tbuckley/cabot-search huggingface dataset:
Prognostic impact of copy number variations in neuroblastoma patients.
Authors: Alexander Druy, Egor Shorikov, Grigory Tsaur, Sergey Tuponogov, Alexander Popov, Leonid Saveliev, Larisa Fechina
Journal: Journal of Clinical Oncology (2014)

e21009 Background: 1p, 11q deletions, MYCN amplification (MNA) are known to be adverse prognostic markers, while significance of many other copy number variations is less clear. Methods: We analyzed 108 primary tumors from patients treated according GPOH NB 2004 protocol by MLPA for loci 1p,2p,3p,11q,17q and 100 tumors for 4p,7q,9p,12q,14q. Prognostic significance was estimated by overall (OS) and event-free survival (EFS) with median of follow-up time 28 months (range 1-166 months). Results: MNA was revealed in 19 patients (17.6%). EFS and OS in this group were significantly low (0.20±0.11 and 0.27±0.12) comparing with normal MYCN status (0.69±0.06 and 0.77±0.06 respectively, both p<0.001). MYCN gain was observed in 15 patients (13.9%) and showed prognostic significance in patients under 1 year (EFS 0.53±0.25 vs. 0.96±0.04, p=0.047). In 29 patients (26.9%) 1p deletion was revealed and had prognostic impact (EFS 0.33±0.10 vs. 0.67±0.06, p=0.002, OS 0.46±0.10 vs. 0.73±0.06, p=0.003). 17q gain was detected in 54 patients (50.0%) and led to decreased survival rates (EFS 0.42±0.08 vs. 0.71±0.07, p<0.001, OS 0.48±0.09 vs. 0.80±0.06, p=0.002). Both 1p deletion and 17q gain retained prognostic significance in MYCN non-amplified patients. 4p gain detected in 8 patients (8.0%) decreased EFS in patients under 1 year (0.00 vs. 0.88±0.06, p=0.055). Gain of both 7p and 7q (6 patients, 6.0%) led to reduced EFS in the whole group (0.33±0.19 vs. 0.56±0.06, p=0.053) and in MYCN non-amplified patients (0.40±0.22 vs. 0.64±0.06, p=0.044). In 8 patients (8.0%) 9p deletion was found. Presence of this aberration resulted in dramatic decreasing of survival rates: both EFS and OS were 0.00 vs. 0.60±0.06 and 0.68±0.06, p=0.035, p=0.014). 3p deletion observed in 30 of 108 patients (27.8%) as a late event in molecular pathogenesis of neuroblastoma, had adverse prognostic significance in the group of patients above 3 years (EFS 0.25±0.23 vs. 0.71±0.11, p=0.034). Conclusions: MNA, 1p, 9p deletions and 17q gain demonstrated negative prognostic impact. Presence of MYCN gain and 4p gain led to decrease EFS in the group of patients below 1 year old, while 1p and 9p deletions, 17q gain and gain of both arms of chromosome 7 retained prognostic significance in MYCN non-amplified patients.
Preliminary results of a randomized placebo-controlled double-blind trial of weekly docetaxel combined with imatinib in men with metastatic androgen-independent prostate cancer (AIPC) and bone metastases (BM)
Authors: P. Mathew, P. F. Thall, M. M. Johnson, W. K. Oh, A. A. Meluch, M. J. Morris, P. Troncoso, C. D. Bucana, I. J. Fidler, C. J. Logothetis
Journal: Journal of Clinical Oncology (2006)

