tbuckley/cabot-search huggingface dataset:
Safe chemotherapy for treating early breast cancer in G6PD-deficient patients
Authors: C. Donisi, F. Atzori, M. Dessì, M. Persano, M. Scartozzi
Journal: Annals of Oncology (2019)

Background: The aim of this study is to evaluate the hematologic and non-hematologic toxicity of adjuvant treatment with anthracyclines in G6PD deficient patients affected by breast cancer. Methods: From July 2009 to May 2017, we enrolled 40 Caucasian female patients carrier of G6PD deficiency with non-metastatic breast cancer. They were treated with adjuvant chemotherapy including anthracyclines. Results: As for treatment, 30% of patients were treated with FEC regimen (Fluoruracil 500mg/m2 iv, Epirubicin 75-100 mg/m2i.v., Cyclophosphamide 500-600mg/m2 every three weeks) for 6 cycles. 70% of the women received chemotherapy including anthracyclines and taxanes: 55% with EC regimen (Epirubicin 90 mg/m2i.v. and Cyclophosphamide 600 mg/m2i.v. every two weeks) for 4 cycles and Paclitaxel 80mg/m2i.v. weekly for 12 cycles; 15% were treated with FEC regimen for 3 cycles and Docetaxel 100 mg/m2i.v. every three weeks for 3 cycles. Anemia of grade 1 (83,6%) or 2 (17,4%) occurred in 57,5% of patients. In 42,5% of patients no anemia occurred. Nobody had acute hemolytic anemia and nobody presented neutropenia or thrombocytopenia. Bilirubin levels were normal in all patients (0.2-1,2 mg/dl) such as reticulocytes count (0,5-1,5%).Haptoglobin levels (50-150 mg/dl) were normal too. In 65% of cases LDH levels were lightly increased (200-500 U/L), but this result was due to a G-CSF injection. A common trait that occurred in 100% of the patients was alopecia.Only 17,5% of patients reported fatigue of grade 1.37,5% reported nausea of grade 1 and 2. 5% of patients presented vomit. 7,5% of patients reported constipation of grade 1 or 2 and 2,5% presented diarrhea of grade 2.7,5% of patients reported oral mucositis of grade 1 or 2. Non-hematologic and hematologic adverse events occurred frequently in patients without G6PD mutations. Conclusions: Despite this is retrospective data and the number of patients analysed in this study is limited, these results prove that the usage of anthracyclines regimen is safe in patients with G6PD deficiency. In the future most clinical trials are welcomed to improve clinical practice. Legal entity responsible for the study: Clelia Donisi. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF TWO DIFFERENT WIRE TECHNIQUES FOR COLD SNARE POLYPECTOMY
Authors: Y Huber, F Thieringer, V Sivanathan, PR Galle, A Kreft, K Mönkemüller, H Neumann
Journal: Endoscopy (2019)

Cold snare polypectomy has shown its effectiveness for treatment of colorectal polyps and is increasingly being used. However, dedicated snares for cold snare polypectomy are still rare and no comparison of different wire techniques for this indication has yet been performed.
Treatment and Long-Term Clinical Outcomes of Incidental Pulmonary Embolism in Patients With Cancer: An International Prospective Cohort Study
Authors: Noémie Kraaijpoel, Suzanne M. Bleker, Guy Meyer, Isabelle Mahé, Andrés Muñoz, Laurent Bertoletti, Annemarieke Bartels-Rutten, Jan Beyer-Westendorf, Ettore Porreca, Carine Boulon, Nick van Es, Diana I. Iosub, Francis Couturaud, Mercedes Biosca, Teresa Lerede, Philippe Lacroix, Anthony Maraveyas, Anita Aggarwal, Philippe Girard, Harry R. Büller, Marcello Di Nisio
Journal: Journal of Clinical Oncology (2019)

