tbuckley/cabot-search huggingface dataset:
Acute toxicity of neoadjuvant chemotherapy in oral cavity cancers: Can it be predicted?
Authors: Bhavesh Poladia, Vijay Patil, Vanita Noronha, Amit Joshi, Bharatsinha Baburao Bhosale, Sachin Punatar, Vibhor Sharama, Kumar Prabhash
Journal: Journal of Clinical Oncology (2013)

e17027 Background: Neoadjuvant chemotherapy administration is associated with significant amount of morbidity and around 2-3% mortality in the Western world protocol settings. In developing countries where malnourishment is prevalent, the same data might not apply. Methods: This analysis was performed on a database of patients undergoing NACT for oral cancers at our center from 2010- 2012. The toxicity was graded according to CTCAE version 4.02 scale. Descriptive analysis, univariate and multivariate analysis were performed to determine factors affecting toxicity. Results: There were 528 patients, the median age was 45 years (22-78 years). The regimens administered were TPF in 35 patients (6.6%) and taxane with platinum in the rest. At least one cycle of chemotherapy was taken at our center by 94.8% (494). The median number of cycles were 2. The any grade toxicity after 1 st cycle of chemotherapy were vomiting, diarrhea, mucositis, fatigue, febrile neutropenia (FN), peripheral neuropathy, hyponatremia, hypokalemia, hperkalemia, transaminitis were in 41.3% (204), 43.9% (217), 44.3% (219), 47.2% (233), 7.2% (35), 3.0% (15), 33.8% (167), 14.4% (71), 4.9% (24) and 12.3% (61).Toxicity details of second cycle of chemotherapy were available for 390 patients. The any grade toxicity after 2 nd cycle of chemotherapy were vomiting, diarrhea, mucositis, fatigue, febrile neutropenia, peripheral neuropathy, hyponatremia, hypokalemia, hyperkalemia, transaminitis were in 28.6% (113), 37.3% (108), 31.3% (124), 39.3% (116), 3.1 % (12), 3.2% (13), 19.7 % (74), 7.4% (30), 3.1% (12) and 4.9% (19). For diarrhoea, female sex, nutrition (BMI below 18.5 KG/m2) and use of 3 drug regimen were predictive. For development of mucositis only nutrition was predictive. Use of 3 drug regimen and overnourishment were predictive of FN. Use of 3 drug regimen and use of docetaxel were predictive for hyponatremia. On multivariate analysis for diarrhoea only nutrition was predictive (p=0.017), for FN both drug regimen (p=0.003) and over nutrition (p=0.035) were predictive and for hyponatremia only use of 3 drug regimen was significant (p=0.017). Conclusions: 3 drug regimen, malnourishment and use of docetaxel are important predictors of acute toxicity associated with NACT in oral cancers.
Neutropenic complications with carboplatin AUC 5 and paclitaxel 175 mg/m<sup>2</sup> (CP) regimen in Indian patients: A community-based single center experience.
Authors: Anubha Bharthuar, Shamit Chopra
Journal: Journal of Clinical Oncology (2012)

e19607 Background: In most oncology clinical trials, the majority of patients are of Caucasian ethnicity. It is often difficult to apply the same chemotherapy with equal dose intensity in Indian patients due to increased risk of complications. The exact incidence of complications &amp; whether the difference in chemotherapy tolerability is due to genetic or environmental factors remain unclear. We provide a community-based single center experience with the commonly used CP regimen in Indian patients. Methods: A retrospective study of all patients who received CP regimen (Cockroft Gault formula for CrCl) from September 2010 to December 2011 was undertaken. Incidence of neutropenic complications, G-CSF utilization &amp; pRBC transfusion was determined. Results: Fifty six patients received 194 cycles of CP (range 1-8 cycles, median 3 cycles, mean paclitaxel dose 256mg, mean carboplatin dose 431mg, average BSA 1.56). Clinical characteristics : male 16, female 40; age range 34 - 82 yrs, median 55 yrs; site - breast 6, ovary 19, cervix/uterus 11, esophagus 8, others 12; stage – I/II/III 7, IV 42; histology – SCC 21, Adenoca 34. After the 1 st cycle, there were 8 neutropenic complications (14%)- 4 patients (7%) with neutropenia (ANC&lt;1500 cells/mm 3 ) and 4 patients (7%) with neutropenic fever. Forty-two patients received the 2 nd cycle, &amp; in total 12 patients required G-CSF support (28%). There were 3 deaths, 2 due to neutropenic fever &amp; sepsis. Average baseline hemoglobin was 11.5gm/dl with 5 episodes of pRBC transfusion. Conclusions: Although the incidence of neutropenia in Indian patients receiving CP is not higher than previous reports (20-25%), there is a much higher incidence of neutropenic fever (over the reported 1-2%) &amp; death, resulting in high G-CSF utilization. This raises several issues such as the role of prophylactic antibiotics, impact of environmental &amp; socio-economic factors (compromised nutritional status &amp; hygiene, lack of disease insight &amp; lack of access to urgent health care). We will need to implement additional measures, increase patient &amp; family awareness by frequent education &amp; counseling so as to reduce complications &amp; improve clinical outcomes in Indian patients.