4562 Background: To further examine preclinical (Uehara, JNCI 2003) and clinical (Mathew, JCO 2004) evidence that the platelet-derived growth factor receptor (PDGFR) inhibitor, Imatinib, may modulate taxane activity in AIPC with BM, a randomized trial was conducted. Methods: 144 men with progressive AIPC with BM, no prior taxane, ECOG Performance Score (PS) ≤ 2, stratified by PS, hemoglobin, alkaline phosphatase and number of prior regimens, were planned for equal randomization to i.v. Docetaxel 30mg/m 2 D 1, 8, 15, 22 q42 + Imatinib 600 mg daily (DI) or placebo (DP) for an improvement in time-to-progression (TTP) from 4.5 to 7.0 months (two-sided α = 0.05,β = 0.20). Secondary endpoints included toxicity, tumor response and phospho-PDGFR expression. An IRB review of gastrointestinal adverse events led to a recommendation to halt accrual early. Results: 104 evaluable men (52/arm) accrued between April 2003 and July 2005 were followed for a median of 7 months (range 0.5–23.4). The median TTP was 4.4 months (95% CI: 3.2–8.7) for DI and 5.3 months (95% CI: 3.4–11.3) for DP (p = 0.49, log-rank test). Median overall survival was 21.3 months for DI and not attained for DP (p = 0.56). Partial response was observed in 11 (3 DI, 8 DP), stable disease in 23 (14 DI, 9 DP), progressive disease in 56 (27 DI, 29 DP). Excess Grade 3 AEs with DI were principally fatigue (16 vs 6), gastrointestinal (11 vs 6), and arrhythmia (5 vs 1). Five cases of perforated sigmoid diverticulitis (4 DI, 1 DP; one death) were associated with high-dose steroid use (Fisher’s exact test p &lt; 0.0001). Expression of phospho-PDGFR on tumor cells (≥2+ intensity) was established by immunohistochemistry in 12/14 (86%) of informative bone marrow biopsies. After cross-over to DI from DP, 5/23 (22%) patients were progression-free at 12 weeks without partial response. Conclusion: Notwithstanding the likely high prevalence of activated PDGFR in AIPC BM, Imatinib does not detectably modulate Docetaxel activity and excess toxicity was noted in this population. In-vivo monitoring of p-PDGFR and bone markers will qualify these findings. [Table: see text]
Physicians, Not Conscripts — Conscientious Objection in Health Care
Authors: Ronit Y. Stahl, Ezekiel J. Emanuel
Journal: New England Journal of Medicine (2017)

Conscientious objection laws give health care professionals the legal right to refuse, on the basis of personal beliefs, to perform certain procedures or care for particular patients. The authors argue that professional societies should declare conscientious objection unethical.
Quality and Safety in Health Care, Part XXVI
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2017)

The Adult Cardiac Surgery Database of the Society of Thoracic Surgeons has provided highly useful information in quality and safety in general thoracic surgery, including ratings of the surgeons and institutions participating in this type of surgery. The Adult Cardiac Surgery Database information is very helpful for writing guidelines and determining optimal protocols and for many research projects. This article discusses the history and current status of this database.
Multiple Spinal Lesions in an Immunocompetent Young Man
Authors: Wenhua Zhu, Sushan Luo, Liping Zhu
Journal: JAMA Neurology (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Neurology journal
Quantifying episode-based costs of care under the oncology care model: Analysis of Medicare beneficiaries in the UAB cancer community network.
Authors: Courtney Williams, Andres Azuero, Maria Pisu, Karina I. Halilova, Warner King Huh, Edward E. Partridge, Gabrielle Betty Rocque
Journal: Journal of Clinical Oncology (2017)

19 Background: The Oncology Care Model (OCM) is a specialty care model developed by the Centers for Medicare &amp; Medicaid (CMS) Innovation Center aimed at providing higher quality, more highly coordinated cancer care and reducing costs for patients undergoing chemotherapy. The OCM calculates costs of care in a novel way by anchoring costs within episodes of care, defined as six-month intervals triggered by initial anti-cancer treatment, as opposed to diagnosis date. The purpose of this study is to assess costs within the OCM episodes of care. Methods: This was a secondary analysis of Medicare administrative claims data for beneficiaries 65 and older with cancer who received anti-cancer drug treatment (chemotherapy, hormone therapy) between 2012-2015 at an institution in the UAB Cancer Community Network (CCN). Total and service-specific costs (Medicare reimbursement to providers) per patient-episode were summed from inpatient, outpatient, chemotherapy, radiation therapy, testing/pathology, evaluation and management (E/M), home health, skilled nursing facility (SNF), and hospice claims. Prescription drug costs were not included. Mean costs for the first three OCM episodes were calculated and compared to (1) diagnosis-based costs (six-month intervals starting at cancer diagnosis) and (2) service type. Results: Average total cost in the first three OCM episodes of care was $24,922 (n=13,902), $18,534 (n=6,618), and $16,548 (n=4,672). Compared to episode-based cost, average total diagnosis-based cost was higher in the first episode of care ($33,244, n=9,615), and lower in the second and third episodes ($17,143, n=9,110; $12,897, n=8,002). Episode-based outpatient, inpatient, and chemotherapy costs were the highest service-specific costs in all three episodes of care (1 st : $8,374, $5,493, $2,445; 2 nd : $6,188, $3,913, $3,158; 3 rd : $5,909, $3,251, $3,399). Conclusions: Costly chemotherapy and inpatient and outpatient visits indicate an opportunity for targeted improvement resulting in higher value care. Knowledge of current costs of care will aid oncology practices in transition to the OCM and in usage of value-based services for better quality cancer care.
Late effects in rare cancer registrants.
Authors: Nora Horick, Adoma Manful, Anita Kinney, Jan Lowery, Susan M. Domchek, Claudine Isaacs, Kala Visvanathan, Constance A. Griffin, Patricia Moorman, Dianne M. Finkelstein
Journal: Journal of Clinical Oncology (2014)

