bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary and secondary endpoint analysis of N08C9 (Alliance): A phase III randomized study of sulfasalazine versus placebo in the prevention of acute radiation enteritis.
Authors: Iott Matthew J. 
Published: February 2017

562 Background: An interim futility analysis at ASTRO 2013 led to early closure of N08C9 (Alliance), a randomized controlled trial (RCT) comparing sulfasalazine (SSZ) versus placebo (PBO) in the prevention of radiation enteritis during pelvic RT. This is the full analysis of the primary endpoint (PE) and secondary endpoints (SEs) of the trial. Methods: A multi-institutional RCT conducted by the Alliance for Clinical Trials in Oncology assessed the effect of 1000 mg SSZ b.i.d. versus PBO b.i.d. in the treatment of pelvic RT related enteritis. Study participants (SPs) received the study agents during RT and for 4 weeks afterwards. The PEwas the maximal severity of diarrhea toxicity (CTCAE version 4.0) during and up to 6 weeks after RT. SEs, including the maximum severity of diarrhea (MSD) and the duration of MSD, rectal bleeding, abdominal cramping, tenesmus, and constipation, were graded weekly during RT by a health care provider. Bowel function was assessed using a self-administered bowel function questionnaire weekly during RT, afterwards at 6 weeks, and at 12 and 24 months. A two-sided 0.05-level Wilcoxon rank-sum test was used to test the equality of the distributions of MSD grades. The planned study size was 128 SPs. Results: 87 SPs were enrolled in the study between 4/29/2011 and 5/13/2013, with evenly distributed baseline factors. Toxicity data were available in 84 SPs during RT and in 54 SPs in the 6 weeks following RT. There was no significant difference in the distribution of MSD grades between the SSZ and PBO arms (p=0.41 regardless of attribution; p=0.09 at least possibly attributed to the study agent). No significant differences were observed in SEs during RT and after RT, except the abdominal pain occurring after completion of RT was higher in SPs receiving SSZ (p=0.02). More SPs required antidiarrheal agents on the SSZ arm (49% vs. 29%, p=0.06). Conclusions: Despite prior single institution RCT’s suggesting a benefit for SSZ (Kilic 2001; Pal 2013) in this clinical context, the results of this large, multi-institutional trial demonstrate that SSZ does not reduce the risk of enteritis and may worsen acute GI toxicity during pelvic RT. Clinical trial information: NCT01198145.
Improving access to molecularly defined clinical trials for patients with colorectal cancer: The EORTC SPECTAcolor platform.
Authors: Folprecht Gunnar , Aust Daniela Ellen , Roth Arnaud , Messina Carlo G. M. , Lacombe Denis A. , Salgado Roberto , Laurent-Puig Pierre , Bosman Fred , Salazar Ramon , Tabernero Josep , Kohne Claus-Henning , Arnold Dirk , Lordick Florian , Mauer Murielle E. , Tejpar Sabine ,   SPECTAcolor Investigators
Published: February 2017

575 Background: Molecular diagnostics can identify subgroups of colorectal and other cancers that are relevant for the mode of action of new anti-cancer agents. The efficient, GCP-conform and quality assured molecular screening to identify potential study patients is one of the major challenges for targeted drug development. The EORTC has implemented a new collaborative molecular screening platform in order to facilitate these next generation trials. Methods: SPECTAcolor (Screening Patients for Efficient Clinical Trial Access in advanced colorectal cancer) is a pan European network of institutions collaborating in centralized, high-throughput screening of tumor material from patients with colorectal cancer. After informed written consent, patients are screened for molecular alterations. Molecularly annotated patients can be offered so called “downstream” clinical trials. Results: Launched in September 2013, SPECTAcolor is now initiated in 19 clinical centers in 9 countries. As of 12 September 2014, 406 patients were enrolled exceeding the expected accrual target of 300 patients in the first year. Of these 406 patients, 293 patients had their tumor block shipped to the central biobank at the Dresden University Hospital for central quality and pathological review, and core analyses. Tumor samples are being additionally analyzed using next generation sequencing for 360 key cancer alterations in cooperation with the Sanger Institute (Cambridge, UK). In the first year, the blocks were analyzed for 5 baseline biomarkers. KRAS was wild type for exon 2, 3 and 4 in 151/284 pts (53%) and mutated 133 pts (47%; 114 pts in exon 2 (40%), 8 pts in exon 3, and 11 pts in exon 4). NRAS was tested in KRAS wild type pts only; mutations were found in 14 pts (4.9%; 6 pts in exon 2 and 8 pts in exon 3). BRAF mutations, all in exon 15, were found in 18 pts (7%). PI3K mutations occurred in 41 pts (15%; 13 in exon 20 and 28 in exon 9). IHC staining was showing deficient mismatch repair in 16 patients. Conclusions: SPECTAcolor is the first pan-European and EORTC screening platform. Its successful implementation proves that a logistically complex infrastructure to run next generation trials in a multinational setting is feasible.
The safety and tolerability of veliparib (V) plus capecitabine (C) and radiation (RT) in subjects with locally advanced rectal cancer (LARC): Results of a phase 1b study.
Authors: Czito Brian G. , Mulcahy Mary Frances , Deming Dustin A. , Vaghefi Houman , Jameson Gayle S. , Deluca Angela , Xiong Hao , Munasinghe Wijith , Dudley Matthew W. , Komarnitsky Philip , Holen Kyle D. , Michael Michael 
Published: February 2017

