bluuebunny/crossref_metadata_2025_split huggingface dataset:
EPID-25. A SEER-MEDICARE ANALYSIS OF EXPOSURE TO COMMONLY USED MEDICATIONS AND 1-YEAR SURVIVAL IN GLIOBLASTOMA
Authors: Shah Roshani , Moeller Patrick , Keith Scott , Hass Richard , Shi Wenyin , Maio Vittorio , Alnahhas Iyad 
Published: November 2024

Abstract

OBJECTIVES
Despite of research efforts, glioblastoma (GBM) remains a deadly disease. We aimed to evaluate the effects of commonly used medications on survival in GBM.

METHODS
We performed a retrospective cohort study and utilized the Surveillance, Epidemiology, and End Results (SEER) national cancer registry database linked with Medicare data to identify patients 66 years and older diagnosed with GBM between 1/1/2008 and 12/31/2019. Patients were excluded if they did not receive treatment after diagnosis. We evaluated several medication groups including metformin and oral hypoglycemics, insulin, fluoxetine, statins, beta-blockers, ACE inhibitors and NSAIDs. Mortality was captured within 1 year after diagnosis. Patients were identified as exposed to the medications if they filled at least 1 prescription between 3 months prior to and 9 months after diagnosis.

RESULTS
9,641 GBM patients were included. 54.4% were male and the mean age was 73.8 ± 5.8 years. As expected, patients 66-70 years of age had the best survival compared to the older age groups. Similarly, patients diagnosed between 2017-2019 had the best survival compared to patients diagnosed in prior years. Moreover, patients with the highest Charlson Comorbidity Index scores had the worst prognosis. Obesity specifically had no effect on survival. Patients who underwent any resection had better survival and patients who received both radiation and chemotherapy had better survival compared to patients who received only one treatment modality. 15.5% of patients were exposed to insulin at 1 year and had worse prognosis (OR 1.65, CI 1.42-1.91). 3.4% of patients were exposed to fluoxetine at one year and surprisingly had worse prognosis (OR 1.35, CI 1.03-1.76). None of the other medication groups had significant effects on survival.

CONCLUSION
Our study suggests that exposure to insulin and fluoxetine negatively affects survival in GBM. Stratification of patients per molecular subgroups is necessary for more accurate conclusions.
EPID-26. STEREOTACTIC RADIOSURGERY FOR CRANIAL NERVE METASTASES: A SINGLE INSTITUTION EXPERIENCE
Authors: Persad Amit , Shahsavari Nastaran , Ahmad Maleeha , McCleary Tamra-Lee , Park David , Hori Yusuke , Emrich Sara , Ustrzynski Louisa , Tayag Armine , Gu Xuejun , Rahimy Elham , Pollom Erqi , Solyts Scott , Meola Antonio , Chang Steven 
Published: November 2024

Abstract
Cranial nerve metastases (CNM) can be primary via leptomeningeal metastasis or secondary by spread due to head and neck cancers or due to distant tumor metastasis to the skull base. In addition, they may cause cranial nerve-related symptoms that can impact patient quality of life. We performed a single-center retrospective cohort study of all patients with CNM treated with SRS at our institution between April 2003 and February 2021. Demographic and clinical information were retrieved from the electronic medical record. Median follow-up was 12.9 months. Our study cohort consisted of 9 patients with primary CNM and 8 with secondary CNM – for a total of 17 patients, with a total of 33 lesions (23 primary, 10 secondary). Eleven patients (64.7%) had symptoms caused by cranial nerve metastases. Symptoms were resolved in 5 of 11 patients (45.5%) after SRS. Patients with secondary CNM were more likely to have cranial nerve symptoms and more likely to have resolution of symptoms following SRS. The median time between SRS and symptom improvement was 3 months. Local tumor control was achieved in 30 of 33 lesions (90.9%). Local tumor control at 6 months and at 1 year were 100%. Our study suggests that SRS may be a safe and effective treatment for cranial nerve metastasis providing 90.9% local tumor control at final follow-up, and symptomatic stability or improvement in 90.9% of symptomatic cases. Patients with secondary CNM may stand to benefit more from a symptom management standpoint.
EPID-33. EPITHELOID SARCOMA IN A LONG-TERM SURVIVOR OF AN ATYPICAL TERATOID / RHABDOID TUMOR WITH RHABDOID TUMOR PREDISPOSITION SYNDROME
Authors: Vanan Magimairajan Issai , Brizini Meziane , Shawyer Anna , Wilkes Courtney , Min Suyin Lum , Stefanovici Camelia , Hamza Sate , Drimes Tina , Bourne Catherine , McDonald Patrick 
Published: November 2024

