tbuckley/cabot-search huggingface dataset:
Prognosis and survival outcomes in melanoma patients with unknown primary site (MUP)
Authors: M. I. Ross, J. N. Cormier, Y. Xing, J. E. Gershenwald, J. E. Lee, P. F. Mansfield
Journal: Journal of Clinical Oncology (2004)

7544 Background: Metastatic melanoma in lymph nodes (LN) in the absence of a known primary site (MUP) can be accurately diagnosed with current histologic methods. However, the true incidence, stage, prognostic factors, treatment, and long-term outcomes of this clinical entity are poorly defined. Methods: A retrospective analysis was performed of 820 consecutive melanoma patients diagnosed between 1990 and 2001 at a tertiary cancer center with melanoma metastatic to regional LN. Of these, 71 patients (8.7%) were confirmed to have MUP without distant metastatic disease. Clinicopathologic and treatment factors were analyzed to determine their impact on long-term disease-free outcome. Results: The most common presentation was a palpable mass in the axillary nodal basin (76%) in a male patient (72%) with a median age of 51 years. Following completion LN dissection (average 22 LN removed), AJCC 2002 (N) category was identified as N1, N2 or N3 in 34 (46%), 11 (16%) and 26 (38%) patients, respectively. Forty-three patients (61%) received additional systemic therapy and 17 patients (24%) were treated with postoperative adjuvant radiotherapy (XRT). With a median follow-up of 7.6 years, the overall 5- and 10-year disease-free survival rates were 53% and 41%, respectively. Five-year regional control was accomplished in 82% of patients. The median times to distant failure and death were 3.03 and 6.05 years, respectively. Male gender and N3 disease were significant predictors of disease-free survival by univariate analysis, while multivariable analysis revealed that gender was the only significant negative prognostic factor. Conclusions: MUP is not an uncommon clinical entity. The relatively favorable long-term survival of these patients supports the premise that MUP with nodal disease represents a manifestation of stage III melanoma rather than stage IV (M1a) subcutaneous/distant nodal disease. Therefore, patients with MUP should be treated with aggressive surgical approaches with curative intent and also be offered participation in adjuvant therapy protocols. No significant financial relationships to disclose.
Impact of intensity-modulated radiotherapy (IMRT) on salivary gland function in early-stage nasopharyngeal carcinoma (NPC) patients: A prospective randomized study
Authors: M. K. Kam, S. F. Leung, B. Zee, P. H. K. Choi, R. M. C. Chau, K. Y. Cheung, J. J. S. Suen, P. M. L. Teo, W. H. Kwan, A. T. C. Chan
Journal: Journal of Clinical Oncology (2005)

5501 Background: Severe xerostomia regularly occurs in NPC patients treated by 2-dimensional radiotherapy (2DRT). Although IMRT reduces parotid gland irradiation in NPC, randomized data supporting its use is lacking. Methods: Patients with T1–2bN0–2M0 NPC were randomized to receive either IMRT or 2DRT, both 66Gy, without chemotherapy. Primary endpoint was RTOG xerostomia at 1 year after treatment. Secondary endpoints included RTOG xerostomia at 6 weeks post treatment, stimulated parotid flow rate (SPFR) and stimulated whole saliva flow rate (SWSFR). Post-RT saliva flow rate was expressed as percentage of residual flow rate over pre-RT baseline. Planned sample size was 27 patients in each arm, to detect a 40% reduction in incidence of severe (RTOG >=grade 2) xerostomia (assumed to occur in >=80% of 2DRT-treated patients) with 80% power for alpha=0.05. Categorical and continuous variables were analyzed with chi-square test and wilcoxon rank-sum test, respectively. Results: 60 patients were recruited, and 56 patients were eligible (28 patients in each arm). Patients in IMRT arm had significantly less severe xerostomia than 2DRT at 6 weeks (13/28 vs 24/28, p=0.0019), and a borderline difference at 6 months (21/28 vs 26/28, p=0.0689) after RT. Post-RT SPFR was significantly higher in IMRT arm at 6 weeks (39% vs 9%, p<0.0001) and at 6 months (70% vs 4%, p<0.0001). Post-RT SWSFR was similar between both arms at 6 weeks and at 6 months. Analysis of 1-year data would be performed in March. No failure or death was observed in either arm. Conclusions: IMRT is superior to 2DRT in preserving parotid function and results in less severe xerostomia as early as 6 weeks post-RT. SPFR, but not SWSFR, shows progressive recovery over time with IMRT. (This study is supported by Hong Kong Research Grant Council CUHK4041/01M) No significant financial relationships to disclose.
Combination of a new TLR9 agonist immunomodulator (CpG 7909) and paclitaxel for treatment of metastatic Lewis Lung Carcinoma (LLC)
Authors: R. D. Weeratna, L. L. Bourne, S. M. Sullivan, H. L. Davis, A. M. Krieg
Journal: Journal of Clinical Oncology (2004)

