tbuckley/cabot-search huggingface dataset:
Prognostic value of isolated peritoneal versus other metastatic sites in colorectal cancer (CRC) patients treated by systemic chemotherapy: Findings from 9,265 pts in the ARCAD database.
Authors: Jan Franko, Qian Shi, Jeffrey P. Meyers, Volker Heinemann, Alfredo Falcone, Niall C. Tebbutt, Tim Maughan, Matthew Seymour, Leonard Saltz, Christophe Tournigand, Eduardo Diaz-Rubio, Ioannis Sougklakos, Benoist Chibaudel, Joseph Moen, Aimery De Gramont, Richard A. Adams, Daniel J. Sargent, Axel Grothey
Journal: Journal of Clinical Oncology (2016)

656 Background: Patients (pts) with peritoneal metastases from CRC (pmCRC) have reduced OS compared to mCRC pts without peritoneal involvement. Here we further investigated the impact of number and location of metastases among pts receiving first-line systemic chemotherapy. Methods: Individual patient data were available on 9,265 pts (median age 64; 63% male; 93% ECOG PS 0-1; 68% colon primary tumor; brain metastases excluded) enrolled onto 12 first-line randomized trials (4 tested targeted regimens). Stratified multivariable Cox models were used to assess the associations with overall survival (OS); adjusted hazard ratios (HR adj ) and 95% confidence intervals are reported (CI). Results: There were 7,963 (86%) pts with non-pmCRC (3,904 with one disease site; 4,059 with ≥2 disease sites), 191 (2%) pts with isolated pmCRC, and 1,111 (12%) non-isolated pmCRC. These groups were similar in age, race, and use of targeted chemotherapy. Compared to non-pmCRC, pts with pmCRC were more likely to be female (41% vs. 36%, p&lt;.001), have colon primary tumors (85% vs. 67%, p&lt;.0001), and have PS2 (10% vs. 6%, p&lt;.0001). Compared to isolated pmCRC, pts with solitary non-peritoneal sites (both M1a) had significantly better OS (HR adj =0.78; CI, 0.64-0.94, p=.009) while pts with ≥2 non-peritoneal sites had similar OS (HR adj =1.06; CI 0.88-1.28, p=.535). OS of pts with pmCRC with a single other disease site (n=446) was similar to isolated pmCRC (HR adj =1.13; CI 0.91-1.40, p=.28), but those with pmCRC + ≥2 additional disease sites (n=665) had shortest survival (HR adj =1.44; CI 1.17-1.77, p&lt;.001). A combination of peritoneal and liver metastases (n=821; HR adj =1.37, CI 1.12-1.67, p=.002) was associated with poorer survival compared with isolated pmCRC; but combination with extrahepatic sites (n=290; HR adj =1.15, CI 0.91-1.45, p=.25) was not. Conclusions: pmCRC pts have significantly worse survival than those with other solitary site mCRC. Among those with multiple disease sites, poorer survival is a function of increased number of metastatic sites and peritoneal involvement, which indicates prognostic heterogeneities among M1b pts.
Prognosis of Japanese breast cancer based on hormone receptor and HER2 expression determined by immunohistochemical staining
Authors: I. Fujiwara, H. Nakajima, N. Mizuta, K. Sakaguchi, Y. Hachimine
Journal: Journal of Clinical Oncology (2008)

1122 Background: We classified Japanese breast cancer patients based on estrogen receptor (ER), progesterone receptor (PR) and HER2 protein expression and compared their prognoses. Methods: Background and prognostic factors were compared among 600 patients with breast cancer who were assigned to groups as follows: luminal A (ER+ and/or PR+ and HER2-; n = 431; 71.8%), luminal B (ER+ and/or PR+ and HER2+; n =27; 4.5%), HER2 subtype (ER-, PR- and HER2+; n = 39; 6.5%) and basal-like breast cancer (BBC) (ER-, PR- and HER2-; n = 103; 17.2%). Results: There were no differences among the groups regarding to age, menopausal state, size of tumors, and axillary metastasis. Disease-free survival rates were significantly lower for the luminal B, HER2 subtype and BBC, than for the luminal A subtype. Cancer tended to recur earlier and overall survival was significantly lower for the BBC, than that for the luminal A and HER2 subtype. Luminal B and HER2 subtype revealed same overall survival rate as luminal A. Conclusions: The subtype distribution for Japanese and Caucasian patients was comparable. BBC had also the poorest prognosis among all subtypes in Japanese breast cancer patinets. Breast cancer tended to recur earlier for the luminal B and HER2, than for the luminal A subtype, but overall survival did not significantly differ among them. No significant financial relationships to disclose.
<sup>11</sup>C-choline PET/CT in selection of patients for salvage cryoablation in recurrent prostate cancer.
Authors: Anthonius J. Breeuwsma, Maxim Rybalov, Anna Maria Leliveld, Rudi A. Dierckx, Jan Pruim, Igle J. de Jong
Journal: Journal of Clinical Oncology (2013)

