tbuckley/cabot-search huggingface dataset:
Training a survivorship care workforce with a novel web-based training curriculum.
Authors: Christine B. Weldon, Julia Rachel Trosman, Betty Roggenkamp, Stephanie Boecher, Patricia A. Robinson, Frank J. Penedo, Sofia F. Garcia, Teresa Lillis, Rosa Berardi, Javier Macias, James Gerhart, Shakuntala Shrestha, Pam Khosla, Shelly S. Lo, William Dale, Sheetal Mehta Kircher, Carol A. Rosenberg
Journal: Journal of Clinical Oncology (2017)

16 Background: The Commission on Cancer (CoC) standard 3.3 requires survivorship care plan (SCP) delivery to patients who complete treatment with curative intent. The Coleman Supportive Oncology Collaborative (CSOC) is focused on improving supportive and survivorship care through tools, processes and training of health professionals. Methods: A collaborative of 30+ clinicians (faculty) from 25 institutions (academic, community and safety net), funded by The Coleman Foundation, reviewed existing supportive oncology and survivorship care training for content, availability, and cost. They developed a unique fundamental survivorship care training curriculum. Results: Although SCP dissemination training is available, it lacks 1+ attributes: &lt;15 minutes to complete; online access; and CME/CEU credit at no cost. Utilizing existing guidelines and literature, the CSOC identified survivorship (9), palliative (11) and distress (6) modules supporting CoC requirements developed by 2+ expert faculty. Standardized modules include references and a slide presentation with links to additional training, guidelines and literature. Modules were reviewed by The National Comprehensive Cancer Network (NCCN) scientists, and edited. Audio was recorded by faculty. Tech assistance aligned video, graphics and narrated audio into a MP4 (movie) format. Survivorship modules include: Cancer Survivorship Defined, Patient Needs at Survivorship Visit and Coc Requirements for SCPs; Cancer Survivor Care; Survivorship Factors (Lifestyle &amp; Behavior, Psychosocial Challenges and Late and Long Term Effects); Cancer Survivors’ Screening and Prevention Strategies; and Genetic Testing for Patients, Families and Survivors. The NCCN Education Portal published the training (https://education.nccn.org/supportive-oncology-care) available publicly (w CME/CEU) for no charge. Conclusions: Various forms of survivorship training for health professionals exist, but they lack needed attributes. The CSOC developed 9 concise survivorship training modules for NCCN’s education portal, with CME/CEU credit available at no cost to participants. CSOC will collect feedback from training enrollees to determine effectiveness and future training needs.
EviQ cancer treatments online (www.eviQ.org.au): A widely used Australian resource.
Authors: Lydia PY. Loke, Robyn L. Ward, Jane Garrad, Kim M. Faulkner, Aimee Kim, Lisa H. King, Annie Zheng, Aisling Kelly, Patricia Ryan, Danielle Peterman, Julia Shingleton, Shelley A. Rushton, Karen P. Briscoe, Amanda Johnston, Andrew Last, Ian Kerridge, Sanchia Aranda, David Currow, Jeremy David Shapiro
Journal: Journal of Clinical Oncology (2014)

