tbuckley/cabot-search huggingface dataset:
Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
Authors: Freddie Bray, Jacques Ferlay, Isabelle Soerjomataram, Rebecca L. Siegel, Lindsey A. Torre, Ahmedin Jemal
Journal: CA A Cancer Journal for Clinicians (2018)

Abstract This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high‐quality cancer registry data, the basis for planning and implementing evidence‐based cancer control programs, are not available in most low‐ and middle‐income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1‐31. © 2018 American Cancer Society
P02 EGFR Amplification and Sensitizing Mutations Correlates with Survival from Erlotinib in Lung Adenocarcinoma Patients
Authors: A. Ruiz-Patiño, C. Castro, L. Ricaurte, A. Cardona, L. Rojas, Z. Zatarain-Barrón, B. Wills, N. Reguart, H. Carranza, C. Vargas, J. Otero, L. Corrales, C. Martín, P. Archila, J. Rodríguez, J. Avila, M. Bravo, L. Pino, R. Rosell, O. Arrieta
Journal: Journal of Thoracic Oncology (2018)
P01.101 Treatment and survival of patients with lower grade glioma according to the 2007 and the 2016 WHO classification: A retrospective analysis of 423 patients.
Authors: E Steidl, P Zeiner, M Wagner, E Fokas, M Forster, M Ronellenfitsch, J P Steinbach, P N Harter, O Bähr
Journal: Neuro-Oncology (2018)

Classification as well as treatment of patients with lower grade gliomas (°II+°III) have changed fundamentally during the last years. Molecular markers have augmented diagnostic workup and combined radiochemotherapy was established for most of the subgroups. However, molecular markers have not been part of the inclusion criteria of most of the relevant clinical trials. Larger analyses outside of clinical trials are rare. We screened our clinical cancer database for patients with lower grade glioma newly diagnosed from 1995 to 2015. We identified 774 patients of whom 345 had to be excluded, resulting in an evaluable cohort of 423 patients. We evaluated general characteristics, morphological diagnosis, molecular markers, treatment, time-to-treatment-failure (TTF; initiation of a new treatment or death) and overall survival (OS). According to the 2007 WHO classification our cohort included 145 (34.3%) Astrocytoma WHO °II, 56 (13.3%) Oligoastrocytoma/Oligodendroglioma WHO °II, 129 (52.5%) Astrocytoma WHO °III and 93 (22.0%) Oligoastrocytoma/Oligodendroglioma WHO °III. In 235 patients we were able to molecularly classify the tumors based on the 2017 WHO classification using IDH status and 1p/19q or ATRX status. Patients with a molecularly defined Oligodendroglioma showed a median TTF of 5.2, 4.2 and 7.8 years for radiotherapy, chemotherapy and radiochemotherapy, respectively. Patients with a molecularly defined Astrocytoma showed a median TTF of 1.6, 2.9 and 6.7 years for radiotherapy, chemotherapy and radiochemotherapy, respectively. In IDH wildtype tumors TTF was below 12 months without relevant differences. Treatment with combined radiochemotherapy resulted in markedly improve TTF in molecular defined oligodendroglioma and astrocytoma compared with either radiotherapy or chemotherapy alone. Due to the short follow-up of 5.3 years (mean) median OS has not been reached for any of the IDH mutant subgroups. Combined treatment with radiotherapy and chemotherapy resulted in markedly improved TTF in patients with molecularly defined oligodendroglioma and astrocytoma.
Cancer center staff effort related to electronic patient portal use: A growing demand.
Authors: David E. Gerber, Beibei Chen, Jennifer Cai, Samantha Gates, Yang Xie, Simon Craddock Lee, Andrew L. Laccetti
Journal: Journal of Clinical Oncology (2016)

