tbuckley/cabot-search huggingface dataset:
Sentinel node research in early gastric cancer.
Authors: Luisa Quaresma, Alexandra Pupo, Teresa Pimentel, Gualdino Silva, Mario Oliveira, Mateus Marques, Jorge Esteves, Ligia Bruno Da Costa, Guedes Da Silva, Antonio Caldeira Fradique
Journal: Journal of Clinical Oncology (2014)

e15064 Background: The definition of a sentinel node is the first lymph node that is in the line of the drainage of a identified tumor. It is assumed that if this lymph node is negative for tumor cells the remaining lymph nodes will also be negative. This concept has been successfully and widely developed and applied in breast and melanoma tumors. In the beginning of XXI century, the Japanese began to use and apply the concept of sentinel lymph node to gastric cancer. In the great majority of the studies the number of cases studied were small, they referred only to the protocol or to a single institution with a wide variety of protocols. From a total of 50 studies published 30 of them came from Japan. The objective of this study is to apply the sentinel node technology into the surgery of patients with gastric cancer stages T1/T2, N0. Methods: Use of green indiocianina in sub serosa injection close to the tumor. Injection into a square of four points into the peritumoral sub serosa, identification and excision of the colored lymph nodes 5 minutes after the injection. The surgical protocol included D2 dissection in all patients. Results: (See Table.) Conclusions: The use of green indocianina as a method to the identification of the sentinel node in gastric carcinoma showed good results. This is an area of very promising study results (very challenging), this could bring enormous advantages in the staging and in the choice of individualized therapy of gastric carcinoma. This study has been pioneered in Portugal. STAGE Nº of sentinel nodes Total Nº of lymph nodes pT2N0 5 30 pT1aN0 1 38 pT2N0 2 33 pT3N0 6 51 pT1aN0 5 48 pT1aN0 8 62 pT1bN1 2 65
Abstract 20038: Left Atrial Scar Predicts Left Atrial Appendage Dysfunction
Authors: Yan Dong, Prasongchai Sattayaprasert, Sonya Dhanvanthari, Ohad Ziv
Journal: Circulation (2017)

Introduction: Atrial fibrillation (Afib) may be a symptom of atrial myopathy and the rhythm itself may not explain patients’ risk for stroke. Left atrial appendage (LAA) dysfunction and low flow ha...
Increased circulating levels of VEGF-C to predict outcome in resectable gastric cancer patients.
Authors: Fernando De Vita, Michele Orditura, Maria Maddalena Laterza, Alessio Fabozzi, Jole Ventriglia, Beatrice Savastano, Angelica Petrillo, Guido Giordano, Valentina Gambardella, Erika Martinelli, Fortunato Ciardiello
Journal: Journal of Clinical Oncology (2014)

