tbuckley/cabot-search huggingface dataset:
Safety and efficacy of first-line bevacizumab (B) plus chemotherapy (CT) for locally recurrent or metastatic breast cancer (LR/mBC): Analysis of MO19391 according to CT
Authors: J. Pierga, K. I. Pritchard, C. Thomssen, H. Cortes-Funes, L. Biganzoli, P. Padrik, Z. Zvirbule, I. Smith
Journal: Journal of Clinical Oncology (2009)

1033 Background: Combination of B with first-line paclitaxel (T P ) or docetaxel (T D ) significantly improves PFS vs taxane alone in pts with LR/mBC. The open-label, multicenter MO19391 trial further assessed safety and efficacy of first-line B plus a taxane in &gt;2,000 pts in routine clinical practice. Methods: Eligible pts had HER2- negative LR/mBC (or HER2-positive LR/mBC progressing after trastuzumab-containing therapy), ECOG PS 0–2, no prior CT for LR/mBC and no evidence of CNS metastases. Pts received B 10mg/kg q2w or 15mg/kg q3w plus the physician's choice of taxane (T P or T D alone or with another CT) or other non-anthracycline CT according to physician's standard of care. Treatment was continued until disease progression, unacceptable toxicity, or refusal. The primary endpoint was safety (NCI CTCAE v3.0); secondary endpoints included TTP, OS, and safety in pts developing CNS metastases. Results: From Sept 2006 to June 2008, 2,027 pts from 37 countries were enrolled. Median follow-up is 7.4 months. CT included a taxane (alone or with CT) in ∼75% of pts. Non-taxane agents included capecitabine (X) and vinorelbine (V). In the overall population, median age was 54 years (range 21–93), 70% were ER and/or PgR positive, and 32% had disease-free interval (DFI) ≤24 months. Baseline characteristics were broadly similar across subgroups. However, the X monotherapy subgroup included fewer pts with &gt;3 metastatic lesions and more with a DFI ≤24 months and/or triple-negative disease compared with other subgroups. Safety and efficacy results grouped by CT are shown below. OS data are still immature (85% of pts alive at this analysis). Conclusions: In this large phase IV study, safety and efficacy of B plus T P or T D was similar to results of E2100 and AVADO. Variations in toxicities were consistent with the known profiles of each CT and no new safety signals for B were observed. The lowest incidences of serious Aes were seen with B plus T P or X. TTP was shorter with X and non-taxane combinations. Such findings are potentially attributable to small pt numbers and differences in baseline characteristics. These results show that B can be safely and effectively combined with a wide range of commonly used CT regimens as first-line therapy for mBC. [Table: see text] [Table: see text]
A comparative study of field-in-field technique and wedge based treatment planning for upper abdominal malignancies in radiotherapy
Authors: R. V. Prabhakar, K. P. Haresh, G. K. Rath, M. A. Laviraj, P. K. Julka
Journal: Journal of Clinical Oncology (2008)

15645 Background: In upper abdominal malignancies, due to the presence of multiple inhomogeneous tissues, a wedge based conformal treatment planning results in high dose regions inside the target volume. This study has been framed to compare the field-in-field (FIF) technique with wedge based treatment planning in such sites. Materials and Methods: Ten patients of upper abdominal malignancies like stomach, gall bladder, gastro-esophageal junction, and pancreas were selected for this study. Computed tomography scans was performed for all the patients and the datasets were transferred to a 3D treatment planning system. Three dimensional conformal wedge plans were generated for a dual energy linear accelerator equipped with 40 pairs of multileaf collimator. The same plan was copied with wedges removed and a field-in-field based plan was generated and compared with the wedge based planning. The two plans were then evaluated and compared for mean dose, maximum dose, median dose, dose received by 2% of the target volume (D2), dose received by 98% of the target volume (D98), volume receiving greater than 107% of the prescribed dose (V>107%), volume receiving less than 95% of the prescribed dose (V<95%), conformality index (CI) and total monitor units. Results: FIF technique gives better dosimetric results as compared to wedges in terms of maximum dose, D2, V>107% and CI for most of the sites with statistically significant reduction in monitor units. Conclusion: FIF technique can be employed in radiotherapy for upper abdominal malignancies in place of wedges. No significant financial relationships to disclose.
Intestinal Trefoil Factor (TFF3) expression and correlation with other signalling proteins in cholangiocarcinoma
Authors: S. Ailawadhi, T. Khoury, J. Yu, C. Levea, M. Javle, B. W. Kuvshinoff, H. Okada, J. Black, M. Brattain
Journal: Journal of Clinical Oncology (2005)

