tbuckley/cabot-search huggingface dataset:
The validity of the MSKCC nomogram in predicting overall survival of black patients with uterine cancer.
Authors: G. Salame, T. S. Pradhan, E. Stevens, Y. Lee, K. Economos, C. Gorelick, E. Serur, N. Ruffner, K. Wilson, O. Abulafia
Journal: Journal of Clinical Oncology (2011)

e15570 Background: To test the validity of a MSKCC nomogram for predicting overall survival in black women with uterine cancer. Methods: Retrospective review of a uterine cancer database at two major teaching institutions identified 636 eligible black patients with uterine cancer who underwent surgery between 1984 and 2009. We compared actual survival at the time of analysis to that predicted by the MSKCC nomogram based on age at diagnosis, grade, stage, histologic subtype, and number of negative lymph nodes. Subjects were divided into quartiles based on their model-based survival probability; Kaplan-Meier (KM) analysis was then applied to generate an independent estimate of survival probability for each quartile, along with a 95% confidence interval (CI). Results: The median age was 64 years (range; 28-100). Final grade included: G1 (n=253), G2 (n=187), G3 (n=391) and missing (4). Stage included: IA (n=149), IB (n=244), IC (n=76), IIA (n=28), IIB (n=62), IIIA (n=32), IIIB (16), IIIC (n=97), IVA (n=16), and IVB (n=115). Histology included: adenocarcinoma (561), carcinosarcoma (158), serous (93) and clear cell carcinoma (23). Median follow-up for survivors was 54 months (range; 1–274 months). For women in the upper two quartiles, the model-based probability of survival at 3 years was 0.976 and 0.924, and the KM for our patient population was 0.983 (95% CI 0.024) and 0.857 (95% CI 0.061), respectively. For women in the lower two quartiles the model-based probability of survival at 3 years was 0.761 and 0.331, and the KM estimate for our patient population was 0.700 (95% CI 0.080) and 0.174 (95% CI 0.063), respectively. Results regarding five-year survival for the upper two quartiles was 0.958 and 0.879, the KM estimate for our patients was 0.938 (95% CI 0.023) and 0.786 (95% CI 0.037) respectively. For patients in the lower two quartiles, the model-based probability was 0.645 and 0.183, and the KM estimates were 0.498 (95% CI 0.044) and 0.183 (95% CI 0.028) respectively. Conclusions: The nomogram is a good predictor of survival in black patients who are young and with early stages of disease. In contrast, the nomogram performed poorly in predicting survival in black patients who were elderly or had advanced stage disease.
Exploring phosphatase and tensin homolog (PTEN) loss via immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) as a potential predictive marker for response to everolimus in patients (pts) with neuroendocrine tumors (NET).
Authors: Moh'd M. Khushman, Alexandra Gomez Arteaga, Liege Diaz, Gabriel Tinoco, Richa Dawar, Ernesto Bustinza, Monica T. Garcia, Yao-Shan Fan, Maria Restrepo, Jaime R. Merchan, Daniel A. Sussman, Joyce Slingerland, Caio Max S. Rocha Lima, Peter Joel Hosein
Journal: Journal of Clinical Oncology (2015)

333 Background: Identification of pts with exquisite sensitivity and/or durable responses to targeted therapies may lead to improved patient selection and allow for more rational treatment designs. Exceptional responders to everolimus in NET including pancreatic (PNET) were observed in our cohort of pts. PTEN is a key negative regulator of the phosphatidylinositol 3-kinase(PI3K)/Akt and mammalian target of rapamycin (mTOR) pathway. Loss of PTEN tumor suppressor gene function, usually due to deletion, leads to PI3K/Akt/mTOR pathway activation. Inthis study, we explored the role of PTEN as a potential predictive marker of everolimus in pts with NET including PNET. Methods: Between 2010 and 2014, pts with well-differentiated unresectable and metastatic gastrointestinal NET treated at our institution with everolimus were identified. 