tbuckley/cabot-search huggingface dataset:
Prevalence of chronic obstructive pulmonary disease (COPD) in a general population in Norway
Authors: Marie Waatevik, Trude Skorge, Ernst Omenaas, Per Bakke, Amund Gulsvik, Ane Johannessen
Journal: European Respiratory Journal (2012)

Introduction : The prevalence of Chronic Obstructive Pulmonary Disease (COPD) is increasing worldwide. There is need for regularly updated estimates to better monitor the burden of disease.   Objectives : To present updated prevalence estimates and risk factors of Global Initiative for Obstructive Lung Disease (GOLD) defined COPD in a general adult population.   Methods : In the Hordaland County Cohort Study (HCCS), 1664 subjects aged 35-90 yrs answered questionnaires and performed spirometry in 2003-05. The prevalence of COPD was calculated using mean estimates, and risk factors for COPD were analysed using logistic regression.   Results : In a previous study phase, prevalence of GOLD-defined COPD was 7%. Nine years later, the prevalence was 14 %. A vast majority (70%) of the subjects experienced one or more respiratory symptoms, but only 1 out of 4 had a physician9s diagnosis. As many as 1 out of 5 current smokers suffered from COPD, while approximately 1 out of 20 never-smokers had COPD. Significant risk factors for COPD were sex, age, smoking habits, pack-years and occupational exposure. Men had 1.7 (OR, 95% CI 1.2, 2.3) higher odds of COPD than women. Subjects older than 65yrs had 10.3 (OR, 95% CI 6.4, 16.5) times higher odds for COPD than subjects younger than 40yrs. Those who smoked more than 20 pack-years had 4.2 (OR, 95% CI 2.6, 6.7) times higher odds for COPD than subjects smoking less than 10 pack-years.   Conclusion : The prevalence of GOLD defined COPD had increased substantially, from 7% to 14%, during the last 9 years. There is still a large amount of under diagnosis in COPD, which indicates that the awareness of the disease including better diagnostic routines is needed.
A phase II study of preoperative chemotherapy with irinotecan(CPT) and cisplatin(CIS) for gastric cancer(NCI 5917): FDG-PET/CT predicts patient outcome
Authors: M. A. Shah, H. Yeung, D. Coit, R. Trocola, D. Ilson, J. Randazzo, L. Tang, M. Brennan, C. Divgi, D. P. Kelsen
Journal: Journal of Clinical Oncology (2007)

4502 Introduction: Preoperative chemotherapy is a standard option for the treatment of locally advanced gastric cancer(GC). FDG-PET scans have been examined to identify early treatment response in esophagus and GEJ adenocarcinoma. We evaluated the utility of an early change in FDG-PET/CT at several time points in predicting response to preoperative chemotherapy in gastric cancer. Methods: 42 pts with locally advanced GC(preoperative stage T2N+M0 or T3–4NanyM0) were treated with CPT 65 mg/m 2 and CIS 30mg/m 2 on day(d)1 and d8, every 21 days for 4 cycles. FDG-PET/CT scans were performed at baseline, and in FDG avid patients, again on d15 and d35. The primary objective was to demonstrate that a decrease in FDG-SUV discriminates treatment response. Response was defined pathologically based on microscopic inspection for residual cancer cells and fibrosis(Mandard, Cancer 1994). Disease free survival(DFS) and overall survival(OS) were secondary endpoints. Results: Pt characteristics are as follows: median age 59(35–77), KPS 90%(70–100%), 27 male, gastric:GEJ 31:11. Median follow up is 23.3 months, with median DFS 23.8 months(95%CI 14-infinity) and median OS 39.1 months(95%CI 31–39months). Surgical resection occurred at a median of 101 days from study initiation. Pathologic response correlates significantly with DFS(p=0.005) and with OS(p=0.01). Amongst 31 FDG avid pts, a drop in SUV from baseline to d35 significantly predicts pathologic response(p=0.007) and DFS(p=0.01), whereas the change at d15 does not. 45% decrease in SUV at d35 best distinguishes good from poor pathologic response. With this cutoff, median DFS has not been reached(eg.&gt;23.3 months) for patients with good PET response, and is 14.4 months(95%CI 8.3-infinity) for poor PET responders, p=0.03. Conclusions: Following preoperative chemotherapy, pathologic response at the time of resection significantly correlates with DFS and OS. We confirm that FDG-PET/CT response predicts both pathologic response and DFS following preoperative chemotherapy for locally advanced GC, although at d35. An early PET response assessment provides an opportunity to change therapy in non responding patients, and is currently under investigation(supported by ASCO CDA). No significant financial relationships to disclose.
The incidence, prophylaxis and treatment of venous thromboembolism in patients undergoing breast cancer surgery
Authors: R. H. I. Andtbacka, G. Babiera, E. Singletary, K. K. Hunt, F. Meric-Bernstam, B. Feig, F. Ames, M. Ross, Y. Dejesus, H. M. Kuerer
Journal: Journal of Clinical Oncology (2004)

