bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of novel peptide vaccines on secondary recurrences and survivorship.
Authors: Valentine Marye Ellen , Chance Lacey , Gompper Peter Todd , Choy Gavin S. 
Published: February 2017

e274 Background: According to the NCI Office of Cancer Survivorship, in 2014, it is estimated there are 14.5 million cancer survivors in the US. By 2024, it is projected there will be 19 million cancer survivors. Peptide-based vaccines are being developed to prevent recurrence in cancer patients following standard of care and increase survivorship by inducing immune responses using antigenic epitopes derived from tumor associated antigens. Two peptide vaccines, nelipepimut-S, a HLA-A2/A3-restricted immunogenic peptide derived from the HER2 protein and E39, a HLA-A2-restricted, folate binding protein (FBP) derived peptide, are being developed to prevent breast cancer and gynecological cancers recurrence, respectively. Methods: Early phase dose finding clinical trials results for both agents have been previously reported by Mittendorf et al. (2014) and Greene et al. (2015). Both agents are concomitantly administered with GM-CSF in the adjuvant setting. Toxicity was monitored and recurrences were documented. Disease free survival (DFS) was analyzed by Kaplan-Myers curves and groups were compared by log-rank test. Results: In the nelipepimut-S Phase 1/2 trial, 97 patients were enrolled in the node positive group. The reported 3-year DFS was 100% in the optimally dosed (1000 mcg vaccine + 250 mcg GM-CSF) vaccinated group vs. 77.8% in the control (p = 0.035, n = 45). In the E39 Phase 1/2 trial, with 9.8 months median follow-up, among optimally dosed (1000 mcg), there is only one recurrence (6.7% vs. 5I% CG, p = 0.01). The 2-year DFS estimate is 19.2% (CG) vs. 85.7% (1000 mcg) (p = 0.09). Nelipepimut-S and E39 were well tolerated. Conclusions: Preliminary results from both Phase 1/2 trials indicate these peptide vaccines derived from the HER2 protein and FBP may be administered chronically, thereby preventing recurrence and increase survivorship in patients with breast, ovarian, and endometrial cancers. Nelipepimut-S is currently being investigated in three ongoing adjuvant clinical trials – 1) single agent in a registrational Phase 3, PRESENT, under a FDA-approved SPA; 2) combination with trastuzumab in IHC 1+/2+ and IHC 3+. Early results of E39 are encouraging and a Phase 2b is being planned in gynecological malignancies. Clinical trial information: NCT00841399, NCT00584789.
A model for delivering survivorship care: Integrating the oncology and the primary care setting—An Italian experience.
Authors: Lorenzi Elena , Morello Lucia , Mazza Rita , Garassino Isabella , Cavina Raffaele , Carlo-Stella Carmelo , Santoro Armando 
Published: February 2017

e275 Background: The population of cancer-survivors faces different lifetime health risk. Thus, models for high-quality and personalized care delivery are strongly needed. ASCO provides different models for survivorship care delivery but there is not an agreement on what is the best in meeting patients’ needs and in terms of cost-effectiveness. In our institution we started a program that tries to integrate survivors’ health care provided by the oncologist and by the Primary Care Physician (PCP). Methods: We included patients (pts) aged more than 18 yrs-old at the time of diagnosis, affected by hematologic or solid tumors. Pts had no evidence of disease from at least 5 yrs from the diagnosis. They are referred to the PCP with the following documents: Survivorship Care-Plan, Survivorship Care-Program, letter to the PCP. Recurrence rate, death rate, treatment related serious clinical events will be calculated after 12 months from the start of the project. Results: We includedin our program 269 cancer-survivors (60% of pts referred to our survivorship-clinic from April to July 2015). The median age was 67 yrs, they were mainly females. The different cancer types were: breast (157), colorectal (36), hematologic (30), gynecologic (11), gastric (9), melanoma (6) lung (5), genitourinary (5), head/neck (3), sarcoma (3) and others (4). 189 of pts had an early stage disease (stage I-II) at diagnosis. 234 of pts underwent surgical treatment and 161 received chemotherapy with different schedules based on tumor types. 59% of pts received anthracycline-based-chemotherapy, 78% at a cumulative dose > 240 mg/m2 . 154 of pts underwent radiation therapy (90% in thoracic field) with a median dose of 60 Gy. We observed 11 cases of secondary cancer after a median of 2.7 yrs from the first diagnosis. The median observation time from the diagnosis to the inclusion in our program was 10 yrs (range 2-31). Conclusions: The observation period from the beginning of the program is too short to provide follow-up data. A high percentage of pts present a high risk of cardiologic late toxicities, therefore they need a more intensive cardiologic follow-up. We will present the first follow-up analysis of this cohort of pts in April 2016.
Conversations about cancer-related infertility: An exploration of online discussion forums.
Authors: Sands Taylor J , Smeltzer Stephanie , Covarrubias Laura , Woodard Terri Lynn 
Published: February 2017

