tbuckley/cabot-search huggingface dataset:
Response to primary chemotherapy (CHT) in advanced epithelial ovarian cancer (EOC) patients (pts) and molecular characterization of CHT-resistant tumor cell populations: Findings from the Arianna 02 Project
Authors: C. Zamagni, R. M. Wirtz, P. De Iaco, A. Altimari, K. Roth, F. Rosati, M. Rosati, F. Massari, N. Cacciari, A. A. Martoni
Journal: Journal of Clinical Oncology (2007)

16059 Background: Despite a high response rate to CHT the prognosis of pts with advanced EOC remains poor. The molecular analysis of pre- and post-CHT tumor specimen may enable the identification of CHT resistant tumor cell populations and thereby lead to adapted treatment options. Methods: Stage III-IV EOC pts diagnosed by laparoscopy and biopsy and not suitable for optimal debulking surgery were eligible. Gene-expression profiles generated from total RNA using the Affymetrix U133A oligonucleotide microarray containing over 22,000 probe sets were obtained at diagnosis and on surgical specimens after 6 courses of primary carboplatin/paclitaxel CHT. Initial comparative analysis focused on proliferative and invasive tumor activity, and on growth factor- and hormone receptors expression. Results: 30 pts were enrolled and data were analyzed according to response to CHT and to time to relapse after surgery. Initial expression analysis results reveal that the quantitative determination of growth factor- and hormone receptors in pre- and post-treatment samples can be used to discriminate responders from non-responders and relates to clinical outcome. Moreover, multiple CHT-resistant tumor cell populations displayed pronounced estrogen receptor expression suggesting a role of hormone receptors in the development of CHT resistance. Conclusions: While hormonal therapies are used in the treatment of other endocrine related tumors, they are not approved for the treatment of EOC. Treatment of EOC cell lines with estrogens down-regulates GnRH activity and promotes cell growth, while tamoxifen has an opposite effect. However, further biological data are lacking in this setting and only few clinical trials have addressed this possibility so far. We have found that the expression of hormone receptors in vivo persists in CHT-resistant tumor cell populations after CHT for EOC. We suggest that hormone receptor activity contributes to the initial development of CHT resistance; hence endocrine therapies particularly in an early setting may be advantageous to a subset of pts and are worth studying. No significant financial relationships to disclose.
Hypoxic challenge assessments in patients with obesity hypoventilation syndrome
Authors: Masood Ali, Ian Smith, Atul Gulati, John Shneerson
Journal: European Respiratory Journal (2012)

Background: With worldwide increase in obesity and air travel, more obese people are likely to travel by air in future. No prospective studies have investigated the degree of arterial hypoxaemia during a hypoxic challenge test (HCT) in patients with obesity hypoventilation syndrome (OHS).

Objectives: To investigate the likelihood of a positive HCT in patients with OHS who are not hypoxaemic at sea level and any possible predictors of desaturation during HCT.

Methods: Ten patients with OHS treated with long term nocturnal non invasive ventilation (NIV) were recruited. Clinically unstable patients and those with COPD were excluded. HCT was part of a detailed assessment and consisted of breathing 15% oxygen via a Douglas bag for 20 minutes.

Results: Mean age 57.4 years (±12.4) and mean BMI 52.8 (±13.3). Seven out of ten had a positive HCT (PaO2 < 6.6 kPa or SpO2 < 85%). Arterial blood gas was attempted in all but could not be taken in two patients. Mean PaO2 before and during HCT was 10 kPa (± 0.4) and 6.2 kPa (± 0.5) respectively. Mean PaCO2 before and during HCT was 5.5 kPa (± 0.8) and 5.3 kPa (± 0.8) respectively. Baseline PaCO2 correlated negatively with PaO2 and SpO2 during HCT ( r = -.823, p = .012 and r = -.795, p = .018 respectively). BMI, baseline PaO2 and SpO2, distance walked and minimum SpO2 during ISWT were not significantly correlated with the PaO2 or SpO2 during HCT.

