tbuckley/cabot-search huggingface dataset:
A multicenter phase Ib/II study of DNA-PK inhibitor peposertib (M3814) in combination with capecitabine and radiotherapy in patients with locally advanced rectal cancer.
Authors: Paul Bernard Romesser, Emma B. Holliday, Tony Philip, Rocio Garcia-Carbonero, Jaume Capdevila, Richard Tuli, Barbara Sarholz, Mirjam Kuipers, Almudena Rodriguez, Ivan Diaz-Padilla, Eric David Miller
Journal: Journal of Clinical Oncology (2021)

TPS144 Background: Perioperative radiotherapy and chemotherapy, followed by total mesorectal excision, is the standard of care for patients with locally advanced rectal cancer (LARC). However, 1/3 of these patients still develop distant metastases, indicating the need for more effective therapies. In addition, strategies that increase pathological complete response rates are needed to enable non-surgical management of LARC. DNA-dependent protein kinase (DNA-PK) regulates a key DNA damage repair pathway for double-strand break repair. Peposertib (M3814), a potent, selective, orally administered DNA-PK inhibitor, has been shown to potentiate the effect of ionizing radiation in a human colon cancer xenograft model and several colon cancer cell lines. Peposertib is being investigated in several different trials across multiple indications. This Phase Ib/II study (NCT03770689) aims to evaluate the safety, tolerability, pharmacokinetics (PK), and efficacy of the neoadjuvant treatment combination of peposertib, capecitabine, and radiotherapy (RT) in patients with LARC. Methods: Patients aged ≥18 years with histologically confirmed and resectable Stage II/III rectal adenocarcinoma are eligible. Induction chemotherapy is permitted, but residual disease must first be documented by MRI, digital rectal examination and endoscopy. Patients who received other anticancer therapies or those with prior pelvic RT are excluded. At open-label Phase Ib (open), 18–30 patients (n = 3 per cohort) will receive peposertib + capecitabine (orally, 825 mg/m 2 twice daily [BID]) + RT (45–50.4 Gy), 5 days/week. Peposertib 50 mg once daily (QD) was the starting dose. Additional dose levels will range between 100─800 mg QD. Dose escalation is determined by the safety monitoring committee and guided by a Bayesian 2-parameter logistic regression model. At Phase II (planned), 150 patients will be randomized (1:1) to receive oral capecitabine (825 mg/m 2 BID) + RT (45–50 Gy), with either oral peposertib (recommended phase II dose [RP2D] or placebo, QD for 5 days/week. Primary objectives are to define a maximum tolerated dose and RP2D (Phase Ib), and to evaluate the efficacy of peposertib + capecitabine + RT in terms of pathological/clinical complete response (Phase II). Secondary objectives include assessment of antitumor activity (Phase Ib), quality of life outcomes (Phase II), and PK of peposertib, and the safety and tolerability of the combination therapy (both phases). To date, one patient has received peposertib 50 mg QD, six patients peposertib 100 mg QD, three patients peposertib 150 mg QD, and three patients peposertib 250 mg QD. Clinical trial information: NCT03770689.
Phase II trial of atezolizumab in BCG-unresponsive non-muscle invasive bladder cancer: SWOG S1605 (NCT #02844816).
Authors: Peter C. Black, Catherine Tangen, Parminder Singh, David James McConkey, Scott Lucia, William Thomas Lowrance, Vadim S Koshkin, Kelly Lynn Stratton, Trinity Bivalacqua, Elad Sharon, Wassim Kassouf, Sima P. Porten, Richard Carlton Bangs, Melissa Plets, Seth P. Lerner, Ian Murchie Thompson
Journal: Journal of Clinical Oncology (2020)

