tbuckley/cabot-search huggingface dataset:
Pegylated liposomal doxorubicin, 5-fluorouracil and cisplatin versus mitomycin-C, 5-fluorouracil and cisplatin for advanced gastric cancer: A randomised phase II trial
Authors: S. Cascinu, R. Labianca, V. Catalano, F. Ferraù, F. Pucci, R. R. Silva, G. Luppi, R. Berardi, G. D. Beretta
Journal: Journal of Clinical Oncology (2008)

13521 Background: In the treatment of gastric cancer a debated question is represented by the role of anthracyclines. In fact, in spite of the results obtained by ECF and the Cochrane’s metanalysis results, there is no general agreement on the contribution of anthracyclines to cisplatin and 5-fluorouracil (5FU). The development of alternative formulations of anthracyclines, such as pegylated liposomal doxorubicin with lower inherent toxicity may improve tolerability and efficacy of anthracycline based regimens. Based on these considerations, a combination of pegylated liposomal doxorubicin, 5FU and cisplatin was evaluated and compared with mitomycin-C and 5FU and cisplatin which served as internal control arm to avoid selection bias. Methods: Patients with locally advanced and/or metastatic gastric cancer were randomly assigned to receive: 5FU 400 mg/m2 bolus, followed by 600 mg/m2, 22h continuous infusion day and 2 and cisplatin 50 mg/m2 day 1 every two weeks combined with pegylated liposomal doxorubicin 20 mg/m2 day 1 every two weeks or mitomycinC 7 mg/m2 every 6 weeks. Results: Seventy-eight patients were randomly assigned. Toxicity was rarely severe. Major toxic effects included leukopenia and cutaneous toxicity, 305 and 25% of patients, respectively in liposomal doxorubicin arm, and leukopenia and thrombocytopenia (35% and 33%, respectively) in mitomycin-C arm. Activity and efficacy are summarised in table 1. Conclusions: Liposomal doxorubicin in combination with 5FU and cisplatin shows promising efficacy compared with a three-drug regimen commonly used in our group. The three-drug regimen including liposomal doxorubicin could be compared with the TCF regimen and may represent a treatment option for the treatment of advanced gastric cancer. Liposomal Doxorubicin Mitomycin-C Evaluable patients 39 39 CR 5 4 PR 17 11 SD 10 13 PD 7 11 PFD (median, months) (HR 0.62, 95%CI, 0.37–0.97, p= 0.04) 7.93 5.14 OS (median, months) (HR, 0.59. 95% CI, 0.34–0.94, p=0.02) 12.1 8.3 No significant financial relationships to disclose.
Temporal trends in colorectal cancer stage and presentation since the introduction of a national bowel screening program.
Authors: David Mansouri, Christine Crearie, Donald C. Mcmillan, Emilia M. Crighton, Paul G. Horgan
Journal: Journal of Clinical Oncology (2015)

522 Background: Screening for colorectal cancer using the fecal occult blood test (FOBt) reduces cancer specific mortality through the detection of early stage disease. However, population screening programs are limited by both uptake and the sensitivity of the test. The present study aimed to examine the effect of a national screening program on TNM stage and presentation in our geographical region. Methods: A biennial FOBt screening program, inviting all males and females aged 50 to 74 years, was introduced in 2007 in a stepwise manner across the region with full coverage achieved by 2011. Regional cancer audit databases and national population statistics were examined to compare Early screening introduction (2007/8), Late screening introduction (2009/10) and Post screening (2011/12) time periods. Results: In a population of 2.4 million, over a 6 year period, 9,723 patients were diagnosed with colorectal cancer (3098 Early; 3282 Late; 3343 Post). There was a small overall increase in incidence during the study period (0.064%/year Early vs 0.068%/year Post, p=0.017). This increase remained when adjusting for sex in both males and females. There was no difference in the age, sex or socioeconomic deprivation status of patients across the three time periods. The proportion of screen-detected cancers increased over time (3% Early vs 18% Post, p&lt;0.001) with a concomitant fall in elective symptomatic presentations (62% Early vs 47% Post, p&lt;0.001). No difference in the proportion of emergency presentations was seen (13% Early vs 13% Post, p=0.282). There was no difference in tumor site (p=0.692) or overall TNM stage at diagnosis (p=0.548) over time. However, when those presenting with non-metastatic disease were examined separately, there was clear trend towards earlier stage disease (18% Stage 1 Early vs 28% Stage 1 Late, p&lt;0.001). Conclusions: Despite only accounting directly for a limited proportion of all tumors detected, the introduction of a national screening program has been accompanied by a stage shift in colorectal cancer disease towards earlier presentation. Further work is required to target those more likely to present as an emergency as they appear resistant to the current program.
Abstract 14057: P Wave Indices and Risk of Atrial Fibrillation: Cross-Cohort Assessments From the Framingham Heart Study and Atherosclerosis Risk in Communities Study
Authors: Jared W Magnani, Faye Lopez, Lei Zhu, Emelia J Benjamin, Michael J Pencina, Elsayed Z Soliman, Alvaro Alonso
Journal: Circulation (2013)

