tbuckley/cabot-search huggingface dataset:
Positron emission tomography/computed tomography (PET/CT) as a biomarker of pathologic response to neoadjuvant chemotherapy in breast carcinoma.
Authors: Catherine M. Kelly, Clare Smith, Susan Conlon, Reem Salman, John McCaffrey, Emmet Jordan
Journal: Journal of Clinical Oncology (2012)

e21147 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast carcinoma is prognostic. Predictive biomarkers for pCR include early response to NAC, estrogen receptor (ER) negativity, HER2 positivity, and high Ki67. We assessed whether absence of fluoro-deoxy glucose (FDG) uptake measured by standardized uptake value (SUV) after NAC would predict pCR. Methods: We identified 23 patients (pts) who had PET/CT scanning pre and post NAC. We examined breast cancer subtype, chemotherapy (CT) regimen, number of cycles of CT given, clinical and pathological staging data and changes in SUV in the breasts and lymph nodes pre and post NAC. pCR was defined as no residual cancer in the breast or axillary lymph nodes. Results: Median age at diagnosis was 46 years (IQR; 37 to 56). Median tumor size at diagnosis was 30mm (IQR; 25 to 43) and 19 pts (83%) had node positive breast cancer. Most tumors were ductal (n=22) with 1 lobular cancer. Preoperatively 95% received all CT. All HER2+ pts received Trastuzumab. Anthracycline/taxane based regimens were most frequently given in 22 cases, 1 received lapatinib/trastuzumab. Five tumors (21.7%) were ER+/HER2+; 14 (60.9%) ER+/HER2-; 2 (8.7%) ER-/HER2+ and 2 (8.7%) were ER-/HER2-. All tumors were high (n=9, 39.1%) or intermediate grade (n=14, 61%). SUV was significantly lower post NAC (p=0.035). We observed no SUV uptake in breast or lymph nodes in 15 cases (65.2%) post NAC, these corresponded to; ER+HER2+ 4/5 (80%); ER+HER2- 7/15 (46.7%); ER-HER2- 2/2(100%), ER-HER2+ 2/2(100%). Absent SUV uptake post NAC was associated with a pCR (breast and lymph nodes) in 5/15 (33%) of pts (ER+HER2+ n=1, ER+HER2- n=1, ER-HER2- n=2, ER-HER2+ n=1). Ten of 15 tumors (67%) had no SUV uptake in the breast post NAC and 7 (47%) were associated with a pCR. There was a trend toward increased odds of pCR with no SUV uptake post NAC (OR 2.76; 95% CI 0.85 to 8.94: P= 0.09). Overall rate of pCR was 21.7% (n=5). Conclusions: A non-statistically significant trend toward increased odds of pCR with no SUV uptake post NAC was observed. Larger subtype-specific breast cancer cohorts will be required to determine the value of PET/CT as a predictive biomarker for pCR.
Ambient air pollution exposure and risk and progression of interstitial lung abnormalities: the Framingham Heart Study
Authors: Mary B Rice, Wenyuan Li, Joel Schwartz, Qian Di, Itai Kloog, Petros Koutrakis, Diane R Gold, Robert W Hallowell, Chunyi Zhang, George O'Connor, George R Washko, Gary M Hunninghake, Murray A Mittleman
Journal: Thorax (2019)

Background Ambient air pollution accelerates lung function decline among adults, however, there are limited data about its role in the development and progression of early stages of interstitial lung disease. Aims To evaluate associations of long-term exposure to traffic and ambient pollutants with odds of interstitial lung abnormalities (ILA) and progression of ILA on repeated imaging. Methods We ascertained ILA on chest CT obtained from 2618 Framingham participants from 2008 to 2011. Among 1846 participants who also completed a cardiac CT from 2002 to 2005, we determined interval ILA progression. We assigned distance from home address to major roadway, and the 5-year average of fine particulate matter (PM 2.5 ), elemental carbon (EC, a traffic-related PM 2.5 constituent) and ozone using spatio-temporal prediction models. Logistic regression models were adjusted for age, sex, body mass index, smoking status, packyears of smoking, household tobacco exposure, neighbourhood household value, primary occupation, cohort and date. Results Among 2618 participants with a chest CT, 176 (6.7%) had ILA, 1361 (52.0%) had no ILA, and the remainder were indeterminate. Among 1846 with a preceding cardiac CT, 118 (6.4%) had ILA with interval progression. In adjusted logistic regression models, an IQR difference in 5-year EC exposure of 0.14 µg/m 3 was associated with a 1.27 (95% CI 1.04 to 1.55) times greater odds of ILA, and a 1.33 (95% CI 1.00 to 1.76) times greater odds of ILA progression. PM 2.5 and O 3 were not associated with ILA or ILA progression. Conclusions Exposure to EC may increase risk of progressive ILA, however, associations with other measures of ambient pollution were inconclusive.
Association between HS and hospitalization for psychiatric disorders
Authors: K.R. Patel, S. Rastogi, V. Singam, H.H. Lee, A.Z. Amin, J.I. Silverberg
Journal: British Journal of Dermatology (2019)

