tbuckley/cabot-search huggingface dataset:
Quantifying the personal financial impact of a career choice in academic hematology/oncology (AHO).
Authors: M. Palmeri, E. Stansfield, A. Stansfield, A. D. Fuld, J. M. Pipas, B. A. Arrick, E. Wadsworth, T. H. Davis
Journal: Journal of Clinical Oncology (2011)

6076 Background: Significant increases in medical student debt (MSD) and housing costs over the last 10 years in conjunction with extended training and delayed retirement savings have created financial pressures for hematology/oncology fellows choosing a career in academic medicine. This study sought to quantify the personal financial impact associated with a career in AHO. Methods: Published retrospective data from the 2009 Bureau of Labor Statistics, 2010 MGMA Physician Compensation Survey, 2010 MGMA Academic Practice Compensation and Production Data and other sources regarding MSD, physician reimbursement, home mortgages, retirement planning, college savings, and cost-of-living expenses were used to develop an average net-income and expense paradigm (based on a model published by M. Palmeri et al, Academic Medicine; 85(11), 2010) for hematology/oncology fellows entering into AHO. Results: AHO careers result in a budgetary deficit in all but the lowest expense scenarios. If a fellow opts to extend training for additional research experience, this discrepancy is even more substantial. Conclusions: Over the last decade there has been a rapid rise in physician educational debt and home prices. When compounded with the financial effects of delayed retirement savings, these factors can create substantial budgetary shortfalls for fellows interested in AHO careers. Understanding the impact of these financial factors could help shape policy or incentives to promote careers in AHO. Net budgetary deficits/surpluses depending on career pathway and expense parameters. Budgetary variables Academic practice (3-years training) Academic practice (5-years training) Year 1 Year 1 to 5 Years to break even Year 1 Year 1 to 5 Years to break even Educational debt No debt +$20,225 +$144,458 N/A +$14,338 +$115,023 N/A $157,944 (Average debt) −$6,715 +$9,759 2 −$15,363 −$33,482 4 $220,000 −$17,299 −$43,161 5 −$27,038 −$91,857 8 Home mortgage $172,100 (Median mortgage) −$6,715 +$9,759 2 −$15,363 −$33,482 4 $250,000 −$11,678 −$15,055 3 −$20,356 −$58,297 5 $400,000 −$21,242 −$62,875 5 −$29,890 −$106,117 9
Solid Tumors Target the HSC Niche to Establish Metastatic Footholds in the Marrow
Authors: Yusuke Shiozawa, Elisabeth A. Pedersen, Aaron M. Havens, Younghun Jung, Anne M. Ziegler, Michael J. Pienta, Junhui Song, Jingcheng Wang, Robert D. Loberg, Paul H. Krebsbach, Kenneth J. Pienta, Russell S Taichman
Journal: Blood (2008)
Risk Factors for the Development of Acute and National Institute of Health (NIH) Chronic Graft-Versus-Host Disease (GVHD).
Authors: Mary E.D. Flowers, Barry E. Storer, Stephanie J. Lee, Paulo Vidal Campregher, Afonso Celso Vigorito, Paul A. Carpenter, Marco Mielcarek, Frederick R. Appelbaum, Paul J. Martin
Journal: Blood (2009)
Eribulin dosing in patients with advanced solid tumors and hepatic impairment.
Authors: L. A. Devriese, P. Witteveen, E. E. Voest, E. N. Overkleeft, M. Langenberg, J. H. Beijnen, L. Reyderman, J. Wanders, D. R. Mould, A. Gupta, Z. Hussein, J. H. M. Schellens
Journal: Journal of Clinical Oncology (2011)