5022 Background: Radical cystectomy (RC) is the standard of care for patients with BCG-unresponsive high risk non-muscle invasive bladder cancer (NMIBC), but many patients are unfit for surgery or elect bladder preservation. Based on the reported efficacy of atezolizumab in metastatic urothelial carcinoma and the known expression of PD-L1 in NMIBC after BCG therapy, this trial was designed to evaluate the activity of atezolizumab in BCG-unresponsive high risk NMIBC. Methods: This single arm phase II registration trial testing systemic atezolizumab (1200 mg IV) every 3 weeks for one year aimed to enroll 135 (70 CIS and 65 non-CIS) eligible patients with histologically proven BCG-unresponsive high risk NMIBC who were unfit for or declined RC. Here we report on the subset with CIS (with or without concomitant Ta/T1) among patients who received at least one protocol treatment. The primary endpoint was pathological complete response (CR) rate at 6 months as defined by mandatory biopsy with a null hypothesis of 30% and alternative of 50% with a 1-sided alpha = 0.05 and 96% power. The 3 month CR rate, defined by cytology, cystoscopy and for-cause biopsy, is reported here as a secondary endpoint, in addition to safety. Results: Seventy-five eligible CIS patients were enrolled. Two received no treatment and are not evaluable. Of 73, median patient age was 73.4 years and median number of prior BCG doses was 12. Concomitant Ta/T1 tumor was found in 30 (41.1%) patients, including T1 disease in 16 (21.9%). A CR was observed in 30 (41.1%; 95% CI 29.7%, 53.2%) patients at 3 months and 19 (26.0%; 95% CI 16.5%, 37.6%) at 6 months. Any possibly or probably treatment-related adverse event (AE) was observed in 61 (83.6%) patients. The most frequent AEs were fatigue 36 (49.3%), pruritis 8 (11.0%), hypothyroidism 8 (11.0%), and nausea 8 (11.0%). Grade 3-5 AEs occurred in 9 (12.3%) patients and there was one treatment-related death (myasthenia gravis with respiratory failure and sepsis). Conclusion: The observed response to atezolizumab at 3 and 6 months in patients with BCG-unresponsive CIS was similar to that reported in recent similar trials and meets the benchmark for initial CR defined by the FDA guidance. This trial provided no new safety concerns. The duration of response will determine if this is a suitable treatment option for patients with BCG-unresponsive high risk CIS. Clinical trial information: 02844816 .
The multidirectional effects of some comorbid disorders on the malignant process and tumor-bearing organism in the experiment.
Authors: Galina V. Zhukova, Alla I. Shikhlyarova, Anna S. Goncharova, Sergey Yu. Tkachev, Tatiana P. Protasova, Elena I. Triandafilidi, Oksana V. Bykadorova, Alexey N. Shevchenko, Elena V. Filatova, Irina A. Khomutenko, Larisa Yu. Shashkina, Oleg I. Kit
Journal: Journal of Clinical Oncology (2020)

e15616 Background: The question of the effects of comorbid diseases on oncogenesis has been little studied else. The increase in the frequency of dorsopathies and arthritis with age determines the important of the question about their influence on malignant process. The aim of the research was to study the features of the tumor growth and animal's condition under chronic neurogenic and inflammatory pain. Methods: In experiments on 54 white unbred male rats of 280-390 g, with transplantable Guerin's carcinoma (сG), two experimental models of chronic pain were used - unilateral sciatic nerve ligation (SNL) according to G.J. Bennet (neurogenic pain) and injections of formalin (Fm) into the ankle joint of the back paw (inflammatory pain). Formalin injection is known to be used to form both acute and chronic pain. The dynamics of tumors size, level of motor activity (MAL) in open field test, hematological parameters (by the blood analyzer «Exigo EOS vet», Sweden), adaptation status (AS) by Selye-Garkavi-Kvakina and also the lifespan of the animals (LS) were evaluated. Results: Unlike the unidirectional negative influence of chronic pain known in tumor-bearing animals in the cases of bilateral SNL, two opposite effects were observed with unilateral SNL and the formalin injection. Along with accelerated tumor growth in some animals (up to 62%), increase of LS of more than a third of the rats of the main groups by 3-30% in comparative with maximal LS in the control group was noted. In these cases, often the death of animals occurred with the larger tumors than in the control groups. In the cases of unilateral SNL, a relation between changes in the characteristics of the AS and the LS was noted. In the cases of Fm injections, animals with diverse LS differed in the features of the inflammatory reaction and the dynamics of the MAL. The prognostic value of shifts of the MAL in chronic inflammatory pain and tumor growth is assumed. Conclusions: A nonlinear relationship between the processes caused by chronic pain, oncogenesis, and individual characteristics of systemic regulation was shown. The question about the mechanisms of adaptation to the malignant process, promoting the body's viability in large tumors in conditions of chronic neurogenic and inflammatory pain is of interest.
Medicaid Expansion, Safety Net Clinics, and Opportunities to Improve Contraceptive Care
Authors: Michelle H. Moniz, Nora Becker, Vanessa K. Dalton
Journal: JAMA Network Open (2020)

