bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of blast-phase MPN and JAK2, MPL, and CALRmutated de novo AML: A propensity score-adjusted cohort study.
Authors: Nurse Daniel Paul , Zabor Emily Craig , Cancilla Daniel , Abdallah Kawther , Adcock Bridget , Batah Heya , Zureigat Hadil , Rauf Asad , Shrivastava Gautam Anand , Nakitandwe Joy , Chen Mark , Younes Ismail Elbaz , Ingraham Austin , Jain Akriti Gupta , Balderman Sophia , Singh Abhay , Advani Anjali S. , Carraway Hetty E , Gerds Aaron Thomas , Mustafa Ali Moaath Khader 
Published: June 2024

6526 Background: Progression to blast phase (BP) occurs in about 10% of patients with BCR-ABL-negative myeloproliferative neoplasms (MPN) and is associated with an extremely poor prognosis with no defined standard of care. The VIALE-A trial, which showed that venetoclax (VEN) improves overall survival (OS) in patients with acute myeloid leukemia (AML) when combined with azacitidine, excluded patients with MPN-BP. Rarely, patients develop de novo AML with a genetic profile like an MPN, harboring JAK2, MPL, or CALR mutations. However, there are a lack of data on the outcomes of these patients. Methods: We conducted a single-center retrospective cohort study to compare composite complete response (CCR), OS and event-free survival (EFS) of patients with MPN-BP or de novo AML with underlying JAK2, MPL, or CALR mutations (AML-D-MPN). CCR was defined as complete response (CR) or CR with incomplete count recovery. Propensity score (PS) modeling was used to adjust for baseline characteristics at AML diagnosis: age, sex, race, comorbidities, ECOG status, cytogenetics, and underlying mutations. Results: Of 750 patients treated from 2015 to 2023, 61 had MPN-BP and 12 had AML-D-MPN. The table describes baseline characteristics. The median time for MPN to BP transformation was 8 years (IQR: 2.8-13.6). With a median follow-up of 8.2 months (mo) (95CI: 1.6-59.6), the median OS for MPN-BP was 4.8 mo (95CI: 2.7-8) and for AML-D-MPN was 6.1 mo (95CI: 1.6-NC). In the MPN-BP, 40 received therapy, which included: intensive regimen [7+3 (n=13); CPX-351 (n=1)], hypomethylating agents (HMA) (n=11), HMA+VEN (n=11) and others (n=4). All AML-D-MPN received therapy, which included 7+3 (n=4), HMA (n=1), HMA+VEN (n=2), and others (n=5). In the whole treated population (n=52), the unadjusted CCR was 60% in intensive regimen, 20% in HMA, 20% in HMA+VEN and 0% in others (p=0.3). The PS-adjusted median (m) OS in mo (95%CI) was: 2.6 (1.4-NC) in intensive regimen, 6.2 (1.2-NC) in HMA, 15 (10-15) in HMA+VEN and 1.7 (0.46-NC) in others (p=0.1). The adjusted m-EFS in the same treatment groups was 1.5 (0.43-NC), 6.2 (1.2-NC), 15 (4.3-15) and 0.92 (0.46-NC) (p=0.16), respectively. In MPN-BP group, the adjusted m-EFS in mo (95%CI) was: 0.62 (0.43-NC) in the intensive regimen, 6.2 (1.2-NC) in HMA, 15 (4.2-15) in HMA+VEN and 0.92 (0.92-NC) in others (p=0.25). Conclusions: Patients with MPN-BP and AML-D-MPN have poor survival with similar responses to therapy. These patients have variable outcomes with different treatments; however, there is a trend toward improved survival with the use of HMA+VEN. [Table: see text]
Olutasidenib for mutated IDH1 acute myeloid leukemia: Final five-year results from the phase 2 pivotal cohort.
