tbuckley/cabot-search huggingface dataset:
Effect of liquid withdraw technique on the incidence of pneumothorax and tumor tissue amount of CT-guided cutting needle lung biopsy: An expanded retrospective study.
Authors: Rutian Li
Journal: Journal of Clinical Oncology (2017)

e20535 Background: CT-guided cutting needle lung biopsy is important for the diagnosis of lung cancer especially in the area of precision medicine. In ASCO 2015, we reported that “Liquid withdraw” technique (to inject small amount of liquid while withdraw of the needle) can prominently reduce incidence of pneumothorax when combined with co-axial technique in 38 cases. In this reported, we retrospectively studied 90 patients undergoing CT-guided cutting needle lung biopsy to investigate the role of this technique in reducing complications and promoting biopsy effectiveness. Methods: From Jan 1 st , 2014 to Nov 30 th , 2016, we retrospectively studied 92 CT-guided percutaneous lung biopsies using co-axial and liquid withdraw techniques in 90 patients. The pathologies and complications secondary to biopsy procedure were noted. Pneumothorax and bleeding was graded as mild (mild and very mild), moderate, and severe. Results: 88 cases were diagnosed out of 92 biopsies (95.7%), of which 60 cases were adenocarcinoma. Liquid withdraw technique assured adequate tissue for diagnosis and treatment planning of lung cancer. Among 71cases diagnosed as NSCLC, only 5 (7.0%) were diagnosed as NOS. Among 52 cases of adenocarcinoma who consented EGFR mutation test, only 1 case (1.9%) failed due to insufficient tissue. Among all the biopsies, when acquiring specimens 4-6 times per procedure, the incidence of pneumothorax was in 18 cases (19.6%), among which 13 cases (14.1%) were very mild pneumothorax (lung surface retraction of≤1 cm), mild and moderate pneumothorax accounted for just 4.3%. No severe pneumothorax occurred. 19 cases (20.7%) happened bleeding (18 cases were mild bleeding). No infection, tumor implantation or aeroembolism happened. Conclusions: Compared to lung biopsy without liquid withdraw, the incidence of pneumothorax was reduced from approximately 35% to 19.6%. The liquid withdraw technique also resulted in low rate of other complications and adequate tissue for diagnosis. Next, we are planning to conduct a prospective study to further evaluate the role of this technique in the precision diagnosis and treatment of lung cancer.
Association of high circulating neuregulin-1 with clinical benefit in EGFR wild-type NSCLC patients treated with rilotumumab and erlotinib.
Authors: Laura P. Stabile, Ahmad A. Tarhini, Mariya Farooqui, Jose Gomez-Garcia, Autumn Gaither-Davis, William E. Gooding, Mark A. Socinski, Jill M. Siegfried
Journal: Journal of Clinical Oncology (2016)

