tbuckley/cabot-search huggingface dataset:
Identification of 46 quality indicators for cancer care in office-based oncology practices in Germany.
Authors: R. E. Buschmann-Maiworm, G. Klein, W. Baumann, H. Lebahn, B. J. Otremba, T. Steinmetz, U. R. Kleeberg, S. Schmitz
Journal: Journal of Clinical Oncology (2011)

e16514 Background: The aim of the study is the identification of quality indicators for an indicator-based quality measurement in German office based oncology practices. They will be used by the WINHO department (collaboration of 210 medical oncology practices in Germany.) for quality improvement and peer to peer benchmarking. Special emphasis is on breast and colorectal cancer. The QOPI model was to some extent a paradigm for our study. Methods: Relevant indicators were collected through literature review. A two-step expert rating procedure with a modified RAND/UCLA method was done. The expert panel consisted of 25 experts from professional associations connected to ambulant oncology, members of the quality management group of the WINHO department and participants from patient support groups. The indicators were rated concerning 1) importance/relevance, 2) benefit for patients, 3) whether they lie within the responsibility of office based oncologists, 4) representation of high quality of care and 5) if the data is present in patient records. The indicators were rated on five stepped categorial rating scales. After discussion, a modified set of indicators was rated in the second session. Results: From literature review a preliminary set of 272 quality indicators was collected. Due to redundancy and/or low specification level, the set was reduced to 67. In the first rating session, 37 indicators were homogeneously rated as relevant and meaningful for high quality of care in oncology practices. The result of the second session is a first set of 46 (32 documentation and therapy, 5 colon, 9 mama) quality indicators for the process of care in German oncology practices. Currently we are running a feasibility study. Results will lead towards a pilot study about the implementation of a routine data collection. Conclusions: The results suggest that the QOPI indicators are to some extent adoptable for German practices as well. First results indicate that it will take a lot of time, effort and money to embed the data collection into a daily practices routine. Sponsored by the German Cancer Aid DKH.
Antibacterial and antibiofilm effects of sodium hypochlorite against<i>Staphylococcus aureus</i>isolates derived from patients with atopic dermatitis
Authors: S. Eriksson, M.J.A. van der Plas, M. Mörgelin, A. Sonesson
Journal: British Journal of Dermatology (2017)

BackgroundAtopic dermatitis (AD) is characterized by an increased susceptibility to skin infections. Staphylococcus aureus is reported to dominate in AD lesions and reports have revealed the presence of staphylococcal biofilms. These infections contribute to aggravation of the eczema. Sodium hypochlorite is known to reduce bacterial load of skin lesions, as well as disease severity, in patients with AD, but the effect on biofilms is unknown.
Do patients and physicians perceive PSA screening discussions the same?
Authors: James Austin Talcott, Gina Aharonoff, Maureen Bezuhly, Michael P. Osborne
Journal: Journal of Clinical Oncology (2016)

160 Background: Shared decision making is recommended for prostate-specific antigen (PSA) screening. We are performing a prospective randomized trial of educational interventions to improve screening compliance at an urban academic medical center. We hypothesize that patient and provider characteristics providers will affect compliance. We report the first results for PSA screening. Methods: In a cluster-randomized trial of educational supports for providers, we are recruiting an age- and sex-stratified sample of 216 patients aged 30 to 89 years undergoing an annual physical examination, 18 patients of each of 12 primary care physicians at two affiliated hospitals. Screening guideline format (color-coding) and academic detailing were randomly assigned in a 2 x 2 design. Surveys occurred immediately post-encounter to record recollections of screening discussions, recommendations and plans. Results: We report on the first 44 of 108 planned male participants. Most were white (77%), had a college degree (83%), and currently married (59%). When providers reported a PSA discussion, 13% of patients disagreed, while 23% of patients disagreed when their provider reported a PSA discussion. Discrepancies also occurred on additional elements of informed decision-making (data not shown). Reports also disagreed on physician recommendations: 2 of 8 patients (25%) disagreed with the physician’s report of recommending screening and 6 of 12 patients (50%) disagreed with the physician’s report of not recommending it. Half of patients (49%) reported distress at getting PSA results, but only 5% reported “a lot” of distress. Over half (58%) reported that PSA testing protected against prostate cancer “a lot.” No physician reported recommending PSA testing to men under age 50 or over age 70, but 1 of 6 men under 50 and 3 of 3 men over 70 reported that their physician had recommended testing. Conclusions: In a highly educated population of men and physicians surveyed immediately after their encounter, reports of whether PSA screening had occurred, the information that had been discussed and the recommendation had important discrepancies. Important differences may exist between patients and physicians in perceptions of PSA screening discussions. Clinical trial information: NCT02430948.
Concurrent Treatment with Minhepcidin and Deferiprone Improves Anemia and Enhances Reduction of Spleen Iron in a Mouse Model of Non-Transfusion Dependent Thalassemia
Authors: Carla Casu, Rea Oikonomidau, Yatrik Shah, Elizabeta Nemeth, Tomas Ganz, Brian MacDonald, Stefano Rivella
Journal: Blood (2014)
Safety and efficacy of carbon dioxide cryotherapy for treatment of neoplastic Barrett’s esophagus
Authors: Marcia Canto, Eun Shin, Mouen Khashab, Daniela Molena, Patrick Okolo, Elizabeth Montgomery, Pankaj Pasricha
Journal: Endoscopy (2015)

