bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom burden among metastatic cancer patients receiving palliative chemotherapy.
Authors: Luna Herdee Gloriane Cristal , Montoya Jose Enrique , Morelos Amherstia , Amparo Jose Roberto , Marbella Leo , Lesaca Reynaldo , Cristal-Luna Gloria R. 
Published: March 2020

e20696 Background: Cancer-related symptoms are less investigated but frequently reported patient-experienced symptom clusters. In palliative oncology, focus is on recognizing and addressing these symptoms, and giving quality of life. The purpose of this study is to determine the severity of cancer related symptoms among metastatic cancer patients on palliative chemotherapy using the MD Anderson Symptom Inventory (Filipino) [MDASI-F]. Methods: A cross-sectional study among metastatic cancer patients undergoing palliative chemotherapy at the National Kidney and Transplant Institute, Philippines, was performed using MDASI-F. Results: A total of 114 patients were included with a mean age of 55.5 years. 61% were female, and 39% were male. 81.6% were married, while 14% were single and 4.4% were widowed. Highest educational level attained were college (78.1%), high school (19.3%) and primary school (2.6%). Average Body Mass Index fall on 23 kg/m2. Majority of the patients have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 1 (54.4%), followed by ECOG 2 (19.3%), ECOG 0 (18.4%), and ECOG 3 (7.9%). The most common cancer site is breast (30.7%), followed by colon (21.9%), and lungs (16.7%), while the remaining 30.7% belong to other cancer sites. Majority of the patients have one metastatic site (68.4%), 22.8% have two, while 8.8% have 3 metastatic sites. Mean duration of illness from the time of diagnosis was 13.67 months. The most severe cancer related symptoms were sleep disturbance (mean 3.48), fatigue (mean 3.36) and pain (mean 3.14). Interestingly, all Filipino metastatic cancer related severity symptoms and interference items belong to the mild severity score (scores of 0-3) using the MDSAI-F. Conclusions: Among Filipino metastatic cancer patients on palliative chemotherapy, cancer-related symptom severity items and interference items were shown to have mild severity scores based on the MDASI-F.
Carbamazepine for the prevention of chemotherapy-induced nausea and vomiting: A pilot study using the Simon's optimal two-stage design.
Authors: Santana Thaiana ARAGAO 
Published: March 2020

e20699 Background: Nausea and vomiting have been a major drawback to patients undergoing chemotherapy. Despite standard preventive treatment, chemotherapy-induced nausea and vomiting (CINV) still occurs in approximately 50% of patients. Because of its high cost, this treatment is unavailable in centers where health assistance is provided by the government. As an effort to ameliorate prevention of CINV at lower costs, we studied the efficacy of the addition of carbamazepine to a regimen of corticosteroid plus 5-hidroxitriptamine-3 receptor antagonist for prevention of CINV as well as its side effects and influence on patients’ quality of life. Methods: This is a prospective open label phase II nonrandomized study carried out in a Brazilian public Oncology service. Patients scheduled to receive the first cycle of highly emetogenic chemotherapy were continuously recruited. Besides the current standard antiemetic treatment, patients received carbamazepine, p.o., according to the following schedule: 200 mg QD on the third day before chemotherapy; 200 mg BID on the second day before chemotherapy; 200 mg TID from one day before until the fifth day after chemotherapy. Considering sparse evidence about the anticonvulsants’ efficacy in CINV prevention, we adopted Simon’s optimal two-stage design which should include 43 patients unless overall complete prevention was not achieved in 9 out of the first 15 entries. Functional Living Index-Emesis (FLIE) questionnaire was used to measure impact on quality of life. Results: None of ten studied patients (0%) had overall complete prevention and nine needed rescue medication. Three quitted carbamazepine therapy because of somnolence and vomiting before chemotherapy infusion. Seven were able to take medication for the entire period and none were responsive, so the study was closed. There was no impact on patients´ quality of life. Conclusions: Carbamazepine was not effective for prevention of CINV and should not be used for this purpose out of experimental settings. The Simon optimal design allowed us to reach this data and stop the trial for futility, minimising the number of patients possibly exposed to an inactive agent.
Prevalence of self-reported cognitive dysfunction in breast cancer patients.
Authors: Skirbe Heidi , Hohn Gabriela , Klein Paula , Juliano Mary Ann , Winell Jeremy , Rosenwald Victoria , Festa Joanne 
Published: March 2020

