bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and characteristics of cancer-associated thrombosis in a racially diverse population: A population-based study.
Authors: Raskob Gary E. , Wendelboe Aaron M. , Heller John Grady , Ding Kai , Reyes Nimia L. , Abe Karon , Adamski Alys , Beckman Michele G. , Richardson Lisa Carolyn 
Published: May 2019

e13088 Background: Venous thromboembolism (VTE) is a common complication in cancer patients, but contemporary data on the incidence and characteristics of cancer-associated VTE in different racial populations is limited. We sought to measure the incidence rate and characteristics of cancer-associated VTE in a racially diverse population. Methods: We performed a prospective, population–based cohort study of VTE in Oklahoma County, OK during April 1, 2012–March 31, 2014. Surveillance staff regularly visited all tertiary care and relevant outpatient facilities in the county and reviewed the text from all imaging results of chest computed tomography or magnetic resonance imaging, lung perfusion scans, and ultrasound of the extremities to identify cases of VTE. Data on patient characteristics were collected from the electronic medical record. VTE was considered cancer-associated if the patient had a history of cancer other than basal or squamous cell skin cancer. Cancer was defined as “active” if metastatic or diagnosed within 6 months prior to VTE. Associations and incidence were calculated using the chi-square test and Poisson regression, respectively. Results: Of 3,255 patients with ≥1 VTE event (deep-vein thrombosis and/or pulmonary embolism), 732 (23%) had a history of cancer, of whom 309 had active cancer. The types of cancer varied widely. The age-adjusted incidence of cancer-associated VTE was 648 per 100,000 adult population (age ≥ 18). Incidence increased with each decade of age. The racial/ethnic-specific incidence rates were as follows (each per 100,000): Whites non-hispanic (607), Blacks non-Hispanic (557), Native Americans (128), Asian/Pacific Islanders (113) and Hispanics (70). Risk factors for VTE among the 732 with cancer-associated VTE included previous VTE (19%), hospitalization (37%), surgery (33%), and central venous catheter (22%). Of those with a history of cancer ≥ 6 months previously, 32% had no other identifiable VTE risk factor. Conclusions: Cancer-associated VTE comprised about 20-25% of the total population burden of VTE. The incidence varied substantially by race/ethnicity. An appreciable proportion of those with a history of cancer ≥ 6 months previously subsequently developed VTE in the absence of other risk factors.
Prediction of attendance to the "60 days law" within the patient navigation program to breast cancer in Rio de Janeiro, Brazil.
Authors: Gioia Sandra , Krush Lindsay , San Miguel Sandra , Galdino Renata , Brigagao Lucia , Goss Paul 
Published: May 2019

e13100 Background: An applied study was conducted on how the use of machine learning techniques can help in the process of identifying compliance with the "60 Day Law", which states that all patients with cancer within the public system must initiate the treatment within 60 days after the diagnosis of cancer. Within the Patient Navigation Program (PNP) for breast cancer in Rio de Janeiro, the study aims to: 1) identify barriers to compliance with the Law; 2) ensure that at least 70% of patients recruited with breast cancer initiate treatment within the mandatory 60-day period; and 3) to construct a model that accurately predicts whether or not a patient meets the period established in the Law. Methods: From August 2017 to May 2018, 105 patients aged 33-80 years (mean 59 years) were recruited for navigation. For the development of the statistical analysis, three learning models were used AdaBoost, Decision Tree and GaussianNB. Results: Patients presented 0-I (17%), II-III (78%) and IV (5%) staging. The main barriers to compliance with the Law were fear and fatalistic thoughts (99%), financial problems (79%), and uncoordinated health care (76%).The PNP had 100% patient satisfaction and in 52% of the cases it helped at the beginning of the treatment within the period established by law. The AdaBoost learning model had superior results in relation to accuracy and f-score (0.8889 and 0.8333, respectively). Conclusions: The PNP generated a positive experience in the public health system, because it is an intentional and proactive process of individual assistance through the health system, accessing services, and actively overcoming the barriers to quality care. The study did not reach the success rate of 70% compliance with the Law as intended (having reached 52%). However, the barriers that NP cannot overcome, such as the lack of human resources and medical supplies, have been reported to health authorities and hospital administrators. We identified 38 important attributes for compliance with the Law, which simplifies the information required for model learning. In the Brazilian context, the PNP may represent an opportunity to adequately implement existing legislation and, as such, would have great potential for integration into federal, state, and local health systems. Clinical trial information: 62728616.5.0000.5274.
Bringing patient navigation to primary health care in Rio de Janeiro: Pilot project in the Andaraí community.
Authors: Gioia Sandra , Torres Cristiane , Galdino Renata , Brigagao Lucia , Heringer Alessandra , Medeiros Marcelle , Krush Lindsay , Goss Paul E. 
Published: May 2019

