tbuckley/cabot-search huggingface dataset:
A retrospective analysis of all non-AIDS defining cancers (NADC): A subset analysis of the County Hospital AIDS Malignancy Project (CHAMP).
Authors: Shweta Gupta, Prantesh Jain, Emilio Araujo Mino, Audrey L. French, Fred R Rosen, Paul G. Rubinstein
Journal: Journal of Clinical Oncology (2012)

1611 Background: County Hospital (CCH) with its HIV clinic, the CORE Center (CC) is the largest provider for HIV patients (pts) in Chicago, treating over 5,500 HIV pts yearly. There is paucity of data on characteristics of HIV+ cancers (ca) in the inner city. The CHAMP cohort is a retrospective study of all HIV associated cancers at CC and CCH over past 14 years (yrs). We analyzed all of the NADC from this cohort. Methods: All HIV pts with NADC were identified from the CHAMP cohort and retrospectively reviewed for HIV and cancer characteristics, overall survival (OS), and pt demographics. Statistics: Survival data was analyzed using Kaplan-Meier analysis and Cox Proportional Hazards model. Results: Of 438 pts identified, 157 were NADC representing 21 ca. The average (ave) age was 48 yrs (range 44-57), with prostate ca having highest age presentation. Over the past 10 yrs, the number of NADC has risen from 10 to over 20 each yr. Unlike historical controls (HC) where lung ca is most common, anal ca (21%) was most frequent followed by lung ca (17%). Prostate, head and neck (HNSCC), liver, and colorectal ca were seen in 9, 9, 8, and 7% respectively. 65% of pts were African Americans (AA) and 18% Caucasians. 78% of all NADC were men. 45% of anal ca present with stage IIIa/b disease, moderately to poorly differentiated ca in 48%, with a median OS of 34 mo. CD4 count did not alter OS but stage predicted better outcomes. 86% lung ca presented as stage III/IV disease with ave CD4 count 204. Histologically, 36% were SCC, 28% adenosquamous and 20% adenocarcinoma. OS was 5.5 mo and did not change by histology, CD4, or age. 68% HNSCC present with stage IVa/b but no IVc. Ave age was 48 yrs with an OS of 18mo. 50% were oropharyngeal compared to 22% in HC. Conclusions: Based on data by Sheilds et. al, CCH treats just over 1% of the country’s NADC population. We demonstrate a higher incidence of NADC over time, dominated by a younger, AA and male population. Each ca presents with advanced stage 45-86% and poorly differentiated tumors ranging from 15-30%. The OS of each cancer is consistent with HC with exception of HNSCC. As HIV pts age becoming prone to cancers of elderly, education and screening of inner city HIV pts will help improve cancer rates.
The prognostic value of cognition in patients with glioblastoma multiforme.
Authors: Birgit Flechl, Cornelia Sax, Michael Ackerl, Richard Crevenna, Alexander Gaiger, Karin Dieckmann, Georg Widhalm, Christine Marosi
Journal: Journal of Clinical Oncology (2013)

2078 Background: In patients with glioblastoma multiforme (GBM) progressive disease leads sooner or later to cognitive decline. In this study we evaluated if two cognitive assessments performed early in the treatment course have a prognostic significance for predicting progression free survival (PFS). Methods: We assessed the cognition of 35 patients with GBM using the program NeuroCogFX with four subscales: working memory, attention, verbal and figural memory and verbal fluency. Baseline evaluation was done at initiation of radiotherapy (11-57 days after diagnosis) and second evaluation three months later (82-117 days after baseline). Results in subscales were categorized in “declined”, “stable” and “improved”. Tumor progression was based on MRI scans. Results: The patients (12 women, 23 men) were in median 54 years old (21-75 years). The majority (61%) showed stable cognitive results, 22% improved and 14% decreased in the summary scale of cognition. The median PFS was 11 months (2.6-27.4 months). An improvement of attention correlated significantly with longer PFS (p = 0.015) whereas the other three cognitive subscales were not associated with PFS. Conclusions: The present study shows evidence, that an increase or decrease of attention scales measured within the first 5 months of disease has prognostic value for PFS.
Active Surveillance in Younger Men With Prostate Cancer
Authors: Michael S. Leapman, Janet E. Cowan, Hao G. Nguyen, Katsuto K. Shinohara, Nannette Perez, Matthew R. Cooperberg, William J. Catalona, Peter R. Carroll
Journal: Journal of Clinical Oncology (2017)

