tbuckley/cabot-search huggingface dataset:
Analysis of the impact of growth factor on the haematological safety of dose-dense regimen in the randomized phase II adjuvant trial BO3
Authors: C. Delbaldo, D. Serin, F. Priou, P. Laplaige, S. Greget, E. Angellier, E. Teissier, J. Berdah, M. Fabbro, E. Quinaux
Journal: Journal of Clinical Oncology (2009)

605 Background: In a randomized phase II study, P. Piedbois et al. explored a dose-dense docetaxel (T) followed by epirubicin/cyclophosphamide (EC) every two weeks versus the reverse sequence, versus standard-dose docetaxel, epiribucin and cyclophosphamide (TEC) every 3 weeks. The main purpose of this second analysis was to further explore the haematological safety of each regimen in patients receiving primary prophylactic pegfilgrastim. Methods: One hundred patients with node-positive invasive breast adenocarcinoma were randomized between (arm A) docetaxel 75 mg/m 2 , epiribucin 75 mg/m 2 and cyclophosphamide 500 mg/m 2 (TEC) every 3 weeks for 6 cycles (35 patients) or (arm B) epiribucin 100 mg/m 2 and cyclophosphamide 600 mg/m 2 every 2 weeks for 4 cycles, followed by T 100 mg/m 2 (EC→T) every 2 weeks for 4 cycles (31 patients) or (arm C) T→ EC (34 patients). Among the 99 patients who received chemotherapy, 79 received pegfilgrastim 6 mg subcutaneous day 1 from the first cycle (27 in arm A, 23 in arm B and 29 in arm C). The safety data of these 79 patients were reported here. Results: Our results showed grade 3/4: neutropenia (arm A 30 %, arm B 39 %, arm C 31 %) and febrile neutropenia (FN) (arm A 11 %, arm B 13 %, arm C 3 %), grade 2–4: anaemia (arm A 26 %, arm B 61 %, arm C 55 %) and thrombocytopenia (arm A 15 %, arm B 9 %, arm C 3 %), respectively. Crude proportion and time to toxicity summaries showed that in dose-dense arms, patients allocated to the EC→ T sequence were more exposed to FN than patients allocated to the T→ EC. In the Cox model taking into account all allocated treatment and age, treatment was a predictor of grade 2–4 anaemia, whereas age was significantly correlated to grade 2–4 thrombocytopenia. There was no clear relationship between haematological toxicity and dose intensity across all treatment arms. Except for nausea (17 % versus 3 %) and neurological toxicity (13 % versus 3 %), non-haematological toxicities were similar in arm B and C. Conclusions: These analyzes confirmed that dose-dense regimens EC→ T or T→ EC are feasible with pegfilgrastim primary prophylaxis. The T→ EC sequence seems to be associated with a better haematological tolerance, and should be the preferred dose-dense regimen providing similar efficacy. The trial was supported by Amgen. No significant financial relationships to disclose.
AB0825 Comparison of bone density changes one year after treatment with zoledronic acid verses daily teriparatide
Authors: AK Aggarwal, D Jain, N Aggarwal
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The treatment of Osteoporosis is difficult to monitor and so usually incomplete resulting in inadequate response.<sup>1</sup> <h3>Objectives</h3> To evaluate the minimum period of treatment required with Bisphosphonates and Parathyroid hormone in order to see a significant change in serial Bone Mineral Density analysis (BMD). <h3>Methods</h3> Low BMD patients were subjected to yearly infusion of Zoledronic Acid 5mg (ZA) verses daily Subcutaneous injections of Teriparatide 20 μg (PTH). A single center pencil beam bone densitometer was used to measure serial BMD at baseline and yearly. Average BMD measures from the Spine L2, L3 and L4 (BS) and Total Hip (BH) were evaluated. The percentage change in the mean BS and BH readings was calculated to look for the least significant change (LSC) in the density scores. <h3>Results</h3> Significant change of 4.65% was seen (LSC=2.6%)<sup>2</sup> in the Spine in the PTH group after one year of treatment while it took two years in the ZA group for a 2.77% change. There was no significant change (LSC=3.6%)<sup>2</sup> in both groups in the BH. A p&gt;0.05 was considered statistically significant. The finding is summarized in Table 1. <h3>Conclusions</h3> Significant result of treatment with PTH requires a period of one year of therapy while with ZA it needs two years. The LSC in BMD is seen in the Spine and not in the Total Hip BMD. <h3>References</h3> Glen M. Blake, Ignac Fogelman. Role of Dual-Energy X-Ray Absorptiometry in the Diagnosis and Treatment of Osteoporosis. Shepherd JA1, Lu Y. A generalized least significant change for individuals measured on different DXA systems. <h3>Disclosure of Interest</h3> None declared
Holding the Self and the World Together
Authors: Jed Myers
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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 phase II study of pembrolizumab in patients with recurrent thymic carcinoma.
