bluuebunny/crossref_metadata_2025_split huggingface dataset:
RNA sequencing analysis and T-cell receptor repertoire in triple-negative breast cancer (TNBC).
Authors: Kim Ju Won , Yu Yun Suk , Choi Jung Yoon , Lee Soohyeon , Chang Won Jin , Choi Yoon Ji , Jung Seung Pil , Kong Sun-Young , Sim Sung Hoon , Lee Keun Seok , Park Jin Young , Seo Yong Bae , Kim Yeul Hong , Lee Eun Sook , Park Kyong Hwa 
Published: May 2020

1075 Background: Triple negative breast cancer (TNBC) is defined by the lack of two hormone receptors (HR) and human epidermal growth factor receptor 2 (HER2), and well known to have poor prognosis. In this study, we conducted a RNA sequencing including T-cell receptor (TCR) repertoire analysis to develop prognostic biomarker in patients with TNBC. In addition, genes and signaling pathways that correlated with selected biomarker were also investigated. Methods: Total of 78 tumor tissues from TNBC patients were participated for RNA-seq (Illumina Hiseq) analysis. Groups of significant genes were selected by differentially expressed genes (DEGs) analysis, whose expression levels differed more than 1.5 times between patients and normal, or early stage and advanced stage TNBC. Transcript expression levels for prognostic biomarker were analyzed based on R v3.4.3. Using CBS ProbePINGS, a genomic big data analytics platform, we evaluated druggable pathways and protein-protein interaction (PPI). The Interaction Frequency Ratio Score (IFRS) was calculated by investigating highly interactive pathways, and the drugs were matched to patients. TCR repertoire analysis was performed by MiXCR. Results: Ten candidate gene signatures were selected based on RNA sequencing data of each sample. Cross-validation through machine learning showed that the accuracy of the first-ranked signature was 92.3%, the second was 92.0%, and the third was 90.3%. The accuracy of 4th to 6th was 88.7%, and the accuracy of 7th to 10th was over 88.0%. Cross-validated gene signature, age, and TNM staging showed significant discriminant power under univariate Cox regression analysis (p < 0.05). In the CBS ProbePINGS, human papillomavirus infection, MAPK pathway, and tumorigenesis pathway were correlated with cell signaling. CDK2, FN1, and JUN genes were highly interactive each other. In addition, the drug matching result according to IFRS value suggested imatinib and regorafenib could be possible candidates. TCR repertoire analysis presented that number of clonecount was lower in recurrent or metastatic TNBC than early stage cancer. Conclusions: This study revealed a specific gene signatures that can accurately determine recurrence and metastasis in patients with TNBC based on RNA sequencing analysis. TCR repertoire analysis and CBS ProbePINGS could be valuable method in treatment selection
Preliminary efficacy data of triple-negative breast cancer cohort of NCI 9881 study: A phase II study of cediranib in combination with olaparib in advanced solid tumors.
Authors: Hafez Navid , Soliman Hatem Hussein , Fu Siqing , Gelmon Karen A. , Abdul Razak Albiruni Ryan , Munster Pamela N. , Vaishampayan Ulka N. , Kato Shumei , Lara Primo , Swisher Elizabeth M. , Nixon Andrew B. , Patel Abhijit , Shyr Yu , Ivy S. Percy , LoRusso Patricia , Kim Joseph W. 
Published: May 2020

