tbuckley/cabot-search huggingface dataset:
Assessing the quality of lung cancer care in community cancer center hospitals in Japan.
Authors: F. Nakamura, T. Higashi, H. Asamura, T. Sobue, M. Ohtani, E. Mekata, S. Higashide, T. Shinkai, T. Okamura
Journal: Journal of Clinical Oncology (2011)

e16570 Background: Although lung cancer is the leading cause of cancer death in Japan, systematic quality monitoring of care for this disease has not been established. In addition, Japanese patients have been concerned with the reports of the variations of cancer care from other countries. We aimed to develop quality indicators for lung cancer and to explore the current status of the quality of lung cancer care in Japan. Methods: We first developed process-of-care quality indicators based on the review of the literature and the formal consensus of a multidisciplinary panel of experts. We then applied these quality indicators to lung cancer patients who were diagnosed at 16 community cancer center hospitals in 2008. Trained cancer registrars abstracted patients’ medical records to obtain the necessary information. Quality scores were calculated for each quality indicator as the percentage of care procedures provided among the recommended procedures. Results: The expert panel selected 35 quality indicators, which covered 5 domains: diagnostic evaluation, surgery, specific treatment for non-small cell cancer or small cell cancer, and radiation therapy. The medical records of 1184 patients were abstracted. Adherence to the quality indicators was higher than 85% for 19 of the 35 indicators (e.g., proportions of lobectomy for the curative surgery, 95%) and less than 50% for 5 of the 35 indicators (e.g., documentation of acute and chronic adverse event of radiotherapy, 28%). Significant variation was observed for some indicators (e.g., chemoradiotherapy for Stage III non-small cell cancer patients who were not eligible for surgery with good performance status: overall, 49%; inter-quartile range, 17- 67%). Conclusions: We developed quality indicators covering various aspects of lung cancer care. Using these indicators, we found room for improvement in the quality of lung cancer care among community cancer center hospitals. The quality of care should be continuously monitored, and effective interventions for improvement in future research should be explored.
Real-world experience of therapeutic sequencing and time to first anticancer intervention (ACI) following sipuleucel-T (sip-T): Initial data from the PROCEED registry.
Authors: A. Oliver Sartor, Matthew R. Cooperberg, Andrew J. Armstrong, Nicholas J. Vogelzang, Jeffrey L. Vacirca, Mark C. Scholz, Shaker R. Dakhil, Luke T. Nordquist, Elisabeth I. Heath, Nancy N. Chang, Jennifer Susan LIll, Celestia S. Higano
Journal: Journal of Clinical Oncology (2016)

194 Background: Sip-T is an autologous immunotherapy approved for asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC).Many therapeutic agents have been approved in a short time frame, and their optimal sequencing in mCRPC is under investigation. The sequencing of agents post–sip-T treatment on PROCEED (NCT01306890) and factors associated with a shorter time to first ACI (tACI) are described. Methods: The number of unique and most common sequences and sequence trends were analyzed. Post–sip-T ACIs evaluated were abiraterone (abi), enzalutamide (enz), docetaxel (D), and cabazitaxel (cbz), excluding radium-223 due to its late approval relative to PROCEED initiation. The tACI and factors associated with shorter tACI were assessed. Results: 1902 pts received ≥1 sip-T infusion, and an estimated 37.0% and 21.2%had not received an ACI at 1 and 2 y, respectively, post–sip-T. 1331 (70%) pts received abi, enz, D, or cbz after sip-T. 47 therapy sequences were recorded post–sip-T, with the most used therapies in order of prevalence: abi alone, enz alone, D alone, abi → enz, abi → D, D → enz, and D → abi. The most common post–sip-T sequences beginning with abi, enz, or D are below (Table). Only 25 pts received cbz as the first ACI post–sip-T. Pts who received abi prior to sip-T had a shorter median tACI (4.6 mos) compared with all pts (8.3 mos) or pts with D prior to sip-T (7.3 mos). Higher baseline alkaline phosphatase, lower hemoglobin, and prior radical prostatectomy were associated with shorter tACI. Conclusions: In the evolving mCRPC space, 47 unique ACI sequences were recorded post-sip-T. The most common sequences post–sip-T were abi, enz, and D as single agents. Prior abi was associated with a shorter tACI post–sip-T, which warrants longer follow-up. While many pts received subsequent therapy, ~20% had not received an ACI at 2 y post–sip-T. Clinical trial information: NCT01306890. [Table: see text]
Survival by lymph node ratio (IG) in colorectal cancer patients in Oncologos del Occidente from Caldas: Colombia 1997–2012.
