tbuckley/cabot-search huggingface dataset:
Isoflavones in Japanese and Caucasian men with prostate cancer in Hawaii.
Authors: Takashi Fukagai, Hideyuki Akaza, Yoshio Ogawa, Robert Carlile, Thomas Namiki, John Leslie Lederer, Gertraud Maskarinec, Hirokazu Tsuji, Kaoru Moriyama, Kiyohide Fujimoto, Yoshihiko Hirao, Mikio Namiki
Journal: Journal of Clinical Oncology (2014)

241 Background: Recently, several studies have reported that soy isoflavones and the ability to produce Equol, an active derivative of soy isoflavone, may play a role in the suppression of prostate cancer. An Equol-producing bacterium, Slackia sp. strain NATTS has been identified in stool cultures. To further investigate this relationship, we evaluated Japanese-Americans (JA) and whites (W) in Hawaii, with and without prostate cancer, with regards to dietary soy intake, serum isoflavone levels, and the presence of stool NATTS. Methods: The serum levels of Daidzein, Genistein, Glysitein, Dihydrodaidzein (DHD), Equol, o-desmethylangolensin (o-DMA) and total isoflavone was determined in 65 JA (34 patients with prostate cancer , 31 controls) and 68 W (34 patients with prostate cancer , 34 controls) subjects. The control group consisted of age matched cancer-free male subjects. To evaluate Equol producing ability, we assessed the presence of NATTS in stool samples. All subjects completed a lifetime dietary soy consumption survey. Results: The serum level of Genistein and o-DMA were significantly higher in JA (Genistein: W 21.5±54.0, JA 61.8±150.9, p=0.04; o-DMA: W 0, JA 2.0±7.9, p=0.04). Daizein level trended higher in JA (W 13.9±34.7, JA 33.3±84.0, p=0.09). Glysitein level was significantly higher in W (W 35.7±10.4, JA 30.7±15.5, p=0.03). No differences were noted in DHD and Equol levels between W and JA. Total isoflavone level trended higher in JA (W 76.3±104.9, JA 135.1±245.6, p=0.07). There were no differences in serum isoflavone level between prostate cancer patients and controls for both JA and W. Only 10 of 120 stool samples were positive for NATTS (8.6%), a rate much lower than seen in Japan. JA showed higher intake of soy than W. Conclusions: The high soy consumption and isoflavone levels in JA may be related to the observed lower incidence of prostate cancer relative to W in Hawaii. The near absence of equal producers in Hawaii JA may contribute to their higher incidence of prostate cancer compared to Japan based Japanese. These results suggest that both soy isoflavone levels and Equol production may be inversely associated with prostate cancer incidence.
Measuring cost savings of process improvement.
Authors: Alexis Barboza, Elizabeth Rebello, Heidi Wied Albright, Johnny Dang, Jennifer Jones, Wei Zhang, Thomas W. Feeley
Journal: Journal of Clinical Oncology (2013)

196 Background: The aim of the project was to use anesthesia providers in a cancer center to lead process improvements using time-driven activity-based costing (TDABC), a system of measuring process and capacity costs. Methods: The process improvement objectives were centered on eliminating unnecessary patient care processes and improving patient flow. Teams were tasked with planning, process mapping, improving processes, and measuring costs. Projects were done in four anesthesia sites: ambulatory surgery, bone marrow aspiration, pediatric CT and XRT, and cardiopulmonary areas. Results: Process mapping identified areas for improvement and costs before and after the improvement. The Table highlights four project areas’ average total cost and time savings per patient using TDABC methodology. Conclusions: TDABC is a costing methodology that measures the costs of care utilizing process maps. Anesthesia providers had front-line insight in improving process flow and found the process mapping useful to improve processes and measure the cost savings of the improvement. In each area there was improvement or no adverse effect on patient outcomes. This project demonstrates that TDABC illustrates inefficiencies and provides a method to evaluate the cost savings of process improvements. As cancer care reimbursement evolves, the ability to control costs while providing value-based care is essential. [Table: see text]
End-of-life discussions with advanced cancer patients and their effects on bereaved families’ mental health.
Authors: Takashi Yamaguchi, Isseki Maeda, Yutaka Hatano, Masanori Mori, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Tatsuya Morita, Takuhiro Yamaguchi, Maho Aoyama, Mitsunori Miyashita
Journal: Journal of Clinical Oncology (2016)

