tbuckley/cabot-search huggingface dataset:
A phase ll study of new combination regimen with trastuzumab, S-1, and CDDP in HER2-positive advanced gastric cancer (HERBIS-1).
Authors: Keisuke Koeda, Naotoshi Sugimoto, Junji Tanaka, Masahiro Tsuda, Wataru Okamoto, Hiroyuki Okuda, Hiroshi Imamura, Jin Matsuyama, Toshio Shimokawa, Daisuke Sakai, Norimasa Fukushima, Yukinori Kurokawa, Yoshito Komatsu, Toshimasa Tsujinaka, Hiroshi Furukawa
Journal: Journal of Clinical Oncology (2013)

4072 Background: S-1, a novel oral fluoropyrimidine, plus cisplatin (SP) regimen is one of the standard chemotherapy as first-line for advanced gastric cancer. ToGA study demonstrated that trastuzumab (T-mab) combination regimen improved the overall survival of patients with HER2-positive advanced gastric cancer. However, there was no study evaluating the efficacy and the safety of T-mab in combination with S-1 plus cisplatin (SP) regimen. Therefore, we planned this study to examine the efficacy and the safety of the SP plus T-mab. Methods: Patients confirmed to be HER2-positive by IHC and/or FISH (IHC 3+ or IHC 2+ and FISH positive) received S-1 at 80 mg/m 2 po, day 1-14, and cisplatin 60 mg/m 2 iv, day 1 plus trastuzumab 8 mg/kg iv, day 1 (6 mg/kg iv, d1 from 2nd course), repeated every 3 weeks until disease progression. Primary endpoint was response rate (RR). Secondary endpoints were progression-free survival, overall survival and safety. The threshold response rate was defined as 35%, and the expected rate was set at 50% with a 80% power and a 1-sided alpha value of 0.1 and the calculated sample size was 50 patients. Results: A total of 56 patients (median age 66) were enrolled in this study. The efficacy and the safety analyses were conducted in the full analysis set of 53 patients. (Two patients were excluded for ineligibility and one was for no treatment). The confirmed RR assessed by the independent review committee was 67.9% (95% CI: 53.7 – 80.1), and the disease control rate was 94.3%. The median PFS was 7.1 months (95% CI: 6.0 – 10.1). The median OS was not reached. (The median follow-up time: 9.2 months) The main grade 3/4 adverse events were as follows: neutropenia 34%, leucopenia 8%, anorexia 23%, diarrhea 8%, hypoalbuminemia 4%, vomiting 6%, and increased creatinine 6%. Conclusions: This tri-week regimen with SP plus T-mab showed promising results in patients with HER2-positive advanced gastric cancer. Clinical trial information: UMIN000005739.
Demographic factors and rate of lymph node evaluation in colon cancer stage II using National Cancer Database (NCDB).
Authors: Ahmed Ibrahim Tahseen, Aabra Ahmed, Peter T. Silberstein
Journal: Journal of Clinical Oncology (2017)

548 Background: Retrieving at least 12 lymph nodes (LN) is a quality indicator in colon cancer. Previous studies have shown about 38% of patients with stage II are estimated to have ≥12 LN checked. Methods: Community Programs (CCP) receive 100-500 newly diagnosed cancer cases per year. Hospitals receiving 500+ patients are either Academic Comprehensive Programs (ACP) or Comprehensive Community Programs (CCCP). Using NCDB (2003-2013), which includes &gt;70% of newly diagnosed cancer patients, we utilized chi-square analysis, and compared frequencies of patients with and without having ≥12 LN examined. Results: In the NCDB database, the percent of patients with stage II colon cancer who have ≥12 LN checked is much lower than current estimates. Non-Hispanic and Hispanic patients have similar LN examination rate, as do Blacks and Whites. 4% less men have ≥12 LN examined than women. Large differences exist among patients with different insurance statuses. Uninsured and Medicaid patients have much lower LN examination with ~80% of having &lt;12 LN examined. CCPs have a lower rate of LN examination, with 7.4% more patients having &lt;12 LN checked than CCCPs and 9.1% more than ACPs. When comparing frequency of those with &lt;12 and ≥12 LN examined in a demographic, p&lt;.05 in all comparisons. Conclusions: This largest, and most recent analysis of frequencies in patients with stage II colon cancer reflects a low rate of ≥12 LN being examined in those with stage II colon cancer. Rates of ≥12 LN being examined is greater in stage III colon cancer, however, there is a significant difference in survival when ≥12 LN are checked in stage II colon cancer as well. From 2004-2008 rates of LN examination increased, but rates of LN examination have since stagnated. Only around a quarter of patients have ≥12 LN examined; thus, this quality measure is only achieved in a minority of patients. [Table: see text]
Comparing intensity modulated radiotherapy and conventional external beam radiotherapy in cervical cancer.