616 Background: Cancer patients are at an increased risk of venous thromboembolism (VTE), which includes both deep venous thrombosis (DVT) and pulmonary embolism (PE). The risk of VTE following abdominal and pelvic surgery is known, while the risk following breast cancer (BC) surgery is not established. We have developed clinical pathways for all BC patients undergoing surgery in order to minimize variation in treatment. Patients receive pre-operative teaching about immediate post-operative ambulation, application of intra-operative lower extremity elastic stockings and intermittent pneumatic compression boots. We wished to determine the peri-operative incidence and treatment of VTE in patients on these pathways. Methods: BC patients undergoing surgery between Jan 1, 2000 and Sep 30, 2003 and treated on the breast pathways were analyzed following IRB approval. VTE within 60 days post-operatively was determined from our prospective breast cancer, radiology and pharmacy databases, medical records and ICD-9-CM codes. Results: 3887 patients underwent 4449 procedures. The median age was 54.4 years (range 11–91.8). Seven patients with post-operative VTE were identified, for a rate of 0.16% per procedure. The median time from surgery to diagnosis of VTE was 14 days (range 2–60) with a mean of 21.8 days. No relationship was identified between the type of breast surgical procedure and development of VTE. Patients were diagnosed by Ventilation Perfusion scan (3), CT Pulmonary angiogram (3), Duplex Doppler of the lower extremities (2) and IV contrast CT of the abdomen and pelvis (1). Three patients respectively presented with only DVT or PE, while one patient was found to have both DVT and PE. One of 7 patients (14%) had received neo-adjuvant therapy. Treatment consisted of Low Molecular Weight Heparin (5) or IV heparin (2) all followed by warfarin. There were no deaths. Conclusions: The incidence and outcome of VTE in BC surgery patients has not been previously reported. VTE following surgery was rare in BC patients on clinical pathways. Based on these results, no additional systemic VTE prophylaxis is indicated in this group of patients. No significant financial relationships to disclose.
Relationship between pretreatment CA-125 level and risk of relapse in advanced ovarian cancer (AOC) patients in a complete clinical response (CCR) who received “maintenance therapy”
Authors: P.-Y. Liu, D. S. Alberts, B. J. Monk, M. Brady, M. Markman
Journal: Journal of Clinical Oncology (2005)

5013 Background: Patients (pts) with AOC who achieve a CCR have a high risk of recurrence. Reliable methods to identify the risk of relapse may lead to modifications in disease management. Methods: Crawford, et al. (Proc ASCO 2004: 23:448) showed that AOC pts with a nadir CA-125 level of ≤ 10 experienced substantially improved 2-year progression-free survival (PFS), compared to pts whose CA-125 ranged from 11–20 or 21–30. Using these criteria but with entry CA-125, we analyzed the risk of progression in pts treated on 2 trials of “maintenance therapy” (MT) in women with AOC who attained a CCR following primary chemotherapy (CT): (1) phase 2 SWOG trial of altretamine (260 mg/m2 daily x 14 days, repeated monthly x 6 months (m)) (n=97); (2) phase 3 SWOG/GOG trial of paclitaxel (175 mg/m2 over 3 hours for 3 or 12 m) (n=287). Pts must enter the trials no later than 8 weeks after the last dose of prior CT. Pretreatment CA-125 was ≤ 35 for all pts. PFS from study entry was analyzed by the Cox regression model stratifying by trial/treatment and adjusting for optimal stage III vs. suboptimal stage III or stage IV disease at diagnosis and age (≤ 65 vs. > 65). Results: The distribution of pretreatment CA-125 for the 384 pts was 58%, 34% and 8% for values (a) ≤ 10, (b) >10–20, (b) >20–35 respectively. 280 pts had progressed at the time of analysis, approximately 25% by CA-125 progression criteria (Vergote, et al. JNCI 2000; 92:1534–1535). CA-125 was highly statistically significant either as a categorical variable as described above (p<0.0001), or as a continuous variable (p<0.0001). Median PFS was 24, 17 and 7 m, respectively, for groups (a), (b), and (c). There was no evidence the CA-125 effect differed by trial or treatment in an interaction analysis. Conclusions: The CA-125 level at the initiation of “MT” in women with AOC who attain a CCR to primary chemotherapy strongly predicts the risk of subsequent relapse. Patients with pretreatment CA-125≤ 10 have superior PFS. No significant financial relationships to disclose.
Divided doses of cisplatin in combination with gemcitabine for patients with advanced non-small cell lung cancer (NSCLC)
Authors: A. Demirkazik, B. Yalcin, H. Akbulut, A. Buyukcelik, F. Cay, G. Utkan, F. Icli
Journal: Journal of Clinical Oncology (2004)