2544 Background: Eribulin mesylate (E7389) inhibits microtubule dynamics by a novel mechanism of action. The effects of hepatic impairment on eribulin exposure following a single intravenous administration in patients (pts) with advanced solid tumors were investigated in a Phase I study. Data from 7 Phase I and one Phase II study were used to develop population pharmacokinetic/adverse event (PK/AE) models. Methods: In the Phase I study (NCT00706095), pts were grouped by hepatic function: normal (n=6), mild (Child-Pugh A; n=7) and moderate (Child-Pugh B; n=4) impairment, and received 1.4, 1.1 and 0.7 mg/m2 eribulin mesylate, respectively. Blood samples were collected post-dose over 144 hours. Log-transformed dose-normalized AUC and Cmax values were analyzed using analysis of variance. For PK modeling (n=269), eribulin mesylate dosing range was 0.1-4 mg/m2 bolus or 1 hour infusion once every 3 weeks in a 21-day cycle or once weekly for 3 weeks in a 28-day cycle. Non-linear mixed effects modeling (NONMEM) was used for model development. PK/AE models correlated the probability of a pt experiencing neutropenia with individual exposure. Results: In pts with mild and moderate hepatic impairment, mean dose-normalized AUC(0-∞) was 1.75-fold (90% CI 1.16, 2.65) and 2.79-fold (90% CI 1.72, 4.51), respectively, compared with normal function. A 3-compartment model with linear elimination described PK profiles. Clearance was significantly affected by body weight, serum albumin, alkaline phosphatase, and bilirubin. The probability of experiencing Grade 4 neutropenia increased with eribulin exposure and plasma aspartate transaminase, and was higher in pts with moderate impairment, but reduced from 22 to 15% in pts receiving 0.7 mg/m2 compared with 1.4 mg/m2 eribulin mesylate. Simulations of expected AUC values showed that this dose reduction for moderate impairment led to similar eribulin exposure in pts with normal function. Eribulin was generally well tolerated. Conclusions: Hepatic impairment decreased clearance, prolonged elimination half-life, and increased exposure to eribulin in pts with advanced solid tumors. The population PK/AE model supports eribulin mesylate dose reduction to 0.7 mg/m2 in pts with moderate hepatic impairment.
Correlation of locoregional treatment failures with radiotherapy target volumes after radiochemotherapy for esophageal cancer.
Authors: Cihan Gani, Stefan Georg Fischer, Daniel Zips
Journal: Journal of Clinical Oncology (2016)

166 Background: Radiotherapy is a mainstay in curative treatment concepts of esophageal cancer. Despite extensive treatment fields locoregional recurrences are frequent. We therefore aimed to evaluate the exact patterns of locoregional recurrence and correlate these recurrences with radiotherapy target volumes. Methods: Diagnostic PET-CT or CT imaging studies showing locoregional recurrences after preoperative or definitive radiochemotherapy for squamous or adenocarcinoma of the esophagus were matched with CT scans used for treatment planning. Distance of the recurrence from the Clinical Target Volume (CTV), Planning Target Volume (PTV) and the dose at the failure site were the determined. Target volume definition was in line with international standards. Results: We identified 104 patients treated with either definitive (n = 81) or preoperative radiochemotherapy (n = 23). After exclusion of patients with a history of second malignancies we found 25 locoregional recurrences in 20 patients. Median time to locoregional failure was 8 months (range 2-26 months). Six of 25 recurrences (24%) were located intraluminal in the initial Gross Tumor Volume (GTV), three of 25 (12%) were in-field nodal failures and five (20%) more than 1 cm distant from the PTV. Nine (36%) locoregional recurrences occurred within 1 cm of the cranial or distal end of the CTV, between the CTV and PTV or out-of-field adjacent to the PTV. Two patients developed anastomotic recurrence after surgery. Conclusions: Matching of diagnostic CTs showing local recurrences with radiotherapy planning CT data set allows the correlations of local recurrences with target volumes. Despite extensive safety margins, field margin recurrences remain a considerable problem in the treatment of esophageal cancer. The use of advanced radiotherapy techniques might facilitate larger treatment volumes without increasing toxicity.
Everolimus in Combination with Rituximab Induces Complete Responses in Heavily Pretreated Diffuse Large B-Cell Lymphoma
Authors: Jeffrey A. Barnes, Eric Jacobsen, Yang Feng, Arnold S. Freedman, Ephraim P. Hochberg, Ann S. LaCasce, Philippe Armand, Robin Joyce, Donna Neuberg, David C. Fisher, Jeremy S. Abramson
Journal: Blood (2011)
Prediagnostic plasma adiponectin and survival among patients with colorectal cancer.
Authors: Dawn Q. Chong, Raaj Mehta, Mingyang Song, Dmitriy Kedrin, Jeffrey A. Meyerhardt, Kimmie Ng, Kana Wu, Shuji Ogino, Charles S. Fuchs, Edward L. Giovannucci, Andrew T. Chan
Journal: Journal of Clinical Oncology (2015)

