bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of a supervised exercise program on arm girth measurements in breast cancer survivors.
Authors: Leach Laura M. , Kleski Amy , Spencer Kathy , LaLonde Michelle , Sweeney Thomas J. , Caulin-Glaser Teresa 
Published: March 2020

9115 Background: There is minimal research examining the effect of cardiovascular and resistance exercise after surgery and/or radiation treatment to the breast and axillary area. Currently there are no guidelines for activity restrictions; however, medical providers historically have recommended limiting activity of the affected arm in an attempt to prevent the development of lymphedema. This could potentially affect future quality of life and other medical issues in breast cancer survivors. Methods: Female breast cancer survivors (n=79) completed an 8-week group exercise program meeting two days per week for cardiovascular and resistance training. Participants were also encouraged to exercise independently in addition to their group sessions. Bilateral arm girth measurements were performed on all participants upon program entry and exit. Measurements were taken distal to the ulnar styloid process (wrist) and three inches above (upper arm) and below (elbow) the lateral epicondyle of the elbow. All participants included in this analysis attended ≥ 70% of the group exercise sessions and had complete entry and exit measurements. Results: Participants attended an average of 15.94 ± 3.75 exercise sessions during the 8 week program. Changes in arm girth measurement were compared for the surgical side and non-surgical sides of the body using paired t-tests. Arm girth changes in the surgical side of the body were compared to the non-surgical side of the body using the Wilcoxon Ranked Sum test. The surgical and the non-surgical arm girths did not significantly increase at the wrist (p=0.55 and p=0.76), elbow (p=0.31 and p=0.24) or upper arm (p=0.18 and p=0.42). The changes in arm girth observed on the surgical body side were not significantly different from the changes observed on the non-surgical side (wrist (p=0.67), elbow (p=0.44), and upper arm (p=0.36). Conclusions: A structured, group-based exercise program involving both cardiovascular and resistance training did not significantly increase arm girth measurements in breast cancer survivors.
Disease-driven symptoms and response to chemotherapy in treatment-naive patients with advanced non-small cell lung cancer (NSCLC).
Authors: Jones Desiree , Vichaya Elisabeth G. , Wang Xin Shelley , Mendoza Tito R. , Mobley Gary M. , Lu Charles , Cleeland Charles S. 
Published: March 2020

9118 Background: The disease-driven symptoms of treatment-naïve patients with advanced NSCLC have not been the primary focus of previous studies. One reason for this gap in the literature is that randomized trials typically lack an opportunity to capture the symptom profiles of patients who are truly treatment-naïve. To address this need, this study sought to: (i) characterize the symptom profile of treatment-naïve patients with advanced NSCLC, and (ii) describe patients’ response to chemotherapy. Methods: The study sampleconsisted of43 treatment-naïve patients (no prior treatment by surgery, radiation, or chemotherapy) with a primary diagnosis of advanced NSCLC from the MD Anderson Cancer Center, and was derived from a larger study (Cleeland et al. J Clin Oncol 29:2859-65, 2011). Patients’ symptoms were assessed pre-chemotherapy, and then prospectively at 6, 12, and 18 weeks from initiation of chemotherapy using the MD Anderson Symptom Inventory Lung Cancer module. Results: The top symptoms reported by patients, in order of severity, were shortness of breath, fatigue, distress, sadness, drowsiness, and pain. Chemotherapy did not significantly improve shortness of breath, drowsiness, pain, disturbed sleep, lack of appetite, coughing, and constipation in this sample of patients, and was associated with a significant increase in levels of fatigue and numbness (mean difference in fatigue at 12 weeks from baseline = 2.8; 95% CI, 0.5–2.9; p = .01; and in numbness from baseline = 1.1; 95% CI, 0.2–2.0; p = .02). Conclusions: This study characterizes the disease-driven symptoms of truly treatment-naïve patients with advanced NSCLC. Knowledge of these symptoms is of intrinsic value in the clinical management of advanced NSCLC as it provides the critical reference point against which symptom palliation must be measured. Patients’ lack of symptomatic improvement from chemotherapy in this study suggests that this sub-set of patients may have had rapidly progressing disease and that chemotherapy may have prevented symptoms levels from worsening. Consistent with literature, transient but significant increase in both fatigue and numbness are chemotherapy-related toxicities.
Using scenarios to explain survival time: Attitudes of people with a cancer experience.
Authors: Stockler Martin R. , Kiely Belinda E. , McCaughan Georgia J. , Christodoulou Sophie , Beale Philip James , Trotman Judith , Grimison Peter , Tattersall Martin HN 
Published: March 2020