PCL20-117: Can Green Tea Extract Inhibit the Tumor Growth and Invasiveness of 5-FU and Gemcitabine-Resistant Metastatic and Remetastatic Cell Lines in a Hamster Pancreatic Cancer Model?
Authors: Cintia Yoko Morioka, Marcel Cerqueira Cesar Machado, Jose Pinhata Otoch, Luma Princess Schneider, Edgard Mesquita Rodrigues Lima, Marcelo Engracia Garcia, Joelmir Silva, Alessandro Costa, Victor Herrera, Paulo Aguiar, Elenir Herrera, Talita Aguiar, Maycon Kublik, Amelia Silva, Kennedy Silva, Eduardo Morioka, Ching Cheng Huang
Journal: Journal of the National Comprehensive Cancer Network (2020)

"PCL20-117: Can Green Tea Extract Inhibit the Tumor Growth and Invasiveness of 5-FU and Gemcitabine-Resistant Metastatic and Remetastatic Cell Lines in a Hamster Pancreatic Cancer Model?" published on 20 Mar 2020 by National Comprehensive Cancer Network.
THE ASSOCIATION BETWEEN SEX, RACE, DIABETES, AND SMOKING AND THE RISK OF INCIDENT PERIPHERAL ARTERY DISEASE AMONG 164,000 VETERANS WITH NORMAL ANKLE-BRACHIAL INDEX TESTING AT BASELINE
Authors: Aaron W. Aday, Meredith S. Duncan, Charles W. Alcorn, Quinn S. Wells, Joshua Beckman, Matthew S. Freiberg
Journal: Journal of the American College of Cardiology (2020)
Treatment of severe acute malnutrition with oat or standard ready-to-use therapeutic food: a triple-blind, randomised controlled clinical trial
Authors: David Taylor Hendrixson, Claire Godbout, Alyssa Los, Meghan Callaghan-Gillespie, Melody Mui, Donna Wegner, Taylor Bryant, Aminata Koroma, Mark J Manary
Journal: Gut (2020)

Objective We hypothesised that an alternative RUTF (ready-to-use therapeutic food) made with oats (oat-RUTF) would be non-inferior to standard RUTF (s-RUTF). Design This was a randomised, triple-blind, controlled, clinical non-inferiority trial comparing oat-RUTF to s-RUTF in rural Sierra Leone. Children aged 6–59 months with severe acute malnutrition (SAM) were randomised to oat-RUTF or s-RUTF. s-RUTF was composed of milk powder, sugar, peanut paste and vegetable oil, with a hydrogenated vegetable oil additive. Oat-RUTF contained oats and no hydrogenated vegetable oil additives. The primary outcome was graduation, an increase in anthropometric measurements such that the child was not acutely malnourished. Secondary outcomes were rates of growth, time to graduation and presence of adverse events. Intention to treat analyses was used. Results Of the 1406 children were enrolled, graduation was attained in 404/721 (56%) children receiving oat-RUTF and 311/685 (45%) receiving s-RUTF (difference 10.6%, 95% CI 5.4% to 15.8%). Death, hospitalisation or remaining with SAM was seen in 87/721 (12%) receiving oat-RUTF and in 125/685 (18%) receiving s-RUTF (difference 6.2%, 95% CI 2.3 to 10.0, p=0.001). Time to graduation was less for children receiving oat RUTF; 3.9±1.8 versus 4.5±1.8 visits, respectively (p&lt;0.001). Rates of weight in the oat-RUTF group were greater than in the s-RUTF group; 3.4±2.7 versus 2.5±2.3 g/kg/d, p&lt;0.001. Conclusion Oat-RUTF is superior to s-RUTF in the treatment of SAM in Sierra Leone. We speculate that might be because of beneficial bioactive components or the absence of hydrogenated vegetable oil in oat-RUTF. Trial registration number NCT03407326 .
