tbuckley/cabot-search huggingface dataset:
The incidence of potential medication interactions including herbs and supplements among breast and prostate cancer patients during and after systemic anticancer therapy.
Authors: N. Kwon, R. T. Lee, M. Ray, R. Z. Szmulewitz, J. H. Von Roenn, W. M. Stadler, F. C. Curlin
Journal: Journal of Clinical Oncology (2010)

9028 Background: Cancer patients take a variety of medications including herbs and supplements (HS) while receiving anticancer therapies. The prevalence of potential medication interactions (PMI) has not been well documented and such interactions may have a direct impact on clinical outcomes. Methods: Breast and prostate cancer patients participated in a phone interview after finishing a regimen of systemic anticancer therapy. Data collected included all medicines taken (including anticancer therapies, prescription (RX), over-the-counter (OTC), and HS), timing of use, and communication with their oncology team. Micromedex interaction software was used to identify PMI. Results: One hundred fourteen patients consented to participate and 68 of 94 eligible patients (72%) have completed the phone survey. Characteristics: mean age of 57 (range, 39-77), 85% breast cancer, 15% prostate cancer, stages I (18%), II (48%), III (25%), IV (9%) and 24% were on a clinical trial. Subjects took an average of 5.8 medicines during anticancer treatment and an average of 5.4 medicines afterwards. The use of HS increased after finishing anticancer therapies from 37% to 51%. The Micromedex software detected 104 PMIs during anticancer therapy and 22 after such treatment. These involved 34% and 15% of subjects, respectively. PMIs were categorized as major (10%), moderate (57%), and minor (33%). RX medications were involved in 97% of identified PMIs followed by OTC (18%), anticancer therapies (13%), and HS (7%) during treatment. Nearly three-fourths of patients (72%) discussed the use of HS with their oncologists and these discussions were most commonly initiated by patients (80%). Half of subjects (49%) reported feeling very confident about their medical teams' advice about complementary and alternative therapies, and the majority of subjects (70%) would stop taking an herb if their physician was concerned about a PMI. Conclusions: One out of three breast and prostate cancer patients given anticancer treatments were at risk for PMI, including OTC and HS. Oncologists need to be aware of these interactions and discuss them with their patients. No significant financial relationships to disclose.
Multi-modality approach in curative local treatment of early rectal carcinomas - 12 years Liverpool experience
Authors: A. Sun Myint, C. Makin, M. J. Hershman
Journal: Journal of Clinical Oncology (2004)

8274 Background: Surgery remains the mainstay for the management of rectal carcinoma. The conventional surgical treatment for low rectal carcinoma is total mesorectal excision with 30% of cases requiring abdomino-perineal excision (APER). Local excision is an alternate treatment option and this could be offered either using manual trans-anal excision (TAR) or transanal endoscopic microsurgery (TEM). Pre operative or post operative chemo radiotherapy was used to improve surgical results. Methods: From January 1992 to December 2003, 120 patients were offered curative local treatment. The majority of patients were staged using endo rectal US. The treatment policy depends on size and stage of the tumour. T1 tumours <3 cm were offered either TEM /TAR or Contact radical radiotherapy using modified Papillon technique. T2 or any T >3cm were offered either preoperative chemo-radiotherapy using 5FU infusion !G/m2 day 1–4 (week1+5) or radiotherapy alone(50.4Gy/28/38) to down size the tumours followed by local excision. Patients who were not fit for surgery had local contact radiotherapy boost (30–60Gy). Results: There were 75 males and 45 females. Median age 71 years (range33–91) Stages of the tumour were TO= 7, T1=64, T2=37,T3=6 TX=5. Eighty seven patients had surgery TEM=54,TAR=29. Thirty five patients had radical radiotherapy. Local recurrence occurred in 10% of patients and salvage surgery was offered in over half (6 patients) of these patients. At the median follow up of 54 months(range 3–140), the overall survival was 72% reflecting the fact that the majority of patients were elderly with co-existing medical problems. Only 10 patients had colostomies. Cancer specific survival was 96%. Conclusions: We conclude that selected patients who were not medically fit or those who are unable to accept a permanent colostomy, local treatment can be offered with curative intent using multi-modality approach. We recommend TEM as a preferred surgical technique and contact radiotherapy boost (60Gy)following EBRT (50.4Gy). In our experiences relapses can be salvaged effectively and we recommend a long term follow up policy. No significant financial relationships to disclose.
Residual tumor resection in patients with germ cell tumors (GCT): Use of IGCCCG risk group and tumor volume to predict additional vascular procedures.
Authors: C. Winter, C. Bingoel, R. Witthuhn, P. De Geeter, P. Albers
Journal: Journal of Clinical Oncology (2010)