1077 Background: Cediranib, a pan-vascular endothelial growth factor receptor tyrosine kinase inhibitor, suppresses expression of BRCA1, BRCA2, and RAD51 and increases sensitivity of tumors to poly-(ADP-ribose) polymerase (PARP) inhibitors in vitro. Olaparib, a PARP inhibitor, demonstrates clinical efficacy in patients with germline BRCA1/2 mutations and HER2-negative metastatic breast cancer. We therefore tested the anti-tumor activity of the combination of cediranib and olaparib in patients (pts) with metastatic triple-negative breast cancer (TNBC). Methods: This multi-institutional, two-stage, phase II study enrolled patients with metastatic TNBC previously treated with a minimum of one prior line of systemic therapy in the advanced setting. Patients were treated with cediranib 30mg po daily plus olaparib 200mg po BID until disease progression or unacceptable toxicity. The primary endpoint was objective response rate by RECIST v1.1. Baseline tumor biopsies were obtained for biomarker analyses. Results: Baseline characteristics of the 37pts enrolled are summarized below. The overall objective response rate was 14% (95% CI: 0.025, 0.2453). Median duration of response was 2.0 months (mos) with a range of 1.8 to 6.3 mos. Disease control rate ((# of pts with CR, PR or SD)/(# of evaluable pts)) was 81% (95% CI: 0.6846, 0.937). Median PFS was 3.7 mos (95% CI: 2.1, 4.3). Grade 3/4 adverse events (G3/4 AEs), irrespective of attribution, occurred in 25 of 38 (66%).G3/4 AEs occurring in > 5% of pts were hypertension (24%) and dyspnea (11%), diarrhea (8%) vomiting (8%). Conclusions: The cediranib/olaparib combination resulted in promising objective responses in 14% of biomarker-unselected patients with heavily pre-treated, metastatic TNBC. The regimen required prompt initiation of antihypertensives, but AEs were overall manageable. Analyses of mutation status in homologous recombination DNA repair genes are ongoing and will be correlated with clinical outcome. Clinical trial information: NCT02498613 . [Table: see text]
Metastatic behavior of mixed invasive ductal lobular carcinoma (mIDC/ILC).
Authors: Nasrazadani Azadeh , Li Yujia , Tseng George , Xavier Jennifer , Lee Adrian V. , Lucas Peter C. , Oesterreich Steffi , Wolmark Norman 
Published: May 2020

1085 Background: Mixed invasive ductal lobular carcinoma (mIDC/ILC) is a poorly described subtype of invasive breast cancer, characterized by its composition of both ductal and lobular histopathology. It is unclear if individual or both components drive metastasis. Literature is sparse regarding sites of metastatic spread of this elusive subtype of invasive breast cancer. Methods: Cohorts of patients with mIDC/ILC, invasive ductal carcinoma (IDC), and invasive lobular carcinoma (ILC) were identified from the UPMC Network Cancer Registry. Among these, 46 patients with mIDC/ILC, 1,131 patients with IDC, and 145 patients with ILC seen at UPMC Magee Women’s Hospital from 1990 – 2017 were found to have developed distant metastasis during the course of their disease. The metastatic pattern of spread was compared between the cohorts. Formalin-fixed, paraffin-embedded patient samples from the metastatic sites of a portion of the mIDC/ILC cases (n = 19) was acquired and evaluated by H&E staining. Results: Patients with IDC were more likely than patients with ILC to have metastasis to the liver (p = 0.001) and lung (p < 0.001), and less likely to have metastasis to the peritoneum (p < 0.001). Patients with mIDC/ILC were more likely than patients with IDC to have peritoneal metastasis (p = 0.01), similar to patients with ILC. Compared to patients with ILC, patients with mIDC/ILC were more likely to have liver metastasis (p = 0.001), similar to patients with IDC. Evaluation of the metastatic lesions originating from mIDC/ILC displayed a spectrum of histopathology including mixed histology (n = 3), pure IDC (n = 3), pure ILC (n = 5), and indeterminate lesions with features of both IDC and ILC (n = 6). Two cases were uninterpretable due to significant crush artifact. Metastatic mIDC/ILC lesions with retained mIDC/ILC histology were found in vertebral, pleural, and skin tissues. Metastatic mIDC/ILC lesions with IDC histology were found in a cerebellar, liver, and chest wall lesion; whereas, those with ILC histology were found in bowel, omental fat, ovary, bone, and sacrum. Indeterminate histology metastatic lesions were found at liver, chest wall, cerebellar, and bone sites. Conclusions: mIDC/ILC metastasizes to a range of distant sites with a higher preference to the liver and peritoneum as compared to ILC and IDC, respectively. Metastatic lesions arising from mIDC/ILC tumors showed a spectrum of histologies, including mIDC/ILC, IDC, ILC and indeterminate lesions with features of both IDC and ILC. Ongoing genomics studies will provide further insight into development of metastases from mIDC/ILC tumors.
Innovation in resident oncology education: Switching from an inpatient ward rotation to a hybrid model of inpatient consultations and outpatient clinics.
Authors: King Jennifer , Saliba Antoine , Akel Reem , Wei Cynthia , Manchanda Naveen , Sinex Noelle , Grethlein Sara Jo , Goldman Mitchell 
Published: May 2020

