bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular and clinical features of hospital admissions and immunotherapy related adverse events of immune checkpoint inhibitors in thoracic malignancies.
Authors: Zhao Dan , Mambetsariev Isa , Chen Chen , Li Haiqing , Fricke Jeremy , Hewelt Blake , Fann Patricia , Kulkarni Prakash , Xing Yan , Koczywas Marianna , Massarelli Erminia , Reckamp Karen L. , Salgia Ravi 
Published: May 2019

e18192 Background: Immunotherapy related adverse events (irAEs) and hospital admissions with Immune Checkpoint Inhibitors (ICIs) in thoracic malignancies remain poorly characterized. Methods: Admissions after ICIs in all thoracic malignancies patients received ICIs at City of Hope (total 384) were identified as of 11/8/2018. IrAEs, outcomes, pathology and next-generation sequencing (NGS) data were collected, including Tumor mutation burden (TMB) and PD-L1 (22C3). Length of stay (LOS) and overall survival (OS) was calculated. Unpaired T-tests if data passed normality test, Chi-square and Fisher’s exact test, Gehan-Breslow-Wilcoxon test were used for comparison between 2 groups (irAEs VS no irAEs) for LOS, demographics and genetics, and survival respectively. Results: 100 patients had hospital admissions after ICIs therapy and 90 patients (41 women, 49 men) had stage IV disease (63 lung adenocarcinomas, 14 squamous cell lung cancer, 5 small cell lung cancer, 8 others). 28 out of 90 patients had irAEs (10 pneumonitis/pneumonia, 4 adrenal insufficiencies, 4 colitis, 3 liver toxicities, 2 nephritis, 1 heart failure, 1 pancreatitis, 1 diabetic ketone acidosis, and others including multiple irAEs). There was no difference between the patients who had irAEs VS no irAEs in LOS (median 7 days VS 6 days, P = 0.57). Patients with irAEs had more invasive diagnostic procedures than no irAEs (53.6% VS 25.8%, P = 0.02). There was a trend of longer OS in irAEs patients (median 16.4 months VS 6.8 months, P = 0.13) than no irAEs. Male gender (71.4% (20/28) VS 46.8% (29/62), OR = 2.85, P = 0.04) and smoking exposure (89.3% (25/28) VS 58.1% (36/62), OR = 6.0, P < 0.01) were associated with irAEs patients. Genetic alterations of LRP1B gene (83.3% (5/6) VS 26.9% (7/26), OR = 13.6, P = 0.02) and MLL3 gene (66.7% (4/6) VS 19.2% (5/26), OR = 8.4, P = 0.04) were associated with patients who had irAES. No difference was found in age, lines of therapy, TP53, KRAS, EGFR, STK11, PIK3CA, TMB, PD-L1 between the irAEs and no irAEs patients. Conclusions: Hospitalized patients who had irAEs had similar LOS compared with patients without irAEs but potentially longer OS. Gender, smoking status and genes associated with irAEs and ICIs outcomes were explored. Larger dataset for molecular and clinical features was planned.
Publication rate of registered clinical trials in lung cancer.
Authors: Al-shbool Ghassan , Latif Hira , Farid Saira , Yin Anqi , Ahn Jaeil , Giaccone Giuseppe , Kim Chul 
Published: May 2019

e18211 Background: Clinical trials play a crucial role in shaping oncology practice. Publishing results of clinical trials is key to reducing publication bias. Lung cancer is the leading cause of cancer-related mortality in the U.S. We assessed the publication rate of registered lung cancer clinical trials. Methods: ClinicalTrials.gov was searched to identify registered lung cancer clinical trials with study completion date between 1/1/2000 and 8/7/2016. Interventional phase II and III clinical trials involving patients ³ 18 years old with a recruitment status of completed or terminated were included. Using National Clinical Trial identifier and keywords including the clinical trial name, three databases (PubMed, Google Scholar, EMBASE) were queried to assess the publication status of each trial. We analyzed the publication rate among the identified clinical trials and predictors of publication. Results: A total of 1293 clinical trials were identified. Among 1037 completed clinical trials, 690 (66.5%; 193,587 patients) were published in peer-reviewed journal, while 347 (33.5%; 51,505 patients) were unpublished. Industry sponsored, non-randomized, and single-center studies were less likely to be published with odds ratio 0.52 (95% CI: 0.28-0.97), 0.67 (0.45-1.00), and 0.36 (0.25-0.51), respectively. Among the 347 unpublished completed trials, 75 (21.6%) trials reported the results as meeting presentation and 63 (18.2%) trials posted the results only on ClinicalTrials.gov. Among 256 terminated clinical trials, 72 (28.1%; 19,858 patients) were published in peer-reviewed journal, while 184 (71.9%; 10,259 patients) were unpublished. Among the 184 unpublished terminated trials, 19 (10.3%) trials reported the results as meeting presentation and 70 (38.0%) trials posted the study results only on ClinicalTrials.gov; reporting of primary outcome was incomplete in 50 (71.4%) of 70 studies whose results were only available on ClinicalTrials.gov. Conclusions: A significant proportion of registered lung cancer clinical trials remain unpublished, raising the concern of publication bias in the field of thoracic oncology.
Factors associated with metastatic presentation in HPV-related squamous cell carcinoma of the head and neck (SCCHN): A National Cancer Database (NCDB) analysis.
Authors: Bean Marta Brygida , Switchenko Jeffrey M. , Steuer Conor Ernst , Patel Mihir , El-Deiry Mark , Higgins Kristin Ann , McDonald Mark William , Chen Zhuo Georgia , Beitler Jonathan Jay , Shin Dong Moon , Gillespie Theresa Wicklin , Saba Nabil F. 
Published: May 2019

