tbuckley/cabot-search huggingface dataset:
Survival of patients with metastatic basal cell carcinoma (mBCC) in the Veterans Affairs (VA) healthcare system.
Authors: Scott L. DuVall, Vanessa Stevens, Aaron Kamauu, David D. Stenehjem, Yeun Mi Yim
Journal: Journal of Clinical Oncology (2015)

e20625 Background: Metastatic basal cell carcinoma (mBCC) is a poorly characterized condition. Because it is rare, there are limited studies available on patient and disease characteristics. Recently, McCusker (2014) was able to identify and collect data on 100 patients through literature review. Our study expands on this previous research by using electronic health records (EHRs) in combination with administrative data sources to collect information on 475 mBCC patients in the VA healthcare system. Methods: This retrospective, observational study was performed using EHR and data analyses in the VA Informatics and Computing Infrastructure (VINCI) research database. The primary outcome of interest was survival, and Kaplan-Meier survival analyses were calculated for the group as a whole and for regional vs distant metastases. Data were also collected on demographics, comorbidities, disease characteristics, treatment patterns, and healthcare utilization and cost. Results: Patients (n = 475) had a median age of 72.0 years and 97.9% were males, in line with the demographics of the VA. The median age-adjusted Charlson Comorbidity Index score was 10.0. Complex reconstructive surgery was the most common first line therapy, and few other interventions were attempted. Overall median survival was 40.5 months (95% CI, 4.8-140 months). Median survival for patients with regional metastases (n = 199) was 59.4 months (95% CI, 17.6-140 months). For those with distant metastases (n = 181) median survival was 17.1 months (95% CI, 2.8-58.0 months). Healthcare utilization and costs were similar pre- and post-diagnosis. Conclusions: The patient population was older than in McCusker, and overall survival was lower (40.5 months vs 54 months). However, similar trends were noted in survival relative to metastatic site—patients with distant metastases showed much shorter survival times than those with regional metastases. EHRs were able to provide granular information on a relatively large patient sample within a single healthcare system. This opens new avenues of investigation for mBCC and other rare conditions.
Abstract 20271: Assisted Reproductive Technologies Increase the Functional and Morphological Severity of Stroke in Mice
Authors: Nicole R Bonetti, Théo A Meister, Rodrigo Soria, Emrush Rexhaj, Juerg H Beer, Giovanni G Camici, Urs Scherrer
Journal: Circulation (2017)

Introduction: Assisted reproductive technologies (ART) induce premature vascular ageing and arterial hypertension in mice and humans. In mice, these problems are related to ART-induced epigenetic a...
Immunologic response to high-dose influenza vaccination in patients with primary central nervous system malignancy (PCNSM).
Authors: Roy E. Strowd, Gregory Russell, Michele Harmon, Annette F Carter, Michael D Chan, Stephen B Tatter, Adrian W Laxton, Kevin High, Glenn Lesser
Journal: Journal of Clinical Oncology (2015)

e20669 Background: Cancer patients have a 4-times greater rate of influenza-associated hospitalization and death. Previously, we reported reduced immunogenicity to the standard (SD) influenza vaccine in patients with PCNSM (PMID:24714522). In other poorly responding populations (e.g. elderly), HD vaccination has improved efficacy and immunogenicity. Methods: A prospective study was designed to evaluate the immunogenicity of the HD influenza vaccine in patients with PCNSM. Data on diagnosis, active oncologic treatment, and post-treatment lymphopenia (PTL, CD4 < 200) were collected. All patients received the HD vaccine (180 mcg). Hemagglutination inhibition (HAI) titers were measured at baseline, day 28, and 3 months following vaccination to determine seroconversion (SC, ≥ 4-fold rise) and seroprotection (SP, titer ≥ 1:40) which were compared to our prior results. Results: 27 patients were enrolled: mean age 53 years; 41% male; 93% white. Diagnoses included high-grade glioma (85%), CNS lymphoma (11%), and meningioma (4%). Treatment at enrollment included glucocorticoids (n = 8, 30%), radiation (n = 2, 7%), and chemotherapy (n = 9, 33%). PTL was observed in 4 (15%). HD vaccination was well tolerated with no grade 3-4 toxicity. SC rates for the A/H1N1, A/H3N2, and B vaccine strains were significantly higher than in our prior study: 65% vs 37%, 69 vs 26, 50 vs 23 (all p < 0.04). In those with PTL, SC to any vaccine strain was only 17%. SP was also significantly higher at all times and unlike with the SD vaccine, 3 month SP did not decline (SP > 93% vs 57-73% previously). Conclusions: HD vaccination performed better than SD influenza vaccine in this cohort with PCNSM. Given a 9% mortality rate for cancer patients hospitalized from this preventable infection, these data support randomized comparison of vaccine doses and suggest further study of immunologic response in those with PTL. Funding: Fluzone High Dose vaccine and HAI titer measurements were provided by Sanofi Pasteur. Acknowledgement: Research was supported by the Comprehensive Cancer Center of Wake Forest University NCI CCSF P30CA012197. The authors acknowledge the services of the Wake Forest Baptist Medical Center’s Clinical Research Unit. Clinical trial information: NCT01941758.
