tbuckley/cabot-search huggingface dataset:
抽吸法治疗早孕合并顽固性宫腔积血
Authors: 李爱斌, 夏良斌, 胡静, 杨菁, 徐望明
Journal: BMJ (2009)

对早孕先兆流产常合并宫腔积血,以往治疗多采取中西医结合保胎、止血治疗,等待积血自然排出或吸收,如果积血顽固可能发展为难免流产,本研究采用抽吸法成功引流治愈早孕合并顽固性宫腔积血患者3例,现报告如下。
Surgery for unresectable stage IIIC and IV melanoma in the era of new systemic therapy.
Authors: Stephanie Blankenstein, Maureen J.B. Aarts, Franchette van den Berkmortel, Marye Boers-Sonderen, Alfonsus Johannes Maria van den Eertwegh, Margreet G. Franken, Jan Willem de Groot, John B. A. G. Haanen, Geke Hospers, Ellen Kapiteijn, Djura Piersma, Rozemarijn Van Rijn, Karijn Suijkerbuijk, Albert J. ten Tije, Astrid Aplonia Maria Van Der Veldt, Gerard Vreugdenhil, Michel W.J.M. Wouters, Alexander Christopher Jonathan Van Akkooi
Journal: Journal of Clinical Oncology (2020)

10032 Background: Over the past decade opportunities for surgical treatment in metastatic melanoma patients have re-emerged due to the development of novel systemic therapies. However, selecting patients who will benefit from surgery after systemic therapy is still difficult. The aim of this study is to present data on outcomes of surgery in patients with unresectable stage III and IV melanoma, who have previously been treated with immune checkpoint inhibitors (ICI) or targeted therapy, to provide insight in which patients may benefit from surgery. Methods: Data was extracted from the prospectively collected, nationwide, Dutch Melanoma Treatment Registry (DMTR) onunresectable stage IIIC or advanced/metastatic stage IV melanomapatients who obtained disease control with systemic therapy and underwent subsequent surgery. Disease control was defined as a complete response (CR), partial response (PR) or stable disease (SD). After disease control was achieved with systemic therapy, progressive disease (PD) was allowed as a most recent status of disease prior to surgery, to avoid excluding patients with oligoprogression. Major exclusion criteria were non-cutaneous melanoma and brain metastases. Results: Of 3959 patients in the DMTR database, 154 patients met our inclusion criteria. Of these patients, 79 (51%) were treated with ICI, 61 (40%) with targeted therapy and 9.1% with study or other treatments before surgery. The best response to systemic therapy was a CR in 5.2%, PR in 46.1% and SD in 44.2% of patients. At a median follow-up of 10.0 months (IQR 4-22) after surgery, the median overall survival (OS) had not been reached in our cohort and median progression free survival (PFS) was 9.0 months (95% CI 6.3-11.7). A multivariate cox regression analysis showed that when surgery led to CR or PR, the PFS and OS were better than if surgery led to SD or PD (p &lt; 001). Also, ICI seemed to be more favorable than targeted therapy in both PFS (median of 15 versus 7 months) and OS (median not reached versus 32 months) (p = 0.026 and p = 0.003). Conclusions: We conclude that selected unresectable stage IIIC or stage IV melanoma patients might benefit from surgery after achieving disease control with systemic therapy. Expected residual tumor after surgery could be an important selection criterion. Especially patients undergoing surgery after initial tumor response on ICI have a chance of long-term survival.
Maintenance olaparib plus bevacizumab (bev) after platinum-based chemotherapy plus bev in patients (pts) with newly diagnosed advanced high-grade ovarian cancer (HGOC): Efficacy by BRCA1 or BRCA2 mutation in the phase III PAOLA-1 trial.
Authors: Domenica Lorusso, Jean-Pierre Lotz, Philipp Harter, Claire Cropet, Maria Jesus Rubio Pérez, Christian Schauer, Takashi Matsumoto, Ignace Vergote, Nicoletta Colombo, Trine Jakobi Noettrup, Hugues Pierre Bourgeois, Andreas Schnelzer, Sandro Pignata, Yolanda Garcia, Magali Provansal, Lars Christian Hanker, Dominique Berton, Dirk Bauerschlag, Florence Joly, Isabelle Laure Ray-Coquard
Journal: Journal of Clinical Oncology (2020)