17 patients had pathology specimens available for testing. PTEN loss detection by FISH was carried out using a commercially available probe for cytoband 10q23, and by IHC using a commercially available antibody. Patients’ response to everolimus was evaluated through August 2014. The primary outcome was PFS and PTEN status was correlated with PFS for any potential association. Results: The median age was 59 years (range 45-78); 7 were male; 8 had PNET (2 gastrinomas, 1 insulinoma and 5 non-functional); 7 had small bowel NET and 2 unknown primary. All pts received everolimus starting at 10mg daily and octreotide LAR. Of the pts with PNETs, 3 had PTEN loss by FISH. Of those, one did not tolerate everolimus. The PFS for the other two pts was 8 and 24 months respectively. Among the 4 pts with intact PTEN; PFS was 14, 26, 3 and 12 months. 1 patient had insufficient tumor for testing. PTEN FISH is ongoing in the 9 non-pancreatic NET pts. PTEN expression by IHC is also ongoing and will be reported at the meeting. Conclusions: Testing for PTEN loss by FISH is feasible. Due to the small sample size, the role of PTEN loss could not be defined as a predictive marker in PNET. Testing on additional cases is ongoing and will be presented at the meeting.
The diagnostic value of the immunochromatographic fecal tumor M2 pyruvate kinase test as a screening tool for colorectal malignant lesions.
Authors: Jin Il Kim, Jae J. Kim
Journal: Journal of Clinical Oncology (2015)

517 Background: The M2 pyruvate kinase (M2-PK) is known as a specific enzyme produced in undifferentiated and proliferating tissues. However, the fecal tumor M2-PK ELISA test is expensive and time consuming, and also needs an available laboratory. For this reason, in the same way as immunochromatographic fecal occult blood test (iFOBT), an immunochromatographic fecal tumor M2-PK test (iM2-PK), has recently been developed. This is the study for the diagnostic value of the iM2-PK as a screening test for colorectal malignant and premalignant lesions. Methods: A total of 323 individuals participated. iFOBT and iM2-PK were performed with the stool samples. The participants consisted of 60 healthy volunteers, 124 patients with colonic adenoma, and 139 patients with colorectal cancer (CRC). The fecal tumor M2-PK ELISA tests were performed with the rest of stool samples from 68 participants, consisting of 40 patients with CRC, 26 patients with colonic adenoma, and 2 healthy volunteers. Results: For diagnosing CRC, the sensitivity, specificity, and area under the curve (AUC) were 92.8%, 83.3%, and 0.88 in iM2-PK, and 47.5%, 83.3%, and 0.65 in iFOBT. For diagnosing adenoma, the sensitivity, specificity, and AUC were 69.4%, 83.3%, and 0.76 in iM2-PK, and 12.1%, 83.3%, and 0.52% in iFOBT. The diagnostic accuracy of iM2-PK by using AUC was significantly higher than that of iFOBT for diagnosing CRC and adenoma (p&lt; 0.05). In ELISA study, the sensitivity for CRC was 97.5% in iM2-PK, 47.5% in iFOBT, and 80.0% in fecal tumor M2-PK ELISA test. The sensitivity for adenoma was 69.2% in iM2-PK, 19.2% in iFOBT, and 61.5% in fecal tumor M2-PK ELISA test. The sensitivity of iM2-PK for diagnosing CRC was superior to that of iFOBT and M2-PK ELISA test (p&lt; 0.05). Conclusions: iM2-PK is a rapid and cost-effective test for diagnosing CRC and colonic adenoma, and can easily performed in outpatient clinics. iM2-PK is a useful test in screening for CRC and colonic adenoma.
Implementing patient-centered care: Challenges in community oncology.