11006 Background: Interest in pursuing a career in oncology has decreased among internal medicine residents completing an inpatient oncology rotation. Over several years, our institutional data at Indiana University School of Medicine reflected lower resident satisfaction with the oncology inpatient ward rotation compared to other rotations. Methods: A hybrid model of inpatient consultations and outpatient clinics replaced the traditional inpatient oncology rotation at our institution. Over a six-month period preceding and following the change in format, residents completed anonymous rotation assessments and rated their experiences on a 5-point Likert scale (low 1 to high 5). Areas assessed included: patient load, educational value of patient mix, quality of didactics and teaching, quality of patient care delivery, adequacy of time for reading, and overall educational quality of the rotation. Results: The hybrid oncology rotation (8 respondents out of 10 residents approached) was rated as significantly superior to the traditional ward format (15 respondents out of 16 residents approached) in six out of eight areas. Improvements in the perceived quality of patient care delivery (p=0.139) and quality of didactics (p=0.058) were also observed without reaching statistical significance. The balance of inpatient and outpatient experiences with the hybrid rotation was highly rated (4.5 ± 0.5). Conclusions: The implementation of a hybrid oncology rotation was associated with perceived improvement in educational value, patient mix, and time for reflection and study without apparent compromise in the quality of patient care delivery. [Table: see text]
Storytelling as a means of improving community and decreasing burnout in a large academic cancer center.
Authors: Rogers Sherise C. , Benson Don M. , Kraut Eric H. , Haque Tamanna Zohra , Mousa Luay , Fowler Jeffery , Dettorre Janet 
Published: May 2020

11018 Background: Burnout is highly experienced amongst physicians who care for patients with cancer. Workplace isolation is a risk factor for burnout. The field of oncology is growing at a rapid pace and many cancer centers are expanding to meet the demands of patient care and research. Prior assessments revealed that our hematology and oncology fellows were experiencing feelings of isolation and disconnection, which was likely reflected from our greater academic community. Methods: The traditional art of storytelling has been used to offer guidance, teaching, new perspective taking and understanding of self. The concept of “My Story”, an interactive storytelling lecture series was developed to address the following objectives at a large academic cancer center: 1) Promote connection and decrease isolation amongst the cancer sub-specialties 2) Increase fellow-faculty interaction for mentorship, 3) provide an outlet to discuss sensitive topics such as burnout, grief, unexpected patient outcomes, medical errors, work- life balance, career transitions, personal struggles, and bias. A faculty member was identified to tell their unique story for a special lecture. Fellows and faculty members from hematology, oncology, radiation-oncology, neuro-oncology, gynecology-oncology, and surgical oncology were invited. All audience members were encouraged to ask questions and engage in discussion. A survey was distributed after the inaugural event for evaluation. Results: A total of 56 people attended the inaugural event. There were 14 fellows, 9 faculty members and 33 others, which included basic scientists and advance practice providers. 17 individuals completed our post survey, which included 6 faculty members, 4 fellows, 1 nurse practitioner, 1 student and 5 others. On a scale from 1-10 (mean scores reported), participants rated the experience 7.5 for enjoyment, 6.6 for sense of connection with the group, 6.0 for inspiring them to make new connections with others and 6.8 when asked if they left with new tools to assist with personal challenge. Conclusions: A lecture series that invites multidisciplinary cancer physicians and surgeons to discuss personal career and life challenges can be beneficial to addressing burnout, decreasing isolation and improving connection and community at a large academic cancer center.
Reflection rounds to facilitate resilience in hematology/medical oncology fellows.
Authors: Nakajima Erica C. , Murray Joseph Christopher , Zimmerman Jacquelyn W. , Messmer Marcus , Waseem Najeff , Nizialek Emily , Sedhom Ramy , Gupta Arjun , Donehower Ross C. , Marrone Kristen 
Published: May 2020