e279 Background: Many patients use Internet discussion forums to seek support and advice on medical conditions, including cancer and fertility. Online discussions about medical issues have been demonstrated to influence patients’ decisions about their care. The objective of this study was to explore online discussions that patients have about cancer and infertility. Methods: An initial search identified the three most popular forums that contained discussions about cancer-related infertility. Within these forums, a search of “cancer” and “infertility” was performed. All threads posted between June 1, 2010, and June 1, 2015 were identified. Qualitative research methods were used to identify, code, and analyze themes within the data. Results: A total of 14 threads and 133 posts were identified. Participants were both male and female and the age range of those disclosing demographic information was 21 to 44 years old. The major themes that were identified were: 1) use of forums as a supportive network, 2) sharing of experiences with fertility counseling and/or treatment, 3) consideration of alternative methods of family building, and 4) challenges encountered when seeking fertility counseling and services. Conclusions: Individuals affected by cancer-related infertility may use online discussion forums to seek information and advice from others who have gone through similar experiences, or to share their personal stories with fertility preservation with the online community. Understanding the role that these online forums play can help health care providers address the unique concerns of this population.
Using Chinese herbal medicine among cancer survivors: Data from a community hospital in China.
Authors: Wang Ying , Wang Hui , Wan Yu , Wang Xiaoyan , Jiang Yiling , Zhang Han , Zhao Yuhua , Chai Feng , Fang Hongming , Lu Weidong 
Published: February 2017

e284 Background: Chinese Herbal Medicine (CHM) is a major component of Traditional Chinese Medicine (TCM) that is widely used in Asian countries. In China, an estimated 397.7 million outpatients and 14.8 million inpatients were cared by TCM physicians and hospitals annually. TCM usage is even higher among pts with cancer. It is reported that 80% of pts with cancer use CHM and 90% of oncologists have prescribed CHM in practice. We reviewed CHM practice among cancer survivors in our hospital, a community general hospital with 800 beds located in the east coast of China. Methods: A retrospective review was conducted by searching outpatient medical records from June 2012 to August 2015. Pts were eligible if pts have pathologically proven cancer and who have completed main anticancer therapies and used CHM prescribed in the outpatient clinic. Descriptive statistical and survival analysis were performed using SPSS. Results: A total of 300 pts were identified, with a median age of 62 years (31-90), 53% were male, with 36 types of cancers. The most common cancers were lung (32%), breast (15%), colorectal (12%), stomach (9%) and liver (6%). 48% pts had stage IV disease. 47% pts used CHM for health maintenance and 53% pts used CHM for anticancer intent. 57% pts used CHM exclusively and 43% used CHM in addition to standard therapies. The median number of outpatient visits was 17 (1-158) with an average of 19 prescribed herbs per person at each visit. During the period, 36% pts passed away with a median overall survival of 24. 9 months (2-108 months). Conclusions: Using CHM for health maintenance or anticancer intent is common among Chinese cancer survivors. A majority of cancer survivors used CHM exclusively without other interventions. Future research should focus on whether using CHM has any survival benefits in cancer survivors.
Assessing the impact of an online survivorship program.
Authors: Waldman Helayne , Fox Shani 
Published: February 2017