7346 Background: Synthetic oligodeoxynucleotides containing CpG motifs (CpG ODN) activate innate and adaptive vertebrate immunity by signaling through the TLR9 receptor. CpG ODN have been shown to prevent and to treat various tumors in rodents, when used alone, with monoclonal antibodies, with chemotherapies, or when used as adjuvants with tumor vaccine antigens. LLC is a model of non-small cell lung cancer (NSCLC) in mice; improvement in survival requires early intervention and high doses of chemotherapy. This study examines the enhancement of paclitaxel (Taxol®) chemotherapy by concomitant immunomodulation with ProMune™ (CPG 7909), a TLR9 agonist which is currently in a clinical trial for NSCLC. Methods: C57Bl/6 mice were injected IV with 1 × 105 LLC cells. Seven days post tumor inoculation, animals were treated with the combination of CPG 7909 + paclitaxel compared to either agent alone. Results: Mice treated with either CPG 7909 or paclitaxel alone had a significant enhancement in survival over control mice with median survival time of 18 and 22 days for CPG 7909 and paclitaxel groups respectively compared to 15 days for the control animals. However, mice treated with the combination of CPG 7909 and paclitaxel showed a further significant enhancement in survival time (median ∼28 days vs. 15 days) (P<0.0001). There was no additive toxicity, weight loss or early mortality of the combination. Additional studies are underway to optimize dose and scheduling and to correlate response with biomarkers of CpG 7909 immunomodulation. Clinical trial using CPG 7909 in combination with chemotherapeutic agents (including paclitaxel) in patients with histologically or cytologically confirmed NSCLC that is beyond surgical cure or that is metastatic (stage IIIB or IV) is in progress. Conclusions: CPG 7909 has potential for treatment of advanced cancer either compared to single agent chemotherapy or in combination to improve partially effective drugs. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Coley Pharmaceutical Group Coley Pharmaceutical Group Coley Pharmaceutical Group
Quantitative analysis of breast parenchymal background enhancement (BPE) on magnetic resonance (MR) imaging: Association with mammographic breast density and aggressiveness of the primary cancer in postmenopausal women.
Authors: Hye Shin Ahn, Sun Mi Kim, Mijung Jang, Bo La Yun
Journal: Journal of Clinical Oncology (2013)

38 Background: To evaluate semiautomated quantitative analysis of the BPE in postmenopausal women who were diagnosed breast cancer and to correlate it with mammographic breast density and aggressiveness of the primary cancer. Methods: Informed patient consent was waived after institutional review board approved this study. Four hundred eighty two breast cancer patients performed breast MRI in our institution during 16 months, and 84 postmenopausal women of them were included in this study (median age, 67.2 years; range, 60-76 years). Ordinary values of BPE and breast density were described by an experienced breast radiologist using the BIRADS lexicon. The BPE was calculated with semiautomated quantitative method for quantitative analysis: BPE coefficient (BEC = SI 1 -SI 0 / S 0 × 100), where SI is signal intensity, SI 1 is the SI enhancement measured in the largest dimension of the sagittal plane at the first postcontrast image, and S 0 is the SI before contrast injection. On surgical pathology, pathologic subtype, nuclear and histologic grade, estrogen receptor (ER), progesterone receptor (PR), HER2≠neu, venous and lymphatic invasion, lymph node metastasis was evaluated. And then, the mean BEC of the patients who diagnosed local or systemic recurrence on follow-up was calculated and compared with that of the patients without recurrence. The statistical analysis was performed using Kruskal-Wallis test and Mann-Whitney U test. Results: The mean BEC of the postmenopausal women was 3.96 ± 6.71 in right breast and 3.41 ± 8.09 in left breast. There was no significant difference in the BEC between mammographic breast density groups (P &gt; 0.05). There was no significant correlation between BPE and aggressiveness of the primary breast cancer. However, the mean BEC was higher in the recurrent patient group (n = 6, mean=16.23 ± 19.88) compared with the patients without recurrence (n = 78, mean=2.44 ± 5.62). Conclusions: No association was found between BPE and aggressiveness of the primary breast cancer, BPE and breast density. However, the mean BEC was higher in the patients who diagnosed local or systemic recurrence.
Thrombopoietin Augments Stem Cell Factor–Dependent Growth of Human Mast Cells From Bone Marrow Multipotential Hematopoietic Progenitors
Authors: Nobukuni Sawai, Kenichi Koike, Hadija Hemed Mwamtemi, Tatsuya Kinoshita, Yumi Kurokawa, Kazuo Sakashita, Tsukasa Higuchi, Kouichi Takeuchi, Masaaki Shiohara, Takehiko Kamijo, Susumu Ito, Takashi Kato, Hiroshi Miyazaki, Tetsuji Yamashita, Atsushi Komiyama
Journal: Blood (1999)
Psychiatric care for patients with self-inflicted gunshot wounds
Authors: L M Conn, B F Rudnick, J R Lion
Journal: American Journal of Psychiatry (1984)

