tbuckley/cabot-search huggingface dataset:
Comprehensive and financially sustainable survivorship care.
Authors: Alicia R. Rosales, Kathleen Clifford, Michele Brown, Lori Watts, Christa Burnham, Nicole Thomas, Julie Graves, Nicole Thurston, Dia Byrne, Dan Sayam Zuckerman
Journal: Journal of Clinical Oncology (2012)

32 Background: New 2015 Commission on Cancer (CoC) standards require that all patients who complete treatment receive an individualized survivorship care plan (SCP). To meet this new standard St. Luke’s Mountain States Institute (MSTI), with support from the NCCCP, implemented a process that is multidisciplinary, efficient and sustainable. Methods: At MSTI, the patient’s SCP is a modified ASCO template with a comprehensive care plan and is prepared in the EMR by a Registered Health Information Technician (RHIT). This document is reviewed during a one hour visit with a nurse practitioner and a social worker. The patient participates in the discussion and sets wellness goals for healthy survivorship. The provider’s dictation is mailed to the PCP with the SCP. From Aug. 2011 – June 2012, 53 breast cancer patients were seen in 1 hour joint nurse practitioner/social work survivorship visits. A chart audit was conducted for these patients and follow-up phone calls were done with 36 patients at one month post-visit to evaluate patient understanding and satisfaction. Financial analysis was also completed to determine return on investment (ROI). Results: From chart review, the most common patient concerns were nutrition and weight loss (36%), anxiety (23%), fatigue (21%), depression (17%), caregiver stress (19%) and sexuality (17%). Phone calls showed high patient satisfaction and understanding. Patients rated the following statements on a Likert scale from 5=strongly agree to 1= strongly disagree: I understand my treatment summary and care plan 92% strongly agree or agree, I feel the survivorship visit met my survivorship needs, 97% strongly agree or agree, and 76% of participants were still working on wellness goals at one month. Patient accounts were reviewed showing approximately 50% ROI. Conclusions: It is possible to implement sustainable and comprehensive survivorship care that meets the new CoC standards. The model at MSTI provides increased patient engagement, patient satisfaction, and improved patient provider communication in addition to ROI. Opportunities remain to measure long term health outcomes and downstream revenues associated with this survivorship model. Project funded with Federal funds from the NCI, Contract No HHSN261200800001E.
CTL Exhaustion in Persistent HTLV-1 Infection and ATLL Is Restored through PD-1/PD-L1 Pathway.
Authors: Tomohiro Kozako, Makoto Yoshimitsu, Hiroshi Fujiwara, Izumi Masamoto, Sawako Horai, Masaki Akimoto, Yukio Suruga, Hideaki Kawada, Heiichiro Hamada, Noriko Aoki, Shinsuke Suzuki, Kakushi Matsushita, Kimiharu Uozumi, Chuwa Tei, Naomichi Arima
Journal: Blood (2007)
Pattern of breast cancer presentation at first diagnosis in 2,246 patients from a single Italian institution
Authors: C. Bareggi, B. Galassi, D. Gambini, E. Locatelli, R. Visintin, S. Poma, S. Carinelli, G. Reali, M. Tomirotti
Journal: Journal of Clinical Oncology (2008)

22182 Background: The aim of this study is to evaluate the pattern of female breast cancer presentation at first diagnosis in a single institution case series in Milan, Italy. Methods: Stage at diagnosis, histology and biological characterization of the disease were retrospectively evaluated in 2,246 consecutives cases of female breast cancer observed in our outpatient department, from January 1985 to December 2007. Results: patients' median age was 58.7 (± 12) years. Most patients were postmenopausal (74%), whereas premenopausal were 25.5% (not evaluated 0.5%). Tumor size and lymph nodal involvement: Tis in 97 pts. (4.3%); T1 in 1.341 pts. (59,7%); T2 in 584 pts (26%); T3 in 74 pts (3,2%); T4 117 pts (5,2%). Out of 825 (36,7%) node positive pts., 346 (41.9%) were T1 and 317 (38.4%) T2. Distant metastases were detected at first diagnosis in 83 pts. (3,7%). Histology showed a prevalence of invasive ductal carcinoma (74.4%), followed