bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract LB174: Discovery and preclinical characterization of INCA00186, a humanized monoclonal antibody antagonist of CD73, as a cancer immunotherapy
Authors: Stewart Shaun , Buonpane Rebecca , Zhou Jing , Hansbury Michael , Smith Michael , Wang Hui , Lu  , Su Bin , Awdew Rahel , Huang Cheng-Yen , Kulkarni Ashwini , Harvey Shane , Mondal Arpita , Wang Steve , Stevens Christina , Pratta Michael , Behshad Elham , Fanuka Alexandra , Ren Xiaodi , Koblish Holly , Nastri Horacio , Mayes Patrick
Published: July 2021

In the tumor microenvironment, dying cells release ATP which gets converted to AMP by CD39. AMP is subsequently converted to immunosuppressive adenosine by the extracellular 5'-nucleotidase CD73. CD73 is linked to the cell surface by a GPI-anchor and can be released into the plasma as soluble CD73. In order to lower extracellular levels and reverse the immunosuppressive activity of adenosine in the tumor microenvironment, an antibody was researched and discovered that antagonizes CD73 function. INCA00186 is a humanized monoclonal antibody that binds and inhibits CD73 function. INCA00186 binds human and cynomolgus CD73 with sub-nanomolar affinity, and inhibits CD73 enzymatic activity in a manner that is non-competitive for AMP binding. In functional studies, INCA00186 restored effector T cell proliferation in the presence of high concentrations of AMP. In the human A375 melanoma tumor model in CD34+ humanized NSG mice, INCA00186 decreased levels of cell surface CD73, displayed high receptor occupancy on tumor cells, and decreased CD73 activity in ex vivo assays of tumor homogenates. In the human MDA-MB-231 breast tumor model in CD34+ humanized NSG mice, INCA00186 decreased intratumoral adenosine concentrations. In combination with the novel A2A/A2B adenosine receptor antagonist INCB106385, INCA00186 synergistically restored effector T cell activity as measured by interferon gamma (IFNγ) production in the presence of high concentrations of AMP. In the human MDA-MB-231 breast tumor model in CD34+ humanized NSG mice, combination treatment with INCA00186 and INCB106385 controlled tumor growth significantly better than monotherapies. In summary, the data presented in this study demonstrates that INCA00186 is a potent CD73 antagonist and effectively attenuates adenosine induced immunosuppression in the tumor microenvironment. INCA00186 demonstrated anti-tumor immunity alone and, to a greater extent, in combination with the A2A/A2B adenosine receptor antagonist INCB106385.

Citation Format: Shaun Stewart, Rebecca Buonpane, Jing Zhou, Michael Hansbury, Michael Smith, Hui Wang, Lu, Bin Su, Rahel Awdew, Cheng-Yen Huang, Ashwini Kulkarni, Shane Harvey, Arpita Mondal, Steve Wang, Christina Stevens, Michael Pratta, Elham Behshad, Alexandra Fanuka, Xiaodi Ren, Holly Koblish, Horacio Nastri, Patrick Mayes. Discovery and preclinical characterization of INCA00186, a humanized monoclonal antibody antagonist of CD73, as a cancer immunotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB174.
Abstract LB238: Multiplex immunohistochemistry profiling with UltraPlex IHC on FFPE lung cancer provides a fast and robust staining platform compatible with clinical laboratory workflows
Authors: Tighe-Snyder Helen , Levin Matt , Akhananaghdam Zohreh , Jiang Yanfei , Schwartz David
Published: July 2021

A wide range of technologies are now available to perform multiplex immunofluorescence(mxIF) to examine the tumor immune microenvironment in FFPE tissue sections, offering the potentialto reveal signatures of anti-tumor immune response. However, mxIF assay performance is often limitedby autofluorescence and other artifacts, particularly in lung and prostate cancer samples. These artifactscan frustrate detection even using dedicated instrumentation to obtain images and advanced softwareto identify and measure the different biomarkers. Compared to immunofluorescence,immunohistochemistry (IHC) displays far less background and uses tools readily available in anypathology lab, but IHC has been traditionally difficult to multiplex especially regarding co-localization oncells. Recently, Cell IDx has overcome this barrier by developing UltraPlex™ multiplex IHC (mxIHC),where we leverage Cell IDx's antibody hapten-tagging technology to enable independent detection of 3-4 primary antibodies from any species on a single tissue section, using different chromogen colors todistinguish each biomarker. In this study of various NSCLC tumors, we display how mxIHC can define theTME while maintaining staining integrity. Using UltraPlex™ mxIHC, we demonstrate a useful clinicalchromogenic triple stain of CD8, PD-L1, and panCK with the ability to produce accurate quantitation forphenotype subsets. Our result show that UltraPlex™ mxIHC on FFPE tissue sections can provideincreased confidence for multiplexing on challenging tissues while requiring only conventionallaboratory methods and apparatus.

