tbuckley/cabot-search huggingface dataset:
Impact of support group participation in women with gynecologic cancer.
Authors: Andrea Garrick, Adam Pyrzak, Fengjiao Hu, Ramses F. Sadek, Donna Wheatley, Bunja Jane Rungruang, Sharad A. Ghamande
Journal: Journal of Clinical Oncology (2016)

252 Background: Unlike breast cancer support group literature, there is no data in women with gynecologic cancer who have different perspectives about their disease and therapy. We have a well-established, grass root level support group unique to women with gynecologic cancers that meets monthly. Our goal was to investigate perceived benefits of support group participation. Methods: We developed an original questionnaire to evaluate the CSRA Gynecologic Oncology Support Group (CGOSG) participant’s perceived effects of attending the group on their side effects and disease status which was distributed to patients attending CGOSG meetings. 47 surveys were collected for analysis; Wilcox rank sum test was used as appropriate. Patients were also administered the validated FACT-G questionnaire addressing physical well-being (PWB), emotional well-being (EWB), social well-being (SWB), and functional well-being (FWB). 33 surveys were collected, and t-tests were conducted using FACIT SAS scoring program. Results: In the original questionnaire, the 2 top reasons that patients attended CGOSG were physician driven (28%) and to meet other women with the same diagnosis (26%). The most concerning physical side effect from their cancer or therapy was fatigue (21%), and patients with more than 5 visits reported that CGOSG participation improved their fatigue with a median score of 7.5 ± 4 out of 10. The most concerning emotional side effect was fear of recurrence (26%), and patients reported the CGOSG improved their fear of recurrence with a median score of 9 ± 2 out of 10. Patients with more than one visit, not on treatment reported a higher quality of life score (p = 0.001) and perceived a positive impact on cancer therapy (p = 0.02) compared to patients on treatment. Among patients who took the validated FACT-G questionnaire, those on active treatment had a lower PWB than patients not on therapy (p = 0.01). The mean subscale scores were PWB 21.99, SWB 24.26, EWB 20.08, FWB 20.92 with patients faring best in social well-being. Conclusions: This is a first of a kind attempt to understand the impact of a well-organized support group on women with gynecological cancers which indicates that these women struggle with fear of recurrence but are able to find some solace.
The BCL9 Oncogene Promotes Tumor Progression by Conferring Enhanced Proliferative, Metastatic and Angiogenic Properties to Myeloma Cells
Authors: Mala Mani, Jui Dutta, Yunyu Zhang, Daniel E Carrasco, Yiming Zhou, Moshe Gatt, Bart Barlogie, John D. Shaughnessy, Kenneth C Anderson, Daniel Ruben Carrasco
Journal: Blood (2008)
Peripheral T-cell lymphoma in an adolescent with unsuspected gaucher disease
Authors: Rosa Sanchez, Joan Etzell, Grace Kim, Seymour Packman, Cecilia Fairley, Robert Goldsby
Journal: Journal of Clinical Oncology (2005)

A previously healthy 16-year-old white male noticed a growing, painless lump on his left shoulder. He was seen by his family physician, who removed the lesion thinking it was a cyst. At the time of resection, the lesion measured roughly 2 to 3 cm in size. Preliminary pathology review was suggestive of a lymphoma, and he was referred to the University of California, San Francisco, for further evaluation. Review of systems was unremarkable. Past medical history revealed that 10 years before this presentation his pediatrician had noted an enlarged liver. Family history was unremarkable, and he has one healthy sibling. Physical examination revealed a healing incision on his left shoulder, a port-wine stain extending along his left arm, hepatosplenomegaly, but no lymphadenopathy. A computed tomography scan of his chest, abdomen, and pelvis confirmed the hepatosplenomegaly, but no other abnormalities. A positron emission tomography scan did not show any abnormal uptake in the liver or spleen. All laboratory tests were within normal limits, including a CBC. Pathology of the lesion demonstrated a peripheral T-cell lymphoma (Fig 1) expressing CD45, CD45R0, CD3, CD15 and lacking EMA, CD20, CD30 and ALK-1. He underwent bilateral bone marrow aspirates and biopsies for staging. Microscopic examination of the bone marrow revealed numerous Gaucher cells, which are large storage cells with abundant cytoplasm containing striations representing abnormal amounts of glycosphingolipids (Fig 2). Enzyme analysis confirmed that he had Gaucher disease. Gaucher disease is a lysosomal storage disorder resulting from a deficient activity of the lysosomal hydrolase, glucocerebrosidase, leading to an excessive accumulation of glucocerebroside in the cells of the reticuloendothelial system. There is a spectrum of clinical consequences, but this patient has chronic, non-neuropathic type 1 Gaucher disease. Individuals with Gaucher disease may be at a 14-fold increased risk for hematologic malignancies. There have been a number of reports of different hematologic malignancies associated with Gaucher disease. These include lymphomas and multiple myeloma. It is important to confirm a diagnosis of Gaucher disease, as pseudo-Gaucher cells can be identified in the bone marrow of patients with lymphomas and other hematologic disorders. Peripheral T-cell lymphomas are rare in children and adolescents and are associated with an aggressive behavior. In this case, we would have considered bone marrow transplantation (which can also ameliorate Gaucher disease) if this patient had disseminated disease. The patient is being treated with six cycles of cyclophosphamide, adriamycin, vincristine, and prednisone, and also receives concurrent enzyme replacement therapy for Gaucher disease.
Benefits of platinum-based chemotherapy (Pt-chemo) in pancreatic adenocarcinoma (PC) associated with BRCA mutations: A translational case series.
Authors: Olusola Olusesan Faluyi, Ben Tran, Zaheer Kanji, Sara Moore, George Zogopoulos, Ayelet Borgida, Spring Holter, Steven Gallinger, Malcolm J. Moore
Journal: Journal of Clinical Oncology (2012)