Authors: Carlos Raul Villegas Mejia, Gustavo Rojas, Jose Arnoby Chacon Cardona, Tomas Sanchez Villegas
Journal: Journal of Clinical Oncology (2014)

641 Background: Colorectal cancer is the third cause of cancer death in the western world and in Colombia the fifth leading cause. The Caldas State being one of the five with the highest mortality rates. There are many prognostic factors reported in the literature but the clinical stage is the most important mainly determined by the number of involved nodes but exist other factors in their evaluation. It has been proposed Lymph Node Ratio (IG) ( Nro. (+) nodes / Nro. nodes removed x 100) for the analysis of nodal stage but there is controversy about its usefulness in various contexts. Methods: We made a descriptive study of patients with colorectal cancer attending at ONCOLOGOS DEL OCCIDENTE from Caldas - Colombia, who applied the Lymph node ratio (IG) and related to demographic, clinical and others prognostic factors in order to see its relation with overall survival at 5, 10 and 15 years. Results: 333 patients with 66% colon cancer, under 40 years 12% , women 50%, 68% without ACE data prior treatment, 41% on right colon, 49% medium rectum, 44% localized stage, 2% pathological complete response and 3% no classification data. Obstruction (29%), ulceration (25%) and 30% without prognostic factors, 33% had 12 or more lymph nodes removed, 50% N0 (TNM), 21% N2; the resected nodes, positive nodes, relapse, prior ACE and TNM as significant variables, 27% relapsed mainly liver, 50% had nodal index group 1 (0%); group 2 (1-20%) 15%, 14% group 3 (21-40%) and 21% group 4 (&gt; 40%) . Mean follow-up: 53.7 months (SD: 43.8, Range:0 -218 months) and overall survival 64% at 5 years and 54% at 10 and 15 years. Conclusions: With an inadequate number of lymph nodes removed (33%) and multiple prognostic factors, Lymph node ratio is proposed like an independent prognostic factor in patients with colorectal cancer associated with overall survival at 5, 10 and 15 years, on which a therapeutic decision can be based.
The Impact of Relative Dose Intensity of Rituximab-CHOP on Survival in Diffuse Large B-Cell Lymphoma Patients
Authors: Yoshiki Terada, Hirohisa Nakamae, Ran Moriguchi, Hiroshi Kanashima, Erina Sakamoto, Dai Momose, Mizuki Aimoto, Shuichirou Okamoto, Eri Wada, Hideo Koh, Takahiko Nakane, Yasunobu Takeoka, Ki- Ryang Koh, Takahisa Yamane, Yoshitaka Nakao, Kensuke Ohta, Atsuko Mugitani, Hirofumi Teshima, Masayuki Hino
Journal: Blood (2008)
Interim Analysis of a Multicenter, Prospective Study for Pediatric Chronic Myeloid Leukemia in Chronic Phase: The JPLSG CML-08 Study
Authors: Hiroyuki Shimada, Hidemitsu Kurosawa, Akihiro Watanabe, Masaki Ito, Chikako Tono, Haruko Shima, Yuki Yuza, Hideki Muramatsu, Noriko Hotta, Masahiko Okada, Akihiko Tanizawa
Journal: Blood (2015)
First use of an oral Hsp90 inhibitor in patients (Pts) with solid tumors: Alvespimycin (A) administered QOD or Q
Authors: K. T. Flaherty, L. Gore, A. N. Avadhani, J. L. Spratlin, K. Harlacker, Z. Zhong, R. G. Johnson, A. L. Hannah, P. J. O’Dwyer, S. G. Eckhardt
Journal: Journal of Clinical Oncology (2008)

