tbuckley/cabot-search huggingface dataset:
Do cancer survivors follow screening guidelines better?
Authors: A. B. Chagpar, T. B. Sanft, C. P. Gross
Journal: Journal of Clinical Oncology (2011)

1597 Background: The Institute of Medicine emphasized the need for survivorship care plans which elucidate screening guidelines for cancer survivors. Few data exist regarding whether a personal history of cancer is associated with better adherence to cancer screening guidelines. We sought to determine whether cancer survivors had better adherence to colorectal, prostate, cervical and breast cancer screening guidelines. Methods: The 2005 National Health Interview Survey (NHIS), including the Cancer supplement issued that year which included data regarding cancer screening practices, was queried. The NHIS is a population-based, face-to-face survey administered by the Centers for Disease Control designed to be representative of the US population. Results: Of the 31,428 people surveyed, 2428 (7.34%) had a previous history of cancer. 5,698 people over the age of 40 (96.89%) had a colorectal screening examination (colonoscopy, sigmoidoscopy, or proctoscopy) in the past 10 years. A past history of cancer (61.34% vs. 40.45%, p<0.001), and specifically colorectal cancer (84.47% vs. 42.95%, p<0.001), significantly influenced the receipt of colorectal screening. 14,659 women over the age of 21 (88.24%) had a PAP smear within the past 3 years. A past history of cancer was associated with a significantly lower rate of PAP smears (81.03% vs. 88.92%, p<0.001); a past history of cervical cancer did not affect receipt of PAP smears (88.29% vs. 88.24%, p==0.984). 2350 men over the age of 40 (42.57%) reported having a PSA test within the past year. A past history of cancer (61.36% vs. 39.26%, p<0.001) and specifically prostate cancer (85.41% vs. 40.48%, p<0.001) were associated with a significantly higher rate of PSA testing. 7061 women over the age of 40 (65.51%) had a mammogram within the past 2 years. A past history of cancer (74.53% vs. 64.34%, p<0.001), and specifically breast cancer (80.06% vs. 64.96%. p<0.001), were associated with a significantly higher rate of mammography. Conclusions: It may be intuitive that cancer survivors would be more diligent in following cancer screening guidelines, but this is not uniformly the case. Survivorship care plans, and other tools, geared towards improving cancer surveillance in the survivorship period are required.
Association of DNA repair inhibition and radiofrequency ablation in the treatment of xenografted colorectal cancer.
Authors: Flavien Devun, Julian Biau, Jian-sheng Sun, Alban Denys, Marie Dutreix
Journal: Journal of Clinical Oncology (2012)

215 Background: Most of the patients with advanced colorectal cancer will develop liver metastasis, even after primary tumor resection. Although surgical resection remains the gold standard treatment of hepatic metastases, only few patients are eligible to curative resection. Radiofrequency ablation (RFA) is the most common curative alternative. Dbait are new molecules that inhibit DNA double-strand breaks repair. In vitro, Dbait has shown to increase cell death after hyperthermia. Here, we have assessed the combination of Dbait and RFA in the treatment of human colorectal cancer model xenografted in nude mice. Methods: 98 mice were flank-grafted with HT29 (human colon adenocarcinoma). When tumor reached 500 mm 3 , mice were sham treated (n=19), treated by Dbait via local injections (n=20), treated by RFA using an incomplete ablation scheme (n=20) or treated by combination of Dbait and RFA (n=39 separated in two Dbait regimens). After RFA, 39 mice were sacrificed for blinded pathological study, and 59 others were followed for survival analysis. Results: Mice treated by RFA-Dbait had significantly longer survival as compared to RFA alone (median survival: 56 vs 39 days, p&lt;0.05) while RFA improved survival as compared to controls (median survival: 39 vs 28 days, p&lt;0.05). Pathological studies of tumor slice have demonstrated significant decrease of tumor area and cancer cell viability in the RFA-Dbait group. Conclusions: While the implication of DNA repair activity in heat sensitivity remains unclear, our results show that the addition of Dbait to RFA enhances the antitumor response in this model and provide an experimental basis for the use of Dbait as an additional therapy to RFA. [Table: see text]
Microarray ANALYSIS of t(11;18)(Q21;Q21)-positive and -negative gastrointestinal MALT lymphomas.
Authors: X. Sagaert, E. Van Cutsem, G. De Hertogh, P. Van Loo, C. De Wolf-Peeters, K. Geboes, T. Tousseyn
Journal: Journal of Clinical Oncology (2010)

