tbuckley/cabot-search huggingface dataset:
Human immunodeficiency virus infection does not worsen prognosis of liver transplantation for hepatocellular carcinoma
Authors: Fernando Agüero, Alejandro Forner, Christian Manzardo, Andres Valdivieso, Marino Blanes, Rafael Barcena, Antoni Rafecas, Lluis Castells, Manuel Abradelo, Julian Torre‐Cisneros, Luisa Gonzalez‐Dieguez, Magdalena Salcedo, Trinidad Serrano, Miguel Jimenez‐Perez, Jose Ignacio Herrero, Mikel Gastaca, Victoria Aguilera, Juan Fabregat, Santos del Campo, Itxarone Bilbao, Carlos Jimenez Romero, Asuncion Moreno, Antoni Rimola, Jose M. Miro
Journal: Hepatology (2015)

The impact of human immunodeficiency virus (HIV) infection on patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC) is uncertain. This study aimed to assess the outcome of a prospective Spanish nationwide cohort of HIV-infected patients undergoing LT for HCC (2002-2014). These patients were matched (age, gender, year of LT, center, and hepatitis C virus (HCV) or hepatitis B virus infection) with non-HIV-infected controls (1:3 ratio). Patients with incidental HCC were excluded. Seventy-four HIV-infected patients and 222 non-HIV-infected patients were included. All patients had cirrhosis, mostly due to HCV infection (92%). HIV-infected patients were younger (47 versus 51 years) and had undetectable HCV RNA at LT (19% versus 9%) more frequently than non-HIV-infected patients. No significant differences were detected between HIV-infected and non-HIV-infected recipients in the radiological characteristics of HCC at enlisting or in the histopathological findings for HCC in the explanted liver. Survival at 1, 3, and 5 years for HIV-infected versus non-HIV-infected patients was 88% versus 90%, 78% versus 78%, and 67% versus 73% (P = 0.779), respectively. HCV infection (hazard ratio = 7.90, 95% confidence interval 1.07-56.82) and maximum nodule diameter >3 cm in the explanted liver (hazard ratio = 1.72, 95% confidence interval 1.02-2.89) were independently associated with mortality in the whole series. HCC recurred in 12 HIV-infected patients (16%) and 32 non-HIV-infected patients (14%), with a probability of 4% versus 5% at 1 year, 18% versus 12% at 3 years, and 20% versus 19% at 5 years (P = 0.904). Microscopic vascular invasion (hazard ratio = 3.40, 95% confidence interval 1.34-8.64) was the only factor independently associated with HCC recurrence.HIV infection had no impact on recurrence of HCC or survival after LT. Our results support the indication of LT in HIV-infected patients with HCC.
Left ventricular geometry predicts mortality in elderly with preserved systolic function: an echocardiographic study in 9771 patients over 70 years old
Authors: C.J. Lavie, R.V. Milani, Y.E. Gilliland, J.A. Bernal, H.K. Dinshaw, H.O. Ventura, F.H. Messerli
Journal: Circulation (2004)
Subclinical C-HUS and complete remission in metastatic gastric cancer treated with C-MAX.
Authors: J. D. Ahlgren, S. J. Simmens, C. S. Bishop, D. M. Kirkel, P. Siegel, S. Schuck, R. S. Siegel
Journal: Journal of Clinical Oncology (2010)

