bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunophenotype and intermediate‐high international prognostic index score are prognostic factors for therapy in diffuse large B‐cell lymphoma patients
Authors: Zinzani Pier Luigi , Broccoli Alessandro , Stefoni Vittorio , Musuraca Gerardo , Abruzzese Elisabetta , De Renzo Amalia , Cantonetti Maria , Bacci Francesco , Baccarani Michele , Pileri Stefano A. 
Published: August 2010

AbstractBACKGROUND.The development of gene expression profiling and tissue microarray techniques have provided more information about the heterogeneity of diffuse large B‐cell lymphoma (DLBCL), enabling categorization of DLBCL patients into 3 prognostic groups according to cell origin (but independently from the International Prognostic Index [IPI] score): germinal center (GCB), activated B‐cell (ABC), and not classified (NC) diffuse large B‐cell lymphoma. This study investigated the role of immunohistochemical discrimination between GCB and ABC&NC‐DLBCL subtypes in identifying those high‐risk patients who may benefit from a more aggressive first‐line therapeutic approach.METHODS.From February 2003 to August 2006, 45 newly diagnosed DLBCL patients, with IPI≥2, were considered eligible for this study: 13 had a GCB, 8 an ABC, and 24 a NC‐DLBCL. GCB patients received 6 courses of rituximab, cyclophophosphamide, doxorubicin, vinicristine, and prednisone (R‐CHOP) chemotherapy, with a subsequent, autologous stem cell transplantation in case of partial response. All ABC and NC‐DLBCL patients received 6 R‐CHOP cycles and autologous stem cell transplantation.RESULTS.Complete response rate for each treatment arm was 84.6% for GCB and 89.7% for ABC&NC‐DLBCL (P = .50), with a continuous complete response rate of 81.8% and 84.6%, respectively (P = .59). Projected 4‐year overall survival is 100% for GCB and 82% for ABC&NC patients (P = .12). Progression‐free survival is 77% and 79% (P = .7), respectively.CONCLUSIONS.The autologous stem cell transplantation consolidation in the ABC&NC‐DLBCL subtypes induced the same rate of complete response (and similar progression‐free survival rate) compared with GCB‐DLBCL. In ABC&NC‐DLBCL patients the authors observed a complete response rate of 89.7% vs. 84.6% in the GCB‐DLBCL subset, without any significant difference in progression‐free survival rate. Cancer 2010. © 2010 American Cancer Society.
Quality of surgical resection for nonsmall cell lung cancer in a US metropolitan area
Authors: Allen Jeffrey W. , Farooq Aamer , O'Brien Thomas F. , Osarogiagbon Raymond U. 
Published: August 2010

AbstractBACKGROUND:Curative treatment of early stage nonsmall cell lung cancer (NSCLC) requires good quality surgical resection (GQR). The degree of compliance with national recommendations for GQR is poorly defined. We sought to quantitatively define the degree of compliance in a consecutive series of NSCLC resections.METHODS:Medical records of patients who underwent curative‐intent resection for NSCLC in the Memphis, TN metropolitan area from January 1, 2004 to December 31, 2007 were retrospectively reviewed (N = 746 patients). GQR criteria were obtained from the National Comprehensive Cancer Network (NCCN), the RADIANT adjuvant study of erlotinib, and the American College of Surgeons Oncology Group (ACOSOG) Z0030 study. Factors associated with or without achievement of GQR were evaluated. Categorical variables were compared using chi‐square or Fisher exact test, and survival curves by the log‐rank test.RESULTS:Twenty‐three and one‐half percent of patients met GQR criteria as established by RADIANT, 8.2% by NCCN, and 0.9% by ACOSOG. The most common limiting factor in achieving GQR was inadequate lymph node sampling. The only patient factor associated with GQR was race (African‐Americans were more likely than Caucasians to have GQR per RADIANT and NCCN criteria [P = .022 and P = .0489, respectively]). There was no significant survival difference between GQR and non‐GQR patients.CONCLUSIONS:The vast majority of curative‐intent resections did not achieve GQR standards. The greatest deficit is in surgical sampling of mediastinal (Level 2) lymph nodes, but evaluation of Level 1 lymph nodes is also suboptimal. Interventions are needed to improve current surgical practices and achieve minimum standards for accurate staging, prognostication, and eligibility for clinical trials. Cancer 2011. © 2010 American Cancer Society.
Phase 1 clinical trials in 83 patients with pancreatic cancer
Authors: Vaklavas Christos , Tsimberidou Apostolia‐Maria , Wen Sijin , Hong David , Wheler Jennifer , Ng Chaan S. , Naing Aung , Uehara Cynthia , Wolff Robert A. , Kurzrock Razelle 
Published: August 2010