526 Background: Adiponectin is a hormone secreted by adipose tissue and has been demonstrated to possess anticarcinogenic, anti-inflammatory and insulin-sensitizing effects. Circulating adiponectin has been shown to be inversely associated with the risk of colorectal cancer (CRC) in prospective studies. However, the association of prediagnostic adiponectin with survival among patients with established colorectal cancer is unclear. Methods: We conducted a prospective study of 621 incident colorectal cancer cases from the Nurses’ Health Study and Health Professionals Follow-up Study to evaluate the association between prediagnostic plasma adiponectin and mortality. Plasma adiponectin levels were determined by enzyme-linked immunosorbent assay from ALPCO Diagnostics. The interbatch coefficient of variation from quality control samples randomly interspersed among the case samples was 8.6%. We examined the associations between quartiles of plasma adiponectin and mortality using a Cox proportional hazards model adjusted for established and putative risk factors. All statistical tests were two sided. Results: After a median follow-up of 9 years, there were 267 (43%) total deaths and 130 (21%) CRC deaths in the total study cohort. Compared with patients in the lowest quartile of adiponectin, patients in the highest quartile had a multivariate hazard ratio (HR) for CRC-specific mortality of 2.70 [95% confidence interval (CI), 1.54-4.75; P trend = 0.001]. The corresponding multivariate HR for overall mortality was 1.64 (95% CI, 1.14-2.36; P trend = 0.007). These associations were reasonably consistent in analyses according to subgroups defined by age, gender, body mass index, stage, grade and site of primary cancer. Similar results were yielded after excluding patients diagnosed within 4 years of blood collection (P trend = 0.027). Conclusions: Prediagnostic adiponectin is associated with an increased risk of colorectal cancer- specific and overall mortality. Further studies are needed to elucidate the mechanistic basis for these findings and determine the potential role of adiponectin as a prognostic marker in colorectal cancer.
Elevated APE1 Mediates Dysregulation of Homologous Recombination in Myeloma: Mechanisms and Translational Significance
Authors: Subodh Kumar, Maria Gkotzamanidou, Jagannath Pal, Renquan Lu, Puru Nanjappa, Jialan Shi, Masood Shammas, Nikhil C. Munshi
Journal: Blood (2014)
Biological Description of 109 Cases of Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) from the French Network of BPDCN
Authors: Eve Poret, Fanny Angelot Delettre, Sabeha Biichle, Anne Roogy, Louis Benazet, Maider Pagadoy, Chrystelle Vidal, Franck Leroux, Véronique Harrivel, Christophe Ferrand, Veronique Salaun, Zehaira Benseddik, Julien Guy, Marie Christine Jacob, Christophe Roumier, Jean Feuillard, Liliana Vila, Lucile Baseggio, Adriana Plesa, Christine Arnoulet, B Benet, Bernard Drenou, Veronique Latger Cannard, Marie-Christine Bene, Michel Ticchioni, Daniel Lusina, Valerie Bardet, Magalie LE Garff Tavernier, Elizabeth Macintyre, Vahid Asnafi, Maria Elena Noguera, Sabrina Bouyer, Carine Lecoq Lafon, Mikael Roussel, Fabrice Jardin, Francoise Solly, Lydia Campos, Anne Galoisy, Anne Arnaud, Sylvie Daliphard, Franck Genevieve, Romaric Lacroix, Françoise Schillinger, Estelle Seilles, Delphine Binda, Eric Deconinck, Philippe Saas, Francine Garnache Ottou
Journal: Blood (2015)
Paricalcitol has a potent <i>in vivo</i> tumoricidal effect on head and neck squamous cell carcinoma
Authors: T.-S. W. Huang, S. Northrup, C. Koumenis, S. M. Hess
Journal: Journal of Clinical Oncology (2005)