e14657 Background: Phillips (JCO 3:723) analyzed antigen-antibody complexes in 6 patients (pts) with C-HUS. All antibodies were specific for the pts' own gastric cancer but not normal gastric mucosa or other cancers; all bound complement. Methods: We review here 22 metastatic gastric cancer pts treated with 8-week cycles of mitomycin 10 mg/m2 day (d) 1, doxorubicin 30 mg/m2 d1 and 29, cisplatin 25 mg/m2 d8, 15, 22, 36, 43, and 50, and capecitabine 2 mg/m2/d 2 weeks every 3 (C-MAX). Early pts received continuous infusion 5FU (CIF), 300 mg/m2/d instead of capecitabine. All pts receiving any dose are included in this analysis. Pts had pathologically confirmed metastatic gastric cancer and no prior therapy. Median age was 50 (31-87). Liver metastases (55%) and carcinomatosis (50%) were most common; 40% had multiple sites. One pt was performance status (PS) 0, 14 PS1, 5 PS2, 2 PS3. Pts had physician exam and tumor markers every 4 weeks and CT every 8. Pts in complete remission (CR) were treated 8 weeks beyond CR, then followed without treatment. Results: Median progression-free survival was 10.7 months; overall survival 14.9 months. 13 of 15 pts (87%) with measurable disease had objective response, 6 (40%) CR. Second-look surgery confirmed CR in 2 more pts. Of 8 pts in CR, 4 died of systemic relapse, 3 relapsed in the CNS and died without systemic disease, one remains in CR at 192 months. Toxicity was mainly neutropenia, grade (gr) 4 in 38%, gr 3 in 35%, with 2 episodes of neutropenic fever. There was 24% gr 3-4 thrombocytopenia; mucositis, hand-foot syndrome, and diarrhea reached gr 3 in 18%, 14%, and 5%. Two pts developed hemolysis consistent with cancer-related hemolytic-uremic syndrome (C- HUS), one self-limited, the other (gr 3) resolving with plasmapheresis. Both pts developing C-HUS became CRs. After noting this, we monitored serum haptoglobin as a possible marker for subclinical C-HUS. 2 of 4 pts so monitored developed transiently undetectable haptoglobin without anemia; both became CRs. Conclusions: Numbers are still small but we suspect subclinical antibody formation is much more frequent than clinical C-HUS. Possibly ADCC by such antibodies may contribute to the activity of regimens like C-MAX. No significant financial relationships to disclose.
Array-comparative genomic hybridization identifies novel copy number alterations in recurrent squamous cell lung cancer
Authors: K. B. Sriram, J. E. Larsen, S. M. S. Francis, C. M. Wright, K. Mattar, M. Windsor, B. E. Clarke, E. E. Duhig, N. K. Hayward, R. V. Bowman, I. A. Yang, K. M. Fong
Journal: Journal of Thoracic Oncology (2011)
Phase II dose escalation study of sorafenib in patients with metastatic renal cell carcinoma (mRCC) who have had prior treatment with VEGFR-TKI antiangiogenic treatment
Authors: A. P. Mancuso, E. Donato De Paola, A. Catalano, F. Calabrò, C. Messina, A. Zivi, L. Cerbone, L. Vigna, R. Caristo, C. N. Sternberg
Journal: Journal of Clinical Oncology (2009)

e16027 Background: Sorafenib is an orally active multikinase inhibitor (Raf kinase, VEGFR 1, 2, 3 and PDGFR inhibitor) for the treatment of advanced RCC. The purpose of this study was to assess the efficacy and toxicity of Sorafenib in mRCC patients (pts) previously treated with an anti-angiogenic VEGFR-TKI using escalating dose levels. Methods: Pts with mRCC, PS 0–2 and adequate organ function were eligible. Pts received Sorafenib 400 mg/BID/continuously in 4-wk cycles. Pts with no progressive disease (evaluated at 12 weeks) continued to receive Sorafenib at the standard dose, while progressive pts received an increasing dose (600 mg BID) with early disease restaging after 4 weeks. Pts who progressed at 600 mg BID were taken off study. Efficacy was assessed by RECIST criteria. Results: 18 pts were entered; baseline characteristics: PS 0–1: 94%; median age 62 years (41–82); nephrectomy: 100%; surgery for metastatic disease: 28%, clear-cell 78%, papillary-cell 16%, sarcomatoid 6%.≥ 2 metastatic sites: 84%. 10 pts were refractory to cytokine treatment and all progressed or experienced unacceptable toxicity after anti-angiogenic VEGFR-TKI treatment, Sunitinib (13 pts) or Pazopanib (5 pts). Median number of cycles was 7.5 (1–16). Overall, 72% of pts had disease control without significant correlations between response to prior therapy and hypertension. 14 pts had progression free survival (PFS) of 4.3 months (mos). 4 pts are still in treatment with a median PFS &gt; 8 mos. Of 6 pts in which the dose was escalated, 3 benefitted with a PFS of &gt; 3 mos. The most common toxicity (NCIC 3.0, all pts) was grade (g) ≥ 1 diarrhea in 10 pts, g2–3 hand-foot syndrome in 7 pts and g-3 mucositis in 1 pt. Other hematological and non-hematological toxicities were g1 with a frequency &lt; 15%. Conclusions: Sorafenib at doses of 400–600 mg/BID/continuosly results in acceptable and well tolerated salvage treatment after VEGFR-TKI failure. In progressive patients, treatment with a higher dose could be a valid option. Final and mature data will be presented in combination with translational research evaluating biological characteristics on tissue and blood. No significant financial relationships to disclose.
Grading system of metastatic epidural spinal cord compression (MESCC).
Authors: S. Ryu, J. Rock, R. Jain, C. Cacas, M. Lu, J. M. Anderson
Journal: Journal of Clinical Oncology (2010)