A phase II study of gemcitabine, ifosfamide, and oxaliplatin (GIFOX) as upfront treatment for high-risk, non-anaplastic large cell, peripheral T-cell lymphomas.
Authors: Gaetano Corazzelli, Gianpaolo Marcacci, Ferdinando Frigeri, Gaetana Capobianco, Francesco Volzone, Cristina Becchimanzi, Daniela Donnarumma, Rosa Azzaro, Rosaria De Filippi, Filippo Russo, Antonio Pinto
Journal: Journal of Clinical Oncology (2013)

8564 Background: Patients (pts) with peripheral T/NK cell lymphomas (PTCL) and intermediate-high/high IPI risk have a 5-yr overall survival &lt; 20%. Current chemotherapy is unsatisfactory while benefit of upfront autologous transplantation (ASCT) is limited by high pre-transplant progression rates and pts advanced age. We evaluated efficacy and stem cells (SCs)-mobilizing activity of a biweekly regimen of gemcitabine (G), ifosfamide (Ifo) and oxaliplatin (Ox) (GIFOX), as an upfront strategy ensuring fast cytoreduction and early ASCT access or an effective alternative to CHOP-like programs in transplant-inelegible pts. Methods: Six biweekly courses of GIFOX [G 1000 mg/m2 D1, Ox 130 mg/m2 D2, Ifo 5 g/m2 D2 as 24h infusion (fractionated over days 2-4 in pts&gt;65 yrs), G-CSF DD 7-11] were planned for all pts, with SCs mobilization at course 3 in ASCT-eligible pts. Simon's minimax two-stage design was adopted with the primary and secondary endpoints of response rate (RR) and progression-free survival (PFS), respectively. Results: Thirty-four pts (median age 63 yrs, r 42-80) [PTCL, nos (n=16), AITL (n=7), extranodal NK/T-cell (n=5), SS (n=6)], with IPI score intermediate-high (62%) or high (38%) were accrued [stage IV: 71%; BM involvement: 38%; E-site &gt;1: 47%; hi LDH: 71%; ECOG&gt;1: 38%; B-symptoms: 44%]. A total of 172 courses was delivered (median 6, r 2-6). Only 5 pts received &lt;4 courses, due to progression (n=4) or early death (n=1). Overall RR was 82% [95% CI, 66-92; 22 complete (CR) and 6 partial (PR) responses]. Twelve pts mobilized SCs (median CD34 + cells harvest: 4.36x10 6 /kg) and 8 (7CRs,1PR) underwent ASCT, 6 to 13 weeks after the 6th course. Estimated 5-yr PFS was 48% (95%CI: 28-65); median PFS for non-transplanted pts was 15 mo.s. Estimated 4-yr disease-free survival was 58%. Relevant toxicities were G4 thrombocytopenia (13%), G4 anemia (23%), G3/G4 infection (29%/6%), G3 encephalopathy (6%). Conclusions: Response and survival rates of GIFOX in high-risk PTCL compared more than favorably to CHOP-based regimens. Effective cytoreduction and prompt access to ASCT were ensured, together with safe delivery of a full induction program to transplant-ineligible pts.
