tbuckley/cabot-search huggingface dataset:
Follow-up for breast cancer: Results of a patients survey
Authors: H. Stemmler, D. Laessig, P. Stieber, I. Bauerfeind, P. Fasching, M. Glattes, U. Goldmann-Posch, V. Hoffmann, M. Untch, V. Heinemann
Journal: Journal of Clinical Oncology (2007)

568 Background: International guidelines for the surveillance of post-treatment breast cancer patients recommend a clinical follow-up including routine history, physical examination and regularly scheduled mammograms. This often discussed practice has previously been shown not to be inferior when compared to an intensified follow-up in randomized trials performed in the eighties. Patients and Methods: We report the patients’ view on the basis of pooled data of two surveys performed in Germany. The questionnaire was sent out to 2,658 patients with a history of breast cancer. Results: A total of 801 patients (30.1%) answered to the questionnaire. The median age was 57 years (range 23–85 years). More than 80% of the patients were disease-free at the time of the survey. Necessity for surveillance was affirmed by a majority (95.6%), and 40.3% of the patients answered that there was a need for more intensive diagnostic effort with regard to laboratory exams and imaging procedures during follow-up. The main expectation from an intensified follow-up include was the increased feeling of security as expressed by 86.6% of the patients. In contrast to the follow-up guidelines, the present survey indicates that most of the regularly scheduled follow-up visits were expanded using extensive laboratory and imaging procedures (ultrasound 81.9%, CT scan 33.8%). In view of the unsatisfactory evidence on follow-up in breast cancer only 25.7% patients indicated that they would participate in a trial randomising between conventional and more intensive follow-up. Conclusion: The survey indicates that a majority of physicians do not accept the present follow-up guidelines. To some extent this may be explained by the observation that patients and possibly also their doctors trust that intensified follow-up increases diagnostic security. Clearly, a new surveillance study is warranted which investigates the impact of an intensified surveillance on survival based on the greatly improved possibilities of modern diagnostics and treatment. No significant financial relationships to disclose.
High-dose cyclophosphamide for poor-prognosis and recurrent pediatric brain tumors: a dose-escalation study.
Authors: S M Yule, N K Foreman, C Mitchell, N Gouldon, P May, H P McDowell
Journal: Journal of Clinical Oncology (1997)

PURPOSE To determine the maximum-tolerated dose (MTD) of cyclophosphamide (CTX) when administered over 2 consecutive days followed by hematopoetic stem-cell rescue given as two sequential courses to children with glioblastoma multiforme, poor-prognosis pontine gliomas, and other recurrent CNS tumors. PATIENTS AND METHODS Two identical doses of CTX were administered 24 hours apart to 14 children and followed by hematopoetic stem-cell rescue. This treatment was repeated immediately following hematologic recovery. The starting dose of CTX was 2.5 g/m2/d with increments of 0.5 g/m2/d. CTX pharmacokinetics and metabolism were measured during 22 courses of treatment. Toxicity and tumor response were recorded. RESULTS There were two toxic deaths at the dose level of 4 g/m2/d. These were not clearly related to cardiac toxicity and may have been due to generalized capillary leak syndrome. Thus, the MTD of CTX was 3.5 g/m2/ d. There were six complete responses (CRs) (46%; (95% confidence interval [CI], 19% to 73%) and four partial responses (PRs) (31%; 95% CI, 6% to 56%), and one patient achieved stable disease. All children with intracranial primitive neuroectodermal tumors (PNETs) improved following CTX. The median duration of tumor response was 6 months (range, 4 to 29) and only one patient remains disease-free following CTX alone. Overall survival is 21% (95% CI, 13% to 29%) at a median follow-up time of 27 months (range, 12 to 34). CONCLUSION The MTD of CTX when followed by hematopoetic stem-cell rescue is 3.5 g/m2 administered on each of 2 consecutive days. This treatment was tolerable in children with poor-prognosis brain tumors and produced complete responses in children with recurrent PNETs.
Proteomic profiling identifies prognostic subsets in Rhabdomyosarcoma (RMS)
Authors: L. J. Helman, C. Yeung, V. Espina, G. Eichler, K. Krishnan, M. Tsokos, S. Qualman, W. Meyer, S. Steinberg, E. F. Petricoin, L. A. Liotta
Journal: Journal of Clinical Oncology (2005)

