tbuckley/cabot-search huggingface dataset:
Retrospective review of 11C-choline detected thoracic lesions in prostate cancer.
Authors: Muneeb Rehman, Aaron Scott Mansfield
Journal: Journal of Clinical Oncology (2019)

325 Background: Prostate cancer recurrence is detected by serum measurements of prostate specific antigen (PSA). Upon PSA elevation, locating sites of recurrence is important to guiding treatment and affecting patient outcomes. The imaging modalities in current practice have varying sensitivities and specificities and often miss early recurrent disease. 11C-choline positron emission tomography (11C-PET) may be able to detect occult disease and guide treatment decisions earlier in the clinical course. We assessed a case series of patients who underwent 11C-PET imaging and were identified to have thoracic disease to estimate the benefit of detection with this modality. Methods: Clinical records were retrospectively reviewed of seventy patients from thoracic oncology teams at Mayo Clinic in Rochester, Minnesota. Patients who had thoracic +/- extra-thoracic metastases on 11C-PET imaging were followed, noting changes in treatment and PSA trends to look for biochemical recurrence of disease. Results: Seventy patients with thoracic metastases discovered on 11C-PET imaging were initially identified. Median time to choline-avid disease from original diagnosis was 82 (IQR: 40-129) months with a median PSA at time of choline of 7.4 (IQR: 3.1-15.7). 11C-PET findings showed 28 patients with metastases limited to the thorax and 42 patients with thoracic and extra-thoracic metastases. After 11C-PET imaging, 1 patient underwent localized therapy only (radiation and surgery), 44 patients underwent systemic therapy only (chemotherapy or hormonal therapy), 19 patients underwent both localized (cryotherapy, radiation, or surgery) and systemic therapy, 3 patients underwent no further treatment, and 3 patients were lost to follow up. After a median follow-up of 36.5 (IQR: 13-52) months, 30 patients had no recurrence and 20 had evidence of biochemical recurrence. For those who underwent local therapy (N=21), 11 had no recurrence of disease. Conclusions: Choline-based imaging may earlier identify metastatic disease that is amenable to local therapy. Further studies are needed to validate the effectiveness of 11C-PET in identifying early, responsive metastatic prostate cancer and its utility in affecting patient outcomes.
Standardized and Simplified Robot-assisted Superextended Pelvic Lymph Node Dissection for Prostate Cancer: The Monoblock Technique
Authors: Agostino Mattei, Christoph Würnschimmel, Philipp Baumeister, Ajet Hyseni, Luca Afferi, Marco Moschini, Livio Mordasini, Pietro Grande
Journal: European Urology (2020)
Nationwide utilization of cardiac imaging in patients undergoing cardiotoxic chemotherapy.
Authors: Michaela Ann Dinan, Yanhong Li, Shelby D. Reed, Winson Y. Cheung
Journal: Journal of Clinical Oncology (2015)

