bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of serum carcinoembryonic antigen in predicting objective responses to chemotherapy and overall survival in patients with non-small cell lung cancer.
Authors: Liu Hongbing 
Published: March 2020

e18084 Background: Previous studies indicated the carcinoembryonic antigen (CEA) could predict the therapeutic objective response (OR) and overall survival (OS) of patients with cancers, including non-small cell lung cancer (NSCLC). However, the role it could play in evaluating therapeutic responses and OS in patients with NSCLC requires further elucidation. Herein, we investigated the potential role of CEA in predicting OR and OS in patients with NSCLC. Methods: 689 patients with NSCLC were enrolled between January 2000 and August 2011. The correlations between the CEA levels and OR or OS were examined via statistical analyses including the chi-squared test, logistical regression, paired-samples t-test, receiver operator characteristic curve, Kaplan-Meier survival analysis, log-rank test and Cox regression model. Results: The calculated cut-off for predicting an OR to chemotherapy in patients with NSCLC was a reduction of 5.28% in serum CEA. This value demonstrated a sensitivity of 61.3% and a specificity of 62.4%. Serum CEA levels significantly decreased after two cycles of chemotherapy in NSCLC patients (t = 2.196, P = 0.031). The Kaplan-Meier survival analysis indicated no significant correlation between baseline CEA and OS (log rank test =0.079). However, according to the Cox regression analysis the number of distant metastatic organs (=1 and ≥2) was the independent risk factor of the OS (P = 0.026; P =0.003), and the cycle numbers of chemotherapy was the protective factor for OS in patients with NSCLC (P=0.011).More importantly, baseline serum CEA was significantly associated with lung adenocarcinoma and adenosquamous subtypes (P = 0.014; P = 0.017, respectively). Conclusions: Our study shows that baseline serum CEA was significantly associated with lung adenocarcinoma and adenosquamous subtypes. While the baseline level of serum CEA was not a prognostic factor, the post-treatment reduction of serum CEA level can predict the OR in patients with NSCLC,. The number of chemotherapy cycles was the independent protective factor, while the numbers of distant metastatic organs was the independent risk factor for NSCLC patients’ OS.
ERCC1, class III β-tubulin, p53, and RRM1-tailored selection of personalized chemotherapy for stage IV NSCLC patients: A prospective study.
Authors: Guo Huiqin , Zhao Yu , Lu Jiangyang , Li Zejian 
Published: March 2020

e18087 Background: ERCC1, class III β-tubulin, p53, and RRM1 are predictive molecular biomarkers of platinum agents, taxel, vinorelbine and gemcitabine respectively in personalized therapies of NSCLC. Tailored therapy with several of these markers suggested patient benefit was reported previously. But there was no report about prospective study involving all of these biomarkers. Here we report a prospective study that patients were treated with the personalized therapy tailored by these 4 markers to assess this new therapy approach. Methods: From Feb. 2009 to Feb. 2011, in our single group at the thoracic surgical department of PUMC hospital, we identified 48 patients with previously untreated stage IV NSCLC, ECOG PS of 0-2, and at least 2 of the 4 low expression level markers were eligible. The expression level of ERCC1, class III β-tubulin, p53, and RRM1 was assayed by immunohistochemical (IHC) staining with the tissue samples obtained from bronchoscopy biopsy, percutaneous lung biopsy or operation. Patients with low ERCC1/low class III β-tubulin expression received cisplatin/taxel, patients with high ERCC1/low class III β-tubulin expression received gemcitabine(with low RRM1 level) or vinorelbine (with low p53 level)/taxel, patients with low ERCC1/high class III β-tubulin expression received cisplatin/gemcitabine(low RRM1) or vinorelbine (low p53), and patients with high ERCC1/high class IIIβ-tubulin expression received gemcitabine/vinorelbine. A follow-up CT was performed after every 2 cycles chemotherapy and every 3 months after chemotherapy. PFS and OS were estimated by the Kaplan-Meier method. Results: Follow-up period was 35 months till Jan. 2012. 16(33.3%) patients died within follow-up period, 32(66.7%) patients are still alive. The overall response(CR+PR) rate is 85.4% with 10CR, 31 PR, 5 SD and 2 PD. Median PFS is 14 months and median OS was 27 months. And 1-year OS was 88.3% Conclusions: Our study suggest ERCC1, class III β-tubulin, p53, and RRM1-tailored selection of personalized chemotherapy of NSCLC could dramatically raise response rate and improve survival over standard chemotherapy. It might be a promising treatment option in the future..
A multicenter, randomized phase II study of sequential vinorelbine (V)/cisplatin (C)/bevacizumab (B) followed by docetaxel (D)/gemcitabine (G)/B versus D/C/B as a first-line therapy for advanced or metastatic nonsquamous non-small cell lung cancer (NSCLC).
Authors: Kotsakis Athanasios Panayotis , Kontopodis Emmanouil , Vardakis Nikolaos , Kalbakis Kostas , Kentepozidis Nikolaos K. , Xyrafas Alexandros , Christophyllakis Charalampos , Mavroudis Dimitrios , Georgoulias Vassilis 
Published: March 2020