6039 Background: In PAOLA-1/ENGOT-ov25 (NCT02477644), adding the PARP inhibitor olaparib to maintenance bev after first-line platinum-based chemotherapy plus bev led to a statistically significant progression-free survival (PFS) benefit in pts with advanced HGOC (HR 0.59; 95% CI 0.49–0.72) (Ray-Coquard et al. 2019). Retrospective subgroup analysis in GOG-0218 (Norquist et al. 2018) suggested BRCA mutation (BRCAm) status did not significantly impact the PFS benefit provided by bev. We explored the efficacy of olaparib plus bev by BRCA1 mutation ( BRCA1m) or BRCA2 mutation ( BRCA2m) in PAOLA-1. Methods: PAOLA-1 is a randomized, double-blind, Phase III trial in pts with newly diagnosed, FIGO stage III–IV, high-grade serous or endometrioid OC, fallopian tube or primary peritoneal cancer receiving platinum-based chemotherapy plus bev then maintenance bev. Pts unrestricted by surgical outcome or BRCAm status and in response to first-line therapy were randomized to maintenance olaparib tablets (300 mg bid for up to 24 months) plus bev (15 mg/kg q3w for up to 15 months in total) or placebo plus bev, stratified by first-line treatment outcome and tumor BRCAm status. Investigator-assessed PFS (modified RECIST v1.1) by BRCAm was a predefined analysis. Results: Of 806 randomized pts, 160 (20%) had tumor BRCA1m, 76 (9%) had tumor BRCA2m and 1 (&lt;1%) had both. Median PFS follow-up was 24.1 and 27.4 months in BRCA1m and BRCA2m pts, respectively. At primary data cutoff, PFS was prolonged with olaparib plus bev versus placebo plus bev in BRCA1m pts and BRCA2m pts (Table). The percentage of BRCA1m pts who received olaparib plus bev and were progression-free at 1 and 2 years was 95% and 73% (vs. 70% and 29% for placebo plus bev) and for BRCA2m pts was 89% and 84% (vs. 84% and 53%) (Kaplan-Meier estimates). Conclusions: In PAOLA-1, maintenance olaparib plus bev provided a significant PFS benefit versus placebo plus bev in all pts analysed, regardless of whether they had BRCA1m or BRCA2m. The median PFS in the control arm suggests a role for bev in this subgroup and the hazard ratio versus an active control arm shows the value of adding maintenance olaparib to bev. Clinical trial information: NCT02477644. [Table: see text]
Differential effect of obesity on comorbidity risk in younger and older women with early breast cancer.
Authors: Michael Lorentsen, Allison Mary Deal, Hyman B. Muss, Yi Tang Chen, Tucker Brenizer, Shlomit S. Shachar, Kirsten A. Nyrop
Journal: Journal of Clinical Oncology (2020)

e13601 Background: Overall survival in women with early breast cancer (EBC) (Stage I-III) has made great strides over the past several decades, with survivors more likely to die from causes other than breast cancer. This study investigates the differential effect of obesity on pre-treatment comorbidity risk in younger versus older women with EBC. Methods: This is a retrospective chart review of women with EBC, age 21 and older, seen at a single institution. Differences in 18 common comorbidities were assessed by age ( &gt; = 65 vs &lt; 65) and Body Mass Index/BMI ( &gt; = BMI 30 vs &lt; 30), with relative risks (RR) estimated from log-binomial regression. Results: In a sample of 590 women, 24% were age 65+, 32% non-white, and 39% had obesity. Patients age 65+ were more likely to report 2+ comorbidities compared to age &lt; 65 (RR 1.62, 69% v 43%). Obese patients (BMI &gt; = 30) were more likely to report 2+ comorbidities compared to BMI &lt; 30 (RR: 1.73, 66% v 38%). Women with obesity were more likely to have hyperlipidemia (RR: 1.85, 28% v 15%) as well as diabetes (RR: 2.51, 17% v 7%). The impact of BMI on comorbidity risk (2+ v &lt; 2) differed by age group (interaction p &lt; 0.001). In the &lt; 65 group, obese patients were more likely to have 2+ comorbidities compared to non-obese (RR: 2.12, 62% v 29%, p &lt; 0.0001). The difference was not as large in the 65+ group (RR: 1.28, 81% v 63%, p = 0.02). Conclusions: This study demonstrates increased comorbidity burden, including hyperlipidemia and diabetes, in women with obesity and EBC, especially those &lt; 65. Providers should ensure that patients with obesity and EBC are appropriately screened and treated for underlying comorbidities. Future research should assess the impact of weight loss on overall survival in EBC patients.
Efficacy of mirror therapy for stroke patients with hemiplegia
Authors: Xiuli Sun, Guojin Hu, Lihuizi Sun, Chao Geng, Li Zhang
Journal: BMJ (2017)

