tbuckley/cabot-search huggingface dataset:
Multicenter phase II study of cetuximab and irinotecan as third line chemotherapy in patients (pts) with metastatic colorectal cancer (MCRC) previously treated with both irinotecan and oxaliplatin regimens
Authors: C. Grande, J. R. Mel, M. Salgado, M. Reboredo, S. Candamio, I. Fernandez, G. Quintero, G. Huidobro, J. L. Firvida, M. Valladares
Journal: Journal of Clinical Oncology (2006)

13551 Background: Pts with chemotherapy-resistant MCRC have a really poor prognosis with few therapeutic options. Cetuximab (Erbitux®) is an IgG1 monoclonal antibody targeting the EGFR, shown to be effective in pts with EGFR-expressing MCRC refractory to prior irinotecan-based chemotherapy (Cunningham NEJM 2004). Methods: The goal of this multicenter phase II study is to investigate the safety and efficacy of cetuximab in combination with irinotecan as third line treatment in 40 pts with heavily pre-treated MCRC. From Jan to Dec 2005, 40 pts with EGFR-expressing MCRC, refractory to irinotecan, pre-treated with both irinotecan and oxaliplatin with fluorouracil or capecitabine combinations, and PS 0–2, were included to receive cetuximab (400 mg/m 2 week 1 and 250 mg/m 2 weekly thereafter) plus irinotecan (180 mg/m 2 every 2 weeks) until tumour progression or unacceptable toxicity. Pts were analysed weekly for toxicity and every 12 weeks for response. Recruitment is completed. Currently, 38 pts are evaluable for toxicity (2 pts recently recruited) and 23 pts for response (16 pts on treatment for &lt;12 weeks and 1 pt withdrew at week 6 due to lung thromboembolism not related to study treatment). Results: M/F 24/14, median age 63 years (range: 33–78), colon/rectum 23/15, ECOG PS=0/1/2 9/23/6, Metastatic sites 1/2/&gt;2 16/19/3 (Liver 43%, lung 23%, nodes 17%, pelvic 5%, others 12%). A total of 418 weekly infusions were administered (mean: 11; range: 3–37). Preliminary efficacy data is as follows: 3 PR, 3 SD, 17 PD with an overall response rate of 13% (95% CI: 3–34%) and disease control rate of 26% (95% CI: 10–48%). Major toxicities (G 1–2/G 3–4) were: Acne-like skin rash 58/11%, Anemia 32/3%, Neutropenia 16/13%, Nausea-vomiting 32/0%, Diarrhoea 32/11%. Median time to progression was 3.5 months (Range: 1–10+) and median overall survival was 7.3 months (Range: 1.5–12+). Conclusions: These preliminary results suggest that cetuximab and irinotecan combination, is a reasonably effective treatment for pts with highly pre-treated MCRC with an acceptable toxicity profile No significant financial relationships to disclose.
Tumor Immunity: Impairment in Tumor-Bearing Hosts
Authors: Irwin D. Bernstein, Harold T. Wepsic, Berton Zbar, Herbert J. Rapp
Journal: JNCI Journal of the National Cancer Institute (1971)

Cell-mediated systemic tumor immunity in strain-2 guinea pigs was transferred passively from immunized donors to unimmunized syngeneic recipients. In unimmunized recipients bearing relatively large established tumors, however, the transferred tumor immunity was markedly impaired. This impairment occurred whether or not the established tumor and the test tumor were antigenically related. Evidence indicated that general debility of the tumor-bearing host was not responsible for the impairment of passively transferred tumor immunity. Serum from animals bearing large tumors had no effect on passively transferred systemic tumor immunity. The presence of a large tumor had no effect on local passively transferred tumor immunity. We conclude that factors contributed by the recipient are required for the successful transfer of systemic tumor immunity.
