tbuckley/cabot-search huggingface dataset:
Potential plasma biomarkers predicting radiation dermatitis in breast cancer patients.
Authors: J. L. Ryan, C. E. Heckler, A. P. Pentland, G. R. Morrow
Journal: Journal of Clinical Oncology (2010)

9144 Background: Radiation dermatitis occurs in nearly 95% of cancer patients receiving radiation therapy. Currently, there are no useful treatments for these skin reactions. Published preclinical studies by our group showed that intragastric administration of curcumin, a potent anti-inflammatory and antioxidant, reduced radiation skin toxicity by 50% in mice. Currently, we are conducting a randomized, double-blind, placebo-controlled study examining the use of curcumin for radiation dermatitis. Alterations in pro-inflammatory cytokines and chemokines may be a novel indicator for radiation-induced skin damage. Methods: Female breast cancer patients prescribed radiation treatment without concurrent chemotherapy were eligible. After randomization, all patients took twelve 500mg capsules of curcumin or placebo daily (i.e., 6.0g daily) during their prescribed course of radiation treatment. The severity of radiation dermatitis was measured weekly using Radiation Dermatitis Score (RDS) ranging from 0 to 4 with 0.5 increments. Milliplex Luminex MAP Human Panel I Assay was used to measure plasma levels (pg/ml) of 42 different cytokines and chemokines in blood collected from patients midway through radiation treatment to elucidate a blood biomarker predictive of radiation dermatitis severity. Results: 21 patients have completed the ongoing clinical trial (95% White, 86% Stage I or II breast cancer, mean age = 58). Correlative and regression analyses showed that plasma levels of eotaxin (p=0.007), IFNα2 (p=0.010), IL-12/p40 (p=0.005), IL-12/p70 (p=0.006), and IP-10 (p=0.033) midway through radiation treatment were predictive of radiation dermatitis severity at the end of treatment. Eotaxin and IL-12/p40 negatively correlated with radiation dermatitis severity, while IFNα2, IL-12/p70, and IP-10 positively correlated with radiation dermatitis severity. Conclusions: Plasma levels of eotaxin, IFNα2, IL-12, and IP-10 could be used to predict radiation dermatitis severity in breast cancer patients. Supported by: Dermatology Foundation Research Career Development Award, KL2 RR024136, and NCI PHS 1R25CA10618 grants. No significant financial relationships to disclose.
Feasibility of robot-assisted radical prostatectomy in elderly patients: Comparative analysis of the perisurgical/oncological outcomes with younger patients.
Authors: Noriyoshi Miura, Osuke Arai, Ryuta Watanabe, Yuichiro Sawada, Seiji Asai, Terutaka Noda, Tetsuya Fukumoto, Yutaka Yanahihara, Yuki Miyauchi, Tadahiko Kikugawa, Takashi Saika, Hirochika Nakajima, Kohei Edamura, Shin Ebara
Journal: Journal of Clinical Oncology (2017)

111 Background: Robot-assisted radical prostatectomy (RARP) has become one of standard treatments for localized prostate cancer. However, a feasibility of RARP in high elderly patients has not been clear yet. We performed a comparative analysis of peri-surgical / oncological outcomes for younger and elder patients underwent RARP. Methods: We reviewed and compared our 631 consecutive patients who underwent RARP from 9/2012 to 6/2016 for peri-surgical outcomes, including surgical times, blood loss, complications, pathological findings, continence recovery, and oncological outcomes stratified by age less than 75 and over 75 years. Results: In our cohort, 555 men were age less than 75 and 76 men were ≥75. Preoperative parameters (age, PSA, Gleason score) were similar in both younger and high elder groups. Operative time (median: 180 vs. 180 minutes) and estimated blood loss were similar in both groups. One of elder patients (1.4%) needed transfusion. Peri/post-operative complications over grade 3 were 0.9% in younger group and 1.4% in elder group. No case needed intra-operative open conversion. Surgical positive margin rates in organ-confined (pT2) disease were also similar (13.4%, younger vs. 17.9%, elder). Continence at 3 months was 73% in elder patients as opposed to 77% in younger patients. Biochemical recurrences in short follow-up period (median 11.1 vs. 11.0 months) were observed 7.9% in elder patients as opposed 8.3% in younger patients. Conclusions: In our study, although urinary continence recovery in high elderly patients might show a short delay, RARP in high elderly patients was relatively safe and yielded good oncologic results. RARP is feasible even in elderly patients.
A review of the stage, recurrence, treatment, and outcomes in penile cancer at a tertiary referral center.
Authors: Andrew Franklin, Elizabeth Koehne, Tyler Haden, Gilbert Ross, Weinstein Stephen, Mark Wakefield, Naveen Pokala, Daniel Hoyt
Journal: Journal of Clinical Oncology (2016)

