tbuckley/cabot-search huggingface dataset:
Time from surgery to first adjuvant chemotherapy: Experiences at an inner-city Canadian hospital.
Authors: Christina Marchand, Maha Hassan, Jalal Ebrahim, Ammar Bookwala, Laura Sevick, Ata Ansari, Audrey Wong, Sophie Hogeveen, Rosane Nisenbaum, Delilah Lisa Topic, Christine Brezden-Masley
Journal: Journal of Clinical Oncology (2013)

527 Background: Cancer Care Ontario (CCO) guidelines advise that colorectal cancer (CRC) patients receive their first adjuvant chemotherapy (AC) no later than 8 weeks after surgical resection, with new data suggesting optimal treatment to commence between 4 and 6 weeks. This retrospective study was performed to determine treatment timelines and identify barriers at St. Michael’s Hospital (SMH). Methods: Of the 507 patients diagnosed with CRC between Jan 1, 2005 and May 1, 2012 at SMH, 304 patients had stage II or III CRC. Our sample population of 159 patients received both surgical resection and AC at SMH. Data collected included: time between surgery and first AC, patient demographics, systemic/clinical barriers and recurrence-free survival. Data was analyzed using SAS statistical software assuming p-values &lt;0.05 as significant. Results: Of our 159 patients, mean age was 61.3 years (range 28 – 91); 54% male and 70% had stage III disease; colon cancer (64%) and mean follow-up was 2.2 years (range 0.1 – 5.7). Mean time from surgery to first AC was 50.4 days (sd = 15.8) or 7.2 weeks ranging from 3 to almost 17 weeks. Medical complications affected 21.4% of patients. The presence of a complication was associated with delay in AC (9.5 days, p=0.001). Moreover, 11.1% of patients were excluded from sample, since complications exceeded treatment past 12 weeks, equating to no AC. Referral from surgeon averaged 21 days (sd=12.0), 10 days awaiting pathology. Medical Oncology consult to first AC averaged 19 days (sd=12.7), 12 days awaiting port-a-cath insertion. Each part of referral process was correlated with delay to AC. Only 18.9% of patients recurred. While trends were identified, association between delay and recurrence was weak (p=0.1457). Medical complication correlated strongly with recurrence (p=0.0472). Patients with complications had a higher rate of recurrence (32.4% vs 15.2%). Conclusions: Compliance to current CCO guidelines can be optimized in CRC patients at SMH. Barriers to timely treatment include patient age, timely referral and presence of a medical complication. Quality improvement rapid cycling of confounding barriers will be used prospectively to lower variance and achieve greater consistency in treatment.
HL-A Expression on the G 1 S, and G 2 Cell-Cycle Stages of Human Lymphoid Cells
Authors: L. K. Everson, B. A. Plocinik, G. N. Rogentine
Journal: JNCI Journal of the National Cancer Institute (1974)

Journal Article HL-A Expression on the G1 S, and G2 Cell-Cycle Stages of Human Lymphoid Cells Get access L. K. Everson, L. K. Everson 2Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, N.Y. 10021. Search for other works by this author on: Oxford Academic PubMed Google Scholar B. A. Plocinik, B. A. Plocinik 3Immunology Branch, National Cancer Institute, National Institutes of Health, Public Health Service, U.S. Department of Health, Education, and Welfare, Bethesda, Md. 20014. Search for other works by this author on: Oxford Academic PubMed Google Scholar G. N. Rogentine, Jr. G. N. Rogentine, Jr. 3Immunology Branch, National Cancer Institute, National Institutes of Health, Public Health Service, U.S. Department of Health, Education, and Welfare, Bethesda, Md. 20014. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 53, Issue 4, October 1974, Pages 913–920, https://doi.org/10.1093/jnci/53.4.913 Published: 01 October 1974 Article history Received: 23 October 1973 Accepted: 22 May 1974 Published: 01 October 1974
Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI
Authors: Ijin Joo, Jeong Min Lee
Journal: Liver Cancer (2015)

