tbuckley/cabot-search huggingface dataset:
Prognostic factors in previously treated non-small cell lung cancer patients with and without a positive response to gefitinib treatment
Authors: Y. Ichinose, H. Wataya, T. Seto, K. Yamazaki, T. Tagawa, S. Fukuyama, A. Osoegawa, F. Hirai, J. Ikeda
Journal: Journal of Clinical Oncology (2008)

19037 Background: Gefitnib, epidermal growth factor receptor tyrosine kinase inhibitor, has been reported to have a certain anti-tumor effect in previously treated patients with non-small cell lung cancer (NSCLC). However, the prognostic factors in those patients with and without a positive response to gefitinib treatment remain unclear. Patients and Methods: A retrospective chart review was performed in 131 advanced NSCLC patients who received 250 mg of gefitinib as either a second-line or even later stage treatment from July 2002 to December 2005. Clinical factors including age, gender, performance status (PS), stage, histology, the number of prior types of chemotherapy and a response to first chemotherapy were analyzed in order to identify which factors were possibly related with survival after treatment with gefitinib in those patients with and without a positive respose to the treatment, respectively. Results: One and 38 patients yielded a complete and partial response, respectively, to gefitinib treatment with an overall response rate of 30%. Factors such as non- smoker, adenocarcinoma, good PS or stage IV disease were more frequently observed in the gefitinib-responders than in the non-responders. The median survival time (MST) of all patients receiving gefitinib treatment was 10 months while the MST was 28 months in the 39 gefitinib- responders and 6 months in the 92 non-responders. Among the 39 gefitinib responders, the predominant prognostic factor was found to be the effectiveness of the first-line chemotherapy. The MST of 20 patients with a response to the first-line chemotherapy was 32 months while the MST of 19 patients without a response to chemotherapy was 22 months (p=0.017). Among the 92 gefitinib non-responders, the predominant prognostic factor was PS (MST of 15 months in PS 0 vs 4.6 months in PS 1–4; p<0.001). Conclusions: The effectiveness of the first-line chemotherapy was therefore found to be a prognostic factor in gefitinib-responders with previously treated NSCLC while PS was shown to be a prognostic factor in gefitinib-non-responders. No significant financial relationships to disclose.
Phase I/II study of transcatheter arterial chemoembolization with cisplatin powder and degradable starch microspheres for unresectable hepatic metastases from colorectal cancer refractory to systemic standard chemotherapy.
Authors: H. Nishiofuku, T. Tanaka, H. Anai, S. Sueyoshi, M. Matsuoka, T. Otsuji, K. Yamamoto, Y. Inaba, H. Sakaguchi, K. Kichikawa
Journal: Journal of Clinical Oncology (2011)

577 Background: We conducted a phase I/II study of novel transcatheter arterial chemoembolization with cisplatin powder and degradable starch microspheres (DSM) to determine the recommended dose (RD) and to assess the efficacy and safety. Methods: Cisplatin powder and DSM mixing solution was administered followed by the injection of DSM alone via hepatic artery every 4 weeks. In phase I, cohorts of 3 patients received escalating dose of cisplatin (50, 65 and 80mg/m 2 ), and RD was estimated during the first cycle. In the phase II, more RD patients were added to assess tumor response, toxicity, hepatic progression free survival (H-PFS) and 6-month overall survival (OS) rate. Results: A total of 24 patients (male 16, female 8; mean age 63.0, range 45-79; colon 15, rectal 9) were enrolled in this study. FOLFOX had previously been administered to all patients, irinotecan-containing regimen to 12 and bevacizumab and/or cetuximab to 14. During phase I (n= 9 patients), maximum tolerated dose was not reached and cisplatin 80 mg/m 2 was recommended for a phase II. Phase II enrolled 15 patients. The following grade 3 toxicities were observed: platelets reduction 16.6%, aspartate transaminase elevation 38.8%, alanine transaminase elevation 16.6%, hyponatremia 11.1%, cholecystitis 5.5%. The tumor response rate was 53.3% (CR 0, PR 8, SD 6, and PD 1). The median H-PFS was 6.3 months (95% CI; 2.71 to 9.88) and 6 -month OS rate was 86.7%. Conclusions: This phase I/II study demonstrates that novel transcatheter arterial chemoembolization with 80 mg/m 2 cisplatin powder and DSM is well tolerable, and can produce a high response rate with encouraging survival duration. Further clinical trials are warranted. No significant financial relationships to disclose.