579 Background: Patients (pts) with LARC treated with neoadjuvant C/RT and then surgery have low rates of pathologic complete response (ypCR) and significant relapse rates. V is a potent, orally bioavailable PARP inhibitor that has been shown to enhance the efficacy of chemotherapy and RT in preclinical models. This study sought to establish the recommended phase 2 dose (RPTD), as well as to assess safety, pharmacokinetics (PK), and preliminary activity of V + RT/C in pts with LARC. Methods: Pts with stage II-III rectal cancer received RT (50.4Gy/1.8Gy/fraction) with C (825 mg/m2 BID) five days per week (W) for 5.5W. Dosing of V (BID, 20mg-400mg) continued from W1D2 to 2 days past RT. Pts underwent surgery 5-10W following RT. Assessments included identification of RPTD with the Exposure Adjusted Continual Reassessment Method, adverse events (AEs), PK, and pathological response (ypCR and tumor downstaging rates). Results: As of August 5, 2014, 30 pts have been enrolled, 24/6 male/female, median age 58 yrs; 1 pt discontinued due to an AE. The most common treatment-emergent AEs possibly or probably related to V (>15% pts, n >4) were nausea (40%), fatigue (37%), diarrhea (30%), vomiting (20%), and dysgeusia (17%). One grade 3/4 event each of anemia and lymphopenia and 2 grade 3/4 events of diarrhea were deemed at least possibly related to V. Two dose limiting toxicities (DLTs) occurred: 1 at 70 mg BID V (radiation skin injury requiring dose interruption); 1 at 400 mg BID (nausea and vomiting requiring discontinuation). The RPTD is 400 mg BID of V in combination with RT/C. PK results from 16 pts suggest that V PK was approximately dose proportional when administered with RT/C and that V had no effect on the PK of C. To date, 18/25 (72%) pts have been downstaged post-surgery; with 7/25 (28%) achieving ypCR. Conclusions: V at 400 mg in combination with RT/C has an acceptable safety profile. 72% of 25 evaluable patients had tumor downstaging post-surgery, including 28% with ypCR. Dose escalation of V resulted in approximately dose-proportional increases in the V PK with no clear effect on C PK. Clinical trial information: NCT01589419.
Angiogenesis genotyping and clinical outcome during regorafenib treatment in metastatic colorectal cancer patients.
Authors: Giampieri Riccardo , Salvatore Lisa , Del Prete Michela , Prochilo Tiziana , D'Anzeo Marco , Faloppi Luca , Bianconi Maristella , Loretelli Cristian , Loupakis Fotios , Montironi Rodolfo , Scarpelli Marina , Zaniboni Alberto , Falcone Alfredo , Scartozzi Mario , Cascinu Stefano 
Published: February 2017