3 Background: End-of-life (EOL) discussions are important for providing appropriate care to patients with advanced cancer at the end of their life. To explore the relationship between EOL discussions and bereaved families’ mental health, as well as the quality of the patient’s death and quality of care at the end of life. Methods: This was a nationwide questionnaire survey of bereaved families of deceased cancer patients who died at 75 sites (20 inpatient palliative care teams in acute hospitals, 33 palliative care units/inpatient hospices, and 22 outpatient clinics that provide home palliative care service) in Japan. 13,711 bereaved family members of cancer patients who died before January 2014 in each of the participating institutions were potential participants. We evaluated the prevalence and details of EOL discussions which were defined as “a discussion with physicians about the preferred place of death or resuscitation”. We also evaluated the prevalence of depression (defined as the Patient Health Questionnaire-9 ≥ 10) and complicated grief (defined as the Brief Grief Questionnaire ≥ 8) in bereaved families. Results: 9123 questionnaires returned (response rate 67%). Of those, 80.6% had EOL discussions. After propensity score weighted adjustment, bereaved families with EOL discussion less frequently developed depression (17.3% and 21.6% ; P &lt; 0.001) and complicated grief (13.7% and 15.9% ; P = 0.03) than without. There were significant differences in the trend test among families without and in those with EOL discussions &lt; 1, 1–3, and &gt; 3 months before the patient’s death, for the prevalence of depression (21.6%, 20.6%, 16.8%, and 15.5%, respectively; P trend &lt; 0.001) and complicated grief (15.9%, 16.4%, 12.8%, and 12.9%, respectively; P trend &lt; 0.001). Conclusions: EOL discussions may contribute to decrease depression and complicated grief in bereaved families. EOL discussions should be initiated with advanced cancer patients when physicians expect a patient’s prognosis is limited to several months.
Correlation of pretreatment nuclear GLI-1 labeling indices (LIs) with initial SUV (iSUV) in esophageal cancer (EC) patients undergoing trimodality therapy (TMT): A potential pathway to esophageal preservation.
Authors: Roopma Wadhwa, Xuemei Wang, Julie Izzo, Heath D. Skinner, Jeffrey H. Lee, Manoop S. Bhutani, Brian Weston, William A. Ross, Wayne Lewis Hofstetter, Dipen M. Maru, David C. Rice, Kazuki Sudo, Hironori Shiozaki, Mariela A. Blum, Qiongrong Chen, Jiankang Jin, Shumei Song, Veera Baladandayuthapani, Jaffer A. Ajani
Journal: Journal of Clinical Oncology (2014)

18 Background: For the purpose of understanding clinical behavior of EC, imaging and biomarkers have not been correlated. We attempted to correlate iSUV with a variety of biomarkers (NF-kB, SHH, ALDH1, ABCB1, survivin, and BCRP) including pre-treatment nuclear Gli-1 LIs in patients with EC who had undergone TMT. Methods: 128 patients were analyzed. The iSUV and pre-treatment nuclear Gli-1 LIs were assessed among others. Post-treatment residual cancer status in the resected specimen was also correlated (P0=0% residual cells, P1=1-50% residual cells, and P2=&gt;50% residual cells) with iSUV and nuclear Gli-1 LIs. The Kruskal-Wallis test was performed to find correlations between (1) iSUV and P status; and (2) between nuclear Gli-1 LIs and P status. Results: The Pearson’s correlation coefficient between iSUV and nuclear Gli-1 LIs was 0.21 (p = 0.02). Pre-treatment nuclear Gli-1 LIs were strongly associated with the P status (p&lt;0.0001) but iSUV was not (as has been reported in the literature; PMID: 17532577, 23247658, and 23994746). iSUV, most likely, is not correlative with the P status because of its narrow range compared to that of nuclear Gli-1 LIs.Conclusions: Our data, for the first time, demonstrate that iSUV can be a surrogate for pre-treatment nuclear Gli-1 LIs in EC. This correlation can be exploited in the development of predictive strategies for esophageal preservation. Pre-treatment nuclear Gli-1 is a strong candidate for the biomarker-based predictive model(s). From U. T. M. D. Anderson Cancer Center (UTMDACC), Houston, Texas, USA. Supported by UTMDACC Multidisciplinary Research Grants, CA138671, CA172741, and CA129926 From the NCI (JAA), and Generous Donors. [Table: see text]
Randomized phase II study of mixing steroid to reduce venous pain in patients with colorectal cancer receiving oxaliplatin through peripheral vein (APOLLO study).
Authors: Taishi Hata, Akihiro Toyokawa, Michiya Kobayashi, Masakazu Miyake, Masahiro Tsuda, Kazutoshi Tobimatsu, Ken Okamoto, Yukihiko Tokunaga, Kozo Takase, Satoshi Morita, Junichi Sakamoto, Hideyuki Mishima
Journal: Journal of Clinical Oncology (2013)

