tbuckley/cabot-search huggingface dataset:
Clinical factors associated with higher detection of circulating tumor cells in patients with pancreatic cancer and their correlation with outcome: A prospective analysis.
Authors: Marcello Ferretti Fanelli, Virgilio Souza e Silva, Fernando Augusto Soares, Marcelo Calil Machado Netto, Aldo Lourenço Abbade Dettino, Fernanda Navarro Loiola, Marcilei Eliza Cavicchioli Buim, Vanessa Alves Silva, Bruna Maria Malagoli Rocha, Natalia Breve Mingues, Luciana Menezes Mendonca Ocea, Jose Luiz Gasparini Junior, Juliana Valim Romero, Emne Ali Abdallah, Ludmilla T.D. Chinen
Journal: Journal of Clinical Oncology (2014)

e22021 Background: Pancreatic cancer has a high mortality rate. Given the aggressiveness of the disease, we still lack molecular markers for predicting prognosis. Circulating tumor cells (CTCs) have emerged as a possible tool to predict outcome in some malignances. At present, the role of CTCs is uncertain in pancreatic cancer. The aim of this study was to evaluate clinical factors and its correlation with CTCs detection in patients with pancreatic cancer. Methods: Patients with metastatic and non-metastatic pancreatic adenocarcinoma treated in a single tertiary institution from Brazil were included in this analysis. Written informed consent was obtained from all patients. Blood was collected before the beginning of the first chemotherapy cycle and every 45 days. The isolation, characterization and counting of CTCs was made by ISET (Isolation by size of Epithelial Tumor Cells; RareCell Diagnostics, Paris, France). Results: We present results from 21 patients recruited, 10 men (47.6%) and 11 women (52.4%) with a median age of 67 years (41-84 years). Median follow up was 14 months. At the time of study enrollment three patients were stage II (14.3%), 4 were stage III (19%) and 14 were stage IV (66.7%). We used the pre-established cut-off of 1 CTC/mL as a positive value. Fisher's exact test was used for statistical analysis. Elderly patients (age ≥ 67 years) had lower levels of CTCs in both the baseline and the first follow-up blood samples (p=0.045 and p=0.049 respectively). Higher levels of CTCs at baseline correlated with lymph node involvement (p=0.048). White blood cells above 4500/mm3 were associated with elevated CTCs count (p=0.05). Among metastatic disease median progression free survival (mPFS) of patients with more than one CTCs/mL was 3.25 months. For those with zero CTCs/ml mPFS has not been reached (p=0.15). Conclusions: Our study showed that age and higher white blood counts may interact with the CTC analysis. Our results also suggest that higher CTCs level could predict worse outcome in advanced disease. Further studies are needed to confirm the true role of CTCs as a prognostic biomarker.
The Pretreatment Controlling Nutritional Status (CONUT) Score Is an Independent Prognostic Factor in Elderly Patients with Diffuse Large B-Cell Lymphoma
Authors: Yuto Kaneda, Nobuhiro Kanemura, Nobuhiko Nakamura, Yoshikazu Ikoma, Kimihiro Yamaguchi, Takuro Matsumoto, Yuhei Shibata, Hiroshi Nakamura, Soranobu Ninomiya, Junichi Kitagawa, Senji Kasahara, Takeshi Hara, Masahito Shimizu, Hisashi Tsurumi
Journal: Blood (2018)
Baseline factors associated with acute progression of metastatic lesions after primary tumor resection in patients with unresectable colorectal cancer.
