tbuckley/cabot-search huggingface dataset:
Prechemotherapy cognitive function in 362 breast cancer (BC) patients and 362 age-paired controls without cancer: A nationwide longitudinal trial conducted through the University of Rochester Cancer Center (URCC) Community Clinical Oncology Program (CCOP) Research Base (RB).
Authors: Michelle Christine Janelsins, Charles E. Heckler, Karen Michelle Mustian, Mary Ontko, Judith O. Hopkins, Matthias Weiss, Steven William Corso, Luke Joseph Peppone, Oxana Palesh, Mohamedtaki Abdulaziz Tejani, Supriya Gupta Mohile, Charles Stewart Kamen, Anita Roselyn Peoples, Marie Anne Flannery, Christine B. Ambrosone, Tim Ahles, Gary R. Morrow
Journal: Journal of Clinical Oncology (2014)

9653 Background: Cancer-related cognitive impairment (CRCI) impairs quality of life. 15% of patients experience CRCI prior to chemotherapy (CT), 75% during CT and 35% after CT. Large studies are needed to confirm these results. Methods: We are conducting a large, nationwide, longitudinal observational study through the URCC CCOP RB and 23 CCOPs to elucidate the natural history of CRCI among BC patients receiving CT compared to similarly aged women without cancer. BC participant eligibility: 1) stage I-IIIc , 2) CT naïve, 3) ≥21 years, 4) no central nervous system disease, 5) scheduled to receive anthracycline or non-anthracycline-based CT with no concurrent radiation. Controls meet eligibility #2-4. CRCI is assessed within one week (wk) prior to CT, within 4 wks after CT and 6 months post-CT. Controls are assessed at the same time intervals. CRCI domains (i.e., memory, attention, processing speed, executive function) are assessed via patient report (Functional Assessment of Cancer Therapy-Cognitive (FACT-Cog) and Behavior Rating Inventory of Executive Function (BRIEF)), and objective measures (computerized neuropsychological battery (CANTAB) and paper-based Trail Making Test (TMT-A)). Results: 362 BC patients were recruited (85% white, mean age=53) and paired with 362 controls.Adjusting for age, education, and WRAT-4 reading score (cognitive reserve), at pre-chemotherapy, BC patients performed less well than controls on FACT-Cog (Effect Size (ES)=0.4), BRIEF (ES=0.2;all p<0.05), CANTAB processing speed/attention and motor task tests (ES=0.2;all p<0.05), and the TMT-A (ES=0.2;p<0.07). There was no difference in these measures in BC patients scheduled to receive anthracycline-based CT vs. non-anthracycline-based CT. Conclusions: BC patients demonstrate poorer processing speed, attention, motor control, and perceived cognitive function prior to CT compared to women without cancer, suggesting it is clinically important to assess for CRCI before CT. NCI Grants: K07CA168886, U10CA037420. Clinical trial information: NCT01382082.
Overall survival advantage with radical prostatectomy for prostate cancer.
Authors: Christopher David Kosarek, Stephen Bentley Williams, Jinhai Huo, Karim Chamie, Marc C. Smaldone, Justin Edwin Fang, Cameron Ghaffary, Preston Kerr, Leslie Ynalvez, Simon P. Kim, Sharon Hermes Giordano, Brian F. Chapin
Journal: Journal of Clinical Oncology (2017)

37 Background: To compare overall survival of patients who underwent radical prostatectomy or radiotherapy versus non-cancer controls in order to discern if there is a survival advantage according to prostate cancer treatment. Methods: A matched cohort study was performedusingthe Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. We identified 34,473 patients age 66 to 75 years without significant comorbidity from who were diagnosed with localized prostate cancer treated with surgery or radiotherapy between 2004 and 2011. These patients were matched to a non-cancer control cohort. We compared the rates of all-cause mortality that occurred within the study period. We used Cox Proportional Hazards Regression analysis to identify determinants associated with overall survival. Results: Of the total 34,473 patients who were included in the analysis, 21,740 (63%) received radiation therapy and 12,733 (37%) received surgery. When compared to the non-cancer control, there was no significant difference between the prostate cancer cohort and the non-cancer control group with exception of race/ethnicity (p &lt; 0.001). There was improved survival in patients treated with surgery (hazard ratio [HR], 0.35; 95% CI, 0.32-0.38) as well as with radiotherapy (HR, 0.72; 95% CI, 0.68-0.75) when compared to non-cancer controls. There was significantly improved overall survival among both treatment groups with most benefit observed among patients who underwent surgery ( log rank p &lt; 0.001). Conclusions: Using population based data, treatment with either surgery or radiotherapy demonstrated improved overall survival when compared to a cohort of matched non-cancer controls. Treatment with surgery resulted in longer overall survival compared to those receiving radiation therapy. These results suggest inherent selection-bias due to unmeasured confounding variables when using cancer registry data.
An evaluation of efficiency, safety, tolerability, patient satisfaction, and preference of subcutaneous (SQ) versus intravenous (IV) bortezomib (BTZ) administration in patients with multiple myeloma (MM).
Authors: Meagan Spencer Barbee, Nicole Maire Wilson, R. Donald Harvey, Trevor McKibbin, Sagar Lonial, Jonathan L. Kaufman, Katherine Sanvidge Shah
Journal: Journal of Clinical Oncology (2012)