Purpose The suitability of younger patients with prostate cancer (PCa) for initial active surveillance (AS) has been questioned on the basis of eventual treatment necessity and concerns of safety; however, the role of age on surveillance outcomes has not been well defined. Patients and Methods We identified men managed with AS at our institution with a minimum follow-up of 6 months. The primary study objective was to examine the association of age with risk of biopsy-based Gleason score upgrade during AS. We also examined the association of age with related end points, including overall biopsy-determined progression, definitive treatment, and pathologic and biochemical outcomes after delayed radical prostatectomy (RP), using descriptive statistics, the Kaplan-Meier method, and multivariable Cox proportional hazards regression. Results A total of 1,433 patients were followed for a median of 49 months; 74% underwent initial biopsy at a referring institution. Median age at diagnosis was 63 years, including 599 patients (42%) ≤ 60 years old and 834 (58%) &gt; 60 years old. The 3- and 5-year biopsy-based Gleason score upgrade-free rates were 73% and 55%, respectively, for men ≤ 60 years old compared with 64% and 48%, respectively, for men older than 60 years ( P &lt; .01). On Cox regression analysis, younger age was independently associated with lower risk of biopsy-based Gleason score upgrade (hazard ratio per 1-year decrease, 0.969 [95% CI, 0.956 to 0.983]; P &lt; .01), and persisted upon restriction to men meeting strict AS inclusion criteria. There was no significant association between younger age and risk of definitive treatment or risk of biochemical recurrence after delayed RP. Conclusion Younger patient age was associated with decreased risk of biopsy-based Gleason score upgrade during AS but not with risk of definitive treatment in the intermediate term. AS represents a strategy to mitigate overtreatment in young patients with low-risk PCa in the early term.
A real-world study on implementation of new therapeutic options, especially bevacizumab, in a cohort of HER2-negative metastatic breast cancer patients treated with first-line chemotherapy.
Authors: Roel JW Van Kampen, Dorien JA Lobbezoo, Maaike De Boer, Adri C Voogd, Wouter Dercksen, Franchette W.P.J. van den Berkmortel, Tineke Jacoba Smilde, Agnes W Van de Wouw, Frank PJ Peters, Johanna MG Van Riel, Natascha AJB Peters, George F Borm, Manuela A Joore, Vivianne C. Tjan-Heijnen
Journal: Journal of Clinical Oncology (2013)

e17549 Background: Treatment of patients with metastatic breast cancer is changing rapidly and real-world data are scarce. Effective implementation of new drugs becomes increasingly important, also from a societal perspective. We questioned how and to whom bevacizumab (BEV) was given in the past few years, also in comparison to the EMA registration trial (NEJM 2007;357:2666-76). Methods: A cohort study was performed, including 480 consecutive breast cancer patients diagnosed with distant metastases in eight Dutch hospitals in the years 2008/2009. We analyzed the real world uptake of first-line chemotherapy with or without BEV in patients with a HER2 negative tumor. Results: Of the 193 HER2 negative patients, 33 received taxane (TAX)-BEV, 29 TAX monotherapy, 63 anthracyclines and 41 capecitabine as first-line chemotherapy after diagnosis of distant metastases. Median follow-up was 2.1 (0.08-3.3) yrs. Median progression-free survival was 7.3 (range 4.3-13.0), 2.7 (1.0-6.2), 5.0 (4.2-5.9) and 4.0 (1.1–4.6) months, respectively (p-value 0.02). Overall survival was 28.4 (14.0-nr), 30.9 (18.2-nr), 17.7 (13.7-22.1), and 24.7 (13.7-28.2) months, respectively (p=0.11). Patients treated with TAX-BEV were younger than those with TAX monotherapy (15% &gt; 65 yrs vs. 27% &gt; 65 yrs; p=0.05), had less co-morbidity and more often received adjuvant chemotherapy (81% vs. 57%; p= &lt;0.0001), also as compared to the EMA registration trial (39%). Patients treated with non-TAX (non-BEV) chemotherapy were older (33% &gt; 65 yrs) and were less likely to have received prior adjuvant chemotherapy (38%). Conclusions: We conclude that real world uptake of BEV was lower than expected and was offered to a selected population. Patient selection differed from the EMA registration trial, which may explain the lower progression-free survival. We recommend the use of broader inclusion criteria in future clinical studies and/or more strict adherence to these criteria in daily practice to guarantee effective implementation of new drugs. Funding: Netherlands Organization for Health Research and Development (ZonMw: 80-82500-98-8003) and Roche Netherlands.
Primary Stroke Centers vs Comprehensive Stroke Centers With Interventional Capabilities
Authors: Louis R. Caplan
Journal: JAMA Neurology (2017)