Magnetic resonance imaging (MRI) using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DPTA), or gadoxetic acid for short, is a hepatocyte-specific contrast agent which is now increasingly used for the detection and characterization of focal hepatic lesions, particularly in patients at high-risk of developing hepatocellular carcinomas (HCC). In fact, several recent guidelines now recognize gadoxetic acid-enhanced MRI (Gd-EOB-MRI) as the primary diagnostic imaging modality for the noninvasive diagnosis of HCC, although it must be noted that several major guidelines still include only extracellular contrast media-enhanced computed tomography and MRI. The primary merits of Gd-EOB-MRI lie in the fact that it can provide not only dynamic imaging, but also hepatobiliary phase (HBP) imaging which can lead to high lesion-to-liver contrast and give additional information regarding hepatocyte uptake via organic anion transporting polypeptides. This, in turn, allows higher sensitivity in detecting small HCCs and helps provide additional information regarding the multistep process of hepatocarcinogenesis. Indeed, many recent studies have investigated the diagnostic value of Gd-EOB-MRI for early HCCs as well as its role as a potential imaging biomarker in predicting outcome. We herein review the recent advances in the imaging diagnosis of HCCs focusing on the applications of Gd-EOB-MRI and the challenging issues that remain.
Identification of 17 mutations in ten exons in the COL4A5 collagen gene, but no mutations found in four exons in COL4A6
Authors: N Heiskari, X Zhang, J Zhou, A Leinonen, D Barker, M Gregory, C L Atkin, K O Netzer, M Weber, S Reeders, C Grönhagen-Riska, H P Neumann, R Trembath, K Tryggvason
Journal: Journal of the American Society of Nephrology (1996)

Conditions for polymerase chain-reaction amplification of ten exon regions (Exons 3, 7, 11 through 13, and 15 through 19) of the collagen COL4A5 gene and four exon regions (Exons 2, and 12 through 14) of the COL4A6 gene were sequenced and established in this study. These Type IV collagen genes contain 51 and 48 exons, respectively. The sequences of these exons were determined in the two genes in 250 male patients with hematuria and suspected Alport syndrome. Seventeen mutations were found in nine of the ten exons studied in the COL4A5 gene in 17 patients, whereas no mutations were identified in COL4A6. One mutation was identical in two patients known to be unrelated. The results indicate that mutations in COL4A5 that leading to renal failure are more frequent than those involved in classic Alport syndrome, and also that mutations in COL4A6 are not likely to cause this disease. Furthermore, mutations in COL4A5 are distributed quite randomly and no "hot spots" were found.
Inequalities in health
Authors: K. Williams
Journal: BMJ (1995)

and 73% (3147/4286) in those in category 7.Conversely, the proportions of pregnancies that resulted in termination were 50% (362/731) in women in deprivation category 1 and 14% (602/4286) in those in category 7. When planning health services to meet the needs of the population it is obviously essential to have information by deprivation category.
Multicenter Feasibility Study of Tumor Molecular Profiling to Inform Therapeutic Decisions in Advanced Pediatric Solid Tumors
Authors: Marian H. Harris, Steven G. DuBois, Julia L. Glade Bender, AeRang Kim, Brian D. Crompton, Erin Parker, Ian P. Dumont, Andrew L. Hong, Dongjing Guo, Alanna Church, Kimberly Stegmaier, Charles W. M. Roberts, Suzanne Shusterman, Wendy B. London, Laura E. MacConaill, Neal I. Lindeman, Lisa Diller, Carlos Rodriguez-Galindo, Katherine A. Janeway
Journal: JAMA Oncology (2016)

