tbuckley/cabot-search huggingface dataset:
Immune related adverse events in NSCLC patients treated with immune checkpoint therapy who received the influenza vaccination versus no vaccination.
Authors: Haritha G. Reddy, Taylor Mai Weis, Shannon Hough, Stephanie Daignault, Bryan J. Schneider
Journal: Journal of Clinical Oncology (2019)

e20657 Background: Influenza vaccination is recommended by the CDC for cancer patients to reduce the risk of influenza-related complications. There is concern that the incidence of immune-related adverse events (irAEs) may be greater in vaccinated patients receiving immune checkpoint inhibitors (ICPI). We sought to interrogate if influenza vaccination in patients with NSCLC receiving ICPI therapy had an increased incidence of irAEs compared to non-vaccinated patients. Methods: We conducted a single-center retrospective analysis of patients with advanced NSCLC who received PD-1 or PD-L1 inhibitor monotherapy between 3/2015 – 12/2018. Influenza immunization records from both institutional and state-wide registries were obtained from 2014 -2019. Comparisons of adverse event incidence between flu vaccinated and control patients were tested using chi-square statistics. Results: 117 patients were included in our analysis, 33 (28%) were vaccinated during ICPI therapy, 19 (58%) received quadrivalent influenza vaccine, 13 (39%) received trivalent influenza vaccine and 1 (3%) was undetermined. 22 (67%) vaccinated patients had an irAE vs 53 (63%) patients who were not vaccinated during ICPI therapy (p = 0.720). 8 (24%) vaccinated patients had an irAE leading to discontinuation of therapy vs 12 (14%) patients who were not vaccinated during ICPI therapy (p = 0.198). The most frequent irAE in both groups was fatigue 16 (48%) vs 28 (33%) (p = 0.128). Notable irAEs included colitis (0 vs 1), pneumonitis (3 vs 3), hepatitis (1 vs 4) in vaccinated patients vs without vaccine, respectively. There were no statistically significant differences in baseline demographics between both groups including age, race, gender, tumor histology or ECOG performance status. Conclusions: Our study suggests that irAEs are not significantly increased with vaccination for influenza during ICPI therapy. However, there is a slight trend toward increased incidence of irAE warranting ICPI discontinuation for which further investigation is needed. Limitations of this study include a small sample size and inability to grade irAE retrospectively.
Randomized phase III study of pemetrexed/cisplatin (Pem/Cis) versus vinorelbine /cisplatin (Vnr/Cis) for completely resected stage II-IIIA non-squamous non-small-cell lung cancer (Ns-NSCLC): The JIPANG study.
Authors: Hirotsugu Kenmotsu, Nobuyuki Yamamoto, Takeharu Yamanaka, Katsuo Yoshiya, Toshiaki Takahashi, Tsuyoshi Ueno, Koichi Goto, Haruko Daga, Norihiko Ikeda, Kenji Sugio, Takashi Seto, Shinichi Toyooka, Hiroshi Date, Tetsuya Mitsudomi, Isamu Okamoto, Kohei Yokoi, Hideo Saka, Hiroaki Okamoto, Yuichi Takiguchi, Masahiro Tsuboi
Journal: Journal of Clinical Oncology (2019)