Correction to: Safety and efficacy of carbon dioxide cryotherapy for treatment of neoplastic Barrett's esophagusEndoscopy 2015; 47(07): 582-591DOI: 10.1055/s-0034-1391734
Muscle invasive bladder cancer in the elderly: Treatment and prognosis in a prospective cohort study.
Authors: Stephanie Slater, Thomas Wright, Adam Devall, Sarah Pirrie, Lucinda Billingham, K K Cheng, Maurice Zeegers, Richard Bryan, Nicholas David James
Journal: Journal of Clinical Oncology (2013)

275 Background: As the prevalence of bladder cancer increases amongst the elderly, nearly 1 in 3 muscle invasive bladder cancer (MIBC) cases are in patients aged &gt;80 years (Taylor JA, III, Kuchel GA. Nat Clin Pract Urol 2009; 6(3):135-1440). However, radical cystectomy remains as the gold standard treatment for MIBC (Yafi FA, Kassouf W. Can Urol Assoc J 2009; 3(5):409-412). In this study we examined treatment patterns and outcomes patients aged &gt;80 years from a prospective study of bladder cancer. Methods: The Bladder Cancer Prognosis Programme (BCPP) is a 5 year prospective cohort study (2006-2011) with 1191 patients confirmed as having newly-diagnosed bladder cancer. Recruitment took place at 9 urological centres within the West Midlands region, UK. From this cohort we identified 67 patients aged &gt;/=80 years with newly diagnosed MIBC. Study records include overall and disease specific survival, time to disease recurrence and radiotherapy (RT) treatment. Simple descriptive statistics were used to describe the outcomes. Results: This cohort consisted of 46 male and 21 female patients with a median age of 83 (IQR=81, 87; range=80, 94). Only 4 (6%) patients underwent cystectomy and 36 (53%) underwent RT. Median survival data is summarised in the table below. Conclusions: Despite guidelines, practising urologists in the West Midlands region do not offer cystectomy to the vast majority of MIBC patients aged &gt;80 years. Furthermore, in this patient cohort, OS was shorter than BCSS by 10 months, suggesting that quality of life after diagnosis will be far more important than cure rates due to deaths from other causes. Of particular note is that the group receiving RT had longer OS and BCSS than the rest of the cohort. This indicates that RT could be a far more appropriate standard of care in the elderly than surgery, which is clearly of limited applicability in this growing demographic. Clinical trial information: 06/MRE04/65. [Table: see text]
TJ-107 for the prevention of oxaliplatin-induced peripheral neuropathy: Results of a phase II randomized placebo-controlled clinical trial.
Authors: Toru Kono, Taishi Hata, Yoshinori Munemoto, Takanori Matsui, Hiroshi Kojima, Hiroyoshi Takemoto, Mutsumi Fukunaga, Mitsuo Shimada, Naoki Nagata, Satoshi Morita, Junichi Sakamoto, Hideyuki Mishima
Journal: Journal of Clinical Oncology (2012)