e18213 Background: Metastasis is an ominous sign in SCCHN. Human papillomavirus (HPV) infection-associated SCCHN cancers tend to have a distinct prognosis. Factors that are associated with metastatic disease at the time of presentation and diagnosis in patients with HPV-related SCCHN tumors were examined. Methods: NCDB was queried to assess 12,857 patients with HPV-related oropharyngeal carcinomas (HPVOPCA) and 952 patients with HPV related non-oropharyngeal carcinomas (HPVNOPCA) diagnosed between between 2010-2014 with non-missing survival or M stage. Rate of metastases at presentation was analyzed using clinical M stage. Multivariable analysis was performed evaluating race, ethnicity, sex, age, facility location, facility type, insurance status, income, education, urban/rural location, surgery, radiation, and chemotherapy using logistic regression. Results: In both HPVOPCA and HPVNOPCA, over 90% of patients were white. Private insurance was carried by 64% and 47% of patients with HPVOPCA and HPVNOPCA, respectively. HPVOPCA cancer was located in the tonsil in 47% of cases. Patients with HPVOPCA were more likely to present with advanced nodal disease than patients with HPVNOPCA. For both HPVOPCA and HPVNOPCA, there was no meaningful difference in the rate of distant metastasis at presentation in facility type or location, sex, race, Hispanic ethnicity, or urban rural location. For HPVOPCA, there were significantly lower odds of metastasis in privately insured patients vs. uninsured patients (HR: 0.35, 95% CI: 0.21-0.59, p < 0.001), and higher odds of metastasis for those living in census tracts with the lowest rates of high school graduates vs. those living in census tracts with the highest rates of high school graduates (HR: 1.82, 95% CI: 1.07-3.09, p = 0.026). For HPVNOPCA, patients living in census tracts with the lowest rates of high school graduates were less likely to develop metastasis compared to those living in census tracts with the highest rates of high school graduates (p = 0.031). Conclusions: This large retrospective analysis identifies likely modifiable risk factors for metastatic presentation in HPV-related SCCHN. Health policies and educational interventions may result in modifications of these patterns.
Depressive symptoms, mental health-related quality of life, and survival among older patients with multiple myeloma.
Authors: Alobaidi Ali , Nabulsi Nadia Azmi , Talon Brian , Asfaw Alemseged Ayele , Zhou Jifang , Sharp Lisa K. , Sweiss Karen , Patel Pritesh Rajni , Chiu Brian C-H , Ko Naomi , Calip Gregory Sampang 
Published: May 2019

