tbuckley/cabot-search huggingface dataset:
Vinorelbine and cisplatin concurrently combined with thoracic radiotherapy in patients with unresectable stage III non-small cell lung cancer: A long-term safety and efficacy report.
Authors: H. Horinouchi, I. Sekine, M. Sumi, K. Noda, Y. Nishiwaki, K. Mori, T. Tamura
Journal: Journal of Clinical Oncology (2010)

7088 Background: Concurrent chemoradiotherapy is the standard treatment for unresectable stage III non-small cell lung cancer (NSCLC). Few researchers, however, have reported on follow-up data of longer than three years. We investigated the long-term feasibility and efficacy of vinorelbine and cisplatin chemotherapy with concurrent thoracic radiotherapy. Methods: Eighteen patients received cisplatin (80 mg/m2) on day 1 and vinorelbine (20 mg/m2 in level 1, and 25 mg/m2 in level 2) on days 1 and 8 every 4 weeks for 4 cycles in phase I trial (Cancer Sci 95: 691-695, 2004). Ninety-three patients received the same chemotherapy regimen except for the fixed vinorelbine (20 mg/m2) dosage and consolidation therapy with docetaxel (J Thorac Oncol 1: 810-815, 2006). The thoracic radiotherapy consisted of a single dose of 2 Gy once daily to a total dose of 60 Gy. Results: A total of 111 patients were analyzed in the present study; male/female: 91/20, median age: 60, stage IIIA/IIIB: 50/61 and squamous/non-squamous histology: 26/85. The objective response rate was 82.0% (95% confidence interval [CI], 74.5-89.1). The 3-, 5- and 7-year progression-free survival and overall survival rates (95% CI) were; 20.2% (13.3-28.2), 15.2% (9.1- 22.7), 13.9% (8.1-21.3) and 43.4% (33.9-52.2), 25.2% (17.6-33.6), 22.2% (15.0-30.4), respectively. The median progression free survival and median survival time (95% CI) were 13.4 (9.8-16.4) months and 30 (24.5-38.8) months, respectively. Four patients (3.6%) experienced grade V pulmonary toxicities between 4.4-9.4 months after the start of the treatment. Cox and logistic regression analyses showed no significant prognostic factors except for age using age, gender, histology, stage, and body weight loss as independent variables. Conclusions: The present long-term analysis showed that approximately 15% of patients who had unresectable stage III NSCLC could be cured with vinorelbine, cisplatin, and concurrent thoracic radiotherapy. Less than 4% of patients developed fatal lung toxicity within 10 months from the start of the treatment. No significant financial relationships to disclose.
Elderly Multiple Myeloma (MM) Patients (≥70 years) Can Safely Undergo Autologous Stem Cell Transplantation (ASCT) but Have Shorter Overall Survival Than Younger Patients (&lt;70 years).
Authors: Carla Borgono, Young Trieu, Wei Xu, Donna E. Reece, Suzanne Trudel, Vishal Kukreti, Peter Anglin, Christine Chen
Journal: Blood (2009)
Cooperating Mutations of IDH1,IDH2, JAK2V617F, NPM1, FLT3-ITD,C-KIT Genes in Chinese Patients with De Novo Acute Myeloid Leukemias
Authors: ZhuXia Jia, Min Zhou, Xuzhang Lu, Lingdi Ma, Rong Xiao, Ri Zhang, HongYing Chao
Journal: Blood (2011)
Impact of a multidisciplinary cancer care program and nurse navigation on pancreatic adenocarcinoma treatment.
Authors: Laurence E. McCahill, Mary May, Coralyn Martinez, Wendy K. Taylor, Alan T. Davis
Journal: Journal of Clinical Oncology (2012)

200 Background: Treatment of pancreatic adenocarcinoma (PanCa) is complex and requires input from multiple physicians. We developed a unique gastrointestinal (GI) cancer program utilizing a multidisciplinary conference, a multidisciplinary clinic (MDC), a GI nurse navigator (NN) and continuous quality assessment with a nurse clinical auditor. The impact of this program, which requires significant additional resources, on adherence to evidence based cancer treatment for newly diagnosed PanCa patients is unknown. Methods: The GI (NN) interviews patients, coordinates staging and biopsies, physician visits and subsequent adjuvant care in the first year of diagnosis. A clinical quality specialist abstracted all treatment received (surgical, radiation, chemotherapy, palliative), and data was entered into a GI Quality database. Treatment received by patients in first year of diagnosis was compared to NCCN guidelines. Results: From January 2010 to April 2012, 68 patients with newly diagnosed PanCA were evaluated/treated. Overall compliance with NCCN treatment guidelines was 83.4%. Compliance was highest for stage I (almost all underwent surgical resection) and stage IV (none underwent surgery). Utilization of adjuvant therapies was 80% (16/20) for patients with stageI/II disease. Eight patients with stage I/II disease did not undergo surgery, due to comorbidities or disease progression. Conclusions: A novel GI cancer program utilizing a multispecialty MDC and a dedicated GI NN demonstrates very high compliance with evidence based therapy for first line treatment for PanCa patients. Although resource intensive, this level of adherence to evidence-based medicine is encouraging and higher than prior reports for PanCa. The relative contribution of the GI MDC clinic format versus the NN warrants further study. [Table: see text]
Correlation of symptoms, quality of life, and functional status in head and neck cancer patients receiving radiation therapy ± chemotherapy
Authors: M. J. Dodd, M. Cho, K. A. Bank, J. Lee, J. Quivey
Journal: Journal of Clinical Oncology (2008)

