tbuckley/cabot-search huggingface dataset:
Comparison of survival outcomes of rectal squamous cell carcinoma with rectal adenocarcinoma.
Authors: Chi Lin, Abhijeet Bhirud, Jinluan Li, Mary E. Charlton
Journal: Journal of Clinical Oncology (2015)

745 Background: Rectal squamous cell carcinoma (RSCC) is a rare disease. It is unclear whether the prognosis or treatment outcomes differ from that of rectal adenocarcinoma (RAC). The objective of this study is to compare the overall survival (OS), cancer specific survival (CSS) and prognostic factors of RSCC to those of rectal adenocarcinoma (RAC) using the Surveillance, Epidemiology, and End Results (SEER) registry. Methods: A total of 42,317 patients diagnosed with RSCC (999) and RAC (41,318) without distant metastasis between 1998 and 2011 were identified from the SEER database. Factors analyzed included histology (RSCC/RAC), age (≤56/&gt;56), gender, race (white/nonwhite), tumor size (&lt;5 cm/≥5 cm), grade (well-moderate/poor-undifferentiated), stage (local/regional), year of diagnosis (1998-2003/2004-2011), with or without surgery, and with or without radiotherapy (RT). OS and CSS were evaluated using the Kaplan-Meier method. Cox proportional hazards regression analysis was performed to examine the prognostic factors for survival. Results: The median follow up is 77 months (M). The entire group had 5 year OS and CSS of 62% and 77% with a median OS of 95 M but did not reach a median CSS. Compared to patients with RAC, patients with RSCC tend to be younger, female, diagnosed more recently, with less advanced stage but higher grade and larger tumor size. For patients with RSCC, 40% underwent surgery and 75% received RT. In contrast, for patients with RAC, 89% underwent surgery and 59% received RT. Patients with RSCC had a higher median OS than those with RAC (105 vs 94 M, Log-rank p &lt;0.05). Cox proportional hazards analysis showed that patients with RAC had worse OS (hazard ratio [HR] 1.4) and CSS (HR 1.6) than patients with RSCC (p&lt;0.05), after adjusting for all prognostic factors. Factors associated with improved OS and CSS in both RSCC and RAC included age ≤56, nonwhite, early stage, well-moderate differentiated, undergoing surgery and receiving RT. Gender is a prognostic factor for OS but not for CSS. Conclusions: Patients with rectal squamous cell carcinoma had a significantly superior OS and CSS than patient with rectal adenocarcinoma. Future studies should seek to explore the optimal management for these two distinct diseases.
Geriatric assessments in senior adults receiving chemotherapy.
Authors: T. M. Wildes, C. Fournier, B. Zubal, J. F. Piccirillo, B. R. Tan
Journal: Journal of Clinical Oncology (2010)

e19567 Background: Older cancer patients (pts) may benefit from and tolerate chemotherapy, but better predictors of toxicity are needed to improve care. Comprehensive geriatric assessment (CGA) may predict toxicity in senior adult cancer pts. Methods: In a prospective study, pts aged ≥ 65 who were to begin a course of chemotherapy underwent CGA with measures of functional status, cognition, depression, comorbidity, nutrition, polypharmacy, falls, and social support. Results: 30 pts have had baseline assessments. Median age was 68.5 (range 65-89); 50% male, 50% female; 96.7% white, 3.3% black. Diagnoses include: 53.3% lymphoma, 40% colorectal, 6.7% breast. 23 pts (76.7%) had a caregiver, including a spouse (78.2%), adult child (17.4%) or friend (4.3%). Only 1 pt (3.3%) resided in a nursing facility; 96.7% resided in the community. 2 pts (6.7%) reported falls within the past month. 9 (30%) screened positive for depression (Geriatric Depression Screen). 1 pt (3.3%) screened positive for cognitive impairment (Short Blessed test). Two pts (6.7%) had dependencies in Activities of Daily Living (Katz ADLs ≤16), while 11 (36.7%) had moderate to severe dependencies in Instrumental Activities of Daily Living (Lawton IADL ≤24). ECOG performance status was 0 in 17 pts (56.7%), 1 in 9(30%), 2 in 3(10%) and 3 in 1(3.3%). Comorbidities (scored using the ACE-27 Index) were None in 5 (16.7%), Mild in 17(56.7%), Moderate in 3(10%) and Severe in 5(16.7%). Four pts (13.3%) were deemed at risk for malnutrition using the Mini Nutritional Assessment. Median number of medications was 5.5 (range 0-20), with 82% reporting polypharmacy, and 39% using potentially inappropriate medications in the elderly (Beers criteria). Of the 20 pts evaluable for completion of chemotherapy, 16 (80%) had completed the planned course of chemotherapy. Reason for failure to complete therapy was progression (1), patient preference (1), and toxicity (2: hematologic and myocardial infarction). Conclusions: In a cohort of older adults selected to receive chemotherapy, the most common geriatric syndromes were polypharmacy, depression and dependencies in IADLs. Enrollment is ongoing; future analyses will focus on the value of CGA in predicting whether pts can complete a planned course of chemotherapy. No significant financial relationships to disclose.
Overuse of five expensive oncology pharmaceuticals in the southeastern United States: A physician-level analysis.
Authors: Charles L. Bennett, Dinah Faith Q. Huff, William S. Shimp, Anmol Baranwal, Avinash Mamgain, Marc L. Fishman, Sharon Davis, Jurgen Kogler, Anna E. Schorer, Laura Rose Bobolts, Melissa Armitage, William J. Hrushesky
Journal: Journal of Clinical Oncology (2014)

