tbuckley/cabot-search huggingface dataset:
Analysis of patients with locally advanced NSCLC after induction therapy: Importance of nodal downstaging, and prognostic factors for survival.
Authors: Jose Antonio Lopez-Vilariño, Manuel Domine, Francisco Lobo, Ana Leon, Victoria Casado, Gustavo Rubio, Jose Ignacio Martin Valades, Yann Izarzugaza, Juan Luis Arranz, Miriam Dorta, Victor Moreno, Gloria Serrano, Cristina Carames, Tatiana Hernandez, Irene Moreno, Jose Zapatero, Pablo Fernandez, Paul Karagounis, Ignacio Muguruza, Jesus Garcia-Foncillas
Journal: Journal of Clinical Oncology (2014)

e18528 Background: NSCLC locally advanced still remains controversial with regard to their treatment. Stages III-A and III-B not N3 are susceptible of receiving induction chemotherapy prior to surgery. Previous studies confirms nodal downstaging in N2 patients as the main prognosis factor of survival. Our objective is to analyze the characteristics of these patients and to define survival prognostic factors, mainly in N2 patients. Methods: Retrospective, observational study of patients treated with induction therapy between 2005 and 2013. We also include those who finally not were operated due to progression during induction or conditions of inoperability. Results: 52 Patients have been included. 50 smokers and 2 not. Medium pack year 45 (10-120). 28 patients had adenocarcinoma, 6 large-cell carcinoma and 18 squamous cell carcinoma. 28 tumors were located in RUL, 6 in RLL, 9 in LUL, 5 in LLL and 4 were hilar. 48 patients received platinum-based doublet CT and 4 CT/RT treatment. 42 patients were N2 confirmed by mediastinoscopy, 7 were T4N0, 2 T4N1 and 1 T2N3. They were achieved by radiological criteria 1 CR (1.9%), 26 PR (50%), 12 SD (23.1%) and 13 patients PD (25%). 34 patients (65.4%) were selected for surgery, although 2 were rejected by inoperability. 23 lobectomies (72%), 7 pneumonectomies (22%), 1 segmentectomy (3%) and 1 atypical resection (3%) were performed. 2 patients (6.2%) died in the perioperative period . 2 complete responses were observed in pathological analysis (6.3%), 16 (50%) partial responses and 14 stable diseases (43.75%). Median PFS was 9.36 months (5.9-12.7 and median of OS was 19.1 months (15.1-23). 23 Patients N2 underwent surgery and 14 (60.9%) downstage nodal status. Survival at 18 months was significantly higher in the downstaging group (66.7% vs. 16.7%). Multivariate analysis showed as independent predictors of survival downstaging (p = 0.00493), non-squamous histology (p = 0.0367) and clinical response to treatment (p = 0.0005). Conclusions: Downstaging continues to be the main prognostic factor for survival in patients undergoing induction therapy prior to surgery. Survival is also better in patients with clinical response to treatment.
Response to: ‘Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis’ by Wu<i>et al</i>
Authors: Elien A M Mahler, Michiel J M Minten, Mathilde M Leseman-Hoogenboom, Philip M P Poortmans, Jan Willem H Leer, Simone S Boks, Frank H J van den Hoogen, Alfons A den Broeder, Cornelia HM van den Ende
Journal: Annals of the Rheumatic Diseases (2019)

We thank Wu et al for their interest in and encouragement of our randomised studies in which we found no substantial beneficial effect on symptoms and inflammatory signs of low-dose radiation therapy (LDRT) in patients with knee and hand osteoarthritis (OA).1–3 The authors emphasise that our results inevitably force involved clinicians to re-examine the true effectiveness of LDRT on OA in real-world clinical practice. However, they addressed two constructive concerns related to our work, to which we will reply hereby.