Pulmonary embolism is incidentally diagnosed in up to 5% of patients with cancer on routine imaging scans. The clinical relevance and optimal therapy for incidental pulmonary embolism, particularly distal clots, is unclear. The aim of the current study was to assess current treatment strategies and the long-term clinical outcomes of incidentally detected pulmonary embolism in patients with cancer.We conducted an international, prospective, observational cohort study between October 22, 2012, and December 31, 2017. Unselected adults with active cancer and a recent diagnosis of incidental pulmonary embolism were eligible. Outcomes were recurrent venous thromboembolism, major bleeding, and all-cause mortality during 12 months of follow-up. Outcome events were centrally adjudicated.A total of 695 patients were included. Mean age was 66 years and 58% of patients were male. Most frequent cancer types were colorectal (21%) and lung cancer (15%). Anticoagulant therapy was initiated in 675 patients (97%), of whom 600 (89%) were treated with low-molecular-weight heparin. Recurrent venous thromboembolism occurred in 41 patients (12-month cumulative incidence, 6.0%; 95% CI, 4.4% to 8.1%), major bleeding in 39 patients (12-month cumulative incidence, 5.7%; 95% CI, 4.1% to 7.7%), and 283 patients died (12-month cumulative incidence, 43%; 95% CI, 39% to 46%). The 12-month incidence of recurrent venous thromboembolism was 6.4% in those with subsegmental pulmonary embolism compared with 6.0% in those with more proximal pulmonary embolism (subdistribution hazard ratio, 1.1; 95% CI, 0.37 to 2.9; P = .93).In patients with cancer with incidental pulmonary embolism, risk of recurrent venous thromboembolism is significant despite anticoagulant treatment. Patients with subsegmental pulmonary embolism seemed to have a risk of recurrent venous thromboembolism comparable to that of patients with more proximal clots.
RESCUE: Reaching for evidence-based chemotherapy use in endocrine sensitive breast cancer - A prospective non-interventional study on risk assessment by the endopredict test and long-term patient outcome in early luminal breast cancer
Authors: J. Ettl, J.-U. Blohmer, C. Denkert, L. Beier, E. Klein, P. Neuser, M. Keller, M. Untch, M. Wittenberg, M. Kiechle
Journal: Annals of Oncology (2019)

Background: Hormone-receptor (HR) positive, HER2-negative breast cancers make up about 60 % of the primary tumors. For these patients with 0 or up to 3 positive lymph nodes, the indication for chemotherapy is based on an accurate risk stratification. In this situation, conventional clinicopathological parameters are often not suitable for selecting those patients who would not benefit from adjuvant chemotherapy. The EndoPredict test combines a molecular signature with clinical risk factors such as tumor size and nodal status and stratifies patients into "low" or "high" risk groups and thereby improves decision-making. The EndoPredict test can predict the 10-year risk of distant metastases in patients with HR+/HER2- primary breast cancer with endocrine treatment (Evidence level I-B). Trial design: Patients with HR+/HER2- primary invasive breast cancer stage I/II and T1 to T3 with 0 to 3 positive lymph nodes and an EndoPredict test within six months prior to inclusion are eligible. Primary objective is to show that patients tested as "low risk" by EndoPredict and treated with adjuvant endocrine therapy alone for at least 5 years have a 10-year distant metastasis-free survival of > 90 %. Secondary endpoints include distant metastasis-free survival, disease-free survival and overall survival in patients with EPclin "low" vs "high" risk. Also, the proportion of patients whose treatment was concordant and non-concordant with EndoPredict test results, will be analyzed for survival. The prognostic performance of classical prognostic factors with respect to survival will also be assessed. Patients will be evaluated annually for 10 years regarding treatment compliance, recurrence, metastases, and survival. Start of accrual was in July 2018. At least 35 sites in Germany and one site in Switzerland will be active. Current data on enrollment will be reported. Survival data of patients who have been tested with EndoPredict are systematically assessed to prospectively prove that patients with a low risk classification by EndoPredict can safely forgo chemotherapy and be treated with endocrine therapy alone. Clinical trial identification: NOGGO-B3 [18.12.2017]. Legal entity responsible for the study: North-Eastern German Society for Gynaecological Oncology e.V. (NOGGO e.V.). Funding: Myriad Service GmbH. Disclosure: C. Denkert: Patent holder: EP18209672 Patent application; Consulting fees: Fa, Teva, Novarits, Pfizer, Roche, Amgen, MSD, Daiichi, Celgene, AstraZeneca; Ownership interests: Sividon Diagnostics. M. Untch: Consulting fees: Linde. M. Kiechle: Speakers honorarium: Myriad, January 2018. All other authors have declared no conflicts of interest.
Review: In generalized anxiety disorder, network meta-analysis shows efficacy and tolerability of various drugs
Authors: Gregory E. Simon
Journal: Annals of Internal Medicine (2019)

