tbuckley/cabot-search huggingface dataset:
Neoadjuvant weekly paclitaxel, and epirubicin (PE) in patients with inflammatory and T4 breast cancer (IBC-T4BC): Result of a VAR Cancer Society tria
Authors: L. Cals, P. Nouyrigat, X. Tchiknavorian, C. Veyret, J. L. Wendling
Journal: Journal of Clinical Oncology (2004)

719 Background: weekly paclitaxel has been reported to shown high clinical activity, even in antracyclin resistant inflammatory breast cancer. Antracyclin chemotherapy are standard regimen for IBC-T4BC. We conducted a phase II study of weekly PE combination, to test the possibility to achieve clinical response rate and or pathological complete response (pCR) for IBC-T4BC in preoperative setting. Methods: eligible patients (pts) were at least 18 years and under 65 years of age with inflammatory and or T4 breast cancer, had WHO performance status 0–1-2 and normal left ventricular ejection fraction. Treatment: (epirubicin 40mg/m2 weekly and paclitaxel 80 mg/m2 given as 1hr infusion weekly)x6 consecutive weeks, 8 week cycle, for 2 cycles. Clinical and radiological (RX) evaluation was performed at week 14 followed by surgery and or irradiation. Results: between 10/99 and 01/02 twenty two pts with median age 50 (32–67) entered the study. The median follow up is 37 months (23–50). 15 pts with IBC and 7 pts with T4BC ( minimum 5 cm tumor size), 10 pts premenopausal, negative estrogen receptor 68%. A total of 248 PE infusions had been given, 7/248 PE infusions delayed, PE was omitted 16/264, a 25% reduced dose of E was administred on 28/248. three pts were non evaluable for efficacy (1 refused treatment, 1 came off the study following anaphylactic reaction due to paclitaxel at third week,1 with early progressive disease). No treatment related death have been reported. Grade 3–4 hematologic toxicity consisted of: neutropenia 18/248, febrile neutropenia 3, anemia 0, thrombocytemia 0. Grade 3–4 non haematological toxicity:nausea-vomiting 1, headache due to GCSF 1, allergy 1. Neurosensory toxicity did not exceed grade 2: 1 patient, grade 1:5 pts. Clinical and RX objective response was achieved in 16/22 pts (72%). Clinical, RX, complete response, and pCR in 3/22 pts (14%). 19 pts underwent mastectomy, 5 pts tumorectomy. Conclusions: preoperative PE for IBC-T4BC is very well tolerated, with 72% response rate (intend to treat) and 14%pCR rate. No significant financial relationships to disclose.
A randomized phase III trial (RTOG 0522) of concurrent accelerated radiation plus cisplatin with or without cetuximab for stage III-IV head and neck squamous cell carcinomas (HNC).
Authors: K. K. Ang, Q. E. Zhang, D. I. Rosenthal, P. Nguyen-Tan, E. J. Sherman, R. S. Weber, J. M. Galvin, D. L. Schwartz, A. K. El-Naggar, M. L. Gillison, R. Jordan, M. A. List, A. A. Konski, W. L. Thorstad, A. Trotti, J. J. Beitler, A. S. Garden, W. J. Spanos, S. S. Yom, R. S. Axelrod
Journal: Journal of Clinical Oncology (2011)

