bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Group Versus Individual Recruitment Strategies to Improve HPV-Self Collection Amongst Women in Kilimanjaro, Tanzania—‘Dada’ Study
Authors: Chelva Melinda , Yuma Safina , Mchome Bariki , Mremi Alex , West Nicola , Taite Ann , Marandu Prisca Dominic , Mmari Leah , Redson Alma , Olomi Gaudensia , Slotman Ava , Yeates Karen
Published: July 2024

PURPOSE

Tanzania ranks fifth in cervical cancer disease burden globally, with 9,772 new cases and 6,695 deaths reported each year. In the newest version of Tanzania's national cervical cancer strategy, the Ministry of Health recommends that HPV DNA testing is integrated with the national cervical cancer prevention program, to align with the WHO screening recommendations. Recruitment to screening programs remains a challenge in low- and middle-income countries, and there is little evidence to inform recruitment strategies that might improve attendance rates, especially in Tanzania. Results from a systematic review of strategies to improve health and medical research suggest that involving community groups in the research process and ensuring that content and delivery of the intervention is socially acceptable, can improve the likelihood of uptake. The ‘Dada’ study will be conducted, as part of the national cervical cancer prevention program.

METHODS

The study aims to recruit 1,500 women (age 25-49 if HIV+ or 30-49 if HIV status unknown) in the Kilimanjaro region to evaluate a hybrid-2 evaluation of intervention and implementation effectiveness (e.g., acceptability, feasibility, and fidelity) with cluster randomization of communities to two arms, each testing a different method of recruitment: A) individual, opportunistic recruitment in public settings and B) recruitment through structured community meetings. Recruitment will be performed by community healthcare workers from 30 communities using the two strategies. In both arms, an educational video (‘Dada’) will be delivered to women to encourage HPV self-collection.

RESULTS

To compare individual and group recruitment strategies in terms of HPV self-collection uptake. This will be examined through various demographic factors, such as age, marital status, education, income, insurance, previous cervical cancer screening, and geographic location (rural, semi-rural or urban).

CONCLUSION

There is a critical need to generate further evidence for implementation of effective and sustainable strategies to optimize cervical cancer screening and increase the number of women that receive HPV self-collection. The results of our study will also generate informed evidence regarding the optimized strategy to improve the cervical screen-triage-treat approach in Tanzania. The knowledge gained will be disseminated to other African countries with a similar cancer-health disparity.
Factors Affecting Breast Cancer Screening in Ukraine
Authors: Karavska Anna , Kizub Darya , Dzhemiliev Ali , Wanis Kerollos , Vus Vadym , Kopetskyi Viacheslay , Huiyaniuk Inesa , Beznosenko Andriy , Semeniy Solomia , Melnitchouk Nelya
Published: July 2024

PURPOSE

Breast cancer early detection in Ukraine and other low and middle-income countries (LMICs) often includes opportunistic screening. Evaluation of factors that affect screening is key to improving early detection.

METHODS

An online survey for primary care physicians (PCPs) was distributed through PCP-focused social media in Ukraine. Data were analyzed using descriptive statistics.

RESULTS

435 PCPs from all regions of Ukraine completed the survey, including 389 (89.4%) women, 375 (86.2%) family medicine, 60 (13.8%) internal medicine physicians. 349 (80.2%) referred women for screening mammography. 252 (57.9%) conducted screening clinical breast exams (CBE), while 135 (31.0%) referred patients to mammalogists or 133 (30.6%) to gynecologists for CBE. Within one's practice, mammography was available for 81 (18.6%), mammalogists for 39 (9.0%), and gynecologists for 133 (30.3%). Breast cancer screening was prompted by MOH Order 504 for 281 (64%), family history 266 (61%), patient pathway guidelines 94 (21.6%), availability of subspecialists 78 (17.9%), and patient request 132 (30%). Reasons for not conducting CBE screening included insufficient experience 88 (20.2%), patients declining CBE 63 (14.5%), lack of time 59 (13.6%). Reasons for not conducting mammography screening included patients declining (11.7%) and absence of mammography (6.4%).). 350 (80.5%) were familiar with the Ministry of Health (MOH) Order 504, which describes eligibility criteria for breast cancer screening, and 291 (66.9%) used it to guide their screening practice. Others used US or European recommendations (62 (14.3%) and 115 (26.4%), respectively), and institution-specific patient pathways 117 (26.9%). Barriers to breast cancer screening included insufficient PCP training (53%) and experience (40%) and insufficient mammography availability (33%). Strategies for increasing breast cancer screening included improving collaboration between PCPs and oncologists 175 (40.2%), educational materials for patients 169 (38.9%), PCP education/training 168 (38.6%), automatic electronic health record reminders 150 (34.5%).

