tbuckley/cabot-search huggingface dataset:
Long-term survival results of a randomized multinational phase 3 trial of dacarbazine (DTIC) with or without Bcl-2 antisense (oblimersen sodium) in patients (pts) with advanced malignant melanoma (MM)
Authors: J. M. Kirkwood, A. Y. Bedikian, M. J. Millward, R. M. Conry, M. E. Gore, H. E. Pehamberger, W. Sterry, A. C. Pavlick, R. C. Deconti, L. M. Itri
Journal: Journal of Clinical Oncology (2005)

7506 Background: Chemotherapy resistance of MM has been linked to anti-apoptotic proteins, including Bcl-2 that is over-expressed in > 80% of pts. Oblimersen sodium (Genasense; G) targets bcl-2 mRNA and increases apoptosis when added to chemotherapy. We conducted a randomized trial of DTIC (D) alone compared with D plus G in pts with advanced MM. The results of this study, reported after all pts had been enrolled for a minimum of 6 mos, indicated a non-statistically significant difference (P=0.18) in overall survival (OS) for the intent-to-treat population (ITT). (Millward et al, JCO 2004; 22: 14S (abstract 7505)). However, there was a statistically significant difference in landmark analysis at 15 and 18 mos. We report here the update of OS 21 mos after completion of enrollment, as well as follow-up status of pts achieving a complete remission (CR) (11 on G/D vs 2 on D). Methods: 771 pts randomized to either G/D or D alone were followed every 2 mos for a total of 24 mos post-randomization. Data were collected and analyzed on survival status after pts had the opportunity to be followed for at least 24 mos post-enrollment. Additional information was collected with regard to disease status in CR patients. Results: Intent-to-treat (ITT) analysis for all 771 randomized pts shows that the 24 month OS after a minimum of 21 mos of follow-up achieves a significance on log-rank analysis of P=.082. Landmark survival analysis demonstrates significant differences at 15 and 18 mos, and a trend toward significance at 21 mos (p = .036, .012 and .057, respectively). On the G/D arm, 7 of 11 CR pts remain alive and disease-free (survival of 38+, 36+, 36+, 27+, 27+, 27+, 26+ mos). Four pts had progressed with 2 deaths (1 with brain mets only). Survival for these four pts is 23+, 22, 19 and 14+ mos. In the D arm, 1 CR pt remains alive and disease free at 27+ mos; the second pt died of progressive disease at 20 mos. Conclusions: Genasense enhances the antitumor effectiveness of DTIC, and results in durable CRs in some patients. Follow-up analysis of OS after 24 mos of follow-up, as well as the status of pts with CR will be presented. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Genta Genta Genta
Curable Potential with TBI Containing Regimen (L-PAM/TBI) Followed by In Vivo Purged Auto-PBSCT for Patients with Relapsed or Refractory Follicular Lymphoma.
Authors: Akane Tsujimura, Hirofumi Taji, Harumi Kato, Yoshitoyo Kagami, Kazuhito Yamamoto, Michinori Ogura, Yasuo Morishima
Journal: Blood (2006)
Gemcitabine radiosensitization after <sup>153</sup>Sm-EDTMP (quadramet) bone-seeking radioisotope therapy for osteoblastic lesions of osteosarcoma: Activity and principles
Authors: P. M. Anderson, G. A. Wiseman
Journal: Journal of Clinical Oncology (2005)

