tbuckley/cabot-search huggingface dataset:
Patterns of EGFR testing for lung cancer among tertiary care centers in India.
Authors: Kumar Prabhash, Purvish M. Parikh, Vanita Noronha, Amit Joshi, Senthill J Rajappa, Shailesh Arjun Bondarde, Shekar Patil, Chirag Jyotiker Desai, Rajesh Naik, Sohit Anand, Raju Titus Chacko, Ghanashyam Biswas, Tarini Prasad Sahoo, Pratap Kishore Das, Ashok K. Vaid, Shyam Aggarwal, Dinesh Doval
Journal: Journal of Clinical Oncology (2015)

e19114 Background: Testing for driver mutations like EGFR has become common for the management of lung cancer. We conducted a pan India survey to ascertain the pattern of EGFR mutation testing across different tertiary care centers. Methods: A total of 81 Medical Oncologists from tertiary care centers located in metro or tier one cities were interviewed using a structured questionnaire. Group 1(n = 21) included centres with in-house facility for EGFR testing and Group 2 (n = 60) included centers who were outsourcing EGFR testing. The answers of the two groups were analyzed. Results: The average number of lung cancer patients seen by a Medical Oncologist was 123 per month. NSCLC constituted 76% of lung cancer patients and 77% presented in very advanced stages (IIIb or IV). The incidence of adenocarcinoma was 54%. Rate of EGFR biomarker testing was 96% in patients with adenocarcinoma and 41% in squamous cell carcinoma. The incidence of EGFR mutation was 39% with del 19 being the most common (37% of positive cases). Real time PCR and sequencing were considered as preferred methods for mutation testing by only 40-43% of Oncologists. A significant number continued to believe that IHC (36%) and FISH (42%) are appropriate methods. The average turnaround time for testing was 15 days for centers with in-house testing and 18 days for outsourcing centers. While 71% of oncologists practicing in centers with in house testing waited for mutation results before starting treatment, this was followed by only 43% of those working in outsourcing centers. If systemic anti-cancer treatment was commenced before the availability of EGFR mutation results, 65 – 75% of oncologists would continue chemotherapy and complete the intended 4 or 6 courses before switching to EGFR targeted therapy. Conclusions: Though EGFR testing is considered as standard of care in the management of advanced NSCLC, its utilization remains suboptimal. There are significant differences between centers having in-house testing facility compared to centers that outsource with former having lesser turnaround time. There exists an unmet need to educate oncologists, other HCPs as well as patients about value of timely and accurate EGFR testing as well as waiting for the test results before initiating therapy.
A single-copy Sleeping Beauty transposon mutagenesis screen identifies new PTEN-cooperating tumor suppressor genes
Authors: Jorge de la Rosa, Julia Weber, Mathias Josef Friedrich, Yilong Li, Lena Rad, Hannes Ponstingl, Qi Liang, Sandra Bernaldo de Quirós, Imran Noorani, Emmanouil Metzakopian, Alexander Strong, Meng Amy Li, Aurora Astudillo, María Teresa Fernández-García, María Soledad Fernández-García, Gary J Hoffman, Rocío Fuente, George S Vassiliou, Roland Rad, Carlos López-Otín, Allan Bradley, Juan Cadiñanos
Journal: Nature Genetics (2017)
Abstract MP034: Muscle strength and Short-term Risk of Cardiovascular Outcomes in Community-dwelling Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Kunihiro Matsushita, Ning Ding, Shoshana H Ballew, Priya Palta, Jennifer A Schrack, Beverly G Windham, Josef Coresh
Journal: Circulation (2017)

Background: Muscle weakness has been shown to predict mortality in older adults. However, its contribution to different cardiovascular disease (CVD) subtypes is not well known. Methods: Among 5,484 participants (age 67-91 years) in the ARIC Study at visit 5 (2011-13), we quantified the associations of grip strength (measured by Jamar Hydraulic Hand Dynamometer) with the risk of coronary heart disease (CHD including myocardial infarction or coronary death), stroke, and heart failure (HF) using Cox models. Results: Over a median follow-up of 1.7 years, there were 119 cases of CHD, 47 cases of stroke, and 168 cases of HF. In crude models, the lowest sex-specific quartile of grip strength demonstrated significantly higher risk of CHD and HF compared to the highest quartile (Table). After accounting for potential confounders such as diabetes, body mass index, and blood pressure, the significant association was only observed for HF (HR 2.09 [95% CI 1.25-3.50] between the lowest vs. highest quartile). Conclusion: Weaker muscle strength was significantly associated with CVD risk in community-dwelling older adults, but its independent association was most evident for HF. Our results suggest the pathophysiological link between skeletal muscle function and HF as well as potential usefulness of grip strength to classify HF risk in older adults.
Abstract MP035: The Clinical Epidemiology of Fatigue in Newly Diagnosed Heart Failure
Authors: Brent Williams
Journal: Circulation (2017)

