tbuckley/cabot-search huggingface dataset:
18F-choline PET/CT for the assesment of pelvic lymph node metastases in high-risk prostate cancer patients.
Authors: Ivan Federico Pinto, Camilo Sandoval, Jorge Gonzalo Diaz, Alvaro Daniel Vidal, Jaime Antonio Altamirano, Roberto Mauricio Vilches
Journal: Journal of Clinical Oncology (2015)

61 Background: Assesment of pelvic lymph node involvement is a major dilemma due to poor diagnostic accuracy of conventional imaging such as computed tomography of the pelvis or magnetic resonance of the pelvis. Recently incorporation of new tools such as 18F-choline PET/CT address this issue, although there are few studies in this set of patients. To evaluate the 18-choline PET/CT diagnostic accuracy for staging of pelvic lymph node involvement in patients with high risk prostate cancer. Methods: Patients with diagnosis of high risk prostate cancer according to D’Amico risk assessment criteria where staged with a 18F-choline PET/CT prior to treatment with retropubic radical prostatectomy plus superextended bilateral lymph node dissection at our institution. 18F-choline PET/CT was compared with the results of pathological analisys of lymph nodes. We calculated sensitivity, specificity, positive and negative predictive value for 18F-choline PET/CT. Results: Between January 2012 and August 2014 a total of 36 patients met the following inclusion criteria: diagnosis of high prostate cancer (cT2c or more or PSA above 20 ng/ml or a gleason score 8-10), good performance status (ECOG 0-2) and a 18F-choline PET/CT as a preoperative staging procedure. Sensitivity, specificity, positive and negative predictive value were 64%, 92%, 77% and 85% respectively. Conclusions: 18F-choline PET/CT is a non invasive procedure that provides good information regarding pelvic lymph node involvement status that is better than the results of other techniques in published series, with a higher sensitivity in our group of patients. It is highly specific which means there is a very good chance that a patient with a normal study does not have lymph node metastases when analyzed.
Health-related quality of life (HR-QOL) and chronic health conditions (CHC) in survivors of childhood acute myelogenous leukemia (AML)
Authors: K. P. Schultz, L. Chen, Z. Chen, T. Kawashima, K. C. Oeffinger, H. S. Nicholson, J. P. Neglia
Journal: Journal of Clinical Oncology (2008)

6590 Background: AML therapy has included chemotherapy with or without autologous stem cell transplantation or allogeneic hematopoietic stem cell transplantation (chemo±auto or alloBMT) based on the availability of a matched sibling donor. This allows unbiased comparison of HR-QOL outcomes between these groups. Methods: We surveyed 207 survivors of AML diagnosed before age 21 and treated from 1979 to 1995 on one of 4 COG protocols who survived ≥5 years from diagnosis. Survivors or proxy caregivers completed a CCSS baseline questionnaire and an age-appropriate measure of HR-QOL (SF-36, CHQ-87 or CHQ-PF50). Survivors with Down syndrome were excluded for this analysis. Results: Of the 182 survivors in this analysis, 128 underwent chemo±auto and 54 underwent alloBMT. Median age at diagnosis was 4 years (range, 0 to 20); median age at enrollment was 20 (range 8 to 39). HR-QOL scores were similar among groups and to the normative population (Physical component score: chemo±auto mean 50.8 vs. alloBMT 49.7, p=0.43; mental component score: chemo±auto 49.8 vs. alloBMT 52.0, p=0.20; normative score 50, SD 10). Differences remained insignificant in adjusted analyses. For children ages 12–13 years and children ages 11 and younger, scores were also similar among groups. With regard to chronic health conditions (CHC), in the chemo±auto group, 47% had at least one CHC compared with 76% in the alloBMT group (OR: 3.5, 95% CI: 1.6- 7.6). Twenty-one percent had a severe or life-threatening CHC (chemo±auto16% vs. 33% alloBMT; OR 2.6, 95% CI: 1.2–5.7). One-fourth had ≥3 CHC (chemo±auto17% vs. 40% alloBMT: OR: 3.2, 95% CI: 1.5–7.0). Nearly all (95%) reported that their health was excellent, very good or good. Less than 10% in each group reported activity limitations, functional impairment and/or cancer-related pain. Conclusions: Scores on the HR-QOL measures were similar between treatment groups; however, alloBMT survivors reported more frequent and severe chronic health conditions. No significant financial relationships to disclose.
Association of the prognostic role of FGFR4 Gly388Arg polymorphism with treatment outcomes after chemoradiotherapy in esophageal cancer.
Authors: Sanghee Cho, Min-Ho Shin, Jun-Eul Hwang, Hyung-jung Shim, Min-Jee Kim, Ik-Joo Chung
Journal: Journal of Clinical Oncology (2014)