495 Background: This was a retrospective review analyzing the epidemiological and pathological association of penile cancer as well as the clinical results in patients managed at the University of Missouri Hospital and Clinics (UMHC) and Harry S Truman VA. Methods: Records were obtained of patients with a pathological diagnosis of penile cancer from 2001−2014 at UMHC and at the Harry S Truman VA. These charts were retrospectively reviewed. Information regarding patient demographics, pathology, treatment, and outcomes were recorded. Results: Forty-four patients with a pathologic diagnosis of penile cancer were identified. Mean age at diagnosis was 64 with 41 being White, 2 unknown, 1 Black, and 1 Hispanic. Seventy-two percent had tobacco exposure, with 66% of all patients having smoked greater than 10 years. HPV was present in 20%. Circumcision status was reviewed showing overall 61% were circumcised, with 4.5% being circumcised before the age of 18. Premalignant lesions were identified in 36% of the patients, with condyloma acuminate being the most common followed by Lichen Sclerosus and severe dysplasia. The vast majority (98%) of penile cancers were squamous cell carcinoma (SCCa), with only one patient having a Buschke−Lowenstein tumor. Invasive SCCa without nodal involvement was the most common pathologic stage (41%) followed by nodal positive disease (36%) and CIS (23%). Of those with node positive disease, 56% were dead less than 5 years after nodal involvement. Ninety-nine procedures with curative intent were performed, with a mean of 2.25 procedure per patient. However, only 79 of the procedures led to a sustainable cure. Of those patients with metastatic disease 13.6% underwent chemotherapy and 9.1% received radiation. Conclusions: Our study reflects the trends in stage, recurrence, treatment, and outcomes at two large centers for penile cancer. In this patient group the majority had exposure to tobacco and almost exclusively had SCCa. A durable cure may require multiple operative interventions. Nodal involvement carries a poor prognosis and high risk of death in less than 5 years once diagnosed.
FCGR2A H131R and FCGR3A V158F polymorphism status in mCRC patients treated with single-agent cetuximab (IMCL 0144 and CA225045) or with second-line irinotecan plus cetuximab (EPIC): A pooled statistical analysis.
Authors: W. Zhang, D. Yang, C. Harbison, S. Khambata-Ford, D. P. Malone, Y. Ning, P. O. Bohanes, A. Gerger, M. J. Labonte, L. Benhaim, A. B. El-Khoueiry, S. Iqbal, H. Lenz
Journal: Journal of Clinical Oncology (2011)

e14025 Background: Beyond K-RAS mutation status, additional positive predictive markers are needed to identify patients who will benefit from cetuximab treatment. Recent studies demonstrate antibody-dependent cell-mediated cytotoxicity (ADCC) may be one of the modes of action for cetuximab. Previous data suggest two Fc gamma receptor polymorphisms (FCGR2A H131R/FCGR3A V158F) may predict efficacy of cetuximab. Here we present analyses of these 2 polymorphisms in 3 phase II trials of mCRC patients treated with either single agent cetuximab (IMCL0144 and CA225045 [045]) or with second-line irinotecan plus cetuximab (EPIC). Methods: A total of 317 patients (133 from IMCL 0144; 84 from EPIC; 100 from 045) had been tested for FCGR2A H131 R and FCGR3A V158F polymorphisms. FCGR2A/3A polymorphisms were tested by PCR-RFLP or allele-specific PCR technique. Results: In a pooled analysis of IMCL 0144 and EPIC, we found patients with FCGR2A 131 HH genotype had shorter PFS (median PFS=1.3 months (95%C.I: 1.2-2.4) compared to those with HR/RR genotypes. (median PFS= 2.5 months [95%CI: 1.5-3.0] p=0.036, log-rank test). No statistically significant associations were observed between FCGR2A/3A polymorphisms and tumor response rate in either all evaluable patients or in the wild-type KRAS subgroup. (p>0.05, Fisher’s exact test). There are no associations between FCGR3A polymorphisms and OS, PFS. In a separate analysis of 045, no statistically significant associations were observed between FCGR2A/3A genotype and the assessed endpoints (response rate or PFS). Conclusions: Our pooled analysis suggested that the FCGR2A polymorphism may be associated with PFS in patients with mCRC, however FCGR3A polymorphism was not associated with efficacy of cetuximab-based treatment. Further larger statistically powered studies to evaluate the significance of FCGR polymorphisms are needed, and international collaborations are necessary to address the need for larger studies to validate molecular markers in the future.
Evaluate algorithms for identifying treatment patterns for patients with metastatic colorectal cancer using administrative claims data.
Authors: Yue Zhong, Rajesh Kamalakar, Carl V Asche, Sibyl Anderson, Brian S. Seal
Journal: Journal of Clinical Oncology (2014)