THE IMPACT OF ANTHRACYCLINE-BASED AND NON-ANTHRACYCLINE-BASED CHEMOTHERAPY ON LEFT VENTRICULAR FUNCTION IN CANCER PATIENTS: A PROSPECTIVE SINGLE CENTER STUDY
Authors: Hua Zhong, Bhoomi Mehrotra, Kristine Bond, Sherly Jacob-Perez, Nathaniel Reichek, Haoyi Zheng
Journal: Journal of the American College of Cardiology (2020)
ENDOVASCULAR MANAGEMENT OF TYPE B ACUTE AORTIC DISSECTION IN NON-SYNDROMIC PATIENTS WITH A FAMILY HISTORY OF AORTIC DISEASE
Authors: Sherene Shalhub, Santi Trimarchi, Joseph E. Bavaria, Anil Bhan, Bradley Taylor, T. Brett Reece, Khaled Abdul-Nour, Stuart Hutchison, Daniel G. Montgomery, G. Chad Hughes, Patroklos Pappas, Anthony Estrera, Kim Eagle, Hans-Henning Eckstein, Christoph Nienaber, Truls Myrmel, Thomas G. Gleason
Journal: Journal of the American College of Cardiology (2020)
TOPOISOMERASE 2 BETA DECREASE RESULTS IN DIASTOLIC DYSFUNCTION VIA P53 AND AKT: A NOVEL PATHWAY
Authors: Rohit Moudgil, Kyung Ae Ko, Hang Thi Vu, Tamlyn N. Thomas, Xin Wang, Jiang Chang, Anilkumar Reddy, Keigi Fujiwara, Junichi Abe
Journal: Journal of the American College of Cardiology (2020)
Molecular prognostic markers in colorectal cancer.
Authors: Krasimir Ivanov, Nikola Kolev, Anton Tonev, Anton Tontchev
Journal: Journal of Clinical Oncology (2012)

e21100 Background: Patient 5-year survival rate from colorectal cancer in the last few decades remains at 40 to 45 percent. Nearly one-half of all patients who undergo a potentially curative resection will relapse because of undetected metastasis. Overall survival rate remains poor which strongly suggests that the dissemination of these cells occurs early in the disease process there is a need of diagnostic methods which evaluate tumor aggressiveness. The p-53, MUC-2, Ki-67, VEGF, Bax, Bcl-2, Stat, MMP2 are markers, which could provide useful individual information about biological potential and prognosis. Methods: We evaluate the expression of those markers in group of 72 patients with colorectal carcinoma. We observed the relations between: 1) type of operation; 2) histological type; 3) clinical stage; 4) individual risk index (IRI), based on evaluated expression of tumor markers; 5) impact on survival rate. Results: Achieving 100% successful rate in our study, we statistically analyzed the data received from marker’s expression. We calculated an IRI for every patient, based on the data from imm3unohystochemical expression by already mentioned molecular markers and divided the patients in 3 groups. A Group A, formed by 28 (38%) patients, which are with low clinical stage and worse molecular prognosis. A Group B, formed by 20 (27%) of patients had low tumor aggression and III or IV clinical stage and Group C, formed by the other 26 (35%) of the patients where is a correlation between the molecular and clinical stage prognosis. We found significant differences in survival rate in Groups A and B, according to clinical stage and our proposed IRI. Conclusions: Multivariate analysis revealed that the IRI is independent prognostic factor for the tumor outcome. There were many evidences for the need of alteration of the surgical behavior in different stages according to biological nature of the tumor. Analysis of a combination of immunohistochemical molecular markers with the conventional diagnostic methods for colorectal cancer allows better prediction of the patients’ prognosis and more accurate and individualized therapeutic strategy. That could decrease the incidence of recurrence-rate and low the mortality rate of this society-significant disease.