Abstract

INTRODUCTION
Rhabdoid tumor predisposition syndrome (RTPS) predisposes to a high risk of developing Rhabdoid tumors in Brain, kidney; and is defined by a germline mutation in SMARCB1 (rarely SMARCA4) gene. The most frequent pediatric tumor associated with RTPS is atypical teratoid/rhabdoid tumor (ATRT), commonly diagnosed in children &lt; 3 years of age. Epitheloid Sarcoma (ES) is a rare soft tissue sarcoma, arising in any age group and histologically defined by loss of SMARCB1 in tumor cells.

METHODS
We describe a long- term survivor of ATRT with RTPS presenting 12 years later with ES. Data was collected from medical chart review.

RESULTS
Our patient was diagnosed with ATRT and RTPS (SMARCB1) at 6 months of age and treated with chemotherapy as per ACNS0333 at diagnosis; by chemotherapy / focal radiation at first relapse and with alisertib on second relapse. At 10yrs of age she presented with multiple firm, skin-colored dermal nodules in both her hands (palms and fingers). She was diagnosed to have palmar warts and treated with topical cantharidin with a waxing and waning course. Subsequently the hand lesions were diagnosed as granuloma annulare and followed up with no therapy. At 12 years of age, lesion in tip of the right thumb increased in size and a punch biopsy was done which revealed ES with IHC showing loss of SMARCB1 in tumor cells. Staging CT of the chest showed multiple bilateral (b/l) small (&lt;1cm) axillary lymph nodes with a negative PET scan. Bilateral axillary lymph node biopsies were negative for ES. She underwent excision of all the hand lesions with negative margins with no further therapy.

CONCLUSION
Based on our case and single case report in literature, we hypothesize that ES is likely a primary malignancy of RTPS and should be included in the spectrum of malignancies of RTPS.
EPID-37. PROGNOSIS OF BRAIN METASTASES PATIENTS WITH WHOLE BRAIN RADIATION THERAPY (WBRT) VS NON-WBRT AT THE NATIONAL CANCER CENTER OF INDONESIA, DHARMAIS HOSPITAL
Authors: Andriani Rini , Susilodinata Alfred , Wilopo Siswanto Agus 
Published: November 2024

Abstract

BACKGROUND
Limited treatment options for brain metastases (BM) remain a challenge for many cancer centers in Indonesia. To improve overall survival, Whole Brain Radiation Therapy (WBRT) is still widely used in many Indonesian cancer centers This study aims to evaluate the effectiveness of WBRT vs non-WBRT for overall survival of brain metastases patients.

METHOD
This retrospective study observed 148 brain metastasis patients admitted to our hospital from January 1st, 2021 to December 31st, 2022 and we followed their overall survival up to July 1st, 2023. The brain metastasis is confirmed by brain MRI. In addition to overall survival, we collected information on age, sex, primary tumor types, sides of metastasis, and treatment received (WBRT, non-WBRT, and surgery). To examine the overall survival among treatment received and tumor characteristics, we present median survival time, Kaplan-Meier curves, and its log-rank statistics using Stata program version 17. Additionally, we use Cox regression for further analysis.

RESULTS
The overall median survival of these patients was 4.3 months. Patients receiving WBRT exhibit higher survival rates than non-WBRT as presented in their median survival rates (1.5 months vs 6.9 months). The primary tumors (breast, lung, and others) have no difference in the median survival rates. The survival rate trends using Kaplan-Meier showed a significant difference between patients with WBRT vs non-WBRT (log-rank p=0.0). A Cox regression shows hazard rates(HR) for patients receiving WBRT =0.40 and it shows only a small change when adjusted for surgery and other variables.

