tbuckley/cabot-search huggingface dataset:
The clinical benefit of cisplatin-doxorubicin combination in heavily pretreated ovarian cancer patients
Authors: M. Steiner, O. Lavie, M. Leviov, Z. Shklar, A. Rabkin, S. Keren, R. Rubinov, D. Loven
Journal: Journal of Clinical Oncology (2006)

15052 Background: Cispatin-doxorubicin (Adriamycin) combination (50 mg/m 2 each every 3 weeks) was used to treat ovarian cancer patients after failure of various chemotherapy lines. Methods: Eighteen patients were treated. Their mean age was 59 years (median 57.8, 41.3–70.3). They all had post operative first line carboplatin combination therapy (77% taxol containing) and all achieved NED status at end of therapy. They relapsed within 1–74 months from end of carboplatin therapy (median 9.5, mean 14.1). 3/13 patients (23%) were platinum resistant relapsing within less than six months. Second line therapy included carboplatin retreatment in 8/18 patients (44.5%) - (combined with taxol in 5 and as single agent in 3 patients). All patients received Topotecan therapy, 8 as second line, 6 as third line and 4 as forth line of therapy. Cis platin - Adriamycin combination was used as 3 rd to 6 th line of therapy (median 4 th ). All patients were in good general condition with normal renal function and had clinical evidence of recurrent disease confirmed by clinical examination and/or CT scan and CA125 level. 6/18 patients (33.3%) had severe symptoms of disease, 6/18 (33.3%) mild to moderate symptoms and 6/18 (33.3%) were asymptomatic. Results: 3–11 cycles of therapy were administered (median 7) using 60–100% of planned dose (median 100). Treatment was generally well tolerated with Grade III toxicity in 4/18 patients (22.2%) - (myelotoxicity in 2 and asthenia in 2 patients). 4/18 patients (22.2%) reported quality of life improvement, 4/18 (22.2%) reported quality of life deterioration and 10/18 (65.6%) stable quality of life during therapy. 13/18 patients (72.2%) benefited from therapy. 5/18 (27.7%) achieved complete response, 3/18 (16.8%) partial response and 5/18 (27.7%) minimal response or disease stabilization. All three platinum resistant patients responded: two achieved complete response and one minimal response. Mean time to progression in all responding patients was 9.4 months (median 8.6, 2.6–16.5). Conclusions: We concluded that Cis-Platin - Adriamycin combination is still effective in heavily pretreated ovarian cancer patients and clinical benefit can be achieved with reasonable toxicity. The combination can be considered an additional treatment option. No significant financial relationships to disclose.
Tuberculosis Treatment Outcomes in Europe: Based on Treatment Completion, Not Cure
Authors: Martin J. Dedicoat, Gunar Günther, Valeriu Crudu, Raquel Duarte, Gina Gualano, Cecile Magis-Escurra, Rudolf Rumetshofer, Alena Skrahina, Victor Spinu, Simon Tiberi, Piret Viiklepp, Frank van Leth, Christoph Lange
Journal: American Journal of Respiratory and Critical Care Medicine (2017)
Phase I/II study of oxaliplatin, fludarabine, cytarabine, and rituximab in patients (OFAR2) with Richter's syndrome (RS), and relapsed or refractory B-cell chronic lymphocytic leukemia (CLL)
Authors: A. M. Tsimberidou, W. G. Wierda, W. K. Plunkett, S. O'Brien, S. Lerner, S. C. Smith, H. M. Kantarjian, M. J. Keating
Journal: Journal of Clinical Oncology (2009)

