tbuckley/cabot-search huggingface dataset:
A randomized phase II trial of dexamethasone versus prednisolone as secondary hormonal therapy in CRPC.
Authors: Ramachandran Venkitaraman, Karen Thomas, Vedang Murthy, Ruth Woode-Amissah, David Paul Dearnaley, Alan Horwich, Robert Anthony Huddart, Johann Sebastian De Bono, Chris Parker
Journal: Journal of Clinical Oncology (2013)

123 Background: Dexamethasone and prednisolone are glucocorticosteroids used as second line hormonal treatment for castration refractory prostate cancer (CRPC). The biochemical response rates in cohort studies suggest that dexamethasone may be the more active agent. We conducted an open label, randomised phase II trial of dexamethasone versus prednisolone. Methods: Patients with castration resistant prostate cancer with progressive disease on androgen deprivation therapy were eligible. They were randomized to receive either prednisolone 10mg daily or dexamethasone 0.5mg daily. The main endpoint was confirmed PSA response rate according to the PSA Working Group 2 criteria. Patients with PSA progression on prednisolone crossed over to dexamethasone. Secondary endpoints included time to PSA progression, radiologic response rate using RECIST criteria, and safety. Results: Seventy-five patients were randomized. Confirmed PSA response was achieved in 12/39 patients (31%) on dexamethasone compared to 6/36 (17%) on prednisolone (p = 0.153). Median time to PSA progression was 9.7 months on dexamethasone compared to 5.1 months on prednisolone (HR 1.57, 95% CI 0.90 -2.75). In 43 patients with measurable disease, the response rate by RECIST criteria was 15% and 6% for dexamethasone and prednisolone, respectively (p = 0.606). Clinically significant toxicities were rare. Of 23 patients who crossed over at progression on prednisolone to dexamethasone, 19 patients were evaluable for PSA response. Seven of the 19 patients (37%) had a confirmed PSA response to dexamethasone after progression on prednisolone. Conclusions: The data are consistent with the hypothesis that dexamethasone is more active than prednisolone in the treatment of CRPC. In the absence of definitive, larger trials, dexamethasone should be used in preference to prednisolone in this setting. Clinical trial information: 2005-006018-16.
Biochemical markers of bone turnover in the diagnosis of myeloma bone disease
Authors: O. Dizdar, I. Barista, U. Kalyoncu, O. Karadag, I. Celik, A. Kars, G. Tekuzman
Journal: Journal of Clinical Oncology (2005)

6600 Background: New biochemical markers of bone turnover are being evaluated for diagnosis and monitoring the activity of bone disease in multiple myeloma (MM). These markers are also increased in osteoporosis, which is commonly seen in the age group of MM patients. The present study was designed to explore the value of four bone turnover markers in the diagnosis of myeloma bone disease regardless of the effect of bone mineral density (BMD) measurements. Methods: Eighteen patients with newly diagnosed and untreated MM and 18 controls with age, sex, and BMD values comparable with patients were enrolled in the study. All MM patients had bone involvement diagnosed with skeletal surveys and spinal magnetic resonance imaging. Four markers of bone turnover, i.e. deoxypyridinoline (DPD), carboxy-terminal telopeptide of type-I collagen (Ctx), bone alkaline phosphatase (BAP), and type-1 collagen propeptide (T1Pro) were assessed in both groups. Results: Both groups consisted of 18 individuals (14 males and 4 females) and did not differ with respect to age and BMD measurements. Levels of serum Ctx and urine DPD were significantly higher in MM patients than controls (p=0.001 and p<0.001, respectively) whereas serum BAP levels were significantly lower in patients than controls (p=0.027). Levels of serum T1Pro did not differ significantly between the two groups. Serum Ctx levels were elevated in 16/18 (88.9%) of patients with MM and 6/18 (33.3%) of controls (χ2=11.69; p=0.001), urine DPD levels were above the upper reference limit in 16/18 (88.9%) of the patients and 3/18 (16.7%) of the controls (χ2=21.13; p<0.001). Skeletal surveys were positive in 11/18 (61.1%) of the patients. Conclusions: This study indicates that Ctx and DPD are sensitive markers of bone disease in MM and higher than normal values suggest the presence of bone disease rather than benign osteoporosis in MM. Both markers are more sensitive than skeletal surveys in depicting bone involvement. Further studies are needed to establish routine use of these non-invasive markers in the diagnosis of myeloma bone disease. No significant financial relationships to disclose.
Prostate cancer incidence in males with Lynch syndrome.
Authors: Sigurdis Haraldsdottir, Heather Hampel, Lai Wei, Christina Sing-Ying Wu, Tanios S. Bekaii-Saab, Albert De La Chapelle, Richard M. Goldberg
Journal: Journal of Clinical Oncology (2013)

