tbuckley/cabot-search huggingface dataset:
Patient and provider perceptions about exercise in cancer care, excluding breast: Are we on the same page?
Authors: Agnes Smaradottir, Kurt R. Oettel, Angela Smith, Andrew Borgert
Journal: Journal of Clinical Oncology (2015)

238 Background: Cancer organizations recommend physical activity as part of therapy to aid in symptom management, reduce recurrence and improve overall quality of life. What the optimal exercise program should look like and what stakeholder barriers exist are unclear. Methods: We convened three focus groups, one with metastatic patients, one with non-metastatic patients, one with the providers in the Cancer Center and conducted individual interviews at Gundersen Health System in La Crosse, Wisconsin. The constant comparative method was used to identify themes about exercise as part of cancer treatment. Results: No statistical differences in demographic characteristics exist between metastatic (N = 9) and non-metastatic (N = 11) patients. Impacts of exercise on cancer, who should instruct patients about exercise and how/where the exercise should take place emerged as the main themes. Discordance between patients and providers (N = 10) was identified in these areas. Patients felt that exercise during treatment provided intrinsic value (“Exercise mentally is important”) whereas providers connect exercise to positive disease outcome (“There are decreased recurrence rates for multiple different malignancies that have been proven in large studies”). Patients resoundingly expressed a desire to receive instructions for exercise from their oncologist (“I rely a lot on my oncologist...they are tuned into you”). Providers expressed a desire for a referral process to a cancer trained physical therapist or trainer who would guide patients through an exercise program (“to have assistance from someone who is trained… would be really beneficial”). Conclusions: Providers recognize the importance of exercise as part of a cancer treatment plan, yet they agree that time constraints associated with a busy practice impacts the priority of exercise instructions. Bridging the gap we identified between patient and providers’ perceptions has potential for cancer care across the nation. We plan to further study the discord after designing standard exercise recommendations at varied levels of intensity through collaboration with oncology providers, physical therapy and Livestrong personnel utilizing venues in our region.
Evaluation of preoperative positron emission tomography with computed tomography (PET-CT) for detecting lymph node metastasis in gynecologic carcinoma
Authors: F. Murakami, N. Ogawa, A. Yamazaki, S. Sakurai, T. Ishiya, K. Katase, Y. Shimizu, S. Tanada
Journal: Journal of Clinical Oncology (2009)

5593 Background: To evaluate the sensitivety, specificity, and accuracy of PET-CT for detecting lymph node metastasis in gynecologic carcinoma. Methods: Between May 2007 to August 2008, 36 consecutive patients (pts) with cervical carcinoma, endometrial carcinoma and epithelial ovarian carcinoma were enrolled. All pts underwent PET-CT prior to the surgery of systematic pelvic and paraaortic lymphadenectomy. For pathological metastatic lymph nodes, the size of intranodal tumor deposits (maximum diameter of metastatic foci in each lymph node) were recorded. Results: The total number of pelvic lymph nodes (PLNs) plus paraaortic lymph nodes (PANs) removed was 2426. The median number of removed lymph nodes (LNs) was 67 each pts (range: 25 to 102). The number of involvement LNs was 79 (3.5%). The sensitivity, specificity and accuracy of preoperative PET-CT to detect LN metastasis were 24%, 99.9%, and 97.5%, respectively. The sensitivity of PLNs and PANs were 39.5% and 7.3%, respectively. The sensitivity of squamous cell carcinoma (SCC) were 35.7%, that of adenocarcinoma were 8.1%. FDG-PET detected 100% of intranodal tumor deposits &gt; or =10 mm, whereas tumor deposits smaller than 5 mm were not detected. Conclusions: The results of our study revealed 76% underdiagnosis (overlooking) in evaluation of preoperative PET-CT in LN metastasis. Particularly, tumor deposits smaller than 5 mm were not detected at all. Using PET-CT for detecting small LN metastasis in gynecologic carcinoma may be unreliable so far. However we found that PLNs are comparatively easy to be detected than PANs, and SCC are comparatively easy to be detected than adenocarcinoma. The improved usability and application of PET-CT for detecting LN metastasis in gynecologic carcinoma have to keep researching constructively. No significant financial relationships to disclose.
A Randomized Trial of Intensive versus Standard Blood-Pressure Control
Authors: Marcel H A Muskiet, Lennart Tonneijck, Mark M Smits
Journal: New England Journal of Medicine (2016)