The first point addresses the heterogeneity of the participants reflecting a real-world population, that is, patients with clinical diagnosis of knee OA after failure of conservative treatment options. Wu et al suggest that randomisation stratified by an objective measure for severity of knee OA (eg, K&L scores) might be preferable to the numeric rating scale for pain to stratify patients. We do not agree on this point because we hypothesised that LDRT would primarily improve clinically relevant OA symptoms including pain and disfunctioning. Accordingly, the …
Carboplatin-based chemoradiotherapy in advanced cervical cancer: An alternative to cisplatin-based regimen?
Authors: Ana Morais Sebastião, Lucila Soares Da Silva Rocha, Rodrigo Darouche Gimenez, Inacelli Queiroz De Souza Caires, Samantha Cabral Severino da Silva, Laryssa Almeida Borges de Barros, Julia Tizue Fukushima, Vanessa Costa Miranda, Dr Elias Abdo Filho, Daniela Freitas, Maria Del Pilar Estevez-Diz
Journal: Journal of Clinical Oncology (2014)

5604 Background: Cisplatin based chemoradiotherapy (cis-RT) is the standard treatment in locally advanced cervical cancer (CC). Carboplatin chemoradiotherapy (carbo-RT) has not been validated in prospective phase III studies, although it is used in the presence of renal impairment, advanced age or comorbidities. Methods: Retrospective analysis of patients (pts) with CC stage IIB-IVA consecutively treated at Instituto do Cancer do Estado de Sao Paulo from May/2008 to December/2012. Primary endpoint was PSF and secondary OS and ORR (CR + PR). Survival was assessed by Kaplan-Meier curves, compared by the log-rank test, frequencies were compared by chi-square test Results: We analyzed 184 pts, 159 treated with cis-Rt and 25 carbo-RT. All received whole pelvic region external-been RT (45Gy and boost-12-14Gy- followed by brachytherapy-4x700cGy). Chemo was weekly cis (40mg/m2) or carbo (AUC2). Median age was 50.42 (21-80) in cis-RT and 64.18y (42-83) in carbo-RT. Most pts have squamous cell carcinoma and ECOG 0-1. Carbo-RT pts have more advanced disease: 52% stage IIIb-IVA vs 36.1% in cis-RT. At least one comorbidity was present in 41.8% in cis-RT and 84% in carbo-RT pts. Five or more chemo cycles were applied 87.3% in cis-RT and 84% pts in carbo-RT (p=0.749). PFS at 3 y was 24m in cis-RT (95% CI 18.8-29.3) vs 27.5m in carbo-RT (95% CI 25.6-29.4) (p=0.249). OS in 3y was 30.3m (95% CI 26.2-32.7) in cis-RT pts and 31.4m in carbo-RT (95% CI 29.9-32.9) (p=0.298). ORR (95.3% vs 95.4%) (p=0.911) and grade ≥ 3 toxicities (8.5% cis-RT vs 11.8% carbo-RT) (p=0.757) were similar. In multivariate analysis, only the ORR was a significance predictor of survival Conclusions: Patients with advanced CC treated with carbo-RT have no different 3 year OS, PFS ORR and toxicities when compared to cis-RT. Carbo-RT may be a treatment alternative in patients that could not receive cisplatin
Survival disparities and trend of head and neck cancer in the United States: A Surveillance, Epidemiology, and End Results (SEER) database study 1973-2010.
Authors: Shahzad Raza, Gautam Kishore Kale, Lata M. Aluri, Akm Mosharraf Hossain
Journal: Journal of Clinical Oncology (2014)