FACTORS INFLUENCING THE USE OF ECHOCARDIOGRAPHY IN THE MANAGEMENT OF ACUTE HOSPITALIZED HEART FAILURE IN A TERTIARY CARE
Authors: Thanaporn Ratchataswan, Thiratest Leesutipornchai, Aunchalee Jaroenlapnopparat, Palapun Waitayangkoon, Supanee Sinphurmsukskul, Aekarach Ariyachaipanich
Journal: Journal of the American College of Cardiology (2020)
Cost-effectiveness of letrozole and anastrozole as adjuvant therapy for hormone receptor positive early breast cancer in postmenopausal women
Authors: T. E. Delea, J. Karnon, V. Barghout, S. K. Thomas, N. L. Papo
Journal: Journal of Clinical Oncology (2006)

10577 Background: The BIG 1–98 and ATAC studies demonstrated that, in postmenopausal women with hormone receptor positive (HR+) early breast cancer, 5 years of initial adjuvant therapy with the aromatase inhibitors (AIs) letrozole (LET) or anastrozole (ANA) is superior to tamoxifen (TAM). The cost-effectiveness TAM, LET, and ANA have not been previously evaluated using a consistent methodology. Methods: A Markov model was used to estimate the incremental cost per quality-adjusted life year (QALY) gained with initial adjuvant therapy with LET vs TAM, ANA vs TAM, and LET vs ANA in postmenopausal women with HR+ early stage breast cancer from the US healthcare system perspective. Probabilities of recurrence (including contralateral tumor) and adverse events (endometrial cancer, thromboembolism, fractures, hypercholesterolemia, MI, and stroke) for TAM were based primarily on published US population-based studies and trials of prophylactic TAM vs placebo. Corresponding probabilities for LET and ANA were calculated by multiplying probabilities for TAM by estimated relative risks of LET vs TAM and ANA vs TAM from the BIG 1–98 and ATAC trials respectively. Other probabilities, costs, and health-state utilities were obtained from published studies. Expected lifetime costs and QALYs were estimated for a cohort of HR+ postmenopausal women with early breast cancer, aged 61 years at therapy initiation and discounted at 3% annually. Probabilistic sensitivity analyses were conducted to assess precision of results. Results: Incremental cost per QALY gained for LET vs TAM is $33,536 (95% CI $20,409 to $70,566) and for ANA vs TAM is $38,967 (95% CI $23,826 to $81,904). Compared with ANA, LET is less costly ($9,647 vs $10,190) and gains more QALYs (0.29 vs 0.26), although differences in costs (95% CI -$1,669 to $671) and QALYs (95% CI -0.16 to 0.22) are not statistically significant. Conclusions: In postmenopausal women with HR+ early breast cancer, adjuvant therapy with either LET or ANA is cost-effective from a US healthcare system perspective. Although LET dominates ANA in our base-case analysis, definitive conclusions regarding the cost-effectiveness of LET vs ANA must await results of comparative clinical studies. [Table: see text]
Use of HER2 score correction for putative chromosome 17 (Chr-17) aneusomy to increase eligibility for anti-HER2 therapy.
Authors: Eugen C. Minca, Bryce P. Portier, Zhen Wang, Christopher Lanigan, G. Thomas Budd, Raymond R. Tubbs
Journal: Journal of Clinical Oncology (2012)

620 Background: HER2 amplification or overexpression status directs therapy choice in breast carcinoma. HER2/Chr-17 ratio is commonly assessed by fluorescence in-situ hybridization (FISH) using a CEP17 centromeric reference probe and ASCO/CAP scoring criteria. However, α-centromeric reference probes may underestimate true HER2 status in cases with para-centromeric amplification. Here we present comprehensive algorithmic testing of an alternative Chr-17 reference locus for resolution of putative CEP17-aneusomic cases in a consecutive series, within a single health system. Methods: 150 of 1256 consecutive breast carcinoma cases accessioned in 2011 within the Cleveland Clinic Health System displayed a mean CEP17 copy number greater than 3.0 by FISH (aneusomy). The patients were reflex-HER2 tested by FISH with a reference probe for the D17S122 locus (17p12) and a corrected HER2/Chr-17 ratio was calculated. Cases with equivocal HER2/D17S122 ratio (1.8-2.2) were further reflex tested for HER2 overexpression by immunohistochemistry (IHC). Results: Of 117 initially non-amplified cases by HER2/CEP17, 20 (17%) were revised to amplified and 18 (15.3%) to equivocal by HER2/D17S122. Of 3 initially equivocal cases, 1 was revised to amplified and 1 remained equivocal. Of the 19 equivocal cases by HER2/D17S122, 3 were revised to positive by IHC. Overall, for CEP17 aneusomic cases tested using this algorithmic approach, 24 of 120 (20%) patients with initial non-amplified or equivocal HER2 status became eligible for anti-HER2-based therapy, which was also considered in 10 equivocal cases with a HER2/D17S122 ratio of 2.0 - 2.2. A significantly lower proportion of initially amplified cases was revised as non-amplified by HER2/D17S122 (1 of 30, 3.3%, p&lt;0.05). Conclusions: Our data, collected within a single health system for a consecutive case series, underscores the clinical limitations of commonly used FISH probes for HER2 testing and demonstrates that algorithmic use of a non-centromeric Chr-17 reference probe alters HER2 status and increases eligibility for anti-HER2 based therapy in a significant proportion of patients.
