tbuckley/cabot-search huggingface dataset:
Cancer patients report high levels of health-related psychosocial distress
Authors: D. E. Theobald, K. Kroenke, S. Bhatia, R. Walling, H. Venkatesh, W. M. Dugan, W. Tu, J. Wu
Journal: Journal of Clinical Oncology (2008)

20533 Background: The Institute of Medicine’s October 2007 report highlighted the lack of attention by the health care system to the psychosocial needs of cancer patients. Well documented extremely high rates of symptom occurrence were also noted. In spite of the growing body of evidence documenting the effectiveness of interventions, these supportive care efforts are rarely included in the routine care of cancer patients. In busy cancer clinics there are many barriers to addressing psychosocial needs of patients. Data from an NIH sponsored trial treating pain and/or depression in cancer patients, documented the extreme multi-dimensional impairment experienced by study patients. Methods: Cancer patients enrolled in the NIH clinical trial Telecare Management of Pain and Depression in Cancer completed inventories including the SF-36 to assess their current health status, functional level and health-care related bed or cut down days. SF-36 data and cut down days from the first 250 patients enrolled in the trial are presented. The SF36 subscales are scored 0 to 100. Group characteristics are cancer patients with pain, depression or both. Results: See Table. Only 15.2% of patients had a mental health visit in the three months prior to the assessment. Four percent of patients had an integrative medicine visit. Conclusions: The amount of impairment across domains documents the importance of these two symptoms for cancer patients. Consistent with other reports, depression when co-morbid with pain adds significantly to lower performance and decreased quality of life. These data warrant further studies addressing reduction of barriers to treating cancer’s psychosocial impact. (n) Pain (57) Depression (82) Both (111) SF36 Vitality (0–100) 40.1 25.5 22.4 SF36 Pain (0–100) 41 48 30 SF36 Mental (0–100) 75 50 52 SF36 General (0–100) 36.3 33.2 20.6 Bed days or cut down days in past 4 wks 10.7 15.8 20.3 No significant financial relationships to disclose.
Patient characteristics and survival outcomes associated with early versus delayed molecular testing in metastatic NSCLC.
Authors: David A. Smith, Craig H. Reynolds, Debra A. Patt, Gregory Smith, Robyn K. Harrell, Ruslan Horblyuk, Debra Rembert, Jack Mardekian, Mark Yap, Leonard Philip James
Journal: Journal of Clinical Oncology (2014)

211 Background: Evidence-based guidelines recommend molecular testing for appropriate patients with advanced NSCLC at the time of diagnosis of adenocarcinoma. This study evaluated patient demographics, clinical characteristics and survival outcomes associated with early molecular testing (EMT) as compared to delayed molecular testing (DMT) in patients with metastatic NSCLC. Methods: Retrospective analysis of patients’ electronic medical records from The US Oncology Network Practices that utilize iKnowMed (iKM). Patients with a diagnosis of metastatic NSCLC between March 2011 and June 2012, &gt;2 visits and &gt;6 months of follow-up were eligible. EMT and DMT was defined as occurring &lt;45 days and &gt;45 days of diagnosis, respectively. Patient characteristics were compared using t-test and chi-square tests as appropriate. Logistic regression was used to predict the likelihood of higher performance status in the cohorts. Progression-free survival (PFS) and overall survival (OS) were compared using Cox proportional hazards models controlling for age, gender, stage at diagnosis, performance status and comorbidities. Results: A total of 350 patients were eligible and had a median follow-up of 17.3 months. Average age was 64, majority were female (55%) and diagnosed with adenocarcinoma (93%). There were no significant differences in demographic characteristics between EMT and DMT cohorts, however DMT patients were more likely to have ECOG 0 or 1 (OR=2.95, 95%CI=1.33-6.54, p=0.008). No difference in OS or PFS was observed between EMT and DMT patients, p&gt;0.05 (log-rank test). However, poor performance status was found to increase risk of progression/death in multivariate OS and PFS analysis, p&lt;0.02 and p&lt;0.01, respectively. Conclusions: While patients undergoing EMT were nearly three times more likely to exhibit poorer performance status as compared to DMT cohort, their survival outcomes were no different, reinforcing the importance of molecular testing in these patients who may otherwise be less likely to receive treatment. Although limited to small sample size, results of this analysis call for further investigation of potential benefits of EMT in metastatic NSCLC in real-world setting.
A Phase II Study of Sepantronium Bromide (YM155) Plus Rituximab in Previously Treated Subjects with Aggressive CD20-Positive B Cell Non-Hodgkin's Lymphoma Who Are Ineligible for or Have Previously Received an Autologous Stem Cell Transplant - Stage I Results.
Authors: Kyriakos P Papadopoulos, Scott E. Smith, Joyce Steinberg, Renelle Papa, Javier Lopez-Jimenez, Anne Keating, Antoine Thyss
Journal: Blood (2012)
Can changes in health-related quality-of-life scores predict survival in colorectal cancer?
Authors: D. P. Braun, D. Gupta, J. F. Grutsch, E. D. Staren
Journal: Journal of Clinical Oncology (2011)