Introduction: Fatigue is a common and distressing, but poorly understood symptom among patients with heart failure (HF). The underlying mechanisms of fatigue in HF have not been clearly elucidated, but may lie in both psychologic and physiologic factors. Whether fatigue remains associated with mortality independent of other common clinical attributes also remains unresolved. Accordingly, the current study sought to evaluate the prevalence, predictors, and prognostic value of clinically documented fatigue in newly diagnosed HF patients. Methods: This retrospective cohort study consisted of 12,285 newly diagnosed HF patients receiving health care services through the Geisinger Health System, with passive data collection through electronic medical records (EMR). Incident HF, fatigue, and other study variables were derived from coded data within EMRs. A collection of 87 candidate predictors were evaluated to ascertain the strongest independent predictors of fatigue using logistic regression. The collection of candidate variables was drawn from several domains including demographics, physical examination findings, medical history, laboratory results, and medications. Patients were followed for all-cause mortality for an average of 4.8 years. The associations between fatigue and six-month, 12-month, and overall mortality were evaluated with Cox proportional hazards regression. Results: Clinically documented fatigue was found in 4827 (39%) newly diagnosed HF patients. Among the 87 candidate predictors, 18 were independently associated with fatigue at a multivariable p-value threshold of 0.001. Depression was the strongest predictor of fatigue. Fatigue was often part of a symptom cluster, as other HF symptoms including dyspnea, chest pain, edema, syncope, and palpitations were significant predictors of fatigue. Volume depletion, low body mass index, and abnormal weight loss were also strong predictors of fatigue. Though fatigue was significantly associated with 6-month (HR=1.49, p&lt;0.01), 12-month (HR=1.39, p&lt;0.01), and all-cause mortality (HR=1.20, p&lt;0.01) in unadjusted models, effect sizes were attenuated and non-significant after adjustment for clinical variables with HRs of 1.12 (p=0.16), 1.07 (p=0.26), and 1.00 (p=0.89), for 6-month, 12-month, and overall mortality, respectively. Conclusions: Fatigue is a commonly documented symptom among newly diagnosed HF patients with likely origins in both psychologic and physiologic factors. Though fatigue provided a prognostic signal in the short-term, this was largely explained by physiologic confounders.
Early change in lactate dehydrogenase is marker of response to PD-1/PDL1 inhibitors.
Authors: Amanda Shreders, Richard Wayne Joseph, Douglas Buckner Johnson, Chengwei Peng, Igor Puzanov, Roxana Stefania Dronca, Alan Haruo Bryce, Svetomir Markovic, Lisa A. Kottschade, Jeffrey Alan Sosman
Journal: Journal of Clinical Oncology (2015)

e20045 Background: Elevated lactate dehydrogenase (LDH) is a known negative prognostic marker in patients (pts) with metastatic melanoma (MM) and may predict lack of response to anti-PD-1/PD-L1 agents. Currently, there are no validated markers to assess early disease response during treatment. We hypothesize that a change in LDH from baseline to cycle 2 can predict which pts are likely to progress or receive benefit from PD-1/PD-L1 inhibitors Methods: We performed a retrospective analysis of MM pts treated with anti-PD1/PDL1 agents at Mayo Clinic and Vanderbilt from 04/2014-present. We used investigator described responses to categorize responders (complete and partial remissions) versus non-responders (stable and progressive disease). We used Fisher’s exact test to determine whether a change in LDH correlated with response. Results: We evaluated 65 MM pts treated with anti-PD1/PDL1 agents with available LDH levels. Among all pts, there was a trend that increasing LDH at cycle 2 associated with non-response (64% vs 36%, p=0.13). In pts with a baseline elevated LDH, a further rise in LDH strongly associated with non-response (93% vs 7%, p=0.005) whereas most pts with a decrease in LDH responded to therapy (54%). In pts with a normal baseline LDH, a change in LDH did not associate with response or lack of response (see table below). Conclusions: In pts with a baseline elevated LDH treated with anti PD-1/PD-L1, a further rise in LDH at cycle 2 (week 3) strongly associates with progression. A change in LDH does not predict benefit in those with a baseline normal LDH. Independent validation in larger studies is necessary to confirm these findings. Increase in LDH Decrease in LDH P-value All Patients (n=65) 0.13 Responders 10 (36%) 21 (57%) Nonresponders 18 (64%) 16 (43%) Baseline LDH Elevated (n=39) 0.005 Responders 1 (7%) 13 (54%) Nonresponders 14 (93%) 11 (46%) Baseline LDH Normal (n=26) 1.0 Responders 9 (69%) 8 (62%) Nonresponders 4 (31%) 5 (38%)
Attention and memory benefits for physical attractiveness may mediate prosocial biases
Authors: David Vaughn Becker
Journal: Behavioral and Brain Sciences (2017)

