tbuckley/cabot-search huggingface dataset:
Outcome of pts with acute myelocytic leukemia (AML) and high-risk myelodysplastic syndrome (MDS) with abnormal pulmonary radiologic findings.
Authors: Hussam Al-Sharif, Ankit Anand, Karthika raya Linga, Ali Al-Ameri
Journal: Journal of Clinical Oncology (2014)

e18013 Background: Pulmonary Infiltrates could be the result of leukemic infiltration of lungs in AML. It should be considered as one of the causes of noninfectious lung infiltration, which may lead to early diagnosis and treatment.Aim: To study the effect of of abnormal pulmonary radiological findings and pulmonary function test (PFT) on the survival of patients with AML and high risk MDS. Methods: A retrospective study at Akron General Medical Center, Ohio, USA. After IRB approval, medical records from 2000 to 2012 of AML and high risk MDS pts were reviewed for abnormal pulmonary radiological findings within 2 wks either before or after the diagnosis in addition to their PFT if available. Kaplan-Meier survival analysis was used. Abnormal radiological findings included but not limited to infiltrates, atelectasis, lymph nodes, nodules, and fibrosis. PFTs were classified as normal vs. abnormal. Results: 187 pts were followed for 200 wks, 26 pts (14%) lost to follow up. 161 pts (86%) reviewed, of these, 75pts (47%) were females. 62 pts (39%) had abnormal radiological findings. Median survival in pts with radiological findings was 8 wks as compared to 31 wks in pts without. Mean survival was 45 wks for pts with radiological findings as compared to 121 wks in pts without findings. SD for pts with radiological findings was 13.59 and 19.93 for pts without. 95% CI for mean was 18.46-71.76 for pts with radiological findings and 81.79-159.93 for pts without. 95% CI of median for pts with radiological findings was 5.00-14.00 and 18.00-53.00 for pts without findings. P value was 0.0003 for pts with abnormal radiological findings. 15pts (9%) found to have abnormal PFT,6 pts (4%) were females. P value was 0.2134 for pts with abnormal PFT. Conclusions: In our study, AML and high risk MDS pts with abnormal pulmonary radiological findings have lower survival rates, while abnormal PFT have no effect, more studies are needed to confirm this finding.
Variation in hospital thromboprophylaxis rates for abdominal cancer surgery.
Authors: Robert Wallace Krell, Sandra L. Wong, Zaid M. Abdelsattar, Nancy J. Birkmeyer, Greta L Krapohl, Peter K. Henke, Darrell A. Campbell, Samantha K. Hendren
Journal: Journal of Clinical Oncology (2014)

6535 Background: Venous thromboembolism (VTE) remains a prominent cause of morbidity and mortality following cancer surgery. Though ASCO evidence-based guidelines recommend major cancer surgery thromboprophylaxis start before incision and continue at least 7-10 days postoperatively, the extent to which the guidelines are followed is unknown. We assessed variation in thromboprophylaxis practices for abdominal cancer surgery in a regional surgical collaborative. Methods: We studied abdominal resections for primary gastrointestinal, hepatopancreaticobiliary (HPB) and neuroendocrine malignancies in the Michigan Surgical Quality Collaborative from July 2012-Sep 2013 (N=1,444 patients in 52 hospitals). We obtained detailed perioperative and postoperative pharmacologic and mechanical thromboprophylaxis information for patients without documented exemptions (e.g. active bleeding, allergy). We then compared differences in procedure mix and operative complexity across hospitals based on their perioperative thromboprophylaxis rates. Results: Overall, 43.1% of eligible patients had perioperative pharmacologic thromboprophylaxis for abdominal cancer surgery, and 25.3% (318/1258) of the highest-risk patients had evidence of inadequate postoperative prophylaxis (under-prophylaxis either by dose or duration). Hospital perioperative thromboprophylaxis rates ranged from 0%-96.1%, and postoperative thromboprophylaxis rates ranged from 73.9%-100%. Compared to hospitals with the lowest perioperative thromboprophylaxis rates, hospitals with the highest perioperative prophylaxis rates performed more HPB procedures (24.1% vs. 5.3%) and fewer concomitant operative procedures (31.1% vs. 44.7%). Epidural use did not impact hospital pharmacologic thromboprophylaxis rates. Conclusions: Fewer than half of patients undergoing abdominal cancer surgery receive perioperative thromboprophylaxis, and there is wide variation in hospital thromboprophylaxis utilization despite strong evidence-based guidelines supporting its use. Identifying reasons for non-adherence to published guidelines and best practices will be important to improve outcomes in this vulnerable patient population.
Abstract 17403: Serum Magnesium Levels and In-Hospital Mortality in Patients With Acute Myocardial Infarction
Authors: Ali Shafiq, Abhinav Goyal, Philip G Jones, Suman Sahil, Mark Hoffman, Mohammed Qintar, Donna Buchanan, Mikhail Kosiborod, Suzanne V Arnold
Journal: Circulation (2016)