9502
Korean National Health Insurance Database—Reply
Authors: Ann Hsing, John P. A. Ioannidis
Journal: JAMA Internal Medicine (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Assessing the impact of a targeted educational initiative on colorectal cancer lymph node retrieval: A Fox Chase Cancer Center Partners' quality initiative
Authors: B. Curley, M. A. O'Grady, S. Litwin, K. Stitzenberg, H. Armitage, A. Bapat, E. R. Sigurdson, N. J. Meropol, P. F. Engstrom, S. J. Cohen
Journal: Journal of Clinical Oncology (2009)

6524 Background: The retrieval of ≥12 lymph nodes in a colorectal cancer surgical specimen is an established quality metric. The impact of targeted education to improve nodal yield at community hospitals has not been studied. We initiated an intensive educational program through the Fox Chase Cancer Center Partner (FCCCP) hospitals to improve nodal retrieval in colon cancer specimens. Methods: At 12 FCCCP community hospitals from 2004–05, educational initiatives were conducted by FCCC staff and included group presentations at hospital tumor boards, cancer and quality committees, and regional CME. Individual presentations to pathologists and surgeons were held. Tumor registry data were retrospectively collected from FCCCP from 2003 (pre-intervention) to 2006 (post-intervention) for patients undergoing curative colon cancer surgery. Data abstracted were age, sex, race, stage, surgical procedure, and total number of nodes examined. The primary end point was % surgical specimens with ≥12 lymph nodes. Obtaining at least 250 records per year would allow ≥90% power to detect a change from a baseline level of ∼40% to ≥50% after intervention. Results: Data from 4,208 patients from 12 FCCCP hospitals were collected. Overall characteristics: male/female (48%/52%), race (W 83%, AA 7%, other 10%), age (&lt;50:6%, 50–70: 34%, &gt;70:60%), node ± (39%/61%). The % of colon cancer operations with ≥12 nodes significantly increased over the four years of the study (Table, p&lt;.00001). This difference persisted when pooling years before and after the intervention (2003–04 vs. 2005–06, p &lt;0.0001). There was no difference in nodal yield between two pre-intervention years (2003 vs. 2004, p=0.1). No differences in other characteristics such as age, sex, race, or % lymph node positive were noted between years. Conclusions: A multi-intervention targeted educational initiative in a large community cancer network is feasible and associated with increased colon cancer nodal retrieval. [Table: see text] No significant financial relationships to disclose.
Pharmacokinetics of ifosfamide and cytochrome P450 3A in a phase II trial of doxorubicin and ifosfamide in sarcoma patients
Authors: R. Chugh, D. G. Thomas, T. Wagner, K. Griffith, J. Taylor, F. Worden, S. Schuetze, M. M. Zalupski, L. H. Baker
Journal: Journal of Clinical Oncology (2005)

2035
Sleep, pain, fatigue, and depressive symptoms in cancer patients
Authors: C. Vena, K. P. Parker, R. Allen, D. Bliwise, S. R. Jain, L. P. Kimble
Journal: Journal of Clinical Oncology (2008)

20523 Background: Sleep disturbance, pain, depression, and fatigue, have been identified as a symptom cluster in patients with cancer because of their frequent co-occurrence. Based on previous research and potential underlying mechanisms, we hypothesized that sleep quality would be positively associated with and mediate the relationship between these symptoms. Methods: The sample included 80 subjects with late stage lung and colorectal cancer with a mean age of 61.01±11.61 years; 39 were female. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Pain, depressive symptoms, and fatigue were measured by the bodily pain (BP), mental health (MH), and vitality (VT) subscales of the SF36v2. Statistical analyses included descriptive, correlational, and linear regression. The significance of mediation models was assessed with the Sobel test. Results: Fifty-seven subjects (71%) had poor quality sleep (PSQI score >5); 52 (65%) reported fatigue (VT <50); 43 (54%) had pain (BP <50); and 27 (34%) reported depressive symptoms (MH<50). Symptom expression did not vary by demographic (age, gender, marital status, or education) or clinical (diagnosis, treatment) factors. However, poor sleepers reported more fatigue (p<.001), pain (p=.017), and depressive symptoms (p=.016) than good sleepers. Fifty-eight subjects (73%) expressed 2 or more of the symptoms and correlations between symptoms were positive and statistically significant (r = .339 - .541; p<.01). Multistage regression analyses revealed that sleep partially mediated the association between pain and fatigue (Sobel 3.41; p<.001), between depressive symptoms and fatigue (Sobel 3.57; p=.001), and between pain and depressive symptoms (Sobel 3.28; p<.001). Conclusions: Poor sleep quality, depressive symptoms, fatigue, and pain were prevalent and associated in our sample. While we cannot confirm the direction of these associations, statistical models supported our hypotheses that sleep would mediate associations between symptoms suggesting common or shared underlying mechanisms. Further research into the etiologies of disturbed sleep in cancer populations is warranted as successful interventions to improve sleep quality may decrease expression of pain, fatigue, and depressive symptoms. No significant financial relationships to disclose.
Role of k-ras mutations in patients affected with NSCLC and treated with tyrosine kinase inhibitors (tkis): Results of a pooled analysis
Authors: O. Martelli, G. Farina, M. C. Garassino, A. Mancuso, M. Gambacorta, G. Gherardi, F. Bianchi, I. Floriani, V. Torrri, A. Scanni
Journal: Journal of Clinical Oncology (2008)

