scholarly journals Correlation of Ezrin Expression Pattern and Clinical Outcomes in Ewing Sarcoma

Sarcoma ◽  
2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Thomas Cash ◽  
Hong Yin ◽  
Courtney McCracken ◽  
Zhi Geng ◽  
Steven G. DuBois ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Tumor Tissue ◽  
Soft Tissue Sarcomas ◽  
Event Free Survival ◽  
Free Survival ◽  
Membrane Cytoskeleton ◽  
Ezrin Expression ◽  
Significant Difference ◽  
Poor Outcomes ◽  
The Relationship

Background. Ezrin is a membrane-cytoskeleton linker protein that has been associated with metastasis and poor outcomes in osteosarcoma and high-grade soft tissue sarcomas. The prognostic value of ezrin expression in Ewing sarcoma is unknown.Methods. The relationship between ezrin expression and outcome was analyzed in a cohort of 53 newly diagnosed Ewing sarcoma patients treated between 2000 and 2011. The intensity and proportion of cells with ezrin immunoreactivity were assessed in diagnostic tumor tissue using a semiquantitative scoring system to yield intensity and positivity scores for each tumor.Results. Ezrin expression was detected in 72% (38/53) of tumor samples. The proportion of patients with metastatic disease was equal in the positive and negative ezrin expression groups. There was no significant difference in the 5-year event-free survival (EFS) between patients with positive versus negative ezrin expression. Patients whose tumor sample showed high ezrin intensity had significantly better 5-year EFS when compared to patients with low/no ezrin intensity (78% versus 55%;P=0.03).Conclusions. Ezrin expression can be detected in the majority of Ewing sarcoma tumor samples. Intense ezrin expression may be correlated with a favorable outcome; however further investigation with a larger cohort is needed to validate this finding.

scholarly journals High-Dose Chemotherapy Compared With Standard Chemotherapy and Lung Radiation in Ewing Sarcoma With Pulmonary Metastases: Results of the European Ewing Tumour Working Initiative of National Groups, 99 Trial and EWING 2008

2019 ◽  
Vol 37 (34) ◽  
pp. 3192-3202 ◽  
Author(s):  
Uta Dirksen ◽  
Bernadette Brennan ◽  
Marie-Cécile Le Deley ◽  
Nathalie Cozic ◽  
Henk van den Berg ◽  
...  
Keyword(s):  
Overall Survival ◽  
Ewing Sarcoma ◽  
High Dose Chemotherapy ◽  
P Value ◽  
High Dose ◽  
Event Free Survival ◽  
Standard Chemotherapy ◽  
Free Survival ◽  
Significant Difference ◽  
Pleural Metastases

PURPOSE The R2Pulm trial was conducted to evaluate the effect of busulfan-melphalan high-dose chemotherapy with autologous stem-cell rescue (BuMel) without whole-lung irradiation (WLI) on event-free survival (main end point) and overall survival, compared with standard chemotherapy with WLI in Ewing sarcoma (ES) presenting with pulmonary and/or pleural metastases. METHODS From 2000 to 2015, we enrolled patients younger than 50 years of age with newly diagnosed ES and with only pulmonary or pleural metastases. Patients received chemotherapy with six courses of vincristine, ifosfamide, doxorubicin, and etoposide (VIDE) and one course of vincristine, dactinomycin, and ifosfamide (VAI) before either BuMel or seven courses of VAI and WLI (VAI plus WLI) by randomized assignment. The analysis was conducted as intention to treat. The estimates of the hazard ratio (HR), 95% CI, and P value were corrected for the three previous interim analyses by the inverse normal method. RESULTS Of 543 potentially eligible patients, 287 were randomly assigned to VAI plus WLI (n = 143) or BuMel (n = 144). Selected patients requiring radiotherapy to an axial primary site were excluded from randomization to avoid excess organ toxicity from interaction between radiotherapy and busulfan. Median follow-up was 8.1 years. We did not observe any significant difference in survival outcomes between treatment groups. Event-free survival was 50.6% versus 56.6% at 3 years and 43.1% versus 52.9% at 8 years, for VAI plus WLI and BuMel patients, respectively, resulting in an HR of 0.79 (95% CI, 0.56 to 1.10; P = .16). For overall survival, the HR was 1.00 (95% CI, 0.70 to 1.44; P = .99). Four patients died as a result of BuMel-related toxicity, and none died after VAI plus WLI. Significantly more patients in the BuMel arm experienced severe acute toxicities than in the VAI plus WLI arm. CONCLUSION In ES with pulmonary or pleural metastases, there is no clear benefit from BuMel compared with conventional VAI plus WLI.