e18553 Background: SQ BTZ is approved for use in patients (pts) with MM; however, there is no data assessing the effect of SQ BTZ administration on practice variables (e.g., chair time, total time in clinic) or patient preferences. Furthermore, few studies have evaluated the incidence of PN with SQ BTZ, especially in treatment naïve patients. Methods: This study is divided into three components. Eligible pts for the retrospective efficiency study received ≥ 6 doses of either IV or SQ BTZ in the clinic in 2011 with no concurrent infusions/transfusions other than IV fluids, premedications, or concurrent chemotherapy during their visit. Individual clinic encounters of eligible pts were assessed for chair time and overall clinic visit time, and the average times were compared between the IV and SQ groups. Eligible pts for the preference/satisfaction survey study received ≥ 1 dose of each IV and SQ BTZ in 2011 and spoke English. Percent response to answer choices are reported. De novo SQ BTZ pts who received ≥ 6 doses were eligible for the retrospective safety/tolerability study. Patient chart notes were reviewed to identify the incidence and grade of PN. Results: 92 pts representing 1458 encounters were included in the efficiency study. Average chair time was 54 min less with SQ BTZ than IV BTZ (95% CI, 48 to 59 min; n = 1077 encounters; 89 vs 143 min). Average overall clinic visit time was 46 min less with SQ BTZ than IV BTZ (95% CI, 40 to 52 min; n = 1102 encounters; 123 vs 169 min). 28 of 47 eligible pts completed the survey. 19/28 (67.8%) preferred and 19/28 (67.8%) were more satisfied with SQ BTZ than IV BTZ. 11/28 (39%) experienced an injection site reaction, and 14/28 (50%) agreed they would feel comfortable with self-administration at home. Of the 14 pts receiving SQ BTZ who were BTZ naïve, 11 were newly diagnosed. One of these pts had new PN and 3 had worsened PN from baseline. SQ BTZ was dose reduced in 2 patients and discontinued in 2 pts due to PN. Conclusions: A complete transition in the practice of administration of BTZ from IV to SQ could improve clinic efficiency and provide a more preferable/satisfactory experience for pts.
Trends in multimodality therapy for gastric cancer post-MAGIC.
Authors: Yvonne Sada, Brandon George Smaglo, Hop Sanderson Tran Cao, Mehmet Akce, Henry Mok, Benjamin Leon Musher, Nader Nabile Massarweh
Journal: Journal of Clinical Oncology (2017)

