首页 > 最新文献

Journal of global oncology最新文献

英文 中文
Comprehensive analysis of maintenance therapy after first-line treatment with pemetrexed and platinum-containing double drug regimen combined by bevacizumab in EGFR wild type advanced non-squamous NSCLC. 培美曲塞加含铂双药方案联合贝伐单抗一线治疗EGFR野生型晚期非鳞状NSCLC后的维持治疗综合分析
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.133
Xianghua Zhang, Li-xia Ma, Ying Cheng, H. Cui
133 Background: Pemetrexed combined with platinum was the standard treatment for first-line EGFR wild type non-squamous NSCLC , but further research is needed to confirm the safety of pemetrexed and bevacizumab treatment in maintenance therapy after first-line treatment in advenced non-squamous NSCLC. Methods: Total 60 patients with newly diagnosed advanced non-squamous NSCLC admitted to the hospital from June 2015 to June 2017, which were ARMS confirmed the EGFR wild type. In the observation group, bevacizumab +pemetrexed+ platinum was maintained with bevacizumab (BAP-B group). Control group: bevacizumab + pemetrexed + platinum was maintained with pemetrexed (BAP-A group). 60 patients completed 4- 6 cycles of chemotherapy and maintenance therapy for more than 4 cycles. The curative effect was evaluated According to Recis 1.1.The toxic reaction was evaluated WHO chemotherapeutic drug toxicity. The quality of life of patients were evaluated by EORTC QLQ-LC43. All the data were processed by SPSS19.0. P < 0.05 was statistically significant. Results: 33 cases in BAP-B and 27 cases in BAP-A . In this study, BAP-B & BAP-A : ORR 61.0% & 50.0% (P > 0.05);DCR 73.5 & 64.8 % ( P>0.05), median PFS 9.6 m & 7.2 m (P < 0.05), OS:18.2 m & 12.6 m (P < 0.05). Adverse incidence: BAP-B & BAP-A: leukopenia rate 43.0% & 41.2% hemoglobin reduction 40.0% & 38.5%; The reaction rate of digestive tract was 35.3% & 34.5%. There was no significant difference between the two groups. The incidence of hypertension in BAP-B (18.8%) was higher than that in BAP-A (0%) (P < 0.05). The incidence of proteuria in BAP-B (8.8%) was higher than that in BAP-A (2.0%) (P < 0.05), BAP-A and BAP-B (P < 0.05). The quality of life score of EORTC QLQ-C43 was (73.17 ±2.75) & (59.68 ±2.52), which was higher than that before treatment (52.75 ±2.02) & (53.01 ±1.98), and the score of BAP-A was higher than that of BAP-B(P < 0.05). Conclusions: The first line treatment of advanced EGFR wild type non-squamous NSCLC needs comprehensive consideration of curative effect, survival time, safety, quality of life and economic problems in order to choose the most suitable treatment.
133背景:培美曲塞联合铂是一线EGFR野生型非鳞状NSCLC的标准治疗方案,但晚期非鳞状NSCLC一线治疗后,培美曲塞联合贝伐单抗用于维持治疗的安全性有待进一步研究证实。方法:2015年6月至2017年6月收治的60例新诊断晚期非鳞状NSCLC患者,均为ARMS确认的EGFR野生型。观察组以贝伐单抗维持贝伐单抗+培美曲塞+铂治疗(BAP-B组)。对照组:贝伐单抗+培美曲塞+铂维持培美曲塞(baba - a组)。60例患者化疗完成4 ~ 6个周期,维持治疗4个周期以上。按照Recis 1.1评价疗效。对毒性反应进行WHO化疗药物毒性评价。采用EORTC QLQ-LC43评价患者的生活质量。所有数据均采用SPSS19.0软件处理。P < 0.05差异有统计学意义。结果:BAP-B 33例,BAP-A 27例。本研究中,BAP-B和BAP-A的ORR分别为61.0%和50.0% (P >0.05), DCR分别为73.5%和64.8% (P >0.05),中位PFS分别为9.6 m和7.2 m (P < 0.05), OS分别为18.2 m和12.6 m (P < 0.05)。不良反应发生率:BAP-B和BAP-A:白细胞减少率43.0%和41.2%,血红蛋白降低40.0%和38.5%;消化道反应率分别为35.3%和34.5%。两组间无显著差异。BAP-B组高血压发生率(18.8%)高于BAP-A组(0%)(P < 0.05)。BAP-B组蛋白尿发生率(8.8%)高于BAP-A组(2.0%)(P < 0.05), BAP-A组和BAP-B组蛋白尿发生率(P < 0.05)。EORTC QLQ-C43生活质量评分分别为(73.17±2.75)和(59.68±2.52)分,高于治疗前的(52.75±2.02)和(53.01±1.98)分,且BAP-A评分高于BAP-B评分(P < 0.05)。结论:晚期EGFR野生型非鳞状NSCLC的一线治疗需要综合考虑疗效、生存时间、安全性、生活质量和经济问题,选择最合适的治疗方案。
{"title":"Comprehensive analysis of maintenance therapy after first-line treatment with pemetrexed and platinum-containing double drug regimen combined by bevacizumab in EGFR wild type advanced non-squamous NSCLC.","authors":"Xianghua Zhang, Li-xia Ma, Ying Cheng, H. Cui","doi":"10.1200/jgo.2019.5.suppl.133","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.133","url":null,"abstract":"133 Background: Pemetrexed combined with platinum was the standard treatment for first-line EGFR wild type non-squamous NSCLC , but further research is needed to confirm the safety of pemetrexed and bevacizumab treatment in maintenance therapy after first-line treatment in advenced non-squamous NSCLC. Methods: Total 60 patients with newly diagnosed advanced non-squamous NSCLC admitted to the hospital from June 2015 to June 2017, which were ARMS confirmed the EGFR wild type. In the observation group, bevacizumab +pemetrexed+ platinum was maintained with bevacizumab (BAP-B group). Control group: bevacizumab + pemetrexed + platinum was maintained with pemetrexed (BAP-A group). 60 patients completed 4- 6 cycles of chemotherapy and maintenance therapy for more than 4 cycles. The curative effect was evaluated According to Recis 1.1.The toxic reaction was evaluated WHO chemotherapeutic drug toxicity. The quality of life of patients were evaluated by EORTC QLQ-LC43. All the data were processed by SPSS19.0. P < 0.05 was statistically significant. Results: 33 cases in BAP-B and 27 cases in BAP-A . In this study, BAP-B & BAP-A : ORR 61.0% & 50.0% (P > 0.05);DCR 73.5 & 64.8 % ( P>0.05), median PFS 9.6 m & 7.2 m (P < 0.05), OS:18.2 m & 12.6 m (P < 0.05). Adverse incidence: BAP-B & BAP-A: leukopenia rate 43.0% & 41.2% hemoglobin reduction 40.0% & 38.5%; The reaction rate of digestive tract was 35.3% & 34.5%. There was no significant difference between the two groups. The incidence of hypertension in BAP-B (18.8%) was higher than that in BAP-A (0%) (P < 0.05). The incidence of proteuria in BAP-B (8.8%) was higher than that in BAP-A (2.0%) (P < 0.05), BAP-A and BAP-B (P < 0.05). The quality of life score of EORTC QLQ-C43 was (73.17 ±2.75) & (59.68 ±2.52), which was higher than that before treatment (52.75 ±2.02) & (53.01 ±1.98), and the score of BAP-A was higher than that of BAP-B(P < 0.05). Conclusions: The first line treatment of advanced EGFR wild type non-squamous NSCLC needs comprehensive consideration of curative effect, survival time, safety, quality of life and economic problems in order to choose the most suitable treatment.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48292548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What Filipinos, the world’s number one Internet users, want to know about cancer: A Google search analysis from 2015 to 2019. 作为世界第一的互联网用户,菲律宾人想知道关于癌症的什么:2015年至2019年的谷歌搜索分析。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.23
L. Catedral, L. Leones, C. M. Berba
23 Background: Filipinos were the world’s heaviest Internet users in 2018. It has been shown that they use the Internet to actively search for health-related information, but it has not yet been determined what kinds of information are sought. There is a gap in our present understanding of the information needs of the Filipino population in relation to cancer. The study assessed the cancer-related information needs of Filipinos using Internet search data from March 2015 to May 2019. Methods: A retrospective longitudinal study was done using Google AdWords Keyword Planner to identify search terms related to cancer from Internet users from the Philippines from June 2015 to May 2019. The identified search terms were assessed descriptively using Microsoft Excel version 16.26. The search terms were qualitatively categorized and described. Results: A total of 806 cancer-related search terms were identified, with 13,632,890 Google web searches, during the period under review. The top ten search terms with the highest monthly search volume in the Philippines (n=4,741,600, 34.78%) were “cancer,” “breast cancer,” “cervical cancer,” “prostate cancer,” “colon cancer,” “breast cancer symptoms,” “lung cancer,” “lung cancer symptoms,” “colon cancer symptoms,” and “lungs.” In this time period, Filipinos sought information on cancer-related signs and symptoms (n=3,307,640, 24.26%) and cancer treatment (n=604,070, 4.43%). Filipinos also searched for alternative, herbal, and natural cancer treatments, but the search volume accounted for a low percentage of the total searches (n=8,710, 0.06%). Searches for the search term, “cancer,” were highest on January to February, a trend observed from January 2016 to 2019. Conclusions: Our study provides insight into the cancer-related information needs of the Filipino population. This information may inform the development of targeted, cost-effective awareness campaigns through the Internet, which may be more effective if launched at the beginning of each year.