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Generation of tumor-specific cytotoxic T-lymphocytes from peripheral blood of colorectal cancer patients for adoptive immunotherapy.
Authors: Marco Bregni, Serena Del Bue, Andrea Galli, Alberto della Valle, Pasquale Ferrante, Silvia Carluccio
Journal: Journal of Clinical Oncology (2013)

3056 Background: Adoptive T-cell transfer (ACT) using autologous TIL, grown ex vivo and then infused into the cancer patient after lymphoablative chemotherapy, has emerged as an effective treatment for patients with metastatic melanoma. However, this approach has been hampered by the difficulty of isolating TILs from tumors other than melanoma, and of amplifying a sufficient quantity of autologous tumor-reactive T cells. So we decided to adopt a recently described procedure for generating in vitro large numbers of anti-tumor HLA-restricted CTLs, by stimulating patient’s CD8-enriched peripheral blood mononuclear cells (PBMCs) with DCs pulsed with apoptotic solid tumor cells (TCs) as a source of tumor antigens. Methods: 61 patients affected by CRC were enrolled. Tumor biopsies were obtained at surgery, together with 100 ml of heparinized peripheral blood. Tumors were dissociated to a single-cell suspension and cultured in order to obtain tumor cell line from each patient. Dendritic cells (DCs) were generated from previously separated PBMCs, using a magnetic positive selection of CD14+ monocytes, cultured in presence of Interleukin-4 and recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF). Anti-tumor cytotoxic T lymphocytes (CTLs) were elicited using DCs as antigen-presenting cells, autologous apoptotic tumor cells as source of antigens and T CD-8 lymphocytes enriched effectors, with weekly stimulation. To evaluate the cytotoxic activity of CTLs, interferon-γ (IFN-γ) secretion was assessed by ELISPOT. Results: Tumor cell lines and DCs were obtained from 19 out of 61 patients. ELISPOT was performed so far for 6 patients: strong IFN-γ secretion was detected at the third, fourth and fifth stimulations for one patient and at the second for another patient, whereas for three patients a weak secretion was detected during the second and the third stimulations. CTLs from one patient did not react to the stimulations. Conclusions: Generation of CTLs suitable for ACT immunotherapy is feasible from peripheral blood in patients with CRC.
Sleep disturbance of adults with a brain tumor and their family caregivers: a systematic review
Authors: Megan Soohwa Jeon, Haryana M. Dhillon, Meera R. Agar
Journal: Neuro-Oncology (2017)

The high incidence and psychophysiological morbidities of sleep disturbance in cancer have been increasingly recognized. Yet, more detailed understanding of sleep disturbance and options for management have been neglected areas in both clinical care and research. Brain tumor patients have been particularly overlooked. A systematic search of the literature from 1990 to 2015 was performed to review sleep disturbance in adults with primary or secondary brain tumor and their family caregivers. Fifty eligible studies were identified, of which 12 focused on sleep, 37 reported sleep items within a health-related quality of life measure and 1 reported caregivers' sleep. No sleep intervention has been developed or tested for brain tumor patients. Sleep disturbance and somnolence were frequently reported as the most severely rated symptoms within health-related quality of life across the disease course or treatments, along with fatigue. However, sleep-focused studies yielded inconsistent results in small samples of mostly benign brain tumors in long-term remission from total tumor resection. The research using standardized, multifaceted sleep assessments, particularly in patients with malignant brain tumor and caregivers who are undergoing treatment, is seriously lacking. A more systematic examination of sleep disturbance is warranted to inform the development of better symptom management programs in this population.
Breast cancer HER-2 amplicon-associated targets for immunotherapy identified by gene array analysis
Authors: D. Kostyal, T. Shay, C. Lanning, K. Horton, S. Welt, S. Whelle
Journal: Journal of Clinical Oncology (2007)