Blair G. Darney, PhD; R. Lorie Jacob, ScM; Megan Hoopes, MPH; Maria I. Rodriguez, MD; Brigit Hatch, MD; Miguel Marino, PhD; Anna Templeton, DNP; Jee Oakley, MPH; Erika K. Cottrell, PhD
规范体格检查重视基本功训练
Authors: 许玉韵
Journal: BMJ (2005)

半年前曾在某三级医院定期查房.某患者,女性,68岁,3个月来出现劳累后心前区憋闷感,持续数分钟或近半小时,休息后可缓解,晨起或去洗手间后站起有时感眼前发黑,瞬间即过.既往无高血压、糖尿病史.门诊医生疑诊冠心病收入院.据当时体格检查示心左界扩大,心率62次/min,律齐,心尖部及胸骨左缘可闻及3级收缩期杂音,血压110/60 mm Hg(1 mm Hg=0.133 kPa),肺呼吸音清,腹软,肝脾未扪及,下肢无水肿.心电图示左室高电压;未做心脏彩超.诊断为劳累性心绞痛、冠心病、心功能Ⅱ级.心尖部杂音原因考虑为二尖瓣关闭不全,老年退化性瓣膜病,准备行冠状动脉造影.但经复查体征后发现心前区及各瓣膜区都可听到3级以上收缩期杂音,以主动脉瓣区最响,伴收缩期震颤,并可传导至右颈部及心尖部,但未传至左腋下。
ERBB2 amplifications and mutations in 109 advanced breast cancer patients by next-generation sequencing.
Authors: Ami N. Shah, Brian Finkelman, Lorenzo Gerratana, Andrew A. Davis, Neelima Katam, Chenyu Lin, Kristen Carroll, Saya Jacob, Firas Wehbe, Michael Gurley, Fang Lin, Luis Blanco, Elena Vagia, Leonidas C. Platanias, William John Gradishar, Amir Behdad, Massimo Cristofanilli
Journal: Journal of Clinical Oncology (2020)

3565 Background: In advanced breast cancer (ABC) HER2 status is based on ASCO/CAP immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) criteria. Next generation sequencing (NGS) of tissue and blood can detect aberrations in ERBB2 such as copy number gain/amplifications (cng/amp) and mutations. Methods: We retrospectively identified patients (pts) seen at Northwestern University between 2015 and 2019 with ABC and an alteration in ERBB2 identified by tissue and/or circulating tumor DNA (ctDNA) NGS. We included pts with testing by Guardant360, TempusX, and/or FoundationOne platforms. NGS reports were evaluated for non-synonymous mutations and cng/amp. HR and HER2 status were determined based on the most recent pathologic assessment. Mutations were categorized as pathologic if they were consider oncogenic (level 1-2 evidence with direct functional data), likely oncogenic, or predicted oncogenic, based on OncoKB (Chakravarty et al., JCO PO 2017). Results: 109 cases of ABC (6 locally advanced, 103 metastatic) with ERBB2 alterations were identified. Tissue NGS was available from 43%, ctDNA from 72%, and both from 19%. The positive predictive value (PPV) of ERBB2 amp/cng by tissue NGS to predict HER2+ using the gold standard as IHC/FISH was 94% (33/35). The PPV of ERBB2 amp by ctDNA was 93% (40/43). ERBB2 mutations were detected in 52 pts. Of these, 23 pts were considered to harbor pathologic ERBB2 mutations, (19 oncogenic, 2 likely oncogenic, 1 predicted oncogenic) detected by ctDNA and tissue in 4, ctDNA in 16, and tissue in 3 pts. The most frequently detected mutations were V777L and S310. Four pts had co-mutations of ERBB2 V777L and S310F. Disease subtype among those with ERBB2 pathologic mutations was HR+ HER2- in 57%, HER2+ in 26%, and triple negative in 17%. In all patients with serial ctDNA analysis and pathologic ERBB2 mutations, the mutation was detected on the first analysis. Pathologic ERBB2 mutation represented the mutant with the highest mutant allele frequency (MAF) in 30% and top 3 highest MAF in an additional 35%. PIK3CA was co-mutated in 48%. Conclusions: The PPV of ERBB2 amp/cng by tissue and ctDNA NGS was high, and has potential utility for cancers where HER2 IHC/FISH is not standardly assessed or cases where biopsy is challenging. ERBB2 pathologic mutations were found in all breast cancer subtypes. When present, they were identified on the initial ctDNA analysis and often represented a significant clone, supporting its role as a ‘driver mutation’.
Results of a completed phase I trial of CBL0137 administered intravenously (IV) to patients (Pts) with advanced solid tumors.
Authors: John Sarantopoulos, Devalingam Mahalingam, Neelesh Sharma, Renuka V. Iyer, Wen Wee Ma, Manmeet Singh Ahluwalia, Saramarie Johnson, Andrei Purmal, Polina Shpigotskaya, Ann Hards, Andrey Leonov, Katerina Gurova, Andrei Gudkov, Kristina Zakurdaeva, Langdon L. Miller, Afshin Dowlati
Journal: Journal of Clinical Oncology (2020)