Introduction: Despite lack of data on the benefit of routine administration of magnesium (Mg) in patients with acute myocardial infarction (AMI), guidelines recommend keeping Mg levels > 2.0 mg/dL ...
Response to Venetoclax and Hypomethylating Agents Among Prognostic Risk Groups and Genetic Subtypes of Acute Myeloid Leukemia
Authors: Ibrahim Aldoss, Dongyun Yang, Raju Pillai, James F Sanchez, Ahmed Aribi, Haris Ali, Karamjeet S Sandhu, Monzr Al Malki, Matthew Mei, Amandeep Salhotra, Samer K. Khaled, Ryotaro Nakamura, Weili Sun, Margaret R O'Donnell, David S Snyder, Anthony S. Stein, Stephen J Forman, Guido Marcucci, Vinod A. Pullarkat
Journal: Blood (2018)
A contemporary population-based study of testicular sex cord stromal tumors: Presentation, treatment patterns, and predictors of outcome.
Authors: Lindsay M Yuh, Primo Lara, Rebecca Rankin Wagenaar, Christopher P Evans, Marc A. Dall'Era, Rosemary Donaldson Cress, Stanley A Yap
Journal: Journal of Clinical Oncology (2014)

4556 Background: Testicular sex cord stromal tumors (SCST) - consisting of Leydig and Sertoli cell subtypes - are a rare adult malignancy. Contemporary clinical data are gathered only from anecdotal case reports or small case series. Therefore, few evidence-based guidelines have been developed regarding the optimal management and surveillance of such tumors. In order to define SCST demographics and patient outcomes and to identify prognostic features, we analyzed the California Cancer Registry, a large statewide database. Methods: All male patients over the age of 18 diagnosed with SCST in California between 1988 and 2010 were included. Baseline demographic variables included age, race, histology, tumor stage, primary treatment, and socioeconomic status. Primary outcome measures were cause-specific survival (CSS) and overall survival (OS). Bivariate and multivariate Cox proportional hazards models were employed to identify predictors of CSS and OS. Results: Of 19,792 patients with testicular tumors, a total of67 patients with SCST were identified, representing 0.3% of the total population. Of these patients, 45 (67%) had Leydig cell and 19 (28%) had Sertoli cell tumors. Median age at presentation was 40 years and the vast majority of patients (84%) presented with localized disease. Following orchiectomy, 9 patients (15%) underwent RPLND, whereas 54 patients (80%) had no further treatment. With a median follow-up time of 75 months, 2-year OS and CSS was 91% and 95% for those presenting with stage I disease. For those presenting with stage II disease, 2-year OS and CSS was 30%. Significant predictors of worse OS on multivariable analysis included age >60 (HR 5.64, p<0.01) and metastatic disease (HR 8.56, p<0.01). Presentation with metastatic disease was the only variable associated with worse CSS (HR 13.36, p<0.01). Histology was not found to be a significant predictor of either CSS or OS. Conclusions: We present the largest reported series to date for this rare tumor and provide contemporary epidemiologic and treatment data. The primary driver of prognosis in patients with SCST is disease stage, emphasizing the importance of early detection and intervention.
Abstract 13540: Peritoneal Dialysis vs. Furosemide for the Treatment of Oliguria in Infants After Cardiopulmonary Bypass
Authors: David M Kwiatkowski, Stuart L Goldstein, David S Cooper, David P Nelson, David L Morales, Catherine D Krawczeski
Journal: Circulation (2015)