Conclusion: Seventy percent of these patients had a positive HCT despite adequate control of their ventilatory failure. Baseline PaCO2 but not the PaO2 or SpO2 was predictive of a positive HCT. Although these results need to be confirmed in larger studies, we suggest assessment of these patients including a HCT before air travel.
Characteristics of men with abnormal prostate-specific antigen (PSA) who had a biopsy in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO).
Authors: W. G. Hocking, C. McCarty, T. Riley, T. Hickey, J. K. Burmester, D. Reding
Journal: Journal of Clinical Oncology (2010)

4659 Background: PLCO is a large-scale, randomized study to determine whether certain screening tests will reduce the number of deaths from these cancers. Methods: PLCO compared screening procedures to a control group to determine the sensitivity and specificity of those screening tests. For prostate cancer (PCA), digital rectal examination (DRE) and a blood test (PSA) were done at baseline and annually × 5. 38,342 men were eligible for analysis in the screened arm (PSA, DRE). 37,450 men answered a baseline questionnaire. Groups were analyzed as Group 1 first positive PSA >4; Group 2 first positive PSA, prior negatives; Group 3 not first positive PSA, no biopsy (bx); Group 4 not first positive PSA, had prior biopsies. 6,301 men were eligible for PSA analysis. Results: Group 1 (no prior PSA positive) 2,830 men; Group 2 (first positive) 3,471 men; Group 3 (multiple positive PSA, no bx) 2,350 men; Group 4 (multiple positive, negative prior bx) 1,557 men. Characteristics of men having a bx were analyzed to determine if different characteristics influence bx. Factors analyzed include age, family history of PCA, BMI, smoking status, prior STD, prostate symptoms, alcohol, smoking, education, and PSA level. Chi-squared and logistic regression analyses were used to determine significant factors. PSA elevation and presence of prostate cancer symptoms were significant factors influencing bx in all groups. Presence of symptoms in Group 1 56.5%, Group 2 70.6%, Group 3 57.6%, and Group 4 58.4%. Mean PSA was higher in Group 1 (6.55) and Group 4 (6.82). Age was younger in Group 1. Logistic regression analysis showed different factors affecting bx by group. Factors influencing bx by group with analysis controlling for PSA: Group 1 - increased rate of bx of PSA >7, family history PCA, BMI 25<30; Group 2 - increased rate of bx of PSA 7-10, decreased rate of bx, education, former smoker, BMI <18.5; Group 3 - increased rate of bx of PSA >7, former smoker; Group 4 – increased rate of bx of PSA >7. Conclusions: In a PCA screening trial, presence of prostate symptoms and elevated PSA lead to significant rates of prostate bx for PCA. Minor variation in other demographic factors affected bx rates by category. No significant financial relationships to disclose.
A peer review quality assurance program for outpatient radiation treatments.
Authors: Matthew T. Ballo, Gregory Chronowski, Pamela Schlembach, Elizabeth S. Bloom, Isidora Arzu, Deborah A. Kuban
Journal: Journal of Clinical Oncology (2013)

13 Background: Our outpatient radiation treatment centers implemented a peer review program in 2007 that required presentation of all definitive cases to a weekly peer review conference. The purpose of this review is to document compliance and determine how this program impacted care over 4 years. Methods: Between 9/2007 and 9/2011, 2,988 patients were eligible for peer review. Patient data was presented to a group of physicians, physicists, and dosimetrists via teleconferencing and the radiotherapy plan was reviewed. Details of any changes made to patient care were documented within a QA note dictated after discussion. Any changes recommended by the peer review process were categorized as changes to radiation dose, target, or major changes. Results: Breast cancer accounted for 47.9% of all cases, followed in frequency by H/N (14.8%), GI (9.9%), GU (9.3%), and thoracic (6.7%) malignancies. Of the 2,988 eligible patients, 158 (5.3%) were not presented for peer review. The number of missed presentations decreased over time; 2007-8.2%; 2008-5.7%; 2009-3.8%; and 2010-2.7% (p&lt;0.001). The reason for a missed presentation was unknown, but varied by disease site and physician. Of the 2,830 cases presented for peer review, a change was recommended in 346 cases (12.2%) and categorized as a dose change in 28.3%, a target change in 69.1% and a major treatment change in 2.6%. When examined by year of treatment the number of changes recommended decreased over time: 2007-16.5%; 2008-11.5%; 2009-12.5%; and 2010-7.8% (p&lt;0.001). The number of changes recommended varied by disease site and physician. H/N, GYN, and GI malignancies accounted for the majority of changes made. Conclusions: Compliance with this weekly peer review QA program was satisfactory and improved significantly over the 4 year study period. The QA program resulted in decreased treatment plan changes over time reflecting a move toward radiation treatment consensus and consistency. Weekly peer review directly improved care in all patients by creating a culture of QA where guideline adherence and discussion are part of normal practice.
Can Early Measurement of Urinary N-Acetyl-β-Glucosaminidase Help Predict Toxicity of Cisplatin-Based Chemotherapy?
Authors: Miho Tamura, Yasuhiro Arakawa, Masaharu Kawashima, Kazuhito Suzuki, Hiroki Yokoyama, Tadashi Uwagawa, Toshikazu Sakuyama, Keisuke Aiba
Journal: Annals of Oncology (2014)
Reduced-intensity allogeneic stem cell transplantation for diffuse large B-cell lymphoma: Clinical evidence of a graft-versus-lymphoma effect
Authors: M. R. Bishop, R. M. Dean, S. Steinberg, J. Odom, S. Z. Pavletic, C. Kasten-Sportes, N. Hardy, S. Pittaluga, R. Gress, D. H. Fowler
Journal: Journal of Clinical Oncology (2006)

