bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer-related self-efficacy in African American prostate cancer patients compared to whites
Authors: Purnell J. Q. , Palesh O. , Mustian K. , Peppone L. , Morrow G. , Colman L. K. , Lord R. , Flynn P. J. 
Published: August 2020

5067 Background: African American (AA) men are nearly twice as likely as white (W) men to be diagnosed with prostate cancer. Cancer-related self-efficacy (i.e., confidence in one's ability to manage cancer) has been associated with better physical and psychosocial functioning, but little is known about self-efficacy in African American prostate cancer patients. This study compared AA and W ratings of cancer-related self-efficacy for 308 prostate cancer patients (M age = 66.13, SD = 8.48; 9% AA) who participated in a group therapy intervention. Method: Independent groups t-tests were used to determine whether there were significant differences at baseline in mean scores for each group on the Stanford Self-Efficacy Scale (SSE), which asks respondents to rate their confidence in the ability to cope with cancer on a 0–100 scale, with 0 indicating no confidence. SSE subscales measure self-efficacy in the ability to: a) communicate with family, friends, and healtcare providers; b) focus and relax; and c) cope with the possibility of dying. Results: A significant difference was observed on SSE total scores (AA mean = 60.39 vs. W mean = 72.70; t = 3.30; p = 0.003). There were also significant differences on the Focus/Relax (AA mean = 68.90 vs. W mean = 77.64; t = 2.04; p = 0.011) and Cope with Dying (AA mean = 49.72 vs. W mean = 70.12; t = 4.85; p = 0.001) subscales, with a trend towards significance on the Ability to Communicate (AA mean = 62.55 vs. W mean = 70.76; t = 3.36; p = 0.095). Conclusions: Results suggest that, compared to W men, AA men have less confidence in their ability to cope with prostate cancer following diagnosis. AA men report the least confidence in their ability to cope with the possibility of death as a result of cancer, and they also report less confidence in their ability to focus and relax. They may also have greater difficulty discussing their cancer with family, friends, and healthcare personnel. As cancer-related self-efficacy has been linked to symptom-related and psychological adjustment, interventions targeting self-efficacy in AA prostate cancer patients are needed that are tailored to their unique needs. No significant financial relationships to disclose.
Race and survival following brachytherapy-based treatment for men with localized or locally advanced adenocarcinoma of the prostate
Authors: Winkfield K. M. , Chen M. , Dosoretz D. E. , Salenius S. A. , Katin M. J. , Ross R. , D’Amico A. V. 
Published: August 2020

5068 Purpose: We investigated whether race was associated with risk of death following brachytherapy-based treatment for localized prostate cancer. Methods: The study cohort was comprised of 4,880 men with clinical stage T1–3N0M0 prostate cancer and minimum follow-up of 2 years who underwent brachytherapy-based treatment at 20 centers within the 21st Century Oncology consortium. A Cox regression multivariable analysis was used to evaluate the risk of death in African-American (AA) and Hispanic (H) men as compared to Caucasian men adjusting for age, pretreatment PSA, Gleason score, clinical T stage, year and type of treatment, and comorbidity level. Results: After a median follow-up of 5 years, there were 924 deaths. AA and H race were significantly associated with an increased risk of ACM (adjusted hazard ratio [AHR] 1.42 and 1.66, [95% confidence interval (CI): 1.01 to 1.99 and 1.14 to 2.41]; p = 0.045 and 0.008, respectively). As shown in the table , other factors significantly associated with an increased risk of death included age (p<0.001), PSA (p = 0.02), Gleason score 8 to 10 (p = 0.001), year of brachytherapy (p<0.001), and presence of 2 or more significant comorbidities (p = 0.003). The risk of ACM was decreased following trimodality therapy (p = 0.02). Conclusions: African-American and Hispanic race as compared to white race appear to confer a higher risk of mortality following brachytherapy-based treatment in men with localized or locally advanced prostate cancer. [Table: see text] No significant financial relationships to disclose.
Impact of race on survival of prostate cancer patients treated with noncurative intent
Authors: Hatcher D. , Rose A. E. , Christos P. J. , Mazumdar M. , John M. , Taneja S. S. , Lee P. , Osman I. 
Published: August 2020