Pediatric cancers represent a unique case with respect to cancer genomics and precision medicine, as the mutation frequency is low, and targeted therapies are less available. Consequently, it is unknown whether clinical sequencing can be of benefit.To assess the feasibility of identifying actionable alterations and making individualized cancer therapy (iCat) recommendations in pediatric patients with extracranial solid tumors.Clinical sequencing study at 4 academic medical centers enrolling patients between September 5, 2012, and November 19, 2013, with 1 year of clinical follow-up. Participants were 30 years or younger with high-risk, recurrent, or refractory extracranial solid tumors. The data analysis was performed October 28, 2014.Tumor profiling performed on archived clinically acquired specimens consisted of mutation detection by a Sequenom assay or targeted next-generation sequencing and copy number assessment by array comparative genomic hybridization. Results were reviewed by a multidisciplinary expert panel, and iCat recommendations were made if an actionable alteration was present, and an appropriate drug was available.Feasibility was assessed using a 2-stage design based on the proportion of patients with recommendations.Of 100 participants (60 male; median [range] age, 13.4 [0.8-29.8] years), profiling was technically successful in 89 (89% [95% CI, 83%-95%]). Median (range) follow-up was 6.8 (2.0-23.6) months. Overall, 31 (31% [95% CI, 23%-41%]) patients received an iCat recommendation and 3 received matched therapy. The most common actionable alterations leading to an iCat recommendation were cancer-associated signaling pathway gene mutations (n = 10) and copy number alterations in MYC/MYCN (n = 6) and cell cycle genes (n = 11). Additional alterations with implications for clinical care but not resulting in iCat recommendations were identified, including mutations indicating the possible presence of a cancer predisposition syndrome and translocations suggesting a change in diagnosis. In total, 43 (43% [95% CI, 33%-53%]) participants had results with potential clinical significance.A multi-institution clinical genomics study in pediatric oncology is feasible and a substantial proportion of relapsed or refractory pediatric solid tumors have actionable alterations.clinicaltrials.gov Identifier: NCT01853345.
Abstract 11418: Clinical Predictors of Endovascular Therapy for Small Vessels of Femoropopliteal Lesion
Authors: Seiichi Hiramori, Yoshimitsu Soga
Journal: Circulation (2013)

Purpose: The outcome of EVT for small vessels of femoropopliteal (FP) lesion is not good. However, little is known about the predictors of clinical outcome.

Methods: REAL-FP is retrospective multicenter analysis of EVT for FP lesions at 13 Japanese medical centers from January 2004 to December 2011. 2742 patients, 3471 limbs were registered. We defined small vessel as less than 4 mm in diameter and excluded vessels over 4mm. Finally, we analyzed 463 patients, 530 limbs and investigated the predictors of primary patency of EVT for small vessels.

Results: The mean follow interval was 27 ± 21 months. Mean age was 71.5 ± 9.5 years and 58% was male. Mean lesion length 104.9 ± 83.1mm and the rate of stent use was 46%. In univariate analysis, age (HR 1.02 [95%CI:1.00-1.03]), female (1.37[1.06-1.76]), diabetes (1.32[1.01-1.75]), CLI (1.34[1.03-1.74]), TASCII classification (2.47[1.91-3.19]), stent use (1.77[1.37-2.28]), total stent length (1.00[1.00-1.01]), cilostazole (0.65 [0.49-0.85]), vessel diameter (0.68[0.51-0.93]) were significant risk factors. After adjustment for age, female, diabetes, CLI, TASCII classification, stent use, cilostazole, and vessel diameter, age (HR 1.01[95% CI:1.00-1.03]), TASCII classification (2.00[1.50-2.67]), stent use (1.39[1.05-1.85]) and cilostazole (0.69[0.52-0.90]) were still significant risk factors. We assigned one point to age (>70 years), TASCII classification, stent use and cilostazole, and calculated total mark (maximum 4, minimum 0. However, there was no 0 point case.). We took those initials and named it CAST score. At 2 years, primary patency rate of CAST score 4 group was significant lower than other groups (67%, 54%, 40%, and 17% for score 1, 2, 3, 4, respectively, log-rank p<.0001).

Conclusions: Cilostazole, age, stent use and TASCII classification were independent predictors of primary patency. And CAST score is the useful tool that we can predict primary patency of EVT for small vessels of FP lesion.

