tbuckley/cabot-search huggingface dataset:
Abstract P262: Weight Gain with Aerobic Exercise Training Results from Increased Fat and Lean Mass
Authors: Julie Holden, Damon Swift, Neil Johannsen, Conrad Earnest, Timothy Church
Journal: Circulation (2012)

Hypothesis: Weight gained in response to aerobic exercise represents an increase in lean mass. Methods: Participants from the exercise group (n=68) of the Inflammation and Exercise (INFLAME) study had fat mass, lean mass, and weight measured at baseline and at follow-up. Fat mass and lean mass were measured using DXA. Changes in lean mass and fat mass were quantified across tertiles of weight change in the exercise training group and were analyzed using generalized linear models with adjustment for baseline value. Results: are presented as least squares means with 95% confidence intervals. Results: Overall, participants exhibited a mean (range) weight change of –0.73 kg (–9.00, 7.00; n=68) following exercise training. Tertiles of mean (range) weight change were: tertile 1 (most weight loss) –3.40 kg (–9.00,–1.50; n=23), tertile 2 (some weight loss) –0.70 kg (–1.30, –0.10; n=22), and tertile 3 (weight gain) 1.93 kg (0, 7.00; n=23). For those in tertile 3, we observed a significant increase (p&lt;0.0001) in lean mass of 0.91 kg (95% CI, 0.48, 1.34) compared to those who lost weight −0.85 kg (−1.28,−0.42) in tertile 1 and −0.52 kg (−0.97,−0.08) in tertile 2. However, no significant difference in lean mass change was seen between the two weight loss tertiles. We also observed a significant increase in fat mass in participants who gained weight (tertile 3) 1.07 kg (0.41, 1.73) while those who lost the most weight (tertile 1) −2.55 kg (−3.21,−1.89) had a significant decrease in fat mass. Participants who experienced some weight loss (tertile 2) showed no significant change in fat mass, −0.24 kg (−0.91, 0.44). Conclusion: Weight gained with aerobic exercise training cannot be attributed to increased lean mass only. Our findings suggest that adults who gained weight with exercise showed significant increases in both fat and lean mass.
Use of gemcitabine- (Gem) and fluropyrimidine (FP)-based chemotherapy to reduce myeloid-derived suppressor cells (MDSCs) in pancreatic (PC) and esophagogastric cancer (EGC).
Authors: R. F. Gabitass, N. E. Annels, J. Crawshaw, H. S. Pandha, G. W. Middleton
Journal: Journal of Clinical Oncology (2011)

2588 Background: Pre-clinical data demonstrates that Gem and FP treatment leads to substantial falls in MDSCs in murine cancer models. We prospectively evaluated whether such a phenomena occurs in patients (pts) with cancers treated with these agents. Methods: Peripheral blood was collected from pancreatic and esophago-gastric cancer pts prior to and following Gem or FP based therapy. PBMC was harvested with subsequent flow-cytometric analysis of HLADR- Linlow/- CD33+ CD11b+ MDSCs. Percentage change in MDSC value was compared to independent evaluation of tumor volume percentage change, measured using the RECIST v1.1 criteria for target lesion assessment. Results: 16 PC pts receiving Gem based treatment and 23 EGC pts treated with FP based therapy were analyzed. There was a statistically significant reduction in pre and post treatment MDSC % (p<0.0001). Of the 21 pts having a >10% decrease in tumor volume, 20 had a fall in MDSCs, 60% of whom the MDSCs fell by >30%. There was a statistically significant reduction in MDSC % in the remaining 18 pts who had a ≤10% decrease in tumor volume or progressive disease (p=0.0016). 4 of 7 pts with a 0-10% tumor volume decrease had a >25% fall in MDSCs. None of the 11 pts with an increase in tumor volume had a >8% increase in MDSCs. Of these, 3 pts had substantial falls in MDSCs >30%, including an EGC pt where MDSCs fell from a value above the upper limit of normal (ULN) (defined by controls, n=47), to within the normal range. In all pts with initial MDSCs above the ULN, Gem or FP therapy reduced MDSCs to within normal range, independent of response. Conclusions: Gem and FP therapy significantly reduces or stabilizes MDSCs in PC and EGC, independent of response. These findings have important significance for programs integrating chemotherapy with immunotherapies such as cancer vaccines.
Results from the pilot phase of the IN-GHO registry for elderly cancer patients
Authors: F. U. Honecker, U. Wedding, M. Kornacker, C. Bokemeyer
Journal: Journal of Clinical Oncology (2008)

