bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A088: Perceived barriers for participating in areca (betel) nut cessation
Authors: Sotto Patrick Francis P. , Mendez Ana Joy , Herzog Thaddeus A. , Cruz Casierra , Chennaux Jade S.N. , Legdesog Chandra , Paulino Yvette C.
Published: August 2020

Background: Areca (betel) nut is a known carcinogenic substance consumed by 11% of the population in Guam. To address this rising public health concern, a cessation program was piloted for chewers. Results of the pilot were used to inform the delivery of the Betel Nut Intervention Trial (ClinicalTrials.gov ID: NCT02942745). Despite the intent of the program to help individuals overcome a potentially harmful behavior, recruiting betel nut chewers is difficult. Therefore, the purpose of this study is to explore the perception of betel nut among chewers and nonchewers in Guam, and to identify the factors preventing a chewer from wanting to quit and from wanting to join the cessation program.

Design: Individual and group discussions were facilitated, utilizing questions designed to elicit responses relevant to perception of betel nut. Questions were adjusted to accommodate both chewer and nonchewer participants. Recurrent themes were extracted from the interviews and categorized into reasons associated with quitting and with joining a cessation program.

Results: Nine interviews were facilitated with 17 chewer and nonchewer residents in Guam, with mean age = 36.4 years (standard deviation = 12.4). Results yielded 5 general categories, aggregated by chewer and nonchewer responses. Subcategories were further extracted to determine barriers for quitting (e.g., addiction, sociocultural importance, betel nut is harmless), and barriers to joining a cessation program (e.g., time, transportation, hypocrisy).

Conclusions: Factors associated with reasons not to quit chewing and not to participate in a cessation program are variable. Current findings highlight a lack of available information regarding the harmful effects of betel nut consumption (i.e., carcinogenicity). The social and cultural construct within Guam's community may be a highly contributing factor to the overall acceptability of betel nut consumption practices, and for the lack of expressed need to quit. In addition, the findings also suggest that a cessation program designed for betel nut chewers should be mobilized to accommodate a chewer's time and transportation restraints. Future considerations include the implementation of betel nut health outcomes into a youth curriculum, and the development of a cessation program both convenient to chewers and specific to young betel nut chewers.

Citation Format: Patrick Francis P. Sotto, Ana Joy Mendez, Thaddeus A. Herzog, Casierra Cruz, Jade S.N. Chennaux, Chandra Legdesog, Yvette C. Paulino. Perceived barriers for participating in areca (betel) nut cessation [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A088.
Abstract A093: Employment and work experiences after breast cancer treatment
Authors: Ekenga Christine C. , McElwain Cora , Perez Maria , Jeffe Donna B.
Published: August 2020

Background: Employment is a social determinant of health. However, few longitudinal studies have examined employment outcomes in African-American women with breast cancer. We examined factors associated with return to work over 2-year follow-up in a sample of African-American breast cancer patients participating in a randomized controlled trial of a cancer-information intervention's impact (vs. standard of care) on quality-of-life and treatment adherence outcomes.

Methods: Interview and medical-record data from 227 newly diagnosed African-American breast cancer patients (stage 0-III), who enrolled a mean 6 days from surgical post-op visit or start of neoadjuvant therapy, were analyzed in association with return to work; four more interviews were conducted over two years. Potential predictors included sociodemographic variables (age, marital status, income, education, insurance status), treatment(s) received (surgery type, chemotherapy, radiation), comorbidity, and elevated depressed mood (Center for Epidemiologic Studies Depression Scale [CES-D] score > 15). Multivariable logistic regression models were used to identify factors independently associated with return to work.

Results: At enrollment, 100 patients (44%) were employed part- or full-time; 71 of employed patients returned to work during 2-year follow-up. Study arm and other treatment and sociodemographic variables were not significantly associated with return to work and was not included in the final model. Patients with elevated depressed mood at baseline were less likely to return to work than nondepressed patients (adjusted odds ratio = 5.8, 95% CI = 1.7-9.3).

Conclusions: Patients with elevated depressed mood were less likely to return to work over 2-year follow-up. Screening for depressed mood at diagnosis and providing treatment might be an effective strategy to improve continued workforce participation in African-American breast cancer patients.