188 Background: 11 C-choline PET/CT has proven to be a sensitive technique for re-staging after radiation therapy (RT). The aim of this study was to analyze the clinical impact of 11 C-choline-PET/CT in the selection of patients with biochemical recurrence (BCR) after RT for salvage cryoablation of the prostate. Methods: This prospective study was conducted between November 2006 and February 2012 on patients considered as candidates for salvage cryoablation. 74 patients, mean age 69.2 years, median – 70.3 years (range 49-79), who were being followed up after RT for histological proven prostate cancer (according to ASTRO-Phoenix) were included. Until 2009 we used PET/CT fusion, but from 2009 all patients were examined with an integrated PET/CT system. After receiving 400 MBq 11 C-choline intravenously, a whole body scan was made. As reference we used biopsy-proven histology from site of suspicion, confirmative imaging modalities (bonescan, CT) or clinical follow-up. PSA doubling time and velocity was calculated. Results: According to the PET/CT results, 40 (54%) patients had a local recurrence, 20 (27%) had regional/distant metastases and 14 (19%) had a negative scan. The positive PET findings were proved by histology from prostate biopsies and/or pelvic lymph node dissections in 63% of cases. Considering PET/CT results: 50/74 (68%) patients received cryoablation, for 24/74 (32%) treatment was changed (active surveillance or androgen deprivation therapy). Conclusions: 11 C-choline-PET/CT could be useful for the selection of patients with BCR after RT for salvage cryoablation of the prostate. 11 C-choline-PET/CT was decisive and led to therapy change in 32% of cases. [Table: see text]
Statistical analysis on the behavior and recurrence of breast phyllodes tumors.
Authors: John Shangming Ye
Journal: Journal of Clinical Oncology (2016)

e294 Background: Statistical analysis on the behavior, diagnosis accuracy, treatment, and recurrence of breast phyllodes tumors. Methods: Thousands of phyllodes tumor cases have been analyzed by mathematical statistics in order to assess the behavior, diagnosis, classification, treatment, recurrence, and five-year survival rates. Results: The age of breast phyllodes tumor patients generally ranges from ten years old to over eighty years old, and the disease most frequently occurs between ages of forty and fifty among various ethnicities. For clinic-pathological features, over 70% of the patients' tumors may be classified as benign, about 20% borderline, and less than 10% malignant. Patients who had ages over 40, larger tumor sizes, permeative borders, atypia, high stromal hypercellularity, and especially high mitotic activity were observed to develop borderline and malignant phyllodes tumor more frequently. Recurrences were noted in about 13% for all patients, but the ratio of recurrence rate of benign : borderline : malignant tumor is approximately 1: 1.5 : 3. A five-year survival rate was observed in almost 100% of patients with benign tumors, 98% with borderline, and about 88% with malignant. Accurate diagnosis at an early stage plays a vital role for effective treatment. Conclusions: Early stage accurate diagnosis, post-excision pathology analysis on the fibroepithelial tumor tissue for confirming the clinicopathological features, and wide excision (with negative margins) may reduce the risk of tumor recurrence and improve the respective survival rates of the breast phyllodes tumor patients.
R-HCVAD Alternating with R-Methotrexate Cytarabine in Younger Patients (pts) with IH and High-Risk Age Adjusted-IPI DLBCL
Authors: Yasuhiro Oki, Jason R. Westin, Nathan Fowler, Sattva Neelapu, F.B. Hagemeister, Peter McLaughlin, Larry W. Kwak, Jorge Enrique Romaguera, Michelle Fanale, Anas Younes, Maria A. Rodriguez, Robert Z. Orlowski, Michael Wang, Souzanne T Ouzounian, Felipe Samaniego, Luis Fayad
Journal: Blood (2012)
Combined effectiveness of prior and current season influenza vaccination in northern Spain: 2016/17 mid-season analysis
Authors: Jesús Castilla, Ana Navascués, Itziar Casado, Jorge Díaz-González, Alejandra Pérez-García, Leticia Fernandino, Iván Martínez-Baz, Aitziber Aguinaga, Francisco Pozo, Carmen Ezpeleta
Journal: Eurosurveillance (2017)

