bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract PO-128: Interrogating the role of race-related alternative splicing of SEMA3C in prostate cancer
Authors: Allen Tyler A. , Chandar Jay , Lacroix Bonnie L. , Patierno Steven R. , George Daniel J. , Freedman Jennifer A.
Published: December 2020

The age-adjusted incidence and mortality rates for prostate cancer (PCa) among African American (AA) men are 1.6- and 2.4-fold greater, respectively, than among white men. These disparities likely result from a complex interplay among social, psycho-social, lifestyle, environmental, health system, and biological determinants of health. Despite the contribution of biological determinants of health, very few studies have utilized this population-based difference to identify the molecular mechanisms underlying race-related tumor aggressiveness. We have previously identified Semaphorin 3C (SEMA3C) as a novel alternatively spliced gene in PCa between AA and white patients. SEMA3C has been shown to be associated with increased cancer growth, poor prognosis in lung, breast, gastric, and ovarian cancers, and promotion of cell migration and invasion in PCa. To further study the significance of race-related skipping/inclusion of SEMA3C exon 19 in PCa cell biology, we used CRISPR/Cas9 technology to engineer a PCa cell line (DU145) expressing the SEMA3C variant skipping exon 19. Proliferation assays were performed with the established cell lines, and the SEMA3C exon 19 KO populations exhibited decreased proliferation rates, compared with the wild-type DU145 cells that express the SEMA3C variant including exon 19. These data suggest race-related alternative splicing of SEMA3C may have an impact on PCa aggressiveness in patients. Current and future experiments focus on interrogating the effect of race-related SEMA3C alternative splicing on PCa cell migration and invasion as well as in vivo tumor formation and metastasis. These findings will provide an increased understanding of the role of race-related alternative splicing in PCa disparities and potentially a new target for development of precision medicine interventions.

Citation Format: Tyler A. Allen, Jay Chandar, Bonnie L. Lacroix, Steven R. Patierno, Daniel J. George, Jennifer A. Freedman. Interrogating the role of race-related alternative splicing of SEMA3C in prostate cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-128.
Abstract PO-143: Gender differences in dietary behavior and urinary gallic acid concentrations in racial minorities in New York City
Authors: Zambrano Cristina N. , Lu Wenyue , Johnson Cicely , Beeber Maayan , Panitz April , Ibrahim Safa , Fraser Marilyn , Ma Grace , Yeh Ming-Chin , Ogunwobi Olorunseun
Published: December 2020

Nutrition is important for cancer prevention. To investigate associations between dietary differences based on demographics and risk of cancer, we assessed dietary behavior and the urinary concentrations of gallic acid, an antioxidant found in various fruits and vegetables, in racial minorities in New York City (NYC). Ninety-one (91) participants were recruited from a senior center in East Harlem, NYC, a racially diverse and underserved community. A National Institute of Health (NIH) - validated diet survey questionnaire was used to collect dietary behavior data. Demographic and cancer information were also collected. All 91 participants completed the survey and forty-five (45) participants provided urine samples for gallic acid analysis. Associations between demographic factors and the intake of certain foods were assessed. Gender differences were significantly associated with dietary behavior and urinary gallic acid concentrations (UGAC). Female participants had a higher daily intake of fruits compared to male participants (p<0.05). Additionally, female participants had significantly higher UGAC compared to male participants (p<0.05). Other associations were also observed. Age was negatively associated with the quantity of french fries/fried potatoes and white potatoes intake (p<0.05), while positively associated with frequency of fruit intake (p<0.05). Furthermore, Asian race was associated with a higher frequency of fruit intake (p<0.05), compared to other races. Among all recruited participants, we collected information on three cancer cases. Compared to non-cancer cases, participants with cancer reported a significantly lower fruit intake quantity (p<0.05). In a multivariate analysis, we observed a significant association between fruit intake quantity and UGAC (p<0.05) after controlling for income. Our findings suggest that gender differences in dietary behavior and UGAC may explain some of the gender differences in cancer incidence and prevalence observed in racial minority groups.

Citation Format: Cristina N. Zambrano, Wenyue Lu, Cicely Johnson, Maayan Beeber, April Panitz, Safa Ibrahim, Marilyn Fraser, Grace Ma, Ming-Chin Yeh, Olorunseun Ogunwobi. Gender differences in dietary behavior and urinary gallic acid concentrations in racial minorities in New York City [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-143.
Abstract PO-144: Assessment of diet and physical activity among prostate cancer survivors: Health Information National Trends Survey (HINTS)
Authors: Ezeani Adaora , Agurs-Collins Tanya
Published: December 2020

PURPOSE: Prostate cancer (PCa) is the third most common cancer diagnosis in US men. Evidence shows that diet and physical activity may play a role in decreasing the risk of PCa progression and improving outcomes. The purpose of this study is to explore lifestyle behaviors of men with and without prostate cancer. METHODS: Data were obtained from the NCI Health Information National Trends and Survey (HINTS), a cross-sectional, nationally representative survey. Using HINTS 5 Cycles 1-3, we identified US. males > 50 years of age with PCa and those without a history of cancer.