Citation Format: Christine C. Ekenga, Cora McElwain, Maria Perez, Donna B. Jeffe. Employment and work experiences after breast cancer treatment [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A093.
Abstract A094: The relationship between migration and integration stressors and tobacco use in a migrant Mixteco community
Authors: Lopez Gilberto , Mattie Heather , Rees Vaughan , Williams David R.
Published: August 2020

Cigarette smoking is one of the leading causes of chronic disease morbidity and mortality across the world. In the U.S., Latinos have a lower prevalence of smoking when compared to other ethnic/racial groups, but when disaggregated there exist significant differences within Latino subgroups (Bandeira et al., 2015). In the scientific literature, little attention has been given to tobacco use among indigenous Mexican migrants. This study analyzes the relationship between experiences (stressors) linked to migration and tobacco use in an indigenous Mixteco migrant community. Migration stressors include the negative experiences on an individual's journey to the United States while integration stressors are the negative experiences of integrating into society once arriving in the U.S. We hypothesize that there is a significant relationship between the level of migration and integration stressors and tobacco use. A sample of 901 indigenous Mixteco participants from a high-emigrating town in the southern Mexican state of Oaxaca completed structured questionnaires focused on migration history, demographics, and health outcomes. In the US, cross-sectional data were collected in the corresponding satellite communities in southern California. Statistical analyses were conducted using Stata 15 and R version 3.4.3. We generated descriptive statistics for sample characteristics, which are stratified by gender (men/women) and tested for association. A series of logistic regression models were used to predict the association between migration stressors and integration stressors and cigarette smoking. This study yields new information on the relationship between migration, integration, and tobacco use among indigenous Mexican migrants. Although the primary predictor of interest showed no significant association with our outcome, certain findings add to the existing literature on migration and health. These findings include gendered differences in smoking, higher odds of smoking among return migrants, and higher odds of smoking among English language speakers.

Citation Format: Gilberto Lopez, Heather Mattie, Vaughan Rees, David R. Williams. The relationship between migration and integration stressors and tobacco use in a migrant Mixteco community [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A094.
Abstract A096: Smartphone use and accessibility to Internet by cancer patients in a socioeconomically diverse community
Authors: Potdar Rashmika R. , Thomas Arun , Dourado Claudia , Mohiuddin Kamran , Djibo Djeneba Audrey M. , Leighton John C. , Ford Jean G.
Published: August 2020

Introduction: Hospitals are increasingly using different patient engagement platforms to improve patient education, engagement, and satisfaction. Most of these patient engagement platforms are smartphone based. This requires patient awareness and understanding of basic technology. Einstein Medical Center serves a large socioeconomically and racially diverse population in North Philadelphia. We undertook a feasibility study before introducing any patient education/engagement platforms in our population. Our primary objective was to assess the use of smartphones and Internet by cancer patients in a socioeconomically diverse population. Our secondary objective was to assess feasibility of introducing technological platforms to improve patient education, engagement and satisfaction.

Methods: A onetime cross-sectional survey of patients attending the outpatient clinic and infusion center were interviewed by a trained interviewer during a one-week period in July 2018. The questionnaire was designed to assess demographic information, questions related to patients' smartphone and Internet availability, and use for health.

Results: We surveyed 75 patients in one week (N=75). Their ages ranged from 21 to 91 years old. There were 25 (33.3%) male and 50 (66.7%) female patients. Around 32 patients had at least a college education and 42 had a high school level education or less. 53 (71.6%) patients owned a smartphone and all of those owners could browse the Internet and download applications on their phone. 20 (26.67%) patients used an iPhone platform and 34 (45.33%) patients used an Android smartphone. Most of the patients who had a smartphone were willing to download applications that can help monitor their cancer and health.

Conclusion: Though our hospital is located in a socioeconomically disadvantaged area, the vast majority of patients own a smartphone and are willing to use them to monitor their cancer care. We can confidently use this technological advancement to help improve patient education, engagement, and satisfaction in this setting.

Note: This abstract was not presented at the conference.

Citation Format: Rashmika R. Potdar, Arun Thomas, Claudia Dourado, Kamran Mohiuddin, Djeneba Audrey M. Djibo, John C. Leighton, Jean G. Ford. Smartphone use and accessibility to Internet by cancer patients in a socioeconomically diverse community [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A096.
Abstract A101: Hair cortisol measurement in chronic hepatitis B patients
Authors: Hann Hie-Won , Yang Hushan , Meyer Jerrold , Juon Hee-Soon
Published: August 2020

Objectives: It is known that chronic hepatitis B (CHB) infection exerts suppressive effects on the host innate and adaptive immune responses. Although there is information about liver disease progression of CHB patients and the adverse effects of stress on the immune system, few studies focus on the effects of chronic stress in CHB patients. To our best knowledge, this is the first study to measure hair cortisol in CHB patients. To address the prolonged exposure to stress associated with CHB diagnosis, we explored the measure of the stress hormone cortisol (CORT) in the hair as a biomarker of chronic stress in CHB patients.

Methods: Eligible CHB patients identified from an existing patient cohort were enrolled in this prospective study. Data collection were done using medical chart reviews, face-to-face interview in Korean or English, and hair and blood samples. Hair samples were cut from the posterior vertex of the scalp, as close to the scalp as possible. Hair CORT in the most proximal 3-cm scalp hair segment was analyzed using luminescence immunoassay.

