bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiologic model estimating number of Hodgkin lymphoma patients who relapsed after autologous stem cell transplant in the United States.
Authors: Lee Andrew , Abbe Adeline , Hamed Alaa , Neumann Frank , Olivares Robert , Younes Anas 
Published: March 2020

e12554 Background: Hodgkin Lymphoma (HL) is an uncommon lymphoid malignancy with an estimated 9,060 new cases and 1,170 patients dying of disease each year in the US. High dose chemotherapy followed by autologous stem cell transplant (ASCT) is standard treatment for relapsed or refractory HL. Patients who do not respond to or relapse after ASCT have a short survival and are candidates for investigational agents. In the absence of published studies, the primary objective of this study was to estimate the percent and number of patients with HL who relapsed after ASCT. Methods: Number of ASCT performed for HL patients and relapse rate reported in the literature was used to estimate number of HL patients who relapsed after ASCT. Number of ASCT in US with HL was extracted from 2008-2010 CIBMTR (Center for International Blood and Marrow Transplant Research) data assuming a stable number for 2010-2012. A literature review (1993-2012) using EMBASE identified relapse rate after ASCT in HL. A model was built using relapse rates at 12, 24, 36, 48 and 60 months. If there was no relapse rate at a time point, it was estimated by dividing nearest data point following relapse rate by period length. Rate differences at 12 and 24 months were used to estimate relapse rate for 2ndyear. Same methods were used to calculate other year rates. Results: An estimated 791 patients underwent ASCT for HL in 2012 based on prior years data. Three clinical trials and 9 epidemiological studies providing post-ASCT relapse rate were identified from the literature review. Relapse rates over 5 years and number of patients with relapsed HL after ASCT were estimated to be 44.7% and 352 patients, respectively, in 2012. Conclusions: : In the absence of published literature, a model was built to estimate the number of HL patients who relapsed after ASCT suggesting a high rate at 44.7% over 5 years. Because not all US centers participate in the CIBMTR registry, these numbers are likely to be conservative and actual rate may be higher. Clinical trials targeting this relatively small patient population with clear unmet medical need require collaborative efforts to enroll patients and more research to understand factors for patients relapsing post-ASCT.
Hereditary cancer families’ perceptions about biobanking as a healthy control.
Authors: Quinn Gwendolyn P. , Gwede Clement K , Sehovic Ivana , Pal Tuya , Meade Cathy 
Published: March 2020

e12556 Background: Biobanks are a promising way to identify links between genetic and environmental factors in relation to disease, particularly cancer. However, there has been skepticism among the general public about the purpose of biospecimen donation. Healthy people are beginning to be approached for participation in biobanking based on NIH initiative to establish national repositories. There is a great need to address public concerns about biospecimen donation. There may be additional and unique concerns among families with a history of hereditary cancer. Methods: Participants were recruited through research networks of families across the US who had received genetic counseling/testing. At-risk individuals (18 and over, no personal cancer diagnosis, first degree family member with cancer, had a test for hereditary cancer) completed a 15-item biobanking statement rating worksheet, selecting from 1 (strongly disagree), 2 (agree), 3 (not sure), 4 (disagree) and 5 (strongly agree). Results: 39 participants (100% white, 92.5% female) completed the worksheet. Most participants (87%) agreed confidentiality with medical information was important. 89% thought genetic research and biobanks were useful even if they only produced scientific knowledge instead of cancer cures. 87% felt the public should be consulted on ethical issues in biospecimen research, and permission should be acquired before conducting research on their samples (74%). 56% were unsure if they were exposing themselves to risk if they donated a specimen, while 46% were concerned that their specimen would be connected to their identity. Participants were uncertain if researchers should explain the use of each biospecimen (36% agreed, 33% unsure, 31% disagreed). 92% felt public education about biobanking would increase biospecimen donation. Conclusions: While participants were supportive of genetic research and biobanks, concerns regarding confidentiality and loss of privacy remain among unaffected carriers. There is a need to enhance existing training for researchers to improve understanding of high genetic risk community members’ perceptions about biobanking.
Long-term responders to first-line bevacizumab-based therapy among patients (pts) with HER2-negative metastatic breast cancer (MBC): Retrospective results of an ambispective observational study.
Authors: Ramos Vazquez Manuel , Redondo Andrés , Ghanem Ismael , Gil Gil Miguel J. , Garau Llinas Isabel , Perez-Carrion Ramon , Garcia-Garre Elisa , Rodriguez Cesar Augusto , Chacon Jose Ignacio , Lopez-Vivanco Guillermo , Perello Antonia , Espinosa Aunion Ruth , Morales Serafin , Ortega Vanessa , Garcia Saenz José Ángel , Martinez Noelia , Gonzalez Paula , Arcusa Lanza Angels , Echarri Maria Jose , Medina Ana 
Published: March 2020