e20701 Background: A series of four time-limited, psycho-educational workshops was piloted by a neuropsychologist at an urban academic medical center, providing information, coping strategies, and resources to women who had been treated for breast cancer (BrCa) and who then sought cognitive treatment. Based on positive evaluations of these workshops, we assessed the prevalence of self-reported cognitive dysfunction in BrCa patients with the goal of assessing the need for and interest in the expansion of cognitive services to affected patients. Methods: The study was IRB approved. A convenience sample of 50 BrCa patients in a medical oncology waiting area completed a 16 item questionnaire which assessed potential cognitive problems on a 4-point Likert scale, with responses ranging from 0 (no problem) to 3 (serious problem). Results: Fifty patients completed the survey, of whom 46% requested further information on cognitive services. Conclusions: An unexpectedly large proportion of BrCa patients perceived cognitive difficulties, possibly compounded by fatigue and emotional dysfunction, and expressed interest in cognitive supportive services. Others may have failed to report cognitive difficulties, unaware of their onset. Quality of life of cancer patients is diminished by cognitive decline. Our data indicate a need for and interest in formal assessment and intervention programs to identify patients with cognitive and emotional dysfunction and offer remediation via workshops and therapy. Formal neuropsychological assessment and treatment resourcestargeting cognitive changes associated with cancer should be expanded to meet documented need. Further research will optimize the scheduling and structure of interventions. [Table: see text]
Epidemiology, risk factors, and outcomes in malignant bowel obstruction.
Authors: Vieito Maria , Martinez Lago Nieves , Campos Marta Carmona , Rodriguez Lopez Carmela , Barón Francisco J. , Candamio Sonia , Galrisa Neto Isabel , Lopez Rafael 
Published: March 2020

e20708 Background: Malignant bowel obstruction is a complex syndrome that needs a multidisciplinary management and a better definition of prognostic risk factors. Methods: Information of patients with known history of cancer, admitted for a first episode of suspected malignant bowel obstruction, between 2008 and 2010 with consultation by a medical oncologist or palliative care specialist was reviewed and epidemiological variables like sex, age, localization, histology, and clinical stage treatments received, presence of infiltrating abdominal tumors, and peritoneal carcinomatosis were recorded at diagnosis and at the time of admission. Results: The basal characteristics of the 115 patients are resumed in the Table. At admission patients had in their majority known stage IV disease (75%) with previous evidence of peritoneal carcinomatosis in 63% of cases and of intra abdominal infiltrating masses in 49%, but only half of the patients were receiving active chemotherapy. Nearly all patients presented symptoms like pain (98%) and nausea (91%), followed by vomit and abdominal distension and a deterioration of their performance score (9% PS0-1, 43% PS2, 33% PS3, 13% PS4). Palliative prognostic index (PPI) altered items were mainly oral intake (64%) and edema (21%). They were treated with antisecretors (octreotide 58%, butylscopolamine 26%), anti-emetics, (ondasetron 65%, metoclopramide 46%) neuroleptics (60%), corticosteroids (59%) and analgesics (opioids in 66%). Conclusions: The episode of obstruction could be resolved in a median of 12 days in more than half of our patients(59%), this led to an acceptable rate of outpatient management of 61%, nerveless the prognosis of this patients is still very poor. with a median survival from the moment of obstruction of only 42 days and a rate of reobstruction of 52%. [Table: see text]
Interobserver correlation of morphometric data obtained from routine preoperative abdominal CT scans in pancreatic surgery.
Authors: Shelton Tiffani Dawn , Franko Jan , Goldman Charles David , Grimm Shawna 
Published: March 2020

