tbuckley/cabot-search huggingface dataset:
Treatment patterns in patients with colorectal liver metastasis: A cohort study.
Authors: D. A. Anaya, P. A. Richardson, D. Albo, A. Artinyan, N. J. Petersen, S. S. Awad, D. H. Berger, J. N. Cormier
Journal: Journal of Clinical Oncology (2010)

3628 Background: The management of colorectal cancer (CRC) liver metastasis (LM) is evolving. Newer chemotherapy and surgical treatment are associated with improved survival. Contemporary data regarding the use of these strategies is lacking. The goal of this study was to characterize treatment patterns for all patients presenting with CRC LM to the Veterans Affairs (VA) system and to examine changes in treatment patterns over time. Methods: A retrospective cohort study was conducted using a nationwide VA database (1998-2007). CRC LM cases were identified using a validated diagnostic algorithm and demographic, clinical characteristics, and treatment patterns were examined. Trends were compared using the Chi-squared test and multivariate analysis was conducted to identify independent predictors for receiving various treatments. Results: 10,203 patients with CRC LM were identified with a mean age of 68 ± 10.7 years (61% were ≥ 65 years). Among CRC LM patients treated within the VA system (n = 4,398), 63.3% did not receive surgery or chemotherapy. This no-treatment approach was more common in patients treated prior to 2003 compared to after 2003 (73% vs. 54.9%, p < 0.0001). After 2003, the use of chemotherapy increased from 16.3% to 32.6% (p < 0.0001), and the use of surgical treatments increased from 10.7% to 12.5 (p < 0.0001). Multivariate analysis identified increasing age: age ≥ 65 (odds ratio [OR] 1.4, 95%CI 1.13-1.73) or age ≥ 75 (OR 2.5, 95%CI 1.91-3.29), African-American race (OR 1.33, 95%CI 1.05-1.7), co-morbidity index ≥ 1 (OR 1.35, 95%CI 1.08-1.7), extrahepatic disease (OR 3.34, 95%CI 2.55-4.39), and treatment period 2003-2007 (OR 0.83, 95%CI 0.68-1.0) as significant factors associated with no treatment. Conclusions: The use of chemotherapy and surgery for the management of CRC LM has increased over time. However, a large proportion of patients are still managed outside this standard of care. The elderly and African-Americans in particular have a lower risk of receiving any type of treatment. Based on these findings, future research should focus on strategies to help overcome these age- and race-related healthcare disparities. No significant financial relationships to disclose.
Changes in lymphocytic populations and autoantibodies resulting from sunitinib treatment of metastatic renal cell carcinoma (mRCC).
Authors: A. Karadimou, M. Tsiatas, N. Gavalas, G. Lainakis, E. Terpos, M. A. Dimopoulos, A. Bamias
Journal: Journal of Clinical Oncology (2010)

