bluuebunny/crossref_metadata_2025_split huggingface dataset:
A three-year epidemiological profile of cancers managed by a Haitian cancer program from 2016 to 2018.
Authors: Bernard Joseph , Alexis Lynn Gabrielle , Pierre Lenz Sacha Christyl , DeGennaro Vincent 
Published: May 2019

e13079 Background: The recent epidemiology of cancers in Haiti is poorly understood, since there is no functional national cancer registry. The data from GLOBOCAN 2012 and 2018 are estimations that do not reflect the actual cancer burden in Haiti. The aim of this study was to present the three-year epidemiology of cancer cases managed by a cancer program in Port-au-Prince, Haiti. Methods: A retrospective study was conducted on patients aged 15 years old or more with pathological and/or clinical diagnosis at the cancer clinic of Innovating Health International (IHI) from January 2016 to December 2018. The chart review collected variables such as age, gender, date of diagnosis, cancer type and outcome to present this epidemiological profile of cancers. Results: One thousand four hundred and eighty-one (1481) cancer cases were managed during this study period, respectively 282 in 2016, 513 in 2017 and 686 in 2018 (p < 0.001). 84% of the patients were female and 16% male. The mean age of the study population was 51.8 years [15 –92], ranging from 51.7 years in 2016 to 52.1 years in 2018 (p = 0.56). Adolescents and young adults (15-39 years old) represented 20.9% of this cohort and geriatric cases (≥ 65 years old) 19.6%. Breast cancer was the most common type (n = 686, 46.3%), followed by gynecological cancers (n = 330, 22.3%) with cervical cancer representing 70.9% of the cases, gastrointestinal cancers (n = 138, 9.3%), hematological malignancies (n = 75, 5.1%), head and neck cancers (n = 64, 4.3%), sarcomas (n = 40, 2.7%), urological cancers (n = 32, 2.2%), skin cancers including melanoma (n = 29, 2%), lung cancer (n = 13, 0.9%), thyroid cancer (n = 10, 0.7%) and central nervous system (CNS) cancers (n = 2, 0.1%). 4.2% of the patients (n = 62) had a cancer of unknown primary (CUP). Breast cancer was the most common type among women (54.7%) and gastrointestinal cancers the most diagnosed among men (25.3%). There was a predominance of women for most of the cancer types. The overall mortality rate was 31% and 8.6% of the patients were lost to follow-up. Conclusions: There was a significant increase of cancer cases in our cancer clinic from 2016 to 2018, likely due to a combination of our cancer awareness campaign, increased diagnosis and referral. Cancer mainly affects Haiti’s young, feminine and active population. Breast and cervical cancers were the most prevalent in this retrospective cohort. The under-representation of prostate and other urological cancers, lung cancer, acute leukemias and CNS cancers was likely due to underdiagnosis, misdiagnosis, under-referral or early mortality.
Gender differences in relative survival among patients with primary peritoneal carcinoma.
Authors: Ananthula Aneesha , Govindarajan Rangaswamy , Sharma Rohan 
Published: May 2019

e13092 Background: Primary peritoneal cancer(PPC) is a very rare aggressive cancer and is usually diagnosed late due to which it is generally portrays a poor prognosis. There are very few retrospective studies with limited knowledge about PPC. NCCN treatment guidelines for PPC is the same as that of ovarian cancer. Methods: We used 18 registries from Surveillance, Epidemiology, and End Results database to identify 6570 patients with Primary peritoneal carcinoma from 2000 to 2012 with follow up period upto 2015. Actuarial method was used to calculate 1 and 3 year Relative Survival (RS). Covariates included age, sex, race and grade. Results: PPC occurs more commonly in women with about 93% of the cases documented in women and about 88% of those documented in white women as per this database. The 1-year and 3-year RS for white women was 77.7% and 46% versus 69.6% and 54.1% for white males respectively. Males with grade I and grade II cancers had a better 3-year RS of 88.1% and 64.6%, in comparison with females with 77.3% and 55% respectively. Females with grade III and Grade IV cancers had a better 3 -year survival of 47.9% and 49% versus males who has a RS of only 35.3% and 39%. RS was significantly better in patients < 60 years with 3-year RS rate of 60.9% versus 36.4% for patients > 70 years. 3-year RS rates at during 2000-04, 2005-09 and 2010-14 were similar with 43.8%, 48.7% and 48.5% respectively. Conclusions: PPC is treated in a similar manner to epithelial ovarian carcinoma given some of its similarities in biological and pathological behavior. The cause of primary peritoneal cancer in unknown and there are only few studies done due to paucity of cases. Over the years survival seems to have not changed significantly and we need more clinical trials to identify the best course of treatment. [Table: see text][Table: see text][Table: see text][Table: see text]
Non-interventional study OVATAR final report: Diagnostic and treatment approaches in Russian ovarian cancer population—BRCAm group analysis.
Authors: Tyulyandina Alexandra , Kekeeva Tatiana , Gorbunova Vera , Kolomiets Larisa , Statsenko Galina , Saevets Valeria , Khokhlova Svetlana Victorovna , Tkachenko Svetlana , Koroleva Irina , Lisyanskaya Alla Sergeevna , Bakashvili Oksana , Novikova Olga , Krikunova Ludmila , Solovieva Ekaterina , Ponomarenko Dmitry , Zagumennova Lyubov , Tsimafeyeu Ilya , Vedrova Olga , Karaseva Vera , Tjulandin Sergei 
Published: May 2019

