tbuckley/cabot-search huggingface dataset:
Significance of multimodality therapy for esophageal cancer synchronously or metachronously associated with head and neck cancer.
Authors: Yasue Kimura, Masaru Morita, Hiroyuki Kawano, Hajime Ohtsu, Koji Ando, Satoshi Ida, Hiroshi Saeki, Eiji Oki, Tetsuya Kusumoto, Yoshihiko Maehara
Journal: Journal of Clinical Oncology (2013)

132 Background: Esophageal cancer is highly aggressive and until recently is associated with a poor prognosis. Another clinical problem of esophageal cancer is the frequent association of head and neck cancer. The therapy for esophageal cancer and head and neck cancer is difficult. Definitive chemoradiotherapy is frequently indicated, while invasive surgical resections have been aggressively performed for patients with esophageal cancer associated with head and neck cancer. Methods: The Japanese 202 patients underwent esophagectomy were divided into two groups according to the association of head and neck cancer. The clinicopathological factors and the method of operations were evaluated and statistically analyzed. Results: The double cancer group included 26 (12.9%) patients that had the cancer of esophagus and the head and neck either synchronously or metachronously, while the control group included 176 (87.1%) patients with esophageal cancer. Seventeen patients were operated synchronously in double cancer group. No statistically significant differences were recognized in other clinical backgrounds such as the gender, location of the tumor, etc. Several types of operations were performed for two groups, such as subtotal esophagectomy, total laryngo-pharyngo-esophagectomy, cervical esophagectomy and laryngo-pharyngectomy and free jejunal transfer.salvage esophagectomy, and two-staged operation after definitive chemoradiotherapy. Salvage esophagectomy was performed in five patients with either remnant or recurrent esophageal cancer after definitive chemoradiotherapy. The mortality as well as morbidity rate of the double cancer group was not significantly different from the control group. Furthermore, patients’ prognosis was similar in the two groups. Conclusions: Esophagectomy can be an effective treatment option by adopting techniques that appropriate for each cases, such as staged operations after definitive chemoradiotherapy, muscular flaps and microvascular anastomosis, even in patients with double cancers of the esophagus and the head and neck cancer.
The effect of transcatheter arterial chemoembolization on hepatitis C virus (HCV) kinetics in patients with HCV-associated hepatocellular carcinoma.
Authors: P. Mahale, A. O. Kaseb, M. Davila, H. A. Torres
Journal: Journal of Clinical Oncology (2011)

e14578 Background: Reactivation of chronic HCV infection due to systemic chemotherapy has been sporadically reported. Transcatheter arterial chemoembolization (TACE) is an important treatment modality for unresectable hepatocellular carcinoma (HCC). A previous prospective study has suggested that TACE does not aggravate hepatitis B virus infection. We retrospectively evaluated the effect of TACE on HCV kinetics and liver function in patients with HCV associated HCC. Methods: Medical records of HCV associated HCC cases seen at our institution between 01/01/2008 and 12/31/2009 were identified. Clinical and virological data were analyzed. Reactivation of HCV was defined as a > 2 log IU/mL increase in post TACE HCV RNA as compared to baseline (pre TACE) levels. Acute exacerbation of hepatitis (AcEx) was defined as a > 3-fold increase in serum alanine aminotransferase (ALT) level, in the absence of other hepatotoxic drugs, systemic infections and recent blood transfusions. Results: Out of the 84 HCV associated HCC cases identified, 24 (29%) received TACE. Three of them had pre and post TACE HCV RNA levels. TACE was conducted with cisplatin, mitomycin and doxorubicin in two patients, and only doxorubicin in one patient. They received a total of six TACE procedures. Six episodes of AcEx were noted, one after every TACE procedure, with a median ALT peak of 394 (range, 191-2,295) IU/mL at an average of 2.7 (range, 2-3) days after TACE. Viral loads were measured on an average of 80 (range, 50-125) days after TACE. Increase in the HCV RNA levels was observed in two patients, average 0.26 (0.14-0.38) log IU/mL. In the third patient, HCV RNA after TACE decreased by 0.20 log IU/ml. No cases of HCV reactivation were identified. Two cases had genotype 1a and one had genotype 2b. All three cases were naïve to HCV therapy. Conclusions: Even though we cannot rule out a transient reactivation of HCV following TACE, increase in HCV activity appears to be uncommon following this procedure. However, larger prospective series are warranted to better define this entity.
Prior and concurrent use of abiraterone and enzalutamide with Ra-223 in an expanded access setting.
Authors: A. Oliver Sartor, Daniel Celestino Fernandez, Michael J. Morris, Andrei Iagaru, Alan Brown, Fabio Almeida, Christopher Sweeney, Matthew Raymond Smith, Adam Dicker, Yu-Ning Wong, Neal D. Shore, Jeremy Gratt, Oana Petrenciuc, Nicholas J. Vogelzang
Journal: Journal of Clinical Oncology (2015)