8501 Background: Although previous trials demonstrated the efficacy and safety of postoperative cisplatin–based adjuvant chemotherapy for resected NSCLC, no phase III study has so far evaluated Pem/Cis in this population. Methods: Patients with completely resected pathological stage II-IIIA Ns-NSCLC were randomized in a 1:1 ratio to receive either Pem (500 mg/m 2 , day 1)/Cis (75 mg/m 2 , day 1) or vinorelbine (Vnr) (25 mg/m 2 , days 1 and 8)/Cis (80 mg/m 2 , day 1), and stratified according to sex, age, pathologic stage, EGFR mutation status and institution. The primary endpoint was recurrence-free survival (RFS), and, the planned sample size was 800 patients in total to detect the superiority of Pem/Cis over Vnr/Cis (Trial Identifier, UMIN000006737). Results: Between March 2012 and August 2016, 804 patients were randomized. Of 784 for the efficacy analysis (389 in Pem/Cis and 395 in Vnr/Cis), median age was 65/65 years; stage IIIA 52/52%; Adenocarcinoma, 96/96%; and EGFR mutation, 24/25%. With a median follow-up of 45.2 months (mo), median RFS was 38.9mo in Pem/Cis and 37.3mo in Vnr/Cis with a hazard ratio (HR) of 0.98 (95% CI, 0.81—1.20; log-rank test, P= 0.948), whereas HRs in patients with and without EGFR mutations were 1.38 (95% CI, 0.95—1.99) and 0.87 (95% CI, 0.69—1.09), respectively (Interaction, P= 0.046). Overall survival rate at 3 years was 83.5% versus 87.2% with a HR of 0.98 (95% CI, 0.71—1.35). Incidences of grade 3 or 4 febrile neutropenia (0.3/11.6%, P&lt; 0.001), neutropenia (22.8/81.1%, P&lt; 0.001), and anemia (2.8/9.3%, P&lt; 0.001); any grade alopecia (12.8/30.1%, P&lt; 0.001). One treatment-related death was observed in each arm. Rates of treatment completions were 87.9% (Pem/Cis) and 72.7% (Vnr/Cis), respectively (P &lt; 0.001). Conclusions: Although this phase III study did not meet the primary endpoint, Pem/Cis had a similar efficacy to Vnr/Cis with a better tolerability as postoperative adjuvant chemotherapy for Ns-NSCLC patients. A significant interaction for RFS was found between treatment and EGFR mutation status. Clinical trial information: UMIN000006737.
Knowledge, attitude and practices regarding the use of medical cannabis: A national survey among Israeli oncologists.
Authors: Dan Mirelman, Barliz Waissengrin, Noam Goldway, Hagai Sharon, Silviu Brill, Ido Wolf
Journal: Journal of Clinical Oncology (2020)

e24125 Background: Despite lack of clinical trials reporting on beneficial effects of the cannabis plant for cancer-associated symptoms, its use is increasing worldwide. Approximately 10,000 Israeli cancer patients receive permits for the use of medical cannabis, making cannabis one of the most commonly prescribed oncology treatments in Israel and making the Israeli oncologists highly experienced with its use. The experience gained by the Israeli oncologists is therefore highly valuable. Methods: We conducted a web-based survey among all 238 Israeli oncologists, addressing personal experience; knowledge and attitudes toward the use of cannabis in oncology. Results: Response rate was 54% (n = 126), with the vast majority (87%) regularly prescribing cannabis to their patients. Anorexia, pain and nausea were the most common indications for cannabis use. While 90% of responders stated lack of sufficient knowledge regarding cannabis, its use was perceived as effective and safe. Interestingly, while most oncologists stated that opioids should be used as a first line treatment for cancer pain, most would prefer cannabis for pain relief if needed by a close relative. Oncologists who support cannabis legalization were more likely to prescribe it. Conclusions: Our findings indicate extensive use and perception of medical cannabis despite lack of knowledge, and support about efficacy and indicate a unique role for moral attitudes affecting clinical decisions. These data call for the implementation of an educational program and practical guidelines enabling more consistent and rational approach toward cannabis role in oncology.
SLFN11 expression (exp) in castration-resistant prostate cancer (CRPC) patients (pts) to predict response to platinum-based chemotherapy (PLT).
Authors: Vincenza Conteduca, Loredana Puca, Sheng-Yu Ku, Judy Hess, Megan Kearney, Luisa Fernandez, Rohan Bareja, Panagiotis J. Vlachostergios, Michael Sigouros, Juan Miguel Mosquera, Andrea Sboner, David M. Nanus, Olivier Elemento, Ryan Dittamore, Scott T. Tagawa, Himisha Beltran
Journal: Journal of Clinical Oncology (2019)