e13111 Background: First large Russian ovarian cancer observational study was conducted in 2014-2018. Methods: A total of 500 patients in 29 sites in Russia with newly diagnosed ovarian, peritoneal and fallopian tube cancer was enrolled (NCT02122588). The primary objective was to describe treatment approaches in the first line treatment. 141 patients (pts) with BRCA1/2 mutations (BRCA1/2mt) detected by NGS in blood and tissue were observed prospectively during at least 2 years. Results: Rate of BRCA1/2 mutations in Russian population is high – 28.4% (141 from 496 available for any testing). 77.6% (388/500) underwent biomarkers blood testing prior to treatment. CA-125 was positive in 99.7% (387/388), 15.2% (59/388) of pts had positive CA19-9, CA72-4 - in 2.3% (9/388). Positive CEA was presented in 15.2% (59/388). This marker was detected more frequently in BRCA2mt pts subgroup (28.0% (7/25)) than in BRCA1mt pts: 9.0% (8/90) (p = 0.05). 26.6% (133/500) of all study population had an oncology family history; 44.0% (62/141) BRCA1/2mt pts had relatives with oncological diseases and 19.7% (70/355) in BRCA wild type pts (p = 0.0001). 98.6% (139/141) of BRCA1/2mt pts received first line therapy. Objective response rate was registered in 79.8% (111/139) pts. Progression after platinum based regimens was observed in 53.6% (59/110) BRCA1mt pts and 44.8% (13/29) BRCA2mt pts. 35.6 % (21/59) of BRCA1mt pts had platinum-refractory and platinum-resistant relapses, while 15.4% in BRCA2mt subgroup (2/13) (p = 0.64). Platinum-sensitive relapses were in 64.4% (38/59) BRCA1mt pts and 84.6% BRCA2mt (11/13) (p = 0,64). Median PFS in BRCA1/2mt pts was 25.5 months. Among BRCA1/2mt pts underwent cytoreduction median PFS in subgroup without visible residual tumor was 36.4 months and in subgroup with residual tumor < 1 cm 15.3 months. Conclusions: In this large-scale prospective non-interventional study diagnostics and treatment approaches in Russian ovarian cancer pts were evaluated and high frequency of BRCA1/2mt was observed. Pts with BRCA1/2mt had better prognosis and most of them had platinum-sensitive relapses after first line chemotherapy that allowed platinum-based regimen rechallenge.
Risk of arterial thromboembolic events (ATEs) with tyrosine kinase inhibitors (TKIs) used in renal cell carcinoma: A systematic review and meta-analysis.
Authors: Farooq Muhammad Zain , Mathew Jessey , Malik Saad , Mukthinuthalapati V V Pavan Kedar , Asghar Noureen , Riaz Anum , Cheema Zarish , Riaz Irbaz Bin , Zahoor Haris 
Published: May 2019

