bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXTH-65. INSERTION OF MICRORNA TARGET SEQUENCES INTO RETROVIRAL REPLICATING VECTORS EFFECTIVELY RESTRICTS TRANSGENE EXPRESSION AND VIRAL REPLICATION IN HUMAN HEMATOPOIETIC STEM AND PROGENITOR CELLS
Authors: Collins Sara , Inagaki Akihito , Barcova Maria , Freedman Alicia , Montoya Megan , Haddad Alexander , Hacke Katrin , Matsuura Suzanne , Timberlake Nina , Lin Amy , Jolly Douglas , Kasahara Noriyuki 
Published: November 2021

Abstract
Prodrug activator gene therapy with a retroviral replicating vector (RRV) has shown a highly favorable safety profile and long-term survival in early-phase trials for recurrent high-grade glioma. Overall endpoints were not met in a recent Phase 3 trial, but highly statistically significant survival was observed in prespecified patient subgroups as compared to randomized matched control patients receiving standard-of-care treatments, and further clinical evaluation is being focused on these subgroups. Additional strategies to enhance therapeutic potency may require two or more RRVs to deliver multiple transgenes simultaneously, but RRVs encoated with the same envelope protein will compete for the same cellular receptors, interfering with efficient co-infection. The current clinical vector (formerly Toca511, now DB107) is encoated by amphotropic murine leukemia virus (MLV) envelope, which binds to inorganic phosphate transporter PiT-2/SLC20A2. To switch RRV tropism, we developed RRVs pseudotyped with a heterologous envelope from Gibbon ape leukemia virus (GALV), which utilizes an alternative phosphate transporter, PiT-1/SLC20A1, for cell entry. Efficient co-infection of established and primary human glioblastoma cells with MLV- and GALV-pseudotyped RRV was achieved, without receptor competition. However, human hematopoietic stem/progenitor cells (HSPC) also express high levels of PiT-1, which may increase potential genotoxicity of GALV-pseudotyped RRV. Accordingly, as a novel strategy to restrict gene expression and replication in HSPC, we have developed and tested new RRV designs incorporating microRNA target sequences (miRT). Insertion of miRT recognized by hematopoietic lineage-specific microRNA-142-3p resulted in complete suppression of RRV replication in primary human CD34+ HSPC, with the percentage of infected cells below 1% after vector inoculation at multiplicities of infection (MOI) 0.05 and 0.1, and remaining below 3% even after inoculation at MOI 0.5 and 1.0. In vivo models have been developed for on-going studies to evaluate miRT-mediated restriction strategies for avoidance of potential genotoxicity by RRV in normal hematopoietic cells.
EXTH-72. TRANSLATIONAL INVESTIGATION OF TD139 FOR THE TREATMENT OF HIGH-GRADE MENINGIOMA
Authors: Stephenson Connor , Ross Katie , III William Vandergrift , Varma Abhay , Frankel Bruce , Patel Sunil , Cachia David , Lindhorst Scott M , Das Arabinda 
Published: November 2021

Abstract

BACKGROUND
High-Grade Meningioma (HGM), such as atypical and anaplastic meningiomas, represent a subgroup of meningiomas with histologic and clinical features suggesting aggressive behavior with a penchant for recurrence, even after surgical resection. Here, we postulate that high levels of Galectin-3 (Gal-3) affect the cellular composition and are at the root of the profoundly immunosuppressive tumor microenvironment of HGM. Our study aimed to validate the effect of the Gal-3 inhibitor (TD139) in in vivo.

METHODS
In vivo MGS2 murine models of HGM were utilized to assess efficacy of treatment with TD139 via intravenous injection. We used ELISA spot, RT-PCR and western blots techniques. MRI and immunohistochemistry -staining methods were used to detect tumor growth in in vivo following TD139 treatments.

RESULTS
Our results demonstrated a significantly elevated level of Gal-3 in both HGM tissue and serum when compared to non-tumor patients. Furthermore, Epithelial membrane antigen, Ki-67, and Transglutaminase 2 were highly expressed in HGM, whereas the number of observed cytotoxic T-cells in HGM was markedly decreased. When human PBMCs were activated with anti-CD3 (1µg/ml) and anti-CD28 (2µg/ml) antibodies and treated with recombinant Gal-3 protein (500ng/ml) for 96hr, we found reduced expression of T-Box Transcription Factor 21 and RAR Related Orphan Receptor C mRNA with concurrent upregulated expression of GATA Binding protein 3 and Forkhead box P3 mRNA. These findings support the concept that Gal-3 skews the differentiation of CD4+ T cells towards Th2 and Treg cells. In vivo treatment of TD139 (1mg/kg per day for 14 days) showed significant decrease (∼35%) in MGS2 tumor growth in orthotopic allograft model (at Day 41) and increased survival via multiple mechanism. Additionally, we observed an upregulation of CD38 (M1 macrophages) and CD8+ T cells in treated cells.

