tbuckley/cabot-search huggingface dataset:
Radiologic Considerations and Standardization of Malignant Pleural Mesothelioma Imaging Within Clinical Trials: Consensus Statement from the NCI Thoracic Malignancy Steering Committee – International Association for the Study of Lung Cancer – Mesothelioma Applied Research Foundation Clinical Trials Planning Meeting
Authors: Ritu R. Gill, Anne S. Tsao, Hedy L. Kindler, William G Richards, Samuel G. Armato, Roslyn J. Francis, Daniel R. Gomez, Suzanne Dahlberg, Andreas Rimner, Charles B. Simone, Marc de Perrot, Gideon Blumenthal, Alex A. Adjei, Raphael Bueno, David H. Harpole, Mary Hesdorffer, Fred R. Hirsch, Harvey I. Pass, Ellen Yorke, Kenneth Rosenzweig, Bryan Burt, Dean A. Fennell, Wolf Lindwasser, Shakun Malik, Tobias Peikert, Aaron S. Mansfield, Ravi Salgia, Haining Yang, Valerie W. Rusch, Anna K. Nowak
Journal: Journal of Thoracic Oncology (2019)

Detailed guidelines pertaining to radiological assessment of malignant pleural mesothelioma are currently lacking due to the rarity of the disease, complex morphology, propensity to invade multiple planes simultaneously, and lack of specific recommendations within the radiology community about assessment, reporting, and follow-up. In March 2017, a multidisciplinary meeting of mesothelioma experts was co-sponsored by the National Cancer Institute Thoracic Malignancy Steering Committee, International Association for the Study of Lung Cancer, and the Mesothelioma Applied Research Foundation. One of the outcomes of this conference was the foundation of detailed, multidisciplinary consensus imaging and management guidelines. Here, we present the recommendations for radiologic assessment of malignant pleural mesothelioma in the setting of clinical trial enrollment. We discuss optimization of imaging parameters across modalities, standardized reporting, and response assessment within clinical trials.
Randomized study of capecitabine versus S-1 in women with metastatic or recurrent breast cancer: Japan Breast Cancer Research Network (JBCRN) 05 trial.
Authors: Daigo Yamamoto, Satoru Iwase, Chizuko Yamamoto, Yu Tsubota, Takuhiro Yamaguchi
Journal: Journal of Clinical Oncology (2013)

1111 Background: Capecitabine and S-1 are orally administered fluorinated pyrimidines with high-level activity against metastatic breast carcinoma (MBC). Methods: This randomized multicenter phase II study was conducted to investigate the activity and safety of two oral fluoropyrimidines, capecitabine and S-1, in breast cancer patients. Patients with MBC were randomly assigned to receive capecitabine at 1,657 mg/m 2 two times daily on days 1–21 every 4 weeks, or S-1 at 40–60 mg two times daily according to the body surface area on days 1–28 every 6 weeks. Results: One hundred and forty-two patients were enrolled, and 136 patients were randomized to capecitabine (N=71) or S-1 (N=65). The median progression-free survival, the primary end-point, was 1.4 years for capecitabine and 1.3 years for S-1, with a hazard ratio (S-1/ capecitabine) of 0.85 (95%CI: 0.52-1.38) (log-rank p = 0.5). The confirmed ORR for both populations was 24.0% for capecitabine and 23.1% for S-1(p = 0.938). The median OS was 3.5 years for capecitabine and 2.7 years for S-1; the hazard ratio (S-1/ capecitabine) was 1.32 (95% CI: 0.7–2.48) (p = 0.39). Further, the most common treatment-related adverse events were grade 1/2 in intensity. However, there were more adverse events, thrombocytopenia (p = 0.040, S-1: 9.2%, capecitabine: 1.4%), and nausea (p = 0.079, S-1: 26.2%, capecitabine: 14.1%) in the S-1 group. Hand–foot syndrome occurred in the S-1 and capecitabine groups (p = 0.029, S-1: 10.8%, capecitabine: 25.4%). Conclusions: The results of the current study demonstrate that S-1 or capecitabine is an effective and well-tolerated treatment in patients with MBC. In addition, they are convenient and orally administered drugs, which makes them attractive agents for use in outpatient treatment. Clinical trial information: NCT 00438100.
Trends in the use of bone agents in metastatic cancer.
Authors: Jurgen Wilhelm Kogler, William J. Hrushesky, Dinah Huff, Laura Rose Bobolts, Akhil Kumar, William S. Shimp, James Edward Krook, Val Fishman, Sharon Davis, Carol Anthony, Robert Walton, Marc L. Fishman
Journal: Journal of Clinical Oncology (2013)