e18105 Background: The combination of D with G has been shown equally active compared to the platinum-based doublets, which is considered the cornerstone for the treatment of NSCLC, with a more favorable toxicity profile (Georgoulias V. Lancet 2001 357: 1478-84). Sequential therapy with four active drugs (two doublets) in NSCLC, including C, was recently investigated and attributed a promising response rate (Pallis A. Lung Cancer, 2006, 52(2): 165-71). Incorporation of B to the standard platinum-based regimen improved its clinical outcome. Aim of this trial was to compare the efficacy of sequential four drug treatment in combination with B to the standard non platinum-based regimen combined with B. Methods: Seventy-seven treatment naïve patients (pts) with stage IIIB and IV non-squamous NSCLC were randomized to receive V 60 mg/m2 PO on day 1 and 8, C 80mg/m2 IV on day 1 and B 15 mg/kg IVon day 1, for 3 cycles followed by D 75 mg/m2 IV, G 1100 mg/m2 IV and B 15 mg/kg IV, all on day 1 (Arm A) or D 75 mg/m2 IV, C 80mg/m2 IV and B 15 mg/kg IV on day. The cycles were repeated every 3 weeks for a total of 6 cycles. The primary endpoint of the study was response rate (RR) and the secondary outcome measures were overall survival (OS) and progression free survival (PFS). Results: Thirty-nine pts were randomized to the control arm (Arm B) and 38 pts to the sequential arm. Pt demographics were balanced in both the arms. The overall RR was 36.8% and 46.2% in arm A and B, respectively (p= 0.49). There were 3 complete responses, one in arm A. Median PFS was 6.87 and 5.53 months in arm A and B, respectively (p= 0.368). Median OS was 19.6 and 10.33, respectively (p= 0.239). The estimated 1 and 2-year survival for arm A versus B were 71.1% and 36% versus 45.3% and 28%, respectively. No statistically significant difference in the toxicity profile was observed between the 2 arms. Conclusions: Sequential treatment with four active drugs is feasible and safe. The combination attributes encouraging results compared to the standard platinum-based regimen.
Pulmonary blastoma: A clinical study of three cases.
Authors: Sandoval-Sus Jose D , Hansra Damien Mikael , Ochoa Roberto Enrique , Ponce Mario , Santos Edgardo S. 
Published: March 2020

e18109 Background: Pulmonary blastoma (PB) is a rare biphasic neoplasm composed of both immature mesenchymal and epithelial cells representing 0.2-0.5% of pulmonary malignancies. Initial presentation ranges from asymptomatic to classical symptoms of advanced pulmonary tumors. Surgical resection is the preferred treatment with no consensus on the role of other adjuvant therapies. Methods: We report the clinical features of PB in 3 patients (pts). Retrospective review of medical records of pts diagnosed with pulmonary blastoma at Jackson Memorial Hospital, Miami, FL since 2009. Staging was done using the 2009 AJCC staging system for NSCLC. All cases required to have confirmed pathological diagnosis before inclusion. Variables analyzed were demographics, clinical presentation, treatments and outcomes. Results: Mean age at diagnosis was 53 years old; two were male; 2 were Hispanic and one African American. Two of them were heavy smokers (80 and 45 packs year, respectively). At diagnosis, all cases where symptomatic; one had mild hypercalcemia of 12.9 mg/dL and two where stage IV with confirmed metastatic disease (bone and thyroid gland). Two of the cases where treated with surgical resection and both achieved complete remission (CR); one pt still remains on CR after 8 months post-surgery and the other one relapsed after 22 months post-surgery. This pt was placed on palliative chemotherapy (3 cycles of cisplatin/docetaxel) with no response. Further palliation was radiotherapy (37 Gy) with no response. The other case was treated with chemotherapy alone (6 cycles of cisplatin/docetaxel) and attained partial remission. All 3 patients remain alive. Conclusions: In our case series, all pts were symptomatic at diagnosis and two presented with metastatic disease. Surgery was the most beneficial intervention in regard to CR and disease-free interval as in previous reports. Chemotherapy has shown mixed responses, thus, larger studies are needed to define the role of chemotherapy in the adjuvant and palliative settings.
Epidermal growth factor receptor tyrosine kinase inhibitor in treatment of brain metastasis from non-small cell lung cancer.
Authors: Zhang Lan-jun , Cai Ling , Zhu Jian-fei , Rong Tie-hua , Wu Shao-xiong , Chen Zhong-pin , Liu Meng-zhong 
Published: March 2020