Oxaliplatin associated neurotoxicity outcomes among older adults with colorectal cancer: A population-based study.
Authors: Michael J. Raphael, Hadas Fischer, Kinwah Fung, Peter Austin, Christopher M. Booth, Geoffrey Anderson, Simron Singh
Journal: Journal of Clinical Oncology (2016)

601 Background: The addition of oxaliplatin to fluorouracil-based regimens in the adjuvant treatment of colorectal cancer (CRC) has been shown to improve overall survival at the expense of increased toxicity. Toxicity may be higher among older patients who may also derive less benefit from oxaliplatin. The incidence of toxicity in the elderly is unknown. Methods: A cohort of patients ≥ 66 years old diagnosed with Stage II and III CRC between 2007 and 2011 in Ontario, Canada was identified using the Ontario Cancer Registry. Linked administrative databases were used to identify patients treated with oxaliplatin who were subsequently diagnosed with peripheral neuropathy (PN) or received a new prescription for a neuropathic pain medication. Patients were stratified into two age strata, ages 66-69 and ages ≥ 70, and each group was compared to a control cohort receiving non-oxaliplatin-based adjuvant chemotherapy (AC). Cause-specific hazard models were used to estimate the effect of Oxaliplatin exposure on the cause-specific hazard of PN and associated neurotoxicity outcomes after accounting for the competing risk of death. Results: We identified 3,607 patients aged ≥ 66 with Stage II and III CRC, of whom 1,541 were treated with an oxaliplatin-based AC regimen. Compared to control subjects receiving non-oxaliplatin based AC, patients ≥ 70 years old treated with oxaliplatin were more likely to be diagnosed with PN (cause-specific hazard ratio (CHR) age ≥ 70, 2.07 [95% CI, 1.43-3.00; p &lt; 0.001]) and receive a new prescription for a neuropathic pain medication (CHR age ≥ 70, 1.86 [95% CI, 1.43-2.42;p &lt; 0.001]). In patients aged 66-69, oxaliplatin use was not associated with a new diagnosis of PN (p = 0.903), but was associated with an increased likelihood of receiving a prescription for a neuropathic pain medication (CHR age 66-70, 1.92 [95% CI, 1.22-3.03; p = 0.005]). By the end of one year, the cumulative incidence of PN was 3.21% (95% CI, 2.02-4.81) for ages 66-69 and 5.51% (95% CI, 4.14-7.15) for age ≥ 70. Conclusions: In this population-based cohort of CRC patients ≥ 70 years old, treatment with oxaliplatin is associated with a significant risk of developing PN and requiring treatment with neuropathic pain medications.
Vessel-sparing Radiotherapy for Localized Prostate Cancer to Preserve Erectile Function: A Single-arm Phase 2 Trial
Authors: Daniel E. Spratt, Jae Y. Lee, Robert T. Dess, Vrinda Narayana, Cheryl Evans, Adam Liss, Raymond Winfield, Matthew J. Schipper, Theodore S. Lawrence, Patrick W. McLaughlin
Journal: European Urology (2017)
Extensive RAG-Mediated Rearrangements and Mutations in BCR-ABL1 and BCR-ABL1-like Adult Acute Lymphoblastic Leukemia
Authors: Mathijs A. Sanders, Anikó Szabó, Carla Exalto, Remco Hoogenboezem, Annelieke Zeilemaker, Jasper E. Koenders, Peter van Geel, Anita Schelen, H. Berna Beverloo, Jan J. Cornelissen, Anita W. Rijneveld, Peter J.M. Valk
Journal: Blood (2016)
Delirium rate and risk factors in palliative oncology outpatients and associated caregiver coping.
