bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gallbladder perforation related to bevacizumab in a patient with lung adenocarcinoma.
Authors: Oyan Basak , Ozturk Mehmet Akif , Kalayci Murat 
Published: March 2020

e20723 Background: Gastrointestinal perforation is one of the most important complications of bevacizumab. In patients with metastatic non-small cell lung cancer, gastrointestinal perforation has been reported with an incidence of less than 1%. Gallbladder perforation in patients receiving bevacizumab is a very rare complication. Methods: A 66-year-old male patient with stage IV lung cancer (adenocarcinoma) admitted to emergency room with the complaints of right upper quadrant abdominal pain, fever, emesis and no bowel movements, seven days after the 3rdcycle of pemetrexed-cisplatin and bevacizumab chemotherapy. CT scan of abdomen showed air images adjacent to the gallbladder suggesting a perforation and an abscess formation of 3.5x3 cm in diameter. The patient underwent surgery. There was a defect of 2 cm in gallbladder wall and there were 4 gallstones inside the gallbladder. Cholecystectomy was performed and the abscess localized between the gallbladder and liver was drained. The pathological examination showed bleeding areas and atrophy in mucosa. No tumor involvement and no microthrombi in microvessels were seen. After recovery, bevacizumab was permanently discontinued. Results: Based on reports from FDA, there are 15 cases of bevacizumab-induced gallbladder perforation, excluding the described case. When the characteristics of the patients are analyzed, it was seen that 75% of gallbladder perforations occurred within the first 6 months of therapy. Most cases were under treatment for gastrointestinal malignancies. Our case is the fifth case with the diagnosis of lung cancer. Although the coexistence of cholelithiasis in other cases is unknown, chronic inflammation in addition to the disruption of vascular regeneration by bevacizumab may increase the risk of gallbladder perforation. Conclusions: Chronic inflammation related to cholelithiasis can be a predisposing factor of bevacizumab-induced gallbladder perforation. Therefore, caution should be exercised when treating these patients with bevacizumab.
OPTiM: A randomized phase III trial of talimogene laherparepvec (T-VEC) versus subcutaneous (SC) granulocyte-macrophage colony-stimulating factor (GM-CSF) for the treatment (tx) of unresected stage IIIB/C and IV melanoma.
Authors: Andtbacka Robert Hans Ingemar , Collichio Frances A. , Amatruda Thomas , Senzer Neil N. , Chesney Jason , Delman Keith A. , Spitler Lynn E. , Puzanov Igor , Doleman Susan , Ye Yining , Vanderwalde Ari M. , Coffin Robert , Kaufman Howard 
Published: March 2020

LBA9008 The full, final text of this abstract will be available at abstract.asco.org at 7:30 AM (EDT) on Saturday, June, 1, 2013, and in the Annual Meeting Proceedings online supplement to the June 20, 2013, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Saturday edition of ASCO Daily News.
A phase III open-label study of nivolumab (anti-PD-1; BMS-936558; ONO-4538) versus investigator’s choice in advanced melanoma patients progressing post anti-CTLA-4 therapy.
Authors: Chmielowski Bartosz , Hamid Omid , Minor David R. , D'Angelo Sandra P. , Pennock Gregory K. , Grossmann Kenneth , Ascierto Paolo Antonio , Daud Adil , Dummer Reinhard , Hodi F. Stephen , Lebbé Céleste , Robert Caroline , Sosman Jeffrey Alan , Yang Arvin , Lambert Alexandre , Weber Jeffrey S. 
Published: March 2020

