tbuckley/cabot-search huggingface dataset:
Adjuvant chemotherapy and outcome in patients (pts) with nodal (N-) and resection margin negative (R0) pancreatic adenocarcinoma (PC): A systematic review and meta-analysis.
Authors: Nicola Flaum, Richard Hubner, Juan W. Valle, Eitan Amir, Mairead G McNamara
Journal: Journal of Clinical Oncology (2017)

4114 Background: Adjuvant chemotherapy following PC resection improves overall survival (OS). It is uncertain whether benefit is influenced by nodal and resection status or other factors. Methods: A systematic review of electronic databases identified published phase 2/3 studies investigating use of adjuvant chemotherapy in pts with resected PC. Efficacy (disease-free survival [DFS], OS, 5 yr OS) was explored using meta-analysis. Subgroup analysis explored effects based on nodal/resection status. Meta-regression also explored influence of age, gender, performance status [PS] and proportion of pts with head of pancreas (HOP) tumors on benefit of adjuvant chemotherapy. Results: Ten studies comprising 3644 pts were included. Two prospective phase 2 studies; 8 phase 3 trials. Median age was 63 yrs (range 24-84), 46% male. In 2268 pts with PS reported; 42% were PS 0, 51% PS 1. Tumor location was reported in 719 pts; 82% had HOP tumors. Of 3524 pts with available data; 33% N- and 67% R0. Overall, in studies of experimental vs control, adjuvant therapy significantly improved DFS (HR 0.67, CI 0.48-0.93, P = 0.02), OS (HR 0.77, 95% CI 0.68-0.87, P &lt; 0.001) and odds of death risk at 5 yrs (OR 0.53, 95% CI 0.41-0.70, P &lt; 0.001). In studies comparing chemotherapy to surgery only, adjuvant therapy also significantly improved DFS (HR 0.57, 95% CI 0.49-0.76, P &lt; 0.001) and OS (HR 0.74, 95% CI 0.64-0.87, P &lt; 0.001). There was a numerical but non-significant greater effect of adjuvant therapy in N- vs N+ pts (HR 0.58 vs 0.71, P for difference = 0.29). There was no difference in effect between pts with R0 or R1 disease (HR 0.70 vs 0.69, P for difference = 0.95). There was greater OS benefit from adjuvant therapy in pts with PS 0 (P = 0.04) and significantly less benefit on 5 yr OS in pts with HOP tumors (P = 0.04). Conclusions: The relative benefit of adjuvant chemotherapy seems similar in N-/N+ and in R0/R1 pts. This will translate into greater absolute benefit in the N+ and R1 pts due to their greater absolute risk of recurrence/death. Adjuvant chemotherapy is recommended for all pts with resected PC, where clinically appropriate, and greater benefit was seen in pts with PS 0 and body/tail tumors.
Effect of Ischaemic Preconditioning of the Intestine on the Portal Venous Blood Flow
Authors: IH Mallick, W Yang, MC Winslet, AM Seifalian
Journal: Endoscopy (2004)

Aims: This study was designed to evaluate the effect of ischaemic preconditioning (IPC) on the portal flow in a rat model of intestinal ischaemia reperfusion (IR) injury.
Reducing racial treatment disparities for early stage breast and lung cancer utilizing a multimodal systems-based intervention.
Authors: Melissa K. Yee, Sam Cykert, Eugenia Eng, Matthew A. Manning, Linda Robertson, Christina Hardy, Jennifer Schaal, Dwight Earl Heron, Nora Jones, Karen Foley, Beth Smith, Alexandra Lightfoot, Cleo A. Samuel, Ziya Gizlice
Journal: Journal of Clinical Oncology (2016)