Abstract Mating motivations can explain attractiveness benefits, but what proximate mechanisms might serve as efficient causes of these biases? There is growing evidence that visual cues of physical attractiveness capture attention and facilitate memory, enhancing salience in ways that could underlie, for example, preferring one job applicant over another. All of these effects beg deeper questions about the meaning of attractiveness.
Nivolumab (ONO-4538/BMS-936558) as salvage treatment after second or later-line chemotherapy for advanced gastric or gastro-esophageal junction cancer (AGC): A double-blinded, randomized, phase III trial.
Authors: Yoon-Koo Kang, Taroh Satoh, Min-Hee Ryu, Yee Chao, Ken Kato, Hyun Cheol Chung, Jen-Shi Chen, Kei Muro, Won Ki Kang, Takaki Yoshikawa, Sang Cheul Oh, Takao Tamura, Keun-Wook Lee, Narikazu Boku, Li-Tzong Chen
Journal: Journal of Clinical Oncology (2017)

2 Background: Recent clinical trials have established 1 st and 2 nd line chemotherapy as the standard treatment for advanced gastric or gastro-esophageal junction cancer (AGC). However, prognosis of AGC is still poor. Nivolumab (ONO-4538/BMS-936558) is a human monoclonal IgG4 antibody which blocks the human programmed cell death-1 (PD-1) receptor. We evaluated the efficacy and safety of nivolumab as salvage treatment after failure of the standard chemotherapy for AGC. Methods: 493 patients aged ≥ 20 years with ECOG PS 0-1 and unresectable advanced or recurrent AGC who had failed two or more previous chemotherapy regimens were randomized in a 2:1 ratio to receive 3 mg/kg nivolumab (N=330) or placebo ( N=163) every 2 weeks until unacceptable toxicity or disease progression. Primary endpoint was overall survival (OS) in Intention-to-Treat population. This trial is registered in ClinicalTrials.gov (NCT02267343). Results: As of the data cut-off on Aug 13 th 2016, 5.6 months after last patient randomized, median OS was 5.32 months with nivolumab versus 4.14 months with placebo (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.50-0.78; p&lt;0.0001), and OS rates at 6 and 12 month were 46.4% versus 34.7% and 26.6% versus 10.9%, respectively. The overall response rate (ORR) was 11.2% (95% CI, 7.7-15.6) with nivolumab versus 0% (95% CI, 0.0-2.8) with placebo (p&lt;0.0001). Median progression-free survival (PFS) was 1.61 months with nivolumab versus 1.45 months with placebo (HR, 0.60; 95% CI, 0.49-0.75; p&lt;0.0001). Grade ≥ 3 drug-related adverse events (AEs) occurred in 11.5 % of nivolumab and 5.5 % of placebo; 2.7% and 2.5%, respectively, discontinued of study treatment due to drug-related AEs (any grade). Conclusions: Nivolumab was effective as the salvage treatment for pretreated AGC with significantly improved OS, PFS and ORR compared to placebo. Funding:Ono Pharmaceutical Co., Ltd. and Bristol-Myers Squibb. Clinical trial information: NCT02267343.
Peripheral Blood Stem Cell Grafts Mobilized by G-CSF and Plerixafor in Comparison to G-CSF Alone: Phenotypic and Functional Characterization,
Authors: Béatrice Gaugler, J Arbez, J Frikeche, Steven Le Gouill, Thomas Gastinne, Philippe Saas, Philippe Moreau, S Derenne, Mohamad Mohty
Journal: Blood (2011)
Comment on Gastaldelli et al. Short-term Effects of Laparoscopic Adjustable Gastric Banding Versus Roux-en-Y Gastric Bypass. Diabetes Care 2016;39:1925–1931
Authors: Mohamed F. Algahim, Heinrich Taegtmeyer
Journal: Diabetes Care (2017)