e18121 Background: Brain metastasis (BM) presents 20-25% of patients with non-small cell lung cancer (NSCLC). Whole brain radiation therapy (WBRT) along with stereotactic radiosurgery (SRS), or surgical resection (SR) or chemotherapy (CXT) were usually used alone or in a combination modality for the treatment. In this study, we purposed to determine the outcome of patients with BM from non-small cell lung cancer treated with EGFR-TKI in combination with conventional therapy. Methods: A total of 201 BM patients with NSCLC were treated sequentially using EGFR-TKI combined with WBRT, or SRS, or SR, or CXT between Jan, 1999 and Nov, 2011 according to our institutional protocol. The median age was 56 yrs (range: 25-80). The histopathological type was predominantly adenocarcinoma (88%) and squamouscell carcinoma (9%), adenosquamous carcinoma (3%). Median follow-up was 28 months (range: 5-80). In addition to the treatment regimen, twelve potential prognostic factors were evaluated including age, gender, smoking status, primary tumor type, tumor size, expression of carcinoembryonic antigen (CEA), intracranial symptoms, lymph nodes metastasis (LNM), number of intracranial metastases, extracerebral metastases, time of taking EGFR-TKI, and TKI-related rash. Results: Median overall survival (OS) for the entire cohort was 29 months (95% CI: 25-34). The OS rate at 1, 2, 3 year were 61%, 38%, and 29%, respectively. On univariate analyses, improved OS was found to be significantly associated with age < 56 yrs (P=0.027), non-expression of CEA (P=0.016), absence of intracranial symptoms (P=0.018), no lymph nodes metastases (P=0.000), number of intracranial metastases < 3 (P=0.003), absence of extracerebral metastases (P=0.000), time of taking medicine ≥ 5 months (P=0.000), and appearance of acneiform rash (P=0.001). On multivariate analysis, time of taking medicine (P=0.000), age (P=0.046), absence of intracranial symptoms (P=0.002) and absence of extracerebral metastases (P=0.000) retained statistical significance. Conclusions: Patients with NSCLC and brain metastasis might benefit from treatment of EGFR-TKI in combination with conventional treatment.
Lymphopenia: Is it a prognostic factor in metastatic non-small cell lung cancer?
Authors: El Mekkeoui Zineb Benbrahim , Arifi Samia , Amaadour Lamiae , Abda Naima , Nejjari Chakib , Nawfel Mellas , El Mesbahi Omar 
Published: March 2020

e18124 Background: Lymphopenia is frequent in advanced cancers and predicts the toxicity of chemotherapy. It is known as a poor prognostic marker in solid tumors such as metastatic breast cancer and sarcomas. However, its impact on relapse and survival in metastatic non small cell lung cancer is unknown. The aim of our study was to establish the correlation between lymphopenia and survival (disease-free survival (DFS) and overall survival (OS)) in metastatic non small cell lung cancer. Methods: We reviewed retrospectively 115 cases of metastatic non small cell lung carcinomas diagnosed between January 2007 to June 2011 at the Medical Oncology Department at Hassan II University Hospital. Complete blood counts were performed at the time of diagnosis and prior to treatment. Lymphopenia was defined as an absolute lymphocyte count (ALC) < 1000 /µL. We used the Kaplan-Meier method and Cox model to estimate OS and DFS. Results: Median age was 57 ± 10 years. 83.5% of patients were men. 81% of patients were treated with platinum based chemotherapy. Twelve patients (13%) had a low ALC at diagnosis with a mean of 854 (± 100)/µL. Lymphopenia was frequent in men patients (p=0.03) and non squamous cell carcinomas (p= 0.04). However, it was not correlated to age, performance status, body mass index, number of metastatic sites involved, pleural effusion, liver metastasis, hypercalcemia, anemia and hypoalbuminemia. The median duration of follow-up was 7.4 months (range: 1-99 months). In the univariate analysis, the medians of OS and DFS were shorter but not significantly different in lymphopenic patients (OS: 7.5 versus 9 months p= 0.07 and DFS: 5 versus 6 months p= 0.12). In multivariate analysis, lymphopenia was not significantly associated with OS and DFS. Conclusions: In this study, the association between lymphopenia and unfavorable OS and DFS was not clearly demonstrated in patients with metastatic non small cell lung carcinoma. Prospective clinical trials are needed to confirm or deny the prognostic role of lymphopenia in this cancer.
MCPH1 (BRIT1) and outcome to erlotinib in non-small cell lung cancer (NSCLC) patients (p) harboring EGFR mutations.
Authors: Garcia-Campelo M. Rosario , Taron Miquel , Benlloch Susana , Sanchez Jose Javier , Costa Carlota , Gimenez Capitan Ana , Bertran-Alamillo Jordi , Mayo Clara , Molina-Vila Miguel Angel , Majem Margarita , Moran Teresa , Massuti Bartomeu , Camps Carlos , Isla Dolores , Cobo Manuel , Cros Sara , Capdevila Laia , Carcereny Costa Enric , Viteri Ramirez Santiago , Rosell Rafael 
Published: March 2020

