tbuckley/cabot-search huggingface dataset:
Ethnodrama: An innovative knowledge translation tool in the management of lymphedema.
Authors: Shahid Ahmed, Elizabeth Quinlan, Linda McMullen, Roanne Thomas, Pam Fichtner, Janice Block
Journal: Journal of Clinical Oncology (2015)

102 Background: Lymphedema can cause significant physical impairment and quality-of-life issues. Yet there is a gap in knowledge about lymphedema among breast cancer survivors (BCS), and health care professionals (HCP). Ethnodrama is an innovative knowledge translation strategy that uses theatrical performances for dissemination of research results. We evaluated the impact of live ethnodrama on HCP’ and BCS' awareness and attitudes in relation to impact of lymphedema on BCS’ lives. Methods: Ethnodrama performances were developed by script writers and a theatre director in collaboration with the investigators and BCS using data from published research and pre-performances workshops. The 25- minute performance follows a readers’ theatre model. Six interactive live performances were given to audiences of BCS, HCP, and community members in four cities across Canada. After watching these live performances, the audiences were asked to complete a survey regarding their knowledge, attitudes and practices toward lymphedema. Results: Of 238 survey participants, 55 (23%) were BCS and 85 (37.5%) were HCP. The mean age was 46±15 years &amp; M:F was 1:4.8. Most members rated the performances as very effective in changing their (84%) or other people's (93%) understanding of lymphedema. Only 2.7% of respondents judged the performances as not effective at all in changing their understanding of lymphedema. Following the performances about 87% of respondents (95% HCP vs. 86.2% BCS, p = 0.10) reported being moderately to extremely motivated to seek additional information on lymphedema; 76% BCS reported interest in discussing arm morbidity issues with their HCP &amp; 72% HCP anticipated changes in their practices related to arm morbidities screening. Overall no significant differences were noted in responses to ethnodrama between BCS and HCP. Open-ended responses were supportive of the findings from the closed-ended questions. One of the performances (The New Normal: Living with Lymphedema) is available on https://www.youtube.com/channel/UCewEVF6CcTlEKYlLNcc8FWQ . Conclusions: Our results indicate that ethnodrama performances effectively convey information and positively affecting changes in HCP’ and BCS’ attitudes toward lymphedema.
A North American population-based outcome for early-stage ovarian clear cell carcinoma (OCCC).
Authors: P. Hoskins, J. S. Albarrak, N. Le, A. Tinker, K. Swenerton, J. Santos, C. B. Gilks
Journal: Journal of Clinical Oncology (2011)

5062 Background: OCCC is regarded as having a poor outcome and being relatively treatment resistant. Recent Japanese data instead have demonstrated high survival in early stage and radiation sensitivity. This study was carried out to reproduce/refute these findings in a North American setting. Methods: Women with OCCC who had attended one of the four British Columbia Cancer Agency (BCCA) centers have staging, pathological, treatment, and outcome data recorded in a computerized database. Irradiation (XRT) plus platin-based chemotherapy was the standard treatment. XRT usage mandated all such women provincially attending a BCCA centre. However, individual physicians within BCCA differed in their uptake of XRT. Outcomes with or without XRT could be compared. Univariate and multivariate (decision-tree analysis) analyses for disease-free survival (DFS) were performed. Results: 241 Stage I-II women attended between January 2000 and December 2008 (IA/IB n=64; Ic n=147; II n=30). 5 year and 10 year DFS for stage IA/B; IC and II were 85 and 70%; 64 and 58%; and 43 and 43% respectively. IC subsets faired differently: rupture alone (spontaneous and surgical were equivalent) - 5 yr DFS 80% versus 34% if cytologically positive and 43% with surface involvement. Decision-tree analysis identified cytologic positivity as the most important factor (recurrence 27% if negative, 72% if positive). Surface involvement then further subdivided the cytologically positive: surface involved 93% recurrence, if not involved 60%. XRT had no effect in stage IA (85% DFS at 5 yrs with or without it) but was superior to chemotherapy alone in IC (5 yr DFS 68% vs 58%, 10 yr DFS 63% vs 52%, HR 0.59). Conclusions: Stage IA OCCC has an excellent long-term outcome as does IC (rupture only). IC otherwise has a poor outcome as does stage II. XRT and chemotherapy improves outcome in stage IC versus chemotherapy alone.