CONCLUSIONS
These findings suggest that TD139 may be an effective approach in the treatment of HGM patients.
QOLP-14. LONG-TERM IMPACT OF ADULT GLIOMA ON HEALTH-RELATED QUALITY OF LIFE: A SYSTEMATIC REVIEW
Authors: Frances Se Maria , Klein Martin , Short Susan , Murray Louise , Velikova Galina , Wright Judy , Boele Florien 
Published: November 2021

Abstract

BACKGROUND
Glioma diagnosis can be devastating, and results in a wide range of symptoms. Relatively little is known about the long-term challenges these symptoms pose on HRQOL. The aim of this review is to identify the long-term HRQOL issues reported at least two years following diagnosis of glioma.

METHOD
Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO, and Web of Science Core Collection. Searches were designed to identify a range of reported HRQOL aspects defined as physical, mental or social issues, in adult WHO grade II or III patients. To capture the full extent of patients’ experience, studies of any design reporting on primary data where patients had at least two years follow-up from diagnosis were included. WHO grade I and grade IV tumours were excluded due to their different prognoses and the expected nature of their disease trajectories. Narrative synthesis was used to collate findings.

RESULTS
The search returned 8438 articles. 477 titles remained after title and abstract screening, with seventeen full text articles included in the final analysis. The majority of studies used quantitative methods, with only two articles reporting qualitative or mixed methodology. Articles were predominantly cross-sectional studies (n = 9), along with cohort studies (n = 3), clinical trials (n = 3) and pilot studies (n = 2). Results indicated that patients reported a variety of issues influencing their HRQOL, with emotional/psychological/cognitive changes the most frequently reported. Physical complaints included problems with fatigue, seizures and maintaining daily activity. Social challenges included strained social relationships and issues managing finances. Patient coping strategies were found to significantly influence wellbeing and subsequent HRQOL.

CONCLUSION
Glioma patients’ long-term HRQOL and daily functioning can be impacted by their physical, mental and social wellbeing. Findings from this review lay the groundwork for efforts to improve patient long-term HRQOL.
QOLP-27. NEURO-ONCOLOGICAL PATIENTS' AND CAREGIVERS' PSYCHOSOCIAL BURDEN DURING THE COVID-19 PANDEMIC – A PROSPECTIVE STUDY WITH QUALITATIVE CONTENT ANALYSIS
Authors: Renovanz Mirjam , Binswanger Julia , Kohl Carolin , Behling Felix , Noell Susan , Hirsch Sophie , Hickmann Anne-Katrin , Tatagiba Marcos , Hippler Melina , Tabatabai Ghazaleh 
Published: November 2021

Abstract

OBJECTIVE
The COVID-19 pandemic may reinforce psychosocial distress of neuro-oncological patients. We aimed to 1) differentiate the burden caused by the pandemic vs. the tumor and 2) establish topics relevant for brain tumor patients (BTPs) and caregivers.

METHODS
Patients and caregivers were prospectively assessed from April 2020 – July 2020 by a 10-item comprising interview over the phone, including qualitative and quantitative questions. They were quantitatively evaluated i.a. by the Distress Thermometer (DT, score 1-10). The qualitative questions were analyzed using structured content analysis: The interview questions defined the main categories. Subcategories were derived by an inductive approach assessing the frequency of patients' and caregivers' answers.

RESULTS
A total of 69 patients and 20 caregivers were interviewed; n= 36 were female (49%), mean age was 53 years (range 32-81). Patients' disease-related DT scores were higher than the COVID-19-related DT scores: the median of the disease-related DT score was 7 (range 2-10) vs. median of COVID-19-related distress: 5.0 (range 2-7). Caregivers perceived a higher burden due to the disease (DT median disease: 8; range 2-10 vs. DT pandemic: 3, range 0-10). A total of 5 main and 21 subcategories were elaborated, most frequently mentioned were "restrictions in public and private affairs" (28%), "changes in the psychological well-being" (23%), "limited social interaction by contact restriction" (25%). Subcategories relevant for caregivers were similar to those of BTPs.

