tbuckley/cabot-search huggingface dataset:
Rural versus urban differences among patients (pts) with hormone-receptor positive (HR+) breast cancer (BC) and a 21-gene assay recurrence score (RS).
Authors: Molly Andreason, Chong Zhang, Adedayo A. Onitilo, John A. Charlson, Wendy M. Ledesma, Kimberly Ridolfi, KyungMann Kim, Kari Braun Wisinski, Torie L Champeny, Jessica Marie Engel, Robert Millholland, James T Dean, Amye Tevaarwerk
Journal: Journal of Clinical Oncology (2012)

6063 Background: Differences in BC outcomes have been noted between rural and urban women. The influence of tumor biology vs treatment factors as the driver of these differences remains unclear. The Oncotype Dx 21-gene assay RS predicts distant recurrence risk for HR+BC; a RS&gt;18 indicates possible chemotherapy benefit. We assessed rural vs urban differences in RS and therapies received (endocrine therapy; chemotherapy for RS&gt;18). Methods: Retrospective chart review was conducted on BC pts diagnosed 2005–2010 with a 21-gene assay RS. Stage, grade, medications and receptor status were abstracted; RS information was obtained from Genomic Health. Rural-Urban Commuting Area (RUCA) codes defined rural vs urban status. Comparisons between rural vs urban pts were made using two-sample tests, chi-square or Fisher’s exact test for discrete data such as RS (≤ 18 vs &gt; 18), stage and ER status. T- or Wilcoxon rank sum test were used for continuous data (RS 0-100 and age.) All tests were at a two-sided significance level of 0.05. Results: Of 495pts with RS, 488 had RUCA codes (91% white, 61% postmenopausal). For rural vs urban pts, mean RS was 18 vs 19, p=0.15. The table shows univariate analysis for other predictors. For treatment, 321/354 (97%) rural vs 118/134 (94%) urban pts started endocrine therapy (p=0.2). For RS&gt;18, 17/55 (31%) rural vs 83/165 (50%) urban pts received chemotherapy (p=0.02, Chi-square test). Conclusions: Rural pts did not have significantly different RS compared with urban pts, but received significantly less chemotherapy for RS&gt;18. This suggests that for HR+ BC, rural vs urban discrepancies may be explained in part by treatment factors. We suggest prospective comparison or confirmation in another cohort. [Table: see text]
Interim analysis of NCT02458716: Feasibility of cytoreductive prostatectomy in men newly diagnosed with metastatic prostate cancer.
Authors: Bertram E. Yuh, Young Suk Kwon, Brian Shinder, Sinae Kim, Nara Lee, Nora Ruel, Isaac Yi Kim
Journal: Journal of Clinical Oncology (2017)

e578 Background: Emerging evidence has suggested that local tumor control may enhance the effect of subsequent therapies in patients with metastatic prostate cancer. However, little is known about surgical safety of cytoreductive prostatectomy (CRP). In this study, we report the first interim analysis of a phase I study evaluating the safety and feasibility of CRP. Methods: The study was approved by the IRB and activated in June, 2015. Individuals with newly diagnosed clinical metastatic prostate cancer to lymph node or bones (cT1-3N1M0 or cT1-3N0M1a-b) were recruited. Following surgery, all patients received androgen deprivation therapy. The primary endpoint is the major complication rate (Clavien ≥ III). The secondary outcome measures are the time to PSA nadir and rate of incontinence (pad-free). Results: A total of 20 men from two institutions have been enrolled and undergone CRP. Overall, 6 (35.3%) perioperative complications were observed, including 1 major complication (Clavien ≥ III). There were 5 minor complications, including deep venous thrombus (Clavien II), postoperative ileus (Clavien II), and 3 cases of urethral anastomotic leaks (Clavien I). In men with a minimum of 6 month follow-up, PSA &lt; 0.2 ng/ml in 63.6% of men and 50% of men were pad free. Conclusions: CRP is surgically feasible in carefully selected patients. However, early incontinence rate is high. Further studies are warranted to further define long-term complications and verify the oncologic benefits of the surgery. Clinical trial information: NCT02458716. [Table: see text]
Losing sleep over cancer: Relationships with negative affect, blood pressure, and disease-free interval among women with metastatic breast cancer.
Authors: Arianna Aldridge Gerry, Oxana Palesh, Michelle Rissling, Jamie M. Zeitzer, Firdaus S. Dhabhar, Booil Jo, Eric Neri, Bita Nouriani, David Spiegel
Journal: Journal of Clinical Oncology (2013)