20671 Background: Oral mucositis is a major side effect of radiation therapy (RT) to the head and neck. Few studies have reported the correlations of prevalent symptoms, quality of life (QOL), and functional status in this population. The purpose of this study is to increase our understanding of these issues. Methods: In this clinical trial testing an innovative mouthwash, symptoms (Symptom Checklists), functional status (Karnofsky Functional Status [KPS]), quality of life (QOL-CA), and the Oral Mucositis Assessment Scale (OMAS) subjective pain score were measured at four times (beginning of RT [T1], onset of mucositis [T2], end of RT [T3], and healing of mucositis [T4]) over an approximate 10-12 week period. Results: Forty-three head and neck cancer patients were enrolled at T1: 78% male, 62% white, 67% married; 15.3 mean education years; 44% employed full time; 58% squamous cell carcinoma; 98% received IMRT, 6463.9 cGY mean total radiation dose, 56% received concurrent CTX. Mean days to onset of mucositis were 15 (SD 6.6), and mean days to healing of mucositis were 60 days after T2 (SD 48.8). Mucositis pain scores (possible range 0–10) were moderate at T2 (x=3.5 SD 2.2) and T3 (x=4.4, SD 2.9). Overall QOL ranged from 6.9 to 7.4 (possible range 0–10); and KPS ranged from 76 to 86 (possible range 0–100). Patients reported 10 co-existing symptoms at T1, and 16 co-existing symptoms at other time points. Notably, > 50% of patients had three symptoms: ‘thirst’, ‘sleep problems’, and ‘fatigue’ at all time points. At T4, ‘dry mouth’, ‘thirst’, and ‘taste changes’ were the most prevalent (> 90% patients) followed by ‘fatigue’ and ‘lack of appetite’. Negative correlations existed between QOL and the number of symptoms at all four time points (r=-0.47 to -0.66, p<0.05), and between QOL and KPS (r=-0.37 to -0.62, p<0.05). The OMAS subjective pain score was significantly negatively correlated only with QOL, and only at T4 (r=-0.65, p<0.01). Conclusions: HNC patients experience multiple symptoms both during and after RT, these multiple symptoms are significantly and negatively associated with QOL and KPS. Therefore, it is important to provide supportive care during and beyond RT. No significant financial relationships to disclose.
Impact of colonoscopy screening on individuals at high risk of hereditary nonpolyposis colorectal cancer (HNPCC).
Authors: C. Guillen-Ponce, C. Martinez-Sevila, R. Jover, R. Perea, M. Molina-Garrido, A. Carrato
Journal: Journal of Clinical Oncology (2011)