33 Background: The Wall Street Journal recently identified that the highest rates of use of erythropoietin to Medicare-covered persons with cancer in the United States was by 11 oncologists who practiced in Florida (WSJ, June 20, 2014). We asked a related, but similar question: Could chemotherapy claims databases be used to identify individual physicians in the southeastern United States who had high rates of prescribing five expensive oncology agents: levoleucovorin (Fusilev), palonosetron plus fosapretitant (Aloxi+Emend), peg-filgastrim (Neulasta), albumin-paclitaxel (Abraxane), and epoetin/darbepoetin? Methods: Chemotherapy requests for more than 2,000 oncologists who practiced in the southeastern United States for the years 2012- 2014 were reviewed. A “high user” oncology provider for a specific drug was operationally defined as an individual whose number of prescriptions for the specific drug was more than 2 standard deviations above that for other oncology providers whose chemotherapy requests were also contained in the same database. Results: Two out of 1,479 oncology providers were identified as “extremely high users” of expensive oncology drugs (operationally defined as a high user for 5 of the 5 study drugs), two were “very high users” of expensive oncology drugs (a high user for 4 of the 5 study drugs), and 25 were “high users” (a high user for three of the five study drugs). The overwhelming majority of oncology providers (1,450) were neither extremely high, very high, nor even high users of the five study drugs. Conclusions: In the Southeastern United States, a small number of oncology physicians are extremely high, very high, and high users of expensive oncology drugs. Additional studies are needed to evaluate case-mix and other patient-related factors that might explain this finding. Focused quality improvement initiatives might also be considered. [Table: see text]
The synergistic effect between celecoxib and luteolin and dependence on estrogen receptor in human breast cancer cells.
Authors: Ye-Won Jeon, Youngjin Suh
Journal: Journal of Clinical Oncology (2015)

135 Background: The anti-cancer effects of celecoxib and luteolin are well known. Although our previous study demonstrated that the combination of celecoxib and luteolin synergistically inhibits breast tumor growth compared with each of the treatments alone, we did not uncover the molecular mechanisms of these effects. The aims of our present study were to compare the effects of a celecoxib and luteolin combination treatment in four different human breast cell lines and to determine the mechanisms of action in vitro and in vivo. Methods: Using MCF-7, MCF7/HER18, MDA-MB-231 and SkBr3 human breast cancer cells, proliferation assay, apoptosis assay, inhibition assay with MEK and PI3K inhibitor in addition to western blotting and xenograft study after treatment with celecoxib and luteolin. Results: The synergistic effects of a celecoxib and luteolin combination treatment yielded significantly greater cell growth inhibition in all four breast cancer cell lines compared with the single agents alone. In particular, combined celecoxib and luteolin treatment significantly decreased the growth of MDA-MB-231 cancer cells in vivo compared with either agent alone. The celecoxib and luteolin combination treatment induced synergistic effects via Akt inactivation and extracellular signal-regulated kinase (ERK) signaling inhibition in MCF-7 and MCF7/HER18 cells and via Akt inactivation and ERK signaling activation in MDA-MB-231 and SkBr3 cells. Conclusions: These results demonstrate the synergistic anti-tumor effect of the celecoxib and luteolin combination treatment in different four breast cancer cell lines, thus introducing the possibility of this combination as a new treatment modality.
Autologous versus reduced-intensity allogeneic hematopoietic cell transplantation for patients with follicular non-hodgkins lymphoma (FL) beyond first complete response or first partial response
Authors: G. Laport, C. Bredeson, M. R. Tomblyn, B. S. Kahl, S. A. Goodman, M. Ewell, J. Klein, M. M. Horowitz, J. M. Vose, R. S. Negrin
Journal: Journal of Clinical Oncology (2008)

