tbuckley/cabot-search huggingface dataset:
Clinical benefit of ipilimumab in patients with metastatic melanoma who progress on high-dose IL-2.
Authors: R. W. Joseph, P. Hwu, M. A. Davies, M. B. Atkins, R. J. Sullivan
Journal: Journal of Clinical Oncology (2011)

8537 Background: Ipilimumab (IPI) improves overall survival (OS) in patients (pts) with metastatic melanoma (MM), but the benefit in pts who progress on high dose IL-2 (HD IL-2) remains unknown. The primary endpoint was to determine if response to prior HD IL-2 would predict clinical benefit to IPI. The secondary endpoint was to determine if pts who progress on HD IL-2 receive clinical benefit from IPI versus other systemic therapies (OST). Methods: We reviewed the records of pts with MM who received systemic therapy after progressing on HD IL-2 at M. D. Anderson Cancer Center or Beth-Israel Deaconess Medical Center from 2004-2009. Pts in the IPI group received IPI at any point after progressing on HD IL-2 and OS was determined from the first dose of IPI. Pts in the OST group received non-IPI containing regimens and OS was calculated from first dose of OST. Pts were also grouped by their best response to HD IL-2: complete or partial response or stable disease (CR/PR/SD) versus progressive disease (PD). OS was determined by Kaplan-Meier analysis; groups were compared using the log-rank test. Results: Of the 208 pts treated with HD IL-2, 44 (21%) remain alive without systemic therapy, and 123 pts (62%) received systemic therapy after progression. Of the 123 pts who received systemic therapy, 47 (38%) received IPI and 76 (37%) received OST. In all pts treated with systemic therapy after HD IL-2, OS trended towards improvement in the CR/PR/SD versus PD subsets (2.4 vs 1.0 years, p=0.07). In the IPI group, pts with a CR/PR/SD to HD IL-2 did not have improved OS compared to pts with PD (1.2 vs 1.1 years, p=0.41). In the OST group, pts with a CR/PR/SD to HD IL-2 trended toward increased OS compared to pts with PD (2.4 vs 0.8 years, p=0.09). There was no difference in OS in all pts who received IPI or OST or in the CR/PR/SD or PD subsets. Conclusions: Prior response to HD IL-2 does not predict clinical benefit to IPI. There is no difference is OS in pts who progress on HD IL-2 and then receive either IPI or OST. ALL n=123 IPI n=47 OST n=76 n OS (yrs) P value (CR/PR/SD vs. PD) n OS (yrs) P value (CR/PR/SD vs. PD) n OS (yrs) P value (CR/PR/SD vs. PD) P value OST vs. IPI All patients 123 1.1 0.07 47 1.1 0.41 76 0.8 0.09 0.74 CR/PR/SD 39 2.4 — 18 1.2 — 21 2.4 — 0.84 PD 84 1.0 — 29 1.1 — 55 0.8 — 0.73
Predictive factors for response to systemic treatments carried out in patients with advanced renal cell carcinoma.
Authors: C. Muriel, E. Esteban, P. Martinez-Camblor, A. Astudillo, G. Crespo, P. Pardo, M. Izquierdo, J. P. Berros, E. Gutierrez, A. J. Lacave
Journal: Journal of Clinical Oncology (2011)

