tbuckley/cabot-search huggingface dataset:
Comparison of microRNA (MiRNA) expression profiles between <i>opisthorchis viverrini</i>-associated cholangiocarcinoma (OV-CCA) and non-<i>opisthorchis viverrini-</i>associated cholangiocarcinoma (non-OV CCA).
Authors: Suebpong Tanasanvimon, Asif Rashid, Sopit Wongkham, Chaitanya Churi, Zhimin Tong, David R. Fogelman, Atit Silsirivanit, Boris Blechacz, Naruemon Klaikaew, Vajarabhongsa Bhudhisawasdi, Jean-Nicolas Vauthey, Milind M. Javle
Journal: Journal of Clinical Oncology (2013)

206 Background: Cholangiocarcinoma in Thailand and Laos is associated with the liver fluke Opisthorchis viverrini (OV). Molecular differences between OV-CCA and Non-OV CCA remain to be defined. MiRNAs are regulators of mRNA that result in transcriptional repression or gene silencing. MiRNA profiles of OV vs. non-OV CCA have not yet been studied. Methods: 50 OV-CCA and 16 non-OV CCA pathological samples were obtained from Liver Fluke and Cholangiocarcinoma Center, Khonkaen University, Thailand and University of Texas, MD Anderson Cancer Center (MDACC), USA, respectively. Macrodissected common bile duct samples from MDACC were used as control groups. Global miRNA expression profiling was performed using the miRCURY LNA microRNA Array (Exiqon).qRT-PCR and in situ hybridization (ISH) were used to validate the miRNAs noted to be significant on the microRNA array. Results: Ten samples of OV and non-OV CCA were analyzed for global miRNA expression; 46 were used for validation. MiRNA microarray identified 71 miRNAs that were differentially expressed between OV-CCA and non-OV CCA (p&lt;0.05). Of the 25 miRNAs with increased expression in OV-CCA, miR-141 and miR-200c were highly significant (p&lt;0.01). These were overexpressed in OV-CCA as compared to control bile duct samples. The validation set on qRT-PCR showed significant miR-200c overexpression in 12 OV-CCA samples (p=0.02) and under expression in four non-OV CCA samples (p=0.006). ISH demonstrated miR-200c overexpression in 32 of 45 (71.1%) OV-CCA samples and 2 of 8 (25%) non-OV CCA samples. There was a trend toward better survival in OV-CCA patients with high miR-200c expression (9.5 vs 5.2 months, p=.08). Conclusions: MiRNA expression profiles differ between OV-CCA and non-OV CCA. MiR-200c was overexpressed in OV-CCA but under expressed in non-OV CCA. MiR-200C is known to repress epithelial-mesenchymal transition and its overexpression in OV-CCA may provide important insight into the distinct pathogenesis and prognosis of OV-CCA.
Improving outcomes through the development of quality indicators in renal cell cancer.
Authors: Lori Wood, Georg A. Bjarnason, Peter C. Black, Ilias Cagiannos, Daniel Yick Chin Heng, Anil Kapoor, Christian K. Kollmannsberger, Forough Mohammadzadeh, Ronald Brian Moore, Ricardo A. Rendon, Denis Soulieres, Simon Tanguay, Peter Venner, Antonio Finelli
Journal: Journal of Clinical Oncology (2012)

