tbuckley/cabot-search huggingface dataset:
Basal subtype and clinical estrogen receptor status of genomically basal breast tumors in Caucasian, African American, and Latin American patients.
Authors: Virginia G. Kaklamani, Cathy Graham, Karen L. Tedesco, Abirami Sivapiragasam, Jennifer A. Crozier, Apurva N. Shah, Andrea Menicucci, Shiyu Wang, Michelle L Bolner, Erin Yoder, William Audeh
Journal: Journal of Clinical Oncology (2020)

556 Background: Genomically basal-type breast cancer is a heterogenous subtype that occurs at higher frequencies in non-Caucasian patients. Triple negative breast cancer (TNBC) has been refined into distinct transcriptomic groups including the basal-like immunoactive (BLIA), basal-like immunosuppressed (BLIS), luminal androgen receptor (LAR), and mesenchymal (MES) subtypes. Here we report the distribution of triple negative subtypes in genomically basal cancers from Caucasian (CA), African American (AA), and Latin American (LA) patients and the association of clinical estrogen receptor (ER) status. Methods: The FLEX Registry (NCT03053193) is an ongoing, prospective study evaluating primary tumors from patients with stage I-III breast cancer who receive the 70-gene signature and 80-gene signature (80-GS) molecular testing and consent to clinically annotated full transcriptome data collection. This sub-analysis evaluated 143 80-GS Basal type tumors from patients with self-reported ethnicity (60 CA, 59 AA, 24 LA). TNBC subtypes BLIA, BLIS, LAR, and MES were derived using an adjusted version of the 80-gene centroid signature published by Burstein and colleagues (2015). Differences in clinical ER expression between ethnicities were assessed by Fisher’s exact test. Results: Basal indices from 80-GS were not influenced by patient ethnicity (one-way ANOVA, p = 0.182). The frequency of BLIA, BLIS, LAR, and MES subtypes did not vary significantly by ethnicity (Fisher’s exact test, p = 0.671). The majority of tumors in all ethnic groups were BLIS (67% CA, 75% AA, 63% LA), followed by BLIA (22% CA, 22% AA, 25% LA), with low frequency of LAR (5% CA, 1.7% AA, 8.3% LA) and MES (5% CA, 1.7% AA, 4.2% LA) subtypes. Nearly one third (31%) of Basal type tumors were defined by IHC as ER positive and were present in all TNBC subtypes (39% BLIA, 29% BLIS, 33% LAR, and 20% MES); ER receptor expression ranged from 1-90% and was not associated with specific basal subtype (p = 0.8) nor ethnicity (P = 0.76). Progesterone receptor expression ranged from 1-50%. Conclusions: This analysis demonstrated that genomic Basal type tumor classification by 80-GS encompasses all TNBC subtypes evaluated regardless of ethnicity. Additionally, we show that IHC ER positive tumors occur in all TNBC subtypes assessed. These findings confirm the heterogeneous nature of basal breast tumors in CA, AA, and LA patients and highlight the clinical need to delineate basal biology in the ER+ cohort to advance treatment for basal-like tumors. Clinical trial information: NCT03053193 .
2型糖尿病胰岛素治疗的新理念及起始治疗方案
Authors: 王静
Journal: BMJ (2010)

胰岛β细胞功能受损早在糖耐量异常阶段已经存在,当进一步发展为2型糖尿病(T2DM)时,胰岛β细胞功能只有原来的50%,其后胰岛β细胞功能逐渐衰竭至丧失[1].早期应用胰岛素治疗取得良好的血糖控制对保护胰岛β细胞功能、防治T2DM并发症、改善患者预后具有重要意义.因此,胰岛素疗法已不是T2DM患者晚期所采用的迫不得已的治疗方法,对严重高血糖的早期T2DM患者进行适当的胰岛素治疗,短期内有效控制高血糖逆转糖毒性对胰岛细胞的损害,已成为目前治疗T2DM的新趋势。
Efficacy of microvascular decompression for treating trigeminal neuralgia and hemifacial spasm
Authors: Tao Li, Yapeng Cheng
Journal: BMJ (2017)

