tbuckley/cabot-search huggingface dataset:
The serum tumour marker Ca19-9 in non-small cell lung cancer (NSCLC).
Authors: Michael Vaslamatzis, Elisabeth Patila, Charalampia P. Margari, Theodoros K. Tegos, Nektarios Alevizopoulos, Georgios Kyriakopoylos, Lamprini Kyriou, Apostolos Laskarakis, Theodora Kapou, Charalampos Stathopoulos
Journal: Journal of Clinical Oncology (2015)

e18535 Background: Ca 19-9 is present in the glands of bronchi & bronchioles, so it is plausible that this serum tumor marker (STM) may increase in NSCLC. Aim: To evaluate the incidence & significance of high serum Ca19-9 values and to correlate with 6 other well-known STMs (CEA, Ca-125, NSE, SCC, Cyfra 21.1, Ca 72-4) in NSCLC pts. Methods: Serum Ca19-9 was detected, using an i2000SR Architect Abbott analyzer, in 350pts, Lea+b+, admitted in our Unit between 12/2007–12/2014. Results: Ca 19-9 > 70 U/ml was recorded in 41(10%)pts, median age 63(44-82)ys, ECOG 1(0-2),stages I-IIIA, IIIb & IV, 10, 5 & 26 pts respectively.Ca19.9 > 1000U/ml found in 8 pts. All pts were thoroughly examined & excluded any GIT disease. Between the 26 stage IV pts, bones, lung, brain, adrenals & liver metastases were documented in 14(54%), 7(27%), 6(23%), 5(19%) & 2(8%)pts respectively. The median serum values of Ca 19-9 were 343(71-14.979) for the total group & 130(74-14.979), 424(282-506) & 520(71-5721) U/ml for pts with stages I-IIIA, IIIB and IV, respectively. Adeno-, squamous & adenosquamous LC had 30/41(73%), 7(17%) & 4(10%) pts vs 225/380(59%), 130(34%) & 25(7%) respectively, in our NSCLC population (0.05 < p < 0.1, 0.01 < p < 0.05, & p = NS). Immunohistological staining for Ca19-9 was positive ++/+++ in 21/41 pts. From 41 pts, 8(19.5%), 16(39%), 8(19.5%), 5(12%) & 4(10%) had simultaneously increased 6,5,4,3, and 2 STMs,respectively. All the pts were reevaluated after at least three courses of chemotherapy with Carbo + Taxol ± Bev ± locoregional RT. CR, PR & SD was documented in 4/10(st.I-IIIA), PR & SD 13/31 & PD 18/31 (st.IIIB & IV, respectively). In the pts with CR & PR a significant reduction of Ca19.9 was documented. No response or disease stability was observed in the 8 pts with initial value of Ca 19-9 > 1000 U/ml. Patients (13/21) with early disease progression ( ≤ 5 ms) had CA 19-9 ≥ 343U/mL. Conclusions: 1) A strong association of high serum Ca19.9 & disease extension was stated. 2) Patients with Ca 19-9 > 1000 U/ml had a bad outcome after chemotherapy. 3) A powerful association in high serum Ca 19-9 with known STMs in NSCLC was documented. 4) Tissue Ca19-9 staining should be checked in NSCLC pts with high Ca19-9 serum values. 5) A significant correlation of increased serum Ca 19-9 values & outcome was recorded.
Advanced Epithelial Ovarian Cancer: Do More Options Mean Greater Benefits?
