tbuckley/cabot-search huggingface dataset:
Longitudinal assessment of symptoms and quality of life: Differences by ablative and non-ablative blood and marrow transplantation
Authors: M. Z. Cohen, T. Mendoza, J. Neumann, I. Gning, A. Aleman, S. Giralt, C. Cleeland
Journal: Journal of Clinical Oncology (2004)

6630 Background: Blood and marrow transplantation (BMT) is both widely used and leads to a variety of severe symptoms. The success of BMT, survival, and quality of life (QOL) for patients is related to successful control of symptoms of the transplantation. Symptoms vary by type and stage of disease and by type of preparative regimen and transplantation. Symptoms are also linked with quality of life, although research findings leave much to be understood about that link. Patients in several studies have rated their QOL positively, despite experiencing psychosocial and physical sequelae such as fatigue, anxiety, pain, sexual dysfunction, depression, sleep disturbances, inability to return to work, and fear of relapse or death. It is important to distinguish between symptom prevalence and perceived quality of life and to understand why patients rate QOL positively in spite of symptoms. Methods: Data were collected from 164 patients longitudinally at 8 points from pre-transplant to 100 days post-transplant. Diagnoses included AML/MDS, Hodgkin's, lymphoma, myeloma, 59 (28%) had allogeneic transplant with myeloablative regimen, 64 (31%) had allogeneic with non-myeloablative regimen and 87 (41%) with autologous transplant. Symptom severity and its impact were measured using the M. D. Anderson Symptom Inventory (MDASI) while QOL was assessed using the Functional Assessment of Cancer Therapy for BMT (FACT-BMT). Results: As hypothesized, larger proportion of patients who had allogeneic transplant with myeloablative regimen showed severe symptoms such as fatigue (p<0.02) and pain (p<.03) and poorer quality of life (p<0.001) across time. Symptom severity is significantly correlated with quality of life across time with correlations ranging from –0.59 to -0.75. Conclusions: Type of transplant and prepatory regimen are both important aspects to consider when managing symptoms and quality of life. Additional measures may be needed for patients with myeloablative regimens and allogeneic transplants. No significant financial relationships to disclose.
A phase II study of neoadjuvant therapy with cisplatin, docetaxel, panitumumab plus radiation therapy followed by surgery in patients with locally advanced adenocarcinoma of the distal esophagus (ACOSOG Z4051).
Authors: Carolyn E Reed, Paul A. Decker, Tracey E. Schefter, Bryan F Meyers, Mark K. Ferguson, Amy R Oeltjen, Joe B. Putnam, Stephen David Cassivi, A. Craig Lockhart
Journal: Journal of Clinical Oncology (2012)

4062 Background: Multiple clinical trials have incorporated preoperative chemotherapy and radiation (RT) in an attempt to improve local tumor control, distant disease failure and overall survival rates for locally advanced but resectable adenocarcinoma of the distal esophagus and gastroesophageal junction (GEJ). This multicenter, cooperative group study combined active chemotherapy agents cisplatin (C), docetaxel (D) and the targeted EGFR agent panitumumab (P) in the induction phase followed by concurrent chemotherapy (CDP) and radiation. Pathologic complete response (pCR), a surrogate for improved survival, was the primary endpoint. Methods: From 01/15/09 to 07/22/11, 70 patients (pts) with Siewert I or II adenocarcinomas and clinical stages T3N0M0, T2-3N1M0 or T2-3N0-1M1a (celiac LN ≤ 2 cm) were accrued. Patients received cisplatin (40 mg/m 2 ), docetaxel (40 mg/m 2 ) and panitumumab (6 mg/kg) on weeks 1, 3, 5, 7, 9 with RT (5040 cGy, 180 cGy/day x 28d) beginning week 5. The decision rule had a 90% power with a 0.10 significance level to detect a pCR rate of at least 35%. Secondary objectives included near-pathologic complete response (near-pCR), toxicity, and overall and disease-free survival rates. Results: Five pts were ineligible. Of the remaining 65 pts (59 M, 6 F; median age 61), 12 pts did not undergo surgery (5 progressed, 4 refused, 3 other). Of the 58 evaluable pts, the pCR rate was 32.8% (90% CI: 22.6% -42.9%) and near-pCR 22.4% (90% CI: 13.4%-31.4%). Total doses of C, D, and P were achieved in 76%, 80%, and 73%, respectively (n = 70). 66 pts (94%) received the total RT dose. Sixteen pts (23%) had a grade 4+ non-heme adverse event possibly related to treatment. Venous thrombosis (5 pts) was most common. Conclusions: The CDP regimen in the neoadjuvant setting in patients with esophageal adenocarcinomas is active (pCR + near-pCR = 55.2%) and feasible. The toxicity though tolerable is substantial.
Chest CT findings among adult survivors of childhood and young adult cancer with a history of chest radiation.
Authors: Emily S. Tonorezos, Dana Barnea, Amber Khan, Joanne F. Chou, Chaya S. Moskowitz, Rana Kaplan, Kevin C. Oeffinger
Journal: Journal of Clinical Oncology (2017)

