tbuckley/cabot-search huggingface dataset:
Locally recurrent colorectal cancer and hepatic metastases: Safety, feasibility, and outcomes after concomitant resection.
Authors: Sarah York Boostrom, Kellie Leanne Mathis, Eric J. Dozois, David Nagorney, Robert R Cima, David W Larson, Bruce G. Wolff, John H Pemberton
Journal: Journal of Clinical Oncology (2013)

535 Background: The most effective management of locally recurrent colorectal cancer (CRC) is resection. This is also true for hepatic metastases (HM). Data remains limited, however, regarding concomitant resection of recurrent CRC and HM. The aims of this study were to determine the feasibility, safety and outcomes in terms of disease-free survival (DFS) and overall survival (OS) in patients undergoing concomitant resection of recurrent CRC with HM. Methods: All patients who underwent resection of recurrent CRC from 1/1995 to 1/2007 at Mayo Clinic, Rochester were reviewed (n=406). The study group consisted of patients who underwentconcomitant resection of locally recurrent CRC and hepatic resection for metastatic CRC (n= 45). Kaplan-Meier Survival was used to estimate DFS and OS. Results: The study group consisted of 27 men and 18 women. The median age was 59 years. Surgical management involved pelvic dissection in 43 patients and ileotransverse colectomy in two. 17 patients required resection of contiguous organs. 24 patients received intra-operative radiation. 34 patients underwent multiple hepatic wedge resections, 6 patients segmentectomy, 3 left hepatectomy, and 2 right hepatectomy. There was no perioperative mortality. Morbidity was 37%, 2 patients required re-operation. The 1, 3, and 5 year DFS was 72.2, 42.3, and 18.5%, respectively. The 1, 3, and 5 year OS was 87.7, 47.6, and 36.2%, respectively. Conclusions: Synchronous resection of locally recurrent CRC and HM is safe and feasible; morbidity is reasonable and mortality zero. DFS and OS in this patient population appear comparable to that of patients undergoing separate, staged resections.
Arsenic Trioxide with Ascorbic Acid and High-Dose Melphalan for Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma.
Authors: Muzaffar H. Qazilbash, Rima M. Saliba, Marilyn S. Davis, Floralyn L. Mendoza, Chitra Hosing, Daniel R. Couriel, Marcos De Lima, Partow Kebriaei, Donna M. Weber, Michael Wang, Amin M. Alousi, Steven G. Matthes, Roy B. Jones, Richard E. Champlin, Sergio A. Giralt
Journal: Blood (2006)
Neoadjuvant and adjuvant, floxuridine, leucovorin, oxaliplatin, and docetaxel (FLOD) in patients with locally advanced operable gastroesophageal adenocarcinoma: A phase II study with pathologic responses and long term follow-up.
Authors: Bach Ardalan, Miriam Gombosh, Dido Franceschi, Eli Avisar, Danny Yakoub, Afonso Ribeiro, Jose Garrido, Nipun Merchant, Alan S Livingstone
Journal: Journal of Clinical Oncology (2016)

124 Background: A complete pathological response to neoadjuvant chemotherapy without the use of radiation has infrequently been reported in operable chemo-naïve stage III gastro esophageal adenocarcinoma patients. Methods: Twenty-nine patients were enrolled in this study. Neoadjuvant therapy consisted of Floxuridine, Leucovorin, Oxaliplatin, and Docetaxel and was administered in 2, four week cycles. Chemotherapy consisted on day one and day fifteen; Oxaliplatin, Docetaxel, FUDR, and Leucovorin. The latter two drugs were given concurrently over twenty four hours. On day eight, chemotherapy consisted of Docetaxel, FUDR, and Leucovorin. Following therapy, patients underwent surgical resection. Those patients having residual disease were offered adjuvant chemotherapy. Patients having a complete pathological response were not offered any further therapy. Results: Twenty-four out of twenty-nine patients completed neoadjuvant therapy and underwent esophagectomy. Two were declared inoperable after treatment. Three patients died prior to surgery. The median follow-up of all patients is now sixty months. The median overall survival has not been reached at sixty months. Five yr actual OS is 51%. Clinical response to neoadjuvant therapy was seen in (72.4%) patients. Complete pathological response to neoadjuvant therapy was seen in (16.7%) who are disease free at sixty month follow-ups. Seven out of twenty-four patients achieved partial pathological response (29.1%) and received adjuvant chemotherapy. They are all alive (100%). Eight patients achieved less than partial pathological response and received adjuvant chemotherapy, four out of eight are alive at sixty months (50%). Grade three and four toxicities were seen in sixteen out of twenty nine patients during neoadjuvant therapy. Grade three and four toxicities were seen in six out of fourteen patients during adjuvant therapy. Conclusions: Our chemotherapy regimen of Floxuridine, Leucovorin, Oxaliplatin and Docetaxel (FLOD) has resulted in long term survival in patients with adenocarcinoma of the esophagus. Clinical trial information: NCT00448760.
Time stamps used to measure the patient's clinic experience.
Authors: Terry Jensen, Roy Brown, Gay Riegel, Lalan S. Wilfong, John Russell Hoverman
Journal: Journal of Clinical Oncology (2016)

