tbuckley/cabot-search huggingface dataset:
Trends in immunotherapy use in patients with advanced non-small cell lung cancer (aNSCLC) patients: Analysis of real-world data.
Authors: Lawrence H. Kushi, Laura Lasiter, Andrew J. Belli, Marley Boyd, Suanna S. Bruinooge, Jennifer Christian, Elizabeth Garrett-Mayer, Eric Hansen, Rebecca Honnold, Ruth Pe Benito, Yanina Natanzon, Lori Sakoda, Donna R. R Rivera, Whitney Rhodes, Nicholas J. Robert, Elad Sharon, Connor Sweetnam, Joseph Wagner, Mark S. Walker, Jeff Allen
Journal: Journal of Clinical Oncology (2020)

e19311 Background: Leveraging data from a collaboration with 9 data partners, Friends of Cancer Research convened the Real-world Evidence Pilot 2.0, to examine trends and real world (rw) data endpoints in immunotherapy (IO) use for the front line treatment of aNSCLC. Methods: This study leveraged parallel analyses of rw data elements across heterogenous data sources (EHR, administrative claims, and registry) to: a) describe trends in uptake and use of novel IO frontline therapy after advanced diagnosis in NSCLC patients treated in usual care settings and b) examine associations between treatment and rw outcomes at one-year follow-up. The proportion of patients treated on each regimen (IO single agent, chemo, or IO + chemo) from 2011 through 2017 were calculated. Analysis included proportion of patients across treatment regimens stratified by year to describe post approval uptake of IO. Kaplan-Meier survival estimates were reported to adjust for follow-up time and stratified by PD-L1 status and stage. Results: Seven datasets identified a range of 999 to 4617 patients per dataset for this analysis. Across datasets, 2508, 3446, and 4176 patients initiated treatment in 2015, 2016, and 2017, respectively. No patients received IO or IO + chemo regimens prior to 2015. Initial approvals for IO use in aNSCLC occurred in October 2015 and for first line in metastatic NSCLC in October 2016. When examining survival at 1 year, overall, OS in PD-(L)1 + patients appeared longer than those with a PD-(L)1 - status. Conclusions: RWE analyses may reveal important trends in clinical cancer patient care including patterns of off-label use. The heterogeneity in the timing of IO uptake across datasets ranged from immediately after approval to ~12 months post-approval. [Table: see text]
The potential biomarkers of checkpoint inhibitor immunotherapy in solid malignancies.
Authors: Nausheen Hakim, Jeffrey Chi, Rajvi Patel, Ryann Quinn, Xinhua Zhu
Journal: Journal of Clinical Oncology (2020)

e15226 Background: Tumor mutational burden (TMB), PDL1 status, microsatellite status (MS), tumor infiltrating lymphocyte, and the microbiome profile are commonly used biomarkers to predict which patients (pts) may benefit from immunotherapy (IO). However, they are imperfect and cannot be used to predict complete response (CR). Next Generation Sequencing (NGS) from Foundation Medicine has identified many gene mutations. We aim to identify potential biomarkers in pts who achieved CR with immunotherapies as opposed to in those who had upfront progression of disease (PD). Methods: We conducted a retrospective analysis of pts with metastatic solid tumors at our institution that received IO after NGS testing. Pts who achieved CR or PD per imaging studies and clinical settings were included. Gene alterations through NGS were identified in each group. Results: Eighty-one pts received IO who had NGS sent prior to treatment. Pembrolizumab, ipilimumab, nivolumab, durvalumab and atezolizumab were used as single agent or in combination with another IO or chemotherapy. 19 pts achieved CR, 18 pts had PD. In the CR group, melanoma and lung adenocarcinoma were most common tumor types (Table). 15 pts (78.9%) received IO as 1 st line treatment. Most common gene mutations in CR group were ROS1 (52.6%), LRP1B (52.6%), GRIN2A (47.4%), and EPHA7 (42.1%) in 19 patients. 18 pts with various tumor types (Table) had PD. Most of IOs were given as 2 nd or 3 rd line setting in NR group. Most common gene alterations were MLL2 (33.3%), CDKN2A/B (27.8%), NTRK1 (27.8%), ARID1B (22.2%) in 18 patients. Conclusions: The cohort of patients who achieved CR with IO had the most common gene mutations of ROS1, LRP1B, GRIN2A, and EPHA7 which can potentially serve as a biomarker to predict response to IO. Increased frequencies of MLL2, CDKN2A/ B, NTRK1, ARID1B mutations were found in patients with PD. The gene mutations in CR and PD groups are mutually exclusive. Further explorations at tumor environment, RNA and proteins levels are needed to identify combined potential biomarkers to predict IO response, followed by validation in the prospective study. The limitation is that the study is retrospective. [Table: see text]
牙痛被认为心绞痛
Authors: 曾昭耆
Journal: BMJ (2007)