Authors: Sara Bouberhan, Meghan Shea, Stephen A. Cannistra
Journal: Journal of Clinical Oncology (2019)

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A healthy 51-year-old woman presented with increasing abdominal and pelvic pain. Computed tomography imaging of the abdomen and pelvis showed an 11.6-cm pelvic mass, retroperitoneal lymphadenopathy, right hydronephrosis, and mesenteric tumor deposits ( Fig 1A ). A serum CA-125 was elevated at 1,149 U/mL. She underwent primary surgical cytoreduction including hysterectomy, bilateral salpingo-oophorectomy, appendectomy, resection of pelvic tumor, omentectomy, and low anterior resection with colorectal anastomosis. Intraoperatively, she was noted to have bilateral ovarian masses, pelvic and para-aortic lymphadenopathy, and a 4-cm omental tumor; in addition, both the uterus and rectosigmoid colon had adherent tumor deposits. All gross tumor was resected during the procedure. Final pathology confirmed high-grade serous carcinoma of ovarian origin ( Fig 1B ) that was determined to be stage IIIC as a result of upper abdominal involvement with greater than 2-cm tumor deposits, as well as retroperitoneal lymph node involvement. She underwent germline genetic testing, which did not identify a mutation in the BRCA1, BRCA2, BRIP1, RAD51C, or RAD51D genes. She presented for adjuvant chemotherapy after an optimal (R0) resection.
Hepatocellular adenomas: one step beyond
Authors: Jean-Yves Scoazec
Journal: Gut (2019)

In Gut , Longerich et al describe the identification of a new gene, RSPO2 , involved in the pathogenesis of hepatocellular adenomas (HCA) and of a small fraction of hepatocellular carcinomas (HCC), through the activation of the Wnt/beta-catenin pathway, already known to be involved in the pathogenesis of a significant proportion of liver tumours.1 These results reduce the percentage of so-called ‘unclassified’ HCA, underline the tight relationship of some HCA with HCC and add another piece to the puzzle of the extraordinary clinical and biological diversity of HCA. This prompts several comments, mainly about the ‘HCA story’, but also about general tumour biology.

The ‘HCA story’ is a paradigm of how the better knowledge of a tumour group might form the basis of a better tumour classification and how a better tumour classification might result in an improved management of the patients. At the end of the previous century, HCA were viewed as rare benign liver tumours, occurring mainly in young females in the context of oral contraception.2 Their management was simple: when feasible, surgical resection was performed in all cases in order to prevent sometimes severe complications, such as rupture or bleeding. The risk of malignant transformation was a matter of debate. With the new millennium, started a series of in-depth molecular investigations which definitively changed our understanding of this tumour group, with major consequences on their clinical management and their understanding.3 From what was previously seen as a homogeneous entity, rapidly emerged a much …
SAT-063-Third-generation cephalosporins are still useful as the empirical antibiotics for spontaneous bacterial peritonitis in Korea
Authors: Sun Woong Kim, Jeonghoon Lee, Sungwon Chung, minseok albert kim, Young Chang, Hyo Young Lee, Jun Sik Yoon, Yun Bin Lee, Eun Ju Cho, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon
Journal: Journal of Hepatology (2019)
Lenalidome in combination with rituximab for relapsed or refractory mantel cell lymphoma: Updated analysis of a phase 2 trial.
