tbuckley/cabot-search huggingface dataset:
JAMA's editor sacked
Authors: M. Nylenna, S. Chapman, D. Carnall
Journal: BMJ (1999)

# World medical journal editors should establish an award for editorial integrity in Lundberg's name {#article-title-2} EDITOR—The sacking of Lundberg as JAMA 's editor1 is a very sad event for editorial freedom in general and for medical journals world wide in particular. This disgraceful incident has shown that neither size nor success gives any guarantee for editorial freedom—not even the two combined. The fight for integrity must go on continuously in every editorial office every day. Lundberg has been an example for other editors through his editorial integrity, scientific judgment, and his personal strength and warmth. I suggest that the global community of medical journal editors, through its organisations, establish an award for editorial integrity and name it the George D Lundberg Award. [Published as a rapid response on our website 22 January 1999] 1. ↵1. Tanne JH .JAMA's editor fired over sex article.BMJ1999; 318: 213. (23 January.) [OpenUrl][1][FREE Full Text][2] # World medical journal editors should draw up email protest petition {#article-title-4} EDITOR—As every editor knows, editors sometimes time the publication of a piece of research so as to add new information to a current community or political debate, an upcoming major report, or an important anniversary. If editors are supposed to make a virtue out of being indifferent to topicality and relevant world … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DHopkins%2BTanne%26rft.auinit1%253DJ.%26rft.volume%253D318%26rft.issue%253D7178%26rft.spage%253D213%26rft.epage%253D213%26rft.atitle%253DJAMA%2527s%2Beditor%2Bfired%2Bover%2Bsex%2Barticle%26rft_id%253Dinfo%253Apmid%252F9915717%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=bmj&resid=318/7178/213&atom=%2Fbmj%2F318%2F7180%2F394.1.atom
Stratification of the normal range of CA125 after chemotherapy as a predictive factor in carcinoma of the ovary
Authors: R. M. Nadal, B. M. Ojeda, V. Artigas, I. Bogunà, I. Gich, A. Ribé, J. Prat, J. López López, A. Barnadas
Journal: Journal of Clinical Oncology (2006)

5059 Background: CA125 is an accurate and reliable marker for monitoring the response to treatment and detecting early relapse in ovarian cancer. The implications of the variation of its normal range are not known.The purpose of this study was to evaluate such variations as a prognostic indicator after first-line chemotherapy Methods: Over a 7 years period (1998–2005), 114 patients (pts) were treated with standard chemotherapy regimen for FIGO stage Ic-IV epithelial ovarian cancer. The median age was 63 years old (24–87) years. The tumors were classified: 56% serous, 12% endometroid, 16% poorly differentiated and 16% clear cell carcinomas. FIGO stage: 12 (11%) Ic, 14 (12%) II, 72 (63%) III, 16, (14%) IV. After surgery, 90% of the patients received a median of 6 cycles/patient with platinum based (cisplatin or carboplatin) chemotherapy in combination with taxane. Serial measurement of CA12.5 had been made before each cycle of chemotherapy and response was assessed according to RECIST or Rustin criteria. Median follow-up has been 31 months. 87 pts achieved levels below 35 u/ml after completion of treatment. The nadir value of CA125 was stratified into three arbitrary groups: group 1, ≤ 10 U/ml, group 2, 11–20 U/ml, and group 3, 21–35 U/ml. The χ 2 /Fisher’s exact test was used to examine patients characteristics for categorical variables. Survival analysis was performed by Kaplan-Meier method with long-rank test for determining statistical significance. Results: No statistical relationship between FIGO stage and gross residual tumor vs nadir groups (p = 0.48 and p = 0.2) was found. Median duration of progression free survival according to 3 groups was 34, 20, 14 months, respectively (p= 0.003). The median overall survival for the group 1 is not yet available, however, the corresponding median overall survival for groups 2 and 3 were 3.8 and 2.7 years, respectively (p = 0.006) Conclusions: Within normal range, the differences between CA125 levels could add prognostic information and stratify patients according to the risk of progression. No significant financial relationships to disclose.
Final results of a phase II randomized trial of neoadjuvant anthracycline-taxane chemotherapy plus lapatinib, trastuzumab, or both in HER2-positive breast cancer (CHER-LOB trial).
Authors: V. Guarneri, A. Frassoldati, A. Bottini, D. G. Generali, K. Cagossi, F. Artioli, G. Bisagni, C. Boni, A. Ravaioli, D. Amadori, A. Musolino, L. Cavanna, M. Untch, L. Orlando, G. Giardina, F. Piacentini, E. Tagliafico, M. Bagnalasta, R. D'Amico, P. F. Conte
Journal: Journal of Clinical Oncology (2011)

