AB 12. Chronomodulated chemotherapy in chemo naïve NSCLC patients
Bibliographic record
Abstract
BACKGROUND: Lung cancer treatment efficiency has reached a plateau during the last decade. Although targeted therapies according to tumors biology and genome expression (pharmacogenomics) have been introduced in the standard care or are under investigation. Therefore new methods of chemotherapy treatment have been investigated in order to augment the efficiency of the already well-established cytotoxic regimens. PATIENTS AND METHODS: Twenty non-small cell lung cancer (NSCLC) chemo naïve patients stage IV were included in the protocol. Sleep disorders were measured with questionnaires (FSS, MRC, Pittsburgh, and ESS), polysomnography and actigraphy for 3 consecutive days. The actigraphy (actiwatch spectrum, Philips, Respironics) was initiated 1 day before treatment when the patient was still at home, the second day when the patient received the platinum analogue doublet and during the 3 day where the patient was still hospitalized for follow up. Laboratory values of ACTH, adrenaline, nor-adrenaline, saliva cortisol (4 measurements/day), morning cortisol and DPD enzyme were collected and measured for 3 consecutive days. The measurements were reevaluated after 3 cycles of chemotherapy. RESULTS: Twenty NSCLC patients entered the protocol and received a doublet of platinum analogue and docetaxel. Two patients were excluded from the protocol since they did not wear the actigraph spectrum watch the proper hours indicated by the treating physicians. No severe hematological toxicity grades 3 or 4 (according to the National Cancer Institute of Canada Common Toxicity Criteria version 3) were observed. An objective tumor response according to the RECIST revised criteria version 1.1 was observed in 10/18 patients. Chronomodulated administration according to the circadian rhythm (rest of cell division of normal cells) is strongly associated with chemo-efficiency (P<0.001). A strong association was observed between circulating hormones and disease status (P<0.006). In addition, sleep disorders were associated with disease status (P<0.005) and normalized with efficient treatment (P<0.003). CONCLUSIONS: Chronomodulate chemotherapy administration is a method to augment the treatment efficiency, however expensive and difficult to perform. Key parameters such as expensive equipment and sleep expert pulmonary physicians are required.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".