tbuckley/cabot-search huggingface dataset:
Are men with favorable intermediate-risk prostate cancer candidates for active surveillance?
Authors: Ann Caroline Raldow, Danjie Zhang, Ming-Hui Chen, Michelle H. Braccioforte, Brian Joseph Moran, Anthony Victor D'Amico
Journal: Journal of Clinical Oncology (2015)

82 Background: Active surveillance (AS) is considered appropriate for patients with low-risk prostate cancer (PC) and a life expectancy of at least 10 years. However, with grade migration following the 2005 International Society of Urologic Pathology consensus conference, AS may also be an initial option for men with favorable intermediate-risk PC. We estimated and compared the risk of PC-specific mortality (PCSM) following high dose radiation therapy and androgen deprivation therapy as appropriate amongst men with low, favorable intermediate, unfavorable intermediate, and high-risk PC. Methods: The study consisted of 6,595 consecutively treated men (median age: 68 years) with localized or locally advanced PC at the Chicago PC Center between 1997 and 2013. Fine and Gray competing risks regression analyses (table) were used to assess the risk of PCSM in men with favorable intermediate, unfavorable intermediate or high-risk compared to low-risk PC, adjusting for age at and year of treatment. Results: After median follow-up of 7.76 years, 820 men died: 72 of PC. While men with favorable intermediate-risk did not have significantly increased risk of PCSM as compared to low-risk PC (adjusted hazard ratio (HR) 1.28, 0.63-2.62 95% confidence interval (CI), p-value 0.49), men with high (adjusted HR 9.91, 5.48-17.94 95% CI, p-value &lt;0.0001) or unfavorable intermediate-risk PC (adjusted HR 3.17, 1.60-6.30, p-value 0.001) did. Eight-year point estimates of PCSM were low: 0.68% [0.32-1.31% 95% CI] and 0.44% [0.25-0.75% 95% CI] for men with favorable intermediate and low-risk PC, respectively. Conclusions: Men with low and favorable intermediate-risk PC have similar and low estimates of PCSM during the first decade following standard management. These results provide evidence to support AS as an initial approach for men with favorable intermediate-risk PC. [Table: see text]
Treatment and Clinical Outcomes of High Grade B-Cell Lymphomas with MYC and BCL2 and/or BCL6 Rearrangements (Double Hit/Triple Hit Lymphomas)
Authors: Thomas M. Habermann, William R. Macon, Matthew J Maurer, Rhett P. Ketterling, Paul J Kurtin, Andrew L Feldman, Rakhee Vaidya, James R Cerhan, Stephen Ansell, Luis Porrata, Grzegorz S. Nowakowski, Thomas E. Witzig, Ellen D. McPhail
Journal: Blood (2016)
Zinc Protoporphyrin/Heme: A Low-Cost Biomarker of Iron Deficiency Among HIV-Infected Children in a Resource Limited Setting,
Authors: Prasanna Kumar Kapavarapu, Anita Shet, Faye Marlene Pais, Karthika Kumar, Shubha K, Anish Sharda, Arun S. Shet
Journal: Blood (2011)
Adaptive planning study of “plan of the day” versus “composite planning” for muscle-invasive bladder cancer (MIBC).