507 Background: This is a randomized phase II trial of preoperative taxane-anthracycline in combination with trastuzumab, lapatinib, or combined trastuzumab and lapatinib in HER2 positive, stage II-IIIA breast cancer patients. Primary aim of the study is the percentage pathological complete response (pCR), defined as complete disappearance of invasive tumor in breast and axillary nodes. Methods: chemotherapy (CT) consists of weekly paclitaxel x 12 followed by FE75C x 4. Pts randomized to arm A receive CT plus weekly trastuzumab; in arm B pts receive CT plus lapatinib 1250 mg po daily; in arm C pts receive CT plus weekly trastuzumab and lapatinib 750 mg po daily. The study sample size has been calculated according to the two-step Simon's design. The overall planned accrual was 120 pts. P95HER2 expression will be measured by bioTheranostics, Inc (San Diego) to explore if there is a clinically relevant difference in the pCR rate according to p-95 status. Gene expression profile analysis to identify a predictive signature is ongoing. Results: 121 pts have been randomized as of November 2010. Pts characteristics are the following: median age 49 yrs (26-68 yrs); stage IIA 32%, IIB 50%; IIIA 18%; ER and or PgR positivity: 59%. Eighty pts have completed surgery and are evaluable for response: 50 pts (62.5%) received breast conservation (BCS). A conversion from mastectomy to BCS was observed in 23/44 pts initially candidate to mastectomy (conversion rate: 52%). The pCR rate is 36.2% (28% in arm A, 32% in arm B, and 48% in arm C). By using a 30% cutoff for p95 positivity, in a preliminary analysis on 48 cases, 57% resulted as p-95 positive. In this preliminary analysis, the pCR rate in 15 trastuzumab treated pts is 86% in p-95-negative and 13% in p-95-positive cases. Mean Left ventricular ejection fraction (range) at baseline was 62% (52%-77%), 61% (44%-78%) after 12-13 weeks, and 61% (44%-74%) at the end of therapy. No patient had symptomatic cardiac events. Conclusions: Preliminary activity data are promising, and cardiac safety data are reassuring. Final results per treatment arm, along with definitive biomarker correlations will be presented at the meeting.
A phase III trial of melphalan/prednisone/lenalidomide (MPR) versus melphalan (200 mg/m<sup>2</sup>) and autologous transplantation (MEL200) in newly diagnosed myeloma patients.
Authors: A. P. Palumbo, F. Cavallo, F. Di Raimondo, D. Ben Yehuda, P. Omedè, V. Montefusco, F. Rossini, I. Hardan, T. Caravita, M. Boccadoro
Journal: Journal of Clinical Oncology (2010)

8015 Background: The introduction of new drugs questions the role of autologous transplantation upfront. We compared MPR with tandem MEL200 in newly diagnosed pts. Methods: All pts (N=402) received four 28-day cycles of lenalidomide (25 mg d 1-21) and low-dose dexamethasone (40 mg d 1,8,15,22) (Rd) as induction. Cyclophosphamide plus G-CSF was used to mobilize stem cells. As consolidation, pts (N=202) were randomized to MPR [six 28-day cycles of melphalan (0.18 mg/kg d 1-4), prednisone (2 mg/kg d 1-4) and lenalidomide (10 mg d 1-21); pts (N=200)] or MEL200 [tandem melphalan 200 mg/m2 with stem-cell support]. Primary end point was PFS. Assuming the HR (MPR vs MEL200) of 1.15 (1-b 80%, 2 side a .05), the sample size was 380 (190/190). Results: The median age was 58 years in both groups. After Rd induction, at least partial response (PR) was 83%, at least very good partial response (VGPR) was 34%, including 6% complete remission (CR). The median yields of CD34+ cells harvested was 8.85x106 CD34+ cells/Kg; 94% of patients collected the minimum dose of 2x106/kg CD34+ cells. In a substudy, pts at diagnosis were also randomize to receive aspirin or LMWH as thrombo-prophylaxis, incidence of DVT was 3,5% and 2% (p= 0.6), respectively. Induction with Rd was well tolerated: grade 3-4 adverse events were <10%. Pts who completed at least 3 MPR and 1 MEL200 were evaluated. After a median follow-up of 12 months, response rate, PFS and OS were similar in the two groups (see table). Consolidation with MEL200 resulted in a higher incidence of grade 3-4 adverse events (see table). Conclusions: Our study confirm the efficacy and safety of Rd induction. Both MPR and MEL200 improved the quality of response, achieved by Rd induction. At present, PFS and OS are not significantly different in the two groups. Clinical outcome after consolidation MPR MEL200 P value CR 14% 25% 0.19 ≥VGPR 57% 62% 0.24 PFS @ 12 months 91% 91% 0.77 OS @ 12 months 97% 98% 0.27 G3-4 hematologic toxicity 45% 86% 0.001 Neutropenia 8% 87% 0.001 Thrombocytopenia G3-4 Extra-hematologic toxicity Infections 0% 15% 0.001 Gastrointestinal 0% 23% 0.001 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Celgene Celgene Celgene
Frequency and prognostic significance of DVT with specific neoplasms
Authors: D. Elsayah, D. Elsayegh, A. Elhajj, L. Emmer, T. Terjanian
Journal: Journal of Clinical Oncology (2004)

