tbuckley/cabot-search huggingface dataset:
Oncology pharmacist opportunities: Closing the gap in quality care.
Authors: Shannon Hough, Vera Vulaj, Karen B Farris, Emily R. Mackler
Journal: Journal of Clinical Oncology (2017)

174 Background: The quality of care provided to oncology patients is beginning to be linked to hospital and practice payment models. Oncology pharmacy specialists are well trained to deliver high-quality oncology care, with a focus on the appropriate utilization and monitoring of medication therapy, patient education and collaboration with other healthcare team members. The extent to which the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) metrics identify specific areas in which pharmacists may enhance care is not known. These findings are important because Centers for Medicare and Medicaid Services designate QOPI as a Qualified Clinical Data Registry (QCDR) and over 1000 US-based oncology practices submit quality data to it. Methods: We reviewed all QOPI measures for potential oncology pharmacist involvement. We utilized a summary of services provided by board-certified oncology pharmacists to identify which services would best fit the care described by the selected QOPI measures. Three individuals identified the areas where pharmacists could contribute and consensus was reached. Metrics were only scored positively for pharmacist impact if they could be obtained via the pharmacist as the primary team member responsible for meeting the measure. Results: Two hundred QOPI quality measures from Fall 2016 were reviewed and 177 were analyzed. Potential areas of pharmacist impact were identified in 67 (38%) of the included metrics. These measures fell within 11 of the 13 possible categories of the service summary. A total of 147 services were identified for the 67 actionable metrics. Patient counseling and education (28%), symptom management and supportive care (23%), chemotherapy adjustment (10%), and participation in protocol-based care (10%) comprised services that most commonly contributed to the ASCO QOPI measure performance. Conclusions: Multiple opportunities exist for pharmacists to directly impact the quality metrics that are measured by the service summary. Focusing new services and patient care activities to address validated quality metrics is a natural next step in the care that oncology clinical pharmacists provide to patients.
Pregnancy screening prior to chemotherapy initiation: A retrospective review.
Authors: Brittany Kayla Rogers, Andrew Kolarich, Merry Jennifer Markham
Journal: Journal of Clinical Oncology (2017)

165 Background: ASCO’s Quality Oncology Practice Initiative (QOPI) sets site standards to promote excellence in oncology care. One standard is screening appropriate female patients for pregnancy prior to chemotherapy. However, no formal guidelines exist regarding pregnancy screening protocols or timing of screening. We believe that women are inconsistently being screened for pregnancy prior to chemotherapy. Methods: A retrospective chart review was conducted using the UF Health (UFH) tumor registry and electronic health record (Epic) to identify women ages 18-55 who received chemotherapy or endocrine therapy by a medical oncologist between January 1, 2012 and December 31, 2014. Exclusions were prior hysterectomy or tubal ligation, known pregnancy, or treatment outside of UFH. The following data was collected: age, race, diagnosis date, cancer type, pregnancy screening test (urine or blood β-HCG) and date, specialty of ordering provider, name of chemotherapy or endocrine agent, and participation in interventional clinical trial. Results: Our search identified 501 potentially eligible women. Of these, 204 were excluded, 96% due to prior hysterectomy or tubal ligation. Of the remaining 297 eligible women, 103 (35%) received pregnancy testing prior to chemotherapy. Three screening tests were positive of the 103 pregnancy tests ordered. Follow up testing revealed 2 were true positives and 1 was a false positive. Of the 103 pregnancy tests, 23 (22%) were ordered by medical oncology, 51 (50%) were ordered by a surgery or anesthesia, and 16 (16%) were ordered by emergency medicine. 48% of the pregnancy tests were performed within 14 days prior to treatment start date. Conclusions: At our institution, pregnancy screening rates in women of childbearing potential were just 35%, and less than half of the women who were screened received pregnancy testing within 14 days of treatment start. Based on this data, a quality improvement project has been initiated in the outpatient medical oncology clinic and infusion center to improve pregnancy screening in this population. [Table: see text]
Effects of capecitabine (X) on quality of life (QoL) in patients (pts) with metastatic colorectal cancer (MCRC)
Authors: C. A. M. Beato, M. H. Federico, B. Van Eyll, S. Cabral, M. Perdicaris, N. G. Skare, S. Lago, M. P. Carvalho, G. L. Moura, R. C. Duarte
Journal: Journal of Clinical Oncology (2004)

