tbuckley/cabot-search huggingface dataset:
Physician's perspectives and racial disparity in the surgical treatment of early lung cancer.
Authors: P. R. Walker, S. Cykert
Journal: Journal of Clinical Oncology (2010)

6041 Background: Racial differences in the treatment of early lung cancer continue to exist. African-Americans (AA) receive less staging (Lathan et al J Clin Onc 2006; 24:413), less surgery, and have poorer lung cancer outcomes than Caucasians. (Bach et al N Engl J Med 1999; 341:1198). Methods: 437 patients with early stage lung cancer were evaluated in five health systems in North and South Carolina before treatment recommendation with a survey including questions about trust, physician-patient communication, attitudes toward cancer, and functional status. Results: 386 patients were eligible for lung cancer surgery. Median age 66 years and 29% were AA. 66% of Caucasians (C) underwent surgery compared to 55% of AAs (p = 0.05). Surgical rates for AA patients were particularly low when 2 or more co-morbidities were present (odds ratio [OR] .04; 95% CI 0.01-0.25) compared to C (OR .45; 95% CI 0.10-2.0) and when there was no regular source of care (OR 0.20; 95% CI 0.10-0.43) compared to C (OR 1.3; 95% CI 0.32-5.3). Increased trust in physician (10 of 100 difference on Safron's Trust Scale) lowered surgical rates in AA (OR .54; 95% CI 0.35-0.85) but not C (OR 1.0; 95% CI 0.76-1.4). Conclusions: Physician perceptions of 2 or more comorbidities and a lack of regular source of care greatly lessened the use of lung cancer surgery in AAs far more than Caucasians. Higher physician trust by this AA population paradoxically lowered the rate of lung cancer surgery supporting the impact that physician perceptions of patients have in a lung cancer surgery recommendation. The racial disparity in the treatment of early lung cancer may rest in a physician's differing perceptions of similar factors in AA and Caucasian patients. No significant financial relationships to disclose.
Detection of disseminated breast cancer growth and treatment response using non-invasive bioluminescence imaging
Authors: T. R. Chaudhuri, Z. Cao, S. Ponnazhagan, A. Stargel, P. L. Simhadri, T. Zhou, A. F. Lobuglio, D. J. Buchsbaum, K. R. Zinn
Journal: Journal of Clinical Oncology (2004)

742
Conditional survival in gastric cancer: Does race influence prognosis in long-term survivors?
Authors: David Luyimbazi, Rebecca A. Nelson, Steven L. Chen, Joseph Kim
Journal: Journal of Clinical Oncology (2013)

22 Background: Conditional survival (CS) estimates of gastric cancer patients have used standard clinical and pathologic factors to predict prognosis during the follow-up period. However, there are known racial disparities in gastric cancer outcomes that have not been previously considered in these CS estimates. Therefore our objective was to evaluate the role of race in CS of gastric cancer patients. Methods: Data from SEER was used to identify gastric cancer patients who underwent curative surgical intervention from 1988-2006. 3-year relative conditional survival (RCS) was computed for patients who had survived 1, 2 and 3 years from diagnosis. RCS was calculated by dividing observed survival by expected survival using an age-, sex-, and race-matched standard population. Results were compared across time and across select racial groups (white, black and Asian/Pacific Islander [API]) using the z test statistic. Results: Of 25,728 patients, 67% were white, 20% API and 13% black. Each racial group had increased RCS over all time periods (p&lt;0.05). For 3-year survivors, we observed a trend towards equivalence of RCS values for all racial groups. This trend is supported by the highest percent improvement in RCS from diagnosis for both white and black patients, with 89% and 95% respectively (p&lt;0.05). In contrast, API patients had a 62% improvement from diagnosis. Conclusions: Our study shows that although pronounced at diagnosis, disparities in RCS values decrease over time as patients approach 3 years after diagnosis. Therefore, while race is a significant prognostic indicator at diagnosis of gastric cancer, it has less impact the longer patients survive. [Table: see text]
CD4 levels as a prognostic marker for metastatic breast cancer.
Authors: H. J. Boyle, O. Tredan, S. Chabaud, A. Bajard, D. Perol, T. D. Bachelot
Journal: Journal of Clinical Oncology (2010)