e20672 Background: Bone modifying agents have been shown to delay and/or prevent skeletal-related events for a range of cancers metastatic to the bone. Various studies have identified pamidronate, zoledronic acid, and denosumab as bone modifying agents, each of which confers clinical benefit. The convenience of administration and costs of these agents differ greatly. Administration spans vary from roughly 2 hours for IV pamidronate, 15 minutes for IV zoledronic acid, and minimal time for subcutaneous denosumab. The estimated cost for a single dose of pamidronate, zoledronic acid, and denosumab are $29, $890, and $1,712, respectively. Methods: All requests for pamidronate, zoledronic acid, and denosumab authorization submitted by practicing oncologists within southeast Florida were tabulated for 2010, 2011, and 2012. Comparisons for both frequency of use and cost over time were made using ANOVA and Chi Square; p&lt;0.05 for significance. Trends were assessed by linear regression. Results: 895 requests for pamidronate, zoledronic acid, or denosumab were examined over this three year span. The use of bone modifying agents for metastatic cancer is increasing rapidly, as treatment request totaled 171, 269, and 455 for all three agents, pamidronate, zoledronic acid, or denosumab, in 2010, 2011, and 2012, respectively. Zoledronic acid requests significantly increased (p&lt;0.001) per year between 2010 and 2011, as with 2011 and 2012. Denosumab requests are also increasing steadily and sharply in 2012. Conclusions: Each of these three agents has demonstrated clear efficacy in delaying or preventing second skeletal events among patients with metastatic cancer already involving bone. Toxicities among these three agents are comparable in the vast majority of eligible cancer patients. Relative costs should be carefully considered when choosing which agent to use as the use of these agents in general is increasing rapidly and will have a major impact upon overall cancer care costs. [Table: see text]
The association of plasma TGFβ1 during radiotherapy and genotypes of TGFβ1 pathway in patients with non-small cell lung cancer.
Authors: Shuanghu Yuan, Jinming Yu, Xuwei Cai, Feng-Ming (Spring) Kong
Journal: Journal of Clinical Oncology (2012)

e21115 Background: Radiation induced thoracic toxicities (RITT) in lung, esophagus and pericardium are dose-limited toxicities in patients with non-small cell lung cancer (NSCLC). Plasma transforming growth factor-beta1 (TGFβ1) and its change during radiotherapy was reported as a biomarker and single nucleotide polymorphisms (SNP) in TGFβ1 pathway was associated with RITT in our previous studies. In order to explore the mechanism of RITT, we tested whether plasma TGFβ1 was associated with genotypes of TGFβ1, tissue plasminogen activator (tPA) and angiotensin converting enzyme (ACE). Methods: Patients with stage I-III NSCLC enrolled in prospective clinical trials were eligible. All patients received radiotherapy with or without concurrent chemotherapy. Platelet-poor plasma was obtained pre-RT and at 4–5 weeks (40–50 Gy) during RT. Plasma TGF-β1 was measured using an enzyme-linked immunosorbent assay. The DNA samples extracted from blood before treatment were analyzed for the following genetic variations: TGFβ1 509C/T, TPA -7351 C/T, and ACE I/D. Results: 76 NSCLC patients received definitive radiotherapy (median dose 66 Gy) were enrolled. For the entire group of patients, the mean pre-RT TGFß1 level was 10.7±2.3 ng/ml, and the mean during-RT TGFß1 level was 6.0±0.7 ng/ml. No significant TGFß1 level differences were found at pre-RT and during-RT in patients with different genotypes of TGFß1 and tPA. Only ACE DD group had marginally higher pre-RT TGFß1 level than II and ID group (DD 23.6ng/ml vs. II 9.0ng/ml vs. ID 7.5ng/ml, p = 0.05), but no difference at during-RT(p=0.346) or during-RT/pre-RT ratio(p = 0.433). However, patients with TGFß1 509CC had higher elevation of plasma TGF ß1 level at fourth week during-RT than T allele carriers (TGFß1 level ratio of during-RT/pre-RT were CC 1.4±0.2 vs. T allele carriers 0.7±0.1, p=0.047). Conclusions: This exploratory study demonstrated that patients with TGFß1 509CC had higher elevation of plasma TGF ß1 level at fourth week during-RT than T allele carriers. This can help explain the correlation of TGF ß1 level elevation and higher risk of radiation induced lung toxicity in patients with NSCLC.
Nonsteroidal Anti-Inflammatory Drugs
Authors: John A. Mills
Journal: New England Journal of Medicine (1974)

