tbuckley/cabot-search huggingface dataset:
Meaningful reporting in primary care: An evaluation of the screening activity report.
Authors: Nicki Cunningham, Christine Stogios, Shama Umar, Dafna Carr, Jason Garay, Joanne Hader, Alex Lee
Journal: Journal of Clinical Oncology (2014)

173 Background: Cancer Care Ontario (CCO) developed the ColonCancerCheck Screening Activity Report (CCC SAR) as a supplementary tool for primary care physicians (PCPs) who are part of a patient enrolment model in Ontario, Canada to support them in increasing their colorectal cancer screening rates and appropriate follow-ups. The report provides PCPs with a summary of their eligible patients’ colorectal cancer screening-related history and was designed with the intent of supporting both population health management and opportunistic screening. Delivered through an online platform, the SAR offers PCPs access to data to facilitate quality cancer screening practices aligned with CCO’s evidence-based clinical guidelines. Methods: The report leverages provincial datasets to summarize screening activities on a per-patient level and actionable follow-up recommendations based on CCO’s clinical guidelines. To evaluate the impact of the reports on colorectal screening participation rates, a Generalized Estimating Equation model was used. Results: Results on the report’s impact on colorectal cancer screening participation rates from the first release (February 2013) are promising. By identifying for PCPs which patients are overdue for screening, the SAR demonstrated a modest and statistically significant 6% increased likelihood of patients being screened using a Fecal Occult Blood Test (FOBT) if their PCP was registered to access the online report, compared to patients of unregistered PCPs. The impact to screening increased to 25% when comparing registered PCPs who logged in and viewed their SAR to registered PCPs who did not login; however, this analysis is at a greater risk of a volunteer bias. Such PCPs may be more likely to screen their patients independent of viewing their SAR. Conclusions: By equipping PCPs with patient-level data grounded in CCO’s evidence-based clinical guidelines, the SAR is innovative in its potential to increase screening rates and the appropriate follow-up of abnormal results. The successful launch of two online CCC SARs, sharing meaningful colorectal cancer screening data to frontline providers, has driven the report’s expansion to include breast and cervical cancer screening data in spring of 2014.
Single-Agent Clofarabine Produces Durable Remissions in Patients with Acute Myelogenous Leukemia (AML) Who Are ≥ 70, Have Intermediate or Unfavorable Cytogenetics, Antecedent Hematological Disorders (AHD), or 2 or More Unfavorable Prognostic Factors.
Authors: Harry P Erba, Stefan Faderl, David F. Claxton, M. Arellano, Roger M Lyons, Tibor J. Kovacsovics, Janice Gabrilove, Stephen Eckert, Dirk Huebner, Hagop M. Kantarjian
Journal: Blood (2009)
The impact of a one month palliative care rotation on medical residents working in a tertiary cancer center in Jordan.
Authors: Omar M. Shamieh, Alia Alawneh, Wafa Ahamd, Sewar S Salmany, Barakat Altamimi, Hamzah Alkam, Khaled Nabil Dibs, Osama Mallah, Khawla Ammar, Rim Turfa, Hikmat Abdel-Razeq, David Hui
Journal: Journal of Clinical Oncology (2015)

