tbuckley/cabot-search huggingface dataset:
Organ preservation with daily concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion for stage III, IV oral cancer: Analysis of therapeutic results in 112 cases.
Authors: Kenji Mitsudo, Toshiyuki Koizumi, Toshinori Iwai, Hideyuki Nakashima, Senri Oguri, Mitomu Kioi, Makoto Hirota, Iwai Tohnai
Journal: Journal of Clinical Oncology (2013)

6060 Background: Retrograde superselective intra-arterial chemotherapy for oral cancer has the advantage of delivering a high concentration of the chemotherapeutic agents to the tumor bed, it can be used to provide daily concurrent chemoradiotherapy for patients with advanced oral cancer. The purpose of this study was to evaluate the therapeutic results and rate of organ preservation in 112 patients of stage III or IV (M0) oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. Methods: Between August 2006 and July 2011, 112 patients with stage III or IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. And treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60 mg/m 2 , cisplatin, total 150 mg/m 2 ) and daily concurrent radiotherapy (total 60 Gy) for 6 weeks. Results: The median follow-up for all patients was 46.2 months (range, 10–90 months). The median follow-up for living patients was 49.7 months (range, 36–90 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Thirty patients (26.8%) died. Using the Kaplan-Meier method, 3-year, and 5-year survival rates were 74.6% and 71.3%, respectively, while 3-year, and 5-year local control rates were both 79.3%. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1%. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure occurred in 0.9%, no patients died as a result of treatment toxicity. Conclusions: Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for Stage III, IV oral cancer provided good overall survival and local control rates, thus preserving organs and contributing to patients’ QOL.
ERRATUM
Authors: Aliana Guerrieri-Gonzaga, Chris Robertson, Bernardo Bonanni, Davide Serrano, Massimiliano Cazzaniga, Serena Mora, Marcella Gulisano, Harriet Johansson, Franca Formelli, Mattia Intra, Antuono Latronico, Dorella Franchi, Giuseppe Pelosi, Karen Johnson, Andrea Decensi
Journal: Journal of Clinical Oncology (2006)
Treatment patterns, biomarker testing, and outcomes in patients with nonsquamous non-small cell lung cancer (NSCLC) receiving second-line treatment in the US Oncology network.
Authors: IWen Pan, Rajiv Mallick, Rahul Dhanda, Eric S. Nadler
Journal: Journal of Clinical Oncology (2013)

e19139 Background: Non-small cell lung cancer (NSCLC) is the leading cause of cancer death in the US, with a 5-year survival rate of &lt; 20%. Treatment patterns and outcomes in late stage NSCLC in US community oncology practices are not well known. Methods: This retrospective study used the iKnowMed database, billing claims, and chart reviews. Eligibility criteria included non-squamous NSCLC, stage IIIB/IV at diagnosis, ECOG status &lt;3, and initiation of second-line therapy (defined as index date) between 1/1/2007-6/30/2011 with &gt; 1 year follow-up. Key outcomes were overall survival (OS), progression-free survival (PFS), time-to-progression (TTP), and time-to-hospitalization (from index date). Progression was defined as change in therapy and/or new metastatic lesion. Kaplan-Meier and Cox proportional hazard models were used to characterize the distribution and predictors of outcomes. Results: 1,168 patients were eligible for the study. The top three second-line therapies were pemetrexed (54.4%), erlotinib-containing regimens (17.6%), and docetaxel (10.0%). OS and PFS were 7.5 (95% CI: 6.6-8.4) and 4.1 (95% CI: 3.7-4.5) months, respectively; 57% of patients were hospitalized post-index date. EGFR testing rates were 2.3% pre-2010, 15.2% in 2010, and 32.0% in the studied 2011 period (p&lt;0.001). Of EGFR-positive patients, 50.0% received erlotinib-containing regimens compared to 16.9% of EGFR-negative patients (p=0.001). Baseline ECOG=1 (HR=1.49; p&lt;0.001) or ECOG=2 (HR=1.79; p&lt;0.001), compared to ECOG=0, existing co-morbid fatigue (HR=1.53; p=0.010) compared to no co-morbid fatigue, and progression (HR=1.78; p&lt;0.001), when it occurred, compared to no progression, increased risk of shorter time to hospitalization, adjusting for other factors. Compared to other second-line treatment, erlotinib-containing regimens prolonged adjusted TTP (HR=0.68; p=0.018). Conclusions: EGFR testing in community practice rose rapidly after 2010 suggesting improved personalized treatment given study evidence that EGFR inhibitors prolonged adjusted TTP. Also, ECOG ≥1 and progression, once it occurred, predicted shorter time-to-hospitalization.
