tbuckley/cabot-search huggingface dataset:
NCOG-45. FIRST-LINE ANTIEPILEPTIC DRUG TREATMENT IN GLIOMA PATIENTS WITH EPILEPSY: LEVETIRACETAM VERSUS VALPROIC ACID
Authors: Pim van der Meer, Linda Dirven, Marta Fiocco, Maaike Vos, Mathilde Kouwenhoven, Martin van den Bent, Martin Taphoorn, Johan Koekkoek
Journal: Neuro-Oncology (2020)

Abstract BACKGROUND Levetiracetam and valproic acid are two of the most commonly prescribed antiepileptic drugs (AEDs) in patients with a glioma and epilepsy. This study aimed at estimating the cumulative incidence of treatment failure of first-line monotherapy levetiracetam versus valproic acid in glioma patients with epilepsy. METHODS In this retrospective observational study, a competing risk model was used to estimate the cumulative incidence of treatment failure, from AED treatment initiation, for the two AEDs with death as competing event. Patients were matched on baseline covariates potentially related to treatment assignment and/or outcomes of interest according to the nearest neighbour propensity score matching technique. Secondary outcomes were the cumulative incidence of recurrent seizure, from AED treatment initiation (estimated with a competing risk model), and severity of adverse effects. Maximum duration of follow-up was 36 months. RESULTS In total, 776 patients using levetiracetam and 659 using valproic were identified. Matching resulted in two equal groups of 429 patients, with similar covariate distribution. The cumulative incidence of treatment failure (any reason) at 12 months for levetiracetam and valproic acid was equal to 33% (95%CI=29-38%) versus 50% (95%CI=45-55%), respectively (p&amp;lt; 0.001). The cumulative incidence of treatment failure due to uncontrolled seizures was significantly lower for levetiracetam compared to valproic acid (12 months: 16% [95%CI=12-19%] versus 28% [95%CI=23-32%]; p&amp;lt; 0.001), but no differences were found for treatment failure due to adverse effects (12 months: 14% [95%CI=11-18%] versus 15% [95%CI=11-18%]; p=0.636). The cumulative incidence of recurrent seizure of levetiracetam was significantly lower compared to valproic acid (12 months: 54% [95%CI=49-59%] versus 67% [95%CI=62-71%]; p&amp;lt; 0.001). No significant differences were found for level of toxicity. CONCLUSION Our results suggest that levetiracetam has superior efficacy compared to valproic acid, while showing a similar level of toxicity. Therefore, levetiracetam seems the preferred choice for first-line AED treatment in glioma patients.
Оценка коморбидного статуса и структурных изменений щитовидной железы у больных с хроническим метапластическим атрофическим гастритом: обзор и собственные исследования
Authors: L.N. Mosiychuk, L.V. Demeshkina, I.S. Konenko, E.V. Zygalo, O.P. Petishko
Journal: GASTROENTEROLOGY (2020)