e15085 Background: Treatment with cytokines has suggested an anticancer role of the immune system in mRCC patients. Given the antitumor activity of select tyrosine kinase inhibitors in mRCC, it is relevant to assess their effect on the immune system. Methods: VEGF, ANA, anti-dsDNA, cANCA, pANCA, AMA, ASMA, C3, C4, RF, anti-Tg, TPO in serum were analyzed in 29 naive patients with mRCC before and during first-line sunitinib therapy (every 2 or 3 cycles) with ELISA, RIA, or immunofluoresence. Lymphocytic populations were studied with flow cytometry. Results: Mean values of C3, C4, the incidence of positive autoantibodies in the Table. Median baseline VEGF levels were 660 pg/ml (125-1,283). At baseline 8 patients had no positive autoantibodies, 8 patients had 1, 8 had 2, 5 had 3, and one had a known autoimmune disease. cANCA, antiTg, and antiTPO were negative at all measurements. Baseline +ve ANA were correlated with increased HLADR+CD8 (17.1% vs. 11.3%, p=0.02). There was a reduction of ASMA titres at 3-4.5 months, which was reversed at 6-9 months of therapy. There was a significant reduction of CD4 (p=0.048), and HLADR+ CD4 (0.033) and CD8 (p=0.018) cells between baseline and at 3- 4.5 months of therapy. Finally, there was a correlation between the occurrence of ANA antibodies and HLADR+ CD8 cells 3-4.5 months after the initiation of treatment (10.2% vs. 8.3% for + and – cases, p=0.032). Conclusions: Sunitinib may induce changes in autoantibodies and lymphocytic populations in patients with mRCC. The development of autoantibodies seems to be correlated with the activation of CD8 lymphocytes. B 3-4,5 mo 6-9 mo >12 PD ANA 14/29 (48%) 6/14 (43%) 2/9 (22%) 1/3 (33%) 2/7 (28%) ds DNA 1/29 (3,4%) 0/14 (0%) 0/9 (0%) 0/3 (0%) 0/6 (0%) cANCA 0/29 (0%) 0/14 (0%) 0/9 (0%) 0/3 (0%) 0/6 (0%) pANCA 3/29 (10%) 2/14 (14%) 0/9 (0%) 0/3 (0%) 0/6 (0%) AMA 5/29 (17%) 3/14 (21%) 0/9 (0%) 0/3 (0%) 0/3 (0%) ASMA 20/29 (69%) 3/14 (21%) 5/9 (56%) 2/3 (66%) 2/6 (33%) C3 144 138 165 149 174 C4 –32 –29 –36 –31 –37 RF 1/29 (3,4%) 0/14 (0%) 0/9 (0%) 0/3 (0%) 0/6 (0%) antiTg 0/12 (0%) 0/7 (0%) 0/3 (0%) 0/1 (0%) 0/3 (0%) antiTPO 0/12 (0%) 0/7 (0%) 0/3 (0%) 0/1 (0%) 0/3 (0%) Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Pfizer
Valuable and Valueless Diversity
Authors: Chris Gyngell
Journal: The American Journal of Bioethics (2015)

In “Imposing Diversity” Robert Sparrow illustrates that objections to genetic selection based on diversity can have counterintuitive implications.  Through a series of thought experiments designed to overcome any status quo bias that may be affecting our assessment of the value of diversity, Sparrow argues that valuing genetic diversity is more problematic than is generally recognized.   In this commentary I argue a well-developed account of the value of genetic diversity can lead to less problematic implications, and remain an important consideration when considering the ethics of genetic selection.  For reasons of space I will only discuss two of Sparrow’s thought experiments “Imposing Disability” and “Genetic Scapegoat”.
Rate of major cardiac adverse events 14 months after coronary bifurcation stenting with culotte vs. crush techniques in the Nordic Bifurcation Stent Technique Study
Authors: K. Kervinen, M. Niemela, A. Erglis, I. Kumsars, M. Maeng, Jens Flensted Lassen, P. Gunnes, S. Stavnes, J.S. Jensen, A. Galloe, I. Narbute, D. Sondore, E.H. Christiansen, Jan Ravkilde, T.K. Steigen, J. Mannsverk, P. Thayssen, K.N. Hansen, K. Virtanen, S. Helquist, S. Vikman, R. Wiseth, Jens Aarøe, L. Thuesen
Journal: Journal of the American College of Cardiology (2009)
The impact of PET imaging on outcomes in patients with stage III non-small cell lung cancer (NSCLC) treated with chemoradiation: A subset analysis of HOG LUN 01-24/USO-023.
Authors: N. H. Jayaram, M. A. Neubauer, C. S. Johnson, T. Breen, C. E. Williams, N. H. Hanna
Journal: Journal of Clinical Oncology (2010)