595 Background: The introduction of regorafenib for the treatment of colorectal cancer represented a sure medical achievement though at a cost of relevant toxicity. As a consequence the lack of predictive factors made the use of regorafenib in the clinical practice challenging. Previous observations suggested that polymorphisms of VEGF and its receptor (VEGFR) genes may regulate angiogenesis and lymphangiogenesis and potentially influence outcome during anti-angiogenesis treatment. Aim of our study was to evaluate the role of VEGF and VEGFR genotyping in determining clinical outcome for colorectal cancer patients receiving regorafenib. Methods: From a multicentre experience 138 samples (tumour or blood samples) of colorectal cancer patients receiving regorafenib were tested for VEGF-A, VEGF-C and VEGFR-1,2,3 single nucleotide polymorphisms (SNPs). Patients’ progression-free survival (PFS) and overall survival (OS) were analysed. Results: Results from angiogenesis genotyping showed that only VEGF-A rs2010963 maintained an independent correlation with PFS and OS (respectively HR: 0.49, 95% CI: 0.33-0.81, p=0.003 and HR: 0.52, 95% CI: 0.34-0.99, p=0.04). A correlation with disease control rate (DCR) was also observed (DCR 55% vs. 26%, p=0.02). Among clinical factors only ECOG PS was independently correlated with OS (HR: 0.52, 95% CI: 0.21-0.81, p=0.009), whereas no correlation with PFS was evident. Grouping together observations from angiogenesis genotyping and ECOG PS allowed further patients stratification into 3 prognostic groups: favourable, intermediate and unfavourable. Median OS resulted progressively decreased across these groups (OS not reached, 7.8 and 3.9 months respectively in the favourable, intermediate and unfavourable group, p<0.0001). Conclusions: VEGF-A rs2010963 genotyping may represent an important tool for a more accurate selection of candidates for regorafenib. This selection opportunity will ultimately improve the therapeutic index of such a treatment approach by limiting treatment to potentially responding patients and sparing unnecessary toxicity to those unlikely to benefit.
Epigenetic regulation and functional roles of SHP1 in gastric carcinoma cell lines.
Authors: Joo Moon Kyung , Park Jong-Jae , Yoo Hyo Soon , Jeoung Yong , Kim Jiwon , Koh Jin Sung , Kim Ho , Choe Jung Wan , Lee Beom Jae , Kim Jae Seon , Bak Young-Tae 
Published: February 2017

61 Background: The SH2-containing protein tyrosine phosphatase 1 (SHP1) is an important negative regulator in cytokine-mediated signal transduction and cell cycling. Recent studies demonstrated that promoter methylation of SHP1 is frequently observed in gastric adenocarcinoma tissues. We tried in this in vitrostudy to reveal promoter hypermethylation and to investigate the effects of SHP1 in gastric carcinoma cell lines. Methods: We performed RT-PCR, Western blot, methylation specific PCR (MSP) and bisulfite pyrosequencing to demonstrate promoter hypermethylation of SHP1. To evaluate functional roles of SHP1, we transfected SHP1 plasmid and analyzed WST-1 assay, wound closure assay and Matrigel invasion assay. Results: We observed that both gene and protein expression of SHP1 were negative in 8 of 10 gastric cancer cell lines (SNU-1, SNU-5, SNU-16, SNU-638, SNU-719, MKN-28, MKN-45, AGS). MSP showed methylation-specific band only in all 10 gastric cancer lines. Bisulfite pyrosequencing revealed 96.5% and 97.3% of methylation frequency in AGS and SNU-719 cells. When treating SNU-719, MKN-28 and AGS cells with 5-Aza-2’-deoxycytidine (5-Aza-dc), SHP1 was re-expressed in all three cells. SHP1 expression is known to be correlated with Janus kinase (JAK) and signal transducers and activators of transcription (STAT) signaling pathway in epithelial cells. When introducing exogenous SHP1 in SNU-719 and MKN-28 cells by transient transfection, protein expression of constitutive phospho-JAK2 (Tyr 1007/1008) and phospho-STAT3 (Tyr 705) were substantially down-regulated both, which in turn decreased target gene expression of STAT3, including cyclin D1, MMP-9, VEGF and survivin. Induction of SHP1 significantly inhibited cell proliferation, migration and invasion in SNU-719 and MKN-28 cells. Conclusions: Epigenetic silencing of SHP1 is frequently caused by promoter hypermethylation in gastric carcinoma cell lines. Overexpression of SHP1 down-regulates JAK2/STAT3 pathway to modulate various target genes and inhibit cell proliferation, migration and invasion in gastric cancer cells.
EGFR ligands and ERCC1 mRNA expression to predict clinical outcome in Japanese (JPN) patients (pts) with metastatic colorectal cancer (mCRC) harboring overexpressed EGFR and KRAS exon 2 wild-type (KRAS wt) treated with cetuximab (cet) plus oxaliplatin-based chemotherapy (JACCRO CC-05/06 AR).
Authors: Sunakawa Yu , Ichikawa Wataru , Tsuji Akihito , Moran Miriana , Astrow Stephanie H. , Yang Dongyun , Zhang Wu , Takahashi Takehiro , Denda Tadamichi , Shimada Ken , Kochi Mitsugu , Nakamura Masato , Kotaka Masahito , Segawa Yoshihiko , Takeuchi Masahiro , Lenz Heinz-Josef , Fujii Masashi , Nakajima Toshifusa 
Published: February 2017

