bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of favorable outcome in a docetaxel rechallenge setting in metastatic castration-resistant prostate cancer.
Authors: Heck Matthias Michael , Thalgott Mark K. , Retz Margitta , Wolf Petra , Maurer Tobias , Gschwend Juergen , Kuebler Hubert 
Published: February 2017

68 Background: To identify predictors of favourable oncological outcome in metastatic castration-resistant prostate cancer (mCRPC) patients who are treated with docetaxel rechallenge following first-line chemotherapy with docetaxel. Methods: We retrospectively evaluated the oncological outcome of mCRPC patients who were treated with 3-weekly docetaxel (75mg/m2) at first-line chemotherapy and rechallenge plus prednisone/ prednisolone. The endpoints of oncological outcome were PSA-progression-free survival (PSA-PFS) and overall survival (OS) after initiation of docetaxel rechallenge. The effect of clinical variables on PSA-PFS and OS was statistically analysed by a log-rank test or Cox regression with hazard ratios. All analyses were performed using a 0.05 level of significance. Results: 47 patients were included on analysis. At a median follow-up of 25.8 months (range 9.8-89.8 months) after the first administration of docetaxel, 27 (57.4%) patients had died. Median PSA-PFS was 5.9 months (95% CI 3.5-6.8 months) and median OS was 21.4 months (95% CI 18.9-23.9 months) after initiation of docetaxel rechallenge. PSA-reduction ≥ 30% was the only pre-treatment variable that correlated significantly with prolonged PSA-PFS (p=0.03) and OS (p=0.002). Patients with PSA-reduction ≥ 30% at first-line chemotherapy showed a median OS of 21.8 months since initiation of docetaxel rechallenge in comparison to 4.5 months in patients with < 30% PSA-reduction. Conclusions: Docetaxel rechallenge represents an active treatment option in selected docetaxel-pretreated patients with mCRPC. In this retrospective study, PSA-reduction ≥ 30% at first-line chemotherapy with docetaxel predicted superior PSA-PFS and OS in the rechallenge setting and might, therefore, present a rational indication for docetaxel rechallenge.
The prostate cancer survivorship program: A new concept for holistic long-term support and follow-up.
Authors: Goonewardene Sanchia Shanika , Young Annie , Symons Mary , Sullivan Anne , McCormack Gary , Milner Vanessa , Makar Adel 
Published: February 2017

72 Background: Previously cancer follow-up was based in secondary care. Survivors were seen in overburdened clinics, receiving brief clinic appointments and limited holistic care. We have piloted a new community based model in prostate cancer survivors in order to reduce service load. Patients are discharged from clinic, and entered into a specially developed web based database. This reviews PSA results, triggers alerts, resulting in specialist nurses (CNS) bringing patients back to clinic. This is supplemented by an annual survivorship conference, where patients have access to heathcare professionals. Patients also have access to community based services including a newly built community centre for patients where they have access to a range of healthcare professionals, ranging from dieticians to psychologists. We present our results, and evaluate this model independently with Pickering Institute patient questionnaires distributed one month pre and post conference and focus groups to develop further recommendations for the programme. Methods: We have developed a team composed of a consultant urological lead, commissioners, a GP, a specialist nurse, patient representatives and an IT specialist. Patients were entered into this programme over the past 1 year (323 so far). Inclusion criteria specify patients must be: 2 years post radical prostatectomy (unrecordable PSA), 3 years post radical radiotherapy with/ without hormones or 3 years post brachytherapy (both with stable PSA) according to the Phoenix criteria. Results: Patients completed an outcome questionnaire before the conference and one month afterwards (55 in total). Perceived control pre-conference was 7.19, post conference 7.38. Concern pre-conference was 3.56, 3.46 post conference. Understanding pre-conference was 7.49, 7.85 post-conference. Focus Group Results: The advantages of community based follow up were having an approachable primary contact, speedy referral, saving time, money and stress over prolonged waits and brief hospital appointments. Conclusions: We discuss how the programme can be developed, including: PSA feedback, a buddying system, and how this can be put into use across other tumour sites and other specialities.
Effect of open versus robot-assisted laparoscopic radical prostatectomy on cancer control in patients with clinically localized prostate cancer: Prospective analysis of 1,014 consecutive patients.
Authors: Fairey Adrian Stuart , Jacobsen Niels , Voaklander Don , Estey Eric 
Published: February 2017