366 Background: Lynch syndrome (LS) is caused by germline mutations in DNA mismatch repair (MMR) genes and increases the risk of colon and several other cancers. Prostate cancer is not currently considered part of the LS-tumor spectrum. The objective of this retrospective study was to assess whether the incidence of prostate cancer is increased above that of the general population in MMR mutation carriers. Methods: Patients who were identified as MMR mutation carriers and included in previous LS studies or evaluated at the genetics clinic at The Ohio State University were contacted and their cancer history documented. Follow-up time was defined as the time between their first index cancer or their entry onto the LS studies until the last date of follow-up or date of death, whichever came first. The prostate cancer incidence was adjusted for age and race and compared to that of the SEER registry of 1999-2009. A standardized rate ratio (SRR) was obtained by comparing the observed rate to the expected rate. Results: 186 males (median age 49 years, range 17-83) were identified as MMR mutation carriers either by testing (95%) or as obligate carriers (5%) in 94 families. Their mean follow-up time was 5.1 years (SD+/-6.0 years) with a total of 938 person-years (p-ys). Caucasians comprised 95.1% of the cohort, African-Americans 3.8% and Asians 1.1%. Of the patients who were tested for mutations, MSH2 was most commonly mutated (49.2%), followed by MLH1 (23.7%), PMS2 (14.7%) and MSH6 (12.4%). Ten patients (5.4%), all Caucasian, were diagnosed with prostate cancer at a median age of 59 years (range 52-82). 7 patients were identified as MSH2 carriers, 2 as MSH6 carriers and 1 as a PMS2 carrier. The observed incidence rate was 102.8 cases per 100,000 p-ys versus the expected number of 158.2 cases per 100,000 p-ys, the standardized rate ratio was 0.65 (95% CI 0.53-0.79). Conclusions: Prostate cancer incidence was not increased in this relatively large cohort of LS patients.
Frequency and factors associated patients decisional control preferences (DCP) in patients with advanced cancer (ACP).
Authors: Sriram Yennu, Luis Fernando Rodrigues, Omar M. Shamieh, Columbe Tricou, Marilène Filbet, Kyaw Naing, Akhileswaran Ramaswamy, Mary Joycylyn S. Bautista, Pedro Emilio Perez-Cruz, Mary Ann Muckaden, Sofia Bunge, Sarah Fakrooden, Vikash Sewram, Antonio Noguera Tejedor, Minjeong Park, Diane D Liu, Suresh K. Reddy, Eduardo Bruera
Journal: Journal of Clinical Oncology (2016)

37 Background: To determine the frequency and socio-demographic and clinical factors associated passive DCP among ACP across the world. Methods: We conducted a survey of ACP referred to palliative care across 11 countries across the five continents across the world. Information was collected on socio-demographic variables, and using validated measures including Karnofsky Performance Scale, Decision Control Preference Scale, and Satisfaction with the Decisions and Care questionnaire. We analyzed using descriptive statistics and logistic regression analysis was performed. Results: Median age was 58 years, karnofsky 70, and 55% were female. Shared, Active and Passive DCP were 33.2%, 44.1% and 22.6% respectively (n = 1490). 91% were satisfied by the way the actual decisions were made. Concordance between the actual decision making and DCP was highest in cohort from USA [k = 0.74 (0.65-0.82) and lowest in Brazil 0.33 (0.22-0.44)]. “Satisfaction with the way the decisions about their care was made” was 91%. Better Karnosfsky performance status (OR 0.99, P = 0.017), higher education status (OR 0.64, P = 0.001) Country of origin (Brazil, France, Singapore, South Africa, Jordan were significantly associated with passive decision making preference (Table 1). Conclusions: DCP is based ACP’s performance status, education and is culture specific. Individualized understanding DCP may be important for quality care and patient satisfaction outcomes. [Table: see text]
Are our severely ill patients hungry?
Authors: F. Gany, T. Lee, J. Ramirez, D. Massie, A. Moran, M. Crist, T. McNish, J. C. F. Leng
Journal: Journal of Clinical Oncology (2011)