TPS9105^ Background: Despite the recent approval of ipilimumab and vemurafenib for advanced melanoma, there is still a large unmet need for patients (pts) who have progressed on anti-CTLA-4 therapy and a BRAF inhibitor (depending on BRAF status). Programmed death-1 (PD-1) is a co-stimulation inhibitory receptor that negatively regulates T-cell activation and is upregulated in tumor-infiltrating lymphocytes. Upregulation of PD-1 is also associated with advanced disease in melanoma. Nivolumab, an anti-PD-1 receptor blocking monoclonal antibody, demonstrated durable antitumor activity in a phase 1 study in 106 pts with advanced melanoma with objective responses (OR) observed in 31% and stable disease ≥24 weeks in 6% with a manageable safety profile (Topalian SL et al; ESMO 2012 [Abstr 453P]). Here we describe a phase III study designed to compare the clinical benefit of nivolumab to chemotherapy of investigator’s choice in previously treated pts with unresectable or metastatic melanoma. Methods: In this two arm open-label study, approximately 390 pts will be randomized 2:1 to receive either nivolumab 3 mg/kg IV every two weeks (Arm A) or either dacarbazine 1000 mg/m2 IV or carboplatin AUC6/paclitaxel 175 mg/m2 IV every 3 weeks (Arm B) until disease progression or treatment discontinuation. Pts included are those with ≤2 regimens for advanced melanoma who have progressed on anti-CTLA-4 therapy as well as a BRAF inhibitor if BRAF V600-mutation positive. Pts without active brain metastases are eligible. All pts require baseline fresh biopsy to determine PD-L1 expression. Pts will be stratified by tumor PD-L1 expression, BRAF status, and prior anti-CTLA-4 best response. Tumor response per RECIST 1.1 will be assessed 9 weeks following randomization and every 6 weeks thereafter for the first year. After the first year, response will be assessed every 12 weeks until disease progression or treatment discontinuation. The co-primary endpoints are overall survival (OS) and OR rate. Secondary endpoints include progression-free survival, correlation of PD-L1 expression with clinical outcome, and health-related quality of life. Clinical trial information: NCT01721746.
A phase III, randomized, double-blind study of nivolumab (anti-PD-1; BMS-936558; ONO-4538) versus dacarbazine in patients (pts) with previously untreated, unresectable, or metastatic melanoma (MEL).
Authors: Robert Caroline , Ascierto Paolo Antonio , Maio Michele , Hernberg Micaela , Schmidt Henrik , Waxman Ian , Garbe Claus , Lebbé Céleste , Hauschild Axel 
Published: March 2020

TPS9106 Background: The 5-year survival rate for late-stage MEL is currently only 15%. Despite recent advances with ipilimumab and vemurafenib, a considerable unmet need remains for pts with previously untreated, unresectable or metastatic BRAF wild-type MEL. Objective response rate (ORR) with first-line dacarbazine, a widely used chemotherapy in MEL, is 13%, with median overall survival (OS) ranging from 5.6 to 11 months. Programmed death-1 (PD-1) is an immune checkpoint receptor that negatively regulates T-cell activation through interaction with its ligand, PD-L1. This ligand is overexpressed by multiple tumor types, including advanced MEL. The PD-1 receptor blocking antibody nivolumab demonstrated clinical activity at 0.1-10 mg/kg in a phase I study in pts with advanced MEL (n = 106), with OR in 33 pts and stable disease ≥24 weeks in 6 pts. We describe a double-blind, randomized phase III study designed to compare the clinical benefit of nivolumab vs dacarbazine in pts with advanced MEL. Methods: Approximately 410 pts with untreated, unresectable stage III or stage IV MEL will be randomized 1:1 to receive either nivolumab 3 mg/kg IV every two weeks or dacarbazine 1000 mg/m2 IV every three weeks until disease progression or unacceptable toxicity. All pts must be BRAF wild-type as per V600 mutational testing. Pts will be stratified by PD-L1 status (positive vs negative/indeterminate) and metastatic (M) stage (M0/M1a/M1b vs M1c). PD-L1 positivity will be defined as ≥5% total membrane staining in tumor cells. Tumor response (per RECIST 1.1) will be assessed 9 weeks following randomization and every 6 weeks thereafter for the first year. After the first year, response will be assessed every 12 weeks until disease progression or treatment discontinuation. Treatment may continue beyond initial progression at the investigator’s discretion for pts showing clinical benefit and tolerating therapy. The primary endpoint is OS. Secondary endpoints include progression-free survival, ORR, whether PD-L1 expression is a predictive biomarker for OS, and health-related quality of life. Clinical trial information: NCT01721772.
Feasibility of implementing a resident oncology video curriculum.
Authors: Brondfield Sam , Iverson Nicholas , Subbaraj Lakshmi , Babik Jennifer 
Published: March 2020

