tbuckley/cabot-search huggingface dataset:
Myeloid deprived suppressive cell to mediate the prognostic value of neutrophil to hemoglobin ratio for hepatocellular carcinoma patients receiving transcatheter arterial chemoembolization.
Authors: Xing Li, Quan Yang, Zhi-Huan Lin, Yingfen Hong, Yu-Feng Liu, Dong-hao Wu, Tian-tian Wang, Zhan-hong Chen, Qu Lin, Mingsheng Huang, Yan-Fang Xing, Xiang-yuan Wu, Jie Zhou
Journal: Journal of Clinical Oncology (2016)

292 Background: The prognosis of hepatocellular carcinoma (HCC) patients receiving transcatheter arterial chemoembolization (TACE) is far from being identified. The present study aimed to assess role of blood cell counts, routine liver function tests and neutrophil to hemoglobin ratio (NHR) in predicting the progression-free survival (PFS) of these patients. Methods: A total of 243 HCC patients receiving TACE were analyzed retrospectively. Results: Cancer of the Liver Italian Program (CLIP) score system was identified to be the best score system among current 12 staging systems for this patient subgroup according akaike information criterion (AIC) index and linear trend χ 2 . Then, the novel prognostic value of parameters was determined by integration into CLIP score system. As a result, NHR were confirmed to an independent predictor for PFS of HCC patients receiving TACE (p = 0.001) with the other parameters, including neutrophil and neutrophil-lymphocyte ratio (NLR), failed to reach statistical significance. Moreover, NHR improved the performance of CLIP by adjusted into it, thus improved the discriminatory ability. Furthermore, NHR were defined value ≤ 0.02 as low level and &gt; 0.02 as high level, according to which patients were dichotomized into two groups. HCC patients receiving TACE with low NHR presented higher 1 year disease control rate (DCR) (50.0% vs 39.35%) and 2 year DCR (45.4% vs 27.0%) compared with patients with high NHR level. Besides, NHR level was associated with prognostic factors such as portal vein thrombosis and distant metastasis. Furthermore, in order to determine the mechanism of predictive value of AHR, we tested the proportion of myeloid deprived suppressive cell (MDSC) in peripheral blood mononuclear cells (PBMC) of 43 HCC patients. It was revealed that MDSC was positively correlated with neutrophil (P&lt; 0.05). Since MDSC was cancer promoter, it might be the mechanism of the prognostic value of NHR. Conclusions: The present study firstly identified NHR as an independent prognostic factor in HCC patients receiving TACE. The positive correlation of MDSC and neutrophil might be the latent mechanism.
Utility of the OSNA assay in sentinel node mapping for early gastric cancer.
Authors: Hiroya Takeuchi, Tomohiko Nishi, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Hirofumi Kawakubo, Yoshiro Saikawa, Tai Omori, Yuko Kitagawa
Journal: Journal of Clinical Oncology (2014)

13 Background: Recent studies on sentinel node (SN) mapping for early gastric cancer have shown acceptable results in terms of detection rate and accuracy to determine lymph node (LN) status. Accurate detection of nodal metastasis including micrometastasis during surgery is indispensable for clinical application of minimized gastrectomy based on SN mapping and biopsy. However, histopathological diagnosis of micrometastasis using frozen sections has to be considered as limitations for intraoperative pathology. We hypothesized that one-step nucleic acid amplification (OSNA) assay may allow the PCR-based intraoperative diagnosis to be applicable to SN mapping for early gastric cancer. Methods: A prospective study of SN mapping using the OSNA (One-step nucleic acid amplification) assay has been conducted for patients with cT1N0M0 gastric cancer at our institution. All SNs and randomly selected non-SNs were examined by routine histopathological diagnosis and the OSNA assay. Results: Histological examination was performed in in 1,732 LNs (286 SNs and 1,446 non-SNs) from 43 patients with cT1N0M0 gastric cancer. We also evaluated 439 LNs (286 SNs and 153 non-SNs) with histological examination and the OSNA assay from the 43 patients. Histological LN metastasis was revealed in 6 (14.0%) of 43 patients. All (100%) of the 6 patients with LN metastasis showed positive SNs by histological examination. The diagnostic accuracy to predict the LN status based on SN concept by histological examination was 100%. The concordance rate between the OSNA assay and the histological examination of paraffin specimens was 0.970 (95 % CI, 0.950–0.984). Discordant results were observed in 13 LNs (3.0 %). Sensitivity and specificity of the OSNA assay compared to the histological examination were 0.636 (95 % CI, 0.407–0.828) and 0.988 (95 % CI, 0.972–0.996), respectively. The OSNA assay to evaluate the SNs status was comparable with intraoperative pathological diagnosis of frozen sections of SNs in terms of concordance rate (0.981), sensitivity (0.800) and specificity (0.995). Conclusions: Our results suggest that the OSNA assay may be a useful tool for the intraoperative detection of metastasis in SNs for patients with early gastric cancer.
Prediction of postoperative histology in patients with prostate cancer using preoperative Ga-68-PSMA-PET/CT.
Authors: Martin Boegemann, Axel Semjonow, Hans-Joerg Breyholz, Andres Jan Schrader, Laura-Maria Krabbe, Matthias Weckesser, Michael Schaefers, Peter J. Barth, Sebastian Huss, Kambiz Rahbar
Journal: Journal of Clinical Oncology (2016)

