tbuckley/cabot-search huggingface dataset:
Circulating tumor cells detected in patients with gastrointestinal cancers associate with tumor stage and response to chemotherapy
Authors: K. Hiraiwa, H. Takeuchi, Y. Kitagawa, H. Hasegawa, Y. Saikawa, T. Ando, T. Irino, T. Yoshikawa, S. Ishii, M. Kitajima
Journal: Journal of Clinical Oncology (2007)

4635 Background: Circulating tumor cells (CTCs) in metastatic breast cancer has been reported to correlate with shorter overall survival. The purpose of this study was to clarify the clinical significance of CTCs in gastrointestinal cancers. Methods: CTCs of 108 patients with stage III or IV gastrointestinal cancers and 38 healthy volunteers were measured by use of the CellSearch system. Correlation between CTC counts and clinicopathologic variables was examined. Results: The number of CTCs in stage IV patients (23.0 ± 109.1) was significantly larger than that in healthy donors (0.1 ± 0.2) and that in stage III patients (0.4 ± 1.8) (p &lt; 0.001). =2 CTCs were more frequently found in stage IV patients (41.6%) than in healthy donors (0%) and in stage III patients (3.2%) (p &lt; 0.001). =2 CTCs in gastric or colorectal cancer had significant correlation with peritoneal dissemination (p = 0.029). =2 CTCs in esophageal cancer had significant correlation with pleural dissemination (p = 0.030). In 10 of 32 CTC positive (=2) patients with stage IV gastrointestinal cancers, CTC was measured before initiation of a new line of chemotherapy and more than 3 weeks after initiation of therapy. The change in CTCs correlated with disease progression and reflected chemotherapeutic effect. Conclusions: This study suggested measurement of CTCs in gastrointestinal cancer patients shows promise as a tool for judging advanced tumor stage, predicting peritoneal or pleural dissemination and monitoring response to chemotherapy. No significant financial relationships to disclose.
Changes in Bone Mineral Density After Prophylactic Bilateral Salpingo-Oophorectomy in Carriers of a <i>BRCA</i> Mutation
Authors: Joanne Kotsopoulos, Elizabeth Hall, Amy Finch, Hanxian Hu, Joan Murphy, Barry Rosen, Steven A. Narod, Angela M. Cheung
Journal: JAMA Network Open (2019)

Preventive surgery is strongly recommended for individuals with a BRCA mutation at a young age to prevent ovarian cancer and improve overall survival. The overall effect of early surgical menopause on various health outcomes, including bone health, has not been clearly elucidated.To evaluate the association of prophylactic bilateral salpingo-oophorectomy with bone mineral density (BMD) loss among individuals with a BRCA mutation.This retrospective cohort study of participants with a BRCA mutation who underwent oophorectomy through the University Health Network, Toronto, Ontario, Canada, recruited participants from January 2000 to May 2013. Eligibility criteria included having a BRCA mutation, at least 1 ovary intact prior to surgery, and no history of any cancer other than breast cancer. Bone mineral density was measured using dual-energy x-ray absorptiometry before and after surgery. Data analysis began in December 2018 and finished in January 2019.The annual change in BMD from baseline to follow-up was calculated for the following 3 anatomical locations: (1) lumbar spine, (2) femoral neck, and (3) total hip.A total of 95 women had both a baseline and postsurgery BMD measurement with a mean (SD) follow-up period of 22.0 (12.7) months. The mean (SD) age at oophorectomy was 48.0 (7.4) years. Among women who were premenopausal at time of surgery (50 [53%]), there was a decrease in BMD from baseline to follow-up across the lumbar spine (annual change, -3.45%; 95% CI, -4.61% to -2.29%), femoral neck (annual change, -2.85%; 95% CI, -3.79% to -1.91%), and total hip (annual change, -2.24%; 95% CI, -3.11% to -1.38%). Self-reported hormone therapy use was associated with significantly less bone loss at the lumbar spine (-2.00% vs -4.69%; P = .02) and total hip (-1.38% vs -3.21; P = .04) compared with no hormone therapy use. Among postmenopausal women at time of surgery (45 [47%]), there was also a significant decrease in BMD across the lumbar spine (annual change, -0.82%; 95% CI, -1.42% to -0.23%) and femoral neck (annual change, -0.68%; 95% CI, -1.33% to -0.04%) but not total hip (annual change, -0.18%; 95% CI, -0.82% to 0.46%).This study found that oophorectomy was associated with postoperative bone loss, especially among women who were premenopausal at the time of surgery. Targeted management strategies should include routine BMD assessment and hormone therapy use to improve management of bone health in this population.
Identification of germ-line 185delAG BRCA1 mutation among breast cancer families in Iran: An experience from northeastern Iran.
Authors: Mohammad Mahdi Kooshyar, Mohammad Reza Nassiri, Morteza Mahdavi, Mohammad Doosti, Amir Reza Parizadeh
Journal: Journal of Clinical Oncology (2013)