THE nonsteroidal anti-inflammatory agents include some of the most widely used drugs in the Western world. Although their number is constantly being augmented by pharmaceutical research, relatively few of the agents that have been demonstrated to have anti-inflammatory activity are clinically useful. Many, but not all, of the agents also have valuable analgesic and antipyretic effects. Although it is probable that each of these actions is brought about by related mechanisms, in this review their anti-inflammatory activity will be considered primarily.Of the many conditions for which nonsteroidal anti-inflammatory agents are used, the rheumatic diseases are the most serious. Because . . .
Should point-of-care ultrasonography replace stethoscopes in acute respiratory failure?
Authors: Nicholas Smallwood, Ashley Miller, Andrew Walden, Mark Hew, Tunn Ren Tay, Najib M Rahman
Journal: BMJ (2019)

Ultrasonography would be a better diagnostic test than auscultation or chest radiography, say <b>Nicholas Smallwood and colleagues</b>. But <b>Mark Hew and colleagues</b> argue the costs are hard to justify without evidence that it would improve patient outcomes
Access to Urologic Care Through Clinical Integration in a Large, Underserved Population
Authors: Stephanie Chu Pannell, Sophia Monica Soni, Paul Giboney, Alvaro Santamaria, Jonathan Bergman
Journal: JAMA Surgery (2019)

patient volume and rate of thoracotomies performed at level I centers, 3 it is possible that greater experience in treatment may have resulted in better outcomes.With regard to patients who underwent SNOM, while statistically significant, the absolute difference was 0.6%.As a result, it is difficult to correlate clinically.Further studies are necessary to assess this finding and determine the reasons behind the difference in risk of mortality.Limitations to our study include lack of data on the location of stab wounds contributing to variation in management, clinician experience, time from injury to arrival, personnel availability, variations in SNOM, and number of stab wounds.Conclusions | This study demonstrates that patients with torso stab wounds treated at level I centers have a lower risk of mortality when treated with thoracotomy or SNOM, compared with patients at level II centers.Future prospective research is needed to evaluate these findings and support the institution of optimal prehospital trauma designation for this population.
Organic Nervous Diseases.
Journal: JAMA (1903)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
A vaccine-induced gene expression signature correlates with protection against SIV and HIV in multiple trials
Authors: Philip K. Ehrenberg, Shida Shangguan, Biju Issac, Galit Alter, Aviva Geretz, Taisuke Izumi, Christopher Bryant, Michael A. Eller, Frank Wegmann, Richard Apps, Matthew Creegan, Diane L. Bolton, Rafick P. Sekaly, Merlin L. Robb, Robert A. Gramzinski, Maria G. Pau, Hanneke Schuitemaker, Dan H. Barouch, Nelson L. Michael, Rasmi Thomas
Journal: Science Translational Medicine (2019)