422 Background: Optimal quality of care is necessary for ideal outcomes, and quality indicators (QI) are increasingly being used to measure quality of care. In renal cell carcinoma (RCC), there is a paucity of information defining such optimal care. This is particularly important as care of RCC patients is becoming increasingly complicated with more options and requiring greater expertise. The goal of this study was to identify QI for RCC across the entire disease spectrum from presentation to palliation. Methods: A multidisciplinary expert panel (13 members) of medical and urologic oncologists from across Canada reviewed potential QI. These potential QI were identified from a systematic review of the literature. In addition, panel members were encouraged to suggest additional potential QI. A modified Delphi technique was utilized to select QI that were both relevant and practical to RCC; this technique incorporated 2 email questionnaires and 1 in-person meeting. Results: From 250 citations in the systematic review, 34 possible QI were identified; 24 additional potential QI were suggested by panel members. A final set of 23 QI were established by the expert panel. These were distributed across the RCC disease spectrum as follows (number of QI in parentheses): screening (1), diagnosis and prognosis (3), management of localized disease (7), surgical management of locally advanced or metastatic disease (3), systemic therapy (4), and follow-up (3). These 21 QI focused largely on the treatment of RCC. In addition, two QI related to survival outcomes (overall and progression-free) were selected. An example of a QI in localized disease is the proportion of patients undergoing partial nephrectomy for tumors &lt; 4 cm. An example in advanced disease is the proportion of patients who are assessed by members of a multidisciplinary genitourinary cancer team. The final 23 QI selected will be presented in detail. Conclusions: A systematic, consensus-based approach was used to determine relevant QI in RCC care. These 23 QIs will provide a means of evaluating the quality of RCC care in an effort to improve outcomes for our patients. The next step will be to establish a means of measuring each of these QI based on defined or yet to be defined benchmarks.
A multicenter study of trastuzumab (H) and vinorelbine (N) as first and second line therapy for patients (pts) with HER2- positive metastatic breast cancer (HER2+ MBC)
Authors: R. M. Franquesa, M. Centelles, K. Villadiego, J. Janáriz, A. Arcusa, L. Cirera, M. Segui, E. Saigi
Journal: Journal of Clinical Oncology (2005)

868 Background: Combination therapy of Trastuzumab (H) and Vinorelbine (N) has recently been reported to be an active and safe regimen for HER2 positive MBC patients. We report here the preliminary results of a multicenter phase II trial. Methods: HER2 positive MBC pts (IHC 2+ or 3+ confirmed centrally by FISH+), PS ≤2, no prior H or N and without prior treatment for metastatic disease or after first line therapy were treated with H: 2 mg/kg/d (4 mg/kg on day 1 as loading dose) followed by N: 25 mg/m2, both given on days 1, 8 and 15 of a 21-day cycle, during 6 cycles. Pts were reassessed every 2 cycles. Results: 18 patients were included in the study, median age: 54 years (46–63), prior neo/adjuvant chemotherapy: 66.6%, prior hormonal therapy: 44.4%, visceral metastasis: 50%. Sixteen patients were evaluable for response and 18 pts for toxicity. The overall response rate (CR+PR) was 44% (95% CI: 20–70%), disease control (CR+PR+SD) was 88% (95% CI: 62–98%) and 12% (95% CI: 2–38%) had PD. Median observation time is 14.7 mo (range 4.3–41.1 mo), median duration of response was 11.7 mo. (95% CI: 6.8–16.6 mo.) and median TTP was 11.9 mo (95% CI: 9.4–14.5 mo). Median survival has not yet been reached. WHO grade 3–4 hematological toxicities were anemia (0.2% of cy), leucopenia (0.5%), neutropenia (13.5%) and thrombopenia (0.1%). Grade 3 non-hematological toxicities were: nausea, alopecia and anorexia in one cycle each (0.1% of cy); no cardiac events have been observed. Conclusions: Our results indicate that N + H is an active regimen for pts with HER2 positive MBC while maintaining a good safety profile. No significant financial relationships to disclose.
Comparison of low-temperature-sensitive liposome encapsulated docetaxel and doxorubicin in a murine model of prostate cancer.
Authors: S. Chokshi, A. Ranjan, C. J. Benjamin, P. H. Chung, A. Rastinehad, M. R. Dreher, B. J. Wood, P. A. Pinto
Journal: Journal of Clinical Oncology (2011)