Citation Format: Helen Tighe-Snyder, Matt Levin, Zohreh Akhananaghdam, Yanfei Jiang, David Schwartz. Multiplex immunohistochemistry profiling with UltraPlex IHC on FFPE lung cancer provides a fast and robust staining platform compatible with clinical laboratory workflows [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB238.
Abstract ND03: PD1-IL2v: A next generation, PD-1-targeted cytokine
Authors: Umana Pablo
Published: July 2021

High dose interleukin-2 (IL-2) has been the first effective cancer immunotherapy to treat metastatic melanoma and renal cell carcinoma, but its clinical use is limited due to toxicity and the detrimental expansion of regulatory T cells (Tregs). As both of these issues are compounded by binding to IL-2Ra (CD25), second generation IL-2 and IL-15 molecules ("IL2Rbg-biased agonists"), engineered to bind preferentially or exclusively to the intermediate-affinity IL-2R but not to CD25, are currently in clinical trials. However, reduced CD25 binding limits the ability of these 2nd generation cytokines for expansion of tumor antigen-specific T-cells. We have now generated a novel PD-1-targeted IL-2 variant (IL2v), by fusing a high-affinity anti-PD-1 antibody to an IL2v with abolished binding to CD25. High-affinity PD-1 binding allows IL2v to effectively expand tumor-antigen specific T-cells, and to differentiate those cells towards better, non-dysfunctional immune effectors, to much higher levels vs. anti-PD-1/-L1 antibodies alone or in combination with either tolerable doses of standard IL-2 or with a non-PD-1-targeted 2nd generation IL-2Rbg agonist currently in clinical development, and thus mediate significantly superior anti-tumor efficacy at well tolerated drug doses. PD1-IL2v is currently being tested in a Ph1 clinical trial.

Citation Format: Pablo Umana. PD1-IL2v: A next generation, PD-1-targeted cytokine [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr ND03.
Abstract ND07: HER2-TTC: A Targeted thorium conjugate to treat HER2 expressing cancers with potent alpha radiation
Authors: Karlsson Jenny
Published: July 2021

HER2-TTC (BAY 2701439) is a new representative of the Targeted Thorium Conjugates (TTCs), a novel class of radiotherapeutics for the treatment of cancer. It is comprised of the α-particle emitter thorium-227 complexed to a 3,2-HOPO chelator and conjugated to a human epidermal growth factor receptor 2 (HER2) targeted monoclonal antibody derived from trastuzumab. The targeted binding of HER2-TTC exposes tumor cells that express HER2 to a cytotoxic dose of alpha radiation. The high energy alpha-particles induce clustered double-strand DNA damage in targeted and adjacent tumor cells, which have a high likelihood to result in cell death in a cell cycle-independent fashion. Alpha particles have a short range of < 100 μm (less than 10 cell diameters), which minimizes damage to surrounding healthy tissue. The mechanism of action for TTCs is not dependent on any specific tumor type or affected by known resistance mechanisms provided that the target tumor epitope continues to be expressed. Potential combinations with inhibitors of DNA damage response (DDR) pathways may lead to synergistic anti-tumor activity. Preclinically, HER2-TTC has demonstrated substantial and selective anti-tumor activity in different models including breast, gastric, lung, bladder, colorectal cancer, with a range of HER2 expressions (IHC scores of 1+ to 3+). These included trastuzumab and T-DM1 resistant models, and models with low HER2 expression (IHC2+/ISH- or IHC1+). HER2-TTC has also demonstrated synergistic efficacy in combination with olaparib in a BRCAmut model. Preclinical data also support potential combinations with immune oncology agents, likely due to immunogenic cell death induced by alpha radiation. HER2-TTC has recently entered a First in Human study (NCT04147819) in patients with advanced tumors that express HER2. These include HER2 high expressing (IHC3+ or ISH+) breast and gastric/gastroesophageal carcinoma relapsed/refractory to trastuzumab/T-DM1, cancers with low HER2 expression, and other tumors that express HER2 such as colorectal cancer, non-small cell lung cancer, salivary, bladder and endometrial tumors.

Citation Format: Jenny Karlsson. HER2-TTC: A Targeted thorium conjugate to treat HER2 expressing cancers with potent alpha radiation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr ND07.
Abstract 10: The Evolution of Parents' Beliefs about Childhood Cancer: A Qualitative Study in Guatemala
Authors: Graetz Dylan , Rivas Silvia , Fuentes Lucia , Caceres-Serrano Annie , Ferrara Gia , Antillon-Klussmann  , Metzger Monika , Rodriguez-Galindo Carlos , Mack Jennifer
Published: July 2021

Purpose: Ninety percent of children with cancer live in low- and middle-income countries, and fewer than 40% survive. In these countries, rates of treatment abandonment can be up to 50-60%, contributing to the mortality gap. Fatalistic cancer beliefs may lead to delayed diagnosis and poor outcomes, including treatment abandonment. This study explored the evolution of Guatemalan parents' cancer beliefs during initial pediatric cancer communication, and the sociocultural and contextual factors that influence these beliefs.