9126 Background: Most people with advanced cancer want some information on their life expectancy. We sought the attitudes of people with a cancer experience to using three scenarios for survival (best-case, worst-case, and typical) to explain life expectancy to people with advanced cancer. Methods: Oncology clinic attendees and Breast Cancer Network Australia (BCNA) members completed a survey describing two formats for explaining life expectancy to a hypothetical patient with incurable cancer - providing either three scenarios for survival or just the median survival time. Associations between respondent attitudes and their demographic and tumour characteristics were explored. Results: Characteristics of the505 respondents from outpatient clinics (n=251) and BCNA (n=254) were: median age 58 years; female 74%; completed high school education 80%; breast primary 64%; self-report of cancer spread to other body parts 23% and; a median of 4 years since diagnosis of cancer. More respondents agreed that explaining three scenarios (vs. just the median survival time) would: make sense (93% vs. 75%), be helpful (93% vs. 69%), convey hope (68% vs. 44%), reassure (60% vs. 40%) and help family members (91% vs. 71%); all p-values <0.001. Fewer respondents agreed that explaining three scenarios (vs. median survival) would upset people (24% v 36%); p<0.001. The proportions of respondents agreeing that each of the 3 scenarios should be presented were: best-case 89%, worst-case 82%, and typical 92%. Most respondents (85%) agreed it would be helpful to receive a printed summary of the scenarios for survival. For information about their own prognosis, 88% preferred all three scenarios and 5% a single estimate of the median. Respondents with higher education were more likely to agree that presenting three scenarios would be helpful (95% v 90%, p=0.05). Respondents with breast cancer were more likely to agree that explaining three scenarios would upset people (31% v 13%, p<0.001). Conclusions: Most respondents judged presentation of best-case, worst-case and typical scenarios preferable and more helpful and reassuring than presentation of just the median survival time when explaining life expectancy to patients with advanced cancer.
Relapse-specific mutations in cytosolic 5’-nucleotidase II in childhood acute lymphoblastic leukemia.
Authors: Meyer Julia , Wang Jinhua , Hogan Laura E. , Patel Jay , Tang Zuojian , Zumbo Paul , Li Sheng , Zavadil Jiri , Levine Ross L. , Cardozo Timothy , Hunger Stephen , Raetz Elizabeth A. , Morrison Debra J. , Mason Christopher , Carroll William L. 
Published: March 2020

9507 Background: Relapsed childhood acute lymphoblastic leukemia (ALL) carries a very poor prognosis despite intensive retreatment that often includes allogeneic stem cell transplantation, due to intrinsic drug resistance. Novel therapeutic approaches are urgently needed and identification of the biological pathways that mediate resistance might provide targets for the effective prevention and treatment of relapsed ALL. However, the spectrum of somatic mutations responsible for ALL relapse is not yet known. Methods: We profiled the transcriptome of matched diagnosis and relapse bone marrow specimens from 10 pediatric B lymphoblastic leukemia patients using massively parallel sequencing technology (RNA-seq) to identify novel mutations specific at disease recurrence. Results: Transcriptome sequencing identified 20 newly acquired novel non-synonymous mutations in 10 relapse specimens not present at initial diagnosis. Two patients harbored relapsed specific mutations in the same gene, NT5C2, which codes for the Cytosolic 5’-nucleotidase II protein at different sites in the protein sequence. Mutations were validated as relapse specific after Sanger resequencing of germline, diagnosis and relapse DNA. RNA-seq coverage of each mutation was >100X, indicating that if a relapsed clone were present at diagnosis it made up < 1% of the bulk leukemia. Full exon sequencing of NT5C2 was completed in 61 additional relapse specimens, identifying 5 additional mutations which were also confirmed as relapse specific. Structural modeling of the relapse-associated mutations in the encoded protein Cytosolic 5’-nucleotidase II suggests alteration of enzyme subunit association/dissociation. Clinically, patients who harbored NT5C2 mutations were more likely to relapse earlier following initial diagnosis than those patients without mutations (p=0.03). Conclusions: Mutations in NT5C2 are associated with the outgrowth of drug resistant cells in childhood ALL.
Results of autologous transplants for children from a tertiary cancer center in India.
Authors: Dongre Amol , Singh Randeep , Thippeswamy Ravi Shankar , Goyal Gautam , Kannan Sadhna , Bagal Bhausaheb Pandurang , Gawande Jayant Shankar , Kurkure Purna Arun , Banavali Shripad , Khattry Navin 
Published: March 2020