Results: We collected hair samples of 50 CHB patients (age 34-74 years) with duration of HBV diagnosis (1-51 years, 23.8±10). Hair samples weighing 19.6 - 29.9 mg were processed and analyzed for cortisol. Mean cortisol levels were 16.42 pg/mg (27.59 SD) ranging from 2.7 to 168.1 pg/mg. About 16% had below normal HCC (<5.5 pg/mg). The rate of distress measured by Distress Thermometer (DT) (defined by the DT cutoff >=4) was 48%. Distress was positively correlated with hair CORT (r=.395, p<.05) among those with below normal CORT.

Conclusion: About one fifth of the patients had very low hair cortisol levels, suggesting long-term suppression of hair cortisol production in the course of HBV diagnosis and antiviral therapy. Low hair cortisol level might indicate a specific pathogenic mechanism with cortisol production. This study suggests further research to determine the longitudinal effects of chronic stress on hair cortisol levels and chronic liver disease progression in CHB patients.

Citation Format: Hie-Won Hann, Hushan Yang, Jerrold Meyer, Hee-Soon Juon. Hair cortisol measurement in chronic hepatitis B patients [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A101.
Abstract A110: Racial disparities in transitional cell carcinoma of the bladder: A population-based study
Authors: Gad Mohamed M. , Saad Anas M. , Obaid Mariam A. , Husseini Muneer J.
Published: August 2020

Introduction: Bladder cancer is among the most common cancers in the U.S. with an estimated 81,190 new cases diagnosed in 2018 as well as 17,240 estimated deaths. The vast majority, around 90%, of bladder cancer cases are transitional cell carcinoma. Due to the significant burden of the disease, and disparities in access to medical care, we aim to study the survival of patients diagnosed with transitional cell carcinoma based on ethnicity.

Methods: Data of White and Black patients with transitional cell carcinoma of the bladder diagnosed between 1973 and 2014 were obtained using the SEER database. We compared the overall and cancer-specific survival of patients using Kaplan-Meier test and Cox models.

Results: We reviewed a total of 199,535 patients with transitional cell carcinoma of the bladder, of whom 10,263 were blacks, while the others were whites. The median overall survival of white patients was 103 months (95%CI, 102.0.34-103.966), which was significantly better than the overall survival of black patients, which was 64 months (95%CI, 60.373-67.627). Bladder cancer-specific survival was also better for whites when compared to blacks. When we adjusted age, sex, grade and stage of cancer, and undergoing surgery for bladder cancer, being black was associated with worse overall survival outcomes and cancer-specific survival outcomes (HR=1.263, 95%CI [1.227-1.300], P<.001) and (HR=1.396, 95%CI [1.342-1.451] P<.001), respectively.

Conclusions: Our results show that significant differences in cancer-specific survival between ethnicities with the majority of diagnosed patients being Whites, while Blacks are suffering from worse survival outcomes. More research can shine a light on the underlying reasons why ethnicity is a significant factor affecting the survival of patients with bladder cancer.

Citation Format: Mohamed M. Gad, Anas M. Saad, Mariam A. Obaid, Muneer J. Husseini. Racial disparities in transitional cell carcinoma of the bladder: A population-based study [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A110.
Abstract A116: University of Guam/University of Hawaii Cancer Center Partnership leads areca (betel) nut research in the Pacific Islands
Authors: Paulino Yvette C. , Biggs Laura , Buente Wayne , Dalisay Francis S. , Farrar Christine E. , Franke Adrian , Hernandez Brenda Y. , Mendez Ana Joy , Penner Reinhold , Pokhrel Pallav , Robinett Hali , Yang Jian , Herzog Thaddeus A.
Published: August 2020

Areca (betel) nut chewing is the 4th most used psychoactive substance in the world and is chewed by approximately 600 million people in the world. In Monograph 85 (2004), the International Agency for Research on Cancer deemed betel nut chewing with and without tobacco an oral carcinogen. In 2006, the NCI-sponsored University of Guam/University of Hawaii Cancer Center Partnership to Advance Cancer Health Equity began to identify areas in the monograph where research efforts were needed, and thus initiated betel nut research in the Western Pacific. Some countries in this region have reported rates of oral cancer mortality as high as 80% compared to the average worldwide 5-year cumulative of less than 50%. Over the past 12 years, a research framework to study betel nut exposure and oral cancer outcomes has evolved within the partnership. To date, 11 betel nut studies have been funded by this partnership: three molecular studies, three population measures studies, three mechanistic studies, and two prevention studies, including an intervention trial. Of the 11 studies, the majority of the research is focused on the measurement of betel nut exposure and carcinogenicity (55%), followed by the measurement of pathological changes (27%) and the prevention of oral cancer (18%). The partnership's investment has resulted in numerous community collaborations, 18 peer-reviewed publications (13 in population sciences and 5 in basic sciences), and contributions to policy prohibiting the sale of betel nut to minors. Betel nut research faculty are also involved in other federally funded research studies with a betel nut component in the Western Pacific region. The partnership's Betel Nut Research Group will continue to strengthen its research infrastructure, contribute to the scientific literature related to betel nut chewing, expand the research to other health outcomes, and translate the findings into appropriate practices, programs, and policies to control and prevent betel nut-associated cancer and other health outcomes in Pacific Island communities.