253 Background: The aim of this prospective early-access program (EAP) was to monitor acute and long-term safety of Ra-223 CL2. The ALSYMPCA RA-223 phase III trial was completed prior to abiraterone (Abi) and enzalutamide (Enza) approval. Herein we provide experience with RA-223 in relationship to Abi and Enza. Methods: Symptomatic bone metastatic CRPC pts in the US who were ineligible for or had prior docetaxel were enrolled. Treatment included Ra-223 50 kBq/kg IV q4weeks for 6 cycles concomitant with standard of care medications. Analyses were conducted to assess safety and overall survival (OS) in pts with prior and concurrent Abi and Enza. Results: Of 184 treated, 120 (65%) had prior and 35 (19%) pts had concurrent Abi; 59 (32%) had prior and 25 (14%) pts had concurrent Enza. Baseline characteristics were generally balanced in the overall and across prior and concurrent groups. Pts with no concurrent Abi or Enza had a similar OS to the overall group (Abi 16m, Enza 17m, overall 17m). Due to a small number of events (7 Abi, 6 Enza), a median value was not calculated for the concurrent groups. 8 deaths occurred during treatment none were related to RA-223. The rate of Grade 3-5 AEs was similar across concurrent (Abi 37%, Enza 36%) and prior groups (Abi 43%, Enza 42%) vs overall 41%. Most frequently occurring Gr 3-4 events were anemia (Abi 17%, Enza 8%, overall 11%), thrombocytopenia (Abi 6%, overall 3%), and back pain (Enza 8%, overall 4%). Conclusions: In this EAP, Ra-223 concurrently administered with either abiraterone or enzalutamide was safe and well tolerated adding important information on concurrent use of RA-223 and hormonal agents. Clinical trial information: NCT01516762. [Table: see text]
Erythroid Adhesion Molecule Expression Profile in Sickle Cell Anemia Infants
Authors: Valentine Brousse, Yves Colin, Catia Pereira, Arnaud Cecile, Marie-Helene Odievre, Anne Boutemy, Claudine Lapoumeroulie, Julien Picot, Mariane De Montalembert, Caroline Le Van Kim, Wassim El Nemer
Journal: Blood (2014)
Short-schedule cisplatin and vinorelbine as induction chemotherapy in stage IIIA(N2)-IIIB non small cell lung cancer (NSCLC)
Authors: P. A. Zucali, H. J. Soto Parra, R. Cavina, F. de Vincenzo, E. Campagnoli, I. Garassino, L. Balzarini, M. Alloisio, G. L. Ceresoli, A. Santoro
Journal: Journal of Clinical Oncology (2005)

7267 Background: Multimodality therapy including induction chemotherapy is the standard treatment for locally advanced NSCLC. Aim of this study was to evaluate the activity and the influence on resectability of a short, intensive schedule of cisplatin and vinorelbine as induction chemotherapy for patients (pts) with stage IIIA(N2)-IIIB NSCLC. Methods: Between 8/01 and 6/04 48 pts with pathological stage IIIA(N2)-IIIB were enrolled in a single institution. Three courses of cisplatin 50 mg/m2 days 1,2 and vinorelbine 25 mg/m2 days 1,3 were given every three weeks with prophylactic G-CSF from day 11 to 15. In absence of disease progression, pts were evaluated for resection and underwent surgery and/or radiotherapy (RT). Results: Pts characteristics were: stage IIIA/IIIB 15/33, M/F 43/5, PS 0/1 31/17. One CR (IIIA) and 37 PR (14/15 IIIA, 23/33 IIIB) were observed, for a RR of 79%. Twenty-six of 48 pts (54%), of which 13/33 stage IIIB (39%), underwent complete resection with 17/26 (65%) downstaged by chemotherapy; adjuvant RT followed surgery in 9 pts. Twenty-two pts were judged unresectable; 13 (12 stage IIIB) were treated with radical RT, 11 received palliative therapy. Major toxicities (grade 3–4) were: neutropenia in 40 pts (83%), febrile neutropenia in 7 (14%); anemia in 3 (6%), constipation in 4 (8%), nausea/vomiting in 10 (21%). No toxic death occurred. With a median follow-up of 13 months (range 5–35), we observed 3 local and 3 distant failures in completely resected pts. Median time to progression was 14 months in all pts and 21 months in resected pts. Median overall survival (OS) has not been reached yet; 1-yr OS was 83%. Conclusions: The short schedule of cisplatin and vinorelbine was notably effective as induction regimen in this unfavorable subset of pts (stage IIIB 69%), with a high RR and resectability rate. A longer follow-up is needed to assess the impact of this treatment on pattern of relapse and survival. No significant financial relationships to disclose.
Molecular characteristics of complete PTEN loss in metastatic colorectal cancer.
Authors: Zhi-Qin Jiang, Laurel Deaton, Nastaran Neishaboori, Jean-Nicolas Vauthey, Michael J. Overman, Dipen M Maru, Scott Kopetz
Journal: Journal of Clinical Oncology (2013)