474 Background: Although theCapeOX (capecitabine+oxaliplatin) regimen obviates the need for a central venous port, administration of oxaliplatin through peripheral vein can cause venous pain. One of the reasons is pH. The pH level of oxaliplatin solution is about 4.8 and that of buffered by steroid is approximately 7.0. To test the hypothesis that adjusting the pH of oxaliplatin solution by mixing steroid can reduce venous pain, we have conducted the randomized control study to compare pH-adjusted oxaliplatin solution with unadjusted oxaliplatin solution. Methods: This was a single-blinded multicenter randomized phase II study. Colorectal cancer patients receiving oxaliplatin through peripheral vein were enrolled and randomly assigned to arm A (oxaliplatin 130 mg/m 2 with dexamethasone (DEX) 2 mg) or arm B (the same, without DEX) (UMIN000004286. Venous pain was evaluated according to CTCAE criteria (ver. 4.0) and the verbal rating scale (VRS). Assessments were conducted every 3 weeks until cycle 4. Results: A total of 53 patients (38 men and 15 women; median age, 67 y.o.) were enrolled at 9 institutions in Japan. Of these, 47 evaluable patients were randomized to either arm A (n = 24) or arm B (n = 23). The incidence of venous pain (grade ≥ 2) was 33.3% in arm A and 60.9% in arm B (relative risk 0.55; p = 0.082). The venous pain (VRS score ≥ 3) was 12.5% in arm A and 26.1% in arm B (relative risk 0.48; p = 0.286). No difference was observed in response rate and safety. Conclusions: Adjusting the pH of oxaliplatin solution by addition of a low dose of DEX reduced severe venous pain without influence on response rate and safety. Clinical trial information: UMIN000004286. [Table: see text]
Quality of life and symptoms in long-term survivors (LTS) of colorectal cancer (CRC): Results from NSABP protocol LTS-01.
Authors: H. Kunitake, P. Zheng, G. A. Yothers, S. R. Land, L. Petersen, L. Fehrenbacher, J. K. Giguere, D. L. Wickerham, C. Y. Ko, P. A. Ganz
Journal: Journal of Clinical Oncology (2010)

9035 Background: Little is known about health-related quality of life (HRQL) in LTS of CRC. The NSABP LTS-01 surveyed CRC survivors previously treated on NSABP adjuvant trials (Protocols C-05, C-06, C-07, R-02, R-03). (See Ganz et al. J Cancer Surviv (2009)3:137-47.) Methods: Long-term CRC survivors (≥ 5 years) were recruited from 60 NSABP study sites. After obtaining informed consent, a telephone survey was administered. The survey battery included standardized measures of HRQL, functioning, and symptoms. A multivariate model was examined to determine predictors of overall health and included demographic variables, the SF-12 PCS and MCS, EORTC Body Image and Gastrointestinal scales, Brief Pain Inventory (BPI), Fatigue Symptom Inventory (FSI), Instrumental Activities of Daily Living (IADL), and Impact of Cancer Scale (IOC). Results: 708 LTS-01 patients (681 colon, 27 rectal) completed the interview; 57% male, mean age 66.2 yr (SD 10.6), median time since surgery 8.2 yrs (range 5-19.5 yrs). LTS-01 patients had significantly higher HRQL and functional capacity compared with age group-matched non-cancer controls as demonstrated by higher mean scores on the SF-12 MCS and PCS (55.57, SD 7.73; 49.47, SD 9.90) and SF-36 Vitality scale (67.10, SD 20.68). LTS-01 patients were also able to accomplish nearly all IADLs (7.86, SD 0.78). Multivariate modeling controlling for demographic factors demonstrated that better overall physical and mental health, positive body image, and less fatigue were strongly associated with good overall health. Interestingly, pain, gastrointestinal complaints, the experience of cancer, and the ability to perform IADLs were not important predictors of overall HRQL. Conclusions: In this select group of CRC survivors who participated in adjuvant clinical trials, overall physical and mental health were excellent compared with the general population. Other disease related symptoms did not detract from overall quality of life. Supported by grant RSGPB-05-236-01-CPPB from the American Cancer Society. No significant financial relationships to disclose.
BCL6 Antagonizes NOTCH2 to Maintain Survival of Human Follicular Lymphoma Cells
Authors: Ester Valls, Camille Lobry, Huimin Geng, Ling Wang, Mariano Cardenas, Martín Rivas, Leandro Cerchietti, Philmo Oh, Shao Ning Yang, Erin Oswald, Camille W. Graham, Yanwen Jiang, Katerina Hatzi, Xabier Agirre, Eric Perkey, Zhuoning Li, Wayne Tam, Kamala Bhatt, John P. Leonard, Patrick A. Zweidler-McKay, Ivan Maillard, Olivier Elemento, Weimin Ci, Iannis Aifantis, Ari Melnick
Journal: Cancer Discovery (2017)