4058 Background: The prognosis of PC is poor with limited response to standard chemotherapy. Prior randomized studies of cisplatin and gemcitabine in PC demonstrated no additional benefit over gemcitabine alone. Preclinical data and case reports suggest that BRCA mutant PC may have increased sensitivity to Pt-chemo. Our case series characterizes the benefits of Pt-chemo in germline BRCA mutant PC. Methods: Patients with PC and germline BRCA mutations were identified using the Ontario Pancreatic Cancer Study and Pharmacy databases. Review of clinical records provided demographic, treatment and survival data. Radiology review assessed responses to chemotherapy. RNA was extracted from tumor samples for gene expression studies using a panel of DNA repair genes and Nanostring technology. BRCA loss of heterozygosity (LOH) was also investigated. Results: We identified 14 PC patients with BRCA mutations (8 BRCA2, 6 BRCA1). 11 of these had metastatic disease of which 5 received Pt-chemo. Of the 5 treated with Pt-chemo, there were 3 partial responses (PR) and 2 complete responses (CR) using Recist criteria. For the remaining 6 not treated with Pt-chemo, there was 1 PR with gemcitabine. Additionally, two patients with locally advanced disease at diagnosis became resectable following Pt-chemo. Overall survival was superior for patients receiving Pt-chemo (33.0±25.6 vs 7.3±4.5 months; p=0.04). Gene expression and LOH results will be presented. Conclusions: Responses and survival associated with Pt-chemo observed in our case series of BRCA mutant PC adds to existing data supporting the use of Pt-chemo in this subgroup. Despite the low (2 to 5%) prevalence of BRCA mutations in PC, the benefits gained from personalizing treatment using Pt-chemo supports BRCA testing in selected patients.
Can patients be cured after cytoreductive surgery plus intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis?
Authors: D. Goéré, D. Tzanis, V. G. Gava, L. Maggiori, F. Dumont, M. Ducreux, D. Elias
Journal: Journal of Clinical Oncology (2011)

3570 Background: Despite the positive results of the randomized trial that compared cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy to systemic chemotherapy, there is being considerable debate over the treatment of peritoneal carcinomatosis (PC) from colorectal cancer (CRC). The aim of this study was to evaluate long-term outcome after CRS followed by intraperitoneal chemotherapy and to identify the prognostic factors associated with cure. Methods: Patients were selected from a prospective database. Patients were considered cured if they have a disease free interval of at least 5 years from the treatment of the PC or from the treatment of their last recurrence. Patients with operative death, non cancer related death and a follow-up of less than 5 years were excluded from this analysis. Results: From 1995 to 2006, 107 patients, with a median age of 48 years (range, 19 to 67) underwent resection followed by intraperitoneal chemotherapy. Most of the patients (82 %) received chemotherapy prior to CRS, and 57% received also postoperative chemotherapy. The 5 and 10-year survival rates were 31% and 12% respectively, after a median follow up of 77.2 (60-144). Seventeen (16%) were considered cured after a disease free interval of at least 5 years, 14 of whom never experienced recurrence. Cured patients had significantly a lower mean peritoneal cancer index (PCI) than non-cured (6.2 ± 4 vs. 13.1 ± 7 respectively, p <.001). Operative time, mean blood loss and hospital stay were significantly lower in the cured patients. Multivariate analysis identified only a value of PCI < 10 as an independent predictive factor of cure. Conclusions: Complete cytoreductive surgery followed by intraperitoneal chemotherapy can cure 16% of patients, rate similar to that obtained after resection of liver metastases initially unresectable. This validates the combined treatment in patients with CRC PC, compared to systemic chemotherapy, which never led to such results. The only factor of cure was the extension of peritoneal disease.
Second-line pancreatic cancer therapy: Patterns of care and survival.
Authors: S. N. Hoang, J. R. Hoverman, B. Turnwald
Journal: Journal of Clinical Oncology (2010)