103 Background: While survivors of childhood and young adult cancer with a history of radiation therapy (RT) to the chest are known to be at increased risk for lung cancer, whether a CT-based lung cancer screening program is appropriate for this population is unknown. We sought to describe CT findings in a clinic-based population of childhood and young adult cancer survivors. Methods: We performed a detailed review of all diagnostic chest CT scans performed among patients seen in the Adult Long-Term Follow-Up Program at Memorial Sloan Kettering between August 2005 and May 2016. Included survivors were at least 5 years from diagnosis and had a history of RT to the mediastinum, mantle, axilla, lung, thoracic spine, or total body irradiation fields. Results were reviewed by at least two authors (ET, DB, or AK) and discrepancies were resolved by consultation with a pulmonologist (RK). Results: We identified 620 survivors with a history of chest field RT who were at least 5 years from diagnosis. The population was 48% male, with a median age at diagnosis of 17.2 years. Approximately half were survivors of Hodgkin Lymphoma (N=306; 49.5%) and almost one-third had undergone hematopoietic cell transplant (N=188; 31%); other diagnoses included non-Hodgkin Lymphoma and sarcoma. The most frequently cited RT field was mantle (N=219; 36%), followed by total body irradiation (N=142; 24%) and whole lung (N=110;18%). Among 351 survivors with at least one chest CT, 206 (59%) had at least one pulmonary nodule, 174 (50%) had fibrosis, and 132 (38%) had a ground glass opacity. Among those with a pulmonary nodule, the large majority (91% of those with a nodule) were followed expectantly or underwent repeat imaging; these patients were spared biopsy or resection. Among 18 patients who underwent biopsy, wedge resection, fine needle aspiration, or bronchoscopy, 4 were diagnosed with lung adenocarcinoma, 3 with metastatic sarcoma, and one with marginal zone lymphoma (MALT). Conclusions: Benign pulmonary nodules among adults with a history of RT for childhood or young adult cancer are common. Any strategy for lung cancer screening in this population will need to account for a high likelihood of benign findings on chest CT.
Forests and Their Canopies: Achievements and Horizons in Canopy Science
Authors: Akihiro Nakamura, Roger L. Kitching, Min Cao, Thomas J. Creedy, Tom M. Fayle, Martin Freiberg, C.N. Hewitt, Takao Itioka, Lian Pin Koh, Keping Ma, Yadvinder Malhi, Andrew Mitchell, Vojtech Novotny, Claire M.P. Ozanne, Liang Song, Han Wang, Louise A. Ashton
Journal: Trends in Ecology & Evolution (2017)
Effect of orally administered S-1 on circulating endothelial cells in patients with metastatic breast cancer.
Authors: Wakako Tsuji, Hiroshi Ishiguro, Takayuki Ueno, Masakazu Toi
Journal: Journal of Clinical Oncology (2012)

