tbuckley/cabot-search huggingface dataset:
Abstract 251: First-Year Medical Students Acquire Contextually Relevant Cardiopulmonary Resuscitation Knowledge When Exposed to an In-Hospital Focused BLS Course Versus a Traditional Healthcare Provider BLS Course: A Prospective, Randomized, Controlled Evaluation
Authors: Jordan M Duval-Arnould, Julianne Perretta, Nnenna Chime, Merona Hollingsworth, Deborah Aksamit, Ida-Marguerite M Twilley, Mary Ann Luksic, Julianna Jung, Kristen Nelson-McMillan, Nicole A Shilkofski, Elizabeth Hunt
Journal: Circulation (2012)

INTRODUCTION: The traditional AHA Healthcare Provider BLS course focuses on out-of-hospital cardiac arrests as the contextual environment and does not provide content focused on optimizing quality of BLS for in-hospital cardiac arrests (IHCA). METHODS: First year medical students participated in a prospective, randomized, controlled evaluation of a traditional AHA Healthcare Provider BLS course “TradBLS” vs. a modified course including objectives focused on managing IHCA, “HospBLS”. The courses were identical in length, taught by the same instructors, and used AHA materials. Students completed a Multiple Choice Question (MCQ) survey evaluating knowledge regarding CPR performance and leadership. This project was approved by our Institutional Ethics Committee as an Educational Quality Assurance evaluation and by the AHA. RESULTS: 122 students completed an MCQ survey. Both groups had similar previous BLS certification [HospBLS 29/62 (47%) vs. TradBLS: 32/60 (53%) p = 0.469], and lack of advanced training (neither ACLS or PALS) [95% vs. 97% p = 0.675]. The HospBLS group was significantly more likely to identify a set of six maneuvers to improve quality of in-hospital CPR [87% vs. 27%, p&lt;0.001]. The HospBLS group was more likely to identify 2-person bag-mask-ventilation (BMV) as a maneuver to try when unable to move the chest [77% vs. 18%, p&lt;0.001] as well as correct O2 delivery when performing BMV [90% vs. 17%, p&lt; 0.001]. An equivalent number of students in each group reported they could either lead until the code team arrives [52% vs. 58%, p=0.46] or could lead a simulation but not a real life scenario [5% vs. 10%, p = 0.28]. However, the HospBLS group was much more likely to identify themselves as qualified to be a team leader [44% vs. (3%), p&lt;0.001]; and much less likely to indicate they were not qualified to be a team leader” [0% vs. 28%, p&lt;0.001]. CONCLUSIONS: Medical students that took the HospBLS curriculum were more likely to identify maneuvers to optimize quality of CPR for the IHCA, and expressed greater confidence in their ability to be a team leader. This evaluation suggests that knowledge on optimizing CPR for IHCA can be effectively acquired with the same time and resource utilization of the standard AHA Healthcare Provider course and should be further evaluated.
Comparison of immunostaining for estrogen receptor in breast cancer using the rabbit monoclonal antibody SP1 or the mouse monoclonal antibody 6F-11
Authors: B. Knight, K. A. Gelmon, D. J. Renouf, H. F. Kennecke, T. Thomson, G. Naus
Journal: Journal of Clinical Oncology (2008)

11562 Background: A high-quality assay to detect estrogen receptor (ER) expression is crucial as ER status guides many therapeutic decisions in breast cancer. Previously the rabbit monoclonal antibody (Ab) SP1 was shown to be more sensitive than the mouse monoclonal Ab 1D5. Results were similar in a comparison of mouse Abs 6F11 and 1D5. This study compares the ER status in breast cancer using SP1 on cases previously interpreted as negative with 6F11. Methods: All low grade (1 or 2), ER negative, invasive breast carcinomas, reviewed at the British Columbia Cancer Agency between 2002 and 2006 were reviewed. Cases that had been stained at the Vancouver site (VCC) with 6F11 were selected and those with available tissue blocks were re-stained with SP1. The patient’s oncologist was notified of any changes in ER status. Results: 123 cases of low grade, ER negative invasive breast tumors were initially selected. 49 of these cases had been stained at VCC with 6F11. Tissue blocks were available for 45/49 (92%) of cases. 5/45 cancers (11%) were grade 1 and 40/45 (89%) were grade 2. With SP1 the ER status changed from negative to positive in 3/45 (6.7%) of the cases. For 2 cases the ER status changed because current scoring criteria regard a test as positive even if only rare cells stain. Review of original 6F11 stained sections revealed these 2 cases would be scored as ER positive using the new criteria. The third case was a core biopsy with scant tumor and only focal staining. Review revealed the change in ER status was likely due to sampling difference in the deeper section. Conclusions: Of 45 previously 6F11 ER negative cases restained with SP1, the ER status changed in 2 because of revised more sensitive scoring criteria and in 1 because of a sampling difference between the original and subsequent sections. The rabbit monoclonal Ab SP1 appears to be as sensitive as the mouse monoclonal Ab 6F11 in detecting ER expression in breast cancer. This highlights the need for good quality ER testing with highly sensitive antibodies. Additional data for grade 3 cases will be presented. No significant financial relationships to disclose.
Prevalence of MGUS in a geriatric population in Turkey
Authors: O. Dizdar, M. Erman, M. Cankurtaran, M. Khalil, B. Yavuz, Z. Ulger, S. Ariogul, A. Pinar, A. Kars, I. Celik
Journal: Journal of Clinical Oncology (2006)