6592 Background: Current guidelines recommend cardiac evaluation in patients undergoing selected cardiotoxic regimens. However, utilization of cardiac imaging and adherence to guidelines have not been previously examined in a nationally representative cancer patient population. Methods: Retrospective SEER-Medicare analysis of patients with incident cancer of the breast, lung, colon, prostate (metastatic), leukemia (acute) or lymphoma between 2000 and 2009. We examined claims-based receipt of chemotherapy, cardiotoxic chemotherapy (anthracycline, trastuzumab, or bevacizumab) and their association with cardiac evaluation in the year following diagnosis. Results: A total of 346,903 patients met study criteria (Table). Receipt of cardiotoxic chemotherapy ranged from 1% in prostate cancer to 35% in lymphoma. Overall, 43% of patients underwent cardiac evaluation (84% echo, 30% exercise EKG, 9% MUGA, 1% nuclear imaging, 0.2% cardiac PET). Among patients receiving cardiotoxic chemotherapy, 80-90% of breast, leukemia, and lymphoma patients underwent one or more cardiac studies compared to only 40-60% of patients with colorectal, lung, or prostate cancer. Conclusions: Cardiac evaluation appears more common in cancer populations more frequently treated with cardiotoxic chemotherapy than in cancer populations with less exposure to these agents. Increased awareness of cardio-oncologic principles may be warranted among oncologists treating cancer types for which cardiotoxicity has not historically been a concern. Cardiac imaging utilization by receipt of systemic and cardiotoxic therapy, 2000-2009. Cohort Total Patients (N = 346,903) Systemic Chemotherapy Cardiac Imaging Any† Cardiotoxic Chemotherapy No Chemotherapy Any Noncardiotoxic Chemotherapy Cardiotoxic Chemotherapy Acute Leukemia 9,621 13% 2% 51% 73% 85% Breast Curative 86,261 20% 12% 27% 68% 84% Palliative 6,882 37% 23% 36% 72% 83% Colorectal Curative 84,504 25% 2% 46% 41% 48% Palliative 20,277 41% 14% 37% 39% 42% Lung Curative 29,715 25% 1% 57% 61% 62% Palliative 78,509 40% 3% 34% 43% 48% Lymphoma Early Stage 10,902 56% 36% 41% 76% 89% Late Stage 12,835 64% 35% 51% 75% 91% Metastatic Prostate 7,397 8% 1% 33% 38% 61%
The Disease Risk Index Predicts Outcomes Including Relapse and Survival in CD34-Selected Allogeneic HCT for Acute Leukemia and Myelodysplastic Syndrome
Authors: Christina Cho, Patrick Hilden, Jonathan U. Peled, Scott T. Avecilla, Pere Barba, Juliet N. Barker, Hugo R. Castro-Malaspina, Sergio A. Giralt, Ann A. Jakubowski, Guenther Koehne, Richard C. Meagher, Molly A. Maloy, Richard J. O'Reilly, Esperanza B. Papadopoulos, Doris M. Ponce, Marcel R. M. van den Brink, James W. Young, Miguel-Angel Perales
Journal: Blood (2016)
Prospective validation of cerebrospinal fluid (CSF) circulating tumor cells (CTC) to diagnose leptomeningeal metastasis (LM) from epithelial tumors.
Authors: Xuling Lin, Martin Fleisher, Antonio Marcilio Padula Omuro, Larisa Shagabayeva, Elena Pentsova
Journal: Journal of Clinical Oncology (2015)

2072 Background: The diagnosis of LM remains challenging, as standard diagnostic tools such as CSF cytology and MRI have low sensitivity. We previously showed that detection of CSF CTC by rare cell capture technology (RCCT) may be a more sensitive technique to detect LM from epithelial tumors at early stages. To validate those findings, we evaluated the performance of CSF CTC analysis in a new cohort of patients with a suspicion of LM. Methods: In this IRB-approved prospective study, patients with epithelial tumors who had clinical symptoms suspicious for LM were enrolled. All patients underwent MRI and CSF analysis through conventional cytology and enumeration of CSF CTC in that same sample.CSF CTCs were enumerated through an FDA-approved, EpCAM-based enrichment, utilizing RCCT immunomagnetic platforms and antibody covered ferroparticles (Janssen Diagnostics, Raritan, NJ). For the present analysis, samples were considered positive for CSF CTCs when there was at least one CSF CTC detected in a 3 mL sample ( ≥ 0.33 CSF CTC/mL). Diagnostic performance of CSF CTC was evaluated; the gold standard was either positive CSF cytology or unequivocal findings on MRI. Results: 62 patients were enrolled (27 breast, 20 lung, 7 GU, 3 GI, 2 renal and 3 other carcinomas). Among these patients, 21 (34%) had LM based on CSF cytology (n = 8), MRI findings (n = 4) or both (n = 9). CSF CTCs were positive in 27/62 samples (median 19.3 CSF CTC/mL, range 0.3 to 66.7), achieving a sensitivity of 95%, compared to 81% for CSF cytology alone and 62% for MRI alone. There were 7 false positive CSF CTCs, all of which with one or fewer CSF CTCs/mL; specificity was 83%. The one false negative sample also had negative CSF cytology but LM was seen on MRI. Conclusions: Detection of CSF CTCs by RCCT is a highly sensitive (95%) method to establish the diagnosis of LM, with superior diagnostic performance as compared to CSF cytology or MRI. However, results showing one or fewer CSF CTCs/mL are of uncertain significance and may correspond to false positive results. Larger studies with longer followup and ROC analysis are needed to investigate alternative CTC enumeration cut-offs to improve specificity.
Abstract MP94: Consumption of Specific Fruits and Incidence of Type 2 Diabetes in Men and Women
Authors: Isao Muraki, Fumiaki Imamura, Frank B Hu, Walter C Willett, Rob van Dam, Qi Sun
Journal: Circulation (2013)

