bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of dinutuximab in the management of high-risk neuroblastoma: A systematic review and meta-analysis.
Authors: Khan Malik Waleed Zeb , Ahmad Muhammad , Bin Zahid Muhammad Maaz , Khan Salman , Shehzad Dawood , Ikram Jibran , Dhar Meekoo 
Published: June 2024

e22000 Background: Neuroblastoma (NB) is a malignant tumor of the sympathetic nervous system that usually occurs in children below 5 years of age. High-risk neuroblastoma (HR-NB) has a poor prognosis despite a number of treatment strategies. Dinutuximab, an anti-GD2 monoclonal antibody, has been recently added to the standard of care due to its improved prognosis. We aimed to systematically assess the outcomes of HR-NB patients treated with dinutuximab and compare them with those on other treatment regimens. Methods: A comprehensive search strategy was used to search PubMed and the Cochrane Library for articles investigating the effect of dinutuximab on the outcomes of patients with HR-NB. Eligibility criteria included: 1) Diagnosis of HR-NB based on INRG and INSS staging and MYCN status 2) Dinutuximab as the primary agent used in the intervention group 3) Mean/median follow-up time greater than 6 months. Three investigators independently reviewed and extracted relevant articles. Any disagreements were addressed through consultation with other authors. The risk of bias assessment of the selected articles was conducted using the Cochrane Risk of Bias Tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa scale for observational studies. Review Manager software was used to obtain and display the meta-analysis estimates in forest plots. Random effects models were used to calculate the mean difference and overall estimated effects for continuous variables. The primary outcomes were all-cause mortality and 5-year event-free survival (5-year-EFS). Results: Five studies, including two RCTs, two secondary analyses of clinical trials, and one retrospective cohort study, comprising 1,393 participants, were included in the analysis. 686 of the patients received dinutuximab, while the remaining 707 patients were assigned to other therapies as controls. Dinutuximab was associated with lower all-cause mortality as compared to control [pooled RR, 0.41; 95% CI, 0.22-0.75, P = 0.004, I2 = 31%]. 5-year-EFS was also greater for patients treated with dinutuximab [MD: 0.12; 95% CI, 0.09-0.16; P < 0.001, I2= 98%]. Conclusions: Our findings suggest that dinutuximab is linked to a significant reduction in overall mortality and a noteworthy improvement in the 5-Year-EFS for patients with HR-NB, when compared to other treatment options.
A fragment-based algorithm for identifying pan-cancer differential methylation markers from cfDNA.
Authors: He Xiaowen , Chen Zhiyu , Li Jian , Li Chunwei , Yang Lingjian , Li Jingjing , Cui Jian , Li Hefei , Liu Wen Xin , Hou Jingjing , Long Ying , Liu Zhichao , Wang Qiumin , Guo Shuang , Guo Qiang , Lan Ping 
Published: June 2024

e22507 Background: Methylation-based sequencing has been developed as a promising approach for Multi-Cancer Early Detection (MCED). Conventionally, cancer-specific methylation markers were identified by comparing paired tumor and adjacent normal tissues using traditional algorithm DSS (Dispersion shrinkage for sequencing data). However, the clinical applicability is limited by the unsatisfactory sensitivity in early-stage disease. Hence, we included blood specific markers derived from paired tissue and blood samples and developed a novel fragment-based algorithm in cfDNA with a better signal to noise ratio (SNR) than DSS to improve the sensitivity of the assay. Methods: A total of 391 plasma samples and 433 tissue samples from 7 cancer types were subjected to whole genome bisulfite sequencing (WGBS) (Table). The proportion of stage I-III and stage IV was 3.5:1 among 7 cancer types. The average sequencing depth was 30X. For each bin, the proportion of fully methylated (M) / un-methylated (U) fragments, defined with methylation level ≥85% / ≤15%, was computed individually. One-sided Wilcoxon rank sum test was employed to test whether cancer cfDNA have significantly (FDR < 0.001) higher proportion of U/M fragments than control cfDNA. Results: To evaluate the performance of fragment-based algorithm in cfDNA, the false positive was assessed