Methods: Twenty families of children with cancer were included in this study. We audio-recorded initial psychosocial and diagnostic conversations between parents, psychologists, and oncologists, then conducted semi-structured interviews with parents. Audio-recordings were transcribed and translated from Spanish into English and thematically analyzed.

Results: Guatemalan parents' beliefs evolve as they learn about cancer through various sources. Sources of information external to the cancer center, including prior experiences with cancer, media exposure, community discussion, and clinical encounters, contribute to pre-existing beliefs, many of which are fatalistic and influenced by Mayan spirituality. Sources internal to the cancer center include psychologists and oncologists, other providers, other patients and families. Psychologists acknowledge pre-existing beliefs and deliver cancer education using verbal explanations and hand-drawings. Oncologists provide diagnostic information and outline treatment plans. Both support hope by providing a path toward cure. Parents' lived experience is a culmination of sources and simultaneously independent. Ultimately most parents arrive at an understanding of cancer that is consistent with an allopathic medical model and offers optimism about outcomes.

Conclusion: An interdisciplinary communication process that includes multimedia education, is attentive to pre-existing beliefs, and supports hope may encourage acceptance of the allopathic model and need for treatment. Providers in settings of all resource levels may be able to use these techniques to support cross-cultural cancer communication, reduce treatment abandonment, and improve therapy adherence.

Citation Format: Dylan Graetz, Silvia Rivas, Lucia Fuentes, Annie Caceres-Serrano, Gia Ferrara, Antillon-Klussmann, Monika Metzger, Carlos Rodriguez-Galindo, Jennifer Mack. The Evolution of Parents' Beliefs about Childhood Cancer: A Qualitative Study in Guatemala [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 10.
Abstract 102: Breakpoints in Protocol Compliance and Their Influence on Outcomes for Children with Wilms Tumor in Northern Tanzania
Authors: Wesevich Austin , George Mocha , Kiwara Frank , Chao Colin , Shabani Idd , Igenge John , Schroeder Kristin
Published: July 2021

Purpose: Standardized treatment protocols for Wilms tumor have been developed for use in low- and middle-income countries (LMICs), but equivalent outcomes as high-income countries are not achieved outside of clinical trials. To identify critical breakpoints in protocol adherence contributing to reduced outcomes, we evaluated treatment compliance and impact of the completion of each stage of therapy on outcomes for Wilms tumor patients at a regional cancer referral hospital in northern Tanzania.

Methods: This is a retrospective single-center cohort study for children diagnosed with Wilms tumor from 2016-2019 in Tanzania, treated per the International Society of Pediatric Oncology (SIOP) Africa adapted (2016-17) or standard (2018-19) therapy protocols. Treatment compliance was evaluated for both timing of chemotherapy initiation, and completion of risk-adapted therapy duration per protocol.

Results: A total of 72 patients were evaluated. The two-year overall survival and event-free survival rates were 44% and 27%, respectively. Only 22% of patients completed recommended chemotherapy per protocol. There were delays at each stage of treatment, especially time to surgery (74 days), pathology report (32 days), and initiation of postoperative chemotherapy (39 days). A total of 38% of patients abandoned care, with 44% of abandonment occurring prior to surgery, 30% immediately after surgery, and 26% during post-operative chemotherapy. Compliance with surgical resection (p=0.05) and postoperative chemotherapy (p=0.04) were predictive of two-year overall survival.

Conclusion: Standardized Wilms tumor treatment protocol compliance outside of clinical trials is low in many LMICs. In the current study, noncompliance with recommended chemotherapy correlated to reduced overall survival rates, with several identified key health system delays contributing to poor compliance. Future interventions targeting health system delays are critical to improve protocol compliance, increasing overall survival for pediatric Wilms tumor patients in LMICs.

Citation Format: Austin Wesevich, Mocha George, Frank Kiwara, Colin Chao, Idd Shabani, John Igenge, Kristin Schroeder. Breakpoints in Protocol Compliance and Their Influence on Outcomes for Children with Wilms Tumor in Northern Tanzania [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 102.
Abstract 107: Self-Reported Physical Activity Patterns among Colorectal Cancer Survivors in Egypt
Authors: Aly Salma Mohamed , Genena Doaa , Shikany James , Bateman Lori Brand , Fouad Mona , Arafat Waleed , Abdelmoneim Salah-Eldin , Bae Sejong , Scarinci Isabel , Hussein Marwa , Zaki Miriam A. , Khamess Somaia , Rogers Laura Q.
Published: July 2021

Purpose: Compared to the U.S., colorectal cancer (CRC) in Egypt is more prevalent among younger individuals (under age 40) and diagnosed at an advanced stage leading to higher mortality rates. Given these higher mortality rates, focusing on tertiary prevention strategies, such as physical activity, is warranted. Our study purpose was to assess physical activity behavior in colorectal cancer survivors living in Egypt.