168 Background: Palliative care education and training remains inadequate for medical professionals especially in developing countries. We evaluated the impact of a one month palliative care clinical rotation on medical residents’ attitude, competency, and knowledge related to palliative care in a tertiary cancer center in Jordan. Methods: All transitional Internal Medicine residents rotated in a monthly palliative care rotation at King Hussein Cancer Center (KHCC), in Amman, Jordan, were requested to participate in this educational intervention study. A concise curriculum in palliative and end of life care, adapted from the Education for Physicians on End-Of-Life Care (EPEC) Curriculum and delivered by our faculty was piloted as a part of the clinical rotation. Residents spent one month in the inpatient palliative care unit, in addition to 10 hours of classroom interactive sessions. The curriculum comprised of five modules: 1- Principles of palliative care, 2- Pain management, 3- Management of distressing symptoms, 4- Communication skills, 5- End-of- life care. To assess our educational outcomes, we adapted a previously developed instruments by David Weisman and used by the National Residency Education in the United States. All Instruments were completed by each resident before and after the rotation, and included self-assessment of attitude, competency and a knowledge test comprising of 32-items of multiple choice questions. Results: Twenty of 27 (74%) residents who started the palliative care rotation completed the required education and had paired evaluations. There was improvement in all three instruments: 37% improvement in competence (p &lt; 0.0001), 17% Improvement in knowledge (p = 0.015), and 5% improvement in attitude (p = 0.02). Conclusions: The one-month mandatory rotation improved knowledge, attitude and competence related to palliative care for medical residents.
Aclarubicin and Low Dose Arabinoside Cytosine (Ara-C) in Combination with Granulocyte Colony Stimulating Factor (G-CSF) in Treating Acute Myeloid Leukemia (AML) Patients with Relapsed or Refractory Disease and Myelodysplasia Syndrome (MDS): A Multi-Center Study of 112 Chinese Patients.
Authors: J.M. Li, Y. Shen, D.P. Wu, H. Liang, J. Jin, F.Y. Chen, Y.P. Song, J.M. Wang, X.F. Qiu, M. Hou, Z.C. Qiu, Z.X. Shen
Journal: Blood (2004)
A physician's practice, attitude and approach for the management of palliative care for cancer.
Authors: Shijian Feng, Qiongwen Zhang, Chunhua Yu, Huashan Shi, Wenxiu Yao, Yuwei Zhao, Yongsheng Wang
Journal: Journal of Clinical Oncology (2015)

112 Background: Pain is the most frequent and persistent symptom experienced by cancer patients. Thus, exploring how to achieve the best outcome of cancer pain management in China is clearly extremely important. Our study focuses on the Chinese physicians' current clinical practice, attitudes, toward and barriers to opioid use, and knowledge of cancer pain management. Methods: A face to face survey include 23 items was designed and conducted to the doctors working with cancer pain managements (oncologists, internists, hematologists, et al) responsible for the care of patients with cancer in 11 tertiary hospitals in China. Descriptive statistics were used to characterize the total sample and for multiple choice questions and each item. Chi-square analysis was used to examine the difference between categorical variables. Results: 500 questionnaires were received out of 550. Most (62.2%) physicians assessed patients’ cancer pain every day, but 85.5% never or occasionally treated patients’ cancer pain together with psychologists. Most respondents appreciated that &gt; 50% of patients with cancer experience severe chronic pain warranting analgesic therapy (73.5%), and that this therapy could control pain adequately in &gt; 50% of patients (77.2%). More than half of physicians indicated that opioid dose titration in patients with poor pain control and assessment of the cause and severity of pain were urgently needed knowledge for cancer pain management. A majority (65.0%) of physicians responded incorrectly (60.0% agreed and 5.0% had no opinion) that they would increase the dosage of a potent opioid and administer it every 4 h as needed (q4h PRN). Inadequate assessment of pain and pain management (63.0%), patients' reluctance to take opioids (62.2%), and inadequate staff knowledge of pain management (61.4%) were the three most frequently barriers to physicians’ pain management. Conclusions: Our results revealed that physician education in cancer pain management in China does not currently provide the necessary levels of knowledge and skills. Therefore, effective strategies and professional education are still needed to encourage physicians’ concern with, experience in, and knowledge of cancer pain management in China.
Systemic PD-1/PD-L1 inhibition combined with local vascular-targeted photodynamic therapy (VTP): Effects on primary tumor and prevention of lung metastasis in a preclinical RCC model.
Authors: Matthew O'Shaughnessy, Katie S Murray, Stephen LaRosa, Sebastien Monette, Kwanghee Kim, Avigdor Scherz, Jonathan A. Coleman
Journal: Journal of Clinical Oncology (2015)