Dendritic cell (DC) antitumor vaccine: TEM8 expression in matured DC identifies clinical responders
Authors: F. Venanzi, A. Riccobon, F. Gabrielli, M. Petrini, L. Fiammenghi, A. M. Granato, E. Bolli, L. Ridolfi, A. Concetti, R. Ridolfi
Journal: Journal of Clinical Oncology (2008)

20017 Background: Although dendritic cells (DC) play a fundamental role in immunoresponse, inside tumor tissue they are highly ineffective, probably because of tumor immunosuppression. Despite this, efficient DC are obtained from peripheral blood precursors and cultured and matured in vitro for therapeutic vaccination. The most widely employed maturation protocol involves the use of a standard cytokine-cocktail (IL-6, IL-1β, TNF-α, PGE2) that aims to endow DC with characteristics that inducean effective T-cell response. However, the matured DC (mDC) may also acquire proangiogeneic potential with counterproductive immunosuppressive features, such as tumor endothelial marker 8 (TEM8) gene expression. TEM8 is an anthrax toxin receptor expressed on the plasma membrane of tumor endothelial cells. It is known to be overexpressed more than tenfold in tumor-associated with respect to normal blood vessels. Methods: We carried out a DC vaccination trial in which a positive correlation between delayed-type hypersensitivity test (DTH) for tumor lysate (TL) and/or keyhole limpet hemocyanin (KLH) and overall survival was observed (Ridolfi et al., J Transl Med, 2006). Within the study, QRT-PCR was used to investigate mDC TEM8 expression (TEM8 mRNA ratio mDC vs. immature DC) in 4 healthy donors and 17 advanced cancer patients (13 melanoma and 4 renal cell carcinoma). Results: ATEM8 mRNA mean fold increase (mfi) of 3.2 (2.8–4) was found in healthy donor mDC. Eight non progressing patients (2 CR, 3 PR and 3, SD > 6 months), all DTH-positive (5 for both TL and KLH, 3 only for KLH) patients and with a median OS of 20.5 months, had an mDC TEM8 expression mfi of 2.4 (0.3–5). Conversely, mDC from nine progressing patients, all but one with negative DTH and a median OS of 5 months, had a TEM8 mfi of 12 (5–30). Conclusions: mDC TEM8 mRNA expression level would seem to identify patients who could benefit from antitumor DC vaccination when its value is < 5 (p = 0.0018). Further studies are now needed on larger case series to verify these data and/or to test different types of maturation cocktails. No significant financial relationships to disclose.
Treating octogenarian and nonagenarian acute myeloid leukemia (AML) patients (pts): Predictive prognostic models
Authors: A. Harb, W. Tan, G. E. Wilding, L. A. Ford, S. N. Sait, A. W. Block, M. Barcos, P. K. Wallace, E. S. Wang, M. Wetzler
Journal: Journal of Clinical Oncology (2008)

20576 Background: Treating the octogenarian and nonagenarianAML pts with intensive chemotherapy is controversial. Several models to predict outcome have been proposed including the use of a comorbidity index. However, it is unclear whether the Charlson Comorbidity Index (CCI) or the Hematopoietic Cell Transplant Comorbidity Index (HCTCI) is more sensitive. Methods: We analyzed our experience with 92 AML pts ≥80 years old evaluated at Roswell Park Cancer Institute between the years 1991 and 2007. We recorded pts’ age, gender, performance status, albumin, lactic dehydrogenase, hemoglobin, white blood cell and platelet counts, peripheral blood blast percentage, CD34 and CD56 positivity of the leukemic blasts, karyotype, de novo vs. secondary AML, CCI and HCTCI, and treatment outcome. Results: All pts were offered intensive treatment (IT); 59 (64%) pts were treated intensively with a variety of regimens while 33 (36%) pts elected to receive supportive care (SC). CCI and HCTCI had similar predictive ability for outcome in both groups. The 2 groups had similar pretreatment characteristics except that there were more pts with unfavorable karyotype in the IT group (P=0.0376). There was no significant difference between IT and SC pts in regards to overall survival (OS) though among the IT pts, those who achieved complete remission had a significantly longer OS (median 39.5 weeks) than those who did not (median 9 weeks; P=0.0024). A favorable group within the IT cohort with albumin ≥3.4g/L (51% of the treated pts) had a 1-year survival rate >33%; there was significant difference between the 2 albumin groups for OS in the IT cohort (P=0.0012). Similarly, a favorable group within the SC cohort with peripheral blood blasts <46% (50% of the pts) had a 1-year survival rate >20%; there was significant difference between the 2 peripheral blood blast percentage groups for OS in the SC cohort (P=0.0053). Conclusions: This retrospective analysis revealed no difference in outcome prediction between CCI and HCTCI for AML pts ≥80 years old. This analysis suggested an association between favorable outcome and near normal albumin level in IT elderly AML pts and low peripheral blood blast percentage in AML pts treated with SC. These findings require further validation in a prospective study. No significant financial relationships to disclose.