The physiology and clinical utility of anti-Müllerian hormone in women
Authors: Didier Dewailly, Claus Yding Andersen, Adam Balen, Frank Broekmans, Nafi Dilaver, Renato Fanchin, Georg Griesinger, Tom W. Kelsey, Antonio La Marca, Cornelius Lambalk, Helen Mason, Scott M. Nelson, Jenny A. Visser, W. Hamish Wallace, Richard A. Anderson
Journal: Human Reproduction Update (2014)
Unmet need, survivorship concerns, and psychosocial outcomes among testicular cancer (TC) survivors.
Authors: Steven C Palmer, Abigail N. Blauch, Donna A. Pucci, David J. Vaughn, Linda A. Jacobs
Journal: Journal of Clinical Oncology (2017)

226 Background: Although some aspects of quality of life are well described among TC survivors, particularly in Europe, unmet need for symptom management, degree of survivorship concern, and their relationship to outcomes such as anxiety and depression have been unexplored among TC survivors in the U.S. Methods: Concurrent TC survivors treated &gt; 1 year prior with no evidence of disease were recruited in a U.S. survivorship clinic. Participants completed a measure of 13 unmet needs and a 17-item scale assessing survivorship concern in follow-up care and screening, symptom management, family and genetic issues, and fear of recurrence (0-3 scale, alpha = 0.92). Anxiety and depression were assessed using the HADS. Results: Participants (N = 199) were primarily white (96%), early middle aged (M = 41 yrs), treated for Stage I (81%) or II TC (11%) with surgery (100%), chemotherapy (39%), and/or XRT (14%) an average of 7 years earlier. 11% reported hormone replacement therapy (HRT), and 16% had experienced a relapse. Participants reported an average 1.1 unmet needs (R = 0-11) with 66% reporting none. Unmet needs most commonly focused on fatigue (16%), sexual interest (12%), weight (12%), and concentration (11%) issues. Survivorship concern was low (M = 1.0) but variable (R = 0-2.9). Depressive (M = 2.1) and anxiety symptoms (M = 4.8) were generally low, though elevated in 4% and 19%, respectively. Age, time from diagnosis, race, curative therapy type, and relapse were unrelated to unmet need, concern, anxiety or depression. Higher staging and those receiving HRT was associated with more unmet need (p &lt; 0.04). Unmet needs were associated with concerns (r = .33), anxiety (r = .24), and depression (r = .50). Concerns were associated with anxiety (r = .36) and depression (r = .32). Conclusions: Psychosocial adaptation appears good among most TC survivors, though a substantial number experience elevated anxiety. Survivorship concerns and unmet needs are associated with poorer adaptation in both depression and anxiety symptoms. Assessing and addressing concerns and unmet needs may improve outcomes among TC survivors.
Liver metastases (LM) to predict for short overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients (pts).