Objectives: Acute kidney injury (AKI) is a frequent and serious complication in infants after cardiac surgery with cardiopulmonary bypass (CPB). Often the earliest sign is oliguria, which can lead to fluid overload, prolonged mechanical ventilation and ICU stay, abnormal electrolytes and increased mortality. We hypothesized that the use of peritoneal dialysis (PD) compared to furosemide use would mitigate these complications. Methods: This is a single-center, surgical complexity-stratified, randomized controlled trial performed within a cohort of patients younger than 6mo undergoing cardiac surgery with a preoperative plan of PD catheter placement due to risk of post-CPB kidney injury. If enrolled patients had urine output &lt; 1mL/kg/hour for 4 hours during the first postoperative day, the patient was randomized to either a standardized regimen of furosemide or PD. If the patient demonstrated poor response to furosemide, PD could be initiated on postoperative day 2. Results: A total of 73 patients were randomized and completed the trial, including 2 patients who were randomized to furosemide and subsequently received PD. Using intention-to-treat analysis, the PD group was less likely to have fluid overload, had a lower delayed-extubation rate and fewer electrolyte replacements. There were no differences in mortality or ICU/hospital stay. No serious PD related complications were observed. PD was discontinued early in 9 patients due to pleural-peritoneal communication. Conclusions: Our study demonstrates that the use of PD in neonates with oliguria after CPB is associated with reduced morbidity but not differences in mortality or ICU/hospital stay. A multi-center study is necessary to further support these findings as well as determine association with mortality.
Comparison of results between the first and updated reports of phase III clinical trials (RCTs).
Authors: Elena Elimova, Bostjan Seruga, Haiyan Jiang, Ian Tannock
Journal: Journal of Clinical Oncology (2014)

6520 Background: Updated results of RCTs may differ from those initially reported due to the longer follow-up. The primary aim of the present study is to compare efficacy and toxicity of experimental anticancer agents between the first and updated published reports of RCTs. Methods: Reports of RCTs evaluating systemic therapies in lung, breast, and prostate cancer, which were published between 1990 and 2010 in JAMA, NEJM, JCO, Annals of Oncology, Lancet, and Lancet Oncology were eligible. Either first or updated report had to be published in one of these major journals. Hazard ratios (HRs) of the primary and secondary time-to event outcomes and the occurrence of adverse events (AEs) were compared between the first and the corresponding updated reports of the eligible RCTs. Results: We included 311 initial and 64 updated reports of RCTs into our analysis. Adjuvant and metastatic trials were equally likely to be updated for efficacy outcomes (56.3% vs 43.8%; p=0.38) and 28% of the updated reports had no update on AEs. Only 30% of the first and 27% of the updated reports used overall survival (OS) for the primary outcome. Definitions of primary, secondary or both outcomes were discordant between the first and updated report in 11.3% of RCTs. When comparing reports of RCTs with the concordant primary outcomes we found that the median hazard ratio (HR) of the primary endpoint increased from 0.75 to 0.83 in updated reports (p=0.003). However, decrease in this treatment effect occurred exclusively in the early setting trials (p<0.001). Both low- and high- grade AEs occurred significantly more often in the updated reports (p=0.01) (Table). Conclusions: Efficacy of anticancer agents in the first reports of RCTs for early lung, breast and prostate cancer is over-estimated. Over-estimated efficacy and under-reported toxicity of anticancer agents may lead to their overly enthusiastic prescribing in the every-day clinical practice. Comparison of effect size and toxicity between the first and updated reports. Median Publication First Updated P value HR by outcome Primary 0.75 0.83 0.003 Secondary 0.83 0.89 0.35 HR by setting (primary) Early 0.74 0.84 <0.001 Advanced 0.77 0.81 0.975 AEs by grade (proportion) 1,2 25.6 27.8 0.012 3,4 8.5 9.5 0.001
<i>Notes from the Field: Mycobacteria chimaera</i> Infections Associated with Heater-Cooler Unit Use During Cardiopulmonary Bypass Surgery — Los Angeles County, 2012–2016
Authors: M. Claire Jarashow, Dawn Terashita, Sharon Balter, Benjamin Schwartz
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

On June 12, 2018, the Michigan Department of Health and Human Services requested assistance from CDC to investigate risk factors for Salmonella infection linked to live backyard poultry originating at a mail-order hatchery in Michigan.
The JAX patient-derived xenograft program: A unique resource to advance genome-guided cancer medicine and therapeutic agent testing.
Authors: Carol J. Bult, Susan D. Airhart, Jeffrey Chuang, Regina Gandour-Edwards, Joshy George, Joel Graber, R. Krishna Murthy Karuturi, James Keck, Hyunsoo Kim, Primo Lara, Tianhong Li, Philip C. Mack, Lenny Shultz, Clifford Tepper, Rebekah Burich, Xing Yi Woo, Yan Yang, Ralph de Vere White, David R. Gandara, Edison T. Liu
Journal: Journal of Clinical Oncology (2014)

