tbuckley/cabot-search huggingface dataset:
Minor response rate to predict patient survival.
Authors: Binsheng Zhao, Shing Mirn Lee, Jing Qi, P. David Mozley, David J. Mauro, Lawrence H. Schwartz
Journal: Journal of Clinical Oncology (2013)

3635 Background: RECIST is widely used to evaluate anticancer therapy efficacy, yet its response cutoff values have not been proven biologically or measurement-error relevant. Our previous study showed that the variability in measuring relative change in total tumor burden (TTB%) was +/-10% in metastatic colorectal cancer (mCRC). Our study investigated the impact of a finer gradation of response categories in predicting survival. Methods: 468 patients enrolled in a phase II/III clinical trial evaluating a systemic therapy in mCRC were analyzed. TTB on baseline and 6-week (+/- 3-wk) scans were obtained per RECIST 1.0. Overall survival (OS) was defined from the start of treatment and the date of the scan using the landmark method. The TTB% was summarized using RECIST category and a finer gradation that included cut-offs established in our variability study (&lt;-30%, -30% - -10%, -10% - 10%, 10% - 20%, &gt;20%). The OS and TTB% correlation was evaluated by the Kaplan Meier method and Cox regression. The discriminatory powers of the response summaries were examined using Harrel’s c statistics and concordance probability. Results: Out of the 468 patients, 141 died. The median survival time for patients with a TTB% at 6 weeks of [-30%, -10%] (n=116), [-10%, 10%] (n=171), [10%, 20%] (n=43), &gt;20% (n=62) were 417, 287, 223 and 172 days, respectively. Among those with a change of &lt; -30% (n=76), over half of patients were still alive. The hazard ratio for OS compared to those with a change of &lt;-30% are listed in the Table. The inclusion of additional categories increased both Harrel’s c-statistic (0.69 vs 0.73) and concordance probability (0.63 vs 0.69). Combining the [-10%, 10%] and the [10%, 20%] categories yielded very similar statistics compared to having all 5 categories. Both definitions of OS yielded consistent results. Conclusions: Evidence suggests that, in the context of this study, the minor change category of [-30%, -10%] at 6-wk correlates with longer survival compared to the change category of [-10%, 20%], suggesting a possible re-evaluation of conventional response cut-off values. [Table: see text]
TimeTree: A Resource for Timelines, Timetrees, and Divergence Times
Authors: Sudhir Kumar, Glen Stecher, Michael Suleski, S. Blair Hedges
Journal: Molecular Biology and Evolution (2017)

Evolutionary information on species divergence times is fundamental to studies of biodiversity, development, and disease. Molecular dating has enhanced our understanding of the temporal patterns of species divergences over the last five decades, and the number of studies is increasing quickly due to an exponential growth in the available collection of molecular sequences from diverse species and large number of genes. Our TimeTree resource is a public knowledge-base with the primary focus to make available all species divergence times derived using molecular sequence data to scientists, educators, and the general public in a consistent and accessible format. Here, we report a major expansion of the TimeTree resource, which more than triples the number of species (>97,000) and more than triples the number of studies assembled (>3,000). Furthermore, scientists can access not only the divergence time between two species or higher taxa, but also a timetree of a group of species and a timeline that traces a species' evolution through time. The new timetree and timeline visualizations are integrated with display of events on earth and environmental history over geological time, which will lead to broader and better understanding of the interplay of the change in the biosphere with the diversity of species on Earth. The next generation TimeTree resource is publicly available online at http://www.timetree.org.
Somatostatin analogs as mainteinance therapy in heavily pretreated thymic epithelial tumors.
Authors: Giovannella Palmieri, Margaret Ottaviano, Lucia Nappi, Pasquale Rescigno, Mirella Marino, Liliana Montella, Mariateresa Micillo, Giuliano Palumbo, Silvana Del Vecchio, Vincenzo Damiano
Journal: Journal of Clinical Oncology (2015)