e20647 Background: We previously reported a 59% disease control rate among EGFR wild-type (WT) patients in a phase II trial of the combination of rilotumumab (an HGF neutralizing antibody) and erlotinib (an EGFR tyrosine kinase inhibitor) in patients with metastatic previously treated NSCLC. There was 1 partial response (PR) and 16 patients with stable disease (SD) among 29 confirmed EGFR WT cases. There were two confirmed EGFR mutant cases (1 PR, 1 SD). Baseline plasma was collected from 35 patients enrolled in the study to identify potential biomarkers of treatment response. Methods: We examined 10 circulating biomarkers associated with the EGFR and c-Met pathways for association with clinical benefit among 35 trial participants for whom blood was successfully processed (31 EGFR WT, 1 EGFR mutant). Biomarkers measured included 4 EGFR ligands: amphiregulin (AREG), heparin-binding EGF (HB-EGF), TGFα, and neuregulin-1 (NRG1). We also measured plasma levels of soluble c-Met, HGF, VEGF, IL6 and IL8. Results: Baseline levels of four proteins (AREG, IL6, NRG1, and TGFα) showed significant associations with progression-free survival, with false discovery rate < 10% High NRG1 was protective and associated with longer PFS (HR = 0.41, 95% CI = .19-.87), while high AREG (HR = 2.14, CI = 1.48-3.08) and TGFα (HR = 1.77, CI = 1.01-3.11) were associated with more rapid progression. Conclusions: NRG1 is a ligand for HER3, an EGFR family member that often dimerizes with EGFR/HER1, and also can be activated by c-Met. HER3 may serve as a mediator of more prolonged signaling from both EGFR and c-Met. NSCLC tumors that show elevated HER3 pathway signaling may be more dependent on EGFR-c-Met cross talk and/or more dependent on HER3 to propagate c-Met signaling.
Characteristics and anticancer interventions (ACIs) in African American (AA) and Caucasian (CAU) patients (pts) treated with sipuleucel-T (sip-T): Real-world experience from the PROCEED registry.
Authors: Andrew J. Armstrong, Celestia S. Higano, Matthew R. Cooperberg, Chiledum Ahaghotu, Ronald F. Tutrone, Laurence H. Belkoff, Carl A. Olsson, Sanjay Goel, Robert Claude Tyler, Nancy N. Chang, Jennifer Susan LIll, A. Oliver Sartor
Journal: Journal of Clinical Oncology (2016)

5025Background: AA men have higher prostate cancer (PC) incidence and mortality than CAU men, potentially related to biologic or socioeconomic factors. A retrospective subgroup analysis suggested g...
TCT-58 Cryoablation method for Pulmonary Artery Sympathetic Denervation in Patients with Chronic Heart Failure and Pulmonary Hypertension
Authors: Boris Rudenko, Oksana Drapkina, Natalia Gavrilova, Vsevolod Vlasov, Daria Feshenko, Daria Chigidinova, Dmitry Vasiliev
Journal: Journal of the American College of Cardiology (2018)
Brain metastases (BM) in pancreatic ductal adenocarcinoma (PDAC): Clinical and molecular characteristics.
Authors: Emmet Jordan, Thomas Joseph Kaley, Marinela Capanu, Hayley Estrella, Steven D Leach, Olca Basturk, David S. Klimstra, Peter J. Allen, Michael F. Berger, Kenneth H. Yu, Maeve Aine Lowery, Eileen Mary O'Reilly
Journal: Journal of Clinical Oncology (2017)

e15728 Background: BM from PDAC represents a rare clinical entity (&lt;0.6%) of PDAC cases for which the clinical and molecular features are not well described. We reviewed detailed clinical characteristics and molecular profiling performed in a cohort of PDAC pts with BM evaluated at MSKCC. Methods: Patients (pts) with BM from PDAC diagnosed from 01/1990-08/2016 were identified from a prospectively maintained database, following IRB approval. Clinicopathological data including time to BM development, overall survival (OS) from PDAC diagnosis (dx) and OS from BM dx was recorded. Molecular profiling was performed by MSK-IMPACT testing (&gt;340 key cancer genes) or via Seqeunom testing (8 gene panel). Results: We identified n= 24 pts with BM from PDAC. Twenty-three/24 pts had imaging for symptoms. Mean no. of systemic regimens was 3 (range 0-7). Three/24 (13%) had BM at initial dx. Median time from PDAC dx to BM development was 17 months (mths) (range 0-79). Median survival from BM was 50 days (range 7-975). BM treatment included; surgery; n=4, RT; n=13 or supportive care; n=7. Two pts had survival of 21 &amp; 31 months post BM, both had resection. Median OS from PDAC dx was 18 mths (0-82). 10 pts had consent/pathology for molecular testing (MSK-IMPACT n=7, Sequenom n=3). Results are available for 6 pts, 3 by IMPACT. 6/6 pts had KRAS mutations (MUT); G12D (4), G12V (1), Q61K (1). 0/6 pts had ERBB2 AMP or MUT. One tumor arising from an IPMN had concurrent GNAS and KRAS MUT. By MSK-IMPACT; 2/3 pts had MYC AMP, 2/3 TP53 MUT, 1/3 ARID1A loss, 1/3 CDKN2A loss. 5/24 pts had germline testing, 3 had BRCA MUT; BRCA1 (2), BRCA2 (1). Conclusions: The presence of BM portends a poor prognosis. In general pts who develop BM are younger at initial PDAC dx and may have a better OS from dx [median OS 18 mths (all pts); OS de novo stage IV pts; 17 mths]. Somatic profiling identified KRAS MUT in all resulted pts with alterations in TP53 and MYC also detected. Although speculative, germline BRCA MUT occurred in 13% (60% of pts tested). See table. [Table: see text]
Management of pure metastatic teratoma in chemotherapy naïve testis cancer patients.
Authors: Shahid Sattar Ahmed, Joseph Jacob, Clint Cary, Richard Foster, Lawrence H. Einhorn
Journal: Journal of Clinical Oncology (2017)

