tbuckley/cabot-search huggingface dataset:
Results of a novel neoadjuvant chemotherapy (NAC) regimen for breast cancer.
Authors: Noridza Rivera-Rodriguez, Fernando Cabanillas, Lesley Lawrenson, Viviana Negron, Orestes Antonio Pavia, Margarita Bruno, Miguel M. Echenique, Victor Carlo, Idalia Liboy
Journal: Journal of Clinical Oncology (2013)

e11610 Background: Achieving a pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) has been associated with improved disease free survival (DFS) and overall survival (OS). The Residual Cancer Burden Score (RCB) method is a useful tool that predicts DFS and OS after NAC. We present the results of pts with either triple negative or HER2 positive breast cancer treated with a novel NAC. Methods: 34 pts with localized breast cancer &gt;1 cm with HER2+ (N=19) or triple negative breast cancer (TNBC) (N=15) were treated with this novel regimen consisting first of TEC (docetaxel 75 mg/m 2 , epirubicin 80 mg/m 2 , and cyclophosphamide 500 mg/m 2 ) + PEG Filgrastim x 4 cycles. Following the 4th course, TNBC patients received 4 additional TEC cycles if they achieved CR by MRI, or were switched to a non cross-resistant regimen (vinorelbine, bevacizumab, capecitabine) if they had &lt; CR. HER2+ pts received TEC x4 followed by docetaxel + trastuzumab x 4. RCB score was used to measure pathologic response. Pretreament PET scan was done and repeated after course 1 in order to correlate with RCB. Results: Median age was 56 (58 for Her2+ and 49 for TNBC). RCB= 0 (pCR) was achieved in 76%, while only 1 responded poorly (RCB=3). There was no significant difference in the pCR rate between Her2+ and TNBC patients (74% vs 80% respectively), but there was a difference in the rate of pCR without DCIS and invasive cancer between these two (see table, p=0.034). Pts with SUV drop &gt; 5% after 1st TEC had 84% pCR while none with &lt; 5% achieved pCR (p=0.001). Comparison of our results with other NAC regimens reported in the literature is summarized in the table below. Conclusions: This novel chemotherapy approach results in a high pCR rate and RCB 0-1, which have been associated with improved clinical outcomes. Early PET can predict pCR. Although sample size is modest, results are encouraging and deserve further evaluation. Clinical trial information: NCT 00830544. [Table: see text]
Three years experience of infantile Wilms tumour at a single institute in a developing country
Authors: A. A. Patel, K. M. Patel, S. A. Shah, P. M. Shah, S. N. Shukla, B. J. Parikh, A. S. Anand, S. S. Talati, R. K. Srivastav, K. A. Kattimani
Journal: Journal of Clinical Oncology (2007)

20028 Background: Wilms tumor (nephroblastoma) is the second most common malignant retroperitoneal tumor. It is the most common primary renal tumour of childhood and is a paradigm for multimodal treatment of a pediatric malignant solid tumor. The median age at diagnosis is 4 years and it is uncommon in infancy. We present a three year retrospective analysis of Wilms tumor in infants treated at out institute. Methods: A total of 16 cases of Wilms tumor were diagnosed in pediatric patients aged one and below between January 2003 to December 2005. Out of these, 11 patients were evaluable. All of them were given treatment as per the National Wilms Tumor Study- 5 protocol. Results: The median age of presentation was 10.8 months, one child was 5 months old rest all were between 10 and 12 months. The male to female ratio was 2.3:1. The most common presenting complaint was mass per abdomen, which was seen in 10 patients, one patient presented with pain in abdomen and hematuria. None of the patients had evidence of any other systemic involvement. 7 patients were in Stage I, 2 each were in stage II and stage III. Triphasic classical type (favorable) was the histopathological subtype in 9 patients and 2 had unfavorable histopathological subtypes. All the 10 cases underwent total Nephrectomy [three at our institute and the rest elsewhere] of the diseased kidney followed by treatment as per the National Wilms Tumor Study- 5 protocol with 50% dose reduction. 7 cases (70%) showed complete remission and presently are under observation. Three cases were lost to follow up after surgery. One patient with stage three disease was given anterior chemotherapy but was lost to follow up after 9 weeks of chemotherapy. Conclusion: Wilms tumor presenting in infancy when treated appropriately has a good outcome although not as good as in older children. No significant financial relationships to disclose.
Predicting respiratory failure in amyotrophic lateral sclerosis: still a long way to go
Authors: Dan Adler, Antoine Poncet, Ruxandra Iancu Ferfoglia, André Truffert, Jean-Paul Janssens
Journal: European Respiratory Journal (2019)

Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive neurodegenerative disease that affects the brain and spinal cord motor neurons leading to progressive muscle weakness, irreversible disability, respiratory failure and death within a time range of a few months to more than 10 years [1]. Although use of noninvasive ventilation (NIV) is standard of care in ALS and improves health-related quality of life and survival [2, 3], no accurate model to predict respiratory failure in ALS was available until the recently published work by Ackrivo et al . [4]. The authors should therefore be congratulated for this much awaited contribution to this field. Recently published model to predict respiratory failure in ALS may not perform well across different populations and in single individuals <http://bit.ly/2XbI6Me>
Capecitabine and cisplatyl as neoadjuvant treatment of locally advanced nasopharyngeal carcinoma
Authors: E. Kerboua
Journal: Journal of Clinical Oncology (2009)

e17036 Background: The main objective of this study is to evaluate the activity and safety of capecitabine (X) and cisplatyl (C) in patients (pts) with locally advanced nasopharyngeal carcinoma(NPC). Capecitabine was reported to have single-agent activity in advanced/metastatic NPC. Combination of X and C should provide a convenient and active regimen. Methods: Pts with undifferentiated NPC type were enrolled from July 2007 to September 2008. They received X 1,000 mg/m 2 orally bid on days 1–14 + C 75/m 2 IV day 1 q 3W, Three cycles were administered in a neoadjuvant setting before radiotherapy. The primary endpoint was overall response rate (ORR). Results: Forty-one (41) pts have been enrolled 28 male/13 female with locally advanced NPC: 15 pts (36,6% ) were stage III (UICC 1997) 26 pts (63,3%) stage IV (n = 6 IVA and n = 20 IVB). All pts were evaluated for safety and 36 pts for response. ORR was 86% with 63,8% (n = 23) complete response (CR), 22,2% (n = 8) partial response (PR), 2 progression disease (PD) and 2 stable disease (SD). The most common grade 3/4 adverse events were diarrhea 4,8% (n = 2), neutropenia 7,3% (n = 3), thrombocytopenia 7,3% (n = 3), vomiting 9,7% (n = 4) . Two pts died from sepsis that was probably treatment-related. A hand-foot syndrome was observed in 25% of pts (grade 1/2). Conclusions: Preliminary results show that X plus C provide an active regimen with an acceptable tolerability profile as neoadjuvant chemotherapy for locally advanced NPC. This regimen requires a shorter hospital stay and is more convenient for pts compared with the gold standard 5-FU plus cisplatyl. No significant financial relationships to disclose.
Abstract 1602: Urine cell-free DNA as early biomarker in immunotherapy response in NSCLC
Authors: Anthonie J. van der Wekken, Arja ter Elst, Anneke Miedema, Thijo J. Hiltermann, Harry J. Goen, Ed Schuuring
Journal: Cancer Research (2018)

Abstract Introduction: Immunotherapy shows a durable tumor response in approximately 20% of advanced NSCLC patients. Imaging by CT is used to evaluate tumor response. PD-L1 immunohistochemistry is generally used to predict survival advantages, however with low predictive value. Therefore, it is important that alternative predictive biomarkers are investigated. Minimal invasive techniques may be a solution. The role of circulating cell-free DNA (cfDNA) was found to be an early biomarker for tumor response in KRAS positive Non-Small Cell Lung Cancer (NSCLC) patients treated with immunotherapy (N=6). In this study we will determine the role of urine cell-free DNA (ucfDNA) in an extended cohort. The non-invasive method of urine collection makes it an excellent source for mutation detection and follow-up. Methods: In an ongoing study KRAS positive patients treated with immunotherapy, are being tested for cfDNA at baseline (before treatment, 1, 2, 4, 6 and thereafter every 12 weeks until disease progression) with a KRAS G12-13 or Q61H digital droplet PCR (ddPCR) screening assay (BioRad). In a pilot study, urine from these patients is collected in a tube with 5 ml of STRECK reagent at baseline and at 6 weeks. Results: In 16/27 patients with KRAS positive advanced NSCLC, the mutation was detected in plasma at baseline and subsequent evaluation time points. Urine cfDNA as a predictive marker seems promising and results will be reported and presented at the AACR meeting. Conclusion: Among patients with advanced NSCLC treated with immunotherapy plasma and urine cfDNA are collected and will be presented as non-invasive early biomarker for tumor response evaluation. Citation Format: Anthonie J. van der Wekken, Arja ter Elst, Anneke Miedema, Thijo J. Hiltermann, Harry J. Goen, Ed Schuuring. Urine cell-free DNA as early biomarker in immunotherapy response in NSCLC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1602.
Scotland’s breast screening review does not tackle benefit-risk issue
Authors: Bryan Christie
Journal: BMJ (2019)