7031 Background: The first Phase I-II clinical trial of oxaliplatin, fluradabine, Ara-C, and rituximab (OFAR1) demonstrated significant activity in refractory CLL and RS (Tsimberidou et al, J Clin Oncol, 2008;26:196). To enhance the response rate with a decrease in myelosuppression, the dose of oxaliplatin was increased to 30 mg daily, the dose of Ara-C was decreased to 0.5g/m 2 daily and the optimal number of days of fluradabine and Ara-C administration was explored (OFAR2). Methods: The OFAR2 regimen consisted of oxaliplatin 30mg/m 2 , D1–4; fludarabine 30mg/m 2 , Ara-C 0.5 g/m 2 ; rituximab 375mg/m 2 , D3; and pelfigrastim 6mg D6. Fludarabine and Ara-C were given on D2–3 (dose level 1) D2–4 (dose level 2) or D2–5 (dose level 3); courses were repeated every 4 wks. Prophylaxis for tumor lysis, DNA viruses, and PCP was given. Results: A total of 55 pts have been treated to date: 12 pts enrolled in phase I (dose level 1, n=3; dose level 2, n=6; and dose level 3, n=3). DLTs were noted in 2/3 pts in dose level 3 (G4 diarrhea, 1; G4 neutropenic sepsis, 1), therefore level 2 was the MTD. Forty-three pts were treated in the Phase II portion of the study (relapsed CLL, 35; RS, 8). The median age was 64 yrs (range, 40- 81); 50 (91%) had β2-microglobulin &gt; 3 mg/L; platelets were &lt; 100 x10 9 /L in 22 pts; and 44 pts had &gt; 1 prior therapies. FISH results were: 17p deletion, n=15; 11q del, n=7; trisomy 12, n=12; 13q del, n=8; normal, n=2; unknown, n=11. Overall, 33 pts had unmutated and 7 mutated IgVH gene; ZAP70 was positive in 30, and negative in 14. Six (46%) of 13 pts with 17p del by FISH responded to OFAR2 (nPR, 2; PR, 4). Eleven pts underwent stem cell transplantation as postremission or salvage therapy. The most common toxicity was myelosuppression. Conclusions: Preliminary results demonstrated that OFAR2 resulted in an overall response rate of 63%, had antileukemic activity in pts with 17p del and clinical outcomes appeared to be superior to those of OFAR1. Accrual is ongoing. [Table: see text] [Table: see text]
Peritoneal recurrence or metastasis in relation to outcome in locally advanced and metastatic gastric cancer.
Authors: Yang Yang, Jia Wei, Nandie Wu, Yaping Zhang, Qing Wang, Juan Du, Zhengyun Zou, Baorui Liu
Journal: Journal of Clinical Oncology (2015)

e15027 Background: The prognosis of locally advanced and metastatic gastric cancer remains dismal. Generally, gastric cancer is considered as systemic disease. The aim of this study is to investigate whether gastric cancer is systemic or regional disease through the exploration of the patterns of recurrence or metastasis of advanced gastric cancer and determination of the factors associated with survival, which may help in identifying effective treatment strategies and establishing future therapeutic prospects considering gastric cancer. Methods: A retrospective analysis of 349 patients with stage III and IV gastric cancer was performed. The relationships between recurrence or metastasis patterns and clinicopathological characteristics and overall survival were evaluated. Results: Peritoneal recurrence or metastasis was detected as any part of the metastasis/recurrence pattern in 219 patients, while distant sites were involved in 208 patients. The locoregional area was involved as any part of recurrence or metastasis in 61 patients. In stage III patients, locoregional recurrence were associated with T4 stage; peritoneal recurrence was associated with distal or whole stomach location, diffuse or mixed subtype, and N3 stage; and distant recurrence was associated with intestinal subtype and negative vascular invasion. On multivariate analysis, stage III patients with locoregional recurrence had longer overall survival time than those with peritoneal or distant recurrence (21 vs. 15 months, HR: 0.628, P = 0.047), while stage IV patients with peritoneal metastasis had shorter survival (7.5 vs. 14 months) and a higher risk of mortality (HR: 2.026, P = 0.004). Conclusions: Peritoneal metastasis appears to be the most common pattern and is associated with poor prognosis in gastric cancer patients. Effective regional treatment is important to guide appropriate further therapy in advanced gastric cancer patients.