8119 Background: : Through its superior activity, improved safety and convenience, × (Xeloda®) is replacing 5-FU/LV as the backbone of MCRC therapy and is now moving into the adjuvant setting. In addition to well-established measures of treatment response, the QoL benefits of oral agents like X over traditional i.v. drugs are becoming increasingly important in MCRC. Methods: : We evaluated QoL in pts receiving X for MCRC. Pts completed the EORTC QLQ C-30 (v3.0) and CR-38 questionnaires at baseline, before cycle 1, at weeks 7 and 13, and at treatment end. We analyzed the proportion of pts with improvement, stabilization or worsening of QoL scores from week 7 using linear models with repeated measures (generalized estimating questions technique) and SAS (v8.2). Results: Baseline characteristics were: 357 evaluable pts, 51% male; median age 59 years (20–100); median ECOG PS 1 (0–3); majority Caucasian (86%). Female pts experienced significant improvements in: global health status (p=0.035), physical functioning (p=0.012), future perspective (p=0.003) defecation problems (0.008) and weight loss (p=0.004). In men, constipation (p=0.019), future perspective (p=0.006), sexual functioning (p=0.013), and weight loss (p=0.013) all improved significantly. The proportion of pts with stable or improved QoL was ≥60% for most scales (none <55%). At least 40% of women had improvements in the following from week 7 onwards: 49% global health status, 49% fatigue, 44% pain, 42% micturition problems, 42% sexual problems, 41% chemotherapy side-effects, and 40% future perspective. Improvements in micturition problems (45%), global health status (42%), future perspective (42%), and sexual functioning (40%) were seen in ≥40% of men. In both men and women, ECOG PS ≥3 at baseline correlated with a greater improvement in QoL compared with that seen in pts with a good PS. Conclusions: X measurably improves QoL in a typical MCRC pt population. These data support its increasing use in first-line and adjuvant settings. QoL should be considered alongside established measures (objective response, TTP and overall survival) when selecting the most appropriate therapy in MCRC. No significant financial relationships to disclose.
Phase II trial of docetaxel plus doxorubicin and cyclophosphamide in locally advanced breast cancer (LABC)
Authors: T. Puertolas, R. Grandez, A. Ruiz de Lobera, J. Lao, A. Herrero, J. Martinez Trufero, R. Pazo, V. Alonso Orduña, A. Artal Cortes, A. Anton Torres
Journal: Journal of Clinical Oncology (2004)

855 Introduction: It has been show that patients achieving a pathological complete response to primary chemotherapy benefit in terms of prolonged overall survival (NSABP B18). Docetaxel (D) plus doxorubicin (d) is a highly active combination in metastatic breast cancer (Mackey JR, Proc ASCO 2002) as well as in the neo-adyuvant setting (Ian C, JCO 2002). A three-drug combination could improve these results. Methods: In this study, females diagnosed of stage II-III LABC between May 2001 to October 2003 with 18–75 years, PS 0–1, and adequate renal, liver and hematological functions were included. Chemotherapy schema (TAC): D 75 mg/m2, Cyclophosphamide 500 mg/m2 and d 50 mg/m2 on day 1, every 21 days plus G-CSF days 5th to 11th. Four to six courses (c) were scheduled and assessment for clinical response (CR) was made after 2nd, 4th and 6th c. Results: 33 patients (p) were enrolled and pathological response (PR) was already available in 26p. Patient characteristics: median age 53 years (39–73); 25p had PS=0 (75,7%); 36,4% presented with stage IIA, 30,3% stage IIB, 30,3% stage IIIA, and 3,0% stage IIIB; 27p had ductal invasive histology and 6p had a lobular invasive cancer; ER were positive in 22p (66,6%) and negative in 11 p (33,4%); c-erb-B2 was +++/+++ in 7p (21,2%), ++/+++ in 9p (27,3%) and negative in 17p (51,5%). Chemotherapy: 137c were given (median 4 c/p). Surgery had been performed in 78,8% of p. Toxicity: all p had grade 3 alopecia and 4p had grade 3 asthenia; 9p had a neutropenic fever episode but none resulted in septic death. No other severe toxicity was recorded (including clinical cardiotoxicity). CR rate was assessed in 30p (90%) and it was complete in 9p and partial in 21p (overall 100%). 6p achieved a complete pathological response (PR) (18%) and 8 p a partial PR (24,2%). 15 p had a mastectomy performed (45,4%). Conclusions: This phase II study of TAC as induction chemotherapy in patients with LABC showed a high (both clinical and pathological) response rate. The main significant toxicity was the high incidence of neutropenic fever despite the routine use of stimulating factors. Final results will be presented. No significant financial relationships to disclose.
Interventions for Anxiety and Depression in Conflict-Affected Areas
Authors: Ka Yiu Lee, Michael Huen Sum Lam, Yazhuo Deng
Journal: JAMA (2017)