e17507 Background: eviQ is an Australian, web-based point-of-care information resource which aims to improve cancer outcomes by supporting evidence-based practice. Over the last decade, eviQ has provided access to more than 500 cancer treatment protocols in Medical/Radiation Oncology, Haematology and Cancer Genetics. Each chemotherapy protocol has a treatment schedule, administering instructions, side effects, key evidence and patient information. Protocols are developed in consultation with oncology, haematology and genetics experts nationally. Methods: A descriptive analysis of eviQ registrants and usage is reported. Registrant demographics and web log-files between October 2009 and December 2013 were analysed. Results: In this 4-year period, there were 34 615 registrants (92% Australian, 8% international) from 140 countries and > 9 million page views on the site. 45% registrants were nurses, 17% doctors and 13% pharmacists respectively. Registrants varied in oncology experience (35% < 2 years, 21%>10 years) and location (73% metropolitan, 27% regional/remote). There are 429 chemotherapy (245 medical oncology, 135 haematology, 29 superseded, 20 discontinued), 41 radiation oncology and 36 cancer genetics protocols on eviQ. Conclusions: eviQ is a widely used and increasingly popular web-based resource, aiding the delivery of evidence-based treatments to cancer patients regardless of geographical location. Total page views 2009-2013. Top 10 protocols Section Page views Safe handling hazardous drugs General 32 978 Docetaxel/cyclophosphamide Breast 32 355 5FU/epirubicin/cyclophosphamide part 1 FEC-D Breast 28 416 Folinic acid/5FU/oxaliplatin FOLFOX Colon 28 210 Doxorubicin/cyclophosphamide Breast 27 756 Carboplatin/gemcitabine Lung 26 373 Docetaxel part 2 FEC-D Breast 24 371 Rituximab/cyclophosphamide/ doxorubicin/vincristine/ prednisolone RCHOP21 Lymphoma 20 994 Paclitaxel weekly Breast 20 688 Carboplatin/paclitaxel Ovarian 20 483 Top viewed sections within a chemotherapy protocol Page views Patient information 310 685 Administering 51 465 Prescribing 15 897 Evidence 13 960 Monitoring 12 730 By year Page views 2009 No data 2010 1 300 753 2011 2 109 175 2012 2 570 737 2013 3 141 280 Total 9 121 945
Aberrant Patterns of Alternative Splicing Are Frequent Events and Harbor Prognostic Significance in Patients with Myelodysplastic Syndrome
Authors: Yi-Tsung Yang, Wen-Chien Chou, Yu-Chiao Chiu, Hsin-An Hou, Jih-Luh Tang, Ming Yao, Chi-Cheng Li, Shang-Yi Huang, Bor-Sheng Ko, Chien-Yuan Chen, Szu-Chun Hsu, Chien-Ting Lin, Shang-Ju Wu, Woei Tsay, Hwei-Fang Tien
Journal: Blood (2016)
Gastric linitis plastica: Have we moved beyond surgical palliation?
Authors: Katherine Woo, Carrie Luu, Khaldoun Almhanna, Domenico Coppola, Jose Mario Pimiento, Pamela Joy Hodul
Journal: Journal of Clinical Oncology (2017)

184 Background: Diffuse type gastric cancer (DGC), especially linitis plastica (LP), is associated with poor survival. Despite curative-intent surgical resection and improvement in perioperative therapy, doubt remains whether long term survival is possible in this aggressive disease. Methods: A retrospective review of the GC database at a comprehensive cancer center was reviewed from 2000 to 2016. Patient demographics, tumor characteristics, and treatment were evaluated. Patients with DGC were assessed. LP was defined as patients with DGC who had circumferential infiltration of the gastric wall for at least a third of the stomach length. Descriptive statistics were used to compare DGC and LP groups; survival was assessed by the Kaplan-Meier method. Results: Of 209 resected GC patients, 114 had diffuse histology; the majority were of the signet ring cell subtype. 38 (33.3%) had LP and 76 (66.7%) had DGC without linitis. LP patients were more likely to present at a later stage, with 27/38 patients (71%) with stage III and 4/38 patients (10.5%) with stage IV compared to 16/76 (21.1%) and 2/76 (2.6%) in the DGC group, respectively, p &lt; 0.001. All patients underwent gastric resection with some for palliative intent including 6 patients found to have metastatic disease on exploration. R0 resection was achieved in 26 patients (68.4%) with LP. Median OS was 31.5 months for the cohort and 13.6 months for LP patients (p &lt; 0.001); survival in LP patients did not improve with R0 resection. When survival was stratified by stage, patients with stage II LP still had a lower median OS than DGC (18.4 vs. 51.2 months, respectively, p = 0.015), though there was no survival differences in stage III and IV. Only half of patients with LP received preoperative chemotherapy or chemoradiation, perhaps due to need for surgical palliation of symptoms; receipt of preoperative therapy was not associated with survival in this subgroup. Conclusions: Gastric LP is associated with a poor prognosis. Early diagnosis and adherence to multimodal therapy may improve survival after surgical resection. Development of novel agents and improvement in neoadjuvant therapy is needed to improve outcomes in this aggressive disease.
Nationwide disparities in testicular cancer care delivery: Racial, ethnic, and economic markers of patient vulnerability.
Authors: Liam Connor Macleod, Shannon Cannon, Oliver Ko, Jonathan L. Wright, George Schade, Daniel W. Lin, John L. Gore, Atreya Dash
Journal: Journal of Clinical Oncology (2017)

