tbuckley/cabot-search huggingface dataset:
Neurocognitive function in patients with glioblastoma multiforme in first or second relapse treated with bevacizumab in the BRAIN study
Authors: J. S. Wefel, T. Cloughesy, J. Zazzali, J. Yi, H. S. Friedman
Journal: Journal of Clinical Oncology (2009)

2056 Background: Patients with glioblastoma multiforme (GBM) suffer from neurocognitive decline due to both the disease and its treatment. We analyzed neurocognitive function of patients with recurrent GBM who participated in the BRAIN study, a phase II, multicenter, randomized, noncomparative clinical trial which assessed the efficacy and safety of bevacizumab alone or in combination with irinotecan. Methods: Eighty-five patients who participated in the bevacizumab-only group of the BRAIN study were assessed with the Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test parts A (TMTA) and B (TMTB), and the Controlled Oral Word Association (COWA) test. Assessments were conducted at baseline and then every 6 weeks while patients remained on study drug, up to 52 weeks. Change in neurocognitive function from baseline to Week 6 was categorized as improved, stable, or declined, using the reliable change index. Changes were confirmed at the next assessment, when available. Results were not adjusted for practice effects. Results: Between 93 and 98% of patients completed each test at baseline and 73–78% completed each test at both baseline and Week 6. The majority of patients demonstrated stable performance on each test at Week 6, relative to baseline. With the exception of the COWA test, 18–25% of patients demonstrated improved performance on one or more tests at Week 6. Conclusions: Preliminary results suggest that the majority of patients with recurrent GBM who were treated with bevacizumab alone in the BRAIN study demonstrated stable or improved neurocognitive function during the first 6 weeks of treatment. Changes across tasks and associations with measures of clinical efficacy, patient characteristics, and concomitant medications will be explored. [Table: see text] [Table: see text]
Results from a phase II trial of conformal radiation therapy for pediatric patients with localized low-grade astrocytoma and quantification of radiation-related CNS effects
Authors: T. E. Merchant, E. N. Kiehna, R. K. Mulhern, L. E. Kun, S. Wu, X. Xiong, T. Williams, A. Gajjar, F. A. Boop, R. A. Sanford
Journal: Journal of Clinical Oncology (2004)

8533 Background: A phase II trial of conformal radiation therapy (CRT) was conducted to determine if the irradiated volume could be reduced without affecting the rate of disease control for pediatric patients with localized low-grade astrocytoma (LGA) and to estimate the incidence and time to onset of clinically significant CNS effects. Methods: Between 8/97 and 1/03, 49 children (median age of 8.7 ± 4.0 yrs) were treated with CRT to 54 Gy using a 10mm anatomically-defined clinical target volume (CTV). The median CTV was 89.3 cc (range, 13.3–340.9 cc). Patients were evaluated serially with psychometric testing, provocative tests of endocrine function and standardized audiometry. Results: The study included mainly patients with juvenile pilocytic astrocytoma (n=31) involving the diencephalon or optic pathway (n=38) and the majority had visual impairment. Fourteen patients had prior chemotherapy and surgery was limited to subtotal resection (n=21) or biopsy (n=20). The 4-year actuarial event-free survival estimate was 84.2% ± 9.3% with a median follow-up of 31.0 months. Six patients experienced local (n=3) or distant (n=3) failure with a median time to failure of 18 months (range 5–54 months). A slight decline in scores for estimated IQ (−0.21 pts/yr; p=0.003), reading (−0.23 pts/yr, p=0.008), spelling (−0.19 pts/yr, p=0.02) and visual auditory learning (−0.16 pts/yr, p=0.06) were noted up to 48 months after CRT for the entire group. The effects on reading (p=0.044) and visual auditory learning (p=0.016) were more prominent in patients with large diencephalic and optic pathway tumors. Pre-CRT endocrinopathy was observed in the majority of patients affecting growth (43%), thyroid (34%), and ACTH (9%) secretion. Hearing loss due to CRT-alone was uncommon during the time interval of this study. Conclusions: The volume of irradiation may be reduced to a 10mm CTV without affecting disease control in localized LGA. Patients with LGA have a high rate of pre-existing endocrinopathy and the cognitive effects of treatment may be limited using focal radiation delivery strategies. No significant financial relationships to disclose.
Histological differentiation of skin toxicity between cetuximab, erlotinib and panitumumab (single ErbB1) and lapatinib (dual ErbB1/2) epidermal growth factor receptor inhibitors
Authors: M. Newman, P. Gerami, J. Guitart, T. Lertsburapa, D. West, S. Rosen, M. Cianfrocca, M. Lacouture
Journal: Journal of Clinical Oncology (2009)