e19626 Background: Food insecurity, a disruption in a household's eating habits due to insufficient resources for food, is a growing problem in the U.S., where 17.4 million households are food insecure. It is especially detrimental to oncology patients. No studies have yet assessed levels of food insecurity among oncology patients in major population centers. This study aims to estimate the prevalence and predictors of food insecurity among a cohort of medically underserved oncology patients. Methods: Demographic background, diagnosis and treatment information, and responses to the USDA Household Food Security Survey Module were collected and analyzed for a sample of 411 patients with a clinical cancer diagnosis who were in care at 10 hospitals in New York, NY. Food insecurity status was defined according to USDA guidelines, by the number of reported food insecure conditions and behaviors in the USDA Household Food Security Survey Module. Results: The prevalence of food insecurity was 55%, with low and very low food security rates of 45% and 10%, respectively. Food insecure patients were more likely to be younger than food secure patients, and have worse access to health care. Conclusions: This cohort of predominantly immigrant and minority cancer patients had rates of food insecurity nearly 5 times higher than the state average. More research is needed to better understand the causes and impact of food insecurity among cancer and other patients with severe and chronic illnesses. Food insecurity screening should be considered as a component of the standard of care for all cancer and chronic disease patients.
Use of urinary microvesicles for noninvasive mRNA expression analysis in patients with prostate cancer.
Authors: L. M. Russo, N. Sadeghi, K. Bate, W. D. Comper, J. Skog, D. P. Petrylak, J. M. McKiernan
Journal: Journal of Clinical Oncology (2011)

e15033 Background: Microvesicles (including exosomes) are small lipid bilayer vesicles released from all cells into bodily fluids and have been shown to harbor both RNA and DNA from the parent cell from which they were released. Recently, a rapid method to extract high integrity RNA from microvesicles was developed allowing reliable assessment of their mRNA content. This allows us to gain a transcriptional profile of organs such as the prostate without the need for invasive biopsy. Here we use microvesicles to examine the expression pattern of various genes associated with prostate cancer including the fusion marker TMPRSS:ERG previously shown to be expressed in ~50% of all prostate cancer patients. Methods: A voided (without DRE) or catheterized urine sample was collected from patients with known or suspected prostate cancer from Columbia University Medical Center under approved IRB guidelines. Microvesicles were isolated using a rapid in-house filtration based isolation technique. During RNA extraction a DNase step was included to remove contaminating DNA. RNA integrity was assessed using the Agilent Bioanalyzer. Isolated RNA was used to assess the expression of key prostate markers such as PSA, PCA3 and TMPRSS:ERG. Results: RNA with visible rRNA peaks was successfully isolated from all urine samples assessed. Prostate marker transcripts for PSA, PCA3 and TMPRSS:ERG could be readily detected without the need for a DRE. An initial blinded pilot study of 11 patients revealed that 4 patients were shown to express TMPRSS:ERG mRNA and that these patients corresponded to known prostate cancer patients. TMPRSS:ERG was undetectable in controls and patients with benign prostatic hyperplasia or previously removed prostate cancers. Conclusions: The gene expression profile of prostate cancer patients and controls can be elucidated by isolation of microvesicle mRNA in a voided sample without the need for a DRE. This novel diagnostic tool is currently being investigated in a cohort of 100 cancer patients and controls.
Abstract 17720: Unique Features of Metabolic Syndrome in High BMI College Football Players
Authors: Edward M Powers, Heidi J Silver, Lynn A Seabolt, Abbie L Warren, Hakmook Kang, Robert W Fitch, Kevin D Niswender
Journal: Circulation (2015)