CONCLUSION

We identified important barriers and facilitators of breast cancer screening from the point of view of PCPs in Ukraine. Our results were limited by online convenience sampling.
Factors Associated With Laser Treatment of Primary Site in 201 Cases of Melanoma
Authors: Kennard Jared , Keirns Darby , Brandt Zachary , Silberstein Peter , Wu Xinxin
Published: July 2024

PURPOSE

Melanoma is a rare form of skin cancer, making up only 4% of all skin cancers, but it accounts for 75% of all skin cancer-related mortality, making the exploration of safe treatments a necessity. As a cutaneous tumor, Melanoma is one of few cancers capable of being treated with laser ablation, yet this treatment is often overlooked in favor of surgical approaches or. It has been used in limited amounts to treat basal cell carcinoma, actinic keratosis, and melanoma with great effect. Studies show that laser ablation, with local anesthesia, results in positive outcomes and fewer recurrences in melanoma, as well as less pain and scarring than traditional treatments such as excision. Mohs surgery, while generally preferred, is somewhat limited when it comes to areas like the eyes. It is in these areas that laser ablation has the opportunity to excel, as with its precision it can be used to treat choroidal melanoma with limited damage and preservation of optic function. While restricted in high-stage tumors, laser ablation use can be expanded to provide rapid treatment for patients with melanoma where surgical approaches are of limited use.

METHODS

This is a retrospective cohort study of patients diagnosed with cutaneous Melanoma between 2004-2020 in the National Cancer Database (NCDB) who underwent the procedure of the primary site by local tumor destruction with laser ablation or laser excision. Descriptive statistics were analyzed via frequency for the year of diagnosis, sex, race, education level, income level, geographic area, Charlson-Deyo Score, tumor stage, and primary site. Overall survival was determined via the Kaplan-Meier test.

RESULTS

Since 2004, there has been a general decrease in laser procedures. The majority of patients were White, male, above the average education level, and earned above the average income level. The average patient was 62.4 years old, lived 20 miles from the treatment facility, and was relatively healthy with 89.6% at a Charlson-Deyo comorbidity score of 0. 60.1% of the cases were treated at an early stage. The most common primary site for laser treatment was the skin of the trunk, followed by skin of the lower limb and hip, and patients had a median overall survival of 88.4 months

CONCLUSION

Though its potential value as a treatment remains high, laser ablation use is lowering and is used in wealthy White patients, likely due to the lower rates and delayed diagnosis experienced by patients with darker skin. The long median survival time shows that despite the low use, Laser ablation is highly effective at treating melanoma, as with a median time of ∼7 years, many patients will die from unrelated conditions. What use there is could be optimized, as there are strikingly few uses in the eyes, where it is most useful. Future research should look into what factors patients consider when choosing laser over surgical resection to better understand social factors in treatment.
Factors Driving NCI-Designated Cancer Center Engagement in Global Oncology
Authors: Garton Elise M. , Chang Shine , Cira Mishka Kohli , Duncan Kalina
Published: July 2024

PURPOSE

In 2021 the U.S. National Cancer Institute (NCI) Center for Global Health conducted two surveys of the 71 NCI-Designated Cancer Centers. The directors’ survey asked cancer center directors about their prioritization and estimated budget for global oncology. The program survey asked global leads about their center’s global oncology programs and non-NCI funded global research projects. This analysis focuses on the associations between cancer centers reported global oncology prioritization, budget, formally structured programs, and research.

METHODS

The director survey was fielded online from May to July 2021 and the program survey was fielded online from July 2021 to January 2022. Data about NIH grants were sourced from internal systems. Data cleaning was done in Microsoft Excel and Python, and single factor ANOVA and Chi-squared tests of independence were used to determine statistical correlation between variables.

RESULTS

Cancer centers who reported a higher prioritization of global oncology engaged in more NCI and non-NCI funded global oncology research (p = <0.0001) but did not report a higher budget for global oncology (p = 0.3351) and were not more likely to report a formal global oncology program than centers who reported a lower prioritization (p = 0.3962). Cancer centers who reported a higher budget for global oncology were more likely to report a formal global oncology program (p = 0.0004) and were engaged in more global oncology research (p = <0.0001) than cancer centers who reported a lower budget; this is largely driven by six comprehensive cancer centers who reported an annual budget of over $500,000.

CONCLUSION

The results of this study demonstrate that higher prioritization of global oncology is correlated with increased global oncology research regardless of formal program existence and reported estimated budget. This suggests that despite limited resources and infrastructure, many cancer centers still engaged in global oncology, although it is not known whether the impact of this engagement could have been greater with additional support. Indeed, factors such as cancer center size, seed funding, dedicated infrastructure, and mature networks can facilitate international collaboration by cancer centers, but nimble and motivated individuals may be instrumental for strengthening global oncology regardless of dedicated cancer center resources.
Feasibility of Monitoring Global Breast Cancer Initiative Framework Key Performance Indicators in 21 Asian Countries
Authors: Ong Sok King , Ching Lai Dephne Teck
Published: July 2024

PURPOSE

This study determines the feasibility of monitoring the status of breast cancer control in the 21 Asian countries based on the three GBCI Framework key performance indicators (KPIs): stage at diagnosis, time to diagnosis, and treatment completion.

METHODS

We establish data availability and compiled the latest indicators for the 21 Asian National Cancer Centers Alliance (ANCCA) countries (Bangladesh, Bhutan, Brunei, Cambodia, China, India, Indonesia, Iran, Japan, Laos, Malaysia, Mongolia, Myanmar, Nepal, Pakistan, the Philippines, Singapore, the Republic of Korea, Sri Lanka, Thailand, and Vietnam). We performed correlation analysis to measure the strength of correlation between stage at diagnosis, mortality and survival rates, and universal health coverage.