384 Background: Colonoscopy screening reduces the incidence of, and mortality from, colorectal cancer (CRC) in individuals with HNPCC. The aim of this study was to determine the impact of colonoscopic follow-up in individuals at high risk of HNPCC, in terms of detection of precursor lesions (adenomas) or cancer. Methods: Between 2005-2008, 163 individuals with HNPCC were advised to undergo regular follow-up colonoscopy. Compliance and results of the scans were evaluated annually and were verified with medical documentation. Results: Of the 125 individuals who underwent at least one colonoscopy during the follow-up period of colonoscopy screening, in 33 subjects (26%) at least one colonic adenoma was detected. The median number of adenomas detected per colonoscopy in individuals with polyps was 2. The number of colonoscopies with polyps did not differ between women and men. However, the number of polyps removed by colonoscopy and the total number of polyps removed during the follow-up period was significantly higher in men (p = 0.005, p = 0.05 bilateral, respectively). 5 individuals (4%) were diagnosed with CRC, one of whom had two synchronous tumors. Of these, four individuals had properly followed the screening recommendations with the recommended frequency. In the case where two synchronous tumors were detected, it was the first colonoscopy screening that had been performed on the individual. None had had cancer previously, they were healthy relatives of an index case. All except one belonged to families that fulfilled the Amsterdam criteria I / II. All the tumors were diagnosed at an early stage, except two, which exhibited positive nodes. Conclusions: Colonoscopy screening is effective in diagnosing colorectal adenomas and cancer in individuals with HNPCC. Men with HNPCC have a greater number of colorectal adenomas. Screening allows the detection of colorectal cancer at an early stages. Funded by a young researcher's grant from the Spanish Society of Medical Oncology 2006. No significant financial relationships to disclose.
Impact of first-line cisplatin versus non-cisplatin based chemotherapy on progression-free survival in patients with advanced urothelial carcinoma previously treated with perioperative cisplatin based chemotherapy.
Authors: Jennifer A Locke, Gregory Russell Pond, Guru Sonpavde, Andrea Necchi, Patrizia Giannatempo, Ravi Kumar Paluri, Guenter Niegisch, Peter Albers, Carlo Buonerba, Giuseppe di Lorenzo, Ulka N. Vaishampayan, Scott A. North, Neeraj Agarwal, Syed A. Hussain, Bernhard J. Eigl
Journal: Journal of Clinical Oncology (2015)

335 Background: Perioperative cisplatin based chemotherapy (PCBC) is a standard of care in the management of muscle invasive urothelial carcinoma (UC). Cisplatin based (C) therapy also represents the historical first line treatment of metastatic disease. There is however no data to guide the optimal choice of first line chemotherapy regimen – C re-treatment vs other second-line or non cisplatin regimens (NC) –in UC patients who relapse after receiving PCBC. This multicenter retrospective study compares C vs NC first line treatment on progression-free survival (PFS) for patients (pts) with advanced UC after PCBC and cystectomy. Methods: Data were collected for patients who received various first-line chemotherapies for advanced UC following previous PCBC therapy. Cox proportional hazards models were used to investigate the prognostic ability of type of peri-operative / first-line chemotherapy, visceral metastasis, ECOG status, time from prior chemotherapy (TFPC), anemia, leukocytosis and albumin on PFS. Results: Data were available for 145 pts from 12 centers. The mean age was 62 years, 113 (77.9%) were men and ECOG-PS was 0 or &gt;0 in 74 (51.0%) and 61 (42.0%) patients. Ninety-one (62.8%) pts received C first line, the median number of cycles was 4 (range 1-17) and the median TFPC was 6.2 months (range 1-154). Median overall survival was 86 weeks (95% CI 70-106) and median PFS was 24 (95% CI 18-27) weeks. Time from perioperative chemotherapy (TFPC) (&gt;52 weeks vs ≤52 weeks; HR 0.63 p=0.027) and ECOG-PS at first line (1+ vs 0; HR 1.73 p=0.010), were prognostic of PFS. No significant effect was noted for C vs NC first line (p=0.70); however, among patients with TFPC &gt;52 weeks, patients with NC had worse PFS (median 4.6 months, 95% CI 1.8-12.2) than those who received C (median 8.1, 95% CI 3.2-16.3). Conclusions: There is no evidence to suggest overall superiority of C vs NC based first line chemotherapy or a second-line regimen in patients with advanced UC who received prior PCBC. However, those with TFPC &gt;52 weeks should probably receive C first line chemotherapy given better PFS with C.
Treatment-free remission following frontline nilotinib in patients with chronic myeloid leukemia in chronic phase: results from the ENESTfreedom study
Authors: A Hochhaus, T Masszi, F J Giles, J P Radich, D M Ross, M T Gómez Casares, A Hellmann, J Stentoft, E Conneally, V García-Gutiérrez, N Gattermann, W Wiktor-Jedrzejczak, P D le Coutre, B Martino, S Saussele, H D Menssen, W Deng, N Krunic, V Bedoucha, G Saglio
Journal: Leukemia (2017)