Respondents reported their height, weight, daily fruit and vegetable intake, physical activity, sedentary behavior, and strength training. Data were weighted to calculate population estimates. Statistical analysis included frequencies and multivariate logistic regression analyses to examine the independent association of demographic factors with health behaviors. SPSS Statistics Version 26 was used to analyze data.

RESULTS: The overall weighted sample was 76.1% NHW (Non-Hispanic Whites), 64.3% post high school education, 38.6% >$75,000 annual income, and 65.8% were married/cohabitating. PCa survivors were older compared to men without a history of cancer. Both PCa survivors and men without a history of cancer reported a BMI >25, less than 150 minutes of moderate physical activity, less than 2 cups of fruit per day, and less than 3 cups of vegetables per day. Compared to men without cancer, PCa survivors were less likely to consume 3 cups of vegetables per day (OR 0.23, 0.08 – 0.63, p <0.01) and less likely to complete more than 2 days of strength training per week (OR 0.47, 0.23 – 0.99, p<0.05), adjusting for age, income, and ethnicity. CONCLUSIONS: Results suggest both PCa survivors and men without cancer do not follow diet and physical activity recommendations. There is a need to develop interventions to encourage healthy behaviors, especially strength training among PCa survivors.

Citation Format: Adaora Ezeani, Tanya Agurs-Collins. Assessment of diet and physical activity among prostate cancer survivors: Health Information National Trends Survey (HINTS) [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-144.
Abstract PO-188: Racial differences in healthcare utilization among lung cancer patients using immune checkpoint inhibitors: A population-based analysis
Authors: Nikita Nikita , Banks Joshua , Keith Scott W. , Johnson Jennifer M. , Wilson Melissa , Sharma Swapnil , LuYao Grace
Published: December 2020

Introduction: Although Immune checkpoint inhibitor (ICI) use for lung cancer has rapidly expanded, racial differences and their impact on clinical outcomes has been under-studied. This study addresses a crucial public health priority by evaluating racial disparities in healthcare utilization among patients with lung cancer receiving ICIs. Methods: We utilized the SEER-Medicare linked database with older adult patients (aged ≥65 years) with a diagnosis of lung cancer receiving ipilimumab (ipi), nivolumab (nivo), pembrolizumab and ipi/nivo in combination. Healthcare utilization was defined as emergency room (ER) and non-ER hospitalizations following ICI initiation. Hospitalization events were modeled by Cox proportional hazards regression using the counting process style of input (to incorporate repeated events) to assess the relative risk (RR) of hospitalization by race. The covariates used in the model were age at first ICI, sex, marital status, year of diagnosis, and Charlson comorbidity status. Results: We identified 4,091 lung cancer patients receiving ICIs; of which 3,451 were White, 350 were Black, and 290 were Asian. Following ICI initiation after adjusting for potential confounding, Asians were 13% less likely to experience ER hospitalization than Whites (RR: 0.87, 95% CI: 0.77-0.98; p=0.027), and Blacks were 22% more likely than Whites to experience ER hospitalization (RR: 1.22, 95% CI: 1.10-1.35; p<0.001). For non-ER hospitalization after adjusting for potential confounding, Asians were 38% less likely than Whites to experience non-ER hospitalization (RR: 0.62, 95% CI: 0.45-0.84; p=0.002), however, Blacks were not significantly different from Whites (RR: 0.95, 95% CI: 0.75-1.21; p=0.67). Conclusion: This retrospective observational study is the first to show the racial differences in healthcare utilization among lung cancer patients receiving ICIs. Although ICI use is markedly increasing, our results could suggest that some populations do not experience their benefits equally. Further studies are warranted to validate the study results about the increase in ER and non-ER hospitalizations among blacks.