31 Background: Low-temperature-sensitive liposomes (LTSLs) release their encapsulated drug into targeted tissue when activated by a source of hyperthermia. The efficacy of an LTSL formulation of docetaxel (DOC) or doxorubicin (DOX) was compared against prostate cancer in a xenograft mouse model. Methods: Under an approved IACUC protocol, Luciferase transfected human prostate PC-3M-luciferase cells were inoculated (3x10 6 cells) subcutaneously in the right hind leg of 8 wk old female athymic nude mice. When tumors reached a volume of 200–300 mm 3 , mice were randomized to receive one intravenous injection of saline, Stealth liposomal DOX (5 mg/kg), LTSL DOX (5 mg/kg), or LTSL DOC (15 mg/kg), with or without hyperthermia treatment (LTSL DOX and LTSL DOC were supplied by Celsion Corp., Columbia MD). Mice undergoing hyperthermia treatment were anesthetized and stabilized in a holder that allowed for only the leg with tumor to be heated to 41–42°C that triggered LTSL drug release. Mice were monitored daily for tumor volume and body weight. Study end-points included growth of tumor to 5x the initial treatment volume or monitoring of survival for 60 days. Results: The LTSL DOC delayed tumor growth longer (&gt; 14 days) than DOX (0 day) and LTSL DOX (1 day) with hyperthermia (P&lt;0.05). Mice treated with LTSL DOC and hyperthermia survived longest (60 days) compared to all other mice (range 6–8 days, P&lt;0.05). LTSL in the setting of hyperthermia demonstrated complete regression of tumor in 57% of mice. Conclusions: LTSL DOC with hyperthermia delayed tumor growth more than all other treatments. Survival studies suggest LTSL DOC is a more effective temperature sensitive delivery system against PC-3M prostate tumors. No significant financial relationships to disclose.
Prospective multicenter feasibility study of laparoscopic sentinel basin dissection for organ preserving surgery in gastric cancer: Quality control study for phase III trial.
Authors: Keun Won Ryu, Young Joon Lee, Sang-Ho Jeong, Hoon Hur, Sang Uk Han, Jae-Seok Min, Ji Yeong Ahn, Woo Jin Hyung, Gyu Seok Cho, Gui Ae Jeong, Oh Jeong, Young-Kyu Park, Mi Ran Jung, Young Woo Kim, Hong Man Yoon, Bang Wool Eom
Journal: Journal of Clinical Oncology (2015)

143 Background: Clinical application of sentinel node biopsy (SNB) in early gastric cancer (EGC) is still controversial even though promising multicenter trial result with minimal false negatives was already reported from Japan. Moreover laparoscopic approach is considered as minimally invasive in addition to organ preserving surgery. Therefore we conducted this study as a prerequisite quality control for phase III trial. Methods: Laparoscopic SBD was performed in patients with preoperative stage T1-2N0 and tumor size less than 4cm in maximal diameter. Intraoperative endoscopic submucosal injection of Technetium 99m-Human Serum Albumin and indocyanine green was done. All removed sentinel basin nodes (SBN) were investigated with intraoperative frozen Hematoxylin Eosin (HE) stain. Postoperative permanent HE stain was done for SBNs and non-SBNs. Strict checklist consisting of essential 7 steps during laparoscopic SBD was made as the quality control study for phase III trial. Ten cases completion of all essential steps in checklist were defined as qualified institution. Results: Seven institutions participated and 112 patients were enrolled in this study. However 4 patients were excluded due to screening failure. SB detection and SBD was performed in 100 of the 108. Lymph node metastases were found in 11 patients at postoperative permanent HE staining and SBD contained metastatic lymph nodes in 11 patients. The detection rate of SB was 92.6% with mean number of SB and SBN was 1.68 and 9.56. Sensitivity and accuracy were 100% in this study. Frozen results of SBN were compatible with permanent reports except one patient who had one SBN with micrometastasis. As the quality control of each institution for phase III trial, 13 to 20 cases were needed based on our strict checklist. Conclusions: Laparoscopic SBD is feasible and improve the sensitivity comparing to the previous study. This study suggests the promising phase III trial of laparoscopic SBD for minimally invasive and organ preserving surgery in EGC after qualifying participating institutions. Clinical trial information: NCT01544413.
Characteristics of long- versus short-surviving patients (Pts): An analysis of the ARIES Observational Cohort Study (OCS) of bevacizumab (BV)-treated pts with metastatic colorectal cancer (mCRC).
Authors: Mark Kozloff, Axel Grothey, Johanna C. Bendell, Allen Lee Cohn, Tanios S. Bekaii-Saab, Nancy Roach, Elizabeth Dawn Flick, Yong Mun, Susan Meredith Fish, Rita Laeufle, Nicolas Sommer, Herbert Hurwitz
Journal: Journal of Clinical Oncology (2015)