Актуальность. Коморбидная патология остается распространенной, но недостаточно изученной проблемой. В настоящее время частота и характер соединенной патологии у больных с хроническим метапластическим атрофическим гастритом (ХМАГ) окончательно не выяснены, как и роль щитовидной железы (ЩЖ) в этиопатогенезе данного заболевания. Цель: оценить состояние коморбидности у больных с ХМАГ и изучить частоту и характер структурных изменений ЩЖ у данной категории больных, исследовать литературные данные по этой проблеме. Материалы и методы. В обследование включен 41 больной с ХМАГ в возрасте (60,1 ± 2,4) года, среди которых было 29 женщин и 12 мужчин. Больным проводилась гастроскопия (с NBI-режимом и забором биопсийного материала), ультразвуковое исследование ЩЖ, анкетирование с помощью Сumulative Illness Rating Scale (CIRS), а также по историям болезни изучались коморбидные заболевания желудочно-кишечного тракта (ЖКТ). Результаты. У 82,9 % больных с ХМАГ выявлены ультразвуковые диффузные изменения ЩЖ, причем у 48,8 % обследованных они выявлялись впервые, а у 37,8 % пациентов данные изменения сочетались с наличием узлов в ЩЖ. К тому же у 9,8 % больных выявлены ультразвуковые признаки аутоиммунного тиреоидита. У 97,6 % пациентов с ХМАГ наблюдалась полиморбидная патология, причем у 92,7 % больных — со стороны 3 систем и больше и только у 4,9 % — со стороны 2 систем. Установлена положительная корреляционная связь между возрастом больных и суммарным количеством баллов, набранных с помощью опросника коморбидности CIRS (r = 0,412, p = 0,04). По данным СIRS, наиболее часто у пациентов с ХМАГ сочеталась патология верхнего и нижнего отделов ЖКТ (97,7 и 53,7 % соответственно), патология костно-мышечного аппарата и кожных покровов (68,3 %), патология глаз, ушей, горла, носа и гортани (56,1 %), сосудистая патология (56,1 %), заболевания сердца (51,2 %) и эндокринно-метаболическая патология (34,1 %). Выводы. У 82,9 % больных с ХМАГ выявлены ультразвуковые структурные изменения ЩЖ. Перспективным направлением дальнейшего исследования, на наш взгляд, было бы изучение аутоиммунных процессов в желудке и ЩЖ (установление возможных взаимосвязей между аутоиммунным тиреоидитом и аутоиммунным гастритом), а также особенностей течения данных коморбидных заболеваний. Необходимо уделить внимание ХМАГ не только как заболеванию, которое является фактором риска развития рака желудка, но и как возможному маркеру наличия сопутствующей патологии щитовидной железы.
NCOG-60. MALIGNANT MELANOMA IN NEUROCUTANEOUS MELANOCYTOSIS: A RETROSPECTIVE CASE SERIES (2000-2020)
Authors: Kevin Elmore, Ugur Sener, Elsie Ennin, Stephanie Suser, Ashfaq Marghoob, Sofia Haque, Yasmin Khakoo
Journal: Neuro-Oncology (2020)

Abstract Neurocutaneous melanocytosis (NCM) is a rare neurocutaneous syndrome which typically develops in children with large congenital melanocytic nevi (LCMN) and excessive melanocyte proliferation in the leptomeninges and brain parenchyma. Malignant melanoma develops in an estimated 2.3% of patients with LCMN and 40-60% of patients with NCM. NCM-associated melanomas frequently harbor NRAS mutations with no well-established role for targeted therapy. In a retrospective, single-institution study, we reviewed eleven patients with NCM-associated CNS melanoma evaluated at Memorial Sloan Kettering Cancer Center from June 2000 to January 2020. Five patients had previously identified focal melanocytosis prior to developing melanoma. In this subgroup, the median time from identification of focal melanocytosis to melanoma diagnosis was 80 months (range: 18-200). Median age at melanoma diagnosis was 9.9 years (range: 1.1-25.3). Presentation at the time of diagnosis with CNS melanoma included headache (45%), focal deficits (45%), and seizure (18%). Eight patients had hydrocephalus (73%). Five patients presented with a focal mass (45%) and six patients had focal or diffuse leptomeningeal disease without a mass (55%). Leptomeningeal spread eventually developed in all patients. Where molecular testing was available, three melanomas had NRAS mutations and none were associated with BRAF mutations. Seven patients were treated with cancer-directed therapy including temozolomide, trametinib, ipilimumab, and nivolumab, with each therapy being administered to two patients. Radiation therapy was used in three patients, including whole brain radiation therapy and stereotactic radiosurgery. Median survival from melanoma diagnosis was 9.1 months (range: 1-60.4). The longest surviving patient was initially diagnosed with cutaneous melanoma, surviving 60.4 months after diagnosis with cutaneous melanoma and 22.7 months after diagnosis with CNS melanoma. Prognosis remains guarded in patients with NCM-associated melanoma, and further investigation is warranted to identify effective management strategies.
Abstract 12352: Circulating Corin in the General Community: A Link to Gender and Metabolic Phenotype
Authors: Tomoko Ichiki, Seethalakshimi R Iyer, Christopher G Scott, Valentina Cannone, Brenda K Huntley, S Jeson Sangaralingham, Denise M Heublein, Kent R Bailey, Richard J Rodeheffer, Jens P Goetze, John C Burnett
Journal: Circulation (2017)