7065 Background: FDG-PET is part of the NCCN recommendations for the pretreatment evaluation of patients with early stage NSCLC. Others have reported improved survival in patients with stage III NSCLC staged by PET. It has been hypothesized that improved outcomes can be realized by PET imaging to reduce treating patients with unsuspected stage IV disease and may improve planning. We, therefore, evaluated the role of PET scan and outcomes treated on a phase III study of cisplatin (P), etoposide (E), and concurrent chest radiation (XRT) with our without consolidation docetaxel (CD). Methods: Eligible patients received standard treatment with EP and concurrent XRT. Those with nonprogression were subsequently randomized to receive CD versus observation (OO). Log-ranked tests were used to evaluate the association of pretreatment PET with overall survival. Comparisons were made of the entire patient set (n=243) with respect to PET versus no PET along with comparison of only randomized patients (n=166). Results: The PET versus no PET groups were well matched except that PET patients on average had a better performance status (62% vs. 52%) and lower stage IIIA (45% vs. 31%). Overall survival outcomes by PET are summarized in the Table. Conclusions: This retrospective, subset analysis of a phase III trial suggests that the use of PET at baseline did not result in substantially better outcomes for patients with stage III NSCLC treated with chemoradiation. Patient population PET MST NO PET MST HR p value All (n=243) 22.8 mo (n=169) 20.1 mo (n=74) 0.84 0.3352 Randomized (n=166) 24.7 mo (n=113) 25.4 mo (n=53) 0.77 0.2250 CD (n=82) 21.5 mo (n=51) 35.1 mo (n=31) 0.58 0.0624 OO (n=84) 28.4 mo (n=62) 17.6 mo (n=22) 1.13 0.6934 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration US Oncology, Inc. OSI Celgene, Genentech, Lilly, Pfizer
A prospective, randomized, controlled, multicenter trial of Chinese herbs by stages combined with chemotherapy for advanced non-small cell lung cancer.
Authors: Z. Xu, C. Jin, Z. Wang, H. Deng, D. Shen, M. Zhang, M. Li, J. Wang, Z. Zheng, Y. Gong
Journal: Journal of Clinical Oncology (2010)

e18000 Background: Chemotherapy plays an important role in the treatment of advanced non-small cell lung cancer (NSCLC), but the overall survival (OS) and the median survival time (MST) are not satisfactory. Chinese herbs (CH) is a popular treatment for NSCLC in china. Our purpose was to observe the efficacy of CH by stages combined with chemotherapy versus chemotherapy alone for NSCLC (stage III/IV). Methods: A prospective, randomized, controlled, multicenter, clinical trial was conducted on 115 patients assigned to treatment group (60) and control group (55). The control group was treated by chemotherapy (cisplatin and gemcitabine [GP]/cisplatin and vinorelbine [NP]) alone, while the treatment group was treated by chemotherapy (GP/NP) combined with CH and was administered Kangliuzengxiao decoction (KLZX) during chemotherapy course and Feiyanning decoction (FYN) maintenance after chemotherapy. End points were OS, MST, response rate, toxicity, and Karnofsky score. Results: MST was 14.47 months (95% confidence interval, 10.37 to 18.57) in treatment group compared with 10.97 months (95% confidence interval, 9.35 to 12.59) in control group (p = 0.001). 1 year, 2 years, 3 years, 5 years survival rates in treatment group were 54.8%, 24.6%, 13.2%, 5.7%, compared to control group 35.6%, 3.7%, 0%, 0% (p = 0.001). The response rates (CR+PR) were 28.3% (treatment group) and 18.2% (control group), there was no statistically significant difference in response rate between the two groups. The toxicities mainly were gastrointestinal dysfunction and myelosuppression of different degrees. Remission rate of nausea/vomiting symptoms was high after patients treated with CH in treatment group (p < 0.05), myelosuppression was more significant in control group than in treatment group (p < 0.05). Karnofsky score of treatment group was higher than that of control group (p < 0.01) (p < 0.01). Conclusions: In this trial, chinese herbs by stages combined with chemotherapy could prolong the MST and OS,still improve Karnofsky score, while the toxicity was not enhanced. Chinese herbal medicine was a promising maintenance treatment for advanced NSCLC. No significant financial relationships to disclose.
Detection of multiple myeloma cells using multicolor flow cytometry
Authors: I. O. Kara, B. Sahin
Journal: Journal of Clinical Oncology (2004)

