bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vivo changes in the cutaneous antioxidant status during sorafenib, sunitinib and capecitabine treatment.
Authors: Jung Sora , Lademann Juergen , Sehouli Jalid , Darvin Maxim E. , Fuss Harald 
Published: September 2018

e21664 Background: A potential pathomechanism for doxorubicin-associated hand-foot syndrome (HFS) was shown based in particular on radical formation in the skin. Topically applied antioxidants (AO) have a therapeutic effect on HFS. Here, radical formation of orally administered sorafenib (Nexavar), sunitinib (Sutent) and capecitabine (Xeloda) was investigated. Methods: 26 patients were included in the study in total, including 13 patients receiving capecitabine (2-4 g/day), 7 patients receiving sunitinib (25-50 mg/day) and 6 patients sorafenib (400 mg/day). Cutaneous carotenoids serving as marker substance of the AO status of the epidermis were measured in vivo using a miniaturized measuring system based on multiple spatially resolved reflectance spectroscopy. Measurements were performed 1 day before the first oral administration and on the 10thday during the first cycle of chemotherapy including an assessment of HFS skin lesions. Results: The mean AO status in capecitabine patients showed an insignificant decrease from 4.09±0.25 to 4±0.25 and in sunitinib patients an insignificant increase from 4.32±0.36 to 4.82±0.52. The AO status in patients treated with sorafenib was shown to increase significantly from 4.77±0.32 to 5.20±0.33, p = 0.028, along with an enhanced subjective vitality and well-being. Overall 3 patients, 1 in each treatment group, developed HFS grade I during the observational period of the first cycle. Conclusions: Sorafenib-, sunitinib- and capecitabine-associated HFS might not occur due to radical formation only, but due to different underlying pathomechanisms. As an AO decay was observed previously after intravenous, but not after oral administration of chemotherapeutics, the metabolisation of these agents after oral and intravenous intake might influence HFS development. Therefore, the application of topical AO might not have preventive effects for these orally applied chemotherapeutics, as shown for capecitabine previously. As therapeutic effects of topically applied AO in case of capecitabine and sorafenib induced HFS have been reported, it seems that although the pathomechanisms are different, radical formation can occur once HFS lesions have developed.
Patient preference for receiving information about long-term symptoms.
Authors: Bennett Antonia Vickery , Eberle Carolyn E. , Schleicher Stephen Matthew , Aviki Emeline , Patil Sujata , Basch Ethan M. , Sloan Jeff A. , Blinder Victoria Susana 
Published: September 2018

e21681 Background: Maintaining quality of life with minimal symptoms is an important goal of cancer treatment. We surveyed patients undergoing cancer treatment about their preferences for information about the long-term symptom burden associated with their current treatment. Methods: Patients undergoing active cancer treatment were enrolled at two large cancer centers from 1/2014 to 7/2015. At the time of enrollment patients reported their household income, employment, performance status and their agreement with the statement, “It would be useful to know the percentage of patients having persistent symptoms more than a year after getting the same treatment I am getting.” Treatment intention (curative vs. palliative) was reported by the treating oncologist. Results: 196 patients completed the survey. The mean age was 55.7 (range 20-80); 54% were female, 69% were white, and 60% were receiving palliative treatment. The majority (83%) of patients either strongly agreed or somewhat agreed that it would be helpful to have information about future symptoms. In univariable analyses, this preference did not significantly differ based on patient-reported performance status, sex, age, treatment intent, race, or household income. Using a more stringent criterion to dichotomize the outcome, 59% of participants strongly agreed that it would be helpful to have information about future symptoms. Patients undergoing treatment with curative intent were significantly more likely to strongly agree (72% vs. 51%, p = 0.0035). In a multivariable analysis adjusting for age, sex, income level, employment status, and patient-reported performance status, participants undergoing curative versus palliative treatment had 3.1 times the odds (95% CI 1.47-6.65) of strongly agreeing. Conclusions: The majority of patients undergoing cancer treatment wanted to know what symptoms to expect in the future, and this was independent of patient demographics. Patients undergoing treatment with curative intent are significantly more likely to want this information than patients undergoing palliative treatment. Symptom data collected through research studies and registries should be summarized by treatment and other key predictors and made available to patients.
Effects of plantar reflexology on sleep and quality of life in patients with breast cancer undergoing chemotherapy and hormonal therapies.
Authors: Magno Stefano , Cappai Elena , Dentale Francesco , Carnevale Stefania , Belella Daniela , Scaldaferri Assunta , Filippone Alessio , Masetti Riccardo 
Published: September 2018

