tbuckley/cabot-search huggingface dataset:
Is routine administration of standardized questionnaires that assess aspects of patients’ quality of life justified in medical oncology clinics?
Authors: Khalid A. Al-Saleh
Journal: Journal of Clinical Oncology (2013)

e20501 Background: increasing interest in the Quality of Life outcomes in cancer patients led to increase implementation of their use in routine clinical practice. The aim of this study is to review the scientific evidence behind recommending the use of quality of life (QoL) scales routinely in outpatient evaluation. Methods: systematic review for all published randomized controlled trials in English language between January 1, 1990 till December 1, 2010. Out of 479 articles (468 identified by electronic search + 11 articles identified by manual search), six trials satisfied the eligibility criteria: 1) the study was a randomized controlled trial (RCT) with randomization of patients or health care providers; 2) the findings of the administered questionnaire or scale (the intervention) were given to health care provider, and compared to standard care with no questionnaire administered (the control); 3) study was conducted in outpatient oncology clinics; and 4) an outcome was measured that related to i) QoL improvement, ii) reduction in morbidity, iii) reduction in stress for the patients, iv) improvement in communication between patients and health care provider, or v) improved patient satisfaction. Assessment for the quality of the study was done using the GRADE methodology. Results: serious methodological issues were affecting most of the trials. Overall the evaluation of the quality of the evidence from these identified trials suggests that there is a weak recommendation to use QoL scales in routine oncology practice to improve communication between physicians and patients. Conclusions: The routine use of such tools in the outpatient settings at improving the patient outcome or satisfaction cannot be recommended based on the available evidence. The potential harm with the excess use of resources needed to implement, collect, store, analyse, and present such data to health care providers should be also considered. Further research and better designed trials is required using recent methodological techniques (such as item-response theory based questionnaire and cluster randomization) might help to reach an answer to this question.
Use of surface-enhanced laser desorption/ionisation time-of-flight mass spectrometry (SELDI-TOF-MS) to detect breast cancer markers in serum
Authors: D. Boehm, A. Lebrecht, R. Schwirz, K. Keller, M. Schmidt, H. Kölbl, F. Grus
Journal: Journal of Clinical Oncology (2009)

e22133 Background: Breast cancer is one of the most frequent and deadly cancers worldwide. Although the survival of patients has increased over the last decades, many patients die from metastatic relapse. Progresses in screening or early diagnosis will improve survival of breast cancer. Breast cancer has never had any good serum tumor markers. Therefore, we developed and evaluated a proteomics approach to search for new biomarkers in serum of breast cancer patients. Methods: Blood samples of 50 women with breast cancer (CA) and 50 healthy women (CTRL), matched to the age, were drawn prior to surgery. We used SELDI-TOF-MS for protein profiling with three different active surfaces of the protein chips: cationic exchanger (CM-10), hydrophobic surface (H50) and a strong anion exchange surface (Q10) with different binding properties. Data were analyzed by multivariate statistical techniques and artificial neural networks. Results: SELDI-TOF- MS could discriminate between serum of breast cancer patients and healthy women. We could generate a statistic significant (p&lt;0.001) panel with 15 biomarkers resulting of multiple peaks with different molecular weights. The diagnostic pattern could differentiate CA from CRTL with specificity of 77% and sensitivity of 85% in serum. Conclusions: In this study we could exemplify SELDI-TOF-MS as a potential screening method to detect breast cancer patients by serum analysis. The protein chip technology could greatly facilitate the discovery of new and better biomarkers in breast cancer patients. This promising approach provides a high sensitivity and specificity by a less invasive method similar to mammography that is used in screening programs. No significant financial relationships to disclose.
Dermatologist‐level classification of malignant lip diseases using a deep convolutional neural network
Authors: S.I. Cho, S. Sun, J.‐H. Mun, C. Kim, S.Y. Kim, S. Cho, S.W. Youn, H.C. Kim, J.H. Chung
Journal: British Journal of Dermatology (2019)