17564 Background: In this study, we aimed to investigate the prevalence of monoclonal gammopathy of unknown significance (MGUS) in the geriatric population in Turkey, with their clinical and laboratory parameters. Methods: The study group consisted of all individuals who applied to the outpatient clinic of Geriatrics Department between January-December 2005 in Hacettepe University Hospital in Ankara, Turkey. This clinic serves patients older than 65 years of age either with various acute/chronic diseases or healthy individuals for check-up purposes. All the participants had serum protein electrophoresis (SPE) -and immunofixation as needed- along with their routine laboratory tests and bone mineral density (BMD) measurements. Patients with a monoclonal protein in their SPEs were further evaluated for the presence of multiple myeloma. Clinical and laboratory parameters of patients with MGUS were compared with a control group of randomly selected 100 individuals who did not have MGUS. Results: A total of 1012 patients were enrolled in the study. Monoclonal band was detected in 22 patients (2.17%). The majority of the M proteins (63%) were of Ig G type. Of the remainder, 32% were Ig A, and 5% Ig M. Further investigations in these patients depicted one patient to have multiple myeloma and one patient to have lung carcinoma. The remaining 20 patients were diagnosed as MGUS (1.97%). BMD measurements of the patients with MGUS were significantly lower than the control group. Median lumbar BMD t score was -2.66 (Interquartile range (IQR): −.72 −3.77) in MGUS patients and -1.76 (IQR: −0.50 −2.47) in controls (p = 0.007). The two groups were found to be comparable in terms of comorbid diseases and other laboratory parameters. Conclusions: The prevalence of MGUS above the age of 25 is 1%, above 50 it is 1.7%, and above 70 it is approximately 3%. In our study, the frequency of MGUS above 65 years of age was found to be 1.97%, which is a little lower than the above quoted figures. It must be noted that our study group was not population-based and chronic diseases may be more common than the general population, resulting in a higher prevalence of MGUS. Another finding was the lower BMD measurements in patients with MGUS. BMD data is limited in patients with MGUS in the literature and further studies are needed to elucidate whether there is an association or not. No significant financial relationships to disclose.
Fibroblast growth factor 23 levels are elevated and associated with severe acute kidney injury and death following cardiac surgery
Authors: David E. Leaf, Marta Christov, Harald Jüppner, Edward Siew, T. Alp Ikizler, Aihua Bian, Guanhua Chen, Venkata S. Sabbisetti, Joseph V. Bonventre, Xuan Cai, Myles Wolf, Sushrut S. Waikar
Journal: Kidney International (2016)
Characterize medical care during disease phases in metastatic colorectal cancer.
Authors: X. Song, B. Barber, Z. Zhao, C. Gregory, Z. Cao
Journal: Journal of Clinical Oncology (2010)