e20577 Background: Knowledge of late effects in rare cancers could improve care, yet data on these outcomes are sparse. We sought to describe physical and mental health outcomes in a registry of patients diagnosed with rare cancers using 3 established assessment tools. Methods: 321 registrants enrolled in the Rare Cancer Genetics Registry with hematologic (31%), genitourinary (21%), gastrointestinal (18%), sarcoma (15%), head/neck (11%) or gynecologic (4%) cancers completed the assessment. Median time since diagnosis was 3 years; most (69%) were no longer receiving treatment. Four outcomes were assessed, reflecting overall physical and mental health, psychological distress, and loneliness, as measured by the SF-12v2 Health Survey, Brief Symptom Inventory-18, and a three-item loneliness scale, respectively. Linear regression was used to assess the association between outcomes and socio-demographic and cancer-related factors, and the mean score for each outcome was compared to the appropriate reference population of healthy individuals. Results: Rare cancer registrants' mean physical health score was significantly poorer than in the general US population, with registrants who were older at diagnosis, unpartnered, and still receiving treatment reporting poorer physical health. Surprisingly, registrants' mean mental health score was better than in the general population, but younger diagnosis age and unpartnered status were associated with poorer mental health. Registrants reported greater psychological distress than the reference population, and results showed significant variation by cancer type, as well as higher distress among currently treated and unpartnered registrants. Registrants’ mean loneliness score was comparable to the reference population. Loneliness varied significantly by cancer type, and was higher among less educated and unpartnered registrants. Conclusions: Rare cancer registrants reported worse physical health and greater psychological distress than the general population, but their overall mental health was better. As in common cancers, unpartnered registrants had significantly poorer scores for all four outcomes, suggesting that increased psychological surveillance may be warranted for unpartnered rare cancer patients.
Evaluation of the impact of infliximab use for the treatment of ipilimumab related diarrhoea on the outcome of patients with advanced melanoma.
Authors: Edurne Arriola, Matthew James Wheater, Arun Warrier, Ioannis Karydis, Christian H.H Ottensmeier
Journal: Journal of Clinical Oncology (2015)