Authors: Giuseppe Giaccone, Jillian Thompson, Jenny Crawford, Colleen McGuire, Maria Manning, Deepa Suresh Subramaniam, Stephen V. Liu
Journal: Journal of Clinical Oncology (2016)

8517 Background: Thymic epithelial tumors are rare and thymic carcinomas represent about 10% of them and have most aggressive behavior. There are few treatment options for thymic carcinoma after failing chemotherapy. Unlike thymomas, thymic carcinomas are usually not associated with autoimmune disorders. Strong PD-L1 expression has been reported in thymic epithelial tumors. We are conducting a phase II study of pembrolizumab in patients with thymic carcinomas. Methods: Main eligibility criteria include: progression after at least one line of chemotherapy, ECOG performance status of 0-2, no history of autoimmune disease or other malignancy requiring treatment, and adequate organ function. Pembrolizumab is given at 200mg every 3 weeks. Primary objective of the study is response rate by RECIST v1.1 criteria; secondary objectives are PFS and OS, and tolerability. Results: From March 2015 the study has accrued 23 patients. 16 were male, 19 Caucasians, median age was 58 (35-75), 9 had squamous carcinoma histology, and 12 had PS 0. So far a median of 4 cycles have been given (1-15). One patient was not eligible due to increased liver enzymes, and one patient is still not evaluable for response. Treatment was overall very well tolerated with mild fatigue, fever, diarrhea and rhinorrhea as the most common side effects. Two serious autoimmune disorders developed: one case of severe myositis/myocarditis which required pacemaker placement and one case of type I diabetes after treatment discontinuation. One other patient developed hypothyroidism. Out of 21 patients evaluable for response so far the response rate is 24%: there were 1 complete response, 4 partial responses, 9 patients with stable disease and 7 progressions. All responses are ongoing. Conclusions: This ongoing study shows promising activity of pembrolizumab in patients with thymic carcinoma. Next generation sequencing of tumors and PD-L1 expression will be presented. Fresh biopsies are also obtained to develop cell lines. The study is actively accruing. Clinical trial information: NCT02364076.
High BMI and male sex as risk factor for increased short-term renal impairment in living kidney donors – Retrospective analysis of 289 consecutive cases
Authors: Lukas W. Unger, Joy Feka, Philipp Sabler, Susanne Rasoul-Rockenschaub, Georg Györi, Michael Hofmann, Christoph Schwarz, Thomas Soliman, Georg Böhmig, Alexander Kainz, Andreas Salat, Gabriela A. Berlakovich
Journal: International Journal of Surgery (2017)
AB0512 Epidemiological, clinical and immunological characteristics of antiphospholipid syndrome: study of 170 patients
Authors: L Riancho-Zarrabeitia, S García-Canale, M Cubería, G Daroca, M Lόpez-Hoyos, P Muñoz, M Agudo, V Martínez-Taboada
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Antiphospholipid syndrome (APS) is an autoimmune disease defined by the presence of antiphospholipid antibodies (aPL) and thrombosis and/or pregnancy morbidity. Although thrombotic and obstetric APS are considered the same disorder, there are pathogenetic and clinical differences between them. <h3>Objectives</h3> To describe the epidemiological, clinical and immunological characteristics of a cohort of APS patients from a defined population and to study the differences between thrombotic, obstetric and mixed APS. <h3>Methods</h3> Retrospective study including patients attending the rheumatology and the obstetric clinics of a tertiary facility in Northern Spain. All patients met APS classification criteria. <h3>Results</h3> We included 84 patients with thrombotic APS, 76 with obstetric APS and 10 with mixed APS. Main demographical characteristics are showed in table. There were