23背景:2018年,菲律宾人是世界上互联网用户最多的国家。研究表明,他们使用互联网积极搜索与健康相关的信息,但尚未确定要寻找哪种信息。我们目前对菲律宾人口在癌症方面的信息需求的理解存在差距。该研究使用2015年3月至2019年5月的互联网搜索数据评估了菲律宾人对癌症相关信息的需求。方法:使用Google AdWords关键词规划器进行回顾性纵向研究,从2015年6月至2019年5月菲律宾互联网用户中识别与癌症相关的搜索词。使用Microsoft Excel版本16.26对识别的搜索项进行描述性评估。对搜索词进行了定性分类和描述。结果:在审查期间,共识别出806个癌症相关搜索词,其中13632890个谷歌网络搜索。菲律宾月度搜索量最高的前十个搜索词(n=4741600,34.78%)是“癌症”、“癌症”、“癌症”、“前列腺癌症”、“癌症”、“癌症乳腺癌症状”、“癌症”、“癌症肺癌症状”、,菲律宾人寻求与癌症相关的体征和症状(n=3307640,24.26%)和癌症治疗(n=604070,4.43%)的信息。菲律宾人为寻找替代、草药和天然癌症治疗方法,但搜索量在总搜索量中所占比例较低(n=8710,0.06%)。1月至2月,搜索词“癌症”的搜索量最高,2016年1月至2019年的趋势。结论:我们的研究提供了对菲律宾人口癌症相关信息需求的见解。这些信息可以为通过互联网开展有针对性、成本效益高的宣传活动提供信息,如果在每年年初发起,宣传活动可能会更加有效。
{"title":"What Filipinos, the world’s number one Internet users, want to know about cancer: A Google search analysis from 2015 to 2019.","authors":"L. Catedral, L. Leones, C. M. Berba","doi":"10.1200/jgo.2019.5.suppl.23","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.23","url":null,"abstract":"23 Background: Filipinos were the world’s heaviest Internet users in 2018. It has been shown that they use the Internet to actively search for health-related information, but it has not yet been determined what kinds of information are sought. There is a gap in our present understanding of the information needs of the Filipino population in relation to cancer. The study assessed the cancer-related information needs of Filipinos using Internet search data from March 2015 to May 2019. Methods: A retrospective longitudinal study was done using Google AdWords Keyword Planner to identify search terms related to cancer from Internet users from the Philippines from June 2015 to May 2019. The identified search terms were assessed descriptively using Microsoft Excel version 16.26. The search terms were qualitatively categorized and described. Results: A total of 806 cancer-related search terms were identified, with 13,632,890 Google web searches, during the period under review. The top ten search terms with the highest monthly search volume in the Philippines (n=4,741,600, 34.78%) were “cancer,” “breast cancer,” “cervical cancer,” “prostate cancer,” “colon cancer,” “breast cancer symptoms,” “lung cancer,” “lung cancer symptoms,” “colon cancer symptoms,” and “lungs.” In this time period, Filipinos sought information on cancer-related signs and symptoms (n=3,307,640, 24.26%) and cancer treatment (n=604,070, 4.43%). Filipinos also searched for alternative, herbal, and natural cancer treatments, but the search volume accounted for a low percentage of the total searches (n=8,710, 0.06%). Searches for the search term, “cancer,” were highest on January to February, a trend observed from January 2016 to 2019. Conclusions: Our study provides insight into the cancer-related information needs of the Filipino population. This information may inform the development of targeted, cost-effective awareness campaigns through the Internet, which may be more effective if launched at the beginning of each year.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42454233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Automate incidental findings in radiology reports using natural language processing and machine learning to identify and classify lung nodules. 使用自然语言处理和机器学习来识别和分类肺结节,自动化放射学报告中的偶然发现。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.49
C. French, D. Kurbegov, D. Spigel, M. Makowski, Samantha R. Terker, P. Clark
49 Background: Pulmonary nodule incidental findings challenge providers to balance resource efficiency and high clinical quality. Incidental findings tend to be under evaluated with studies reporting appropriate follow-up rates as low as 29%. The efficient identification of patients with high risk nodules is foundational to ensuring appropriate follow-up and requires the clinical reading and classification of radiology reports. We tested the feasibility of automating this process with natural language processing (NLP) and machine learning (ML). Methods: In cooperation with Sarah Cannon, the Cancer Institute of HCA Healthcare, we conducted a series of experiments on 8,879 free-text, narrative CT radiology reports. A representative sample of health system ED, IP, and OP reports dated from Dec 2015 - April 2017 were divided into a development set for model training and validation, and a test set to evaluate model performance. A “Nodule Model” was trained to detect the reported presence of a pulmonary nodule and a rules-based “Size Model” was developed to extract the size of the nodule in mms. Reports were bucketed into three prediction groups: ≥ 6 mm, <6 mm, and no size indicated. Nodules were placed in a queue for follow-up if the nodule was predicted ≥ 6 mm, or if the nodule had no size indicated and the report contained the word “mass.” The Fleischner Society Guidelines and clinical review informed these definitions. Results: Precision and recall metrics were calculated for multiple model thresholds. A threshold was selected based on the validation set calculations and a success criterion of 90% queue precision was selected to minimize false positives. On the test dataset, the F1 measure of the entire pipeline was 72.9%, recall was 60.3%, and queue precision was 90.2%, exceeding success criteria. Conclusions: The experiments demonstrate the feasibility of technology to automate the detection and classification of pulmonary nodule incidental findings in radiology reports. This approach promises to improve healthcare quality by increasing the rate of appropriate lung nodule incidental finding follow-up and treatment without excessive labor or risking overutilization.
