tbuckley/cabot-search huggingface dataset:
Patterns of recurrence and outcomes in pancreatic cancer.
Authors: Kathryn Tzung-Kai Chen, Smit Singla, Pavlos Papavasiliou, Rodrigo Arrangoiz, John P. Gaughan, John Parker Hoffman
Journal: Journal of Clinical Oncology (2013)

234 Background: There is limited evidence supporting improved overall survival in patients with pancreatic cancer with isolated lung metastases compared to other metastatic sites. We reviewed our experience with patterns of metastases and outcomes in pancreatic cancer. Methods: A retrospective review of 378 patients who underwent potentially curative pancreatic resection for pancreatic adenocarcinoma at a tertiary care cancer center between 1997-2010. All patients were restaged in accordance with AJCC 7 th edition guidelines. Kaplan-Meier analysis with log-rank test and Cox regression was used to compare median overall and disease-free survival (OS and DFS). Results: Patients were divided into 8 groups based upon site of first recurrence. 40% of patients were without evidence of recurrence at time of last follow up (n=165). Sites of first recurrence are as follow: liver (n=93, 24.6%), lung (n=37, 9.8%), locoregional (n=49, 13%), peritoneum (n=17, 4.5%), bone (n=6, 1.6%), and distant (n=2, 0.5%). 23 patients (6.1%) presented with multiple sites as first recurrence. Patients with isolated lung metastases had longest median OS while those with liver metastases had the shortest median OS (32 months vs. 17 months, p&lt;0.001). Time to recurrence for lung vs. liver metastases was 14.9 vs. 7.4 months (p&lt;0.005). Patients with liver metastases uniformly had significantly worse median OS as compared to other sites of recurrence. Finally, with respect to isolated lung recurrences, only CA19-9 was a significant prognostic factor. Those patients with a CA19-9 at diagnosis &gt;185 had a 5-fold greater risk of death in our length of follow-up. Conclusions: Pancreatic cancer patients with isolated lung metastases as the site of first recurrence have improved OS compared to other sites, while patients with liver metastases have worse OS. CA19-9 &gt;185 at time of diagnosis among patients with isolated lung recurrences was predictive for worse outcomes.
Influence of nonclinical patient factors on decisions to recommend breast cancer adjuvant chemotherapy.
Authors: T. M. Pini, S. T. Hawley, S. J. Katz, J. Graff, A. S. Hamilton, J. J. Griggs
Journal: Journal of Clinical Oncology (2010)

6032 Background: Little is known about the extent nonclinical patient factors are considered by oncologists when deciding to recommend adjuvant breast cancer chemotherapy and whether oncologist and practice characteristics are associated with these attitudes. Methods: Medical oncologists (n = 305) providing care to early-stage breast cancer patients reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries were invited to complete a survey. They were asked to rate how strongly they consider each of the following—a patient's ability to follow instructions, level of social support, and level of support/flexibility at work—when making adjuvant chemotherapy recommendations. For each nonclinical factor, a multivariate logistic regression model was used to investigate associations between oncologist/practice characteristics and response that the nonclinical factor is strongly (4 or 5 on a 5-point Likert scale) considered, controlling for demographics such as sex, race, and academic affiliation. Results: 206 oncologists completed the survey (67.5% response rate). A patient's ability to follow instructions was reported by 58.8% to be strongly considered, social support by 38.0%, and work support/flexibility by 35.8%. In multivariate analyses, devoting a larger percent of practice to breast cancer was associated with lower likelihood that patients' ability to follow instructions was strongly considered (OR 0.98, p = 0.04). Increased years in practice was associated with lower odds that social support was considered (OR 0.97, p = 0.03). Access to tumor board increased the odds that social support (OR 2.04, p = 0.05) and work support/flexibility (OR 2.21, p = 0.03) were considered. No other oncologist or practice characteristics were associated with strong consideration of the 3 nonclinical factors. Conclusions: Medical oncologists frequently report that they consider nonclinical factors in their decision to recommend breast cancer adjuvant chemotherapy. Greater specialization and longer practice experience are associated with less emphasis on nonclinical factors, while access to a tumor board is associated with stronger consideration of these factors. No significant financial relationships to disclose.
