tbuckley/cabot-search huggingface dataset:
Nab-paclitaxel (Nab-P) in patients (pts) with HER2-ve advanced breast cancer (ABC): A focus on the elderly— Preliminary results of the GIM-13 AMBRA study.
Authors: Giorgio Mustacchi, Paolo Pronzato, Alessia D'Alonzo, Carmela Mocerino, Emanuela Romagnoli, Ornella Garrone, Livio Blasi, Michelino De Laurentiis, Andrea Michelotti, Alessandra Bologna, Monica Giordano, Anna Turletti, Filippo Montemurro, Sabino De Placido, Clara Natoli, Cristiana Taverniti, Laura Biganzoli, Icro Meattini, Paolo Marchetti, Marina Elena Cazzaniga
Journal: Journal of Clinical Oncology (2018)

e13078 Background: Two randomized studies demonstrated that Nab-P produces a significantly higher overall response rate (ORR), longer Time to Progression (TTP) and greater overall survival (OS) in ABC pts treated with second-line or greater therapy. The improved safety and efficacy profile for Nab-P compared with solvent-based taxanes suggests that Nab-P may be particularly useful in older patients. A post-hoc analysis showed that weekly Nab-P (wNab-P) was safe and more efficacious in comparison to the q3w schedule and with solvent-based taxanes in older patients with ABC. Aim of the present analysis is to describe the use of Nab-P in the elderly (≥ 65 years) population registered in the GIM-13 AMBRA study. Methods: AMBRA is a longitudinal cohort study, aiming to describe the choice of first and subsequent lines of treatment in HER2-ve ABC pts receiving at least one CHT (SABCS 2016, P5-15-07 & P5-14-09) in the years 2012-2015. For the present analysis, we focused on the use of Nab-P pts aged ≥ 65 years. Results: So far, 791/1500 pts have been registered into the study and 73 (9.2%) received Nab-P as 1st-line (1 pt), 2nd (37, 50.7%) or further (38, 52%) line of treatment; 3 pts who have received Nab-P in 2nd-line were re-treated with the same drug in 4th-line. Seventeen pts (23.3%) were aged ≥ 65 years. Median age was 67.9years (65.1 – 81.1). All pts except 3 had Luminal tumors. Median DFI was 50 months (15-196). Eleven pts (64.7%) received Nab-P as 2nd-line of treatment, the remaining pts as further therapy at progression. Seven pts (41.2%) received the q3w schedule, the most frequently dose used in the weekly schedule was 125 mg/mq (7 pts, 41.2%). Median time of exposure to Nab-P was 154 days (0-499) and median number of cycles received was 7.1 (1-22), with no significant differences in comparison to younger pts (median time of exposure: 93 days, median number of cycles: 5). Conclusions: Nab-P has been demonstrated to be a valid option for the treatment of metastatic disease even in elderly pts.
ERCC1 expression in tumor tissue as biomarker of outcomes of oral vinorelbine-cisplatin (oVP) combination in metastatic squamous cell lung cancer (SqLC): A prospective study—GGCP 052/12.
Authors: Carolina Pena, Monica Alvarez, Natalia Fernández Núñez, Ana Alonso Herrero, Margarita Amenedo, Jose Luis Firvida Perez, BegoÃ Â±a Campos Balea, Susana Gomez Garcia, Marta Covela Rúa, Marinha Costa Rivas, Lorena Cadavid Vieitez, Sergio Vazquez-Estevez
Journal: Journal of Clinical Oncology (2016)