702 Background: Median overall survival (OS) in mCRC has significantly improved over the past 20 yrs, but the observed range of OS in pts remains wide; a large percentage of pts have OS &lt;1 yr or &gt;4 yrs. ARIES was a prospective OCS conducted from 2006–2012 that evaluated outcomes in pts receiving BV + chemotherapy (CT) for mCRC in general clinical practice. The objective of this analysis is to examine clinical characteristics of pts with long vs short OS. Methods: This analysis included 1,417/1,550 first-line (1L) BV-treated mCRC pts who died or had complete follow-up on study. Long OS was defined as OS within the upper quartile of the analysis population (range 42–67 mos); short OS was defined as OS within the lower quartile (range 0.3–12 mos). Progression-free survival (PFS) was estimated using Kaplan-Meier methods. Pt and disease characteristics and treatment patterns were described using summary statistics. Results: Pt and disease characteristics are shown in the Table. Median PFS was 22.3 mos (95% CI, 19.9–23.3) vs. 4.9 mos (95% CI, 4.6–5.4), in the long-OS vs. short-OS groups. More pts with long OS received any second-line (2L) therapy (71% vs. 46%), and were exposed to 5-fluorouracil, oxaliplatin, and irinotecan throughout the course of their disease (53% vs. 32%) compared with pts with short OS. KRAS/BRAF mutation status was not collected. Conclusions: Pts with long OS had better baseline performance status, primary tumors more likely to have been resected, and were more likely to have received 2L CT. Additional analyses of detailed treatment patterns and safety are ongoing. Clinical trial information: NCT00388206. [Table: see text]
“It looks good”: How a provincial radiation oncology program benefits from implementing peer review across cancer centers.
Authors: Michael Donald Brundage, Margaret Hart, Jennifer O'Donnell, Sophie Foxcroft, Eric Gutierrez, Lindsay Elizabeth Reddeman, Gunita Mitera, Padraig Richard Warde
Journal: Journal of Clinical Oncology (2016)

238 Background: Peer review (PR) in radiation oncology (RO) has been endorsed as an indicator of treatment quality in North America and internationally. The direct benefits of PR include quality assurance (QA) on individual treatment plans. The indirect benefits for radiation oncology departments or programs (ROPs) have been postulated but not systematically evaluated. We used a rigorous and comprehensive qualitative approach to explore the indirect benefits of PR across a jurisdiction of cancer care, and to identify factors that facilitate PR, barriers to implementation, and strategies for expansion of PR across centers. Methods: Semi-structured qualitative interviews were held with all RO heads and Radiation therapy Managers (or delegate) in all 14 Radiation Oncology Programs (ROPs) in Ontario, Canada. The interview questions were developed using a Knowledge Translation Theoretical Domains Framework (TDF), guided by the results of a previous survey of Ontario cancer centers and by expert consensus. Interviews were audiotaped and abstracted for relevant themes by two independent analysts. Results: All interviewees endorsed numerous direct and indirect benefits of PR, and identified multiple facilitators and barriers to the implementation of PR. Thematic saturation was achieved. The structure-process-outcome model was used to categorize the results. Key findings included the identification of 34 independent benefits (structure n = 4, process n = 17, outcome n = 13), 40 key barriers (structure n = 9, process n = 26, outcome n = 5), and 22 facilitators (structure n = 4, process n = 15, outcome n = 3). Beyond QA, commonly endorsed benefits included enhanced knowledge sharing, efficiency, standardization, and education. Multiple potential strategies for the expansion of PR activities were revealed. Conclusions: The qualitative exploration of Ontario ROPs acknowledges that multiple barriers and facilitators to PR exist while clearly establishing the indirect benefit of PR on ROPs. Understanding reported barriers and facilitators and exploration of suggested strategies will inform continued implementation and expansion of PR activities, and seem generalizable to other jurisdictions.
Anemia in dialysis patients diagnosed with cancer: Results of the CANDY study.
Authors: N. Janus, J. Thariat, V. Launay-Vacher, H. Boulanger, V. Roth, K. Maurizi, M. S. Islam, G. Deray, J. Durande, M. Ducret, L. Juillard, Z. Soltani, G. Motte, O. Moranne, J. Rottembourg, J. Rey
Journal: Journal of Clinical Oncology (2011)