3625 Background: Three new biologics have been approved to treat metastatic colorectal cancer (mCRC) since 2004. This study describes the medical care and its costs among patients diagnosed with mCRC in 2004-2009. Methods: Using a large claims database of a U.S. nationally commercially insured population, patients with newly diagnosed mCRC were identified between 2004 and 2008. Patients were followed from initial mCRC diagnosis to either death, disenrollment, or 07/31/2009, whichever occurred first. The observation period was divided into three distinct phases of disease per a previously published algorithm: the diagnostic phase, the treatment phase, and the death phase. Medical care costs were estimated per month in each phase. Within phases, costs were further classified as inpatient, emergency room (ER), outpatient, or medication- related. Costs specific to chemotherapy and biologic agents were also estimated. Results: A total of 6,675 newly diagnosed mCRC patients were included in this analysis. Mean (standard deviation [SD]) age was 64.1 (13.1) years and just over half (55.5%) were males. The Table presents mean and SD months of duration and total costs per month for the diagnostic, treatment, and death phases. Monthly costs in each phase include inpatient, outpatient, ER, and medication-related costs. Inpatient care was the primary cost driver in the diagnostic phase (41.7%) and in the death phase (71.4%); while outpatient care was the cost driver in the treatment phase (45.0%). Within the treatment phase, chemotherapies and biologics represented 15.6% and 17.6% of total costs, respectively. Conclusions: Substantial monthly cost differences exist among the three phases of disease with monthly costs being the highest in the death phase followed by the diagnostic phase. Cost drivers vary across the phases of disease with total costs driven by inpatient care in the diagnostic phase and the death phase and by outpatient care in the treatment phase. Diagnostic phase (n=6063) Treatment phase (n=5313) Death phase (n=1818) Mean (SD) months in phase 2.8 (0.5) 16.4 (13.8) 2.4 (1.0) Mean (SD) costs per month in phase $16,340 ($18,951) $8,599 ($10,046) $26,649 ($83,321) Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen Amgen
Presurgical chemotherapy (CT) with FOLFOX4-regimen for patients (pts) with unresectable liver metastases (LM) from colorectal cancer (CRC)
Authors: U. Tirelli, M. Berretta, F. Di Benedetto, E. Zanet, A. Bearz, A. Lleshi, C. Simonelli, S. Berretta, D. Spartà
Journal: Journal of Clinical Oncology (2008)

15052 Background: Hepatic resection is the only treatment that currently offers a chance of long-term survival in pts with CRC LM. FOLFOX4-regimen has proved efficacy in advanced disease. Primary objective of this study was to evaluate resecability rate of LM in pts with un-resectable disease, after “neoadjuvant” CT with FOLFOX4-regimen and secondary objective is to evaluate the objective response and CT toxicity. Methods: From March 2001 to May 2006, 36 consecutive pts, were prospectively enrolled into the study. The treatment consists of FOLFOX4-regimen every two weeks, before elective surgery for 6 cycles, then postoperative therapy for another 6 cycles. Before surgery of LM the CT-PET scan evaluation was required. Response rate was evaluated with RECIST criteria. Results: Nineteen (53%) of 36 pts experienced a reduction of tumour burden and underwent surgical LM resection. No major surgical complications occurred. Seventeen pts completed their planned post-surgical CT. All pts were considered assessable for survival. After a median follow-up time of 45 months, 27 pts (75%) have died, and 9 (47%) of 19 pts who underwent surgical LM are still alive. Unfavourable prognostic factors were: number of LM (>3), metastases diameter (>5cm) and R0 resection rate. The main recurrences have occurred in the liver. The clinical characteristics have reported in the table. Conclusions: Our preliminary data suggests that FOLFOX4-regimen has a high response rate in pts with unresectable LM by CRC and a good safety, although the number of pts with long term survival s still limited. Probably the use of target therapy may also provide additional benefit. The accrual of pts into the study is still on-going. Sex M/F 24/12 Age median (range) 57 (43–73) ECOG PS median 1 (0–2) Metastases Synchronous 12 (33%) Metachronous 25 (67%) Number of metastases <3 10 (28%) 3–6 19 (53%) >6 7 (19%) Reason of unresectability Number 26 (72%) Size 8 (22%) Location 2 (6%) Response to CT Complete + Partial response 19 (53%) Stable disease 8 (22%) Progression disease 9 (25%) R0 resection rate (19 pts) Yes 13 (68%) No 6 (32) Haematological toxicities (neutropenia) G1-G2 20 (56%) G3-G4 4 (12%) Gastrointestinal toxicities (diarrhoea) G1-G2 5 (14%) G3-G4 8 (22%) No significant financial relationships to disclose.
A new docetaxel (D) gemcitabine (G) regimen as first-line chemotherapy in advanced non-small cell lung cancer (NSCLC): A phase II study
Authors: J. F. Morere, P. Terrioux, J. M. Brechot, J. Tredaniel, M. Bouchahda, J. P. Duhamel, J. Mandet, E. Brain, K. Beerblock, R. Fellague
Journal: Journal of Clinical Oncology (2005)