AbstractBACKGROUND:The outcomes of patients with pancreatic cancer treated on early phase clinical trials have not been systematically analyzed. The purpose of this study was to report the presenting characteristics and outcomes of patients with locally advanced or metastatic pancreatic cancer treated on phase 1 clinical trials at a single institution.METHODS:The authors reviewed the records of consecutive patients with metastatic pancreatic cancer who were treated in the Phase I Clinical Trials Program at The University of Texas M. D. Anderson Cancer Center from November 2004 to March 2009. Data recorded and analyzed included survival, response, and disease characteristics.RESULTS:Eighty‐three patients were identified. The median age was 62 years (range, 39‐81 years). Of 78 patients evaluable for response, 2 (3%) had a partial response (PR), and 10 (13%) had stable disease (SD) for ≥4 months. With a median follow‐up for survivors of 3.7 months, the median survival from presentation in the phase 1 clinic was 5.0 months (95% confidence interval [CI], 3.3‐6.2). The median overall survival from diagnosis was 22.1 months (95% CI, 17.9‐26.5). The median time to treatment failure was 1.5 months (95% CI, 1.3‐1.8). Independent factors associated with lower rates of PR/SD were liver metastases (P = .001) and performance status >0 (P = .01). Independent factors associated with shorter survival were liver metastases (P = .007), low calcium level (P = .015), and elevated CEA level (>6 ng/mL) (P = .005).CONCLUSIONS:Our results suggest that phase 1 clinical trials offer a reasonable therapeutic approach for patients with advanced pancreatic cancer. Cancer 2011. © 2010 American Cancer Society.
Estimating recurrences prevented from using trastuzumab in HER‐2/neu–positive adjuvant breast cancer in the United States
Authors: Danese Mark D. , Lalla Deepa , Brammer Melissa , Doan Quan , Knopf Kevin 
Published: August 2010

AbstractBACKGROUND.Breast cancer recurrence is associated with significant morbidity, mortality, and cost. Patients with early stage HER2+ tumors are at increased risk of recurrence. The use of trastuzumab for these patients has been shown to reduce recurrences and improve overall survival.METHODS.A Monte Carlo simulation was conducted based on Surveillance, Epidemiology, and End Results incidence rates for 2005, United States Census data for 2005, and the results of key trials of the adjuvant use of trastuzumab. Patients included in this analysis had incident, HER2+, stage I to III breast cancer. The number of recurrences that could be prevented with trastuzumab, the cardiac adverse events that might occur, and the associated cost savings were estimated.RESULTS.Approximately 31,200 women had HER2+ breast cancer in 2005, of whom 7298 would have had a recurrence over the subsequent 5 years despite standard of care adjuvant treatment. If trastuzumab were added to their regimen, 2791 women might have avoided recurrence, and 948 may have had an asymptomatic or symptomatic cardiac adverse event, for a ratio of expected recurrences to cardiac adverse events of 3.2 (95% confidence interval, 1.5‐5.9). In economic terms, avoidance of future breast cancer recurrences was associated with lifetime reduction in future direct and indirect costs on the order of $240 million to $1.7 billion.CONCLUSIONS.On the basis of the simulation results, targeting HER2+ tumors with trastuzumab in the adjuvant setting should prevent a significant number of women from recurrence events, with important outcomes for patients, physicians, payers, and society. Cancer 2010. © 2010 American Cancer Society.
Defining the course and prognosis of adults with acute lymphocytic leukemia in first salvage after induction failure or short first remission duration
Authors: Kantarjian Hagop M. , Thomas Deborah , Ravandi Farhad , Faderl Stefan , Jabbour Elias , Garcia‐Manero Guillermo , Pierce Sherry , Shan Jianquin , Cortes Jorge , O'Brien Susan 
Published: August 2010