11019 Background: Given the prevalence of burnout among medical oncologists (40-60% in the literature), education on burnout risk factors, recovery, and prevention are needed urgently in training curricula for medical oncology fellows. Care of patients with cancer is increasingly complex, and often can seem overwhelming to new trainees. Debriefing as a resiliency skill to develop self-reflection and identify coping strategies may provide a durable way to navigate these complexities. Optimization of fellowship Reflection Rounds (RR) was selected as a fellow-led quality improvement (QI) project for the current academic year. Methods: A QI team including the APD and representatives from all levels of fellowship training was assembled. Feedback regarding previously unstructured, monthly, hour long faculty-facilitated RR for first year fellows was reviewed. Topics with associated readings were selected and paired with fellow-nominated faculty based on the most common recurring themes. The QI team administered the Stanford Professional Fulfillment Index (PFI) to all fellows at the midway point of the academic year. RR were re-structured to include a chaplain with trainee communication expertise and a chief fellow to participate the sessions to assess changes in trainee engagement. Repeat assessment of the Stanford PFI is planned for the end of the academic year. Results: Topics identified for discussion included handling bias, futile care, patient communication, end of life care, and work-life balance. 26 fellows completed the Stanford PFI including nine 1st year fellows, 13 2nd year fellows, and 6 3rd year fellows. Survey results revealed emotional and/or physical fatigue as areas of greatest need for improvement in fellow well-being with 27% of fellows reporting “moderate” emotional or physical exhaustion. Conclusions: RR provides a safe and effective forum to develop peer debriefing and self-refection as resiliency skills within hematology/medical oncology fellowship training. Optimization of RR will continue as fellows become more involved in planning and implementation of curricular improvements to promote resiliency and enhance wellness.
Practice gaps and challenges integrating new immuno-oncology agents in the treatment of cancer patients in the United States: A mixed-method study.
Authors: Ready Neal E. , Parikh Aparna Raj , Lazure Patrice , Peniuta Morgan , Davies Marianne , Augustyniak Monica , Caterino Jeffrey , Lewandowski Robert , Lazar Alexander J. , Murray Suzanne 
Published: May 2020

11028 Background: Previous research has indicated challenges integrating new immuno-oncology agents (IOAs) and predictive immune biomarkers into practice. Barriers, clinical gaps and underlying causalities explaining these challenges, however, are poorly understood. Methods: A mixed-methods educational needs assessment was conducted with physicians from 6 specialties (oncology, interventional radiology, pathology, pulmonology, emergency medicine and rheumatology), clinical pharmacists, physician assistants and advanced nurse practitioners involved in the care of cancer patients in the United States. Semi-structured interviews and discussion groups were thematically analyzed to identify challenges, barriers and underlying causalities. Qualitative findings subsequently informed the development of online surveys, which served to quantify findings. The following findings pertain to oncologists. Results: A total of 660 health care providers participated in the study, in which 17 interviews and 88 surveys were completed with oncologists. Seventy-two percent reported sub-optimal knowledge of the interactions between IOAs and the tumor’s micro-environment, while 62% reported sub-optimal skills determining which IOA to select based on this information. Oncologists reported sub-optimal knowledge of best practices for using IOAs to treat cancer in presence of an autoimmune disease (74%-80% depending on condition), and sub-optimal skills weighing the risks and benefits of prescribing IOAs for these profiles (66%-77%). In addition, 50% of oncologists reported feeling overwhelmed by the volume of new IOAs being made available. Many oncologists expressed doubts regarding the clinical benefit (59%) and innovative nature (43%) of emerging IOAs. Finally, 46% reported limited skills identifying viable treatment options based on pharmacodiagnostic test reports. Barriers to having predictive biomarkers inform treatment decisions included sub-optimal communication between specialists regarding specimen requirements and desired biomarker information. Conclusions: This study demonstrates the need to further support healthcare professionals as they face challenges integrating new IOAs and predictive immune biomarkers into practice. Given the wide array of IOAs becoming available each year, addressing the knowledge, skills, confidence and attitude gaps identified in this study could help improve health care delivery and potentially optimize outcomes for cancer patients.
Content analysis of pancreatic cancer conversations on Twitter: What matters most to users?
Authors: Grewal Udhayvir Singh , Doggett Jamie , Lou Emil , Ocean Allyson J. , Gusani Niraj Jaysukh , Gupta Arjun , Maitra Anirban , Beg Muhammad Shaalan 
Published: May 2020

