American Journal of Clinical Oncology最新文献

{"title":"Expansion of the LabBM Score: Is the LabPS the Best Tool Predicting Survival in Patients With Brain Metastases?","authors":"Carsten Nieder,&nbsp;Rosalba Yobuta,&nbsp;Bård Mannsåker","doi":"10.1097/COC.0000000000000784","DOIUrl":"https://doi.org/10.1097/COC.0000000000000784","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study were to improve the 3-tiered, purely biomarker-based LabBM score, which predicts the survival of patients with brain metastases, by adding the well-established prognostic factor performance status (PS), and to define its role in comparison with the recently proposed Extracranial-Graded Prognostic Assessment score, which is based on the well-known Diagnosis-specific Graded Prognostic Assessment and 2 of the same biomarkers.</p><p><strong>Materials and methods: </strong>This was a retrospective single-institution analysis of 212 patients, managed with upfront brain irradiation. Survival was stratified by LabBM and LabPS score. Each included serum hemoglobin, platelets, albumin, C-reactive protein, and lactate dehydrogenase (plus PS for the LabPS). Zero, 0.5, or 1 point was assigned and the final point sum calculated. A higher point sum indicates shorter survival.</p><p><strong>Results: </strong>The new LabPS score predicted overall survival very well (median: 12.1 to 0.7 mo, 1-y rate: 52% to 0%), P=0.0001. However, the group with the poorest prognosis (3 or 3.5 points) was very small (4%). Most patients with comparably short survival had a lower point sum. The LabPS score failed to outperform the recently proposed Extracranial-Graded Prognostic Assessment score.</p><p><strong>Conclusions: </strong>Integration of blood biomarkers should be considered when attempting to develop improved scores. Additional research is needed to improve the tools which predict short survival, because many of these patients continue to go undetected with all available scores.</p>","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"53-57"},"PeriodicalIF":2.6,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38740928","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}

{"title":"Nanoliposomal Irinotecan and Metronomic Temozolomide for Patients With Recurrent Glioblastoma: BrUOG329, A Phase I Brown University Oncology Research Group Trial.","authors":"Heinrich Elinzano,&nbsp;Steven Toms,&nbsp;Jordan Robison,&nbsp;Alex Mohler,&nbsp;Arieana Carcieri,&nbsp;Deus Cielo,&nbsp;Jennifer Donnelly,&nbsp;Dylan Disano,&nbsp;John Vatketich,&nbsp;John Baekey,&nbsp;Ashlee Sturtevant,&nbsp;Kelsey MacKinnon,&nbsp;Roxanne Wood,&nbsp;Howard Safran","doi":"10.1097/COC.0000000000000780","DOIUrl":"https://doi.org/10.1097/COC.0000000000000780","url":null,"abstract":"<p><strong>Background: </strong>Liposomal formulations may improve the solubility and bioavailability of drugs potentially increasing their ability to cross the blood-brain barrier. We performed a phase I study to determine the maximum tolerated dose and preliminary efficacy of pegylated nanoliposomal irinotecan (nal-IRI)+metronomic temozolomide (TMZ) in patients with recurrent glioblastoma.</p><p><strong>Patients and methods: </strong>Patients with glioblastoma who progressed after at least 1 line of therapy were eligible. All patients received TMZ 50 mg/m2/d until disease progression. Three dose levels of nal-IRI were planned, 50, 70, and 80 mg/m2, intravenously every 2 weeks. Patients were accrued in a 3+3 design. The study included a preliminary assessment after the first 13 evaluable patients. The trial would be terminated early if 0 or 1 responses were observed in these patients.</p><p><strong>Results: </strong>Twelve patients were treated over 2 dose levels (nal-IRI 50 and 70 mg/m2). At dose level 2, nal-IRI 70 mg/m2, 2 of 3 patients developed dose-limiting toxicities including 1 patient who developed grade 4 neutropenia and grade 3 diarrhea and anorexia and 1 patient with grade 3 diarrhea, hypokalemia fatigue, and anorexia. Accrual to dose level 1 was expanded to 9 patients. The Drug Safety Monitoring Board (DSMB) reviewed the data of the initial 12 patients-there were 0/12 responses (0%) and the median progression-free survival was 2 months and accrual was halted.</p><p><strong>Conclusions: </strong>The maximum tolerated dose of nal-IRI was 50 mg/m2 every 2 weeks with TMZ 50 mg/m2/d. The dose-limiting toxicities were diarrhea and neutropenia. No activity was seen at interim analysis and the study was terminated.</p>","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"49-52"},"PeriodicalIF":2.6,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38692322","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}

