tbuckley/cabot-search huggingface dataset:
The prevalence and burden of cancer symptoms among underserved Chinese American patients.
Authors: Lara Dhingra, Kin Y. Lam, William Cheung, Theresa Shao, Victor Tsu-Shih Chang, Jack Chen, Sabrina Cheng, Vanessa Li, Wan Lam, Selina Chan, Marilyn Bookbinder, Graciete Lo, Russell Portenoy
Journal: Journal of Clinical Oncology (2012)

106 Background: Chinese Americans are the largest Asian subgroup in the U.S., and many are recent immigrants with high rates of cancer, a leading cause of death for this population. Although Chinese American patients frequently present with advanced illness and poorly controlled pain, information on symptom burden in this population is very limited. As part of an ongoing community study to test the effectiveness of a rapid-cycle quality improvement (QI) intervention to enhance symptom management, we evaluated the prevalence and burden of cancer symptoms in a large sample of first-generation, non-English speaking, ethnic Chinese patients. Methods: A consecutive sample of Chinese American patients in two large community-based oncology practices and one hospital-based practice in New York were screened for cancer symptoms. Eligible adults who self-identified as ethnic Chinese, spoke Cantonese or Mandarin as their primary language, and had a history of cancer completed translated instruments assessing symptom prevalence, severity, and distress administered by bilingual research assistants. The study was approved by the IRB at Beth Israel Medical Center in New York. Results: Of 1,018 cancer patients screened to date (62.2% women; M age = 64.0 years (SD = 13.7, range = 23 to 101); 20.6% reported persistent cancer pain for the past month. The most common cancers were breast (34.3%) lung (12.6%), and head and neck (11.8%) and 41.9% were undergoing active treatment. The mean worst pain intensity on a 0-10 numeric scale was 5.5 (SD = 2.2), with 34.4% rating their worst pain as &gt; 6 of 10. Many (84.5%) reported other symptoms, including fatigue (54.4%), dry mouth (52.4%), difficulty sleeping (44.8%), and drowsiness (37.5%). Overall, 32.7% rated their symptoms as “quite a bit” or “very much” distressing, with sleep disturbance (33.1%), lack of appetite (31.3%), and constipation (29.2%) causing the most severe distress. Conclusions: Symptom burden is high among community-dwelling, economically-disadvantaged ethnic Chinese cancer patients. Our ongoing QI intervention may alleviate the high symptom rate in this population and clarify potential patient, provider, and system-related factors that are associated with symptom control outcomes.
Alternative Super-Enhancer States Determine MYC Sensitivity to Notch and Brd4 Inhibitors in T Lymphoblastic Leukemia/Lymphoma
Authors: Hongfang Wang, Yumi Yashiro-Ohtani, Chongzhi Zang, Yinling Joey Wong, Will Bailis, Birgit Knoechel, Bradley Bernstein, Steve Blacklow, X. Shirley Liu, Warren S. Pear, Jon C Aster
Journal: Blood (2014)
Assessment of macroscopic features in relation to tumor response to neoadjuvant chemoradiation therapy in rectal cancer.
Authors: Amanda Kathleen Arrington, Julio Garcia-Aguilar, Marjun Philip Duldulao, Carrie Luu, Julian Sanchez, Joseph Kim, Kristi Choy
Journal: Journal of Clinical Oncology (2013)

