bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the understanding of integrative oncology approaches among hospitalized patients with cancer.
Authors: Luo Meiqi , Siddiqui Iqra , Flynn John , Khan Natalie , Monti Daniel , Bi Xia , Filicko-O'Hara Joanne E. , Gergis Usama , Porcu Pierluigi , Lopez Ana Maria 
Published: June 2024

e23234 Background: Many integrative oncology (IO) outpatient (OP) cancer care approaches—yoga, acupuncture, massage, physical activity—have demonstrated benefit and are now part of guideline care. We report on a pilot inpatient (IP) IO consultative service aimed at introducing patients and families to IO at a time when cancer- and treatment-related symptoms can be significant. As a measure of patient-centered care, we assessed patient’s change in perceived understanding, intention to promote health, confidence in care, and plan for IO OP follow up. Methods: IO consultations that assess nutrition, activity, and stress were made available to patients in the Bone Marrow Transplant Unit at Thomas Jefferson University Hospital (TJUH) starting in July 2023 as ordered by the primary oncology team. Consultations (69) have been conducted by an Integrative Medicine Fellow and an attending Board Certified in both Medical Oncology and Integrative Medicine. The post-IO consultation survey includes 7 questions with a 5-point Likert Scale (1 = Do Not Agree, 5 = Completely Agree).The survey was initially offered as an online link. A paper format was developed at patient request. Results: A total of 34 patients (50%) completed the post-consultation survey. Conclusions: Patients expressed a greater likelihood of focusing on wellness through diet, nutrition, meditation, and stress reduction (76.4%) and of taking steps to promote their health (87.9%); as well as an improved understanding of the relationship between nutrition and health (88.2%) and stress and health (88.2%). Patients noted a more positive view of TJUH (84.4%) and greater confidence in their treatment (81.8%). In addition, only 10% of patients decided not to pursue an IO appointment after discharge. These pilot data suggest a benefit to IP IO consultation. [Table: see text]
Mobilizing exercise recommendations for people with bone metastases: An experience-based co-design approach.
Authors: Nadler Michelle B. , Bland Kelcey , Neil-Sztramko Sarah , Langelier David , Lane Kirstin N. , Chalmers Alana , Dinardo Rhonda , Alibhai Shabbir M.H. , Capozzi Lauren , McDonald Karen , Copp Jane , Mackenzie Kelly , McNeely Margaret , Lambert Leah , Bates Alan , Simmons Christine E. , Campbell Kristin L. 
Published: June 2024

e23241 Background: People with bone metastases have historically been advised to limit exercise due to potential risks, such as fractures. Although published exercise recommendations by the International Bone Metastases Exercise Working Group emphasize regular exercise may benefit people with bone metastases, adopting guidelines into clinical practice remains challenging. Our study aims to use an experience-based co-design (EBCD) approach to collaborate with knowledge users (KUs) to develop knowledge mobilization (KM) products and a dissemination plan to promote the adoption of exercise recommendations for people with bone metastases. Methods: Three KU groups participated in EBCD: patient/family partners, oncology healthcare providers (e.g., physicians, nurses, allied health), and community-based exercise professionals (e.g., physiotherapists, exercise physiologists). Through four facilitated meetings, KM products were co-created and a dissemination strategy was planned. A survey of exercise professionals was used to collect further information on professional development (PD) preferences. Results: Twenty-nine KUs from five Canadian provinces participated (n = 10 patient/family partners, n = 9 healthcare providers, and n = 10 exercise professionals). KM products prioritized for co-development were: 1) a patient education handout; 2) patient education videos; 3) a clinical communication tool; and 4) PD resources for exercise professionals and healthcare providers. Finalized KM products will be presented at the meeting. A total of 183 international exercise professionals completed the PD survey, with 80% indicating that more PD resources were needed for bone metastases, focusing on exercise safety, feasibility, and prescription considerations. The dissemination plan will involve partnerships with Canadian and international organizations. Conclusions: Collaborating with KUs through EBCD may enhance KM product development and maximize utility and acceptability compared to researcher-designed products. Our KM products, tailored to support people with bone metastases to exercise safely, may also increase healthcare providers' and exercise professionals' satisfaction by improving the quality of information they can offer patients. A fulsome evaluation is planned to assess the reach, use, and partnership indicators of the KM products and dissemination plan.