Authors: Yucai Wang, Maria Lourdes Dela Rosa, Shouhao Zhou, Maria Badillo, Alicia Addison, Liang Zhang, Hun Ju Lee, Jorge Enrique Romaguera, Michael Wang
Journal: Journal of Clinical Oncology (2015)

8542 Background: We previously reported favorable safety and efficacy of lenalidomide plus rituximab in relapsed or refractory (R/R) mantle cell lymphoma (MCL) in a phase 1/2 trial (Wang et al, Lancet Oncol 2012). We performed an updated analysis of the phase 2 data after an extended follow up. We also investigated whether Ki-67 level affected response and survival in this study, as we recently reported that lower Ki-67 was associated with extremely high response rate to ibrutinib plus rituximab in R/R MCL (Wang et al, ASH 2014). Methods: Patients with R/R MCL were enrolled in this single arm phase 1/2 trial. In phase 2, lenalidomide was administered orally at 20 mg daily dose on days 1-21 of each 28-day cycle, and 375 mg/m2 rituximab was administered intravenously weekly during the first cycle only. Treatment was continued until disease progression, stem-cell transplantation, or severe toxicity. The primary endpoint was overall response, and the secondary endpoint was survival. Analysis was by intention to treat. Results: 46 patients were enrolled, of which 42 were male. The median age was 66.5 (range 46-85). Median number of prior lines of therapy was 2 (range 1-4). At a median follow up of 24.7 months (range 1.2-96.1), 16 (34.8%) and 10 (21.7%) patients achieved CR and PR, respectively, with an ORR of 56.5%. An additional 10 (21.7%) patients achieved MR or SD. ORR was independent of age, gender, number of prior lines of therapy and Ki-67 at registration. Median time to response was 1.8 months (range 1.6-7.7). Median duration of response was 20.9 months (95% CI 10.9-NR). The median PFS was 14.1 months (95% CI 8.2-26.7), and median OS was 24.6 months (95% CI 16.8-33.7). The 12- and 24-month PFS rates were 53.1% and 39.9%, respectively. The 1-, 2- and 5-year OS rates were 82.6%, 52.2% and 26.1%, respectively. Lower Ki-67 at registration ( < 50%) and fewer prior lines of therapy ( < 2) were predictive of better PFS (HR = 0.242, 95% CI 0.070-0.715, P = 0.012; and HR = 0.245, 95% CI = 0.071-0.841, P = 0.025) and OS (HR = 0.267, 95% CI 0.110-0.648, P = 0.003; and HR = 0.363, 95% CI = 0.147-0.896, P = 0.028). Conclusions: Lenalidomide plus rituximab is efficacious in treating R/R MCL. Lower Ki-67 is associated with better survival outcomes. Clinical trial information: NCT00294632.
Why are UK junior doctors taking time out of training and what are their experiences? A qualitative study
Authors: Chantelle Rizan, Julia Montgomery, Charlotte Ramage, Jan Welch, Graeme Dewhurst
Journal: Journal of the Royal Society of Medicine (2019)

Objectives The number of doctors directly entering UK specialty training after their foundation year 2 (F2) has steadily declined from 83% in 2010 to 42.6% in 2017. The year following F2, outside the UK training pathway, is informally termed an ‘F3’ year. There is a paucity of qualitative research exploring why increasingly doctors are taking F3s. The aim of this study is to explore the reasons why F2 doctors are choosing to take a year out of training and the impact upon future career choices. Design This is an exploratory qualitative study, using in-depth interviews and content analysis. Setting UK. Participants Fourteen participants were interviewed from one foundation school. Participants included five doctors who commenced their F3 in 2015, five who started in 2016 and finally four recently starting this in 2017. Main outcome measures Content analysis was conducted to distill the themes which exemplified the totality of the experience of the three groups. Results There were four predominant themes arising within the data set which can be framed as ‘unmet needs’ arising within foundation years, sought to be fulfilled by the F3 year. First, doctors describe exhaustion and stress resulting in a need for a ‘break’. Second, doctors required more time to make decisions surrounding specialty applications and prepare competitive portfolios. Third, participants felt a loss of control which was (partially) regained during their F3s. The final theme was the impact of taking time out upon return to training (for those participants who had completed their F3 year). When doctors returned to NHS posts they brought valuable experience. Conclusions This study provides evidence to support the important ongoing initiatives from Health Education England and other postgraduate bodies, exploring approaches to further engage, retain and support the junior doctor workforce.
