tbuckley/cabot-search huggingface dataset:
Cancer of unknown primary in adolescents and young adults: Clinicopathologic features, prognostic factors, and survival outcomes.
Authors: Kanwal Pratap Singh Raghav, Hemendra Mhadgut, Xiudong Lei, Michael J. Overman, Renato Lenzi, Martin N. Raber, Gauri R. Varadhachary
Journal: Journal of Clinical Oncology (2014)

4140 Background: Cancer in adolescents and young adults (AYAs) (15-39 yrs) is increasingly recognized as a distinct clinical and biological entity. Cancer of unknown primary (CUP) although rare in young adults, poses a complex and unique challenge. Our study describes clinicopathologic features and outcomes in AYA-CUP patients (pts). Methods: We performed a retrospective review of 47 AYA pts diagnosed with CUP at The Univ. of Texas, MD Anderson Cancer Center, between 6/2006 and 6/2013. Data on demographics, imaging, pathology and treatment was collected from a prospectively maintained CUP database. Kaplan-Meier product limit method was used to estimate median overall survival (OS) and log-rank test was used for comparison. Cox proportional hazards model was used for multivariate analysis. Results: Median age was 35 years (19–39 yrs). Pts had comprehensive workup (CT 100%); PET scan, upper endoscopy, colonoscopy and mammography was performed in 60%, 51%, 47% and 40% pts, respectively; none yielding a primary diagnosis. Adenocarcinoma was the predominant histology (70%) with a median of 9 immunostains (range 2–29). Most common putative primary (tissue of origin) was biliary profile based on clinicopathologic parameters as well as gene expression profiling. Patients presented with a median of 2 metastatic sites, most common being lymph node (60%), lung (47%), liver (38%) and bone (34%). Systemic chemotherapy used included gemcitabine, fluorouracil, taxanes and platinum agents. Median OS for the entire cohort was 9.9 months. On multivariate analysis, elevated LDH (HR 3.86; 95%CI 1.58-9.44; P=0.003) and multiple metastatic sites (2 sites: HR 4.45; 95%CI 1.05-18.9; P=0.043; 3 or more sites: HR 8.5; 95%CI 1.9-37.9; P = 0.001) compared to 1 site were associated with poor OS. Culine CUP prognostic model (performance status, liver metastasis, LDH) was validated in this cohort (median OS: good risk 25.2 months vs. poor risk 6.1 months). Conclusions: AYA-CUP is associated with a poor prognosis. In the current “-omics” era collaborative research efforts towards understanding tumor biology and therapeutic targets in AYA-CUP is an unmet need, necessary for improving outcomes in young CUP patients.
Optimal indications for chemotherapy in elderly patients with unresectable pancreatic cancer.
Authors: Shoichi Nakazuru, Shoji Nakamori, Seiya Kato, Ayaka Shoji, Ryosuke Kiyota, Kazuma Shinkai, Taku Tashiro, Kentaro Nakagawa, Hisashi Ishida, Eiji Mita
Journal: Journal of Clinical Oncology (2017)

450 Background: Pancreatic cancer is seen predominantly in elderly patients. Since many patients with pancreatic cancer have locally advanced unresectable tumors or distant metastases at diagnosis, they require chemotherapy. However, it is difficult to appropriately select elderly patients who are likely to benefit from chemotherapy. This study aimed to identify prognostic factors for elderly patients with unresectable pancreatic cancer treated with chemotherapy. Methods: We retrospectively analyzed the data of 191 patients with pancreatic cancer, aged ≥ 70 years, who had been diagnosed at our hospital between January 2006 and August 2016. Their overall survival (OS) was calculated using Kaplan-Meyer analysis. Prognostic factors were evaluated using Cox regression analysis. Results: Of the 191 patients, 52 patients with unresectable pancreatic cancer were treated with chemotherapy. Their median age was 76.5 years (range, 