tbuckley/cabot-search huggingface dataset:
Exploratory analysis of technical factors that influence sentinel lymph node biopsy (SLNB) performance.
Authors: D. Silbermins, M. E. Valsecchi, N. de Rosa, S. L. Wong, G. H. Lyman
Journal: Journal of Clinical Oncology (2011)

8559 Background: The false negative rate (FNR) for SLNB in patients with cutaneous melanoma is estimated to be approximately 12.5%. The aim of this study was to explore the influence of technical factors, including the selection of blue dye and radioactive tracers as well as pathology techniques, in SLNB performance. Methods: A systematic review of the worldwide literature was previously performed with the objective of assessing measures of test performance of SLNB in patients with melanoma. Dual blind data extraction of selected articles was conducted. We used the extensive database generated by this process to explore the following outcomes: 1) – whether the use of blue dye or the type of radio-tracer [human serum albumin (HSA), Tc-sulfide, Tc-antimony or Tc-rhenium] affect the proportion successfully mapped (PSM) and the number of basin or lymph node detected. 2) – whether the use of multiple antibodies for IHC affect the FNR. Results: A total of 58 studies including 16,173 patients were selected. The average number of patients per study was 279 (min 54; max 1313); 14 (24%) studies came from US and 44 (76%) came from other parts of the world. No significant association was found regarding PSM and use vs. not use of blue dye (P =.15) or the type of radiotracer used (P =.10). The use of blue dye was associated with an increased number of basins detected (P =.04), as was the type of radiotracer chosen (P =.06, for HSA). None of these variables, however, influenced the mean number of lymph node detected per patient. Regarding the pathology variables examined, the use of multiple antibodies for detection of neoplastic cells, in the lymph nodes, do not significantly influence the FNR. Conclusions: None of the factors investigated seem to have much influence in the FNR or other measurements of test performance. The addition of blue dye does not improve significantly the performance of radiotracer alone, any of the four worldwide recognized radiopharmaceuticals derive in similar results and multiple antibodies do not add much accuracy. Other factors, such as volume and surgeon experience, may play a more relevant role.
Effect of training on the self-efficacy of informal caregivers of colorectal cancer patients.
Authors: Rachel D. Havyer, Michelle van Ryn, Patrick Wilson, Joan M. Griffin
Journal: Journal of Clinical Oncology (2015)

226 Background: Patients undergoing cancer treatment often need support from an informal caregiver to help manage symptoms. Self-efficacy (SE) in caregiving refers to confidence in being able to care for the patient’s needs. Low SE has been associated with increased caregiver burden and mental health symptoms, which in turn, can affect the quality of informal care provided. The objective of this study was to examine the relationship between caregiver training received from cancer care providers and SE in caregivers of patients with colorectal cancer (CRC). Methods: Caregivers of CRC patients diagnosed in 2009 were invited to complete a self-administered questionnaire. Caregivers were asked about specific patient problems (pain, bowel, fatigue, medications, and other). Caregiver perceptions of training adequacy and SE were assessed on a problem specific basis. The patient’s stage of disease was obtained from cancer registry data. Associations between training and SE were examined for each problem using multivariate logistic regression and adjusted for age, relationship to patient, race, care burden, level of education, stage of disease, perception of patient’s health, and general confidence as a caregiver. Results: 417 caregivers completed the survey (70% response rate), of whom 374 (90%) were female and 284 (68%) were the patient’s spouse/partner. The number of caregivers reporting inadequate training for CRC-related problems were pain 77 (38%), bowel 80 (38%), fatigue 121 (48%), medication 65 (26%), and other 101 (40%). The odds of having low SE were significantly higher among those with perceptions of inadequate training across the following CRC-related problems: pain, 10.10 (3.36, 30.39); bowel, 5.04 (1.98, 12.82); fatigue, 8.45 (3.22, 22.15); managing medications, 9.00 (3.30, 24.51); and other, 3.87 (1.68, 8.93). Conclusions: This study showed a significant association between caregiver training and SE in a cross-sectional study. Given that the perception of inadequate training among caregivers was common, further exploration of the longitudinal impact of training on caregiver SE should be done to identify interventions to help improve the experience of cancer caregivers.
Detection of BCR-ABL1 Compound and Polyclonal Mutants in Chronic Myeloid Leukemia Patients Using a Novel Next Generation Sequencing Approach That Minimises PCR and Sequencing Errors
Authors: Wendy T Parker, Stuart R Phillis, David T Yeung, David Lawrence, Andreas Schreiber, Paul Wang, Joel Geoghegan, Stephanie Lustgarten, Graeme Hodgson, Victor M. Rivera, Timothy P. Hughes, Hamish Scott, Susan Branford
Journal: Blood (2014)
Phase II study of 2-methoxyestradiol (2ME2) NanoCrystal Dispersion (NCD) in patients with taxane-refractory, metastatic hormone-refractory prostate cancer (HRPC)
Authors: M. R. Harrison, N. Hahn, R. Pili, W. K. Oh, K. Kim, G. Wilding, C. J. Sweeney, C. Sidor, J. Arnott, G. Liu
Journal: Journal of Clinical Oncology (2008)