e14610 Background: Among the genetic abnormalities that occur in MALT lymphomas, the translocation t(11;18) is of particular interest because it is predominantly documented in MALT lymphomas of the gut. It results in the creation of a fusion protein API2-MALT1 that activates the transcription factor NF-kB via enhanced IKKγ polyubiquitination. Here, we apply microarray analysis to identify differentially expressed genes related to the pathogenesis of gastrointestinal (GI) MALT lymphomas. Methods: 8 t(11;18)-positive and 6 t(11;18)-negative GI MALT lymphomas were compared with normal lymphoid by microarray (Affymetrix Plus 2.0 Gene Chip). 6 splenectomy specimens (with a prominent marginal zone but without obvious morphologic anomalies) of healthy individuals suffering from traumatic splenic rupture were selected as reference tissue, as the marginal zone is assumed to be the non-tumoural counterpart of MALT lymphomas. For this particular study, the number of representative cases documented with both surgical resection specimens and frozen tissue (as required for gene expression profiling) is limited, due to the current conservative treatment of GI MALT lymphomas (the majority of gastric lymphomas regresses after Helicobacter pylori eradication therapy). Results: By comparing the 8 t(11;18)-positive MALT lymphomas as well as their 6 t(11;18)-negative counterparts to normal lymphoid tissue (e.g. spleen with prominent marginal zones), we could define a common GI MALT lymphoma signature, most likely comprising the genes with significance in the development of type of cancer. Moreover, unsupervised analysis of the gene expression profiles of these fourteen GI MALT lymphomas clustered in 2 groups, with the clustering being determined by presence or absence of the API2-MALT1 fusion protein. The latter finding suggests different pathways for both t(11;18)-positive and -negative GI MALT lymphomas. Interestingly, within the group of t(11;18)-positive GI MALT lymphomas, there was a tendency that the gene expression profiles of these tumours tended to cluster according to the location of the MALT1 breakpoint. Conclusions: Our study reveals several genes that play an important rol in MALT lymphomagenesis. No significant financial relationships to disclose.
Successful autologous hematopoietic stem cell (AHSC) mobilization with salvage etoposide (VP16)-ifosfamide-platinum (VIP) followed by high-dose chemotherapy (HDC) and AHSC transplantation (AHSCT) in relapsed malignancies: preliminary single center experience.
Authors: C. Kosmas, A. Athanasopoulos, P. Politis, T. Papachrysanthou, T. Daladimos, A. Papadaki, E. Panagiotidi, D. Moschovis, N. Ziras, A. Karabelis, N. Mylonakis
Journal: Journal of Clinical Oncology (2011)

6540 Background: HDC followed by AHSCT represents a curative treatment option in certain relapsed solid tumors and lymphomaslymphomas. Our current report evaluates the mobilizing potential of VIP CT in a variety of advanced malignancies. Methods: 12 patients (pts) with relapsed malignancies; Ewing family tumors (EFT); 4, Wilm’s tumor (WT); 1, mantle-cell lymphoma (MCL) (3yrs after R-hyperCVAD); 1, transformed B-cell low-grade lymphoma (B-NHL) (5-yrs after R-CHOP); 1, relapsed Hodgkin’s lymphoma (HL) (<1 yr after ABVD); 1, stage III myeloma (MM) after VRD; 1, ovarian cancer (OC); 1, osteosarcoma (OS); 1, germ cell tumors (GCTs); 2, received; VP16: 120mg/m2 d1-3, Ifosfamide: 2.5g/m2 d1+2, CDDP: 40mg/m2 d1+2 (R-VIP in MCL and B-NHL) followed by G-CSF from d5-completion of leukapheresis to a target CD34>2x106/kg or higher if >1 AHSCT were planned. HDC included; Bu/Mel or tandem Mel/VP16→TMC: topotecan/Mel/CTX (EFTs), BEAM: BCNU/VP16/AraC/Mel (MCL, B-NHL, HL), MECb: Mel/VP16/Cb→TMC (WT), topotecan/Cb(x3)→TMC (OC), MECb (OS), and CarbopEC: Cb/VP16/CTX (GCTs). AHSCs were infused on d0 followed by G-CSF from d+1. Results: After VIP+G-CSF mobilization, collected median CD34 were: 11x106/kg (range, 3-27x106/kg) after a median of 1 apheresis (range, 1-2). Until today, 12 pts proceeded to 19 AHSCTs; 7 in CR, 4 in PR, and 1 in PD. Engraftment; ANC>500/μl, PLT>20000/μl, occurred in all at a median of 8d (range, 8-35) and 12d (range 11-76), respectively. Non-hematologic toxicities (Bearman’s criteria) included: grade 2-3 enteritis; 5, grade 2 mucositis; 8, grade 1 liver; 5, and grade 2 hemorrhagic cystitis; 2. All developed neutropenic fever managed by broad-spectrum antibiotics and anti-fungals. All pts survived >100+ days post-transplant, and 5 remain in CR. Conclusions: The VIP combination (+G-CSF) is highly effective in AHSC mobilization leading to successful engraftment in all pts presented. The study is ongoing.
Outcomes associated with T4 esophageal cancer.
Authors: K. Meredith, J. Weber, R. Shridhar, S. E. Hoffe, K. Almhanna, M. Melis, M. Biagioli, J. Mcloughlin, J. S. Barthel, R. C. Karl
Journal: Journal of Clinical Oncology (2011)

