tbuckley/cabot-search huggingface dataset:
Older cancer survivors’ use of biologically based complementary and alternative medicine (CAM): A national, population-based study in the United States
Authors: R. T. Lee, D. Qato, F. Curlin, W. M. Stadler, S. T. Lindau
Journal: Journal of Clinical Oncology (2008)

9508 Background: The use of CAM is prevalent among cancer patients, including the geriatric population. The prevalent poly- pharmacy in geriatric patients raises the possibility of significant CAM-medication (MED) interactions. Methods: A national population- based sample of community-residing U.S. adults ages 57–85 years were surveyed, which included cancer survivors, defined as anyone with a diagnosis of cancer, excluding skin cancer. Subjects were queried on the use of CAM in the prior 12 months, and interviewers logged, by direct observation, all current MEDs. Biologically based CAM included any nutritional supplements (NS) (e.g., vitamins), nutraceuticals (NTC) (e.g., glucosamine), and herbal medicines (HM) (e.g., garlic). Thomson Micromedex online software was used to determine potential MED interactions. Analyses were weighted when applicable. Results: A total of 3,005 subjects participated (75.5% response rate), of which 373 subjects (12.5%; 95% CI, 11.2–13.8) were cancer survivors with median age of 71 and mean cancer survivorship of 12 years (range 0–56) and used a median of 5 MEDs (range 0–20). 62% (95% CI, 55–69) used biologically based CAM in the prior 12 months, including 24% (95% CI, 18–30) that used HM. Of documented current HM users, 15 of 36 did not report taking any when asked. The most commonly used NTC and HM were glucosamine (34%), chondroitin (23%), and omega-3 fatty acids (19%). 43 of 75 documented current NTC or HM users were at risk for 116 potential MED interactions (NTC-MED and HM-MED: 12%, NS-MED: 43%, and MED-MED: 45%). Of the NTC-MED and HM-MED interactions, Thomson Micromedex identified 3 severe, 8 moderate, and 3 minor interactions. Conclusions: This population-based survey provides the first detailed information on the prevalent use of biologically based CAM by older Americans with cancer. A substantial number taking HM failed to report doing so. Among current users of biologically based CAM, over half of all interactions identified were related to CAM therapies and affected over one-third of these patients. Oncologists’ awareness of CAM use in this population is important for patient education and prevention of MED interactions. No significant financial relationships to disclose.
Bevacizumab-based conformal radio-chemotherapy for locally advanced inoperable colorectal cancer
Authors: M. I. Koukourakis, P. G. Tsoutsou, M. Pitiakoudis, G. Kouklakis, N. Liratzopoulos, A. Polychronidis, I. Abatzoglou, C. Simopoulos, K. Manolas
Journal: Journal of Clinical Oncology (2008)

15068 Background: Anti-VEGF therapy enhances the activity of radiotherapy in experimental models and has shown important activity in patients with metastatic colorectal cancer (CRC). We report our experience in the treatment of locally advanced inoperable CRC (LA/I-CRC) with accelerated high dose radiotherapy, capecitabine and bevacizumab anti-VEGF monocolonal antibody. Methods: Eligible patients had an adenocarcinoma histology, LA/I-CRC and a median performance status of 1 (0–2). Eleven patients with LA/I-CRC were treated with conformal hypofractionated accelerated radiotherapy (3.4 Gy × 15 fractions within 4 weeks, biological equivalent dose of 70 Gy), capecitabine (600 mg/m2 daily, 5-days per week) and bevacizumab (5 mg/kgr every 2 weeks). Capecitabine and bevacizumab were continued thereafter for 3 months (same schedule). Amifostine (1,000 mg/day) was administered subcutaneously before each radiotherapy fraction. Primary endpoints were toxicities assessed by common toxicity criteria, delay in radiotherapy administration, response and progression-free survival. Results: The regimen showed increased but acceptable early toxicity. Diarrhea grade 3/4 appeared in 3/11 (27 %) and proctitis grade 3 in 2/11 (18 %) patients. One patient died from intercurrent disease and another 1 died from Fournier's gangrene syndrome after the 2nd week of therapy. Out of 9 evaluable patients, 7 (78 %) had a complete response, and 2 (22 %) a partial response. Within a median of 12 months of follow-up (range 6–24 months), 9/11 patients are alive with no evidence of local or distant disease progression and without severe late sequelae. Conclusions: These preliminary data show an impressive rate of long lasting complete responses obtained by this regimen in LA/I-CRC. Early toxicity was, however, high and the radiotherapy schedule has thereafter been modified to deliver the same dose within 5 weeks instead of 4 in a new prospective study. No significant financial relationships to disclose.
MicroRNA expression in nodal and extranodal Diffuse Large B-cell Lymphoma
Authors: Charlotte Mandrup, Anders Petersen, Anne Dirks Højfeldt, Henrik F Thomsen, Jakob Madsen, Jesper Dahlgaard, Preben Johansen, Anne Bukh, Karen Dybkær, Hans Erik Johnsen
Journal: Annals of Oncology (2008)
Clinical outcome in patients with endometrial papillary serous and endometrioid carcinomas as related to WT-1, Pax-2, and p16 immunohistochemical expression profiles
Authors: M. Rollins-Raval, R. Byler Dann, R. P. Edwards, M. Chivukula
Journal: Journal of Clinical Oncology (2009)