4080 Background: Vascular Endothelial Growth Factor C (VEGF-C), is a VEGF growth factor family member playing a key-role in lymphangiogenesis. It is overexpressed in 30-60% of gastric cancer patients, showing a strong correlation with an advanced stage and a poor survival. Based on this background we investigated the meaning of serum levels of VEGF-C in gastric cancer patients suitable for surgery. Methods: Preoperative VEGF-C serum levels were determined by enzyme-linked immunoadsorbent assay (ELISA) in 183 patients with gastric carcinoma and 51 healthy subjects (control group) observed at our department from January 2008 until December 2012. Results: Patients characteristics were the following: median age was 64 years (range 22 - 91), the male/female ratio was 115/68. The stage at diagnosis was 1A: 2.2%, 1B: 10.9%, 2A: 13.1%, 2B: 11.5%, 3A: 25.1%, 3B: 15.3%, 4: 21.9%. 29% of patients showed a proximal primary site of tumor, 32.2% a middle and 38.8% a distal primary site localization. Preoperative VEGF-C serum levels were significantly higher in gastric cancer patients (mean, 295 pg/mL; range, 55–865 pg/mL) if compared with the control group (mean, 30 pg/mL; range, 11.8– 60,2 pg/mL; P< 0.001). High VEGF-C serum levels correlated with nodal diffusion: in fact, node positive patients showed significantly higher levels (mean, 339 pg/mL – 95% C.I, 307.4 – 370.6; P< 0.001) when compared to node negative ones (mean 93 pg/mL – 95%C.I, 72 – 114; P<0.001). Moreover, preoperative VEGF-C serum levels were significantly lower in patients who underwent curative surgery (248.7 pg/mL, range: 54.9 – 865.2 pg/mL) compared with patients who underwent palliative surgery (mean 461.1 pg/mL, range: 120.5 - 805.8; P < 0.001). Pearson correlation analysis demonstrated a significant negative correlation between preoperative VEGF-C serum levels and OS (Pearson correlation -0.281; Sig.2 tails 0,001). Finally at multivariate analysis elevated serum VEGF-C levels were an independent prognostic factor in our population. Conclusions: Our data obtained in this setting suggest that increased serum VEGF-levels appear as a poor prognostic factor correlating with a wide nodal involvement, a palliative surgery, and a worse overall survival.
Association between rituximab use and progressive multifocal leukoencephalopathy among non-HIV, non-Hodgkin lymphoma Veteran’s Administration patients.
Authors: LeAnn B. Norris, Peter Georgantopoulos, Gowtham A Rao, Kathlyn Sue Haddock, Charles L. Bennett
Journal: Journal of Clinical Oncology (2014)

e19540 Background: Progressive multifocal leukoencephalopathy (PML) is a rare, fatal disease that results from activation of a highly prevalent, dormant JC virus during immunosuppressed states. Rituximab, a CD20 monoclonal antibody immunomodulator, has been approved for non-Hodgkin's lymphoma (NHL). Methods: Using electronic medical records from the Veteran's Administration (VA); ICD-9 codes were used to identify patients diagnosed with NHL, PML, and HIV within the VA from 2003 to 2011. Pharmacy records were used to identify patients receiving rituximab, cyclophosphamide, hydroxydaunorubicin, and vincrisitne. This project was conducted inside the Veterans Affairs Informatics and Computing Infrastructure after obtaining approvals from the VA IRB and other oversight groups. Results: We identified 57,041 non-HIV NHL patients. A total of 14/57,041 (0.025%) patients had developed PML; 7/8,895 (7.8 per 10,000) NHL patients who received rituximab subsequently developed PML while 7/48,146 (1.5 per 10,000) NHL patients who did not receive rituximab subsequently developed PML, which results in a statistically significant unadjusted relative risk of 5.4 (95% CI: 1.9 - 15.4). Univariate analyses of other outcomes were not statistically significant between patients who received and those that did not receive rituximab (Table). Conclusions: These results show that among lymphoma patients, the use of rituximab is associated with a statistically significant relative risk for documented PML of 5.4. Measurement of JC virus prior to initiation of rituximab therapy as well as during rituximab therapy should be considered. PML patients with rituximab (n=7) PML patients without rituximab (n=7) Male (%) 7 (100) 7 (100) Died (%) 6 (85.7) 6 (85.7) Mean age in years at death (sd) 65.1 years (6.9) 67.3 years (6.6) Mean age at PML diagnosis (sd) 65.5 years (6.7) 68.7 years (7.3) Mean time to death from lymphoma diagnosis (sd) 34.0 mo (17.8) 26.6 mo (27.5) Mean time to death from PML diagnosis (sd) 5.1 mo (8.6) 3.0 (3.9) Mean time to PML diagnosis from lymphoma diagnosis (sd) 36.2 mo (27.6) 31.0 mo (31.7) Mean time to PML diagnosis from first rituximab dose (sd) 14.9 mo (22.8) N/A
Johnson &amp; Johnson knew for decades talcum powder contained asbestos, reports allege
Authors: Owen Dyer
Journal: BMJ (2018)

Executives at Johnson & Johnson repeatedly discussed their worries about the potential health effects of asbestos contamination of their talcum Baby Powder even as they told regulators and the public that all their tests were finding none, investigations by Reuters and the New York Times show.

