Pub Date : 2019-10-07DOI: 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.
{"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}
Pub Date : 2019-10-07DOI: 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.
{"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}
Pub Date : 2019-10-07DOI: 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.
{"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}
Pub Date : 2019-10-07DOI: 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}
Pub Date : 2019-10-07DOI: 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]
{"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}
Pub Date : 2019-10-07DOI: 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.
{"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}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.100
Tomohiro Tanaka, T. Yoshida, K. Masuda, Y. Takeyasu, Y. Shinno, Y. Matsumoto, Y. Okuma, Y. Goto, H. Horinouchi, N. Yamamoto, Y. Ohe
100 Background: Immunosenescence, an age-related impairment of the immune system, dampens acquired immunity and promotes inflammation. Therefore, it could also influence the degree of effectiveness of immune checkpoint inhibitors. Methods: We retrospectively reviewed the data of 52 NSCLC patients aged ≧75 years old treated with nivolumab or pembrolizumab from December 2015 to April 2019. Immunosenescence was assessed by the modified Glasgow Prognostic Scale (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson Comorbidity Index (CCI), which are related to nutrition, inflammation and comorbidity, respectively. The Cox proportional hazard model and Kaplan-Meier curves were used to identify factors associated with survival. Results: The median follow-up duration was 19.5M (IQR:1-41). The patient characteristics were as follows: median age 79.7 years; male/female ratio, 41/11; PS0/1/2/3, 10/32/8/2; adeno/squamous histology/others, 33/15/4;stage III/IV/recurrence, 2/26/24; PD-L1 (22C3) (%)unknown/0/1-49/50-100, 18/2/8/24; driver mutation status positive/negative, 11/41; nivolumab/pembrolizumab, 29/23; treatment line 1/2/3/4 or more, 28/15/3/6; median number of treatment cycles 7.0 (1-53). The overall response rate (ORR) and disease control rate (DCR) were29.1% and 56.2%, respectively. The median progression-free survival (PFS) was 4.2 months (95% CI 1.8-7.5). The mGPS was significantly associated with the DCR (High/Low = 37.5/68.8%, p = 0.02) and the PFS (score 0-1/2 = 4.1/0.6 months) (HR: 0.37, 95% CI 0.18-0.74, p <0.01). However, neither the CCI nor the NLR wasassociated with the PFS (CCI: High/Low = 3.8/1.8 months, p = 0.64, and NLR: High (>3.5)/Low (≦3.5) = 3.8/5.6 months, p = 0.89). Multivariate regression analysis identified the mGPS as a significant predictor of the PFS(HR: 0.40, p = 0.008). Conclusions: A high mGPS score was significantly associated with a lower DCR and shorter PFS in elderly NSCLC patients treated with anti-PD-1 antibody.
100背景:免疫衰老是一种与年龄相关的免疫系统损伤，它会抑制获得性免疫并促进炎症。因此，它也可能影响免疫检查点抑制剂的有效程度。方法:回顾性分析2015年12月至2019年4月接受纳武单抗或派姆单抗治疗的52例年龄≥75岁的非小细胞肺癌患者的资料。免疫衰老采用改良的格拉斯哥预后量表(mGPS)、中性粒细胞与淋巴细胞比值(NLR)和Charlson共病指数(CCI)进行评估，这三个指标分别与营养、炎症和共病有关。采用Cox比例风险模型和Kaplan-Meier曲线确定与生存率相关的因素。结果:中位随访时间为195m (IQR:1-41)。患者特征如下:中位年龄79.7岁;男女比例41/11;PS0/1/2/3 10/32/8/2;腺/鳞状组织/其他，33/15/4;III/IV期/复发，2/26/24;未知PD-L1 (c3) 22日(%)/ 0/1 - 49/50 - 100,18/2/8/24;驱动突变状态为阳性/阴性，11/41;nivolumab / pembrolizumab, 29/23;处理线1/2/3/4以上，28/15/3/6;治疗周期中位数为7.0(1-53)。总有效率(ORR)和疾病控制率(DCR)分别为29.1%和56.2%。中位无进展生存期(PFS)为4.2个月(95% CI 1.8-7.5)。mGPS与DCR(高/低= 37.5/68.8%，p = 0.02)和PFS(评分0-1/2 = 4.1/0.6个月)(HR: 0.37, 95% CI 0.18-0.74, p = 3.5)/低(≦3.5)= 3.8/5.6个月，p = 0.89)有显著相关性。多因素回归分析发现mGPS是PFS的显著预测因子(HR: 0.40, p = 0.008)。结论:在抗pd -1抗体治疗的老年NSCLC患者中，高mGPS评分与较低的DCR和较短的PFS显著相关。