8534 Background: Osteoblastic metastases can avidly concentrate bone-seeking radiopharmaceuticals. We sought to increase effectiveness of high-dose 153Samarium ethylenediaminetetramethylenephosphonate (153Sm-EDTMP; Quadramet) on osteosarcomas using a radiosensitizer, gemcitabine. Methods: Fourteen patients with osteoblastic lesions of osteosarcoma were treated. With high-dose 153Sm-EDTMP (30 mCi/kg) and stem cell support. Gemcitabine was administered 1 day after samarium. Imaging studies used to assess response. Results: The residual total body radioactivity was within the safe range of <3.6 mCi on day +14 (1.1 +/− 0.4 mCi; range 0.67–1.8 mCi). Expected cytopenias from skeletal binding of the radiopharmaceutical occurred within 14 days. Peripheral blood progenitor cells (PBPC) were infused 2 weeks after samarium in 11 patients; three patients had marrow infused. Blood count recovery was uneventful after PBPC in 11/11 patients. Toxicity from the daily gemcitabine regimen (250 mg/M2/day x 5) was excessive (grade 3 mucositis; N=1). Toxicity from a single infusion of gemcitabine (1500 mg/M2) in combination with 153Sm-EDTMP was minimal (pancytopenia). There were no reported episodes of hemorrhagic cystitis (hematuria) or nephrotoxicity. At the 6–8 week follow-up there were 6 PR, 2 mixed responses, and 6 patients with progressive disease. In the 12 patients followed >1 year, there have been no durable responses. Conclusions: High-dose 153Sm-EDTMP + gemcitabine has activity in osteoblastic osteosarcoma lesions, but recurrence is very common. Other strategies such as repeated standard doses of samarium with gemcitabine and/or use of additional measures of local and systemic control should be considered for more prolonged control of osteoblastic metastases. No significant financial relationships to disclose.
Phase II study of histology-guided chemotherapy in stage IIIb/IV non-small cell lung cancer with pemetrexed plus platinum for nonsquamous carcinomas and taxane plus platinum for squamous and nonsquamous carcinomas.
Authors: A. Dechaphunkul, S. Nirattisaikul, K. Kayasut, V. Viriyachaiyo, S. Juthong, W. Keeratichananont, A. Navasakulpong, P. Sunpaweravong
Journal: Journal of Clinical Oncology (2011)

e18058 Background: Non-small cell lung cancer (NSCLC) accounts for 80-85% of all diagnosed lung cancers in which nonsquamous predominates histology subgroups. Over 70% of NSCLC patients are locally advanced or metastatic diseases and platinum-based doublets remain the treatment backbone resulting in better survival and quality of life. Pemetrexed/platinum has become an efficacious regimen in non-squamous NSCLC. Methods: Two platinum-doublet regimens were utilized in this phase II trial for newly diagnosed stage IIIb (malignant pleural effusion)/IV NSCLC patients. For nonsquamous carcinomas, 16 patients were planned to receive 500 mg/m2 of pemetrexed in combination with platinum (cisplatin 80 mg/m2 or carboplatin AUC = 5) and 16 patients with 175 mg/m2 of paclitaxel in combination with platinum. Eight patients with squamous cell carcinoma were allocated to paclitaxel and cisplatin. Cycles were repeated every 3 weeks until disease progression with 6 cycles maximum. Response evaluation was performed every 2 cycles. Results: From December 2009 to December 2010, 33 NSCLC patients gave consent. Three patients were excluded from the analysis (early death before treatment, co-primary cancers, and unmet liver function, each). Among 30 eligible patients, 26 patients had nonsquamous whereas 4 patients were squamous histology. Fifteen patients in the non-squamous group received pemetrexed/platinum and 11 patients received paclitaxel/platinum. Responses and grade 3/4 toxicities to each treatment regimen was described in the table. Conclusions: Implementation of pemetrexed/platinum regimen to the non-squamous NSCLC tends to provide better response with tolerable toxicity profile compared to the paclitaxel/platinum. Survival benefit needs to be followed and further evaluated. Histology Treatment Pts CR PR SD PD Fatigue Vomiting Anemia Neutropenia Nonsquamous Pemetrexed +platinum 15 - 2 (13%) 13 (87%) - 20% 13% 7% 13% Nonsquamous Paclitaxel +platinum 11 - - 11 (100%) - - 9% 27% 27% Squamous Paclitaxel +cisplatin 4 - 1 (25%) 3 (75%) - 25% 50% 25% -
A retrospective study of neoadjuvant DCF (docetaxel, cisplatin, 5-fluorouracil) for locally advanced gastric or gastro-esophageal junction adenocarcinoma (GC).
Authors: Raquel Castellanos, Vinicius Ernani, Ulas Darda Bayraktar, Lorraine Portelance, Alberto J. Montero, Caio Max S. Rocha Lima, Peter Joel Hosein
Journal: Journal of Clinical Oncology (2013)