4137 Background: The mucin-associated trefoil factor (TFF) peptides are integral to cytoprotection and mucosal repair in the gastrointestinal tract. Existing literature supports the role of TFF in both, tumor suppression and tumor progression. TFF-3 is associated with an invasive phenotype and is over expressed in hepatolithiasis, gastric and hepatocellular carcinomas. TFF-mediated tumor progression involves resistance to apoptosis, angiogenesis, motogenic function and transactivation of EGFR, AKT, COX-2, and MAPK-signaling pathways. Methods: Twenty-four consecutive cases of cholangiocarcinoma treated from 1996–2002 were studied. Immunohistochemistry was performed using a monoclonal antibody to TFF-3. Sections were stained for biomarkers to assess co- expression of other signaling proteins including EGFR (Zymed), pEGFR (Santa Cruz), MAPK (Cell Signaling), pMAPK (Santa Cruz), AKT (Santa Cruz), pAKT (Cell Signaling) and COX-2 (DAKO). Clinical data were obtained per IRB approved protocol. Results: Median age was 67 years (range 35–77). There were 15 females and 9 males with a SEER (Surveillance, Epidemiology and End Results) staging of local in 1, regional in 15 and distant in 8. Treatments included chemotherapy (n=3), surgery (n=8), combined (n=11, 1 radiation + surgery, 5 chemotherapy + surgery and 5 all three) or no therapy (n=2). TFF-3 expression was positive in 19 samples. There were no significant associations between TFF-3 expression and sex, stage, grade, survival or SEER score. MAPK in tumor had a borderline positive association with pAKT (tau = 0.328, p = 0.0535) and a borderline negative correlation with TFF-3 [p=0.0588 (exact test), 0.059 (Pearson)]. Conclusions: TFF-3, COX-2, AKT and MAPK are commonly expressed in biliary cancers. Evaluation of co- expression and linkages between these signaling proteins may provide insight into pathogenesis of these cancers and suggest future targets for intervention. No significant financial relationships to disclose.
A phase II study of concurrent chemoradiotherapy with weekly docetaxel, carboplatin, and radiation therapy followed by consolidation chemotherapy with docetaxel and carboplatin for locally advanced inoperable non-small cell lung cancer
Authors: R. S. Hughes, A. B. Sandler, A. K. Jain, A. Dowlati, L. S. Schwartzberg, T. Dobbs, L. Schlabach, J. Wu, N. J. Muldowney, H. Choy
Journal: Journal of Clinical Oncology (2008)

7565 The current standard of care for good performance status patients with locally advanced non-small cell lung carcinoma is concurrent chemoradiation, although a clearly superior regimen has not been identified. Docetaxel has been shown to possess good single agent activity against NSCLC as well as radiosensiziting properties, both alone and synergisitically with carboplatin. We undertook this phase II study to determine the safety and efficacy of weekly docetaxel-carboplatin and concurrent radiation therapy followed by docetaxel-carboplatin consolidation for the treatment of locally advanced NSCLC. Sixty-seven patients with previously untreated Stage IIIA or IIIB unresectable NSCLC were enrolled. Docetaxel 20 mg/m2 IV infusion over 30min followed by carboplatin AUC=2 over 30 min was administered weekly during concurrent thoracic radiotherapy. After three week rest period, consolidation docetaxel 75 mg/m2 IV infusion over 60 min and carboplatin AUC=6 over 30 min was administered every three weeks for two cycles. Concurrent thoracic radiation consisted of 45 Gy (1.8 Gy fractions 5 days/wk for first five weeks) followed by 18 Gy boost (2.0 Gy fractions 5 days/wk for two weeks) for a total dose of 63 Gy. Sixty-seven patients were evaluable for survival and toxicity. One and two year overall survival rates were 45% and 20%. Esophagitis was the principal toxicity. Grade 3 or 4 esophagitis occurred in 14 patients (21%) by RTOG toxicity criteria. There were 14 grade III pulmonary toxicities (21%). Weekly docetaxel/carboplatin plus concurrent RT is a relatively well tolerated out-patient regimen. The response and one year survival rate from this regimen is not encouraging. These findings do not warrant further clinical evaluation of weekly docetaxel/carboplatin/RT in phase III trials. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration sanofi-aventis sanofi-aventis sanofi-aventis
Persistence of BCR-ABL-Expressing LEUKEMIC STEM CELLS IN Chronic MYELOID LEUKEMIA (CML) PATIENTS IN COMPLETE REMISSION with Undetectable MOLECULAR Disease
Authors: Jean-Claude Chomel, Marie Laure Bonnet, Nathalie Sorel, Angelina Bertrand, Marie Claude Meunier, Michael Melkus, Annelise Bennaceur-Griscelli, Francois Guilhot, Ali G. Turhan
Journal: Blood (2010)
Characterizing cancer research in Brazil through bibliometric analysis of abstracts from the ASCO meetings 2001–2005
Authors: C. A. Pinheiro, A. S. Masson, G. Borghesi, F. Prisco, W. Rotea, P. M. Hoff, E. D. Saad
Journal: Journal of Clinical Oncology (2008)