5584 Background: Paricalcitol is a calcitriol analog that has low clinical toxicity and produces significantly less hypercalcemia compared to calcitriol. Previous in vitro study from our lab has shown that paricalcitol is antiproliferative in 3 human head and neck squamous cell carcinoma cell lines, SCC 9, 15, and 25. The purpose of this study is to evaluate the in vivo activity of paricalcitol on SCC 15 cells grown in athymic nude mice. The effect of paricalcitol on serum calcium was also assessed. Methods: Each flank of nude mice was injected subcutaneously with 2.5 million SCC 15 cells. After the xenografts reached at least 50 mm3 in size, paricalcitol at 1.25 mcg/kg (treatment group with 4 mice) or drug carrier (control group with 4 mice) was administered by intraperitoneal (i.p.) injection every other day, three times a week, for 2 weeks. Serum calcium was obtained on days 0 and 14 of treatment. Results: In the control group, the xenografts reached a maximum mean size of 336 mm3 (S.E.193 mm3) at day 16, and all mice had to be euthanized due to tumor burden by day 43. In the treatment group, the xenografts grew to a maximum mean size of 252 mm3 (S.E. 195 mm3) at day 13. One mouse in the treatment group was euthanized due to tumor burden at day 7, but three mice remained alive and healthy at day 93. At day 93, two treated mice had no palpable residual tumors and one treated mouse had stable tumors measuring 38 and 27 mm3. In the control and treatment groups, calcium levels at days 0 and 14 were within normal limits. Conclusions: Paricalcitol, given at 1.25 mcg/kg i.p. every other day for 2 weeks, produced a potent tumoricidal effect on SCC 15 xenografts without hypercalcemia in nude mice. The results of this study provide support for further investigations of paricalcitol in the treatment of head and neck cancers. No significant financial relationships to disclose.
Augmentation of cancer outcomes through safe transitions.
Authors: Adarsh Hiremath, Joanna-Grace Manzano, Josiah Halm, Jeff Farroni
Journal: Journal of Clinical Oncology (2014)

250 Background: Policymakers have identified 30-day readmissions as an important quality indicator of poor care or coordination of care. Among cancer centers, there is no benchmark data in terms of readmission rates or recommendations in terms of risk adjustment models. Methods: Retrospective data analysis to estimate baseline readmission rate and identify risk factors. Interventions: (1)admitting to single floor, (2) twice weekly interdisciplinary meetings with using risk assessment tool–Cancer Outcomes Augmented through Safe Transitions (COAST) tool, and (3) re-evaluate readmission rate post intervention at 6 months and 1 year. Results: Unplanned readmission rate on the Hospitalist Service at MD Anderson was 21.5% at baseline. After 6 months of interventions, our readmission rate over 6 months was 23.3%. Age 45-65, having Medicare insurance, and being discharged to hospice were protective of a readmission. Distant metastases and having more comorbidities were associated with increased risk for readmission. Readmitted patients have a greater length of stay (7 days) and a higher average cost of inpatient stay ($20.3K vs. 17.9K). The median days to readmission was 11 days. Top comorbidities: hypertension, fluid and electrolyte disorders, anemia, diabetes mellitus, and abnormal weight loss. Top reasons: metastatic disease, biliary tract disease, GI hemorrhage, intestinal obstruction, septicemia, renal failure. Conclusions: Our project has provided insight into the rates and risk factors for readmission in oncology hospitalist service in a tertiary cancer center. The development of web-based COAST risk assessment tool is expected to give an improved understanding of our patient population. Although our readmission rates have not shown decrease over the 6 months after our interventions, this means that more interventions and more time may be necessary to impact readmission rates of services dealing with complex cancer patients. Additionally, a proportion of these unplanned readmissions in cancer patients may not be preventable. Benchmark data we have presented and that we continue to collect will help inform recommendations for effective transitions of care, patient safety practices as well as strategies for reducing readmission rates in cancer centers.
Survivorship workshop delivery to primary care providers.
Authors: Genevieve Chaput, Kristin Hendricks, Vinita D'Souza, Sarah Khan, Laura Naismith
Journal: Journal of Clinical Oncology (2016)

2 Background: There are approximately 15 million cancer survivors (CS) in North America. In addition to higher risk of recurrence, over 50% of CS are afflicted with late effects. CS are burdened with more medical conditions than the general population. CS visit specialists during treatment, and 75% of them also see their primary care provider (PCP) during and after treatments. Despite their integral role in survivorship care, PCP lack survivorship knowledge and have low confidence regarding CS care, supporting the urgent need to educate them about CS issues and surveillance needs. This study aimed to assess the educational benefit of a survivorship workshop targeting PCP in Montreal, Canada. Methods: An accredited workshop based on NCCN’s 8 common survivor issues was developed and delivered to 155 PCP at 5 sites. Matched pre and post surveys were designed using Likert scale and short-answer questions, and were completed on a voluntary basis by PCP. Specific outcome measures were based on the first 3 levels of Kirkpatrick’s learning model: satisfaction, knowledge, and behaviour. Data analysis included an open-coding approach to identify major themes of qualitative data. Ethics approval was granted. Results: Response rate was 64%. 95% indicated high satisfaction and relevancy of content for primary care. Using t-tests to compare pre and post responses, results were statistically significant for both “list 2 standards of survivorship” and “name 2 late-effects of cancer treatment” survey items, indicating an increase in both standards and late effects identified post workshop. 99% expressed behavioural intent to incorporate survivorship information into practice. Conclusions: Much research has focused on identifying PCP barriers to optimal survivorship care delivery such as limited topic proficiency, yet further efforts are warranted to close that knowledge gap. Our findings revealed increased knowledge of CS issues and surveillance needs post workshop. 3 months survey data is being collected to evaluate for actual practice changes and willingness to manage specific CS issues (i.e. treating depression). A second workshop targeting cardiovascular health promotion interventions has been created: delivery is anticipated early 2016.
A phase II trial of salvage treatment with gemcitabine and S-1 combination in heavily pretreated patients with metastatic colorectal cancer.
Authors: Sun Jin Sym, Junshik Hong, Minkyu Jung, Jinny Park, Eun Kyung Cho, Jae Hoon Lee, Won-Suk Lee, Jeong-Heum Baek, Dong Bok Shin
Journal: Journal of Clinical Oncology (2012)