e14061 Background: Several studies have demonstrated the predictive significance of baseline health-related quality of life (QoL) on survival in colorectal cancer (CRC). We investigated whether changes in QoL could predict survival in CRC patients treated with an integrative model of care. Methods: We evaluated 512 CRC patients treated at our institution between Jan 2001 and Dec 2009 who were available for a minimum follow-up of 3 months. QoL was evaluated at baseline and after 3 months of treatment using EORTC-QLQ-C30. The QLQ-C30 incorporates a global scale, 5 function scales and 8 symptom scales. Patient survival was defined as the time between date of first patient visit and date of death from any cause/date of last contact. Cox regression was performed to evaluate the prognostic significance of baseline, 3-month and changes in QoL scores after adjusting for age, gender and stage at diagnosis. Results: Mean age at diagnosis was 52.9 years. 266 were males and 246 females. 150 patients were newly diagnosed while 362 were previously treated. Stage at diagnosis was I, 37; II, 61; III, 177; IV, 222; and 15 indeterminate. Median overall survival was 18.7 months (95% CI: 16.2-21.2 months). Baseline QoL scales predictive of survival upon multivariate analysis were pain (p=0.009) and dyspnea (p=0.03). Three-month QoL scale predictive of survival upon multivariate analysis was physical function only (p=<0.001). Associations between changes in QoL and survival were observed only for physical function. Every 10-point increase (improvement) in physical function from baseline to 3 months was associated with a 16% decreased risk of death (HR=0.84; 95% CI=0.77 to 0.92, p=<0.001). The significance of physical function change on survival for stage III/IV patients analyzed as a separate cohort showed that improvement was associated with an 18% reduction in death (p<0.001). Conclusions: This exploratory study provides some preliminary evidence to indicate that CRC patients whose physical function improves within 3 months of treatment have a significantly increased probability of survival. These findings should be used in clinical practice to systematically address QoL-related problems of CRC patients throughout their treatment course.
Multiplatform molecular analysis of biomarkers in renal cell carcinoma.
Authors: Thai Huu Ho, Sherri Z. Millis, Nancy Doll, Zoran Gatalica, Sandeep K. Reddy, David Bryant, Richard Wayne Joseph, Nicholas J. Vogelzang
Journal: Journal of Clinical Oncology (2015)

501 Background: Predictive biomarkers of response to targeted therapy are lacking in renal cell carcinoma (RCC). We evaluated a cohort of RCC patients referred for molecular profiling to identify potentially actionable recurrent molecular aberrations. Methods: 166 consecutive renal cases referred to Caris Life Sciences over 2 yrs were evaluated with central pathology review. Cases were subtyped into clear cell (ccRCC), n=100, papillary (PRCC), n=20, sarcomatoid, n=10, translocation, n=6, medullary, n=4 or unclassified, n=26. 63% of cases were metastatic. Testing included a combination of sequencing (Sanger or next generation sequencing [NGS]), protein expression (immunohistochemistry [IHC]), and/or gene amplification (CISH or FISH). Results: ccRCC had a 52% loss of PTEN, while PRCC had a 21% loss (p value=0.02). 100% of ccRCC with sarcomatoid features (4) showed aberrant expression of PD-L1 and were infiltrated with PD-1+ tumor infiltrating lymphocytes; 100% of 10 non-ccRCC sarcomatoids also had aberrant expression of PD-L1. Loss of PBRM1 expression was observed in 60% of ccRCC. Loss of histone 3 lysine 36 trimethylation (H3K36me3), which is associated with SETD2 mutations, was observed in 30% of ccRCC. TOP2A was overexpressed in ccRCC at 30% and in non-ccRCC at 50%. 100% of ccRCC and PRCC overexpressed EGFR; a single unclassified renal cell carcinoma did not overexpress EGFR. 50% of cases had cMET overexpression, amplification, or mutation. HER2 was not amplified or overexpressed in any RCC; a single rare HER2 mutation (R816H) was found in a collecting duct carcinoma. VHL mutations were identified in 50% of ccRCC tumors. We observed lower rates of TP53 (14%), ATM (6%), and PIK3CA(4% ccRCC, 7% PRCC) mutations compared to other cancers. Conclusions: Multiplatform molecular profiling of renal cell carcinoma identifies potential predictive biomarkers in ccRCC. The documented activity of everolimus in ccRCC (RECORD-1 trial) may be attributable to PIK3CA pathway alterations. RCC with sarcomatoid features may respond to PD1/PD-L1 targeted immunotherapies. The impact of molecular profiling in ccRCC to predict responses to currently available targeted therapy has important implications for trial design and patient selection.
Oxaliplatin and cyclophosphamide as neoadjuvant chemotherapy (NACT) followed by surgery for patients with locally advanced cervical cancer (LACC). A preliminary report
Authors: F. Gutierrez-Delgado, A. Lopez-Mariscal, H. Maldonado-Hernandez, I. Luna-Benitez, F. Salazar-Macias, A. Aceves-Escarcega, J. Delgadillo-Hernandez
Journal: Journal of Clinical Oncology (2005)

