tbuckley/cabot-search huggingface dataset:
Racial differences in early-stage colorectal cancer outcomes and prognostic factors.
Authors: J. D. Acoba, C. D. K. Chong
Journal: Journal of Clinical Oncology (2011)

1564 Background: Despite improvements in colorectal cancer treatment, racial disparities in survival persist. This is particularly disturbing for patients with early stage, potentially curable cancers. We performed a comprehensive analysis to evaluate outcomes and prognostic factors among racial groups with a focus on Whites (W), Asians (A), and Native Hawaiians/Pacific Islanders (NH). Methods: Data from 3150 consecutive stage I-III colorectal cancer patients were collected from hospital tumor registries between 1990 and 2007. Multivariable Cox proportional hazards regression models for survival were built for race, age at diagnosis, stage, histologic grade, tumor location (colon vs. rectum), systemic treatment, and insurance status for the entire study population and separately for each race. Results: NH patients were significantly younger than W (p < 0.0005) with a higher ratio of rectal to colon cancers, (p<0.0005). NH were more likely to be uninsured or underinsured (18%) compared to A (2%) or W (5%), (p<0.0005). There were no racial differences in stage at diagnosis, yet NH more often received adjuvant chemotherapy (p=0.002). Multivariate Cox regression revealed that NH race adversely impacted survival even after adjusting for age, stage, grade, tumor location, treatment and insurance status [HR 1.5 (1.1-2.1, 95% CI)]. Stage and age were prognostic for all races, however grade was prognostic only for A (p=0.01) and NH (p<0.0005) patients. Insurance status significantly affected outcomes of W patients (p=0.025) but not A or NH. Furthermore, the use of chemotherapy was a favorable prognostic factor for A (p<0.0005) patients but had no significant impact on survival of W or NH. Conclusions: NH patients with early stage colorectal cancer have significantly shorter survival than A or W despite high rates of adjuvant chemotherapy. Prognostic factors for early stage colorectal cancer are unique for each racial group. These findings suggest that differences in prognosis among racial groups cannot be completely explained by demographics and clinical and pathological tumor features. Variations in molecular tumor characteristics among W, A, and NH patients should be explored.
Gene Expression Analysis of Peripheral T-Cell Lymphoma Not Otherwise Specified Reveals the Existance of Two Subgroups Related to Different Cellular Counterparts and Recurrent PDGFRA Deregulation.
Authors: Pier-Paolo Piccaluga, Claudio Agostinelli, Simona Zupo, Andrea Califano, Philip Went, Stefano Ascani, Katia Basso, Fabio Facchetti, Brunangelo Falini, Manlio Ferrarini, Andrea Gallamini, Ulf Klein, Domenico Novero, Marco Paulli, Sante Tura, Pier Luigi Zinzani, Michele Baccarani, Riccardo Dalla-Favera, Stefano A. Pileri
Journal: Blood (2005)
Integration of survivorship care in community oncology practice.
Authors: Michele Renee O’Brien, Kimberly Ness, Aimee Arlen, Rowena Schwartz, Jackie Foster, Mark D. Sborov
Journal: Journal of Clinical Oncology (2012)

33 Background: Each of the 12 million cancer survivors in the United States has unique needs, giving oncology providers the opportunity to address survivorship issues and optimize care. Minnesota Oncology, a community oncology practice, has implemented a survivorship program that evaluates patient specific issues through a series of clinic visits guided by results from the Functional Assessment of Chronic Illness Therapy (FACIT) quality of life assessment tool. Methods: Survivorship care is initiated at diagnosis. After determining the treatment plan, a one hour survivorship visit with a midlevel provider is dedicated to patient concerns and quality of life. Additionally, visits are scheduled at the time of treatment completion and 3-6 months later. The frequency and focus of visits is determined by the patient. Patients complete the FACIT assessment on an electronic tablet in the clinic, immediately prior to scheduled visits. This tool addresses physical, social, emotional and functional well-being, and takes 5-7 minutes to complete. A report of patient specific information is generated for providers to guide each visit, and ultimately to coordinate additional referrals for care. Patient satisfaction is measured at each visit and via a follow up survey. Results: A total of 152 patients (168 visits) have taken the FACIT survey from January 1 – June 30, 2012. Average FACIT general raw scores at baseline, treatment conclusion and 3-6 months following completion were 77.6 (n=121), 76.9 (n=37) and 82.3 (n=10), respectively. Median patient age was 59 (range 22-84). Breast cancer (n = 44) was the most common diagnosis seen and initial visit disease status was: stage I (n = 28), II (n = 37), III (n = 43), IV (n = 36). As a result of the surveys and/or clinic visits referrals to social work, dietician, rehab and counseling have occurred. Conclusions: Attention to survivorship issues is essential to provide comprehensive care to those affected by cancer. Early intervention should consider disease state along with patient specific factors. Following a standard method for addressing survivorship issues allows for cancer care referral coordination. Benefits of adopting a survivorship program include improvement in quality of care and patient satisfaction.
Development of Smilow's EPIC ambulatory dashboard and the impact on bar code scanning compliance at care centers.
Authors: Stephanie Buia Amport, Lisa Shomsky, Catherine A. Lyons, Roberta Sterling, Mandeep Smith, Nancy Beaulieu, Diane Corjulo, Kerin B. Adelson, Anne C. Chiang
Journal: Journal of Clinical Oncology (2014)