e18232 Background: Few studies have evaluated the impacts of depressive symptoms and mental health on patients diagnosed with multiple myeloma (MM). The aim of this study was to examine associations between depressive symptoms and poor mental health-related quality of life in relation to survival in a cohort of older MM patients. Methods: We conducted an analysis using a prospective cohort from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) of patients aged 65 years and older diagnosed with first primary MM between 1998 and 2014. Subjects were required to have completed at least 1 pre-diagnosis survey and depressive symptoms were determined based on positive responses to at least 1 of 3 depression screening questions. Veterans-RAND-12 mental component scores (MCS) were also analyzed to evaluate mental health-related quality of life. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between pre-diagnosis depressive symptoms and risks of all-cause and cancer-specific mortality. Secondary analyses examined mortality risks in relation to pre-diagnosis MCS. Results: Of 522 multiple myeloma patients, the mean (SD) age at diagnosis was 76.9 (6.1) years and 158 (30%) self-reported positive depressive symptoms. Patients with depressive symptoms had a higher number of comorbid conditions and nearly all (84%) scored below the median MCS. Pre-diagnosis depressive symptoms were not associated with all-cause (HR 1.01, 95% CI: 0.79-1.29) or cancer-specific mortality (HR 0.94, 95% CI: 0.69-1.28). Myeloma patients scoring in the second MCS tertile (versus the highest tertile) had a modestly increased risk of all-cause (HR 1.19, 95% CI 0.91-1.55) and cancer-specific mortality (HR 1.17, 95% CI 0.86-1.60), but these estimates were not statistically significant. Conclusions: Pre-diagnosis depressive symptoms and lower mental health-related quality of life are not associated with survival for MM. Nevertheless, the considerably high prevalence of depressive symptoms and poor mental health status among older patients with multiple myeloma deserves clinical attention.
Trends in the incidence and outcomes of Clostridioides difficile infection in hematological cancers: A nationwide analysis.
Authors: Furqan Fateeha , Tariq Raseen , Goldstein Nicolas , Kashinath Sanjana , Jamshed Saad , Khanna Sahil 
Published: May 2019

e18244 Background: Clostridioides difficile infection (CDI) has higher incidence in cancer patients. To characterize the extent of CDI burden among hematologic cancer patients, we used the National Hospital Discharge Survey (NHDS) to report the incidence and outcomes of CDI. Methods: NHDS data from 2001-2010 were analyzed using diagnosis codes to identify patients with hematologic cancers and CDI. Demographics and discharge information were compared amongst hematologic cancer patients with and without CDI. Logistic regression models were runto estimate the impact of CDI on hematologic cancer patient outcomes, using STATA 12.0. Results: During the years 2001-2010, about 3.7 million patients (weighted data) were discharged with hematologic cancer. Among them, the incidence of CDI was 2.3%. Hematologic cancer patients with CDI were younger (mean age 66 vs 68 years), more likely to be men (66% vs 64.5%), to be of white race (68.1% vs 67.7%) and to have emergent admissions (73% vs 69%), all p values < 0.001. CDI incidence in these patients showed a steeper increase than non-cancer patients, with highest incidence in 2008-2009. Hematologic cancer patients with CDI had a longer mean Length of stay (16.9 vs 7.1 days; adjusted odds ratio (aOR) 9.5, 95% CI 9.4-9.6), all cause hospital mortality (11.3% vs 6.3%; aOR 1.92, 95% CI 1.88-1.97) and discharge to a care facility (28.4% vs 18.8%; aOR 2.06, 95% CI 2.02-2.10) compared to non-CDI cancer patients. Conclusions: CDI incidence is higher in patients with hematologic malignancy. They also have worse outcomes including overall mortality, longer hospitalizations and discharge to healthcare facility. These patients warrant closer screening and prompt treatment of CDI as they are at greater risk of unfavorable outcomes. [Table: see text]
Trends in mortality due to hypercalcemia in breast cancer.
Authors: Perimbeti Stuthi , Shrivastav Rishi , Stanchina Michele Dana , Pathak Priyadarshini , Rainone Michael Raphael , Jain Maneesh Rajiv , Ward Kristine Marie , Styler Michael 
Published: May 2019

e18252 Background: Hypercalcemia (HC) in metastatic breast cancers results from various mechanisms including increased bone turnover and secretion of Parathyroid hormone-related peptide. The presence of HC has traditionally been associated with poor prognosis but recent advances in the treatment of both HC with bisphosphonates and RANK-L inhibitors, and metastatic breast cancers with chemotherapy and immunotherapy, have improved symptoms and progression free survival. It has yet to be determined whether HC remains a poor prognostic indicator. Methods: Adult admissions ( > 18 years) between 1999 and 2014 with a primary diagnosis of breast cancer (BC) were extracted from the Nationwide Inpatient Sample using ICD-9 code 174.9. They were stratified for the presence of HC (ICD-9 code: 275.42), and further according to the year of admission. Chi-Square test and cox proportional hazard regression were used to determine in-hospital mortality and hazard of death based on the presence of HC. Results: A total of 484,859 (N = 98,631, weighted N = 484,859) admissions with a primary diagnosis of BC were obtained. The prevalence of HC increased from 0.52% in 1999 to 1.32% in 2014, yet inpatient mortality and adjusted Hazard Ratios (HR) of mortality declined over time as shown in Table. Despite this, patients with HC continued to have a significant increase in hospital mortality and HR (p < .001). Conclusions: Due to advances in medical therapy, in hospital mortality for patients with metastatic breast cancer has been declining over the last 15 years, however, the presence of HC continues to carry an independent risk for mortality. More research is needed to elucidate why HC continues to confer worse prognosis despite new calcium-lowering treatment modalities.[Table: see text]
Muscle MASS and mortality in cancer patients.
Authors: Salas Claudio , De La Maza Maria PIA , von Geldern Paula , Silva Claudio , Alvayay Pablo , Berkovits Alejandro 
Published: May 2019

