bluuebunny/crossref_metadata_2025_split huggingface dataset:
It starts at the top: An analysis of female representation in academic medical oncology (MO), radiation oncology (RO), and surgical oncology (SO) program leadership positions.
Authors: Chowdhary Mudit , Chowdhary Akansha , Patel Kirtesh R. , Royce Trevor J. , Sen Neilayan , Barry Parul Nafees , Jain Shikha , Rao Ruta D. , Levy Mia Alyce , Knoll Miriam , Vapiwala Neha , Wang Dian , Pro Barbara , Marwaha Gaurav 
Published: March 2020

10520 Background: Female underrepresentation in academic medicine leadership is well-documented; however, oncology specific data are scarce. This study evaluates female leadership representation in academic medical oncology (MO), radiation oncology (RO) and surgical oncology (SO) programs. Furthermore, we examine the impact of female leadership on overall female faculty representation. Methods: A total of 264 (96%) Accreditation Council for Graduate Medical Education actively accredited MO [144 of 153], RO [93 of 94] and SO [27 of 27] training programs were included. The gender of overall faculty and those in leadership positions (program director and departmental chair/division chief) of each program was determined using hospital websites from 10/01/18 to 01/27/19. The chi-squared goodness-of-fit test was used to examine whether the observed proportion of females in leadership positions deviates significantly from the expected proportion based on the actual proportion of overall female faculty in MO, RO and SO. Two-sample t-tests were used to compare rates of female faculty representation across each program based on the presence/absence of female in a leadership position for MO, RO and SO. Results: Female faculty representation in MO, RO and SO was 37.1% (1,554/4,191), 30.7% (389/1,269) and 38.8% (212/546), respectively. Female representation in leadership positions was 31.5% (82/260), 17.4% (31/178) and 11.1% (5/45), respectively. The observed proportion of females in leadership positions was significantly lower than the expected proportion of females in leadership positions for RO (17.4% vs. 30.7%, p = .0001) and SO (11.1% vs. 38.8%, p = .0001), and demonstrated a trend towards significance for MO (31.5% vs. 37.1%, p = .063). 47.9%, 33% and 18.5% of MO, RO and SO programs had ≥1 female in a leadership position, respectively. Programs that had a female in a leadership position had a higher mean percentage of overall female faculty than those that did not: 41.0% vs 35.0% (p = .0006), 36.0% vs 26.0% (p = .0002) and 39.0% vs 32.0% (p = .348) for MO, RO and SO, respectively. Conclusions: Gender disparity exists in academic MO, RO and SO faculty and is magnified at the leadership level. Programs with a female physician in a leadership position are associated with a higher percentage of female faculty.
From presentation to paper: Gender disparities in oncological research.
Authors: Dijksterhuis Willemieke P.M. , Stroes Charlotte I. , Tan Wan Ling , Ithimakin Suthinee , Calles Antonio , Barriuso Jorge , Oosting Sjoukje , Kolarevic Daniela , Furness Andrew J.S. , Bozovic Ivana , Gomez-Roca Carlos Alberto , Van Laarhoven Hanneke W.M. 
Published: March 2020

10523 Background: Gender discrepancies have been identified in authorships of scientific publications, grant applications, and peer review in many disciplines, including oncology. The exact share of women presenting results of oncological studies at large conferences is unknown, while the oral presentation of a study at such a podium enhances the international visibility and recognition of the presenting person. Therefore, we aim to identify gender-based differences in contributions to presentations at two major oncological conferences. Methods: We collected consecutive abstracts presented at the plenary sessions of the American Society of Clinical Oncology (ASCO) Annual Meetings and presidential sessions of the European Society for Medical Oncology (ESMO) Congresses. Sex of the presenters and abstract authors, study results (positive vs. negative), and subsequently published papers were identified. Chi square tests were used to compare the distribution of sex over time. The association between presenter’s or last author’s sex and study outcome and impact factors were analyzed using Chi square tests and Mann-Whitney U tests, respectively. Results: Of available abstracts presented at ASCO between 2011 and 2018 (N = 34), and ESMO between 2008 and 2018 (N = 132), presenters were female in 24% and 21%, respectively. Female last authors were seen in 21% and 20% of these ASCO and ESMO abstracts. Of all contributing authors to these ASCO (N = 569) and ESMO (N = 1851) abstracts, 31% and 27% were female, respectively. The distribution of male and female ASCO and ESMO presenters (P = 0.580, P = 0.707, respectively) and abstract authors (P = 0.429, P = 0.062) was similar over the years. Of all abstracts, sex of the presenter or last abstract author were not associated with study outcomes (P = 0.718, P = 0.4331), nor with impact factor of subsequently published papers (P = 0.209, P = 0.661). Conclusions: There is a clear gender disparity in the presentation of oncological research at two main conferences, with less than a third of abstract authors female and less than a quarter of these studies presented by a woman. The lack of visibility of female researchers at presentations on these conferences could impair the acknowledgement for their research, opportunities in their academic career, and even hamper heterogeneity and outcomes in research.
Satisfaction of general versus specialized continuity clinic in hematology oncology fellowship training: A survey.
Authors: Ilyas Sama Imran , Murphy Martina Cathryn , Duff Jennifer Michelle , Close Julia Lee 
Published: March 2020