4586 Background: Residual tumor resection (RTR) after chemotherapy is mandatory in patients with advanced GCT and visible residual tumor. Aim of this analysis was to identify parameters to predict possible RTR complications and additional procedures and, thus, to facilitate preoperative planning. Methods: We performed a retrospective analysis of 124 patients who underwent 134 RTRs in 2 referral centers (2003-2009) with identical surgical technique (2 surgeons). The RTR database was queried for extent of surgery, complications, additional procedures and outcome, which were correlated to IGCCCG and residual tumor volume. The median age of patients was 33 yrs (15-65). 47% of patients initially had IGCCCG intermediate and poor prognosis features. Results: The median time of surgery was 243min (120-480) with a median blood loss of 680ml (50-5000). One patient died perioperatively due to a postoperative aorto-duodenal fistula. Median follow-up is currently 3.3 yrs (0.1-6.3). In 16 pts a vena cava resection, in 15 pts a nephrectomy and in 8 pts a liver resection was necessary. Intraoperative hemorrhage with transfusion was significantly correlated with IGCCCG (50,0% intermediate/poor vs. 14.5% good; p<0.01) as well as residual tumor size (57,9% >10cm vs. 18,1% <5cm; p<0.01). However, intraoperative vascular injury rate (12.9% intermediate/poor vs. 1.6% good; p<0.01) and necessity of vena cava resection (21,0% intermediate/poor vs. 3.2% good; p<0.01) was significantly correlated with IGCCCG but not with tumor size. Other CTCAE grade 3/4 complications like lymphoceles and constipation showed no correlation to IGCCCG or tumor size. Conclusions: The RTR vascular complication rate and the necessity for additional vascular procedures are significantly correlated to the initial IGCCCG classification suggesting that IGCCCG risk group is a better predictor for the necessity of vascular surgery than mere residual tumor size. Patients with IGCCCG intermediate and poor risk features can be initially identified as high risk patients for vascular replacement (21%) and therefore should be referred to specialized surgical centers with ad hoc possibility of vascular interventions. No significant financial relationships to disclose.
Cancer-related distress and unmet needs among members of a metastatic breast cancer registry.
Authors: Joanne S. Buzaglo, Melissa F Miller, Anne Morris, Allison Harvey, Mitch Golant
Journal: Journal of Clinical Oncology (2014)

118 Background: An estimated 155,000 people are living with metastatic breast cancer (MBC) in the US. Emotional distress among people living with MBC is common; yet, little is known about the patient experience and distress screening. Methods: Since March 2013, the Cancer Support Community has registered 909 people living with MBC to the Cancer Experience Registry, an online initiative that is designed to raise awareness about the psychosocial impact of cancer. 599 registrants responded to questions about cancer related distress. This sample was 99% female, 91% Caucasian, and 69% with a college degree and median age 56. Median time since MBC diagnosis was 3 years. Results: The top sources of distress (% rated seriously or very seriously concerned) were: (1) worry about the future (44%); (2) fatigue (39%); (3) health insurance or money worries (38%). 49% reported fatigue was ‘quite a bit’ or ‘very much’ disruptive in their life and 46% reported intrusive ideation about the financial cost of care. Factors that were independently associated with greater overall distress included younger age (p&lt;0.001), higher comorbidity (p&lt;0.001), lower income (p=0.001). 43% of respondents were never asked about distress by their health care team. Those who received all or part of their treatment in an academic or comprehensive cancer center were significantly more likely to be asked about distress versus those receiving treatment anywhere else (65% vs. 50%, p=0.002). Among those who were asked about distress (n=340), 62% received referrals to manage distress within their health care system, and 19% at a community-based organization; 47% reported their health care team helped coordinated distress-related care. 20% of those asked about distress never received referrals for managing it. Conclusions: These findings support the need for integrated supportive care services and better side-effect management. Disturbingly, 20% of patients who asked for referrals never received them and only 19% of patients were referred to community-based organizations for treating their distress where these services are often provided at low or no-cost. There is an on-going need for coordinated care that integrates programs and services across health care systems.
Effect of arecoline, the major alkaloid of areca nut, on the number of N-benzyl-N-methylnitrosamine (NMBA)-induced esophageal papilloma in F344 male rats.
Authors: Ming-Tsang Wu
Journal: Journal of Clinical Oncology (2015)