5065 Background: Schlafen family member 11 (SLFN11) sensitizes tumor cells to DNA-damaging agents and has been investigated as a potential predictive biomarker of response to PLT and PARP inhibitors, especially in small cell lung cancer (Lok, CCR 2017; Pietanza, JCO 2018). We aimed to explore the predictive/prognostic role of SLFN11 in PLT-treated CRPC. Methods: We assessed tumor exp of SLFN11 in PLT-treated, metastatic CRPC pts by RNAseq (N=27) and/or CTCs (N=20) (via the Epic Sciences platform). In addition, tumor morphology for neuroendocrine (NE) features and genomic status of select genes (ie, AR, TP53, RB1, BRCA2, BRCA1, ATM) by whole exome sequencing were evaluated. Statistical comparisons used Cox regression analysis and Kaplan Meier method for the association with overall/radiographic progression free survival (OS/rPFS). A dose response curve with PLT was performed in patient-derived organoids using Cell Title Glo according to the manufacturer’s protocol. Results: 41 CRPC (including 20 CRPC-NE) treated with PLT monotherapy (N=3) or PLT combination therapy (N=38) between August 2013 and December 2017 were evaluated. Median age was 67.1 years (range 51-91). Median number of prior therapies was 2 (range 1-7). A longer median rPFS was observed in all SLFN11+ pts treated with PLT (regardless of histology, RB1, TP53, PTEN, or DNA repair status) compared to SLFN11- [5.2 vs 2.3 months, HR 3.5, 95%CI 1.6-7.7, P&lt;0.0001]. No association was reported for OS. On multivariable analysis (Table), SLFN11 was an independent factor associated with rPFS. Organoids derived from patient tumors expressing SLFN11 showed sensitivity to PLT in vitro. Conclusions: SLFN11 exp identifies both CRPC and CRPC-NE pts with a better response to PLT. Patient-derived organoids expressing SLFN11 confirmed increased sensitivity to PLT. Larger prospective evaluation of therapy decisions based on SLFN11 exp is now required. [Table: see text]
SAT0253 PROGNOSTIC VALUE OF CARDIAC MAGNETIC RESONANCE IN SYSTEMIC SCLEROSIS
Authors: Cosimo Bruni, Luna Gargani, Alessia Pepe, Antonella Meloni, Daniele De Marchi, Giancarlo Todiere, Fabio Fulgenzi, Yacob Ghebru, Serena Guiducci, Raffaele De Caterina, Marco Matucci-Cerinic
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Cardiac involvement is frequent in patients with systemic sclerosis (SSc). It is often subclinical, but significantly affects the prognosis of the disease. Cardiovascular magnetic resonance (CMR) is the non-invasive gold standard to quantify biventricular functional parameters and to perform a myocardial tissue characterization. <h3>Objectives:</h3> To evaluate the prognostic value of CMR for cardiac events in SSc. <h3>Methods:</h3> Two hundred and seventy-three SSc patients with a thorough clinical assessment underwent a CMR exam using a 1.5 T GE scanner. We quantified biventricular function parameter by SSFP cine images, oedema by STIR T2 images, and macroscopic fibrosis by late gadolinium enhancement (LGE) technique. Patients were followed-up and cardiac events were recorded as new onset of pulmonary arterial hypertension (PAH), new onset of heart failure (HF), or at least sustained ventricular tachycardia. <h3>Results:</h3> Mean follow-up was 23.9 ± 17.0 months. During the follow-up a total of 14 events occurred (3 new onset PAH, 5 new onset HF, 6 ventricular tachycardia). CMR predictors of cardiac events by univariate analysis were left and right ventricular ejection fractions, indexed left and right atrial areas, and LGE (see Table). Myocardial fibrosis by LGE was the only independent predictor at multivariate analysis (hazard ratio 3.175; 95% C.I. 1.021-9.870, see Figure). <h3>Conclusion:</h3> Cardiac magnetic resonance anatomical and functional parameters of both the left and right heart have significant prognostic value in patients with SSc. <h3>Disclosure of Interests:</h3> Cosimo Bruni: None declared, Luna Gargani: None declared, Alessia Pepe: None declared, Antonella Meloni: None declared, Daniele De Marchi: None declared, Giancarlo Todiere: None declared, Fabio Fulgenzi: None declared, Yacob Ghebru: None declared, Serena Guiducci: None declared, Raffaele De Caterina: None declared, Marco Matucci-Cerinic Grant/research support from: Actelion, MSD, Pfizer, BMS, Chemomab, Sanipedia, Speakers bureau: Actelion, BMS; MSD, Janssen
Functional cell profiling (FCP) of ~100,000 CTCs from multiple cancer types identifies morphologically distinguishable CTC subtypes within and between cancer types.
Authors: Gordon Vansant, Adam Jendrisak, Ramsay Sutton, Sarah Orr, David Lu, Joseph Schonhoft, Yipeng Wang, Ryan Dittamore
Journal: Journal of Clinical Oncology (2019)