e12514 Background: Surgery of MESCC improves ambulatory function. We demonstrated a radiosurgical decompression of MESCC, with 75% epidural tumor reduction, and 81% neurological improvement or stable. To better select patients for treatments, we developed a grading system of MESCC. Methods: Spine radiosurgery was performed in 62 pts with 85 MESCC lesions in phase II study. MESCC was diagnosed by MRI. Radiosurgery was given to the involved spine segment with median dose16 Gy in single session. All patients had prospective clinical follow-up with median 11.5 months (1–48). The proposed grading system has radiographic and neurologic components. Radiologic grades (0- V): grade 0 is spine bone involvement only, grade I is epidural tumor within the epidural fat with no thecal sac compression, grade II is involvement of dura and arachnoid with mild compression of thecal sac, grade III is tumor impingement to the spinal cord, grade IV is spinal cord displacement with CSF still visible, and grade V is spinal cord compression with CSF not visible between the tumor and the spinal cord. Neurologic gtrades (a-e): Grade a is no symptoms. Grade b is focal minor symptom such as pain. Grade c is functional paresis with muscle strength 4/5. The involved muscle is functional and ambulatory. Grade d is nonfunctional paresis with muscle strength ≤ 3/5, with the involved muscle nonfunctional or nonambulatory. Grade e is plegic, urinary or rectal incontinence. Results: There was no correlation between the radiographic and neurological grades. Patients were evenly distributed. After radiosurgery, all radiographic grade 0-II showed complete tumor response, and grade III-V showed progression in 13% (4/30 pts). Patients with neurological grades a-c progressed in 18% (9/50 pts) on neuro exam, whereas patients with grades d-e improved or stable neurologically. Conclusions: Radiographic grade and neurologic grade are mutually independent. Imaging study cannot be used to predict neurologic status. The proposed system appears to be useful in patient evaluation and reporting. Although there are many factors to be considered, this system may be used for selection of different treatments for spinal cord compression. No significant financial relationships to disclose.
Pegylated liposomal doxorubicin in recurrent serous carcinoma of the uterus
Authors: D. S. Dizon, A. Stuckey, J. Schwartz
Journal: Journal of Clinical Oncology (2009)

e16538 Background: Serous carcinoma of the uterus behaves in a much more aggressive fashion than endometrioid tumors of the uterus with risks almost equivalent to ovarian cancers. Given this, we were interested in seeing if pegylated liposomal doxorubicin had a differential benefit in serous cancers of the uterus when compared to endometrioid carcinomas. Methods: Patients with recurrent serous and endometrioid uterine cancer treated with pegylated liposomal doxorubicin between 1999 and 2007 were identified. Demographics, stage, grade, and prior lines of chemotherapy were collected. The primary objectives were to determine progression-free (PFS) and overall survivals (OS) in these subsets of women with recurrent endometrial cancer. Results: Twenty-three patients with recurrent serous histology and 24 with endometrioid histology were identified. The median age at diagnosis in the serous group was 70 (45–89) and 62 (37–94) in the endometrioid cohort. The majority of patients in both groups were Caucasian. There was no difference between the serous and endometrioid cohorts by stage with advanced disease in 65% and 73%, respectively (p = 0.95). The majority of patients had 2 prior lines of treatment. The most common prior chemotherapy was carboplatin and paclitaxel. The median number of pegylated liposomal doxorubicin cycles was 4 in both groups. The median PFS was 4.6 months in the serous cohort and 4.7 months in the endometrioid group (p = 0.47). The median overall survival in the serous group was 9.8 months and in the endometrioid group it was 9.6 months (p &gt; 0.5). Conclusions: We did not find a difference in survival endpoints in women with serous versus endometrioid histologies. While pegylated liposomal doxorubicin appears to be equally active in these groups, survival is uniformly poor in the context of recurrent disease. No significant financial relationships to disclose.
Frequency of neutropenia-related events during chemotherapy and the use of pegfilgrastim and filgrastim in community practice: Results of the ACCEPT study
Authors: L. T. Campos, M. Folbe, L. Meza, V. Charu, R. Dansey, F. Xie
Journal: Journal of Clinical Oncology (2005)