Self-inflicted gunshot wounds are the commonest form of suicide in this country. Seventeen individuals with such injuries were admitted to a trauma center over a 3-month period. Review of their records showed that psychiatric consultation was requested for only nine of the 13 patients who survived their wounds. Information on alcohol use was missing from half the case records and only six of the 13 survivors received psychiatric care after discharge. Use of guns in suicide attempts may evoke strong feelings in health care providers, resulting in omissions in history taking, evaluation, and follow-up.
Natural history of pancreatic mucinous cystic neoplasms.
Authors: S. D. Finkelstein, W. Spence, E. M. Ellsworth, D. Mallat, D. M. Smith
Journal: Journal of Clinical Oncology (2010)

e21115 Background: Pancreatic cysts (PC) are increasingly being detected; proper management requires a balance between aggressive intervention and surveillance. Mucinous cysts may develop adenocarcinoma; however, only a minority will do so. To better understand the evolution of mucinous cystic neoplasms, we studied the natural history of PC by integrating molecular analyses of cyst fluid with other clinical parameters in a continuous series of patients with extended follow-up. Methods: A continuous series of 299 patients with pancreatic cysts yielded 43 mucinous cysts with one or more ASGE criteria and/or risk factors for cancer formation. Patients with overt pancreatic cancer were excluded. Molecular analyses measured 1) DNA quantity, 2) DNA quality, 3) Kras point mutation, 4) allelic imbalance (loss of heterozygosity [LOH]) for 16 markers, and 5) degree of clonal expansion of DNA alterations (RedPath PathFinderTG). Follow up ranged from 25 to 45 months. Results: Of 43 patients predicted to be non-malignant (Benign or Statistically Indolent), 41 (95%) are alive more than 2 years later (average of 41 months since initial diagnosis). The 2 that died were 83 and 85 years old (cause of death not yet established). 92% of patients with one or more ASGE/risk factors are alive more than 2 years later. The only death occurred in a single patient predicted to have aggressive disease by molecular features. Molecular analysis complemented existing practice by using as little as 20 μl of aspirated fluid. Conclusions: The vast majority of mucinous cysts did not manifest neoplastic progression for up to 36 months. Molecular analyses are useful tools to detect aggressive behavior in aspirated pancreatic cyst fluid. Serial molecular analyses can plot the trajectory of molecular change over time in challenging pancreatic cyst patients with otherwise indeterminate imaging, chemistry and/or cytologic risk factors. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration RedPath Integrated Pathology RedPath Integrated Pathology
Randomized trial of atenolol versus losartan in children and young adults with Marfan syndrome
Authors: Ronald Lacro, Harry C Dietz, Lynn A Sleeper, Anji T Yetman, Timothy J Bradley, Steven D Colan, Gail D Pearson, Elif S Selamet Tierney, Jami C Levine, Andrew M Atz, DW Benson, Alan C Braverman, Shan Chen, Julie De Backer, Bruce D Gelb, Paul D Grossfeld, Gloria L Klein, Wyman W Lai, Aimée Liou, Bart Loeys, Larry W Markham, Aaron K Olson, Stephen M Paridon, Victoria L Pemberton, Mary E Pierpont, Reed E Pyeritz, Elizabeth Radojewski, Mary J Roman, Angela M Sharkey, Mario P Stylianou, Stephanie B Wechsler, Luciana T Young, Lynn Mahony
Journal: Circulation (2014)
Chemo-immunotherapy regimen with gemcitabine + FOLFOX 4 (GOLF) followed by subcutaneous (sc) granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-2 (IL-2). Results from a multicenter phase II trial in colon carcinoma patients
Authors: P. Correale, C. Remondo, F. Montagnani, M. S. Rotundo, S. Marsili, M. Laplaca, P. Tassone, P. Tagliaferri, S. Venuta, G. Francini
Journal: Journal of Clinical Oncology (2006)