Carfilzomib PLUS Melphalan and Prednisone (CMP) Is A Promising Combination Therapy For The Treatment Of Elderly Patients With NEWLY Diagnosed Multiple Myeloma: Results Of A PHASE I/II Trial In 68 CASES
Authors: Philippe Moreau, Brigitte Kolb, Cyrille Hulin, Denis Caillot, Lotfi Benboubker, Mourad Tiab, Cyrille Touzeau, Xavier Leleu, Murielle Roussel, Carine Chaleteix, Michel Attal, Thierry Facon
Journal: Blood (2013)
Validation of a treatment algorithm for orthopaedic implant-related infections with device-retention—results from a prospective observational cohort study
Authors: S. Tschudin-Sutter, R. Frei, M. Dangel, M. Jakob, C. Balmelli, D.J. Schaefer, M. Weisser, L. Elzi, M. Battegay, A.F. Widmer
Journal: Clinical Microbiology and Infection (2016)
Integrated Omics Analysis of Pathogenic Host Responses during Pandemic H1N1 Influenza Virus Infection: The Crucial Role of Lipid Metabolism
Authors: Jennifer Tisoncik-Go, David J. Gasper, Jennifer E. Kyle, Amie J. Eisfeld, Christian Selinger, Masato Hatta, Juliet Morrison, Marcus J. Korth, Erika M. Zink, Young-Mo Kim, Athena A. Schepmoes, Carrie D. Nicora, Samuel O. Purvine, Karl K. Weitz, Xinxia Peng, Richard R. Green, Susan C. Tilton, Bobbie-Jo Webb-Robertson, Katrina M. Waters, Thomas O. Metz, Richard D. Smith, Yoshihiro Kawaoka, M. Suresh, Laurence Josset, Michael G. Katze
Journal: Cell Host & Microbe (2016)
Effect of GTx-758, an ERα agonist, on serum-free testosterone and serum PSA in men with advanced prostate cancer.
Authors: Evan Y. Yu, Marc Gittelman, Thomas E. Keane, Ronald Tutrone, Laurence Belkoff, Robert Given, Joel Bass, Franklin Chu, Mike Gambla, Franklin Gaylis, James Bailen, Robert H. Getzenberg, Christopher Coss, Michael L. Hancock, James T. Dalton, Mitchell S. Steiner
Journal: Journal of Clinical Oncology (2013)

104 Background: Androgen deprivation therapy (ADT) improves disease-free survival in men with advanced prostate cancer, but patients develop castrate resistant prostate cancer (CRPC); one of the causes of which is ineffective castration. Total serum testosterone (T) does not accurately predict prostatic levels of T. Further reduction of androgens in men with CRPC can result in improvement of survival. Herein we compare the effects GTx-758 an oral, selective estrogen receptor alpha (ERα) agonist versus leuprolide on total and free (unbound) serum T levels in men with advanced prostate cancer. Methods: In Phase II studies, men with advanced prostate cancer (n=164) received 1000 mg or 2000 mg GTx-758 daily or Lupron Depot (4 month), while men with CRPC (n=9) received 2000 mg GTx-758 daily. Serum concentrations of total T, free T, SHBG and PSA were determined at baseline and during treatment. Results: In ADT naïve advanced prostate cancer patients, 28 days of 1000 mg or 2000 mg daily GTx-758 or Lupron therapy castrated (T&lt;50ng/dL) 50, 31 and 100% of patients, reducing mean serum total T in castrated patients to 23±14, 19±9 and 14±7 ng/dL, respectively. However, treatment with 1000 mg or 2000 mg GTx-758 daily reduced mean free T levels to a greater extent (0.9±0.7 and 0.7±0.7 pg/mL, respectively) than Lupron (1.7±1.1 pg/mL). Changes in PSA at 28 days were more closely associated with the observed changes in free T, with reductions of 74, 72 and 56% for 1000 mg, 2000 mg doses of GTx-758 and Lupron, respectively. In CRPC patients, 2000 mg GTx-758 daily did not further reduce serum total T levels, but did result in free T reductions and PSA decreases from baseline following 15 days of therapy in all of the men maintained on ADT with LHRH agonists alone. Conclusions: Although GTx-758 and LHRH based ADT both reduce total serum T and PSA levels in ADT naïve advanced prostate cancer patients, free T was rapidly reduced to a greater degree in the GTx-758 treated patients. In men with CRPC, GTx-758 therapy resulted in significant reductions in free T and resultant PSA declines. The ability of GTx-758 to reduce free T provides a unique mechanism to treat men with advanced prostate cancer and CRPC. Clinical trial information: NCT01326312.
