tbuckley/cabot-search huggingface dataset:
Role of 18F-FDG PET/CT in the diagnosis and management of multiple myeloma and other plasma cell disorders: a consensus statement by the International Myeloma Working Group
Authors: Michele Cavo, Evangelos Terpos, Cristina Nanni, Philippe Moreau, Suzanne Lentzsch, Sonja Zweegman, Jens Hillengass, Monika Engelhardt, Saad Z Usmani, David H Vesole, Jesus San-Miguel, Shaji K Kumar, Paul G Richardson, Joseph R Mikhael, Fernando Leal da Costa, Meletios-Athanassios Dimopoulos, Chiara Zingaretti, Niels Abildgaard, Hartmut Goldschmidt, Robert Z Orlowski, Wee Joo Chng, Hermann Einsele, Sagar Lonial, Bart Barlogie, Kenneth C Anderson, S Vincent Rajkumar, Brian G M Durie, Elena Zamagni
Journal: The Lancet Oncology (2017)
Hormone receptors and HER2 expression in primary tumor and synchronous axillary lymph node metastasis in estrogen receptor positive breast cancer.
Authors: Isabel Alvarez, Ricardo Rezola, Irune Ruiz, Arrate Plazaola, Marta Rezola, Kepa Elorriaga, Ainhara Lahuerta, Francisco Javier Recio, Maria Arestin, Charles Lawrie
Journal: Journal of Clinical Oncology (2015)

e11580 Background: The receptor status, Estrogen Receptor (ER), Progesterone Receptor (PR) and HER-2 can change between the primary (P) and the synchronous axillary lymph node (ALN) metastases. The frequency of this change and its clinical significance is poorly known. We have investigated this situation in cases with ER positive BC. Methods: We retrospectively identified cases with ER positive, node positive non metastatic BC treated with surgery (lumpectomy or mastectomy plus ALN dissection) in two centres (Hospital Universitario Donostia and Onkologikoa) between 2001-2006. Specimens from the primary tumour and matched ALN were retrieved and tissue arrays were made to perform the inmunostaining for ER, PR and HER 2. HR was considered positive if at least 1% of the cells were stained. The intensity of the HR staining was grouped as negative (0%), low (1-10%), moderate (10-50%) and high ( > 50%. HER2 scoring was done following ASCO-CAP criteria (0, 1+,2+,3+). Clinical data were collected from the clinical record including: age, menopause status, T size, number of positive nodes, type of surgery, adjuvant therapy (chemo and hormone therapy and radiotherapy), recurrence and death. Results: 340 cases were identified and eventually 289 (85%) were analyzed. 284 were women, median age 59 years, 187 postmenopausal, and the median number of positive ALN was 2. All cases were ER + in the P and also in the matched ALN. The PR was positive in 92% of the P and 88% of the ALN. According to the intensity of staining groups the concordance between the P and ALN was 87% for the ER expression and 67% for the PR expression. HER2 was 3+ in 14 cases 4,8% of the primary and the concordance T/ALN was 94,7%. With a median follow up of 104 months, 66 (22,8%) has recurred, with an actuarial disease free survival of 64% and 67% breast cancer specific overall survival. No significant differences in DFS or OS were seen in discordant cases compared with concordant cases. Conclusions: The concordance in expression of receptors between the P and ALN in ER+BC is high for ER and HER2, being the PR the receptor with the highest rate of discordance although its clinical prognostic impact does not appear to be relevant.
Early response assessment after one cycle of neoadjuvant chemotherapy in breast cancer by FLT-PET/CT.
Authors: Ewa Chmielowska, Bogdan Malkowski, Maciej Studzinski, Michal Marjanski, Monika Olejniczak, Karolina Krokosz-Wcislo
Journal: Journal of Clinical Oncology (2014)