7288 Background: Non containing cisplatin doublets could be an alternative chemotherapy in some NSCLC patients (pts). The optimal schedule of a DG regimen and the optimal duration of G infusion has not yet been determined. Methods: We evaluated the activity and toxicity of a regimen with D 50mg/m2in 60mn and G 1200mg/m2 in 120mn q2 wks at the first step for 10 pts followed in the absence of grade 4 toxicity by D 50mg/m2 in 60mn and G 1500mg/m2 in 150mn q2 wks for the second step. Eligibility criteria were the following: 18–75 years old pts with histologically confirmed NSCLC stage IIIB or IV, PS ≤2, measurable disease (RECIST criteria), no prior radiotherapy or chemotherapy, no symptomatic cerebral metastasis, adequate biological parameters. Results: Between April 2002 and June 2004, 42 eligible pts were enrolled in the study, M/F 34/8, median age 59y (46–77), stade IIIB/IV 8/34, PS≤1 88%. In intent-to-treat analysis, overall response rate was 21,4% (respectively 50% and 19,6% in stage IIIB and IV). With a median follow-up of 7 months (mo), median progression-free survival was 5,5 mo, median overall survival was 13,5 mo and 1-year survival was 51%. Grade 3–4 toxicities per pt were neutropenia (28,6% with 2,4% febrile neutropenia), fluid retention syndrome (7,1%), anemia (4,8%), thrombocytopenia (4,8) and diarrhea (2,4%). Grade 2 alopecia was observed in 16,7% of pts. Conclusion: This two-week regimen has a manageable toxicity profile and achieves an encouraging one-year survival rate of 51% in this poor prognosis population of patients. No significant financial relationships to disclose.
Effects of age on the pharmacokinetics (PK) and pharmacodynamics (PD) of 8 oral anticancer agents from phase I/II trials: A single institution experience
Authors: S. Beeram, M. Beeram, A. Patnaik, C. H. Takimoto, W. A. Knight, J. Cooper, A. Karnad
Journal: Journal of Clinical Oncology (2005)

2027 Background: In the next 2 decades, 70% of cancers will occur in patients (pts) >70. Aging influences the disposition and effects of several classes of anticancer drugs. Alterations in GI absorption, decline in renal & hepatic clearance and decrease in end-organ functional reserve have been identified in aging population. There have, however, been few studies of the PK and PD of oral anticancer drugs in the elderly pts. Most studies to date have evaluated I.V agents. We are, therefore, performing a study to discern any existing relationships between aging, absorption and clearance rate of investigational oral anticancer agents in clinical evaluation at the Institute for Drug Development. Methods: Demographic data from pts participating in 9 early phase clinical evaluations of 8 oral anticancer agents (shown in table below) is being obtained and stratified according to age (> 65 or 65 years of age are the study set and pts < 65 years serve as controls in each study. Parameters of drug exposure such as area under the concentration-curve (AUC) and clearance and toxicity profiles for each individual agent are being evaluated in the two sets. Results: A total of 251 pts were evaluated. The study set (> 65 yrs) included 67 pts [M 35 /F 32; Median age 70; PS 0–15, PS 1–49, PS 2 -3] and control set included 186 pts [M 76 /F 110; Median age-54; PS 0–50, PS 1- 124, PS 2 - 12]. Tumor types in the Study/ Control sets were Breast (6/ 57), Colorectal (16/ 20), Hepatocellular (5/ 6), NSCLC (13/ 13), Renal (12/ 37), Pancreas (4/ 11) and others (11/ 42). The median number of treatment courses in the Study and Control sets were 3 and 2 respectively. PK/ PD analyses to assess the differences between the two sets is ongoing. Conclusions: Significant disparities in the PK’s of oral anticancer agents are possible in the elderly cancer pts. PK analysis is ongoing. Given the small study set in our evaluation, larger studies are warranted to discern these differences. No significant financial relationships to disclose.
Target focal therapy in early prostate cancer: Initial single institution results
Authors: A. Barqawi, J. Lugg, E. D. Crawford
Journal: Journal of Clinical Oncology (2007)