Citation Format: Yvette C. Paulino, Laura Biggs, Wayne Buente, Francis S. Dalisay, Christine E. Farrar, Adrian Franke, Brenda Y. Hernandez, Ana Joy Mendez, Reinhold Penner, Pallav Pokhrel, Hali Robinett, Jian Yang, Thaddeus A. Herzog. University of Guam/University of Hawaii Cancer Center Partnership leads areca (betel) nut research in the Pacific Islands [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A116.
Abstract B033: Breast cancer and other cause of death among adult women in rural Ethiopia: Presentation and duration of suffering using the direct sisterhood method
Authors: Manamo Wondimu Ayele , Nuramo Adamu Addissie , Andreas Wienke , Gash Fikre Enquselassi , Kantelhardt Eva J.
Published: August 2020

Background: In Ethiopia, breast cancer is the leading cause of cancer morbidity and mortality among women. Studies on breast cancer death are very scarce in Ethiopia. Moreover, little is known about breast cancer compared to other causes of death in Ethiopia, particularly in a rural setting, where there is no registration about the cause of death. Hence, the present study assessed breast cancer and other deaths with a special focus on the duration of suffering in a rural setting using the direct sisterhood method.

Methods: We determined the pattern of causes of death among randomly selected adult women in rural Ethiopia. A modified standard verbal autopsy (VA) questionnaire was filled and reviewed by two independent local physicians to assign causes of death; contradicting diagnoses were reviewed by a third physician. Descriptive statistics with relative frequencies and their 95% confidence intervals (CI) on the basis of the binomial distribution were used. Duration of suffering was taken from the standard verbal autopsy questionnaire.

Result: The median age of breast cancer death was 37 years, younger than the other cause of death. Breast cancer deaths were the second leading neoplasm responsible for 2.7% of all deaths (95% CI 1.5%-3.7%) and among top five noncommunicable diseases death. The median duration of illness for breast cancer deaths, which accounted for only 2.7% of the total cause of death, was above one year. Reproductive neoplasms, breast cancer, and epilepsy were those three causes of deaths with the largest proportion of women (more than 70%) suffering for more than six months compared to all other causes of death.

Conclusion and Recommendation: Breast cancer deaths occurred in younger age groups than other causes of death. This age is considered a young age group as compared to the country overall lifespan. The very long duration of illness for a considerable number of women has practical implications to introduce palliatives care for a cancer patient. Substantial efforts need to be made to improve the prevention and control of breast cancer in order to reduce premature death of women.

Citation Format: Wondimu Ayele Manamo, Adamu Addissie Nuramo, Wienke Andreas, Fikre Enquselassi Gash, Eva J. Kantelhardt. Breast cancer and other cause of death among adult women in rural Ethiopia: Presentation and duration of suffering using the direct sisterhood method [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B033.
Abstract B046: SAHA and EGCG reduce breast cancer migration, possibly through modulation of cIAP2
Authors: Lewis Kayla A. , Tollefsbol Trygve O.
Published: August 2020

Pathways of proliferation, apoptosis, and migration are interconnected. This crosstalk has implications in embryonic development and differentiation, as well as cancer. cIAP2 is an inhibitor of apoptosis that has the ability to indirectly activate genes involved in the epithelial-to-mesenchymal transition (EMT) through controlling ERK/MAPK, TGF-beta, and NF-kappa beta pathways. In this study we used two epigenome-modifying compounds: SAHA, which is a histone deacetylase (HDAC) inhibitor, and EGCG, which is a DNA methyltransferase (DNMT) inhibiting green tea polyphenol. We found that SAHA and EGCG were capable of reducing the migration of four breast cancer cell lines across a fibronectin (FN) matrix. Since cIAP2 can upregulate the expression of FN through TGF-beta, we also investigated the expression of cIAP2 in breast cancer cells with the treatment of SAHA and EGCG and found reduced levels of cIAP2. We conducted apoptosis assays to determine if the decrease in cIAP2 resulted in an increase in breast cancer cell apoptosis. Finally, we evaluated the effects of SAHA and EGCG on mammosphere formation. Mammospheres result when EMT is induced in immortalized or cancerous breast cells. We found that mammosphere formation decreased with the administration of SAHA and EGCG. These findings demonstrate the ability of SAHA and EGCG to reduce breast cancer cell migration while increasing apoptosis through interconnected pathways. Future studies will explore the specific epigenetic modifications associated with the decrease in cIAP2 expression.