5173 Background: 2ME2 is a non-estrogenic derivative of estradiol with antiproliferative and antiangiogenic activity. Preclinical data support antitumor activity in prostate cancer. Prior studies with 2ME2 capsules showed evidence for antitumor activity in chemotherapy-naive HRPC as evidenced by decreases in PSA velocity, despite suboptimal exposures. Here we report the phase II results of 2ME2 NCD in men with taxane-refractory HRPC. Methods: Pts with HRPC who had progressed on only one prior taxane-based regimen were eligible. All pts received 2ME2 NCD at 1500 mg orally four times daily, repeated in 28 day cycles. The primary endpoint was progression free survival at month 6, with a secondary endpoint of PSA response (consensus criteria). An exploratory endpoint was the metabolic response on FDG-PET imaging (baseline to 28 days). Results: A total of 50 pts was planned. The study was terminated after 21 pts when a futility analysis showed the primary endpoint was unlikely to be reached, as no pts remained on study for > 6 mo. The median number of cycles on study was 2 (range <1 to 4). Reasons for study termination include: disease progression (17) and adverse events (3). One pt remains on study. Adverse events (AE) of grade 3 or greater occurred in 12 patients (57%). Most frequent AE were: fatigue (48%), nausea (43%), anorexia (33%), and vomiting and diarrhea (28%). Transient transaminase elevations occurred in 3 patients. Paired FDG-PET scans were obtained for 11 pts. No metabolic responses were observed as defined by the protocol. Mean SUVmax change was -7.73% (range -27.05% to +20.45%). Conclusions: 2ME2 NCD did not appear to have clinically significant activity in this study and thus cannot be recommended for use as monotherapy in men with taxane-refractory HRPC. Given the aggressive biology in this taxane-refractory population, the potential benefit from a cytostatic agent like 2ME2 might better be realized in the pre-chemotherapy (or rising PSA only) stage. Of note, FDG-PET positive metastasis was found in 100% of pts with taxane-refractory HRPC (as opposed to reported 70% in the chemo-naive HRPC population). Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration EntreMed EntreMed EntreMed EntreMed
Correlation of cytokine levels and response to radiation therapy and/or brachytherapy in low/intermediate risk prostate cancer
Authors: H. Ashamalla, V. Marella, J. Feliberti, E. Kavosh, A. Guirguis, O. Fahim, G. Wise
Journal: Journal of Clinical Oncology (2005)

