bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast cancer in male veterans: A retrospective chart review.
Authors: Aggarwal Anita , Liu Min-Ling L , Patel Nihar Kiritkumar , Evangelista Rebecca , Krasnow Steven 
Published: March 2020

e12531 Background: Male breast cancer (BCA) is rare and makes up < 1% of all of breast cancer cases. Treatment is mainly based on what is known from female BCA and survival is similar between genders. Objectives: To investigate the clinicopathologic characteristics of BCA and overall survival in male veterans. Methods: Medical records of male patients diagnosed with breast cancer at the Veterans Affairs Medical Centers of Washington DC, Baltimore and Martinsburg from 1992-2012 were reviewed after Institutional Review Board approval. Results: From 1995-2012, 51 male patients with BCA were identified from cancer registry. 29/51(57%) were African American (AA), 41% Caucasian (WM), and 2% other race. Median age was 70 years (44-86years). Palpable mass was presenting symptom in 41/51(80%) and 8(16%) had gynecomastia or bloody nipple discharge. Family history of breast cancer was positive in 11 patients without mention of BRCA genes except pt #24 who was BRCA2+. 3 patients were exposed to Agent Orange. ER/PR was positive in 36(71%), ER+/PR- in 1(2%), ER+/PR+/HER2+ in 2(4%), ER-/PR-/HER- in 2(4%). 41% & 57% had right and left BCA, respectively. 40 (80%) underwent mastectomy. 18(36%) had lymph node involvement (1-13 LN). 90% had invasive ductal carcinoma (IDC), 8% DCIS, and 2% sarcoma. Cancer in 26% was stage I, 38% stage II, 18% stage III and 8% stage IV. 12(24%) received combination chemotherapy. 33(66%) were given tamoxifen. 4(8%) patients had relapsed/recurrent disease in 1-5 years of their diagnosis and died within 2-12 years after the relapse. At median follow up of 174m (4m-19years), 28(56%) patients died (cause of death not known in all), 21(42%) alive and 3(6%) lost to follow up. Conclusions: Median age at diagnosis of BCA seems to be higher in males (70 years) as compared to historical female age (60 years). IDC is the main pathology and 73% tumors were ER +. Survival rate is approximately 40% at >10years of follow up. Survival by stage revealed no difference.
Cancer in pregnancy: To treat or not?
Authors: Walsh Elaine , O'Kane Grainne , Cadoo Karen Anne , Graham Donna M. , Korpanty Grzegorz , Power Derek Gerard , Carney Desmond 
Published: March 2020

e12533 Background: Cancer in pregnancy accounts for ~1 in 1,000 pregnancies. Studies show that cytotoxic agents are safe from the second trimester. Long-term follow up has not shown increased malformations or malignancies in children exposed to chemotherapy in utero. There is no evidence of worse outcomes among women diagnosed in pregnancy. Methods: We retrospectively identified women diagnosed with cancer in pregnancy over a 25-year period. Medical records were reviewed for demographics, diagnosis, gestation, timing of treatment and outcomes. We assessed if all cancers need to be treated in pregnancy or if treatment could be safely deferred to allow normal delivery. Results: Twenty-five women were diagnosed with cancer in pregnancy and referred to medical oncology. Of 25 women, 16 (64%) received chemotherapy during pregnancy. These included 13 cases of breast cancer, one Ewing’s sarcoma, one ovarian cancer, and one small cell of cervix. All 16 women received doxorubicin and cyclophosphamide. There were 15 live births and no abnormalities seen in children who received chemotherapy in utero. At a median follow-up of 6 years 11 mothers (69%) are disease free and 4 (25%) have recurrent disease. Of nine mothers who did not receive chemotherapy in pregnancy, seven received chemotherapy immediately post-partum. Six (86%) were diagnosed in early pregnancy (median gestation 13 weeks). There were three cases of Hodgkin lymphoma, two breast cancers, and one ovarian cancer. At a median follow-up of 12 years, all mothers remain disease free. There were no abnormalities seen in these children. Conclusions: We did not identify any adverse outcomes in mothers or infants exposed to chemotherapy during pregnancy. We identified a cohort of patients that do not need immediate treatment during pregnancy. In selected cases, it is safe and appropriate to delay chemotherapy until delivery of the baby. There were no adverse outcomes to mothers due to delayed treatment and no adverse outcomes to babies not exposed to chemotherapy in utero. A multi-disciplinary team is essential to individualize treatment planning. [Table: see text]
Potential risk of residential asbestos exposure: Japanese general screening study for asbestos-related diseases (JGSARD).
Authors: Seki Nobuhiko , Yamaguchi Takuhiro , Eguchi Kenji , Kaneko Masahiro , Kusumoto Masahiko ,   JGSARD Study Group
Published: March 2020