Authors: Kathleen Clifford, Colleen Tallen, Mary Helen Davis, Tamara Griess, Dan Sayam Zuckerman, Lynne Padgett
Journal: Journal of Clinical Oncology (2012)

192 Background: The newest Commission on Cancer (CoC) standards focus on patient-centered care across the cancer continuum and include palliative care (PC) and psychosocial care (PS). Little is published regarding the challenges of implementing these standards in community oncology settings. To help examine the integration of PC and PS and to identify barriers and best practices, an assessment was conducted by sites selected to take part in the National Cancer Institutes’ Community Cancer Centers Project (NCCCP). Methods: The NCCCP’s goals to improve quality of care and reduce healthcare disparities included goals for expansion of PC and PS services. Volunteers formed workgroups using monthly teleconferences to share best practices and resources. A questionnaire based on the National Quality Forum (NQF) preferred practices was completed (January-April 2012) by 22 of 29 sites. Results: All respondents have inpatient PC available, 65% in the outpatient setting; 39% described PC as an integral part of their cancer program. All have designated outpatient staff providing symptom management and rehabilitation services. Nurse practitioners and physician assistants are used at 78% of the centers. Interdisciplinary staff includes pharmacists and dietitians; integrative/complementary medicine is found in 57% of the centers. All have integrated PS services: social workers are available in 91% of sites, 30% have psychiatrists, and 30% have psychologists. Most perform psychosocial screening using the NCCN Distress Management tool; 74% have standardized processes. Spiritual support is present in 70% of programs, sexual counseling services in 26%. The majority provides bereavement support. 48% have an outpatient advanced directive program. Inpatient hospice beds are available in 52% of the institutions and 22% own a hospice. Conclusions: Challenges remain with implementation of psychosocial screening and care. Programs to address sexual counseling and advanced directives are lacking. Additional efforts are needed to integrate PC services across the cancer continuum. Project funded with federal funds from the NCI, Contract No. HHSN261200800001E.
Incidence and predictors of ovarian function recovery (OFR) in exemestane patients with breast cancer (BC) with chemotherapy-induced amenorrhea (CIA) using two estradiol assays.
Authors: A. Guerrero-Zotano, J. Gavila, E. Folkerd, B. Ortiz, T. Labrador, F. Martinez, A. Garcia, M. A. Climent, V. Guillem, M. Dowsett, A. Ruiz
Journal: Journal of Clinical Oncology (2011)

521 Background: Aromatase inhibitors (AIs) may promote OFR in patients with CIA. True incidence of OFR is unknown partly because estradiol (E2) assays used in the clinical setting lacking sensitivity. We studied incidence and predictors of OFR measuring E2 by a clinical assay (direct) or by a highly sensitive (indirect) immunoassay, together with other markers of ovarian reserve. Methods: Prospective exploratory study in ER positive BC patients, who had CIA lasting at least two years and postmenopausal E2 levels, while on tamoxifen. Patients received exemestane and underwent assessments of E2 (indirect and direct assay), FSH, antimullerian hormone (AMH), and antral follicule count (AFC) at baseline and at month 1, 3 and 6. We considered OFR if: resumption of menses, or developed (i) both E2 levels inconsistent with postmenopausal women on AI (indirect: >8 pmol/L; direct >165 pmol/L) and FSH (<26 IU/L) levels), or (ii) frankly non-postmenopausal E2 values (indirect >55 pmol/L; direct >220 pmol/L). Results: Fifty-three consecutive patients were enrolled; median age: 48y (41-55). By indirect assay, 15 patients (28.3%; CI95%:16.1-40.4) had OFR, (11 menses, 4 OFR without menses). By direct assay 14 had OFR (11 menses, 3 OFR without menses). Mean time to OFR by indirect assay was 5.7 months (CI95%: 3.1-8.3) and 6.4 months (CI95%: 3.7-9.1) by direct assay. There was no difference in baseline E2 levels among those who recover or not OFR. Mean age was the only baseline marker different between patients who had OFR or not (45.7 vs 49.1 years, t-test p<0.0001). In patients ≤48 years (n=26) rate of OFR was 46%. AMH at baseline was below detection limit in all patients and it did not change during exemestane. Baseline and serial values for AFC were not different among patients who had OFR or not. Conclusions: There is a high incidence (28%) of OFR, in patients with CIA treated with AIs, especially in women ≤48y. The two E2 assays showed similar incidence of OFR and time to OFR, despite having markedly different performance characteristics. AMH was not helpful in defining ovarian reserve and likelihood of OFR.