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Quantitative HER2 levels and steroid receptor expression in primary breast cancers and in matched brain metastases.
Authors: Wojciech Biernat, Renata Duchnowska, Tomasz Trojanowski, Tomasz Mandat, Anna Kowalczyk, Bogumila Czartoryska-Arlukowicz, Barbara Radecka, Bozena Jarosz, Rafal Staszkiewicz, Ewa Kalinka-Warzocha, Malgorzata Chudzik, Jeff Sperinde, Mojgan Haddad, Agnes Paquet, Yolanda Lie, John William Winslow, Jodi Marie Weidler, Weidong Huang, Christos J. Petropoulos, Jacek Jassem
Journal: Journal of Clinical Oncology (2012)

603 Background: Breast cancer patients with HER2-positive tumors are at high risk for brain metastases. In the current study we examined expression of ER, PR and HER2 in primary breast tumors and in matched brain metastases, as changes of their levels might reflect modes of escape from therapy. Methods: Fifty-three pairs of matched formalin-fixed paraffin-embedded samples from primary breast cancers and brain metastases were assayed for ER and PR status by immuno-histochemistry, whereas HER2 expression was quantified using the novel HERmark assay. Nuclear staining of ER and PR &gt;10%, and relative fluorescence of HER2 &gt;17.8/mm 2 were considered as positive results. Results: HER2 levels in brain metastases were generally higher than in the primary tumors (p = 3e-6), with a median increase of 1.9-fold (range 0.08 to 199-fold). There were also substantial differences in ER and PR status between primary tumors and brain metastases. Loss of steroid receptor positivity in brain metastases was more frequent than its gain (ER: 46% vs. 26%; p = 0.16; PR: 57% vs. 23%; p = 0.044). These changes resulted in a net increase in the number of HER2-positive/ER-negative brain metastases, which more than doubled the proportion of primary breast tumors with this phenotype (26% vs. 11%, respectively; p = 0.08). Additionally, HER2 levels in the primary tumors significantly correlated with overall survival when stratified by ER status (p = 0.011). Conclusions: Brain metastases of breast cancer show significant changes in steroid receptor status and in quantitative HER2 levels compared to matched primary tumors. These data provide a rationale for future studies and may help in designing treatment strategies that target the most likely escape pathways of breast cancer.
Leukemogenic potential of adjuvant chemotherapy for early-stage breast cancer: the Eastern Cooperative Oncology Group experience.
Authors: M S Tallman, R Gray, J M Bennett, D Variakojis, N Robert, W C Wood, J M Rowe, P H Wiernik
Journal: Journal of Clinical Oncology (1995)

PURPOSE Since large numbers of patients with early-stage breast cancer now receive adjuvant chemotherapy containing cyclophosphamide, a known leukemogenic agent, it is important to determine the risk of secondary acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Therefore, we identified all cases of AML or MDS developing in patients treated on six clinical adjuvant chemotherapy trials conducted by the Eastern Cooperative Oncology Group (ECOG). PATIENTS AND METHODS The patients population included 2,638 patients with previously untreated primary operable breast cancer entered onto six clinical trials conducted by the ECOG between 1978 and 1987. There are 19,200 persons-years of follow-up study and a mean follow-up duration of 7.3 years. Clinical data were obtained from flow sheets submitted to the ECOG Data Management Office. RESULTS Of 2,638 patients at risk with 19,200 person-years of follow-up study, three patients developed MDS (two with a characteristic cytogenetic abnormality). Two patients developed acute leukemia; however, one had adult T-cell leukemia associated with human T-lymphotrophic virus type 1 (HTLV-1) and a second patient developed AML after receiving additional cyclophosphamide for metastatic breast cancer. The estimated incidence rate for MDS is three per 19,200 or 16 per 100,000 person-years of follow-up study with a 95 percent confidence interval of three to 46 per 100,000 person-years. If all five patients (three MDS and two acute leukemia) are included, the estimated incidence rate is five per 19,200 or 26 per 100,000 person-years of follow-up study with a 95 percent confidence interval of eight to 61 per 100,000 person-years. CONCLUSION These data suggest that the risk of secondary AML or MDS among patients with early breast cancer who receive standard-dose cyclophosphamide-containing adjuvant chemotherapy is not much higher than in the general population. However, physicians must remain alert to the possible long-term consequences of alkylating agent and anthracycline-based chemotherapy.
Pre-operative chemoradiation with cisplatin (CDDP), 5-fluorouracil (5FU), and paclitaxel (Tax), followed by surgery and adjuvant chemotherapy, for loco-regional esophageal carcinoma
Authors: S. Urba, J. Hayman, M. Ianettonni, M. Orringer, J. Scheiman, Z. Yuan, T. Braun
Journal: Journal of Clinical Oncology (2004)

