Medicine and Health Sciences Commons^™

Clinical Impact Of Number Of Lymph Nodes Dissected On Postoperative Survival In Node-Negative Small Cell Lung Cancer, Shinkichi Takamori, Takefumi Komiya Md, Emily Powell Phd

PCI Publications and Projects

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Objectives: Small cell lung cancer (SCLC) is a lethal histologic subtype of lung cancer. Although the Commission on Cancer recommends pathological examination of at least 10 lymph nodes dissected (LNDs) for resected early-stage non-small cell lung cancer, its survival benefit of LNDs in patients with early-stage SCLC is unknown.

Methods: The National Cancer Database was queried for SCLC patients with clinical stage I-II and clinical N0, NX disease per AJCC 7th edition who had undergone lobectomy between 2004 and 2017. Overall survival of SCLC patients by the number of LNDs was compared using Log-rank tests. Univariate and multivariable Cox proportional …

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Lymph Node Dissections And Survival In Sublobar Resection Of Non-Small Cell Lung Cancer ≤ 20 Mm., Shinkichi Takamori, Takefumi Komiya Md, Mototsugu Shimokawa, Emily Powell Phd

PCI Publications and Projects

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BACKGROUND: A randomized trial of lobectomy versus segmentectomy for small-sized (≤ 20 mm) non-small cell lung cancer (NSCLC) showed that patients who had undergone segmentectomy had a significantly longer overall survival (OS) than those who had lobectomy. More attention is needed regarding the required extent of thoracic lymphadenectomy in patients with small-sized NSCLC who undergo sublobar resection.

METHODS: The National Cancer Database was queried for patients with clinically node-negative NSCLC ≤ 20 mm who had undergone sublobar resection between 2004 and 2017. OS of NSCLC patients by the number of lymph node dissections (LNDs) was analyzed using log-rank tests and …

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Does Acute Pancreatitis Herald Pancreatic Ductal Adenocarcinoma? A Multicenter Electronic Health Research Network Study., Ritu R. Singh, Alison P Klein, Neil Sharma Md, Eileen M O'Reilly

PCI Publications and Projects

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BACKGROUND AND OBJECTIVES: High mortality in pancreas ductal adenocarcinoma (PDAC) is related to delayed diagnosis and lack of cost-effective early detection strategies. Retrospective studies have demonstrated an association between PDAC and acute pancreatitis (AP). Herein, we explore the incidence of PDAC in patients with non-biliary and non-alcoholic AP.

METHODS: A population-based, retrospective cohort study was conducted utilizing TriNetX (Cambridge, MA). Patients ≥40 years with AP (ICD-10-CM code: K85) and without biliary AP (K85.1), alcohol-induced AP (K85.2) or chronic pancreatitis (K86.0, K86.1), were identified. The primary outcome was incidence of PDAC (C25) in patients at defined intervals following AP. We compared …

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Patient Efficacy In Telehealth Is Moderated By Distress Among Patients With Cancer: A Cross-Sectional Survey Study, Joseph Mccollom Do, Rachel Pfafman, Michelle Drouin, Mindy Flanagan, Tammy Toscos Phd

PCI Publications and Projects

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Low emotional distress and high confidence with tech impacts cancer patients’ choice of in person or telehealth visits.

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Endoscopic Management Of Complex Colorectal Polyps: Current Insights And Future Trends, Rupinder Mann, Mahesh Gajendran, Chandraprakash Umapathy, Abhilash Perisetti Md, Hermant Goyal, Shreyas Saligram, Juan Echavarria

PCI Publications and Projects

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Most colorectal cancers arise from adenomatous polyps and sessile serrated lesions. Screening colonoscopy and therapeutic polypectomy can potentially reduce colorectal cancer burden by early detection and removal of these polyps, thus decreasing colorectal cancer incidence and mortality. Most endoscopists are skilled in detecting and removing the vast majority of polyps endoscopically during a routine colonoscopy. Polyps can be considered “complex” based on size, location, morphology, underlying scar tissue, which are not amenable to removal by conventional endoscopic polypectomy techniques. They are technically more challenging to resect and carry an increased risk of complications. Most of these polyps were used to …