e22166 Background: Currently solid tumor response is based on anatomic measurements as defined by RECIST criteria. 18F-FLT is a PET tracer that allows imagining of cell proliferation rate. Imaging of cellular proliferation by 18F-FLT-PET/CT scans may provide an quantitative read-out for therapeutic effects, earlier than do size measurements by CT. The aim of the study was to evaluate correlation of proliferation parameters, Ki67 and SUVmax, assessed by 18F-FLT-PET/CT scan before and after 1 cycle of chemotherapy in context of breast cancer subtype. Methods: 35 women, aged 32-68 years with locally advanced breast cancer (staged cT2-4 N1-2) receiving neoadjuvant AC chemotherapy (CHTH) regimen. According to St. Gallen 2011 classification following subtypes were recognized - luminal A (n=3 patients), luminal B1 (n=18 pts), luminal B2 (n=3 pts), non-luminal (n=3 pts), basal-like (n=7 pts). 18F-FLT-PET/CT scans were performed before and after one cycle of CHTH, SUVmax was measured in primary lesion. Tumor tissue samples were obtained before and after 1 cycle of CHTH to assess cancer subtype and Ki67 index. Results: In patients with hormone-receptor (HR) negative tumors (n=10) there was clear SUVmax and Ki67 index reduction - average reduction was 50% and 82% respectively. In patients with HR-positive tumors (n=24 pts) SUVmax (avrg. reduction 17%) and Ki67 (avrg. reduction 50%) reduction was less pronounced than in HR-negative cancers (p=0,006 and p=0,13 in t-test respectively for SUVmax and Ki67). There was no correlation regarding change of SUVmax and Ki67 index in patients with HR-positive tumors (r=0,19, p=0,4) and weak, but significant statistically correlation in HR-negative tumors (r=0,6, p=0,04). Conclusions: SUVmax and Ki67 reduction rate is more clear in tumors with low HR expression and high proliferation rate, as defined by Ki67.
Empathy and the action-perception resonances of basic socio-emotional systems of the brain
Authors: Jaak Panksepp, Nakia Gordon, Jeff Burgdorf
Journal: Behavioral and Brain Sciences (2002)

Mammalian brains contain a variety of self-centered socio-emotional systems. An understanding of how they interact with more recent cognitive structures may be essential for understanding empathy. Preston &amp; de Waal have neglected this vast territory of proximal brain issues in their analysis.
Distinct copy number alteration patterns as prognostic of endometrial cancer outcomes.
Authors: Itai Max Pashtan, Donna S. Neuberg, Rameen Beroukhim, Helga B Salvesen, Andrew Cherniack
Journal: Journal of Clinical Oncology (2013)

5511 Background: Endometrial cancer is classified by tumor stage, histologic subtype and grade. However, a substantial proportion of presumed non-high risk cases recur, supporting the need for improved tools of prognostication. Methods: Using clinical and Affymetrix SNP 6.0 data from The Cancer Genome Atlas (TCGA) endometrial carcinoma project, we identified 4 somatic copy number alteration (SCNA) subtypes, established their prognostic value and validated them in an independent, population-based cohort from Norway. Patients had endometrioid, uterine papillary serous carcinoma (UPSC) or mixed histology tumors. Progression-free survival (PFS) was defined as time from diagnosis to recurrence or progression, and estimated by the Kaplan-Meier method. Results: Four groups of SCNA patterns were identified using hierarchical clustering: low SCNA, moderate SCNA, SCNA dominated by 1q amplification (1q amplified) and high SCNA level (serous-like). Their prognostic value was assessed in all TCGA patients (N = 292) and in a low risk subset with endometrioid histology, stage 1 disease (N = 210). In the full TCGA cohort, patients with low SCNA (reference group) had excellent 2-year PFS of 94%, while for moderate SCNA it was 84% (hazard ratio[HR] 2.7, p = .08). The 1q amplified and serous-like groups had significantly worse outcomes with 2-year PFS of 74% (HR 5.9, p= .002) and 74% (HR 6.0, p &lt;.001), respectively. On multivariable analysis, adjusting for variables including stage and grade, 1q amplified and serous-like SCNA patterns remained independently prognostic (respectively, adjusted HR 6.2, p = .002 and 4.7, p = .02). Similar results were found in the low risk subset. The prognostic value of the SCNA patterns was validated in an independent group of patients with low risk disease (N = 57). 5-year PFS was 91% for low SCNA, 83% for moderate SCNA (HR 2.0, p = .58), 72% for 1q amplified (HR 3.7, p = .11) and 50% for the serous-like SCNA group (HR 6.7, p = .04). Conclusions: Four subtypes of DNA SCNA patterns in endometrial cancer were identified and validated to be prognostic of outcome. These novel biomarkers may be useful in guiding therapeutic decisions, and shed insight on the biology of more, or less, aggressive endometrial cancer.
Seeking second opinions in oncology: Adherence of standard of care among first doctors.
Authors: Hitomi Sakai, Noriyuki Katsumata, Masanori Matsuda, Genmu Kadokura
Journal: Journal of Clinical Oncology (2015)