130 Background: Esophageal cancer often presents as locally advanced disease with 15% of patients having T4 tumors upon diagnosis. Esophagectomy was often reserved for palliation given the dismal survival rates and high rates of R1/R2 resections. However, neoadjuvant therapy (NT) has the potential to significantly downstage esophageal cancers and thus increase complete resection rates. We report our experience with surgically resected T4 cancers of the esophagus. Methods: Using a comprehensive esophageal cancer database, we identified patients who underwent an esophagectomy for T4 tumors between 1994 and 2008. Neoadjuvant therapy and pathologic response were recorded and denoted as complete (pCR), partial (pPR), and non-response (NR). Clinical and pathologic data were compared using Fisher's exact and chi-square when appropriate while Kaplan Meier estimates were used for survival analysis. Results: We identified 39 patients with T4 tumors who underwent esophagectomy of which 38 (97%) underwent NT. The median age was 61 (31-79) years with a median follow-up of 32 (5-97) months. There were 3 (7.9%) pCR, 17 (44.7%) pPR, and 18 (47.4%) NR. R0 resections were accomplished in 37 (94.9%). Two patients had incomplete resections. One patient had a R2 resection after NT and was deemed as NR. An additional patient had a R1 resection after NT and was a pPR with a residual 0.2 cm tumor on permanent pathology. There were 14 (35.9%) recurrences with a median time to recurrence of 19.5 (4-71) months. Complete pathologic response represented 1 (7.1%), whereas pPR and NR represented 6 (42.9%), and 7 (50%) respectively of all recurrences. The overall and disease free survival for all patients with T4 tumors was 28% and 34% respectively. Patients achieving a pCR had a 5-year overall and disease free survival of (43% and 47%), compared to pPR (30% and 21%) while there were no 5-year survivors in the NR cohort. Conclusions: T4 esophageal cancer often portends a dismal prognosis even after surgical resection. Historical incomplete resections and dismal survival rates often make surgery palliative rather then curative. However, we have demonstrated that neoadjuvant therapy and down staging of T4 tumors leads to increased R0 resections and improvements in overall and disease free survival. No significant financial relationships to disclose.
Evaluation of an advanced practice radiation therapist role in palliative radiation therapy.
Authors: Mary Job, Tanya Holt
Journal: Journal of Clinical Oncology (2016)

136 Background: To evaluate the impact a new Advanced Practice Palliative Radiation Therapist (APRT) role had on patients treated with palliative intent, with respect to reducing time from referral to treatment. To evaluate the technical ability of the APRT to delineate palliative field borders on digitally reconstructed radiographs (DRR) compared to the treating Radiation Oncologist (RO). Methods: The time in working days from referral to treatment and referral to planning was recorded for all palliative patients having 10 fractions or less. The patients were classified into two groups. Patients from G1 were referred to one of four selected ROs or directly to the APRT. All clinical and technical elements of their radiotherapy treatment were managed by the APRT. Patients from G2 were referred to one of the remaining four ROs in the department and had their radiation therapy treatment managed through the standard pathway. The APRT delineated field borders on all patients in G1, blinded to the ROs field delineation. The RO then deemed the APRTs field placement acceptable or unacceptable. If unacceptable the RO documented the reasons for rejection. Results: Over 5 months, data was collected on 150 palliative patients. The APRT managed 94 patients. The remaining 56 patients were processed through the standard pathway. The APRT delineated 90 palliative fields on patients blinded to the RO. Of these, 89% were deemed acceptable by the RO. Conclusions: There has been a positive impact with respect to reducing time from referral to treatment for patients receiving palliative radiotherapy with the introduction of the APRT role in palliative radiotherapy.[Table: see text]
Treatment results in patients with brain metastases: Zagreb experience.
Authors: L. Markulin-Grgic, F. Santek
Journal: Journal of Clinical Oncology (2010)