e12558 Background: LORENA is an ambispective observational study evaluating B-based therapy in a real world setting which purpose is to assess clinical features, treatments and prognosis of HER2-negative MBC pts with ≥12 months (mo.) of PFS to 1st-line B-based chemotherapy (CT). Methods: Pts with MBC receiving 1st-line CT and B are enrolled. No prespecified schedules, doses or assessments. Data since the introduction of the treatment with B were collected at inclusion (retrospective phase), and prospectively at 18 mo. after enrollment for the patients alive at the time of inclusion, including B-targeted adverse events (AEs). Relevant baseline and on-study variables were analyzed by Cox model to identify independent effects on PFS. Results: By Jan 2013, complete retrospective data were available for 84 pts, 33 (39.3%) of them having stage III-IV at diagnosis. Median age, 50 years (r: 29–77); age ≥65 years, 13%; triple negative, 20.2%; bone/liver/lung metastases (%), 55/27/40; ≥2 metastases sites: 46.4%; ECOG status 0-1: 91.7%, ≥2: 5.9%, UK: 2.3%. 67% of pts have received prior (neo)adjuvant CT, with 56 and 30% of them with anthracyclines and taxanes, respectively. The objective response was 78%, including complete responses in 23%. A further 22% had stable disease. Median duration of B-based therapy was 12.4 mo. PFS events had been recorded in 44% of pts. Median PFS: 19.5 mo. (95%CI: 15.6-23.2). Cox proportional hazard multivariate regression model showed that B-based therapy ≥15 vs <15 mo was associated with improved PFS (26.5 vs 14.0 mo, p= 0.009; HR 0.40 [95%CI: 0.19-0.81]). The most common grade ≥3 B-related AEs were: Hypertension 9.5%, proteinuria 3.5%, bleeding 3.5%, and thromboembolic events 1.1%. No B-related death was reported. Conclusions: Outcomes in routine oncology practice for LORENA patients are consistent with those from prospective trials of 1st-line B-containing therapy and ATHENA study. These results suggest a benefit from a maintained VEGF suppression and that B continuation either as a single agent or combined with CT, until disease progression is recommended. Follow-up is ongoing.
Effect of beta blocker on breast cancer progression in minority population.
Authors: Chakraborty Rajshekhar , Mukkamalla Shiva Kumar Reddy , Calderon Natalia , Bulone Linda 
Published: March 2020

e12564 Background: Recent pharmaco-epidemiological studies have shown positive effects of beta blockers (BB) on breast cancer progression, recurrence, metastasis, and cancer specific mortality. To the best of our knowledge none of these studies specifically targeted the minority population. The purpose of our study was to determine the effect of beta blockers on the Progression Free Survival (PFS) of breast cancer patients belonging to the minority subgroup of US population. Methods: We retrospectively reviewed 142 consecutive cases of breast cancer in a city hospital in Queens County of New York City (Asians 36%, Blacks 42%, Hispanics 18% and Whites 4%) diagnosed between January 2007 and December 2009. Patients using beta blockers prior to diagnosis were compared to those who were not on any in terms of PFS after adjusting for the confounding effect of stage at presentation. Kaplan-Meier survival curves were used to look for any significant difference in the PFS between these two groups in minority population. Results: Patients on beta blockers (n=25) were compared to those who were not (n=111). The median follow-up time of this study was 54 months. The study population was stratified according to the stage of presentation (Stage I=32%, Stage II=36%, Stage III=22%, Stage IV=10%).Using Kaplan Meier survival analysis we found significant differences in PFS of patients in stages II and IV (Wilcoxon Test p<0.0001, Log-Rank Test p<0.0001). There was no progression of disease in stage I irrespective of beta blocker intake. In stage II, PFS at the end of study in patients on BB vs. not on BB was 91% vs. 87%. In stage IV the PFS was 100% vs. 10% in patients on BB vs. not on BB. However, in stage III the PFS was better in patients not on BB, which could be explained by the small number of patients on BB (50% vs. 77% in BB vs. no BB subgroup). Conclusions: In this study of breast cancer PFS in minority population, we found that beta blocker use was associated with improved PFS in stages II and IV. However, additional studies with larger sample size are required to substantiate this finding.
Therapeutic effect of gemcitabine on experimental tumors of the brain.
Authors: Chubenko Viacheslav , Stukov Aleksandr Nikolaevich , Belyaeva Olesya , Bespalov Vladimir , Moiseenko Fedor Vladimirovich , Lukyanchikova Valentina , Semiglazova Tatyana , Murazov Yaroslav , Vershinina Sofia 
Published: March 2020