Authors: Sarah Deur Livermore, Marin Feldman Xavier
Journal: Journal of Clinical Oncology (2014)

46 Background: Delirium causes suffering and undermines important palliative goals of care at end of life. Prior evaluation of outpatient delirium rate was 14% among demented elders. It is hypothesized that frail, palliative oncology outpatients have high rates of missed delirium. Improved knowledge and screening can improve patient outcomes through treatment in the home. This study examined the prevalence rate and risk factors for delirium among palliative care outpatients, and identified caregiver coping strategies associated with the episode. Methods: This was a descriptive, correlational study using a convenience sample of patient/caregiver dyads at an urban cancer center based on Rigney's Allopathic Load in Delirium Model. Oncology patient participants consented to a chart review for demographic risk factors. Caregivers of patients with a life-limiting illness were asked to complete two surveys at the time of their usual visit. The Family Administered Confusion Assessment Method, FAM-CAM scale reflected upon the patient's behavior over the past month using 12 simple yes/no questions. Risk factors such as age, gender, marital status, medications and diagnosis were correlated with delirium. The Folkman Lazarus Ways of Coping compared coping styles. Results: The rate of delirium among palliative care outpatients in this sample of 52 patient/caregiver dyads was 27%. The results suggested that opioid use slightly increases the odds for an episode of delirium, and approaches significance (r(50) =.270, p =.052). The majority of caregiver participants reported positive coping styles, however positive reappraisal and emotion-focused coping mechanism were more common in caregivers with a cognitively intact patient. Problem-focused coping was more common if the patient screened positive for delirium (m =.22, SD =.073). Conclusions: Oncology clinicians must screen for delirium in order to improve quality of care, especially among those on palliative chemotherapy.
The impact of androgen deprivation and pelvic radiation on the development of bladder cancer.
Authors: Navid Hafez, Rong Wang, Michael E. Hurwitz, Xiaomei Ma, Daniel Peter Petrylak
Journal: Journal of Clinical Oncology (2016)

439 Background: The male predilection of urothelial bladder cancer (UBC) as well as the expression of the androgen receptor in bladder tissue point to the role for androgens in UBC tumorigenesis. Animal studies demonstrate a potential role for androgen deprivation in diminishing UBC. More recently, two separate groups demonstrated decreased rates of both primary and recurrent UBC in prostate cancer patients previously receiving androgen deprivation therapy (ADT). Given the common use of radiation therapy (RT) in the treatment of localized prostate cancer, and previous data supporting the increased frequency of UBC in prostate cancer patients treated with RT, the interaction between ADT and RT in UBC remains an important consideration. Methods: Using the linked SEER-Medicare database, we investigated the interactions among ADT, RT and UBC by performing a retrospective cohort study of elderly (age 66-99) prostate cancer patients diagnosed between 1999-2011. Kaplan-Meier analysis and Cox proportional modeling were used to determine the risk of developing secondary bladder cancer after prostate cancer treatment (based on exposure to ADT, RT, both, or neither). All analyses were two-sided. Results: Of 121,927 patients with primary prostate cancer, 1,466 (1.20%) developed subsequent UBC with a median follow up of 5.08 years (range 0.003-12.00). Compared with patients never receiving ADT or RT (n = 43,809), the hazard ratios for the development of secondary bladder cancer in patients ever receiving ADT but no RT (n = 14,009), RT but no ADT (n = 16,672), or both ADT and RT (n = 17,465) were 0.76 (95% confidence interval [CI]: 0.63-0.91 ), 0.73 (95% CI: 0.64-0.83), and 0.69 (95% CI: 0.61-0.79), respectively. Conclusions: Both ADT and RT are independently associated with a reduced risk of secondary bladder cancers in prostate cancer patients. The finding of decreased UBC incidence in patients receiving RT was surprising, and in direct contradiction to previous studies of similar patient populations. Possible explanations include differences in cohort selection, changes in RT delivery, and differences in control groups.
