bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom burden in adult survivors of allogeneic hematopoietic stem cell transplantation.
Authors: Ellithi Moataz , Trinh Jonathan , Nilles Jonathan , Gundabolu Krishna , Haddadin Michael , Maness Lori J. , Wichman Christopher S. , Bhatt Vijaya Raj 
Published: June 2024

6557 Background: Progress in allogeneic hematopoietic cell transplantation (HCT) and supportive care has significantly improved transplant outcomes and expanded the number of HCT survivors. A growing responsibility exists to address long-term morbidity and symptom burden. We sought to investigate symptom burden in adult survivors of HCT using a set of validated tools. Methods: We analyzed adults aged 19 years or older with hematologic malignancies who were treated with allogenic HCT at our institution from June 2018 to November 2022. Patients required at least one visit to our survivorship clinic for inclusion. We assessed symptom burden using the National Comprehensive Cancer Network (NCCN) Survivorship Assessment Questionnaire, which is a 25-question survey designed to assesses symptoms related to the following domains: cardiac, mood, cognition, fatigue, lymphedema, hormonal, pain, sexual dysfunction, and sleep. The short physical performance battery (SPPB) and short blessed test were used to assess physical function and conduct cognitive screen, respectively. Finally, we compared scores between patients <60 and ≥60 years old to examine an association between age and post-transplant symptoms. Results: A total of 152 patients have a median age of 61 years (range 21-76); 59.2% were males, and 28.5% had a BMI ≥30. Median Hematopoietic Cell Transplantation-specific Comorbidity Index was 3. The most common indication for transplant was acute myeloid leukemia (48.0%), and the most common donor type was matched unrelated (57.2%). The median time from transplant to the first survivorship clinic visit was 99 days. The most common symptom domains affected, according to the NCCN questionnaire results, were fatigue (50.7%), sleep (45.3%), and cognition (42.0%) whereas the least affected domains were pain (29.5%), cardiac (26.2%), and sexual (19.4%). When we stratified patients by <60 years old and ≥60 years old, we saw similar rates of reported symptoms, particularly regarding sleep disorder (44.3% vs. 45.7%, respectively), mood disturbance (31.4% vs. 34.1%, respectively), and sexual dysfunction (17.9% vs. 20.5%, respectively). Older patients, however, had higher rates of physical impairment according to SPPB scores (50.0% vs. 15.7%, OR = 5.4 [95% CI = 2.2-14.3]). Blessed test showed impaired cognitive screen in 7.2% without a significant difference based on age. Conclusions: Adult survivors of allogeneic HCT at 3-month post-transplant commonly suffer from symptoms across a variety of domains, especially pertaining to fatigue, sleep, and cognition. These symptoms affect both younger and older patients, although older patients are more likely to have physical impairment. The NCCN Survivorship Assessment Questionnaire captures a number of symptoms related to quality of life and can be more widely utilized as a tool to evaluate survivorship symptoms in patients who undergo HCT.
Neoadjuvant chemoimmunotherapy in patients with limited-stage small cell lung cancer: A retrospective study.
Authors: Wang Ting , Huang Kai LI , Pu Dan , Mei Ting , Fan Ming Yu , Tian Long , Li Lu , Zhou Qing Hua 
Published: June 2024

e20002 Background: The addition of immune checkpoint inhibitors to chemotherapy significantly improves survival in extensive-stage small cell lung cancer (SCLC) and represents a promising advance in this field. However, the clinical benefit of the implementation of immunotherapy in the first-line setting for limited-stage SCLC (LS-SCLC) remains to be proven. Thus, we conducted a retrospective study to explore the efficacy of neoadjuvant chemoimmunotherapy as a first-line treatment for LS-SCLC. Methods: A retrospective study of patients with LS-SCLC who were treated with neoadjuvant PD-L1/PD-1 inhibitor combined with platinum-based chemotherapy followed by surgery between February 2020 and September 2023 was conducted. Clinical characteristics, R0 resection rate, pathologic complete response (pCR), major pathologic response (MPR), downstaging rate and disease-free survival (DFS) were evaluated. Results: As of September 30, 2023, all 21 patients (stage IIB, n = 4; stage IIIA, n = 9; stage IIIB, n = 8) received 2 to 6 cycles of neoadjuvant chemoimmunotherapy (Table 1). Nine (42.9%) patients achieved pCR and 10 (47.6%) presented an MPR (Table 2). Moreover, the R0 resection rate in total and stage III patients were 95.2% (20/21) and 94.1% (16/17), respectively. After a median follow-up of 11.2 months (range: 2.6-24.2), only two patients relapsed and the median DFS was not reached due to insufficient events. Conclusions: Neoadjuvant immune checkpoint inhibitors combined with chemotherapy demonstrated promising efficacy and feasibility, and are a potential strategy for the management of LS-SCLC. Further prospective clinical trials are necessary to clearly define the benefit of neoadjuvant chemoimmunotherapy and optimize LS-SCLC treatment. [Table: see text][Table: see text]
Sex-based disparities in patients with lung cancer undergoing lobectomy via robotic-assisted thoracoscopic surgery.