e22079 Background: The present study evaluated the prevalence of 185DelAG BRCA1 mutation in the group of Iranian women breast cancer patients, or their relative with family history of breast cancer. Breast cancer is the most common malignancy in women and the leading cause of cancer death in females worldwide. BRCA1 is among the best known cancer susceptibility genes with high penetrance and have multiple cellular functions including critical roles in homologous DNA repair. Identifying gremlin BRCA mutations associated with significant cancer susceptibility has the potential to change all aspects of an individual's care, from screening to cancer treatment. The combination of breast cancer susceptibility alleles together with other risk factors may be important clinically. Methods: Subjects included in this study were thirty nine patients diagnosed with breast cancer and 29 women, from first degree relative of patients. The clinical and demographic details from these individuals were collected from medical records, pathological reports, and when needed and using a detailed questionnaire. Genomic DNA from peripheral blood mononuclear cells was extracted and analyzed by polymerase chain reaction and SSCP methods in order to finding 185DelAG founder mutation. Results: The results indicated that four patients and three healthy relatives had this founder mutation. The identification of these founder mutations facilitates mutation population screening and subsequent management options available to an individual woman including screening or prevention are then dependent on this level of assessed risk. Conclusions: Finally identifying the effective risks regarding breast cancer among Iranian women requires many works. However, a complete BRCA1 gene sequence analysis might be useful, regarding targeted cancer prevention and therapeutics.
Safety profile of first-line bevacizumab and chemotherapy in patients with unresected primary colorectal cancer and synchronous metastases
Authors: C. Mello, T. B. Oliveira, T. F. Paiva, M. J. Silva, S. M. Sanches, M. R. Cruz, U. R. Nicolau, M. F. Fanelli
Journal: Journal of Clinical Oncology (2009)

e15133 Background: The role of palliative resection of the primary tumour in patients who present with metastatic colorectal cancer (mCRC) is unclear. Most recently bevacizumab has been used as first line treatment for mCRC showing improvement in survival with a slight increase in the risk of bleeding and rarely gastrointestinal (GI) perforation. These side effects would cause concern in patients with unresected colorectal cancers (CRC). Methods: Retrospective analysis of twelve patients treated straightaway by chemotherapy (CT) and bevacizumab without primary tumour resection, between January 2007 and August 2008. The aim of the study was to evaluate the rate of complications related to the unresected colorectal tumour and to determine the safety of bevacizumab use in this situation. All of these patients had none or minimal symptoms related to the primary tumour. Results: Mean age 54.6 years (range 28–75), 5 males and 7 females, all patients ECOG 0. The sites of the primary lesion were the rectum in 8 patients (66.6%), the left sigmoid colon in 3 (25%), and the transverse colon in 1 (8.3%). Eight patients (66.6%) presented with rectal bleeding at diagnosis (mild). The mean interval between diagnosis and start of CT was 40,8 days (range 6–125). The total number of bevacizumab cycles was 151 (mean 12,5 cycles, range 4–37). First line CT was FOLFOX-6 in 66% and FOLFIRI in 33% of patients. Only 3 patients (25%) developed low GI bleeding, all grade 1, without bevacizumab interruption. None of them developed intestinal perforation or obstruction. Two patients (16.6%) developed grade 1 epistaxis and 1 (8.3%) grade 2 hypertension. No other complications were observed in a mean follow up of 9.3 months. Conclusions: Our data show that upfront chemotherapy with bevacizumab in patients with unresected primary CRC and synchronous metastases is safe. No major complications related to the primary tumour were observed. Although our data comes from a limited number of patients there is a lack of prospective controlled trials in the literature on this topic. Therefore, in select cases, a non-operative management of asymptomatic or minimal symptomatic mCRC could be advised, even with the use of anti-angiogenic therapy. No significant financial relationships to disclose.
The expanded role of palliative procedures with minimally invasive tumor ablation techniques
Authors: T. J. Miner, J. Gaydos-Gabriel, W. Kim, W. Mayo-Smith, D. Dupuy
Journal: Journal of Clinical Oncology (2007)