Initial Results of a Phase 2 Study of Guadecitabine (SGI-110), a Novel Subcutaneous (sc) Hypomethylating Agent, for Patients with Previously Untreated Intermediate-2 or High Risk Myelodysplastic Syndromes (MDS) or Chronic Myelomonocytic Leukemia (CMML)
Authors: Guillermo Montalban-Bravo, Prithviraj Bose, Yesid Alvarado, Naval Daver, Farhad Ravandi, Gautam Borthakur, Koichi Takahashi, Michael Andreeff, Jorge E. Cortes, Courtney D. DiNardo, Elias Jabbour, Tapan M. Kadia, Steven M. Kornblau, Maro Ohanian, Ana Alfonso Pierola, Xuelin Huang, Graciela M. Nogueras-Gonzalez, Kristy Bodden, Kristina Littles, Sherry Pierce, Carlos E Bueso-Ramos, Hagop M. Kantarjian, Guillermo Garcia-Manero
Journal: Blood (2016)
The impact of pelvic magnetic resonance imaging on risk stratification in patients with localized prostate cancer.
Authors: David Mitchell Marcus, Peter John Rossi, Sherif Nour, Ashesh B. Jani
Journal: Journal of Clinical Oncology (2014)

130 Background: We aimed to determine the impact of multiparametric magnetic resonance imaging (MRI) of the prostate on established risk stratification criteria in patients with clinically localized adenocarcinoma of the prostate (ACP). Methods: We included patients who had undergone multiparametric prostate MRI at our institution as part of their initial workup for ACP. Traditional risk stratification criteria (prostate specific antigen, clinical T stage, biopsy Gleason score) were recorded, and the initial National Comprehensive Cancer Network (NCCN) risk group was calculated. The NCCN risk group was then recalculated incorporating MRI findings. The impact of MRI findings on changes in risk group classification was evaluated using the Stuart-Maxwell test for marginal homogeneity. Results: Of 71 patients analyzed, 11 (15.5%), 39 (54.9%), and 21 (29.6%) had low, intermediate, and high risk disease, respectively. MRI findings led to risk group upstaging in 12 cases (16.9%). The highest yield was demonstrated in patients with intermediate-risk disease, in whom MRI led to upstaging in 25.6% of patients. The Stuart-Maxwell test demonstrated a significant difference between pre-MRI and post-MRI risk group classifications (p &lt;0.01) for the entire cohort. Pre-MRI and post-MRI risk groups for all patients are shown in the table, with off-diagonal elements representing risk group changes. MRI findings resulted in clearly documented changes in the treatment strategy for 5 patients (7.0%), including addition of androgen deprivation therapy in 2 patients, elimination of definitive therapy in 2 patients determined to have metastatic disease, and elimination of a brachytherapy boost in one patient. Conclusions: In our cohort of patients with clinically localized ACP, MRI findings often led to significant changes in risk stratification and treatment. Our findings support the routine use of MRI in the workup of patients with clinically localized ACP, particularly those with intermediate risk disease . [Table: see text]
Categorization of measures of quality in radiation treatment.