e21697 Background: In the last decade, several studies have shown the role that integrative therapies (e.g. acupuncture, herbal medicine, body-mind practices) can play to relieve symptoms related to cancer and its mainstream treatment. However, conclusive evidence about the value of Plantar Reflexology (PR) on side effects management in breast cancer patients is still lacking. Methods: Forty-four breast cancer patients, treated at Catholic University Hospital’s Breast Unit, were enrolled and invited to complete the Pittsburgh Sleep Quality Index (PSQI) and the Quality of Life index (QL). Afterward, they were randomized into two groups: 23 patients were treated with 6 weekly sessions of PR (1 hour each) conducted by a specialist (experimental arm), while the other 21 underwent standard medical treatment alone (control arm). At the end of treatment sessions, PSQI and QL were re-administered in both groups. Results: A Multivariate Analysis of Covariance (MANCOVA) was conducted, including the participation to experimental vs. control group as an independent variable, PSQI and QL post-test scores as dependent variables, PSQI and QL pre-test scores and patients’ age as covariates. Results showed that PR improved significantly the quality of sleep [F(1, 39) = 4.94, p < .05)], but no significant effects emerged on the quality of life. A further MANCOVA, conducted on the subscales of the PSQI, showed significant mean differences in sleep disturbances [F(1, 34) = 4.38, p < .05), sleep latency [F(1, 34) = 4.88, p < .05) and sleep quality [F(1, 34) = 6.92, p < .05) in favor of the experimental group. Conclusions: Results suggest that PR may relieve sleep difficulties typically linked to mainstream therapies for breast cancer. No effects of PR emerged for patients’ quality of life, although the small sample tested does not allow to draw any definitive conclusion. These promising results encourage further investigations about the beneficial role of PR. In our initial experience, PR appears as easy, well-tolerated and safe procedure, that can play a role in the management of symptoms that are poorly controlled by conventional pharmacological treatments.
Evaluation of art therapy on mood, anxiety, and pain levels in patients with cancer undergoing chemotherapy treatment.
Authors: Doll Marie , Roshon Steven Gale , Stone Elizabeth Rodriguez , Butler Robert Sam 
Published: September 2018

e21713 Background: Art therapy is a mental health modality that uses art-making to improve the physical, mental, and emotional wellbeing of individuals for a variety of purposes. The primary purpose of the trial is to assess the effect of art therapy on cancer patients' mood, anxiety, and pain levels. Secondary endpoints include exploring difference in response to art therapy by specific patient characteristics. Methods: Trial enrolled 50 cancer patients receiving chemotherapy. They participated in an hour long art therapy session with Art Therapist. Patients completed four visual analog scales (VAS) at three different time points: pre-treatment, post treatment (immediately after session) and 48-72 hours after session. Primary end points are pre and post session changes in the VAS for distress, depression, anxiety and pain. Secondary endpoints include differences in VAS scores by ethnic groups (Hispanic vs non-Hispanic), race (white vs non-white), age, gender, and marital status. Analysis was performed using repeated measures, mixed models, and pairwise means comparisons for the four measurements using the Tukey-Kramer adjustments for multiple comparisons. Results: Study revealed a statistically significant difference between pre treatment and post treatment as well as pre-treatment and follow up across distress, depression, anxiety and pain. There was no statistically significant difference between post treatment and follow up. The only significant correlation seen among patient characteristics was that Hispanic patients had higher depression scores at all time points vs non-Hispanics. Conclusions: Art therapy improved mood, anxiety and pain among all patients. Benefits were seen immediately after session and persisted at least 48-72 hours across all groups equally. Hispanic patients had higher depression scores compared to non-Hispanics. Clinical trial information: NCT02659345. [Table: see text]
Benign metastasizing leiomyoma (BML): A retrospective case series analysis of 8 patients (pts).
Authors: Colia Vittoria , Dei Tos Angelo Paolo , Fumagalli Elena , Bertulli Rossella , Lorusso Domenica , Raspagliesi Francesco , Morosi Carlo , Carcangiu Maria Luisa , Casali Paolo Giovanni , Sanfilippo Roberta 
Published: September 2018