Introduction: P wave indices (PWI) have been employed in risk algorithms for atrial fibrillation (AF). PWI measure atrial electrical function and are quantified by duration, area, and amplitude. We...
Abstract P154: Association of Coronary Calcium Score with Cardiovascular Risk Factors in African Americans: The Jackson Heart Study (JHS)
Authors: Che L Smith, Joseph Yeboah, Mario Sims, Jane L Harman, J G Terry, Mary E Crump, Michael Doherty, J J Carr, Herman A Taylor
Journal: Circulation (2012)

Background: It remains unclear if individuals with low Framingham risk score (FRS) could benefit from coronary artery calcium (CAC) screening for coronary heart disease (CHD) risk, especially in African Americans (AA) who have a lower prevalence of CAC and in whom the FRS is less robust. The CAC score has previously been shown to independently predict hard events in AA men and women. We assessed the association of CAC with cardiovascular risk factors and its distribution by the FRS categories in AA who were part of the Jackson Heart Study (JHS). Methods: CAC was measured with non-contrast cardiac CT in 2944 participants between April 2007 and February 2010 in the JHS, a NHLBI-funded cohort study of AA based in Jackson, MS. Participants were dichotomized based on the presence or absence of CAC. FRS was calculated based on 10 year risk for each participant and categorized as low (&lt;10%), intermediate (10–20%) and high (&gt;20%). Multi-variable linear and logistic regression analyses were used to estimate the associations of CAC with cardiovascular risk factors by FRS categories in AA. Results: The mean age of the cohort is 60 years, 65% were females, 26% had diabetes mellitus, 50% were obese (BMI≥30) and 30% were current or former smokers. Participants with CAC were significantly older (mean age 65 vs. 55 years, p&lt;0.0001), had high mean SBP (131 vs.124mmHg, p&lt;0.0001) and had lower HDL. Males were more likely to have CAC compared with females [odds ratio (95% CI): 1.50(1.29 – 1.75), p&lt;0.0001], current and former smokers were also more like to have CAC compared with never smokers [OR (95%CI): 2.24(1.75 – 2.89), p&lt;0.006 and 2.10(1.73 – 2.55), p&lt;0.002 respectively]. Diabetics were more likely to have CAC compared with non diabetics [OR (95%CI): 3.27(2.70 – 3.96), p&lt;0.0001]. Total cholesterol and BMI were not different among subjects with CAC or without CAC. The distribution of CAC stratified by FRS groups of low, intermediate and high 10 year risk of CHD results in mean [median, range] CAC scores of 132.3 [0, (0–3884)], 101.8 [0, (0–5498)] and 315.1 [33.8, (0–10801)] and CAC prevalence of 39.7%, 42.1%, and 65.8%, respectively. After adjusting for age, gender, smoking status, systolic blood pressure and diabetes status, subjects with high FRS were about 3 times as likely to have CAC compared with subjects in the intermediate or low risk category [OR(95%CI): 2.92(2.41 – 3.51), p&lt;0.0001]. Individuals with intermediate FRS had similar rate of CAC compared with low FRS individuals. Conclusion: CAC in AA is strongly associated with traditional CV risk factors. Interestingly, AA with low and intermediate FRS have similar amounts and prevalence of CAC. This finding suggests that further refinement of traditional CHD risk models, such at FRS, may allow improved prediction of CHD and better targeting of prevention in the AA community.
A phase II study of the selective phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor idelalisib (GS-1101) in combination with rituximab (R) in treatment-naive patients (pts) ≥65 years with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).
Authors: Susan Mary O'Brien, Nicole Lamanna, Thomas J. Kipps, Ian Flinn, Andrew David Zelenetz, Jan Andreas Burger, Leanne Holes, David Michael Johnson, Jessie Gu, Roger D. Dansey, Ronald L. Dubowy, Steven E. Coutre
Journal: Journal of Clinical Oncology (2013)