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Induction Immunotherapy Followed By Thoracic Radiation Without Chemotherapy In Unresectable Stage Iii Non-Small Cell Lung Cancer: A Case Series., Srikiran Dasari, Takefumi Komiya Md

PCI Publications and Projects

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OBJECTIVE: Although concurrent chemoradiation has been the standard of care for unresectable stage III non-small cell lung cancer (NSCLC) due to increased survival and decreased disease progression, patients with poor performance status cannot tolerate chemotherapy toxicity well. Durvalumab, an immune checkpoint inhibitor targeting the programmed death receptor-1 (PD-1) / programmed death-ligand 1 (PD-L1) axis, demonstrated efficacy as maintenance therapy after definitive chemoradiation. However, the role of immunotherapy in those who cannot tolerate chemoradiation is unclear.

METHODS: This retrospective case series reports adult patients with PD-L1-expressing stage III NSCLC diagnosed at Parkview Cancer Institute from 2019-2021 and treated initially with pembrolizumab …

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The Evolution Of Device-Assisted Enteroscopy: From Sonde Enteroscopy To Motorized Spiral Enteroscopy, Freddy Nehme, Hermant Goyal, Abhilash Perisetti Md, Ben Tharian, Neil Sharma Md, Tony C. Tham, Rajiv Chhabra

PCI Publications and Projects

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THIS ARTICLE IS PART OF THE RESEARCH TOPIC: Recent Updates in Advanced Gastrointestinal Endoscopy

The introduction of capsule endoscopy in 2001 opened the last “black box” of the gastrointestinal tract enabling complete visualization of the small bowel. Since then, numerous new developments in the field of deep enteroscopy have emerged expanding the diagnostic and therapeutic armamentarium against small bowel diseases. The ability to achieve total enteroscopy and visualize the entire small bowel remains the holy grail in enteroscopy. Our journey in the small bowel started historically with sonde type enteroscopy and ropeway enteroscopy. Currently, double-balloon enteroscopy, single-balloon enteroscopy, and spiral …

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Scope Of Artificial Intelligence In Gastrointestinal Oncology, Hermant Goyal Md, Syed A.A. Sheraz, Rupinder Mann, Zainab Gandhi, Abhilash Perisetti Md, Muhammad Aziz, Saurabh Chandan, Jonathan Kopel, Benjamin Tharian Md, Neil Sharma Md, Nirav Thosani

PCI Publications and Projects

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Simple Summary

Gastrointestinal cancers cause over 2.8 million deaths annually worldwide. Currently, the diagnosis of various gastrointestinal cancer mainly relies on manual interpretation of radiographic images by radiologists and various endoscopic images by endoscopists. Artificial intelligence (AI) may be useful in screening, diagnosing, and treating various cancers by accurately analyzing diagnostic clinical images, identifying therapeutic targets, and processing large datasets. The use of AI in endoscopic procedures is a significant breakthrough in modern medicine. Although the diagnostic accuracy of AI systems has markedly increased, it still needs collaboration with physicians. In the near future, AI-assisted systems will become a vital …

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Improved Resection Rates In Locally Advanced Pancreatic Cancer (Lapc) Following Eus-Fni Of Large Surface Area Microparticle Paclitaxel (Lsam Pac), Neil Sharma Md, C Max Schmidt Md, Sushil Jain Md, Joseph Mccollom Do, Holly Maulhardt Bs, Shelagh Verco Bsc, Phd, Mariajose Rojas Md, Saurabh Gupta Md, Chetan Mittal Md, Christina Zelt, Ashley Rumple Rn, Bsn, James Verco Bs, Ccra, Abhilash Perisetti Md, Gere S. Dizerega Md

PCI Publications and Projects

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Introduction:

LAPC is generally defined as unresectable disease without evidence of metastatic spread, and reports suggest between 8-25% of these patients may become resectable following current standard of care (SOC) therapy. EUS-FNI allows for the delivery of drug therapies directly into the tumor, which led to the development of LSAM pac currently being evaluated in LAPC and other solid tumors by means of direct injection, where the particles of pure drug act as a depot releasing paclitaxel over several weeks.