Larger Size of Donor Alloreactive NK Cell Repertoire Correlates with Better Response to NK Cell Immunotherapy in Elderly Acute Myeloid Leukemia Patients
Authors: Antonio Curti, Loredana Ruggeri, Sarah Parisi, Andrea Bontadini, Elisa Dan, Maria Rosa Motta, Simonetta Rizzi, Sara Trabanelli, Darina Ocadlikova, Mariangela Lecciso, Valeria Giudice, Fiorenza Fruet, Elena Urbani, Cristina Papayannidis, Giovanni Martinelli, Giuseppe Bandini, Francesca Bonifazi, Russell E. Lewis, Michele Cavo, Andrea Velardi, Roberto M. Lemoli
Journal: Clinical Cancer Research (2016)

In acute myeloid leukemia (AML), alloreactive natural killer (NK) cells are crucial mediators of immune responses after haploidentical stem cell transplantation. Allogeneic NK cell infusions have been adoptively transferred with promising clinical results. We aimed at determining whether the composition of NK graft in terms of frequency of alloreactive NK cells influence the clinical response in a group of elderly AML patients undergoing NK immunotherapy.Seventeen AML patients, in first complete remission (CR; median age 64 years, range 53-73) received NK cells from haploidentical KIR-ligand-mismatched donors after fludarabine/cyclophosphamide chemotherapy, followed by IL2. To correlate donor NK cell activity with clinical response, donor NK cells were assessed before and after infusion.Toxicity was moderate, although 1 patient died due to bacterial pneumonia and was censored for clinical follow-up. With a median follow-up of 22.5 months (range, 6-68 months), 9 of 16 evaluable patients (0.56) are alive disease-free, whereas 7 of 16 (0.44) relapsed with a median time to relapse of 9 months (range, 3-51 months). All patients treated with molecular disease achieved molecular CR. A significantly higher number of donor alloreactive NK cell clones was observed in responders over nonresponders. The infusion of higher number of alloreactive NK cells was associated with prolonged disease-free survival (0.81 vs. 0.14, respectively;P= 0.03).Infusion of purified NK cells is feasible in elderly AML patients as post-CR consolidation strategy. The clinical efficacy of adoptively transferred haploidentical NK cells may be improved by infusing high numbers of alloreactive NK cells.
Transfer RNA Species in Solid Human Tumors&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: E. E. Penhoet, J. J. Holland
Journal: JNCI Journal of the National Cancer Institute (1971)

Transfer RNA populations isolated from a variety of solid human tumors were compared to transfer RNAs from normal tissues by methylated albumin Kieselguhr (MAK) and reverse phase chromatography. Most tumors examined contained transfer RNA species chromatographically indistinguishable from those found in normal human tissues. However, 1 of 3 breast carcinomas contained tyrosyl transfer RNA which eluted from MAK and reverse phase columns at a higher salt concentration than the bulk of the corresponding RNA from normal tissues. This tyrosyl transfer RNA was chromatographically similar to that found in many cultured tumor cells.
Chemotherapy with mitoxantrone in hormone-refractory prostate cancer.