10500 Background: ACGME survey results consistently show that 40% of University of California, San Francisco (UCSF) internal medicine (IM) residents are dissatisfied with their oncology education—higher than the oncology national average and highest among UCSF IM subspecialties. A needs assessment revealed that UCSF residents desire online oncology resources for asynchronous learning. To address this need, we sought online oncology videos targeted to residents but found none. We thus used cognitive theory of multimedia learning principles to develop an oncology video curriculum and evaluated three feasibility components: demand (frequency of use), efficacy, and acceptability. Methods: We chose common cancers from the ABIM blueprint and filmed five 10-minute videos of UCSF oncologists discussing content they chose for residents. We created modules with pre/post tests derived from video content. After a pilot, we sent links to all IM residents on required oncology clinic rotations over four months (n = 25) and offered protected clinic time for optional completion. We compared pre/post test scores with a paired t test and surveyed residents. Results: Demand: 72% (18 of 25) completed ≥1 module; 32% completed all 5. Efficacy: The mean pre- vs. post-test score improved (50% vs. 87%, p = 0.002). Acceptability: 64% completed the survey. Of those who completed ≥1 module, 93% (13 of 14) felt strongly that the videos contributed to their knowledge. 93% recommended the videos to others. Residents praised the length, key points, and pre/post tests. Finding time for the modules was difficult; most did them at home. Suggestions included focusing on fundamentals and creating videos for all common cancers. Conclusions: We present demand, efficacy, and acceptability evidence supporting the feasibility of a resident oncology video curriculum. Formal protected time for module use is critical. We will focus on fundamentals for generalists as we make more videos. We will track ACGME survey results, examination scores, and clinical performance to study impact. We aim to publish the modules online for broader use and as a model solution to address similar needs across specialties and institutions, as complex resident schedules increasingly require asynchronous learning.
Which factors are influencing good digital education? Analysis on ecancer programs from major international congresses.
Authors: Burke Danny , Thalmann Eva , McVie Gordon 
Published: March 2020

10501 Background: Factors limit the opportunities for healthcare professionals to attendinternational conferences including lack of financial support or time. Digital education from Independent Medical Education providers is therefore an important source of education for clinicians. One such provider is the ecancer Global Foundation (ecancer), an educational charity who publish ecancer.org. A landmark ecancer activity is sharing developments from conferences with video interviews of experts discussing the key data. Methods: We aim to get a deeper understanding of the factors that influence viewer satisfaction with these resources including whether industry support (through un-restricted educational grants) had a significant impact. Viewer satisfaction is measured using 3 metrics: 1. Viewer feedback; 2. Number of views; 3. Average viewing time. The analysis is based on programs from ASCO GU 2018, ASCO 2018 andESMO 2018 covering prostate and lung cancer education including unsupported as well as industry supported programs by Janssen, and two other pharma companies through unrestricted educational grants. Results: 68 videos were analysed with 95,249 views. This included 4 Expert to Expert Interviews, 4 Expert Panel Discussions and 60 To Camera Interviews. Of the 68 videos, 24 were supported by industry and all were peer-reviewed. Viewer feedback includes Net Promotor Score and a measure of likely impact on clinical practice as a result of watching the video. Conclusions: Expert to Expert and Expert Panel formats achieve higher viewer satisfaction than To Camera Interviews. Viewer satisfaction scores are very similar for industry supported vs non-industry supported content. These findings seem to suggest that the format of the educational video is a more important factor than whether it is supported by industry when impacting viewer satisfaction.[Table: see text]
Development of an “Art of Oncology” curriculum to mitigate burnout and foster solidarity among hematology/oncology fellows.
Authors: Richardson Daniel R. , Winzelberg Gary , Rosenstein Donald Lee , Collichio Frances A. 
Published: March 2020