5500 Background: The concurrent use of cisplatin (CDDP) or cetuximab (CET) with radiation (RT) has been shown to improve survival of patients with stage III-IV HNC. Since CET enhances the response of metastatic HNC to platinum-containing regimens and survival, the RTOG launched a phase III trial to test the hypothesis that adding CET to the RT-CDDP platform for frontline therapy of stage III-IV HNC improves progression free survival. Methods: Patients with stage III-IV carcinoma of the oropharynx, larynx, and hypopharynx, having Zubrod performance of 0-1, and meeting predefined blood chemistry criteria were enrolled after providing consent. The experimental regimen (Arm A) consisted of a loading dose and 6-7 weekly doses of CET given in conjunction with the control arm (B) of 70-72 Gy (6 weeks) + 2 cycles of CDDP (q3 weeks). Results: From 11/’05 to 3/’09, 940 patients were enrolled. Of the 895 evaluable patients, 447 randomized to Arm A and 448 to Arm B. Over 90% of patients received 2 CDDP cycles in both arms and 74% of cases received the loading plus 6 or more doses of CET in Arm A. The median follow-up was 2.4 years for surviving patients. There were no significant differences in progression-free survival (HR [A/B]: 1.05, 0.84-1.29; P=0.66; 2-Y rates: 63% vs. 64%), the primary endpoint, or in overall survival (HR: 0.87, 0.66-1.15; P=0.17; 2-Y rates: 83% vs. 80%), death within 30 days of therapy (2.0% vs. 1.8%, P=0.81), and total grade 3-5 adverse events (92% vs. 90%, P=0.30). Arm A had higher rates of grade 3-4 mucositis (45% vs. 35%, P=0.003) and skin reactions (40% vs. 17%, P<0.0001) but grade 3-4 dysphagia rates were not significantly different (62% vs. 66%, P=0.27). Conclusions: The addition of cetuximab to the radiation-cisplatin platform did not improve progression-free or overall survival. The triplet regimen was associated with higher rates of mucositis and CET-induced skin reactions but no unexpected toxicity was observed. Whether tumor human papillomavirus status would affect the relative efficacy of the triplet regimen and the overall outcome of this trial is being addressed. Funding: NCI U10CA21661, U10CA37422, and Bristol-Myers Squibb.
Abstract 18351: Prevalence, Clinical Significance and Relevance to Screening of Electrocardiographic Abnormalities in Hypertrophic Cardiomyopathy Versus Athlete's Heart
Authors: Chiara Calore, Paola Melacini, Antonio Pelliccia, Cianfrocca Cinzia, Maurizio Schiavon, Di Paolo Fernando M, Bovolato Francesca, Quattrini Filippo M, Cristina Basso, Gateano Thiene, Sabino Iliceto, Domenico Corrado
Journal: Circulation (2012)

Background: Hypertrophic cardiomyopathy is often in the differential diagnosis with athlete’s heart due to the partial overlap of ECG and echocardiographic abnormalities. This study assessed the pr...
Societal costs after renal cancer surgery.
Authors: Peter Chang, Peter Renehan, Kimberly Taylor, Ostap Dovirak, Kyle McAnally, Arie Carneiro, Catrina Crociani, Andrew Percy, Andrew A Wagner
Journal: Journal of Clinical Oncology (2015)

512 Background: The hospital costs of radical or partial nephrectomy for treatment of confirmed or suspected renal cell carcinoma have been well described. We sought to estimate a previously unreported societal cost of renal cancer surgery by assessing surgery-related time off work (TOW) taken by patients and their caretakers. Methods: To a cohort of 315 subjects enrolled in an IRB-approved prospective renal quality-of-life study who underwent radical or partial nephrectomy at our institution, we administered an occupational survey asking subjects to recall employment status, physical demands at work (sedentary, moderate activity, heavy lifting), income by tax bracket, surgery-related TOW (in days), and caretaker assistance. We excluded subjects who underwent cytoreductive nephrectomy. We estimated potential wages lost using individual income and TOW, and used logistic regression to assess for factors predictive of TOW &gt; 30 days. Results: Of the 108 subjects who responded to the survey, 69 were employed at time of surgery. 4 subjects did not return to work after surgery, all of whom were older than 65. 12 subjects were excluded per the above-described criteria, leaving 53 subjects with complete occupational information. Mean (SD) age was 54. The majority (54%) of subjects had sedentary jobs. Subjects’ time off work ranged from 14 to 88 days; mean (SD) and median (IQR) TOW was 38 (17) and 34 (26-45) days, respectively. Mean potential wages lost for TOW was $10,371 (SD=$7,966). 23 (43%) subjects had at least one caretaker take TOW (mean/median caretaker TOW: 10/5 days, respectively) to assist in post-operative recovery. On univariate and multivariable analysis, age, work physicality, type of surgery (radical vs partial nephrectomy), surgical approach (minimally invasive vs open), income bracket, post-operative complications, or caretaker assistance were not significantly associated with taking &gt; 30 days off from work. Conclusions: Despite advances in minimally invasive surgery, most patients take over one month off from work after renal cancer surgery. Incorporating these societal costs may allow for more comprehensive cost-effectiveness analyses in renal cancer care. Future directions include assessing TOW prospectively in a larger, more diverse cohort.
A phase II study of sunitinib (SU11248) in patients (pts) with recurrent epithelial ovarian, fallopian tube or primary peritoneal carcinoma - NCIC CTG IND 185
Authors: J. J. Biagi, A. M. Oza, R. Grimshaw, S. L. Ellard, U. Lee, J. Sederias, S. P. Ivy, E. A. Eisenhauer
Journal: Journal of Clinical Oncology (2008)