10529 Background: At the University of Florida (UF), oncology fellows participate in two general types of continuity clinic as part of their training. One clinic at the Veterans Hospital (VA) allows them to care for patients in a general clinic setting that encompasses a variety of hematology oncology diagnoses. The other clinic, located at the university site, is disease or system specific (such as breast or GI clinic). Considerable research supports the value of continuity clinic in residency and fellowship training, but the differences in having a general versus specialized clinic for oncology fellows have not been explored. The purpose of this study is to investigate the perceived differences of general versus specialized continuity clinics by recent oncology graduates from UF, and what features of a continuity clinic they feel were most important for an effective and meaningful experience. Methods: An anonymous survey was sent to the last six graduating classes of oncology fellows at UF. The survey contained short demographic questions, followed by five open ended questions pertaining to both continuity clinic experiences. Graduates were asked about their opinions of both the general and specialized clinics during their training at UF. Survey responses were reviewed and coded for common themes. Results: The most common themes that emerged from the surveys were concerning autonomy, supervision, and the diversity of cases and patient population. A majority of respondents felt they had more autonomy and personal responsibility at the VA general clinic, but less direct supervision than at the specialized clinics. They also believed they got a broader exposure of different disease types at the VA general clinic. Surveyed participants also commented on the quality of educational seminars and activities, preceptor expertise and teaching, and ability to observe cutting edge practice and clinical trials. Eleven out of thirty surveys were returned and we anticipate a greater than 50% response for the final poster. Conclusions: Graduated oncology fellows from UF believe that there is a balance that exists between having autonomy and ownership of their patients versus having adequate supervision. Many believe that having “controlled autonomy” and “as much independence as is safe for patients” is key to a meaningful continuity clinic experience during oncology fellowship training.
A novel qualitative methodology study to characterize discrimination and inclusion among hematology/oncology trainees.
Authors: Warsame Rahma M. , Asiedu Gladys , Kumbamu Ashok , Hayes Sharonne , Thompson Carrie A. , Hobday Timothy J. , Price Katharine Andress Rowe 
Published: March 2020

10530 Background: Learner wellbeing may be adversely affected by the experience of discrimination. Eliciting details from this vulnerable population about these experiences is a challenge. This study characterizes trainee experiences of discrimination and inclusion to inform graduate medical education (GME) policies and practice. Methods: Anonymous semi-structured, private phone interviews were conducted with fellows after informed consent. No identifying information was exchanged and the interviewer had no supervisory role over learners. Demographic information was obtained via anonymous online survey. Results: Of 29 fellows approached, 20 consented; 17 interviewed (10 men; median age 32 years). Racial & ethnic distribution: 6 Asian, 2 Black, 2 Multi-racial, 4 White, 3 Hispanic/Latino. All fellows reported discriminatory behavior that they either experienced or witnessed. Incidents of discriminatory behavior towards trainees were more common from patients (pts) (n = 41) than staff (n = 12). Discrimination from pts included requesting a different physician based on accent (n = 13), race (n = 11), perceived avoidance of a trainee considered “different” (n = 11), sex (n = 5), & ethnicity (n = 4). Six trainees were aware of policies against pt discrimination but only 1 trainee reported an incident. Trainees did not report because of the nature of incidents (micro aggressions that are difficult to characterize) and sense of futility of reporting. Discriminatory behavior from staff was based on perceived micro aggressions (n = 4), sex (n = 3), ethnicity (n = 3), ageism (n = 1), and sexual orientation (n = 1). Impact on trainees ranged from negative (personal anguish) to positive (motivation to improve communication). Coping mechanisms included debriefing with family/trainees and focusing on good pt experiences. Trainees felt that having diverse co-fellows, involvement on committees, and supportive program leadership promoted inclusivity. Conclusions: Our study found that discriminatory behavior towards trainees is common. Our methodology allows for honest & safe discussions. GME programs must assess their learning climate with respect to bias/inclusivity & develop appropriate processes.
FitFirms: A wellness option for oncology trainees.
Authors: Pathak Bhavana , Eapen Ann M. , Zell Jason A. 
Published: March 2020