e15014 Background: The analysis of predictive factors of response could help to select those patients with advanced renal cell carcinoma (RCC) who would be good candidates for systemic treatments improving responses and minimising toxicities. Methods: The expression of several biomarkers was retrospectively analysed using immunohistochemistry (IHC) as well as 2 analytical variables in 135 patients with advanced RCC treated with cytokines (CK) and/or biological agents and was correlated to the response. Results: 67 patients were treated only with biological agents and 68 with CK (23 treated also with biological agents). Univariate statistical analysis: HIF1α did not correlate significantly with the response to biological agents and CK. The overexpression of CAIX was associated to a larger response (%) to biological agents (64.7 vs 21.1 with low expression p=0.004) including sunitinib (65.9 vs 16.7 p<0.001), sorafenib (61.9 vs 0 p=0.007) and CK (22.6 vs 0 p=0.038). PTEN did not correlate significantly with the response to biological agents including sorafenib, PTEN positive did have a predictive value of response (%) for sunitinib (70.8 vs 34.1 with PTEN negative p=0.005). p21 did not correlate significantly with the response to biological agents including sorafenib, although the high expression of p21 was associated to a lower response (%) with sunitinib (35.9 vs 65.4 with low expression p=0.025). Thrombocytosis was not significantly associated with the response (%) to biological agents although it was associated to CK (0 vs 20 without thrombocytosis p=0.017). Neutrophilia correlated with a smaller response to biological agents (29.6 vs 57.5 without neutrophilia p=0.045) although it did not associate with a response to CK. In the multivariate analysis the overexpression of CAIX was an independent predictor of a larger response to biological agents and CK with OR of 8,773 (p<0.001). Conclusions: Our findings prove the usefulness of CAIX to select patients with advanced RCC candidates to receive systemic treatment. PTEN and p21 could be important in the prediction of response to sunitinib. Thrombocytosis and neutrophilia appear to relate to the response to CK and biological agents respectively.
Tandem Autologous/Allogeneic Stem Cell Transplantation for Multiple myeloma: Long-Term Outcome of a Retrospective Study
Authors: Claire Fabre, Jalil Bennani, Alain Brebion, Jean Mendiboure, Vincent Ribrag, Christophe Ferme, Nathalie Auger, Naziha Menasria, Annelise Bennaceur-Griscelli, Frédéric Troalen, Valérie Lapierre, Jean-Henri Bourhis
Journal: Blood (2008)
Experience with palliative sedation (PS) in an inpatient oncology setting.
Authors: Bernard Lobato Prado, Diogo Bugano Diniz Gomes, Pedro Luiz Serrano Uson Junior, Patricia Taranto, Monique Sedlmaier Franca, Daniel Eiger, Rodrigo COUTINHO Mariano, David Hui, Auro Del Giglio
Journal: Journal of Clinical Oncology (2016)

63 Background: Palliative sedation (PS) is an intervention to treat refractory symptoms and to relieve suffering at the end of life. Its prevalence and practice patterns vary widely. Methods: This is a retrospective study of the use of PS in cancer patients who died at our comprehensive cancer center between March 1, 2012 and December 31, 2014. PS was defined as the use of continuous infusion of midazolam or neuroleptics for refractory symptoms as stated in the progress notes. Patients who died in the ICU were excluded. The aim of our study was to evaluate PS practice patterns, describing its frequency, clinical indications and outcomes. Results: During the study period, 556 cancer patients died at the institution and 203 (36.5%) received PS. Main reasons for exclusion were death in the ICU (168 patients) and no use of midazolam or neuroleptics (77 patients). Patients who received PS as compared to those not sedated were younger (67.8 vs. 71.5 years-old, p = 0.007) and more likely to have a primary diagnosis of lung cancer (23% vs. 15% p &lt; 0.001). Patients receiving PS were more likely to be seen by oncology/hematology rather than other specialties (70% vs 45% p &lt; 0.001) and more likely to have a longer hospital stay from admission to death (47.9 days vs 26.2 days p &lt; 0.001). Only 25 patients (12%) were seen by a dedicated palliative care team. The most common indications for sedation were dyspnea (51.5%) and delirium (19.5%) and the most common dugs used were midazolam (52.9%) or midazolam and a neuroleptic (39.2%). Median initial midazolam infusion rate was 0.75 mg/h (interquartile range – IQR - 0.6-1.5) and final rate was 1.5 mg/h (IQR 0.9-3.0). Median time from sedation to death was 27 hours (IQR 12-58). Conclusions: Palliative sedation is a common practice at our hospital and it is not associated with shortening of hospital stay. Further research is needed to identify factors that may affect the frequency and outcomes associated with palliative sedation.
Defective mismatch repair (dMMR) status as a predictive biomarker in Chinese patients (pts) with metastatic colorectal cancer (mCRC) treated with bevacizumab (BV) + chemotherapy.
Authors: Jiayu Ling, Dianke Chen, Jianwei Zhang, Lixing Zhong, Yue Cai, Yanhong Deng
Journal: Journal of Clinical Oncology (2016)