5522 Background: Sunitinib is a multi-targeted receptor tyrosine kinase (RTK) inhibitor with potent activity against a number of RTK targets that are implicated in epithelial ovarian cancer (EOC) growth and metastasis, including vascular endothelial growth factor and platelet- derived growth factor receptors. Methods: A 2-stage phase II study was designed to evaluate single agent activity of oral sunitinib in recurrent EOC, primary peritoneal and fallopian tube cancers. Primary endpoint was objective response by RECIST criteria. CA125 response was secondary endpoint. Using hypotheses of H0 < 5% and Ha> 20%, 1 response in 15 pts enrolled in stage 1 would lead to accrual of a further 10 pts. Eligibility required measurable disease (CA125-only not eligible), 1–2 prior chemotherapy regimens, but no prior angiogenic or RTK inhibitor. Platinum-sensitive and -resistant pts were eligible. Treatment was sunitinib 50 mg po daily for 4 out of 6 weeks, with response assessed each cycle. Results: 17 pts (16 eligible) have been accrued; Median age 55 years (range 41–82); histology adeno 3, endometrioid 1, serous 12; 12 pts had 2 prior chemo regimens; total number of cycles 42, median 3 (range 1 - 5). Partial response has been seen in 2 pts, stable disease in 10 (range 2.6–6.9 mo), progressive disease (PD) in 4. Notably, by size criterion alone 4 pts had decrease >30% but two developed effusions and were therefore PD by RECIST; a further 9 had decrease <30% measurable disease. Of 11 pts evaluable for CA125 response, 6 were responders (3 confirmed, 3 unconfirmed), and 5 were non-responders. Common Grade 1–3 adverse events (AE) were fatigue, mucositis, dysgeusia, hypertension, nausea, hand-foot reaction. There was one serious, unexpected drug-related AE (pulmonary embolism) but no GI perforation. Conclusions: Stage 1 response criterion was met. Results demonstrate single-agent sunitinib activity and tolerability in advanced ovarian cancer. Evidence of fluid collection after the 2-week treatment break has led to a protocol modification to daily continuous dosing for stage 2 accrual. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Pfizer Oncology Pfizer Oncology
Abstract 18909: Symptoms and Coronary Anatomy are Associated with Management Decisions in Children and Young Adults with Anomalous Aortic Origin of a Coronary Artery: A Congenital Heart Surgeons' Society (CHSS) Study
Authors: Jeffrey A Poynter, Marshall L Jacobs, William G Williams, Julie A Brothers
Journal: Circulation (2012)

Background: Anomalous Aortic Origin of a Coronary Artery (AAOCA) is a rare congenital heart lesion associated with myocardial ischemia and sudden death in the young. Evidence-based criteria for managing young patients with AAOCA are lacking. The CHSS began multi-center enrollment of patients with AAOCA age ≤ 30 years to develop these criteria. We hypothesized that demographics, symptoms and features of coronary morphology would correlate with whether or not the patient had surgery. Methods: To date, we have enrolled 199 patients from 23 CHSS member institutions (median age at diagnosis= 10.4 years; 64% male). Data was extracted from clinical records. Fifty-three percent were symptomatic at presentation (most commonly chest pain, N=78). AAOCA was diagnosed at autopsy in two patients who presented after sudden death (1 with anomalous left coronary artery [ALCA]; 1 with a single ostium above a commissure). Correlation analysis compared demographics, symptoms, coronary anatomy and management. Results: Imaging reports documented anomalous right coronary artery [ARCA] in 142 patients (74%) and ALCA in 51 patients (26%). Surgery was performed in 106 patients (70 ARCA [66%]; 34 ALCA [32%]; 2 ARCA/ALCA [2%]) at a median age of 12.6 years. Overall, 71% of patients with ARCA vs. 51% with ALCA had surgery. Most surgical patients (96/106) had an intramural anomalous coronary artery (69/72 ARCA; 27/36 ALCA). The correlation of diagnostic reports (N=100) with surgical findings was poor (45%). Surgery correlated with symptoms, older age and intramural ALCA (Table). Conclusions: A high index of suspicion for coronary anomalies should be present when a young patient presents with exertional chest pain, presyncope or syncope. Surgical management of these patients is influenced by patient symptoms and coronary morphology. Future analysis of this expanding cohort will lead to evidence-based protocols to manage the spectrum of risk in this heterogeneous population of young patients.
Health-related quality of life and survival in HCC treated with transplantation, TACE or 90-yttrium
Authors: T. C. Gamblin, B. I. Carr, M. A. Dew, P. Fontes, J. L. Steel
Journal: Journal of Clinical Oncology (2008)

