tbuckley/cabot-search huggingface dataset:
The Academy of Nutrition and Dietetics, corporate sponsorship and the alternative: dietitians for professional integrity
Authors: Andy Bellatti
Journal: British Journal of Sports Medicine (2018)

The Academy of Nutrition and Dietetics ('the Academy'), founded in 1917, is the USA's largest organisation of nutrition professionals.1 It represents >100 000 nutrition professionals, most of them registered dietitians (RDs). The Academy's recent history of food industry ties has resulted in some members publishing 'statements of concern',2 These dietitian-penned accounts shed light on why some dietitians renounced their memberships. Many of these first-person pieces call for sponsorship reform and question whether the Academy's actions align with its mission ('a world where all people thrive through the transformative power of food and nutrition') and vision ('accelerate improvements in global health and well-being through food and nutrition').3 The purpose of this editorial is to highlight some facts that may surprise the BJSM reader. Over the past 25 years, the Academy entered into the following seven partnerships, sponsorships and agreements:
Dendritic cell based immunotherapy in metastatic uveal melanoma.
Authors: Jan Nesselhut, Dagmar Marx, Raymond Y. Chang, Thomas Nesselhut
Journal: Journal of Clinical Oncology (2018)

e21526 Background: Uveal melanoma is the most common malignant tumor of the eye. Metastasis occurs in about 50% of patients. With only 6 months the median survival time for patients with metastasis is very low. Thus the prognosis is poor with a 80% mortality rate after the first year. Up to now no existing treatment has been proven to extend survival for metastatic cancer. Methods: n = 14 patients with metastatic uveal melanoma were treated with a dendritic cell based immunotherapy. Dendritic cells were generated from patients own isolated monocytes using standard protocol. Survival times were calculated by Kaplan Meyer survival analysis. Results: Kaplan Meyer survival analysis shows a median overall survival after onset of DC therapy of 15 months. 71% (n = 10) of treated patients survive more than 1 year. After 2 years n = 2 patients were still alive. These two patients died of their disease after 37 and 52 months respectively. Most patients tolerate the therapy very well with only mild side effects. Conclusions: Dendritic cell therapy is well known to be effective in malignant melanoma of the skin. Here we show that a dendritic cell therapy is a successful immunotherapy in metastatic uveal melanoma inducing a prolongation of the survival when compared to historical collectives. Molecular biological analyses may further help to identify a subgroup of patients who respond to immunotherapy.
Disparities in supportive care needs among minority and non-minority patients with advanced lung cancer.
Authors: Danielle Seiden, Jose Morillo, Juan P. Wisnivesky, Cardinale B. Smith
Journal: Journal of Clinical Oncology (2017)

e21690 Background: Significant racial and ethnic disparities exist in lung cancer care. Thus, minorities are diagnosed with late stage cancer and have inferior outcomes likely leading to increased suffering. Little is known, however, about disparities in supportive care needs among patients with advanced lung cancer. Methods: We performed a prospective cohort study of patients newly diagnosed with advanced lung cancer (stage III and IV). At baseline (within 3 months of diagnosis), patients completed a validated survey assessing needs among seven domains: medical communication and information, psychological and emotional support, daily living, financial concerns, physical symptoms, spiritual needs, and social needs. Univariate and multivariate regression analyses compared differences in supportive care needs among minority (Black and Hispanic) and non-minority patients with advanced lung cancer. Results: We have enrolled 95/160 patients (60%). To date, baseline surveys have been completed on 55 patients. Of those, 37 (67%) are minorities and 18 (33%) non-minorities. Minorities were less likely to be married (p = 0.01), had a lower annual income (p &lt; 0.001), lower education attainment (p = .02) and more likely to have Medicaid (p &lt; 0.001). There were no differences in gender (p = 0.35) or performance status (p = 0.13). Overall, 39% of minorities report having higher supportive care needs across all domains compared with 25% of non-minorities (p &lt; 0.001). Similarly, minorities reported having significantly higher needs among each domain except medical communication and information (p = 0.06). Multivariate analysis, controlling for patient characteristics, found minorities had increased odds of overall supportive care needs (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.03-1.16). Conclusions: Minority patients with advanced lung cancer are more likely to have increased supportive care needs than non-minority patients. Ensuring minority patients have adequate supportive care evaluation and treatment is necessary to mitigating health disparities among patients with lung cancer. Future studies will be performed to evaluate how these needs change throughout the trajectory of lung cancer.
Peritoneal mesothelioma: Evaluation of chemotherapeutic agents used for HIPEC through the RENAPE database.
Authors: Brice Malgras, Etienne Gayat, Rea Lo Dico, Clarisse Eveno, Karine Pautrat, Thierry Andre, Marc Pocard
Journal: Journal of Clinical Oncology (2016)

