tbuckley/cabot-search huggingface dataset:
TCT-65 High-Definition Micro-Optical Coherence Tomography for Endothelial Cell Visualization in the Coronary Arteries
Authors: Kensuke Nishimiya, Biwei Yin, Zhonglie Piao, Hany Osman, Jiheun Ryu, Hui Min Leung, Gargi Sharma, Joseph Gardecki, Guillermo Tearney
Journal: Journal of the American College of Cardiology (2018)
A novel integrative medicine educational program for radiation oncology patients: Feasibility and patient-reported outcomes.
Authors: Kareem Fakhoury, Mark J. Stavas
Journal: Journal of Clinical Oncology (2017)

e21629 Background: Integrative medicine uses complementary health approaches (CHAs) to improve wellness. Many patients use CHAs to manage acute and late toxicities of radiotherapy (RT). However, few patients disclose CHA use to their radiation oncologist. Patients acknowledge a need for improved education on CHAs and have shown interest in attending a hospital-based educational program. Here we assess the feasibility of implementing such a program and the associated patient-reported outcomes, including intention to disclose CHA use and patient satisfaction. Methods: A structured curriculum was designed as a collaboration between an academic institution’s integrative medicine center and radiation oncology department. Four one-hour lectures covered topics of meditation, yoga, massage therapy, and nutrition, each led by a topic expert. Lectures included didactic and interactive components. Individuals over age 18 and actively receiving RT were recruited by nurses, radiation therapists, and a designated study team member in the waiting room. Pre- and post-lecture surveys were used to assess patient characteristics, CHA use disclosure, satisfaction, and qualitative feedback. Results: 43 surveys were completed. The patient sample was 47% female, median age 63. The majority had breast or prostate cancer (60%). Of about 100 patients receiving RT each day, 5 to 7 attended each lecture. 36% of participants had disclosed their use of CHAs before the lecture; 67% intended to disclose their use after the lecture. 98% felt the lecture enhanced their patient experience with a median agreement of 8 on a 9-point Likert scale. Conclusions: This program is the first to increase satisfaction and CHA use disclosure. Patients expressed interest in learning simple, convenient, and effective tools to abate acute toxicities, rather than focus on chronic symptoms of remission and recovery. However, patient recruitment could not be effectively integrated into the clinical workflow. Attendance was limited by timing, transportation, and performance status. To increase reach and minimize cost, we suggest investigating a program that is integrated into the clinic visit or available in an online format.
Effects of enzalutamide and abiraterone on patients physical, social and emotional function: Result of a prospective patients reported outcome tool.
Authors: Prantik Das, Karen Simmonds, Akram Ali, Lesley Mckenna, Prabir R Chakraborti
Journal: Journal of Clinical Oncology (2018)

e18857 Background: Enzalutamide (ENZ) and abiraterone acetate plus prednisone (AA+P) are effective treatment options for metastatic castration-resistant prostate cancer (mCRPC) and both may impair patient’s quality of life (QOL). Methods: A tool has designed for Health Care Professionals to track patients’ experience of treatment for mCRPC with a focus on QOL aspects, and to gain real insights into patient’s wellbeing over time. A set of questionnaires has been developed in-house, influenced by existing recognised tools, such as FACT-P and PHQ-9. This questionnaire named as Patient reported outcome tool. They primarily relate to physical, emotional and social aspect of quality of life of patients. Each category has 4 questions. The questions are quite generic and they are not leading and allow the patient to apply them to what’s important in their lives. Answers are on a scale of 0-10 .The purpose of the questionnaire is to assess a balance of physical, cognitive and independence related aspects of their life over the course of their treatment. All patients are asked to complete the baseline questionnaire and then in every clinical visit in 4 weekly interval. Results: Data were collected prospectively of mCRPC patients who had received AA+P or ENZ from December 2016 to January 2017. Total 60 patients were included, 34 received AA+P and 26 were on ENZ. There was a higher rate of significant worsening for the physical well-being (PWB) subscale for Enzalutamide versus Abiraterone +P. Higher number of patients reported worsening in sleep pattern while on AA+P. Problem with eating were more pronounced on ENZ arm. There is no obvious difference of SWB score on both treatments though some improvement in interactions with friends in AA+P group. Emotionally, there were significant worsening of the level of sadness, fear of death, forming thought and slowness of thinking while on ENZ in comparison with AA+P. Conclusions: Our data suggest that there are marked differences between AA + P vs ENZA and their effects on physical and emotional wellbeing. Patients reported more depression symptoms and a clear trend towards an increase in cognitive impairment with ENZ as compared to AA+P.
Identification of ideal strategy of cervical cancer screening in Japan based on Fukui cervical cancer screening study.
Authors: Tetsuji Kurokawa, Akiko Shinagawa, Yoko Chino, Motohiro Kobayashi, Yoshio Yoshida
Journal: Journal of Clinical Oncology (2017)