6511 Background: Blacks with potentially curable lung and breast cancer are less likely to receive or complete standard treatments compared to Whites, contributing to racial inequities in mortality. The Accountability for Cancer Care through Undoing Racism and Equity Study aims to implement system changes to reduce these treatment disparities. Methods: The intervention consists of: a real time warning system to signal missed appointments or unmet milestones in expected care; race-specific data feedback on treatment adherence; a nurse navigator trained in race-specific barriers; and quarterly health equity training for staff. Baseline data were retrospectively obtained from 2007-2011 electronic records at two cancer centers, with intervention cohort enrollment initiated in 2013. The primary outcome, “Treatment Completion” (TC), is a composite consisting of receipt of surgical resection or stereotactic radiosurgery for early stage lung cancer, surgery for early stage breast cancer, completion of ≥80% of prescribed adjuvant radiation after lumpectomy, and ≥80% of prescribed adjuvant breast cancer chemotherapy. We employed logistic regressions estimating TC, controlling for patient demographic and clinical characteristics. Results: At Center 1 (n=2532 baseline, n=147 intervention), 81% of Whites completed therapy at baseline compared to 85% during the intervention period (p=0.41), and 80% and 87%, respectively in Blacks (p=0.28). Adjusted analyses showed a trend toward, but no statistical improvement in TC with intervention. At Center 2 (n=5265 baseline, n=126 intervention), TC at baseline compared to the intervention was 91% and 96%, respectively in Whites (p=0.21) and 81% and 92% in Blacks (p=0.07). In adjusted analyses, we observed a significant racial disparity pre-intervention (probability of TC: Black 78% vs White 89%, p<0.001) that resolved with intervention (Black 97% vs White 99%, p=0.22). Conclusions: A multimodal intervention improved overall treatment completion rates. While there was a racial disparity in one center prior to 2011, there were no racial differences in treatment completion in either center among intervention patients. Clinical trial information: NCT01954641.
Mesenchymal Stem Cells Preconditioned with Myeloma Cells from High-Risk Patients Support the Growth of Myeloma Cells from Low-Risk Patients
Authors: Syed Mehdi, Sharmin Khan, Wen Ling, Randal S Shelton, Joshua Epstein, Ricky D Edmondson, Frits van Rhee, Maurizio Zangari, Faith E Davies, Bart Barlogie, Gareth J Morgan, Shmuel Yaccoby
Journal: Blood (2016)
Longitudinal 18f-FDG-PET-CT Analysis in Newly Diagnosed Multiple Myeloma (NDMM) Patients Following Carfilzomib, Lenalidomide, Dexamethasone Induction and Lenalidomide Maintenance (CRd-R)
Authors: Neha S Korde, Dickran Kazandjian, Mark Roschewski, Sham Mailankody, Malin Hultcrantz, Constance M. Yuan, Maryalice Stetler-Stevenson, Peter Choyke, Hani Hassoun, Alexander M. Lesokhin, Nikoletta Lendvai, Eric L. Smith, Ola Landgren, Karen A. Kurdziel, Maria Liza Lindenberg
Journal: Blood (2016)
Transpancreatic sphincterotomy has a higher cannulation success rate than needle-knife precut papillotomy – a meta-analysis
Authors: Dániel Pécsi, Nelli Farkas, Péter Hegyi, Márta Balaskó, József Czimmer, András Garami, Anita Illés, Dóra Mosztbacher, Gabriella Pár, Andrea Párniczky, Patrícia Sarlós, Imre Szabó, Kata Szemes, Ákos Szűcs, Áron Vincze
Journal: Endoscopy (2017)

Abstract Background and aim While many studies have discussed the different cannulation techniques used in patients with difficult biliary access, no previous meta-analyses have compared transpancreatic sphincterotomy (TPS) to other advanced techniques. Therefore, we aimed to identify all studies comparing the efficacy and adverse event rates of TPS with needle-knife precut papillotomy (NKPP), the most commonly used technique, and to perform a meta-analysis. Methods The Embase, PubMed, and Cochrane databases were searched for trials comparing the outcomes of TPS with NKPP up till December 2016. A meta-analysis focusing on outcome (cannulation success, post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), post-procedural bleeding, and total adverse events) was performed. The population, intervention, comparison, outcome (PICO) format was used to compare these cannulation approaches. Five prospective and eight retrospective studies were included in our meta-analysis. Results NKPP has a significantly lower success rate (odds ratio [OR] 0.50, P = 0.046; relative risk [RR] 0.92, P = 0.03) and a higher rate of bleeding complications (OR 2.24, P = 0.02; RR 2.18, P = 0.02) than TPS. However, no significant differences were found in PEP (OR 0.79, P = 0.24; RR 0.80, P = 0.19), perforation (risk difference [RD] 0.01, P = 0.23), or total complication rates (OR 1.22, P = 0.44; RR 1.17, P = 0.47). Conclusion While TPS has a higher success rate in difficult biliary access and causes less bleeding than NKPP, there are no differences in PEP, perforation, or total complication rates between the two approaches. We conclude that TPS, in the hands of expert endoscopists, is a safe procedure, which should be used more widely in patients with difficult biliary access.
Solar ultraviolet B exposure and global variation in tuberculosis incidence: an ecological analysis
Authors: Tjarda M. Boere, Douwe H. Visser, A. Marceline van Furth, Paul Lips, Frank G.J. Cobelens
Journal: European Respiratory Journal (2017)