e18131 Background: Progression-free survival (PFS) in EGFR-mutant NSCLC p treated with erlotinib can range from a few months (m) to more than two years, but genetic influences on the duration of response remain unclear. The cytotoxic effect of erlotinib has been related to several proteins that regulate DNA damage response (eg, BRCA1, BRCA2). MCPH1 contains 3 BRCT domains which are conserved in important molecules involved in DNA damage signaling, including BRCA1, MDC1 and 53BP1. MCPH1 binds to BRCA2 and regulates the localization of BRCA2 and Rad51 at sites of DNA damage. MCPH1 also regulates the ATP-dependent SWI-SNF chromatin remodeling complex during DNA repair. Methods: We used the NanoString nCounter gene expression system, which captures and counts individual mRNA transcripts, to analyze the expression of 44 selected genes, many of which are involved in DNA damage response, in 55 erlotinib-treated NSCLC p. We identified MCPH1 and correlated expression levels with clinical outcomes. Results: p characteristics: 16 males, 39 females (70.9%); 39 never-smokers (70.9%), 12 former smokers, 4 current smokers; 34 with EGFR deletion in exon 19 (61.8%), 21 with L858R mutation (38.2%). PFS was not reached for patients with high MCPH1, while it was 19 m for those with intermediate levels and 9 m for those with low levels (P=0.01). Median survival was 31 m for p with high levels, not reached for p with intermediate levels and 17 m for p with low levels (P=0.004). Conclusions: The enhanced effect of erlotinib in the presence of elevated MCPH1 could be due to the fact that MCPH1 can interfere with the function of MDC1 and 53BP1. The role of MCPH1 merits validation as a predictive marker of erlotinib response.
The use of primary radiation for ocular adnexal MALTomas.
Authors: Russell Wesley Alan , Gessert David , Cohen Jack A. , Rubenstein Jonathan B. , Herskovic Arnold M. , Gregory Stephanie A. 
Published: March 2020

e18502 Background: Ocular adnexal mucosal associated lymphoid tissue lymphomas (MALTomas) are rare with no phase III trials to guide treatment. Typical management has been primary radiation therapy. This retrospective series aims to report the experience of a single institution and add to the current literature. Methods: Using our electronic medical record systems and available paper charts, we identified patients with MALTomas of the lacrimal gland or sac, conjunctiva, and posterior orbital structures. Records were reviewed to determine pathology, staging, treatment information, local and distant control, salvage treatments, and late toxicity. Results: Sixteen patients with ocular adnexal MALTomas had local radiation between 1992 and 2011 for primary or recurrent disease. 50% had lymphoma in the conjunctiva, 25% in the lacrimal sac/gland, and 25% in the posterior orbit. 75% had stage IAE disease, 6% had stage IIAE, and 19% had a positive bone marrow biopsy. One patient received chemotherapy as part of his initial therapy. The median radiation dose was 30 Gy (25.5-36 Gy) delivered with electrons (31%) or photons (69%). After a median follow-up of 34.78 months, two patients had residual/progressive disease, two had contralateral recurrence, and 1 had a distant failure, for local control of 87.5% and overall disease control of 68.75%. Recurrence/progression occurred at a median of 35.45 months. Two patients with residual/progressive disease and one with a contralateral recurrence were followed, successfully salvaged, and are NED. Fourteen patients are still alive and there were no disease-related/toxicity deaths. Seven patients developed cataracts in the treated eye, 2 had radiation retinopathy, 2 had permanent dry eye syndrome, and 1 had severe keratopathy requiring enucleation. Six patients (3.75%) had worsening visual acuity of unclear etiology. Conclusions: Primary radiation therapy for ocular adnexal MALTomas with a median dose of 30 Gy led to excellent local control. Those patients who did recur were successfully salvaged. Radiation was generally well-tolerated with expected cataractogenesis given the dose required to achieve local control with only one patient developing severe keratopathy after receiving the highest dose in this series.
R-ICE versus R-ESHAP for salvage therapy in aggressive B-cell non-Hodgkin lymphoma.
Authors: Freyer Craig , George Timothy , Price Samantha , Shah Bijal Dinesh , Bello Celeste M. , Sokol Lubomir , Sotomayor Eduardo M. , Cultrera Jennifer L. 
Published: March 2020