Citation Format: Nikita Nikita, Joshua Banks, Scott W. Keith, Jennifer M. Johnson, Melissa Wilson, Swapnil Sharma, Grace LuYao. Racial differences in healthcare utilization among lung cancer patients using immune checkpoint inhibitors: A population-based analysis [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-188.
Abstract PO-206: Influence of social determinants of health on timeliness to treatment for metastatic HCC and the impact of Affordable Care Act
Authors: Jayakrishnan Thejus , Bakalov Veli , Finley Gene , Monga Dulabh , Wegner Rodney
Published: December 2020

Background While we strive for progress in treatment and outcomes, it is imperative that disparities driven by socioeconomic factors are also recognized and addressed. We hypothesized that social determinants of health may predict delay in systemic therapy for metastatic hepatocellular carcinoma patients (HCC) and sought to examine the impact of Affordable Care Act (ACA). Methods National Cancer Database (NCDB) was queried for patients with metastatic hepatocellular carcinoma diagnosed from 2004-2015 and considered for first line systemic therapy within 6 months (180 days) of diagnosis. Time to initiation (TTI) was defined as time in days(d) from diagnosis of cancer to initiation of systemic therapy. Survival was measured in months(m) from the day of diagnosis. Multivariate analyses was performed using 2010 as cut-off between pre- and post-ACA for analysis. Results 630 patients meeting the eligibility criteria. Median TTI in the group was 57d. Only factor associated with delayed TTI (defined as forth quartile of TTI) in a multivariate logistic regression was non-Hispanic Black (NHB) race Odds Ratio OR 1.94(95%CI 1.0–3.3), p-value=0.052.

The OR showed improvement with implementation of ACA – OR3.6(95%CI 1.4-9.4),p- value 0.008 during pre-ACA vs. 1.3(0.5-3.1),p-value=0.6 post-ACA. There were non- significant trend towards higher mortality among NHB vs. NHW (HR 1.2, 95% CI 1.0- 1.6) and lower mortality for those insured vs. uninsured (HR 0.8, 95% CI 0.5-1.1.

Conclusion Race appears to impact timeliness to therapy in metastatic HCC patients and was positively impacted by ACA. Continued research to monitor disparities in care and identify underlying mechanisms to mitigate them are warranted.

Citation Format: Thejus Jayakrishnan, Veli Bakalov, Gene Finley, Dulabh Monga, Rodney Wegner. Influence of social determinants of health on timeliness to treatment for metastatic HCC and the impact of Affordable Care Act [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-206.
Abstract PO-212: Disparities in the enrollment to systemic therapy and survival for patients with multiple myeloma
Authors: Jayakrishnan Thejus , Bakalov Veli , Chahine Zena , Lister John , Wegner Rodney , Sadashiv Santhosh
Published: December 2020

Background The treatment options in Multiple Myeloma (MM) are variable and may involve combinations of chemotherapy, immunomodulatory therapy, monoclonal antibodies and stem cell transplant. In the present study, we hypothesized that socioeconomic factors impact the treatment and survival of patients with MM who receive systemic therapy as firstline treatment. Methods We queried the National Cancer Database (NCDB) for patients with MM (ICD-0-3 code 9732) diagnosed from 2004-2016. We included only that received systemic therapy as first line treatment. Active MM patients were defined as those treated within 120 days of diagnosis.

Enrollment rates were calculated as receipt of primary therapy as the incident-event (numerator) over time-to-initiation of therapy or TTI (denominator) and used to calculate incident-rate ratios that was further analyzed using Poisson regression analysis- reported as enrollment-rate ratios (ER, <1 indicating lower enrollment rate). Multivariate Cox-proportional hazard model was performed for survival analysis and reported as calculate Hazard Ratios (HR). IQR=Interquartile range. Results We identified 56,102 patients for enrollment analysis and 50,543 for survival analysis respectively. Median age was 69 (IQR 60-77) years and included 55% males. Overall rate of enrollment to systemic therapy was 42.3 per 1000 person days, mean TTI was 17d (range 6-66d) and median overall survival was 33.4 (11.2-73.5) months. Therapy enrollment in a multivariate model was significiantly impacted by race and gender (p-value<0.005). Advanced age, earlier year of diagnosis, lack of insurance or medicaid insurance, higher comorbidity were associated with higher mortality (HR>1, p-value<0.005) while female gender, non hispanic black race, higher income and treatment at academic center were associated with lower mortality (HR<1, p- value<0.005). Conclusion Study suggests that multiple myeloma patients treated with systemic therapy as first line represent a vulnerable section of the patients and disparities in terms of socioeconomic characteristics exist in the treatment and outcomes.