CONCLUSION
A considerable proportion of patients and caregivers still perceived the brain tumor disease as more burdensome than the pandemic. We established main and subcategories of interview items possibly of great relevance to patients during these difficult times, which could be implemented in the content-related adaption of the psychosocial assessment.
QOLP-29. THE EFFECTS OF AN ONLINE, NURSE-LED NEEDS-BASED SUPPORT PROGRAM ON NEURO-ONCOLOGY FAMILY CAREGIVERS' DISTRESS: A RANDOMIZED CONTROLLED TRIAL
Authors: Boele Florien , Sherwood Paula , Weimer Jason , Proudfoot Judith , Marsland Anna , Armstrong Terri , Given Charles , Drappatz Jan , Donovan Heidi 
Published: November 2021

Abstract

BACKGROUND
Patients with primary malignant brain tumors have high symptom burden and commonly rely on family caregivers for practical and emotional support. This can lead to negative mental and physical consequences for caregivers. We investigated effectiveness of an 8-week nurse-led online needs-based support program (SmartCare©) with and without online self-guided cognitive behavioral therapy (CBT) for depression compared to enhanced care as usual (ECAU) on depressive symptoms, caregiving-specific distress, anxiety, mastery, and burden.

METHODS
Family caregivers with depressive symptoms were randomized to three groups: SmartCare© plus/minus self-guided CBT, or ECAU. Primary outcomes (depressive symptoms (CES-D); caregiving-specific distress (Caregiver Needs Screen)) and secondary outcomes (anxiety (POMS-A), caregiver mastery (Caregiver Mastery Scale), and caregiver burden (Caregiver Reactions Assessment)) were assessed online. Intention to treat analyses of covariance corrected for baseline scores were performed for outcomes at four months.

RESULTS
In total, 120 family caregivers participated. Accrual and CBT engagement were lower than expected, therefore intervention groups were combined (n=80) and compared to ECAU (n=40). For depressive symptoms, no statistically significant group differences were found. Caregiving-specific distress decreased in the intervention group compared with ECAU (p=0.01, partial ɳ 2=0.08). Among secondary outcomes, there was a trend towards improvement in mastery for the intervention group compared with ECAU (p=0.08, partial ɳ 2=0.04).

CONCLUSION
SmartCare©, with or without self-guided CBT, reduced caregiving-specific distress with a trend towards improving mastery. SmartCare© has the potential to improve the lives of families coping with a brain tumor diagnosis.
QOLP-30. LONG-TERM UNMET SUPPORTIVE CARE NEEDS OF TYA CHILDHOOD BRAIN TUMOUR SURVIVORS AND THEIR CAREGIVERS: A CROSS-SECTIONAL SURVEY
Authors: Nicklin Emma , Velikova Galina , Glaser Adam , Kwok-WIlliam Michelle , Debono Miguel , Sarwar Naseem , Boele Florien 
Published: November 2021

Abstract

INTRODUCTION
The supportive care needs of long-term childhood brain tumour survivors, now teenagers and young adults (TYAs), and their caregivers are largely unknown. TYAs are a unique patient cohort with specific challenges and vulnerabilities differing from children or older adults. We aimed to describe their supportive care needs and explore associations between needs and quality of life (QoL).This is the first study to collect quantitative data about needs in this survivorship group.

METHODS
Participants were recruited from long-term follow-up clinics (in three National Health Service Trusts in England) and online. Participants included childhood brain tumour survivors, ≥ 5 years from diagnosis, currently aged 13-30, and their primary caregivers. Survivors completed the Supportive Care Needs Survey (SCNS) Short-Form and Paediatric Functional Assessment of Cancer Therapy – Brain (Peds-FACT-Br). While caregivers completed the SCNS-Partners and Caregivers (SCNS-P&C) and the Caregiver Quality of Life Index–Cancer (CQOLC).