e14553 Background: Different cancers subtypes can often be effectively treated with similar Rx classes (i.e. platinum or taxane Rx). Yet, within a disease patient therapy benefit can be variable. The origins of precision medicine derive from pathologic sub-stratification to guide therapy (e.g. SCLC vs. NSCLC). Using the Epic Sciences platform, we performed FPC analysis of ~100,000 single CTCs from multiple indications and sought to utilize high resolution digital pathology and machine learning to index metastatic cancers for the purpose of improving our understanding of therapy response and precision medicine. Methods: 92,300 CTCs underwent FCP analysis (single cell digital pathology features of cellular and sub-cellular morphometrics) were collected from prostate (1641 pts, 70,747 CTCs), breast (268 pts, 8,718 CTCs), NSCLC ( 110 pts, 1884 CTCs), SCLC ( 141 pts, 8,872 CTCs) and bladder (65 pts, 2079 CTCs) cancer pts. After pre-processing the raw data, a training set was balanced by sampling the same number of CTCs from each indication. K-means clustering was applied on the training set and optimized number of clusters were determined by using the elbow approach. After generating the clusters on the training set, the cluster centers were extracted from k-means, and used to train a k-Nearest Neighbor (k-NN) classifier to predict the cluster assignment for the remaining CTCs (test set). Results: The optimized # of clusters was 9. The % and characteristics of CTCs in each indication are listed below. BCa CTCs were more enriched in cluster c1, which had higher CK expression, while SCLC and some of mCRPC shared the small cell features (c5). Conclusions: Heterogeneous CTC phenotypic subtypes were observed across multiple indications. Each indication harbored subtype heterogeneity and shared clusters with other disease subtypes. Patient cluster subtype analysis to prognosis and therapy benefit are on-going. Analysis of linking of CTC subtypes genotypes (by single cell sequencing) and to patient survival on multiple indications is ongoing.[Table: see text]
Breast cancer treatment according to pathogenic variants in cancer susceptibility genes in a population-based cohort.
Authors: Allison W. Kurian, Kevin C. Ward, Paul Abrahamse, Ann S Hamilton, Dennis Deapen, Monica Morrow, Steven J. Katz
Journal: Journal of Clinical Oncology (2019)

560 Background: Increasing use of germline genetic testing may have unintended consequences on breast cancer treatment. We do not know whether treatment deviates from guidelines for women with pathogenic variants (PV) in cancer susceptibility genes. Methods: SEER data for all women aged ≥20 years, diagnosed with breast cancer in 2014-15 and reported to Georgia and California registries (N = 77,588) by December 1, 2016 were linked to germline genetic testing results from 4 laboratories that did nearly all clinical testing. We examined first course of therapy (before recurrence or progression) of stage &lt; IV patients who linked to a genetic test: bilateral mastectomy (BLM) in candidates for surgery (unilateral, stages 0-III); post-lumpectomy radiation in those with an indication (all but age ≥70, stage I, hormone receptor (HR)-positive and HER2-negative); and chemotherapy in those without a definitive indication (stage I-II, HR-positive, HER2-negative and 21-gene recurrence score &lt; 30). We report the percent treated based on multivariable modeling, adjusted for age, race, stage, grade, insurance and socioeconomic status. Results: The table shows that 9% of patients who linked to a genetic test result had a PV (N = 1,283). Compared to women with negative results,women with BRCA1/2 PVs were more likely to receive BLM, more likely to receive chemotherapy without definitive indication, and less likely to receive indicated radiation in their first course of therapy. Lower-magnitude effects were seen with other PVs but not variants of uncertain significance (VUS). Conclusions: In a population-based setting, women with PVs in BRCA1/2 or other cancer susceptibility genes may have a higher risk of receiving locoregional and systemic treatment that does not follow guidelines. [Table: see text]
A Paradox of Choice and Opportunity in the Social Mediated Participant Recruitment Space: Opportunities and Caveats
Authors: Sheena M. Eagan, Erika K. Johnson, Liam X. N. Eagan
Journal: The American Journal of Bioethics (2019)

Facebook is a social media giant that has played a vital role in the sea change presently visible within the landscape of communication. This platform enables stable and instantaneous communication...
Sport Participation Among Individuals With Adverse Childhood Experiences—Leveling the Playing Field
Authors: Amanda E. Paluch, Nia Heard-Garris, Mercedes R. Carnethon
Journal: JAMA Pediatrics (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Risk of QTc interval prolongation among cancer patients treated with tyrosine kinase inhibitors.
Authors: Anan Abdelmoti Abu Rmilah, Grace Lin, Joerg Herrmann
Journal: Journal of Clinical Oncology (2019)