Reuters reported on 14 December that it had examined thousands of pages of company memos and other internal documents provided to plaintiffs’ lawyers in ongoing talcum powder litigation.1 Many of the documents have not yet been used in court or were designated confidential by court order, it said.

The company’s share price fell by 10% within hours of the investigation being published. Although it earns less than 1% of Johnson & Johnson’s revenue, Baby Powder is an iconic product for …
A feasibility and safety study of vaccination with poly-ICLC and peptide-pulsed dendritic cells in patients with metastatic, locally advanced unresectable, or recurrent pancreatic adenocarcinoma.
Authors: Steve Hsukwo Chin
Journal: Journal of Clinical Oncology (2014)

e15254 Background: Survival for the pancreatic adenocarcinoma (PC) patients is poor with 5-year survival rate ~6% for all stages combined. Therefore, new therapeutically approaches are urgently needed. Methods: In this protocol, we generated autologous DCs from peripheral blood monocytes of patients with PC and pulsed the DCs with three immunogenic epitopes expressed by PC cells, namely HLA-A2-restricted peptides derived from human telomerase reverse transcriptase (hTERT, TERT572Y), carcinoembryonic antigen (CEA; Cap1-6D) and survivin (SRV.A2). The novel design of this trial lies in using DCs pulsed with multiple epitopes along with concomitant administration of Poly-ICLC, a Toll-like receptor 3 ligand. Four injections of DC vaccines every 2 weeks with Poly-ICLC. The immune response was measured at each time point of injections by enumerating both phenotype and functions of the effector T cells in a total of 12 patients. Results: A total of 12 patients were enrolled: 4 male and 8 female. Ten patients were with metastatic PC and 2 patients presented with locally advanced unresectable PC. Primary objective of this study was to assess safety and feasibility, whereas the secondary objective was to determine overall survival, response rate and immunologic response after vaccination. Toxicity was assessed by CTC AE v4.0 and efficacy by RECIST 1.1 criteria. Total of 8 patients were evaluable for toxicity and response. On day 56, 3 patients had stable disease and 5 patients had disease progression. No Grade 3 or 4 treatment related SAE or AE. Grade 1-2 AEs: fatigue (most common), myalgia, fever, injection site reaction, chill, night sweat, hot flashes and abdominal pain. The immunomonitoring data from this study shows an effective expansion in anti-tumor T cells at day 56 (i.e. 14 day after last injection, follow up range 14-56 days). Conclusions: Vaccination with Poly-ICLC and peptide-pulsed dendritic cells appears to be safe and able to induce a measurable tumor specific T cell population in patients with PC. The immunomonitoring data combined with clinical outcome will be used to design future autologous cell therapeutic trial. Clinical trial information: NCT01410968.
Survival of adolescents and young adults (AYAs) with skeletal Ewing sarcoma: A Dutch population-based study.
Authors: S.E.J. Kaal, Winette T.A. Van Der Graaf, Carola J. C. Van Aart, Gerhard A. Zielhuis, Katja K. H. Aben
Journal: Journal of Clinical Oncology (2014)