Authors: Gadhiya Dhruvkumar , Adla Jala Saisree Reddy , Sakthivel Hemamalini , Dhaliwal Kanwar Bir Singh , Ramphul Kamleshun , Sharma Shivani 
Published: June 2024

e20005 Background: The 2023 report from the World Health Organization(WHO) ranked lung cancer (LC) as the top cause of cancer-related fatalities worldwide. Recently, minimally invasive procedures such as robotic-assisted thoracoscopic surgery (RATS) have been introduced as part of the treatment of some LC cases. Our study aims to bridge the understanding of potential sex-based disparities among LC patients undergoing lobectomy via RATS. Methods: We analyzed the 2016-2020 National Inpatient Sample (NIS) for adult lung cancer(malignant or carcinoma in situ) patients with a principal procedure code of lobectomy with RATS. Cases with underlying mycoses, mycobacterial infection, and pulmonary abscesses were excluded based on recommendations from prior studies. Multivariate regression models helped evaluate sex-based differences in several complications. Results: An estimated 26385 lung cancer patients underwent lobectomy via RATS, consisting of 56.68% females (14955 cases) and 43.32% males (11430 cases). Age differences were noted as females were younger (mean age 67.80 years vs. 69.14 years, p < 0.01). We also found that females were less likely to report several complications, such as acute kidney injury (AKI) (3% vs. 6.6%, aOR 0.538, p < 0.001), pneumonia (2.8% vs. 4.3%, aOR 0.725, p < 0.001), post-procedural air leak (9.2% vs. 11.2%, aOR 0.797, p < 0.001), post-procedural cardiac arrest (0.6 % vs. 1.6%, aOR 0.349, p < 0.001), pulmonary embolism (0.2% vs. 0.5%, aOR 0.345, p < 0.001), deep vein thrombosis (DVT)(1.5% vs. 2.2%, aOR 0.742, p: 0.003), atrial fibrillation (AF)(13% vs 21.7%, aOR 0.564, p < 0.001), acute myocardial infarction (AMI) (0.2% vs. 0.5%, aOR 0.58, p:0.027), and death (0.3% vs. 0.9%, aOR 0.505, p < 0.001). Notably, females were more likely to have an open procedure conversion (0.2% vs 0.1%, aOR 2.235, p:0.017). However, there is no significant difference between the two sexes regarding post-procedural pneumothorax and respiratory failure, atelectasis, supraventricular tachycardia, and events of acute ischemic stroke. Conclusions: Our most recent analysis confirms that among LC patients undergoing lobectomy via RATS, males were more prone to several complications than females. However, we also found that females were more likely to necessitate an open procedure conversion. We, therefore, advocate for further research to enhance our understanding of such disparities and strategies to address them effectively.
Multiple sclerosis and lung cancer: A single cancer center experience in Philadelphia.