Ninety nine patients with trigeminal neuralgia (TN, n=59) or hemifacial spasm (HFS, n=40) underwent microvascular decompression (MVD ) treatment in our hospital from January 2012 to December 2015, and were followed up for more than 1 year. Total 94 patients (94.9%) were cured after the surgery, including 55 TN cases (93.2%) and 39 HFS cases (97.5%). The 1-year follow up showed that total 98 patients (99.0%) were cured, including 58 TN cases (98.3%) and 40 HFS cases (100.0%). Among the HFS cases, 1 patient got gentle spasm, 1 patient got hearing deficit, 1 patient got light facial palsy after the operation, and all recovered completely during the follow-up. Among the TN cases, 4 patients got pain attack infrequently after the operation, 3 of them recovered during the follow-up, and the symptoms were satisfactorily controlled by taking carbamazepine in rest 1 case. No cases had cerebrospinal fluid leakage or intracerebral infection. The results indicate that MVD is an effective treatment of HFS and TN with less surgical injury or complications.


Key words: 
Trigeminal neuralgia; Microsurgery; Vascular surgical procedures
End-of-life health care utilization (EOLHCU) in patients with recurrent, metastatic head and neck squamous cell carcinoma (RMHNSCC) treated with immune checkpoint inhibitors (IO).
Authors: Cameron Chalker, Rafael Santana-Davila, Jenna M. Voutsinas, Vicky Wu, Victoria Hwang, Christina S Baik, Brittany Barber, Neal D. Futran, Jeffrey Houlton, George E Laramore, Sylvia Lee, Jay Justin Liao, Upendra Parvathaneni, Renato G. Martins, Keith D. Eaton, Cristina P. Rodriguez
Journal: Journal of Clinical Oncology (2020)

e18516 Background: Demographic and EOLHCU trends are undefined in the growing population of IO-treated RMHNSCC; we sought to study these in a single institution retrospective study. Methods: We identified 228 RMHNSCC pts who received ≥1 IO dose between 01/2013 and 12/2018; of these, 74 were deceased with accessible EOLHCU data such as advanced care plan documentation (ACPD) or evidence of systemic therapy or ER/hospital/ICU admission within 30 days of death (DOD). Demographic, tumor and treatment data were obtained. Overall survival (OS) was estimated using the Kaplan Meier method; multivariable analysis was performed using a Cox proportional hazards model. In an exploratory analysis, EOLHCU was compared to a cohort of 379 deceased thoracic malignancy (TM) pts using a chi-square test. This project was approved by our institutional IRB. Results: Median pt age was 62 (25 – 90). Most were male (56, 75%), white (60, 81%), current/former smokers (46, 62%); 34 (46%) smoked ≥10 pack years. Common primary sites included the oral cavity (28, 37.8%) and oropharynx (24, 32.4%). ECOG PS at IO initiation was 0 in 15 pts (20%,) 1 in 37 (50%), 2 in 20 (27%), 3 in 1 (1%), and unknown in 1 (1%). Of the 42 (57%) treated off-trial, 18 (42%) had an ECOG ≥ 2. 71 (95%) had prior curative intent therapy. 42 (57%) had distant metastases. Compared to TM, IO-treated RMHNSCC pts were more likely to have ACPD (66% vs. 45% p &lt; 0.01), an ED visit (42.3% vs 19.5%, p &lt; 0.01) and/or a hospital admission (42.3% vs 17%, p &lt; 0.01) within 30 DOD. There was no difference in ICU admissions within 30 DOD (9.9% vs. 8.2%, p = 0.81), ICU deaths (7% vs. 4%, p = 0.4), or systemic therapy within 7 (4.2% vs. 2.4%, p = 0.63), 14 (8.5% vs. 6.6%, p = 0.76) or 30 (25% vs 19%, p = 0.31) DOD. Among IO-treated RMHNSCC pts, multivariable analysis revealed inferior OS with worse PS (ECOG 2-3 vs. 0: HR = 7.76, p = 0.00002, 95% CI = 3.07 - 19.64; ECOG 1 vs. 0: HR = 2.97, p = 0.008, CI = 1.33 - 6.62). OS also decreased with smoking status (current/former vs. never: HR 2.18, p = 0.007, CI = 1.24-3.84). No association was observed between ECOG PS, age or smoking status at IO initiation and any EOLHCU metric. Conclusions: At our center, a significant proportion of deceased, IO-treated RMHNSCC pts had an ECOG PS ≥ 2 and an inferior OS compared to ECOG 0/1. Exploratory comparison with a non-RMHNSCC TM cohort suggests high rates of EOLHCU within 30 DOD despite ACPD, representing an opportunity for supportive care augmentation. Whether EOLHCU differs among IO vs non-IO treated RMHNSCC is unknown and merits further study.
Evaluation of immune-related adverse events in patients treated with sequential immunotherapy and tyrosine kinase inhibitor treatment in non-small cell lung cancer.
Authors: Angel Ray Baroz, Isa Mambetsariev, Jeremy Fricke, Rebecca Pharaon, Dan Zhao, Marianna Koczywas, Erminia Massarelli, Ravi Salgia
Journal: Journal of Clinical Oncology (2020)