421 Background: Testis cancer is often curable, yet early presentation is a key determinant of survival and treatment morbidity. Testis cancer affects the young, who have less consistent primary care access. This may impede timely mobilization of complex healthcare resources needed for cancer care. We analyze the National Cancer Database (NCDB) for disparity in disease-specific outcomes. Methods: The NCDB identified adult males with testicular tumors (2004-2013). Four outcomes were selected as markers of care delays: higher stage presentation (defined as stage III+), large primary lesion at diagnosis, time to orchiectomy and overall mortality. Key exposures included race/ethnicity, socioeconomic factors and insurance status. Outcomes were assessed with multivariable hazards regression (survival) or logistic regression (others). Results: 31,964 men were eligible. Seventeen percent had higher stage presentation, 29% had a large primary, and 9.9% had delayed orchiectomy and 4.8% died during follow up. All outcomes were associated with multiple markers of patient vulnerability at the p &lt; 0.001 level. The most consistent and greatest magnitude association was insurance status (e.g. for mortality Medicaid HR 1.9, 95% CI 1.6-2.3, uninsured HR 1.7, 95% CI 1.5-2.1, for large primary Medicaid OR 1.8, 95% CI 1.7-2.0, uninsured OR 2.1, 95% CI 2.0-2.3 [referent private payer]). In addition to markers of vulnerability, center case volume and travel burden were also associated with poor outcomes (p &lt; 0.001). Conclusions: We find association between severity of disease and markers of patient vulnerability. Insurance had the greatest magnitude and most consistent association with poor outcomes and is therefore a priority for quality improvement. As access to primary care is expanded for the testis cancer population with the Affordable Care Act, it will be important to assess whether gains in coverage translate to improvements in cancer outcomes.
A 36-month analysis of treatment patterns and outcomes in patients with lower-risk myelodysplastic syndromes from a prospective observational study.
Authors: Roger M. Lyons, Billie J. Marek, Carole S. Paley, Jason Esposito, Lawrence E. Garbo, Nicholas J. DiBella, Guillermo Garcia-Manero
Journal: Journal of Clinical Oncology (2013)

7122 Background: Many patients (pts) with lower-risk myelodysplastic syndromes (MDS) require chronic red blood cell transfusions for symptomatic anemia, which can result in iron overload. We present a 36-month interim analysis of a 5-year US registry that prospectively collected data on clinical events and survival in chelated vs non-chelated, transfused, lower-risk MDS pts. Methods: This multicenter, non-interventional registry enrolled 600 pts ≥18 yr old with lower-risk MDS (WHO, FAB, and/or IPSS risk stratification criteria) and transfusional iron overload (serum ferritin ≥1,000 ng/mL and/or ≥20 packed red blood cell units and/or ≥6 units every 12 wks). The chelated group included pts who had received any chelation. Results: Median age was 76 yr (range, 21–99), 57.8% were male, and risk status was 38.6% IPSS low risk and 61.4% IPSS INT-1 risk. Baseline demographics and IPSS risk status were similar between groups, although transfusion burden trended higher in chelated pts. As of April 30, 2012, 169 pts continued on the registry, and 431 discontinued (345 died, 57.5%; 61 lost to follow-up, 10.2%; and 25 other, 4.2%). In all, 264 pts (44%) received chelation therapy; 200 had ≥6 mos chelation. Overall survival (OS) and time to acute myeloid leukemia (AML) transformation were significantly longer, and the percentage of deaths was significantly lower, in chelated ≥6 mos vs non-chelated pts (P&lt;0.0001, P=0.011 [median not reached in either group], P=0.0002, respectively. AML transformations appeared to be lower in chelated ≥6 mos pts (not significant [NS]). At baseline in non-chelated vs chelated ≥6 mos pts, there was a higher prevalence of vascular, cardiac, endocrine, and ophthalmologic disorders; this trend continued at 36 mos. Most frequent causes of death were MDS/AML, cardiac events, and infection. Use of MDS therapy was lower among non-chelated pts (non-chelated, 88.4%; ≥6 mos chelation, 93.5%; NS). Conclusions: At 36 mos,chelated pts had significantly longer OS and time to AML, as well as significantly fewer deaths. Trends toward fewer AML transformations and fewer vascular, cardiac, endocrine, and ophthalmologic disorders were observed in chelated pts.
Cost-effectiveness and optimal diagnostic sequence of CT, MRI, and PET-CT in the management of colorectal liver metastases.
Authors: Vincent S. Yip, Brendan Colins, Mei Y. Koay, Joseph Tang, Hulya Wieshmann, Stephen W. Fenwick, Graeme John Poston, Hassan Zakria Malik
Journal: Journal of Clinical Oncology (2013)