Methods: Egyptian study staff recruited 86 participants from the Alexandria University Oncology Department. Eligible participants were post-primary or currently undergoing treatment for CRC. Study staff administered the World Health Organization physical activity questionnaire (GPAQ; www.who.int/chp/steps/GPAQ/en/) and Godin Leisure-Time Exercise Questionnaire (GLTEQ). Both assessments were translated into Arabic.

Results: The median age of study participants was 52 years old with 43% being male, 64% reporting early stage cancer, 77% reporting one or more years of school, and 79% living in an urban location. Most participants (76%) had a normal or overweight BMI. According to the GPAQ, the median total MET mins/wk for participants was 1440 with interquartile range of 225 to 6720; 63% of participants met the GPAQ WHO recommendations of ≥600 MET mins/wk. Occupational and transportation contributed to the majority of total MET mins/wk. According to the GLTEQ, the median for weekly minutes of ≥moderate intensity physical activity was 0 with interquartile range of 0 to 23 minutes per week. Only 14% were meeting physical activity recommendations of ≥150 weekly minutes of ≥moderate intensity physical activity based on the GLTEQ.

Conclusion: The prevalence of meeting physical activity recommendations varies depending on measurement tool used. Considering sources of physical activity beyond recreational alone is important for more fully understanding physical activity behavior. The low levels of recreational or leisure exercise provides an opportunity for increasing the prevalence of sufficient physical activity in CRC survivors in Egypt.

Citation Format: Salma Mohamed Aly, Doaa Genena, James Shikany, Lori Brand Bateman, Mona Fouad, Waleed Arafat, Salah-Eldin Abdelmoneim, Sejong Bae, Isabel Scarinci, Marwa Hussein, Miriam A. Zaki, Somaia Khamess, Laura Q. Rogers. Self-Reported Physical Activity Patterns among Colorectal Cancer Survivors in Egypt [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 107.
Abstract 109: A Longitudinal Telehealth Curriculum for Radiation Oncology Centers in Low and Middle-Income Countries Transitioning from 2D to 3D External Beam Radiation Therapy
Authors: Yang Fei , Carter Raymond , Ahmed Soha , Plautz Tia , Dubrowski Piotr , Wadi-Ramahi Shada , Ashmeg Sarah , Ascoli Frank , Wakefield Daniel , Adamson Justus , Li Benjamin
Published: July 2021

Purpose: The transition from 2-dimensional (2D) to 3-dimensional (3D) external beam radiation therapy (EBRT) can dramatically improve the quality of radiotherapy in low and middle-income countries (LMICs); however, many cancer centers in LMICs lack training support to effectively make this transition. Remote training is a low-cost, accessible option to bridge this gap, and we sought to evaluate the efficacy of such a program.

Methods: The nonprofit Rayos Contra Cancer identified 9 LMIC operational cancer centers in the Middle East and Northern Africa that had recently acquired technology to transition from 2D to 3D EBRT. Baseline information for each center was collected electronically, then a team of EBRT content experts developed a 12-week, 25-session continuing medical education curriculum. Each session invited live participation using Zoom video communications and lasted 1 - 2 hours. Participants were administered a Likert scale (1-5) confidence evaluation on 13 foundational topics in 3D EBRT and a 49-point knowledge-based multiple-choice examination pre- and post- curriculum. Anonymous feedback with 1-5 satisfaction scores for each session was solicited midway and at the conclusion of the curriculum. Training was provided for free.

Results: Among centers, 260 participants enrolled in training, including 39 medical physicists, 36 radiation oncologists, 54 radiation therapists, 15 dosimetrists, and 116 in training or other roles. Pre- and post-curriculum average examination scores were 22.95/49 (53.4%, N = 171) and 30.76/49 (62.8%, N=87), respectively. Pre- and post-curriculum confidence evaluation showed an average of 1.4/5 (27.7%, N=260) and 3.86 (77.2%, N=74) confidence among 13 topics. Satisfaction surveys (halfway N=51, end N=48) showed high satisfaction with helpfulness (4.3/5) enjoyableness (4.2/5), and well-preparedness (4.4/5) of sessions.

Conclusion: Satisfaction, confidence, and knowledge domains were all measured with favorable results. This innovative low-cost telehealth model for EBRT training is a promising vehicle for advancing cancer care in LMICs by providing educational support.