Citation Format: Thejus Jayakrishnan, Veli Bakalov, Zena Chahine, John Lister, Rodney Wegner, Santhosh Sadashiv. Disparities in the enrollment to systemic therapy and survival for patients with multiple myeloma [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-212.
Abstract PO-218: Molecular profiling of basal 2 subtypes of triple negative breast cancer cells and their response to a histone deacetylase inhibitor
Authors: Word Beverly , Cotton Ebony , Hammons George , Lyn-Cook Beverly , Stovall Density
Published: December 2020

Triple negative breast cancer (TNBC) is an aggressive form of breast cancer that often strikes young women, particularly minority women in their reproductive years. This cancer is very aggressive and has a poor prognosis mainly, due to the lack of effective chemotherapeutic agents. Recently, molecular profiling of a patients’ tumors yielded detection of specific driver genes in primary tumors that resulted in the use of a single or combination therapies targeting those driver genes. Triple negative breast cancers present an additional problem, in that they are found in different forms or subtypes histologically and molecularly. Basal 2 subtype is one of the most aggressive form of TNBC. Studies have shown that histologically designated tumors yield different treatment results. This study examined the molecular profiles of two Basal 2 triple negative breast cancers representing two different African American women and their response to vorinostat. Using a RT2 Profiler PCR gene expression array, vorinostat was found to up-regulate 54 genes and downregulated 3 genes in HCC70 TNBC. In HCC1806, 23 genes were upregulated and 38 downregulated. The most significant changes in gene expression were noted in CCND2 expression.

Changes were also noted in SNA12, SERPINE, SLC39A6, AR, BRAC1 and TWIST. In HCC1806, significant changes in gene expression were noted in ABCB1, CCND2, CDKN1C and MMP9. Up-regulation of CCND2 was observed in both basal 2 cell lines. CCND2 encodes cyclin D2 in which low expression is associated with poor prognosis. Understanding individual differences in cancer driver genes will greatly improved personalized medicine in triple negative breast cancer.

Citation Format: Beverly Word, Ebony Cotton, George Hammons, Beverly Lyn-Cook, Density Stovall. Molecular profiling of basal 2 subtypes of triple negative breast cancer cells and their response to a histone deacetylase inhibitor [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-218.
Abstract PO-220: Comprehensive "omic" portraits of breast cancer in Mexican-Hispanic women
Authors: Romero-Cordoba Sandra Lorena , Salido-Guadarrama Ivan , Rebollar-Vega Rosa , Tenorio-Flores Alberto , Bautista-Piña Verónica , Villegas-Carlos Felipe , Dominguez-Reyes Carlos , Hidalgo-Miranda Alfredo
Published: December 2020

Breast cancer is a relevant public health problem that affects millions of women worldwide. Breast tumors are recognized as a clinically and molecular heterogeneous pathology, but the genomic basis of its variability remains poorly understood, mainly regarding the comprehensive of ethnicity/racial disparities and their consequences in genomics studies. Moreover, most of the comprehensive molecular characterizations are predominantly centered on Caucasian population. Thus, we deeply characterized the molecular architecture of breast cancer in a set of Mexican patients through genomic and transcriptomic portraits. We explored the molecular features of breast cancers in Mexican-Hispanic (HM) women and compared them with public multi-ethnic datasets. HM patients presented an earlier onset of the disease, in particular in the aggressive Basal-like/triple negative and Luminal B subtypes. The significant E17K hotspot mutation in AKT1 gene occurred in 8% of the HM tumors, an enriched prevalence exclusively seen in this dataset. An integrative analysis also revealed an important role of the AKT1/PIK3CA axis as a potentially druggable target and indicate an aggressive biology. Computational analysis allowed us to identify age-related COSMIC (v2) signature 1 to be present in a much broader spectrum of HM women than in those from other ethnicities. On the basis of transcriptome immunogenomic analysis across human population we identified that luminal breast tumors with HM ancestry presented an enhanced immunogenic phenotype than their Asiatic and Caucasian counterparts. To the best of our knowledge, this dataset represents the largest breast cancer genomics characterization of breast tumors in Mexican women, and, provides novel insights into molecular phenotypes and mechanisms underlying carcinogenesis in a group of Mexican Hispanic women. In conclusion, this study provides a conceptual framework to better understand ethnic disparities of breast cancer.

Citation Format: Sandra Lorena Romero-Cordoba, Ivan Salido-Guadarrama, Rosa Rebollar-Vega, Alberto Tenorio-Flores, Verónica Bautista-Piña, Felipe Villegas-Carlos, Carlos Dominguez-Reyes, Alfredo Hidalgo-Miranda. Comprehensive "omic" portraits of breast cancer in Mexican-Hispanic women [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-220.
Abstract PO-228: Trends in uterine cancer incidence and mortality in New York City
Authors: Balogun Onyinye
Published: December 2020

