tbuckley/cabot-search huggingface dataset:
Patients' perception of palliative treatment objectives.
Authors: Ahmed Gamal Elsayed, Maria R. B. Tria Tirona
Journal: Journal of Clinical Oncology (2016)

43 Background: Palliative chemotherapy and radiation are often used in patients with advanced stage of cancer. To weigh the risks and the benefits of this treatment, patients need to be adequately informed about all treatment aspects including the side effects and potential benefits. Unfortunately, many patients are not well informed about the goal of their treatment, and many are under the impression that this treatment can be curative. Methods: This is a prospective survey based study that enrolled 46 patients with stage IV disease of all solid malignancies, who are being treated with palliative intent at the Edwards Comprehensive Cancer Center. Patients were given a questionnaire designed to test their level of knowledge of their current treatment goals, and to evaluate the efforts of health care team to educate patients. Results: 35% of patients had lung cancer, 34% had GI cancer, 14% had breast cancer and 13% had GU cancers. 37% of patients were under the impression that they are receiving curative treatment, 28% were not sure about the goals of the treatment, while only 35% of patients understood that the treatment was not curative. 91% of patients received written educational material. 93% of patients chose personal communication with the physician as their preferred method of getting educated about their disease. Conclusions: Our data shows that most of the patients at our local cancer center who are actively receiving treatment with palliative intent are satisfied with amount of time spent with physician and have received written educational material. Despite these efforts, a majority of patients are still not clear on the treatment goal. Most patients chose personal discussion as the preferred method of education. Hence, physicians on staff were informed about the results and further emphasis on treatment goal during counseling is being undertaken. [Table: see text]
Final results of a randomized phase II trial (NCT00637975) evaluating activity and toxicity of fixed-dose oxycodone and increasing dose of pregabalin versus increasing dose of oxycodone and fixed-dose pregabalin for the treatment of oncologic neuropathic pain (NEUROPAIN-01).
Authors: M. C. Garassino, A. Bianchi, A. Febbraro, I. Spagnoletti, V. Iorno, A. Bramati, C. Carbone, L. Isa, E. Breda, R. Magarotto, V. Torri, G. Farina
Journal: Journal of Clinical Oncology (2011)

9028 Background: The rate of neuropathic pain (NP) control with single agents is low. Oxycodone and pregabalin alone have proven activity in NP, but controlled data on their rational combination is still unavailable. Methods: A multicenter independent centrally randomized phase II trial was conducted to evaluate activity and tolerability of two different combination strategies: oxycodone at a fixed dose and an increasing dose of pregabalin (A) or a fixed dose of pregabalin and an increasing dose of oxycodone (B). Main eligibility criteria were: NRS ≥ 4 with neuropathic component, PS <3, no previous pregabalin treatment. All patients were evaluated at different times from t-7 to t14 with NRS, SDN, ESAS scales. Primary endpoint was effectiveness described as the reduction of at least 1/3 of pain (NRS) from trial entry; secondary endpoints were the time to analgesia, side effects, break through pain reduction, allodinia. The best arm was selected for a phase III trial according to a randomized selection design of Simon. With 74 patients, the study had a 90% probability of choosing the best strategy if the true difference was at least 15%. Results: From October 2008 75 patients (A: 38, B:37) were randomized in 7 institutions. Baseline characteristics: mean age 67 years, Male 51%, PS>1 11%, NRS pain >6: 41%. Pain control was achieved in 70% of patients (A: 76%, B: 64%). Treatment A was more effective even after control of baseline factors (gender, pain at baseline). The odds ratio of achieving pain reduction was 1.76 in favour of A (95% C.I.: 0.47-5.00). Side effects were less frequent in group A than in group B (constipation: 52.4% vs 63.6%; nausea: 28.6% vs 54.5%; drowsiness: 42.9% vs 59.1%; confusion: 19.0% vs 40.0%; itching: 14.3% vs 31.8%). Conclusions: Both strategies are very active in controlling NP in oncological patients without increasing toxicity when compared with opioids alone. Pain control and toxicity profile fare better in the “increasing pregabalin arm.”
Distinct Gene Expression Pattern of CD34+ Stem and Progenitor Cells Mobilized by Pegfilgrastim after Cytotoxic Therapy in Multiple Myeloma in Comparison to G-CSF.
Authors: Ingmar Bruns, Ulrich Steidl, Guido Kobbe, Roland Fenk, Slawomir Kliszewski, Sabrina Pechtel, Rainer Haas, Ralf Kronenwett
Journal: Blood (2005)
Molecular expression profiling and pathway analysis of formalin-fixed paraffin-embedded primary renal tumor specimens.
Authors: Luis M. Antón Aparicio, Vanessa Medina Villaamil, Guadalupe Aparicio Gallego, Isabel Santamarina Cainzos, Maria Quindós Varela, Manuel Valladares Ayerbes
Journal: Journal of Clinical Oncology (2013)