Hidradenitis suppurativa is a chronic disease that causes painful, swollen, fluid and pus‐filled lumps on the skin. Hidradenitis affects between 0.3 to 4.0% of the population worldwide. The researchers of this study are based in U.S.A. They aimed to find out if hidradenitis is linked with higher likelihood and costs of mental health disorders. They examined the National Inpatient Sample, a nationwide database of hospitalizations in the U.S.A., between the years 2002 to 2012. They performed statistical analyses to explore the relationship between hidradenitis and mental health disorders. The study found that hidradenitis was associated with higher likelihood of being hospitalized with mental health disorders, including: depression, suicidal risk, anxiety, attention deficit or conduct disorder, schizophrenia, personality disorder, substance use disorder, adjustment disorders, and developmental disorders. The authors also discovered that patients with hidradenitis had higher costs of care related to hospitalization for mental health disorders. In summary, the results of the study showed that patients with hidradenitis were more likely to be hospitalized and have higher costs of care for mental health disorders.
Metastatic melanoma patients: Prospective follow-up of pigmented lesions under vemurafenib by digital dermoscopy.
Authors: Marie Perier-Muzet, Stephane Dalle, Gerard Duru, Luc Thomas, Sebastien Debarbieux, Nicolas Poulalhon, Brigitte Balme
Journal: Journal of Clinical Oncology (2013)

9093 Background: Vemurafenib is the first approved by the FDA BRAF V600 inhibitor for the treatment of metastatic melanoma. Many cutaneous side-effects such as squamous cell carcinoma, xerosis, photosensitivity are observed. We first reported the occurrence of second primary melanomas (SPM) under BRAF inhibition. These SPM were shown to be wild-type for BRAF. The exact occurrence of these changes is still unknown. We wanted then to explore prospectively the impact of vemurafenib on cutaneous pigmented lesions using sequential digital dermoscopy. Methods: We registered prospectively following inform consent the pigmented lesions of patients under vemurafenib. We examined the total body surface and captured from 9 to 134 pigmented lesions on 24 patients. Each single lesion was followed monthly from vemurafenib initiation to vemurafenib disruption due to disease progression. Dermoscopic modifications of the melanocytic lesions including external diameter, dermoscopical pattern, pigmentation, network thickness, dots distribution and keratosis appearance were analyzed. Results: The median duration of dermoscopic follow up was 6,9 months ( range from 2 to 16 months), 1098 pigmented lesions were included. At least one modification occurred in 56% of the lesions. Most frequent modifications were the occurrence of dark globules (56%), change in the pigmentation coloration (47%), variations in network thickness (32%), increase of the external size (20,1%), onset of black areas (14%), onset of keratosis (4,4%). Up to 5,3% of lesions spontaneously disappeared; 21 excisions were performed due to significant dermoscopic changes and revealed 10 early melanomas in 5/24 patients (20,8%). The 11 remaining lesions were benign. Conclusions: More than fifty percent of the patients under vemurafenib will experiment significant modifications on their pigmented lesions. In our experience 10/21 removed lesions were early melanomas that could not be otherwise diagnosed using naked-eyes examinations only. Digital dermoscopy is one of the tool that can be use to discriminate earlier the modifications. Such careful monitoring will improved the safety when evaluating BRAF inhibitors in adjuvant setting.
Rebiopsy in TKI-resistance: A retrospective analysis.
Authors: Justine Leonie Kuiper, Danielle Heideman, Erik Thunnissen, M A Paul, Egbert F. Smit
Journal: Journal of Clinical Oncology (2013)