14658 Background: The magnitude of survival benefit of TKIs in pts with advanced non small lung cancer (NSCLC) is modest. However, an increasing body of evidence supports a greater survival benefit of TKIs in pts with EGFR mutations, EGFR high copy number and or EGFR overexpression and in females, Asians and non squamous carcinoma. Furthermore, a negative outcome in those pts with K-ras mutations is reported. Methods: We performed a pooled analysis of the most unbiased acknowledges to assess the role of these factors in predicting efficacy of TKIs. An electronic search focused on all phase II and III trials assessing efficacy or activity of TKIs alone or associated with chemotherapy in NSCLC was performed. Evaluable trials had to report at least a subgroup analysis for K ras tests. A pooled analysis was accomplished and Hazard Ratio (HR) with 95% confidence interval was derived for each level of analysed factors. Results: Out of 17 retrieved papers only two were considered for analysis (BR.21, TRIBUTE). Patients with K-ras mutations have and increased relative risk of death of 97% (HR 1.97 95%CI. 1.16–3.33 and interaction (p=0.003)) and an increased risk of progression of 90% (HR 1.90 95%CI. 1.05–3.44). Patients without K ras mutations have a reduction risk of death of 31% (HR 0.79 95%CI. 0.59- 1.05) and a risk of progression similar to placebo (HR 1.06 95%CI. 0.81–1.38). Conclusions: Interaction suggests a detrimental effect of TKIs in pts with K-ras mutations versus placebo; however, it is unclear whether this negative effect is related only to TKIs, in fact, INTEREST trial failed in demonstrating this effect in respect to chemotherapy. In conclusion, at the moment we are very far from understanding how to select patients and none of the trials is able to answer properly the question. Properly planned studies defining the exact role of this marker, in particular in respect to chemotherapy are warranted in order to choose the most appropriate therapy and to avoid any risks for these patients. No significant financial relationships to disclose.
The role of staging laparoscopy in type 4 gastric cancer.
Authors: Norihiko Sugisawa, Etsuro Bando, Yuichiro Miki, Rie Makuuchi, Hironobu Goto, Masanori Tokunaga, Yutaka Tanizawa, Taiichi Kawamura, Masanori Terashima
Journal: Journal of Clinical Oncology (2014)