144 Background: Recently developed 68 Ga labeled prostate specific membrane antigen (PSMA) ligands were introduced as diagnostic tools to detect prostate cancer (PCa), PCa relapse and metastases with high accuracy. In this study we assessed the usability of preoperative PSMA-PET/CT information on congruency of spread of PCA compared with postoperative PCa-maps derived from radical prostatectomy (RPE) specimens. Methods: We referred 6 patients with biopsy proven high risk PCa to PSMA-PET/CT prior to RPE. Whole body PET/CT (Biograph mCT with 128 slice CT, Siemens) was performed 62±8 minutes after injection of 160±31 MBq [ 68 Ga]-PSMA-HBED-CC (DKFZ-Ga-PSMA-11) as described by routine acquisition protocol. After RPE, prostate specimens were processed in the local pathology department. Topographical analysis of extension of PCa was reconstructed from representative slides on a schematic diagram resulting in a PCa-map of the prostate. After aligning the cutting planes of the PSMA-PET/CT to the PCa-map we defined 20 segments of the prostate and the seminal vesicles. We measured the maximum standard uptake value (SUV) of PSMA activity of the respective segments and compared the concordance of PSMA-positive and -negative areas with those of PCa and no PCa on the PCa-maps. We calculated sensitivity, specificity, positive and negative likelihood ratios (LR) taking available segments into account. Results: 106/112 segments were analyzed. 8 segments were excluded due to spillover of PSMA-activity in bladder urine. All but 3 segments with no PCa on the PCa-maps showed no uptake in PSMA-PET/CT (Specificity = 92%). The sensitivity of PSMA-PET/CT for showing PCa areas was equally 92%. The positive and negative LR for PSMA-PET/CT detecting or ruling out PCa was 11.5 and 0.09, respectively. Conclusions: This preliminary proof of concept study shows that prediction of later pathologic results in RPE-specimens could be estimated by preoperative PSMA-PET/CT. With optimized acquisition protocols it may be possible to improve our preliminary results. Perspectively PSMA-PET/CT may be helpful for identifying PCa suspicious lesions prior to prostate biopsy and support decision making prior to RPE or radiation therapy.
Changes in non-invasive liver fibrosis indices during chemotherapy: Potential marker for oxaliplatin-induced sinusoidal obstruction syndrome.
Authors: Jin-Soo Kim, Sehhoon Park, Ki Hwan Kim, Jin Hyun Park, Won Kim, In Sil Choi, Yong Jin Jung, Hwi Young Kim
Journal: Journal of Clinical Oncology (2016)