e20617 Background: Epidermal growth factor receptor inhibition by monoclonal antibodies and tyrosine kinase inhibitors has demonstrated activity in solid tumors. However, blockade of EGFR in skin results in disabling skin toxicity that may lead to therapeutic dose modification or interruption. This study compares cutaneous histological alterations among four EGFR inhibitors (EGFRIs): cetuximab (C), erlotinib (E), lapatinib (L) and panitumumab (P). Methods: Punch skin biopsies from patients with papulopustular rash were collected from 8 patients per each EGFRI (n=32). Two dermatopathologists performed independent blinded assessment of epidermis, dermis, follicle and inflammatory infiltrates. Histologic features were rated as 0 (absent) or 1 (present), with the exception of dyskeratosis, rated from 0 (absent) to 2 (severe) and infiltrate, rated from 0 (absent) to 3 (most prominent). Where variation occurred, scores were reconciled and combined for analysis. Results: Epidermal atrophy was observed for C, E, L and P (range 0–1, median 1, 1, 0, 0.5, respectively) and neutrophilic follicular infiltrate was observed for C, E, L and P (range 0–3, median 0.5, 3, 0, 3, respectively). Neutrophilic dermal infiltrate (range 0–3) and follicular neutrophilic pustules (range 0–1) were most prevalent in P (median 0.5), whereas the median for C, E and L was 0. A mononuclear dermal infiltrate (range 0–3) was least prevalent with C (median 0) while E, L and P had a median of 0.5. Concretions (range 0–1) were most prevalent for E (median 1), whereas the median for C, L and P was 0. Conclusions: Lapatinib, a dual ErbB1/2 inhibitor, induced the least structural disarray and inflammation in the skin as measured by median scores for epidermal atrophy, neutrophilic dermal and follicular infiltrates, neutrophilic pustules and lack of bacterial concretions. These histological data confirm a more benign pattern of rash with lapatinib compared to single ErbB1 inhibitors. [Table: see text]
Health-related quality of life (HRQL) and progression-free survival (PFS) in patients with recurrent ovarian cancer: Results from the CALYPSO trial.
Authors: M. Brundage, M. Gropp, F. Mefti, K. Mann, B. Lund, V. Gebski, G. Wolfram, N. Reed, S. Pignata, A. Ferrero
Journal: Journal of Clinical Oncology (2010)

5044 Background: In the CALYPSO trial, carboplatin (C)-pegylated liposomal doxorubicin (PLD) demonstrated superior therapeutic index (TI) vs C-paclitaxel (P) in recurrent ovarian cancer (ROC): ≥ 6 months after first- or second-line platinum-based therapy. This analysis reports on HRQL and its correlation to PFS. Methods: HRQL was measured with the EORTC QOLQC30 questionnaire and OV28 OC module. Mean change scores from baseline in HRQL subscales (5 functionnal scales and global health status) in each arm and the proportion of patients (pts) achieving clinically significant improvement (≥ 10 points) were calculated every 3 months until 12 months. Disease symptoms were assessed using the OV28 abdominal-symptom subscale (abd-symp). The potential correlation between abd-symp improvement and PFS was evaluated by a landmark analysis at 3 months. Results: Compliance was 90% at baseline and 76%, 64%, 57% at 3, 6, and 9 mo. Baseline HRQL showed already impaired global QOL (62/100) and abd-symp burden (30/100), with 90% of patients reporting abd-symp. Global QOL and abd-symp scores improved over time; at 6 mo 36% of pts met criteria for improved abd-symp. Global QOL and abd-symp scores did not show any significance between two arms at 3, 6 and 9 months measurement. However, less peripheral neuropathy (9.8 vs. 24.2), fewer other chemo side effects (9.5 vs. 16.2), and less impact on body image (3.8 vs. 10.4) were found on HRQL in C-D arm versus CP arm (all p < 0.02) at 6 months. Analysis at 3-months showed similar PFS in pts with improved abd-symp compared to those not improved (HR 0.86, p = 0.1). Conclusions: Significant differences in HRQL scores are related to differences in toxicities between arms. Global QOL and abdominal symptoms are comparable between arms and therefore independent of the impact of different therapies on PFS. Improvement in abdominal- symptoms proved not to correlate with improved PFS. Further exploration of the relationships between other HRQL domains and disease-related outcomes is needed. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Schering-Plough Schering-Plough Schering-Plough
Building the case for expanded support services to young breast cancer survivors: An evaluation of a cooperative agreement.
Authors: Sarah O'Dell, Marnie House, Mary Ann Hall, Angela Moore, Temeika Fairley
Journal: Journal of Clinical Oncology (2014)