e22525 Background: BML is a rare entity marked by the presence of lung lesions in women with a history of surgery for a benign leiomyoma of the uterus. Optimal treatment strategy for BML is poorly defined. We report on the activity of systemic therapy in a retrospective series of pts with BML. Methods: Cases diagnosed with BML from June 1993 to January 2017 at Istituto Nazionale Tumori, Milan, were reviewed. Results: Eight pts were identified, with a median age of 43 yrs. Estrogen and progesteron receptors were positive in all cases. All pts underwent surgery (3 hysterectomy, 2 myomectomy, 2 hysteroannessiectomy and 1 left ovariectomy) for suspected uterine leiomyoma (1 leg; 1 thigh); 2 pts had concomitant lung disease. 8 pts developed lung metastases and 2 had also limb metastases. 2 pts underwent lung metastasectomy, followed by watchful waiting with CT every 6 mos and were disease-free at their last follow up after 132 mos and 84 mos from diagnosis. 6 pts received systemic therapy for progressing advanced disease (1-6 lines). Among 6 pts treated, 2 were in fertility age and underwent ovary-sparing hysterectomy, receiving GnRH agonist with 1 PR lasting 96 mos and 1 SD lasting 38 mos; 2 pts received an aromatase inhibitor with 1 PR lasting 24 mos and 1 SD lasting 12 mos; 2 pts received oral estrogens with 1 PR lasting 39 mos and 1 SD lasting 2 mos; 1 pt received oral progestins with a PR lasting 12 mos; 3 patients received antracyclin +/- ifosfamide obtaining 2 PR after 3 cycles (cys) and 1 SD after 3 cys lasting 6 mos; 1 pt received high-dose ifosfamide with a PR after 5 cys; 1 pt received ifosfamide+dacarbazine obtaining a CR after 6 cys; 2 pts received gemcitabine with 1 PR after 3 cys and 1 SD after 2 cys lasting 6 mos; 1 pt received oral etoposide with a PR lasting 21 mos; 1 pt received sorafenib with a SD lasting 6 mos; 1 pt received everolimus with a PR lasting 57 mos. In this case, everolimus was discontinued due to lung toxicity. No pts progressed during treatment. At a median follow-up of 55 mos, 6 pts are alive, while 2 are dead of disease. Conclusions: In a series of 8 pts, we confirm the activity of hormonal treatment in BML. mTOR inihibitors or chemotherapy also show to be active.
Carcinosarcoma: A single centre experience and population based study.
Authors: Bhattacharya Gaurav , Aljawi Ghufran Abdulghaffar , Bang Andrew , El Sayed Samy 
Published: September 2018

e22526 Background: Carcinosarcomas, consisting of biphasic morphological patterns including both epithelial and sarcomatoid components, are rare malignant tumours. We highlight the incidence and outcomes of this unique disease at our large cancer referral centre. Methods: A retrospective review consisting of carcinosarcoma patients over a 10 years span from 1/1/2005 to 1/1/2015 with follow up data through to 2/2017 to ensure at least 2 years of post-treatment data collection by purveying Electronic Medical Records, paper charts and where required, communication with peripheral facilities, was conducted. Inclusion and exclusion criteria were histologic confirmation and age < 18 years respectively. A comprehensive literature review was also conducted to identify current outcomes trends. Results: Seventy patients meeting selection criteria were identified out of a total of 968 entries involving all soft tissue tumors. Incidence was mainly of gynecological origin (88.5%), in female patients (92.9%) and chiefly Grade 3 disease. Commonest presenting symptom was vaginal bleeding (54.3%). A majority received surgery (90.0%) primarily with a curative intent. 54.3% of the patients received chemotherapy and 51.4% received radiation; both largely in an adjuvant setting. Commonest treatment regimen was Carboplatin/Paclitaxel (73.7%) with a median of 6 cycles provided. Overall, 11 patients had a component of local failure with the latest failure recorded at 13.3 months. Conclusions: Treatment outcomes for carcinosarcoma over the years remain comparable to published results although there remains room for improvement. More research is required to identify strategies for improvement in both locoregional and systemic control. [Table: see text]
Comparison of tumor mutational burden (TMB) across tumor tissue and circulating tumor DNA (ctDNA).
Authors: Davis Andrew A. , Chae Young Kwang , Agte Sarita , Pan Alan , Simon Nicholas I , Taxter Timothy J. , Behdad Amir , Carneiro Benedito A. , Cristofanilli Massimo , Giles Francis J. 
Published: September 2018