e13119 Background: Tyrosine kinase inhibitors (TKIs) are routinely used in the treatment of metastatic RCC and Sunitinib is approved for the use in adjuvant setting. Arterial thromboembolic events (ATEs) have been described with these agents, although the overall risk remains unclear. We did a systematic review and meta-analysis to determine the incidence associated with the use of FDA approved TKIs used in treatment of RCC. Methods: PubMed, EMBASE, Cochrane Central and Scopus databases were searched to identify phase 2 and 3 RCTs of TKI therapy in RCC. Trials were included if they reported ATEs defined as arterial thrombosis, cerebral ischemia or infarction, myocardial ischemia and myocardial infarction. The DerSimonian-Laird random effects meta-analysis was performed using CMAv3 software to derive pooled estimates of incidence rates of ATEs with its 95% confidence interval (CI). I2 statistic was computed to express the percentage of the total observed variability due to study heterogeneity. Risk for bias was assessed using the Cochrane Collaboration’s tool. Results: 1755 studies retrieved in the initial search, and 13 phase 2 and 3 clinical trials (n = 4983) were included in the quantitative analysis. The trials had open label design which can potentially result in bias. Risk of bias was low in all other domains. TKIs used for the treatment of RCC included sunitinib (n = 2632), sorafenib (n = 981), cabozantinib (n = 78), pazopanib (n = 844), axitinib (n = 189) and tivozanib (n = 259). The incidence of ATEs with the use of TKIs was 2.9% (95% CI: 2-3%). Cabozantinib was associated with the highest rate of ATEs (11.5%, 95% CI: 6-21%), followed by sunitinib (2.6%, 95% CI:2-3%) pazopanib (2.6%, 95% CI:2-4%) and axitinib (2.1%, 95% CI: 1-6%). The TKI with lowest event rate of ATE was tivozanib (0.8%, 95% CI:0.2-3%). Conclusions: The use of TKIs is associated with increased risk of developing ATEs. Clinicians should be aware of the possibility of increased ATEs and counsel the patients about this increased risk to enhance the process of informed decision making.
HIV associated head and neck cancers in an inner-city minority population.
Authors: Katiyar Vatsala , Araujo Tiago , Gupta Shweta , Rubinstein Paul G. , Rosen Fred R. 
Published: May 2019

e13124 Background: Head and Neck Cancer (HNC) is a common non-AIDS defining malignancy and its risk increases by 1.7 to 4-fold with HIV infection. Little is known about the epidemiology and outcomes in this subset of patients. This study was undertaken to evaluate the characteristics of HIV+ HNC in an inner city minority population. Methods: All patients with a diagnosis of HNC from January 2008 to December 2017 were identified from the Tumor Registry Database of Cook County Health. We screened patients for HIV+ status at the time of HNC diagnosis. Retrospective chart review of those with Squamous cell carcinoma (SCC) was performed and compared to the largest reported HIV+ HNC cohort (SPORE consortium – J Acquir Immune Defic Syndr. 2015; 65(5):603-10). Other histologies were not included. Results: A total of 1379 charts were screened and 38 unique HIV+ patients with SCC were identified. The most common tumor sites were oral cavity (34%), larynx (26%) and oropharynx (26%), similar to SPORE. However, our cohort had a higher number of African Americans (AA) and a greater proportion of female patients. The median age of diagnosis was 52 years, which is similar in both studies but much lower than the non-HIV population (SEER database - median age 65). Over 63% had an undetectable viral load (VL) compared to 1.4% in SPORE, but the median CD4 count did not differ (298 vs 300 cells/µL). Survival information was available for 27 patients, with a median of 21 months (mo) versus 49 mo in SPORE. Overall survival (OS) was higher in non-smokers (34.5 mo vs 21 mo) and those with CD4>500 when compared to CD4<100 (42mo vs 15mo) Table summarizes the comparison of data. Conclusions: HIV+ HNC was predominantly seen in AA males. When compared to the SPORE cohort, OS was much poorer in the inner city minority, despite similar median age and CD4 counts. In addition, smokers and those with CD4 <100 cells/µL at diagnosis seem to have worse outcomes. [Table: see text]
A pharmacogenetic analysis of peripheral sensory neuropathy related to administration of taxanes in breast cancer patients.
Authors: Leonard Alyson , Gudena Vinay K. 
Published: May 2019