e285 Background: In the report From Cancer Patient to Cancer Survivor: Lost in Transition (2006), the Institute of Medicine identified follow-up of cancer survivors as a missing link in cancer care and made recommendations to the medical establishment to fill that gap. So far, studies of recommendation effectiveness have revolved around survivorship care plan implementation. However, a 2013 study indicated that use of SCPs is still more the exception than the rule. Methods: We have created a unique online program that is intended to address two key mandates of the IOM report: 1) Educationfor theprevention of recurrent and new cancers, and 2) Self-carestrategiesto help deal with consequences of cancer and its treatment i.e. lymphedema, fatigue; [and] psychological distress. Dr. Helayne Waldman and Dr. Shani Foxhave fashioned an online, real time, 12 week education and support program for cancer survivors, the first of its type in the U.S. The focus of the content is on maintaining wellness after treatment and includes topics such as physical activity, dietary guidelines, inflammation control and stress management. The program also contains a coaching component, where participants track their activities and share information via live discussion and interactive blogs. Results: We have established a framework for gathering, analyzing and reporting our data. Our target sample size is 40-50 participants. At the program’s outset we will administer a 20 question self-assessment to test participants’ knowledge of self-care practices and attitudes about their current state of wellness. At the program’s end in December we'll readminister in order to measure the change in both knowledge and attitude. We’ll then conduct an analysis of the data, and will report our findings at the ASCO meeting in January. Conclusions: We believe that education and support for survivors is critical to their physical and emotional well-being. Unfortunately, there is currently no program available to do this in a live, interactive format from the comfort of one’s home. We believe PCPs, hospital support groups and other non-profits will find this type of program to be an invaluable resource in serving to educate and manage the concerns of cancer survivors and to move closer to realizing the promise of the IOM report.
Thoughts and experience 10 years post surgery from a cancer researcher and survivor: The burdens of a prostate cancer survivor.
Authors: Jurgens Raymond W. 
Published: February 2017

e290 Background: There are a myriad of experiences reported from various cancer survivors, but few individuals have been involved with cancer drug development, speaking publicly to prostate cancer groups, working privately with prostate cancer survivors and studying the psychosocial aspects of post treatment patients. Methods: N/A Results: The postsurgical and post treatment issues , particularly ED are either not discussed by the patient due to embarrassment or lack of knowledgeable of the type of questions to ask, or not addressed directly by the HCP. Unlike other oncological disciplines, the prostate cancer patient is confronted with major decisions on which treatment approach to choose from which therapeutic discipline. The clinicians they are meeting are explaining their expertise on radiation, surgery, chemo, or other interventions leading the patient to become overwehlemed at these choices. There are few “neutral” voices talking to the patient on which procedure or treatment would suit him best. In addition to the treatment decisions the patient is also told about watch and wait approach. Besides the tough decision for the patient to choose the right approach for himself, he is shown data by each treatment specialty from postsurgical & other treatments relative to the percentage success rates for ED and continence that the patient may expect. These numbers through data from the participating surgical centers etc are typically very inflated. Many patients leave thinking they will return to normal function in x amount of months, only to find that they are quite dysfunctional for much longer or in some cases never gaining functionality. The last part of the discussion is what is available for these men with continuing dysfunction. Potential options exist but for many men they are met with mixed results. The treatments for ED are quite expensive to most men, and in many cases do not work. When the diesterase inhibitors fail to work for the patient, options for ED remain vary greatly-from mechanical interventions to various chemical and pharmacological approaches, and the patient has no voice to turn to get non biased information needed to help with the next steps. Conclusions: Suggestions for the HCP.
Second neoplasms in survivors of childhood acute lymphoblastic leukemia treated with both chemotherapy and radiotherapy.
Authors: Looi Wen Shen , Koh Jia Wen Janine Cynthia , Chin Francis , Teh Yi Hui Jonathan , Chan Mei Yoke , Tan Ah Moy 
Published: February 2017