7041 Background: Although patients with FL typically experience an indolent course, FL is rarely curable with conventional chemotherapy. Autologous HCT (autoHCT) can extend progression-free survival (PFS) and overall survival (OS) but relapse is the primary cause of failure. Reduced intensity allogeneic HCT (alloHCT) confers lower relapse rates due to the graft vs lymphoma effect. Methods: The BMT CTN conducted a multicenter trial comparing these 2 strategies in FL patients with relapsed, chemosensitive disease. Pts were assigned to treatment arm based on the availability of a matched sibling donor (MSD). Pts with a MSD underwent alloHCT with the FCR preparative regimen (fludarabine, cyclophosphamide (Cy), rituximab (RTX)) and received tacrolimus and methotrexate for graft vs host disease (GVHD) prophylaxis. Pts without a MSD underwent mobilization with Cy, rituximab and filgrastim and received a conditioning regimen of either CBV(Cy,carmustine,VP16) or total body irradiation with Cy and VP16. AutoHCT pts received 4 doses of weekly maintenance RTX (375 mg/m2) starting at day+42 post autoHCT. Results: Eleven pts were in complete remission (CR) and 19 pts were in partial remission after salvage therapy and prior to HCT. The median follow-up is 16 months (range, 1–28 months). The incidence of grade 2–4 acute GVHD was 0% and 2 pts developed extensive chronic GVHD. By univariate analysis, age (<50 y vs >50 y) and remission status (CR vs not CR) did not significantly affect OS and PFS. The alloHCT pts had a superior 2 yr PFS (p=.04) compared to the autoHCT pts. Three autoHCT pts expired from infection-related causes. This trial closed early due to slow accrual. Conclusion: We show that the FCR regimen is well tolerated and that alloHCT may result in lower relapse rates compared to autoHCT. Due to the indolent course of FL, longer follow-up is needed to confirm if reduced intensity alloHCT will lead to improved survival compared to autoHCT. Patient Outcomes at 2 Years n Median Age Time from Dx to HCT OS PFS Relapse NRM AutoHCT 22 50 y (36–66) 29mos (16–66) 80% 69% 16% 15% Allo HCT 8 48 y (40–64) 40mos (10-111) 100% 100% 0% 0% NRM: nonrelapse mortality; mos: months; Dx: diagnosis; y: years No significant financial relationships to disclose.
A phase II trial of zoledronic acid in combination with cisplatin and docetaxel in non-small cell lung cancer patients with bone metastases.
Authors: K. Yoh, K. Kubota, H. Ohmatsu, K. Goto, S. Niho, Y. Naito, Y. Ohe, N. Saijo, Y. Nishiwaki
Journal: Journal of Clinical Oncology (2010)

e18104 Background: Recent studies suggest that zoledronic acid (ZOL) may act by directly affecting tumor progression, possibly in synergy with chemotherapy. However, combination of ZOL and cisplatin may have the potential for deterioration in renal function. This study was conducted to evaluate the safety and efficacy of combined ZOL, cisplatin and docetaxel in patients with non- small cell lung cancer (NSCLC) with bone metastases. Methods: Cisplatin 80 mg/m2 and docetaxel 60 mg/m2 (CD) with ZOL 4mg were given intravenously on day 1 every 3-4 weeks for up to 4cycles. Main eligibility criteria included advanced NSCLC with bone metastases, no prior chemotherapy, and performance status of 0 or 1. The primary endpoint was feasibility defined by the number of patients receiving two cycles or more of CD with ZOL without severe toxicity. Data was also assessed prospectively on development of skeletal-related events (SRE), pain score, and urinary N-telopeptide (NTX) and bone-specific alkaline phosphatase as bone marker. Results: Between July 2007 and November 2009, 35 patients were enrolled in the study. The primary endpoint was met: Two or more cycles of CD with ZOL were administered in 29 (83%) patients. Within the first cycle, only 2 patients had an increase in serum creatinine levels of > 0.5 mg/dL from a baseline level. No grade 3 or 4 renal toxicity including serum creatinine increase was observed. To date, 7 PR, 16 SD, and 7 PD were observed among the 30 patients assessed for efficacy. After 6 weeks, the majority of patients experienced improvement in pain score and decrease of NTX level from baseline. Conclusions: Combination of CD with ZOL is well tolerated with acceptable renal toxicity as treatment of advanced NSCLC patients with bone metastases. No significant financial relationships to disclose.
The antiproliferative effect of pasireotide LAR alone and in combination with everolimus (RAD001) in patients with progressive medullary thyroid cancer (MTC): A single-center, open-label, phase II, proof-of-concept study.
Authors: A. Faggiano, A. Colao
Journal: Journal of Clinical Oncology (2010)