9504 Background: Few studies have examined how polysomnographic (PSG) measured sleep disturbance is associated with negative affect and markers of health status among women with metastatic breast cancer (MBC). Methods: 91 women with MBC (aged 57.9 ± 7.3 yrs) and Karnofsky ratings of at least 70 were recruited. We used latent profile analysis to identify distinct patterns of in-lab sleep disturbance. These profiles were used to predict affect (measured by PANAS), blood pressure, and disease progression (disease free months before metastases). Results: Two classes of women emerged and were distinguished as “severely disturbed sleepers” (n = 24) or “mildly disturbed sleepers” (n = 67). Severely disturbed sleepers had worse quality of sleep (e.g., sleep efficiency=54% vs. 69%) and spent significantly and less time in slow wave and REM sleep. One-way ANOVA revealed that severely disturbed sleepers reported significantly more negative affect (p &lt; .05). Specifically, they reported greater negative affect in the afternoon (2-3pm) and evening (6:30-7pm) prior to lab-sleep, and the morning (9:30-10:30am) and afternoon (12:30pm and 2pm) following lab-sleep. In addition, severely disturbed sleepers had higher systolic blood pressure (M=140 vs. M=124, p = .001) measured the afternoon prior to lab-sleep. Strikingly, women with severely disturbed sleep had significantly shorter disease free intervals (49 months vs. 80 months, p &lt; .05), and worse Karnofsky ratings (p &lt; .05) indicating worse medical prognosis than mildly disturbed sleepers. Conclusions: Women with MBC and severely disturbed sleep experienced more negative affect prior to and following a poor night’s sleep. In addition, they exhibited hypertension and accelerated cancer progression relative to women with mild sleep disruption. These detrimental changes may be an indication of the effects of chronic sleep disruption. Understanding the role of daily negative affect in conjunction with physiological markers of disease progression may inform better treatment methods for women with MBC experiencing severe sleep disruption.
Phase II Study of Temsirolimus and Lenalidomide in Patients with Relapsed and Refractory Lymphomas: Final Analysis of NCI 8309
Authors: Justin Kline, Aaron P. Rapoport, Adam M. Petrich, Kenneth S. Cohen, Sachdev P. Thomas, Sreenivasa Nattam, Krishna Rao, Bethany Sleckman, Walter Stadler, Theodore Karrison, Sonali M. Smith
Journal: Blood (2016)
Medicare cancer screening in the context of clinical guidelines: 2000-2012.
Authors: Sean Maroongroge, James B. Yu
Journal: Journal of Clinical Oncology (2015)

e17579 Background: Cancer screening is a ubiquitous and controversial public health issue, particularly in the elderly population. Despite the plethora of evidence-based guidelines for screening, it is unclear how cancer screening has changed in the Medicare population over time. We analyzed Medicare Part B Fee-For-Service (FFS) claims from 2000-2012 to compare trends in cancer screening modalities over time in the context of prominent clinical guidelines. Methods: We analyzed service counts for each CPT code in the Medicare Part B National Summary Data File in conjunction with beneficiary counts from the Medicare Enrollment Reports to determine the annual screening rates for breast, colorectal, and prostate cancer in the Medicare Part B population. We further summarized relevant clinical guidelines from the American Cancer Society, the United States Preventative Services Task Force, and specialty societies from 2000-2012. Results: 231,416,732 screening tests were analyzed from 2000-2012, representing an average of 436.8 tests per 1000 beneficiaries per year. Mammography rates declined 7.4% overall, with digital mammography extensively replacing film. Colorectal cancer screening rates declined overall. As a percentage of all CRC screening tests, colonoscopy grew from 32% to 71% over the observed period. Prostate screening rates increased 16% from 2000-2007, and then declined to 7% less than its 2000 rate by 2012. Guideline recommendations for greater screening and Medicare coverage expansions occurred early in the study period, while guidelines recommended less screening and increased shared decision-making later in the period. Conclusions: Screening rates for the Medicare FFS population peaked and then declined from 2000-2012, which matches trends in the aggressiveness of screening guidelines from prominent organizations. Although prior analyses have attributed part of the decline in cancer screening to the economic recession, our results suggest that guidelines and the major studies informing them have also played a role. Further research should be performed on the role of multiple, conflicting guidelines and patient preferences in the observed trends.
Rest and treatment/rehabilitation following sport-related concussion: a systematic review
Authors: Kathryn J Schneider, John J Leddy, Kevin M Guskiewicz, Tad Seifert, Michael McCrea, Noah D Silverberg, Nina Feddermann-Demont, Grant L Iverson, Alix Hayden, Michael Makdissi
Journal: British Journal of Sports Medicine (2017)