Authors: William Kevin Kelly, Susan Halabi, Michael Anthony Carducci, Daniel J. George, John Francis Mahoney, Walter Michael Stadler, Michael J. Morris, Philip W. Kantoff, J. P. Monk, Eric Jay Small
Journal: Journal of Clinical Oncology (2012)

4655 Background: Patients withCRPC with LM represent a subset of patients with a poor prognosis. An exploratory analysis was performed to evaluate the difference in baseline characteristics and clinical outcomes in patients with and without LM from a randomized phase III trial (CALGB 90401) in men with mCRPC. Methods: Data from 1,050 men treated with docetaxel, prednisone with either bevacizumab or placebo were used. Pts were chemotherapy naïve, and had evidence of progressive mCRPC despite castrate testosterone levels and anti-androgen withdrawal, ECOG performance status ≤ 2, and adequate bone marrow, hepatic and renal functions. The proportional hazards model was used to assess the prognostic significance of LM in predicting OS and progression free survival (PFS) adjusting for stratification factors. Results: Fifty-nine (5.6%) of the 1045 pts with a complete data set had documented LM. Patients with LM had higher baseline alkaline phosphatase (ALK, 167 vs 117 U/L, p =0.0205) and lactate dehydrogenase (LDH, 262 vs 205 U/L, p =0.0001) compared to patients without LM. There were strong associations between LM status and lung metastasis (p=0.0004) and other visceral disease (p=&lt;0.001) but not with bone disease. Clinical outcomes as a function of LM status are listed in the table. The median OS time in LM pts was 14.4 compared to 22.6 months, with a hazard ratio (HR) 1.4. The HR for treatment effect (DP+B vs. DP) for LM was not statistically significant for either group. Conclusions: Compared to pts without LM, mCRPC with LM are characterized by higher LDH and ALK and have a poor OS despite having similar PFS and objectivebiochemical response to docetaxel based therapy. [Table: see text]
Concordance between abstracts, virtual meeting (VM) presentations, and final publication of phase III clinical trials presented at the Annual Meeting of the American Society of Clinical Oncology.
Authors: Suneil Kumar Khanna, Matthew John Boyko, Daniel Yick Chin Heng, Michael M. Vickers, Vincent Channing Tam
Journal: Journal of Clinical Oncology (2013)

6622 Background: Phase III clinical trial results described in abstracts in the ASCO Annual Meeting Proceedings often differ from final results seen in publication. We hypothesize that the abstracts may act only as place holders, while the results presented at the ASCO Annual Meeting are more highly concordant with the final publication. Methods: A retrospective review of all abstracts submitted to the ASCO Annual Meeting in 2005 to 2007 was conducted. Inclusion Criteria: randomized, prospective phase III clinical trials of greater than 200 patients with at least one quantitative primary endpoint such as OS or PFS. For each abstract, we viewed the VM presentation and searched Pubmed and Medline for the corresponding publications. Data regarding the clinical trials was extracted from all three sources and statistical comparisons were made. Results: A total of 7,900 abstracts were screened from the ASCO 2005 and 2007 Annual Meetings, of which 124 met the inclusion criteria. An additional 43 studies were excluded due to absence of either a VM presentation or publication. The majority (96%) of these trials were presented as either an oral presentation or poster discussion. Key comparisons of the concordance between the abstract or VM presentation and the final publication are shown in the Table below. Conclusions: While the statistical significance of the primary endpoint and conclusions from all three sources are very similar, the results reported in VM presentations at ASCO Annual Meetings are a better representation of the final publication compared to the abstract. When relying on clinical trial results from these meetings to change clinical practice, physicians should refer to the VM presentation rather than the abstract. [Table: see text]
Assessment of discomfort and pain in patients undergoing fusion-MRI-guided versus TRUS-guided prostate biopsy.