{"title":"Prognostic role of immunosenscence associated with index in elderly non-small cell lung cancer patients treated with an anti-PD-1 antibody.","authors":"Tomohiro Tanaka, T. Yoshida, K. Masuda, Y. Takeyasu, Y. Shinno, Y. Matsumoto, Y. Okuma, Y. Goto, H. Horinouchi, N. Yamamoto, Y. Ohe","doi":"10.1200/jgo.2019.5.suppl.100","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.100","url":null,"abstract":"100 Background: Immunosenescence, an age-related impairment of the immune system, dampens acquired immunity and promotes inflammation. Therefore, it could also influence the degree of effectiveness of immune checkpoint inhibitors. Methods: We retrospectively reviewed the data of 52 NSCLC patients aged ≧75 years old treated with nivolumab or pembrolizumab from December 2015 to April 2019. Immunosenescence was assessed by the modified Glasgow Prognostic Scale (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson Comorbidity Index (CCI), which are related to nutrition, inflammation and comorbidity, respectively. The Cox proportional hazard model and Kaplan-Meier curves were used to identify factors associated with survival. Results: The median follow-up duration was 19.5M (IQR:1-41). The patient characteristics were as follows: median age 79.7 years; male/female ratio, 41/11; PS0/1/2/3, 10/32/8/2; adeno/squamous histology/others, 33/15/4;stage III/IV/recurrence, 2/26/24; PD-L1 (22C3) (%)unknown/0/1-49/50-100, 18/2/8/24; driver mutation status positive/negative, 11/41; nivolumab/pembrolizumab, 29/23; treatment line 1/2/3/4 or more, 28/15/3/6; median number of treatment cycles 7.0 (1-53). The overall response rate (ORR) and disease control rate (DCR) were29.1% and 56.2%, respectively. The median progression-free survival (PFS) was 4.2 months (95% CI 1.8-7.5). The mGPS was significantly associated with the DCR (High/Low = 37.5/68.8%, p = 0.02) and the PFS (score 0-1/2 = 4.1/0.6 months) (HR: 0.37, 95% CI 0.18-0.74, p <0.01). However, neither the CCI nor the NLR wasassociated with the PFS (CCI: High/Low = 3.8/1.8 months, p = 0.64, and NLR: High (>3.5)/Low (≦3.5) = 3.8/5.6 months, p = 0.89). Multivariate regression analysis identified the mGPS as a significant predictor of the PFS(HR: 0.40, p = 0.008). Conclusions: A high mGPS score was significantly associated with a lower DCR and shorter PFS in elderly NSCLC patients treated with anti-PD-1 antibody.","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":"44036848","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}
Pub Date : 2019-10-07DOI: 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}
Pub Date : 2019-10-07DOI: 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.
{"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}
Pub Date : 2019-10-07DOI: 10.1200/jgo.2019.5.suppl.9
N. Prasongsook, K. Seetalarom, S. Saichaemchan, Kitipong Udomdamrongkul
9 Background: Web-based patient reported outcome (PRO) improved quality of life (QoL), and overall survival (OS) in patients with advanced NSCLC who were treating with specific therapy. Lung Cancer Care application is a mobile application program that provides patients with individually tailored information on patient reported outcome. This study aims to invent a novel mobile application evaluating PRO for Thai NSCLC patients, and to evaluate the validity of mobile application. Methods: Our mobile application-based PRO was designed for monitoring quality of life. The validity of the application was tested following guidelines for translating, and validating a questionnaire. The quality of life score (FACT-L score). After the validated mobile application-based PRO, patients with advanced NSCLC were randomized to use mobile application-based PRO versus routine follow-up. The primary endpoint was quality of life (QoL). Secondary endpoint was OS. Results: Thirty-three patients with advanced NSCLC were enrolled. The mean of FACT-L score at baseline in mobile application-based PRO arm and routine follow up arm was similar (90.08 ± 5.66 vs 91.78 ± 5.26, p-value= 0.82). Patients with mobile application group had more FACT-L score at 3 months than patients with routine follow up arm (106 ± 5.97 vs 99.96 ± 5.74, p-value = 0.07). There was a trend towards increased in different mean of FACT-L score at baseline and 3 months in patients with mobile application compared to patients with routine follow up ( p-value = 0.05). The median follow-up time was 5.43 months, patients with mobile application had longer median OS than patients with routine follow up (4 months vs 2.9 months, p-value = 0.5). Conclusions: Lung Cancer Care application based on self-reported symptoms is a novel electronic device for real-time patient care monitoring. Our study results showed trend towards improved quality of life from using this novel mobile application. However, there was small samples for pilot testing, the relatively large sampling errors may reduce the statistical power needed to validate this tool.