Authors: David E McIntosh, Gareth Webster, Julia Stratford, Apurna Jegannathen, Richard Cowan, John P. Logue, James Wylie, Jacqueline E. Livsey, P. Anthony Elliott, Ananya Choudhury
Journal: Journal of Clinical Oncology (2012)

309 Background: Bladder motion during treatment can be considerable resulting in either inadequate coverage of planning target volume (PTV) or significant overdose to organs at risk (OAR). Adaptive radiotherapy planning using either “plan of the day” or “composite planning” may offer a method to reduce PTV, while optimizing the clinical target volume (CTV) coverage and reducing the dose to OAR. Methods: Patients were planned using a radiotherapy CT planning scan (RTP). CTV was defined as whole bladder and this was expanded by 1.5 cm to form the PTV. PTV was treated to 52.5 Gy in 20 fractions over 4 weeks. Off line correction was performed using cone beam imaging (XVI) taken on days 1-3 and weekly thereafter, as a minimum. We performed a retrospective planning study on 8 patients treated for MIBC. For “plan of the day,” 4 separate plans were created by expanding the superior CTV margin by 0.5 cm, 1 cm, 1.5 cm, or 2 cm. All other margins were 1.5 cm in all directions. Composite plans were created from the CTV drawn on the first 3 XVIs. This composite CTV was grown by 5mm to create PTV1 and by 10mm to create PTV2. Subsequent XVIs were assessed to determine if the CTV was encompassed by the 95% isodose for each plan. We compared the PTV for each plan with the standard RTP volume. Results: Preliminary data reveal that the composite plan using a 10mm margin resulted in adequate coverage for all remaining treatments as assessed by XVI. The composite plan with a 5mm margin failed to adequately cover the CTV. Using the composite plan with a 10mm margin the PTV is decreased by a mean of 27.5% compared with conventional planning. Plan of the day resulted in a mean decrease in PTV of 17.0%. Conclusions: This data suggests a potential advantage of adaptive planning with both techniques showing a reduction in PTV compared with conventional planning. This could lead to an associated reduction in dose and toxicity to OAR. Composite planning with a 10mm margin showed the greatest benefit in terms of reduced irradiated volume while adequately covering the CTV. Further studies are needed to investigate any effect on toxicity due to reduced dose to OAR.
Prognostic significance of cyclooxygenase-2 (COX-2) expression in young Korean patients with invasive breast carcinoma
Authors: D. H. Choi, E. S. Kim, Y. H. Kim, M. H. Lee, S. Y. Jin, D. W. Lee, H. S. Park
Journal: Journal of Clinical Oncology (2005)

829 Background: The proportion of early-onset breast carcinoma is high in Korea. We evaluated COX-2 expression, roles of prognostic significance and association with other clinicopathologic parameters in Korean patients with early-onset, invasive breast carcinoma. Methods: Paraffin embedded tissue samples were selected from 175 Korean patients with invasive breast carcinoma, at the age 45 or younger. The patients had undergone curative surgery between 1993 and 2002 and received adjuvant therapy according to clinicopathologic status and median follow-up was 58 months. Samples were immunohistochemically stained with antibodies to COX-2 and the expression was then related to clinicopathologic parameters and follow-up data. Results: COX-2 expression was detected in 58 of the 175 (33.1%) invasive carcinoma studied. COX-2 positivity was correlated with tumor size, axillary lymph node status and estrogen receptor negativity (p<0.05). The 5-year disease free survival for patients with COX-2 negative and positive staining were 87.0% and 69.0%, respectively (p=0.0167). In a multivariate analysis, expression of COX-2 was of borderline significance for disease free survival (relative risk, 2.09; 95% confidence interval, 0.95–4.60), adjusting for tumor size, histologic grade, number of positive lymph node, hormone receptor status, and patients age. Conclusions: Our data suggest that COX-2 expression may play an important role in the progression of Korean patients with early-onset breast carcinoma. No significant financial relationships to disclose.