e18012 Background: Electronic portals provide patients with real-time access to personal health records (PHR). They are a convenient means of communicating with providers and have the potential to improve patient satisfaction and education. Use of this technology by individuals with cancer is particularly frequent and may place heavy burden on healthcare professionals. For this reason, we examined the use of electronic portals by clinic staff at our National Cancer Institute-designated comprehensive cancer center. Methods: We identified and characterized providers and clinic staff at the Harold C. Simmons Comprehensive Cancer Center who performed electronic activities related to MyChart, the institution’s PHR portal, from 2009 to 2014. We quantified total MyChart actions and messages received, and characterized them according to type, timing, and staff category. Results: 290 employees were included in our analysis: 89 nurses (29.3 %), 80 ancillary staff (27.6 %), 49 clerical staff (16.9%), 47 physicians (16.7%), and 29 midlevel providers (10 %). In total, these individuals performed 740,613 MyChart actions and received 117,800 messages. 76.5% of actions were performed by nurses, 12.1% by clerical and ancillary staff, 6.0% by midlevel providers and 5.3% by physicians. From 2011 to 2015, staff MyChart activity increased 10-fold. In 2014, nurses performed an average of 3,838 MyChart actions and received an average of 687 messages (medians: 1226 and 271) compared to 602 actions and 104 messages in 2011 (medians: 244 and 46; p < 0.001). 14.1% of all actions and 13.3% of received messages occurred outside clinic hours. Conclusions: Cancer center employee effort related to an electronic patient portal has increased markedly over time, particularly among nursing staff. As further uptake of this technology is expected, it is critical to consider potential effects on clinical resources, employee and patient satisfaction, and patient safety.
Effect of chemotherapy on survival of patients with recurrent pancreatic ductal adenocarcinoma (PDAC) following surgical therapy.
Authors: Olumide B. Gbolahan, Yan Tong, Bert H. O'Neil, Safi Shahda
Journal: Journal of Clinical Oncology (2017)

e15748 Background: Patients with recurrent PDAC are treated similarly to patients with de novo metastatic disease. The aim of this study is to report the outcome of patients with recurrent PDAC following initial definitive resection and adjuvant therapy. Methods: Patients were identified from an IRB approved, retrospective database at Indiana University that contained patient and tumor characteristics, adjuvant therapy and all treatment for metastatic disease. Follow-up was updated as of 6/2014. Overall survival (OS) from recurrence until death or last follow up was estimated using the Kaplan Meier method. Results: Between 2008-2014, 451 patients with resectable PDAC and available follow up data were identified, of whom 234 had documented relapse. Patient/tumor characteristics were as follows: median age: 64.2 years (25-89), 54% male, 76% LN+, 24% positive margins, 66% and 85% with lymphovascular and perineural invasion respectively. 69% of patients received adjuvant gemcitabine (GEM). Median time to relapse was 10 months. 60% of patients received at least 1 line of systemic therapy and 18% received 2 lines. Chemotherapy was GEM-based: 33%, 5FU-based 33%, or both 33% and 1% other treatment. Median OS from time of relapse was significantly improved following chemotherapy compared to no chemotherapy (10 months vs 3 months, P &lt; 0.0001). Median OS for 5FU based and GEM based treatment was 6 and 8 months, respectively (P = 0.09). Those who received both had mOS of 14 months (95% C.I 10-17months, P &lt; 0.0001). On univariate analysis, chemotherapy, regardless of type was associated with a survival benefit. Conclusions: Chemotherapy appears to be associated with survival benefit for patients with relapsed PDAC following initial curative therapy. Survival in our retrospective study appears similar to reported literature for de novo metastatic disease.
Phase 1b multi-indication study of the antibody drug conjugate anetumab ravtansine in patients with mesothelin-expressing advanced or recurrent malignancies.
Authors: Alex A. Adjei, Tanios S. Bekaii-Saab, Jordan Berlin, Philip Agop Philip, Teresa Macarulla Mercade, Annette Walter, Lisa Cupit, Rong Liu, Scott Z. Fields, Ariadna Holynskyj
Journal: Journal of Clinical Oncology (2018)