Methods:

Clinical study [NCT # 03077685] enrolled patients with LAPC, confirmed non-surgical despite SOC therapy, to additionally receive LSAM pac …

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Impact Of Race And Socioeconomics Disparities On Survival In Young-Onset Colorectal Adenocarcinoma-A Seer Registry Analysis., Mark M Aloysius, Hemant Goyal, Niraj J Shah, Kumar Pallav, Nimy John, Mahesh Gajendran, Abhilash Perisetti Md, Benjamin Tharian

PCI Publications and Projects

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INTRODUCTION: We aimed to assess the impact of socio-economic determinants of health (SEDH) on survival disparities within and between the ethnic groups of young-onset (age) colorectal adenocarcinoma patients.

PATIENTS AND METHODS: Surveillance, epidemiology, and end results (SEER) registry was used to identify colorectal adenocarcinoma patients aged between 25-49 years from 2012 and 2016. Survival analysis was performed using the Kaplan-Meir method. Cox proportional hazards model was used to determine the hazard effect of SEDH. American community survey (ACS) data 2012-2016 were used to analyze the impact of high school education, immigration status, poverty, household income, employment, marital status, and insurance …

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Pembrolizumab Plus Concurrent Chemoradiation Therapy In Patients With Unresectable, Locally Advanced, Stage Iii Non-Small Cell Lung Cancer: The Phase 2 Keynote-799 Nonrandomized Trial, Salma K. Jabbour, Ki Hyeong Lee, Nikolaj Frost, Valeriy Breder, Dariusz M. Kowalski, Theodore Pollock, Evgeny Levchenko, Noemi Reguart, Alex Martinez-Marti, Baerin Houghton, Jean-Baptiste Paoli, Sufia Safina, Keunchil Park, Takefumi Komiya Md, Amy Sanford, Vishal Boolell, Hong Liu, Ayman Samkari, Steven M. Keller, Martin Reck

PCI Publications and Projects

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Importance: Administration of pembrolizumab plus concurrent chemoradiation therapy (cCRT) may provide treatment benefit to patients with locally advanced, stage III non-small cell lung cancer (NSCLC).

Objective: To evaluate treatment outcomes and safety of pembrolizumab plus cCRT in stage III NSCLC.

Design, setting, and participants: The phase 2, nonrandomized, 2-cohort, open-label KEYNOTE-799 study enrolled patients between November 5, 2018, and July 31, 2020, from 52 academic facilities and community-based institutions across 10 countries. As of October 28, 2020, median (range) follow-up was 18.5 (13.6-23.8) months in cohort A and 13.7 (2.9-23.5) months in cohort B. Of 301 patients screened, 216 eligible …

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Pembrolizumab Plus Concurrent Chemoradiation Therapy In Patients With Unresectable, Locally Advanced, Stage Iii Non-Small Cell Lung Cancer: The Phase 2 Keynote-799 Nonrandomized Trial., Salma K Jabbour, Ki Hyeong Lee, Nikolaj Frost, Valeriy Breder, Dariusz M Kowalski, Theodore Pollock, Evgeny Levchenko, Noemi Reguart, Alex Martinez-Marti, Baerin Houghton, Jean-Baptiste Paoli, Sufia Safina, Keunchil Park, Takefumi Komiya Md, Amy Sanford, Vishal Boolell, Hong Liu, Ayman Samkari, Steven M Keller, Martin Reck

PCI Publications and Projects

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IMPORTANCE: Administration of pembrolizumab plus concurrent chemoradiation therapy (cCRT) may provide treatment benefit to patients with locally advanced, stage III non-small cell lung cancer (NSCLC).

OBJECTIVE: To evaluate treatment outcomes and safety of pembrolizumab plus cCRT in stage III NSCLC.