8115 Background: The frequency of neutropenia-related complications during chemotherapy (CT) is reduced by the use of pegfilgrastim (Neulasta) and filgrastim (Neupogen). The introduction of pegfilgrastim in 2002 may have changed both the use of filgrastim and the outcomes related to neutropenia. Methods: 99 US community oncology practices, stratified by CT use, participated in the study. Consecutive medical records were abstracted for adult cancer patients (pts) receiving CT in 2001 with filgrastim support (pre-pegfilgrastim launch) or in 2003 with pegfilgrastim support (post-pegfilgrastim launch). The associated CT was initiated from Jan 1 to Dec 31 in 2001 or 2003. In addition to clinical records documenting the complications of CT (febrile neutropenia and hospitalization) available in pt charts, additional data was derived from available laboratory results. Results: 2751 charts documented pegfilgrastim or filgrastim use; 829 pts received filgrastim in 2001; 1922 pts received pegfilgrastim in 2003. The 3 most common tumor types observed were breast cancer (51%), lung cancer (19%), and NHL (18%). The predominant CT cycle length was Q21 days. A total of 39% (95% CL: 36, 41) of pts receiving pegfilgrastim were reported to have neutropenia (ANC < 1 x 109/L) compared with 51% (95% CI: 48, 55) of filgrastim pts. CT-related outcomes that are associated with neutropenia are in the table below. Conclusions: Neutropenia-related complications of CT were observed to be lower in pts receiving pegfilgrastim in 2003 (1 year post pegfilgrastim launch) compared with pts receiving filgrastim in 2001 (1 year before pegfilgrastim launch). Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen Amgen Amgen
The Role Of High Dose Chemotherapy and Autologous Stem Cell Transplantation (ASCT) In Patients With POEMS Syndrome: A Retrospective study Of The Plasma Cell Disorders Subcommittee Of The Chronic Malignancy Working Party Of The EBMT
Authors: Gordon Cook, Laurent Garderet, Simona Iacobelli, Curly Morris, Nikolaus Kroeger, Anja van Biezen, M Rovira, Jenny Byrne, Dominique Bordessoule, Giuseppe Leone, Arnon Nagler, Mark Cook, Laurence Legros, Gert J. Ossenkoppele, R Gacria Sanz, Jennifer Hoek, Luca Castagna
Journal: Blood (2013)
Phase II study of oxaliplatin in patients with unresectable, metastatic or recurrent hepatocellular cancer
Authors: S. Shibata, Y. Yen, J. Doroshow, L. Leong, L. Wagman, H. Marx, K. Clarke, P. Frankel, H. Lenz, D. Gandara
Journal: Journal of Clinical Oncology (2005)

4161 Background: Prolonged survival for patients with unresectable HCC has remained elusive, with median overall survival consistently lower than 6 months. Oxaliplatin has recently demonstrated promise in HCC, and the aim of this study is to examine the response rate, survival, time to progression and toxicity in patients with poor prognosis HCC treated with single agent oxaliplatin. Methods: Patients were required to have measurable recurrent, metastatic or unresectable HCC, exposed to no more than 2 prior chemotherapy regimens. Prior radiation, chemoembolization, and/or alcohol injections were permitted. Karnofsky performance of 70% or above and adequate organ and hematologic function were required. All patients (pts) received treatment with oxaliplatin 100 mg/m2 on day 1 and 15 as a two hour IV infusion and were pretreated with antiemetics. Treatment was repeated every 28 days. Results: Thirty four patients have been enrolled and thirty two eligible patients are evaluable for response; there are seventeen Caucasians, three African-American, and fourteen Asians, with 28 males and 6 females. Median age at study entry was 60 years, range (21–84). Karnofsky performance status was 70/80/90/100% in 4/10/7/13 pts; All patients had previous surgery. Among the 32 evaluable pts, one had a PR and twelve had stable disease. Of the remaining 19 patients, 18 had disease progression and 1 had UPR.Overall, median time to progression or death on this study is 2 months; the overall median survival is 6 months. Six month survival is 51% (95% CI 34%–77%) and 6 month event-free survival is 16% (95% CI 6%–42%). Grade III toxicities included neutropenia (2), anemia (1), fatigue (4), transaminitis (8), hyperbilirubinemia (1), elevated alkaline phosphatase (2), hyperglycemia (1), hyponatremia (2), and neuropathy (1). Conclusion: Oxaliplatin as a single agent has demonstrated potential activity in the treatment of poor prognosis HCC, although the majority of patients did not achieve a partial response a significant number had stable disease with a favorable toxicity profile. The combination of oxaliplatin and other agents, may have better efficacy in this patient population. (Supported by CA62505 and N01-CM17101) No significant financial relationships to disclose.
Analysis of the speech of dying patients with cancer on end-of-life decision making
Authors: I. N. Olver, J. A. Eliott
Journal: Journal of Clinical Oncology (2004)