7347 Background: Cisplatin was generally administered on day 1 when used in combination with gemcitabine. High-dose of cisplatin ( >50 mg/m2) in outpatient setting are highly toxic in terms of nephropathy, acute and delayed emesis. Methods: Between 1999 and 2003 we retrospectively evaluated patients (pts) with advanced NSCLC who were treated with divided doses of cisplatin in combination with gemcitabine. Half doses of cisplatin was given on day 1 and 8 so that pts would undergo lower toxicity than expected. Eligibility criteria included measurable disease, adequate organ function, and good performance (ECOG, PS≤ 2). Cisplatin 35 mg/m2 with gemcitabine 800 mg/m2 on days 1, 8 administered every 21 days for a maximum of 6 courses, and dose adjustments were scheduled for grade 3&4 toxicity. Objective response was assessed every two cycles. Results: Thirty patients who enrolled to this trial were all evaluable for toxicity. Twenty-seven pts were evaluable for response. Patients characteristics were as follows: Male/female, 24/6; median age (range), 58 (38–70) years; PS 0/1/2, 5/20/5; chemo-naive, 25. Median follow up was 9.7 (range 2–64 ) months. Overall objective response was 62 % consisted of 6 (22 %) partial response, 11 (40 %) minimal response. Eight pts (29 %) had stable disease, and 2 progressive disease. A median of 3 cycles (1–6) was administered. Grade 3&4 toxicities (WHO) included neutropenia in 2 pts (6.6 %, 1 febrile), thrombocytopenia in 1 pt (3.3 %), emesis in 3 pts (10 %). One pt died unexpectedly during treatment. Median overall survival (OS) was 13 ±5.7 months and median time to progression (TTP) was 5.8 ±0.7 months. In terms of the performance status (PS), median TTP was better in good PS (0,1) group (5.8 ±1 months vs 2.3 ±1.4 months, p=0.054). Although median OS was better in good PS group, this was not statistically significant (13 ±5.4 months vs 6.5 ±0.5 months, p=0.46). Conclusions: Divided doses of cisplatin in combination with gemcitabine had decreased toxicity and longer TTP although we did not reach a required patient number for phase II design. No significant financial relationships to disclose.
Analysis of the MyLifeLine.org Cancer Foundation user database: Does a cancer patient website for internet communication between cancer patients and their wellwisher community assist in cancer patient support?
Authors: R. E. Fisher, M. Donziger, L. Lahr
Journal: Journal of Clinical Oncology (2009)

e20700 Background: The MyLifeLine.org Cancer Foundation established a website (MyLifeLine.org) in 2007 to provide a dedicated home base for communication between a cancer patient and his/her support circle. The premise of this program is the assumption that internet messaging fosters support and communication between patients and wellwishers in a more convenient format than use of standard communication, such as telephone use. Methods: In October, 2008, an email survey was conducted among the 250 individuals that made use of this home base for communication. Survey respondents were informed that the information tallied would be used anonymously for analysis of pattern use, and for publication. All data was collected anonymously. Results: Thirty-three percent of users submitted survey answers. Users were in all phases of cancer treatment. By age and gender, 64% of users were female, and 80% of users were between the ages of 30 and 70. Forty-one percent of respondents used this communication tool at least once a week. Seventy-one percent of users reported an improved sense of communication through use of this web-based tool. Forty-four percent of users felt this tool limited the number of phone calls they received. Sixty-six percent of users felt that their supporting community were better informed of their health status by mutual use of this home base internet site. Conclusions: This survey demonstrates that internet communication through a dedicated cancer patient home page for two-way messaging provides a number of benefits for support and communication. This tool limited the number of phone calls that would burden a patient receiving cancer care, and improved the sense of connectedness between a cancer patient and his/her support community . Demographics of this web tool user base demonstrate that the majority of users are female, and that its users span the ages of 30–70, which shows the acceptance of internet use by younger and older populations. The survey confirms the premise that initiated the website's inception. Use of this web based tool can be a valuable form of communication for cancer patients and their supporting community. [Table: see text]
Tandem stem cell transplantation as consolidation therapy for high-risk neuroblastoma: The Children's Healthcare of Atlanta experience.
Authors: M. Qayed, K. Y. Chiang, A. E. Haight, B. A. George, R. Ricketts, A. Alazraki, A. Tahvildari, N. Esiashvili, H. M. Katzenstein
Journal: Journal of Clinical Oncology (2010)