70–85 years). Twenty-two patients (42%) were men, and 44 (85%) had metastatic disease. Forty-one (79%) and 11 (21%) patients had ECOG performance status (PS) 0–1 and 2–3, respectively. Thirty-eight (73%), 10 (19%), and 4 (8%) patients received gemcitabine, gemcitabine-based combination regimens, and S-1, respectively, as first-line chemotherapy. The median OS was 219 days (range, 7–920 days). On univariate analysis, ECOG PS ≥ 2 (hazard ratio [HR], 4.37; P = 0.0005), carcinoembryonic antigen ≥ 10 ng/mL (HR, 2.32; P = 0.0162), serum AST ≥ 30 U/L (HR, 2.02; P = 0.0263), serum albumin &lt; 3.0 g/dL (HR, 2.38; P = 0.0247), serum C-reactive protein ≥ 0.5 mg/dL (HR, 2.21; P = 0.0140), neutrophil-to-lymphocyte ratio ≥ 5.0 (HR, 3.25; P = 0.0066), and presence of ascites on computed tomography (CT) scans (HR, 3.02; P = 0.0016) were significantly associated with shorter survival times. On multivariate analysis, ECOG PS ≥ 2 (HR, 5.49; 95% confidence interval [CI], 2.18–13.32; P = 0.0005) and presence of ascites on CT scans (HR, 2.53; 95% CI, 1.20–5.24; P = 0.0148) were associated with poor OS. Conclusions: Elderly patients with unresectable pancreatic cancer who have a good performance status and do not show ascites on CT scans are likely to benefit from chemotherapy.
Tumor budding is a strong predictor of disease-free survival in stage II colorectal cancer: Validation study based on the International Tumor Budding Consensus Conference (ITBCC) recommendations.
Authors: Heather Dawson, Naziheh Assarzadegan, Robert Riddell, Richard Kirsch, Annika Blank, Inti Zlobec, Alessandro Lugli
Journal: Journal of Clinical Oncology (2017)

594 Background: Tumor budding, defined as single tumor cells or small clusters of four or less tumor cells at the invasive front, has been shown to be a strong and independent prognostic factor in colorectal cancer (CRC). However, widespread reporting of tumor budding has been held back largely due to a lack of consensus on scoring methods. 23 experts from the United States, Canada, Japan and Europe participated at the International Tumor Budding Consensus Conference (ITBCC), held in April 2016 in Bern, Switzerland, and agreed on a set of recommendations for assessing and reporting tumor budding in CRC. The aim of this study was to validate the method proposed by ITBCC in the clinically relevant scenario of Stage II CRC. Methods: In 151 Stage II CRC patients, tumor budding was assessed on scanned H&amp;E-stained slides in a single hot spot measuring 0.785mm 2 . Cutoffs as defined by ITBCC were used: Low (Bd1): 0-4 buds, intermediate (Bd2): 5-9 buds, high (Bd3): ≥ 10 buds. Statistical analysis for associations with clinicopathological features, disease free survival (DFS) and overall survival (OS) was performed. Results: The average number of buds/hotspot was 6.8 (median 5.0). 43.1% of cases were Bd1, 27.2% Bd2 and 29.8% Bd3. Tumor budding as a continuous variable was associated with extramural venous invasion (EMVI) (p = 0.05). Tumor budding was associated with poorer OS in univariate analysis (p = 0.0386, HR 1.048, 95%CI 1.002-1.095). For 3- and 5- year DFS, Bd3 was associated with significantly worse survival in comparison with Bd1/2 (p = 0.0031 and p = 0.0025, respectively). In multivariate analysis adjusting for pT, tumor grade and EMVI, tumor budding retained its adverse prognostic effect for DFS (p = 0.006, HR 3.293, 95%CI 1.66-6.53). Conclusions: This study provides promising data on tumor budding assessed by the ITBCC method in the Stage II scenario. Especially Bd3 shows a detrimental adverse impact on DFS in comparison to Bd1/Bd2. Based on the ITBCC, tumor budding has the potential to strongly affect the management of Stage II CRC patients and should be therefore included in reporting guidelines and staging systems in CRC.
