tbuckley/cabot-search huggingface dataset:
Comparative evaluation of effectiveness of neoadjuvant chemoimmunotherapy (nPCIT) for non-small cell lung cancer (NSCLC).
Authors: Yuri Lazutin, Sergey P. Pyltsin, Igor N. Turkin, Liubov Yu Vladimirova, Tamara G. Ayrapetova, Anna V. Chubaryan, Igor A. Leyman, Pavel A. Anistratov, Oleg N. Stateshny, A. S. Shogenov, M. A. Gappoeva, M. Afaunov, S. G. Beleckiy, Rukiyat Isaeva
Journal: Journal of Clinical Oncology (2018)

8534 Background: The purpose of the study was to compare the results of neoadjuvant polychemoimmunotherapy (nPCIT) and conventional neoadjuvant polychemotherapy (nPCT) in patients with NSCLC. Methods: 64 pts with NSCLC were divided into 2 groups: main group – 32 pts, 2 nPCIT cycles (cisplatin 80 mg/m2 on day 1, gemcitabine 1200 mg/m2 on days 1 and 8 with i.v. infusions of the recombinant hybrid protein of tumor necrosis factor-alpha-thymosin-alpha1 100 000 IU on days 0, 3 and 6); control group – 32 pts, nPCT with the same cytostatics. Central cancer in 17(53.1%) pts of the main group (cT1NX-6.2%, cT2NX-37.5%, cT3NX-3.1%) and 20 (62.5%) (cT1NX-9.4%, cT2NX-40.6%) controls, peripheral cancer in 15(46.9%) (cT2b NX-9.4%, cT3> 7 NX-21.8%, cT3NX-18.7%, cT4NX-3.1%) and 12(37.5%) (cT2b NX-12.5%, cT3NX-34.3%, cT4NX-3.1%), respectively. Squamous cell carcinoma in 17(53.2%) and 14(43.8%), adenocarcinoma in 7(21.8%) and 5(15.6%), non-small cell carcinoma in 8(25%) and 13(40.6%) pts, respectively. Results: CR in 3 (9.4%) and 2 (6.2%), PR - 14 (43.7%) and 13 (40.6%), SD - 13 (40.6%) and 14 (43.7%), PD - 2 (6.2%) and 3 (9.4%). Objective overall response rate was 53.1% in nPCIT vs 46.8% in nPCT, CR+PR+SD was 93.7% and 90.6%, respectively. 29 (90.6%) pts in each group received surgery. Extended lobectomy/bilobectomy in 14 (48.2%) pts in each group, extended pneumonectomy in 7 (24.1%) in nPCIT and 8 (27.5%) in nPCT. N2 disease in 10 (34.5%) and 13 (44.8%) pts, respectively. Post-surgical restaging: st. 0 – 10.3% vs 6.9%, st. I - 34.5% vs 31%, st. II - 20.7% vs 17.2%, st. IIIА - 34.5% vs 44.7%. Median survival in the main group - not reached, in controls – 23 months. OS was studied in pts with st. 0-II and st. IIIAN2 NSCLC; 3-year OS in early stages was 72% in the main group vs 49% in controls (p = 0.0735). Conclusions: The direct results were similar in nPCIT and nPCT, but 2-year EFS was 72% and 44%, respectively, with a tendency to improvement (p = 0.05421). 2-year OS in pts with st. IIIAN2 NSCLC improved to 55% in the main group vs 32% in controls (p = 0.031777).
Phenotypic characteristics of erythrocytes in patients with malignant and benign tumors.