e17025 Background:The estimated age-standardized incidence rate for cervical cancer is higher in Japan than in North America and the UK. It is important to improve cancer screening. The introduction of HPV testing with cytology for triage of those that test positive for cervical cancer screening has been challenging. The Fukui Cervical Cancer Screening (FCCS) study was designed to determine the best cervical cancer screening method in the Japanese population. We performed a subanalysis using baseline data of FCCS study to determine the performance of cytology, the human papillomavirus (HPV) testing and cotesting with cytology and HPV testing, and to evaluate whether the stratification of HPV16, HPV18, and 12 other hrHPV types appropriately balances risks and harms in the Japanese cancer screening population. Methods:The study enrolled 7,584 women aged 25 years or older undergoing routine screening. All women underwent liquid-based cytology (LBC) and cobas HPV testing. Women with abnormal cytology regardless of the HPV status, women with positive hrHPV results regardless of cytology results, and women randomly selected from among those with normal cytology and negative hrHPV results were referred for colposcopy. Results:The prevalence of hrHPV, HPV16, and HPV18 was 6.8%, 1.2%, and 0.5%, respectively. The estimated sensitivities for cervical intraepithelial neoplasia (CIN) 2 or worse for cytology, HPV testing, and cotesting with cytology and HPV testing were 71%, 92%, and 100%, respectively. The estimated positive predictive values for cytology, HPV testing, and cotesting with cytology and HPV testing were 33%, 21% and 21%, respectively. Using a strategy whereby those with abnormal cytology or positive HPV16 genotype undergo colposcopy and biopsy results in a sensitivity of 85% and a positive predictive value of 33%. This strategy results in improved sensitivity while at the same time maintains the positive predictive value compared to screening with cytology alone. Conclusions:Baseline data from the FCCS study suggests that strategy of using colposcopy for women with abnormal cytology and/or HPV16 positivity appropriately balances risks and harms for Japanese women. Clinical trial information: UMIN000025977.
Socioeconomic resources and survival in patients with metastatic breast cancer treated with palliative radiotherapy.
Authors: Yushen Qian, Sonya Aggarwal, Sara Aileen Dudley, Ben Y Durkee, Kiran Kumar, Aadel Chaudhuri, Erqi L. Pollom, Rie von Eyben, Daniel Tandel Chang, Kathleen C. Horst
Journal: Journal of Clinical Oncology (2016)