2600 Background: Tumor Necrosis Factor -α (TNF-α) has been studied extensively for its sensitizing effect on LNCAP cells for apoptosis by γ- irradiation. Significant elevations of Interleukin-6 (IL-6) were noted in patients with hormone refractory prostate cancer. We evaluated the above two-mentioned cytokine levels in prostate cancer patients, who received brachytherapy and/or external radiation therapy. Methods: 105 prostate cancer patients were treated by one of the following two regimens. Regimen A) Brachytherapy alone: 58 patients. Median pre treatment PSA was 6.8 ng/mL and median Gleason score was 6. Regimen B) Brachytherapy and/or External radiation therapy; 47 patients. Median pretreatment PSA was 10.5 ng/mL, and median Gleason score was 7 (range 7–10). Median brachytherapy V90 dose in group A was 140 Gy and 120 Gy in group B. Median external radiation dose was 45 Gy. Blood specimens were collected in 39 patients before radiation therapy, and also at an average of 6-month period. Serum levels of IL-6 and TNF-α were measured by ELISA. Optical Density (OD) value of each specimen was measured and analyzed by log-linear curve method with ELISA plate reader (SoftMax). Results: 5 years actuarial PSA free survival of the whole group is 91%. Median (5-year) post treatment PSA for the two groups is 0.7& 1.5 respectively. Levels of the anti-inflammatory cytokine Interleukin-6 (IL-6) were not significantly different between the two groups. However, the TNF-α was higher in group B than in group A; 0.06 and 0.03 Pg/MI respectively. The median value ± one standard deviation is illustrated in the following table. Conclusions: Levels of cytokines correlate well with excellent local control in the two groups. Higher TNF-α levels encountered in group B correlate favorably with intermediate risk parameters. Significant drop of the pretreatment levels was observed more in group A denoting appropriate patient and treatment selection. No significant financial relationships to disclose.
Prospective study comparing Broviac cuffed catheter and implantable vascular access device for adjuvant and neoadjuvant chemotherapy for breast cancer : infectious and mechanical risks
Authors: I. Kriegel, M. Esteve, A. Guillaume, P. Goater, B. Asselain, M. Queinnec, A. Guimouz, M.-C. Falcou
Journal: Journal of Clinical Oncology (2005)

8114 Background: Some studies have failed to demonstrate the superiority of implantable ports for short-course chemotherapy for cancer patients with a low risk of infection. Methods: we present the result of a prospective, single centre, nonrandomized evaluation of 423 tunelled cuffed catheters and 742 implantable ports inserted over a five year period for adjuvant or neo-adjuvant chemotherapy in a homogenous population of breast cancer patients known to present a low risk of infection. No significant difference was observed for the choice of device, taking in account: age, body mass index,site of insertion (most devices via the subclavian vein (n=997), history of previous cancer and difficulty of insertion. Results: The median life span was 123 days for Broviac and 227 for ports (p<0.001).No death was attributed to a device-related complication.The abnormal removal rate for 1 000 days of catheterization was 1.28 for Broviac and 0.27 for ports. The relative risk of abnormal removal for a Broviac was 3.37(2.40–4.73; p<0.001).The local infection rate for 1000 days was 0.36 for Broviac and 0.07 for ports. The relative risk of removal for local infection for a Broviac was 4.4 (2.38–8.68;p<0.001)The systemic infection rate was 0.23 for Broviac and 0.05 for ports. The relative risk of removal for systemic infection for a Broviac was 4.06 (2.4–6.87; p<0.001)The micro-organisms isolated on blood cultures did not differ according to the type of device. The abnormal removal rate for mechanical problems was 3.3 for Broviac and 0.12 for ports. Memory of the pain experienced during insertion was equivalent in the two groups and pain was more marked in the case of jugular insertion. while discomfort was more marked in the Broviac group. Conclusions: This study suggests a definite superiority of ports over tunelled catheters. No significant financial relationships to disclose.
Peer-review of radiation treatment planning in a provincial radiation oncology program: A survey of current practice.
Authors: Thomas S. McGowan, Sophie Foxcroft, Michael Donald Brundage, Michael Sharpe, Eric Gutierrez, Padraig Richard Warde
Journal: Journal of Clinical Oncology (2012)