e20714 Background: Quantification of frailty is necessary for estimation of therapy tolerance. Sarcopenia is a recognized measure of frailty and predicts long-term survival in both non-surgical and surgical cohorts. Here we set to evaluate interobserver agreement for certain sarcopenia parameters on routine abdominal CT scans among patients undergoing Whipple procedure for suspicion of neoplasm. Methods: Two observers using a standardized protocol for measurements of linear and surface morphometric parameters independently reviewed thirty abdominal CT scans. Results: Mean morphometric data for the entire group were: total psoas area 2237±868 mm2, mean psoas muscle density 46±9 HU, mean psoas antero-posterior diameter 40±8mm, mean psoas latero-lateral diameter 36±8 mm, mean rectus muscle thickness 9.2±2.6 mm, mean distance between anterior vertebral L4 surface and linea alba 115±28 mm (L4-alba distance), mean subcutaneous fat thickness 23.7 ±11.5mm, mean L4 vertebra antero-posterior diameter 37.6±5.2 mm. Excellent inter-observer correlation was observed for total psoas area is R2=0.788, p<0.001. Similarly good correlation was detected between observers for rectus muscle thickness (R2=0.6019, p<0.001), subcutaneous fat thickness (R2=0.731, p<0.001), and L4-alba distance (R2=0.601, p<0.001). Poor correlation was observed for L4 diameter (R2=0.392,p=0.0014). No interobserver correlation was observed for psoas muscle density (R2=0.005, p=0.743). Conclusions: Excellent degree of interobserver correlation was observed for the following morphometric data obtained from abdominal CT scans: Total psoas muscle area, L4-alba distance, rectus muscle and subcutaneous fat thickness. Further studies are needed to evaluate utility of morphometric parameters for prediction of surgical outcomes.
AVAST-M: Adjuvant bevacizumab as treatment for melanoma patients at high risk of recurrence.
Authors: Corrie Philippa , Marshall Andrea , Goonewardena Madusha , Dunn Janet A. , Middleton Mark R. , Nathan Paul D. , Gore Martin Eric , Davidson Neville , Nicholson Steve , Kelly Charles G. , Marples Maria , Danson Sarah , Marshall Ernest , Houston Stephen , Board Ruth E. , Waterston Ashita Marie , Nobes Jenny , Harries Mark , Barber Jim , Lorigan Paul 
Published: March 2020

LBA9000 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.
An open-label, randomized, phase II study of nivolumab (anti-PD-1; BMS-936558; ONO-4538) given sequentially with ipilimumab in patients (pts) with advanced or metastatic melanoma (MEL).
Authors: Hodi F. Stephen , Baudelet Christine , Chen Allen C. , Weber Jeffrey S. 
Published: March 2020

TPS9107^ Background: Programmed death-1 (PD-1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4) are immune checkpoint receptors that attenuate T-cell responses and contribute to immune evasion by tumor cells. Nivolumab is a PD-1 receptor blocking monoclonal antibody that has shown clinical activity in phase 1 trials with various tumor types including MEL. Ipilimumab is an anti-CTLA-4 monoclonal antibody approved for advanced or metastatic MEL. Preclinical data suggest that combined PD-1 and CTLA-4 receptor blockade may improve antitumor activity in MEL, with PD-1 blockade upregulating CTLA-4 expression and CTLA-4 blockade upregulating PD-1 expression on tumor-infiltrating T cells. We describe a phase II study evaluating nivolumab administered sequentially with ipilimumab in pts with advanced (unresectable stage III) or metastatic (stage IV) MEL. Methods: This open-label, phase II study will enroll approximately 80 pts. During the induction period, pts will be randomized 1:1 to either nivolumab (3 mg/kg, q2w) from Weeks (Wk) 1-13 followed by ipilimumab (3 mg/kg, q3w) from Wks 14-25, or ipilimumab followed by nivolumab at the same doses and schedules. All pts will then receive nivolumab (3 mg/kg, q2wk) during the continuation period until disease progression or unacceptable toxicity, for ≤2 years from initial study treatment. Pts may be treatment-naive or have disease recurrence or progression after one prior systemic therapy, excluding prior anti-PD-1, anti-CTLA-4, or a BRAF inhibitor. The primary endpoint is the incidence of treatment-related Grade 3–5 adverse events (AEs) during the induction period. Secondary endpoints are response rate at Wk 25 and progression rates at Wks 13 and 25. Exploratory endpoints include safety and tolerability; overall survival; pt-level time course of treatment-related grade 3–5 AEs, response, progression, treatment discontinuation, and death; the association of changes in pharmacodynamic immune markers from baseline to Wk 13 and Wk 25 and clinical response; the association between baseline immunological parameters and clinical response; and immune-related single nucleotide polymorphisms. Clinical trial information: NCT01783938.
Exercise for cancer-related fatigue and putative functional, inflammatory, and metabolic mechanisms in patients receiving chemotherapy: A URCC CCOP research base phase III RCT.
Authors: Mustian Karen Michelle , Janelsins Michelle Christine , Peppone Luke Joseph , Sprod Lisa , Palesh Oxana , Kamen Charles Stewart , Peoples Anita Roselyn , Heckler Charles E. , Kasbari Samer S. , Scalzo Anthony Joseph , Reddy Pavan S. , Esparaz Benjamin , Morrow Gary R. 
Published: March 2020

