tbuckley/cabot-search huggingface dataset:
Erythropoietin use in medically underserved patients (pts)
Authors: J. Khatcheressian, T. Smith, L. Lyckholm, L. A. Hansen, L. Shickle
Journal: Journal of Clinical Oncology (2004)

8139 Background: Erythropoetin (Epo) use in the practice of oncology is widespread and considered a standard of care in many settings. We designed a project to assess how effectively indigent pts in our fellows' clinic were treated for chemotherapy induced anemia (CIA) and whether those outcomes improved with a simple educational intervention. Methods: Eligible pts were those who received chemotherapy in the 2 months prior to their visit. Medical records were reviewed for the presence of anemia, defined as a hemoglobin (Hgb) level less than 10g/dL, and the initiation of treatment with Epo. Pts with hematologic malignancies were included if they had no improvement in Hgb levels after conventional therapy. Afterwards, an educational in-service for clinic nurses and fellows was administered with attention to the prevalence of CIA, its associated adverse effects, and Epo treatment guidelines published jointly by ASCO and ASH. Nurses and fellows were trained to recognize anemia and begin treatment. A review of medical records was performed several months later to assess whether the incidence of treatment with Epo improved. All Epo used to treat indigent pts was procured through an organized manufacturer patient assistance program; as a result, drug costs to the health system were minimal. Results: Thirty pts seen in clinic between Sept. 16 and Nov. 1, 2002 were eligible for review. Eight (27%) pts developed CIA and 4 (50%) began treatment with Epo. After the intervention, records were reviewed for pts seen between Apr. 18 and Jun. 20, 2003. Of the 35 eligible pts, 7 (20%) developed CIA and all 7 (100%) started treatment with Epo. Chi-square results for the difference in treatment was significant, p=0.029. Conclusions: Although patient numbers in this study are small, they demonstrate that a simple educational program for oncology nurses and fellows can improve the appropriate delivery of care to indigent cancer pts with CIA. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Ortho-Biotech
Effect on patient care of repeat pathologic review for breast cancer.
Authors: Andrew Cota Shaw, Hanna Kelly Sanoff, Mark E Smolkin
Journal: Journal of Clinical Oncology (2013)

6599 Background: Many cancer centers routinely re-review outside pathologic specimens. We hypothesized re-review rarely changes patient treatment plans. Methods: Of 1495 patients seen at the University of Virginia with a diagnosis of breast cancer from 2006-2011, the 276 cases with both internal and outside pathology reports comprised the study cohort. Interobserver agreement (kappa coefficient, K) between internal and outside diagnoses were calculated for histopathology, lymph node, margin, ER/PR, and HER2 status. We then evaluated if the change would result in a change in therapy or surveillance per the National Comprehensive Cancer Network (NCCN) guidelines. The effect of region and teaching affiliation of outside institutions was explored. Results: For the 276 cases with re-reviewed pathology at UVA there was absolute agreement for ER/PR and surgical margins, and excellent agreement for lymph node, K= 0.93, and histopathology, K=0.93. Agreement was good for HER2, K=0.83. 3 cases were changed from HER2 positive to negative (2) or intermediate (1). Of 9 changes in histopathology, 2 had a major upgrade: 1 ADH to DCIS; 1 DCIS to carcinoma. 3 had a major downgrade: 2 from DCIS to ADH; 1 from carcinoma to DCIS. 2 cases changed from ALH to LCIS. Lymph node status was changed from positive to negative in one out of 31 reviewed cases. Treatment plan would have changed for all 13, 4.7% of all patients. Changes were made almost exclusively (11/13) if referred from a hospital with no or minor teaching affiliation, including all major histopathology changes and changes in lymph node and HER2 status. Conclusions: Interobserver agreement for breast pathology between pathologists at an NCI designated cancer center and outside institutions was good. However, 4.7% of women had discordant results that would lead to a change in their care. Changes were most common for noninvasive carcinoma and benign atypia. In order to best utilize resources, referral centers may want to consider limiting re-review to the pathology from centers with high risk for discordance.
Evaluating the patient-centered quality of cancer survivorship care models.
Authors: Holly Mead, Mandi Pratt-Chapman, Sean Cleary, Sarah Raskin
Journal: Journal of Clinical Oncology (2017)