Treatment patterns and outcomes in patients with early onset cholangiocarcinoma: A large database analysis.
Authors: Grewal Udhayvir Singh , Manchkanti Srija , Fei Naomi , Chandrasekharan Chandrikha 
Published: June 2024

e23294 Background: Although the average age of onset of cholangiocarcinoma (CCA) is ≥ 65 years, recent data have demonstrated an alarming rise in incidence of CCA in the United States (US) among people younger than 50 years of age. However, robust data regarding the characteristics and outcomes of CCA among young patients are lacking. Methods: We used TriNetX, a national database comprising approximately 74 million patients across 54 healthcare organizations in the US, to perform the current analysis. We retrospectively identified patients with CCA (using ICD-10 code C22.1) from Jul 2009 to Jan 2022. We then performed comparative analysis between patients ≤ 49 years (early-onset CCA or EOCCA) and ≥ 50 years old (average-onset CCA or AOCCA). We performed a comparative analysis of baseline characteristics, treatment patterns and overall outcomes. We used the Chi-square test for the comparative analysis and Kaplan-Meier estimates were plotted for survival analysis. A p-value of < 0.05 was considered statistically significant. Results: We included a total of 1,343 patients with EOCCA. Compared to AOCCA, patients in the EOCCA group were more likely to be females (51% vs 48%, p < 0.0001), African Americans (13% vs 9%, p < 0.0001) and have a history of primary sclerosing cholangitis (7% vs 1%, p < 0.0001). Patients in the EOCCA group were more likely to undergo surgical resection (9.7% vs 8%, p = 0.007), liver transplant (4.5% vs 1.6%, p < 0.0001) and adjuvant chemotherapy (39.2% vs 33.5%, p < 0.0001). Young patients were also more like to receive palliative chemotherapy (16.7% vs 12.6%, P < 0.00001) and FGFR-directed targeted therapy (1.5% vs 0.3%, p < 0.00001). Compared to older patients, we noted a significantly higher overall survival among young patients undergoing surgical resection (85 months vs 43 months, p = 0.008) and patients with advanced disease (28 months vs 15 months, p < 0.0001), however, no difference in overall survival was noted between young and older patients undergoing liver transplant (88 months vs 117 months, p = 0.6). Conclusions: We present a large real-world analysis highlighting treatment patterns and outcomes in patients with EOCCA. Young patients received more surgical resections, both adjuvant therapies and palliative therapies, and had a significantly longer overall survival than their older counterparts. Although more patients underwent liver transplant in the EOCCA group, post-transplant survival was not significantly better compared to their older counterparts. Prospective clinical studies tailored to assess surgical and systemic therapeutic approaches specific to EOCCA patients are warranted.
Evaluation of cyclin-dependent kinase 4/6 inhibitor-induced serum creatinine elevations in patients with hormone receptor positive breast cancer.