Authors: Dennis Robins, Michael Lipsky, Sven Wenske
Journal: Journal of Clinical Oncology (2017)

e556 Background: The addition of MRI fusion guided prostate biopsy (FusionBx) to transrectal ultrasound guided template biopsy (TRUSBx) has increased sensitivity in detecting clinically relevant prostate cancer (PCa) over TRUSBx alone. FusionBx in conjunction with TRUSBx requires more biopsies in less accessible locations and takes more time than TRUSBx, suggesting that FusionBx+TRUSBx may be less tolerable to patients than TRUSBx alone. Objective of our study was to investigate patient pain associated with FusionBx+TRUSBx versus TRUSBx. Methods: Patients undergoing FusionBx+TRUSBx or TRUSBx alone from April through September 2016 at Columbia University Medical Center for PCa detection or surveillance were asked to complete a validated pain survey immediately after biopsy. Responses were graded from 0-10 (0: no pain/willing to return for repeat procedure; 10: excruciating pain/not willing to return for repeat procedure). Procedures were performed by a single urologist with a 1% Lidocaine periprostatic nerve block. Pain scores between groups were compared via Mann-Whitney U test. Results: A total of 94 patients were included, with 50 FusionBx+TRUSBx and 44 TRUSBx. For each group, median age was 66.5 (range 47-84) and 68 years (range 44-86), and median number of cores was 14 (range 12-22) and 12 (range 6-14), respectively. Prostate biopsy pain questionnaire scores did not differ significantly for any of the questions. Patients in both groups had mild discomfort overall with the procedure (3 out of 10), the probe insertion (2 out of 10) and the biopsy portion of the exam (3 out of 10). If medically necessary, both groups were very willing to come back for the same procedure again (1 out of 10). Conclusions: Patients reported no difference in pain or discomfort with added FusionBx relative to TRUSBx alone. Both procedures were mildly painful with patients very willing to return for repeat biopsy. Patients tolerate the addition of FusionBx to TRUSBx alone. Patients’ pain experience or discomfort does not seem to hinder whether FusionBx of the prostate should be performed, or not.
Epidermal growth factor receptor tyrosine kinase inhibitors on clinical outcome of advanced non-small cell lung cancer patients with leptomeningeal carcinomatosis.
Authors: Bin-Chi Liao, Jih-hsiang Lee, Chia-Chi Lin, Chao-Chi Ho, Jin-Yuan Shih, Chong-Jen Yu, James Chih-Hsin Yang
Journal: Journal of Clinical Oncology (2015)

e19061 Background: Leptomeningeal carcinomatosis (LC) is a detrimental complication of patients with advanced non-small cell lung cancer (NSCLC). The effect of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) on clinical outcome of advanced NSCLC patients, especially patients who harbored an EGFR mutation, with LC has not been addressed previously. Methods: Patients with lung cancer diagnosed between 2003 and 2010 in National Taiwan University Hospital were screened retrospectively. LC was identified by cytology of cerebral spinal fluid or neuroimaging studies. The treatments and clinical outcomes were reviewed. Results: In total, 5526 lung cancer patients were screened and 212 (3.8%) patients were identified to carry NSCLC and LC. Most patients (88.7%) have adenocarcinoma histology. One hundred and twenty-nine (60.9%) patients had been treated with at least one EGFR-TKI before the diagnosis of LC. One hundred and twenty-four (58.5%) and 128 (60.4%) patients were treated with EGFR-TKI and whole-brain radiation therapy (WBRT), respectively following diagnosis of LC. The median overall survival (OS) was 6.5 months (95% Confidence Interval [CI]: 4.1-9.3). A multivariate analysis suggested that EGFR-TKI therapy, WBRT, and cytotoxic chemotherapy were independent predictors for longer OS. Mutational status of EGFR was evaluated in 101 patients and 75 mutations (74.3%) were detected. Among the 75 patients who harbored an EGFR mutation, EGFR-TKI therapy and WBRT following diagnosis of LC remained the independent favorable predictors for OS in multivariate analysis. Conclusions: Treating LC with EGFR-TKI or WBRT in selected patients and patients who harbored an EGFR mutation might prolong survival.
Survival outcomes of primary myelodysplastic syndrome in United States.