Authors: Jeffrey Quoc Cao, Holly Donaldson, John French, Caitlin Gillan, Michael Milosevic, Catarina Lam, Peter Dunscombe
Journal: Journal of Clinical Oncology (2012)

187 Background: The Canadian Partnership for Quality Radiotherapy (CPQR) has revised an outdated version of quality assurance (QA) guidelines for use in Canadian radiation treatment (RT) centres. This updated document contains concise, specific quality statements against which program structure and performance can be evaluated. Our objective was to review available international guidelines for quality in RT, categorize them according to a defined taxonomy, and inform a modified Delphi process for further evaluation of the guidelines. Methods: We identified 8 relevant standards documents issued by jurisdictions internationally. Taken together, 454 statements, or groups of statements, describing measures of quality were identified. These disparate quality statements were consolidated into a limited number of manageable groups using an appropriate classification scheme. A decision tree with two major categories was developed. Category 1 was based on the classification proposed by Donabedian as to whether the statement addressed a structure, process, outcome, or other. Category 2 addressed whether the statement referred to activities directed towards the organization, patients, staff, equipment/clinical processes, or other. Five reviewers assigned each of the 454 statements independently to one of these 20 (4 x 5) category decision tree endpoints. Results: A free marginal kappa analysis of agreement between the 5 reviewers in all 20 endpoints yielded a value of 0.38 which is fair agreement. Restricting analysis to Category 1, there is better agreement with a kappa of 0.54. Alternatively, 3 or more of the 5 reviewers agreed on their assignments 93% of the time for Category 1 and 76% for Categories 1 and 2. There were 290 statements with less than 100% agreement in Category 1 extracted for a second mapping using additional descriptive qualifiers. Subsequently, the overall free-marginal kappa increased to 0.71, considered substantial agreement. Conclusions: Kappa values varied among the 8 documents reviewed, possibly indicating differences in clarity of the descriptions. The 454 standards identified have been categorized and provide a manageable input to our ongoing effort to maintain appropriate, up-to-date Canadian quality guidelines for RT.
Dovitinib in first-line renal cell carcinoma: An investigation into tumour gene status and correlation with efficacy: A phase II clinical trial.
Authors: Reuben James Broom, Steven Duffey, Carol Fraser-Browne, Georgia Wilson, Kerin Thompson, Fritha Hanning, Nicola Jane Mitchell, Jonathan Zwi, Mark James McKeage, George Dranitsaris, Paul Oei, Peter C.C. Fong
Journal: Journal of Clinical Oncology (2014)

443 Background: Dovitinib is an anti-VEGFR tyrosine kinase inhibitor, differentiated by its inhibition of FGFR-1,-2,-3 and PDGFRβ. We evaluated its activity as 1st-line therapy in patients with metastatic clear-cell renal cell carcinoma (mCCRCC) in correlation with status of genes relevant to its mechanism of action. Methods: 31 treatment-naïve patients with mCCRCC were enrolled in this single-arm, single-site, phase II study (ACTRN12612000140853) and received dovitinib at 500mg 5 days on/2 days off until progression. Patients were offered an optional post-treatment biopsy to elucidate resistance mechanisms. The primary endpoint was progression free survival (PFS) using RECIST 1.1. Secondary endpoints include response rate (RR) and efficacy by FGFR gene status (FISH and DNA sequence using Sequenom OncoCarta panel). Results: Accrual occurred over 15 months from March 2012. Median patient age was 64 years and 72% were male. ECOG performance status was 0 in 45% and 1 in 55%. Heng prognostic group was favorable-risk in 38%, intermediate-risk in 52% and poor-risk in 10%. 38% of patients had bone metastases. Four patients stopped treatment due to toxicity and 1 patient withdrew (investigator decision). Median PFS was 6.2 months (inter quartile range: 3.3 to 8.2). Of 28 evaluable patients, best response was; PR (29%), SD (53%) and PD (18%). All-cause grade 3/4 adverse events (AE’s) occurring in ≥5% of patients were; fatigue (16%), abdominal pain (13%), pancreatitis (10%), gout (7%), diarrhea (7%), bone pain (7%), hypercalcaemia (7%), elevated lipase (7%) and pulmonary embolism (7%). No Grade 5 AE’s occurred. Pre-treatment tumor tissue is available for analysis from primary and metastatic sites from 93% and 54% of patients respectively. To date, 6 patients have donated post-progression tumor tissue. Gene status (FISH) for FGFR-1,-2,-3, PDGFβ and PDGFRβ is available for 20 primary and 17 metastatic specimens. Conclusions: Dovitinib has activity when administered in the 1 st -line setting of mCCRCC with a tolerable safety profile at this dosing schedule. Correlation of this activity to relevant gene status in tumor samples from study patients will be presented. Clinical trial information: ACTRN12612000140853.