389 Background: Loss of expression of phosphatase and tensin homolog (PTEN) is associated with activation of the PI3K/AKT pathway, and has been identified as a potential modulator of response to targeted therapies in metastatic colorectal cancer (mCRC). The association of PTEN loss with other molecular characteristics and outcomes has not been described for mCRC. Methods: Tumor from 229 mCRC patients (pts) were included for analysis of PTEN staining by IHC from whole-mounts, across two cohorts of unresectable mCRC or resectable liver-limited disease. PTEN loss was defined as complete loss of staining with preservation of expression of stromal components. Mutation status was defined using mass-spectroscopy or next-generation sequencing platforms. CpG island methylation (CIMP) status was determined using a previously defined 6-marker panel, with methylation of ≥3 markers denoting CIMP-High. Methylation findings where confirmed in 193 pts from the Cancer Genome Atlas (TCGA) database, using previously defined classifications. Results: The overall frequency of complete PTEN loss was 12% in the primary tumor and 15% when assayed from metastatic sites (P=NS). There was no difference in clinical characteristics in patients with PTEN-loss tumors. Complete PTEN loss and PIK3CA mutations were not mutually exclusive, with PIK3CA mutation rate of 24% and 14% in PTEN loss and intact, respectively (p=0.3). There was no association of PTEN loss with KRAS mutations (p=0.3), although there were non-significant trends toward higher rates of CIMP-High, BRAF mutations, and R-sided tumors (OR 3.2, 2.7, and 1.6, respectively; p&lt;0.2), consistent with an association with the serrated adenoma pathway and epigenetic inactivation. In the TCGA, PTEN protein loss (defined by the lowest 12% of expression) was associated with increased AKT signaling (77% increase in pAKT/AKT, p&lt;0.01) and a similar trend with CIMP-H tumors (OR 3.1, p=0.13). Conclusions: In patient samples, PTEN loss is independent of KRAS and PIK3CA mutations, associated with robust AKT pathway activation, and may be more prominent in tumors with hypermethylation and BRAF mutations.
Validation of a real-time patient-reported experience measurement tool for cancer patients in Ontario.
Authors: Lesley Moody, Sarah Benn, Luciano Ieraci, Saurabh Ingale, Simron Singh
Journal: Journal of Clinical Oncology (2016)