4101 Background: peritoneal mesothelioma (PM) is a rare and rapidly fatal neoplasm with an estimated survival of one year. The introduction of cytoreductive surgery with hyperthermic intraperitonal chemotherapy (CRS + HIPEC) has greatly improved overall survival rates. Many chemotherapeutic agents have been used in HIPEC therapy but nonetheless without difference in terms of patient survival. The aim of the study was to evaluate the prognostic impact of the different cytotoxic agents used in HIPEC to treat PM. Methods: from 1989 to 2014, 260 patients with PM were treated with CRS + HIPEC in 20 tertiary French centers and prospectively included in the RENAPE database. Inclusion criteria were age ≤ 80, performance status ≤ 2, no significant comorbidities and no extraperitoneal metastases. Results: 5 cytotoxic agents (CA) were used for HIPEC (Cisplatin (C), Doxorubicin (D), Mitomycin (M), oxaliplatin (O), irinotecan(I)) including 6 combination regimens (C, C+D, C+M, M, O, O+I). Regimen did not influence postoperative survival. But, regimen that use 2 CA (C+D, C+M, O+I) improve overall survival compared to regimen using 1 CA (C, M, O), P = 0.03 HR[95%CI] = 0.54 [0.31-0.95]. No difference was found according to major complications (Grade ≥ 3) between the 2 groups. The 2 groups were comparable according to median age, gender, neoadjuvant chemotherapy, asbestos exposure, CC0 resection, follow up, histologic subtypes, except for median PCI which was higher in 1 CA group (15) than in 2 CA group (19) (P = 0.006). In CC0 patients overall survival was still improved in 2 CA group versus 1 CA group (P = 0.01, HR[95%CI] = 0.34[0.14-0.83]). Conclusions: CRS + HIPEC using 2 CA drugs seems to be associated with an improvement in overall survival in patients with PM, in particular when given to patients with high PCI. No difference was found in term of postoperative complication between HIPEC using 2 CA versus 1 CA.
TCT-352 Long-term Clinical Data and Multimodality Imaging Analysis of the BIOSOLVE-II Study with the Drug-eluting Absorbable Metal Scaffold in the Treatment of Subjects with de Novo Lesions in Native Coronary Arteries – BIOSOLVE-II
Authors: Michael Haude, Hüseyin Ince, Alexandre Abizaid, Ralph Toelg, Pedro A. Lemos, Clemens von Birgelen, Evald Christiansen, Emanuele Barbato, Franz-Josef Neumann, Christoph Kaiser, Eric Eeckhout, Javier Escaned, Hector Garcia-Garcia, Ron Waksman
Journal: Journal of the American College of Cardiology (2018)
The evidence on effectiveness of upper neck irradiation vs whole neck irradiation as elective neck irradiation among node negative nasopharyngeal cancer: A meta analysis.
Authors: Jayson L. Co, Michael Benedict A. Mejia, Janine Margarita R. Dizon
Journal: Journal of Clinical Oncology (2016)