differences in the age of discovery a positive serology (46±15 yr in thrombotic APS, 36±8 yr in obstetric, and 36±14 in mixed APS). Moreover, the prevalence of systemic lupus erythematosus (SLE) was higher in patients with thrombotic and mixed APS (26% and 30% vs 5% in obstetric APS, p=0.001). Anticardiolipin antibodies were, overall, the most frequently positive. Lupus anticoagulant was significantly more common in patients with thrombotic and mixed APS (70% and 71% vs 30% in obstetric APS, p=0.002). We found no differences in the load of antibodies between the three groups. Regarding traditional cardiovascular risk factors (CVRF), tobacco use was the most common, followed by hypertension and dyslipidemia. The last two factors were more frequent in patients with thrombotic and mixed APS than in those with obstetric APS (p&lt;0.001). As expected, treatment with heparin was more frequent in obstetric and mixed APS, while oral anticoagulants were more frequently used in thrombotic APS. Antimalarial drugs were less frequently used in obstetric APS (17% vs 37% and 30%, p=0.020), probably due to a lower prevalence of lupus in this group. <h3>Conclusions</h3> In our cohort, patients with thrombotic or mixed APS have a higher frequency of SLE than patients with obstetric APS. Positivity for lupus anticoagulant is more common in patients with thrombotic or mixed APS. Regarding traditional CVRF, hypertension and dislypidemia are more common in patients with thrombotic or mixed APS. <h3>Disclosure of Interest</h3> None declared
AB0211 The effect of smoking, alcohol and caffeine on early rheumatoid arthritis outcomes
Authors: E Chamizo-Carmona, C Carrasco Cubero, JJ Aznar Sanchez, R Veroz Gonzalez, PJ Cossío Jimenez, SM Rojas Herrera
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> The aim of early RA treatment is remission. Intensive treatment with MTX achieve remission in 30–50% patients (pts). Modifiable risk factors, as smoking, alcohol, coffee and tea, may affect response to MTX. <h3>Objectives</h3> To study the influence of tobacco, alcohol, caffeine on the MTX response in early RA pats. <h3>Methods</h3> A case-control study (2010–2015): cases were pts who achieved DAS28&lt;2.6 (remission) and controls were pts who did not. We collected information from pts&gt;18years with early RA, treated with MTX, evaluated quarterly in a specialized unit early RA. All the pts underwent a structured interview about their smoking history and others habits. A descriptive and comparative study, was performed (SPSS21). <h3>Results</h3> 182 pts (age 50,96±13,11y, 67,6% female, 81,3% FR+ and 65,7% ACPA+) was treated with MTX and followed 105,03±7,15 months since 1995. More than 95% pts received MTX (in rapid escalation) in the first 24 months of the onset of symptoms. DAS28&lt;2.6 was achieved for 67 (36,8%) pts, who required an lower average dose of MTX (15,07mg/w) than those who did not (18,04mg/w) (p=0,000). Age, DAS28 and physical function at baseline, treatment delay, smoking and adverse events by MTX were related to remission.The univariate and multivariate analysis of the baseline pts characteristics and the relationship of their smoking history with age, RF, ACPA and outcome of MTX monotherapy are shown in table 1and 2, respectively. The median survival of MTX monotherapy was 87,39 months (100.27 non-smokers and 47.70 months for current smokers (Log Rank 10.32, p 0.001) (see graphic). <h3>Conclusions</h3> The treatment of early RA with MTX alone achieved high rates of remission, especially in non-smokers. Smoking cessation could significantly improve the response to MTX and therefore should be an integral part of the treatment of early RA patients. <h3>References</h3> Söderlin, et al. Scandinavian Journal of Rheumatology. 2011;40(4):249–55. <h3>Disclosure of Interest</h3> None declared