by invasive lobular carcinoma (8.7%), invasive tubular carcinoma (2.6%), mucinous (1.2%), invasive medullar carcinoma (1%), intraductal (3.2%), lobular in situ carcinoma (0.3%). Cytological grading: G1 15.4% of the 2,092 tested, G2 35% and G3 25%. (24,5% not evaluated). Angioinvasivity 12.4% of the 2,233 tested. Ki67 was <10% in 33% of the 1.532 tested, 10–20% in 30% and >20% in 33%. HER-2 was positive in 90.3% and negative 9.7% of the 1.440 tested. Hormonal receptor status: Er + and PgR + in 53.8%, Er - and PgR- in 15.8%, Er+ and PgR- in 14% or PgR + and Er - in 2%. In 13.3% hormonal status was not assessed. In 680 pts. (30,3%) there was family history of breast cancer. Among them 55.4% had first degree relative with breast cancer, 29.3% pts. had second degree relatives with breast cancer, 15.3% pts. out of them had third degree relatives with breast cancer. Conclusions: The collected data represent the breast cancer pattern of presentation in a general hospital based in the urban area of Milan, Italy. Interestingly, 48,6% of pts were diagnosed in early stage (pTis-pT1, N0) and in 64% of all pts. tumor size was < 2 cm. No significant financial relationships to disclose.
5-Azacytidine and Decitabine Induce FAS Re-Expression, Exert Major Proapoptotic Effects, and Cooperate with the FAS Ligand in Producing Apoptosis in Neoplastic Human Mast Cells,
Authors: Viviane Ghanim, Harald Herrmann, Emir Hadzijusufovic, Barbara Peter, Katharina Blatt, Karina Schuch, Sabine Cerny-Reiterer, Irina Mirkina, Gerwin Heller, Sabine Zöchbauer-Müller, Heidrun Karlic, Winfried F Pickl, Peter Valent
Journal: Blood (2011)
Adjuvant chemotherapy for invasive nonmetastatic breast cancer in limited-resource countries: Evidence-based guidelines therapies versus allocation of resources matter
Authors: M. R. Guerra, J. R. Duarte-Cintra, M. T. Bustamante-Teixeira, C. Domenge
Journal: Journal of Clinical Oncology (2008)

11523 Background: In the last decades, the use of adjuvant systemic treatment for early breast cancer has increased progressively and has contributed to the disease survival improvement. Cyclophosphamide, methotrexate and 5-fluorouracil (CMF) combination was among the first adjuvant chemotherapy schemes found to decrease both disease recurrence and mortality. Then several studies have suggested that anthracycline-based regimens are more effective than others. However, treating breast cancer under the restriction of significantly limited health care resources poses a great challenge. Methods: We analyzed the 5-year breast cancer specific survival (BCSS) among 428 women diagnosed with invasive nonmetastatic disease between 1998 and 2000, who underwent curative surgery and adjuvant chemotherapy in the Southeast Brazilian region, to compare outcome according to the type of chemotherapy regimen used (CMF versus anthracycline). Kaplan-Meier method and Cox proportional hazard model were used to calculate BCSS and to determine the importance of chemotherapy schemes after adjusting for known prognostic factors. Results: The median follow-up was of 5.5 years; 43.0% CMF users versus 56.1% anthracycline users. Patients who received anthracycline-based schemes presented with more advanced disease than patients who received CMF scheme (P<0.001). At 5 years BCSS was 77.6% for patients who used anthracycline regimens versus 88.0% for patients who used CMF regimen (p=0.008); however, when adjusted for age, tumor size, number of nodes involved, hormone therapy use, and race this effect disappeared (p=0.5). The main important prognostic factors were involvement nodal (1–9: HR=4.3; 95%CI=2.0–9.1 and ≥10: HR=6.9; 95%CI=2.8–17.0), and hormone therapy use (HR=0.5; 95%CI=0.3–0.8). Conclusions: Considering the adjuvant chemotherapy regimen used, women with invasive nonmetastatic breast cancer have similar stage-adjusted clinical outcomes. Nevertheless, the treatment of early breast cancer may be less resource intensive, with the use of less aggressive agents (as CMF regimen), highlighting the potential benefit of earlier detection and diagnosis, mainly in limited-resource countries. No significant financial relationships to disclose.