e20601 Background: Many people seek a second opinion to hear different opinions on the best treatment options and to learn more about the cancer. There are few reports on second-opinion seeking in oncology. Methods: We performed a retrospective chart review of patients to visit to a medical oncologist at Nippon Medical School Musashikosugi Hospital to seek a second opinion between December 2011 and October 2014. We (3 medical oncologists) independently evaluated adherence to standards of care among first doctors in 3 point scales: optimal, satisfactory and inadequate. If unanimous decision was not made, we built a consensus through discussions. We examined correlation between adherence of standards of care and hospital type (accredited hospital or non-accredited hospital for cancer care), outcome after second opinion (changed hospital or not) or primary site of cancer. Results: We reviewed charts for 223 patients. The median age was 53 years. Most patients were women (90.6%). The common primary sites were epithelial ovarian, fallopian tube, and primary peritoneal cancer (43.0％) and breast cancer (17.9％). The majority (79.8%) had recurrent or metastatic disease. Evaluation of adherence to the standards of care was as follows: 76.2%; optimal, 5.8%; satisfactory and 17.9%; inadequate. There was no significant difference in adherence rates to standards of care between accredited hospital and non-accredited hospital for cancer care (p = 0.626). Patients who did not changed the hospital after the second opinion consultation significantly more often had received standard of care (p = 0.029). Adherence rates to standards of care did not differ significantly between primary cancer site (p = 0.055). Conclusions: A second opinion can alter patients’ treatment. Accredited hospitals for cancer care in Japan do not necessarily provide standard cancer care.
A multicenter phase II study of combination therapy with oral S-1 plus cisplatin in elderly patients with advanced gastric cancer.
Authors: Tetsuji Terazawa, Satoru Iwasa, Yusuke Sasaki, Shunsuke Okazaki, Masahiro Goto, Yasushi Kojima, Atsushi Naganuma, Kengo Nagashima, Hidekazu Hirano, Yoshitaka Honma, Atsuo Takashima, Ken Kato, Tetsuya Hamaguchi
Journal: Journal of Clinical Oncology (2017)

157 Background: The incidence of gastric cancer increases gradually in individuals aged ≥ 75 years who account for about 40% of all patients. From the SPIRITS study, comparing S-1 monotherapy with S-1 and cisplatin (CDDP) combination therapy (median overall survival [OS]: 11.0 versus 13.0 months, p=0.04), S-1 and CDDP chemotherapy (SP regimen) is recognized as one of the standard first-line regimens for patients with advanced gastric cancer in Japan. However, patients in this trial were aged &lt; 75 years. Methods: The aim of this phase II study was to evaluate the efficacy and safety of SP regimen in elderly patients with chemotherapy-naive advanced gastric cancer. Patients aged ≥ 76 years were given oral S-1 twice daily for 21 days, followed by 14 days rest; CDDP was intravenously infused at day 8, repeated every 35 days, for up to eight cycles. The dose of S-1 (50–120 mg/body) and CDDP (30–60 mg/m 2 ) was adjusted depending on the patient’s body surface area and creatinine clearance (Ccr-adjusted SP regimen). The primary endpoint was OS. The threshold and expected OS were estimated at 8 and 14 months, respectively. Secondary endpoints included response rate (RR), progression-free survival (PFS), time to treatment failure (TTF) and adverse events. Results: From December 2012 to October 2014, 40 patients were enrolled at 15 institutions. Patient characteristics were: gender (M/F) 29/11; median age 78 (range, 76–89); ECOG PS0/1, 13/27; and unresectable/recurrence 30/10. The median cycle for each patient was four (range, 1–8). The median OS was 12.3 months (80% confidence interval, 10.2–14.4 months). The median PFS and TTF were 7.8 and 4.3 months, respectively. The RR was 54%. A dose reduction of S-1 and CDDP was made for 30% and 35% of patients, respectively. The protocol was discontinued in 17 patients (43%) for disease progression, 10 patients (25%) for adverse events and 7 patients (17%) for patient refusal. The main adverse events at a grade 3 or higher were anorexia (25%), neutropenia (23%), hyponatremia (20%) and anemia (18%). Treatment-related deaths did not occur. Conclusions: Ccr-adjusted SP regimen showed promising activity and was tolerated well by elderly patients with advanced gastric cancer. Clinical trial information: UMIN000009349.
Comparison of concurrent chemoradiation therapy with 3-weekly versus weekly cisplatin in patients with locally advanced nasopharyngeal cancer: A multicenter randomized phase II noninferiority trial (KCSG-HN10-02).
Authors: Ji Yun Lee, Sung Hee Lim, Kwai Han Yoo, Moonjin Kim, Sungmin Kim, Hyun Ae Jung, Jong-Mu Sun, Sung-Bae Kim, Keon Uk Park, Hoon-Kyo Kim, Dae Sik Hong, Jun Suk Kim, Seong-Geun Kim, Seong Yoon Yi, Hwan Jung Yun, Myung Soo Hyun, Hyo Jung Kim, Keunchil Park, Yong Chan Ahn, Myung-Ju Ahn
Journal: Journal of Clinical Oncology (2014)

