tbuckley/cabot-search huggingface dataset:
The impact of COVID-19 pandemic on oncology workload: The experience of an Italian Reference Cancer Center.
Authors: Carla Corvaja, Giada Targato, Silvio Ken Garattini, Cristina Barazzutti, Alessandra Bin, Raffaela Donato, Mauro Mansutti, Chiara Riosa, Simona Rizzato, Graziella Troiero, Gianpiero Fasola
Journal: Journal of Clinical Oncology (2021)

e13520 Background: Since its outbreak in January 2020, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic dramatically affected health systems worldwide and a prompt realignment of clinical activities had to be thought. International Oncology guidelines recommended that routine oncology care continued to be delivered, ensuring triage procedures to prevent COVID-19 diffusion alongside treatments prioritization. Aim of this study was to assess the variation of activity volumes due to COVID-19 pandemic in the Oncology Department of the Academic Reference Cancer Center of Udine, Italy. Methods: We extracted activity volumes from the electronic “Data Warehouse” accountability system and compared activity in 2020 with historical activity in 2019. We then narrowed the analysis to the peak of COVID-19 pandemic, comparing data of a four-months period (February-May 2020 vs 2019). In accordance with the Italian Association of Medical Oncology guidelines, the activities analyzed included: new patients referrals, first consultations, new therapy assignments, treatment prescriptions and therapy administrations, disease re-assessments, follow-up visits, tele-examinations, unplanned visits and ward discharges. Results: Overall, throughout COVID-19 pandemic a negligible reduction in the number of first consultations (-5%) and new patients referrals to our Oncology Department (-10%) was detected. Of note, a significant reduction in the number of unplanned oncologic visits was observed (-23%). The replacement of follow up visits with telephonic interviews with the interpretation of laboratory and radiologic examinations (tele-examinations) led to a substantial reduction in follow-up visits throughout 2020 (-25%). Conversely, treatment-related activities, including new therapy assignments (+1%), treatment prescriptions and therapy administrations (+2% and +3%, respectively), confirmed the increasing trend of the previous year. Interestingly, similar trends were observed in the four-months peak period with a substantially higher decrease in follow-up visits in 2020 vs 2019 (-51%), whereas treatment-related activities remained stable. Conclusions: In the context of COVID-19 pandemic, our Oncology Department maintained stable performances on critical oncology activities. Strict triage procedures, serial swabs for patients and healthcare professionals and strategic follow-up visits remodulation were crucial. Notwithstanding the significant decrease in cancer treatments observed in several published reports, our experience demonstrates that the reorganization of oncology departments during a global pandemic is feasible and it should be pursued to preserve patients’ safety without compromising the continuum of care.
Pre-anthracycline left ventricular ejection fraction (LVEF) assessment and long-term cardiovascular (CV) outcomes in adolescent and young adult (AYA) lymphoma survivors.
Authors: Alma Farooque, Cibele Carroll, Amye Juliet Tevaarwerk, Priyanka Avinash Pophali
Journal: Journal of Clinical Oncology (2021)