e13104 Background: This research project aims to study the increase of mammographic coverage rate with Patient Navigation Program (PNP) in a community of Rio de Janeiro. The general objective is to measure adherence to Ministry of Health’s recommendations for breast cancer screening with mammography, with the help of a patient navigator. Other objectives include: (1) establish the viability of the PNP in this context; 2) identify the barriers to mammography screening and; 3) ensure that at least 70% of women recruited between 50 and 69 years of age and asymptomatic update the biennial mammographic examination and annual clinical examination, increasing the mammographic coverage from 14% to at least 70% considered acceptable by the World Health Organization. Methods: From March to September 2018, women from the Andaraí Community were recruited in the Municipality of Rio de Janeiro. The follow-up was carried out by telephone, e-mail, and text messages. Of the 678 women (average age = 58), 12% of women refused to participate in the PNP for cultural reasons. Results: All 599 women participants reported barriers to obtaining breast health care with the number of barriers reported ranging from 1 to 6 barriers, (average = 3). The main barriers were system problems with health care programming (100%), financial problems (64%), communication concerns with the medical staff (58%), fear (44%), and social support (14%). We obtained 100% satisfaction with the PNP and exceeded our goal with 88% mammographic coverage rate. Conclusions: The PNP for breast cancer in the Andaraí Community has proven to be feasible in the context of local public health. The PNP promoted an increase in the mammographic coverage rate to 88%, assisted in the transmission of quality information, reduced the fear of mammography, and facilitated access to breast health care. Clinical trial information: 70832117.8.0000.5279.
Prevalence of targetable mutations in black patients with lung cancer: A systematic review and meta-analysis.
Authors: Paul Yonette , Iyer Sunil G , Tamariz Leonardo , Nemeth Zsuzsanna , Lopes Gilberto 
Published: May 2019

e13105 Background: Although poorer outcomes of lung cancer in Blacks compared to other racial groups has been strongly linked to socio-economic factors, it is important to investigate whether lower prevalence of targetable mutations limit treatment options, thereby also contributing to worse outcomes. This study examines the prevalence of EGFR, ALK, ROS-1 and BRAF lung cancer mutations in Blacks compared to other races. Methods: We conducted a meta- analysis compliant with PRISMA guidelines. Searched databases included PubMed/MEDLINE, Cochrane CENTRAL, EMBASE, Google Scholar and clinicaltrials.gov. Publication bias was mitigated by searching clinicaltrials.gov for unpublished studies. Searches were run to 11/19/2018. Two rounds of screening were performed based on title and then abstract by two independent reviewers. For the purposes of this study we defined racial groups as Black, Asian, Hispanic, and White/Caucasian. We selected studies of lung cancer patients (any stage or type) where the prevalence of at least one mutation was reported in Blacks. We calculated the pooled prevalence of mutations by racial group using fixed effects, exact binomial distributions and Freeman-Turkey double arcsine transformation to stabilize the variances. Results: Prevalence % of mutations by race reported with 95% Confidence Interval in parentheses N = number of tests performed We included 20 studies which totaled 11,867 lung cancer patients. Each mutation tested on a tissue sample was considered an event, for a total of 15,306 events. EGFR was the most prevalent mutation in Blacks (6%). Compared to other races Blacks had the lowest prevalence of all four mutations. Conclusions: In the era of targeted therapy, outcomes for metastatic lung have improved significantly. Of concern, our results show that Blacks are disproportionately ineligible for these therapies due to lower prevalence of targetable mutations. More research is needed to evaluate the unique tumor characteristics and therapeutic strategies in this sub group of patients, in the hope of achieving better disease outcomes.[Table: see text]
Study of the expression of programmed death ligand 1 (PD-L1) on non-small cell lung cancers (NSCLCs) at Bach Mai Hospital, Vietnam.
Authors: TRANG NGO Thuy , Pham Van Tuyen , Doan Minh Khuy , Hoang Anh Tuan , Lu Long-Sheng 
Published: May 2019