53 Background: Arecoline is the major alkaloid of areca nut which is one major risk of developing esophageal squamous cell carcinoma (ESCC) in the Asian population. This study aims to establish one rat model to study the relationship of areca nut exposure with the development of ESCC. Methods: Six-week-old Fischer 344 male rats were injected subcutaneously with 0.5 mg/kg NMBA thrice a week for the first 5 weeks and given water without or with arecoline (500 mg/ml) for 30 weeks. Results: With co-treatment of arecoline, NMBA-injected rats had significantly more esophageal papillomas (p = 0.02) and marginally significantly more tongue papillomas (p= 0.09) per rat, compared to those with NMBA only in the end of week 30. No papilloma was found in the lung, liver and/or stomach among all experimental groups. The histological features of esophageal papilloma showed the hyperplastic changes of squamous epithelium. Conclusions: This established animal model can be ideally used to study areca nut-associated esophageal carcinogenesis.
Baseline (BL) radiographic characteristics and severe pulmonary hemorrhage (SPH) in bevacizumab (BV)-treated non-small cell lung cancer (NSCLC) patients (pt): Results from ARIES, an observational cohort study (OCS).
Authors: P. Kumar, N. A. Fischbach, J. R. Brahmer, D. R. Spigel, S. Beatty, S. Teng, E. D. Flick, A. Sing, T. J. Lynch
Journal: Journal of Clinical Oncology (2010)

7619 Background: BV prolongs progression free and overall survival in advanced NSCLC pts. ARIES, a prospective OCS, evaluates BV clinical outcomes in a real world setting. Post hoc analyses from randomized controlled trials suggest location and cavitation as potential risk factors for SPH, a serious and often fatal adverse event (AE). ARIES presents a unique opportunity to independently evaluate BL tumor characteristics and correlate with SPH. Methods: Pts with advanced nonsquamous NSCLC on first-line chemotherapy and BV enrolled. No doses, regimens or assessments were prespecified. Data were collected electronically at BL and quarterly. SPH were reported expeditiously. BL CT scans were requested for all pts and reviewed by an independent review facility (IRF). Results: NSCLC enrollment completed 06/2009. As of 09/2009, 1,970 pts had median follow-up of 9.6 mo. The IRF reviewed BL scans of 1,881 pts; 1,470 (78%) had ≥ 1 BL measurable (meas) tumor (≥ 0.5cm) and 49% (718) were central; 67% had largest tumor size ≥ 3 cm; 14% had cavities and 10% had > 1 cavity. BL tumor characteristics were generally similar across subpopulations (age ≥ 70, PS ≥ 2, pts with CNS mets). Pts with a history (Hx) of hemoptysis (n = 105) had more centrally located tumors, fewer numbers of meas tumor, and larger cavity size. There are 15 (0.8%) reported SPH events to date; 2 pts had no BL CT scan submitted and 2 pts with BL scans had no meas tumor (1 had Hx of hemoptysis). Of the remaining 11 pts with SPH: 8 had central tumors; 1 had cavitation (1.2 cm); 0 were on anticoagulants at BL; largest tumor size ranged from 1.8-11.6cm. There was 1 SPH in pts with ≥ 1 cavity (0.5%) and 8 in pts with central tumors (1.1%). Conclusions: ARIES has the largest series of independently reviewed BL scans from advanced NSCLC pts, providing an opportunity to correlate radiographic factors with outcomes in BV treated pts. Although limited by small numbers, the data suggest that cavitation is not predictive of SPH. Correlation of BL radiographic characteristics with outcomes and risk factor analysis will be presented. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Genentech, Infinity Pharma AstraZeneca, BIPI, Genentech, Merck Infinity Pharma, Roche Genentech
Prognostic effect of CD55<sup>SC-1</sup> in gastric carcinoma (GC) and survival after treatment with the monoclonal antibody SC-1
Authors: W. Timmermann, B. Illert, H. Reindl, H. Rückle-Lanz, M. Wilhelm, F. Hensel, H. P. Vollmers, H. K. Müller-Hermelink, D. Coquoz, A. Thiede
Journal: Journal of Clinical Oncology (2004)