Epidemiological evidence supports vitamin D deficiency as a risk factor for tuberculosis. Differences in solar ultraviolet B (UV-B) exposure, the major source of vitamin D, might therefore partially explain global variation in tuberculosis incidence. In a global country-based ecological study, we explored the correlation between vitamin D-proxies, such as solar UV-B exposure, and other relevant variables with tuberculosis incidence, averaged over the period 2004–2013. Across 154 countries, annual solar UV-B exposure was associated with tuberculosis incidence. Tuberculosis incidence in countries in the highest quartile of UV-B exposure was 78% (95% CI 57–88%, p&lt;0.001) lower than that in countries in the lowest quartile, taking into account other vitamin D-proxies and covariates. Of the explained global variation in tuberculosis incidence, 6.3% could be attributed to variations in annual UV-B exposure. Exposure to UV-B had a similar, but weaker association with tuberculosis notification rates in the multilevel analysis with sub-national level data for large countries (highest versus lowest quartile 29% lower incidence; p=0.057). The potential preventive applications of vitamin D supplementation in high-risk groups for tuberculosis merits further investigation.
Erratum: Evolutionary history and global spread of the Mycobacterium tuberculosis Beijing lineage (Nat. Genet. (2015) DOI: 10.1038/ng.3195)
Authors: Matthias Merker, Camille Blin, Stefano Mona, Nicolas Duforet-Frebourg, Sophie Lecher, Eve Willery, Michael G.B. Blum, Sabine Rüsch-Gerdes, Igor Mokrousov, Eman Aleksic, Caroline Allix-Béguec, Annick Antierens, Ewa Augustynowicz-Kopeć, Marie Ballif, Francesca Barletta, Hans Peter Beck, Clifton E. Barry, Maryline Bonnet, Emanuele Borroni, Isolina Campos-Herrero, Daniela Cirillo, Helen Cox, Suzanne Crowe, Valeriu Crudu, Roland Diel, Francis Drobniewski, Maryse Fauville-Dufaux, Sébastien Gagneux, Solomon Ghebremichael, Madeleine Hanekom, Sven Hoffner, Wei Wei Jiao, Stobdan Kalon, Thomas A. Kohl, Irina Kontsevaya, Troels Lillebæk, Shinji Maeda, Vladyslav Nikolayevskyy, Michael Rasmussen, Nalin Rastogi, Sofia Samper, Elisabeth Sanchez-Padilla, Branislava Savic, Isdore Chola Shamputa, Adong Shen, Li Hwei Sng, Petras Stakenas, Kadri Toit, Francis Varaine, Dragana Vukovic, Céline Wahl, Robin Warren, Philip Supply, Stefan Niemann, Thierry Wirth
Journal: Nature Genetics (2015)
A real-world registry to evaluate HER2-directed therapy in Australian patients with metastatic breast cancer (MBC).
Authors: Margaret Lee, Sheau Wen Lok, Natalie Heather Turner, Daphne Day, Sally Greenberg, Michael Green, Serene S. Foo, Desmond Yip, Louise M. Nott, Peter Gibbs, Richard H. De Boer
Journal: Journal of Clinical Oncology (2017)