e20533 Background: Median overall survival (mOS) of SqLC is 9-10 months, despite treatment with platinum combinations. The ERCC1 expression is related to platinum resistance, so it could help to select patients (pts) not candidates to receive a platinum-based chemotherapy. Methods: Pts with > 18 years (y), with histologically proven untreated and not candidate to radical treatment SqLC, eligible to be treated with platinum combination and ECOG-PS 0-1, were included and stratified by ERCC1 expression by immunohistochemically analysis. Pts received a maximum of 6 cycles (cy) of oVP. Primary endpoint was median overall survival (mOS) according to the ERCC1 expression. Secondary endpoints: overall response rate (ORR), time to progression (TTP), mOS of all pts, survival rate at 1 year (Sv1y) and safety. Results: 53 pts were recruited and treated in 5 centers of GGCP cooperative group between 07/2012-07/2015. Median age of 65y [50-80]; 92% males; 86% ECOG-PS 1; 19% with hepatic metastases. 37 pts were eligible. Main reason to not being eligible was the hepatic function. 203 cy were administered; median of cycles was 5 [1-6]. Most common G3/4 AEs (%pts) were asthenia (16), neutropenia (38), neutropenia febrile (19), thrombocytopenia (5), constipation (8) and vomiting (6). The ORR was 43%. After a median follow-up of 8.6m [0.3-23], 92% of pts have progressed and 78% of pts have died. The median TTP was of 5,1m (IC95%; 3,6-6,6) and mOS was 8.9m (IC95%; 6-11,8) with a survival rate at 1y of 36.7% (IC95%; 19.3-54.1). 21 elegible pts had tumor tissue available. ERCC1 expression was positive in 48% of pts, negative in 29% of pts and not assessable in 23% of pts. The mOS was 12,8m (IC95%; 0,3-25,4) in positive ERCC1 population and 7,8m (IC95%; 5,6-9,9) in ERCC1 negative population. Conclusions: Efficacy results of this study are similar than other. ERCC1 was postulated as a biomarker which may help to select population not candidate to be treated with platinum-based combinations. However, our results showed a better overall survival in this population, contrary to expectations.
A hope-based intervention to address disrupted goal pursuits and quality of life in young adult cancer survivors.
Authors: Carla Berg, Robin C Vanderpool, Betelihem Getachew, Meghan F Johnson, Jackelyn B Payne, Yasmeni Sandridge, Jennifer Bierhoff, Jasmine Kelly, Karen Elizabeth Effinger, Wendy Demark-Wahnefried, Ann C. Mertens
Journal: Journal of Clinical Oncology (2018)

e22135 Background: Young adulthood is a critical time entailing several important life transitions and goal pursuits. Unfortunately, > 60,000 US young adults are diagnosed with cancer yearly, disrupting this pivotal time. Young adult cancer survivors (YACS) have been underserved and understudied, particularly in addressing such sequelae. Hope, a positive psychology construct regarding goal pursuit, is related to better overall quality of life (QOL). Methods: We developed Achieving Wellness After Kancer in Early life (AWAKE), a scalable 8-week app-based program involving educational videos, mood/activity tracking, and telephone-based coaching to promote goal-oriented thinking and QOL in YACS. AWAKE was pilot-tested among 57 YACS (18-40 years) completing treatment within the past two years to examine feasibility and acceptability, and obtain parameter estimates. Participants were recruited from two NCI-designated cancer centers in the South and randomly assigned to AWAKE (n = 38) vs. an attention control (n = 19). We assessed hope (Trait Hope Scale) and QOL (36-Item Short Form Health Survey, Functional Assessment of Cancer Therapy-General) at weeks 0, 8, and 24. Results: The study sample was 32.2±5.6 years old, 75.0% female, and 77.6% non-Hispanic White. The most prevalent diagnoses were breast cancer (28.6%), hematologic malignancies (12.2%), and melanoma (12.2%). Respondents were largely employed (61.2%), married/stable union (67.3%), and had children (53.1%). Adherence to AWAKE over the 8-week period averaged 86.1% (range: 100.0% at week 1 to 75.7% at week 8). Retention at end-of-treatment was 90.7%. Among AWAKE participants, 90.9% were satisfied with AWAKE; > 84.8% reported that AWAKE components were helpful, with most indicating scores of “quite” to “very” helpful (range: 54.6% for videos to 87.9% for coaching). Moreover, 90.9% indicated that they would recommend AWAKE to a friend with cancer. Trends of higher indices of hope and QOL were observed in AWAKE vs. control participants. Conclusions: Findings indicate the promise of AWAKE in addressing disrupted goal pursuits and overall quality of life among YACS, and provides the basis for sufficiently powered efficacy and effectiveness trials. Clinical trial information: 00086797.
Use of granulocyte colony stimulating factor (GCSF) in patients receiving highly myelosuppressive chemotherapy for breast cancer.
Authors: Emily Kornelsen, Winson Y. Cheung
Journal: Journal of Clinical Oncology (2017)