537 Background: Monoclonal antibody bevacizumab targeting the vascular endothelial growth factor has become the standard treatment of metastatic colorectal cancer(mCRC) and has led to modest but significant improvements in patient outcomes. Given the modest gains there is a pressing need for predictive factors to better identify patients who would benefit from this target therapy. Methods: We performed retrospective study of 94 Chinese pts with mCRC who received BV combining chemotherapy, whose MMR protein (MLH1, MSH2, MSH6, PMS2) expression was analyzed. Overall survival (OS) was recorded. Univariate and multivariate Cox proportional hazard regression models were used to assess the influence of clinical factors on OS in the cohort. Results: A total of 94 pts (male/female, 58/37; median age, 51.0 years (range 20.0-79.0); synchronous/metachronous metastasis, 70/24; primary lesion resected/unresected 69/25) were enrolled in this study from October 2010 to March 2014. Median OS of the full cohort was 24.5 months (95% CI, 21.2-28.0 months). Of 94 pts, 70 pts were evaluable for MMR. Seven pts (10.0%) had dMMR and 63 pts (90.0%) had pMMR. The pts characteristics between those with dMMR and pMMR were different in age younger than 65 years (100% in dMMR, 69.0% in pMMR; p = 0.08) and synchronous metastasis (100% in dMMR, 75.0% in pMMR; p = 0.13). The median OS was 36.3 months in dMMR versus 21.6 months in pMMR (p = 0.056), and dMMR versus pMMR in bev treating CRC pts was associated with marginal significantly better OS (HR = 0.143; 95%CI, 0.02-1.05; P = 0.056). This association was consistent with that in a multivariable analysis. Also, we found a statistically significant interaction between MMR status and synchronous metastasis (Pinteraction = 0.041). Primary lesion resection was significantly associated with superior OS and was dependent of clinical variables or MMR status. (HR adjusted = 0.43 95% CI 0.20-0.95 P = 0.036 ). Conclusions: MMR status and primary lesion resection status may be predictive factors to better identify patients who would benefit from bevacizumab therapy in Chinese mCRC.
Breathlessness and opioid therapy: A retrospective chart analysis in 2,958 patients.
Authors: Benjamin Gronwald, Michael Wolff, Jan Gaertner, Patric Bialas, Marcus Niewald, Andrea Schmitz, Sebastian Faehndrich, Sven Gottschling
Journal: Journal of Clinical Oncology (2015)

192 Background: Breathlessness is a common and distressing symptom, which increases in many diseases as they progress and is difficult to manage. It is widely accepted that opioids are safe and effective for treating dyspnea, although no single opioid has an authorization for the treatment of breathlessness. The aims of the study were to assess prevalence rates of breathlessness as well as the treatment approaches especially with respect to opioid therapy in all patients cared by a hospital palliative care team in a university hospital over a period of five years. Methods: A systematic review of all electronically available records of patients under palliative care service from April 2010 – April 2015 was performed. Results: Breathlessness was the third most common symptom in our patient group behind fatigue and pain. Furthermore it was classified as the utmost distressing symptom of all. Many patients suffering from breathlessness were opioid-naive before contact with our palliative care team. Many of these patients were put on prolonged-release opioids together with short-acting opioids (mucosal fentanyl) as rescue medication for breathlessness. Opioid therapy was judged to be very effective by the majority of patients suffering from breathlessness however caused (cancer-related or due to a benign disease e.g. chronic obstructive pulmonary disease). Conclusions: In a large cohort of patients breathlessness is a major topic and is clearly positively influenceable by opioids. In our opinion it is longtime overdue to strive for an authorization for opioids against breathlessness.
Colon adenocarcinoma and the human immunodeficiency virus in the HAART era: A retrospective tricenter analysis.
Authors: Y. Modi, A. Kumar, H. Shaaban, N. Shah, S. Yerrabothala, G. K. Guron
Journal: Journal of Clinical Oncology (2011)

e14098 Background: In the highly active antiretroviral therapy (HAART) era, non–AIDS-defining cancers (NADCs) such as Hodgkin’s lymphoma and certain carcinomas (including colon, anal and head and neck) account for an increasing proportion of the malignancies seen in HIV patients. In order to establish effective screening and treatment guidelines in the Human Immunodeficiency Virus (HIV) population, a better understanding of NADCs is needed. This study aimed to characterize the clinicopathologic findings and outcomes of HIV-infected patients with colon adenocarcinoma. Methods: The study examined 20 HIV patients with colon cancer diagnosis. Each patient was matched with 3 HIV-negative colorectal cancer patients based on age, sex, race, and TNM stage at cancer diagnosis. Retrospective patient data between 2000 and 2009 was acquired at Saint Michael’s Medical Center (12), St. Josephs Regional Medical Center (3) and Trinitas Regional Medical Center (5). Data included patient demographics (age, sex), HIV status (duration, CD4+ T-cell count, ART), colon carcinoma pathology (tumor site, stage) and survival outcome. Results: The mean patient age was 51 years (range 35-71 years, male:female ratio, 12:8). 17 were African American, 1 was Hispanic and 2 were Caucasian. 10 were intravenous drug users, and 10 had hepatitis C. The mean CD4+ T-cell count was 570 cells/mm3(median 406). Duration of HIV infection was on average 8 years (range, 1-16 years) at time of colon cancer diagnosis. The majority (80%) of tumors were located in the left colon; the rest involved transverse or right colon. Most (40%) cases had stage 1 cancer at presentation, and less often were stage 4 (30%) and stage 2/3 malignancies (30%). When present, metastases were mainly to the liver and peritoneum. Many individuals (45%) died shortly (within 1-50 months) after cancer diagnosis. No significant difference was observed in survival versus non-HIV patients. Conclusions: Degree of immunosuppression does not appear to dictate tumor stage or adverse outcome in patients with colon cancer. Also of interest is the inability to detect any significant survival difference between the HIV-infected colon cancer patients and colon cancer patients without HIV.
ithlete Heart Rate Variability app: knowing when to train
Authors: Lucía Sagarra-Romero, Mercedes Ruidiaz Peña, Antonio Monroy Antón, Santiago Calero Morales
Journal: British Journal of Sports Medicine (2017)

ithlete Heart Rate Variability.