Knowledge of the French population on colorectal cancer screening: Data from the EDIFICE 3 survey.
Authors: Jérôme Viguier, Yvan Coscas, Chantal Touboul, Jean F. Morere, Jean-Yves Blay, Xavier B. Pivot, Christine Lhomel, François Eisinger
Journal: Journal of Clinical Oncology (2013)

352 Background: In France, following a pilot population-based screening program in 2002-2003, a national organized program targeting 17 million people was progressively implemented from 2005 to 2009. EDIFICE surveys are iterative polls focusing on cancer screening behavior. The EDIFICE 3 survey was conducted in 2011 and partly dedicated to knowledge of the colorectal cancer screening process. Methods: This third nationwide observational study, EDIFICE 3, was conducted via phone interviews among a representative sample of 946 subjects aged between 50 and 74 years, who had never been treated for cancer. 59% of the population declared having undergone colorectal cancer screening (fecal test or colonoscopy). Results: Interviewed about the screening process, 510/946 (54%) of the French population were unaware of the procedure after a positive fecal test and 782/946 (83%) were unaware of how soon a new test should be performed after a negative result. Only 79/946 (8%) were aware of what to do after either a positive or a negative test and 47% in one out of the two cases. 84% of subjects over assessed (by a factor 2 to 10) the probability of having cancer after a positive test. In contrast, 65% were aware of the possibility of a false negative test. Only 3% of our sample know both the right screening agenda (every other year) and the need for a colonoscopy after a positive test. Neither gender, educational level and socio economic level significantly impacted the rate of right answers. Conclusions: This study demonstrates a lack of detailed knowledge on the colorectal cancer screening process in the French national program. This raises the issue of the fairness of the process (an ethical issue) and may be a reason for the current poor uptake (an effectiveness issue). This should be tackled by improving the transmission of information, preferentially via general practitioners, institutional letters sent directly to subjects (in our survey these two media were found to be readily accepted) and lay press.
Computed aided classification of circulating tumor cell and CK+ subclasses.
Authors: Oleg Gusyatin, David Tims, Aladin Milutinovic, Chunsheng Jiang
Journal: Journal of Clinical Oncology (2012)

54 Background: Fluorescence microscopy imaging system (OnQView, On-Q-ity, Waltham, MA) in combination with advanced cell capture techniques (OnQChip, On-Q-ity, Waltham, MA) provides necessary sensitivity to detect circulating tumor cells (CTCs) in a blood sample. The detection process involves automatic identification of CTC candidates from the collected imagery followed by CTC subclass identification. Subclass identification process is manual and usually leads to increased sample processing time. Methods: We have developed a fully automated CTC detection and classification system allowing for substantial increase in throughput while maintaining high sensitivity and specificity. Detection is accomplished by a robust segmentation technique. A set of 25 image-based features is automatically computed for each detected candidate. Features include texture measurements, morphology measurements, multichannel intensity and contextual characteristics. All CTC subclasses as well as artifact classes are manually labeled and verified by trained imaging technologists.A hierarchy of Multi-Layer Perceptron Neural Network (MLPNN) classifiers is then trained and used to identify and reject artifacts and to identify CTC subclasses. Results: A total of 27 prostate cancer patients and 33 normal controls with two 3.75ml blood samples per patient were used to validate techniques. Probability of successful artifact rejection was achieved to be 0.78 and probabilities of subsequent successful CTC subclass identification ranged between 0.79 and 0.98 (intact CTCs = 95%; irregular CTCs = 98%; fragmented CTCs = 82%). Conclusions: A fully automated CTC detection and classification system was developed. Testing was conducted with 27 prostate cancer patients and 33 normal controls to yield an artifact rejection probability of 0.78 and CTC subclass identification probabilities of 0.79 to 0.98.
Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup
Authors: Lakhmir S. Chawla, Rinaldo Bellomo, Azra Bihorac, Stuart L. Goldstein, Edward D. Siew, Sean M. Bagshaw, David Bittleman, Dinna Cruz, Zoltan Endre, Robert L. Fitzgerald, Lui Forni, Sandra L. Kane-Gill, Eric Hoste, Jay Koyner, Kathleen D. Liu, Etienne Macedo, Ravindra Mehta, Patrick Murray, Mitra Nadim, Marlies Ostermann, Paul M. Palevsky, Neesh Pannu, Mitchell Rosner, Ron Wald, Alexander Zarbock, Claudio Ronco, John A. Kellum
Journal: Nature Reviews Nephrology (2017)

Acute kidney injury (AKI) and chronic kidney disease are increasingly recognized as interconnected entities and the term acute kidney disease (AKD) has been proposed to define ongoing pathophysiologic processes following an episode of AKI. In this Consensus statement, the Acute Disease Quality Initiative 16 Workgroup propose definitions and staging criteria for AKD, and strategies for the management of affected patients. They also make recommendations for areas of future research with the aims of improving understanding of the underlying processes and improving outcomes. Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD) and these definitions are now routinely used in research and clinical practice. The KDIGO guideline defines AKI as an abrupt decrease in kidney function occurring over 7 days or less, whereas CKD is defined by the persistence of kidney disease for a period of >90 days. AKI and CKD are increasingly recognized as related entities and in some instances probably represent a continuum of the disease process. For patients in whom pathophysiologic processes are ongoing, the term acute kidney disease (AKD) has been proposed to define the course of disease after AKI; however, definitions of AKD and strategies for the management of patients with AKD are not currently available. In this consensus statement, the Acute Disease Quality Initiative (ADQI) proposes definitions, staging criteria for AKD, and strategies for the management of affected patients. We also make recommendations for areas of future research, which aim to improve understanding of the underlying processes and improve outcomes for patients with AKD.
Effectiveness and safety of valrubicin in non–muscle-invasive bladder cancer following reintroduction: Results from a medical chart review study.
Authors: Michael S. Cookson, Christine Francis Lihou, Samira Q. Harper, Thomas Li, Surya Chitra, Ronald Tutrone
Journal: Journal of Clinical Oncology (2013)

296 Background: Valrubicin was approved in the United States in 1998, removed from the market in 2002 because of manufacturing issues, and reintroduced in 2009. We report secondary outcomes and concomitant medication use from a US multicenter, observational, retrospective study. Methods: Medical records of adult patients with non–muscle-invasive bladder cancer (NMIBC) who used valrubicin were abstracted (March–September 2011). Kaplan-Meier analyses were performed for disease-free survival (DFS), progression-free survival (PFS), worsening-free survival (WFS), cystectomy-free survival (CFS), and time to cystectomy. Results: 113 patients (mean age, 73.7 years) received intravesical valrubicin (median, 6 instillations [range, 2–18]). 107 patients (94.7%) received &gt;3 instillations; 97 (85.8%) completed the full course of therapy (≥6 instillations). DFS was 51.6% (95% CI, 40.9%–61.3%) at 3 months, 30.4% (95% CI, 20.4%–41.1%) at 6 months, and median DFS was 3.5 months (95% CI, 2.5–4.0). PFS was 97.6% (95% CI, 90.9%–99.4%) at 3 months, 87.2% (95% CI, 75.4%–93.5%) at 6 months, and median PFS was 18.2 months (95% CI, 17.2–19.0). WFS was 47.4% (95% CI, 37.2%–57.0%) at 3 months and 28.1% (95% CI, 18.8%–38.2%) at 6 months. CFS was 98.0% (95% CI, 92.2%–99.5%) at 3 months and 93.7% (95% CI, 85.2%–97.4%) at 6 months. Median CFS was not reached; only 13.3% of patients underwent radical cystectomy after starting valrubicin. 56 patients (49.6%) experienced ≥1 local adverse reaction; the most common were hematuria and pollakiuria (both 17.7%), micturition urgency (15.9%), and bladder spasm (14.2%). 55 patients (48.7%) used ≥1 concomitant medication for local adverse reactions; the most commonly used were urinary antispasmodics (21.2%), fluoroquinolones (14.2%), and other urologicals (14.2%). Conclusions: In patients with NMIBC treated with intravesical valrubicin, median DFS and PFS were 3.5 and 18.2 months, respectively, and median CFS was not reached as only 13% of patients underwent radical cystectomy. Valrubicin was well tolerated, and most patients received the full course of 6 instillations. Funding: Research and abstract were supported by Endo Pharmaceuticals Inc.