e22151 Background: To address the demand for new pre-clinical models,The Jackson Laboratory (JAX), in collaboration with founding member UCDCC and 24 other medical centers, has engrafted primary and metastatic tumors from over 20 types of human cancer into NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ (NSG) mice to create a bank of >270 clinically annotated and genomically characterized Patient Derived Xenografts (PDXs). Compared to cell lines, PDX models reflect the complexity of human tumors, including clonal heterogeneity and stromal interactions. Sub-grouping PDX models using genomic properties (e.g., cancer driver gene mutations) provides a unique platform for study of new therapies and mechanisms of drug resistance. Methods: Patient tumors were implanted subcutaneously in the flank of NSG mice. The first tumor to reach the target volume was harvested and used for expansion to a second passage (P1). Tumors from P1 were cryoviably frozen and re-implanted as needed to create study cohorts for therapeutic agent testing. PDX tumor genomes were characterized for somatic mutations, gene expression, and copy number variation. Some models have been tested for drug response using Standard of Care drug treatment regimens as part of the PDX platform validation strategy. Results: The JAX PDX resource includes 270 established models and 640 models in development from 1270 implantation events. Engraftment success varies significantly by tumor type, grade and stage. Genomic analysis reveals a high degree of complexity among different models established for the same tumor type, which can be subgrouped based on mutational status and other genomic properties. Passaged tumors show strong concordance in histology and genome properties with the original patient tumor and across passages. Conclusions: The JAX program is unique among similar resources in the breadth of the cancers represented, the use of the NSG mouse as the tumor host, the depth of genomic characterization of the models, and the quality of clinical annotation. This platform is ideally suited for drug development, precision therapeutic interventions based on genomic characterization, and identification and circumvention of drug resistance.
Molecular Patterns of Response and Outcome in the Chemotherapy and Venetoclax in Elderly AML Trial (CAVEAT study)
Authors: Andrew H Wei, Chong Chyn Chua, Ing S Tiong, Chun Yew Fong, Stephen B Ting, Sarah Macraild, Jessica M Salmon, Adam Ivey, John Nguyen, Flora Yuen, Richard Hall, Shaun Fleming, Stefan K. Bohlander, John Reynolds, Andrew W. Roberts
Journal: Blood (2018)
Correlation between circulating tumor cells (CTC) and plasma cytokines and angiogenic factors (CAF) in early breast cancer patients.
Authors: Michal Mego, Dana Cholujova, Paulina Gronesova, Marian Karaba, Gabriel Minarik, Tatiana Sedlackova, Denisa Manasova, Zuzana Cierna, Daniel Pindak, Jozef Sufliarsky, James M. Reuben, Jozef Mardiak
Journal: Journal of Clinical Oncology (2014)

e22038 Background: CAFs are involved in cancer invasion and metastasis. CTCs play role in tumor dissemination and are an independent survival predictor in breast cancer (BC) patients. The aim of this study was to assess correlation between CTCs and plasma CAFs in early BC patients. Methods: This study included 149 early BC chemo-naive patients treated by surgery from March 2012 to March 2013 in National Cancer Institute in Slovakia. Blood for analyses were drawn at the time of surgery. Peripheral blood mononuclear cells (PBMC) were depleted of hematopoetic cells using RossetteSep negative selection kit. RNA extracted from CD45-depleted PBMC was interrogated for expression of transcription factors (TWIST1, SNAIL1, SLUG, ZEB1) that induce epithelial-to-mesenchymal transcription (EMT-TF) and epithelial (CK19) gene transcripts by qRT-PCR. Patient samples with higher epithelial and/or mesenchymal gene transcripts than those of healthy donors (n=60) were considered as CTC positive. The concentrations of 51 plasma CAFs were measured using multiplex bead arrays (Human Group I and II cytokine panels and TGF beta by Bio-Plex 200 system). Results: CTCs were detected in 24.0% patients. CTCs exhibiting only epithelial markers (CTC_EP) were present in 12.0% patients, whereas CTCs with only EMT markers (CTC_EMT) were observed in 10.7% of patients and CTCs co-expressing both markers were detected in 1.3% patients. Patients with presence of CTC_EP had significantly elevated levels of plasma IFN-a2, IL-3, MCP-3, b-NGF, SCF, SCGF-b, SDF-1 and TNF-b compared to patients without CTC_EP. There was no positive correlation between CTC_EMT and plasma CAF; however, patients with CTC_EMT had significantly decreased plasma levels of IFN-a, b-NGF, CTACK, MIF and TRAIL compared to patients without CTC_EMT. CTCs positively correlated with axillary lymph node involvement as well (p = 0.03). Conclusions: Using CAFs profiling, we identified cytokines associated with CTCs subpopulations in early breast cancer patients. We suggest that these cytokines could be involved in CTCs trafficking and homing or alternatively, increased levels of these cytokines could be marker of more aggressive disease.
Metabolic response to enzalutamide (ENZ), assessed by choline positron emission tomography (cPET), in castration resistant prostate cancer (CRPC) patients (pts): Updated results of a monoinstitutional prospective study.
Authors: Francesca Maines, Orazio Caffo, Davide Donner, Antonello Veccia, Franca Chierichetti, Enzo Galligioni
Journal: Journal of Clinical Oncology (2014)