5069 Background: We previously reported that African American (AA) men have a higher recurrence rate than Caucasian (CA) men treated with radical prostatectomy at the New York Veteran Administration Medical Center (NY-VAMC), an equal access to care facility (J Urol. 2006). In the current study, we attempted to examine the differences in survival of AA and CA prostate cancer (PC) patients with clinically detected localized disease treated with non curative intent. We hypothesized that comparing patients whose PC was not altered by primary treatment might give a better idea about the difference, if any, of the natural history of PC in AA compared to CA patients. Methods: Men diagnosed with PC at NY-VAMC during 1990–2005 were identified. Inclusion criteria were: 1) biopsy confirmed PC; 2) no evidence of metastatic disease within 6 months after diagnosis; 3) no curative intent treatment. Results: The study included 530 men (288 AA and 242 CA) with median follow-up of 8.1 years (range: 0.6–17.6 years). AA men presented with significantly higher PSA compared to CA patients (median 18.5 versus 11.4 respectively, p = 0.004), however, there were no differences in age at presentation (median 73 versus 74, p = 0.98) or Gleason score (23% of AA and CA had Gleason >7, p = 0.92). Of the 530 patients, 198 (37%) are alive with disease, 67 (13%) died of prostate cancer, 206 (39%) died of other causes, and 59 (11%) died of unknown causes. AA patients had shorter median overall survival compared to CA patients (8 versus 9 years, respectively), however, the difference was not significant (p = 0.29). Factors most predictive of mortality by Cox regression multivariable analysis were PSA at diagnosis (p = 0.001), Gleason score (p = 0.04), and age of patient at diagnosis (p < 0.0001). Race was not an independent predictor of mortality in this model (p = 0.37). Competing risk analysis distinguishing the types of death is underway. Conclusions: The extended follow up available for our study cohort points to non PC related mortality as the major cause of death in patients treated with non-curative intent. No significant financial relationships to disclose.
A phase II randomized four-regimen selection trial incorporating response for sequential chemotherapy in metastatic, unresectable urothelial cancer: Final results from the M. D. Anderson Cancer Center
Authors: Siefker-Radtke A. O. , Kamat A. M. , Williams D. L. , Tannir N. M. , Tu S. , Pagliaro L. C. , Dinney C. P. , Millikan R. E. 
Published: August 2020

5071 Background: We developed a clinical trial incorporating response into the treatment algorithm. Patients meeting a certain threshold of response continued with the same treatment; those with insufficient response were switched to alternative chemotherapy. We now report on final results from this trial. Methods: Patients were randomly assigned to one of four regimens: ifosfamide, doxorubicin, gemcitabine; ifosfamide, paclitaxel, cisplatin; gemcitabine, cisplatin; or cisplatin, gemcitabine, and ifosfamide. To continue with chemotherapy, patients must have had at least a 40% response after the first 6-week interval, and a >90% response after the second 6 weeks. Otherwise, they were re-randomized to alternate chemotherapy. Overall success (OSX) was defined as patients with a >90% response with either front-line or second-line therapy. Surgical consolidation was offered to patients at the discretion of their treating physician. Results: Median overall survival (OS) for 120 patients was 19.1 mo. (3 and 5-yr survival: 33% and 20%). OSX was achieved in 41 patients (median OS: 51 mo.); the median OS in the other 79 patients was 15 mo. (p = 0.0001), with a 5-yr survival of 42% and 10% respectively. Surgical consolidation was performed in 35 patients: 23 with nodal metastases to pelvic and/or RPLN, 6 with cT4b tumors, and an additional 6 patients with distant metastases. Their median OS from surgery was 23.7 months, (5-yr survival: 31%). Surgical consolidation in the setting of OSX was associated with a 42% 5-yr survival as compared to 11% in those undergoing surgery in the absence of OSX. Visceral metastases and poor performance status were associated with a worse prognosis. Conclusions: With sequential therapy, 34% of patients had a >90% response (OSX). A potential benefit in long-term survival was seen in patients who had surgical consolidation in the setting of OSX. This trial design provides a novel method for assessing the benefits of sequential chemotherapy, and enhancing the population of patients who may be offered surgical consolidation in the setting of initially unresectable, or metastatic urothelial cancer. No significant financial relationships to disclose.
Adjuvant chemotherapy for high-risk upper tract urothelial carcinoma: Results from the Upper Tract Urothelial Carcinoma Collaboration
Authors: Hellenthal N. , Shariat S. F. , Margulis V. , Karakiewicz P. I. , Roscigno M. , Bolenz C. , Remzi M. , Weizer A. , Zigeuner R. , Koppie T. M. ,   Upper Tract Urothelial Carcinoma Collaboration
Published: August 2020