e16043 Background: Management of metastatic testicular cancer often requires post-chemotherapy resection of teratoma. This is well known and described in literature. However, the ability of teratoma to metastasize independently is not as well appreciated, making chemotherapy futile in patients with pure metastatic teratoma. Methods: 15 patients with metastatic teratoma were identified of which 13 had only teratoma in the orchiectomy and 2 had predominantly teratoma. All 15 had normal serum hCG and AFP. Cases were derived from a retrospective review of patients seen from 1989-2016. Results: Mean age of patients was 27 years. 12 patients presented initially with Stage II disease and 2 presented with stage III disease. Median RP mass size was 6 cm with a range of 1.5-24 cm. 2 of 15 patients were treated initially with a single course of chemotherapy with BEP and showed no response. The remaining 13 patients only received resection(s). All 15 patients underwent RPLND with 2 patients requiring additional mediastinal and retrocrural resection and 1 requiring lobectomy. All surgical specimens showed pure teratoma on pathology with no other active germ cells. Patients were followed for a median duration of 5 years and all 15 remain with no evidence of disease at most recent follow up. However, 1 patient needed subsequent surgery for a late relapse of teratoma and 1 patient had a second extra-gonadal primary. Conclusions: Teratoma can metastasize in the absence of other germ cells. Surgical treatment alone for patients with pure metastatic teratoma of any stage can result in cure for the majority of patients and this approach can help avoid unnecessary chemotherapy.
A first report of robotic-assisted sentinel lymph node mapping and inguinal lymph node dissection, using near-infared fluorescence, in vulvar cancer.
Authors: Mark Hunter, Kevin Kremer, Kristen Wymore
Journal: Journal of Clinical Oncology (2017)