4132 Background: CT, PET-CT and MRI play a role in the decision making process in managing colorectal liver metastases (CRLM). This study aimed to determine the optimal sequence of these investigations in order to reduce the rate of futile laparotomy and improve cost effectiveness of treatment. Methods: All patients referred to our specialist multidisciplinary team (sMDT) with CRLM were reviewed to investigate specific reason(s) for not offering potentially curative surgery. Clinical parameters were recorded for analysis. Three hypothetical scenarios were derived for cost-effectiveness analyses: 1) “up-front” with all imaging prior to sMDT, 2) “sequential”, with individual imaging following each sMDT, and 3) “hybrid” with PET-CT and MRI after review of the initial CT scan. Results: 644 consecutive patients were reviewed. Following assessment of initial CT, 165 patients (26%) were referred for palliative chemotherapy. After further evaluation by PET +/- MRI, 307 patients proceeded for potentially curative resection. Of those excluded from surgery, 48% were following PET-CT. Median overall survival (OS) for the resection and palliative groups were 46 and 14 months respectively (p&lt;0.001). Futile laparotomy rate was 5.5%.The optimum strategy of lowest average time to decision, and lowest average cost is the hybrid model. Cost-utility analyses demonstrated a saving of approx. £319 (USD$ 515) per patient compared to the other 2 models. Conclusions: Decision making regarding further imaging after initial CT scan for CRLM should be performed at the sMDT to minimise delays and maximise efficiency of resources allocation. Triple assessment with CT, PET and MRI and sMDT decision process may reduce risk of futile laparotomy. A hybrid model using PET and MRI following a sMDT discussion of the initial CT provides the most cost effective algorithm for the management of CRLM.
EXERCISE-BASED KNEE INJURY PREVENTION CLINICAL PRACTICE GUIDELINES
Authors: Amelia Arundale, Mario Bizzini, Airelle Giordano, Joseph Godges, Timothy Hewett, David Logerstedt, Bert Mandelbaum, David Scalzitti, Hollly Silvers-Granelli, Lynn Snyder-Mackler
Journal: British Journal of Sports Medicine (2017)

Background Knee injuries are prevalent in cutting, pivoting, and jumping sports. Studies have investigated the effects of exercise-based knee injury prevention programs, however no clinical practice guidelines (CPG) exist. Objective 1) Review the evidence for exercise-based knee injury prevention programs, 2) identify if there are exercise-based knee injury prevention programs that are effective for particular groups of athletes, 3) explore the evidence for dosage and delivery of exercise-based knee injury prevention programs, 4) provide information on how exercise-based knee injury prevention should be implemented. Design Systematic review for CPG development. Setting Multiple. Patients (or Participants) Healthy, active individuals, particularly athletes participating in cutting, pivoting, and jumping sports. Interventions (or Assessment of Risk Factors) A systematic review of literature was performed via PubMed, Scopus, SportDiscus, CINAHL, and the Cochrane databases for relevant articles addressing the effects of an exercise-based knee injury prevention program. The final search was performed in April, 2016 to identify all articles published prior to that point. Main Outcome Measurements The effects and outcomes of exercise-based knee injury prevention programs. Results Thirty-seven studies met the inclusion criteria for this CPG. Exercise-based knee injury prevention programs have a low implementation cost and large relative risk reductions. Clinicians should implement an exercise-based knee injury prevention program for all athletes involved in cutting and pivoting type sports to reduce the number of significant knee injuries. The program should be implemented two to three times per week in the preseason and one to three times per week in the competitive season. It should consist of a combination of plyometric training, strength and power exercises, balance and dynamic stabilization training, core strengthening, technique training, and/or sports-specific drills. Conclusions This CPG will provide evidence based guidance for clinicians in choosing and implementing exercise-based knee injury prevention programs appropriate for the athlete(s) they work with.
Weekly paclitaxel (P) with concurrent external beam radiation (EBRT) and androgen deprivation therapy (ADT) in high-risk prostate cancer (PC) patients with or without prior prostatectomy (RP)
Authors: Y. Wu, Y. Kwok, A. Mirmiran, O. Goloubeva, H. Mannuel, N. Dawson, P. Amin, A. Hussain
Journal: Journal of Clinical Oncology (2009)