150 Background: In 2013, a patient reported satisfaction survey indicated 19% of patients waited 20-40 minutes, 8% 40-60 minutes and 4% over 1 hour. We initiated a project to objectively quantify the components of wait times to investigate opportunities for improvement. Methods: Utilizing existing technology in the practice management system, clinic staff use the Day List feature to capture time stamps as patients move through the clinic. We focused on provider appointments but these visits could also include business office, labs, infusion and diagnostics. It was important to define where the wait(s) occurred. The Time Stamp durations measured are as follows: Arrival to Depart – duration of each appointment; Arrival to site to Exam Start – duration of activity until ready to be seen by the provider, includes rooming, labs and business office activity. Used to compare to the patient satisfaction survey responses; Exam Start to Depart – the provider portion of the office visit, includes patient wait plus exam time. Three reports are generated: Time Stamp Error Report indicating the completeness of data collection; Average Wait Times Report with appointment counts by physician by site and average durations; Provider Wait Times Report with office visit counts, Wait Time Category counts ( &lt; 10 min, 10-20, 20-40, 40-60, and &gt; 1 hour ) and average durations. Results: There was a correlation calculation to the patient satisfaction survey of .779, with long wait times more likely to be underreported by patients. Site and physician data were available for review at site Quality Committees. The data can be used by the site to improve processes, such as lab and infusion room scheduling. Time stamps are used to communicate patient readiness for next steps in the office visit. The time stamps provide objective data to discuss patient complaints with staff. Conclusions: Patient wait times are a valued measure of patient satisfaction and quality. Full utilization of the Day List and supporting technology allows us to objectively monitor and improve this aspect of patient care. Table 1: Sample Provider Report [Table: see text]
Proteinuria monitoring in patients receiving bevacizumab at a community cancer center.
Authors: Amin Benyounes, Sherry Pomerantz, Ann Christian, Gentry Teng King, Nancy Leahy, William J. Tester, John Charles Leighton
Journal: Journal of Clinical Oncology (2014)

13 Background: The use of bevacizumab has been associated with the development of proteinuria. The manufacturer suggests monitoring for proteinuria with serial urine dipsticks. We set to evaluate the relevance and cost of this practice in a Community Cancer Center in Philadelphia. Methods: We performed a retrospective chart review at Albert Einstein Cancer Center. Consecutive patients treated with bevacizumab from January 2011 to March 2014 were included in the study. Primary endpoints were the incidence and grade of proteinuria under bevacizumab therapy and the implication of proteinuria in treatment (holding or cessation of bevacizumab). Secondary objectives included the association between the number of bevacizumab infusions or patient’s comorbidities (diabetes, hypertension, chronic kidney disease) and the development or worsening of proteinuria. We also calculated the cost of monitoring for proteinuria in our cohort. Results: 71 patients were screened. A total of 66 patients (corresponding to 738 infusions) were included in the analysis. Typical monitoring interval was every 2 cycles. None developed nephrotic range proteinuria. One patient (1.5%) developed grade 2 proteinuria. Bevaciuzumab was discontinued due to proteinuria in 2 patients (3%): neither of them developed permanent kidney damage or required an intervention as a consequence of the proteinuria. The most common reason of bevacizumab discontinuation was progression of disease (75%). Neither the number of infusions nor concomitant comorbidities were significantly associated with the development or worsening of proteinuria (p=0.8, p&gt;0.05 respectively). The cost of monitoring for proteinuria in our cohort was estimated at $3980. Conclusions: These results show that the development of grade 2 proteinuria, let alone grade 3, with bevacizumab is uncommon and rarely affects treatment decisions in our Community Cancer Center. We therefore question the necessity of routine monitoring for proteinuria during bevacizumab treatment.
Patient-reported outcome driven case management system for hematology and oncology patients.
Authors: Rahma M. Warsame, Angela Dispenzieri, Katrina Croghan, Joleen Marie Hubbard, Carrie A. Thompson, Jeffrey Sloan
Journal: Journal of Clinical Oncology (2016)