Race-based socioeconomic and treatment disparities in adolescent and young adults with stage II-III rectal cancer.
Authors: David Y Lee, Annabelle Teng, Rose C Pedersen, Farees R Tavangari, Vikram Attaluri, Elisabeth C McLemore, Stacey Stern, Anton J. Bilchik, Melanie R Goldfarb
Journal: Journal of Clinical Oncology (2016)

714 Background: Stage II-III rectal cancer (CA) requires a multidisciplinary approach to optimize outcomes. This study explores whether treatment disparities account for racial differences in outcomes of AYA (ages 15-39) patients. Methods: AYAs with clinical stage II-III rectal CA were identified in the National Cancer Database. Demographic, clinical, and pathologic features predictive of receipt of adjuvant and surgical therapies were examined as well as factors associated with overall survival (OS). Results: Most of the 3,295 patients were white (72.0%), male (57.5%) and free of comorbidities (93.8%). Income, education levels, and rates of health insurance coverage were higher for whites than for blacks or Hispanics. Clinical stage was balanced by race, but more blacks and Hispanics did not receive radiation (24.5% and 27.1%, respectively, vs 16.5% for whites), surgery (22.4% and 15.3%, vs 12.3%), or chemotherapy (21.5% and 24.1%, vs 16.7%; p &lt; 0.05). Additionally, the average number of days before treatment was 34.0 for blacks and 33.3 for Hispanics, versus 27.5 for whites (p &lt; 0.05). Multivariate analysis showed that receipt of neoadjuvant chemoradiation was less likely when patients were black (OR 0.7, 95%CI 0.5-0.9, p = 0.014), Hispanic (OR 0.6, 95%CI 0.4-0.9, p = 0.012), female (OR 0.8, 95% CI 0.63-0.94, p = 0.011), without insurance (OR 0.5, 95%CI 0.36-0.69, p &lt; 0.001), or treated at a community cancer center (OR 0.5, 95%CI 0.36- 0.74, p &lt; 0.05). Race significantly influenced treatment, regardless of disease stage. Although 5-year OS was lower (p &lt; 0.05) in blacks (59.8±3.3%) and Hispanics (65.9±3.5%) compared to whites (74.9±1.1%), race did not impact mortality on Cox regression. Instead, mortality was associated with male sex (HR 1.5, 95%CI 1.1-2.0, p = 0.009), nodal positivity (HR 2.6, 95%CI 1.9-3.6, p &lt; 0.001), nonsurgical therapy (HR 7.1, 95%CI 2.8-18.2, p &lt; 0.001), no chemotherapy (HR 1.9, 95%CI 1.03-3.6, p = 0.04), poorly differentiated histology (HR 3.0, 95%CI 1.3-6.5, p = 0.007), and no insurance (HR 1.7, 95%CI 1.1-2.7, p = 0.022). Conclusions: Race-based socioeconomic and treatment disparities may contribute to survival differences among AYAs with rectal cancer.
Integrating contemplative and spiritual care in outpatient palliative care: A pilot study.