3583 Background: The novel curaxin CBL0137 intercalates into DNA, interfering with histone/DNA binding. Consequent trapping of histone chaperone FACT leads to MYC, NF-kB, and HSF1 inhibition, p53 activation, and an IFN response. CBL0137 shows broad nonclinical antitumor activity (Gasparian et al. Sci Transl Med. 2011; 3(95):95ra74). Methods: This dose-ranging study assessed the CBL0137 maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) and CBL0137 safety, pharmacokinetics (PK), and efficacy in adults with advanced treatment-refractory solid tumors. CBL0137 was administered IV on Days 1, 8, and 15 of repeated 28-day cycles until progressive disease (PD) or unacceptable toxicity. Doses were escalated using a 3+3 design based on Cycle 1 dose-limiting toxicities (DLTs). PK was assessed through 168 hours after Day 1. Efficacy was evaluated every 8 weeks. Results: The study enrolled 83 pts (M/F [n] = 49/34; median [range] age = 64 [33-85] years; ECOG status [n] = 1/2 [32/51]), with cancer types (n) of colorectal (23), prostate (7), glioblastoma (6), liver (6), non-small-cell (5), and others (36) across 17 dose levels from 10 to 700 mg/m 2 /infusion. Durations of therapy ranged to 24 months. Cycle 1 DLTs (n type) were observed at 240 mg/m 2 (1 Gr 3 photosensitivity), 400 mg/m 2 (1 Gr 3 anemia), 700 mg/m 2 (1 Gr 4 thrombocytopenia, 1 Gr 4 neutropenia/Gr 4 thrombocytopenia), and 650 mg/m 2 (1 Gr 3 thrombocytopenia, 1 Gr 4 neutropenia/Gr 3 thrombocytopenia). Nausea and vomiting were successfully prevented with dexamethasone/serotonin antagonists. Photosensitization was effectively managed with sun protection. Peripheral venous thrombosis required central vein infusion in subjects with glioblastoma. PK showed dose-proportional increases in plasma CBL0137 area under the concentration-time curve (AUC), a high mean (range) volume of distribution (Vd) of 1,030 (655-1460) L/m 2 consistent with extensive tissue distribution and DNA intercalation, and an average mean (range) half-life (t 1/2 ) of 24.7 (10.3-40.7) hours without dose dependence. The best response was stable disease: 2 pts with liver cancer had tumor control for 9 and 24 months and a maximum tumor regression of 10%; 2 pts with prostate cancer had tumor regressions by 11% and 22%; 1 pt with uterine cancer had a 20% tumor regression. Conclusions: CBL0137 administered IV was generally well tolerated with manageable toxicities The MTD and RP2D were estimated at 540 mg/m 2 due to myelosuppressive DLTs. PK were predictable. Preliminary evidence of antitumor activity supports Phase 2 testing. Clinical trial information: NCT01905228 .
Symptomatic delayed seromas vs incidental findings on MR, and likelihood of BIA-ALCL in women with textured implants.
Authors: Paola Ghione, Elizabeth J. Sutton, Qunying Hu, Natasha Galasso, Nivetha Ganesan, Neelam Tyagi, Danny Francisco Martinez, Ahmet Dogan, Elizabeth Anne Morris, Steven M. Horwitz, Peter G. Cordeiro
Journal: Journal of Clinical Oncology (2020)