Molecular profiling of liposarcoma subtypes
Authors: S. Singer, N. D. Socci, E. Sambol, R. O’Conner, P. Eckle, R. Geha, R. G. Maki, C. Sander, C. R. Antonescu
Journal: Journal of Clinical Oncology (2005)

9016 Background: Liposarcoma (LS) is a heterogeneous group of tumors comprising 5 pathologic subtypes: well-differentiated (WD), dedifferentiated (DD), myxoid (MY), round cell (RC), and pleomorphic (PL). Assessment of pathologic diagnosis and grade remain often a challenge. Our aim was to define the expression profiles of a group of LS to better understand their histogenesis, to identify differentially expressed genes specific for each LS subtype, in order to determine if their genetic signatures can be used for classification and diagnosis. Methods: 69 liposarcoma (13WD, 20 DD, 19 MY, 9 RC, and 8 PL) and 9 normal fat tissue samples were studied using the Affymetrix oligonucleotide platform (U133A chip). Data analysis was performed using both unsupervised and supervised clustering approaches. A multiclass support vector machine (SVM)-based classifier was applied, using a leave one out cross validation method to predict the class of the withheld sample. Results: An unsupervised hierarchical clustering showed that the liposarcoma subtypes form discrete clusters. MY/RC liposarcomas formed a distinct cluster from other subtypes. Although the majority of the WD samples separated from normal fat, a few WD tumors grouped with DD liposarcoma. PL liposarcomas clustered distinctly from the DD liposarcoma subtype. A multiclass SVM-based classifier for liposarcoma subtype/normal fat was applied on all 78 samples. Table 1. shows the percentage of samples correctly classified as a function of the number of genes used per paired classifier. Conclusions: Liposarcoma subtypes are associated with distinct gene expression profiles and grouped in distinct genomic clusters by unsupervised learning methods. The SVM algorithm supported a genomic basis for diagnosis, with both high sensitivity and specificity. The genes differentially expressed for each liposarcoma subtype compared to normal fat are subtype specific and may serve as potential novel therapeutic targets. No significant financial relationships to disclose.
Diagnostic and therapeutic significance of the cerebrospinal fluid (CSF) EGFR mutation analysis for the patients with NSCLC suffering meningitis carcinomatosa harboring active EGFR mutation, after gefitinib therapy failure.
Authors: S. Sasaki, Y. Yoshioka, R. Ko, Y. Katsura, Y. Namba, K. Koike, M. Yoshioka, S. Tominaga
Journal: Journal of Clinical Oncology (2011)

10608 Background: After discovery of the active EGFR mutation as an addictive oncogene of NSCLC patients, tyrosine kinase inhibitors (TKIs) have been widely indicated for such patients. However, despite initial excellent remission, every patient should get into recurrence within one or two years. Meningitis is one of the major recurrent forms, which is difficult to be diagnosed and managed. We have analyzed the EGFR mutation (including T790M resistance mutation) of the CSF from meningeal relapsed patients, and evaluated its usefulness in terms of the diagnostic and treatment strategy. Methods: Six gefitinib failure cases of NSCLC patients harboring active EGFR mutation, suffering from symptom of meningitis (Table). Patients' CSF were examined both cytology and EGFR mutation analysis by Cycleave PCR method. Moreover, we evaluated the efficacy of erlotinib for the patients who not yet had the T790M resistance mutation in their CSF. Results: In all of the six cases, we could detect an EGFR mutation just same as the primary site, never additional T790M mutation, in their CSF. Interestingly, the cytology was positive in only three patients. Moreover, we administered erlotinib to five cases and resulting could have, temporary however, good efficacy. Conclusions: The EGFR mutation analysis of the CSF could contribute not only to the diagnosis of the meningitis carcinomatosa, but also to the decision making in terms of the indication of erlotinib for the NSCLC patients harboring EGFR mutation. Case Age Gender EGFR mutation CSF mutation Additional T790M CSF cytology Erlotinib efficacy 1 56 F Exon19 deletion Positive No Negative Yes 2 67 F Exon19 deletion Positive No Negative Yes 3 42 F Exon19 deletion Positive No Positive ND 4 54 F Exon19 deletion Positive No Positive Yes 5 65 F Exon21 L858R Positive No Negative Yes 6 54 F Exon21 L858R Positive No Positive Yes
Capecitabine maintenance therapy after adjuvant chemotherapy of FOLFOX (or XELOX) in patients with stage IIIC or R0 resected stage IV colorectal cancer (CAMCO study).