20602 Background: Health related quality of life (HRQL) in patients diagnosed with hepatocellular carcinoma (HCC) has been understudied, particularly those treated with liver transplantation (LT). The aims of the study were to assess HRQL and survival in patients diagnosed with HCC who were treated with (1) LT, (2) TACE or 90-yttrium as a bridge to LT, and (3) TACE or 90-yttrium and who were ineligible for LT. Methods: A prospective study of 40 age- and gender-matched patients referred for treatment of HCC were administered the Functional Assessment of Cancer Therapy-Hepatobiliary to assess HRQL. Survival was assessed from diagnosis to death. Results: Using Chi-square and Analysis of Variance (ANOVA), significant between group differences were found on disease-specific factors such as vascular invasion [Chi-square=9.5, p=0.009] and tumor size [F(2,35)=3.9, p=0.03]. Using repeated measures ANOVA, differences were observed between patients who were transplanted when compared to patients treated with TACE or 90-yttrium and were ineligible for LT on the physical [F(1,11)=4.2, p=0.05], emotional [F(1,12)=3.8, p=0.05], symptoms/side effects subscales [F(1,12)=5.0, p=0.03] and overall HRQL [F(1,11)=4.6, p=0.04]. Using Kaplan-Meier survival analyses, patients who underwent LT had the longest mean survival (102.3 months) compared to patients who received bridge therapy but did not receive LT (20.2 months) and patients receiving TACE or 90-yttrium and were ineligible for LT (10 months; Log rank Chi-Square=31.7, p=0.001]. Conclusions: Patients who underwent LT had better HRQL and extended survival when compared to those who were receiving bridge therapy for LT with TACE or 90-yttrium and patients treated with TACE or 90-yttrium and who ineligible for transplantation. No significant financial relationships to disclose.
Prevalence and severity of sleep disturbance in 596 cancer patients: A URCC CCOP study
Authors: O. Palesh, K. Mustian, J. Roscoe, G. Morrow, M. L. Perlis, B. Issell, T. K. Banerjee, J. E. Delmore
Journal: Journal of Clinical Oncology (2007)

9016 Background: Sleep disturbance is a prevalent and, potentially, chronic problem among cancer patients, persisting for many months and years after treatments. As part of a multi-center longitudinal survey of patients beginning cancer treatments, we prospectively investigated the prevalence and severity of self-reported sleep disturbance. Methods: 596 Cancer patients (mean age=61; 66.4%=female) receiving chemotherapy and/or radiation (37.1%=chemotherapy, 40.1%=radiation therapy, 22.8%=both) from 17 NCI CCOPs reported whether they experienced any sleep disturbance using an 11-point Likert Scale (0 = “Not present” to 10 = “As bad as you can imagine”) prior to treatments, during treatments, and 6 months after finishing treatments. A side effect level 7 was considered “severe.” Results: Sleep disruption was reported by 31.9% (median=2; 10.6% severe) at baseline, 77.2% (median=4; 28.5% severe) during treatment and 65.1% (median=2; 15% severe) at 6 months post-treatment. Repeated-measures ANOVAs revealed statistically significant treatment group (chemotherapy, radiation, or both), age (&lt; 61 or ≥ 61 yrs), and gender by time interactions (all p&lt;0.05). Sleep disturbance was significantly higher among survivors in the two groups receiving chemotherapy, younger survivors, and women (all p&lt;0.05). Sleep disruption increased from baseline to post-treatment and decreased from post-treatment to 6 months post-treatment (all p&lt;0.05). There were no significant differences between baseline and 6 months post-treatment. Conclusions: These results show that difficulties with sleep increase during cancer treatment. Patients who are at higher risk for having sleep problems are women, younger patients, and patients undergoing chemotherapy. Supported by NCI Grants U10-CA37420 and R25-CA102618 No significant financial relationships to disclose.
Effect of addition of rituximab to CHOP on survival of patients in both the GCB and non-GCB subgroups of diffuse large B-cell lymphoma
Authors: K. Fu, K. D. Perry, L. M. Smith, C. P. Hans, T. C. Greiner, W. C. Chan, D. D. Weisenburger, P. J. Bierman, R. G. Bociek, J. O. Armitage, J. M. Vose
Journal: Journal of Clinical Oncology (2007)