The single-arm, phase 2 ENESTfreedom trial assessed the potential for treatment-free remission (TFR; i.e., the ability to maintain a molecular response after stopping therapy) following frontline nilotinib treatment. Patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase with MR4.5 (BCR-ABL1⩽0.0032% on the International Scale (BCR-ABL1IS)) and ⩾2 years of frontline nilotinib therapy were enrolled. Patients with sustained deep molecular response during the 1-year nilotinib consolidation phase were eligible to stop treatment and enter the TFR phase. Patients with loss of major molecular response (MMR; BCR-ABL1IS⩽0.1%) during the TFR phase reinitiated nilotinib. In total, 215 patients entered the consolidation phase, of whom 190 entered the TFR phase. The median duration of nilotinib before stopping treatment was 43.5 months. At 48 weeks after stopping nilotinib, 98 patients (51.6%; 95% confidence interval, 44.2–58.9%) remained in MMR or better (primary end point). Of the 86 patients who restarted nilotinib in the treatment reinitiation phase after loss of MMR, 98.8% and 88.4%, respectively, regained MMR and MR4.5 by the data cutoff date. Consistent with prior reports of imatinib-treated patients, musculoskeletal pain-related events were reported in 24.7% of patients in the TFR phase (consolidation phase, 16.3%).
Role of cytoreductive nephrectomy in renal cell cancer (RCC) with venous tumor thrombus.
Authors: Edwin Jason Abel, Kamran Zargar, Vitaly Margulis, Michael Mann, Philippe E. Spiess, Kenan Ashouri, Leonardo Daniel Borregales, Ahmed Haddad, Charles Rew, Gong Chen, Fangfang Shi, Surena F. Matin, Christopher G. Wood, Jose A. Karam
Journal: Journal of Clinical Oncology (2016)

496 Background: RCC with tumor thrombus may require complex surgery to remove the primary tumor. Some patients with tumor venous thrombus and metastatic RCC are unlikely to benefit from cytoreductive nephrectomy. The purpose of this study was to identify risk factors for poor overall survival in metastatic RCC patients with tumor thrombus. Methods: Patient data was collected from 4 centers for patients with mRCC and venous thrombus at presentation treated surgically from 2000-2014. Kaplan Meier analysis was used to estimate OS using two prognostic classification systems (MSKCC, IMDC) assessed at time of surgery. MDACC criteria (Cancer 2010) were calculated to estimate potential benefit from cytoreductive nephrectomy. Univariate and multivariate Cox proportional hazard models were used to evaluate the association of individual variables with OS. Results: A total of 293 patients were evaluated and median OS (IQR) was 17.2 (6.4-41.0) months for the entire cohort. Venous thrombus level (Neves classification) was 0,1,2,3, and 4 for 77, 38, 104, 45, and 29 patients respectively. Median OS (IQR) was worse (p = 0.03) for patients with IVC thrombus above the diaphragm 6.8 (2.2-19.1) months compared to renal vein only thrombus 18.8(8.1-37.8) months or IVC thrombus below the diaphragm 18.9 (6.7-44.5) months. Using MSKCC criteria, patients were classified as favorable (21), intermediate (213) or poor risk (59). MSKCC risk grouping was not predictive of OS (p = 0.14). Using IMDC criteria, patients were classified as favorable (24), intermediate (176) or poor risk (93). IMDC risk grouping was not predictive of OS (p = 0.99). Using MDACC criteria, patients were divided into favorable (258) and unfavorable (35) groups. Median OS was higher (p = 0.008) in favorable risk patients, 18.8 (7.2-43.7) vs. 8.2 (2.3-28.2) months. Preoperative variables that were independent predictors of OS included: body mass index, IVC thrombus above diaphragm, lactate dehydrogenase &gt; ULN, and retroperitoneal lymphadenopathy. Conclusions: Metastatic RCC patients with IVC thrombus above the diaphragm or patients classified as unfavorable using MDACC criteria have poor OS and may not benefit from cytoreductive nephrectomy in the presence of venous tumor thrombus.
Defining user needs for an electronic tool to improve chemotherapy-related toxicity management.
Authors: Rebecca M. Prince, Laura Parente, Anthony Soung Yee, Melanie Powis, Katherine Enright, Sonal Gandhi, Eva Grunfeld, Rashida Haq, Amna Husain, Monika K. Krzyzanowska
Journal: Journal of Clinical Oncology (2016)