Deep convolutional neural networks (DCNNs) can classify skin diseases at a level equivalent to a dermatologist, but their performance in specific areas requires further research. To evaluate the performance of a trained DCNN‐based algorithm in classifying benign and malignant lip diseases. A training set of 1629 images (743 malignant, 886 benign) was used with Inception‐Resnet‐V2. Performance was evaluated using another set of 344 images and 281 images from other hospitals. Classifications by 44 participants (six board‐certified dermatologists, 12 dermatology residents, nine medical doctors not specialized in dermatology and 17 medical students) were used for comparison. The outcomes based on the area under curve, sensitivity and specificity were 0·827 [95% confidence interval (CI) 0·782–0·873], 0·755 (95% CI 0·673–0·827) and 0·803 (95% CI 0·752–0·855), respectively, for the set of 344 images; and 0·774 (95% CI 0·699–0·849), 0·702 (95% CI 0·579–0·808) and 0·759 (95% CI 0·701–0·813), respectively, for the set of 281 images. The DCNN was equivalent to the dermatologists and superior to the nondermatologists in classifying malignancy. After referencing the DCNN result, the mean ± SD Youden index increased significantly for nondermatologists, from 0·201 ± 0·156 to 0·322 ± 0·141 (P < 0·001). DCNNs can classify lip diseases at a level similar to dermatologists. This will help unskilled physicians discriminate between benign and malignant lip diseases. What's already known about this topic? Deep convolutional neural networks (DCNNs) can classify malignant and benign skin diseases at a level equivalent to dermatologists. The lips are a unique feature in terms of histology and morphology. Previous studies of DCNNs have not investigated tumours on specific locations. What does this study add? This study shows that DCNNs can distinguish rare malignant and benign lip disorders at the same rate as dermatologists. DCNNs can help nondermatologists to distinguish malignant lip diseases. What are the clinical implications of this work? DCNNs can distinguish malignant and benign skin diseases even at specific locations such as the lips, as well as board‐certified dermatologists. Malignant lip diseases are rare and difficult for less trained doctors to differentiate them from benign lesions. This study shows that in dermatology, DCNN can help improve decision‐making processes for rare skin diseases in specific areas of the body.
Antiplatelet Therapy in Patients with Coronary Disease and Type 2 Diabetes
Authors: Eric R. Bates
Journal: New England Journal of Medicine (2019)

Clopidogrel, prasugrel, and ticagrelor are antiplatelet drugs that act by inhibiting the platelet P2Y12 receptor. Any one of them is usually combined with low-dose aspirin as dual antiplatelet therapy in patients who have acute coronary syndromes or who are undergoing coronary stent implantation to decrease the risk of subsequent platelet-mediated thrombotic cardiovascular events. Many investigations have been performed to determine whether these clinical indications should be broadened. The PARTHENON clinical development program1 for ticagrelor included five randomized, controlled, double-blind trials across the spectrum of cardiovascular diseases (Table 1). In patients who were admitted to the hospital for myocardial infarction or . . .
Bisphosphonates (BP)-related osteonecrosis of the jaw (ONJ): Clinical experience of the “Rete Oncologica di Piemonte e Valle d’Aosta” network
Authors: V. Fusco, C. Ortega, F. Goia, L. Ciuffreda, M. Ardine, P. Falco, G. Gorzeglio, A. Baraldi, M. Airoldi, O. Bertetto
Journal: Journal of Clinical Oncology (2006)

18584 Background: ONJ have been recently reported in patients (pts) treated with BP, especially Pamidronate (P) and Zoledronic Acid (Z). Measures of screening, treatment, and prevention have been planned in our regional oncology network. Methods: We evaluated dental history of pts previously treated with BP and/or under treatment in 2005, finding 60 cases of ONJ, but a large number of suspected cases are under investigation/observation. Full details of oncologic and dental history have been collected so far of 43 pts. Results: Pts characteristics: sex: 14/29 M/F; median age 66 years (range 45–81); tumour: 24 breast cancer, 7 prostate cancer; 12 myeloma. BP treatment: 5 P, 14 P changed to Z, 24 Z; median number of infusions: 22 of P (range 12–52), 18 of Z (range 7–43). Site of ONJ: 33 (77%) in mandible, 9 (21%) in maxilla, 1 (2%) in both. Presenting findings included exposed bone or infections (95%), pain, mobile teeth, soft-tissue swelling, nonhealing fistulas . Dental comorbidities were present in all pts and 92 % had precipitating events, as teeth extraction, periodontal surgery, dental implants, or traumatic use of dentures. Conclusions: Our oncology network planned: a) review of all pts treated with BP since 2000, to obtain real estimates of frequency and of possible risk factors; b) screening of all pts under treatment with BP, with panoramic X-rays and maxillofacial surgeon visit (w/o CT or MR scan in selected cases); c) careful evaluation of pts candidate to be treated with BP (as above), with pretherapy dental care if necessary; d) prospective evaluation of incidence in future, after pretherapy dental care policy and avoiding (as possible) surgical dental procedures during BP treatment; e) prospective trials of evaluation of palliative treatment of ONJ and related complications in affected pts (chlorohexidine mouthwashes, antibiotics, metronidazole, hyperbaric oxygen, etc.). No significant financial relationships to disclose.
Augmenting canonical Wnt signalling in therapeutically inert cells converts them into therapeutically potent exosome factories
Authors: Ahmed G. E. Ibrahim, Chang Li, Russel Rogers, Mario Fournier, Liang Li, Sharon D. Vaturi, Travis Antes, Lizbeth Sanchez, Akbarshakh Akhmerov, Jennifer Johnson Moseley, Brooke Tobin, Luis Rodriguez-Borlado, Rachel R. Smith, Linda Marbán, Eduardo Marbán
Journal: Nature Biomedical Engineering (2019)
Differential mitochondrial scoring associated with chemotherapeutic effect on ovarian cancer
Authors: S. Isonishi, R. Matsumoto, M. Hirama, K. Ochiai, T. Tachibana, H. Ishikawa, M. Yasuda, T. Tanaka
Journal: Journal of Clinical Oncology (2009)