8065 Background: EGFR-TKI provides a clinical benefit in patients with EGFR-mutated NSCLC with median progression-free survival (PFS) of 12 months. Several resistance mechanisms (e.g. T790M mutation) have been described, however data are sparse. We analysed EGFR-mutation spectra in NSCLC patients with acquired resistance to TKI. Methods: Biopsies from patients with EGFR-mutation or TKI-response&gt;24 weeks with both pre- and post TKI biopsy available were retrospectively analysed. Information was collected from the medical record. Response to TKI-treatment was assessed according to RECIST. PFS after TKI-treatment was calculated with a Kaplan-Meier curve. Results: 63 patients were included for analysis. Pre- and post TKI biopsy results are described in the Table. 32 patients received 1 (38%), 2 (10%) or 3 (3%) lines of chemotherapy before start of TKI and 18 patients received 1 (13%), 2 (11%), 3 (3%), or 5 (2%) lines of therapy after TKI treatment. Median PFS on TKI-treatment was 12,3 months (range: 1,4 – 43,2). Objective response rate was 61,9%. 47,6% of patients developed the T790M mutation. One patient developed transformation to SCLC with the original exon 19 deletion. One patient with pre-TKI an exon 18 + exon 21 mutation was found to have a KRAS-mutation post-TKI. Conclusions: In this cohort, frequency of development of T790M mutation was consistent with earlier reports. Transformation to SCLC occurred less than described earlier. Two patients did not retain their original mutation. Surprisingly, one patient developed a KRAS mutation: a second primary tumor is not excluded in this case. Rebiopsy in TKI-resistance provides important information on dynamic tumour characteristics and has management implications in certain patients. [Table: see text]
Rubella immunity and vaccination coverage of the population of northern Greece in 2006
Authors: G Gioula, A Fylaktou, M Exindari, G Atmatzidis, D Chatzidimitriou, A Melidou, V Kyriazopoulou-Dalaina
Journal: Eurosurveillance (2007)

This study was prompted by two rubella outbreaks that occurred in northern Greece in the last decade (1993 and 1999) and by periodic changes to the immunisation strategy. It was designed to determine the current status of rubella immunity and vaccination coverage in this region, eight years after the last outbreak in 1999 and seven years after the last epidemiological study in the area. Among the 685 subjects studied the seroprevalence was 83.7% and the total vaccination rate was 31.3%. In people born before the introduction in 1989 of the measles/mumps/rubella (MMR) vaccine into the national immunisation programme, higher rates of rubella seropositivity (88.1%) were observed compared to those born after 1989 (77.1%). The vaccination rates for these age groups were 14.8% and 58.1%, respectively. The reason for this difference is the lack of vaccination at the time these people were children, and it underlines the need for a vaccination strategy targeting older people as well. Among women of reproductive age (16-40 years), who represented 44.8% of the study population, 13.9% were susceptible to rubella and only 18.5% were vaccinated. These results indicate that there is a great need for a comprehensive policy designed to protect mostly young adults and women of childbearing age in order to prevent congenital rubella infections. This policy should also include competent surveillance systems for rubella and congenital rubella syndrome and an evaluation of existing immunisation programmes.
Neutrophil/lymphocyte ratio (NLR) as a prognostic factor in biliary tract cancer (BTC).
Authors: Mairead Geraldine McNamara, Arnoud J. Templeton, Manjula Maganti, Thomas Walter, Anne M Horgan, Elizabeth McKeever, Trisha Min, Jennifer J. Knox
Journal: Journal of Clinical Oncology (2013)