Survival in patients with HPV-positive oropharynx squamous cell carcinoma with distant metastases.
Authors: Katharine Andress Rowe Price, Scott H. Okuno, Joaquin J. Garcia, Julian R. Molina, Kerry D. Olsen, Jan C. Kasperbauer, Daniel L. Price, Yolanda I. Garces, Daniel Ma, Michelle A. Neben-Wittich, Shastin E. Shull, Robert Leonard Foote, Eric J. Moore
Journal: Journal of Clinical Oncology (2013)

6095 Background: Prognosis for patients (pts) with locally-advanced, HPV-positive oropharynx squamous cell carcinoma (HPV+OPSCC) is significantly better than for pts with HPV-negative head and neck squamous cell carcinoma (HNSCC). Historic survival of pts with metastatic HNSCC is 6-9 months with palliative therapy. However, the prognosis and survival of pts with HPV+OPSCC with distant metastases is not known. Methods: Pts with HPV+OPSCC with distant metastatic disease were identified from databases from the departments of surgery, radiation, and medical oncology. Demographic and clinical data was abstracted from the medical record. All pts had confirmed HPV/p16+ disease. Results: Fifteen pts with metastatic HPV+ OPSCC were identified. The median age was 57 years (range 42-78, 15 male). The median pack-year smoking was 0 (range 0-120). Primary site included 10 tonsil and 5 tongue base. At diagnosis, one pt had stage III and 14 had stage IV disease (IVA: 9, IVB: 2, IVC: 3). T- and N-stage included T1 (1), T2 (10), T3 (3), T4 (1) and N1 (1), N2a (1), N2b (9), N2c (3), N3 (1). Extracapsular extension was seen in 8 pts, absent in 2, and unknown in 5. Seven pts had lymph node (LN) involvement at level IV/V. Initial therapy for locally-advanced disease included surgery followed by adjuvant radiation (RT) in 1 pt and chemoRT in 8, and definitive chemoRT in 3 pts. Three pts were metastatic at initial diagnosis. Of 6 pts with an isolated metastatic site, 3 pts are alive &gt; 2 years from diagnosis of metastasis (median 1.97 years, range 0.49-2.29). Palliative therapy included surgery (3), RT (9), platinum chemo +/- cetuximab (8), cetuximab alone (2) or with a taxane (2). The most common sites of metastasis included bone (6), lung (5), and LNs (5). The 1-year survival rate after diagnosis of metastatic disease was 92%. The median time to diagnosis of metastatic disease after definitive therapy was 0.47 years (95% CI 0.19-1.29); 75% of pts who developed metastatic disease did so within 1 year of definitive therapy. Of note, 2 of the 15 pts developed a secondary immune-mediated malignancy (melanoma and non-HIV associated Kaposi’s sarcoma). Conclusions: The survival of pts with metastatic HPV+OPSCC is significantly better than that of historic controls.
Incidence and risk factors for winged scapula after surgical treatment for lung cancer: A single center experience.