8216 Background: Patients with cancer approaching the end of life were interviewed to ascertain their views on the formulation of “do not resuscitate” (DNR) orders to guide policy. Methods: Consecutive eligible patients had semi-structured interviews which were recorded, transcribed, and subjected to qualitative analysis. Accrual ended when data saturation occurred, that is no new issues were being raised. Results: Twenty-eight patients, 13 females, 15 males (average age 61, range 39–79) were interviewed, 86% as inpatients, half with family members or friends present. All were Australian residents with English as their first language; 64% were currently married. The patients spanned 11 different cancers from which 23 (82%) died within 12 weeks of interview, including 4 within 1 week, with the longest survivor just over 6 months. Fourteen patients had a DNR order recorded in their file at interview and only 1 had not clearly specified their wishes at time of death. However, for 7 patients there were discrepancies between their views at interview and what was recorded. All but 4 patients understood the term DNR. Resuscitation was often spoken of as a medical intervention which may stop an appropriate peaceful death. The majority believed that the patient should make the DNR decision stressing the importance of individual autonomy but some preferred a shared decision with physicians or family. Patients said that being lucid was necessary for making DNR decisions. There was no consensus on the appropriate timing of a DNR discussion. Some favored no discussion. A minority favored a discussion early before possible mental incapacity, but those who supported holding the discussion when the issue became pressing wanted to spare patients the negative emotions of an earlier discussion. There was ambivalence about who should decide when to discuss, some believing it to be the patient's decision but others deferring to the experience of the physician. Conclusions: DNR policies must allow the flexibility to accommodate diverse individual patient wishes. Documentation of DNR orders can be problematic, both in accurately ascertaining patients' wishes, and accommodating changes that may occur. No significant financial relationships to disclose.
Intrahepatic mitomycin C as treatment of breast cancer hepatic metastasis
Authors: W. Demey, H. Wildiers, G. Maleux, P. Clement, S. Heye, P. Debruyne, A. Van Oosterom, R. Paridaens
Journal: Journal of Clinical Oncology (2006)

10690 Background: Because of increasing survival due to improving systemic treatment, liver metastasis represents a major and increasing cause of death in women with metastatic breast cancer. Regional treatment is an attractive option in the treatment of liver metastases. We reviewed the tolerability and efficacy of intrahepatic administration of mitomycin C (MMC) performed in our institution. Patients with only or predominant liver metastasis were eligible, independent of previous chemotherapy for metastatic breast cancer. Methods: In a unicentric protocol we reviewed retrospectively all patients (n = 11) who received intrahepatic MMC for liver metastasis of breast cancer between January 2000 and July 2005 in the University Hospital Leuven. MMC was administered as a bolus of 6 mg in 50 ml saline directly into the right and left hepatic arteries by transcatheter technique. The procedure was performed by an interventional radiologist. Patients were hospitalised for 24 hours. In patients with severe liver function disturbances or more than six administrations of MMC a dose reduction was applied. Results: All treated patients were reviewed. The median age was 52 years (range, 36–61). Most patients were heavily pre-treated with a median of 4 systemic chemotherapy regimens (range, 1–5). Treatment was well tolerated, no grade 3 or 4 adverse events were reported. Only one patient had persistent thrombocytopenia for which interruption of treatment was required. One patient had fatigue. There were no procedure-related complications. Six patients received only 1 or 2 administrations because of rapid disease progression within the first two months. Among the remainders, 4 patients had 6 and 1 had 11administrations. When evaluatde by RECIST criteria one patient had a complete remisson, two patients had a partial remission and 2 patients remained stable for at least 6 months. Conclusions: In this retrospective analysis intrahepatic administration of MMC was well tolerated and provided clincal benefit (respons or at least disease stabilization for 6 months) in 45% of heavily pre-treated patients. This treatment represents a valid therapeutic option for patients with predominant liver metastases of breast cancer after failure of standard systemic treatment. No significant financial relationships to disclose.