138 Background: Perioperative chemotherapy (chemo) with ECF (epirubicin/cisplatin/5-fluorouracil) plus surgery improved survival over surgery alone in GC in the MAGIC trial. Herein we report our experience using DCF in the perioperative setting in patients (pts) with locally advanced GC. Methods: We conducted a retrospective IRB-approved study of pts with potentially resectable locally advanced GC who were treated with DCF with neoadjuvant intent. Pts received 3 cycles of preoperative (pre-op) DCF every 3 weeks, followed by surgery, then 3 cycles of postoperative (post-op) DCF. Patients with a poor pathologic response could be changed to radiation (RT) or an alternate chemo regimen postop. Results: A total of 41 pts were identified, 24 with gastric and 17 with GEJ adenocarcinoma. All pts received at least 1 cycle of DCF and 78% received at least 3 cycles pre-op. Five pts progressed during neoadjuvant DCF, 4 were unresectable by CT after neoadjuvant DCF and 2 were lost to follow-up. The remaining 30 pts had surgery with curative intent. Post-op, 2 pts were lost to follow-up, 12 received DCF (with 6 of these also receiving RT), 11 received a different chemo regimen due to a poor response to neoadjuvant DCF (including 6 pts who also received RT). Two pts received post-op RT only. The median PFS was 16.8 months (95% CI 7.7 - 25.9) and the median OS was 26.9 months (95% CI 18.7–35.1). The PFS was longer for pts who had a radiological or pathological response to neoadjuvant DCF (log rank p = 0.005 and 0.02 respectively) and for pts who received DCF post-op (log rank p = 0.005). Among pts who did not receive DCF post-op, there was no survival difference between the pts who were switched to an alternative chemo or chemoRT regimen post-op compared to those who received no further therapy. The most common chemo-related adverse events were anemia (27% grade 3 or 4), nausea/vomiting (17% G3 or 4), and febrile neutropenia (12%). Conclusions: The DCF regimen is well tolerated in locally advanced GC. Patients who do not have a good response (either radiologic or pathologic) to pre-op DCF appear to have a poor prognosis regardless of the post-op treatment given.
hnRNP K Is a Novel Haploinsufficient Tumor Suppressor at the 9q21.32 Locus That Defines a Subset of AML
Authors: Miguel Gallardo, Hun Ju Lee, Xiaorui Zhang, Carlos E. Bueso-Ramos, Laura Pageon, Mark McArthur, Asha Multani, Aziz Nazha, Taghi Manshouri, Jan Parker-Thornburg, Peter Hu, Yuan Qi, Xiaoping Su, Inmaculada Rapado, Alfonso Quintás-Cardama, Steven M. Kornblau, Joaquin Martinez-López, Sean M. Post
Journal: Blood (2015)
Pancreatic injury, genetic variation of <i>PNPLA3</i>, and risk of pancreatic cancer.
Authors: Mohammed Aly, Ibrahim Halil Sahin, Donghui Li, Mohamed Fahd Khalil, Ping Chang, David R. Fogelman, Milind M. Javle, James L. Abbruzzese, Manal Hassan
Journal: Journal of Clinical Oncology (2013)

141 Background: Similar to primary liver cancer, obesity, diabetes mellitus and hepatitis B virus infection have been associated with increased risk of pancreatic cancer (PC) development. A genome-wide association study has reported that a polymorphic variant of the patatin-like phospholipase domain containing 3 (PNPLA3) gene was associated with a higher susceptibility to fatty liver and liver cancer. The relationship between this variation and PC has not been previously examined. We investigated the correlation in the degree of organ damage between the liver and the pancreas in patients with PC. In addition, we examined the effect of PNPLA3genetic variation (rs738409: C&gt;G) on PC development. Methods: Using resources of our case-control study in MD Anderson Cancer Center, we analyzed 544 pathologically confirmed PC patients and 498 healthy controls. Cases and controls were frequency matched by age, gender, and race. Multivariate logistic regression analysis was performed to adjust for the confounding factors. Medical records of PC patients were reviewed for pancreatic and liver fatty changes. Results: We found that 18.8% of PC patients had evidence of pancreatic steatosis, fibrosis, or pancreatitis. Fatty liver was observed in 14.5% of PC patients which was frequently detected in patients with pancreatitis (p=0.002). A significant correlation between pancreatitis and cirrhosis was observed in PC patients with a prior history of obesity but not in patients without a history of obesity (p=0.001). On the other hand, we observed no significant association between PNPLA3 genotype and risk of PC. The adjusted odds ratio (OR) was 1.4 (95% confidence interval [CI], 0.7-2.7) for the homozygous variant GG genotype compared with the CC/CG genotypes. Conclusions: We concluded that despite the similarities between the liver and the pancreas, genetic susceptibility to fatty infiltration and its effect on cancer development may differ between the two organs. Evaluation and assessment of nonalcoholic fatty pancreatic disease (NAFPD) in PC patients and genetic susceptibility of NAFPD may be warranted in future research.
Driving performance improvement using ASCO’s Quality Oncology Practice Initiative (QOPI).
Authors: Shelby Darland, Christa Burnham, Nicolas Camilo, Thomas M. Beck, Dan Sayam Zuckerman
Journal: Journal of Clinical Oncology (2012)