e13133 Background: Commonly used in the treatment of breast cancer, the taxane class includes paclitaxel and docetaxel. Both medications are primarily metabolized by cytochrome P450 enzymes and transporters mediate drug membrane influx and efflux. Variability in metabolizing enzymes and drug transporter function can affect drug clearance. This study sought to determine if the presence of pharmacogenetic changes in metabolizing enzymes and transporters resulted in a patient experiencing peripheral sensory neuropathy. Methods: In this case-control study, patients were enrolled between April 13, 2018 and April 30, 2018. Electronic medical records of patients with current appointments at Cone Health Cancer Center- Wesley Long were reviewed to identify patients who completed treatment with taxanes for breast cancer after January 1, 2017 for evaluation for inclusion in the study. Buccal swabs for pharmacogenetics testing were collected. Genes of interest, ABCB1, CYP3A4, CYP3A5, and SLCO1B1, were evaluated and data was categorized by phenotype. Baseline characteristics and phenotype results were compared using Fisher's exact test for categorical variables and Wilcoxon Rank Sum for numeric variables as appropriate. Results: Thirty-three patients were included in the final analysis. The population was mainly white at 72% and all patients in the study were female. The average patient age was 57 years old. Most patients had stage 1 breast cancer. Most patients received docetaxel. Among patients with peripheral sensory neuropathy, nine were grade 1, five were grade 2, and seven were grade 3. Resulting phenotypes: CYP3A5, all patients were normal metabolizers. CYP3A5, 7 normal metabolizer, 4 intermediate, and 22 poor. SLCO1B1, 25 normal function, 8 intermediate, and no low. ABCB1, 13 normal function, 7 intermediate, and 13 low. For all genes, there was no statistically significant difference in phenotype between the neuropathy and no neuropathy study arms, CYP3A5 (p = 0.075) SLCO1B1 (p = 0.106), ABCB1 (p = 0.902). Conclusions: The findings of our study indicate that having pharmacogenetics changes in the genes, ABCB1, CYP3A4, CYP3A5, and SLCO1B1 did not influence the patients experience with peripheral sensory neuropathy.
Genomic profiling for unfavorable carcinoma of unknown primary patients.
Authors: Lu Hsueh-Ju , Liu Hsuan , Hang Jen-Fan , Chao Yee , Chen Ming-Huang , Liu Chun-Yu , Huang Chi-Ying F. , Chang Mu-Hsin 
Published: May 2019

e13140 Background: Cancer of unknown primary site (CUP) is the seventh prevalent cancer around the world. Whether most CUP patients share a distinct molecular genome-phenotype is unclear. Methods: A total of 179 unfavorable CUP patients were retrospectively enrolled from Taipei Veterans General Hospital between Jan 2000 and Dec 2009. 33 qualified FFPE samples were sequenced by 275 target gene panel (QIAseq Human Comprehensive Cancer Panel [DHS-3501Z], QIAGEN). Identified significant variants were enriched by using DAVID software (https://david.ncifcrf.gov/). Results: Among 33 patients’ samples, total 6816 variants, including SNP and INDEL from both germline SNPs and somatic mutations were enrolled. After clustering, 112 variants which accounted for 1.64% were selected. Somatic and germline variants were 63.4% (71/112) and 36.6% (41/112), respectively. Profiles between these two groups were different after enrichment that pathway in cancer (fold enrichment [FE] = 6.64, P = 7.03E-09) is most important for somatic mutation and lysine degradation (FE = 25.6, P = 3.78E-04) for germline SNPs (Table). Conclusions: This genomic profile provides new insight into unfavorable CUP patients. Further studies between genotypes vs. phenotypes and drug targets vs. genotypes are warranted.[Table: see text]
VONC: A solution for the clinical assessment of somatic genomic alterations.
Authors: Kueffner Robert , Li Hui , Cheung Kakit , Fink Marc , Soens Zachry , Wang Jinlian , Siddiqui Osman , Thiumurthi Umadevi , Uzilov Andrew , Song Chunying , Villar Joaquin , Pollock Andrew , Jeganathan Bharath , Zimmermann Michelle , Kip Nefize Sertac , Rossi Michael , Schadt Eric , Li Dan , Hantash Feras , Chen Rong 
Published: May 2019