Authors: Ly Emily , Howard Frederick Matthew , Chen Nan , Hahn Olwen Mary , Fleming Gini F. , Nanda Rita , Patel Shivani , Thimothy Lida , Yang Heng 
Published: June 2024

e23304 Background: Cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) have improved the efficacy of endocrine therapy in hormone receptor-positive (HR+)/HER2- breast cancer (BC) and are now used in both early-stage and metastatic disease. In the MONARCH-3 trial, 98% of patients (pts) treated with abemaciclib (abema) experienced elevated serum creatinine (sCr). Chappell et al. reported that abema caused pseudo-elevation in sCr by inhibiting renal tubular secretion. This effect was not evaluated in trials of palbociclib (palbo) and ribociclib (ribo), but case reports suggest that pseudo-sCr elevations are likely a class effect of CDK 4/6i. In this retrospective study, we sought to evaluate the incidence of sCr elevation in pts being treated with CDK4/6i for early and advanced stage BC. Methods: This single-center retrospective analysis included pts aged ≥18 years who received at least one dose of palbo, ribo, or abema for the treatment (tx) of HR+/HER2- BC in the early or advanced setting at the University of Chicago Medicine from January 2015 to August 2023. Pts were categorized into subgroups based on the CDK4/6i received. The primary objective was to evaluate the incidence of pseudo-sCr elevation in the subgroups. sCr elevation was graded according to Common Terminology Criteria for Adverse Events Version 5. CDK4/6i-induced pseudo-sCr elevation was suspected when the sCr elevation could not be fully explained by other causes. Secondary endpoints included the grade, onset, duration, and clinical consequences of pseudo-sCr elevation. Incidence of pseudo-sCr elevation among the three groups were compared using the Chi-squared test. Descriptive statistics were used for pt characteristics and secondary endpoints. Results: In total, 143 pts were analyzed. Pseudo-sCr elevation was suspected in pts treated with palbo, ribo, and abema, with incidences of 16% (8/50), 14% (6/43), and 20% (10/50), respectively. Rates did not significantly differ between agents (p = 0.727). Among pts with CDK4/6i-induced pseudo-sCr elevation, all pts experienced either grade 1 (8.3%) or 2 (91.7%) events, with a median sCr increase from baseline to peak of 0.69 mg/dL (range, 0.39 – 2.9 mg/dL). The median onset from tx initiation to first sCr elevation was 33.5, 42, and 21.5 days, for palbo, ribo, and abema, respectively. Based on available data at study cutoff, 13 of the 24 pts with suspected pseudo-sCr elevation were still on tx with continued sCr elevation. Nine of 24 pts were no longer on CDK4/6i tx; none due to sCr elevation. Three of the 9 pts had sCr returned to baseline within 3 months of tx discontinuation. Conclusions: Pseudo-sCr elevation appears to be a class effect of CDK4/6i, with similar rates of sCr elevation observed across the three CDK4/6i currently FDA approved. Further analyses evaluating differences by age, race, and stage are ongoing.
Clinical and outcome patterns in epithelial ovarian cancer (EOC) within a Latin American cohort.
Authors: Roque Katia , Heredia Marcos , Ruiz Rossana , Galvez-Nino Marco , Castro-Mollo Melanie Wendy , Flores Claudio J. , Coanqui Ofelia , Valdiviezo Natalia , Olivera Hurtado de Mendoza Mivael , De Mello Ramon Andrade B. , Mas Luis 
Published: June 2024

e23308 Background: Epithelial Ovarian Cancer (EOC) is an heterogenous disease which is usually diagnosed inadvanced stages. Despite the advent of new therapies, the outcomes for this disease remain poor in certain scenarios. We describe the clinical features and survival outcomes in a developing country. Methods: Retrospective study based on case review of women with newly diagnosed EOC between 2015 and 2017 at Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima- Peru. Descriptive analysis was conducted for clinical characteristics, epidemiological factors and treatment. PFS was calculated from the date of diagnosis until the first documented progression and OS from the date of diagnosis to death. Both were calculated using the Kaplan Meier curve. Results: 234 patients were included, the most common histology subtype was high grade serous carcinoma (47,5%), followed by mucinous (15.9%) and clear cell carcinoma (15.4%). Median age was 55.7 yo (range 19-88). Breast and ovarian cancer family history were reported in 3.8% and 3.0%, respectively. 35.8% of patients were overweight, and 12.5% were obese. Most patients (61.5%) were diagnosed at advanced disease (III-IV) and the most common site of metastasis was liver (43.6%) and lung/pleural (28.2%). BCRA testing was performed only in 6% of patients, and 4/14 patients had a pathologic mutation. Ca125 was elevated in 86.2% of patients. Regarding treatment, all patients with early stage disease (I-II) underwent surgical staging. For advanced stage disease, 47.6% (69/145) of patients underwent upfront surgery and 41.4% (60/145) received platinum-based chemotherapy in neoadjuvant setting; 57.3% (35/61) of these patients achieved optimal secondary cytoreduction. With a median follow up of 74,4 months, median PFS was 32.61 months (0.6-474) and global median OS was 58.13 months. Median OS for early disease (I-II) was not reached and for advanced disease (III-IV) was 33.73 months. Survival rate at 5y for all stages was 45.2%; 60.8% and 28.4% for early and advanced disease, respectively. Conclusions: These findings highlight the prevalence of high-grade serous carcinoma and the significance of advanced-stage diagnosis in the survival outcomes. In the era of targeted therapies, the lack of access to BRCA detection tests restricts therapeutic options and, consequently, hinders responses in this group of patients.