10537 Background: Burnout in oncologists has been rising over the past decade. Burnout leads to poor patient outcomes and poor physician health. Younger oncologists are at higher risk for burnout. The Firm System was designed by Victor McKusick at the Johns Hopkins hospital in 1975 to integrate faculty and trainees into clinical and psychologically supportive cohorts. Here we describe an adapted Firm System called the FitFirms, which focused on social connectivity and altruistic service as means to combat burnout in oncology trainees. Methods: We divided the Hematology and Oncology Division of an academic Comprehensive Cancer Care center into four cohorts of faculty-fellow teams called FitFirms. Each FitFirm was named after a notable local or national female leader in the field of cancer medicine—The Henrietta Lacks Firm, The Jane Wright Firm, The Padmini Iyer Firm, and The Rita Mehta Firm. The faculty and fellows interacted on an at-minimum quarterly basis in casual social events and/or community service-oriented events for 15 months. The social events included group dinners, bowling, paint and game nights. The service events included participation in 5K walk/run fundraiser for our institution’s cancer center and support of a National Cancer Survivors Day event for US Veterans. A didactic discussion series was created to explore concepts of resiliency, work-life balance, and the role of art in medicine—mentored by faculty across the spectrum of oncologic disciplines (Surgical Oncology, Gynecologic Oncology, Palliative Care, and Health Communication). The Maslach Burnout Inventory survey was used to survey the oncology trainees before and after the interventions. Results: Nine pre-intervention surveys were collected with 78% of trainees describing themselves as on the burnout spectrum of feeling either ineffective, overextended, disengaged, or burned out (22% engaged). After 15 months, 10 post-intervention surveys were collected in which 60% of trainees described themselves on the burnout spectrum (40% engaged). Conclusions: The FitFirms are a novel system using social capital to reduce the problem of burnout in oncology trainees by engaging in social connectivity and altruistic service through faculty-mentored, historically-named divisional cohorts.
Preoperative chemoradiation +/- pazopanib in non-rhabdomyosarcoma soft tissue sarcoma (NRSTS): A report from Children's Oncology Group (COG) and NRG Oncology.
Authors: Weiss Aaron R. , Chi Yueh-Yun , Chen Yen-Lin , Choy Edwin , Davis Jessica L. , Fanburg-Smith Julie , Hawkins Douglas S. , Kayton Mark , Million Lynn , Okuno Scott H. , Ostrenga Andrew , Randall R. Lor , Scharschmidt Thomas , Sorger Joel , Spunt Sheri L. , Tian Jing , Terezakis Stephanie Alicia , Wang Dian , Zambrano Eduardo , Black Jennifer O. 
Published: March 2020