9563 Background: Despite aggressive treatment for high risk neuroblastoma, event free survival (EFS) remains < 30-40%. In single arm studies, intensifying therapy with tandem autologous stem cell transplantation (SCT) improved outcome. We report our experience in utilizing tandem SCT as consolidation for high risk neuroblastoma. Methods: Between November 1996 and November 2008, 91 patients underwent autologous SCT for neuroblastoma at Children's Healthcare of Atlanta. Seven patients who underwent SCT for relapsed disease or received additional therapy after standard induction were excluded. There were 29 single and 55 tandem transplants. Survival times were measured from the infusion date of the final SCT. Results: Median age at diagnosis was 2.8 years (0.6 – 21.5 years) with a median follow-up of 4.7 years (0.7 – 13 years). At the end of induction, 44.1% of patients had a complete response (CR), 25% had a very good partial response (VGPR), 21.4% had a partial response and 2.4% had no/mixed response. Response status was not determinable for 7.1%. The 4 year EFS and overall survival (OS) for all patients were 50.8% (95% CI 39.1 – 61.3), and 63.8% (95% CI 51.5 – 73.8%). The 4 year EFS and OS were 64.5% (95% CI 50.0 - 75.7%) and 72.1% (95% CI 57.3 - 82.6%) after tandem SCT, compared to 21.5% (95% CI 7.7 – 39.9%) and 47.1% (95% CI 25.9-65.8%) after single SCT (p = 0.003 and 0.036 respectively). Twenty four patients received total body irradiation (TBI). There was no difference in EFS or OS stratifying according to TBI. Among 58 patients achieving CR/VGPR, 4 year EFS and OS after tandem SCT were 70.1% (95% CI 52.4 – 82.2%) and 74.7% (95% CI 56.9 - 86.0%) compared to 23.3% (95% CI 6.9 – 45.4%) and 44.0% (95% CI 20.3 – 65.5%) after single SCT (p= 0.002 and 0.014 respectively). Three patients died of acute toxicity: One died of gastrointestinal bleeding following a single SCT, and 2 died of veno-occlusive disease following tandem SCT. One patient died of pulmonary toxicity 2 years following a single SCT. Conclusions: Tandem SCT as consolidation for high risk neuroblastoma may improve survival without increasing acute toxicities. The potential advantage of tandem SCT needs to be confirmed through randomized cooperative group trials. No significant financial relationships to disclose.
A Markov model to evaluate the cost effectiveness of intravenous (IV) zoledronic acid vs IV generic pamidronate or oral ibandronate in the prevention of bone complications in breast cancer patients with bone metastases
Authors: J. M. Stephens, M. S. Aapro, M. F. Botteman, J. W. Hay, J. Brandman
Journal: Journal of Clinical Oncology (2005)

664 Background: Bisphosphonates are commonly used to reduce the burden of skeletal related events [SREs] and bone pain in breast cancer patients with bone metastasis. These agents are characterized by different efficacy, safety, dosage form, time of administration, compliance, and acquisition costs. We assessed the cost effectiveness of commonly-used bisphosphonate therapies from the perspective of the UK NHS. Methods: We developed a Markov model to simulate the incidence of SREs, cost of care, survival and quality-adjusted life years (QALYs) for a hypothetical cohort of patients receiving no treatment (NT), daily oral ibandronate (OI), or monthly injections of generic pamidronate (PA) or zoledronic acid (ZA). This literature-based model includes assumptions about skeletal morbidity rates (SMR, directly obtained or extrapolated from placebo-controlled clinical trials), mortality, costs of drug (including infusion cost), cost of SRE, utility values for time with and without SREs and relief from bone pain, and compliance with therapy. Results: Based on relative reductions of risk of SREs (ratio of SMR of bisphosphonate therapy vs no therapy) and compliance with therapy, the cumulative number of SREs over the lifetime of a patient was projected to be lowest for ZA (3.82 per patient), followed by PA (4.43), OI (4.91), and NT (6.02). Total discounted costs (which included drug costs, infusion administration costs, and cost of treating SREs) were £1949 per patient lower for ZA than OI, £1160 per patient lower than PA, and £556 per patient lower than NT. Survival was identical across all groups (25 months). However, discounted QALYs per patient were highest with ZA (0.822), followed by PA (0.816), OI (0.812), and NT (0.773). ZA was therefore less expensive and more effective than all other options. These findings were robust across various sensitivity analyses. Conclusions: For breast cancer patients with bone metastasis, zoledronic acid appears to be the most cost-effective bisphosphonate therapy and is also highly cost effective compared to no therapy. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Novartis, Roche Novartis, Roche Novartis, Roche
Health professions students' understanding and attitudes about cancer clinical trials: Implications for including cancer clinical trial competencies in curricula.
Authors: S. J. Gainor, A. Bradlyn, C. V. Harris, S. C. Remick, J. Shumway
Journal: Journal of Clinical Oncology (2010)