Authors: A E Denes
Journal: Journal of Clinical Oncology (1997)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1997.15.1.410 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 8996172 Chemotherapy with mitoxantrone in hormone-refractory prostate cancer. A E DenesxA E DenesSearch for articles by this author https://doi.org/10.1200/JCO.1997.15.1.410 PDF "Chemotherapy with mitoxantrone in hormone-refractory prostate cancer.." Journal of Clinical Oncology, 15(1), pp. 410–411© 1997 by American Society of Clinical Oncology
Systemic chemotherapy with capecitabine, doxorubicin and cisplatin for metastatic hepatocellular carcinoma
Authors: D. Shin, S. I. Lee, J. Park, S. H. Park, S.-M. Bang, E. K. Cho, J. H. Lee
Journal: Journal of Clinical Oncology (2005)

4177 Background: Metastatic hepatocellular carcinoma (HCC) is associated with a very poor prognosis. Although numerous chemotherapeutic agents have been tested, the role of systemic chemotherapy for HCC has not been clarified. New therapeutic strategies are thus needed to improve outcomes, and we designed this study with new effective drug combination. Methods: Patients with histologically-confirmed, metastatic HCC received a combination chemotherapy with doxorubicin 50 mg/m2, cisplatin 60 mg/m2 on day 1, plus capecitabine 2,000 mg/m2/day as an intermittent regimen of 2 weeks of treatment followed by a 1-week rest. Treatment was repeated every 3 weeks. Results: Of 27 patients accrued, 2 were ineligible or never received protocol therapy. The median age was 49 years (range, 32–64) and 18 patients were hepatitis B virus seropositive. Child-Pugh grade was A in all patients and 3 had ECOG performance status of 2. The objective response rate was 26% (95% CI, 9–42) with 5 stable diseases. Median survival time was 11.6 months (95% CI, 2.2–21.0) and the median time to progression was 3.7 months (95% CI, 2.0–5.5). Of 25 evaluable patients, 33% showed more than 50% decrease in serum alpha-fetoprotein level from their baseline. In total, 90 chemotherapy cycles were given, with a median of 3 cycles per patient (range, 0–6). The chemotherapy was generally well tolerated with one treatment-related death. Conclusions: Combination chemotherapy with capecitabine, doxorubicin and cisplatin in patients with metastatic HCC showed significant antitumor activity with tolerable adverse effects. Further studies of this combination should be considered. No significant financial relationships to disclose.
Linifanib treatment in patients with non-small cell lung cancer (NSCLC): Phase II results.
Authors: R. A. Soo, G. D. Goss, R. Salgia, B. Besse, D. R. Gandara, N. H. Hanna, J. L. Ricker, J. Qian, D. M. Carlson, E. Tan
Journal: Journal of Clinical Oncology (2010)

7590 Background: Linifanib (ABT-869), a novel orally active VEGF/PDGF RTK inhibitor, had single-agent activity in pts with advanced solid tumors including NSCLC. Methods: This open-label multicenter trial assessed linifanib in advanced or metastatic NSCLC pts, randomized 1:1 to 0.10 mg/kg (Arm A) or 0.25 mg/kg (Arm B) daily until PD or intolerable toxicity. Eligibility included 1-2 prior systemic therapies and ≥1 measurable lesion. Endpoints were PFR at 16 wks (primary), and ORR, TTP, PFS, OS (secondary). PFS and OS were compared. Results: All 139 pts enrolled from 08/07 to 10/08 received prior systemic therapy; 60% had ≥2 prior regimens; 12% had squamous cell carcinoma. Median age was 62 y. Median PFR at 16 wks was 34.5% (32.3% Arm A; 36.5% Arm B), median PFS was 3.6 m (3.5 m Arm A; 3.7 m Arm B), ORR was 1.4% (0% Arm A; 2.7% Arm B), and median OS was 9.0 m (10.0 m Arm A; 8.3 m Arm B). ECOG PS 0 or age ≥65 y were associated with improved outcomes (Table). The most common linifanib-related AEs were fatigue (41%) and hypertension (HT 37%). HT, proteinuria, and fatigue rates were lower in Arm A. The most common linifanib-related grade 3/4 AE was HT (14%). 