5173
Survival of patients with papillary type II renal cell carcinoma treated with tyrosine-kinase inhibitors: A comparison with clear cell histologies.
Authors: Jozefina Casuscelli, Alexander Buchner, Bernadett Szabados, Christian G. Stief, Michael D. Staehler
Journal: Journal of Clinical Oncology (2014)

511 Background: The sequential use of Tyrosine-kinase inhibitors leads to a longer survival in patients with clear-cell renal cell carcinoma (ccRCC). However to-date there is little data available on the survival of patients with non-clear-cell RCC treated with TKI. We focused on papillary type II renal cell carcinoma (papIIRCC) and assessed the outcome of our patients with metastatic disease on systemic treatment. The outcome was compared with our patients with clear cell histology. Methods: Patients with histologic evidence of papillary type II renal cell carcinoma or clear cell renal cell carcinoma were treated with single agent sunitinib or sorafenib. Progression free survival (PFS) and overall survival (OS) were analyzed with Kaplan-Meier curves. Patients were identified from an institutional database and had to have a follow up of ≥2 years. Subgroup analyses were performed to determine the influence of primary tumor stage and cell differentiation on PFS and OS. Results: 18 patients with papIIRCC received sunitinib (16) or sorafenib (2) while 166 patients with ccRCC were treated with sunitinib (78%) or sorafenib (22%). Median PFS for papIIRCC is 8.9 mos, for ccRCC it is 11 mos. OS for papIIRCC is 15 mos, while ccRCC show an OS of 32 mos. The same tendency for longer PFS and OS is seen in ccRCC patients with low primary tumor grade and highly differentiated carcinomas, whereas large tumors and low differentiation determine a poor prognosis in both groups. Conclusions: Most papIIRCC patients have a poor outcome and shorter PFS than ccRCC on the same therapy. They benefit from the TKI therapy, but the survival is clearly reduced compared with ccRCC patients. This may be due to the poor prognosis of the papillary type II histology, but the assumption is that the administered therapy is not conceived for this type of RCC. Future studies are required to determine the optimal therapy for papillary type II renal cell cancer.
Tryptophan Catabolism Is Associated with Clinical Outcome of Patients with Malignant Lymphoma
Authors: Soranobu Ninomiya, Hisashi Tsurumi, Takeshi Hara, Masato Hoshi, Naoe Goto, Nobuhiro Kanemura, Senji Kasahara, Masahito Shimizu, Kuniaki Saito, Hisataka Moriwaki
Journal: Blood (2010)
Economic burden of advanced gastric cancer (AGC) in Taiwan.
Authors: Jihyung Hong, Yiling Tsai, Diego Novick, Frank Hsiao, Rebecca Cheng, Jen-Shi Chen
Journal: Journal of Clinical Oncology (2016)

