bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender disparities in National Institute of Health funding for hematologic malignancies, hematopoietic stem cell transplantation, and cellular therapeutics.
Authors: Siddiqui Raheel Sufian , Shahzad Moazzam , Majeed Mahrukh , Hussain Ali , Murtaza Faryal , Khalid Farhan , Habib Ayesha , Aijaz Zobia , Bukhari Syeda Sadia , Anwar Iqra , Altaf Sehar , Anwer Faiz , Chaudhary Sibgha Gull , Balusu Ramesh , Ahmed Nausheen , Ganguly Siddhartha , Abhyankar Sunil H. , McGuirk Joseph , Khosa Faisal , Mushtaq Muhammad Umair 
Published: June 2021

11020 Background: Gender inequality in research funding has been studied extensively; however, the literature lacks evidence in Hematology. We investigated trends in National Institutes of Health (NIH) funding for hematologic malignancies (HM), hematopoietic stem cell transplantation (HSCT), and cellular therapeutics (CT). Methods: The data on Hematology funding was retrieved from NIH Research Portfolio Online Reporting Tools (RePORT) Categorical Spending for fiscal years 2018 and 2019. A total of 6351 entries were reported. Only grants (n=1834) that were related to HM, HSCT, and CT were included. After excluding non-relevant, 975 principal investigators (PIs) were included in the analysis. Additional data regarding PIs was ascertained from the Scopus database, LinkedIn, Doximity, and departmental websites, including the number of publications, number of years of active research, H-index, highest degree, gender, and institution. Data were analyzed using SPSS version 21. Bivariate analyses, using chi-square and t-test, and linear regression analyses were performed. Results: In 2018 and 2019, 1834 grants totaling $799.4 million were awarded by the NIH for malignant hematology research (men 1301, 71% vs women 533, 29%). Of 975 PIs, 680 (70%) were men and 295 (30%) were women. Table highlights gender disparities in NIH funding and associated factors. Most of the grant recipients were Ph.D. or M.D./Ph.D. About 70% of total funding was awarded to male PIs. There were no gender differences in the mean number of grants and mean grant amount. Women had significantly lower years of active research and academic productivity. Conclusions: Although the gender gap in academic hematology has decreased in recent years, the latest trend suggests significant gender inequality in NIH funding for malignant hematology, transplantation, and cellular therapy.[Table: see text]
Cancer specialists in the VA as early adopters of clinical genetic services.
Authors: Scheuner Maren Theresa , Sales Paloma , Whooley Mary , Hoggatt Katherine , Kelley Michael 
Published: June 2021

11029 Background: Genetic testing has become essential to delivery of cancer treatment, risk assessment, surveillance, and prevention. We sought to understand the use of genetic tests by clinicians in the Department of Veterans Affairs (VA). Methods: We administered a web-based survey to clinicians at 20 VA facilities with precision oncology programs. We excluded respondents if they were: not at one of the 20 VA facilities; not seeing patients in VA; not a physician, nurse practitioner (NP), physician assistant (PA), or pharmacist; a medical geneticist or specialty was not reported; or if the survey was incomplete. Using multiple logistic regression, we assessed the association between genetic test ordering, genetics referral, and clinician characteristics. Results: There were 909 (909/11,442, 8%) eligible respondents with 61% women and 64% under age 55. There were 571 physicians (63%), 200 NPs (22%), 93 pharmacists (10%), and 45 PAs 5(%). There were 361 (40%) primary care providers (PCPs), 90 (10%) cancer specialists, and 458 (50%) non-cancer specialists. Only 21% of clinicians reported feeling prepared to use genetic tests in their practice. In the past year, only 8% had ordered at least one multi-gene cancer test (germline, tumor or both), 12% a pharmacogenetic test, and 0.2%, an exome. Compared to physicians, NPs were 60% less likely (OR = 0.42, 0.23-0.77, p = 0.005), pharmacists, 80% less likely (OR = 0.22, 0.08-0.62, p = 0.005), and PAs, 90% less likely (OR = 0.08, 0.01-0.58, p = 0.01) to have ordered a genetic test. Compared to PCPs, cancer specialists were almost 5 times more likely to order a genetic test (OR = 4.74, 2.57-8.73, p < 0.0001); there was no difference in genetic test ordering between PCPs and non-cancer specialists. Among clinicians (n = 72) who had ordered cancer genetic tests, only about two-thirds were confident in knowing the indications for testing; discussing the potential benefits, harms and limitations of testing; understanding the test report; and knowing implications of results on disease management and prevention. Clinicians (n = 106) who had ordered pharmacogenetic tests had lower frequencies of confidence in these tasks. About half (52%) of the cancer specialists had referred patients to genetics in the past year; they were 1.8 times more likely than PCPs to refer (OR = 1.82, 1.10-3.03, p = 0.02), and non-cancer specialists were about 50% less likely than PCPs to refer (OR = 0.46, 0.33-0.64, p < 0.0001). Conclusions: In the VA, cancer specialists are integrating genetic testing and genetics referral into their practice more than PCPs and other specialists. However, genetic testing is underutilized, and many clinicians remain unprepared to use genetic tests in their practice. These results will inform workforce planning, clinician education, and development of clinical decision support to facilitate genetic risk assessment, informed consent, and ordering of genetic tests.