80 Background: There are limited prospective data comparing outcomes of Open Radical Prostatectomy (ORP) and Robot-Assisted Laparoscopic Radical Prostatectomy (RALRP) for clinically localized prostate cancer. Our aim was to compare ORP and RALRP with respect to cancer control outcomes. Methods: A prospective analysis of data from the University of Alberta Radical Prostatectomy Database was performed. Between September 2007 and August 2010, 1019 consecutive men underwent radical prostatectomy for clinically localized prostate cancer. The surgical approach was selected by the surgeon. The outcomes were biochemical recurrence (BCR) and positive surgical margins (PSM). BCR was defined as a PSA ≥ 0.1 ng/ml followed by a subsequent confirmatory value or initiation of salvage therapy. PSM was defined as the presence of cancer at the inked margin in the radical prostatectomy specimen. The Kaplan-Meier method was used to estimate biochemical recurrence free survival (BCRFS). Univariable and multivariable analyses were used to determine the association between surgical approach and outcomes. Results: Data were evaluable for 1014 out of 1019 patients. 204 patients underwent ORP and 810 patients underwent RALRP. The median follow-up duration was 21 months (IQR 12 to 29). Baseline characteristics were similar between the groups. In univariable analysis, 3-year BCRFS (90.6% versus 88.9%), overall PSM (26.5% versus 28.8%), and stage-stratified PSM (pT2: 19.9% versus 21.8%; pT3: 40.6% versus 49.1%) did not differ between the groups (all comparisons p>0.05). In multivariable analysis, surgical approach was not independently associated with BCR (HR 0.77, 95% CI 0.43 to 1.37, p=0.37) or PSM (OR 1.2, 95% CI 0.80 to 1.67, p=0.44). Conclusions: ORP and RALRP provided comparable short-term oncologic efficacy. Extended follow-up of the prospective cohort is needed to confirm these preliminary findings.
The safety of prostate biopsy procedures in the research setting: A 10-year multicenter experience.
Authors: Tadros Nicholas N. , Farris Paige E. , Shannon Jackilen , Beer Tomasz M. , Garzotto Mark 
Published: February 2017

87 Background: The safety of routine prostate biopsies has recently been called into question, citing increasing rates of complications compared to historical data. We examined our experience with prostate biopsies done as a component of multiple clinical research trials. Methods: The safety of routine prostate biopsies has recently been called into question, citing increasing rates of complications compared to historical data. We examined our experience with prostate biopsies done as a component of multiple clinical research trials. Results: 141 charts had adequate documentation. A mean of 12 +/- 4 cores were obtained during the procedures (8-26). Of these patients, 136 of the 141 had no adverse events during or after their biopsies. Of the five adverse events, there were three (2.2%) minor and two (1.4%) major complications. The minor complication group consisted of three patients with mild, but prolonged hematuria (12-14 days). Of the two major complications, one patient had hematospermia for 28 days and the second patient was diagnosed with prostatitis 18 days after biopsy and required multiple antibiotics. No patient required any further intentions or hospitalizations. There was no correlation between complication rate and study type (p=0.662) or treatment setting (p=0.411). Overall, 96.5% of patients undergoing prostate biopsies for research purposes had no adverse events or complications related to the procedure. Conclusions: Research related prostate biopsy procedures can be performed in a diverse range of treatment settings and do not incur any increased risk versus clinical biopsies.
A phase II study of atorvastatin and celecoxib in patients with rising PSA following local therapy for prostate cancer (PC).
Authors: Goodin Susan , Stein Mark N. , Shih Weichung , Lu Shou-En , Zheng Xi , Anand Monica , Jeyamohan Chandrika , Mayer Tina M. , Somer Robert A. , Heath Elisabeth , Conney Allan , DiPaola Robert S. 
Published: February 2017