Objective
To evaluate the efficacy of mirror therapy for stroke patients with hemiplegia.


Methods
Eighty stroke patients with hemiplegia were randomly divided into study group and control group with 40 cases in each group. Conventional rehabilitation training was given to patients in both groups; patients in study group were given additional mirror therapy for 24 weeks. The Fugl-Meyer Assessment (FMA) scale was used to assess the motor function, Functional Independence Measurement (FIM) scale to assess the activity of daily living, Modified Barthel Index to assess the ability of daily living, Brunnstrom Stage Scale to evaluate the states of the upper extremities, and the modified Ashworth Scale to evaluate muscle spasticity before and after 24-week treatment.


Results
After 24 weeks of treatment, there were significant differences in FMA score [(44.08 + 2.44) vs. (40.53+ 2.11), t=7.07, P 0.05).


Conclusion
Mirror therapy can improve upper limb and hand function of the stroke patients with hemiplegia and enhance their ability of daily life activities; however, it has no significant effect to improve the limb spasm.


Key words: 
Stroke; Hemiplegia; Therapy; Rehabilitation
Initial Experience with Cancer Guidelines Navigator, a tool to standardize and improve the quality of cancer care in Sub-Saharan Africa, at Ocean Road Cancer Institute in Tanzania.
Authors: Fernando Jose Suarez Saiz, Leemor Yuravlivker, Jerry Ndumbalo, Julius Mwaiselage, Sadiq Maalim Siu, Wui-Jin Koh, Natalie Dawe, Daniel Strauss
Journal: Journal of Clinical Oncology (2020)

e14106 Background: The IBM Cancer Guidelines Navigator (CGN) is a digital reference system to support treatment planning that allows clinicians to enter a cancer patient’s clinical characteristics and presents the corresponding treatment options in the NCCN Harmonized Guidelines (TM) for Sub-Saharan Africa. In October 2019, Ocean Road Cancer Institute (ORCI) in Tanzania became the first site in Africa to initiate a hospital-wide implementation of the tool to help clinicians reduce cancer treatment variability by increasing adherence to standard evidence-based care. We describe training and lessons learned from system introduction. Methods: Training for clinical staff at ORCI occurred over one week and included daily one-hour lectures, followed by personalized hands-on training. A survey was administered to assess usability and use cases of the tool. Results: Thirty-one ORCI clinical and IT staff members participated in training, and 12 completed the survey. Responses indicated that the most beneficial uses for CGN were at point of care and for self-learning. Participants indicated that the top benefits of the tool were quick access to guidelines and evidence (75%) and ease of use (58%). Expanding cancer coverage (42%), offline access and better integration into the workflow (25%) were identified as areas for improvement. Post-training, ORCI implemented easier access to CGN on each computer and tablet used for consultation and care management. Conclusions: CGN is a digital reference system that is designed to support easy and efficient access to regionalized cancer-treatment guidelines for point-of-care treatment planning and education. Expansion of this program has been planned for other hospitals in Tanzania. Future studies will examine whether CGN usage affects guideline adherence.
Randomized, phase II study of ficlatuzumab with or without cetuximab in patients with pan-refractory, recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).
Authors: Julie E. Bauman, Denise Roe, Nabil F. Saba, Jessica Ruth Bauman, John M. Kaczmar, Barbara Burtness, Jameel Muzaffar, Ricklie Ann Julian, Steven Wang, Shethal Bearelly, Audrey Baker, Conor Ernst Steuer, Aarti K. Bhatia, Anshu Giri, Carlos Caulin, Laura P. Stabile, Sara Centuori, Christine H. Chung
Journal: Journal of Clinical Oncology (2020)