448 Background: Many studies have demonstrated genetic and environmental factors lead to renal cell carcinoma (RCC) occurring during a protracted period of tumorigenesis. It seemed suitable identify and characterize potential molecular markers which might provide rapid and effective possibilities for early detection of RCC. The purpose from this analysis was to derive predictive models which could predict more accurately than any one factor alone. Methods: We assessed using quantitative real-time PCR (qPCR) with SYBR Green the profile of 32 predictive markers involved in the cascade of events leading to the formation and progression of this disease to evaluate their involvement in oncogenesis. RNA of quality was obtained in 90% of samples (N=80, 52/80 clear RCC, 6/80 papillary RCC and 14/80 chromophobe RCC) to carry out the study of gene expression. GenEx software was used for qPCR data processing and analysis. The potential correlation between mRNA expression and the pathological features of the study subjects was assessed by Pearson Chi-squared. Linear rather than logistic regression models were used (SPSS statistics 21.0 software). Additionally, a knowledgebases of biological pathways, Reactome and Snow (Babelomics), were used to superimpose our quantitative expression data. Results: The best gene predictors related to different pathological variables (histological type, tumor size, Fuhrman grade, number of involved nodes, renal pelvis invasion, lymphatic vessels invasion, and rupture of the renal capsule): Hif1-α (p &lt; 0.001), Hif1-β (p = 0.035), DLL1 (p = 0 .012), DLL3 (p&lt; 0.001), c-Kit (p = 0.002), PDGFR-β (p =0.002), PDGFR-α (p = 0.026), Bax-β (p = 0.005), Survivin (p = 0.028), Notch1 (p = 0.006), Notch2 (p = 0.007), Notch3 (p = 0.016), Notch4 (p = 0.005), EGFR (p = 0.029), Glut3 (p = 0.026), Glut5 (p = 0.036), FH (p = 0.018), CA9 (p = 0.030), and VHL-1(p = 0.015). Conclusions: Our data suggested that altered expression of certain members involved in the main pathways which feed RCC and their downstream targets analyzed together could improve the diagnostic accuracy for renal cancer by combining determinations of mRNA markers.
The effect of 3 months of integrative cancer treatment on quality of life for patients with lung cancer.
Authors: E. D. Staren, D. Gupta, J. F. Grutsch, D. P. Braun
Journal: Journal of Clinical Oncology (2011)

7539 Background: Several studies have demonstrated the predictive significance of baseline health-related quality of life (QoL) on survival in lung cancer. We investigated whether changes in QoL could predict survival in lung cancer patients treated with an integrative model of care. Methods: We evaluated 525 lung cancer 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 56.8 years. 262 were males and 263 females. 303 patients were newly diagnosed at our hospital while 222 were previously treated elsewhere. Patient stage of disease at diagnosis was I, 51; II, 28; III, 161; IV, 277; and 8 indeterminate. Median overall survival was 13.9 months (95% CI: 11.9-15.9 months). Baseline QoL scales predictive of survival upon multivariate analysis were physical function (p=0.004) and diarrhea (p=0.04). 3-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 an 8% decreased risk of death (HR=0.92; 95% CI=0.86 to 0.99, p=0.03). Conclusions: In this exploratory study, physical function emerged as the strongest independent predictor of survival at baseline and after 3 months of treatment. Moreover, patients whose physical function improved after 3 months of treatment had a significantly increased probability of survival. These findings should be used in clinical practice to systematically address QoL-related problems of lung cancer patients throughout their treatment course.
Weekly docetaxel, estramustine phosphate and low-dose dexamethasone in Japanese men with hormone refractory prostate cancer
Authors: T. Fukagai, M. Morita, K. Fuji, H. Yoshida
Journal: Journal of Clinical Oncology (2005)