299 Background: Administrative claims data are widely used to identify treatment patterns. However, as new drugs are brought to clinical practice, treatment regimens become more complicated for cancer patients receiving both chemotherapy and biologic agents. We evaluated the influence of using different treatment length algorithms on identification of treatment patterns for patients with metastatic colorectal cancer (mCRC). Methods: We identified patients aged 18 or older with at least one primary CRC diagnosis between 01/01/2008 and 03/31/2012 in the MarketScan databases. mCRC patients were included if claims indicated the presence of distant metastases (ICD-9-CM codes: 196.x, 197.0 to 197.4, 197.6 to 197.8, 198.x, and 199.0). All treatment claims were extracted and patients were followed for more than 6 months, until end of enrollment or study end date (03/01/2013). We identified all chemotherapy and/or biologic drugs given to a patient during 30, 60, or 90 days after initiation of treatment and compared differences in type and number of treatment lines (TLs). Results: A total of 2,046 mCRC patients received at least one TL. Using a 30-day cutoff period, 30% patients received 1 TL; 30% received 2 TLs; and 40% received ≥3 TLs. Results changed after using a 60-day cutoff period: 39% patients with 1 TL, 33% with 2 TLs, and 28% with ≥3 TLs. If using 90 days as a cutoff period, 44% received 1 TL; 35% received 2 TLs; and 22% received ≥3 TLs. For all cutoff periods, the most common first TL prescribed were FOLFOX +/- bevacizumab and 5-FU/LV. For patients receiving a second TL, FOLFOX was most frequently prescribed if using a 30-day or 60-day cutoff, while FOLFIRI/bevacizumab had a higher prescription rate with a 90-day cutoff. Regimens varied in third and fourth-line therapy using different cutoff periods and FOLFIRI +/- bevacizumab was more frequently used than other regimens. Conclusions: The cutoff period did not significantly influence treatment regimens detected for first and second TL. Using a 30-day cutoff period resulted in 30% patients with one TL and 40% with three or more TLs, while with a 90-day cutoff, 44% patients received one TL and only 22% received three or more TLs.
Intraperitoneal and intrapleural administrations of triamcinolone acetonide for control of malignant ascites and pleural effusion.
Authors: K. Inoue, H. Tsubamoto, K. Ito, K. Hori, R. Kanazawa, Y. Ito, S. Yamamoto, K. Onishi, R. Ando, S. Komori
Journal: Journal of Clinical Oncology (2011)

e15505 Background: Patients with advanced gynecologic cancer often have massive ascites and pleural effusion, requiring frequent paracentesis (PC). Triamcinolone acetonide (TA) is a slowly metabolized corticosteroid. We evaluated the efficacy of intraperitoneal and intrapleural administrations of TA for control of malignant ascites and pleural effusion. Methods: We conducted a retrospective review of 48 patients with gynecologic cancer who were treated with PC followed by 400 mg of TA at our institutions since 2005. Results: Intraperitoneal TA therapy was performed in 44 patients (38 ovarian, 3 endometrial, 3 cervical) and intrapleural therapy in 4 (2 ovarian, 1 cervical, 1 endometrial), of whom 31 (65%) had recurrent cancer. Twenty-five (52%) were treated in a palliative setting, while 23 (48%) underwent chemotherapy (n=21) or surgery (n=2) following TA therapy. The median age of all patients was 60 years (range, 36-80). ECOG performance status (PS) before TA therapy was 1 in 2, 2 in 10, 3 in 28, and 4 in 8, with 43 (90%) showing improved PS after therapy. In addition, the interval between PC treatments was prolonged in 16 of 21 (76%) assessable patients. One patient complained of abdominal pain (grade 2, NCI-CTCAE ver.3) 1 day after TA therapy, while bowel perforation occurred 7 days after TA therapy in 2 ovarian cancer patients in a palliative setting. Median overall survival after therapy in a palliative setting was 20 days (range: 5-168), while it was 137 days (range: 15-1319) in other settings. Conclusions: Intraperitoneal and intrapleural TA administrations were found to be feasible and effective for patients receiving either palliative or aggressive treatment.
Induced Pluripotent Stem Cell Model of Chronic Myeloid Leukemia Revealed Olfactomedin 4 As a Novel Survival Factor for Primitive Leukemia Cells
Authors: Kran Suknuntha, Yuki Ishii, Kejin Hu, Mcintosch Brayan, David T. Yang, Scott Swanson, Ron Stewart, Jean YJ Wang, James Thomson, Igor Slukvin
Journal: Blood (2014)
Raising the safety bar: The hematology/oncology patient safety committee.
Authors: Myrna Rita Nahas, Jessica A. Zerillo, Stephen A. Cannistra, Cheryle Totte
Journal: Journal of Clinical Oncology (2014)