TPS9651 Background: Up to 100% of cancer patients report cancer-related fatigue (CRF) during chemotherapy which co-occurs with impaired cardiopulmonary (CPF) and neuromuscular function (NMF), chronically up-regulated inflammatory responses, and low metabolic energy expenditure. CRF interferes with completion of treatment, increases cancer morbidity and mortality, and impairs quality of life (QOL). Exercise is one of the most promising treatments available for CRF, but no large multicenter phase III RCTs have confirmed these findings and little is known about the mechanisms through which exercise may impact CRF. Methods: We are conducting a nationwide multicenter phase III RCT (N=692) through the URCC CCOP Research Base with 23 CCOP affiliates. The primary aim is to determine if exercise will significantly improve CRF, and secondarily, CPF, NMF, inflammation, energy expenditure, and QOL compared to standard care in cancer patients receiving chemotherapy. The exercise intervention is our standardized, individually-tailored, home-based walking and progressive resistance program, “Exercise for Cancer Patients” (EXCAP, 7 days/wk, 6wks). To be eligible, patients must: 1) have a confirmed diagnosis of cancer with no leukemia or metastasis, 2) be chemotherapy naïve and scheduled to start, 3) not be receiving concurrent radiation, 4) have a KPS of >70, 5) be ≥21 years of age, 6) have no contraindications to exercise or functional testing, and 7) not be currently exercising. CRF and all secondary outcomes are assessed at baseline (pre-chemotherapy), 3 weeks (mid-intervention), and 6 weeks (post-intervention). Measures include: 1) CRF-Brief Fatigue Inventory, 2) CPF-6-minute walk test, 3) NMF-handgrip dynamometry, 4) inflammation-serum ELISA levels, 5) energy expenditure-actigraphy, and 6) quality of life-Functional Assessment of Chronic Illness Therapy. The DSMC reviewed the trial in October of 2012 and suggested it continue as planned. 532 participants have been enrolled in 36 months. Funding: NCI U10CA037420, U10CA37402-28, K07CA120025, K07CA132916, 1R25CA102618, ACS MRSG1300101CCE. Clinical trial information: NCT00924651.
Gender-based analysis of pre-residency research productivity among a current United States radiation oncology resident class.
Authors: McClelland Shearwood , Murphy Blair , Jaboin Jerry Jeff , Zellars Richard C. 
Published: March 2020

10504 Background: The increasing proportion of women in medicine has not been adequately reflected in the gender distribution of residents, particularly in highly competitive subspecialties such as neurosurgery and radiation oncology. The presence of at least one pre-residency peer-reviewed publication (PRP) was found to be associated with future resident choice of academic over private practice career in a recent radiation oncology resident graduating class, with no significant gender difference in the likelihood of having a PRP (McClelland et al., Practical Radiation Oncology 2017). We sought to pursue a gender-based analysis of PRP productivity in a current junior resident class. Methods: A list of radiation oncology residents from the graduating class of 2022 (PGY-2 academic year of 2018-2019) was obtained through internet investigation. In addition to gender, demographics included dual degree status and presence/absence of a PhD. Research productivity was calculated using PRP number, defined as the number of a resident’s publications listed in PubMed (pubmed.gov) through the calendar year of residency application (2016 for the class of 2022), as previously described. Fisher’s exact test was used for statistical analysis. Results: Of 179 residents examined from the 2022 class, 55 (31%) were women, representing a nine percent increase from the resident class of 2016. Four-fifths had at least one PRP, 33% had dual degrees, and 18% had a PhD. These percentages were comparable to their male counterparts, 73% of whom had at least one PRP, 28% who had dual degrees, and 15% who had a PhD. Specific analyses revealed no statistically significant differences by gender in any of these benchmarks (p>0.05). Conclusions: While slower than the overall trend of increased female representation in medicine, the proportion of women in radiation oncology residency has increased by approximately 1.4% per year over a recent six year span. There remain no significant differences in PRP productivity between male and female residents, and there are no significant gender differences in the likelihood of dual degree status or PhD status. Further study will be needed to determine how these findings manifest in career choice following graduation.
Mindful fellows: Study results from a pilot wellness curriculum in hematology oncology.
Authors: Chatwal Monica Sheila , Vinci Christine , Reich Richard R. , McDowell Marc , Reagan Angela , Gray Jhanelle Elaine 
Published: March 2020