by resampling from healthy subjects. The healthy cfDNA were randomly assigned 20 times as pseudo case-control groups of 30 /170. The number of markers among healthy samples was recorded as NFalse Positive (NFP), while the number of markers between cancer and healthy samples was recorded as NPositive (NP). SNR was defined as (NP-NFP)/NFP. We calculated SNR using the fragment-based algorithm and achieved SNR of 135.2 for colorectal cancer, compared to SNR of 2.2 using DSS. The improved SNR was also reproduced in other cancer types. Concordance between plasma and tissue markers was 30.09%-95.92% (median 66.72%) among 7 cancer types, which was related to the proportion of ctDNA for each cancer type. Plasma markers which show weak signals in tissue are defined as blood-specific markers. These markers were enriched in immune-related pathways, suggesting a correlation to the immune response of cancer patients. Conclusions: We developed a novel fragment-based algorithm that achieves much higher SNR than DSS in cfDNA. We also identified blood-specific methylation markers which may improve the sensitivity of early cancer detection in clinical. [Table: see text]
Unintentional weight loss, body composition, and all-cause mortality among United States adults with cancer.
Authors: Lucido Thomas , Visaria Aayush , Bates Benjamin 
Published: June 2024

e22527 Background: While unintentional weight loss (UWL) is a common presenting symptom of malignancy, weight changes also occur regularly in patients with diagnosed cancer.UWL is often characterized by considerable muscle and fat loss and can lead to cachexia, which may increase risk of mortality. This nationally representative study aims to assess the association between UWL and mortality among adults with history of cancer and characterize differences in body composition. Methods: This was a retrospective cohort study of the National Health and Nutrition Examination Survey 1999-2018 linked to the 2019 National Death Index. We identified adults with self-reported history of cancer, excluding non-melanoma skin cancer. Weight change was determined as the difference between current weight and self-reported weight 1 year prior to interview. We categorized weight change into: UWL (unintentionally losing > 5% of weight), intention weight loss (IWL) (intentional loss > 5% weight), no weight change (NWC) (≤5% weight change), weight gain (WG) ( > 5% weight gain). We estimated risk of all-cause mortality using gender-stratified multivariable Cox regression, adjusting for demographics (age, race, income, education, insurance status), sociobehavioral factors (smoking, alcohol, nutrition, physical activity, self-reported health), comorbidities, and albumin. We additionally identified participants with cancer who had whole-body dual x-ray absorptiometry scans (2011-2018) and assessed body composition measurements including total lean mass, lean-to-fat ratio, subcutaneous fat mass, and visceral fat mass by weight change category using multivariable linear regression. Results: Among 3,153 participants (mean age 62 years, 55% women, 82% non-Hispanic White), the top four primary cancers were breast (21%), prostate (14%), melanoma (11%), and cervical (11%). Approximately 9% of men and 11% of women experienced UWL. Adults with UWL were more likely to have lower socioeconomic status, more functional limitations, and higher comorbidity burden. Across a median 7 years (IQR, 3-11y) follow-up, 22% of females and 34% of men died. Both men and women experiencing UWL had more than 2 times the risk of all-cause mortality compared to NWC (adjusted HR [95% CI]; men: 2.02 [1.47, 2.78]), women: 2.43 [1.78, 3.34]). Participants with UWL had less subcutaneous fat mass (-113g, 95% CI [-242, 16]) and visceral fat mass (-65g, 95% CI [-146, 16]) compared to NWC, though not statistically significance. Conclusions: UWL in patients with history of cancer is independently associated with more than 2 times the risk of all-cause mortality in both men and women. UWL was associated with proportional loss of both subcutaneous and visceral fat mass. Further longitudinal studies examining UWL’s impact on body composition changes and downstream outcomes by cancer type and stage are needed.
Does the most common gynecological cancer have an awareness blind spot? An Israeli preliminary study.