Multicenter Evaluation of a Novel ROS1 Immunohistochemistry Assay (SP384) for Detection of ROS1 Rearrangements in a Large Cohort of Lung Adenocarcinoma Patients
Authors: Véronique Hofman, Isabelle Rouquette, Elodie Long-Mira, Nicolas Piton, Emmanuel Chamorey, Simon Heeke, Jean Michel Vignaud, Clémence Yguel, Julien Mazières, Anne-Laure Lepage, Frédéric Bibeau, Hugues Begueret, Sandra Lassalle, Salomé Lalvée, Katia Zahaf, Jonathan Benzaquen, Michel Poudenx, Charles-Hugo Marquette, Jean-Christophe Sabourin, Marius Ilié, Paul Hofman
Journal: Journal of Thoracic Oncology (2019)
FRI-422-Genetic and pathophysiological factors leading to deficient acyl-CoA oxidase 2 (ACOX2) activity in hepatocytes, an alteration which causes oxidative and endoplasmic reticulum stress in liver cells
Authors: Marta Alonso-Peña, Heike Hermanns, Elisa Herraez, Oscar Briz, Maria Monte, Manuel Sánchez-Martín, Pablo Berrocal, Ignacio Garcia-Tuñon, Ricardo A. Espinosa-Escudero, Jesus Prieto, Andreas Geier, Jose Marin
Journal: Journal of Hepatology (2019)
PS-016-Prospective evaluation of serum alkaline phosphatase variability and prognostic utility in primary sclerosing cholangitis using controlled clinical trial data
Authors: Palak Trivedi, Andrew Muir, Cynthia Levy, Christopher Bowlus, Michael P. Manns, Xiaomin Lu, Gerald Crans, Mani Subramanian, Robert Myers, Zachary Goodman, Naga Chalasani, John M. Vierling, Neil Guha, Gideon Hirschfield
Journal: Journal of Hepatology (2019)
SAT-454-Management of hepatocellular carcinoma in a real life multinational, longitudinal, observational study (TARGET-HCC)
Authors: Roniel Cabrera, Amit Singal, Neehar D. Parikh, Hannah Lee, massimo colombo, Katie Kelley, Rajender Reddy, Bruno Sangro, Laura Malahias, Richard Zink, AdrianMDi Bisceglie, Tim Meyer
Journal: Journal of Hepatology (2019)
Characterization of HER2 overexpressing breast cell lines selected for long-term culture with trastuzumab
Authors: Sumanta Kumar Pal, Avirath Chowdhury, Sameer Sivaamnuaiphorn, Malgorzata Beryt, Mark Pegram
Journal: Cancer Research (2005)

2647  Trastuzumab (T, Herceptin, Genentech) is a humanized monoclonal antibody (Ab) targeting the extracellular domain (ECD) of the HER2 receptor, and has been shown to promote objective response and survival in patients with HER2-overexpressing metastatic breast cancer. Response rate to T monotherapy is ∼34% with a median duration of 9 months. These data suggest that de novo and acquired clinical resistance to T is a common occurrence. BT474, SKBR3 and MDA-MB361 breast cell lines with HER2 gene amplification were selected by long-term exposure (approximately 6 months) in the presence of T at 100 mcg/mL. Following long term slection, these cells became less responsive to T. In order to determine HER2 gene amplification status before and following T-selection, FISH analysis was performed using probes specific for HER2 and chromosome (chr) 17 centromere. HER2 protein expression was determined by quantitative ELISA (c-neu (Ab-5), Oncogene). Surface expression of HER2 was determined via flow cytometric analysis utilizing the same primary antibody. Using FISH, HER2/chr 17 ratios in T-selected and unselected cell lines were 14.99±4.24 and 15.91±9.39 in BT474 cells (p=0.69), 9.75±4.12 and 10.38±3.09 