203 Background: Defining and quantifying quality care is a challenge for cancer care providers. Since 2007 St. Luke’s Mountain States Tumor Institute (MSTI) has been participating in QOPI and was one of 23 practices that received the inaugural QOPI Certification in June 2010. The goal of participation is to benchmark MSTI’s performance with oncology practices across the nation and identify areas for improvement that are recognized as national quality standards. Methods: After each round of QOPI data abstraction, physician and administrative leadership selected measures with the greatest opportunity for improvement. Monthly chart audits for each measure were completed and the results were shared with individual staff to increase education and accountability. In Spring 2010, the education assessment in MSTI’s Electronic Medical Record (EMR) was redesigned to facilitate efficient documentation and data collection of smoking cessation counseling. In July 2011, the performance improvement (PI) team created “Quality Checklists (QCL)” in MSTI’s EMR for three different QOPI measures: i) signed chemotherapy consent, ii) smoking cessation counseling, and iii) assessment of emotional well-being. To ensure signed chemotherapy consent, one QCL included a reminder sent by the primary nurse or secretary to the chemotherapy infusion nurses. To ensure smoking cessation counseling and assessment of emotional well-being by social work, the other QCL included an alert sent by the new patient representative to the primary nurse and social worker. Results: Signed chemotherapy consent improved from 10% (n=229) in 2007 to 100% (n=117) in 2012. Smoking cessation counseling improved from 13% (n=40) in 2007 to 93% (n=272) in 2012. Assessment of emotional well-being improved from 78% (n=302) in 2007 to 95% (n=120) in 2012. Of the patients that had problems with emotional well-being, 73% (n=55) in 2007 had their problems addressed and 95% (n=41) in 2012. Conclusions: QOPI has provided MSTI with the initiatives and benchmarks to quantify quality cancer care. By combining participation in QOPI and ongoing PI data collection, analysis, and action plan implementation MSTI has enjoyed marked improvements in quality.
Understanding patients’ attitudes toward communication about the cost of cancer care.
Authors: A. J. Bullock, E. W. Hofstatter, M. Yushak, M. K. Buss
Journal: Journal of Clinical Oncology (2011)

6065 Background: Recent publications have promoted physician patient communication on cost as a means of decreasing overall spending and minimizing patients' financial burden in oncology. Studies show that most oncologists feel uncomfortable and ill-equipped to lead cost discussions, and many fear it may compromise the physician patient relationship. To date no study has assessed patients' perspectives on cost communication in oncology. We sought to: describe patients' attitudes toward communication about cancer costs, explore potential predictors for patients' communication preferences, and assess how cancer patients consider cost when making management decisions. Methods: A 31 item questionnaire was developed to measure oncology patients' communication preferences regarding the cost of cancer care. Items were adapted from other instruments when possible. After piloting, patients were recruited from an academic, ambulatory oncology practice. Basic descriptive statistics were applied. Bivariate analyses were performed using the Fisher exact test statistic. Results: Of the 771 patients approached, 256 responded (response rate 33%). Most (68%) prefer to know about out-of-pocket costs before they are treated. A majority (59%) would like their doctor to discuss these costs with them. While 76% report feeling comfortable discussing cost with their doctor, 74% are amenable to discussing cost with someone other than their doctor. Most patients do not consider out-of-pocket costs (57%) or the country's health care costs (61%) in their decision making and do not believe their doctor should (55%). Patients on active chemotherapy were less likely to want to discuss cost with their doctor (p=0.035). Conclusions: This is the first study to evaluate oncology patients' attitudes toward communication about cancer costs. Patients' comfort and desire to discuss cancer costs exceeds that of oncologists, suggesting a need to educate oncologists on this important topic. Despite the substantial cost burden faced, the majority of cancer patients do not want cost to influence medical decision making. Employing an individual skilled in financial communication may be an alternative way to meet patients' needs.
Characteristics of patients with early gastric cancer who had undergone surgery in single institute
Authors: J. Baek, S. Shin, M. Kim, D. Kim, G. Kim, H. Cho, J. Park, Y. Min
Journal: Journal of Clinical Oncology (2008)