ACP Journal Club21 May 2019Review: In generalized anxiety disorder, network meta-analysis shows efficacy and tolerability of various drugsGregory E. Simon, MD, MPHGregory E. Simon, MD, MPHKaiser Permanente Washington Health Research Institute, Seattle, Washington, USA (G.E.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJ201905210-054 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationSlee A, Nazareth I, Bondaronek P, et al. Pharmacological treatments for generalised anxiety disorder: a systematic review and network meta-analysis. Lancet. 2019;393:768-77. https://pubmed.ncbi.nlm.nih.gov/30712879Clinical Impact RatingsGIM/FP/GP: Mental Health: Reference1 Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391:1357-66. [PMID: 29477251] Google Scholar Author, Article, and Disclosure InformationAffiliations: Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA (G.E.S.)This article was published at Annals.org on 7 May 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 May 2019Volume 170, Issue 10Page: JC54KeywordsAnxietyAnxiolyticsDrug therapyDrugsGeneralized anxiety disorderNetwork analysisOdds ratioOutpatientsPsychiatry and mental healthStatistical data ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
COMPARISON OF THE DIAGNOSTIC YIELD OF “PILLCAM SB3” AND “OMOM” CAPSULE ENDOSCOPY IN SMALL BOWEL BLEEDING
Authors: G Blanco-Velasco, OM Solorzano-Pineda, R Zamarripa-Mottu, D Espinosa-Saavedra, OV Hernandez-Mondragon
Journal: Endoscopy (2019)

Capsule endoscopy (CE) is considered the gold standard for the diagnosis of small bowel bleeding (SBB). The CE Pillcam SB3 has a diagnostic yield above 80% for SBB. CE OMOM offers an adequate diagnostic yield with a lower price.
Cost-effectiveness and cost-utility of population-based glaucoma screening in China: a decision-analytic Markov model
Authors: Jianjun Tang, Yuanbo Liang, Ciaran O'Neill, Frank Kee, Junhong Jiang, Nathan Congdon
Journal: The Lancet Global Health (2019)