in MDA-MB361 cells (p=0.59), and 8.43±4.89 and 7.25±2.33 in SKBR3 cells (p=0.34), respectively. Thus, long-term exposure to T did not affect HER2 gene copy number. At the protein level, no significant difference was detected in p185HER2 surface expression by flow cytometric analysis. The geometric mean of fluorescence in the gated T-selected and unselected cells were 773.09±507.14 and 196.86±169.08 in BT474 cells (p=0.28), 63.49±48.74 and 153.45±110.45 in MDA-MB361 cells (p=0.45), and 475.45±324.35 and 751.01±420.04 in SKBR3 cells (p=0.60), respectively. By ELISA, the total cellular p185HER2 quantity was elevated in BT474 cell lines, with 6.24±3.47x10−7 ng/cell in T-selected cells and 6.41±2.38x10−8 ng/cell in unselected cells (p=0.02). However, no difference was observed in the remaining two cell lines, with T-selected and unselected cells containing 3.44±1.50x10−8 and 3.48±0.09x−8 ng/cell in MDA-MB361 cells (p=0.97), and 2.74±0.94x10−8 and 7.06±2.68x10−8 ng/cell in SKBR3 cells (p=0.12), respectively. These data demonstrate: 1) long term selection of HER2 amplified cells with T at clinically achievable concentrations can yield a relative T-resistant phenotype, 2) HER2 gene copy number is neither increased or decreased following T-selection and therefore cannot explain the phenotype, 3) p185HER2 surface expression is unaltered by long-term exposure to T, and 4) total p185HER2 content before and after T-selection was similar in 2 of 3 cell lines. We conclude that neither HER2 amplification status or expression play a role in acquired T resistance, and that other mechanisms must be operative.
FRI-332-Effect of combined farnesoid X receptor agonist and angiotensin 2 receptor blocker on established liver fibrosis in rats
Authors: Tadashi Namisaki, Kosuke Kaji, Keisuke Nakanishi, Yuki Tsuji, Shinya Sato, Yasuhiko Sawada, Takemi Akahane, Masanori Furukawa, Yukihisa Fujinaga, Hiroaki Takaya, Hitoshi YOSHIJI
Journal: Journal of Hepatology (2019)
SAT-142-Incidence of hepatocellular carcinoma and cirrhotic complications in patients with psychiatric illness: A territory-wide cohort study
Authors: Vincent Wai-Sun Wong, Terry CF Yip, Yee-Kit Tse, Becky Wing-Yan Yuen, Hester Wing-Sum Luk, Marco Ho-Bun Lam, Michael Kin Kong Li, Ching Kong Loo, Tak Yin Owen Tsang, Steven Woon-Choy Tsang, Henry Chan, Yun Kwok Wing, Grace Lai-Hung Wong
Journal: Journal of Hepatology (2019)
Abstract 11747: Variation in Chest Tube Duration and Length of Stay Across Centers in the Pediatric Acute Care Cardiology Collaborative (PAC3) and Pediatric Cardiac Critical Care Consortium (PC4)
Authors: Katherine E Bates, Lara Khadr, Janet Donohue, Kari Crawford, Michael G Gaies, Margaret Graupe, Samuel P Hanke, Anthony M Hlavacek, Nicolas L Madsen, Evonne Morell, Sara K Pasquali, Jennifer L Russell, Susan K Schachtner, Ronn E Tanel, Adam L Ware, Alaina K Kipps
Journal: Circulation (2018)

Background: Most children undergoing congenital heart surgery have chest tubes (CT) placed intraoperatively. Center variation in practices related to timing of removal and impact on outcomes has no...
Effect of timing of pegfilgrastim administration on absolute neutrophil count (ANC) trajectory among cancer patients (pts) receiving myelosuppressive chemotherapy (chemo).