A major review into the operation of Scotland’s breast cancer screening programme is to be conducted, three decades after the service was introduced. It will look at the current pressures on the service and future delivery options while examining how to encourage greater participation.

Although the Scottish government described it as a “fundamental review,” it will not deal with concerns among some leading clinicians that breast cancer screening does more harm than …
Operative outcomes using bevacizumab, docetaxel, and cisplatin as induction therapy in patients with operable lung cancer
Authors: D. J. Finley, R. Shen, N. A. Rizvi, V. W. Rusch, M. G. Kris
Journal: Journal of Clinical Oncology (2009)

7559 Background: Induction chemotherapy in patients with operable non-small cell lung cancer (NSCLC) is better tolerated than adjuvant chemotherapy. Bevacizumab improves survival in patients with advanced NSCLC; however its impact as an induction agent in patients undergoing lung resection is unknown. Here, we evaluated surgical outcomes in patients undergoing resection for NSCLC after induction therapy with bevacizumab (Bev), docetaxel (D) and cisplatin (C). Methods: Patients with stage IB-IIIA NSCLC, who could undergo resection with curative intent, were eligible for this phase II trial. None had squamous histology, large central tumors, or recent hemoptysis. All patients received up to 4 cycles of D 75 mg/m2 and C 75 mg/m2 and also received 3 cycles of Bev 15 mg/kg, followed by surgery. Two age and stage matched controls who received induction chemotherapy were selected per study patient. Fisher's exact tests compared pathologic stage, gender, and smoking history. Conditional logistic regression explored the association between clinical variables and outcomes in study versus control patients. Results: 30 patients received Bev-DC. Gender, smoking history, operative time, blood loss, and overall 30-day morbidity was similar between study and control patients. The 30 patients who received Bev-DC preoperatively had 12 complications vs 23 in the 60 controls. In the Bev-DC group there were 7 grade 3/4 complications (abscess (1), empyema (1), bronchopleural fistula (2), sigmoid volvulus (1), anastomotic dehiscence (1), GI bleed (1)) as compared to 2 in the control group (p=0.004). There were no deaths in the Bev-DC group and 2 among the controls. After controlling for age, gender and stage, patients in the study group had a trend towards increase incidence of overall complications (OR=3.89 (95%CI: 0.61–24.77) p=0.151). Conclusions: Although rates of 30-day morbidity were comparable, patients receiving Bev-DC induction had a higher incidence of grade 3/4 complications. There was no 30-day mortality among the patients receiving Bev-DC. Based on this interim analysis, patients receiving Bev-DC in the preoperative setting merit close monitoring. [Table: see text]
Phase II study of pemetrexed (Pem) and cisplatin (Cis) plus cetuximab (Cet) followed by Pem and Cet maintenance therapy in patients (Pts) with advanced nonsquamous non-small cell lung cancer (NSCLC).
Authors: Gerald Schmid-Bindert, Vittorio Gebbia, Frank Mayer, Edurne Arriola, Diego Marquez-Medina, Konstantinos N. Syrigos, Bonne Biesma, Monika Iris Leschinger, Carla M. Visseren Grul, Bente Frimodt-Moller, Veronique Ripoche, Scott Myrand, Tuan Nguyen, Annamaria Zimmermann, Wolfgang Schuette
Journal: Journal of Clinical Oncology (2012)