4029 Background: We conducted a trial for patients (pts) with loco-regional esophageal carcinoma consisting of pre-operative chemoradiation followed by surgery and then adjuvant chemotherapy. Methods: The pre-op regimen was 5-FU 200 mg/m2/day continuous infusion on Days #1–26, CDDP 30 mg/m2 and Tax 45 mg/m2 on Days #3, 10, 17, and 24. Radiation was 45 Gy in 1.5 Gy bid over 3 weeks. Transhiatial esophagectomy was done on approximately Day #43. Post-op chemo was 5FU 750 mg/m2/day continuous infusion on Days #71–75 and #99–103, CDDP 50 mg/m2 on Days #71–72, and #99–100, and Tax 135 mg/m2 on Day #71 and #99. Results: 65 eligible pts enrolled. Sex: male-52, female-13. Age: median – 60, range –40–73. Histology: adenoCA – 85%, squamous – 14%, undifferentiated – 1%. Toxicity (grade 3 or 4): neutropenia – 12%, thrombocytopenia – 5%, diarrhea – 11%, nausea – 6%; 1 treatment-related death. 60% of pts (39/65) did not receive the planned post-op adjuvant chemotherapy. 60 pts went to surgery; 59 had complete resections, 1 had positive margins. Pathologic complete response was 17%. Median follow-up = 2.2 years. Survival: median – 2.8 years; 1 year – 78%; 3 year – 50%. Disease-free survival: median – 2 years; 1 year – 65%; 3 year – 45%. There was no significant difference in survival based on the amount of pre-op or post-op chemotherapy received. Conclusions: This 3-drug, intensive combined modality regimen resulted in a very promising survival rate. No significant financial relationships to disclose.
Pilot Trial of Interleukin-2 With Granulocyte Colony-Stimulating Factor for the Mobilization of Progenitor Cells in Advanced Breast Cancer Patients Undergoing High-Dose Chemotherapy: Expansion of Immune Effectors Within the Stem-Cell Graft and Post–Stem-Cell Infusion
Authors: J.A. Sosman, P. Stiff, S.M. Moss, P. Sorokin, B. Martone, R. Bayer, K. van Besien, S. Devine, W. Stock, D. Peace, Y. Chen, C. Long, D. Gustin, M. Viana, R. Hoffman
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To evaluate whether administration of interleukin-2 (IL-2) with granulocyte colony-stimulating factor (G-CSF) improves mobilization of immune effector cells into the stem-cell graft of patients undergoing high-dose chemotherapy and autografting. PATIENTS AND METHODS: We performed a trial of stem-cell mobilization with IL-2 and G-CSF in advanced breast cancer patients receiving high-dose chemotherapy with cyclophosphamide, thiotepa, and carboplatin and stem cells followed by IL-2. The trial defined immune, hematologic, and clinical effects of IL-2 in this setting. RESULTS: Of 32 patients enrolled, nine received G-CSF alone for mobilization. Twenty-one of 23 patients mobilized with IL-2 plus G-CSF had stem cells collected with more mononuclear cells than those receiving G-CSF (19.3 v 10.4 × 10 8 /kg; P = .006), but fewer CD34 + progenitor cells (6.9 v 22.0 × 10 6 /kg; P = .049). The IL-2 plus G-CSF–mobilized patients had greater numbers of activated T (CD3 + /CD25 + ) cells (P = .009), natural killer (NK; CD56 + ) cells (P = .007), and activated NK (CD56 bright + ) cells (P = .039) than those patients mobilized with G-CSF. NK (P = .042) and lymphokine-activated killer (LAK) (P = .016) activity was increased in those mobilized with IL-2 + G-CSF, whereas G-CSF–mobilized patients had a decline in cytolytic activity. In the third week posttransplantation, immune reconstitution was superior in those mobilized with IL-2 plus G-CSF based on greater numbers of activated T cells (P = .003), activated NK cells (P = .04), and greater LAK activity (P = .003). The 16 of 21 IL-2 + G-CSF–mobilized patients with adequate numbers of stem cells (&gt; 1.5 × 10 6 CD34 + cells/kg) collected engrafted rapidly posttransplantation. CONCLUSION: The results demonstrate that G-CSF + IL-2 can enhance the number and function of antitumor effector cells in a mobilized autograft without impairing the hematologic engraftment, provided that CD34 cell counts are more than 1.5 × 10 6 cells/kg. Mobilization of CD34 + stem cells does seem to be adversely affected. In those mobilized with IL-2 and G-CSF, post–stem-cell immune reconstitution of antitumor immune effector cells was enhanced.
High-Dose Cytarabine Consolidation (≥1.5 g/m2) Might Have Shown a Better Outcomes Than Intermediate-Dose Cytarabine (1.0 g/m2) Combined With Anthracyclines In AML Patients Who Had Achieved Complete Remissions In The First Induction by Standard 3+7 Regimen
Authors: Yong Park, Ga-won Kang, Dae Sik Kim, Suk-young Lee, Se Ryeon Lee, Hwa Jung Sung, Chul Won Choi, Seok Jin Kim, Myunghyun Nam, Ji-Seon Choi, Soo-Young Yoon, Byung Soo Kim, Insun Kim
Journal: Blood (2013)
NHS must reform to avoid “busting” public finances, says health secretary
Authors: Gareth Iacobucci
Journal: BMJ (2015)

