tbuckley/cabot-search huggingface dataset:
Effect of body mass index on outcomes in patients with Dukes B and C colon cancer: An analysis of NSABP randomized trials
Authors: J. J. Dignam, B. Polite, G. Yothers, P. Raich, L. Colangelo, M. O’Connell, N. Wolmark
Journal: Journal of Clinical Oncology (2005)

3533 Background: While several studies have established a link between obesity and colon cancer risk, few have examined the impact of obesity on outcomes after colon cancer diagnosis. We examined obesity in relation to outcomes among cooperative group clinical trial participants. Methods: The study cohort consisted of 4310 patients (pts) with Dukes B and C colon cancer accrued from 1989–1994 to National Surgical Adjuvant Breast and Bowel Project (NSABP) randomized trials (C-04 and C-05). We evaluated the influence of body mass index (BMI: weight (kg)/height (m)2) on disease-free survival (DFS), events comprising DFS (recurrence, 2nd primary cancer, and deaths without recurrence or 2nd primary), overall survival, and deaths following recurrence/2nd primary, using statistical models to control for other prognostic factors. Results: Mean age at diagnosis was 57; male/female, 2355(54.6%)/1955(45.3%); race, 3735 (86.6%) white, 344 (8.0%) AA; Stage, 2472 Dukes C (57.4%), 1816 Dukes B (42.1%). BMI category frequencies: 4.6% underweight (BMI < 19), 40.7% normal weight (BMI 19–24.9), 35.8% overweight (BMI 25–29.9), 13.4% obese (BMI 30–34.9), 5.6% very obese (VO) (BMI≥35). At median follow-up of 9.9 years, there were 2080 events and 1700 deaths. Compared to normal weight pts, DFS hazard, adjusted for age, sex, race, and no. of positive nodes was similar for obese pts (hazard ratio (HR)=1.05; 95% confidence interval (CI): 0.92–1.20) and greater for VO pts (HR=1.25; 95%CI: 1.04–1.51). Underweight pts had greater DFS hazard (HR=1.45; 95%CI: 1.19–1.77). Recurrence hazard was increased for VO pts (HR=1.28; 95%CI: 1.01–1.61). Mortality was greater for underweight (HR=1.53; 95%CI: 1.23–1.90), obese (HR=1.09 95%CI: 0.94–1.27) and VO (HR=1.24 95%CI: 1.01–1.53) pts. Both cancer deaths and non-cancer deaths were greater in underweight and VO pts. Influence of BMI on outcomes was similar for males and females. Conclusions: Underweight and very obese colon cancer pts have worse overall survival than normal weight pts, due to both greater recurrence risk and risk of non-cancer deaths. Additional analyses will examine the relationship of BMI to drug dosing, regimen completion, and adverse events. No significant financial relationships to disclose.
Effect of online education on use of molecular markers to guide treatment selection for advanced gastric or gastroesophageal (GE) cancer.
Authors: Kevin Obholz, Eric Van Cutsem, Michael F. Press, Andrew Bowser, Jim A. Mortimer, June Wasserstrom, Axel Grothey
Journal: Journal of Clinical Oncology (2012)

111 Background: Trastuzumab in combination with chemotherapy is recommended for advanced gastric cancer positive for human epidermal growth factor receptor 2 (HER2) overexpression. Despite this recommendation, an informal pilot survey suggested that many oncologists do not include HER2 testing as part of routine practice to identify patients most likely to benefit from adding trastuzumab to chemotherapy. Methods: An interactive online educational activity was developed to provide expert guidance on HER2 testing and use of HER2-targeted agents in gastric or GE cancer. Pre- and post-education surveys were administered as part of the activity to measure changes in participant competence. In addition, 3 months after completing the educational activity, participants were sent another follow-up survey by email to assess changes in practice. Results: To date, pre-and post-education surveys have been obtained for 122 oncologists and 3-month follow-up surveys obtained from 14 oncologists. In the pre-education survey, only 46% said they were testing all of their patients with advanced gastric or GE cancer for HER2 overexpression. However, immediately after participating in the educational intervention, this proportion increased to 93%. Importantly, a follow-up survey indicated that HER2 testing of all patients with advanced gastric or GE cancer was now part of routine practice for 79% of those surveyed. A final analysis of pre- and post-education and 3-month follow-up surveys will be presented. Conclusions: Expert guidance on HER2 testing and use of HER2-targeted agents in gastric or GE cancer provided through an interactive online educational intervention substantially improved oncologist competence and practice patterns.