e12005
Overall survival and complications of cancer therapy in HIV-positive cancer patients on HAART compared to HIV-negative cancer patients.
Authors: Kelly Ann Fritz, David D. Stenehjem, Stephanie A. Sanders, Adam Louis Cohen
Journal: Journal of Clinical Oncology (2014)

276 Background: HIV-positive patients are living longer and are at higher risk for any type of cancer, not only traditional AIDS-defining cancers (ADC). This study aims to assess our overall survival rate in HIV-positive cancer patients compared to HIV-negative patients, and identify differences in complications of cancer therapy in order to ensure quality of care and outcomes in this patient population. Methods: HIV-positive patients ≥ 18 years of age with a diagnosis of cancer in the Huntsman Cancer Institute Tumor Registry from 2008-2013 were matched to HIV-negative cancer patients by cancer type, stage, age, and sex. Overall survival (OS), admission for febrile neutropenia (FN), total hospital length (LOS) of stay for any reason, and the total number of blood transfusions were assessed. Kaplan-Meier methodology was used to assess differences in cancer survival. Results: A total of 55 HIV-positive patients and 40 HIV-negative patients were included. HIV-positive patients were younger at cancer diagnosis than HIV-negative patients, 50 vs. 56 years old (p = 0.0017). A trend for reduced median OS in HIV-positive patients was observed compared to HIV-negative patients (HR 1.81; 95% CI 0.77-4.71; p = 0.1835). One-year OS was 78% for HIV-positive vs 88% for HIV-negative patients (p = 0.2673). Numerically an increased mean number of hospital admissions for FN (0.7 ± 2.0 vs. 0.4 ± 1.3; p = 0.2663), transfusions (2.5 ± 12.7 vs. 0.9 ± 2.5; p = 0.4907), and inpatient LOS (12.7 ± 23.6 vs. 7.0 ± 13.0; p = 0.2381) were observed in the HIV-positive group compared to the HIV-negative group, however this did not meet statistical significance. Conclusions: This retrospective study highlights a trend for a reduction in survival and increased FN admissions, LOS and transfusion requirements in HIV-positive patients with cancer. We have identified a need for improvement in supportive care treatments such as primary febrile neutropenia prophylaxis, opportunistic infection prophylaxis, and anemia management to improve the quality of cancer treatment in this patient population.
Significance of core needle biopsies with ductal carcinoma in situ suspicious for microinvasive carcinoma.
Authors: Jukes P. Namm, Jeffrey Mueller, Swati Kulkarni
Journal: Journal of Clinical Oncology (2013)