3587 We have recently described a poly-chemotherapy (GOLF) regimen that: A) is active in colon carcinoma patients as second line of therapy; B) induces high levels of necrosis and apoptosis in colon cancer cells; C) up-regulates the expression and release of heat shock proteins (HSP)-70 and -90 and tumour-associated antigens (2,3); and D) down-regulates tumour cell resistance to the death signals of cytotoxic-T-lymphocytes.These effects represented the rationale for projecting GOLFIG regimen. Here we describe the results of a multi-center translational phase II trial designed to evaluate the toxicity, anti-tumour activity of a novel regimen designated as GOLFIG-1, composed by the GOLF poly-chemotherapy followed by the subcutaneous (sc.) administration of GM-CSF and low-dose IL-2 in colorectal carcinoma patients. The study involved 37 patients (21M and 16F, mean age 62.5 years), 24 of whom had received a previous line of treatment, and 24 had liver involvement. All the patients received biweekly chemotherapy with gemcitabine (1g/m 2 , day 1 and 15), oxaliplatin (85 mg/m 2 , day 2 and 16), levo-folinic acid (100 mg /m 2 , day 1, 2, 15, 16) and 5-Fluorouracil (400 mg/m 2 as a bolus, and 800 mg/m 2 as 24 hour infusion, days 1, 2, 15, 16). These patients also received sc GM-CSF (100 μg, day 3 to 8) followed by sc IL-2 (0.5 X 10 6 IUs twice a day from day 9 to 14 and from 17 to 29). The treatment was well tolerated and very active in colon carcinoma patients, with high objective response (64.9%) and disease control rates (97.3%), with an average time to progression of 12.94 months (CI 95%: 9.98–15.91). An immunological study confirmed the immunological response to colon carcinoma antigen, a significant reduction in suppressive regulatory T lymphocytes (CD4 + CD25 + T-reg ) and a significant reduction of VEGF levels reported in a previous study. In conclusion, these results suggest that the GOLFIG regimen exerts strong immunological and anti-tumour activity in colorectal cancer patients. A randomized phase III trials aimed to compare the efficacy of GOLFIG-1 with FOLFOX-4 regimen in patients with advanced colorectal carcinoma is presently ongoing. No significant financial relationships to disclose.
Landscape of Driver Lesions in Multiple Myeloma and Consequences for Targeted Drug Response
Authors: David Tamborero, Muntasir Mamun Majumder, Raija Silvennoinen, Samuli Eldfors, Pekka Anttila, Juha Lievonen, Alun Parsons, Minna Suvela, Marjanna Säily, Kimmo Porkka, Caroline A Heckman
Journal: Blood (2014)
A national survey: Are oncology caregivers getting what they want?
Authors: Kamal Patel, Christopher G. Lis, Mark Rodeghier, Mark Rogers, Digant Gupta
Journal: Journal of Clinical Oncology (2013)

91 Background: More than 65 million people will serve as caregivers and about 1.6 million new cancer cases will be diagnosed in the US in 2013. These staggering numbers serve as the impetus on evaluating the quality of medical care. To this end, we conducted a national cancer survey to evaluate caregiver experience with service quality. Methods: An online survey was conducted among a national random sample of 1000 cancer caregivers in Aug-Sept 2012. Importance of 15 service quality items was measured on a 5-point Likert scale ranging from “not at all important” to “extremely important”. Caregiver experience with those 15 service quality items was captured as a yes/no response. Caregiver satisfaction was measured on a 5-point Likert scale ranging from “completely dissatisfied” to “completely satisfied”. Results: The top 3 areas of gaps between importance and experience were ‘having a specific individual to coordinate care’ (33%, p&lt;.01), ‘after-treatment care and support’ (25%, p &lt; 0.01) and ‘providing a comforting and stress-free environment’ (25%, p &lt; 0.01). Among respondents who rated these areas as very/extremely important, only 45%, 63% and 64% experienced it, respectively. Conclusions: These national findings illustrate that information on caregiver satisfaction can be useful for healthcare managers in the exercise of quality assurance and identification of unmet needs. [Table: see text]
Updated analysis of the phase III, double-blind, randomized, multinational study of radium-223 chloride in castration-resistant prostate cancer (CRPC) patients with bone metastases (ALSYMPCA).
Authors: Chris Parker, Sten Nilsson, Daniel Heinrich, Joe M. O'Sullivan, Sophie D. Fossa, Ales Chodacki, Pawel J. Wiechno, John P. Logue, Mihalj Seke, Anders Widmark, Dag Clement Johannessen, Peter Hoskin, David Bottomley, Robert Edward Coleman, Nicholas J. Vogelzang, C. Gillies O'Bryan-Tear, Jose E. Garcia-Vargas, Minghua Shan, A. Oliver Sartor
Journal: Journal of Clinical Oncology (2012)