60 Background: Fibroblast growth factor receptor 4 (FGFR4) has been associated with increased risk, staging, and metastasis in several type of cancer. The purpose of this study was to evaluate the prognostic role of FGFR4 Gly388Arg polymorphism in esophageal cancer after chemoradiotherapy. Methods: Peripheral blood samples from 250 patients who were treated with chemoradiotherapy were used for this study. Patients were diagnosed as a stage of I in 12 (5%), II in 54 (21%), III in 115 (46%) and IV in 69 (28) patients. All of the patients were received chemotherapy using cisplatin and fluorouracil or docetaxel. Results: The overall response was 85%, with 21% complete response and 64% partial response. The overall survival (stage II, 34months; stage III, 23.3 months; stage IV, 19.3 months, p=0.005) and progression survival (stage II, 23.8 months; stage III, 12.8 months; stage IV, 9 months, p=0.001) was significantly improved according to stage. In FGFR4 genotypic analysis, 96 patients (38.6%) were homozygous for Gly388 allele, with 113 heterozygous (45.4%) and 40 (16.0) homozygous for Arg388 allele. There was no significant association between FGFR4 genotype and stage. However, Gly388 allele patients show better overall response rate (90.6%) than Arg388 carriers (82.4%, p=0.050). In early stage (I, II, n=66), Gly388 allele patients tendted to have a better OS (p=0.898) or PFS (p=0.597) than Arg388 carriers. However, in advanced stage (III, IV), the survival outcomes was similar between genotypes. Conclusions: Present study shows that FGFR4 Gly388 allele has a prognostic role in response after chemoradiotherapy in esophageal cancer. Especially in early stage of esophageal cancer, FGFR4 might have an important role in disease progression and survival outcomes. It suggests that the possibility of new therapeutic target for esophageal cancer treatment.
The comparison of the usefulness of nab-paclitaxel and paclitaxel for advanced or recurrent gastric cancer.
Authors: Yasue Kimura, Tetsuya Kusumoto, Eiji Kusumoto, Masahiko Sugiyama, Mitsuhiko Ohta, Norifumi Tsutsumi, Yoshihisa Sakaguchi, Koji Ikejiri
Journal: Journal of Clinical Oncology (2015)

217 Background: For patients who do not respond to S-1-based treatment in Japan, weekly paclitaxel (PTX) therapy is more frequently used as second-line chemotherapy. On the other hand, the agent could not be used for alcohol hypersensitivity in some cases. Nab-Paclitaxel (N-PTX), which is the protein-bound paclitaxel, has recently been introduced in Japan. The purpose of this study was to retrospectively determine the more preferable agent, N-PTX or PTX, following the S-1-containing chemotherapy in patients with advanced or recurrent gastric cancer (ARGC). Methods: We conducted a retrospective review of the data for 40 patients with ARGC, who received either N-PTX monotherapy for 5 patients or PTX monotherapy for 35 patients. N-PTX was used as the second-line for all patients in this group. On the other hand, in the PTX group, 4, 28 and 3 patients received PTX monotherapy as the 1st-, 2nd- and 3rd-line, respectively. N-PTX was administered intravenously at a dose of 260 mg/m 2 repeated triweekly. PTX was administered intravenously at a dose of 80 mg/m 2 repeated weekly (on days 1, 8 and 15) every four weeks. The objective response rate (ORR), adverse events, progression-free survival (PFS) were compared between the two groups. Results: For tumor response, in the N-PTX group, CR/PR/SD/PD were 0/3/1/1, respectively for an ORR of 60% and a DCR of 80%; in the PTX group, CR/PR/SD/PD were 0/3/15/13, respectively for an ORR of 10% and a DCR of 58%. The ORR of the N-PTX group was higher, which might result from the higher dose intensity in the group, compared with the PTX group. For the adverse toxicity, in the both group, events of grade ≥ 3 were not observed. Serious neurotoxicity (≥grade 3), as commonly described for treatment with paclitaxel, was not observed in this study. The survival data showed that the PFS was 253 days in the N-PTX group, compared with 176 days in the PTX group, which were not significantly different. Conclusions: We suggest the application of N-PTX in place of PTX after S-1 containing chemotherapy for ARGC, only from the perspective of the tumor response. Further data accumulation is required for overall survival.
Predictors of successful breast-conserving surgery (BCS) in patients with ductal carcinoma in situ (DCIS).
Authors: J. J. Griggs, M. E. Sorbero, G. M. Ahrendt, L. M. Schiffhauer, A. Stark, A. W. Dick
Journal: Journal of Clinical Oncology (2011)