DESIGN, SETTING, AND PARTICIPANTS: The phase 2, nonrandomized, 2-cohort, open-label KEYNOTE-799 study enrolled patients between November 5, 2018, and July 31, 2020, from 52 academic facilities and community-based institutions across 10 countries. As of October 28, 2020, median (range) follow-up was 18.5 (13.6-23.8) months in cohort A and 13.7 (2.9-23.5) months in cohort B. Of 301 patients screened, 216 eligible …

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Emerging Role Of Fascin-1 In The Pathogenesis, Diagnosis, And Treatment Of The Gastrointestinal Cancers., Bojana Ristic, Jonathan Kopel, Syed A A Sherazi, Shweta Gupta, Sonali Sachdeva, Pardeep Bansal, Aman Ali, Abhilash Perisetti Md, Hemant Goyal

PCI Publications and Projects

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Gastrointestinal (GI) cancers, including esophageal, gastric, colorectal, liver, and pancreatic cancers, remain as one of the leading causes of death worldwide, with a large proportion accounting for fatalities related to metastatic disease. Invasion of primary cancer occurs by the actin cytoskeleton remodeling, including the formation of the filopodia, stereocilia, and other finger-like membrane protrusions. The crucial step of actin remodeling in the malignant cells is mediated by the fascin protein family, with fascin-1 being the most active. Fascin-1 is an actin-binding protein that cross-links filamentous actin into tightly packed parallel bundles, giving rise to finger-like cell protrusions, thus equipping the …

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Increased Diagnosis Of Hepatocellular Carcinoma In Hospitalized Patients With Alcohol Related Hepatitis After The Covid-19 Outbreak: A Global Multi-Center Propensity Matched Analysis., Abhilash Perisetti Md, Randeep Kaur, Ragesh Thandassery

PCI Publications and Projects

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No abstract provided.

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Prognostic Impact Of Single And Multiple Descriptors In Pathologically Staged T3n0m0 Nsclc, Takefumi Komiya Md, Emily Powell Phd, Shinkichi Takamori Md, Phd

PCI Publications and Projects

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Introduction

T components of the current eighth edition of lung cancer American Joint Commission on Cancer (AJCC) staging assignment include size of primary tumor and others such as chest wall invasion. The role of the presence of multiple T3 descriptors in prognosis remains unknown.

Methods

Using the National Cancer Database and the AJCC seventh edition, pathologically staged (R0) N0M0 NSCLC cases diagnosed in 2010 to 2016 were analyzed. The selected cases had primary size larger than 5 cm or staged as T3 by the AJCC seventh edition despite the size of less than 5 cm. T3 descriptor status according to …

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Application Of Artificial Intelligence In Pancreaticobiliary Diseases, Hemant Goyal, Rupinder Mann, Zainab Gandhi, Abhilash Perisetti, Zhongheng Zhang, Neil Sharma Md, Shreyas Saligram, Sumant Inamdar, Benjamin Tharian

PCI Publications and Projects

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The role of artificial intelligence and its applications has been increasing at a rapid pace in the field of gastroenterology. The application of artificial intelligence in gastroenterology ranges from colon cancer screening and characterization of dysplastic and neoplastic polyps to the endoscopic ultrasonographic evaluation of pancreatic diseases. Artificial intelligence has been found to be useful in the evaluation and enhancement of the quality measure for endoscopic retrograde cholangiopancreatography. Similarly, artificial intelligence techniques like artificial neural networks and faster region-based convolution network are showing promising results in early and accurate diagnosis of pancreatic cancer and its differentiation from chronic pancreatitis. Other …

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Role Of Immunotherapy In Stage Iv Large Cell Neuroendocrine Carcinoma Of The Lung., Takefumi Komiya Md, Neema Ravindra, Emily Powell Phd

PCI Publications and Projects

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BACKGROUND: Despite approvals of immune checkpoint inhibitors in both small cell and non-small cell lung cancers, the role of immunotherapy in large cell neuroendocrine carcinoma (LCNEC) in lung is undefined.

METHODS: Using the National Cancer Database (NCDB), Stage IV lung LCNEC cases diagnosed from 2014 to 2016 were analyzed. Information regarding cancer treatment was limited to first course of therapy, including surgery for primary lesion, radiation, chemotherapy, and immunotherapy. Survival analysis was performed using Kaplan-Meier curves and Log-rank tests. Cox proportional hazard model was used for multivariate analysis.