1140 Background: Metastatic breast cancer is a very frequent disease but its presentation and evolution vary a lot between patients. However it is very difficult to predict individual evolution. We retrospectively analyzed two prospective cohorts of patients with metastatic breast cancer to evaluate prognostic factors. Methods: The first cohort (A) consisted of 39 patients with metastatic or locally advanced breast cancer treated with first line chemotherapy between September 2004 and October 2007. The second cohort (B) consisted of 114 patients with metastatic or locally advanced breast cancer who relapsed after at least one line of chemotherapy between December 2000 and November 2005 and who received further chemotherapy. In the cohort A the blood samples were drawn before administration of any chemotherapy. In the cohort B the samples were drawn after white blood cell recovery. We performed Kaplan Meier curves with log-rank tests. Results: In the cohort A, 84% of patients had a ductal carcinoma, 81% of tumors expressed hormone receptors, 11% over expressed HER2 and 8% were triple negative. Seventeen percent of patients were metastatic at initial diagnosis. CD4 T cell levels of less than 450/μ L were associated with a worse overall survival (HR=0.35 (CI95%=0.15-0.82), p=0.0150) but there was no difference in progression-free survival (HR=0.56 (CI95%=0.29-1.09) p=0.0872). In the cohort B, 90% of patients were metastatic. Forty-eight percent of patients had received one previous line of chemotherapy; more than 50% had received more than one. CD4 T cell levels of less than 450/μ L were also associated with a worse overall survival (HR=0.621 (IC=0.392–0.983), p=0.04). In neither cohort, CD8 levels had a prognostic value for overall survival. Conclusions: CD 4 levels seem to be a prognostic factor for overall survival in patients with metastatic breast cancer treated with chemotherapy in the first-line setting or in further lines. These results have to be confirmed in a larger prospective cohort. No significant financial relationships to disclose.
The outcome of patients with triple negative breast cancer: Evidence for a favorable ethnic subgroup? The Turkish Oncology Group experience
Authors: Y. Eralp, G. Basaran, M. Dogan, D. Dincol, S. Demirci, F. Icli, H. Onur, P. Saip, E. Topuz, A. Haydaroglu
Journal: Journal of Clinical Oncology (2009)

e22158 Background: Triple negative breast cancer (TNBC) is generally considered as a poorer prognostic subgroup, with a propensity for earlier relapse and visceral involvement. The aim of this study is to evaluate the outcome of non-metastatic TNBC patients in a National registry setting and identify clinical and pathologic variables associated with survival. Methods: From a retrospective registry cohort of 296 TNBC patients treated and followed between 1993–2007, we identified 248 patients with early stage disease, with follow-up of at least 12 months. The prognostic impact of several clinical variables were evaluated by the Kaplan-Meier and Cox multivariate anayses. Results: Median age was 48. The majority of the patient group had invasive ductal carcinoma (n:204, 82.3%). Distribution by stage was as follows: stage 1: 49 (19.8%), st 2: 125 (50.4%), st 3: 69 (27.8%). Excluding 11 patients, all had received adjuvant chemotherapy. 5 year overall survival (OS) and disease-free survival (DFS) rates were 84±2.7 % and 69±3.3%, respectively. Median survival after initial recurrence was 20 months. Sites of relapse were as follows: lung: 26 (36.1%), liver:8 (11.1%), brain: 8 (11.1%), bone: 14 (19.4%), skin/lymphatic: 7 (9.7%). Univariate analysis revealed locally advanced disease (p:0.0001), larger tumor size (p:0.004), nodal positivity (p&lt;0.00001), and extent of nodal involvement as significant factors for DFS; whereas, locally advanced disease (p:0.0099) and extent of nodal involvement (p:0.018) were identified as prognostic factors with an impact on OS. Multivariate analysis revealed locally advanced disease (HR: 3.3, p:0.02, 95% CI: 0.14–0.64) and extent of nodal involvement (HR:4.3, p:0.033, 95% CI: 0.059–0.88) as significant independent prognostic factors for DFS and OS, respectively. Conclusions: The outcome of patients with TNBC in this National registry cohort is comparable to other subsets with similar prognostic features and do not support the generally accepted notion that TNBC entails poor prognosis. It may be speculated that there may be inherent ethnic differences leading to distinctive tumor behaviour. Further translational research is required to identify molecular prognostic groups within the TN subset. No significant financial relationships to disclose.
Relationship of lymphocyte count to effectiveness of preoperative radiotherapy in advanced rectal cancer.
Authors: J. Kitayama, K. Kawai, K. Yasuda, E. Sunami, H. Nagawa
Journal: Journal of Clinical Oncology (2010)