6546 Background: Despite being the most common non-Hodgkin’s lymphoma, there have been no specific reports on the use of reduced-intensity (RI) allogeneic stem cell transplantation (alloSCT) to treat patients (pts) with diffuse large B-cell lymphomas (DBCL). This may be due to a lack of definitive evidence for a therapeutic graft-versus-lymphoma (GVL) effect against DLBC. We undertook a retrospective analysis to assess clinical outcomes and evidence of a GVL effect in DLBC pts undergoing RI alloSCT. Methods: The analysis was limited to 18 pts with primary refractory (n = 6) or relapsed (n = 12) DLBC. The median age was 43 years (range: 31–61); median number of previous treatments was 3 (range: 2–9). Nine (50%) pts had undergone autologous transplantation. Three (16%) pts were determined to have chemo-sensitive disease to last treatment prior to RI alloSCT. All pts received a RI conditioning regimen consisting of fludarabine (30 mg/m 2 /d × 4d) and cyclophosphamide (1200 mg/m 2 /d × 4d) followed by a T-cell replete allograft from HLA-matched siblings. Results: Median potential follow-up from transplant is 43 months. Seven (39%) pts developed grade II-IV acute GVHD. Response at day +100 post-transplant was as follows: complete response (CR/CRu) = 5; partial response = 5; progressive disease = 8. Nine of 17 (53%) evaluable pts developed chronic GVHD. Median progression-free survival (PFS) was 4.8 months; however, PFS after 9 months post-transplant was 31% with 5 pts in continuous CR/CRu &gt; 12 months post-transplant. Among 14 pts who were not in CR/CRu (n = 12) or progressed after achieving a CR/CRu (n = 2) at day +100 post-transplant, 8 (57%) subsequently achieved a CR/CRu after removal of immune suppression and/or donor lymphocyte infusion (DLI) ± chemotherapy. Seven of these 8 pts remain in continuous (median = 34 months; range: 6–55+) CR/CRu without further treatment. Median survival for all 18 pts was 19 months with survival probability of 40% plateauing at 25 months post-transplant. Conclusions: The clinical observations of sustained CR/CRu after withdrawal of immune suppression and DLI suggest that a GVL effect exists against DLBC. RI alloSCT should be considered as a treatment option for pts with primary refractory and relapsed DLBC. No significant financial relationships to disclose.
Clinical outcomes of a multi-institutional retrospective study for 419 patients with locally advanced non-small cell lung cancer (NSCLC)
Authors: M. Ichikawa, T. Mio, S. Teramukai, M. Nakagawa, Y. Nagata, S. Fujita, K. Yanagihara, H. Ishiguro, M. Hiraoka, M. Mishima
Journal: Journal of Clinical Oncology (2006)