7554 Background: A prospective, nonrandomized, multicenter study was conducted to assess the effect of adding cet to pem and cis in pts with advanced nonsquamous NSCLC. Methods: 113 Caucasian performance status 0-1 pts received 1 st line pem (500 mg/m 2 ) and cis (75 mg/m 2 ) on day 1 (21d cycle) for 4-6 cycles and cet (400 mg/m 2 loading dose followed by 250 mg/m 2 ) weekly. Non-progressive pts received pem 500 mg/m 2 on day 1 (21d cycle) plus cet (250mg/m 2 weekly) until progression. Pts received vitamin B12/folic acid and dexamethasone. Primary endpoint was objective response rate (ORR) (RECIST 1.0). Secondary endpoints were progression free survival (PFS), 1 year survival rate, translational research (TR) and safety. Results: Pts’ characteristics: median age 59.7 years, 64% male, 50% PS 0, 92% stage IV, and 78% adenocarcinoma. All pts completed ≥ 1 cycle of induction therapy and 45% and 43% completed ≥ 1 cycle of maintenance with pem and cet, respectively. ORR (n=109) was 38.5% (80% CI 32.2-45.1), all partial responses. Disease control rate (response/stable disease) was 59.6% (80% CI: 53.1-65.9). Median PFS was 5.82 months (80% CI: 4.40-6.70). One year survival rate was 0.45 (80% CI: 0.39-0.51). Significant associations were seen between high EGFR by IHC and increased PFS (cytoplasm: HR=0.46, p=0.035; membrane: HR=0.41, p=0.008), and between high nuclear TTF-1 and increased ORR (OR=7.73, p=0.021) / PFS (HR=0.21, p&lt;0.001) / OS (HR=0.25, p=0.035). Of 113 pts evaluated for safety, 73 (64.6%) pts had drug related CTC Grade 3/4 adverse events (AE): most frequent were neutropenia (14.2%), rash (15%), and vomiting (8.8%). Drug related serious AEs were reported in 27.4% pts: most frequent were anemia (5.3%), neutropenia (5.3%), vomiting (3.5%), and rash, renal failure, diarrhea and fatigue (1.8% each). There were 2 potential on-study drug related deaths (sudden death and large intestinal perforation). Conclusions: Pem, cis and cet appeared efficacious and tolerable. These results support further evaluation in a randomized trial. The TR outcomes are hypothesis generating given the study’s size and nonrandomized nature.
Risk factors for oral mucositis (OM) in multiple myeloma (MM) patients receiving high-dose melphalan (Mel) prior to autologous stem cell transplantation (SCT).
Authors: Bhavana Bhatnagar, Olga G. Goloubeva, Steven Gilmore, Arnold Hoffman, Kathleen Ruehle, Gorgun Akpek, Aaron Rapoport, Saul Yanovich, Ashraf Z. Badros
Journal: Journal of Clinical Oncology (2012)