RESULTS: Among 661 eligible cases, 37 patients were treated with immunotherapy. No …

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Aspirin For Prevention Of Colorectal Cancer In The Elderly: Friend Or Foe?, Abhilash Perisetti Md, Hemant Goyal, Benjamin Tharian, Sumant Inamdar, Jawahar L Mehta

PCI Publications and Projects

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Cancer is the leading cause of death among men and women aged 60-79 years. Colorectal cancer is the third most common cancer in males and the second most common in females, with about 0.8 million deaths worldwide per year. Individuals older than 50 years account for 20-50% of colonic adenomas. Several measures have been proposed to decrease colorectal cancer risks, such as an increase in dietary fiber, use of aspirin, and physical activity. Nonsteroidal anti-inflammatory drugs have been proposed as protective agents against the development of colorectal cancer and colorectal adenomas. Aspirin was the first pharmacological agent endorsed by the …

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Survival Benefit From Immunocheckpoint Inhibitors In Stage Iv Non-Small Cell Lung Cancer Patients With Brain Metastases: A National Cancer Database Propensity-Matched Analysis., Shinkichi Takamori, Takefumi Komiya Md, Emily Powell

PCI Publications and Projects

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Immunocheckpoint inhibitors (ICIs) have become a standard pharmacological therapy in non-small cell lung cancer (NSCLC). Because brain metastases (BMs) have historically been listed as exclusion criteria in previous clinical trials involving ICIs in advanced NSCLC, the survival benefit from ICI in NSCLC patients with BMs remains unclear. The National Cancer Database was queried for stage IV NSCLC patients with or without BMs between 2014 and 2015. Overall survival (OS) of stage IV NSCLC patients who received immunotherapy and that of stage IV NSCLC patients who did not receive immunotherapy were compared according to the presence or absence of BMs. Multivariable …

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Prognostic Impact Of Single And Multiple Descriptors In Pathologically Staged T3n0m0 Non-Small Cell Lung Cancer, Takefumi Komiya Md, Emily Powell Phd, Shinkichi Takamori Md Phd

PCI Publications and Projects

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Background

T components of the current 8th edition of lung cancer American Joint Commission on Cancer (AJCC) staging assignment include size of primary tumor and others such as chest wall invasion. The role of the presence of multiple T3 descriptors in prognosis remains unknown.

Materials and methods

Using National Cancer Database (NCDB) and of AJCC 7th edition, pathologically staged (R0) N0M0 non-small cell lung cancer (NSCLC) cases diagnosed in 2010-2016 were analyzed. Selected cases had primary size larger than 5cm or staged as T3 by AJCC 7th edition despite size <5cm. T3 descriptor status by 8th edition was defined as single descriptor (“T3-single”) as primary size 5-7cm or size <5cm and T3 per 7th edition (“T3-other”), or multiple descriptor (“T3-multi”) as presence of both descriptors. Survival analysis was performed with validation of multivariate analyses.

Results

Of the 108,632 surgically resected pathologically staged N0M0R0 NSCLC …

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Scope Of Artificial Intelligence In Screening And Diagnosis Of Colorectal Cancer, Hemant Goyal Md, Rupinder Mann Md, Zainab Gandhi Mbbs, Abhilash Perisetti Md, Aman Ali Md, Khizar Amani Ali, Neil Sharma Md, Benjamin Tharian Md, Shreyas Saligram, Sumant Inamdar

PCI Publications and Projects

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Globally, colorectal cancer is the third most diagnosed malignancy. It causes significant mortality and morbidity, which can be reduced by early diagnosis with an effective screening test. Integrating artificial intelligence (AI) and computer-aided detection (CAD) with screening methods have shown promising results for colorectal cancer screening. AI could provide a “second look” for endoscopists to decrease the rate of missed polyps during a colonoscopy. It can also improve detection and characterization of polyps by integration with colonoscopy, various advanced endoscopic modalities like magnifying narrow-band imaging, endocytoscopy, confocal endomicroscopy, laser-induced fluorescence spectroscopy, and magnifying chromoendoscopy. In this review, we have discussed …

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Impact Of Immunotherapy Use In Patients With Stage Iv Pancreatic Carcinoma, Achuta K. Guddati, Takefumi Komiya Md, Sunny J. Patel, Neil Sharma Md, Emily Powell

PCI Publications and Projects

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Background: Most patients with pancreatic cancer have non-resectable disease at the time of diagnosis and usually die within 6-12 months. Despite indications in other solid tumors, the role of immunotherapy (IO) is unknown for late stage, advanced pancreatic cancer.

