bluuebunny/crossref_metadata_2025_split huggingface dataset:
EPID-23. HISTORY OF TYPE III IMMUNE HYPERSENSITIVITY IMPROVES SURVIVAL IN GLIOBLASTOMA
Authors: Neff Corey , Ballard Christine , Price Mackenzie , Liu Zhen , Cioffi Gino , Barnholtz-Sloan Jill , Walsh Kyle , Fecci Peter , Ostrom Quinn 
Published: November 2024

Abstract
Preexisting atopy, particularly allergic rhinitis, is consistently associated with decreased risk of glioma, and there is evidence that preexisting autoimmune conditions may also decrease risk. Glioblastoma is both locally and systemically immunosuppressive and, unlike many other forms of cancer, its initiation is not strongly linked with chronic inflammation. Therefore, history of immune hypersensitivity could be associated with improved anti-glioma immunosurveillance. We leveraged Surveillance, Epidemiology and End Results (SEER) data combined with Medicare claims to investigate the effect of preexisting immune hypersensitivities on overall survival of glioblastoma patients receiving resection, radiation, and temozolomide (standard of care, or SOC) from 2008-2019. Patients &lt;66 years of age, enrolled in Medicare Advantage, not continuously enrolled in Medicare Part A/B, missing follow-up, reported by autopsy/death certificate only, or who did not receive surgery were excluded. Prior history of immune hypersensitivity (≥6 months prior to primary cancer diagnosis) was identified by ICD-9/ICD-10 codes. Treatment pattern was determined using ICD-9/ICD-10 and HCPCS/CPT codes. Conditions were classified into broad immune hypersensitivity types: type I (IgE-mediated, including atopy), type II (IgG- or IgM-mediated), type III (immune complex-mediated, including lupus and rheumatoid arthritis), and type IV (cell-mediated). Survival comparisons were made using Cox proportional hazard models adjusted for demographics, extent of resection, and Charlson comorbidity score (excluding immune conditions) to estimate hazard ratios, 95% confidence intervals, and p-values. Overall, 44% of 3,426 glioblastoma patients who received SOC had an immune hypersensitivity (type I: 33%, type II: 4%, type III: 8%, and type IV: 15%). These conditions were significantly more common in females (47% vs 41%, p&lt;0.001). After adjustment, only type III immune sensitivity was associated with improved OS (HR=0.81, 95% CI:0.71-0.92, p=0.002). These results suggest that underlying immune-complex mediated hypersensitivity may improve treatment response and prognosis in glioblastoma, and that these pathways could potentially be exploited for therapy.
EPID-28. TRENDS IN LOW GRADE GLIOMA PROGNOSIS AND THE EVOLVING IMPACT OF GROSS TOTAL RESECTION ACROSS FIFTY YEARS: A MULTICOHORT ANALYSIS
Authors: Jin Michael , Young Jacob , Umbach Gray , Ravi Karthik , Lim Michael , Hervey-Jumper Shawn 
Published: November 2024

Abstract

OBJECTIVE
Significant advancements in neurosurgical planning, approach, and practice over the past five decades have improved the surgical management of diffuse low and high-grade gliomas. We sought to evaluate the extent to which LGG survival outcomes have evolved over the past fifty years using glioma registry datasets with histopathological groups defined by WHO diagnostic criteria and supplemented with next generation genome-sequencing.

METHODS
Three datasets (SEER, TCGA, and GENIE) were used to evaluate trends in prognosis following LGG diagnosis and resection between 1975 and present (GBM as a comparator cohort). The primary outcomes evaluated were longitudinal disease-specific survival and overall survival, with secondary fixed-timepoint outcomes evaluated at 12-months, 24-months, and 60-months. Subjects from SEER were categorized by histology, while subjects from TCGA and GENIE were included based IDH mutation status with available histopathology.

RESULTS
A total of 39,958 adult patients were included. Overall survival increased for both LGG and GBM between 1975 and 2010, however only LGG outcomes continued to improve following 2010 (2010-; HR=0.955, 95%CI 0.926 to 0.986). Evaluation of the interaction between resection extent and diagnosis year revealed a progressive increase in the survival benefit of GTR in recent years, particularly for LGG. Independent of other available clinical/molecular features and considering the interaction term between year of diagnosis and resection extent, the gap in independent prognostic benefit associated with GTR between LGG and GBM has significantly widened (2010-2020 vs 1990-2000, p&lt;0.05).