33 Background: Gastric cancer is one of the leading causes of cancer deaths in both sexes worldwide, especially in East Asia. This study aimed to estimate the economic burden of advanced gastric cancer (AGC) in Taiwan. Methods: The costs of AGC in 2013 were estimated using resource use data from a chart review study (n = 122 with AGC) and national statistics. Annual per-patient costs were estimated from 82 patients who had complete resource use data. The costs were composed of direct medical costs (inpatient, outpatients, and chemotherapy-related costs), direct non-medical costs (healthcare travel and caregiver costs), morbidity costs, and mortality costs. Relevant unit costs were retrieved mainly from literature and national statistics, and applied to the resource use data. Broad definitions of morbidity and mortality costs were employed to value the productivity loss in patients with unpaid employment, economically inactive and unemployed as well as the life years after the age of retirement. Narrow definitions were also used in sensitivity analyses, using age- and/or sex-specific employment rates. Forgone future earnings/productivity loss were discounted at 3%. Annual per-patient costs were projected to estimate the total costs of AGC at the national level with an estimated number of patients with AGC (N = 2,611) in 2013 in Taiwan. Results: The mean age of the 82 patients was 59.3 (SD: 11.9) years, and 67.1% were male. Per-patient costs were US$26,431 for direct medical costs, US$4,669 for direct non-medical costs, US$5,758 for morbidity costs, and US$145,990 for mortality costs (per death). These per-patient costs were projected to incur total AGC costs of US$423 million in 2013 in Taiwan. Mortality costs accounted for 77.3% of the total costs, followed by direct medical costs (16.3%), morbidity costs (3.6%), and direct non-medical costs (2.9%). Conclusions: The total costs of AGC in Taiwan were estimated to be about US$423million in 2013. Such high costs, despite relatively low AGC incidence/prevalence rates in Taiwan, were mainly due to high mortality rates and high mortality costs (per death). Reducing mortality rates and providing effective treatments may help to reduce its burden on patients, caregivers and society as a whole.
Use of microRNA signature to distinguish early from late biochemical failure in prostate cancer.
Authors: Zsuzsanna Lichner, Annika Schaefer, Carol Saleh, Aurfan Nasser, Dina Boles, Sahar Al-Haddad, Peter Kupchak, Moyez Dharsee, Paulo S. Nuin, Kenneth R. Evans, Klaus Jung, Carsten Stephan, Neil Eric Fleshner, George M. Yousef
Journal: Journal of Clinical Oncology (2013)

194 Background: With the introduction of PSA testing, the problem of over-treatment emerged in prostate cancer. Only a small subset of prostate cancer patients will require more intensive adjuvant therapy. There is currently no biomarker that can predict disease aggressiveness at the time of surgery. Methods: We analyzed miRNA expression in 41 patients (the discovery set) which were dichotomized into; 'high risk'- experienced biochemical failure within 24 months after radical prostatectomy (n=26) and 'low risk' who did not have biochemical failure for at least 35 months (n=15). The validation set consisted of 72 cases. Total RNA was isolated from FFPE cores. cDNA was prepared for each patients and expression miRNA expression was screened by qRT-PCR –based panel. miRNAs were ranked by non-parametric tests. Linear regression models were built to predict biochemical failure. We used TargetScan for miRNA target prediction. Targets were validated by transient transfection of synthetic miRNA precursors followed by qRT-PCR quantification of the targets. Proliferation was assessed by measuring cell viability. Results: We compared the expression of 754 mature human miRNAs in patients with ‘high’ or ‘low’ risk for biochemical failure. We identified 24 miRNAs that were differentially expressed between the risk groups. We developed three logistic regression models, based on the expression of 2-3 miRNAs (PPV=100% and NPV ranges 86.4-100%). We confirmed the differential expression on the study set and on a larger, independent set of PCa pateints. We also validated one model on an independent set of patients. Further, we show that transfection of miR-152 and miR-331-3p, featured in the logistic regression models, altered proliferation of PCa3 and DU145 cells. Target prediction indicated Erbb3 and Erbb2 as potential direct targets and their mRNA expression significantly reduced when miR-152 and miR-331-3p were overexpressed. Conclusions: Altered miR-331-3p and miR-152 expression represent a potential tool for assessing the risk of early biochemical failure. These miRNAs may act through the Erbb family to induce an alternative way of AR activation.
Evaluation of MRI/TRUS fusion targeted biopsy versus 12-Core standard biopsy with pre-biopsy 1.5 Tesla multi-parametric MRI for diagnosis of prostate cancer in a community cancer center.
Authors: Mark Gregory Bandyk
Journal: Journal of Clinical Oncology (2016)

