tbuckley/cabot-search huggingface dataset:
Triplet therapy with gemcitabine, 5-fluorouracil, leucovorin and cisplatin in patients with metastatic pancreatic cancer
Authors: A. Viúdez, J. Rodríguez, J. De La Cámara, E. Salgado, A. Chopitea, I. Gil-Bazo, J. García-Foncillas, J. Valero, J. Espinós, S. Martin-Algarra
Journal: Journal of Clinical Oncology (2004)

4252 Background: To determine the activity and tolerance of gemcitabine, 5-fluorouracil, leucovorin and cisplatin in patients with metastatic pancreatic cancer. Methods: Thirty-two patients with confirmed diagnosis of stage IV pancreatic carcinoma, with a median age of 60 years and ECOG performance of 0 to 2 (59.4% ECOG 1), received gemcitabine 800 mg/m2 intravenously (iv) days 1 and 14, cisplatin iv 75 mg/m2 day 1, leucovorin 500 mg/2 iv days 1 and 14 and 5-fluorouracil (FU) 2600 mg/m2 iv days 1 and 14. Cycles were repeated every 28 days. Liver, lung, locoregional or peritoneal involvement was found in 81.3 %, 18.8 %, 81.3 % and 15.6% of patients, respectively. 87 % of patients were chemotherapy naive. 13 % of patients had received prior chemotherapy, including cisplatin (6.3%), gemcitabine (6.3%), FU (6.3%) or docetaxel (3.1%). Results: The total number of courses administered was 148, with a median of 4 cycles per patient (range 1 to 14). Grade III/IV leucopenia, neutropenia or anemia was found in 21.8 %, 37.5 % and 19.25 %, respectively. Main non-haematological grade III/IV toxicities included asthenia (18.8 %) anorexia (12.5 %) and nausea (9.4 %). 18.7 % of patients required a 25 % dose reduction. Day 14 dose had to be omitted in 15.6 % of the pts. 11 patients (34.4 %) achieved an objective response, stable disease was observed in 34.4 %. 10 patients (31.3 %) progressed while on-therapy. With a median follow-up of 25 months (range 5.6 to 52.83), the median time to progression was 4.67 months (95% CI: 3.61 to 5.73), and the median overall survival was 10.23 months (95% CI: 4.30 to 14). The actuarial 1 and 2 year-survival was 35.8 % and 11.96 % respectively. Conclusions: The combination of gemcitabine, FU, leucovorin and cisplatin, has moderate activity in metastatic carcinoma of the pancreas at an expense of an acceptable toxicity profile. No significant financial relationships to disclose.
Planned nerve preservation modifications to reduce positive surgical margins during robotic-assisted laparoscopic radical prostatectomy
Authors: K. Zorn, O. N. Gofrit, S. Lin, G. D. Steinberg, G. Zagaja, A. L. Shalhav
Journal: Journal of Clinical Oncology (2007)

15599 Background: Robotic-assisted laparoscopic radical prostatectomy (RLRP) is increasingly being utilized for the treatment of localized prostate cancer at many centers. The main objective of RLRP is cancer control and preservation of erectile function with reduced positive surgical margin (PSM) rates. We evaluated the effect of a side-specific nerve preservation (NP)protocol which was implemented in June 2006 to help further reduce PSM rates. Methods: Between June-November 2006, 150 consecutive RLRPs were performed using select ipsilateral, NP techniques (interfascial, extrafascial and wide resection) based on pre-operative risk factors (clinical stage, biopsy Gleason score (GS), percentage of core number positive and maximal core cancer percentage). Prior to June 2006, only interfascial and wide resection were performed. The NP protocol, included ipsilateral extrafascial dissection in all patients with GS=7 with non-palpable disease. All patients with GS≤6, non-palpable disease and whose biopsy pathology demonstrated &lt;33% of ipsilateral cores positive for cancer were offered interfascial dissection. Wide resection was performed for patients with palpable disease, GS≥8 and ≥66% of all ipsilateral biopsy cores positive for cancer. Pathological outcomes were compared with the 245 consecutive RLRP cases performed prior to June 2006, where more liberal interfascial NP was performed. Results: Relative to the modified NP group, mean patient age (60 vs 59, p= 0.21), PSA (6.7 vs 6.8, p=0.77), clinical stage (p=0.93), biopsy Gleason score (p=0.51), pathologic Gleason score (p=0.32) and stage (p=0.65) were similar to the control group. Mean total number of positive cores involved with cancer were also comparable between groups (3.5 vs 3.3, p=0.31). Overall PSM rate was significantly lower in the modified NP group (12.6% vs 20.4%,p=0.04). Specific pT2-PSM rates were significantly lower (8.3% vs 15%, p=0.04) while only a trend was observed for pT3-PSM rates (34.5% vs 40.4%, p=0.60) in the modified NP group. Conclusions: Modifying ipsilateral nerve preservation for patients undergoing RLRP, based on specific pre-operative variables has significantly helped further reduce overall and pT2-specific PSM rates. No significant financial relationships to disclose.
Evaluation of the microscopic observation drug susceptibility assay for the detection of first- and second-line drug susceptibility for<i>Mycobacterium tuberculosis</i>
Authors: Donald G. Catanzaro, Andre P. Trollip, Marva Seifert, Sophia B. Georghiou, Richard S. Garfein, Timothy C. Rodwell, Antonino Catanzaro, Kathleen D. Eisenach
Journal: European Respiratory Journal (2017)