Authors: Craig D Blinderman, Alex Beth Schapiro
Journal: Journal of Clinical Oncology (2016)

247 Background: Spiritual support is associated with better outcomes in cancer care and at the end of life (1, 2). Consensus guidelines advocate for incorporating spiritual care in the provision of specialist level palliative care (3). Contemplative care practices and chaplaincy interventions have the potential for mitigating existential distress, cultivating prognostic awareness, and fostering spiritual approaches to grieving and coping with advanced cancer. We present the results of a pilot program demonstrating the feasibility and impact of integrating a contemplative care chaplain in an outpatient palliative care program in a culturally diverse patient population in a large, academic cancer center. Methods: Case series and descriptive analysis. A description of 10 cases seen by a contemplative care chaplain in our outpatient palliative care clinic in the Herbert Irving Comprehensive Cancer Center (HICCC) at Columbia University will be presented. A descriptive analysis using a chaplaincy-centered model of assessment will highlight the domains of suffering and subjective integration of psychosocial and spiritual concepts. Results: Patients were generally in favor of meeting with and sharing their feelings openly with the chaplain. Patients’ describe important domains pertinent to their well being: meaning, family integration, spiritual practices, existential concerns, prognostic awareness. Subjective transformation and integration of the following constructs: “healing,” “gratitude,” “anger,” “hope,” “fear” were possible with only a few patient encounters. None of the patients were opposed to an initial visit and assessment. In only one case, the family requested not having further visits due to strong emotional reactions that came up. Conclusions: Preliminary results from a novel, pilot program integrating contemplative and spiritual care in an outpatient palliative care program suggest that it is a feasible intervention and should be considered in other cancer centers. Further studies will need to qualify and quantify the additional value and impact of spiritual care integrated in ambulatory palliative care services.
A novel method combining gene and protein platforms on one slide for the detection of HER2 in gastric cancer: Final results.
Authors: Dominique Werner, Achim Battmann, Kristina Steinmetz, Tobin Jones, Tiffany Lamb, Michele Martinez, Salah-Eddin Al-Batran
Journal: Journal of Clinical Oncology (2014)

19 Background: The evaluation of gene amplification and/or protein overexpression of HER2 in gastric cancer is a prerequisite to establish an adequate treatment strategy. Gastric tumors are heterogeneous and separate evaluations lead to uncertainties in localizing distinct clones and are time consuming. The aim of this study was to evaluate the feasibility of gene-protein platform in comparison to single staining methods. Methods: Immunohistochemistry (IHC) plus silver in situ hybridization (SISH) (IHC/SISH) and the new gene-protein platform (gene/protein) method for HER2 were performed in randomly collected 100 cases of gastric carcinoma. Evaluation was performed by two observers, in discrepant cases a third observer was consulted to make a decision by consensus. Results of IHC and SISH were compared with gene/protein staining. Rüschoff criteria were applied. Tumors showing HER2 expression 3+ or amplification were considered HER2 positive. Results: 96 of 100 samples were eligible. Amplification was observed in 14.6% by both, conventional SISH and gene/protein platform. 70.8% by IHC and gene/protein had no expression (0) and 10.4%/11.5% (IHC vs. gene/protein) had weak (1+) HER2 expression. Moderate expression (2+) was observed in 9.4% by IHC and 7.3% by gene/protein. Rate of overexpression (3+) was similar in IHC (9.4%) and gene/protein (10.4%). There were complete concordances (100%; κ=1) in IHC assessment of cases with score 0 and SISH amplified tumors. High concordance are shown in score 1+ (98.96%; κ=0.947) and 3+ (96.88%; κ=0.825) cases. Concordance in cases with score 2+ was found in 95.83% (κ=0.728) of the observations. After third observation, there were 5 discordant cases with most discrepancies in assessment of IHC score 2+ or 3+. Conclusions: Gene-protein platform has been tested for first time in gastric carcinoma. Results showed that this novel platform can be a feasible alternative to single methods. Discrepancies in cases with moderate HER2 expression are a result of observer variability.
Study of laboratorial methods for hymenoptera allergy diagnosis: a critical analysis
Authors: S. H. lena Grosso Esher, A. P. ula Beltran Castro, J. Croce, M. S. rgio Palma, O. Malaspina, J. E. ias Kalil, F. F. rnandes Morato Castro
Journal: Journal of Allergy and Clinical Immunology (2001)
Can combined chemo-radiation be started after induction chemotherapy in the curative treatment of stage III non-small cell lung carcinoma (NSCLC)? A multicenter, phase II study 5-year update.