507 Background: Several studies show locally advanced rectal cancer patients with clinical complete response (cCR) have comparable oncologic outcomes to pathologic complete response (pCR) to neoadjuvant chemoradiation therapy (NCRT). Thus, total mesorectal excision (TME) could potentially be avoided. Our objective was to validate macroscopic features of cCR. Methods: 164 patients with stage II/III rectal cancer were previously enrolled in a phase II trial and treated by NCRT and TME. Tumor response in the surgical specimens was assessed according to AJCC guidelines. A pCR was defined as absence of viable tumor cells. Gross macroscopic features by the pathologist were tabulated and our cohort was applied to previously published cCR criteria. Results: 25.0% (n = 41) had pCR; 75.0% (n = 123) had non-pCR. Descriptors were condensed into 14 macroscopic features by combining terms and excluding those rarely mentioned. Several reports affirm that scarring signifies cCR, while others suggest that fibrosis, edema, ulceration and nonpalpable tumor to be consistent with cCR. In our study, scarring was found in 6.1% of patients, 16.7% of which had pCR. We found that hyperemia, scarring, flat, smooth, and tan-pink mucosa were significantly associated with pCR (p &lt; 0.05). In contrast, a firm lesion and ulceration were frequently observed in patients with non-pCR (p = 0.02 and 0.05 respectively). Conclusions: Our study suggests that macroscopic pathologic features do correlate with pCR. Although cCR has comparable oncologic outcomes as pCR with favorable outcomes, standard criteria of cCR should first be defined so NCRT patients can safely be selected for observation only. [Table: see text]
Impact of physician and center case volume on the adequacy of cardiac monitoring during adjuvant trastuzumab in breast cancer.
Authors: Alexander Kumachev, Nicolas J. Chin-Yee, Andrew Yan, George A. Tomlinson, Craig Earle, Maureen E. Trudeau, Dennis Ko, Monika K. Krzyzanowska, Raveen Pal, Christine B. Brezden, Scott Gavura, Kelly Lien, Kelvin K. Chan
Journal: Journal of Clinical Oncology (2013)

128 Background: A recent study suggests that cardiotoxicity from adjuvant trastuzumab (T-mab) is associated with inadequate cardiac monitoring (Ng et al. SABCS 2012). Few studies have examined the impact of centre or physician (MD) case volume (vol) on the quality of care in systemic therapy, including the adequacy of cardiac monitoring during T-mab treatment. Methods: All breast cancer patients treated with adjuvant T-mab in Ontario between 2003-2009 were identified through a provincial drug funding program. Patient demographics, hospitalizations, cardiac risk factors, cardiac imaging, comorbidities, treatment centres and MDs were ascertained. Annual case vol was calculated as the number of patients treated per year with adjuvant T-mab by each MD and centre. Cumulative case vol was calculated as the total number of patients treated with adjuvant T-mab. Centre and MD vol were divided into terciles (T1, T2 and T3) by the year of diagnosis. Inadequate cardiac monitoring was defined as per recent guidelines and per Ng et al. Hierarchical multivariable logistic regression models were constructed to examine factors associated with inadequate cardiac monitoring. Results: Our cohort consisted of 3,777 patients, 214 MDs and 68 centres. Of the total patients, 16.5% were over age 65; 30.3%, 9.4%, and 1.2% had previous diagnoses of hypertension, diabetes, and heart failure (HF), respectively; 24.3% did not receive adequate cardiac monitoring. Inadequate cardiac monitoring was associated with lower cumulative MD vol (T1: 27.9%, T2: 23.3%, T3: 20.8%, p &lt; 0.0001) and lower annual centre vol (T1: 32.5%, T2: 19.7%, T3: 20.7%, p &lt; 0.0001) in univariate analyses, and remained significant after adjusting for age, comorbidities, previous HF, socioeconomic status based on income, rural residence and calendar period. After adjusting for patient clustering at the MD, centre, and regional levels, lower cumulative MD vol (p=0.012), but not annual centre vol, remained a significant predictor for inadequate cardiac monitoring. Conclusions: Our findings suggest improved cardiac monitoring with greater MD experience, supporting the notion of centralization of systemic therapy to high vol MDs to optimize outcomes.
Quality improvement outcomes in an academic practice participating in ASCO’s Quality Oncology Practice Initiative (QOPI).
Authors: Mary Anne Fenton
Journal: Journal of Clinical Oncology (2012)