SAT-414-Baveno VI principle for non-invasive assessment of high risk varices is also applicable with shear wave elastography
Authors: Oana Farcau, Felix Bende, Andreea Ardelean, Fischer Petra, Monica Lupsor-Platon, Bogdan Procopet, Radu Badea, Marcel Tantau, Ioan Sporea, Horia Stefanescu
Journal: Journal of Hepatology (2019)
THU-399-First Belgian hepatitis E seroprevalence study shows low stable birth-cohort specific seroprevalence until, with recent 2016-2018 increase in single centre estimates
Authors: Erwin Ho, Veronik Hutse, Vera Verburgh, Marjorie Jacques, Heidi Theeten, Amber Lizroth, Vanessa Suin, Steven Van Gucht, Stéphanie Blaizot, Abbas Rahman, Niel Hens, Pierre Van Damme, Peter Michielsen, Thomas Vanwolleghem
Journal: Journal of Hepatology (2019)
Brigatinib experience on the ALK project
Authors: F. Gomes, N. Tokaca, K. Yip, S. Ghosh, T. Newsom-Davis, A. Greystoke, H. Mills, S. Ahmed, A.S. Harle, G. Ayre, R. Shah, S. Popat, F.H. Blackhall, Y. Summers
Journal: Annals of Oncology (2019)

Background: The ALK Project established a network across the UK with the aim to analyse treatment patterns/outcomes and promote collaborations and research. The treatment pathway for ALK+ patients has been revolutionised in recent years. Methods: A multicentre retrospective analysis across 32 NHS hospitals/trusts identified 196 ALK+ non-small cell lung cancer (NSCLC) patients who were offered treatment by Dec-2018. Patients who received brigatinib during their treatment pathway were selected. The primary aims were 2-years overall survival (OS) and median OS from start of brigatinib. The secondary aims were objective response rate (ORR), incidence of grade 3-4 toxicity and 5-years/median OS from diagnosis of advanced NSCLC. Results: A total of 50 patients were included with 48% being males, 70% never smoked tobacco and the median age at diagnosis was 50 years. 66% of patients developed brain metastasis at some point during their care and 52% had brain metastasis at the start of brigatinib. Brigatinib was used as the first, second or subsequent ALK inhibitor in 18%, 50% and 32% of cases, respectively. 82% of patients were exposed to other ALK inhibitors during their treatment pathway and 46% received chemotherapy prior to the start of any ALK inhibitor. On a median follow-up (since start of brigatinib) of 10 months, patients stayed on brigatinib for a median of 9 months (95% CI, 3.1-14.9), reaching 14 months (95%CI 11.0-19.9) if no brain metastasis (p = 0.15). The overall ORR was 64% and the incidence of grade 3-4 toxicity was 16%. Median OS from start of brigatinib was not reached and the 2-years OS according to brain metastasis was 61% or 83%, in favour of those without brain metastasis (p = 0.037). The median OS from diagnosis of advanced NSCLC was not reached and the 5-years OS was 55%. Conclusions: Brigatinib is well tolerated and an effective treatment even in heavily pre-treated patients or in those with brain metastasis. A nationwide collaboration is possible and revealed the remarkable survival improvements for ALK+ patients with the development of newer generations of ALK inhibitors. Legal entity responsible for the study: The Christie NHS Foundation Trust. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Deep learning in estimating prevalence and systemic risk factors for diabetic retinopathy: a multi-ethnic study
Authors: Daniel S. W. Ting, Carol Y. Cheung, Quang Nguyen, Charumathi Sabanayagam, Gilbert Lim, Zhan Wei Lim, Gavin S. W. Tan, Yu Qiang Soh, Leopold Schmetterer, Ya Xing Wang, Jost B. Jonas, Rohit Varma, Mong Li Lee, Wynne Hsu, Ecosse Lamoureux, Ching-Yu Cheng, Tien Yin Wong
Journal: npj Digital Medicine (2019)

In any community, the key to understanding the burden of a specific condition is to conduct an epidemiological study. The deep learning system (DLS) recently showed promising diagnostic performance for diabetic retinopathy (DR). This study aims to use DLS as the grading tool, instead of human assessors, to determine the prevalence and the systemic cardiovascular risk factors for DR on fundus photographs, in patients with diabetes. This is a multi-ethnic (5 races), multi-site (8 datasets from Singapore, USA, Hong Kong, China and Australia), cross-sectional study involving 18,912 patients (n = 93,293 images). We compared these results and the time taken for DR assessment by DLS versus 17 human assessors - 10 retinal specialists/ophthalmologists and 7 professional graders). The estimation of DR prevalence between DLS and human assessors is comparable for any DR, referable DR and vision-threatening DR (VTDR) (Human assessors: 15.9, 6.5% and 4.1%; DLS: 16.1%, 6.4%, 3.7%). Both assessment methods identified similar risk factors (with comparable AUCs), including younger age, longer diabetes duration, increased HbA1c and systolic blood pressure, for any DR, referable DR and VTDR (p > 0.05). The total time taken for DLS to evaluate DR from 93,293 fundus photographs was ~1 month compared to 2 years for human assessors. In conclusion, the prevalence and systemic risk factors for DR in multi-ethnic population could be determined accurately using a DLS, in significantly less time than human assessors. This study highlights the potential use of AI for future epidemiology or clinical trials for DR grading in the global communities.