174 Background: Cancer Care Ontario (CCO) organizes and ensures quality cancer care for 16 million residents in Ontario. CCO's goal is to create a tool to enable reporting of the patient experience in real time. The study objective was to develop a validated real-time (close to or at point of care) patient reported experience measurement (PREM) tool to drive quality improvement, advance system planning and ensure cost effective resource allocation based on patients’ needs, wants and preferences in ambulatory oncology treatment phase. Methods: Consisting of 28 questions – 18 core questions; 2 open-ended responses; and 8 demographic questions the tool underwent cognitive testing with patient family advisors and was validated using a pilot at 6 cancer centres from April to August, 2015. It was administered using several delivery modes: tablets, patient portals, post cards and paper. The patient journey in visiting centres was conceptualized as containing the steps or domains of interest: arrival, appointment/consultation and overall experience. To validate the patient experience conceptual model, an exploratory factor analysis was performed and compared to CCO’s 8 domain patient experience model. Reliability and validity of the tool was tested using Cronbach’s alpha and multiple variable regression analysis in partnership with Ipsos Reid. Results: 557 responses (496 electronic and 61 paper) formed the basis of the analysis. The tool was shown to be both valid and reliable - an overall adjusted R 2 value of 64% from multiple variable regression on overall patient experience; and an overall Cronbach alpha value of 0.83, respectively. Individual Cronbach alpha values ranged from: 0.69 for “appointment/consultation”, 0.55 for “overall experience” and 0.24 for patient “arrival.” Conclusions: Statistical analysis results were used to produce a final validated tool for deployment to systematically capture PREMs through an electronic system in Ontario, Canada in 2016.To our knowledge this is the first of its kind. Collection of real time PREMS will ensure local and system level planning and quality improvement in the cancer system are rooted in what matters most to patients and their families.
Low Day 30 Total Donor Chimerism After Reduced-Intensity Conditioning Allogeneic Hematopoietic Stem Cell Transplantation Is Associated with Poorer Overall Survival In Myeloid but Not Lymphoid Disorders
Authors: John Koreth, Haesook T Kim, Vincent T. Ho, Corey Cutler, Philippe Armand, Robert J Soiffer, Joseph H. Antin, Edwin P. Alyea
Journal: Blood (2010)
Influence of KRAS mutation status in metachronous and synchronous metastatic colorectal adenocarcinomas.
Authors: D. S. Serna, L. K. Martin, X. Li, L. M. Weatherby, J. S. Rose, T. Bekaii-Saab
Journal: Journal of Clinical Oncology (2011)

388 Background: Mutations in the KRAS oncogene are present in approximately 30-40% of colorectal adenocarcinomas. Wild-type (WT) KRAS mutational status is recognized to be predictive of tumor response with epidermal growth factor receptor-directed therapies such as cetuximab and panitumumab. Studies evaluating the prognostic value of KRAS status in localized (stage II and III) disease have been contradictory. The prognostic value in metastatic disease, either synchronous or metachronous, is less studied. Methods: Consecutive patients with metastatic colorectal adenocarcinoma underwent tumor testing for KRAS exon 2 (codons 12 and 13) mutations by polymerase chain reaction amplification and direct nucleotide sequencing. The clinical characteristics, treatments, and outcomes of these patients were then retrospectively analyzed, stratified by synchronous or metastatic disease and KRAS mutational status (WT or mutated). Results: For synchronous metastatic disease, KRAS WT patients (n = 39) had median overall survival (OS) of 34.3 months (95% CI, 21.8-58.3). KRAS mutated patients (n = 24) had median OS of 40.3 months (95% CI, 25.7-51.0; log-rank p = 0.55). By Kaplan-Meier survival analysis, 3-year OS was 48.9% (95% CI, 31.1-64.5) for KRAS WT and 51.1% (95% CI, 27.6-70.6) for KRAS mutated patients. Five-year OS was 27.8% (95% CI, 11.6-46.8) for KRAS WT and 9.7% (95% CI, 0.7-33.8) for KRAS mutated patients. For metachronous metastatic disease, from time of development of metastasis, KRAS WT patients (n = 29) had median OS of 33.2 months (95% CI, 28.3-40.7). KRAS mutated patients (n = 16) had median OS of 53.0 months (95% CI, 27.8-not applicable; log-rank p = 0.29). By Kaplan-Meier survival analysis, 3-year OS was 40.1% (95% CI, 19.9-59.7) for KRAS WT and 57.3% (95% CI, 25.0-80.0) for KRAS mutated patients. Five-year OS was 22.9% (95% CI, 7.6-43.2) for KRAS WT and 28.6% (95% CI, 1.7-68.1) for KRAS mutated patients. Conclusions: KRAS mutation status does not influence overall survival in either synchronous or metachronous metastatic colorectal adenocarcinoma. No significant financial relationships to disclose.
Cancer with diabetes: Prevalence, metabolic control, and survival in a general oncology practice.
Authors: N. J. Karlin, A. C. Dueck, C. Cook
Journal: Journal of Clinical Oncology (2011)