567 Background: Oxaliplatin-induced peripheral neuropathy (OPN) continues to be a substantial problem for many cancer patients. In light of the promising data on TJ-107 from a previous pilot study (ASCO-GI, 2009), the present clinical trial was conducted to evaluate its efficacy for the prevention of OPN. To determine whether TJ-107 given as an adjuvant therapy effectively prevents oxaliplatin-induced peripheral neuropathy Methods: A phase II, randomized, double-blind, placebo-controlled trial was conducted in colorectal cancer patients undergoing therapy with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX). TJ-107 (7.5g) or matching placebo was orally administered three times daily. The primary endpoint was the incidence of grade 2 or greater OPN according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE; version 3) criteria after 8 cycles of chemotherapy. Patient-reported neurotoxicity symptoms were also assessed using the neurotoxicity subscale of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity (FACT/GOG-Ntx, version 4). Secondary endpoints included the incidence of all grades of OPN after each cycle and chemotherapy response rates. Results: A total of 93 patients were enrolled from May 1, 2009 to March 31, 2010 at 37 participating GONE trial institutions in Japan. Eighty-nine evaluable patients were randomized to either the TJ-107 group (n = 44) or the placebo group (n = 45). Placebo patients showed a significantly higher rate of neurotoxicity than that of TJ-107 patients (p &lt; 0.001), with the median difference in NTX-12 score of 3 and 3.5 at the 8th week and 26th week, respectively. There were no significant between-group differences in response to chemotherapy (55.5% in TJ-107, 39.1% in placebo). In addition, TJ-107 treatment was well tolerated overall. Conclusions: TJ-107 shows promise in reducing the incidence of OPN. Further investigation in a larger phase III trial is necessary before any conclusions can be drawn. [Table: see text]
Vascular endothelial growth factors (VEGF) and VEGF receptor expression as predictive biomarkers for benefit with bevacizumab in metastatic colorectal cancer (mCRC): Analysis of the phase III MAX study.
Authors: A. J. Weickhardt, D. Williams, C. Lee, J. Simes, C. Murone, K. Wilson, M. Cummins, K. Asadi, T. J. Price, J. Mariadason, N. C. Tebbutt
Journal: Journal of Clinical Oncology (2011)

3531 Background: Bevacizumab (B) in combination with chemotherapy prolongs progression-free survival (PFS) in patients with mCRC. However, the subgroup that derives greatest benefit with B is not known. Since B only targets VEGF A and given the redundancy within biologic family members, we hypothesized that overexpression of other VEGF ligands could constitute a mechanism of resistance. We tested this hypothesis using tumor samples from patients in the MAX study. Methods: We analyzed tumor samples from 268 of 471 patients (56.9%) who were randomly assigned to capecitabine (C), or C and B (CB), or C, B, and mitomycin (CBM). We examined expression of VEGF A, B, C, D, R1 and R2 by immunohistochemistry using tissue microarrays. We assessed whether expression of these biomarkers (grade 0,1 vs 2 vs 3) was predictive for B for PFS and overall survival (OS) using interactions between biomarker expression and treatment. Results: When each biomarker was examined singly, lower expression of VEGF D was associated with greater B benefits on PFS and OS (Table) and was the only significant factor biomarker in a step-down multivariate analysis for PFS. When examined singly, lower expression of VEGFR1 was associated with greater B benefits for OS (p=0.001 for treatment-biomarker interaction) but not PFS. VEGFR1 was the remaining significant biomarker in a step-down multivariate analysis for OS. Conclusions: High expression of VEGF D is predictive of resistance to B, particularly in terms of PFS. This finding is biologically plausible but requires confirmation in other trials. Selection of patients with mCRC for B treatment based on VEGF D expression may have the potential to increase absolute benefits and improve cost-effectiveness. Treatment effect (C vs. CB + CBM) PFS OS N HR (95% CI) HR (95% CI) Unselected population 471 0.61 (0.50 – 0.74) 0.93 (0.75 – 1.16) VEGF D 0,1 32 0.21 (0.08 – 0.55) 0.35 (0.13 – 0.90) VEGF D 2 117 0.67 (0.45 – 1.00) 0.82 (0.52 – 1.30) VEGF D 3 110 0.77 (0.5 – 1.17) 1.28 (0.79 – 2.09) Treatment-biomarker interaction Unadjusted P = 0.02 P = 0.01 Adjusted for other biomarkers P = 0.04 P = 0.24 Adjusted for clinical factors P = 0.04 P = 0.02
Gene expression profiles of rectal cancers with mutant or wild-type Kras.
Authors: Julio Garcia-Aguilar, Zhenbin Chen, Charles Warden, Karin Avila, Ning Zhou, Yate-Ching Yuan, Ching-Tung Chen, Martin R. Weiser
Journal: Journal of Clinical Oncology (2013)