e21052 Background: S-1 is an oral cytotoxic preparation combining tegafur, 5-chloro-2, 4-dihydroxypyridine, and potassium oxonate at a molar ratio of 1:0.4:1, respectively. Tegafur is metabolized into 5-fluorouracil (5-FU), γ-butyrolactone (GBL), and γ-hydroxybutyric acid (GHB). GBL and GHB are known to suppress VEGF-mediated angiogenic activity. Circulating endothelial cells (CECs) have been suggested to be useful for predicting response to anti-angiogenic agents. We evaluated the effects of S-1 on CEC counts in patients with metastatic breast cancer. Methods: Patients with metastatic breast cancer received S-1 orally in 28-day cycles. The dose of S-1 was 80-120 mg/day depending on body surface area. Cycles were repeated every 42 days. CEC counts were measured with the CellSearch system (Veridex, LLC Co. Ltd., NJ) on days 1 (before the 1 st cycle of S-1), 15, 29, 43 (before the 2 nd cycle of S-1), and 85 (before the 3 rd cycle of S-1). Plasma GBL and 5-FU levels were measured by a gas chromatographic-mass spectrometric method at one point each on days 1 (before the 1 st cycle of S-1), 15 (1 hour after S-1 administration), 43 (before the 2 nd cycle of S-1), and 57 (1 hour after S-1 administration). VEGF levels on days 1, 15, 43, and 57 were measured by an enzyme-linked immunosorbent assay. Results: A total of 18 patients were enrolled. Plasma GBL levels on days 15 and 57 were 42.0 ± 16.2 ng/mL and 43.2 ± 10.5 ng/mL, respectively. Both levels exceeded 25.8 ng/mL, the previously reported (Angiogenesis 2001). Both CEC and CD34+CEC levels significantly decreased on day 15, and low levels were maintained low until day 85. Plasma levels of VEGF also decreased similarly, but not significantly. Conclusions: The results of this exploratory study suggest that S-1 not only has cytotoxic effects on tumor tissue, but also anti-angiogenic activity in patients with metastatic breast cancer.
Feasibility of dietary intervention in a breast cancer population.
Authors: Colin E. Champ, Pramila R. Anne, Timothy Norman Showalter, Mila J Heersink, Rosanne Iacono, Mark Vikas Mishra, Adam P. Dicker, Anne Louise Rosenberg, Nicole L. Simone
Journal: Journal of Clinical Oncology (2012)

e11505 Background: Caloric restriction (CR), or reducing caloric intake by 20-40%, induces molecular changes which are also altered in breast cancer leaving cancer cells more susceptible to cytotoxic treatment. In vivo, CR decreases tumor growth and metastases. Recent research shows that breast cancer patients with metabolic syndrome and high blood glucose had higher mortality and poorer response to treatment. Diet modification may be an attractive potential adjunct to improve standard therapies, but little is known of the feasibility of enrolling patients into such a trial. Methods: After obtaining IRB approval, a survey was administered to a sample of patients in an academic breast cancer clinic to determine their interest in participating in nutrition trials during cancer treatment. Women were questioned regarding demographics, overall health status, comorbidities, and willingness to participate in clinical trials aimed at potentially increasing the efficacy of treatment through diet. Results: 50 breast cancer patients participated. 48% had comorbidities, 56% were self or physician-described as overweight, and 76% exercise at least once per week. 70% of respondents state that nutrition was never discussed with a physician prior to cancer care, 32% searched online for dietary information, and 62% expressed willingness to participate in a clinical trial involving a dietary regimen. Patients willing to participate in such a trial were more likely to be: currently exercising (73%), vitamin users (90%), not obese (64%), and more educated about diet related information (78%). Patients determined the most important tools to help them with dietary trial compliance would be speaking with a dietician weekly and weekly phone calls with the physician. Adherence would be increased if participants were provided meals. Conclusions: A significant proportion of breast cancer patients in this survey are interested in nutritional guidance and there is strong interest in participating in clinical trials with a dietary modification. Promising approaches include weekly meetings with dieticians and phone-based support. Based on these data, clinical trials of nutritional interventions appear warranted and feasible for enrolling breast cancer patients.
Psychiatric Genomics: Ethical Implications for Public Health in Lower- and Middle-Income Countries
Authors: Jantina de Vries, Dan J. Stein, Dorcas Kamuya, Ilina Singh
Journal: The American Journal of Bioethics (2017)

Kong and colleagues (Kong, Dunn, and Parker 2017) explore how a genomic medicine approach may impact on the perceptions and treatment of psychiatric conditions, and set out an interdisciplinary, cl...
Clinicopathological characteristics and outcomes of young patients (YP) with metastatic colorectal cancer (mCRC) in Australia.
Authors: Margaret Lee, Natalie Heather Turner, Hui-Li Wong, Soe Yu Aung, Rajat RAi, Claire Maddison, Kortnye Morris, Louise M. Nott, Desmond Yip, Kathryn Maree Field, Jeremy David Shapiro, Jeanne Tie, Ben Tran, Rachel Wong, Sumitra Ananda, Greg Stefanou, Ross Jennens, Peter Gibbs
Journal: Journal of Clinical Oncology (2015)

