bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemoradiation and maintenance chemotherapy with cisplatin and 5-fluorouracil in anal squamous cell carcinoma
Authors: Ahn J. , Cho B. , Choi H. , Jeung H. , Rha S. , Roh J. , Kim G. , Kim B. , Chung H. 
Published: March 2020

14057 Background: Chemoradiation is the standard treatment for anal carcinoma. Mitomycin-C (MMC) with 5-fluorouracil (5-FU) is the widely used regimen, but MMC is not a radiation sensitizer and has significant toxicities. This study was conducted to update our experience in treating anal carcinomas with an external beam radiation and continuous infusion of 5-FU with cisplatin. Methods: Twenty-eight patients with locally advanced squamous cell carcinoma of the anus were treated between 1995 and 2005. The primary tumor and involved lymph nodes received a total of 41.4–64.8 Gy and 39.6–60.4 Gy, respectively. Chemotherapy consisted of 5-FU (1,000 mg/m2 CI, D1–5 and D36–40) and cisplatin (80 mg/m2 IVF, D2 and D37) q 4weeks for 4 courses. Results: One patients had T1 lesions, 15 had T2, 7 had T3, and 5 patients had T4 disease. Seventeen patients presented with clinically detectable lymphadenopathy. Eight patients failed to start maintenance chemotherapy due to events during chemoradiation. Of the 19 patients who started maintenance chemotherapy, 3 failed to complete all four courses due to intolerance to chemotherapy. With a median follow-up duration of 68.5 months, the actuarial 5-year OS rate was 83.2 %, the DFS rate 80.7%, and the colostomy-free survival was 91.7%. Patterns of recurrence were local relapses in 3 patients, distant metastases in 2, and both in 1, respectively. Seventeen patients (60.7%) developed moist skin reaction, which frequently caused the interruption of radiotherapy. Principal grade 3/4 hematologic toxicities were neutropenia in 10 patients (35.8%) and thrombocytopenia in 4 (14.2%). The most common late complications were lymphedema (14.3%). Conclusions: Our results demonstrate that combined modality therapy with external beam radiation, cisplatin and 5-FU yields an excellent outcome in terms of survival and sphincter preservation which is comparable to the results of MMC regimens. No significant financial relationships to disclose.
Single-agent pemetrexed in patients with advanced and metastatic hepatoma
Authors: Cohn A. , Myers J. W. , Mamus S. , Deur C. , Nicol S. , Hood K. E. , Khan M. M. , Ilegbodu D. , Asmar L. 
Published: March 2020

14064 Background: The incidence of hepatoma is rising in the United States, primarily due to the increase in the prevalence of hepatitis C. Surgical treatments are rarely an option for patients with advanced hepatoma, and while chemotherapy, particularly with doxorubicin-based regimens, has marginally prolonged survival, response rates have been poor with the burden of high toxicity. Pemetrexed, a folate antimetabolite, has demonstrated activity in hepatoma cell lines with a manageable toxicity profile, making it a potentially useful agent in hepatocellular carcinoma. Methods: A multicenter, Phase II study was conducted to assess the response rate and evaluate the toxicity profile of single-agent pemetrexed (ALIMTA) in first-line patients with advanced or metastatic hepatoma. Pemetrexed 600 mg/m2 IV was administered on Day 1 of each 21-day cycle until disease progression (PD). Patients were premedicated with dexamethasone 4 mg PO BID and received daily folic acid 350–1000 μg PO and Vitamin B12 1000 μg IM every 9 weeks. Results: This nonrandomized study employed Simon’s 2-stage design. There were 21 eligible patients enrolled in the first stage, and all 21 patients were enrolled within 4 months of trial opening. Median age was 72 years (range, 44–88), and most patients were white (62%) and male (81%). Ten percent (10%) had an ECOG PS of 2, 48% Stage IV disease, 52% prior surgery, and 33% tumors of unknown histological grade. The plan was to stop accrual if ≤2 responders were observed among the 21 patients. Of the 21 patients, 3 had SD, 2 had early toxicities (renal/liver failure, sepsis), 15 progressed, and 1 was noncompliant. The trial was closed due to lack of response. The most common Grade 3 hematological toxicities were neutropenia 6/21 (28.6%) and thrombocytopenia 3/21 (14.3%). One patient experienced both Grade 3 nausea and vomiting. There were no Grade 4 toxicities. There were 10 on-study deaths: 9 PD and 1 liver failure. None of the deaths were drug-related. The median actual survival was 2.5 months (range, <1–8). Conclusions: While pemetrexed was well tolerated in this patient population, it was not active. Most adverse events were related to disease state, not study treatment. Supported by Eli Lilly and Company, Indianapolis, IN [Table: see text]
Prognostic significance of CD44s expression in bile duct carcinomas
Authors: Lee K. , Shim Y. , Lee S. , Cho M. , Mun Y. , Seong C. , Lee S. 
Published: March 2020