Citation Format: Kayla A. Lewis, Trygve O. Tollefsbol. SAHA and EGCG reduce breast cancer migration, possibly through modulation of cIAP2 [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B046.
Abstract B064: Investigation of the breast microbiome and mucosal immune system in African American and non-Hispanic White women with and without breast cancer: A pilot study
Authors: Smith Alana , Reed Breia , Pierre Joseph F. , Lyn-Cook Beverly , Starlard-Davenport Athena
Published: August 2020

Growing evidence shows that an imbalance in the breast microbiome due to inflammation may give rise to cancer development, particularly in non-Hispanic white women. However, there is a lack of data on the role of the breast microbiome among African American women. Since African American women are more likely to develop aggressive forms of breast cancer and die from the disease, we hypothesize that distinct microbial signatures exist in the breast and these signatures differ between normal and breast cancer tissues by race. Using 16S rDNA hypervariable tag sequencing, we identified distinct microbial signatures between normal (n = 40) and breast tumor (n = 61) tissues samples from African American and non-Hispanic white women. Women with breast cancer had a higher abundance of Enterobacteriaceae, Bifidobacteriaceae, Bacteroides, and Streptococcus when compared to women without breast cancer. African American breast tumors (n = 27) had lower abundance of the phyla Proteobacteria, Firmicutes, and Actinobacteria compared to non-Hispanic white breast tumors (n = 34). We further evaluated expression of genes involved in immune response using the Innate and Adaptive RT2 Profiler PCR microarray in breast cancer tissues and adjacent normal tissues from the same donor. Expression of several inflammatory response genes, including CD8, TLR8, and GATA3, were significantly increased in breast tumors compared to adjacent normal breast tissues from the same donor. This study provides preliminary evidence of a breast microbiome in African American women and supports further investigation to identify a microbial risk signature for breast cancer and potential microbial-based prevention therapies.

Citation Format: Alana Smith, Breia Reed, Joseph F. Pierre, Beverly Lyn-Cook, Athena Starlard-Davenport. Investigation of the breast microbiome and mucosal immune system in African American and non-Hispanic White women with and without breast cancer: A pilot study [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B064.
Abstract B070: Loss of cytoskeletal protein palladin desensitizes pancreatic cancer associated fibroblast to TGFβ1-dependent desmoplastic induction
Authors: Alexander Jennifer , Cukierman Edna
Published: August 2020

Pancreatic ductal adenocarcinoma (PDAC) claims ~93% of patient lives in less than 5 years proceeding diagnosis. Therapeutic options for PDAC are challenged by the deposition of a fibrous-like extracellular matrix (ECM) known as desmoplasia. This desmoplastic-ECM (D-ECM) forms the bulk of the tumor mass while remodeling the once tumor-suppressive microenvironment to become tumor permissive. Ironically, ablation of the D-ECM results in an even more aggressive PDAC. Thus, unraveling the mechanism of D-ECM induction is vital to reinstating the natural tumor-restrictive microenvironment of the pancreas. Although the underlying biology remains unclear, the D-ECM is initiated and maintained by activated cancer associated fibroblasts (CAFs). CAF activation is primarily driven by TGFβ1 signaling, which causes cytoskeletal rearrangements in support of CAF-dependent D-ECM onset. As such, the goal of this study is to define the cytoskeletal regulation needed to restore the natural tumor-suppressive properties of the pancreas. Therefore, we focused on the actin cross-linker palladin whose expression is regulated by TGFβ1 and has been identified as an independent prognostic marker for PDAC progression as well as CAF activation. We postulate palladin has an isoform-specific role in PDAC-associated desmoplasia that ultimately fuels cancer progression. Using an in vivo-mimetic 3D stroma model, I used a CRISPR/Cas9 approach to delete one or both of the major palladin isoforms in patient-derived CAFs and assessed CAF's activation via quantitative immunoblots, real-time polymerase chain reaction, and multiplex confocal microscopy in addition to palladin knockout CAF-derived ECM's ability to influence PDAC cell viability and invasive spread. My data indicate that palladin isoforms 3 and 4 are required for TGFβ1-depdendent CAF activation as well as for CAF-dependent D-ECM induction whereby knockdown of either isoform in CAFs results in a normalized ECM that restrains the inherent aggressive nature of PDAC cells. These findings suggest that targeting palladin alters the desmoplastic compartment by impeding tumor progression. Taken together, these results propose a strategy to restore a normal tumor-suppressive stroma in PDAC that will complement current PDAC treatment dogmas.