Sport and Health.

Android, iOS.

€8.99 (£6.99, $8.99).

‘ithlete Heart Rate Variability’ app has been scientifically designed for monitoring the body heart rate and give information about when to train and when to rest.

The process of training is stressing and has an impact on health. This app offers a very quick and healthy biofeedback of how stressed, recovered and ready for training your body is. It can also avoid injuries by giving users information related  to optimising the effectiveness of their workout sequence.

The app allows users to register their heart rate variability (HRV) and the time gap between the heartbeats when the body is resting, in order to offer users a more precise picture of their overall health and fitness status (figure …
Health disparities in advance care planning at a safety-net hospital.
Authors: Elizabeth Levin, Michael Ries, Jeffrey B Rubins, Andres Wiernik
Journal: Journal of Clinical Oncology (2015)

125 Background: Advance health care directives (AHCDs) are recommended by ASCO as a strategy to improve compliance with patient wishes at the end-of-life, thereby facilitating appropriate use of health care resources. We already know too few cancer patients complete AHCDs, but we know less about barriers to their completion. This study assessed the frequency with which AHCDs were completed in different ethnic groups and whether hospice enrollment varied by ethnicity. Methods: Retrospective analysis conducted at Hennepin County Medical Center in Minneapolis, MN with review of the cancer registry data from 2008 to 2013. Data were collected for deceased patients with stage III-IV cancer from the time of diagnosis through death. Demographics, AHCD, hospital deaths, enrollment in hospice, and individual patient data were analyzed using logistic regression, adjusting for both race and language as covariates. Results: From 2008 to 2013, there were 273 patients diagnosed with stage III-IV cancer and followed through death. Fourteen percent of patients were non-English speaking. Thirty-one percent were African American (AA), 4% were Hispanic, and 4% were Asian. Only 21% of patients completed an AHCD during their care, and none were Asian or Hispanic. English speakers were almost five times more likely than non-English speakers to have an AHCD (OR = 4.66, 95% CI = (1.06, 20.46), p = 0.04). Fifty-one percent of English-speaking patients enrolled in hospice compared to 39% of non-English-speaking patients (p = 0.08). Sixty percent of patients with an AHCD enrolled in hospice compared to 46% of those patients without an AHCD (p = 0.10). Forty-three percent of patients with an AHCD died in the hospital, 33% of whom died in an intensive care unit (ICU), versus 46% without an AHCD, 49% of whom died in an ICU. Of patients with advanced cancer, 46% died in the hospital and 21% died in the intensive care unit (ICU). Conclusions: Non-English-speaking patients are far less likely to have an AHCD than English speakers. Some ethnicities in our study had no patients with an AHCD. Since completing an AHCD may increase hospice enrollment and decrease ICU deaths, strategies to promote advance care planning are urgently needed, particularly with non-English speaking patients.
Use of clinical features to select a chemotherapy-responsive variant of aggressive prostate cancer (PC)
Authors: A. M. Aparicio, A. M. Lin, J. C. Araujo, C. J. Logothetis, J. Kim, L. C. Pagliaro, S. Tu, C. Guo, D. Jones, P. Thall, P. Mathew
Journal: Journal of Clinical Oncology (2008)