A phase II trial on the combination of bevacizumab and irinotecan in recurrent ovarian cancer.
Authors: Huichung Tina Ling, Franco Muggia, James L. Speyer, John Patrick Curtin, Stephanie V. Blank, Leslie R. Boyd, Bhavana Pothuri, Xiaochun Li, Judith D. Goldberg, Amy Tiersten
Journal: Journal of Clinical Oncology (2014)

5564 Background: Irinotecan and bevacizumab have single agent activity in both platinum sensitive and resistant recurrent ovarian cancer. We sought to evaluate the efficacy and safety of the combination in this setting. The primary endpoint is to estimate the progression free survival (PFS) at 6 months. Secondary objectives include overall survival (OS), observed response rate (ORR), duration of response, and toxicity. Methods: Ovarian cancer patients with recurrence after any number of prior regimens were eligible. Irinotecan 250 mg/m2 (amended to 175 mg/m2 after treatment-related toxicities in the first 6 patients) and bevacizumab 15 mg/kg were administered every 3 weeks until disease progression or toxicity. Response was assessed by RECIST every 2 cycles and by CA-125 criteria for those without measurable disease. Results: Of the 29 patients enrolled, 10 were platinum-sensitive and 19 were platinum-resistant. The median number of prior regimens was 5 (range 1-12): 13 patients had prior bevacizumab and 11 patients prior topotecan. The median number of study cycles given was 7 (range 1-34); 5 patients withdrew after 1 cycle (3 due to toxicity). Of the 24 patients assessable for response, 8 patients experienced partial response (PR), 13 maintained stable disease (SD), and 3 had progressive disease; 12 patients with PR/SD were platinum resistant. The ORR was 27.6% (95% CI: 0.127-0.472) and the clinical benefit rate was 72.4% (95% CI: 0.565-0.873) for the intention-to-treat population (n=29). Twelve patients had longer than 6 months of sustained response. Median PFS was 8.1 months (95% CI: 5.1-12.3 months); median OS was 15.9 months (95% CI: 13.4 months- upper bound not reached). The PFS rate at 6 months was 55.2% (95% CI: 0.397-0.766). The most common grade 3/4 toxicities included diarrhea (5 pts), neutropenia (3), hypertension (3), proteinuria (2), fatigue (2), nausea (2), abdominal pain (2), and GI perforation (1). No treatment-related deaths were observed. Conclusions: The combination of irinotecan and bevacizumab showed encouraging activity in heavily-pretreated patients with recurrent ovarian cancer. The median PFS of 8.1 months is comparable to other bevacizumab-containing doublets reported in the AURELIA trial. Clinical trial information: NCT01091259.
One course of adjuvant BEP in clinical stage I, nonseminoma: Mature and expanded results from the SWENOTECA group.
Authors: Torgrim Tandstad, Eva Cavallin-Stahl, Olav Dahl, Hege Sagstuen Haugnes, Carl Wilhelm Langberg, Anna Laurell, Ulrika K. Stierner, Arne Solberg, Najme Wall, Gabriella Cohn-Cedermark
Journal: Journal of Clinical Oncology (2013)

4553 Background: The SWENOTECA group has since 1998 offered patients with clinical stage I (CSI) nonseminoma (NSGCT) treatment based on a risk-adapted approach. Patients with lymphovascular invasion (VASC+) were recommended one course of adjuvant chemotherapy (ACT) with bleomycin, etoposide and cisplatin (BEP). Patients without lymphovascular invasion (VASC-) had the choice between one course of adjuvant BEP or active surveillance. Methods: From 1998-2010, 491 patients with CSI NSGCT received one course of adjuvant BEP. Following histopathological evaluation 247 patients were classified as VASC+, 239 as VASC- and five patients had uncertain VASC status. All patients were included into a prospective, community-based, multicenter SWENOTECA management program. Initial results from patients treated during 1998-2005 have earlier been reported. We now report the mature data, expanded with patients treated during 2005-2010. Results: The median follow-up was 8.0 years. Eleven relapses were observed. After one course of adjuvant BEP 2.3% of patients relapsed. In regard to VASC status 3.4% of VASC+ and 1.3% of VASC- patients relapsed. The latest relapse was detected 3.3 years after ACT. Ten patients have died, only one due to testicular cancer. The 5 and 10-year overall survival rates were 98.9% and 96.8%, respectively. The 5 and 10-year disease-specific survival rates were 100% and 99.6% respectively. Conclusions: One course of adjuvant BEP reduces the risk of relapse in CSI NSGCT with over 90%. These mature results confirm our earlier results on one course of adjuvant BEP. There is no evidence of late relapses, or chemotherapy-resistance in relapses following ACT. To detect relapses, a follow-up of five years is sufficient.