e16043 Background: ENZ is a new generation hormone therapy, able to produce a survival improvement in CRPC pts pre-treated with docetaxel. In Italy, ENZ is not approved yet for the daily clinical practice but until few months ago it was available through a named patient programme (NPP). Patients treated with ENZ were monitored cPET to evaluate the treatment response. Methods: Eligible pts received ENZ at the standard dose of 160 mg po daily until progression. The cPET was performed at baseline, at the 3rd treatment month and every 4 mos thereafter. For each cPET we recorded the median of the maximum standard uptake values (SUVmax) of the 5 most choline-avid region of interest (ROI) and the overall number of ROIs with SUVmax > 2.5. A progressive disease (PD) was defined as the increase ≥ 30% of median SUVmax or the appearance of at least two new ROIs; a partial response (PR) as the reduction ≤ 30% of median SUVmax compared to the baseline; otherwise we considered the disease as stable (SD). Results: Out of the 31 CRPC pts treated with ENZ in our hospital from 09/12 to 03/13, we had data on cPET re-evaluation at 3-mos in 28 pts, at 7-mos in 19 and at 11-mos in 15 pts, respectively. The metabolic changes are shown in the Table. The best metabolic response was PR in 9 pts (all showing a PSA reduction ≥ 50%), SD in 9 pts (8 showing a PSA reduction ≥ 50% and 1 stable PSA values), and PD in 10 pts (with a PSA reduction ≥ 50%, a PSA stabilization and a PSA increase in 3,3,and 4 pts respectively). Conclusions: To our knowledge this is the first report concerning the metabolic response to ENZ and its correlation to PSA response. Our updated data suggest that metabolic PR and SD are usually correlated to PSA reduction, while most of the pts with PD may present different biochemical outcomes. Further studies are required to define the role of cPET in monitoring the treatment efficacy in pts receiving ENZ. Baseline 3-mo 7-mo 11-mo Median SUVmax 10.82 9.30 7.15 6.99 New lesions NA 8 pts 5 pts 3 pts Overall response PR SD PD NA NA NA 7 pts 10 pts 11 pts 6 pts 7 pts 6 pts 3 pts 7 pts 5 pts
Locally advanced high-grade extremity soft tissue sarcoma: Response with novel approach to neoadjuvant chemoradiation using induction spatially fractionated GRID radiotherapy (SFGRT).
Authors: Mohammed Mohiuddin, Muhammad Memon, Ahmed Nobah, Medhat Elsebaie, Abdullah AL Suhaibani, Rajive Pant, Mahmoud Shaheen, Majid Alyamani, Fouad Al Dayal
Journal: Journal of Clinical Oncology (2014)

10575 Background: Improved local control and survival has been observed with increasing rate of tumor necrosis >90% with preoperative chemo-radiation for STS. However the rate of necrosis (90%+) following pre-operative chemo radiation remains low (<50%) and likely even less for locally advanced (>8 cm) tumors. The purpose of this study was to increase the rate of tumor necrosis following preoperative chemo-radiation in the management of soft tissue sarcomas (STS) using induction SFGRT. Methods: Fourteen patients with locally advanced extremity STS ranging in size from 8 cm to 26 cm (median 11.5 cm) were treated with high dose megavoltage radiation using an SFGRT technique. Single dose of induction SFGRT 18 Gy was delivered using 6 MV photons followed by external beam radiation 50 Gy combined with iphosfamide 2 gm/m2/day x 3 and mesna 2 gm/day x 3 in divided doses every three weeks followed by surgery 4-6 weeks after completing neoadjuvant therapy. Results: 12 patients completed the planned treatment. 1 patient had treatment interrupted due to Grade 3 skin reaction and 1 patient underwent an amputation of the foot mid treatment. Follow up ranges from 3 months to 43 months (median 14 mo). 13/14 patients underwent limb salvage surgery with 12 having negative margins. 2 patients have had delayed wound healing. 9/14 (65%) patients had > 90 % tumor necrosis with 2 patients having a pathological complete response. 2 additional patients have had greater than 80% necrosis. There have been no local recurrences and 12 patients are alive with no evidence of disease. Conclusions: The combined use of induction SFGRT and external beam radiation/chemotherapy is an effective way to enhance the necrosis and response to neoadjuvant chemo-radiation and potentially improve local control/ limb salvage and survival in locally advanced extremity STS.