Authors: Deleep Kumar Gudipudi, Krishnam Raju Alluri, Maria B. De Leon, Higinia Rosa Cardenes, Giuseppe Del Priore
Journal: Journal of Clinical Oncology (2013)

5610 Background: To compare Intensity-modulated radiation therapy (IMRT) with conventional external beam radiation therapy (CXRT) regarding morbidity, tumor response, and quality of life (QOL) in cervical cancer patients. Methods: Between 8/2009-2/2010, 50 patients (pts) with age range 20-85, with FIGO Stage IIA- IIIB were prospectively randomized 2:1 to CXRT and IMRT at Indo-American Cancer Institute. Both groups received concurrent chemotherapy (weekly cisplatin 30-40mg/m 2 ) with external beam radiation (EBRT), 50Gy/25fractions followed by intracavitary brachytherapy at 21Gy/3fractions. Complications and QOL were evaluated during treatment and in follow-up with CTC 4.0 and EORTC QLQ-C30, and disease recurrence was based on pelvic exam. Analysis used Chi square(X 2 ) at a significance level of 0.05. Results: Average time to completion was 49 and 48 days in CXRT and IMRT arms (p&gt;.05). Four pts did not complete the treatment in the CXRT. Two months after completion 31/35 (89%) of CXRT and 15/15 (100%) of IMRT had complete response (p&gt;.05). At 5 months, 30/35 (86%) of CXRT, and 14/15 (100%) of IMRT had no loco-regional disease (LRD); 1 IMRT pt died from distant metastasis (DM). At 18 months, 25/35 (72%) in CXRT and 14/15 (93.5%) in IMRT had no LRD or DM. Most common acute side effects in the CXRT were Grade 1 vomiting/cystitis/diarrhea and Grade 2 nausea/skin reactions/proctitis. One pt developed vesicovaginal fistula (VVF) after 50Gy by EBRT. Most common acute side effects in the IMRT were Grade1 nausea/vomiting/cystitis/proctitis/diarrhea. Two pts had grade 3 neutropenia in the 5 th week of RT. QOL was better in IMRT (p &lt;.01) based on functional, symptom, single items, and global scales except for pain, insomnia, loss of appetite. Diarrhea, financial problems were worse in the CXRT (p&lt;.05). Chronic complications such as radiation induced proctitis in 5 patients, and sub-acute intestinal obstruction in 2 patients during follow-up period in CXRT vs. IMRT (p &lt; 0.001). Conclusions: IMRT is superior to CXRT with fewer chronic side effects and similar acute side effects and treatment responses. This is the first randomized clinical trial of these treatments in cervical cancer.
The association of BMI and PSA density on survival among patients with metastatic or castration-resistant prostate cancer.