A Randomized Trial of Intensive versus Standard Blood-Pressure ControlTo the Editor: Wright et al. (Nov.26 issue) 1 report on the Systolic Blood Pressure Intervention Trial (SPRINT).By focusing on blood-pressure levels, rather than on specific antihypertensive agents, this trial follows a rich heritage of government-funded, noncommercial, randomized trials in hypertension that address major public health issues.The clear differences in outcomes, including lower rates of death among patients who were randomly assigned to intensive treatment than among those assigned to standard treatment, underscore the major impact of implementing this lower blood-pressure target for the appropriate population.Achievement of a difference of 15 mm Hg between patients who were randomly assigned to the intensive-treatment group (target systolic blood pressure <120 mm Hg) and patients who were randomly assigned to the standard-treatment group (target <140 mm Hg) was central to testing the authors' hypothesis.Their design article specifies that in the standard-treatment group, antihypertensive therapy should be withdrawn in a patient whose systolic blood pressure is less than 130 mm Hg on any occasion or less than 135 mm Hg on two consecutive visits. 2 Since withdrawal of antihypertensive therapy in asymptomatic patients in whom these pressures are achieved is not necessarily considered to be standard, interpretation of the overall trial results could be affected by knowledge of how often, and in how many patients, this nonstandard action was taken.
QUANTITATIVE ESTIMATION OF THE TOTAL PROTEIN IN THE CEREBROSPINAL FLUID
Journal: JAMA (1921)

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A phase III study of Æ-941 with induction chemotherapy (IC) and concomitant chemoradiotherapy (CRT) for stage III non- small cell lung cancer (NSCLC) (NCI T99–0046, RTOG 02–70, MDA 99–303)
Authors: C. Lu, J. J. Lee, R. Komaki, R. S. Herbst, W. K. Evans, H. Choy, P. Desjardins, B. T. Esparaz, M. Truong, M. J. Fisch
Journal: Journal of Clinical Oncology (2007)

7527 Background: Æ-941 is a shark cartilage extract with antiangiogenic properties. We conducted a placebo-controlled trial testing Æ-941, with IC and CRT, in unresectable stage III NSCLC. Methods: Eligibility criteria included performance status (PS) &lt; 2, weight loss &lt; 10%. Subjects received one of two treatment regimens depending on site of enrollment: carboplatin (C) (AUC 6) and paclitaxel (P) (200 mg/m 2 ) × 2 cycles followed by CRT (60 Gy/30 fractions) with weekly C (AUC 2) and P (45 mg/m 2 ) × 6 doses or cisplatin (CDDP) (75 mg/m 2 , d1) and vinorelbine (V) (30 mg/m 2 , d1 and 8) × 2 cycles followed by CRT (60 Gy/30 fractions) with CDDP (75 mg/m 2 , day 1) and V (15 mg/m 2 , d1 and 8) × 2 cycles. Subjects were randomized to receive Æ-941 (Arm A) or placebo (Arm B), 120 mL orally twice daily, at the start of IC and continuing after CRT as maintenance therapy. Randomization was stratified for stage, gender, and type of chemotherapy. The primary endpoint was overall survival (OS), with a planned sample size of 756 subjects providing 80% power to detect a 25% difference in OS, assuming a control arm median survival time (MST) of 13 months, type I error 0.05. Results: Between 6/00 and 2/06, 384 subjects were enrolled onto the trial and randomized. In 2/06 the trial was closed to new patient entry due to insufficient accrual. This final analysis is based on 379 randomized and eligible subjects (188 arm A, 191 arm B). Subject characteristics: 60% male, median age 63 years (range 37–84), 56% stage IIIB, 58% C-based chemotherapy, median follow-up 3.7 years. There was no significant difference in OS between arms A and B, with MSTs of 14.4 (95% CI 12.6–17.9) and 15.6 (95% CI 13.8–18.1) months, respectively (log-rank p=0.73). OS by pre-specified stratification factors: stage IIIB vs IIIA (MST 13.9 vs. 17.4 months, p=0.25), C vs. CDDP chemotherapy (MST 14.4 vs. 16.7 months, p=0.13), and male vs. female (MST 15.7 vs. 15.1 months, p=0.74). The study drug was well tolerated. Fewer subjects in arm A experienced grade 3 or higher adverse events (66% vs. 77%, p=0.018). Conclusions: The addition of Æ−941 to IC and CRT does not improve OS in patients with unresectable stage III NSCLC. No significant financial relationships to disclose.
Development of a novel information technology (IT) system using the electronic medical record (EMR) in daily clinical practice
Authors: S. Matsumoto, T. Nishimura, M. Kanai, H. Ishiguro, H. Yasuda, K. Yoshikawa, A. Misawa, T. Kitano, K. Yanagihara, M. Fukushima
Journal: Journal of Clinical Oncology (2007)