6679 Background: The advent of new therapeutic approaches to multiple myeloma made necessary the introduction of novel methods for detection of minimal residual disease. Among others approaches residual disease can be detected by using flow cytometry. Methods: We have examined the co-expression of CD19, CD38, CD45, CD56, and CD138 molecules in cells of bone marrow aspirates in patients with multiple myeloma by multi-color flow cytometry. For the detection and characterization of multiple myeloma cells, combinations of following antibodies were used: anti-CD19 FITC, anti-CD38 FITC, anti-CD56 PE-Cy5, anti-CD45 PE, anti-CD45 PE-Cy5 and anti CD138 PE. The samples were analyzed using EPICS XL (Coulter) flow cytometer, and the analysis was based on at least 50,000 events. Results: EPICS XL (Coulter) flow cytometer, and the analysis was based on at least 50,000 events. Samples from 15 patients were analyzed of whom 2 smoldering myeloma, 2 plasmocytoma and 11 multiple myeloma. The percentage of multiple myeloma cells ranged between 2.5% and 90% in bone marrow aspirates. The expression of CD138, CD38, CD45, CD19 and CD56 molecules was found in 73%, 80%, 93%, 13% and 26% of examined cases, respectively. Conclusions: In our opinion, multiple myeloma cells are best characterized by following combinations of antibodies: CD38+ /CD138+/CD45+. The identification of a malignant clone is the first and the most important step in the characterization of the disease, determination of its prognosis and the detection of residual disease after treatment. Multi-color flow cytometry represents a method which can meet these goals. No significant financial relationships to disclose.
Is UGT1A1*28 homozygosity the strongest predictor for severe hematotoxicity in patients treated with 5-fluorouracil (5-FU)-irinotecan (IRI)? Results of the PETACC 3 - EORTC 40993 -SAKK 60/00 trial comparing IRI/5-FU/folinic acid (FA) to 5-FU/FA in stage II- III colon cancer (COC) patients
Authors: A. D. Roth, P. Yan, D. Dietrich, R. Fiocca, G. Bodoky, R. Labianca, D. Cunningham, E. Van Cutsem, F. Bosman, S. Tejpar
Journal: Journal of Clinical Oncology (2008)