一位82岁女病人因右下牙床痛到某院急诊.虽然心电图所见无异常,医生仍认为是心绞痛,留下输了几天液.病人自己去该院口腔科,因急诊医生认为是冠心病,口腔科医生不敢给予处理,故来我院就诊。
Biological analysis of HER2 equivocal (2+) cases in primary breast cancer.
Authors: Reiki Nishimura, Tomofumi Osako, Yasuhiro Okumura, Masahiro Nakano, Mamiko Fujisue, Nobuyuki Arima
Journal: Journal of Clinical Oncology (2020)

e12555 Background: Overexpression and/or amplification of HER2 is observed in 15–20% of all invasive breast cancer cases. Breast cancer patients with HER2 overexpression can benefit from anti-HER2 therapy. HER2 IHC results are generally divided into four values (range, 0 to 3+). The cases with a HER2 (2+) value should be assessed using FISH. The aim of this retrospective study was to evaluate the biological variables and prognosis of HER2 (2+) cases according to the FISH status. Methods: Primary breast cancer patients (n = 5419) were enrolled in this study from January 2002 to September 2019. The factors investigated included nodal status, tumor size, nuclear grade, ER/PgR and HER2 status, p53 overexpression, and the Ki-67 index values. Positive for HER2 is categorized as having a HER2 value of 3 + or FISH amplified in equivocal cases. Results: The HER2 3+ rate in non-invasive carcinoma was higher than the rate in the invasive carcinoma cases (16.4% vs 12.9%; p &lt; 0.0001). The distribution of HER2 IHC status in invasive carcinoma cases was 3+ (12.9%), 2+ (5.8%) and negative (84.3%). The FISH positive rate of the HER2 2+ cases was 57.0 % (158 cases). HER2 positivity significantly correlated with ER/PgR negative, p53 overexpression, higher Ki-67 value and nuclear grade. The FISH positivity of the HER2 2+ cases significantly correlated with PgR negative, p53 overexpression and higher grade. There were significant differences in biological variables between IHC 3+ and 2+/FISH positive, and between IHC 2+/FISH negative and IHC negative. Patients with HER2 3+ had significantly worse disease-free survival (DFS) rates than the cases before the approval of trastuzumab in Japan. However, there was no difference after trastuzumab was approved. Moreover, there was no difference in DFS according to the FISH status in HER2 2+ cases. Conclusions: HER2 positivity indicated a higher degree of malignancy. HER2 2+ had different independent biological characteristics from HER2 negative (0 &amp; 1+) or positive (3+) cases. Therefore, the difference in biology of HER2 2+ cases may influence the prognosis and should be reconsidered in breast cancer cases.
Research progress of comprehensive assessment tools in home care service
Authors: Xiaojingyuan Xu, Meirong Wang, Yingjie Liu
Journal: BMJ (2019)

A comprehensive assessment tool for home care can help to determine the service needs. This article summarizes some of the advanced assessment scales that have been internationally applied for the home health care and to discuss the direction for development of the assessment tools in China.


Key words: 
Geriatric assessment; Community health services; Home care service
Different imaging techniques in localization and diagnosis of insulinoma
Authors: Xiulian Gu, Jingtao Dou, Weijun Gu, Guoqing Yang, Jin Du, Kang Chen, Lijuan Yang, Li Zang, Xianling Wang, Nan Jin, Zhaohui Lü, Jianming Ba, Yiming Mu, Juming Lu, Jiangyuan Li
Journal: BMJ (2015)

Objective
To evaluate the application of different imaging techniques in diagnosis and localization of insulinoma.


Methods
The clinical data of 210 patients with insulinoma who underwent surgical treatment in Chinese PLA General Hospital from January 1985 to May 2014 were retrospectively reviewed.


Results
The typical Whipple Triad was presented in 92.4% (194/210) patients, and their venous blood glucose levels were lower than 2.8 mmol/L. The ratio of insulin to blood glucose was over 0.3 in 90.6%(163/180) patients. The positive rate of insulinoma localization by ultrasonography, CT, MRI, digital subtraction angiography (DSA), endoscopic ultrasonography (EUS) and contrast-enhanced ultrasonography (CEUS) were 33.5%(62/185), 66.0%(128/194), 72.5%(58/80), 94.5%(104/110), 83.2%(109/131) and 96.8%(92/95) respectively. EUS and CEUS had significantly higher positive rate in localizing insulinoma compared to other imaging techniques (χ2=7.48, P=0.00); there was no significant difference between EUS and CEUS(χ2=0.64, P=0.42).