148 Background: Althoughmultimodality therapy (MMT) is recommended for most patients with resectable gastric cancer, no single approach has been established as standard. As such, little is known about current national practice patterns and MMT treatment sequencing for patients with gastric cancer. Methods: This was a retrospective cohort study of ≥ T2 and/or node positive gastric cancer patients treated with MMT using the National Cancer Database (2006-2012). Patients were categorized based on type of MMT (chemotherapy, concurrent chemoradiation (cXRT), or both chemotherapy and cXRT) and treatment sequence (preoperative, postoperative, or perioperative). Accuracy of pre-treatment clinical nodal staging was ascertained by comparison to pathologic nodal staging in patients treated with upfront surgery. Multivariable Cox regression was used to evaluate the association between overall risk of death and MMT type and sequence. Results: Among 4,857 patients, 14.1% were treated perioperatively, 48.0% preoperatively, and 37.9% postoperatively. Rates of chemotherapy, cXRT, and both chemotherapy and cXRT were 32.1%, 53.4%, and 14.5%. Among patients treated with upfront surgery, sensitivity, specificity, PPV, and NPV of clinical nodal staging were 70.7%, 88.8%, 92.1%, and 62.2%, respectively. Over the study period, use of cXRT decreased (61.8% 2006 vs 52.0% 2012; trend test, p &lt; 0.001) while use of chemotherapy increased (23.6% vs 35.7%; trend test, p &lt; 0.001) and use of both chemotherapy and cXRT did not change. There was an increase in the use of perioperative treatment (8.1% vs 17.4%; trend test, p &lt; 0.001) while postoperative treatment decreased (44.4% vs 31.1%; trend test, p &lt; 0.001). After multivariable modeling, neither type of MMT nor treatment sequence was associated with risk of death. Conclusions: Although current national practice patterns favor pre- and perioperative treatment, one third of patients were treated with upfront surgery. Survival was not associated with MMT type or sequence. However, given the high false negative rate of clinical nodal staging and high non-completion rate of postoperative treatment (50% in MAGIC trial), efforts to improve gastric cancer outcomes should focus on increasing use of preoperative therapy.
Interactive voice response system compliance in chronic myeloid leukemiapopulation.
Authors: Araceli Garcia-Gonzalez, Patricia Ault, Loretta A. Williams, Janet L. Williams, Charles S. Cleeland, Jorge E. Cortes
Journal: Journal of Clinical Oncology (2012)

e19589 Background: Recent advances in telecommunication technology have created sophisticated systems to support and evaluate chronic disease. The telephone-based interactive voice response system (IVRS) is a simple method of delivering specific health information to patients and allowing them to interact with care providers. The IVRS has been used to monitor chronic conditions such as cancer, diabetes, asthma, hypertension, and psychiatric disorders. Our study aimed to evaluate patient adherence to routine IVRS symptom assessment in chronic myeloid leukemia (CML). Methods: We conducted a longitudinal study in patients with a diagnosis of Philadelphia chromosome-positive CML treated at a tertiary cancer center. We collected IVRS data every 2 weeks for 6 months. Upon recruitment, patients were trained to use the IVRS and selected preferred days and times to receive IVRS calls. The IVRS asked patients to rate symptoms using the M. D. Anderson Symptom Inventory CML module (MDASI-CML), which assesses 20 symptom items and 6 interference items on a 0-10 scale (0 = not present and 10 = symptom as bad as you can imagine or complete intereference). Compliance equaled the number of answered IVRS calls divided by total calls for that patient. Univariate analysis examined associations between IVRS compliance and various demographic, clinical, and treatment variables. Results: Of 160 patients enrolled in the study, 12 withdrew and were excluded from analysis. Mean age of the sample was 51 years (SD 13.7); most were female (54%) and white non-Hispanic (74%). We collected 1,197 MDASI-CML assessments overall and found a 66% compliance rate. Almost one-third (29.7%) of the patients had 100% compliance; 10% answered no IVRS calls. IVRS compliance was statistically significantly associated with marital status (p=.016) and ethnic group (p=.045). Patients who were married or white were more likely to answer IVRS calls. Conclusions: 66% of our sample answered every IVRS call. The IVRS could be extremely useful for population survey research. It should be especially useful for assessing symptoms in chronic disease over time. More studies are needed to evaluate the utility of capturing symptom clinical trials status via the IVRS in the cancer population.
Phototherapy for Vitiligo
Authors: Jung Min Bae, Han Mi Jung, Bo Young Hong, Joo Hee Lee, Won Joon Choi, Ji Hae Lee, Gyong Moon Kim
Journal: JAMA Dermatology (2017)