Citation Format: Fei Yang, Raymond Carter, Soha Ahmed, Tia Plautz, Piotr Dubrowski, Shada Wadi-Ramahi, Sarah Ashmeg, Frank Ascoli, Daniel Wakefield, Justus Adamson, Benjamin Li. A Longitudinal Telehealth Curriculum for Radiation Oncology Centers in Low and Middle-Income Countries Transitioning from 2D to 3D External Beam Radiation Therapy [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 109.
Abstract 11: Neglected Elements of Cancer Control During The COVID-19 Pandemic in Africa: Call for Action from 2019-2020 African Cancer Research and Control ECHO Programme
Authors: Nakaganda Annet , Lasebikan Nwamaka , Garton Elise M. , Kithaka Benda , Cira Mishka K.
Published: July 2021

Purpose: As the world is learning to live with the coronavirus (COVID-19) pandemic, there is a shift in cancer control priorities and focus, with innovations to ensure continuity of cancer treatment and patient support during the COVID-19 pandemic. However, cancer control requires a comprehensive approach to minimize cancer incidence, mortality and improve the quality of life of those living with cancer. Hence, this analysis aimed to identify areas of cancer control affected by the COVID-19 pandemic that would equally affect cancer incidence, morbidity and mortality in Africa.

Methods: The Africa Cancer Research and Control ECHO® Programme (Africa Cancer ECHO) is a community of practice that meets in an online platform to discuss cancer control challenges and solutions in the Africa region. The Africa Cancer ECHO conducted eleven sessions from April to August 2020 about the emerging COVID-19 pandemic, its impact on cancer control in Africa, and country-level practices as presented through case and didactic presentations. Sessions were analysed thematically to identify elements of cancer control that are adversely affected as a result of the COVID-19 pandemic and how they have been addressed.

Results: HPV vaccination, cancer screening and early detection services, palliative care (PC) services, and cancer registration were particularly adversely affected, and in many cases have not yet resumed in some African countries. Recommendations included: use of affordable point of care HPV tests with immediate results; introducing COVID-19 testing along with HPV-testing; transitioning PC services from hospice to home care; and embracing Information Technology to enhance cancer registration.

Conclusion: Cancer prevention, screening, supportive care, and surveillance services need to be urgently revitalised in Africa. The Africa Cancer ECHO platform highlights the need for generation of locally-relevant, evidence-based strategies that will safeguard past gains and continue to maximize the reduction of cancer incidence, morbidity and mortality during the COVID-19 pandemic.

Citation Format: Annet Nakaganda, Nwamaka Lasebikan, Elise M. Garton, Benda Kithaka, Mishka K. Cira. Neglected Elements of Cancer Control During The COVID-19 Pandemic in Africa: Call for Action from 2019-2020 African Cancer Research and Control ECHO Programme [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 11.
Abstract 111: Colorectal Cancer Presentation and Survival Outcomes in Nigeria: A Prospective Multi-Centre Cohort Study of 543 Patients
Authors: Aderibigbe Adeniyi , Dare Anna , Knapp Gregory , Alatise Olusegan , Kingham T. Peter
Published: July 2021

Purpose: Prospective data on colorectal cancer (CRC) presentation and outcomes in Nigeria is limited, however emergency presentation with advanced disease is thought to be common. Using the African Research Group for Oncology's prospective, multisite database of CRC patients in Southwest Nigeria, we evaluated risk factors for emergency CRC presentation and effects on overall survival (OS).

Methods: Consecutive CRC patients presenting between 2013 and May 2020 to five referral sites were included. Demographic, socioeconomic and disease-related risk factors for emergency presentation were evaluated using univariate and multivariable logistic regression methods. We compared OS between emergency and elective patients, stratified for clinical stage, using Kaplan-Meier survival and Cox proportional hazards methods.

Results: Of 543 CRC patients, 168 (30.9%) presented emergently. Median age at diagnosis was 55 years, 53% were male, and 4.8% reported a family history of cancer. Patients presenting emergently were more likely to have cancers proximal to the splenic flexure (41.1% vs 24.6%, p<0.001), stage IV disease (62.7% vs 43.4%, p<0.001) use non-motorized transport (54.4% vs 37.7%, p=0.001), have a lower median household income (USD$65/month vs $USD79/month, p<0.04), and lower education level than those presenting electively. On multivariable regression analysis, only low BMI, stage IV disease, mode of transport and hospital site were significantly associated with emergency presentation. Median OS was 5.4 months (IQR 0.9-14.5; n=146) in the emergency group compared to 10.7 months (IQR 3/8-22.5; n=375) among elective patients. After adjustment for clinical stage at diagnosis, emergency presentation was still associated with significantly worse OS (HR 1.52; 95% C.I. 1.36-1.63, p<0.001).

Conclusion: A high proportion of CRC patients in Nigeria present emergently, with advanced disease. Even after adjusting for clinical stage, these patients have worse overall survival. Earlier detection of cancers, including removing barriers to timely presentation and diagnosis, should be a focus of cancer control efforts.