206 Background: The ASCO QOPI is an instrument for community and academic practices to assess quality and adherence to guidelines in areas of treatment planning and goals, chemotherapy consent documentation, smoking cessation, symptom control, palliative care, and disease specific measures. Following data submission QOPI summary reports for the submitting practice and QOPI aggregate are available for review and comparison. Methods: The academic practice of Rhode Island Hospital Comprehensive Cancer Center has participated in QOPI since the fall of 2008. QOPI measure summary reports for our practice and comparison to the Academic Aggregate are reviewed by our physicians after each round of chart abstraction, measures are identified for improvement. Interventions include education on practice improvement and development of policy and procedures for implementation by our Quality Control Officer in compliance with hospital policies. Results: Presented is a summary of quality improvement interventions implemented. Additional areas of quality improvement have been identified based on QOPI data, and improvement plans are ongoing including treatment summaries for patient and primary care physicians, tools to assess patient emotional well being, documentation of family history and referral for genetic assessment. Conclusions: QOPI provides a platform for collection, analysis and comparison of quality measures. For the measures of formulating a pain plan the intervention was a reminder to document the plan. For the measure hospice enrollment, a reflection on our hospice enrollment has lead to an increase in referral to palliative care. The ASCO QOPI program is a tool for quality improvement, our Quality Control Officer was essential in implementation of our improvement projects. [Table: see text]
A Phase II Open-Label, Multi-Center Study of Anti-CCR4 Monoclonal Antibody Mogamulizumab (KW-0761) in Patients with Previously Treated Peripheral T-Cell Lymphoma(PTCL)
Authors: Pier Luigi Zinzani, Bertrand Coiffier, John Radford, Dolores Caballero, Paul Fields, Martine ED Chamuleau, Francesco d'Amore, Corinne Haioun, Catherine Thieblemont, Eva González Barca, Carlos Grande García, Peter W Johnson, Gustaaf W van Imhoff, Andrew Saunders, Karen Dwyer, Franck Morschhauser
Journal: Blood (2014)
Adaptation of Augmented Berlin-Frankfurt-Munster (ABFM) Therapy in Adolescents and Young Adults with Acute Lymphoblastic Leukemia (ALL).
Authors: Michael Rytting, Deborah Thomas, Hagop Kantarjian, Jorge Cortes, Gautam Borthakur, William Wierda, Cesar Nunez, Steven Kornblau, Farhad Ravandi, Robert Wells, Muriera Brenda, Franklin Anna, Susan O’Brien
Journal: Blood (2007)
Nature of intrafractional and interfractional prostate motion during stereotactic radiation.
Authors: Karthikeyan Perumal, Mahadev Potharaju
Journal: Journal of Clinical Oncology (2016)

152 Background: To characterize the intra-fraction and inter-fraction prostate motion as tracked by the X-ray images of the implanted gold fiducials during stereotactic radiotherapy with CyberKnife. The published data have analysed the linear and angular prostate motion intrafraction and interfraction prostate motion among patients. We sought to quantify the same within each patient. Methods: Twenty Five patients with localized prostate cancer treated with CyberKnife radiosurgery between January 2013 and August 2015 were studied retrospectively. A data set constitutes the deviations derived from X-ray images obtained between two consecutive couch motions. Results: Included in the analysis were 3926 data sets. A total of 210 non-coplanar fields were used per fraction. The mean total treatment time for all fields per fraction was 36.13 minutes. The detected and corrected movements over all were in a range of ± 10.1 mm in linear direction (Right: mean 1.1±0.4 mm; Left: mean 1.0±0.6 mm; Superior: mean 0.7±0.3 mm; Inferior: mean 1.6±0.6 mm; Anterior: mean 1.6±0.7 mm; Posterior: mean 0.5±0.3 mm with maximum (max) movement range of Right max 9.9±6.4 mm, Left max 7.1±3.4 mm, Superior max 8.6±5.4 mm, Inferior max 10.1±8.5 mm, Anterior max 9.2±6.5 mm, Posterior max 8.4±2.9 mm) and angular movements were in a range of ± 6.7 deg in all directions (Right Angle: mean 0.6±0.3 deg; Left Angle: mean 0.6±0.3 deg; Head Up(H-U): mean 1.3±0.6 deg; Head Down(H-D): mean 1.4±0.6 deg; Counter-Clockwise movement (CCW): mean 0.7±0.3 deg; Clockwise movement (CW): mean 0.5±0.3 deg with max rotation range of Right angle max 2.4±2 deg, Left angle max 2.7±2 deg, H-U max 10.2±3.5 deg, H-D max 6.7±4.8 deg, CCW 4±2.9 deg, CW max 2.8±2.4 deg). There was an unpredictable change in prostate motion inter-fraction in each patient. But, a unique observation is that a predictable pattern exists for prostate motion intra-fraction within a patient. Change in the linear or angular prostate motion intra-fraction in any direction is not erratic. Conclusions: The linear and rotational prostate motion intra-fraction in any direction has a predictable pattern and any change is gradual and not erratic. The motion shows secular trend during the course of treatment.
Validation of a 12-gene colon cancer recurrence score (RS) in patients (pts) with stage II colon cancer (CC) from CALGB 9581.
Authors: A. P. Venook, D. Niedzwiecki, M. Lopatin, M. Lee, P. N. Friedman, W. Frankel, K. Clark-Langone, C. Yoshizawa, C. Millward, S. Shak, R. M. Goldberg, N. N. Mahmoud, R. L. Schilsky, M. M. Bertagnolli
Journal: Journal of Clinical Oncology (2011)