RESULTS

The proportion of patients diagnosed in stages I and II strongly correlated with the five-year survival rate and with the universal health coverage (UHC) index. Three countries (14%) reported national data with >60% of invasive breast cancer patients diagnosed at stages I and II, and a five-year survival rate of >80%. Over 60% of the ANCCA countries had no published national data on breast cancer staging, the time interval from presentation to diagnosis, and diagnosis to treatment. Five (24%) countries reported data on treatment completion.

CONCLUSION

GBCI’s Pillar 1 KPI correlates strongly with five-year survival rate and with the UHC index. Most ANCCA countries lacked national data on cancer staging, timely diagnosis, and treatment completion KPIs. Strengthening cancer surveillance is crucial for effective breast cancer control. The GBCI Framework indicators warrant more detailed definitions for standardized data collection. Surrogate indicators which are measurable and manageable in country-specific settings, could be considered for monitoring GBCI indicators. Ensuring UHC and addressing health inequalities are essential to early diagnosis and treatment of breast cancer.
Geographical Mapping of Biological and Environmental Risk Factors of Colorectal Cancer in the United States
Authors: Palliyaguru Nipuni , Palliyaguru Dushani , Liyanage Sanka
Published: July 2024

PURPOSE

Colorectal cancer (CRC) is a leading cause of morbidity and mortality in the United States (US) and worldwide. Previous studies have identified several behavioral and biological risk factors of CRC, including lack of physical activity, smoking, alcohol use, poor dietary patterns, obesity and type 2 diabetes. Emerging risk factors, e.g., air pollution and pesticide exposure may also exacerbate colorectal cancer risk. Furthermore, rural populations show poorer CRC outcomes compared to urban ones within the US.

METHODS

In order to quantitatively assess this, we examined publicly available US county-level CRC incidence and mortality data from the Surveillance, Epidemiology and End Results (SEER) program and risk factor prevalence data from Behavioral Risk Factor Surveillance System (BRFSS) to identify geographical patterns and interactions of colorectal cancer risk factors by applying simple and multiple linear regression modeling as well as machine learning.

RESULTS

Our analyses indicated that multiple risk factors were strongly correlated with CRC and co-occurred in counties with high CRC incidence and mortality, e.g, obesity, diabetes, smoking and low physical activity. Stratifying data by urban and rural counties showed differences in how these factors contributed to CRC risk.

CONCLUSION

Identifying etiological factors driving these co-occurrence trends and examining additional CRC risk factors will therefore be critical components of future CRC risk identification and risk mitigation effort.
Health Related Quality of Life of Prostate Cancer Patients: Assessment Using the Short Form 12 Health Survey and Patient Oriented Prostate Utility Scale
Authors: Tolani Musliu Adetola , Oyelowo Nasir , Kabir Abdulkareem , Eneh Patrick , Aliu Surai , Abubakar Bashie Dauda , Aminu Adeniyi , Paul Zilpah Kura , Ahmed Muhammed
Published: July 2024

PURPOSE

The understanding of patient-centered needs is integral to quality of life strengthening and value-based care. Despite the complexity of prostate cancer management in resource limited settings, data on self-reported functional measures and health state utility index are limited. This study aims to describe the general and disease specific health-related quality of life (HRQoL) of prostate cancer patients in Nigeria.

METHODS

A cross-sectional survey of 80 prostate cancer patients was conducted at our academic tertiary hospital in Nigeria. Information on their demographic details, clinical characteristics, and Eastern Cooperative Oncology Group (ECOG) score at presentation were collected. HRQoL was assessed using the generic Short Form 12 (SF-12) and a prostate cancer specific econometric instrument, the 10-item Patient Oriented Prostate Utility Scale (PORPUS). Data analysis was done using Statistical Package for Social Science to summarize the outcome indicators.

RESULTS

The mean age was 69 years. Ninety seven percent (n = 76) were symptomatic at presentation. The median PSA at diagnosis was 96 (IQR 39.3 – 129.5) ng/ml, 77% (n = 60) had Gleason score 7 to 10, and 40% (n = 31) had metastatic disease. Fifty nine percent (n = 39) had an Eastern Cooperative Oncology Group score of 2 to 4. On the SF-12 survey, 33% (n = 25) rated their overall health to at least good. Seventy percent (n = 53) reported at least some limitation in physical activity, 59% (n = 45) reported at least some feeling of being down and blue, 52% (n = 38) reported moderate to extreme interference of pain with work, and 52% (n = 40) reported interference of these functions with their social activities. The crude PORPUS score was in the third quartile on its 100-point scale (71.2 ± 13.1). The most severe PORPUS scores (median with IQR) were in the domains of energy, 2.0 (1.0 – 3.0), emotional wellbeing 2.0 (1.0 – 3.0), urinary frequency and urgency 2.0 (2.0 – 3.0), sexual function 3.0 (1.0 – 3.0), and sexual interest 3.0 (1.0 – 3.8).

CONCLUSION

The prostate cancer patients had limited HRQoL experience in the physical and psychological domains. They also had severely limited health utility in the voiding and sexual domains. The interplay of QoL optimization with the delivery of value-based care in the patient care pathway will be further explored in future studies.
HPV Typing in Women Undergoing Cervical Cancer Screening: Insights From the General Population in Bamako, Mali
Authors: Diakite Brehima , Kassogue Yaya , Maiga Mamoudou , Traore Bam , Diarra Fousseiyni , Cisse Kadidiatou , Kamate Bakarou , Traore Cheick B , Holl Jane L , Hou Lifang
Published: July 2024

PURPOSE

This study aimed to evaluate HPV genotypes among women undergoing cervical cancer screening in Bamako from the general population.