Authors: Levy Bar , Vaknin Zvi 
Published: June 2024

e22540 Background: Our objectives were to assess the awareness of healthy women who present online to endometrial cancer (EC) symptoms and risk factors among the Israeli population. Methods: A survey regarding awareness of EC symptoms and risk factors was published in secure link on popular Israeli feminine social-media groups ( > 20,000 users), for accurate reach. The survey was conducted during May 2023 just before establishing June as Uterine Cancer Awareness Month by IGCS. 1161 healthy women completed the survey voluntarily and anonymously. Results: Thousand-fifty-six women met the survey’s inclusion criteria. About 90% graduated college, all graduated high-school. The respondents were predominantly non-orthodox Jewish. More than quarter had a healthcare background. About two-thirds visit gynecologist at least once a year and about three-quarters had a gynecological examination in the last year. Most respondents were aware of other gynecological cancers, mainly cervical and ovarian cancers. Only about a quarter of the survey population had some awareness of EC symptoms. Nearly half of study population had some idea about signs and symptoms of any gynecological cancer. Regarding EC, more than a quarter were unaware of vaginal bleeding as an EC symptom and about 90% were unaware of any EC risk factors. More than three-quarters were defined as unaware at all. Only about 1% were fully aware. A statistical trend was observed as women older than 45 were more aware than younger. If a symptom occurs, most declared they would visit a gynecologist and only about 8% would refer to their general-practitioner. Conclusions: In our study population, we observed an extremely-low awareness of the most common gynecological cancer in the industrial world (EC) which has easily diagnosed symptoms and risk factors. This striking findings, in a highly-educated and media-exposed group, are a wakeup-call for policymakers and regulators to take further action in order to achieve earlier diagnosis and curative prognosis in EC patients.
Progress Tracker Breast Cancer Registry: A Breast Cancer Canada initiative.
Authors: Leduc Shaniah , Gibson Amanda Williams , Dean Michelle Liane , Carson Kimberly , Howell Doris , Khan Omar Farooq 
Published: June 2024

e23018 Background: Significant gaps exist in the collection of real-world evidence and validated patient-reported outcome measures (PROMs) data from individuals with breast cancer. Variations in treatment and surveillance care across regional jurisdictions present knowledge gaps across diverse populations which remain difficult to study. The PROgress Tracker Breast Cancer Registry, a large, prospective Canadian PROMs cohort study aims to identify care gaps through the lived patient experience to inform patient-centered care and new research directions. Methods: PROgress Tracker is a real-world, longitudinal, non-interventional PROMs registry directed by Breast Cancer Canada, a registered non-profit patient-led organization, and data managed by University of Calgary’s POET program. Launched in October 2023, this registry aims to enroll up to 50,000 adult Canadian participants with a histologic diagnosis of in-situ or invasive breast cancer (stage 0 through IV) within 10 years. A volunteer-led peer-to-peer support model, based in regional and provincial hubs across Canada, facilitates participant recruitment, engagement, and retention. Individuals who self-identify for study inclusion provide informed consent, demographic and socioeconomic profile, and clinical information on their breast cancer diagnosis. Every three months (and up to 10 years) a bilingual digital platform to reduce barriers to access is used to provide all PROgress Tracker participants 8 validated PROMs to capture evolving measures of self-efficacy for wellbeing, symptoms and overall global functioning. Based on treatment, up to 10 additional PROMs to assess the immediate adverse effects and long-term impacts of treatment are collected. PROgress Tracker has the additional capacity to link to external ethics-approved studies to investigate clinical outcome and healthcare utilization metrics for participants consenting to additional studies. Results: In progress. Conclusions: PROgress Tracker represents Canada’s first national PROMs breast cancer registry. Its unique design and implementation by a patient-led research organization helps fill gaps in current knowledge through longitudinal follow up of patients prior to, during, and after cancer care, and from the time from diagnosis through active treatment, long-term survivorship, and/or palliative care. The PROgress Tracker Registry will comprehensively gather the validated real-world data information rarely collected in in the traditional clinical or trial-based research setting using a novel self-enroll design and digital process. Such information is crucial to support evidence-based decision making to inform patient-centered healthcare change. This allows comparison across Canadian jurisdictions, is scalable to other jurisdictions around the world and further explores the utility of electronic PROMs data capture within a diverse patient population.