211 Background: The use of peer-review activities in oncology is not well described as a quality improvement process. We sought to describe current patterns of practice of radiation oncology peer-review across a large Provincial Cancer program and to identifiy barriers to its use. Methods: Ontario cancer centres were surveyed. Survey item responses were typically scored using a 10-point Likert scale. The survey was administered electronically with follow-up reminders as required. The use of free-text for comments elaborating on responses was encouraged. Results: Fourteen (100%) centres responded. All rated the importance of peer-review as at least 8/10 (10=extremely important). Detection of medical error and improvement of planning processes were the highest-rated benefits of peer-review (each median 9/10). Four centres (29%) conducted peer-review in more than 80% of cases treated with curative intent; six (43%) peer-reviewed at least 50% of curative cases. Five centres (36%) reported “always” or “almost always” conducting peer-review prior to the initiation of treatment. Variation was seen in which aspects of a case were typically reviewed (e.g., GTV “almost always” reviewed in 67%; contouring of organs at risk in 50%). Five centres (46% of those with regular peer-review) reported that 5% to 9% of peer-reviewed cases were flagged as requiring a change, whereas 3 centres (27%) reported that &lt; 2% of peer-reviewed cases required a change to be made. Five centres (36%) recorded the outcomes of peer-review on the medical record. Thirteen centres (93%) planned to expand peer-review activities; the two factors rated as most limiting to expanding peer-review were a critical mass of radiation oncologists (median score 6/10), and prioritization of peer review by the program overall (median 5/10). Conclusions: Peer review in radiation oncology practices it is now widely used as a quality assurance activity in Ontario, identifies changes to improve quality in the individual case, and improves departmental process. The development of guidelines and standards for peer-review activities, coupled with effective knowledge translation activities are recommended.
Monitoring spontaneous adherence to therapeutic guidelines in 500 cancer patients
Authors: E. G. Rivarola, A. Negro, M. de Romedi, S. Ares, S. Carnaval, L. Ezcurdia, D. Cascallar, E. Morgenfeld, E. Gil Deza, F. G. Gercovich
Journal: Journal of Clinical Oncology (2005)

6055 Background: Our institution adheres to recognized guidelines for cancer treatment (GCT) as those from NCI (USA) or NICE (UK). These are essential tools to our understanding, for monitoring quality of medical care. In a previous study, over 90% of physicians complied with these guidelines when they were included in a monitored program, however an evaluation of spontaneous (non monitored) adherence to GCT by practicing oncologists in our country is lacking and it was the purpose of the study. Methods: We retrieved from our database 500 consecutive requests for cancer treatment received from 1997 to 2004 from outside non monitored institutions. Results: The treatment received by 389 patients (78%) was according to GCT, whereas 111 (22.6%) were treated without any compliance of existing GCT’s. Major deviations from GCT were detected in this cohort, such as investigational treatments in 43 (8.6%), inadequate treatment for the actual stage of the disease 43 (8.6%), inadequate dosage: 13 (2.6%), lack of correlation between diagnosis and treatment prescribed 5 (1%) and delayed treatment 7 (1.4%). Compared to our historical series of monitored prescriptions, the likelihood of receiving an inadequate therapy significantly increased when practicing oncologists were not monitored (p=0.0001). Conclusions: When treatment was not monitored, one every five patients received an inadequate therapy either because of inaccurate treatment for stage, incorrect dosing or by utilizing investigational treatments instead of a proven one. No significant financial relationships to disclose.
Anaplastic lymphoma kinase (ALK) in rhabdomyosarcoma.
Authors: J. C. van Gaal, U. E. Flucke, M. H. S. Roeffen, E. S. de Bont, A. J. Suurmeijer, W. T. Van Der Graaf, Y. M. H. Versleijen-Jonkers
Journal: Journal of Clinical Oncology (2011)