e16547 Background: Endometrial papillary serous carcinoma (EPS) can be difficult to differentiate histologically from high grade endometrial endometrioid carcinoma (EE). Both of these tumors often present with solid growth pattern with few papillary features. Recurrences have been found to be more frequent in EPS than high grade EE. These differences were found despite the same preoperative and postoperative radiotherapy and chemotherapy, indicating more aggressive tumor biology. To date, there are no well defined immunophenotypic or molecular methods to differentiate these two tumors or their clinical behavior. Methods: Eleven cases of EE and twenty-three cases of EPS were retrieved from our departmental archives and stained using Pax-2, WT-1 and p16 antibodies. For all three antibodies, a strong nuclear staining is considered positive. The intensity and proportion of cells positive are noted. Seven cases from each group were further examined for their staging and clinical outcome in terms of recurrence, metastasis and treatment. Results: WT-1 is negative in 100% of EE cases. p16 is positive in 95% of EPS cases, and only 55% of EE cases. In addition, out of the seven EPS patients whose clinical information was obtained, the three EPS patients who had strong Pax-2 staining are still alive more than two years status post surgical intervention, while four other EPS patients are deceased. The three patients with the strongly staining PAX-2 EPS tumors all had varying tumor characteristics, recurrence and adjuvant therapies. This finding is now being evaluated in the additional cases. Conclusions: WT-1, Pax-2 and p16 are useful to differentiate high grade EE and EPS cases. Strong Pax-2 staining in three cases of EPS with better outcome is an interesting finding that deserves further investigation. No significant financial relationships to disclose.
Discontinuing chronic medications: Perceptions of patients with life-limiting illness.
Authors: Jean Kutner, Christine Ritchie, Jon Furuno, Maryjo Prince-Paul, Jennifer Tjia, Mary Lynn McPherson, Jeff A. Sloan, Tamara Somers, Amy Pickar Abernethy, Patrick Jud Blatchford
Journal: Journal of Clinical Oncology (2014)

97 Background: Optimal management of chronic medications is uncertain in life-limiting illness. To inform shared decision making, we assessed patient perceptions in a trial on the safety of discontinuing statins in life-limiting illness. Methods: Eligible adults (life expectancy 1–12 months, on statin for ≥ 3 months for primary/secondary prevention, recent functional decline, no active cardiovascular disease) were randomized to discontinue or continue statins and were followed monthly for up to 1 year. Cognitively intact participants were asked 9 questions regarding discontinuing statins prior to randomization. We used Pearson chi-square to compare responses between study groups and between those with and without cancer. Of 381 participants, 297 (78%) were cognitively intact (138 discontinued, 159 continued statins). Mean age was 72 years (SD 11) and mean number of medications used was 11.5 (SD 5.0); 58% (N = 173) had cancer. Results: There were no statistically significant differences between the study groups in responses to the medication perception questions. Aggregate findings are presented (Table). Patients with cancer were less likely to think that they may be able to stop other medications (28% vs. 42%, p=0.007) and that statin discontinuation means that the doctor is giving up on them (1% vs. 7%, p=0.013). Conclusions: Few participants expressed concerns about discontinuing statins; many perceived potential benefits. Cancer patients may perceive less impact from stopping statins. Clinicians should inquire about patient concerns when engaging in shared decision making about discontinuing chronic medications in the setting of advanced cancer. Clinical trial information: NCT01415934. [Table: see text]
Nonmyeloablative hematopoietic cell transplantation (HCT) for treatment of patients (pts) with fludarabine-refractory chronic lymphocytic leukemia (CLL) results in prolonged median survival
Authors: M. Sorror, B. Sandmaier, M. Maris, B. Storer, J. Radich, E. Agura, D. Niederwieser, K. Blume, R. Storb, D. Maloney
Journal: Journal of Clinical Oncology (2006)