144 Background: Enhancing patient safety can prevent unintended outcomes arising from defects in healthcare delivery systems. The Hematology/Oncology Patient Safety Committee (HOPSC) at Beth Israel Deaconess Medical Center (BIDMC) is a multidisciplinary team of healthcare providers that meets monthly to review inpatient and outpatient adverse events, near misses, and medical errors that impact patient safety. Methods: Our aim was to quantify and qualify the cases that the HOPSC has reviewed from 2012-2013. In order to identify trends in event reporting, we reviewed the number of events reported to the HOPSC in both the inpatient and outpatient settings. We further subdivided events into two categories: medication-related and non-medication related. Additionally, we delineated which healthcare provider initiated the reporting of each event. Results: Over the two-year period, a total number of 1,061 events were reported to the HOPSC. Of these, 259 were medication-related events. Of the events reported, 40 were by a physician/NP and 1,021 were by a nurse. There was a discrepancy in the type of event reported (24.4% medication vs. 75.6% non-medication related) as well as in the type of reporter (3.8% physician/NP vs. 96.2% nurse). Of all the events reported, 8 were escalated to the Department of Medicine Peer Review Committee. Conclusions: Through review of healthcare provider event reports, the HOPSC has identified several types of adverse events and near misses in the Hematology/Oncology division at BIDMC. The events are mostly reported by inpatient nurses and are primarily medication-related. Given this skewed reporting pattern, we will investigate the reasons why reporting by physicians, especially in the outpatient setting, is limited. Our reported outline of the HOPSC operations may also guide oncology practices elsewhere in their own development of patient safety peer review committees. [Table: see text]
The Clinical and Biological Characterization of De Novo Acute Myeloid Leukemia (AML) with GATA2 Mutation
Authors: Feng-Ming Tien, Wen-Chien Chou, Hsin-An Hou, Yu-Chiao Chiu, Eric Y. Chuang, Chien-Yuan Chen, Jih-Luh Tang, Ming Yao, Shang-Yi Huang, Bor-Sheng Ko, Szu-Chun Hsu, Shang-Ju Wu, Woei Tsay, Hwei-Fang Tien
Journal: Blood (2015)
Budget impact analysis of <i>CYP2C19</i> genotyping to guide voriconazole prophylaxis in acute myeloid leukemia (AML).
Authors: Neil Thomas Mason, Gillian Casey Bell, Rod E. Quilitz, John N. Greene, Howard L. McLeod
Journal: Journal of Clinical Oncology (2015)

e17777 Background: During induction and salvage chemotherapy, AML patients (pts) suffer severe myelosuppression and immunosuppression, increasing the risk of fungal infection. Vorizonazole has been shown to be an effective antifungal prophylactic. However, CYP2C19 ultrarapid metabolizers (UMs) (*1/*17 or *17/*17) are at risk of receiving sub-prophylactic doses of voriconazole under standard dosing and may benefit from genotype-guided dosing and/or drug selection. The objective of this analysis is to assess the financial impact of genotype-guided voriconazole prophylaxis in AML. Methods: An Excel-based model was created to estimate the cost of treating a hypothetical cohort of 100 AML pts undergoing antifungal prophylaxis. The model compares 1) standard prophylactic dosing and 2) CYP2C19genotyping of all pts and therapeutic drug monitoring of UMs to guide voriconazole dosing. Model parameters were taken from published literature and 2014 CMS Laboratory Fee Schedule. Results: Genotype-guided dosing of voriconazole conservatively spares 2.3 patients per year from invasive fungal infections, saving a total of $41,467 or $415 per patient. Substituting Moffitt Cancer Center data, cost savings were within $100/patient, supporting the real world relevance of the findings. The primary driver of these savings is the avoidance of expensive antifungal treatment in patients succumbing to fungal infection. Conclusions: The model, based on robust national clinical and economic data, predicts that genotyping AML patients for CYP2C19*17 prior to induction or salvage chemotherapy is expected to be cost-saving while reducing the incidence of invasive fungal infections and improving patient care. These results may mitigate potential budgetary concerns, thereby reducing barriers to a test that can be clinically beneficial to AML patients. Model Parameter Base Case Incidence of fungal infection w/ prophylaxis 6.6% % of pts w/ undetectable voriconazole levels who are CYP2C19 UMs 56% Frequency of UMs in population 27.8% Cost of CYP2C19 genotyping $291.80 Cost of voriconazole blood Level $18.68 Marginal cost of treating fungal infection $30,952
Increased risk of overall and cardiovascular mortality after radical nephrectomy for renal cell carcinoma less than or equal to 2 cm.
Authors: M. Kates, G. M. Badalato, N. Sadeghi, M. S. Pitman, J. M. McKiernan
Journal: Journal of Clinical Oncology (2011)