166 Background: Barcode scanning of patient wristbands is a critical stop-gap to prevent administration errors. After EPIC go-live and the implementation of barcode scanning, we created 10 EPIC-based metric reports including scanning compliance. Prior to having reports, our clinical leadership relied on variable qualitative feedback on scanning rates. Our AIM was to reach 90% patient barcode scanning compliance by Feb, 2014 and 95% by Aug, 2014 across Smilow Cancer Hospital Care Centers of Yale-New Haven Hospital. Methods: To engage staff, we shared data on the importance of barcode scanning, compliance and related adverse event reports. Staff reported challenges with scanning patients. We engaged pharmacy leadership to rectify barcode mapping errors. Leadership shared the expectation that all patients would be scanned, that there would be spot checks to prevent workarounds, that staff would be accountable for their own performance and that of their peers, remediation plans for areas &lt;90% compliant and use of a dashboard for employee and medication specific reports. Results: Monitoring, feedback, competition, and improved scanning equipment led to compliance increasing form 89% to 99%. Conclusions: Staff input, detailed reports and workflow review were needed for successful barcode scanning implementation. Staff knowledge that compliance was monitored, communicating improvement, and competition were required for incentive to change practice. Leaders encouraged a culture of safety by ensuring staff feedback was addressed and issues were resolved.Interdisciplinary teamwork between nursing, pharmacy, education and products was necessary to improve barcoding capability.EPIC-based metric reports can drive awareness of and improvement in quality metrics to ensure safe patient-care. [Table: see text]
Improved Patient-Reported Outcomes with a Film-Coated Versus Dispersible Tablet Formulation of Deferasirox: Results from the Randomized, Phase II E.C.L.I.P.S.E. Study
Authors: Ali T. Taher, Raffaella Origa, Silverio Perrotta, Alexandra Kouraklis, Giovan Battista Ruffo, Antonis Kattamis, Ai-Sim Goh, Annelore Cortoos, Vicky Huang, Marine Weill, Raquel Merino Herranz, John B. Porter
Journal: Blood (2016)
An academic prospective single-arm phase II clinical trial for evaluation of advanced functional neuroimaging and molecular markers during bevacizumab/irinotecan therapy for recurrent malignant glioma.
Authors: M. Hutterer, M. Nowosielski, T. Gotwald, D. Putzer, D. Waitz, H. Maier, A. Muigg, H. Kostron, G. Stockhammer
Journal: Journal of Clinical Oncology (2010)