48 Background: With 15.5 million cancer survivors in the U.S., cancer is increasingly viewed as a chronic illness that requires systematic, coordinated care. Yet research has not determined what models of survivorship are most effective in providing high quality, patient-centered care. This study evaluates the quality of three models of cancer survivorship care using a newly developed patient-centered measure. Methods: We conducted a comparative effectiveness study with 32 cancer programs distributed across 3 distinct models of survivorship care: 1) Consultative Specialized Survivorship Clinic; 2) Longitudinal Specialized Survivorship Clinic; and 3) Oncology-Embedded Survivorship Clinic with Referrals. We developed the Patient-Prioritized Measure of High Quality Survivorship Care (PPM), a scale comprising 9 patient-prioritized components of survivorship care. We enrolled 991 survivors of breast, colorectal and prostate cancer across these programs and followed them over 6 months collecting self-reported data on quality of survivorship services. Results: Preliminary results suggest statistically significant differences across models of care for six PPM components. Model 1 is more likely than the other two models to provide a full spectrum of services (p=0.0001), mental health and social support (p&lt;0.0001), and information and resources for patients in survivorship (p=0.0002). Model 2 is better than model 3 at providing a medical home (0.04), and outperforms both other models at coordinating care and transitions (p=0.0059). Both Models 1 and 2 are better than model 3 in ensuring productive patient-provider interactions (p=0.006). Conclusions: It appears that certain models of survivorship care are better at specific domains of patient-centered quality, suggesting cancer centers should consider their organizational context and their patients’ needs before committing to a particular model of care.
Status and methodology of publicly available national HIV care continua and 90-90-90 targets: A systematic review
Authors: Reuben Granich, Somya Gupta, Irene Hall, John Aberle-Grasse, Shannon Hader, Jonathan Mermin
Journal: PLoS Medicine (2017)

Background In 2014, the Joint United Nations Program on HIV/AIDS (UNAIDS) issued treatment goals for human immunodeficiency virus (HIV). The 90-90-90 target specifies that by 2020, 90% of individuals living with HIV will know their HIV status, 90% of people with diagnosed HIV infection will receive antiretroviral treatment (ART), and 90% of those taking ART will be virally suppressed. Consistent methods and routine reporting in the public domain will be necessary for tracking progress towards the 90-90-90 target. Methods and findings For the period 2010–2016, we searched PubMed, UNAIDS country progress reports, World Health Organization (WHO), UNAIDS reports, national surveillance and program reports, United States President’s Emergency Plan for AIDS Relief (PEPFAR) Country Operational Plans, and conference presentations and/or abstracts for the latest available national HIV care continuum in the public domain. Continua of care included the number and proportion of people living with HIV (PLHIV) who are diagnosed, on ART, and virally suppressed out of the estimated number of PLHIV. We ranked the described methods for indicators to derive high-, medium-, and low-quality continuum. For 2010–2016, we identified 53 national care continua with viral suppression estimates representing 19.7 million (54%) of the 2015 global estimate of PLHIV. Of the 53, 6 (with 2% of global burden) were high quality, using standard surveillance methods to derive an overall denominator and program data from national cohorts for estimating steps in the continuum. Only nine countries in sub-Saharan Africa had care continua with viral suppression estimates. Of the 53 countries, the average proportion of the aggregate of PLHIV from all countries on ART was 48%, and the proportion of PLHIV who were virally suppressed was 40%. Seven countries (Sweden, Cambodia, United Kingdom, Switzerland, Denmark, Rwanda, and Namibia) were within 12% and 10% of achieving the 90-90-90 target for “on ART” and for “viral suppression,” respectively. The limitations to consider when interpreting the results include significant variation in methods used to determine national continua and the possibility that complete continua were not available through our comprehensive search of the public domain. Conclusions Relatively few complete national continua of care are available in the public domain, and there is considerable variation in the methods for determining progress towards the 90-90-90 target. Despite bearing the highest HIV burden, national care continua from sub-Saharan Africa were less likely to be in the public domain. A standardized monitoring and evaluation approach could improve the use of scarce resources to achieve 90-90-90 through improved transparency, accountability, and efficiency.
S-1 versus placebo in patients with sorafenib-refractory advanced hepatocellular carcinoma (S-CUBE): a randomised, double-blind, multicentre, phase 3 trial
Authors: Masatoshi Kudo, Michihisa Moriguchi, Kazushi Numata, Hisashi Hidaka, Hironori Tanaka, Masafumi Ikeda, Seiji Kawazoe, Shinichi Ohkawa, Yozo Sato, Shuichi Kaneko, Junji Furuse, Madoka Takeuchi, Xuemin Fang, Yoshito Date, Masahiro Takeuchi, Takuji Okusaka
Journal: The Lancet. Gastroenterology & hepatology (2017)
Across the cancer continuum: A communication skills curriculum for oncology fellows.
Authors: Deepa Rangachari, Ross C. Donehower
Journal: Journal of Clinical Oncology (2014)