CONCLUSION
Over the past three decades, consistent improvements in LGG outcomes were observed while prognosis following GBM diagnosis has remained largely unchanged following 2010. Notably, we observed increasing prognostic value of achieving GTR particularly in patients with LGG.
EPID-36. CLINICAL FEATURES OF 614 PRIMARY INTRACRANIAL GERM CELL TUMORS: AN 15-YEAR EXPERIENCE OF A SINGLE CENTER IN CHINA
Authors: Ge Jing-Jing , Li Cheng , Xue Feng-Jun , Qi Shao-Pei , Zhao Chi , Kong Chen-Chen , Zhao Chuan , Zhang Jun-Ping 
Published: November 2024

Abstract
Incidence of primary intracranial germ cell tumors (ICGCT) in Asian countries is higher than Western countries. This study aims to describe the characteristics of ICGCT patients in China. Data on all patients with ICGCT who were seen at the Department of Neuro-oncology, Sanbo Brain Hospital, Capital Medical University from 2007 to 2022 were collected retrospectively. Patient demographics, disease characteristics and treatment outcomes were analyzed. A total of 614 patients were identified, with 309 germinomas and 305 non-germinomatous germ cell tumors (NGGCT). The median age at diagnosis was 12.8 years. The male-female ratio is 2.4 to 1. The primary disease sites were mainly pineal gland and suprasellar region. Adults (age≥23) were more likely to develop germinomas (65.3%). 78% patients received radiotherapy after initial diagnosis. In M0 patients, whole brain radiotherapy was the most common approach, while in M+ was craniospinal radiotherapy. Whole ventricle radiotherapy was uncommon (4%). The most common chemotherapy regimen for germinoma was a combination of bleomycin, cisplatin and etoposide/tenipside; while for the NGGCT was ifosfamide combined with carboplatin/cisplatin and etoposide. For germinoma, the median recurrence-free survival (RFS) and overall survival (OS) were 150.3 months and 222 months; the 10 year RFS and OS were 58.2% and 85.1%, respectively. For NGGCT, the median RFS and OS were 80.4 months and 166.7 months; the 10 year RFS and OS were 46.9% and 60.5%. At relapse, four (0.65%) developed secondary malignancies. Seven (1.14%) developed extracranial dissemination. Chemotherapy and radiotherapy could improve the RFS and OS. Higher radiation dose was associated with better prognosis. The prognosis of focal radiotherapy alone was poor. M0 germinoma treated with focal radiotherapy alone were more likely relapse. This study suggested that treatment outcomes of our ICGCT patients are comparable with those in Western centers. Adjuvant chemotherapy and whole brain/craniospinal radiotherapy are pivotal treatment.
EPID-38. GLOBAL DISPARITIES AND PROJECTIONS IN PEDIATRIC BRAIN AND CNS CANCERS: A COMPREHENSIVE ANALYSIS THROUGH 2050
Authors: Sennani Sara , Erefai Ouassima , Hadrya Fatine , Soulaymani Abdelmajid , Mokhtari Abdelrhani , Hami Hinde 
Published: November 2024

Abstract

BACKGROUND
Brain and other central nervous system (CNS) cancers are the most prevalent solid tumors and the leading cause of death among children worldwide. This study investigates trends in the incidence, mortality, and global distribution of pediatric brain and other CNS cancers projected through 2050.

METHODS
Data on pediatric brain and other CNS cancer incidence and mortality were extracted from Globocan 2022 for children aged 0 to 14 years. Age-standardized incidence and mortality rates were calculated by continent, country, and Human Development Index (HDI) categories.

RESULTS
The Globocan dataset revealed 24,677 new cases and 12,249 deaths, corresponding to age-standardized incidence rates (ASIRs) of 1.3 and age-standardized mortality rates (ASMRs) of 0.62 per 100,000 population. Significant geographic disparities were observed: North America reported the highest incidence rate at 3.6, followed by Europe (2.2), Latin America (1.7), Oceania (1.4), Asia (1.3), and Africa (0.67). Europe recorded the highest mortality rate at 0.89, followed by Latin America (0.87), North America (0.70), Asia (0.66), and Africa (0.40). A country-specific analysis revealed that the highest incidence rates were in Montenegro (3.7), Estonia (3.4), and Austria (3.2), whereas the highest mortality rates were in Lithuania (2.1), Angola (2.0), and Honduras (1.7). Additionally, 37.82% of new cases and 40.71% of deaths occurred in high-HDI countries. Projections: The annual increase in incidence and mortality rates for brain and other CNS cancers is projected at 1.3% through 2050, with new cases expected to rise to 25,004 and deaths to 12,404.