Introduction: Corin is a cardiac serine protease which processes pronatriuretic peptides into mature natriuretic peptides (NPs), suggesting it plays a role to modulate the bioactivity of NPs. Corin...
AB0888 REASONS FOR LETHALITY IN ELDERLY AND SENIOR AGE PATIENTS WITH OSTEOPOROTIC FRACTURES OF FEMUR
Authors: J. Averkieva, T. Raskina, M. Letaeva, O. Malyshenko, I. Grigoreva
Journal: Annals of the Rheumatic Diseases (2020)

Objectives: to identify the causes of mortality in middle-aged and elderly patients during the first year after they had a low-energy hip fracture. Methods: the causes of lethality were examined of the patients with a non-traumatic femur fracture. 432 patients with osteoporotic hip fractures were under observation: 328 women and 104 men. The mean age of women was 75, 4 (70; 82) years, the mean age of men was 71,5 (65; 80) years. Results: after 12 months, mortality rate was 137 cases (total mortality - 31.8%). Most of the deaths were due to cardiovascular system diseases. The total number of fatal cases was 93 (67.8%): for men - 22 (66.0%) cases, for women - 71 (68.3%) (p = 0.65). Diseases of the respiratory system caused death in 23 (16.8%) patients: in men - 5 (15.1%) cases and in women - 18 (17.3%) (p = 0.31). Mortality from oncological diseases was 15 (10.9%) cases: in men - 3 (9.09%) cases and in women - 12 (11.5%) (p = 0.45). Diseases of the digestive system, as the cause of death, were detected in 5 (3.6%) men and women (2 (6.06%) and 3 (2.9%) cases, respectively (p = 0.1)). Conclusion: the most of the deceased men and women had cardiovascular and respiratory diseases. The gender differences in mortality rates were not found. Disclosure of Interests: None declared
TMOD-09. GLIOBLASTOMA BIOPHYSICAL GROWTH ESTIMATION USING DEEP LEARNING-BASED REGRESSION
Authors: Sarthak Pati, Vaibhav Sharma, Heena Aslam, Siddhesh Thakur, Hamed Akbari, Andreas Mang, Shashank Subramanian, George Biros, Christos Davatzikos, Spyridon Bakas
Journal: Neuro-Oncology (2020)

Abstract BACKGROUND Glioblastomas are arguably the most aggressive, infiltrative, and heterogeneous adult brain tumor. Biophysical modeling of glioblastoma growth has shown its predictive value towards clinical endpoints, enabling more informed decision-making. However, the mathematically rigorous formulations of biophysical modeling come with a large computational footprint, hindering their application to clinical studies. METHODS We present a deep learning (DL)-based logistical regression model, to estimate in seconds glioblastoma biophysical growth, defined through three tumor-specific parameters: 1) diffusion coefficient of white matter (Dw), which describes how easily the tumor can infiltrate through the white matter, 2) mass-effect parameter (Mp), which defines the average tumor expansion, and 3) estimated time (T) in number of days that the tumor has been growing. Pre-operative multi-parametric MRI (mpMRI) structural scans (T1, T1-Gd, T1, T2-FLAIR) from 135 subjects of the TCGA-GBM imaging collection are used to quantitatively evaluate our approach. We consider the mpMRI intensities within the region defined by the abnormal T2-FLAIR signal envelope, for training three DL models for the three tumor-specific parameters. Each of our DL models consist of two sets of convolution layers followed by a single max-pooling layer, with a normalized root mean squared error as the minimization metric and evaluated using 10-fold cross validation. We train and validate the DL-based predictions against parameters derived from biophysical inversion models. RESULTS Pearson correlation coefficients between our DL-based estimations and the biophysical parameters were equal to 0.85 for Dw, 0.90 for Mp, and 0.94 for T. CONCLUSION This study unlocks the power of tumor-specific parameters from biophysical tumor growth estimation, paving the way towards their utilization in more clinical studies, while opening the door for leveraging advanced radiomic descriptors in future studies, as well as allowing for significantly faster parameter reconstruction compared to biophysical growth modeling approaches. *denotes equal senior authorship.
MBCL-17. METASTATIC MEDULLOBLASTOMA CAN BE CURED WITHOUT EXCISION OF THE PRIMARY TUMOR: A SINGLE CENTER EXPERIENCE
Authors: Rina Dvir, Shlomi Constantini, Jonathan Roth, Hila Rosenfeld-Keidar, Inna Ospovat, Ronit Elhasid
Journal: Neuro-Oncology (2020)