e16514 Background: We reported mitochondrial (MT) scoring system related to platinum response in ovarian cancer (OC) (Oncol Rep2008). We investigated whether the system could be useful to evaluate cellular drug sensitivity and patients’ prognosis. Methods: Ultrathin sections of surgical specimens prepared from 41 OC patients were examined by electron microscopy. Ovarian carcinoma cell line 2008 and its platinum- or taxane-resistant variant C13 or PX24 were used as control cells. Seven independent MT features including diameter and pattern of cresta structure were examined. Clinical response and in vitro sensitivity to platinum (P), taxane (T), irrinotecan (CPT), and doxorubicine (D) were examined while the MT scoring was performed independently. Results: Of 41 cases, 37 were available for clinical evaluation (stage II-IV, received 6 cycles of TP chemotherapy). Fifteen cases were responsive, while 22 were resistant. Total MT score in 15 responsive cases was 5.13 ± 1.13 (M ± SE) and was 11.41 ± 0.43 in 22 resistant cases (p &lt; 0.001). Receptor operative characteristics (ROC) analysis revealed that resistant total “cut-off” score was ≥ 10 points (p &lt; 0.05; AUC = 0.86). Except for D, the scoring system well related to P, T, and CPT sensitivity (p; &lt;0.001, &lt;0.001, 0.006). ROC analysis revealed resistant “cut-off” score for P, T and CPT were ≥ 11, 5, and 10 points (p &lt; 0.05; AUC &gt; 0.80). With a median follow up of 20 months, 11 patients have relapsed. The progression-free survival (PFS) curves show a difference in favor of low scoring group of patients (N = 14) compared to high scoring group (N = 19) (hazard ratio 3.99, p = 0.045), corresponding to an absolute difference in 6-months PFS 16% (89 vs 73%). Conclusions: This MT scoring system excellently related to clinically diagnosed P sensitivity as well as cellular sensitivity to P, T and CPT. Each drug has its own specific “cut-off” score, suggesting that the MT function might be differentially involved in drug sensitivity. No significant financial relationships to disclose.
A Phase I Study of the Anti-CC Chemokine Receptor 4 Antibody, Mogamulizumab, in Combination with Nivolumab in Patients with Advanced or Metastatic Solid Tumors
Authors: Toshihiko Doi, Kei Muro, Hiroshi Ishii, Terufumi Kato, Takahiro Tsushima, Mitsuhiro Takenoyama, Satoshi Oizumi, Kazuto Gemmoto, Hideaki Suna, Kouki Enokitani, Tetsuyoshi Kawakami, Hiroyoshi Nishikawa, Noboru Yamamoto
Journal: Clinical Cancer Research (2019)