20654 Background: The internet-based IN-GHO registry prospectively collects data of elderly cancer patients (pt) ≥70 y. In order to gain more insight into feasibility of cancer treatment, results of a short geriatric assessment (GA), physicians’ and pts’ judgement of fitness, and outcome measures were studied. Methods: Demographic information, ADLs, IADLs, Karnofsky Performance Status (KPS), comorbidity (Charlson score), medication, and mobility (timed up&go) were registered. Age, results of GA, and physicians’ and pt self rated fitness were analysed by univariate analysis for association with the following clinical endpoints: documentation of adverse events (AE), feasibility of planned chemotherapy, and death within follow up. Results: During the pilot phase, 11 centers enrolled 210 pt. Median age was 76 y (range 70–95). 40% of pt were classified as vulnerable or frail by the treating physician. 44% of pt rated their fitness as less then fair. 30% of pt had AE within 8–12 weeks of follow up, and 38% died within 6 months. The following significant associations (p<0.05) were found: Documentation of AE: Fitness rated less than fair by pt, judged frail by physician, Charlson score >=2 Feasibility of planned therapy: Fitness rated fair or better by pt Death: Any impairment in ADL, IADL, KPS <90%, fitness rated less than fair by pt, judged vulnerable or frail by physician. Conclusions: Prospective internet-based data collection is feasible. High rates of AE, unplanned treatment termination, and deaths were documented. Whereas age was not, fitness as rated by the pt was associated with all clinical endpoints. Recruitment continues in >100 centers, aiming at collecting data from approximately 3,000 pts. The registry will help to identify suitable assessment tools for tailoring therapy in elderly cancer pt. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Ortho Biotech Ortho Biotech Ortho Biotech
Influenza vaccination programme – Are the UK government incentives working?
Authors: Mohammad Paracha, Rizwan Ahmed, Mohammad Salahuddin
Journal: European Respiratory Journal (2011)

Background: Influenza A (H1N1) virus has spread globally in recent years. The UK government recommends all people in high-risk groups (all >65 yrs old, people with chronic diseases, the immunocompromised, carers, healthcare workers & pregnant women) be vaccinated against H1N1. Pregnant women are four times more likely to be hospitalised due to the virus as compared with non-pregnant women [1]. The rate of H1N1 hospitalisation among children is also significantly higher compared to those over 65 years old [2]. General practices in the UK are given financial incentive to achieve >70% uptake in high-risk groups.

Methods: We retrospectively reviewed vaccination uptake amongst the high-risk population in two practices in different regions of the UK for winter 2010/11. Both practices use the computer input software (EMIS). The programme Population Manger was used to retrieve the uptake data.

Results: Both surgeries are achieving the required national target, practice A: 75% (1502/1998) & practice B: 73% (917/1250), hence received full financial incentive. However, both practices have a very low uptake in under 16 year olds, practice A: 35% (27/78) & practice B: 40% (21/52) and among pregnant women, practice A: 40% (12/30) & practice B: 14% (4/28).

Conclusion: Incentives for the vaccination programme should be revisited so that all the sub groups of high-risk population, including those most at risk of complications and hospital admissions, achieve the same high level of immunisation.

References: 

*   1. Toal M. et. al. Swine flu and pregnancy. J Obstet Gynaecol, Feb 2010; 30(2):97-100.

*   2. Jain S. et. al. Hospitalized Patients with 2009 H1N1 Influenza in the United States, April–June 2009. N Engl J Med. Nov 2009; 361(20):1935–1944.
Phase II clinical trial of triazinate in combination with mitomycin C for patients with advanced gastric cancer.
Authors: M J O'Connell, A J Schutt, C G Moertel, R G Hahn
Journal: Journal of Clinical Oncology (1987)

Thirty-three patients with advanced measurable gastric cancer were treated with a combination of mitomycin C and triazinate. Twenty-nine of these patients had failed prior chemotherapy. Nine patients (27%) had an objective tumor response (median duration, 10 weeks). Median survival of all patients treated was 21 weeks. This study demonstrates that carefully selected patients with advanced gastric cancer who have failed a trial of chemotherapy, but are still ambulatory and maintaining adequate nutrition are appropriate subjects for studies of new treatment regimens. Based on the observed objective tumor response rate and median patient survival, further studies of these drugs in combination for the treatment of advanced gastric cancer are indicated.
Local Transmission of Zika Virus — Puerto Rico, November 23, 2015–January 28, 2016
Authors: Dana L. Thomas, Tyler M. Sharp, Jomil Torres, Paige A. Armstrong, Jorge Munoz-Jordan, Kyle R. Ryff, Alma Martinez-Quiñones, José Arias-Berríos, Marrielle Mayshack, Glenn J. Garayalde, Sonia Saavedra, Carlos A. Luciano, Miguel Valencia-Prado, Steve Waterman, Brenda Rivera-García
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