<h3>Aim or objective</h3> The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC). <h3>Design</h3> Systematic review. <h3>Data sources</h3> MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically. <h3>Eligibility criteria for selecting studies</h3> Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded. <h3>Results</h3> Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care. <h3>Summary/conclusions</h3> A brief period (24–48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit. <h3>Systematic review registration</h3> PROSPERO 2016:CRD42016039570
Phase I study of neoadjuvant chemotherapy with xeloda and oxaliplatin (G-XELOX) for locally advanced gastric cancer.
Authors: Hironaga Satake, Masato Kondo, Takeshi Kotake, Yoshihiro Okita, Takatsugu Ogata, Yukimasa Hatachi, Hisateru Yasui, Satoshi Kaihara, Masahito Kotaka, Takeshi Kato, Akihito Tsuji
Journal: Journal of Clinical Oncology (2017)

149 Background: Prognosis for locally advanced gastric cancer, such as clinical T4 disease, bulky nodal involvement, type 4 and large type 3 gastric cancer, remains unsatisfactory, even with D2 gastrectomy followed by adjuvant chemotherapy. Neoadjuvant chemotherapy is a promising approach, and combination chemotherapy with Xeloda and oxaliplatin (G-XELOX) is recognized as a potentially promising regimen for gastric cancer. However, the use of neoadjuvant chemotherapy consisting of G-XELOX for locally advanced gastric cancer has not been reported. The aim of this study was to evaluate the incidence of dose limiting toxicities (DLTs) during the neoadjuvant chemotherapy and to determine the maximum tolerated dose (MTD) and recommended dose of preoperative chemotherapy combined with oxaliplatin with a fixed Xeloda dose for locally advanced gastric cancer. Methods: Patients received two cycles of neoadjuvant chemotherapy with oxaliplatin on day 1, as well as Xeloda (2000 mg/m 2 /day, b.i.d.) for 14 days, repeatedly every 3 weeks. They then underwent gastrectomy with curative D2/3 lymph-node dissection followed by adjuvant S-1 (80 mg/m 2 /day, b.i.d.) for one year. A decrease of oxaliplatin dose was planned (starting at level 1, 130 mg/m 2 ). Results: Six patients (5 male, 1 female) with a median age of 72 (range 68-79) were enrolled. MTD was not reached at level 1. Oxaliplatin 130 mg/m 2 in combination with Xeloda 2000 mg/m 2 /day, b.i.d. could be administered with acceptable toxicity. No treatment-related death was observed. Most frequent drug-related AEs during the neoadjuvant chemotherapy period were G1 anemia, G1/2 thrombocytopenia and G1 peripheral neuropathy. One patient refused surgical resection, therefore five received resection with curative intent. Of the five patients, all achieved a pathological downstaging after neoadjuvant G-XELOX therapy. The incidence of operative morbidity was tolerable. Conclusions: Neoadjuvant chemotherapy with G-XELOX regimen was feasible by patients with locally advanced gastric cancer. Clinical trial information: UMIN000015950.
Conley Scale (CS) compared to Timed Up and Go Test (TUGT) in a Fall Prevention and Detection Project (FAPRE).
Authors: Elvira De Marino, Elvira De Marino, Sara Lattuada, Renata Torazzo, Elisabetta Rugge, Teresa Posca, Alessandra Di Cola
Journal: Journal of Clinical Oncology (2015)