Endogenous Ligands Selectively Stimulate Highly Avid Autoreactive Human Invariant Natural Killer T Cells with Distinctive T-Cell Receptor Vβ11 CDR3 Sequence Motifs
Authors: Osamu Imataki, Makito Tanaka, Alla Berezovskaya, Marcus O. Butler, Lee M. Nadler, Naoto Hirano
Journal: Blood (2011)
Clinical outcome of endoscopic submucosal dissection versus surgery for patients with early gastric cancer.
Authors: Ki-Nam Shim, Ji Young Chang, Chung Hyun Tae, Hyo Moon Son, KoEun Lee, Min Sun Ryu, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Sung-Ae Jung, Joo-Ho Lee
Journal: Journal of Clinical Oncology (2016)

15 Background: This study aimed to compare the clinical outcomes of endoscopic submucosal dissection (ESD) and surgery for the patients with early gastric cancer (EGC). Methods: Data of 79 EGCs in 76 patients treated with ESD and 59 EGCs in 57 patients treated with surgery between 2005 and 2015 were analyzed retrospectively. We only included EGCs confined to the mucosal layer. Demographic data, pathologic data, complication, 5-year overall survival (OS) data were collected. Results: The clinicopathological characteristics of the patients were shown in Table 1. The mean follow-up periods were 31.5 months (5-96 months) for ESD group and 68.4 months (1-139 months) for surgery group (P &lt; 0.001). One patient (1.9%) in ESD group has experienced metachronous tumor, but there was no patient who had recurrence tumor or metastasis in surgery group. The 5-year OS rates did not differ between two groups (91.2% in ESD group versus 87.4% in surgery group, respectively; P = 0.490 by log-rank test). The early complication rates happened within 3 months of procedure were similar in both groups (P = 0.501). However, the late complication rates were significantly higher in surgery group than those in ESD group (P = 0.002). Conclusions: The clinical outcomes after ESD including 5-year OS were comparable to those of surgery. Regarding the late complication, ESD was superior to surgery.
Sequential Treatment With Bendamustine, Rituximab, Chlorambucil and Fludarabine Leads To a Major Survival Improvement Of Patients With Chronic Lymphocytic Leukemia (CLL) In Routine Care
Authors: Rudolf Weide, Stefan Feiten, Vera Friesenhahn, Jochen Heymanns, Kristina Kleboth, Jörg Thomalla, Christoph van Roye, Hubert Köppler
Journal: Blood (2013)
Design, implementation, and assessment of a metrics management system for quality improvement studies.
Authors: Patrick Samedy
Journal: Journal of Clinical Oncology (2013)

34 Background: Research and quality improvement studies often involve an extensive amount of manual review of medical records. The effective management of this process is critical to the consistent, accurate, and cost effective collection and timely dissemination of quality data. Methods: The purpose of this paper is to introduce “OpenQA”, a data management tool designed specifically to help organize, track, and communicate data related to quality improvement studies. OpenQA is designed with ease of chart abstraction, efficiency of data collection, and data transparency as a goal, while providing reporting that support a range of activities related to data management tasks common to hospital quality management departments. The basic method behind OpenQA is to: (1) Provide a centralized online repository for measure related metadata; (2) automatically identify retrospective and prospective encounters that meet specified study inclusion/exclusion criteria; (3) extract key details from structured and unstructured data sources and then combine them to help quality auditors make compliance decisions; (4) provide a workflow engine that supports work lists, alerting and a feedback mechanism for metric stakeholders; (5) provide audit tracking to enable measurability of data collection efforts. Results: Favorable effects were realized post implementation across all measures of performance despite an increase in case volume. Results indicate a decrease in median audit turnaround time, defined as the time between the patient encounter and a decision is made by the auditor, by 23 days (85%). Results also indicate a decrease in the audit reporting turnaround time, defined as the time between the patient encounter and the compliance decision is made and reported. Both reductions were significant at a p value of &lt; 0.05. Conclusions: We suggest that a tool designed to help streamline and standardize the quality improvement data collection process may offer the advantage of minimizing the resource utilization associated with data collection while improving data integrity and shortening the feedback loop.