AbstractBACKGROUND:Results from salvage therapy in adult patients with acute lymphocytic leukemia (ALL) are wide‐ranging and depend on several disease and patient characteristics. The objectives of this study were to define the prognosis for adult patients with ALL after first salvage through multivariate analyses of patient and disease characteristics.METHODS:Adults with ALL who had primary resistance to frontline therapy or who had a disease recurrence after a first complete response (CR) duration <1 year were analyzed. Multivariate analyses for subsequent CR and survival were conducted.RESULTS:Seventy‐five of 245 patients (31%) achieved CR. The median CR duration was 5 months, the median survival was 4.7 months. In multivariate analysis, independent poor prognostic factors for not achieving CR were age >55 years, bone marrow blasts ≥20%, and platelet count <75 × 109/L. Variables that were associated independently with shorter survival were age >55 years, bone marrow blasts ≥20%, platelet count <75 × 109/L, albumin level <3 g/L, and lactic dehydrogenase level ≥1000 IU/L. Patients who had ≥3 of the 5 adverse factors (45%) had a median survival of 2 to 3 months and CR rates of 8% to 15%. Achieving CR was associated independently with improved survival in a landmark multivariate analysis (P< .0001; hazard ratio, 0.40; 95% confidence interval, 0.03‐0.72).CONCLUSIONS:The current analyses identified a subset of adults patients ALL in first salvage for whom standard therapies were associated with an extremely poor outcome. The results also confirmed the importance of achieving CR to attain improved survival. Cancer 2010. © 2010 American Cancer Society.
The expanding melanoma burden in California hispanics
Authors: Pollitt Ricardo A. , Clarke Christina A. , Swetter Susan M. , Peng David H. , Zadnick John , Cockburn Myles 
Published: August 2010

AbstractBACKGROUND:The incidence patterns and socioeconomic distribution of cutaneous melanoma among Hispanics are poorly understood.METHODS:The authors obtained population‐based incidence data for all Hispanic and non‐Hispanic white (NHW) patients who were diagnosed with invasive cutaneous melanoma from 1988 to 2007 in California. By using a neighborhood‐level measure of socioeconomic status (SES), the variables investigated included incidence, thickness at diagnosis, histologic subtype, anatomic site, and the relative risk (RR) for thicker (>2 mm) versus thinner (≤2 mm) tumors at diagnosis for groups categorized by SES.RESULTS:Age‐adjusted melanoma incidence rates per million were higher in NHWs (P < .0001), and tumor thickness at diagnosis was greater in Hispanics (P < .0001). Sixty‐one percent of melanomas in NHWs occurred in the High SES group. Among Hispanics, only 35% occurred in the High SES group; and 22% occurred in the Low SES group. Lower SES was associated with thicker tumors (P < .0001); this association was stronger in Hispanics. The RR of thicker tumors versus thinner tumors (≤2 mm) in the Low SES group versus the High SES group was 1.48 (95% confidence interval [CI], 1.37‐1.61) for NHW men and 2.18 (95% CI, 1.73‐2.74) for Hispanic men. Patients with lower SES had less of the superficial spreading melanoma subtype (especially among Hispanic men) and more of the nodular melanoma subtype. Leg/hip melanomas were associated with higher SES in NHW men but with lower SES in Hispanic men.CONCLUSIONS:The socioeconomic distribution of melanoma incidence and tumor thickness differed substantially between Hispanic and NHW Californians, particularly among men. Melanoma prevention efforts targeted to lower SES Hispanics and increased physician awareness of melanoma patterns among Hispanics are needed. Cancer 2011. © 2010 American Cancer Society.
Toward curative treatment of peritoneal carcinomatosis from nonovarian origin by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy
Authors: Glehen Olivier , Gilly François N. , Boutitie Florent , Bereder Jean M. , Quenet François , Sideris Lucas , Mansvelt Baudouin , Lorimier Gérard , Msika Simon , Elias Dominique 
Published: August 2010