3518 Background: The 12-gene RS (Genomic Health, Inc.) has been shown to predict risk of recurrence in stage II colon cancer (CC) pts in QUASAR. We conducted a validation study in tumor specimens from pts enrolled in CALGB 9581, which found no difference for edrecolomab (MoAb 17-1A) v. observation in 1672 pts with, on average, low risk stage II CC (14% 5-yr recurrence.) Methods: Cohort sampling included all pts with available tissue and recurrence and random pts w/o recurrence (3:1 ratio). Gene expression was analyzed by RT-PCR using FFPE from primary tumor. Mismatch repair (MMR) protein status (D= Deficient; I= Intact) was assessed by IHC for MLH1 and MSH2. Primary aim: prognostic value of continuous RS alone and in presence of MMR and traditional clinical/pathologic prognostic variables. A weighted Cox proportional hazards model was used to test the association between RS and recurrence-free interval (RFI) based on a Wald-type test statistic constructed using a weighted partial likelihood estimate and robust variance estimate. Results: Tumor was available for 1361/1672 (81%) pts. RT-PCR was successful in 690 (162 recurrences) of 736 pts (21% MMR-D, 35% > 70 yrs old, 47% < 12 nodes.) The continuous RS was significantly associated with RFI in univariate analysis (hazard ratio (HR)/ 25 units, 1.52; 95% CI, 1.09-2.12; p=0.01). MMR-D was also associated with RFI (HR, 0.62; 95%CI, 0.39-0.99; p=0.04); # nodes examined and lymphovascular invasion (LVI) were borderline significant (both p=0.06). In a pre-specified multivariate analysis w/ MMR, T-stage, nodes examined, grade, and LVI, RS was the only significant predictor of recurrence (HR/25 units=1.68, 95%CI 1.18-2.38; p=0.004). Recurrence risk at 5 yrs increased as RS increased and among subgroups defined by T-stage and MMR. In pts with T3, MMR-I tumors (n=488) pre-specified low (44% of pts RS < 29), intermediate (33%), and high (22% w/ RS > 39) RS groups had average 5-yr recurrence risks of 13%, 16%, and 21%, respectively. Conclusions: In 9581, RS improves the ability to discriminate higher from lower recurrence risk stage II CC pts beyond known prognostic factors, particularly in T3, MMR-I pts where traditional factors like grade and LVI were not prognostic.
Comparative analysis of resected duodenal and ampullary adenocarcinoma.
Authors: Angelena Crown, Alicia M Edwards, Flavio G. Rocha, Vincent J. Picozzi, Scott Helton, Thomas R Biehl, Adnan Alseidi, Bruce S. Lin
Journal: Journal of Clinical Oncology (2016)