e21677 Background:We hypothesized that GCSF use may be suboptimal in the real world despite prior research that shows prophylaxis with GCSF can reduce neutropenic fevers and hospitalizations. Our aims were to characterize patterns of GCSF use in a population-based cohort of breast cancer patients receiving highly myelosuppressive chemotherapy and to describe outcomes and predictors associated with appropriate GCSF prophylaxis. Methods:Patients diagnosed with breast cancer from 2008 to 2012, seen at any 1 of 5 comprehensive cancer centers in a Canadian province, and treated with chemotherapy that posed &gt; 20% risk of neutropenic fever were reviewed. Associations between GCSF use and 1) patient and physician factors and 2) treatment outcomes, including rate of neutropenic fevers, were analyzed using regression models. Results:We included 805 women: median age was 52 (IQR 44 to 61) years, 40% reported smoking, 52% used alcohol regularly, 64% were ECOG 0, and 24% had private health insurance. In this cohort, 330 (41%) patients were given GCSF. Among those treated with GCSF, 132 (40%) and 198 (60%) individuals received GCSF as primary and secondary prophylaxis, respectively. Overall, neutropenia was noted in 467 (58%) cases while neutropenic fever was experienced by 161 (20%) patients. When compared to those who did not use GCSF, patients who used GCSF experienced a lower rate of neutropenia (14% vs. 61%, p &lt; 0.01) and a decreased incidence of neutropenic fever (8% vs. 23%, p &lt; 0.01). In regression models, patients lacking extended medical coverage (32% vs. 49%, p = 0.02), poor performance status (30% vs. 55%, p = 0.03), and those who were evaluated at non-teaching institutions (25% vs. 69% p &lt; 0.01) were less likely to receive GCSF. Patients seen at non-teaching institutions were also given primary GCSF prophylaxis less frequently (16% vs 59%, p &lt; 0.01) than those at teaching centers. Conclusions:GCSF prophylaxis was associated with improved neutropenia-related outcomes in the real world. Despite evidence-based recommendations, use of GCSF remains suboptimal in this population-based cohort of breast cancer patients receiving highly myelosuppressive chemotherapy.
The LIBERATE Trial: Options to Reduce the Risk of Post-procedural Pneumothorax and Length of Stay
Authors: Gerard J. Fitzmaurice, Kelvin Lau, Karen C. Redmond
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

inhalation can affect children's health not only in the acute phase such as HDLI but also years after the exposure.Thorough safety evaluation of household chemicals is needed to prevent future chemical-related fatalities and health crises in children.
Outcomes of prechemotherapy (pCHT) abiraterone (AA) or enzalutamide (E) for metastatic castration-resistant prostate cancer (mCRPC) after androgen deprivation therapy (ADT) + docetaxel (D) or ADT alone for metastatic hormone sensitive prostate cancer (mHSPC) in a hospital-based registry.
Authors: Edoardo Francini, Kathryn P. Gray, Carolyn Evan, Marina D. Kaymakcalan, Grace Katherine Shaw, Philip W. Kantoff, Mary-Ellen Taplin, Christopher Sweeney
Journal: Journal of Clinical Oncology (2017)