AbstractBACKGROUND:Peritoneal carcinomatosis (PC) from nonovarian malignancies long has been regarded as a terminal disease. Over the past decade, new locoregional therapeutic approaches combining cytoreductive surgery with perioperative intraperitoneal chemotherapy (PIC) have evolved that have demonstrated improved survival.METHODS:A retrospective, multicenter cohort study was performed in French‐speaking institutions to evaluate toxicity and principal prognostic factors after cytoreductive surgery and PIC (hyperthermic intraperitoneal chemotherapy [HIPEC] and/or early postoperative intraperitoneal chemotherapy [EPIC]) for PC from nongynecologic malignancies.RESULTS:The study included 1290 patients from 25 institutions who underwent 1344 procedures between February 1989 and December 2007. HIPEC was performed in 1154 procedures. The principal origins of PC were colorectal adenocarcinoma (N = 523), pseudomyxoma peritonei (N = 301), gastric adenocarcinoma (N = 159), peritoneal mesothelioma (N = 88), and appendiceal adenocarcinoma (N = 50). The overall morbidity and mortality rates were 33.6% and 4.1%, respectively. In multivariate analysis, patient age, the extent of PC, and institutional experience had a significant influence on toxicity. The overall median survival was 34 months; and the median survival was 30 months for patients with colorectal PC, not reached for patients with pseudomyxoma peritonei, 9 months for patients with gastric PC, 41 months for patients with peritoneal mesothelioma, and 77 months for patients with PC from appendiceal adenocarcinoma. Independent prognostic indicators in multivariate analysis were institution, origin of PC, completeness of cytoreductive surgery, extent of carcinomatosis, and lymph node involvement.CONCLUSIONS:A therapeutic approach that combined cytoreductive surgery with PIC was able to achieve long‐term survival in a selected group of patients who had PC of nonovarian origin and had acceptable morbidity and mortality. The current results indicated that this treatment should be centralized to institutions with expertise in the management of PC. Cancer 2010. © 2010 American Cancer Society.
Predictors of competing mortality in early breast cancer
Authors: Mell Loren K. , Jeong Jong‐Hyeon , Nichols Michael A. , Polite Blase N. , Weichselbaum Ralph R. , Chmura Steven J. 
Published: August 2010

AbstractBACKGROUND:Death in the absence of disease recurrence (competing mortality) is an important determinant of disease‐free survival (DFS) in early breast cancer. The authors sought to identify predictors of this event using competing risks modeling.METHODS:A cohort study was made of 1231 consecutive women with stage I to II invasive breast cancer diagnosed between 1986 and 2004, treated with breast conservation therapy. Median follow‐up was 82 months. The authors used a parametric competing risks regression model to analyze factors associated with the cumulative incidence of competing mortality. They generated a risk score from the model coefficient estimates and stratified patients according to low and high risk score for analysis.RESULTS:Ten‐year DFS was 69.7% (95% confidence interval [CI], 66.2%‐72.9%). The 10‐year cumulative incidence of locoregional recurrence (LRR) was 4.4% (95% CI, 3.0%‐5.8%), distant recurrence was 7.1% (95% CI, 5.4%‐8.9%), and competing mortality was 18.7% (95% CI, 15.9%‐21.6%). On multivariate analysis, competing mortality was associated with increasing age (hazard ratio [HR], 1.83 per 10 years; 95% CI, 1.58‐2.12), black race (HR, 1.71; 95% CI, 1.17‐2.51), and comorbid disease (HR, 1.93, 95% CI, 1.40‐2.65). Ten‐year cumulative incidences of competing mortality, locoregional recurrence, and distant recurrence for patients at low (n = 638) versus high (n = 593) risk of competing mortality were 7.2% versus 30.6% (P< .001), 4.4% versus 4.4% (P= .97), and 8.6% versus 5.6% (P= .12), respectively.CONCLUSIONS:Competing mortality is an important event influencing 10‐year DFS in early breast cancer and is associated with increasing age, black race, and comorbid disease. Stratifying patients according to competing mortality risk may be useful in designing clinical trials. Cancer 2010. © 2010 American Cancer Society.
Clinical significance of regulatory T cells and CD8+ effector populations in patients with human endometrial carcinoma
Authors: Chang Wen‐Chun , Li Chao‐Hsu , Huang Su‐Cheng , Chang Daw‐Yuan , Chou Li‐Yun , Sheu Bor‐Ching 
Published: August 2010