8040 Background: Diffuse large B-cell lymphoma (DLBCL) includes at least two prognostically important subgroups, i.e. germinal center B-cell (GCB) and activated B-cell (ABC) DLBCL, which were initially characterized by gene expression profiling and subsequently validated by immunostaining. Bcl-2 has also been identified as a prognostic indicator in the ABC subgroup. However, with the addition of rituximab (R) to standard chemotherapy, the prognostic significance of this subclassification of DLBCL is unclear. Methods: We studied 119 cases of de novo DLBCL including 70 cases treated with R-CHOP and 49 cases treated with CHOP. The cases were assigned to either the GCB or non-GCB subgroups using the methodology described by Hans et al (Blood 2004; 103:275). Characteristics of the patients were compared using the Chi-square test. Overall survival (OS) and event-free survival (EFS) were estimated using the Kaplan Meier method and compared with the log-rank test. Results: The median age of the 119 patients was 67 years, ranging from 20 to 90 years, and there were 62 males and 57 females. The clinical characteristics of patients treated with CHOP versus R-CHOP, including the IPI, were comparable. R-CHOP was more effective than CHOP with improved 5-year EFS (63% vs 41%, p=0.013) and OS (78% vs 47%, p&lt;0.001). In both patient groups treated with R-CHOP or CHOP, the GCB subgroup had a significantly better 5-year EFS and OS compared to the non-GCB subgroup (OS: 91% vs 64% for R-CHOP, p=0.0073; 67% vs 31% for CHOP, p=0.034, respectively). Additionally, both the GCB and non-GCB subgroups treated with R-CHOP had a significantly improved OS compared to their respective subgroups receiving CHOP alone (GCB, p=0.015; non-GCB, p=0.019). Bcl-2 expression was not a significant predictor in either the GCB or non-GCB subgroups treated with R-CHOP (OS, GCB: p=0.32; non-GCB: p=0.43). Conclusions: In this retrospective study, we demonstrate that subclassification based on the cell of origin continues to have prognostic significance in patients with DLBCL treated with R-CHOP. Addition of rituximab to CHOP improves the overall survival of patients with DLBCL in both the GCB and non-GCB subgroups. No significant financial relationships to disclose.
Cancer screening trial using whole-body <sup>18</sup>F-FDG-PET scanin healthy subjects - Hamamatsu Medical Imaging Center study
Authors: S. Kojima, M. Inubushi, F. Ozawa, H. Okada, M. Tanaka, Y. Fukunaga, E. Oda, S. Teramukai, M. Fukushima, S. Nishizawa
Journal: Journal of Clinical Oncology (2005)

1022
The acute effect of surgical repair of mitral valve insufficiency on airway and respiratory tissue mechanics and pulmonary hemodynamics in children
Authors: Iliona Malaspinas, Lionel Chok, Maurice Beghetti, Walid Habre, Ferenc Petak
Journal: European Respiratory Journal (2012)

RATIONALE: Increased pulmonary blood flow and pressure were shown to be responsible for the lung function impairment in children with congenital heart diseases (Anesthesiology, 110: 1348-55, 2009). We assessed whether mitral valve insufficiency (MVI) leading to postcapillary pulmonary hypertension is reflected in the mechanical properties of the respiratory system, and whether surgical repair of MVI improves respiratory mechanics in children.  METHODS: Airway resistance (Raw), respiratory tissue damping (G) and elastance (H) were obtained by forced oscillations in 8 children aged 12±2 (Mean±SD) years under general anaesthesia before and immediately after surgical repair of the MVI. Concomitantly, pulmonary arterial pressure (PAP) was directly measured in the pulmonary artery before aortic cannulation and chest closure.  RESULTS: Surgical repair of MVI led to strong tendency in the mean PAP for a decrease (from 33.0±12 to 27.7±9.0 mmHg, p=0.054). These postoperative pulmonary haemodynamical changes were associated with significant decreases in Raw (5.5±1.7 to 4.4±1.1 cmH2O.s/l, p=0.008) with no significant effects on G (11.5±5.2, 10.1±3.1 cmH2O/l, p=0.7) and H (60.2±9.5, 65.2±13.7 cmH2O/l, p=0.2). Postoperative changes in Raw and PAP exhibited no significant correlation.  CONCLUSIONS: These findings demonstrate an immediate improvement of airway function after surgical repair of MVI in children. Further experiments are needed to clarify the role of the direct effect of the postoperative decrease in postcapillary pulmonary hypertension and vascular engorgement in this beneficial change.  Supported by SNSF grant 3200B0-118231.