7005 Background: PI3K-delta is critical for activation, proliferation and survival of B cells and plays a role in homing and retention in lymphoid tissues. PI3Kδ signaling is hyperactive in many B-cell malignancies. Idelalisib is a first-in-class, selective oral inhibitor of PI3Kδ. When combined with R in 19 relapsed/refractory patients with CLL, the ORR was 78% (Coutre, ASH 2012). Methods: Treatment-naive pts ≥65 yrs with CLL or SLL were treated with R 375 mg/m 2 weekly x 8 and idelalisib 150 mg bid continuously for 48 weeks (primary study). Pts completing 48 wks w/o progression could continue to receive idelalisib on an extension study. Responses and progression were based on investigator assessment using IWCLL criteria (Hallek, Blood 2008). Results: Data is presented here on the first 50 of 64 pts enrolled, 48 CLL/2 SLL, median age 71 yrs (range: 65-89), M/F 70/30 (%), Rai stage III/IV 10/32 (%), nodes ≥5 cm in 16%, WHO 0/1/2 in 34/64/2 (%); del(17p) in 6 pts and del(11q) in 13 pts. 32 pts completed 48 wks (18 discontinued, 11 due to AE, 4 due to death and 3 other); 30 pts entered the extension study and 26 remain on treatment. The median time on treatment was 16 months (range 0.8-27.5). The ORRwas 96% with 4% nonevaluable; median time to response was 1.9 mos (range 1.0-6.5). There have been no on-study relapses. The Kaplan-Meier estimated PFS is 91% at 24 mos. Of note, 6/6 pts with del(17p) responded (1 CR, 5 PR) and 3 remain on treatment for more than 21 months. 13/14 (93%) pts with thrombocytopenia and 12/12 (100%) pts with anemia at baseline responded. Of 20 pts with B symptoms at baseline, 13 (65%) were asymptomatic by 8 wks. Most frequent AEs (total%/ ≥G3%) were diarrhea (including reported as colitis) (46/16), pyrexia (42/4), chills (34/0), fatigue (34/2), rash (34/10), pneumonia (30/20) and nausea (28/0). Elevated ALT/AST was seen in 60%, Gr ≥3 in 22%. Conclusions: Idelalisib + R is highly active, resulting in durable disease control in treatment-naïve older pts with CLL. These results support the further development of idelalisib in frontline CLL. Clinical trial information: NCT01203930.
Clinical analysis of adverse reactions to second line anti TB drugs
Authors: Alpa Dalal, Ranjan Desai
Journal: European Respiratory Journal (2012)

Introduction: Adverse reactions to second line anti T B drugs not only leads to permanent system damage in patients but also MDR/XDR treatment failure  Aims and Objective: MDR/XDR TB patients on second line anti T B drugs were analysed clinicaly for adverse reactions.These patients underwent pretreatment counselling for possible adverse reactions to improve treatment adherance.  Methods: 146 patients with MDR/XDR T B on second line drugs were analysed. These adverse reactions were classified in to two groups. Severity based and system based. Severity further classified as 1) mild not requiring discontinuation of drugs 2) those requiring temporary discontinuation 3) requiring permanent discontinuation.  Results: 47.9 % had no adverse reactions. 21.3% had mild reactions.11.6% required temporary discontinuation and 19.2% required permanent discontinuation.Gastrointestinal were commenest system based reaction effecting 30% of patients Followed by Peripheral neuritis 18.4%, Endocrinal (hypothyroidism)10.5%, Auditary and vestibular(deafness)9.2%, Ophthalmic (optic neuritis)6.5%,Hepatic 5.2%,Joint pains 5.2%,Psychiatric disturbance 1.3% and 19.7%patients had more than one system involved.Majority of patients with peripheral neuritis,optic neuritis and hypothyroidism required discontinuation of offending drug.  Conclusion: Significant number of patients developed adverse reaction including very severe reaction requiring discontinuation of drug which may effect treatment outcome.close monitoring and patient counselling is necessary to prevent permanent system damage and discontinuation of therapy.
The effect of exemestane on the lipidemic profile of breast cancer patients: Preliminary results of the TEAM trial Greek sub-study
Authors: C. Markopoulos, A. Polychronis, C. Farfarelos, V. Zobolas, J. Papadiamantis, D. Bafaloukos, J. Misitzis, A. Michailidou, H. Gogas
Journal: Journal of Clinical Oncology (2004)