9559 Background: Autologous transplantation is a curative option for children with various malignancies. We report the results of our center with the aim of evaluating toxicities and prognostic factors that may influence decision making to use our limited resources judiciously. Methods: Forty-six patients diagnosed below 18 years from 1st April 1994- 28th February 2011 were included in this retrospective study. Twenty-four patients had lymphoma, 12- neuroblastoma and 10-others ( 5- acute leukemia, 4- Ewing sarcoma and 1 - rhabdomyosarcoma). Twenty-eight patients received peripheral blood stem cells, 12 – marrow and 6-both. Prognostic factors evaluated for overall survival (OS) and progression-free survival (PFS) were remission status at transplant, baseline and pre-transplant serum albumin, time interval between diagnosis and transplant, type of malignancy and number of lines of chemotherapy pre transplant. Results: Median age at diagnosis and transplant were 9 and 12 years respectively. Median baseline and pre transplant serum albumin were 3.6 and 3.9 g/dl. Median number of lines of chemotherapy was 2. Median time from diagnosis to transplant was 1.1 years. Incidence of grade 3 and 4 oral mucositis and diarrhea were 46% and 25% respectively. At the time of transplant, 45% were in complete remission (CR), 41% in partial remission (PR) and 13% in refractory state. Total Parenteral Nutrition (TPN) was used in 63% patients with median duration of 11 days. No patient developed sinusoidal obstruction syndrome.Median days to neutrophil and platelet engraftment were 11 and 15 days respectively. Neutropenic sepsis leading to death was seen in 17%. Median follow up was 1.5 years. At 2 years, the probability of OS and PFS were 39% and 35% for all patients while OS and PFS for lymphoma, neuroblastoma and others were 45% and 32%, 17% and 0% and 50% and 40% respectively. CR at transplant was the most important determinant of better OS (59 % vs 28%; p = 0.000004) and PFS (53% vs 8%; p = 0.0000018). Conclusions: CR at transplant is the most important prognostic factor. Patients with neuroblastoma have dismal outcome which requires reevaluation of transplant strategies for this group.
Use of pharmacokinetic modeling to optimize direct inhibition of the "undruggable" target EWS-FLI1 of Ewing sarcoma.
Authors: Toretsky Jeffrey , Hong S. Peter , Gamble S. Ellen , Hong Sung-Hyeok , Kobs Christina L. , Elsass Karen E. , South Natalie L. , Summer Stephen J. , Monroe Philip J. , Uren Aykut 
Published: March 2020