e20028 Background: Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a subtype of ALCL, arises as a seroma in the space between the implant and the capsule, or as an adjacent mass. BIA-ALCL appears to be related to textured-surface implants, after 7-10 years of exposure. We conducted two large cohort studies. The 1 st , a retrospective series (Sutton, 2019) assessed the incidental findings of masses or seromas in 1070 women with breast implants undergoing MR for FDA recommended screening for silent ruptures of silicone implants. Incidental finding of seromas or breast masses on MRI were found in 18/1070 (1.7%) women, of which 1/15 had BIA-ALCL, and was symptomatic at the time of MRI. The 2 nd , a prospective study (Cordeiro, 2020) defined the incidence of BIA-ALCL (1/355) in a cohort of 3546 women with textured implants followed long term. Within this cohort, there were 28 clinically relevant delayed seromas (0.79%), 8 of which were BIA-ALCL (28.5%). We hypothesize that combining these databases will inform whether asymptomatic women with textured implants may benefit from MR to r/o BIA-ALCL. Methods: The two IRB approved databases were merged. Patients with incidental findings of seroma on MRI were identified. A majority of the MRIs in this merged cohort were performed to follow the FDA recommended screening for silent ruptures. We identified all clinically relevant late seromas sent to hematopathology to r/o BIA-ALCL by cross checking pathology reports containing the words “lymphoma” or “anaplastic” or “ALCL”. Results: 572 women were included in both studies: followed long term and received an MRI after a median time of 7.4 years after breast reconstruction. 8 of 572 women had an incidental finding of seroma on random MRI, and 2 had capsular masses. None of these 10 asymptomatic women have developed BIA-ALCL to date (median follow-up 9 years). 11 of 572 women had a symptomatic seroma or mass, 4 of which later developed BIA-ALCL, a fifth patient was found to have BIA-ALCL on a PET/CT + lymph node, despite being asymptomatic. Median time from last MR to lymphoma was 5 years (3-8 years). Conclusions: In this merged cohort of patients with textured breast implants, incidence of BIA-ALCL in patients with symptomatic late seromas is around 30%, while seromas found incidentally on MR of asymptomatic patients were negative for BIA-ALCL.
Real-world experience of pembrolizumab plus lenvatinib in unresectable hepatocellular carcinoma in Taiwan.
Authors: Chi-Jung Wu, Ya-Wen Hung, Pei_Chang Lee, ChiehJu Lee, Ming Huang Chen, Yee Chao, Ming-Chih Hou, Yi-Hsiang Huang
Journal: Journal of Clinical Oncology (2020)

e16627 Background: Multi-kinase inhibitors and immune checkpoint inhibitors (ICIs) are treatment options of systemic therapy for unresectable hepatocellular carcinoma (HCC). Targeted therapy can potentially enhance T cell infiltration and activation, consequently, cooperate with ICIs to produce synergistic anti-tumor effects. The ongoing clinical trial shows promising data by combining pembrolizumab with lenvatinib for advanced HCC. The study tried to evaluate the treatment response and adverse events of pembrolizumab plus lenvatinib for HCC in real-world setting. Methods: From Jul. 2019, patients who received pembrolizumab plus lenvatinib for unresectable HCC in a tertiary medical center in Taiwan were prospectively enrolled. The status of HCC was either in advanced HCC or failed by prior locoregional treatment. The dosage of pembrolizumab was 100mg every 3 weeks. The starting dose of lenvatinib was 10mg per day then titrating to weight-based dose according to recommendation. Patients who had received at least 2 cycles of pembrolizumab were evaluated in this report. The tumor response was assessed with Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 and modified RECIST (mRECIST). The treatment related adverse events (TRAEs) were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Results: Till the end of Jan. 2020, 27 patients had received at least 2 cycles of pembrolizumab, and 17 had evaluable post-treatment images either by CT or MRI. There were 6 (22.2%) in BCLC B, and 21 (77.8%) in BCLC C. Of them, 17 (63%) were treated as the first-line systemic treatment, 8 as the second-line and 2 as the third line systemic treatment. Of the 17 cases with post-treatment image studies, there were 6 (35.3%) in partial response (PR), 7 (41.2%) in stable disease (SD), and 4 (23.5%) in progressive disease (PD) by RECIST v1.1; and 1 (5.8%) in complete response (CR), 9 (52.9%) in PR, 3 (17.6%) in SD and 4 (23.5%) in PD by mRECIST, respectively. The objective response rate (ORR) and disease control rate (DCR) by mRECIST were 58.7% and 76.5%, respectively. The most common TRAEs in any grade were hypertension 24 (88.4%), palmar-plantar syndrome 19 (70.4%), hypothyroidism 19(70.4%). The Grade 3/4 TRAEs were 3 (11.1%) with psoriasis-like skin reaction, 3 (11.1%) with hypertension and 2 (7.4%) with palmar-plantar syndrome. Conclusions: Pembrolizumab plus lenvatinib can produce excellent ORR and DCR with tolerable safety profiles. Such combination could be a promising strategy for unresectable HCC in the future.
Inhibitory effects of dexmedetomidine on cardiovascular responses of endotracheal intubation in chronic smokers
Authors: Yan Xu, Jianqing Cheng, Yeying Ge
Journal: BMJ (2014)