14071 Background: CD44 is a surface glycoprotein and has a key role for surface hyaluronan receptor, which is associated with adhesion and metastasis in many solid tumors. There are CD44 standard isoform (CD44s) and ten variant isoforms (CD44v1–10). CD44s and CD44 variant 6 (CD44v6) were evaluated to clarify the applicable prognostic factor in patients with bile duct carcinomas. Methods: A retrospective study was performed in bile duct carcinomas. Immunohistochemical stain was done with primary antibodies for CD44 (Novocastra, Newcastle upon Tyne, UK) and CD44v6 (Novocastra) using automated machine (Vision Biosystems, Mount Waverley, VIC, Australia) and bond polymer detection system with counterstain (Vision Biosystems) in paraffin embedded tissues. The extent of staining categorized as 0% (none), <10% (weak), 10%-50% (moderate), and >50% (strong). Clinical characteristics including age, sex, stage, grade and overall survival were reviewed. Results: Ninety six patients (M:F=35:61) were evaluated and the median age of these patients was 64 years old (37∼86). The rate of overexpression (>10%) of CD44s was 50% and the rate of CD44v6 expression was 16.9%. With median 34.2 months of follow up, the overall survival of total 96 patients was 12.2 months. The Cox proportional hazards test identified CD44s overexpression. (HR:2.379, 95% CI:1.195–4.736, p=0.014) and the stage as prognostic factors. But the expression of CD44v6 (weak vs. moderate to strong, HR:3.983, 95%CI:0.295–1.588, p=0.377) showed no prognostic significance on overall survival. Conclusion: CD44s overexpression can be a poor prognostic marker in bile duct carcinomas. And there is a potential to apply postoperative investigational or aggressive therapy in this poor prognostic group. No significant financial relationships to disclose.
The role of alpha-fetoprotein in maintaining the growth of human hepatoma cells
Authors: Li M. , Zhou S. , Liu X. , Li G. 
Published: March 2020

14081 Background: This study was to explored the functional mechanism of alpha-fetoprotein (AFP) in maintaining the proliferation of human hepatoma cells line Bel 7402 and the immunsuppression of lymphocyte Jurkat cells. Methods: Western blot was used to detecting the expression of some apoptosis-related gene, fluorescence labeled AFP and confocal microscopy scanning for receptor binding assay in the membrane in Jurkat cells. Results: It showed that AFP could enhance the expression of survivin and c-ras, but restrain caspase-3 express in Bel 7402 cells by Western blotting analysis. It also showed that AFP could bind to the membrane of Jurkat cells by confocal microscopy scanning, and when treated Jurkat with AFP, it indicated that AFP could repress the expression of survivin and Livin and elevated the activity of caspase-3 in the cells; Co-cultured Bel 7402 cells with Jurkat cells, the expression of tumor necrosis related-apoptosis induced ligand (TRAIL) in Jurkt cells was inhibited, when pretreatment with monoclonal antibody of AFP (Anti-AFP), the restrained effect of TRAIL express and the activity of caspase-3 was elevated in Jurkat cells was removed. It also indicated that Anti-AFP had an ability to block these functions of AFP. Conclusions: AFP has a capability to promote the growth and escape from immune surveillance of human hepatoma cells through enhancing the expression of ras and survivin gene in Bel 7402 cells, suppressing TRAIL, survivin and Livin expressed and upregulated activity of caspase-3 in Jurkat cells. No significant financial relationships to disclose.
World-wide medical treatment practice in functional gastro-entero-pancreatic (GEP) tumors: The GEPTOSIS study
Authors: Pavel M. , Silva A. , Schupp J. , Bouterfa H. 
Published: March 2020