RESULTS
In total, 112 individuals (69 survivors/43 caregivers) participated. Survivors reported on average 9.4 (±8.5) unmet needs. Needs were greatest in the psychological domain, with anxiety (60.3%), uncertainty about the future (50.7%) and feeling down and depressed (48.5%) most commonly reported. Caregivers reported on average 12.4 (±12.3) unmet needs. Again, the greatest number of unmet needs were observed in the psychological domain. Many caregivers also reported information needs around financial support/government benefits (42.9%) and possible survivor fertility problems (42.9%). Multivariable linear regression analysis showed that female survivors, unemployed survivors, survivors further away from diagnosis, and single caregivers were more likely to report unmet needs. More unmet needs were significantly associated with poorer QoL in survivors and caregivers.

CONCLUSION
This research provides leads to improving supportive care and long-term follow-up services. Psychological support appears to be the biggest gap in care. Understanding unmet needs and recognising what services are required is critical to improving quality of long-term survival.
QOLP-32. EFFECT OF CANNABIS USE ON QUALITY OF LIFE AMONG GLIOMA PATIENTS: A LONGITUDINAL PERSPECTIVE
Authors: Almaraz Eduardo Rodriguez , Chang Susan , Oberheim-Bush Nancy Ann , Clarke Jennifer , Taylor Jennie , Schulte Jessica , Daras Mariza , Busby Laura , Gibson David , Butowski Nicholas 
Published: November 2021

Abstract

BACKGROUND
Gliomas are devastating primary tumors of the central nervous system that often present with difficult to manage symptoms in addition to the antineoplastic tumor itself. Due to recent increase in popularity and societal acceptance of cannabis products, their use by glioma patients has increased.

METHODS
We conducted a single center, prospective study: patients with glioma answered a locally validated survey to inquire about their cannabis use at baseline and every three months. Quality of Life was measured using the EORTC QLQ-C30, its complementary module BN-20 and the EQ-5D-5L instrument. Eligible participants were classified as cannabis users or non-users. We performed linear regression clustered by subjects to see differences by user group and trends overtime.

RESULTS
To date, 89 patients agreed to participate, enrolled, and answered the baseline questionnaires, and 64 have answered the 3 month follow up survey. The mean age was 49.7(SD 13.74), 55 were male, 55 were cannabis users at baseline (61.8%) and 34 at 3 months (53.13%). Patients who were cannabis users scored 11.73 lower points at baseline when compared to non-users (79.65 [SD 18.93] vs 67.92 [SD 19.22]) in the QLQ-C30 instrument. Similarly, cannabis users recorded 9.624 lower points at 3 months compared to non-users (70.1 [SD 21.33] vs 79.72 [SD13.95]). The difference-in-difference estimator was 2.108 (p&lt; 0.7).

CONCLUSION
Although we observed cannabis users scoring lower QoL measurements (p&lt; 0.05) at baseline and 3 months, we observed a slight improvement in QoL of cannabis users while observing no change or decline (in some measures) among non-users. Our findings provide insight to the impact that cannabis has in QoL over time. While not conclusive, these preliminary results need to be studied on a longer-term basis with a larger sample size in order to detect trends on quality of life among patients with different tumor types.
QOLP-34. EVALUATING ADJUSTMENT DISORDER AND POST-TRAUMATIC STRESS DISORDER IN BRAIN TUMOR PATIENTS
Authors: Gibson Alec , Graber Jerome 
Published: November 2021

Abstract
Patients with primary and metastatic brain tumors are particularly susceptible to psychiatric comorbidities. Adjustment disorder (AD) and post-traumatic stress disorder (PTSD) are particularly prevalent in cancer patients and benefit from focused treatment; however, few studies have assessed these conditions in both brain tumor patients and their caregivers. This study aims to evaluate the prevalence of cancer-related AD and PTSD in both brain tumor patients and caregivers, including patients with gliomas, meningiomas, metastases and other brain tumor types. Patients and caregivers at the University of Washington’s Alvord Brain Tumor Center completed modified ADNM-20 and PCL-5 questionnaires to screen for cancer-related AD and PTSD, respectively. Cutoff scores for a positive screen were set at 47.5 for the ADNM-20 and 33 for the PCL-5. A total of 11 patients and 5 caregivers completed both surveys between December 2019 and May 2021. Two caregivers (40%) screened positive for AD, while none of the brain tumor patients met the cutoff score. One brain tumor patient (9%) screened positive for PTSD, while no caregivers had a positive score. Mean ADNM-20 scores were 34.9 (± 8.8) for brain tumor patients and 34.2 (± 14.8) for caregivers (p = 0.890, Mann-Whitney test). Mean PCL-5 scores were 15.3 (± 10.5) for brain tumor patients and 16.6 (± 11.2) for caregivers (p = 0.681, Mann-Whitney test). Mean scores for ADNM-20 and PCL-5 did not differ between groups, confirming that both caregivers and patients are psychologically affected, and 2 out of 5 caregivers screened positive for AD while 1 out of 11 brain tumor patients screened positive for PTSD. These results demonstrate that cancer-related AD and PTSD can be identified in these populations and suggest a difference in these psychiatric conditions between patients and caregivers. Identifying patients and their caregivers with AD and PTSD could improve their quality of life.
QOLP-35. PEDIATRIC POST-MORTEM TISSUE DONATION DURING A PANDEMIC: A MODEL OF COLLABORATION
Authors: Uceda Esteban , Campbell Cindy , McThenia Sheila , Degliuomini Melanie , Khakoo Yasmin , Pisapia David J , Greenfield Jeffrey 
Published: November 2021