The End Tuberculosis Strategy of the World Health Organization (WHO) calls for the early diagnosis of tuberculosis (TB) and use of universal drug susceptibility testing (DST) in order to start patients on the most effective treatment regimen as early as possible. DST using solid or liquid media and rapid molecular-based DST to detect drug-resistant TB are available and endorsed by WHO; however, in 2015, WHO reported that among new cases of bacteriologically confirmed TB, only 12% had undergone DST [1]. Most national tuberculosis programmes do not offer universal DST [2], and in 2015, 12 countries reported no capacity to perform phenotypic DST [1] while 28 countries had neither in-country capacity nor a linkage with a partner laboratory for second-line DST. A new multinational study of the noncommercial MODS assay shows excellent performance in detecting M/XDR-tuberculosis <http://ow.ly/FAEJ308OiOw> The authors would like to acknowledge the site investigators, Valeriu Crudu (Phthisiopneumology Institute), Tommie Victor (Stellenbosch University) and Camilla Rodriques (P.D. Hinduja National Hospital and Medical Research Centre), as well as their clinical and laboratory staff for their assistance in acquiring and testing patient specimens.
Clinical criteria are critical to diagnosing alcoholic hepatitis
Authors: Ewan Forrest
Journal: Hepatology (2017)

Potential conflict of interest: Nothing to report. TO THE EDITOR: In the recent article by Bissonnette et al.,1 it is surprising that only 55% of the patients in the initial test population had histological confirmation after initial clinical suspicion of this condition. Recently published recommendations for clinical trials in patients with alcoholic hepatitis go some way toward defining criteria for probable alcoholic hepatitis.2 Onset of jaundice within 8 weeks of presentation, alcohol excess within 60 days of presentation, compatible transaminase values, and a bilirubin level >3 mg/dL are fundamental to this diagnosis. Bissonette et al. did not use these criteria, indicating only “moderately elevated” serum bilirubin levels without any information as to the duration of onset of jaundice or the length of time since alcohol use was taken to excess. It is evident that some of the patients who were studied had low levels of bilirubin and high levels of AST incompatible with a clinical diagnosis of alcoholic hepatitis. The lower value of the interquartile range (IQR) for bilirubin was only 32 μmol/L (1.9 mg/dL) for some patients (Table 1), whereas the higher value of the IQR for AST was 536 IU/L for others (Supporting Table 2.1). A high concordance of clinical and histological diagnoses has been described in studies with a bilirubin level of >80 μmol/L (4.7 mg/dL).3 When Bissonette et al. restricted their analysis to patients with a bilirubin level of >5 mg/dL, there was an increase of 8%‐10% in the rate of histological confirmation. The STOPAH trial defined patients using all of these criteria, and in those patients who were biopsied, 88% had histological confirmation, with higher rates seen in subgroups.4 In addition, histological features of alcoholic hepatitis are not specific. Patients with “chronically decompensated alcoholic cirrhosis” have “moderate” or “severe” alcoholic hepatitis in 27% of biopsies.5 Clearly, it is possible to have histologic features of alcoholic hepatitis without the context that practicing clinicians would recognize. The clinical presentation is key to the diagnosis. Bissonette et al. have added to our knowledge of alcoholic liver disease; however, we need to define our patients by clear clinical criteria if we are to understand its most florid manifestation, alcoholic hepatitis.
SP1049C as first-line therapy in advanced (inoperable or metastatic) adenocarcinoma of the oesophagus: A phase II window study
Authors: A. Armstrong, J. Brewer, C. Newman, V. Alakhov, G. Pietrzynski, S. Campbell, P. Corrie, M. Ranson, J. W. Valle
Journal: Journal of Clinical Oncology (2006)