6069 Background: Nasopharyngeal carcinoma (NPC) is a central tumor with rich lymphatic network and a propensity for bilateral cervical lymph node metastasis. There is an orderly pattern of lymph node involvement in NPC as opposed to other head and neck squamous cell carcinoma where skip metastasis is present. These lymph nodes are prophylactically irradiated even in node negative disease. However, there is no current standard for prophylactic neck irradiation in node negative or limited retropharyngeal node (RP) positive NPC. Limiting radiation to the upper neck spares lower neck soft tissues and thyroid gland. The aim of this paper is to synthesize the current evidence regarding effectiveness of upper neck irradiation (UNI) versus whole neck irradiation (WNI) as prophylactic neck irradiation in node negative or limited RP node positive NPC. Methods: Search of relevant articles were done from 2000 to October 2015. Critical appraisal and meta-analysis of the eligible studies were undertaken to assess the effectiveness of UNI versus WNI as prophylactic neck irradiation in node negative or limited involved retropharyngeal node NPC. Results: One randomized controlled trial and 4 retrospective cohorts were included in this meta-analysis. Only one randomized controlled trial investigated on the use of prophylactic UNI versus WNI and showed no confirmed nodal relapse in both arms. Pooled analysis of four retrospective studies showed an odds ratio of 1.68 (CI- 0.64- 4.40) in nodal recurrence, whether in-field or out-of-field recurrence. There was no significant difference on the rate of nodal recurrence when UNI versus WNI as prophylactic node irradiation was used for node negative or limited RP positive NPC. Pooled data from three studies showed no significant difference in 5-year distant metastasis and overall survival between UNI and WNI with an odds ratio of 1.09 (0.58-2.03) and 0.99 (O.60-1.63) respectively. Conclusions: In node negative or limited RP positive NPC, it may be a reasonable option to treat only the upper neck (levels II, III and VA) without compromising nodal control, distant metastasis and overall survival.
The value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in salivary gland tumors.
Authors: Idris Yucel, Ozgur Kemal, Yasemin Kemal, Ayse Bel, Ugur Yildirim, Sinan Atmaca, Mehmet Koyuncu, Recep Unal
Journal: Journal of Clinical Oncology (2017)

e17592 Background: Salivary gland tumors are rare, comprising only 6 to 8 percent of head and neck neoplasms. Most of them are benign and commonly occur in the parotid gland. In the last decade elevated hematological inflammatory parameters like neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were identified as predictive and prognostic factors in various malignancies. The aim of this study was to evaluate the differences of preoperative of NLR and PLR levels in benign and malignant causes of salivary gland tumors. Methods: This retrospective study was made of a total of 133 patients with salivary gland tumors (age range: 17-89 years; 68 male and 65 female) who were treated between January 2006 and May 2016. Preoperative counts and levels of hematological parameters were obtained from the recorded computerized database in benign and malignant tumors. Results: NLR and PLR levels were significantly higher in the malignant salivary gland tumor group than the benign group( NLR: 0.66±1.3 vs 0.59±0.31 p=0.001, PLR: 160.3±85.7 vs 124.6±44.1 p=0.014). Conclusions: The results of the current study revealed the potential predicitve role of NLR and PLR in patients with salivary gland tumors. These cheap and easily available blood count parameters could be useful biomarkers in the future; but further investigations are needed to confirm our findings. [Table: see text]
Phase II study of lapatinib and tegafur combination efficacy for the treatment of HER2+ metastatic breast cancer.
Authors: Alexey Manikhas, Ineza O. Sharvashidze, Tatjana N. Kotkova
Journal: Journal of Clinical Oncology (2012)

e11086 Background: One of effective ways to overcome resistance to trastusumab is to prescribe lapatinib, an inhibitor of ErbB1 and ErbB2 receptors, in combination with capecitabine, a fluopirimidine cytostatic agent. We examined the efficacy and safety of combination of lapatinib plus tegafur, another oral fluopirimidine, in patients with ErbB2-positive metastatic breast cancer (MBC). Methods: 13 patients with HER2+ MBC were enrolled into the study. 11 patients were analyzed, as 2 women had been included into the study too late to be assessed. Median age was 43.5 years. All patients had previously received trastuzumab for MBC, 92% of patients had been treated with taxanes, 77% - with anthracyclines, and 31% received capecitabine. 69% of patients were treated with more than 2 lines of chemotherapy for MBC. The study included 4 patients with CNS metastases. During the study, the patients received lapatinib 1250 mg/day and tegafur 1200 mg/day, days 1-21, with 3-week intervals. Results: 1 patient achieved and still is in partial response which has been lasting for 5 months, while disease stabilization was observed in 9 out of 10 cases. The clinical benefit rate in this trial was 90%. There was 1 case of the disease progression. At the time of analysis median TTP was 10.1 months (95%CI 6-13). The combination of lapatinib and tegafur was effective in 4 out of 5 patients with CNS metastases. There were no adverse events greater than grade I observed on lapatinib plus tegafur therapy. Diarrhea was the most common adverse event, but it did not compromise the patients' quality of life. Conclusions: The lapatinib plus tegafur combination is a promising option for treatment of patients with HER2+ MBC after progression on trastuzumab-containing therapy. This mode was acceptable for patients who had received 2 or more lines of previous therapy. The combination was well tolerated by the patients. Both agents being oral formulations, the treatment mode is quite suitable for outpatient use.
Mutational profile of HPV-driven head and neck cancers according to tobacco consumption.
Authors: Haitham Mirghani, Ludovic Lacroix, Odile Casiraghi, Anne Auperin, Caroline Rossoni, Aude Villepelet, Roger Lacave, Virginie Marty, Caroline Even
Journal: Journal of Clinical Oncology (2017)

