tbuckley/cabot-search huggingface dataset:
SOCCAR: Sequential or concurrent chemotherapy and hypofractionated accelerated radiotherapy in inoperable stage III NSCLC.
Authors: J. Maguire, R. McMenemin, N. O'Rourke, C. Peedell, M. Snee, S. McNee, V. Kelly
Journal: Journal of Clinical Oncology (2011)

7039 Background: Concurrent chemoradiation is standard therapy for inoperable stage III NSCLC but there is uncertainty as to the optimal regimen and outcomes with conventional treatment are disappointing. SOCCAR addresses the feasibility, toxicity and efficacy of accelerated radical radiotherapy when combined with either concurrent (con) or sequential (seq) chemotherapy. Methods: 130 patients were randomised to 55Gy (ICRU reference point) in 20 fractions over four weeks with four cycles of either con or seq cisplatinum and vinorelbine. Entry required pathologically confirmed stage III inoperable NSCLC treatable in a radical RT volume with v20 ≤ 30% and ≤ 12cm oesophagus in PTV; PS 0 or 1, FEV1 ≥ 1L and TLCO ≥ 50%. Patients with weight loss or N3 disease were included, with no upper age limit. Results: Data is on 67 con and 60 seq patients at a median follow up of 31 months. Median age was 62; 61% male, 64% squamous, 27% adenoca; 52% PS 0; 44% IIIA, 56% IIIB. Compliance: median chemo cycles three (con) vs four (seq). Dose delays 53% con vs 60% seq. Toxicity: treatment related deaths - two con vs one seq; deaths within 6 months of starting treatment - three con vs two seq. SAEs - 46% con vs 47% seq. CTC grade 3 oesophagitis - six con vs one seq. Grade 4 oesophagitis did not occur. Survival: deaths 52.2% con vs 68.3% seq; median survival (months) - 27.4 con vs 18.6 seq; 2 year survival 54% con vs 42% seq. 3 year survival 38% con vs 27% seq. Conclusions: These findings confirm that accelerated XRT with concurrent cisplatinum and vinorelbine is feasible, safe and effective for patients with stage III NSCLC, with a two year survival rate in excess of 50%.
Possible role of the systemic inflammatory reaction in defining tumor responder vs. nonresponder in cancer macrobead therapy.
Authors: Barry H. Smith, Zoe Padua Andrada, Angelica Nazarian, Allyson J. Ocean, Tapan Parikh, Jia Lu, Anna Arreglado, Thomas J. Fahey, Nathaniel Berman, Larry Gazda, Prithy Martis, Melissa Laramore, Eugene Akahoho, Joanne Thomas, David J. Wolf
Journal: Journal of Clinical Oncology (2016)

572 Background: Peritoneal implantation of mouse renal adenocarcinoma cell-containing (RENCA) Macrobead (MB) represents a cell-system-based approach to the treatment of advanced, mCRC that has been evaluated to date in Phase IIa trials. The data indicate that there are “responders” (R) and “non-responders”(NR) as reflected in overall survival (OS), where “response” is defined as a &gt;20% decrease in either/both CEA or CA19-9 during the first 30 days after MB implantation. We analyzed whether the “response” is due to a post-implant systemic inflammatory response (SIR) or rather a direct inhibitory effect of the MB. Methods: Thirty-four treatment-resistant mCRC patients (pts) were implanted laparoscopically at least once with RENCA MB. Pts were considered R (n=25), or NR (n=9), based on tumor marker responses within the first 30 days. CRP, IL-6, TNF-alpha, and ESR, as measures of SIR, were measured at Day 14 and 30. Results: All 34 pts showed SIR to MB implantation, as indicated by transient rises in CRP, IL-6, TNF-a, and ESR. Baseline CRP values (R, mean 3.24+/-4.39 vs. NR, 2.96+/-3.43; t-test, p=0.86), Day 14 CRP values (R, mean 20.97 +/- 7.21 vs. NR, 14.5+/-8.78; t-test, p=0.04), Day 30 CRP values (R, mean 8.21+/-5.43 vs. NR, 10.76+/-6.92; t-test, p=0.27) and mean changes in IL-6 (baseline p=0.28; Day 14 p=0.36; Day 30 p=0.54), TNF-a (baseline p=0.37; Day 14 p=0.32; Day 30 p=0.29) did not show statistically significant differences between R and NR groups. Conclusions: Data suggest that early tumor marker decreases in R of RENCA MB are likely not due to the induced SIR, but rather a possibly direct anti-tumor-cell effect by factors released by MB. This supports the importance of the MB-induced changes in the MEF-2 pathway in the target colorectal cancer cell/tumor reported previously. Studies of clinical efficacy of MB continue in a Phase IIb clinical trial. Clinical trial information: NCT01053013.
Pattern and outcome of disease progression in phase I study of vemurafenib in patients with metastatic melanoma (MM).
Authors: K. B. Kim, K. T. Flaherty, P. B. Chapman, J. A. Sosman, A. Ribas, G. A. McArthur, R. K. Amaravadi, R. J. Lee, K. B. Nolop, I. Puzanov
Journal: Journal of Clinical Oncology (2011)