e293 Background: Second malignant neoplasms (SMNs) are a concern in survivors of childhood cancer. Chemotherapy forms the mainstay of treatment for acute lymphoblastic leukaemia, but radiotherapy is used in certain situations. As both chemotherapy and radiotherapy can be carcinogenic, patients treated with both modalities may be at a higher risk of SMNs. This study aims to investigate the incidence of SMNs in patients treated with both chemotherapy and radiotherapy. Methods: Children aged 16 years and below diagnosed with acute lymphoblastic leukaemia from 1993 to 2014 were identified in the Childhood Cancer Registry. Manual and electronic medical records were reviewed for information on demographics, management and SMNs. Results: A total of 64 patients treated with both chemotherapy and radiotherapy were identified. Seventeen (26.6%) were female and 47 (73.4%) were male. The median follow-up was 9.2 years (range, 1.1-22.0 years). The median age at diagnosis was 5.3 years, (range, 0.3-14.6 years). The median age at which radiotherapy was given was 6.6 years (range, 2.9-15.4 years). SMNs were noted in 3 of 64 (4.7%) patients. Two of 3 patients had a SMN within the radiation field (both cranial). The histological diagnoses were basal cell carcinoma and cerebral PNET. The remaining patient had an ovarian immature teratoma outside the radiation field. The latency period ranged from 8.3 years to 13.3 years (median 9.4 years) from date of diagnosis to development of SMN. The estimated 10-year cumulative incidence was 4.3%, 95% CI [0.01, 0.13] using a competing risks analysis. Radiotherapy data was available in 63 patients. Fifty-one of 63 (81.0%) received cranial irradiation, of which 3 (5.9%) also received spinal irradiation. Total body irradiation was performed in 20 of 63 (31.7%), and testicular irradiation in 17 of 63 (27.0%) patients. The orbit was targeted in 3 of 63 (4.8%) patients. Conclusions: Long term survivors of acute lymphoblastic leukaemia treated with both chemotherapy and radiotherapy may have a significant risk of second malignant neoplasms, which may occur years after the initial diagnosis.
Identifying lifestyle and genetic factors to prevent recurrence of non-muscle invasive bladder cancer in a prospective cohort study at Kaiser Permanente (the Be-Well study).
Authors: Kwan Marilyn L. , Kushi Lawrence H. , Quinn Virginia P. , Ghai Nirupa R. , Roh Janise M. , Becerra Tracy A. , Martinez Adriana A. , Cannavale Kimberly L. , Carruth Alexander S. , Lee Valerie S. , Ergas Isaac J. , Loo Ronald K. , Aaronson David S. , Zhang Yuesheng , Ambrosone Christine B. , Tang Li 
Published: February 2017

e296 Background: Bladder cancer is one of the top 10 incident cancers. Most cases (75%) are diagnosed as non-muscle invasive disease (NMID), yet NMID typically recurs (70%) and a subset (25%) progresses to muscle-invasive disease. Be-Well is a 5-year, NCI-funded prospective cohort study of NMID bladder cancer patients at Kaiser Permanente Northern (KPNC) and Southern California (KPSC). The goal is to examine diet and lifestyle factors and prognosis, with an emphasis on cruciferous vegetable (CV) intake and their unique isothiocyanate (ITC) content, the modifying effect of polymorphisms of ITC-metabolizing genes, and interactions with treatment. Our prior work suggests that dietary ITCs may prevent disease recurrence and progression in NMID patients. Methods: Newly-diagnosed patients with NMID (Ta, Tis, T1), who are English-speaking, KP members, and ≥ 21 years of age, are rapidly ascertained from electronic pathology reports and enrolled on average 2.6 months post-diagnosis. Baseline participation consists of a telephone interview including a food frequency questionnaire focused on CV intake, and providing blood and urine samples. Patients will be contacted for follow-up interviews and urine samples at 12 and 24 months. Smoking, medication use, occupational exposures, physical activity, quality of life, and urinary function are also queried. Biospecimens are processed and assayed at Roswell Park Cancer Institute. Strong support for Be-Well by KP urologists will promote dissemination of study results in patient care and recommendations. Results: Recruitment began in February 2015. To date, 159 patients have completed the baseline interview, representing 76% male and 24% female, and 80% White, 8% Black, 6% Hispanic, 3% Asian, and 3% Other. Urine specimens have been collected from 87% of consented patients. Blood specimens have been collected from 87% of KPNC patients, with collection at KPSC to begin in Fall 2015. Conclusions: The Be-Well Study is poised to be the largest and most comprehensive study to answer critical questions related to prognosis, quality of life, and care in patients diagnosed with early-stage bladder cancer.
Management of dysphagia in esophageal cancer (EC): A population-based study.
Authors: Mikhail Sameh , Hinton Alice , Wuthrick Evan John , Perry Kyle , Merritt Robert , Williams Terence Marques , Conwell Darwin , Bekaii-Saab Tanios S. , Krishna Somashekar 
Published: February 2017