e24060 Background: Anthracyclines are known to cause long-term cardiotoxicity. There are no specific guidelines for CV screening and follow-up of AYA patients treated with anthracyclines. Pediatric guidelines focus on long-term imaging surveillance, while for adults, LVEF assessment prior to anthracyclines is recommended. Multiple studies have demonstrated LVEF assessment rarely impacts treatment decisions, especially in the absence of CV symptoms/risk factors, adds to unnecessary costs and delays treatment initiation. Our study aimed to determine the pre-treatment LVEF assessment practices in AYA lymphoma patients treated with anthracyclines and its association with long-term cardiotoxicity. Methods: AYA survivors diagnosed with lymphoma &gt; 5 years ago and treated with anthracyclines at age 15-39 years were identified in a retrospective single institution registry. To ensure adequate follow-up, at least 2 follow-up visits during 2015-19 were required. Data abstracted on eligible subjects included documentation of pre-treatment LVEF evaluation, clinical rationale and treatment regimen. CV risk factors and events were collected pre-treatment and during follow-up. Descriptive statistics were used to summarize data. Results: 64/115 (56%) of AYA lymphoma patients underwent pre-treatment LVEF assessment. Rationale for/against LVEF assessment was rarely documented: low CV risk was recorded as rationale for no LVEF assessment in 2 subjects. Among AYAs who underwent pre-treatment LVEF assessment, no significant abnormalities were detected and no changes in subsequent treatment plans were found. During median follow-up of 6.7 (inter-quartile range 5.4-9.5) years, 6/115 (5%) experienced CV events. Only 2 (1.7%) survivors experienced potential anthracycline-related CV events: 1 moderate cardiomyopathy at 9 years, 1 peri-partum cardiomyopathy and atrial fibrillation due to post-radiation SVC occlusion at 15 years post-treatment. Both these AYAs (aged 38 and 31 years at time of CV events) also had other CV risk factors- family history, smoking, obesity, and hyperlipidemia. Four (3.5%) survivors’ experienced CV events (1 sinus tachyarrhythmia, 1 junctional rhythm, 2 acute/asymptomatic drop in LVEF) unrelated to anthracyclines with clear alternative etiology e.g. sepsis/symptom burden. There was no correlation between having pre-treatment LVEF assessment and occurrence of CV events. 13/115 (11.3%) developed new CV risk factors: 4 hypertension, 6 hyperlipidemia, 3 diabetes. Conclusions: Pre-treatment LVEF assessment is done inconsistently in AYA lymphoma patients but does not impact initial treatment or predict late cardiotoxicity. CV events in long-term AYA lymphoma survivors are rare but evaluation of CV risk factors, early detection and management may be more important than focusing on LVEF assessment.
Preventive HIPEC in combination with perioperative FLOT versus FLOT alone for resectable diffuse type gastric and gastroesophageal junction type II/III adenocarcinoma: The phase III “PREVENT” trial of the AIO /CAOGI /ACO.
Authors: Thorsten Oliver Goetze, Pompiliu Piso, Sylvie Lorenzen, Ulli Simone Bankstahl, Marcin Ostrzyzek, Claudia Pauligk, Timursah Habibzade, Daniel Reim, Wolf Otto Bechstein, Alfred Königsrainer, Stefan Paul Mönig, Beate Rau, Matthias Schwarzbach, Salah-Eddin Al-Batran
Journal: Journal of Clinical Oncology (2021)

TPS4149 Background: The main reason for treatment failure after curative surgical resection of gastric cancer is intra-abdominal spread, with 40- 50% peritoneal seeding as primary localization of recurrence. Peritoneal relapse is seen in 60-70% of tumors of diffuse type, compared to only 20-30% of intestinal type. Hyperthermic IntraPEritoneal Chemoperfusion (HIPEC) is an increasingly used therapy method for patients with peritoneal metastases. The preventive use of HIPEC could represent an elegant approach for patients (pts) before macroscopic peritoneal seeding, since patients with operable disease are fit and may have potential risk of microscopic involvement, thus having a theoretical chance of cure with HIPEC even without the need for cytoreduction. No results from a PCRT from the Western hemisphere have yet been published. Methods: This is a multicenter, randomized, controlled, open-label study including a total of 200 pts with localized and locally advanced diffuse and mixed type (Laurens`s classification) adenocarcinoma of the stomach and Type II/III GEJ (i.e. ≥cT3 any N or any T N positive). All enrolled pts will have received 3-6 pre-operative cycles of biweekly FLOT (Docetaxel 50 mg/m²; Oxaliplatin 85 mg/m²; Leucovorin 200 mg/m²; 5-FU 2600 mg/m², q2wk). Pts will be randomized 1:1 to receive surgery only and postoperative FLOT (Arm A- Control arm) or surgery + intraoperative HIPEC (cisplatin 75mg/m2 solution administered at a temperature of 42°C for 90 minutes) and postoperative FLOT (Arm B- experimental arm). Surgery is carried out as gastrectomy or transhiatal extended gastrectomy. Primary endpoint is PFS/DFS, major secondary endpoints are OS, R0 resection rate, perioperative morbidity/mortality including VAS pain score and quality of life as assessed by EORTC QLQ C30 questionnaire. The trial starts with a safety run-in phase. After 20 patients had curatively intended resection in Arm B, an interim safety analysis is performed assessing feasibility, safety, and tolerability in Arm B. First patient was randomized on 18JAN2021. Currently one patient is recruited. EudraCT: 2017-003832-35; ClinicalTrials.gov ID: NCT04447352. Clinical trial information: NCT04447352.
Residencial radon and small cell lung cancer: A case control study.
Authors: Angeles Rodriguez Martinez, Alberto Ruano
Journal: Journal of Clinical Oncology (2021)