e18132 Background: Brain is a common site of widespread malignant disease. Metastases can be found in 40% of patients with metastatic cancer. Surgery, radiotherapy and chemotherapy are standard treatment methods. Methods: Results of treatment of 198 patients with braintrater metastases are discussed. Multiple metastases were present in 66.4% and solitary metastases in 33.6%. The most common site of primary tumor was bronchial carcinoma (62%), followed by breast carcinoma (15%), melanoma (4.5%), gastrointestinal tumors (4.5%), hypernephroma (2.5%), ovarian IIIC carcinoma (2.5%), hypernephropma (2.5%), testicular carcinoma (1.5%). In 7.5% of patients the primary tumor was unknown. The patients were treated by radiotherapy, chemotherapy and surgery in various combinations. Results: A significantly better survival was achieved in patients in younger age group (p < 0.05). The survival was also significantly better in female patients with breast carcinoma (p < 0.001), median survival 10.5 months. In the entire cohort of patients 3 months survival was 67%, 6 months survival 45%, 12 months survival 20.5%, 18 months survival 7.3% and 24 months survival was 3.2%. Median survival for the entire cohort was 6 months. Significantly better results were obtained in patients treated by surgery and radiotherapy, median 10 months, than in patients treated by radiotherapy only, median 5 months. Best results were obtained when surgery, radiotherapy and chemotherapy were applied, median survival time was 12 months. Conclusions: The best survival results were achieved in patients treated by surgery,whole brain irradiation and postoperative postirradiation chemotherapy (p < 0.001) with median survival time 12 months. No significant financial relationships to disclose.
Association of CTCAE v4 grading of hypertension with toxicity in patients with renal cancer receiving vascular endothelial growth factor (VEGF)-targeting agents.
Authors: Naveed Hassan Akhtar, Irene Karpenko, Beerinder Singh, Himisha Beltran, David M. Nanus, Scott T. Tagawa
Journal: Journal of Clinical Oncology (2013)

447 Background: The NCI Common Terminology Criteria for Adverse Events (CTCAE) system underwent a change to version 4 in May 2009. In addition to system re-organization, several AE categories underwent changes in grading, including hypertension (HTN). As many anti-neoplastic agents, particularly those targeting VEGF are associated with HTN, changing in the grading system may result in changes to maximum tolerated or recommended phase II doses (MTD or RP2D) in dose-escalation studies using classic trial schemas (such as 3+3 design). Methods: We reviewed individual patient data of a phase I/II trial of sorafenib plus gemcitabine and capecitabine for advanced renal cell carcinoma (RCC). The phase I portion of the study was conducted to define the dose-limiting toxicity and RP2D of the combination (Am J Clin Oncol, 2011). The phase II portion further assessed efficacy as defined by objective response rate. Initial grading of AE’s during this study used CTCAE v3. Individual patient data was reviewed and HTN AE’s were re-graded using CTCAE v4 criteria for up to 12 cycles of therapy on study. Results: Of 28 pts enrolled, 23 (82.1%) had complete source documents available for the complete evaluation of HTN. The table compares each individual’s highest CTCAE v3 versus v4 grading of HTN on study. All pts had HTN AE’s using CTCAE v4. Only 1 pt maintained grading using both versions (Gr 3), with 22 (95.7%) changing grades. Two (8.7%) moved from Gr 0 to Gr 1, fourteen 60.9(%) from Gr 0 to Gr 2, four (17.4%) from Gr 1 to Gr 2, one from Gr 1 to Gr 3, and two (8.7%) from Gr 2 to Gr 3. Conclusions: Re-classification of grading in this study demonstrates that only 4.3% maintained stable grading of HTN across systems, with 65.2% increasing by 2 grades. The change in AE reporting criteria has the potential significantly impact results of clinical trials. This may be particularly important with VEGF-targeted agents, with emerging data pointing towards HTN as a pharmacodynamic marker in pts with RCC, and may affect dosing of other drugs with blood pressure effects, including CYP17 inhibitors for prostate cancer. Clinical trial information: NCT00121251. [Table: see text]
PKM2 mRNA expression to predict disease recurrence in patients with stage II or III colon cancer treated with oxaliplatin in combination with fluoropyrimidines.
Authors: Chara Papadaki, Maria Sfakianaki, Zacharenia Saridaki, Georgios Giagas, Kyriakos Mpananis, Maria Tzardi, Eleftheria Tsakalaki, Maria Trypaki, Vassilis Georgoulias, Ioannis Sougklakos
Journal: Journal of Clinical Oncology (2012)