7581 Background: Thymic epithelial tumors are rare neoplasms with a particular biological behavior, treated with a combination of therapeutic strategies such as surgery, chemotherapy, radiotherapy and target agents. No continuation maintenance therapy exists for these rare tumors. An high uptake of indium-labeled octreotide (111In-DTPA-D-Phe1-octreotide) and curative application of somatostatin analogs in thymic tumors have been widely demonstrated. Methods: Eighteen patients (nine women and nine men, median age 54.5 years; range 32-78) with advanced thymic tumors (seven patients with stage III; seven with IVa; Four with IVb according to the Masaoka-Koga staging system), histotype sec WHO revised by central review (three AB, two B1, three B2, five B3, three B2/B3, two thymic carcinoma) with a partial response or stable disease to conventional chemotherapeutic regimens platinum or not platinum-based, after performed OctreoScan, were enrolled in this monocentric referral center study. The schedule includes administration of long-acting analog octreotide (30 mg/every 28 days intramuscularly), until progression of disease was documented. Median time to progression and toxicity were evaluated. Results: Median follow-up was of 43 months with a median time to progression of 14,5 months (range 77-2). Treatment was generally well tolerated with acceptable toxicity: Grade 1 diarrhea (5 patients), Grade 2 hyperglycemia (4 patients). No patients interrupted treatment because of toxicity. Conclusions: The current study indicates that single-agent somatostatin analogs maintenance therapy is a potential treatment strategy for advanced TETs OctreoScan positive which responde to previous conventional chemotherapy. In particular, somatostatin analogs may provide an effective maintenance treatment duration regardless of histotype and stage of disease with an acceptable toxicity and an improved patients’compliance.
Clinical Response to Pazopanib in a Patient With <i>KDR</i>-Mutated Metastatic Basal Cell Carcinoma
Authors: Todd C. Knepper, Morganna L. Freeman, Geoffrey T. Gibney, Howard L. McLeod, Jeffery S. Russell
Journal: JAMA Dermatology (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Outcomes of small cell lung cancer (SCLC) chemotherapy. Results of a retrospective analysis
Authors: G. Genestreti, D. Tassinari, E. Pasquini, M. Papi, B. Roudnas, F. Fochessati, M. Fantini, B. Poggi, V. Agostini, A. Ravaioli
Journal: Journal of Clinical Oncology (2004)

7277 Background. First line chemo-radiotherapy is the treatment of choice in SCLC, while second line treatment at relapse still remains controversial. Methods. The records of all the patients with SCLC we treated from 1990 to 2003 were reviewed. Overall survival was the main outcome of our review; survival analysis was performed using the Cox regression model, stratifying the patients on the basis of the stage of the disease (limited vs extended). Results. The records of 190 patients were reviewed, and the results are summarised in the table. First line treatment was cyclophosphamide-epidoxorubicin-etoposide (CEVP16) before 1999, and carboplatin-etoposide (CP) from 1999 till today. The kind of first line treatment (334 days vs 238 days for CEVP16 and CP respectively, p=0.01), the use of complementary radiotherapy (390 days vs 208 days respectively, p=0.009) and the second line chemotherapy at relapse (430 days vs 212 days respectively, p=0.001) were independent prognostic factors of survival. No differences in side effects were observed between CEVP16 and CP groups (Grade III-IV haematological toxicity: 58.9% vs 48%, p=0.17; grade III-IV not-haematological toxicity: 8.4% vs 5.8%, p=0.57, using the Fisher exact test). Conclusions. Although our data are extracted by a retrospective analysis, it is of interest the datum of a better outcome of patients treated with CEVP16 when compared with the outcome of those treated with CP. No significant differences in haematological and not-haematological side effects were observed in the two groups. On the opposite, a selection bias could influenced the better outcome of patients treated with II line chemotherapy at relapse for the exclusion from the treatment of patients with low performance status (supported by IOR). No significant financial relationships to disclose.
Three-dimensional computed tomography-guided brachytherapy of prostate cancer in patients without rectum
Authors: P. G. Koutrouvelis
Journal: Journal of Clinical Oncology (2004)

4667 Background: Approximately 50,000 men will survive colorectal cancer in the US after treatment with colectomy, radiation therapy, and chemotherapy, and 10% (5,000) of these patients may develop a second primary with prostate cancer. Because of previous radiation therapy and radical surgery, these patients are not candidates for a second external-beam radiation therapy (EBRT) or radical prostatectomy, and have no rectum for transrectal ultrasound-guided biopsy or transperineal brachytherapy. For the first time, we report the only method of treatment for these patients using three-dimensional stereotactic system with computed tomography-guided brachytherapy with iodine 125 seeds. The low dose rate and high attenuation of iodine 125 seeds allows a second radiotherapy treatment with interstitial implant. Methods: From June 1994 to November 2003, in the concord of 800 patients treated with three-dimensional stereotactic system with computed tomography-guided permanent implant, 5 patients did not have a rectum. Four of these patients had colectomy for colorectal cancer and 1 for ulcerative colitis. One patient had extensive invasion of the seminal vesicles of prostate cancer. The three-dimensional stereotactic system is adjusted to avoid obstruction of the needle by the coccyx. Precise placement of seeds with use of the stereotactic system is accomplished to cover the target prostate, 5 mm outside the capsule, and seminal vesicles if involved. Pre- and post-implant dosimetry were performed with Varian software. Radiation dose of 144 Gy was accomplished with iodine 125 seeds. Results: All patients except one with seminal vesicle invasion had excellent clinical and biochemical control in 1 - 4 years post-implant. There was no gastrointestinal or urinary morbidity except the patient with seminal vesicle involvement developed stricture of the distal ureter requiring stent. Conclusions: Brachytherapy of prostate cancer in patients without rectum using three-dimensional stereotactic system and computed tomography-guidance is the only currently available effective method of treatment. No significant financial relationships to disclose.
A phase Ib/II study of afatinib in combination with nimotuzumab in non-small cell lung cancer patients with acquired resistance to gefitinib or erlotinib.
Authors: Myung-Ju Ahn, Ji Yun Lee, Jong-Mu Sun, Bo Mi Ku, Jiae Koh, Sung Hee Lim, Min-Young Lee, Haesu Kim, Jin Seok Ahn, Keunchil Park
Journal: Journal of Clinical Oncology (2015)