5122 Background: EBRT with ADT (4 mos to 2–3 yrs) is standard treatment for high risk PC. In this trial, we evaluated weekly P given concurrently with EBRT and ADT in high risk PC. Methods: For pts undergoing RP, high risk was defined as: pT3 and/or pN+, M0, and/or rising PSA (&gt; 0.5) post RP. For pts not undergoing RP (i.e. locally advanced PC [LAPC]) high risk included: cT2b-4N0, N+, M0; bGS 8–10; bGS ≥ 7 + PSA ≥ 10 but ≤ 150; and/or PSA ≥ 20 but ≤ 150. Treatment included ADT (4 or 24 mos, preplanned based on clinical presentation), P (40, 50, or 60 mg/m2/wk) x 7 with EBRT, and whole pelvis EBRT 45 Gy with 19.8 Gy boost (total 64.8 Gy) to prostate bed in RP pts and 25.2 Gy boost (total 70.2 Gy) to prostate in LAPC pts. Results: Between October 1999 and December 2006, 59 pts (29 W, 28 AA) were enrolled (n = 29 LAPC, n = 30 RP); median age 67 yrs, median PSA at trial entry 5.9 (27.5 LAPC, 1.6 RP), median GS 8. Pts were enrolled at different weekly doses of P: 40 mg/m2 n = 10 pts; 50 mg/m2 n = 31 pts; 60 mg/m2 n = 18 pts. ADT for 4 mos was given in 29 pts and for 24 mos in 30 pts. At 40 mg/m2 67/70 (96%), 50 mg/m2 202/217 (93%), and 60 mg/m2 98/126 (78%) planned doses of P were given. There were no acute grade 4 toxicities. Most common grade 3 toxicities were diarrhea 15%, urinary urgency or incontinence 10%, tenesmus 5%, and leukopenia 3%. Median duration of f/u was 75.3 mos, OS 78%, biochemical progression 24/59 (41%) pts, clinical progression 11/59 (19%) pts. Time to biochemical progression was similar between RP vs. LAPC (p = 0.17), between ADT 4 mos vs. 24 mos (p = 0.61), and between AA vs. W (p = 0.54). Conclusions: This trial establishes the feasibility of tri-modality therapy with ADT, EBRT and weekly paclitaxel in high risk PC, both in RP pts and in LAPC pts with intact prostate glands. The maximum tolerated dose of paclitaxel is 50 mg/m2 /wk when given weekly with concurrent radiation to the pelvis and hormone ablation. No significant financial relationships to disclose.
Targeted DNA and RNA sequencing of paired urothelial and squamous bladder cancers to reveal discordant genomic and transcriptomic events and unique therapeutic opportunities.
Authors: Daniel H. Hovelson, Lorena Lazo De La Vega, Andrew McDaniel, Aaron Udager, Rohit Mehra, Ganesh S. Palapattu, Alon Z. Weizer, Todd Matthew Morgan, Jeffrey Scott Montgomery, Scott A. Tomlins
Journal: Journal of Clinical Oncology (2017)

296 Background: Expression-based molecular subtypes thought to be intrinsic in bladder cancer have been widely reported, carrying important potential clinical treatment implications. Histologically, bladder cancers are also heterogeneous diseases, with a large portion of urothelial carcinomas exhibiting divergent differentiation. Previous subtyping efforts have been carried out using predominantly fresh frozen tissue samples, potentially obscuring this known differentiation heterogeneity. Methods: Here we performed targeted multiplexed, amplicon-based DNA and RNA sequencing on 100 formalin-fixed paraffin-embedded (FFPE) bladder cancer samples (including 12 paired urothelial / squamous lesions). High-confidence somatic point mutations, short insertions/deletions (indels), and copy number alterations were detected using the DNA component of the Oncomine Comprehensive Assay (OCP). Targeted RNA sequencing was carried out using a custom Ampliseq panel comprised of 8 housekeeping genes and 103 target genes assessing major transcriptional programs as identified from publically available data. Results: By DNA analysis, we observe frequent TP53 (35%) and activating hotspot PIK3CA (23%) somatic mutations across the cohort, as well as targetable high-level (log-2 copy number ratio &gt; = 1.5) focal amplifications of ERBB2 (3%) or EGFR (3%) in a subset of samples. We report a novel approach for detecting sub-gene copy-number alterations, and confirm several detectable multi-exon losses using whole transcriptome RNA sequencing. Pairing targeted RNA expression analysis with DNA-based alterations, we show high level expression of EGFR and ERBB2 in focally-amplified samples. Most importantly, we show that despite identical prioritized somatic genomic alterations, we observe divergent expression-based profiles in 3 of 12 (25%) paired urothelial and squamous samples. Conclusions: Taken together, these results highlight the importance of molecular heterogeneity in bladder cancer and suggest important considerations for using existing expression-based clustering approaches to guide clinical treatment decisions.
β2 integrins rather than β1 integrins mediate Alternaria-induced group 2 innate lymphoid cell trafficking to the lung
Authors: Maya R. Karta, Peter S. Rosenthal, Andrew Beppu, Christine Y. Vuong, Marina Miller, Sudipta Das, Richard C. Kurten, Taylor A. Doherty, David H. Broide
Journal: Journal of Allergy and Clinical Immunology (2017)