e20566 Background: Residential radon is the second most important risk factor for lung cancer. We aim to asses the effect of residential radon exposure on the risk of SCLC in general population. Methods: A multicentric hospital-based case-control study was designed including 10 hospitals from Spain and Portugal. Incident cases with pathological diagnosis of SCLC were prospectively recruited. Controls consisted in patients undergoing non-complex surgery unrelated to tobacco consumption. All study participants were sent a radon detector. Results: A total of 375 cases and 902 controls were recruited. 24.5% of cases were women. The median age at diagnosis was 66 for cases. 6.4% of the cases were younger than 50 years. Tobacco consumption was higher in cases compared to controls. Residential radon concentrations were higher than 147 Bq/m3 in 161 SCLC cases (42.9%). Median residential radon concentration was also higher in SCLC cases compared to controls (152.5 Bq/m3 vs 142 Bq/m3). Those people exposed to more than 147 Bq/m3 and heavy smokers showed an OR of 72,62 (95%CI 17.95 - 499.41) compared to never-smokers with less than 50 Bq/m3. Conclusions: radon exposure seems to increase the risk of small cell lung cancer. There is a significant lung cancer risk departing from 148 Bq/m3 and there is also a linear dose-response pattern. Tobacco consumption may also produce an important effect modification for radon exposure. Those individuals exposed to high radon concentrations and heavy smokers can have a very high risk of this cancer type compared with their low exposed and never-smoking counterparts. It is necessary to increase radon awareness among citizens and administrations in order they can establish the necessary protective and mitigation measures against residential radon. Effect modification between residential radon exposure and tobacco consumption on the risk of small cell lung cancer.[Table: see text]
Targeted agents recommended by the CNS TAP tool compared to those selected by a tumor board in a molecularly-driven clinical trial in children and young adults with DIPG.
Authors: Holly Roberts, Karthik Ravi, Cassie Kline, Sabine Mueller, Carl Johannes Koschmann, Bernard Marini, Andrea Franson
Journal: Journal of Clinical Oncology (2021)

2048 Background: Genetic sequencing of diffuse intrinsic pontine glioma (DIPG) and diffuse midline glioma (DMG) biopsy specimens has revealed genomic heterogeneity, fueling an interest in individualized, targeted treatment options. The Pacific Pediatric Neuro-Oncology Consortium recently completed a feasibility study PNOC003: Molecular Profiling for Individualized Treatment Plan for DIPG (NCT02274987), in which a multidisciplinary tumor board recommended targeted agents based on the molecular and genetic profiling of each patient’s tumor. Separately, our group developed a numeric scoring tool of targeted anticancer agents, the Central Nervous System Targeted Agent Prediction (CNS TAP) tool, which combines pre-clinical, clinical, and CNS penetration data with patient-specific genomic information to generate a numeric score for each agent to objectively evaluate these targeted therapies for use in patients with CNS tumors. We hypothesized that highly-scored agents within the CNS-TAP tool would overlap, at least in part, with the agents recommended by the molecular tumor board in PNOC003. Methods: For each study participant (n=28), a retrospective analysis was completed, utilizing the genomic report to identify actionable genetic alterations and to input patient-specific data into CNS TAP to identify the highest scoring agents. We compared high-scoring agents within the CNS TAP tool with recommendations from the PNOC003 tumor board for each of the enrolled 28 patients. Results: Overall, 93% (26/28) of patients had at least one agent recommended by both the tumor board and CNS TAP. Additionally, 39% (37/95) of all agents recommended by the tumor board were also selected by CNS TAP, with additional analysis ongoing. Conclusions: There was significant overlap between the highest-scoring and selected agents via CNS TAP compared with those chose by the molecular tumor board. Through this work, we also identified factors that likely contributed to the discordance in choice of targeted therapies. Without clinician input, the CNS TAP tool is unable to account for drug-drug interactions, includes only designated anticancer agents, and cannot easily be updated in real time, requiring extensive manual literature review for each included agent. However, CNS TAP provides an objective evaluation of targeted therapies, in contrast to inherently subjective recommendations of a tumor board. Given the discordance identified between these methods and the strengths of each, a prospective study incorporating both CNS TAP and a molecular tumor board for targeted therapy selection in patients with high grade glioma is warranted.
Unusual Abdominal and Pelvic Tumors
Authors: Raquel Andrés, Alberto Saenz, José I. Mayordomo, Pedro Zaballos, Dolores Isla, Pilar Escudero, Ignacio Alvarez, Eduardo Polo, Ricardo Lara, Alejandro Tres
Journal: Journal of Clinical Oncology (2003)