The 2016/17 mid-season vaccine effectiveness estimate against influenza A(H3N2) was 15% (95% confidence interval: −11 to 35) in Navarre. Comparing to individuals unvaccinated in the current and four prior seasons, effectiveness was 24% for current and 3–4 prior doses, 61% for current and 1–2 prior doses, 42% for only current vaccination, and 58% for 3–4 prior doses. This suggests moderate effectiveness for different combinations of vaccination in the current and prior seasons.
The potential of a medical student patient navigator program: An analysis of partners against cancer.
Authors: Naomi Whittaker, Helen S. Uong, Evan Kirschner, Peter T. Silberstein
Journal: Journal of Clinical Oncology (2012)

34 Background: The Partners Against Cancer (PAC) program pairs first and second year medical student volunteers with individual cancer patients in need at the Division of Hematology/Oncology at Creighton University Medical Center. A review of the scientific literature yields no publications about student run programs at medical institutions pairing students with cancer patients. Methods: Prior to beginning the program, each student completed an entry survey. While in the program, students were asked to submit log entries after each patient encounter. A total of 137 student logs from 30 students were surveyed for themes (e.g. student addressing patient’s physical needs), which were counted. Results: PAC trained 129 medical students about patient resources and matched over 51 patient-student pairs. In the entry surveys, 98.5% of students entering the PAC program wanted to learn more about the psychosocial issues cancer patients experience and their quality of life. Most students (98.5%) wanted to gain more experience talking about death and dying with patients and working with a dying patient. Of reported patient contact, 39% was in clinic, 44% phone, 8% email, and 6% was an inpatient or treatment facility visit. In the log data, students noted helping patients emotionally (85%) and with access to resources or promoting health and compliance (28%). Medical students demonstrated empathy in 75% of logs and gaining knowledge of medicine in 26%. 12% of logs noted schedule conflicts or contact difficulties. Conclusions: PAC is a longitudinal experience where medical students play an active role in their individual patient’s care. Students provide physical assistance to patients, such as helping with access to resources, and emotional assistance by listening to the patient. In return, the student has the opportunity to learn empathy by understanding the impact of chronic and, often terminal, disease on the patient. The challenges of the program have included scheduling difficulties and student confusion with the program. A website and mentor program have been developed to address these issues. Despite challenges, PAC exhibits great potential for enhancements in patient care and medical education, most notably empathy.
Neonatal Recipients Offer Permissive Hematopoietic Microenvironment for Engraftment of Embryonic Murine Hematopoietic Stem Cells
Authors: Natasha Arora, Shannon McKinney-Freeman, Garrett C Heffner, Il-Ho Jang, Pamela L. Wenzel, Momoko Yoshimoto, Mervin C. Yoder, George Q. Daley
Journal: Blood (2011)
Changing trends in pelvic lymphadenectomy in radical prostatectomy with the advent of robotic surgery.
Authors: William Sohn, Alan Paciorek, Peter Carroll, David F. Penson, Atreya Dash
Journal: Journal of Clinical Oncology (2013)

39 Background: It is important to determine whether changes in technology have impacted surgical practice. With the adoption of robotic surgery, it is our hypothesis that rates of pelvic lymphadenectomy (LND) have decreased, even when controlling for cancer risk and comorbidities. To assess whether adoption of surgical technology versus practice patterns in the extent of surgery over time changed, we propose to compare the rates of pelvic LND at the time of radical prostatectomy during the time period when robotic surgery was adopted. Methods: Data was extracted from CaPSURE, a multi-institutional, longitudinal observational database of men with prostate cancer. A total of 3,938 men diagnosed with localized prostate cancer between 2000 and 2011 were included in the analysis if they underwent surgical extirpation. The inclusion of LND was calculated for both groups. Other information included site type, age at diagnosis, comorbidities, and CAPRA risk assessment score. Results: A total of 3,616 open retropubic prostatectomies and 322 robotic prostatectomies were included for analysis. Among the open prostatectomies, 78.9% underwent pelvic LND. During the same time period, among robotic prostatectomies, 45.3% underwent pelvic LND. There was a statistically significant correlation between method of radical prostatectomy and the performance of LND (p &lt; 0.001). There were no statistically significant differences between the two groups in CAPRA score, age, or comorbidities (p= 0.06, 0.29, and 0.60; respectively). The adjusted odds ratio of LND for the open group compared to the robotic group is 5.90 (95% CI [4.48,7.78]) while adjusting for clinical stage, grade, and PSA. Conclusions: Controlling for other factors, the difference in rates of LND between the open and robotic groups were statistically significant. These data suggest changes in surgical practice may have been altered by the adoption of a new technique to perform surgery (rather than new scientific data supporting omission of LND).
Adequacy of lung cancer tissue samples for ancillary molecular testing in conventionally obtained biopsy material: A 3-year experience of the Louisiana State University (LSU) public hospital in New Orleans.
Authors: Shravan Kumar Narmala, Brian C. Boulmay
Journal: Journal of Clinical Oncology (2013)