4789 Background: Recently, docetaxel have shown promising clinical results in patients with hormone-refractory prostate cancer (HRPC). However, their optimal treatment schedule has not been established. The current study determined the efficacy and toxicity of weekly docetaxel, estramustine phosphate (EMP), and low-dose dexamethasone in men with HRPC. Methods: Eligible patients had castrate testosterone levels and evidence of progressive HRPC after hormone therapy. Prior chemotherapy was allowed; including prior EMP. Patients with progressive HRPC received 25mg/m docetaxel weekly for 3 weeks, followed by a 1-week treatment rest. Patients were treated with EMP 560 mg/day and dexamethasone 1 mg PO daily. All patients did not receive commonly corticosteroid premedication. Results: Data on the first 22 patients are available. The median age was 71 (54–83), median PS 0 (0–1), and median PSA at study entry 205 ng/ml (16–1400). Bone metastases were present in 19/22 pts (86%); Patients received an average of 6.0 cycles of therapy. 16/22 (72.7%) had 50% PSA reduction; 11/22 (50%) had 75% PSA reduction, and 6 patients (27.2%) had normalization of PSA. Maximum response occurred after 3.5 cycles. Grade 3–4 toxicities were uncommon. Only 3 patients (11.7%) experienced Grade 3 anemia. No patients had leucopenia and neutropenic fever. Other toxicities were all < Grade 2. Conclusions: A combination of low dose of weekly docetaxel, daily estramustine plus low dose of oral dexamethasone has demonstrated promising efficacy and tolerability in HRPC patients with a history of extensive prior treatment. No significant financial relationships to disclose.
Implementation of adjuvant trastuzumab in Northern Ireland: Patient selection and treatment tolerability
Authors: H. A. McCarty, F. Green, J. I. Clarke, J. J. McAleer, A. J. Clayton
Journal: Journal of Clinical Oncology (2008)

11533 Background: Recent large multicentre trials have demonstrated a survival advantage with adjuvant trastuzumab but have also highlighted potential side effects especially cardiotoxicity. We have audited the first year of adjuvant trastuzumab in Northern Ireland, examining adherence to guidelines, toxicity and service impact. Methods: 117 patients were identified as starting adjuvant treatment in the first year. The regional guideline (based on the HERA protocol) advised trastuzumab for patients who were HER2 positive, (immunohistochemistry 3+, or 2+ and positive on fluorescent in-situ hybridisation), who had received adjuvant chemotherapy and had either node-positive tumours or node-negative tumours with a primary larger than 1 cm. Trastuzumab was given on a 21 day cycle for 18 doses and patients were reviewed at cycle 1,2,5,9,13 and 18 with echocardiogram at baseline and repeated at 3 month intervals. Adverse events and reasons for deferring or stopping treatment were documented. Results: From December 2005 to November 2006, 117 patients started treatment and all met the criteria set out in regional guidelines. At analysis in December 2007, 26 patients (22%) had not remained on schedule. Five patients had developed relapse and moved to a metastatic disease protocol. Thirteen patients (11%) suffered a decline in left ventricular ejection fraction (LVEF), with 4 patients continuing after a 4 week deferment and 9 (7%) stopping, one of whom subsequently died from cardiac failure. Two patients stopped because of arrhythmia, without decline in LVEF, two stopped because of severe allergic reaction and a further two had neurological symptoms that led to early discontinuation. One was deferred for one month due to dyspnoea and palpitations, but with no LVEF drop and one was deferred 3 weeks with a line infection. The remaining 90 patients have either completed treatment (87 patients) or are continuing on their planned schedule. Service impact was in very close accord with the pre-implementation estimates in the business case. Conclusions: The introduction of adjuvant trastuzumab in Northern Ireland has been shown to accord with agreed regional guidelines and was associated with toxicity comparable to that described in the registration clinical trials. No significant financial relationships to disclose.
Retrospective cohort study on the safety and efficacy of panitumumab for patients with metastatic colorectal cancer: The HGCSG1002 study—Analysis of after cetuximab refractory.
Authors: Yoshimitsu Kobayashi, Hiraku Fukushima, Takahide Sasaki, Satoshi Yuki, Hiroyuki Okuda, Takaya Kusumi, Ayako Doi, Yasushi Tsuji, Kazuteru Hatanaka, Minoru Uebayashi, Masahiko Koike, Takashi Kato, Michio Nakamura, Yasushi Sato, Tomoyuki Ohta, Mineo Kudo, Jun Konno, Kazuhiro Iwai, Yuh Sakata, Yoshito Komatsu
Journal: Journal of Clinical Oncology (2013)