e20556 Background: Communicating difficult news is a frequent activity in cancer care. Many providers have had limited communication skills (CS) training, leading to stress, dissatisfaction, and burnout.1,2,3 Cancer patients also report unmet communication needs.4-8 The purpose of this study was to implement and evaluate a CS curriculum for oncology fellows using simulation, didactics, and feedback. Methods: First-year fellows were each assigned to one standardized patient (SP) and one faculty preceptor for a half-day session. On the day of the workshop, each fellow completed four vignettes with a single SP: diagnosis, recurrence, progression, and end-of-life. Encounters were observed by preceptors. Each triad then met for verbal feedback using the
Increased risk of rheumatoid arthritis among mothers with children who carry<i>DRB1</i>risk-associated alleles
Authors: Giovanna Ibeth Cruz, Xiaorong Shao, Hong Quach, Kimberly A Ho, Kirsten Sterba, Janelle A Noble, Nikolaos A Patsopoulos, Michael P Busch, Darrell J Triulzi, Wendy SW Wong, Benjamin D Solomon, John E Niederhuber, Lindsey A Criswell, Lisa F Barcellos
Journal: Annals of the Rheumatic Diseases (2017)

To investigate whether a child's genotype affects a mother's risk of rheumatoid arthritis (RA) beyond the risk associated with her genotype and to test whether exposure to fetal alleles inherited from the father increases risk of RA among mothers without risk alleles.A case-control study was conducted among 1165 mothers (170 cases/995 controls) and their respective 1482 children. We tested the association between having any child with alleles encoding amino acids (AAs) associated with RA including the 'shared epitope' (SE) and DERAA AA sequences at positions 70-74; AA valine, lysine and alanine at positions 11, 71 and 74 of HLA-DRB1; aspartic acid at position 9 of HLA-B and phenylalanine at position 9 of DPB1. We used logistic regression models to estimate OR and 95% CI for each group of alleles, adjusting for maternal genotype and number of live births.We found increased risk of RA among mothers who had any child with SE (OR 3.0; 95% CI 2.0 to 4.6); DERAA (OR 1.7; 95% CI 1.1 to 2.6); or valine (OR 2.3; 95% CI 1.6 to 3.5), lysine (OR 2.3; 95% CI 1.5 to 3.4) and alanine (OR 2.8; 95% CI 1.2 to 6.4) at DRB1 positions 11, 71 and 74, respectively. Among non-carrier mothers, increased risk of RA was associated with having children who carried DERAA (OR 1.7; 95% CI 1.0 to 2.7) and alleles encoding lysine at DRB1 position 71 (OR 2.3; 95% CI 1.5 to 4.8).Findings support the hypothesis that a child's genotype can contribute independently to risk of RA among mothers.
Design of the effect of adaptive servo‐ventilation on survival and cardiovascular hospital admissions in patients with heart failure and sleep apnoea: the ADVENT‐HF trial
Authors: Owen D. Lyons, John S. Floras, Alexander G. Logan, Robert Beanlands, Joaquin Durán Cantolla, Michael Fitzpatrick, John Fleetham, R. John Kimoff, Richard S.T. Leung, Geraldo Lorenzi Filho, Pierre Mayer, Lisa Mielniczuk, Debra L. Morrison, Clodagh M. Ryan, Frederic Series, George A. Tomlinson, Anna Woo, Michael Arzt, Sairam Parthasarathy, Stefania Redolfi, Takatoshi Kasai, Gianfranco Parati, Diego H. Delgado, T. Douglas Bradley
Journal: European Journal of Heart Failure (2017)
PROMs and PREMs in Dutch integrated head and neck cancer care: Measurements and evaluation.
Authors: Lydia Francisca Jacoba van Overveld, Robert P. Takes, Jozé C.C. Braspenning, Ludi E Smeele, Matthias A.W. Merkx, Rosella P.M.G. Hermens
Journal: Journal of Clinical Oncology (2017)