e17027 Background: Vulvar carcinoma is a rare gynecologic malignancy which has seen a considerable evolution in surgical techniques over the last several decades. However, the morbidity associated with inguinal lymph node dissections remains significant. The majority of patients undergoing full lymphadenectomy will have some complication, with wound breakdown being the most common. In males, robotic inguinal lymph node dissection has been described for penile cancer. This report represents a first use of near-infared fluorescence for sentinel inguinal lymph node mapping, and the first description of complete robotic inguinal lymph node dissection for patients with vulvar malignancies. Methods: Bilateral robotic-assisted inguinal lymph node mapping and and lymphadenectomy was performed using the daVinci Xi system with a near-infared fluourescence. Results: The patient presented at 81 years old with a 3 cm lesion on the left labia. In the operating room, the vulvar lesion was injected circumferentially with indocyanine green. A 1 cm incision was made in the skin over the apex of the left femoral triangle carried past the underlying campers fascia. The tissue plain was developed overlying the femoral triangle using a tissue expander balloon. Under visual guidance, an 8 mm camera port and two 8 mm instrument ports were placed and the robot docked. The ipsilateral sentinel lymph nodes were identified using near-infared fluorescence and resected. We then performed a complete left superficial inguinal lymph node dissection. The right side was then performed in identical fashion. No sentinel node was identified on the right side. Radical hemivulvectomy was then performed without difficulty. All 11 lymph nodes were negative for disease. She was returned to the OR once for replacement of her JP drains. Her postoperative course was otherwise unremarkable and she is currently 15 months postoperative without complications or recurrence. Conclusions: Sentinel lymph node mapping and superficial inguinal lymph node dissection using robotic-assisted techniques and near-infared fluorescence is feasible and warrants further investigation.
Management and outcomes of patients with renal medullary carcinoma (RMC): A collaborative multi-center study of 52 patients.
Authors: Amishi Yogesh Shah, Jose A. Karam, Gabriel G. Malouf, Priya Rao, Zita Dubauskas Lim, Eric Jonasch, Lianchun Xiao, Jianjun Gao, Ulka N. Vaishampayan, Daniel Yick Chin Heng, Elizabeth R. Plimack, Elizabeth A. Guancial, Chunkit Fung, Stefanie Rose Lowas, Pheroze Tamboli, Kanishka Sircar, Surena F. Matin, Kimryn Rathmell, Christopher G. Wood, Nizar M. Tannir
Journal: Journal of Clinical Oncology (2016)

e16111 Background: Renal medullary carcinoma (RMC) is a rare and aggressive malignancy that afflicts young patients with sickle cell trait. Data regarding patient management and outcomes are limited. Our objective is to evaluate the management strategies and outcomes of patients with RMC and characterize predictors of overall survival (OS). Methods: This is a retrospective, multi-institutional study of patients with RMC who were treated during 2000-2015 at eight academic institutions in North America and France. The Kaplan-Meier method was used to estimate OS, which was measured from initial diagnosis of RMC to date of death. Cox regression analysis was used to determine predictors of OS. Results: Fifty-two patients (37 males) were identified. Median age at diagnosis was 28.2 years. Forty-four patients (85%) had lymph node metastasis and 35 patients (67%) had distant metastasis at diagnosis. Median OS for all patients was 13.0 months. All patients had at least one line of systemic therapy and 38 patients (75%) had nephrectomy. 45 patients received cytotoxic chemotherapy and 13 (29%) had a major response; 28 patients received targeted agents (sunitinib, bevacizumab, sorafenib, imatinib, bortezomib, everolimus, pazopanib) with 8 weeks median time on therapy and no major responses to single agent therapy. Patients who underwent nephrectomy had superior OS compared to patients who were treated with systemic therapy alone (median OS 16.4 vs. 7.0 months, p = 0.0004). This held true even in patients who had PS 2/3 at initial diagnosis and received initial chemotherapy (p = 0.045). Seven patients (15%) survived longer than two years, and two of them remain alive without disease 45 months and 42 months from initial diagnosis. The limitation of this study is its retrospective nature with potential patient selection bias. Conclusions: The prognosis of RMC remains poor with less than 15% of patients surviving longer than two years, underscoring the need to develop more effective systemic therapy for this rare tumor. Cytoxic chemotherapies can provide palliation, but targeted agents do not provide major responses. In this retrospective study, nephrectomy was associated with improved OS.
Prognostic and predictive value of HPV status in metastatic squamous cell carcinoma of the head and neck.
Authors: Luke Roy George Pike, William L. Hwang, Trevor Joseph Royce, Nina Niu Sanford, Brandon Arvin Virgil Mahal
Journal: Journal of Clinical Oncology (2018)