5075 Background: There is relatively little literature regarding the use of adjuvant chemotherapy following radical nephroureterectomy in the management of patients with upper tract urothelial carcinoma (UTUC). Our goal was to determine the incidence of receipt of adjuvant chemotherapy in high-risk patients and the ensuing effect on overall- and cancer-specific survival. Methods: Using an international collaborative database, we identified 1390 patients who underwent nephroureterectomy for non-metastatic UTUC between the years of 1992 and 2006. Of these, 542 (39%) patients were classified as high-risk (pT3N0, pT4N0, and/or lymph node positive). These patients were separated into two groups—those who did and did not receive adjuvant chemotherapy—and were stratified by gender, age group, performance status, tumor grade and stage. Cox proportional hazard modeling and Kaplan-Meier analyses were used to determine overall- and cancer-specific survival amongst the cohorts. Results: Of the high-risk patients, 121 (22%) received adjuvant chemotherapy. Adjuvant chemotherapy was more commonly administered in the context of increased tumor grade and stage (p < 0.001). Median survival in the entire cohort was 24 months (range 0–231 months). There was no significant difference in overall- or cancer-specific survival between those who did and did not receive adjuvant chemotherapy; however age, performance status, tumor grade, and tumor stage were significant predictors of both overall and cancer-specific survival. Conclusions: Adjuvant chemotherapy is infrequently utilized in the treatment of patients with high-risk UTUC after nephroureterectomy. Despite this, it appears that adjuvant chemotherapy confers minimal impact on overall- or cancer-specific survival in this group. No significant financial relationships to disclose.
Major prognostic value of modeled AUChCG-AFP, a dynamic kinetic marker characterizing tumor marker decline of nonseminomatous germ cell tumors (NSGCT) intermediate-poor-risk patients according to the IGCCCG
Authors: Boyle H. , You B. , Fronton L. , Ribba B. , Girard P. , Tranchand B. , Tod M. , Coquelin H. , Droz J. , Flechon A. 
Published: August 2020

5085 Background: The level of human chorionic gonadotrophin (hCG) and alpha-foetoprotein (AFP) serum tumor marker is well established in NSGCT as prognostic factor, the relevance of marker kinetic analysis under treatment is still unclear. This may be due to the inaccuracy of methods employed so far, simplifying complex exponential decrease curves by a median half-life (HL). We propose to model patient's AFP and hCG decline profiles in order to calculate area under the curve of marker concentrations versus time (AUChCG-AFP) and to test its prognostic value. Methods: Our retrospective study involved 65 pts treated by 4 cycles of bleomycin-etoposide-cisplatin (BEP) regimen for an intermediate-poor-risk group NSGCT in the same center between 1997 and 2008. A kinetic population approach with NONMEM software was used to model equations of hCG and AFP individual decrease profiles between day 7 (D7) and D42 after the first BEP cycle. AUChCG and AUCAFP were calculated between day D0 and D42 as: AUC0–42=AUC0–7+AUC7–42 where AUC0–7 = trapezium area between D0 and D7 while AUC7–42=integral of modeled equation. Survival univariate and multivariate analyses tested the prognostic value of AUChCG-AFP regarding PFS. Results: Mono-exponential models best fitted AFP and hCG decreases: CAFP (t) = 381*e - 0.14 *t +3.27 and ChCG (t) = 1230*e - 0.25 *t +1.22. Three prognostic groups (AUChCG-AFP) were determined according to AUCAFP median and AUChCG terciles: good if AUCAFP<=11729.4 and AUChCG0–42<=6670; intermediate if AUCAFP>11729 and/or if 6670<=AUChCG<18178 and poor risk if AUChCG>18178 whatever AUCAFP. AUChCG-AFP was a significant prognostic factor in the univariate analysis on the 2 year PFS (100% vs 73.8% vs 67.7%, p = 0.035) as well as IGCCCG score (poor/intermediate risk groups), primary site (mediastinal/other) and HLhCG-AFP. Yet AUChCG-AFP was the only significant independent factor in the multivariate Cox model (HR = 3.3, 95%CI = [1.2–9.2], p = 0.032). Conclusions: Modeled AUChCG-AFP is a dynamic kinetic marker characterizing NSGCT patient marker decline during BEP treatment. These results must be validated in a prospective cohort. It may be a major prognostic factor. No significant financial relationships to disclose.
On the necessity for postchemotherapy surgery for residual abdominal masses in metastatic nonseminomatous germ cell tumors (NSGCT) of testis
Authors: Harland S. J. , Welch R. , Huddart R. , Stenning S. , Pollock P. , Gabe R. 
Published: August 2020