e18082 Background: Studies have shown that socioeconomic (SE) disparities contribute to differences in cancer survival, with patients in lower SE classes consistently having poorer survival compared to those in higher SE classes. A recent National Cancer Data Base analysis found a SE gradient in all-cause mortality for women with breast cancer. We investigated the relationship between extent of SE resources and survival in patients with metastatic breast cancer (MBC) treated with palliative radiotherapy (pRT). Methods: Between 2001 and 2015, 217 patients with MBC underwent pRT at a single institution and were included in the analysis. Ethnicity and type of healthcare insurance was obtained from the medical record. Income level was extrapolated from demographic data of area of residence. Date of death was obtained from medical records, Social Security Death Index, or published obituaries. Patients who were alive or whose date of death could not be determined were censored at the date of their last encounter. Survival was calculated from the start of treatment to the date of death or censorship. Results: Patients without healthcare insurance had shorter survival (median survival 4.6 months) compared to those who had private (median survival 16 months) or public insurance (median survival 25.5 months) (p < 0.01). There was no difference in survival according to ethnicity (p = 0.82), distance from treatment center (p = 0.75), or median income level, with median survival of 19.6 months for median household income > $100,000, and 21.7 months for median household income ≤ $100,000 (p = 0.99). Conclusions: For patients with metastatic breast cancer treated with palliative radiotherapy, lack of healthcare insurance was associated with poorer survival. Other socioeconomic and patient factors such as patient ethnicity, income level, or distance from treatment center do not appear to impact survival outcomes. Additional study in a broader setting is warranted to further elucidate this relationship.
Financial conflicts of interest at three prominent oncology clinical pathway vendors.
Authors: Robert Michael Daly, Peter Bach, Ray D. Page
Journal: Journal of Clinical Oncology (2017)

6529 Background: The American Society of Clinical Oncology (ASCO) reports that in 2015 62% of oncology practices are adhering to a clinical pathway and 31% are adhering to more than one pathway. ASCO and the American Medical Association have raised concerns about the conflicts of interest of those that design these pathways. Methods: Using the public Centers for Medicare and Medicaid Services Open Payments database, we abstracted the 2015 financial conflicts of interest for the 2016 voting members of the Value Pathways (a combined effort of US Oncology and NCCN), the medical oncology committee chairs for Via Oncology, and the medical advisory board for eviti. We focused on national pathway vendors and on non-research general payments, such as gifts, consulting, and speaker fees. Results: Nearly all involved in pathway development received non-research general payments in 2015, including 92% of US oncology, 84% of NCCN, 84% of Via Oncology, and 69% eviti. The average general payments ranged from $3.5K for US Oncology Value Pathways voting members to $15.3K for NCCN Value Pathways voting members. Eight percent of US Oncology voting members, 19% of the eviti medical advisory board, 28% of Via Oncology chairs, and 42% of NCCN voting members received $10,000 or more in general payments in 2015. Conclusions: Given the prominent role clinical pathways have on oncologists’ prescribing behavior and the often subjective nature of determining on-pathway treatment, pathway vendors should take care to make accessible their conflict of interest policies and elucidate how they manage relationships of concern.Steps would include potentially limiting the number of committee members receiving payments and limiting the amount of general payments to each physician.
Improving patient and caregiver outcomes in oncology: Team-based, timely, and targeted palliative care
Authors: David Hui, Breffni L. Hannon, Camilla Zimmermann, Eduardo Bruera
Journal: CA A Cancer Journal for Clinicians (2018)

Abstract Over the past decade, a large body of evidence has accumulated supporting the integration of palliative care into oncology practice for patients with advanced cancer. The question is no longer whether palliative care should be offered, but what is the optimal model of delivery, when is the ideal time to refer, who is in greatest need of a referral, and how much palliative care should oncologists themselves be providing. These questions are particularly relevant given the scarcity of palliative care resources internationally. In this state‐of‐the‐science review directed at the practicing cancer clinician, the authors first discuss the contemporary literature examining the impact of specialist palliative care on various health outcomes. Then, conceptual models are provided to support team‐based, timely, and targeted palliative care. Team‐based palliative care allows the interdisciplinary members to address comprehensively the multidimensional care needs of patients and their caregivers. Timely palliative care, at its best, is preventive care to minimize crises at the end of life. Targeted palliative care involves identifying the patients most likely to benefit from specialist palliative care interventions, akin to the concept of targeted cancer therapies. Finally, the strengths and weaknesses of innovative care models, such as outpatient clinics, embedded clinics, nurse‐led palliative care, primary palliative care provided by oncology teams, and automatic referral, are summarized. Moving forward, more research is needed to determine how different health systems can best personalize palliative care to provide the right level of intervention, for the right patient, in the right setting, at the right time. CA Cancer J Clin. 2018;680:00‐00. 2018 American Cancer Society, Inc.
Predicting cumulative incidence of chemotherapy toxicity in older patients with cancer: Korean Cancer Study Group prospective cohort study (KCSG) PC 13-09.
Authors: Jee Hyun Kim, Jin Won Kim, Se Hyun Kim, Yun-Gyoo Lee, In Gyu Hwang, Hong-Suk Song, Su-Jin Koh, Yoon Ho Ko, SeongHoon Shin, In Sook Woo, Soojung Hong, Tae Yong Kim, Sun Young Kim, Byung-Ho Nam, Hyun Jung Kim, Hyo Jung Kim, Myung Ah Lee, Jung Hye Kwon, Yong Sang Hong, Hun-Mo Ryoo
Journal: Journal of Clinical Oncology (2017)