6520 Background: Pts with fludarabine-refractory CLL have a poor prognosis with median survival of 12 months. A phase II trial of Campath resulted in median survival of 16 months. Curative alternatives are required. Methods: We previously reported 2-year overall survival (OS) of 60% for 64 pts treated with nonmyeloablative HCT from related (n=44) or unrelated (n=20) donors (Sorror. JCO, 2005). Those pts were refractory to fludarabine (88%) ± additional agents. Eligibility criteria, conditioning and immunosuppression regimens, and primary endpoint were previously described. Here, we extended the follow up to 38 (range: 10–74) months after HCT ( Table ). Results: Chronic extensive graft-versus-host disease (GVHD) at 3 years was 53% and non-relapse mortality (NRM) was 27%. Among 30 pts who achieved initial responses {25 complete (CR) and 5 partial (PR)}, one patient died while in CR from NRM, one patient with PR progressed, while remaining 28 pts continued alive and in remission. CR and relapse rate at 3 years were 54% and 32%, respectively. Unrelated recipients had a significantly higher CR rate than related recipients. Ten responding pts were tested for molecular eradication of their disease and all were negative at a median of 52 months. There were 6 deaths in this extended follow up, 5 from relapse/progression and one from pneumonia. Overall, 33 pts are alive; 24 in CR, 4 in PR, 2 with stable disease, and 3 with relapse/progression. Estimated 3-year rates of OS, disease-free survival (DFS), and NRM were 54%, 42%, and 27% respectively. In multivariate analysis, high pretransplant comorbidity scores predicted higher NRM and worse OS while bulky lymphadenopathy predicted increased risk of progression. Conclusion: Nonmyeloablative HCT resulted in an extended median survival of greater than 3 years for pts with fludarabine-refractory CLL. The use of unrelated grafts was associated with a trend toward better DFS. [Table: see text] No significant financial relationships to disclose.
cDNA-based comparative genomic hybridization (cCGH) analysis of genomic aberrations of pancreatic cancer cells
Authors: B. B. Chang, L. Ramdas, J. L. Abbruzzese, J. A. Ajani, W.-K. Hong, W. Zhang
Journal: Journal of Clinical Oncology (2004)

4122 Introduction: Pancreatic carcinoma (PanCa) is the fourth leading cause of cancer mortality in US with a 5-year survival rate of 5%. urrent treatments have only a minimal survival benefit. In this study, we are using cDNA-based comparative genomic hybridization (cCGH) technologies to search for common genomic alternations in human PanCa cell lines. Methods: Genomic DNA from seven human PanCa cell lines was extracted and labeled with Cyanine 3-dUTP. Normal human genomic DNA isolated from leukocytes of healthy male and female volunteers was labeled with Cyanine 5-dUTP. The labeled probe mixtures were then hybridized with 10K (5K in replicates) cDNA slides prepared by the UT MD Anderson Cancer Genomics Core Laboratory. The gain or loss of individual genes after background subtraction and appropriate normalization. The identified genomic alternations were then verified by florescent in situ hybridization (FISH) analysis in pancreatic cells and biopsy tissues with human BAC clone DNA and the centromere controls. Results: We successfully performed cCGH analysis using 7 pancreatic cancer cell lines. Our data revealed that human hepatocyte nuclear factor-6 (HNF6), telomeric repeat binding factor 2 (TRF2), reticulocalbin 2 EF-hand calcium binding domain (RCN2), and bromodomain testis-specific (BRDT) were amplified by more than 6 copies and fucose-1-phosphate guanyltransferase (FPGT) lost two endogenous copies in 43 to 71% of the PanCa cell lines studied (see the attached table). The genomic amplifications of HNF6 and TRF2 have been validated by FISH assays. We are validating FISH analysis for RCN3, BRDT and FPGT and with PanCa tissues from primary and metastatic tumors. Conclusions: We identified 4 genes with 6+fold gain and one gene with complete loss in PanCa cell lines. Two of these genes have been validated by the FISH analysis. Using similar analyses with patient tissues, we are searching for predictive and prognostic genomic markers and new therapeutic targets for improving PanCa survival (Supported by a pilot study grant and a T32 training grant from UT MD Anderson Cancer Center and NCI). Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration M.D. Anderson Cancer Center; National Cancer Institute
A new prognostic index score for metastatic nasopharyngeal carcinoma: A validation study
Authors: C. K. Toh, D. Heng, Y. K. Ong, S. S. Leong, K. W. Fong, T. Tan, J. Wee, E. H. Tan
Journal: Journal of Clinical Oncology (2004)