e21562 Background: Immune-related adverse events (irAEs) have been frequently observed with non-small cell lung cancer (NSCLC) patients treated with immunotherapy (IO). The severity of irAEs in response to IO treatment may reflect antitumor response. The effect of irAEs with sequential IO and tyrosine kinase inhibitor therapies has not been fully characterized. This study aims to evaluate the irAEs in NSCLC patients who have received sequential IO and TKI treatment. Methods: A retrospective cohort of 387 NSCLC patients previously treated with IO was identified from the City of Hope Thoracic Registry (THOR) from February 2010 to January 2020. Patients had confirmed pathologic disease and received IO and TKI, either on clinical trial or as standard of care. IO-treated patients were classified into two groups: TKI vs non-TKI treated. The non-TKI IO-treated group was used to verify that outcomes are not dependent on the immunotherapy given, but rather TKI therapy. IrAEs were collected from treatment courses and assessed based on the treating physician diagnosis. Results: A total of 63 NSCLC patients received sequential IO and TKI treatment. Histology was nonsquamous in 59 (93.7%) and squamous in 4 (6.3%). Multiple lines of therapies were accounted for in each patient. IO therapies received included nivolumab (n = 30), pembrolizumab (n = 24) and atezolizumab (n = 11). Mostly frequently used TKI therapies were erlotinib (n = 43), osimertinib (n = 25), afatinib (n = 11), crizotinib (n = 10), gefitinib (n = 5), and alectinib (n = 4). IrAEs occurred in 23 patients (36.5%). 22/23 (95.7%) patients who reported irAEs received TKI treatment prior to receiving IO treatment. The most common irAEs were pneumonitis (n = 5), diarrhea (n = 4), fatigue (n = 3) and rash/pruritus (n = 3). Other irAEs included arthralgias &amp; myalgias (n = 2), new onset diabetes (n = 1) and renal insufficiency (n = 1). Conclusions: The severity of irAEs and sequential IO and TKI treatment in NSCLC patients is still not well-defined. Overall and progression-free survival were considered in this cohort. Preliminary data suggested that EGFR-TKI treated patients have low response to immune checkpoint inhibitors, but outcomes vary by allele variation. Further prospective analyses are needed to investigate the correlation of irAEs and survival outcomes with TKI-resistant NSCLC patients treated with IO. Also, treating physician’s diagnosis of irAEs exposed a need to clarify grade and severity of irAEs.
The optimal living and wellness program: Piloting a novel survivorship care model.
Authors: Stacie Corcoran, John Russell, Andrea Smith, Bridget Kelly, Jill Clayton, Bennet Stein, Kathleen Keenan, Mark E. Robson, Neil M. Iyengar
Journal: Journal of Clinical Oncology (2020)