A phase I dose escalation safety and pharmacokinetic (PK) study of SSR244738 administered as a one-hour intravenous (IV) infusion twice-weekly during a 3-week cycle in patients (pts) with refractory solid tumors
Authors: N. Isambert, G. Spitaleri, P. Fumoleau, C. Noberasco, C. Ramazeilles, M. Chadjaa, L. Bolloni, F. De Braud
Journal: Journal of Clinical Oncology (2009)

2539 Background: SSR244738 is a new cytotoxic agent (G2-cell cycle inhibitor). In this first in man study the original schedule of administration was an IV infusion once every 3 weeks (Q3W); and due to the high clearance variability, 1300 mg/m 2 was considered the maximum administered dose (MAD). The study was amended to test the twice weekly schedule (D1-D4-D8-D11-D15, every 3 weeks). Methods: Standard escalation was used in cohorts of 3–6 pts. PK profiles (up to T48h or T96h) were obtained in each pt after the 1st and the 5 th administration (D1 and D15) of Cycle 1. In the Q3W, there was a trend to lower clearance (CL) in CYP2C9 *3/*3 and *1/*3 genotype pts therefore genotype samples were analyzed at baseline to identify poor metabolizers (PM) and adjust-dosing accordingly. Results: 22 heavily pretreated patients received SSR244738 at doses of 200 (3 pts), 280 (4 pts), 400 (3 pts), 560 (3 pts), 780 (3 pt), 1000 (6 pts; one pt was a PM and received 500 mg/m 2 ). 15 females, 7 males, median age: 60 years (29–82), ECOG: (0:12, 1:9, Unk:1). Main tumor types: ovary, lung, breast, colon and prostate. Nb cycles/pts: &gt; 2 cycles/21 (95%), &gt; 4 cycles/9 (41%), &gt; 6 cycles/6 (27%), &gt; 8 cycles/2 (9%). The most common reason for treatment discontinuation was disease progression. DLT was seen in 2 pts at 1000 mg/m 2 dose level: one patient had febrile neutropenia associated with Grade 3 mucositis and the second patient had Grade 3 neutropenia, which caused a treatment delay. Both pts showed high SSR244738 plasma exposures on D15. SD was reported in 11 patients. No CRs or PRs were observed. SSR244738 exhibited an overall low plasma CL (mean [range]: 0.9 [0.3–2.1] L/h). CL slightly decreased with repeated administration. The distribution volume was low [Vss mean (CV%): 11.6 L (30%)] and the terminal half life was long [mean (CV%): 15.6 h (58%)]. No deviation from dose proportionality could be observed, despite the moderate-to-high inter-individual variability (CV&lt;64%) in exposure. Conclusions: SSR244738 is well tolerated with PK profile similar to the Q3W schedule; by changing the schedule of administration we were able to reach the MAD dose (5000 mg/m 2 /cycle). [Table: see text]
Outcome of effective intervention to improve screening colonoscopy in a downtown Brooklyn community hospital.