515 Background: Oxaliplatin-based regimens are standard treatments for patients with colorectal (CRC) and advanced gastric cancer (AGC). However, the use of oxaliplatin sometimes results in hepatic sinusoidal obstruction syndrome (SOS). The aim of the study was to evaluate the utility of non-invasive liver fibrosis indices for monitoring oxaliplatin-induced hepatic SOS. We have reported a preliminary data in ASCO Annual Meeting 2014. Methods: From February 2004 to April 2014, patients with CRC or AGC who received oxaliplatin-based chemotherapy were studied. Possibility of SOS development was evaluated before and after the oxaliplatin exposure with splenic volume index (SVI). Four different non-invasive liver fibrosis indices were used for risk analysis: age-platelet index (API), AST to platelet ratio index (APRI), platelet to spleen ratio (PSR), Fibrosis-4 score (FIB-4). A prospective observation with serial elastrography is also ongoing. Results: A total of 275 patients were eligible for evaluation: 200 patients had CRC, and 75 patients had AGC. Using a cutoff of SVI increase ≥ 0.3, 113 patients (41.1%) were positive for hepatic SOS. Changes of indices were significantly correlated with SVI increase. Adjusted odds ratios for those indices were as follows: API = 1.16 (95% Confidential Interval [CI], 1.01 - 1.32; P = 0.032); APRI = 2.45 (95% CI, 1.30 - 4.63; P = 0.006); PSR = 0.69 (95% CI, 0.59 - 0.80; P &lt; 0.001); FIB-4 = 1.37 (95% CI, 1.16 - 1.63; P &lt; 0.001). Optimal cutoff-value with statistical significance were calculated and suggested. A total of 20 patients have been enrolled into the prospective observation until now. Comparison of elastographic changes and the indices in these patients will be presented. Conclusions: Changes of non-invasive liver fibrosis indices showed good correlation with SVI increase during oxaliplatin-based chemotherapy. These indices might be useful markers for monitoring of oxaliplatin-induced hepatic SOS. Serial monitoring of hepatic elastography could also be used for non-invasive monitoring of hepatic SOS.
Structural and functional MRI of the brain as biomarker for postcancer fatigue.
Authors: H. Prinsen, A. Heerschap, G. Bleijenberg, M. Zwarts, M. van der Graaf, M. Rijpkema, H. Van Laarhoven
Journal: Journal of Clinical Oncology (2011)

9050 Background: Fatigue after curative cancer treatment is a frequently occurring problem, impairing quality of life. Little is known about physiological factors determining postcancer fatigue. We aim to assess if structural and/or functional magnetic resonance imaging (MRI) of the brain can be used as a biomarker for postcancer fatigue. Methods: Severely fatigued (n=25) and matched non-fatigued (n=16) disease-free cancer survivors, who completed treatment of a malignant tumor ≥1 year earlier, participated in this case-control study. Patients with a brain tumor were excluded. Structural MRI was performed on a 3T MR system and segmentation of the brain into gray matter (GM) and white matter (WM) was carried out using a voxel-based morphometry method. Volumes of hippocampus and thalamus were obtained using FMRIB Software Library (FSL FIRST). Functional MRI by magnetic resonance spectroscopic imaging (MRSI) at 3T was used to measure N-acetylaspartate (NAA) levels in the hippocampus and the ratio of choline to creatine (Cho:Cr) in the occipital cortex. LCModel was used to analyze the 1H-spectra. One-way ANOVA was performed and differences were considered statistically significant at p<0.05. Results: Volumetry results (Table) showed a significantly smaller volume of the thalamus (p=0.015) in fatigued compared to non-fatigued cancer-survivors. Other MR(S)I parameters were not significantly different between severely fatigued and non-fatigued participants (Table). Conclusions: Thalamus volume was significantly smaller in fatigued compared to non-fatigued cancer-survivors. As non-motor functions of the basal ganglia play a key role in central fatigue, the thalamus, which interacts with the basal ganglia, may also contribute to fatigue. Thus, thalamus volume may serve as a possible biological marker for postcancer fatigue. MR(S)I results. Structure Severely fatigued Non-fatigued GM 689.133 ± 75.857 ml 663.414 ± 61.457 ml WM 526.633 ± 89.716 ml 496.485 ± 64.695 ml Hippocampus 0.445 ± 0.042 % of TBV 0.464 ± 0.048 % of TBV Thalamus 0.885 ± 0.050 % of TBV 0.929 ± 0.056 % of TBV Hippocampus [NAA] 8.60 ± 0.76 mmol l-1 8.97 ± 0.99 mmol l-1 Occipital cortex (Cho/Cr) 1.09 ± 0.30 peak intensity 1.03 ± 0.21 peak intensity Abbreviation: TBV, total brain volume.
Oncolytic virotherapy tested in clinical trials: Literature survey from 2001 to 2010—Any progress?
Authors: G. L. S. Pereira, G. Castro, J. R. Merchan
Journal: Journal of Clinical Oncology (2011)