414 Background: The Kras oncogene is one of the most common mutations in colorectal cancer. Kras mutations are associated with increased tumor aggressiveness, poor response to selected targeted therapies, and reduced patient survival. We have previously shown that rectal cancers carrying a Kras mutation were less likely to achieve a pathologic complete response to radiation compared to tumors with wild type Kras. Our objective was to compare the gene expression profiles of rectal cancers with mutant and wild type Kras to identify genes that could be related to the Kras–dependent aggressive phenotype. Methods: Pretreatment biopsy tissue was collected from 120 patients with stages I, II and III rectal cancer treated in two prospective trials (NCT00335816 and NCT00114231). DNA and total RNA were extracted from microdissected cancer cells. Mutations in codons 12, 13, and 61 of the Kras gene were detected by pCR. 50ng of total RNAs were amplified to generate cDNA libraries using Ovation FFPE WTA System (NuGEN Technologies, Inc., San Carlos, CA). The amplified cDNA was labeled using the Encore Biotin Module, and hybridized to GeneChip Human Genome U133A plus 2.0 arrays (Affymetrix, Inc., Cleveland, OH). Differences in gene expression between mutant and wild type Kras tumors were determined using T-test and Q-bound to correct for multiple testing by performing false discovery rate (FDR) analysis. Results: A total of 44 of 117 (37.6%) were mutant Kras. A total of 379 probes were upregulated and 262 were downregulated in tumors with Kras mutant compared to Kras wild type. Heatmap based on differentially expressed genes showed separation according to Kras mutant status. REG4 expression was increased 3 fold and CXCL5 was reduced 2.4 fold in tumors with mutant Kras compared to wild type Kras. The changes in expression on these genes are concordant with their known involvement in prognosis and response to therapy of colorectal cancer. Conclusions: The search for changes in gene expression in response to Kras activation led to identifying a number of genes associated with the tumor aggressive phenotype.
Treatment patterns in patients with recurrent high-risk bladder cancer.
Authors: Eric Christian Ballon-Landa, Karim Chamie, Jeffrey C. Bassett, Timothy J. Daskivich, Julie Lai, Janet Hanley, Badrinath R. Konety, Mark S. Litwin, Christopher Saigal
Journal: Journal of Clinical Oncology (2014)

303 Background: Patients with high-risk bladder cancer are apt to develop multiple recurrences. Since the association of recurrences with aggressive treatment in individuals with recurrent high-grade disease has not been quantified, we sought to determine whether increasing number of recurrences correlates with higher treatment rates. Methods: Using linked SEER-Medicare data, we identified subjects with recurrent high-grade, non-muscle-invasive disease diagnosed in 1992–2002 and followed until 2007. Using propensity score and competing-risks regression analyses, we quantified the incidence of radical cystectomy, radiotherapy, and systemic chemotherapy after each recurrence. We further restricted our analyses of treatment in auspicious environments, defined as those patients most suited for aggressive intervention: age &lt;70, Charlson 0, and undifferentiated T1 tumors treated at academic cancer centers. Results: Of 4,521 subjects, (59.6%) 2,694 recurred more than once within two years of diagnosis. Compared with patients who only had one recurrence, those with ≥4 recurrences were less likely to undergo radical cystectomy (9.7% vs 12.1%, p value=0.03), but more likely to undergo radiotherapy (18.0% vs 12.1%, p value&lt;0.01) and systemic chemotherapy (6.7% vs 4.2%, p value&lt;0.01). For patients with ≥4 recurrences, only 25% were treated with curative intent, while 43% were similarly treated in auspicious environments. Conclusions: Only 25% of patients with high-risk bladder cancer who recur ≥4 times undergo treatment for curative intent. Increasing recurrences do not appear to alter the treatment course, as patients and their doctors may be unable or unwilling to proceed with aggressive treatment despite mounting risk of disease progression. [Table: see text]
Phase II trial of the novel oral Akt inhibitor perifosine in relapsed and/or refractory Waldenstrom macroglobulinemia (WM)
Authors: I. M. Ghobrial, X. Leleu, N. Rubin, R. Leduc, S. Chuma, M. Nelson, P. Sportelli, P. G. Richardson, S. P. Treon, K. C. Anderson
Journal: Journal of Clinical Oncology (2008)