6131 Background: Second-line therapy for patients with pancreatic cancer who have failed gemcitabine (GEM) based chemotherapy has been poorly studied. Limited clinical data suggest some survival benefit for second-line treatment; however, there is no second-line regimen that can be considered standard of care. This retrospective study reports the patterns of care and outcomes for second-line pancreatic cancer therapy among patients previously treated with GEM. Methods: Electronic medical records (iKnowMed) of 27 outpatient community cancer centers were reviewed. Pancreatic cancer patients with documented first-line GEM-based therapy during June 2006 to March 2009 were identified and followed through October 2009 or death. Chemotherapy and survival patterns were evaluated. Patients were excluded if there was history of clinical trial and/or insufficient data. Overall survival (OS) was calculated from date of diagnosis to death. Results: 368 out of 432 patients did not receive therapy beyond first-line (median age 66 years, 63% male); 64 out of 432 (15%) patients received second-line treatment (median age 67 years, 50% male). The most common second-line treatments reported were: capecitabine (CAP) or 5-FU (36%), oxaliplatin + CAP or 5-FU (23%), GEM + erlotinib (9%), other GEM combinations (17%) and other (15%). The median OS for patients receiving second-line therapy versus best supportive care was 435 weeks vs. 207 weeks (p < 0.0001; HR 1.66 [1.33-2.09]). Conclusions: The lack of use of and wide variation in second-line chemotherapy confirm that there is no standard alternative to supportive care. The benefit from second-line therapy is uncertain as, in the community setting, this patient population is highly selected. Further evaluation to determine patient characteristics and second-line therapy options to optimize survival benefit is warranted. No significant financial relationships to disclose.
Circulating tumor cells as a predictive marker for chemotherapy and prognostic marker in patients with metastatic non-small cell lung cancer.
Authors: T. Hirose, Y. Oki, S. Kusumoto, T. Sugiyama, T. Shirai, M. Nakashima, T. Yamaoka, K. Okuda, T. Ohnishi, T. Ohmori, M. Adachi
Journal: Journal of Clinical Oncology (2011)

e21020 Background: Circulating tumor cells (CTCs) are extremely rare in healthy subjects and patients with nonmalignant diseases but present in various metastatic carcinomas. The number of CTCs before treatment has been reported to be prognostic factor for metastatic breast cancer. We investigated the relationship of the number of CTCs with overall survival, progression free survival, and response rate in patients with metastatic non-small cell lung cancer (NSCLC). Methods: We prospectively evaluated CTCs in 7.5-mL samples of peripheral blood sampled from patients with previously untreated metastatic NSCLC. A semiautomated system was used to capture CTCs with an antibody against epithelial cell adhesion molecule. From May 2008 through August 2010, 33 patients (23 men and 10 women; median age, 64 years; range, 46 to 74 years) were enrolled. All patients received chemotherapy of the combination of gemcitabine and carboplatin. Results: CTCs were detected in 36.4% of patients. Patients with positive CTCs were trend toward to longer survival (23 months) and progression free survival (5 months) than patients with negative CTCs (7 months, 2.5 months), although there were not statistically significant differences. The stable disease rate to chemotherapy was significantly lower in patients with positive CTCs (18%) than in patients with negative CTCs (75%; p = 0.002). Conclusions: CTCs could be a useful predictive marker for chemotherapy and might be prognostic marker in patients with metastatic NSCLC.
Advanced cancer patients' priorities regarding wishes at the end of life: A randomized controlled study.
Authors: Marvin Omar Delgado-Guay, Alfredo Rodriguez-Nunez, Vera J De la Cruz, Susan Frisbee-Hume, Janet L. Williams, Jimin Wu, Diane D Liu, Michael Fisch, Eduardo Bruera
Journal: Journal of Clinical Oncology (2015)