5088 Background: Residual abdominal masses after chemotherapy for metastatic NSGCT of testis may contain viable tumor-derived tissue which can be a nidus for relapse of disease, particularly when the tissue is frankly malignant. This justifies routine retroperitoneal lymph node dissection (RPLND) for large masses where malignant tissue is found at an appreciable rate. Yet RPLND is often carried out for smaller, or even absent, residual masses and differentiated teratoma (TD) is commonly found. There is little data on the consequence of leaving these smaller masses in situ, which is the practice in some units in the UK. Methods: 51 patients were identified from the MRC patients entered into the TE20 trial of 3 vs 4 cycles of BEP for good prognosis metastatic NSGCT who fell into the following category: metastatic NSGCT, residual abdominal mass only, unresected post-chemotherapy, response evaluation: CR or PR marker -ve. Collaborators were asked to report on mass size, relapse status, whether an operation was ever performed and the latest CT appearance. Results: 51/51 responses were received. Follow-up from the end of chemotherapy was >3years in all but two cases and the median was 5 years. When later surgery was carried out, for persistence or enlargement of the masses, the specimens contained TD with or without necrosis. One patient suffered a relapse one year after the surgery which took place 4.5 years after chemotherapy. Of the 41 patients who did not undergo surgery, 37 were considered on subsequent CTs to have normal appearances without further treatment. Conclusions: For patients with small residual masses in good prognosis metastatic disease no short or medium term benefit from routine surgery would have been seen. Its role in this situation is therefore questionable. For larger (>14mm) masses the need for routine surgery merits further study. [Table: see text] No significant financial relationships to disclose.
Macroscopic versus microscopic vascular tumour invasion in patients with clear cell renal cell carcinoma: Does it make a difference?
Authors: Zigeuner R. , Hutterer G. , Chromecki T. , Rehak P. , Pummer K. 
Published: August 2020

5093 Background: We evaluated the prognostic impact of macroscopic vs. microscopic vascular invasion on metastasis-free survival in a large European single centre series of patients with RCC over a period of 23 years. Methods: The pathology reports of 2333 consecutive patients operated between 01/1984 and 12/2006 were re-evaluated with regard to histological subtype, pT categories (TNM 2002), tumor grade, lymph node status, tumor size, presence of necrosis, and vascular invasion (defined as either absent, microscopic, or macroscopic). Only patients with unilateral clear cell (CC)-RCC and no distant metastases at operation were included. Metastasis-free survival probabilities for patients with absent, microscopic, or macroscopic invasion were evaluated using the Kaplan-Meier method and the log-rank test. For multivariate analysis, a Cox's proportional hazards model was used. Results: Out of 1797 CC-RCC-patients fulfilling the selection criteria, 1754 (97.6%) with complete data including follow-up were evaluated. Microscopic and macroscopic invasion was noted in 99 (5.6%) and 278 (15.8%) tumours, respectively. After a mean follow-up of 95 months, 375/1754 (21.4%) patients developed distant metastases. 10-year metastasis-free survival probabilities were 84%, 55%, and 42% in patients with absent, microscopic, and macroscopic invasion (p < 0.0001 overall; p = 0.13 for microscopic vs. macroscopic). Multivariate analysis proved pT-categories, grade, node status, size, necrosis and overall vascular invasion (p < 0.0001; RR = 2.09, 95%CI = 1.46–2.98) as independent predictors of metastatic disease. When microscopic and macroscopic invasion were differentiated, microscopic invasion remained significant (p < 0.0001; RR = 2.19, 95%CI = 1.54–3.12) whereas macroscopic invasion was not an independent predictor. Conclusions: Our data indicate that both macroscopic and microscopic vascular invasions are associated with poor outcome. Microscopic invasion was an independent predictor of metastatic disease, whereas macroscopic invasion which is directly related to categories pT3b/c was not. Vascular invasion should be considered in prognostic models for patients with RCC. No significant financial relationships to disclose.
A randomized, open label, prospective study comparing the association between sorafenib (So) and interleukin-2 (IL-2) versus So alone in advanced untreated renal cell cancer (RCC): Rosorc Trial
Authors: Procopio G. , Verzoni E. , Bracarda S. , Ricci S. , Sacco C. , Ridolfi L. , Porta C. , Miceli R. , Zilembo N. , Bajetta E. ,   on behalf of ITMO Study Group
Published: August 2020