Methods: Using the National Cancer Database (NCDB), cases of Stage IV pancreatic cancers diagnosed in the period of 2014-2016 with at least 30-day follow up were retrospectively analyzed. The following clinical demographics were included: age (younger than 70 vs. older than 70), sex (male vs. female), race (whites vs. others), insurance (uninsured vs. insured), type of institution …

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The Incidence Of Chemotherapy Extravasation In The Inpatient And Ambulatory Infusion Areas Of A Community Cancer Center, Nancy Ehmke Mn, Rn, Aocn

Nursing Active Studies

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Few studies have been conducted in non-National Cancer Institute (non-NCI) designated cancer centers and even less have included both the inpatient and outpatient settings. This study is being conducted in order to establish a benchmark for the incidence of chemotherapy extravasation in an inpatient oncology unit and outpatient infusion center at a non-NCI-designated community cancer center. This retrospective review is to determine the common chemotherapy agents involved in extravasation, patient factors contributing to the extravasation, and severity of extravasations.

PI: Nancy Ehmke MN, RN, AOCN

Contact: nancy.ehmke@parkview.com

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Phase 1 Dose-Escalation Study Of Momelotinib, A Janus Kinase 1/2 Inhibitor, Combined With Gemcitabine And Nab-Paclitaxel In Patients With Previously Untreated Metastatic Pancreatic Ductal Adenocarcinoma., Kimmie Ng, Andrew Hendifar, Alexander Starodub Md, Jorge Chaves, Yingsi Yang, Brian Koh, David Barbie, William C Hahn, Charles S Fuchs

PCI Publications and Projects

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Purpose Preclinical evidence suggests the importance of Janus activating kinase (JAK) and TANK-binding kinase 1 (TBK1) in pancreatic ductal adenocarcinoma (PDAC). We evaluated the safety and efficacy of momelotinib (MMB), a JAK1/2 inhibitor with additional activity against TBK1, plus albumin-bound paclitaxel + gemcitabine (nab-P + G), in patients with previously untreated metastatic PDAC. Experimental Design Patients were enrolled into five cohorts of increasing doses of MMB between 100 and 200 mg administered once or twice daily in combination with nab-P + G in 28-day cycles to determine maximum tolerated dose (MTD). Safety, efficacy, pharmacokinetics, and pharmacodynamics were assessed for all …

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Clear Cell Adenocarcinoma Subtype Is An Independent Predictor Of Better Survival In Patients With Lung Adenocarcinoma, Takefumi Komiya Md

PCI Publications and Projects

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Background:

Clear cell adenocarcinoma (CCA) has been considered as a rare subtype of lung adenocarcinoma. However, the 2011 World Health Organization (WHO) classification of lung adenocarcinoma proposed to discontinue CCA due to lack of available data with clinical significance. The role of CCA in patient prognosis needs to be investigated by using large data sources.

Methods:

Lung adenocarcinoma patients were queried from The Surveillance, Epidemiology, and End Results Program (SEER) database and were divided into CCA and ‘not otherwise specified’ category (NOS). Cancer-specific survival was studied according to gender (male, female), age (0-69,70+), SEER specific stage A system (localized, regional …

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14th Annual Parkview Research Symposium, Michael J. Mirro, Neil Sharma, Tammy Toscos, Roy Robertson Md, Micah Smith Md, Jason Voorhies Md

Presentations and Events

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14th Annual Parkview Research Symposium: Innovative Interventions in Healthcare

Objectives

* Discuss latest innovative interventions in informatics, oncology, cardiology, orthopedids and neurosurgery.

* Develop a strategy for efficient diagnosis and treatment planning using the latest innovative techniques and research findings in informatics, oncology, cardiology, orthopedics and neurosurgery.

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