1542 Background: Diabetes and cancer are both common diseases, but more data is needed about the population in order to develop clinical programs to treat the patients (pts) with these two complex coexisting disorders. Therefore, we examined the prevalence of diabetes in a general oncology practice, the level of glycemic control, and the impact of diabetes on overall survival (OS). Methods: Data on cancer cases from 1999-2008 were retrieved from the institutional cancer registry and linked to electonic files to establish which pts had a diagnosis of diabetes and determine hemoglobin A1c (A1c) levels during the first 6 months post diagnosis. Continuous and categorical values were compared using F-tests and chi-squared tests, respectively. OS was compared between pts with and without diabetes by cancer type using Cox regression adjusting for age and sex. Results: Excluding skin and hematologic malignancies there were a total of 15,951 cancer cases. The 3 most common primary cancer diagnoses were prostate (27%), breast (15%), and lung (11%). Overall diabetes prevalence among cancer pts was 6.8% and was most frequent among pts with pancreatic, colorectal, and bladder cancers. Pts with diabetes were older than those without (70 vs 66 yrs, P<0.001), and had a higher rate of male sex (66% vs 60%, P<0.001); age and gender differences were noted specifically for lung, colorectal, and pancreatic cancer, and age for breast and prostate cancer. Overall mean A1c was 6.8% and did not significantly differ across cancer types (p=0.80). Only 59% of pts overall maintained an A1c<7.0%. Pts with pancreatic cancer and diabetes had better OS than pancreatic pts without diabetes (HR=0.60, P<0.001). Conversely, pts with prostate cancer and diabetes had worse OS than pts with prostate cancer without diabetes (HR=1.36, P<0.02). Conclusions: Diabetes is common in a general oncology practice, with age and gender variation seen in diabetes prevalence. Glycemic control is suboptimal in many pts, and survival varies by cancer type. Additional study is needed on how to best optimize glucose management in pts with coexisting cancer and diabetes, and into the mechanisms in how diabetes influences survival in some pts with cancer.
The VcR-CVAD Regimen Produces a High Complete Response Rate in Untreated Mantle Cell Lymphoma (MCL): First Analysis of E1405 – A Phase II Study of VcR-CVAD with Maintenance Rituximab for MCL.
Authors: Brad S Kahl, Hailun Li, Mitchell R Smith, Randy D. Gascoyne, Elisabeth Paietta, Ranjana Advani, Sandra J Horning
Journal: Blood (2009)
CT scan scoring to predict optimal debulking in advanced epithelial ovarian carcinoma(EOC): A randomized study
Authors: L. Kumar, R. Hariprasad, S. Thulkar, S. Kumar, N. Bhatla, S. Deo, N. K. Shukla, R. Singh
Journal: Journal of Clinical Oncology (2008)

5592 Background: Amount of residual tumor following primary surgery in advanced EOC is an important prognostic factor. We validated Meyer's scoring model (AJR 1995; 165: 875–8) and developed a modified scoring model based on CT scan findings to predict optimal debulking (residual tumor ≤1cm). Methods: In an ongoing randomized study previously untreated patients with stage IIIC & IV (pleural effusion only) underwent either primary surgery followed by 6 cycles of paclitaxel plus carboplatin (TC) (Arm A) OR Neoadjuvant chemotherapy - 3 cycles of TC followed by interval debulking then 3 more cycles of TC (Arm B) (ASCO 2007, abstract 5531). Preoperative CT films of patients in arm A were evaluated by a radiologist blinded of surgical results. Residual tumor >1 cm was considered suboptimal. We modified Meyer's scoring by taking liver and diaphragm as one parameter and additional 7 pelvic regions for evidence and extent of metastatic disease. A score of 0 was given if uterus was involved, 1- if rectum, urinary bladder or sigmoid colon and a score of 2 for involvement of ureter, pelvic side walls or vascular encasement. These scores were added together for a total score of 0–10 and were compared with the surgical findings. Results: 57 patients (median age 52 years (range 28–62 years) (stage IIIC -48, IV-9), were randomized to primary surgery arm. Overall optimal debulking rate was 30% (17/57). Meyer's Scoring : 35 patients had a score of ≥3; 33 had suboptimal debulking. Among 22 patients with a score of <3, 15 had optimal debulking (p<0.0001). Modified scoring : 37 patients had a score of ≥3; 35 had suboptimal debulking. of 20 patients with a score of <3; 15 had optimal debulking (p<0.0001). The sensitivity, specificity, positive and negative predictive values to predict suboptimal debulking (score ≥3) as per Meyer's criteria are - 68%, 94%, 88%, and 82%, respectively. These are further improved using modified scoring, being 75%, 95%, 88%, and 88%, respectively. Encasement of ureter and pelvic side walls by tumor always resulted in suboptimal debulking. Conclusions: A careful analysis of preoperative CT scan findings may help to identify patients likely to have suboptimal debulking. Adding pelvic findings to Meyer's scoring increases the sensitivity and negative predictive value of the score. No significant financial relationships to disclose.