e12515 Background: The management and outcomes of HER2 positive MBC have dramatically evolved with the introduction of HER2-targeted therapies. However, limited data regarding the uptake, impact and safety of these treatments in the real-world context, prompted us to initiate a comprehensive registry across multiple settings in Australia. Methods: We examined the multisite electronic registry TABITHA (Treatment of Advanced Breast Cancer in the HER2 positive Australian Patient) to capture clinical data of consecutive patients diagnosed with HER2 positive MBC between Jan 2016-Jan 2017. Patient demographics, use and outcomes of treatment were explored. Results: An initial cohort of 74 patients was identified, 28 (38%) with de novo metastatic and 46 (62%) with relapsed disease. The median age at presentation with MBC was 57 years (range 27-83), with main metastatic sites being bone (n = 41, 55%), major organs (n = 40, 54%), locoregional (N = 26, 35%) and central nervous system (n = 13, 18%). In total, 64 (86%) patients had received first-line HER2 therapy, including trastuzumab plus pertuzumab (n = 48, 75%), trastuzumab alone (n = 10, 16%) and trastuzumab-emtansine (n = 6, 9%). Ten patients had not received any HER2 therapy, of which 8 received best supportive care alone, 1 received endocrine therapy, and 1 received anti-resorptive therapy. The median age of non-HER2 treated patients was 61 (range 44-81) and 40% were ECOG 2+ compared to 25% of patients receiving HER2 therapy (p = NS). First-line HER2 therapy had been discontinued in 20/63 (32%) patients, due to progressive disease (n = 18, 90%) or toxicity (n = 2, 10%). Median time to progression was 12.7+ months (range 2.0-81.9+). Conclusions: Whilst trials of HER2 directed therapies have demonstrated a substantial impact on survival outcomes for MBC with modest toxicity, a proportion of HER2 positive patients in routine care may not receive these agents. Poor performance status contributes to non-HER2 therapy use, however data collection is ongoing and other potential drivers will be further examined. Where HER2 directed therapies are used, the preliminary data indicates good activity with the majority of patients still currently on treatment.
NIVORAD: A randomised phase 2 trial of nivolumab and stereotactic ablative body radiotherapy in advanced non-small cell lung cancer, progressing after first or second line chemotherapy.
Authors: Paul Mitchell, Shankar Siva, Peey Sei Kok, Ken O'Byrne, Annie Yeung, Ann Livingstone, Mark Donoghoe, Sonia Yip, Martin R. Stockler
Journal: Journal of Clinical Oncology (2017)

TPS9097 Background: Recent data has demonstrated improvements in overall survival in patients with advanced non-small cell lung cancer (NSCLC) treated with nivolumab. Radiation may augment the immune response through abscopal effects - evidence of tumour control at sites other than those irradiated. We hypothesize that the addition of stereotactic ablative body radiotherapy (SABR) to immunotherapy with nivolumab will improve progression free survival (PFS) compared with nivolumab alone. Methods: DESIGN: Open label, randomised phase II trial with 25 sites across Australia and New Zealand. ELIGIBILITY: Metastatic NSCLC progressing after 1 or 2 lines of chemotherapy with an extrapulmonary metastasis suitable for SABR. STRATIFICATION: Age, lines of chemotherapy, histology and treating institution. TREATMENT: A single dose of SABR (18-20Gy) plus nivolumab or nivolumab alone (240mg 2-weekly) given until disease progression or prohibitive adverse events. ENDPOINTS: PFS at 6 months (PFS6; primary), objective tumour response rate, adverse events, overall survival, PFS at 1 and 2 years. Tertiary correlative objectives include associations between possible prognostic/ predictive biomarkers and outcomes (including PD-L1 expression). STATISTICS:Total sample size of 120 participants allocated in a ratio of 2:1, 80 to nivolumab + SABR and 40 nivolumab alone to provide 80% power, one-sided type I error rate of 5% for PFS6 of 50% (worthy of pursuit) vs 35% (not worthy of pursuit). BIOSPECIMENS: Tumour tissue and serial bloods (4 time points) will be collected for translational research. CURRENT ENROLLMENT (as of Feb 2017): 2 out of 20 sites are open. NIVORAD is an investigator-initiated, cooperative-group trial led by the ALTG in collaboration with the NHMRC Clinical Trials Centre, University of Sydney and the Trans Tasman Radiation Oncology Group (TROG). Australian New Zealand Clinical Trials Registry: ACTRN12616000352404.
A Comparison of Efficacy Following Two Different Doses of Granulocyte Colony Stimulating Factor (G-CSF) Alone for Mobilization of Peripheral Blood Stem Cells in 221 Multiple Myeloma Patients
Authors: Soufi Osmani, Mohamed Brahimi, Souad Talhi, Kamila Amani, Hafida Ouldjeriouat, Samira Bouchama, Leila Charef, Mohamed Amine Mazari, Badra Entasoltan, Nabil Yafour, Amina Krim, Rachid Amar Bouhass, Abdessamed Arabi, Mohamed Amine Bekadja
Journal: Blood (2016)
Prostaglandin D 2 and leukotriene E 4 synergize to stimulate diverse T H 2 functions and T H 2 cell/neutrophil crosstalk
Authors: Luzheng Xue, Joannah Fergusson, Maryam Salimi, Isabel Panse, James E Ussher, Ahmed N Hegazy, Shân L Vinall, David G Jackson, Michael G Hunter, Roy Pettipher, Graham Ogg, Paul Klenerman
Journal: Journal of Allergy and Clinical Immunology (2015)
Prognostic factors for survival in gastric cancer after radical resection: A retrospective study of 1,594 patients in Shanghai.
Authors: Yihong Sun, Cong Wang, Zhenbin Shen, Naiqing Zhao, Weidong Chen, Xuefei Wang, Hongshan Wang, Yong Fang, Fenlin Liu, Zhaoqing Tang, Haojie Li, Chentao Lv, Jing Qin, Yanna Wang, Yongzhe Piao, Lisa Wang, Laura Chu, Wei Dong, Xinyu Qin
Journal: Journal of Clinical Oncology (2012)