e14003 Background: Multiple national agencies define cancer survivorship as beginning at the time of cancer diagnosis. However, traditional care models deliver “survivorship care” months or years after diagnosis, which can lead to disruption in care and “transition anxiety”. We hypothesized that an approach centered around wellbeing could be applied across the cancer continuum (starting at diagnosis) and serve as a novel survivorship care model. Methods: We developed the Optimal Living and Wellness Program, a multilevel intervention with 3 key components: 1) a centralized model that provides coordinated multidisciplinary care; 2) an individualized Wellness Plan (WP); and 3) enrollment at the time of cancer diagnosis in order to mitigate the experience of post-treatment transition. Participants complete a digital wellness questionnaire (WQ) prior to the first medical oncology consult, receive a validated algorithm-based WP reviewed by a Wellness Coordinator, and meet with a Wellness Advanced Practice Provider (WAPP) via tele-medicine. The WP consists of individualized education and referrals to indicated supportive services (e.g., nutrition, exercise physiology, financial counseling, integrative medicine). The WAPP will ultimately assume care of the patient in the post-treatment (“survivorship”) phase. We piloted this approach in patients diagnosed with breast cancer beginning in November 2019. The primary outcome is feasibility defined by completion of the WQ. Secondary outcomes include participation in the WAPP visits, attendance at referral appointments, and quality of life (QOL). Results: As of January 31, 2020, a total of 39 eligible patients with newly diagnosed breast cancer were approached. Of these, 36 (92%) have completed the WQ. All 36 participants received a WP with indicated supportive referrals and educational resources. Initial WAPP tele-visits will begin in May 2020. Qualitative data regarding patient experience and QOL will be obtained via focused interviews and feedback will be categorized in thematic domains. Conclusions: In this pilot, the majority of patients with newly diagnosed breast cancer completed a WQ in advance of their initial medical oncology visit, indicating preliminary feasibility. Patient enrollment is ongoing, and updated data including additional feasibility metrics and QOL will be presented. Earlier patient engagement and incorporation of wellness and supportive services from time of diagnosis may significantly improve the transition to post-treatment care.
Comprehensive analysis of KRAS variants in patients (pts) with pancreatic cancer (PDAC): Clinical/molecular correlations and real-world outcomes across standard therapies.
Authors: Andrew Eugene Hendifar, Edik Matthew Blais, Camille Ng, Dzung Thach, Jun Gong, Davendra Sohal, Vincent Chung, Vaibhav Sahai, Christos Fountzilas, Sameh Mikhail, Gary Gregory, Jonathan Robert Brody, Emily Lyons, Patricia DeArbeloa, Lynn McCormick Matrisian, Emanuel Petricoin, Michael J. Pishvaian
Journal: Journal of Clinical Oncology (2020)

4641 Background: Approximately 90% of PDAC tumors are driven by activating KRAS mutations. The biological and clinical impact of common KRAS variants (e.g. G12D, G12V, G12R) and less common variants (e.g. G12C, Q61H, Q61R) remains largely unknown despite the emergence of variant-specific treatment strategies. Methods: We retrospectively analyzed real-world outcomes from 1475 PDAC pts who underwent molecular profiling via the Know Your Tumor program. Overall survival (OS) and progression-free survival (PFS) were analyzed by choice of 1st line standard therapies. Outcomes in pts with specific KRAS mutations were compared against the KRAS G12D cohort using Cox regression. Based on our prior data, tumor profiles with actionable molecular findings (DDR mutations or other drivers) were evaluated separately. Results: The prognostic/predictive value of specific KRAS variants revealed differences in real-world outcomes (Table). OS was greater in pts with KRAS G12V and G12R variants, as was PFS on 5FU-Based Therapy (e.g. FOLFIRINOX) but not for Gemcitabine/nab-Paclitaxel. Opposing trends were noted for KRAS Q61. Pts with KRAS wild type tumors as well as both actionable subgroups also had an improved OS. Conclusions: In this large national dataset, we demonstrate that KRAS mutation status and specific variants appear to be prognostic as well as predictive in pancreatic cancer. [Table: see text]
Treatment of nonsyndromic hereditary gingival fibromatosis: a case report
Authors: Zhiping Li, Jian Meng, Jie Zhang, Qianping Gu
Journal: BMJ (2014)

Nonsyndromic hereditary gingival fibromatosis (HGF) was a rare hereditary condition characterized by a progressive increase in gingival tissue, simultaneously with hypertrichosis and mental retardation. The patients often had troubles with mastication, appearance and pronunciation. The measure include surgical therapy. One case of HGF was reported and its relevant literature reviewed.


Key words: 
Fibromatosis, gingival; Oral Surgical procedures
Video-assisted thoracoscopic surgery in the prone position for esophageal carcinoma
Authors: Yu-long Hou, Jian-qiang Zhao, Wei Guo, Bao Zang, De-rong Tang
Journal: BMJ (2012)

Forty one patients with esophageal carcinoma (T3N1 M0 or less) underwent video-assisted thoracoscopic surgery (VATS) in prone position for esophagectomy from September 2006 to September 2010.The postoperative outcome and survival of patients were retrospectively analyzed.The results confirmed the feasibility and safety of this minimally invasive esophagectomy performed by thoracoscopy in the prone position for patients with esophageal carcinoma.