105 Background: The National Comprehensive Cancer Network recommends that all patients with lung adenocarcinoma (LA) be tested for EGFR mutation and ALK gene rearrangement (EGFR/ALK). Metastatic LA is diagnosed with biopsies often sufficient only for non-molecular based diagnostic techniques; our institutional experience suggested conventionally obtained material was inadequate for EGFR/ALK. We analyzed biopsies performed only with the intent of diagnosing malignancy for adequacy for EGFR/ALK. Methods: We identified patients from LSU diagnosed with metastatic LA whose specimens were sent for EGFR/ALK from January 1, 2009, to June 30, 2013. Data collected included number of specimens sent for EGFR/ALK, number of samples with inadequate tumor, biopsy technique utilized and number of rebiopsy attempts for EGFR/ALK. Results: 54 patients were evaluated in the study time period: 58 individual biopsy specimens were sent for EGFR/ALK. 24/58 (41%) of specimens were found to be inadequate for EGFR/ALK. 11/26 (42%) of bronchoscopically obtained biopsies were inadequate, 9/18 (50%) of computed tomography guided core needle (CTGCN) biopsies were inadequate and 4/14 (28%) samples obtained via thoracentesis, wedge resection, craniotomy, spinal tumor excision, fine needle aspiration of lymph nodes or video assisted thoracoscopic surgery were inadequate. 4/54 (7%) patients underwent rebiopsy, 3 via bronchoscopy and 1 via CTGCN; 3/4 (75%) rebiopsies were sufficient for EGFR/ALK analysis. Conclusions: A substantial proportion of initial LA diagnostic biopsies were inadequate for EGFR/ALK analysis. While EGFR/ALK analysis is now standard of care for patients with LA, only a small percentage of patients in our study underwent rebiopsy. Our institutional practice will be modified to encourage additional biopsies for the specific purpose of molecular testing at the time of initial biopsy for those with suspected LA.
Intrapatient correlation of clinical benefit from VEGF and mTOR inhibition in metastatic renal cell carcinoma.
Authors: G. Ratnayake, A. Pender, L. M. Pickering, M. E. Gore, J. M. G. Larkin
Journal: Journal of Clinical Oncology (2011)

e15175 Background: Sequential inhibition of vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) signalling is the standard systemic therapy paradigm for metastatic renal cell carcinoma (mRCC). We investigated whether clinical benefit for mRCC patients treated with VEGF inhibitors (VEGFi) predicted clinical benefit from mTOR inhibitors (mTORi) in individual patients. Methods: Data were analysed for mRCC patients treated with VEGFi and mTORi in either sequence. Median time on treatment (TT) for VEGFi and mTORi were compared using the Mann-Whitney U test, and Kendall’s tau to assess correlation of VEGFi and mTORi TT for each patient. For patients treated with >1 VEGFi, TT for the 1st VEGFi was analysed. Patients were divided into 4 groups: TT of mTORi and VEGFi <6 and >6 months duration, comparing duration between groups with a log rank test. Modified Motzer Scores (mMS) at time of 1st VEGFi/mTORi for these 4 groups were calculated as surrogate markers for tumour biology. Results: Thirty five patients received both mTORi and VEGFi to disease progression, of whom only 2 received mTORi before VEGFi. Seven patients were female, and median age at start of 1st VEGFi/mTORi was 58.9 years. The median TT for VEGFi and mTORi were 5.4 months (95% CI 2.2-8.6) and 6.9 months (95% CI 2.5-11.3) respectively, and not significantly different. Kendall tau intrapatient correlation coefficient for TT on mTORi and VEGFi was 0.069 (p=0.56), suggesting no significant correlation. The mean mMS for patients with TT on mTORi <6 vs >6 months were 2.00 and 1.89 (median 2 and 2) respectively (p=0.79), and 2.11 and 1.18 (median 2 and 1) respectively (p=0.00092) for TT on VEGFi. Conclusions: In this small retrospective analysis, there was no significant correlation within patients between TT for mTORi and VEGFi. The significantly lower mMS for patients on VEGFi with a TT >6 months vs <6 months is consistent with previous analyses by Heng and colleagues. No such significant difference was seen with mTORi, implying mMS may not have the same prognostic value. These associations require further study.
The<i>Bacteroides fragilis</i>pathogenicity island links virulence and strain competition
Authors: Benjamin W. Casterline, Aaron L. Hecht, Vivian M. Choi, Juliane Bubeck Wardenburg
Journal: Gut Microbes (2017)