Mesenchymal stromal cells as vehicles of tetravalent bispecific Tandab (CD3/CD19) for the treatment of B cell lymphoma combined with IDO pathway inhibitor d-1-methyl-tryptophan
Authors: Xiaolong Zhang, Yuanyuan Yang, Leisheng Zhang, Yang Lu, Qing Zhang, Dongmei Fan, Yizhi Zhang, Yanjun Zhang, Zhou Ye, Dongsheng Xiong
Journal: Journal of Hematology & Oncology (2017)

Although blinatumomab, a bispecific T cell engaging antibody, exhibits high clinical response rates in patients with relapsed or refractory B-precursor acute lymphoblastic leukemia (B-ALL) and B cell non-Hodgkin's lymphoma (B-NHL), it still has some limitations because of its short half-life. Mesenchymal stromal cells (MSCs) represent an attractive approach for delivery of therapeutic agents to cancer sites owing to their tropism towards tumors, but their immunosuppression capabilities, especially induced by indoleamine 2,3-dioxygenase (IDO), should also be taken into consideration. Human umbilical cord-derived MSCs (UC-MSCs) were genetically modified to secrete Tandab (CD3/CD19), a tetravalent bispecific tandem diabody with two binding sites for CD3 and two for CD19. The tropism of MSCs towards Raji cells in vitro was determined by migration assays, and the homing property of MSCs in vivo was analyzed with firefly luciferase-labeled MSCs (MSC-Luc) by bioluminescent imaging (BLI). The cytotoxicity of T cells induced by MSC-secreting Tandab (CD3/CD19) was detected in vitro and in vivo in combination with d-1-methyl-tryptophan (D-1MT), an IDO pathway inhibitor. The purified Tandab (CD3/CD19) was functional with high-binding capability both for CD3-positive cells and CD19-positive cells and was able to induce specific lysis of CD19-positive cell lines (Raji, Daudi, and BJAB) in the presence of T cells. Additionally, results from co-culture killing experiments demonstrated that Tandab (CD3/CD19) secreted from MSCs was also effective. Then, we confirmed that D-1MT could enhance the cytotoxicity of T cells triggered by MSC-Tandab through reversing T cell anergy with down-regulation of CD98 and Jumonji and restoring the proliferation capacity of T cells. Furthermore, MSC-Luc could selectively migrate to tumor site in a BALB/c nude mouse model with Raji cells. And mice injected with MSC-Tandab in combination with D-1MT significantly inhibited the tumor growth. These results suggest that UC-MSCs releasing Tandab (CD3/CD19) is an efficient therapeutic tool for the treatment of B cell lymphoma when combined with D-1MT.
Quality-of-life outcomes for prostate cancer treatment in Australia.