14097 Background: Because of their efficacy and safety profile, somatostatin analogues have become the preferred medical therapy for symptom control in functioning GEP tumors. There is significant medical interest on how the use of different treatment regimens in GEP tumor patients may impact the clinical course of the disease. The objectives of this study are to describe the clinical decision making in context of a medical treatment with a chosen dose of Sandostatin LAR, and to identify optimal dosing regimens which may lead to improved patient outcomes. Methods: GEPTOSIS (Neuroendocrine GEP Tumors: An Observational Study on the Impact of Sandostatin LAR) is an open label, multicenter, non-comparative, longitudinal, observational study in recently diagnosed, previously medically untreated, functionally active GEP neuroendocrine tumors (NET) such as carcinoid, insulinoma or glucagonoma. Observations will include the efficacy on biochemical parameters (Chromogranin A, 5-HIAA) and symptoms (flush and diarrhea), effect on tumor volume, safety and tolerability. Data are entered via a Palm based device and transferred to a central study database accessible by the study centers via a web-based study portal. Data from each patient will be collected under (conditions of) normal clinical practice in quarterly intervals over a period of 18 months. This study is planned to recruit up to 1500 patients and will involve about 300 sites world-wide. Results: At time of abstract submission, 133 sites have committed to enroll 495 patients and further sites are being recruited to meet the targeted 1500 patients. Results of a first interim analysis will be presented. Conclusions: With increasing enrollment into the GEPTOSIS study, more data on prescribing and dosing patterns in recently diagnosed GEP NET patients are expected to be available throughout 2006. [Table: see text]
A phase II trial of combination of capecitabine, oxaliplatin with bevacizumab in treatment of advanced hepatocellular carcinoma (HCC): Preliminary safety analysis
Authors: Hewitt M. R. , Sun W. , Haller D. G. , Mykulowycz K. , Tuite C. M. , Rosen M. A. , Soulen M. C. , Caparro M. , Giantonio B. J. , Olthoff K. M. 
Published: March 2020

14098 Background: Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third leading cause of cancer-related death, with increasing incidence in USA. Most patients with HCC are unsuitable for surgery. There is no generally accepted ‘standard’ chemotherapy regimen for HCC because of the heterogeneity of disease and poor liver function in many patients. Continuous efforts have been made for investigating effective and tolerable therapy for patients with advanced HCC. This phase II study evaluates the feasibility and efficacy of the combination of bevacizumab, oxaliplatin, and capecitabine in patients with advanced/metastatic HCC. Methods: Patients with unresectable/untransplantable or metastatic HCC who have adequate bone marrow, liver and renal function (ANC ≥ 1,500/mm3, platelets ≥ 75,000/mm3, serum creatinine ≤ 2.0 mg/dl, total bilirubin ≤ 3.0 mg/dl, transaminases ≤ 5 upper limit of normal, and INR ≤ 1.5) are treated with the combination: intravenous bevacizumab (5 mg/kg) and oxaliplatin (130 mg/m2 over 2 hours) are administered on day 1 of each 21- day cycle. Capecitabine (825 mg/m2, twice a day) is given days 1 to 14. Results: To date, 17 patients (male/female: 14/3) with median age of 57 (range 27–76) have been treated. The mean number of treatment cycles is six. After 12 cycles of therapy, one patient was withdrawn from the treatment because of side effect; the other is continuing his 13th cycle of treatment. Six patients developed Gr. 2/3 oxaliplatin-related peripheral neuropathy and 4 patients had capecitabine-related Gr. 2/3 hand-foot syndrome. One patient had gastrointestinal perforation and sepsis right after his first administration of bevacizumab and oxaliplatin. There has been no treatment -related bleeding or arterial ischemia event noticed. Conclusions: The preliminary results suggest that the combination of bevacizumab, oxaliplatin, and capecitabine is encouraging and tolerable in treatment of patients with advanced HCC. [Table: see text]
Phase II trial of capecitabine and oxaliplatin in patients with advanced or metastatic pancreatic adenocarcinoma
Authors: Garrot L. C. , Berkenblit A. , Goldstein M. , Florendo E. , Underhill J. , Forino P. , Stuart K. 
Published: March 2020

