tbuckley/cabot-search huggingface dataset:
A prospective patient (pt) survey on clinical trials.
Authors: Sing Yu Moorcraft, Cheryl Marriott, Clare Peckitt, David Cunningham, Ian Chau, Naureen Starling, David Watkins, Jervoise Andreyev, Sheela Rao
Journal: Journal of Clinical Oncology (2015)

707 Background: Recruitment to clinical trials can be challenging. We conducted a patient survey to improve our understanding of pts’ views and experiences of clinical trials and what aspects could be improved. Methods: Pts who had been approached about participation in any clinical trial in the Gastrointestinal (GI) and Lymphoma Unit at the Royal Marsden were prospectively invited to complete a questionnaire about their views and experiences of cancer research. Results: Between August 2013 and July 2014, 276 pts (90% GI, 10% lymphoma) received 298 clinical trial pt information sheets (PIS) and were asked to complete a questionnaire. 263 respondents (Res) consented to a trial and 249 of these (95%) completed the questionnaire (65 for clinical trials of an investigational medicinal product (CTIMP), 156 for non-CTIMPs and 28 for molecular pre-screening trials). 25 Res declined a trial and 10 of these completed the questionnaire. Of the 249 Res who consented to a trial, 96% were glad to be approached about clinical trials. 90% of Res felt the PIS was easy to understand and rated the verbal explanation of the trial as excellent/good. 10 Res who declined a trial felt the verbal explanation was excellent/good and that the PIS was easy to understand. The mean total PIS length (including sub-studies) was 17 pages (range 3-50 pages). 9% of Res who consented to a trial felt the PIS was too long. Regarding CTIMP trials, 48-50% of Res would have liked more information on trial drugs and any additional research procedures, 28-30% were neutral and 20-24% did not want more information. 75% of Res would consider participating in studies requiring a research biopsy and 78% would donate their tissue for genetic research. 79% of pre-screening trial Res, 66% of non-CTIMP trial Res and 54% of CTIMP trial Res would have been willing to consent to the trial on the day they received the PIS. 75% of Res (including 89% of CTIMP Res) believed pts should be told trial results, even if results are not available for many years. Conclusions: The majority of pts are willing to be approached regarding clinical trials. A high proportion of pts would consider studies involving research biopsies. New strategies for tailoring additional trial information according to the patient and informing pts of trial results should be explored.
Infliximab therapy leads to clinical and radiographic benefits in early rheumatoid arthritis patients receiving optimum methotrexate dose
Authors: J. Bathon, Jean-Pierre Devogelaer, Kalden, M Shiff, P. Emery, RN Maini, D van der Heijde, E Keystone, D. Baker, K Patel, J. Han, J. Smolen, Ews Clair
Journal: Annals of the Rheumatic Diseases (2004)
Abstract 16460: Deletion of Aryl Hydrocarbon Receptor Nuclear Translocator (HIF1-{beta}) in the Heart Leads to Cardiomyopathy and Lipid Accumulation via PPAR{alpha}
Authors: Rongxue Wu, Kusum Chawla, Mohsen Granefar, Minh Tran, Arineh Khechaduri, Marina Bayeva, Amy Rines, Hossein Ardehali
Journal: Circulation (2012)

Background: Patients with type 2 diabetes are prone to cardiovascular complications, including high rates of lipid uptake and accumulation in cardiomycoytes. However, the mechanism for lipid build ...
Phase I Clinical/Pharmacokinetic and Pharmacodynamic Trial of the c-<i>raf</i>-1 Antisense Oligonucleotide ISIS 5132 (CGP 69846A)
Authors: James P. Stevenson, Kang-Shen Yao, Maryann Gallagher, David Friedland, Edith P. Mitchell, Amy Cassella, Brett Monia, T. Jesse Kwoh, Rosie Yu, Jon Holmlund, F. Andrew Dorr, Peter J. O'Dwyer
Journal: Journal of Clinical Oncology (1999)