Citation Format: Adeniyi Aderibigbe, Anna Dare, Gregory Knapp, Olusegan Alatise, T. Peter Kingham. Colorectal Cancer Presentation and Survival Outcomes in Nigeria: A Prospective Multi-Centre Cohort Study of 543 Patients [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 111.
Abstract 112: Use of WhatsApp to Improve Medical Provider Communication for Children with Wilms Tumor in Tanzania
Authors: Igenge John , Stocks Jacob , Zhang Gloria , George Mocha , Kiwara Frank , Mafwimbo Judy , Maxmilian Mastidia , Wesevich Austin , Schroeder Kristin
Published: July 2021

Purpose: Due to the rapid expansion of mobile phone usage throughout the world, mobile health (mHealth) technologies offer an innovative strategy to overcome challenges of care coordination and limited communication between pediatric cancer providers in LMICs. Our objective was to evaluate the use of the social media application WhatsApp to improve provider communication and outcomes for children diagnosed with Wilms tumor at a regional cancer treatment facility in Tanzania.

Methods: A WhatsApp provider group was established in 2016 to facilitate communication between surgical, medical and psychosocial support providers at the regional cancer referral hospital in northern Tanzania. All messages exchanged from 2016-2019 were extracted and coded for thematic content. Treatment compliance and process outcomes were compared for patients discussed versus those that were not over the 4-year period.

Results: A total of 669 messages for 55 patients were reviewed. Most messages were sent by the pediatric oncologist (44.8%, n=273) and urology resident (43.2%, n=263). Using the application to coordinate patient care reduced time to surgery from 90 days [IQR 65-109] to 60 days [IQR 47-80], and time to post-operative chemotherapy initiation from 46 days [IQR 39-55] to 19 days [IQR 16-30]. Rate of treatment abandonment was decreased for patients discussed in the chat group (26.7%) compared to those not discussed (38.2%).

Conclusion: To our knowledge this is the first study to assess the use of WhatsApp to improve provider communication for children with cancer in LMICs. As access to smartphone technology and internet access improves, applications like WhatsApp can be used as a low-cost strategy to target health system inefficiencies and improve outcomes for children with cancer globally.

Citation Format: John Igenge, Jacob Stocks, Gloria Zhang, Mocha George, Frank Kiwara, Judy Mafwimbo, Mastidia Maxmilian, Austin Wesevich, Kristin Schroeder. Use of WhatsApp to Improve Medical Provider Communication for Children with Wilms Tumor in Tanzania [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 112.
Abstract 22: Screening and Treatment of Female Sex Workers for Cervical Precancers in Cameroon
Authors: Manga Simon , Nulah Kathleen , Manjuh Florence , Fokom Joel , Ngatchou Denisse , Welty Edith , Shete Sanjay , Liang Margaret , Welty Thomas
Published: July 2021

Purpose: To prevent cervical cancer among female sex workers (FSWs) who are at high risk of acquiring HPV infections (through occupational exposure) that may progress to invasive cervical cancer (ICC) if not treated.

Methods: With funding from a Prevent Cancer Foundation grant and in collaboration with Horizons Femmes, an NGO that provides services to FSWs, the Women's Health Program (WHP) of the Cameroon Baptist Convention Health Services screened FSWs in three large Cameroonian cities with visual inspection with acetic acid and Lugol's iodine (VIA/VILI) enhanced by digital cervicography (DC) and collected vaginal specimens from FSWs aged 30+ years for AmpFire HPV genotyping.

Results: Of the 757 FSWs who were screened in August 2020, 510 (67.4%) were aged 30 or over, 308 (60.4%) had one or more high risk HPV types and 47(9.2%) had positive VIA/VILI-DC (34 with ablative eligible lesions and 13 with LEEP eligible lesions). Of the women less than age 30, 27(10.9%) had positive VIA/VILI-DC (92.6% with ablative and 7.4% LEEP eligible lesions). Of the 74 women with ablative and LEEP eligible lesions, 38 (64.4%) and 8 (53.3%) respectively were treated. Of 272 women aged 30+years who were HPV positive but DC negative, 61 (22.4%) were treated with thermal ablation. The WHP continues to follow up on FSWs who need treatment and is analyzing HPV genotypes' frequency and their relation to the VIA/VILI-DC results.

Conclusions: With appropriate education and support, FSWs can be screened for cervical cancer and a high proportion of those with positive screening tests can be appropriately treated to reduce their risk of ICC.

Citation Format: Simon Manga, Kathleen Nulah, Florence Manjuh, Joel Fokom, Denisse Ngatchou, Edith Welty, Sanjay Shete, Margaret Liang, Thomas Welty. Screening and Treatment of Female Sex Workers for Cervical Precancers in Cameroon [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 22.
Abstract 25: End User Support for Telemedicine Oncology Care in Sub Saharan Africa
Authors: Sigu Lamech , Achieng Emmah , Asirwa Chite , Kitur Gloria
Published: July 2021

Purpose: Health Information Technology has hugely improved patient healthcare with fast and simple information access and communication. Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. International Cancer Institute (ICI) number one goal is to provide end-to-end solutions for optimization of care on patients' journey in sub-Saharan Africa. Supporting the end-user clearly shows there is a lot going on “under the skin” in healthcare Information technology (IT) to bring information access to life and patients closer to the oncology experts. Methods: In 2020, ICI IT team provided end-user support in bi-weekly multidisciplinary oncology –tumour boards with specialists from Africa and the world. It also provided support in Provider-to-provider tele-consults for patients in 10 partner counties in Kenya. The IT team also provided online support to healthcare providers to access online oncology preceptorships/training and webinars in different aspects of the cancer control continuum.

