tbuckley/cabot-search huggingface dataset:
A multicenter, noncontrolled clinical study of sorafenib adjuvant therapy in advanced renal cell carcinoma.
Authors: Dingwei Ye, Zhisong He, Yinghao Sun, Chuize Kong, Liping Xie, Qiang Wei, Zhangqun Ye, Min Li, Zhoujun Shen, Lin Qi, Hanzhong Li, Guang Sun, Jianhui Ma
Journal: Journal of Clinical Oncology (2014)

e15553^ Background: Systemic adjuvant therapy in RCC patients may eliminate residual micrometastases and reduce risk of relapse. Sorafenib is a candidate for investigation as adjuvant therapy. Methods: 69 patients at multiple centers between Nov 2008 and Jul 2010 with locally advanced clear cell RCC at high risk for disease recurrence postoperatively were enrolled. The criteria for high risk were defined according to Leibovich Score (≥6), which was based on tumor stage, regional lymph node status, tumor size, nuclear grade. The patients received sorafenib 400 mg bid in 4-12 weeks post radical nephrectomy for a total 9 cycles (6weeks/cycle). The primary endpoint was median disease free survival (DFS). Overall survival (OS) and other safety profiles were investigated, and the efficacy of Udderly Smooth Udder Cream in management of hand and foot skin reaction (HFSR) induced by sorafenib was determined by stratification into two groups (consistent usage or only start use the scream since the onset of HFSR). Results: Median age was 54 years, and the surgical features for the patients are listed in the Table. Leibovich Score 6,7,8,9,10 is respectively 34 (49.28%), 17 (24.64%), 11 (15.94%), 5 (7.24%), 2 (2.90%). 35 patients had already either progression or died till the time of analysis, the median DFS is 41.4 months. Median OS has not yet been reached, and 1, 2, 3, 4 years survival rate was 92.4%, 86.0%, 76.2%, 67.5%.The most common AEs were HFSR (81.2%), alopecia (42.0%), and diarrhea (36.2%), and most AEs (82.6%) were grade 1 or 2 severity. The AE profile was consistent with reported data in sorafenib Asian population. Udderly Smooth udder cream had not been proven to decrease the incidence, grade, onset or duration of HFSR. Conclusions: In high risk of relapse RCC patients who underwent radical nephrectomy, sorafenib seemed to provide longer DFS while comparing with previously reported literatures, and side effects were acceptable. Due to the single arm study design and limited sample size, the effect of sorafenib adjuvant therapy will require further validation in randomized controlled trials. Clinical trial information: NCT01041482. TNM stage N (%) T2N0 13 (18.84) T2N1-2 5 (7.25) T3aN0 24 (34.78) T3aN1-2 4 (5.80) T3bN0-1 13 (18.84) T3cN0 3 (4.35) T4N0 7 (10.14)
Optimizing somatic genomic reporting and physician interpretation with web-based, interactive technologies.
Authors: Stacy W. Gray, Angel M. Cronin, Lynette M. Sholl, Ethan Cerami, Jeffrey Gagan, Hajime Uno, Nelly Oliver, Carol Lowenstein, Ruth Lederman, Anna Revette, Aaron Suarez, Charlotte Lee, Jordan Byran, Eliezer Mendel Van Allen
Journal: Journal of Clinical Oncology (2017)

1517 Background: The increased availability of tumor genomic profiling is revolutionizing oncology. However, the promise of precision care will not be realized if providers misinterpret complex genomic data. Methods: We created web-based, interactive reports with enhanced data visualization elements and embedded decision support for &gt; 300 gene panels. We conducted a randomized vignette-based survey study to determine whether exposure to the interactive reports, as compared to static reports, improves physicians’ genomic understanding and report-based satisfaction. Overall comprehension and satisfaction scores were calculated across three vignettes (possible range 0-18 and 1-4 respectively, higher score correspond to improved endpoints). Results: 105 physicians at a major cancer center participated (29% participation rate); 67% medical, 20% pediatric, 7% radiation and 7% surgical oncology; 37% female. Prior to viewing the case-based vignette reports, 34% of physicians reported that they found it difficult to make treatment recommendations based on the standard report in their routine practice. After viewing the case-based vignettes, physicians’ overall comprehension scores did not differ significantly by report type (mean score interactive 11.6 vs. static 10.5, difference = 1.1, 95% CI -0.3, 2.5, p = 0.13). However, physicians who viewed the interactive report were more likely to correctly assess sequencing quality (p &lt; 0.001) and understand when reports needed to be interpreted with caution (e.g., if low tumor purity, p = 0.02). Overall satisfaction scores were significantly higher in the interactive group than the static group (mean score 2.5 vs. 2.1, difference = 0.4, 95% CI 0.2, 0.7, p = 0.001). Of the 92 physicians who endorsed the need for additional genomic support for providers, 66% reported that interactive genomic reports would be helpful. Conclusions: Interactive, genomic reports may improve physicians’ ability to accurately assess genomic data and increase physician satisfaction. To advance the field, further research in representative provider populations is warranted and efforts to integrate interactive genomic reports into electronic health records are needed.
Etude prospective chez 195 patients du risque de rétention de capsule lors de l'exploration du grêle: Attention aux AINS!
Authors: O Favre, J Daudet, P Jacob
Journal: Endoscopy (2006)