Authors: Palecki Julia , Bernstein Andrew , Melby Garrett , Tucker Matthew , Begun Zoe , Zhan Tingting , Micaily Ida 
Published: June 2024

e20027 Background: The association between multiple sclerosis (MS) and lung cancer remains poorly understood. This retrospective, single center study aims to characterize the clinical features and outcomes of lung cancer in patients with MS, shedding light on this unique patient cohort characterized by immune dysregulation and significant immunosuppressive therapy. Methods: This retrospective study analyzed 40 MS patients diagnosed with lung cancer at Sidney Kimmel Cancer Center in Philadelphia, PA between 1/1/2016 and 7/1/2023. Clinical data including patient demographics, MS treatments, cancer diagnosis details (date, stage, histology), molecular and fusion data, PD-L1 status, and patient mortality dates were recorded and analyzed. Results: In our cohort of 40 patients, 28 (70.0%) patients were female, with 28 (70.0%) identifying as White and 7 (17.5%) as Black. NSCLC was seen in 37 patients (26 adenocarcinoma, 5 squamous cell carcinoma), while 3 had SCLC. Among the 33 patients with available MS treatment data, 9 (26.5%) received steroids, and 15 (44.1%) received biologic therapy. The average age at lung cancer diagnosis was 62.8 (±10.9) years, with 18 out of 40 patients (45.0%) diagnosed with stage I disease. Advanced stages were found in 22 patients (55.0%) at diagnosis: 2 (5.0%) with stage II, 1 (2.5%) with stage III, and 19 (47.5%) with stage IV disease. Among 15 patients with molecular testing, BRAF mutation was found in 1 (6.7%), EGFR mutation in 4 (26.7%), and KRAS mutation in 2 (13.3%). One subject demonstrated an ALK fusion (7.1%). PD-L1 testing was recorded in 13 patients: 3 (23.1%) had 0%, 1 (7.7%) had 1%, 5 (38.5%) had 1-49%, and 4 (30.8%) had > 50% PD-L1 expression. The average overall survival was 2.4 years (95% CI: 1.4-8.1 years). Conclusions: In this cohort, MS patients with lung cancer exhibited targetable mutations, such as EGFR mutations and high PD-L1 expression rates. While the use of immunotherapy in lung cancer with concurrent MS has been limited, our data suggests the importance of molecular profiling in all lung cancer patients. We consider that these patients received significant exposure to immunosuppressive therapies for MS, potentially impacting immune surveillance and lung cancer development. Despite this, nearly half of the cohort had Stage 1 lung cancer and showed favorable overall survival rates. Our cohort study suggests a need to investigate the relationship between MS and lung cancer further.
Potential role and prognostic value of Globo-H in lung cancer.
Authors: Kuo Tzer-Min , Lai Jiann-Shiun , Hsu Hui-Ting , Wei Cheng-Yen , Lai Ming-Tain 
Published: June 2024

e20037 Background: Globo-H (GH), a globo-series carbohydrate antigen highly expressed on multiple epithelial cancers, is a promising target for cancer immunotherapy. Clinical trials have been conducted to evaluate the efficacy of anti-GH vaccine Adagloxad Simolenin/OBI-821 (in Ph 3) and OBI-833/OBI-821 (in Ph 2) in cancer patients. Epidermal growth factor receptor (EGFR) mutations are well known as a frequent class of driver mutations in lung cancer (LC), which are responsible for tyrosine kinase inhibitors. Besides high expression in cancer cells, GH has been implicated in regulation of EGFR signaling pathway. Knockdown of key enzyme involved in GH biosynthesis β1,3-galactosyltransferase V (β3GalT5) induces apoptosis through disruption of EGFR-related signaling protein complex. In addition, GH is reported to associate the EGFR mutant in LC patients. This study aims to further investigate the potential role of GH in LC. Methods: Clinical study: The level of GH expression was evaluated by immunohistochemistry (IHC) using H-score in clinical samples from 141 patients with lung adenocarcinoma. In vitro study: FACS and Western blotting methods were used to measure the levels of total EGFR, phospho-EGFRs or GH in LC cell lines. Microwestern protein array (MWA) analysis was performed in LC NCI-H1975 cells. Results: Clinical study: Positive GH expression (H score≥1; 18.4%) was significantly associated with poor differentiation grade (p = 0.044) in all samples and disease specific survival in patients with metastasis and stage 4 LC (p = 0.033). In vitro study: Inhibition of EGFR by an EGFR-specific shRNA resulted in a decrease of GH expression in LC cells while overexpression of EGFR resulted in an increase of GH levels. β3GalT5 knockout cells and anti-GH-antibody-treated cells showed a reduction of cell proliferation as well as the total level of EGFR and phosphor-EGFRs expression, which is consistent with the results from previous studies. MWA analysis on LC cells with β3GalT5 knockout, GH ceramide-treated β3GalT5 knockout cells and anti-GH Ab-treated LC cells indicated a positive correlation between the level of GH and EGFR-related signaling proteins including phosphor-JNK, phosphor-c-Jun, phosphor-PP2A, phosphor-PP2A, phosphor-AKT, and Cyclin D1 proteins. In addition, JNK signaling inhibitor partially reduced GH expression in NCI-H1975 cells. These results revealed the mechanistic link between GH regulation and tumor promoting signals in LC. Conclusions: GH expression was associated with the worse survival of LC patients in clinical setting. In addition, the level of GH is positively correlated with levels of EGFR and EGFR-related signaling proteins in vitro. Expression of GH can induce the expression of EGFR and vice versa in LC cells. Furthermore, EGFR downstream JNK signaling pathway might involve in GH regulation by EGFR. Taken together, GH-targeting therapy has a potential application for the treatment of LC patients.