8519 Background: Vemurafenib (V; RG7204, PLX4032), a BRAF inhibitor, induces responses in a majority of patients (pts) with V600EBRAF mutant melanoma, but most eventually progress. We report the patterns of disease progression (PD) of pts with MM treated on the phase I study of V. Methods: Dose escalation cohort pts were treated with V 240-1,120 mg po BID, and MTD extension cohort pts with 960 mg BID. Clinical response was evaluated by RECIST every 8 weeks. Pts with PD in a disease site for which local therapy (surgery or radiotherapy) was feasible were allowed to continue on V post-progression. Survival from time of progression was estimated for pts who were and were not treated post-progression. Results: 48 pts (16 escalation, 32 extension cohort) with V600EBRAF mutation were treated. Median age 53 yrs, 27 (56%) male, 35 (73%) M1c, 27 (56%) ECOG PS of 1, and 23 (48%) had received ≥ 2 prior systemic therapies. Median OS has not been reached for all 48 pts (median follow up [F/U] was 12.5 mo (range 1.2-29.2). The common sites of PD were: Skin/soft tissue (44% of all 48 pts); nodes (27%); brain/CNS (25%); lungs (19%); liver (15%); bone, GI (10%). Among 42 pts with PD, 19 (45%) progressed only in new sites, 8 (19%) in the brain only and 11 (26%) in both new and original sites. Among 18 pts who continued PLX4032 >30 days after a local therapy of a PD lesion(s), a median OS has not been reached with a median F/U of 15.5 mo from initiation of PLX4032. Median treatment duration beyond initial PD was 3.6 mo (range, 1.1-9.9), and median OS from the time of initial PD has not been reached (median F/U 6.0 mo). For pts who did not continue treatment after PD, median OS from the time of PD was 1.4 mo. Adverse events during continued dosing in these pts were similar to those observed before PD. Conclusions: For subset of pts with PD in limited sites, continuation of PLX4032 treatment beyond PD is potentially beneficial after a local therapy. Further study of the impact of post-progression treatment is warranted while mechanisms of resistance and novel agents for MM are emerging. Median (mo) All pts (n=48) Pts—new site PD only (n=19) Pts—existing sites PD only (n=9) Pts—both existing and new sites PD (n=11) PFS 7.0 6.7 5.3 5.4 OS Not reached 12.3 18.0 11.5 * 3 pts: symptomatic PD.
Quality of life in patients with pancreatic cancer during neoadjuvant chemotherapy using gemcitabine and bevazizumab: A pilot study.
Authors: F. Fitzal, M. Schindl, F. Wrba, K. Koelblinger, P. Goetzinger, G. Kornek, K. Sahora, M. Gnant, I. Kuehrer
Journal: Journal of Clinical Oncology (2011)