CONCLUSIONS
The findings indicate a 23% decrease in brain and other CNS cancer cases in high-HDI countries by 2050, contrasted with a 45.3% increase in low-HDI countries. These disparities underscore the critical need for global health strategies that promote equitable healthcare access and advanced treatments to reduce the global burden of these cancers and address inequities in health outcomes.
DISP-02. SOCIOECONOMIC FACTORS INFLUENCE OVERALL SURVIVAL IN CHEMORADIATION-TREATED NEWLY DIAGNOSED WHO GRADE 4 GLIOBLASTOMA
Authors: Dada Abraham , Mehari Mulki , Kabir Aymen , Aabedi Alexander , Ore Cecilia Dalle , Hervey-Jumper Shawn 
Published: November 2024

Abstract
Social determinants of health are known to influence health outcomes, yet the interactive effects of patient-specific socioeconomic variables on overall survival remain poorly characterized in patients with glioblastoma (GBM). We aimed to assess socioeconomic factors associated with overall survival in a clinically homogenous GBM population. Patients with newly diagnosed isocitrate dehydrogenase wild-type glioblastoma, who underwent maximal safe resection of contrast-enhanced (CE) and non-contrast enhanced tissue (NC) tissue with adjuvant chemoradiation from 1997-2017 were selected for inclusion. Socioeconomic factors were collected through retrospective chart review. Variables associated with overall survival on univariate cox proportional hazards models (p&lt;0.05) were selected for multivariate analysis. 272 patients (42.6% female, 14.3% minority) were included. On univariate logistic regression, older age (HR: 1.23, p&lt;0.001), greater residual CE tissue (HR: 3.95, p&lt;0.001), were associated with reduced survival. Greater extent of resection NCE tissue (HR 0.94, p=0.028), higher postoperative KPS (HR 0.89, p=0.034), and unemployment (HR: 0.67, p=0.022), were associated with longer overall survival. On multivariate analysis, age was associated with reduced survival (HR: 1.31, p&lt;0.001), while unemployment (HR:0.69, p=0.049) was associated with longer overall survival. Subgroup multivariate analyses was performed dividing patients into those &lt;65 (n=185, 45% female, 11.9% minority, 48% employed) and those ≥65 (n=87, 37% female, 14% minority, 20% employed). In the &lt;65 cohort, protective factors included retirement (HR: 0.49 p=0.004), and unemployment (HR:.57, p=0.006). Older age (HR: 1.03, p=0.004), and greater residual CE tissue (HR: 1.16, p=0.03) continued to be associated with poorer survival. No variables correlated with outcomes in the ≥65 cohort. Active employment was associated with reduced survival in GBM patients treated with standard care, potentially serving as a proxy for access to subsequent treatment.
DISP-03. HEALTH DISPARITIES IN NEURO-ONCOLOGY
Authors: Budhu Joshua , Michaelson Nara , Watsula Amanda , Bakare Anu , Mohamadpour Mali , Chukwueke Ugonma 
Published: November 2024

Abstract
Significant disparities in diagnosis, research, and treatment exist in neuro-oncology. Patients who identify as racial or ethnic minorities, sexual or gender minorities, elderly, rural, or have low socioeconomic status are more likely to have adverse outcomes. Using PubMed and expert opinion, we summarized the existing literature on health disparities in neuro-oncology. We categorized disparities based on primary central nervous system tumors (CNS), secondary CNS tumors, pediatric neuro-oncology, clinical trial enrollment and diversity, and financial toxicity. For patients with primary CNS tumors, we found that marginalized groups faced delays in diagnosis, lower rates of resection, and lower rates of postoperative radiation. For secondary CNS tumors, marginalized groups had lower rates of indicated cancer screening, less access to genetic testing, less access to advanced imaging, and lower rates of stereotactic radiosurgery and targeted therapies. Pediatric neuro-oncology patients had differences in morbidity and mortality based on socioeconomic status and race and faced substantial delays in diagnosis. Financial toxicity, the side effects of the high financial cost of a cancer diagnosis, disproportionately affects marginalized populations. This may be further exacerbated by the use of long-term medications such as IDH inhibitors. There is also unequal representation of diverse populations in neuro-oncology clinical trials. Compared to other cancer subspecialties, there is less available data on disparities, however, the types of disparities such as delays in diagnosis and outcomes are similar. Notably, there are not many interventions focused on mitigating these disparities. There needs to be additional research on health disparities in neuro-oncology, including both descriptions of existing disparities, but also on methods and interventions to address these disparities.
DISP-04. SEX DIFFERENCES IN LUNG CANCER BRAIN METASTASES ADVERSE EVENTS
Authors: Dmukauskas Mantas , Cioffi Gino , Waite Kristin , Mammoser Aaron , Sloan Andrew , Ma Patric , Barnholtz-Sloan Jill 
Published: November 2024