Conclusion
Compared to other imaging techniques EUS and CEUS are more sensitive in diagnosis and localization of insulinoma; particularly, CEUS as a low-cost and simple method, should be used for preoperative diagnosis of insulinoma.


Key words: 
Insulinoma; Localization diagnosis; Contrast-enhanced ultrasonography
辅助生殖技术后宫内外同时妊娠八例
Authors: 潘颖, 明蕾, 杨菁, 黄琴
Journal: BMJ (2012)

回顾性分析8例辅助生殖技术后宫内外同时妊娠的患者,5例患者于移植后30 d内行阴道B超确诊,3例分别在移植后35、38、40 d确诊.宫内外妊娠因其确诊时间晚,极少能继续妊娠至分娩.早期阴道B超检查、定期监测和腹腔镜下患侧输卵管部分切除术是宫内外同时妊娠患者首选诊治方案。
上海市静安区467名商务楼宇员工健康调查和体检结果分析
Authors: 李莉, 徐慧明, 吕琳, 栾沁颖, 丁玎
Journal: BMJ (2011)

上海静安寺社区内现共有商务楼宇33幢,职工17 653名,商务楼宇员工已经逐渐成为一个新的群体.为进一步做好健康楼字工作,促进楼宇人群健康水平的提高,我们对上海静安区商务楼员工进行了健康问卷调查和健康体检,旨在发现楼宇员工的健康隐患,有针对性地提出健康促进方案和具体措施。
Predictive value of the Lung Immune Prognostic Index (LIPI) in locally advanced non-small-cell lung cancer (NSCLC) patients treated with concurrent chemoradiotherapy (CCRT) in the multicenter retrospective study.
Authors: Yuko Oya, Go Saito, Akihiro Tamiya, Hayato Kawachi, Daichi Fujimoto, Shunichiro Iwasawa, Hidekazu Suzuki, Takayuki Niitsu, Hirotaka Matsumoto, Eisaku Miyauchi, Takashi Yokoi, Miho Mitsui, Takeshi Uenami, Yoshihiko Sakata, Ichiro Nakachi, Asuka Okada, Satoshi Hara, Shunsuke Teraoka, Masaki Kokubo
Journal: Journal of Clinical Oncology (2020)

e21076 Background: PD-L1 inhibitor, durvalumab has been approved since the PACIFIC study showed its efficacy as consolidation therapy after CCRT for locally advanced NSCLC. But predictive factor for the efficacy of CCRT on this post PACIFIC era have not been known. LIPI has been proposed as a new biomarker for the anti-PD-1 therapy of advanced NSCLC. In this study, we investigated the usefulness of LIPI as a predictive marker in multicenter cohort of patients with locally advanced NSCLC who received CCRT as initial treatment. Methods: 219 patients with available baseline LIPI were reviewed. The progression free survival (PFS) was estimated by the Kaplan-Meier method, and LIPI were calculated at baseline. Kaplan-Meier estimates of PFS and recurrence were compared using the log-rank test for trend. Multivariable analysis was conducted using the Cox and logistic regression models, respectively, adjusted for age, sex, ECOG-PS, smoking, histology, TNM stage, chemotherapy regimens, Body mass index (BMI), PD-L1 status, EGFR or ALK mutation, and baseline LIPI. Results: 62.5% (n = 137) of the patients had a good (0 factors) LIPI, while 37.5% (n = 82) had intermediate (1 factor) and poor (2 factors) LIPI respectively. In multivariable analysis, good LIPI (0 factors) were significantly associated with longer PFS (HR = 0.46, 95% CI 0.28-0.75; P &lt; 0.01) as did ECOG-PS0 (P &lt; 0.01), ≤stageIIIA (P &lt; 0.01), being treated with durvalumab after CRT (P = 0.04). There were no difference in the patient characteristics between good LIPI and intermediate/poor LIPI, significantly. Higher LIPI (1 or 2 factors) were strongly prognostic factor for recurrence after CCRT in multivariate analysis (P = 0.04), along with ECOG-PS1≤ (P &lt; 0.01), stage IIIB≤ (P &lt; 0.01). Conclusions: The good LIPI predictive value for PFS and disease control in patients treated with CCRT was confirmed. Although a strong statistical significance, we needs to be confirmed further with longer follow-up and prospective study.
Phase I study of SNK01 (autologous non-genetically modified natural killer cells with enhanced cytotoxicity) in refractory metastatic solid tumors.
Authors: Sant P. Chawla, Katherine M Kim, Victoria S. Chua, Omid Jafari, Paul Y. Song
Journal: Journal of Clinical Oncology (2020)