6079 Background: Patients with DCIS who prefer breast preservation may ultimately require mastectomy to achieve optimal local control. The objectives of this study were to identify factors that were predictive of successful BCS and to develop a simple index to aid in surgical decision making. Methods: We defined the dependent variable, “successful BCS,” as preservation of the breast with negative margins (more than 2 mm). Detailed clinical, pathologic, and demographic data were abstracted from medical records of patients with DCIS over a 15-year period in two registries (N = 1,031). We first estimated logistic regression models to identify factors associated with successful BCS in patients whose first therapeutic procedure was a breast conserving procedure. We then estimated a similar logistic regression model controlling for the number of “positive” and “negative” predictors of success and used these estimates to create an index of successful BCS. Results: The logistic regression models fit well and showed excellent discrimination (C-statistic = 0.78; Hosmer-Lemeshow, p=0.31). Factors found to be positively predictive of successful BCS were tumor size under 0.5 cm, cribriform histology, low nuclear grade, mammographic detection, and age of 65 or older. Factors found to be negatively predictive of successful BCS were positive margins after the first therapeutic procedure, extensive disease, multifocal disease, comedo histology, a positive family history, tumor size over 1.5 cm or unspecified, and age less than 40 years. The matrix below shows predicted probabilities of successful BCS based on the second logistic regression model estimates that included only the number of positive and negative predictors. Conclusions: If confirmed in other patient samples, this predictive index could serve as the foundation of a decision aid, benefitting patients and providers by decreasing multiple attempts at breast conservation in patients unlikely to achieve successful BCS. Probability of successful breast conservation (N = 1,031). No. of unfavorable factors 0 1 2 3 4 5 No. of favorable factors 0 0.45 0.40 0.28 0.17 0.07 0.03 1 0.61 0.56 0.42 0.28 0.12 0.06 2 or more 0.69 0.64 0.50 0.36 0.16 0.08
A Crucial Role of CXCL14 for Promoting Regulatory T Cells Activation in Stroke
Authors: Hsu-Tung Lee, Shih-Ping Liu, Chen-Huan Lin, Sophie Wei Lee, Chung Y. Hsu, Huey-Kang Sytwu, Chia-Hung Hsieh, Woei-Cherng Shyu
Journal: Theranostics (2017)

Inflammatory processes have a detrimental role in the pathophysiology of ischemic stroke.However, little is known about the endogenous anti-inflammatory mechanisms in ischemic brain.Here, we identify CXCL14 as a critical mediator of these mechanisms.CXCL14 levels were upregulated in the ischemic brains of humans and rodents.Moreover, hypoxia inducible factor-1α (HIF-1α) drives hypoxia-or cerebral ischemia (CI)-dependent CXCL14 expression via directly binding to the CXCL14 promoter.Depletion of CXCL14 inhibited the accumulation of immature dendritic cells (iDC) or regulatory T cells (Treg) and increased the infarct volume, whereas the supplementation of CXCL14 had the opposite effects.CXCL14 promoted the adhesion, migration, and homing of circulating CD11c + iDC to the ischemic tissue via the upregulation of the cellular prion protein (PrP C ), PECAM-1, and MMPs.The accumulation of Treg in ischemic areas of the brain was mediated through a cooperative effect of CXCL14 and iDC-secreted IL-2-induced Treg differentiation.Interestingly, CXCL14 largely promoted IL-2-induced Treg differentiation.These findings indicate that CXCL14 is a critical immunomodulator involved in the stroke-induced inflammatory reaction.Passive CXCL14 supplementation provides a tractable path for clinical translation in the improvement of stroke-induced neuroinflammation.
Second primary malignancies in anal carcinoma.
Authors: Binay Kumar Shah, Nibash Budhathoki
Journal: Journal of Clinical Oncology (2015)