Atif Rahman, PhD; Syed Usman Hamdani, MBBS; Naila Riaz Awan, PhD; Richard A. Bryant, PhD; Katie S. Dawson, PhD; Muhammad Firaz Khan, MRCPsych; Mian Mukhtar-ul-Haq Azeemi, MBBS; Parveen Akhtar, MPhil; Huma Nazir, BS (Hons); Anna Chiumento, MSc; Marit Sijbrandij, PhD; Duolao Wang, PhD; Saeed Farooq, PhD; Mark van Ommeren, PhD
Trastuzumab (T) and docetaxel (D) for the treatment of HER2 metastatic breast cancer (MBC): A literature based (LB) and individual patient data (IPD) meta-analysis (MA) of phase II trial
Authors: S. Verma, V. Gallant, M. Trudeau, S. Dahrouge
Journal: Journal of Clinical Oncology (2004)

706 Background: Phase II studies of T with D have demonstrated encouraging response rates in women with HER2/neu overexpressing (HER2+) MBC. Because there are no studies comparing this combination to the efficacy of the well-studied combination of Paclitaxel (P) and T, we undertook a MA to obtain a summary estimate of the response rate and toxicity, and to derive aggregate measures of other efficacy parameters. Methods: The project was designed in 2 phases: An LBMA and an IPDMA. Studies were included in the LBMA if they were prospective clinical trials of D + T in women with HER2+ MBC containing ≥ 10 patients. Studies were identified by an electronic literature search of 8 medical databases (Medline and Premedline, Embase, Cancerlit, CINAHL, Biological Abstracts, HealthStar, ACP Journal Club, and Cochrane Database of Systematic Reviews) for the years 1966–2002 using the following criteria; “trastuzuamab”, “herceptin”, “docetaxel” and “taxotere”. This was supplemented by hand searches of abstracts from proceedings of the European Society of Medical Oncology, American Society for Clinical Oncology and San Antonio Breast Cancer meetings for the years 1995 - 2002. Summary estimates of the objective response rates (OR) (intent to treat) were obtained using methods described by Laird and Mosteller (Int J Technol Assess in Health Care 6:5–30, 1990) for random effects adjustment.Results: 7 phase II trials with a total of 165 patients were identified. The overall estimated response rate was 60% (95% CI 52%–68%). Major grade 3/4 toxicities are presented. The IPDMA is currently underway and is to be completed in the spring of 2004. Conclusions: Results of the LBMA and IPDMA will be presented and their clinical implication discussed in light of known outcome with P + T and subsequent clinical implications. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Aventis; Roche Canada
Serum HOTAIR as a novel diagnostic biomarker for esophageal squamous cell carcinoma
Authors: Wenjian Wang, Xiaotian He, Zehua Zheng, Xiaofan Ma, Xueting Hu, Duoguang Wu, Minghui Wang
Journal: Molecular Cancer (2017)

Early diagnosis of esophageal squamous cell carcinoma (ESCC) is an important issue to improve the prognosis. HOX transcript antisense RNA (HOTAIR), a long noncoding RNA (lncRNA) expressed from the HOXC locus, has been recently revealed as an oncogenic regulator in ESCC. This study aimed to investigate whether serum HOTAIR is involved in the diagnosis of ESCC.In this study, we detected serum HOTAIR expression in 50 patients with ESCC (including 42 tumor resection and 8 without surgery) and 20 healthy volunteers to investigate the role of serum HOTAIR in ESCC using the quantitative real-time polymerase chain reaction (qRT-PCR) method.Clinical data indicated that serum HOTAIR were correlated with TNM stage. The expression level of serum HOTAIR (0.189 ± 0.010) was significantly higher in ESCC patients compared with that of healthy controls (0.055 ± 0.008, P < 0.01). The ROC curve analysis yielded an area under the ROC curve (AUC) value of 0.793 (95% CI: 0.692 to 0.895, P < 0.01). Also, the serum HOTAIR expression level decreased obviously in postoperative samples (one month after the surgery) compared to preoperative specimens. Moreover, there was a significant correlation between serum HOTAIR expression and the expression of HOTAIR in ESCC tissue according to Pearson correlation analysis.Our study, for the first time, demonstrated that serum HOTAIR might serve as a potential biomarker for the diagnosis of ESCC.
Diagnostic tools in ocular allergy
Authors: A. Leonardi, S. Doan, J. L. Fauquert, B. Bozkurt, P. Allegri, F. Marmouz, C. Rondon, M. Jedrzejczak, P. Hellings, L. Delgado, V. Calder
Journal: Allergy (2017)