229 Background: Modern clinical practice places time restrictions on the amount of information and processing that can be done in a typical office visit. Meeting patient needs within the healthcare system is often inefficient and ineffective, contributing to patient and clinician dissatisfaction and suboptimal outcomes. We developed a point-of-care case management system for oncology clinical practices adapted from an algorithm initially designed for patients with diabetes. The system’s goal is to obtain patient-reported quality of life (QOL) outcomes and provide clinicians with information regarding QOL issues to address. Methods: Literature review and focus groups of oncology patients were used to identify key patient concerns. The program was adapted for cancer patients to collect the identified patient concern including QOL, fatigue, pain and other cancer-specific issues scored on a scale of 0-10. Suggested actions and available resources were identified for the patient/clinician based on the issue selected. We performed a pilot study involving 20 cancer patients to assess feasibility, and administered a “was it worth it survey” (WIWI). Results: The resultant hematology/oncology electronic system includes a set of eight primary “buttons”: Personal Relationships, Emotional health, Physical healthy, Cancer diagnosis and treatment, Health behaviors, Money, Care planning and Something else. Every “button” was selected, most commonly Cancer diagnosis and treatment 6/20 (30%). The median (range) reported QOL, fatigue and pain were 7 (1-10), 4 (0-8), 2 (0-8), respectively. The average completion of the tool took 4 minutes. One hundred percent of patients who took the survey thought it was worth it, would participate again and recommend it to others. Conclusions: The system was quick and easy to utilize in a small pilot of patients. All of the identified categories were chosen and relevant to our patient population. This tool has the potential to improve patient well-being and clinical outcomes, reduce the burden on clinicians and distribute case management activities to the most appropriate providers. Next steps include initiating a larger prospective protocol to assess if this tool improves QOL over time.
Influence of age on chemoradiotherapy outcome in patients with rectal cancer: Exploratory analysis from the phase III study ACCORD 12/0405 PRODIGE 2.
Authors: Eric Francois, David Azria, Sophie Gourgou-Bourgade, Isabelle Martel-Lafay, Christophe Hennequin, Pierre-Luc Etienne, Veronique Vendrely, Jean Francois Seitz, Thierry Conroy, Beata Juzyna, Jean-Pierce Gerard
Journal: Journal of Clinical Oncology (2012)

550 Background: Preoperative radiochemotherapy (RCT) is the standard of care for patients (pts) with locally advanced rectal adenocarcinoma. However elderly pts may have an increased risk of adverse events after combined modality treatment. The randomized trial ACCORD 12/0405 PRODIGE 2 compared 5 weeks of treatment with radiotherapy 45 Gy/25 fractions (f) with concurrent capecitabine 800 mg/m² twice daily 5 days per week (Cap 45) or radiotherapy 50 Gy/25 f with capecitabine 800 mg/m 2 twice daily, 5 days per week and oxaliplatin 50 mg/m 2 once weekly (Capox 50), results of efficacy (complete pathologic response) were not different between the two arms. We analyzed the results of RCT according to pts age. Methods: All eligible pts (n=584) were included in this exploratory analysis. Pts were divided in 2 groups: &lt;70 y and ≥70 y. Toxicity and tumor regression scores were compared between the 2 groups. Results: 442 pts were &lt;70 y and 142 were ≥70 y. Pts characteristics were well balanced between groups (gender, ECOG performance status, primary tumor, histology). Tolerance was worse in pts ≥70 y as shown in the table. Surgical procedures were not different between the 2 groups. Results on histological response were similar between the 2 groups: complete pathologic response was 16.9% (95% CI 13.1 to 20.2%) for pts &lt;70 y and 14.7% (95% CI 9.2 to 21.8%) for pts ≥70 y, (p=0.55) and rates of R0 surgery for pts &lt; 70 y and pts ≥ 70 y were respectively: 90.6% and 88.2%, (p=0.54). Conclusions: As tolerance of elderly pts treated with preoperative RTCT is worse than in younger pts, appropriate therapeutic schedule are warranted for these pts. [Table: see text]
Outcome and prognostic factors of pancreatic cancer in a tertiary cancer center in Saudi Arabia: Ten years' experience.
Authors: S. Alfaifi, H. AlGhamdi, S. Musaad, A. A. M. Alolayan, A. R. Jazieh
Journal: Journal of Clinical Oncology (2011)