e18038 Background: The prognostic and predictive value of human papillomavirus (HPV) status in metastatic squamous cell carcinoma of the head and neck (SCCHN) is unclear. Methods: A Surveillance, Epidemiology, and End Results (SEER) custom database identified 5,940 adult patients, > 18-years-old, with primary SCCHN and known HPV status, diagnosed from 2013-2014. Wilcoxon rank-sum and Mantel-Haenszel χ2 tests compared distributions of continuous and categorical covariates. Fine-Gray competing risks regressions estimated hazard ratios by HPV status, and predictive analyses were performed including the interaction term HPV status x Receipt of Chemotherapy. Results: 240 out of 5,940 patients (4.0%) had metastatic SCCHN at diagnosis (119/3,925 [3.0%] HPV+ and 121/1,894 [6.0%] HPV-, p < 0.001). HPV+ and HPV- cohorts were predominantly white and male, with a median age at diagnosis of 62 and 64-years-old, respectively. HPV+ cases were more commonly of oropharyngeal origin (89.1% vs 62.8%, p < 0.001). HPV+ metastases were more likely to involve non-vital tissues than HPV- metastases (29.4% vs 13.2%, p < 0.001). HPV+ disease was prognostic for improved 20-month cancer-specific mortality (CSM) (74.1% vs 45.1%, HR 0.40, 95% CI 0.30–0.53, p = 0.001) on univariable analysis. Notably, HPV status was predictive of response to chemotherapy—adjusted HRs for receipt of chemotherapy were 0.09 (95% CI 0.03-0.31) and 0.33 (95% CI 0.18-0.60) for HPV+ versus HPV- disease, respectively (PHPV statusÃChemotherapy= 0.04). Conclusions: HPV status has known prognostic value in locally advanced SCCHN, but data on metastatic SCCHN are sparse. In this work, we demonstrate that HPV status is strongly prognostic for CSM in metastatic SCCHN and show for the first time that HPV status predicts for response to chemotherapy.
TCT-535 Left Ventricular Diastolic Function and Cardiovascular Mortality after Transcatheter Aortic Valve Replacement
Authors: Sang Yong Om, Yong-Hoon Yoon, Minsoo Kim, Hanbit Park, Sang-Cheol Cho, Sangwoo Park, Tae oh Kim, Sun Hack Lee, Osung Kwon, Kyusup Lee, Euihong Ko, Do-yoon Kang, Pil Hyung Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2018)
Targeted DNA- and RNA-based next-generation sequencing for identifying MET exon 14 alterations in pulmonary sarcomatoid carcinoma.
Authors: Jianming Ying, Lianju Gao, Yan Li, Bing Liu, Lamei Deng, Lei Li, Di Ma, Junling Li, Zhi Jiang
Journal: Journal of Clinical Oncology (2017)

e20591 Background:Highly diverse somatic splice site alteration at MET exon 14 ( METex14) result in exon skipping, which is supposed to be a therapeutic target in NSCLC. Here we report detection of METex14 alterations using targeted DNA- and RNA-based Next-Generation Sequencing (NGS) in pulmonary sarcomatoid carcinoma (PSC) with a high frequency of METex14 skipping. Methods: Tumor specimens were collected from 100 Chinese PSC patients. DNA and RNA were subject to targeted NGS, allowing the detection of somatic splice site alterations and intragenic METex14 skipping respectively. Then, somatic mutations that lead to METex14 skipping were recognized. Meanwhile, cross-platform performance comparison for detecting MET exon 14 skipping was achieved. Moreover, Sanger sequencing was also performed on the METex14-positive specimens. Results: So far, we have detected genetic aberrations in 34 FFPE samples. For RNA-based NGS, METex14 skipping was identified in 8 (23.5%) of 34 patient cases. The population frequency was accordant to the reported percent of 22% (PMID: 26215952). And 5 (62.5%) of 8 METex14-positive patients were detected somatic splice site mutations by DNA-based NGS, including 4 cases with known point mutations at the 3’ splice region and one case with a novel deletion (chr7: 116412027- 116412042) at MET exon14 region, which is newly discovered. No somatic mutation was found at the splice junctions of METex14 in the remaining 3 samples using DNA-based NGS. Conclusions: Mutational events of MET leading to exon 14 skipping are frequent occurred in Chinese PSC patients. Our study also suggests that RNA-based NGS could identify more METex14 skipping, and thus provide more accurate results than DNA-based NGS.
Compliance with oral cancer medications when dispensed in the oncology clinic vs. when provided directly by health care payers: A prospective multicenter study by the Oncoclinicas Group.
Authors: Felipe Feistauer Gomes, Eldsamira Mascarenhas Sobrinho, Rayza Martins Miranda, Lilian Martins Mercurio, Marjorie Moreira Dias, Karen Sandes Nascimento, Andre Luis Alves, Emanuela Tavares, Luciana Moraes Teixeira, Oscar Zeferino Silva, Priscila Silva Fernandes, Tatiane Rios Sousa, Gilberto Lopes
Journal: Journal of Clinical Oncology (2016)