468 Background: Tumor cells have been shown to express exclusively the embryonic M2 isoform of pyruvate kinase (PKM2), which is a key enzyme that regulates aerobic glycolysis in tumor cells. Use of RNA interfering (RNAi) targeting PKM2 significantly inhibits tumor growth when combined with cisplatin in xenograft models. We evaluated the predictive significance of PKM2 in patients with “high” risk stage II or stage III colon cancer treated with oxaliplatin-fluoropyrimidines chemotherapy adjuvant treatment. Methods: FFPE primary tumours from 261 patients with stage II or III colon cancer with colon cancer were analyzed for PKM2 mRNA expression by RT-qPCR. All patients had received adjuvant treatment with an oxaliplatin and fluoropyrimidine combination. Also, match normal mucosas from 50 of these patients have been analyzed. Finally, 50 polyps (20 with low grade dysplasia, 20 high grade dysplasia and 10 serrated adenomas) from non-colon cancer patients were included in the for PKM2 mRNA expression by RT-qPCR. The analysis was performed with a set of primers and probes which amplify only the M2 isoform. Results: PKM2 mRNA expression was significantly higher in tumor areas in comparison with normal mucosa (p=0.001) and low-grade adenomas (p=0.001) as well as in tumors with BRAF mutations (p=0.001). Adenomas with high-grade dysplasia (p=0.002) and serrated adenomas (p=0.001) presented significantly higher PKM2 mRNA expression. Overexpression of PKM2 was associated with significantly lower Disease Free (p=0.018) and Overall Survival (p=0.031). Multivariate analysis revealed PKM2 high mRNA expression as independent prognostic factors for decreased DFS (HR: 2.1, p=0.003) and OS (HR: 1.8, p=0.019). Conclusions: These results provide evidence that the PKM2 mRNA expression could be used as prognostic/predictive marker for disease recurrence in patients with operable colon cancer. Analysis of the PKM2 mRNA expression in patients treated with non-oxaliplatin containing adjuvant treatment is currently performed.
Evaluation of a risk-adapted visit for post-treatment cancer survivors.
Authors: Carol A. Rosenberg, Carol Flanagan, Bruce Brockstein, Jennifer Carrie Obel, Elaine Lee Wade, Teresa Murray Law, Leon Harold Dragon, Douglas E. Merkel, Janardan D. Khandekar, Thomas A. Hensing
Journal: Journal of Clinical Oncology (2014)

113 Background: The Living in the Future (LIFE) Cancer Survivorship Program at NorthShore University HealthSystem provides a risk adapted visit (RAV) directed by a physician and facilitated by an oncology nurse during which an electronic medical record documented LIFE survivorship care plan (SCP) is provided and discussed. We evaluated the degree to which a RAV promotes individualized healthcare and self-management as survivors transition from active treatment to follow-up care. Methods: Patients anonymously complete a post-RAV evaluation on the day of their RAV and then another at least one year after their RAV. Results: 1,713 RAVS, the majority for breast cancer, occurred from 1/2007 to 3/2014.There are 1,615 complete “day of” post- RAV evaluative data with a median time from completion of last therapy of &lt; 6 months. Respondents scaled statements as strongly agree/ agree/disagree/ strongly disagree. Combined strongly agree/agree ratings are: 94% felt more confident in their ability to communicate information about their cancer treatments to other members of their healthcare team; 90% felt more comfortable recognizing signs and symptoms to report to their healthcare provider; 98% had a better appreciation for potentially helpful community programs and services. Of the 488 respondents (RAV between 1/2007 and 12/2012 n=1,366) to a questionnaire at least one year after the RAV, nearly 100%/97%/93%/91%/85% found the SCP useful in at least 1/2/3/4/5 ways: to summarize medical information, to reinforce follow up care, to recognize symptoms to report, to identify lifestyle practices that promote health, and for assistance in identifying local resources for support. 72% discussed their SCP with their PCP or another healthcare provider, 97% stated they made at least one positive lifestyle change, 89% attended at least one LIFE health promotion seminar, and 80% continue to work on wellness goals. Conclusions: Participation in a LIFE RAV following oncology treatment helps survivors construct a useful understanding of their cancer experience to guide self-care behavior. Data demonstrate that benefits persist one year after the visit and support the feasibility of a nurse-led RAV to establish a SCP in post-treatment cancer survivors.