16000 Background: Clinical features in Table 1 define atypical presentations of castration-resistant PC associated with aggressive behavior and increased likelihood of small cell carcinoma of the prostate (SCCP) on biopsy. Clinical criteria were prospectively applied to select patients (pts) with this “anaplastic” phenotype of PC to receive front-line carboplatin and docetaxel (CD) followed by salvage cisplatin and etoposide (CE). Methods: 120 pts with progressive AIPC and at least 1 of the “anaplastic” features in Table 1 will receive 4–6 cycles of CD (AUC 5 & 75 mg/m2) Q21 days (d). At progression (PD), pts will receive 4–6 cycles of CE (25 mg/m2 & 120 mg/m2) ×3d Q21d. Primary objectives are to estimate rate and time to PD after CD and CE. Results: Of 36 registered pts, 31 were eligible: 2 (6%) had primary SCCP; Gleason was 10 in 13%, 9 in 48%, 8 in 6%, 7 in 16%, 6 in 6%. 10 (32%) had NE features. Median age 67 (43–74), time from original diagnosis 14 months (0–168), PSA 2.2 ng/mL (<0.1–196.5), CEA 2.65 ng/mL (<0.5–832.6), LDH 544 (183–1942). 4 of 28 (14.3%) evaluable pts had PD after 2 cycles of CD. Median PFS after CD was 154 d (95% CI 84 - 306). 4 of 13 pts (30.7%) had PD after 2 cycles of CE. There were 2 neutropenic fevers and 1 death from neutropenic sepsis but no Grade 3 or 4 neurotoxicity or nephrotoxicity. At a median follow-up of 240 d (95% CI 126–409), 3 pts had brain mets and 8 died from PD. Median OS is 376 d (95% CI 347 - NA). Conclusions: These data support the hypothesis that clinical features can be used to detect PC characterized by a high likelihood of morphologic SCCP and high responsiveness to chemotherapy but a poor survival. The ongoing molecular characterization may provide insight into the underlying biology and the identification of predictive and prognostic biomarkers. Androgen-independent PC (AIPC) with at least 1: No. of Pts Histologic evidence of SCPC 7 (23%) Exclusive visceral metastases (mets) 4 (13%) Predominantly lytic bone mets 2 (6%) Bulky (≥ 5cm) lymphadenopathy or pelvic/prostate tumor mass 14 (45%) PSA ≤ 10ng/mL plus ≥ 20 bone mets 6 (19%) Neuroendocrine (NE) markers on histology (ChrA or Syn) or serum (ChrA or GRP)plus LDH≥2xULN, CEA≥2xULN or malignant hypercalcemia 3 (10%) Response to androgen deprivation therapy ≤ 6 months 11 (35%) Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Bristol-Myers Squibb
The effect of a 3-day oral aprepitant regimen on the prevention of CINV over standard therapy in Chinese patients receiving high-dose cisplatin.
Authors: Y. Cheng, L. Zhang, H. Zhang, C. Zhou, B. Han, Y. Zhang, C. Huang, J. H. Chang, X. Song, J. Liang, H. Liang, J. Hu, S. Y. Yu, J. Chen, J. Wang, H. Pan, A. Carides, D. Chitkara
Journal: Journal of Clinical Oncology (2011)

9105 Background: Clinical studies have shown that Aprepitant (APR), a Neurokinin-1 receptor antagonist, is efficacious in preventing chemotherapy induced nausea and vomiting (CINV) and well tolerated. The efficacy, safety, and tolerability of APR in Chinese patients have not been studied. In this phase III, multicenter, double-blind, placebo-controlled, randomized study, we assessed the efficacy, safety, and tolerability of a 3-day oral APR regimen compared with that provided by a standard therapy regimen (ST) in Chinese patients. Methods: Four hundred twenty-one patients receiving chemotherapy including cisplatin (≥70 mg/m2) were randomly assigned (1:1) to receive the APR regimen (APR 125 mg po d1 and 80 mg d2-3, granisetron 3 mg iv d1, DEX 6 mg po d1, and 3.75 mg d2-4) (n=209) or the ST (placebo d1-3, granisetron 3 mg iv d1, and DEX 10.5 mg d1 and 7.5 mg d2-4) (n=212). The primary endpoint was the percentage of patients with complete response (CR; no emesis and no use of rescue therapy) in the overall phase (0 – 120 hours after chemotherapy); secondary endpoints were no vomiting (NV), time to first vomiting episode, and patient-reported impact of CINV on daily life. Results: Overall baseline characteristics were balanced between two arms. All patients received at least one dose of treatment drug and had at least one post-treatment assessment. The proportions of patients with CR in the overall phase were 69.6% in the APR regimen and 57.0% in the ST regimen (p=0.007). The proportions of patients with NV were 70.6% and 57.0%, respectively (p=0.003). Results from the Quality of Life questionnaire showed significant differences between the APR and ST in two of the vomiting domains: ‘ability to enjoy a meal’ (76.0% vs. 66.3%; p<0.05) and ‘hardship on others’ (78.0% vs. 67.3%; p<0.05). The incidence of adverse events was generally similar in both treatment groups. In addition, the distribution of toxicity grades was also generally similar between groups. Conclusions: In our study, the addition of APR to the standard antiemetic treatment regimen was superior in preventing CINV and was well tolerated compared with the ST alone in Chinese patients undergoing cisplatin therapy.