Abstract

BACKGROUND
Obtaining post-mortem tissue from pediatric oncology patients is not only critical to research, but studies show that participating in the process can also help grieving families heal. Since 2019, the national Gift from a Child program — a multi-institutional effort to increase the rate of rapid autopsies for pediatric CNS tumor patients — has made significant progress. Collecting high-quality post-mortem tissue has advanced research through cell line generation and genomic analyses. Unfortunately, some autopsy programs temporarily shut down during the COVID-19 pandemic.

METHODS
We retrospectively reviewed autopsies of four patients treated at Memorial Sloan Kettering (MSK) who underwent limited brain post-mortem examination at Weill Cornell Medicine College (WCMC) from June 2020 to June 2021. We collected patient demographics; DNR status; time of death and procedure; restrictions due to the COVID-19 pandemic; and results of the tissue analysis. Each case presented unique challenges and the timing of securing parental consent varied.

RESULTS
Three of four specimens were processed within 12 hours of the time of death. Two Spanish-speaking families required interpreters services to obtain consent. In all cases tumor aliquots were flash frozen for further study. All specimens contained viable tumor and cell line generation was successful in one case. All families/caregivers expressed gratitude for the opportunity to participate and for the handling of the procedures.

DISCUSSION
Despite the sensitive nature of these cases, clinicians should offer the option of a rapid autopsy to caregivers of pediatric patients based on the scientific need and the positive effect it has on grieving families. This paper outlines the logistical efforts required for these donations to take place and provides a framework for providers to offer rapid autopsy as an option for families through this program.
QOLP-36. PATTERN OF CARE OF BRAIN TUMOR PATIENTS IN THE LAST MONTHS OF LIFE: ANALYSIS OF A COHORT OF 3045 PATIENTS IN THE LAZIO REGION IN THE LAST 10 YEARS
Authors: Pace Andrea , Belleudi Valeria , Pinarelli Luigi , Villani Veronica , poggi Francesca , Benincasa Dario , Davoli Marina 
Published: November 2021

Abstract
The final days of life of Brain Tumor patients (BT) present special challenges and often palliative care approach is underutilyzed. Several studies reported that BT patients in the last months of life receive frequent hospital readmissions and ER accesses as result of bad quality of End of Life care. Early integration of pallative care has been demonstrated to improve quality of care in advanced stage of disease and quality of death in cancer patients. With the aim to evaluate pattern of treatment and the rate of hospital readmission in the last months of life, we retrospectively analyzed a consecutive serie of BT patients discharged after a diagnosis of BT. METHODS: Data regarding hospital readmission and treatment received in the last two months of life were collected from the Lazio Region Healthcare database. Adult patients discharged with diagnosis ICD-9 191.* between 1/1/2010 until 31/12/2019, were included in this study. RESULTS: 6672 patients were identified and 3045 death before 31/12/2019 were included (median age 67 y;M1700). In the last month of life 42.6% received hospital reamission (4.6% intensive care unit) and 37.9% had ER accesses. 24.5% received chemotherapy and 12.1% radiotherapy. In the last 30 days 33% were readmitted in hospital and 24.2% were admitted in ER. 11.7% were treated with chemotherapy and 6% with radiotherapy. CONCLUSION: Strategies to improve quality of care at the end of life and to decrease rehospitalization and futile treatments are becoming increasingly important to improve quality of death and to reduce costs of Healthcare System.