bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of online activities to reinforce multidisciplinary management of advanced soft tissue sarcoma and extend education globally.
Authors: Heller Elizabeth Jean , Smith Keira P. , Brook Lyn , Maack Eden , Karfonta Amy J. 
Published: July 2024

e21013 Background: Soft tissue sarcoma is a heterogeneous group of rare tumors. The multidisciplinary team is integral to optimize patient care and prolong survival. Online video platforms provide a convenient and costless method to deliver content, but their ability to reach and teach clinicians has not been studied extensively. We investigated usage and pre/post-survey data from viewers of a continuing medical education (CME)/nursing continuing professional development (NCPD) Virtual Tumor Board (VTB) video activity. Methods: We developed Virtual Tumor Board: Multidisciplinary Management of Advanced Soft Tissue Sarcoma, for oncologists, pathologists, nurse practitioners, physician assistants, and nurses. The VTB discussed strategies to optimize treatment outcomes of patients with soft tissue sarcoma using case studies. It was made accessible on August 10, 2023, on the i3 Health website, YouTube, and VuMedi. Viewers can receive CME/NCPD. Responses were analyzed, with Fisher’s exact test used to compare responses. Results: At the 5-month follow-up, the VTB has been viewed 1,547 times: 459 views on i3 Health, 988 views on YouTube, and 150 views on VuMedi, representing viewers from across the US and internationally. Baseline assessment data revealed gaps in knowledge in areas addressed by the VTB. For learners who completed the assessments (N=422), the mean score for all topics combined rose by 56% (33% vs 89%). The activity resulted in significant gains in knowledge and competence, with P < 0.001 for all learning gains (Table).Upon completion, 92% of learners self-reported that knowledge acquired from this activity would be utilized to improve the outcomes of their patients, and 91% self-reported that, based on the information learned during the activity, they felt more confident in treating patients with soft tissue sarcoma. Conclusions: Over 1,500 viewers from both rural and urban areas have viewed this lecture, primarily on YouTube. Learners of i3 Health’s accredited activities have grown from 100,000 YouTube viewers in 2021 to over 600,000 by the end of 2023. In 2023, viewership extended to 60 countries, including 30 countries classified as low-to-middle income by The World Bank. The post-activity knowledge gains and improvements in competence show significant impact and the educational benefits of online video viewing. [Table: see text]
Descriptive and content analysis of breast cancer vlogs on YouTube.
Authors: Morena Nina , Htite Elly , Ahisar Yitzchok , Hayman Victoria , Rentschler Carrie A. , Meguerditchian Ari N. 
Published: July 2024

e21016 Background: Vlogs, or “video blogs,” are personally-created experiential videos based on wide-ranging topics, usually posted to YouTube. Many women with breast cancer (BC) document their cancer experiences in YouTube vlogs. These may have the potential to serve as peer-to-peer support and provide community. This study provides a descriptive and content analysis of vlogs by women with BC. Methods: YouTube was searched in incognito mode in 11/2023 using the search terms “breast cancer vlog.” A maximum of 10 videos/creator were included based on viewership and date created. Video characteristics collected included: title, length, number of views, likes, comments, and playlist inclusion. Videos were assessed for sponsorship, presence of explanation and discussion on BC, type of content, and themes. Creator characteristics included age, location, and engagement approaches. Descriptive and content analysis were performed to assess and analyze video content and potential areas where peer-to-peer support may be provided. Results: 90 vlogs by 13 creators were included, all originating from personal accounts. Mean video length, number of views, and number of comments were 21.4 minutes (SD 9.1), 266,780 (SD 534,465), and 1485 (SD 3422), respectively. 38.9% included hashtags. 12.2% included paid sponsorships. Most common filming location was at home (96.7%), followed by the hospital (31.1%), or in the car (21.1%). Home vlogs were most often set in the living room (44.3%), bedroom (33.0%), or kitchen (20.6%). 56.7% included visuals of treatment as well as physical findings. Creators addressed motivation for vlogging in 48.9%; the two most common reasons were wanting to build a community and helping others in a similar situation. In 46.7%, creators explicitly expressed emotion. Most common themes were treatment (85.6%), mental health (81.1%), side effects (72.2%), appearance (63.3%), and family relationships (36.7%). Subthemes included young age, finances, and the importance of online community support. Patient-directed advice was offered in 60.0%, mostly on treatment-related issues. In 56.7%, creators provided explicit treatment definitions. Chemotherapy was discussed in 70.0%; surgery in 57.8%, primarily mastectomy; radiation in 30.0%; general side effects in 71.1%. 24.4% were about a new diagnosis. When mentioned (44.4%), most common creator location was the USA. When mentioned (30.0%), most common age demographic was 20-29 years old. Conclusions: Vlogs by women with BC receive significant levels of engagement. The dedication to building community demonstrated by vlog creators, and the personal nature of their storytelling, advice, and suggestions, may make these vlogs a potential resource for peer-to-peer support.