10507 Background: Oncologists and fellows in Hematology/Oncology (HO) training programs report high levels of burnout. The ACGME requires accredited programs to have a mechanism to foster “well-being” and “ethical behavior” among fellows. A loss of solidarity among oncology professionals may contribute to known causes of burnout, such as heavy workload and severity of patient illness, that may in turn negatively impact patient outcomes. Methods: Through a multidisciplinary process involving fellows and faculty from psychiatry, palliative care, and hematology/oncology, a 3-year longitudinal “Art of Oncology” (AOO) curriculum was created for HO fellows at our institution to foster solidarity and mitigate burnout. The curriculum principally involved monthly hour-long sessions intended to promote reflection on oncologists’ shared experiences and the humanistic aspects of caring for patients with cancer. Facilitated by topic experts utilizing personal and published narratives, sessions foster group discussion. Fellows are also invited to write a personal narrative reflecting on their role as an oncologist. Topics include death and dying, caring for patients after treatment failure, cultivating resilience, religion/spirituality, the moral responsibility of oncologists, and oncology as a calling. Cancer patients and spouses were invited to facilitate a session to emphasize the patient experience. Burnout and preparedness for covered topic areas were measured prior to curriculum initiation and will be re-assessed annually. Results: The curriculum began in 2018. Of current fellows, 94.7% (18/19) completed the initial survey. A greater proportion of HO fellows participated in the AOO sessions than non-AOO didactic lectures (mean attendance, 59.2% v. 42.7%, p = 0.037). At curriculum initiation, most fellows reported burnout a few times or more a month (all fellows = 75%, 1st year = 85.7%, 2nd year = 80%, and higher = 62.5%). Conclusions: The implementation of a dedicated curriculum to foster solidarity among HO fellows through narrative medicine and group discussion of the humanistic aspects of oncology is feasible. A substantial degree of burnout exists among HO fellows, even incoming fellows. Further research to assess whether this curriculum mitigates burnout is needed. Because burnout is already a problem for incoming fellows, further work should investigate interventions aimed at ameliorating burnout among both residents and fellows.
ASCO Direct GU: A multistakeholder blended-learning project to make global education local.
Authors: Miller Kurt , Malhotra Suneil Singh , Nanchanatt Daina , Thalmann Eva , Van Der Zwart Robert A. , Joniau Steven 
Published: March 2020

10515 Background: International clinicians (HCPs) often find it difficult to attend North American congresses due to time out of the clinic, institutional travel restrictions, & individual financial burden. HCPs continue to highlight the value of peer to peer scientific exchange at international meetings & peer reviewed journals. Coupled with the dramatic increase of new scientific & clinical data that are rapidly changing clinical paradigms, there is a need for an effective & efficient digital solution to reach as many HCPs as possible. ASCO GU Direct sought to develop an educational program that culled the latest clinical & scientific data from ASCO GU in real time to global HCPs. ASCO GU Direct is a partnership between ASCO, MEDtalks Netherlands, Bayer & Janssen to drive global education locally since 2016. The live connection was broadcast in real time to local digital hubs in Europe, Middle East & Asia, where an expert panel from ASCO GU reviewed key scientific data with local HCPs in real time. HCPs were able to view ASCO presentations & ask questions to the panel despite time zone & geography. Methods: We present results from the surveys done with participating HCPs to understand the effectiveness of this blended program by examining the quality & objectivity of the content, impact on their clinical treatment, & the Net Promotor Score (NPS). Results: To measure quality & objectivity, NPS was calculated based on HCP responses to: “Would you recommend ASCO GU Direct to a colleague.” The NPS was 59 in 17 & 72 in 18 (scale: -100 to +100), showing willingness to recommend the educational program. Conclusions: Providing digital access can effectively & efficiently bridge gaps that would otherwise exist for international HCPs who did not attend ASCO GU. Digital access through this collaboration with live access to experts provides an excellent solution for HCPs who want to remain updated on clinical & scientific data.
Cross-cultural validation of a medical leadership competencies survey in Latin-American physicians: A multinational study.
Authors: Mano Max S. , Gomes Rafaela , Barrios Carlos H. , Marta Gustavo Nader , Villarreal-Garza Cynthia , Frasson Antonio Luiz , Sternberg Cinthya , Clara Renan , Simon Sergio D. , Werutsky Gustavo , Çitaku Fadil 
Published: March 2020