62% of pts (40% Arm A, 81% Arm B) had dose interruptions due to AEs; most commonly for HT, hand-foot syndrome, and proteinuria, which were reversible. 26% of pts required dose reductions due to AEs (9% Arm A, 41% Arm B). As of 11/09, 7 pts (4 Arm A) remained on study. 107 pts discontinued due to PD (clinical, radiographic or AE related to PD), 17 due to AEs not related to PD (including hemoptysis 1.4% and pulmonary embolism 1.4%), 8 for other reasons. There was 1 death from cancer erosion into pulmonary vessels (Arm B 62 d after start of linifanib). Conclusions: Linifanib demonstrates an acceptable safety profile and is active in NSCLC pts regardless of baseline status. PFS OS HR [95% CI] P value HR [95% CI] P value Asian vs. non-Asian 1.2 [0.8, 1.7] 0.48 1.0 [0.7, 1.5] 0.98 ECOG status 1-2 vs. 0 1.6 [1.1, 2.5] 0.03* 4.1 [2.0, 8.3] <0.001* ≥2 prior systemic therapies vs. 1 1.2 [0.8, 1.7] 0.49 1.6 [0.9, 2.6] 0.09 Age ≥65 vs. <65 0.7 [0.4, 1.0] 0.05* 0.7 [0.4, 1.2] 0.23 Men vs. women 1.0 [0.7, 1.5] 0.98 1.0 [0.6, 1.7] 0.93 Smoker vs. nonsmoker 1.0 [0.6, 1.5] 0.92 1.4 [0.8, 2.3] 0.25 US vs. ex-US 1.0 [0.7, 1.5] 0.87 0.9 [0.6, 1.5] 0.70 Abbreviation: HR, hazard ratio. * Significant. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Abbott Laboratories Abbott Laboratories Abbott Laboratories Abbott Laboratories, OSI AstraZeneca, Bristol-Myers Squibb, Genentech, Lilly, Pfizer Celgene, Merck
Cytogenetic analysis using multiple myeloma targets in POEMS syndrome
Authors: A. H. Bryce, R. P. Ketterling, M. A. Gertz, R. A. Kyle, J. A. Lust, R. Fonseca, M. Lacy, P. R. Greipp, T. A. Witzig, S. Rajkumar, A. Dispenzieri
Journal: Journal of Clinical Oncology (2007)

8116 Background: POEMS syndrome, or osteosclerotic myeloma, is an uncommon plasma cell disorder associated with Peripheral neuropathy, Organomegaly, Endocrinopathy, M protein, and Skin changes, as well as bone lesions, Castlemans disease, and edema. The pathogenesis of POEMS is poorly understood, and its clinical course is distinct from Multiple Myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS). While various cytogenetic abnormalities have been well described in MM and MGUS, we provide the first report of testing for these abnormalities in POEMS syndrome. Methods: Using a prospectively held dysproteinemia database, we reviewed all cases of POEMS seen at our institution, identifying 36 with metaphase cytogenetic testing results, and 9 with fluorescence in situ hybridization (FISH) testing results. Combined cytoplasmic immunoglobulin/FISH testing (cIg- FISH) was performed with fluorescent-tagged antibodies to kappa/lambda immunoglobulin and FISH probes corresponding to the following anomalies: trisomies 3, 7, 9, 11, 15 and 17; del13/del13q; 14q32 split/del14; and t(11;14). Results: Five patients had insufficient plasma cells for cIg-FISH, and 9 were adequate for testing. Monosomy 13 was seen in 5 of the 9 cIg-FISH samples of which 2 of these cases also had apparent monosomy 14. cIg-FISH in one patient revealed trisomy 3 and 7. No abnormalities were seen at 11q13 (CCND1), 17p13 (p53) or translocations involving 14q32 (IGH). Thrity-eight total karyotypes analyses were attempted, though two showed an insufficient number of suitable metaphases. Of the 36 karyotype analyses, 31 were normal, 2 displayed characteristic plasma cell anomalies (hyperdiploid with structural anomalies), 2 treated patients displayed del20q anomalies and 1 patient had a constitutional 13;14 translocation. Conclusion: We are the first to report del13 as a possibly common abnormality in POEMS syndrome, detected by cIg-FISH in 5 of 9 (55%) samples with sufficient plasma cells, similar to the rate observed in MM and MGUS. The lack of abnormalities at 14q32 (IgH locus) is in contrast to MM and MGUS. Abnormal karyotypes, consistent with dividing plasma cells, are rare in POEMS, observed in only 2 of 36 (5.5%) cases. These observations could possibly lend insight into all three disorders. No significant financial relationships to disclose.