9575 Background: Chimeric transcription factors are ideal anti-cancer targets; however, they lack enzymatic activity thus rendering them ‘undruggable’ proteins. The EWS-FLI1 fusion protein of Ewing sarcoma (ES) has been validated as an anticancer target both alone and as a partner of RNA Helicase A (RHA). Our prior work identified the small molecule YK-4-279 as a specific inhibitor that blocks RHA from binding to EWS-FLI1. Blocking this interaction leads to apoptosis. We have modeled YK-4-279 treatment using ES cells to establish the duration of YK-4-279 exposure that leads to apoptosis. Methods: Apoptosis was measured by caspase-3 cleavage. A validated plasma detection method allows for HPLC measurement of YK-4-279. Pharmacokinetic (PK) models of YK-4-279 for both intraperitoneal (IP) and intravenous (IV) administration were developed in SD rats and BL6 mice. Results: ES cell lines were exposed to YK-4-279 over a time-course, followed by a caspase-3 activity assay that demonstrated a minimum of 16 hours exposure was necessary to achieve maximal apoptosis using either 3 or 10 microM compound. A dose-dependency assay demonstrated that while apoptosis could be achieved with 30 – 80 microM YK-4-279 after 4 hours of treatment, caspase-3 activity was less than or equal to 3 microM for 16 hours. Rat PK modeling demonstrated a t1/2 of 30 minutes following IV administration. BL6 mice demonstrated similar kinetics to the rat. SCID/bg mice, which are necessary for tumor efficacy studies, demonstrated approximately 50% faster clearance than either rat or BL6 mice. Absolute bioavailability for IP administration was 41%. Conclusions: Models will be created to optimize IP dosing regimen. The optimized IP dosage and dosing intervals will be evaluated in tumor bearing animals in order to advance development of YK-4-279. The results of these studies will be used to guide toxicology studies in animals. In addition, pharmacodynamics models are being developed to compare YK-4-279 levels with functional activity. The combined results of these investigations will lead to human clinical trials for this first-in-chemical class, first-in-mechanism drug candidate.
Bevacizumab (BEV) plus chemotherapy (CT) continued beyond first progression in patients with metastatic colorectal cancer (mCRC) previously treated with BEV plus CT: Results of a randomized phase III intergroup study (TML study).
Authors: Arnold Dirk , Andre Thierry , Bennouna Jaafar , Sastre Javier , Osterlund Pia J. , Greil Richard , Van Cutsem Eric , Von Moos Roger , Reyes-Rivera Irmarie , Bendahmane Belguendouz , Kubicka Stefan 
Published: March 2020

CRA3503 The full, final text of this abstract will be available at abstract.asco.org at 12:01 AM (EDT) on Sunday, June 3, 2012, and in the Annual Meeting Proceedings online supplement to the June 20, 2012, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Sunday edition of ASCO Daily News.
Neoadjuvant chemotherapy in locally advanced breast cancer.
Authors: Soraya Sami sahnoun 
Published: March 2020

e11034 Background: Neoadjuvant chemotherapy(NAC)is one of the treatment options for locally advanced breast cancer. In this study, we evaluated the efficacy and safety of 4 cycles of NAC doxorubicine,docetaxel and cyclophosphamide(TAC),correlation between the response to NAC and molecular classification sub-groups and between the pCR and the time to progression(TTP). Methods: This is a prospective study from January 2005 to December 2008.110 pts with locally advanced breast cancer stage III.All pts have received 4 cycles of NAC based on docetaxel 75 mg/m², doxorubicine 50 mg/m² and cyclophosphamide 500 mg/m² every 3 weeks, followed by surgery.101 pts were assessed, since 9 of them have progressed on treatment and came out of the study. Pts were stratified according to age, menopausal status, histopathological analysis (luminal tumors(ER-positive and HER2-negative), triple-negative tumors (TN)and HER2-positive tumors), response to the treatment and survival. The median follow up of patients was 39 months. The statistical study was done using SPSS 17. Results: The median age was 41(23–65).30% of pts were younger than 35 and 80% were premenopausal. 55% luminal tumors(56 pts), 33% HER2 positive(33 pts) and 12 % TN(12 pts).CRR was estimated at 89%(37% of CR and 63% of PR).There were 23, 7% of pCR according to Chevallier’s classification. In luminal, TN and HER2-positive pCR rates were 16%(9 of 56), 66,6%(8 of 12), and 21,2%(7 of 33) respectively. Multivariate analysis showed that the ER status was the only significant predictor of pCR(P = 0.025).HER2 status was not significantly associated with pCR(P= 0,423).TTP was 50 months. In luminal tumors, TN and HER2-positive tumors the TTP was respectively 59, 52 and 49 months. There was not a significant difference in TTP between the pCR(51 months) and the non-pCR group(44 months)(CI 95, p= 0.109).Grade III/IV toxicity included neutropenia(22%), febrile neutropenia(6,5%), mucositis(13%), and diarrhea(4%). Conclusions: Breast cancer occurs in young women in Algeria. In this study, neoadjuvant TAC was effective and well tolerated. The ER status was the only significant predictor of pCR. The molecular classification group with the highest percentage of pCR was the TN group. pCR was not associated with a better prognosis.
Invasive ductal breast cancer, tumor size, and its correlation between physical examination, imaging techniques, and pathological anatomy.
Authors: Lopez-Gonzalez Ana , Ibeas Patricia , Carmona Maria Soledad , Rivero Elisabeth , Lopez Roberto , Huelves Miriam , Doger de Speville Bernard Gaston , Cantos Blanca , Pastrana Miguel Angel , Provencio Mariano 
Published: March 2020