e18290 Background: Detection and prevention of cancer cachexia during oncologic treatment is an important issue in cancer patients care. AIM: To analyze the relation between overall survival and nutritional status assessed both by subjective and objective methods, in a prospective cohort of oncologic patients. Methods: Between 2012-2014 all patients under treatment in the Oncology Unit of Clinica Alemana de Santiago were invited to participate in this study, and follow-up was completed August 2018. Exclusion criteria were terminal phase patients, or those with cognitive deterioration. Apart from recording demographic, clinical and nutritional data, whenever possible, recent computed tomographic images were analyzed through Slice O Matic, at the level of the third lumbar vertebra, for measurement of abdominal fat and muscle area. Muscle Mass Index (MMI) was calculated as muscle area/squared height. The control group was composed by 130 healthy subjects 18-40 years, whose computed tomography images were obtained as part of the trauma protocol. The cutoff for sarcopenia was MMI < -1 SD respect control subjects. In addition, nutritional status was assessed through anthropometric measurements and the Patient Generated Subjective Global Assessment (VGSGP). Results: We included 103 patients, predominant cancer sites were digestive, haematologic and lung; average survival was 33 ± 23 months. The sample was divided in 2 groups (TNM stages 1 and 2 versus 3 and 4). MMI in control subjects was significantly higher than values obtained from 64 oncologic patients with available CT scans, while fat area, specifically visceral, was the opposite. VGSGP scores correlated negatively and significantly with MMI (p < 0.001). According to univariate analysis, survival time was inversely associated with age among male patients ( p = 0.002), cancer stage in both genders p < 0.01), VGSGP (p < 0.01), and positively associated with MMI, only among men (p = 004). Kaplan Meir survival estimates were significant both sarcopenia and cancer stage. According to Cox regression, both sarcopenia and cancer stage were significant predictors of mortality, without any effect of age or sex. Conclusions: Both sarcopenia and cancer stage are predictors of survival during treatment of cancer.
Strategies for reducing grade 2 and 3 adverse events due to immunotherapy in a Spanish university hospital.
Authors: Gomez Ana , Gómez Solana Paloma , Ruiz Elena , Anton Antonio , Aranda Enrique , Camps Carlos , Constenla Manuel , Cruz Juan Jesús , Díaz-Rubio Eduardo , Feyjoo Margarita , García Foncillas Jesús , Gascon Pedro , Guillem Vicente , Lopez Rafael , Lugo Ilse , Carrato Alfredo 
Published: May 2019

e18295 Background: To develop an improvement project, the Lung Cancer Unit of Ramón y Cajal Hospital (Madrid) analyzed 45 patients treated with immunotherapy in 2017 and detected that 55% presented moderate-to-severe Adverse Events (AEs). Consequently, a specialized team from Ramon y Cajal Hospital and the ECO Foundation proposed to identify improvement areas that reduce grade 2 (G2) and 3 (G3) AEs. ECO is a collaboration of experts representing the major Spanish hospitals in the pursuit of excellence in cancer treatment. Methods: The team used as an instrument the American Society of Clinical Oncology (ASCO) Quality Training Program (QTP). A data collection process was conducted before attending the first out of three sessions of the QTP with the revision of medical records from lung cancer patients. The goal for the final QTP session in June 2018 was to reduce G2 and G3 AEs by 25%, by standardizing patient education sessions using ASCO guidelines for the management of immune-related AEs. Results: The data collected showed that G2 and G3 AEs had an impact on quality of care, specifically a treatment delay in 31% of patients, unscheduled visits in 19%, serious complications in 11% and patient dissatisfaction with the reporting system. The team created a cause and effect diagram, in which the most relevant causes were inadequate patient knowledge and a lack of communication with patients between visits. A run chart of the percentage of G2 and G3 AEs during 2017 displayed that G2 AEs were higher during January and August; and G3 AEs in February and December. The team, including patient advocates, prioritized the implementation of these short-term measures for patients: improvement of education, education follow-up, satisfaction questionnaire development and AE knowledge test. By June 2018, the resulting value of the “(mean + range)/standard deviation” formula for AEs perceived knowledge in patients increased from 5.4 to 11.1 points, the same value for patients’ AEs knowledge increased from 7.3 to 13.8 points, the percentage of G2 AEs reduced in 5% and the percentage of G3 AEs maintained in 0%. Conclusions: This improvement approach indicates the need to continue further quality projects in healthcare. Broader participation of Spanish hospitals in improvement initiatives will enhance the goal of a quality-oriented health care system.
Oral chemotherapy follow up on a Brazilian private health care unit.
Authors: Zukin Mauro , Soares Marcos Coelho Simões Travassos , Gamboa Nathalia Fonseca , Pombo Fabiano Hosken , Carvalho Lucyana 
Published: May 2019