Authors: Momoko Akashi, Takayuki Ando, Ayumu Hosokawa, Hiroki Yoshita, Sohachi Nanjyo, Akira Ueda, Hiroshi Mihara, Haruka Fujinami, Shinya Kajiura, Kohei Ogawa, Toshiro Sugiyama
Journal: Journal of Clinical Oncology (2018)

860 Background: In patients with unresectable colorectal cancer, primary tumor resection is expected not only local control but also prolongation of survival time. However, in some cases, metastatic tumors have been known to rapidly progress after primary tumor resection. We examined clinical factors associated with acute metastatic progress after primary tumor resection, and it might lead to worse survival. Methods: We retrospectively analyzed 183 patients who were newly diagnosed with unresectable colorectal cancer in our institution between April 2007 and April 2016. Among all patients, 83 patients received resection of primary tumor without the presence of symptoms. They were divided into progression and non-progression group according to metastatic progression that evaluated CT scan from four to six weeks after surgery. We analyzed clinicopathological factors related to acute progression after primary tumor resection using Cox proportional hazards. Results: After resection of the primary tumor, 25 patients were classified into progression group and 58 patients were classified into non-progression group. In progression group, the median percent change in the sum of the longest diameters of target lesions was 29.6% (10.0-191.7%), and 22 (88.0%) patients showed to have new lesions after resection of the primary tumor. Multivariate analysis revealed LDH (HR 4.44, 95%CI 1.15-18.5, p = 0.02), number of liver metastasis (HR 3.28, 95% CI 1.09-10.0, p = 0.03) and RAS status (HR 3.08, 95% CI 1.05-9.46, p = 0.03) were independent baseline factors associated with acute progression after resection of the primary tumor. The median overall survival (OS) was 12.3 and 27.8 months in progression and non-progression group, respectively. Conclusions: Serum LDH, number of liver metastasis, and RAS mutation were baseline factors associated with acute progression of metastatic tumors after resection of primary tumor in patients with unresectable colorectal cancer. These results indicated that the resection of the primary tumor in patients with these factors might be avoided when they have no clinical symptoms.
Favorable Outcomes of Acute Leukemia of Ambiguous Lineage Treated with Hypercvad: A Multi-Center Retrospective Study
Authors: Vu H. Duong, Kebede H. Begna, Kendra L. Sweet, Eunice S. Wang, Ryan James Caddell, Danielle Shafer, Zeba Singh, Maria R. Baer, Aref Al-Kali
Journal: Blood (2018)
Hepatocellular carcinoma specific graded prognostic assessment to predict the outcome for patients with brain metastases from hepatocellular carcinoma.
Authors: Seungtaek Lim, Hye Jin Choi, Soohyeon Lee, Joo-Hang Kim
Journal: Journal of Clinical Oncology (2014)

e15094 Background: Stratifying patients with brain metastasis (BM) from hepatocellular carcinoma (HCC) by prognostic factors can be useful in making decisions about treatment. The Diagnosis-specific Graded Prognostic Assessment (GPA) for HCC has not been well established. Methods: A total of 118 HCC patients were newly diagnosed with BM at Yonsei University Health System between 1985 and 2011. After univariate and multivariate analyses of the prognostic factors were performed, significant prognostic factors were used to develop the HCC-GPA. Results: The median overall survival after brain metastasis in all patients was only 6.1 weeks (95% confidence interval: 4.8 – 7.4 weeks). Using the prognostic factors identified with the multivariate analysis, we developed the HCC specific GPA score (HCC-GPA): number of brain metastases (single: 1, multiple: 0 point), alpha-feto protein (AFP) (<400ng/mL: 1, ≥400ng/mL: 0 point), and Child-Pugh-Score (A: 2, B: 1, C: 0 point). The median survival times from brain metastasis were significantly separated by the HCC-GPA score: 2.0, 5.3, 8.4, and 27.0 weeks in HCC-GPA score 0 or 1 (N=28), 2 (N=36), 3 (N=33), and 4 (N=21) with a p value less than 0.001. The efficacy of HCC-GPA score was validated in a separate cohort (N=25). Conclusions: Although the overall prognosis of patients with BM from HCC is dismal, the present data demonstrated that the newly developed HCC-GPA index can discriminate the prognosis of HCC patients with brain metastasis. It can be used as a valuable tool to select patients who may be good candidates for active local treatment.