Authors: Luiz Felipe Nevola Teixeira, Ruy Fernando Kuenzer Caetano da Silva, Visnu Lohsiriwat, Fabio Sandrin, Federica Baggi, Maria Claudia Simoncini, Andre Deeke Sasse, Lorenzo Spaggiari
Journal: Journal of Clinical Oncology (2014)

e20710 Background: Winged scapula is most frequently reported in literature associated with traumatic or surgical procedures. The aim of this study is to evaluate the incidence of winged scapula following lung cancer surgery and correlated factors that might influence this incidence. Methods: We conducted a prospective study, in the European Institute of Oncology (EIO) thoracic surgery department, including 435 patients with lung cancer who underwent surgical treatment, between May and December 2013. Each patient was assessed before and after surgery. The incidence rate of winged scapula was evaluated and related with different risk factors. Results: None of our patients presented winged scapula at the preoperative assessment, while 129 patients (29.6%) were shown to have this complication after the procedure. BMI, previous thoracic surgery, side of surgery, mediastinal lymphadenectomy and disease stage were not statistically relevant. Otherwise, 73% of patients who underwent pneumectomy had winged scapula, and 38% of patients had winged scapula after lobectomy. The duration of surgery and the analyses between open surgeries (217 muscle-sparing thoracotomy patients with and 52% of winged scapula incidence) and a minimally invasive approach (video assisted thoracic surgery and robot had 7% of sequela incidence in 218 patients), showed a statistically relevant significance (p<0.0001). Patients who underwent neoadjuvant regime showed a greater tendency to nerve palsy (p=0.0007). The length of stay, were higher in patients with winged scapula (p<0.0001). Conclusions: This study showed that the incidence of winged scapula in post- surgical lung cancer patients is not rare. Furthermore, a greater incidence of winged scapula was noted in patients who underwent neodjuvant treatment, open access surgeries and had a prolonged time of surgery. These variables are correlated to a higher hospital length of stay. Patients with a positive diagnosis should be assessed prior to receiving rehabilitation indications. Future studies are warranted to test rehabilitation protocols and compare our results with other institutes.
Expression of tumor biomarkers in HIV-infected patients with head and neck cancer.
Authors: Hongzheng Zhang, Sungjin Kim, Zhengjia Chen, Sreevinas Nannapaneni, Gabriel Sica, Thomas E. Carey, William N. William, Minh Ly Nguyen, James Riddell, Sara I Pai, Heather M Walline, J. Jack Lee, Gregory T. Wolf, Jennifer R. Grandis, Robert L. Ferris, Zhuo Georgia Chen, Dong Moon Shin
Journal: Journal of Clinical Oncology (2014)

6086 Background: Human immunodeficiency virus (HIV)-infected individuals are at increased risk for head and neck cancer (HNC). Poor survival is associated with low CD4 counts, larynx/hypopharynx site and current tobacco use. The expression of tumor biomarkers and their correlation with risk factors has not been studied in HIV+HNC. We compared a panel of tumor oncogenic (NFkB, pAKTS473, pSTAT3tyr705 and Bcl2) and inflammatory (TGFβ, IL-6 and VEGF) biomarkers in tumors from patients with HIV+ vs HIV-HNC. Methods: 56 HIV+HNC cases were identified at 5 US tertiary care referral centers between 1991-2011. Expression of tumor biomarkers was detected on tissue microarray by immunohistochemistry using formalin-fixed paraffin-embedded surgical specimens from primary tumors matched with anatomical site in HIV-patients with HNC (N=44/group), and scored by a pathologist. Clinical information was captured in the HIV+HNC cohort only (N=29 for biomarker analysis). Results: In the HIV+HNC group: median age 49 (range 28-70), median CD4 counts 298 cells/µL (range 5-1038), 78% patients were current alcohol consumers, 79% current smokers, 61% receiving highly active antiretroviral therapy at time of cancer diagnosis. Median follow up was 517 days. Tumors from the HIV- cohort tended to express greater NFkB than those from HIV+ cohort (p=0.062). In the HIV+HNC cohort, VEGF expression was associated with advanced tumor stage (p<0.05) while pSTAT3 expression was associated with early stage (p<0.05). Regardless of HIV status, NFkB expression was positively correlated with pAKT (r=0.753, p<0.001), both were expressed at greater levels in the oral cavity than other sites (p<0.001 and p=0.003, respectively), and both lower in current alcohol drinkers (p<0.001) and current smokers (p<0.05) than in former and/or never drinkers/smokers. Multivariate analysis indicated that high pSTAT3 (p<0.05) and VEGF (p=0.061) were associated with improved overall survival and African American race (p<0.05) with poor prognosis. Conclusions: This is the first exploratory study linking tumor biomarkers with risk factors in HIV+HNC. Tumor biomarkers are differentially expressed by HIV status, alcohol and tobacco use, and are associated with overall survival.
Retrospective analysis of dose intensity, toxicity, and clinical outcomes in 5-fluorouracil based regimens in the treatment of metastatic colorectal cancer.