From May 2012 to May 2013, 60 chronic male smokers received an intravenous infusion of dexmedetomidine 1 μg/kg (Group D, n=30) or an equal volume of normal saline (Group C, n=30) before anesthesia induction. At time of dexmedetomidine or normal saline dosing, after induction of anesthesia, 1 and 3 min after intubation, the heart rates and rate-pressure products were significantly lower in Group D than Group C (P<0.05). Thus the dosing of dexmedetomidine before anesthesia induction could suppress the cardiovascular responses of endotracheal intubation in chronic smokers and avoid increasing myocardial oxygen consumption so as to protect heart functions.


Key words: 
Dexmedetomidine; Smoking
Minimally invasive percutaneous nephrolithotomy for lower caliceal stone
Authors: Chang-xing Ke, De-lin Yang, Yi-gang Zuo, Jian-song Wang, Ru-ping Yan, Wei Wang
Journal: BMJ (2008)

Clinical data of 53 patients with lower caliceal stone during August 2005 and March2007 were analyzed retrospectively.The stones were 11-35 mm in diameter.Under the guidance of X-ray.single renal tract parallel to the lower caliceal for percutaneous nephrolithotomy was established.The procedures were successful in all the patients.Fifty patients were stone free after first minimally invasive pereutaneous nephrolithotomy(MPCNL),2 were stone free following second MPCNL,1 saw residual small stones clear off spontaneously during the follow-up period.Operative time was 65-162 minutes.and blood loss was 10-200 ml.No severe complications or death occurred.MPCNL may be related with minimal invasion and fewer complications,thus provides an effective and safe way of lower caliceal stone treatment.

Key words: 
Kidney calculi;  Ureteroscope
Skeletal muscle adiposity and outcomes in candidates for lung transplantation: a lung transplant body composition cohort study
Authors: Michaela R Anderson, Imaani Easthausen, Grace Gallagher, Jayaram Udupa, Yubing Tong, Drew Torigian, Joshua Matthew Diamond, Mary Katherine Porteous, Scott M Palmer, Laurie D Snyder, Luke Benvenuto, Meghan Aversa, Selim Arcasoy, John R Greenland, Steven R Hays, Jasleen Kukreja, Edward Cantu, John Shinn Kim, Dympna Gallagher, Matthew R Baldwin, R Graham Barr, David J Lederer, Jason D Christie, Jonathan Paul Singer
Journal: Thorax (2020)

CT measurement of body composition may improve lung transplant candidate selection. We assessed whether skeletal muscle adipose deposition on abdominal and thigh CT scans was associated with 6 min walk distance (6MWD) and wait-list survival in lung transplant candidates. Each ½-SD decrease in abdominal muscle attenuation (indicating greater lipid content) was associated with 14 m decrease in 6MWD (95% CI −20 to −8) and 20% increased risk of death or delisting (95% CI 10% to 40%). Each ½-standard deviation decrease in thigh muscle attenuation was associated with 15 m decrease in 6MWD (95% CI −21 to −10). CT imaging may improve candidate risk stratification.