541 Background: In the previous studies, panitumumab (Pmab) has been demonstrated the efficacy for patients with metastatic colorectal cancer (mCRC) in all treatment lines. It is still controversial about the efficacy of Pmab for patients that had progressed on prior cetuximab (Cmab), though there had been a few reports (from Metges et al. and Wadlow et al.) regarding the efficacy of Pmab after Cmab refractory or intolerance. To evaluate the efficacy and safety of Pmab in patients with cetuximab-refractory mCRC, in comparison with anti-EGFR antibody naïve patients (Cmab-naïve) and Cmab-refractory or intolerance patients (prior-Cmab). Methods: Two hundred patients with mCRC treated by Pmab contained chemotherapy were retrospectively registered from 20 centers in Japan (HGCSG 1002 study). Of these, the patients that were refractory to or intolerant for 5-FU/ irinotecan/ oxaliplatin, and were administered Pmab monotherapy were included in this analysis. Results: Of 93 patients (44 prior-Cmab and 49 Cmab-naïve) were evaluated. There were no significant differences in the baseline characteristics of the patients in each group. The incidence of Grade 3 or higher any skin toxicities were higher in the Cmab-naïve (26.5.%) than in the prior-Cmab (11.4%). The overall response rate (RR) was not significantly difference (prior-Cmab/ Cmab-naïve, 9.1%/ 10.2%), but the disease control rate (DCR) was slightly higher in Cmab-naïve group (38.6%/ 55.1%, p=0.15). Progression free survival (PFS) and overall survival (OS) were follows: prior-Cmab/ Cmab-naïve, 2.8m/ 3.1m, 6.8m / 9.5m. There was a significant difference between the two groups in OS curve (p=0.04). Conclusions: Pmab was safely administered to heavily pretreated mCRC patients in daily practice. Although there were no significant differences in RR, DCS and PFS between prior-Cmab and Cmab-naïve, but the median OS was longer for the Cmab-naïve group compared with the prior-Cmab group. Therapeutic efficacies of Pmab for prior-Cmab patients did not comparable to those for Cmab-naïve patients. We are now performing a phase II trial on the efficacy of Pmab for Cmab-refractory mCRC patients.
Tumor heterogeneity: Evidence from BRAF V600E mutation detection
Authors: A. J. Litterman, D. Pollens, M. A. Warycha, R. L. Shapiro, R. S. Berman, A. C. Pavlick, S. V. Blank, P. Lee, I. Osman, D. Polsky
Journal: Journal of Clinical Oncology (2008)