2502 Background: A, a water soluble Hsp90 inhibitor, is currently under clinical development using intravenous and oral (PO) dosing. Objectives of this study were to determine the DLT, MTD, recommended phase II dose (RP2D), PK and PD of A using 2 schedules of administration in pts with advanced solid tumors. Methods: A is orally administered QOD or QD for 4 out of 6 weeks. An initial IV dose was given to calculate absolute bioavailability (F); PK is evaluated on Days 1 and 21 of oral dosing. PBMCs were collected to investigate changes in intracellular signaling proteins by immunoblot. Results: 47 pts were enrolled: 31 pts (QOD at 5, 10, 20, 30, 40, and 50 mg) and 15 pts (QD at 10, 20, and 30 mg). Demographics: 20/27 male/female, median age 58 (19–89), ECOG 0/1 in 24/23 pts. Common drug-related toxicities (n=47): fatigue 43%, nausea 28%, anorexia 21%, diarrhea 19%, peripheral edema 19%, and arthralgia 15%. Potential drug-related grade 3–4 toxicities (2 each): anemia, thrombocytopenia, fatigue, peripheral edema, and dehydration. DLTs at 50 mg QOD (n=3 out of 5 pts) and 30 mg QD (n=2 out of 4 pts): thrombocytopenia (n=2), hemorrhagic colitis, nephrotic syndrome, and dehydration. No DLTs were observed at the RP2D of each schedule (40mg QOD in 5 pts and 20mg QD in 4 pts evaluable for toxicity); these doses were well tolerated. Following PO, median Tmax was reached at ∼2 hr; F ∼52% (CV 41%) without dose dependency. Mean drug clearance was 17 L/hr (IV) and 44 L/hr (CL/F, PO); t½ 21 hr (IV) and 19 hr (PO). Drug exposure was slightly greater than proportional to an increase in dose for both IV and PO administration. Drug accumulation ratio on Day 21 was 1.5 (QOD) and 2 (QD). At the RP2D on each schedule, ∼2-fold Hsp70 induction was seen, with increased PD activity comparing Day 21 to Day 1 (this degree of PD activity is similar to that observed at the IV RP2D of 80 mg/m2 weekly). Clinical evidence of SD ≥12 weeks (w) was observed in 11 pts, including melanoma (60 w), carcinoid (42+ w), ovarian (38 w), hemangioendothelioma (30 w), and renal cell carcinoma (23 w). Conclusions: A RP2D was defined on each of two schedules: 40mg QOD and 20mg QD for 4 out of every 6 weeks. Bioavailability equaled 52%, with modest drug accumulation upon repeated dosing. The safety profile was very manageable; early signs of activity were observed. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Kosan Biosciences Kosan Biosciences Kosan Biosciences Kosan Biosciences
A novel, cremophor-free, polymeric nanoparticle paclitaxel (do/ndr/02) multicenter study in advanced/ metastatic breast cancer
Authors: A. A. Ranade, P. P. Bapsy, S. Nag, D. Raghunadharao, V. Raina, S. H. Advani, S. K. Mishra, S. Tyagi, A. C. Burman, P. M. Parikh
Journal: Journal of Clinical Oncology (2008)

1115 Background: Nanoparticle paclitaxel (NP), DO/NDR/02 is a cremophor-free polymer based formulation of paclitaxel, developed to alleviate the toxicities associated with cremophor component of conventional paclitaxel (CP). Methods: This phase II (N = 194), open label, randomized, three-arm study was conducted in anthracycline failed advanced recurrent/metastatic breast cancer patients. Estrogen/progesterone receptor positive patients were excluded. Sixty-four patients received CP as a 3-hour intravenous (i.v.) infusion at 175 mg/m2 along with standard premedication, 64 patients received a one-hour i.v. infusion of NP at 300 mg/m2 (NP-300) and 