49背景:肺结节的偶然发现挑战了提供者在资源效率和高临床质量之间的平衡。偶然发现往往被低估,研究报告适当的随访率低至29%。有效识别高危结节患者是确保适当随访的基础,需要临床阅读和分类放射学报告。我们用自然语言处理(NLP)和机器学习(ML)测试了自动化这一过程的可行性。方法:与HCA医疗保健癌症研究所Sarah Cannon合作,我们对8879份自由文本、叙述性CT放射学报告进行了一系列实验。2015年12月至2017年4月的卫生系统ED、IP和OP报告的代表性样本分为用于模型训练和验证的开发集和用于评估模型性能的测试集。训练了一个“结节模型”来检测报告中是否存在肺结节,并开发了一个基于规则的“大小模型”来提取以mms为单位的结节大小。报告分为三个预测组:≥6 mm、<6 mm,未显示大小。如果预测结节≥6毫米,或者结节没有显示大小,并且报告中包含“肿块”一词,则将结节排在队列中进行随访。Fleischner学会指南和临床审查告知了这些定义。结果:计算了多个模型阈值的精确度和召回率指标。根据验证集计算选择阈值,并选择90%队列精度的成功标准,以最大限度地减少误报。在测试数据集上,整个管道的F1度量为72.9%,召回率为60.3%,队列精度为90.2%,超过了成功标准。结论:实验证明了在放射学报告中自动检测和分类肺结节偶然发现的技术的可行性。这种方法有望通过提高适当的肺结节偶然发现随访和治疗率来提高医疗质量,而不会产生过度劳动或过度使用的风险。
{"title":"Automate incidental findings in radiology reports using natural language processing and machine learning to identify and classify lung nodules.","authors":"C. French, D. Kurbegov, D. Spigel, M. Makowski, Samantha R. Terker, P. Clark","doi":"10.1200/jgo.2019.5.suppl.49","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.49","url":null,"abstract":"49 Background: Pulmonary nodule incidental findings challenge providers to balance resource efficiency and high clinical quality. Incidental findings tend to be under evaluated with studies reporting appropriate follow-up rates as low as 29%. The efficient identification of patients with high risk nodules is foundational to ensuring appropriate follow-up and requires the clinical reading and classification of radiology reports. We tested the feasibility of automating this process with natural language processing (NLP) and machine learning (ML). Methods: In cooperation with Sarah Cannon, the Cancer Institute of HCA Healthcare, we conducted a series of experiments on 8,879 free-text, narrative CT radiology reports. A representative sample of health system ED, IP, and OP reports dated from Dec 2015 - April 2017 were divided into a development set for model training and validation, and a test set to evaluate model performance. A “Nodule Model” was trained to detect the reported presence of a pulmonary nodule and a rules-based “Size Model” was developed to extract the size of the nodule in mms. Reports were bucketed into three prediction groups: ≥ 6 mm, <6 mm, and no size indicated. Nodules were placed in a queue for follow-up if the nodule was predicted ≥ 6 mm, or if the nodule had no size indicated and the report contained the word “mass.” The Fleischner Society Guidelines and clinical review informed these definitions. Results: Precision and recall metrics were calculated for multiple model thresholds. A threshold was selected based on the validation set calculations and a success criterion of 90% queue precision was selected to minimize false positives. On the test dataset, the F1 measure of the entire pipeline was 72.9%, recall was 60.3%, and queue precision was 90.2%, exceeding success criteria. Conclusions: The experiments demonstrate the feasibility of technology to automate the detection and classification of pulmonary nodule incidental findings in radiology reports. This approach promises to improve healthcare quality by increasing the rate of appropriate lung nodule incidental finding follow-up and treatment without excessive labor or risking overutilization.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46212648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microvascular invasion guiding selection of candidates for combination treatment with sorafenib and TACE for intermediate recurrent hepatocellular carcinoma. 微血管侵袭指导选择索拉非尼和TACE联合治疗中复发性肝细胞癌的候选药物。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.105
Zhenwei Peng, Shuling Chen, Han Xiao, Yuanqi Wang, M. Kuang
105 Background: To investigate the role of sorafenib combined with transarterial chemoembolization (TACE) for the treatment of intermediate recurrent hepatocellular carcinoma (rHCC) after initial hepatectomy and whether the status of microvascular invasion (MVI) could help screen out the appropriate candidates for the combination treatment. Methods: The study was approved by the ethics committee of two tertiary medical centers in China. From Jan 2010 to Dec 2016, 260 consecutive patients with intermediate rHCC after initial hepatectomy who underwent combination treatment or TACE were enrolled. Overall survival (OS) and progression-free survival (PFS) were compared between these two treatments according to MVI status. Results: The 1-, 3-, 5-year OS (77.1% vs. 62.0%, 49.3% vs. 35.2%, 38.9% vs. 20.5%, P = 0.011) and PFS (74.2% vs. 56.5%, 37.5% vs. 18.7%, 37.5% vs. 18.7%, P = 0.003) rates were significantly higher in the combination group than those in the TACE group for intermediate rHCC. For MVI-positive patients, the median OS (17.2 months vs. 12.1 months, P = 0.024) and PFS (17.0 months vs. 11.0 months, P = 0.022) after combination treatment (n = 55) were significantly longer than those after TACE alone (n = 72). For MVI-negative patients, the median OS (42.7 months vs. 32.6 months, P = 0.247) and PFS (24.6 months vs. 17.2 months, P = 0.113) were comparable between combination therapy (n = 73) and TACE alone (n = 60). Multivariate analysis revealed that tumor number, MVI status and treatment allocation were significant predictors of OS and PFS, while the tumor size was another prognostic factor for PFS. Conclusions: Patients with intermediate rHCC can benefit from sorafenib plus TACE treatment, while MVI-positive patients were good candidates for combination treatment.