19548 Background: To effectively and appropriately manage the debilitating symptoms of advanced cancer, physicians must balance the potential promise of palliative interventions against requirements to avoid toxic or futile therapy. Ablative technologies are increasingly used for the local destruction of tumors. This study examines the outcomes of ablative procedures performed with palliative intent. Methods: Minimally invasive ablative procedures (microwave and radiofrequency) to explicitly palliate symptoms of advanced cancer were identified from all procedures performed. Patients were observed for &gt;90 days or until death. Results: There were 175 palliative ablative procedures performed in 129 patients from 1999 to 2004. Ablations were performed most commonly for pain (90%) caused by metastatic (90%), locally advanced (5%), and locally recurrent (5%) disease. Primary malignancies treated were lung (31%), colorectal (14%), renal (11%), breast (9%), sarcoma (9%) and other (26%). Symptom improvement or resolution within 30 days was achieved in 69% (89/129). Median duration of symptom control was 315 days. Recurrence of the primary symptom occurred in 46% (59/129) while treatment of additional symptoms was needed in 22% (29/129). Palliative ablative procedures were associated with postoperative morbidity (25%) and mortality (7%). A postoperative complication reduced the probability of symptom improvement to 25% (p&lt;0.001). Effective symptom relief was associated with improved overall survival (median 408 days vs. 161 days, p&lt;0.001). Conclusions: In carefully selected patients, relief of symptoms following palliative ablative procedures can be expected, but new or recurrent symptoms limit durability. As observed in other palliative procedures, potential benefits are minimized by postoperative complications. Optimal management for these patients with advanced cancer, who are often not suitable candidates for operation, requires the highest level of multidisciplinary care. No significant financial relationships to disclose.
Everolimus in combination with octreotide LAR as the first-line treatment for advanced neuroendocrine tumors: A phase II trial of the I.T.M.O. (Italian Trials in Medical Oncology) group.
Authors: Emilio Bajetta, Laura Catena, Nicola Fazio, Sara Pusceddu, Pamela Biondani, Giusi Blanco, Sergio Ricci, Michele Aieta, Francesca Pucci, Monica Valente, Nadia Bianco, Fernanda Bellomo, Chiara Mauri, Pasquale Buonandi, Vincenza Roberto
Journal: Journal of Clinical Oncology (2013)

4136^ Background: Everolimus has shown antitumor activity in patients (pts) with advanced pancreatic neuroendocrine tumors (NETs). We aimed to assess efficacy and safety of everolimus in combination with octreotide long-acting repeatable (LAR) in patients with well differentiated NETs of gastroenteropancreatic and of lung origin. Methods: We performed a phase II, multicenter trial using a Simon two-stage minmax design. Pts with advanced well differentiated, previously untreated NETs of the gastroenteropancreatic tract and of the lung received octreotide LAR 30 mg every 28 days in conjunction with everolimus 10 mg per day continuously. The primary endpoint was objective response rate (ORR). Results: A total of 50 pts (58% males) were enrolled. The median age was 60.5 years (range 25-76). Primary tumor site was pancreas in 14 (28%), unknown in 14 (28%), lung in 11 (22%), ileum in 9 (18%) and jejunum and duodenum in 2 (4%) of pts. 13 (26%) pts had carcinoid syndrome. The ORR, calculated on the ITT population, was 20.0% (95% CI 8.9-31.1): 2 patients (4%) had a complete response (CR), 8 (16%) a partial response (PR). Thirty-six patients (72%) achieved stable disease (SD). All CR and all PR as well as 91.7% of SD had a duration ≥ 6 months. Clinical benefit (CR+PR+SD) was 92%. At a median follow-up of 277 days, the median time to progression (TTP) was 16.3 months (95% CI 10.7-20.1). Overall survival could not be assessed. Treatment-related adverse events (AEs) were mostly of grade 1 or 2; the only grade 4 AE was mucositis in 1 patient, while grade 3 AEs included skin rash in 1 case, stomatitis in 4 cases (8%) and diarrhea in 11 cases (22%). Conclusions: Everolimus in combination with octreotide LAR has shown to be active and well tolerated in advanced NETs and, in this study, not only in primary pancreatic tumors. Compared to other clinical trials with everolimus in NETs, the observed ORR in this study was higher. Aknowledgements: The Authors thank the Italian Trials in Medical Oncology (I.T.M.O.) group and Novartis Pharma for the support provided. Clinical trial information: 2008-007153-13.
Estimating the benefits of therapy for early-stage breast cancer: the St. Gallen International Consensus Guidelines for the primary therapy of early breast cancer 2019
Authors: H.J. Burstein, G. Curigliano, S. Loibl, P. Dubsky, M. Gnant, P. Poortmans, M. Colleoni, C. Denkert, M. Piccart-Gebhart, M. Regan, H.-J. Senn, E.P. Winer, B. Thurlimann
Journal: Annals of Oncology (2019)