Abstract INTRODUCTION Metastatic medulloblastoma is a challenging disease The current clinical approach advocates removal of the primary tumor in the posterior fossa despite evidence of metastatic disease and administer oncologic treatment within several weeks: Infants of 3–4 years are treated by tandem high dose chemotherapy with stem cell support (ACNS0334 protocol), while older children are given radiotherapy and tandem high dose chemotherapy with stem cell support (SJMB03 protocol). We postulate that a resection of the primary tumor is not obligatory, and a biopsy may suffice in order to enable prompt oncological treatment without affecting the long-term survival. PATIENTS AND METHODS Between 2010-2019 7 patients with metastatic medulloblastoma (median age 4.5, age 1–10) were treated with biopsy only, five spinal and two from the primary tumor. Six children had a concurrent VP shunt. Four presented with cord compression, and two with neurological deterioration. Four needed emergency radiotherapy. Two infants received protocol ACNS0334, five patients received protocol SJMB03. RESULTS Six patients (85%) survived; .3 patients are long term survivors (&amp;gt; 5 years), 2 patients are in remission for 2–3 years, one patient is on active therapy. Only 1 patient died after a late (4 years) metastatic relapse not in the posterior fossa. CONCLUSIONS Metastatic medulloblastoma can be cured without excision of the primary tumor and without mutilating surgery. Long term prognosis is probably more attributable to disease subtype and prompt oncologic treatment. This approach merits further studies and may have implications on treatment of non-metastatic tumors.
Docetaxel-Induced Interstitial Pneumonitis Detected on 68Ga-PSMA PET/CT
Authors: Sunil Kumar, Harmandeep Singh, Chandan K. Das, Rajender Kumar, Bhagwant Rai Mittal
Journal: Clinical Nuclear Medicine (2020)

Abstract 68 Ga-PSMA PET/CT is a commonly performed procedure in the staging of intermediate- and high-risk prostate cancer after biochemical recurrence. Uptake of 68 Ga-PSMA in benign conditions is also reported in the literature. Docetaxel is the mainstay of treatment in high-volume hormone-sensitive prostate cancer and castration-resistant prostate cancer. The major treatment-emergent adverse drug reactions attributed to docetaxel include myelosuppression, alopecia, and asthenia. Interstitial pneumonitis is seen in less than 2% of docetaxel-treated patients. We present a case of metastatic castration-resistant prostate cancer, wherein docetaxel-induced interstitial pneumonitis was detected on 68 Ga-PSMA PET/CT, after docetaxel treatment.
TAMI-64. PHYSICAL STRESSES IN BRAIN TUMORS
Authors: Ashwin Kumar, Hadi Nia, Meenal Datta, Sampurna Chatterjee, Gino Ferraro, Brian Nahed, Rakesh Jain
Journal: Neuro-Oncology (2020)