The mature microbiome is a stable ecosystem that resists perturbation despite constant host exposure to exogenous microbes. However, the microbial mechanisms determining microbiome development and composition are poorly understood. We recently demonstrated that a non-toxigenic B. fragilis (NTBF) strain restricts enteric colonization by an enterotoxigenic (ETBF) strain dependent on a type VI secretion system (T6SS). We show here that a second enterotoxigenic strain is competent to colonize, dependent on the Bacteroides fragilis pathogenicity island (BFPAI). Additional data showing complex environmental regulation of the Bacteroides fragilis toxin (BFT) suggest that virulence factors may be adapted to modify the colonic niche to provide a strain-specific colonization advantage. We conclude that more complex models of host-microbe-microbiome interactions are needed to investigate this hypothesis.
Phase II study of weekly low-dose everolimus plus weekly 24-hour infusions of cisplatin and high-dose 5-fluorouracil and leucovorin for first-line treatment in patients with advanced gastric cancers.
Authors: K. Yeh, Y. Shen, C. Li, C. Yen, C. Hsu, Z. Lin, L. Chen, W. Su, Y. Chao, A. Cheng
Journal: Journal of Clinical Oncology (2011)

86 Background: Cisplatin-HDFL, consisting of weekly 24-hour infusions of cisplatin and high-dose 5-fluorouracil (5-FU) and leucovorin (LV), is an effective and low-toxicity regimen for patients with advanced gastric cancer (GC) in Taiwan (J Clin Oncol. 1994;12(4):875; J Clin Oncol. 2006;24(18S):A14063). Everolimus (RAD001), a derivative of rapamycin, is an orally bioavailable mTOR inhibitor. We have demonstrated that low-dose everolimus (0.5-5.0 nM) sensitizes cytotoxic effects of cisplatin and 5-FU in GC cells (Proc Am Assoc Cancer Res. 2007;48:A4043). Methods: Patients who had pathologically confirmed chemonaive advanced GC, at least 1 measurable lesion, a fasting serum triglyceride level &gt; 70 mg/dl, ECOG PS 0-2, and adequate organ functions were treated with everolimus 10 mg po on days 1, 8, and 15 concurrently with the initiation of chemotherapy; cisplatin 35 mg/m 2 iv 24h infusion on days 1 and 8; 5-FU 2,000 mg/m 2 and LV 300 mg/m 2 (HDFL) iv 24h infusion on days 1, 8, and 15, in a every 28-day cycle. Response assessment was performed every 2 cycles. The primary endpoint was confirmed objective response rate (RR) by RECIST. Results: Between March 2008 and July 2010, 24 patients (M:11, F:13) with a median age of 53 (range: 33-69) were evaluable for response. The overall RR was 50% (95% CI: 29-71%) with 12 partial responders. Among a total of 162 cycles (median: 7, range: 1-13) given, grade (Gr) 3/4 toxicities included neutropenia (4.3%), infection (2.5%), nausea (3.1%) and vomiting (3.1%). Gr 1/2 nausea, vomiting, stomatitis, and diarrhea developed in 19.2%, 15.4%, 14.8%, and 5.5% of cycles, respectively. Skin rash and hand-foot syndrome were mild. One patient developed reversible HDFL-related hyperammonemic encephalopathy. Median progression-free survival was 8.4 months (range: 1.3-15.4+) and median overall survival was 14.8 months (range: 4.0-21.6+). Conclusions: Weekly low-dose everolimus plus weekly cisplatin-HDFL is an effective first-line regimen for patients with advanced GC. Addition of weekly low-dose everolimus to infusional cisplatin-HDFL did not add gastrointestinal toxicities. No significant financial relationships to disclose.