Authors: Andrey A. Maslov, Oleg Ivanovich Kit, Nailya Guskova, Svetlana V. Belgova, Ekaterina Guskova, Izabella Torpudzhyan, Aliya K. Donskaya, Marina A. Gusareva, Kristina Avanesova, Anastasia Nozdricheva, Nadezhda Golomeeva, Svetlana V. Abakumova, Tatiana Yu. Myagkova, Zinaida P. Lisunova, Viktoria Zakharchenko, Irina V. Tselishcheva, Ineya I. Zekhtser
Journal: Journal of Clinical Oncology (2018)

e24327 Background: The purpose of the study was to analyze the phenotypic profile of erythrocytes in Rhesus and Kell systems in patients with malignant and benign tumors. Methods: Phenotyping of erythrocytes by the D, C, c, Cw, E, e, K, k and с antigens was performed with the gel technology (Auto Vue Innova system, USA) in 147 patients: acute lymphoblastic leukemia (ALL) – 26 (17.6%) patients, cancer - 39 (26.5%), lymphoma - 18 (12.2%), sarcoma - 25 (17%), neuroblastoma - 15 (10.2%), benign tumors - 24 (16.3%). Results: Rh (D) positive phenotype was found in 106 (72.1%) patients which was similar to the antigen prevalence in the European population. Kell phenotype distribution was as follows: СсееК- (31.2%) > ссееК- - (20.4%) > ССееК- (17.0%) > ссЕеК- (10.8%) > СсЕеК- (9.5%) > ссЕЕК- (4.0%) > СсЕЕК- (1.4%) > ccееК+ (1.4%) > ссЕеК+ (1.4%) > ccEEК+ (0.68%) > СсееК+ (0.68%) > СсЕеК+ (0.68%) > СсЕЕК+ (0.68%). Three phenotypes were the more frequent: СсееК- in 46 (31.2%) patients, ссееК- - in 30 (20.4%), СееК- - in 25 (17.0%). The most common phenotype in ALL was СсееК- (27.0%), cancer – ccееК- (30.7%), lymphoma - СсееК- (55.5%), sarcoma - cceeK- (32.0%), neuroblastoma - CceeK- (53.3%), benign tumors – ССееК- (25.0%). 124 (85.04%) of 147 patients had homozygous combinations of Rhesus antigens - СС, сc, ЕЕ and ее. 25 (17.0%) patients were homozygous for the C antigen and 52 (35.4%) - for the c antigen. In ALL, homozygotes for the C and c antigens were observed in 11.5% and 42.2%, respectively, in cancer – 15.3% and 25.5%, lymphoma – 16.6%, and 16.6%, sarcoma – 20.0% and 40.0%, neuroblastoma – 13.3% and 19.9%, benign tumors – 25.0% and 37.5%, respectively. Thus, every third patient had the c antigen, except patients with ALL (every second patient) and lymphoma (every sixth patient). Conclusions: The most frequent phenotypes were СсееК-, ссееК- and ССееК-. Patients with oncopathologies homozygous for the C antigen with the ССееК- phenotype were at risk of blood transfusion complications.
Abstract 17874: Quantitative Assessment of Left Ventricular Function in MYH7 and MYBPC3-Related Hypertrophic Cardiomypathy by Feature-Tracking Magnetic Resonance Imaging
Authors: Shi Chen, Jie Wang, Weihao Li, Ke Wan, Jiayu Sun, Yucheng Chen
Journal: Circulation (2017)

Introduction: Gene mutations in myosin-binding protein C3 (MyBPC3) and beta-myosin heavy chain (MYH7) are the 2 most common genetic cause of hypertrophic cardiomyopathy(HCM). Limited studies compar...
A pilot study to assess the accuracy of “intuition” in analyzing post chemotherapy (chemo) residual retroperitoneal (RP) masses in patients (pts) with non seminomatous germ cell tumor (NSCGCT).