TPS2607 Background: Mesothelin expression is associated with poor prognosis in patients with a wide variety of tumors, including mesothelioma, pancreatic, gastric/gastroesophageal juncture, NSCLC, ovarian, triple-negative breast cancer, and thymic carcinomas. Anetumab ravtansine is a novel fully human anti-mesothelin IgG1 antibody conjugated to the maytansinoid tubulin inhibitor DM4. We are conducting a signal-generating study with anetumab ravtansine in five tumor types with high unmet medical need in patients pre-screened for mesothelin expression (NCT03102320). Methods: Eligibility criteria include: ≥18 years, unresectable locally advanced or metastatic recurrent or relapsing disease, no prior (pancreatic adenocarcinoma) or one or more prior lines of therapy for their advanced stage of disease, and availability of tumor tissue for mesothelin expression testing as determined by the Ventana MSLN (SP74) immunohistochemistry assay. Mesothelin-positive patients with selected adenocarcinomas (gastric including gastroesophageal junction, NSCLC, and triple negative breast) and thymic carcinoma will receive anetumab ravtansine as monotherapy at 6.5 mg/kg IV on a 21-day cycle. Following a safety run-in phase (18-24 patients each), patients with pancreatic adenocarcinoma will receive anetumab ravtansine in combination with gemcitabine (1000 mg/m2 IV day 1 and 8 on a 21-day cycle). The primary objective is objective response rate (ORR) of anetumab ravtansine as monotherapy or combination therapy in patients with either of two mesothelin expression levels: high (≥30% positive tumor cells with moderate and stronger membrane staining intensity) and low-mid (≥5% all intensities and < 30% positive tumor cells with moderate and stronger membrane staining intensity). Secondary objectives include safety, disease control rate, duration of response, durable response rate, and progression-free survival. Approximately 350 patients will be enrolled. Clinical trial information: NCT03102320.
Re-evaluating the optimal threshold for lymph node (LN) harvest in colon cancer: Insights from a population-based study.
Authors: Joseph Del Paggio, Yingwei Peng, Xuejiao Wei, Sulaiman Nanji, P. Hugh MacDonald, Chandramohan Krishnan Nair, Christopher M. Booth
Journal: Journal of Clinical Oncology (2016)

3610 Background: Colorectal cancer guidelines recommend ≥ 12 LNs be harvested during resection; however, this threshold is based on limited evidence. While numerous studies show that LN yield is associated with survival, the optimal threshold is inconsistent in the literature. Here, we evaluate thresholds associated with both LN positivity and survival using a population-based dataset. Methods: Treatment records were linked to the Ontario Cancer Registry to identify all colon cancer patients during 2002-2008. Surgical pathology reports were reviewed for a random 25% sample. Modified Poisson regression was used to identify factors associated with LN positivity, and Cox proportional Hazards model was used for survival analysis. Sequential regression analysis using multiple thresholds and Pearson/martingale residuals were used to evaluate the optimal threshold for LN positivity and survival. Results: 25613 patients underwent colon cancer resection. 7519 (~25%) randomly selected cases were reviewed; 5508 met eligibility criteria. On adjusted analysis, younger age (p < 0.001), left sided tumours (p = 0.003), higher T stage (p < 0.001), and greater LN harvest (p = 0.007) were associated with greater likelihood of LN positivity. Regression analyses with multiple cut-points suggested that beyond 12-14 LN there was little incremental increase in LN positivity. Results were consistent on Pearson residual plot. Cox model analysis showed that increased LN harvest was associated with improved cancer-specific survival for stage 2 and 3 disease. Sequential Cox analyses with multiple cut-points in stage 2 disease suggested no gain in survival beyond 20 LNs; for stage 3 disease, no threshold effect was observed. Martingale residual analysis confirmed the thresholds. Conclusions: While greater LN harvest is associated with improved outcome in colon cancer, these data show a disconnect between the number of LNs needed to accurately determine LN positivity, and the optimal LNs needed for improved survival. Although the historically stated threshold of requiring a LN harvest of ≥ 12 may insure accurate LN staging, the threshold for optimal survival requires a significantly greater harvest.
COG AALL0434: A randomized trial testing nelarabine in newly diagnosed t-cell malignancy.
Authors: Kimberly P. Dunsmore, Stuart Winter, Meenakshi Devidas, Brent L. Wood, Natia Esiashvili, Nancy Eisenberg, Nikki Briegel, Robert J. Hayashi, Julie M Gastier-Foster, Andrew J Carroll, Nyla A. Heerema, Barbara Asselin, Karen R. Rabin, Patrick Zweidler-McKay, Elizabeth A. Raetz, Mignon L. Loh, Naomi J. Winick, William L. Carroll, Stephen Hunger
Journal: Journal of Clinical Oncology (2018)