Background: Metabolic syndrome in football players is a common, yet poorly understood phenomenon. With 88,000 college football players and one million high school football players, there is a large, at-risk population. Hypothesis: We hypothesized that metabolic syndrome in football players is driven by oxidative stress and positive energy balance. Methods: A single site, cross-sectional study was performed at Vanderbilt University Medical Center of high BMI college football players (n=33). Prevalence of metabolic syndrome was determined. Data related to diet composition, oxidative stress, inflammation, body composition, glucose disposition, lipoprotein metabolism, and endothelial function were assessed to identify drivers of the metabolic syndrome in this cohort. Results: Prevalence of clinical metabolic syndrome was 33% (11/33) despite high cardiorespiratory fitness in all players (Table 1). Elevated waist circumference, HDL, and elevated blood pressure were present together in 73% of cases. Cases had increased oxidative stress (F2-isoprostanes) and inflammation (CRP). Insulin resistance was not worse by HOMA. Visceral fat predicted HDL and CRP. Respiratory quotient was identical between groups but metabolomics revealed decreased TCA cycle intermediates in cases. There were no differences in caloric intake but cases had gained more weight (4.2 vs 2.0 kg, p=.06). Conclusion: High BMI collegiate football players have metabolic syndrome at unexpectedly high rates with a unique set of risk factors and unusual pathophysiology. They have low HDL despite normal triglyceride levels and no defects in glucose metabolism. These data suggest deleterious effects of positive energy balance and oxidative stress irrespective of exercise quantity. These results provide strong rationale to conduct larger, longitudinal studies.
Perioperative decrement of factor XIII as a predictor of anastomotic leakage after esophagectomy in patients with esophageal cancer.
Authors: Hiroya Takeuchi, Masazumi Inoue, Satoru Matsuda, Kazumasa Fukuda, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Hirofumi Kawakubo, Yuko Kitagawa
Journal: Journal of Clinical Oncology (2016)

32 Background: Factor XIII(F13), or fibrin stabilizing factor, is involved in the last stage of blood coagulation. Although F13 is also known to be activated in wound healing after surgery, the association between F13 levels and postoperative complications after surgery remains unknown. In this study, we hypothesized that the F13 levels during perioperative periods may be related to the postoperative complications after esophagectomy in patients with esophageal cancer. Methods: A prospective study has been conducted for patients with esophageal cancer at our institution (UMIN000011658). Preoperative and postoperative (1st, 3rd, 5th, and 7th postoperative days) F13 levels were examined in 73 patients with primary esophageal cancer who underwent transthoracic esophagectomy. We investigated the association of F13 levels with clinicopathological background factors and the postoperative complications after esophagectomy. Results: The average age of the patients who underwent esophagectomy was 64.8 years, and 66 patients (90%) were males. Major postoperative complications included anastomotic leakage (C-D grade ≥ I: 19%), and pneumonia (C-D grade ≥ I: 34%). F13 level in preoperative esophageal cancer patients ranged from 36 to 155% (median 102%). In general, F13 levels markedly decreased after esophagectomy and gradually recovered after the 5th postoperative day. Preoperative and postoperative F13 levels at each point did not correlate with occurrence of any postoperative complications. However, the patients with 35% or more reduction of F13 level in the 1st postoperative day compared to the preoperative F13 level significantly correlated with higher incidence of anastomotic leakage. The incidence of anastomotic leakage of the patients with F13 change≥35% was 27% while that of the patients with F13 change&lt;35% was only 4% (p = 0.013). Conclusions: This study revealed that perioperative decrement of factor XIII may be a promising predictor of anastomotic leakage after esophagectomy in patients with esophageal cancer.
Early 2016/17 vaccine effectiveness estimates against influenza A(H3N2): I-MOVE multicentre case control studies at primary care and hospital levels in Europe
Authors: Esther Kissling, Marc Rondy, I-Move Study
Journal: Eurosurveillance (2017)