CONCLUSIONS
Brain metastasis patients who received WBRT have better survival than non-WBRT patients who could reduce HR to 0.4. This means that WBRT patients are protected 60% of the risk for overall survival.
DISP-07. CURRENT NEURO-ONCOLOGY CAPACITY IN SUB-SAHARAN AFRICAN COUNTRIES: A QUESTIONNAIRE-BASED SURVEY
Authors: Odukoya Lateef , Ghomsi Nathalie , Kabare Gloria , Kamson David , Eckel-Passow Jeanette , Jenkins Robert , Kitange Gaspar , Akinjo Andrea , Badmos Kabir , Bankole Olufemi , Idowu Olufemi , Karekazi Claire , Darko Kwadwo , Edrick Elias , Ekhator Chukwuyem , Katasi Victoria , Lachance Daniel , Brown Desmond , Huse Jason , Llewellyn Henry , Magambo Margreth , Magoha Michael , Ngaiza Advera , Nyalundja Arsene , Higgins Dominique , Okenwa Minda , Osei-Tutu Lawrence , Petershie Bernard , Yevudza Elorm , Anunobi Charles , Tiamiyu Liadi , Gankpe Gbetoho , Heronima Kashaigili , Shroeder Kristin , Fonkem Ekokobe , Teddy Totimeh , Balogun James , Cheserem Beverly , Zerd Francis 
Published: November 2024

Abstract
Brain tumors constitute significant morbidity and mortality in sub-Saharan Africa (SSA). There is no previous large-scale effort focusing on brain tumor genetics in SSA. This project aims to map out the current neuro-oncology capacity in terms of workforce and available services in SSA. This is an ongoing online survey among a cross section of neuro-oncology practitioners spread across SSA countries to capture information on the distribution, number of available neuro-oncology care practitioners, capacity for neuropathology and molecular diagnosis, management of brain tumors, cancer registration, and tumor biobanking. The survey was disseminated by the Society for Neuro-oncology in SSA (SNOSSA). There were 83 respondents representing 15 countries and 52 health institutions: 46 tertiary, 4 secondary, 1 private and 1 other. Here, we present data on the 52 institutions. The prevalence of specialties was 87% neurosurgery, 75% anatomic pathology, 69% medical oncology, 64% neurology, 60% radiation oncology, and 39% neuropathology. For radiologic evaluation, 81% of institutions were reported to have both CT and MRI, 17% CT only, and one institution neither. For molecular testing, 46% have access to IHC or NGS testing, whereas 52% were reported to have neither. A neuro-oncology tumor board was reported at 58% of institutions. A general cancer registry is available in 64% of institutions, 31% have a brain tumor specific registry and 10% have a brain tumor biorepository. This study shows that SSA has substantial potential in neuro-oncology care practice capacity and facilities. Most significant gaps remain in areas such as neuropathology and molecular testing, which makes widespread implementation of the WHO 2021 diagnosis challenging. Understanding the prevalence of CNS tumor subtypes is also difficult due to low number of brain tumor registries and biobanks in SSA. The present findings reveal strategic opportunities, especially in neuropathology, tumor registries, biobanks, and infrastructure for IHC and NGS in SSA.
DISP-12. AN ECONOMIC STUDY OF NEURO-ONCOLOGICAL PATIENTS IN A LARGE DEVELOPING COUNTRY – A COST ANALYSIS
Authors: Campos Paiva Aline Lariessy , Araujo João Luiz Vitorino , Lovato Renan Maximillian , Daoud Alex Michel , de Oliveira Jean Gonçalves , Veiga José Carlos Esteves 
Published: November 2024

Abstract

BACKGROUND
Neuro-oncological patients require specialized medical care. However, the data on the costs incurred for such specialized care in developing countries are currently lacking; these data are relevant for international cooperation.

OBJECTIVE
This study aimed to estimate the direct cost of specialized care for an adult neuro-oncological patient with meningioma or glioma during hospitalization in the largest philanthropic hospital in Latin America.

METHODS
This observational economic analysis describes the direct cost of care of neuro-oncological patients in Santa Casa de São Paulo, Brazil. Only adult patients with a common primary brain tumor were included.

RESULTS
Due to differences in the system records, the period analyzed for cost estimation was between December 2016 and December 2019. A group of patients with meningiomas and gliomas was analyzed. The estimated mean cost of neurosurgical hospitalization was US$4,166. The cost of the operating room and intensive care unit represented the largest proportion of the total cost. A total of 17.5% of patients had some type of infection, and 66.67% these occurred in nonelective procedures. The mortality rates during emergency procedures were 12.7% and 92.3%.

CONCLUSIONS
Emergency surgeries were associated with an increased rate of infections and mortality. The findings of this study could be used by stakeholders and policymakers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals. KEY WORDS: costs; brain tumor; glioma; meningioma.
DISP-18. RACIAL DISPARITY IN THE UTILIZATION OF MOLECULAR DIAGNOSTIC AS A PROXY FOR SUB-OPTIMAL CLINICAL CARE IN GLIOBLASTOMA PATIENTS
Authors: Zhu Ping , Do Huy , Chen Clark 
Published: November 2024

Abstract

BACKGROUND
Molecular characterization of IDH mutation and MGMT-promoter methylation (MGMTm) are standard-of-care (SOC) diagnostics and essential to diagnosis, treatment, and prognosis of glioblastomas. Here, we determined the extent to which racial disparity occurs in this dimension of oncologic care.