Authors: Zachary A Glaser, Svetlana Avulova, Blair Stocks, David F. Penson, Kelvin A. Moses
Journal: Journal of Clinical Oncology (2017)

207 Background: The majority of deaths from prostate cancer are among men with metastatic (mPCa) or castration-resistant prostate cancer (CRPC). Long-term outcomes of these patients are generally not well characterized as data from most randomized trials were censored at interim analysis. The objective of our study is to investigate factors associated with survival in a dedicated outpatient clinic. Variables of interest included body mass index (BMI) and PSA density (PSAD) at diagnosis, as well as initial treatment. Methods: All patients with mPCa or CRPC seen in the Vanderbilt Comprehensive Prostate Cancer Clinic were eligible. Demographic and pathologic information were extracted from the electronic record under IRB-protocol. Overall survival (OS) was estimated using the Kaplan-Meier method. Multivariate analyses using Cox proportional hazard models were also performed. Results: Clinicopathological data was available for 65 patients at interim analysis of a total of 198 patients. Median follow-up was 7.4 years and median BMI was 28.5 kg/m 2 . Disease characteristics included 31/65 (47.5%) with Gleason 8 or greater on biopsy, median PSAD of 0.34, and 14 (23.3%) presenting with M1 disease. Patients underwent surgery (53%), radiation (20%) or androgen deprivation (ADT, 24.6%) initial therapy. BMI &gt; 30 kg/m 2 was associated with lower 5-year mortality (6.5% vs. 13.3% BMI &lt; 30 kg/m 2 , p = 0.042). In addition, PSAD above median was associated with worse 5-year mortality (37.7% vs 6.1% PSAD &lt; 0.34, p = 0.048). Initial treatment was also associated with 5-year mortality (10% surgery vs 0% radiation vs 100% ADT, p &lt; 0.01). Multivariate analysis showed BMI is independently associated with OS (HR 0.807 (95% CI 0.70-0.93), p &lt; 0.01) correcting for age and stage. Conclusions: We show BMI, PSAD and initial treatment are associated with survival for patients who develop advanced prostate cancer. Furthermore, BMI is significantly associated with survival in this cohort. The survival benefit of surgery likely reflects the higher percentage of M1 disease among patients who receive ADT only. Our findings should prompt further analysis of the impact of clincopathlogic factors and treatment type in a larger cohort.
Annual Report to the Nation on the Status of Cancer, 1975–2014, Featuring Survival
Authors: Ahmedin Jemal, Elizabeth M Ward, Christopher J Johnson, Kathleen A Cronin, Jiemin Ma, A Blythe Ryerson, Angela Mariotto, Andrew J Lake, Reda Wilson, Recinda L Sherman, Robert N Anderson, S Jane Henley, Betsy A Kohler, Lynne Penberthy, Eric J Feuer, Hannah K Weir
Journal: JNCI Journal of the National Cancer Institute (2017)

The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States. This Annual Report highlights survival rates. Data were from the CDC- and NCI-funded population-based cancer registry programs and compiled by NAACCR. Trends in age-standardized incidence and death rates for all cancers combined and for the leading cancer types by sex were estimated by joinpoint analysis and expressed as annual percent change. We used relative survival ratios and adjusted relative risk of death after a diagnosis of cancer (hazard ratios [HRs]) using Cox regression model to examine changes or differences in survival over time and by sociodemographic factors.Overall cancer death rates from 2010 to 2014 decreased by 1.8% (95% confidence interval [CI] = -1.8 to -1.8) per year in men, by 1.4% (95% CI = -1.4 to -1.3) per year in women, and by 1.6% (95% CI = -2.0 to -1.3) per year in children. Death rates decreased for 11 of the 16 most common cancer types in men and for 13 of the 18 most common cancer types in women, including lung, colorectal, female breast, and prostate, whereas death rates increased for liver (men and women), pancreas (men), brain (men), and uterine cancers. In contrast, overall incidence rates from 2009 to 2013 decreased by 2.3% (95% CI = -3.1 to -1.4) per year in men but stabilized in women. For several but not all cancer types, survival statistically significantly improved over time for both early and late-stage diseases. Between 1975 and 1977, and 2006 and 2012, for example, five-year relative survival for distant-stage disease statistically significantly increased from 18.7% (95% CI = 16.9% to 20.6%) to 33.6% (95% CI = 32.2% to 35.0%) for female breast cancer but not for liver cancer (from 1.1%, 95% CI = 0.3% to 2.9%, to 2.3%, 95% CI = 1.6% to 3.2%). Survival varied by race/ethnicity and state. For example, the adjusted relative risk of death for all cancers combined was 33% (HR = 1.33, 95% CI = 1.32 to 1.34) higher in non-Hispanic blacks and 51% (HR = 1.51, 95% CI = 1.46 to 1.56) higher in non-Hispanic American Indian/Alaska Native compared with non-Hispanic whites.Cancer death rates continue to decrease in the United States. However, progress in reducing death rates and improving survival is limited for several cancer types, underscoring the need for intensified efforts to discover new strategies for prevention, early detection, and treatment and to apply proven preventive measures broadly and equitably.