BackgroundGlaucoma, particularly primary angle closure glaucoma (PACG), is a leading cause of global blindness. Nearly half of all people with PACG are of Chinese descent. Population-level glaucoma screening has generally not been found to be cost-effective in high-income countries; however, this assessment has rarely been done in low-income or middle-income countries. We aimed to assess the cost-effectiveness and cost-utility of population-level glaucoma screening in China.MethodsWe developed decision-analytic Markov models for separate and combined screening for PACG and primary open angle glaucoma (POAG) to evaluate costs and benefits of community-level screening versus opportunistic case finding from a societal perspective. A cohort of individuals was followed in the model from age 50 years through a total of 30 1-year Markov cycles. Analyses were done separately for rural and urban settings. We did a meta-analysis of glaucoma prevalence studies in China to obtain prevalence estimates for PACG and POAG. Screening costs were taken from a Chinese screening programme and treatment costs from a tertiary Chinese eye hospital. Main outcomes were incremental cost-utility ratios (ICURs) using quality-adjusted life-years and incremental cost-effectiveness ratios (ICERs) using years of blindness avoided. We did one-way deterministic and simulated probabilistic sensitivity analyses to reflect uncertainty around ICURs and ICERs.FindingsCompared with no screening, combined screening of POAG and PACG in rural China is predicted to result in an ICUR of US$569 (95% CI 17 to 4180) and an ICER of $1280 (−58 to 7940), both of which are below the WHO cost-effectiveness threshold of one to three times rural gross domestic product. For the urban China setting, combined screening is predicted to result in fewer net costs and greater gain in health benefits than no screening. Findings were robust in all sensitivity analyses. Over 30 years, a total of 246 (95% CI 63 to 628) and 1325 (510 to 2828) years of blindness are predicted to be avoided for every 100 000 rural and urban residents screened, respectively.InterpretationPopulation screening for glaucoma (POAG and PACG combined) is likely to be cost-effective in both urban and rural China. Future studies should investigate the effectiveness of interventions to improve acceptance of definitive care among people screened.FundingUlverscroft Foundation, Wenzhou Medical University Research Fund, Zhejiang Province Health Innovation Talents Project, and Wenzhou's Ten Major Livelihood Issues 2015.
Complications des coloscopies du programme de dépistage organisé du cancer colorectal par test immunologique: une étude de cohorte en population
Authors: B Denis, I Gendre, S Weber, P Perrin
Journal: Endoscopy (2019)

La balance bénéfice/risque du programme de dépistage organisé (DO) du cancer colorectal (CCR) par test immunologique (FIT) est inconnue.
TILs in ER+/HER2- breast cancer
Authors: C. Criscitiello, A. Vingiani, P. Maisonneuve, G. Viale, G. Viale, G. Curigliano
Journal: Annals of Oncology (2019)

Background: The role of tumor-infiltrating lymphocytes (TILs) in ER+/HER2- breast cancer (BC) is debated. We evaluated the association of TILs and clinico-pathological (CP) features with distant disease-free survival (DDFS) in a large series of patients (pts) with ER+/HER2- BC. Methods: A case-cohort was built by randomly selecting 17% of an initial cohort of 3986 pts who underwent surgery at IEO in the period 1998-2002, and for whom long-term follow-up data was available (680 pts). 307 more pts with an event were added to this cohort. TILs were assessed for these 987 cases on centralized H&E slides. TILs were considered both as continuous variable, and dichotomized in low (<5%) vs high (≥5%). DDFS was calculated from the date of surgery to the date of any first event or the date of last contact with the patient. Median f-up was 7.5 years (0.1-10). Differences between BC subtypes were assessed using the log-rank test. Univariable and multivariable Cox proportional hazards regression with inverse sub-cohort sampling probability weighting were used to evaluate the risk across groups. Analyses were carried out with the SAS software version 9.4. Results: Median TILs was 2%. Higher TILs were positively associated with pN (p = 0.003), grade (p < 0.0001), peritumoral vascular invasion (p = 0.003), Ki-67 (p = 0.0001), lumB subtype (p < 0.0001), and chemotherapy (p < 0.0001), while they were inversely associated with ER (p < 0.0001) and age (p = 0.02). In multivariable regression analysis, only Ki-67 expression retained significant association with TILs. Age and ER showed a trend towards negative association with TILs. In univariate Cox regression, TILs expression (≥5% vs. <5%) was not associated with DDFS (HR 1.08, 95% CI 0.80-1.46, p = 0.62). At stratified cox exploratory analyses, we found an association between high TILs and low risk in very young women (p = 0.03) and G3 tumors (p = 0.047); high TILs were associated with worse outcome in G1 tumors (p = 0.05). TILs were not associated with DDFS in the group without chemo. Instead, in the group with chemo, high TILs were associated with better DDFS (p = 0.006), particularly for ki67≥20% (p = 0.01). Conclusions: High TILs in ER+/HER2- BC are significantly associated with several CP features of dismal outcome. This subgroup might be more immunogenic, thus deserving the exploration of immunotherapy approaches. Legal entity responsible for the study: Carmen Criscitiello. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Re: Sebastian Berg, Alexander P. Cole, Marieke J. Krimphove, et al. Comparative Effectiveness of Radical Prostatectomy Versus External Beam Radiation Therapy Plus Brachytherapy in Patients with High-risk Localized Prostate Cancer. Eur Urol 2019;75:552–5
Authors: Michael Froehner, Christian Thomas
Journal: European Urology (2019)
INCIDENCE AND CHARACTERISTICS OF INTERVAL COLORECTAL CANCER. IDENTIFICATION OF IMPROVEMENT AREAS
Authors: L Pérez Citores, R Bonoso Criado, Á Montero Moretón, M Cimavilla, M De Gracia Villanueva Arias, B Moreira Da Silva, F Santos Santamarta, S Maestro Antolín, M Curieses, I Peñas, A Pérez Millán, J Barcenilla Laguna
Journal: Endoscopy (2019)