Abstract Solid stress, distinct from fluid pressure, is a physical force contained in and transmitted by solid components of the brain tumor, including cells and the matrix they produce. Solid stress has been shown to promote tumor progression, and decrease anticancer therapy efficacy. This is especially relevant in brain tumors, as the rigid skull results in these trapped forces, increasing intracranial pressure, and potentially leading to other complications, including neuronal cell death. Here we present a novel method of quantifying these physical stresses in situ in both mice (glioblastoma [U87], brain metastasis [BT474], and ependymoma models) and patients. Briefly, following a craniotomy, mechanical forces that include solid stress are released, which causes the tissue to deform in peaks (areas under compression) and valleys (areas originally under tension). This tissue deformation is imaged via high-resolution ultrasound, and analysed via custom code to produce an accurate 3D model of the entire mouse brain, including the tumour region. For human samples, a pre-operative MRI is used to generate a detailed 3D model of the human brain. During surgery, the trapped physical stresses results in a bulge of the dura post craniotomy, which is mapped via Brainlab. These deformations are analysed in an identical fashion to the murine model. We further show that in the brain metastases model, chemotherapy reduces compression stresses by 51%. Further, our technique results in fast processing time (~ 15 minutes), and has the potential to prevent the need for intraoperative MRI based on position simulations. As such, solid stress measurements provide a new class of mechanical biomarkers that can be correlated to clinical outcomes for predictive and prognostic value.
IMG-02. USEFUL DIAGNOSIS OF PEDIATRIC CYSTIC BRAIN TUMORS USING MULTIPLE POSITRON EMISSION TOMOGRAPHY STUDIES
Authors: Keisuke Miyake, Takeshi Fujimori, Yasunori Toyota, Daisuke Ogawa, Tetsuhiro Hatakeyama, Masanobu Okauchi, Masahiko Kawanishi, Takashi Tamiya
Journal: Neuro-Oncology (2020)

Abstract OBJECTIVE Pediatric brain tumors are primarily diagnosed using MRI or CT examination; however, determining the correct diagnosis using only morphological MRI can sometimes be challenging. Positron emission tomography (PET) uses radiotracers for metabolic and molecular imaging. We examined the accumulation of multiple PET (FDG, MET, FLT, and FMISO) studies for diagnosing pediatric cystic brain tumors. METHODS We performed PET scans for eight pediatric patients (five pilocytic astrocytoma, one pleomorphic xanthoastrocytoma, one diffuse astrocytoma with IDH1 mutation, one ganglioglioma) from April 2010 to December 2019. The resulting studies were compared by measuring the tumor-to-normal lesion (T/N) ratio of FDG, MET, and FLT and the tumor-to-blood value (T/B) ratio of FMISO between each pediatric cystic brain tumor. RESULTS All pediatric brain tumors showed tumor uptake of FDG, MET, and FLT. We could not examine FMISO PET for one diffuse astrocytoma with IDH1 mutation. The T/N ratios of FDG, MET, and FLT and the T/B ratio of FMISO were 1.07, 2.76, 4.6, and 1.12 for pilocytic astrocytoma; 0.65, 4.6, 7.67, and 1.38 for pleomorphic xanthoastrocytoma; 0.61, 2.14, and 3.82 for diffuse astrocytoma with IDH1 mutation; and 0.79, 1.78, 5, and 1.49 for ganglioglioma, respectively. The T/N ratios of MET and FLT for pleomorphic xanthoastrocytoma were high, but the Ki-67 labeling index was 1%. In the ganglioglioma, the T/N ratio of FLT was high, but the T/N ratio of MET was low. CONCLUSION Specialized multiple PET accumulation patterns for tumors are useful for discriminating each tumor.
NCOG-70. RELIABILITY AND VALIDITY OF A NEW SELF-REPORT INDEX OF COGNITIVE CONCERNS IN BRAIN TUMOR PATIENTS
Authors: Giuliana Zarrella, Alice Perez, Jorg Dietrich, Michael Parsons
Journal: Neuro-Oncology (2020)