e15024 Background: Natural Killer (NK) cells possess the innate ability to detect transformed cancer cells and kill them, thus playing a key role in cancer immunosurveillance and antitumor immunity. In general, prior NK cell therapies have not shown efficacy in solid tumors and the expansion of NK cells in cancer patients to clinically therapeutic doses is quite challenging, making allogenic preferable to autologous treatment. SNK01 is a first-in-kind, autologous non-genetically modified NK cell therapy with enhanced cytotoxicity which can be consistently produced even from heavily pretreated cancer patients, and has been shown to have efficacy against numerous solid tumor types in preclinical studies. Methods: In this single-arm Phase I study (NCT03941262) to investigate the safety and efficacy of SNK01, patients with refractory metastatic solid tumors were treated in a 3 + 3 dose escalation study with five weekly infusions of SNK01 at 1, 2, or 4 x 10 9 cells per infusion. Primary endpoint is safety and quality of life (QoL), and secondary endpoint is objective response rate (ORR). Results: Seven of nine planned patients have been enrolled up to date and five have completed treatment. All patients have rapidly progressive metastatic disease and have received an average of five lines of prior therapy. Tumor types include one non-small lung cancer, one colorectal cancer, and five sarcomas. Median age is 52 (32-62). All patients have had successful expansion and cytotoxic enhancement of their NK cells. Three patients have completed 1 x 10 9 SNK01 and two patients have completed 2 x 10 9 SNK01. There have been no adverse events according to NCI-CTCAE v 5.0 or any cytokine release syndrome, and all patients have reported an overall improvement in QoL. At week 9, three of three patients at the 1 x 10 9 dose and one of two at the 2 x 10 9 achieved a best overall response of stable disease as per RECIST 1.1. Conclusions: Expanding and increasing the cytotoxicity of NK cells in our heavily pretreated patients has been consistently reliable. SNK01 monotherapy has been very safe and well tolerated in patients with rapidly progressive solid tumors. MTD has not been reached and dose escalation is ongoing. Evaluation of anti-tumor activity is ongoing, but at a minimum, SNK01 appears to slow and possibly halt progression in very aggressive disease and improve quality of life while improving the overall quality of life. The remaining two planned patients are currently being enrolled and a full update will be presented. Clinical trial information: NCT03941262 .
Safety of a trastuzumab biosimilar, used under routine clinical practice conditions in adult HER2+ breast cancer patients in Morocco.
Authors: Hassan Errihani, Narjiss Berrada, Mouna Khouchani, Abdelkader Acharki, Kamal Lahbabi, Hassan Jouhadi, Meryem Glaoui
Journal: Journal of Clinical Oncology (2020)

e13024 Background: Hertraz, the first trastuzumab biosimilar was approved in Morocco in 2017. Real world data on trastuzumab biosimilars are very limited or not available. HERLife is a prospective, non-interventional phase IV study program that investigated the experience of using Hertraz, a biosimilar for trastuzumab (Herceptin), under routine clinical practice conditions in Morocco. The primary aim of this study was to confirm the acceptable safety and tolerability of Hertraz. Methods: Ninety-nine patients with HER2-positive breast cancer treated with Hertraz were enrolled from 8 public and private sector hospitals and followed up for 12 months as part of this non-interventional study. Cardiac events (LVEF) and other unexpected or serious adverse events were monitored. The study arms consisted of patients with early breast cancer (Arm 1, n=70) and metastatic breast cancer (Arm 2, n=29) whose median age was 53 years in both groups. Results: Switching from Herceptin to Hertraz was observed in 45% of 29 MBC patients and 27% of 70 EBC patients. Switching was done at a median of 4th cycle. Pertuzumab was used in combination with Hertraz in 69% and 19% of patients in the metastatic and neoadjuvant settings, respectively. Two patients had a decline in LVEF. One patient treated with Hertraz alone and one patient treated with Hertraz and pertuzumab developed a decrease in LVEF requiring a three-week treatment discontinuation of Hertraz. Treatment of Hertraz was continued after 1 skipped cycle without occurrence of new side effects. No other trastuzumab related adverse events was observed. Four patients in the metastatic group and 2 patients in the early breast cancer arm had a relapse in the 12 months of clinical follow-up. Conclusions: The management of HER2+ breast cancer in Morocco follows the international recommendations. This is the first real world safety data of Hertraz from Morocco. The 12-month follow-up treatment with Hertraz showed an acceptable cardiac safety profile. In cases where there was a switch from Herceptin to Hertraz or Hertraz combined with pertuzumab, the safety profile was similar to that previously reported in other studies.
Age-related lymphoma patient experience: Results from the Lymphoma Coalition 2018 Global Patient Survey.
Authors: Raul Cordoba, Natacha Bolanos, Lorna Warwick, Natalie Dren
Journal: Journal of Clinical Oncology (2020)