209 Background: Providing patient-centred care is an essential component of high quality integrated care. Nowadays, patient reported outcomes and experiences are increasingly used to measure quality of care. As part of a quality registration, the Dutch Head and Neck Audit, patient reported outcomes (PROs) and experiences (PREs) of patients with head and neck cancer (HNC) are measured with questionnaires and evaluated to increase patient-centred care. Methods: Patientswere recruited from nine hospitals participating in the DHNA. Validated questionnaires were distributed at baseline, 3, 6 and 12 months follow-up. Included PROMs were EQ-5D-3L, EORTC QLQ-C30 and EORTC QLQ-H&amp;N35. Included PREMs were Consumer Quality index for Oncologic care (CQO) and Radiotherapeutic care (CQR). CQO and CQR have similar domains with different questions. With descriptive analysis, ANOVA and mixed model analysis, differences over time and between treatment groups were analyzed. Results: Questionnaires were filled in by 238 patients. Pain decreased significantly at 6 and 12 months follow-up and dry mouth increased significantly at 3, 6 and 12 months follow-up compared to baseline. Sticky Salvia, problems with social eating and sense problems increased at 3 and 6 months follow-up, but were similar to the baseline score at 12 months follow-up. Pain and sticky saliva differed between radiotherapy and chemoradiotherapy or surgery and radiotherapy respectively (p ≤ 0.05). Regarding the CQO domain scores, all treatment groups differ significantly from each other (p ≤ 0.05). This was not regarding the CQR domain scores. Except for the domain Organisation, no differences between the CQO and CQR domain scores were found. Recognizing the emotional side of HNC (care) and intensifying guidance after the treatment period needs improvement. Conclusions: This study gives clues to improve healthcare according the experiences of the patient and we can predict more carefully the outcomes of the patients with different treatment types. PROMs according to the ICHOM criteria and PREMs are promising for measuring and improving quality and personalization of HNC care. However, the usage of two PREMs had no added value to evaluate and address points of improvement.
Doxycycline improves clinical outcomes during cystic fibrosis exacerbations
Authors: Xin Xu, Tarek Abdalla, Preston E. Bratcher, Patricia L. Jackson, Gina Sabbatini, J. Michael Wells, Xiang-Yang Lou, Rebecca Quinn, J. Edwin Blalock, J. P. Clancy, Amit Gaggar
Journal: European Respiratory Journal (2017)

Matrix metalloprotease-9 (MMP-9) plays a role in progression of cystic fibrosis, and doxycycline can reduce MMP-9 in vitro . Here, we explore the effect of doxycycline during cystic fibrosis exacerbation treatment on MMP-9 related readouts and clinical end-points. This randomised, double-blind, placebo-controlled study enrolled hospitalised patients with cystic fibrosis undergoing exacerbation. In total, 20 participants were given doxycycline and 19 participants were given placebo over an 8-day period during hospitalisation. Biospecimens were collected at the beginning and the end of the study period. Primary end-points were total MMP-9 levels in the sputum and safety/tolerability. Secondary end-points included change in lung function, time to next exacerbation, and markers of MMP-9-related protease activity (active MMP-9 and TIMP-1). Nonparametric testing was used for within-group and between-group analyses. Doxycycline was well tolerated, with no treatment discontinuations or serious adverse events. Doxycycline reduced total sputum MMP-9 levels by 63.2% (p&lt;0.05), and was also associated with a 56.5% reduction in active MMP-9 levels (p&lt;0.05), a 1.6-fold increase in sputum TIMP-1 (p&lt;0.05), improvement in forced expiratory volume in 1 s (p&lt;0.05), and an increase in time to next exacerbation (p&lt;0.01). Adjunctive use of doxycycline improved dysregulated MMP-9 levels in sputum, along with biomarkers consistent with a reduced proteolytic pulmonary environment. Improvement in clinical outcome measures suggests an important therapeutic benefit of doxycycline for individuals with cystic fibrosis.
Primary tumor cells from cancer patients “decorated” with a novel form of CD80 protein effectively induce autologous T-cell responses ex-vivo
Authors: N. Singh, E. S. Yolcu, R. W. Miller, H. Shirwan, R. M. Huseby, O. Kilinc, D. Taylor, M. Oechsli, R. Larocca
Journal: Journal of Clinical Oncology (2004)