Article Tools DIAGNOSIS IN ONCOLOGY Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2003.11.080 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 12972534 Unusual Abdominal and Pelvic Tumors CASE 4. HYPERTROPHIC OSTEOARTHROPATHY ASSOCIATED WITH PULMONARY METASTASIS OF UTERINE LEIOMYOSARCOMA Raquel AndrésxRaquel AndrésSearch for articles by this author , Alberto SaenzxAlberto SaenzSearch for articles by this author , José I. MayordomoxJosé I. MayordomoSearch for articles by this author , Pedro ZaballosxPedro ZaballosSearch for articles by this author , Dolores IslaxDolores IslaSearch for articles by this author , Pilar EscuderoxPilar EscuderoSearch for articles by this author , Ignacio AlvarezxIgnacio AlvarezSearch for articles by this author , Eduardo PoloxEduardo PoloSearch for articles by this author , Ricardo LaraxRicardo LaraSearch for articles by this author , Alejandro TresxAlejandro TresSearch for articles by this author Show More Divisions of Medical Oncology and Dermatology, University Hospital, Zaragoza, Spain https://doi.org/10.1200/JCO.2003.11.080 First Page Full Text PDF Figures and Tables © 2003 by American Society of Clinical Oncology
A 4-chemokine signature to predict intermediate immunogenicity in homologous recombination repair deficient tumors.
Authors: Joan Miguel Romero, Yifan Wang, Alain Pacis, Robert Edward Denroche, Gun Ho Jang, Barbara Grunwald, Steven Gallinger, George Zogopoulos
Journal: Journal of Clinical Oncology (2021)

2546 Background: Treatment responses to immune checkpoint blockade (ICB) associate with T cell tumor inflammation. Tumors with mismatch repair deficiency display an inflammatory tumor phenotype and respond to ICB. Similarly, tumors with homologous recombination repair deficiency (HR-d) may be primed for ICB treatment. We have previously shown that a panel of 4 chemokines identifies a subclass of pancreatic cancer with markers of T cell-inflammation. Here, we evaluated this 4-chemokine signature in cancer types with HR-d molecular subclasses. Methods: We combined paired transcriptomes and genomic data of breast (n = 699), ovarian (n = 174) and prostate (n = 457) cancers from the Cancer Genome Atlas and tumor-enriched pancreas cancers (n = 121) to evaluate the 4-chemokine signature in HR-d vs. HR-proficient tumors across these 4 cancers. Metrics of antitumor immunity were also compared. Results: Across tumor types, elevated expression of the 4-chemokine signature (chemokine-hi) associated with transcriptional hallmarks of a T cell-mediated antitumor response, including antigen presenting cell stimulation, antigen presentation, and T cell activity. In tumors with a predominant COSMIC signature 3, which associates with HR-d, the 4-chemokine signature predicted intermediate levels of T cell-inflammation. Conclusions: These data suggest that 1) the 4-chemokine signature may be a clinically relevant biomarker in identifying subclasses of tumours responsive to immunotherapies, and that 2) HR-d tumors harbor intermediate immunogenicity. Correlation of treatment responses to immunotherapies with the 4-chemokine signature is needed validate its predictive value as a biomarker for treatment stratification with immunotherapies.[Table: see text]
A commentary on “Economic impact of surgery on households and individuals in low income countries: A systematic review” [Int. J. Surg. 90 (2021) 105956]
Authors: Michael Gregorio Ortega-Sierra, María del Carmen Castillo-Montalvo, Jesús Alberto Manotas-Berdugo, Jonhatan Guillermo Jiménez-Chimá, Maria Paz Bolaño-Romero
Journal: International Journal of Surgery (2021)
Stereotactic body radiotherapy to the lung primary lesion improves the survival of patients with non-oligometastatic NSCLC harboring EGFR activating mutation with first-line EGFR-TKIs: A real-world study.
Authors: Yongmei Liu, Hao Wei, Xiaojuan Zhou, Hui Yang, Youling Gong, Jin Wang, Yong Xu, Lin Zhou, Jianxin Xue, Zou Bing Wen, Yan Zhang, Jiang Zhu, Feng Peng, Meijuan Huang, You Lu
Journal: Journal of Clinical Oncology (2021)