TPS219 Background: MTC is a well-differentiated neuroendocrine tumor (NET) of the thyroid parafollicular cells and expression of somatostatin receptor subtypes sst1, sst2 and/or sst5 have been shown in the majority (∼80%) of patients with MTC. Pasireotide (SOM230) is a novel, multi-receptor targeted somatostatin analogue with high-binding affinity for sst1,2,3 and sst5, and has antisecretory and potential antitumor properties. Everolimus, an inhibitor of mTOR (a central regulator of growth/proliferation, cellular metabolism and angiogenesis) has shown antitumor benefit in patients with NETs alone and in combination with octreotide LAR. Methods: Patients with progressive metastatic or persistent postoperative MTC and evidence of biochemical progression (escalating serum calcitonin levels) will receive pasireotide LAR 60 mg/month for 6 months with efficacy evaluated every 3 months. Patients exhibiting progressive disease at 3 months will then be administered oral everolimus 10 mg/day as combination therapy. The primary endpoint is the effect of pasireotide LAR on progression-free survival (PFS), according to RECIST. Secondary endpoints include PFS with pasireotide LAR + everolimus, safety, and change in serum calcitonin and carcinoembryonic antigen levels. Patients achieving benefit (stable disease or better) with monotherapy or combination therapy at 6 months may enroll in an optional extension phase. Results: 20 patients are expected to be enrolled. In December 2009 the study protocol received institutional review board approval and in March 2010 the trial commenced enrollment. Recruitment is expected to be completed in September 2010, with the last patient visit estimated in March 2011. Study results are anticipated in 2011. Conclusions: There is a high unmet medical need for patients with persistent postoperative MTC. This study will investigate the antiproliferative potential of pasireotide LAR alone and in combination with everolimus in patients with progressive, metastatic or persistent postoperative MTC. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Ipsen, Novartis
Evaluating the prognostic effect of a pain classification system in patients with advanced cancer.
Authors: Joseph Anthony Arthur, Kimberson Cochien Tanco, Ali Haider, Courtney Maligi, Minjeong Park, Diane D Liu, Eduardo Bruera
Journal: Journal of Clinical Oncology (2016)

95 Background: The Edmonton Classification System for Cancer Pain (ECS-CP) has been shown to predict pain management complexity based on five features: pain mechanism, incident pain, psychological distress, addictive behavior, and cognitive function. The main objective of our study was to explore the association between increasing sum of negative ECS-CP features and achievement of good pain control at first follow up visit at an outpatient palliative care clinic. Methods: Initial and follow up clinical information of 409 eligible supportive care outpatients such as patient demographics, ECS–CP assessment, morphine equivalent daily dose (MEDD), opioid rotation, Edmonton Symptom Assessment Score (ESAS), and personalized pain goal (PPG) were retrospectively reviewed and analyzed. Results: Between the initial consultation and the first follow up visit, the median MEDD requirement increased from 30mg/day to 45mg/day (p &lt; 0.0001) and median pain intensity improved from 6 to 4 (p &lt; 0.0001). Increasing sum of negative ECS–CP features was associated with higher MEDD at consultation, with an increase from 30mg/day with no negative features to 40mg/day with ≥2 negative features (p = 0.046). There was no significant association between increasing sum of negative ECS-CP features and achievement of pain control at follow up visit (0.991, 95% CI: 0.747 – 1.304, p = 0.948). Conclusions: Increasing sum of negative ECS-CP features was associated with higher MEDD at referral but was not predictive of pain control at the follow up visit when pain was managed by a palliative medicine specialist. Further research is needed to further explore these observations.
Developing a cultural and socioecological patient-centered survivorship care plan template for African American survivors.
Authors: Kimlin T. Ashing-Giwa, Carlyn Tapp, Shirley Brown, June Smith, Eudora Mitchell, Rhonda Santifer, Kommah McDowell, Virginia Martin, Betty Betts-Turner, DeBorrah Carter, Paris Adkins Jackson, Monica Rosales, Gingi Fulcher
Journal: Journal of Clinical Oncology (2012)