Authors: Cortes Jorge E. , Jonas Brian Andrew , Watts Justin M. , Chao Mwe Mwe , De Botton Stéphane 
Published: June 2024

6528 Background: Olutasidenib is a potent, selective, oral inhibitor of mIDH1 and is FDA-approved for relapsed/refractory (R/R) acute myeloid leukemia (AML) based on a registrational, Phase 2, open-label, multicenter trial (NCT02719574). We report final five-year results from the pivotal cohort. Methods: In the pivotal cohort of the Phase 2 trial, patients with mIDH1 AML received olutasidenib 150mg BID. Primary endpoint was complete remission (CR) + CR with partial hematologic recovery (CRh) by modified IWG Criteria 2003. Data cutoff: May 15, 2023. Results: Baseline characteristics of 153 enrolled patients are shown in Table. Of 147 efficacy evaluable patients, CR was achieved in 32% (95% CI: 24.5, 40.2) and CR/CRh in 35% (95% CI: 27, 43; P<0.0001). Median time to CR/CRh was 1.9 mo (range: 0.9, 5.6). The median duration of CR/CRh was 25.3 mo (95% CI: 13.5, not reached), with maximum duration 54.6 mo. Overall response rate was 48% (95% CI: 40, 56.7), with median duration 15.5 mo (95% CI: 7.4, 26.2) and maximum duration 54.6 mo. Median overall survival was 11.6 mo (95%CI: 8.9, 15.5). In the 12 patients R/R to prior venetoclax, 33% achieved a CR/CRh; median duration of CR/CRh is not reached (ongoing at 54.3 months), and median overall survival is 16.2 months (95%CI: 2.6, not reached). Transfusion independence from red blood cells and platelets was achieved in 34 of 87 (39%) patients and 28 of 69 (41%) patients, respectively, who were dependent at baseline. 16 (11%) patients proceeded to stem cell transplant. The 5-year safety profile was consistent with what was previously reported. The most common AEs (% reported over 3 years and over the full 5 years) were: febrile neutropenia (22% and 22%), constipation (26% and 27%), diarrhea (20% and 21%), nausea (38% and 39%), fatigue (23% and 23%), pyrexia (24% and 24%), hypokalaemia (20% and 22%), red blood cell count decreased (26% and 26%), white blood cell count increased (25% and 25%). Differentiation syndrome was reported in 14% by Year 3, with no new events by Year 5. The safety profile was stable with long-term follow up. Conclusions: This analysis provides an additional 2 years of data beyond the results that led to FDA approval of olutasidenib. This first report of the five-year data further demonstrates the rapid and durable responses observed with olutasidenib in heavily pretreated patients with mIDH1 AML, including those R/R to prior venetoclax. Clinical trial information: NCT02719574 . [Table: see text]
Impact of spleen volume on post-allogenic hematopoietic transplant outcomes in myelofibrosis: Utility of 3D volumetrics in splenomegaly.
Authors: Haseeb Rafay , Yang Dongyun , Motarjem Pejman , Al Malki Monzr M. , Aldoss Ibrahim , Amanam Idoroenyi Usua , Otoukesh Salman , Forman Stephen J. , Marcucci Guido , Rahmanuddin Syed , Ali Haris 
Published: June 2024

6558 Background: Splenomegaly is a hallmark of myelofibrosis, thought to be correlated with graft failure and worsened overall survival in transplant patients. Past studies have utilized manual spleen measurement, potentially affecting accuracy. Using 3D volume can more precisely measure spleen size. Hence, the true impact of splenomegaly on transplant outcomes remains unclear. In this retrospective study, we examined myelofibrosis patients who underwent HCT and, using 3D volumetrics, analyzed the impact of splenomegaly and volume reduction over time on post HCT outcomes. Methods: This retrospective study included 130 City of Hope myelofibrosis patients with pre HCT imaging (2004–2023). Patients were divided into pre HCT spleen volume of >3000 cc and <3000 cc, with >3000 cc considered massive splenomegaly. Spleen volume was measured using Vitrea 3D volumetric software. For each patient, depending on imaging available, volume was measured 0-3 months pre HCT, 3-6 months, 6-9 months, and 9-12 months post HCT with corresponding volume reduction calculations. Pre HCT spleen volume was also temporally correlated with several post HCT outcomes. Results: Median age at HCT was 60 (17-75), and 95% of patients received the Fludarabine/Melphalan conditioning regimen. Median spleen volume pre HCT was 1150 cc (41-6695 cc). Sixteen patients measured >3000cc, and 