e11035 Background: The most frequent indication of magnetic resonance in breast cancer is the evaluation of tumoral extension. Several studies suggest that mammography and ultrasound underestimate tumor size. We try to analize the correlation between the tumor size of invasive ductal carcinomas in physical examination, mammography, magnetic resonance and pathological anatomy. Methods: We review the 290 magnetic resonance made in our Radiology Department from 1st January 2009 to 1st September 2010. 56 of them were applied as complementary study before surgery of suspected lesions of breast cancer. We made an analysis of paired test, and then a hypothesis test for equal sample testing, supported by an analysis of power curves. The paired test analysed were physical examination (PE)- mammography - magnetic resonance (MR) - pathological anatomy (PA). Results: A 100% were women; average of age of 54.1 years old. A 42.8% were premenopausal. Averages of tumor size: 18.3mm in PE; 18.8mm in mammography; 25.3mm in MR and 24.8mm in PA. The correlation between the tumor size in PE and PA is not statistically significant (p=0.05, 95% CI 11.07; 1.93), and also between the mammography and the PA (p=0.05, 95% CI 10.69; 1.47). The correlation between tumor size in mammography and MR is statistically significant (p=0.05, 95% CI -9.83; -3.26), and also between MR and PA (p=0.05, 95% CI -3.31; 4.25). We analysed the relation between clinical tumor size by MR and PA size, and in a 25% of the cases, the clinical and the pathological stage were different. The pathological was more advance in a 57.1% of them. Conclusions: Mammography underestimate the tumor size, with no correlation with the pathological tumor size. However, there is a good correlation between the tumor size in MR and the pathological size. The MR is the most reliable imaging technique to optimize the surgical and oncological treatment in patients with breast cancer.
Role of clinical and histologic factors in decision making on adjuvant therapy of small HER2-positive breast cancer.
Authors: Azam Faisal , Yousif Saif , Aaseem Aarifah , Ahmed Eliyaz 
Published: March 2020

e11053 Background: With increased use of screening mammography for breast cancer (BC), the incidence of small (T1a, b), node negative BC has increased. These cancers are considered low-risk and hence not offered adjuvant (adj) chemotherapy (CT). However, increasing retrospective studies suggest that outcomes in small node negative HER-2 positive BC might be worse than the HER-2 negative tumours of similar size. Current guidelines generally do not recommend adj CT and Trastuzumab (T) for small (T1 a, b) HER-2 positive tumours. As a part of our ongoing audit on the outcome of small HER -2 positive BC, we wished to determine the factors that oncologists consider in decision making on adj treatment of these tumours in the absence of clear guidelines. Methods: Patients (pts) with a diagnosis of node negative T1a, b, HER-2 positive BC treated across our cancer network, between Jan 2008 and Dec 2011, were identified from our electronic database. Results: A total 230 pts had stage T1, HER 2 +ve BC. Out of those 41(17%) pts had tumour size of < 1cm (13, 31%pts were T1a and 28, 74%pts wereT1b) and node negative disease. Median age was 55 years (29-84yrs). 33 Pts had BCS and 8 pts had mastectomy. All pts with BCS received adj radiotherapy and all pts who were ER positive received adj endocrine therapy. 21(51%) out of 41pts received adjuvant CT and T. All pts had anthracycline based CT. The clinical and pathological characteristics of pts who received adj CT and T were as follows; Median age- 50 (33-64years), grade 1- 1(4%), grade 2 – 9(43%), grade 3- 11(53%), LVI present- 2(9%), LVI absent- 7(34%), LVI unknown – 12(57%), ER positive- 16(76%), ER negative – 5(24%). None of the pts had recurred or died at the time of analysis of the data and longer follow up is needed for survival analysis. Conclusions: In the absence of clear guidelines on adj CT and T in node negative small HER-2 positive BC, the oncologists relied on the traditional factors such as grade, ER status in risk stratification and decision on adj therapy. Tumour grade was the most important factor but age and ER status were not discriminating factors in this study. Prospective randomised trials needed to clearly define the role of adj systemic therapy in this group of pts.