e17535 Background: HPV-driven oropharyngeal cancer (OPC) patients are characterized by a better prognosis than their HPV-negative counterparts. However, this significant survival advantage is not homogeneous and studies have highlighted that among HPV-positive patients those with a smoking history have a significantly increased risk of disease progression and death compared to those who have never smoked. The reason why tobacco consumption impacts negatively the prognosis is still elusive. Tobacco might induce additional genetic alterations leading to a more aggressive phenotype. The purpose of this study is to characterize the mutational profile of HPV-positive OPC by smoking status. We hypothesize a higher frequency of mutations affecting among smokers. Methods: Targeted next-generation sequencing of 38 oncogenes/tumor suppressor genes that are commonly mutated in cancers caused by tobacco/alcohol consumption was performed in 62 HPV-driven OPC cases stratified by smoking status. Results: The study population included 37 (60%) non-smokers and 25 (40%) smokers distributed as follows: 1 (4%) patient smoked &lt;10 pack-year (PY), 8 (32%) patients between 10-20 PY and 16 (64%) &gt;20 PY. Twenty (31%) patients had no mutation, 14 (23%) had 1 mutation and 28 (46%) had 2 or more mutations. The most commonly mutated genes regardless of tobacco consumption were PIK3CA (20%), MLL2 (20%), TP53 (8%), FAT 1 (15%), FBXW7 (16%), NOTCH 1 (9%) and FGFR3 (9%). Mutation rate was not significantly different in smokers compared to non-smokers even when analyses focused on heavy smokers (&gt;20 pack-years compared to &lt;20 pack-years). Similarly there was no significant difference in mutations patterns according to tobacco consumption. The 3 years overall survival, disease-specific-survival and loco-regional-control rates for the whole cohort are respectively 88% (95% CI: 76.4-94.1), 88% (95% CI: 76.4-94.1) and 80.6% (95% CI: 67.5-88.8). Despite a median follow-up was 4.5 years (6 months to 11.7 years), the few number of events (13 relapses, 13 deaths including 10 due to OPC) precludes detailed prognosis analyses. Conclusions: HPV-driven OPC patients with a smoking history have a comparable mutational rate than non-smokers. Smoking impact on the prognosis isn’t attributable to the mutational burden. Further studies are warranted.
Mouse primary visual cortex in not part of the reverberant neural circuitry critical for visual perception
Authors: M Watanabe, S Nagaoka, L Kirchberger, E Poyraz, S Lowe, B Uysal, A Vaiceliunaite, NK Totah, NK Logothetis, L Busse, S Katzner
Journal: Nature Neuroscience (2017)
What do patients want to know when selecting a hospital for cancer care?
Authors: Allison Nicole Lipitz Snyderman, Elizabeth Fortier, Diane G. Li, Susan Chimonas
Journal: Journal of Clinical Oncology (2018)