4080 Background: SP1049C (a block co-polymer incorporating doxorubicin) has demonstrated broad in vitro activity and superior anti-tumour activity in 9/9 in vivo animal tumour models compared to doxorubicin. Methods: Chemotherapy- or radiotherapy-naïve patients with measurable, inoperable, recurrent or metastatic adenocarcinoma of the oesophagus; KP ≥60; normal cardiac LVEF; adequate swallowing and adequate renal, hepatic and bone marrow function were eligible. SP1049C 75mg/m 2 IV 30-minute infusion was given q3w, for up to 6 cycles. Radiological response was assessed after cycles 2, 4 and 6. Upon disease progression (PD) patients were offered standard chemotherapy. QoL (by QLQ-C30 and QLQ-OES24 questionnaires), toxicity, disease-related symptoms and cardiac function were also prospectively assessed. Results: From February 2002 to December 2004, 21 patients (all male), median age 62 years (range 38–78) with stage 3 (n = 1) of stage IV (n = 20) disease were enrolled. Response rate (WHO criteria) in 19 patients eligible for efficacy analysis (radiologically re-assessed after ≥2 cycles of treatment) included: PR 9/19 (47%), SD (8/19) 42% and PD (2/19) 11% by investigator assessment (confirmed PR 41%, unconfirmed PR 12% and SD 29% by independent review, RECIST criteria). One responding patient underwent salvage resection of a pT2N0 (Stage 2A) tumour. All patients are evaluable for toxicity. Toxicity (Gd 1–2/3–4, by patient) included: neutropaenia 24%/62%, leucopaenia 19%/29%, anaemia 38%/5% and thrombocytopaenia 9.5%/0% (resulting in 9 (43%) patients being dose-reduced to 55 mg/m 2 at cycle 2), nausea 81%/19%, vomiting 62%/24%, anorexia 52.4%/14%, lethargy 81%/14%, febrile neutropaenia -/29%, mucositis 48%/5%, and Gd 1–2 alopecia in 67%. Grade I cardiotoxicity (fall in LVEF by 10–19% from baseline, CTC v2.0) was seen in 4 (19%) patients. The median overall survival (all patients) is 10 months; four patients received 2 nd -line chemotherapy. Conclusions: SP1049C appears to have activity in monotherapy in this patient group and combination studies with other active agents are warranted. [Table: see text]
High degree of correlation between in vivo tumor oxygenation measurements and carbonic anhydrase IX tissue staining in operable human breast cancer
Authors: Z. Vujaskovic, E. Jones, E. Rosen, Z. Rabbani, S. Kim, V. Liotcheva, M. Dewhirst, T. Samulski, L. Prosnitz, K. Blackwell
Journal: Journal of Clinical Oncology (2004)