Authors: S. Faria, S. P. Owen, D. Soulieres, P. Del Vecchio, L. Ofiara, J. M. Ayoub, D. Charpentier, J. Gruber, J. F. Wan, L. Souhami, N. Kopek, V. Hirsh
Journal: Journal of Clinical Oncology (2011)

e17507 Background: The standard treatment for inoperable stage 3 NSCLC is concurrent chemo-radiation (CRT). In busy centers such as ours, radiation treatment often cannot be started soon. To prevent treatment delays, we performed a phase II study using induction chemotherapy followed by CRT instead of the standard CRT on day one. We report the long-term outcomes with this regimen. Methods: Forty-one stage 3 NSCLC patients (pts), with performance status < 1, were treated between January/2003 and November/2004: 27 males, 14 females, median age 60 (37-70), stage 3A (22 pts) or 3B (19 pts). The induction chemotherapy consisted of two cycles of carboplatin AUC=5 iv on day 1 and gemcitabine 1000mg/m2 iv on days 1 and 8 every 3 weeks x2, followed on day 50 by CRT, 60Gy/30 over 6 weeks, concomitantly with paclitaxel 50mg/m2 iv and gemcitabine 100mg/m2 iv on days 1 and 8 every three weeks x 2 cycles. Results: After induction chemotherapy, the partial response was 73.1%, stable disease was 24.4% and one patient progressed. With 72 months of median follow-up, the 3, 4 and 5 year overall survival rates were 34% (14 pts), 22% (9 pts), and 22% (9 pts) respectively. The 5 year progression-free survival was 17% (7 pts). During CRT, grade 3 neutropenia, thrombocytopenia, and anemia occurred in 8, 3, and 3 pts respectively, and grade 4 neutropenia and thrombocytopenia in one patient each. There were only 2 possible late toxicities (beyond 1 year) identified, including one case of coronary artery disease and one case of second malignancy within the treatment field (esophageal cancer). Twelve pts received further lines of chemotherapy. Conclusions: In addition to its favourable acute toxicity profile and response rates, at a median follow-up of 72 months, this regimen demonstrates a better than expected survival outcome with minimal late toxicity, deserving further investigations.
Secondary acute myeloid leukemia following severe congenital neutropenia: Case presentation.
Authors: A. C. Bello, M. Zavahra, S. Pachano, C. Reyes, M. E. Rivero
Journal: Journal of Clinical Oncology (2011)

e20001 Background: Therapy with granulocyte colony stimulating factor (G-CSF) is standard of care to prevent sepsis in severe congenital neutropenia (SCN). This successful approach has unmasked the predisposition to myelodysplastic syndrome and acute myeloid leukaemia (MDS/AML). This appears greatest in patients who require higher doses of G-CSF to achieve an adequate neutrophil response. Methods: 9 year old boy started severe infections since early infancy, neutropenia consistently below 500. Severe congenital neutropenia (SCN) was diagnosed at age 3 months, after marrow assessment. On high dose G-CSF since then, 10 to 15 mcg/Kg/d, to keep adequate ANC. Asymptomatic since then, normal development. No physical stigmata. Blood smears always dysplastic on myeloid line. At age 8, on check-up, had mild bicytopenia (anemia and thrombocytopenia). Was followed with bone marrow aspirates and biopsies. Normocellular, myeloid blasts 10 to 12%, by morphology and immunophenotype. Normal karyotype. Peripheral cytopenias advanced, until becoming transfusion-dependent for RBC and later platelets. WBC remained stable after discontinuing G-CSF. Viral and other infections were rulled out. Samples were analyzed for ELA-2 mutation, which was positive. G-CSF receptor mutation was negative. Course was progressive, transfusions given frequently. Splenomegaly stable at 3cm. Bone marrow performed monthly. Started iron chelation after 15 RBC transfusions and ferritin over 1000mcg/dl. No sibling available for HSCT. Results: Transformed to overt AML, with a rapid disease progression, despite giving AML chemotherapy. He ultimately died of refractory disease, after 2 blocks of chemotherapy. Conclusions: It is imperative that all patients with severe congenital neutropenia be closely monitored for leukaemic transformation. Risks and benefits of early haematopoietic stem cell transplantation should be evaluated for patients who respond poorly to a high dose of G-CSF.