A prospective, nonrandomized phase II/III trial of definitive chemoradiation, with or without cetuximab, in advanced esophageal squamous cell carcinoma.
Authors: Yongshun Chen, Jianhua Wang, Xiaoyuan Wu, Chunyu He, Wen Wang, Jinsong Liu, Wei Guo, Bo Tan, Yanxia Wang
Journal: Journal of Clinical Oncology (2012)

e14645 Background: Chemoradiotherapy is the standard treatment option for patients with esophageal cancer unsuitable for surgery, but the majority of patients will die of their disease, most commonly with local tumor progression/recurrence. We initiated this study to determine the efficacy and safety of the addition of cetuximab with paclitaxel, cisplatin, and radiation for patients with advanced esophageal squamous cell carcinoma (ESCC). Methods: A total of 127 patients with clinical stage II–IVa disease were selected to receive combined-modality therapy consisting of cetuximab (400 mg/m 2 /wk week 1, then 250 mg/m 2 /wk week 2-8), paclitaxel (45 mg/m 2 /wk) and cisplatin (20 mg/m 2 /wk) in weeks 2-8 with 59.4 Gy of radiation (Group A, n = 29) versus the same chemoradiotherapy schedule but without cetuximab (Group B, n = 98). Results: At the time of this analysis, 27 and 88 patients were available for evaluation of response and survival in Group A and B respectively. In Group A, 20 patients (74.1%) achieved complete response (CR) and 7 (25.9%) achieved partial response (PR), resulting in an objective response rate (ORR) of 100%. The 1- and 2-year progression-free survival (PFS) was 91.2% and 85.1%, the median PFS was not reached. No association between tumor EGFR expression and response or survival was found. In Group B, 33 patients (37.5%) achieved CR, 51 (58.0%) achieved PR and 4 (4.5%) had stable disease, thus the ORR was 95.5%. The 1- and 2-year PFS was 89.0% and 50.5%, with the median PFS of 24.3 months. The difference in PFS between the two groups was statistically significant (p = 0.011). Treatment-related toxicities were generally grade 1 or 2. The most common toxicities were rash (89.3%), followed by neutropenia (71.4%) and esophagitis (60.7%) in chemoradiation-plus-cetuximab group. Adverse events were most often neutropenia (81.8%) and esophagitis (76.1%) in chemoradiation group. Locoregional failure rate was 3.7% and 15.9% in Group A and B, respectively. Conclusions: Cetuximab can be safely administered with chemoradiation and may prolong progression-free survival for Chinese patients with ESCC.
Endoscopic closure of a fistula between an ileal conduit and an ileal handle localized between two uretero-ileal anastomoses
Authors: Benedetto Mangiavillano, Mario Bianchetti, Loretta Amato, Sara Melegari, Mauro Seveso, Gianluigi Taverna, Alessandro Repici
Journal: Endoscopy (2017)

Cystectomy is the gold standard treatment for patients with bladder cancer. Urinary diversion with ileal conduit and uretero-ileal anastomoses, as described by Bricker, is the most widely used surgical therapy because of the lower risk of postoperative complications in elderly patients and in those with co-morbidities. The Bricker technique involves the use of a segment of the ileum as a conduit to the skin, with a successive uretero-ileal-cutaneous anastomosis for each ureter [1]. The endoscopic approach to construction of the ileal conduit for urological obstruction is rarely reported [2]. We present the case of a patient who underwent cystectomy with a Bricker uretero-ileal-cutaneous anastomosis, who developed a fistula between the ileal conduit and an ileal handle.