The 16th St. Gallen International Breast Cancer Conference 2019 in Vienna, Austria reviewed substantial new evidence on loco-regional and systemic therapies for early breast cancer.
Optimizing Joy in Surgery
Authors: Robert S. Sawin
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Perioperative Bridging Anticoagulation
Authors: Lubina Arjyal
Journal: Annals of Internal Medicine (2019)

Letters6 August 2019Perioperative Bridging AnticoagulationLubina Arjyal, MDLubina Arjyal, MDGundersen Health System, La Crosse, Wisconsin (L.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0158 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read Grant's commentary on the use of perioperative bridging anticoagulation with interest (1). For many years, bridging with heparin was the usual approach for almost all patients having surgery. The simple rationale was that heparin would provide an antithrombotic effect. However, we did not realize the increased risk for bleeding with this approach until the results of the BRIDGE (Bridging Anticoagulation in Patients who Require Temporary Interruption of Warfarin Therapy for an Elective Invasive Procedure or Surgery) study were published (2). Many providers have since shied away from bridging anticoagulation in the perioperative period.In addition ...References1. Grant PJ. Web exclusive. Annals for Hospitalists inpatient notes: how I changed my practice—perioperative bridging anticoagulation. Ann Intern Med. 2018;169:HO2-3. [PMID: 30452578]. doi:10.7326/M18-2734 LinkGoogle Scholar2. Douketis JD, Spyropoulos AC, Kaatz S, et al; BRIDGE Investigators. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med. 2015;373:823-33. [PMID: 26095867] doi:10.1056/NEJMoa1501035 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Gundersen Health System, La Crosse, Wisconsin (L.A.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0158. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists Inpatient Notes - How I Changed My Practice—Perioperative Bridging Anticoagulation Paul J. Grant Metrics 6 August 2019Volume 171, Issue 3Page: 224-225KeywordsAtrial fibrillationConflicts of interestDisclosureHeartHemorrhageHeparinStrokeSurgeryThromboembolism ePublished: 6 August 2019 Issue Published: 6 August 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
High dose <sup>90</sup>Yttrium ibritumomab tiuxetan with PBSC support in refractory-resistant NHL patients: Preliminary results of a phase I/II study
Authors: A. Vanazzi, P. Ferrucci, C. Grana, M. Cremonesi, M. Chinol, S. Papi, L. Calabrese, D. Radice, G. Paganelli, G. Martinelli
Journal: Journal of Clinical Oncology (2006)