Effect of rituximab on outcomes in gastric B-cell lymphomas and on early mortality in gastric DLBCL.
Authors: Eric Wiedower, Jason Claud Chandler, Arnel M. Pallera, Robert Alan Johnson, Gitonga Munene, Paxton Dickson, Jeremiah Lee Deneve, Martin D. Fleming, Kurt W. Tauer, Lee Steven Schwartzberg, Michael Gary Martin
Journal: Journal of Clinical Oncology (2014)

e19501 Background: Rituximab has improved outcomes in B-cell NHL though early complications, such as gastric perforation have been reported (median time to event 6 days). Methods: Using case listing session of SEER 18 (1973-2010) we examined the impact of the approval of rituximab (1997 and previous v 1998 and beyond) on outcomes in gastric B-cell NHL, including risk of early death (less than 60 days). Analyses were conducted with SEER*Stat 8.1.2, Microsoft Excel 2007 and GraphPadPrism 6. Comparisons were made using the chi-squared test and log rank test (Mantel-Cox); all p-values were 2-sided. Results: Detailed in the table below. Primary cancer-directed surgery for DLBCL has decreased since the introduction of rituximab (49.7% v 13.8%; p<0.0001). Conclusions: The introduction of rituximab has improved outcomes for gastric B-cell NHL on a population level, but there has been an increase in early fatalities in patients with gastric DLBCL. Strategies should be explored to decrease these early events. All gastric B-cell NHL p DLBCL p MALToma p No. identified 10,790 5,846 4,017 Median age (range) 70 (4-105) 71 (4-105) 68 (10-101) Median age 1997 and previous (range) 69 (4-99) 69 (4-99) 69 (20-98) Median age 1998 and beyond (range) 70 (7-105) 72 (7-105) 68 (10-101) Gender (M/F%) 53.3/46.5 55.1/44.9 50.2/49.8 Race (W/B/O%) 81.2/7.7/11.1 81.6/7.2/11.2 80.3/8.6/11.1 Median OS 1997 and previous (months) 63 48 124 Median OS 1998 and beyond (months) 102 <0.0001* 65 0.0430* 140 0.0513 ALL death(s) within 60 days of Dx 1159/10790 (10.7%) 921/5846 (15.8%) 131/4017 (3.3%) Death within 60 days of Dx 1997 and previous 331/2728 (12.1%) 297/2096 (14.1%) 13/332 (3.9%) Death within 60 days of Dx 1998 and beyond 828/8062 (10.3%) 0.0073* 624/3750 (16.6%) 0.0143* 118/3685 (3.2%) 0.5894
Clinical outcomes of elderly patients with esophageal cancer treated with chemoradiotherapy in the modern era.