e13107 Background: Programmed death ligand 1 (PD-L1) expressions is a known predictor for anti-PD1 therapy outcomes. This study is the first study that describe the status of PD-L1 status on Vietnamese non-small cell lung cancers (NSLCs) patients. Methods: Patients who were diagnosed with advanced NSCLCs and PD-L1 testing from 14 Dec 2017 to 14 Dec 2018 at The Pathology Center, Bach Mai Hospital, Hanoi, Vietnam. Study team collected data of age, gender, histopathological types, biopsy sites and PD-L1 expressions. Qualified pathologists interpret levels of PD-L1 via immunohistochemical (IHC) assays Ventana PD-L1 (SP263) with archive formalin-fixed, paraffin-embedded (FFPE) NSCLCs tissues (primary lung tumor or metastases) on VENTANA BenchMark XT. Results: In total 166 patients, the majority were male (73.49%) with male/female ratio is 2.77. Age range from 29 to 85 with median age was 61 years old. The most common histopathological type was adenocarcinoma (n = 143, 86.14%). Other patients including 19 squamous cell carcinoma (11.45%) and 3 patients with “not otherwise specified” (NOS) tissues (2.41%). Overall 127/166 (76.51%) specimens were taken from lung tumors while 39 (23.49%) samples were from lymph node (10), pleura (20), liver (2), pericardia (2), brain (3) and bone (2). Rates of high expression (≥50%), expression (≥1% and ≤49%) and no expression (<1%) of PD-L1 were 26.51%, 31.32% and 42.17%, respectively. In multivariable regression analysis, we did not observe correlation between PD-L1 expression and age (p = 0.25, CI 95%), type of histopathological tissues (p = 0.41, CI 95%), biopsy sites (compare between lung vs non-lung samples, p = 0.89, CI 95%). Male gender has higher chance to have high expression ò PD-L1 with p = 0.0044, CI 95%. In female patients only, age has negative correlation with PD-L1 expression (p = 0.014, CI 95%). Conclusions: We found that male Vietnamese or younger female NSCLCs are likely to have higher PD-L1 expression. Further data on sequential anti PD-L1 treatment after PD-L1 testing is needed for validation the benefit of Ventana PD-L1 (SP263) IHC assay in Vietnamese NSCLC patients.
Effects on histologic subgroup, race, and BMI in 2,110 breast cancer patient: Results from single institution in Georgia.
Authors: Alvarez Ricardo H. , Rollins Rebecca , Ensor Joe , Nixon Daniel W. , Ramey Jonathan , Pannell Rachel , Rados Karen , Ahn Eugene R , Aithal Sramila , Lynch Cynthia , Pabbathi Haritha , Hansra Damien , McKnight John Edward , Kim Elizabeth MH , Johnson Anita 
Published: May 2019