Le but de ce travail était d'établir de façon prospective l'incidence de la rétention de capsule lors de l'exploration du grêle, d'en définir les facteurs de risque, recenser les prises en charge proposées et rechercher le bénéfice clinique des diagnostics retrouvés à cette occasion.
A randomized trial of a barrier lipid replacement strategy for the prevention of atopic dermatitis and allergic sensitization: the <scp>PEBBLES</scp> pilot study
Authors: A.J. Lowe, J.C. Su, K.J. Allen, M.J. Abramson, N. Cranswick, C.F. Robertson, D. Forster, G. Varigos, S. Hamilton, R. Kennedy, C. Axelrad, M.L.K. Tang, S.C. Dharmage
Journal: British Journal of Dermatology (2017)

It is hypothesised that the impaired skin barrier in atopic dermatitis (AD) allows the immune system to be exposed to environmental allergens, resulting in sensitisation and allergic disease[1]. Two small trials recently found that routine use of emollients reduced the incidence of AD during the active treatment period by approximately half [2, 3]. It remains unknown if prophylactic use of emollients can prevent the development of AD beyond the treatment period (as opposed to simply delay its onset) or if this reduction in AD leads to a reduced risk of allergic sensitisation.

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A disconnect between disease activity and functional ability already in patients with early rheumatoid arthritis, depending on large joint involvement
Authors: Andrea Rubbert-Roth, Johannes W G Jacobs, Johannes W J Bijlsma, Paco M J Welsing
Journal: Annals of the Rheumatic Diseases (2017)

Current strategies in rheumatoid arthritis (RA) management aim at diagnosing patients and starting disease-modifying antirheumatic drug (DMARD) treatment very early to optimise outcome. International guidelines recommend the initial use of conventional synthetic disease-modifying drugs, especially methotrexate (MTX),1 even though it has recently been demonstrated that early addition of biologics to the therapeutic regimen with MTX can optimise response.2 The prevention of functional deterioration is an important treatment goal from both patient and societal perspectives. Previous studies in patients with early RA,3 and in patients with established RA,4 demonstrated that large joint involvement is strongly associated with functional impairment and with mortality in long-term observational cohorts.5 

This post hoc analysis of the U-Act-Early trial was conducted to examine in a cohort of patients with very early RA the impact of large joint involvement (LJI) on disease activity and functional capacity over time. In this trial, 317 patients from 21 Dutch centres were randomised to start treatment with either MTX or …
The BTG2-PRMT1 module limits pre-B cell expansion by regulating the CDK4-Cyclin-D3 complex
Authors: Elmar Dolezal, Simona Infantino, Friedel Drepper, Theresa Börsig, Aparajita Singh, Thomas Wossning, Gina J Fiala, Susana Minguet, Bettina Warscheid, David M Tarlinton, Hassan Jumaa, David Medgyesi, Michael Reth
Journal: Nature Immunology (2017)
<i>BRCA1/2</i> mutation prevalence in triple-negative breast cancer patients without family history of breast and ovarian cancer.
Authors: Kerstin Rhiem, Christoph Engel, Jutta Engel, Dieter Niederacher, Christian Sutter, Raymonda Varon-Mateeva, Doris Steinemann, Norbert Arnold, Bernd Dworniczak, Shan Wang-Gohrke, Andrea Gehrig, Barbara Wappenschmidt, Alfons Meindl, Rita K. Schmutzler
Journal: Journal of Clinical Oncology (2016)