e13005 Background: Gemcitabine has a very modest potency to penetrate blood-brain barrier (BBB). So far it's therapeutic activity in intracranial tumors is unknown. Methods: we explored the effect of gemcitabine (G) on overall survival in models of intracranial Ehrlich's tumor and lymphosarcoma LIO-1. As a comparison for the investigation group we've chosen drugs with different ability to penetrate into brain. We injected BCNU (50 mg/kg), cyclophosphamide (C) (150 mg/kg) and CDDP (9 mg/kg) intraperitoneally once 24 hours after transplantation. Results: The mean overall survival (OS) of mice in a selected model is 9,6+/-0,4 days. The injection of G resulted in substantial increase in OS up to 16,2 +/-0,4 (69%, p = 0,0000). In comparative groups administration of BCNU resulted in an increase in OS of 49% (the average OS 14,3+/-0,8, p = 0.000289), C - in 20% OS increase (11,5+/-0,4, p = 0.00272) and CDDP did not influence OS comparing with control group (10,2+0,4 days, p = 0.315). In other experiment mice with intracranial transplantated lymphosarcoma LIO-1 lived 15.4+1.3 days after single i.p. administration of G (25 mg/kg in 24 hours after transplantation) in comparison with 11.2+0.4 days in control group. The absolute increase of life expectancy was 37.5% (p = 0.013). In control group at 14 day after the transplantation all animals died whereas in G group only 3 mice out of 10 (30 %, g = 0.0003) died. Single i.p. administration of 25 mg/kg G on the 5th day after the intracranial transplantation of LIO-1, increased average OS of the animals from 10,9+ 0,4 days in control group to 13.5±0.5 days (increase in OS 24%, p = 0.0003). Conclusions: In our series of experiment we showed the potency of gemcitabine in treatment of various intracranial tumors. Until our work we can not find any data obtained on efficacy of gemcitabine in this tumor types.
Treatment outcomes of patients with primary central nervous system lymphoma: Single center experience from south India.
Authors: Mallavarapu Krishna Mohan V T , Ayyagari Santa , Rajappa Senthil Jagannathan , Alluri Krishnam Raju , S Sudha Murthy 
Published: March 2020

e13010 Background: Primary CNS Lymphoma (PCNSL) is a rare neoplasm of the brain accounting for 1-2% of all brain tumours. Incidence and histopathologic features of PCNSL in India has been reported; however, reports on therapy outcomes of the disease are lacking. We report treatment outcomes of patients with PCNSL at our institute. Methods: Case records of all patients treated for PCNSL between 2008 and 2012 were retrospectively analysed. Epidemiologic details, treatments given, progression free and overall survival were calculated. Patients who completed at least high dose methotrexate (1.5 gram/ m2) for 5 courses with or without RT were included for analysis. Overall survival (OS) was defined as time from diagnosis till death/lost to follow up. Results: A total of seventeen patients were analysed. The median age at diagnosis was 58 years and M: F ratio was 1.14:1. Thirteen out of seventeen patients were eligible for analysis; six could complete the total treatment protocol which included methotrexate, vincristine, procarbazine, Dexamethasone, Radiation therapy followed by high dose cytarabine. Median overall survival was 20 months (range 2-54 months). Among those who completed the protocol, median survival at 21 months was not reached with 66% survival. Conclusions: Treatment of PCNSL with at least high dose methotrexate with or without whole brain radiation offers moderate results. Completion of treatment protocol is associated with better overall survival.
Phase II trial for patients with newly diagnosed glioblastoma (GBM) treated with carmustine wafers followed by concurrent radiation therapy (RT), temozolomide (TMZ), and bevacizumab (BV), then followed by TMZ and BV post-RT.
Authors: Ranjan Tulika , Peters Katherine B. , Vlahovic Gordana , Alderson Lloyd M , Herndon James Emmett , McSherry Frances , Threatt Stevie , Sampson John Howard , Friedman Allan H. , Bigner Darell D. , Friedman Henry S. , Vredenburgh James J , Desjardins Annick 
Published: March 2020