e13112 Background: Disparities in breast cancer (BC) care still clearly exist among Whites (W) and African-Americans (AA) racial groups. These disparities resulting in higher mortality among AA compared to W. The objective of this analysis was to estimate the prevalence of BC subtypes in a population-based sample of BC cases, collected in a Breast Cancer Database (BCD) and to examine correlations with demographic and clinicopathologic variables and patient survival. Methods: retrospective analysis of patients registered at BCD was performed. Pts with BC were analyzed for differences in survival based on histologic subgroup (HS), race and BMI. Median Kaplan Meyer estimate for potential follow-up was 13.1 months with 95% CI (10.6, 15.0). Univariate and multivariate analysis were used to identify factors associated with demographic and cancer biology variables. Results: A total of 2,110 patients were registered at BCD and were available for this analysis.The median age at diagnosis was 50.8 years with 95% CI of (50.2, 51.0). 50% were W and 46.6% were AA. HS were classified by immunohistochemistry CLIA central lab, ER+ 61.1%, HER2+ 21.8% and TNBC 17%.Fisher’s exact test showed statistically difference in HS distribution among the races (p < 0.0001); 25% and 11.7% TNBC, for AA and W, respectively. The mean BMI was 29.0 with 95% CI of (29.6, 30.2). BMI characteristics were obese 47.2%, overweight 28.6% and normal 22.2%. Fisher’s exact test showed statistically difference in BMI distribution among the races, 57% and 39% obesity, for AA and W, respectively (p < 0.0001). Log-rank test showed that 2-years OS is worse for TNBC (48%), than for ER+ (72%) and HER2+ (75%). In the multivariable model AA survival was statistically inferior than for W ( p= 0.0094). Cox proportional hazard model was constructed to assess the effect of age, BMI, race and HS (Table). Conclusions: This single institution analysis demonstrated a statistically differences between TNBC, AA, and abnormal BMI as poor prognostic factors in BC pts impacting OS. Further research should investigate how to improve care for AA women who are at higher risk for breast cancer mortality. [Table: see text]
The association between volumetric breast density and breast cancer subtypes among women newly diagnosed with breast cancer.
Authors: Balema Wintana A. , Moseley Tanya W. , Weaver Olena , Hess Kenneth R. , Brewster Abenaa M. 
Published: May 2019

e13115 Background: Increased breast density is a strong risk factor for breast cancer, women with high breast density have a four to six-fold increased risk of breast cancer compared to those with low density. This study explores breast density as a risk factor for specific breast cancer subtypes in order to improve risk assessment and screening recommendations for the general population. Methods: 790 women ≥ 18 years with breast cancer were evaluated who had volumetric percent density and volumetric density grade (VDG) assessed from diagnostic mammograms obtained within 9 months of diagnosis. Breast cancer subtypes were approximated based on the estrogen receptor (ER), progesterone (PR) and Her2neu status; ER and/or PR positive/Her2 negative or positive (HR+), ER and PR negative and Her2 positive (Her2-positive) and ER, PR and Her2 negative (TN). A linear model on a log scale was conducted to evaluate the associations between percentage volumetric breast density and VDG and breast cancer subtypes and race. Results: 36% of women were < 50 years and 64% ≥50 years, 76% were white, 12% Black and 12% other race. There was no significant association between breast cancer subtype with age ( P = 0.068), BMI ( P = 0.81) or race ( P = 0.11). Women with VDG 1 or 2 were more likely to have HR+ (81.3%) than Her2-positive (5.1%) or TN subtypes (13.6%) (P = 0.024). There was no significant association between the percent volumetric breast density and breast tumor subtype or race. Conclusions: We found a significant association between lower breast density measured using VDG and the HR+ breast cancer subtype. This suggests a potential opportunity for assessing volumetric density grade for the development of individualized risk prediction models and for the identification of women who may benefit from preventive therapy to reduce HR+ breast cancer risk.
Adverse events following the use of immune checkpoint inhibitors: An analysis of the WHO VigiAccess database.
Authors: Nikita Nikita , Zinner Ralph , Johnson Jennifer Maria , Ghosh Natasha , Wilson Melissa , Lu-Yao Grace L. 
Published: May 2019

e13118 Background: Immune checkpoint inhibitors (ICIs), especially ipilimumab (ipi) and nivolumab (nivo), have received approvals from the U.S. Food and Drug Administration for the treatment of multiple tumor types. These medications have shown great promise in the treatment of several malignancies but are associated with immune-related adverse events. This study was undertaken to better understand the patterns of adverse events following different ICIs. Methods: We used the World Health Organization (WHO) Vigiaccess Database, the largest adverse events reporting database, to identify, summarize, and report adverse drug events (AE) attributed to ipi and nivo. The database contains reports for ipi beginning in 2008 and for nivo beginning in 2012. We manually extracted the data from the database and conducted Chi-square tests to examine the difference in occurrence of AEs in various organ systems between patients receiving ipi and nivo. The five most common organ systems affected by AE associated with ipi and nivo were identified. Results: AEs were reported in 15,504 ipi users and 21,306 nivo users. Ipi users reported significantly higher AEs in gastrointestinal system compared to nivo users (p < 0.0001). Conversely, nivo users reported significantly higher AEs in respiratory disorders (p < 0.0001), skin and subcutaneous tissue organ systems (p = 0.0001), and neoplasms benign, malignant and unspecified (p < 0.0001) compared to ipi users. Conclusions: To our knowledge this is the largest study on reported AEs following ipi and nivo. The patterns of treatment-related AEs differed significantly for these two immune checkpoint inhibitor therapies. Further studies are required to guide treatment selection.[Table: see text]
Relationship between underlying causes of HCC and its complications.
Authors: Kyung Daniel , Perimbeti Stuthi , Adepoju Bolanle , Hanson Shaun Bryan , McCormack Michael Joseph , Ward Kristine Marie , Jain Maneesh Rajiv , Styler Michael 
Published: May 2019