Stereotactic body radiotherapy for unresectable hepatocellular carcinoma: A population based analysis of tumors up to 15 cm.
Authors: Rosanna Yeung, Thomas Rackley, Britta Weber, Richard Lee, Marie-Laure Camborde, Moira Pearson, Cheryl Duzenli, Shaun Loewen, Mitchell Liu, Roy Ma, Devin Schellenberg
Journal: Journal of Clinical Oncology (2016)

322 Background: Stereotactic body radiotherapy (SBRT) has an emerging role for patients with hepatocellular (HCC). The purpose of this study is to describe the efficacy of HCC SBRT at a population level without any tumor size restriction. Methods: A retrospective study of the first 49 HCC patients treated with SBRT between March 2011-July 2015 at the British Columbia Cancer Agency was conducted. All patients were either ineligible for or failed standard local therapies (partial hepatectomy, radiofrequency ablation, percutaneous ethanol injection, transarterial chemoembolization, or radioembolization) and discussed in a multidisciplinary rounds setting. Local control (LC), progression free survival (PFS) (defined as freedom from failure elsewhere in the liver) and overall survival (OS) were analyzed at 1 and 2 years. Changes to Child’s Pugh (CP) score at 3 months post-SBRT were also analyzed. Results: Median follow-up was 14 months with 35 patients (71%) alive at last follow-up. Fifty-two separate HCC lesions were treated with a median size of 4.2 cm (range: 1.3-15.6 cm) and a planning treatment volume (PTV) of 114 cm 3 (range: 22-1776 cm 3 ). Over half of the lesions (55%) were ≥ 4cm. Thirty-six patients (74%) had previous local therapies. Prior to SBRT, 57% of patients were CP A5, 33% were CP B6, 8% were CP B7, and 1 patient (2%) was CP B8. At 3 months post-SBRT, 35% of patients had an increased CP score, with a mean increase of 1.8 points. The most common dose and fractionation was 45Gy in 3 or 5 fractions. Median V90 (dose to 90% of the PTV) was 99.8% (range: 74.1-100%). LC for all patients was 96% at 1 and 2 years. LC was comparable between moderate to large tumors ( ≥ 4cm) and those &lt; 4cm (1 and 2 year LC: 96% for ≥ 4cm vs 95% for &lt; 4cm). OS for all patients at 1 year was 67% and 62% at 2 years. PFS was 53% and 38% at 1 and 2 years respectively. The median PFS was 13.7 months with 13 patients (27%) undergoing further local treatment due to regional progression including 4 patients who had liver transplants. Conclusions: SBRT provides high local control for patients with HCC of even moderate to large size. Regional progression is prominent in HCC patients and SBRT does not appear to preclude further local treatments.
Systemic therapy usage and outcomes for patients diagnosed with malignant pleural mesothelioma (MPM) between 2005 and 2010 in Ontario, Canada.