Influence of prognostic factors in pediatric high-grade osteosarcoma survival.
Authors: A. Castellanos-Toledo, R. Rivera-Luna, R. Cardenas-Cardos, J. d. J. Figueroa Carbajal, C. A. Leal-Cavazos
Journal: Journal of Clinical Oncology (2011)

9572 Background: Some others prognostic factors are interrelated with the well-known prognostic factors in high-grade Osteosarcoma (HGO), this can result in poor survival and should be considered for appropriate clinical decision making. Methods: Retrospective, longitudinal and clinical study was performed from Jan/1991-Dec/1998, 58 patients younger than 18 years with extremity HGO and no prior chemotherapy treatment were included. All received CDDP, DOX, CFA and VP-16. Prognostic-factors and Cox analysis with odds-ratio (OR) and p<0.05 were calculated. Outcome variables were age, histologic patterns (HP), primary site, tumor size (TS), metastatic disease, soft-tissue involvement (STI), histological response (HR) assessed by Huvos-grades and disease-free survival (DFS). Results: Median age was 12 years (5-18y) with 18 patients (31%) younger than 10 years. Skeletal site (SS) distribution was 59% distal femur, 17% proximal humerus, 14% proximal tibia, 7% fibula and 3% proximal femur. 18 patients (31%) had pulmonary metastases and 3 patients (5%) had multifocal disease at diagnosis. There were 74% osteoblastic tumors, 14% osteoblastic and chondroblastic, and 5% chondroblastic. 15 patients had an amputation procedure and 33 patients undergoing limb salvage of which 5 patients (15%) had eventual local recurrence. The more significant associated prognostic factors (APF) for local recurrence were STI at diagnosis (OR=6), grade-II HR (OR=2.8), grade-III HR (OR=10), TS (p0.0350) and chondroblastic-HP (p0.0089). For amputation procedures were SS (p0.0018) and have microscopic surgical margins (MSM) p0.0075. For development of metastatic disease were TS (p0.0008), MSM (p0.000), pulmonary metastases at diagnosis (p0.000), SS (p0.000) and chondroblastic-HP (p0.000). For death by tumor activity was poor in HR (p0.0013) and TS (p0.0278). 5-years DFS without APF was 68% Vs 43% with APF (p0.021). Conclusions: APF play a very important roll in Osteosarcoma prognosis and should be considered for appropriate clinical decisions making.
An open-label phase II study of intermittent oral capecitabine (X) as first-line treatment for patients (pts) with metastatic colorectal cancer (MCRC)
Authors: G. Zhongzhen, F. Fengyi, L. Xiaoqing, W. Yajie, Y. Baoming, Z. Qionghua, S. Lin, Y. Shiying, W. Huaqing
Journal: Journal of Clinical Oncology (2005)

3730 Background: X is an orally administered, fluoropyrimidine carbamate that is converted to 5-FU in tumors by the enzyme thymidine phosphorylase (TP). The localization of TP within tumors results in higher concentrations of 5-FU within tumors compared with plasma and normal tissues. X has been shown to be highly active and well tolerated in both MCRC and as adjuvant therapy in pts with early-stage colon cancer. Methods: We studied the efficacy and safety of capecitabine as first-line treatment in an open label, phase II study in MCRC. Pts received X at a dose of 1250mg/m2 twice daily on days 114, every 3 weeks for 16 cycles. Results: Baseline characteristics of the 64 pts enrolled between May 2003 and Oct 2003 at 9 centers: 33 men and 31 women; median age 63 years (range 18–81). Main sites of metastases were: liver, lung, and lymph nodes. The overall best response rate was 20%, including complete responses in 3% of pts. The median time to response was 1.4 months (95% CI, 1.3–2.0 months). The median time to disease progression was 5.8 months (95% CI, 3.0–7.6 months). At the time of the analysis (Oct 2004), the median overall survival was 10.5 months (95% CI, 6.8–12.2 months). The most common treatment-related adverse events (all grades combined) were: hand-foot syndrome, nausea/vomiting, fatigue, diarrhea, fever, anorexia, abdominal pain, and dizziness. The most common treatment-related grade 3/4 adverse events (NCIC-CTC) were fatigue 8%, diarrhea 6%, hand-foot syndrome 5%, nausea 5%, vomiting 5%, and fever 5%. Conclusion: Oral X is both effective and well tolerated as first-line treatment for Chinese pts with MCRC. No significant financial relationships to disclose.