According to the American Cancer Society's 2020 Annual Report, uterine cancer continues to pose a serious threat to the lives of women in the United States, particularly among African-Americans. Nationally, the incidence of uterine cancers rose 1% per year from 2007 to 2016 among Caucasian women but it rose 2% each year among African-American women. Although the mortality rate increased by 2% per year from 2008 to 2017 for both African-American and Caucasian women, the survival rates are strikingly different. The 5-year relative survival rate is 84% for Caucasian women but drops to 62% for African-American women. The purpose of this study was to evaluate the local trends in uterine cancer incidence and mortality among women in New York City. Methods: Publicly available data from the New York State Cancer Registry were analyzed. We evaluated uterine cancer incidence and mortality rates between 1976 to 2016 according to race and borough. Uterine cancer incidence and mortality rates according to Hispanic ethnicity were also evaluated from 2012-2016. Results: Between 1976 and 2016, the uterine cancer incidence rate increased from 24.1 cases per 100,000 women to 31 cases per 100,000 women among Caucasian women. During the same period, the uterine cancer incidence rate more than doubled from 16 cases per 100,000 women to 34.2 per 100,000 women among Black women. By 2010, the uterine cancer incidence rate among Black women had surpassed those of their Caucasian counterparts. From 2012 to 2016, uterine cancer incidence was lower for Hispanic women (24.2 per 100,000) compared to Black and Caucasian women. However, the mortality rate (5.1 per 100,000) for Hispanic women was comparable to that of Caucasian women (5.9 per 100,000) but nearly half of that for Black women (11.3 per 100,000). Between 1976 and 2016, uterine cancer incidence rates nearly doubled in the Bronx and Kings County. Uterine cancer mortality also nearly doubled in the Bronx over the past 4 decades. Conclusion: In New York City, uterine cancer mortality and incidence rates have risen sharply among Black women. The reasons for disparities among uterine cancer patients require further investigation. They may include access to healthcare, socioeconomic status, health literacy and genetic mutations.

Citation Format: Onyinye Balogun. Trends in uterine cancer incidence and mortality in New York City [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-228.
Abstract PO-236: Enhancing African American participation in biospecimens: A case in point for pancreatic cancer
Authors: Behar-Horenstein Linda , Warren Rueben C. , Setiawan V. Wendy , Perkins Corey M. , Schmittgen Thomas D.
Published: December 2020

Diseases of the pancreas (i.e. chronic pancreatitis, diabetes and pancreatic cancer) disproportionally affect the African American community. Challenges associated with engaging the African American community in biospecimen research are longstanding. We surveyed a number of pancreas-related biobanks and data repositories for African American representation. While some of the biobanks and databases surveyed contain biospecimens and data from African American donors at levels that reflect minority representation among the general population, others do not. A number of factors have historically contributed to reduced participation of the African Americans community in biospecimen donation including medical mistrust, lack of transparency, fear and a poor knowledge and understanding about the use of biospecimens for research. Suggestions for increasing African American participation in organ and biospecimen donation include educational interventions, particularly in community groups, and providing printed and online recruitment materials to patients, patient advocates and care partners. Increasing awareness of the many benefits of biospecimen donation among African Americans will positively affect health disparities research into pancreatic cancer and other diseases.

Citation Format: Linda Behar-Horenstein, Rueben C. Warren, V. Wendy Setiawan, Corey M. Perkins, Thomas D. Schmittgen. Enhancing African American participation in biospecimens: A case in point for pancreatic cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-236.
Abstract PO-264: Examining factors of adherence to low-dose computed tomography lung cancer screenings among high-risk patients
Authors: Erkmen Cherie P. , Lee Mark , Zhu Lin , Merceir Ra'Ann , Lin Timmy R. , Patterson Freda
Published: December 2020

Background: Low-dose computed tomography (LDCT) scans have reported a significant reduction in lung cancer mortality among high-risk patients. However, there are low adherence rates to annual LDCT screenings among patients who initially screen negative. This descriptive study seeks to understand the factors that influence adherence to annual screenings. Methods: A survey was conducted among patients with initial negative LDCT screenings from 2016-2019 at Temple University Hospital. Patients were between ages 55-80, have at least 30 pack-year smoking history, who are current smokers or quit within the past 15 years. Surveys assessed participants’ health literacy, beliefs, psychosocial factors, patient-provider relationship, and knowledge of lung cancer screenings. The outcome measure is adherence to LDCT, which is defined as following up with 15 months after initial screenings. These attributes were measured on various-point Likert scales. The Fagerstrom test was used to measure cigarette dependence and International Physical Activities Questionnaire was used to measure physical activity. Results: Bivariable analysis results indicate lung cancer screening knowledge varied across racial groups. Caucasians had the highest score of lung cancer knowledge followed by African Americans. Lung cancer screening knowledge also varied among education attainment levels. Those who graduated high school or have higher education had higher scores of lung cancer screening knowledge compared to those who did not graduate high school. Results also showed that participants who were cigarette dependent had a higher perceived risk of lung cancer. Overall, participants demonstrated a strong patient-provider relationship with an average score of 4.49 out of 5. Conclusion: This study demonstrated that factors such as low lung cancer screening knowledge, race, low perceived risk, and cigarette dependence may be factors that influence nonadherence to annual screenings. Furthermore, findings suggest that strong patient-provider relationship and shared decision making models may be the key to increasing annual adherence rates.