Evidence-based indications for the use of proton beam therapy in central nervous system malignancies for a new proton therapy set up in Singapore.
Authors: Daniel Yat Harn Tan
Journal: Journal of Clinical Oncology (2014)

e13014 Background: Proton Bean therapy is a novel method for treating malignant disease with radiotherapy. Tumours in the central nervous system are particularly suited for proton treatment due to the vicinity of critical structures and the catastrophic consequences of radiation late effects in this region. Singapore is in the midst of building a proton therapy facility. To ensure fair and appropriate resource utilisation within the framework of its government-funded public healthcare system, an evidence-based guideline of the indications for the use of proton beam in the CNS was developed in preparation for its new proton centre. Methods: A literature review of was performed using the keywords ‘proton beam therapy’, ‘brain’, ‘spine’ and ‘central nervous system’. Four systematic reviews, 24 single institution retrospective studies, and 9 so called in-silico studies up to December 2013 were identified. Recommendations from various national bodies and research agencies on behalf of major insurers were also taken into account. Indications were categorised as ‘standard’, ‘potential’ and ‘non-standard’. The categorisation was based on clinical effectiveness, dosimetric superiority and the (non)availability of alternative therapies, with the ‘standard’ category fulfilling all three criteria. Results: Standard indications include intra-ocular melanoma and other cancers of the eye, skull base and para-spinal tumours including but not limited to chordoma and chondrosarcoma and paediatric CNS tumours. Potential indications include low grade gliomas, benign brain tumors such as meningioma and pituitary adenoma and re-irradiation cases with otherwise good systemic prognosis. Non-standard indications include GBM and poor prognosis high grade gliomas where the benefits of proton therapy is limited by disease and patient-related factors. Conclusions: While we await the emergence of high quality evidence for the use of proton therapy in the CNS, clinicians will have to judiciously consider the merits of this advanced and expensive technology using current available evidence within the framework of their local healthcare system.
Similarities between the biology of breast cancer in Kenya among blacks and that seen among whites elsewhere.
Authors: Nicolas Anthony Othieno-Abinya, Saidi Hassan, Cheryl Kerama-Likoko, Catherine Nyongesa, Ronald Wasike, Alice Musibi, Moses Alobo, Ahmed Kalebi, Andrew Gachii, Gladwell Wanjiru Gichuru
Journal: Journal of Clinical Oncology (2014)

1117 Background: Breast cancer is the commonest type of cancer among women worldwide, and the number one cause of cancer deaths among women. Its incidence increases with age, and the commonest pathological subtype is invasive ductal carcinoma. Hormone receptors (ER/PR) are expressed in about 70% of the cases and are associated with favourable outcome. HERr2/Neu is overexpressed in 20-30% of breast cancers and is associated with aggressive disease with poor outcomes. Tumours not expressing any of these biological features (triple negative) are commonly associated with dire outcome. Reports so far indicate racial differences with triple negative disease being more common among Blacks than other races. Methods: A prospective breast cancer care (BRECC) registry at the Kenyatta National Hospital, Nairobi. Details taken included biodata, symptoms, pathology, hormone receptors, HER2 overexpression, mode of diagnosis, stage at diagnosis, intervention and outcome. Results: A total of 269 patients - 268 were females, 1 male, all black. Median age was 48 years. Of 260 cases evaluable, 148 (56.9%) were aged < 50 years and 112 (43.1%) ≥ 50. The commonest modes of presentation were breast lump in 149 out of 228 cases evaluable (65.4%), breast pain in 70 (30.7%) and nipple changes in 65 (28.5%). Of 181 cases evaluable, 146 (80.7%) were invasive ductal carcinoma. Two out of 113 were grade 1, 48 (42.5%) grade 2, 63 (55.8%) grade 3. Of 62 cases evaluable, 38 (61.3%) were oestrogen receptor positive, 40 (64.5%) progesterone receptor positive and 11 (17.7%) Her2 positive. Hormone receptor positive, HER2 negative cases were 40 (64.5%); hormone receptor negative, HER2 positive were 6 (9.7%); hormone receptor negative, HER2-negative (triple negative) were 10 (16.1%); hormone receptor positive, HER2-positive were 6 (9.7%). Conclusions: The median age for breast cancer in Kenya is young, though increasingly approaching that seen in whites. Hormone receptor and HER2 expression levels don’t differ significantly from what is reported among whites.