Key words: 
Esophageal neoplasms;  Thoracic surgery, video-assisted
The oncogenic role of ARG2 in hepatocellular carcinoma.
Authors: Pin-Jen Lin, Fang-Yen Chiu, Shu-Chi Wang, Chia-Yang Li
Journal: Journal of Clinical Oncology (2020)

e16713 Background: Hepatocellular carcinoma (HCC) is the most common primary liver cancer in adult and is a leading cause of cancer-related death worldwide. In most mammals, two isoforms of arginase have been identified (ARG1 and ARG2). Clinical Data revealed that ARG2 is highly expressed in various types of cancers including HCC. However, the role of ARG2 in regulating the progression of HCC has not yet been examined. The present study aimed to examine the role of ARG2 on the progression of HCC. Methods: Cell growth and proliferation were examined by MTT assay and colony formation assay, respectively. Cell migration was determined using wound-healing assay. The expression of ARG2 and its correlated survival rate in HCC was analyzed by DriverDBv3 database. Results: Our experimental results showed that knockdown of ARG2 suppresses cell growth, colony formation and migration ability in HepG2 cells. In HCC patients, ARG2 is highly expressed in primary solid tumor and recurrence solid tumor samples comparing to solid tissue normal samples. In addition, high level of ARG2 is associated with poor overall survival in HCC patients. Conclusions: These results suggest that ARG2 plays an oncogenic role in modulating HCC progression.
Marital status and survival analysis of patients with pure mucinous breast carcinoma: A SEER population-based retrospective study.
Authors: Fan Tang, Xiaoqing Wei, Li ping Dian, Qu zhi Zhou, Rui Xu, Liping Ren, Yuzhu Zhang, Qianjun Chen
Journal: Journal of Clinical Oncology (2020)

e13598 Background: The present study was conducted to investigate the influence of marital status on survival of pure mucinous breast carcinoma(PMBC) based on surveillance, epidemiology, and end results (SEER) databases. Methods: Data were extracted from the SEER database on eligible patients diagnosed with pure mucinous breast carcinoma between 1998 and 2015. Patients were divided into married groups (including common law) and not married groups (including single[never married]/unmarried or domestic Partner、Divorced、Separated、Widowed). Survival curves were generated using the kaplan-meier method, and survival differences were estimated using the log-rank test. Multivariate Cox proportional risk models were used to assess independent risk factors for survival. Results: A total of 14972 eligible pure mucinous breast carcinoma patients were enrolled from the SEER database, including 7462(49.84%) married and 7510(50.16%) not married patients. The OS and CSS were significantly greater in married patients than not married patients (79.27 vs 62.49% for OS and 96.07 vs 93.34% for CSS, both P =0.000). Married patients were more likely to be more younger (aged≥75) (21.5% vs. 44.1%), cancer stage were even lower(stage I)(69.6% vs. 62.6%), (stage II)(28.6% vs. 33.9%), (stage III)(0.6% vs. 0.9%), (stage IV)(1.3% vs. 2.5%), more patients received breast conserving surgery(67.4% vs. 62.9%), chemotherapy(15.3% vs. 11.0%) and radiation therapy(54.3% vs. 43.1%), also no recurrent lymph node metastasis was observed(82.8% vs. 74.6%) compared to unmarried group(All P =0.000). The multivariate Cox proportional hazards model showed that marriage is an independent protective factor for OS (HR = 1.356, 95% CI: 1.271-1.446, P =0.000) and CSS (HR = 1.942, 95% CI: 1.681–2.644, P =0.000). Conclusions: Marital status was an independent prognostic indicator in PMBC patients. Research data showed that married pure mucinous breast carcinoma patients can obtain better OS and CSS than unmarried patients.
上海市浦东新区社区医务人员控烟情况调查
Authors: 徐奇, 陆勇, 傅东波
Journal: BMJ (2011)