6066 Background: Despite recent advances in the management of head and neck cancer (HNC), there is little evidence of improvement in 5-year overall survival (OS) over the last few decades. Ethnicity, age, and socioeconomic status have all been associated with outcomes in HNC. We examine the survival disparities and trends of HNC in major ethnicities using the largest population based database. Methods: Frequency, rate and survival sessions (Kaplan-Meier, age adjusted) on demographics and survival trends were performed and compared among Non-Hispanic-White (NHW), African-American (AA), Hispanics, Asians and Pacific-Islanders (A/PI) and Asian-Indian and Alaskan-Natives (AI/AN) with SEER*Stat using SEER 1973-2010 data. Results: A total of 247,310 HNC patients were reported from 1973-2010 in SEER database. The primary sites were lip (11%), Tongue (27%), floor of mouth (8%), gum and other parts of mouth (16%), tonsils (15%), oropharynx (4%), nasopharynx (7%), hypopharynx (9%) and others (3%). Overall, 71% patients were male. The incidence rates per 100,000 were reported highest in AA (16.4) compare to NHW (15.3), Hispanics (9.6), A/PI (9.7), and AI/AN (7.8). There were 40% stage IV cases which were equally distributed across all ethnicities. After adjusting for age, stage and year of treatment, AA has significantly (p<0.05) inferior 5-year OS (41.8%) compared to NHW (60.8%), Hispanics (59.3%), A/PI (62%) and AI/AN (50.2%).The OS rates in A/PI and AI/AN have improved by 17.5% and 14.6% (p<0.05) over last 37 years respectively. In contrast, the AA had 6.1% decreased OS (p<0.05) from 1973 to 2010. In subset analysis, OS for stage IV in AA is poor (21%) compare to other ethnicities (p<0.001). Conclusions: According to SEER analysis, the OS in AA has decreased significantly from 1973 to 2010 and they continue to have dismal prognosis. The underlying causes are largely unknown. However, biologic/genetic and epigenetic factors, access to health care, socioeconomic status may play a role. Prospective studies are needed to define these factors in AA and to formulate treatment strategies that would improve survival outcome in AA.
Abstract 13091: Relaxation and Calcium Cycling in Isolated Contracting Myocardium From Patients With Hypertensive Heart Disease and Heart Failure With Preserved Ejection Fraction
Authors: K. E Runte, Stephen Bell, Donald E Selby, Martin M LeWinter, Bradley M Palmer, Markus F Meyer
Journal: Circulation (2016)

Prolonged myocardial relaxation is believed to play an important role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF). An impairment of cellular Ca 2+ extrusion in diastole may contribute to this delay in relaxation. We investigated relaxation characteristics and cellular Ca 2+ - and Na + -handling in intact, contracting myocardial strip preparations dissected from epicardial biopsies obtained from patients with hypertensive heart disease (HHD) with and without HFpEF. Relaxation time parameters (at rates of 60/min and 180/min), cellular Ca 2+ - (Fura-2) and Na + - (ANG-2) cycling were studied in 20 patients with HHD without HFpEF (HHD), 12 with HHD and HFpEF (HHD(+)HFpEF) and 26 without HHD or HFpEF, who served as referent controls (CTR). Expression levels of key ion transporters were also measured. Since Ca 2+ -handling can be pharmacologically modified, we evaluated the therapeutic potential of the Na + -influx inhibitors ranolazine (10μM), furosemide (50μM) and amiloride (50μM) to accelerate relaxation. Compared with controls, the time to half maximal relaxation at 60/min was prolonged in both HHD and HHD(+)HFpEF (CTR: 263±5ms, HHD: 295±12ms, HHD(+)HFpEF: 296±11ms; p=0.01 and p&lt;0.01, respectively). When the stimulation rate was increased to 180/min, this prolongation resulted in incomplete relaxation manifested as increased diastolic force in both HHD (26±3%, p=0.01) and HHD(+)HFpEF (33±9%, p=0.01). This finding was associated with an increase in diastolic Ca 2+ (Fura-2: 28±6%; p&lt;0.01) and a minor increase in Na + (ANG-2: 0.5±0.2%; p=0.05). Expression levels of Ca 2+ - and Na + -handling proteins were not different between the groups. None of the pharmacologic agents accelerated relaxation or improved incomplete relaxation at high heart rates. We conclude that relaxation is prolonged in isolated myocardium from patients with HHD and HHD(+)HFpEF. An impairment of diastolic Ca 2+ removal appears to play a role in incomplete relaxation at higher heart rates. This functional deficit is not due to changes in expression levels of key transporters or regulatory proteins and was not improved by pharmacologic inhibition of Na + -influx.
Safety of percutaneous, image guided biopsy in a series of children and young adults with pediatric sarcomas.
Authors: Matthew Wright
Journal: Journal of Clinical Oncology (2014)