Citation Format: Cherie P. Erkmen, Mark Lee, Lin Zhu, Ra'Ann Merceir, Timmy R. Lin, Freda Patterson. Examining factors of adherence to low-dose computed tomography lung cancer screenings among high-risk patients [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-264.
Abstract PO-270: The validation and redevelopment of a risk prediction model identifying patients unlikely to complete a colonoscopy following an abnormal FIT test in community clinics
Authors: Petrik Amanda F. , Johnson Eric S. , Slaughter Matthew , Rawlings Andreea , Leo Michael , Thompson Jamie , Jimenez Ricardo , Coronado Gloria D.
Published: December 2020

Background: Fecal testing (FIT) is an effective screening tool for colorectal cancer. If a FIT is abnormal, a follow-up colonoscopy is necessary to remove polyps or find cancers. Predicting which patients may be at risk for failing to follow-up on an abnormal fecal test could help identify patients in need of early interventions aimed at completing a colonoscopy. Using predictive analytics to determine who is unlikely to follow-up will allow health systems to tailor interventions and outreach.

Understanding the application of predictive analytics across health systems is imperative to providing appropriate care to distinct patient populations. Early interventions could decrease the disease burden if colorectal cancer is found at earlier stages. Methods: We compare two models created in two different settings. The models were created from data from FQHC’s and Logistic and Cox regressions to validate and redevelop a risk prediction model among a retrospective dataset of patients with abnormal FIT results. Results: The initial FQHC risk model included eight variables including race, clinic system, prior no-shows, insurance, prior flu shots, age, indication of anti-coagulation use, and income inequality. However, the model did not validate in a large similar health system in the Pacific Northwest. Risk factors for colonoscopy varied by county, clinics, regions, and patient populations.

Inner and outer setting variables, like referral workflows and access to colonoscopy, contributed to the likelihood of a patient completing their screening. The second model retained most predictors except for anti-coagulation use, and included new predictors like language, homeless status, prior screenings, and a comorbidity index. Conclusions: Application of a risk model helps tailor interventions to help patients complete the continuum of screening for colorectal cancer. However, health systems differ, and precision medicine is best applied when risk is understood in context and interventions are tailored for specific populations predictors.

Citation Format: Amanda F. Petrik, Eric S. Johnson, Matthew Slaughter, Andreea Rawlings, Michael Leo, Jamie Thompson, Ricardo Jimenez, Gloria D. Coronado. The validation and redevelopment of a risk prediction model identifying patients unlikely to complete a colonoscopy following an abnormal FIT test in community clinics [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-270.
Abstract PO-271: Does residential distance from a lung cancer screening facility predict baseline screening?
Authors: McIntire Russell K. , Butt Seif , Shusted Christine , Crittendon Denine , Ruane Brooke , Zeigler-Johnson Charnita , Juon Hee-Soon , Barta Julie
Published: December 2020

Background. Previous studies identified important correlates of receiving low-dose computerized tomography (LDCT) among those referred to a lung cancer screening program in Philadelphia. However, studies have not considered whether distance from the screening site is a factor in whether eligible patients receive screening. In this study, we examine whether residential distance to the screening facility predicts receipt of baseline LDCT among eligible patients referred to the Jefferson Lung Cancer Screening Program (JLCSP), after controlling for covariates. Methods. We retrospectively selected eligible patients referred to JLCSP between 1/1/18 and 8/31/18 (N=399). We geocoded each patients’ address using ArcGIS 10.3. We used ArcGIS Network Analysis to identify the distance from each patients’ residence to the screening facility in downtown Philadelphia. We used bivariate statistical tests (chi- square, t-tests) and multivariable logistic regression to identify correlations between individual-level patient characteristics, including distance to facility, and receipt of baseline screening. Results. Residential distance to facility was not related to receipt of baseline LDCT screening, when we treated distance as a continuous variable.