139 Background: Academic centers report the magnetic resonance imaging (MRI)/ transrectal ultrasound (TRUS) fusion biopsy increases detection of high−risk and high Gleason score (GS) prostate cancer (CaP) as compared to standard 12−core biopsy among men for suspected CaP. This prospective trial evaluated the utility and benefits of performing MRI/TRUS fusion biopsy in a community cancer center. Methods: Men suspected of CaP underwent prostate multi−parametric magnetic resonance imaging (mpMRI) using a 1.5 tesla GE 450W GEMS magnet with a 32 channel phased anterior array coil to identify suspicious regions for prostate cancer. Regions were graded with Prostate Imaging Reporting and Data System (PI−RADS V2.0) by a single radiologist (5 years of experience). Men underwent concurrent MRI/TRUS fusion targeted and 12−core standard biopsies using an image guided fusion system. This prospective trial evaluated 79 men for number of positive biopsies by GS, biopsy technique and cohort (biopsy naïve, prior negative biopsy and CaP under surveillance). McNemar test was used for statistical analysis. Results: Study group included 79 men (mean age 66 years) with mean PSA 8.25 ng/mL. Cancer detection rate (CDR) and GS for the entire cohort by biopsy technique were determined. Overall, target biopsy (TB) diagnosed more GS ≥ 7 versus the 12−core standard biopsy (SB) (26 vs 18) and less GS6 (13 vs 21) (p = 0.057). Exact agreement was demonstrated in 66% of cases between TB and SB for GS ≥ 7, GS6 and no cancer. SB found cancers in 11 men missed by the TB, but 73% of these cancers were low grade GS6. TB of higher PI−RADS category lesions found more and higher grade cancers: 73% PI−RAD 5, GS ≥ 7; 80% PI−RAD 4, GS &gt; 6; and 73% PI−RAD 3 were benign. In the biopsy naïve group (32 men), TB detected more GS ≥ 7 than SB (19 vs 13) (p = 0.11). Conclusions: Utilizing a mpMRI with a 1.5 tesla magnet and no endorectal coil, these encouraging preliminary results suggest MRI/TRUS fusion biopsy can be validated in the community for CaP detection. Results support a new paradigm in CaP detection utilizing pre−biopsy mpMRI and targeting higher PI−RADS lesions possibly eliminating SB.
How often is the planned dose intensity of XELOX and FOLFOX administered to colon cancer patients older than age 65 in clinical practice?
Authors: G. Romano, M. Colonna, A. Gnoni, S. A. Leo, C. Nuzzo, R. Forcignano, E. Veltri, V. Lorusso
Journal: Journal of Clinical Oncology (2011)

e14113 Background: The addition of oxaliplatin to FU/LV has been shown to significantly prolong DFS in patients (pts) with stage II/III colon cancer. Capecitabine can replace bolus FU/LV, with the added benefit of the convenient oral administration compared with more-cumbersome infusional therapy. XELOX regimen was compared to bolus FU/LV in 1,886 resected colorectal cancer pts, showing superior DFS, but higher rate of withdrawals for toxicity, especially in over 65 years pts (30% vs. 9%). Given this threefold rate of toxicity-related interruptions reported for XELOX, we performed a retrospective analysis to verify if the dose intensity of chemotherapy is administered in routine clinical practice in a consecutive non-selected series of over 65 years pts with resected colorectal cancer. Methods: All pts over 65 years, treated with adjuvant FOLFOX or XELOX, between 01/08-12/10, were retrospectively identified. We assessed the completion of the prescribed adjuvant chemotherapy and dose reduction due to toxicity. Dose intensity was calculated as follows: dose intensity = actual dose given/planned dose. Results: Thirty-one pts began Adj XELOX. and 44 Adj FOLFOX. Median age (XELOX vs. FOLFOX): 71 vs. 70; ECOG PS 0-1= 71% vs. 77%. Toxicity: (XELOX vs. FOLFOX): grade 3/4 neutropenia (19% vs.16%); grade 3/4 thrombocytopenia (26% vs.18%); grade 3/4 neuropathy: (26% vs.16%); diarrhoea 2/3 (23% vs. 14%), nausea/vomiting 2/3 (23% vs.18%); hand-foot syndrome (23% vs.0%). A toxicity-related withdrawals was registered in 32% vs 18%. The median oxaliplatin dose intensity of XELOX was 0.70 compared with 0.85 for FOLFOX. A delay of drug administration there was in 18% of XELOX cycles and in 15% of FOLFOX. Conclusions: Given the convenient oral administration of capecitabine respect to infusional therapy, XELOX is often used in adj setting, but data from large phase III trial indicate that a very large rate of elderly pts undergo to withdrawals for toxicity. Our retrospective analysis in a non selected series of pts over 65 years confirms that in clinical practice the oxaliplatin planned dose density is rarely administered, so a different schedule (i.e. CAPOX) could be explored in this setting of pts.