Zika virus, a mosquito-borne flavivirus, spread to the Region of the Americas (Americas) in mid-2015, and appears to be related to congenital microcephaly and Guillain-Barré syndrome (1,2). On February 1, 2016, the World Health Organization (WHO) declared the occurrence of microcephaly cases in association with Zika virus infection to be a Public Health Emergency of International Concern.* On December 31, 2015, Puerto Rico Department of Health (PRDH) reported the first locally acquired (index) case of Zika virus disease in a jurisdiction of the United States in a patient from southeastern Puerto Rico. During November 23, 2015-January 28, 2016, passive and enhanced surveillance for Zika virus disease identified 30 laboratory-confirmed cases. Most (93%) patients resided in eastern Puerto Rico or the San Juan metropolitan area. The most frequently reported signs and symptoms were rash (77%), myalgia (77%), arthralgia (73%), and fever (73%). Three (10%) patients were hospitalized. One case occurred in a patient hospitalized for Guillain-Barré syndrome, and one occurred in a pregnant woman. Because the most common mosquito vector of Zika virus, Aedes aegypti, is present throughout Puerto Rico, Zika virus is expected to continue to spread across the island. The public health response in Puerto Rico is being coordinated by PRDH with assistance from CDC. Clinicians in Puerto Rico should report all cases of microcephaly, Guillain-Barré syndrome, and suspected Zika virus disease to PRDH. Other adverse reproductive outcomes, including fetal demise associated with Zika virus infection, should be reported to PRDH. To avoid infection with Zika virus, residents of and visitors to Puerto Rico, particularly pregnant women, should strictly follow steps to avoid mosquito bites, including wearing pants and long-sleeved shirts, using permethrin-treated clothing and gear, using an Environmental Protection Agency (EPA)-registered insect repellent, and ensuring that windows and doors have intact screens.
Are timing of chemoradiation and early therapy response as detected by PET prognostic factors of a multimodality treatment approach for NSCLC stage III? (LUCAS-MD)
Authors: M. Schmuecking, C. P. Schneider, N. Presselt, R. P. Baum, J. Leonhardi, K. Hoeffken, A. Niesen, K. M. Mueller, T. G. Wendt, R. Bonnet
Journal: Journal of Clinical Oncology (2007)

7532 Background: A randomized multicenter phase III trial was designed to assess if timing of chemoradiation may alter treatment outcome for patients (pts) with stage III NSCLC in a multimodality treatment approach. Additionally, the role of F-18 FDG PET within clinical trials is evaluated for staging, therapy management, molecular radiation treatment planning (MRTP) and early therapy response and its effect on survival as compared to regression grade (RG). Methods: Inclusion criteria: histologically confirmed NSCLC stage IIIA/IIIB. ECOG PS 0–1. Primary end points: OS, DFS. Secondary end points: TTP, QoL, RR. Neoadjuvant treatment: 2–3 cycles of paclitaxel/carboplatin and a block of chemoradiation (45 Gy, 1.5 Gy b.i.d., concomitant paclitaxel/carboplatin) followed by surgery. Randomization: late (Arm1) vs. early (Arm2) chemoradiation. Staging: PET in addition to CT and/or MRI after randomization, second PET after completion of neoadjuvant therapy. Assessment of standardized uptake values (SUV) in primary tumor (PT) and all metastatic lymph nodes (LN). Documentation of involved LN as detected by PET and LN sampling during surgery according to Naruke/ATS-LCSG classification. Evaluation of RG and correlation with PET for PT and each LN. MRTP using fused PET/CT data. Intent to treat analyses using Kaplan-Meier estimates, log rank tests, Cox multivariate models. Results: 210 eligible pts were enrolled (Arm1: 106, Arm2: 104, well-balanced on all factors). Paraoperative lethality 4.3%. Treatment-related deaths in Arm1: 8.3%, in Arm2: 5.9%. Up-staging in 26/210 pts due to distant metastases, down-staging in 5/210 pts resulting in 15% stage migration. Actuarial tumor specific survival after 60 months: complete vs. incomplete metabolic remission: 56% vs. 24% (p =0.005), RG III/IIb (no/less than 10% of vital tumor cells) vs. RG IIa/I (more than 10% vital tumor cells): 61% vs. 25% (p &lt;0.001). Late vs. early chemoradiation: 30% vs. 45% (p =0.313). Multivariate Cox regression for initial SUV: p &gt;0.05. Conclusions: Long-term survivors with early chemoradiation have a trend to better survival being not statistically significant. Metabolic remission correlates well with RG and may predict therapeutic outcome. No significant financial relationships to disclose.
Genitourinary (GU) small cell carcinoma (SCC): A retrospective review of treatment and survival patterns at the Ottawa Regional Cancer Center (ORCC)
Authors: T. R. Asmis, M. N. Reaume, S. Dahrouge, S. Malone
Journal: Journal of Clinical Oncology (2004)