We read with interest the article by Gastaldelli et al. (1), and we commend the authors on their findings. They studied obese patients without diabetes and demonstrated a difference in insulin sensitivity between the two surgical approaches. Specifically, they note an improvement in insulin sensitivity of adipose and muscle tissue in the Roux-en-Y group.

We would like to share with you that the authors’ findings corroborate our observations on the impact of the weight-loss surgeries on …
Solid tumor profiling via next-generation sequencing to identify tumor-specific actionable variants.
Authors: Sara E. Patterson, Christopher S. Potter, Grace A. Stafford, Xing Yi Woo, Vanessa Spotlow, Talia Mitchell, Roger Liu, Guruprasad Ananda, Gregory J. Tsongalis, Susan M. Mockus
Journal: Journal of Clinical Oncology (2015)

1539 Background: Different tumor types are often associated with reoccurring mutations. Performing detailed genetic profiling to identify the milieu of actionable gene variants characteristic of specific tumors may guide targeted approaches to treatment, as well as uncover new therapeutic targets. To this end, we used a next-generation sequencing approach to identify characteristic actionable variants across various solid tumor types. Methods: DNA from FFPE sections of 58 solid tumor samples (15 colon, 14 ovarian, 13 lung, 11 melanoma, and 5 squamous cell carcinoma) was sequenced using the Jackson Laboratory Cancer Treatment Profile, a 358-gene targeted panel and submitted to the Clinical Genomics Analytical (CGA) bioinformatics pipeline. Resultant variant calls were filtered based on impact and actionable variants (defined as those having therapeutic relevance) were identified through extensive literature review from in-house curation efforts. Results: Tumor profiling for actionable variants demonstrated genetic heterogeneity among solid tumor types. Colon tumors contained codon 12 or 13 variants in KRAS (47%; 7/15), and RET G691S (33%; 5/15); lung tumors contained frequent AURKA F31I (31%; 4/13), and KDR Q472H (69% 9/15) variants; melanomas contained BRAF V600 (91%; 10/11) and AURKA F31I (64%; 7/11) variants; squamous cell carcinomas contained frequent FGFR4 G388R (60%; 3/5), with high prevalence of AURKA F31I, RET G691S, and PIK3CA E542K (each 40%; 2/5). KRAS variants were identified in 80% (4/5) of mucinous ovarian tumor samples. Mucinous ovarian tumors were also associated with MET T1010I (29%; 2/5), which was not identified in any other analyzed tumor type. Conclusions: Somatic variant profiling in solid tumors is biologically heterogeneous but often results in clinically actionable genomic characteristics. In this survey of 5 different tumor types, we identified various genetic variants including a frequent occurrence of MET T1010I in mucinous ovarian tumors. MET T1010I is an activating mutation in MET that has been demonstrated to enhance tumor cell proliferation and migration, and represents a potential therapeutic target that has not been previously identified in ovarian cancer.
Treatment, outcomes, and clinical trial participation in very elderly patients (pts) with metastatic pancreas cancer (mPC).
Authors: Daneng Li, Marinela Capanu, Kenneth H. Yu, Maeve Aine Lowery, David Paul Kelsen, Eileen Mary O'Reilly
Journal: Journal of Clinical Oncology (2014)