8225 Background: Deep Venous Thrombosis (DVT) has been found to be the second most common cause of death among hospitalized patients with cancer. Virtually all types of malignancies have been associated with thrombosis. The objective of our study is to find out the incidence of DVT at our institution, and in order to try to formulate an effective prophylaxis strategy depending on which cancers are more likely to cause DVT. Methods: All cancer cases registered in our Cancer Data Bank between 1990 and 2000 were collected. The cases of DVT were selected based on discharge DRG's and correlated with the Data Bank. Excluding skin malignancies, 16,198 cases of cancer were diagnosed and treated in our institution between 1990 and 2000. The diagnosed malignancies were distributed to 30 subtypes depending on the anatomical location. Two hundred three cases were also diagnosed with DVT. Demographic data, pathologic cancer diagnosis, date of diagnosis of DVT, extension of DVT, and date of death (when applicable) were obtained for each patient. Results: One percent of all the cancer diagnoses were followed by a diagnosis of DVT at our institution. The highest relative risk (RR) for the occurrence of DVT was associated with the following malignancies: CNS (2.58), gastric (2.40), pancreatic (2.17), multiple myeloma (2.10), eosophageal (2.05), and lung (1.74). The mean time of death from diagnosis of DVT was about 4 months. Conclusion: The incidence of DVT at our institution was found to be 1.0 %, well below the reported rates of 7 –20 %. This may be due to factors related to the methods of data collection and the retrospective type of the study. In view of the higher incidence of DVT in CNS, gastric, and pancreatic cancers, a more aggressive DVT prophylaxis regimen might need to be considered in patients with those diagnoses. The mean DVT - expiration time may indicate that DVT is a poor prognostic factor. However, a controlled prospective trial is needed to further evaluate the prognostic significance of the occurrence of a DVT in patients with cancer. No significant financial relationships to disclose.
Exposure to risk information and women's interest in direct to consumer testing for BRCA 1 and 2 mutations
Authors: S. W. Gray, C. O'Grady, L. Karp, D. Smith, R. Hornik, K. Armstrong
Journal: Journal of Clinical Oncology (2008)

6526 Background: Direct to consumer (DTC) access to cancer genetic testing has the potential to enhance cancer control efforts. However, it is not known if current DTC websites provide adequate risk information for informed medical decision-making. Methods: 767 women were randomly assigned to view a “mock” DTC commercial website (control condition: CC, n=257) or the same “mock” website that included information on the potential risks of obtaining genetic testing online (risk condition: RC). Risk information was framed in two different ways: basic risk information (BR, n=253) and risk information from expert sources (ES, n=257). Subjects then completed an online survey. The primary endpoints were intentions to get BRCA testing and attitudes about DTC BRCA testing. Results: Sample characteristics: mean age 37 (range 18–71), 79% white, 62% married, mean education 3 yrs. college. Women in the RC reported lower intentions to get BRCA testing than women in the CC (mean 2.78 vs. 3.07, p<0.05) and were more likely to report wanting to obtain testing in clinic rather than online (mean 5.11 vs. 4.83, p<0.05). Women in the RC had more negative attitudes about online BRCA testing than women in the CC (mean 23.76 vs. 25.18, p <0.001). Framing effects were seen: women in the ES group were more likely to report a preference for clinic based testing and had more negative attitudes about online testing than the BR group. Conclusions: Exposing women to information on the potential risks of online BRCA testing altered their intentions to get testing as well as their attitudes about testing. Additionally, some risk messages appear to be more effective in altering attitudes and intentions than other risk messages. Policy makers may want to consider both the content and framing of risk information on DTC commercial websites as they enact regulation aimed at optimizing informed decision-making in this rapidly growing industry. No significant financial relationships to disclose.
Symptom clusters in irradiated brain tumor survivors
Authors: P. A. Saconn, E. Ip, S. Rapp, R. B. D’Agostino, M. J. Naughton, J. Gleason, E. G. Shaw
Journal: Journal of Clinical Oncology (2006)