Although the BCL6 transcriptional repressor is frequently expressed in human follicular lymphomas (FL), its biological role in this disease remains unknown. Herein, we comprehensively identify the set of gene promoters directly targeted by BCL6 in primary human FLs. We noted that BCL6 binds and represses
Maximum tumor diameter as a predictor for outcome following salvage radiation for prostate cancer.
Authors: Skyler B. Johnson, William C. Jackson, Yeohan Song, Benjamin Foster, Darren Li, Corey Foster, Ganesh S. Palapattu, Rohit Mehra, Priya Kunju, Felix Yi-Chung Feng, Daniel A. Hamstra
Journal: Journal of Clinical Oncology (2013)

78 Background: While maximum tumor diameter (MTD), as identified on radical prostatectomy (RP) specimens, has been associated with prostate cancer recurrence, the prognostic significance of this variable is unknown in the context of salvage external beam radiation therapy (EBRT) following a rising PSA after RP. Here, we investigate associations between MTD and outcomes in this setting. Methods: From an IRB approved retrospective single-institutional cohort, 575 patients treated with salvage radiation therapy (SRT) were identified, with MTD data available on 173. ANOVA and chi-square were utilized to compare prognostic variables with MTD. The impact of MTD on biochemical failure (BF), metastasis (Mets), prostate cancer-specific mortality (PCSM) and overall survival (OS) was assessed on univariate and multivariate analysis using Kaplan-Meier and Cox-proportional hazards regression. Results: Median follow up was 76.5 months (IQR, 46.5-104.0) and median MTD was 18 mm (IQR, 13-22). Median RT dose was 68.4 Gy (IQR, 64.8-68.4). MTD size correlated with pT-stage, Gleason score, and presence of seminal vesicle invasion or lymph node invasion. Receiver operator characteristic (ROC) curve analysis was used to correlate MTD with clinical end-points and identified 14 mm as the most prognostic cut-point. A MTD &gt;14 mm was associated with a 1.8, 4.0 and 8-fold increase in the risk of BF (p&lt;0.02), Mets (p&lt;0.002), and PCSM (p&lt;0.02), respectively. As a continuous variable, on multivariate analysis, MTD was shown to be a marginally significant predictor of OS (p=0.056, HR [95%] 1.6 [1.0-2.5]), and a significant predictor of PCSM (p&lt;0.03, HR [95%] 2.0 [1.1-3.8]) and Mets (p=0.01, HR [95%] 1.7 [1.1-2.6) but not BF. In this model, for every 10 mm increase in MTD, there is a 1.7, 2.0, and 1.6 fold risk of metastasis, prostate cancer death and overall death, respectively. Conclusions: As a categorical and continuous variable, MTD is a significant predictor of prostate cancer outcomes following SRT and should be used in clinical decision making in this population and in future clinical risk assessment tools.
Measuring the impact of integrating palliative care into a multidisciplinary brain and spine oncology clinic.
Authors: Matthew Manning, Mary Larach, Susan Boyles, Abigail Stern
Journal: Journal of Clinical Oncology (2015)

163 Background: Recent literature indicates that palliative care (PC) improves the outcomes of patients with cancer. Integration of PC providers into cancer centers is increasingly recognized to enhance symptom management with a beneficial effect on patient survival. In order to predict the impact of widespread PC integration, we hypothesized that a small pilot program may provide evidence supporting broader implementation. The current study endeavors to measure the result of adding a dedicated PC provider to a multidisciplinary brain and spine oncology program. Methods: Over the six month study period, a PC nurse practitioner was integrated into an existing weekly multidisciplinary brain and spine oncology conference and clinic. The provider participated in the multidisciplinary conference reviewing recent MRIs and discussing current disease status and treatment options. Following conference, the PC provider would consult on up to four of the clinic patients. Data were recorded regarding patient characteristics, goals of care, and changes in therapy. Results: The PC provider participated in 14 multidisciplinary clinics with a total of 180 subjects. Of those, 24 subjects met with the PC provider in formal consultation. The most common diagnoses were 41.6% with metastatic lung cancer and 25% with glioblastoma. For goals of care, an Advanced Directive discussion was documented in 100%. Do Not Resuscitate (DNR) orders were activated in 37.5% and documented in 54%. Medical Orders for Scope of Treatment (MOST) forms were introduced in 87.5% and completed in 25%. For changes in therapy, enrollment in hospice occurred in 33.3%. Pain medication was changed in 33.3%. Other symptoms including fatigue, weakness, anorexia, constipation, anxiety, lymphedema, dysphagia, depression, insomnia, and alopecia were managed in 87.5%. Conclusions: This study suggests that the integration of a PC provider into an existing multidisciplinary cancer program can produce a high rate of establishing goals of care and result in changes in treatment in a significant number of cases. Further study on the impact of integrating PC in cancer centers seems to be warranted.
Phase II study of carfilzomib (CFZ) in combination with current agents for relapsed and refractory multiple myeloma (RRMM).
Authors: J. Szymonifka, S. Z. Usmani, R. Sexton, S. Panozzo, B. P. Nair, S. Waheed, Y. Alsayed, J. Crowley, B. Barlogie
Journal: Journal of Clinical Oncology (2011)