Abstract 13354: Event-Free Survival in African American Patients with Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kelly L Adams ◽  
Rebecca L Dekker ◽  
Terry A Lennie ◽  
Misook L Chung ◽  
Kathleen Dracup ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
African American ◽  
Ace Inhibitors ◽  
Nyha Class ◽  
Future Research ◽  
Event Free Survival ◽  
Data Set ◽  
Free Survival ◽  
The Relationship

Introduction: Health outcomes such as event-free survival (cumulative end-point in time to first health event) in heart failure (HF) patients is worse in African American than Caucasians. While the direct impact of traditional risk factors on outcomes are recognized, it is unknown how sociodemographic and psychosocial variables, disease, and treatment factors may alter the relationship between race and event-free survival. Hypothesis: Sociodemographics (age, gender, economic status), psychosocial factors (anxiety, depression), disease factors (smoking, functional status, diabetes) and treatments (beta blockers, ACE inhibitors) moderate the relationship between race and shorter event-free survival among patients with HF. Methods: Data were analyzed from 993 outpatients in a multicenter HF registry who were followed for a median of 1.9 years (37% female, 11.3% African American, 64±13 years, 44% NYHA Class III/IV). Data were collected via chart review and interview. Potential proposed moderators were analyzed with race as the predictor and the outcome event-free survival. Regressions were conducted on event-free survival using race and each proposed moderator, and the product of race and each moderator. Results: A primary analysis showed that African American patients are 1.54 times more likely to experience a cardiac event within this data set (p=.003). Further regression analyses indicate event-free survival in African American patients with HF is not moderated by the proposed moderators (all p>.05). Although an incomplete moderation, interactions with medication and race demonstrated better outcomes in African Americans than Caucasians not on ACE inhibitors, but Caucasians on prescribed ACE inhibitors have better comparative outcomes. Conclusions: Although many modifiable and non-modifiable risk factors may be associated with event free survival in African American HF patients, sociodemographic, psychosocial, disease, and treatment factors do not moderate the relationship between race and event-free survival. Future research is needed to better understand what factors contribute to and moderate evident disparities in the event-free survival of African American patients with HF.

Abstract 2728: Nonadherence to Prescribed Medications Mediates the Link between Anxiety and Event-Free Survival in Patients with Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Marla J De Jong ◽  
Debra K Moser ◽  
Misook L Chung ◽  
Jia-Rong Wu
Keyword(s):  
Heart Failure ◽  
Medication Adherence ◽  
Clinical Outcomes ◽  
Nyha Class ◽  
Event Free Survival ◽  
High Anxiety ◽  
Medication Nonadherence ◽  
Free Survival ◽  
Clinical Events ◽  
The Relationship

Anxiety has been linked to adverse outcomes for patients with cardiac disease but the mechanism for this relationship is unknown. Nonadherence to prescribed medications is common in heart disease, particularly heart failure (HF), and may mediate the relationship between anxiety and outcomes. To determine if nonadherence to prescribed medications mediates any relationship between anxiety and clinical outcomes in patients with HF. Patients (N=147; age 61±11 yrs, 44% female, 59% NYHA class III/IV) with chronic HF were followed 389±324 days for clinical events (composite of death, emergency department visit, or hospitalization). Patients completed the anxiety subscale of the Brief Symptom Inventory at baseline. Objective evidence of medication adherence was measured with the Medication Event Monitoring System. Survival and regression analyses were used to test whether medication nonadherence mediated any association between anxiety and outcomes. Patients with highest anxiety had shorter event-free survival than patients with lower anxiety (Fig. ). After adjusting for age, gender, and NYHA class in Cox regression, high anxiety predicted (OR 2.4; p=.001) clinical events. Anxiety predicted medication doses taken (p=.01) and days correct doses taken (p=.008). Medication doses taken (p=.01) and days dose taken (p=.008) also predicted clinical outcomes. Medication nonadherence mediated the relationship between high anxiety and worse outcomes. This is the first study to show that medication nonadherence links anxiety and clinical outcomes. Interventions that decrease anxiety may improve both medication adherence and outcomes.

scholarly journals Primary and Metastatic Intracranial Ewing Sarcoma at Diagnosis: Retrospective International Study and Systematic Review

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1675
Author(s):  
Lianne M. Haveman ◽  
Andreas Ranft ◽  
Henk van den Berg ◽  
Stephanie Klco-Brosius ◽  
Ruth Ladenstein ◽  
...  
Keyword(s):  
Local Control ◽  
Ewing Sarcoma ◽  
Univariate Analysis ◽  
International Study ◽  
Cerebral Metastases ◽  
The Body ◽  
Event Free Survival ◽  
Free Survival ◽  
Metastatic Lesions ◽  
Chemotherapeutic Treatment