Budget impact analysis of participating in sponsored clinical trials in cancer within the Colombian healthcare system: A real-world evidence approach.
Authors: Cardona Zorrilla Andres Felipe , Rojas Puentes Luis Leonardo , Robles Antonio , Badillo Carlos , Ceballos Jorge , Sanchez Natalia , Abello Virginia , Bonilla Gonzalez Carlos Eduardo E. , Mantilla William Armando , Zuluaga Jairo Andrés 
Published: June 2024

e23031 Background: Clinical trials (CTs) are a key element in researching and developing new technologies for cancer. Assessing the economic impact of CTs and the potential savings for healthcare systems in Low- and Middle-Income Countries (LMICs) is vital to guide healthcare decision-making. This research aims to quantify the budget impact for the Colombian Health System of including hematology and oncology patients in sponsored clinical trials. Methods: This study uses real-world data (RWD) from CTIC, a high-complexity cancer center from Bogotá, Colombia. We followed the Budget Impact Analysis methodology defined by the local HTA agency using data for five tumors retrieved from an institutional data lake resource using clinical information and related costs. Tumors were selected based on their prevalence and economic burden. CTIC’s clinical experts validated the cost-generating events for each disease. The eligible population for phase 3 clinical trials was estimated from the literature and CTIC oncology units’ leaders’ opinions. Prevalent and incident population data were obtained from the Colombian High-Cost Account (CAC). Results: There are 7,703 potential patients to be included in CTs, representing a total cost of 217,544,023 for 2023 USD (1 USD = 4,325 COP). If at least 25% of patients with these tumors were included in CTs in 2023, the approximate cost would be 54,386,006 USD. Advanced prostate cancer represented the highest cost, given its prevalence and CT inclusion opportunity. Conclusions: With approximately USD 24 billion spent on healthcare (USD 5 billion in drugs), Colombia could save around 4% of its drug expenditure if all potential candidates were to be included in cancer CTs. Furthermore, assuming similar average costs per patient, inclusion rates, and population growth for 5-years, this could represent savings of around USD 1.1 billion. These savings would ease the reimbursement and access to innovation for Colombian patients, improving health outcomes and enhancing long-term financial sustainability. [Table: see text]
Discharge outcomes in COVID and non-COVID cohorts of hospitalized patients with cancer: A comparative analysis in the first year of the COVID-19 pandemic.
Authors: Sajith Bilja Kurian , Cesario Sandra K. , Fadol Anecita P. , Nates Joseph ,   D3CODE
Published: June 2024

e23063 Background: This research aimed to assess and compare the discharge outcomes in two cohorts of hospitalized oncology patients – those with COVID-19 and those without COVID-19 in the initial year of COVID pandemic. Methods: This study compared the length of hospital stay, 30-day readmission, in-hospital mortality, death within 30 days of admission, and death within 90 days of admission between the COVID cohort and the non-COVID cohort, based on prospectively collected hospitalization data from March 2020 to February 2021 at a prominent US cancer center. Results: The study included 4,225 oncology patients, with 551 having COVID-19. Aged on average around 61, both cohorts showed similar gender distribution and were predominantly White or Caucasian, with the most common cancers being hematological. Patients in the COVID cohort experienced a significantly extended hospital stay with a mean length of 12.2 days versus 8.27 days for the non-COVID cohort (p < 0.001). The median stay was also longer for the COVID cohort at 8 days [1, 103] compared to 5 days [1, 141] for the non-COVID cohort. The COVID cohort had a lower 30-day readmission rate post-discharge at 66.6% compared to 71.7% in the non-COVID cohort, with the difference being statistically significant (p = 0.015). Within the COVID cohort, a smaller proportion of patients were readmitted within 30 days of discharge (66.6%), as opposed to the non-COVID cohort (71.7%), with a p-value of 0.015. Although the COVID cohort experienced a higher rate of in-hospital mortality at 11.3% compared to 6.9% in the non-COVID cohort (p < 0.001), there were no significant differences in the rates of death within 30 days of admission (COVID cohort: 25.6% vs. non-COVID cohort: 27.6%, p = 0.349) or within 90 days of admission (COVID cohort: 28.9% vs. non-COVID cohort: 31.7%, p = 0.195) between the two cohorts. Conclusions: Oncology patients with COVID-19 faced longer hospital stays and higher in-hospital mortality rates than those without COVID-19. However, the COVID-19 cohort had a lower rate of readmission within 30 days after discharge. Despite the greater severity of hospitalization for COVID-19 patients, the mortality rates 30 and 90 days post-admission did not significantly differ from those without COVID-19. These findings underscore the need for intensified care and monitoring of hospitalized oncology patients with COVID-19, while also acknowledging the comparable longer-term survival between the cohorts.