35 Background: In type 4 gastric cancer, the incidence of peritoneal metastasis which was unexpectedly found during surgery was as high as 40 percent. It is very difficult to detect peritoneal metastasis in clinical imaging such as computed tomography or ultrasound before operation. Staging laparoscopy (SL) is considered to be an only minimal invasive procedure to detect peritoneal metastasis. However, the significance of SL had not yet been fully elucidated. The aim of this study is to assess the role of SL in type 4 gastric cancer. Methods: From September 2002 to March 2012, a total of 169 patients with type 4 gastric cancer who were diagnosed as not having distant metastasis in clinical imaging were enrolled in this study. SL was performed for 56 patients, and the other 113 patients underwent open laparotomy (OL) without SL. We retrospectively examined the incidence of peritoneal metastasis and positive peritoneal cytology and treatment courses in patients who underwent SL and OL. Results: In 56 patients undergoing SL, 23 (41%) had peritoneal metastasis and 40 (71%) had positive peritoneal cytology. Similarly, 54 (48%) had peritoneal metastasis and 86 (76%) had positive peritoneal cytology in 113 patients undergoing OL. There were no significant differences of the incidence of peritoneal metastasis and positive peritoneal cytology between the two groups. Subsequent treatments after SL or OL were diverse depends on patients condition and participating clinical trials, however, 17 (32%) in SL group and 13 (12%) in OL group were treated without surgical interventions. There was no morbidity and mortality in both SL group and OL group. In SL group, open surgery was performed soon afterword in 39 patients. Among them, 2 patients was failed to detect peritoneal metastasis by SL. Therefore the accuracy of detecting peritoneal metastasis in SL was 23/25 (92%). Conclusions: In type 4 gastric cancer, the incidence of peritoneal metastasis was around 40% and positive peritoneal lavage cytology was around 70% in both SL and OL. As SL is less invasive than OL, SL appears to be a useful way to detect peritoneal seeding and establish treatment strategy in patients with type 4 gastric cancer.
De Novo Mutation Detection from Ctdna Correlates with Variants Detected on Metastasis of Patients with Any Kind of Refractory Cancer from the Shiva Trial
Authors: J. Pierga, C. Decraene, V. Bernard, M. Kamal, A. Blin, T. Rio Frio, N. Servant, F.C. Bidard, X. Paoletti, M. Stern, R. Lebofsky, C. Le Tourneau
Journal: Annals of Oncology (2014)
Independent validation and comparison with fibroscan, fibrotest and liver biopsy of clinical glycomics for the non invasive assessment of liver fibrosis in chronic hepatitis C
Authors: L Castera, Annelies Van Hecke, P Trimoulet, Nico Callewaert, P Couzigou, De Ledinghen, Roland Contreras, Wouter Laroy
Journal: Hepatology (2005)
Imaging, dosimetry, and radioimmunotherapy with iodine 131-labeled anti-CD37 antibody in B-cell lymphoma.
Authors: M S Kaminski, L M Fig, K R Zasadny, K F Koral, R B DelRosario, I R Francis, C A Hanson, D P Normolle, E Mudgett, C P Liu
Journal: Journal of Clinical Oncology (1992)

PURPOSE This study was undertaken to evaluate the tumor targeting, toxicity, and therapeutic potential of the anti-B-cell-reactive monoclonal antibody MB-1 (anti-CD37) labeled with iodine 131 given in a nonmarrow ablative dose range in B-cell lymphoma patients who relapsed after chemotherapy. PATIENTS AND METHODS Twelve patients with MB-1-reactive tumors were infused first with 40 mg of trace-labeled (3 to 7 mCi) MB-1. Ten patients who had no serious toxicity postinfusion and who had successful tumor imaging on serial gamma scans then received at least one 40-mg radioimmunotherapy (RIT) dose (25 to 161 mCi). Tracer estimates of delivered whole-body dose (WBD) were used in prescribing a millicurie RIT dose for seven patients. RESULTS Eleven patients had positive tumor imaging after a tracer dose, including patients with bulky tumors and/or large tumor burdens (&gt; or = 1 kg) +/- splenomegaly. However, overall sensitivity for the detection of known tumor sites was only 39%. In six of eight patients with dose-assessable tumors, the radiation dose to at least one tumor was 1.1 to 3.1 times higher than to any normal organ, excluding the spleen for a 40-mg tracer dose. Tracer-dose toxicities included reversible glossal edema in one patient, grade 3 hepatic transaminasemia in another, and early drops in both circulating B and T cells (with decreases in B cells more pronounced) in nearly all patients. RIT toxicity was primarily myelosuppression (especially thrombocytopenia), which had a delayed onset and protracted recovery (without significant recovery until at least 2 months post-RIT). Grade 3 myelosuppression in two of two patients who were treated at a tracer-projected 50-cGy WBD level (133 and 149 mCi) precluded further planned RIT dose escalation. Less myelosuppression was generally observed in patients who were treated at &lt; or = 40-cGy WBD levels. Antimouse antibodies developed in two patients. Six patients had tumor responses post-RIT. Four had responses that lasted more than 1 month (2 to 6 months), which included one complete response, one partial response, one minor response, and one mixed response. Responses seemed to occur more frequently in imaged tumors than in nonimaged tumors. The most durable response occurred in a patient who had the best antibody targeting to tumor. CONCLUSIONS Although 131I-MB-1 has limited diagnostic value, it can produce tumor responses at nonmarrow ablative RIT doses. Further studies that focus on improving tumor targeting with this or other B-cell-reactive radiolabeled antibodies and on ameliorating the myelosuppression associated with the RIT-dosing approach used in this trial are warranted.
Phase II clinical trial of curcumin in patients with advanced pancreatic cancer
Authors: N. Dhillon, R. A. Wolff, J. L. Abbruzzese, D. S. Hong, L. H. Camacho, L. Li, F. S. Braiteh, R. Kurzrock
Journal: Journal of Clinical Oncology (2006)