4067
Regular medical check-up of patients treated for basal cell carcinoma of skin
Authors: E. L. Sekerzhinskaya, A. F. Lazarev, V. D. Petrova, S. A. Terekhova
Journal: Journal of Clinical Oncology (2008)

22196 Background: Skin cancer is the second by the frequency in the structure of cancer incidence in the Altai territory. According to the State direction in Russian Federation basal cell carcinoma of skin is the reported site of cancer, it is subjected to the registration by cancer registries, but at the absence of recurrence or progression should be stricken off the registry when 5 year after the treatment pass. Annually 500 patients treated for basal cell carcinoma of skin are stricken off the Altai Territory Cancer Registry (ATCR). Methods: The study aimed to estimate the periods of time till second primary cancer appeared in patients treated for basal cell carcinoma of skin and to determine the necessary duration of regular medical check-up of these patients. The data of ATCR were analyzed. Results: Among patients with multiple primary tumours (MPT) registered in the Altai territory in 1995–2005 skin was the most frequent site of the first cancer (744 patients - 20.9%). Among these patients 647 ( 86.9%) had basal cell carcinoma. 20.5% of them (133 patients) developed the second tumour synchronously and 79.5% (514 patients) had metachronous MPT. In the whole the period between the first and the second tumour was less then 5 years in 411 patients (63.5%). Thus, 103 (16.0%) patients developed the second tumour after the moment they were stricken off the registry (with the max interval of 30 years). Among the sites of the second cancer the most frequent were skin (22.4%), lung (12.8%), stomach (7.5%), breast (5.8%) and lip (5.1%). Conclusion: Taking into account high frequency of the second cancer development in patients treated for basal cell carcinoma of skin, they are subjected to lifelong regular medical check-up. No significant financial relationships to disclose.
Molecular basis of altered uracil catabolism in individuals with 5-FU toxicity and normal DPD enzyme activity
Authors: H. A. Reed, H. H. Ezzeldin, L. K. Mattison, R. B. Diasio
Journal: Journal of Clinical Oncology (2006)

3070 Background: Dihydropyrimidine dehydrogenase (DPD) deficiency accounts for approximately 43% of grade 3–4 toxicity to 5-Fluorouracil (5-FU). However, a significant number of patients with normal DPD enzyme activity remain with unexplained molecular basis of 5-FU toxicity. It has been suggested by the few cases previously reported that deficiency of dihydropyrimidinase (DHP)enzyme encoded by the DPYS gene and/or beta-ureidopropionase enzyme, encoded by the BUP-1 gene, could also be implicated in 5-FU toxicity. Methods: This study included 40 volunteers with known 13C-UraBT and DPD enzyme activity, 25 cancer patients with 5-FU toxicity despite normal DPD enzyme activity, and 25 liver biopsies from cancer patients with different grades of toxicity. All samples were analyzed for molecular defects in the DPYS and BUP-1 genes, using DHPLC and RT-PCR techniques. Results: Molecular analysis of the DPYS gene revealed the presence of two non-conservative amino acid changes, one frame-shift mutation that leads to a stop codon and premature termination of the DHP protein, five silent mutations, nine intronic sequence variations, two sequence variations in the 5’UTR and one in the non-coding region of exon 10. Molecular analysis of the BUP-1 gene revealed the presence of two non-conservative amino acid changes, one of which (314C&gt;A: A85E) has already been reported to abolish enzyme activity; six silent mutations, four intronic sequence variations, one polymorphism in the 5’upstream sequence, and one sequence variation in each of the 5’UTR and the 3’UTR. Conclusions: The molecular basis of 5-FU toxicity is not limited to DPD deficiency; since molecular defects in genes downstream of DPD can potentially also impair 5-FU catabolism. Genetic testing for molecular defects in DPYS and BUP-1 may predict patients at risk of developing 5-FU toxicity despite having normal DPD enzyme activity. Assessing the integrity of the entire uracil catabolic pathway might be crucial to avoid toxicity in a significant group of patients receiving 5-FU or a related drug (CA62164). No significant financial relationships to disclose.
Uncommon breast malignancies: Presentation pattern, treatment options and outcome in a single Institution experience
Authors: C. Bareggi, D. Consonni, B. Galassi, D. Gambini, E. Locatelli, R. Visintin, L. Runza, M. Giroda, G. Reali, M. Tomirotti
Journal: Journal of Clinical Oncology (2009)