Interval cancer is a major cause of concern. It is conditioned by multiple reasons such as colonic preparation, exploration time and adequate polyps resection.
Erratum: Corrigendum: Protein kinase CK2 links extracellular growth factor signaling with the control of p27Kip1 stability in the heart
Authors: Ludger Hauck, Christoph Harms, Junfeng An, Jens Rohne, Karen Gertz, Rainer Dietz, Matthias Endres, Rüdiger von Harsdorf
Journal: Nature Medicine (2008)
T helper 22 cells from Han Chinese patients with atopic dermatitis exhibit high expression of inducible T‐cell costimulator
Authors: Q. Jiao, Q. Qian, C. Liu, Y. Luo, F. Fang, M. Wang, J. Ji, H. Qian, X. Zhang, M. Maurer
Journal: British Journal of Dermatology (2019)

Atopic dermatitis (AD) is a heterogeneous disease, characterized by excess T helper (Th) 22 activation in Asian AD. Inducible T‐cell costimulator (ICOS) is crucial for T‐cell activation and differentiation. However, the role of ICOS in AD and its effect on Th22 cells remain unclear. To gain a better understanding of the role of ICOS and ICOS ligand (ICOSL) in the pathogenesis of Asian AD and its underlying mechanisms. We quantified ICOS and ICOSL expression in Han Chinese patients with AD and healthy controls (HC). Then, we assessed the proliferation and the production of the Th22 chemokines CCR4 and CCR10 by ICOSL‐stimulated AD peripheral blood mononuclear cells (PBMCs) as well as their effects on keratinocyte filaggrin production. Finally, we explored the link between ICOS‐expressing Th22 cells and disease activity and IgE levels in our patients with AD. Our patients with AD showed higher levels of ICOS‐expressing Th22 cells as well as ICOSL‐expressing CD19+ B cells and CD14+ monocytes compared with HC. ICOSL increased the proliferation and expression of CCR4 and CCR10, and of interleukin (IL)‐22 in AD PBMCs. ICOSL treatment also significantly increased the downregulation of filaggrin expression by keratinocytes cocultured with PBMCs from patients with AD. Finally, blood levels of ICOS+ Th22 cells and ICOSL+ B cells in this AD cohort were correlated with disease activity as assessed by the SCORing Atopic Dermatitis index and with total IgE levels. In Han Chinese patients with AD, circulating Th22 cells, serum levels of IL‐22 and IL‐22+ cells in lesional skin were all markedly increased. Our findings demonstrate that ICOS/ICOSL expression and effects are linked to Th22 skewing and the pathogenesis of Han Chinese AD, which suggests ICOSL and ICOS as well as Th22 cells and IL‐22 as new and promising therapeutic targets. What's already known about this topic? In Asian patients, atopic dermatitis (AD) is characterized by excess T helper (Th) 22 activation. Inducible T‐cell costimulator (ICOS) is crucial for T‐cell activation and differentiation. What does this study add? This study demonstrates that circulating Th22 cells, serum levels of interleukin (IL)‐22 and IL‐22+ cells are all markedly increased in lesional skin in Han Chinese patients with AD. In Han Chinese patients with AD, ICOS and ICOS ligand (ICOSL) drive Th22 skewing and increase filaggrin downregulation, and ICOS+ Th22 cells and ICOSL+ B cells are linked to disease activity. What is the translational message? ICOS+ Th22 cells and ICOSL+ B cells are potential clinical biomarkers of disease activity in Han Chinese patients with AD. ICOS‐ and ICOSL‐targeted treatment approaches may benefit Han Chinese patients with AD.
Abstract 16748: The Severity of Left Ventricular Diastolic Dysfunction is Associated With Higher Prevalence of Myocardial Fibrosis
Authors: Lin Wang, Rozalia Tverskaya, Jie J Cao
Journal: Circulation (2016)