METHODS

A prospective cross-sectional study enrolled 199 women from Bamako's general population. Data were collected via survey forms, and vaginal swabs were self-collected for HPV genotyping using GeneXpert technology.

RESULTS

The age group ≥30 years constituted the majority (61.3%), with a mean age of 35.38 ± 11.09 years. The average age at first sexual intercourse was 19.69 ± 3.739 years. The study revealed an HPV infection prevalence of 21.6%. The most commonly detected HPV subtypes were P3 (41.9%), followed by P5 (9.3%), 18/45 (9.3%), P4 (9.3%), P4P5 (7%), 16 (4.7%), and others (2.3%). HPV infection was more prevalent in the age group ≥ 30 years (P=0.009), multiparous women (P=0.003), and those with a history of sexually transmitted infections (P=0.019).

CONCLUSION

The burden of cervical cancer remains substantial in our population. HPV genotyping through self-sampling presents a promising approach to improve early detection, treatment, and prevention of the disease among Mali's general population.
Identifying Research Impacts Within a Global Cancer Survivorship Grants Portfolio
Authors: Abudu Rachel , Oliver Kathryn
Published: July 2024

PURPOSE

Research impact assessments (RIAs) are exercises conducted to measure research outputs, outcomes, and impacts of research projects and programs. While use among funders has been growing, RIA adoption has been fragmented, and a global, multi-funder RIA on cancer survivorship research has not been conducted. The field is an ideal case-study for RIA because the number of cancer survivors worldwide is currently over 30 million and projected to increase, and has comparatively less investment than research on other CSO categories. We aim to examine the global evidence base produced by cancer survivorship projects funded by International Cancer Research Partnership (ICRP) partners to determine their broader research, economic, and social impacts.

METHODS

Our evaluation will measure the impacts of projects from ICRP funders for 2006-2018 coded to CSO codes 6.1 Patient Care of Survivorship Issues or 6.6 End-of-life Care, using the Canadian Academy of Health Sciences Framework. To ensure high methodological quality, we have utilized seven key steps for RIA implementation developed from our previous work, including setting the stage for analysis (considering context, goals, and stakeholders); framework selection; metrics/indicator selection; primary data collection; data synthesis; communicating results; and reflecting on best practices. Impact data will be sourced from Dimensions. Ai and Overton; two leading databases capturing global research and policy impacts.

RESULTS

Among 146 cancer research funders participating in the ICRP during 2006-2018, 103 funded a total of 5,814 projects coded to CSO codes 6.1 and 6.6. Anticipated results include the numbers of matching projects identified within Dimensions. Ai with linked publications, altmetrics, clinical trials, and datasets, and linked policy citations identified through Overton as well as an overview of the types and ranges of impacts found. Preliminary results show high coverage of ICRP projects within the Dimensions. Ai database, and the ability to identify impacts increasingly likely among public funders.

CONCLUSION

Understanding downstream impacts of funded research is critical to ensuring that public and charitable funds are making a tangible impact towards improving survivorship and end-of-life care for persons living with and beyond cancer. We hope our analysis is the first of several that may begin to link research impacts with future opportunities to improve patient-oriented care and research.
Implementation of a Novel Analytical Strategy for Profiling Altered Genes in Adjacent Tissue to Prostate Cancer: Unveiling Pathways and Clinical Implications
Authors: Payán-Gómez César , Guevara-Nieto Michelle , Rodriguez-Morales Dayana , Vargas Elizabeth , Ramierz-Clavijo Sandra , Parra-Medina Rafael
Published: July 2024

PURPOSE

Prostate cancer is a significant global health issue. The tumor microenvironment significantly influences cancer progression, treatment response, and metastasis. There's a lack of studies directly comparing adjacent tissue behavior to both tumor and normal tissue. An analytical strategy was developed to identify genes altered in the adjacent tissue to the tumor without the need for comparison with tumor or normal tissue.

METHODS

Data sets containing information on both adjacent tumor and normal tissue were searched. Also, transcriptomic data from the prostate cancer project in TCGA for adjacent tumor samples were searched. Differentially expressed genes (DEGs) were identified from the dataset enabling direct comparison between adjacent tissue and normal tissue. The DEGs were utilized as probes to identify other genes of interest within the TCGA database. We hypothesized that genes showing correlated expression with the DEGs would also exhibit altered expression in adjacent tissue within TCGA.A co-expression network was constructed using all genes displaying a correlation coefficient greater than 0.6 with at least one of the DEGs. Finally, a network analysis was conducted.

RESULTS

GSE6919 was the only dataset that allowed direct comparison of adjacent tissue to prostate cancer with normal tissue. Six DEGs were identified TRIB1, C18orf54, ARF1, NFKBIZ, and LINC00662, and MAFB. The transcriptomes of the 54 adjacent tissues to prostate cancer from TCGA were interrogated, revealing that the expression profiles of 3316 genes had a Pearson correlation coefficient greater than 0.6 with at least one of the 6 DEGs. With these genes, a co-expression network was constructed, retaining 3254 genes. Two networks were identified, one with 2234 genes and another with 395 genes. The first network was enriched with genes related to protein synthesis and vesicle transport from the endoplasmic reticulum to the Golgi apparatus. The second network was enriched with genes from the IL17 signaling pathway and the TNF signaling pathway.