Effect of tumor-associated macrophages on neoplastic progression in sepsis-surviving mice through CXCL12/CXCR4.
Authors: Jose Mauricio Segundo Correia Mota, Caio Abner Leite, Lucas Eduardo Sousa, Virginia Mara Wagatsuma, Houtan Noushmehr, Fernando Queiroz Cunha, Eduardo Magalhaes Rego
Journal: Journal of Clinical Oncology (2015)

e22107 Background: Sepsis surviving mice (SSM) present increased tumor progression. We assessed the role of tumor-associated macrophage (TAM) and CXCL12/CXCR4 in that scenario. Methods: C57/BL6 mice were submitted to cecal ligation and puncture (CLP) and treated with ertapenem (20 mg/kg, ip. - 6 h after CLP and then each 12 h for 3 days). SSM or naïve mice were inoculated with B16-F10 (30,000 cells, sc., 15 days after CLP). Tumor progression, survival and pulmonary metastasis were measured. Fourteen days after inoculation (D+14), mice were killed for TAM measurement by flow cytometry (CD45+F4/80+CD206+) and for cytokines by ELISA (TNF-α, TGF-β, CCL2 and CXCL12). TAM in situ proliferation was assessed by flow cytometry Ki67 expression. Bone marrow-derived macrophage (BMDM) were isolated and co-inoculated with B16 for tumor progression and survival evaluation. TAM were isolated (Percoll gradient followed by adhesion) and the RNA purified for gene expression analysis using microarray slides. In order to evaluate the role of CXCL12/CXCR4, we used AMD3100 (5 mg/kg, ip., at D+10 and D+14) and followed mice for tumor progression, survival and TAM. Results: SSM had increased tumoral progression (15, 30 or 60 days after CLP), metastatic burden (15 days after CLP), and less survival. TAM were increased in post-sepsis mice (D+14) with more in situ proliferation. Serum TGF-β, CXCL12, CCL2 e TNF-α levels were increased in SSM tumor-bearing mice. Co-inoculation with BMDM from SSM led to an increment of tumoral progression. TAM from post-sepsis had mild differences in gene expression analysis in comparison to TAM from naïve mice: decreased expression of MHC-II related genes and genes related to leukocyte activation. CXCL12/CXCR4 inhibition prevented the tumor progression, TAM accumulation and TAM in situ proliferation in SSM. Conclusions: TAM accumulation contributes to increased tumor progression in SSM. CXCL12/CXCR4 is important to TAM accumulation through in situ proliferation.
Recurrence detection in children with extra-cranial tumors at Ann &amp; Robert H. Lurie Children's Hospital (LCH) of Chicago.