Ocular allergy (OA) includes a group of common and less frequent hypersensitivity disorders frequently misdiagnosed and not properly managed. The diagnosis of OA is usually based on clinical history and signs and symptoms, with the support of in vivo and in vitro tests when identification of the specific allergen is required. To date, no specific test is available for the diagnosis of the whole spectrum of the different forms of OA. The lack of recommendations on diagnosis of OA is considered a medical need not only for allergists but also for ophthalmologists. This position paper aims to provide a comprehensive overview of the currently available tools for diagnosing OA to promote a common nomenclature and procedures to be used by different specialists. Questionnaires, sign and symptom grading scales, tests, and potential biomarkers for OA are reviewed. We also identified several unmet needs in the diagnostic tools to generate interest, increase understanding, and inspire further investigations. Tools, recommendations, and algorithms for the diagnosis of OA are proposed for use by both allergists and ophthalmologists. Several unmet needs in the diagnostic tools should be further improved by specific clinical research in OA.
Risk of second primary malignancies in young patients with colorectal cancer.
Authors: Hsu Wu, Yi-Hsin Liang, Yu Yun Shao, Ho-Min Chen, Chiu-Lin Lai, Zhong-Zhe Lin, Wen-Yi Shau, Kun-Huei Yeh, Ann-Lii Cheng, Mei-Shu Lai
Journal: Journal of Clinical Oncology (2014)

e14533 Background: Colorectal cancer (CRC) is one of the most common cancers. Because of the increase in long survivors of CRC, second primary cancer (SPC) became a major issue. Methods: We searched the database of Taiwan Cancer Registry for patients who have histology-proven primary colon cancer or rectal cancer from 1995 to 2005. We observed SPC events which had to be histology-proven except for liver cancers until 2009. We calculated the standardized incidence ratios (SIRs), which were the numbers of observed SPC events divided by the expected numbers of cancers occurrences in general population. Results: A total of 65,648 patients were enrolled. With median follow-up of 4.4 years, 3,810 SPC events were identified. In the entire cohort, the SIR was 1.03 (95% confidence interval [CI]: 0.99-1.06). Patients who aged < 50 and 50-69 years had significantly increased SIRs of 2.52 (95% CI: 2.28-2.78) and 1.18 (95% CI: 1.12-1.23), respectively. For young patients who aged < 50 years, the significantly increased SIR could last for over 10 years after the CRC diagnosis and was consistent in all subgroup analysis regarding gender, primary sites, diagnosis year, and treatment modalities. The increased SIR of patients who aged 50-69 years was only significant in the first three years after CRC diagnosis. On the contrary, older patients (> 70 years) had a significantly decreased SIR of 0.80 (95% CI: 0.76-0.84) and this significance also lasted for 10 years. The most prevalent SPC types were cancers from the gastrointestinal (GI) tract, especially malignancies from small bowels and colorectal sites. These types SPC events comprised around 25% of all SPC events. Conclusions: We demonstrated a population-based study for CRC patients in Asia-Pacific area. Although the overall risk of developing SPC for CRC patients was not significantly elevated, the risk of developing SPC was significantly elevated in younger patients, especially for who aged < 50 years. This study was supported by a grant from the Science and Technology Unit, Department of Health in Taiwan.
Intra-arterial infusion of fluorouracil as adjuvant chemotherapy by using removable catheters with shape-memory alloy following curative hepatectomy of metastatic colorectal carcinoma
Authors: T. Tono, T. Kanoh, T. Ohnishi, M. Matsushita, Y. Nakano, Y. Kimura, T. Iwazawa, H. Yano, T. Monden
Journal: Journal of Clinical Oncology (2004)