86 Background: Sentinel lymph node biopsy (SLNB) is not routinely recommended for women diagnosed with ductal carcinoma in situ (DCIS); however, when the pathologist cannot rule out microinvasion on core biopsy (CB), the surgeon must decide whether to perform a SLNB at the time of surgical excision. Up to 10% of patients with T1mi are found to have breast cancer cells in the axillary lymph nodes, but less than 2% contain macrometastasis making the utility of SLNB in this setting unclear. Methods: The University of Chicago pathology database was queried for patients whose CB showed DCIS suspicious for microinvasion (Smic) or definite microinvasion (Mic) from 2000 to 2012. We analyzed histology, imaging, nodal status, core needle size, and the use of myoepithelial immunohistochemistry (IHC) markers to identify microinvasion. Results: We identified 60 women with Smic and 19 women with Mic on CB. In the Smic group, 33% had infiltrating ductal carcinoma (IDC) in the surgical specimen (35, 30, 30, 1 and 0% for T1mi, T1a, T1b, T1c, and T2 respectively compared to 58, 21, 0, 10.5 and 10.5% in the Mic group). A SLNB was performed at the initial surgery in 38/60 (63%) of Smic and in all Mic biopsies; they were positive in 3/42 (7%) and 2/19 (11%) respectively (p=0.64). When N1mic was excluded, the incidence of macroscopic nodal disease was 1/42 (2.4%) and 1/19 (5.3%) p=0.53. Of those with Smic, we observed a higher proportion of IDC associated with a lesion size ≥ 14 mm on imaging (75% versus 15% for &lt; 14 mm, p&lt;0.02); smaller CB needle size (69% with 11, 12 and 14 gauge versus 0% with 9 gauge, p&lt;0.01); and the use of IHC on the CB to identify microinvasion (58% versus 22% without IHC, p&lt;0.01). There was no association to IDC with respect to grade, necrosis, mass on imaging, or biopsy guidance. Conclusions: The incidence of clinically positive nodal disease in patients with Smic on CB is extremely low. However, those with tumors ≥ 14 mm, the use of smaller gauge CB needles, and Smic based on myoepithelial IHC may be at higher risk for IDC. Of the Smic group with DCIS after excision, none harbored nodal disease; therefore, the use of SLNB only after a definitive diagnosis of IDC may prevent overtreatment.
Improving new patient access for patients with colorectal cancer.
Authors: Kathy Denton, Jessica Campbell
Journal: Journal of Clinical Oncology (2012)

131 Background: Colorectal cancer is a common and lethal disease. The University of Texas MD Anderson Cancer Center has seen an increase in patients who want colorectal cancer treatment. This increase has had a negative result on the referral to appointment cycle time for new patients. Responding to this, Colorectal split from GI in 2010 and separate processes were developed. A performance improvement team was identified in September 2011 with the goal to decrease the referral to appointment cycle time for colorectal patients. Methods: The PI team Aim Statement was to facilitate patient access to the Colorectal Center by decreasing the days of referral to appointment by 10% within the first year. A retrospective study was conducted of the access data for the previous two years. A comprehensive 3-week audit of access center staff and processes was completed. A key component of project success was process standardization and staff education for the new patient communication. A physician designed and presented colorectal practice guidelines and education to the access staff to helped staff identify the correct first appointment type. Scripting was developed to establish clear patient expectations of their responsibilities obtaining medical records; the structure of the first visit; and to provide consistent answers to FAQ to improve access and the patient experience. Access teams were formed and new processes created for receiving and responding to first patient communication. Scheduling templates were revised to accommodate the increased patient volume. Staff work schedules were adjusted to accommodate the workload. There were also many “quick fixes” identified such as implementing separate fax/phone numbers for Colorectal and GI. Results: Within two years, new patient access time decreased from 19.48 days in fiscal year 2011 to 15.76 days in fiscal year 2012 through May 2012, a 19% decrease. The highest access month in fiscal year 2011 was 29 days and the lowest access month in fiscal year 2012 was 12.71 days, while realizing a 15% increase in referrals. Conclusions: The team realized success with the decrease in access time which provided a better quality patient experience. The next step is to further reduce access time by focusing on a different access process for local patients.