e21026 Background: Tumor biopsies are increasingly utilized in the research setting to identify patients eligible for trial, to validate molecularly targeted therapies, or to confirm target inhibition by investigational agents. As a result, there has been growing interest in the use of biopsies for research endpoints in pediatric studies of targeted therapies. However, little has been published on the feasibility, risk, or outcome of tumor biopsies, particularly in the pediatric population. Here we report safety and feasibility of percutaneous biopsies undertaken in a recent immunotherapy protocol for pediatric and young adult patients with sarcomas. Methods: Patients with pediatric sarcomas were enrolled on an IRB approved protocol and underwent protocol-directed, image-guided biopsy in order to obtain tumor lysate for use as a component in a dendritic cell vaccine. The biopsy safety and efficacy data were obtained on chart review at the completion of accrual of all patients. Results: Nineteen pediatric patients (age range 6-17yo) and fifteen adult patients (age range 18-35yo) underwent image-guided biopsy. Tumor procurement included multiple core needle biopsies (n= 2), fine needle aspirations (FNA) (n= 11), or both (n= 20). The majority of the biopsies involved tumors of the bone or soft tissue; however, four tumors in the thoracic cavity and five in the abdominal cavity were biopsied. Of the 31 biopsies that involved an FNA, an average of 11 passes were performed. Of the 22 biopsies that involved a core needle biopsy, an average of 4 passes were performed. Adverse events included one episode of fluid-responsive hypotension due to anesthesia, and 6 patients who reported Grade 1 pain the day following procedure. Of the 35 biopsies performed in 34 patients, 2 biopsies did not yield enough protein to create the tumor vaccine. Conclusions: FNA and core needle biopsies were found to be safe in this experience of 35 percutaneous, image-guided biopsies of sarcomas in pediatric and young adult patients. This is despite the use of multiple passes to obtain adequate tissue. These results suggest that biopsies may be performed safely for research endpoints in molecularly targeted trials for pediatric solid tumors. Clinical trial information: nct00923351.
Pretreatment neutrophil to lymphocyte ratio and prognosis of patients with advanced hepatocelullar carcinoma treated with sorafenib.
Authors: Leonardo Gomes Fonseca, Romualdo Barroso-Sousa, Bruna Paccola Blanco, Gabriel Luis Valente, Maria Ignez Freitas Melro Braghiroli, Tulio Eduardo Flesch Pfiffer, Jorge Sabbaga, Paulo Marcelo Hoff
Journal: Journal of Clinical Oncology (2014)

e15144 Background: Inflammation has a critical role in tumor biological behavior. In particular, neutrophil-lymphocyte ratio (NLR), an inflammation index, has been shown to influence clinical outcome in solid tumors. Published data suggest that an elevated NLR may correlate with poor prognosis in patients with hepatocellular carcinoma (HCC) who underwent transarterial chemoembolization or liver transplant. The aim of this study was investigate the prognostic significance of NLR of patients with advanced HCC treated with sorafenib. Methods: We retrospectively evaluated 105 patients with advanced HCC who received sorafenib as initial systemic treatment between July 2009 and November 2013. NRL was calculated from the ratio of peripheral blood absolute neutrophil and lymphocyte counts before treatment. Patients were divided into NLR ≤3.5 and >3,5. Kaplan-Meier method was used for survival analysis and multivariate analysis was performed by Cox regression. Results: The median age was 59.7 years (19-80.2), 75 (71.4%) were male, 91 (86.7%) were PS 0-1, and 89 (84.8%) had preserved liver function (Child-Pugh A). Extrahepatic spread was found in 60 (57.1%) and vascular invasion in 53 patients (50.5%). Hepatitis C, B and alcohol were preexisting in 33.3%, 20% and 27.6% of patients, respectively. Initial dose of sorafenib was 800mg/day in 88.6%. The median duration of treatment was 100 days (83-116) and median pretreatment NLR was 3.4. For the entire cohort, the median overall survival (OS) was 8.03 months (95% CI 5.13-10.93). Median OS of patients with NLR>3.5 (n=53) was 6.33 months (95% CI 4.49-8.17) compared with 15.44 months (6.93-23.86) for patients with NLR≤3.5 (n=52). In univariate analysis, NLR>3,5 was significantly associated with decreased overall survival (p=0,003). After adjustment for distant metastasis, vascular invasion, performance status, initial dose and Child-Pugh score, high NLR was an independent prognostic factor for OS (p=0,002). Conclusions: Our results support the idea that NLR may be a predictor of poor prognosis in patients with advanced HCC treated with sorafenib, and may serve as a cost-effective and broadly avalilable independent prognostic biomarker.
The Role of Imaging in Measuring Disease Progression and Assessing Novel Therapies in Aortic Stenosis
Authors: Mhairi K. Doris, Russell J. Everett, Matthew Shun-Shin, Marie-Annick Clavel, Marc R. Dweck
Journal: JACC. Cardiovascular imaging (2019)