e13123 Background: Hepatocellular carcinoma (HCC) remains the 4th leading cause of cancer mortality in the US. While mortality varies by stage, the presence of certain HCC-related complications contribute to increased mortality. In this study, we assessed whether the underlying cause for HCC influenced the frequency of common complications. Methods: The National Inpatient Sample between 1999 and 2014 was analyzed using ICD-9 codes. The ICD-9 code for HCC was used to extract all admissions from the years 1999-2014 and weighted to approximate the full inpatient population of the US over the 16 year interval. The prevalence of HCC-related complications were calculated for portal vein thrombosis (PVT), erythrocytosis, peritonitis, esophageal variceal bleeding (EVB), portal hypertension (Portal HTN) and hepatic encephalopathy (HE). Bivariate analysis using Chi square test was performed to compare the percentages of each complication with underlying risk factors for HCC (HBV, HCV, NASH and alcohol). Results: Total of 131,115 admissions (weighted = 648,732) was identified to have HCC. Conclusions: Portal HTN was the most common complication associated with HCV and NASH, whereas hepatic encephalopathy was most frequently seen with alcohol and PVT with HBV, respectively. Alcohol was associated with the highest rate of HCC-complications with the exception of portal vein thrombosis. HBV was associated with the lowest frequencies of complications except for PVT, for which it was the highest. Future studies might look at whether disease modifying measures such as cessation of alcohol and eradication of active HBV, HCV would impact the natural history of HCC.[Table: see text][Table: see text]
Suspected and confirmed germline variants from tumor-only somatic sequencing of 864 gastrointestinal malignancies.
Authors: Khanna Shivani , Maron Steven Brad , Chase Leah , Lomnicki Samantha , Kupfer Sonia , Catenacci Daniel V.T. 
Published: May 2019

e13131 Background: Targeted tumor-only somatic sequencing informs therapies and is becoming a routine part of cancer care. It also identifies patients with possible germline variants who require confirmatory genetic testing. The aim was to identify patients with suspected and confirmed germline variants whose GI tumors underwent somatic sequencing. Methods: 864 patients with GI tumors who had Foundation One (FO) somatic sequencing from 4/2003-3/2018 were evaluated. Inclusion criteria for suspected germline variants were: a) allele frequency ≥ 35% in hereditary cancer genes and b) pathogenic variants by FO and/or ClinVar. Variants in commonly mutated somatic genes ( TP53, KRAS, CDKN2A) were excluded in patients over age 40. Recommendation of genetic evaluation and germline test results were recorded. Patient, family, and tumor characteristics were compared using univariate analysis. Results: 199 of 864 patients had suspected germline pathogenic variants. 50 patients were recommended genetic evaluation, and 26 patients underwent genetic testing. A germline pathogenic variant was confirmed in 15 patients. Among all patients suspected to have germline variants, 8% were confirmed by genetic testing. Patients under age 40 and those with family cancer history were more often referred for testing (Table). Patients with variants in BRCA1, MLH1, MSH2, PMS2, POLE and TP53 were more often referred for testing. Conclusions: A quarter of patients carried a somatic pathogenic variant with allele frequency ≥35% in a hereditary cancer gene. 25% of these patients were recommended for genetic evaluation. Younger patients and those with family history were more often referred. 8% of patients with suspected germline variants were confirmed by genetic testing. These results provide “real world” experience in using somatic only tumor testing to identify patients with germline pathogenic variants who then might benefit from future cancer screening and genetic testing in family members. Comparison of characteristics by recommendation to undergo genetic testing based on somatic tumor sequencing results. [Table: see text]