Authors: K. Veerabhadrappa, Z. M. Bo, K. T. Lyar, R. Sultana, G. M. Villani
Journal: Journal of Clinical Oncology (2011)

1540 Background: The Cancer Prevention and Control Program at New York City Department of Health and Mental Hygiene Launched the Colonoscopy Patient Navigator Program in 2003 to address the low rates of colorectal cancer screening in New York City. Brooklyn Hospital became part of this program in 2009. We wanted to evaluate the effectiveness of this intervention in our colonoscopy no show rates. Methods: Retrospective analysis of two groups of patients scheduled for colonoscopies in the year 2009- 2010 which bracketed the implementation of navigator in Downtown Brooklyn hospital was done to evaluate the efficacy of an intervention. We compared the no show rates for patients scheduled for colonoscopies pre and post navigator implementation. A generalized linear model was fitted, with fixed factors pre-post navigator, race, gender and their respective interactions. Asians were excluded since their small numbers introduced sampling zeroes. SAS (SAS Institute, Cary NC) Release 9.2 software was used. Results: Of the 1263 patients’, 625 patients’ were evaluated by the navigator. The no show rate decreased from 17.7% to 8.5% after the implementation of the navigator (p<0.001). The adjusted odds ratio of no-show for the post- vs. pre-navigator period is 0.43 (95% confidence interval [0.34, 0.54]). This improvement in no show rate was seen in both genders (17.6% to 9.5% in males and 17.6% to 8.2% in females). Our data also showed that the improvement in no show rate was seen across all races. Of interest, was significant decrease seen in no show rates among the Hispanic population which improved from 19.2% to 4.9%. Conclusions: There was an association between screening colonoscopy compliance and patient navigator-based intervention in our community hospital consistent with findings in other institutions. The significant increase in utilization among Hispanic population can be attributed to the navigator’s language proficiency. We postulate that patient’s belief in navigator significantly increased along with better understanding of the procedure when communicated in their language. Our data supports patient navigation to be an effective tool in overcoming the health care system barriers.
Spinal or epidural analgesia for cancer pain: The Ottawa Hospital experience.
Authors: N. Yarom, C. Smyth, V. Jarvis, G. Gresham, D. J. Jonker
Journal: Journal of Clinical Oncology (2011)

e19701 Background: Cancer pain is occasionally intractable, resistant to opioid and associated with increased mortality and long hospitalizations. Invasive nerve blocks and catheters are perceived as complex, with a high rate of adverse effects. Methods: Consecutive hospitalised cancer patients (pts) treated with nerve blocks by a complex pain clinic team including a dedicated anaesthiologist were retrospectively reviewed. Results: Between November 2007 and 2010 20 pts were treated with spinal block and 25 pts with an epidural block. Patients had a variety of solid tumours including lung (20%), breast (15%), colorectal (15%), bladder cancer (8%), sarcomas(8%), and others. Median age was 58 years (range 19-85) in the epidural group and 61 (range 49-79) in the spinal group. Analgesics via the spinal catheter included bupivacaine, fentanyl, hydromorphone via the epidural catheter analgesics included epinephrine, bupivacaine, fentanyl and hydromorphone. Patients routinely completed edmonton symptom assesment scales (ESAS) and brief pain inventory scores. A pain relief category was assigned for each patient: 0 = no change in pain/ analgesics, 1 = pain/analgesics reduced, and 2 = other analgesics discontinued. Overall, 93% experienced pain relief (category 1-2). The table below shows the results of the two procedures. After epidural analgesia pts reported more urinary retention (20%) and numbness (8%). After spinal analgesia there was more fever (10%), pruritus (5%) and nausea (5%). All complications were reversible. Catheter repositioning was required in 3 pts with spinal and 2 pts with epidural catheters. 28.8% were successfully discharged home. Survival data will be presented. Conclusions: Epidural and spinal analgesia were effective palliative techniques in most patients. Complications were generally infrequent and manageable. Nerve block Pain relief category P value 0-1 2 Spinal 8 (40%) 12 (60%) 0.18 Epidural 15 (60%) 10 (40%)
Identification of LASEP3 as a new serological and prognostic biomarker for lung cancer.