534 Background: Survival of cancer patients is increasing. Therefore, there is a need to evaluate long term complications in cancer survivors. There is no data on second primary malignancies in anal cancer. This study was conducted to evaluate second primary malignancies in patients with anal carcinoma. Methods: We selected adult patients diagnosed with anal cancer from National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) 13 database We calculated the risk of second primary malignancies in the anal cancer patients using multiple primary standardized incidence ratio (MP-SIR) session of SEER*stat software. Results: Among 7,661 patients with anal carcinoma, 3,196 were men and 4,465 were women. Median follow up duration was 87 months (range: 7-239 months). Median age at the time of diagnosis of SPM was 69.33 yrs (range: 34-103 yrs). Median latency for SPM was 52 months (range: 6-219 months). A total of 675 patients (9.07%) developed 747 second primary malignancies, with an observed/expected (O/E) ratio of 1.41 (95% confidence interval =1.32-1.52, p&lt;0.001), and an absolute excess risk of 55.36 per 10,000 populations. Significant excess risks were observed for oral cavity and pharyngeal tumor, rectal and anal canal tumor, laryngeal tumor, lung and bronchial cancer, Kaposi sarcoma, hematologic malignancies, ovarian, vaginal, and vulval tumors. Conclusions: The risk of second primary malignancies in adult patients with anal cancer is significantly increased compared to general population.
Case review for ramucirumab as a single agent in our hospital.
Authors: Satoshi Murahashi, Daisuke Takahari
Journal: Journal of Clinical Oncology (2016)

52 Background: Ramucirumab is approved in the USA, EU, and Japan as second-line treatment in advanced gastric or gastroesophageal junction adenocarcinoma. This agent is often used with paclitaxel, but we can use it as a single agent in second-line treatment. Because REGARD trial has shown that Ramucirumab as a single agent prolongs overall survival and progression-free survival. However, this trial doesn’t include Japanese patients, and we have no trial concerning the efficacy of Ramucirumab as third or later-line treatment up to date. We reviewed retrospectively the efficacy and safety of Ramucirumab as a single agent in our hospital. Methods: We investigated 12 cases from June (when Ramucirumab has been approved) to September. Results: The median age was 61 years old, 6 male and 6 female patients. Performance status (0/1/2) = (1/10/1) cases. (second/third/fourth or later)-lines = (4/4/4) cases. Metastatic sites are lymph node, liver, lung, bone, and peritoneum. 7 patients had gastrectomy and 5 patients of them received adjuvant chemotherapy. Response rate is 50%, median progressive-free survival is 51 days, and median overall survival is 13 months. Some patients experienced grade 1or 2 adverse events: fatigue, loss of appetite, diarrhea, and hypertension. Conclusions: We cannot say that single agent administration of Ramucirumab demonstrates good response, some patients kept stable disease in this regimen. Ramucirumab as a single agent can be an option of treatments after paclitaxel fails or when it is difficult to administrate it.
Developing and piloting an electronic telephone triage application.
Authors: Peter G. Ellis, Justin S. Rushford, Melinda Krebs, Christine Carlisle, Colleen F. Ford, Peggy Nikolajski, Carol Reidmiller, Leslie Stewart, Amanda Barry
Journal: Journal of Clinical Oncology (2017)

137 Background: With the shift of cancer care to the outpatient setting, telephone triage is a vital part of today’s oncology practice. UPMC CancerCenter (UPMC) desires to streamline the current telephone triage process across its 31 outpatient clinics. UPMC and Via Oncology collaborated to develop and pilot a prototype of an electronic telephone triage application. The key components of the prototype were defined as decision support, EHR integration, reporting, and workflow management. Methods: A prototype application, Symptom Manager (SM), was developed and piloted with 4 nurses at 3 outpatient clinics. Front office staff registered inbound calls in SM, which populated a phone triage queue. The nurse was prompted to enter information about the call. Decision support materials were displayed for reference, including algorithms for symptom assessment, adjudication, and treatment. The output was a structured summary of the encounter that was copied to the patient’s chart. From the queue, the nurse was also prompted to make outbound calls for symptom reassessment. A feedback session with the nurse users and institution leadership was held following the pilot. Results: A total of 235 inbound calls were captured in the application, of which 74 (31.5%) were symptom-related. Additional data fields collected during the pilot included symptom, adjudication, time elapsed for callback, and symptom status at follow up. The ability to extract and report on data of this type was viewed as valuable for quality and process improvement. The nurse users praised SM’s ease of use, but prototype performance issues shortened the pilot. They indicated that the standardized documentation increased efficiency. Requests for future enhancements included deeper EHR integration and additional fields for data capture. Conclusions: This pilot provided the feedback necessary to develop the latest version of SM which begins roll out across UPMC in November 2016 and includes EMR integration. An update on the software and additional data captured during the pilot will be provided at presentation.
The impact of preoperative dexamethasone on the postoperative systemic inflammatory response and complications following surgery for colorectal cancer.
Authors: Stephen Thomas McSorley, Paul G. Horgan, Donald C McMillan
Journal: Journal of Clinical Oncology (2016)