1090 Background: Data on BRCA1/2 mutation prevalence in patients with triple-negative breast cancer (TNBC) without a family history of breast and ovarian cancer remains insufficient. Moreover, the impact of genetic testing on health economy is unclear. Methods: We collected a consecutive cohort of patients with TNBC without family history (n = 750) within the German Consortium for Hereditary Breast and Ovarian cancer (GC-HBOC). Results: We identified a total of 161 deleterious BRCA1/2 mutations (21.5%). The mutation prevalence was significantly dependent on the age at diagnosis and decreased with age, e.g. 38.8% (age 20 to 29 years), 24.1% (age 30 to 39 years), 19.1% (age 40 to 49 years) and 10.8% (age 50 to 59 years), respectively. We further extrapolated the number of TNBC diagnosed per age group and year using data from the Munich Tumor Registry and the German Cancer Registry. From a total of almost 70,000 newly diagnosed breast cancer patients per year in Germany, approx. 6,000 will develop a TNBC (8.5%). Of these, 486 patients will develop TNBC < 40 years, 1022 patients develop TNBC between 40 and 49 years, 1354 between 50 and 59 years, 1161 between 60 and 69 years and 1069 between 70 and 79 years. Conclusions: BRCA1/2 mutation prevalence in TNBC patients without family history depends on age at diagnosis. Our data provide guidance for health professionals and decision makers to identify individuals who should undergo genetic testing.
Современные подходы к профилактике и лечению НПВП-гастропатий
Authors: S.M. Tkach
Journal: GASTROENTEROLOGY (2013)

Приведены современные данные о разных стратегиях лечения и профилактики НПВП-гастропатий. На основании проведенного анализа сделан вывод, что наилучшими стратегиями являются применение ингибиторов протонной помпы и эрадикация инфекции Helicobacter pylori. Применение двойных доз ингибиторов протонной помпы дает возможность повысить эффективность профилактики и лечения НПВП-гастропатий.
Prospective Implementation of Multi-Disciplinary Obstetric Team Decreases the Mortality Rate of Pregnant Women with Sickle Cell Disease in Ghana
Authors: Eugenia Vicky Naa Kwarley Asare, Yvonne Adomakoh, Edeghonghon Olayemi, Enoch Mensah, Harriet Ghansah, Yvonnne Osei- Bonsu, Selina Crabbe, Latif Musah, Charles Hayfron- Benjamin, Theodore Boafor, Brittany Covert, Adetola A. Kassim, Andra H. James, Michael DeBaun, Samuel Antwi Oppong
Journal: Blood (2016)
The endoscopic appearance of the oesophago-gastric junction during 'J Manoeuvre' is associated with gastro-oesophageal reflux
Authors: S Farrell, C Renfrew, MD Shields, WA McCallion
Journal: Endoscopy (2005)

Introduction: The endoscopic appearance of the oesophago-gastric junction (OGJ) during 'j manoeuvre' is often used as subjective evidence for the presence of gastro-oesophageal reflux (GOR). Our aim was to establish whether the appearance of the OGJ could be used to predict the presence of GOR.
Phase 2 study to evaluate safety and efficacy of MEDI4736 (durvalumab [DUR]) in glioblastoma (GBM) patients: An update.
Authors: David A. Reardon, Thomas Joseph Kaley, Jorg Dietrich, Jennifer Leigh Clarke, Gavin P Dunn, Michael Lim, Timothy Francis Cloughesy, Hui Kong Gan, Andrew J. Park, Paul Schwarzenberger, Toni Ricciardi, Mary J. Macri, Aileen Ryan, Ralph Rudolph Venhaus
Journal: Journal of Clinical Oncology (2017)