4545 Background: SCC of the bladder (SCCB), prostate (SCCP), and kidney (SCCK) remains a therapeutic challenge. Much debate exists in the literature about the ideal course of therapy. Methods: All charts of all patients seen at the ORCC between 1991–2002 for any GU diagnosis were manually reviewed to identify GUSCC. Demographic, staging, treatment and outcome data was extracted. The Veterans Administration small cell lung cancer classification of limited and extensive disease was adapted to the genitourinary system(limited:disease localized to the true and false pelvis, extensive:disease beyond the pelvis). Results: 555, 858 and 5066 new cases of primary renal, bladder and prostate cancer respectively, were identified. Of these cases, 22 patients were GUSCC: 12 SCCB, 10 SCCP and no SCCK. 8/12 SCCB had limited disease. 5 patients with SCCB are alive and were all limited at diagnosis. Surviving patients received similar therapy with transurethral resection of the bladder tumor, platinum chemotherapy, etoposide (4–6 cycles), and radical radiotherapy (56–60 Gray). All cases of SCCP have died. 2/10 had limited stage. Of these two patients one was treated with platinum chemotherapy and etoposide followed by radical radiotherapy (66 Gray), the other patient had a poor performance status at diagnosis and was treated with palliative hormonal ablation and radiotherapy. Our table illustrates the median survival according to site and stage (SCCB and SCCP combined) at diagnosis. Conclusions: Our findings support that GU SCC is an aggressive cancer. We have found that limited stage SCCB and SCCP, when treated with platinum/etoposide chemotherapy along with radical radiotherapy tends to have a more favourable outcome than that of extensive GUSCC. No significant financial relationships to disclose.
Phase II trial of fludarabine monophosphate as first-line treatment in patients with advanced follicular lymphoma: a multicenter study by the Groupe d'Etude des Lymphomes de l'Adulte.
Authors: P Solal-Céligny, P Brice, N Brousse, H Caspard, Y Bastion, C Haïoun, A Bosly, H Tilly, D Bordessoule, C Sebban, J L Harousseau, P Morel, B Dupas, F Plassart, N Vasile, N Fort, M Leporrier
Journal: Journal of Clinical Oncology (1996)

PURPOSE Fludarabine monophosphate (FAMP) is a major drug in the treatment of chronic lymphocytic leukemia and showed efficacy in selected groups of patients with low-grade lymphomas, most of them pretreated. The aim of this trial was to assess the efficacy and the toxicity of FAMP in untreated patients with follicular lymphoma. PATIENTS AND METHODS Fifty-four untreated patients with advanced follicular lymphoma were treated with intravenous (i.v.) fludarabine at a dose of 25 mg/m2/d during 5 days every 4 weeks, to a maximum of nine cycles. RESULTS The toxicity of the drug was mild, mainly granulocytic. Granulocytopenia &gt; or = 3 (World Health Organization [WHO]) was observed during 48 of 328 cycles (14.6%) and in 22 of 53 (41%) patients assessable for toxicity. Fludarabine had to be stopped prematurely because of toxicity in nine patients: marrow toxicity in five, peripheral neuropathy in two, and interstitial pneumonitis and hepatitis in one patient each. Among 49 patients assessable for response, the overall response rate was 65% and the complete response (CR) rate 37%. The median progression-free survival interval for all patients was 13.6 months. CONCLUSION These results confirm that fludarabine is active when used as first-line treatment in patients with follicular lymphoma and has a low toxicity rate. It may be used as single treatment in elderly patients. Associations of fludarabine with other drugs active against follicular lymphoma need to be determined.
Abstract P315: Increase in Stress May Contribute to Lower Heart Rate Variability in Healthy Young Subjects
Authors: Amanda C Costa, Ana Gabriela C Silva, Cibele T Ribeiro, Guilherme A Fregonezi, Fernando A Dias
Journal: Circulation (2012)