Natural History of Patients with Multiple Myeloma Refractory to CD38-Targeted Monoclonal Antibody-Based Treatment
Authors: Ujjawal H Gandhi, Arjun Lakshman, Zhubin Gahvari, Elizabeth McGehee, Megan Helena Jagosky, Ridhi Gupta, William Varnado, Saurabh Chhabra, Mark A. Fiala, Ehsan Malek, Joshua Mansour, Barry Paul, Alyssa Barnstead, Saranya Kodali, Amarendra K. Neppalli, Michaela Liedtke, Kelly N. Godby, Yubin Kang, Ankit Kansagra, Emma C. Scott, Elvira Umyarova, Parameswaran Hari, Ravi Vij, Saad Z. Usmani, Natalie Scott Callander, Robert Frank Cornell, Shaji K. Kumar, Luciano J Costa
Journal: Blood (2018)
A 5-day course of oral antibiotics followed by faecal transplantation to eradicate carriage of multidrug-resistant Enterobacteriaceae: a randomized clinical trial
Authors: B.D. Huttner, V. de Lastours, M. Wassenberg, N. Maharshak, A. Mauris, T. Galperine, V. Zanichelli, N. Kapel, A. Bellanger, F. Olearo, X. Duval, L. Armand-Lefevre, Y. Carmeli, M. Bonten, B. Fantin, S. Harbarth, L. Colle, F. Kloosterman, W. van Bentum-Puijk, J. Vlooswijk, A. Andremont, M. Ben Hayoun, E. Canoui, A. Chabrol, N. Gamany, M. Lafaurie, A. Lefort, R. Lepeule, Z. Louis, E. Rondinaud, H. Sadou Yayé, L. Sarfati, V. Zarrouk, C. Brossier, L. Carrez, V. Lazarevic, G. Renzi, E. von Dach, S. Cohen Percia, R. Shvartz, J. Lellouche
Journal: Clinical Microbiology and Infection (2019)

ObjectivesIntestinal carriage with extended spectrum β-lactamase Enterobacteriaceae (ESBL-E) and carbapenemase-producing Enterobacteriaceae (CPE) can persist for months. We aimed to evaluate whether oral antibiotics followed by faecal microbiota transplantation (FMT) can eradicate intestinal carriage with ESBL-E/CPE.MethodsRandomized, open-label, superiority trial in four tertiary-care centres (Geneva (G), Paris (P), Utrecht (U), Tel Aviv (T)). Non-immunocompromised adult patients were randomized 1: 1 to either no intervention (control) or a 5-day course of oral antibiotics (colistin sulphate 2 × 106 IU 4×/day; neomycin sulphate 500 mg 4×/day) followed by frozen FMT obtained from unrelated healthy donors. The primary outcome was detectable intestinal carriage of ESBL-E/CPE by stool culture 35–48 days after randomization (V4). ClinicalTrials.govNCT02472600. The trial was funded by the European Commission (FP7).ResultsThirty-nine patients (G = 14; P = 16; U = 7; T = 2) colonized by ESBL-E (n = 36) and/or CPE (n = 11) were enrolled between February 2016 and June 2017. In the intention-to-treat analysis 9/22 (41%) patients assigned to the intervention arm were negative for ESBL-E/CPE at V4 (1/22 not receiving the intervention imputed as positive) whereas in the control arm 5/17 (29%) patients were negative (one lost to follow up imputed as negative) resulting in an OR for decolonization success of 1.7 (95% CI 0.4–6.4). Study drugs were well tolerated overall but three patients in the intervention group prematurely stopped the study antibiotics because of diarrhoea (all received FMT).ConclusionsNon-absorbable antibiotics followed by FMT slightly decreased ESBL-E/CPE carriage compared with controls; this difference was not statistically significant, potentially due to early trial termination. Further clinical investigations seem warranted.