89 Background: Single agent atorvastatin and celecoxib have been associated with reductions in the risk of PC. Our laboratories have demonstrated that low doses of the drug combination have synergistic effects inhibiting the progression of LNCaP tumors to androgen independence. We therefore sought to determine the effects of the combination in androgen-dependent PC on PSA kinetics and the plasma correlates of IL-6, C-reactive protein (CRP), PGE-2, and the pharmacokinetics of the drug combination to validate preclinical biomarker findings. Methods: Patients with rising PSA after primary therapy for PC were enrolled. Patient must have three rising PSA values, each obtained at least 1 month apart. No prior hormone-ablative therapy was allowed, except in the neoadjuvant setting or in the setting of salvage XRT completed 3 months prior to enrollment. Patients with any history of coronary artery disease or a previous myocardial infarction in the past 6 months were excluded. All patients were treated with atorvastatin 20 mg daily and celecoxib 200 mg twice a day for 6 months. Paired pre-treatment and on treatment PSA kinetics were compared using the Wilcoxon Signed Rank test. Results: We report on 14 patients that have completed therapy. Median pretreatment PSA slope was 0.14 log PSA/mo (median PSADT 4.98 mos), in contrast to the median on treatment slope of 0.09 log PSA/mo (median PSADT 7.37 mos); p=0.11. Eleven of the fourteen patients completed the 6 months of therapy, 1 patient withdrew and 2 patients therapy was stopped early due to lack of response. A declining PSA was observed in one patient. The combination was well tolerated, with no clinically significant therapy related toxicities ( > grade 1) reported in 76 months of therapy. Conclusions: In this ongoing phase II trial, the combination of low dose atorvastatin and celecoxib has been well tolerated and demonstrates a tendency of increasing PSA doubling time. Enrollment continues with analysis of IL-6, CRP, and PGE-2 to be correlated to individual clinical results.
Frequency and prognostic significance of the PSA flare-up phenomenon in men with castration-resistant prostate cancer (CRPC) who undergo docetaxel-based chemotherapy.
Authors: Piper Charlotte , van Erps Thomas , Pfister David J. K. P. , Epplen Robin , Porres Daniel , Heidenreich Axel 
Published: February 2017

92 Background: Chemotherapy with docetaxel and prednisone represents the guideline-recommended first-line therapy in men with metastatic CRPC. Until now there is a lack of information with regard to the oncological efficacy, survival and treatment-associated toxicity in patients who are treated in the community beside clinical trials. Methods: 487 patients were prospectively recruited according to a standardized questionnaire within a 1-year time interval. Patients were treated in 144 institutions who contributed between 2 and 48 patients. The mean age was 73.4 (41 – 85) years, the mean PSA level was 135.9 (2.1 – 1.895) ng/ml. 445 (91.5%) patients had bone metastases and/or lymph node metastases. Cardiovascular, pulmonary, neurological or endocrinological comorbidities were present in 157 (27.5%) patients. Results: The mean follow-up was 24 (15-36) months. A mean of 6.6 (1-21) cycles docetaxel were delivered. 101 (20.7%) patients received 1-3 cycles, 222 (45.6%) patients received 4-6 cycles and 167 (34.3%) patients underwent 7-10 cycles. 29 (5.9%) and 295 (61.4%) patients achieved a complete or partial remission, respectively; 95 (19.5%) and 19 (3.9%) patients demonstrated stable disease or progression, respectively. An immediate, delayed (flare-up) or no PSA response was achieved in 40.9%, 29.9% and. 21.8%, respectively. During follow-up 192 (40.6%) patients developed progressive disease. 49 (10.4%) patients died, 37 (7.8%) died due to cancer progression. The mean and median progression-free survival was 256.6 ± 14.8 and 216 days, respectively. The mean and median overall survival was 394 ± 10.7 and 476 days, respectively. Significant Grad 3/4 toxicities were identified in 46 (9.4%) patients with predominantly hematotoxicity and gastrointestinal toxicity. Conclusions: We were able to reproduce the therapeutic response rate of clinical studies with a selected pool of patients. We verified the efficacy of docetaxel in general in patients with CRPC. A flare-up phenomenon within the first three cycles was observed in 30% of patients, which suggest to continue therapy for at least that period of time.
Phase III Randomized Study of 4 Weeks of High-Dose Interferon-α-2b in Stage T2bNO, T3a-bNO, T4a-bNO, and T1-4N1a-2a (microscopic) Melanoma: A Trial of the Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group (E1697)
Authors: Agarwala Sanjiv S. , Lee Sandra J. , Yip Waiki , Rao Uma N. , Tarhini Ahmad A. , Cohen Gary I. , Reintgen Douglas S. , Evans Terry L. , Brell Joanna M. , Albertini Mark R. , Atkins Michael B. , Dakhil Shaker R. , Conry Robert M. , Sosman Jeffrey A. , Flaherty Lawrence E. , Sondak Vernon K. , Carson William E. , Smylie Michael G. , Pappo Alberto S. , Kefford Richard F. , Kirkwood John M. 
Published: February 2017