Background: Consumption of whole fruits, but not fruit juice, has been associated with lower risk of type 2 diabetes. However, individual fruits have different compositions of carbohydrate, phytochemicals and other nutrients, and may thus have different effects on diabetes risk. We examined whether consumption of specific fruits was prospectively associated with risk of type 2 diabetes in US men and women. In addition, we evaluated whether the associations of fruits with diabetes were determined by the glycemic load (GL) of fruits consumption. Methods: After excluding participants with chronic diseases at baseline, we evaluated 66,720 women from the Nurses' Health Study (1984-2008); 85,961 women from the Nurses’ Health Study II (1991-2009); and 26,149 men from the Health Professionals Follow-up Study (1986-2008). Validated semi-quantitative food frequency questionnaires were administered to assess habitual consumption of fruits and other foods every two to four years. Incidences of type 2 diabetes were identified using biennial self-reported questionnaires and confirmed using supplementary questionnaires. The associations were prospectively assessed in each cohort, using Cox proportional hazard regression. Sociodemographics, lifestyle, caloric intakes, intakes of other fruits, and other dietary factors were adjusted for to control for confounding. Cohort-specific estimates were pooled by a random-effects meta-analysis. Results: During 3,447,866 person-years of follow-up, 11,521 participants were newly diagnosed with type 2 diabetes. The pooled multivariable-adjusted hazard ratios (HRs) for type 2 diabetes (for every 3 servings/week increase of fruit intake) were 0.74 [95% confidence interval (CI): 0.66, 0.83] for blueberries; 0.86 (0.80, 0.93) for grapes or raisins; 0.86 (0.75, 0.99) for prunes; 0.91 (0.81, 1.03) for bananas; 0.93 (0.88, 0.97) for apples or pears; 0.95 (0.91, 1.00) for grapefruits; 0.96 (0.90, 1.02) for peaches, plums or apricots; 1.01 (0.97, 1.05) for oranges; 1.06 (0.96, 1.19) for strawberries; and 1.11 (1.03, 1.20) for cantaloupe. No significant heterogeneity was found among the three cohorts, except associations with banana consumption. In contrast, each drink per day of fruit juice was associated with a HR (95% CI) of 1.07 (1.00, 1.14). The HRs for type 2 diabetes were 0.81 (0.69, 0.96) per 1 serving/day of high GL fruits, 0.96 (0.86, 1.07) for moderate GL fruits, and 1.05 (0.92, 1.19) for low GL fruits. Conclusion: Our data suggest that intakes of certain whole fruits, including grapes or raisins, prunes, apples or pears, grapefruits, and blueberries, are associated with lower risk of type 2 diabetes, whereas high consumption of fruit juice may lead to increased risk. Future research is needed to confirm our findings and elucidate mechanism underlying the associations for individual fruits.
Abstract P316: A Longitudinal Assessment of Exercise Participation From Mid- to Late-Life: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Samantha Schilsky, Priya Palta, Anna Porter, Gerardo Heiss, Kelly Evenson
Journal: Circulation (2019)

Background: Physical activity is a modifiable behavior with cumulative health benefits across the lifespan. Most studies of adult exercise patterns have been cross-sectional and limited to non-US populations. Describing longitudinal changes in exercise from mid- to late-life can provide insight into targeted exercise recommendations for middle-aged and older adults. Objective: In the biracial ARIC Study (n=15792), we report trends in the type and duration of exercise among adults aged 45-64 years who were followed for over 20 years. We further examined exercise patterns in a subset of adults who reported engaging in exercise at each ARIC visit (n=1254). Methods: Individuals self-reported type and duration of up to 4 exercises participated in the past year at four visits. Participant’s total minutes/week of exercise was estimated as a composite of the 4 exercises. Type of exercise was categorized as defined in Table 1. Participants were identified as having engaged in &lt;30 minutes or ≥30 minutes/week for each exercise category. Results: Overall, 9,866 adults (female n=5,288; Black n=1,874) reported engaging in exercise at baseline (Table 1). Adults who reported exercise participation at all visits (n=1254; female n=658; Black n=163) had, on average, increased and then decreased their exercise duration from visits 1 to 6. Consistently active adults participated in exercises for a longer duration over time, while among the whole cohort, duration decreased. Walking was the most frequently reported exercise overall for the whole and consistently active cohort. The number of consistently active adults who walked for at least 30 minutes/week increased from 704 to 790 at visits 1 and 6, respectively Conclusion: Exercise patterns differed for adults reporting participation in exercise at a minimum at visit 1 compared to consistently active adults. Further exploration of predictors (i.e. retirement or health status) of exercise change should be examined to guide recommendations that aim to optimize energy expenditure in adulthood.
Prognostic impact of MSI compared to other clinicopathological factors in stage II colon cancer: a single institution experience.
Authors: Carl Amireault, Maryam Razmpoosh, Isabelle Ethier, Francine Aubin, Jean-Pierre M. Ayoub, Rasmy Loungnarath, Carole S. Richard, Genevieve Soucy, Mustapha Ali Tehfe
Journal: Journal of Clinical Oncology (2015)