105背景:探讨索拉非尼联合经动脉化疗栓塞(TACE)治疗原发性肝切除术后中期复发性肝细胞癌(rHCC)的作用,以及微血管侵犯(MVI)状况是否有助于筛选合适的联合治疗候选者。方法:本研究经国内两家三级医疗中心伦理委员会批准。2010年1月至2016年12月,连续纳入260例首次肝切除术后接受联合治疗或TACE的中度rHCC患者。根据MVI状态比较两种治疗的总生存期(OS)和无进展生存期(PFS)。结果:中期rHCC联合组的1、3、5年OS (77.1% vs. 62.0%, 49.3% vs. 35.2%, 38.9% vs. 20.5%, P = 0.011)和PFS (74.2% vs. 56.5%, 37.5% vs. 18.7%, 37.5% vs. 18.7%, P = 0.003)率显著高于TACE组。对于mvi阳性患者,联合治疗(n = 55)后的中位OS(17.2个月vs 12.1个月,P = 0.024)和PFS(17.0个月vs 11.0个月,P = 0.022)明显长于单独接受TACE治疗(n = 72)的患者。对于mvi阴性患者,联合治疗(n = 73)和单独TACE (n = 60)的中位OS(42.7个月vs. 32.6个月,P = 0.247)和PFS(24.6个月vs. 17.2个月,P = 0.113)具有可比性。多因素分析显示,肿瘤数量、MVI状态和治疗分配是OS和PFS的重要预测因素,肿瘤大小是PFS的另一个预后因素。结论:中度rHCC患者可以从索拉非尼联合TACE治疗中获益,而mvi阳性患者是联合治疗的良好候选者。
{"title":"Microvascular invasion guiding selection of candidates for combination treatment with sorafenib and TACE for intermediate recurrent hepatocellular carcinoma.","authors":"Zhenwei Peng, Shuling Chen, Han Xiao, Yuanqi Wang, M. Kuang","doi":"10.1200/jgo.2019.5.suppl.105","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.105","url":null,"abstract":"105 Background: To investigate the role of sorafenib combined with transarterial chemoembolization (TACE) for the treatment of intermediate recurrent hepatocellular carcinoma (rHCC) after initial hepatectomy and whether the status of microvascular invasion (MVI) could help screen out the appropriate candidates for the combination treatment. Methods: The study was approved by the ethics committee of two tertiary medical centers in China. From Jan 2010 to Dec 2016, 260 consecutive patients with intermediate rHCC after initial hepatectomy who underwent combination treatment or TACE were enrolled. Overall survival (OS) and progression-free survival (PFS) were compared between these two treatments according to MVI status. Results: The 1-, 3-, 5-year OS (77.1% vs. 62.0%, 49.3% vs. 35.2%, 38.9% vs. 20.5%, P = 0.011) and PFS (74.2% vs. 56.5%, 37.5% vs. 18.7%, 37.5% vs. 18.7%, P = 0.003) rates were significantly higher in the combination group than those in the TACE group for intermediate rHCC. For MVI-positive patients, the median OS (17.2 months vs. 12.1 months, P = 0.024) and PFS (17.0 months vs. 11.0 months, P = 0.022) after combination treatment (n = 55) were significantly longer than those after TACE alone (n = 72). For MVI-negative patients, the median OS (42.7 months vs. 32.6 months, P = 0.247) and PFS (24.6 months vs. 17.2 months, P = 0.113) were comparable between combination therapy (n = 73) and TACE alone (n = 60). Multivariate analysis revealed that tumor number, MVI status and treatment allocation were significant predictors of OS and PFS, while the tumor size was another prognostic factor for PFS. Conclusions: Patients with intermediate rHCC can benefit from sorafenib plus TACE treatment, while MVI-positive patients were good candidates for combination treatment.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46420316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multidimensional integrative medicine applied to outpatient cancer treatment in southern Brazil: Preliminary cost-effectiveness analysis. 多维整合医学应用于巴西南部门诊癌症治疗:初步成本效益分析。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.5
J. Fleck, R. Preger, L. Venegas, H. D. A. V. Trasel
5 Background: Cost-effective analysis as part of cancer treatment decision-making. Methods: We reviewed deaths of 52 metastatic cancer patients treated with multidimensional integrative medicine (MIM) approach. Patients received standard oncologic treatment plus a MIM predefined program of emotional, cognitive and social support. The method included empathy improvement, changes on physician attitude and office environment, modulation of staff behavior supporting patient’s needs and rights, promotion of belongingness, increasing on patient’s protagonism using multimedia interactive narrative and shared decision-making. Patients were categorised according to the tumor site, pathologic, molecular and IHC characteristics, clinical stage and treatment. Observed survival was defined as the time elapsed between the detection of first metastasis and death. The observed survival for each patient was compared with the median expected survival previously reported on prospective randomised trials which had accrued patients with similar prognostic factors based on a best fit model. Treatment monthly cost for each patient was converted in American dollars (USD) on a daily exchange basis. Cost of the treatment periods were compared with those analysed in four large USA commercial managed care plans. Results: Treatment of metastatic cancer patients using MIM showed a 44% increase in median survival and a 48% decrease in cost. The estimated ICER/QALY was of 32304 USD, which represented 2.0 of Brazilian PPP. Conclusions: Despite methodological limitations, this is the first study to indicate a cost-effective survival increase in metastatic cancer patients using a MIM-behavioral modulation model. [Table: see text]
5背景:成本效益分析是癌症治疗决策的一部分。方法:回顾52例转移性癌症患者采用多维综合医学(MIM)方法治疗的死亡情况。患者接受标准肿瘤学治疗,再加上MIM预定义的情感、认知和社会支持计划。该方法包括提高同理心、改变医生态度和办公环境、调整员工行为以支持患者的需求和权利、促进归属感、使用多媒体互动叙事和共享决策提高患者的主动性。根据肿瘤部位、病理、分子和IHC特征、临床分期和治疗对患者进行分类。观察到的存活率定义为从检测到首次转移到死亡之间的时间。将每位患者的观察生存率与先前在前瞻性随机试验中报告的预期生存率中位数进行比较,该试验基于最佳拟合模型计算出具有相似预后因素的患者。每位患者的每月治疗费用按每日汇率换算为美元。将治疗期的费用与美国四个大型商业管理护理计划中分析的费用进行了比较。结果:使用MIM治疗转移性癌症患者的中位生存率提高了44%,成本降低了48%。估计ICER/QALY为32304美元,相当于巴西购买力平价的2.0。结论:尽管方法上有局限性,但这是第一项使用MIM-行为调节模型表明转移性癌症患者的生存率提高具有成本效益的研究。[表格:见正文]
{"title":"Multidimensional integrative medicine applied to outpatient cancer treatment in southern Brazil: Preliminary cost-effectiveness analysis.","authors":"J. Fleck, R. Preger, L. Venegas, H. D. A. V. Trasel","doi":"10.1200/jgo.2019.5.suppl.5","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.5","url":null,"abstract":"5 Background: Cost-effective analysis as part of cancer treatment decision-making. Methods: We reviewed deaths of 52 metastatic cancer patients treated with multidimensional integrative medicine (MIM) approach. Patients received standard oncologic treatment plus a MIM predefined program of emotional, cognitive and social support. The method included empathy improvement, changes on physician attitude and office environment, modulation of staff behavior supporting patient’s needs and rights, promotion of belongingness, increasing on patient’s protagonism using multimedia interactive narrative and shared decision-making. Patients were categorised according to the tumor site, pathologic, molecular and IHC characteristics, clinical stage and treatment. Observed survival was defined as the time elapsed between the detection of first metastasis and death. The observed survival for each patient was compared with the median expected survival previously reported on prospective randomised trials which had accrued patients with similar prognostic factors based on a best fit model. Treatment monthly cost for each patient was converted in American dollars (USD) on a daily exchange basis. Cost of the treatment periods were compared with those analysed in four large USA commercial managed care plans. Results: Treatment of metastatic cancer patients using MIM showed a 44% increase in median survival and a 48% decrease in cost. The estimated ICER/QALY was of 32304 USD, which represented 2.0 of Brazilian PPP. Conclusions: Despite methodological limitations, this is the first study to indicate a cost-effective survival increase in metastatic cancer patients using a MIM-behavioral modulation model. [Table: see text]","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48205770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Novel CT-guided 188-rhenium brachytherapy device for local primary and secondary lung malignancies. 新型ct引导的188-铼近距离治疗局部原发性和继发性肺恶性肿瘤装置。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.96
H. Belhadj-Tahar, Jindde Chen, P. Song, Jun Zhao, M. Quan, Caixin Li, Xingjian Gu, Guanghua Yang, Yong Gao
96 Background: Stereotactic brachytherapy for extensive local tumors offers a very effective treatment option locally without significant complications in medically impaired patients. In this context, we have recently developed a new potential anticancer agent from Poly-L-Lysins dendrimer as a delivery nano system loaded with diffusible Imidazolic probes complexed with 188-Rhenium for targeting in particular hypoxic tumors resistant to conventional cancer treatments. The aim of the study is assessment the safety profile and therapeutic efficacy of anticancer agent derived from [188Re]rhenium-ligand as radioactive ligand loaded 5th generation poly-L-lysine dendrimer in patients with unresectable Lung Malignancies. Methods: The experiment agent “ 188Re-ImDendrim” is consisting of 5th generation poly-L-lysine dendrimer (20 nM) mixed with nitro-imidazole-methyl-1,2,3-triazol-methyl-di-(2-pycolyl) amine at GMP grade and labelled with [188Re]-rhenium. The study was approved by Shanghai East Hospital ethics committee. 5 patients received “188Re-ImDendrim” directly into lung tumors under CT-guidance, at an activity level of 162 MBq/cc of tumor (range 2 to 7 cm; mean diameter, 4 cm) . For voluminous tumors ( > 65 cc) the dose is given in divided injection spaced 2 weeks apart (Tumor of 115cc: 2 administrations, Tumor of 180 cc: 3 administrations). At H0.5, H 4, H24, H36 , H72 post-administration, the patient get a SPECT control. The response to treatment is evaluated thanks to PET/CT Standardized Uptake Values (SUVs). Results: Stereotactic administrations of “188-Rhenium-ImDendrim” were successfully carried out in all patients under local anesthesia. The radioactive product diffuses homogeneously in the tumor volume and remains 72 hours post-administration with no significant diffusion out site of injection. The One of the 5 patients reported discrete transitive hemoptysis as adverse events. All targeted tumors were responding at 12 weeks, with two complete responses. Conclusions: Percutaneous single and iterative administrations of this novel 188-Rhenium-Imdendrim brachytherapy device into lung cancers are safe and well tolerated. The initial data on therapeutic response are promising. Clinical trial information: EC.D (BG) 016.03.1.