8086 Background: Afatinib (A) is a potent irreversible ErbB family blocker and nimotuzumab (N) is a humanized anti-EGFR mAb. In this phase Ib/II study, we aimed to assess the safety and activity of A plus N in advanced NSCLC patients with acquired resistance to gefitinib or erlotinib. In our preclinical study, using a mouse xenograft model, Nimotuzumab enhanced the antitumor efficacy of Afatinib. Methods: Major inclusion criteria were advanced NSCLC with activating EGFR mutation or disease control for at least six months with previous gefitinib or erlotinib therapy. In phase Ib study using classic 3+3 dose escalation method, patients were treated with A either 40mg/d or 30mg/d in combination with N either 100mg/w or 200mg/w. One cycle was composed of 4 weeks of treatment. In phase II study, patients were treated with A plus N in the level of RP2D defined in phase Ib study. Results: Overall, fifty pts were enrolled and treated: 13 in phase Ib and 37 in phase II. The median age of the patients was 55 years and 62% were female. EGFR mutation types were as follows: del19 (N = 23, 46%), L858R (N = 15, 30%), and others. All patients had received prior gefitinib (N = 34, 68%) or erlotinib (N = 16, 32%). At the first cohort (A 40mg/d + N 100mg/w), 1 out of 6 pts experienced 1 DLT (G3 diarrhea), and 2 out of 6 pts experienced DLTs (G3 diarrhea and G3 neutropenia, respectively) during the 1st cycle in the next cohort (A 40mg/d + N 200mg/w). Thus, RP2D was accordingly determined as A 40mg/d + N 100mg/w per protocol. In phase II part, there was no treatment related death and 27% (10/37) of patients experienced any grade 3 adverse events (no one in grade 4 or 5), including diarrhea and skin rash. In phase II part, the response rate was 38% (14/37), disease control rate 81% (30/37), duration of response 4.0 months (range, 1.8-8.5 months) and the median PFS was 4.2 months (95% CI:2.44-5.96 months). Conclusions: Combination of A and N showed an acceptable safety profile and promising antitumor activity in advanced NSCLC patients with acquired resistance to gefitinib or erlotinib. Clinical trial information: 1200.189.
Switching specialties must be made easier, says GMC
Authors: Abi Rimmer
Journal: BMJ (2017)

Postgraduate medical training must become more flexible to end the “snakes and ladders” experience of trainees wishing to switch between specialties, the General Medical Council has said.

In its plan to improve the flexibility of training, submitted to the four UK health departments, the GMC said that the current training structure was too rigid and too slow to adapt to workforce and patient needs. Trainees switching specialties currently experience a type of “snakes and ladders” where instead of having their previous training recognised, they have to start again from scratch, it said.

The GMC published the plan after it was asked by Jeremy Hunt, the secretary …
GP partnership model is “no longer fit for purpose,” says Lords inquiry
Authors: Gareth Iacobucci
Journal: BMJ (2017)

The traditional partnership model of general practice is “no longer fit for purpose” and should be phased out in favour of alternative models such as salaried employment, concludes a major parliamentary inquiry.

The report from the House of Lords select committee on the long term sustainability of the NHS concluded that the small business model of general practice was “inhibiting change” and frustrating efforts to deliver more care outside hospitals in response to increasing demand from patients and NHS staff shortages.1

The inquiry, published on Wednesday 5 April, found broad support for general practices working together in federations to deliver an extended range of services. But it said that NHS England and the Department of Health must help GPs do this and work with the profession’s leaders to look at alternative contractual models, including “direct employment, which would reflect arrangements elsewhere in the NHS.”