618 Background: Previous studies have reported that EGFR ligands, amphiregulin (AREG) and epiregulin (EREG), are potential predictive markers for cet and high ERCC1 expression is associated with resistance to platinum-containing chemotherapy. However, there are still few studies to assess predictive values of these expression levels in JPN mCRC pts. The aim of this study was to evaluate the values in JPN mCRC pts treated with cet. Methods: This study enrolled 77 pts with tissue available from 2 prospective clinical trials evaluating combination of cet with oxaliplatin-based chemotherapy as first-line treatment in pts with KRAS wt and EGFR-expressing tumors, modified FOLFOX6 (n=28/57, UMIN000004197) and SOX (n=49/67, UMIN000007022). Total RNA isolated by macro-dissection from tissue was screened by RT-PCR for mRNA expression levels of AREG, EREG, and ERCC1, the cut-off values of which were based on the optimal cut-off value using the maximal chi-square approach on tumor response with adjusted p values. The same cut-off values were used to evaluate associations with progression-free survival (PFS) and overall survival (OS). Results: Median age and follow-up time were 63 (range: 39-79) years old and 24.7 (range: 5.5-39.3) months, respectively. In 73 evaluable pts, response rate (RR) was 77 % (95% CI, 67 to 86), but no significant association was seen in RR. Pts with high AREG expression (>1.59) had significantly longer PFS (11.6 vs. 6.6 months, HR: 0.53, logrank p=0.047) but not OS in 67 assessable pts. Pts with low ERCC1 expression (≤1.35) had significantly longer OS (42.8 vs. 22.0 months, HR: 2.46, logrank p=0.014) but a trend toward longer PFS (11.6 vs. 8.9 months, HR: 1.63, logrank p=0.092) in 68 assessable pts. On the other hand, high EREG expression (>3.21) was not associated with clinical outcome in 64 assessable pts. Conclusions: Our study identified predictive roles for AREG and ERCC1 mRNA expression in JPN mCRC pts treated with cet plus oxaliplatin. However, extended RAS mutations analysis is warranted (UMIN000010635).
Prognostic and predictive effect of microsatellite instability (MSI) in MAGIC.
Authors: Smyth Elizabeth Catherine , Hulkki Wilson Sanna , Nankivell Matthew Guy , Gonzalez de Castro David , Wotherspoon Andrew , Okines Alicia Frances Clare , Langley Ruth E , Stenning Sally Patricia , Cunningham David 
Published: February 2017

62 Background: MSI is prognostic for survival in diverse cancers and predicts resistance to fluoropyrimidine chemotherapy in colon cancer. We examined the interaction between MSI and patient (pt) characteristics and survival for pts randomised to surgery alone or perioperative ECF chemotherapy in the MRC MAGIC trial. Methods: Tumor and normal control DNA was extracted from resection FFPE. MSI status was determined using the Promega MSI Analysis System (NR-21, BAT-26, BAT-25, NR-24, MONO-27). Tumors were classified as MSS when all markers were stable, MSI-L when only one marker was unstable and MSI-H with minimum of instability in two markers. MSI status was correlated with pt characteristics and survival. Results: MSI results were available for 303 pts (66% resected pts). Twenty (6.6%) and 2 (0.6%) pts were MSI-H and MSI-L. All pts with MSI-H had stomach tumors (vs.GEJ/esophagus). KRAS mutation was more common in MSI-H tumours (30% vs. 4%, p-value <0.001); rates of BRAF, PIK3CA and TP53 mutations were comparable. Median overall survival (OS) from surgery was greater for pts with MSI-H tumours treated with surgery alone (1.69y for MSS vs. not reached for MSI-H) (Table 1), whereas patients with MSI-H tumors treated with chemotherapy plus surgery had inferior outcomes compared to MSS stable pts (median OS 0.8y vs. 1.89y respectively). An interaction test for MSI-H vs. MSS status and treatment arm was positive (p=0.007). Conclusions: In MAGIC, MSI-H status is associated with a positive prognostic effect in pts treated with surgery alone, and a negative predictive effect in pts treated with chemotherapy. As pt selection biomarkers for perioperative chemotherapy are lacking, validation of this finding in an independent dataset is warranted. [Table: see text]
Association of the apoptotic effect of the coffee deterpene kahweol on human colon cancer cell with the expression of heat shock proteins (HSPs).
Authors: Park Sung Chul , Choi Dong Wook , Park Jin Myung , Choi Dae Hee , Kang Chang Don , Lee Sung Joon , Chun Wan Joo 
Published: February 2017