PurposeTo test the efficacy of 4 weeks of intravenous (IV) induction with high-dose interferon (IFN) as part of the Eastern Cooperative Oncology Group regimen compared with observation (OBS) in patients with surgically resected intermediate-risk melanoma.Patients and MethodsIn this intergroup international trial, eligible patients had surgically resected cutaneous melanoma in the following categories: (1) T2bN0, (2) T3a-bN0, (3) T4a-bN0, and (4) T1-4N1a-2a (microscopic). Patients were randomly assigned to receive IFN α-2b at 20 MU/m2/d IV for 5 days (Monday to Friday) every week for 4 weeks (IFN) or OBS. Stratification factors were pathologic lymph node status, lymph node staging procedure, Breslow depth, ulceration of the primary lesion, and disease stage. The primary end point was relapse-free survival. Secondary end points included overall survival, toxicity, and quality of life.ResultsA total of 1,150 patients were randomly assigned. At a median follow-up of 7 years, the 5-year relapse-free survival rate was 0.70 (95% CI, 0.66 to 0.74) for OBS and 0.70, (95% CI, 0.66 to 0.74) for IFN ( P = .964). The 5-year overall survival rate was 0.83 (95% CI, 0.79 to 0.86) for OBS and 0.83 (95% CI, 0.80 to 0.86) for IFN ( P = .558). Treatment-related grade 3 and higher toxicity was 4.6% versus 57.9% for OBS and IFN, respectively ( P < .001). Quality of life was worse for the treated group.ConclusionFour weeks of IV induction as part of the Eastern Cooperative Oncology Group high-dose IFN regimen is not better than OBS alone for patients with intermediate-risk melanoma as defined in this trial.
Pain Management and Use of Opioids in Pediatric Oncology in India: A Qualitative Approach
Authors: Angelini Paola , Boydell Katherine M. , Breakey Vicky , Kurkure Purna A. , Muckaden Marian A. , Bouffet Eric , Arora Brijesh 
Published: February 2017

Purpose Consumption of medical opium for pain relief in India is low, despite the country being one of the main world producers of the substance. We investigated obstacles to opioid use and physician perceptions about optimal pain management in pediatric oncology patients in India. Methods Semistructured interviews were conducted with oncologists who work in pediatric oncology settings. A mixed sampling strategy was used, including maximum variation and confirmation and disconfirmation of cases, as well as snowball sampling. Key informants were identified. Interviews were audio recorded, transcribed verbatim, and analyzed by thematic analysis methodology. Results Twenty-three interviews were performed across 20 Indian institutions. The main obstacles identified were lack of financial resources, inadequate education of health care providers on pain management, insufficient human resources (particularly lack of dedicated trained oncology nurses), poor access to opioids, and cultural perceptions about pain. Children from rural areas, treated in public hospitals, and from lower socioeconomic classes appear disadvantaged. A significant equality gap exists between public institutions and private institutions, which provide state-of-the-art treatment. Conclusion The study illuminates the complexity of pain management in pediatric oncology in India, where financial constraints, lack of education, and poor access to opioids play a dominant role, but lack of awareness and cultural perceptions about pain management among health care providers and parents emerged as important contributing factors. Urgent interventions are needed to optimize care in this vulnerable population.
Hematopoietic Stem-Cell Transplantation in the Resource-Limited Setting: Establishing the First Bone Marrow Transplantation Unit in Bangladesh
Authors: Yeh Albert C. , Khan Mohiuddin A. , Harlow Jason , Biswas Akhil R. , Akter Mafruha , Ferdous Jannatul , Ara Tasneem , Islam Manirul , Caron Martin , Barron Anne-Marie , Moran Jenna , Brezina Mark , Nazneen Humayra , Kamruzzaman Md , Saha Anup , Marshall Ariela , Afrose Salma , Stowell Christopher , Preffer Frederic , Bangsberg David , Goodman Annekathryn , Attar Eyal , McAfee Steven , Spitzer Thomas R. , Dey Bimalangshu R. 
Published: February 2017