Clinical and epidemiological profile of patients with atypical melanomas treated with immunotherapy.
Authors: Cicilini Andre Luiz , Saruwatari Thamilyn , Tavares Monique Celeste 
Published: July 2024

e21532 Background: Atypical melanomas, such as acral lentiginous, uveal, mucosal, spitzoid, desmoplastic, meningeal, and primary occult site, represent less than 5% of melanoma cases. Due to their different biological tumor behavior from cutaneous melanomas, their treatment is still challenging. Currently, checkpoint inhibitors are the main treatment based on extrapolations or data from small surveys. Methods: This study aims to describe the epidemiological profile, clinical and pathological characteristics, and treatment of patients with atypical melanomas treated with immunotherapy. It is an observational, descriptive, retrospective study that analyzed 72 medical records of patients with atypical melanomas, ECOG 0-1, > 18 years old, treated with immunotherapy (neo, adjuvant, and palliative lines), between January 2015 and December 2023 at the A.C. Camargo Cancer Center, São Paulo, Brazil. Results: We gathered 72 patients, 61% male and 39% female, with an average age of 58.89 (±13.63) years; 57% were white, 15% African-descendant (black and brown), 8% Asian, and 20% not specified. Regarding primary site, 26% were acral, 24% mucosal, 24% occult primary site, 15% uveal, 8% desmoplastic, 1% amelanocytic, 1% spitzoid, and 1% cauda equina meningeal. Regarding staging, (3%) were stage I, (15%) stage II, (25%) stage III, (47%) stage IV, and (10%) unknown. LDH: 372.5 (±360) mg/dL. Metastases: lymph node 29%; hepatic 23%; pulmonary 21%; bone 18%; central nervous system 15%; peritoneal carcinomatosis 5%; stomach 3%; cauda equina 3%; adrenal 1%; in transit 1%; intestine 1%; bone marrow 1%; parotid 1%. BRAF mutations were present in 23% of cases (variants V660E, V600K, V660R, and G469R); NRAS 6% (codons 13 and 61); KIT 1% (exon 11) and NTRAK 1% (S701F). In relation to treatment, 5 received neoadjuvant anti-pd1 + anti-ctla4 combination, 13 adjuvant with anti-pd1+/- anti-ctla4. About 50 patients received systemic treatment for metastatic disease anti-pd1+/- anti-ctla4. Overall survival: 26 (±14.8) months. Conclusions: Atypical melanoma primary occult site is the most prevalent, with the majority diagnosed at stage IV, with high LDH levels and lymph nodes as the main sites of metastases. Twenty-three percent had a BRAF gene mutation. The majority were treated palliatively with first-line immunotherapy, with median survivals of 14.8 months.
Dendritic cell vaccine as a strategy to prevent melanoma recurrence after local resection: A systematic review and meta-analysis.