e23028 Background: TMB is a potential biomarker for response to checkpoint blockade. Prior studies have associated tissue TMB with genomic instability and neoantigen binding sites for activated effector T cells. The goal of our study was to compare TMB in patients with paired next-generation sequencing (NGS) tests from tissue and ctDNA. Methods: Ninety-seven patients with NSCLC (N=53), breast cancer (N=34), and other solid tumors (N=10) with paired tissue (FoundationOne) and ctDNA (Guardant360, currently not clinically indicated for TMB) were examined retrospectively. Insufficient samples were eliminated (e.g., poor tissue quality or no mutations detected). TMB was compared using variants of unknown significance and synonymous mutations both with (N=74) and without potentially functional/driver variants (N=55). Results: Paired samples were compared using both continuous and binary TMB classifications (Table 1). TMB scores were significantly different using both comparisons (paired t-test, p<0.05). In addition, correlation coefficients between the two assays were low (Pearson Correlation, r=0.24-0.33). No significant differences were found based on timeframe between biopsies. Conclusions: This study demonstrated a lack of concordance between TMB for tissue and ctDNA in paired samples. Potential reasons include differences in sequencing length (~0.79-1.1 million bp for tissue vs. 78,000-138,000 bp for ctDNA), mutation detection, and methods of determining TMB. Future studies are warranted to determine whether ctDNA TMB can predict response to immunotherapy. [Table: see text]
The role of atypical chemokine receptor-1 in breast cancer immune response.
Authors: Martini Rachel , Nikolinakos Petros , Hodgson Jamie , Jenkins Brittany , Davis Melissa 
Published: September 2018

e23072 Background: Interactions between chemokines and their receptors can regulate anti-tumor response by influencing the migration of immune cells. Atypical Chemokine Receptor 1 (ACKR1/DARC), a genetically diverse transmembrane GPCR, acts as a decoy receptor for a variety of CXC and CC chemokines, including those with pro-malignant and pro-inflammatory effects, such as CCL2 and CXCL8 . The purpose of this study is to determine if the migration of tumor-associated immune cells is unique based on epithelial ACKR1 expression on breast cancer cells, and if this association is correlated to an increase in pro-malignant chemokines, survival, or race. Methods: Immunohistochemistry techniques were used to determine expression of ACKR1 on primary breast tumors, along with T-cells, B-cells, dendritic cells, and macrophages. Concentrations of pro-inflammatory chemokines in circulation were determined using a Luminex-based immunoassay. In silco analyses were performed to determine associations between ACKR1 tumor status, race, and survival. Finally, using human breast cancer cell lines and immunofluorescence techniques, co-localization between ACKR1 and pro-inflammatory chemokines was investigated. Results: Results from these tests indicate that there is differential infiltration of immune cell types in tumors expressing ACKR1, , which were not detected in ACKR1 negative tumors. Significantly increased circulating CCL2 and CXCL8 chemokine levels we also determined to be positively correlated with ACKR1 expression in primary breast tumors. Survival analyses showed a significantly increased relapse free survival in patients having tumors with high ACKR1 expression, while investigations into racial differences revealed a significant race effect, with Caucasians having higher ACKR1 levels on their tumors than African-Americans. Finally, co-localization between ACKR1 with CCL2 and CXCL8 is observed in cultured human breast cancer cells. Conclusions: tumors positively expressing ACKR1 to have a more favorable prognosis suggest that a role of ACKR1 on breast tumor cells is to sequester pro-inflammatory chemokines in the tumor microenvironment, recruiting a distinct subset of tumor-associated immune cells.
Detection of EGFR mutations in NSCLC patients in clinical practice: Comparison between cobas and Scorpion ARMS method.
Authors: Takano Natsuki , Kitazono Satoru , Ariyasu Ryo , Koyama Junji , Saiki Masafumi , Sonoda Tomoaki , Kawashima Yosuke , Oguri Tomoyo , Nishikawa Shingo , Yanagitani Noriko , Ohyanagi Fumiyoshi , Horiike Atsushi , Horai Takeshi , Nishio Makoto 
Published: September 2018