114 patients measured <3000cc. Median spleen volume 3-6 months post HCT was 661 cc (80-1731 cc) with a median 48% volume reduction. The data suggests that majority of volume reduction occurred during this time (table). Five-year overall survival (OS) was 72.8%. Relapse was 11.0% at 1 year and 14.7% at 5 years. NRM at 5 years was 17.3%. ANC engraftment peaked at 28 days at 92.3%. Pre HCT spleen volume (<1000 cc, 1000-2000 cc, >2000 cc) did not have a significant impact on OS (P = 0.992), disease free survival (P = 0.783), relapse (P = 0.187), NRM (P = 0.627), or ANC Engraftment (P = 0.526). There was a statistically insignificant downward trend for platelet engraftment (P = 0.162). For patients with or without massive splenomegaly (>3000cc), there was no significant effect with any of the analyzed post HCT outcomes. Conclusions: This retrospective study includes an analysis of spleen volume by 3D volumetrics, a more accurate measurement of spleen size, and whether it significantly impacts post HCT outcomes. Our data analysis demonstrates that splenomegaly, massive or not, does not significantly impact transplant outcomes for patients receiving a reduced intensity conditioning regimen.[Table: see text]
Assessment of carcinoembryonic antigen-related cell adhesion molecule 5 expression by immunohistochemistry in real-world clinical samples of non-small cell lung cancer.
Authors: Hsu Ying-Han Roger , Almutrafi Amna , Hueniken Katrina , Tsao Ming Sound 
Published: June 2024

e20013 Background: Carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5) is an emerging target of antibody-drug conjugate therapy for non-small cell lung cancer (NSCLC). High expression of CEACAM5 has been reported in approximately 25% of patients with lung adenocarcinoma (Lefebvre AM, et al. Lung Cancer. 2023; 184:107356). However, CEACAM5 expression has not been systematically examined in a real-world patient population with NSCLC. In this study, we evaluated our experience in the assessment of CEACAM5 expression by immunohistochemistry (IHC) in routinely diagnosed clinical samples. Methods: We assessed the expression of CEACAM5 by IHC on clinical biopsy/resection samples of consecutively diagnosed NSCLC from September 2022 to June 2023 at our institution, using the anti-CEACAM5 clone 769 antibody assay protocol developed for tusamitamab ravtansine clinical trials. Only cases adequate for PD-L1 22C3 and Oncomine Comprehensive Assay v3 NGS assay were included. CEACAM5 expression was scored independently by three pathologists based on the method proposed by Lefebvre et al. Expression levels were categorized as high (≥ 50% tumor cells at ≥ 2+ intensity), moderate (1–49% tumor cells at ≥ 2+ intensity), and negative (0 or 1+ intensity). Interrater reliability was assessed by Kendall’s coefficient of concordance (KCC) and Fleiss’ Kappa. Discordant classification was reviewed with the final classification achieved by consensus. Association with PD-L1 TPS and NGS results was determined by Chi-squared test. Results: This study cohort consisted of 150 consecutively diagnosed NSCLC, including 133 adenocarcinomas and 17 squamous cell carcinomas. The samples were derived from both primary (n = 138) and metastatic sites (n = 12). Both membranous and cytoplasmic CEACAM5 expression was observed in neoplastic cells, but was consistently absent in nonneoplastic cells. The prevalence of consensus high CEACAM5 membranous expression was 21% (n = 32) overall, 20% in primary (n = 28) and 33% (n = 4) in metastatic sites. The level of interrater agreement across all categories was moderate (KCC = 0.77). Interrater agreement between high CEACAM5 expression versus moderate/negative categories combined was also moderate (Kappa = 0.60). Challenging features included the determination of staining intensity and mixed membranous and cytoplasmic staining pattern, and cases near the cut-offs of the defined categories. CEACAM5 expression was not associated with PD-L1 TPS (p = 0.42) or EGFR mutations (p = 0.44). Conclusions: Our data showed that approximately 20% of routinely diagnosed clinical NSCLC samples had high CEACAM5 expression by IHC. The interrater reliability on the determination of high CEACAM5 expression was moderate among the three pathologists. We highlighted the challenging aspects in the evaluation of this biomarker.