e20071 Background: Over the past two decades, the incidence of lymphoma has increased by 8-10% per year in older adults. Despite the growing population of older cancer patients, there are a limited number of studies that focus on the experience of these patients. Lymphoma Coalition (LC) saw the need in the 2019 Report Card on Lymphomas to examine the age-related lymphoma patient experience. The objectives of this study were to identify: 1) informational needs and understanding levels, 2) physical conditions and medical issues, 3) psychosocial issues, and 4) barriers in patient-doctor communication. Methods: Using a subset of data from the LC 2018 Global Patient Survey on Lymphomas and CLL (LC 2018 GPS), this study will specifically examine the experiences of newly diagnosed lymphoma patients within the following age categories: 1) Young (18-59) (n = 1473); Mid (60-69) (n = 371); Old (70+) (n = 162). Results: From January to March 2018, 2,006 participants were included in this analysis from 47 countries. The majority of all three patient groups wanted additional medical information beyond what was provided at their diagnosis meeting with the doctor, with the greatest need for information in the young patient group (73%). The highest proportion of poor understanding was reported by the mid-age group (14%) and the highest proportion of very good understanding was reported by the old age group (53%). Across all three age groups, fatigue was the top reported physical condition affecting well-being. Regarding older patients, hair loss was reported in 36% vs 54% in younger patients (p = 0.01), and muscle weakness was reported in 40%. A greater proportion of those in the old group reported that their lifestyle (86%) and general activity level (87%) had been affected. The reported prevalence of medical issues was highest in the young group and lowest in the old group, both during and after treatment. Fear of relapse was the top reported psychosocial issue following treatment for patients in all three age groups. Of those who discussed their fear of relapse with their doctor (young 42% vs old 21%, p = 0.0022), less than one third of patients felt their discussion helped alleviate the fear. Conclusions: This study emphasizes that lymphoma patients in all age groups need more information and support beyond what is currently being provided. While certain age-specific trends were identified, the majority of patient-reported issues span across all three of the age groups examined.
Clinical Practice Guideline for Systemic Antifungal Prophylaxis in Pediatric Patients With Cancer and Hematopoietic Stem-Cell Transplantation Recipients
Authors: Thomas Lehrnbecher, Brian T. Fisher, Bob Phillips, Melissa Beauchemin, Fabianne Carlesse, Elio Castagnola, Nathan Duong, L. Lee Dupuis, Vicky Fioravantti, Andreas H. Groll, Gabrielle M. Haeusler, Emmanuel Roilides, Michelle Science, William J. Steinbach, Wim Tissing, Adilia Warris, Priya Patel, Paula D. Robinson, Lillian Sung
Journal: Journal of Clinical Oncology (2020)

To develop a clinical practice guideline for systemic antifungal prophylaxis in pediatric patients with cancer and hematopoietic stem-cell transplantation (HSCT) recipients.Recommendations were developed by an international multidisciplinary panel that included a patient advocate. We conducted a systematic review of systemic antifungal prophylaxis in children and adults with cancer and HSCT recipients. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to make strong or weak recommendations and to classify level of evidence as high, moderate, low, or very low. The panel considered directness of the data to pediatric patients.There were 68 randomized trials included in the systematic review, of which 6 (9%) were conducted in a solely pediatric population. Strong recommendations were made to administer systemic antifungal prophylaxis to children and adolescents receiving treatment of acute myeloid leukemia, to those undergoing allogeneic HSCT pre-engraftment, and to those receiving systemic immunosuppression for graft-versus-host disease treatment. A strong recommendation was made to administer a mold-active agent with an echinocandin or a mold-active azole when systemic antifungal prophylaxis is warranted. For children younger than 13 years of age, an echinocandin, voriconazole, or itraconazole is suggested. Posaconazole may also be used in those age 13 years or older. A strong recommendation against routine administration of amphotericin as systemic antifungal prophylaxis was made.We developed a clinical practice guideline for systemic antifungal prophylaxis administration in pediatric patients with cancer and HSCT recipients. Implementation and assessment of guideline-concordant rates and impacts are important future steps.