We measured early 2016/17 season influenza vaccine effectiveness (IVE) against influenza A(H3N2) in Europe using multicentre case control studies at primary care and hospital levels. IVE at primary care level was 44.1%, 46.9% and 23.4% among 0–14, 15–64 and ≥ 65 year-olds, and 25.7% in the influenza vaccination target group. At hospital level, IVE was 2.5%, 7.9% and 2.4% among ≥ 65, 65–79 and ≥ 80 year-olds. As in previous seasons, we observed suboptimal IVE against influenza A(H3N2).
Chronic Graft Versus Host Disease (cGVHD) Following Unrelated Donor Hematopoietic Stem Cell Transplantation (HSCT): Higher Response Rate in Recipients of Unrelated Donor (URD) Umbilical Cord Blood (UCB).
Authors: Mukta Arora, Sriharsha Nagaraj, John E. Wagner, Juliet N. Barker, Claudio G. Brunstein, Linda J. Burns, Margaret L. MacMillan, Jeffrey S. Miller, Daniel J. Weisdorf
Journal: Blood (2005)
Identifying tools for capturing the overall experience of dyspnea in a lung cancer population: The patient’s perspective.
Authors: Gursharan Gill, Aixin Liu, Brandon Chan, Brandon Tsui, Elizabeth Hall, Lauren Wong, Mindy Liang, Samantha Sarabia, Sabrina Yeung, Andrea Perez-Cosio, Catherine Brown, Yvonne Leung, Doris Howell, Geoffrey Liu
Journal: Journal of Clinical Oncology (2016)

73 Background: Efficient methods of tracking dyspnea can improve quality of care. We asked lung cancer patients to assess five validated patient-reported outcome (PRO) tools and determine whether these tools captured different domains of their dyspnea experience. Methods: This cross-sectional study of adult lung cancer outpatients of all stages utilized touch screen tablets to administer five dyspnea tools (Borg severity (B), Reduced Cancer Dyspnea (R), Breathlessness intensity (I), breathlessness distress (D), and MRC breathlessness (M) scales) that focused on the severity, experience, intensity, extent, and functional impairment of dyspnea, respectively. Patients were then asked whether each tool captured their dyspnea experience. Results: Of 226 lung cancer patients, 120 reported some level of dyspnea, and their responses were analyzed. Median age (range) was 67 (30-97) years; 53% were males; 37% were stage I-II; 56%, were stage III-IV. All the tools except B were completed by over 90% of patients (R 95%, I 93%, D 91%, M 91%). 71% of patients thought that M captured functional impairment well, while 58-62% of patients thought that R, S, A captured experience, intensity and distress well. B had the lowest completion rate (83%) and the lowest patient perception that is captured severity of dyspnea well (49%). Qualitative analysis suggests that most dyspnea is activity-related in this population, which would be consistent with patients favoring M (functional assessment) over B (dyspnea at present in clinic). I+D+M takes under 5 minutes to complete, whilst R takes 5+ minutes alone to complete. Conclusions: In a sample of cancer patients with high prevalence of dyspnea, patients felt four of five tools were useful in capturing various domains of their dyspnea experience. The majority of patients felt that the questions were relevant to their circumstances. I, D, M are appropriate screening tools, whilst R may be useful under specific circumstances. Our next step is the application and evaluation of self management tools in the dyspnea setting using these four tools.
Association of use of bisphosphonates with risk of colorectal cancer.
Authors: G. Rennert, M. Pinchev, H. S. Rennert, S. B. Gruber
Journal: Journal of Clinical Oncology (2011)

371 Background: Bisphosphonates are commonly used for the treatment of osteoporosis and of bone metastases due to breast cancer and were recently reported to be associated with reduced risk of breast cancer, but their association with risk of other cancers is unknown. Methods: The Molecular Epidemiology of Colorectal Cancer (MECC) study is a population-based case-control study in northern Israel of colorectal cancer cases and age/sex/clinic/ethnic-group matched controls. Use of bisphosphonates prior to diagnosis was assessed in a subset of 933 pairs of post-menopausal female cases and controls, enrolled in Clalit Health Services (CHS), using computerized pharmacy records. Results: The use of bisphosphonates for more than one year prior to diagnosis, but not for less than a year, was associated with a significantly reduced relative risk of colorectal cancer (odds ratio=0.50, 95% CI: 0.35-0.71). This association remained statistically significant after adjustment for, vegetable consumption, sports activity, family history of colorectal cancer, , BMI, use of low-dose aspirin, statins, vitamin D and post-menopausal hormones (OR=0.40, 0.24-0.64). Concomitant use of bisphosphonates and statins did not further reduce the risk. Conclusions: The use of oral bisphosphonates for more than 1 year was associated with a 60% relative reduction in the risk of colorectal cancer similar to the recently reported association of this drug class with reduction in breast cancer risk. No significant financial relationships to disclose.