Comparison and performance of three plasma next-generation sequencing assays versus tissue testing for the detection of actionable driver mutations in advanced non-squamous non-small cell lung carcinoma.
Authors: Hofman Paul , Bontoux Christophe , Lacoux Caroline , Inaudi Rignol Guylène , Goffinet Samantha , Lespinet Virginie , Bordone Olivier , Tanga Virginie , Allegra Maryline , Garnier Georges , Boutros Jacques , Benzaquen Jonathan , Marquette Charles Hugo , Ilie Marius , Hofman Veronique 
Published: June 2024

e20018 Background: Liquid biopsy (LB) is a useful tool for the detection of actionable mutations in advanced non-squamous non-small cell lung cancer (NS-NSCLC) at progression. However, the clinical benefits of integrating both LB and tissue biopsy (TB)-based genomic profiling at diagnosis of NS-NSCLC remain uncertain. Methods: We tested three commercially available next-generation sequencing (NGS) gene panel assays in circulating cell-free DNA (cfDNA) using replicate sets of 85 LB samples from advanced NS-NSCLC patients at baseline and compared the results with matched TB for the detection of tier IA/B (AMP/ASCO/CAP classification) alterations. We used methylation testing of cfDNA to assess the tumor fraction (TF). We correlated molecular data with clinico-pathological features and follow-up data. Results: All TB-based NGS results were interpretable. 5 LB-based NGS results for one assay were not performed due to the material exhaustion. Tier IA/B gene alteration was detected by LB-based NGS and TB-based NGS in 18 to 23 (21 to 27%) patients and in 35 (41%) patients, respectively. The positive percent agreement of each LB-based NGS assay method compared with TB-based NGS assay ranged from 51% to 68%. The incremental add provided by first LB-based NGS ranged from 0 to 23% versus 25 to 45% for first TB-based NGS, depending on the LB-based NGS assay. It includes one EGFR uncommon mutation, 9 MET amplifications and 2 HER2 amplifications detected by LB-based NGS assays that were not detected by TB-based NGS. Overall agreement between the three LB-based NGS assays was 44%. Hybrid-capture based assay detects 14 MET/HER2 CNVs, two METex14 skipping mutation and two ALK fusions that were not detected by amplicon-based assay. Amplicon-based assay detects one uncommon EGFR mutation, one KRAS non-G12C and one ALK fusion that were not detected by hybrid-capture based assay. 64 LB samples were tested for cfDNA methylation. Positive predictive value and negative predictive value of the detection of TF by cfDNA methylation profiling was 90% and 92%, respectively. The only false-negative result of TF evaluation by cfDNA methylation profiling was observed for a variant with a cfDNA VAF < 1%. Correlation analyses with clinicopathological data are ongoing. Conclusions: While concordance with tissue is relatively high, the incremental add provided by LB-based NGS at diagnosis of advanced NS-NSCLC compared to TB-based NGS is limited and greatly varies according to the sequencing method used. Thus, LB-based NGS at diagnosis of NSCLC can be used as a complement of TB-based NGS or as an alternative when tissue is not available.
Genomic characteristics of tumour necrosis in lung squamous cell carcinoma.