A double-blind placebo-control randomized study of the efficacy of Chinese herbal medicine (CHM) in reduction of cytotoxic chemotherapy-induced toxicity
Authors: T. Mok, W. Yeo, P. Hui, K. Chak, A. T. C. Chan, P. Johnson, Z. R. Pan, M. Xu, W. C. Au, B. Zee
Journal: Journal of Clinical Oncology (2005)

8157 Background: CHM is a common complimentary and alternative medicine used by both East and West cancer patients for reduction of chemotherapy-induced toxicity. A double-blind placebo-control randomized study was carried out to evaluate the incidence of chemotherapy-induced toxicity, quality of life (QOL), chemotherapy tolerance and CHM compliance. Methods: Patients were age >18; ECOG 0–2; Dukes B2/C colon ca or stage Ib/IIab breast ca; no prior chemotherapy; adequate bone marrow/hepatic/renal function. Enrolled pt received one of the standard adjuvant chemotherapy (FUFA for colon ca, AC for breast ca.). The randomization process includes random assignment to Chinese herbalist and to study treatment. Pt was randomly assigned to 1 of 3 certified Chinese herbalists who would evaluate pt and prescribe a combination of single-item packaged herbal extract granule accordingly. Pts received either the CHM or placebo packages with corresponding serial number. Placebo contains non-therapeutic herbs with artificial smell and taste similar to a typical herbal tea. Toxicity measurement: CTC-V2. QOL measurement: EORTC QLQ-C30. Results: 120 pts enrolled and 111 (AC 84, FUFA 27) were eligible. Age, gender, education level, performance status, tumor type and chemotherapy were balanced. Comparison of hematologic toxicity and selective non-hematologic toxicity was summarized in table. Pt in CHM arm had significantly less ≥gr 2 nausea and constipation. Changes of QOL were not significantly different between the two arms. Chemotherapy completion rate were also similar between the 2 arms. The 100%, 90–99% and <90% compliance rate to TCM/placebo packages was 67.6%, 18.9% and 13.5%, respectively. Conclusion: CHM may reduce incidence of moderately severe nausea and constipation in chemotherapy pts but has no significant impact on hematologic toxicity and QOL. No significant financial relationships to disclose.
Neutrophil lymphocyte ratio (NLR) change after systemic treatment as a predictive factor of cancer specific survival in stage IV breast cancer.