17058 Background: Chemo-Radiotherapy (CRT) is considered the standard of care in locally advanced NSCLC. However, regimen of chemotherapy (CT), schedule of radiotherapy (RT), and application for surgical interventions (OP) are still controversial. We performed a study to establish clinical outcomes of NSCLC patients treated with CRT in Japan. Methods: A total of 373 consecutive patients (CRT: 307, OP after CRT (OP/CRT): 66) with stage III NSCLC, PS 0–2, no indications of OP at the initial evaluation, treated with CRT between January 1997 and December 2002 were analyzed. We also investigated 46 patients treated with RT alone as control. Results: We investigated a total of 419 patients (354 men and 65 women; average age: 64.5 ± 9.5 years) from nine institutes. Distributions of pathological subtypes were: squamous cell carcinoma: 225; adenocarcinoma: 154; large cell carcinoma: 14; non-small cell carcinoma: 26. In 189 stage IIIA patients, median survival time (MST) was 21.2 M, and MST of CRT, OP/CRT and RT were 19.1 M, 61.7 M, and 18.0 M, respectively. Multivariate analysis with Cox proportional hazards model indicates age, PS, existence of double cancer, existence of diabetes mellitus, stage IIIB, white blood cell counts increase, hemoglobin decrease as significant prognostic factors in CRT or OP/CRT patients. Multivariate analysis in stage IIIA patients indicated BMI decrease, double cancer, body weight loss, white blood cell increase, hemoglobin decrease as prognostic factors. There was a statistically significant difference between overall survival of CRT and OP/CRT in stage IIIA patients (p = 0.038 after adjustment for the effect of prognostic factors). However, there were no differences between CRT and RT, and among any schedules of CRT therapy. Conclusions: This clinical study suggests that OP after CRT could results in good survival compared with CRT alone, and BMI, double cancer, body weight loss, white blood cell, and hemoglobin could be prognostic factors in locally advanced NSCLC. No significant financial relationships to disclose.
Capecitabine + epirubicin + cyclophosphamide (CEX) has comparable safety to 5-FU + epirubicin + cyclophosphamide (FEC) as neoadjuvant therapy in patients (pts) with operable breast cancer (BC): Early safety findings from a randomized phase III trial
Authors: H. Roché, R. Deporte, D. Berton-Rigaud, B. Coudert, N. Tubiana-Mathieu, J. Ferrero, H. Orfeuvre, B. Audhuy, L. Bobadilla, P. Fumoleau
Journal: Journal of Clinical Oncology (2006)

10655 Background: FEC100 is an established regimen in early-stage BC. Substituting capecitabine (X) for 5-FU in the neoadjuvant setting is logical. Here we present interim safety findings from a phase III trial of CEX vs. FEC as neoadjuvant chemotherapy in operable BC. Methods: Between Mar 04 and Jan 05, 60/182 planned pts were randomized to receive CEX (X 900mg/m 2 bid d1–14, epirubicin 100mg/m 2 and cyclophosphamide 500mg/m 2 d1) or FEC (short i.v. infusions of 5-FU 500mg/m 2 , epirubicin 100mg/m 2 and cyclophosphamide 500mg/m 2 d1), q3w x4. Surgery with lymph node dissection was performed &lt;5 wks (±1 wk) after last course of treatment. The primary endpoint was pCR. All patients received 4 courses of docetaxel 100 mg/m 2 d1 after surgery. All adverse events (AEs) were graded according to the NCI-CTC (v3.0) and the Hand-Foot Syndrome (HFS) classification. Peripheral blood mononuclear cells (PBMC) were evaluated for dihydropyrimidine deshydrogenase (DPD) deficiency. Results: Baseline characteristics in the CEX (n = 30) vs. FEC (n = 30) groups: median age (49.1 vs. 50.8 years); ER+/PR+ (60%/53% vs. 73%/37%). The median no. of cycles received was 4 in each group. The overall rate of AEs was very similar in the two groups, with no difference in grade 3/4 neutropenia. FEC was associated with more grade 3/4 nausea/vomiting (see table) . No evidence of PBMC DPD deficiency was observed. Conclusions: CEX and FEC are well tolerated in neoadjuvant BC. CEX offers the potential benefit of greater tumor exposure to 5-FU. Our findings also indicate that toxicity is not related to DPD activity. Recruitment is ongoing. [Table: see text] [Table: see text]
Increased TCF-4 Expression Correlates with Reduced Caspase-3 Induction and Confers Resistance to Bortezomib.
Authors: Reshma Shringarpure, Deepak Bhole, Renate Burger, Laurence Catley, Klaus Podar, Yu-Tzu Tai, Teru Hideshima, Constantine Mitsiades, Nikhil C. Munshi, Dharminder Chauhan, Kenneth C. Anderson
Journal: Blood (2004)
Are skin reactions a surrogate marker in predicting response to therapy in patients with chronic myeloid leukemia receiving imatinib?
Authors: S. V. Attili, P. Bapsy, D. Lokanatha, K. Govindababu, J. George, L. A. Jacob, H. K. Dadhich, G. Anupama
Journal: Journal of Clinical Oncology (2007)