66 patients received 220 mg/m2 (NP-220), without premedication. Treatment was administered at three-week intervals for 6 cycles. Efficacy was assessed using Response Evaluation Criteria in Solid Tumours (RECIST) and adverse events were graded as per National Cancer Institute Common Terminology Criteria (NCICTC) version 3. Results: Demographic data revealed that the disease burden with respect to the number of metastatic sites, presence of liver metastasis and raised tumour marker (CA 15.3) levels was higher in the NP-300 arm as compared to NP-220 and CP-175 arms. Other demographic characteristics were comparable in the three arms. Efficacy analysis revealed 40% objective response rate (ORR) each with NP-300 and NP-220, while CP had an ORR of 32.3%. Stable disease was 32.7% and 29.0% for NP-300 and NP-220, respectively; and 27.3% for CP. Progressive disease for NP-300 was 27.3% and NP-220 was 32.7% compared to 38.7% with CP. Hypersensitivity was not observed with NP inspite of absence of premedication. Incidence of neutropenia was 56.3% and 39.4% with NP-300 and NP-220, respectively; and 50% with CP. Grade 4 neutropenia was 21.8%, 12.1% and 14% with NP-300, NP-220 and CP, respectively. There was no grade 4 neuropathy. Grade 3 sensory neuropathy was observed in 12.5% and 1.5% patients with NP-300 and NP-220, respectively and 6.3% with CP. Conclusions: Nanoparticle paclitaxel (DO/NDR/02) can be safely administered as one-hour i.v. infusion without any premedication. Although, this study was not designed as powered study, but the novel formulation has shown improved efficacy and safety. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Dabur Research Foundation Dabur Research Foundation Dabur Research Foundation
The impact of 21-gene recurrence score (RS) scores on treatment decisions: Retrospective evaluation in Turkish early-stage breast cancer (BC) patients.
Authors: G. Basaran, S. Saglam, S. Tansan, M. Demirel, E. Gokmen, S. Aktan, E. Goker, K. K. Kaban, P. Saip, G. Demir, S. E. Bavbek, N. M. Mandel, C. Tecimer, N. S. Turhal, M. Garipoglu
Journal: Journal of Clinical Oncology (2011)

e11042 Background: The RS assay has been shown to quantify the likelihood of distant recurrence and also predict the magnitude of benefit from chemotherapy (CT) in women with estrogen receptor positive, node negative with BC. We planned to examine our experience about the effect of RS on treatment decisions in Turkish early BC patients (pts). Methods: We retrospectively reviewed the medical records of the pts whose tumor (tm) tissue has been sent for RS analysis from 8 different oncology centers. We noted the patient, tm, treatment-related characteristics and demographic information. Oncologists are requested to provide their treatment decision before and after the RS assay. Results: We identified 89 cases with a median age of 48 (27-73). Fifty-one pts were premenopausal. Seventy-five pts had breast conserving surgery, 86 pts had SLNB. Sixteen pts had T2 disease, 7 pts had N1 disease, 9 pts had nodal micrometastases. The percentage of grade 1/2/3 tms were 29/57/14% respectively. All tms were ER positive and 5 tms were PR negative by IHC. The number of pts with high, intermediate and low RS was 17, 19 and 53 respectively. So far, all pts are alive without