Hepatic focal nodular hyperplasia in children post-oncologic therapy: Review of case reports and institutional observation.
Authors: Lilibeth Ramilo Torno, Victor Wong, Rebecca Gologorsky, Asghar Haider, W.Nathan Holmes, David Imagawa
Journal: Journal of Clinical Oncology (2014)

e21027 Background: Focal nodular hyperplasia (FNH) is a benign tumor-like structure found in the liver with ill-defined etiology. In asymptomatic patients, serial imaging may be required to monitor for progression. Further confirmation of diagnosis is needed when patients with previous malignancies present with hepatic lesions. An increased incidence of FNH has been reported in children previously treated for extra-hepatic malignancies. This study aims to review the literature and compare them with our institution’s case series. Methods: We reviewed 13 case reports/series (total 80 patients) published over the last 15 years and compared them to our retrospective review of 16 childhood cancer survivors (CCS) found to have liver lesions in the long-term follow-up period. Lesions were evaluated by imaging studies, including MRI with Eovist. Several patients had biopsy for further characterization. Results: No significant generalizations could be made regarding causative factors, e.g. specific chemotherapy, history of veno-occlusive disease or graft-vs-host disease. However, most patients underwent stem cell transplantation (SCT) or radiation (XRT). The general consensus was that these lesions could be conservatively managed. In our series of patients, 4 had history of neuroblastoma, 3 germ cell tumors, 2 PNET, 1 Langerhans Cell Histiocytosis, 1 medulloblastoma, 1 hepatoblastoma, 1 Ewing's sarcoma, 1 Wilms, 1 ALL, 1 rhabdomyosarcoma. Characterizing these lesions on imaging was difficult and resulted in biopsy in some cases. Consistent with the reviewed reports, most of these lesions occurred during the surveillance period. A majority of our patients had solid neoplasms and underwent SCT or XRT. Lesions were often multiple and have not required resection. One patient treated for ALL developed an EBV-driven spindle cell neoplasm in the liver 7 months after finishing treatment. Conclusions: CCS have an increased risk of developing liver lesions, mostly benign. Diagnostic imaging techniques such as MRI with Eovist has allowed lesions to be observed without biopsy. However management at this time remains on a case-by-case basis. Regardless, any CCS requires close follow-up.
Safety of EBUS TBNA in patients with mediastinal and hilar adenopathy taking clopidogrel.
Authors: Rabih Bechara, Ralitza Martin, Christopher Parks, Christina Sharaf
Journal: Journal of Clinical Oncology (2014)

e19074 Background: Endobronchial ultrasonography has proven to be highly helpful in the diagnosis of patients with mediastinal and hilar adenopathy. Many are on clopidogrel because of neurological/cardiac related comorbidities and stopping anticoagulation may pose high risk for complications. We have previously showed that thoracentesis with an 8F catheter is safe in patients taking clopidogrel with low risk for complications. Here we investigate the safety of EBUS TBNA in patients still taking clopidogrel. Methods: Patients presenting to our institution with mediastinal/hilar adnopathy requiring EBUS TBNA were included in the study if they were still actively taking clopidogrel. If clopidogrel could be stopped for 5-7 days prior to the procedure after discussion with the prescribing team, then patient was not included; clopidogrel was held, and EBUS TBNA performed after 5-7 days. If clopidogrel couldn’t be held due to high risk of thrombosis (based on the prescribing team’s recommendation), the patient was included. EBUS TBNA was performed by our team per protocol on a total of 15 patients. All received deep sedation with Propofol and a laryngeal mask airway. A total of 40 nodes were sampled. If no complications were encountered after 3 passes per node with a 22G needle then 3 passes with a 21G needle followed. Rapid on site evaluation was performed in all cases. Bleeding at the puncture site was considered significant if it required cold saline, topical sympathomimetics or balloon tamponade for hemostasis. Bleeding was considered as non-significant if no interventions were required. Results: We were able to perform all procedures successfully both with a 22 and 21G needle. Our yield was comparable to the existing reports. No significant complications occurred after the use of the 22G or 21G needles. No nodal puncture site required interventions for hemostasis. All patients were contracted within 24h after the procedure and none reported bloody sputum. Conclusions: We suggest that EBUS TBNA, using 22 or 22G needle, is safe and with high yield in patients with undiagnosed mediastinal and/or hilar adenopathy, actively taking clopidogrel, and are at high risk for thrombotic complications if the medication is discontinued.