100 Background: Dysphagia is associated with significant morbidity in patients (pts) with EC. Our study is the first report of national trends in hospitalizations due to EC and dysphagia, with special emphasis on nutritional interventions and related outcomes. Methods: The analysis included all adult inpatients with EC and dysphagia in the Nationwide Inpatient Sample from 2002-2012. We examined temporal trends and performed multivariate analysis for key outcomes; controlling for demographics, hospital factors, comorbidities, and interventions. Results: Among 509,593 hospitalizations involving pts with EC, 12,205 were related to dysphagia. The percentage of all hospitalizations for EC (1.52 vs. 3.28%; p < 0.001) and EC with dysphagia (0.0025 vs. 0.0059%, p < 0.001) doubled over the study period. Among all pts with EC, inpatient mortality for EC with dysphagia was 4.39%. Mean length of stay (LOS) and cost of hospitalization were 8.1 days and $15,171, respectively. Feeding tube (FT) placement was performed in 27 % of pts, esophageal stenting in 13% and peripheral nutrition (TPN) was used in 11%. The incidence of stent placement was higher in urban teaching hospitals (33%) vs. urban non-teaching (21%) or rural nonteaching hospitals (17%). On multivariate analysis, placement of FT and stents was associated with comparable inpatient mortality and LOS, but TPN was associated with higher mortality (OR 2.25; 95% CI 1.93, 2.62) and prolonged LOS (+3.4 days, CI 2.79, 3.97). Compared to FT, stents (+ $3,042, CI 432, 5,652) and TPN (+ $10,573, CI 8,766, 12,380) resulted in higher cost of hospitalization. More pts developed sepsis on TPN (6.1%) compared to FT (2.5%) or stents (1.8%). Inpatient mortality associated with any nutritional intervention was lower in urban teaching compared to rural nonteaching hospitals (0.71; CI 0.65, 0.79). Conclusions: Hospitalizations for EC and dysphagia are increasing and mortality in such pts is high and multifactorial. TPN is associated with sepsis and mortality in this setting. Nutritional intervention practices and possibly outcomes vary significantly based on hospital type. This finding should be further explored to better define the most appropriate interventions and treatment setting for this patient population.
Results of Phase II trial of AUY922, a novel heat shock protein inhibitor in patients with metastatic gastrointestinal stromal tumor (GIST) and imatinib and sunitinib therapy.
Authors: Chiang Nai-Jung , Yeh Kun-Huei , Chiu Chang-Fang , Chen Jen-Shi , Yen Chueh-Chuan , Lee Kuan-Der , Lin Yu-Lin , Bai Li-Yuan , Chen Ming-Huang , Lin Jen-Shi , Yang Youngsen , Rau Kun-Ming , Hsiao Hui-Hua , Shan Yan-Shen , Chen Li-Tzong 
Published: February 2017

134 Background: Our preclinical studies showed that AUY922 treatment could induce downregulation of KIT protein and apoptosis in both imatinib-sensitive and -resistant GIST cells (Autophagy 2013). This prospective, phase II trial evaluated the efficacy and safety of AUY922 in patients with metastatic GISTs after failure or intolerance to imatinib and sunitinib in an Asian population. Methods: Based on the MTD defined in previous phase I study, infusion 70 mg/m2 of AUY922 was given once weekly, 4 weeks as a cycle. The primary endpoint was disease control rate (DCR, objective response + stable disease ≥ 16 weeks), assessed by computed tomography (CT) scan according to RECIST v1.1 every 8 weeks. Metabolic response was assessed by positron emission tomography (PET)-CT scans performed at baseline and after 4 weeks of treatment. Treatment was continued until disease progression, unacceptable toxicity or withdrawal of informed consent. Results: Between 2011.10 and 2015.01, 25 evaluable patients were enrolled. DCR at 16 weeks was 20% but none had partial response. According to the EORTC-defined PET response criteria, ten patients (40%) had metabolic partial response ( > 25% decrease of SUV from baseline) at 4 weeks after AUY922 treatment. At a median follow-up time of 7.8 months (range, 2.0-33.4 months), median progression-free survival (PFS) was 2.4 months (95% confidence interval (CI), 1.6-3.2 months) and median overall survival was 9.6 months (95% CI, 0-21.1 months). Metabolic partial responders had a trend of better PFS (3.8 vs. 1.9 months in non-responders, P = 0.09). The common adverse events (AEs) were fatigue (82%), visual disturbances (70%), diarrhea (55%). Grade 3/4 AEs included visual field darkening (3.7%), blurred vision (7.4%) and diarrhea (7.4%). Treatment interruption and dose modification were frequently required (62%) in patients with more than 8 weeks of treatment because of grade 2-3 visual field darkening. Conclusions: AUY922 showed modest antitumor activity in heavily pretreated GIST patients. Clinical relevant ocular toxicity was unexpectedly high in current study cohort; its correlation with PK will be further explored. Clinical trial information: NCT 01389583.