e16515 Background: The E3805: CHAARTED trial noted use of D at time of commencing ADT for mHSPC was associated with an improvement in time to CRPC (PSA rise or clinical progression [CP]) or time to CP and resulted in a prolongation of overall survival (OS). Therefore, we postulated that pCHT AA or E maintained activity after ADT+D. Methods: A cohort of CRPC patients (pts) treated with pCHT AA or E for CRPC between 2010 and 2016 was selected from the Dana-Farber Cancer Institute IRB approved database. Patients were grouped by use of D and whether they had prior localized therapy (PLT) or de novo (DN) metastatic disease, at time of ADT start for mHSPC. The analysis endpoints included OS (time to death from all causes) from ADT start, time to AA/E start from ADT start, OS from AA/E start. Kaplan-Meier method estimated the time to events distribution with median (95% CI). Results: Of the 147 pts selected, 134 (91.2%) had previously received ADT alone, while 13 (8.8%) had ADT+D. Once stratified by PLT or DN, the distributions of the 4 groups are 33.3% (ADT/PLT), 57.8% (ADT/DN), 0.7% (ADT+D/PLT), and 8.2% (ADT+D/DN). In the ADT alone group, the median OS with pCHT AA or E for CRPC was approximately 3 years from the AA/E start, regardless of PLT or DN. In the smaller cohort of pts selected for treatment with ADT+D, both the OS from ADT start and from AA/E start were shorter than the ADT alone cohort. However, even in this group with shorter time to AA/E start, the median OS from AA/E start was still 1.5 years despite prior chemotherapy. Conclusions: Within limitations of a hospital-based registry, small sample size for ADT+D and lack of volume of metastases data, pts selected for ADT+D show poorer outcomes but still have an OS of 1.5 yrs from AA/E start. [Table: see text]
Abstract MP03: The AHA Life’s Simple 7 Metric is Inversely Associated with Subclinical Atherosclerosis Among South Asians: Findings From the Mediators of Atherosclerosis in South Asians Living in America Study
Authors: Yichen Jin, Alka M Kanaya, Namratha R Kandula, Sameera A Talegawkar
Journal: Circulation (2016)

Objective: To examine the prevalence of the Life’s Simple 7 (LS7) metric and its associations with measures of subclinical atherosclerosis in a community-based cohort of South Asians in the U.S. Methods: We conducted a cross-sectional analysis of data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study consisting of 875 South Asians (mean age 55 y, SD=9.4, 47% women). Each LS7 component was assigned a score of 0 (poor), 1 (intermediate) and 2 (ideal) and these scores were summed to derive an overall cardiovascular health score ranging from 0 (poor adherence to AHA guidelines) to 14 (perfect adherence to AHA guidelines).Carotid intima media thickness (cIMT) and coronary artery calcium (CAC) were measures of subclinical atherosclerosis. Multivariate linear and multinomial logistic regression models were used to examine associations between the overall cardiovascular health score, modeled as tertiles, and subclinical atherosclerosis. Covariates included age, sex, insurance type, length of residency in the U.S., and acculturation. Results: The prevalence of having 0, 1, 2, 3, 4, 5, 6, and 7 ideal metrics was 1.6%, 8.3%, 20.1%, 27.9%, 21.6%, 15.8%, 4.7%, and 0%, respectively. The overall LS7 score ranged from 3-13, with median of 9; men had a lower median score compared with women (9 vs. 10, p&lt;0.05). In adjusted analyses, compared to those in the lowest tertile, those in upper tertiles had lower common cIMT (score:9-10: β= -0.06, 95% CI: -0.09 to -0.02; score:11-13: β= -0.07, 95% CI: -0.11 to -0.04), and internal cIMT (score:9-10: β= -0.14, 95% CI: -0.21 to -0.08; score:11-13: β= -0.14, 95% CI: -0.21 to -0.07). Higher LS7 scores were also associated with decreased odds of CAC. As compared to the lowest tertile of LS7, those in the highest tertile had 70% (OR=0.30, 95% CI: 0.19 to 0.47) lower odds of having CAC between 1 and 400, and 79% (OR=0.21, 95% CI: 0.08 to 0.54) lower odds of having CAC over 400. Conclusion: This is the first study to show that better cardiovascular health, as defined by the LS7 metrics, is associated with a lower burden of subclinical atherosclerosis in middle- and older-aged U.S. South Asians. Prospective follow-up of MASALA will determine whether the LS7 metric will predict incident atherosclerotic vascular disease events.
Expression and correlation of HLA-G and sHLA-G as prognostic factors in renal cell carcinoma.
Authors: Alberto Rodrigo, Ana Callejo, Rodrigo Lastra, Alexia Fernandez, Patricia Iranzo, Mauro Antonio Valles Cancela, Elisa Quilez, Alfonso Yubero-Esteban, Nieves Galan, Julio Lambea, Laura Murillo, Raquel Andres, Pilar Escudero, Eduardo Pujol, Alberto Saenz, Berta Saez, Dolores Isla
Journal: Journal of Clinical Oncology (2016)