e14137 Background: We conducted a phase II trial of gemcitabine with S-1 to evaluate the activity and toxicity of such a combination in heavily pre-treated patients (pts) with metastatic colorectal cancer (mCRC) who have progressed after treatment with 5-fluorouracil, oxaliplatin and irinotecan. Methods: Between Dec 2009 and Nov 2011, 23 pts were enrolled, with the following characteristics: 12 males and 11 females, median age 57 years (28-72). S-1 was given orally (30 mg/m 2 ) b.i.d for 14 consecutive days and gemcitabine (1000 mg/m 2 ) was given on days 1 and 8, every 21 days, until disease progression and for a maximum of 9 cycles. The primary endpoint was objective response rate (ORR). Results: The median number of cycles was four (range 1-9). OR was 8.7% (95% confidence interval [CI] 0-20.2) and disease control rate was 56.5% (95% CI 36.4-76.9) with two partial responses and eleven stable diseases. Median duration of disease control was 8.5 months (95% CI 3.8-13.2). Median progression-free survival was 3.2 months (95% CI 1.9-4.5) and median overall survival was 11.8 months (95% CI 4.0-19.5). Grade 3-4 toxicities were neutropenia (8%) and thrombocytopenia (4%). Conclusions: Combination chemotherapy with gemcitabine and S-1 was well tolerated and efficacious for refractory mCRC pts.
Cognitive function and predictors for mild cognitive impairment in women receiving adjuvant hormone therapy.
Authors: Y. Lu, C. Su, S. C. K. Lee
Journal: Journal of Clinical Oncology (2011)

e11082 Background: Women with breast cancer (BC) often complained memory loss and attention deficit after cancer treatment. However, cognitive function deficit was multivariate issues. The purpose of this study was to describe cognitive function in women receiving adjuvant hormonal therapy(HT) and examine its predictors. Methods: A conveniences sample of 129 women with early BC who have been receiving adjuvant HT for at least 6 months was recruited from a medical center in Taipei. Those who had hitory of psych history, brain injury, CNS disease or organ failure was excluded. Cognitive function was measured by Montreal Cognitive Assessment (MoCA) that included a battery of visuospatial, memory, attention, language, abstraction and orientation tests, originally being designed for detection of mild cognitive impairment. EORTC-CF was also included to test the perceived cognitive difficulty. Clinical data were gathered including cancer and its treatment, chronic disease, prescribed and over-the-counter drugs, and demography information. Results: The sample had a mean age of 52.2 and mean time of 2.5 year since BC diagnosis. A majority of them were married, with high-school-or-above education and had stage II BC (56.6%), MRM (53.5%), chemotherapy (74.4%) and tamoxifen (75.2%). Results showed that the women reported a mild to moderate cognitive difficulty (67.5±21.4) on EORTC-CF. Only 58.1% of them performed greater than 26 scores on MoCA (normal cognitive function) after adjusted with education, and 24% were even compatible with mild cognitive deficit. Greater than 25% can’t perform visuolspatial test and more complicated attention test, had poorer delay memory as well. The significant associated factors included the time since chemotherapy being associated with visualspatial test, menopause with MoCA total score and memory, use of other drugs with attention. However, only age and education remained as the significant predictors for mild cognitive impairment (MoCA scores <26) from logistic regression analysis. Conclusions: Many breast cancer women receiving adjuvant HT had a mild to moderate cognitive difficulty. Further studies with age-and-education-matched control group were warranted.