New Concepts in Liver Regeneration Mechanisms in Human Severe Alcoholic Steatohepatitis
Authors: Adrienne Lejeune, Peter Starkel, Alexandre Louvet, Axel Hittelet, Celine Bazille, Boris Bastens, Hans Orient, Luc I. Lasser, Xavier Dekoninck, Sergio Negrin Dastis, Jean Delwaide, Anja Geerts, Chantal De Galocsy, Virginie Putzeys, Phillippe Langlet, Hendrik Reynaert, Sven M. Francque, Mina Komuta, Nicolas Lanthier
Journal: Hepatology (2018)
Improved results with ADE as induction chemotherapy in the treatment of children with acute myeloid leukemia: Experience at Instituto Nacional de Pediatria, Mexico.
Authors: Daniela Cardenas-Pedraza, Marta Zapata-Tarres, Rocio Cardenas-Cardos, Roberto Rivera-Luna, Liliana Velasco-Hidalgo
Journal: Journal of Clinical Oncology (2014)

e21007 Background: Results of treatment of children with acute myeloid leukemia (AML) is a challenge. In low income countries toxicity of these regimens is the main cause of death. We present promising results of a cohort of patients under 18 treated in a single institution. Methods: a retrospective, longitudinal and clinical study was performed from January 2005 to September 2013. Nineteen cases of patients with AML were included. All patients received ADE as induction therapy (cytarabine 100mg/m2 q12h for 20 doses, daunorubicin 50mg/m2 days 1,3,5 and etoposide 100mg/m2 over days 1 to 5 and Medical Research Council (MRC) maintenance with four cycles. M3 AML were treated with ATRA and MRC protocol. Results: Median age was 124 months (21-210). 10.5% were M0, 15.5% M2, 21.1% M3, 26.3% M4, 10.5% M5, 15.8% M7. Two patients had inv16, two t(15;17), two t(8;21) and one 11q23. 42.1% had extramedular infiltration at diagnosis. Three patients needed one cycle for remission, ten needed two cycles and 5 three. The remission rate was 100%. Patients had between one and 9 infectious events, none fatal. One patient abandoned, two die of hemorrhage and one of septic shock. Four patients had bone marrow relapse and were rescued with progenitor cell transplantation. Analyzing non-M3 patients overall survival was 77.4% at 100 months. Conclusions: As an oncology department we have a selection bias with almost half of patients with extramedular infiltration. However, ADE induction therapy showed improved results in overall survival compared with other standard regimens. This regimen can be useful in other developing countries.
Characterisation of Long-Term Responders to First-Line Myeloma Therapy - Results from the UK Myeloma IX and XI Trials
Authors: Vallari Shah, David C. Johnson, Amy L Sherborne, Sidra Ellis, Amy Price, Jack Kendall, Laura Chiecchio, Alina Striha, Anna Hockaday, Charlotte Pawlyn, Matthew Jenner, Mark T Drayson, Roger G Owen, Walter M Gregory, Gareth Morgan, Faith E. Davies, Richard S Houlston, Gordon Cook, David Cairns, Graham H Jackson, Martin Kaiser
Journal: Blood (2018)