e14604 Background: Adjuvant chemotherapy for stage II colon cancer is still controversial. Recent data consider microsatellite instability (MSI) a prognostic biomarker associated with a lower recurrence risk and a lack of benefit from adjuvant 5-FU monotherapy. Our objective was to determine the effect of MSI on recurrence, compared to other clinicopathologic factors. Methods: We designed a retrospective study of stage II colon cancer patients at the Centre Hospitalier de l’Université de Montréal (CHUM) between 2006 and 2013. We collected variables associated with high risk of recurrence, but we only included patients with data available for MSI. Kaplan-Meier analyses where used to evaluate disease-free survival and overall survival functions. Univariate and multivariate Cox proportional hazards models were built to assess association between MSI and risk of recurrence. Results: There were 320 patients with stage II colon cancer, but MSI was available for 130 patients. Median age at diagnosis was 69 years for the entire cohort, but it was 76 years for MSI-H group. Thirty-three patients (25,4%) had MSI-H status. Only eleven patients (8,5%) received at least one cycle of chemotherapy in the entire group and two patients in the MSI-H cohort (6,1%). For the 130 evaluable patients, relapse rate was 11,5% and there were six deaths (4,6%). Only one patient relapsed in the MSI-H group (3,0%). 3-year and 5-year DFS were 90% and 80% respectively. Five-year survival was 91%. Univariate and multivariate analyses did not reach any statistical prognostic impact with MSI status compared to other prognostic factors, but MSI-H tend to recur less than MSI-S (HR 0,24 and p = 0,16). No statistical prognostic impact was found with other factors, but T4 tend to recur more than T3 (HR 1,72 and p = 0,33), < 12LN more than ≥ 12 LN (HR 1,22 and p = 0,79) and perforation more than no perforation (HR 1,12 and p = 0,93). Conclusions: MSI-H patients seem to have less recurrence risk in comparison to other high risk factors, although this was not statistically significant neither by univariate nor multivariate analysis. Disease-free survival and overall survival in our cohort compared favorably with data from the literature.
Utilization of patient assistance programs for oral chemotherapy at a comprehensive cancer center.
Authors: Ann Schwemm, Michelle Lentz, Veena Shankaran
Journal: Journal of Clinical Oncology (2015)

e17530 Background: High out-of-pocket (OOP) costs for prescription cancer drugs has been implicated as a major cause of cancer patients’ increasing financial burden. While many foundations and pharmaceutical companies offer patient assistance programs (PAPs) to improve the affordability of these drugs, navigation through these programs is poorly understood. Here, we describe utilization of and cost savings achieved through PAPs for oral chemotherapy (CTx) at a comprehensive cancer center. Methods: Pharmacy and clinical records for patients referred to PAPs for oral CTx at our institution between Jan 1, 2013 and Dec 31, 2013 were reviewed. Reason for referral, diagnosis, drug name, application outcome (approved vs. denied), source of funding (foundation or pharma), and type of patient assistance dispersed (e.g. free drug, payment toward OOP cost for drug) were recorded. Total patient cost savings was calculated as payment towards OOP drug cost or total number of months of free drug multiplied by the drug’s wholesale acquisition cost (WAC). Results: A total of 221 PAP referrals were made for oral CTx in 2013. Median age of referred patients was 64. 80% of patients were insured (70% Medicare, 29% Commercial, Medicaid 1%), of whom 24% lacked prescription coverage, and 20% were uninsured. The most common PAP referrals were for erlotinib, pazopanib, sorafenib, and sunitinib. Of the 221 PAP referrals, 75% were approved (82% pharma, 18% foundation), 16% were denied (54% ineligible, 46% insurance coverage established), and 9% were incomplete applications. Patient assistance was dispersed in the form of free drug from manufacturers (75%), payment toward patient portion of the drug cost (21%), or copayment card (4%). Of the 91% of approvals in which total drug cost savings could be determined, a total of $3,059,309 was obtained through PAPs in 2013, averaging $21,245 per patient. Conclusions: The majority of PAP referrals for oral CTx were approved, resulting in substantial cost savings to patients. While the denominator of patients who may have benefited from PAP but were not referred is unknown, PAPs represent one important source of support for patients. Pharmacy staffing to handle PAP referrals and applications is essential.
Genomic biomarkers of response to nivolumab/ipilimumab (nivo/ipi) and nivolumab (nivo) monotherapy in 108 patients with advanced renal cell carcinoma.
Authors: Chung-Han Lee, Renzo G Di Natale, Diego Chowell, Vladimir Makarov, Almedina Redzematovic, Samuel J. Murray, Maria Isabel Carlo, Martin Henner Voss, Darren R. Feldman, Robert J. Motzer, Timothy An-thy Chan, A. Ari Hakimi
Journal: Journal of Clinical Oncology (2019)