Authors: Clint Cary, Maitri Kalra, Alvaro G. Menendez, Timothy A. Masterson, Richard Foster, Lawrence H. Einhorn
Journal: Journal of Clinical Oncology (2018)

e16535 Background: About half of the pts operated for residual RP mass after chemo for NSGCT do not benefit from surgery because the residual mass contains only necrosis. We sought to assess the accuracy of “intuition” or experienced guess by urologists at a large tertiary referral center for identifying malignant tumors (teratoma and/or viable cancer cells) after primary chemo for disseminated NSGCT. Methods: We included pts with persistent RP mass after chemo who were referred to urology clinic for assessment for post chemo RP lymph node dissection (PC RPLND). All pts had normal tumor markers (serum HCG and AFP) after completion of chemo and at the time of analysis. The urologists looked at clinical data – pt history, orchiectomy histology, post chemo CT scans, tumor markers and made an intuitional analysis of the residual mass as teratoma, necrosis or malignancy. After pts had RPLND, their histology was compared to the intuition analyses. Results: Pt characteristics are summarized in Table 1. The urologists’ intuition matched the final pathology in 37/53 (70%) cases. Table 2 shows number of correct predictions. Table 3 shows the histology compared to predictions. There was a trend towards an interaction of residual mass size and urologist intuition to correctly predict histology, but this was not statistically significant (p = 0.57). Conclusions: Urologists at a tertiary care center with experience of treating NSGCT pts can predict histology reasonably well. Future directions will be implemented towards combining this with radiology and potential molecular assessments to reduce surgeries in pts with necrosis. TABLE 1 CHARACTERISTICS No.(%) Median Age (range) 29 (25-37) Teratoma in orchiectomy · Yes 32 (62) · No 20 (38) Chemotherapy regimens · BEPx3 16 (30) · EPx4 9 (17) · BEPx4 15 (28) · Combination of BEP/EP 5 (9) · Combination of BEP/VIP 2 (4) · HDCT 1 (2) · VIP 5 (10) TABLE 2 RPLND histology Correct prediction (%) Cancer 2 0 Teratoma 38 30(79) Necrosis 13 7(53.9) TABLE 3 Pathologic correlation of Urologists’ intuition Urologist intuition RPLND histology Cancer 0 - Teratoma 38 30 Teratoma, 6 Necrosis, 2 Cancer Necrosis 15 7 Necrosis, 8 Teratoma
Effect of therapeutic pressure on stability of EGFR amplification in glioblastoma.
Authors: Manmeet Singh Ahluwalia, Cara R. Dimino, Mahesh M. Mansukhani, Vundavalli V. Murty, Peter Canoll, Yoshitaka Narita, Yoshihiro Muragaki, Hui Kong Gan, Ryan Thomas Merrell, Martin J. Van Den Bent, Zheng Zha, Lisa Roberts-Rapp, Fang Jiang, Maria Guseva, Earle E. Bain, Christopher Joseph Ocampo, Peter J Ansell, Andrew B. Lassman
Journal: Journal of Clinical Oncology (2018)

2033 Background: Depatuxizumab mafodotin (depatux-m, formerly ABT-414) is an EGFR-directed antibody-drug conjugate being developed for treatment of EGFR-amplified glioblastoma (GBM). As therapeutic pressure engenders tumor adaptations, it is important to understand the stability of biomarkers targeted by precision medicine approaches such as depatux-m. Therefore, we assessed EGFR amplification (amp) and expression in longitudinally-sampled GBMs from patients (pts) treated +/- depatux-m to explore biomarker stability. Methods: Formalin-fixed, paraffin embedded GBM tumor tissue was analyzed from 68 patients who underwent at least 2 surgeries; EGFR amp was detected by in situ hybridization (e.g., FISH) or next-generation sequencing in all samples. Fifty-six pts did not receive depatux-m; among 12 pts who did, EGFR expression was also evaluated by RNA sequencing. Results: Of 56 pts who did not receive depatux-m, 31 (55%) had tumors harboring EGFR amp at 1st surgery (initial diagnosis); among those, EGFR amp was maintained at re-operation in 27 (87%), and not maintained in 4 (13%). None of the 25 cases without baseline EGFR amp acquired it at the 2nd surgery. Of 12 pts treated with depatux-m between surgeries, 9 cases harbored EGFR amp at baseline which was maintained in 4 (44%) at the 2nd surgery, all 4 of which had the highest levels of EGFR expression at baseline. Of the 3 cases without EGFR amp at baseline, none acquired amplification at the 2nd surgery, and all 3 had the lowest levels of EGFR expression at study start. Conclusions: The presence of EGFR amp in GBM tissue at baseline was maintained at 2nd surgery in 87% of pts who received treatment other than depatux-m, and in 44% following depatux-m exposure. Therefore, depatux-m exposure appears to reduce EGFR amp maintenance (p = 0.0159 by Fisher's exact test); accordingly, the therapeutic approach may influence EGFR status. In no case was EGFR amp acquired at recurrence, regardless of depatux-m therapy. Ongoing analyses of additional tumor samples will increase power and further examine concordance among EGFR amp assays.