Authors: Zhang Longfeng , Lin Gen , Zhong Qiaofeng , Wu Lin , Zhao Jun , Sun Jianguo , Huang Cheng 
Published: June 2024

e20030 Background: Tumor necrosis and cavity on enhanced chest CT are common hallmarks of lung squamous cell carcinoma (LUSC). However, the genetic characteristics of necrosis on CT scan remain unclear. This study aims to elucidate the genetic landscape of LUSC with tumor necrosis. Methods: We implemented transcriptome and whole-exome sequencing to analyze early postoperative LUSC specimens. They were classified into necrosis and non-necrosis group based on preoperative enhanced chest CT. Subsequently, the genomic landscape between the two groups were compared. To substantiate our findings, we further employed immunohistochemistry and analysis of a clinical cohort as comprehensive methods of validation. Results: In study cohort (65 samples), the necrosis group (n = 37) showed a higher number and length of copy number variations (CNVs) and elevated Genomic Instability Index (GII) compared to the non-necrosis group (n = 28). Transcriptome sequencing revealed increased hypoxic hallmarks and activation of 11 fundamental metabolic pathways in the necrosis group. Endothelial cells were observably fewer, but matrix remodeling score was higher in the necrosis group. Here, the decreased activity of several immune-related pathways, such as antigen processing and presentation, natural killer cell-mediated cytotoxicity, etc, were notably suppressed in the necrosis group. Immunohistochemistry indicated that the expressions of hypoxy-related genes (HIF-1, NDRG1), proliferation-related genes (ki-67) and angiogenesis related genes (CD31) in necrosis group were significantly higher than those in non-necrosis group. In the clinical validation cohort, we enrolled 538 advanced LUSC patients from 25 medical centers receiving systemic treatment, categorized into chemotherapy (n = 270) and ICIs (n = 268) groups. A notable difference in progression-free survival (PFS) was observed in the ICIs group, with patients without tumor necrosis or cavity exhibiting significantly longer PFS (8.7 vs. 6.5 months; HR 0.67; 95% CI 0.42–0.63; p < 0.001). Multivariate Cox analysis identified necrosis or cavity as an independent predictor of reduced PFS (HR 0.68; 95% CI, 0.51-0.9; p = 0.007). Conclusions: LUSC with necrosis is distinguished by increased genomic instability, hypoxia, enhanced tumor proliferation, matrix remodeling, and an immunosuppressive tumor microenvironment. Baseline chest CT findings of tumor necrosis or cavities may serve as negative predictors for the efficacy of ICIs treatment in LUSC.
Multi-omics profiling the genomic origin and adeno-squamous transdifferentiation mechanism in adenosquamous carcinoma.
Authors: Zheng Xinlong , Li Chao , Jiang Kan , Zhou Zhipeng , Bai Jing , Long Feng , Yan Jianfeng , Lin Gen 
Published: June 2024

e20032 Background: Adenosquamous carcinoma (ASC) represents a rare subtype (0.4-4%) of non-small-cell lung cancer (NSCLC), with its multi-omic landscape yet to be fully elucidated. This study aims to explore the genomic origins and molecular mechanisms of adeno-squamous transdifferentiation in lung ASC through comprehensive multi-omics. Methods: We analyzed 69 samples from 31 lung ASC patients, including 16 FFPE samples with microdissected paired adenocarcinoma (AC) and squamous cell carcinoma (SCC) components, and additionally, incorporated pure Lung Adenocarcinoma (LUAD, n = 51) and pure Squamous Cell Carcinoma (LUSC, n = 28) for comparative analysis. Techniques included whole-exome sequencing, whole-genome methylation profiling, transcriptomics, single-cell RNA sequencing, and spatial transcriptomics. Results: AC and SCC exhibited similar genomic mutation landscapes, indicating a common genomic origin for AD and SCC. The SCC component in ASC displayed higher homologous recombination repair deficiency (HRD) and a notable 16p13.3 deletion in 31% of ASC transformations. Differential methylation analysis highlighted TP63's lower methylation in SCC, correlating negatively with RNA expression (P < 0.001), indicative of methylation-driven regulation. DMR binding motif analysis revealed hypo-methylation in p63, p53, and AP-1 motifs, and hyper-methylation in MKX2-1, FOXA1/2 motifs (P < 0.05). The transition from AC to SCC in ASC was marked by upregulated MYC signaling, proliferation, and DNA repair, with EMT changes not methylation-driven. Metabolic pathways were upregulated, and EMT/KRAS pathways downregulated in SCC compared to LUSC. Immune infiltration in LUAD-AC-ASC transformation showed an initial increase and subsequent decrease, transitioning from immune-infiltrated and immune-excluded to immune-desert phenotypes. IL36G of the IL1 family was highly expressed in the SCC component and strongly correlated with the squamous marker P63 (Pearson r = 0.72, P < 0.001). Single-cell RNA-seq data demonstrated a significant increase in IL36G in squamous cells of lung ASC. In vivo models showed adeno-squamous differentiation in adenocarcinoma cells expressing IL36G. Conclusions: This study provides a comprehensive multi-omic insight into the complex genomic and epigenomic landscape of ASC, highlighting a shared genomic origin and distinct molecular mechanisms in the adeno-squamous transdifferentiation process. The findings, particularly the role of TP63 methylation and IL36G expression in the SCC component, offer novel insights into the molecular heterogeneity of ASC. These results not only deepen our understanding of ASC but also pave the way for future investigations into targeted therapies that could potentially exploit these molecular distinctions for more effective treatment strategies in ASC.