9045 Background: The use of immunosuppressants for the treatment of immune related (IR) toxicities from immunoregulatory antibodies, such as ipilimumab is intended to dampen harmful adaptive immune responses. It is uncertain whether this also results in reduction of anti-tumour immunity and adversely affects disease specific outcome. The aim of our study was to evaluate the impact on overall survival (OS) of infliximab use for the treatment of immune related diarrhoea from ipilimumab in patients with metastatic melanoma. Methods: We retrospectively evaluated 90 patients with advanced melanoma treated with ipilimumab (3mg/kg) with assessment of response during and following treatment. We recorded clinical characteristics, toxicity data and outcome. Kaplan Meier and Log rank tests were used to assess outcome differences. Results: Fifty-one percent of patients were male, the median age was 64 years; sixty-nine (77%) patients has cutaneous primaries, 11(12%) uveal and 2(2%) mucosal. Sixty-five patients (72%) had M1c disease. BRAFassessment was available in 77% of tumours and 32% cases harboured a V600E mutation. Ipilimumab was administered as second line treatment and 60% completed four cycles. Thirty percent (n = 27) of patients developed ipilimumab-related diarrhoea of any grade. Twenty-one (80%) required oral steroids for management, escalated to iv methylprednisolone (1-2mg/kg/24hrs) in 12 cases. In seven patients (25%) infliximab was required to control G3/4 colitis. Median follow up was 8 months for the whole population. M1c disease, poor performance status at treatment initiation and progression at the week 12 response assessment were associated with shorter survival (all p-values < 0.05). Patients who developed diarrhoea had improved OS when compared to those who did not (8.8m vs 5.4m; p = 0.041). Within patients with diarrhoea, the median OS of those treated with infliximab compared to those without was 8.8m vs 6.8 (p = 0.16), respectively. Conclusions: In our series infliximab does not negatively affect the outcome of patients with advanced melanoma treated with ipilimumab and early switch in order to spare steroid toxicity appears warranted and safe.
A comparison of survival among patients with anal adenocarcinoma (AA), anal squamous cell carcinoma (ASCC), and rectal adenocarcinoma (RA) using a population based approach.
Authors: Robert A Franklin, Smith Giri, Poojitha Valasareddy, Ranjan Pathak, Michael Gary Martin
Journal: Journal of Clinical Oncology (2015)

e14500 Background: AA represents about 5-10% of all anal cancers. AA has an anatomic analogue in ASCC and a histologic analogue in RA. Owing to the rarity of AA and the tendency to conflate AA with either ASCC or RA, little is known about the natural history and prognosis of this disease. Using a population based approach, we aimed to compare survival of AA with ASCC and RA. Methods: We utilized the SEER 18 database and appropriate histology codes to identify patients aged 18 years or older with AA, ASCC, and RA from 1990-2011. Microscopically confirmed cases with known grade, stage, use of radiation and surgery were included. Median Overall Survival (OS), 3 year OS, and 5 year OS were computed using actuarial (life table) analysis. The difference between Kaplan Meier survival curves was estimated using log-rank test. A cox proportional hazard regression model was used to adjust survival differences for age, gender, year of diagnosis, race, grade, tumor stage, receipt of surgery and radiation therapy. All p-values were 2 sided and the level of significance was chosen at 0.05. Results: A total of 56,509 cases were identified out of which 80% (n = 49,744) were RAs, 0.8% (n = 445) AAs and 11.2% (n = 6320) ASCC. The median age was 70 years (28-96) for AA as compared to 66 years (18-103) and 58 years (19-104) for RA and AS respectively. The median, 3 year and 5 year OS was significantly lower for AA (33 months, 34%% and 18% respectively) as compared to ASCC (116 months, 49% and 32%) %) and RA (68 months, 49% and 32%) (p < 0.01 in all cases). On multivariate analysis, AA had a worse prognosis as compared to ASCC (HR 1.7; 95% CI 1.48-1.95; p < 0.01) as well as RA (1.3; 95% CI 1.15-1.46; p < 0.01), after adjusting for age, sex, race, stage, grade and surgery. Conclusions: Anal adenocarcinoma appears to have a significantly worse prognosis as compared to both anal squamous cell carcinoma and rectal adenocarcinoma based on this study; vigilance in accurate diagnosis and considerations of more aggressive treatment may consequently be warranted.
A comparative analysis of the association between health expenditure and cancer survival in 168 countries.
Authors: Felipe Ades, Pedro Rua Rodriguez Rochedo, Otto Metzger-Filho, Gustavo Werutsky, Jose Bines, Dimitrios Zardavas, Evandro De Azambuja, Kamal V.S. Saini, Florence Parent, Martine J. Piccart-Gebhart, Andre Frossard Pereira de Lucena
Journal: Journal of Clinical Oncology (2014)