A phase 1b study of avelumab plus DCC-3014, a potent and selective inhibitor of colony stimulating factor 1 receptor (CSF1R), in patients with advanced high-grade sarcoma.
Authors: Rosenbaum Evan , Movva Sujana , Kelly Ciara Marie , Dickson Mark Andrew , Keohan Mary Louise , Gounder Mrinal M. , Thornton Katherine Anne , Chi Ping , Chan Jason Earl , Nacev Benjamin , Avutu Viswatej , Biniakewitz Matthew , McKennan Olivia Robin , Phelan Haley , Perez Silvia , Hwang Sinchun , Singer Samuel , Qin Li-Xuan , Tap William D. , D'Angelo Sandra P. 
Published: June 2021

11549 Background: Select sarcomas are infiltrated with immunosuppressive myeloid cells. DCC-3014 is an inhibitor of the CSF1R kinase that decreases tumor infiltrating myeloid cells in preclinical models. We hypothesized that DCC-3014 combined with the anti-PDL1 inhibitor avelumab would be safe and tolerable, decrease immunosuppressive myeloid cells, and increase cytotoxic T cells. Methods: This investigator initiated, open label, single center, phase I study of DCC-3014 plus avelumab in patients (pts) with unresectable or metastatic sarcoma utilized a standard 3+3 dose escalation design. DCC-3014 was administered on days 1-3 (loading dose of 20, 30, or 50 mg) followed by oral daily maintenance (10, 14, or 20 mg) in 28-day cycles; 800 mg of IV avelumab was administered q2weeks. The primary endpoint was to determine the recommended phase 2 dose (RP2D). Secondary endpoints defined the adverse event (AE) profile and assessed clinical efficacy. Peripheral blood CD14+Lin-HLA-DRlo myeloid-derived suppressor cells (MDSCs) were measured by flow cytometry. Results: 13 pts were treated; median age was 61 (range 32 – 71), 8 were female, and median prior lines of therapy was 5 (range 2 – 10). Histologic subtypes included leiomyosarcoma (LMS, n = 7), undifferentiated pleomorphic sarcoma (2), dedifferentiated liposarcoma (LPS, 2), synovial sarcoma (1), and pleomorphic LPS (1). The Table lists treatment-related AEs (TRAEs) of any grade (G) occurring in ≥ 10% of pts and all G ≥ 3 TRAEs, sorted by frequency. All pts had at least 1 TRAE. Seven pts (54%) had a G ≥ 3 TRAE. Most TRAEs were either G ≤ 2 or expected on-target effects of CSF1R inhibition. 1 of 6 pts on the highest dose level had a dose limiting toxicity (G4 elevated AST with abdominal pain) that resolved with treatment cessation. The highest dose level was declared the RP2D. Best objective response by RECIST 1.1 was stable disease in 3 pts; 2 had LMS and were treated at the highest dose level. At baseline, the mean proportion of monocytes in peripheral blood samples with an MDSC phenotype was 12.2% (range 7.1 – 19.9). 5 of 7 pts with serial blood samples had decreased circulating MDSCs (mean decrease of 26.9% from baseline to last time point). Conclusions: DCC-3014 combined with avelumab was safe and tolerable. Study therapy decreased circulating MDSCs in select patients; T cell analyses will be reported. Study expansion at the RP2D is ongoing. Clinical trial information: NCT04242238. [Table: see text]
Health concerns in long-term survivors with ovarian cancer: Results of Expression VI–Carolin meets HANNA–Holistic Analysis of Long-term survival with Ovarian Cancer—The international NOGGO, ENGOT and GCIG survey.