e13155 Background: Next generation sequencing (NGS) technology is transforming the diagnosis and treatment of cancer. However, the massive scale of data has overwhelmed pathologists who need streamlined tools to process this data, automate report generation and minimize human errors. Methods: We developed the Variant interpretation station for ONCology, VONC, as an end-to-end solution for moving from NGS whole exome and transcriptome data to actionable clinical reports that support cancer diagnosis, prognosis, and personalized treatment strategies for solid and hematologic malignancies. Results: VONC integrates all steps for moving from raw NGS data, variant calling and LIMS, to comprehensive annotation of variants. The main functional feature of VONC is a transparent process that effectively combines automated and expert curation to identify clinically relevant and actionable driver variants. VONC also enables efficient management of multi-group, -role, -system and -site curation processes. In contrast to current tools, VONC handles all somatic and constitutional genomic alterations including SNV, indel, CNV, fusion, splicing, and gene expression. Key data sources include 1) 350,000 variants for 50 tumor types across 57,000 sequenced cancer patients; 2) variant frequencies estimated from 1.5M cancer patients; 3) expert curated literature evidence from 16,818 papers covering 26,496 alterations spanning 2,448 cancer driver genes; and 4) curated database of FDA-approved drugs and recruiting clinical trials. VONC presents a prioritized list of variants in oncogenes and tumor suppressors through functional (literature-based) and structure-based (hotspots) algorithms. This is coupled to all supporting information necessary for clinical decision making. Curators can quickly screen variant type, QC metrics, and frequency in sequencing cohorts of cancer patients as well as healthy subjects. Within minutes, variants can be triaged and annotated with FDA approved, NCCN guidelines reported, or literature supported therapeutics, including resistance and contraindicated. Conclusions: VONC is a clinically-ready tool with an intuitive end-user interface tailored for the rapid assessment of variants in cancer patients, to facilitate personalized cancer medicine in a high-throughput laboratory.
Enhanced family history screening is crucial to individualized cancer surveillance.
Authors: Clift Kristin , Macklin Sarah K , Wallace Michael B , Presutti R. John 
Published: May 2019

e13161 Background: Capturing family health history is a simple and cost-effective way to identify individuals at increased risk for hereditary cancers. Several barriers exist to family history collection in the clinical setting. Self-reported histories can be limited, inaccurate or static. Physicians are often overwhelmed with data and “alert fatigue.” These complex factors make it difficult to quantify hereditary risks. Patients with increased genetic predisposition may be missed and may not receive individualized cancer surveillance measures. Methods: A practice improvement project was implemented at Mayo Clinic Florida to enhance family history screening. A questionnaire and simple scoring algorithm were developed to prompt referral for genetic counseling. This tool was pilot tested in a multi-specialty gastroenterology clinic. The questionnaire was administered in the waiting room (tablet interface). Patients with significant risk factors identified were contacted and offered genetic counseling. Results: Currently, 291 patients have completed the questionnaire. Thirty of the 60 patients identified to have significant familial risk factors met with a genetic counselor. Of the twenty who completed genetic testing, 9 patients received one or more variants of unknown significance. Two pathogenic variants were identified. One patient was molecularly confirmed to have multiple endocrine neoplasia type 2, which can allow for cascade screening in her unaffected sibling. A pathogenic ATM variant was found in a patient with a recent personal history of pancreatic cancer. The result prompted consideration of platinum based chemotherapy and/or PARP inhibitors in her cancer management. She has had a visible response thus far with the treatment. Her sister implemented a new surveillance regimen after testing positive for the familial variant. Conclusions: Enhanced family history screening is a low cost, effective method for the identification of patients who may benefit from hereditary cancer screening and genetic testing. Increased attention to family history is a vital component of precision medicine in any care setting.
National trends in the use of immunotherapy in the up front management of glioblastoma.
Authors: White Richard , Abel Stephen , Hasan Shaakir , Verma Vivek , Ranjan Tulika , Karlovits Stephen , Wegner Rodney E 
Published: May 2019

e13500 Background: Glioblastoma (GBM) carries an abysmal prognosis. Current standard of care involves an aggressive multimodality approach including surgical resection followed by adjuvant chemoradiation. Despite this approach, overall survival remains poor and treatment approaches continue to evolve. Given the successes of immunotherapy in other disease sites, implementation in GBM management may improve outcomes. Methods: We conducted this NCDB-driven retrospective study to analyze treatment trends and outcomes from 2004-2015 with respect to GBM and immunotherapy. We queried the NCDB diagnosed between 2004-2015 with GBM and excluded patients treated without surgery, extracranial radiation, or chemotherapy as well as those lost to follow up. Results: Of the 39,317 eligible patients in this study, 511 were treated with immunotherapy and 38,806 lack thereof. Median overall survival for all patients was 15 months with a 2 and 5 year survival rate of 29% and 8%, respectively. Factors positively influencing delivery of immunotherapy included younger age, higher income, facility location in a metropolitan location, greater distance to the treatment facility, treatment at an academic facility, treatment outside of the years 2007 to 2009, and Caucasian race. On propensity matched analysis, survival was 18 months and 17 months with and without immunotherapy, respectively (p = 0.15). Higher comorbidity, lower income, and male gender predicted for worse survival. Conclusions: The results of the NCDB analysis showed an initial decrease and then increase in the use of immunotherapy in the management of GBM. Propensity-matched and –adjusted analyses did not show an overall survival benefit, consistent with data from randomized trials.