When we treated distance as categorical by quartiles, residents living in the second quartile (2.41-3.25 miles) had lower odds of receiving LDCT compared to those in the closest quartile (AOR=0.55; CI=0.30-0.99). Other correlates of receiving LDCT screening were younger age, and being a former smoker (compared to current smokers). Conclusion. Individuals that lived 2.41-3.25 miles from the screening facility had lower odds of receiving LDCT compared to those that lived closest to the facility. This relationship may be the result of inadequate public transportation, or may reflect neighborhood poverty and resource inequities in Philadelphia neighborhoods. Our study did not collect patient income data, which could confound this relationship. More research is necessary to identify the extent to which distance from screening facilities serves as a barrier for receipt of LDCT services in order to reduce this barrier and improve screening adherence.

Citation Format: Russell K. McIntire, Seif Butt, Christine Shusted, Denine Crittendon, Brooke Ruane, Charnita Zeigler-Johnson, Hee-Soon Juon, Julie Barta. Does residential distance from a lung cancer screening facility predict baseline screening? [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-271.
Abstract PR18: The immune landscape of prostate cancer in African-American patients is skewed towards inhibitory signatures relative to Caucasian-American patients
Authors: Schultz Andrew , Noyes David , Bag Arup , Adeegbe Dennis
Published: December 2020

Prostate Cancer is a leading cause of cancer-related deaths among men in the United States. Within the general population, African-Americans who constitute a minority group suffer a higher burden of the disease compared to other racial groups. Given that immune cells recruited to the tumor micro-environment shape tumor behavior, an outstanding issue is whether the immunological landscape of prostate cancer in African-American patients is a contributory factor to disease disparity seen in this minority patient population. In this regard, the present study sought to investigate whether prostate cancer in African-American men harbor distinctive immunological features compared to their Caucasian counterparts. Fresh prostate cancer specimens were obtained from consented African-American and Caucasian patients after prostatectomy. Gleason scores were comparable between the two demographics with an average score of 7 for African-American patients and 7.5 for Caucasian patients. We analyzed both tumor and matched peripheral blood mononuclear cells from each patient using comprehensive, multi-parameter flow cytometry. We found that both CD4+ and CD8+ T cells in African-American prostate cancer displayed upregulated expression of a number of inhibitory proteins that restrain T cell response. These cells also expressed reduced levels of co-stimulatory receptors and a less activated phenotype compared to equivalent cells in the tumors of Caucasian patients. Furthermore, analysis of serum from patients in each demographic revealed an enrichment of cytokines skewed towards immunosuppressive profile which may support reduced immune cell function against tumor-associated antigens. These findings suggest that the immunological profile of prostate cancer in African-American men harbors intrinsic signatures that may contribute to muting of potential anti-tumor responses in this patient demographic, enabling tumor immune evasion to support aggressive tumor growth and progression. Collectively, our data is in support of the contributory role of immunological factors to disease behavior and associated disparity in African-American prostate cancer patients.

Citation Format: Andrew Schultz, David Noyes, Arup Bag, Dennis Adeegbe. The immune landscape of prostate cancer in African-American patients is skewed towards inhibitory signatures relative to Caucasian-American patients [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PR18.
Abstract IA04: COVID-19 in patients with lung cancers in New York City
Authors: Luo Jia , Rizvi Hira , Preeshagul Isabel R. , Egger Jacklynn V. , Hoyos David , Bandlamudi Chaitanya , Donoghue Mark T.A. , Łuksza Marta , Greenbaum Benjamin D. , Wolchok Jedd D. , Kris Mark G. , Hellmann Matthew D.
Published: December 2020

Background: Patients with lung cancers may have distinct vulnerability to severe COVID-19. Understanding the patient-specific and cancer-specific features that impact severity of COVID-19 may inform optimal cancer care during this pandemic. A key question is whether PD-1 blockade therapy impacts COVID-19 severity.

Methods: We identified consecutive patients with lung cancer and a positive SARS-CoV-2 RT-PCR test seen at a single cancer center in New York City. We performed detailed manual review of the disease course, medical and oncologic history. COVID-19 severity outcomes were predefined, including need for hospitalization, ICU/intubation/transition to DNI-status, or death. We examined clinical features associated with severity using single and multivariable analyses. Regarding the impact of PD-1 blockade, we prespecified several bio-plausible comparisons of PD-1 exposure. HLA alleles were inferred from NGS and compared to controls with lung cancer and no known COVID-19.

Results: We identified 102 patients with lung cancers and a SARS-CoV-2 positive swab between March 12, 2020 and May 6, 2020. Patients were followed until May 11, 2020. COVID-19 was severe in patients with lung cancers (62% hospitalized, 25% died), but accounted for only 11% of deaths among patients with lung cancer during the pandemic. Determinants of COVID-19 severity were largely patient specific, including smoking status and chronic obstructive pulmonary disease. Cancer-specific features, including prior thoracic surgery/radiation and recent systemic therapies, did not impact severity. Likelihood of severe COVID-19 was generally similar across HLA class I supertypes. We found no significant differences in the impact of PD-1 blockade on COVID-19 severity. Modest numerical increases in severity of COVID-19 associated with prior PD-1 blockade were diminished (Odds ratio 0.86-1.01) after adjusting for expected imbalances in prior smoking history. Most patients recovered from COVID-19, including 25% of patients initially requiring intubation.