7587 Background: Therapeutic options are limited in the treatment of relapsing NHL pts not suitable to HDCT. 90 Yttrium ibritumomab tiuxetan (Zevalin) is active in DLBCL at 0.4 mCi/kg, but duration of response is usually short. We present feasibility and toxicity results of a phase I/II study of HD-Zevalin with PBSC support in resistant-refractory NHL pts. From 04/04 to 11/05, 14 pts were enrolled. Median age was 68ys. 13/14 pts had advanced stage disease (III/IV) at diagnosis. 8 DLBCL, 4 MCL, 1 FL G3, 1 transformed MZL. Median number of prior therapies were 3, including rituximab, RT and HD-CT. Methods: 3 dose levels were fixed: 0.8, 1.2, 1.5 mCi/kg. 4 pts received 0.8, 4 pts 1.2 and 6 pts 1.5 mCi/kg. 1wk prior to Zevalin all pts underwent dosimetry: if no abnormal uptake was observed they received the planned dose. On d13 pts received PBSC previously harvested. On d28 from reinfusion (+41 from Zevalin) engraftment was considered to be delayed if ANC &lt;1.0×10 9 /L or PLT&lt;20.0×10 9 /L. Results: Dosimetry showed acceptable radiation-absorbed doses to uninvolved organs, reaching max 20Gy. Only 1pt received 30Gy to the liver without developing toxicity. The median radiation-activity delivered was 90 mCi (range 57–150): 8 pts received a dose within 80 and 100 and 6 pts &gt;100 mCi. Mean dose to red marrow: 0.8±0.2 mGy/MBq. All pts but 1 engrafted promptly. PLT/ANC count nadirs were observed 21/17 days after Zevalin (median values: 11×10 9 /L and 0.01×10 9 /L). No statistically significant difference in terms of hematological toxicity exists in PLT-recovering for pts receiving 1.5 mCi/kg and it is probably influenced by PLT count at baseline and by the several treatment previously received. Non-haematologic toxicity: 1 febrile neutropenia and 1HZV at 2nd level; 1 febrile neutropenia, 1 G3 liver toxicity, 1 bacterial pneumonia, 1HZV, 1HCV reactivation (pt died 4 months after treatment) at the 3rd level. 13/14pts are evaluable for response: 6CR, 2PR, 5PD. Conclusions: Zevalin at myeloablative activity with PBSC is feasible. It could be safely delivered in elderly and heavily pretreated pts, including those who previously received HDCT. Efficacy and mild toxicities suggest further investigation. We are continuing enrollment, including pts who previously received no more than 2 lines of CT. No significant financial relationships to disclose.
FDA Approval Summary: Mogamulizumab-kpkc for Mycosis Fungoides and Sézary Syndrome
Authors: Yvette L. Kasamon, Haiyan Chen, R. Angelo de Claro, Lei Nie, Jingjing Ye, Gideon M. Blumenthal, Ann T. Farrell, Richard Pazdur
Journal: Clinical Cancer Research (2019)

Abstract The FDA-approved mogamulizumab-kpkc, a CC chemokine receptor type 4 (CCR4)-directed mAb, in August 2018 for treatment of adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy. Regular approval was based on a randomized, open-label trial that randomized 372 such patients, with a median of 3 prior systemic therapies, to either mogamulizumab-kpkc or vorinostat. Investigator-assessed progression-free survival (PFS) was statistically significantly longer in the mogamulizumab-kpkc arm, which had an estimated median PFS of 7.6 months [95% confidence interval (CI), 5.6–10.2] compared with 3.1 months (95% CI, 2.8–4.0) in the vorinostat arm (HR = 0.53; 95% CI, 0.41–0.69). The confirmed overall response rate was 28% and 5%, respectively (P &amp;lt; 0.001), based on global composite response criteria. Adverse reactions occurring in at least 20% of mogamulizumab-kpkc recipients included rash, infusion-related reactions, fatigue, diarrhea, musculoskeletal pain, and upper respiratory tract infection. Serious adverse reactions occurred in 36% of patients, most often from infection. The prescribing information includes warnings for dermatologic toxicity, infusion reactions, infections, autoimmune complications, and complications of allogeneic hematopoietic stem cell transplantation, including severe and steroid-refractory graft-versus-host disease. See related commentary by Larocca et al., p. 7272
Local and abscopal responses in advanced intrahepatic cholangiocarcinoma with low TMB, MSS, pMMR and negative PD-L1 expression following combined therapy of SBRT with PD-1 blockade
Authors: Xiaoliang Liu, Jianfei Yao, Lele Song, Sujing Zhang, Tanxiao Huang, Yu Li
Journal: Journal for ImmunoTherapy of Cancer (2019)

Late-stage or recurrent intrahepatic cholangiocarcinoma (ICC) patients exhibit poor prognosis due to limited sensitivity to chemotherapy or radiotherapy and coexistence of multiple lesions. Programmed cell death protein 1 (PD-1) blockade provides a therapeutic opportunity for patients with high tumor mutation burden (TMB), high microsatellite instability (MSI-H), deficient mismatch repair (dMMR) and/or positive programmed cell death ligand 1 (PD-L1) expression. However, it is currently believed that patients with low TMB, microsatellite stable (MSS), proficient mismatch repair (pMMR) or negative PD-L1 expression are less likely to benefit from PD-1 blockade.