10517 Background: Despite the growing complexity in the healthcare sector, physicians rarely receive formal training in leadership skills. In a previous survey, Citaku et el identified a set of leadership competencies (LC) which were evaluated by North-American (NA) and European (EU) leaders involved with medical education. We aim 1) To apply this same survey to a population of Latin-American (LA) physicians from the oncology community and related areas who hold leadership positions of various levels; 2) To compare the results with those of the previous survey and 3) To perform subgroup analyses within the LA cohort. Methods: The survey was sent to close to 8.000 members of contributing medical societies from LA countries. In addition to the 63 questions with 5 possible responses, we also collected data on type of institution (private vs public), country of practice, main specialty, gender, age, years of experience in oncology and years of experience in leadership position. Results: We collected a total of 217 responses on a web-based tool. LA leaders placed the highest value on task-management competencies(91,37% of `important` or `very important` responses vs 87,0% for NA/EU; p < .0001), followed by self-management(87,45% vs 87,55%; p = NS), social responsibility(86,83% vs 87,48% ; p = NS), innovation(86,69% vs 85,31% ; p = NS) and leading others(83,31% vs 84,71% ; p = NS). Social responsibility, which was first in importance in the NA/EU survey, was only third in the LA survey. Subgroup analyses revealed significant interactions which will be fully presented. Conclusions: We successfully applied the survey to a population of LA medical leaders from the oncology community and related areas. LC valued by LA leaders somewhat differ from those valued by their NA/EU counterparts, implying that cultural aspects might influence the perception of desired/required LC. We also detected significant variations in the responses within the LA population. Our data might indicate that current physician leadership training programs should be tailored to suit specific needs and cultural aspects of each region. Further validation of this survey in other clusters of world culture is warranted.
Support structures for female physicians: Motivations and barriers to gender-specific conferences and symposia.
Authors: Jain Shikha , Graff Stephanie L. , Swaroop M , Woitowich Nicole C. 
Published: March 2020

10518 Background: While nearly half of all medical school graduates are female, women remain underrepresented in the physician workforce. Conferences or symposia designed to address issues relevant to female physicians, such as gender-bias, sexual harassment, and work-life balance are one strategy to improve retention and advancement, yet, limited data exists surrounding their utility. To address this gap, we surveyed a multi-disciplinary group of female physicians to identify motivations or barriers to attendance. Methods: An online survey instrument was distributed nationally via social media and shared by respondents. The survey assessed participants ’ demographics, attendance at gender-specific conferences or symposia, motivations or barriers to attendance, and perceived benefits of attendance. Results: Of 792 respondents, 34% had attended a conference or symposia for women in medicine, while 66% had not. Attendees were significantly more likely to hold a leadership position (68% vs. 43%, p < 0.0001), an academic faculty position (74% vs. 56%, p < 0.0001), and have received a professional accolade within the past year (42% vs. 28%, p < 0.0001). Non-attendees were significantly more likely to be the primary caregiver for children or seniors (64% vs. 56%, p = 0.042). Respondents indicated that an interest in discussion topics, a sense of community, and growth of professional network were key motivators in attendance. The majority of respondents indicated that attendance improved their self-advocacy, self-image, and leadership skills. Of those who did not attend, 51% were unaware of such conferences or symposia. Those who were aware, but unable to attend, cited lack of time as the major barrier to participation. Conclusions: The results of this study provide preliminary data surrounding gender-specific conferences or symposia for women in medicine and highlight opportunities for increased engagement. While not causative, attendees share attributes of professional success and report personal and professional benefits. Lack of awareness and access to child/family care are likely major barriers to participation, which can be addressed through strategic initiatives.