Treating lung cancer in resource limited setting: Retrospective study from Armenia.
Authors: Mailyan Mariam , Zohrabyan Davit , Safaryan Liana , Harutyunyan Lilit , Avagyan Armen , Harutyunyan Martin , Sargsyan Amalya , Karapetyan Nune , Rushanyan Marine , Mkrtchyan Gohar , Avinyan Anna , Sargsyan Mariam , Galoyan Arevik , Kostanyan Julia , Khachatryan Mariam , Baloyan Elen , Bardakhchyan Samvel 
Published: June 2024

e20055 Background: Lung cancer (LC) is second most common cancer by incidence in Armenia. Every year approximately 800-900 new cases are diagnosed, from all cases 55.5% are in the 4th stage. Methods: We have collected data from three oncology centers in Armenia: Yeolyan Hematology and Oncology Center, Mikaelyan Institute of Surgery, and Muratsan Hospital Complex of Yerevan State Medical University. In this retrospective hospital-based study the data of patients with LC who were treated at these three centers during the 01 Oct 2009 - 31 Dec 2023 period was collected․ Results: Four hundred and eighty-nine LC patients were involved in the final analysis. Male to female ratio was 6:1. From the all patients 10.6% were diagnosed at age ≤ 50, 79,6% of patients 50-70, and 9.6% ≥ 70 years. In 71.6% of all cases, LC was diagnosed in current or former smokers. Only 3% of patients were diagnosed in stage I, 9.8% in stage II, 44.8% in stage III, 41.1% in stage IV, and for 1.2% of patients' stage was unknown. From all cases 74% of patients had non small cell lung cancer (NSCLC), 22.7% small cell lung cancer (SCLC) and 3.3% had other histological types of lung cancer. Of all patients 63% are dead. The median overall survival (mOS) for all stages was 21 months for the entire cohort. Median OS was not reached for stage I ( > 100 months), was 61 months for stage II, 23 months for stage III, and 13 months for stage IV (p < 0,001). ALK mutation was checked in 22.7%, EGFR in 22%,ROS in 14.1%, KRAS in 11.2%, BRAF in 9.8% and of all patients. From all checked AKL was positive in 1.8%, EGFR in 19.4%, ROS in 2.8%, KRAS in 21.8%, BRAF in 8,3% and of cases. For patients with stage IV lung cancer (41.1%), we found a significant difference in mOS in those who received first line immunotherapy in combination with chemotherapy (19,4%) compared to those who received only chemotherapy (74.1%) (mOS: 24 months vs 11 months accordingly, p = 0.014). For stage I-III LC patients, those who received systematic therapy with cisplatin showed better overall survival than those who received systemic therapy with carboplatin (mOS 31 vs 25 months, p = 0.01), but for stage IV LC patients survival difference was not found (mOS 15 vs 12 months, p = 0.24). Conclusions: In Armenia, lung cancer is mostly diagnosed in the advanced stage where overall survival is approximately one year. In our study population, those who received immunotherapy in combination with chemotherapy showed doubled mOS, compared with only chemotherapy. In the nonmetastatic group, chemotherapy with cisplatin showed a significant increase in mOS compared with carboplatin.
Effect of novel polygenetic variant of HUNT lung cancer model on lung cancer risk assessment over clinical model among light smokers (average <9 pack-years).
Authors: Nguyen Olav Toai Duc , Fotopoulos Yannis , Nøst Therese Haugdahl , Markaki Maria , Lagani Vincenzo , Tsamardinos Ioannis , Røe Oluf Dimitri D. 