40 Background: Cancer and its treatments bring added health and life challenges. Cancer survivors require ongoing surveillance and medical care. To facilitate best practice in follow-up care, the Institute of Medicine, the American Society of Clinical Oncology and advocacy organizations advise that cancer survivors be provided with treatment summaries and Survivorship Care Plan (SCP). African-American breast cancer survivors (AABCS) have poorer outcomes characterized by greater morbidity and mortality, hence warranting their careful surveillance and follow-up medical care. SCP investigations are urgently needed to improve follow-up care and cancer outcomes in AABCS. Methods: The study embraced a community-based participatory research framework, building upon a series of research projects conducted by the African American Cancer Coalition, a partnership of scientific researchers and community-based advocates. Three informative focus groups were conducted with AABCS (N=25) and advocates (N=3) to obtain input on cultural and socio-ecological SCP contents to increase patient responsiveness. Results: AABCS believed that increased mortality may be due to comorbidities and inadequate surveillance and follow-up care. Participants recommended that the SCP attend to and document all comorbidities and medications; allow for participation of primary care providers; referrals for providers especially surgeons who are familiar with treating AABCS to the reduce keloid, and health advisories on nutrition, exercise and stress management. Quality-of-life related components and community referrals should be included because they are important for overall health. AABCS noted the importance of spirituality in life, and the disproportionately high levels of socioecological stress in the community. Conclusions: Participants infused cultural and socioecologic relevance towards the development of a patient centered SCP template to increase acceptability and utilization among AABCS. Participants underscored that developing the SCP responsive to AABCS and facilitating adherence to SCP recommendations, are areas warranting increased intervention and research.
Integrating the primary care physician into cancer follow-up.
Authors: Andrew L. Salner, Deborah Walker, Amanda Seltzer, SarahLena Panzer, Carrie Stricker, Ellen A Dornelas
Journal: Journal of Clinical Oncology (2016)

102 Background: After a diagnosis of breast cancer, it can be difficult for patients to understand the role their primary care physician (PCP) should play in their follow up care. Methods: 65 women (mean age 60 years, SD = 10) with breast cancer (stage 0-III) were seen by a nurse practitioner for a 60-90 minute consultative survivorship visit and received a treatment summary and personalized survivorship care plan (SCP) utilizing Carevive Care Planning Systems software. The Carevive system incorporates patient-reported and clinical data to create tailored care plans with personalized recommendations for follow up care and supportive referrals, including direction to follow up with primary care for specific care and health maintenance activities. Approximately 6 weeks following their survivorship care visit, patients completed a survey assessing their use of and satisfaction with the SCP. Patients were advised that the SCP would be mailed to their referring oncologist and primary care physician. Results: Out of 65 sent, 35 surveys have been completed to date. Survivors were diagnosed approximately 10 months prior, and all were within 6 months following completion of treatment. All patients (100%) reported that they read, or planned to read, their survivorship care plan packet carefully. While all care plans included a recommendation to follow up with their PCP, only (71%) of survivors remembered receiving this recommendation. Of those who did, most (74%) had either seen or scheduled an appointment with their PCP. Patients who reported higher anxiety at the time of the survivorship visit were more likely to report that the follow up care plan helped them take action about seeing their PCP (p = .03). Conclusions: Coordination between primary and oncology care providers has previously been shown to improve the quality of care for cancer survivors. SCPs that emphasize the importance of and activities to be undertaken in primary care may help to improve this coordination. Continuation of this research will help to better understand how to integrate the primary care physician into cancer follow up care. Updated data will be shared at time of presentation.
High-Resolution CGH Analysis of CD34+ Cells from Lower-Risk Myelodysplastic Patients Reveals Cryptic Copy Number Alterations and Predicts Overall and Leukemia-Free Survival.
Authors: Daniel T. Starczynowski, Suzanne Vercauteren, Adele Telenius, Sandy Sung, Kaoru Tohyama, Angela Brooks-Wilson, John J. Spinelli, Connie J. Eaves, Allen C. Eaves, Douglas E. Horsman, Wan L. Lam, Aly Karsan
Journal: Blood (2007)
Outcomes of Relapsed/Refractory B-Cell Lymphoma Is Improved by Salvage Chemotherapy Consisting of Two to Three Cycles of Dexamethasone (D), High Dose Ara-C (HA) and Carboplatin (DHAC) with or without Rituximab (R) Followed by Autologous Stem Cell Transplantation.
Authors: Swaminathan Padmanabhan, Anjana Elefante, Prakash Varadarajan, Minoo Battiwalla, Arvinder Bir, Theresa Hahn, Shannon Smiley, Francisco J. Hernandez-Illizalitturi, Loretta Miner, Alice Mohr, Zale P. Bernstein, Asher Chanan-Khan, Philip McCarthy, Myron Czuczman
Journal: Blood (2007)