14103 Background: Advanced pancreatic adenocarcinoma (PCa) portends a poor prognosis. Both capecitabine (CAP) and oxaliplatin (OX) have demonstrated activity in pancreas cancer, may be synergistic, and are well tolerated. We report the outcomes and toxicities of patients (pts) with PCa treated with CAP and OX in combination. Methods: Entry criteria: ECOG PS ≥ 2, adequate renal, hepatic and bone marrow function and at least one measurable lesion. Pts were allowed to have received one prior chemotherapy for advanced disease, or adjuvant therapy if completed more than 12 months prior. Pts received CAP 2000 mg/m2 po taken in two divided doses for 14 days starting on day one and OX 130 mg/m2 IV on day 1 of each 21 day cycle. Response was recorded per RECIST criteria. Results: Sixteen pts have been enrolled, 14 have been treated (2 pts suffered rapid decline prior to start) thus far. The average number of cycles was 2.7, and 3 pts received 4 or more cycles. Of 10 evaluable pts, 6 had stable disease, 1 had a partial response and 3 had progressive disease. Of the 5 pts who had received prior chemotherapy with progression, 3 had stable disease, and one had a partial response, and 1 had progressive disease. Of the 5 pts who had not recieved prior chemotherapy, 3 had stable disease and 2 had progressive disease. Median time to progression was 7 weeks. Four pts are still undergoing treatment. Toxicity was acceptable in the12 pts evaluated. Three grade 4 events occurred and were unrelated to therapy (venous thromboembolism, stroke, hyperbilirubinemia). Grade 3 toxicity was noted in 5 pts (fatigue, nausea, vomiting and diarrhea). Grade 1/2 toxicity was minimal, predominated by neurosensory deficits in 7 pts, hand foot syndrome (HFS) in four pts, and nausea in 4 pts. Two pts stopped therapy due to toxicity, one for HFS (grade 2) after 1 cycle, and one for diarrhea (grade 3) after two cycles. Four pts required dose reduction. Conclusion: The combination of CAP and OX is reasonable and tolerable treatment of pancreas cancer with activity even in pts receiving second line chemotherapy. Accrual is ongoing. No significant financial relationships to disclose.
Dose-dense chemotherapy with modified TCF regimen (TCF-DD) in metastatic gastric cancer (MGC): A feasibility study
Authors: Dalla Chiesa M. , Tomasello G. , Buti S. , Negri F. , Buononato M. , Lazzarelli S. , Brighenti M. , Donati G. , Cattaneo M. , Passalacqua R. 
Published: March 2020