e21539 Background: Older adults have increased risk of developing chemotherapy toxicity. Currently available prediction tools do not provide information on cumulative risk and none are from Asia. Methods: Patients with histologically confirmed solid cancer aged ≥70 years were prospectively enrolled from 17 centers and underwent geriatric assessment before starting their 1st line chemotherapy. Chemotherapy toxicity prediction model was built for adverse events (AEs) ≥G3, among geriatric assessment, laboratory and clinical variables. Model discrimination values were evaluated using c-statistics compared with actual cumulative incidence of AE ≥G3 in each cycle. Results: 301 patients were enrolled with a median age of 75 years (range 70-93). Primary site included colorectal (28.9%), lung (24.6%), hepato-biliary-pancreatic (22.3%), stomach (10.6%) and others (13.6%). Median chemotherapy cycle was 4 (2-7 cycles). During first line chemotherapy, 53.8% of patients experienced AEs ≥G3. Six variables significantly associated with occurrence of AEs ≥ G3 were serum protein &lt; 6.7 g/dL, no dose reduction at first cycle, suffering from psychological stress or acute disease in the past 3 months, water consumption of less than 3 cups per day, not being able to obey command of 'Grab a piece of paper in your hand', and self-perception of ‘not in good health’. Model with all six variables was selected with the highest mean value of c statistics (0.646) and prediction tool indicated score ranging from 0 to 8 points. Patients were classified to 4 risk groups; 61 (21.0%), 143 (49.3%), 66 (22.8%), and 20 (6.9%) in low (0, 1 point), medium-low (2, 3), medium-high (4, 5), and high risk group (6, 7, 8). Predicted cumulative incidence of AEs ≥G3 was discriminated according to risk groups; low risk group: 13%, 19%, 27%, 30%, 30% in cycle 1, cycle 2, cycle 3, cycle 4, cycle 5, medium-low risk: 17%, 37%, 48%, 56%, 60%, medium-high risk: 26%, 44%, 50%, 68%, 75%, and high risk: 45%, 62%, 87%, 94%, 94%. Conclusions: Novel prediction tool could identify those at high risk of developing AEs ≥G3 after chemotherapy, which provided information on cumulative incidence in each cycle.
Brain metastasis due to triple-negative breast cancer in the Peruvian population.
Authors: Renato Gustavo Luque Benavides, Zaida Morante, Gabriel Antonio De la Cruz Ku, Daniel Enriquez, Maria Luján, Eduardo Eyzaguirre, Antonella Saavedra, Jhajaira M Araujo, Joseph A. Pinto, Hugo Alejandro Fuentes, Silvia P. Neciosup, Henry Leonidas Gomez
Journal: Journal of Clinical Oncology (2018)