11040 Background: Social media has an important role in addressing medical misinformation by connecting the global community of health care professional (HCP), cancer patients and advocates. We evaluated the content and dynamics of discussions around pancreatic cancer (PC) on Twitter to identify subtopics of greatest interest to these users. Methods: We used online analytical tool (CREATION Pinpoint) to quantify Twitter mentions (tweets and re-tweets) related to PC between 1/2018 to 12/2019. Keywords, hashtags, word combinations and phrases were used to query for PC mentions. HCP profiles were identified using machine learning and then human verified and remaining user profiles were classified as general public (GP). Data from conversations were analysed and stratified qualitatively (using e.g keywords/combinations/phrases) into 5 categories; 1) prevention (P), 2) survivorship (S), 3) treatment (T), 4) research (R), and 5) policy (Po). We analysed the impact of PC awareness month (PCAM) and celebrity PC diagnosis on the overall level of conversations. Results: Out of 1,258,028 mentions on PC, 313,668 unique mentions were classified into the 5 categories. We found that HCP discuss PC research more than the GP, while GP are more interested in treatment. PCAM did not increase mentions by HCP in any of 5 categories while GP mentions over 2 years, increased temporarily in all categories except prevention. HCP mentions did not increase with celebrity PC diagnosis. Alex Trebek’s diagnosis increased GP mentions on survivorship, while Ruth Ginsburg’s diagnosis increased conversations on treatment (Table). Conclusions: Twitter mentions between HCP and GP around PC are not aligned. The HCP conversation was mainly limited to research while GP were more interested in treatment. PCAM temporarily increased GP conversations around treatment, research, survivorship and policy but not prevention. Future studies should address which factors determine how celebrity diagnoses drive conversations. [Table: see text]
Patterns of Twitter use among trainees in hematology-oncology related areas.
Authors: Gonzalez Velez Miguel , Duma Narjust , Cabrera Daniel , Marshall Ariela L. , Attai Deanna J. , Markham Merry Jennifer , Fonseca Rafael 
Published: May 2020

11041 Background: Twitter (TW) is an essential tool in the medical community. Few studies have examined the use of TW by medical trainees. We aimed to assess its utilization among trainees in hematology-oncology related areas (HORAs). Methods: 576 training programs in HORAs were obtained. We contacted a potential pool of 3,142 trainees. A 50 item survey was distributed between 2/2019-5/2019, focusing on: demographics, professional use, attitudes toward TW, and patient interactions. Responses were analyzed using parametric descriptive statistics. Results: 442 responses (14% response rate) were received; 203 (46%) used a TW account for professional activities. See table for demographics. The most common reasons for using TW were: continuous education (73%), dissemination of information (62%), and networking (62%). > 80% of users have positive views on using TW for: promoting academic discussions (92%), trainees education (89%), and conference networking (83%). 50 (25%) have used TW for collaborations, with abstracts and papers being the most common (20%). Most agreed or strongly agreed that TW: is a useful education tool (89%), and might be useful for career advancement (85%). The most common challenges were: the value of TW content can be decreased by irrelevant content and biased sources (64%), not peer-reviewed (51%), and difficulty searching information (50%). 68% considered that programs should promote the engagement of trainees, but only 21% reported instruction in the use of TW. 83% agree or strongly agree that TW is useful for physicians and patient interactions, but 82% have concerns about legal repercussions. Conclusions: Almost half of trainees in HORAs use TW for professional activities. The most common uses are for education, dissemination of information and networking. Most trainees that use TW have positive views regarding education and academic collaborations. Use of Twitter may strengthen trainees’ education, provide mentorship opportunities, and promote career advancement. Challenges on TW use should continue to be addressed. [Table: see text]