Authors: Anish Butala, Jill Woodman, Alfred Rademaker, Yasmin Gosiengfiao, Jennifer Reichek, Joanna L. Weinstein, Elaine Morgan, Nobuko Hijiya, David Walterhouse
Journal: Journal of Clinical Oncology (2015)

e21012 Background: Children with solid tumors usually undergo surveillance scans every 3 months for the first 2 years following therapy and then less frequently up to 5 years to detect recurrences before they are symptomatic. Early detection might improve outcome by allowing more therapeutic options. However, some scans may be prompted by clinical symptoms. In fact, prior reports suggest that most recurrences are found because of symptoms. The goal of our review was to assess the yield of surveillance imaging by analyzing the method of recurrence detection (MORD). Methods: We conducted a retrospective chart review of 699 patients who were treated at LCH from 2000-2010. Patients < 21 yrs with an extra-cranial solid tumor or Hodgkin lymphoma were eligible if they recurred > 3 months after completing therapy, had radiographic evidence of recurrence, and underwent regularly scheduled surveillance scans. We used a chi-square test to analyze the association between MORD and whether the initial disease was localized or metastatic, if the recurrence was local or distant, and survival after recurrence (SAR). A t-test was used to analyze the association between MORD and age at diagnosis. We also evaluated the subset of patients with non-pulmonary recurrence (NPR). Results: 67 patients (54 solid tumors, 13 Hodgkin lymphoma) met the eligibility criteria. 42 recurrences (63%) were identified by surveillance imaging and 25 (37%) were initially detected clinically. Stage at diagnosis, site of recurrence, SAR, and age at diagnosis had no statistical association with MORD. 8 of 9 isolated pulmonary recurrences were found by imaging. Age at diagnosis was associated with whether NPRs (n = 44) were found clinically (mean 11.7 years) or by imaging (mean 8.0 years) (p = 0.07). Conclusions: Our routine surveillance practice detects most recurrences prior to clinical symptoms. Surveillance imaging may detect NPRs earlier in younger children who may not express specific complaints. SAR was not related to MORD but sample size does not allow definitive assessment. Small sample size precludes evaluation by disease type.
FRI-170-Real-world effectiveness and renal safety of tenofovir alafenamide fumarate among chronic hepatitis B patients in Canada
Authors: Mina Farag, Scott Fung, Edward Tam, Karen Doucette, Alexander Wong, Alnoor Ramji, Brian Conway, Curtis Cooper, Keith Tsoi, Jordan Feld, Seng Liem, Carla Coffin, Bettina Hansen, Harry Janssen
Journal: Journal of Hepatology (2019)
FRI-002-Sustained remission after treatment withdrawal in autoimmune hepatitis: A multicenter retrospective study
Authors: Yasmina Ben Merabet, Coralie Barbe, Alexandra Heurgue-berlot, Thierry Thévenot, Anne Minello Franza, François Habersetzer, Didier Samuel, Brigitte Bernard Chabert, Delphine Weil-Verhoeven, Pascal Renard, Hélène Clot, Vincent Di Martino, Hervé Louvet, Solange Bresson hadni, Gérard Thiéfin
Journal: Journal of Hepatology (2019)
LBP-03-LPCN 1144, an Androgen Receptor Agonist Targeted for NASH, Reduces Liver Fat and Key Serum Biomarkers
Authors: Jonathan Baker, Kilyoung Kim, Burke Byrne, Nachaippan Chidambaram, Arun Sanyal, Michael Charlton, Mahesh Patel
Journal: Journal of Hepatology (2019)
THU-161-Baseline risk factors determine lack of biochemical response after SVR in chronic hepatitis C treated with DAAs: Results from the German hepatitis C registry (DHC-R)
Authors: Stefan Mauss, Klaus Boeker, Hartwig Klinker, Renate Heyne, Peter Buggisch, Anita Pathil, Johannes Wiegand, Markus Cornberg, Christian Lange, Thomas Berg, Stefan Zeuzem, Frank Tacke, Deutsches Hepatitis C-Register
Journal: Journal of Hepatology (2019)