背景:立体定向近距离治疗广泛的局部肿瘤是一种非常有效的治疗选择,对医学功能受损的患者没有明显的并发症。在这种背景下,我们最近从Poly-L-Lysins树状大分子中开发了一种新的潜在抗癌剂,作为递送纳米系统,负载可扩散咪唑探针与188-铼络合,用于靶向对常规癌症治疗具有抗性的特定缺氧肿瘤。该研究的目的是评估由[188Re]铼配体衍生的抗癌药物作为放射性配体负载第五代聚l -赖氨酸树突状物在不可切除的肺部恶性肿瘤患者中的安全性和治疗效果。方法:实验药剂“188Re- imdendrim”由第5代聚l-赖氨酸树状大分子(20 nM)与GMP级硝基咪唑-甲基-1,2,3-三唑-甲基-二-(2-pycolyl)胺混合而成,用[188Re]-铼标记。本研究经上海东方医院伦理委员会批准。5例患者在ct引导下将“188Re-ImDendrim”直接植入肺肿瘤,活性水平为162 MBq/cc肿瘤(范围2 ~ 7 cm;平均直径4厘米)。对于体积较大的肿瘤(bbb65 cc),剂量间隔2周分次注射(肿瘤115cc: 2次给药,肿瘤180cc: 3次给药)。给药后H0.5、h4、H24、H36、H72行SPECT对照。通过PET/CT标准化摄取值(suv)评估治疗反应。结果:所有患者均在局麻下成功进行立体定向给药。放射性产物在肿瘤体积内均匀扩散,给药后72小时仍存在,注射部位外无明显扩散。5例患者中有1例报告离散性移行性咯血为不良事件。所有靶向肿瘤在12周时均有应答,其中2例完全应答。结论:这种新型的188-铼- imendendrim近距离治疗装置经皮单次和反复应用于肺癌是安全且耐受性良好的。关于治疗反应的初步数据是有希望的。临床试验信息:EC。D (bg) 016.03.1。
{"title":"Novel CT-guided 188-rhenium brachytherapy device for local primary and secondary lung malignancies.","authors":"H. Belhadj-Tahar, Jindde Chen, P. Song, Jun Zhao, M. Quan, Caixin Li, Xingjian Gu, Guanghua Yang, Yong Gao","doi":"10.1200/jgo.2019.5.suppl.96","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.96","url":null,"abstract":"96 Background: Stereotactic brachytherapy for extensive local tumors offers a very effective treatment option locally without significant complications in medically impaired patients. In this context, we have recently developed a new potential anticancer agent from Poly-L-Lysins dendrimer as a delivery nano system loaded with diffusible Imidazolic probes complexed with 188-Rhenium for targeting in particular hypoxic tumors resistant to conventional cancer treatments. The aim of the study is assessment the safety profile and therapeutic efficacy of anticancer agent derived from [188Re]rhenium-ligand as radioactive ligand loaded 5th generation poly-L-lysine dendrimer in patients with unresectable Lung Malignancies. Methods: The experiment agent “ 188Re-ImDendrim” is consisting of 5th generation poly-L-lysine dendrimer (20 nM) mixed with nitro-imidazole-methyl-1,2,3-triazol-methyl-di-(2-pycolyl) amine at GMP grade and labelled with [188Re]-rhenium. The study was approved by Shanghai East Hospital ethics committee. 5 patients received “188Re-ImDendrim” directly into lung tumors under CT-guidance, at an activity level of 162 MBq/cc of tumor (range 2 to 7 cm; mean diameter, 4 cm) . For voluminous tumors ( > 65 cc) the dose is given in divided injection spaced 2 weeks apart (Tumor of 115cc: 2 administrations, Tumor of 180 cc: 3 administrations). At H0.5, H 4, H24, H36 , H72 post-administration, the patient get a SPECT control. The response to treatment is evaluated thanks to PET/CT Standardized Uptake Values (SUVs). Results: Stereotactic administrations of “188-Rhenium-ImDendrim” were successfully carried out in all patients under local anesthesia. The radioactive product diffuses homogeneously in the tumor volume and remains 72 hours post-administration with no significant diffusion out site of injection. The One of the 5 patients reported discrete transitive hemoptysis as adverse events. All targeted tumors were responding at 12 weeks, with two complete responses. Conclusions: Percutaneous single and iterative administrations of this novel 188-Rhenium-Imdendrim brachytherapy device into lung cancers are safe and well tolerated. The initial data on therapeutic response are promising. Clinical trial information: EC.D (BG) 016.03.1.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41344584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Adjuvant nab-paclitaxel plus gemcitabine versus gemcitabine in resected pancreatic ductal adenocarcinoma: A Chinese single institution experience. nab-紫杉醇+吉西他滨与吉西他滨在胰腺导管腺癌切除术中的辅助治疗:中国单一机构的经验。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.85
Z. Yin, Rong Liu
85 Background: Adjuvant chemotherapy with gemcitabine (GEM) is standard care for resected pancreatic ductal adenocarcinoma (PDAC). Nab-paclitaxel plus gemcitabine (AG) vs gemcitabine (GEM) have shown better survival and tumor response with in advanced or metastatic PDAC. We aimed to determine the efficacy and safety of AG compared with GEM for resected PDAC. Methods: We retrospectively reviewed resectable PDAC patients (pts) who received AG or GEM as adjuvant chemotherapy from January 2013 to December 2016 at the Chinese PLA General Hospital, Bei Jing, China. Pts received nab-paclitaxel (125mg/m2) followed by GEM (1,000 mg/m2) on days 1, 8 every 3 weeks or GEM (1,000 mg/m2) alone on days 1, 8 every 3 weeks for 6 cycles unless disease progression or there was unacceptable level of adverse events. Disease free survival (DFS), overall survival (OS) and toxicity were analyzed. Results: Among 70 pts received AG or GEM as adjuvant chemotherapy, 10 pts were excluded due to the serious complication or R2 resection. The analysis was based on 30 pts in each group undergone complete macroscopic (R0 or R1) resection. Median DFS was 15.8 months (95% CI 13.1-18.5) in AG group (6 pts not arrived) compared with 12.2 months in GEM group (95% CI 9.6-14.8, P = 0.039, 3 pts not arrived). Median OS was 28.3 months (95% CI 21.9-34.6) in AG group (11 pts not arrived) as compared with 20.6 months in GEM group (95% CI 11.2-29.9, P= 0.028, 7 pts not arrived). The 2 years survival rate was 63.3% versus 43.3% in AG group versus GEM group. The most common adverse events of grade 3 or higher were leukopenia (32.3% in AG group vs. 20.7% in GEM group, P= 0.387), neutropenia (45.2% vs.31%, P= 0.298), G-CSF use (41.9% vs. 24.1%, P= 0.177), sensory peripheral neuropathy (51.6% vs. 24.1%, P= 0.036) and fatigue (3.2% vs. 3.4%, P= 0.737). Conclusions: Our results provide the evidence that the adjuvant combination of nab-paclitaxel plus gemcitabine significantly improved DFS and OS of resected PDAC.