e14101 Background: Although preoperative radiotherapy (RT) is widely used as the initial treatment for locally advanced rectal cancer (RC) in the neoadjuvant setting, factors determining clinical response have not been adequately defined. In order to find other factors possibly related with radio sensitivity, we evaluated the relationships between circulating blood cell counts and RT effects. Methods: In a total of 165 cases with advanced RC who received 50.4 Gy radiation before surgery, we retrospectively examined hemoglobin (Hb) levels and counts of white blood cells (WBC), platelets and WBC subsets before and after RT and investigated their associations with the complete response (CR) rate together with other clinicopathological factors. Results: After radiotherapy, Hb, WBC, and platelets were significantly reduced from pre-RT levels. In particular, the post-RT lymphocyte counts were markedly reduced to less than half of the pre-RT values (1,570 ± 676 to 605 ± 258, p < 0.001; average 42.4% ± 22.1%). Fifteen of the 165 patients (9%) showed CR clinically. Among these laboratory data, only lymphocyte counts were significantly greater in CR than in non-CR cases both pre-RT (1,990 ± 503 vs. 1,640 ± 662, p < 0.05) and post-RT (742 ± 198 vs. 567 ± 262, p < 0.01). CR rate showed positive associations with nodal metastasis, the circumferential extent of the tumor, and combination with chemotherapy (CRT). However, on multivariate analysis, only lymphocyte counts showed an independent association with CR. Conclusions: In RC patients, peripheral blood lymphocyte counts have a major impact on the CR rate in response to RT. This raises the possibility of lymphocyte-mediated immune reactions being essential for achieving complete eradication of tumor cells. Enhancement of immune function during RT may critically improve the effectiveness of RT for advanced RC. No significant financial relationships to disclose.
Predictive and prognostic factors in patients treated by neoadjuvant chemotherapy: A retrospective study
Authors: P. Chollet, S. Amat, B. Leduc, D. Méry-Mignard, M.-A. Mouret-Reynier, V. Feillel, J.-P. Bleuse, H. Curé, J. Dauplat, F. Penault-Llorca
Journal: Journal of Clinical Oncology (2004)

9702 Background: The increasing use of neoadjuvant chemotherapy (NCT) in patients (pts) with operable breast cancer allows the identification of factors predicting the response to treatment and prognostic factors of outcome. Methods: This study considers 677 pts treated by NCT (median tumoral diameter: 40 mm), who were registered into several prospective phase II trials, based on anthracyclin, taxane or a combinaison of both. We retrospectively evaluated the predictive and prognostic influence of clinical and pathological characteristics of the tumor before and, when possible, after NCT. Results: The overall clinical response rate was 69.5% (16.0%CR; 53.5% PR), allowing 66.7% breast conservation. A pathological complete response (pCR) rate was confirmed in 13.9% according to Chevallier's classification. Pts received adjuvant chemotherapy (19.1%) and/or hormonotherapy with tamoxifen (52.8%). The 15-year overall survival (OS) and disease-free survival (DFS) were 59.9% and 47.2%, respectively. Predictive factors: Pre-CT SBR grade III tumors responded significantly better to NCT than SBR grade I (p=5.10−3 and p=1.10−8 for clinical and pathological responses, respectively). Tumor response to treatment resulted in SBR grade changes (p=1.10−7) and breast tumor persistence was associated with positive axillary nodes (p=1.10−7). Clinically involved nodes and positive hormonal receptors (+HR) were inversely linked to pCR (p=8.10−3 and p=2.10−5, respectively). Prognostic factors: OS and DFS were higher in pts with pCR (p<1.10−3); but the number of nodes still involved after CT appeared as the most significant prognostic factor (p<1.10−5), followed by post-CT SBR grading (p<1.10−4) and +HR (p=7.10−3, only for DFS). Conclusions: NCT induced modifications of tumor characteristics and required to distinguish the pre- and post-CT parameters. Some pre-CT features are to be used as predictive of response; conversely post-CT factors must be used as the new prognostic parameters. No significant financial relationships to disclose.
Cetuximab-induced thrombotic thrombocytopenic purpura in a patient with a resected squamous cell carcinoma of the lip
Authors: F. Rosen, T. Lad, M. Telfer, R. Catchatourian, B. Yim, D. S. Griza, M. Yogore, A. Jajeh, S. Nathan, S. Ofori-Ntow
Journal: Journal of Clinical Oncology (2007)