17066 Background: The information generated in daily practices is critical to assure safety and efficacy of therapeutic interventions. Clinical investigators are faced with enormous amounts of data and a greater need to organize it in a meaningful and coherent manner than ever before. Computerization could offer many advantages that clinical data systematically accumulated in the course of routine medical care can provide researchers with the clues to resolve many medical questions. Methods: We developed a novel clinical database system, named CyberOncology, integrated in EMR of Kyoto University Hospital. It contained summarized treatment history, national cancer registry and consecutive clinical database. All adverse events according CTCAE ver.3, response to the treatment based on RECIST criteria and survival data were collected. The medical staffs have routinely used the CyberOncology since its starting on October 2003. The CyberOncology directly collected all data concerning oncology management of inpatient and outpatient care from EMR, and simultaneously analyzed clinical outcomes. Results: For three years since October 2003, consecutive 1,516 new cancer patients including 590 GI, 435 lung, 234 breast cancer, and 140 lymphoma with 19,767 chemotherapeutic administrations were registered in the CyberOncology. Main benefits are improvement of the quality of patient care and safety, practice standardization, and the quickness and the reliability of collecting the data. Moreover, it had the capability to serve a cross-sectional approach of cancer and drug-orientated analysis. For example, this system can easily provided with a review of clinical practice in a real time manner. Conclusions: The CyberOncology form integrated EMR successfully meets requirements of electronic case report. It has been useful in monitoring outcomes of care, effectiveness, efficiency and adherence to clinical trial. No significant financial relationships to disclose.
Abstract 3386: The development of a highly specific monoclonal antibody against Ki67 useful for immunohistochemistry
Authors: Caiwei Chen, Kehu Yuan, Boyang Chu, Youmin Shu, Jian Chen, Joe Stafford, Wei Fu, Wei-Wu He, Ross Chambers, Donghui Ma
Journal: Cancer Research (2015)

Abstract Ki-67 is a nuclear protein that is a useful marker of proliferation. Ki-67 antibodies are used to generate a Ki-67 labeling index, which is the percentage of cells with nuclear immunostaining in immunohistochemistry. The Ki-67 labeling index may be useful as a prognostic and predictive marker in cancer. The Ki-67 labeling index relies on the use of antibodies with a suitable level of sensitivity and specificity, and many Ki-67 antibodies have been developed over the last two decades. One of the most widely used Ki-67 antibodies is the mouse monoclonal MIB1. However, there have been many reports showing that in some cases MIB1 detects an unexpected membranous and cytoplasmic staining pattern in immunohistochemistry. Since Ki-67 is exclusively expressed in the nucleus this raises questions about the specificity of MIB1. We have created a nearly comprehensive microarray of about 17,000 human proteins to investigate the specificity of MIB1 and identify cross reacting proteins. The protein microarray was also used to screen new panels of mouse monoclonals against Ki-67. We have identified the antibody UMAB107 that in immunohistochemistry performs with similar sensitivity as MIB1, but unlike MIB1, UMAB107 is highly specific. Citation Format: Caiwei Chen, Kehu Yuan, Boyang Chu, Youmin Shu, Jian Chen, Joe Stafford, Wei Fu, Wei-Wu He, Ross Chambers, Donghui Ma. The development of a highly specific monoclonal antibody against Ki67 useful for immunohistochemistry. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3386. doi:10.1158/1538-7445.AM2015-3386
Characteristics of relapse in patients with clinical stage I testis cancer undergoing primary surveillance
Authors: C. J. Moore, B. Hayes-Lattin, S. Daneshmand, C. R. Nichols
Journal: Journal of Clinical Oncology (2008)