e18810 Background: Information transparency is a critical tool for empowering patients to make evidence-based healthcare decisions. Yet patients seldom consult available resources like provider “report cards,” in part because patients do not perceive the information as relevant. To inform more effective public reporting efforts, this study sought to explore patients’ information preferences and priorities when choosing a hospital for cancer treatment. Methods: We conducted a series of national focus groups. Using a semi-structured discussion guide, a trained moderator delved deeply into the factors that had guided participants’ hospital choices. Eligible participants received cancer treatment within the last two years. To capture possible differences by geography and age, separate sessions were held with patients aged 18-54 and 55 and older in Philadelphia, PA, Phoenix, AZ, and Indianapolis, IN (N = 38 participants). Results: Nearly all participants agreed that quality of care varies among hospitals. In their deliberations, many had considered such factors as reputation and the facilities available. For most participants, however, hospital selection was guided by advice from friends, fellow patients, and physicians. Most participants agreed that advice from a trusted physician would sway them to disregard objective data. Nonetheless, nearly all participants expressed strong interest in robust quality of care information for different hospitals. Participants varied widely in selecting “the top three things you would want to know when choosing a hospital for cancer care.” The most commonly selected items were “overall quality” and “patient satisfaction;” the least included clinical outcomes, most notably survival rates – many felt such data were disturbing and should be avoided. Conclusions: Patients want data comparing hospitals’ quality. However, their information preferences are diverse and often conflict dramatically with what physicians, researchers, and other experts value. Our findings suggest that psychological factors strongly shape patients’ views. Public reporting efforts should include extensive outreach to referring physicians, engaging them to consult the data and advise their patients accordingly.
Long-term outcomes of high-dose melphalan and carmustine followed by autologous hematopoietic cell transplantation for multiple myeloma.
Authors: Amarendra Kumar Neppalli, Judith Shizuru, Laura J. Johnston, Lori S. Muffly, Wen-Kai Weng, Robert Negrin, Everett Meyer, Ginna Laport, Robert Lowsky, Sally Arai, David Bernard Miklos, Andrew R. Rezvani
Journal: Journal of Clinical Oncology (2016)

8026 Background: Autologous hematopoietic cell transplantation (AHCT) is an important component of multiple myeloma treatment. Single-agent melphalan is the most commonly used conditioning regimen. We tested a novel conditioning regimen of carmustine plus melphalan. Methods: 414 patients with multiple myeloma received carmustine (BCNU) 350 mg/m2 and melphalan 200 mg/m2 followed by AHCT between 10/2006 and 1/2015. Median follow-up was 3.0 years. Results: See Table. Median overall survival from AHCT was 7.4 years (95% CI, 6.0 years-not reached) and median progression-free survival was 3.0 (95% CI, 2.8-3.5) years. Nonrelapse mortality was 2% at day +100 and 5% at 3 years. The 3-year cumulative incidence of relapse was 42%. Disease status at AHCT (CR vs. not in CR) did not significantly impact OS (p=0.614) or PFS (p=0.779) by log-rank test, nor post-transplant relapse (HR 1.06, 95% CI 0.67-1.66, p=0.81) by Fine-Gray test. However, relapse in patients entering AHCT in CR reached a plateau at approximately 3 years post-transplant, while patients with measurable disease at AHCT relapsed continuously over time. Pneumonitis related to BCNU occurred in 104 of 414 patients (25%) and caused 2 deaths. Second malignancies (excluding non-melanomatous skin cancers) occurred in 29 patients (7%) at a median of 16 months post-transplant. Conclusions: High-dose conditioning with BCNU/melphalan followed by AHCT was safe and effective in this large cohort of patients with myeloma, with outcomes comparable or superior to those reported in registry data (Costa et al., BBMT 2014). Patients benefited regardless of disease status at AHCT; a subset of patients transplanted in CR may achieve long-term cure, based on the plateau in relapse incidence in this group. Pneumonitis remains a concern with BCNU-containing regimens. Further studies directly comparing this regimen to single-agent melphalan are needed. N 414 Median Age 57 (32-72) 31-40 11 41-50 72 51-60 176 61-70 150 >70 5 Gender Male 259 Female 155 Disease status prior to AHCT CR 68 vgPR 103 PR 214 Less than PR 29 Months from diagnosis to AHCT (median, 13) < 6 7 6-12 208 12-24 127 24-36 37 >36 35 Myeloma subtype IgG 252 IgA 81 Light chain 60 Nonsecretory 10 Other 11