11002 Background: Pazopanib is a multi-targeted tyrosine kinase inhibitor with activity in advanced soft tissue sarcoma. ARST1321 is a phase II study designed to compare the near complete pathologic response rate (≥ 90% necrosis) of preoperative chemoradiation +/- pazopanib in children and adults with intermediate/high risk chemotherapy-sensitive NRSTS. Methods: ARST1321 is a jointly designed COG and NRG Oncology study opened to enrollment in July 2014. Eligible adult (≥18 years) and pediatric ( < 18 years) patients with unresected, newly diagnosed truncal/extremity NRSTS were enrolled into the Chemotherapy Cohort ( > 5 cm, grade 2/3, protocol-designated chemotherapy-sensitive histology). Following a dose-finding phase, patients were randomized to receive (Regimen A) or not receive (Regimen B) pazopanib ( < 18 years: 350 mg/m2/day; ≥ 18 years: 600 mg/day) in combination with ifosfamide (7.5 gm/m2/cycle) and doxorubicin (75 mg/m2/cycle) + 45 Gy preoperative RT followed by primary resection at week 13, then adjuvant chemotherapy. Results: As of June 30, 2018, 81 eligible patients were enrolled and randomized. Week 13 response is available for 42 patients (60% of expected information). The rate of ≥ 90% pathologic necrosis was 58.3% for Regimen A and 22.2% for Regimen B. Based on the significance level of 0.081 (for the second efficacy analysis with overall one-sided significance level of 0.20, power of 0.80, and O’Brien-Fleming-type cumulative error spending function), the 83.8% confidence interval for the difference was between 16.5% and 55.8%. At this predetermined interim analysis, the efficacy bound was crossed indicating that Regimen A is more efficacious than Regimen B. Given these findings, enrollment was stopped. Grade 3/4 toxicities were 73.8% for Regimen A and 29% for Regimen B with neutropenia, thrombocytopenia and febrile neutropenia being the most common toxicities. Conclusions: The rate of near complete pathologic response was significantly greater with the addition of pazopanib to preoperative chemoradiation in children and adults with intermediate/high risk NRSTS. The comparison of survival outcomes requires longer follow-up. Clinical trial information: NCT02180867.
Apatinib plus camrelizumab (SHR-1210) for unresectable high-grade osteosarcoma (APFAO) progressing after chemotherapy: A prospective, open label, phase II trial.
Authors: Xie Lu , Guo Wei , Xu Jie , Sun Xin , Liu Kuisheng , Zheng Bingxin , Ren Ting , Huang Yi , Tang Xiaodong , Yan Taiqiang , Yang Rongli , Sun Kunkun , Shen Danhua , Li Yuan 
Published: March 2020

11013 Background: Results of previous study showed high objective response but short-term activity of apatinib in advanced osteosarcoma. Given the recent success of immunotherapies, combinations of antiangiogenics with immune checkpoint blockers have become an attractive strategy. We aimed to investigate the activity of apatinib in combination with camrelizumab in patients with inoperable high-grade osteosarcoma progressing after chemotherapy. Methods: We did this open-label phase 2 trial in Peking University People’s Hospital. We enrolled patients (≥14 years) with advanced osteosarcoma progressing after chemotherapy. Patients received 500 mg apatinib orally taken once daily plus 200 mg camrelizumab intravenous infusion every 2 weeks until disease progression or unacceptable toxicity. The primary endpoint was 6 month progression-free survival (PFS). All analyses were intention-to-treatment. This trial is registered with ClinicalTrials.gov. (NCT03359018). Results: We enrolled 41 patients between January 1, and September 4, 2018. 20 (48.8%, 95%CI 32.8%-64.8%) of 41 patients were progression free at 6 months. Until final follow-up, the objective response rate was 21.95% (9/41). And the 6-m PFS rate and 4-m PFS rate were 54.32% (95% CI 37.62%-68.33%) and 70.00% (95% CI 53.24%–81.73%) respectively. Median PFS was 6.50 (95% CI 4.23–7.50) months while the median OS has not reached yet. And there were no statistical differences in the response rates or PFS between different PD-L1 expression groups ( P=0.153 and 0.231). Whereas target lesions with only pulmonary metastasis had obviously longer PFS than those lesions located at other places ( P <0.001). We also summarized all those lesions’ progression patterns as follows: slow pulmonary lesions’ progression(N=7), stable disease with lung but new lesions outside lung(N=4) and bone lesions’ progression(N=13), of which we found that there was obvious difference in PFS ( P=0.009) between different progression groups.Toxic effects led to dose reductions, or short interruptions, or both in 20 (48.78%) of 41 patients. There were no treatment-related deaths. Conclusions: The combination of apatinib and camrelizumab obviously prolonged PFS than single apatinib in the treatment for patients with advanced osteosarcoma progressing after chemotherapy. Those with pulmonary metastatic lesions obviously had longer PFS. Whether patients benefit from overall survival needs further observation. Clinical trial information: NCT03359018.
A three-gene signature to predict survival in pediatric osteosarcoma (OS) to follow patients toward liquid biopsy: A collaborative work in OS2006 protocol.
Authors: Entz-Werle Natacha , Tripp Aurelien , Weingertner Noëlle , Redini Francoise , Brouchet Anne , Gaspar Nathalie , Brugieres Laurence , Neumann Sophie Piperno , Marec-Berard Perrine , Dontenwill Monique 
Published: March 2020