PURPOSE: Raf-1 is a protein kinase that plays a broad role in oncogenic signaling and acts as a downstream effector of Ras in the mitogen-activated protein kinase pathway. The present study was designed to determine the maximum-tolerated dose (MTD), toxicity profile, pharmacokinetics, and antitumor activity of the c-raf-1 antisense oligodeoxynucleotide ISIS 5132 (CGP 69846A; ISIS Pharmaceuticals Inc, Carlsbad, CA). The effect of ISIS 5132 on c-raf-1 gene expression in peripheral-blood mononuclear cells (PBMCs) of treated patients was studied using a reverse transcriptase polymerase chain reaction assay. PATIENTS AND METHODS: Patients with refractory malignancies received ISIS 5132 as a 2-hour intravenous infusion three times weekly for 3 consecutive weeks. Pharmacokinetic sampling was performed during the first cycle in all patients; PBMCs for c-raf-1 mRNA analysis were collected at baseline and on days 3, 5, 8, and 15 of cycle 1 and on day 1 of each cycle thereafter. RESULTS: Thirty-one patients received ISIS 5132 at one of nine dose levels ranging from 0.5 mg/kg to 6.0 mg/kg. Clinical toxicities included fever and fatigue, but these were not dose limiting. A clinically defined MTD was not reached. The harmonic mean half-life of ISIS 5132 was 59.8 minutes (range, 35.5 to 107.3 minutes). The area under the concentration-time curve increased linearly with dose, and mean plasma clearance was 1.86 mL/kg/min (range, 1.21 to 2.41 mL/kg/min). Two patients experienced prolonged stable disease lasting more than 7 months, which was associated with persistent reduction in c-raf-1 expression in PBMCs. Significant decreases in c-raf-1 expression were identified at time points after the baseline value (P &lt; .05) at doses ≥ 2.5 mg/kg. CONCLUSION: ISIS 5132 is well tolerated at doses up to 6.0 mg/kg when administered as a thrice weekly 2-hour infusion for 3 consecutive weeks. The pharmacokinetic behavior of the drug is reproducible, and suppression of target gene expression is observed in circulating PBMCs.
Videothoracoscopic talc poudrage pleurodesis for the treatment of malignant pleural effusions secondary to breast cancer
Authors: M. Glogowski, I. Glogowska, I. Lemanska, M. Zmijewski, T. Pienkowski, A. Pietraszek
Journal: Journal of Clinical Oncology (2005)

8216 Background: Metastatic breast cancer (mbc) is a most frequent reason of malignant pleural effusion(MPE) in women. The effective treatment of pleural fluid reaccumulation is a important aim in managment and paliative care of patients (pts) with mbc.The aim of this report is to evaluate the results of videothoracoscopic talc poudrage (TPP) pleurodesis secondary to mbc. Methods: Between November 1999 and December 2003, 57 pts with MPE with primary breast cancer uderwent videothoracoscopy (VATS). Clinical symptoms of MPE were observed in all pts and ECOG PS were:1–39pts, 2–16pts,3–2pts. Pleural fluid was a single site of mbc in 8 pts and was the first site of mbc in 24 pts. Median time from radiologic diagnosis to VATS was 34days (r 6–517). Histology of mbc was confirmed in 52pts(91%). Pleurodesis was performed with 5 g of sterile purified talc insufflated through a talc atomizer. One chest tube was left in pleural space until the fluid drainage was less than 200ml per postoperative day. 50pts were treated by systemic therapy after TPP. Results: No perioperative mortality was observed. We noted 7(12%) severe postoperative complications: 3 cases of acute respiratory failure,one case of heart failure one case of renal insufficiency, one case of pulmonary embolism and one case of gastric perforation. Averange hospitalisation was 6 days (3–51). We noted 6 cases of incomplete lung reexpansion (10%).It correlated with long time from radiologic to VATS diagnosis (over 6 mts). 51 pts (90%) had succesful pleurodesis and regresion of symptoms. In this group we observed 3 reccurences of effusion-after 2,3 and 7 mts. After a median follow-up of 10 mts (range 1–37), talc pleurodesis was succesful in controlling recurrence of effusion in 52 pts (91%). 35 pts died as a result of progression of mbc. 22 pts alive without recurrence of effusion. Overall survival (OS) at 6,12 and 24 mts was 65%, 52% and 28% and correlated with number of metastatic sites and PS. We noted better prognosis in pts with single metastatic site in pleura (median survival time 18 vs 8mts, p<0,001). Conclusions: TPP is an effective and safe method of lifelong pleurodesis in pts with mbc. It is able to help efficiency of systemic therapy and supportive care. No significant financial relationships to disclose.
Initial versus recent outcomes with a non–risk adapted surveillance policy in stage I non-seminomatous germ cell tumors (NSGCT)
Authors: I. Duran, J. F. Sturgeon, M. A. Jewett, L. Anson-Cartwright, D. R. Berthold, D. Kakiashvili, P. R. Warde, R. E. Alison, G. R. Pond, M. J. Moore
Journal: Journal of Clinical Oncology (2007)