14151 Background: Pancreatic cancer is virtually always lethal, and the only FDA-approved therapies- gemcitabine and erlotinib- produce objective responses in less than 10% of patients. Curcumin (diferuloyl methane) is a plant- derived compound that inhibits the nuclear factor-kappa B (NF-kappa B) transcription factor (central to pancreatic cancer growth) and has substantial antitumor activity in preclinical models. We evaluated the toxicity and anti-tumor activity of curcumin, and its impact on survival and biologic correlates. Methods: Patients received 8 grams of curcumin (Sabinsa Corp.) by mouth daily for two months. Maintenance therapy was continued at the same dose and schedule until disease progression. Results: Seventeen patients were enrolled as of the date of analysis. Six were inevaluable: noncompliance (n = 1), never dosed (n = 1), noted to have gastric obstruction after one dose (n = 1), and too early (n = 3). Eleven patients were evaluable for response and 15 were evaluable for toxicity. To date, four patients have stable disease (2+, 2+, 3+ and 7 months) and one patient had a brief partial remission (73% reduction in tumor size by RECIST) that lasted one month. No toxicities have been observed. Serum was available for evaluation of pre-and post-dose cytokine levels in thirteen patients. Interestingly, the patient with the partial remission had marked increases (4–35 fold) in serum IL-1 receptor antagonist, IL-6, IL-10 and IL-8 levels. One to three other patients also had post-treatment increases in one or more of the above cytokines, albeit to a lesser extent (2–6 fold). Conclusions: We conclude that curcumin is well tolerated and our preliminary results suggest biologic activity in pancreatic cancer. Supported in part by the National Cancer Institute grant R21 CA 104337–01, The Topfer Fund for Pancreatic Cancer and Pancreatic SPORE grant 1 P20 CA10193–03. No significant financial relationships to disclose.
CD40 ligand gene therapy directly induces apoptosis in carcinomas
Authors: D. H. Palmer, T. El-Metwali, A. E. Milner, E. Hodgkin, L. S. Young
Journal: Journal of Clinical Oncology (2007)

14082 Background: CD40 is a member of the TNFReceptor superfamily expressed on a variety of immune cells. Interaction of CD40 with its ligand (CD40L) plays a key role in orchestrating immune responses. We have shown that CD40 is also expressed on a variety of carcinomas. CD40 ligation in this context can induce cancer cell death. Thus CD40 represents a rational target with direct cytotoxicity and induction of anti-tumour immunity. Methods: We generated an adenovirus encoding CD40L (AdCD40L) and investigated its effect in CD40-expressing carcinoma cells (bladder, ovary, hepatocellular) as follows:(i)comparison of Ad-delivered CD40L with recombinant soluble ligand (rsCD40L);(ii)inhibition of cleavage of CD40L from the cell membrane using metalloproteinase inhibitors (MMPI);(iii)generation of a mutant CD40L resistant to MMP cleavage. Results: (i)CD40 ligation in carcinomas stimulates survival and apoptotic signaling. rsCD40L is only cytotoxic in the presence of protein synthesis inhibition, which blocks survival pathways and allows apoptosis. In contrast, AdCD40L is cytotoxic even in the absence of protein synthesis inhibitor;(ii)AdCD40L results in expression at the cell membrane but this is cleaved from the membrane and detected as soluble ligand in supernatant of infected cells. Cleavage is inhibited by MMPI and this increases apoptosis, suggesting that membrane-bound CD40L is a more potent apoptotic stimulus than soluble ligand;(iii)we identified the cleavage site of CD40L and generated a mutant by deletion of this region and cloned this mCD40L into an adenovirus. AdmCD40L results in membrane expression of CD40L, with no detectable soluble CD40L, confirming its resistance to cleavage. AdmCD40L is significantly more cytotoxic than wild-type AdCD40L. Conclusions: The effect of CD40 ligation depends on the cellular context and the method of CD40L delivery: adenovirus delivery results in membrane-bound expression and this provides a stronger apoptotic stimulus than rsCD40L. Apoptosis is further enhanced by a mutant CD40L that is resistant to cleavage from the cell membrane. Thus AdmCD40L is a novel therapeutic that is a potent inducer of apoptosis. Studies are underway to assess these effects in vivo and to elucidate the contribution of immunostimulatory effects in syngeneic models. No significant financial relationships to disclose.