3721 Background: Although there are some reports that adjuvant hepatic arterial infusion (HAI) chemotherapy reduces the hepatic recurrence following curative resection of colorectal liver metastases, a problem of indwelling catheters after cessation of the chemotherapy remains unsolved. The authors investigated the usefulness of adjuvant HAI by using a removable port-catheter system which was recently developed. Methods: A W spiral catheter was tried to place in 17 patients who underwent curative hepatectomy. The catheter was postoperatively inserted into the hepatic artery via the right femoral artery by percutaneous method. A W spiral catheter has a special shape-memory alloy in its apical portion, which allows stable fixation of the catheter in the vascular wall without coiling and removal of the catheter if necessary. 1500 mg of 5-fluorouracil (5-FU) was intra-arterially administered for 5 hours once a week for 8 weeks by using disposable infusion pumps, and the total dose was 12g. Results: A W spiral catheter was successfully placed into the aimed portion of the hepatic artery in 82% of the patients, and dislocation of the catheter was not observed throughout the period. All patients received the scheduled courses of chemotherapy without serious adverse events. The port-catheter system was removed easily and uneventfully after termination of the chemotherapy. Three-dimensional CT angiography revealed that the patency of the hepatic artery was well preserved in most cases. Postoperative hepatic recurrence was observed only in 3 patients. With the median follow-up time of 18.1 months, the 1- and 2-year hepatic disease free survival were 80% and 67%, respectively and the accumulative survival was 93% and 93%, respectively. Conclusions: Prophylactic HAI of 5-FU by using a W spiral catheter and subsequent extirpation of the catheter is a promising strategy following curative resection of colorectal liver metastases. No significant financial relationships to disclose.
Ending tuberculosis in risk groups in Europe: challenges from travel and population movement
Authors: Charlotte Jackson, Ibrahim Abubakar
Journal: Eurosurveillance (2017)

Preview this article: Ending tuberculosis in risk groups in Europe: challenges from travel and population movement, Page 1 of 1 < Previous page | Next page > /docserver/preview/fulltext/eurosurveillance/22/12/eurosurv-22-30489-1-1.gif
Outpatient management of cancer-related pulmonary embolism: Analysis of 562 consecutive patients from the EPIPHANY study.
Authors: Paula Jiménez-Fonseca, Alberto Carmona Bayonas, Carmen Beato, Laura Faez, Angeles Vicente, Merce Biosca, Olga Madridano, Juani Plasencia, David Calvo-Temprano, Angel Dominguez, Alejandro Puerta, Pedro Arguis, Carme Font, Reme Otero, Francisco Ayala, Vicente Vicente
Journal: Journal of Clinical Oncology (2014)

9526 Background: Cancer is as a predictor of adverse outcomes in symptomatic pulmonary embolism (PE). Nowadays, the increasing diagnosis of incidental thrombosis in scheduled CT scans implies a change in PE presentation. Clinical guidelines suggest that home treatment is an appropriate alternative for selected low-risk PE-patients although specific data regarding this approach in cancer population remain scarce. The aim of the present report is to describe clinical characteristics, outcomes and feasibility of outpatient management of patients with cancer-related PEs. Methods: EPIPHANY is an ongoing multicenter observational study of consecutive cancer-related PEs (acute symptomatic and incidentally-found in scheduled CT scans) recruited from daily clinical practice with a minimum 3-month follow-up after PE. Outpatient management was considered on discharge from hospital less than 24 hours after PE diagnosis. Results: From January 2006 to September 2013 we enrolled 562 cancer patients with PE, 385 of whom (68%) were treated in hospital and 177 (32%) were managed as outpatients. Most patients treated at home (93%) had advanced cancer (TNM stages III-IV), most (77%) were being treated with chemotherapy or biological/targeted therapies and 6% underwent major surgery within 1 month. Patients treated at home more likely had an incidentally-detected PE (91% vs. 35%; p<0.001) and were ‘truly asymptomatic’ cases (86% vs. 30.5%; p<0.001) compared to patients treated with conventional hospitalization. The rate of major complications within 15 days of PE in patients treated at home was 3.4% (95% CI, 1.9-4.9%). Overall mortality rates were lower in outpatients at 30 days (2.3% vs. 21%; p<0.001) and 90 days (9.6% vs. 33%; p<0.001) of follow-up compared to patients treated in hospital. The most frequent cause of death was cancer progression in both groups. The rates of venous thromboembolic recurrences and major bleeding events at 30 and 90 days were comparable in both groups. Conclusions: Cancer-related PE can be managed at home in a high proportion of patients, especially those incidentally diagnosed. Further studies addressed to better define low risk patients in this setting should be developed.