Authors: Cai Xu, Mian Xi, Amy Moreno, Yutaka Shraishi, Ritsuko Komaki, Steven H. Lin
Journal: Journal of Clinical Oncology (2017)

174 Background: The optimal treatment approach is not clearly defined for elderly patients with esophageal cancer. We retrospectively analyzed the clinical outcomes of elderly patients ≥ 80 years old treated at a single institution in the modern era. Methods: Patients 80 years or greater with thoracic esophageal cancer who were treated consecutively with conventional modern radiotherapy (intensity-modulated radiation therapy or proton beam therapy) and concurrent chemotherapy between 2004 and 2016 were identified and included in this study. The one patient who had surgery was excluded. Toxicity was assessed using the CTCAE v.4.0. The rates of overall survival (OS) and recurrence free survival (RFS) were calculated with the Kaplan-Meier method. A p-value less than 0.05 indicated statistical significance. Results: Of the 1617 patients, 47 patients met the eligibility criteria. The median age was 81 years (range, 80-92 years). Most patients had some comorbid illnesses, with 81%, 9%, and 11% of patients having some cardiac, pulmonary, or diabetic related diseases, respectively. Twelve of 47 patients (26%) were given induction chemotherapy. The median dose was 50.4 Gy (range, 45 Gy-50.4 Gy). The clinical complete rate was 86%. With a median follow-up of 18 months (ranges, 1.9-117.6 months), the 2-year and 5-year OS was 54.5% and 27.7%, respectively, and the 2-year RFS was 63.6%. Three patients (6.4%) developed grade 3-5 radiation pneumonitis, with 2 (4.2%) being grade 5. Eighteen patients (38%) developed grade 1 pleural effusion, and 1 was grade 3. Three patients had grade 2 arrhythmia. Six patients had grades 1-2 pericardial effusion. One patient died from myocardial infarction. Four (9%) patients developed ≥ grade 3 esophagitis, with 7 patients having grade 3 esophageal stricture. Conclusions: The treatment of esophageal cancer patients 80 years or older with concurrent chemoradiotherapy was associated with an acceptable disease outcome, but the acute and late toxicities were higher than expected, which may be due to accompanying comorbidities. More research is needed to validate our observations and to better select patients who can optimally benefit from concurrent chemoradiotherapy.
A new model for training patient advocates to advance the adoption of research results in community oncology practices
Authors: E. Railey, M. Smith, J. Perotti
Journal: Journal of Clinical Oncology (2006)

6094 Background: The advocate community has been identified as an influential component in disseminating the results of research reported at ASCO. A pilot program offered by Research Advocacy Network prepared advocates to better understand the common concepts in oncology, improve statistical skills to interpret the presentations and identify the influencers and barriers to adoption of research results in clinical practice. Methods: Advocates were selected based on their ability to disseminate results reported at ASCO to a patient constituency. Pre-ASCO webconference lecture topics included: targeted therapies, drug safety and approval process, statistics for advocates. Post ASCO webconferences explored evidence-based medicine principles with case presentations and discussions. Participants were responsible for reporting their efforts in disseminating the results that could change clinical practice in their disease site. Results: Fifteen advocates representing six cancer sites participated in the program. Six of the participants were first time attendees. Participants reported an increased 1) understanding of scientific concepts and language; 2) increased confidence in dialoguing with researchers; and 3) improved ability to translate research results for their constituencies. Research results were provided by the participants to staff and volunteers, via teleconferences, web sites and individually to newly diagnosed patients, caregivers, support groups, survivor hotlines and in newsletter articles with a combined circulation of over 125,000 readers. Conclusions: Preparatory lectures help advocates maximize the experience of interpreting and translating the results from the ASCO meeting. More prepared advocates help to advance the dissemination of research results through their formal and informal distribution channels and are able to translate the information more rapidly to their constituencies. No significant financial relationships to disclose.