TPS153 Background: Bevacizumab has been approved by the FDA for treatment of recurrent GBM. Standard MRI using Macdonald criteria is insufficient to adequately predict response to antiangiogenic treatment. The main goal of this study is to prospectively evaluate neuroradiological and nuclear medical imaging markers predictive for response to bevacizumab/irinotecan treatment in malignant glioma patients using advanced MRI and PET techniques. The second goal is to identify biomarkers in glioma tissue and blood relevant to bevacizumab/irinotecan treatment. Methods: This is an academic, prospective, single-arm, phase II clinical trial recruiting 35 patients presenting with a first or second tumor recurrence/progression of a histologically confirmed malignant glioma WHO grade III-IV who failed standard therapy. Patients will be treated biweekly with bevacizumab 10 mg/kg and irinotecan 125 or 340 mg/m2. Clinical and biochemical evaluation will be performed every second week, neuroradiologic follow-up every 8 weeks. The primary endpoint of the clinical trial is to determine imaging response criteria during bevacizumab/irinotecan treatment assessed by MRI, using standard MRI T1/T2 sequences, diffusion and perfusion MRI, T1-dynamic and MR-spectroscopy, and PET using 18F-fluoroethyltyrosine (18F-FET) and 18F-fluorothymidine (18F-FLT). The goal of the translational part is to evaluate the predictive and prognostic value of tumor vascularization and the expression of angiogenic pathway molecules (VEGF/VEGFR1-3, PDGF/PDGFR-α/β, c-KIT, Angiopoietin-1/2, DLL4, Gas6/Axl) in patients with malignant glioma treated with bevacizumab/irinotecan, assessed on glioma tissue using immunohistochemistry and blood by ELISA. No significant financial relationships to disclose.
Bendamustine in combination with fludarabine and rituximab: A novel nonmyeloablative conditioning for allogeneic stem cell transplantation (AST) in patients with lymphoid malignancies.
Authors: I. F. Khouri, R. Saliba, M. Korbling, A. M. Alousi, U. R. Popat, P. Anderlini, P. Kebriaei, M. Qazilbash, R. E. Champlin, R. L. Bassett
Journal: Journal of Clinical Oncology (2011)

e18511 Background: We previously reported the use of fludarabine, rituximab and cyclophosphamide as a nonmyeloablative conditioning for lymphomas (Khouri et al, Blood 2008;111:5530). Bendamustine is a novel compound which was found to be effective in pts who failed to respond to alkylating agents. In order to improve outcomes in AST, we substituted cyclophosphamide with bendamustine in the conditioning. Methods: Bendamustine was given iv in an escalated dose of 70, 90, 110, 130 mg/m2 daily on days -5 to - 3 prior to AST, together with 30 mg/m2 of fludarabine given on the same days. Rituximab was given at a dose of 375 mg/m2 on day –13 and 1000 mg/m2 on days -6, +1, and +8, as previously described. Tacrolimus and methotrexate was used for GVHD prophylaxis. In addition, thymoglobulin of 1 mg/kg was given on days -2, -1 in pts receiving an unrelated donor Results: The study included 16 pts (Mantle cell=5 , Follicular =4,CLL=4, Large cell=3). Median age was 58 yrs. Median prior treatments was 3 . At transplant, 8 pts (50%) were in CR, 6 (37%) in PR, and 2 pts (13%) had stable disease. Twelve pts (75%) received their transplants from HLA-compatible siblings and 4 (25%) from unrelated donors. The number of pts who received the 70, 90, 110, 130 mg/m2 daily doses of bendamustine were 2, 3, 3, and 8 pts, respectively. Nine pts (56%) did not nadir to an ANC< 500, and 13 (81%) did not experience a platelet count < 20,000/mm3. Median donor T cells at day 30 was 70%. Two pts developed acute GVHD (none > grade2 ); 2/13 evaluable pts had chronic GVHD. With a median follow-up time of 6 months (range, 3-20 months), the OS and PFS rates were 87% and 78%, respectively. Fungal infection was the cause of the only death observed. The maximal grade of other observed toxicities was 3. No DLT was observed. Conclusions: Our results represent the first report to suggest that combining bendamustine at a dose up 130 mg/m2 daily x 3 days, together with fludarabine and rituximab is safe and constitutes a well tolerated conditioning for AST. We are treating pts with this regimen in the outpatient setting. The study is currently ongoing to verify its safety and assess its efficacy in a larger cohort of pts.
Phase II trial of subcutaneous methylnaltrexone in the treatment of severe opioid-induced constipation in cancer patients.
Authors: M. Mori, T. Ashikaga, S. M. Grunberg
Journal: Journal of Clinical Oncology (2011)