Abstract
While sexual dimorphism is evident among adverse events (AEs) in response to treatments for many cancers, including brain tumors, little is known about sexual dimorphism among AE in brain metastases (BrM). As over 50% of BrM cases arise from lung cancer (LC), we examined sex differences in AEs associated with LC-BrM among individuals in the SEER-Medicare dataset aged ≥66 years at the time of LC diagnosis. Multivariable logistic regression models adjusted for demographic variables and Elixhauser comorbidity scores were used to analyze sex differences in AEs among individuals with BrM derived from primary LC. Analyses were stratified by the following histological subtypes: small-cell, adenocarcinoma, squamous cell carcinoma, or other non-small cell carcinomas. Additional variables analyzed included BrM treatment, age at BrM diagnosis, and year of diagnosis (at or before 2013/after 2013) to account for the introduction of targeted therapies. Differences in AE profiles, based by sex, in individuals diagnosed with LC-BrM were observed. Females diagnosed after 2013 with either small-cell, squamous cell, or other non-small cell carcinoma BrMs were more likely to experience headaches compared to males. Males diagnosed after 2013 with adenocarcinoma were more likely to experience brain herniation compared to females. Additionally, females aged 76 and older with small-cell BrM demonstrated an elevated risk of developing vision difficulties relative to males, whereas no significant sex difference observed in those under 76 years. Risk of most AEs decreased across all histological subtypes with receiving treatment after BrM diagnosis when compared to no treatment. This study underscores the existence of sex-specific differences in AEs among individuals aged 66 years and older diagnosed with LC-BrM. The AEs observed varied across histological subtypes, age cohorts, year of diagnosis, and treatment. Notably, receipt of treatment demonstrates consistent reduction in AE risk across all histological subgroups, underscoring the therapeutic benefit of treatment.
DISP-09. IMPROVING ADHERENCE TO CANCER CARE IN UNDERSERVED PATIENTS WITH CENTRAL NERVOUS SYSTEM TUMORS
Authors: Elshiekh Cleopatra , Phillips Ashley , Rodriguez Ashley , Narang Bharat , Gany Francesca , Budhu Joshua 
Published: November 2024

Abstract
Patients with central nervous system tumors have disease-specific symptoms such as aphasias, motor symptoms, neuropsychiatric symptoms, or seizures that make treatment adherence difficult. This is further exacerbated by the social determinants of health – patients from historically marginalized groups or those with lower socioeconomic status have additional barriers to treatment. The Integrated Cancer Care Access Network (ICCAN) is a multi-institutional patient navigation program assisting patients who express socioeconomic needs during cancer treatment. In this pilot program, we assessed the impact of ICCAN on treatment adherence and quality of life of CNS cancer patients from marginalized backgrounds. 42 participants with primary brain tumors or brain metastases were recruited from inpatient and outpatient services at Memorial Sloan Kettering Cancer Center to enroll in ICCAN-CNS. Patients were eligible if they were 18 years or older, receiving active treatment or under active surveillance, and screened positive for an essential need. Through standardized patient interviews and questionnaires, we evaluated their needs such as food access, housing, and financial needs. The clinical research coordinator interviewed the patients via phone, taking approximately 60 minutes. The interviews comprised an Essential Needs Assessment, Health Related Social Needs Assessment, NCCN Distress Thermometer, and an ICCAN-CNS questionnaire focused on neurology-specific symptoms. Caregivers helped complete the questions for patients with cognitive impairments. Patients were then matched with resources based on their initial needs assessment. The interviewer conducted 2, 4, and 6-month follow-ups to see if new needs emerged for which resources were provided. Response to the program was overwhelmingly positive with many patients expressing gratitude for the resources provided to them. This pilot demonstrates the feasibility of CNS tumor patients participating in the ICCAN intervention and the need for additional patient navigation programs and interventions that focus on the social determinants of health.
DISP-14. THE IMPACT OF DISTANCE IN TREATING GLIOBLASTOMA: A RETROSPECTIVE SINGLE CENTER STUDY
Authors: Kropp Samantha , Tenhoeve Sam , Zhao Yuxin , Chen Ann , Mendez Joe , Malani Rachna 
Published: November 2024

Abstract

INTRODUCTION
Glioblastoma (GBM) is an aggressive primary brain tumor associated with poor survival. Research shows that patients living in rural areas have poorer outcomes than those in metropolitan areas; however, little is known about how distance between patients and their subspecialist impacts outcomes. We explored the effect of distance from a National Cancer Institute-designated Comprehensive Cancer Center (CCC) has on overall survival (OS) and clinical trial enrollment for patients with GBM.