3033 Background: QTc interval prolongation can lead to life-threatening complications such as torsade de pointes (TdP), ventricular tachycardia (VT), and sudden cardiac death (SCD). It can occur with various tyrosine kinase inhibitors (TKIs) but comparative analyses on the incidence and complication rates are scarce. We thus conducted a comprehensive analysis of TKI use and QTc prolongation in clinical practice. Methods: We retrospectively reviewed the electronic medical records of all cancer patients who were treated with TKI between 01/2005 and 12/2018 at our institution. QTc prolongation was defined as a QTc ≥ 450 ms or 460 ms among male or female patients, respectively. For each type of TKIs, we determined the administration rate and incidence of QTc interval prolongation. We also studied the frequency of QTc prolongation ≥ 500 ms, rate of increase of the QTc interval by ≥ 60 ms, and the development of complications (VT, TdP and SCD). Results: In the present study, we analyzed the data of 685 cancer patients (431 male and 254 female), including 299 patients with RCC, 188 with chronic leukemia, 55 with acute leukemia, 65 with thyroid cancer, 48 with lung cancer and 39 with GIST. These patients received 902 TKI administrations and QTc prolongation was reported in 1/3 of these (289 administrations). The highest frequency was seen with imatinib, nilotinib and dasatinib (30, 40 and 50%). Among cases of QTc prolongation, a QTc interval ≥ 500 ms was documented in 53 (18.3%) and QTc progression ≥ 60 ms in 72 (25%). Complications were found in 14 cases (5%) including VT in 9, TdP in 2 and SCD in 3 administrations. Conclusions: The current findings suggest that TKI therapy leads to QTc prolongation in 1/3 of patients on average and most commonly with the Bcr-Abl TKIs, imatinib, nilotinib and dasatinib. While SCD is rare (1%) it can still evolve and in 5% of all QTc prolongations with TKIs are potentially life-threatening. These data support recommendations for serial ECGs in cancer patients undergoing TKI therapy. [Table: see text]
Predictors of anxiety and depression risk among individuals with lung cancer.
Authors: Kevin Stein, Shauna McManus, Pierre M. Gardan, Julie S. Olson, Melissa F. Miller, Kelly Clark, Linda S. House, Alexandra Katherine Zaleta
Journal: Journal of Clinical Oncology (2019)

e23136 Background: Lung cancer (LC) patients can face long-term symptom burden, quality of life concerns, and enduring distress. This study explored predictors of psychosocial distress among a community-based sample of LC survivors. Methods: 208 individuals with LC enrolled in Cancer Support Community’s Cancer Experience Registry, provided demographic/clinical background, and reported cancer-related distress using CancerSupportSource, a 25-item tool measuring level of concern ( 0-4) over 5 domains: emotional well-being (including 2-item depression and 2-item anxiety risk screening subscales), symptom burden and impact, body image and healthy lifestyle, health care team communication (HCTC), and relationships and intimacy. Using logistic regression, we estimate which domains influence anxiety and depression risk, controlling for significant demographic/clinical variables. Results: Participants were 68% female, 83% non-Hispanic White; mean ( SD) age = 61 (11) years; mean ( SD) years since diagnosis = 3.1 (4.5); 86% non-small cell lung cancer (NSCLC); 43% ever diagnosed as metastatic. 52% underwent surgery; 76% received chemotherapy, 65% radiation. 53% were at risk for clinically significant anxiety; 42% for clinically significant depression. Concerns about relationships and intimacy were associated with greater odds of anxiety risk ( OR= 1.70; p&lt; .01); a positive interaction suggested that anxiety risk among individuals with NSCLC varied by HCTC concerns, with greater concerns being associated with higher risk ( p&lt; .05). Concerns about symptom burden and impact ( OR= 1.21; p&lt; .01) and HCTC ( OR= 1.57; p&lt; .05) were significantly associated with greater odds of depression risk; these associations did not vary by LC type. Conclusions: Concerns around health care team communication, relationships and intimacy, and symptom burden and impact are important considerations in understanding risk for anxiety and depression among lung cancer patients and survivors. Additionally, type of lung cancer (NSCLC) can moderate the degree to which concerns about HCTC are associated with risk. Findings highlight the need for constructive patient-provider communication, particularly around relationships and intimacy and symptom burden. Clinical trial information: NCT02333604.