TPS236 Background: Opioid-induced constipation (OIC) is mainly caused by binding of opioids to mu-opioid receptors in the gastrointestinal system, which affects gastrointestinal motility, secretion, fluid absorption and blood flow, and causes delayed colonic transit and inhibited defecation. Methylnaltrexone bromide is a peripherally-acting antagonist of the mu-opioid receptor. It has recently been approved by the U.S. Food and Drug Administration for treatment of OIC in patients with advanced disease receiving palliative care. However, its clinical utility has not been documented in cancer patients at earlier stages of disease. Methods: The objective of this prospective, single-arm, phase II trial is to evaluate the efficacy of methylnaltrexone in relieving OIC in cancer patients at earlier stages of disease. The primary endpoint is a rescue-free laxation ≤ 4 hours after the dose. Eligible for enrollment are cancer patients at earlier stages of disease with life expectancy ≥ 6 months and OIC with < 3 laxations during the preceding week and no clinically meaningful laxation (as determined by the investigators) ≤ 24 hours before the study entry. A single dose of methylnaltrexone will be administered subcutaneously to eligible patients. The efficacy and adverse events will be evaluated for 48 hours. Patients will complete questionnaires on laxation (frequency, consistency and difficulty), constipation (severity and distress), pain score, symptoms of opioid withdrawal, and satisfaction with the response at 4, 24 and 48 hours following the dose. 17 subjects are required assuming a baseline response rate of 15% against an alternative value of 50% using an exact binomial test with a two-tailed Type I error level of 10% and a power level of 90%. To date 5 patients have been enrolled. Obstacles to enrollment have included the multi-factorial nature of constipation in cancer patients which makes the detection of OIC difficult, initiation of various empirical treatments for OIC in patients who would otherwise be eligible, and lack of timely referral of potentially eligible patients because of poor awareness of supportive care trials. (NCT01004393)
Circulating tumor cell (CTC) as a clinical marker in malignant pleural mesothelioma (MPM).
Authors: F. Tanaka, K. Yoneda, N. Kondo, M. Hashimoto, T. Takuwa, S. Matsumoto, S. Hasegawa, Y. Okumura, T. Tsujimura, K. Fukuoka, T. Nakano
Journal: Journal of Clinical Oncology (2011)

10572 Background: Circulating tumor cell (CTC), a surrogate of distant micro-metastasis, is potentially useful in the diagnosis of malignant tumors, but its clinical significance in malignant pleural mesothelioma (MPM) remains unknown. The “CellSearch” system is a reliable detection system designed for capturing CTCs of epithelial origin with an antibody against epithelial call adhesion molecule (EpCAM), and in our previous examination, expression of EpCAM was positive in around 50% of MPM tissue samples. Following a promising result of our preliminary study showing the diagnostic value of CTC in MPM (Tanaka F. et al ASCO2008), we conducted a prospective study to evaluate the diagnostic capability and the relation to the clinical outcome. Methods: Patients who presented at our institute with suspicion or diagnosis of MPM were eligible in this study. CTCs in 7.5mL of peripheral blood were captured and quantitatively evaluated with the “CellSearch” system without knowledge of clinical characteristics of each case. Results: Among 170 eligible cases, 137 were finally diagnosed as having MPM and 33 as nonmalignant diseases (NM). CTC was positive (CTC-count, one or more) in 38% (52/137) of MPM cases, and was also positive in 9% (3/33) of NM cases. (p=0.024) CTC-count was significantly higher in MPM (range, 0-27) than in NM (range, 0-1; Mann-Whitney's p=0.019), but receiver operating characteristic (ROC) curve analysis failed to show a significant diagnostic performance of the CTC-test in discrimination between MPM and NM with the area under curve (AUC) of 0.599 (95% confidence interval [CI], 0.501-0.696; p=0.079). The sensitivity and specificity of the CTC-test were 28% and 91%, respectively. In MPM patients, CTC positivity (≥P) and CTC-count significantly increased with tumor progression (p=0.037 and p=0.029, respectively). However, CTC-positivity was not correlated with the prognosis (mean survival time [MST], 427days and 446days for CTC-positive and CTC-negative patienst, respectively; p=0.957). Conclusions: CTC can be detected in the peripheral blood in a small subset of MPM patients, but the CTC-test with the current “CellSearch” system provided no significant clinical value.
Increased cholesterol synthesis via squalene monooxygenase to predict lethal prostate cancer.
Authors: Konrad Hermann Stopsack, Travis Gerke, James Robert Cerhan, Lorelei A. Mucci, Jennifer R. Rider
Journal: Journal of Clinical Oncology (2016)