21174 Background: Gene array technology was used to investigate Trastuzumab (T) induced molecular expression patterns in HER/2 amplified breast cancer cell lines. A variety of over-expressed and aberrantly expressed proteins were identified. Further analysis of these data demonstrated potential candidate target proteins for T-cell immunotherapy. The advantages of utilizing gene array analysis to identify target proteins for immunotherapy include rapid data generation and analysis, statistical confidence and reproducibility. Methods: BT 474 and SK-BR3 breast cancer cell lines contain the HER/2 amplicon. Under growth conditions demonstrating inhibitory effects of T (0.25–50 micrograms/ml), RNA extracts from treated and untreated cells were analyzed and compared by whole human genome, gene array analysis. Results: Three sperm associated proteins were found to be expressed in these breast cancer cell lines. In comparison to the HER/2 expression, sperm associated antigen-1 (saa-1) was found to be expressed at very high levels, approximately 30–40% the level of HER/2. Furthermore, treatment of breast cancer cell lines with T did not reduce the level of saa-1 expression. Two other aberrantly expressed genes were also identified, sperm associated antigen 8 (saa-8) and sperm associated antigen-14 (saa-14). Unlike saa-1, both saa-8 and saa-14 expression were down regulated by T treatments. Conclusions: Breast cancer patients with HER/2 over expressing tumors have a poorer prognosis. T treatment is an important part of the clinical management of these patients especially early in their course. The immunotherapy targets described here may further improve outcomes of T treatments and for T resistant disease when utilized as vaccines. These proteins are components of sperm acrosomes and whether they play a role in invasion and metastases is under investigation. No significant financial relationships to disclose.
Gaps in survivorship care plan delivery and potential benefits to survivorship care.
Authors: Laura Pence Forsythe, Carla Parry, Catherine M. Alfano, Erin E. Kent, Corinne Leach, David Haggstrom, Patricia A. Ganz, Noreen Aziz, Julia Howe Rowland
Journal: Journal of Clinical Oncology (2013)

9594 Background: Survivorship care plans (SCPs), consisting of a treatment summary and follow-up plan, are intended to promote coordination of post-treatment cancer care. Yet, little is known about the provision of these documents by oncologists to primary care physicians (PCPs). This study compared self-reported oncologist provision and PCP receipt of treatment summaries and follow-up plans, characterized oncologists who reported consistent provision of these documents to PCPs, and examined associations between PCP receipt of these documents and survivorship care. Methods: A nationally representative sample of medical oncologists (N=1130) and primary care physicians (PCPs; N=1020) were surveyed regarding follow-up care for breast and colon cancer survivors using the cross-sectional Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) in 2009. Results: Nearly half of oncologists reported always/almost always providing treatment summaries, while 20.2% reported always/almost always providing SCPs (treatment summary + follow-up plan). Approximately one-third of PCPs indicated always/almost always receiving treatment summaries, while 13.4% reported always/almost always receiving SCPs. Oncologists who reported training in late and long-term effects of cancer and use of electronic medical records were more likely to report SCP provision (p&lt;0.05). PCP receipt of SCPs was associated with better PCP-reported care coordination, physician-physician communication, and confidence in survivorship care knowledge compared to receipt of neither treatment summaries nor SCPs (p&lt;0.05). Conclusions: Providing SCPs to PCPs may enhance survivorship care coordination, physician-physician communication, and PCP confidence in caring for survivors. However, a minority of oncologists report routinely delivering SCPs to PCPs. Considerable progress will be necessary to achieve sharing of SCPs among oncologists and PCPs.
Cancer in adolescents and young adults (AYA) in North Netherlands (1989–2003): Increased incidence, stable survival and high incidence of secondary tumors
Authors: J. C. van Gaal, E. S. de Bont, E. Bastiaannet, M. Schaapveld, J. C. Kluin-Nelemans, W. T. van der Graaf
Journal: Journal of Clinical Oncology (2007)