11014 Background: The survival of pediatric OS is stable worldwide since two decades. The management of OS is lacking new approaches to classify closely the patients and adapt thereafter the treatments. The objectives of our molecular study, using allelotyping, quantitative PCR (qPCR) and droplet digital PCR (ddPCR), were to determine the survival impact of tumor molecular profiling in the initial tumor biopsy, in the tumor resection after neoadjuvant chemotherapy and on circulating DNA at different treatment steps. The gene panel based on biomarkers of bone dedifferentiation was already identified in the large tumor cohort of the French national protocol OS94 and demonstrated a significant prognostic impact of 3 genes MET, TWIST and APC. To go further and understand its significance throughout protocols, the same study was performed in OS2006 tumors. Methods: We applied retrospectively in the cohort of OS2006 protocol (135 patients) the same molecular assessment comprising the targeting of those 3 genes with 3 techniques evaluating their rearrangement by allelotyping, their copy number variations by qPCR and ddPCR. A preliminary cohort of 20 patients with liquid biopsies at diagnosis, before tumor surgery and at the end of chemotherapy was screened by ddPCR. Results: We were able to determine frequent rearrangements in the regions containing these 3 genes and a statistically significant correlation was made between the presence of a gene rearrangement and a worst outcome. The 3-gene signature was significantly predicting the outcome of more than 85% of patients diagnosed for an OS. Furthermore, the persistence of those genes’ rearrangements in the primitive tumor after neoadjuvant chemotherapy comparatively to the initial biopsy was correlated to a higher risk of relapse. This 3-gene signature was also used for assessment of residual disease (RD) in liquid biopsies and was able to determine before tumor surgery the level of RD. Conclusions: This molecular signature seems to be clearly associated with patient outcome and was able to provide evidence that this approach is a powerful tool to be used in pediatric OS follow up to determine early relapse or progression.
Clinical characterization of patients with SDHC epimutation in gastrointestinal stromal tumors.
Authors: Ilanchezhian Maran , Fuller Sarah N. , Raygada Margarita , Stratakis Constantine A. , Meltzer Paul S. , Miettinen Markku , Glod John , Killian Keith , Arnaldez Fernanda Irene 
Published: March 2020

11033 Background: Gastrointestinal Stromal Tumors are the most common malignancy in the GI tract. While the vast majority exhibit somatic mutations in KIT and PDGFRA, approximately 15% of GIST patients do not have this feature. This group of KIT and PDGFRA “wildtype” GISTs have in common a negative expression of SDHB when interrogated by immunohistochemistry. Succinate dehydrogenase (SDH) is a conserved enzyme that plays a critical role in cellular metabolism and energy production. A loss in SDH function is a mechanism observed in several types of cancers, and germline SDH mutations are considered a tumor predisposition syndrome. This group has reported that SDH-deficient gastrointestinal stromal tumors often harbor germline mutations in the SDH subunit genes (SDHA, SDHB, SDHC, and SDHD, termed SDHx). There is, however, a defined group that shows lack of SDH expression in the absence of mutation. Methods: We performed targeted exome sequencing on GIST patients’ tumor samples from the NIH GIST clinic and identified 25 SDHx-WT cases. Genome-wide DNA methylation and expression profiling showed SDHC promoter-specific CpG island hypermethylation and gene silencing in these 25 SDHx-WT, SDH deficient GISTs. Results: Clinical characterization of this cohort revealed that 24 of 25 SDHC-epimutant GISTs occurred in female patients, with a median age of 12 upon diagnosis. The median tumor size of this cohort of patients was 4.0 cm. Of the 16 patients from whom we were able to obtain complete pathology data, 15 showed epithelioid or mixed-epithelioid tumor morphology. All of them showed negative immunohistochemical staining for SDHB. 15 of 16 patients had multifocal tumors, which is a common finding in this population. Conclusions: The profiling of this cohort provides further insights into the natural history and pathogenesis of SDHC-epimutant GIST tumors.