8581 Background: Symptom clusters, whereby ≥2 symptoms coexist within patients, occur with cancer and its treatment. Identification and treatment of symptom clusters may improve functional status and health-related quality of life (HRQL). We report the characterization of symptom clusters occurring in irradiated brain tumor survivors. Materials/Methods: 34 adult survivors of primary or metastatic brain tumors following partial or whole brain irradiation ≥6 months prior were enrolled in an open-label Phase II study of donepezil, an acetylcholinesterase inhibitor (Rapp et al and Shaw et al, Neuro-Oncology 6:357 and 358, 2004). Eligibility criteria included life expectancy ≥30 weeks, no imaging evidence of progressive brain disease ≥3 months, stable/decreasing steroid dose, Karnofsky Performance Status (KPS) ≥70, and no brain tumor therapy during the study period. Patients received donepezil 5mg/day for 6 weeks, then 10mg/day for 18 weeks, followed by 6 weeks observation off drug. Symptoms were assessed at baseline, 6, 12, 24, and 30 weeks with the Functional Assessment of Cancer Therapy - Brain (FACT-Br) and Profile of Mood States (POMS). Factor analysis, multidimensional scaling and multivariate cluster analysis were used to characterize symptom clustering. Results: Of 34 patients enrolled, 24 remained on study for 24 weeks and 21 remained for the entire 30 weeks. Utilizing the HRQL data, all three methods of analysis demonstrated 3 distinct symptom clusters: mood, cognition and energy. The factor analysis table below illustrates such findings. Conclusions: Three symptom clusters with symptoms related to mood, cognitive function and energy were identified in this group of irradiated brain tumor survivors. Further research should focus on therapeutic interventions for symptom clusters rather than the traditional emphasis on single-symptom therapy. This study was supported by NCI grant 1 U10 CA81851. [Table: see text] No significant financial relationships to disclose.
Human chorionic gonadotropin free beta chain is a negative prognostic indicator in malignant carcinoid
Authors: E. Rock, D. Levy, K. Stuart, T. Anderson, L. Cole
Journal: Journal of Clinical Oncology (2005)

9657 Background: Human chorionic gonadotropin (hCG) is not by itself sensitive or specific for malignancy. However, in multiple carcinomas multivariate analysis indicates that preoperative serum hCG free beta chain has negative prognostic significance that is independent of both stage and grade. Malignant carcinoid is a neuroendocrine malignancy having significant variability in the rate of disease progression that remains poorly explained by identified prognostic factors. We tested whether any known hormone-specific forms of serum hCG are prognostic in malignant carcinoid. Methods: ECOG study 9292 was a multicenter, nonrandomized Phase II clinical trial of daily subcutaneous gamma-interferon in malignant carcinoid. 48 patients received treatment for a median of 17.9 weeks. Median time to progression and overall survival were 5.5 and 42 months, respectively. 20 pre-treatment sera were available. hCG measurement was performed using established solid-phase two-site sequential immunometric assays. The log-rank test was applied to test for differences in progression free and overall survival between groups with marker levels above or below cut-off values that were based on the 97.5 percentile of healthy blood donors. Results: Of 20 patients with analyzable serum samples, 14 (70%) had detectable hCG holoprotein; 3 (15%) had detectable hCG free beta chain; and 13 (65%) had detectable hyperglycosylated hCG. Correlations among the three hCG forms tested were not statistically significant (p > 0.23). Patients with detectable hCG free beta chain had lower 3-year survival than those without detectable levels (3 year OS = 33% versus 59%, p=0.0271). There was a trend towards decreased survival at three years in those with detectable holoprotein (p=0.1971) and hyperglycosylated hCG (p=0.4561). Conclusions: This is the first report of hCG free beta chain having prognostic significance in a non-epithelial malignancy. Although the sample size was relatively small, these data mirror results previously obtained in colorectal, oropharyngeal, ovarian, pancreatic, and renal cell carcinomas, i.e. that free beta hCG predicts for shortened survival, whereas hCG holoprotein does not. No significant financial relationships to disclose.
Circulating tumor cells (CTC) in newly diagnosed breast or colorectal cancers
Authors: M. D. Groot, M. Croonen, W. Mastboom, I. Vermes, A. Tibbe, H. Tissing, L. Terstappen
Journal: Journal of Clinical Oncology (2007)