Authors: Silva Raquel Oliveira de Sousa , Freitas João Luís Reis , Gonçalves Ocílio de Deus da Rocha Ribeiro , Melão Bárbara , Neto Edgar Paulo da Silva , De Paiva Reis Camila Mariana de Paiva , Lech Gabriele Eckerdt , Viana Patricia , Morriello Rafael 
Published: July 2024

e21561 Background: Melanoma has a high risk of recurrence and death even following complete surgical excision, specially in stages III and IV. Immunotherapy with checkpoint inhibitors, among other treatments, has been employed as adjuvant therapy in an effort to improve overall survival (OS) and disease free survival (DFS) in these patients. Cancer vaccines, particularly those based on dendritic cells loaded with tumor lysate particles (TLPLDC), have been investigated as new adjuvant therapy, these vaccines utilize autologous tumor lysate from an individual tumor, captured by dendritic cells to generate a personalized vaccine that stimulates an active cellular immune response. We conducted a meta-analysis to assess the effectiveness of these vaccines in patients with melanoma following complete resection. Methods: We searched in Pubmed, Cochrane and Embase in December 2023 for articles evaluating the effectiveness of TLPLDC vaccines on the recurrence and survival of patients with locoregional melanoma completely resected. The outcomes of interest included DFS for 3 years and OS for 2 and 3 years, comparing TLPLDC against the control. Additionally, we performed a subgroup analysis comparing an alternative TLPLDC technique named TLPLDC+G against the control. Random-effects models were employed to pool hazard ratios from studies using R software version 4.3.1. Results: We included 4 randomized controlled trials comprising 564 patients. The OS at the 3-year follow-up favored TLPLDC against control (logHR = -1.718[-2.697,-0.740], p = 0.0006,I² = 0%). In the 2-year comparison, treatment was also favored (logHR = -1.511,CI[-2.743,-0.279],p = 0.0162,I² = 36%). However, TLPLDC+G did not exhibit a statistically significant difference from the control in the 3-year long comparison (logHR = 0.043[-0.504,0.590],p = 0.8780,I² = 0%). Regarding the DFS in 36-month comparison, TLPLDC was favored with a 95% CI (logHR = -0.419,[-0.831,-0.006],p = 0.0468,I² = 48%). For TLPLDC+G, there was no statistical difference (0.269[-0.07,0.609],p = 0.1201,I² = 0%). Conclusions: Our results suggests that TLPLDC had a significant impact on OS at 2 and 3-year follow-up with a relatively low heterogeneity between the studies. Regarding the DFS, the TLPLDC group showed a significant difference favoring the vaccine; however, it presented higher heterogeneity. The TLPLDC+G subgroup did not exhibit a significant difference from control in both OS and DFS. Despite the favorable outcomes associated with the TLPLDC vaccine it is important to consider the potential effects of curve reconstruction, the limited number of studies, individual variations in patients immune responses, and differences in vaccine protocols between institutions as limitations of our analysis.
Mucosal melanoma treatment patterns and outcomes in real clinical practice: Single institution experience.
Authors: Samoylenko Igor , Stroganova Anna , Orlova Kristina V. , Kuzmenko Angelina , Martynova Margarita , Kogai Ekaterina , Nazarova Valery V. , Petenko Natalia N. , Demidov Lev V. 
Published: July 2024

e21571 Background: Mucosal melanoma (MM) is a challenging malignancy to diagnose and treat, even with the advent of modern drug therapies. There is a lack of established surgical, radiological, or pharmacological treatment approaches for locally advanced or metastatic mucosal melanoma. This study analyzes the treatment practices and clinical outcomes at a single institution over a five-year period to understand real-world clinical practices. Methods: A сomprehensive, continuous, retrospective study analyzed medical records of adults with histologically confirmed MM at the N.N. Blokhin Russian Cancer Research Center from January 2018 to December 2023. Data was digitized into an electronic questionnaire, with patient follow-up conducted via telephone. Results: A total of 87 patients were identified, comprising 72 females (82.8%) from 31 regions of Russia. The median age was 67.8 years (ranging from 29.5 to 90.1 years). The patient breakdown was as follows: 6 with head&neck MM (6.9%), 41 with vulvovaginal MM (47.1%), 5 with penile MM (5.7%), 27 with anorectal MM (31.0%), and 8 with gastrointestinal MM (9.2%). A significant portion of the patients presented with locally advanced (22.9%) or metastatic disease (67.8%), while 9.2% of the patients had undergone surgery and were being considered for adjuvant treatment. The most common sites of metastasis were regional lymph nodes (23%), liver (14%), and lungs (11.5%), with one patient having CNS metastasis. Mutational status was determined for 48 of the 87 patients, revealing driver mutations in 12 patients (Table). The majority of patients were initially treated with immunotherapy. The most frequently used therapies included monotherapy with anti-PD-1 agents (nivolumab or pembrolizumab, accounting for 41.6%) and a combination of ipilimumab and nivolumab (33.3%). After a median follow-up of 17.7 months, the median overall survival (OS) for the entire cohort was 18.1 months (with a 95% confidence interval ranging from 6.8 to 23.2 months), showing no significant statistical differences in outcomes based on the location of the mucosal melanoma or the type of treatment received. Conclusions: Mucosal melanoma remains an under-researched malignancy. There is a critical need for prospective, randomized trials to explore more effective treatment options for patients with this condition. [Table: see text]
Immunosuppressant drug-associated skin cancer: A real-world pharmacovigilance database analysis.