1591 Background: Whereas cancer incidence is higher in high and middle income countries, cancer survival is lower in low income countries. In this analysis we investigated the relationship between health expenditure and cancer-related survival in 168 countries. Methods: Health expenditure data from 168 countries and cancer indicators data from 28 cancer types from the same countries were extracted from the World Bank (WB) and the World Health Organization (WHO) databases. The mortality/incidence (M/I) ratio was calculated to evaluate the fraction of patients dying after a cancer diagnosis. A regression analysis was conducted using a lin-log functional form that accounts for a non-linear relationship between (M/I) ratio and health expenditure. The coefficient of determination (R2), indicates the proportion of outcomes explained by the model. Results: Health expenditure was significantly higher in high income countries than in middle and low income countries. For cancers with effective screening and/or effective treatment options higher expenditure was strongly correlated with improved survival. For cancers with no screening and moderately efficient treatment options survival was moderately correlated with health expenditure. For cancers with no screening and poor treatment options survival was poorly correlated to health expenditure. The estimated non-linear relationship shows that increases in health expenditure have a much more significant effect when health expenditure is low, especially for the first two groups of diseases. Significant survival improvements are expected from increasing health expenditure of low and middle income countries as in South America, Africa and parts of Asia, and only marginal incremental improvements, if any, in high income countries as the USA and Western Europe. Conclusions: Higher health expenditure is correlated with improved survival in cancers with available effective screening methods and/or treatment options. For cancer with no effective treatment options health expenditure has little impact on survival. Cancer type R2 Breast 0,80 Prostate 0,79 Bladder 0,66 Multiple myeloma 0,54 Esophagus 0,20 Pancreas 0,12
Gemcitabine in heavily pretreated adult soft tissue sarcoma patients
Authors: D. Schoeler, A. Kunitz, P. Reichardt
Journal: Journal of Clinical Oncology (2007)

20524 Background: The number of effective cytotoxic agents in treatment of advanced soft tissue sarcoma (STS) is limited when patients have failed anthracyclin and ifosfamide therapy. There are inconsistent data in phase I / II studies and retrospective analyses evaluating the efficiacy of gemcitabine (G, 900mg/m 2 , d1+8, q3w) or combination of gemcitabine and docetaxel (GD, G: 900mg/m 2 , d1+8, D: 100 mg/m 2 , d8, q3w). Methods: Between 2002 and 2006 we retrospectively analyzed 14 females and 6 males with heavily pretreated advanced soft tissue sarcoma (1–5 pretreatments) who were treated in our department (Charité Campus Virchow-Klinikum) with G (n=10) or GD (n=10) depending on their performance status. The following histology types were represented: leiomyosarcoma (10), liposarcoma (3), MPNST (3), synovial sarcoma (2), undifferentiated sarcoma (1), malignant large cell sarcoma (1). Results: A total of 99 cycles (range 1 to 15) were applied. Best response was partial remission (PR=20%, G: n=2, GD: n=2) and was achieved in four patients, among them three leiomyosarcoma and one MPNST. In six cases disease stabilization was achieved for up to 15 month (SD=30%, G: n=2, GD: n=4). Four patients had progressive disease after 2–3 cycles of gemcitabine based therapy (PD=20%, G: n=0, GD: n=4). In another six cases only day one of the first cycle (G alone) was administered because of serious problems due to pretreatment and poor performance status (e.g. prolonged thrombopenia and neutropenia Grade IV, gemcitabine-induced vasculitis, gastrointestinal bleeding due to tumor localization, pneumonia, rapid tumor progression). Conclusions: Gemcitabine-based therapy for heavily pretreated STS patients in our retrospective analysis has a significant overall response rate. In patients considered unfit for GD combination, single agent G treatment remains an option with moderate effiacy. No significant financial relationships to disclose.
Virgin Beta Cells Persist throughout Life at a Neogenic Niche within Pancreatic Islets
Authors: Talitha van der Meulen, Alex M. Mawla, Michael R. DiGruccio, Michael W. Adams, Vera Nies, Sophie Dólleman, Siming Liu, Amanda M. Ackermann, Elena Cáceres, Anna E. Hunter, Klaus H. Kaestner, Cynthia J. Donaldson, Mark O. Huising
Journal: Cell Metabolism (2017)
The P2X7 receptor antagonist, oxidized adenosine triphosphate, ameliorates renal ischemia-reperfusion injury by expansion of regulatory T cells
Authors: Tai Yeon Koo, Jae-Ghi Lee, Ji-Jing Yan, Joon Young Jang, Kyung Don Ju, Miyeun Han, Kook-Hwan Oh, Curie Ahn, Jaeseok Yang
Journal: Kidney International (2017)