8028 Background: CFZ is an epoxomicin derivative with ability to irreversibly inhibit proteosomes, with clinical activity. It has been shown in preclinical and early clinical studies to have activity in myeloma. We performed a phase II study evaluating the efficacy of this drug in RRMM. Methods: First cycle CFZ was given at 20mg/m2 IV day 1,2, then 27mg/m2 IV days 8,9,15,16 every 28 days; 4mg of dexamethasone (DEX) was given with each CFZ dose. In the absence of PR, CFZ dose was escalated to 36 mg/m2 IV and DEX increased to 20mg. Other drugs were added with subsequent cycles. Cox regression modeling was employed for OS/EFS. Results: 74 patients with RRMM were enrolled. Baseline characteristics included age >=65yr in 34%, ISS stage >=II was seen in 76% of patients, cytogenetic abnormalities (CA) in 71%, and GEP-defined high risk in 58% of patients. 73 patients had prior autologous stem cell transplant. 61 patients (82%) had at least 2 transplants. 67 patients had received regimens containing bortezomib, thalidomide, lenalidomide, melphalan and steroids. At least 1 cycle of treatment was administered to all 74 patients enrolled, 62% patients receiving >1 cycle of treatment and only 16% received >5 cycles. 54/74 patients discontinued therapy primarily due to progression, death or toxicity. 15/74 (20%) patients achieved nCR/CR, 53% had stable disease. EFS benefit was observed in patients receiving > 3 cycles on univariate (HR= 0.16, p=0.001) and multivariate (HR=0.04, p=0.006) analyses after adjusting for GEP defined risk status. Most common toxicities (grades 1-5) were: hyperglycemia (96%), thrombocytopenia (96%), anemia (95%), hypoalbuminemia (92%), leucopenia (89%), hypokalemia (86%), hypophosphatemia (82%) and fatigue (76%). Overall and event free survival at 6 months were 53% and 21%, respectively. Conclusions: In this far advanced patient population, CFZ seemed to have single agent activity, especially in combination with other agents an improvement in disease was seen in about half the patients.
Impact of age on treatment and survival in soft tissus sarcoma. A study of 1568 sarcomas from the French Sarcoma Group
Authors: F. Peyrade, E. Chamorey, B. Bui, J. M. Coindre, F. Bonichon, P. Y. Bondiau, P. Terrier, A. Thyss
Journal: Journal of Clinical Oncology (2005)

9061 Background: Age was reported as a possible prognostic factor in STS for OS. The goal of this study is to study the impact of age on therapeutic, OS, SS in a population of 1568 STS patients treated from 1980 to 1999 and registered in the GSF data base. Methods: The OS and SS analyses was examined using log-rank test and cox’s model respectively for univariate and multivariate analysis. Difference were considered to be statistically significant when the p-value was 0,01 or less. Results: The two groups are statically similar except for surgery (group A 83% of R0 VS group B 76% of R0) and the use of chemotherapy (group A 44% of ct VS group B 19% of ct). In a univariate analysis, in term of overall survival, specific survival and disease free survival the following parameters are statically significant: age (p<10–6), location (p<10–3) tumor size (p<10–6), histological limits (p<10–6), ct (p<10–3), tumor grade (p<10–6). In a multivariate analysis for the two groups, grade III, resection R1 or R2, trunk location, age > 65y and tumor size>8cm show a significant unfavourable influence on OS, DFS and SS. Conclusion: The analyses demonstrates that for newly diagnosis STS in the ederly, the poorer survival could be linked with age itself but also with a less agressive surgery. No significant financial relationships to disclose.