AbstractBACKGROUND:A study was carried out to determine the functional attributes of CD4+ CD25+ regulatory T cells in cancer progression by suppressing antitumor immunity.METHODS:Triple‐color flow cytometry was used to study the phenotype expression of CD4+ CD25+ regulatory T cells and CD8+ T cells in the peripheral blood lymphocytes (PBLs) and tumor‐infiltrating lymphocytes (TILs) of 57 cases of stage I to IV endometrial carcinoma. The expression of T cell subsets was correlated with clinical prognostic parameters.RESULTS:The prevalence of CD4+ CD25+ T cells was significantly higher in the TILs than PBLs. The expression of CD4+ CD25+ regulatory T cells in cancer milieu correlated with the tumor grade, stage, and myometrium invasion. The expression of FOXP3 and GITR in CD4+ CD25+ regulatory T cells was lower in PBLs than TILs. Most tumor‐infiltrating CD8+ T cells were CD28− CD45RA− CD45RO+ CCR7−, suggesting good terminal differentiation. Most of them had an activated role with CD69+ CD103+ CD152+. Functionally, both granzyme B and perforin were scarcely expressed in peripheral regulatory T cells but were highly expressed in peripheral regulatory T cells in the tumor microenvironment. In contrast, CD8+ cytotoxic T cells derived from PBLs expressed both granzyme B and perforin, and at significantly higher levels than in TILs. Further functional assays demonstrated that Th1 cytokines and cytotoxic molecules can be synchronously up‐regulated in CD8+ cytotoxic T cells.CONCLUSIONS:Regulatory T cells in the tumor microenvironment may abrogate CD8+ T cell cytotoxicity in a granzyme B‐ and perforin‐dependent conduit. Decreases in both Th1 cytokines and cytotoxic enzymes are relevant for regulatory T cell‐mediated restraint of tumor clearance in vivo. Of clinical significance, the expression of regulatory T cells in TILs may mediate T cell immune repression within cancer milieu and thus greatly correlate with cancer progression. Cancer 2010. © 2010 American Cancer Society.
Prognostic factors and long‐term outcomes of childhood nasopharyngeal carcinoma
Authors: Cheuk Daniel Ka Leung , Billups Catherine A. , Martin Michael G. , Roland Cynthia R. , Ribeiro Raul C. , Krasin Matthew J. , Rodriguez‐Galindo Carlos 
Published: August 2010