e18509 Background: Standard therapy for aggressive Non-Hodgkin’s lymphoma (NHL) consists of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), however the 5 year relapse rate is 20%. Patients with relapsed/refractory (RR) NHL are offered autologous stem cell transplantation (SCT) after salvage chemotherapy demonstrates chemosensitivity and reduces tumor burden. No standard salvage regimen for RR-NHL exists. Frequently used regimens include R-ICE (rituximab, ifosfamide, carboplatin, etoposide) and R-ESHAP (rituximab, etoposide, methylprednisolone, cytarabine, cisplatin). Which regimen provides the greatest efficacy with least toxicity remains unclear. Methods: Patients diagnosed with RR aggressive NHL who received R-ICE or R-ESHAP between 1/1/2000 and 9/30/2011 were identified. Patients may have received either regimen after failure of initial therapy. The primary objective was to determine the overall response rate (ORR) for each regimen. Secondary objectives included determination of overall survival (OS), and proportion of patients able to receive SCT. OS for each regimen was compared using Kaplan-Meier survival curves. Continuous data was compared using the student’s T-test. Results: The median age was 59 years, 27% were female and 90% were described as Caucasian. 78% were diagnosed with diffuse large B cell lymphoma (DLBCL), 13% with transformed follicular lymphoma, 9% with related aggressive NHL subtypes. 55% had a revised International Prognosis Score of 2. Conclusions: No standard of care exists for management of RR-NHL. No regimen has shown superior efficacy or long term outcomes over another. Our trial suggests similar ORR and OS between two commonly used regimens. Although toxicity profiles differ between these regimens, discontinuation rates due to toxicity were similar. The choice of salvage regimen may be determined by ease of administration, toxicity profile and patient/physician preference rather than improved efficacy between R-ICE and R-ESHAP. [Table: see text]
Comparison of clinical parameters and survival in Vietnam era (V) versus non-Vietnam era (non-V) veterans with non-Hodgkin lymphoma (NHL).
Authors: Srinivas Shanthi , Chang Victor T , Floyd Leroy Cordero , Kasimis Basil , Gonzalez Melanie L. , McPherson Monica , Cogswell Janet , Crump Barbara , Duque Lourdes , Paz-Querubin Emma R 
Published: March 2020

e18516 Background: The incidence of NHL has been increasing in the US population. Agent Orange exposure has been implicated in the development of B cell lymphoproliferative disorders including NHL. We explored possible differences in the clinical and lab parameters and predictors of survival in V versus Non-V veterans with diagnosis of NHL at the VAHCSNJ. Methods: In an IRB-approved protocol, the records of veterans diagnosed with NHL from January 1997 to December 2011 were reviewed for demographic, clinical, and pathology data, including HIV, Hep B, Hep C titers, Vietnam Veteran status and survival. We tabulated the ECOG Performance Status (PS), International Prognosis Index (IPI)/ Follicular Lymphoma International Prognostic Index (FLIPI), Charlson Comorbidity Index (CMI), the Kaplan-Feinstein Index (KFI), the Cumulative Illness Rating Scale (CIRS) and Vietnam status. Cox regression analyses were performed to determine predictors of survival. Results: There were 152 veterans who met the eligibility criteria; 78 V and 74 non-V; the groups did not differ by PS, stage, beta 2microglobulin (b2m), and HIV status, IPI/FLIPI. Differences in their clinical features are summarized (Table). The proportion of V vets with high grade lymphomas was greater than non V vets (p .036). Survival predictors for both the V and non-V veterans were the age, PS, hemoglobin, LDH, albumin, grade, IPI/FLIPI. However, in V veterans, b2m (p< 0.001) and stage were additional predictors of survival. Median survival for V veterans was 1454 days (95%CI 864-3377) and Non-V was 1824 days (95% CI 560-2075). Conclusions: The V veterans were younger with higher grade disease compared to the Non-V veterans. While their stage and PS were not different, survival was shorter. These should be studied further in a larger sample. [Table: see text]