Comparative analysis of survival in colon cancer undergoing sentinel lymph node mapping versus conventional surgery based on number of positive lymph nodes.
Authors: Sabarina Ramanathan, Sukamal Saha, Suresh Mukkamala, Michael Hicks, Patrick Knight, Daniel Mazzaferro, Thushy Siva, Vinay Bajaj, Lori Hutcherson, Avian Chang, David Livert, Rajen Oza
Journal: Journal of Clinical Oncology (2017)

734 Background: Unlike in breast cancer or melanoma, resection during sentinel lymph node mapping (SLNM) in colon cancer (CCa) includes regional lymphadenectomy including SLNs and non SLNs. However, SLNM often identifies micrometastases which can be missed by conventional (Conv) surgery and pathologic examination. It is unknown whether this impacts survival or recurrence. Hence, a retrospective analysis was undertaken to study overall (OS) and disease -specific (DSS) survival between patients (pts) undergoing SLNM vs Conv surgery based on the number of +veLNs. Methods: SLNM was done by subserosal injection with blue dye followed by segmental resection including regional lymphadenectomy. All SLNs were ultrastaged and other nodes were examined by conv. methods with H&amp;E. Results: There are 309 pts in SLNM (GpA) vs 499 pts in Conv surgery (GpB); with average no. of lymph nodes (LNs) and +ve LNs 17.3/1.6 vs 14.4/2.49 respectively. For GpA, success rate was 99.6% and the average no of SLN was 3. Of the pts in GpA vs GpB, 1+ve LN were found in 38% vs 27%, 2+ve LNs in 10% vs 16%, and &gt; 2 LNs in 53% vs 57%, respectively. Comparing 5 years OS between GpA vs GpB, for 1+ve LN was 62.8% vs 52.38%, for 2 +ve LNs 72.7% vs 48.65% and for &gt; 2 +ve LNs 35% vs 33.33%, respectively. Similarly, DSS for 1 +veLN was 54.4% vs 47.6%, 2+ve LNs 40% vs 40.54% and &gt; 2+ve LNs, 30.4% vs 25.76%, respectively(Table1.). Conclusions: Compared to Conv surgery, SLNM identified higher no. of LNs per pt with high success rate. Five-year OS and DSS also are better in SLNM vs Conv surgery for all +ve LN gps. Hence, SLNM in CCa may have prognostic value. A larger multicenter trial needs to be done to validate such data. [Table: see text]
Use and spending on antineoplastic therapy (AT) in the Medicare population and the role of supplemental coverage.