641 Background: Both the combination of nivo/ipi and nivo monotherapy have shown efficacy across multiple malignancies including clear cell Renal Cell Carcinoma (ccRCC). Biomarkers such as tumor mutation burden (TMB) are prognostic in other malignancies, however, remain unvalidated in ccRCC. This study investigates genomic biomarkers associated with nivo/ipi and nivo clinical response. Methods: Whole exome sequencing (WES) was performed on pretreatment tumor derived DNA from nivo/ipi and nivo treated patients from MSKCC and publicly available WES datasets (Miao D, Science, 2018, 359: 6377). Somatic mutations, TMB, neoantigen load (NA), and HLA zyogosity were correlated to objective response rate (ORR), progression free survival (PFS), and Overall Survival (OS). Alterations occurring in &lt; 10% of the cohort were considered non-evaluable (NE). Results: 108 patients had tumors studied; 32 patients with nivo/ipi and 76 patients with nivo therapy. No individual factors showed significant correlations to ORR or both PFS and OS. In the combined cohort, homozygosity at HLA-C was associated with shorter OS (HR=2.55 95% CI 1.17-5.57; P=0.02). In the nivo/ipi cohort, TMB (HR=0.36 95% CI 0.16-0.84; P=0.02) and NA (HR=0.43 95% CI 0.19-0.98; P=0.04) were associated with longer PFS. Conclusions: Increased TMB and NA load may predict for improved outcomes, and homozygosity at HLA loci may predict for worse outcomes. The predictors of response to nivo may not be generalizable to nivo/ipi. To rule out artifacts of multiple testing in a small cohort, validation in a larger dataset is necessary. [Table: see text]
Abstract P136: The Association Between Depressive Symptoms and Cardiovascular Disease Risk Factors Among West African Immigrants in the African Immigrant Health Study
Authors: Nwakaego A Nmezi, Ruth-Alma Turkson-Ocran, Yvonne Commodore-Mensah
Journal: Circulation (2019)

Introduction: Cardiovascular disease (CVD) is the leading cause of death globally and in the US. Blacks have a higher burden of CVD compared to other racial/ethnic groups. However, Blacks are not monolithic and include both foreign-born and US-born individuals. West African immigrants (WAIs)—a sub-group of US Blacks—are a growing immigrant population. It is unknown whether depressive symptoms are associated with CVD risk factors among WAIs. Hypothesis: We hypothesized that depressive symptoms will be associated with having ≥2 CVD risk factors among WAIs. Methods: We included WAIs born in Ghana, Nigeria, Liberia, Sierra Leone and Cameroon who participated in the African Immigrant Health Study in Baltimore-Washington D.C. The main predictor was depression scores on the Patient Health Questionnaire (PHQ-8). The main outcome variable was CVD risk defined as having ≥2 risk factors, including body mass index, self-reported diabetes, hypertension, and hyperlipidemia. Multivariable logistic regression was used to examine the association between depressive symptoms and CVD risk adjusting for age, sex, household income, marital status, and level of education. Results: A total of 326 WAIs were included. The mean age (±SD) was 46 (±10.6) years. Females made up approximately 60% of the sample (n=194). Approximately half of participants reported residing in the US for ≥10 years. Also, 31% were diagnosed with hypertension, 88% were overweight/obese, 20% were diagnosed with high cholesterol and 13% were diagnosed with diabetes. Overall, 41% of participants (n=133) had ≥2 CVD risk factors and 7% (n=22) had moderate/severe depression (PHQ-8 scores ≥10). WAIs who had mild to severe depression were 2.31 (95%CI: 1.2-4.4) times more likely to have ≥2 CVD risk factors compared to those without reported minimal depression levels in the adjusted analyses. Conclusion: We observed a positive association between symptoms of depression and CVD risk factors. WAIs with elevated symptoms of depression had a higher likelihood of having ≥2 CVD risk factors than those reporting minimal depressive symptomology. Targeted behavioral health interventions are needed to help address psychosocial determinants of cardiovascular health among WAIs residing in the US.