Authors: Karen E. Mulder, Jonathan Loree, Sunita Ghosh, Jennifer L. Spratlin
Journal: Journal of Clinical Oncology (2013)

e14595 Background: Metastatic colorectal cancer (mCRC) chemotherapy utilizes either sequential monotherapy followed by combination therapy or early combination therapies. Patients receive therapy consisting of oxaliplatin with 5-FU as an intravenous formulation (FOLFOX6) or capecitabine (CAPOX). A retrospective analysis was performed comparing average relative dose intensity (ARDI), overall survival (OS), progression free survival (PFS), and toxicity profiles of these 2 regimens in mCRC patients. Methods: 122 mCRC patients identified between January 1, 2006 and December 31, 2011 received either FOLFOX6 (n= 46) or CAPOX (n=76) in Edmonton, Alberta. ARDI was compared by calculating a percent of target dose achieved in the average cycle for each patient. Data on OS, PFS, baseline demographics, and toxicities was gathered. Survival data was plotted using the Kaplan-Meier method and compared using the log-rank test. Variable comparisons were performed with the Student’s t-test or the Fisher’s Exact test. Follow up was complete until November 1, 2012. Results: Oxaliplatin ARDI trended towards being lower in those treated with CAPOX compared to FOLFOX6 (84.01 vs 89.52 p=0.0553), and 5-FU component was significantly lower (81.28 vs 95.76, p&lt;0.0001). More patients treated with CAPOX had dose limiting toxicities (DLTs), although not statistically significant (68.42% vs 54.35%, p=0.1268), while toxicities of grade 2 and higher were increased with CAPOX (38.16% of patients vs 15.22%, p=0.0079). Neuropathy rates were similar between regimens as were cycle numbers were completed between CAPOX and FOLFOX6 (5.329 vs 6.174, p=0.2796). Survival analysis demonstrated trends towards improved median OS (300 vs 227 days, p=0.1183) and median PFS (132 vs 101.5 days, p=0.1674) with CAPOX. The groups had similar age, gender, and ECOG at diagnosis. Conclusions: Patients treated with CAPOX had significantly more DLTs resulting in lower doses of oxaliplatin and capecitabine compared to FOLFOX6. This does not seem to impact clinical outcomes as mCRC patients on CAPOX showed a trend toward improved outcomes compared to FOLFOX6.
Validation of the M. D. Anderson Symptom Inventory multiple myeloma module.
Authors: Nina Shah, Desiree Jones, Tito R. Mendoza, Loretta A. Williams, Xin Shelley Wang, Elisabeth G. Vichaya, Mary H Sailors, Richard E. Champlin, Charles S. Cleeland
Journal: Journal of Clinical Oncology (2012)

6551 Background: Validated scales exist for quality of life assessment in patients with multiple myeloma (MM); however, no existing tool comprehensively assesses disease- and treatment-related symptoms in these patients. The aim of this study was to validate a module of the M. D. Anderson Symptom Inventory developed for patients with MM (MDASI-MM). The MDASI-MM includes 13 core symptoms, 6 interference items, and 7 MM-specific items: constipation, muscle weakness, diarrhea, sore mouth/throat, rash, difficulty concentrating, and bone aches. Methods: The MDASI-MM was administered to 2 cohorts of patients with MM. The first cohort (N=86) consisted of cross-sectional symptom data from patients at the beginning of induction chemotherapy or autologous hematopoietic stem cell transplant (HSCT). This cohort was used to demonstrate i) known-group validity, by detecting differences in groups by performance status; ii) concurrent validity, by correlating selected items and subscales from the MDASI-MM with those from the Short Form Health Survey (SF-12) and the EORTC-QLQC30; and iii) reliability, by computing Cronbach alpha values. The second cohort (N=53) consisted of symptom data collected at 2 points: prior to transplant and 7 days post-HSCT. This cohort was used to demonstrate the sensitivity of the MDASI-MM to detect acute worsening of patients’ symptoms post-HSCT. Results: The MDASI-MM detected significant differences in symptoms and interference levels according to patients’ performance status (P &lt; .001). MDASI-MM scores correlated with those from SF-12 subscales for physical, emotional, cognitive, and social functioning (all P &lt;.001) and with comparable items from the EORTC-QLQC30 (such as pain, fatigue, difficulty concentrating, constipation, and diarrhea, all P &lt; .001). Cronbach alphas were 0.85 for symptom severity and 0.87 for interference. The MDASI-MM’s overall mean scores worsened between pre- and post-HSCT (1.32 vs. 2.55 (range = 0-10), P &lt; .001). Conclusions: The MDASI-MM is a valid, reliable, and concise tool that can be used to quantitatively assess symptom severity and interference in clinical trials and care of MM patients.