330 Background: Neoadjuvant chemotherapy (nCT) for pancreatic cancer is increasing due to the fact that 75% of patients diagnosed with pancreatic cancer are borderline or non-resectable. The use of antibodies may improve the efficacy of nCT. The influence on quality of life is not clear. Methods: We prospectively evaluated quality of life in patients comparing nCT with gemcitabine (1000mg/m 2 ; 1, 8, 15 for 4 cycles) and bevacizumab (nCT-GA; n=8) with patients with (aCT-G, n=15) or without adjuvant gemcitabine (noCT; n=14) using the EORTC-QLQ PAN26 modul. We also included patients operated due to benign disease as a control group (B; n=15). Quality of life was measured before as well as 3-7 months after surgery. Results: 52 patients were included in the study. There was no difference between the four groups before surgery in overall quality of life sores (p=0.280). Overall quality of life was also not impaired three months after surgery in any group (nCT-GA: 45 ± 23 vs. 65 ± 23 p=0.196; aCT-G: 42 ± 16 vs. 58 ± 22 p=0.104; noCT: 42 ± 16 vs. 49 ± 24 p=0.462; B: 60 ± 22 vs. 58 ± 21 p=0.894). There were no statistic significant differences between the four groups three to seven months after surgery (p=0.578). Similar function scores such as appetite loss, digestive symptoms or others did not differ significantly. Conclusions: Chemotherapy with or without bevacizumab seems to be well tolerated. The similar appetite score in patients comparing malignant (±chemotherapy) with benign disease is of importance as weight loss is a bad prognostic marker in pancreatic cancer patients. Thus, chemotherapy with or without bevacizumab may be safe in this respect. Further prospective trials with larger patient numbers are needed. [Table: see text]
Phase II Trial of Weekly Bortezomib in Combination with Rituximab in Untreated Patients with Waldenstrom's Macroglobulinemia.
Authors: Irene M. Ghobrial, Swaminathan Padmanabhan, Ashraf Z. Badros, Renee Leduc, Meghan Rourke, Stacey Chuma, Janet Kunsman, Diane Warren, Brianna Harris, Amy Sam, Kenneth C. Anderson, Paul Richardson, Steven Treon, Jeffrey Matous
Journal: Blood (2009)
Colorectal cancers in United Arab Emirates nationals: The Sheik Khalifa Medical Center's experience.
Authors: Nidal Dehni, Ali Al Hassani, Abdulrahman Nimeri
Journal: Journal of Clinical Oncology (2012)

442 Background: Previous reports suggested that colorectal cancers (CRC) appear at younger age in the United Arabs Emirates (UAE). However, these reports included nationals and expatriates in their analysis with heterogeneous population leading to biased analysis. our objective was to determine age and stage of disease in newly diagnosed UEA nationals with CRC treated at one major referral hospital in Abu Dhabi (SKMC) Methods: Charts of all patients diagnosed and/ or treated for CRC at SKMC between January 2000 and May 2011 were reviewed. Ultimately, only UEA nationals with diagnosis of adenocarcinoma of the colon and rectum were retained for further analysis. Results: Two hundreds six patients were diagnosed at SKMC as having colon or rectal carcinomas. Ninety two were expatriates and in 10 out of 113 nationals, the final diagnosis was squamous or adenosquamous carcinoma leaving 103 patients forming the population of this study. Median age was 57(10-100 years), with 59 men. The patient’s condition necessitated emergency operation in 38 and 15 either refused or were unfit for treatment mainly because of very advanced disease or severe co morbidity. The tumor location was: sigmoid: 46%, rectum: 33:, right colon :17% and 4% for descending and transverse colon. The stage of the disease was I; 4 pts, II: 16 pts, III 25 pts, IV in 49 pts and undetermined in 7. Resection was curative for 46 pts, palliative in 45, unknown in 10 and 2 refused surgery. Fifty one patients had their treatment essentially at SKMC and the others were treated both at SKMC and abroad. Average follow-up was 2 years and at last FU 39 were confirmed deceased, 29 were alive and the outcome in the remaining was unknown. Conclusions: UAE nationals with CRC presenting to our facility have relatively young age but presented with stage IV disease in half of the cases. Screening program for this population is warranted. Because a substantial number of patients had had their treatment abroad, rigorous follow-up and cancer outcome assessment was unreliable.
Occurrence and timing of organ space surgical site infections (SSI) in rectal cancer patients: A NSQIP database review.
Authors: Hiromichi Miyagaki, HMC Shantha Kumara, Yan Xiaohong, Vesna Cekic, Richard L. Whelan
Journal: Journal of Clinical Oncology (2014)

552 Background: This study’s aim was to determine the incidence and date of presentation of organ space SSI (in this setting most likely due to anastomotic leak or pelvic abscess) in rectal cancer resection patients. A second purpose was to determine which variable(s) impacted the timing of the presentation. Methods: The NSQIP database was queried from 2007 to 2011 for elective rectal cancer resections. Exclusion criteria included; ASA 5 status, preoperative(preop) shock/sepsis, SIRS, and recent surgery. Demographic parameters, comorbidities, lab data, and incidence and timing of organ space SSI were assessed. The statistical methods used were Fisher’s exact test (categorical variables) and Wilcoxon’s rank tests (continuous variables). Results: 8,093 rectal cancer patients were identified (Male/Female; 60.1%/39.9%; median age, 60; APR, 28 %; sphincter saving procedures,72%). The incidence of organ space SSI was 6 % (485 patients; 2.7% presented before and 3.3% after discharge). The rate was significantly greater for men, younger patients (&lt; 60), smokers, sphincter saving resections (vs. APR). Preop radiotherapy (RT) did not increase the rate of and stomas did not protect against the formation of organ space SSI. The mean date of detection was 14.6±7.3 days after surgery (Mean±SD). A further delay was noted in those who had preop RT regardless of the operation performed (n=184, added delay 2.7 days, p&lt;0.05). Significant delays (p&lt;0.05) were also noted in patients that had APR (n=112, mean delay 2.4days), stoma formation (n=285, mean delay 1.6days) and open surgery (n=368, mean delay 1.8 days). Multivariate analysis revealed preop RT (p=0.0002) and APR (p=0.0258) as independent risk factors for delayed presentation. Conclusions: Most organ space SSI after rectal cancer surgery occur after hospital discharge. The mean presentation date is about 2 weeks after surgery. Patients who received preop RT or underwent APR presented about 2.5 days later than the mean date. Rectal cancer patients should be followed closely for 3 weeks as regards organ space SSI.
Cost and duration of illness for lung cancer in national payer database.
Authors: L. N. Newcomer
Journal: Journal of Clinical Oncology (2010)