Prevalence of polypharmacy, drug-drug interactions, and inappropriate prescription in elderly patients with urological cancers.
Authors: Castro Carballeira Clara , Ibañez Alda María , Lanza María , Sánchez Laura , Sotelo Marta , Cacho Diego , Gómez Borja , Duran Ignacio 
Published: June 2024

e23312 Background: Around 50% of new cancer diagnoses occur in patients (pts) > 65 years. Older adults tend to have more comorbidities and therefore prescription of several drugs. Polypharmacy (PP) [defined as prescription of > 5 drugs] has been identified as a prognostic factor and might also lead to relevant drug-drug interactions (DDI) and it is also associated in occasions with inappropriate prescriptions (IP). This study aims to determine prevalence of PP, DDI and potential IP in a uro-oncology clinic. Methods: Pts ≥ 70 years with urological tumors consecutively seen in a medical oncology clinic [May 1st- August31st2023] were offered to complete a questionnaire that included questions about drugs regularly taken, doses, frequency, objective of the treatment along with some key epidemiological data. A descriptive analysis of this information was performed to identify PF along with a search for DDI ( DrugDex ®) and IP (STAR/STOPP criteria). Results: 91 pts agreed to participate and 87 complete the questionnaires. Mean age was 76 years (range 70-91) and 84.5% were men; 64%, 31 and 5% had ECOG 0,1 and 2 respectively. The predominant cancer type was bladder (41%), followed by prostate (40%) and kidney cancer (19%). Polypharmacy was identified in 54 pts (62%), with 12 pts (22%) having ≥ 10 drugs prescribed. Two cases (2%) of duplicity of treatment were found (laxative; hypnotic). Ninety-five major and 37 moderate DDI were detected, of which 8 occurred between anticancer drugs (abiraterone, pazopanib, everolimus and carboplatin) and outpatient treatments. An IP analysis is being currently conducted and data will be presented at the meeting. Conclusions: Our study shows a high prevalence of polypharmacy in older adults with urological tumors and a significant rate of drug-drug interactions including interferences with oncological treatments. These results highlight the need for careful reviewing and monitoring the drugs prescribed to our patients in the clinic and calls for strengthen collaborations with pharmacists and nurses to optimize integral management of GU cancer patients.
Melanoma immunotherapy longitudinal database: A comprehensive approach to capture oncological and toxicity data.