Authors: Hae-na Shin, Jisun Kim, Hee Jeong Kim
Journal: Journal of Clinical Oncology (2015)

29 Background: Inflammatory response exacerbates mechanisms linked to tumor growth and dissemination. As an index of systemic inflammatory status, neutrophil lymphocyte ratio (NLR) may be a predictive biomarker of both prognosis and response to therapy. We evaluated initial pre-treatment NLR and post-treatment NLR change to assess whether initial and change in NLR would be predictive of disease outcome in stage IV breast cancer patients. Methods: This study included 250 stage IV breast cancer patients diagnosed at Asan Medical Center between 1997 and 2012. The NLR was calculated from the differential count by dividing neutrophil percentage by lymphocyte percentage. All initial (pre-treatment) NLR was evaluated at the first visit day in Asan medical center. Post-treatment NLR was obtained at the first follow-up visit at the outpatient department after first treatment (chemotherapy first: about after 3weeks/endocrine therapy: after 3~6 months). The initial (pre-treatment) NLR was divided by quartile, and the NLR change was calculated by dividing post-treatment NLR by pre-treatment NLR. If the value was ≥ 1.2, NLR change was increased; if not, it was not changed or decreased. We evaluated prognostic value of NLR by comparison with Cancer Specific Survival (CSS). Results: When comparing pre-treatment NLR and post-treatment NLR, the NLR was increased in 85 patients (34%) and stationary or decreased in 165 patients (66%). There was no significant difference between two groups in baseline characteristics. On the other hand, in CSS, the difference between two groups are shown, but does not have statistical significance (log rank p = 0.052). The 1, 3, 5 year CSS rate was 78.8%, 35.7%, 20.5% in increased NLR group, and 87.1%, 49.3%, 26.9% in the other group. Multivariate analysis suggested that increased NLR change (Post/Pre NLR ≥ 1.2) had statistical significance as prognostic factor of stage IV breast cancer patients after treatment (HR = 1.750, 95% CI 1.130-2.709, p-value = 0.012). Conclusions: After start of treatment, increased NLR can be correlated with poor cancer specific survival in stage IV breast cancer. The NLR change might be an index of response of systemic treatment.
Does interval from histologic diagnosis (Dx) to start of chemotherapy (Ctx) impact survival in metastatic colorectal cancer (MCRC)?
Authors: Anuradha Jayaram, MinYuen Teo, Niamh Keegan, Emily Harrold, Niamh Coleman, M. John Kennedy
Journal: Journal of Clinical Oncology (2014)

615 Background: Optimal timing from colorectal surgery to initiation of adjuvant chemotherapy is between 4 to 6 weeks based on recent data. In MCRC, therapeutic benefits of ctx are frequently calculated from start of treatment. We investigated whether the interval between dx and commencement of ctx influences overall survival (OS) in patients (pts) with MCRC. Methods: Pts with CRC were identified from the institutional database. Inclusion criteria were MCRC and receipt of ctx. Clinicopathologic details were collected. Intervals from histologic dx to ctx were calculated. Analyses were based on receipt of ctx within 4 weeks (w), 5-8w and &gt; 8w of dx. Survival was compared between groups. OS was presented as hazard ratio (HR) with associated p value. Results: Between 2003 and 2013, 123 pts were identified, where 58 pts receive ctx within 4w, 38 within 5-8w and 27 &gt; 8w. Median OS (mOS) was 8.7, 15.7 and 13.7 months (mths) respectively. Improvement in OS was noted in pts treated 5-8w and &gt;8w compared to within 4w (HR 0.53, 0.45; p=&lt;0.01, &lt;0.01). Surgical resection of the primary was noted in 14% of pts receiving ctx in 4w, 45% between 5-8w and 70% &gt; 8w and mOS amongst these groups were 19.5, 16.3, and 22.1 mths respectively versus 6.5, 10.5 and 8.9 mths in similar groups without surgery. Improved OS in resected pts is noted in when treated 5-8w and &gt; 8w compared to 4w (HR 0.76, 0.72 p= 0.55, 0.46) with no difference in OS between groups treated at 5-8w and &gt; 8 w (HR 1.06, p= 0.85). Univariate and multivariate analyses for 5 variables are described in the Table, two of which are statistically significant on multivariate analyses. Conclusions: Our data did not suggest a detrimental effect on OS from ctx delay and the lack of survival benefit from early ctx might be due to a number of confounding variables as described above. [Table: see text]
Phase I trials in patients with salivary gland cancers (SGCs): The Cancer Therapy and Research Center (CTRC) experience.