Charlson Comorbidity Index (CCI) score to predict early reduced relative dose intensity in patients receiving oxaliplatin for colorectal cancer.
Authors: Sorcha Ring, Derbrenn O'Connor, Niamh Cooney, Brian Richard Bird
Journal: Journal of Clinical Oncology (2017)

e18125 Background: Colorectal cancer (CRC) is commonly treated in both adjuvant and palliative settings with Oxaliplatin. Painful peripheral neuropathy resulting in dose adjustments is a well recognized side effect in up to 30% of cases. Relative dose intensity (RDI), an expression of the percentage of planned dose received at a scheduled time, is a tool used to measure how closely a prescription has been adhered to. Studies have suggested a decreased RDI (&lt;85%) is associated with inferior outcomes. The aim of this study was to calculate the RDI for CRC patients undergoing treatment with Oxaliplatin, to investigate reasons for dose delays and reductions and to calculate a Charlson Co-Morbidity Index Score (CCIS) for each patient Methods: CRC patients treated with Oxaliplatin from 2010-2016 within the BSHC were identified using pharmacy lists and pathology reports. The following exclusion criteria were applied: non first line Oxaliplatin and excluding cycles after three months. Data was obtained through a systematic, retrospective chart review. An audit of the chemotherapy prescriptions allowed the RDI to be calculated and the CCIS was calculated using a colorectal specific Index previously described. Results: We identified 176 eligible patients, 83 charts were available for review and 69 charts contained all necessary information to be included. Xelox (61%), Folfox-6 (35%) and Flox (4%) were the chemotherapy agents involved in this study. The average RDI achieved was 87.47%, with a range of 25%-103.17%. The primary cause for dose adjustments was peripheral neuropathy (64%). The CCIS range was 0 -3, with results demonstrating a significant connection between a higher CCI and lower RDI, see table 1. Conclusions: A CCIS ≤ 1 correlates to achieving a higher RDI, with each of these subgroups achieving above the acceptable cut off for RDI (&gt;85%), as such certain co-morbidities may be early predictors of reduced RDI. [Table: see text]
Abstract 13301: Comparative Utilization of Cardiac Stress Testing in US Patients With and without Chronic Kidney Disease
Authors: Charles A Herzog, Tanya Natwick, Shuling Li, David M Charytan
Journal: Circulation (2016)

Introduction: A “nihilistic approach” to coronary artery disease (CAD) in pts with chronic kidney disease (CKD) has previously been reported. We have revisited this “truism” in the context of cardiac stress testing in the modern era (2008-12). Methods: The 20% Medicare sample was searched by single cohort years (2008-12) to identify pts age 65+ with no CKD (n = 4,232,080 in 2012) and Stages 1-5D CKD (n= 332,058 in 2012). Rates of non-invasive CAD testing (Stress: Echo, Nuclear, MRI, and ECG and CT: angiography or Calcium score) were estimated within each cohort by year. Results: Non-CKD demographics (2012): 33% age 75-84, 14% age 85+, 87% white, 7% black, 42% male; CKD (2012): 41% age 75-84, 25% age 85+, 81% white, 13% black, 47% male, 7% CKD stages 1 &amp; 2, 64% 3,4,5ND, 7% ESRD, and 22% unknown stage. Demographics of pts receiving tests (2012): non-CKD: 35% age 75-84, 6% age 85+, 88% white, 7% black, 48% male; CKD: 44% age 75-84, 10% age 85+, 80% white, 13% black, 54% male, 7% CKD stages 1 &amp; 2, 67% 3,4,5ND, 8% ESRD and 17% unknown stage. The rate of stress testing (per 100 pt-yrs) was 11.5 for non-CKD and 16.8 for CKD pts in 2008, declining to 9.4 and 13.4 respectively in 2012 (see figure for stress testing rate by yr). Stress nuclear testing predominated: 80.3% (non-CKD) and 88.2% (CKD) of all stress tests in 2008 and 77.7% (non-CKD) and 87.1% (CKD) in 2012 vs stress echo: 11.6% (non-CKD) and 7.4% (CKD) in 2008 and 12.6% (non-CKD) and 7.4% (CKD) in 2012. Approximately 2,000,000 Medicare pts age 65+ received a stress test In 2012. Conclusions: There has been a progressive decline in rates of stress testing in both non-CKD and CKD pts from 2008 to 2012. Stress nuclear imaging accounts for more than three-fourths of all stress tests. CKD pts have a consistently higher rate of stress testing compared to non-CKD pts in 2008-12. Commonly held perceptions of under-utilization of stress testing for CAD in CKD pts are false in the current era.