e18311 Background: Oral antineoplastic therapy is a growing reality, and ensures greater comfort and better quality of life for patients. However, this modality of treatment requires greater attention of the professionals to avoid dispensing errors and to guarantee adherence to the treatment. The goal of this study is to present a method to follow up cancer patients to reduce percentage of problems related to medication and improve oral antineoplastic adherence. Methods: The study was conducted at a private oncology clinic in Rio de Janeiro during the year 2018. In the first dispensation, patients received verbal and written pharmaceutical advice on posology, proper storage, safe handling requirements and strategies to avoid adverse side effects and food and drugs interactions. There were also given nutrition, sexuality, rights and duties guidelines. To improve adherence and to avoid forgetfulness or duplicity of dosing, patients received a medication calendar. Pharmacist made dispensing, managed adverse side effects and assessed adherence of patient using a model based on Morisky Medication Adherence Scale. Patients that answered "yes" to any questions were considered non-adherents. All information was registered in medical record. Non-compliances were considered: wrong medicine, incorrect dose and delays of any administrative reason. Results: In 2018, on average 1487 dispensings were made and 1053 patients’ adherence behavior were measured. 94.37% were considered adherent. Monthly percentage of non-compliance was 1.5% of dispensings. Conclusions: The present study demonstrates that with education and pharmaceutical follow-up since the first dispensation, it is possible to guarantee a safer and more effective treatment for patients using oral cancer medication. It is imperative to maintain the objective of developing better techniques for dispensing, guiding and guaranteeing high adherence.
NCI and ASCO CancerLinQ collaboration to advance quality of cancer care and surveillance.
Authors: Rivera Donna , Rubinstein Wendy S. , Schussler Nicola C. , Charlton Mary E. , Coyle Linda , Cronin Kathleen A , Howe Will , Kolacevski Andrej , Komatsoulis George Anthony , Lynch Charles F , Negoita Serban , Miller Robert S. , Penberthy Lynne 
Published: May 2019

e18317 Background: The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program curates population-based cancer data representing 34% of the US population. CancerLinQ is an ASCO initiative that collects and analyzes electronic health record (EHR) data to give oncologists opportunities to improve the quality of patient care. With the shared goal of understanding care delivery, NCI SEER and CancerLinQ launched a pilot linkage. Purpose: Establish data exchange between registries and oncology practices to a) provide clinicians with SEER data to more effectively evaluate care within their practices, and b) enhance ability of SEER registries to capture cancer-related data and facilitate compliance of legally mandated public health reporting requirements while supporting metrics for quality reporting to providers. Methods: The SEER Iowa Cancer Registry is developing bidirectional linkages with CancerLinQ practices. The initial pilot in Iowa establishes connectivity and a data pipeline to capture discrete data elements in EHRs. The linkage methods are securely conducted by IMS, an honest broker for the Registry and ASCO. Patterns of care will be evaluated in the matched patient population. Analysis of shared data elements will provide comparative validation of data captured electronically (EHR) and manually (abstraction). Enhancing the patient care quality through efficient utilization of shared data was paramount when selecting treatment-related Quality Oncology Practice Initiative (QOPI) measures for calculation focusing on breast (QPP 449, QPP 450) and prostate cancer (QPP 102, QPP 104). Results: Publicly available SEER data for cohort evaluation is available to providers via SEERLinQ. The two-way exchange data pipeline complies with reporting requirements. Validation of shared data elements, statistics for matched patients, improved data completeness measures, and automated calculation of QOPI measures will be demonstrated. Conclusions: This collaboration builds an initial foundation of curated Registry-EHR linked data to automate cancer reporting to lower the physician burden, improve SEER evaluation of clinical care patterns, and enhance patient care quality.