Authors: Jeremy L. Millar, Susan M. Evans, Mark Frydenberg, Declan G. Murphy, Damien M. Bolton, Graham G. Giles, Ian D. Davis
Journal: Journal of Clinical Oncology (2013)

143 Background: We aimed to use a population based quality registry established in Australia, to review patient-reported health-related QOL after the diagnosis of Prostate Cancer (PCa). Methods: Prospective registry of men with PCa from statutory notifications to the canonical population-based cancer registry in Victoria. An "opt-off" mechanism used. Coverage expanded from 30%-80% of State population over time. Demographics and disease features, management, and outcomes from medical record; men phoned at 12 and 24 months (m), interviewed with script including SF12 and items from standard form (UCLA PCI) for specific QOL outcomes. Urinary, rectal, and sexual function bother (UB, RB, and SB) scores where analysed by univariate and multivariable modelling for relationship of these with presentation or management factors, adjusting for risk. Results: Men from 8/2008 - 2/2011; 1.9% of eligible opted out. Followed 1172 to 12 &amp; 24 m. Median diagnosis age 65 yr; median PSA 6.8 ng/mL; 97.3% clinically localised with 47.7% having NCCN intermediate risk. 520 had treatment with Radical Prostatectomy (RP) (89 also with external beam-EBRT), 171 had EBRT (with or without HDR brachy), and 211 seed implant (SI). 226 had no treatment (NT) in the first 12 m. 52.5% managed in public hospitals, rest private. Univariate analysis: UB associated with management type, and hospital type, and RB and SB associated with these factors, as well as age and disease stage. On multivariate regression SB at 12 m was associated with increasing age (p=0.002) and radical treatment types (RP and EBRT/HDR, p&lt;0.001 and 0.003 respectively)—except SI—compared to NT; RB was associated with SI (0.02) and EBRT/HDR (0.007) and treatment in a public hospital (0.006); and UB was associated with public hospital (&lt;0.001). All associations at 12 m remained significant at 24 m. SF12 physical score had a positive association with RP vs NT (0.014), hospital type (0.001) and younger age. SF12 mental health also showed associations. Conclusions: A large scale registry in Australia assessing patient-reported quality of life outcomes after prostate cancer treatment shows patterns similar to that seen in North American reports.
Significant Reduction of Treatment Related Mortality after Stem Cell Transplantation in 647 Children and Adolescents with ALL within BFM Trials during the Last 12 Years: A Long Term Analysis from 1996 to 2007
Authors: André Schrauder, Martin Schrappe, Arend Stackelberg, Peter Bader, Wolfgang Holter, Rupert Handgretinger, Wolfram Ebell, Dagmar Dilloo, Tayfun Güngör, Monika Fuehrer, Hartmut Kabisch, Martin Zimmermann, Ulrike Poetschger, Karl-Walter Sykora, Christina Peters
Journal: Blood (2008)
The Thalidomide Analogue (Actimid) Induces T-Cell Activation at Day 28 in Patients with Relapsed Refractory Myeloma but Does Not Correlate with Improved Outcome.
Authors: Gulrukh Ahsan, Mathew Streetly, Paul A. Fields, Auther R. Bradwell, Steve A. Schey, Majid Kazmi
Journal: Blood (2005)
Medical care costs and survival associated with hepatocellular carcinoma in a medicare population.