Intracranial Ewing sarcoma (EwS) is rare and publications on primary or metastatic intracranial EwS are minimal. The aim of this study was to describe incidence, clinical behavior, treatment, and factors associated with outcome in patients with primary intracranial EwS or patients with a primary extracranial EwS and cerebral metastases at diagnosis. We reviewed all patients with primary or with metastatic intracranial EwS at diagnosis registered in the International Clinical Trial Euro-E.W.I.N.G.99 (EE99). In total, 17 of 1435 patients (1.2%) presented with primary intracranial EwS; 3 of them had metastatic disease. Four patients (0.3%) with primary extracranial EwS presented with intracranial metastatic lesions. The 3-year event-free survival (EFS) was 64% and overall survival (OS) was 70% in patients with a primary intracranial EwS. Local control in patients with primary intracranial EwS consisted of surgery (6%), radiotherapy (RT) (18%), or both modalities (76%). Univariate analysis showed that patients < 15 years of age had significantly better outcome (EFS: 72%; OS: 76%) compared to those aged above 15 years (EFS: 13%; OS: 25%). In conclusion, primary intracranial EwS and extracranial EwS with cerebral metastases at diagnosis is rare, yet survival is comparable with local and metastatic EwS elsewhere in the body. Age and stage of disease are important prognostic factors. Besides chemotherapeutic treatment, local control with surgical resection combined with RT is recommended whenever feasible.

Common and variant gene fusions predict distinct clinical phenotypes in rhabdomyosarcoma.

1997 ◽  
Vol 15 (5) ◽  
pp. 1831-1836 ◽  
Author(s):  
K M Kelly ◽  
R B Womer ◽  
P H Sorensen ◽  
Q B Xiong ◽  
F G Barr
Keyword(s):  
Metastatic Disease ◽  
Fusion Gene ◽  
Gene Fusions ◽  
Event Free Survival ◽  
Free Survival ◽  
Clinical Phenotypes ◽  
Significant Difference ◽  
The Common ◽  
Polymerase Chain ◽  
Gene Status

PURPOSE We evaluated the clinical features of the common PAX3-FKHR and variant PAX7-FKHR gene fusions observed in rhabdomyosarcoma. PATIENTS AND METHODS Reverse-transcriptase polymerase chain reaction (RT-PCR) assays were used to detect the gene fusions in 34 cases of rhabdomyosarcoma. Clinical data were obtained retrospectively and compared with the molecular results. RESULTS The PAX3-FKHR and PAX7-FKHR gene fusions were present in tumors from 18 and 16 patients, respectively. The group with a PAX7-FKHR fusion was younger (P = .01) and presented more often with an extremity lesion (82% v 22%; P = .001). PAX7-FKHR tumors were more often localized than PAX3-FKHR tumors (P = .03). In patients with metastatic disease at diagnosis, the patterns were different: PAX7-FKHR patients had metastatic disease that involved only bone (n = 2) and distant nodes (n = 2), while the PAX3-FKHR group had multiple sites involved, including bone (n = 7), marrow (n = 7), lungs (n = 3), distant nodes (n = 2), skin (n = 1), and brain (n = 1). No significant difference in relapse rate was observed. A trend toward improved overall survival in the PAX7-FKHR group was noted (P = .09). Event-free survival for this PAX7-FKHR group was significantly longer (P = .04). CONCLUSION Our results suggest that the common PAX3-FKHR and the variant PAX7-FKHR fusions are associated with distinct clinical phenotypes. Identification of fusion gene status may be a useful diagnostic tool in rhabdomyosarcoma.

scholarly journals Clinicopathological, Treatment and Event-Free Survival Characteristics in a Moroccan Population of Triple-Negative Breast Cancer

2020 ◽  
Vol 14 ◽  
pp. 117822342090642
Author(s):  
Fatima Zahra Mouh ◽  
Meriem Slaoui ◽  
Rachid Razine ◽  
Mohammed EL Mzibri ◽  
Mariam Amrani
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Survival Rate ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Menopausal Status ◽  
Age At Menarche ◽  
Event Free Survival ◽  
Free Survival ◽  
Significant Difference