relapse; 23 pts received CT, all pts received adjuvant endocrine therapy (ET) and 77 pts received adjuvant radiotherapy. There has been a change from recommending CT to ET after getting RS in 14 cases (9 pts with low RS and 5 pts with intermediate RS). Conclusions: Overall, RS led to a 28% change on the initial treatment plan, so that 14 patients (%15) were saved from CT. Long-term follow up is necessary to analyze the impact of RS on clinical outcome of our patients. High RS Intermediate RS Low RS N 17 19 53 <50 yrs 11 12 21 Premenopausal 10 11 21 T1/T2 tumors 12/5 17/2 25/5 Nodal status 2 micromets, 2 node positive, 13 node negative 2 node positive, 17 node negative 7 mikromet, 3 node positive, 1 isolated tm cells, 42 node negative Grade 1/2/3 0/12/5 6/10/2 20/28/4 (unknown :1) Her-2 (IHC): 0/1+/2+/3+ 12/1/1/2 18/0/1/0 47/3/3/0 Adj. chemotherapy 14 5 4 Change in treatment decision based on RS From HT to CT: 6 pts No change: 11 pts From CT to HT: 5 pts From HT to CT: 2 pts No change: 12 pts From CT to HT: 9 pts From HT to CT: 3 pts No change: 41 pts
Fruit and vegetable consumption and risk of COPD: a prospective cohort study of men
Authors: Joanna Kaluza, Susanna C Larsson, Nicola Orsini, Anders Linden, Alicja Wolk
Journal: Thorax (2017)

Antioxidants present in fruits and vegetables may protect the lung from oxidative damage and prevent COPD.To determine the association between fruit and vegetable consumption and risk of COPD by smoking status in men.The population-based prospective Cohort of Swedish Men included 44 335 men, aged 45-79 years, with no history of COPD at baseline. Fruit and vegetable consumption was assessed with a self-administered questionnaire.During a mean follow-up of 13.2 years, 1918 incident cases of COPD were ascertained. A strong inverse association between total fruit and vegetable consumption and COPD was observed in smokers but not in never-smokers (p-interaction=0.02). The age-standardised incidence rate per 100 000 person-years in the lowest quintile (<2 servings/day) of total fruit and vegetable consumption was 1166 in current smokers and 506 in ex-smokers; among those in the highest quintile (≥5.3 servings/day), 546 and 255 per 100 000 person-years, respectively. The multivariable HR of COPD comparing extreme quintiles of total fruit and vegetable consumption was 0.60 (95% CI 0.47 to 0.76, p-trend <0.0001) in current smokers and 0.66 (95% CI 0.51 to 0.85, p-trend=0.001) in ex-smokers. Each one serving per day increment in total fruit and vegetable consumption decreased risk of COPD significantly by 8% (95% CI 4% to 11%) in current smokers and by 4% (95% CI 0% to 7%) in ex-smokers.These results indicate that high consumption of fruits and vegetables is associated with reduced COPD incidence in both current and ex-smokers but not in never-smokers.
Pancreatoduodenectomy for periampullary cancer and biliary obstruction: impact of a pathway to avoid preoperative biliary drainage
Authors: Pooja Prasad, Yvonne Steele, Francesca Marcon, Thomas Faulkner, Bobby Dasari, Ravi Marudanayagam, Robert P Sutcliffe, Paolo Muiesan, Darius F Mirza, John R Isaac, Keith J Roberts
Journal: The Lancet (2017)
Conditional survival (CS) of metastatic renal cell carcinoma (mRCC) patients treated with high dose interleukin-2 (HD IL-2).