Introduction: Myocardial fibrosis is likely an important cause of left ventricular (LV) diastolic dysfunction which is associated with important morbidity and mortality. In this study we investigat...
BRCA status, treatment patterns and outcomes in HER2- advanced breast cancer (ABC): A multi-country real-world study
Authors: A. Niyazov, R.G.W. Quek, K. Lewis, J. Kemp, A. Rider
Journal: Annals of Oncology (2019)

Background: BRCA testing rates, treatment patterns and outcomes were compared based on BRCA mutation status in HER2- adult women with ABC. Methods: Oncologists extracted data from patient charts in adult women with HER2- ABC across the US and France, Germany, Italy, Spain and the United Kingdom (EU5) via the Adelphi Advanced Breast Cancer Disease Specific Program. Data drawn from 2015 and 2017 were merged across common variables. Patients were categorized into three mutually exclusive cohorts; BRCA mutations (BRCAm), wild type (BRCAwt), and unknown status (BRCAunk). Treatments received and 1st line duration of therapy was compared between BRCAm and BRCAwt using Fisher exact, Mann-Whitney tests, and t-tests. Results: The study included 6,161 adult women with HER2- ABC (4,611 hormone receptor positive [HR+/HER2-], 1,415 triple negative breast cancer [TNBC], 135 unknown hormone status). Overall, 28% of patients received ≥1 BRCA test at any point in their lifetime (23% HR+/HER2-, 41% TNBC). 235/6,161 (4%) patients were identified as BRCAm, 1,025/6,161 (17%) as BRCAwt, and 4,901/6,161 (80%) as BRCAunk. Within the HR+/HER2- cohort, patients with BRCAm were more likely to receive 1st line chemotherapy compared to BRCAwt (65% vs 49%; P = 0.005) and less likely to receive endocrine +/- targeted therapies (33% vs 49%; P = 0.003). TNBC treatments consisted primarily of chemotherapy and were similar between BRCAm vs. BRCAwt, (89% vs. 91%; P = 0.545). Mean duration among patients who completed 1st line treatment was numerically shorter for patients with BRCAm [Table].Table161P 1st line duration of therapy (mean months [SD]) based on BRCA statusBRCAm (n = 34)BRCAwt (n = 282)P valueHR+/HER2-7.8[10.0]11.4 [5.5]0.648TNBC6.4 [6.1]5.0 [2.9]0.933HER2-aIncludes HR+, TNBC and HR unknown patients.6.6 [7.0]9.0 [13.4]0.408a Includes HR+, TNBC and HR unknown patients. Open table in a new tab Conclusions: In this study of adult women with HER2- ABC, low BRCA testing rates were observed. Patients with BRCAm were significantly more likely to utilize chemotherapy relative to BRCAwt. Mean duration of 1st line therapy was numerically lower among patients with BRCAm. With the advent of new treatment options, additional studies are warranted to validate these findings. Legal entity responsible for the study: Pfizer. Funding: Pfizer. Disclosure: A. Niyazov: Employee, stockholder: Pfizer; R.G.W. Quek: Employee, ownership interest: Pfizer. All other authors have declared no conflicts of interest.