362 Background: Duodenal and ampullary adenocarcinomas are rare gastrointestinal cancers that share similar anatomic location and treatment strategy. We report a single-institution experience regarding the association between clinicopathologic features, treatment, and survival outcomes. Methods: A retrospective review of all patients resected with curative intent for duodenal adenocarcinoma (DUO) between 2005-2015 and ampullary adenocarcinoma (AMP) between 2011-2015 at VMMC was performed. For AMP, histologic subtyping into intestinal (IT) and pancreatobiliary (PB) phenotypes was determined. Demographic and clinicopathologic parameters were compared between DUO and AMP patients using Chi-square test. Overall survival was calculated using Kaplan-Meier analysis and prognostic factors were identified by univariate Cox regression. Results: Patients with DUO (n = 44) presented at higher T-stage (p = 0.002) and with larger tumors (4.35cm vs 2.33cm, p &lt; 0.001) than AMP patients (n = 46). DUO patients had a higher rate of surgical complications (68% vs 41%, p = 0.01) with a trend for more pancreatic fistulas (36% vs 20%, p = 0.08). There was no difference in median overall survival between groups. Factors positively influencing survival included Caucasian race (p = 0.02) and normal CA19-9 level at diagnosis (p = 0.01). Tumor factors negatively influencing survival included positive lymph nodes (p = 0.04), lymphovascular invasion (p = 0.001), and perineural invasion (p = 0.02). Within AMP, the PB subtype presented at higher T-stage (p = 0.01) and with more positive lymph nodes (p = 0.03) than IT. There was no difference in survival between subtypes. Majority received adjuvant chemotherapy (88.8% in AMP, 76.3% in DUO), fewer received adjuvant radiotherapy (23.3% in AMP, 30% in DUO), but no survival difference was seen. Conclusions: DUO presents with larger tumors and higher T-stage than AMP and is associated with more surgical complications. The PB phenotype has more advanced pathologic features than IT. No survival difference was seen between anatomic locations or subtypes. Better surgical and chemotherapeutic strategies may be needed to overcome high risk features. Longer follow-up with more patients is needed to confirm these findings.
A population pharmacokinetic analysis for BIBF 1120, an angiokinase inhibitor, in patients with advanced non-small-cell lung cancer (NSCLC)
Authors: M. Freiwald, K. Liesenfeld, R. Bruno, L. Hodge, P. Stopfer, C. Eschbach, M. Reck, J. von Pawel, R. Kaiser, A. Staab
Journal: Journal of Clinical Oncology (2008)

14528
Time trade-offs in advanced ovarian cancer.
Authors: Lari B. Wenzel, Dana B Mukamel, David E. Cohn, Laura Havrilesky, Alexi A. Wright, Joseph Lipscomb, Lisa Sparks, Heather Ladd, Kathryn Osann
Journal: Journal of Clinical Oncology (2016)

20 Background: Most women with advanced ovarian cancer develop recurrence and die within five years of diagnosis. This creates a clinical imperative to discuss tradeoffs between the risks and benefits of treatment options. The purpose of this study is to examine the experience of ovarian cancer patients presented with a decision aid leading them through a time-tradeoff (TTO) exercise to guide choice of therapy. Methods: Newly diagnosed advanced ovarian cancer patients (N = 64) participated in a study evaluating the effectiveness and usefulness of a Patient-Centered Outcome Aid (PCOA). This i-Pad based interactive aid included an exercise during which patients evaluated personal tradeoffs between longer survival and adverse events associated with chemotherapy, in consultation with providers. Patients were educated about potential side effects, asked to rank their concerns about each side effect, and then asked: “Now that you have thought about and ranked the side effects, we ask you to think about the worst side effect for you as it relates to survival in good health. Would you be willing to go through 6 months of your worst side effect, if it gave you 5 years of good health?” There was a forced choice (Yes vs. No); then the tradeoff question was repeated with decreasing survival times: i.e. 3 years, 1 year, and 9, 6, 5, 4, 3, 2, and 1 months. Results: Of the 61 patients who responded to the TTO question, 52% required 1 or more years of good health to endure 6 months of their worst side effect. Among the non-neoadjuvant patients (N = 50), 18% indicated they would trade 6 months of the worst side effect for 1-2 months of additional life in good health, however 56% would require 9 months or more. While 95% of patients found it easy to rank order concerns about side effects, 75% considered the TTO question difficult to answer. Conclusions: Decisions aids which incorporate tradeoffs must be designed with sensitivity to differential health literacy levels, and the extremely personal nature of this decision.
John David Thornhill
Authors: Brian Hammersley
Journal: BMJ (2017)