799 Background: Side effects of endocrine therapy for breast cancer (BC) may have clinical implications. Drugs that alter lipid profile potentially interfere with the risk of developing cardiovascular disease (CVD). Tamoxifen (T) has proven to have a favorable effect on CVD risk factors by modestly decreasing total plasma cholesterol (TC) and low-density lipoprotein (LDL) levels while having little effect on high-density lipoprotein (HDL). However, it increases serum triglycerides (TG). Exemestane (Ε), a steroidal anti-aromatase agent with demonstrated efficacy in (PM) metastatic BC patients, is under evaluation in the adjuvant setting but, there is limited information about its effect on lipidemic parameters. Methods: TEAM -Tamoxifen and Exemestane Adjuvant Multicenter–international trial is a direct comparison of 5 yrs of T to 5 yrs of E in PM women with ER+, BC and in the Greek substudy effect of either treatment on lipids is studied in comparison to pretreatment values. Data on TC, HDL, LDL and TG levels at 3 and 6 months of treatment have been analyzed in 56 patients. Multiple comparisons of the mean value of each parameter at different time points (baseline, 3 and 6 months) were performed for each arm of the trial. Results: After 6 months treatment, comparison of percentage changes of TC and HDL levels from baseline values between groups is non significant. There is a trend to increased LDL levels in E arm (+8.97% and + 5.72% at 3 and 6 months, respectively) and decreased levels (- 0.01% and - 15.24% at 3 and 6 months) in T arm, however, the changes from baseline values between groups are NS. TG levels are increased at month 3 (+18.81%) and remained elevated (+8.62%) at month 6 in patients on T, while in patients on E it progressively decreased at both time points (-4.84% and -7.18%), with differences being significant at month 3 (p=0,037).Conclusions: From the currently available preliminary data E appears to have a stabilizing effect on TC and HDL parallel to the beneficial effect of T. Exemestane treatment results in a mild but non-significant increase in LDL levels at 3 and 6 months and a beneficial effect on TG levels. Data continues to mature. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Pharmacia; Shering Plough Pfizer-Pharmacia
Stimulation of myelopoiesis in a patient with congenital neutropenia: biology and nature of response to recombinant human granulocyte- macrophage colony-stimulating factor
Authors: S Vadhan-Raj, SS Jeha, S Buescher, A LeMaistre, G Yee, L Lu, J Lloreta, WK Hoots, WN Hittelman, JU Gutterman
Journal: Blood (1990)
Influence of place of treatment on diagnosis, treatment, and survival in three pediatric solid tumors.
Authors: S Kramer, A T Meadows, G Pastore, P Jarrett, D Bruce
Journal: Journal of Clinical Oncology (1984)

This study examines differences between cancer centers (CC) and noncancer centers (NCC) in terms of management procedures and outcomes for three pediatric solid tumors: Wilms' tumor (N = 147), rhabdomyosarcoma (N = 87), and medulloblastoma (N = 76). Data were derived for the period 1970-1979 from the population-based Greater Delaware Valley Pediatric Tumor Registry maintained at the Children's Cancer Research Center, which routinely collects data on all childhood neoplasms that occur in a 31-county region. Management measures reviewed included the degree to which important pretreatment evaluations were performed, types of therapy used, and extent of follow-up examinations conducted. Outcome variables were three-year disease-free survival and frequency of deaths related to complications of therapy. Differences in three-year disease-free survival between CC and NCC were noted for medulloblastoma (52% v 24%) and rhabdomyosarcoma (48% v 10%), but not for Wilms' tumor (79% v 68%). Among medulloblastoma patients, differences were detected in the frequency of pretreatment evaluations and in the therapy used. The principal management contrast found in rhabdomyosarcoma was that multiagent chemotherapy was used less often in NCC. Wilms' tumor patients were evaluated and treated similarly in the community versus the CC, except for some contrasts in the surgical approach and the frequency of follow-up for the detection of late complications.
A monooclonal antibody against HER-2 (Trastuzumab) for metastatic breast cancer: A model-based cost-effectiveness analysis
Authors: J. Norum, T. Risberg, J. A. Olsen
Journal: Journal of Clinical Oncology (2005)