CONCLUSION

The proposed method proved effective in identifying genes potentially altered in adjacent tissue to the tumor, even in the absence of normal tissue for comparison. Some pathways identified have been previously associated with cancer progression, metastasis, and treatment response. Further studies are warranted to determine whether the behavior of these and novel discovered pathways in adjacent tissue has clinical implications for prostate cancer.
Implementation of Self-Sampling-Based Human Papillomavirus Screening in HIV-Infected Women in Mali
Authors: Maiga Mamoudou , Diakite Brehima , Kassogue Yaya , Traore Ban , Diarra Fousseiyni , Kassogie Oumar , Kamate Bakarou , Traore Cheick B. , Holl Jane L. , Hou Lifang
Published: July 2024

PURPOSE

This study aimed to assess the implementation of self-sampling (SS)-based HPV screening among high-risk HIV-infected women in an HIV Care Center in Bamako, Mali.

METHODS

Participants received self-sampling kits after receiving explanations and answering questions regarding their preferences. The Cepheid Xpert HPV test, which detects the 14 most common HPV subtypes, was utilized. High-risk (hr)-HPV+ participants underwent visual inspection tests and histology if cancerous lesions were detected, followed by treatment.

RESULTS

Among the 100 enrolled HIV-infected women, 92% opted to conduct self-sampling on-site, while 8% preferred home sampling. Only four out of the eight women who chose home sampling returned their samples, whereas all participants who opted for on-site sampling provided their samples. The concept of self-sampling was well-received, with 40.6% of women testing positive for high-risk HPV, predominantly HPV18/45 (45%) and the P3 group (HPV31, 35, 33, 52, 58) (33%). Co-infections were common, and all positive cases agreed to undergo further testing and treatment as necessary.

CONCLUSION

The majority of women (92%) preferred on-site self-sampling. This self-sampling strategy for HPV screening appears to be acceptable among HIV-infected women in Mali and holds potential for widespread implementation to decrease cervical cancer incidence in resource-limited settings.
International Patients Paths to Chimeric Antigen Receptor T-Cell Therapy for B-ALL: No Two Journeys Are Alike
Authors: Zakieh Abdulhafiz , Vadlamudi Priya , Huth Hannah , Foley Toni , Little Lauren , Yates Bonnie , Silbert Sara , Shah Nirali , Sankaran Hari
Published: July 2024

PURPOSE

Chimeric antigen receptor (CAR) T-cell therapy for relapsed/refractory B-cell acute lymphoblastic leukemia (r/r B-ALL) has a critical role in improving outcomes. Access to CAR T-cell therapy is limited for international patients for whom standard therapies have failed, forcing many to undertake substantial travel in search of a cure. Our institution offers phase I CAR T-cell clinical trials for pediatric, and adolescent and young adult (AYA) patients, and is one of few that can accept patients nationally and internationally.

METHODS

This was a retrospective study of international patients with r/r B-ALL enrolled on a CAR T-cell trial at the pediatric oncology branch (POB) from 6/2012 through 3/2021. Variables including demographics and prior therapies (among others) were manually extracted from the electronic medical records, and analyzed using Microsoft Excel and R software, version 4.3.

RESULTS

A total of 57 patients (71.9% male) were included, including 35 (61.4%) from high income countries (World Bank Classification), 14 (24.6%) from upper-middle income countries, and 8 (14.0%) from low-middle income countries. Most common referrals were for a relapse after hematopoietic stem cell transplantation (HSCT) and/or CAR T-cell (43.9%), followed by CD19 negative relapse/refractory disease (29.8%). Twenty-six patients (45.6%) were enrolled for CD22, 21 (36.8%) for CD19, and 10 (17.6%) for dual CD19/CD22 directed CAR T-cell therapy. The median number of prior therapy lines was 5 (range 2-12, Q1 = 4, Q2 = 6). Thirty-five patients (61.4%) underwent at least one prior HSCT, 29 (50.1%) had received prior immunotherapy, and 19 patients (33.3%) received at least one prior CAR T-cell at other institutions “Only 3 of 21 CAR T-cell products (14.3%) were received in the patient's home country. Twenty-six patients (45.6%) received chemotherapy to control the disease during travel to our institution for enrollment, 47 patients (82.5%) received at least one anti-microbial prophylactic agent, and 26 patients (49.1%) had central venous access on arrival. Median age at CAR T-cell infusion was 13 years (Q1 = 9, Q3 = 20).

CONCLUSION

Our study is the largest to describe prior lines of therapy and treatment paths for international pediatric and AYA patients with relapsed/refractory B-ALL undergoing CAR T-cell therapy. Characterizing prior therapies and paths of this heavily treated population will help inform future directions in expanding this novel immunotherapy availability and addressing access disparities across the world.
Knowledge, Perception, and Intended Healthcare-Seeking Behavior for Ovarian Cancer Among Female Undergraduate Students of the University of Ibadan, Nigeria
Authors: Temitan Imole , Oliwasanu Mojisola , John-Akinola Yetunde
Published: July 2024

PURPOSE

Ovarian cancer is the deadliest of all gynecological malignancies, making it a major public health concern. Major global research finding highlighted a low level of ovarian cancer knowledge and education among women of reproductive age especially the younger ones. Therefore, the study assessed knowledge, perception, and intended healthcare-seeking behavior for ovarian cancer among female undergraduate students of University of Ibadan, the first tertiary institution in Nigeria.