10500 Background: Nelarabine (Nel) is a T-cell specific agent, FDA approved for patients who have failed at least two chemotherapy regimens. COG AALL0434 evaluated its safety and efficacy when incorporated into COG augmented BFM (ABFM) chemotherapy in newly diagnosed T-ALL and T-LL patients. Methods: AALL0434 enrolled 1,895 patients (2007-2014) and included a 2 x 2 pseudo-factorial randomization using the ABFM regimen. Patients were randomized to receive escalating dose methotrexate without leucovorin rescue + pegaspargase (CMTX) or High Dose MTX (HDMTX) + leucovorin rescue. Intermediate and high-risk patients with T-ALL and T-LL were randomized to receive or not receive six 5-day courses of (Nel) 650 mg/m2/day. The intermediate and high risk T-ALL patients received prophylactic (1200 cGy) or therapeutic (1800 cGy for CNS3) cranial irradiation. T-ALL patients with induction failure were non-randomly assigned to HDMTX+Nel. Results: For all randomized T-ALL patients, the 4-year disease-free survival (DFS) and overall survival (OS) rates were 84.3 +/- 1.1% and 90.2 +/- 0.9%. The 4-year DFS rate for T-ALL patients randomized to Nel (N = 323) vs no Nel (N = 336) was 88.9 +/- 2.2% vs 83.3 +/- 2.5%, (p = 0.0332). Among T-ALL patients randomized to CMTX the 4-year DFS for Nel (N = 147) vs no Nel (N = 151) was 92.2 +/- 2.8% vs 89.8 +/- 3.0%, p = 0.3825. For those randomized to HDMTX, 4-year DFS was 86.2 +/- 3.2% with Nel (N = 176) vs 78.0 +/- 3.7% without Nel (N = 185), p = 0.024. Differences between DFS in a 4-arm comparison were highly significant (P = 0.002), with no significant interactions between MTX and nelarabine randomizations (p = 0.41). T-ALL induction failure patients (N = 43) assigned to HDMTX/Nel had a 4-year DFS of 54.8 +/- 8.9%. Nelarabine did not show an advantage for high risk T-LL patients, with 4-year DFS 85.0 +/- 5.6% vs 89.0 +/- 4.7% for Nel (N = 60) vs no Nel (N = 58), p = 0.2788. Overall toxicity and neurotoxicity were acceptable and not significantly different between all four arms. Conclusions: COG AALL0434 is the largest trial ever conducted for newly diagnosed T-ALL and T-LL, and showed outstanding overall outcomes. Nelarabine improves DFS for children and young adults with T-ALL and should become a new standard of care for this population. Clinical trial information: NCT00408005.
Growth factors in tissues of squamous cell carcinoma of the esophagus (gender differences).
Authors: Natalia D. Cheryarina, Oleg Ivanovich Kit, Evgeniy N. Kolesnikov, Elena Mikhaylovna Frantsiyants, Yulia A. Pogorelova, Alexander V. Snezhko, Roman E. Myagkov, Sergey Vladimirovich Sanamyanc
Journal: Journal of Clinical Oncology (2016)