692 Background: It is now clear that there is a significant association between the magnitude of the systemic inflammatory response and postoperative complications (Adamina et al. Br J Surg 2015;102(6):590-8). The present study examined the impact of preoperative steroids on the postoperative systemic inflammatory response and complications, following elective surgery for colorectal cancer. Methods: The administration of dexamethasone at induction of anaesthesia was prospectively audited from a cohort of patients who underwent elective, potentially curative surgery for colorectal cancer at a single centre between 2008 and 2013. Results: 286 patients were included, of which the majority were male (161, 57%), over 65 (190, 66%) with colonic (183, 64%) and node negative disease (192, 67%). 114 (40%) received dexamethasone at induction of anaesthesia. There was a significant association (Table 1) between preoperative dexamethasone administration and the proportion of patients breaching established CRP thresholds on postoperative days 2 (190mg/L, 14% vs. 50%, p&lt;0.001), and 3 (170mg/L, 27% vs. 49%, p&lt;0.001) but not 4 (145mg/L, 50% vs. 36%, p=0.658). There was no significant association between preoperative dexamethasone and postoperative complications. Conclusions: The present study suggests that the systemic inflammatory response following surgery for colorectal cancer may be attenuated by preoperative steroids. It remains to be determined whether this will lead to a reduction in postoperative complications. [Table: see text]
The role of the loss of <i>CDKN2A</i> gene on prognosis in adult <i>BCR-ABL1</i>-positive acute lymphoblastic leukemia (ALL)
Authors: I. Iacobucci, A. Ferrari, A. Lonetti, C. Papayannidis, F. Paoloni, M. Abbenante, V. Guadagnuolo, E. Ottaviani, F. Cattina, A. Vitale, S. Paolini, S. Soverini, S. Parisi, M. Vignetti, M. Baccarani, G. Martinelli
Journal: Journal of Clinical Oncology (2011)

6532 Background: Loss of CDKN2A/B has been associated with poorer survival and higher leukemia-initiating-cell-frequency in xenograft models (Notta F et al. Nature 2011). Here, we aimed to: a) explore the frequency and size of deletions in CDKN2A/B genes in adult BCR-ABL1-positive ALL patients; b) determine the main mechanism of inactivation; c) investigate their prognostic role. Methods: 112 patients were analyzed: 82 (73%) de novo cases, 11 (10%) unpaired relapse cases, 19 (17%) diagnosis-relapse matched samples. Affymetrix single nucleotide polymorphism (SNP) arrays (GeneChip® Human Mapping 250K NspI and Genome-Wide Human SNP 6.0) were used to identify at a high resolution copy number changes; gene-expression profiling (Affymetrix Human Exon 1ST Array) was performed to draw a specific signature associated with deletions. Results: At diagnosis, CDKN2A and CDKN2B deletions were identified in 29% and 24% of patients, respectively. Deletions were monoallelic in 72% of cases and in 43% of them the minimal overlapping region of the lost area spanned only the CDKN2A/ B genes. In contrast, in 57% of cases the loss was considerable larger and extended sometimes over the entire short arm. Analysis of the genomic status at the relapse showed a marked increase in the detection rate of CDKN2A loss (47%) compared to diagnosis (p = 0.06). The mutation screening, performed by PCR amplification and subsequent sequencing on each exon of ARF/CDKN2A/B, showed that missense point mutations are rare with only the identification of D146N in the CDKN2A exon 2 in one case. Correlation with clinical features demonstrated that deletions of CDKN2A/B are significantly associated with poor outcome both in terms of disease free-survival (p=0.001) and cumulative incidence of relapse (p=0.001). Conclusions: Novel treatment strategies targeting the ARF-MDM2-p53 pathway or CDK4/6 may be effective in this subset of patients to overcome aggressive growth properties and in vitro studies are ongoing to confirm this hypothesis. Supported by: ELN, AIL, AIRC, Fondazione Del Monte di Bologna e Ravenna, FIRB 2006, Ateneo RFO grants, Project of integreted program, Programma di Ricerca Regione – Università 2007 – 2009.
Prediction of Poor Outcome in CLL Patients Treated with FCR (Fludarabine, Cyclophosphamide, Rituximab) in the CLL8 Trial of the German CLL Study Group (GCLLSG)
Authors: Anna Fink, Raymonde Busch, Natali Pflug, Sebastian Boettcher, Dirk Winkler, Andreas Buehler, Matthias Ritgen, Kirsten Fischer, Barbara Eichhorst, Clemens-Martin Wendtner, Myriam Mendila, Michael K. Wenger, Hartmut Doehner, Michael Kneba, Stephan Stilgenbauer, Michael Hallek
Journal: Blood (2011)