16040 Background: Primary active surveillance (PAS) has increasingly become standard of care for patients (pts) with clinical stage I testis cancer (CSITC), given the fact that 50–80% are cured with orchiectomy alone. This study investigated sites of relapse and prognostic status at time of relapse. Methods: Since 1998, Oregon Health & Science University's institutional policy has been to recommend active surveillance alone to all CSITC pts after orchiectomy, independent of known risk factors. We retrospectively identified and reviewed the charts of 85 pts with CSITC treated between 1998 and 2007. Site of relapse, prognostic category at relapse, and overall survival data were tabulated. Results: Of 44 pts with seminoma, 10 pts (23%) experienced relapse at a median of 10.5 months after orchiectomy. All 10 pts were good prognosis at time of relapse by the International Germ Cell Cancer Collaborative Group (IGCCCG) classification system. Nine of 10 pts relapsed with low volume abdominal disease only. One patient relapsed with low volume abdominal disease and low level HCG elevation. Seven of ten pts received abdominal radiation. Three pts received 3 cycles of bleomycin, etoposide, and cisplatin (BEP) - two due to pt preference and one due to horseshoe kidney. Two of ten pts had subsequent relapses after radiation (one in thoracic spine and one in supraclavicular nodes) and both pts were rendered disease free with subsequent therapies. All 44 pts (100%) are alive with a median follow up of 28 months. Of 41 pts with nonseminomatous germ cell tumor, 14 pts (34%) experienced relapse at a median of 6 months after orchiectomy. All 14 pts were good prognosis at time of relapse by IGCCCG classification. Six pts relapsed with both low level marker elevation and low volume retroperitoneal disease. Five pts had low level serologic relapse only. Two pts had pulmonary metastic disease without serologic relapse. One pt had relapse in supraclavicular nodes without serologic relapse. All pts received 3 cycles of BEP. All 41 pts (100%) are alive with a median follow up of 28 months. Conclusions: In our series, all pts on PAS relapsed with good prognosis disease and were cured with subsequent therapies. PAS is a safe and reliable management method which reduces the overall burden of treatment in pts with CSITC. No significant financial relationships to disclose.
The radiation dose to the ventricles of the heart and survival after radical treated locally advanced NSCLC
Authors: O. Hansen, C. Brink, M. Nielsen, T. Stolberg-Rohr, C. Ruhlmann
Journal: Journal of Clinical Oncology (2008)

7566 Background: Cardiac toxicity may be a risk factor for survival in radical radiotherapy of NSCLC. We have performed a retrospective analysis of locally advanced NSCLC treated at our institution. Methods: From September 1995 to June 2005, 221 patients with inoperable non-small cell lung cancer stage IIB-IIIB received radical 3-D conformal radiotherapy in planned doses 60 to 66 Gy in 30 to 33 fractions. The dose plans were re-analyzed with regard to mean delivered dose (MDD) to the left ventricles (LV), both ventricles (BV), and the whole of the heart (WH). Results: In 215 out 217 patients fulfilling the scheduled radiotherapy data on MDD was obtainable. The median, 2 year and 5 year survival were 15.5 m., 35% and 14%. The median MDD to the LV, BV, and WH was 8.0, 9.3, and 16.8 Gy, respectively, and the 75% quartile (q) MDD was 16.4, 18.4, and 27.9 Gy. When the overall survival was analyzed in univariate analyses with the patient grouped according to quartiles of MDD, the patients receiving a dose above the 75%q to the ventricles had poorer overall survival than patients receiving lesser doses (median survival 10.6 vs. 17.6 m.). There were no significant differences in survival between the patients in 3 lower quartiles of MDD. As of Dec 1st, 2007, 192 of the patients had died, 166 due to recurrent lung cancer and 26 due to other causes. A small but significant excess of deaths of other reason occurred in patients receiving a high MDD above the 75%q. In Cox-analyses MDD to BV (>75%q), gross tumor volume (GTV>125 mL), lung dose (V20 ≥ 40%) were independent significant factors (p<0.05) indicating poor overall survival. Dose to WH were inferior to dose to BV and LV in predicting survival. Conclusions: In a series of NSCLC patients treated with 3-D conformal radiotherapy a high mean dose to the heart was associated with excess mortality. Dose to the WH were no better to predict poor survival than dose to ventricles. No significant financial relationships to disclose.
Combined systemic chemoimmunotherapy in advanced diffuse malignant mesothelioma. Report of a phase I-II study of weekly cisplatin/interferon alfa-2a.
Authors: P Soulié, P Ruffié, L Trandafir, I Monnet, A Tardivon, P Terrier, E Cvitkovic, T Le Chevalier, J P Armand
Journal: Journal of Clinical Oncology (1996)