5021 Background: Since 1981 the Princess Margaret Hospital testicular cancer group has used surveillance as the preferred management option for all patients (pts) with clinical stage I NSGCT. In a report of the first 105 pts [Sturgeon et al. J Clin Oncol, 1992] the relapse rate was 35% and the disease specific 5-year survival 99%. Improvements in imaging technique over time could cause stage migration with an overall lower relapse rate in this patient population. We compare our experience with surveillance over different time points. Methods: Three-hundred and five pts with stage I NS-GCT were placed on an active surveillance protocol between 1981–2004. They were not stratified by risk and only received treatment on the event of a relapse. Recurrence rates, time to relapse, risk factors predictive for recurrence, disease specific and overall survival were determined. For the analysis by time period, pts were divided in two groups based on diagnosis date. (Initial=1981–1992 [N=141] and Recent=1993–2004 [N=164]). Results: With a median follow-up of 6.3 years, 77/305 pts (25%) relapsed; 46/141 pts (32.6%) in the initial group and 31/164 (18.9%) in the recent. All but 3 (4%) relapses occurred within 2 years after orchiectomy with a median time to relapse of 7 months. A multivariate analysis established lympho-vascular invasion (p&lt;0.01) and pure embryonal carcinoma (p= 0.03) as independent predictors of recurrence. Overall 104/305 (34.1%) pts were designated as ‘high- risk’ based on the presence of at least one of these factors. In the initial group 60/141 (42.6%) pts were high risk and 32/60 (53%) relapsed versus 14/81 (17.3%) low-risk (p=0.047). In the recent group 44/164 (26.8%) pts were high-risk and 17/44 (38.6%) recurred, versus 14/120 (11.7%) low-risk (p&lt;0.001). There were 2 (0.7%) deaths due to testis cancer. The estimated 5-year disease specific survival was 98.9% in the initial group and 100% in the recent one. Conclusions: Surveillance is an effective strategy for the management of all stage I NSGCT. A risk-adapted policy would result in more than 50% of the patients being unnecessarily treated. The relapse rate has reduced over time, likely due to improvements in imaging causing stage migration. No significant financial relationships to disclose.
The Road to Nowhere: The Genesis of President Clinton's Plan for Health Security, by Jacob S Hacker
Authors: D. Light
Journal: BMJ (1997)

Jacob S Hacker: Princeton University Press, £29.95, pp 248 ISBN 0 691 04423 6

Given the many ways that Margaret Thatcher's transformation of the NHS into a competitive marketplace increased costs and created dislocations, “The Road to Nowhere” might aptly title a book about NHS policies in the 1990s. But, instead, Jacob Hacker examines how managed competition came to be so uncritically embraced in the United States, why universal health insurance seemed so certain to pass, and why President Clinton's reform proposal went nowhere—”One of the most dramatic reversals of political fortune since President Woodrow Wilson's ill-fated campaign on behalf of the League of Nations.”

Since then, the number of uninsured has been rising at about 100 000 a month to one sixth of the population, and those with illnesses or high risks are increasingly deselected. Coverage of the insured has steadily thinned, charges and fees have risen sharply, and the “savings” are credited to competition. The original vision of equitable, responsible managed competition rewarding efficiency, it seems, has become an excuse for reducing coverage and discriminating against the sick.

The strength of this brief, readable book lies in the way it pulls together threads of history …
P1034 : Characterisation of the prevalence and risk factors for biopsy-proven non-alcoholic steatohepatitis among patients with gallstones: A prospective study
Authors: C. Garcia-Monzon, J. Vargas-Castrillon, J.L Porrero, M.T. Alonso, O. Bonachia, M.J. Castillo, A. Marcos, E. Quiros, B. Ramos, C. Sanchez-Cabezudo, S. Villar, A. Saez, J. Rodriguez de Cia, E. Del Pozo, L. Vega, S. Soto-Fernandez, O. Lo Iacono, M.E. Miquilena-Colina
Journal: Journal of Hepatology (2015)
Serum 25 hydroxyvitamin D levels in early and advanced breast cancer
Authors: C. Palmieri, T. Macgregor, S. Girgis, D. M. Vigushin
Journal: Journal of Clinical Oncology (2005)