e13526 Background: Therapeutic oncolytic viruses (OV) are anticancer agents that preferentially infect, replicate in and lyse tumor (Tu) cells. The goals of this analysis were to evaluate the progress in the clinical development of OVs in the last decade and identify potential safety and efficacy signals from available studies. Methods: We searched for original papers using PubMed database with the terms neoplasms and viruses, or OV [limited to clinical trials, English and from 01/2001-12/2010]. Studies based on replication-defective viruses, interim and post-hoc analyses were excluded. For each clinical trial (CT), data were summarized for year (yr) of publication, sample size, phase (P-), virus, route, toxicity, definition of MTD, Tu type, combined treatments and geographic affiliation. Comparisons were performed between the first and second halves of the decade. Results: 46 CTs, with 932 patients (pts), were included. The average of CTs per yr was balanced between the first (4/yr) and second (5.2/yr) half of the decade, with an increase in the number of published trials occurring in the last biennium (7/yr). While, in the first half, adenoviruses were the predominant viral platform (83% of CTs per yr), the percentage of non-adenovirus and third generation OV CTs per yr increased in the second half (17% to 69%, p=0.009 and 10% to 31%; p=0.024, respectively). Of all CTs, 85% (717 pts) were P-I and P-I/II and 15% P-II (215 pts). The only P-III, published in Chinese, was excluded. Most CTs evaluated pts with different solid (37%) and GI Tu (22%). MTD was defined in 4 of 39 P-I CTs (10.2%). G 3-4 AEs at least possibly related to OVs were found in 57% of CTs, with no G5 due to OV. Route of administration: IT (59%); IV (26%); loco regional (15%). OV was combined with other therapies in 12 CTs (26%). Five out of 7 P-II CTs reported clinical benefit. The proportion of non-US studies has increased in the second half decade (from 20% to 56% of CTs). Conclusions: The proportion of non-adenoviral OVs in clinical development has significantly increased in the second half of the decade, showing safety and early evidence of clinical activity. However, establishment of MTD with OV was sporadic and little progress to large randomized trials has been demonstrated in the last decade.
Rho GDP dissociation inhibitor beta ARHGDIB in renal cell cancer.
Authors: Christoph A. J. von Klot, Natalia Dubrowinskaja, Jörg Hennenlotter, Mario W. Kramer, Axel S. Merseburger, Arnulf Stenzl, Inga Peters, Hossein Tezval, Markus A. Kuczyk, Juergen Serth
Journal: Journal of Clinical Oncology (2015)

474 Background: Rho GDP dissociation inhibitor 2 (ARHGDIB) is an important mediator of cellular signaling. The expression of ARHGDIB correlates with tumor growth and metastasis in a variety of non genitourinary cancers, however the role of ARHGDIB in renal cell cancer (RCC) has not yet been evaluated. Methods: Tissue samples from 106 patients undergoing surgery for RCC were obtained. The expression of ARHGDIB mRNA in normal kidney tissue and in corresponding cancer tissue was analyzed by means of quantitative real time PCR. Differences in mRNA expression levels were assessed using paired two-sample tests. Associations of relative mRNA expression levels and clinicopathological parameters were statistically analyzed using an univariate logistic regression model. Relative mRNA expression levels in healthy renal tissue compared to cancerous tissue from the same kidney was assessed using a paired t-test. Results: When comparing 74 tissues from kidney tumors with adjacent histologically normal appearing paired tissues, mRNA expression of ARHGDIB was significantly higher in the tumor tissue (p &lt; 0.001). Paired analysis did not only show significantly higher mRNA expression levels for ARHGDIB over all RCC but also for the subgroup with clear cell RCC (ccRCC). The mRNA expression of ARHGDIB was also more pronounced in ccRCC when compared with papillary RCC (p &lt; 0.001). When looking at clinicopathological parameters in univariate logistic regression analysis ccRCC was significantly associated with nodal involvement (p = 0.03) and also with tumor grade (p = 0.05). For all RCC there was no association with clinicopathological parameters. A bivariate Cox regression model, adjusted for metastatic status (p = 0.001), tumor diameter (p = 0.043), state of advanced disease (p = 0.030) and lymph node metastasis (p = 0.006) identified ARHGDIB mRNA expression as a candidate positive prognosticator for RFS. Conclusions: Increased ARHGDIB mRNA expression is significantly associated with RCC tissues. Higher relative expression observed within tumor tissues represents a candidate prognosticator for better RFS of patients.
Snapshot of an outpatient supportive care center at a comprehensive cancer center.
Authors: Lindsey E Pimentel, Maxine Grace De la Cruz, Angelique Wong, Debra Castro, Eduardo Bruera
Journal: Journal of Clinical Oncology (2016)