e13015^ Background: Standard treatment for GBM includes RT and TMZ, followed by six cycles of TMZ, for a median overall survival (OS) and progression-free survival (PFS) of 14.6 and 6.9 months, respectively. BV is FDA approved for recurrent GBM and carmustine wafers are approved for newly diagnosed and recurrent GBM. We evaluated the safety and efficacy of carmustine wafers insertion followed by concurrent RT, TMZ and BV, followed by TMZ and BV for newly diagnosed GBM patients. Methods: Treatment consisted of: Part A- carmustine wafers insertion at resection followed by RT and TMZ at 75 mg/m2/day. BV at 10 mg/kg every two weeks started at least 28 days post-operatively. Part B- Patients received 12 cycles of TMZ (200 mg/m2on days 1-5 of a 28-day cycle) and BV every two weeks (day 1 and 15). Results: Forty one patients of a planned accrual of 72 were enrolled. The study was closed early due to six grade 4-5 toxicities related to study intervention, which met the safety criteria to discontinue the trial. Three patients had grade 4 cerebral edema and one each had grade 4 fatigue, wound infection and meningitis. Median age was 56 years (range, 27-77 years) and 28 patients were men. Of 41 patients, 36 completed part A and 31 started part B. Eleven patients are still on study and 4 have completed part B. Twenty six patients are off study due to progression (n = 16), adverse events (n = 8) and consent withdrawal (n = 2). At a median follow-up of 12.6 months (95% CI: 10.8-15.6 months) the median PFS is 11.3 months (95% CI: 9.2-12.9 months) and the median OS is 16.1 months (95% CI: 15.8 months- ∞). Grade 3-5 toxicities so far include: thrombocytopenia (grade 3, n = 2; grade 4, n = 2), stroke (grade 3, n = 1; grade 5, n = 1), infection (grade 3, n = 2), meningitis (grade 3, n = 1; grade 4, n=1), venous thromboembolic events (grade 3, n = 5), cerebral edema (grade 4, n = 3), fatigue (grade 4, n = 1), enterocolitis (grade 3, n = 1), and wound infection (grade 3, n = 2; grade 4, n = 1). Conclusions: For the patients who did well post carmustine wafers insertion, the treatment was tolerable and median PFS and OS has improved. Updated survival and toxicity results will be presented. Clinical trial information: NT01186406.
Patient selection for anti-EGFViii therapies in glioblastoma multiforme (GBM): Use of circulating tumor DNA.
Authors: Bahassi El Mustapha , Salkeni Mohamad Adham , McPherson Christopher , Warnick Ronald , Rixe Olivier 
Published: March 2020

e13023 Background: Several strategies have been recently developed to target EGFRvIII in Glioblastoma Multiforme (GBM), including vaccines (CDX-110) and antibody-drug conjugates (AMG595) and represents a new challenging therapeutic avenue with potential great clinical benefits. EGFRvIII is a truncated extracellular mutant of the EGF receptor (EGFR) found in about a third of GBMs, confers enhanced tumorigenic behavior and is associated with chemo- and radio-resistance. GBM patients testing positive for EGFRvIII have a bleaker prognosis than those who do not. Methods: We developed a strategy to detect EGFRvIII deletion in the circulating tumor DNA. The purpose of this study is to identify a simple and robust biomarker from the peripheral of patients diagnosed with GBM in order to screen patients for the EGFRvIII deletion. 11 patients have been included in this study. Results: The circulating DNA status for EGFvIII correlates with the analysis performed on the respective tumors samples, and its level seems to be correlated with the extend of the tumor resection. Conclusions: This semi-quantitative blood biomarker may represents a strategy to 1) screen patients for anti-EGFRvIII therapy 2) monitor the therapeutic response to specific targeted therapies.
Risk factors for venous thromboembolism in elderly patients with glioblastoma.
Authors: Hashemi-Sadraei Neda , Sharif Roozbeh , Machicado Jorge , Dahiya Saurabh , Ahluwalia Manmeet Singh 
Published: March 2020