Authors: Yanli Li, Zandra Karina Klippel, Xiaolong Shih, Hong Wang, Maureen Reiner, John Page
Journal: Journal of Clinical Oncology (2015)

e20674 Background: Neutropenia is a common side effect of myelosuppressive chemo, and duration and severity of neutropenia increase susceptibility to infection. Pegfilgrastim is indicated to reduce incidence of febrile neutropenia (FN) when administered the day after chemo (day 2). However, some pts receive pegfilgrastim the same day as chemo (day 1). Here we compare the depth and duration of ANC suppression when pegfilgrastim is administered on day 1 vs day 2. Methods: This is a secondary analysis of data from 4 Amgen-sponsored clinical trials combining individual data from adult pts with nonmyeloid cancer randomized to receive pegfilgrastim on day 1 vs day 2 following chemo who had ≥ 4 ANC measurements per cycle. Cycle 1 ANC nadir and time to nadir by day of pegfilgrastim use were compared using Wilcoxon rank sum test. Mean difference of cycle 1 area over the curve (AOC; a composite measure for duration and severity of ANC suppression by calculating area below different clinical thresholds and above ANC-time response curve) by day of pegfilgrastim use was calculated, and 95% CIs were estimated using a bootstrap procedure (percentile method). Results: 99 pts received pegfilgrastim on day 1, 102 on day 2. Most were female (66.7%), ≤ 60 years (55.2%), and had ECOG 0 (54.7%). 32.3% had non-small cell lung cancer, 6.0% ovarian cancer, 31.3% breast cancer, and 30.3% non-Hodgkin lymphoma. Demographics and disease characteristics were well balanced between arms. Median (95% CI) ANC at nadir was 0.2 x 109/L (0.1, 0.4) for day 1 pts and 0.6 x 109/L (0.3, 0.8) for day 2 pts (P<0.01 for difference). Day 1 pts reached ANC nadir earlier than day 2 pts (24.2% vs 8.9% reached ANC nadir <7 days after chemo administration, P<0.01). AOC was greater for day 1 vs day 2 pts (see table). Conclusions: The depth and duration of neutropenia were greater when pegfilgrastim was administered on the same day as chemo vs the day after chemo. Pegfilgrastim use the day following chemo rather than same day use should be considered in the setting of FN prophylaxis. Clinical Threshold Mean AOC Difference (day 1- day 2) 95% CI 0.5 x 109/L 0.02 -0.02, 0.05 1.0 x 109/L 0.08 0.00, 0.16 1.5 x 109/L 0.15 0.00, 0.29
PS-115-Evaluation of LI-RADS v2018 by magnetic resonance in US-detected nodules &lt; 2 cm in cirrhotics
Authors: Alejandro Forner, Anna Darnell, Carla Caparroz, Jordi Rimola, Maria Ángeles García-Criado, Ernest Belmonte, Maria Reig, Carnen Ayuso, Jordi Bruix
Journal: Journal of Hepatology (2019)
TCTAP A-101 Clopidogrel Resistance in Patient Undergoing Percutaneous Coronary Intervention (PCI): A Single Center Experience in Apollo Hospitals Dhaka
Authors: Shams Munwar, Ahm Waliul Islam, Azfar H. Bhuiyan, Aqm Reza, Shahab Uddin Talukder, Tamzeed Ahmed, Mizanur Rahman, Kazi Atiqur Rahman
Journal: Journal of the American College of Cardiology (2019)
GS-04-Addition of stent placement to angioplasty for Budd-Chiari syndrome improves recanalization patency and reduces symptom recurrence with adequate safety: A randomised controlled trial
Authors: Qiuhe Wang, Xingshun Qi, Jiahao Fan, Chuangye He, Wenggang Guo, Kai Li, Xulong Yuan, Tianlei Yu, Bohan Luo, Zhengyu Wang, Jie Yuan, Xiaomei Li, Ying Zhu, Na Han, Jing Niu, Yong Lv, Jing Li, Shihao Tang, Shuai Guo, Enxin Wang, Dongdong Xia, Zhexuan Wang, Hongwei Cai, Zhanxin Yin, Jielai Xia, Daiming Fan, Guohong Han
Journal: Journal of Hepatology (2019)
FRI-069-Quantitative MRCP imaging: Preliminary observations in a cohort of paediatric patients with liver and biliary diseases
Authors: Kamil Janowski, Gary Woodward, Marija Mavar, Ged Ridgway, Matt Kelly, Carlos Ferreira, Andrea Borghetto, Maciej Pronicki, Wieslawa Grajkowska, Malgorzata Wozniak, Piotr Pawliszak, Elzbieta Jurkiewicz, John Michael Brady, Rajarshi Banerjee, Piotr Socha
Journal: Journal of Hepatology (2019)
Novel method to stratify elderly patients with prostate cancer.