17539 Background: One of the common toxicities observed with small molecule tyrosine kinase inhibitors are skin rashes, which were proven to predict the response to therapy in cases of lung cancer (Ann. Onc., 2005; 16(5): 780 - 785). However, very few have evaluated the same in patients with chronic myeloid leukemia (CML) on treatment with imatinib. Therefore we thought of doing a prospective study to evaluate skin rashes, and compare it with the clinical, hematological, cytogenetic and molecular remission rates in CML patients on Imatinib therapy. Methods: It is a non randomized, prospective study conducted at a tertiary care cancer center with an approximate attendance of 15,000 new cases. The patients were stratified into those who had skin reactions and do not. CTC version 3.0 was used to assess the skin toxicity. Differences in the proportions were calculated with the help of Medcalc Version 7.5. Results: A total of 314 patients with CML were evaluated who were on regular treatment with Imatinib. Hematological response was assessed monthly, cytogenetic analysis (available in 212 patients) at the end of 3 rd month and molecular response (available in 136 patients) at the end of 6 th months respectively. The response rates in two groups are as follows. *Percentages calculated for the subset of patients in whom results of either cytogenetic or molecular response are available Conclusion: Our findings suggest that skin reactions are not a good marker to predict either response rates or progression free interval in cases of CML. This is further substantiated by the findings that the percent of skin reactions in west are far less compared to our results, who had a better molecular as well as cytogenetic responses. [Table: see text] No significant financial relationships to disclose.
Challenging Cases and Diagnostic Dilemmas
Authors: Mitchell A. Garrison, Christopher Glanton, Mark Rasnke, Michael E. Smith, Deborah L. Ornstein
Journal: Journal of Clinical Oncology (2002)

Article Tools DIAGNOSIS IN ONCOLOGY Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2002.20.15.3344 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 12149308 Challenging Cases and Diagnostic Dilemmas Case 1. Tracheal Compression in Hodgkin's Disease Mitchell A. GarrisonxMitchell A. GarrisonSearch for articles by this author , Christopher GlantonxChristopher GlantonSearch for articles by this author , Mark RasnkexMark RasnkeSearch for articles by this author , Michael E. SmithxMichael E. SmithSearch for articles by this author , Deborah L. OrnsteinxDeborah L. OrnsteinSearch for articles by this author Show More Brooke Army Medical Center and Wilford Hall Medical Center, San Antonio, TX https://doi.org/10.1200/JCO.2002.20.15.3344 First Page Full Text PDF Figures and Tables © 2002 by American Society of Clinical Oncology
Assessment of inter-observer and intra-observer variability in measuring compliance of breast tissue with the Tissue Compliance Meter in healthy volunteers: Implications for studying fibrosis in breast cancer patients
Authors: G. A. Wernicke, P. Parhar, M. Rasca, P. Christos, A. Fischer, D. Nori
Journal: Journal of Clinical Oncology (2008)

11558 Background: As survival of breast cancer patients increases, management of long-term toxicities presents a challenge. Intervention for radiation or chemotherapy-induced fibrosis (RIF or CIF) occurs mostly when it is irreversible. Objective quantification of RIF/CIF in evolution remains a challenge. Prior to measuring fibrosis with TCM, we assess it in healthy volunteers with regard to inter- observer/intra-observer variability. Methods: Three independent physicians applied TCM to 4 locations of the right and left breasts, respectively: upper outer quadrant, lower outer quadrant, lower inner quadrant, and upper outer quadrant. In the blinded fashion, every investigator obtained 3 consecutive measurements in each quadrant. Twenty healthy volunteers, with no breast disease or surgical intervention, partook in this project. The median age was 33 years (range, 24–55). All subjects were matched for use of oral contraceptives, hormone replacement therapy, and pre- or post-ovulatory status in the menstrual cycle. Results: The results for the difference between the average readings for the right and left respective quadrants (paired data) obtained by the 3 raters revealed no significant difference (intra- observer variability). A 2-way ANOVA method was applied to assess the variability in the obtained measurements, while controlling for variability between readers and patients. For 4 quadrants of both breasts, there was no statistically significant difference among the measurements performed by each investigator (intra-observer variability) (p>0.05). Further, while there was variability among patients (p<0.0001), there was no significant variability among readers (inter-observer variability) (p>0.05). Conclusions: Our data indicate that TCM objectively measures breast tissue compliance. Inter-observer and intra-observer variability is small and the measurements are reproducible. We can now embark on analyzing TCM in evolution of RIF/ CIF. Potential implications for the survivors of breast cancer are detection and treatment of early functional impairment induced by fibrosis, while it is still in evolution and reversible. No significant financial relationships to disclose.