METHODS

This cross-sectional survey involved 275 female undergraduate students of the University of Ibadan selected by a four-stage sampling technique. A pre-tested and retested semi-structured self-administered questionnaire was used to obtain data on their socio-demographic characteristics, knowledge, perception, and intended healthcare-seeking behavior toward ovarian cancer. Data was analyzed using frequency distribution, Chi-square, Spearman’s rank order correlation, Mann-Whitney U and Kruskal-Wallis H tests with ±0.05.

RESULTS

Age was 22.12±2.2 years and 76% were Christians. Majority (95.3%) were aware of ovarian cancer however, only 33.2% had good knowledge. The top-two identified symptoms were abdominal pain (66%) and pelvic pain (63.8%). Over two third, (68.3%) had poor knowledge of its risk factors. Having ovarian cysts (29.5%) was the commonly recognized risk factor while the least was ‘menopause’ (16.4%). Majority had moderate perceived susceptibility and severity, but high perceived benefits, cues to action and self-efficacy. The majority (80.2%) intended to visit the health facility once they notice any symptoms of ovarian cancer and (66.0%) plan to do so within a few days. Knowledge was significantly and positively correlated with perception, the strongest was with perceived severity (p<0.001).

CONCLUSION

The knowledge of ovarian cancer is still very low when compared to other malignancies such as breast and cervical cancer. The female undergraduate students had low knowledge of ovarian cancer, but high intention to seek medical help. The results highlight the need for multi-component educational interventions and strengthening of the health system.
Knowlege, Attitudes and Perceptions of Traditional Healers on Cancer: A Pilot Survey
Authors: Madzudzo Michelle , Musosi Godwin , Muzvondiwa Ivan
Published: July 2024

PURPOSE

To assess traditional medical practitioners (TMP) conception of cancer and assess their understanding of cancer causes, symptoms, screening, diagnosis and treatment as well as their stance on collaborations between western and traditional medicine as part of the overall healthcare system.

METHODS

The qualitative survey was designed to identify knowledge levels, attitudes perceptions of TMPs in Manicaland province in Zimbabwe towards cancer. A workshop was organized and a questionnaire was given as pretest and post test to the participants. In depth interviews and focus group discussions were carried out, transcribed and thematically analysed. Emerging themes related to cancer causes, symptoms, screening, diagnosis and treatment modalities and their comparative effectiveness and the need for collaboration.

RESULTS

There was total of 135 participants with 58,5% being males. The age range was 17 to 60 years. 90% could not describe cancer but alluded to its causes and recurring theme was spiritual attack. None had knowledge on cancer screening and diagnosis and only one stated that he can diagnose cancer spiritually while the rest agreed to using diagnosis from western medicine. There was no uniform opinion on treatment effectiveness and there was a general consensus that collaboration between western and traditional medicine is important for improved cancer care.

CONCLUSION

A clear knowledge gap exists and there is need for health education and awareness of TMP. The survey revealed that they want to learn more about cancer and collaborate with western medicine. Traditional medicine should therefore be formally recognized as a component of the national health system in order to control cancer care and improve the quality of service across the continuum of cancer care.
Management and Outcomes of Low-Grade Lymphomas in a Prospective Lymphoma Cohort in Malawi
Authors: Chikaonda Tarsizious , Fedoriw Yuri , Chikasema Maria , Mponda Marriam , Kasonkanji Edwards , Simwinga Lusayo , Tomoka Tamiwe , Paindchab Matthew
Published: July 2024

PURPOSE

To outline the baseline characteristics, treatment, and outcomes of adults with low-grade lymphomas in Malawi.

METHODS

We describe a prospective, observational cohort of newly diagnosed low grade lymphomas at a national teaching hospital in Lilongwe, Malawi June 2013--December 2021; follow up was censored December 2022. Diagnoses were supported by histopathology and immunohistochemistry during weekly telepathology conferences between Malawi and U.S. Treatment guidelines were standardized and generally only started if patients met GELF criteria. Simple descriptive statistics and Kaplan Meier methods were used.

RESULTS

We enrolled 55 patients with low grade lymphoma. Median age was 58 (range 28-82), 35 (64%) were male, and three (9%) HIV-positive. Of 42 patients who required treatment, 37 received CVP (cyclophosphamide, vincristine, and prednisone) and 3 received CHOP (CVP plus doxorubicin), 1 received Mini-CHOP and 1 Received R-CHOP. Median chemotherapy cycles received was six (range 1-8). Of 39 evaluable patients, response was: seven (18%) complete response, 4 (10%) stable disease, 26 (67%) partial response, and 2 (5%) progressive disease. Median follow-up was 34 months (range 5-49 months) among those alive. One- and two-year overall survival were 60% (95% CI 48-75%) and 44% (95% CI 33-60%), respectively. One- and two-year progression free survival were 44% (95% CI 32-59%) and 28% (95% CI 18-43%), respectively. There were a total of four non-hematologic grade 3/4 adverse events and 44 deaths, 29 attributed to disease progression.