4589 Background: For patients with T1a renal cell carcinoma (RCC), partial nephrectomy (PN) is now the standard of care, with similar cancer control and better long term kidney function than radical nephrectomy (RN). Recent reports have suggested that improved renal functional outcomes from PN may confer protection against some of the long-term cardiovascular risks associated with RN. Our objective was to utilize a large population-based registry to assess whether a difference in overall and cardiovascular survival may exist between RN and PN for RCC ≤2cm. Methods: From the SEER registry, we identified 4,216 patients with histologically confirmed RCC ≤2cm who were treated with either PN or RN. Patient and tumor characteristics were compared between the two patient groups, and a multivariate logistic regression was constructed to predict the odds of undergoing RN. Cardiovascular and overall survival were then compared between the two cohorts, adjusting for patients and tumor characteristics. Results: Overall, 55% (2,301) of patients underwent PN. The use of PN steadily increased over the study period, from 27% of all cases in 1998 to 66% in 2007. On average, patients undergoing PN were 2.5 years younger than patients treated with RN (56.4 vs. 58.9 years, P<0.001), and were more likely to be Caucasian and from the western or northeastern United States. Older age was the only independent predictor of receiving RN (OR: 1.02; 95% CI: 1.01-1.03). When controlling for patient characteristics and year of surgery, RN was associated with worse overall mortality (HR: 2.24; 95%CI 1.75-2.84) and cardiovascular mortality (HR: 2.53; 95%CI 1.51-4.23). Conclusions: RN is associated with worse overall and cardiovascular survival compared with PN in patients with localized RCC ≤2cm. These findings justify the widespread application of nephron-sparing techniques in the treatment of localized kidney cancer.
Use of radiofrequency ablation and stereotactic body radiotherapy for the treatment of hepatocellular carcinoma: An analysis of the SEER-Medicare database.
Authors: Mary Uan-Sian Feng, Vincent D. Marshall, Neehar Parikh
Journal: Journal of Clinical Oncology (2016)

463 Background: Hepatocellular carcinoma (HCC) is an increasingly common and highly morbid malignancy worldwide, including the US. For early stage patients ablative strategies are important potentially curative treatment options. Stereotactic body radiotherapy (SBRT) has emerged as a promising non-surgical ablative therapy, although it is technically demanding and its comparison with radiofrequency ablation (RFA) remains confined to a single institution retrospective review. We queried the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to assess RFA and SBRT use in the US. Methods: We identified patients greater than 65 years old who were diagnosed from 2004-11 with stage I or II HCC and treated with RFA or SBRT. Survival analysis was conducted using Kaplan-Meier curves and log rank test. Factors associated with overall survival (OS) and early ( ≤ 90 day) hospital admission post-treatment were identified using propensity score (PS) adjusted multivariate analysis. Results: 825 patients were identified, 747 treated with RFA and 78 SBRT. 22 pts received both treatments and were excluded from this analysis. The mean Charlson comorbidity index was 1.0±1.1. Median age was 74, range 66-90. Patients who received RFA were more likely to live in the West and have liver decompensation. Patients who received SBRT were more likely to be white and treated in the Midwest. After using PS matching there were 78 in each cohort. In these patients, mean overall survival (OS) was 2.25 and 2.04 yrs for RFA and SBRT, p = 0.06. Younger age, lack of liver decompensation, treatment in the West, and liver transplantation were associated with longer OS, HR 0.96, p = 0.05; HR 0.37, p = 0.002; HR 0.57, p = 0.04; HR 0.18, p = 0.008, respectively. 90 day hospitalization rates did not differ between treatments; only liver decompensation was predictive of hospitalization, OR 3.33, p = 0.032. Conclusions: In a national cohort of early stage HCC patients, treatment with RFA vs SBRT resulted in no significant difference in OS. SBRT appears to be a comparable ablative strategy to RFA in this population. This highlights the need for a randomized trial comparing these two modalities.