44 Background: Conversations about wishes around the end-of-life(EOL) are challenging for clinicians. There is limited literature about the type and stability of patient’s reported EOL planning priorities. We compared a set of 36 cards (“Go-wish-Game”: GWG) v. a paper list of statements (LOS) to assist patients in establishing priorities. Methods: Randomized controlled study. Pts. were randomized to the GWG or to 36 LOS and were asked to categorize them as very, somewhat, or not important; Group A received LOS followed by LOS 4-24 hours later; group B: GWG-GWG; group C: GWG-LOS, and group D: LOS-GWG. The State-Trait Anxiety inventory for Adults(STAI) was done after the first set of questionnaires. Results: 100 pts. Median age (IQR): 56 (27-83) years. 60% female. 68% White, 17% Hispanic, and 9% African-American. 62% married. Age, marital status, religion, education and cancer diagnosis were not significant different among groups. All pts. were able to complete the GWG. 43/50 (88%) agreed that instructions of GWG were clear. 45/50 (92%) agreed that GWG was easy to understand. 31/50 (64%) patients exposed to both tools, preferred GWG. 39/50 (79%) expressed that GWG did not increased their anxiety. 31/50 (63%) expressed that having conversations about priorities near EOL is beneficial to them (p=NS). STAI median (IQR) score after GWG was 48 (39-59) v. 47 (27-63) for LOS, p=0.2952. The 10 most common “Very important” wishes expressed by pts. the first and second time they received the test (%; Spearman, p-value) were: to be at peace with God(74% v. 71%; r=0.73, p&lt;0.0001), to pray(62% v. 61%, r=0.53, p&lt;0.0001), to have my family with me(57% v. 61%; r=0.23, p=0.02), to be free from pain(54% v. 60%, r=0.31, p=0.001), not being a burden to my family(48% v. 49%, r=0.23, p=0.02), to trust my doctor(44% v. 45%; r=0.49, p&lt;0.0001), to keep my sense of humor(41% v. 45%; r=0.53, p&lt;0.0001), to say goodbye to important people in my life(41% v. 37%; r=0.46, p&lt;0.0001); to have my family prepared for my death(40% v. 49%; r=0.48, p&lt;0.0001). Conclusions: EOL wishes were similar and persistent using both GWG and LOS. Completing both GWG and LOS did not increase anxiety. All patients were able to complete and most preferred GWG.
Can we improve community adjuvant treatment reporting to a hospital tumor registry?
Authors: Nina Bickell, Jill Wellner, Rebeca Franco, Ann McAlearney
Journal: Journal of Clinical Oncology (2012)

136 Background: Accurate cancer treatment reporting to a hospital tumor registry (TR) is critical as data measurement is the foundation for improvement. Yet as adjuvant treatment moves to outpatient settings, reporting is problematic. We undertook a solutions-focused exercise to identify reporting barriers and facilitators and devise a pilot intervention to improve reporting. Methods: We convened a multidisciplinary group of community-based surgical and medical oncologists, TR staff, and hospital leadership. The group identified 3 key barriers: 1) inability to identify correct managing MD, 2) poor communication, and 3) manual reporting burden. The intervention focused on the 1st 2 barriers—those with easy fixes and great potential impact: TR obtained correct information, changed contact forms, worked with pathology to ascertain cases in real-time, tracked and reported practice responses weekly; MDs primed office staff to respond to TR requests. Results: Pre-intervention, the TR identified none of 20 pilot patients’ managing medical oncologist or adjuvant treatment. During the April to May 2012 intervention, 22 breast cancer patients listed our volunteer surgeon as managing MD. The TR sent 22 treatment letters to the surgeon’s office, received 20 (91%) responses with managing MD data provided for all. Patients were referred to full-time (26%) and community (74%) medical oncologists; 64% of required adjuvant treatment was reported. 47% of cases were closed; 53% remain open. Closed cases required 5.9 contacts (38.9 mins; sd=8.99), open cases had 8.2 contacts (48.4 mins; sd=2.85). Surgical staff spent ~1/2 hour per case to identify the oncologist prescribing adjuvant treatment. Conclusions: The solutions-focused exercise successfully improved identification of managing oncologists from 0% to 86% for patients treated by community oncologists. Treatment reporting increased from 2.6% to 64%. The pilot did not address the burden of reporting which remains great for both TR and community oncologists. While electronic access can reduce this burden through direct interface between an EMR and TR software, this approach is not currently feasible for community-based oncologists.
Preventing cancer in the colon: Effect of ginger root extract on markers of inflammation in colon mucosa in people at high risk for colorectal cancer.
Authors: S. M. Zick, D. K. Turgeon, S. Vareed, M. T. Ruffin, Z. Djuric, A. J. Litzinger, B. Wright, D. P. Normolle, D. E. Brenner
Journal: Journal of Clinical Oncology (2011)