477 Background: Immune checkpoint inhibitors targeting the PD-1 pathway have shown activity against advanced renal cell carcinoma in phase 2 clinical trials. The response to PD-1 inhibition is not consistent however and may depend on host factors (ie. PD-L1 expression). Strategies that modulate immune regulation in the tumor microenvironment can impact responses to PD-1 pathway inhibitors. We have previously shown that VTP treatment of primary tumors using the novel photosensitizer WST-11 induces a defined local inflammatory response. We sought to evaluate whether response to PD-1/PD-L1 inhibition could be enhanced with VTP treatment of primary tumors. Methods: Balb/c mice bearing orthotopically implanted Renca kidney tumors were treated with IgG alone, anti-PD-1/anti-PD-L1 monoclonal antibodies (mAbs), VTP alone, or VTP + mAbs. VTP treatment of the primary tumor was performed 10 days (d10) after tumor implantation. Primary tumor response, enumeration of lung metastases and histologic analysis was performed on d21. Results: Treatment of the primary tumor with VTP and systemic PD-1/PD-L1 inhibition (n=15) resulted in regression of primary tumors whereas PD-1/PD-L1 inhibition alone (n=21) or VTP treatment alone (n=16) did not (no gross tumor vs. median tumor size 96mm 2 vs 36 mm 2 vs 81 mm 2 for combination vs mAbs alone vs VTP alone vs control, p&lt;0.0001). Significant treatment effect was also observed in the combined treatment group by histologic analysis. Furthermore, growth of lung metastases was prevented with the combined treatment regimen compared to either treatment alone (median number lung mets=3 vs 56 vs 53 vs 23 for combination, mAb alone, VTP alone and control, respectively, p=0.0252). Conclusions: Only the combination of systemic PD-1/PD-L1 inhibition and local VTP provided primary tumor control and prevention of distant metastasis. Modulation of the inflammatory response in the tumor microenvironment with local therapy such as VTP may enhance the effects of systemic PD-1/PD-L1 blockade to provide better local and metastatic tumor control that can be investigated in prospective clinical trials.
PLATFORM: Planning treatment of oesophago-gastric (OG) cancer—A randomised maintenance therapy trial.
Authors: Catherine Cafferkey, Ian Chau, Fiona Thistlethwaite, Russell D. Petty, Naureen Starling, David Watkins, Sheela Rao, Claire Saffery, Bijal Patel, Clare Peckitt, David Cunningham
Journal: Journal of Clinical Oncology (2016)

TPS187 Background: Outcomes for patients with advanced OG cancer remain poor, median overall survival for fit patients treated with platinum and fluoropyrimidine based chemotherapy is less than one year, with second line chemotherapy resulting in a modest (approximately 6 weeks) survival benefit for selected patients. Evidence from NSCLC trials suggests a survival benefit from maintenance treatment following first line chemotherapy. Emerging data also supports the use of immunotherapy in previously treated OG cancer. The PLATFORM study aims to evaluate maintenance therapy in patients with advanced OG cancer. Methods: This is a prospective, open label, multicentre, randomised phase II clinical trial which will recruit at multiple UK cancer centres. Eligible patients are those who have measurable stable disease or better following completion of first line chemotherapy (at least 6 cycles) for locally advanced unresectable or metastatic disease. First line chemotherapy regime should contain a platinum and 5-fluoropyridimine (with trastuzumab if HER2 +), doublet or triplet drug combinations are permitted. Maintenance strategies are split by HER 2 status. For HER2 negative patients these are: Arm A1: surveillance, Arm A2: capecitabine, Arm A3: MEDI 4736 (anti PDL1 inhibitor) and for HER2 positive patients; Arm B1: trastuzumab, Arm B2: in development. Target recruitment is six hundred and sixteen patients, 154 patients will be recruited to each arm, with an interim analysis following recruitment of 61 patients to each arm. An adaptive trial design enables ineffective treatments to be discontinued early, with the opportunity to add novel treatment arms as the trial progresses. Primary endpoint is progression free survival. Secondary endpoints are progression free rate at 3, 6 &amp; 12 months, overall survival, objective response rate by RECIST 1.1, toxicity and analysis of efficacy endpoints according to biomarker status for selected arms. Thirty two patients have been registered for the study with 3 patients randomised, recruitment is ongoing. Clinical trial information: EUDRACT: 2014-002169-30.
Bridging the gap in psychosocial care in cancer survivorship: A pilot project evaluating psychosocial interventions through telemedicine.
Authors: Kaitlin Bomar, Elizabeth Willingham, Terra Dillard, Chad M Dingman, Crystal Humphries, Stacey Kindall, Patricia D. Hegedus, James D. Bearden, Hal E. Crosswell
Journal: Journal of Clinical Oncology (2016)