9530 Background: Rhabdomyosarcoma (RMS) is a highly malignant soft tissue sarcoma that occurs predominantly in children. Despite the use of multi-agent chemotherapy, survival for patients with alveolar histology (ARMS), metastatic and recurrent disease remains poor. Moreover, the intensive treatment regimens result in a high rate of adverse effects. This urges the development of new therapeutic strategies in RMS. ALK inhibitors are currently available for clinical trials. The aim of this study is to investigate ALK as a potential therapeutic target in RMS, with emphasis on protein expression and the underlying genomic aberrations. Methods: Paraffin-embedded RMS tissue samples were collected on tissue microarrays. ALK protein expression was evaluated by immunohistochemistry (ALK1, DAKO). A semiquantitative scoring system was used in which staining was scored negative “0”, and weak “1” or strong “2” when present in at least 10% of the tumor cells. ALK gene copy number and presence of ALK translocation were determined by in situ hybridization. Copy number was divided into normal (0-4 copies), gain (5-10 copies), or amplification (>10 copies) with a cut-off at 10% of the nuclei. LAF (2q11) was used as a reference probe for chromosome 2 aberrations. Results: A total of 107 primary RMS tumors were evaluated (83 embryonal (ERMS) and 24 ARMS). Strong cytoplasmic ALK protein expression was observed more frequently in ARMS than in ERMS (90.9% versus 35.8%, p<0.001). ALK gene copy number gain was detected in the vast majority of ARMS (overall 59.6%; ARMS 90.0%, ERMS 52.1%, p=0.002), and one amplification was identified (ARMS). A significant correlation was observed between ALK copy number gain and strong ALK protein expression (p<0.001). In ERMS cases with ALK gain evaluable for LAF copy number analysis (N=31), ALK/LAF ratio (range 1.10-2.72) was 1.5-2 in 54.8%, and >2 in 12.9%. In ARMS (N=16), ALK/LAF ratio (range 0.95-2.18) was 1.5-2 in 25%, and >2 in 18,75%. No ALK translocations were identified. Conclusions: This study reveals that ALK is a promising target for future treatment of RMS patients. Copy number gains appeared to be one of the underlying mechanisms for ALK protein expression. Further insight into additional genetic aberrations should be subject of future research.
Increased Efficacy of Chemomobilization with Intermediate Dose Cytarabine + G-CSF Compared to G-CSF Alone for Patients with Multiple Myeloma: Results of a Prospective, Randomized Trial
Authors: Tomasz Czerw, Wlodzimierz Mendrek, Jacek Najda, Malgorzata Sobczyk-Kruszelnicka, Maria Sadus-Wojciechowska, Katarzyna Soska, Magdalena Glowala-Kosinska, Agata Chwieduk, Wojciech Fidyk, Jerzy Holowiecki, Sebastian Giebel
Journal: Blood (2016)
Abstract 15325: Chromogranin B Levels are Increased in Myocardial Tissue in the Dyssynchronous Left Ventricle and Relate to Abnormalities in Regional Myocardial Deformation
Authors: Helge Røsjø, van Middendorp B Lars, Mai Britt Dahl, Anett H Ottesen, Mats Stridsberg, Geir Christensen, Frits W Prinzen, Otto A Smiseth, Espen Remme
Journal: Circulation (2015)

Introduction: Left bundle branch block (LBBB) induces abnormal activation and deformation of the LV wall. Chromogranin B (CgB) levels are increased in myocardium and plasma of heart failure patients and are linked to cardiomyocyte Ca 2+ handling. Hypothesis: That CgB expression is increased in distinct LV regions during LBBB and may be related to regional deformation abnormalities. Methods: CgB and pro-B-type natriuretic peptide (proBNP) protein levels were measured in biopsies from septum and LV lateral wall in 6 dogs with chronic LBBB (16 weeks), 8 control animals, and in 8 dogs with LBBB that received cardiac resynchronization therapy (CRT) between 8 and 16 weeks after creation of LBBB. Regional myocardial strain was assessed by speckle tracking echocardiography, LV volumes by MRI, and hemodynamics were assessed by invasive pressure measurements (LV dP/dt max and min, tau , LVP max and min, and LV end-diastolic pressure). Results: LBBB animals had increased end-diastolic volumes (55±1 vs.45±4 mL, p=0.038) but normal LV ejection fraction (50±3 vs. 55±4 %, p=0.42) compared to control animals. CgB levels were increased in both septum (p&lt;0.001) and LV lateral wall (p=0.01) in LBBB compared to controls, despite no changes in LV proBNP levels, and with the most prominent increment found in the septum (Figure). In LBBB+CRT animals, CgB levels were 36±18% (septum) and 50±11% (LV later wall) lower compared to LBBB animals, but this difference was not statistically significant. Septal CgB levels correlated with septal early systolic rebound stretch (r=0.76, p=0.017) and lateral wall CgB levels with lateral wall pre-ejection stretch (r=0.76, p=0.018), while no correlations were found with LV dimensions or indices of global hemodynamic function. Conclusion: Myocardial CgB expression was increased in the absence of elevated proBNP levels in LBBB animals with preserved systolic function. Local CgB levels appear to relate to abnormal local early-systolic mechanical loading.
Results of Imatinib Dose Escalation After 36 Months of Follow-up in Chronic Myeloid Leukemia Patients with Failure or Sub-Optimal Response According to 2006 EuropeanLeukemia Net (ELN) Criteria.
Authors: Massimo Breccia, Fabio Stagno, Roberto Latagliata, Paolo Vigneri, Laura Cannella, Ida Carmosino, Vittorio Del Fabro, Francesco Di Raimondo, Giuliana Alimena
Journal: Blood (2009)