4119 Background: PC has a median age at diagnosis of 72 years. Aldoss et al. (Veterans Affairs Cancer Registry) and Vijayvergia et al. have reported that elderly pts are less likely to receive standard therapy compared to younger pts. Limited other studies in the very elderly (>80 years) with PC have been undertaken. Methods: A retrospective analysis on 237 pts with mPC >75 years of age who received care at Memorial Sloan Kettering Cancer Center between 2005 to 2013 was performed. Age groups: 75-79, 80-84, and 85+ years were analyzed and compared with respect to demographics, comorbidities, performance status, primary site of tumor, location and number of metastatic sites, laboratory data, treatment including type and number of systemic agents, clinical trial participation and overall survival (OS) after diagnosis. Results: A total of 196 (83%) pts received systemic therapy. The median OS of the entire cohort was 7 months. Use of therapy versus no therapy was significantly associated with longer OS (p<0.01). No significant difference was detected in survival between the different age groups among those receiving chemotherapy (p=0.49). Seventy-seven (32%) pts participated in a clinical study (biospecimen collection, psychosocial, therapeutic, etc); however, only 13 (5%) pts were enrolled in a therapeutic clinical trial with no pt age 85+ participating in a therapeutic study. Conclusions: Use of systemic therapy has a survival benefit in selected very elderly pts with mPC. While participation in any study was high, the number of very elderly pts enrolled in a therapeutic trial remains very low and similar to overall PC clinical trial participation (4.57%, Hoos et al. J Clin Oncol, 2013). In the future, therapeutic trials participation in this age group should be further encouraged. Age Total cohort 75-79 80-84 85+ N 237 114 84 39 Male 104 51 40 13 Female 133 63 44 26 ECOG PS 0-1 2 3+ 144 71 22 69 37 8 51 24 9 24 10 5 Charlson comorbid index (median) 5 5 5 6 Chemotherapy use 196 (83%) 101 (89%) 70 (83%) 25 (64%) Clinical trial participation 77 (32%) 43 (38%) 29 (34%) 5 (13%) Participation in a therapeutic trial 13 (5%) 9 (8%) 4 (5%) - OS (median months) Systemic therapy No therapy 7.0 7.9 2.3 7.1 7.9 1.4 7.3 8.1 2.7 5.9 7.7 4.7
Sedation vs Intubation for Patients With Acute Stroke Undergoing Thrombectomy
Authors: Alfred P. See, Andrew F. Ducruet
Journal: JAMA (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Utilization of accelerated partial breast irradiation for ductal carcinoma in situ, 2002-2007: Report from the National Cancer Data Base.
Authors: Tomasz Czechura, Katharine Yao, Dezheng Huo, Arif Shaikh, David Porter Winchester, David J. Winchester
Journal: Journal of Clinical Oncology (2012)

6040 Background: The use of accelerated partial breast irradiation using brachytherapy (APBI-b) for patients with invasive cancer is increasing but data for ductal carcinoma in situ (DCIS) cases are limited. The American Society of Radiation Oncology (ASTRO) guidelines suggest that APBI-b should be used only on a "cautionary" or "on trial" basis for women with DCIS. The purpose of this study was to examine utilization trends and correlates of APBI-b use for patients with DCIS. Methods: A total of 70,043 postlumpectomy patients from the National Cancer Database diagnosed with DCIS between 2002 and 2007 were studied. Chi-square tests and logistic regression models were used to determine trends and factors related to APBI-b use. Results: The use of APBI-b increased from 0.7% in 2002 to 10.0% in 2007 (p&lt;0.001). Independent predictors APBI-b use were age, race, insurance status, comorbidity index, facility type, and facility location. Older patients were more likely to use APBI-b; relative to patients 30-39 years old, the OR for patients 80-89 years old was 5.9 (95% CI: 3.7-9.6). APBI-b use was higher in whites (4.9%), compared to blacks (4.4%), Hispanics (2.8%), and Asian pacific islanders (1.5%; p&lt;0.001). Compared to noninsured, Medicare (OR=2.1, 95% CI: 1.3-3.3) and managed care patients (OR=2.0, 95% CI: 1.3-3.2) were more likely to undergo APBI-b. 2.3% of community cancer programs, 5.7% of comprehensive community programs and 4.1% of academic/research programs utilized APBI-b for treating DCIS (p&lt;0.001). The use of APBI-b varied significantly by facility location; the West and South regions of the country were more likely to use APBI-b (OR=14, 95% CI: 10.1-19.6) than the Northeast region. 91% of the APBI-b patients fit the ASTRO "cautionary" guideline and 9% of patients fit the ASTRO "on trial" guidelines. In 2002, 4% of ABPI-b patients fit the "on trial" guidelines which increased to 8.6% in 2007 (p&lt;0.001). Conclusions: The use of APBI-b for DCIS increased from 2002-2007. APBI-b use varies by socioeconomic and facility factors with age being the most significant factor. Future studies are needed to determine the indications for APBI-b in patients with DCIS.