622 Background: It has been reported that coffee has a preventative effect in several cancers because of its anti-oxidant, anti-inflammatory, and anti-tumor properties. However, there have been few reports about the effect and mechanism of coffee compounds in colorectal cancer. Heat shock proteins (HSPs) are molecular chaperones that prevent cell death. Their expression is significantly elevated in many tumors and is accompanied by increased cell proliferation, metastasis, and poor response to chemotherapy. Methods: We investigated the apoptotic effect of major components of coffee in the HT-29 human colon adenocarcinoma cells and evaluated the antitumor mechanism via the regulation of HSPs expression. HT-29 cells were cultured with bioactive compounds of coffee such as caffeine, chlorogenic acid, caffeic acid, and kahweol. Cell viability was determined by MTT and LDH assay according to the concentration of each component. Western blot assay was taken for evaluation of the apoptosis-related signals such as cleaved caspase-3, cleaved PAPR, Bcl-2, phospho-AKT(p-AKT), and HSPs including HSP40, HSP70, and HSP90. Results: Among the various coffee compounds, only kahweol showed significant anti-tumor cell activity, and cell death was observed in a concentration-dependent manner on MTT and LDH assay. Kahweol induced an increase in expression of cleaved caspase-3 and PAPR. In contrast, the reduction of anti-apoptotic proteins such as Bcl-2 and p-AKT was derived. HSPs including HSP40, HSP70, and HSP90 were decreased by kahweol treatment. HSP70 inhibitor such as quercetin and triptolide showed the significantly decreased viability of HT-29 cells. Conclusions: Kahweol had a cytotoxic effect on HT-29 cells via the apoptotic signal pathway in a concentration-dependent manner and inhibited the expressions of HSPs. HSP70 inhibitors showed tumor cell cytotoxicity, suggesting that HSP might play a significant role in the proliferation of cancer cells.
Somatic mutations in young-onset colorectal cancer unrelated to hereditary syndromes: A comparative study using high-depth targeted exome sequencing.
Authors: You Y. Nancy , Chang Kyle , Chen Ken , Mehdizadeh Amir , Cuddy Amanda , Lieu Christopher Hanyoung , Shaw Kenna Rael , Vilar Sanchez Eduardo , Eng Cathy 
Published: February 2017

623 Background: Colorectal cancer (CRC) is being increasingly diagnosed among young adults, but known hereditary syndromes do not account for the majority of these cases. Young patients often present with metastatic disease and exhibit aggressive clinical courses. We aimed to elucidate the potentially unique biology of young-onset CRC. Methods: Patients diagnosed with metastatic CRC prior to age 40 without a known predisposing syndrome (young-onset) were compared to similar patients diagnosed after age 60 (later-onset). Primary and/or metastatic tumor tissues from 19 young- and 51 later-onset patients underwent targeted exome sequencing on a panel of 200 genes using Illumina HiSeq2000 performed by the Institute of Personalized Cancer Therapeutics of MD Anderson Cancer Center. Sequencing was to an average depth of 800x; single nucleotide variations (SNVs) were called according to in-house algorithms. Results: The median age of patients with young-onset CRCs was 34 years (interquartile range: 31-37), while that of later-onset CRCs was 66 years (IQR: 62- 72). The primary CRC was in the rectum in 30% of the young- vs. 16% of the later-onset cases. The overall mutational rate as measured by the number of SNVs per patient (median: 7 vs. 9) did not differ significantly between the groups. However, the median allelic frequency of SNVs was higher in the young-onset group (0.34 vs. 0.17%), suggesting differing patterns of tumor heterogeneity. Genes known to be associated with CRC carcinogenesis were mutated at different proportions (Table); SMAD4, mismatch repair genes (MSH6, MLH1, MSH2), ARID1A, IGF1R and KITappear to be more frequently mutated among the young. Conclusions: This exploratory study suggests that the somatic mutation profiles are distinct between young- vs. later-onset CRCs. More in-depth analysis of the genomic landscape of young-onset CRCs may reveal distinct and novel therapeutic avenues. [Table: see text]