CONCLUSION

This is among the first prospective cohorts of low-grade lymphoma from sub-Saharan Africa. Patients with low grade lymphomas in Malawi have poor progression-free and overall survival compared to high income countries and all deaths in our cohort were from disease progression. Thus, increased resources (e.g., rituximab and other novel therapies) and investigation of the underlying biology of low-grade lymphoma in Malawi and similar contexts are needed to improve patient outcomes.
Mechanobiological Markers for Theragnostics in Breast Cancer
Authors: Maksimova Ksenia , Leonov Sergey , Pistovalova Margarita , Merkher Yulia
Published: July 2024

PURPOSE

Metastasis is the leading cause of cancer mortality. An accurate prediction of metastases helps to improve the patient's life quality. We have previously studied the relationship between mechanobiology (invasion, migration, endocytosis) and metastasis, where the actin cytoskeleton plays a key role in all these processes. The purpose of the study is to investigate associated with the actin cytoskeleton rearrangement genes, as potential markers of metastasis and targets for therapy.

METHODS

We have used genetic dependency data from the CRISPR screen from the 22Q2 public data release (DepMap, Broad Institute), including data for 17,386 genes across 1,086 cell-lines. Drug effects were taken from the PRISM Repurencing database (Broad Institute);4518 chemical compounds were evaluated. Data analysis was performed using RStudio software (2023 Posit Software, PBC). Ten previously defined mechanobiology-related markers were examined in 72 breast cancer (BC) and 52 non-cancerous cell-lines. Cell-lines were clustered by two methods: 1) isolated from metastatic, primary tumors and non-cancerous tissues;2) subgroups according to BC disease type. The parameters like gene effect, expression, copy number, RNAi, proteomics were evaluated. To analyze the correlation of drugs effect, Pearson's coefficient was calculated separately for metastatic and primary breast cancer cell lines. The effect of treatment on marker expression was considered significant when a coefficient was below -0.5 (at p < 0.001), chemical compounds with more significant effects on metastatic cells were identified separately, and matches were found in chemical connections between different markers.

RESULTS

The gene expression was the most significant parameter, enabling the statistically reliable differentiation of various BC cell-lines subgroups. Among the studied markers, TAGLN, FSCN1, ECM1 revealed differences in more than three explored parameters for two or more clusters, making them potential markers for metastasis. The most effective chemicals in terms of the combination of affected genes and dependent parameters were: DEHYDROEPIANDROSTERONE, RESIQUIMOD, LEVOMEPROMAZINE, BMS-806, MERBROMIN. Interestingly, among the studied markers the most influential were TAGLN, FSCN1, ECM1, making them potential targets for the therapy.

CONCLUSION

The markers defined by bioinformatical methods, TAGLN, FSCN1, and ECM1, have promising value for theragnostic purposes in breast cancer and should be further examined experimentally.
Vebreltinib for Advanced Non–Small Cell Lung Cancer Harboring c-Met Exon 14 Skipping Mutation: A Multicenter, Single-Arm, Phase II KUNPENG Study
Authors: Yang Jin-Ji , Zhang Yan , Wu Lin , Hu Jie , Wang Zhe-Hai , Chen Jing-Hua , Fan Yun , Lin Gen , Wang Qi-Ming , Yao Yu , Zhao Jun , Chen Yuan , Fang Jian , Song Yong , Zhang Wei , Cheng Ying , Guo Ren-Hua , Li Xing-Ya , Shi He-Peng , Xue Wei-Zhe , Han Di , Zhang Pei-Long , Wu Yi-Long
Published: July 2024

PURPOSE

The KUNPENG study aimed to evaluate the efficacy and safety of vebreltinib (also known as bozitinib, APL-101, PLB-1001, and CBT-101), a potent and highly selective inhibitor of c-mesenchymal-epithelial transition (
MET
), in patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) harboring c-Met alterations.

METHODS

This multicenter, multicohort, open-label, single-arm, phase II trial enrolled patients with c-Met dysregulated, locally advanced or metastatic NSCLC from January 2020 to August 2022 across 17 centers. Cohort 1 included patients with
MET
exon 14 skipping (
MET
ex14)–mutant NSCLC who had not previously received
MET
inhibitors. Participants were administered vebreltinib at a dosage of 200 mg twice a day in 28-day cycles. The primary end point was the objective response rate (ORR), and the key secondary end point was the duration of response (DoR), both evaluated by a blinded independent review committee according to the RECIST version 1.1.

RESULTS

As of August 9, 2022, 52 patients had been enrolled in cohort 1, of whom 35 (67.3%) were treatment-naïve. The ORR reached 75% (95% CI, 61.1 to 86). Among treatment-naïve patients, the ORR was 77.1% (95% CI, 59.9 to 89.6), and in previously treated patients, it was 70.6% (95% CI, 44.0 to 89.7). The disease control rate was 96.2%, with a median DoR of 15.9 months, a median progression-free survival of 14.1 months, and a median overall survival of 20.7 months. The most common treatment-related adverse events were peripheral edema (82.7%), QT prolongation (30.8%), and elevated serum creatinine (28.8%).