LBA4512 The full, final text of this abstract will be available at abstract.asco.org at 12:01 AM (EDT) on Monday, June 4, 2012, and in the Annual Meeting Proceedings online supplement to the June 20, 2012, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.
Association of receptor activator of NF-kb (RANK) expression with bone metastasis in breast carcinomas.
Authors: D. Santini, B. Vincenzi, A. Russo, C. Ortega, C. Porta, S. Galluzzo, N. M. La Verde, C. Caroti, R. Addeo, G. Tonini
Journal: Journal of Clinical Oncology (2010)

1053 Background: Recently, it has been demonstrated that RANK is overexpressed in about 65% of primary breast tumors. Here we explored the clinical significance of RANK expression in early breast cancer. For this purpose we included in the study a series of early breast cancer primary tissues and correlated IHC RANK expression with skeletal clinical outcome. Methods: This study included 93 patients with breast cancer with complete clinicopathological information and up to 2 years of follow-up. Samples contained 15 lobular carcinomas and 77 ductal carcinomas; N0-1 versus N2-3: 63/29; HER2/neu ±/unknown: 25/55/13; sites of metastases: 16 patients only skeletal, 16 only visceral, 29 skeletal plus visceral, 32 without metastases. No patient was treated with neoadjuvant therapy. RANK protein expression was determined using immunohistochemistry. We considered RANK-positive patients when more than 50% of tumoral tissues was scored as grade 2 (intensity higher than internal control -macrophages-) or 3 (intensity much higher than internal control). Results: RANK was expressed in 38 (41%) of the primary tumor samples. RANK expression was independent from histotype (p:0.23), HER2/neu expression (p:0.47), and grading (p:0.39) but was dependent on nodes status (p:0.05). RANK-positive patients showed a higher risk to develop skeletal metastases (p:0.023). Moreover, RANK expression was associated with accelerated bone metastasis formation (p > 0.034). Multivariate analysis confirmed that RANK is an independent prognostic indicator for early bone metastasis development (p > 0.037). Conclusions: RANK is clearly associated with bone metastasis formation and thus might have clinical utility in identification of patients with increased risk of bone metastasis and with increased probability to respond to anti-RANKL monoclonal therapy (denosumab). This is the first time that RANK has been linked to the bone metastasis process in breast cancer. No significant financial relationships to disclose.
Sentinel node staging of resectable colon cancer: Results of CALGB 80001
Authors: M. M. Bertagnolli, M. Redston, B. Miedema, J. Dowell, D. Niedzwiecki, R. Mayer, J. Fleshman, J. Bem, C. Compton
Journal: Journal of Clinical Oncology (2004)

3506 The most important outcome predictor for resectable colon cancer (RCC) is the status of locoregional lymph nodes. This information is critical, as patients with positive nodes may benefit from post-operative adjuvant therapy. A subset of patients with node-negative RCC experiences a poor outcome, suggesting that improved staging would benefit this population by identifying patients who should receive additional treatment. CALGB 80001, a study conducted by 25 surgery-pathology teams at 12 institutions, was designed to determine whether sentinel lymph node sampling (SLNS) could identify a subset of lymph nodes that predict the status of the nodal basin for RCC, and therefore could be extensively evaluated for the presence of metastases. SLNS was performed on 79 of 91 patients enrolled, followed by multilevel sectioning (MLS) of the nodes, and examination by H&E as well as IHC to identify cells positive for cytokeratin (CK) and carcinoembryonic antigen (CEA). Sentinel nodes (SN) were successfully located in 66 of 72 colon cancer cases (92%), with an average of 2.0 sentinel nodes per patient. SNs were negative in 14 of 25 node-positive cases (56%). MLS revealed tumor in a SN in one of these cases, bringing the sensitivity of SN examination by H&E and MLS to 48%. Results of further sentinel node studies are as follows: The addition of IHC for CK and CEA doubled the total number of node positive colon cancer cases from 25 to 50 of 62 (40 to 81%). Conclusion: These results show that SN examined by H&E and MLS failed to predict nodal status in 52% of cases. Analysis of SNs from colon cancer is unlikely to predict the nodal status of the patient, and studies to examine micrometastatic disease should involve all draining nodes removed. No significant financial relationships to disclose.