Authors: Jiayu Ling, Wenjing Wang, Shanshan Li, Yue Cai, Huabin Hu, Yanhong Deng
Journal: Journal of Clinical Oncology (2016)

TPS781 Background: Surgical resection and adjuvant therapy has become the main treatment for resectable colorectal cancer (CRC). Treatment with current strategies, however, recurrent rate is high for stage IIIc or R0 resected stage IV CRC (high risk-CRC). For some other maglinancies with high risk of recurrence, such as gastric cancer or high-risk gastrointestinal stromal tumor, longer period of postoperative chemotherapy was applied. The effectiveness of maintenance therapy following standard adjuvant chemotherapy in high risk-CRC has not been verified in clinical trial. Capecitabine is is an orally-administered chemotherapeutic agent used in the treatment of CRC, either as neoadjuvant therapy with radiation, adjuvant therapy or for metastatic cases. This study is exploring the efficacy and safety of strategy of surgical resection and adjuvant chemotherapy followed by maintenance capecitabine for stage IIIC or R0 resected stage IV CRC. Methods: The study was designed as an open-label phase II trial with 200 patients assigned to two thearapy group: experimental arm A (Adjuvant chemotherapy with mFOLFOX6 or XELOX for more than four months + oral capecitabine 1000mg/m2 twice daily days1-14 every 3 weeks for 12 months maintenance) or standard arm B (Adjuvant chemotherapy with mFOLFOX6 or XELOX for more than four months + observation). Eligibility included patients of 18-80 years of age, diagnosis of adenocarcinoma of the colon or rectum, received curative resection when diagnosed, with postoperative stage of IIIC OR IV(R0 resected), PS 0-1 and adequate organ function. Doses were modified for hand-foot syndrome, diarrhea and other grade 3 toxicities. The primary aim is to evaluate the 3 year disease free survival of the patients. Secondary aims inclued overall survival, safety, quality of life and an assessment of predictive molecular markers of maintenance strategy. After completion of adjuvant treatment, patients are followed every 3 months for 2 years, and then every 6 months for 3rd-5th years. This study is now open to accrual in The Sixth Affiliated Hospital of Sun Yat-sen University. Clinical trial information: NCT01880658. Clinical trial information: NCT01880658.
What studies are appropriate and necessary for staging gastric cancer? Results of a RAND/UCLA expert panel.
Authors: Matthew Dixon, Roberta Cardoso, Jill Tinmouth, Lucy K. Helyer, Calvin Law, Carol Jane Swallow, Lawrence Frank Paszat, Robin S. McLeod, Rajini Seevaratnam, Alyson L. Mahar, Natalie G. Coburn
Journal: Journal of Clinical Oncology (2012)

15 Background: The approach for staging gastric cancer (GC) patients has not been well defined, resulting in widespread heterogeneity in the application of pre-operative staging modalities. Methods: A multi-disciplinary expert panel of 16 physicians from 6 countries scored 84 scenarios using the RAND/UCLA Appropriateness Methodology. Appropriateness was scored from 1 (highly inappropriate) to 9 (highly appropriate). Median appropriateness scores (AS) from 1-3 were considered inappropriate, 4-6 uncertain, and 7-9, appropriate. Agreement was reached when 11 of 16 panelists scored the scenario similarly. If a scenario was agreed to be appropriate, it was given a necessity score (NS) in the same manner. AS and NS are reported if agreed upon. Results: TNM staging should be determined pre-operatively (AS 7.0-9.0; NS 7.0-9.0). Pre-operative radiological assessment should include a computed tomography (CT)−abdomen, CT−pelvis, and should be performed with a multi−detector CT scanner with 5 mm slices (AS 8.0−9.0; NS 7.0−9.0). A CT Chest may be performed (AS 7.5). The utility of a chest radiograph was indeterminate. All patients should have a pre-operative esophagogastroduodenoscopy (EGD). The endoscopist should biopsy the tumor; document its size, description, location, distance from the GE junction, and any GE junction, esophageal or duodenal involvement. If the EGD report is unclear, the surgeon should repeat it to confirm tumor location (AS 7.5-9.0, NS 7.0−9.0). Endoscopic ultrasound is appropriate prior to endoscopic resection, but not surgical resection (AS 9.0). Diagnostic laparoscopy (DL) should be performed prior to resection of cT3,4 lesions, or multi−visceral resections. DL should include visual inspection of the stomach, diaphragm, liver, and ovaries (AS 8.0−9.0, NS 7.0−9.0). Conclusions: The Gastric Cancer Processes of Care expert panel has made recommendations regarding pre−operative staging modalities in an effort to standardize work up. Standardization could lead to more accurate staging and allocation towards optimal stage−specific treatments.