14155 Background: Chemotherapy-associated thrombotic thrombocytopenic purpura (TTP) has been described in the literature. However Cetuximab, a monoclonal antibody targeted to the EGF receptor, has not yet been associated with TTP. We report a case of an 85 year old woman with a resected squamous cell carcinoma of the lip who developed TTP after receiving cetuximab. Methods: A day after receiving Cetuximab, as part of an adjuvant concurrent cetuximab-radiotherapy regimen, the patient presented with gingival bleeding and confusion without fever but with significant petechial rash and jaundice.. Hemoglobin level was 6.9 g/dL WBC 3.9 k/uL Platelet count 4 k/uL Lactate dehydrogenase 1350 U/L Indirect bilirubin 3.8 mg/dL Haptoglobulin &lt; 6 mg/dL Reticulocyte count 4.4 %. Serum creatinine, ANA, coagulation profile, coomb‘s test were normal. Peripheral blood smear showed 3+ schistocytes. TTP was diagnosed and daily plasmapheresis was initiated. TTP resolved after 8 sessions of plasmapheresis with platelet count increasing to 446 k/uL and sustained. Results: Competing etiologies for our patient’s TTP were cancer and cetuximab. Most reported cases of cancer-associated TTP occurred in patients with metastatic adenocarcinoma. Our patient had a non-metastatic resected squamous cell carcinoma with only residual microscopic disease. Since TTP developed closely following cetuximab administration and resolved with plasmapheresis after stopping cetuximab, we concluded that its development was most likely secondary to cetuximab or to antibody developed to it. Possible mechanisms for cetuximab-induced TTP are direct endothelial damage by cetuximab leading to platelet activation and aggregation or inhibition of metalloproteinase, resulting in accumulation of Ultra-large VWF multimers. Conclusions: Targeted-therapy is emerging as an effective treatment modality in medical-oncology. Further clinical experience is needed to ascertain the full extent of potentially fatal adverse events. To our knowledge this is the first case of cetuximab-induced TTP. No significant financial relationships to disclose.
Risk of stroke among &gt; 5 year survivors of childhood leukemia and brain tumors; a report from the Childhood Cancer Survivor Study
Authors: D. C. Bowers, D. E. McNeil, Y. Liu, W. Leisenring, J. Gurney, M. Stovall, S. S. Donaldson, R. J. Packer, L. L. Robison, K. C. Oeffinger
Journal: Journal of Clinical Oncology (2005)

8517 Background: Leukemia and brain tumors are the two most common cancers of childhood. This report examines the frequency of and risk factors for stroke that occur > 5 years following diagnosis among survivors of childhood leukemia and brain tumors. Methods: The CCSS is a multi-institutional cohort study of > 5 years survivors diagnosed between 1970 - 1986. The rate of first occurrence of self-reported strokes was determined for leukemia survivors (n = 4828), brain tumor survivors (n = 1871), and a random sample of siblings (n = 3846). Multivariate analyses were used to determine the relative risks (RR) and 95% confidence intervals (CI) for strokes occurring > 5 years after diagnosis by demographic features and treatment exposures. Results: The mean age at diagnosis and interview of the leukemia survivors was 5.9 years and 24.3 years, respectively. The mean age at diagnosis and interview of the brain tumor survivors was 7.7 years and 25.8 years, respectively. The mean age at interview of the sibling comparison group was 28.8 years. 97 leukemia survivors and 117 brain tumor survivors reported a stroke at a mean age of 11.5 and 15.9 years, respectively. The relative risk for stroke among > 5 year survivors of childhood leukemia was 7.41 (95% CI, 3.3 - 16.5; p< 0.0001) and of brain tumors was 33.23 (95% CI, 15.2 - 72.7; p< 0.0001), adjusted for age, gender, and race. The relative risk for stroke among > 5 year survivors of childhood leukemia treated with cranial radiation therapy was 6.75 (95% CI, 2.9 - 15.9; p< 0.0001) and of childhood brain tumors treated with cranial radiation therapy was 42.64 (95% CI, 19.2 - 94.7; p< 0.0001). Conclusions: Survivors of childhood leukemia and brain tumors and especially those with brain tumors treated with cranial radiation therapy are at an increased risk of stroke. More work is necessary to understand the etiology of and prevention of stroke in cancer survivors. No significant financial relationships to disclose.
The first nationwide survival analysis of Japanese mesothelioma patients from Vital Statistics of Japan.
Authors: K. Aoe, A. Hiraki, N. Fujimoto, K. Gemba, T. Kishimoto
Journal: Journal of Clinical Oncology (2010)

e12007 Background: The incidence of mesothelioma is increasing in Japan. Mesothelioma has become an independent category from thoracic malignancy since 1995 in Vital Statistics of Japan. Whilst the death cases caused by mesothelioma were 500 cases in 1995, the number increased to 1,068 in 2007. However, there has been no report for nationwide survival analysis of Japanese mesothelioma patients until now. Methods: Among the 4860 mesothelioma death cases extracted from the document
Rituximab Maintenance (MR) for Patients with Mantle Cell Lymphoma (MCL) – a Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCTs)
Authors: Liat Vidal, Anat Gafter-Gvili, Martin Dreyling, Michele Ghielmini, Michael Unterhalt, Pia Raanani, Ofer Shpilberg, Ron Ram, Ronit Gurion
Journal: Blood (2014)
A phase I study of ultra low dose interleukin-2 (IL-2) and stem cell factor (SCF) in patients with cancer and or HIV infection
Authors: D. M. Benson, M. Shah, A. Freud, A. Ferketich, B. J. Dezube, Z. P. Bernstein, M. A. Caligiuri
Journal: Journal of Clinical Oncology (2006)