e16066 Background: many studies have related HLA-G to increased tumorigenicity. Serum HLA-G (sHLA-G) has been detected in plasma of patients with malignant diseases. Levels of sHLA-G are higher in patients with Renal Cell Carcinoma (RCC) compared to Healthy Controls (HC). Previous studies have found HLA-G expression in 45-60% of the RCC lesions, but not in normal kidney tissue. We determined expression of HLA-G in surgery specimens, levels of sHLA-G in patients and HC, correlation between levels of sHLA-G and clinical parameters (sex, age, subtypes, progression and survival) and between HLA-G/sHLA-G. Methods: histological samples of patients from HCU Lozano Blesa in Zaragoza (Spain) with histologically confirmed RCC by nephrectomy, of every subtypes and stages. Patients who received prior chemotherapy or radiotherapy were excluded. Blood serum is obtained during surgery and in HC. Cytokeratin, vimentin, Ki-67 and HLA-G were analyzed. sHLA-G were determined using ELISA test kits. Results: A sample of 33 patients obtained from Jul-2008 to dec-2009. 67'7% were male (37-85 y). 85% of patients had localized disease at diagnosis with predominant histology of Clear Cell Carcinoma. After 5y follow-up 20% progressed and 10 deaths were observed. Levels of sHLA-G in patients with RCC were higher than the HC (46'6 U/ml vs 18'3 U/ml). Pearson correlation test with a score of 0.41 was made, appreciating a positive relationship between patients and HC. Spearman Rho test was analyzed between sHLA-G and HLA-G in tumor specimen (0'4533 positive relationship). There is a positive relationship between sHLA-G patients with advanced stage and progression (Spearman Rho correlation 0'6589 and 0'255 respectively). The higher value of sHLA-G was, the more advanced tumor stages and progression rates were found. Conclusions: The degree of HLA-G expression in tumor tissue of RCC could influence the evolution of this disease, and may develop as an useful marker in clinical practice. Because of direct relationship between plasma sHLA-G and HLA-G in nephrectomy tissue, an easy determination by blood collection is allowed. From this data, future studies with larger samples are necessary to take into account the role of sHLA-G as a prognostic factor for RCC.
Project ECHO: Ensuring that best practice cancer care and precision medicine reach the last mile.
Authors: Sanjeev Arora
Journal: Journal of Clinical Oncology (2018)