e12541 Background: Currently, an argument about health risks by residential asbestos exposure as well as occupational asbestos exposure has been closed up in Japan. Therefore, the latest large-scale CT screening study reflective of a country's general situation of asbestos exposure will help citizens understand significant information about asbestos-related diseases. Methods: JGSARD is a prospective cohort study for the general population representative of Japan designed to evaluate the actual situation of asbestos exposure and the prevalence of asbestos-related diseases through chest radiography and low-dose CT (LDCT) at baseline and after 2 years of follow-up. From 2006 to 2008, 9810 subjects (mean age, 57 years; 54% male and 50% smokers) underwent baseline screening at 26 institutions in Japan. Lifetime self-reported history of asbestos exposure (SHAE) was obtained. Results: Occupational SHAE was definite and possible in 1103 (11.2%) and 1702 (17.3%) subjects, respectively, whereas residential SHAE was definite and possible in 262 (2.7%) and 931 (9.5%) subjects, respectively, although asbestos factory in their residential areas actually existed in 2870 (29.3%) subjects. The false negative rates of residential SHAE in all participants of this study (n=9810), those with pleural plaque on LDCT (n=264), and those with pleural plaque without occupational SHAE (n=83) were calculated as high value of 85.6%, 76.0%, and 87.9%, respectively. Presence of pleural plaque was significantly correlated with male (odds ratio [OR], 2.32), age 60 years and older (OR, 1.75), smoking (OR, 1.60), occupational or residential SHAE (OR, 3.92), residential period in asbestos factory area (OR every 10 years, 1.13), and asbestos-related work period (7 works identified). Lung cancer was identified in 29 (0.3%) subjects. Presence of lung cancer was significantly correlated with age 60 years and older (OR, 2.67) and presence of pleural plaque (OR, 4.17) regardless of occupational and residential SHAE. Conclusions: Our results indicate the potential risk of residential asbestos exposure and thus the importance of public relations and enlightenment for them among Japanese general population.
Breast cancer incidence in a large cohort of Peruvian women affiliated to a pre-paid system.
Authors: Suazo Juan F. , Valdiviezo Priscila I. , Flores Claudio J. , Iberico Jorge , Pinto Joseph A. , Aguilar Alfredo , Vigil Carlos Enrique , Gomez Henry , Vallejos Carlos S. 
Published: March 2020

e12570 Background: Breast cancer (BC) is the second most common malignancy and the leading cause of death by cancer in Peruvian women (age-standarized rate [ASR] of 34 new cases/100,000 women estimated by GLOBOCAN 2008). The purpose of this study was to assess the incidence of BCin acohort ofwomenat Oncosalud, an oncologic pre-paid system that currently has 600,000 affiliates. Methods: We evaluated a dynamic cohort (period 1989 to 2011) of women affiliatedat Oncosalud – AUNA, an oncologic prepaid system.The crude incidence rate per year (number of new cases/women at risk), the specific rate according to age (number of new cases / persons-year) and cumulative risk were calculated. Results: Overall, during the assessment period, the BC incidence rate per year was 175.6 and the ASR incidence was 111.9 per 100,000 affiliates respectively. In our cohort of affiliates there were no BC cases before 1993 (with 907 women at risk for that year). The highest incidence rate was 177.6 registered in 1997 (11,822 women at risk). Incidence rates started decreasing in 2003 (169.2 with a population at risk of 39,593 women). The lowest incidence was 71.5, registered in 2011 (279,680 women at risk).According to age-groups, there were no BC cases under20 years old. Specificincidence ratesper age-group increases from the 30 year old-group (55.8). The peak of BC incidence was between 70 to 74 years old (407.4). In the same way, the cumulative risk increases after 30 years old. Conclusions: In our cohort of affiliates, the incidence of BC is greater than the general population, it could be due to the process of negative selection; however, specific incidence rates per age-group and cumulative risk are increased after 30 years, as seen in the general population.
Breast cancer: First results of an institutional cancer registry 2007-2011 in Colombia.
Authors: Yepes Andres , Gonzalez Luis , Durango Isabel Cristina , Pineda Beatriz , Figueroa Juan D. , Triana Jaime 
Published: March 2020