e20741 Background: falling down is a great danger for patients (PTS) with cancer as it often causes serious injury; furthermore it increases hospital costs. Fall prevention and timely detection is a new challenge in clinical practice.We implemented the FAPRE project to identify potential Risk Fallers (RF) and to compare the CS and TUGT tests Methods: we performed CS and TUGT in an ambulatory room equipped with pressure sensors on floor (intelligent carpet), webcam, home gateway, WI-FI router and smartphone. RF were identified by CS score > 2 and TUGT > 10. All PTS signed informed consent Results: we enrolled 100 PTS since January to April 2014, performance status ECOG < 2, mean age 73yrs, range 34-87, males 51, females 49. There were 11 Hematologic (H) and 89 Solid Tumors (ST), 46/89 ST had metastatic disease, 98/100 had chemotherapy, 2 palliative care. Six PTS had brain metastasis, 9 bone ; 33 had previous pathological fractures. Comorbidity: 14 diabetes and 33 hypertension, 10 were taking psychoactive drugs, 22 opiate and 5 both. All PTS underwent CS and TUGT and were evaluable; 9 fell down after the two tests. We considered RF all PTS with CS > = 2 and TUGT > = 11
Quality of life in a multicenter phase II trial of metastasectomy for intra- and extra-hepatic metastases from colorectal adenocarcinoma.
Authors: Alice Chia-chi Wei, Pablo Emilio Serrano Aybar, Sean P. Cleary, Natalie G. Coburn, Paul David Greig, Calvin Law, Carol-anne Moulton, Steven Gallinger
Journal: Journal of Clinical Oncology (2013)

e14573 Background: The combination of intra- and extra-hepatic metastases (IHM and EHM) from colorectal cancer (CRC) has traditionally been considered a contraindication for surgery. Currently there is a growing interest in resecting IHM and EHM. The purpose of this study was to evaluate the health related quality of life (HRQoL) of patients with IHM and EHM from CRC undergoing complete metastasectomy. Methods: Participants with any number of CRC IHM and up to 3 foci of EHM, resectable with RO intent were eligible for the HRQoL component of a Phase-II multi-institutional trial. The effects of therapy on HRQoL were evaluated using: EORTC-QLQ C30, EORTC-LMC21 and FACT-HEP at baseline, prior to surgery and at 4, 8 and 12 months following complete metastasectomy. Results were compared to baseline. &gt;10% mean score change was considered a minimally important clinical difference (MICD). Results: Twenty-five participants were enrolled with a median age: 57 (range: 32-84) years. Protocol surgery was completed in 18/25 (72%) including 11/25 (44%) staged resections. Perioperative morbidity and mortality was 11/25 (44%) and 1/25 (4%), respectively. Median disease-free survival was 6 (range: 0-17) months. 22/25, 88% participants underwent perioperative chemotherapy. EORTC-QLQ C30 Global-HRQoL remained statistically and clinically unchanged compared to baseline at 4 and 8 months but had a MCID decrease at 12 months (mean score change: 15.3) that was not statistically significant. This was associated with a significant decrease in social and role functioning and an increase in fatigue, pain and dyspnea. FACT-Hep score was statistically lower at 4 months post surgery, without reaching a MICD. There was no difference in any of the subscales analyzed in regards to sex, age or the presence of peri-operative complications. Conclusions: Aggressive metastasectomy of multi-site CRC is feasible and safe. Despite disease recurrence in the majority of patients there was no significant deterioration of Global HRQoL as a result of treatment. There was a transient effect on symptoms including fatigue, pain dyspnea and role functioning, which improved by 12 months. Clinical trial information: NCT00606398.
More than metastasis: MACC1 as a glucose metabolic regulator in gastric cancer.
Authors: Li Lin, Hui Huang, Wenjun Liao, Huanrong Ma, Jing Liu, Lin Wang, Na Huang, Yulin Liao, Wangjun Liao
Journal: Journal of Clinical Oncology (2014)