Authors: A. Takano, Y. Nakamura, Y. Daigo
Journal: Journal of Clinical Oncology (2011)

10552 Background: Characterization of cancer-specific oncoantigens is an effective strategy to identify novel diagnostic/prognostic biomarkers. Methods: We screened for genes encoding transmembrane/secretory molecules that are transactivated commonly in lung cancers by the gene-expression profile analysis of 120 lung cancers. LASEP3 (lung cancer-associated serum protein 3) that encodes a secretory protein was selected as a candidate. Immunohistochemical staining using lung cancer tissue microarray was applied to examine the expression level of LASEP3 and its prognostic value. Serum LASEP3 levels in lung cancer patients and healthy individuals were measured by ELISA. A role of LASEP3 in cancer cell growth was examined by small interfering RNA experiments. Results:Immunohistochemical analysis showed that LASEP3 was frequently over-expressed in various histological types of lung cancers. Positive staining of LASEP3 was observed in 198 (54.8%) of 361 NSCLCs. In addition, a high level of LASEP3 expression was associated with poor prognosis for NSCLC patients (P=0.0183) and a high level of LASEP3 expression was associated with tumor size (P = 0.0183) and lymph node metastasis (P = 0.0016). Serum LASEP3 levels were higher in NSCLC patients than in healthy volunteers. The proportion of serum LASEP3-positive cases was 160 (61.8%) of 259 NSCLCs:131 (63.6%) of 206 ADCs and 29 (54.7%) of 53 SCCs, while 6 (5.5%) of 109 healthy volunteers were falsely diagnosed. A combined assay using both LASEP3 and CEA increased sensitivity because 79.5% of the NSCLC patients were then diagnosed as positive, whereas only 7.3% of 109 healthy volunteers were falsely diagnosed as positive. Serum LASEP3 levels were significantly higher in other types of cancer (breast, cervical, and colon cancer) patients than in healthy volunteers. Furthermore, treatment of lung cancer cells with siRNAs against LASEP3 suppressed its expression and resulted in growth suppression of the lung cancer cells. Conclusions: We have identified LASEP3 as a potential target for the development of diagnostic and prognostic biomarkers for lung cancer.
Response to neoadjuvant chemotherapy and impact on survival for resected gastric cancer.
Authors: Erin Greenleaf, Christopher S Hollenbeak, Joyce Wong
Journal: Journal of Clinical Oncology (2016)

122 Background: This study assesses the survival impact of perioperative chemotherapy, with further analysis of pathologic response to neoadjuvant chemotherapy (NAC), in patients undergoing gastrectomy for gastric cancer (GC) in a large US sample. Methods: Using the 2003-2012 ACS National Cancer Database, 16,128 patients underwent gastrectomy for cancer. Treatment groups were categorized as: NAC, adjuvant chemotherapy, and surgery only. Patients receiving NAC were further categorized as: down-staged, no response, and disease progression. Univariate and multivariate analyses were performed to estimate the impact of treatment on overall survival. Results: Of patients undergoing gastrectomy, 36.6% received NAC, 19.5% received adjuvant chemotherapy, and 43.9% underwent surgery only. Median time of survival was longer in patients with more advanced disease who underwent either NAC or adjuvant chemotherapy versus surgery alone (see Table). In multivariate analysis, patients who received NAC had 20% lower hazard of death than surgery only patients (HR = 0.80, p &lt; 0.0001). Within the NAC cohort (N = 5,909), 47.7% were down-staged, 36.5% had no response, and 15.7% demonstrated disease progression. Having a pathologic response to NAC was associated with having private insurance (OR = 1.22, p &lt; 0.0001), higher socioeconomic status (OR = 1.21, p = 0.003), treatment in the central US (p &lt; 0.0001, both), and undergoing proximal gastrectomy (OR = 1.59, p &lt; 0.0001). Among patients who received NAC, median time of survival was longer if NAC down-staged patients to stages 0 or 1, with no survival difference in advanced stage disease. Conclusions: Neoadjuvant chemotherapy elicits a survival benefit in patients with advanced GC. Pathologic response is achieved in nearly half of patients undergoing NAC and is associated with improved survival, although only when down-staging to early stage disease. [Table: see text] [Table: see text]