Citation Format: Jennifer Alexander, Edna Cukierman. Loss of cytoskeletal protein palladin desensitizes pancreatic cancer associated fibroblast to TGFβ1-dependent desmoplastic induction [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B070.
Abstract B084: Factors associated with longer time to surgical treatment in melanoma
Authors: Baranowski Marissa L.H. , Yeung Howa , Chen Suephy C. , Gillespie Theresa W. , Goodman Michael
Published: August 2020

Background: Timely treatment for melanoma may affect survival, and characterizing predictors of treatment delay may inform intervention strategies.

Objective: To determine patient-, provider-, and facility-level characteristics associated with a delay to treatment in melanoma.

Methods: The National Cancer Database was used to examine factors associated with an increased interval between diagnosis and definitive surgical treatment among 205,665 patients with Stage I, II, or III cutaneous melanoma between 2004 and 2015 using multivariable Cox proportional hazards modeling.

Results: The data demonstrated that the direction of the association between age at diagnosis and timing of surgery differed depending on insurance status. Among 115,461 privately insured patients, delay in surgical treatment was associated with older age (HR 0.85 in 70+ years, p <0.0001; HR 0.97 in 50-70 years, p <0.0001). By contrast, in 90,204 patients without private insurance, the association with age was weaker and in the opposite direction (HR 1.09 in 70+ years, p <0.0001; HR 1.09 in 50-70 years, p <0.0001). After adjustment for important patient and disease characteristics, other factors significantly associated with a longer time from diagnosis to surgery included non-white race, higher comorbidity burden, thicker tumor, higher disease stage, and head or neck melanoma location.

Conclusion: Melanoma patients experience disparities in timely receipt of surgery. Identifying groups at risk of delay reveals who would benefit most from patient navigation or care-coordination programs. Public health intervention is warranted to address specific roadblocks contributing to surgical delay to improve care for all patients with melanoma.

Citation Format: Marissa L.H. Baranowski, Howa Yeung, Suephy C. Chen, Theresa W. Gillespie, Michael Goodman. Factors associated with longer time to surgical treatment in melanoma [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B084.
Abstract B124: Indigenizing cancer biobanks as a form of cultural resistance
Authors: Haring Rodney C. , Rodriguez Elisa M. , Henry Whitney Ann E.
Published: August 2020

Purpose/Objective(s): Roswell Park is the oldest comprehensive cancer center in the US, founded in 1868. Roswell is also situated within the largest confederacy of Native American Nations in the Northeast, the Haudenosaunee, People of the Longhouse, also known as the Iroquois. Holdings of Indigenous biospecimens collected and housed in Roswell's biorepository were reported back to Indigenous urban communities and the largest Haudenosaunee Nation in the region. The purpose of the presentation was to share and engage discussion on indigenizing biorepository collections, procedures, storage, and utilization for investigation as a means of cultural resistance.

Materials/Methods: Two projects were conducted. The first reviewed feedback on clincial trial recruitment methods in urban indigenous communiteis related to biospecimen research (n=16, phase 1; n=20, phase 2) and a second study is under way investigating reservation-based and urban perspectives on biobanking storage, perceptions of genetic research, ethics, and policy (n=35 interviews; n=6 focus groups). Both studies utilized a qualitative framework to collect, analyze, and report experiences, perceptions on clinical research, recruitment, biospecimen donation, and investigation. Mulitple analysts were incorporated from interdisciplinary qualitative paradigms, training, cultural backgrounds, and experience to enhance rigor.

Summary: Preliminary results included the process of creating trust through respectful partnerships, understanding the consenting process, respecting traditional views, the need for education on the field of genetics, being congnizant of environmental spaces, and benefit to family and future generations. Other conclusions focused on macro level recommendations for indigenizing cancer-based biorepository collections, procedures, storage, and utilization for investigation as a means of cultural resistance and honoring.

Conclusions: Conversations included conceptualization of macro-level policy initiatives that have the ability to enlighten the process of “Western science” in creating new narratives for future generations and building meaningful biologic specimen research agendas towards culturally attuned prevention and personalized medicine. It is important that unique societies contribute to the science and crucial that science respects the sovereignty of Native Nations to contribute for the benefit of all generations.