10530 Background: Ewing sarcoma is most prevalent among children and adolescents. Although increasing age in general is associated with poorer survival, little is known about survival in adolescents and young adults (AYA: 15-39 years) compared to children (0-14 yrs). Methods: In this cohort study data from all patients diagnosed with skeletal Ewing sarcoma between 1989 and 2011 were obtained from the Netherlands Cancer Registry. Patients were divided in three age groups: children (age 0-14), AYAs (age 15-39) and older adults (age 40+). One, 3 and 5 year overall survival (OS) estimates by age group were determined and sex, period (1989-1994 vs 1995-2000, 2001-2006, 2007-2011), site (axial vs extremity) and stage (with or without metastases) adjusted Hazard Ratios (HR) and 95% Confidence Intervals (95%CI) were calculated using a Cox Proportional Hazard Regression model. Results: In total 180 children, 247 AYAs, and 29 older adults with skeletal Ewing sarcoma were identified. AYAs appear to be more often male compared to children (64% and 53% respectively, Chi2 p-value=0.02) and were more often diagnosed with metastatic disease (31% and 22% respectively, Chi2p-value=0.05). Five-year OS for AYAs was 46% (95%CI: 39-52%) compared to 68% (95%CI: 60-74%) in children and 33% in older adults (95%CI: 16-50%). Table shows 1, 3 and 5 year OS survival data. AYAs have an almost twofold increased risk of death compared to children; the gender, site, stage, and period adjusted HR was 1.9 (95%CI 1.4-2.6) for AYAs compared to children. Conclusions: As compared to children AYAs with skeletal Ewing sarcoma more often are male, present with metastatic disease at diagnosis and have a worse survival even after adjustment for tumor stage, site, gender and treatment period. Since detailed data about treatment were not available, no conclusion can be drawn about the effect of treatment on survival. Furthermore, differences in tumor biology should be considered. 1, 3, and 5 years OS percentages (with 95% confidence intervals) in patients with skeletal Ewing sarcoma. Age group 1 yr OS 3 yr OS 5 yr OS Children 94 % (90-97) 73% (66-79) 68% (60-74) AYAs 87% (82-91) 50% (44-57) 46% (39-52) 40 + 66% (45-80) 38% (20-55) 33% (16-50)
Sentinel node location and patient survival in trunk and extremity melanoma.
Authors: Daniela Gordon, Karin E Smedby, Inkeri Schultz, Henrik Olsson, Johan Hansson, Christian Ingvar, Peter Gillgren
Journal: Journal of Clinical Oncology (2014)

e20006 Background: Patients with cutaneous melanoma (CM) on the trunk have a worse prognosis than those with extremity CM. One reason could be multiple or uncommon (outside axilla or groin) sentinel node locations (SNL). Methods: We identified 859 patients that underwent sentinel node biopsy for trunk (n=465) or extremity (n=394) CM in three Swedish health care regions 2000 to 2008. We collected patient-, tumor- and sentinel node characteristics through clinical registers and medical records. We investigated the distribution of SNL in a logistic regression model, and risk of overall and melanoma-specific death through 2011 in a multivariable Cox regression model. Results: Trunk CM was associated with multiple SNL (31% vs 7%, Odds Ratio [OR] 7.1; 95% Confidence Interval [CI] 4.6-11.5; p<0.001) but not uncommon SNL (8% vs 7%, OR 1.1; CI 0.6-1.9; p=0.75), compared with extremity CM. The increased risk of melanoma-specific death was confirmed for trunk CM (Hazard Ratio [HR] 1.9; CI 1.3-2.9; p=0.003), especially on the upper back (HR 2.3; CI 1.4-3.6; p<0.001), compared with extremity CM. Uncommon SNL (HR 0.5; CI 0.2-1.4; p=0.21) or multiple SNL (HR 1.1; CI 0.4-2.9; p=0.81) were not associated with melanoma-specific death, compared with those with common/single SNL. Conclusions: Trunk melanomas were associated with multiple lymph drainage, but the worse prognosis of trunk melanomas could not be explained by the increased frequency of multiple, or uncommon SNL.
Microscopic residual carcinoma at interval debulking surgery after neoadjuvant chemotherapy in patients with IIIc/IV Müllerian carcinoma.
Authors: Kyoko Nishikimi, Shinichi Tate, Kazuyoshi Kato, Takako Kiyokawa, Makio Shozu
Journal: Journal of Clinical Oncology (2014)