630 Background: Laboratory and epidemiological studies have implicated vitamin D deficiency in the pathogenesis of breast cancer. 1,25-dihydroxyvitamin D (1,25(OH)2D) promotes differentiation and apoptosis, and potently inhibits proliferation of malignant breast epithelial cells in culture. Breast cancer incidence and mortality are both increased in countries at high latitudes and increased skin pigmentation is associated with more aggressive breast cancers Decreased exposure to effective solar radiation resulting in reduced cutaneous synthesis of vitamin D3 is the likely mechanism. Conversely, vitamin D sufficiency and exposure to sunlight reduce the risk of developing breast cancer and serum levels of 1,25(OH)2D are higher in normal women compared to patients with primary breast cancer. This study aims to clarify the role of vitamin D in breast cancer progression by comparing the levels of serum vitamin D in patients with early and advanced breast cancer. Methods: Circulating levels of 25 hydroxyvitamin D 25(OH)D, parathyroid hormone (PTH), and calcium were measured in 279 caucasian women with invasive breast cancer, 204 with early stage malignancy and 75 with locally advanced or metastatic disease. Patients with renal impairment or receiving bisphosphonate therapy were excluded. Results: Patients with early stage breast cancer had significantly higher circulating levels of 25(OH)D (P=0.0049) and significantly lower PTH (P=0.0001) levels compared to those with advanced disease. Calcium levels did not differ significantly between the two groups (p=0.74). Conclusion: Serum levels of 25(OH)D are significantly higher in patients with early stage breast cancer compared to those with locally advanced and/or metastatic disease. The potential clinical implications of monitoring and/or maintaining high circulating vitamin D levels in breast cancer patients remain to be elucidated. No significant financial relationships to disclose.
Two studies from the JP Wilmot Cancer Center on the relationship of treatment, expectations, and race with post-treatment skin reactions reported by cancer patients
Authors: J. L. Ryan, C. Figueroa-Moseley, C. Bole, J. T. Hickok, L. K. Colman, R. C. Khanna, M. Lennon, A. P. Pentland, G. R. Morrow
Journal: Journal of Clinical Oncology (2006)

18560 Background: Cancer patients may experience skin problems while undergoing treatment. Frequency of skin reactions may be influenced skin pigmentation and/or psychological factors. Methods: A Symptom Inventory (SI) completed by 411 cancer patients nationwide before and after treatment was analyzed to determine if treatment type, race (Black versus White), and pre-treatment expectations influenced post-treatment skin reactions. Subsequent analysis of a SI completed weekly for five weeks by 167 local patients receiving radiotherapy examined severity of reported skin reactions. Results: One-way between-group ANOVA, with Bonferroni correction, showed significantly more patients receiving radiotherapy had stronger expectations of skin problems (62%) compared to patients receiving chemotherapy (40%, p = 0.001) or chemotherapy plus radiotherapy (45%, p = 0.003). Overall, expectations did not correlate with patient reported skin problems post-treatment (Spearman’s rho = 0.02, p = 0.70). Likewise, a Kruskal Wallis test showed no significant difference in severity of skin reactions reported by patients receiving radiotherapy (n = 138) and/or chemotherapy (n = 273, p = 0.56). Severe skin problems were reported more frequently by 10/18 (56%) Blacks than 90/393 (23%) Whites (p = 0.001), although no significant difference was found between Blacks and Whites in their pre-treatment expectations of skin problems (p = 0.32). Further, pre-treatment expectations of skin problems did not influence post-treatment reporting of skin problems in Blacks (Spearman’s rho = −0.02, p = 0.93) or Whites (Spearman’s rho = 0.02, p = 0.65). Similarly, the local study showed that significantly more Blacks (38%) reported severe skin reactions at the treatment site than Whites (6%). Total radiation exposure was significantly related to the severity of skin problems reported by Blacks (Spearman’s rho = 0.90, p = 0.04), but not Whites (Spearman’s rho = −0.06 p = 0.52). Conclusions: Overall, Blacks reported more severe post-treatment skin problems than Whites. How this self-reported skin damage correlates with clinical findings remains to be determined. Supported by NCI PHS grants 1R25CA102618 and U10CA37420. No significant financial relationships to disclose.
Between Openness and Privacy in Genomics
Authors: Effy Vayena, Urs Gasser
Journal: PLoS Medicine (2016)