14117 Background: Previous studies reported that in early breast cancer, lymphomas and bladder, dose-dense chemotherapy is more effective than conventional treatments. In MGC chemotherapy with Docetaxel, Cisplatin and 5-FU (TCF) q3w is very active. Based on these studies, we tested for the first time the feasibility and activity of an intensified dose-dense TCF regimen (q2w) modifying the 5-FU continuous infusion with Folinic Acid/5-FU, according to the “De Gramont regimen.” Methods: patients (pts) with histologically confirmed measurable MGC, ECOG PS 0–3 received up to six cycles of Docetaxel 85 mg/m2 day (d) 1, Cisplatin 75 mg/m2 d 1, L-Folinic Acid 100 mg/m2 d 1 and 2, followed by 5-FU 400 mg/m2 bolus d 1 and 2 and then 600 mg/m2 as a 22-hour continuous infusion d 1 and 2, every 14 days, plus Granulocyte-Colony Stimulating Factor 5 μg/kg/d, from day 4 to 10 of each cycle or pegfilgrastim 6 mg on day 3. Pts with a PS > 1 and/or age > 65 years and/or pre-treated for the advanced disease, received the same schedule with a dose reduction by 30%. Results: 16 consecutive pts were enrolled (81% male, 19% female; median age: 60, range 40–79; median ECOG PS:1, range 0–3). Two pts received previously chemotherapy for the advanced disease. A median of 4 cycles (range 1–6) per patient were administered. Eleven pts were evaluated for response (3 too early, 2 early deaths) and 13 for toxicity; 1 CR (multiple liver metastases), 6 PR, 2 SD and 2 PD were observed, for an overall disease control rate, by intention to treat, of 69% (95% CI 44–95). No treatment delays were observed in 5 pts (PS 0–1, < 65 years old and all but one chemo-naïve); 8 pts did not respect the schedule (4 had PS >1, two of whom were > 65 years old; 4 were > 65 years old with PS 0–1). Grade 3/4 neutropenia (all not febrile), thrombocytopenia, and anemia occurred in 61%, 23% and 0% of pts, respectively. Grade 3/4 nausea/vomiting occurred in 15%. Conclusion: A dose-dense TCF regimen in MGC is feasible and active and deserves to be tested in randomised studies. No significant financial relationships to disclose.
PET/CT imaging in patients with suspected recurrence of pancreatic cancer
Authors: Epelbaum R. , Bar-Shalom R. , Keidar Z. , Gaitini D. , Haddad R. , Israel O. 
Published: March 2020

14137 Background: The goal of the study was to review our clinical experience with 18F-FDG PET/CT in patients (pts) with suspected recurrence of pancreatic cancer. Methods: Nine pts (M/F=3/6, age 47–73y) with increasing levels of CA 19–9 and/or CEA during follow-up and negative or equivocal CT scan were included. Seven pts were asymptomatic and 2 pts had mild abdominal pain. Previous treatment included pancreaticoduodenectomy in 6 pts and distal pancreatectomy in 3 pts. Adjuvant chemoradiation was given to 5 pts as well. Tumor markers first increased 2 to 14 months after the operation. CT scan was done within one month in all pts, and found to be normal in 6 pts and equivocal in 3 pts. PET/CT was performed one months (5 pts), 2 months (2 pts) and 3 months (2 pts) later. However, the last 2 pts had a 2nd normal CT scan 1–2 months after the PET/CT. A final diagnosis of recurrence was confirmed by histopathology or by further clinical and radiologic follow up. Results: Of the 9 pts, 8 exhibited PET/CT findings consisted with recurrent cancer. Increased tracer uptakes with abnormal findings on CT were found in 5 pts with CT scan previously defined as normal ( 2 in tumor bed and 3 in distant sites, 1 liver, 1 liver and lymph nodes, 1 abdominal wall). PET/CT was also positive in 3 pts with equivocal CT findings (2 tumor bed, 1 liver with a new unsuspected positive site in tumor bed). Chemotherapy (followed by surgery in 1 pt and by radiation therapy in 1 pt, both with local recurrence) was instituted in 7 pts following PET/CT findings. One pt underwent resection of an isolated abdominal recurrence. After a median follow-up of 7 months (range, 4 -27 m) 4 pts had died of disease, 2 are alive with progressing disease, one has responded to treatment (PET/CT became normal) and one is undergoing ghemotherapy. One of the 9 pts had a false negative PET/CT test, as abdominal spread was later found by an additional CT scan, still with a 2nd negative PET/CT image. Conclusions: PET/CT is a useful tool for detecting recurrent pancreatic cancer, and can demonstrate recurrence site when CT is non-diagnostic. Its impact on clinical management and treatment results should be further evaluated. No significant financial relationships to disclose.
Abdominal catecholamine producing paragangliomas: A rare disease
Authors: Karras R. , Sardi A. 
Published: March 2020