e12571 Background: The aim of this retrospective study was to describe the clinical characteristics of patients with breast cancer (BC) treated at the Oncology Unit of the Hospital Pablo Tobon Uribe in Medellin, Colombia, an institution's 10-year experience. Methods: All cases were Identified from our institution's cancer registry from 2007-2011. Results: During the study period 1224 BC were cases identified. Men: 12 (1%). Median age at diagnosis was 56 years (range 23-88). Stage at diagnosis was stage 0 (6.1%), stage I (30%), stage IIA (24.5%), stage IIB (10.8%), stage IIIA (6.8%), stage IIIB ( 6.1%), stage IIIC (9.5%), stage IV (3.4%) and unknown (2.8%). Primary right breast (50.2%). Most common histology was invasive ductal carcinoma (71%) and histologic grade 2 (34.6%). Estrogen and progesterone receptor status assessed at diagnosis was positive in 74,7% and 69% of cases tested respectively. HER2/neu status was positive in 14.2% (with hormone receptor positive 8,1% and hormone receptor negative 6.1%). Triple-negative BC 12.2%. Median tumor size was 2.3 cm (range 0.4-14.0 cm). Procedure performed was mastectomy in 59% and lumpectomy in 35%. Nodal staging was performed by axillary dissection (AD) (81%) and sentinel node biopsy (SN) alone (19%). Neoadjuvant chemotherapy was given to 39%, adjuvant chemotherapy to 69%, adjuvant hormonal therapy to 62% and adjuvant radiation therapy was used in 40,6%. The preferred adjuvant regimens was AC (doxorubicin / cyclophosphamide) followed by weekly paclitaxel in 51%. The average time from diagnosis to entry into consultation with specialist breast surgery 12 days. Time from diagnosis and staging complete and the beginning of the treatment: 16 days. Conclusions: The patient profile inquiry to our hospital with breast cancer is a woman of 56 years, with commitment right breast, invasive ductal carcinoma, grade 2, luminal A (estrogen receptor positive and / or progesterone receptor positive, HER2 negative), stage I and most commonly treated with mastectomy and chemotherapy with AC and paclitaxel.
MRI-based maps differentiating tumor from nontumor tissues for improved clinical management of brain tumor patients.
Authors: Mardor Yael , Guez David , Last David , Daniels Dianne , Grober Yuval , Nissim Ouzi , Hoffmann Chen , Nass Dvora , Talianski Alisa , Spiegelmann Roberto , Cohen Zvi R , Zach Leor 
Published: March 2020

e13002 Background: We have recently demonstrated delayed contrast extravasation MRI for calculating maps providing clear, high resolution depiction of tumor/non-tumor tissues. >100 brain tumor patients have been recruited in 3 clinical studies. In all cases increased tumor volumes (TVs) on our maps were followed by progression while stable/decreased TVs did not require treatment changes. Following histological validation the maps are being used for clinical decisions. Methods: Our maps were applied for improved patient management in 23 patients post treatment in which consensus regarding tumor progression vs. treatment effects (TEs) has not been reached. In all cases increased enhancement was shown on T1-MRI and rCBV was low/inconclusive. Results: In 5 GBM patients 1-3 months post surgery our maps showed significant TVs, therefore 2 were started on Avastin and 3 were re-operated. One of the latter showed increased enhancement on T1-MRI after the second operation. The maps showed no TV consistent with later clinical improvement. Two GBM patients 3-4.5 months post chemoRT showed increased TEs and stable TVs consistent with pseudoprogression. Adjuvant TMZ was continued followed by decreased lesion volumes. 2 patients (GBM/AA) showed increased TVs 5 months/years post chemoRT and were referred to Avastin/surgery. One patient was scanned 2 wks post chemoRT with clinical deterioration and rescanned 3 wks later when stabilized showing significantly increased TVs with no change on standard MRI. The patient was re-operated. Brain mets patients were recruited 1-21 months post SRS. Four showed significant TVs and were referred to treatment (surgery, WBRT, Xeloda). Two were followed for 3-6 months and upon increase in TV were referred to surgery. In 6 patients 73-100% of the enhancing lesion consisted of TEs thus are currently stable under FU. In 3 the lesion has resolved within 2-4 months. Active tumor was confirmed histologically in all above resected lesions. Conclusions: Following validation of our easily interpreted color code maps patients are now referred from 4 major Israeli hospitals with a question of progression vs TEs. Our data suggests that the maps may be used for improved patient management when standard MRI is inconclusive.
Analysis of long-term survival in patients with glioblastoma.
Authors: Melegari Elisabetta , Dall'Agata Monia , Guiducci Graziano , Cremonini Anna Maria , Cerasoli Serenella , Ibrahim Toni , Sintini Michele , Cenni Patrizia , Bomprezzi Chiara , Faedi Marina 
Published: March 2020