PURPOSE To assess the tolerance, toxicity, and antitumoral activity of the weekly combination of cisplatin (CDDP) and interferon alfa-2a (IFNalpha2a) in advanced diffuse malignant mesothelioma (DMM). PATENTS AND METHODS: Twenty-six patients with DMM (23 pleural and three peritoneal), previously untreated, were enrolled onto this study between August 1991 and December 1992. All patients had measurable disease defined by computed tomographic (CT) scan and diagnostic confirmation by histopathology review panel. IFNalpha2a (3 x 10(6) IU subcutaneously on days 1 to 4) and CDDP (60 mg/m2/wk on day 2) were given weekly. Initially planned as a 5-weeks-on/3-weeks-off treatment cycle, poor patient tolerance observed in the first 12 patients treated (group A) led to schedule adaptation with a shorter treatment sequence and prolongation of the rest period (4 weeks on/4 weeks off) in the following 14 patients (group B). At least two cycles were administered to each patient in the absence of tumor progression. RESULTS Twenty-six patients were assessable for toxicity and 25 for efficacy (World Health Organization [WHO] criteria). Sixty-eight cycles of IFN/CDDP were given, with a median of three cycles per patient (range, one to five). Toxicity was mainly clinical, with progressive anorexia, asthenia, and prolonged nausea/emesis; these side effects have limited treatment acceptance in many patients. Thrombocytopenia and leukopenia were rarely noted as treatment-limiting toxicities. Objective responses (all partial) were obtained in 10 patients (95% confidence interval [CI], 20% to 60%). The median response duration was 11 months (range, 6 to 18). The median time to progression (TTP) for the whole cohort was 6 months and the median survival time was 12 months (range, 5 to 32). Objective responders had a significantly longer median TTP (21 months) and survival time (25 months) than nonresponders (3 and 8 months, respectively). CONCLUSION The results of this pilot phase I-II study show encouraging antitumor activity in this traditionally resistant tumor, even if the specific contribution of IFN remains speculative and needs further clinical research. Our ongoing program is exploring the dose-intensity impact of IFN dose within the same combination.
Irinotecan plus oral etoposide (IRET) combination is an highly active and promising treatment in heavily pre-treated small cell lung cancer patients
Authors: H. Akbulut, I. Tek, A. Demirkazik, F. Icli, H. Doruk, B. Yalcin, G. Utkan, A. Buyukcelik
Journal: Journal of Clinical Oncology (2005)

7301 Background: Irinotecan and etoposide are active drugs in small cell lung cancer (SCLC). We aimed to assess the activity of irinotecan plus oral etoposide (IRET) combination in patients with small cell lung cancer. Here we present the very impressive preliminary results of the trial. Methods: Patients with SCLC who were resistant to previous treatments or relapsed within 3 months of the completion of treatment constituted the study group. Treatment schedule consisted of irinotecan 80 mg/m2 on days 1 and 8, and oral etoposide 50 mg/day for 20 days, repeated every 30 days. Treatment was continued until disease progression or further 2 cycles after disease stabilization. Results: To date a total of 20 consecutive patients (16 male, 4 female) with a median age of 59 years (range: 41–71) have been included. While two patients had locally advanced disease the others had distant metastases (7 cerebral, 7 liver, 4 bone, 4 surrenal and 1 bone marrow). The results of initial 17 patients are currently available within a median follow-up time of 9 months (range: 3–18 months). Seven patients were given the current schedule as a second line treatment, 8 third line and 2 fourth line. There were 10 objective responses (OR) (55.6%) with one complete response. Median progression-free survival time was 7 (95% CI: 4 - 9) months. Median overall survival time has not been reached yet. Six-month survival rate was 60.4%. The toxicity was acceptable with grade 3 neutropenia in 2 patients and grade 2 diarrhea in 2 patients. However, one patient with bone marrow metastases died of febrile neutropenia following the first cycle. Conclusions: Irinotecan plus oral etoposide combination is a well-tolerated and active regimen in heavily pre-treated small cell lung cancer patients and the current schedule merits a phase III trial. No significant financial relationships to disclose.