Authors: Kinjal Parikh, David D. Stenehjem, Arun Sendilnathan, Hilda Crispin, Joan Van Atta, Julia Anne Batten, Daniel Sageser, Kenneth F. Grossmann, Junfeng Wang, Wolfram E. Samlowski, Srinivas Kiran Tantravahi, Neeraj Agarwal
Journal: Journal of Clinical Oncology (2014)

460 Background: CS is a clinically useful prediction measure that adjusts prognosis of patients on the basis of survival since treatment initiation or therapy duration. CS was recently reported in mRCC patients treated with VEGF targeted therapy in patients stratified by Heng’s criteria. CS has not been reported in mRCC in the context of treatment with HD IL-2. Methods: Patients with histologically confirmed clear cell mRCC treated with HD IL-2 at the University of Utah Huntsman Cancer Institute from 2000 to 2012 were evaluated. Performance status and prognostic risk groups were included. Two-year CS was defined as the probability of surviving an additional 2 years from initiation of HD IL-2 to 18 months after the start of HD IL-2 at 3-month intervals estimated by Kaplan-Meier methodology. Results: A total of 85 patients were included with a median age of 56 years (range 32-76 years) and 79% (n = 67) were male. The median overall survival from HD IL-2 administration was 817 days. Stratification by Heng’s criteria at therapyinitiation resulted in survival estimates for the favorable (n = 13; 15%), intermediate (n = 56; 66%) and poor (n = 16; 19%) prognostic groups of 1616 (p = 0.1993 vs intermediate), 817 (p = 0.0041 vs poor), and 365 (p &lt; 0.0001 vs favorable) days, respectively. Two-year overall CS increased from 56.2% at therapy initiation to 89.5% at 18 months (Table). Two-year CS stratified by Heng’s favorable, intermediate, and poor prognostic risk groups is presented in the Table. Conclusions: CS is a relevant prediction measure in the context of mRCC treated with HD IL-2.A longer survival interval from HD IL-2 treatment was associated with an increased survival probability. CS in this cohort was especially relevant in adjusting prognosis for patients with Heng’s intermediate risk. [Table: see text]
Distant recurrence risk with prospective use of the 21-gene assay at a single institution.
Authors: John Mullinax, Danielle Carr, Nora Vera, Weihong Sun, M. Catherine Lee, Susan Hoover, William J. Fulp, Geza Acs, Christine Laronga
Journal: Journal of Clinical Oncology (2015)

131 Background: Distant recurrence (DR) is the cause of most breast cancer deaths. The 21-gene assay (ODX) Recurrence Score (RS) result predicts both 5 and 10-yr DR risk and can guide adjuvant chemotherapy (CT) recommendations to mitigate this risk. This study analyzed the use of the RS result to guide adjuvant treatment decisions in a large single-institution, prospective cohort of patients (pts). Methods: This is an IRB-approved review of a prospective database of pts receiving ODX on an initial primary breast cancer. Data collected included demographics, primary operation, margin status, receptor status, RS, adjuvant treatment, recurrence, and survival. Pts were stratified as low risk (RS &lt; 18), intermediate risk, or high risk (RS &gt; 30). The primary analysis computed Kaplan-Meier estimates for rate of DR at 5 yrs when pts were stratified by RS. Results: From 2003 to 2009, a RS result was obtained on 606 pts. Median follow up was 2.9 yrs (0.1-9.7) and median age was 58 yrs (27-84). Median RS result was 16 (0-63); 344(57%) pts were low, 212(35%) intermediate, 50(8%) high. Endocrine therapy was given to 92.4%, 94.3%, and 87.5% low, intermediate, and high risk pts, respectively. Adjuvant CT was given to 8.6%, 47.6%, and 70.8% low, intermediate, and high risk pts, respectively. There were 8 DR events with 1.8% 5-yr estimated risk of DR. The 5-yr estimated risk of DR was 0.7% for low risk (344) pts, 3.4% for intermediate risk (211) pts, and 2.6% for high risk (50) pts. Among node negative [N(-)] pts (502), the 5-yr estimated risk of DR was 0.8% for low risk (287) pts, 3.7% for intermediate risk (174) pts, and 3.3% for high risk (41) pts. Among node positive [(N+)] pts (54) there was only 1 DR, which was in a high risk pt. Of pts with unknown nodal status (50), there were no DRs. Conclusions: The RS result is predictive of DR at 5 yrs as shown in historical datasets (Table). The use of ODX to guide adjuvant treatment recommendations in our contemporary, prospective cohort resulted in a much lower 5-year DR rate and thus supports its use to guide adjuvant treatment decisions. [Table: see text]