In parallel, the committee urged the NHS to tackle its “over-reliance” on the acute care hospital sector, which posed “a serious threat to the long-term …
Autologous stem-cell transplantation in treatment-refractory Crohn's disease: an analysis of pooled data from the ASTIC trial
Authors: James O Lindsay, Mathieu Allez, Miranda Clark, Myriam Labopin, Elenor Ricart, Gerhard Rogler, Montserrat Rovira, Jack Satsangi, Dominique Farge, Christopher J Hawkey, Christopher J Hawkey, Matthieu Allez, Miranda Clark, Myriam Labopin, James O Lindsay, Elena Ricart, Gerhard Rogler, Montserrat Rovira, Jack Satsangi, Silvio Danese, Nigel Russell, John Gribben, Peter Johnson, Jerome Larghero, Catherine Thieblemont, Sandro Ardizzone, Daan Dierickx, Adalberto Ibatici, Timothy Littlewood, Francesco Onida, Urs Schanz, Severine Vermeire, Jean-Frederic Colombel, Jean-Paul Jouet, Elizabeth Clark, Riccardo Saccardi, Alan Tyndall, Simon Travis, Dominique Farge
Journal: The Lancet. Gastroenterology & hepatology (2017)
Allele-Specific Gene Expression May Influence Mental Health
Authors: Tracy Hampton
Journal: JAMA (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
A clinical analysis of thyroid cancer in adult patients exposed to ionising radiation due to the Chernobyl Nuclear Accident, Ukraine 1986
Authors: M. Gorobeyko, S. Cherenko, O. Larin
Journal: Journal of Clinical Oncology (2004)

6103 Background: The world's worst nuclear disaster occurred at the Chernobyl in 1986.Thyroid cancer in children from Ukraine after 1986 has been recognised precisely as radio-induced disease,the question about development of thyroid cancer in adult patients still remains controversial.The aim of the study is to compare the clinical and pathologic findings of surgical tumour pathology of thyroid in adults with or without history of irradiation due the Chernobyl disaster. Methods: In the Centre of Endocrine Surgery,a total of 2363 adult patients who have been operated on their thyroid (benign and malignant tumours) with no evidence of radiation influence in their medical history (Group A).311 patients were operated (born before 1969) with thyroid tumours and strict evidence of Chernobyl irradiation (Group B).Patients of Group B represented three official categories of people affected by Chernobyl.Group:I-participants of the clean up operation (93 patients);II-people evacuated from the restricted area (82);III-inhabitants of polluted territories (136). Results: Detailed information concerning this is to found in table.More distinct differences were observed in the 1st and 2nd subGroups of Group B patients.The most distinguished features were found in I category of B Group:T4-in47%,N1a-1b-in 62%,multifocality-in 41%. Conclusion: We can speculate on the supposition that the stage of aggressiveness of thyroid cancer is dependant on the uptake of isotope of iodine during the first days of the catastrophe and during the work on Nuclear reactor.Adults who are living in polluted by Ce-isotope lands do not have significant difference in the rate or aggressiveness of thyroid cancer with Group A. The increasing rate of thyroid malignancy in those adults irradiated at Chernobyl demands the undertaking of the most radical mode of treatment in such patients. No significant financial relationships to disclose.
Comparison of clinical outcomes between concurrent chemoradiotherapy followed by adjuvant chemotherapy and concurrent chemoradiotherapy alone for patients associated with locally advanced nasopharyngeal carcinoma: A retrospective analysis of single center experience.
Authors: Chi Hoon Maeng, Silvia Park, Hyun Ae Jung, Hee Kyung Ahn, Deok Won Hwang, Keunchil Park, Myung-Ju Ahn, Jun Ho Ji, Lee Chun Park, Su-Hee Cho, Ji Yean Lee
Journal: Journal of Clinical Oncology (2012)

e16003 Background: Up to date, the mainstay of treatment is concurrent chemoradiotherapy (CCRT) with or without adjuvant chemotherapy for locally advanced nasopharyngeal carcinoma. However, the exact role of adjuvant chemotherapy has not been established yet. Methods: Medical record review and data collection were performed for 148 patients who were diagnosed of locally advanced nasopharyngeal carcinoma from October 1996 to September 2009. We analyzed clinical outcomes between the patients who received CCRT followed by adjuvant chemotherapy with cisplatin and 5-FU, and CCRT alone. Results: The estimated 5 year survival rates were 78.3% for the CCRT group and 69.1% for the CCRT followed by adjuvant chemotherapy, respectively (p=0.223). For patients of TNM stage IVA or IVB, the progression-free survival (PFS) and overall survival (OS) had no significant differences between the two groups (p=0.062 and 0.538, respectively). For the patients with stage I, II or III at diagnosis, the PFS and OS were not statistically significant either (p=0.112 and 0.266, respectively). Conclusions: For all stages of nasopharyngeal carcinoma, adjuvant chemotherapy after CCRT did not affect the survival or recurrent rate. A randomized prospective study with long-term follow-up is necessary.