5567 Background: Neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) is a treatment option in patients with bulky stage IIIC/IV müllerian carcinoma. Because disseminated tumors may have disappeared macroscopically following chemotherapy, a potential drawback of IDS is difficulty deciding which sites should be excised. We therefore evaluate microscopic residual carcinoma after NAC in each previously disseminated site. Methods: Fifty patients with stage IIIc /IV müllerian carcinoma with a poor general condition, or those with a widely metastatic tumor and extensive ascites who had an unresectable residual tumor at the time of initial laparotomy, were included in the study. At the time of the initial laparotomy, we performed either a salpingo-oophorectomy or biopsy only, and then marked the residual tumors >1 cm with silk sutures. We then recorded the site and size of the tumors and placed an implantable port system (IPS) in the pelvis for peritoneal washing cytology during NAC (platinum/taxane). IDS was performed after the patients were shown to be IPS-cytology negative. At the time of IDS, we excised the initially marked site even if the tumors were macroscopically negative, and then investigated whether or not microscopic residual carcinoma was present in each disseminated site. Results: Forty-one patients (38 high-grade serous carcinomas, 3 other histological types) underwent IDS (39 complete resection, 2 with residual tumor <1 cm). Microscopic examination revealed residual carcinoma in each site as follows: 82% (28/ 34) in the recto-uterine pouch/rectosigmoid colon, 71% (5/7) in the ileocecal area, 69% (20/29) in the paracolic gutters, 65%(15/23) in the small intestine and mesentery, 63% (5/8) in the transverse mesocolon, 57% (20/35) in the vesicouterine pouch, 53% (19/36) in the right diaphragm, 53% (18/34) in the lymph nodes, 50% (3/6) in the hepatic capsule, 44% (8/18) in the splenic capsule, and 40% (6/15) in the left diaphragm. Conclusions: Our results suggest that it is necessary to excise all sites during IDS after NAC in patients with a disseminated tumor >1 cm at the initial exploratory laparotomy, but with negative peritoneal cytology. Clinical trial information: UMIN000013079.
Shared Decision Making Rarely Happens for Lung Cancer Screening
Authors: Claudia C. Dobler
Journal: JAMA Internal Medicine (2019)