4036 Background: Several studies with limited patient (pt) numbers reported a higher risk of severe toxicity in homozygous UGT1A1*28 (*28/*28) pts treated with IRI, with inconsistent findings due to IRI dosage heterogeneity. To better evaluate the risk attributable to IRI in *28/*28 pts, we took advantage of PETACC 3, a large adjuvant trial with 3005 COC pts, where 91% of the pts treated in arm A received IRI at 180mg/m2 q2w with infusional 5-FU/FA (FOLFIRI). Methods: DNA was extracted from normal formalin fixed paraffin embedded tissue. UGT1A1 genotype (Ge) was assessed by PCR and fragment sizing. Frequency of grade (Gd) 4 neutropenia (N) and of febrile neutropenia (FN) according to UGT1A1 Ge status (Normal: *1/*1, heterozygous: *1/*28 or homozygous: *28/*28) was assessed by chi-square tests and Cochran-Armitage trend tests. Logistic regression (LR) was used to test the impact of other variables (Var) on toxicity outcomes. Results: Of the 1,405 patients genotyped 44% are 1*/1*, 43% *1/*28 and 13% *28/*28. Decreased occurrence (occ) of Gd ≥3 diarrhea with Ge *28/*28 in both arms was reported elsewhere (ASCO GI 2008, abstr #277). Gd 4 N occ in arm A (A) is 9% and 3.2% in arm B (B). Gd 4 N occ according to Ge (*1/*1 and *1/*28 vs *28/*28) is 7.9% vs 16.1% (p=0.013, odds ratio (OR) 2.3 [95%CI 1.2–4.3]) in A, and 3.5% vs 1.4% (p=0.54) in B. FN occ in A is 5.2% and 1.76% in B. FN occ according to Ge (*1/*1, *1/*28 and *28/*28) is 6.5%, 2.2% and 11.5% (p=0.002 for *1/*1 vs *1/*28 vs *28/*28 and p=0.009, OR 3.0 [1.4–6.4] for *28/*28 vs all others) in A, and 1.7%, 1.6% and 2.7% (p=0.80) in B. Multiple LR analysis in A looking at age <60, sex, PS (1–0), bilirubin (0.5 x ULN) and Ge *28/*28 shows Female sex (FS) (OR 2.6 [1.4–4.6]) Ge *28/*28 (OR 2.5 [1.3–4.9]) PS (OR 2.0 [1.1–3.7]) and age (OR 0.6 [0.3–0.9]) to be significant as Var influencing Gd 4 N. If only cycle 1 is considered, the only significant Var influencing Gd 4 N are FS (OR 4.1 [1.8–9.6], p=0.0011) and UGT1A1 (OR 2.6 [1.05–6.5], p<0.04). Conclusion: The risk of developing grade 4 N and FN with FOLFIRI is increased in *28/*28 pts. However, FS is a stronger predictor of Gd 4 N than UGT1A1 Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Pfizer Oncology Pfizer Oncology Pfizer Oncology
Chemotherapy followed by accelerated fractionated radiation for larynx preservation in patients with advanced laryngeal cancer.
Authors: A Eisbruch, A F Thornton, S Urba, R M Esclamado, W R Carroll, C R Bradford, M B Hazuka, F J Littles, M Strawderman, G T Wolf
Journal: Journal of Clinical Oncology (1996)

Larynx preservation in advanced, resectable laryngeal cancer may be achieved using induction chemotherapy (CT) followed in responding patients by definitive radiation (RT). To address potential accelerated repopulation of clonogenic tumor cells during the prolonged total treatment time, we studied the feasibility of accelerated fractionated RT after CT.Patients with advanced laryngeal cancer received two cycles of cisplatin 100 mg/m2 and fluorouracil (5-Fu) 1,000 mg/m2/d for 5 days. Responding patients received a third cycle after which those who had complete response or tumor down-staging to T1 proceeded with accelerated RT: 70.4 Gy delivered over 5.5 weeks. Patients who achieved a lesser response to CT underwent total laryngectomy and postoperative RT.Thirty-three patients were accrued. Three died during the course of CT and two declined definitive treatment after CT. Twenty-one patients had a major response to CT, 20 of whom received accelerated RT. Median weight loss during RT was 11%. Late severe morbidity was observed in five patients (25%). All four patients who underwent salvage laryngectomy after accelerated RT experienced major postoperative complications. The locoregional failure rate was 25%. The larynx was preserved in 48% of the total study population and in 80% of the patients irradiated according to the study protocol.Accelerated RT after CT as delivered in this study may increase both acute and long-term morbidity rates compared with studies using standard RT after CT. It did not seem to improve local/regional tumor control or survival despite stringent patient selection criteria.
What do patients think about CA-125 monitoring in the follow-up? Results from a multicenter trial in 1,060 patients with ovarian cancer
Authors: G. Oskay-Oezcelik, A. du Bois, P. A. Fasching, S. Mahner, C. Liebrich, A. Glaβ, S. Schmidt-Wetze, L. Sepp, K. Münstedt, W. Lichtenegger, J. Sehouli
Journal: Journal of Clinical Oncology (2009)