e14575 Background: Gastric Cancer (GC) is the second leading cause of cancer death in Shanghai,and the overall treatment response remains poor. This study aimed to describe overall survival and identify prognostic factors for survival among GC patients (pts) after radical resection. Methods: Clinical data of 1594 GC pts (Shanghai residents) who had undergone R0 or R1 resection in Zhongshan hospital, January 2003 to June 2010, were analyzed. Potential prognostic factors including demographic and tumor characteristics were collected. Survival was calculated by the Kaplan-Meier method and Log-rank test was used to determine statistical significance. Prognostic factors were analyzed using Cox regression multivariate analysis. Results: Overall 5-year cumulative survival for all pts was 55.8%. The 5-year cumulative survival by TNM stage I, II, III, and IV (classified using AJCC 7th edition staging system) were 93.8%, 72.7%, 33.3%, and 12.7%, respectively. The distribution of pts by AJCC stage I-IV was 22.5%, 23.1%, 51.7% and 2.8% respectively. In univariate analyses, gender and the number of lymph nodes removed was not associated with survival (p&gt;0.05). However, age, tumor differentiation, tumor site, lympahtic/venous invasion, depth of infiltration, presence of lymph node metastasis, and presence of distant metastasis were related to survival (p&lt;0.05). In multivariate Cox regression model analysis, age (p&lt;0.001), tumor site (p=0.004), lymphatic/venous invasion (p&lt;0.001), TNM stage(p&lt;0.001) were independent prognosticators. Among pts with TNM stage III , number of lymph nodes removed was also an independent prognostic factor (p&lt;0.001). Conclusions: Age, tumor site, lymphatic/venous invasion, TNM stage in all patients, and the number of lymph nodes removed in TNM stage III patients, were independent prognostic factors. GC remains a significant unmet medical need in China and effective therapies are urgently needed.
Dynamic Comparison of Current Ballistocardiographic Methods
Authors: SAMUEL A. TALBOT, W. KIRBY HARRISON
Journal: Circulation (1955)

Part I dealt with dynamic arrangements (Dock, Smith, Walter, Nickerson, Burger, v. Wittern) which could be treated approximately as single masses in the lower frequency range. It was shown that in addition to the cardiovascular forces sought, other undesired forces from the support were mixed in, seriously altering the record: especially for components in the important 4 to 8 cycles per second region. Second, emphasis was laid on the several meanings that could be assigned the displacement, velocity and acceleration (DVA) records, according to what dynamic aspect (motion, momentum or force) of the cardiovascular action they were referred. It was explained that all direct-body and stiff-bed ballistocardiographic records were "compound", as they could not be referred to any one of these dynamical quantities. In part II, we will discuss the platform methods in detail, showing how the platform mass comes into the record. The arguments for and limitations of the various platform methods are considered, including the "shin-platform" and the very light pendular platforms now being tried.
A Man With a Nonblanchable Purpuric Rash
Authors: Nathalie E. Chalhoub, Dinkar Kaw, Vivek Nagaraja
Journal: JAMA (2017)

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