20022 Background: The mutation frequency of the BRAF oncogene has varied widely between tumor types, and especially among melanoma patient specimens. This is therapeutically relevant as patients whose tumors harbor BRAF mutations might be more likely to respond to targeted therapies such as MEK inhibitors. To better assess the BRAF mutation status in melanoma specimens, we developed a highly sensitive, fluorescent-based mutant-specific PCR assay (MS-PCR) (J Mol Diagn. 2007). Here we compare the sensitivity of MS-PCR to routine DNA sequencing in the detection of mutant BRAF in other solid tumors. Methods: 468 tumor specimens were analyzed (276 melanoma, 110 ovarian and 82 prostate). DNA was extracted from a single H&E stained slide for each tumor. BRAFV600E mutation was assessed by both routine sequencing of exon 15, and by MS-PCR. Differences in the relative sensitivity of sequencing versus MS-PCR were compared across the 3 solid tumor types. Results: BRAFV600E was detected more frequently using MS-PCR than sequencing. Of 276 melanomas 49 (18%) mutant tumors were detected by sequencing vs. 214 (78%) detected by MS-PCR. Among 110 ovarian cancers 5 (4.5%) mutations were detected by sequencing vs. 12 (11%) by MS-PCR; and among 82 prostate cancers 1 (1.2%) mutation was detected by sequencing vs. 15 (18%) by MS-PCR. In all cases mutations detected by sequencing were also detected by MS-PCR. Interestingly, the increase in the proportion of mutant cases as detected by MS-PCR was markedly greater in melanoma than in ovarian or prostate cancer. Conclusions: These data suggest that relatively small numbers of BRAF mutant cells, undetectable by routine sequencing, are present in the vast majority of primary and metastatic melanoma specimens. BRAF mutant cells are also present, albeit to a lesser degree, in prostate tumors. These findings provide evidence that these cancers, especially melanomas, are not clonal entities by the time they are detected and removed. These findings may impact the response of these patients to therapies designed to preferentially target BRAF-mutant tumors. No significant financial relationships to disclose.
Unrelated Donor (URD) or Partially Matched Related Donor (PMRD) Peripheral Stem Cell Transplant (PSCT) with CD34+ Selection and CD3+ Addback for Pediatric Patients with Leukemias.
Authors: Nancy Bunin, Stephan Grupp, Giuliana Pierson, Robert Iannone, Dmitri Monos, Richard Aplenc
Journal: Blood (2004)
Circulating CD62E Occurs in Soluble Form as Well as Bound to Endothelial Microparticles (EMP): Functional Differences in Platelet Aggregation in Thrombotic Thrombocytopenic Purpura (TTP).
Authors: Joaquin J. Jimenez, Wenche Jy, Lucia M. Mauro, Michael N. Markou, George W. Burke, Lawrence L. Horstman, Yeon S. Ahn
Journal: Blood (2004)
Evaluating the role of palliative care consultations in patients with advanced gastrointestinal cancers.
Authors: Julia Paris, Qingling Du, R. Sean Morrison
Journal: Journal of Clinical Oncology (2013)

6 Background: Though research shows that patients with terminal illnesses prefer to die at home, over 60% of patients with advanced cancer are hospitalized in the last month of life. Additionally, less than half of these patients receive any form of hospice care at the end of life, despite its demonstrated potential to improve quality of care. Inpatient palliative care (PC) consultations may serve as a bridge from hospitalization to receiving the kind of end-of-life care that patients prefer. Tumors of the gastrointestinal (GI) system include some of the most common and deadliest cancers and these patients can benefit from PC services, especially when the disease has reached an advanced stage. Our objective was to compare the effectiveness of inpatient PC consultations vs. usual care on post-discharge outcomes in patients with advanced GI cancers. Methods: 202 adults with advanced GI cancers admitted to 5 US hospitals were followed prospectively through hospitalization and 6 months post-discharge. 82 patients received a palliative care consult during hospitalization. Propensity scores were used to match treated to control patients, with exposure to a palliative care consult as the intervention. Outcome measures included: referral to hospice, subsequent ER visit, hospital readmission, and place of death. Results: Significantly more patients in the treatment group were referred to hospice upon hospital discharge (38% vs. 8%, p=0.000). 70 patients died in the 6-month follow-up period. Receiving a PC consult increased the odds of dying at home 3-fold (OR=2.9, p=0.046, 95% CI 1.02-8.44) and decreased the odds of dying in a hospital by 85% (OR=0.159, p=0.002, 95% CI 0.05-0.52). At 2 and 6 months post-discharge, significantly more patients in the treatment group were receiving hospice services at death (75% vs. 18%, p=0.001 and 82% vs. 24%, p=0.000 respectively). There were no significant differences between the two groups regarding hospital readmission and ER visits post-discharge. Conclusions: PC consults for patients with advanced GI cancers was associated with increased referral to hospice, decreased likelihood of dying in a hospital and increased likelihood of dying at home.