Authors: A. Hasani, B. Sun, G. Liu, W. Xu, R. Feld, N. B. Leighl
Journal: Journal of Clinical Oncology (2011)

7085 Background: Systemic therapy (ST) is the only treatment modality with proven survival benefit for advanced MPM. Since 2005 MPM patients in Ontario have been eligible for ST with pemetrexed/platinum [Workplace Safety Insurance Board (WSIB) coverage] or raltitrexed/platinum (Ontario public healthcare coverage). Methods: Information for patients diagnosed with MPM between 2005-2010 was obtained from administrative databases at University Health Network, Cancer Care Ontario and WSIB. Overall survival (OS) was calculated from diagnosis date by the Kaplan-Meier method, differences between the survival curves were analyzed by the log-rank test. Results: 557 patients were diagnosed with MPM in Ontario between 2005 and 2010. Of these, most were male (82.4%), had right sided tumors (61.7%), and epithelioid histology (77.8%). The average age was 70.5 years (range 29.3-94.7). Treatment consisted of extrapleural pneumonectomy (EPP) in 57 (10.2%); and first, second and third line ST confirmed in 232 (41.7%), 60 (10.8%) and 5 (0.9%) patients respectively. Median survival for those treated with ST compared with those not treated with ST was 13.3 and 5.5 months respectively (p<0.001). Median survival for those receiving first line ST [by intention to treat (ITT) based on first cycle] including pemetrexed (n=149), raltitrexed (n=52), or other (n=29) was 13.1, 12.8, and 13.7 months respectively (p-value=0.53). Median survival for those receiving first line ST (by ITT) with cisplatin (n=174) compared with carboplatin (n=36) or no platinum (n=21) was 12.9, 14.3 and 18.4 months respectively (p-value=0.79). Conclusions: most patients diagnosed with MPM do not receive ST. Of those treated with ST, survival was similar for patients treated with pemetrexed-based ST compared with raltitrexed-based ST, and for those treated with cisplatin compared with carboplatin.
A pilot study of vaccination with sialyl Lewis<sup>a</sup> (sLe<sup>a</sup>)–keyhole limpet hemocyanin (KLH) conjugate plus the immunologic adjuvant QS-21 in metastatic breast cancer patients (pts).
Authors: A. Diab, G. Ragupathi, W. W. Scholz, K. Panageas, C. Hudis, P. O. Livingston, T. Gilewski
Journal: Journal of Clinical Oncology (2011)

2599 Background: The carbohydrate antigen sLea, recognized by the monoclonal antibody (mAb), CA19-9, is commonly expressed on breast cancer cells and is a potential target for vaccine therapy. Methods: The primary endpoints were safety and immunogenicity. Secondary endpoint was presence of circulating tumor cells (CTC) pre and post injection. Pts received sLea (10 or 30 mcg) conjugated to KLH + 100 mcg QS-21 via subcutaneous vaccination during weeks 1, 2, 3, 7, and 19. Pts with metastatic breast cancer with no evidence of disease or stable disease were eligible. Results: Seven pts were treated (10 mcg n=3, 30 mcg n=4), median age 45 years (range 31-65). Six pts were on hormone therapy during the study; 2 pts with no disease and 5 pts with stable disease. Six pts completed 5/5 planned injections. One pt received 4/5 injections. Overall the injections were well tolerated, with grade 1-2 local skin injection site reactions and grade 1 flu-like symptoms the most common toxicities. In 5/7 pts there were no CTC detected; in 2 pts there was no change in CTC. IgM and IgG Ab were induced in all pts (Table). Cell surface reactivity by FACS and effector functions of Abs in sera from pt 1 have been completed. Cell surface reactivity against DMS79 (small cell lung cancer) and Co205 (colon cancer) was confirmed by FACS. Complement dependent cytotoxicity (73% in a 2 hour assay at a ¼ serum dilution with human complement) and Ab dependant cellular cytotoxicity (32%) were observed in post immunization sera. Conclusions: The results confirm the safety and immunogenicity of sLea-KLH vaccine for the first time in humans and are the basis for its inclusion in a polyvalent construct. IgM/ IgG titers. Week IgM Pt 1 Pt 2 Pt 3 Pt 4 Pt 5 Pt 6 Pt 7 1 20 0 0 0 0 0 0 2 0 0 0 0 1,280 0 0 3 80 80 80 640 160 2,560 40 5 1,280 2,560 2,560 2,560 2,560 2,560 640 7 80 2,560 2,560 2,560 1,280 2,560 320 9 2,560 2,560 2,560 2,560 2,560 2,560 1,280 13 1,280 2,560 2,560 2,560 1,280 1,280 640 19 640 2,560 2,560 2,560 640 2,560 80 23 2,560 2,560 2,560 1,280 640 640 1,280 IgG Pt 1 Pt 2 Pt 3 Pt 4 Pt 5 Pt 6 Pt 7 1 0 0 0 0 0 0 0 2 0 0 0 0 20 0 0 3 20 80 0 40 0 20 0 5 40 640 640 20 80 160 0 7 20 640 320 20 40 160 0 9 640 640 320 320 160 640 320 13 640 2,560 320 160 160 320 160 19 640 640 320 160 160 320 160 23 2,560 2,560 1,280 2,560 640 320 640
Comparison of two schedules in locally advanced nasopharyngeal carcinoma observed in a nonendemic population.