127 Background: To determine effective and appropriate communication interventions to address the psychosocial needs of young breast cancer survivors (YBCS), the Centers for Disease Control and Prevention (CDC) established a cooperative agreement with seven organizations offering tailored support and education services to YBCS. The process evaluation of this cooperative agreement aims to document program implementation and the extent to which the cooperative agreement relationship (funding, subject matter expert support, technical assistance, and training) facilitates organizations’ delivery of programs. An additional five organizations were studied for comparison to gain a broader perspective on programmatic offerings for YBCS across the United States. Methods: The evaluation utilizes a multiple case study design, entailing document review, site visits, program observation, and in-depth interviews with program staff to describe program implementation and perceptions related to program effectiveness. Thematic analysis is being utilized to analyze all qualitative data collected. Results: Organizations offer a range of services, including psychosocial support and education to YBCS, YBCS caregivers and health care providers. Services offered cover the cancer care continuum, ranging from the provision of community outreach and education via multiple platforms (e.g., partnership development, online resource compilations, social media) to structured support services offered (e.g., patient navigation, structured support plans, tailored support groups for survivors and caregivers) to relevant YBCS audiences. Specifically, grantee program staff members report that cooperative agreement funding helped to expand and strengthen organizations' YBCS-focused efforts; all organizations offer lessons learned for communication with YBCS. Conclusions: Findings from this evaluation demonstrate the utility of federal funds to help organizations augment existing or create new resources and services for YBCS. Further, findings from this evaluation support the use of tailored interventions as a promising strategy to improve YBCS communication and education efforts.
Integration of intra-operative electron irradiation (IOERT) in breast conserving treatment for T1/T2N0 breast cancer: Early results of a phase II tria
Authors: W. Wong, B. Pockaj, M. Halyard, R. Gray, S. Vora, S. Schild, H. Apsey
Journal: Journal of Clinical Oncology (2004)

708 Background: The standard radiation technique used for early stage breast cancer includes whole breast external beam irradiation (EBRT) plus an electron boost to the tumor bed, requiring 6–7 weeks of daily treatment. We initiated a phase II study for patients with T1/T2N0 breast cancer in which IOERT was used as the boost, thus shortening the treatment days by 6–8 days. Methods: Informed consent was obtained from all participants. Patients underwent lumpectomy and sentinel lymph node(SLN) biopsy. If the surgical margin and lymph nodes were free of disease by frozen section, 10 Gy was delivered to the tumor bed by IOERT. Three to 5 weeks later, 48 Gy EBRT was given to the whole breast in 24 fractions. Adjuvant systemic therapy, if indicated, was given after completion of EBRT. Results: 37 patients were enrolled in the study, and 28 received treatment per protocol. 9 patients were excluded because of positive SLN (5), patient refusal (1), insurance issue (1), and more extensive surgery than initially planned (2). The median age was 67 (range: 39–81). Median tumor size was 1 cm (range: 0.1–2.6 cm). Median and minimum tumor-free margin was 1 cm and 0.25 cm, respectively. Extensive intraductal carcinoma was present in 8 patients. There was no increase in wound complications after IOERT. All but 4 patients have completed their EBRT. The median follow-up time was 6.7 months (0.5–13 months). Cardiac and lung toxicity was grade 0 for all patients. A cost analysis showed significant saving compared to standard radiation. Conclusions: Early results of our study suggests that IOERT can be used as the tumor bed boost in lieu of 6–8 days of standard electron beam treatment with acceptable acute toxicity, allowing a shortening of treatment time and decrease in cost. Longer follow-up is needed to evaluate the long term efficacy and side effects. The study continues to accrue patients. No significant financial relationships to disclose.
Telomerase activity and human telomerase reverse transcriptase mRNA expression in acute lymphoblastic leukemia
Authors: B. Arora, L. Kumar, B. C. Das, U. Kailash, C. C. Soundararajan, T. Seth, V. Kochupillai
Journal: Journal of Clinical Oncology (2004)