Lung and bronchus cancer in young females: Exploring sex disparities across diverse racial and ethnic groups in the U.S. (2000-2020).
Authors: Hechter Sharon , Kanukuntla Anish Kumar , Eliachevsky Christina , Ji Sophia , Appiah Jennifer , Alnaser Ibrahim , Nair Ambica , Greenberg David B. 
Published: June 2024

e20048 Background: Lung and bronchus cancer incidence rates have been reported to be higher among females than males under the age of 50, particularly after 2004. The first e-cigarette device emerged in 2003, raising questions about its potential impact on cancer incidence in females compared to males and its connection to the sudden rise in female cases. This study aims to investigate sex differences in cancer incidence across diverse racial and ethnic groups, aiming to determine whether these variations stem from biological factors or unexplored environmental exposures. Methods: Cancer incidence data from the Surveillance, Epidemiology, and End Result (SEER) program (2000-2020) were utilized to analyze female-to-male incidence rate ratios (FM IRR) for young-onset lung and bronchus cancer diagnosed before the age of 50. The data was stratified by race and ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic Asian/Pacific Islander, American Indian/Alaskan Native, and Hispanic) and age-standardized to the 2000 U.S. population. Results: In the period from 2000 to 2020, 41,066 patients with lung and bronchus cancer under the age of 50 were identified. Incidence trends showed a consistent decrease each year, reaching the lowest rates in 2020 (2.1 per 100,000 cases) and the highest in 2000 (4.9 per 100,000 cases). Males accounted for 49.4% (20,303), while females constituted 50.6% (20,763). Despite the overall declining trend, FM IRR steadily increased post-2004, exhibiting a constant rise between 2005 and 2020. Non-Hispanic White comprised 65.9% of the cases, with the second and third largest groups being Non-Hispanic Black (15.3%) and Hispanic (9.62%). Incidence rates were highest among non-Hispanic Black (4.9 per 100,000 cases), followed by non-Hispanic White (4.2 per 100,000 cases), and lowest in the Hispanic population (1.6 per 100,000 cases). Young-onset lung and bronchus cancer diagnosed before age 50 showed a female predominance after 2004, with the Hispanic population having the highest FM IRR between 2000 and 2020 (1.13), followed by Non-Hispanic American Indian/Alaska Native (1.09) and Non-Hispanic White (1.02). There was a lower FM IRR among Non-Hispanic Black and Non-Hispanic Asian/Pacific Islander (0.83) and (0.96), respectively. Conclusions: The FM IRR for young-onset lung and bronchus cancer exhibited variations among racial and ethnic groups, with the highest rates observed among the Hispanic population. This study was limited by the absence of data on smoking habits and other environmental factors. Further research is needed to investigate the influence of e-cigarettes and other environmental factors on the incidence of lung and bronchus cancer, considering variations by sex.