157 Background: Cancer drugs are associated with toxicities which can negatively impact patients’ (pts) quality of life, outcomes and increase acute care use (ACU). There is increasing interest in leveraging technology to solve clinical problems in healthcare. We hypothesized that an electronic tool (toxicity module) targeting management of chemotherapy toxicities could decrease ACU by facilitating more effective symptom management. Methods: Participatory design methodology consisting of end user needs assessment through ethnographic field study (shadowing and in-depth interviews) and focus groups was used to inform design of an interactive prototype toxicity module. Oncology pts and their caregivers, and health care providers (HCPs) including oncologists, oncology nurses and primary care providers were included in all stages of development. Contemporaneous notes were taken during ethnography while focus groups were also audio recorded. Thematic analysis through ideation sessions and time-of-day exercises allowed identification of overarching issues. Results: Eight pts and 8 HCPs participated in the ethnographic field study. Two focus groups, one with 7 pts, one with 4 HCPs were held. Most themes were common to both pts and HCPs; gaps and barriers in the current system, need for decision aids, improved HCP communication and options in care delivery, and access to credible information delivered in a timely, secure manner and integrated into existing systems. Additionally, pts further identified missed opportunities, care not meeting their needs, feeling overwhelmed and anxious and wanting to be more empowered; HCPs identified accountability as an issue. These themes informed development of a prototype for a web-based toxicity management tool, which has served the purpose of defining user needs for symptom tracking, self-management advice, and timely communication with an oncology provider. Iterative evaluation over 2 rounds of usability testing is currently underway. Conclusions: An electronic tool that integrates just-in-time self-management advice and oncology provider support into routine care may address some of the gaps identified in the current system for managing chemotherapy toxicity.
Variation over time and interdependence between disease progression and death among patients with glioblastoma (GBM) on RTOG 0525.
Authors: M. Wang, J. Dignam, M. Won, W. J. Curran, M. P. Mehta, M. R. Gilbert
Journal: Journal of Clinical Oncology (2011)

2017 Background: We assessed the longitudinal hazard characteristics for death and progression in newly diagnosed GBM patients, evaluated the impact of prognostic factors and treatment on the hazard within different time intervals to determine if effects are time-variant, and quantified the prognostic influence of disease progression on survival. Methods: Among patients randomized to Radiation Therapy Oncology Group (RTOG) 0525 comparing dose-dense (dd) with standard dose (sd) temozolomide (TMZ), we estimated the death and failure (death or progression) hazards over time, compared the hazard difference between subgroups within time intervals, and assessed the effect of disease progression on survival. Results: In the entire group, the peak hazard of death occurred from 9 to 24 months with a slow decline after that; the average monthly hazards are 2.9%, 6.07%, and 3.71%, respectively for three intervals: prior to 9, 9-24 and after 24 months; the hazard of progression/death reached a peak around 6 months (interval of 0 to prior to 9 months) with the average monthly hazard of 11.06% and decreased dramatically thereafter. Patients with better prognosis (MGMT methylated tumor and RPA III) had a lower hazard at all intervals. The relative benefit (longer survival) of MGMT methylated vs unmethylated was substantial in the first 2.5 years, but was diminished thereafter. The relative benefit (longer progression-free survival) of dd over sd TMZ occurred in the first 6 months (hazard ratio (HR): 0.70; 95% CI: 0.58-0.86); p<0.001), although it was diminished thereafter. After adjusting RPA class and MGMT methylation status, the HR of death for patients who had progressed over non-progressors was 6.59 (95% CI: 5.12-8.43, p<0.001). Conclusions: Hazards over time reveal changes in the risk that may have biologic and therapeutic relevance. After the peak hazard of death between 9 and 24 months, a consistently high hazard remains, but it is lower than in the peak period. The rate of dying after progression is about 6.59 times the rate for non-progressors; suggesting that progression free survival is a relevant clinical endpoint. Supported by NCI U10 CA 21661 and U10 CA37422.
Reasons for attending the emergency room in oncologic patients
Authors: A. Ferrer, M. Vidal, S. Serrano, M. Tobeña, E. Millastre, M. Ruiz-Echarri, J. I. Mayordomo, A. Tres
Journal: Journal of Clinical Oncology (2008)

20683 Background: In the last years, we are living a progressive rising of prevalence in cancer. More aggresive treatments are being applied to older patients with more comorbilities than years ago. For these reasons, oncologic patients are prone to develop complications which may need emergency attention. We report all patients who have been seen in our emergency service during three consecutive months. Methods: Between September 1, 2007 and November 30, 2007, 112 cancer patients were seen in our emergency service. We describe the characteristics of these patients and the causes of complaint. Results: A total of 112 patients were seen in 3 months, mean was 11 per week. Tumor type: 26 patients had lung cancer (23%), 23 patients had colorectal cancer (20%), and 18 patients had breast cancer (16%). Of all patients, 75.8% had metastatic disease (85 patients). Forty-four of them (53%) were receiving chemotherapy treatment. The most common cause to seek emergency care was fever, 21 patients (18.75%); dyspnoea, 15 (13.39%); acute abdominal pain, 11 (9.82%) and pain, 11 (9.82%). 58 of all patients (51%) needed admission to the hospital. Conclusions: Stage IV patients and patients under chemotherapy treatment seem to be the most frequent seekers of emergency care. Although fever, dyspnoea or pain may not be a life-threatening emergency in most cases, they deteriorate quality of life. More than half of all patients who attend the emergency room are admitted to hospital. No significant financial relationships to disclose.