e22174 Background: Uncommon breast tumors are often neglected by large clinical trials, even if their incidence is not so low. Methods: We investigated stage, treatment and outcome of 112 patients affected by uncommon breast cancer, out of 2,185 breast cancer patients diagnosed and followed in our Institution from January 1985 to October 2008. Results: Rare subtypes were represented as follows: tubular 2.7% (58 pts), mucinous 1.1% (25 pts), medullary 1% (21 pts), papillary 0.4% (8 pts). Median age at diagnosis was 56.5 years among patients with tubular histotype, 68.9 years for mucinous, 55 and 61.7 years for medullary and papillary, respectively. Stage I tumors were 87.7% among patients with tubular differentiation, 60% for mucinous, 26.3% for medullary and 50% for papillary, (compared to 45.7% in invasive ductal carcinoma: 1,626 pts). Stage II represented 12.3% among patients with tubular carcinoma, 32% for mucinous, 57.9% for medullary and 37.5% for papillary. Surgical option for stage I and stage II was usually conservative surgery (quadrantectomy, lumpectomy) plus local radiotherapy, followed by estrogenic blockade. In stage III radical mastectomy was often performed, followed by hormonal suppression. Median DFS for patients with tubular cancer was 4.1 years, for mucinous 3.7 years, 10.5 and 5.1 years for medullary and papillary, respectively. Median OS for patients with tubular cancer was 4.3 years, whereas for mucinous 4.2 years, for medullary 11 years and 5.3 years for papillary. Conclusions: In our retrospective analysis, uncommon breast tumors are often diagnosed at limited stages, resulting in good prognosis, with standard treatment. Further studies are warranted for a better management of these diseases. No significant financial relationships to disclose.
Late effects following treatment for female pelvic rhabdomyosarcoma (RMS)
Authors: A. L. Hester, T. A. Sweeney, M. M. Hudson, C. A. Billups, M. J. Krasin, S. L. Spunt
Journal: Journal of Clinical Oncology (2004)

8547 Background Most girls treated for RMS of the pelvic region are cured, but the effects of this treatment on long term health status are poorly documented. Methods We retrospectively reviewed the medical records of all 5-year survivors of female pelvic RMS treated at our institution between 3/62 and 12/96. Late effects occurring beyond 5 years from diagnosis were recorded and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results Among the 26 patients studied, the median age at diagnosis of RMS was 3.4 years (range, 0.2–17.2 years). The most common tumor sites were vagina (n=7), pelvis/retroperitoneum (n=6), and bladder (n=4). All patients received chemotherapy, which in some cases included an alkylating agent (n=23), doxorubicin (n=16), or etoposide (n=2). Radiotherapy was administered to 22 patients (dose range 16–60.5 Gy, median 46 Gy). Doxorubicin cardiomyopathy and secondary osteosarcoma were responsible for 2 deaths. Median follow-up for the 24 survivors is 19.6 years (range, 7.0–39.6 years) and 22 of the 24 patients had been seen or contacted within 3 years of the analysis. A total of 238 toxicities were identified in the 26 patients (143 grade 1/2, 95 grade 3/4). Twenty-three patients (88%) had at least one grade 3/4 toxicity. The 4 patients who did not receive radiotherapy had a significantly lower median number of late effects (1) compared to the 22 who received radiotherapy (9) (p=0.003). The most common grade 3/4 toxicities were endocrine (17 patients), gynecologic (14 patients), urologic (10 patients), and gastrointestinal (8 patients). Eighteen patients (69%) were sterile due to hysterectomy, bilateral oophorectomy or ovarian failure. Surgical intervention for treatment of late complications was required in fourteen patients (54%). Conclusions This retrospective study suggests that most long term survivors of female pelvic RMS experience severe late effects that adversely affect multiple organ systems. Prospective studies are needed to better define late effects in this patient population, and to assess the impact of these complications on quality of life, functional outcome, and ongoing medical needs. No significant financial relationships to disclose.