5575 Background: Patients with metastatic undifferentiated nasopharyngeal carcinoma (mets NPC) comprise a heterogeneous group with varying survival duration. Previously, we retrospectively analyzed the factors determining survival in these patients and designed a prognostic index score (PIS). (Ong YK et al; proc ASCO 2001) We now present our analysis on a different cohort of pts to validate the PIS. Methods: The present cohort included 137 mets NPC pts. Eighty-eight percent of them received chemotherapy and this proportion is higher than that in our previous cohort. We re-analyzed the previous cohort to include only pts who received chemotherapy to derive a new PIS (nPIS) that stratified the pts into 3 prognostic groups with significantly different median survivals. The nPIS was applied to the present cohort of 118 pts who was treated with chemotherapy. Logrank test was used to compare the overall survival between the 3 groups. Results: The significant prognostic variables in the nPIS included poor performance status of ECOG ≥2, short disease-free interval (DFI) of < 6 mths, presence of mets at initial diagnosis, and anemia of Hb<12 g/dl. A score of 0 was assigned if the factor was absent or 1 for mets at initial diagnosis, 4 for anaemia, 5 for ECOG≥2 and 10 for short DFI. The maximum score attainable was 19 and the pts were stratified into 3 groups- good prognosis: 0–3, intermediate prognosis: 4–8, poor prognosis: ≥9. Fifty-seven pts were good prognosis, 43 intermediate prognosis and 18 poor prognosis, with median survival of 20.2 (95% CI 15.2, 25.2), 14.3 (95% CI 12.3, 16.2) and 7.9 (95% CI 6.6, 9.2) months respectively. (logrank test: p=0.003) Conclusions: The nPIS is validated in our present cohort of mets NPC pts who received chemotherapy. The factors involved are readily available in the clinics and will prove useful as a method for risk assessment and stratification of pts with mets NPC. With stratification also come uniform classification and consistent reporting in clinical trials that will help us better interpret results of any therapeutic intervention. No significant financial relationships to disclose.
XELOX regimen in elderly patients with metastatic colorectal cancer (MCRC), a FNCLCC French Collaborative Group GERICO 02 phase II study
Authors: F. Viret, R. Bugat, M. Ducreux, F. Cvitkovic, E. Carola, M. Gisselbrecht, B. Esterni, F. Gouttenoire, F. Rousseau
Journal: Journal of Clinical Oncology (2007)

19513 Background: Xelox regimen is an active combination in 1 st line MCRC. In elderly patients, independence measured by the 6-items Activity of Daily Living Katz scale (ADL) determines whether an elderly can eventually live alone. We wanted to evaluate, the impact of Xelox regimen on independence of elderly patients measured by ADL after 3 and 6 cycles (CY), the response rate and safety profile. Methods: Elderly patients above 70 with histological proven MCRC were treated with an adapted XELOX regimen capecitabine (CPT) 750 mg/m 2 orally bid d1–14 + oxaliplatin (OXP) 90 mg/m 2 iv d1,q3w). After 3 CY with no significant toxicity, OXP and CPT were increased to 120 mg/m 2 iv d1 and 1,000 mg/m 2 bid d1–14 respectively. Results: 60 patients were enrolled at 6 centers over 36 months, of the 53 analyzed to date: M/F, 30/23, median age 78 years, Karnofsky index 80, 88.68% patients had comorbidity. Metastatic sites were liver (70.59%), lung (43.14%) and bone (9.8%). 39 % of patients (20) stopped treatment prematurely: progressive disease (6), toxicity (11), patients wish (3). Median ADL baseline was high (5.5; 1.5–6). Primary endpoint was achieved: after 3 CY 32/35 (91%) had no ADL decrease (median 6; 3.5–6) and unilateral Wilcoxon tested on paired data showed ADL improvement (p=0.0001). After 6 CY, 96% of patients had no ADL decrease. Median number of CY administered was 6 (1–6) with 88.24% of patients received ≥ 3 cycles. The dose of chemotherapy OXP and/or CPT was increased in 31.6 % of the elderly patients. Efficacy analysis: 1 patient achieved CR, 19 PR, 11 SD, 11 PD, 9 NE. Toxicity was moderated: diarrhea (g3/4: 13%), neurotoxicity (g1/2: 67%, g3/4: 2%), hand-foot syndrome (g1/2:19%, g3/4: 0%) and haematological (g3/4: 12%). Conclusions: This study shows that Xelox regimen does not impair independence measured by ADL in MCRC elderly patients. It is also a safe, well tolerated (in 1st line treatment) and active regimen in this population of patients. [Table: see text]
Prognostic value of cancer stem cell expression and growth in glioblastoma
Authors: G. L. Banna, R. Pallini, L. Ricci-Vitiani, M. Signore, M. Todaro, M. V. Martini, G. Maira, D. Giuffrida, L. M. Larocca, R. De Maria
Journal: Journal of Clinical Oncology (2008)