1570 Background: Studies using drugs that inhibit cyclooxygenase enzymes (COX-1,-2) indicate that up-regulation of inflammatory eicasanoids, and in particular prostaglandin E2 (PGE2) are early events in the development of CRC. Ginger root has demonstrated down regulation of COX-1,-2, apoptosis in CRC cell lines and decreased incidence and multiplicity of adenomas in rats. This study was conducted to determine if 2.0 g/day of ginger extract could decrease the levels of PGE2, 5-,12-, & 15-hydroxyeicosatetraenoic acid (5-,12-, & 15-HETE), 13-hydroxyoctadecadienoic acid (13-HODE) and Leukotriene B4 (LTB4), in the gut mucosa of people at increased risk of colorectal cancer when taken for 28 days. Methods: A total of 20 subjects were randomized to 2.0 g/day ginger or placebo for 28 days. Flexible sigmoidoscopy at baseline and day 28 was used to obtain rectal biopsies. A liquid chromatography mass spectrometry (LC/MS/MS) method was used to simultaneously determine PGE2, 5-HETE, 12-HETE, 15-HETE, LTB4 and 13-HODE in the biopsies. Results: When examining differences in mean percent change between baseline and day 28 of the eicosanoids, when normalized to protein there was significantly more LTB4 (p=0.02) and close to significantly more PGE2 (p=0.06), HETE-5 (p=0.06) and HETE-15 (p=0.06) in the participants who received ginger compared to placebo. In contrast, there was no significant decrease in mean percent change in any of the eicasanoids compared to placebo when normalized to free arachidonic acid (AA). There was, however, a significant decrease in free AA in the ginger group compared to the placebo group (-49%, p=0.02). There was no difference in the number or type of adverse events. Conclusions: Ginger increased certain eicosanoid levels when normalized to protein, but not free AA in colon biopsies after 28 days of consumption, as compared to placebo. Ginger also appeared to be both tolerable and safe when taken for 28 days at the 2.0 g/day dose. Further investigation in larger studies in people at high risk for CRC seems unwarranted.
Mammography use among breast cancer survivors: Administrative data and chart review
Authors: M. J. Nissen, J. W. Leach, K. K. Swenson
Journal: Journal of Clinical Oncology (2008)

6569 Background: At least 13 articles, including 5 in the Journal of Clinical Oncology, have reported low rates of mammography in breast cancer survivors. In studies analyzing the first 12 to 18 months following breast cancer diagnosis and/or treatment, mammography rates were typically between 70% and 80%. Analyses of administrative data at our institution, Park Nicollet Health Services (PNHS), showed the same result despite oncologists' insistence that they were diligent about this aspect of follow-up care. Method: Using the PNHS Cancer Registry, we identified 191 women diagnosed with non-metastatic breast cancer at PNHS in 2001 who allowed their records to be used for research, were alive as of January 15, 2007, and received cancer care and primary care within PNHS. We used the PNHS administrative (claims) database to determine whether each woman received mammography during the year following active breast cancer treatment, and we used the PNHS electronic medical record to review charts of women who according to claims data did not. Results: Administrative data indicated that 79.1% of women received mammography during the year following active treatment for breast cancer, an estimate in agreement with published studies. However, chart review of those who did not receive mammography indicated that 26 had undergone bilateral mastectomy; only 16 of these were indicated in the Cancer Registry. An additional 2 women had received mammography but their medical record and billing identifiers mismatched, and 3 women received mammography out of system. The final mammography rate was 94.5%. Conclusion: Published reports underestimate mammography rates in breast cancer survivors, primarily because of failure to exclude women who have had bilateral mastectomy. Only 4 reports mentioned that women with bilateral mastectomy were excluded, and in 2 of those, the proportions excluded were less than 1.5%. Studies should document type of surgery in order to provide a realistic picture of the care of breast cancer survivors. No significant financial relationships to disclose.