Healthcare spending in the United Kingdom has the potential to “bust national finances” unless new technologies and changes to service delivery are embraced, England’s health secretary, Jeremy Hunt, has warned.

Speaking at a fringe meeting organised by the Reform think tank at the Conservative Party’s conference in Manchester on 5 October, Hunt said that without such reform the funding currently available to the NHS would not be enough to help it cope with the “triple whammy” of an ageing …
Cortical gray matter volume deficit in patients with first-episode schizophrenia
Authors: K O Lim, W Tew, M Kushner, K Chow, B Matsumoto, L E DeLisi
Journal: American Journal of Psychiatry (1996)

A cortical gray matter deficit has been found in cross-sectional studies of patients with chronic schizophrenia. The purpose of this study was to examine whether this deficit is present early in the course of illness.The authors measured cortical gray matter volume on magnetic resonance images acquired within 6 months of onset of illness from 22 patients with first-episode schizophrenia and 51 age-matched comparison subjects from the Stony Brook First Episode Study.A significant cortical gray matter deficit and lateral ventricular enlargement were found in schizophrenic patients relative to the comparison group.The presence of the cortical gray matter deficit close to onset of illness supports the role of preexisting structural brain deficits in the genesis of schizophrenia.
Lessons learned — resolving the enigma of genetic factors in IBS
Authors: Maria Gazouli, Mira M. Wouters, Lejla Kapur-Pojskić, May-Bente Bengtson, Eitan Friedman, Gordana Nikčević, Christiana A. Demetriou, Agata Mulak, Javier Santos, Beate Niesler
Journal: Nature Reviews Gastroenterology & Hepatology (2016)