背景:吉西他滨辅助化疗(GEM)是切除胰腺导管腺癌(PDAC)的标准治疗。nab -紫杉醇加吉西他滨(AG)与吉西他滨(GEM)在晚期或转移性PDAC中显示出更好的生存和肿瘤反应。我们的目的是确定AG与GEM在切除PDAC中的疗效和安全性。方法:回顾性分析2013年1月至2016年12月在北京中国人民解放军总医院接受AG或GEM辅助化疗的可切除PDAC患者。除非疾病进展或出现不可接受的不良事件,否则患者接受nab-紫杉醇治疗(125mg/m2),随后每3周第1、8天接受GEM治疗(1000 mg/m2),或每3周第1、8天单独接受GEM治疗(1000 mg/m2),持续6个周期。分析无病生存期(DFS)、总生存期(OS)和毒性。结果:70例患者接受AG或GEM辅助化疗,10例患者因并发症严重或R2切除而被排除。分析基于每组30例患者进行完全宏观(R0或R1)切除。AG组的中位DFS为15.8个月(95% CI 13.1-18.5)(6名患者未到达),而GEM组的中位DFS为12.2个月(95% CI 9.6-14.8, P = 0.039, 3名患者未到达)。AG组的中位OS为28.3个月(95% CI 21.9-34.6)(11例未到达),而GEM组的中位OS为20.6个月(95% CI 11.2-29.9, P= 0.028, 7例未到达)。AG组和GEM组2年生存率分别为63.3%和43.3%。3级及以上最常见的不良事件是白细胞减少(AG组32.3% vs. GEM组20.7%,P= 0.387)、中性粒细胞减少(45.2% vs.31%, P= 0.298)、G-CSF使用(41.9% vs. 24.1%, P= 0.177)、感觉周围神经病变(51.6% vs. 24.1%, P= 0.036)和疲劳(3.2% vs. 3.4%, P= 0.737)。结论:我们的研究结果提供了nab-紫杉醇联合吉西他滨辅助治疗可显著改善PDAC切除的DFS和OS的证据。
{"title":"Adjuvant nab-paclitaxel plus gemcitabine versus gemcitabine in resected pancreatic ductal adenocarcinoma: A Chinese single institution experience.","authors":"Z. Yin, Rong Liu","doi":"10.1200/jgo.2019.5.suppl.85","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.85","url":null,"abstract":"85 Background: Adjuvant chemotherapy with gemcitabine (GEM) is standard care for resected pancreatic ductal adenocarcinoma (PDAC). Nab-paclitaxel plus gemcitabine (AG) vs gemcitabine (GEM) have shown better survival and tumor response with in advanced or metastatic PDAC. We aimed to determine the efficacy and safety of AG compared with GEM for resected PDAC. Methods: We retrospectively reviewed resectable PDAC patients (pts) who received AG or GEM as adjuvant chemotherapy from January 2013 to December 2016 at the Chinese PLA General Hospital, Bei Jing, China. Pts received nab-paclitaxel (125mg/m2) followed by GEM (1,000 mg/m2) on days 1, 8 every 3 weeks or GEM (1,000 mg/m2) alone on days 1, 8 every 3 weeks for 6 cycles unless disease progression or there was unacceptable level of adverse events. Disease free survival (DFS), overall survival (OS) and toxicity were analyzed. Results: Among 70 pts received AG or GEM as adjuvant chemotherapy, 10 pts were excluded due to the serious complication or R2 resection. The analysis was based on 30 pts in each group undergone complete macroscopic (R0 or R1) resection. Median DFS was 15.8 months (95% CI 13.1-18.5) in AG group (6 pts not arrived) compared with 12.2 months in GEM group (95% CI 9.6-14.8, P = 0.039, 3 pts not arrived). Median OS was 28.3 months (95% CI 21.9-34.6) in AG group (11 pts not arrived) as compared with 20.6 months in GEM group (95% CI 11.2-29.9, P= 0.028, 7 pts not arrived). The 2 years survival rate was 63.3% versus 43.3% in AG group versus GEM group. The most common adverse events of grade 3 or higher were leukopenia (32.3% in AG group vs. 20.7% in GEM group, P= 0.387), neutropenia (45.2% vs.31%, P= 0.298), G-CSF use (41.9% vs. 24.1%, P= 0.177), sensory peripheral neuropathy (51.6% vs. 24.1%, P= 0.036) and fatigue (3.2% vs. 3.4%, P= 0.737). Conclusions: Our results provide the evidence that the adjuvant combination of nab-paclitaxel plus gemcitabine significantly improved DFS and OS of resected PDAC.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43753742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CancerScreen: A novel ultrasensitive liquid biopsy for early-stage cancer detection by ctDNA Duplex Sequencing and Tissue of Origin identification with supervised machine learning. CancerScreen:一种新型的超灵敏液体活检,用于早期癌症检测,通过ctDNA双工测序和组织起源识别与监督机器学习。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.60
Elizabeth Ding, Zhilong Zhao, Hongsheng Xue, Jianxin Li, T. Lei, Xuezhen Ma, Jianlin Wu, Qin Huang
60 Background: Circulating tumor DNA (ctDNA) in blood holds promise as a cancer-specific biomarker for early-stage cancer diagnosis. However, detection of ultra-low mutation allelic frequency (MAF) of ctDNA at early stages of cancer is infeasible by conventional next generation sequencing (NGS). Using duplex sequencing with unique molecular identifiers (UMIs) and custom-designed probes, we tested the hypothesis that ctDNA duplex sequencing with UMIs was able to detect ultra-low MAF of ctDNA in patients with early-stage cancers. Methods: A 128-gene panel that contains probes targeted to clinical relevant genome variations in cancers of the lung, stomach, and esophagus was designed and validated with reference DNA and controls using ctDNA duplex sequencing with UMIs. A data analysis pipeline was implemented withimproved algorithms for variant calling, blood tumor mutational burden (bTMB) calculation, and supervised machine learning for tissue-of-origin primary cancer identification. Results: We designed and validated a ctDNA duplex sequencing with UMIs assay that enables simultaneous detection of 128 clinical relevant geneswith SNPs, indels, amplifications, and fusions in a single blood test. Compared to conventional ctDNA NGS, our assay achieved high sensitivity (over 82%) and specificity (over 96%) with LOD at 0.1% MAF for stage I lung, gastric and esophageal cancers with the sequencing depth at 30,000x from a cohort of 136 clinical samples. Results also showed significant concordance of MAF and TMB between DNA from tumor tissues and plasma ctDNA. Our deep learning predictive model with novel algorithms and features for tumor tissue-of-origin classification achieved an overall 85% accuracy. Conclusions: In this study, a novel ultrasensitive assay was designed and validated for accurate detection of MAF at 0.1% from plasma ctDNA of multiple tumors, and accurate classification on tissue-of-origin for major primary cancers using supervised deep learning. The results of this liquid biopsy study from initial clinical testing showed its promise on clinical applications for early-stage cancer diagnosis.