e13031 Background: Venous thromboembolism (VTE) is a common complication in glioblastoma (GBM) patients. Physicians are reluctant to administer anticoagulants to GBM patients with VTE, particularly to the elderly patients. Methods: After obtaining IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify patients with histologically confirmed GBM who were diagnosed with VTE and were ≥65 years of age at the time of diagnosis of GBM. Bivariate comparison of demographic and clinical features was performed by occurrence of DVT, using t-test for continuous data and fishers exact test for categorical variables. Multivariate proportional hazard model was developed adjusting for number of comorbidities (none, 1, 2-3, >3), Karnofsky Performance Status (KPS) at presentation (>70, ≤70), age (>75, ≤75), race, treatment (chemotherapy, radiation therapy, tumor resection). All p-values were 2-sided and were considered significant when <0.005. Results: Chart records of 517 patients diagnosed between 1990 and 2010 were included for analysis. Among 517 cases, 99 patients (54% male, median age at presentation 72 years, range 65-92 years) developed VTE. Median follow-up was 6.58 ± 9.58 months. Eighty-nine (90.8%) cases were diagnosed within 3 months of craniotomy. On univariable analysis, risk factors for VTE included lower KPS (HR 0.98, CI 0.96– 0.99, p = 0.001), thalamic tumors (HR 3.11, CI 1.14– 8.50, p = 0.027), and lower extremity paresis (HR 2.24, CI 1.46-3.46, p < 0.0001). Caucasian patients had a lower trend for developing VTE, however this was not statistically significant. On multivariable analysis, lower KPS was found to be related with higher incidence of VTE (HR 0.35, CI 0.18 – 0.66, p = 0.001). Conclusions: Lower KPS is associated with higher incidence of VTE. Further studies are needed to determine risk stratification and whether the use of medical prophylaxis after neurosurgical intervention can lead to decrease in the rates of VTE in elderly GBM patients.
Glioblastoma multiforme metastasis outside the central nervous system: Three case reports and possible mechanisms of escape.
Authors: Boelke Edwin , Matuschek Christiane , Ginsberg Lawrence E. , Prabhu Sujit S. , Budach Wilfried , Hayman Anne , Hamilton Jackson 
Published: March 2020

e13035 Background: Primary brain and central nervous system (CNS) tumor incidence is approximately 19 per 100,000 individuals per year in the United States (US) compared with 7 per 100,000 individuals worldwide. The most common intra-axial tumor is gliomas, which account for 32% of all primary CNS tumors and 80% of all malignant tumors of the CNS.The most common diffuse glioma is grade 4 astrocytoma (glioblastoma, GBM), which makes up 54% of diffuse glial tumors. GBM is also the most aggressive brain tumor with poor prognosis.GBM metastases outside the CNS are rare, so therapeutic experience with these types of tumors is limited. Methods: Herein, we present 3 GBM patients with extra-CNS metastasis. Results: One patient developed GBM metastasis in the lung and pleura 5 years after his GBM diagnosis had been confirmed. Another patient who underwent resection of the primary GBM developed disease that extended through the sphenoid to involve the orbit and skull and subsequently invaded the parotid gland and neck nodes 1 year after diagnosis. A third patient developed GBM metastasis in the skull and L5 vertebra 2 years after her primary brain tumor had been resected. Conclusions: The exact mechanism of GBM metastasis outside the central nervous system is not well understood but likely involves the invasion of structures such as bone, lymphatics, and vasculature, especially veins. Above-average survival time and repeated surgical intervention may place GBM patients at higher risk for these unusual metastases.