Authors: M. Garzaro, L. Raimondo, G. Pecorari, F. Pedani, C. Giordano, M. Airoldi
Journal: Journal of Clinical Oncology (2011)

5542 Background: Aim of this study was the clinical evaluation of two different schemes of neoadjuvant chemotherapy (NACT) followed by two different concomitant chemoradiotherapy (CHRT) schedules in loco-regionally advanced nasopharyngeal carcinoma (A-NPC) observed in a non endemic population and treated in the same institution. Methods: Seventy patients (51M, 19F; median age: 53.5 yrs; ECOG PS: 0 -63 pts; 1 - 7 pts; 63 pts type 3 and 7 pts type 2 WHO histology; 36 pts stage III, 28 pts stage IVa and 6 pts IVb, 47 pts N2/N3 AJCC TNM 7th ed) were enrolled. Forty pts (group A) were treated with 3 cycles of NACT with cisplatin (100 mg/m2, d.1) + epirubicin (90 mg/m2, d.1) q 3wks, followed by cisplatin (100 mg/m2, d. 1,22,43) and concomitant 70 Gy RT; 30 (group B) received 3 cycles of NACT with carboplatin (AUC6, d.1 ) + taxol (175mg/m2, d.1), q 3 wks, followed by weekly carboplatin (AUC1) + taxol (60mg/m2) for seven wks and concomitant 70Gy RT. Clinical and pathological characteristics in group A and B were strictly superimposeable. Results: After IC results in group A and B were respectively : CRs 30 % vs 33%, PRs 60% vs 60%, NC 10% vs 6.6% ; after CHRT: CRs 75% vs 87%, PRs 25% vs 13%. After a median follow-up of 54 months (A) and 49 months (B): 3 and 5 yrs progression free survival were 75% vs 80% and 65% vs 75% respectively and overall survival was 84% vs 85% and 77% vs 80% respectively; 5 yrs locoregional control was 70% vs 90% and 5 yrs distant metastases free survival was 75% vs 85%. IC toxicity was as follows: G3-4 neutropenia 40% vs 83%, G3 thrombocytopenia 12% vs 13%, G3 anaemia 0% vs 10% and G3 mucositis 2.5 vs 6.6%; CHRT toxicity was as follows: G3-G4 neutropenia 20% vs 63%; G3 thrombocytopenia 10% vs 7.5%; G3 anaemia 2.5% vs 17%, G3-G4 mucositis 32.5% vs 69%; skin toxicity 25% vs 23% and G3 neurotoxicity 5% vs 10%. Conclusions: NACT followed by concomitant CHT represents a feasible, highly effective treatment for patients with A-NPC, with excellent locoregional disease control and overall survival and with low incidence of distant metastases. Higher incidence of acute toxicities was observed in group B, without a significant impact on major clinical outcomes. Group A treatment seems feasible with a good safety profile.
The role of the organic anion transporting polypeptide OATP4A1 in immunactivation in colorectal cancer and inflammatory colon disease.