Authors: Woopen Hannah , Keller Maren , Braicu Ioana , Zocholl Dario , Baum Joanna , Krabisch Petra , Boxler Tamara , Wimberger Pauline , Madroñal Catarina , Gil-Martin Marta , Bjelic-Radisic Vesna , Trpchevski Sinisha , Samartzis Eleftherios Pierre , Heinzelmann-Schwarz Viola A. , Achimaș-Cadariu Patriciu , Kubelac Paul , Vardar Mehmet Ali , Jedryka Marcin Andrzej , Vergote Ignace , Sehouli Jalid 
Published: June 2021

12023 Background: So-called long-term survivors (LTS) may be cured from cancer but still experience a wide range of long-term side effects. Aim was to analyze the main concerns in long-term survival to improve follow-up care. Methods: Within the study “Carolin meets HANNA” (www.carolinmeetshanna.com) long-term survivors with ovarian cancer (LTS) were recruited since 11/2016. Long-term survival was defined as an ovarian cancer diagnosis more than five years ago. Results: Until 02/2021 1,044 long-term survivors with ovarian cancer could be recruited. Median survival time at recruitment was 11 years (range 5-43 years). More than half had been diagnosed with advanced stage ovarian cancer (58.6% FIGO III/IV). Almost half have developed recurrent disease (43.4%). 26.0% were under cancer treatment at recruitment. Health status was rated very good or good by 52.0% while 20.3% report a bad or very bad health status. Almost half of the LTS have current concerns/long-term side effects (46.1%). Main concerns are fatigue (23.9%), pain (21.6%), polyneuropathy (16.9%), gastrointestinal symptoms (16.6%) and memory problems (15.5%). 42.8% still regard themselves as cancer patients. Health status and distress did not differ between LTS 5-10 years after diagnosis and > 10 years after diagnosis (p = 0.59 and p = 0.0843 respectively). Patients with a history of recurrence and those under current treatment had a worse health status and more health concerns. LTS without recurrence reported fatigue in 18.4%, pain in 19.2%, polyneuropathy in 13.1%, gastrointestinal problems in 13.4% and memory problems in 14.4%. Fatigue, polyneuropathy, nausea and concentration problems improve with the time of survival. However, fatigue is still present in 21.1% after ten years survival time. There was no significant difference in pain between 5-10 (20.1%) and > 10 years (22.0%) survival time. In this cohort 94.2% receive regular follow-up care including CA125 testing in 77.0%, clinical examination in 54.3%, transvaginal ultrasound in 55.1%, abdominal ultrasound in 43.9%, mammogram in 50.5% and further radiological examinations such as CT scans in 53.4%. Conclusions: Follow-up care in ovarian cancer is usually delivered within the first five years after diagnosis. However, our analyses show the high frequency of health concerns in LTS despite the high frequency of follow-up care in this cohort. Therefore, specialized survivorship care should be offered beyond the typical five years of follow-up care with a focus on long-term side effects.
Prognostic understanding, hospitalization, and hospice use among older patients with advanced cancer.
Authors: Loh Kah Poh , Seplaki Christopher , Yousefi Nooraie Reza , Lund Jennifer Leigh , Epstein Ronald M. , Duberstein Paul , Flannery Marie Anne , Culakova Eva , Xu Huiwen , Klepin Heidi D. , Lin Po-Ju , Sanapala Chandrika , Watson Erin , Targia Valerie , Vogelzang Nicholas J. , Dib Elie G. , Onitilo Adedayo A. , Mustian Karen Michelle , Mohile Supriya Gupta 
Published: June 2021

12037 Background: Poor prognostic understanding of curability is associated with lower hospice use in patients with advanced cancer. Little is known if this holds true for older adults specifically. In addition, prognostic understanding are variably assessed and defined in prior studies. We evaluated the associations of poor prognostic understanding and patient-oncologist discordance in both curability and survival estimates with hospitalization and hospice use in older patients with advanced cancer. Methods: We utilized data from a national geriatric assessment cluster-randomized trial (URCC 13070: PI Mohile) that recruited 541 patients aged ≥70 with incurable solid tumor or lymphoma considering any line of cancer treatment and their oncologists. At enrollment, patients and oncologists were asked about their beliefs about cancer curability (options: 100%, > 50%, 50/50, < 50%, 0%, and uncertain) and estimates of patient’s survival (options: 0-6 months, 7-12 months, 1-2 years, 2-5 years, and > 5 years). Non-0% options were considered poor understanding of curability (uncertain was removed from the analysis) and > 5 years was considered poor understanding of survival estimates. Any difference in response options was considered discordant. We used generalized estimating equations to estimate adjusted odds ratios (AOR) assessing associations of poor prognostic understanding and discordance with hospitalization and hospice use at 6 months, adjusting for covariates and practice clusters. Results: Poor prognostic understanding of curability and survival estimates occurred in 59% (206/348) and 41% (205/496) of patients, respectively. Approximately 60% (202/336) and 72% (356/492) of patient-oncologist dyads were discordant in curability and survival estimates, respectively. In the first 6 months after enrollment, 24% were hospitalized and 15% utilized hospice. Poor prognostic understanding of survival estimates was associated with lower odds of hospice use (AOR 0.30, 95% CI 0.16-0.59) (Table). Discordance in survival estimates was associated with greater odds of hospitalization (AOR 1.64, 95% CI 1.01-2.66). Conclusions: Prognostic understanding may be associated with hospitalization or hospice use depending on how patients were queried about their prognosis and whether oncologists’ estimates were considered.[Table: see text]
Pre-existing geriatric conditions in older adults with poor prognosis cancers.