Authors: V. Madhusudanannair, G. Medina, S. Lee, M. M. Mita, A. B. Karnad
Journal: Journal of Clinical Oncology (2011)

e16017 Background: SGCs are rare neoplasms with variable clinical behavior where cytotoxic chemotherapy is palliative for some with symptomatic progressive disease, and novel agents have been insufficiently studied. We assessed patients with SGCs in a dedicated phase-I clinical trials clinic in order to determine their outcome. Methods: We reviewed records of consecutive patients with SGCs referred to our phase-I clinical trials program from 2002-2010. Best response was assessed by Response Evaluation Criteria in Solid Tumors. Results: Twenty-seven patients were identified. The median age was 53 years (range 36-77 years). 10 (37%) had Adenoid cystic carcinoma (ACC), 7 (25.9%) had Acinic cell carcinoma, 7 (25.9%) had Adenocarcinoma, and 3 (11%) had Mucoepidermoid or other histologies. All had distant site metastases: lung (88.8%), bone (46.4%), and liver (46.4%). All had prior surgery, radiation therapy, and multiple prior chemotherapy regimens: 6 (21%) had more than 6 prior chemo regimens, 15 (53.6%) had between 4-6 different prior regimens, 7 (25%) had less than 4 regimens. The agents used in the Phase-I trials included Ispinesib mesilate, Lapatinib, various TKI, anti-IGF-1R mab, MTOR inhibitor, Satraplatin, thalidomide analog, Angiopep2 and 3’-C-ethynylcytidine. Of the 27 patients evaluable for response, two patients (7.4%) had stable disease (SD) with a median progression-free survival (PFS) of 361.5 (± 197) days, and 25 (92.5%) had progressive disease with a median PFS of 90 (± 46) days. The median PFS for the entire sample was 114.5 (±9 5) days. Both patients with stable disease had ACC. Conclusions: Twenty-five of 27 (92.5%) patients with advanced, heavily pre-treated SGCs had progressive disease on a phase-I trial with 20% (2 out of 10) patients with ACC demonstrating SD during study duration. Clinical trials with a translational component to accelerate the identification of key molecular pathways in these tumors are urgently needed.
Context- and Output Layer-Dependent Long-Term Ensemble Plasticity in a Sensory Circuit
Authors: Yoshiyuki Yamada, Khaleel Bhaukaurally, Tamás J. Madarász, Alexandre Pouget, Ivan Rodriguez, Alan Carleton
Journal: Neuron (2017)

Highlights•Mitral and tufted cells in the olfactory bulb show similar odor-evoked responses•Passive odor experience reorganizes ensemble odor representations in both cell types•Associative odor learning specifically improves pattern separation in mitral cells•Cortical feedback can trigger both forms of plasticity in a network modelSummarySensory information is translated into ensemble representations by various populations of projection neurons in brain circuits. The dynamics of ensemble representations formed by distinct channels of output neurons in diverse behavioral contexts remains largely unknown. We studied the two output neuron layers in the olfactory bulb (OB), mitral and tufted cells, using chronic two-photon calcium imaging in awake mice. Both output populations displayed similar odor response profiles. During passive sensory experience, both populations showed reorganization of ensemble odor representations yet stable pattern separation across days. Intriguingly, during active odor discrimination learning, mitral but not tufted cells exhibited improved pattern separation, although both populations showed reorganization of ensemble representations. An olfactory circuitry model suggests that cortical feedback on OB interneurons can trigger both forms of plasticity. In conclusion, we show that different OB output layers display unique context-dependent long-term ensemble plasticity, allowing parallel transfer of non-redundant sensory information to downstream centers.Video AbstracteyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiIxMDkzMjAxNDA0NzBhZjFlYmM2MjE5OGIwYzRmZmY0MSIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNzI2MTEzMzA3fQ.fD61AqASAr7sqZ070qtw_uXz_MntIepo2vq8YTaaWQ0WH6rtpYTPLcHbd-zCTZr7pfsEcl1aBQHgwba6EfG0oUa9CtwGP71Ff3-K7-DWlTcWxteIEqfO6eCkCgiK9wBg6zyuylw3j439BBZt3T0rTifJoMXzlkPLhKFmOJBZVFMz3XK5Yn3HVzhnQkCj4cg4jWn4FdU7dYPPPHWqceQZzrJKLY3zBwJjZydUPijH8qsdibXTFSRf6A9FHR1uSbUi1LJW6j4BbLZrD4WWlWSpppbj9kJfYNjf7Nkgx5lsFo5HCk4w492NfGE63OTLRChkr3O3sJu09hMqTLEmBBfVhADownload video (mp4, 57 MB)