METHODS
31,439 glioblastoma patients were derived from the National Cancer Database (NCDB,2018-2021), with 20,736 IDH-wildtype patients with defined MGMT-status. Accessibility to SOC diagnostics was defined as whether patients got IDH/MGMT testing or not. Race/Ethnicity was grouped into Non-Hispanic White (NHW), Non-Hispanic Black, Asian/Pacific Islander, Hispanic, and Others. Receipt of SOC diagnostics and treatments, post-operative outcomes, and overall survival (OS) were explored using multivariable logistic regression, Kaplan-Meier method, and Cox proportional hazards models.

RESULTS
Relative to NHWs, all racial minority groups were less likely to have undergone IDH or MGMT-testing. These effects remain robust after adjusting for economic status, insurance, and facility type. Patients who received neither IDH nor MGMT-testing were 38% less likely to undergo SOC concurrent chemo-/radiation therapy (cCRT) relative to those having both testing. Further, patients having neither IDH nor MGMT-testing showed significantly higher risk of 30-day mortality (aOR:2.20), 90-day mortality (aOR:1.60), and hazard of death (median OS:8.9-mon,aHR:1.09,p=0.002) than those having both testing (median OS:12.9-mon). Of those tested for both IDH/MGMT, the odds of bearing a methylated MGMT-promoter remained relatively constant across five racial groups. Non-NHW glioblastomas patients were significantly less likely to receive SOC-modality. Of the patients who underwent IDH/MGMT-testing and cCRT, median OSs were 23.7 and 14.4-mon for MGMT-methylated and unmethylated glioblastoma, respectively. No significant difference in hazards of death for racial/ethnic minorities compared to NHWs was detected, regardless of MGMT-methylation status.

CONCLUSIONS
Our findings suggest that non-NHW glioblastoma patients are less likely to undergo SOC diagnostic (IDH/MGMT) testing, which serves as a proxy for receipt of sub-optimal clinical care. For glioblastoma patients who underwent SOC molecular testing and treatment, survival is similar across racial groups.
DISP-20. SEX DIFFERENCES IN MENINGIOMA AGGRESSIVE BEHAVIOR IN RURAL POPULATIONS: A GEO-ECOLOGICAL RISK ASSESSMENT OF MENINGIOMAS IN A SINGLE RURAL HEALTH CARE SYSTEM
Authors: Ali Haadi , Gatson Na Tosha 
Published: November 2024

Abstract

BACKGROUND
Cause for health outcome disparities in rural populations is multifactorial. These populations are potentially more vulnerable due to rural area environmental policies and practices. Environmental justice populations (EJP) are designated by the Environmental Protection Agency as at risk for generational exposer to environmental contaminants. We assessed these population for an association between EJP density and aggressiveness of indolent brain tumors. Meningiomas are the most common benign intracranial tumor and have a female predominance. We evaluated meningioma patients in a large rural health system for oncogenic risk associated geo-ecological factors.

METHODS
A retrospective review of 415 pathology confirmed CNS WHO grades 1-3 meningiomas cases between 2007 – 2017 within the Geisinger Health system in Pennsylvania. Cases were mapped by county for meningioma incidence, tumor grade, and tumor recurrence. Counties were rated for EJP density. We mapped geographic areas with a higher meningioma incidence, grade, and rates of recurrence, and evaluated sex-predilections.

RESULTS
Seventy-three percent of tumors were WHO grade 1 (n=303), 23.4% (n=97) were grade 2, and 3.6% (n=15) were grade 3. The highest incidence of meningiomas were localized to higher density EJP counties that bordered riverbeds, Lackawanna and Luzerne. Females had a 3.5:1 predominance as compared to males. The grade 1 10-year progression free survival rate was 54.7% in Luzerne, Columbia, and Montour counties (moderate to high density EJP). Males in high EJP counties had a 12% increased risk for developing high grade meningiomas. Males aged 51-60 were more likely to develop a grade 2 or 3 meningioma as compared to males aged 61-70 in these counties. Females aged 50-60 more likely had grade 1 meningiomas but demonstrated consistently increasing risk for recurrence every decile.