Regulatory T cells (Tregs) expressing CC chemokine receptor 4 (CCR4) can suppress antitumor immune responses and are associated with poor prognoses in several cancers. We assessed the safety and efficacy of combined mogamulizumab (anti-CCR4 antibody) and nivolumab [anti-programmed death-1 (PD-1) antibody] in immunotherapy-naïve patients with advanced/metastatic solid tumors.This study (NCT02476123) comprised dose-escalation (3+3 design) and expansion parts. Patients received nivolumab (3.0 mg/kg) every 2 weeks, with mogamulizumab (0.3 or 1.0 mg/kg in dose escalation, 1.0 mg/kg in expansion) once weekly for 4 weeks, then every 2 weeks, until progression or unacceptable toxicity. Primary objective was safety; secondary objectives were antitumor effects, pharmacokinetics, and immunogenicity. Exploratory biomarker analyses were conducted.Ninety-six patients were enrolled (July 2015-November 2016): six patients in the dose-escalation part and 90 in the expansion part. No dose-limiting toxicities were observed in the dose-escalation part. Grade 3/4 treatment-related adverse events (TRAEs) occurred in 29% of patients in the expansion part (no grade 5 TRAEs). The most frequent TRAEs were rash (39%), rash maculopapular (20%), diarrhea (13%), stomatitis (12%), and pruritus (11%). There were four (27%) confirmed tumor responses among 15 patients with hepatocellular carcinoma, and one confirmed and two unconfirmed responses among 15 patients with pancreatic adenocarcinoma. During treatment, populations of effector Tregs (CD4+CD45RA-FoxP3high) decreased and CD8+ T cells in tumor-infiltrating lymphocytes increased.Combining an anti-PD-1 antibody, nivolumab, with a Treg-depleting anti-CCR4 antibody, mogamulizumab, provides an acceptable safety profile, antitumor activity, and a potentially effective option in cancer immunotherapy.
Variation in the intensity of end-of-life care, hospice enrollment, and the cost of care by cancer site.
Authors: Shitanshu Uppal, Versha Pleasant, Sarah Bell, R. Kevin Reynolds, Laurel Rice, Ryan J. Spencer
Journal: Journal of Clinical Oncology (2019)

11539 Background: To compare end-of-life (EOL) care intensity across multiple cancer sites and its impact on the cost of care during the last 30-days of life. Methods: Cross-sectional retrospective study using Surveillance, Epidemiology, and End Results Program (SEER)-Medicare linked database from 2008-2013. Utilization of the following in the EOL period (last 30 days of life prior to death) was examined: 2 or more visits to the Emergency Department (ED), hospitalizations, receipt of any life-extending procedures, admission to intensive care unit, any hospice use, hospice used ≤3 days, death in hospital, or receipt of chemotherapy (last 14 days). We tallied the claims made during the EOL period for each patient. Median expenditures during the EOL period were tabulated by cancer site and stratified by receipt of hospice care. Results: EOL care utilization varied widely between cancer sites. The rates of any hospice utilization were the highest for breast cancer (48.2%) compared to ovarian (17.4%) (p &lt; 0.001). Chemotherapy during the last two weeks of life was the highest for ovarian cancer (1.7%) and the lowest for colorectal cancer (0.5%). The median cost of care during the EOL period for patients who received hospice care was $7,547.84 (Interquartile range [IQR] $5,422-$17,293) compared to $17,179 (IQR $10,323 - $30,824) for those never received hospice care (p &lt; .0001). There was no significant variation in median cost by cancer site for those who received hospice services (range $7,317 - $9,816). However, the cost of care varied for those who did not receive hospice care. Median costs for this subgroup was the lowest for pancreatic cancer ($14,635) and the highest for colorectal cancer ($24,324) (p &lt; 0.001). Conclusions: Despite increasing acceptance of palliative care services and hospice in cancer care, there continues to be intensive and costly care administered during the EOL period. These costs vary considerably across cancer sites when patients do not receive hospice care, but costs are relatively similar when patient are enrolled in hospice Further research to investigate the causes of this variation should be undertaken to design interventions aimed at improving timely hospice enrollment at the EOL and reducing costly care in the EOL period.
Aspirin as an adjuvant treatment for cancer: feasibility results from the Add-Aspirin randomised trial
Authors: Nalinie Joharatnam-Hogan, Fay Cafferty, Richard Hubner, Daniel Swinson, Sharmila Sothi, Kamalnayan Gupta, Stephen Falk, Kinnari Patel, Nicola Warner, Victoria Kunene, Sam Rowley, Komel Khabra, Tim Underwood, Janusz Jankowski, John Bridgewater, Anne Crossley, Verity Henson, Lindy Berkman, Duncan Gilbert, Howard Kynaston, Alistair Ring, David Cameron, Farhat Din, Janet Graham, Timothy Iveson, Richard Adams, Anne Thomas, Richard Wilson, C S Pramesh, Ruth Langley, John Burn, Sue Campbell, Lisa Capaldi, Yvonne Carse, Durga Gadgil, Arnold Goldman, Sudeep Gupta, Gregory Leonard, Mairead MacKenzie, Mahesh Parmar, Carlo Patrono, Russell Petty, Peter M. Rothwell, Robert J.C. Steele
Journal: The Lancet. Gastroenterology & hepatology (2019)
Growth of palliative care (PC) in United States cancer centers: A national survey.
Authors: David Hui, Allison De La Rosa, Joseph Chen, Marvin Delgado-Guay, Yvonne Heung, Diane D. Liu, Kenneth R. Hess, Eduardo Bruera
Journal: Journal of Clinical Oncology (2019)