17561 Background: The science and practice of cancer medicine in Brazil currently display features of both developing and developed countries. Cancer research is increasing in Brazil, and several recent large, international, industry-sponsored trials have included a substantial number of Brazilian patients. However, it is unclear to what extent there is proportional increase in research originated in Brazil. We approached this question using a bibliometric analysis of Brazilian abstracts from recent ASCO Annual Meetings. Methods: We conducted a manual search of the 16,925 abstracts published in the Program Proceedings and late-breaking abstracts booklets for 2001 through 2005. We defined as Brazilian an abstract for which at least two-thirds of institutions were from Brazil. We tabulated study characteristics and searched PubMed and Lilacs databases for their full publications, using first and last authors’ names. Results: We located 154 Brazilian studies (0.90% of total; 95% CI 0.77% - 1.07%), of which 76.0% were categorized as clinical investigation, 14.9% as basic research, and 9.1% as epidemiologic research. In clinical investigation, the most frequent study types were retrospective (N=43) and phase II trials (N=37). The most frequent topic categories were tumor biology (N=27), patient care (N=22), breast (N=19), lung and gastrointestinal cancer (N=13 each). There was a significant increase in the proportion of Brazilian abstracts from 2001 to 2005 (P=0.011 for trend). Only 31.8% of the studies were presented at the meeting, usually as posters, with the other 68.2% appearing as “publication only”. There was no significant trend in the proportion of “publication only” abstracts (P=0.407). After a median follow up of 35 months, only 16.9% of studies were published (median time to publication, 13.5 months). Univariate Kaplan-Meier analyses showed no significant predictors of publication, although “publication only” abstracts were less likely to be published in full (P=0.059). Conclusions: Our study provides empiric evidence for an increase in research that is originated in Brazil. However, it also suggests that the quality of such research needs to improved, and that efforts are also needed in order to increase the rate of full publication. No significant financial relationships to disclose.
A comparison of competing lymph node staging schemes in resectable biliary cancer.
Authors: D. D. Smith, R. A. Nelson, R. Schwarz
Journal: Journal of Clinical Oncology (2011)

166 Background: New schemes for lymph node (LN) staging have been proposed to improve upon the AJCC TNM cancer staging convention. We compared AJCC N0/N1 staging with the LN ratio and logarithmic odds systems in predicting overall survival (OS) in resectable biliary cancer patients, including cancer of the gallbladder, extrahepatic bile duct (EHBD), and ampulla of Vater (AOV). Methods: In a large, multiinstitutional U.S.-based biliary cancer data set, we identified 4,288 nonmetastatic resectable biliary cancer patients diagnosed between 1988 and 2006. We compared each subject's AJCC N stage with the two novel staging schemes. We split patients into two groups above or below the median for the two novel staging schemes and analyzed OS. Our comparison metric was the log-rank chi-squared statistic. As a baseline comparator, we included the median number of LNs resected. Results: Median (range) of follow- up was 2.5 years (1 month–19 years), with an overall median survival of 2.0 years (95% CI: 2.0–2.1 years). For all biliary patients combined, we found that the AJCC N0/N1 system and LN ratio schemes performed similarly. For gallbladder cancers (N= 1,340), LN ratio showed higher OS prediction utility, whereas in EHBD (N= 1,083) and AOV cancers (N= 1,865), AJCC staging was superior among competing methods. Conclusions: The LN ratio method is comparable with AJCC N staging for OS prediction, although the AJCC scheme is superior in two of three biliary cancers. We conclude that AJCC staging remains adequate for staging biliary cancers given the newer staging proposals. [Table: see text] No significant financial relationships to disclose.
Autologous Stem-Cell Transplant with a Rituximab Purge and Maintenance vs. Standard Chemotherapy for Mantle Cell Lymphoma: Extended Follow-Up of a Matched Pair Analysis.
Authors: Lisa Hicks, Joseph M. Connors, Joy Mangel, Rena Buckstein, Michael Crump, Heather Leitch, Kevin Imrie, Tracy Nagy, Angela Boudreau, Nancy Pennell, David Spaner, Neil Berinstein
Journal: Blood (2006)
Biopsychosocial distress screening using the National Comprehensive Cancer Network (NCCN) distress thermometer (DT) and patient reported outcome measurement information system (PROMIS) in an academic genitourinary (GU) medical oncology practice.
Authors: Elizabeth A. Guancial, Christopher DaSilva, Andrea Baran, Sandra Sabatka, Judith Baumhauer, Paul Duberstein
Journal: Journal of Clinical Oncology (2016)