Aortic stenosis represents a growing health care burden in high-income countries. Currently, the only definitive treatment is surgical or transcatheter valve intervention at the end stages of disease. As the understanding of the underlying pathophysiology evolves, many promising therapies are being investigated. These seek to both slow disease progression in the valve and delay the transition from hypertrophy to heart failure in the myocardium, with the ultimate aim of avoiding the need for valve replacement in the elderly patients afflicted by this condition. Noninvasive imaging has played a pivotal role in enhancing our understanding of the complex pathophysiology underlying aortic stenosis, as well as disease progression in both the valve and myocardium. In this review, the authors discuss the means by which contemporary imaging may be used to assess disease progression and how these approaches may be utilized, both in clinical practice and research trials exploring the clinical efficacy of novel therapies.
Post-ASCT Outcomes in Multiple Myeloma Patients Who Underwent ASCT with G-CSF+Plerixafor Versus G-CSF Mobilized Graft
Authors: Harsh Shah, Seongho Kim, Paramveer Singh, Asif Alavi, Lois Ayash, Voravit Ratanatharathorn, Joseph P. Uberti, Abhinav Deol
Journal: Blood (2018)
Randomized Phase II/III Study of Standard R-CHOP Versus CHOP Combined with Dose-Dense Weekly Rituximab (RW-CHOP) for Previously Untreated DLBCL: JCOG0601
Authors: Ken Ohmachi, Tomohiro Kinoshita, Kensei Tobinai, Gakuto Ogawa, Tomonori Mizutani, Nobuhiko Yamauchi, Noriko Fukuhara, Toshiki Uchida, Kazuhito Yamamoto, Kana Miyazaki, Norifumi Tsukamoto, Shinsuke Iida, Takahiko Utsumi, Isao Yoshida, Yoshitaka Imaizumi, Takashi Tokunaga, Shinichiro Yoshida, Yasufumi Masaki, Tohru Murayama, Yoshihiro Yakushijin, Youko Suehiro, Kisato Nosaka, Nobuaki Dobashi, Junya Kuroda, Yasushi Takamatsu, Dai Maruyama, Kiyoshi Ando, Kenichi Ishizawa, Michinori Ogura, Tadashi Yoshino, Tomomitsu Hotta, Kunihiro Tsukasaki, Hirokazu Nagai
Journal: Blood (2018)
Adjuvant treatment of completely resected stage IB-IIIA non-small-cell lung cancer. A retrospective study with cisplatin or carboplatin and oral vinorelbine.
Authors: Friederike Sophie Magnet, Nina Alten, Andreas Bachinger, Walburga Engel-Riedel, Corinna Ludwig, Erich Stoelben
Journal: Journal of Clinical Oncology (2014)