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SAT0716-HPR Patients preference goes to methotrexate autoinjectors over prefilled syringes: results from a phase iii trial, selfi
Authors: A. Saraux, C. Hudry, E. Zinovieva, H. Herman-Demars
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The offer of injectable MTX in Europe expanded during past few years with different types of enhanced devices such as prefilled syringes and autoinjector pens. <h3>Objectives</h3> SELFi trial intended to compare historical MTX prefilled syringes <i>vs</i> a new MTX autoinjector in terms of treatment adherence, functional capacity and patients’ preference at 6 months in RA patients. <h3>Methods</h3> SELFi was a phase III, randomised open-label trial, conducted in France between Sept. 2015 and March 2017. It included RA patients, treated by oral or injectable MTX for ≥3 months (monotherapy or association). Patients were randomised in two arms: MTX in prefilled syringes (PS) or MTX in autoinjectors (AI) at the dosage decided by the investigator. Primary objectives of the trial were to prove the 4% non-inferiority of AI <i>vs</i> PS in terms of patients’ adherence and functional capacity (HAQ-DI) at 6 months. Secondary objectives included the evaluation of satisfaction and patients’ preference. <h3>Results</h3> Between Sept. 2015 and ,Sept. 2016 50 rheumatologists, mostly in private practice, included 271 patients, 197 of which composed the <i>per protocol</i> population. Patients baseline characteristics were [mean (±SD)]: age: 59.2 (±12.3) yrs; BMI: 26.0 (±4.9) kg/m²; RA duration: 5.35 (±6.70) yrs; DAS28: 3.1 (±1.2); HAQ-DI: 0.6 (±0.6). All patients were treated by MTX (1/3 oral; 2/3 parenteral) at a mean dose of 15.4 (±4.1) mg/wk. There were no significant differences at baseline between PS and AI arms. At 6 months, the treatment adherence was over 95% for both arms, and HAQ-DI was improved by a mean of 0.05 in both arms. The AI 4% non-inferiority as compared to PS was shown for both primary criteria. Patients’ reported satisfaction was very significantly higher (p≤0.001) in AI arm<i> vs</i> PS for the following criteria: easy to use, pleasant, satisfying, willingness for further utilisation and significantly higher (p&lt;0,05) for reassuring and not constraining. Of the 132 patients who experienced both devices (during the study or before it), 127 (96%; p&lt;0.001) preferred the auto injector over the historical prefilled syringe. No unexpected safety issues were observed during this trial and injection point safety tolerance satisfaction was higher for AI <i>vs</i> PS. <h3>Conclusions</h3> SELFi trial showed that although the new MTX autoinjector is comparable to historical prefilled syringe in terms of treatment adherence and functional capacity improvement, it is significantly superior in terms of patients’ satisfaction. Over 95% of patients who have tried both devices report preferring the pen. <h3>Disclosure of Interest</h3> A. Saraux Consultant for: Nordic Pharma, C. Hudry Consultant for: Nordic Pharma, E. Zinovieva Employee of: Nordic Pharma, H. Herman-Demars Employee of: Nordic Pharma
Modified DCF (mDCF, docetaxel cisplatin 5FU) for patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN) unfit to DCF: A retrospective study.
Authors: Clara Delaruelle, Alexis Ambrun, Clementine Daveau, Marc Poupart, Philippe Zrounba, Eve-Marie Neidhardt, Philippe Ceruse, Antoine Ramade, Jerome Fayette
Journal: Journal of Clinical Oncology (2014)

e17018 Background: DCF is the standard chemotherapy for induction in LASCCHN. Its toxicity reserves it to younger patients (pts) without comorbidity and of PS 0-1. In gastric cancer mDCF demonstrated higher tolerability with similar and even better efficacy (ASCO 2010 abstract 4014). Can mDCF be proposed to pts with LASCCHN unfit to DCF? Methods: We retrospectively reviewed all 42 pts of two French institutions with LASCCHN who received from July 2010 to December 2013 mDCF (D and C 40 mg/m2, leucovorine 400 mg/m2, F 400 mg/m2 bolus then 1000 mg/m2/d, d1-2 followed by 3 days of G-CSF, q2 weeks) for 3 or 6 cycles. Results: Pts had advanced disease with 23 stages 4A and 10 stages 4B. Median age was 60 years [44-85]. Localizations: oral cavity (21%), oropharynx (31%), hypopharynx (29%) larynx (17%), node without known primary (2%). mDCF was chosen due to age>70 years (10 pts) severe denutrition (3 pts), comorbidities or PS>1 (25 pts) or after severe toxicity of standard DCF (4 pts). Induction was proposed for organ preservation in 29 pts. The total number of cycles delivered was 177, the median 4. Toxicity was studied in the 4 first cycles (for a total of 140; after no particular toxicity was observed): 2 pts died due to toxicity, 10 secondary hospitalizations were required and 17 pts stopped treatment due to toxicity. After induction 2 pts died during radiotherapy. The response rate was 93% with 24% complete response and 69% partial response. With a median follow-up of 9.2 months at the time of last news, 22 pts were alive with no evidence of disease, 4 died during treatment, 4 died of non-cancer related trouble, and 12 pts progressed with 8 deaths. Conclusions: mDCF is effective in terms of response rate compared with the standard DCF for patients unfit to DCF. This regimen could become a new option in induction for LASCCHN in pts >70 years, PS>1, with comorbidities or denutrition or after severe toxicity of DCF. This schedule deserves further investigations in this population of poor prognosis.