Trial prospector update: A point of care automated clinical trials matching application.
Authors: David Lawrence Bajor, Neelesh Sharma, Mital Shirish Patel, GQ Zhang, Patrick Mergler, Shiqiang Tao, Saroj Sigdel, Sarah Fulton, Jessica Surdam, Neal J. Meropol
Journal: Journal of Clinical Oncology (2018)

6554 Background: Advances in oncological care and patient outcomes are commonly based on clinical trials, however only 3-7% of cancer patients participate. One major barrier to patient enrollment is the physician effort needed to identify clinical trials for which their patients are eligible. As clinical trial eligibility becomes more complex with cohorts defined by specific lines of therapy or genetic data this barrier grows. Health information technology presents an opportunity to develop automated systems capable of matching patients to appropriate clinical trials in real time without impeding clinical workflow. Methods: Trial Prospector (TP) is a web-based, point-of-care, automated clinical trials matching application. (Sahoo SS, et al. Trial Prospector: matching patients with cancer research studies using an automated and scalable approach. Cancer Informatics 13:157-66, 2014. Corresponding author. PMID: 25506198) In order to enhance its utility, we systematically reviewed eligibility criteria in all lung cancer trials on clinicaltrials.gov, and integrated five new criteria into TP, including the capability to match based on next-generation sequencing data. We then deployed TP in lung cancer clinics, surveyed users for usability, independently verified the accuracy of TP, and measured clinical trial accrual. Results: A total of 380 patient visits (282 unique), were included; 10.3% of patients were subsequently accrued to a clinical trial. Among a sample of 25 TP reports, the accuracy of TP, defined as the percentage of correctly matched trials, was 98%. Clinician surveys (n = 38) revealed that 82% found the information provided by TP to be accurate, 71% reported that TP saved them time in identifying potential clinical trials, and 87% would recommend utilizing TP for eligibility screening. Conclusions: TP is an adaptable software platform that accurately matches patients to clinical trials in a point-of-care setting. Further testing is warranted to determine the optimal settings for deployment and the impact on physician effort and trial accrual.
Real-world adherence and treatment discontinuation with trifluridine/tipiracil (FTD-TPI) compared with regorafenib (REG) for the treatment of metastatic colorectal cancer (mCRC).
Authors: Anuj K. Patel, Mei Sheng Duh, Victoria E. Barghout, Mihran Ara Yenikomshian, Yongling Xiao, Willy Wynant, Majid Tabesh, Charles S. Fuchs
Journal: Journal of Clinical Oncology (2017)

e15000 Background: FTD-TPI and REG both prolong survival in refractory mCRC. Both agents have the benefit of oral administration but with distinct side effect profiles. This study aims to compare real-world treatment patterns following initiation of FTD-TPI or REG for mCRC in a large, nationally representative US claims database. Methods: Retrospective data from 10/2014 to 7/2016 from the US Symphony Health Solutions’ Integrated Dataverse (IDV®) database were analyzed for patients (pts) receiving FTD-TPI or REG. The index date was the date of first FTD-TPI or REG prescription. Pts were included if: 1) age ≥18 years old, 2) ≥1 CRC diagnosis, 3) no diagnosis of gastric cancer or gastrointestinal stromal tumor, and 4) continuous clinical activity for ≥3 months before and after index date. The observation period spanned from index date to end of data, end of continuous clinical activity, or switch to another mCRC treatment. Medication adherence was assessed by medication possession ratio (MPR), with MPR ≥80% as the defined threshold for adherence, as well as by proportion of days covered (PDC) at 3 months. Between treatment groups, binary endpoints were compared using Chi-square tests and mean and median time to treatment discontinuation (TTD) were compared using t-test and Wilcoxon test, respectively. Results: The study population consisted of 1,630 FTD-TPI pts and 1,425 REG pts. Mean ± standard deviation (SD) age of FTD-TPI pts was 61 ± 11 and REG pts was 63 ± 11 (p &lt; 0.01). Mean ± SD length of observation period in days was 161 ± 59 for FTD-TPI pts and REG pts was 212 ± 113 (p &lt; 0.01). 84% of FTD-TPI and 74% of REG pts reached MPR ≥80% (p &lt; 0.01). FTD-TPI pts had higher mean PDC (71% vs 59%, p &lt; 0.01) than REG pts. Mean and median TTD were significantly longer for FTD-TPI than REG pts (mean: 101 vs. 88 days, p &lt; 0.01; median: 97 vs. 69 days, p &lt; 0.01). Conclusions: In this analysis of real-world medication utilization for mCRC pts, those pts started on FTD-TPI had significantly higher medication adherence and longer TTD than those on REG.