732 Background: Trastuzumab has shown considerable activity in patients with metastatic breast cancer (MBC) that overexpress HER2. However, significant resources have been allocated to finance this new therapy. Due to ever increasing pressures on health care budgets, economic evaluations are requested in order to compare health effects with costs. We aimed to evaluate the cost effectiveness of trastuzumab in patients with metastatic breast cancer in a model based cost effectiveness analysis (CEA). Methods: All available data on trastuzumab in MBC presented at the San Antonio breast cancer conference in late 2003 and all data on the Medline in December 2003 were analysed for life years (LY) gained and quality of life (QoL) with regard to the use of this new monoclonal antibody. Randomised studies comparing standard chemotherapy with or without trastuzumab were focused. The costs were calculated according to Norwegian prices as in January 2003. Results: The LY gained ranged between 0.3–0.7 years. The median cost per patient treated was calculated €44,196 yielding costs per life year saved in the range between €63,137 - €162,417 depending on survival gain and discount rate employed. A sensitivity analysis documented the price of trastuzumab and the survival benefit the two major factors influencing the cost-effectiveness ratio. Conclusions: The economic evaluation indicates trastuzumab not cost effective in metastatic breast cancer. Reduced drug costs and/or improved survival may alter the Conclusion: No significant financial relationships to disclose.
Case 2: Acute Respiratory Failure Secondary to Lymphangitic Carcinomatosis
Authors: Namita Sood, Nicolas Bandarenko, Linda J. Paradowski
Journal: Journal of Clinical Oncology (2000)

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.2000.18.1.229 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10623714 Case 2: Acute Respiratory Failure Secondary to Lymphangitic Carcinomatosis Namita SoodxNamita SoodSearch for articles by this author , Nicolas BandarenkoxNicolas BandarenkoSearch for articles by this author , Linda J. ParadowskixLinda J. ParadowskiSearch for articles by this author Show More University of Iowa Hospitals and Clinics, Iowa City, IA https://doi.org/10.1200/JCO.2000.18.1.229 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical Oncology
Phase III trial of modulation of cisplatin/fluorouracil chemotherapy by interferon alfa-2b in patients with recurrent or metastatic head and neck cancer. Head and Neck Interferon Cooperative Study Group.
Authors: D Schrijvers, J Johnson, U Jiminez, M Gore, P Kosmidis, H Szpirglas, K Robbins, J Oliveira, R Lewensohn, J Schüller, A Riviere, C Arvay, P Langecker, H Jacob, E Cvitkovic, E Vokes
Journal: Journal of Clinical Oncology (1998)

PURPOSE In preclinical experiments, interferon alfa modulates the anticancer activity of fluorouracil (5-FU) and cisplatin (CDDP). To test this effect clinically in patients with recurrent or metastatic head and neck cancer (RMHNC), a multicenter randomized controlled trial with CDDP and 5-FU with or without interferon alfa-2b (IFNalpha) was performed. PATIENTS AND METHODS Eligible patients had histologically confirmed RMHNC; a good performance status; measurable disease; adequate bone marrow, hepatic, and renal function; no prior chemotherapy for recurrent or metastatic disease; only one chemotherapy regimen administered with previous local therapy; and a treatment-free interval of at least 3 months following previous local therapy. Patients were randomized and stratified according to treatment center, and prior radiotherapy and chemotherapy. The treatment regimen consisted of CDDP 100 mg/m2 on day 1 and 5-FU 1,000 mg/m2/d by continuous infusion for 96 hours (days 1 to 4), without (arm A) or with (arm B) IFNg alpha 3 x 10(6) U/d subcutaneously on days 1 to 5. Cycles were repeated every 21 days. RESULTS One hundred twenty-two patients were entered on each arm. The response rate (RR) was similar in both arms (arm A: complete response [CR] 10.7%, partial response [PR] 36.4%; arm B: CR 6.8%, PR 31.6%) (.70 &lt; P &lt; .50). There was no difference in median survival between the two arms (arm A 6.3 months v arm B 6.0 months; P = .49). Anorexia, fever, leukopenia, and thrombocytopenia grade III to IV were significantly more frequent in the IFNalpha arm. CONCLUSION Modulation of CDDP and 5-FU with IFNalpha as used in this study does not improve the RR or the median survival in patients with RMHNC. Patients on both study arms had a poor prognosis, which indicates the need for novel therapies.