e14648 Background: Colorectal cancer, typically a disease of aging, is increasing in incidence amongst YP. Potential differences in clinicopathological features, treatment response, and survival between YP and older patients (OP) have yet to be fully explored. Methods: Using data from a prospective, comprehensive, Australian mCRC registry of consecutive patients diagnosed between January 2009 and January 2015, clinicopathological features, treatment and survival outcomes between YP (diagnosed ≤ 40 years), and OP (diagnosed > 40 years) were compared. Results: Sixty-nine YP and 1486 OP were identified; median follow up was 25.8 months. Compared with OP, YP were more likely to be female (53% vs 41%, p = 0.05), and have a Charlson Comorbidity Index < 3 (99% vs 90%, p = 0.02). YP were significantly more likely to present with de novo mCRC (84% vs 60%, p = 0.0001). There was no significant difference in anatomical site or resection incidence of the primary or metastatic disease. Treatment intent was similar, however YP were more likely to receive first-line combination chemotherapy (88% vs 77%, p = 0.05). There was a non-significant trend towards overall survival (OS) benefit in YP (34.2 vs 24.6 months, HR 0.75, 95%CI 0.56 - 1.08), the OS difference appearing to increase over time. YP were more likely than OP to have MMR testing (65% vs 35%, p = 0.0001) but less likely to have KRAS testing (64% vs 73%, p = 0.001) performed. However, there was no difference in MMR status, or in the incidence of KRAS or BRAF mutation. Further details on clinical presentation were available for 62 (90%) YP. Within this group, 57 (92%) were symptomatic at diagnosis. The majority (n = 36, 69%) had symptoms for more than one month, and 18 (34%) initially treated for an alternative pathology. Conclusions: Compared with OP, YP are more likely to present with de novo mCRC, which may in part be attributed to a delay in diagnosis. However, despite this, there appears to be a trend towards improved OS, which cannot be purely explained by a difference in treatment intent or underlying prognostic mutations, but may be influenced by treatment given. Further research in this disease affecting YP with increasing incidence is warranted.
Neoadjuvant mFOLFOX6 for stage II/III rectal cancer patients with a T3/T4 tumor.
Authors: Junichi Koike, Kimihiko Funahashi, Kazuhiko Yoshimatsu, Hajime Yokomizo, Hayato Kan, Takeshi Yamada, Hideyuki Ishida, Keiichiro Ishibashi, Yoshihisa Saida, Toshiyuki Enomoto, Kenji Katsumata, Masayuki Hisada, Hirotoshi Hasegawa, Keiji Koda, Takumi Ochiai, Kazuhiro Sakamoto, Hiroyuki Shiokawa, Shimpei Ogawa, Michio Itabashi, Shingo Kameoka
Journal: Journal of Clinical Oncology (2014)

3554 Background: The efficacy and safety of neoadjuvant modified FOLFOX6 (mFOLFOX6) therapy in stage II/III rectal cancer patients with a T3/T4 tumor is yet to be determined. Methods: Stage II/III (Ra/Rb) rectal cancer patients aged 20–80 years of age with a T3/T4 tumor were enrolled in this phase II multicenter study. Accrual of patient data began in August 2011 with a planned patient population set at 50. All patients had an Eastern Cooperative Oncology Group performance status of 0–1. The primary endpoint was preoperative response rate, and the secondary endpoints were histological effect, R0 resection rate, pCR rate, down-staging rate, neoadjuvant therapy completion rate, occurrence of adverse events, the incidence of postoperative complications, and three-year disease-free survival. Computed tomography was performed after four courses of neoadjuvant mFOLFOX6 therapy. Patients with progression disease (PD) underwent resection of the primary lesion, while those without PD received another two courses of treatment. Treatment was discontinued when resection was not possible in patients with PD. Results: Registered patients in July 2013 totaled 53 (male n=41, female n=12) with a mean age of 60 (38–77). The number of patients with T3 and T4 tumors was 42 and 10, and patients at stages II and III were 10 and 42, respectively. One patient withdrew due to consent retraction. Median relative dose intensity of mFOLFOX6 therapy was 93.2% for L-OHP, 5-FU, and l-LV. Treatment completion was achieved in 96.2% and 84.6% for four and six courses, respectively, and withdrawal was due to patient’s discretion, not adverse events. Surgery was performed in 78.8% of patients. Serious (grade ≥3) adverse events included neutropenia (n=5), leukopenia (n=1), thrombocytopenia (n=1), febrile neutropenia (n=1), nausea (n=1), vomiting (n=1), and peripheral neuropathy (n=2). The rates of R0 resection, pCR, and sphincter preservation, were 91.0%, 10.3%, and 82.9%, respectively. Postoperative complications included suture failure (n=3), wound infection (n=2), pneumonia (n=1), and intestinal obstruction (n=1). Conclusions: Neoadjuvant therapy using mFOLFOX6 is a safe and efficacious treatment option for rectal cancer, especially locally advanced disease. Clinical trial information: UMIN000006583.
Inhaled steroids reduce pain and sVCAM levels in individuals with sickle cell disease: A triple‐blind, randomized trial
Authors: Jeffrey Glassberg, Caterina Minnitti, Caroline Cromwell, Lawrence Cytryn, Thomas Kraus, Gwen S. Skloot, Jason T. Connor, Adeeb H. Rahman, William J. Meurer
Journal: American Journal of Hematology (2017)