14512 Background: The presence of CTCs is associated with poor prognosis in patients with metastatic carcinomas. The significance of CTCs at the time of diagnosis and after therapy is not known. A prospective clinical trial is conducted to determine if monitoring CTC levels in pts diagnosed with breast and colorectal cancer identify pts at risk for recurrence. CTCs are correlated with pathological stage as follow-up is too short to assess recurrence risk. Methods: Currently 213 pts with newly diagnosed breast and 119 pts with colorectal cancer before surgery with curative intend have been enrolled as well as a control group of 120 patients in whom diagnosis of breast or colorectal cancer was excluded. Thirty ml of blood was screened for the presence of CTCs at baseline before surgery and every following year using the CellSearch™ System. Results: Presence of CTCs in 30mL of blood in breast, colorectal cancer and the control group is provided in the table . In colorectal cancer the average number of CTCs /30 mL at baseline for Dukes A, B and C was 0.2, 0.7 and 1.1 respectively, for stage 0, I, II, III breast cancer 0.3, 0.5, 0.6 and 1.8 respectively and for the control group 0.24 CTCs /30 mL. Conclusions: CTC can be detected in a substantial proportion of pts before and after definitive surgery for breast and colorectal cancer. The number of CTCs before surgery correlated with the stage of the disease. Specificity of the CellSearch™ System is being increased to improve the discrimination of patients with benign and malignant disease. Follow-up must clarify whether the presence CTCs is an identifier for the risk of recurrence. [Table: see text] No significant financial relationships to disclose.
Long-term outcomes of preoperative chemotherapy with modified DCS therapy for highly advanced gastric cancer with distant metastasis.
Authors: Atsushi Matsuki, Atsushi Nashimoto, Hiroshi Yabusaki, Masaki Aizawa
Journal: Journal of Clinical Oncology (2015)

193 Background: Among patients (pts) with advanced gastric cancer (AGC), the poor prognosis was exhibited and many pts died even after R0 resection. The aim of this study is to evaluate the preoperative chemotherapy with docetaxel, cisplatin and S-1 (modified DCS therapy) for treatment in highly AGC with distant metastasis. Methods: A retrospective analysis was performed in 58 pts (man/woman; 49/9, median age; 64.5-years) treated with preoperative modified DCS therapy in our hospital between 2009 and 2012. Eligibility criteria included StageIV AGC with distant metastasis (H1;14, P1;18,CY1;31, LYM;25, PUL;2, OTH;2), a Performance status of 0-2 and no prior chemotherapy. The regimen consisted of docetaxel and cisplatin infusion (35mg/m 2 , days 1 and 15) and oral administration of S-1 (80mg/m 2 , days 1-14) every 4 weeks. Surgery was planned 3 to 4 weeks after the chemotherapy. Pathological response was graded according to the JGCA criteria. Almost all pts were treated with S-1 as postoperative adjuvant chemotherapy. Results: The median cycles was 2 (1-13). The incidence of grade 3/4 toxicity was neutropenia 53.4%, anemia 8.6%, anorexia 15.5%, nausea 5.2%, and diarrhea 3.4%. All of these toxicities were well tolerable and there was no TRD. According to RECIST, The overall response rate was 79.3%. Forty-tree pts underwent gastrectomy (R0/R1/R2; 27/8/8), respectively. Postoperative morbidity rate was 20.9% and there was no mortality. Over all 5 years survival rate (5YSR) was 21.4 % and that of R0 was 44.8%, on the other hand 5YSR and MST of chemotherapy alone was 0% and 14.5 month. Pathological response rate (&gt;=1b) was 60.5% and complete response was achieved 1 pts. 5YSR of pathological responders who underwent R0 resection was 81.4% and that of non-responders who underwent even R0 resection was 22.5% (P&lt;0.05). Conclusions: Preoperative modified DCS therapy for AGC was tolerable, and survival benefit of pathological responders with R0 surgery was promising and warrants further investigation.
Abstract 15489: Circulating Levels of Interleukin-17 and Cardiovascular Outcomes in Patients with Acute Myocardial Infarction
Authors: Tabassome Simon, Soraya Taleb, salma kotti, Benoit Rousseau, Simon Cattan, Jean-Michel Montely, Olivier Dubourg, alain tedgui, nicolas danchin, ziad mallat
Journal: Circulation (2012)

Aim: IL-17 pathway is being clinically targeted in immune-mediated diseases, most of which are associated with a significant cardiovascular risk.We investigated the relationship between serum level...