e14520 Background: Our study is the first in region that aims at determining outcome and prognostic factors for survival in patients with pancreatic cancer in Saudi Arabia. Methods: A retrospective review of the records of patients with pancreatic cancer at King Abdulaziz Medical City-Saudi Arabia during the period from 2000 to 2010. Data were collected using custom made data abstraction form, then analyzed using SAS version 9.2 (SAS Institute Inc., Cary, NC). Descriptive statistics were conducted for demographics, family history, tumor characteristics, symptoms at diagnosis and therapy given. Survival was calculated using the Kaplan-Meier estimate. Univariate then multiple regression analysis were done using the Cox proportional hazards model. A p value of ≤0.05 was considered significant in this study. Results: 179 patients were included in the study. Median age was 63 years (15-96) and 116 (64.8%) were male. The 1- and 5- year survival rates were 39% and 10%, respectively. Median overall survival (OS) since diagnosis was 6.9 months [95% confidence interval (CI), 4.6-9.7 months]. On univariate Cox proportional hazards regression analysis, age at diagnosis, grade, T stage, N stage, M stage, TNM stage group and the combined stage group (stage III/IV vs. others), site of distant metastasis, CEA, Ca19-9, surgery and chemotherapy were significant predictors for overall survival. The results of the multiple regression model incorporating all the significant predictors are shown in this table. Conclusions: Our patients present at younger age compared to the U.S. SEER data (73 years), similar to other cancers in the region, which warrants further exploration. Furthermore, our patients have better 5-years survival compared to U.S. SEER data (5.6%), which may be a result of younger age of our patients population. Age and M stage were identified as independent prognostic factors for survival in patients with pancreatic cancer. Variable Hazard ratio 95% confidence interval P value Age at time of diagnosis 1.051 1.007-1.097 0.0241 M stage: M0 vs. M1 0.004 0.000-0.181 0.0043
Nasopharyngeal/nasal type peripheral T-cell lymphomas: Long-term outcomes and prognostic analysis of 112 cases in Southern China
Authors: Y.-J. Zhang, Y.-F. Xia, Q.-L. Wu, T.-Y. Lin, N.-J. Cui
Journal: Journal of Clinical Oncology (2005)

6646 Background: Extranodal peripheral T-cell lymphoma arising in facial midline has unique clinicopathologic features, the optimal treatment and prognostic factors remain unclear. Methods: 112 patients with pathologically confirmed nasopharyngeal/nasal type peripheral T cell lymphomas were included from April, 1994 to Dec, 2003, 39 patients were identified as CD56(+) NK/T cell lymphoma. Median pre-treatment disease history(PTDH) was 4 months, male/female ratio was 3.0:1, with a median age of 46 years. 91.1% of the patients were staged as Ann Arbor I and II diseases. International Prognostic Indices were < 2 scores in 78.8% of the patients. Most patients underwent combined chemo and radiotherapy, 32 patients underwent chemotherapy only. Chemotherapy was mainly in CHOP like regimens(median 5 cycles). High energy photon/electron rays were used for radiotherapy(median curative dose 54Gy). Results: Median follow-up time for survived patients was 42 months. Chemotherapy achieved a CR rate of 34.4% as initial treatment, the CR rate after primary treatment was 65.1%. Median time to disease progression (TTP) was 11 months, local control rate for stage I and II tumors was 50.5%. There were evidences indicating systemic relapse in > 30% of the patients. Radiation therapy showed a positive correlation with local control and TTP. The number of chemo cycles was positively correlated with TTP, but not with local control. Progress-free survival and overall survival rates were 38.8% and 52.4% at 3 years, and 34.9% and 44.8% at 5 years, respectively. In univariate analysis survival favorable factors included PTDH > 2 months, earlier clinical stage, non-NK/T lymphoma diagnoses, no skin invasion, lower risk IPI, CR after initial chemotherapy and radiotherapy. In multivariate analysis, PTDH > 2 months, non-NK/T lymphoma diagnoses, CR after initial chemotherapy, and radiotherapy were survival favorable prognostic factors. Conclusions: CD56(+) NK/T lymphoma can be more aggressive than other nasopharyngeal/nasal type peripheral T-cell lymphomas. Combined chemo and radiotherapy as principal treatments need improvement to increase remission rates so as to improve survival. No significant financial relationships to disclose.
Phase I trial of preoperative cetuximab in combination with oxaliplatin, capecitabine, and radiation therapy for locally advanced rectal cancer
Authors: E. C. Cabebe, T. Kuo, A. Koong, M. Welton, A. Shelton, P. L. Kunz, J. M. Ford, B. I. Sikic, H. L. Kaiser, J. Rogers, G. A. Fisher
Journal: Journal of Clinical Oncology (2008)