Citation Format: Rodney C. Haring, Elisa M. Rodriguez, Whitney Ann E. Henry. Indigenizing cancer biobanks as a form of cultural resistance [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B124.
Abstract C010: The wiring between genes and short noncoding RNAs in cancer depends on race/ethnicity and sex
Authors: Telonis Aristeidis G. , Rigoutsos Isidore
Published: August 2020

Short noncoding RNAs (ncRNAs) have been attracting increasing interest as regulators of messenger RNA (mRNA) abundance. Such regulatory molecules can have influence the abundance of mRNAs both positively and negatively. Two important categories of short ncRNAs are microRNAs (miRNAs) and their isoforms (isomiRs), and the tRNA-derived fragments (tRFs). We previously showed that their “wiring” with mRNA abundance strongly depends on the race/ethnicity in triple-negative breast cancer. Here, we focused on two cancers, bladder urothelial carcinoma (BLCA) and stomach adenocarcinoma (STAD). Men and women have been known to exhibit different incidence rates of BLCA, as well as differences in invasion, and overall aggressiveness. Analogous observations hold true when comparing White and Asian individuals in the case of STAD. We mined a total of 615 primary tumors, 337 from STAD and 278 from BLCA patients. After stringent abundance filtering, we identified 1,478 distinct isomiRs and 355 distinct tRFs. We found that the abundance profiles of these molecules exhibited strong tissue dependencies. We constructed gene co-expression networks for the healthy and disease states. Mining the correlations of isomiRs/tRFs with mRNAs, we found that core cancer pathways are wired with small ncRNAs. We carried out a large-scale computational analysis of the correlation patterns to dissect the dependencies on race/ethnicity and sex in STAD and BLCA, respectively. We found that core pathways are differentially wired in each case. For example, in BLCA, cell cycle genes are linked with several tRFs in one sex but not in the other. While the contribution of isomiRs in sex disparities in BLCA is limited, we find that isomiRs exhibit strong sex-independent associations with immune system responses and extracellular matrix and cell adhesion. In the case of STAD, we observed several instances of differential-by-race/ethnicity correlations of tRFs with genes involved in cell signaling, like ITPA and PICK1 and numerous cell adhesion genes differentially wired with isomiRs. Our data provide a detailed perspective of the structure and hubs of the gene expression networks in BLCA and STAD as well as their sex- and race/ethnicity-specific components. The identification and discovery of context-specific potential regulators have considerable ramifications for precision medicine and can be leveraged to facilitate the design of better-targeted treatments that are tuned to the patient's sex and race.

Citation Format: Aristeidis G. Telonis, Isidore Rigoutsos. The wiring between genes and short noncoding RNAs in cancer depends on race/ethnicity and sex [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C010.
Abstract C028: Hypoxia-associated genes on disparities in the aggressiveness of prostate cancer
Authors: Espinoza Ingrid C. , Moreno Carlos S. , Gomez Christian R.
Published: August 2020

The incidence of prostate cancer (PCa) is 70% greater and the mortality rate 137% higher in African-American men (AAM) relative to Caucasian-American men (CAM) (Siegel et al., 2016). AAM also show faster tumor growth, higher levels of PSA, and more aggressive disease relative to CAM (Martin et al., 2013). These data, related to the biology of PCa, suggest that biologic mechanisms contribute to PCa health disparities. Because stratification by clinical parameters alone is not sufficient to predict aggressive PCa, there is an unmet need of reliable biomarkers to anticipate outcome and disease progression. This study was designed to identify hypoxia-associated genes with the potential to anticipate the risk of aggressive PCa in a race-specific manner. Seventy annotated cases with documented follow-up for evidence of biochemical recurrence (BCR) were located. Of these, 22 were AAM (8 with BCR and 14 without BCR) and 48 were CAM (31 with BCR and 17 without BCR). Next, we performed a global sequencing analysis in RNA extracted from formalin-fixed, paraffin-embedded blocks. Among 27 hypoxia-associated genes associated with race and PCa by use of Cox proportional hazards regression analysis (p ≤ 0.05), we identified three genes related with BCR and race: regulator of G-protein signaling 1 (RGS1), nuclear receptor subfamily 3, group C, member 1-glucocorticoid receptor (NR3C1), and myosin light chain kinase (MYLK). A race-independent in silico analysis utilizing TCGA data suggested tumor-specific association between transcripts of RGS1, NR3C1, and MYLK and Gleason score. Likewise, low expression of these transcripts was suggestive of poor survival. Currently, we are analyzing transcripts of these three hypoxia-associated genes by independent techniques. Integration of gene expression data with clinical parameters of prognosis will allow us to develop predictive scores. These studies may enable race-specific differentiation of patients at higher and lower risk of BCR. Our findings underscore the prognostic value of hypoxia-regulated genes in aggressive PCa. They also warrant studies to establish the relevance of RGS1, NR3C1, and MYLK as race-specific markers.

Funding sources: GMaP 2 Pilot Grant (IE).