SP0031 How could gps enhance the early diagnosis of rheumatic diseases
Authors: CD Mallen
Journal: Annals of the Rheumatic Diseases (2017)

Primary care and general practice has a key role to play in the early and accurate detection of patients with rheumatoid arthritis. This talk will explore some of the current barriers to best practice, highlighting the workload associated with musculoskeletal problems in primary care and the challenges in making a prompt diagnosis. Possible solutions will be explored, highlighting the importance of strong patient and professional partnerships <h3>Disclosure of Interest</h3> None declared
SAT0619 Ankle evaluation in active rheumatoid arthritis by ultrasound: a cross sectional study
Authors: AM Elsaman, ES Mostafa, AR Radwan
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Ankle joint evaluation is underestimated in many clinical and sonographic scores used for evaluation and follow-up of rheumatoid arthritis (RA) patients. Moreover, sonographic scores which included the ankle joint had no agreement on examination parameters. More effort is needed to detect the value of the ankle joint examination in RA and also a description of the earliest and the most frequent ultrasonographic signs that should be considered in ankle assessment (1). <h3>Objectives</h3> detection of ankle affection by ultrasound (US) in active RA and correlate this finding with disease duration, DAS28-ESR 28 score and rheumatoid factor (RF). <h3>Methods</h3> 126 ankle joints and tendons of 63 active RA patients, aged above 18 years old were included in the study. US examination was done to the tibiotalar and talonavicular joints for synovitis and/or effusion on Greyscale (GS) mode and power doppler (PD). The anterior, lateral and posterior ankle tendons were examined for tenosynovitis and tendinosis. <h3>Results</h3> The mean age and ± standard deviation were 35.1±8.3 with the female-to-male ratio 2:1. The mean disease duration was 22.7±9.6 months. The mean DAS28-ESR 28 score was 3.05±0.66. The most frequent pathologies detected were tenosynovitis of the flexor, extensor or peroneal tendons (found in 30.2% of the affected ankles); followed by synovitis of the tibiotalar and talonavicular joints (18.3%); next was erosion (8.7%) and lastly tendinosis (4%). The earliest sonographic signs were tenosynovitis, followed by synovitis, erosion, and lastly tendinosis. <h3>Conclusions</h3> It can be stated that ankle evaluation should be considered more in RA assessment. The tibialis anterior and posterior tendons, the tibiotalar and talonavicular joints were the commonest and most frequent sites to be involved in the ankle. Tenosynovitis appears earlier than synovitis. DAS28-ESR score was correlated to synovitis and tenosynovitis but not to erosion. Bilaterality and erosion were correlated with disease duration. RF positivity has a positive correlation with positive US findings in the ankle region. <h3>References</h3> Alsuwaidi M, Ehrenstein BP, Fleck M, Hartung W: Ankle Joint Involvement In Rheumatoid Arthritis. An Ultrasound Study Using High Resolution-and Colour Doppler Ultrasound. In: <i>Arthritis and Rheumatism: 2013</i>: Wiley-Blackwell. <h3>Disclosure of Interest</h3> None declared
Changes in cause-specific neonatal and 1–59-month child mortality in India from 2000 to 2015: a nationally representative survey
Authors: Shaza A Fadel, Reeta Rasaily, Shally Awasthi, Rehana Begum, Robert E Black, Hellen Gelband, Patrick Gerland, Rajesh Kumar, Li Liu, Colin Mathers, Shaun K Morris, Saritha Nair, Leslie Newcombe, Arvind Pandey, Faujdar Ram, Usha Ram, Peter S Rodriguez, Damodar Sahu, Prabha Sati, Prakash J Shah, Anita Shet, Jay Sheth, Jitenkumar K Singh, Lucky Singh, Anju Sinha, Wilson Suraweera, Prabhat Jha
Journal: The Lancet (2017)
SAT0626 Metacarpophalangeal joint swelling in psoriatic arthritis: what does it mean?