Authors: Christoph Alexander Ausch, Simone Zotter, Maidah Scheikh, Heike Bauer, Marina Mollik, Erika Bajna, Christian Sebesta, Angelika Reiner, Theresia Thalhammer, Veronika Buxhofer-Ausch
Journal: Journal of Clinical Oncology (2014)

481 Background: OATP-transporter proteins, such as OATP4A1, present influence cancer progression by providing compounds (hormones, prostaglandins, cyclic nucleotides, second messenger proteins, drugs) which either inhibit or stimulate tumor cells growth. Therefore, OATP expression in cancer cells and in the stroma, i.e., the microenvironment surrounding the epithelial cells can become a critical parameter. Methods: OATP4A1 was investigated in paraffin-embedded specimens from 148 patients with colorectal cancer and 20 with diverticulitis by immunohistochemistry (IHC) on an automatic quantitative microscopic image analysis system (TissuesFaxs). With the Histoquest program, the immunoreactive score (IRS), was calculated from the degree of the staining intensity and the number of OATP4A1-positive cells. To identify OATP4A1+-cells, double-immunofluorescence staining (IF) was done with antibodies against appropriate cellular markers. Results: OATP4A1 was located in the membrane and cytosol of colon cancer cells and immune cells, while membranous OATP4A1staining was seen in normal mucosa. OATP4A1 levels were higher in cancer cells in patients without tumor recurrence for up to 5 years (NR) than in patients with an early relapse (R) having IRS of 4391±231 and 3026±373 (Mean±SEM), respectively. Highest OATP4A1 levels were observed in immune cells in the tumors of Rs (IRS, 5712 ±254, while in NRs they were lower (IRS: 3549±358; p=0.05). In both groups, OATP4A1 levels in stroma cells were low (288±54 vs. 611±82). OATP4A1 expressing immune cell subtypes in cancer and diverticulitis sections were identified as CD45+ leukocytes, CD3+ T- and CD20+ B-cells, CD68+ macrophages, CD34+precursor cells. OATP4A1 was not detectable in Conclusions: High levels of OATP4A1 in immune cells in malignant and non-malignant colon disease suggest a role of the transporter in the activation of the immune system in malignant and non-malignant colon disease. Whether OATP4A1 might be a therapeutical target has to be established.
Evaluation of factors that intervention of palliative care team contributes to quality-of-life improvement of Japanese patients with advanced cancer.
Authors: T. Ioroi, T. Kakuma, A. Sakashita, Y. Ishibashi, K. Ohtagaki, Y. Fujiwara, T. Mukohara, M. Kume, M. Hirai, H. Minami, Y. Nishimura
Journal: Journal of Clinical Oncology (2011)

e19517 Background: Quality of life (QOL) has not been evaluated in Japanese patients with advanced cancer by EORTC QLQ C-15 PAL, which was developed to measure QOL in palliative care. The patient characteristic that relates to EORTC QLQ C-15 PAL score is not known. Thus, we investigated the factor that related to EORTC QLQ C-15 PAL domain score change before and after the palliative care team (PCT) intervention. Methods: We executed the prospective study to the in-patient who had hoped for the PCT intervention. Patients were asked to complete the self-administered questionnaires according to EORTC QLQ C-15 PAL on before and day 7 of PCT intervention. We analyzed the QOL domain score changing and its correlation to clinical and physiological variables such as age, gender, performance status (PS), and baseline domain scoring in the multivariate stepwise linear regression and bootstrap analysis. Results: Thirty-five patients were recruited, and of those 26 completed the questionnaires and 9 were withdrawn from the trial due to discharge. Median age was 58.5 (range: 22-81), Male: Female = 19:7, PS 0:1:2:3:4 = 2:11:6:7:0, lung cancer = 17 (65%). In the multivariate analysis, the stepwise protocol detected significant baseline valuables which influence each QOL domain. Physical function (r(2)=0.56); baseline physical function scores (coefficient -0.70, [95%CI -1.03, -0.38], p<0.001), gender (male) (38.1, [19.4, 56.7], p<0.001). Emotional function (r(2)=0.70); baseline emotional function score (-0.62, [-0.86, -0.38], p<0.001), gender (male) (15.7, [0.21, 31.27], p=0.047), age (-0.61, [-1.11, -0.11], p=0.018), PS (2-4) (24.75, [10.69, 38.82], p=0.002). Global QOL (r(2)=0.46); baseline global QOL score (-0.7, [-1.02, -0.38], p<0.001). Conclusions: We observed significant associations of factors, such as baseline score, age, gender (male) and PS (2-4) with increased QOL domain score after PCT intervention. The rise of the baseline score and the age of the patient were suggested that a negative factor in the QOL improvement.