8546 Background: Perifosine is an oral, synthetic alkylphospholipid, with multiple effects including inhibition of Akt. We previously showed that perifosine induces significant growth inhibition in vitro and in vivo in WM models. This phase II study aimed to determine the activity and safety of orally-administered perifosine at a dose of 150 mg in patients (pts) with relapsed/refractory WM. Methods: Pts who had at least one previous therapy for WM and who had relapsed or refractory disease were eligible. NCI CTCAE v3.0 was used for toxicity assessment. All pts received 150 mg perifosine daily for 28 days per cycle until progression; response was assessed after 2 cycles. Results: The trial accrued from 10/06 to 11/07, with 37 pts (27 men and 10 women, median age 65 years, range 51 - 80) treated to date. The median number of lines of prior treatment was 3 (range 1 - 5). The median IgM at baseline was 3245 mg/dL (range 972- 8480). Prior therapy included rituximab, nucleoside analogues (fludarabine and 2-CDA), combination chemotherapy (e.g CHOP, CVP), chlorambucil, and bortezomib. Thirty one pts are currently evaluable for response by IgM monoclonal protein after at least 2 cycles of therapy; best response was as follows: 1 (3%) partial response and 10 (32%) minimal response for an overall response rate (ORR) of 35%, with a median decrease of IgM of 44% (range, 26–51%). Only 2 pts (6%) progressed, and 18 (58%) pts achieved stable disease. The median duration of response has not been reached. With a median followup of 4 months (range, 1–13+) 16 (44%) pts remain on therapy and free of disease progression. Dose reduction (to 100 mg/d) was required in 5 pts due to toxicities, which included grade 3 nausea/vomiting in 3 pts and grade 3 arthritis/gout-like symptoms in 2 pts (which correlated with rapid response in these pts). Grade 3 corneal ulceration occurred in 1 pt which was possibly related to therapy. Attributable toxicities otherwise proved manageable with appropriate supportive care, and perifosine was generally well tolerated. Conclusions: Oral perifosine as monotherapy has been well tolerated and has encouraging activity with an ORR of 35% as a single agent in pts with relapsed and/or refractory WM. Future clinical trials in combination are planned. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Keryx Keryx
Localized pancreatic cancer (LPC) with isolated positive peritoneal cytology (PPC): A single-institution experience.
Authors: Stephen Y Oh, Alicia M Edwards, Hejin P Hahn, Margaret T Mandelson, Vincent J. Picozzi
Journal: Journal of Clinical Oncology (2015)

411 Background: Natural history (NHx) and overall survival (OS) of patients (pts) with LPC and PPC without gross metastasis (GM) at initial diagnosis are rarely studied. We assessed rate, time and pattern of disease recurrence (REC), impact of local therapy (Rx) and OS in this pt cohort from our institution. Methods: The Virginia Mason Pancreatic Cancer (PC) Database (Picozzi et.al. Proc GI Cancer Symp 2011) was used to identify pt cohort. Inclusion criteria were 1) laparoscopic PPC and 2) no other evidence of GM (radiographic/ laparoscopic). Local progression (LP) was defined as primary tumor growth with change/cessation of chemoRx. Systemic progression (SP) was defined as radiological/pathological metastastic progression. The database provided OS. Results: 39/884 (4.4%) pts initiating Rx at VMMC from 2003-2014 met these criteria. 13/39 pts were included in a prior report (Clark et.al. Am J Surg 2010). Pt characteristics include: 21/39 (54%) male; median (med) age 65 (range 49 – 83) yrs; 25/39 (64%) head lesions; med tumor size 39 (range 25 - 100) mm. Med pt follow-up is 13 mo. All pts received gemcitabine-combination chemoRx as initial Rx. 14/39 (36%) pts also received local Rx (13 consolidative chemoXRT, 1 surgery). 3 month (mo) disease control (DC) was 86% (31/36 pts, 3 pts followed &lt;3 mo). 6 mo progression - free survival (PFS) was 72% (26/36 pts). 6/36 pts (16%, range 9+-15+ mo) are progression – free. 30/36 pts (83%) progressed (med time 8.1 mo). REC pattern was local (13/30 pts, 43%), distant (9/30 pts, 30%) and combined (8/30 pts, 27%). Pts given local Rx did not differ statistically from pts given systemic Rx only with respect to 3 mo DC, 6 mo PFS, REC rate, time, or pattern, or OS. OS for LPC with PPC was significantly better than pts with GM (n = 277) identified from the database from 2003-2014 (med OS 15 vs. 9.3 mo, p = 0.0002; 1-yr OS 68 vs. 32%, p = 0.01; 2-yr OS 34 vs. 12%, p = 0.007). Conclusions: 1)LPC with PPC is a rare PC pt cohort with high response rates to chemoRx and superior OS to those with GM. 2) However, long-term disease free OS was not seen. 3)Local Rx did not clearly alter pt cohort NHx. 4)This is the largest pt series of this pt cohort compiled from a US institution; their further study seems of value.