Authors: J. Menzin, J. Korn, K. Lang, L. A. White, M. D. McKee, J. L. Ricker, S. Ray
Journal: Journal of Clinical Oncology (2011)

e14584 Background: Although incidence of hepatocellular carcinoma (HCC) is increasing in the US, the economic impact of HCC has not been extensively studied. The objective of this study was to assess the burden of HCC in terms of mortality and medical care costs, relative to a control group of non-HCC Medicare patients. Methods: This retrospective analysis used the SEER-Medicare database (1991-2007), which includes information on cancer diagnoses, stage and mortality, as well as linked Medicare claims for diagnosed cancer patients. Patients aged 66+ years at the time of diagnosis of incident primary HCC, who were entitled for Medicare Parts A and B and not enrolled in HMOs were included. Non-HCC controls were identified from a 5% sample of Medicare beneficiaries residing in SEER areas, matched one-to-one on age, sex, race, and geographic region. Kaplan-Meier analysis was used to estimate survival distributions. Costs were reported in 2009 USD, and per-patient-per-month (PPPM) costs were compared between cases and controls using Wilcoxon rank sum tests. Results: 5,719 HCC patients met all cohort selection criteria, and 5,712 were matched to controls. Average age of cases and controls was 75; 34.7% were female. The majority of HCC patients were diagnosed with localized disease (38.2%), followed by regional (24.0%), unknown (20.4%), and distant (17.3%). Median survival was estimated at 5 months for HCC patients versus 60 months for controls; and was 3 months for HCC patients with distant disease, followed by 4 months for regional and 9 months for localized disease. Mean PPPM costs were $7,863 for cases, and $1,243 for controls (P<0.0001). Major cost drivers were inpatient (mean $5,439 vs $682; P<0.0001) and hospice care (mean $554 vs $42; P<0.0001). Mean PPPM costs by stage were $7,265 (localized) vs $8,072 (regional) vs $9,585 (distant) (P<0.0001 for trend). Conclusions: These results suggest that costs are approximately 6-8 times higher for HCC patients than for controls. Patients with localized disease had the lowest mean PPPM costs, followed by those with regional and distant disease. Findings from this study highlight the substantial medical cost burden of HCC in the elderly.
EAU and NCCN surveillance guidelines for bladder cancer: Do they effectively capture recurrences following cystectomy?
Authors: Suzanne B. Stewart, Stephen A. Boorjian, Sarah P. Psutka, John C. Cheville, Prabin Thapa, Robert F. Tarrell, Matthew K. Tollefson, Robert Houston Thompson, Igor Frank
Journal: Journal of Clinical Oncology (2014)

310 Background: The European Association of Urology (EAU) and the National Comprehensive Cancer Network (NCCN) provide general guidelines for bladder cancer (BC) surveillance following radical cystectomy (RC). However, it is unclear how well these guidelines capture recurrences after surgery. Herein, we assess the ability of current guidelines to effectively capture BC recurrence following RC and propose a risk stratified and recurrence site-specific surveillance strategy. Methods: We reviewed our institutional database of 1,800 patients who underwent primary RC between 1980-2007. Guideline effectiveness was assessed by calculating the percentage of recurrences detected within the prescribed follow-up periods: EAU—5yrs; NCCN—2yrs. Patients were then stratified according to stage: &lt; = pT1Nx-0, &gt; = pT2Nx-0, pN+, and recurrence site: urothelium, abdomen, chest, other. Recurrence free survival estimates for stage groups and recurrence site were assessed with Kaplan Meier models. Results: Of the 1,800 patients, 634 (35.2%) were classified as &gt; pT2Nx-0 and 234 (13%) as pN+ and overall 228 (12.7%) received perioperative chemotherapy. Median postoperative follow-up was 10.6yrs (IQR 6.8-15.2), during which 716 (39.8%) patients developed recurrence. Of these recurrences, 492 (68.7%) would have been detected using the NCCN guidelines and 644 (89.8%) by EAU recommendations. However, ending oncologic surveillance at 5 years would only capture 81.7% of all recurrences for &lt; = pT1Nx-0 patients and 83% of urothelial specific recurrences across all stage groups. Capture of 90% of recurrences, by stage group, in the urothelium, abdomen and chest would require surveillance for 8yrs, 8yrs and 4yrs, respectively in &lt; = pT1Nx-0, 6yrs, 4yrs and 3yrs in &gt; = pT2Nx-0 and 3yrs, 3yrs and 2yrs for pN+ patients. Conclusions: Duration of surveillance recommended for BC following RC by the EAU and NCCN do not comprehensively capture recurrences seen, specifically, in low risk patients and in cases of urothelial recurrence. Guidelines using risk stratification and site-specific recurrence patterns to assign length of surveillance may allow providers to better individualize surveillance regimens.
The Combination of Bortezomib, Melphalan, Dexamethasone and Intermittent Thalidomide (VMDT) Is an Effective Regimen for Relapsed/Refractory Myeloma and Reduces Serum Levels of Dickkopf-1, RANKL, MIP-1α and Angiogenic Cytokines.