Plasma Hemoglobin and Heme Trigger Weibel Palade Body Exocytosis and Vaso-Occlusion in Transgenic Sickle Mice
Authors: John D Belcher, Julia Nguyen, Chunsheng Chen, Ann Smith, Abdu I Alayash, Sethu L Nair, Arif Somani, Robert P Hebbel, Gregory M Vercellotti
Journal: Blood (2011)
The use of FDG-PET to guide consolidative radiotherapy in patients with advanced-stage Hodgkin lymphoma with residual abnormalities on CT scan following ABVD chemotherapy.
Authors: K. J. Savage, J. M. Connors, R. J. Klasa, P. Hoskins, T. N. Shenkier, R. D. Gascoyne, S. Bhimji, T. Pickles, F. Benard, D. Wilson, L. H. Sehn
Journal: Journal of Clinical Oncology (2011)

8034 Background: Consolidative radiotherapy (RT) is frequently administered following chemotherapy (CHT) for advanced stage Hodgkin lymphoma (HL) patients who have bulky disease at diagnosis and/or residual abnormalities on post-CHT CT imaging. The GHSG HD15 trial has recently shown that RT can be omitted in cases that have residual disease on CT imaging following BEACOPP-based CHT but are FDG-PET-negative (PET-neg). However, it is unknown whether this also applies to patients treated with ABVD CHT and to those with initial bulky disease. Further, the effectiveness of RT for cases that are PET positive (PET-pos) following ABVD CHT remains unclear. Methods: Since July 2005, adult (> 16 y) patients in British Columbia (BC) with advanced stage HL (stage III /IV and/or the presence B symptoms and/or bulky disease [> 10cm]) have been recommended to undergo FDG-PET imaging if residual abnormalities > 2 cm are seen on the post CHT CT scan. If the PET scan was negative, patients were observed, regardless of initial disease bulk. If the PET scan was positive RT was administered, if feasible. Results: In total, 163 patients responding patients have had a PET scan following curative intent ABVD or equivalent CHT: PET-neg 80% (n=130); PET-pos 19% (n=31); PET-indeterminate 1% (n=2). Patient characteristics include: M:F 1:1.04; median age, 31 y (17-76 y); stage II, 52%; bulky disease, 50%; B symptoms, 68%; IPFP Prognostic score > 3, 15%. With a median follow-up of 34 months, patients with a PET-neg scan post CHT have a far superior 3-year TTP compared to those with a PET-pos scan (89% vs 55%, p= .00001). In the PET-neg patients, there was no difference in the 3-year TTP in those with bulky vs non-bulky disease at diagnosis (86% vs 91%, p=.71). In the PET-pos group, 25 (81%) received the planned RT and of these, 10 (40%) have relapsed. Conclusions: Advanced stage HL patients with a negative PET scan following ABVD CHT are at low risk of relapse and do not routinely require additional consolidative RT thus avoiding potential long-term side effects. Although some patients with a positive PET-scan remain disease free after consolidative RT, a high proportion ultimately relapse.