e16563 Background: A national claims database is available for descriptive statistical analysis of lung cancer patients. Methods: Primary lung cancer patients with at least one claim in a national payer database occurring between 7/01/08 and 6/30/09 were studied. All claims for this cohort were examined from the first diagnostic surgical procedure to the last claim using the longer time period from 11/01/05 to 6/30/09. The patients were divided into four cohorts: chemotherapy only, radiation therapy (XRT) only, chemotherapy and radiation therapy and no therapy. The duration of illness was defined as the number of days from the original surgical diagnosis to the last claim. The last claim usually represents an impending patient death or change in payer coverage. Deaths were not confirmed in this study. There is no hypothesis to suggest that the incidence of either event would be higher in one group. All medical costs for 3Q/08 to 2Q/09 were computed for each group. Staging data is not available. Results: See Table. Conclusions: This data suggests that an outcome study of community lung cancer patients is warranted. A national payer database is less selective than the patient cohort reported in drug registry trials. Cancer therapy for patients seen in community cancer clinics appear to significantly increase the total cost of care, but it does not appear to have any effect on duration of illness. This analysis is limited by lack of information on quality of life, exact dates of death and staging. Treatment option Number of patients Duration of illness average days Total cost average No therapy 949 493 $31,308 Chemo only 571 505 $54,851* XRT only 290 303** $97,661* Chemo and XRT 584 341** $88,230* * p < 0.001 compared to no therapy. ** p <0.001 compared to no therapy. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration United Healthcare
Comparing the classification precision and prognostic performance of an intrinsic gastric cancer signature with existing genomic signatures in six independent datasets.
Authors: I. B. Tan, H. Grabsch, H. C. Toh, J. Lee, A. Boussioutas, S. Y. Rha, J. A. Ajani, P. Tan
Journal: Journal of Clinical Oncology (2011)

4025 Background: Several gene expression signatures derived from supervised approaches based on histology, peritoneal or lymph node metastases and survival have been proposed to classify gastric adenocarcinomas and provide prognostic information. These studies had relatively small samples sizes. Methods: 7 datasets of gene expression profiles across different microarray platforms were generated in house or obtained from collaborators, namely a panel of 37 gastric cancer cell lines (GCCL) with Affymetrix U133-2Plus and 549 patients from 6 independent patient cohorts (Affymetrix U133-2plus: 197 (Singapore), 70 (Australia), Affymetrix U133AB: 31 (UK), Illumina Human-6 v2 : 65 (Korea1), Custom arrays: 90 (HK), 96 (Korea2). Unsupervised techniques were used to distinguish major intrinsic subtypes from GCCLs and distinguishing features identified using Linear models for microarray data (LIMMA). We classified patient tumors using the nearest template prediction algorithm and evaluated classification precision and correlation with patient survival. Results: Beginning with unsupervised techniques, 2 major intrinsic subtypes were identified from our training set (GCCL). A 171-gene signature was identified. At a false discovery rate of 0.05, our signature precisely classified 432 (78.6%) of primary tumors with 61.1% to 88.6% of tumors precisely classified in each dataset and 55% of the classified tumors belonging to the larger of 2 intrinsic subgroups. With 5 other published signatures, classification precision was < 30%. This intrinsic subtypes classification provided prognostic information with the more aggressive subgroup having inferior overall survival: median survival: 30 mths vs 71mths (HR 1.48; 95%CI: 1.14-1.92, p<0.01, univariate analysis and HR 1.39 ; 95% CI: 1.05-1.78, p=0.02 after adjusting for stage). All other published gene signatures were not prognostic. Conclusions: An intrinsic signature precisely classifies gastric cancers in 6 large patient cohorts from different countries and with microarray platforms and provides better prognostic information compared to existing signatures.
Clinical features of metastatic renal cell carcinoma patients with intrinsic resistance to sunitinib: A Korean multicenter study.
Authors: Jung Hoon Kim, Young-Woong Won, Seung Tae Kim, Se Hoon Park, Soonil Lee, Sung Hee Lim, In Gyu Hwang, Sung Yong Oh, Jun Ho Ji, Ji Yun Lee
Journal: Journal of Clinical Oncology (2015)