Authors: Evangelos Terpos, Athanasios Anagnostopoulos, Deborah Heath, Efstathios Kastritis, Dimitrios Christoulas, Nikolaos Anagnostopoulos, Maria Roussou, Konstantinos Tsionos, Peter Croucher, Meletios A. Dimopoulos
Journal: Blood (2006)
Short Telomeres Combined with Low Telomerase Activity Are Associated with a Longer Survival in Patients with Acute Myeloid Leukemia.
Authors: Veronique Saada, Pierre Tran Ba Loc, Camille Legeai, Marine Castaing, Jean-Henri Bourhis, Martine Raphael, Annelise Bennaceur-Griscelli
Journal: Blood (2007)
Observational cohort study of 1st line bevacizumab combined with chemotherapy in metastatic colorectal cancer (HGCSG0802): Sub-group analysis by the GERCOR index.
Authors: Osamu Muto, Satoshi Yuki, Tetsuhito Muranaka, Takashi Kato, Takashi Meguro, Michio Nakamura, Atsushi Sato, Ichiro Iwanaga, Minoru Uebayashi, Miki Tateyama, Kazuteru Hatanaka, Kazunori Eto, Hiroyuki Okuda, Susumu Sogabe, Masakazu Abe, Kanji Kato, Sosuke Kato, Kencho Miyashita, Yuh Sakata, Yoshito Komatsu
Journal: Journal of Clinical Oncology (2016)

743 Background: The GERCOR index based on performance status and serum LDH was reported to be useful to predict survival for patients with previously untreated mCRC. However, the validity of the GERCOR index has not been reported in patients treated with bevacizumab (Bev)-based first line chemotherapy. Methods: 115 patients with mCRC treated with Bev contained first line chemotherapy were registered from 15 centers in Japan. Univariate and multivariate analysis for overall survival (OS) were performed using patient characteristics. Survival analyses were performed with the Kaplan-Meier method, log-rank test and the Cox proportional hazards model. The analysis was also designed to determine whether the GERCOR index could be extended to progression-free survival (PFS). Results: All data were available for prognostic categorization in 108 patients. Patients with the GERCOR index of low, intermediate and high risk were 45, 57, and 6, respectively. The pts characteristics between low risk (L) and intermediate/high risk (I/H) were generally balanced except for prior colorectomy (75.6% in L, 54.0% in I/H; p = 0.027), based cytotoxic agent (oxaliplatin) (80.0% in L, 93.7% in I/H; p = 0.039), liver metastasis (53.3% in L, 79.4% in I/H; p = 0.006) and median number of metastatic organ (1 in L, 2 in I/H; p = 0.024). The distribution and median OS / PFS for the GERCOR index were as follows: L (n = 45; 29.9/10.0 months), I/H (n = 63; 17.0/8.5 months). For OS, there was significant difference between L and I/H (p = 0.003). For PFS, there was not significant difference between L and I/H (p = 0.522). In the Cox multivariate analysis, GI did not show an independent prognostic impact (L vs I/H ; HR 1.499, p = 0.120) and predictive impact (L vs I/H ; HR 0.922, p = 0.733). Conclusions: In this analysis, the GERCOR index might be neither the predictive nor prognostic factor in the bevacizumab combined first line chemotherapy for patients with mCRC.
Long-acting somatostatin analogues survival differences in limited- and extensive-disease SCLC patients.