6023 Background: Concurrent chemoradiation therapy (CCRT) with every 3 week schedule of cisplatin is the standard treatment for locally advanced nasopharyngeal carcinoma (NPC), but concerns have been raised about treatment-related complications. We conducted a randomized phase II non-inferiority study of CCRT with three week versus weekly cisplatin to compare the efficacy and toxicity profiles. Methods: From September 2009 through August 2011, 111 patients with locally advanced NPC who have stage II-IVb were enrolled from 22 centers in Korea. Patients were randomized into treatment groups that either received cisplatin 100 mg/m² every 3 weeks for 3 cycles (arm A) or cisplatin 40 mg/m² weekly for 7 cycles (arm B) concurrently with RT. Subsequent adjuvant chemotherapy, cisplatin 80 mg/m² day 1 and fluorouracil 1,000 mg/m²/day day 1-4 was administered every 3 weeks for a total of 3 cycles. Results: Of the 109 eligible patients, 56 were assigned to arm A, and 53 to arm B. The two arms were well-balanced in all prognostic factors and RT parameters. There was no significant difference in RT dose (67.28 Gy vs 68.30 Gy, p=0.559) or cisplatin dose (257 vs 249 mg/m², p=0.433) between two arms. About 90% of patients in both arms completed protocols of CCRT. However, 29% of patients in arm A and 45% of those in arm B received subsequent adjuvant chemotherapy (p=0.045). Overall tumor response was 97 % but no difference was noted in tumor response between two arms (96 vs 98%, p=1.000). Overall, the grade 3/4 toxicities were similar between the two arms. The most common grade 3/4 adverse events during CCRT were neutropenia (15% in arm A vs 28% in arm B), stomatitis (13% vs 15%), and nausea/vomiting (11% vs 8%). Conclusions: These results demonstrated that weekly regimen of cisplatin as CCRT is well tolerated and shows similar treatment efficacy compared with 3 weekly schedule of cisplatin in patients with locally advanced NPC. Longer follow-up is needed to evaluate the final results of progression free survival and overall survival.
Correlation of high body mass index and circulating tumor cell positivity in patients with early-stage breast cancer.
Authors: Uta Ortmann, Wolfgang Janni, Ulrich Andergassen, Thomas Beck, Matthias W. Beckmann, Werner Lichtenegger, Julia Katharina Neugebauer, Jessica Salmen, Christian Schindlbeck, Andreas Schneeweiss, Christoph Scholz, Jörg Schreier, Frank Spickhoff, Thomas Zwingers, Brigitte Kathrin Rack
Journal: Journal of Clinical Oncology (2012)

1600^ Background: The prognostic relevance of both body mass index (BMI) and circulating tumor cells (CTC) has been confirmed in different trials for patients with early breast cancer. This analysis evaluates the correlation between high BMI and CTC positivity as risk factors for reduced disease free and overall survival. Methods: Data of 3658 patients of the SUCCESS A trial have been analyzed. CTC count and BMI were documented before (N = 2026) and after (N = 1504) chemotherapy. Within this trial patients with early breast cancer were randomized to two chemotherapy regimens and received either 3 cycles of fluorouracil, epirubicin and cyclophosphamide followed by 3 cycles of docetaxel (FE100C-Doc) or 3 cycles of fluorouracil, epirubicin and cyclophosphamide followed by 3 cycles of docetaxel and gemcitabine(FE100C-DG). In addition, patients were randomized to zoledronic acid either for 2 or 5 years. CTC were analyzed using the CellSearch System (Veridex, USA). Different groups of bodyweight were classified according to the WHO’s international definition: Underweight (BMI &lt; 18,5 kg/m 2 ), normal range (BMI &gt; 18,5- &lt; 25), overweight (BMI &gt;25- &lt; 30), obesity (BMI &gt; 30). Correlation between CTC count and BMI was analyzed using frequency-table methods. Results: At study entry 24 (1.2%) patients were underweight, 952 (47%) patients were normal weight, 658 (32.5%) patients were overweight and 392 (19.4%) patients were obese. Before the start of chemotherapy, CTC were detected in 435 (21.5%) patients. We did not find a correlation between CTC positivity and BMI (p=0.94). After chemotherapy CTC were detected in 330 (16,3%) patients. Again, there was no statistically significant correlation between BMI and CTC positivity (p=0.86). In particular, CTC positivity was not observed more frequently in obese patients neither before (p=0.70) nor after chemotherapy (p=0.95) compared to patients with a BMI &lt; 30 kg/m 2 . Conclusions: As compared to patients with normal BMI, there was no significant difference in the prevalence of CTC in underweight, overweight and obese patients, respectively, neither before nor after chemotherapy. The risk factors obesity and prevalence of CTC seem to be independent prognostic factors.
Integration of Ki67 with residual cancer burden (RCB) compared to Ki67 or RCB alone to predict long-term term outcome following neoadjuvant chemotherapy.
Authors: Amna Sheri, Roger A'Hern, Robin Lewis Jones, William Fraser Symmans, Ashutosh Nerurkar, Margaret Hills, Simone Detre, Stephen R. D. Johnston, Mitchell Dowsett
Journal: Journal of Clinical Oncology (2013)