350 Background: The NCCN defines “distress” as a “multifactorial…emotional experience…that may interfere with the ability to cope effectively with cancer, its physical symptoms and its treatment.” NCCN DT scores ≥ 4 on a scale of 1-10 are associated with increased biopsychosocial distress among oncology patients. We piloted the use of an electronic tool for distress screening in an academic GU medical oncology practice to determine feasibility and impact on workflow. Methods: At each clinic visit, patients completed a modified NCCN DT with distress score only and pain interference, depression, and anxiety PROMIS domains on an iPad before meeting the clinician. Results were immediately available in the electronic medical record. Results: Between July 1, and August 31, 2015, 108 assessments were completed by 73 patients; 12% were new patients and 88% were follow-ups. Patients ranged from 30 to 93 years of age. Mean DT score was 3.67 [standard deviation (SD) 2.79]. DT scores of ≥ 4 were reported in 41% of assessments. Mean distress scores based on cancer stage were: stages 1-3, 4.04 (SD 2.96; N = 23); and stage 4, 3.56 (SD 2.75; N = 85). Mean distress scores based on cancer diagnosis were: prostate, 3.20 (SD 2.38; N = 46); urothelial, 3.97 (SD 3.35; N = 33); kidney, 3.92 (SD 2.55; N = 24); and testicular, 4.80 (SD 3.42; N = 5). Mean T scores for each of the PROMIS domains were: pain interference, 54.16 (SD 10.28; N = 103); depression, 49.54 (SD 8.95; N = 101), and anxiety, 50.79 (SD 9.37; N = 101). Median time to assessment completion was 3.77 minutes (mean 6.15 minutes). Mean times by age groups were: 50-59, 7.65 minutes (N = 21); 60-69, 5.57 (N = 48); 70-79, 11.61 (N = 16); and ≥ 80, 10.21 (N = 12). Conclusions: Electronic biopsychosocial distress screening at each clinic visit is feasible and has minimal impact on workflow. Pain interference but neither anxiety nor depression scores were increased in this population. Future research is needed on the influence of cancer stage and type on distress and on the associations between NCCN DT and PROMIS scores.
A year in the life of oncology health services research.
Authors: M. Brundage, C. F. Snyder, B. H. Bass
Journal: Journal of Clinical Oncology (2011)

6088 Background: We examined the body of oncology health-services research (HSR) published in 2009 in order to describe current research in three dimensions: a) the HSR domain of interest b) the place on the cancer care continuum that was studied and c) important elements of study design. Methods: We searched Medline using terms relevant to both HSR and cancer. 10,435 publications were identified, of which 8215 were excluded based on a title review. The remaining 2230 abstracts were reviewed (1117 were rejected as either not HSR or as descriptions of research methodology). Data regarding the HSR domain (access, quality, cost, well-being), place on the cancer continuum (from screening through palliation), and study design characteristics were abstracted by one of three reviewers (after 3 training rounds to minimize inter-observer variation). Results: Overall, 1113 research studies met eligibility criteria. The most commonly studied HSR domain was quality of care (n=719; 65%), with fewer studies on access to care (n=334; 30%), cost (n=77; 7%), or wellbeing of subjects (n=182; 16%). Regarding placement on the care continuum, treatment received the greatest attention (n=416; 37%), with fewer studies addressing survivorship (n=241; 22%) or screening (n=210; 19%) and even less focus on diagnosis/assessment (n=122; 11%), palliation (n=102; 9%), or prevention (n=53; 5%). Combining these dimensions of HSR: quality of treatment was most often studied (n=253; 23%); cost was the least studied HSR domain and was rarely assessed in the areas of prevention (n=5; 0.5%), or palliation (n=3; 0.3%). 835 studies were purely descriptive (75%); 278 (25%) evaluated an intervention designed to improve health services. The majority of studies were either retrospective (n=387; 35%) or cross-sectional (n=389; 35%); a minority used a randomized design (n=49; 4%). Study sample size varied widely, ranging from <100 subjects in 213 publications (19%) to >100,000 subject in 210 studies (19%). Conclusions: Based on studies published in 2009, the focus of HSR in oncology was on treatment quality, with less emphasis on access, cost, and other places on the cancer care continuum. Descriptive studies far outweigh controlled studies of interventions designed to improve health services.
Publication of quality improvement in medical oncology: A descriptive numerical summary from a scoping review.
Authors: Laavanya Dharmakulaseelan, Bryan B. Franco, Matthew C. Cheung, Adam E. Haynes, Brian M. Wong, Simron Singh
Journal: Journal of Clinical Oncology (2016)