추계학술대회 초록집 : 대한간학회 학술연구기금 당선과제 발표 ; 국소 치료가 가능한, B형간염 관련 간세포암종 환자에서 혈청 HBV DNA 치에 따른 간내 재발에 관한 전향 코호트 연구
Authors: 김원 ( Won Kim )
Journal: Clinical and Molecular Hepatology (2006)
The biasing effects of appearances go beyond physical attractiveness and mating motives
Authors: Christopher Y. Olivola, Alexander Todorov
Journal: Behavioral and Brain Sciences (2017)

Abstract The influence of appearances goes well beyond physical attractiveness and includes the surprisingly powerful impact of “face-ism” – the tendency to stereotype individuals based on their facial features. A growing body of research has revealed that these face-based social attributions bias the outcomes of labor markets and experimental economic games in ways that are hard to explain via evolutionary mating motives.
Impact of Somatic Mutations on the Outcome of Children and Adolescents with Therapy-Related Myelodysplastic Syndrome
Authors: Brigitte Strahm, Marcin W Wlodarski, Victor B Pastor, Bart Przychodzien, Albert Catala, Michael Dworzak, Oksana Fabri, Henrik Hasle, Kristián Kállay, Riccardo Masetti, Barbara De Moerloose, Marena R Niewisch, Jan Stary, Marek Ussowicz, Ayami Yoshimi, Wilfried Truckenmueller, Peter Noellke, Gudrun Göhring, Irith Baumann, Franco Locatelli, Charlotte M Niemeyer
Journal: Blood (2016)
Adjuvant therapy and outcomes in patients with stage IA breast cancer.
Authors: Grazia Arpino, Mario Giuliano, Carmine De Angelis, Massimo Di Maio, Francesco Schettini, Claudia Von Arx, Ferdinando Riccardi, Giuliano Palumbo, Michelino De Laurentiis, Anna Crispo, Maurizio Montella, Maria Grimaldi, Martino Trunfio, Gennaro Limite, Antonello Accurso, Sabino De Placido
Journal: Journal of Clinical Oncology (2015)

e11556 Background: Node negative (N0), early breast cancers (EBC) smaller than 2 cm (stage IA) are generally considered at good prognosis. However, the prognostic role of tumor characteristics such as size (T), grade (G), HER2 status and Ki67, as well as the impact on survival of different types of adjuvant therapies are still controversial in this subset of tumors. Methods: Clinical and tumor characteristics from 1041 patients with T1a-c N0 M0 EBC, treated between 1996 and 2011 at 3 major Institutions of Southern Italy (Federico II, Pascale and Cardarelli), were retrospectively analyzed. Survival analyses were performed using the Kaplan Meier method for univariate analyses and the Cox proportional hazard model for multivariate analyses. When comparing patients who received vs. patients who did not receive adjuvant chemotherapy (CT), Propensity Score (PS) matching was used to partially correct for selection bias. Results: Among the 708 patients with hormone receptor positive (HR+) and HER2-negative EBC, 708 (100%) received adjuvant endocrine therapy (ET) and 285 (40%) were also treated with adjuvant CT. At univariate analyses, low ki67 ( < 20%) was associated with a significantly longer DFS compared to high Ki67 ( ≥ 20%) (p = 0.04). Once adjusted for the PS, the administration of CT had no impact on DFS or OS when compared with ET alone. At multivariate analysis, neither the known clinical and tumor characteristics (though for T and G there was a borderline statistical significance) nor CT administration impacted patients’ outcome. Among the 172 patients with HER2+ disease, 154 (89%) received CT, 116 (67%) ET and 79 (46%) received also trastuzumab. At univariate analyses, DFS and OS were better for patients treated with trastuzumab vs. no trastuzumab (5 ys DFS 91% vs. 84% and OS 99% vs. 91%, respectively), although the difference was not statistically significant. Conclusions: Our analyses show that in small HR+/HER2-negative EBC, adjuvant CT may have a marginal impact in improving patients’ outcome. However, Ki67 level, T and G may help to select a subgroup of more aggressive tumors. Interestingly, the addition orastuzumab to adjuvant therapy in HER2+ EBC seems relevant for patients outcome, though larger prospective studies are needed to confirm our findings.