Use of a fever fast track tool to reduce time to antibiotic dose in febrile pediatric oncology patients.
Authors: Prasanna Ananth, Natasha Archer, Natalie Bucheimer Collins, Stacy Croteau, Andrew Lee Hong, Junne Kamihara, Dan Kim, Kelly Kort, Robert Mersereau, Sara Mosadegh, Amy Billett
Journal: Journal of Clinical Oncology (2014)

222 Background: Given the risk of serious bacterial infection in immunocompromised cancer patients, fever should be promptly treated with empiric antibiotics. Our institutional standard is to administer antibiotics in ≤ 60 minutes from on-site fever or from arrival time with known fever. Review of our febrile outpatient pediatric oncology clinic patients from October-December 2013 revealed that 53% met this metric. Our aim: To achieve a sustained rate of 80% of febrile patients receiving antibiotics in ≤ 60 minutes within 8 weeks. Methods: We developed and implemented a fever fast track tool in our pediatric oncology clinic. Providers time stamped each step in the process from fever to antibiotic administration; additional time points were collected from the medical record. Interviews with staff were conducted to identify barriers. Five revisions of the fever fast track tool were made. We also streamlined same-day encounters for febrile patients in order to flag their acute visits and facilitate pre-arrival order entry. Results: 21 patients were treated for fever between 2/26/14 and 4/17/14. 4 fevers were documented in clinic. Time to antibiotics ranged from 23 minutes to 165 minutes. The median time to antibiotic administration was reduced from 58 minutes during the first four weeks to 40 minutes after the second 4-week block. Over the same period, patients receiving antibiotics in ≤ 60 minutes increased from 62% to 88%. Conclusions: Use of a fever fast track tool improved the proportion of febrile patients receiving antibiotics in ≤ 60 minutes. Modifications facilitating antibiotic order entry and pre-arrival awareness of febrile patients should prove helpful in sustaining this success.
Mapatumumab, A TRAIL Receptor 1 Agonist Antibody, Induces Apoptosis in Bortezomib Resistant Multiple Myeloma.
Authors: Pushpankur Ghoshal, Kasyapa Chitta, Slavoljub Vujcic, Jacquelyne Gaddy, Kiersten M. Miles, Leighton Stein, Taimur Sher, Kelvin P. Lee, Asher A. Chanan-Khan
Journal: Blood (2009)
Benefits and adverse events (AEs) in younger (Y) (age &lt;50) versus older patients (pts) receiving adjuvant chemotherapy (AT) for colon cancer (CC): Findings from the 33,574 pt ACCENT dataset.
Authors: D. J. Sargent, G. A. Yothers, E. Green, C. D. Blanke, M. J. O'Connell, R. Labianca, A. Bleyer, A. De Gramont, D. M. Thomas
Journal: Journal of Clinical Oncology (2010)

3523 Background: Limited data exists regarding outcomes and AT benefit/toxicity in Y pts with stage II and III CC. We examined overall survival (OS), disease-free survival (DFS), recurrence-free interval (RFI) and AEs in the 33,574 pt ACCENT dataset. Methods: Individual pt data from 24 randomized phase III clinical trials (CT) was obtained for survival outcomes, and 10 CT for AE outcomes. Two age-based cutoffs were used to define Y pts, age < 40 and < 50. Cox models stratified by study and adjusted for gender and stage. AT benefit analyses were limited to 9 CT testing 5-FU/LV or Lev vs control (7 CT) or oxaliplatin+5-FU/LV vs 5-FU/LV (2 CT). Results: 1,758 (5.2%) pts were age < 40; 5,817 (17.3%) were < 50; only 299 (0.9%) were age < 30. No differences in gender or stage were present in Y vs older pts. Y and older pts did not differ in RFI (HR=1.02 for each age cutpoint, p≥0.35). Y pts had improved OS and DFS (Table), even when restricting to age < 50 vs 50-60 (HR = 1.08, p=0.0061 for DFS comparing < 50 to 50-59). In trials demonstrating AT benefit, similar benefit was observed in Y and older pts (DFS HR for AT benefit 0.66 for pts < 50, 0.76 for pts ≥50, interaction p=0.19). No clinically meaningful differences in AEs were observed between ages. Conclusions: Among pts on CT, Y (age 30-50) stage II and III CC pts had similar RFI and AT benefit as older pts, with no clinically meaningful differences in AEs. Y pts have improved OS and DFS, likely primarily due to fewer competing causes of death. Adjuvant therapy is beneficial for CC pts aged 30-50 meeting typical CT eligibility criteria. Efficacy endpoint Age <40 Age ≥40 HR (95% CI) P value Age <50 Age ≥50 HR (95% CI) P value 5yr OS 75% 71% 1.31 (1.20-1.44) <0.001 76% 71% 1.33 (1.26-1.40) <0.001 5yr DFS 68% 63% 1.18 (1.09-1.29) <0.001 68% 63% 1.19 (1.13-1.25) <0.001 5yr RFI 68% 67% 1.02 (0.94-1.13) 0.62 67% 67% 1.02 (0.97-1.08) 0.35 AE endpoint (grade ≥ 3) OR (95% CI) OR (95% CI) Diarrhea 15% 16% 1.08 (0.78-1.52) 0.68 15% 16% 1.15 (0.94-1.41) 0.19 Leukopenia 3% 8% 2.82 (1.12-4.66) 0.02 4% 8% 1.89 (1.30-2.74) 0.007 Stomatitis 6% 9% 1.71 (0.97-3.01) 0.06 6% 10% 1.60 (1.17-2.17) 0.003 Nausea/vomiting 10% 7% 0.64 (0.42-0.98) 0.04 8% 7% 0.80 (0.60-1.05) 0.11 No significant financial relationships to disclose.
A province-wide retrospective comparison of pathologic response and progression-free survival in locally advanced esophagus cancer patients treated with either cisplatin-5FU (CF) or carboplatin-paclitaxel (CP) concurrent with radiation (XRT) with or without surgery.
Authors: Devin Schellenberg, Renata Peixoto, Andrea Lee, Howard John Lim
Journal: Journal of Clinical Oncology (2014)

107 Background: The 2012 CROSS trial demonstrated an overall survival (OS) benefit for neoadjuvant, concurrent Carboplatin-Paclitaxel (CP) and radiation versus surgery alone. Based on this trial, the standard chemotherapy treatment for locally advanced esophageal (LAE) cancer in British Columbia (BC) became CP instead of Cisplatin-5FU (CF). This study evaluates the pCR rates and progression free survival (PFS) of those patients treated immediately prior and immediately after the change in provincial standard. Methods: All BC patients with LAE cancer diagnosed between February 2010 and February 2013 who completed at least 40 Gy of neoadjuvant radiation were analyzed. Standard demographics, chemotherapy delivered, radiation dose, surgical pathology and follow-up data were collected. Pathologic response was compared by chi-squared analysis. Patients were followed until death or last follow-up. Survival was compared by log-rank test. Results: Seventy-three patients received CF and 39 received CP. The tumor characteristics of the subgroups were similar: squamous histology was 57% (CF) vs. 49% (CP), node positivity rate on pre-treatment PET scan was 66 vs. 67%, and median tumor length was 5.7 vs. 5.8 cm. Median radiation dose was 50 Gy in both arms. The CP arm was slightly older (Median 66 vs. 61 yo) and had a greater percentage of males (80% vs. 57%). Forty eight and 49% percent of patients were able to undergo resection. The pCR rates were 49% (CF) vs. 16% (CP) (p&lt;0.01) in the surgical subgroups. Median FU was 14.5 (CF) vs. 9.3 (CP) months. Median PFS for all patients was 16.5 (CF) and 14.6 (CP) (p=0.44). Median PFS in surgical patients was 23.4 months (CF) and 14.6 months (CP) (p=0.16. Conclusions: In patients with similar tumor characteristics, XRT with CF resulted in greater pCR rates than with CP. The pCR rate in the CP subgroup is lower than the 29% seen in the trial. With relatively short follow-up, no difference in PFS has yet been identified. [Table: see text]