{"title":"\"Was It Worth It?\" A Pilot Study in Patient Perspectives on the Worthwhileness of Radiation Therapy: Erratum.","authors":"","doi":"10.1097/COC.0000000000000782","DOIUrl":"https://doi.org/10.1097/COC.0000000000000782","url":null,"abstract":"","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"91"},"PeriodicalIF":2.6,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38777893","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}

{"title":"Characterization of a Novel Entity of G3 (High-grade Well-differentiated) Colorectal Neuroendocrine Tumors (NET) in the SEER Database.","authors":"Omar Abdel-Rahman","doi":"10.1097/COC.0000000000000777","DOIUrl":"https://doi.org/10.1097/COC.0000000000000777","url":null,"abstract":"To the Editor: I have read with interest the recent article published in AJCO entitled “Characterization of a Novel Entity of G3 (High-grade Well-differentiated) Colorectal Neuroendocrine Tumors (NET) in the SEER Database,”1 and I would like to thank the authors for their efforts. That being said, the core concept of the article is based, in my opinion, on a misunderstanding on how Surveillance, Epidemiology, and End Results (SEER) database information is being organized and reported. In the methods section, the authors described their method in defining the study cohort as follows “We grouped patients on the basis of tumor grade and differentiation into the following cohorts: G1-2 NET (defined as low-intermediate grade [grades 1-2] well-differentiated histology [ICD 0-3= carcinoid]), G3 NET (defined as HG [grades 3-4] well-differentiated histology [ICD 0-3= carcinoid]), and NEC (defined as HG [grade 3] poorly differentiated NETs [ICD 0-3= small cell neuroendocrine]).” I am not sure from where the authors concluded that the 4-tiered grading system reported in the SEER database is equivalent to World Health Organization (WHO) grading published in 2010, 2017, or 2019 (which is based on Ki67 and/or mitotic index). I am hereby summarizing my main objections to the conclusions of this study: (1) Ki67 and mitotic index are not reported within the SEER database. These are the pillars of the grading system according to WHO 2010 classification. How can we trust any subsequent conclusions from this study? (2) The study duration is from 2000 to 2015 (ie, almost two-thirds of the study population were recruited before 2010); so, it is impossible that they could have been graded by the WHO grading system of 2010 or its later modifications. (3) As defined in the SEER documentation itself, grading is based on differentiation only (not Ki67 or mitotic index) (https://seer.cancer.gov/tools/ grade/). So, the whole premise of the study (which discusses discordance between differentiation and KI67-based grading) is wrong. (4) WHO 2010 classification and its subsequent revisions recommended not using the term carcinoid. So, having cases labeled as carcinoid indicate probably that they either have been diagnosed before the WHO 2010 classification or they have been diagnosed by a pathologist not knowledgeable about WHO classification. In both cases, this information cannot be used to derive any credible conclusions.","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"43"},"PeriodicalIF":2.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38725594","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}

{"title":"The Segmentation of Neuroendocrine Neoplasms According to Histology.","authors":"Salman R Punekar,&nbsp;Daniel J Becker","doi":"10.1097/COC.0000000000000776","DOIUrl":"https://doi.org/10.1097/COC.0000000000000776","url":null,"abstract":"","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"43"},"PeriodicalIF":2.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38725595","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}

{"title":"Systematic Review and Meta-Analysis on the Use of Photon-based Stereotactic Radiosurgery Versus Fractionated Stereotactic Radiotherapy for the Treatment of Uveal Melanoma.","authors":"Samuel Kosydar,&nbsp;Jake C Robertson,&nbsp;Michael Woodfin,&nbsp;Nina A Mayr,&nbsp;Arjun Sahgal,&nbsp;Robert D Timmerman,&nbsp;Simon S Lo","doi":"10.1097/COC.0000000000000775","DOIUrl":"https://doi.org/10.1097/COC.0000000000000775","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this report is to assess the efficacy and adverse event profile of photon-based stereotactic radiosurgery (SRS) compared with fractionated stereotactic radiotherapy (fSRT) for the treatment of uveal melanoma. Primary outcomes include incidence proportions of local control, enucleation, metastatic progression, disease-specific, and overall mortality. Treatment-related toxicities such as incidence proportions of radiation retinopathy, neovascular glaucoma, optic neuropathy, and cataract formation were examined as secondary outcomes. Five-year survival and 5-year local control rates were also assessed.</p><p><strong>Materials and methods: </strong>PubMed, Embase, Web of Science, Scopus, and 2 Cochrane databases were searched up to December 31, 2018. Random effects models were used to calculate pooled incidence proportions of outcome measures. Meta-regression was carried out to explore the potential impact of dose per fraction on local control.</p><p><strong>Results: </strong>Twenty-four articles with a total of 1745 patients were included in the meta-analysis. There were no statistically significant differences between photon-based fSRT and SRS for all primary, secondary and 5-year outcome measures, including local control (P=0.28), enucleation (P=0.51), and neovascular glaucoma (P=0.40). The 5-year local control rate was 90% (95% confidence interval: 76%, 96%) for fSRT and 89% (70%, 97%) for SRS.</p><p><strong>Conclusions: </strong>Our meta-analysis showed no difference in tumor control, survival and toxicities, as defined in this paper, between SRS and fSRT for uveal melanoma. Confounding biases remain an expected limitation in this study of novel treatment modalities deployed in rare tumors. Further investigation is needed to validate outcomes and compare stereotactic treatment techniques.</p>","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"32-42"},"PeriodicalIF":2.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38712895","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}