References to the expected treatment response to phototherapy would be helpful in the management of vitiligo because phototherapy requires long treatment durations over several months.To estimate the treatment response of vitiligo to phototherapy.A comprehensive database search of MEDLINE, EMBASE, and the Cochrane library from inception to January 26, 2016, was performed for all prospective studies. The main keywords used were vitiligo, phototherapy, psoralen, PUVA, ultraviolet, NBUVB, and narrowband.All prospective studies reporting phototherapy outcome for at least 10 participants with generalized vitiligo were included. Of 319 studies initially identified, the full texts of 141 studies were assessed for eligibility, and 35 were finally included in the analysis. Of these, 29 studies included 1201 patients undergoing narrowband UV-B (NBUVB) phototherapy, and 9 included 227 patients undergoing psoralen-UV-A (PUVA) phototherapy.Two reviewers independently extracted the following data: study design, number and characteristics of the participants, phototherapy protocol, and rate of repigmentation based on the quartile scale. Single-arm meta-analyses were performed for the NBUVB and PUVA groups. Sample size-weighted means were calculated using a random-effects model for the repigmentation rates of the included studies.The primary outcomes were at least mild (≥25%), at least moderate (≥50%), and marked (≥75%) responses on a quartile scale. Response rates were calculated as the number of participants who showed the corresponding repigmentation divided by the number of all participants enrolled in the individual studies.The meta-analysis included 35 unique studies (1428 unique patients). For NBUVB phototherapy, an at least mild response occurred in 62.1% (95% CI, 46.9%-77.3%) of 130 patients in 3 studies at 3 months, 74.2% (95% CI, 68.5%-79.8%) of 232 patients in 11 studies at 6 months, and 75.0% (95% CI, 60.9%-89.2%) of 512 patients in 8 studies at 12 months. A marked response was achieved in 13.0% (95% CI, 2.1%-23.9%) of 106 patients in 2 studies at 3 months, 19.2% (95% CI, 11.4%-27.0%) of 266 patients in 13 studies at 6 months, and 35.7% (95% CI, 21.5%-49.9%) of 540 patients in 9 studies at 12 months. For PUVA phototherapy, an at least mild response occurred in 51.4% (95% CI, 28.1%-74.7%) of 103 patients in 4 studies at 6 months and 61.6% (95% CI, 20.2%-100%) of 72 patients in 3 studies at 12 months. In the subgroup analyses, marked responses were achieved on the face and neck in 44.2% (95% CI, 24.2%-64.2%), on the trunk in 26.1% (95% CI, 8.7%-43.5%), on the extremities in 17.3% (95% CI, 8.2%-26.5%), and on the hands and feet in none after at least 6 months of NBUVB phototherapy.Long-duration phototherapy should be encouraged to enhance the treatment response in vitiligo. The greatest response is anticipated on the face and neck.
Correlation of circulating IL-8 levels with improved overall survival in advanced pancreatic cancer patients in response to antisense OT-101 (trabedersen) therapy.
Authors: Vuong N. Trieu, Osmond D'Cruz, Sanjive Qazi, Kevin Ng, Larn Hwang
Journal: Journal of Clinical Oncology (2017)

444 Background: Overexpression of the transforming growth factor-beta 2 (TGF-β2) has been suggested as a pivotal factor for malignant progression of pancreatic cancer (PAC). OT-101 (Trabedersen) is a phosphorothioate antisense oligodeoxynucleotide target the human TGF-β2 mRNA. A Phase I/II study of OT-101 was characterized by outstanding overall survival (OS) in patients with advanced PAC. In this study, we examined the association between plasma levels of 31 cyto-/chemokines and OS outcomes in PAC patients treated with OT-101. Methods: Plasma levels of 31 cyto-/chemokine were tracked over a period of 11 days at 8 time points during 3 cycles of intravenous OT-101 therapy (140 mg/m 2 /day) for 12 PAC patients. A mixed ANCOVA model was developed to time evolution of 19 cyto-/chemokine levels with median expression 1 following OT-101 therapy. Pearson pairwise correlation coefficients of cyto-/chemokine levels across all time points and all patients were utilized to construct a correlation cluster to identify co-regulated cyto-/chemokines. Regression and hierarchical cluster analyses were performed to identify potential cytokine signatures. Protein-protein interaction networks were constructed using STRING10 algorithm. Plasma cyto-/chemokine levels were compared with OS outcome. Results: Three highly correlated subsets of cyto-/chemokines (Cluster 1: EGF, MIP-1α, MIP-1b; Cluster 2: FGF-2, IL-1R, MIG, IP-10, IL-15, IFN-α, IL-12A; Cluster 3: IL-2R, IL-6, IL-8, HGF) were identified following OT-101 therapy. An increasing trend was observed among 13 cytokines. 4 of the 12 patients exhibited a consistent increase in MIP-1α and IL-1b. Suppression of TGF-b signaling by OT-101 led to upregulation of IL-15, IP-10 and HGF. 3 significant associations of cyto-/chemokine and OS were observed at Cycle 1 measurements. The ANCOVA model that examined the levels of 31 cyto-/chemokines with OS as the co-variate resulted in IL-8 exhibiting a significant positive association with OS ( P= 0.0039). Conclusions: Levels of IL-8 were positively associated with OS across 12 PAC patients serving as potential biomarkers for treatment outcome following OT-101 therapy. Clinical trial information: NCT00844064.
The prevalence and prognostic relevance of PD-L1 expression in patients with HPV-negative and HPV-positive oropharyngeal cancer.
Authors: Hae Su Kim, Jun soo Ham, Seonggyu Byeon, Hee Kyung Kim, Ji Yun Lee, Min-Young Lee, Sung Hee Lim, Jong-Mu Sun, Keunchil Park, Chung-Hwan Baek, HanSin Jeoung, young-Ik Son, Mineui Hong, Young-Hyeh Ko, Yong Chan Ahn, Myung-Ju Ahn
Journal: Journal of Clinical Oncology (2015)