烟草危害是当今世界最严重的公共卫生问题之一,是人类健康所面临的最大的可预防的危险因素.社区医务人员尤其全科医生是我国开展控烟人群干预最有力的实施者[1],因此了解社区医务人员控烟工作的状况,对社区医务人员开展控烟工作具有指导意义。
Changes of coagulation function and serum cytokines in patients with bee-sting poisoning
Authors: Cai-juan Yue, Jing-jing Wang
Journal: BMJ (2012)

Fifty-one patients with bee-sting poisoning were divided into slight poisoning group (n =22),moderate poisoning group (n =20) and severe poisoning group (n =9).And 30 healthy persons were selected as control group.The levels of interleukin-8 (IL-8),Von Willebrand factor (vWF),prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),thrombin time (TT) and D-dimer were measured.The levels of all parameters in slight poisoning group were no significantly different from with control group (P ＞ 0.05).The levels of PT,APTT,IL-8 and vWF were significantly higher in moderate and severe poisoning groups than those in the control group (P ＜0.01).But the levels of APTT,IL-8 and vWF in severe poisoning group were much higher than those in moderate poisoning group (P ＜0.01).The injury of vascular endothelial cell by IL-8 and vWF caused the change of coagulative function and promoted the progress of inflammation.

Key words: 
Blood coagulation disorders; Bee-sting poisoning
Brentuximab vedotin in combination with nivolumab, doxorubicin, and dacarbazine in newly diagnosed patients with advanced-stage Hodgkin lymphoma (Trial in Progress).
Authors: Judah D. Friedman, Hun Ju Lee, Linda Ho, Ian Flinn
Journal: Journal of Clinical Oncology (2020)

TPS8068 Background: Brentuximab vedotin (BV, ADCETRIS) is approved for the treatment of adults with treatment-naïve Stage III or IV cHL in combination with AVD (Connors 2017). Nivolumab is approved for treatment of adults with relapsed/refractory cHL. Both agents have been well tolerated with promising activity when combined with multi-agent chemotherapy. The combination of BV plus nivolumab was evaluated as a frontline treatment option for patients (pts) with cHL who are over 60 years and ineligible for or declined conventional combination chemotherapy (Friedberg, 2018). The ongoing study reported an ORR of 82% in 11 pts and appears well tolerated in this population. In another trial in 93 patients in the first salvage setting, the combination produced a 67% CR rate (Herrera 2018, Moskowitz 2019) and the majority of patients were able to undergo subsequent stem cell transplant. It is reasonable to expect that the combination of BV, nivolumab, A, and D (AN + AD) will result in high response rates and be well tolerated, with potentially less toxicity. Methods: SGN35-027 (NCT03646123) is a phase 2 study designed to evaluate the efficacy and safety of A+AVD when administered with growth factor prophylaxis in pts with stage III/IV cHL (Part A). Part B will evaluate the combination of AN + AD in a similar patient population. The primary objective of Part B is to estimate the CR rate at EOT in pts with treatment-naïve advanced cHL. Patients in Part B will have Ann Arbor Stage IIB/III/IV cHL or Stage IIA cHL with bulky mediastinal disease. Enrollment is ongoing in both parts of the study. Approximately 50 pts will be enrolled in Part B. All pts will be treated with BV 1.2 mg/kg, nivolumab 240 mg, doxorubicin 25 mg/m 2 , and dacarbazine 375 mg/m 2 , administered separately by IV infusion on Days 1 and 15 of each 28-day cycle for up to 6 cycles. Efficacy will be assessed by PET/CT scans at C2 and EOT. Disease assessments will be performed periodically during follow up. Disease response and progression will be assessed using Lugano with the incorporation of LYRIC (Cheson 2016). Clinical trial information: NCT03646123 .
腹腔灌洗治疗重症急性胰腺炎35例
Authors: 徐萍, 吕农华, 朱萱, 陈幼祥, 李宝莲, 蔡军峰, 王崇文
Journal: BMJ (2005)

重症急性胰腺炎(severe acute pancreatitis,SAP)发病急骤,并发症多,过去死亡率较高(40%～70%).近10年来,由于SAP诊疗技术的进步,疗效有很大提高,总的生存率在80%以上,但病死率仍达20%左右[1].我院自2000年3月至2003年11月收治的35例SAP均采用早期单管腹腔灌洗治疗,取得良好效果,现报告如下。