{"title":"Which Lymph Node Staging System Better Predicts Prognosis in Patients With Gastric Carcinoma? A Comparative Study Between 3 Different Lymph Node Classifications for Resected Gastric Cancer in a Western Tertiary Center.","authors":"Cristina Díaz Del Arco,&nbsp;Lourdes Estrada Muñoz,&nbsp;Andrés Sánchez Pernaute,&nbsp;Luis Ortega Medina,&nbsp;Soledad García Gómez de Las Heras,&nbsp;Ricardo García Martínez,&nbsp;María Jesús Fernández Aceñero","doi":"10.1097/COC.0000000000000770","DOIUrl":"https://doi.org/10.1097/COC.0000000000000770","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric cancer (GC) is an aggressive disease with high mortality rates. Lymph node (LN) staging of GC is a major source of controversy. The aim of this study is to compare the prognostic value of 3 different LN classifications for patients with resected GC: the eighth TNM staging system, lymph node ratio (LNR, ratio between positive and total LN) and a new anatomic-based classification (Choi classification).</p><p><strong>Materials and methods: </strong>A retrospective study of all cases of GC resected in a tertiary hospital in Spain (n=377). Clinical data were collected; histologic slides were reviewed; and univariate and multivariate analyses of disease-free survival (DFS) and overall survival (OS) were performed.</p><p><strong>Results: </strong>In all, 315 patients fulfilled inclusion criteria. Univariate analysis showed that all classifications were significantly associated with tumor death and progression (P<0.001). All staging systems were independent prognostic factors for DFS. Area under the curve ratios for Choi, N stage, and LNR classifications were 0.738, 0.730, and 0.735, respectively. TNM and LNR classifications were independent prognosticators for OS, while Choi classification was an independent factor only in patients with ≥16 LN resected. Area under the curve ratios for Choi, N stage, and LNR classifications were 0.707, 0.728, and 0.732, respectively. Kaplan-Meier curves depending on LNR classification showed the best patient stratification for both OS and DFS.</p><p><strong>Conclusions: </strong>The 3-staging systems had similar prognostic performance, but LNR-based classification stratified patients better. Further studies are needed to evaluate the impact of the number of LN examined, cutoff values, and anatomic extent of LN disease in GC.</p>","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38513078","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}

{"title":"Palliative Irradiation of Sacral Metastases: Must the Entire Bone Be Treated?","authors":"Viacheslav Soyfer,&nbsp;Elihau Gez,&nbsp;Ilya Novikov,&nbsp;Oded Brautbar,&nbsp;Benjamin W Corn","doi":"10.1097/COC.0000000000000774","DOIUrl":"https://doi.org/10.1097/COC.0000000000000774","url":null,"abstract":"<p><strong>Background and purpose: </strong>The sacrum as radiation target, raises a conceptual question: should the structure be regarded as a single unit or 5 distinct bones. If the entire sacrum must be irradiated there is a higher risk of rectal morbidity.</p><p><strong>Materials and methods: </strong>Images of 53 patients with sacral metastases were reviewed. The extent of sacral involvement was documented. The location of the rectum was recorded relative to the individual sacral bones.</p><p><strong>Results: </strong>In 37.7% only S1 and S2 were involved by metastatic disease. In 41.5% there was metastatic involvement of S1-S3. In 1 patient there was involvement of S5 only. In 10 cases the entire sacrum was infested by metastatic disease. The rectum never extended to the height of S1. In 38% the upper pole of the rectum reached the S3 level. In toto, there were 64.2% where the inferior extension of sacral metastatic involvement did not overlap the upper pole of the rectum. Palliation of pain was achieved in 19/20 patients treated with partial sacral irradiation.</p><p><strong>Conclusions: </strong>The distal part of the sacrum is rarely involved in the metastatic process. Avoidance of radiation therapy to the lower sacrum simultaneously enables effective palliation and sparing of the adjacent rectum.</p>","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"902-904"},"PeriodicalIF":2.6,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40555402","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}