678 Background: Tumor oxygenation has been shown to play an important role in determining treatment resistance. However, the use of tumor oxygenation as a predictive marker has been hindered because (1) the invasiveness and time required for in vivo oxygen measurements and (2) the inability to determine tumor oxygenation on archival tissue. This study examined the relationship between endogenous hypoxia marker (carbonic anhydrase IX; CA IX) and in vivo oxygenation measurements in breast cancer. Methods: 30 patients with operable breast cancer scheduled to undergo neoadjuvant chemotherapy/hyperthermia treatment were enrolled. In vivo tumor oxygenation was performed using Eppendorf probes. Core needle biopsies were acquired at the same time as the in vivo tumor oxygenation measurements. CA IX staining was performed using the G250 murine antihuman monoclonal antibody (gift from Dr. Oosterwijk). Angiogenesis was determined using Microvessel Density counts (MVD) obtained after JC70 monoclonal antihuman CD31 antibody staining. Results: Tumor hypoxia (median pO2 < 10 mmHg) was present in 18/30 patients (median pO2 = 3.7 mmHg). Twelve patients had well oxygenated tumors (average median pO2 = 37.1 mmHg). Tumors with positive CA IX staining had a significantly lower in vivo oxygenation measurement than those tumors with no CA IX staining (mean pO2 = 2.2 vs.8.8 mmHg; Mann-Whitney p-value=0.02). In addition, there was a correlation between MVD and CA IX expression (r=0.35; p=0.06). Conclusions: This study demonstrates a correlation between in vivo oxygenation measurements and CA IX staining in breast cancer. In addition, the correlation established between angiogenesis as measured by MVD and CA IX, and the lack of correlation between MVD and in vivo oxygenation measurements, indicates that simple detection of vessels by CD31 might not truly reflect functional vasculature. This finding might have implications for the use of MVD as a predictor in anti-angiogenesis trials, and would suggest that tumor oxygenation markers might have some predictive utility in this therapeutic setting. Supported by NIH/NCI CA42745. No significant financial relationships to disclose.
Countermarketing Alcohol and Unhealthy Food: An Effective Strategy for Preventing Noncommunicable Diseases? Lessons from Tobacco
Authors: P. Christopher Palmedo, Lori Dorfman, Sarah Garza, Eleni Murphy, Nicholas Freudenberg
Journal: Annual Review of Public Health (2017)

Countermarketing campaigns use health communications to reduce the demand for unhealthy products by exposing motives and undermining marketing practices of producers. These campaigns can contribute to the prevention of noncommunicable diseases by denormalizing the marketing of tobacco, alcohol, and unhealthy food. By portraying these activities as outside the boundaries of civilized corporate behavior, countermarketing can reduce the demand for unhealthy products and lead to changes in industry marketing practices. Countermarketing blends consumer protection, media advocacy, and health education with the demand for corporate accountability. Countermarketing campaigns have been demonstrated to be an effective component of comprehensive tobacco control. This review describes common elements of tobacco countermarketing such as describing adverse health consequences, appealing to negative emotions, highlighting industry manipulation of consumers, and engaging users in the design or implementation of campaigns. It then assesses the potential for using these elements to reduce consumption of alcohol and unhealthy foods.
Cardiometabolic Abnormalities Among Normal-Weight Persons From Five Racial/Ethnic Groups in the United States
Authors: Unjali P. Gujral, Eric Vittinghoff, Morgana Mongraw-Chaffin, Dhananjay Vaidya, Namratha R. Kandula, Matthew Allison, Jeffrey Carr, Kiang Liu, K.M. Venkat Narayan, Alka M. Kanaya
Journal: Annals of Internal Medicine (2017)

The relationship between body weight and cardiometabolic disease may vary substantially by race/ethnicity.To determine the prevalence and correlates of the phenotype of metabolic abnormality but normal weight (MAN) for 5 racial/ethnic groups.Cross-sectional analysis.2 community-based cohorts.2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study.Prevalence of 2 or more cardiometabolic abnormalities (high fasting glucose, low high-density lipoprotein cholesterol, and high triglyceride levels and hypertension) among normal-weight participants was estimated. Correlates of MAN were assessed by using log-binomial models.Among normal-weight participants (n = 846 whites, 323 Chinese Americans, 334 African Americans, 252 Hispanics, and 195 South Asians), the prevalence of MAN was 21.0% (95% CI, 18.4% to 23.9%) in whites, 32.2% (CI, 27.3% to 37.4%) in Chinese Americans, 31.1% (CI, 26.3% to 36.3%) in African Americans, 38.5% (CI, 32.6% to 44.6%) in Hispanics, and 43.6% (CI, 36.8% to 50.6%) in South Asians. Adjustment for demographic, behavioral, and ectopic body fat measures did not explain racial/ethnic differences. After adjustment for age, sex, and race/ethnicity-body mass index (BMI) interaction, for the equivalent MAN prevalence at a BMI of 25.0 kg/m2 in whites, the corresponding BMI values were 22.9 kg/m2 (CI, 19.5 to 26.3 kg/m2) in African Americans, 21.5 kg/m2 (CI, 18.5 to 24.5 kg/m2) in Hispanics, 20.9 kg/m2 (CI, 19.7 to 22.1 kg/m2) in Chinese Americans, and 19.6 kg/m2 (CI, 17.2 to 22.0 kg/m2) in South Asians.Cross-sectional study design and lack of harmonized dietary data between studies.Compared with whites, all racial/ethnic minority groups had a statistically significantly higher prevalence of MAN, which was not explained by demographic, behavioral, or ectopic fat measures. Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked.National Institutes of Health.
Marked clinical activity of the novel proteasome inhibitor bortezomib in patients with relapsed follicular (RL) and mantle cell lymphoma (MCL)
Authors: O. A. O'Connor
Journal: Journal of Clinical Oncology (2004)