e23101 Background: Epidermal growth factor receptor (EGFR) mutation is the most important factor for determining the treatment strategy for non-small-cell lung cancers (NSCLCs). Currently, two methods (cobas and Scorpion ARMS) have been approved as companion diagnostics for using EGFR tyrosine kinase inhibitor (TKI). Although there are some differences in the spectrums and sensitivities for detecting EGFRmutations such as exon 19 deletions (ex19del), L858R and T790M mutations, the extent of the differences affecting clinical practice is unclear. Methods: All patients with NSCLC who underwent EGFR mutation tests and treated at our hospital from February 2014 to February 2016 were enrolled. To detect EGFR mutations, the Scorpion ARMS (S) method was used from 2014 to 2015 and thecobasEGFR Mutation Test (C) from 2015 to 2016. We retrospectively investigated the detection rate of each EGFRmutation type and compared the rates between the two methods. Results: A total of 1,287 patients were enrolled. To detect EGFR mutations, 627 patients were tested by the S method and 660 by the C method, respectively. Of 1287 patients, 910 patients underwent initial biopsy, whereas 121 patients underwent re-biopsy after EGFR-TKI failure. EGFRmutations were detected in 130 of 418 (31.1%) patients and 153 of 492 (31.1%) patients by the S and C methods, respectively in the initial biopsy (P = 0.982). However, the detection rate of ex19del was slightly lower in the S method (12.6%) than in the C method (16.3%) (P = 0.105). Conversely, the detection rate of L858R was lower in the C method (13.8%) than in the S method (16.7%), but the difference was not significant (P = 0.252). De novo T790M was detected in one (0.2%) patient by the S method and in none by the C method. In re-biopsy after EGFR-TKI failure, the detection rates of T790M were as follows: 19 of 55 patients (34.5%) by the S method and 20 of 66 (30.3%) by the C method (P = 0.619). Conclusions: The different spectrums and sensitivities of EGFR mutations between the S and C methods were observed; however, they did not significantly affect clinical practice.
Practical implications of single-gene versus NGS testing in advanced NSCLC.
Authors: Yu Tiffany , Tradonsky Alison , Layton Andrew 
Published: September 2018

e23106 Background: Genetic testing to guide 1st-line treatment is recommended for advanced non-small cell lung cancer (aNSCLC), but is complicated by small biopsy specimens available to test increasing numbers of biomarkers. This study compared commercially-available genetic tests for aNSCLC and the investigational use Oncomine™ Dx Target Test next generation sequencing (NGS) assay. Methods: This retrospective analysis used data from a large commercial lab, which offered clinical single-gene tests (EGFR therascreen, ALK Vysis, BRAF cobas, laboratory developed tests [LDT] for ROS1, BRAF, KRAS, MET, RET, and FGFR1); and NGS LDT (Illumina NextSeq 500). The lab also conducted investigational use of Oncomine Dx Target Test assay (Ion Torrent PGM Dx) on archival tissue. Clinical test orders received September 2015 – October 2016 were included. Sample rejection, test initiation, success rates, slide consumption, testing time, and turnaround time (TAT) were assessed. Results: Clinically, 3,857 single-gene and 219 NGS LDT tests were ordered on 1,479 samples for 1,436 patients. A total of 169 Oncomine Dx Target Tests were conducted. Conclusions: Investigational use of Oncomine Dx Target Test at this laboratory showed higher rates of test initiation and successful completion while using less tissue compared to either single-gene testing for ≥4 biomarkers or NGS LDT. This early experience suggests Oncomine Dx Target Test may enable therapy selection with multiple biomarker testing on small tissue samples for more aNSCLC patients compared to current methods. [Table: see text]