4130 Background: BTCs include intrahepatic (IHC), hilar, distal bile duct (DBD), and gallbladder carcinoma (GBC). Risk factors include conditions associated with chronic inflammation. NLR, an inflammatory marker, is prognostic in several cancers but has not been reviewed in large BTC series, hilar or GBC. Methods: Baseline demographics and NLR at diagnosis were evaluated in 864 patients (pts) with BTC from 01/87 - 12/12 treated at Princess Margaret Cancer Center. Their prognostic significance for overall survival (OS) was determined using a Cox proportional hazards model. Results: High NLR ≥3.0 was associated with poor survival using univariable analysis as was stage/site of primary (P&lt;0.05), age &gt;65yrs, lymphocytes ≤1.6 (P&lt;0.01), neutrophils ≥5.0, platelets ≥280, hemoglobin (Hb) &lt; 110 g/L (P&lt;0.001). Median OS in pts with NLR&lt;3.0 was 21.6 mo, 12.0 mo with NLR ≥3.0 (P&lt;0.001). NLR retained its significance as a prognostic marker on multivariable analysis (Table), along with GBC (P&lt;0.05), age&gt;65yrs, DBD primary (P&lt;0.01), stage and Hb &lt;110g/L (P&lt;0.001). NLR was prognostic for OS on multivariable analysis for hilar: overall (Table) and advanced grp (n=102) (HR 1.68, 95%CI 1.07-2.64, P&lt;0.05) and in advanced DBD (n=102) (HR 1.63, 95%CI 1.03-2.57,P&lt;0.05). On subgrp analysis, NLR was prognostic for OS in advanced BTC (ABTC) (n=538) (P&lt;0.01) but not in surgical grp. NLR did not predict RECIST response to first line palliative chemotherapy in ABTC. Conclusions: Baseline NLR is prognostic in BTC, specifically ABTC and hilar subgrp, suggesting the importance of systemic inflammation influencing outcome in pts with ABTC, thus providing a simple inexpensive prognostic biomarker while also possibly identifying pts that may benefit from antiinflammatory mediation. NLR was not predictive for response in BTC. [Table: see text]
Frequency of carcinoma not otherwise specified (NOS) as a histologic diagnosis among non-small cell lung cancer (NSCLC) cases between 1989 to 2006: An epidemiologic study from the California Cancer Registry
Authors: S. I. Ou, J. A. Zell
Journal: Journal of Clinical Oncology (2009)

e19049 Background: Recent clinical trials demonstrated differential survival benefit from different chemotherapy regimens according to NSCLC histologies. We investigated the distribution of carcinoma NOS (not otherwise specified) among NSCLC cases in California. Methods: Retrospective population-based analysis of 175,298 NSCLC patients diagnosed histologically or cytologically from the statewide California Cancer Registry from 1989 to 2006. Results: Carcinoma NOS accounted for 22.2% of all NSCLC patients, was most commonly diagnosed cytologically (36.7%) and had the worst 5-year survival estimates (5.8%) and median OS (5 months) compared to other major histologies. The proportion of carcinoma NOS was highest among stage 4 disease and increased significantly from 1989 to 2006 among all patients, both males and females, all 4 major ethnicities (Caucasian, African-American, Hispanic, and Asian), all age- categories, and all AJCC stages. The percentage of the very elderly (80+) increased from 10.8% to 17.1% among all NSCLC patients and they had the highest percentages of carcinoma NOS and cytologically-diagnosed NSCLC among all age categories. Among stage 4 patients, carcinoma NOS patients derived less survival benefit from chemotherapy than adenocarcinoma patients during the most recent period of diagnosis and Cox proportional hazards analysis indicated carcinoma NOS (vs. adenocarcinoma; HR = 1.061, 95% CI: 1.040- 1.083) and cytologically-diagnosed NSCLC (vs. histologically-diagnosed NSCLC, HR = 1.043, 95% CI: 1.024–1.062) were independent unfavorable prognostic factors for OS. Conclusions: Carcinoma NOS was a common histologic diagnosis and was increasing in proportion among NSCLC in California from 1989 to 2006. This may be partially attributed to the increasing number of the very elderly patients and stage 4 patients. No significant financial relationships to disclose.
Seeing red after a prostate procedure
Authors: Maximillian Hugo Brodermann, Mark A Samaan, Shameer Mehta, Sara McCartney
Journal: Gut (2019)

A 71-year-old man attended accident and emergency with a 1-day history of rectal bleeding without associated abdominal pain, change in bowel habit or history of GI disease. On admission, his haemoglobin was normal at 147 g/L with normal platelets of 194×109/L. There was a raised white blood cell count of 12.2×109/L (normal range 4.5−11×109/L) and normal C-reactive protein of 2.2 mg/L. His urea and electrolytes and liver function tests were normal. The patient had no recent changes to his regular medication and did not take non-steroidal anti-inflammatory drugs, antiplatelet or anticoagulant medications. He reported feeling well with no fevers or weight loss and denied any previous similar episodes. He had recently undergone a minimally …
Inter-criteria reproducibility of RECIST, WHO, Japanese response criteria for gastric cancer or esophageal cancer: From the response dataset of Japan Clinical Oncology Group (JCOG) phase III trials
Authors: Y. Kurokawa, K. Yoshimura, S. Yamamoto, A. Sato, I. Saito, H. Fukuda
Journal: Journal of Clinical Oncology (2006)