14144 Background: Paragangliomas are rare extra-adrenal neuroendocrine tumors of chromaffin cells. It is estimated that 90 percent of paragangliomas are intra-abdominal. 50% of which are catecholamine secreting. Patients with abdominal masses are not routinely screened. A literature review and our experience is reported. Methods: A retrospective literature review of 85 cases reported over the past 26 years are discussed with regard to age, gender, clinical presentation, catecholamine status, preoperative evaluation, clinical course and outcome. Additionally, a review of compiled data from 1997 to 2005 identified 4 cases at our institution. Results: Males numbered 57.3% of the cases reviewed. The mean age was 57.9 years (range 11–76). The primary site of tumor included: 42 retroperitoneal, 44 intra-abdominal and 1 multifocal. 61/89 (68.5%) reported elevated urine and/or plasma catecholamines. Clinical presentations included, abdominal pain (10%), hematuria (3%), and a history of hypertension (46%). Only one case presented as an incidental finding. Primary work-up consisted of a CT scan in 86/89 (96.6%) of cases. Tumor size ranged from 1.2 cm to 25 cm. CAT scan preceded appropriate medical therapy with alpha blockade, and subsequent surgical excision via laparoscopy, laparotomy and one case of ERCP. Of the 63 cases which reported follow-up, 2 patients developed metastatic disease, 1 patient had unresolved hypertension and 60 were disease free. Conclusions: This retrospective review demonstrates the importance of pre-operative screening for safe and efficacious treatment of patients with paragangliomas. No significant financial relationships to disclose.
Weekly paclitaxel, oxaliplatin, 5-FU and leucovorin in the treatment of metastatic pancreatic cancer
Authors: Chue B. , Chen N. 
Published: March 2020

14146 Background: Patients with metastatic PC have poor prognosis due to lack of effective treatment options. We did a pilot study on weekly chemotherapy with TOFL in the treatment of patients with advanced PC associated with severe clinical symptoms. Methods: 4 patients age 35 to 56 with biopsy proven metastatic PC were treated with weekly T: 50 mg/m2, O: 60 mg/m2, L: 20 mg/m2 and F: 425 mg/m2. One patient (A.B.) also received intermittent Cetuximab. Pre-medication with I.V. Glutathione and calcium magnesium was routinely used to prevent Oxaliplatin-related sensory neuropathy. Patients were seen every week. Sequential CA19–9 levels and CT scans were obtained for followup. Results: After 12 weeks of treatments, all 4 patients had dramatic reduction of CA 19–9 levels (see table) and improvement of cancer-related symptoms. 3 patients now have normalization of CA19–9 levels. Patient D.P. had bilirubin of 27 and severe abdominal pain after disease progression following first-line chemotherapy. His bilirubin returned to normal range and abdominal pain resolved after 6 weeks on the protocol. Patient A.B. was severely debilitated (ECOG 4) following progression of disease after 2 prior lines of chemotherapy. He is now alive over a year with PR and ECOG 1. Patient L.C. presented with bilirubin of 9.6, nausea and abdominal pain. Her total bilirubin normalized and GI symptoms resolved after 12 weeks. Patient I.S. had disease progression with liver metastasis and worsening abdominal pain after failing 2 lines of prior chemotherapy. Her CA 19–9 decreased by over 80% and abdominal pain resolved after 12 weeks. The regimen was well tolerated with only one grade 3 neurotoxicity. Conclusions: Weekly combination of Paclitaxel, Oxaliplatin, 5-Fu and Leucovorin has significant activity against advanced PC with manageable side effects. Phase II study is underway. [Table: see text] No significant financial relationships to disclose.