TPS6594 Background: Patients with pan-refractory R/M HNSCC, with clinical resistance to cytotoxic therapy, anti-EGFR molecular targeting, and immunotherapy, have poor survival. An established tumor-intrinsic resistance mechanism to cetuximab, an anti-EGFR IgG1 monoclonal antibody (mAb), is activation of the hepatocyte growth factor (HGF)/cMet pathway, which converges with the EGFR network at both the PI3K/Akt and MAPK nodes allowing for reciprocal compensation. Moreover, over-expression of HGF in the tumor microenvironment is immunosuppressive. Convergent data suggest that HGF/cMet pathway inhibition concurrent with EGFR blockade may overcome cetuximab resistance. We previously reported a Phase I study of ficlatuzumab, a humanized anti-HGF IgG1 mAb, with cetuximab in cetuximab-resistant R/M HNSCC. The combination showed promising safety, overall response rate (ORR) and progression-free survival (PFS). Preliminary biomarker analyses showed that high circulating cMet was associated with poor PFS whereas serum Veristrat, a proteomic classifier associated with worse prognosis in the setting of anti-EGFR monotherapy, was not. An increase in total peripheral T cells, particularly the CD8 + subset, was associated with treatment response while progression was associated with expansion of a unique myeloid population. We designed a follow-on randomized phase II trial evaluating ficlatuzumab with or without cetuximab in pan-refractory, R/M HNSCC with signaling and immune correlatives. Methods: This is a multicenter phase II trial with a randomized, non-comparative, two-arm design (ficlatuzumab 20 mg/kg with or without cetuximab 500 mg/m 2 every 2 weeks) in patients with pan-refractory R/M HNSCC. Key eligibility criteria include: R/M HNSCC; cetuximab resistance (progression during or within 6 months of cetuximab-radiation or palliative cetuximab); platinum resistance; prior exposure to anti-PD1 mAb; ECOG 0-1; consent to baseline research biopsy. The primary objective is to evaluate the efficacy of each arm as measured by PFS. To test the hypothesis that either regimen improves historical PFS from 2 to 3.33 months requires 66 eligible patients. Key secondary endpoints are ORR and survival. Mechanistic biomarkers include tumor HGF/cMet pathway activation, tumor and peripheral immune profiles, soluble cMet, and serum Veristrat. Thirty-five of 66 subjects have enrolled at 6 centers. A Bayesian continuous monitoring rule for futility has not been triggered for either arm. Clinical trial information: NCT03422536 .
Improved sensitivity using a dual target, E and RdRp assay for the diagnosis of SARS-CoV-2 infection: Experience at a large NHS Foundation Trust in the UK
Authors: Hayley Colton, Michael Ankcorn, Mehmet Yavuz, Leeanne Tovey, Alison Cope, Mohammad Raza, Alexander J Keeley, Amy State, Bozena Poller, Matthew Parker, Thushan I de Silva, Cariad Evans
Journal: Journal of Infection (2020)
Predictive evaluation of quantitative spatial profiling of the tumor microenvironment by multiplex immunofluorescence in recurrent glioblastoma treated with PD-1 inhibitors.
Authors: David Cieremans, Ju Young Kim, Ariana Valencia, Justin Santos, Jennifer Bordeaux, Thai Tran, Christine Vaupel, Naveen Dakappagari, Shabnam Tangri, Fabio Massaiti Iwamoto
Journal: Journal of Clinical Oncology (2020)