Authors: Tsang Mazie , Gan Siqi , Wong Melisa L. , Walter Louise Christie , Smith Alexander K. 
Published: June 2021

12044 Background: Older adults with poor prognosis cancers are more likely to experience toxicity from cancer-directed therapies. Although geriatric assessment (GA) reduces chemotherapy toxicity by detecting pre-existing conditions, GA can be difficult for oncologists to perform because of limited time and resources. We aim to determine the prevalence of pre-existing geriatric conditions that could be detected if GA were performed during routine oncology care. Methods: We used the Health and Retirement Study (HRS) linked with Medicare (1998-2016) to identify adults age >65 with poor prognosis cancers (median overall survival < 1 year). The HRS is a biennial nationally representative survey that asks about pre-existing geriatric conditions. Using the interview prior to the cancer diagnosis, we determined the presence of conditions included in GA: functional status (i.e. difficulty with climbing stairs, walking one block, getting up from a chair, bathing or showering, taking medications, and managing money), falls and injurious falls, unintentional weight loss, self-rated health, social support, mentation, advanced care planning, use of pain or sleep medications, and mobility. To identify groups with the highest prevalence of pre-existing geriatric conditions, we stratified results by age (adjusted for gender) and gender (adjusted for age). Results: Our study included 2,121 participants. At the time of cancer diagnosis, mean age was 76, 51% were female, 79% were non-Hispanic White, 26% had lung cancer, 14% had a GI cancer, and 60% had other metastatic cancers. Mean time between the HRS interview and cancer diagnosis was 12.7 months. The median overall survival of the entire cohort was 9.6 months with a 45% 1-year survival rate. The adjusted prevalence of pre-existing geriatric concerns were as follows: 65% had difficulty with climbing several flights of stairs, 27% had difficulty with walking one block, 47% had difficulty getting up from a chair after sitting down, 12% had difficulty in bathing or showering, 6% had difficulty taking medications, 11% had difficulty in managing money, 35% had a fall in the last 2 years with 12% of participants reporting injury after their fall. Those who were aged 85+, vs those aged 65-74, had higher rates of conditions indicative of cognitive impairment (e.g. 12 vs 4% had difficulty taking medications, p = 0.000, 26% vs 6% had difficulty managing money, p = 0.000) and physical impairments (e.g. 54% vs 30% had falls, respectively, p = 0.000). Rates of geriatric conditions indicative of physical impairment were higher in women vs men (e.g. 72% vs 58% had difficulty climbing stairs, p = 0.000 and 52% vs 41% had difficulty getting up from a chair, p = 0.000). Conclusions: Patients with poor prognosis cancers have high rates of pre-existing geriatric conditions that can be detected by GA. Geriatric assessments could find important impairments that could be addressed prior to cancer therapy to reduce adverse effects.
Complementary and alternative medicine use among cancer patients at two cancer centers in Brazil.