Current HIV vaccines are only partially efficacious, presenting an opportunity to identify correlates of protection and, thereby, potential insight into mechanisms that prevent HIV acquisition. Two independent preclinical challenge studies in nonhuman primates (NHPs) previously showed partial efficacy of a mosaic adenovirus 26 (Ad26)-based HIV-1 vaccine candidate. To investigate the basis of this protection, we performed whole transcriptomics profiling by RNA sequencing (RNA-seq) in sorted lymphocytes from peripheral blood samples taken during these studies at different time points after vaccination but before challenge. We observed a transcriptional signature in B cells that associated with protection from acquisition of simian immunodeficiency virus (SIV) or the simian-human immunodeficiency virus (SHIV) in both studies. Strong antibody responses were elicited, and genes from the signature for which expression was enriched specifically associated with higher magnitude of functional antibody responses. The same gene expression signature also associated with protection in RV144 in the only human HIV vaccine trial to date that has shown efficacy and in two additional NHP studies that evaluated similar canarypox-based vaccine regimens. A composite gene expression score derived from the gene signature was one of the top-ranked correlates of protection in the NHP vaccine studies. This study aims to bridge preclinical and clinical data with the identification of a gene signature in B cells that is associated with protection from SIV and HIV infection by providing a new approach for evaluating future vaccine candidates.
Analysis of financial sustainability of survivorship clinics led by advanced practice providers.
Authors: Maria Alma Rodriguez, Guadalupe R. Palos, Katherine Ramsey Gilmore, Paula A. Lewis-Patterson, Patricia Chapman, Weiqi Bi
Journal: Journal of Clinical Oncology (2019)

11560 Background: Disease specific Survivorship Care Clinics (SCs) have been established within a comprehensive cancer center. Clinics are staffed by Advanced Practice Providers (APPs), Physician Assistants and Advanced Practice Registered Nurses, with experience in the management of each disease type. To determine the sustainability of this model of survivorship care, we analyzed the professional fees’ revenue generated by APPs’ billings for 6 clinics and then compared the APPs’ salaries across all clinics. Methods: A retrospective analysis was conducted of 6 survivorship clinic’s patient volumes and clinic days supported by APPs from 9/1/16-4/30/17. The full FTE salary of the APPs, including benefits were prorated to the time dedicated to each of the SCs. Institutional financial data was used to align professional fees to actual reimbursements received. Salary recovery percentage was calculated as the ratio of reimbursement received to prorated FTE salary. Results: Table shows variation in APPs’ salary commensurate to FTE proportion. Results also indicate there was an average of 99% professional fee recovery. Clinics with an FTE proportion &gt; 0.5 had recovery higher than the anticipated prorated salary, suggesting there is a threshold to maximize efficacy and sustainability. Conclusions: APPs professional fees for care provided to cancer survivors are reimbursable, across disease types or payers, and proportionally supports their salaries. Our findings suggest delivery models based on APPs to manage care of long-term survivors can be self-supporting.[Table: see text]
Pathologic response rates after neoadjuvant therapy for sarcoma.
Authors: Gautam A. Shrivastava, John Stewart Jarboe, Awad Ahmed, Sheila Ann Conway, Juan Pretell, Laura M. Freedman, Aaron Howard Wolfson, Andrew Rosenberg, Jonathan C. Trent, Raphael Yechieli
Journal: Journal of Clinical Oncology (2019)

11060 Background: Treatment approaches for soft-tissue sarcomas (STS) vary across sarcoma centers of excellence. A multi-institutional study showed neoadjuvant doxorubicin and ifosfamide (AI) surpassed other agents in recurrence-free survival of several sarcoma subtypes. Our institution manages high-grade STS of the extremity and trunk with neoadjuvant chemotherapy (NA-CTX), neoadjuvant radiation (NA-XRT), or neoadjuvant sequential chemoradiation (NA-CRT) followed by oncologic resection and adjuvant chemotherapy. We report the pathologic (%) necrosis in 48 patients comparing NA-XRT, NA-CTX, and NA-CRT. We also investigated initial clinical outcomes correlated with % necrosis. Methods: We reviewed records of patients who received neoadjuvant therapy for sarcoma over the last four years at our center. We required a pathology report that detailed % necrosis in the specimen. We excluded the same histologies according to RTOG 9514 and RTOG 0630 protocols. There were 48 patients evaluable. The primary regimens compared were NA-CTX, NA-XRT, and NA-CRT before oncologic resection. After determining the mean % necrosis and SE for each group, we determined statistical significance through one-way ANOVA with post-hoc Tukey HSD Test. Kaplan-Meier Analysis was used to compare rates of % necrosis with OS, LC, and DF. Radiation therapy was 50Gy in 25 fractions over 5 weeks. The most common preoperative chemotherapy regimen was 3-4 cycles of AI. Results: Whole cohort evaluation found significant improvement in % necrosis with sequential NA-CRT (78%) compared to NA-CTX (51%, p = 0.049), but a trend when compared to NA-XRT (45%, p = 0.075). Evaluation of patients only receiving neoadjuvant AI revealed significantly improved % necrosis with NA-CRT (83%) compared to either NA-CTX (44%, p = 0.011) or NA-XRT (45%, p = 0.031). At a MFU of 1.6 years we found a non-significant trend toward improved outcomes with higher % necrosis [at 70%, OS (HR = 0.11), LC (HR = 0.34), and DF (HR = 0.61)]. Conclusions: In patients diagnosed with high-grade STS of the extremity or trunk, sequential NA-CRT followed by surgery yields greater % necrosis in tumors when compared to NA-CTX or NA-XRT alone. Longer follow up is required to determine if pathologic response correlates with improved outcomes.
Localized Treatment with Oncolytic Adenovirus Delta-24-RGDOX Induces Systemic Immunity against Disseminated Subcutaneous and Intracranial Melanomas
Authors: Hong Jiang, Dong Ho Shin, Teresa T. Nguyen, Juan Fueyo, Xuejun Fan, Verlene Henry, Caroline C. Carrillo, Yanhua Yi, Marta M. Alonso, Tiara L. Collier, Ying Yuan, Frederick F. Lang, Candelaria Gomez-Manzano
Journal: Clinical Cancer Research (2019)