15019 Background: Preoperative chemoradiotherapy with 5-fluorouracil (5-FU) is associated with improved regional control of locally advanced rectal cancer with reduced toxicity when compared with postoperative therapy. Cetuximab, a monoclonal antibody targeting the epidermal growth factor receptor (EGFR), has been shown to have anti-tumor activity in colorectal malignancies. This study investigates the safety and tolerability of preoperative cetuximab in combination with chemoradiotherapy for locally advanced rectal cancer. Methods: Patients with locally advanced rectal cancer (ultrasound-staged T3-T4 or N1) were treated with preoperative weekly cetuximab (400 mg/m2 loading dose followed by 250 mg/m2 weekly dose) for 9 weeks. During the first 6 weeks, patients received standard radiation therapy (5040 cGy over 28 days) to the rectal tumor and pelvis concurrent with capecitabine 800 mg/m2 p.o. twice daily Monday through Friday. Two doses of oxaliplatin 100 mg/m2 are to be given on days 2 and 23 of the preoperative course. Patients were assessed for toxicity weekly during the treatment period. Results: From August 2004 to December 2007, twenty- three patients have completed the 9 week preoperative study treatment. Ten patients were given all three agents, however because of adverse events related to oxaliplatin’s radiosensitising properties, the protocol was amended and the subsequent thirteen patients were treated with cextuximab and capecitabine in combination with radiation therapy. Median age was 52 years (24 to 69) and all patients had KPS ≥ 80%. Toxicities encountered included rash, diarrhea, fatigue, and hand-foot syndrome. Three patients withdrew from the study for adverse events (two for EGFR-related skin toxicity and one for radiation induced ileus). Four of 23 patients (17%) had a pathologic complete response (CR). Thirteen of 23 patients (57%) were downstaged after surgical resection. Conclusions: Radiation with concurrent capecitabine and cetuximab is a tolerable regimen for preoperative therapy of locally advanced rectal cancer with a pathological CR similar to that of 5-FU based therapy alone. No significant financial relationships to disclose.
Phase 0 microdose trial to identify chemoresistance in lung and bladder cancer.
Authors: P. T. Henderson, M. He, S. Wang, R. de Vere White, P. Lara, D. R. Gandara, P. C. Mack, M. P. Dutia, K. Turteltaub, C. Pan
Journal: Journal of Clinical Oncology (2010)

TPS336 Background: DNA damage is the critical step in cytotoxicity of platinum (Pt) chemotherapy. We hypothesize Pt-DNA damage induced by nontoxic “microdoses” (1/100th of therapeutic dose) is predictive of chemoresistance. Accelerator mass spectrometry (AMS) is an ultrasensitive method for measuring radiocarbon. By measuring 14C bound to DNA, AMS can quantify carboplatin-induced DNA damage after treatment with one microdose of 14C-labeled carboplatin. In preclinical studies, the levels of microdose-induced Pt-DNA damage were linearly proportional to those caused by the therapeutic dose (R2=0.92, p<0.001); and low levels of Pt-induced DNA damage correlated with chemoresistance. Measurement of drug uptake/efflux, intracellular inactivation, DNA damage and repair allowed insights into some of the underlying resistance mechanisms. Methods: We have designed a phase 0 microdosing trial to determine if chemoresistance can be identified with AMS before patients receive toxic Pt-based chemotherapy. The eligibility criteria include patients with clinical diagnosis of lung or bladder cancer who are scheduled to have biopsy/resection and to receive Pt-based chemotherapy. Up to 80 patients will be recruited. One nontoxic microdose of 14C-carboplatin will be administered to each patient before biopsy/resection. Peripheral blood specimens will be analyzed for Pt-induced DNA damage in peripheral blood mononuclear cells (PBMC) and for pharmacokinetics (PK). Left-over biopsy tissue (only a few milligrams are needed) will be analyzed for Pt-induced DNA damage, repair and other relevant parameters. Molecular analysis of genes such as ERCC1 and RRM1 will be performed. Patients will subsequently receive therapeutic chemotherapy. Information on response and toxicity to chemotherapy will be collected for correlation to Pt-induced DNA damage and repair in PBMC and tumor specimens, PK, cell uptake and efflux, and molecular markers. The primary endpoint is whether low levels or rapid repair of microdose-induced Pt-DNA damage in PBMC and in tumor tissue predicts chemoresistance. The secondary endpoints are to determine the underlying mechanisms of chemoresistance, and to correlate molecular studies with patient outcomes. No significant financial relationships to disclose.