6582 Background: Targeting of the ubiquitin proteasome pathway has proven to be a valid and efficacious approach for the treatment of several hematologic malignancies. Methods/Results: To date, we have treated 25 previously treated patients with relapsed or refractory indolent lymphomas, including: 3 patients with small lymphocytic lymphoma; 9 patients with FL; 11 patients with MCL; and 2 patients with marginal zone lymphoma. All but one patient had received some form of treatment prior to receiving bortezomib, including: CHOP +/- R (60%); CVP +/- R (20%); or some other purine analog based treatment program (15%), with some patients having received prior high dose chemotherapy with peripheral blood stem cell transplant (12%) or radioimmunotherapy (8%). Patients were treated at a dose of 1.5 mg/m2 twice weekly for two consecutive weeks with a one-week rest period. No Grade III or IV toxicities were observed, save one patient that developed a grade 3 sensory and motor neuropathy. Re-staging studies were routinely performed after two complete cycles of therapy. All patients with small lymphocytic lymphoma were found to have stable disease after 2 and 4 cycles respectively. Six of nine evaluable patients with follicular lymphoma achieved a major response, with one patient obtaining a durable complete remission. To date, these responses have lasted 3, 4, 6, 9, 9+ and 12+ plus months. The two patients with marginal zone lymphoma achieved a PR after 2 cycles of therapy, lasting now 3+ and 6+ months each.. Of the 10 evaluable patients with mantle cell lymphoma, 5 achieved a partial remission (response rate of 50%), with this response lasting 1+, 1+, 3+ 6 and 19 months. The one patient who attained a PR lasting 19 months was retreated with 4 cycles of bortezomib, and achieved a second PR now lasting 4+ months. To date no patient with small lymphocytic lymphoma/CLL has responded (n=3). Conclusions: These data continue to support the biological activity of bortezomib in patients with select sub-types of indolent NHL. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Millenniuum
Quality of life after morphine treatment in patients with advanced and terminal cancer.
Authors: Tammy Alonso
Journal: Journal of Clinical Oncology (2017)

54 Background: Life quality evaluation is the main indicator of the impact of palliative care, which has the objective of diminished suffering. It includes symptoms control and the satisfactions of patients and relatives. Opioids constitute a milestone in pain treatment. Present work is aimed to evaluate the secondary effects in oncological patients with bad prognosis treated with morphine at the Palliative Care Unit (PCU) of the National institute of Oncology and Radiobiology. Methods: The sample includes 72 cancer patients that arrive to the Palliative Care Unit of the National Institute of Oncology and Radiobiology of Cuba, from May 2015 to May 2016. It was characterized in terms of the demographic and clinical parameters. Severity of symptoms was evaluated using the Visual Analogue Scale (VAS). Pain was evaluated using Analogue Visual Scale. Morphine was administered subcutaneously. Incidence of adverse effects related to morphine administration and accuracy of moderate to severe pain was measured. Results: The age range was from 41 to 50 and females predominate. Gynecological cancers were the most frequent pathology. Most frequent adverse effects related to morphine administration were: constipation (35%), nauseas and vomiting (25%) and somnolence (22%). Despite of morphine myths that terrify many physicians and make them use this drug at the end of analgesic scale, in the present work was used in patients in clinical stage III (58.6 % of the 63.8 % survivors) with an effective pain control. Life quality, that includes mood, functional capacity, social interaction and recurrent symptoms, was improved. Conclusions: The use of morphine for pain relief in stage III oncological patients increases the quality of life of patients and relatives for a longer period of time.