e14524 Background: PD-1 inhibitors have shown limited efficacy in glioblastoma (GBM) due to microenvironment immunosuppression and low tumor mutational burden. In GBM, PD-L1 expression is not a predictive marker for response to PD-1 or PD-L1 inhibitors. Multiplex immunostaining panel technology allows for detailed analyses of tumor microenvironment cells and their interaction. Methods: Pre-treatment tumor tissue was collected retrospectively from 27 patients in our neurooncology database at Columbia University Irving Medical Center with primary glioblastoma who were diagnosed within the past three years, had surgery here, and were either treated with SOC therapy (n = 8) or PD-1 inhibitors at recurrence (n = 19). Multiplex immunofluorescence was done for 1) CD11b/IDO1/HLADR/GFAP, 2) PD1/PD-L1/GFAP, and 3) CD4/CD8/CD25/FoxP3/Ki67/GFAP. Results: Multiplex immunofluorescence panels did not show any correlation with outcomes in patients treated with SOC therapy (non-immunotherapy). Among the 19 patients treated with PD-1 inhibitors, those with more HLA-DR positive cells had worse outcomes (p = 0.02). PD-L1 expression on tumor cells was not predictive of outcomes. There was a correlation trend between PD-1/PD-L1 interaction score (p = 0.08), which measures density of PD-1-positive cells in proximity to PD-L1-positive cells, and outcomes. This assay allowed us to evaluate tumor-associated macrophages, myeloid-derived suppressor cells, CD8+ lymphocytes, and CD4+ T regulatory cells; however, none of these were predictive of survival. Conclusions: Quantitative spatial profiling by multiplex immunofluorescence is feasible in FFPE glioblastoma tissue. More refined and extensive quantitative and spatial microenvironment analyses may allow for the development of biomarkers for immunotherapy in GBM.
Bacteriological examination of digital X-ray imaging device before and after disinfection
Authors: Hai Luan, Hui Li, Dai-bing Wang, Chun-sheng Wang
Journal: BMJ (2013)

The digital X-ray imaging device was disinfected with trichloro-isocyanuric acid solution. The samples were taken with cotton swab pouring method before and 1, 2, 3 and 6 h after disinfection and the bacteriological examination was performed. Before disinfection the colony count of samples was all above the standard (>10 cfu/cm2) with bacilli and gram-positive cocci predominantly. The highest count was detected in the X-ray photographic bed (58 cfu/cm2) and the lowest was in the exposure button (19 cfu/cm2). After disinfection the colony count in radiation suits still exceeded the standard, the colony count in diagnosis bed 2 h after disinfection, that in all parts of device 3 h after disinfection was off levels. The results indicate that the chlorine disinfectants can only achieve short-term effect in disinfection of digital X-ray imaging device.


Key words: 
Equipment contamination; Radiography; Disinfection
Evaluation of tumor growth inhibition activity of a novel multi-TRK inhibitor ABP-1119 on pancreatic tumor xenograft model.
Authors: Zheng-Yun James Zhan, Wanlong Pan, Hua Yan
Journal: Journal of Clinical Oncology (2020)

e16741 Background: Owing to its high mortality and lack of effective treatments, there is therefore an urgent unmet need to develop novel and more effective treatments for pancreatic cancer (PC). ABP-1119 is a novel and potent multi-TRK Inhibitor for several PC-related prime tyrosine kinases (TRKs), such as EGFR, HER2, ALK, and BTK. Pre-clinical studies with ABP-1119, especially study to evaluate its tumor growth inhibition activity on pancreatic tumor xenograft model, are planned. Methods: (1) Mobility-Shift Assay used to Analyze the multi-TRK (such as EGFR, HER2, ALK, and BTK) Inhibition activity of new anti-tumor compounds, (2) CTG Assay used to analyze the inhibition activity of Mia-Paca-2 Cell Line, (3) Anti-tumor inhibition study of ABP-1119 with the pancreatic cancer nude mice, (4) Safety studies of ABP-1119 for Ames, hERG, and maximum tolerated dose (MTD). Results: It was determined that its multi-TRK inhibition activity (IC50) of ABP-1119 was 0.9nM to EGFR, 4.8nM to HER2, 0.9nM to ALK, and 2.1nM to BTK, respectively. Its inhibition activity for Cell Line Mia-Paca-2 was 0.06 µM. In anti-tumor inhibition study with the Mia-Paca-2 tumor nude mice for 14 days, the anti-tumor inhibition rate of ABP-1119 (50 mg/kg, QD) was over 82% (vs Erlotinib as a positive control, 50mg/kg, QD, inhibition rate: 48%), and no any death and other serious side effects were observed during the nude mice tests. Moreover, for other safety issues, its Ames is negative and hERG is &gt; 30 µM, and no test-article related death or adverse events occurred in MTD studies with ABP-1119 (100mg/kg, QD) for 14 days. ABP-1119 also had very good metabolic stability in Human (T 1/2 = 2.5hr). Conclusions: Based on our completed preclinical study results, ABP-1119 is a novel and potent multi-TRK Inhibitor, showing excellent enzymatic activity, prominent in-vitro anti-cancer activity, and good tumor growth inhibition activity with tolerable toxicity in pancreatic tumor xenograft in nude mice model. It is warranted to continue further investigation in pancreatic cancer.
辽宁两所医院963例急性中毒分析
Authors: 赵敏, 刘淑英, 王丽荣, 王淑娟, 孙铭
Journal: BMJ (2005)

