patients taking oral etoposide developed febrile neutropenia and 3 (5.9%) developed grade 3-4 thrombocytopenia. Chemotherapy was postponed in 5 (9.8%) patients due to toxicity while no toxic death was observed. After a median follow-up of 19 months, 32 (62.7%) patients experienced progression of disease and 29 (56.8%) died. Median progression free survival was found 11.6 months (%95 CI; 10.2-12.9 months) and median overall survival was found 15.6 (%95CI; 11.5-19.7 months) months. Conclusions: Our results were similar with the previous literature. Oral etoposide maintenance therapy following cisplatin plus etoposide therapy in advanced SCLC is effective and tolerable. Further randomized studies are needed in this topic.
Cisplatin, gemcitabine, and vinorelbine (PGV) compared with cisplatin and etoposide (PE) in the first-line treatment of extensive-stage small-cell lung cancer: Two Brazilian institution experience.
Authors: Pereira Augusto Akikubo Rodrigues , Assis Ronnei J F , Pereira Emiliano da Costa , Lima Vladmir C. , Nugue Pedro B. , Pereira Jose Rodrigues 
Published: March 2020

e18548 Background: The standard first-line treatment for extensive-stage small-cell lung cancer (ES-SCLC) has been cisplatin plus etoposide (PE). Phase II studies showed comparable outcomes and less toxicity with platinum-doublets containing gemcitabine or vinorelbine. Aiming to improve response rates without increasing toxicity, we evaluated the combination of cisplatin, gemcitabine plus vinorelbine (PGV) in comparison to PE. Methods: Patients with ES-SCLC, ECOG 0-1, admitted from January 2002 to January 2011 in two brazilian institutions were analyzed. We compared patients treated with PE (cisplatin 80 mg/m2 D1 and etoposide 100 mg/m2 D1-D3 every 3 weeks for up to 6 cycles) versus modified PGV (cisplatin 80 mg/m2 D1, gemcitabine 1500 mg/m2 D1 and vinorelbine 30 mg/m2 D1 every 3 weeks for up to 6 cycles). Results: Of 69 patients analyzed, 29 were treated with PGV and 40 with PE. Clinical characteristics were comparable in both groups, except for adrenal metastases that were more frequent in PE group (20% vs. 0%; p=0,02). Overall response and complete response rates with PGV and PE were 75.9% vs. 65.0% (p=0.33) and 6 (20.7%) vs. 3(7.5%) (p=0.15), respectively. Median progression-free survival for PGV and PE was 6.47 and 5.06 months (p=0.37). Median overall survival for PGV and PE was 10.94 months versus 9.65 months (p=0.76). Severe neutropenia was higher with PE versus PGV (57.1% vs. 23.1%; p=0.01). Severe vomiting (38.5% vs. 17.2%; p=0.07) and peripheral neuropathy (15.4% vs. 5.3%; p=0.37) were more common with PGV than PE, although without statistical significance. Conclusions: Modified PGV presented comparable efficacy to standard PE in the first-line treatment of ES-SCLC. Response rates were higher with PGV, but without statistical significance. PGV showed less severe neutropenia than PE, but higher non-significant severe vomiting and neuropathy. Prospective studies with a large number of patients should be provided to confirm these results.
Expression of FLI-1 and the proliferation and survival of small cell lung cancer cells.
Authors: Song Wei , Cui Jiuwei , Li Wei , Wang Guanjun , Li Yan 
Published: March 2020

e18550 Background: Small cell lung cancer (SCLC) exhibits aggressive behavior, rapid growth, early spread to distant sites. Over the last few decades, prognosis for patients with SCLC has changed little and there remains an critical need for evaluating novel agents. Here, we report that Fli-1 (Friend leukemia virus integration 1), a transcription factor and member of the Ets family, has an essential role in SCLC progression and may be a promising target for therapy. Methods: Immunohistochemical staining was used to investigate the expression level of Fli-1 in 25 patients with SCLC, including 12 patients in limited stage and 13 patients in extensive stage. The growth, apoptosis assay and molecular mechanism of Fli-1 in SCLC cell line (NCI-H446) was studied by down-regulating Fli-1 expression through RNA interference. Results: It was shown that expression level of Fli-1 was significantly up-regulated in SCLC tissues compared with adjacent tissues (p=0.0002). Its staining was found specifically in the nuclei of cancer cells. Expression level of Fli-1 was higher in extensive stage disease than that in limited stage disease (p=0.0045). Down-regulation of Fli-1 expression by RNA interference in NCI-H446 was found to strongly decrease cell growth, promote cell apoptosis and reduce metastasis. Importantly, when Fli-1 was down-regulated in NCI-H446, epidermal growth factor (EGF)-induced Akt activation was dramatically decreased. It was implied that Fli-1 was involved in the Akt regulation passway. It was also confirmed that the apoptosis induced by decrease of Fli-1 expression via down-regulation of its target regulation gene, bcl-2. Conclusions: The novel mechanistic insight into a critical role of Fli-1 in SCLC progression was shown in this study. Fli-1 overexpression promotes SCLC aggression partly via activating Akt phosphorylation. We propose that Fli-1 is a new powerful predictor for SCLC progression, and is also a new potential target for SCLC treatment.
Efficacy results of first-line chemotherapy re-challenge in sensitive small cell lung cancer (SCLC): A retrospective multicenter analysis.
Authors: Genestreti Giovenzio , Tiseo Marcello , Burgio Marco Angelo , Monti Manuela , Scarpi Emanuela , Carloni Federica , Verlicchi Alberto , Casanova Claudia , Dazzi Claudio , Amadori Dino 
Published: March 2020

e18561 Background: Response and duration to initial chemotherapy are important factors used to classify SCLC patients into two groups. The first group comprises sensitive disease that responds to initial chemotherapy and relapses after more than 3 months and for which disease control could be obtained by re-challenging with first-line chemotherapy. The second group comprises refractory disease that progresses at the end or within 3 months of finishing first-line chemotherapy and for whom second-line chemotherapy represents the gold-standard. Methods: We reviewed clinical data from 4 Oncology Departments on sensitive SCLC treated with a first-line chemotherapy re-challenge in order to evaluate its activity and efficacy. Results: Of 211 SCLC patients diagnosed from January 2007 to December 2011, 25 (12%; 20 males, 5 females) had sensitive disease of whom 13 (52%) limited disease (LD) and 12 (48%) extended disease (ED). Median interval between the last day of chemotherapy and the onset of disease progression was 205 days (95% CI 169 – 279; range: 90 – 665). Chemotherapy consisted of etoposide + carboplatin in 15 (60%) patients or cisplatin in 10 (40%). On average 3-4 (range: 1-6) chemotherapy courses were administered, producing 8 (32%) partial responses, 3 (12%) stable disease, 10 (40%) progressive disease and 4 (16%) non evaluable disease. Further-line chemotherapy, mainly topotecan, was administered in 13 (52%) patients. Median overall survival produced by all treatments was 19.6 months (95% CI 16.5 – 27.6). Conclusions: In our experience, sensitive SCLC treated with first-line platinum/etoposide re-challenge produced interesting results in terms of activity and efficacy. Prospective randomized trials are warranted to investigate whether this strategy produces better results than standard second-line chemotherapy.