e18685 Background: Tremendous disparities in cancer care access, quality and outcomes exist, particularly among minority populations, the poor and vulnerable and in low to middle income countries. Often, quality prevention, screening, treatment, palliative care and survivorship services are either unavailable or access is very limited. A significant driver of disparities is a gap in knowledge transfer and access, which inhibits patients from getting the right care at the right place and right time. Methods: Project ECHO is a model that enables effective knowledge sharing and mentoring in issues of great complexity, including broad applications in cancer. This low-cost, high-impact intervention is accomplished by linking expert multidisciplinary specialist teams with multiple primary care providers for case-based learning and ongoing telementoring. The ECHO model can strengthen, inspire and better deliver cancer care including precision medicine and cancer trial enrollment by bringing together public-private partnerships and promoting cross-sector and cross-organizational collaborations. ECHO enables local providers to deliver care in their own communities, improving the efficiency of triaging and serving as a force multiplier. Results: Currently in 175 hubs in 25 countries with more than 480 programs, the ECHO model is being applied for prevention, screening, treatment, and palliation. The ECHO model is a highly effective means of training the healthcare workforce and scaling best practices so they reach the “last healthcare mile.” Conclusions: ECHO, through its technology-enabled “all teach, all learn” approach, is bringing governmental stakeholders across nations together with multinational NGOs to improve the dissemination of best practices in cancer policy-making, prevention, screening and care. We will present data from many different implementations of the ECHO model, demonstrating increases in provider self-efficacy, knowledge and skills. We will share best practices for the replication of the model, including the broad (and growing) spectrum of applications in the field of cancer.
Abstract 11225: Co-existing Multiple Vulnerable Plaque Characteristic Factors in Single Non-Obstructive Non Calcified or Mixed Plaques in Coronary Arteries on CT Could Predict Occurrence of Major Cardiac Events on Follow-up for a Median of 103 Months
Authors: Hiroyuki Takaoka, Nobusada Funabashi, Koya Ozawa, Yoshio Kobayashi
Journal: Circulation (2013)

Purpose: To evaluate significance of presence of three vulnerable plaque characteristics (VPC) co-existing in single non calcified plaques (NCP) or mixed plaques (MP) in non obstructed coronary art...
PTH-059 Cost reductions and in- patient bed days saved by an inflammatory bowel disease nurse helpline
Authors: K Kemp, J Brooks, M Kirkbride, F Birchall, H Dutton, S Levison
Journal: Gut (2017)

Introduction  Reducing emergency admissions is a recognised Quality Premium outcome by the Better Care Fund (NHS England) and it is one the of outcome measures against which CCGs are required to set targets. The IBD helpline can be directly translated into in-patient beds saved and direct costs. This prospective audit measured both cost savings and income generated and also calculated A and E avoidances and in-patient beds saved.  Method  The aim was to measure how an IBD Nurse helpline could influence key outcomes. Between 1/1/2016-30/6/2016 all calls to the IBD helpline were prospectively audited in a large tertiary Hospital Trust. Patients were also asked what action they would take if there were no helpline available at that time point and their thoughts/concerns recorded. The tariff from the helpline, the OPDs saved, number of in- patient bed days saved and costs were calculated with the Specialist Medicine Informatics and Accountants.  Results  In 6 mths there were 876 IBD related appropriate and chargeable calls to the helpline. This tariff generated an income of £26 280. 741 OPD s were avoided resulting in £62 244 savings to the CCG. 76 A and E attendances were directly avoided. Based on a 5 day in-patient stay (average in-pt stay for previous 6 mths) 380 days were saved over 6mth, saving 2.1 beds per day. The 2.1 bed days per day saved equates to £96 000 over the 6mth period. Of the 90 ‘other’, 32 were given OPDs generating an income £3648. 6 patients were admitted directly from the helpline. 273 GP consultations were avoided.  Conclusion  IBD helplines are a vital resource for IBD patients. There is great emphasis demonstrating the value of the IBD nurse in both monetary terms and patient experience. The presence of an IBD helpline can assist NHS Trusts and CCGs to meet national targets by avoiding A and E admissions and in-patient bed stays, reducing opds whilst maintaining a high quality, efficient and optimal service.  Disclosure of Interest  K. Kemp Conflict with: Abbvie, MSD, Takeda, Janssen, J Brooks: None Declared, M Kirkbride: None Declared, F Birchall: None Declared, H Dutton: None Declared, S Levison: None Declared