调查分析中国医科大学附属第一医院和辽宁省凤城市中心医院急诊科急性中毒患者963例的流行病学资料,所有来诊患者均填写急性中毒表格,包括年龄、性别、职业、发生时间、地点、患者来源、意图、中毒类型、中毒物质名称、剂量、毒物种类、侵入途径、急诊处理方式、诊断及转归等.结果表明,急性中毒患者以20～39岁多见,女性发病率高.常见毒物为镇静催眠类药物、一氧化碳、农药等.自杀是常见的中毒原因,口服为主要中毒途径.农民、待业人员、家务劳动者和学生是主要的中毒职业分布。
Population-based analysis of guideline adherence for patients with rectal cancer in California.
Authors: Michael Del Rosario, Jenny Chang, Argyrios Ziogas, Kiran Clair, Robert E. Bristow, Sora Park Tanjasiri, Jason A. Zell
Journal: Journal of Clinical Oncology (2020)

e19045 Background: The goal of oncology-specific evidence-based treatment guidelines is to improve cancer care. We sought to analyze adherence to National Comprehensive Cancer Network (NCCN) treatment guidelines for rectal cancer in the state of California and the associated impacts on survival. Methods: Patients aged 18 to 79 years diagnosed with rectal adenocarcinoma between January 1, 2004 and December 31, 2017 with follow-up through November 30, 2018 were identified in the California Cancer Registry. Patient characteristics such as age, race, insurance status, socioeconomic status (SES), marital status, and tumor stage were identified. In addition, based on available data our investigators determined whether patients received NCCN guideline-adherent care. Odds ratios (OR) and 95% confidence intervals (CI) were used for logistic regression to analyze patients receiving NCCN adherent care. Disease specific-survival analysis was calculated using Cox regression model. Results: A total of 30,118 patients identified with diagnosis of rectal cancer in California, 16,442 (54.6%) of whom did not receive guideline-adherent care. Disease specific-survival was worse for those who did not receive NCCN adherent care with hazard ratio (HR) 1.52 (95% CI 1.41 - 1.63, p &lt; 0.0001). Compared to Caucasians as a referent group, Asians (in aggregate) were more likely to receive guideline adherent care and had better disease specific survival with adjusted HR 0.88 (95% CI 0.80 -0.97, p = 0.008). Also compared to Caucasians, Hispanics were more likely to receive guideline adherent care and had better disease specific survival HR 0.90 (95% CI 0.83 – 0.98, p &lt; 0.015). As compared to managed care insured patients, uninsured patients were least likely to receive care and were observed to have worse disease specific survival adjusted HR 1.34 (95% CI 1.18 – 1.54, p &lt; 0.0001). Patients with Medicaid were also significantly associated with lower survival HR 1.39 (95% CI 1.26 – 1.53, p &lt; 0.0001) – and the CIs indicate Medicaid and uninsured were not statistically different from each other. Comparing to patients with highest SES as a referent group, patients with lowest SES were least likely to receive guideline adherent care and also were observed to have worse disease-specific survival with HR 1.22 (95% CI 1.09 – 1.36, p &lt; 0.0004). Conclusions: In this population-based analysis of rectal cancer patients in California, guideline-adherent care was associated with improved survival.