10508 Background: Rates of physician burnout, depression, and career dissatisfaction are rising. It is imperative to develop solutions. Studies find mindfulness is an effective therapeutic means for physician burnout, but few programs address this in clinical trainees, specifically hematology oncology fellows. The aims of this pilot study were to determine the feasibility and acceptability of a mindfulness-based wellness curriculum. To our knowledge, this is the first study assessing this type of intervention in this population. Methods: In this single center, nonrandomized study, six monthly 30-45 minute sessions were integrated within the framework of existing didactic conferences. Each session had two parts – didactics on mindfulness and guided meditation exercises. Sessions were led by a social worker trained in mindfulness techniques. Participants completed pre and post intervention questionnaires, including Mindfulness Attention Awareness Scale (MAAS) (Carlson, 2005), Perceived Stress Scale (PSS) (Cohen, 1983), and reflection questions, with an opportunity for free responses. The primary endpoint was feasibility as determined through recruitment (target 70%) and treatment adherence defined as participation and questionnaire completion (target 80%). A secondary aim was acceptability determined through self-reflection questions (target 80%). Results: A total of 27 participants (59% female) enrolled with 37% in post-graduate year 6 (PGY-6). Of the eligible fellows, 96% enrolled and 96% of participants completed questionnaires. On self-reflection questions, 65% reported that the program was useful and 81% reported they would participate again in the future. Participants suggested modifications including location, timing, and a broader scope to include skills in addition to mindfulness (e.g. resiliency-focused). Data on self-reported levels of stress and self-awareness, an exploratory aim, will be presented at the meeting. Conclusions: Findings indicate that a mindfulness-based wellness curriculum was both feasible and acceptable for hematology oncology fellows. Modifications are being made to expand on this program, and incorporate it as a recurring component of the existing curriculum.
Evaluation of Colorado oncology providers on the use of medical marijuana.
Authors: Glode Ashley Elizabeth , Wright Garth C. , Leong Stephen 
Published: March 2020

10511 Background: There is a lack of knowledge regarding medical marijuana use in cancer patients. More information is needed due to increase in both state approvals and access to medical marijuana. We hypothesized that variation in provider knowledge, attitudes, and behaviors exists across all professions in oncology, which contributes to a lack of both provider awareness of patient use and patient education on marijuana use. Methods: A survey was distributed to oncology providers in the state of Colorado. The primary objective was to describe provider knowledge, attitudes, and behaviors regarding medical marijuana use in cancer patients. Other objectives were identifying educational needs for oncology providers to feel comfortable recommending medical marijuana and reporting provider interest in future marijuana studies. Results: We received responses from 172 oncology providers; 48 advanced practice providers, 47 physicians, 53 registered nurses, 17 pharmacists, and 7 other. Most providers (73.3%) believe marijuana provides a medical benefit to cancer patients, and 81.5% believe it should be available as a prescription drug. Yet, 60.1% had not recommend its use to any cancer patient in the past 6 months, and 54.3% are not comfortable recommending or suggesting it to a patient to manage cancer related symptoms. Major concerns included uncertain dosing (83%), limited knowledge of available products and where to get them (73.1%), and interactions with other medications (64.9%). Providers reported that educational programs for healthcare providers (79.3%), more clinical data (74%), and endorsed clinical guidelines (67.5%) would increase their comfort level in recommending medical marijuana. The areas of research most interesting or important were specific product information and doses (77.6%), efficacy for specific side effects (77.6%), and drug-drug interactions (74.7%). Conclusions: Regardless of profession, the majority of oncology providers in Colorado do not recommend and do not feel comfortable recommending or suggesting medical marijuana to a cancer patient, yet most believe it provides medical benefit. Providers believe there is a need for education and research on the use of medical marijuana in oncology patients.