Citation Format: Ingrid C. Espinoza, Carlos S. Moreno, Christian R. Gomez. Hypoxia-associated genes on disparities in the aggressiveness of prostate cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C028.
Abstract C029: Exosomes-associated miR-5001, miR-3692 and miR-4529 are novel biomarkers for aggressive prostate cancer and associated with poor prognosis in African American patients
Authors: Gaballa Rofaida , Gaballah Mohamed , Ali Hamdy E.A. , Sholl Andrew S. , Ali Hamed I. , Elmageed Zakaria Y. Abd
Published: August 2020

Background: Although microRNA (miR) profiling has been widely used to predict clinical outcomes, differential miR expressions that can segregate prostate cancer (PCa) patients based on their races and tumor aggressiveness have not been fully investigated. We aimed to determine the diagnostic and prognostic abilities of exosomal miRs to identify the aggressive phenotypes of PCa in African American (AA) men.

Methods: Exosomes were isolated from blood of twenty AA and European Americans (EuA) PCa patients at low and high Gleason scores and their aged-matched healthy subjects (n=20) as well as AA and EuA normal and PCa cells. miR profiling was performed on PCa exosomes derived from blood and PCa cells. The expression level was correlated with clinical outcomes of PCa patients. The sensitivity and specificity of exosomal miRs were assessed using receiver operating characteristic (ROC) curve.

Results: Results from miR profiling showed a number of exosomal miRs that were able to differentiate normal from PCa, low from high Gleason scores and AA from EuA PCa patients. These dysregulated miRs were validated in another cohort of forty PCa patients in addition to a large panel of PCa cell lines. In the validation cohort, miR-5001, miR-3692 and miR-4529 were upregulated in the exosomes derived from blood of AA compared to EuA men. These miRs were correlated with age, T-stage, residual tumor, involvement of lymph nodes, Gleason score, and overall survival of AA patients. The combination of these miRs showed high discriminatory power (AUC=0.91) for segregation of PCa patients according to their clinical outcomes.

Conclusion: miR profiling identified a new set of miRs that can differentiate PCa specimens based on their race and Gleason score. The differential expression of these miRs demonstrates their potential role as biomarkers in the context of racial disparity. Further studies are warranted to determine their role in PCa at advanced stages.

Citation Format: Rofaida Gaballa, Mohamed Gaballah, Hamdy E.A. Ali, Andrew S. Sholl, Hamed I. Ali, Zakaria Y. Abd Elmageed. Exosomes-associated miR-5001, miR-3692 and miR-4529 are novel biomarkers for aggressive prostate cancer and associated with poor prognosis in African American patients [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C029.
Abstract C037: Racial disparity in systemic growth-related oncogene-alpha (GRO-α) expression in head and neck cancer patients
Authors: Moore-Medlin Tara , Mijalis Eleni , Ma Xiaohui , McLarty Jerry , Mills Glenn , Nathan Cherie-Ann
Published: August 2020

Introduction: The objective of this study was to perform an analysis of cytokines reported to be upregulated in cancer patients to determine differences that may exist between Caucasians and African-Americans. Cancer biomarkers aid in identifying therapeutic targets as well as providing information on the involved signaling pathways. As African-Americans are known to present with advanced disease and have poorer survival even in nonmetastatic head and neck cancer, findings may be indicative of a potential therapeutic target for this population.

Methods: In this IRB approved study, we utilized a multiplex bead-based immunoassay by Millipore to compare serum levels of 13 cytokines (FGF-2, GM-CSF, GRO-α, IFNγ, IL-1β, IL-6, IL-8, IL-10, IL-13, IP-10, MIP-1β, TNFα and VEGF) in African-Americans and Caucasians at diagnosis of primary head and neck cancer. Cytokine expression was detected using Luminex xMAP technology with xPonent software, then analyzed using Milliplex Analyst.

Results: Growth-related oncogene-alpha (GRO-α) was the only significantly different cytokine analyzed in regard to ethnicity, where African-Americans (n=36) exhibited higher serum levels in pg/ml compared to Caucasians (n=85) (1287±303.9 and 415.5±50.1, respectively; 95% CI 453.1 to 1290; p<0.0001).

Conclusions: Systemic levels of GRO-α were higher in African-American compared to Caucasian head and neck cancer patients. There is accumulating evidence that GRO-α is overexpressed in human skin, breast, colorectal and hepatocellular cancers. GRO-α has been most notably implicated in cell proliferation, immune response, and as a regulator of tumor invasion and chemoresistance. With the present survival disparities in head and neck cancer patients, this striking overexpression warrants further study into a possible biomarker or targeted therapeutic agent for African-American patients.

Citation Format: Tara Moore-Medlin, Eleni Mijalis, Xiaohui Ma, Jerry McLarty, Glenn Mills, Cherie-Ann Nathan. Racial disparity in systemic growth-related oncogene-alpha (GRO-α) expression in head and neck cancer patients [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C037.