5522 Background: In the clinical day CA-125 monitoring is frequently used as a part of follow-up care for patients with ovarian cancer (OC). However, the potential benefit of CA-125 controls in the absence clinical symptoms are still unclear.There is little known about the expectations and preferences of patients with OC. Therefore we have initiated a multi-institutional survey. Methods: A semi-structered consisting 15 questions was developed in a pilot-study of 20 patients. After this validation all gynecological departments and gynecological-oncological practices were invited to participate in this trial using an anonynomous print version of the questionaire Results: Between December 2006 and December 2007 a total of 1,060 patients were enrolled. The median age of the patients was 58 years (range 16–87). 60% of the patients had primary ovarian cancer, 40% had relapsed ovarian cancer. Routine follow-up visits were mostly performed by gynaecologists in a gynaecological practice (56.9%) and in hospitals (49.5%). Patients were informed about the procedures and goals of cancer care predominantly after primary surgery (62.5%) and in 15.7% after last cycle of first-line chemotherapy. 7.7% declared that they were informed only at the first follow-up visit, 9.2% stated that they have never received any information about their cancer care management. According the patient´s opinion the main objective for the follow-up is the early detection of relapse and a prolongation of overall survival (95.8%). About more than 90% get CA-125 measurements. These were the procedures with highest anxiety but also the most important procedure for the patient. Finally, most patients (89%) were satisfied from their management of cancer care. Conclusions: The present study is the largest survey about cancer care so far and provides several important data for physician-patient communication concerning the follow-up management of patients OC. No significant financial relationships to disclose.
Standard versus saturation biopsy before primary focal cryosurgery of the prostate: Does it matter?
Authors: Jamie Sungmin Pak, Philippa J. Cheetham, Aaron Katz, Sven Wenske
Journal: Journal of Clinical Oncology (2015)

123 Background: Primary focal cryosurgery (PFC) has emerged as a viable option for local therapy in prostate cancer (PCa), most suitable for patients with clinical stage T1c-T3 disease of any tumor grade in whom potency is not of primary concern and who are not suitable for radical prostatectomy or radiation therapy. Success of 5-year biochemical recurrence (BCR)-free survival, depending on criteria, ranges from 60% to 90% in the literature. We hypothesize that saturation biopsy before PFC leads to lower rates of BCR compared to standard 12-core biopsy. Methods: We compiled a consecutive series of patients who underwent PFC at our institution for localized PCa. Parameters including demographics, PSA levels, and Gleason scores before primary treatment and at time of recurrence were assessed. Biochemical failure was defined by both Phoenix (PD) and Stuttgart (SD) definitions. Chi-square analysis was performed to compare outcomes. Results: One hundred and forty-seven patients underwent PFC at our institution between August 2000 and January 2014. Forty-five patients were excluded due to incomplete follow-up data and/or missing biopsy information. Median follow-up was 40.3 months (0.8-116, IQR 41). Conclusions: Zero of the six patients who underwent a saturation biopsy before PFC experienced biochemical failure or progression. This in contrast to those who underwent a standard 12-core biopsy before PFC, of which 19% experienced biochemical failure by PD and 26% by SD, and 6% underwent progression. This may be due to more informed selection for local therapy and more comprehensive assessment of the extent of tumor for treatment planning. Though these differences were not statistically significant in our study, we believe that our results lay the groundwork for a larger study to assess differences in outcomes after PFC depending on the extent of biopsy before treatment. [Table: see text]
Abstract 13507: Human Cardiac Progenitor Cells Engineered with {beta}ARK-ct Have Increased Survival and Proliferation
Authors: Mohsin Khan, Sadia Mohsin, Jonathan Nguyen, Monique Alkatib, Silvia Truffa, Natalie Gude, Walter J Koch, Mark A Sussman
Journal: Circulation (2012)

Rationale: Failing human hearts are characterized by activated adrenergic signaling leading to receptor desensitization and upregulated GRK2. βARK-ct, a GRK2 inhibitory peptide, rescues the failing...