2004 Background: Cancer stem cells (CSCs) expressing the CD133 marker are a small fraction of tumorigenic cells responsible for glioblastoma development and spreading, and are relatively resistant to conventional radiotherapy and chemotherapy. To evaluate the prognostic value of CSC expression and growth. Methods: We investigated the relationship between patient death or disease progression and the in vitro growth potential of glioblastoma CSCs, CD133 and CD133/Ki67 expression by immunohistochemistry and immunofluorescence, in tumors of 44 glioblastoma patients treated with complete or partial tumorectomy, followed by radiotherapy combined with temozolomide treatment. Results: CSC cultures were obtained from 14 of the 44 tumors (32 percent). CSC generation was significantly associated with overall survival (OS) (p<0.001) and progression-free survival (PFS) (p<0.001). The time required for CSC expansion strongly correlated with OS (r=0.74; p=0.002) and PFS (r=0.85; p<0.001). The presence of ≥ 2% CD133+ cells in tumor lesions were significantly associated with OS p=0.02) and PFS (p=0.01). A very poor OS (p=0.007) and PFS (p=0.001) was observed among the 10 of the 44 patients whose tumors contained CD133+ cells expressing Ki67. A higher CD133 expression significantly associated with tumors generating CSCs (p=0.006), and correlated with a higher risk of death in patients with tumors generating CSCs in vitro (p=0.028). CD133/ki67 co-expression segregated patients with the worst outcome among those with tumor generating CSCs (p=0.036). The generation of CSCs and CD133/Ki67 co-expression emerged as significant independent prognostic factors, with an adjusted hazard ratio of 4.03 (95 percent confidence interval, 1.82 to 8.93; p<0.001) and 4.87 (95 percent confidence interval, 1.94 to 12.22; p<0.001), respectively. Conclusions: In vitro CSC growth and the presence of CD133+/Ki67+ cells may predict the survival of glioblastoma patients and are two considerable prognostic factors of disease progression and poor clinical outcome. No significant financial relationships to disclose.
A nomogram predicting survival of patients (pts) with metastatic or unresectable urothelial cancer (UC) treated with cisplatin-based chemotherapy
Authors: D. F. Bajorin, I. Ostrovnaya, A. Iasonos, M. I. Milowsky, M. Boyle, J. Riches
Journal: Journal of Clinical Oncology (2007)

5055 Background: Cisplatin-based chemotherapy is the standard of care for pts with metastatic or unresectable UC with phase III studies reporting median survivals of 12–15 months. Even more survival variation exists in phase II studies and this disparity is most frequently due to prognostic factors and not individual regimens. Thus, better tools are needed to predict survival both for individual pts and to balance phase III trials. Nomograms have utility in predicting short- and long-term outcome in muscle-invasive UC treated by surgery but they have not been explored in more advanced UC. Methods: We identified 308 pts with metastatic and/or unresectable UC treated on prospective phase II MSKCC protocols of cisplatin-based therapy containing 3–5 total chemotherapy agents. 203 pts received methotrexate, vinblastine, doxorubicin and cisplatin (MVAC), 45 had ifosfamide, paclitaxel and cisplatin (ITP) and 60 pts received doxorubicin plus gemcitabine (AG) followed by ITP (AG-ITP). Survival distributions were compared across trials. Pre-treatment characteristics were then assessed for impact on survival and a nomogram from a fitted Cox model was created to predict 1-yr, 2-yr, 5-yr and median survival. Results: No difference in median survivals were seen among the 3 regimens; median survival was 14.8 months for MVAC, 18.0 months for ITP and 16.1 months for AG- ITP (p=NS). Median survival for all pts was 12.99 months; 268 pts died and 40 pts were censored. 288 pts had all pre-treatment data. Characteristics most associated with survival included visceral metastases (present versus absent, p=.00001) and Karnofsky poor performance status (≥ 80 versus &lt; 80, p= .0005) followed by hemoglobin (normal versus &lt; normal, p=.01) and albumin (actual values, p&lt;.02). These characteristics were then used to construct a nomogram utilizing all 4 factors to predict probabilities of 1-yr, 2-yr, and 5-yr survival. Conclusions: The number and sequence of drugs utilized in cisplatin-based chemotherapy did not substantially impact survival of pts with advanced UC. A nomogram of pre-treatment clinical factors can predict probability of pt survival at 1 yr, 2yrs, and 5 yrs. This nomogram may also be useful to balance treatment arms in phase III trials. No significant financial relationships to disclose.