2042 Background: DUR is a human IgG1 monoclonal Ab against PD-L1. PD-1/PD-L1 blockade has shown benefit in solid tumors. PD-L1 is expressed by many GBM tumors while cytotoxic lymphocytes infiltrating GBM tumors often express PD-1; thus, there is a rationale for exploring PD-1/PD-L1 blockade in GBM. Bevacizumab (BEV) is a VEGF-specific angiogenesis inhibitor approved for recurrent GBM. PD-L1 blockade and angiogenesis inhibition may be synergistic. Methods: This ongoing Phase 2, multicenter, open-label study (NCT02336165) evaluates safety/efficacy of DUR (10 mg/kg every 2 wks) in 5 GBM cohorts. Secondary endpoints are safety/tolerability, median PFS/OS, overall response rate and quality of life measures. Exploratory endpoints: neurologic function and immunocorrelative biomarkers. Results: Enrollment as of 16 Dec 2016: Cohort A = 35, B = 31, B2 = 34, B3 = 34, and C = 20 pts. Enrollment is ongoing for Cohorts A and C. This is an update to the interim analysis that was reported for Cohort B (male: 83.9%; mean age: 54.0 [24-77] years; baseline ECOG PS0: 51.6%, PS1: 48.4%; baseline measurable lesions: 77.4%). Incidences of treatment-related adverse events (TRAEs) by max CTCAE grade (Gr) were Gr1: 35.5%; Gr2: 41.9%; Gr3: 9.7%; and Gr4/5: 0%. Most common TRAEs (≥3 pts): fatigue, headache, hemiparesis, gait disturbance, increased AST, and decreased platelets/WBCs/lymphs. Six of 30 evaluable pts were progression free at 6 months (Kaplan-Meier, 20.0% [90% CI: 9.7, 33.0]); best overall response: partial response, 4 (13.3%) pts and stable disease, 14 (46.7%). At 1 year, 4 pts remained progression free (longest PFS ongoing at 80 wks, n=2). OS-6 and OS-12 are 59.0 and 44.4%, respectively. As of 16 Dec 2016, 7 pts remain alive (longest OS ongoing at 86 wks). Conclusions: DUR monotherapy appears to be well tolerated and shows durable activity in a subset of BEV-naïve recurrent GBM pts. Study is ongoing. Clinical trial information: NCT02336165. [Table: see text]
Withdrawal of treatment from "dying" teenager to be reconsidered by court after he defies expectations
Authors: C. Dyer
Journal: BMJ (2015)

A blind teenager with a brain tumour who was expected to die within two weeks after a High Court judge authorised doctors to discontinue treatment is still alive three months later and is to have his case reassessed.

At the Court of Protection in London last February, Mrs Justice Hogg ruled that doctors could stop treating the 18 year old against his parents’ wishes.

At …
Management of cancer treatment-related painful bone lesions.
Authors: Mounika Mandadi, Melissa Potts, Martin Sven Vyleta, Mahmoud Samman, Goetz H. Kloecker, Douglas M. Coldwell
Journal: Journal of Clinical Oncology (2014)

e20543 Background: The use of chemotherapy agents and general inactivity in cancer patients increases osteopenia with the resulting vertebral compression fractures and other bony lesions. Frequently these lesions are the site of pain that results in the decrease in mobility and quality of life. Local measures to treat these lesions have traditionally relied only on radiotherapy but the use of vertebral augmentation is an attractive alternate for those patients who are either refractory to radiotherapeutic options or have marrow eliminating response to chemotherapy for myltiple myeloma. Methods: A retrospective review of 37 patients (19 men, 18 women, mean age 64 years) who received vertebral augementation was performed. There were two patients who had sterna fractures due to marrow elimination due to successful myeloma treatment, 8 sacral fractures and radio-resistant tumors, and the remainder of the patients had vertebral compression fractures at 46 levels in 27 patients. All patients received vertebral augmentation with polymethylmethacrylate cement after use of radiofrequency ablation of the tumor with a purpose designed bipolar needle (DFINE, Inc., Palo Alto, CA) had been performed. Results: Prior to treatment the pain score (1-10) was a mean of 8.2 and 2 hours following treatment was 1.1 (p<0.05) and one week later was 1.0 (p<0.05). Complications included one case of foot drop that did not resolve after six months in a case of sacral augmentation. Conclusions: Vertebral augementation with radiofrequency ablation is an effective method to control bone pain due to localized lesions in cancer patients.
Use of Oncotype DX in systemic treatment decision making for patients with stage I and II, hormone receptor positive, HER2/neu-negative breast cancer.
Authors: Xiaofu Zhu, Susan Faye Dent, Lise Paquet, Tinghua Zhang, Nadine A. Graham, Xinni Song
Journal: Journal of Clinical Oncology (2014)