e14003 Background: Human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma of head and neck is an immunosuppressive malignancy. In head and neck squamous cell carcinoma (HNSCC), various mechanisms have been proposed for the immune escape including immune checkpoint receptors such as PD-1/PD-L1. In this study, we investigated the expression of PD-L1 in HPV-negative and HPV-positive oropharyngeal cancer to determine its prevalence and prognostic relevance. Methods: The expression of PD-L1 was evaluated by immunohistochemistry in 135 specimens of oropharyngeal cancer. A minimum of 20 % tumor cells stained considered positive for PD-L1 expression.HPV-positive tumor was defined as a tumor for which p16 expression was stained in 70 % or more of the tumor cells. Results: The median age of patients was 57 years (range: 35-80), and most of patients were male (90.4 %). Ever smokers were account for 62 % of patients, and most common site of primary tumor was tonsil(78 %). Patient had received CCRT (72 %) or curative surgical resection (28 %). PD-L1 expression was noted in 92 of the 135 patients (68 %). A total of 91 (67 %) patients were positive for p16 expression by immunohistochemistry. There was no significant difference in PD-L1 expression between HPV(-) and HPV(+) tumor (61.4 % vs 71.4 %, p= 0.239). There was no statistically significant difference in the distribution of gender, age, subtype of oropharyngeal cancer, or smoking according to PD-L1 status. With median 43.6 months follow-up, older age (p= 0.070) and T4 stage (p= 0.041) was associated with poor overall survival, while PD-L1 expression was not associated with patients outcome (p = 0.827). Conclusions: PD-L1 expression was found in majority of oropharyngeal cancer patients regardless of HPV status. Further clinical studies with immune checkpoint inhibitors should be warranted both in HPV(-) and HPV(+) oropharyngeal cancer.
NP model of survivorship care: Lessons learned.
Authors: Gretchen Dawson, Stacy Wentworth
Journal: Journal of Clinical Oncology (2017)

26 Background: The number of cancer survivors is expected to reach 20 million by 2026. As patient volumes increase, oncologists are tasked with seeing more patients, often allowing less time for survivorship-related concerns. In an effort to address this issue, nurse practitioners (NPs) are equipped to aid survivors by managing late/long-term side effects of treatment, monitor for recurrence, provide survivorship care plan (SCP), and promote overall health and wellness. Methods: When initiating a survivorship program, our community cancer center utilized survivorship nurse practitioners (SNP) to address increasing patient volumes and patients’ survivorship issues. By beginning with breast cancer survivors, we were able to meet patients prospectively at diagnosis to provide support and introduce survivorship. SNP later saw patients in designated Survivorship Clinic, after completing treatment and in long-term survivorship to address physical/psychosocial concerns, place appropriate referrals, and promote overall wellness. Collaboration with local Primary Care Providers (PCP) was integral for the long-term care of survivors. Results: In 9 months, prospective data collection surveys helped to better understand patients’ needs, allocation of appropriate resources, and measure patient empowerment. Collaboration with EMR team helped address patient volumes and workflow. Future collaboration of survivors’ healthcare needs with PCP was done by routing 162 completed SCPs to patient-designated PCP and mailing over 185 survivorship program introduction letters to community PCPs. Conclusions: Meeting patients prospectively aided in promoting the importance of survivorship helped provide evaluation of our survivorship program’s growth and development. However, patients introduced to survivorship at diagnosis required a formal referral at the completion of treatment, which disrupted workflow. Collaborating with EMR team to develop survivorship referrals, survivorship clinic templates, and SCP reports were important. Continued work with PCPs will be integral to future success. NPs provide survivorship-focused care in the oncology setting, while meeting continued demands of a growing cancer survivorship patient population.