11601 Background: Outpatient PC facilitates timely referral and improved outcomes for cancer patients. We examined the change in outpatient PC services at US cancer centers over the past decade. Methods: Between April and August 2018, we surveyed all 62 National Cancer Institute designated cancer centers (NCI-CCs) and a random sample of 61 out of 1306 non-NCI-CCs. Two surveys previously used in a national study (Hui et al. JAMA 2010) were sent to each institution: a 22-question executive survey inquired about PC infrastructure and attitudes toward PC and an 82-question PC program leader survey inquired about the PC structures, processes and outcomes in detail. Generalized linear mixed model and logistic regression were used to examine the change in availability of outpatient PC services between 2009 and 2018 among NCI-CCs and non-NCI-CCs, respectively. Results: Among NCI-CCs, 40/62 (65%) executives and 52/61 (85%) program leaders responded. Among non-NCI-CCs, 41/61 (67%) executives and 27/39 (69%) program leaders responded. For NCI-CCs, we observed a significant increase in outpatient PC clinic between 2009 and 2018 (59% v. 95%; OR 13.1, 95% CI 2.6-66.8; P = 0.004) but no significant change in inpatient consultation team (92% v. 90%), PC unit (26% v. 40), nor institute-run hospice (31% v. 18%). For non-NCI-CCs, there was a significant increase in outpatient PC clinics (22% v. 42%; OR 2.51, 95% CI 1.01, 6.26; P = 0.05) and decrease in institute-run hospice (42% v. 22%; P = 0.05) over the past decade but no significant change in inpatient consultation team (56% v. 68%) and PC unit (20% v. 17%). The median (IQR) duration from outpatient referral to death increased from 90 (84, 120) days to 180 (131, 220) days for NCI-CCs and from 41 (28, 54) days to 84 (48, 120) days for non-NCI-CCs, respectively. We also observed significant growth in staffing, service hours, number of referrals, fellowship programs and rotations for oncology fellows, although research activity remains low. Conclusions: Cancer centers reported significant growth in outpatient PC clinics and overall PC infrastructure since 2009. However, major gaps in structures and processes exist, such as the lack of outpatient clinics at non-NCI-CCs, absence of PC units and limited research.
Comprehensive Profiling of the Rheumatoid Arthritis Antibody Repertoire
Authors: Ken C. Lo, Eric Sullivan, Ryan M. Bannen, Huiyan Jin, Mark Rowe, Hanying Li, Richard S. Pinapati, Adam J. Cartwright, John C. Tan, Jigar Patel, Edward C. Keystone, Katherine A. Siminovitch
Journal: Arthritis & Rheumatology (2019)

Objective Autoantibodies against citrullinated proteins are found in 64–89% of rheumatoid arthritis ( RA ) patients, with 88–99% specificity. This study was undertaken to create an unbiased, comprehensive profile of serum antibodies against the human proteome, including the citrullinome and the homocitrullinome, in RA patients, using a high‐density peptide array. Methods Our high‐density peptide array, consisting of &gt;4.6 million peptides, contained the entire annotated human proteome. The 20,246 proteins were represented as overlapping 16‐mer peptides. In addition to native peptides, citrullinated and homocitrullinated peptides were included, as substitutions for arginine and lysine, and provided a comprehensive screen against all possible epitopes. Twenty‐six serum samples (from 8 controls and 18 RA patients) were profiled on the high‐density peptide array. Using RA ‐specific epitopes, we constructed an 8‐epitope diagnostic biomarker on a Gyrolab xP lore instrument with a cohort of 92 serum samples (from 29 controls and 63 RA patients). The diagnostic biomarker was further validated with an independent cohort of 181 serum samples (from 54 controls and 127 RA patients). Results In the initial cohort the diagnostic performance of the 8‐epitope biomarker yielded 96.6% specificity and 92.1% sensitivity. The overall diagnostic performance in the validation cohort was 94.4% specificity and 85% sensitivity. In both cohorts, the performance of the 8‐epitope diagnostic biomarker compared favorably against the Abnova cyclic citrullinated peptide 2 ( CCP 2) assay. Using data from the peptide array, we identified novel RA ‐specific epitopes and formed the basis of a new RA diagnostic assay. Conclusion Comprehensive antibody profiling using a high‐density peptide array not only identified novel RA ‐specific epitopes but also allowed us to construct a novel diagnostic biomarker that is as specific as and more sensitive than the Abnova CCP 2 assay.