Purpose Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell transplantation (HSCT) was first described almost 60 years ago, and its use has expanded significantly over the last 20 years. Whereas HSCT has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and health care provider training that are required to provide such a service have prohibited it from being widely adopted, particularly in developing countries. Methods Over the past two decades, however, efforts to bring HSCT to the developing world have increased, and several institutions have described their efforts to establish such a program. We aim to provide an overview of the current challenges and applications of HSCT in developing countries as well as to describe our experience in developing an HSCT program at Dhaka Medical College and Hospital in Bangladesh via a partnership with health care providers at Massachusetts General Hospital. Results and Conclusion We discuss key steps of the program, including the formation of a collaborative partnership, infrastructure development, human resource capacity building, and financial considerations.
Breast Cancer and HIV in Sub-Saharan Africa: A Complex Relationship
Authors: Grover Surbhi , Martei Yehoda M. , Puri Priya , Prabhakar Pooja , Mutebi Miriam , Balogun Onyinye D. , Price Aryeh J. , Freeman Alexandra H. , Narasimhamurthy Mohan , Rodin Danielle , Rayne Sarah , Zetola Nicola M. 
Published: February 2017

Introduction The number and lifespan of individuals living with HIV have increased significantly with the scale-up of antiretroviral therapy. Furthermore, the incidence of breast cancer in women with HIV is growing, especially in sub-Saharan Africa (SSA). However, the association between HIV infection and breast cancer is not well understood. Methods A literature search was performed to identify articles published in journals pertaining to breast cancer and HIV, with an emphasis on SSA. Selected US-based studies were also identified for comparison. Results Among the 56 studies reviewed, the largest study examined 314 patients with breast cancer and HIV in the United States. There is no consensus on whether HIV infection acts as a pro-oncogenic or antioncogenic factor in breast cancer, and it may have no relation to breast cancer. A higher incidence of breast cancer is reported in high-income countries than in SSA, although breast cancer in SSA presents at a younger age and at a more advanced stage. Some studies show that patients with breast cancer and HIV experience worse chemotherapy toxicity than do patients without HIV. Data on treatment outcomes are limited. The largest study showed worse treatment outcomes in patients with HIV, compared with their counterparts without HIV. Conclusion HIV infection has not been associated with different clinical presentation of breast cancer. However, some evidence suggests that concurrent diagnosis of HIV with breast cancer is associated with increased therapy-related toxicity and worse outcomes. Systematic prospective studies are needed to establish whether there is a specific association between breast cancer and HIV.
Developing a Breast Cancer Screening Program in Nigeria: Evaluating Current Practices, Perceptions, and Possible Barriers
Authors: Olasehinde Olalekan , Boutin-Foster Carla , Alatise Olusegun I. , Adisa Adewale O. , Lawal Oladejo O. , Akinkuolie Akinbolaji A. , Adesunkanmi Abdul-Rasheed K. , Arije Olujide O. , Kingham Thomas P. 
Published: February 2017

Purpose In low- and middle-income countries like Nigeria, women present with advanced breast cancer at an earlier age. Given the limited resources, development of screening programs that parallel resource capabilities of low- and middle-income countries is imperative. The objective of this study was to evaluate the perceptions, practices, and barriers regarding clinical breast examination (CBE) screening in a low-income community in Nigeria. Materials and Methods A cross-sectional survey of women age 40 years or older in Ife, Nigeria, using multistaged sampling was performed. Information on sociodemographics, knowledge of breast cancer, screening practices, and willingness to participate in CBE screening was obtained using an interviewer-administered questionnaire. Results A total of 1,169 women whose ages ranged from 40 to 86 years (mean age, 47.7 years; standard deviation, 8.79 years) were interviewed. The majority of women (94%) knew about breast cancer, whereas 27.5% knew someone who had had breast cancer, the majority of whom (64.5%) had died of the disease. Of the 36% of women who had breast screening recommended to them, only 19.7% had an actual CBE. Of these, only 6% had it in the last year. The majority of women (65.4%) were willing to have regular CBEs and did not care about the sex of the examiner in most instances. Lack of perceived need was the reason cited by women unwilling to participate. Conclusion The majority of women were aware of breast cancer and knew it as a fatal disease. With the relatively encouraging number of those willing to be examined, a carefully designed CBE program coupled with advocacy to correct uneducated beliefs seems promising.