6705 Background: Human telomeres and telomerase are believed to play important roles in the regulation of cellular ageing and tumorigenesis. The impact of increased telomerase activity (TA) on the course of patients with acute lymphoblastic leukemia (ALL) is still unknown. We attempted to study the role of TA, human telomerase reverse transcriptase mRNA (hTERT) and human telomerase mRNA (hTR) expression in ALL patients. Methods: The TA, hTERT and hTR expression were evaluated in bone marrow samples of 34 patients with ALL before starting treatment and 28 of them after the induction phase. The TA was studied by telomerase reverse amplification protocol (TRAP) assay and hTERT and hTR expression were determined by RT-PCR. The results were correlated with patient characteristics. Results: The TA, hTERT and hTR expression were uniformly high in all patients before starting the treatment. After the induction phase the TA and hTERT showed down regulation in 25%(7/28) and 100%(28/28) patients respectively. The hTR expression did not show any change. The baseline hTERT expression was very high in patients with high total leucocyte counts (>20000/cmm) (p0.05). Majority of the relapsed cases (4/7) and refractory cases (2/2) had significant hTERT expression after the induction treatment. Conclusions: TA and hTERT expression are upregulated in newly diagnosed ALL patients indicating the high proliferative activity in these patients. The serial analysis of these markers during the treatment course of ALL patients may be useful in monitoring the disease status and prognostication. No significant financial relationships to disclose.
Authors’ response: British Society of Gastroenterology guidelines on the diagnosis and management of coeliac disease
Authors: Andrew S Austin, Julia M Forsyth, Peter G Hill, Geoffrey K T Holmes
Journal: Gut (2015)

We were interested to read the reply to our letter1 by Kurien et al 2 but consider that they have not made the case for performing a small bowel biopsy in all patients with coeliac disease (CD) to establish the diagnosis. Further support for our view that duodenal biopsy can be avoided in some patients was recently provided by Tortora et al .3 Kurien et al have also responded to that paper and their two responses suggest a fundamental misunderstanding of the data on which a ‘biopsy avoidance strategy’ is based.

It is incorrect of them to assert that their 2008 study4 ‘clearly refutes’ our suggestion. First, it is essential to use an assay with high specificity (>97%) but the IgA-class antitissue transglutaminase …
Childhood non-Hodgkin's lymphoma involving the testis: clinical features and treatment outcome.
Authors: S J Kellie, C H Pui, S B Murphy
Journal: Journal of Clinical Oncology (1989)

Among 131 boys with advanced (stage III or IV) non-Hodgkin's lymphoma (NHL) consecutively treated at St. Jude Children's Research Hospital, testicular involvement was present at the time of diagnosis in six and as an isolated site of relapse in three. Testicular involvement was not seen in any patient with localized (stage I or II) disease. Four of the six patients with involvement at presentation are free of disease 2.9+ to 8.3+ years after diagnosis, following chemotherapy alone (three patients) or chemotherapy plus orchiectomy. Overt testicular relapse while on therapy resulted in death from progressive disease in two patients; the third relapsed after completing therapy for Burkitt's lymphoma and is in second remission after chemotherapy, orchiectomy, and scrotal irradiation. The prolonged remissions seen in children with testicular involvement at diagnosis suggest that scrotal irradiation may not be necessary in chemosensitive disease. By contrast, testicular relapse on therapy appears to indicate drug-resistant disease and a poor prognosis, despite testicular irradiation and chemotherapy.
Effects of aprepitant use in patients (pts) with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) treated with high-dose cisplatin and radiation (RT).
Authors: M. Ong, J. Martin, L. Sax, D. S. Ernst, E. Winquist
Journal: Journal of Clinical Oncology (2010)