Authors: Ananthaneni Anil , Jones Sarah , Nadeem Daniyal , Moore Sydney , Ghoweba Mohamed , Ramadas Poornima 
Published: July 2024

e21575 Background: The association between immunosuppressant drugs and skin cancer has been frequently reported; however, the precise relationship remains uncertain. Skin cancer is among the most common cancers associated with long-term immunosuppressant drug use. The FDA Adverse Event Reporting System (FAERS) is a publicly available tool that collects reports of adverse events related to the use of certain drugs and biologic agents, thereby generating real-world data. Methods: The FAERS database was searched for skin cancer as an adverse event. Nine drugs belonging to different immunosuppressant classes were shortlisted. Reporting odds ratio (ROR) was used to measure disproportionality in reporting of adverse events for these drugs. Results: When skin cancer was analyzed as a percentage of all cancers reported as an adverse event for a particular drug,sirolimus had the highest percentage (30.11%) followed by infliximab (23.91%), azathioprine (23.69%), cyclosporine (19.71%), adalimumab (16.79%), mycophenolate (16.77%), etanercept (15.69%), tacrolimus (14.07%) and methotrexate (10.95%). Drugs with highest ROR for skin cancer included sirolimus (2.12, 1.88-2.39) followed by infliximab (1.68, 1.62-1.75) and azathioprine (1.54, 1.44-1.66). Drugs with lowest ROR for skin cancer included methotrexate (0.55, 0.52-0.57) followed by tacrolimus (0.78, 0.74-0.83) and etanercept (0.89, 0.85-0.93). Conclusions: Although all immunosuppressive drugs have been associated with an increased risk of developing skin cancer, it is advisable to exercise caution with prescribing sirolimus, infliximab and azathioprine in patients with preexisting risk. While methotrexate use is known to possess an increased risk, it had the lowest odds of skin cancer compared to other drugs in the study. Prospective studies are needed to understand the true incidence of skin cancer associated with the use of immunosuppressant drugs. [Table: see text]
Association between immunotherapy and hypothyroidism in a Latin American population: An analytical study of cases and controls from 2019 to 2023.