535 Background: RCB and Ki67 after neoadjuvant chemotherapy have each been shown to predict long-term outcome. Their combined use might provide greater prognostic information. RCB requires collection of data beyond that in routine pathological work-up of residual disease, which may not be required when Ki67 is added. Aims: (i) To test the hypothesis that combining Ki67 and RCB as the residual proliferative cancer burden (R-P-CB) provides significantly more prognostic information than either alone. (ii) To determine if a simplified algorithm integrating Ki67 and standard characteristics of residual disease can provide as much information. Methods: Cases at the Royal Marsden Hospital between 2002-2010 were identified and residual disease assessed. The primary endpoint of the study was time to recurrence. The primary analysis compared the prognostic information from Ki67, RCB and R-P-CB. Analyses employed a Cox proportional hazards model. Prognostic indices (PIs) were also created adding Ki67, grade and ER to the RCB and AJCC staging. Leave-one-out cross validation was used to reduce bias. The overall change in chi-square (ΔX2) of the best model for each index was used to compare the prognostic ability of the different indices a ΔX2 of more than 3.84 indicates statistical significance. Results: A total of 222 evaluable patients were included in the study, median age was 50 with a median follow up of 60 months. The addition of Ki67 improved the prognostic power of all indices. The R-P-CB (ΔX2=69.5) was significantly more prognostic than the RCB alone (ΔX2=35) and Ki67 alone (ΔX2=41.4). A novel proliferative residual cancer index (PRECI) using post-treatment values of T size, number of involved lymph nodes, grade, ER status (±) and Ki67 gave ΔX2=81.1 and performed similarly to a model including the RCB, Ki67, ER and grade (ΔX2=80.2). Conclusions: Addition of Ki67 to RCB improved prediction of long-term outcome. In this study, a novel index the PRECI provided as much prognostic information as a more complex assessment involving RCB and warrants further investigation for estimating post-neoadjuvant risk of recurrence.
Attitudes regarding informing clinical study result to participants in Japan.
Authors: Izumi Miki, Keiko Sato, Hiroko Nakahama, Noriyuki Katsumata, Toru Watanabe
Journal: Journal of Clinical Oncology (2012)

e19557 Background: Informing the participants about study result is increased demand in recent years. Some studies reported that almost all participants want to receive study result. However, how much information do participants want and how do researcher offer were not mentioned. Moreover there were concerned about resource for providing study result and the attitude regarding informing result to participants in Japan was not studied. The purpose of this study was aimed to discuss and propose the way of informing study results to Japanese participants. Methods: Summarizing study result and a self-administrated questionnaire survey were conducted. Summary was created from abstract of academic paper with lay language and illustration using color. Objective study was Oral Uracil and Tegafur Compared With Classic Cyclophosphamide, Methotrexate, Fluorouracil As Postoperative Chemotherapy in Patients With Node-Negative, High-Risk Breast Cancer: National Surgical Adjuvant Study for Breast Cancer 01 Trial “N-SAS-BC01 trial”(J Clin Oncol 2009). Objective subject was participants of N-SAS-BC01 trial in National Cancer Center Hospital. A cross table and inductive analyze were performed. Results: Summary of result was made A4 (letter size) form 4sheet. 58 patients responded to questionnaire of 116 patients (50%). In 58 responders, 92% of them preferred to be informed of the result. About 80% of responders answered that summary was clear to understand and 30% of them reported that the document should contain more information. The way of receive result preferred by the mail. When the result included bad news, 67% of responders wanted to receive result; on the other hand, three patients answered that they would not to receive because of psychological harmful influence. Conclusions: These answers suggested that participants in Japan desired to inform study result. Therefore, Clinical study result should be provided participants whenever it takes time to get results, including bad news in a careful way. Summary of result should be created using lay language and illustration. Planning the cost, keeping participant contact list, and noticing participants that study result would be informed were needed at the start of the study.