Authors: Abdel-Wahab Reham , Zuri Qais , Rinsurongkawong Waree , Pappachan Binu , Swaim Michael , Master Priya , Harris Calvin , Lewis Jeff , Abdel-Wahab Noha , Diab Adi 
Published: June 2024

e23314 Background: Evaluating immunotherapy approaches is consistently performed in melanoma, a forefront cancer in immunotherapy responsiveness. Although immune checkpoint inhibitors (ICIs) showed the highest significant survival benefits in melanoma, 50% of patients experience recurrence/refractory disease, and ~59% develop grade 3/4 immune-related adverse events (irAEs). Thus, understanding the disease's natural history, exploring biomarkers of response/toxicity, and identifying the efficacy/safety of immunotherapy using real-world data is warranted. Methods: We established a centralized pro-/retrospective database on Research Electronic Data Capture (REDCap), encompassing patients' demographics/comorbidities, disease risk factors, clinicopathological parameters, genomic/immune profiling, treatment modalities, tumor outcomes, irAEs, and patients’ reported outcomes (PROs). Additionally, to streamline data collection and minimize the required time, effort, and cost for manual retrieval, we developed an automated pathway for data capture using MD Anderson Cancer Center (MDACC) electronic data capture (EDC) tools which pull clinical data from EPIC. Data quality will be validated by comparing it to manually retrieved data from an ongoing study of melanoma patients treated with ICIs in the adjuvant setting (NCT04990726). Results: A total of 4074 immunotherapy-treated melanoma patients were identified. We automatically captured demographics and laboratory values at predefined time points from REDCap, along with PROs using validated electronic self-reported questionnaires already built in REDCap. We also automatically captured family history, comorbidities, pathology data, and cancer treatments from the Data Management Initiative (DMI) validated software that automatically captures data from 12 various institutional sources that complement each other, including Radiation Oncology Database, the Biospecimen Information Management System,...etc. Moreover, genomic data were automatically pulled from the Molecular and Clinical Data Integration Platform for 1850 patients. Automated capture of tumor response and irAEs according to the Response Evaluation Criteria in Solid Tumors 1.1. and Common Terminology Criteria for Adverse Events version-5, respectively are currently ongoing and will be presented. Conclusions: Integrating EDC tools demonstrated accurate real-time data capture and minimized the manual retrieval burden. Our immunotherapy-treated melanoma patients’ cohort provides a comprehensive and a valuable resource for exploring the safety signals and efficacy of various immunotherapeutic approaches beyond clinical trials.
Physician justification for anti-cancer treatment decisions in the evolving oncology market.
Authors: Moseley Angelena , Brierly Margaret 
Published: June 2024

e23317 Background: Oncology is a rapidly expanding pharmaceutical space, driven by innovative research and clinical technology. Continued growth in anti-cancer therapy has generated an exceedingly competitive market. As treatment options increase, physicians must weigh a variety of factors to make individualized care decisions. Many elements are patient-specific, but physician biases may also impact selection. As the market evolves, it is unknown whether oncology providers will shift priorities to align with contemporary findings or continue to trust in historical experiences. Methods: The Ipsos Global Oncology Monitor is an online, multi-center medical chart review of oncology patients receiving drug therapy. Over 1,900 cancer-treating physicians in the United States were screened for seniority and caseload and submitted data on 253,051 cancer patients (aggregate; all tumor types) between January 2020 to December 2023. Upon record submission, physicians were prompted to select up to three responses most associated with the reason for prescribing the reported therapy. Responses were chosen from a finite list of closed-ended options. Results: Influence of “Approved Standard of Care” fell amongst sampled physicians, cited as a reason for selecting treatment in 61% of reported annual patients in 2023, declining by 2.94 percentage points since 2020. “Biomarker results” recorded increased influence on therapy selection, rising in association with 8% of reported patients in 2020 to 11% in 2023. Within tumor-specific cohorts, “Maintain/improve quality of life” was a notable reason for drug therapy decisions in both breast and colorectal cancer patient subsets in 2023 (10% and 19% respectively). Contrary to the overall patient cohort, drug therapy choice for reported prostate cancer patients has increasingly shown association with “Approved Standard of Care” (53% in 2020 to 60% in 2023). Conclusions: Results of this study highlight the evolution of factors influencing anti-cancer treatment decisions in sampled physicians. Sampled providers appear to be shifting away from universal treatments, as shown by lowered association with “Approved Standard of Care”. Sampled physicians seem to be opting for specific therapies, demonstrated by rising influence of “Biomarker results”. Discrepancies between tumors merit expansion of research in rarer indications and emphasize the importance of diagnostic testing to continue improving quality of care. Further investigation using comparator cohort is warranted.