215 Background: Psychosocial distress is a well‐recognized consequence of cancer therapy, but psychosocial care for cancer survivors remains fragmented. Through the use of telemedicine, establishing an integrated, information technology‐based infrastructure between community‐based cancer programs may enhance coordination of survivorship care and increase psychosocial distress screening and intervention. We describe a one year pilot program intended to bridge institutional and geographic gaps in psychosocial intervention for cancer survivors through the use of telemedicine. Methods: There are 17 Commission on Cancer-accredited sites in South Carolina-only 31% of sites routinely conduct distress screening. This SC Cancer Alliance-supported pilot was designed as a quality care improvement project between two community-based cancer programs. The development and execution of the telemedicine project will be described. A survey-based, qualitative assessment of patient satisfaction with psychosocial intervention with between both physical and virtual counselling was performed and scored. Results: All patients seen in survivorship clinics at both institutions received psychosocial distress screening. By the end of the pilot project, 9 cancer survivors from the Spartanburg area were identified as having significant psychosocial distress, participated in counselling and reported on their experiences. Patients were seen either via face-to-face and/or virtual encounters. Counselling sessions performed via telemedicine were well accepted and that there was no difference in patient satisfaction as compared to face-to-face sessions. Anecdotal experiences and comments will be highlighted. Conclusions: Our pilot project demonstrates that psychosocial screening and intervention via telemedicine is feasible and may be effective at reducing psychosocial distress in cancer survivors. Psychosocial intervention via telemedicine may serve as a viable method of providing counselling services to resource poor areas, but significant barriers exist, including reimbursement, institutional variations in screening and care and information technology.
Erythrocyte protein band 4.1-like5 expression in patients with upper urinary tract urothelial carcinoma correlates with tumor recurrence.
Authors: Tatsuaki Daimon, Takeo Kosaka, Shuji Mikami, Yasumasa Miyazaki, Ryuichi Mizuno, Eiji Kikuchi, Akira Miyajima, Ken Nakagawa, Hisataka Sabe, Mototsugu Oya
Journal: Journal of Clinical Oncology (2014)

e22131 Background: Erythrocyte protein band 4.1-like5 (EPB41L5) regulates E-cadherin in the GEP100–Arf6–AMAP1 signaling pathway and some studies reported it was induced in the epithelial–mesenchymal transition (EMT) by TGF-β treatment, and related to invasion and metastasis of cancer in some tumor cells. This study aimed to investigate the prognostic significance of EPB41L5 in upper urinary tract urothelial carcinoma (UTUC). Methods: We retrospectively analyzed the clinical records of 180 patients with UTUC (Ta-4N0M0) undergone radical nephroureterectomy. We immunohistochemically examined EPB41L5 expression in UTUC. Immunohistochemical staining was evaluated by semiquantitative assessment of the intensity of staining and the percentage of positive cells. Results: The median follow-up period was 60 months. A total of 48 patients experienced tumor recurrence; of these, 39 died of the disease during follow-up. EPB41L5 expression was particularly strong in tumor cells at the most invasive part. We decided the cut-off score of EPB41L5 expression between the high- and low-score groups according to median score. The number of patients in the high-score and low-score groups was 61 and 121, respectively. The score of EPB41L5 was significantly correlated with tumor grade, pathological T stage, and lymphovascular invasion (LVI) (all p < 0.001). Kaplan–Meier analysis revelaed the 5-year recurrence-free and cancer-specific survival rates were 44.0% and 50.3%, respectively, in the high-score group and 81.7% and 86.8%, respectively, in the low-score group (all p < 0.001). Multivariate analyses revealed that the high expression of EPB41L5 was an independent prognostic factor for tumor recurrence (p = 0.039, HR = 1.88). Conclusions: EPB41L5 expression was a predictive factor for prognosis in patients with UTUC. These results suggest that the GEP100–Arf6–AMAP1 signaling pathway could provide additional prognostic information in patients with UTUC.
External validation of proposals for the revision of the TNM stage groupings by the IASLC lung cancer staging project in Korean non-small cell lung cancer patients
Authors: J. Uhm, J. Hong, M. Choi, K. Kim, J. Han, J. Kim, Y. Shim, O. Kwon, J. Ahn, M. Ahn, K. Park
Journal: Journal of Clinical Oncology (2008)