e11515 Background: Oncotype DX (ODX) is a prognostic and predictive tool that can aid in the treatment of early breast cancer. However, data on how oncologists decide to use this tool is scarce. We evaluated the utilization of ODX in breast cancer decision-making through a survey of Canadian medical oncologists. Methods: A 34-item survey was distributed to Canadian medical oncologists via CAMO (Canadian Association of Medical Oncologists). Data were collected on physician demographics and ODX usage patterns. Survey also included clinical cases to examine the reasons to utilize ODX. A validated questionnaire was included to measure individual’s tolerance for uncertainty. Results: Response rate was 20.6% with 47 responses received from 228 surveys sent. Forty-five responses were eligible for analysis. Sixty-two percent (28/45) of respondents treated predominately breast cancer, and 60% (27/45) have been in practice for at least 10 years. The most commonly cited reason for using ODX was to avoid giving patients unnecessary chemotherapy (64 %; 29/45). Sixty-seven percent (30/45) deferred making treatment decisions until ODX testing was completed. Factors most strongly impacting ODX utilization included: patient request, medical comorbidities, and tumor grade. In clinical scenarios, ODX was more frequently selected for patients age 40-65 (vs <40 or >65, p<0.001), grade 2 tumors (vs grade 1 or 3, p<0.001), and Ki-67 index of 10-20% (vs <10% or >20%, p=0.001). There was no significant correlation between physician’s tolerance of uncertainty and ODX usage (p=0.362). Conclusions: This survey demonstrated that Canadian medical oncologists are preferentially using ODX to avoid giving patients unnecessary chemotherapy. The utilization of ODX is mainly in patients with intermediate clinical and pathologic features. This reflects the subgroup of patients with early breast cancer where additional predictive tools may offer guidance for optimal adjuvant treatment decision-making.
Temporal Changes in Subsequent Malignancies Among Childhood Cancer Survivors—Reply
Authors: Lucie M. Turcotte, Yutaka Yasui, Joseph P. Neglia
Journal: JAMA (2017)

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Pattern of blood count change during craniospinal irradiation and the effect on progression free survival in medulloblastoma adult patients.
Authors: Khaled Nabil Dibs, Imad A. Jaradat, Jamal Khader, Laith Al Khairi, Nasim Sarhan, Ahmad Mohammad, Awf Sulaiman, Mohammad Amoudi, Yousef Ismael, Ramiz Hijlih, Hamza Ghatasheh, Abdelatif Al-Mousa
Journal: Journal of Clinical Oncology (2017)

e13500 Background: The primary treatment of medulloblastoma in adults is surgery followed by radiotherapy. Craniospinal irradiation in such patients holds a clinical significant effect on blood count drop, as more than 50% of bone marrow is irradiated during CSI. Precise guidelines on how often a patient's peripheral blood count should be monitored are yet to be established. Methods: A retrospective analysis of blood count data on 42 adult medulloblastoma patients who underwent surgical resection followed by CSI as 36-39.6Gy over 20-22 fractions followed by boost to posterior cranial fossa up to 54Gy and spinal boost up to 45Gy. The manner of blood count cells during radiotherapy and the correlation between WBC drop and outcome were examined. Results: Our study showed a drop in WBCs to 4 and below in 64% of patients during CSI. Eight patients (19%) had Hb drop below 12. There was no grade 3 or 4 anemia. Significant drop in neutrophils below 1500 was observed in 8 patients (20%), with 2.4% had grade 3 neutropenia. In 26 patients (62%) who developed platelets drop, three patients (7%) had platelets of less than 50000 (grade 3 and 4 thrombocytopenia). The Hb, lymphocyte, neutrophils, and platelets nadirs were 8.7 g/dL, 42 cells /microL, 720 cells /microL, and 1000 platelets/microL, respectively. The minimum interval between the nadir and starting radiotherapy for Hb, WBCs, and platelets were 13, 6, and 11 days, respectively. The median interval between the nadir and starting radiotherapy for all cells was 3 weeks. The median WBCs percentage drop was 71%. In 23 patients who had non-metastatic disease, the estimated three year progression free survival was 70%. In those who had WBC drop below 2.7 the PFS was 100% vs. 46%. (P value = 0.042). Conclusions: Some institutions reduced monitoring of CBC during conventional radiotherapy may result in financial saving; however, our study suggests the need for weekly CBC for patients receiving CSI irradiation. Fortunately, no one developed serious infection during radiotherapy, but a precaution should be there. A WBCs change during radiotherapy could reflect the outcome and may suggest more aggressive treatment in patients who had a nadir of 2.7 and above.