Authors: Ricardo Eliza Dalsasso , Oishi Denise , Uchiyama Angel Ayumi Tome , Marchon da Silva Catarina , Bravo Espinoza Josué , Moreira Frederico Rafael , Dos Santos Marcelo Oliveira , Riechelmann Rachel Pimenta , D'Alpino Renata D'Alpino 
Published: June 2021

12060 Background: Complementary and alternative medicine (CAM) use is relatively common among cancer patients. Data regarding CAM use in Brazil is scarce. We sought to define CAM use among cancer patients and investigate factors that might influence it. Methods: We conducted a cross-sectional survey of adults diagnosed with any cancer type who came to appointments at two cancer centers in Brazil from January 2020 to January 2021. Unadjusted and adjusted analyses were conducted by using Logistic Regression models to determine the association of covariates with binary outcome. Statistical analyses were performed with SAS 9.4 (SAS Institute Inc, Cary, NC). All tests were 2-sided, and P < 0.05 was considered significant. Results: In total, 319 patients who consented to the face-to-face interview were included and all of them completed the questionnaires. Most patients (52.4%) were between 51 and 70 years-old, 59,6% were female, 85,2% were from the private service and 67% had college graduate/baccalaureate. Most cancer types were from gastrointestinal tract (31,4%), breast (20.4%), lung (12.3%) and genitourinary type. More than 85% of the participants were on any active cancer treatment. The prevalence of current CAM use was 34.2% and 50.2% of the patients did not believe CAM has anti-cancer properties. Two-thirds of the participants have never discussed about CAM with their oncologists. Only 4.1% of the respondents would abandon conventional cancer treatment in order to use just CAM. Among CAM users, 55% referred multiple therapies use. Of those therapies, spiritual surgery was the most prevalent one. There was a significant higher proportion of females reporting CAM use (p = 0,008) as well as a higher proportion of CAM use among private patients (p = 0,008). Conclusions: CAM use was common among our study population, especially spiritual surgery. Women and private patients were more prone to use CAM. Although most patients would not abandon conventional treatment, many of them have never discussed about CAM with their oncologists.
Overall and cardiac-specific mortality following serious cardiovascular events in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS).
Authors: Bottinor Wendy , Im Cindy , Armenian Saro , Hong Borah , Howell Rebecca M. , Ness Kirsten K. , Oeffinger Kevin C. , Armstrong Gregory T. , Yasui Yutaka , Chow Eric Jessen 
Published: June 2021

12073 Background: The direct impact of a major cardiovascular (CV) event on mortality among childhood cancer survivors is not well described. We hypothesized that mortality following a major CV event would be higher among survivors compared with siblings and that mortality would be influenced by primary cancer treatment. Methods: The CCSS cohort has conducted longitudinal follow-up of 25,658 survivors of childhood cancer and 5,051 siblings. All-cause and CV-cause specific mortality after a first event of heart failure (HF), coronary artery disease (CAD), or stroke occurring at least 5 years after cancer diagnosis, was estimated using the Kaplan-Meier method. The relative hazards (HR) and 95% confidence intervals (CI) between survivors and siblings as well as the influence of demographic (sex, age, race/ethnicity) and cancer treatment factors were estimated via Cox regression. Results: In total, 1780 survivors and 91 siblings experienced a serious CV event. Total deaths included 706 survivors (271 cardiac causes, 381 non-cardiac causes, 54 unknown causes) and 14 siblings. Survivors were a median age of 31.5 years (range 6.5-61.5) and 20.0 years (range 5.0-44.6) since cancer diagnosis at time of CV event. After a CV event, estimated 10- and 20-y all-cause mortality was significantly higher among survivors than siblings (Table). The HR for all-cause mortality was significantly higher among survivors than siblings after HF (HR 5.2, CI 2.1-13.0), CAD (HR 4.2, CI 2.0-9.0), and stroke (HR 4.6, CI 1.5-14.6). HF and stroke-specific mortality were not significantly increased among survivors versus siblings, in contrast to CAD-specific mortality (HR 3.5, CI 1.1-11.0). Among survivors, heart dose from radiotherapy (per 10 Gy) was associated with increased all-cause and cause-specific mortality after HF (HR 1.2, CI 1.0-1.3; HR 1.3, CI 1.0-1.7), all-cause mortality after CAD (HR 1.2, CI 1.0-1.3), and cause-specific mortality after stroke (HR 2.5, CI 1.2-4.9). Brain dose from radiotherapy was associated with increased all-cause mortality (HR 1.1, CI, 1.0-1.2, per 10 Gy) after stroke. Anthracycline dose was not associated with increased overall or cause-specific mortality risk after a CV event. Conclusions: After a CV event, mortality is higher among survivors than siblings. In survivors, mortality is primarily driven by non-cardiac causes. CAD and prior radiotherapy exposure to the heart and brain also influenced mortality.[Table: see text]