e16534 Background: Less than 3% of adult cancer patients participate in clinical trials (CT). Health providers may be unaware of cancer CT resources or believe that CTs are not appropriate for their patients. Our line of reasoning is that a competency-based curriculum in CTs will have salutary effects on cancer CT participation by improving awareness, building advocacy, and by eventually increasing accrual. Methods: To assess the understanding and attitudes of health professions students (first-year and graduating) about cancer CTs, a survey was developed which included questions about knowledge of CT procedures, provider attitudes, and perceived barriers to patient participation. An interdisciplinary sample of 279 (129 medical, 89 nursing, 42 pharmacy, and 19 dental) students at the WVU HSC completed the survey. Results: Overall, 70.2% indicated they were “not very familiar” with CTs for treatment of cancer, and only 1.6% reported being “very familiar” with CTs. However, 85.7% agreed/strongly agreed that they would be interested in training to improve their knowledge of cancer CTs. Likewise, 84% planned to become familiar with cancer CTs, and 92.4% would like to be able to refer cancer patients to CTs when they are in practice. Of note, however, statistically significant differences (p < 0.05) were found for medical and nursing students that suggest graduating students had less enthusiasm for the importance of CTs when compared with first-year students. Conclusions: There are clear gaps in health professions students' understanding of cancer CTs. There are distinct attitudes and recognition of patient (and student) barriers influencing participation in cancer CTs. Students are interested in learning more and referring future patients to CTs. It is worrisome, however, that data suggest that as students progress in their training, they become less inclined to believe in the relevance of cancer CTs. Given the current paucity of education about CTs, it is appropriate, therefore, to integrate competency-based cancer CT education into all health professions students' curricula. No significant financial relationships to disclose.
AB0339 Stratification of Cardiovascular Risk by Framingham Score in a Mexican Mestizo Rheumatoid Arthritis Cohort
Authors: D.A. Galarza-Delgado, I.J. Colunga-Pedraza, J.R. Azpiri, J.A. Cardenas-de la Garza, R. Vera-Pineda, G. Serna-Peña, D.O. Treviño-Montes, M.A. Garza-Elizondo
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Cardiovascular (CV) morbidity and mortality in patients with rheumatoid arthritis (RA) is higher than general population. It is the leading cause of death in this group. The traditional cardiovascular risk (CVR) factors do not fulfilled explain this increased risk. The Framingham risk score (FRS) is the main tool to stratify CVR in general population; its usefulness in RA patients remains controversial as it is believed may underestimate the CVR. <h3>Objectives</h3> The aim of this study is to stratify CVR by FRS in a Mexican Mestizo RA cohort. <h3>Methods</h3> A descriptive, cross sectional study was designed. This study included diagnosed RA patients (ACR criteria 1987/2010) who attended our referral center, in a period of three months (July to September 2014). Information from clinical records was collected. Patients whose clinical records did not include age, gender, diagnosis, weight, height, blood pressure, smoking and use of antihypertensive medications were excluded. <h3>Results</h3> 204 patients with RA were included. The mean age was 54.19 years and 90.19% (n=184) were women. It was found an increased CV risk of 10% at 10 years in 45 patients (22%). The mean for this group of patients was 7.22% at 10 years. <h3>Conclusions</h3> FRS could underestimate CVR in our population. Optimum control of CV risk factors entails a risk of 3.6%. Standard risk prediction models used in the general population do not adequately identify many RA patients with elevated CV risk. More studies are needed to evaluate the ability of FRS to predict CV risk in RA Mexican population. <h3>References</h3> Sandoo A, et al. The relationship between cardiovascular disease risk prediction scores and vascular function and morphology in rheumatoid arthritis.Clin Exp Rheumatol. 2014 Nov-Dec;32(6):914-21. Arts EE, et al. Performance of four current risk algorithms in predicting cardiovascular events in patients with early rheumatoid arthritis. Ann Rheum Dis. 2014 Jan 3. <h3>Disclosure of Interest</h3> None declared