Authors: K. Zarogoulidis, E. Eleftheriadou, G. Gerasimou, P. Zarogoulidis, I. Sapardanis, T. Kontakiotis, G. Galaktidou, A. Gotzamani-Psarrakou, N. Karatzas
Journal: Journal of Clinical Oncology (2010)

7051 Background: Long acting somatostatin analogues combined with platinum analogues have demonstrated an antiproliferative effect on growth of human SCLC xenografs. Methods: 114 (52 with limited disease) previously untreated SCLC patients with positive somatostatin receptors were included in the study. All patients performed 111In-Octreotide scanning before CHT, every 3 months and up to 4 times. All patients were treated with paclitaxel 190mg/m2+ carboplatin AUC=5.5 for up to 8 cycles. 48 hours after each CHT 30/114 patients (Group A) also received 30mg lanreotide (somatuline) in order to block somatostatine receptors for 2 weeks. 40/114 patients (Group B) received 60mg lanreotide to block somatostatine receptors for 4 weeks. 44/114 patients (Group C, control) received only CHT. No differences were observed between the 3 Groups regarding LD and ED patient ratios, age and PS. Patients in Groups A and B after the completion of the CHT continued maintenance therapy with lanreotide. Both non and hematological toxicity had no statistical significant differences between the Groups and generally toxicity was well managed. Results: Group A (median: 375.days, 95%CI: 206.3-543.7) had a survival benefit (p<0.001) in comparison to Group B (median: 347 days, 95%CI: 319.1-374.9 days). In limited disease patients group A had a statistical significant benefit compared to control group and to group B. 537 95% CI 449.8-624.2, 300 95%CI 244.2-355.8, 347 95%CI 187.9-506 respectively (p=0.04 Tarone-Ware test). Conclusions: Long acting somatostatin analogues could be used as an additive therapy in combination to antineoplastic agents in patients positive for somatostatine receptors. 30 mg dose improve survival only in limited disease SCLC patients. No significant financial relationships to disclose.
Prospective structured smoking behavior assessment at diagnosis and long-term cancer survival.
Authors: G. W. Warren, K. Kasza, M. E. Reid, K. M. Cummings, J. R. Marshall
Journal: Journal of Clinical Oncology (2011)

1557 Background: Evidence suggests tobacco use decreases survival in cancer patients, but research to date is limited by a lack of standardized prospective tobacco use assessments. Methods: A standardized prospective assessment of smoking behavior was collected on patients from 1982-98. Survival data on patients completing the assessment within 30 days of cancer diagnosis were analyzed to assess the impact of smoking status at diagnosis on disease specific mortality (DSM) and overall mortality (OM). Patients were categorized as current, former (more than 12 months since quitting), and never smokers. The following potential confounders were considered: age, stage, gender, disease site, race, diagnosis date, body mass index, and pack-years of smoking. Hazard ratios (HR) were obtained using logistic regression and Cox proportional hazards analysis in disease sites with at least 100 patients. Results: In 5185 patients (minimum 12 year follow-up), mean age at diagnosis was 59, 46% were male, 97% are white, 39% presented with local disease, 30% with regional disease, and 31% with distant disease. After adjustment for confounders, Cox proportional hazards analysis of the overall population demonstrates that current smoking significantly increased OM (HR 1.29 vs. former, 1.38 vs. never) and DSM (HR 1.23 vs. former, 1.18 vs. never). In men, Current smoking increased OM in lung (HR 1.43 vs. former), head/neck (HR 1.73 vs. former), and prostate cancer (HR 2.83 vs. never) and current smoking increased DSM in lung (HR 1.42 vs. former), head/neck (HR 1.9 vs. former), prostate (HR 2.17 vs. never), and leukemia (HR 1.77 vs. former, 1.81 vs. never). In women, current smoking increased OM in breast (HR 1.81 vs. former, 1.84 vs. never) and uterine (HR 1.88 vs. never) and current smoking increased DSM in breast (HR 1.69 vs. former, 1.73 vs. never). Current smoking status at diagnosis in several disease sites with small patient subsets achieved near significance for adverse outcome. Conclusions: Current smoking at diagnosis is a significant adverse risk factor for long term OM and DSM in cancer patients. Tobacco use is an important variable that should be accurately accounted for in survival analyses for cancer patients.