e15054 Background: Cancer cells mainly metabolize by glycolysis (the Warburg effect) and are better adapted to resist metabolic stress. Metastasis-associated in colon cancer-1 (MACC1) is an oncogene promoting gastric cancer (GC) growth and metastasis, and its expression positively correlates with GC progression. However, it is unknown why MACC1 elevates with GC progression and what is its role in cancer metabolism. Methods: MACC1 mRNA and protein expression was evaluated under glucose deprivation-induced metabolic stress in human GC cell lines. Then, immunohistochemistry analysis on GC patients was carried out, and experiments on athymic mouse xenografts as well as MACC1-overexpression or -silenced GC cells were performed to find out how MACC1 modulates the Warburg effect. Finally, mitochondria function and GC cell survival were analyzed in order to figure out how MACC1 influences GC cells under metabolic stress. Results: MACC1 expression was significantly upregulated via AMPK signaling in response to glucose deprivation-induced metabolic stress. In patients, MACC1 expression was higher in advanced stage GC. MACC1 expression was proved positively correlate with 18F-deoxyglucose SUVmax in the patients, and MACC1 enhanced 18F-deoxyglucose uptake in GC cells and the xenografts. The underlying mechanism was that MACC1 promoted the Warburg effect by upregulating the activities and expressions of a series of glycolytic enzymes, including hexokinase, pyruvate dehydrogenase kinase and lactate dehydrogenase, in GC cells. This metabolic shift enhanced cell viability and resistance to apoptosis by facilitating ATP generation, reducing the reactive oxygen species production and stabilizing the mitochondrial membrane potential. In contrast, MACC1-silenced or the Warburg effect-blocked GC cells were more vulnerable to metabolic stress. Conclusions: Metabolic stress is one of the mechanisms that elevate MACC1 expression in GC, and MACC1 upregulation ensures GC cell survival against metabolic stress by facilitating the Warburg effect.
Phase I trial of docetaxel (D) plus samarium<sup>153</sup> (Sm <sup>153</sup>) in patients (pts) with hormone refractory prostate cancer (HRPC)
Authors: V. J. Sinibaldi, M. A. Carducci, T. DeWeese, J. Weber, R. Drew, S. Moore-Cooper, S. Denmeade, R. Pili, J. Walczak, E. Sugar, M. A. Eisenberger
Journal: Journal of Clinical Oncology (2007)

15547 Background: Bone targeted approaches hold great promise for improving outcomes in HRPC. Docetaxel (D) and samarium 153 (Sm 153 ) have individually demonstrated a clinical benefit and preclinical data strongly support biological synergism in HRPC. Preclinical data suggests that 24 hour after a dose of D, there is maximum G 2 M arrest. This results in the accumulation of cells in the most radiosensitive phase of the cell cycle. This phase I trial was designed to evaluate toxicity and preliminary efficacy of combined D and Sm 153 administered sequentially in advanced HRPC. Methods: HRPC pts progressing after anti-androgen withdrawal; = 2 prior chemotherapy regimens; acceptable bone marrow, renal and hepatic function were eligible. Planned D treatment in 4 cohorts (N=3/cohort) includes: Cohort 1: D 50mg/m 2 IV on days 1, 22, 91, and 112; cohort 2: D 75mg/m 2 IV on days 1 and 22 followed by 50mg/m 2 IV on days 91 and 112; cohort 3: D 75mg/m 2 IV on days 1 and 22 followed by 75mg/m 2 IV on days 91 and 112; cohort 4: D 75 mg/m 2 IV on days 1, 22, 42, 91, 112, and 133. Sm 153 (1.0 mi/Kg) is administered IV days 2 and 92 of each cycle. Cycles are repeated Q 12 wks (max 2 cycles). The endpoint for this trial is dose limiting toxicity and maximal tolerated dose. Results: From 5/11/05 - 1/7/07 ten pts were enrolled. Median: age 69.5 yrs (range 58–76), ECOG performance status 1 (range 0–1), baseline PSA 76.65 ng/ml (range 9.6–1064 ng/ml ), prior hormonal manipulations 3 (range1–6). Three pts had prior taxotere and 3 pts had prior palliative RT. All had bone metastases and 2 also had soft tissue disease. Five pts completed 2 cycles of treatment as planned. Five pts had 1 cycle (one pt is on treatment, 3 pts had PD and 1 had prolonged grade 1 thrombocytopenia =3 wks). Nine of 10 pts had reversible grade 3 / 4 neutropenia (1 pt had reversible episode of neutropenia with fever). Seven of 7 symptomatic pts had improvement in pain. Four of 10 of pts had a 50 % decline in PSA level lasting = 4 weeks; no soft tissue disease responses. Conclusions: Our preliminary data suggest that Q 3 wk D and Q 3 month Sm 153 may be administered simultaneously at full doses in extensively pretreated HRPC pts, with acceptable toxicity and significant activity. This study is supported by a grant from sanofi- aventis and Sm 153 is provided by Cytogen. No significant financial relationships to disclose.