Authors: C Macía, S Falcao, M Gutierrez, J Medina, HB Hammer, E De Miguel
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Clinical metacarpophalangeal joint (MCPj) swelling is a frequent finding in psoriatic arthritis (PsA). It is assumed to be caused by intra-articular synovitis (IAS). However, ultrasound (US) have also demonstrated in PsA peritenon inflammation of the extensor digitorum tendon (PTI).To date the data about the significance of this two lesions (IAS and PTI) in MCPj swelling are sparse. <h3>Objectives</h3> Our objective was to explore PTI and IAS as the cause of clinical MCPj swelling in PsA patients. <h3>Methods</h3> 27 consecutive non selected PsA patients, fulfilling CASPAR criteria, with clinical involvement of at least one 2nd to 5th MCPj were included. A MyLab 70 XVG machine, Esaote, Genova, Italy, with a greyscale (GS) 13 MHz probe, and a 7.1 MHz power Doppler (PD) frequency (PRF 750 Hz, Gain 60) was used. Videos (3–5 sec) of each MCPj 2nd to 5th of both hands in transversal and longitudinal views were obtained for central reader analysis, scoring US as presence or absence in GS and PD of: 1) PTI (defined as an hypoechoic swelling of the soft tissue surrounding the extensor tendon at MCPj level with or without PD) and 2) IAS (OMERACT definition). US pathology for each joint and lesion was defined as at least three of five central readers having the same score. SPSS analysis was performed for frequencies, percentage of agreement and Cohen9s Kappa test. <h3>Results</h3> 27 PsA patients with a mean (SD) age of 56 (11) years and disease duration 109 (101) months were included. Isolated peripheral involvement was present in 21 patients (78%) and 6 (22%) had both axial and peripheral affection. Mean (SD) CRP level was 8.3 (8.2) mg/l and ESR 21.9 (19.3) mm. The mean DAS28 ESR was 3.88 (1.23). Psoriasis involvement included skin and nails in 15 (55.5%) of the patients. A total of 216 MCPj were examined, with 60 (27,7%) being clinically swollen. The figure illustrates the agreement between clinical and US assessments, and the table shows the kappa values for the agreements. PTI in at least one MCPj was found in 19/27 patients (70%) with a total of 41/216 locations (19%) in GS. For IAS, there was GS in at least one MCPj in 23/27 patients (85%) with a total of 63/216 locations (29%). 28 of 41 (68.3%) joints had both PTI and IAS. <h3>Conclusions</h3> Our study identifies two different US lesions (IAS and PTI) causing clinical joint swelling. PTI is near as frequent as IAS as a cause of MCPj swelling, and future studies are necessary to explore the added value of assessing PTI for prognosis or treatment. <h3>Disclosure of Interest</h3> None declared
Cost of chemotherapy for metastatic colorectal cancer with either bevacizumab or cetuximab: Economic analysis of CALGB/SWOG 80405.
Authors: Deborah Schrag, Amylou C. Dueck, Michelle Joy Naughton, Donna Niedzwiecki, Craig Earle, James Edward Shaw, Axel Grothey, Howard S. Hochster, Charles David Blanke, Alan P. Venook
Journal: Journal of Clinical Oncology (2015)

6504 Background: CALGB/SWOG 80405, a phase III trial, found that adding either bevacizumab or cetuximab to standard first-line chemotherapy for metastatic colorectal cancer (mCRC) resulted in similar survival. We compared the economics of treatment on each arm. Methods: Patients were assigned to standard chemotherapy (Cx) and randomized to either bevacizumab (B, N = 559) or cetuximab (C, N = 578).Quality of life was assessed at baseline and at 8 week intervals using the EQ5D on a representative subgroup of participants (N = 56 for B and N = 55 for C) to estimate utilities. Because survival and quality of life were similar in each arm, cost-minimization rather than cost-effectiveness analysis was performed. Chemotherapy utilization was tracked from randomization to progression and drug costs were estimated using 4thquarter 2014 average sales price from the US Center for Medicare and Medicaid Services. Resource utilization of acute care including hospitalizations, emergency room visits and ICU care were tracked while patients were on study and costs assigned based on CMS estimates for mCRC patients. End of life and downstream costs were assumed to be comparable per survival month. Out of pocket costs were not tracked. All cost estimates are in 2014 USD. Results: Acute care costs were similar but drug costs were higher in the cetuximab arm (Table). Results were robust to sensitivity analyses and did not change whether the chemotherapy backbone included oxaliplatin or irinotecan. Conclusions: For first-line chemotherapy treatment of patients with kras wild type mCRC, based on US 2014 drug costs, bevacizumab is preferable to cetuximab from a health economic standpoint. Clinical trial information: NCT00265850. Mean Costs of treatment for participants in CALGB 80405 Chemo+B N=559 Chemo+C N=578 Difference (95% CI) Protocol-directed chemotherapy Acute care on study Chemo and acute care costs $37,124 $28,951 $66,076 $75,845 $29,494 $105,339 $-38,720 (-45,699 to -31,740) $-543 (-2831 to +1,745) $-39,264 (-46,521 to -32,005)