Published: June 2024

e20066 Background: As lung cancer incidence and mortality increase, methods of early diagnosis are needed to increase survival. The validated HUNT Lung Cancer Model (HUNT LCM) predicts individual 6-year risk of lung cancer in ever smokers with an AUC of 0.87 based on eight clinical variables: sex, age, BMI, pack-years, smoking intensity number of cigarettes per day, quit time, daily cough, and daily indoors smoke exposure. We aimed to explore whether the performance of the HUNT model can be improved by adding genetic information, and in what group of ever smokers these differences in performance emerges. Methods: Based on the eight clinical variables of the HUNT LCM and 22 single nucleotide polymorphisms (SNPs) previously identified in the literature as highly associated with lung cancer risk, the novel lung cancer risk prediction model HUNT Lung-SNP was developed. Clinical and genetical data of ever-smokers from the HUNT2 population study (n = 30746, median follow-up 15.26 years) where 160 individuals were diagnosed with lung cancer within six years were used for the model fitting. External validation was performed in another population-based cohort, the Tromsø Study (n = 2663) where 39 were diagnosed with lung cancer within 6 years. Results: The integrated discrimination improvement index (IDI) between the HUNT Lung-SNP and the HUNT LCM shows that the HUNT Lung-SNP significantly improve the LC risk stratification within six years with an IDI of 0.019 (95% CI 0.015-0.025), p < 0·001 and of 0.013 (95% CI 0.008-0.018), p < 0·001 in the HUNT2 and Tromsø cohorts, respectively. Of the cases, 21/160 (13%) and 10/39 (25%) in the HUNT and Tromsø cohort respectively, were low risk by the HUNT LCM but high risk by the HUNT Lung-SNP model. The main difference in characteristics among cases predicted by the HUNT Lung-SNP model, but missed by the HUNT LCM, was the average number of pack-years: 8.22 vs. 29.8 (p < 0.001) in HUNT2 and 7.7 vs. 33.7 (p < 0.001) in Tromsø cohort. Conclusions: A genetic approach combined with clinical variables of the HUNT LCM can improve the lung cancer risk prediction significantly by increasing the sensitivity among light smokers. Thus, we identified a high-risk population in two independent cohorts that would not be eligible for screening by clinical cutoffs nor with a clinical risk prediction model. This novel HUNT Lung-SNP needs further validation in other populations to evaluate its clinical utility.
Neoadjuvant immuno-chemotherapy in resectable non-small cell lung cancer: A retrospective cohort study.
Authors: Verma Saurav , Vincent Mark David , Black Morgan , Nayak Rahul , Cecchini Matthew , Malthaner Richard , Raphael Jacques , Inculet Richard , Fortin Dalilah , Blanchette Philip , Kuruvilla Sara , Qiabi Mehdi , Younus Jawaid , Breadner Daniel Adam 
Published: June 2024

e20077 Background: Neoadjuvant (NA) nivolumab-chemotherapy (nivo-chemo) has shown an improved survival and pathological complete response (pCR) rate, vs chemo alone, in early-stage, resectable non-small cell lung cancer (NSCLC). Nevertheless, there is a paucity of real-world data. Methods: We performed a real-world, retrospective analysis of outcomes and toxicities in patients with resectable NSCLC (stage IB-IIIA; EGFR/ALK alterations excluded) treated with three cycles of NA nivo-chemo followed by surgery at a single, tertiary-level Canadian cancer centre from September 2022 to September 2023. Results: Fifteen patients were treated with NA nivo-chemo. The median age was 70 years (range, 58 to 78) and 66% were males. 20% (n-3) and 40% (n-6) had N1 and N2 nodes, respectively. All patients completed three cycles of NA nivo-chemo. Objective response rate was 73% (n-11); including 1 complete response. Progression was noted in two patients (the CT predated initiation of treatment by more than 8 weeks in these patients). The median time to surgery was 10.6 weeks (range, 6-17.5). 80% patients (n-12) had a surgery (1 pneumonectomy, 11 lobectomies); and of these, 83% (n-10) are on surveillance while two patients had an event (death or progression). All (n-11) had R0 resection except one. 33% patients (n-5) had a pCR, including two with stage IIIA disease (PDL1 TPS < 1% in three patients, PDL1 TPS ≥ 50% in two patients). 60% patients were started at a reduced chemo dose in cycle 1. 25% patients required further dose reduction. Grade 3 or 4 toxicities were seen in 25% patients (n-4) (neutropenia (n-2), febrile neutropenia (n-1) and pneumonitis (n-1)). Surgical complications were seen in 33% patients (n-5), including death in one patient due to postoperative intrathoracic bleed. Conclusions: NA nivo-chemo in resectable NSCLC is safe and associated with improved pCR rate. A few patients may progress on NA treatment or have a grade 3-5 toxicity precluding curative surgery. Hence, individualized informed decisions should be made. There is an unmet need of biomarkers/models that can predict pCR/toxicity for better patient selection. [Table: see text]