Authors: Guru Subramanian Guru Murthy, Pooja Motwani, Yogesh Jethava, Laura Fulper Hutchins, Peter D. Emanuel, Ishwori Dhakal, Issam Makhoul, Jeannette Y. Lee
Journal: Journal of Clinical Oncology (2014)

7112 Background: Hypomethylating agents were approved for use in treatment of MDS after 2004. This study aims to delineate the discrepancies in survival of MDS at population level before and after approval of these agents. Methods: Using Surveillance, Epidemiology and End Results (SEER-17) database, adult patients with primary MDS, diagnosed between 2001 to 2010 were identified. Overall survival analysis was performed using Kaplan-Meier method and compared by log rank. Period of diagnosis for survival was analyzed between 2001-2005 and 2006-2010. Multivariate analysis was performed using Cox Proportional Hazards regression method. Results: 22,051 patients with MDS with a median age of 76 years were included. Median overall survival (OS) for different age groups was as follows: age < 60 – 59 months, age 60 to70 – 36 months, age > 70 – 23 months, p < 0.001). We found that 5 year OS has improved across all age groups diagnosed from 2006-2010 compared to 2001-2005 (age < 60 – 50.3% vs. 16%, age 60-70 – 37.8% vs. 14 %, age > 70 – 23% vs. 3% p<0.01). Females had a better overall survival than males (32 month vs 24 months respectively, p < 0.001). Blacks had a higher overall survival than whites or other races (34 months vs 27 months) (p-not significant). On multivariate analysis age > 60 years ( HR-1.38 95% CI 1.30-1.46, p<0.01) and male sex ( HR-1.17, 95% CI 1.13-1.21, p<0.01) were significantly associated with higher mortality. Diagnosis after the year 2005 was associated with decreased mortality (HR 0.78, 95% CI 0.74-0.82, P<0.001). Conclusions: Overall survival has continued to improve across all age groups with introduction of hypomethylating agents and better supportive care.
5-fluorouracil (5-FU) plus cisplatin (CDDP) induction chemotherapy followed by combined external bean radiation therapy (XRT) and mitomycin-C (MMC) and 5-FU chemotherapy in locally advanced anal canal cancer (ACC)
Authors: J. J. Rodriguez-Riao, D. Figueira, E. Zarraga, L. Lion, M. B. Fuentes, P. Fernandez, I. Nasr, C. Gamboa, J. Ochoa
Journal: Journal of Clinical Oncology (2006)

14016 Background: Definitive chemoradiation therapy is the standard of care for squamous or cloacogenic cell ACC. The chemotherapy regimen comprising 5-FU and MMC is the most commonly used among patients with ACC, nearly 70% of patients can get complete response (CR), with the benefit of sphincter preservation, but patients with a large tumors (T3/T4) or nodal metastases have a response of 50%. Methods: To improve outcome, we conducted a phase II, study of 5-FU and CDDP followed by combined XRT plus 5-FU and MMC. Eligibility included patients withT3/T4 ACC with limited locoregional nodal involvement (N0/N1). Treatment: 5-FU 1000 mg/m 2 /days 1 to 5 in continuous i.v. infusion plus CDDP 100 mg/m 2 i.v. day 1 q21d was administered for 2 cycles (weeks 1 and 4) followed by XRT (4.5 Gy) during 6 weeks (weeks 7 to12) with concurrent 5-FU 1000 mg/m 2 /days 1 to 4 in continuous i.v. infusion plus MMC 10 mg/m2 i.v. day 1 (weeks 9 and 17). RECIST criteria were used to assess tumor response Results: 59 patients were entered on this study from 8/2000 to 2/2005. Median age: 57 yrs (37–83), 49 F/10 M, median ECOG PS 0 (0–1), T3/T4 44/15, N0/N1 20/39. 54 patients were evaluable for clinical response: Induction chemotherapy led to 13 (24%) CR, 38 (70%) partial responses (PR) and 2 (6%) stable disease. After combined modality treatment, there were a total of 36 (67%) CR, 13 (24%) PR, 5 (9%) SD. Median follow up was 21.6 months (5–52).The median time to progression is 20.5 months (3–52). Toxicity grade 3/4: Neutropenia 20% (10/54), thrombocytopenia 13% (7/54), radiodermatitis 13% (7/54), nausea/vomiting 7% (4/54). Our previous experience with concurrent treatment without induction (n=27) resulted in a CR 59%, PR 37%, and 4% progressive disease Conclusions: We concluded that induction chemotherapy followed by combined XRT and chemotherapy could be an option in treatment of locally advanced ACC. No significant financial relationships to disclose.
Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study
Authors: Tarun Chakravarty, Lars Søndergaard, John Friedman, Ole De Backer, Daniel Berman, Klaus F Kofoed, Hasan Jilaihawi, Takahiro Shiota, Yigal Abramowitz, Troels H Jørgensen, Tanya Rami, Sharjeel Israr, Gregory Fontana, Martina de Knegt, Andreas Fuchs, Patrick Lyden, Alfredo Trento, Deepak L Bhatt, Martin B Leon, Raj R Makkar, Danny Ramzy, Wen Cheng, Robert J Siegel, Louise M Thomson, Geeteshwar Mangat, Babak Hariri, Fadi J Sawaya, Helle K Iversen
Journal: The Lancet (2017)
Metabolic tumor burden for prediction of overall survival following combined BRAF/MEK inhibition in patients with advanced BRAF mutant melanoma.
Authors: Grant A. McArthur, Jason Callahan, Antoni Ribas, Rene Gonzalez, Anna C. Pavlick, Omid Hamid, Thomas Gajewski, Igor Puzanov, Adil Daud, Ming Yin, Nicholas Choong, Jinay K Shah, Jill Fredrickson, Rodney J Hicks
Journal: Journal of Clinical Oncology (2014)

9006^ Background: BRAF mutation is a common and potent oncogenic driver of ERK signalling in melanoma. Abrogation of pERK reduces 18-F-fluorodeoxyglucose (FDG) uptake on PET with recovery in glycolytic metabolism being a hallmark of resistance. FDG-PET also allows accurate quantification of melanoma burden. In a Ph1b trial (BRIM7), combining vemurafenib (vem) with a MEK inhibitor, cobimetinib (cobi), BRAFi-naïve patients (pts) with advanced BRAFV600-mutated melanoma attained 87% confirmed response rate, by RECIST and median progression-free survival of 13.7 months. We evaluated FDG-PET response as predictor of clinical outcome in BRAFi/MEKi naïve patients (pts) treated with this combination. Methods: FDG-PET scanning was performed in cycle 1 (C1) (day 10-15) and in C2 (day 35-49) of BRIM7. The percentage of the injected dose (%ID) of FDG and metabolic tumor volume (MTV), as measures of tumor burden, and maximum standardized uptake value (SUVmax) in up to 5 target lesions, as an indicator of metabolism, were assessed at baseline, C1 and C2. PFS and OS were analysed by the log rank method. Results: 35 evaluable BRAFi-naïve pts (mean %ID 1.6±2.9% and mean `MTV 166±251 ml) demonstrated a mean reduction in %ID, MTV and SUVmax of 86±14%, 72±23% and 76±18% at C1, respectively, and 95±10%, 92±12% and 89±14% at C2, respectively. All pts achieved a partial metabolic response (PMR) (> 30% decrease in SUVmax) by C1 with 5 complete metabolic responses (CMR) (14%) in C1 and 17 CMR (51%) in C2. Pts achieving a CMR in C1 had longer PFS when compared to Pts achieving PMR. Although tumor burden at baseline was not correlated with metabolic response, both %ID and MTV were predictors of OS. Pts with a baseline %ID <median (0.36%) or MTV <median (47.5 ml) had better OS (HR 0.19, p<0.02 and 0.14, p=0.03) compared to pts with >median values. Conclusion: Independent of tumor burden, BRAFi/MEKi naïve pts treated with vem/cobi achieved a marked, early and progressive metabolic response on FDG-PET consistent with successful inhibition of ERK-signaling. Tumor burden was a predictor of clinical outcome in this small patient cohort with low baseline %ID or MTV associated with longer overall survival; further validation is warranted. Clinical trial information: NCT01271803.