Result: The IT team was able to support over 80 Multidisciplinary tumor boards, ensuring a team-based care approach to delivering care. Provider-to-provider tele-oncology ensured a platform to support interprofessional care and mentorship to non-specialists in remote sites. It has also provided one on one county patient consultations and hence ensured delivery of cancer services in 10 county government clinics & 8 private health facilities. Over 300 patient consults have been completed. Online platforms have ensured healthcare provider training despite COVID 19 restrictions; ICI has successfully trained over 1000 health care providers using eLearning and online platforms.

Conclusion IT support has successfully provided assistance to physicians, healthcare providers, and patients with technical & non-technical support demonstrating the potential of delivering specialized oncology consultations and improved access to information in primary care settings with limited resources.

Citation Format: Lamech Sigu, Emmah Achieng, Chite Asirwa, Gloria Kitur. End User Support for Telemedicine Oncology Care in Sub Saharan Africa [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 25.
Abstract 29: Demographics, Source of Health Information, and Screening-Related Factors on Interests in Cancer Communication Programs among Church-Based Chinese Adults
Authors: Hou Su-I
Published: July 2021

Purpose: This study examined demographics, source of health information, and screening-related factors on interests in cancer screening communication programs among church-based Chinese adults. In particular, interest in social-media delivered cancer communication programs was analyzed.

Methods: Participants were recruited from 9 Chinese churches. A self-administered survey including items on screening knowledge and beliefs, and sources of health information and preferred delivery strategies was administered. Interests in cancer prevention communication programs were recoded into no (little or medium interests) and yes (high or very high interests).

Results: 372 Chinese participated in the survey, mean age was 44.31 (SD=14.74), 60% males, and the majority had college education (85%). Overall, about 46%-52% got health information from the Internet or social media sites, with internet being the top source of health information (mean=3.46 on 5-point Likert scale). Half showed high interests in social-media cancer communication programs if available. After adjusting for age, gender, marital, and family cancer history, logistic regressions showed those who were single (OR=2.18; p=.021), perceived higher cancer risk (OR=1.47; p=.022), had been a primary cancer caregiver (OR=2.23; p=.026), and had lower screening barriers (OR=.823; p<.001) were more likely to report interests in cancer communication programs (p<.001; 71% correct classification). Analyses further showed that those interested in programs delivered via social media had higher acceptance towards academic social media sites (OR=1.98; p=.002) and believe social media as an effective strategy for health communication (OR=2.41; p=.001).

Conclusions: Current data show beliefs towards social media was the only factor related to interested in program delivered via social media channel; while cancer related factors (higher perceived cancer risk, lower perceived barriers, and cancer caregiver experience) were key to interests in cancer communication programs. Study results has implication on program delivery strategies and identifying potential early adopters for cancer communication programs among Chinese adults.

Citation Format: Su-I Hou. Demographics, Source of Health Information, and Screening-Related Factors on Interests in Cancer Communication Programs among Church-Based Chinese Adults [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 29.
Abstract 33: Characterizing the Changes in Mechanical Properties of the Actin Cortex in Highly Metastatic Cancers
Authors: Neal Jamie , Smith Chynna , Baird Michelle , Cartagena-Rivera Alexander
Published: July 2021

Purpose: Cancer is the second leading cause of death globally with approximately 9.5 million cancer related deaths worldwide in 2018. Many of these deaths are the result of complications due to metastatic progression. Metastasis is a complex, dynamic process that requires cancerous cells to undergo major cytoskeletal reorganization prior to migration and intravasation. Previous research studying the biophysical properties of the cytoskeleton utilize techniques that require the cells be adhered to a hard substrate, causing modifications to the organization of the cytoskeleton that are not physiologically relevant. To better understand the mechanics of cancer cells and metastasis, we have developed an alternative approach to studying the cell cortex.

Methods: Utilizing a novel, Atomic Force Microscopy-based, quasi-static force spectroscopy method pioneered by our lab, we are able to measure cortical tension and intracellular pressure by gently compressing non-adherent cells with a tipless cantilever, which results in a more physiologically relevant cortical morphology. We utilized this method to compare changes in cortical mechanics between healthy and cancerous cells, as well during metastatic progression of cancer cells in vitro for melanoma, breast, and ovarian cancers.

Results: Previous research that utilized adherent cells indicated a decrease in stiffness after tumorigenesis, but our method indicates an increase in stiffness by determining the cortical tension and intracellular pressure in the case of melanoma. Additionally, a non-linear, overall decrease in tension and pressure can be seen in both the melanoma and ovarian cell lines that model increasing metastatic potential.