Intratumoral injection of oncolytic adenovirus Delta-24-RGDOX induces efficacious antiglioma immunity in syngeneic glioma mouse models. We hypothesized that localized treatment with the virus is effective against disseminated melanomas.We tested the therapeutic effect of injecting Delta-24-RGDOX into primary subcutaneous (s.c.) B16-Red-FLuc tumors in s.c./s.c. and s.c./intracranial (i.c.) melanoma models in C57BL/6 mice. Tumor growth and in vivo luciferase-expressing ovalbumin-specific (OT-I/Luc) T cells were monitored with bioluminescence imaging. Cells were profiled for surface markers with flow cytometry.In both s.c./s.c. and s.c./i.c. models, 3 injections of Delta-24-RGDOX significantly inhibited the growth of both the virus-injected s.c. tumor and untreated distant s.c. and i.c. tumors, thereby prolonging survival. The surviving mice were protected from rechallenging with the same tumor cells. The virus treatment increased the presence of T cells and the frequency of effector T cells in the virus-injected tumor and mediated the same changes in T cells from peripheral blood, spleen, and brain hemispheres with untreated tumor. Moreover, Delta-24-RGDOX decreased the numbers of exhausted T cells and regulatory T cells in the virus-injected and untreated tumors. Consequently, the virus promoted the in situ expansion of tumor-specific T cells and their migration to tumors expressing the target antigen.Localized intratumoral injection of Delta-24-RGDOX induces an in situ antovaccination of the treated melanoma, the effect of which changes the immune landscape of the treated mice, resulting in systemic immunity against disseminated s.c. and i.c. tumors.
Medical Implications of Computed Tomography (“CAT Scanning”)
Authors: Herbert L. Abrams, Barbara J. McNeil
Journal: New England Journal of Medicine (1978)

THE introduction of computed tomography (CT) has stimulated the interest of both the medical profession and the nonmedical public. Its importance to physicians in the evaluation of patients with brain disease was rapidly established: neurologists and neurosurgeons who had CT available soon found that their method of practice was markedly changed. As medical enthusiasm mounted, however, public resistance to this expensive new technology became apparent, particularly among those responsible for funding health care. Recent papers have dealt with the distribution and planning of CT,1 cost implications1 2 3 4 and quantitative limitations of the information base associated with its rapid diffusion.4 The implications . . .
Balanced Crystalloids versus Saline in Sepsis. A Secondary Analysis of the SMART Clinical Trial
Authors: Ryan M. Brown, Li Wang, Taylor D. Coston, Nathan I. Krishnan, Jonathan D. Casey, Jonathan P. Wanderer, Jesse M. Ehrenfeld, Daniel W. Byrne, Joanna L. Stollings, Edward D. Siew, Gordon R. Bernard, Wesley H. Self, Todd W. Rice, Matthew W. Semler
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

Administration of intravenous crystalloid solutions is a fundamental therapy for sepsis, but the effect of crystalloid composition on patient outcomes remains unknown.