Authors: Ruben Carmona, Kaveh Zakeri, Garrett Barnard Green, Daniel P Triplett, James Don Murphy, Loren K. Mell
Journal: Journal of Clinical Oncology (2015)

9532 Background: Standard prognostic methods do not optimally stratify patients according to the risk of cancer death relative to competing events. In contrast, competing event (CE) models (ref: PMID 24969798) have the potential to better inform practitioners regarding when to treat elderly patients with localized prostate cancer (PC). Methods: Using SEER-Medicare data, we identified 68,259 patients with localized PC treated with either radical prostatectomy (RP) or radiotherapy (RT) alone, splitting each group into 60% training / 40% test sets. Using patients’ demographic, tumor, and clinical characteristics, we trained risk scores based on CE models vs. standard Cox models for cancer-specific and all-cause mortality (ACM). In test sets, we compared how well models stratified subpopulations according to the ratio (ω) of the hazard for prostate cancer mortality (PCM) to the hazard for ACM. We tested the predictive ability for the cause-specific events, using the area under the curve (AUC). Results: For patients treated with RP, the CE risk score was associated with increased risk of PCM (HR 1.93, P< .001). Similar findings were observed for the cancer-specific and ACM risk scores. However, unlike standard models, increasing CE risk score was not associated with second cancer mortality (HR 0.90, P= .19) or non-cancer mortality (HR 0.96, P= .56). For patients treated with RT, the CE risk score was associated with increased risk of PCM (HR 2.13, P< .001), but was not associated with second cancer mortality (HR 0.90, P= .19), and was associated with decreased risk of non-cancer mortality (HR 0.84, P< .001). For patients treated with RP, the AIC was superior for CE models, relative to the cancer-specific and ACM models (AIC, 50.1 vs. 54.6 vs. 53.8, respectively). Similar findings were observed for RT patients (AIC, 43.4 vs. 45.2 vs. 54.4). The CE models also created greater separation in AUC for cancer mortality vs. non-cancer mortality, compared to the cancer-specific and ACM models (P < .001). Conclusions: Compared to standard methods, CE models more efficiently stratify elderly PC patients according to likelihood to benefit from therapy.
Immune profiling of pre- and post-treatment breast cancer tissues from the SWOG S0800 neoadjuvant trial
Authors: Xiaotong Li, Sarah Warren, Vasiliki Pelekanou, Vikram Wali, Alessandra Cesano, Mingdong Liu, Patrick Danaher, Nathane Elliott, Zeina A. Nahleh, Daniel F. Hayes, Gabriel N. Hortobagyi, William E. Barlow, Christos Hatzis, Lajos Pusztai
Journal: Journal for ImmunoTherapy of Cancer (2019)

How the immune microenvironment changes during neoadjuvant chemotherapy of primary breast cancer is not well understood.We analyzed pre- and post-treatment samples from 60 patients using the NanoString PanCancer IO360™ assay to measure the expression of 750 immune-related genes corresponding to 14 immune cell types and various immune functions, and assessed TIL counts and PD-L1 protein expression by immunohistochemistry. Treatment associated changes in gene expression levels were compared using t-test with Bonferroni correction. TIL count, PD-L1 protein and immune metagenes were compared using Wilcoxon test. Baseline immune markers were correlated with pathologic complete response (pCR) using estrogen receptor and treatment arm adjusted logistic regression.At baseline, high TIL counts and high expression of chemoattractant cytokines (CCL21, CCL19) and cytotoxic T cell markers were associated with higher pCR rate. High expression of stromal genes (VEGFB, TGFB3, PDGFB, FGFR1, IGFR1), mast and myeloid inflammatory cell metagenes, stem cell related genes (CD90, WNT11, CTNNB1) and CX3CR1, and IL11RA were associated with residual disease (RD). After treatment, in cases with pCR, TIL counts and most immune genes decreased significantly. Among RD cases, TIL counts and PD-L1 expression did not change but cellular stress and hypoxia associated genes (DUSP1, EGR1), and IL6, CD36, CXCL2, CD69 and the IL8/VEGF metagene increased.Activated T cells in the tumor microenvironment are associated with pCR whereas stromal functions are associated with residual disease. Most immune functions decrease during neoadjuvant chemotherapy but several immunotherapy targets (PD-L1, IL6, IL8) remain expressed in RD suggesting potential therapeutic strategies.