Authors: Amy J. Davidoff, Thomas Shaffer, Ilene H. Zuckerman, Naimish B. Pandya, Bruce C. Stuart, Mujde Z. Erten, J. Samantha Shoemaker, Lynda Bryant-Comstock, Rahul Shenolikar
Journal: Journal of Clinical Oncology (2012)

6060 Background: Oral antineoplastic agents (OAA) represent a growing sector of cancer therapy. Prior studies of older adult cancer patients (pts) examined use of infused/ injected chemotherapy (IICT) covered by Medicare Part B. We examined trends in IICT and OAA use, and the effect of supplemental coverage on AT use and spending. Methods: We used Medicare Current Beneficiary Survey data (1997-2007). Newly diagnosed cancer pts were selected using ICD-9CM codes. IICT use was identified from Part B claims; OAAs were identified from self reported prescription medication events. Supplemental coverage and pt characteristics were assessed from administrative records and self-report. Total spending summed payments from all sources during the cancer diagnosis and subsequent year. Logistic regression examined factors associated with use of any and type of AT; Generalized Linear Models estimated factors associated with spending. Results: Of 1,836 newly diagnosed cancer pts 559 (31%) received AT; 395 (21%) used IICT and 253 (15%) used OAAs. Spending per user was $7,544(AT), $9,892 (IICT), and $1,535 (OAA). Supplemental coverage was associated with increased odds of AT use compared to no supplemental coverage (see Table). Cancer site and age were key predictors of spending among users. OAA spending increased during 2006-7 relative to 2004-5. Conclusions: AT use in Medicare beneficiaries is sensitive to the presence but not type of supplemental coverage. OAAs were used by a relatively large proportion of cancer pts receiving AT, although spending was less than for IICT during this largely pre-Part D period. With the growing number of relatively new OAAs, and more in the pipeline, monitoring the role of supplemental coverage, and particularly the role of Part D on access and spending is a critical area for ongoing research. [Table: see text]
Would screening benefit 75- to 84-year-old patients with non-small cell lung cancer (NSCLC)?
Authors: Jessica Lake, John Charles Flickinger, John M. Varlotto, Abram Recht, Malcolm M. DeCamp, Chandra Prakash Belani, Heath B. Mackley, Chris Sciamanna, Michael Reed, Jennifer Toth, Allan Lipton, Suhail M. Ali
Journal: Journal of Clinical Oncology (2012)

7055 Background: The Lung Cancer Screening Trial has shown an overall survival (OS) benefit and reduced lung cancer mortality in the 55-74 age group (gp). We chose to evaluate whether NSCLC patients aged 75-84 are increasing in the USA and whether they would benefit from aggressive therapy. Methods: SEER-17 was used to calculate NSCLC rates during the years 2000-2008. SEER-9 was used to estimate the proportional change in both 55-74 and 75-84 gp from 1973-2008. OS was analyzed in a modern population from SEER-17 (2004-2008) to assess the effects of increasingly aggressive therapy (observation(Ob), radiation (RT) or lobectomy (LB)) for a proposed screening population with T1N0 tumors. Chi-square test and Cox Regression (CR) were used to evaluate OS. Paired T-tests assessed changes in rates and proportions over time. Results: The 55-74 gp rose from 64.4% in 1973 to 67.25% in 1984, but fell to 58.8% by 2008, while the 75-84 gp rose from 12.1% in 1973 to 24% in 2008 (p&lt;0.01), similar in both sexes. The rates/100,000 have been increasing in the 75-84 gp (p=0.02), mainly in females (p=0.003) while the rates in the 55-74 gp did not vary, but fell for men (p=0.03). In the Ob gp (n=1344), NSCLC was the most common cause of death (COD) in the 55-74 (29.8%) and 75-84 gp (40.6%), more than all other CODs combined (median survival (MS) = 11mn). CR revealed that OS was associated with the 55-74 gp (0.59) and females (0.62) (p &lt; 0.001). In the RT gp (n=1870), MS was 14mn and lung cancer was the most common COD at 27.7% (55-74) and 28.8% (75-84), again more than all other CODs combined. CR found that females (0.68) and black race (0.72) had better OS (p&lt;0.017), but age was not. MS was 24 mn in the LB group (n=9384). COD from NSCLC and all other CODs was 8.2% and 6.1% (55-74) and 10.9% and 11.4% (75-84). CR showed that 55-74 (0.36), females (0.58), and Asians (0.73) had lower death rates (all p&lt;0.015). Mean OS between the 55-74 (26.0) and 75-84 (24.2) gp showed a small yet significant difference. Conclusions: Rates and proportions of NSCLC have been steadily increasing in the 75-84 gp. These data show that COD by lung cancer decreased significantly with increasingly aggressive treatment and treatment reduced the effects of age gp on survival. We feel that screening may be of benefit to the 75-84 gp.