{"title":"False-positive 1p/19q Testing Results in Gliomas: Clinical and Research Consequences.","authors":"Iyad Alnahhas,&nbsp;Appaji Rayi,&nbsp;Diana Thomas,&nbsp;Shirley Ong,&nbsp;Pierre Giglio,&nbsp;Vinay Puduvalli","doi":"10.1097/COC.0000000000000755","DOIUrl":"https://doi.org/10.1097/COC.0000000000000755","url":null,"abstract":"<p><strong>Background: </strong>The revised fourth edition of the World Health Organization Classification of Tumors of the Central Nervous System-published in 2016-established 1p19q codeletion as the molecular hallmark for the diagnosis of oligodendrogliomas. Fluorescence in situ hybridization (FISH) is currently the most commonly used modality for 1p19q testing. However, as with most laboratory testing, 1p19q FISH testing has a false-positive rate, potentially resulting in an erroneous diagnosis of oligodendroglioma with significant implications for the choice of therapy and prognosis.</p><p><strong>Methods: </strong>The authors describe a case series of 5 patients treated at the Ohio State University James Cancer Center to illustrate the problem of false-positive 1p19q FISH results.</p><p><strong>Results: </strong>In our case series, the authors present a spectrum of possibilities for conflicting 1p19q testing results and the clinical consequences. The authors present 4 cases that, in retrospect, are believed to have had a false 1p19q FISH results. One other case may represent a true transformation of oligodendroglioma to glioblastoma or a second malignancy. Neuro-oncologists should pay attention to additional molecular markers, namely ATRX, TP53, and MGMT methylation status, before discussing the pathology with the patient and formulating a treatment plan.</p><p><strong>Conclusions: </strong>Pathologists and neuro-oncologists should be aware of false-positive 1p19q FISH results as they can significantly change treatment and prognosis for glioma patients. Moreover, this issue should be taken into account when designing clinical trials specific to this disease cohort.</p>","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"802-805"},"PeriodicalIF":2.6,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/COC.0000000000000755","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40454489","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}

{"title":"Food Intake During Cancer Therapy: A Systematic Review.","authors":"Teresa Conigliaro,&nbsp;Lindsay M Boyce,&nbsp;Carlos A Lopez,&nbsp;Emily S Tonorezos","doi":"10.1097/COC.0000000000000749","DOIUrl":"https://doi.org/10.1097/COC.0000000000000749","url":null,"abstract":"<p><strong>Aim: </strong>Conduct a systematic review of available evidence on food and beverage intake during cancer treatment.</p><p><strong>Objective: </strong>Determine what food or beverages consumed during cancer treatment might prevent recurrence, subsequent malignancies, treatment-related toxicity, or death.</p><p><strong>Background: </strong>Food and beverage intake, as well as weight status, can integrate with cancer treatment to mitigate treatment-related toxicities, support treatment success, and prevent recurrence. Yet, evidence-based recommendations are lacking.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochran for research studies conducted within the last 10 years on food and beverage consumption during cancer treatment, with no restrictions on age or cancer type. Two reviewers independently extracted information on intervention type, diet, and outcomes; these data were confirmed by a third reviewer.</p><p><strong>Results: </strong>Nineteen studies were selected from 1551 potential studies. Nine were randomized controlled trials, analyzing high protein diets, short-term fasting, low-fat diets, FODMAP diet, or comparing consumption of 1 specific food or nutrient, including Concord grape juice, onions, and fiber. The remaining 10 studies were observational or retrospective and tracked treatment symptoms, general dietary intake, or weight status as well as consumption of specific foods including nuts, coffee, sugar-sweetened beverages.</p><p><strong>Conclusions: </strong>Available evidence suggests food can be effective at ameliorating cancer treatment-related toxicities and improving prognosis, but more research is needed.</p>","PeriodicalId":501816,"journal":{"name":"American Journal of Clinical Oncology","volume":" ","pages":"813-819"},"PeriodicalIF":2.6,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/COC.0000000000000749","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40454854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}