CONCLUSION

Vebreltinib has shown promising efficacy and a favorable safety profile in patients with
MET
ex14-mutant NSCLC.
All-cause Mortality and Incidence of Cardiovascular Diseases in Lean Patients With Newly Diagnosed Type 2 Diabetes
Authors: Song Do Kyeong , Oh Jongmin , Sung Yeon-Ah , Hong Young Sun , Lee Hyejin , Ha Eunhee
Published: July 2024

Context

A few studies have evaluated all-cause mortality or risk of cardiovascular diseases according to the body mass index (BMI) level in patients with type 2 diabetes.

Objective

We evaluated all-cause mortality and the incidence of cardiovascular diseases in lean patients with newly diagnosed type 2 diabetes in Korea. Additionally, we aimed to determine a difference in all-cause mortality and the incidence of cardiovascular diseases according to changes in BMI over time among patients with newly diagnosed type 2 diabetes in Korea.

Methods

We analyzed 419 509 patients with newly diagnosed type 2 diabetes who underwent health screening between 2010 and 2014 and followed up until 2019. We conducted a multivariate Cox proportional hazards model to determine the association between BMI and all-cause mortality or risk of cardiovascular diseases.

Results

Lean patients with type 2 diabetes had a higher risk of all-cause mortality [hazard ratio (HR): 2.106, 95% confidence interval (CI): 1.974-2.248], cardiovascular disease (HR: 1.132, 95% CI: 1.078-1.189), coronary heart disease (HR: 1.219, 95% CI: 1.124-1.323), heart failure (HR: 1.405, 95% CI: 1.279-1.543), stroke (HR: 1.155, 95% CI: 1.024-1.302), and ischemic stroke (HR: 1.205, 95% CI: 1.045-1.388) compared to patients with type 2 diabetes and normal BMI. Patients with newly diagnosed type 2 diabetes had the highest all-cause mortality when they remained lean during the follow-up.

Conclusion

Our findings underscore the critical role of maintaining an appropriate weight status to reduce all-cause mortality and incidence of cardiovascular diseases among lean patients with newly diagnosed type 2 diabetes.
Postnatal Cardiometabolic Health After Metformin Use in Gestational Diabetes: A Secondary Analysis of the EMERGE Trial
Authors: Dunne Fidelma , Newman Christine , Alvarez-Iglesias Alberto , O’Shea Paula , Devane Declan , Gillespie Paddy , Egan Aoife , O'Donnell Martin , Smyth Andrew
Published: July 2024

Aim

Women with gestational diabetes mellitus (GDM) display adverse lifetime cardiometabolic health. We examined whether early metformin in GDM could impact cardiometabolic risk factors postpartum.

Methods

EMERGE, a double-blind, placebo-controlled trial, randomized pregnancies 1:1 to placebo or metformin at GDM diagnosis and followed participants from randomization until 12 ± 4 weeks postpartum. In total, 478 pregnancies were available for postpartum maternal assessment, 237 and 241 assigned to metformin and placebo respectively. Weight (kg), body mass index (BMI) (kg/m2), waist circumference (cm), and blood pressure (mmHg) were measured, infant feeding method documented, and blood specimens drawn for a 75-gram oral glucose tolerance test, fasting insulin, C-peptide, and lipid analysis.

Results

Despite similar weight and BMI at trial randomization, participants receiving metformin had significantly lower weight (79.5 ± 15.9 vs 82.6 ± 16.9 kg; P = .04) and BMI (29.3 [5.6] vs 30.5 [5.4]; P = .018) at the postpartum visit. However, no difference in weight change from randomization to 12 weeks postpartum was observed between metformin and placebo groups. Overall, 29% (n = 139) of the cohort met criteria for prediabetes or diabetes, with no positive impact with metformin. There were also no differences in measurements of insulin resistance, blood pressure, or lipids between groups.

Conclusion

Early metformin use in GDM did not impact important cardiometabolic parameters in the early postpartum period despite significant benefits in weight gain and insulin use in pregnancy.
Comprehensive Characterization of Islet Remodeling in Development and in Diabetes Using Mass Cytometry
Authors: Toledo Maria Pilar , Xie Gengqiang , Wang Yue J
Published: July 2024

The pancreatic islet is the functional and structural unit of the pancreatic endocrine portion. Islet remodeling occurs in both normal development and pathogenesis of type 1 (T1D) and type 2 diabetes (T2D). However, accurately quantifying changes in islet cellular makeup and hormone expressions poses significant challenges due to large intra- and inter-donor heterogeneity and the limited scalability of traditional methods such as immunostaining. The cytometry by time-of-flight (CyTOF) technology enables simultaneous quantification of more than 30 protein markers at single-cell resolution in a high-throughput fashion. Moreover, with distinct DNA and viability markers, single live cells can be explicitly selected in CyTOF. Here, leveraging the CyTOF data generated by the Human Pancreas Analysis Program, we characterized more than 12 million islet cells from 71 donors. Our data revealed continued age-related changes in islet endocrine cell compositions, but the maturity of endocrine cells is reached by 3 years of age. We also observed significant changes in beta cell numbers and key protein expressions, along with a significant increase in bihormonal cells in T1D donors. In contrast, T2D donors exhibited minimal islet remodeling events. Our data shine a light on the islet dynamics during development and diabetes pathogenesis and suggest divergent pathogenesis processes of T1D and T2D. Our comprehensive approach not only elucidates islet plasticity but also establishes a foundation for integrated CyTOF analysis in islet biology and beyond.