5593 Background: Aprepitant is an NK-1 antagonist that reduces delayed nausea and vomiting (N&V) in pts receiving high-dose (HD) cisplatin. Single-agent HD cisplatin 100 mg/m2 iv q3weeks × 3 doses concurrent with RT is a standard curative regimen for LA SCCHN. In Oct 2007, aprepitant was approved for use in Canada and immediately entered clinical use. We examined treatment delivery and health resource use in pts with LA SCCHN, before and after the introduction of aprepitant. Methods: LA SCCHN pts receiving HD cisplatin (>=70mg/m2) with curative intent Jan 2006-Jan 2009 were identified and data extracted including use of aprepitant, >=grade 2 N&V, hospitalization, chemotherapy delivery, and mortality. Outcomes in pts were compared pre- and post-Oct 2007. Results: HD cisplatin was administered 453 times (212 pre-/241 post-) in 179 pts (89 pre-/90 post-). Pts were similar pre- and post- with exception of more stage 4B disease treated post- (9 vs. 22%, p=0.02). HD cisplatin + RT was used in 202 treatments (95%) pre- vs. 186 (77%) post-; neoadjuvant docetaxel/cisplatin/5-FU (TPF) was used in 9 (4%) pre- vs. 55 (23%) post- (p<0.001). Aprepitant was used in 0% pre- and 82% post-. Rates of nausea and vomiting diminished (35 vs. 22%, 15 vs. 5%; p<0.001), more pts completed 2 and 3 cycles of HD cisplatin (85 vs. 96%, 53 vs. 72%; p<0.05) and 1 year mortality improved (21 vs. 8%, p=0.01) post-Oct 2007. Overall hospitalization and length of stay increased (43 vs. 52%, 5.9 vs. 7.3 days) due to admissions for administration and complications of neoadjuvant TPF. Conclusions: Most LA SCCHN pts treated with HD cisplatin received aprepitant once it was available. After the introduction of aprepitant, a greater proportion of pts were free of nausea or vomiting and completed planned chemotherapy. Despite increased use of multi-agent neoadjuvant chemotherapy and a higher proportion of pts with stage IVB disease treated, more pts were alive at 1 year in the post-aprepitant era. Although these retrospective data cannot prove causality, they suggest beneficial effects of aprepitant that allow improved treatment delivery by reducing treatment toxicity. No significant financial relationships to disclose.
Maintenance or no maintenance treatment in AML?
Authors: C Sauter
Journal: Journal of Clinical Oncology (1988)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1988.6.9.1521 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3166487 Maintenance or no maintenance treatment in AML? C SauterxC SauterSearch for articles by this author https://doi.org/10.1200/JCO.1988.6.9.1521 PDF "Maintenance or no maintenance treatment in AML?." Journal of Clinical Oncology, 6(9), pp. 1521–1522© 1988 by American Society of Clinical Oncology
Influence of the level of subjective distress of healthcare professionals on the perception of symptom intensity reported by patients with terminal cancer
Authors: S. Zloklikovits, V. Ladinek, E. Andritsch, A. Greimel, E. H. Pilgram, I. Strohscheer, J. Verebes, I. Springer-Schlegl, H. Stoger, H. Samonigg
Journal: Journal of Clinical Oncology (2006)

18503 Background: In palliative cancer care, effective symptom management requires knowledge of the factors influencing the accuracy of assessment by other raters. The aim of this study is to describe differences in symptom severity ratings between patients and their professional caregivers depending on the subjective level of distress of the proxy raters. Methods: A total of 50 patients with advanced cancer admitted to the palliative care unit of the University Hospital Graz, Austria participated in the study. Socio-demographic data, different physical, psychological and functional disorders as well as pain were assessed within the first three days after admission to the ward. Symptoms were rated independently by the patients themselves, their treating physicians as well as nurses using a modified standardized Symptom List for Quality Assurance in Palliative Care (MIDOS) drafted by the Working Group on the Core Documentation for Palliative Care Units in Germany and the psychological subscale of the Memorial Symptom Assessment Scale (MSAS-PSYCH). The Distress Thermometer (DT), a one item self-report measure, was completed by the different raters. Results: Statistical analyses were computed on individual symptoms (Mann-Whitney-U-Test) as well as different sum-scores for pain, physical/functional symptoms and psychological symptoms (ANOVAs). The preliminary results concerning the sum-scores showed that nurses significantly underestimated the intensity of patients’ pain (p = .005) and physical/functional symptoms (p = .022) whereas physicians agreed with the patients self-assessments. Both physicians and nurses scored psychological items (MSAS) more severe than the patients with significant higher scores for the physicians’ ratings (p = .015). In addition, comparisons between congruent and non-congruent rater dyads were analysed in relation to caregivers’ distress. Significant differences were found only for the pain sum-score, where nurses in the non-congruent dyads had significantly higher distress levels than nurses in the congruent dyads (p = .014). Conclusions: The findings indicate that at least the perception of pain of terminally-ill patients depends on healthcare professionals’ distress. No significant financial relationships to disclose.