Introduction: Triple-negative breast cancer (TNBC) is a group of breast carcinoma characterized by the lack of expression of estrogen and progesterone hormone receptors (ER, PgR) and HER2. This form is also characterized by its aggressiveness, a low survival rate, and the absence of targeted therapies. This study was planned to evaluate the clinical features, treatment, and prognosis characteristics of TNBC in a population of Moroccan patients. Methods: In this retrospective study, a total of 905 patients diagnosed with breast cancer at the National Institute of Oncology in Rabat, Morocco, have been included. Based on molecular subtype, patients were divided into 2 categories: TNBC and non-TNBC patients. Data were recorded from patients’ medical files and analyzed using SPSS 13.0 software (IBM). Results: Overall, 17% of the patients had TNBC. At diagnosis, the median age of TNBC cases was 47 years, with extreme ages of 40 and 55 years. The median follow-up time was 30 months (10-53 months) and the 3-year survival rate was 76%. No significant difference was observed among the patients in terms of age at diagnosis, age at menarche, age at the time of first birth, nulliparity, oral contraception, and family history of breast cancer. Menopausal status and the number of pregnancy were significantly higher in the non-TNBC group. The percentage of grade 3 (G3) tumors was higher in the TNBC group ( P < .001). Using neoadjuvant, adjuvant chemotherapy and radiotherapy, a net benefit in the event-free survival was registered for the 2 groups. Conclusions: This retrospective study was very informative and showed that women with TNBC had a less favorable prognosis than non-TNBC cases. Clinical data demonstrated that risk factors including age, premenopausal status, parity, hormonal contraceptive use, advanced disease, and a high histologic grade were independently associated with TNBC. However, large tumors and high Scarff-Bloom and Richardson grade prevail in TNBC cases with a higher incidence of lymph node metastases.

scholarly journals MNG-03 PD-L1 EXPRESSION, PATIENT PROGNOSIS AND INITIAL WHO GRADE IN GRADE II/III MENINGIOMA

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii36-ii36
Author(s):  
Dai Kamamoto ◽  
Hikaru Sasaki ◽  
Ryota Sasao ◽  
Takumi Fujiyama ◽  
Kazunari Yoshida
Keyword(s):  
Radiation Therapy ◽  
Progression Free Survival ◽  
Who Grade ◽  
Free Survival ◽  
Specific Data ◽  
Tumor Immune Evasion ◽  
Significant Difference ◽  
Grade Ii ◽  
Patient Prognosis ◽  
The Relationship

Abstract The optimal treatment for grade II/III meningioma is operation with or without radiation therapy. However, their natural course is sometimes aggressive with high recurrent rate. There is no effective treatment other than operation and radiation therapy, therefore, a new therapeutic strategy for grade II/III meningioma is urgently required.PD-1 and PD-L1 play important roles as immune-checkpoint mediators within tumor microenvironment and the antibodies to these molecules are now approved for the treatment of various kinds of cancers. In Japan, anti-PD-1 antibody and anti-CTLA-4 antibody are approved for unresectable melanoma or advanced / recurrent non-small cell lung cancer and their high effectiveness has been reported. We investigated the expression of PD-L1 (clone:28-8) in 51 cases of grade II/III meningioma by immunohistochemistry and analyzed the relationship between the expression with overall survival, progression free survival and initial WHO grade. For now, we have evaluated 25 cases of PD-L1 immunohistochemistry and PD-L1 showed positivity in 15 cases. There is no correlation observed between PD-L1 expression and patients’ prognosis. Although it does not reach a significant difference, the WHO grade at the time of initial operation tends to be high in those with high PD-L1 staining rate.Similar studies that were previously reported did not use antibodies targeting clone 28-8, which was used as a companion diagnosis for nivolumab administration, but “Correlation between PD-L1 expression and WHO grade”, or “PD-L1 expression is an independent prognostic factor” have been reported. In our investigation, which was using antibodies for companion diagnosis, PD-L1 was positive in more than half of Grade II / III meningiomas and it also related to WHO grade. These results suggest the possibility that tumor immune evasion mechanisms are also working in meningiomas. At the conference, we will report it with the specific data from all cases with a literature review.

Depressive Symptoms

2016 ◽  
Vol 39 (4) ◽  
pp. 539-552
Author(s):  
Muna H. Hammash ◽  
Terry A. Lennie ◽  
Timothy Crawford ◽  
Seongkum Heo ◽  
Misook L. Chung ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Survival Data ◽  
Proportional Hazards ◽  
Heart Association ◽  
Cox Proportional Hazards ◽  
Health Perceptions ◽  
Class Iii ◽  
Event Free Survival ◽  
Free Survival ◽  
The Relationship

Depressive symptoms and poor health perceptions are predictors of higher hospitalization and mortality rates (heart failure [HF]). However, the association between depressive symptoms and health perceptions as they affect event-free survival outcomes in patients with HF has not been studied. The purpose of this secondary analysis was to determine whether depressive symptoms mediate the relationship between health perceptions and event-free survival in patients with HF. A total of 458 HF patients (61.6 ± 12 years, 55% New York Heart Association Class III/IV) responded to one-item health perception question and completed the Patient Health Questionnaire–9. Event-free survival data were collected for up to 4 years. Multiple regression and Cox proportional hazards regression analysis showed that depressive symptoms mediated the relationship between health perceptions and event-free survival. Decreasing depressive symptoms is essential to improve event-free survival in patients with HF.

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