Abstract INTRODUCTION Subjective cognitive dysfunction is an important outcome measure in neuro-oncology and may provide additional information beyond performance-based neuropsychological testing. The Functional Assessment of Cancer Therapy-Brain (FACT-Br) is a frequently used quality of life (QoL) measure that includes indices of physical, emotional, social, and neurologic aspects of disease, but does not measure cognitive concerns. This study seeks to develop and validate an index of self-reported cognition derived from existing items on the FACT-Br. METHODS 145 patients (Mage=51.08, Medu=15.63) with heterogeneous brain tumor diagnoses completed neuropsychological evaluation including cognitive testing and self-report measures. Nine FACT-Br items regarding cognition were combined to form the Cognitive Index (CI). Reliability of the CI was measured with Cronbach’s alpha. Concurrent validity was assessed by correlating the CI with the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Abilities-8 or PROMIS Cognitive Concerns-8. Discriminant validity was assessed by correlation of the CI with other FACT-Br indices and the Beck Depression and Anxiety Inventories (BDI, BAI). RESULTS Internal consistency within the CI was high (Cronbach’s a 0.864). The CI correlated strongly with the PROMIS-Abilities (r =.680; p&amp;lt; 0.001) and PROMIS-Concerns (r=.780; p&amp;lt; 0.001) indicating high convergent validity. Moderate correlations were observed between the CI and the physical and functional subscales of the FACT (r=.453 and .555), whereas correlations with the social and emotional functioning subscales were weaker (r=.381 and .325). The FACT-Br-CI correlated strongly with BDI (r=-.622) and more weakly with the BAI (r=-.344). Consistent with prior literature, the CI showed modest correlations with neuropsychological measures, including verbal memory encoding (r=.300), verbal fluency (r=.252) and a composite measure of cognition (r=.249; all p’s&amp;lt; .01). CONCLUSIONS The FACT-Br-CI is a reliable and valid measure of self-reported cognition. Studies that include the FACT-Br could be retrospectively analyzed to assess self-reported cognitive outcomes, enriching the information gained from prior research.
Re: Hiten D. Patel, Farzana A. Faisal, Bruce J. Trock, et al. Effect of Pharmacologic Prophylaxis on Venous Thromboembolism After Radical Prostatectomy: The PREVENTER Randomized Clinical Trial. Eur Urol 2020;78:360–368
Authors: Luigi Nocera, Alberto Briganti, Pierre I. Karakiewicz
Journal: European Urology (2020)
Optimal Timing for Cancer Screening and Adaptive Surveillance Using Mathematical Modeling
Authors: Kit Curtius, Anup Dewanji, William D. Hazelton, Joel H. Rubenstein, Georg E. Luebeck
Journal: Cancer Research (2020)

Abstract Cancer screening and early detection efforts have been partially successful in reducing incidence and mortality, but many improvements are needed. Although current medical practice is informed by epidemiologic studies and experts, the decisions for guidelines are ultimately ad hoc. We propose here that quantitative optimization of protocols can potentially increase screening success and reduce overdiagnosis. Mathematical modeling of the stochastic process of cancer evolution can be used to derive and optimize the timing of clinical screens so that the probability is maximal that a patient is screened within a certain “window of opportunity” for intervention when early cancer development may be observable. Alternative to a strictly empirical approach or microsimulations of a multitude of possible scenarios, biologically based mechanistic modeling can be used for predicting when best to screen and begin adaptive surveillance. We introduce a methodology for optimizing screening, assessing potential risks, and quantifying associated costs to healthcare using multiscale models. As a case study in Barrett's esophagus, these methods were applied for a model of esophageal adenocarcinoma that was previously calibrated to U.S. cancer registry data. Optimal screening ages for patients with symptomatic gastroesophageal reflux disease were older (58 for men and 64 for women) than what is currently recommended (age &amp;gt; 50 years). These ages are in a cost-effective range to start screening and were independently validated by data used in current guidelines. Collectively, our framework captures critical aspects of cancer evolution within patients with Barrett's esophagus for a more personalized screening design. Significance: This study demonstrates how mathematical modeling of cancer evolution can be used to optimize screening regimes, with the added potential to improve surveillance regimes.