e14013 Background: Breast cancer is an important cause of cancer-related death in women worldwide and represents the second most frequent cause of brain metastases after lung cancer. The aim of this study was to determine the characteristics and outcomes of Brain Metastasis (BM) due to Triple Negative Breast Cancer (TNBC). Methods: We retrospectively reviewed a database of 2007 pts diagnosed with TNBC at the “Instituto Nacional de Enfermedades Neoplasicas” (period 2000-2014) to select pts who developed BM. Survival rates were assessed by Kaplan-Meier method, and prognostic factors were identified with Cox regression analysis. Results: Of our study population, 9.62%(N = 193) of pts developed BM. The median age was 46 years (range:21-92); 103(54.8%) were premenopausal, and 172 (89.1%) had a family history of breast and/or ovary cancer. BM occurred in 4(2.1%) pts with clinical stage (CS) I, 24(12.5%) with CS II, 141(73.4%) with CS III and 23(12%) with CS IV. Neoadjuvant chemotherapy was administered in 121 (62.7%) pts, and 71(36.8%) received adjuvant chemotherapy. The mean time of symptoms presentation was 13.36 days (1-60), which were cephalea(80.5%), nausea-vomits(51.1%), ataxia(14.4%), muscular weakness(12.6%) and seizures(5.7%). Furthermore, the majority of pts presented ECOG ≥2 (70.3%). Image findings showed that 88(52.1%) had more than one metastatic brain lesion. Regarding the treatment of BM pts were submitted to; radiotherapy (RT) 149(93.3%), surgical resection 4(2.7%) and surgical resection plus RT 6 (4%). The mean dose of RT was 3028cGy, where 15(10.3%) pts received < 3000cGy, those pts had a worse OS than others with ≥3000cGy (20%vs57%, HR = 2.45, 95%CI:1.39-4.32, p = 0.001). Overall survival (OS) was 47%, 33% and 12% at 3, 6, and 12 months, respectively. In the univariate analysis, RT was associated with a better OS (p < 0.001), while ECOG ≥2 (p = 0.001), > 1 lesion (p = 0.037) were correlated with worse OS. At multivariate analysis, RT was the only factor with a positive impact on OS (HR = 0.51, 95%CI:0.34-0.78, p = 0.002), while ECOG ≥2 was associated with a worse OS (HR = 1.81, 95%CI:1.26-2.60, p = 0.001). Conclusions: Despite having a poor prognosis, patients who received radiotherapy treatment have better survival rates.
A birch sublingual allergy immunotherapy tablet reduces rhinoconjunctivitis symptoms when exposed to birch and oak and induces IgG<sub>4</sub> to allergens from all trees in the birch homologous group
Authors: Peter Couroux, Henrik Ipsen, Brian Sonne Stage, Jakob Thomas Damkjær, Maria Abildgaard Steffensen, Anne Marie Salapatek, Kaare Lund, Peter Adler Würtzen
Journal: Allergy (2018)

Abstract Background This randomized, double‐blind trial was conducted to determine the optimal dose for clinical efficacy of the SQ tree SLIT ‐tablet. An environmental exposure chamber ( EEC ) was used to reduce variability of allergen exposure and allow investigation of symptom reduction towards different species from the birch homologous group in separate EEC sessions. Methods Eligible subjects (N = 219) were randomized to receive treatment with placebo or the SQ tree SLIT ‐tablet (2, 7, or 12 DU ) for 24 weeks. EEC pollen challenges were conducted outside the birch pollen season and included four birch and two oak EEC sessions. The primary efficacy endpoint was the average allergic rhinoconjunctivitis ( ARC ) total symptom score ( TSS ) after 24 weeks of treatment. Results There was a statistically significantly lower TSS during the 24‐week birch EEC session for 7 DU and 12 DU compared to placebo with relative differences of 24% ( P = 0.03) and 25% ( P = 0.02). For the 24‐week oak EEC session, there was a statistically significant difference for 12 DU (24%, P = 0.03). IgE and IgG4 measurements supported these findings and demonstrated cross‐reactivity to all other species within the birch homologous group. Treatment was well‐tolerated with the most frequently reported adverse reactions being the local reactions in the oral cavity of mild‐to‐moderate severity. Conclusion This trial demonstrates that the SQ tree SLIT ‐tablet reduce ARC symptoms triggered by birch or oak pollen. The optimal dose for further development was 12 DU . Clinical and immunological findings suggest that the tablet may be used to treat allergies to all species within the birch homologous group.