4065 Background: For assessments of tumor response in upper gastrointestinal cancers, Japanese criteria (JPN), which needs X-ray or endoscopic findings for primary lesion, has been generally used in Japan instead of international RECIST or WHO criteria. To compare the inter-criteria reproducibility of these radiological assessments, we analyzed the datasets of tumor responses from two phase III trials. Methods: A total of 115 gastric cancer patients in two treatment arms of JCOG9205, 5-FU and 5-FU plus cisplatin, and 103 esophageal cancer patients in a neoadjuvant 5-FU plus cisplatin arm of JCOG9907 were eligible for this analysis. Overall response rates (ORR) were calculated according to each of three criteria. The tumor responses, furthermore, were divided into four categories (CR, PR, SD, PD), following estimation of kappa statistics between two criteria as agreement measure. Results: As shown in the Table , ORR according to RECIST and WHO were very similar in both cancers. JPN tended to estimate higher ORR comparing to RECIST or WHO, particularly in esophageal cancer. In gastric cancer, kappa for concordance to RECIST were 0.92 for WHO and 0.86 for JPN. While in esophageal cancer, kappa were 0.72 for WHO and 0.40 for JPN. Conclusions: In these trials for gastric cancer and esophageal cancer, there was fairly consistent reproducibility between unidimensional RECIST and bidimensional WHO criteria. JPN criteria, depending on assessment of primary lesion, may give higher ORR particularly in esophageal cancer, and cautious interpretation may be necessary when evaluating ORR from Japanese trials using JPN criteria (Table). Overall response rates of respective treatment arms calculated according to RECIST, WHO and JPN criteria. [Table: see text] No significant financial relationships to disclose.
A pilot study exploring issues around decision making in older women with primary operable breast cancer.
Authors: Ruth M. Parks, Louise Hall, Siau-Wei Tang, Radhika Lakshmanan, Penny Howard, Linda Winterbottom, David A. L. Morgan, Davina Porock, Karen Cox, Kwok-Leung Cheung
Journal: Journal of Clinical Oncology (2013)

e20588 Background: Decision making process related to cancer treatment is complex, influenced by tumour factors, patients and clinicians, and may affect outcomes eg quality of life (QOL). Studies are scarce in exploring this subject in the older population. This pilot study aimed to investigate this in older (≥70 years) women newly diagnosed with clinically T0-2N0-1M0 breast cancer. Methods: Patients as described were invited to participate. Actual treatment planning was made by the clinical team and was not part of the study. Semi-structured interviews were conducted within 6 weeks and at 6 months, alongside Comprehensive Geriatric Assessment (CGA) and QOL assessment using EORTC QLQ-C30. Interview recordings were transcribed (intelligent verbatim) and then analysed by (i) identifying themes; and (ii) comparing them with CGA and QOL measures. Results: Forty-one patients took part at the time of analysis. The following themes emerged in different patient combinations, at both time points. 1) Symptoms - The majority presented symptomatically (87%, 21/31). At 6 months, 45% (18/40) reported a negative feeling, but 81% (22/27) said they would choose the same treatment again. 2) Knowledge - Most patients (80%, 28/35) knew someone with a cancer diagnosis, but did not know much about breast cancer or treatment (87%, 18/24). 3) Reactions - At diagnosis, only 48% (10/23) felt ‘shocked’ or ‘surprised,’ while the remainder had ‘no reaction’ or ‘were prepared’. The majority (91%, 29/32) felt that they had received enough information about treatment options or that they did not have an option. 4) QOL - Most patients (88%, 15/17) thought they had made the right treatment choice. The majority (86%, 6/7) were not worried about the future and 91% (10/11) reported no change in QOL. No relationship was seen between these interview findings and the treatment modalities received. These findings were consistent with the results of CGA and QOL assessment. Conclusions: These preliminary findings suggest that these patients were generally happy with the decision made for their treatments and had a fairly good QOL and future outlook. The study has now entered into a second stage where more in-depth interviews are being conducted.