9背景：基于网络的患者报告结果（PRO）改善了接受特定治疗的晚期NSCLC患者的生活质量（QoL）和总生存率（OS）。Lung癌症Care应用程序是一个移动应用程序，为患者提供关于患者报告结果的个人定制信息。本研究旨在发明一种新的移动应用程序，用于评估泰国NSCLC患者的PRO，并评估移动应用程序的有效性。方法：我们设计了基于移动应用程序的PRO，用于监测生活质量。根据翻译和验证问卷的指导原则，对申请的有效性进行了测试。生活质量评分（FACT-L评分）。在验证了基于移动应用程序的PRO后，将晚期NSCLC患者随机分为使用基于移动应用的PRO和常规随访。主要终点是生活质量（QoL）。次要终结点是操作系统。结果：纳入了33例晚期NSCLC患者。基于移动应用程序的PRO组和常规随访组的基线FACT-L评分平均值相似（90.08±5.66 vs 91.78±5.26，p值=0.82）。移动应用程序组患者在3个月时的FACT-L评分高于常规随访组患者（106±5.97 vs 99.96±5.74，p值=0.07）基线和3个月的移动应用患者与常规随访患者相比（p值=0.05）。中位随访时间为5.43个月，与常规随访患者相比，移动应用的患者OS中位数更长（4个月vs 2.9个月，p值=0.5）。结论：基于自我报告症状的肺癌护理应用是一种新型的实时患者护理监测电子设备。我们的研究结果表明，使用这种新型移动应用程序有提高生活质量的趋势。然而，试点测试的样本很小，相对较大的采样误差可能会降低验证该工具所需的统计能力。
{"title":"A pilot study of using smartphone application versus routine follow up for patients' care in advanced non-small cell lung cancer (NSCLC).","authors":"N. Prasongsook, K. Seetalarom, S. Saichaemchan, Kitipong Udomdamrongkul","doi":"10.1200/jgo.2019.5.suppl.9","DOIUrl":"https://doi.org/10.1200/jgo.2019.5.suppl.9","url":null,"abstract":"9 Background: Web-based patient reported outcome (PRO) improved quality of life (QoL), and overall survival (OS) in patients with advanced NSCLC who were treating with specific therapy. Lung Cancer Care application is a mobile application program that provides patients with individually tailored information on patient reported outcome. This study aims to invent a novel mobile application evaluating PRO for Thai NSCLC patients, and to evaluate the validity of mobile application. Methods: Our mobile application-based PRO was designed for monitoring quality of life. The validity of the application was tested following guidelines for translating, and validating a questionnaire. The quality of life score (FACT-L score). After the validated mobile application-based PRO, patients with advanced NSCLC were randomized to use mobile application-based PRO versus routine follow-up. The primary endpoint was quality of life (QoL). Secondary endpoint was OS. Results: Thirty-three patients with advanced NSCLC were enrolled. The mean of FACT-L score at baseline in mobile application-based PRO arm and routine follow up arm was similar (90.08 ± 5.66 vs 91.78 ± 5.26, p-value= 0.82). Patients with mobile application group had more FACT-L score at 3 months than patients with routine follow up arm (106 ± 5.97 vs 99.96 ± 5.74, p-value = 0.07). There was a trend towards increased in different mean of FACT-L score at baseline and 3 months in patients with mobile application compared to patients with routine follow up ( p-value = 0.05). The median follow-up time was 5.43 months, patients with mobile application had longer median OS than patients with routine follow up (4 months vs 2.9 months, p-value = 0.5). Conclusions: Lung Cancer Care application based on self-reported symptoms is a novel electronic device for real-time patient care monitoring. Our study results showed trend towards improved quality of life from using this novel mobile application. However, there was small samples for pilot testing, the relatively large sampling errors may reduce the statistical power needed to validate this tool.","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":"41599529","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}
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