METHODS
Retrospective data was collected from patients with newly diagnosed GBM per the World Health Organization 2021 who received treatment at Huntsman Cancer Institute (HCI) from 2018 to 2022. Distance was evaluated as a categorical (near: 0-25 miles, intermediate: 25-40 miles, far: &gt;40 miles) and continuous variable for analyses. In addition to univariable models, multivariable models adjusting for known prognostic factors were also performed.

RESULTS
A total of 167 patients were identified. Baseline characteristics including age, sex, race, and KPS scores were similar across groups. The univariable COX regression model found no significant difference in OS when comparing the near group to the intermediate (p=0.125) and far (p=0.599). However, the multivariable model found poorer OS in the intermediate group that was statistically significant when compared to the near group (HR (95% CI) = 1.55 (1.01, 2.39), p = 0.047). When comparing distances as a continuous variable, patients in the far group had statistically significant lower clinical trial enrollment rates (near group 43%, intermediate 35%, far 18%; p=0.0001).

DISCUSSION
Patients with GBM seeing a neuro-oncologist at our CCC did have a difference in OS as well as clinical trial enrollment when considering distance traveled. Clinical trials are standard of care for patients with GBM; our data provides evidence that distance from a CCC significantly affects trial enrollment, underscoring the importance of ensuring availability of resources for clinical trial participants.
DISP-16. EXPLORING SEX-BASED DIFFERENCES IN RESPONSE TO IMMUNOTHERAPY IN GLIOBLASTOMA: A RETROSPECTIVE REVIEW
Authors: Westergaard Catharina , Nakhate Vihang , Lasica Aleksandra Beata , Muzikansky Alona , Barlow Brooke , Russ Alyssa , Nwagwu Chibueze , Lee Eudocia , Chukwueke Ugonma , Nayak Lakshmi , Castro Luis Nicolas Gonzalez , Figueroa Jose Ricardo McFaline , Aquilanti Elisa , Beroukhim Rameen , Batchelor Tracy , Reardon David , Wen Patrick , Youssef Gilbert 
Published: November 2024

Abstract

BACKGROUND
The prognostic implication of sex is unclear in glioblastoma. A recent preclinical study suggested that T-cell exhaustion in males confers improved response to anti-PD1 therapy (PMID: 37378557). We conducted a retrospective study of patients with newly diagnosed (nGBM) and recurrent (rGBM) glioblastoma enrolled on immunotherapy trials at Dana-Farber Cancer Institute from 2014 to 2022 to determine whether sex influences the response to immunotherapy.

METHODS
Clinical, molecular, and radiographic data were collected, and their association with progression-free survival (PFS) and overall survival (OS) was evaluated using log-rank.

RESULTS
We evaluated 299 subjects with nGBM (172 male, 127 female) and 539 with rGBM (329 male, 210 female). In the nGBM cohort, median PFS for males vs females was 9.1 [7.2, 13.8] months vs 8.8 [6.5, 10.1] months (p=0.59) among subjects on immunotherapy trials (N=106), and 6.9 [6.1, 8.0] vs 6.5 [5.8, 8.1] months (p=0.44) in those on non-immunotherapy trials (N=193). Median OS was 18.6 [15.4, 24.0] in males vs 18.8 [15.9, 23.1] months in females (p=0.85) in immunotherapy trials and 15.6 [14.7, 17.3] vs 15.3 [13.1, 16.9] months (p=0.77) in non-immunotherapy trials. There was also no statistically significant difference in OS and PFS between sexes in the rGBM cohort: median PFS was 3.6 [3.0, 4.1] months in males vs 4.1 [3.8, 5.2] months in females and median OS was 8.4 [7.4, 9.6] vs 9.6 [8.2, 12.1] months in immunotherapy trials (N=254); median PFS was 1.8 [1.7, 2.1] vs 1.9 [1.8, 2.4] months and median OS was 8.6 [7.5, 9.6] vs 8.5 [7.3, 9.6] months in non-immunotherapy trials (N=285).

CONCLUSION
Sex did not have a prognostic impact on survival outcomes, regardless of the treatment modality. The impact of other clinical variables such as corticosteroid use, performance status, lymphocyte counts, and tumor burden will be reported.