What We Are
Authors: Carol Snyder Halberstadt
Journal: JAMA (2017)

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A combined EpCAM and MCAM circulating tumor cell (CTC) CellSearch enrichment to improve CTC capture rate in stage II/III breast cancer: A Dutch Breast Cancer Trialists' Group (BOOG) side study.
Authors: Wendy Onstenk, Jaco Kraan, Ayoub Charehbili, Bianca Mostert, Vincent T. H. B. M. Smit, Judith R. Kroep, J. W. R. Nortier, Gerrit-Jan Liefers, Saskia van de Ven, Joan Barbara Heijns, Lonneke Kessels, Hanneke W. M. Van Laarhoven, Monique M.E.M. Bos, Cornelis J. H. Van De Velde, Jan-Willem Gratama, Anieta M. Sieuwerts, John W. M. Martens, John A. Foekens, Stefan Sleijfer
Journal: Journal of Clinical Oncology (2013)

e22106 Background: Using the CellSearch System (Veridex, USA), ≥1 CTC/7.5 mL of peripheral blood is found in ~20% of primary breast cancer (BC) patients. However, epithelial cell adhesion molecule (EpCAM)-negative CTCs may be missed. We previously showed that a subset of BC cell lines lacks EpCAM, but does express melanoma cell adhesion molecule (MCAM) and that MCAM-positive CTCs (M-CTCs) do occur in metastatic breast cancer patients. In a side-study of the NEOZOTAC trial, a randomized study comparing neoadjuvant chemotherapy (NAC) with or without zoledronic acid in stage II/III BC, we investigated whether combined enrichment with EpCAM and MCAM increases the CTC detection rate. Besides, we hypothesized that CTC counts would correlate with pathological complete response (pCR) to NAC. Additionally, as exploratory study, circulated endothelial cells (CECs) were measured. Methods: At baseline and after the 1 st chemotherapy cycle, blood was drawn from all patients in the NEOZOTAC trial who gave additional informed consent. The CellSearch System was used to count EpCAM-positive CTCs (E-CTCs) and M-CTCs. For the latter, the anti-EpCAM-ferrofluid was replaced by an anti-MCAM-ferrofluid (both Veridex). CECs were measured using flow cytometry. Results: At baseline, blood was received from 73 patients; ≥1 E-CTCs and M-CTCs were detected in 14/73 (19%, median 1) and 8/68 (12%, median 1), respectively. Combining both counts, ≥1 CTCs were detected in 17/68 (25%) of patients (p=0.01). After 1 chemotherapy cycle, E-CTCs, M-CTCs and overall CTCs were detected in 9/47 (19%), 7/45 (16%), and 13/44 (30%; p&lt;0.01) patients. Median CEC count was 43 at baseline and 142 after cycle 1 (p&lt;0.001). No differences in CTC and CEC count were found between the treatment arms. Baseline CTC counts, nor changes in counts, were associated with pCR. Conclusions: Combined enrichment of CTCs with EpCAM and MCAM significantly increased CTC detection rates in stage II/III BC with about 10%. CTC counts were not associated with pCR to NAC. Associations with disease free survival will follow when available.