In-hospital mortality patterns and risk factors in patients with cancer with COVID-19.
Authors: Didier Alexander James , Campbell Andrew , Nandwani Swamroop , Fahoury Alan , Arsene Camelia 
Published: June 2024

e23070 Background: The current body of knowledge regarding outcomes of patients with cancer and COVID-19 is conflicting, with some studies suggesting worsened mortality in those with both diseases This study seeks to shed light on the distinctive factors influencing in-hospital mortality in these two cohorts, providing crucial insights that can guide targeted interventions and enhance healthcare strategies for individuals facing the dual burden of cancer and COVID-19. Methods: We conducted a retrospective review of all patients hospitalized with COVID-19 at our institution between January 1, 2021 and April 1, 2023. Patients were stratified into a cohort of those with cancer and coexisting COVID-19 infection and those with solely COVID-19. The cancer and COVID-19 cohort included patients over the age of 18 who had received treatment for cancer within the last 6 months. Information regarding patient demographic characteristics and comorbidities, as well as in-hospital treatment characteristics and outcomes. We performed descriptive analysis and conducted Chi-squared and t-tests to assess for differences in baseline characteristics between cohorts, then developed Cox proportional hazards models to evaluate risk factors for in-hospital mortality. Results: 456 patients with cancer and COVID-19 were compared with 12,566 patients with only COVID-19. In-hospital mortality was 8.2% in the cancer cohort compared with 9.0% in the COVID-19 only cohort. Patients in the cancer cohort were more likely to be male (55.7% vs 48.2%, p = 0.004), older (71 vs 64 years, p < 0.001) with histories of heart failure (27% vs 21%, p = 0.002), chronic kidney disease (50% vs 39%, p < 0.001), COPD (35% vs 24%, p < 0.001), and anemia (57% vs 24%, p < 0.001). The cancer cohort experienced significantly longer length of stay (9 vs 7 days, p < 0.001). Requirement of mechanical ventilation and ICU stay were similar between groups. Multivariate Cox proportional hazards ratios demonstrated similar mortality between cohorts (HR = 0.863, p = 0.361), with age (HR = 1.041, p < 0.001) and history of acute myocardial infarction (HR = 1.275, p = 0.01) being significant predictors of death. Conclusions: Our study demonstrates the complex relationship between cancer, COVID-19, and in-hospital mortality. Despite differences in baseline characteristics between the cohorts, our findings reveal that, after adjusting for confounding factors, there is no significant disparity in mortality rates between patients concurrently battling cancer and COVID-19 and those solely afflicted by COVID-19. The identification of age and a history of acute myocardial infarction as significant predictors of mortality underscores the need for targeted interventions and vigilant management strategies for individuals facing the dual burden of cancer and COVID-19, ensuring equitable and effective healthcare outcomes in this complicated patient population.