15574 Background: Currently the potential for over- and under-treatment using radical and watchful waiting options respectively constitutes a challenge in the management of patients with early organ-confined prostate cancer. Target focal therapy (TFT) is emerging as an intermediary alternative option for such men. The goal is to provide ablative treatment with minimal impact on morbidity. Methods: As part of an IRB approved study protocol a total of 24 patients initially underwent a 3 dimensional transperineal mapping biopsy under TRUS guidance to confirm the extent of tumor burden and localize the cancer foci within the prostate. Only 12 men qualified to undergo target focal cryotherapy. The remaining patients did not qualify due to upgrading or downgrading of their stage and opted for other treatment options. Follow- up consisted of serial PSA measurements at 3 months interval, disease specific QOL questionnaires, IPSS, and SHIM scores. Results: The mean age was 62.4 years. The mean (SD) prostate size at the time of mapping biopsy was 39 ±14.8g. After mapping biopsy all patients reported time limited hematuria and 2 patients developed urinary retention and were managed successfully with Foley’s catheter for 5 days. Mean PSA before treatment was 5.2 ± 4.1 ng/dl. 10/12 patients had Gleason score (GS) of 3+3, the remaining 2 patients had GS of 3+4. At 3 months follow-up. A median drop of PSA of 1.9 (0, 9.5) ng/dl. All patients reported full urinary continence post operatively. IPSS median drop of 0 (2, -16). Sexual health as assessed by SHIM score showed a median drop of 6 (1, -15) points. In general 4 patients reported a significant change in sexual performance. 2 of which opted for PDE inhibitor with successful regaining of erection at 6 months follow-up. Overall EPIC QOL scores showed no change in rectal, urinary and hormonal components. Sexual component registered a drop of 5 points. Conclusions: The current initial early results appear to be encouraging for future implementation of TFT on select patients with organ confined early stage cancer. Future larger randomized studies are needed to better understand the value of this alternative option in the management of prostate cancer. No significant financial relationships to disclose.
Phase 1 study of a focal adhesion kinase (FAK) inhibitor PF-00562271 in patients (pts) with advanced solid tumors
Authors: L. L. Siu, H. A. Burris, L. Mileshkin, D. R. Camidge, D. Rischin, E. X. Chen, S. Jones, D. Yin, H. Fingert
Journal: Journal of Clinical Oncology (2007)

3527 Background: PF-00562271 is a potent ATP-competitive inhibitor of FAK and, to a lesser extent, Pyk2. FAK transduces signaling from integrins and growth factors to modulate multiple properties important in neoplasia, including tumor cell invasion, proliferation and survival. Structure-activity relationships and preclinical antitumor activity are reported (W.G. Roberts et al, Proc AACR, 2007). Methods: Phase 1 dose-escalation study of PF-00562271 given as twice daily oral doses in 21 day cycles. Endpoints included safety, tolerability, PK, PD (serial tumor biopsies) and antitumor activity. PD was also evaluated by tumor glucose metabolism using FDG-PET. Dose escalation was performed in sequential cohorts of 3–6 pts. Results: 32 pts received 5 mg up to 105 mg BID with demographics M:F = 10:22; median age 60 (range 38–80). Primary tumor sites: colorectal (10), breast (4), neuroendocrine (2), lung (2), gastric (2), SCC (2), ovary (2), others (8). A total of 136 cycles have been administered, median = 3.2, range = 1–10+. Adverse events (AEs) possibly related to PF-00562271 in over 10% of pts included nausea, vomiting, fatigue, anorexia, abdominal pain, diarrhea, headache, sensory neuropathy, rash, constipation, dizziness. AEs were generally CTC grades 1–2 and reversible. Cmax and AUC increased dose-dependently, and AUC accumulated over 6-fold by day 14. Doses over 15 mg BID produced steady-state plasma concentrations, exceeding target efficacious levels predicted from preclinical models. On day 14, PET scans in one pt demonstrated significant (46%) decline in SUV of metastatic ovarian carcinoma, associated with improved tumor-related symptoms. Nine pts tolerated over 3 cycles and another 4 pts continued treatment over 6 cycles with stable disease. At 105 mg BID, dose- limiting toxicities included nausea, vomiting, diarrhea. Conclusions: At the doses evaluated, PF-00562271 is tolerable with extended BID oral administration and exhibits favorable PK and PD. Additional dose and schedule evaluations continue, and updated clinical and biomarker results will be presented. No significant financial relationships to disclose.
Abstract 18016: Comparison of a Lower-Dosimetry 3D Rb-82 PET Myocardial Perfusion Imaging Protocol Versus the Conventional 2D Protocol
Authors: James Case, Harshal Patil, Staci A Courter, Timothy M Bateman
Journal: Circulation (2012)

Background: Lowering the infusion dose of Rb-82 offers reduced radiation exposure and extends generator life. We therefore compared 3D PET after a lower Rb-82 dose (∼20 mCi) processed using a Monte...