77 Background: Prostate cancer cells rely on cholesterol for proliferation and androgen production. We recently demonstrated that increased expression of the second key enzyme of cholesterol synthesis, squalene monooxygenase (SQLE), is associated with higher prostate cancer-specific mortality (PCSM). We here validate findings in two additional prospective studies and investigate putative mechanisms. Methods: We analyzed the prospective prostatectomy cohorts within the Health Professionals Follow-up Study (HPFS) and the Physicians’ Health Study (PHS) as well as initially expectantly managed patients in the Swedish Watchful Waiting Study (SWWS). 258 lethal cancer cases and 469 patients who survived &gt; 8 years without metastases were included. SQLE mRNA was measured in tumor specimens at diagnosis of all patients and in benign prostate tissue of 197 patients. Markers of tumor angiogenesis were assessed via immunohistochemistry in 169 HPFS patients. We estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. Results: Higher SQLE expression was confirmed to be predictive of higher PCSM in the validation prostatectomy cohort PHS. Combining the two prostatectomy cohorts, men with high SQLE expression ( &gt; 1 standard deviation above the mean) were 6.7 times (95% CI, 2.9 to 15.8; p &lt; 0.001) more likely to die from their cancer compared to men with the mean level of SQLE expression. A 10% higher ratio of SQLE mRNA expression in tumor vs. benign prostate tissue of the same patient was predictive of 42% higher PCSM (95% CI, 15% to 74%). Higher SQLE expression was strongly associated with increased angiogenesis markers (all p ≤ 0.001). This increased risk associated with high SQLE expression was not modified by statin use (p ≥ 0.52). In initially untreated patients in SWWS, a more modest association of tumor SQLE expression with PCSM was observed (p = 0.047). Conclusions: SQLE, the second rate-limiting enzyme of cholesterol synthesis, is associated with prostate cancer progression. Its expression at cancer diagnosis is predictive of lethal disease both after curative-intent prostatectomy and in a watchful waiting setting, possibly by facilitating micrometastatic disease.
Unexpected cutaneous toxicity of IGEV regimen in patients with Hodgkin lymphoma.
Authors: E. Paszkiewicz-Kozik, J. Romejko-Jarosinska, B. Brzeska, W. Osiadacz, M. Swierkowska-Czeneszew, M. Osowiecki, A. Druzd-Sitek, J. Tajer, E. Wojciechowska-Lampka, J. A. Walewski
Journal: Journal of Clinical Oncology (2011)

e18543 Background: IGEV (ifosfamide, gemcitabine, vinorelbine, and prednisolone) is an active regimen increasingly used in relapsed/refractory Hodgkin lymphoma (HL) before autologous stem cell transplantation with CR and adequate CD34+ cell collection rate of more than 50% and 90%, respectively. No substantial non-hematological toxicity had been reported so far. Methods: Between December 2009 and October 2010, 12 patients (pts): 5 female and 7 male, median age of 35, range: 23-51, with refractory HL received IGEV regimen. 10 pts were diagnosed with refractory classical HL NS type, one male pts had HL transformed from follicular lymphoma, one female pts had classical HL partly transformed to diffuse large B-cell lymphoma and additionally received rituximab. Results: Of a total of 44 cycles followed by G-CSF support, 4 (9%) were delayed and dose reduced due to grade 3/4 hematologic toxicity. 6 pts, 5 female and 1 male (50%) experienced cutaneous toxicity including grade 3/4 reactions in 4/6 pts (60%). Skin symptoms included rash, maculopapular pruritic eruptions and vesicular erythema with serous effusion in 2 pts. Lesions were itchy or burning, located on the trunk and extremities. Skin symptoms occurred repeatedly after each cycle and resolved within 10-14 days with glucocorticoid and antihistaminic treatment. In 1 case, IGEV chemotherapy was terminated due to prolonged itching and burning sensations. Of 11 evaluable pts, 7 responded (64%) with CR in 4 pts (36%). Conclusions: Reportedly, rate of cutaneous adverse events related to gemcitabine monotherapy is up to 30%. Unexpectedly high incidence of skin events in our pts might have resulted from peculiar toxic synergy of combination agents. The only clinical characteristic apparently related to skin toxicity of gemcitabine was female sex.