John David Thornhill, known to all as “David,” was born in Darley Dale, Derbyshire, and his early education, after prep school in Sheffield, entailed boarding at the Shrewsbury School. From 1970 to 1973 he was at Manchester University, where he gained a 2.1 degree in social science. Early on in his studies for this first degree he realised that he really wanted to study medicine. He was encouraged in this goal by an early mentor, Professor E Wilkes of the department of community medicine at Sheffield, who recognised David’s undoubted early potential. In 1974 David began his medical studies for 1st MB at Sheffield Medical School.

Even at this early stage of his career David had decided to be a GP. He was a “people person,” and general practice was to be his natural milieu. One of his fellow students at this time describes him …
Phase II study of induction chemotherapy with gemcitabine and carboplatin (IndGC) followed by paclitaxel and carboplatin with concurrent thoracic radiation (PCRT) for patients with unresectable stage III non-small-cell lung cancer (NSCLC): MCC-13240
Authors: C. C. Williams, H. Wagner, H. Greenberg, A. Sharma, T. Hazelton, F. Walsh, A. Cantor, G. Simon, E. Haura, G. Bepler
Journal: Journal of Clinical Oncology (2005)

7307 Background: We are assessing the efficacy of IndGC followed by PCRT in patients with unresectable stage III NSCLC. The primary clinical endpoints are the radiographic response rates to IndGC and complete treatment. The secondary endpoints are overall and progression-free survival; toxicity, and patterns of failure. Methods: All patients have staging with chest CT, whole body PET, and brain MRI. IndGC consists of G (1,000 mg/m2) d 1+8 and C (AUC 5) d 1 q28d x2. Imaging studies are repeated in week 8. Concurrent PCRT starting in week 9 consists of P (50 mg/m2) and C (AUC 2) qw during RT with RT given in daily fractions of 2 Gy to a total dose of 74 Gy. Imaging studies are repeated 8 weeks after completion of all therapy. Disease response is determined by RECIST criteria. Results: Between 11/03 and 11/04, 19 eligible patients enrolled. 10 were women; the median age was 63 (range 51–82 years); the histopathology was adca in 5, sqc in 7, and NSCLC in 7. Of the 16 patients evaluated after IndGC, 1 (6%) had a CR, 4 (25%) had a PR, and 11 (69%) had stable disease. Of the 12 patients evaluated after complete treatment, 3 (25%) had a CR, 6 (50%) had a PR, 1 (8%) had stable disease, and 2 (17%) progressed. The median overall and progression-free survival has not been reached. One patient died after 4.8 months from cardiovascular disease, and all others are alive. There have been no deaths or unexpected morbidities related to therapy. A dose reduction of IndGC was necessary in 2 patients. In one patient, RT was stopped after 34 Gy because of severe esophagitis, and the average RT dose delivered was 69 Gy. Seven patients received all cycles of concurrent PCRT, and 7 had dose reductions for cytopenia, esophagitis, or allergic reactions. Two patients developed pneumonitis after completion of therapy, which resolved with corticosteroids. Conclusions: IndGC followed by PCRT to 74 Gy in patients with unresectable stage III NSCLC appears to be highly efficacious with acceptable toxicity. 1-year and 2-year survival rates and the median survival time are required to better compare this regimen with others. No significant financial relationships to disclose.