e13007 Background: Adult glioblastoma (GBM) is the most common type of malignant primary brain tumor. Despite advances made in treatment, median survival is between 12 and 15 months. Standard care is concomitant radiotherapy (RT)/temozolomide (TMZ) and adjuvant TMZ for 6 cycles (EORTC/NCIC trial 2005). At progression, subsequent treatments are left to the discretion of the treating physician. Methods: We evaluated retrospective data of GBM patients (pts) treated from 2003 to 2010, focusing on the treatment of patients with longer survival (over 24 months). Results: 139 pts with GBM were treated during the period. Thirty of these showed survival > 24 months: 20 were subjected to macroscopically radical neurosurgery, 9 to non-radical surgery and 1 to biopsy. All pts had a KPS 100%. 11 pts were treated in the period pre-EORTC/NCIC trial (Stupp et all) and 19 in the period “post-Stupp”. In the former group 10 pts underwent RT followed by TMZ ( 2-12cycles) and 1 patient received only RT. All pts in the latter group were treated with concomitant radio-chemotherapy followed by TMZ. 3 pts are currently disease stable. After the first documented evidence of disease progression (PD) 21 pts were treated, one with neurosurgery, 4 with neurosurgery plus chemotherapy (CT), 15 with only CT and 1 with CT and tomotherapy. With regard to chemotherapy, 14 pts received TMZ ( 2-21cycles), 3 fotemustine (4-16 cycles), 1 carboplatin and VP16 (2 cycles) and 1 irinotecan plus bevacizumab (2 cycles). Further progression was treated with another line of CT in only 8 pts, fotemustine in 5 (1-3 cycles), TMZ in 2 (2 cycles) and carboplatin plus VP16 In 1 (5 cycles). Median overall survival (mOS) of our long-term survivors was 36.18 months (CI 95% 28.32 – 42.01). Considering the two groups separately (pre- and post- Stupp), we observed a mOS of 36.18 months (CI 95% 26.45 – 42.01) (1 pt alive) for the first group and of 36.15 months (CI 95% 28.26 – 48.52) (7 pts alive) for the second. Conclusions: Our long-term survivors, independently of treatment, showed an mOS of 36.18 months (CI 95% 28.32 – 42.01). There was no significant difference in mOS between the 2 groups (p=0.6963). Further research is needed to identify the biomolecular and genetic pattern that is responsible for the long survival of some patients.
Multimodality treatment for intracranial germ cell tumors: Experience from an Asian tertiary hospital.
Authors: Chong Dawn QQ , Tan Iain BeeHuat , Tan Daniel HY , Chua Eu Tiong , Tham Chee Kian 
Published: March 2020

e13027 Background: Intracranial germ cell tumors (GCTs) represent up to 11 percent of pediatric central nervous system (CNS) tumors in Asia. We compared the efficacy of radiotherapy alone (RT) with platinum-based chemotherapy (CT) in combination with dose-attenuated RT. Methods: We identified 61 patients treated at National Cancer Centre Singapore from 1995 to 2011. Patient’s demographics, histopathologic characteristics and survival data were collected. Median follow up was 39 months. Results: Forty-eight (79%) patients were male; mean age at diagnosis was 17 years. Most (87%) patients had pineal or suprasellar tumors. The distribution of pure germinomas, non-germinomatous tumors and mixed tumors was 54 (89%), 5 (8%) and 2 (3%) patients, respectively. Twenty patients had RT alone, 2 had CT alone, and 31 received a combination of CT and attenuated RT. There was no difference in overall survival (OS) between unifocal or multifocal disease (p = 0.81). Amongst the germinomas, there was no difference in OS between patients given RT alone and CT combined with attenuated RT (median OS not reached vs 145 months, respectively, p = 0.668). Conclusions: Treatment with CT followed by dose attenuated RT is an alternative to conventional craniospinal RT and did not compromise survival in patients with germinomas. This may represent a therapeutic modality with a more favorable long term toxicity profile in these patients who have excellent long term outcomes.
Patient-specific mathematical modeling as a precision-medicine approach to evaluating therapeutic gains of a novel chemoprotection treatment in newly diagnosed glioblastoma.
Authors: Johnston Sandra K. , Adair Jennifer E. , Bridge Carly , Guyman Laura , Hawkins-Daarud Andrea , Rockne Russell , Baldock Anne , Rockhill Jason K. , Mrugala Maciej M. , Beard Brian C. , Kiem Hans-Peter , Swanson Kristin 
Published: March 2020