9538 Background: Lack of improvement in survival in AYA cancer patients as compared to children has led to increased awareness of this young population. We performed a population-based study of the incidence and survival of primary tumors and incidence of second tumors in patients 12–24 years, diagnosed in North Netherlands. Methods: Patients, diagnosed 1989–2003, classified according to Birch, were retrieved from the regional cancer registry and were divided into age groups (12–15, 16–19, 20–24). Age-specific incidence rates per 100,000 were calculated using population data from Statistics Netherlands. Three-year moving means of incidence were calculated for the three age groups. 5-years survival over time for males (M) and females (F) was calculated; difference in survival was assessed with log-rank test. Results: From 1989–2003 1,118 patients were diagnosed: lymphoma 22.9%, germ-cell malignancies 14.5%, melanoma 13.7%, carcinoma 12.7%, sarcoma 11.7%, CNS tumors 11.5%, leukaemia 10%. The total age-specific incidence rates per 100,000 were: M:13.4 (12–15 yrs), 26.9 (16–19 yrs), and 27.5 (20–24 yrs) and F:13.9, 20.7, 20.7. M/F ratio was 1.32. Between 1999–2003 a remarkable high incidence of Hodgkin's lymphoma in 16–19 yrs (M 9.4, F 7.6), germ cell malignancies 14.1 (M, 20–24), and melanoma 7.0 (F, 20–24) was found. The estimated annual percent change in incidence was 2.15% (p=0.001) overall. Multivariate analysis of the incidence showed a significant increase by age and year of diagnosis. The 5 years-survival was 0.80, 0.80 and 0.82 for the three age groups. Survival did not change significantly during the study period, except for a better survival for leukemias (p=0.04). With a follow-up of 8.7 years the relative risk of secondary tumors was 34.98 (23.06- 50.89; p&lt;0.05). Conclusions: Between 1989 and 2003 the total incidence of cancer in AYA increased. Except for leukaemia survival was stable over time. No difference in survival between the age groups (12–15;16–19; 20–24) was found. From 1999–2003 a remarkable high incidence of Hodgkin's lymphomas (M, 16–19), germ cell malignancies (M, 20–24) and melanomas (F, 20–24) was observed. The relative risk of a secondary tumor in this young cohort was 35-fold increased. No significant financial relationships to disclose.
Validation of two gene-expression risk scores in a large colon cancer cohort and contribution to an improved prognostic method.
Authors: Arnaud Roth, Antonio Fabio Di Narzo, Sabine Tejpar, Fred Bosman, Vlad Calin Popovici, Pratyaksha Wirapati, Tao Xie, Heather Estrella, Adam Pavlicek, Mao Mao, Eric Martin, Scott Weinrich, John Graeme Hodgson, Eric Van Cutsem, Mauro Delorenzi
Journal: Journal of Clinical Oncology (2012)

3509 Background: Prognosis prediction for resected primary colon cancer is currently based on the tumor, nodes, metastasis (TNM) staging system. Gene expression based risk scores have been proposed, but need to be validated and integrated with clinical and TNM variables. We performed an independent assessment of the individual recurrence signatures developed for commercial use by Veridex and Genomic Health. Methods: The Veridex (aVDS) and Genomic Health (aGHS) risk scores were applied to existing gene expression data of 580 stage III and 108 stage II tumors from the PETACC-3 trial. Association of the scores with relapse-free (RFS) and overall survival (OS) of the patients was assessed singularly, and in a combination with TNM and other clinico-pathological variables, by univariate and multivariate Cox regression models and logrank methods. Results: Both risk scores were significantly associated with RFS in univariate and multivariate models (Table) for the stage III cohort. The scores contributed different and additive prognostic information, and reached highest effect sizes (approximate p-value 0.001 and HR per interquartile range 1.4 each) in a combined model (Table) that includes both scores as well as T-stage, N-stage and MSI status as significant factors. Analysis in the stage II cohort gave similar effect estimates. Conclusions: This study confirms in an independent colon cancer patient cohort that gene expression based risk scores improve current prognostic models. The best prognostic model was obtained by using clinico-pathological variables and both gene-expression risk-scores. [Table: see text]