e18001 Background: The use of oral cancer medicines is rising. In Brazil, after coverage was mandated in January 2014, oral cancer medications can be dispensed in the clinic where a patient is treated or directly by the health care payer (or by a payer designated third-party). Methods: We conducted an observational prospective multicenter study to compare compliance (primary endpoint) between patients who received their oral medications in oncology clinics versus those who received them directly from health care payers. Patients 18 years of age or older, receiving oral cancer treatment prescribed in any of the group´s 34 clinics were eligible. Patients filled an anonymous questionnaire. Respondents were classified as
Trends of hospitalizations with invasive fungal infections in patients with acute leukemia and hematopoietic stem cell from 2005-2014 in the United States.
Authors: Sukriti Kamboj, Harold Elias, Varun Kumar
Journal: Journal of Clinical Oncology (2018)

6618 Background: Invasive fungal infections (IFI) are a cause of morbidity, mortality and increased health costs in patients with Acute Leukemia (AL) and hematopoietic stem cell transplant (HSCT). With this study, we aim to examine trends of IFI related hospitalizations in patients with AL and HSCT in the United States. Methods: We utilized Nationwide Inpatient Sample (NIS) data from 2005- 2014 and identified patients with AL (acute lymphoblastic leukemia and acute myelogenous leukemia) and HSCT hospitalization using ICD 9 CM codes. Patients with missing information on age, gender and mortality were excluded. Patients with age < 18 years were excluded as well. IFI (candidemia, aspergillosis, zygomycosis) were identified by using appropriate ICD 9 codes in secondary diagnosis field. P-values for trends were generated using Cochran Armitage test. Results: A total of 666,567 hospitalizations with HM were identified. Out of which 15,316 (2.31%) had IFIs. A majority were males (57.8%), Caucasian (58%) and belong to age group 50-64 (36.8%). Overall Incidence of fungemia was 2.3% and remained stable over 11 years (2.16% in 2005 to 2.2 % in 20114, relative increase = 7.25%, p trend-0.0064). Overall In-hospital mortality was 21.84% (unchanged over 11 years with a relative decrease of 8.1 % with p trend - 0.131. After stratifying for specific IFIs, in-hospital mortality for candidemia (35.0%), zygomycosis (26.51%) and aspergillosis (18.48%). None of which have changed over 11 years. In multivariate analysis, old age (age > = 65 years), female gender was associated with higher mortality and elective admissions were associated with lower mortality. Conclusions: Despite much advances in fungemia treatment and prophylaxis, incidence and outcomes of IFI have not changed over last decade. Future studies to identify limiting factors are needed to provide crucial information to prevent fungemia and improve outcomes.
Abstract 19179: Impact of the 2013 ACC/AHA Cholesterol Management Guideline: Have Treatment Patterns Evolved After 2 Years?
Authors: Tope Olufade, Deborah Anzalone, Siting Zhou, Vincent Willey, Mark J Cziraky
Journal: Circulation (2016)

Objective: To characterize changes in statin treatment patterns in the 2 years after the release of the 2013 ACC/AHA cholesterol management guideline in a commercially insured/Medicare Advantage po...