e18505 Background: Adjuvant chemotherapy is the standard treatment for early stage non-small-cell lung cancer (NSCLC) patients after complete resection. The most evidence-based data exist for the combination of cisplatin (cis) and vinorelbine (vrb), whereas carboplatin (carbo) can be administered as combination partner in cis-unfit patients. To analyze effectiveness and tolerability of platinum-based combination therapy with predominantly oral vrb in daily practice we performed a retrospective study in our hospital. Methods: Data from 152 patients with completely resected NSCLC (stage IB-IIIA) receiving adjuvant chemotherapy with cis or carbo in combination with intravenous or oral vrb (Navelbine Oral) between March 2005 and November 2011 were retrospectively analyzed. Results: Patients were on average 61 years old and diagnosed with stage IB (35%), IIA (5%), IIB (38%) or IIIA (22%) NSCLC. 66% of the patients were male, and 93% were former or active smokers. Vrb was predominantly administered orally (89%) and most patients received carbo (74%). The combination treatment was effective with an estimated 5-year survival of 62% (cis/vrb: 62%, carbo/vrb: 62%) and recurrence-free survival after five years of 61% (cis/vrb: 63%, carbo/vrb: 60%). Toxicities (all grades) related to combination therapy mainly concerned the hematologic system with 70% leukopenia (carbo/vrb: 74%), 32% thrombocytopenia (carbo/vrb: 40%), 40% anemia, 28% neutropenia, and 5% febrile neutropenia. The treatment caused nausea and vomiting in 47% and 23% of the patients (cis/vrb: 59% and 28%), respectively, and fatigue was reported for 23% of the patients. Of note, overall 64% of the patients (carbo/vrb: 71%, cis/vrb: 44%) completed combination therapy with the planned number of cycles. Conclusions: The results of this retrospective study are in line with clinical trials of cis in combination with intravenous vrb and show that adjuvant chemotherapy of a platinum-based combination therapy with vrb is effective. Carbo was better tolerated than cis resulting in superior treatment compliance and comparable effectiveness.
Problem list documentation and surveillance mammography: Can meaningful use be useful?
Authors: Francine L Maloney, Aymen Elfiky, Adam Wright
Journal: Journal of Clinical Oncology (2014)

e17696 Background: The electronic health record problem list (ePL) plays important roles in clinical decision support and communication with consequent improved care delivery. Despite established national guidelines, 20-55% of breast cancer survivors do not receive routine surveillance imaging. We established the correlation between ePL documentation and surveillance imaging for breast cancer (BC) survivors per ASCO guidelines. Methods: The Dana-Farber/Partners Cancer Center Registry was used to identify women diagnosed with BC at Dana-Farber/Brigham and Women’s Hospital (DF/BWH) between 1/1/01 to 12/31/06. We excluded subjects with age > 85, male gender, bilateral mastectomy, or stage IV disease at diagnosis. Additional exclusions for each analysis year were diagnosis of a new primary, disease recurrence, death or loss to follow-up. Using information integration and protocol-based checking we then queried the Partners Healthcare system to determine whether a five year annual surveillance mammogram or MRI was obtained beginning 18 months after diagnosis in accordance with published ASCO guidelines. An analysis was conducted to determine whether demographic disparities, AJCC stage, or structured ePL documentation of BC attributed to differences in surveillance mammography. Results: During the study period 4,068 women were diagnosed with BC at DF/BWH. During each 1-year post-therapy surveillance period, an average of 75.3% women received surveillance imaging. Among the 2,030 for whom data was analyzed for all 5 years of follow-up, 4.7% had no annual surveillance imaging, 7.9% had 1, 6.3% had 2,7.3% had 3, 18.4% had 4, and 55.4% had all 5. After adjusting for age, language, race, income, marital status and AJCC stage, the ePL documentation of BC was significantly associated with surveillance imaging (p=0.02). Compared to patients who have no problem list documentation of BC, those who had it added at any time during the study period were more likely to have surveillance imaging all five years (OR 1.40; 95% CI 1.05-1.86). Conclusions: Electronic documentation of BC is significantly associated with 5-years of surveillance imaging in accordance with published guidelines, even after controlling for demographic variables.