15535 Background: The incidence of early gastric cancer (EGC) has been increasing worldwide owing to advances with diagnositic techniques and screening programs. Radical gastrectomy with lymph node dissection is still the gold-standard treatment for EGC. The present study was designed to investigate the characteristics of EGC patients who had undergone surgery. Methods: According to the Japanese classification of gastric carcinoma, EGC is defined as a lesion confined to the mucosa or submucosa, regardless of the presence of regional lymph node metastasis. We reviewed 529 patients with gastric cancer who had undergone gastrectomy at Ulsan University Hospital, Ulsan, Korea, from December 2002 to December 2005. Results: Two hundred sixty-one patients (49%) were diagnosed as EGC (155 intramucosal EGC (mEGC), 106 intrasubmucosal EGC (smEGC), 123 differentiated EGC, and 138 undifferentiated EGC). One hundred sixty-one patients (61.7%) were male and median age was 55. The mean diameter of tumor was 2.49 ± 1.55 cm (2.18 ± 1.45 cm in mEGC and 2.94 ± 1.60 cm in smEGC, p=0.000). The incidence of lymph node metastasis was 11.5% (30 out of 261 patients). Univariate analysis revealed that a tumor larger than 2 cm (17.6% vs. 6.3%), submucosal invasion (20.8% vs. 5.2%), and the presence of lymphovascular invasion (LVI) (33.3% vs. 6.6%) were significantly associated with a higher lymph node metastasis rate. There were no significant associations between lymph node metastasis and differentiation, age, gender, tumor location, macroscopic type, CEA level,or CA19- 9 level. In multivariate analysis, LVI was independent predictive factor for lymph node metastasis (p=0.005), while submucosal invasion was marginally predictive (p=0.069) and tumor size was not (p=0.208). At a median follow-up of 1023 days, only 2 patients relapsed and 1 patient died due to disease progression. Conclusions: LVI was independent predictive factor for lymph node metastasis. In cases that LVI was present after endoscopic resection, radical gastrectomy should be recommended. Endoscopic resection data will be analyzed and compared with surgery data. No significant financial relationships to disclose.
A GEP-NEN analysis of incidence, ethic variation, and mortality using the SEER database.
Authors: Ben Lawrence, Mark Kidd, Bjorn Gustafsson, Anthony Chan, Simon Schimmack, Irvin M Modlin
Journal: Journal of Clinical Oncology (2012)

225 Background: A decade of epidemiological analysis of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has defined this malignancy as more common than previously recognized, but the cause of an apparent increase in incidence is controversial. The maturity of the contemporary SEER17 database allows this issue to be addressed. Methods: We analyzed the most recent SEER17 database (including 32,862 cases of GEP-NEN) to calculate incidence, primary site distribution and survival (cause-specific and all-cause) by age and ethnicity in 2000 to 2008, then examined 20-year limited-duration prevalence and the pattern of second cancer risk. Results: The incidence of GEP-NENs continues to rise (APC; 4.2% per year) and is now 3.6/100,000 but this reflects an improved diagnostic acuity rather than a true increase in disease occurrence. Of paramount import, the prevalence of GEP-NENs (23/100,000) accounts for only approximately 2% of the prevalence observed in autopsy studies (1,110/100,000), providing the necessary perspective to recognize the change in incidence as “trivial” relative to the undiagnosed disease burden. The current analysis also reminds us that GEP-NENs are not uniformly fatal. Cause-specific GEP-NEN survival is considerably more favorable than the commonly described ‘all-cause’ survival, so that many patients with rectal (62%), gastric (49%), small intestinal (44%), appendiceal (24%), and colonic (19%) NENs died from other causes. The high proportion of rectal primaries in Japan (56%) persists after population migration to the US (65%), suggesting a “relatively” stable inherited predisposition. The risk of second cancers after GEP-NENs is increased by 55% and occurs in organs with epithelium that contain neuroendocrine cells (both GI and distant), not limited to the luminal sites potentially exposed to a dietary carcinogen. Conclusions: The increase in GEP-NEN incidence is illusory, disease specific survival is higher than previously recognized while the stable ethnic differences and systemic second cancer risk support a non-environmental genetic etiology for tumorigenesis.