e13041 Background: Glioblastoma (GBM) is the most common and lethal of all brain tumors (median overall survival (OS)14.6 months), yet the incidence is low posing difficulty in creating statistically powered clinical trials, delaying advances in treatment. A patient-specific mathematical model for disease progression coupled with clinical imaging data may provide a tool for quantifying each individual tumor’s response relative to its inherent growth kinetics rather than a universal approach, and, potentially, predicting treatment efficacy. Methods: An exploratory analysis with a patient-specific mathematical model of GBM was used to evaluate therapeutic effect of a novel treatment for newly diagnosed GBM compared to standard care treatment. A cohort of 3 patients from a novel-chemoprotective stem cell gene therapy treatment study (CSCGT) received RT only, followed by dose-intense BCNU and infusion of autologous gene-modified hematopoietic stem cells. Patients then received TMZ combined with O6-benzylguanine (O6BG). Tumor volumes were calculated using T1 weighted gadolinium -enhanced and T2-weighted pretreatment MRI images to estimate patient-specific net rates of proliferation and invasion for predicting untreated tumor growth. Control patients were selected based on matching model-based rates of net proliferation and invasion and standard prognostic variables (age, performance, extent of resection). Deflection of tumor growth, days gained (DG), was determined by finding the time point on the untreated growth curve that corresponded to the post-treatment tumor size and calculating the amount of time treatment gained for the patient. DG per mg of TMZ dosed is used to compare treatment effects of TMZ with differing dose regimens. Results: CSCGT patients experienced higher DG per mg of TMZ dosed compared to their matched controls treated with standard care regimens. Conclusions: Patient-specific mathematical modeling can be used to evaluate treatment gains in small clinical trial design. The addition of O6BG to TMZ in the post RT milieu can provide greater treatment gains per mg of TMZ dose than TMZ alone. Clinical trial information: NCT 00669669.
A model-based approach to optimize detection of treatment effects in early oncology trials.
Authors: Retout Sylvie , Phipps Alex , Geho David , Tessier Jean , Nichols Gwen L. , Bottino Dean 
Published: March 2020

e13508 Background: Tumor size change from baseline (RECIST) is often used to assess antitumor activity of investigational agents in phase 1 trials, but this measure does not take into account the tumor growth rate (TGR) prior to treatment. TGR could be highly variable in a phase 1 ‘all-comers’ patient population, with a high TGR potentially masking a meaningful treatment effect (TE). Assessing the change in TGR (Mehrara et al, BJC 2011) using historical tumor burden assessments (Gomez-Roca et al, Eur J Cancer 2011) may provide higher sensitivity to true TE (TTE). The objectives of the current study are to formalize a Growth Rate Based Method (GRBM) and to compare, using simulated patients, the ability of GRBM and RECIST assessments to detect and quantify TTE. Methods: The exponential tumor growth model (Claret et al, J Clin Oncol. 2009) was used to simulate the sum of the longest diameters (SLD) individual time courses of 2000 virtual patients under different TGR scenarios: slow, medium, fast and ‘all comers’ (highly variable TGR as often encountered in phase 1). Different sampling designs were simulated wherein tumor assessments with measurement errors were obtained, ranging from 16 to 4 weeks prior to treatment initiation (TI), immediately before TI, and 8 and 16 weeks after TI. TTE was defined as the difference between the simulated SLDs at 16 weeks with and without treatment. GRBM response was defined as the model-predicted difference between the SLDs with and without treatment, as estimated from the simulated samples. Sensitivity (Se) of RECIST or GRBM was defined as the probability of classifying a patient as a RECIST or GRBM >30% reduction when the TTE >30%, and specificity (Sp) as the probability of RECIST or GRBM reduction <30% when TTE <30%. Results: RECIST Se was consistently inferior to GRBM, notably in the all-comers TGR (37% vs 74-89%) scenario. GRBM maintained Se (71-89%) irrespective of TGR whereas RECIST Se degraded significantly with increasing TGR. RECIST Sp was high (97-100%) while GRBM Sp was lower (55-80%) depending on sampling design and TGR. Conclusions: Incorporation of an additional pretreatment tumor assessment by GRBM may augment RECIST by increasing sensitivity to TTE, particularly in a heterogeneous TGR phase 1 setting.