背景:血液中循环肿瘤DNA (ctDNA)有望成为早期癌症诊断的癌症特异性生物标志物。然而,传统的下一代测序(NGS)无法在癌症早期检测到ctDNA的超低突变等位基因频率(MAF)。使用具有独特分子标识符(UMIs)的双工测序和定制设计的探针,我们验证了具有UMIs的ctDNA双工测序能够检测早期癌症患者中ctDNA的超低MAF的假设。方法:设计了一个包含针对肺癌、胃癌和食管癌临床相关基因组变异的探针的128个基因面板,并使用带有UMIs的ctDNA双链测序与对照DNA进行了验证。采用改进的算法实现了数据分析管道,用于变体调用、血液肿瘤突变负担(bTMB)计算和用于起源组织原发性癌症识别的监督机器学习。结果:我们设计并验证了一种ctDNA双工测序方法,该方法可以在一次血液检测中同时检测128个具有snp、indels、扩增和融合的临床相关基因。与传统的ctDNA NGS相比,我们的检测方法对I期肺癌、胃癌和食管癌具有高灵敏度(82%以上)和特异性(96%以上),LOD为0.1% MAF,测序深度为3万倍,来自136个临床样本的队列。结果还显示肿瘤组织DNA与血浆ctDNA之间的MAF和TMB具有显著的一致性。我们的深度学习预测模型具有新颖的算法和特征,用于肿瘤组织起源分类,总体准确率达到85%。结论:在本研究中,设计并验证了一种新的超灵敏检测方法,用于从多种肿瘤的血浆ctDNA中准确检测0.1%的MAF,并使用监督深度学习对主要原发性癌症的起源组织进行准确分类。这项液体活检研究的初步临床试验结果显示其在早期癌症诊断的临床应用前景。
{"title":"CancerScreen: A novel ultrasensitive liquid biopsy for early-stage cancer detection by ctDNA Duplex Sequencing and Tissue of Origin identification with supervised machine learning.","authors":"Elizabeth Ding, Zhilong Zhao, Hongsheng Xue, Jianxin Li, T. Lei, Xuezhen Ma, Jianlin Wu, Qin Huang","doi":"10.1200/jgo.2019.5.suppl.60","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.60","url":null,"abstract":"60 Background: Circulating tumor DNA (ctDNA) in blood holds promise as a cancer-specific biomarker for early-stage cancer diagnosis. However, detection of ultra-low mutation allelic frequency (MAF) of ctDNA at early stages of cancer is infeasible by conventional next generation sequencing (NGS). Using duplex sequencing with unique molecular identifiers (UMIs) and custom-designed probes, we tested the hypothesis that ctDNA duplex sequencing with UMIs was able to detect ultra-low MAF of ctDNA in patients with early-stage cancers. Methods: A 128-gene panel that contains probes targeted to clinical relevant genome variations in cancers of the lung, stomach, and esophagus was designed and validated with reference DNA and controls using ctDNA duplex sequencing with UMIs. A data analysis pipeline was implemented withimproved algorithms for variant calling, blood tumor mutational burden (bTMB) calculation, and supervised machine learning for tissue-of-origin primary cancer identification. Results: We designed and validated a ctDNA duplex sequencing with UMIs assay that enables simultaneous detection of 128 clinical relevant geneswith SNPs, indels, amplifications, and fusions in a single blood test. Compared to conventional ctDNA NGS, our assay achieved high sensitivity (over 82%) and specificity (over 96%) with LOD at 0.1% MAF for stage I lung, gastric and esophageal cancers with the sequencing depth at 30,000x from a cohort of 136 clinical samples. Results also showed significant concordance of MAF and TMB between DNA from tumor tissues and plasma ctDNA. Our deep learning predictive model with novel algorithms and features for tumor tissue-of-origin classification achieved an overall 85% accuracy. Conclusions: In this study, a novel ultrasensitive assay was designed and validated for accurate detection of MAF at 0.1% from plasma ctDNA of multiple tumors, and accurate classification on tissue-of-origin for major primary cancers using supervised deep learning. The results of this liquid biopsy study from initial clinical testing showed its promise on clinical applications for early-stage cancer diagnosis.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43770950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk factors and therapeutic significance for inguinal lymph node metastasis in advanced lower rectal cancer. 晚期下直肠癌腹股沟淋巴结转移的危险因素及治疗意义。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.120
H. Nozawa, Hiroshi Shiratori, K. Kawai, K. Hata, Toshiaki Tanaka, T. Nishikawa, Y. Shuno, K. Sasaki, M. Kaneko, S. Emoto, K. Murono, H. Sonoda, H. Ishii, S. Ishihara
120 Background: Which patients with lower rectal cancer are at risk of inguinal lymph node metastasis (ILNM) and how to treat ILNM remain unclear. This study aimed to clarify the predictors of ILNM and clinical significance of treatment for ILNM. Methods: Consecutive patients with rectal adenocarcinoma invading the anal canal who underwent curative surgery between 2003 and 2019 at a single institution were retrospectively reviewed. The pathological nodal involvement in mesorectal, lateral pelvic or inguinal lymph nodes (ILN) at the time of rectal surgery and of later onset were collectively defined as final nodal metastasis (f-LNM) in this study. Factors associated with f-LNM were analyzed. Moreover, the ‘modified therapeutic value index’ defined by the 5-year overall survival rate of patients treated against f-LNM multiplied by their frequency was calculated for each lymph node area. Results: A total of 145 patients were enrolled, among whom16 patients developed ILNM. For predicting f-ILNM, the cutoff 8.5 mm of ILN diameter gave area under the curve of 0.889. Dentate line involvement and ILN larger than a simplified cutoff of 8 mm were independently associated with the development of ILNM (odds ratio: 33.4 and 11.9, respectively). The modified therapeutic value indice of inguinal, lateral pelvic and mesorectal LNs in the entire population were 6.1, 8.2 and 20.3 points, respectively. In patients with dentate line invaded by cancer, they were 11.7, 5.8 and 16.2 points, respectively. Moreover, the index of ILN was 21.1 points when confined to patients with ILN larger than 8 mm. Conclusions: Dentate line involvement and ILN larger than 8 mm were predictive of developing ILNM in patients with rectal cancer invading the anal canal. Treatment of ILNM may be recommended for patients manifesting the above predictors, given the significant therapeutic outcomes.