e21131 Background: This study aimed to explore the clinical value of SBRT for lung primary lesions of EGFR-mutant NSCLC patients with non-oligometastatic disease during first-line EGFR-TKI treatment. Methods: Patients with stage IV EGFR-mutant NSCLC and more than five metastases at diagnosis were identified. All patients were treated with first-line EGFR-TKIs and SBRT for their primary lesions. The primary end points were the progression-free survival-1 (PFS1, time of first TKI dose relative to disease progression based on RECIST), and PFS2 (time of first TKI dose relative to disease progression after SBRT). The secondary endpoints were overall survival (OS) and safety. Results: 79 patients were enrolled, including 45 patients who received SBRT for their primary tumor at the maximal response of EGFR-TKI (the preemptive RT group) and 34 patients who received SBRT for their primary tumor after the occurrence of oligo-progression (the delayed RT group). The preemptive RT group had a significantly better median PFS1 than the delayed RT group (22.3 months vs. 12.9 months, P = 0.0031). The median PFS2 in the preemptive RT and delayed RT groups were 22.3 and 28.9 months, respectively (P = 0.17). The median OS did not differ significantly between the preemptive RT group and the delayed RT group (46.6 versus 51.3 months, P = 0.54). No severe toxicities (≥ grade 3) were recorded. Conclusions: This real-world study showed that preemptive RT to lung primary tumors is a feasible option for patients with EGFR-mutant non-oligometastatic NSCLC who had stable disease during first-line EGFR-TKI treatment, with significantly improved PFS and OS.
Immune checkpoint inhibitor plus anti-EGFR target therapy plus chemotherapy in patients with locally advanced penile squamous cell carcinoma.
Authors: Hui Han, Xin An, Ru Yan, Shengjie Guo, Cong Xue, Tingyu Liu, Li Tian, Huali Ma, Yonghong Li, Zike Qin, Zhuowei Liu, Fang-Jian Zhou, Yanxia Shi
Journal: Journal of Clinical Oncology (2021)

e17016 Background: Locally advanced penile squamous cell carcinomas (PSCCs) have poor prognosis and limited therapeutic options. We aim to evaluate the safety and the efficacy of neoadjuvant therapy with anti-PD-1 immune therapy (toripalimab) plus anti-EGFR target therapy (nimotuzumab) plus chemotherapy (TIP) in locally advanced PSCCs. Methods: We retrospectively reviewed chemotherapy-naive, unresectable locally advanced PSCCs (T 4 N any M 0 or T any N 3 M 0 ) who received combined neoadjuvant therapy and subsequently radical surgery in Sun Yat-sen University Cancer Center between 2018 and 2020. All patients received toripalimab 240mg on day 1 plus nimotuzumab 400mg on day 1 plus standard-of-care TIP (Cisplatin 25mg/m 2 on day 1 to day 3; ifosfamide 1.2g/m 2 on day 1 to day 3; paclitaxel 175mg/m 2 or albumin-bound paclitaxel 260mg/m 2 on day 1) every 3-4 weeks. Pathologic complete response(pCR) rate and toxicity were evaluated. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier estimation. Results: We screened 12 patients in total who had performed toripalimab plus nimotuzumab plus TIP (TNTIP) as neoadjuvant treatment and subsequently radical surgery. Median age was 51 (95% confidence interval [CI]: 44-60.5) years old. 10(83.3%) patients received 3 or 4 courses of TNTIP neoadjuvant treatment. After neoadjuvant treatment and radical surgery, 8(66.7%) patients had a pCR. 2(16.7%) patients died of disease progress or recurrence, which 1(8.3%) patient occurred bone metastases after 2 courses of TNTIP, and 1(8.3%) patient appeared recurrence after 6 months of radical surgery. The median follow-up time was 21.3 months (95%CI 19.9-22.6). Median PFS and OS were not reached. The 1-year PFS rate was 83.3% and 1-year OS rate was 91.7%. 3(25%) patients experienced grade 3 treatment-related adverse events of fatigue, anemia and neutropenia. No grade 4 or 5 adverse events or death associated with treatment. Conclusions: Compared with other therapeutic options, our results suggest that TNTIP in neoadjuvant stage effectively improve the disease control and prognosis in locally advanced PSCCs. Based on this result, we are conducting a phase II study in Sun Yat-sen University Cancer Center to further validate the efficacy and safety of TNTIP neoadjuvant regimen in locally advanced PSCCs. (ClinicalTrials.gov No. NCT04475016).