Authors: Triana Ivan Camilo , Cantor Rizo Erick Andres , Segovia Javier , Vargas Henry , Jaramillo Andres , Kattah Laura , Hernandez Isabel , Pino Luis Eduardo , Bustamante Lizeth , Sanabria Daniela , Murillo Silva John Alejandro , Bejarano Andres Felipe 
Published: July 2024

e24135 Background: In different clinical studies worldwide, the use of immunotherapy has been related to the development of hypothyroidism; However, there is no data on this association in Latin American population. Methods: An analytical observational case-control study conducted in a 3-year follow-up cohort at an oncology institute of cancer patients treated with immunotherapy who developed hypothyroidism in Colombia. The aim of the study was to evaluate the development of new hypothyroidism cases after immunotherapy. Cases and controls were randomized in a ratio of 1:3. A multivariate analysis was performed to identify risk factors for developing hypothyroidism and an inferential analysis was performed over time between levothyroxine dose vs TSH levels. Results: 112 patients were included, 57% men and 42% women with a mean age of 63 years. 21% developed hypothyroidism after immunotherapy, while 12% presented with thyrotoxicosis as first alteration and 9% with central hypothyroidism. During the first semester 54% of patients developed hypothyroidism, 84% in the first year and 100% at 2 years . Pembrolizumab and nivolumab were used most frequently with 58% and 29% respectively developing hypothyroidism. The most common underlying pathology was lung cancer with 33% and kidney at 38%. In the multivariate analysis, female were found as a protective factor compared to men (OR:0.10 CI: 0.05-0.63 95% p = 0.02), and the use of pembrolizumab was associated with a higher risk trend, but this result was not statistically significant (OR:2.49 CI: 0.5-2.7 p = 0.2). The average initial dose of levothyroxine was 1.4 mcg/kg, at 3 months of 1.2 mcg/kg and 6 months of 0.82 mcg/kg. Average TSH levels at diagnosis were 23.3, uUI/ml, achieving target values for 100% of patients after 9 months of substitution. After two years of follow-up, patients continued with an average dose of levothyroxine of 0.8 mcg/kg. Conclusions: The incidence of hypothyroidism in our population is similar to that reported worldwide. Male patients who start immunotherapy should have their thyroid profile monitored strictly given that they present a higher risk. Additionally, monthly monitoring of the thyroid profile should be done within the first year. In Latin American population, more conservative initial doses of levothyroxine (1.0 - 1.1 mcg/kg) could be used and titrated.
Romiplostim for chemotherapy induced thrombocytopenia in solid tumors: A meta-analysis.
Authors: Sainatham Chiranjeevi , Singh Sahib , Agrawal Shubham , Dilli Babu Aravind , Vinnakota Sailaja , Tallapalli Jayanth Reddy , Jindal Vishal , Kumar Pallavi P. , Lutfi Forat , Patell Rushad , Paul Sonal 
Published: July 2024

e24137 Background: Chemotherapy-induced thrombocytopenia (CIT), defined as platelets < 100,000/mcL persisting for ≥3-4 weeks post-chemotherapy affects 20-25% of cases necessitating platelet transfusions or dose reductions leading to treatment delays and impacting patient outcomes. (1,2) Despite multiple studied agents, there are no established guidelines. Romiplostim, a thrombopoietin receptor agonist approved for immune thrombocytopenic purpura, stands out. NCCN suggests its use, but pooled analyses are lacking. Our meta-analysis addresses this gap, exploring romiplostim's efficacy in CIT management. Methods: We performed a systematic search of PUBMED, EMBASE, and COCHRANE databases for studies that evaluate the use of romiplostim in the setting of CIT for solid tumors. The primary endpoint was the proportion of patients that showed improvement in platelet counts in response to romiplostim. Secondary endpoints were the proportion of patients that continued full dose chemotherapy dose on romiplostim and incidence of thromboembolic events. Pooled proportions were calculated along with 95% confidence intervals (CI) using a random-effects model. I2 statistic was used to depict inter-study heterogeneity. Results: A total of 10 single arm studies - 3 prospective studies, 3 case series, and 4 retrospective studies were included. The pooled outcomes were: significant improvement of platelet count above 100K with response to romiplostim therapy in 80.53% patients [95 % CI 72.47 - 87.48, I2 = 69%], proportion of patients that continued full dose chemotherapy on romiplostim was 70.89% [95% CI 63.40 - 77.84, I2 = 0%], and incidence of thromboembolic events was 6.81% [ 95% CI 3.64 – 10.89, I2 = 35%]. Variables like platelet transfusions, bleeding events, type and stage of cancer were not reported uniformly and hence subgroup analyses could not be performed. Conclusions: Our analysis reveals that romiplostim improved the platelet counts in majority of patients with underlying CIT associated with solid tumors. It also shows that a majority of the patients were able to resume their full dose chemotherapy when maintained on romiplostim. The incidence rate of thromboembolic events with romiplostim believed to be consistent with what expected of this population with majority having advanced/high-risk malignancies. Given its efficacy, romiplostim may be used for routinely managing CIT in solid tumors. This analysis is limited by lack of comparative studies and warrant further randomized trials to confirm the safety and efficacy of romiplostim in this patient population.