462 Background: In a subset of patients with metastatic renal cell carcinoma (RCC), primary resistance to first VEGF targeted therapy is not fully understood, and the optimal treatment approach for these patients is still controversial. This study was aimed to characterize the primary sunitinib resistant patients and associated predicting factors. Methods: A total of 134 patients with recurrent or metastatic RCC, who were initially treated with sunitinib, consecutively selected from 4 centers in Korea, between January 2008 and March 2013. Patients in whom progressive disease (PD) was the best response during treatment with sunitinib were included in the primary sunitinib resistant group. Results: Among 134 patients, 33 (25%) patients primary resistant to sunitinib with a median age of 59 years (range, 28-78) were identified. Most patients had clear cell histology (94%) and good ECOG performance status (0, 1) (82%). According to MSKCC risk, 25% of patients were at favorable risk, 72% at intermediate risk, and 3% at poor risk. Univariate analysis revealed that poor performance status (ECOG≥2), elevated LDH, neutrophilia, and higher number of distant metastatic disease (≥3) and bone or hepatic metastasis were significant factors associated with intrinsic resistant disease. Neutrophilia (OR=7.4, p=0.015) and more than three distant metastatic disease (OR=3.6, p=0.031) were independently significant risk factors of predicting intrinsic resistant disease on multivariate analysis. There was statistically significant difference with regard to overall survival (median, 11.7 vs. 31.1 month; p=0.001) and progression free survival (median, 2.4 vs. 12.5 month; p&lt;0.0001) between the patients with and without intrinsic resistance. Conclusions: Intrinsic resistance to sunitinib treatment is associated with a dismal prognosis in metastatic RCC patients. Along with above predicting clinical features, more understanding of the underlying mechanism and molecular biomarkers for detecting the intrinsic resistant disease are needed.
Use of mobile technology by patients in a comprehensive cancer center.
Authors: M. A. Kirch, L. C. Smith, P. M. Clark, K. J. Hammelef, M. B. Waldinger, L. C. An
Journal: Journal of Clinical Oncology (2011)

e19697 Background: Use of mobile technologies (e.g. smart phones) is increasingly common among U.S. adults, and could become an important channel to provide cancer patients with information and support services. While rates of use for the general population are documented, little information is available about cancer patients overall or by specific diagnosis. We address this deficit by conducting a survey of patients’ cell phone use in a comprehensive cancer center. Methods: We surveyed a sample of volunteer adult cancer patients (n = 1,282) at the University of Michigan Comprehensive Cancer Center during 2010 (survey response rate=75%). This pen and paper survey took 15 minutes to complete. The survey assessed cell phone ownership, use of additional cell phone based functions (e.g. texting, Internet searches), and use of cell phones to find information about cancer. Results: Overall, 88% of cancer patients reported owning a cell phone. Nearly half of patients (46%) reported using additional cell phone based functions, such as texting, instant messaging, or email (46%), Internet searching (22%), or downloading applications (15%). Rates of cell phone use were similar for patients across a range of cancer diagnoses: 92% breast, 87% urologic, 89% leukemia, and 86% skin cancer. There was some variation in the use of additional phone features across cancer diagnoses: 53% breast, 35% urologic, 47% leukemia, and 44% skin cancer. Additional respondent characteristics related to use of cell phone applications include age (37% > 50 vs. 74% <50, p < 0.001), gender (50% women vs. 41% men, p = 0.006), and college education (52% some college vs. 25% no college, p < 0.001). Use of cell phones to search for information about cancer was uncommon (5%). Conclusions: Cell phone ownership is common for patients across a range of cancer diagnoses and many patients use of additional cell phone features, particularly messaging. Since patients do not appear to rely on their cell phones for cancer-related information, our findings suggest that there are opportunities to improve the use of mobile technologies in cancer care. Future work could examine use of mobile technology by cancer patients treated in a variety of settings or in population-based samples of cancer patients.