Quickly sequencing your DNA on your mobile phone is science fiction but might not be for long-companies are already investing in the idea [1,2].Genomic data are being generated at ever higher speeds: clinics, personal genomic companies like 23andme.com and ancestry.com,pharmaceutical industry labs, funding agencies, and public-private initiatives are all grappling with the implications.Genomics, along with proteomics, metabolomics, and other omics, promises, as President Obama recently put it, to give "us all access to the personalized information we need to keep ourselves and our families healthier" [3].Generating genomic data is nothing without translating it into practical heath care measures [4].Breakthroughs depend on linking genomic data with other omics and phenotypic data [5,6].Yet, genomic datasets have become subject to access restrictions on technological, cultural, ethical, and legal grounds.Restrictive policies diminish the data's utility by creating bottlenecks, hampering discoverability, imposing burdensome access authorization processes, and Summary Points• Advancing genomic research depends on the accessing and sharing of genomic data.However, the increasing need for sharing escalates the tension between genomic privacy and openness.
Breast cancer in elder women in China
Authors: S. Wu
Journal: Journal of Clinical Oncology (2008)

11588 Background: The objective of this retrospective study was to discuss the clinical feature, the therapeutic results and the prognostic factors of breast cancer in elder women throughout a study of 464 women patients aged more than 60 years. Methods: We reviewed the epidemioclinical records of all the patients of our hospital. Nonmetastatic and operable patients were treated with surgery (conservative or radical) followed by an adjuvant treatment (chemotherapy, radiotherapy, endocrine therapy) indicated according to the prognostic factors. Locally advanced or metastasis tumors were treated with chemotherapy. Overall survival was calculated according to the Kaplan-Meier method. The multivariate analysis was performed according to the Cox model. Results: The mean age was of 65.2 years. The 5 years overall survival of elder patients was of 77.04%. Pejorative prognostic factors in univariate analysis and multivariate analysis were: clinical phase, N+, adjuvant radiation treatment and adjuvant endocrine therapy. Conclusions: Clinical presentation and outcome of breast cancer in our elder patients aged more than 60 years seems to be better prognostic than those of younger patients. No significant financial relationships to disclose.
Phase II study of docetaxel, cisplatin, and 5-fluorouracil (TPF) as first-line chemotherapy in advanced gastric cancer
Authors: Q. Chowdhury, S. Hossain, S. Reza, M. A. Hai, M. Faruqui, M. S. Morshed
Journal: Journal of Clinical Oncology (2008)

15640 Background: Cisplatin and 5-FU is the standard chemotherapy for advanced gastric cancer. Single agent docetaxel or combination with cisplatin & 5-FU shows better efficacy in advanced gastric cancer. This study was conducted in different hospitals & institute to determine toxicity and efficacy of a combination chemotherapy using docetaxel, cisplatin and 5-fluorouracil (TPF) in Bangladeshi patients with advanced gastric cancer. Methods: Patients with previously untreated measurable metastatic gastric cancer were included in this trial. Pts with unresectable (T2–3N0–1M0) gastric cancer were treated with this combination chemotherapy repeated every 21 days for six cycle. Patient received docetaxel 75 mg/m2 on day 1, intravenously cisplatin 80 mg/m2 on day 1 and continuous infusion 5-FU 800 mg/m2 on day 1–4. Results: Between 2003 and 2007, 30 pts were enrolled in this protocol, Male/Female 25/5, Median age 59 (40–75), Adeno/Undifferentiated carcinoma 22/8, EUS staging: T2N0 5 pts, T2N1 2 pts, T3N0 10 pts, T3N1 13 pts. The major toxicity were Neutropenia (Grade 3 and 4, 56%), Leukocytopenia (Grade 3, 44%), Anemia (Grade 3, 11%), Diarrhea (Grade 3, 33%) and stomatitis (Grade 3, 11%). The overall response rate was 50.0%. Conclusions: This combination chemotherapy of TPF appeared to be highly active with a good response rate along with acceptable toxicities. No significant financial relationships to disclose.
Long-Term Evaluation (Efficacy and Safety) of Infliximab in the Treatment of Persistently Active Juvenile Idiopathic Arthritis (JIA), Refractory to Standard Treatments
Authors: V. Gerloni, I. Pontikaki, G. De Marco, M. Gattinara, E. Valcamonica, A. Lurati, A. Salmaso, B. Teruzzi, F. Fantini
Journal: Annals of the Rheumatic Diseases (2005)