120背景:哪些下段直肠癌患者存在腹股沟淋巴结转移(ILNM)的风险以及如何治疗ILNM尚不清楚。本研究旨在阐明ILNM的预测因素及治疗ILNM的临床意义。方法:回顾性分析2003年至2019年在同一医院连续行根治性手术的直肠腺癌侵犯肛管患者。本研究将直肠手术时病理性淋巴结累及直肠系膜淋巴结、盆腔外侧淋巴结或腹股沟淋巴结(ILN)及发病较晚者统称为最终淋巴结转移(f-LNM)。分析与f-LNM相关的因素。此外,计算每个淋巴结区域的“改良治疗价值指数”,该指数由f-LNM治疗患者的5年总生存率乘以其频率定义。结果:共纳入145例患者,其中16例发生ILNM。对于预测f-ILNM, ILN直径8.5 mm的截止值为曲线下面积0.889。齿状线累及和ILN大于8 mm的简化截断与ILNM的发展独立相关(优势比分别为33.4和11.9)。整体人群腹股沟、盆腔外侧、直肠系膜LNs的改良治疗价值指数分别为6.1、8.2、20.3分。齿状线受累患者分别为11.7分、5.8分和16.2分。局限于ILN大于8 mm的患者,ILN指数为21.1分。结论:牙状线累及和ILN大于8mm是直肠癌侵犯肛管患者发生ILNM的预测因素。考虑到显著的治疗效果,可能建议对出现上述预测因素的患者进行ILNM治疗。
{"title":"Risk factors and therapeutic significance for inguinal lymph node metastasis in advanced lower rectal cancer.","authors":"H. Nozawa, Hiroshi Shiratori, K. Kawai, K. Hata, Toshiaki Tanaka, T. Nishikawa, Y. Shuno, K. Sasaki, M. Kaneko, S. Emoto, K. Murono, H. Sonoda, H. Ishii, S. Ishihara","doi":"10.1200/jgo.2019.5.suppl.120","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.120","url":null,"abstract":"120 Background: Which patients with lower rectal cancer are at risk of inguinal lymph node metastasis (ILNM) and how to treat ILNM remain unclear. This study aimed to clarify the predictors of ILNM and clinical significance of treatment for ILNM. Methods: Consecutive patients with rectal adenocarcinoma invading the anal canal who underwent curative surgery between 2003 and 2019 at a single institution were retrospectively reviewed. The pathological nodal involvement in mesorectal, lateral pelvic or inguinal lymph nodes (ILN) at the time of rectal surgery and of later onset were collectively defined as final nodal metastasis (f-LNM) in this study. Factors associated with f-LNM were analyzed. Moreover, the ‘modified therapeutic value index’ defined by the 5-year overall survival rate of patients treated against f-LNM multiplied by their frequency was calculated for each lymph node area. Results: A total of 145 patients were enrolled, among whom16 patients developed ILNM. For predicting f-ILNM, the cutoff 8.5 mm of ILN diameter gave area under the curve of 0.889. Dentate line involvement and ILN larger than a simplified cutoff of 8 mm were independently associated with the development of ILNM (odds ratio: 33.4 and 11.9, respectively). The modified therapeutic value indice of inguinal, lateral pelvic and mesorectal LNs in the entire population were 6.1, 8.2 and 20.3 points, respectively. In patients with dentate line invaded by cancer, they were 11.7, 5.8 and 16.2 points, respectively. Moreover, the index of ILN was 21.1 points when confined to patients with ILN larger than 8 mm. Conclusions: Dentate line involvement and ILN larger than 8 mm were predictive of developing ILNM in patients with rectal cancer invading the anal canal. Treatment of ILNM may be recommended for patients manifesting the above predictors, given the significant therapeutic outcomes.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42383042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Prognostic implication of forkhead box protein O1 (FOXO1) and paired box gene 3 (PAX3) in epithelial ovarian cancer. 叉头盒蛋白O1 (FOXO1)和配对盒基因3 (PAX3)在上皮性卵巢癌中的预后意义。
Pub Date : 2019-10-07 DOI: 10.1200/jgo.2019.5.suppl.61
Hanbyoul Cho, Gwan Hee Han, Jae-Hoon Kim
61 Background: Transcriptional factor, Forkhead box protein O1 (FOXO1) has been reported to play an imported role in human cancer, but the role in epithelial ovarian cancer (EOC) has not yet been clarified. Here, we evaluatedthe expression and clinical significance of FOXO1 in EOC. Methods: Immunohistochemical analyses of FOXO1 and PAX3 in 212 in EOCs, 57 borderline ovarian tumors and 153 benign epithelial ovarian tumors and 79 nonadjacent normal epithelial tissues were performed using tissue microarray analysis. The data were compared with clinicopathological variables including the survival of EOC patients. Also, the effect of FOXO1 on cell growth were assessed in EOC cell lines. Results: The expressions of FOXO1 and PAX3 protein were significantly higher in EOC tissues than in nonadjacent normal epithelial tissues, benign tissues and borderline tumors respectively (all p< 0.001). Overexpression of FOXO1 was significantly associated with poor grade ( p = 0.004). FOXO1 expression showed trend of positive correlation with that of PAX3 in EOC tissues ( Spearman’s rho0.118, p= 0.149). Multivariate survival analysis revealed that the high expression of FOXO1 (hazard ratio = 2.74 [95% CI, 1.22–13.10], p = 0.001) could be an independent prognostic factor for overall survival. Most importantly, high expression of both FOXO1 and PAX3 showed high hazard ratio (hazard ratio = 5.53 [95% CI, 2.47–12.40], p< 0.001) for overall survival. In vitro result revealed that knockdown of FOXO1 was associated decreased cell viability and migration. Conclusions: This study reveals that high expression of FOXO1/PAX3 is an indicator of poor prognosis in EOC. Our results not only suggest the promising potential of FOXO1 and PAX3 as a prognostic and survival marker, but also warrant further studies on a possible link between the biological function of FOXO1 and PAX3 of EOC.
61背景:转录因子叉头盒蛋白O1(FOXO1)已被报道在人类癌症中起输入作用,但其在上皮性卵巢癌症(EOC)中的作用尚未阐明。在此,我们评估了FOXO1在EOC中的表达及其临床意义。方法:应用组织微阵列技术对212例EOCs、57例交界性卵巢肿瘤、153例良性上皮性卵巢肿瘤和79例非相邻正常上皮组织中FOXO1和PAX3进行免疫组织化学分析。将数据与包括EOC患者生存率在内的临床病理变量进行比较。此外,在EOC细胞系中评估FOXO1对细胞生长的影响。结果:FOXO1和PAX3蛋白在EOC组织中的表达明显高于非相邻正常上皮组织,良性组织和交界性肿瘤(均p<0.001)。FOXO1的过度表达与分级差显著相关(p=0.004)。在EOC组织中,FOXO1表达与PAX3表达呈正相关趋势(Spearman’s rho0.118,p=0.149)。多因素生存分析显示,FOXO 1的高表达(危险比=2.74[95%CI,1.22–13.10]p=0.001)可能是总生存率的独立预后因素。最重要的是,FOXO1和PAX3的高表达显示出总生存率的高风险比(风险比=5.53[95%CI,2.47-12.40],p<0.001)。体外结果显示,FOXO1的敲除与细胞活力和迁移的降低有关。结论:FOXO1/PAX3的高表达是EOC预后不良的指标。我们的研究结果不仅表明了FOXO1和PAX3作为预后和生存标志物的潜力,而且还保证了对FOXO1与PAX3的EOC生物学功能之间可能联系的进一步研究。
{"title":"Prognostic implication of forkhead box protein O1 (FOXO1) and paired box gene 3 (PAX3) in epithelial ovarian cancer.","authors":"Hanbyoul Cho, Gwan Hee Han, Jae-Hoon Kim","doi":"10.1200/jgo.2019.5.suppl.61","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.61","url":null,"abstract":"61 Background: Transcriptional factor, Forkhead box protein O1 (FOXO1) has been reported to play an imported role in human cancer, but the role in epithelial ovarian cancer (EOC) has not yet been clarified. Here, we evaluatedthe expression and clinical significance of FOXO1 in EOC. Methods: Immunohistochemical analyses of FOXO1 and PAX3 in 212 in EOCs, 57 borderline ovarian tumors and 153 benign epithelial ovarian tumors and 79 nonadjacent normal epithelial tissues were performed using tissue microarray analysis. The data were compared with clinicopathological variables including the survival of EOC patients. Also, the effect of FOXO1 on cell growth were assessed in EOC cell lines. Results: The expressions of FOXO1 and PAX3 protein were significantly higher in EOC tissues than in nonadjacent normal epithelial tissues, benign tissues and borderline tumors respectively (all p< 0.001). Overexpression of FOXO1 was significantly associated with poor grade ( p = 0.004). FOXO1 expression showed trend of positive correlation with that of PAX3 in EOC tissues ( Spearman’s rho0.118, p= 0.149). Multivariate survival analysis revealed that the high expression of FOXO1 (hazard ratio = 2.74 [95% CI, 1.22–13.10], p = 0.001) could be an independent prognostic factor for overall survival. Most importantly, high expression of both FOXO1 and PAX3 showed high hazard ratio (hazard ratio = 5.53 [95% CI, 2.47–12.40], p< 0.001) for overall survival. In vitro result revealed that knockdown of FOXO1 was associated decreased cell viability and migration. Conclusions: This study reveals that high expression of FOXO1/PAX3 is an indicator of poor prognosis in EOC. Our results not only suggest the promising potential of FOXO1 and PAX3 as a prognostic and survival marker, but also warrant further studies on a possible link between the biological function of FOXO1 and PAX3 of EOC.","PeriodicalId":15862,"journal":{"name":"Journal of global oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45656032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of global oncology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1