2580 Background: The genetic modification of tumor cells is an elaborate process and has several limitations for effective use as cancer immunotherapy in clinical settings. We have recently developed a novel technology, ProtExä, that allows for rapid, efficient, and durable display of exogenous proteins on the cell surface. This technology involves generation of chimeric molecules composed of immunological proteins of interest and core streptavidin, biotinylation of biological surfaces, and decoration with chimeric proteins. In a mouse B lymphoma model, vaccination with tumor cells decorated with a chimeric costimulatory protein (CD80-SA) containing the extracellular portion of human CD80 and core streptavidin was effective in preventing tumor growth in 100% of animals. In this study, we tested whether primary tumor cells resected from cancer patients and decorated with CD80-SA can induce autologous proliferative and cytotoxic T-cell responses ex vivo. Methods: Primary tumor cells and blood samples were collected from 10 lung and 6 colon cancer patients of various stage (I to IV) who were treatment naïve. T-cell proliferative (CFSE and 3H-thymidine incorporation) and cytolytic (JAM) assays were used.Results: Tumor cells decorated with CD80-SA generated effective proliferative responses [Stimulation Index (SI) >2] in 8 out of 10 lung cancer patients and 3 out of 6 colon cancer patients. These responses varied from patient to patient and ranged from 3 to 50 SI. Cytotoxic T cell responses were informative in 10 lung and 4 colon cancer patients and ranged from 5% to 70% specific killing. Conclusions: Tumor cells decorated with CD80-SA can induce proliferative and cytotoxic responses ex-vivo. The rapid and durable cell-surface display of immunostimulatory proteins using the ProtExä technology will now be utilized in Phase I clinical trials in cancer patients to ascertain tolerability, toxicity and eventual immune mediated anti-tumor activity. This study was supported by Grants from Kentucky Lung Cancer Program and Jewish Hospital Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration ApoImmune, Inc. ApoImmune, Inc. ApoImmune, Inc.
Utilization of an on-site oncofertility service at comprehensive cancer center.
Authors: Terri Lynn Woodard, Mary Peavey, Sara Arian Mehr, William E Gibbons, Karen H. Lu, David Marc Gershenson
Journal: Journal of Clinical Oncology (2015)

e17573 Background: While the importance of addressing potential cancer-related infertility with reproductive-age individuals is increasingly recognized, nearly half of oncologists at academic medical centers don’t routinely refer patients to reproductive specialists due to lack of access and time constraints. Provision of rapid, accessible reproductive services may facilitate referral and utilization. We describe the patient population referred to an on-site oncofertility service at a comprehensive cancer center (CCC) during its first year. Methods: This is a retrospective chart review of females who had a consultation with the MD Anderson Oncofertility Service from 2013–2014. A total of 182 patients had a consultation. Data collected included age, ethnicity, gravidity/parity, number of living children, prior exposure to chemotherapy or pelvic radiation, cancer type, and future treatment plans. Results: Most patients were seen within 24-48 hours of referral. Mean patient age was 32 (range 10-47 years). The majority was seen for fertility preservation (FP) (62%), but a significant proportion (35%) presented to explore options for family building after cancer treatment. Only 55% were Caucasian, while 21% were Hispanic and 11% were African-American. The most common diagnoses were breast (29%), hematologic (26%) and gynecologic malignancies (19%). A majority of patients (66%) had never been pregnant, and 76% had no living children. Approximately 38% had received chemotherapy or radiation at the time of presentation and 7% of patients were awaiting a stem cell transplant. 14% of patients seeking consultation for FP elected to freeze eggs and/or embryos. Conclusions: Patients utilizing an on-site oncofertility service at a CCC represent a diverse group of women presenting with varying needs. Nearly 200 women received consultation during the first year, highlighting patient interest in these services. Over a third of patients wished to explore their family building options post-treatment, emphasizing the importance of addressing fertility issues throughout the course of diagnosis, treatment and remission. Although only a minority pursued FP, the consultation in itself may be beneficial to women’s treatment satisfaction.