CONCLUSIONS
Pennsylvania high density EJP counties (especially along the Lackawanna River supply) have a disproportionate risk for aggressive meningiomas and lower progression free survival as compared to national averages. A sex-discrepancy exists for males in these areas to have the most aggressive tumors.
IMMU-10. IDENTIFICATION OF A NEW THERAPEUTIC ANTIGEN FOR GLIOBLASTOMA USING A MONOCLONAL ANTIBODY LIBRARY FROM PATIENT-DERIVED TUMOR SPHERES
Authors: Kuroda Hideki 
Published: November 2024

Abstract
Glioblastoma (GBM) has a poor prognosis despite intensive treatment by surgery, radiation, and chemotherapy, thus new treatment strategies are urgently needed. Various innovative cancer therapies targeting cancer-specific cell surface antigens, such as chimeric antigen receptor T cell therapy, are developed and more cell surface antigens that is highly specific for GBM cells are needed. Although extensive transcriptome analyses or proteomic analysis of GBM cells were performed, few transcripts specific for GBM cells have been identified. However, GBM cell-specific antigen epitopes formed by post-translational modifications of proteins may have been missed by transcriptome or proteomic analysis, and could still be discovered by thoroughly searching for cancer-specific monoclonal antibodies. In this study, we aimed to identify GBM-specific antigens using a monoclonal antibody library from patient-derived tumor spheres, create CAR-T cells against the antigen, and check antitumor efficiency of the CAR-T cells. Approximately 25,000 monoclonal antibody-producing hybridomas were establishment using BALB/c mice and patient derived tumor spheres. Among them, a antibodies that bind to plural glioblastomas and not to plural normal brain cells were selected and we identified the antigen as Prostaglandin F2 receptor negative regulator (PTGFRN) by the expression cloning method. PTGFRN witch is expressed in several cancers regulate migration, angiogenesis, and cell polarity and decreases the radiosensitivity of GBM cells. We created CAR-T cells against the antigen and co-cultured it with GBM cells, which significantly increased the production of IL-2 and INF-γ. Furthermore, the CAR-T cells injected intracranial in an orthotopic xenograft model with patient-derived GBM cells, significantly reduced tumor growth. PTGFRN CAR-T-cell therapy may be a potential novel therapeutic target for GBM.
IMMU-11. GUARDIANS OF INNATE IMMUNE ACTIVATION: CRUCIAL ROLES OF NONO AND CGAMP IN GLIOMA VIROTHERAPY
Authors: Gillard Andrew , Shin Dong Ho , Laspidea Virginia , Singh Sanjay , Jiang Hong , Xuejun Fan , Lopez-Rivas Andres , Parthasarathy Akhila , He Jiasen , Garcia-Moure Marc , Fueyo Juan , Gomez-Manzano Candelaria 
Published: November 2024

Abstract
Despite aggressive therapeutic interventions, glioblastoma patients face a median survival of seven months after tumor recurrence. Alarmingly, there has been no improvement to the standard of care for two decades, and patients still receive toxic doses of radiation and chemotherapy, rendering many unable to perform daily functions. An emerging approach, oncolytic virotherapy (OV) using Delta-24-RGD, is gaining traction due to recent clinical trials (NCT00805376, NCT03178032, and NCT02798406) exhibiting robust responses in subsets of patients. While these studies demonstrated the therapeutic potential of OV, findings also indicate the early clearance of the virus, hindering the establishment of an effective anti-tumor immune response in most patients. We propose that mitigating the innate immune response against the therapeutic virus should result in improved intratumoral persistence, increasing the window of opportunity for developing an anti-tumor immune response. RNA-sequencing identified the non-POU domain containing octamer-binding (NONO) pathway as highly upregulated in syngenic glioma models and further amplified by OV treatment. In-vitro RNA sequencing and comparative analysis complemented these results to define a unique transcriptomic profile induced by adenovirus infection. LC-MS/MS identified host cGAS and adenoviral capsid proteins as candidate binding partners of NONO, which were validated using co-immunoprecipitation. Although the type I interferon cluster is deleted in most gliomas, tumor cells have a profound influence on their microenvironment through the secretion of the second messenger cGAMP. We show that NONO is required for cGAMP production, providing a mechanism to modulate antiviral responses in the tumor microenvironment during OV. Our findings underscore the significance of cGAMP shed from tumor cells in response to OV, and how NONO interacts with cGAS in the nucleus to sensor adenovirus infection. These findings uncover novel innate immunity mechanisms in gliomas and will inform the design of more efficacious oncolytic adenoviruses for glioma therapy.