2503 Background: HIV infection depletes crucial lymphocyte subsets and often culminates in patients’ demise due to infectious or malignant complications. We have shown in previous work that ultra low dose interleukin-2 (IL-2) expands natural killer (NK) cells and other lymphocyte subsets in patients with AIDS-associated malignancies. Preclinical work by our group has demonstrated that CD56 bright NK cells, an important source of interferon-γ, constitutively express the c-kit receptor and proliferate synergistically in vitro and in vivo in response to IL-2 and stem cell factor (SCF) presented together. To determine the safety, toxicity, and immune modulatation of IL-2 and SCF in patients, we report a first-in-man Phase I trial of this combination of cytokines in patients with HIV and HIV-associated malignancies. Methods: Eligible adults had a history of cancer and HIV or an AIDS defining illness, Karnofsky score &gt; 70%, CD4 T-cell count &gt; 20/mm3, and had to be on HAART therapy. Patients received IL-2 subcutaneously (SQ) daily at 900,000 IU/m 2 (cohort 1) or 450,000 IU/m 2 (cohorts 2 and 3) except Sunday and SCF (SQ) three times a week (at 5 mcg/kg/d or 10 mcg/kg/d) for 8 weeks. Toxicities and side effects of therapy were closely monitored. Changes in lymphocyte subsets were assessed by flow cytometry. Results: 13 patients (median age = 42, range 33–62) with cancer and HIV (5) or AIDS (8) were enrolled. 10 patients completed therapy, whereas three exhibited the grade 3 dose limiting toxicity (DLT) of fatigue and withdrew. Treatment led to statistically significant increases in NK cells (2.2-fold, p = 0.02) and regulatory T cells (Tregs) (6-fold, 0.005). These were similar to a previous study using a slightly higher dose of IL-2 alone (1 million IU/m 2 ) in which NK were expanded 1.6 fold (p = 0.02) and Treg were expanded nearly 9-fold (p = 0.0003). Conclusions: Simultaneous administration of IL-2 and SCF is safe and well tolerated. The maximum tolerated doses of IL-2 and SCF were 450,000 IU/m 2 and 5 mcg/kg/d respectively. Fatigue was the DLT. A trend towards preferential expansion of CD56 bright NK cells as opposed to Tregs was seen; however, these changes were not significantly different from changes in response to a similar ultra low dose of IL-2 alone. No significant financial relationships to disclose.
Transitional change of the relationship between clinical efficacy of treatment for pulmonary MAC disease and drug-sensitivity test for MAC isolated
Authors: Yoshihiro Kobashi, Masaaki Abe, Keiji Mouri, Yasushi Obase, Naoyuki Miyashita, Mikio Oka
Journal: European Respiratory Journal (2011)

Objective:  We investigated the relaltionship between the clinical efficacy of treamtent for pulmonary MAC disease and drug-sensitivity test for isolated MAC compared 2005-2007 and 2008-2010.   Materials and methods:  The subjects consisted of 60 patients who satisfied the diagnostic criteria of ATS and received the combiation therapy using RFP, EB, SM and CAM. We divided into the former period (24 patients) and the latter period (36 patients).   Results:  The average administration dose of CAM has been increased from the former period (517mg/day) to the latter period (800mg/day) between both periods. Sputum conversion rate has been increased frm 63% in the former period to 83% in the latter period. Clinical improvement has been increased from 38% in the former period to 53% in the latter period. The causative microorganisms isolated were M.avium in 35 patients and M.intracellulare in 25. There were no significant differences in the sputum conversion rate, clinical improvement, and drug-sensitivity test between M.avium and M.intracellulare in both periods. The isolated MAC strains showed excellent MICs of CAM and RFP in both periods. Regarding the relationship between clinical efficacy and MICs of RFP, EB, CAM, and SM, there was a good relationship only for CAM in both periods.   Conclusions:  The good clinical effect has been obtaied with the increase dose of CAM in the latter period. Because there was no significant difference in the result of drug-sensitivity test for isolated MAC in both periods, we speculated that the increase of administration dose of CAM has been influenced the good clinical effect in both periods.