AbstractBACKGROUND:The authors studied the survival and long‐term morbidities of children with nasopharyngeal carcinoma (NPC).METHODS:This was a retrospective review of children with NPC who were treated at St. Jude Children's Research Hospital between 1961 and 2004. Prognostic factors and long term effects of therapy were analyzed.RESULTS:Fifty‐nine patients (median age, 14.1 years) were identified. Most were male (66.1%) and black (54.2%) and had lymphoepithelioma (93.2%). Thirty‐five patients had stage IV disease (59.3%), 20 patients had stage III disease (33.9%), and 4 patients had stage II disease (6.8%). All patients received radiotherapy (RT) to the primary tumor, and most received cervical RT (98.3%) and chemotherapy (88.1%). The 15‐year survival and event‐free survival (EFS) rates were 67.2% ± 7.5% and 63.5% ± 7.8%, respectively. Five patients (8.5%) developed subsequent malignancies 8.6 to 27 years after NPC diagnosis. EFS was improved in patients who were diagnosed after 1980 (74.8% ± 10% vs 45.5% ± 10.1%; P = .031), in patients who had stage III disease compared with patients who had stage IV disease (79.3% ± 9.6% vs 56.2% ± 11.8%; P = .049), in patients who received cisplatin (81% ± 10.7% vs 45.8% ± 9.7%; P = .013), and in patients who received ≥50 grays of RT (71.4% ± 9.3% vs 43.8% ± 11.6%; P = .048). White patients had higher distant failure rates than black patients (41.7% ± 10.4% vs 15.6 ± 6.5%; P = .045). The 15‐year cumulative incidence (CI) of any morbidity was 83.7% ± 5.4%, the CI of sensorineural hearing loss was 52.9% ± 6.7%, the CI of primary hypothyroidism was 42.7% ± 6.6%, and the CI of growth hormone deficiency (GHD) was 14.1% ± 4.7%. Dose‐response relations were observed between the RT dose and primary hypothyroidism and GHD.CONCLUSIONS:The outcome of children with NPC improved over the past 4 decades with the use of cisplatin‐based chemotherapy and higher RT doses. However, many survivors had long‐term treatment‐related morbidities. Cancer 2011. © 2010 American Cancer Society.
Biologic and immunologic effects of preoperative trastuzumab for ductal carcinoma in situ of the breast
Authors: Kuerer Henry M. , Buzdar Aman U. , Mittendorf Elizabeth A. , Esteva Francisco J. , Lucci Anthony , Vence Luis M. , Radvanyi Laszlo , Meric‐Bernstam Funda , Hunt Kelly K. , Symmans William Fraser 
Published: August 2010

AbstractBACKGROUND:Through this study, the authors sought to investigate the biologic and immunologic effects of preoperative trastuzumab in patients with ductal carcinoma in situ (DCIS) of the breast.METHODS:Patients with DCIS were enrolled in this open‐label phase 2 trial and tested for HER2. Trastuzumab was given by intravenous infusion (8 mg/kg). The patients then had surgery 14 to 28 days after treatment. Tissue and peripheral blood samples were obtained before therapy and at the time of surgery to examine residual disease and immunologic response.RESULTS:Median age of the 69 enrolled patients was 53 years, mean mammographic size of the DCIS lesions was 5.2 ± 1.2 cm, and 24 patients (35%) were found to have HER2 overexpression/amplification (12 received trastuzumab and 12 untreated patients provided tissue for blinded, controlled biomarker analyses). No overt histologic evidence of response was noted. No significant change in mean pretherapy staining for Ki‐67 (44.3 ± 3.4%) and cleaved caspase‐3 (2.6 ± 0.8%) was noted when surgical specimens from drug‐treated patient samples were compared with those not treated. Trastuzumab significantly augmented antibody‐dependent cell mediated cytotoxicity (ADCC) in 100% of patients; this was demonstrated to be mediated through CD56+ degranulating natural killer cells (P < .01). One patient developed a significant anti‐HER2 humoral CD4 T‐cell response.CONCLUSIONS:Single‐dose monotherapy with trastuzumab for patients with HER2‐positive DCIS does not result in significant, clinically overt, histologic, antiproliferative, or apoptotic changes, but does result in the ability to mount ADCC mediated through natural killer cells and may also induce T‐cell dependent humoral immunity. Further studies of trastuzumab for DCIS appear warranted. Cancer 2011. © 2010 American Cancer Society.