22140 Background: The IASLC proposed the revision of the TNM staging system of NSCLC to prepare the seventh edition of the TNM Classification of Malignant Tumors. The revised TNM stage suggests that tumors > 7cm move from T2 to T3; additional pulmonary nodules are reassigned according to locations; and pleural effusions are reclassified as an M1a descriptor. In addition, it proposes that T2bN0M0 be moved from stage IB to stage IIA, T2aN1M0 from stage IIB to stage IIA, and T4N0–1M0 from stage IIIB to stage IIIA. This study was performed to validate the revised proposals for TNM lung cancer staging systems. Methods: 1728 consecutive cases of the patients, who were newly diagnosed with NSCLC between 1998 and 2003, were identified from the database at Samsung Medical Center. Among them, 1442 patients followed up at least 3 months were included in analysis. Small cell lung cancer, carcinoid tumors and sarcomas were excluded. Results: At that time of diagnosis, 98, 243, 12, 103, 197, 256 and 533 patients were in stage IA, IB, IIA, IIB, IIIA, IIIB and IV by TNM 6th edition. After restaging according to revised system, 98, 196, 103, 64, 253, 127 and 601 patients were categorized to each stage. The median overall survival (OS) of all patients was 16 months (95% CI, 14.5∼17.5) with 15 months of median follow-up. The overall survivals of each staging groups by new proposals showed statistically significant differences (p<0.001). Considering the changes according to tumor size, T2bN0M0 demonstrated prolonged survival than T3N0M0 (5-year survival rates 60.9% vs. 32.8%, p=0.006). The patients reassigned to M1a due to malignant pleural effusion from T4M0 cases had shorter survival than those without pleural effusion (median OS 10.0 months vs. 14 months, p=0.049). However, T1a vs. T1b and T2a vs. T2b did not show statistical significances in overall survival. Conclusions: We verified that recently proposed IASLC staging system for NSCLC could predict the patients' prognosis. Although there is an element of doubt about the necessity of subdivision of T1 and T2, further studies are warranted to verify the significance of the subdivision of T stage as regards for the subgroups to benefit from treatment modalities such as adjuvant or neoadjuvant treatment. No significant financial relationships to disclose.
A phase II study of 5-FU/l-LV/oxaliplatin (mFOLFOX6) in patients with metastatic or unresectable small bowel adenocarcinoma: A post hoc analysis.
Authors: Taro Funakoshi, Takahiro Horimatsu, Norisuke Nakayama, Toshikazu Moriwaki, Yoshinori Hirashima, Mikio Fujita, Masako Asayama, Ichiro Moriyama, Koji Nakajima, Eishi Baba, Hiroshi Kitamura, Takao Tamura, Ayumu Hosokawa, Manabu Muto
Journal: Journal of Clinical Oncology (2015)

430 Background: Small bowel adenocarcinoma (SBA) is a rare disease. Previous studies suggested several prognostic factors of unresectable SBA, including age, performance status (PS), primary site, resection of primary tumor, histology, and tumor marker (CEA and CA19–9) levels. However, prognostic factors of the patients treated with oxaliplatin–fluoropyrimidine combination therapy were unknown, while these drugs were reported as a promising chemotherapy regimen for SBA. Methods: Previously untreated SBA patients were treated with an mFOLFOX6 regimen, and a post hoc analyses for prognostic factors were performed. Results: Between April 2010 and November 2012, 24 patients were included in this study. The overall response rate was 45% (9/20). The median progression-free survival and overall survival (OS) were 5.4 months (95% CI, 4.8–6.0) and 17.3 months (95% CI, 11.7–19.0), respectively. Univariate analysis revealed that lower PS (HR= 0.27; 95% CI, 0.10–0.77; p= 0.014), primary disease of the jejunum (HR= 0.35; 95% CI, 0.11–1.12; p=0.077), and serum CEA in the normal range (HR= 0.40; 95% CI, 0.14–1.11; p= 0.079) were potential prognostic factors of longer OS (threshold, p&lt; 0.10). Although resection of the primary tumor was not a predictive factor of survival in this study, 54% and 21% of the patients needed surgery (primary resection or bypass) because of stenosis before and during chemotherapy, respectively. It is considered that bowel obstruction should be addressed before and during treatment. Conclusions: PS, primary site, and serum CEA levels are potential prognostic factors of unresectable SBA. There is a higher incidence of bowel stenosis or obstruction caused by the primary tumor before and during the treatment of SBA.