Conclusion: COVID-19 is associated with a high burden of severity in patients with lung cancers. Patient-specific features, rather than cancer-specific features or treatments, were the greatest determinants of severity. In particular, PD-1 blockade did not appear to impact severity of COVID-19 in patients with lung cancers.

Citation Format: Jia Luo, Hira Rizvi, Isabel R. Preeshagul, Jacklynn V. Egger, David Hoyos, Chaitanya Bandlamudi, Mark T.A. Donoghue, Marta Łuksza, Benjamin D. Greenbaum, Jedd D. Wolchok, Mark G. Kris, Matthew D. Hellmann. COVID-19 in patients with lung cancers in New York City [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr IA04.
Abstract IA17: Ethics, cancer, and COVID
Authors: Caplan Arthur
Published: December 2020

This talk will review (1) the impact of the covid-19 outbreak on treating cancer patients who were infected with the virus with unapproved and off-label agents under a philosophy of compassionate use including disclosure of conflicts of interest; (2) the ethics of withholding diagnosis and treatment from patients with cancer or who might have acquired cancer in the USA once social isolation, quarantines, and restriction of “nonessential” services began; (3) decisions about how to define “essential” services during the onset of the pandemic in severely impacted areas of the U.S.; (4) the management of those who died during the pandemic as lessons for future clinical care of cancer patients; (5) decisions about how to decide how much risk to permit those involved in clinical care for cancer or for reassigned duties to assume during an ongoing pandemic; and (6) how to prioritize future cancer research as the viral outbreak continues and resources remain restricted.

Citation Format: Arthur Caplan. Ethics, cancer, and COVID [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr IA17.
Abstract PO-015: Differences in level-of-service for telehealth visits as compared to in-office visits for cancer and hematology patients seen in practices within the ASCO PracticeNET learning network
Authors: Bourbeau Brian , Guharoy Mou , Grubbs Stephen , Garrett-Mayer Elizabeth , Olson Kevin , Schilsky Richard L.
Published: December 2020

Introduction: In response to the need for social distancing and infection prevention during the COVID-19 pandemic, there has been increased use of telehealth services to manage cancer and hematology patients. Throughout March and April of 2020, the Medicare and Medicaid programs expanded coverage of telehealth services, allowing cancer and hematology patients to receive certain telehealth services from their home during the public health emergency. We analyzed data from ASCO’s PracticeNET learning network to examine the reported level-of-service for telehealth services compared to standard in-office visits.

Methods: 20 practices submitted their billing data for analysis; practices were located in 14 states and ranged in size from 2 to 29 hematologists/oncologists. We analyzed a total of 33,435 established patient evaluation and management visits performed by hematologists/oncologists from March 15 to April 18, 2020. 3,062 (9.1%) visits were performed via telehealth and 30,373 were performed in a physician office or outpatient hospital department. The level-of-service of each visit was identified through the reported Current Procedure Terminology (CPT) code, where levels 1-5 correspond to CPT codes 99211-99215, respectively, and level 5 represents the highest complexity visit. Telehealth visits were identified through use of the modifiers 95, GQ, and GT, as appended to the applicable CPT code.

Results: The level-of-service distribution for telehealth-based visits was level 1 (1%), level 2 (4%), level 3 (35%), level 4 (50%), and level 5 (11%). This contrasted with in-office visits: level 1 (3%), level 2 (2%), level 3 (27%), level 4 (51%), and level 5 (18%). Differences were greatest in level 3 visits (35% vs. 27%) and level 5 visits (11% vs. 18%). Differences in level-of-service persisted when exploring various disease cohorts, including patients with solid neoplasms, blood neoplasms, benign hematology disorders, and circulatory disorders.

Conclusions: Analysis of established patient visits showed that telehealth visits were reported at lower level-of-service as compared to in-office visits. This finding may be related to directing straightforward visits to be performed via telehealth or due to limitations in using telehealth by patients with complex medical problems.

Citation Format: Brian Bourbeau, Mou Guharoy, Stephen Grubbs, Elizabeth Garrett-Mayer, Kevin Olson, Richard L. Schilsky. Differences in level-of-service for telehealth visits as compared to in-office visits for cancer and hematology patients seen in practices within the ASCO PracticeNET learning network [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-015.