251 Background: Quality improvement (QI) is becoming a professional expectation and essential to medical oncology practice. A study of medical oncologists found that most QI interventions are not published, suggesting barriers to knowledge dissemination. We aim to describe the authors, settings of QI interventions, and publishing journals of scholarly QI literature. Methods: We conducted a scoping review using Arksey and O'Malley's framework. A search of MEDLINE and EMBASE databases found 48,186 unique English citations from January 2001 to August 2014. Two independent reviewers were responsible for screening the search results and 270 studies were included. Characteristics of first authors, settings of QI interventions, and publishing journals were charted. We used online search engines to find institutional profiles to obtain author and institutional information. A descriptive numerical summary analysis was used to summarize and report the results. Results: The number of QI publications has increased over time, with 60 between 2001 and 2006 and 199 from 2007 to 2013. The majority of first authors are clinicians (65%), of which 59% are physicians, 31% are nurses, and 5% are pharmacists. Furthermore, 27% of first authors are primarily researchers whereas 5% are solely administrators. In addition to professional degrees, having an advanced degree was common amongst clinicians (48% of physicians, 85% of nurses, 44% of pharmacists). Forty-four percent of interventions were conducted in settings affiliated with an academic institution, as opposed to community-based settings. Only 9% of articles were published in a quality of care focused journal. Conclusions: Our scoping review found that most first authors of QI interventions are clinicians, many with an advanced degree in academic settings (rather than community-based settings where most patients receive care). The lack of studies published in quality of care focused journals may result in lost opportunities for knowledge transfer. These findings suggest that more effective knowledge dissemination and increased support for QI studies are needed to further the science of quality and ultimately improve quality of care.
Incidence of breast cancer among women in the United States, by human epidermal growth factor receptor-2 status: An analysis of National Registry data 2010.
Authors: Kathy Lang, Yanni Hao, Huan Huang, Victoria Federico, Joseph Menzin
Journal: Journal of Clinical Oncology (2013)

112 Background: Few studies of breast cancer (BC) incidence by human epidermal growth factor receptor 2 (HER2) status exist as it is not routinely collected in population-based registries. This study used newly collected registry data to evaluate incidence of BC by HER2 status. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program is a system of tumor registries designed to track cancer incidence and survival, covering about 25% of the US population. The SEER*Stat Database used for this analysis provides summary prevalence/incidence rates, frequencies, and case statistics. We evaluated age-adjusted (to the 2000 US population) incidence (number of cases per 100,000 females) of newly diagnosed female BC during 2010, by HER2 status, stratified by age, race, and stage at diagnosis. Cases with unknown values for any stratifier were excluded. Patients were classified as HER2+/HER2- based on a new HER2 status variable collected beginning in 2010. Results: There were 49,347 cases of newly diagnosed female BC in 2010 (7,331 [14.9%] HER2+ and 42,016 [85.1%] HER2-). Annual incidence of HER2+ BC was lower than incidence of HER2- BC (15.5 vs. 87.9 per 100,000 females; p&lt;0.01). Incidence was highest among patients aged 65-74 years (42.4 [HER2+] and 318.1 [HER2-]), followed by 75+ (34.3 and 292.2), 45-64 (33.7 and 170.4) and under 45 (4.8 and 17.5). Incidence rates by race were as follows: Blacks (17.1 [HER2+] and 83.1 [HER2-]), Whites (15.5 and 91.3), Asian or Pacific Islanders (14.9 and 65.5), and American Indian/Alaska Natives (7.3 and 37.1). Incidence rates were highest for less advanced stages of BC: Stage I (6.1 [HER2+], 45.9 [HER2-]), II (5.5, 28.1), III (2.7, 9.9), and IV (1.2, 4.0). Differences in incidence rates across all strata among HER2+ and HER2- patients were statistically significant (p&lt;0.01). Conclusions: This analysis is among the first to utilize the new SEER HER2 status variable. About 15% of newly diagnosed BC cases reported to SEER in 2010 were HER2+. Differences in incidence across age and stage followed a similar pattern for both HER2+ and HER2- BC, while slight differences by race were observed. Further outcomes studies by HER2 status are warranted.