Conclusion: Due to the important role invasiveness plays in the severity of cancer, categorizing the mechanical properties of cancer cells may prove to be a critical diagnostic and prognostic indicator for oncologists. Our novel force microscopy method better captures physiologically relevant cortical morphology and may enable the capture of clinically significant information on tumor invasiveness and progression.

Citation Format: Jamie Neal, Chynna Smith, Michelle Baird, Alexander Cartagena-Rivera. Characterizing the Changes in Mechanical Properties of the Actin Cortex in Highly Metastatic Cancers [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 33.
Abstract 5: Establishment of ASCP Equipment Donation Program to Support International Histopathology Laboratories
Authors: Basu Debby , Tashpulatova Lola , Milner Dan , Landgraf Kenneth
Published: July 2021

Purpose: In order to address the unmet needs of international histopathology laboratories with regard to procurement of laboratory equipment and consumables, the ASCP Center for Global Health has established a program which facilitates donation of these goods to laboratories in need.

Methods: Using a member-based outreach approach, donors with key histopathology laboratory equipment or consumables submit an interest in donation to ASCP. ASCP performs an assessment of the quality and longevity of the donated item. ASCP pairs the donation with a laboratory within the Partners for Cancer Diagnosis and Treatment Initiative network which has expressed need. Recipient lab-specific parameters are further evaluated (e.g. space, voltage compatibility, need for service contract, etc.). Should the donation be a compatible fit, ASCP works with both recipient and international shippers to facilitate the donation.

Results: Since August 2018, ASCP has supported nearly 20 international equipment donations (fair market value of goods totaling approximately $120K) to 12 countries. These donations are composed of routine histopathology lab consumables (e.g. tissue cassettes, glass slides, etc.) as well as specialized equipment (e.g. whole slide imaging scanners, microtomes, microscopes, etc.), basic laboratory operations equipment (e.g. computers, keyboards, etc), and educational materials (e.g. textbooks, etc.).

Conclusions: This donation program allows for redistribution of key histopathology lab equipment and consumables to laboratories in needs. The impact of this program has been far-reaching, both relieving laboratory strain associated with under-procurement often experienced in international laboratories to expanding capacitation of diagnostic testing services including, in some cases, telepathology-based secondary consultations from subspecialty pathologists unavailable in-country.

Citation Format: Debby Basu, Lola Tashpulatova, Dan Milner, Kenneth Landgraf. Establishment of ASCP Equipment Donation Program to Support International Histopathology Laboratories [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 5.
Abstract 56: Landscape and Challenges of Cancer Registration in the Middle East, North Africa and Turkey (MENAT)
Authors: Sater Zahi Abdul , Shamseddine Ali , Taher Ali , Fouad Fouad , Abu-Sitta Ghassan , Fadhil Ibtihal , Saab Raya , Sullivan Richard , Adib Salim M. , Saleh Shadi , Mukherji Deborah
Published: July 2021

Purpose: National and regional cancer control strategies have been identified as essential tools for reducing and managing the growing burden of cancer in low- and middle-income countries. Cancer registration is an instrumental component of any national cancer control strategy. In the Middle East, North-Africa and Turkey (MENAT) region, cancer registration varies immensely across countries and faces multifaceted challenges including protracted conflict. This study maps out the present capacities and outputs of cancer registration in the MENAT region and identifying thematic barriers facing implementation and utilization of cancer registry data.

Methods: We employed a mixed-method approach utilizing a self-administered online survey with open and close ended questions targeting national and institutional cancer registry managers in the MENAT countries. The questions focused on the country-wide and registry-specific status and challenges of cancer registration.

Results: Data from 20 MENAT countries were collected through the online survey. MENAT registry managers reported the presence of 97 population-based registries, 48 hospital-based registries, and 24 pathology-based registries. Most population-based registries were well or partially developed. Lack of accurate death records, complete medical records, communication between stakeholders, and trained personnel were critical challenges. These challenges are more severe in conflict-affected countries (both active conflict zones and neighbouring regions affected by conflict). Cancer registration challenges in these countries included weak health care infrastructure, absence of legislation mandating cancer registration, and cessation or disruption of cancer registration due to active conflict and loss of funding. Furthermore, refugee host countries such as Lebanon, Turkey and Jordan, also reported conflict-related challenges including refugee mobility and lack of accurate data on forced migrants.

Conclusion: This study provides a much-needed understanding of the current landscape and contextual challenges affecting cancer registration in the MENAT, especially in conflict affected settings. These data are important for identifying areas on which to focus regional capacity-strengthening initiatives.

Citation Format: Zahi Abdul Sater, Ali Shamseddine, Ali Taher, Fouad Fouad, Ghassan Abu-Sitta, Ibtihal Fadhil, Raya Saab, Richard Sullivan, Salim M. Adib, Shadi Saleh, Deborah Mukherji. Landscape and Challenges of Cancer Registration in the Middle East, North Africa and Turkey (MENAT) [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 56.