e15510 Background: Esophageal cancer is a highly malignant disease characterized by early lymphogenous metastasis. Women suffer from it 4-7 times less than men. Do growth factors reflect this difference? The purpose of the study was to analyze levels of growth factors in tumor tissue (TT), peritumoral zone (PTZ) and intact tissue (IT) in men and women with esophageal cancer. Methods: We studied tissues obtained during the surgery from 12 women and 30 men with pTNM stage II squamous cell carcinoma of the esophagus (G2) with various degrees of keratinization, mean age 59.2±4.7. 46.7% of men had metastases to the lymph nodes. Levels of IGF-1, IGF-2, VEGF-A, VEGFR-1, VEGF-C and TGFβ-1 were determined by ELISA. Results: We revealed some differences in levels of growth factors in TT compared to IT and PTZ in men and women. Common features included: decrease in IGF-1 and IGF-2 levels – by 28.9% and 45.4% in women and by 36.4% and 48.9% in men, respectively (PTZ values did not differ significantly from IT); increase in VEGFR-1 level – by 6.7 and 2 times in women and by 4.7 and 1.3 times in men, respectively; increase in VEGF-C level – by 2 and 1.2 times in women and by 5.1 and 1.5 times in men, respectively. Gender differences were found in VEGF-A and TGFβ-1 levels in IT: VEGF-A in women was 2.1 times lower than in men, while TGFβ-1 was twice higher. VEGF-A in TT of women did not differ significantly from the level in IT, and in PTZ it was 2.8 times higher. VEGF-A in TT and PTZ of men was 4.7 and 1.4 times higher than in IT, respectively. TGFβ-1 in TT of women was 1.7 times higher than in men. TGFβ-1 in PTZ of women and men did not differ from the level in IT. Conclusions: Neoangiogenesis in squamous cell carcinoma of the esophagus develops in PTZ in women and in TT in men. TGFβ-1 plays a protective role in esophageal cancer. Changes in VEGF-C level in men reflect metastatic potential of tumor.
Preliminary results of a reduced burden of therapy trial by incorporation of rituximab and intrathecal liposomal cytarabine in children, adolescents and young adults with intermediate (FAB Group B) and high risk (FAB Group C) mature B-cell lymphoma/leukemia.
Authors: Stanton Goldman, Matthew John Barth, Javier E. Oesterheld, Kenneth Heym, Lauren Harrison, Berkley Nickerson, Nader El-Mallawany, Jessica Hochberg, Mitchell S. Cairo
Journal: Journal of Clinical Oncology (2016)

10534 Background: An international study, FAB 96, has shown that it was possible to reduce treatment in intermediate risk but not high-risk patients. (Cairo, JCO 2012) Previous studies have demonstrated no additional benefit of anthracycline (Sposto, Med. Ped. Onc. 2001) and even 120 mg/m2 is associated with long-term cardiac toxicity (Lipshultz, JCO 2012). We have shown the safety of incorporating rituximab to the FAB 96 regimen.(Goldman, BJH 2014) The prolonged CNS half-life of liposomal encapsulated cytarabine (L-ARA-C) (Bomgaars, JCO 2004) makes it an ideal candidate to test as a means to reduce the frequent number of IT injections. Methods: An ongoing multicenter study (NCT01859819) is enrolling intermediate and high risk mature B-cell lymphoma/ leukemia patients, ages 3-30. Patients receive rituximab in induction and consolidation with reduced doxorubicin (60%) in intermediate-risk patients. CNS negative patients receive IT L-ARA-C (35 mg 3-16 years and 50 mg > 16 years) with dexamethasone during induction cycles 1 and 2 after systemic methotrexate clearance. CNS positive patients receive two additional IT-L-ARA-C doses. Results: As of January 2016, 24 patients, median age 12 years (range 3-25), 15 males, 11 Burkitt/13 DLBL, 18 Group B (2 Stage II, 16 stage III) and 6 Group C (4 CNS+) have been enrolled. There has been one reported rituximab related grade 3 anaphylaxis managed with steroids. With reduced anthracycline exposure the incidence of grade III/IV mucositis and febrile neutropenia is below 6% in induction for intermediate risk patients. With 56 IT L-ARA-C injections to date there have been no neurological toxicities. At a median of 54 weeks from study entry (range 6-152 weeks) the EFS and OS is 100%. Conclusions: When administered after methotrexate clearance, there were no limiting side effects of L-ARA-C and allowed a decrease in IT therapy administration. In this highly curative disease, rituximab may be logically applied to reduce the exposure of anthracycline therapy with reduction in short-term toxicity and potentially late treatment effects. Clinical trial information: NCT01859819.