Background: Stress is one of the risk factors for cardiovascular disease and decreased heart rate variability is associated to increased mortality in some cardiac diseases. The aim of the study was to assess the impact of perceived stress on cardiac autonomic regulation in young healthy volunteers. Methods: 35 young healthy volunteers (19 to 29 years old, 6 men) from a Brazilian population were assessed for perceived stress by the translated and validated Perceived Stress Scale (PSS, 14 questions) and had the R-R intervals recorded at rest on supine position (POLAR RS800CX) and analyzed (5 minutes, Kubius HRV software) by Fast-Fourier Transform for quantification of Heart Rate Variability (HRV). Results: Average data (±SD) for age, heart rate, BMI, waist circumference and percentage of body fat (%BF) were: 21.3±2.7 years; 65.5±7.9 bpm; 22.3±1.9 Kg/m 2 ; 76.0±6.1 cm and 32.1±6.6%; respectively. The mean score for the PSS-14 was 23.5±7.2 and for the HRV parameter as follow: SSDN=54.8±21.2ms; rMSSD=55.9±32.2ms; low-frequency (LF)= 794.8±579.7ms 2 ; High-frequency (HF)= 1508.0±1783.0 ms 2 ; LF(n.u.)= 41.1±16.2; HF(n.u.)= 58.9±16.2; LF/HF=0.89±0.80 and Total power (TP)= 3151±2570ms 2 . Spearman nonparametric correlation was calculated and there was a significant correlation of PSS-14 scores and LF (ms 2 ) (r=−0.343; p= 0.044). Other HRV variables did not shown significant correlation but also had negative values for Spearman r (TP r=−0.265, p=0.124; HF r=−0.158; SSDN r=−0.207; rMSSD r=−0.243, p=0.160). LF/HF and LF(n.u.) did not correlate to PSS-14 having Spearman r very close to zero (LF/HF r=−0.007, p=0.969; LF(n.u.) r=−0.005, p=0.976). No correlation was found for HRV parameters and BMI and there was a trend for statistical correlation of %BF and LF (ms 2 ) (r=−0.309, p=0.071). Conclusions: These data demonstrate a possible association of perceived stress level and HRV at rest. Changes in LF can be a consequence of both sympathetic and parasympathetic activity, however, analyzing the other variables HF, TP, SSDN and rMSSD (all negative Spearman r) and due to the lack of changes in LF/HF ratio and LF(n.u.) we interpret that increased stress may be associated to decrease in overall heart rate variability. These changes were seen in healthy individuals and may point out an important mechanism in cardiovascular disease development.
The human tumor clonogenic assay in human breast cancer.
Authors: S E Jones, J C Dean, L A Young, S E Salmon
Journal: Journal of Clinical Oncology (1985)

The human tumor clonogenic assay (HTCA) was evaluated in 407 fresh samples of breast cancer from 288 patients. Seventy samples were inadequate for testing. Adequate in vitro growth for drug testing (greater than 30 colonies/plate) was obtained in 91 (27%) of the 337 viable samples, inadequate growth for drug evaluation (5 to 30 colonies/plate) in 17%, and no colony formation (less than 5 colonies/plate) in 56%. Operationally defining a greater than or equal to 50% inhibition of colony formation as in vitro drug sensitivity, the in vitro response rates to 12 anticancer drugs tested against ten to 36 different cancers (arranged in decreasing order according to the number of tests performed) were as follows: doxorubicin (14%), bisantrene (54%), vinblastine (33%), mitomycin (36%), interferon clone A (23%), 5-fluorouracil (20%), methotrexate (17%), leukocyte interferon (33%), mitoxantrone (42%), cyclophosphamide (25%), m-AMSA (16%), and melphalan (10%). Among 25 patients receiving single-agent therapy, there were ten (59%) of 17 with in vitro sensitivity who responded; resistance was correctly predicted in nine patients (100%), P = .01. Among 34 patients treated with combination chemotherapy, seven (50%) of 14 with in vitro sensitivity responded, and resistance was predicted in 13 (65%) of 20 patients. Difficulties in using the HTCA in breast cancer (including small specimen size, difficulties in disaggregation, and inadequacy of growth) will require additional research. Nonetheless, the assay appears to detect in vitro activity as well as resistance of a variety of anticancer agents and appears to predict clinical responsiveness to standard as well as some investigational single agents.