145 Background: Integration of Palliative Care (PC) in oncology has been found to improve symptom distress, quality of life and survival in patients with advanced cancer. Early integration is most appropriate in the outpatient (OP) setting. However, most PC services in the U.S. do not have an OP component. Our study aims to provide a snapshot of the type of patients that are referred to this novel setting for the delivery of early PC. Methods: We reviewed a day in the SCC to illustrate the structure and process involved in the delivery of outpatient PC. We highlighted 9 patients seen that day to show the variety of patients, scope of services, and the unique roles that PC interdisciplinary team members perform. Results: 41 patients were seen that day in the SCC: 10 scheduled consults, 22 scheduled follow-ups, 9 (22%) same-day unscheduled patients: 4 follow-ups, 1 consult and 4 nurse triages. There were also 31 telephone encounters. Most patients seen were for routine follow-up and symptom assessment. However, 10 presented with worsening symptoms with one needing hospital admission. 21 patients required additional counseling: 2 for hospice transitioning, 12 for psychosocial distress, 7 for opioid education. PC was delivered predominantly by physicians and nurses with collaboration with our pharmacist, counselors, and case manager. Conclusions: Traditionally, PC has been delivered predominantly to patients with advanced disease and to aid in transition to end of life. In recent years, OP centers have dramatically changed the nature of PC work as in our snapshot. In addition to patients regarded as traditional PC patients, such as those transitioning to end of life, there are now patients who come in soon after arrival to a cancer center requiring specialized care to address a variety of symptom and educational needs, thus requiring adaptation of structure and processes to allow access for frequent follow ups and counseling and flexibility for walk-in visits. Our findings suggest that SCC needs to practice in a very different way which requires certain skills and assessment tools that are not conventionally present in traditional oncology clinic setting. More research is needed to identify the type of patients that would benefit most from a PC referral.
Quality-of-life (QOL) assessment at time of fertility preservation (FP) counseling in female cancer patients: Results of a university-based registry at two years.
Authors: N. Noyes, A. Reh, C. Mullin, M. E. Fino, J. A. Grifo
Journal: Journal of Clinical Oncology (2010)

e19674 Background: Objectives - 1) Establish a prospective registry with long-term follow-up of female cancer patients (CP) who presented for initial consultation for FP; 2) Introduce the FACT-B QOL survey for novel use in a FP population. Methods: All consenting female CP completed the registry survey/FACT-B and agreed to yearly follow-up. Results: From 3/2008 to 1/2010, 22 CP enrolled in the registry, 2 declined, and 1 was lost to follow-up. Cancer diagnoses included 6 cervical, 4 breast, 3 endometrial, 2 ovarian, 2 Hodgkin's, 1 childhood neuroblastoma + renal cell carcinoma, 1 Ewing's sarcoma, 1 thymic carcinoma, 1 AML, 1 papillary mesothelioma. The average age at enrollment was 33.1±5 (range 23 - 44) y. Sixteen patients sought FP with oocyte (OC) and/or embryo cryopreservation (EC), and 5 underwent in vitro fertilization (IVF). 15/22 were referred from their medical or surgical oncologists. Thirteen patients sought treatment prior to cancer surgery and/or chemo and began FP treatment an average of 12 (range 1 - 22) days from initial consult. Twenty patients completed 30 cycles; 14 used OC and/or EC, 5 IVF and 1 oocyte donation (OD), of which 7 patients underwent embryo transfers resulting in 1 delivery, 1 ongoing (in 8th month) and 1 miscarried pregnancy. One year follow-up is ongoing. By survery, most patients (12/22) felt having a child was most important in their life (scale 1 - 7; mean 6.1), and 14/22 were most concerned with the impact of their cancer treatment on fertility (mean 6.1). IVF and OD were the most and least preferred treatments, respectively. Recognizing the limited data on the long-term risks for FP patients, most (14/22) were “unsure” regarding the risk they would undertake to pursue fertility treatment. Most patients reported high baseline QOL scores across all categories of physical, social, emotional, and functional well being. Conclusions: Fertility after cancer remains a significant issue, yet most patients are unsure of their risk tolerance. We introduce the FACT-B QOL survey for novel use in a FP population and aim to determine the long-term safety, effectiveness, and QOL impact of FP treatment in female CP. No significant financial relationships to disclose.