PS-085-The impact of ABO blood group on von Willebrand factor levels and the prevalence of portal vein thrombosis in patients with advanced chronic liver disease
Authors: Bernhard Scheiner, Prof. Patrick G. Northup, Anselm B. Gruber, Gerda Leitner, Prof. Peter Quehenberger, Michael Trauner, Thomas Reiberger, Ton Lisman, Mattias Mandorfer
Journal: Journal of Hepatology (2019)
FRI-268-Microbiota signature differs significantly between NAFLD and healthy controls but not between NAFL and NASH
Authors: Münevver Demir, Sonja Lang, Fedja Farowski, Hilmar Wisplinghoff, Maria J.G.T. Vehreschild, Marcin Krawczyk, Angela Nowag, Frank Lammert, Anna Martin, Tobias Goeser, Hans-Michael Steffen
Journal: Journal of Hepatology (2019)
FRI-205-Entecavir improves liver function and fibrosis in hepatitis B virus-associated cirrhosis: A 6 years-multicenter study
Authors: Seung Kak Shin, Oh Sang Kwon, Jeong Han Kim, Chan Uk Lee, Jong Eun Yeon, Sang Jun Suh, Hyung Joon Yim, Yun Soo Kim, Ju Hyun Kim
Journal: Journal of Hepatology (2019)
FRI-078-Serious liver injury induced by nimesulide: An international collaboration reporting 57 cases
Authors: Fernando Bessone, Nélia Hernandez, Manuel Mendizabal, Ezequiel Ridruejo, Gisela Lorena Gualano, Eduardo Fassio, Mirta Peralta, Hugo Fainboim, Maria Margarita Anders, Federico Tanno, Hugo Enrique Tano, Raymundo Parana Filho, I Medina-Caliz, Mercedes Robles, Camilla Stephens, Luis Arturo Colombato, Maria Virginia Reggiardo, Maria Isabel Lucena, Raul J. Andrade
Journal: Journal of Hepatology (2019)
Use of extracellular vesicles from lymphatic drainage as surrogate markers of melanoma progression and BRAFV600E mutation
Authors: Susana García-Silva, Alberto Benito-Martín, Sara Sánchez-Redondo, Alberto Hernández-Barranco, Pilar Ximénez-Embún, Laura Nogués, Marina S. Mazariegos, Kay Brinkmann, Ana Amor López, Lisa Meyer, Carlos Rodríguez, Carmen García-Martín, Jasminka Boskovic, Rocío Letón, Cristina Montero, Mercedes Robledo, Laura Santambrogio, Mary Sue Brady, Anna Szumera-Ciećkiewicz, Iwona Kalinowska, Johan Skog, Mikkel Noerholm, Javier Muñoz, Pablo L. Ortiz-Romero, Yolanda Ruano, José L. Rodríguez-Peralto, Piotr Rutkowski, Héctor Peinado
Journal: The Journal of Experimental Medicine (2019)

Liquid biopsies from cancer patients have the potential to improve diagnosis and prognosis. The assessment of surrogate markers of tumor progression in circulating extracellular vesicles could be a powerful non-invasive approach in this setting. We have characterized extracellular vesicles purified from the lymphatic drainage also known as exudative seroma (ES) of stage III melanoma patients obtained after lymphadenectomy. Proteomic analysis showed that seroma-derived exosomes are enriched in proteins resembling melanoma progression. In addition, we found that the BRAFV600E mutation can be detected in ES-derived extracellular vesicles and its detection correlated with patients at risk of relapse.
Update in Chronic Obstructive Pulmonary Disease 2018
Authors: Wassim W. Labaki, Lucas M. Kimmig, Gökhan M. Mutlu, MeiLan K. Han, Surya P. Bhatt
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality worldwide.In this Update, we review the progress made in 2018 on mechanisms of disease, clinical epidemiology, and therapeutic options and highlight areas for future research.