5099 Background: So is an orally active multikinase inhibitor with a well documented activity in advanced RCC. IL-2 is a pleiotropic cytokine with antitumoral activity depending on dose and schedule. The aim of the study is to evaluate the activity and the safety of So and IL-2 association compared to So alone. Methods: In this multicenter, randomized, open label, phase II study, 128 previously untreated metastatic RCC patients (pts) were randomized to receive 400 mg of So, orally given twice daily continuously, in combination with IL-2, 4.5 MIU administered subcutaneously, five times a week for six consecutive weeks any eight weeks (arm A), or So alone (arm B) at the same dose. Therapy continued until progression of disease or unacceptable toxicity. The primary end point was progression free survival (PFS) and the secondary endpoints were response rate, safety and overall survival. Eligible pts had histological diagnosis of RCC, ECOG 0–2, no brain metastases, measurable disease and any Motzer's score. Pts were stratified according to different histotypes and Motzer's score. Results: All pts were enrolled from October 2006 to February 2008. Response rates (all partial responses, PR) were 23 % and 10 % in arm A and B respectively. Overall disease control rates (PR + stable disease SD) were 81 % versus 74 %. Tumour shrinkage was reported in 52 % and 34 % of arm A and B therapies respectively. Median PFS was 38 weeks (range 6–104+) for So + IL-2 and 30 weeks (range 6–102+) for So alone. PFS at 1 year was 31% in the combination therapy versus 22% in arm B. The most common adverse events (AEs) were asthenia, hand foot syndrome, hypertension, fever, diarrhoea and mucositis. AE were usually low or moderate in severity and always reversible and manageable. Grade 3–4 AE were reported in 33% and 22% in arm A and B, respectively. Conclusions: The safety and efficacy data suggest that the association So + IL-2 is safe and feasible and, compared to So alone, improves tumour shrinkage, disease control rate and PFS. [Table: see text]
A phase II trial of perifosine in patients with advanced renal cell carcinoma (RCC) who have failed tyrosine kinase inhibitors (TKI)
Authors: Cho D. C. , Figlin R. A. , Flaherty K. T. , Michaelson D. , Sosman J. A. , Ghebremichael M. , Bowers M. E. , Mier J. W. , Atkins M. B. , McDermott D. F. 
Published: August 2020

5101 Background: The recently demonstrated activity of inhibitors of TORC1 in RCC has raised the possibility that even greater effects may be achieved by targeting upstream of this pathway. Perifosine is a synthetic alkylphospholipid which inhibits Akt activity and also has cell-dependent effects upon the MAP-kinase pathway. Prior single-agent trials showed disease stabilization/regression in patients (pts) with advanced RCC; however, few pts were previously treated with a TKI. Therefore, we conducted a multi-center phase II trial to determine the safety and efficacy of perifosine in pts with advanced RCC refractory to VEGFR TKI. Methods: Primary objectives were to measure the % of pts progression-free at 12 weeks (wks) and overall progression-free survival (PFS) of perifosine (100 mg qhs). Secondary objectives included overall response rate (> PR), and safety, Eligibility: ECOG PS 0–1, pts with metastatic RCC who have RECIST defined progression on either sunitinib or sorafenib. Prior Rx with immunotherapy and bevacizumab was permitted. Normal organ and marrow function required. Results: From 4/07–10/08, 24 pts were treated at four sites. Median age 67 (range 47–78) and 16 were male; 90% of pts had predominantly clear cell histology. Prior sunitinib = 12; prior sorafenib = 12 (1.5 avg prior Rx). As of 12/08, all 24 pts were evaluable for PFS, response and toxicity as follows in the table . 6/24 pts remain on treatment (range 7 - 84 wks). Therapy was well tolerated with primarily Grade (G) 1 & 2 adverse events. G 3 & 4 events were: dyspnea (8%), hyponatremia (8%), pulmonary embolism (4%) and arthalgia (4%). Conclusions: Perifosine has promising activity in pts with RCC who have failed prior TKI therapy. The favorable toxicity profile suggests potential for combinational therapies with VEGF-targeted agents. Additional studies are under consideration to evaluate perifosine for clinical benefit in pts with previously treated RCC. [Table: see text] [Table: see text]