An in vitro and in vivo study of the brain-targeting effects of an epidermal growth factor-functionalized cholera toxin-like chimeric protein
Authors: Huafeng He, Danmin Lin, Jiajie Sun, Xianying He, Tiantian Wang, Yinglin Fang, Yijun Liu, Kaixiang Fan, Xinxin Chen, Huahong He, Xiangguang Li, Biansheng Ji, Suqing Zhao, Xi Zheng, Kun Zhang, Huaqian Wang
Journal: Journal of Controlled Release (2020)
INFLAMMATION AND EXERCISE INTOLERANCE IN HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Emily Lau, Shahrooz Zarbafian, Ruslan Ilyasovich, John Sbarbaro, Robyn Farrell, Mark Schoenike, Rajeev Malhotra, Susan Cheng, Mohit Jain, Gregory D. Lewis, Jennifer Ho
Journal: Journal of the American College of Cardiology (2020)
Offline: A dangerous virus, but not the one you think
Authors: Richard Horton
Journal: The Lancet (2020)

Perspective. It's in short supply these days. Coronavirus has saturated the attention of politicians, policy makers, journalists, and even medical journal editors for several months now. There seems to be no end in sight. But while we wrestle with the difference between containment and delay, prospects for a vaccine, and the mental state of an American President who wilfully ignores the advice of his own Centers for Disease Control and Prevention, we should not forget the threat posed by other viruses.
Analysis of gemcitabine pathway genotypes in ethnic Asians and their relationship with outcome in non-small cell lung cancer (NSCLC) patients
Authors: R. A. Soo, S. C. Lee, S. S. Ng, P. Y. Chong, L. S. Tham, L. Z. Wang, H. S. Lee, R. Soong, B. C. Goh
Journal: Journal of Clinical Oncology (2006)

2008 Background: Genotypic variation for drug metabolising enzymes, targets and transporters is associated with inter-patient and inter-ethnic variability in toxicity and efficacy. Gemcitabine is a nucleoside anti-metabolite used in a range of solid tumors. Aims: 1) to determine genotype distribution of genes involved in gemcitabine pharmacology pathway in ethnic groups; 2) to evaluate the association between genotypes and treatment related outcomes in patients with chemo-naive, advanced NSCLC receiving gemcitabine based chemotherapy on a prospective study. Methods: Candidate genes involved in gemcitabine pharmacology were identified from a comprehensive search of public databases (NCBI, PharmGKB), and publications. 25 variants of 9 candidate genes (RRM-1, SLC28A1, SLC28A2, SLC28A3, SLC29A2, POLA2, DCTD, CDA, TS) were genotyped from blood in 94 healthy donors and 76 cancer patients (breast 22, NSCLC 54) with pyrosequencing. Chi-squared, Kruskall-Wallis, and Kaplan-Meier analysis were used to evaluate associations between genotypes and ethnic groups and clinical end points. Results: Significant differences in genotype distribution between Chinese, Malay and Indian were seen in 5/25 loci (see table ). In NSCLC patients, POLA2 2089 (G &gt; A) was associated with neutropenia (p = 0.022), SLC28A1-1576 (C &gt; T) with neutropenia nadir (p = 0.030) and thrombocytopenia nadir (p = 0.037), RRM-1 -524 (T &gt; C) with neutropenia (p = 0.024) and SLC28A2–283 (CA 18.3 vs CC 8.5 months, p = 0.004), and SLC28A2–22 (CC 8.0 vs CT 18.3 months, p = 0.002) with survival. Conclusions: Our results suggest there is significant genotypic variability among ethnic groups. Variants in gemcitabine transporters and targets may be useful indicators of gemcitabine related toxicity and survival. Further studies should be performed to confirm these preliminary findings. [Table: see text] No significant financial relationships to disclose.