e19565 Background: OM is a common complication of high-dose melphalan in MM patients (pts). Proposed risk factors for OM in SCT include: low albumin and high serum creatinine (Cr) levels, both were evaluated in MM patients undergoing Mel/ASCT. (Grazziutti, ML, Bone Marrow Transplant 2006). Methods: This is a single center retrospective chart review of 214 sequentially treated MM pts who received Mel 200mg/m2 conditioning prior to SCT between January 2005-September 2011. Data collected included: demographics, Hgb, Cr, C-reactive protein and albumin on the day of SCT, length of hospital stay. OM assessment was graded as follows: Grade 1, no OM; Grade 2, mild OM; the pts maintained adequate oral intake; Grade 3, decreased oral intake and/or use of oral narcotics; Grade 4, severe OM needing intravenous narcotics. Results: The table below describes pt characteristics grouped by OM grade. Overall, 56 pts (27%) had grade 3/4 OM. Multivariate analysis of variance revealed no statistically significant correlation between OM grade and Hgb, Cr, albumin, CRP; the overall test’s p value = 0.55. There were no racial or gender differences with regard to grade of mucositis, the p-values range are 0.75 and 0.31, respectively (likelihood ratio chi-square test). Most interestingly, OM did not impact length of hospital stay. Conclusions: We did not establish any predictive risk factors for OM as previously described. Analysis of the impact of OM on MM response and event and overall survival will be presented. Studies of Mel pharmacogenetics may provide insight to patients' predisposition to OM. [Table: see text]
Identification of Emergency Care–Sensitive Conditions and Characteristics of Emergency Department Utilization
Authors: Anita A. Vashi, Tracy Urech, Brendan Carr, Liberty Greene, Theodore Warsavage, Renee Hsia, Steven M. Asch
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Monitoring emergency care quality requires understanding which conditions benefit most from timely, quality emergency care. <h3>Objectives</h3> To identify a set of emergency care–sensitive conditions (ECSCs) that are treated in most emergency departments (EDs), are associated with a spectrum of adult age groups, and represent common reasons for seeking emergency care and to provide benchmark national estimates of ECSC acute care utilization. <h3>Design, Setting, and Participants</h3> A modified Delphi method was used to identify ECSCs. In a cross-sectional analysis, ECSC-associated visits by adults (aged ≥18 years) were identified based on<i>International Statistical Classification of Diseases, Tenth Revision, Clinical Modification</i>diagnosis codes and analyzed with nationally representative data from the 2016 US Nationwide Emergency Department Sample. Data analysis was conducted from January 2018 to December 2018. <h3>Main Outcomes and Measures</h3> Identification of ECSCs and ECSC-associated ED utilization patterns, length of stay, and charges. <h3>Results</h3> An expert panel rated 51 condition groups as emergency care sensitive. Emergency care–sensitive conditions represented 16 033 359 of 114 323 044 ED visits (14.0%) in 2016. On average, 8 535 261 of 17 886 220 ED admissions (47.7%) were attributed to ECSCs. The most common ECSC ED visits were for sepsis (1 716 004 [10.7%]), chronic obstructive pulmonary disease (1 273 319 [7.9%]), pneumonia (1 263 971 [7.9%]), asthma (970 829 [6.1%]), and heart failure (911 602 [5.7%]) but varied by age group. Median (interquartile range) length of stay for ECSC ED admissions was longer than non-ECSC ED admissions (3.2 [1.7-5.8] days vs 2.7 [1.4-4.9] days;<i>P</i> &lt; .001). In 2016, median (interquartile range) ED charges per visit for ECSCs were $2736 ($1684-$4605) compared with $2179 ($1118-$4359) per visit for non-ECSC ED visits (<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> This comprehensive list of ECSCs can be used to guide indicator development for pre-ED, intra-ED, and post-ED care and overall assessment of the adult, non–mental health, acute care system. Health care utilization and costs among patients with ECSCs are substantial and warrant future study of validation, variations in care, and outcomes associated with ECSCs.
Trends in rectal cancer survival in relation to the local control strategy
Authors: S. Latosinsky, A. A. Demers, X. Sun, D. Turner
Journal: Journal of Clinical Oncology (2006)

13536 Background: The Swedish Rectal Cancer Trial showed improved survival with improved local control due to adjuvant radiotherapy. Improved survival in several population-based studies, credited to improved local control due to quality assurance programs involving surgery, ± radiotherapy, has also been reported. In Manitoba (Canada) local control in rectal cancer was suboptimal in the mid 1990’s (local recurrence &gt;18% in stage I-III) despite adopting the 1991 NIH chemo-radiotherapy guidelines. There continues to be no quality assurance program. We were interested in exploring trends in survival in Manitoba, particularly in the subset of patients where local control is an issue. Methods: All patients diagnosed with rectum and rectosigmoid adenocarcinoma from 1985 to 1999 were identified from the Manitoba Cancer Registry. Demographic, peri-operative and operative treatment information, and death dates were abstracted from the Registry. Manitoba population and death counts used in the calculation of age-specific relative survival probabilities were obtained from Statistics Canada. Survival was examined for all patients for the time periods of 1985–89, 1990–94 and 1995–99 and subsequently limited to those that underwent major rectal cancer surgery (Hartmann’s, anterior, and abdominal perineal resection). The Ederer II method was used in the estimation of survival probabilities. Results: A total of 3021 rectal cancer patients were identified with 1723 (57.0%) having major surgery. Five-year relative survival for all patients was 48.7%, 49.6% and 56.2% for the three periods respectively. The major surgery group results were 56.9%, 58.1% and 59.7%. Peri-operative radiotherapy was used in 38% of the 1995–99 major surgery group, twice the rate of 1985–89; peri-operative chemotherapy 41%, a ten-fold increase. Conclusions: Consistent with other studies, overall rectal cancer five-year survival in Manitoba has improved since 1985. Smaller survival improvements in the major surgery subgroup, despite increased radiotherapy use (as well as chemotherapy), suggests that better local control was not the major factor in the overall survival improvement, as has been suggested in other studies. Future work should include review of the local control strategy and factors to explain the improved survival. No significant financial relationships to disclose.