Clinical and preclinical data demonstrate that altered pulmonary physiology (including increased inflammation, increased blood flow, airway resistance, and hyper-reactivity) is an intrinsic component of Sickle Cell Disease (SCD) and may contribute to excess SCD morbidity and mortality. Inhaled corticosteroids (ICS), a safe and effective therapy for pulmonary inflammation in asthma, may ameliorate the altered pulmonary physiologic milieu in SCD. With this single-center, longitudinal, randomized, triple-blind, placebo controlled trial we studied the efficacy and feasibility of ICS in 54 nonasthmatic individuals with SCD. Participants received once daily mometasone furoate 220 mcg dry powder inhalation or placebo for 16 weeks. The primary outcome was feasibility (the number who complete the trial divided by the total number enrolled) with prespecified efficacy outcomes including daily pain score over time (patient reported) and change in soluble vascular cell adhesion molecule (sVCAM) levels between entry and 8-weeks. For the primary outcome of feasibility, the result was 96% (52 of 54, 95% CI 87%-99%) for the intent-to-treat analysis and 83% (45 of 54, 95% CI 71%-91%) for the per-protocol analysis. The adjusted treatment effect of mometasone was a reduction in daily pain score of 1.42 points (95%CI 0.61-2.21, P = 0.001). Mometasone was associated with a reduction in sVCAM levels of 526.94 ng/mL more than placebo (95% CI 50.66-1003.23, P = 0.03). These results support further study of ICS in SCD including multicenter trials and longer durations of treatment. www.clinicaltrials.gov (NCT02061202).
Socioeconomic and demographic factors associated with use of sentinel node biopsy and adjuvant biologic response modifiers in melanoma
Authors: J. R. Lange, D. Chang, B. E. Palis, C. M. Balch
Journal: Journal of Clinical Oncology (2006)

6027 Background: Cancer management may be influenced by factors other than disease characteristics. Little is known about the association of demographic and socioeconomic factors with melanoma care. Methods: The National Cancer Data Base, a hospital-based registry, was queried on reported use of adjuvant biologic response modifiers (BRM) for patients with resected regional metastases and the use of sentinel node biopsy (SNBx) for patients with clinical stage I and II melanoma in patients ages 1–69 between 1994 and 2003. Independent variables were age, sex, race, severity of disease, income, insurance type, U. S. Census region and type of treating facility. Analysis was performed by forward stepwise logistic regression. Results: Between 1994 and 2003, 37.8% of 10,790 patients with resected node-positive melanoma received BRM. Between 1998 and 2002, 61,251 patients with clinical stage I and II melanoma had a SNBx in 13.2%, 46.2%, 55.9%, and 41.7% of those with T1, T2, T3, and T4 tumors, respectively. In multivariate analysis, geographic variance in use of BRM and SNBx was striking ( Table ). Insurance type (commercial vs. others) and facility type (teaching/research vs. others) were also significantly associated with these modalities. Use of BRM was also associated with age, number of positive nodes and earlier treatment year, but not with sex, income or race. Use of SNBx was also associated with T stage, later treatment year, age and income, but not with sex or race. Conclusions: BRM and SNBx use varied significantly with geographic region, insurance type, and type of treating facility; this may have implications for provider education and public policy. [Table: see text] No significant financial relationships to disclose.
The wolf will live with the lamb
Authors: Richard Ronay, Joshua M. Tybur
Journal: Behavioral and Brain Sciences (2017)

Abstract Maestripieri et al. pit evolutionary psychology against social psychological and economic perspectives in a winner-take-all empirical battle. In doing so, they risk positioning evolutionary psychology as an antagonistic subdisciplinary enterprise. We worry that such a framing may exacerbate tensions between “competing” scientific perspectives and limit evolutionary psychology's potential to serve as a unifying core theory.