Propensity score analysis: Frontline therapy with hyper-CVAD (HCVAD) + ponatinib vs. HCVAD + dasatinib in patients (pts) with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL).
Authors: Koji Sasaki, Hagop M. Kantarjian, Farhad Ravandi, Deborah A. Thomas, Naval Guastad Daver, Tapan M. Kadia, Marina Konopleva, Nitin Jain, Nicholas James Short, Ghayas C. Issa, Vicky Jeanis, H. Gal Moore, Rebecca S. Garris, Guillermo Garcia-Manero, Jorge E. Cortes, Susan Mary O'Brien, Elias Jabbour
Journal: Journal of Clinical Oncology (2016)

7025 Background: Combination of chemotherapy and tyrosine kinase inhibitor is standard of care in Ph+ ALL. The combination of HCVAD plus ponatinib induced a 3-y survival rate of 80%. The clinical efficacy of this combination has not been compared to that of HCVAD plus dasatinib. Methods: Response and survival for 109 pts with newly diagnosed Ph+ ALL enrolled in two consecutive prospective phase 2 clinical trials of frontline HCVAD with either ponatinib (n = 47; NCT01424982) or dasatinib (n = 62; NCT00390793) were analyzed. Logistic regression after multiple imputations for missing variables was used for propensity score (PS) calculation from baseline pt characteristics. PS analysis with 1:1 matching was performed with the nearest matching method with a caliper of 0.20. Results: PS matching identified 42 pts in each cohort (table 1). The median follow-up for pts treated with HCVAD and ponatinib and HCVAD and dasatinib was 31 and 67 months, respectively. Complete response (CR) rate and minimal residual disease (MRD) status at CR did not differ [CR, 100% vs. 95%, respectively (p = .359); MRD, 74% vs. 56%, respectively (p = .091)]. 1-y and 3-y EFS and OS were superior with HCVAD + ponatinib compared to HCVAD + dasatinib [1-y and 3-y EFS; 86% and 73% vs. 69% and 50%, respectively (p = .035): 1-y and 3-y OS; 89% and 83% vs. 74% and 60%, respectively (p = .041)]. Conclusions: The clinical outcome of HCVAD + ponatinib appears superior to that of HCVAD + dasatinib. Prospective confirmation of these results is warranted. Patient characteristics. Median, (range) / No. (%) Ponatinib N = 42 Dasatinib N = 42 P Age 57 (27-80) 58.5 (22-78) .858 Performance status 0-1 36 (86) 39 (93) .483 2 6 (14) 3 (7) White blood cell count (/µL) 8.0 (0.9-629.4) 9.9 (0.4-658.1) .802 Cytogenetic abnormalities Isolated Ph+ 6 (14) 7 (17) .771 Ph+ with other abnormalities 30 (71) 27 (64) Diploid/Unknown (+BCR/ABL1) 6 (14) 8 (19) Transcript type B2A2 6 (14) 5 (12) .144 B3A2 4 (10) 0 B2A2 + B3A2 1 (2) 1 (2) E1A2 29 (69) 36 (86) E1A3 2 (5) 0 CNS disease 3 (7) 2 (5) .500 CD20 positivity 8.45 (0-100) 15.6 (0-98) .416 Rituximab therapy 14 (33) 12 (29) .637 Allogeneic SCT 9 (25) 7 (23) .875